-- NEW YORK -- The family of brain-damaged Russian heavyweight boxer Magomed Abdusalamov has filed court documents that state its intent to file a $100 million lawsuit against the state of New York and its athletic commission, alleging negligence and medical malpractice.
Abdusalamov, 32, was in a coma for weeks following emergency brain surgery to remove a large blood clot hours after his Nov. 2 Madison Square Garden bout with Mike Perez. Perez won a unanimous 10-round decision, landing 312 punches to Abdusalamov's 248. Now in a rehabilitation facility, Abdusalamov has shown slight movement and can follow simple commands, but he remains bedridden, said Dr. Rupendra Swarup, medical director of the Mount Sinai Roosevelt Hospital department of neurosurgery. Abdusalamov may never walk or talk again.
During a postfight exam in the dressing room, Abdusalamov, who broke his upper jaw and hand during the fight, told New York State Athletic Commission doctors that his head hurt, according to his handlers. They said doctors gave him a neurological test that required him to read a series of numbers, sutured a cut above his left eye and told him he had a broken nose and that he should have his injuries looked at by a doctor within a day or two upon returning home to Florida.
What neither the commission doctors nor anyone else realized was that at some point Abdusalamov's brain started bleeding. Left untreated, Swarup said, the condition would have killed him.
Matt Farrago, the state athletic commission inspector assigned to monitor Abdusalamov that night, said that after commission doctors cleared the fighter and left the dressing room, he noticed blood in Abdusalamov's urine sample -- a possible sign of internal bleeding. Farrago, who boxed professionally for eight years, said he advised Abdusalamov's handlers to take him by taxi to a hospital. A Madison Square Garden source who spoke only on the condition of anonymity told "Outside the Lines" that two ambulances were on site (state boxing regulations require at least one for a fight card), but commission doctors summoned neither one for Abdusalamov.
In early November, acting on a request from the office of New York's Secretary of State, which oversees the athletic commission, the state inspector general launched an investigation of the fight and what happened after it. No date for the inquiry's completion has been announced. State athletic commission chairwoman Melvina Lathan and chief medical officer Dr. Barry Jordan -- both of whom were at ringside -- the other commission doctors on duty that night and referee Benjy Esteves Jr. have not commented publicly since the probe began and declined "Outside the Lines" interview requests.
Paul Edelstein, the attorney for Abdusalamov's wife and three young daughters, told "Outside the Lines" that he soon will file a lawsuit against commission doctors and other parties.
He said the legislation that created the commission gives it immunity against some types of litigation but that the state could be liable if there is a legal finding that Abdusalamov was mishandled by the state-employed doctors and others who oversaw the fight.
There is recent precedent of the state settling a claim after a ring tragedy, Edelstein said. The widow of boxer Beethavean Scottland, who died from injuries in a 2001 New York fight against George Jones, filed a wrongful death claim that was settled 11 years later for $150,000. The contention was that Scottland shouldn't have been allowed to fight Jones and that the bout should have been stopped before Scottland's injuries became life-threatening.
The Court of Claims notice filed by Edelstein charges the state with allowing Abdusalamov to be "unreasonably and violently beaten" and states that "improper, untimely and inadequate medical care and treatment" contributed to his condition.
Brutal fight but no knockdowns
"That fight was just an all-out war, two guys giving their all, giving and taking all they can," said John David Jackson, Abdusalamov's trainer.
A devout Muslim from the Russian republic of Dagestan, Abdusalamov was the WBC's U.S. champion and entered the bout 18-0, all on knockouts in the fifth round or earlier, with 15 in the first or second round. The 6-foot-3, 231-pound lefty was ranked among the top contenders for the world heavyweight championship with a title shot likely two bouts away -- but he hadn't faced an opponent of the caliber of Perez, who entered the fight with a 19-0 record.
Abdusalamov's manager, Boris Grinberg Sr., said the fighter and his camp knew the HBO-televised matchup was "the most important fight of his life."
In the first round, the 6-foot, 235-pound Perez staggered Abdusalamov with a quick left forearm to his face. Referee Esteves could have declared a "no contest" as a result of the illegal blow, but he was positioned behind Abdusalamov -- it's unclear what he saw, and many other observers missed the forearm shot. Abdusalamov and his corner men did not ask for the fight to be stopped, and neither did ring doctors, although at the end of the first round, Abdusalamov looked up at his image on the big screen video monitor and asked his corner whether his nose was broken.
As the fight progressed, Abdusalamov appeared unable to breathe out of his nose, and the left side of his face became severely swollen and disfigured. His left eye was half shut, and he was bleeding from the cut above it. Despite the damage inflicted by both fighters, the fight had no knockdowns.
"Outside the Lines" interviewed all four of Abdusalamov's corner men -- Jackson, the trainer; cut man Chico Rivas; interpreter Boris Grinberg Jr. (the son of Abdusalamov's manager) and Abdusalamov's brother, Abdusalam. Jackson said he considered stopping the fight around the seventh round because of the punishment Abdusalamov had taken, but that he didn't have a sense from him or the doctors that he was imperiled. And his fighter came back strong -- he won the ninth round.
