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January 19, 2007

Wayne Arthurs


THE MODERATOR: Dr. Tim Wood, chief medical officer, is here to answer any questions you have about Wayne Arthurs' injury. First question, please.

Q. Wayne, what went wrong?
WAYNE ARTHURS: I had a preexisting injury with my hip. It was getting sorer and sorer over the last probably three days where I injured it during my second-round match. It got worse yesterday during the doubles.
Went and saw Tim yesterday, their medical staff. It was an idea to have a local anaesthetic in my hip this morning. It was like a practice run for the local anaesthetic, to see how I would react to it.
I'd gone in, had the anaesthetic. Felt great during practice. Everything was fine. The hip was good. That was a short-term acting anaesthetic which wore off within the hour type of thing.
Went to have another one, which was a pre-plan, as well, which was going to be a longer-lasting, three- to four-hour type of anaesthetic. Had that probably 15 minutes before the match, which was all right, on queue.
Went on the court. I had a reaction to the anaesthetic and had no coordination, no feelings in my right leg at all. Just completely gone on the right side. As you could see, I couldn't coordinate at all on the right side.

Q. Tim, do you accept any of the responsibility for that?
DR. TIM WOOD: Not personally, because I didn't give the anaesthetic, I suppose. A colleague did.
I don't suppose it's accepting responsibility. I think Wayne was given indications as to the risks and benefits of this procedure. It's an extreme measure to take in a sport such as tennis where these sort of injuries can occur.
Obviously the circumstances, in our opinion, we discussed this with Wayne last night, were exceptional. It was potentially his last match in his home country in a Grand Slam. Wayne was clearly coming to us last night in a position saying, I was in trouble. He was going to struggle to play anyway today without any intervention.
The trial worked very well this morning. Unfortunately, it didn't work as well this afternoon. The anaesthetic has sort of inhibited the muscle from working. That muscle is an important stabilizer of the hip and pelvis. As a result, obviously you can see the result: Wayne struggled to move around the court.

Q. Do you blame the doctor for what happened?
WAYNE ARTHURS: I don't blame the doctor, no. I've been told it's a one-in-a-thousand thing. I've reacted to it like one in a thousand person would. I'm not putting blame on anybody.

Q. Could you have played without the anaesthetic?
WAYNE ARTHURS: I would have been probably about 65, 70% of my full fitness. Whether the injury was going to get worse over the course of the match, that's unknown. It's all hindsight now, really is.

Q. I think everyone was feeling for you watching it from a distance. Take us through your thoughts as that couple of minutes unfolded.
WAYNE ARTHURS: Couldn't believe it actually. I couldn't really believe that this is the way that my last Aussie Open was going to finish. I looked up the crowd as I went out. The flags, Aussie stuff everywhere. It was an amazing atmosphere.
A bit of a surreal feeling because I went to the net, we had the coin toss. The coin hit the ground, and I called heads after the coin had hit the ground. Maybe the anaesthetic was something to do with that, as well. I think it all just got too much for me.
Major disappointment, really was, 'cause the crowd, I could see it was building up to be a great afternoon.

Q. Certainly very emotional. What was it like for you at that moment? You tried to battle on.
WAYNE ARTHURS: I did. I wanted to battle on. It started to rain. I thought, Here we go, this is sort of a Godsend here. It wasn't raining hard enough. My body just wouldn't let me run to the ball. I'd see the ball, and it just wouldn't go where I wanted it to go.
I really didn't want to walk off that court at that moment. I knew there was nothing I could do.

Q. Did you know you were in trouble during the warmup?
WAYNE ARTHURS: I did actually. After the coin toss, I ran to the back of the court. My knee sort of went like this (back and forth). I was thinking. That was not right. Mardy hit a ball straight up the middle, I nearly tripped over. Then I went forward to the net, and nothing was working. The knee was just going left-right, left-right.
Then the timeout we had underneath the tunnel, physio was trying to manipulate anything to see if I had the feeling. The feeling in the quad wasn't quite right there. I ran up and down, and it was not good.

Q. How does your leg feel now?
WAYNE ARTHURS: Still a bit strange. Not fully recovered. The anaesthetic takes four hours sort of to wear off. I'll know in a few more hours.

Q. How bad is the hip? Is it a premature end for your tennis career?
WAYNE ARTHURS: No, it's not that bad. It's a strain above the hip joint which inhibited me, when I'm serving volleying, to put full pressure down on my knee. I sort of volley a little bit upright. Moving across the court was bad, as well, sort of coming back from the right side back to the middle. It was not right either. Yesterday it was probably worse than the singles the day before.
I don't think it's a long-term injury. Something maybe I'll get an MRI scan in the next day or so and see what the problem is. I don't expect it to be a life-threatening sort of thing.

Q. You'll be hoping to be right for Davis Cup?
WAYNE ARTHURS: Yeah. I mean, that's two weeks away. Tim could probably explain it. If it's a little tear in the hip, it's going to take two to three weeks. Who knows.

Q. Did you do it in the doubles or aggravate it in the singles?
WAYNE ARTHURS: Aggravated it in the singles. I got really stiff after my first-round match, obviously because the virus had kicked in as well as not having played that many matches in the sort of last two and a half months.
I got a lot of work on it in the days after. By the end of the singles match, it was pretty sore.

