Ala. Admin. Code r. 165-X-8-.04

Current through Register Vol. 43, No. 1, October 31, 2024

Section 165-X-8-.04 - Medical Requirements

(1) Medical Examinations.

(a) Neurological Examination.

1. All bare-knuckle boxers intended to compete in Alabama who have competed in over two-hundred (200) rounds during their professional career, according to the number of rounds disclosed on the official ring record(s), and prior to competing in Alabama, must submit to the Commission the results of a detailed neurological examination performed within the previous twelve (12) months by a board certified and state licensed neurologist. These two-hundred (200) rounds are cumulative amongst all records, in all combative disciplines.

2. Such examination shall include a careful examination for signs of any trauma-induced neurological damage along with any other specific test or tests requested by the neurologist.

3. Any bare-knuckle boxer not submitting said results prior to the match may be allowed to compete, at the determination of the Chief Inspector, provided however that such bare-knuckle boxer's license will, at the conclusion of the match, be medically suspended until such time as his/her neurological examination requirement is fulfilled.

(b) Eye Examination.

1. All bare-knuckle boxers intending to compete in Alabama who have competed in over two-hundred (200) rounds during their professional career, according to the number of rounds disclosed on the official ring record(s), and prior to competing in Alabama, must submit to the Commission results from a complete ophthalmological or optometric examination performed within the previous twelve (12) months by a state licensed optometrist or board-certified ophthalmologist. These two-hundred (200) rounds are cumulative amongst all records, in all combative disciplines.

2. Such examination shall include a careful dilated examination of the retinal periphery utilizing indirect ophthalmoscope sufficient to identify any sign of previous trauma or retinal damage along with any other specific test or tests requested by said ophthalmologist or optometrist.

3. Any bare-knuckle boxer not submitting said results prior to the match may be allowed to compete, at the determination of the Chief Inspector, provided however that such boxer's license will, at the conclusion of the match, be medically suspended until such time as this ophthalmological or optometric requirement is fulfilled.

(i) The Commission may require updated examinations pursuant to sub-paragraphs (a) and (b) of this rule after each successive fifty (50) fought rounds after the previous submission, as disclosed on such boxer's official ring record.

(2) Pre-Fight Examination. At the time of weigh-in, or at such other time as is then announced, all boxers must pass a pre-fight medical examination and a Commission designated physician must complete a Pre-Fight Medical Examination Form. The examining physician shall deliver all Pre-Fight Examination Forms to the Athletic Commission or to its authorized representative on the day of the weigh-in.

(a) Pregnancy Testing.

1. Each female bare-knuckle boxer, during the pre-fight physical, will be required to submit to a pregnancy test administered under the direction of the examining physician, or such physician's authorized assistant. The cost of such test, unless the bare-knuckle boxer's contract or bout agreement states otherwise, shall be the responsibility of the promoter. Pregnant fighters shall not fight.

2. Female bare-knuckle boxers submitting written documentation acceptable to the examining physician may be waived from the pre-fight physical pregnancy test requirement. Such documentation shall be limited to:

(i) A copy of a lab report from a recognized clinical laboratory and dated within ten (10) days of the pre-fight physical attesting that the boxer is not pregnant, or

(ii) A statement from a state licensed physician, on such physician's letterhead stationery, stating that the bare-knuckle boxer has undergone certain medical procedures rendering her medically improbable of bearing children.

(b) Failed Pre-Fight Physical.

1. Whenever a bare-knuckle boxer's examination indicates that he or she is unfit for competition, because of any weakness or disability discovered by the physician, an immediate report of such evidence must be made to the Commission. In such case, the bare-knuckle boxer shall be prohibited from participating in the match.

2. The examining physician shall deliver all pre-fight examination reports to the Commission or to its authorized representative immediately after the weigh-in.

3. Any contestant who fails his or her pre-fight physical for medical reasons or for lack of general conditioning shall be placed on immediate medical suspension and reported to the Commission.

(c) Hydration Testing.

1. At the official weigh-in, all bare-knuckle boxers' hydration shall be tested using digital fiber optic refractometers or other hydration testing method as determined by the appointed event physician.

(d) Minimum Uncorrected Visual Acuity.

1. A bare-knuckle boxer must have a minimum uncorrected visual acuity of 20/200 in both eyes. Any person who applies for a license or renewal of license to compete as a professional bare-knuckle boxer in Alabama may, upon the request of the Commission, be required to present evidence of his/her visual acuity.

(e) Additional Medical Examinations.

1. Upon recommendation of the examining physician or the medical advisory panel, the Commission may require a bare-knuckle boxer to undergo additional medical examinations performed by a state licensed physician to determine the bare-knuckle boxer's medical fitness to compete.

