Telekom Cycling Scandal Widens Commission Report Alleges Systematic Doping at German Hospital

An expert committee has finished its two-year investigation into doping practices at a German hospital specializing in sports medicine. The findings allege that members of the T-Mobile cycling team used performance-enhancing drugs for years -- under the guidance of two doctors.

The eighth stage of the Tour de France, on July 9, 2006, led from Saint-Méen-le-Grand to Lorient on the Atlantic. With the tallest hill at only 294 meters (965 feet), the 181-kilometer (113-mile) ride through Brittany is a breeze for a professional cyclist. On that day, Serhiy Honchar, a then-member of the T-Mobile team, was never in danger of losing his yellow jersey.

His team physician, Lothar Heinrich, was absent during that stage. Instead of attending the race, Heinrich drove to the airport in Rennes that afternoon to catch a flight to Basel, Switzerland, where he landed at 5:00 p.m. By 7:05 p.m., he was sitting in another plane, on an Air France flight to Bordeaux, via Orly airport in Paris.

During his short layover in Basel, Heinrich had rented a car and drove across the Rhine River to the nearby University Medical Center Freiburg, located just across the border from Switzerland in the southern German town of Freiburg. He had brought along seven blood samples, which were likely taken from cyclists on the T-Mobile team.

Riders on the team had apparently given themselves autologous blood transfusions a week earlier, at the beginning of the Tour de France, in a bid to illicitly enhance their performance. Now their blood counts had to be tested. One of Heinrich's assistants, who had gained access to the hospital's central laboratory, performed the blood analysis on that same evening, while Heinrich was on his way back to France.

By that time, in the summer of 2006, doping allegations had already done serious damage to professional cycling. Shortly before the tour, reports on a doping laboratory run by Spanish doctor Eufemiano Fuentes had resulted in the suspension of German cyclist Jan Ullrich and one of his fellow members of the T-Mobile team. Fuentes's customers are believed to have included the two men and 56 other professional cyclists from Italy, Germany and Spain.

Despite the commotion and seemingly genuine expressions of shock over the revelations, the doping continued at the T-Mobile team. What Heinrich and Andreas Schmid, as well as riders on the team, did that summer could be described as insane or simply criminal. Only someone who is part of the world of professional cycling could understand it.

The T-Mobile team no longer exists, nor does a competing German team sponsored by the bottled water company Gerolsteiner. In recent years, a growing number of doping cases has taken the sport to the point of moral and economic bankruptcy.

How the Telekom team and its successor, the T-Mobile team, arrived at that point is detailed in a new report by an independent expert commission appointed by the University of Freiburg, which also describes how the seven blood samples were brought to Freiburg in July 2006. The report, which is more than 60 pages long, details the acts of deception and manipulation committed by team members over a period of close to 12 years, from 1995 to 2007. The document leaves almost no questions unanswered when it comes to the systematic and all-encompassing use of performance-enhancing drugs within Germany's most successful professional cycling team. Perhaps fittingly, the document, with its account of the demise of a German sporting legend, is entitled "Final Report."

The authors are Hans-Joachim Schäfer, a lawyer and former chief justice of the Social Court in the southwestern German city of Reutlingen, Cologne biochemist Wilhelm Schänzer and Heidelberg pharmacologist Ulrich Schwabe. Following the publication of a SPIEGEL cover story on the subject in April 2007, the three men were appointed to conduct a thorough investigation of the accusations made by SPIEGEL against physicians at the renowned hospital.

The men pursued hundreds of leads. They examined the hospital's cash flows. They reviewed files compiled by the Freiburg public prosecutor's office and the Federal Criminal Police Office (BKA), both of which are investigating former T-Mobile team physicians Heinrich and Schmid. They also scrutinized receipts for drugs and travel expenses and ordered laboratory tests of 58,000 blood samples taken at the hospital's sports medicine department between 1995 and 2007.

Finally, the three men interviewed 77 witnesses. They would have liked to interview many more, but a number of professional cyclists, like Jan Ullrich, Matthias Kessler, Andreas Klöden and Udo Bölts, did not comply with their request for an interview.

