Tuesday, July 5, 2011

NCAA: WHO IS WALTER BYERS AND WHAT HAS HE SAID ABOUT THE COMMERCIALISM OF AMATEUR NCAA ATHLETES?

"Today, the NCAA Presidents Commission is preoccupied with tightening a few loose bolts in a worn machine, firmly committed to the neoplantation belief that the enormous proceeds from college games belongs to the overseers (the administrators) and supervisors (coaches). The plantation workers performing in the arena may receive only those benefits authorized by the overseers. The system is so biased against human nature and simple fairness in light of today's high dollar, commercialized college marketplace that the ever increasing number of primary and secondary NCAA infractions cases of the 1990s emerge in the current environment as mostly an indictment of the system itself."


Walter Byers, Unsportmanlike Conduct, 1995


For many of us who live in the south, terms like "plantation" and "overseer" invoke strong images and thoughts. So, when I read these words (and others I will detail) in Walter Byers book, written in 1995, I immediately took notice.

WHO IS WALTER BYERS? Walter Byers served as executive director of the NCAA from 1951 to 1987. Among other things, he started the NCAA enforcement program, pioneered a national academic rule for athletes and negotiated more than 50 television contracts. I think this qualifies him to opine on the subject of amateurism and compensating players.

As the NCAA entered the 90s, they had just disposed of the Jerry Tarkanian matter. For those of us old enough to remember, Tark the Shark was a successful basketball coach at UNLV. The NCAA went to war with Shark the Tark and the shark bit back. Who won depends on who you ask.

The case had all of the usual story lines. Money, cars, admissions issues, suspect grades, all in the backdrop of sin city. Throw in an upstart program (not Kentucky or UCLA) and you have a made for television movie. If there had only been sports talk radio and the internet back then.



As it always does, the NCAA considered itself victorious. Good had defeated evil. The case would serve notice to potential violators. And, it proved the NCAAs essential point, that being if you allowed money into amateur athletics, the conduct would be worse than what occurred at UNLV.

Against this backdrop, the NCAA dug in on its position on amateurism, emphasized its public relations campaign (that sound familiar--"where does the money go" ads we see on TV now), expanded it's enforcement and compliance departments, and enlarged its bureaucracy.

Was the NCAA right? By 1995, Walter Byers, who some say created the NCAA in its current form, didn't think so.  Fast forward 16 years. Have we finally reached the tipping point?


More coming in Part II


Chris Hellums is the managing shareholder of Pittman Dutton & Hellums. He currently represents former Alabama wide receiver Tyrone Prothro in In Re NCAA Student-Athlete Name and Likeness Licensing Litigation, Case No. 09-cv-1967-CW.

Friday, July 1, 2011

FDA Warning: Atypical Femur Fractures Seen In Fosamax Recipients

As a result of ongoing investigations regarding Fosamax and the use of bisphosphonates (BPs) to treat osteoporosis, the FDA has announced that the risk of atypical fractures of the thigh will be added to the Warnings and Precautions section of all labels of BP drugs. Specifically, these atypical fractures are known as subtrochanteric and diaphyseal femur fractures. Recent studies strongly suggest there is a causal link between people who take BPs and the increased risk of these atypical fractures. Furthermore, not only are people who take BPs put in greater risk of fracture, these particular types of fracture are especially more dangerous than the more common femur fractures. Additionally, the use of BPs results in longer and more complicated healing of the bone.


What is a subtrochanteric and diaphyseal femur fracture?
Aytpical subtrochanteric femur fracture is a fracture occurring on the shaft of the femur immediately below the lesser trochanter. That is, right below the hip joint. These fractures are not common, rather they account for only 7% to 10% of all “hip/femoral diaphyseal fractures.”Furthermore, given the unique nature of this fracture, special implants are required in order for the fracture to heal, and they are also more susceptible to malunion or nonunion. Additionally, those affected are liable to suffer long term effects. One study indicated that after 2 years, about 50% of persons who suffered a subtrochanteric fracture did not recuperate their pre-fracture walking abilities and faced difficulties performing routine activities. A total of 71% could not live in the same conditions as they lived previously. 

diaphyseal fracture on the other hand, is a fracture that occurs on the main or midsection of the femur. These of course are one of the more common fractures. What is significant however is that these fractures are more typically associated with high trauma incidents, whereas people taking BPs have incurred these fractures as a result of little to no trauma.

In general there are also other features seen in people taking BPs that make these particular subtrochanteric and diaphyseal fractures atypical. First, the fractures are transverse, that is a straight break perpendicular to the shaft of the femur, or it is a straight angled break.  Second, the breaks are clean, in that the bones are not crushed or splintered as you would expect from high trauma breaks. Third, incomplete fractures tend to occur on the lateral side of the femur. Finally, more minor features include fractures in patients whose bones show evidence of an increase in the thickness of the femurs wall, delayed healing, and patients also report that weeks prior to the fracture they experienced symptoms such as dullness and aching in their groin or thigh.  


What’s the cause?

The evidence of BP causing unusual femur fractures, has certainly convinced the FDA to prompt these new warning label requirements. Studies are showing that BPs do increase bone density and strength, that is after all exactly what they prescribed to do. That increased strength and density however is achieved by reducing bone turnover. This means essentially instead of “out with the old, in with the new,” as is the case for normal bone “remodeling,” it is more like, “keeping the old, and piling on the new.” The problem however is that bones naturally incur cracks and micro-damage, which is in turn naturally repaired by the body through the process of remodeling. Absent remodeling which is suppressed by the BPs, micro-damage begins to accumulate. Over time, the end result is a thicker, much denser bone, albeit one that is less structurally sound, thus the increased risk of these atypical fractures.

In the short run, it may be that using BPs to combat osteoporosis is an effective treatment. However, for those patients unaware of the risks associated with BPs, like those who have been affected by Fosamax, evidence indicates that whether a person should undergo long term treatment requires a careful assessment of the risks versus its benefits. For this reason the FDA specifically recommends that health care professionals reevaluate a patients need to continue BP therapy, especially for those who have been treated with BPs over five years. c

Chris Hellums can be contacted at Chrish@PittmanDutton.com


References:

[1] US Food and Drug Admin. FDA Drug Safety Commc’n: Safety Update for Osteoporosis Drugs, Bisphosphonates, and Atypical Fractures (2010).
[2] Shane E, Burr D. Ebeling PR, et al. Atypical Subtrochanteric and Diaphyseal Femoral Fractures: Report of a Task Force of the American Society for Bone and Mineral Research. 25 J. Bone Miner. Res. 2267 (2010).

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