A prescription for suspension

Manny Ramirez abruptly dropped an appeal of his drug suspension within hours of a scheduled hearing last week, cornered not by test results but by a prescription for a banned substance that appeared in his medical records, sources told The Times.

The substance -- human chorionic gonadotrophin (HCG) -- is classified as a performance-enhancing substance in baseball’s drug policy.

Although a test result revealed elevated levels of testosterone and triggered an investigation, Ramirez ultimately accepted his suspension on the basis of a little-known clause in baseball’s drug policy enabling the commissioner to levy suspensions “for just cause,” the sources said.

Within the first two weeks of April, Ramirez was notified that he had tested positive for abnormally high levels of testosterone during spring training. His test showed between four and 10 times the normal range of testosterone, ESPN reported Monday night.

Further testing revealed the testosterone to be synthetic, as opposed to naturally occurring within Ramirez’s body, the New York Daily News reported.


In their appeal, Ramirez and his representatives planned to argue the testosterone indicated the presence of DHEA, a steroid precursor banned under Olympic rules but not under federal law or baseball’s drug policy, the San Diego Union-Tribune reported.

However, that drug policy also includes a requirement that players must turn over medical records for reasonable cause. The union provided Ramirez’s records, which included a prescription from a private physician for HCG.

Ramirez had not obtained a therapeutic-use exemption from baseball, which certifies the use of banned substances for proven medical need.

That “non-analytical evidence” -- that is, evidence beyond a positive test -- was the basis for the 50-game suspension. On the eve of the hearing scheduled last Wednesday, Ramirez dropped his appeal, and the suspension was announced the following day.

Scott Boras, the agent for Ramirez, has declined to comment on matters involving the suspension, including why the appeal was dropped. Baseball’s drug policy restricts the commissioner’s office and players’ union from comment.

However, sources said that the appeal was dropped because the evidence of the prescription without the existence of an exemption gave baseball indisputable proof of a violation of the drug policy. In addition, Ramirez could complete his suspension before the second half of the season, rather than risk waiting weeks or months for a hearing that would be unlikely to succeed and could turn up additional evidence.

Baseball officials agreed not to contest the issue further, because a 50-game suspension is the maximum punishment for a first offender and the testosterone-related case would have been more difficult to prove.

In a statement issued by the players’ union, Ramirez said he took “a medication, not a steroid,” prescribed by a physician unaware that the substance was banned under baseball’s drug policy.

Although anti-doping experts have said HCG is commonly used to replenish testosterone after a cycle of steroids, sources close to Ramirez have suggested the HCG was prescribed to combat issues surrounding sexual performance.

Ramirez is 36. Among men ages 30-39, about 2% have significantly low levels of testosterone, said Dr. Glenn Braunstein, chairman of the Department of Medicine at Cedars-Sinai Medical Center.

Braunstein, an expert in reproductive endocrinology, said such patients generally would be treated with testosterone, not with HCG.

“There’s no reason to use it in healthy male adults,” he said.

In rare cases, he said, HCG could be prescribed. In the case of a healthy male in Ramirez’s age group, he said, the odds of such treatment would be less than 1 in 1,000.


Times staff writer Dylan Hernandez contributed to this report.




When: 4 PDT.

Where: Citizens Bank Park.

On the air: TV: Ch. 9. Radio: 790, 930.

Pitchers: Clayton Kershaw vs. Chan Ho Park.

Randy Wolf (1-1, 2.95) vs. Jamie Moyer (3-2, 7.26) Wednesday, 4 p.m.; Chad Billingsley (5-1, 2.45) vs. Cole Hamels (1-2, 6.17) Thursday, 10 a.m.

Update: Park, a standout long reliever with the Dodgers last season, signed with the Phillies in part because he wanted to be a starter again. He has had a rough season but pitched well in his last start, limiting the New York Mets to a hit over six shutout innings. Park will have to continue to pitch well to keep his spot in the rotation. Kershaw held Washington to a run over five innings in his last start and wasn’t allowed to pitch any longer because his pitch count was already at 99. He was doomed to a premature exit by a 31-pitch first inning.

-- Dylan Hernandez