The compilation of the results, which was completed on April 16 and approved by all three members of the commission, has not been published yet, because various issues are still unresolved in Freiburg. They include questions relating to the analysis and the fact that much of the information the commission has compiled is likely to have legal implications, under both criminal and labor law. In addition, the statements made by Klöden, who has denied all use of performance-enhancing drugs until now, could lead to his suspension. The university's lawyers are currently examining the report.

According to the commission's findings, team physicians Heinrich and Schmid were the masterminds behind a system of deception that became increasingly professional over the years. In May 2007, after the SPIEGEL revelations, the two men admitted to having administered performance-enhancing drugs to Deutsche Telekom cyclists in the 1990s. Those actions are now statute-barred. However, the report claims that Heinrich and Schmid continued to procure and administer performance-enhancing drugs to cyclists until at least 2006.

The commission's conclusions also show that the two physicians wrote bogus medical certificates for cyclists, used shady connections to obtain drugs, deceived their superiors and covered up payments, all the while portraying themselves as champions of drug-free cycling. They exploited their hospital's excellent reputation to give themselves a veneer of respectability, while simultaneously supplying the cyclists with all manner of pharmaceutical concoctions.

The commission also found that Heinrich and Schmid often kept athletes in the dark over the side effects of their doping regimens. And when problems occurred, including blood coagulating in the sample bags, they apparently risked the lives of the athletes in their care.

The drugs were not supplied by the hospital pharmacy, but primarily by the Rathaus pharmacy in Elzach, a town in the Black Forest about 25 kilometers (16 miles) north of Freiburg. For the 2006 season, Schmid and Heinrich ordered roughly two-thirds of their drugs from the pharmacy in Elzach, for which they were billed a grand total of €20,855.51 ($27,530). The pharmacists, however, charged the two physicians only a 10-percent markup on their wholesale price, an illegal practice when it comes to dispensing prescription medication, according to an expert consulted by the commission.

Over the years, Schmid and Heinrich obtained a wide range of drugs which cyclists can use to enhance their performance. These included NeoRecormon, a drug containing a synthetic version of the naturally-occurring hormone erythropoietin (EPO), the human growth hormone medication Genotropin, the testosterone drugs Unestor and Andriol (not to mention Kryptocur, a testosterone spray), the corticosteroid preparation Diprophos and the iron preparations Kendural and Ferrlecit. The cyclists would order their drugs by sending the two physicians text messages or emails. In the orders, only the first letter of the substance would be used, and there were also code words for some of the drugs, including "Luft" ("air") for EPO.

To minimize the risks involved in taking the banned substances, Heinrich and Schmid even wrote fake medical reports for the athletes. In April 2006, for example, Schmid diagnosed T-Mobile rider Patrik Sinkewitz  with an inflammation of the patellar tendon and asked the International Cycling Union (UCI) for special permission to use betamethasone, a corticosteroid. The UCI approved the request. As a result, Sinkewitz, whose patellar tendon was in perfectly good order, was able to use the cream, which is normally banned, for six weeks. The same tactic was used a year later, only with Heinrich making the diagnosis and signing the request.

According to the report, "for both doctors it was important that they themselves kept control over the supply of the performance-enhancing drugs." In one instance, Schmid dispatched a Deutsche Bahn courier with a refrigerated bag containing a performance-enhancing drug to meet Telekom cyclist Jörg Jaksche at the main train station in the Bavarian city of Nuremberg. The doctor had given the cyclist the code number for the delivery by telephone.

And when the hematocrit level in one rider's blood reached the critical limit of 50 percent during an EPO treatment and was not brought down by the administration of saline solutions and blood thinners, Schmid and Heinrich wrote the following comments on the analysis printouts: "Be careful, Bert"; "Okay, at 46 you can up the levels again"; "I don't know either why the centrifuge is showing 48 and the laboratory value is 52."

Schmid, at least, felt the occasional pang of conscience. One of his colleagues told the commission that Schmid felt "fearful and apprehensive" about his activities in the cycling world, and that he wanted to "get out" and devote himself to sports for the disabled. But despite his moral qualms, Schmid even continued his illegal activities after Ullrich was suspended in 2006 and a shocked public wondered what else Germany's premier professional cycling team was capable of.