Q. Are you feeling more pain physically or emotionally?
WAYNE ARTHURS: Totally emotionally at the moment.

Q. What were the risks the doctors told you about last night if you took the injection? What were the risks involved? The doctor said you were told the risks. What were they?
WAYNE ARTHURS: I think more the risk that if I didn't have it, maybe I'd still only be playing at 65%. No real risk of doing any damage to myself having it.

Q. Do you think there should be tighter guidelines on the use of anesthetics?
WAYNE ARTHURS: No, I don't think so. It's a very rare case. The doctors have been in the football business for the last 25 years injecting footballers quite often, a lot. I mean, it's a very rare case.

Q. You were as deep as you'd been into your home Slam. Not the way you want it to end. Any thoughts of maybe looking ahead to next year?
WAYNE ARTHURS: That's a long way off (smiling). A bit of an emotional decision. I don't want be making any decisions like that at the moment.

Q. Tim, to clarify, is there any element of medical error here or is it just a pure sense of luck or bad luck that this has happened?
DR. TIM WOOD: It's certainly the latter. Certainly no medical negligence. Local anaesthetic injections carry risks to them. The reason we did the trial this morning was to try and avert what happened this afternoon. Because of those risks, we like to do it in non-competitive situations first. Wayne came in this morning, had the short-acting local so if there were any adverse events, that would have worn off by the time he had to play.
As Wayne said, he had the local. Seemed to work well; took his pain away. He felt he was able to move around the court more freely. As Wayne will I'm sure testify, the same spot was injected. The only difference was that it was a longer-acting local because obviously we weren't able to determine how long his match would go for. Within the rules of tennis, we're not allowed to inject during the course of a match for an injury. We had to make sure that we covered the full duration of a potential five-set, four- to five-hour match. We used a longer-acting anaesthetic.
That was discussed amongst, as I said, two of my colleagues. Together they have 50 years of AFL experience. They determined the anaesthetic to be used, the same spot was injected, the same volume as the initial local anaesthetic this morning.
It's just an unfortunate complication, but certainly there's no evidence, no sign of any medical negligence at all. It's a recognized complication.

Q. AFL, there's been a lot of talk of injections over the course of the past 12 months. As a doctor, do you feel this is going to put the whole topic of injections in sport back into the public eye again?
DR. TIM WOOD: Look, it's going to be obviously newsworthy judging by the number of people here. But both at the AFL level and my experience, this is my sixth tournament as the chief medical officer, I think if you add up the matches, that is been over a thousand, 1200 matches, this is only the second time that we've used local anaesthetic in tennis.
As far as tennis goes, it's an extremely rare occurrence. It's done under exceptional situations. Wayne's circumstance was exceptional. He had to play, wanted to play clearly. His performance, as he said, would have been well below what he would have wanted. We have no idea what would happen once he got on court and into a tough match and may have had to retire with injury.
We discussed that in those circumstances, the only thing we could do too assist him was to consider local anaesthetic. You know, this was discussed and trialed successfully this morning. But an unfortunate adverse event this afternoon.

Q. Was it the same anaesthetic, the same drug you used this morning you used again this afternoon? Or was it a dosage change?
DR. TIM WOOD: No, totally different local anaesthetic.

Q. Who were the colleagues?
DR. TIM WOOD: Hugh Seward and Gary Zimmerman. Past president or current president, just about to retire from the AFL Medical Officers Association, general football club doctor for 25 years. And Gary Zimmerman has had the same level experience at Richmond and the Bulldogs.
They were closely involved. Gary gave the first injection to Wayne this afternoon -- this morning, and would have given the injection this morning, but had to leave before Wayne was able to have the injection. Another colleague, who is also heavily involved in professional sport as the Melbourne Storm doctor, who gives a lot of injections in Rugby League as you can appreciate, and he's never come across this complication before. I'm sure all aware of Mick McGuane's local anaesthetic incident. That's probably the most well-documented similar, but in a totally different area and totally different risk. This was well away from any major nerves. It's really the muscle function itself that has been inhibited by the action of the local anaesthetic.

Q. Who was the Melbourne Storm doctor who actually gave it?
DR. TIM WOOD: Dr. Masci.

Q. First name?
DR. TIM WOOD: Lorenzo. He's part of the medical staff here. We have a highly experienced team of sports physicians with a lot of experience, particularly Dr. Zimmerman, Dr. Seward and myself.

Q. Was there any interaction between you and Mardy? He said it didn't seem right, couldn't quite put his finger on it, he didn't know what was wrong. Was there any interaction?
WAYNE ARTHURS: No, there really wasn't, no. I didn't say anything to him before the match, anything like that. All just happened so quickly. The onset was really quick. I was walking out to the court feeling nothing, then all of a sudden on the court it happened. I don't think he knew what was going on either.

Q. Were you hoping he might just hit a ball back towards you?
WAYNE ARTHURS: Who, yeah, no, a bit annoying he was hitting it away from me.

Q. Was it a bit frightening?
WAYNE ARTHURS: It was a bit frightening, yeah. Never had that feeling before. I'm sort of looking at these guys now watching the TV. They're running like this. I'm sort of wincing at them running. It was such a weird sensation, not being able to even probably react to the ball. You're seeing the ball, but it's just sort of passing you.

Q. Who was the other player that has had the local anaesthetic? You said this is the second one.
DR. TIM WOOD: I can't comment on that for confidentiality reasons I'm afraid. Patient confidentiality, as you can understand.

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