Throughout the bout, Jackson said, "there was a lack of communication in the corner." He said he repeatedly asked Abdusalamov about his condition, but the fighter spoke almost exclusively with his brother -- in Russian, and that Grinberg Jr. was ineffectual at relaying what they were saying.
A friend of Abdusalamov's who helped him learn basic English said the corner difficulties may have been compounded by the fighter's pride and independence. "He had a history of not paying attention to his corner, he did what he wanted to do," said Chris Jay.
A review of the video and interviews with Abdusalamov's corner men, as well as with Farrago, were inconclusive as to how extensively ring doctors examined Abdusalamov during the fight.
"No one in the medical field over there that night gave me any indication that I should stop this fight," Jackson said. "And the kid was fighting back hard, so I had to give him every chance I could give him to win."
After the final bell at 10:51 p.m., Abdusalamov's brother said his brother made a surprising statement in the ring.
"He hugged me and said, 'Abdusalam, I did everything I could under the circumstances.' I remember that phrase very well -- 'under the circumstances,'" his brother told "Outside the Lines" through an interpreter.
What Abdusalamov's brother and others learned from him was that he had injured his hand early in the fight.
"In the first round, I hit his [Perez's] head with my left hand, and after that I couldn't make a fist and I couldn't operate with my left like I wanted to," was the Abdusalamov quote in the ring provided by Nathan Lewkowicz, executive vice president of Sampson Boxing, Abdusalamov's promoter, for ESPN.com's postfight report.
"But a champ is a champ, and he was a great champion tonight."
Concerns after the final bell
"When we removed his glove after the fight, his hand was badly swollen," said his brother, Abdusalam.
For Grinberg Jr., the broken hand underscored that Abusalamov wouldn't have wanted the fight stopped for anything.
According to his handlers who were in the cramped dressing room, two commission doctors attended to Abdusalamov. His promoter, Sampson Lewkowicz -- father of Nathan -- said he told them, "We should take him to the hospital." And Jackson said he, too, said that, as Abdusalamov told them his head hurt while he was having ice applied by Rivas.
The doctors administered the King-Devick neurological test, which also was given to him the day before the fight, requiring the reading of a series of numbers.
"He made a couple mistakes, but pretty clearly he stated all the numbers and did it pretty quick. I was pretty impressed," said Grinberg Jr., who was with Abdusalamov for the pre- and postfight tests.
Jackson, though, said he was incredulous as the numbers test was given, so he protested and then briefly walked out.
"Why do this? Take him to a hospital. When you get there, then give him the test," Jackson said. "There's time that was wasted because they didn't do, to me, what they were supposed to do and get him to the hospital if he said he's hurting."
"I said, but didn't demand, the hospital. I would never allow that to happen again," Sampson Lewkowicz said. "I never saw anybody get beaten up like that and not get taken to the hospital."
The doctors examined Abdusalamov's face, said he had a broken nose, stitched the gash above his eye and told him to see a doctor in a day or two for his injuries and then in a week to remove the stitches, the fighter's team said.
"It seemed to go by the normal protocol, and steps were taken -- the proper steps were taken -- for him to get medical treatment for what they saw," said the athletic commission inspector, Farrago.
After clearing Abdusalamov, the doctors left the dressing room. Farrago, though, still had to get a urine sample from Abdusalamov, who was having difficulty producing one. After taking a shower, he finally did. When Farrago saw blood in the sample, he advised going by taxi to the nearest hospital, although he said he couldn't recommend a specific one.
"I have to defend what was done, because at no time did he show signs of head trauma serious enough -- of course, he had head trauma -- to warrant the ambulance and to think that there was brain bleeding," Farrago said. "Would I change anything? Yes, knowing the outcome, of course."
What Farrago and Abdusalamov's handlers didn't know at the time during the postfight exam is that critical minutes were slipping away.
"If you have an intracranial injury," said Mt. Sinai Roosevelt's Swarup, "time is of the essence."
Mago's health declines
Sampson Lewkowicz said after the doctors cleared Abdusalamov, Lewkowicz went back into the arena to watch some of the next fight.
When Grinberg Sr. reached him to say Abdusalamov needed to go to the hospital, Lewkowicz said he told that to the commission chairwoman, Lathan. Lewkowicz said Lathan said he should talk to Dr. Jordan, who told Lewkowicz there was an ambulance available, if needed.
But Jordan remained in his seat, and neither took any action nor directed the fighter's handlers to an ambulance, Lewkowicz said.
Abdusalamov needed help to get dressed and leave the dressing room, his brother said.
"He was incapable of doing anything at that point. He was on the verge of passing out and he kept saying to me, 'Abdusalam, I'm about to pass out, I'm about to pass out,'" his brother said.
The two brothers, their father and Grinberg Jr. headed for the street, along with Grinberg Sr. and his wife.