Bad Blood

On July 2, 2006, after the first stage of the Tour de France, T-Mobile cyclists Sinkewitz, Klöden and Kessler separated from their team and had Sinkewitz's girlfriend drive them to the University Medical Center Freiburg. According to the commission's report, Schmid met them there in the basement-level biochemistry laboratory, where he closed the shades and began to reinfuse into the athletes blood that had been brought there for storage several weeks earlier.

But there were complications. The blood in Sinkewitz's first bag coagulated, but Schmid, instead of abandoning the effort, "simply infused the second bag," referring to the false start as "bad luck." Once again, the blood did not enter Sinkewitz's body as anticipated. The problem was apparently the result of either a "defective" technique while taking the original blood sample or "bacterial contamination" of the blood.

The experts conclude that Schmid's behavior was in violation of a German law that regulates blood transfusions. They also state that his actions were "particularly irresponsible," because Schmid sent the athletes on their way after the procedure. Sinkewitz, according to the report, left the lab with half a liter of apparently faulty blood coursing through his veins. Schmid, the experts write, exposed Sinkewitz to the "risk of extremely serious complications," including septic shock and pulmonary embolisms, two potentially fatal conditions.

The commission assumes that it was not just Sinkewitz, who later confessed, but also Kessler and Klöden who received transfusions of their own, previously stored blood on that July 2. Kessler was later given a two-year suspension for testosterone doping, while Klöden is now a member of Kazakhstan's Astana team and is considered Germany's best professional cyclist still active today. Kessler and Klöden have not commented on the allegations.

The commission members also cite as evidence of blood doping the samples Heinrich had analyzed a week later during his short trip to Freiburg. All of these samples contained extremely low levels of reticulocytes, which suggests a "high probability of earlier manipulation." This evidence, the report concludes, helps to explain why the T-Mobile team won the team classification and Klöden arrived in Paris in third place despite the loss of the T-Mobile captain, Jan Ullrich.

Only four of the seven blood samples could be traced to T-Mobile cyclists. The three others were labeled with the "personal identification codes" of team staff members, two of which had remarkably athletic blood counts. The commission assumes that this was how the two physicians tried to cover up the identities of the remaining riders. The way the Freiburg doctors "ignored and downplayed the health hazards of doping" was "horrifying," the final report concludes.

The commission also came to the conclusion that Schmid and Heinrich had no accomplices at the University Medical Center Freiburg. Strict secrecy was apparently part of their strategy. The cyclists derisively referred to another doctor who occasionally helped out during races and was even hesitant to administer vitamin preparations as "Dr. Banana."

The three investigators also found no evidence that Joseph Keul, the former head of the institution, who began promoting the Freiburg hospital's sports medicine department internationally in the 1970s, played an active role in Schmid's and Heinrich's activities. However, they believe that Keul, with his equivocal views on the use of drugs in professional sports, paved the way for the later doping career of his students Schmid and Heinrich. Keul apparently argued that EPO was "safe when used correctly," even though the risks of EPO use had been known for years, and included thrombosis, pulmonary embolisms, strokes and tumor growth.

For professional cyclists, there could be nothing better than being taken under the wing of a recognized German university hospital, especially with Keul as the department head. Keul was Germany's best-known sports physician, a longtime physician to the West German Olympic team and tennis federation, a man with excellent connections in the political world. In other words, Keul was virtually untouchable. And, according to the report, he was a man who "was always prepared" to downplay the use of drugs in sports.

Keul, who died in 2000, even misled the public when it came to the case of the Telekom team, the predecessor to the T-Mobile team. During its scandalous 1998 tour, Keul told Telekom's PR director, Jürgen Kindervater, that he had given "five television and nine radio interviews" in which he had been able to demonstrate "that our Telekom team is under our control and is not taking any banned substances."

In 1999, when SPIEGEL first reported on systematic and comprehensive doping in the Telekom team, Kindervater characterized the story as a "perfidious campaign of character assassination" and tried to prevent its publication with legal means. Joseph Keul was one of the key witnesses in the case. In a sworn affidavit, the professor stated that his institute had "complete documentation" of the cyclists' "examinations by sports physicians" on file, and that there was "not a single case" in which the results showed that they had "taken banned substances."

To demonstrate that it was serious about its opposition to doping, Telekom established and funded a working group called "Doping-Free Sports" after the scandalous 1998 tour. The chairman of the group was Joseph Keul. Lothar Heinrich, one of the two team physicians, was a founding member of the group and also its secretary.