(i) The Commission shall require re-examinations submitted after each successive fifty (50) professional rounds after the previous submission, as disclosed on such bare-knuckle boxer's official ring record(s).

(f) Medical Suspensions by Other Commissions.

1. Medical suspensions. Other athletic commissions recognized by the Association of Boxing Commissions and Combative Sports and which are published by any boxing and/or mixed martial arts registry approved for such purposes by the Association of Boxing Commissions and Combative Sports, shall be recognized by the Commission.

2. Medical examinations after suspensions. A bare-knuckle boxer who is under medical suspension in another state shall submit to any medical examination listed in this chapter as requested by the Commission prior to competing in a contest or exhibition in this state.

(g) Drugs Prohibited.

1. The administration or use of any drugs, alcohol, stimulants, or injections in any part of the bare-knuckle boxer's body, either prior to or during a match, is prohibited unless such drugs are administered by a physician and with the approval of the Commission.

(i) The Commission may order a bare-knuckle boxer to undergo a drug screening at any time. A Drug Screen Form must be completed by an approved laboratory and submitted to the Commission within seven (7) days of the order.

(h) Post Contest Inactive Period.

1. No bare-knuckle boxer shall be permitted to engage in another contest or exhibition in this state for a period of seven (7) days after competing in a contest or exhibition.

(i) Head Injury.

1. Any bare-knuckle boxer who suffers a knockout, concussion, or other serious head injury shall be examined by the Ringside Physician. The Physician shall immediately report to the Commission or its representative, the condition of such boxer and whether or not additional medical attention is advised.

(j) Knock Out and Technical Knock Out.

1. When a bare-knuckle boxer is defeated by knock out, that boxer's license shall be placed on an immediate sixty (60) day medical suspension.

2. Upon a bare-knuckle boxer's second defeat by knock out, the competitor's license shall be placed on an immediate ninety (90) day medical suspension and the boxer shall submit to a medical examination.

3. A Post-Knock Out Examination Form shall be completed by a physician and submitted to the Commission along with request for medical clearance for thirty (30) days prior to participating in a contest or exhibition in this state. Any bare-knuckle boxer losing by knock out in two (2) or more consecutive fights shall be placed on immediate medical suspension for a period of six (6) months.

4. Unless otherwise ordered by the attending ringside physician, there shall be a minimum thirty (30) day medical suspension after a technical knockout.

5. Technical knock outs caused by a severe cut shall result in either a forty-five (45) day or sixty (60) day medical suspension.

6. Stoppages with injury may also warrant a medical suspension as determined by the ringside physician.

7. Completing a suspension may require approved medical evaluations as determined by the ringside physician.

(k) Under-Conditioned Fighter.

1. A bare-knuckle boxer deemed under-conditioned by the referee, the Commission, or any designated representative of the Commission, shall be immediately disqualified and suspended for ninety (90) days.

(i) If it should be determined by the referee, any member of the Commission present, or any designated representative of the Commission present that a bare-knuckle boxer did not give a good faith effort to display his or her skills, then that bare-knuckle boxer shall be subject to disciplinary action.

(ii) A disqualified bare-knuckle boxer may be disciplined by the Commission.

(l) Consecutive Losses.

2. Four or More Consecutive Losses by TKO, KO, or DQ. A bare-knuckle boxer who has lost four (4) consecutive fights by knock-out, technical knock-out, or disqualification, according to their official ring record(s) compiled and maintained by the ABC Registries, shall be summarily suspended pending a hearing by the Commission. Suspension will be listed as "Indefinite Pending Hearing."

3. History of Poor Performance. Any bare-knuckle boxer with a history of poor performance shall not be approved to compete against any other bare-knuckle boxer, except another bare-knuckle boxer who has a similar history of poor performance in the same weight class.

(m) Verification of Contestant Experience.

1. The trainer or manager for a bare-knuckle boxer that meets the following criteria shall submit an affidavit that the boxer is prepared for a professional contest:

(i) Bare-knuckle boxer has competed in a fewer than four (4) professional boxing, professional bare-knuckle boxing, professional mixed martial arts, and/or professional kickboxing bout.

(ii) Bare-knuckle boxer has not competed in the last twelve (12) months.

(iii) Bare-knuckle boxer has lost his or her last six (6) consecutive events.

(iv) Bare-knuckle boxer has lost three (3) consecutive events by TKO, KO, or DQ.

(n) General Responsibilities and Provisions.

1. During the performance of any promotion, it shall be the promoter's responsibility to ensure the compliance with all laws and rules governing professional bare-knuckle boxing in Alabama. Such responsibilities shall include, but will not be limited to the following:

(i) Medical Insurance.