Grinberg Jr. said he left everyone at the curb as he tried to flag a cab, unsuccessfully seeking help from a policeman. "You feel powerless," he said, estimating it took 15 to 20 minutes to find an open taxi.
At 11:47 p.m., the subsequent fight concluded, and fans started to stream out of the Garden.
"There were already people waiting, and I had to ask them, 'Hey guys, can I take this taxi? We have a situation.' They gave me their taxi," Grinberg Jr. said.
As he went to get Abdusalamov, who was sitting on the curb, Grinberg Jr. said his mother told him Abdusalamov had thrown up. Sampson Lewkowicz said he came out to the street, too, and saw Abdusalamov throwing up.
Lewkowicz said he and Grinberg Sr. then ran back inside and told Jordan they didn't see an ambulance, so they had put Abdusalamov in a taxi. Jordan recommended nearby Roosevelt Hospital, as had the cab driver.
Jordan is listed as a board member of the Association of Ringside Physicians, whose website recommends that "the ringside physician should notify the local hospital and on-call neurosurgeon that a boxing match will be taking place." A Mt. Sinai Roosevelt spokesperson said the hospital did not receive such a call about the Nov. 2 fights or notification about Abdusalamov.
Edelstein, the Abdusalamov family lawyer, points out that a 1993 book edited by Jordan, "Medical Aspects of Boxing," states "severe lacerations, fractures, dislocations, impaired vision, and eyes swollen shut should be referred to the emergency room."
As they walked through the sliding doors of Mt. Sinai Roosevelt, about a mile and a half from the Garden, Grinberg Jr. said Abdusalamov vomited again, and leaned on him to make it inside.
Arriving by taxi rather than ambulance, Grinberg Jr. said, cost time even after they reached the emergency room, as he said they were told by a hospital employee, "You have to wait, there are people ahead of you." Grinberg Jr. said he told the employee that Abdusalamov had just been in a 10-round boxing match and needed help.
As they waited, Abdusalamov asked to lie down, was given a gurney and was having dry heaves, Grinberg Jr. said. "As I'm freaking out and cussing," he said, "a security guard saw it and told me to call 911.
"He actually said, 'It would be better if you go outside, you call 911 and they will bring an ambulance to you guys there, because then they would treat him right away instead of waiting.'"
Grinberg Jr. said he left Abdusalamov in the waiting room with his brother, Abdusalam, when he went outside to call 911 from his cellphone. The 911 call came in at 12:16 a.m. and lasted five minutes, according to police department records obtained by "Outside the Lines."
Grinberg Jr. said he went back inside and learned his father had arrived in another taxi and already had gotten attention for Abdusalamov. The hospital record provided by Mt. Sinai Roosevelt states he was registered at 12:31 a.m.
Asked by "Outside the Lines" about the hospital's initial handling of Abdusalamov, and Grinberg Jr.'s 911 call, Mt. Sinai Roosevelt issued the following statement:
"The medical care provided to Mr. Abdusalamov was life-saving, originating in the expert care he received in the emergency department. All three of the security officers who were on-duty in the emergency department that night have been interviewed and while each of them remembers the patient and there being a language barrier, none suggested calling 911 to enhance faster service."
When a doctor examined Abdusalamov, Grinberg Jr. said, he was becoming less responsive. "He was struggling to even talk. ... It was just, you know, grave situation."
Said Dr. Swarup: "His survival was in doubt at the time of presentation because of the degree of injury to his brain that was visible on the initial CT [computed tomography] scan. We didn't know whether or not we were going to be able to save him."
The CT scan taken at 12:50 a.m. had revealed a large blood clot on the left side of Abdusalamov's brain that pushed it against the skull, Swarup said. Abdusalamov was rushed to the operating room.
Doctors began surgery at 1:33 a.m., removed the left side of the skull to relieve pressure, removed the clot and then administered therapies to reduce the swelling of the brain. But by then, said Swarup, the herniation -- the compression of the brain against the skull -- had caused multiple strokes and extensive damage.
"We saved as much as we could, but we cannot make him the same as he was again," Swarup said. "He is young, so is likely to regain more function, but it is difficult to say what extent he will recover."
On Christmas Eve, Abdusalamov was moved to the suburban New York rehab facility where he has been since, with the exception of a return to Mt. Sinai Roosevelt in late January for a cranioplasty, a procedure to replace the removed portion of the skull with a synthetic material.
Abdusalamov's wife, Bakanay, describes him as a dad who loved to play with and teach their girls, ages 7, 4 and 1. She told "Outside the Lines" through an interpreter he is "the best person, the best father, husband, son and brother, and friend."
Said friend Chris Jay: "Mago was funny, an outgoing guy, with a wonderful spirit and so bright and positive, not just this serious warrior from Russia. My biggest regret will be if people never find out that side of him -- this is a tragedy on all levels."
William Weinbaum is a producer in ESPN's Enterprise and Investigative Unit, where John Barr is a reporter.