A Third Fatality for Modern Mixed Martial Arts

The latest unfortunate death in Mixed Martial Arts (“MMA”), that of Sam Vasquez, has again raised questions concerning the sport’s safety. MMA fans, promoters, blogger, and other commentors went on the offensive and made sure that their spin described the fatality as the first death during a “sanctioned” MMA bout. With the addition of that single word, previous deaths in modern MMA are summarily forgotten. I happen to think that not only do the deceased fighters deserve better, but that in the long run it does a disservice to the sport.

Here I’m defining “modern MMA” as anything occurring after the 1993 debut of the Ultimate Fighting Championship (“UFC”). Not only because that promotion became the driving force behind MMA’s current popularity, but because earlier fatalities may or may not have much relevance to the sport in its current incarnation. In other words, events today are roughly similar due to a common agreement on exactly what the sport of MMA is and how it should take place. Looking at older MMA fatalities includes problems of documentation and interpretation beyond the scope of this post.

For example, look at the difficulty figuring out exactly what happened in the most famous MMA death to ever occur, that of Arrichion, which is still being discussed millennia later. I also have no doubt that there have been vale tudo deaths, but until someone who knows Portuguese spends a lot of time in Brazil doing interviews and reading old papers, we can’t know for sure. More recently, but still pre-modern MMA as I have defined it, there was the death of fifteen year old Alfred Castro Herrera in 1981. He was participating in “full contact” in Tijuana Mexico, which was described as “boxing mixed with karate and judo” in the St. Louis Globe Democrat (April 15, 1981). Was that MMA? Sounds like it, but maybe it was some Mexican wrestling hybrid, or maybe it was all stand-up striking. For the sake of consistency, I’m using the first UFC as the starting date.

Incidentally, the Herrera death was pulled from EJMAS.com. Joseph Svinth has added a separate MMA fatality section to his excellent resource Death Under the Spotlight: The Manuel Velazquez Boxing Fatality Collection Go to the MMA fatalities to see the listings of known recent MMA deaths. The deaths prior to Vasquez are there and include Douglas Dedge’s fight in the Ukraine and Lee’s in Korea.

The reports on Lee are sketchy, but it appears that he may have died from a heart attack (myocardial infarction). Dedge is less clear, but there are numerous reports that he had been experiencing dizziness and blackouts in training. See Sherdog.com, which discusses those reports and gives a more balanced presentation than the earlier Guardian article cited at EJMAS. Judging by the video of the end of the Dedge fight, the Guardian made up its description of the fight wholesale. In fact, other than Dedge being either outclassed, tired, or both, it appears little different from any U.S. sanctioned bout, including a closely watching referee and prompt medical attention. While there are mandatory medical screenings before sanctioned events, it is questionable whether Dedge’s medical issues would have been discovered, because he obviously was avoiding diagnosis of the problem.

The “sanctioned event” spin assumes that the existence of athletic commissions and regulatory bodies are a necessity in putting on a safe fight, but safe fights regularly take place in states without commissions. Similarly, there are few, if any, boxing deaths in non-commissioned states. Obviously more boxing matches take place in commissioned states, but the point is that the promoter is probably more important to the safety of a bout than a regulatory body. MMA’s track record is not much different, as the UK and Japan have both held a significant number of unsanctioned shows without deaths and few serious injuries.

Commissions with weak enforcement may be worse than having no commission at all. In a non-regulated state or territory, coaches and fighters know to judge a promoter on his/her merits and past events. The presence of an athletic commission may grant a false sense of confidence if the commission fails to strongly enforce its own rules. An unscrupulous promoter in such a state ignoring proper safety precautions or lining up mismatches is worse than a good promoter in a non-sanctioned area. A good promoter in a state with a good commission would be the best of both worlds.

Based on the very few MMA deaths that have occurred, Joe Svinth pointed out in correspondence the same thing I had noticed, which is that there appeared to be two potential risk factors when looking at the three deaths in modern MMA. Those factors are the age of the participant and the length of time since the participant’s last fight.

The age correlation is shown in the Velazquez Collection with boxers; older boxers are at a higher risk than younger. See, e.g., Harris, C. Harris, DiRusso, S., Sullivan, T., and Benzil, D.L. (2004, May) Mortality risk after head injury increases at 30 years, Journal of American College of Surgeons 198:5, pp. 852-853. It is likely that the risk of mortality in MMA also increases slowly with the age of the fighter once they pass 30.

Also, a long layoff between fights likely increases the potential risk of mortality. However, this may be a damned-if-you-do, damned-if-you-don’t situation, as fighting too frequently in boxing also raises the risk of injury and mortality.

On the other hand, as Joe Svinth pointed out, both of those conclusions are drawn from a pretty small MMA pool and might be best considered a working hypothesis.

Lastly, although it would be difficult to quantify, it stands to reason that risk of serious injury increases when inexperienced fighters are mismatched against those significantly more experience.

A separate point to be drawn from the recent attention is the clear need for proper health care and disability insurance. Mandatory health, life, and disability insurance may be a good place to start. Boxing has a high incidence of career-affecting hand, head, and eye injuries. Because MMA has a higher incidence of striking injuries due to the lighter and smaller gloves and the allowance f elbows (see, e.g., Gregory Bledsoe, et al., “Incidence of injury in professional Mixed Martial Arts competition,” Journal of Sports Science and Medicine (July 2006) 5, pp. 136-142, which can be downloaded here), it is even more important that MMA fighters are sufficiently covered.

I think distinguishing MMA deaths based on “sanctioned” versus non-sanctioned bouts serves little purpose. MMA is a sport, and just like any other sport, it will experience future deaths. Instead of trying to define away past deaths, let’s move forward MMA safety while remembering those who have lost their lives in the sport they love.

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