(I) The promoter shall provide for the bare-knuckle boxers' insurance covering ambulance services, medical, surgical, and hospital care with a minimum limit of $20,000 for injuries sustained while participating in said program and for a minimum limit of $20,000 death benefit awarded to the estate of any contestant should death occur from injuries received while participating in the contest or exhibition.

(ii) Physician.

(I) A minimum of two (2) physicians shall be present at all events. A Commission designated ringside physician must be at ringside each bout, with the remaining physician(s) available to perform suturing of injured fighters, in a designated medical area. A Commission designated ringside physician shall be either a M.D. or D.O.

I. Physicians not having completed the Ringside Physician Certification shall be licensed as "Non-Ringside Physicians," but may serve at ring or cage side so long as a minimum of one certified Ringside Physician is present.

(II) All "Ringside" physicians serving ring or cage side shall obtain ARP/ACSM Certified Ringside Physician (CRP) certification. All physicians having completed the CPR shall be licensed as a "Ringside Physician."

(iii) Ambulance Service.

(I) The promoter shall provide continuous ambulance service with a state-certified EMT attendant and state-certified paramedic, who shall provide a resuscitator, stretcher, backboard, oxygen, and such other medical equipment reasonably expected for immediate trauma care, and who shall be present before the start of each contest and shall remain on site until the end of the program.

(II) For the purposes of this section, a program of Bare-knuckle boxing begins with the commencement of the first contest or exhibition and ends when the last bare-knuckle boxer leaves the site of the program.

(III) The chief inspector and/or Commission appointed supervisor shall meet with the EMT and paramedic prior to the beginning of the match, contest, or exhibition. During such meeting the chief inspector or Commission supervisor will instruct the EMT and paramedic concerning the match, contest, or exhibition, placement of the stretcher and any other information necessary to ensure prompt and appropriate immediate care.

(IV) An ambulance shall be able and available to immediately transport any severely injured bare-knuckle boxer to an appropriate medical facility. No other scheduled contest or exhibition may proceed until there is an ambulance and paramedic at the facility, that has met with the chief inspector and/or the Commission appointed supervisor as described in subparagraph (III), above.

(V) In addition to the above-mentioned ambulance, a paramedic, licensed by the State of Alabama, shall be present at ringside with the ringside physician. The paramedic shall possess advanced life support equipment necessary to resuscitate a fighter and package them for transport to the hospital. The paramedic is in addition to any EMT's or paramedics that are hired for the safety of the crowd and shall not leave ringside while a fight is taking place and shall be in direct communication with the ringside physician at all times. The ringside paramedic shall only leave ringside to attend to a spectator or another person in the event of an emergency and when no other paramedic is available.

(iv) A minimum of two (2) licensed cutmen are required for each bare-knuckle boxing event; one for each corner. All cutmen shall be licensed by the Commission.

(v) Hepatitis and HIV Testing.

(I) Blood borne pathogen testing. All bare-knuckle boxers in all bouts shall be tested for Hepatitis B, Hepatitis C, and HIV by a laboratory approved by the Commission. The initial test for Hepatitis B, Hepatitis C, and HIV detection shall be conducted within (365) days prior to competition.

I. In addition to the pre-competition test, any bare-knuckle boxer shall be re-tested for Hepatitis B, Hepatitis C, and HIV prior to his or her participation in each boxing match, contest, or exhibition in Alabama if the match, contest, or exhibition is scheduled to occur more than (365) days after the date of the most recent test. The results must be submitted to the Commission with the show date request prior to the official weigh-in.

(II) Positive tests for blood-borne pathogens. Any bare-knuckle boxer who tests positive for Hepatitis B, Hepatitis C, or HIV shall appear before the medical advisory panel, which after verifying the results of the test, shall advise the Commission as to whether the bare-knuckle boxer's participation in a match, contest, or exhibition would pose a threat to the health and safety of a participant, official, or spectator.

I. Any bare-knuckle boxer that tests positive for Hepatitis B, Hepatitis C, or HIV who is scheduled for competition must disclose to the promoter that he or she has tested positive for Hepatitis B, Hepatitis C, or HIV.

Ala. Admin. Code r. 165-X-8-.04

Adopted by Alabama Administrative Monthly Volume XXXVIII, Issue No. 05, February 28, 2020, eff. 4/13/2020.

Amended by Alabama Administrative Monthly Volume XL, Issue No. 11, August 31, 2022, eff. 10/15/2022.

Authors: Dr. John Marshall, Joel R. Blankenship, Larry Bright, Stan Frierson, Shane Sears

Statutory Authority:Code of Ala. 1975, § 41-9-1024.