Although Keul's Freiburg working group commissioned a handful of studies by outside scientists, it benefited mainly from €792,500 ($1 million) in funding from Deutsche Telekom. Ironically, the Doping-Free Sports initiative promoted a number of academic projects conducted by Schmid, the results of which could be used to perfect his Freiburg doping network. The elaborate cover-up was strongly reminiscent of the state-sponsoring doping system in the former East Germany.

In May 1999, Keul and Heinrich headed a seminar, sponsored by the Doping-Free Sports group, for coaches, doctors and journalists in the Black Forest. While experts discussed drug-free sports inside the conference facility, Heinrich was outside, delivering at least 20,000 units of NeoRecormon to cyclist Jaksche, who paid for the drug in cash.

The commission discovered that Heinrich used the Doping-Free Sports group's account to pay for subsequent shipments of performance-enhancing drugs. One of these shipments was allegedly sent to Klöden's then-girlfriend. Keul examined, approved and vouched for the accuracy of the invoice.

Keul took advantage of the fact that, as an éminence grise of the German sports community, he had practically free rein to do as he pleased in Freiburg. Outside donations to the institute, including funds from sports associations, were deposited into private accounts and the account of the Nenad Keul Foundation, which he had founded. The commission writes that it could not understand why the "years of inaccuracies relating to virtually all aspects of Professor Keul's revenues were not discovered until after his death."

Questions of Accountability

But as detailed and convincing as the report's description of the Freiburg physicians' involvement in the doping system is, it remains vague when it comes to examining the question of accountability. After Keul's death, a physician named Aloys Berg assumed his position temporarily, until Professor Hans-Hermann Dickhuth was named director of the department in 2002. The commission found no evidence that either man was involved or complicit in doping activities.

Nevertheless, once the report has been published, University Medical Center Freiburg management will have to address the question of whether Berg and Dickhuth could be held accountable for what happened in their department. The issue is all the more relevant because Schmid and Heinrich were not the only ones involved in the doping system. Another doctor, Georg Huber, who was responsible for amateur riders, was active, as were two others who no longer work at the hospital today.

Another question that remains unclear is how much the sponsor knew about the many thousands of tablets, injections and blood bags. The statements given by Telekom and T-Mobile managers were "unproductive," the commission writes. According to the commission's findings, the sponsor did not inspect, or was even interested in, the doctors' accounts with the pharmacies involved. The cycling team's Bonn backers had apparently relied completely on the supposed "persons of integrity" in Freiburg.

Nevertheless, after the first stage of the 2006 Tour de France, when the three German cyclists disappeared and spent several hours in Freiburg receiving blood infusions, their absence was "widely noticed," Luuc Eisenga, the T-Mobile team's technical director at the time, told the commission.

Eisenga makes himself even clearer in an internal report written by private detectives who also investigated the doping scene. Eisenga said that "essentially everyone knew about the Freiburg sports physicians' work." Eisenga claimed that he himself had discussed the subject with one of the sponsor's representatives after the trio's visit to Freiburg. T-Mobile, however, continues to deny having had any knowledge of the matter.

The University Medical Center Freiburg dismissed Heinrich and Schmid without notice in 2007, and the office of the Freiburg public prosecutor is investigating both men. In addition, the German state of Baden-Württemberg wants both physicians to hand over the money they earned with their illegal activities. Despite the commission's intensive efforts, the two doctors, as well as the owner of the pharmacy in Elzach and the professional cyclists Kessler and Klöden, refused to cooperate. When contacted by SPIEGEL last Friday, none of the individuals involved was prepared to comment on the accusations.

Heinrich initially sued the university for wrongful dismissal, arguing that he was acting under orders. According to his attorney, Heinrich had, at the beginning of his career, entered what "may have been an existing system," one for which he could not have been held accountable. The attorney argued that holding Heinrich responsible would be "highly questionable." Meanwhile, Heinrich has withdrawn the suit and now works abroad. Schmid sued the university in a labor court and lost the case, which is now before an appeals court.

Schmid and Heinrich have not yet had their licenses to practice medicine revoked. They are still permitted to work as physicians.

Translated from the German by Christopher Sultan
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