HISA: No Specific Cause for Churchill Deaths; 'All Hands on Deck' Protocols in Pipeline

A months-long investigation by the Horseracing Integrity and Safety Authority (HISA) has determined that there was no specific cause for the 12 equine fatalities that occurred at Churchill Downs this past spring.

The detailed study released Sept. 12, however, has yielded a newly created “strategic response plan” that HISA believes “will either contribute meaningfully to the reduction of equine fatalities or allow further study and analysis for future implementation if confirmed by the data.”

Speaking at a press conference that followed the release of the investigation's findings, Lisa Lazarus, HISA's chief executive officer, said, “This is, for certain, an 'all hands on deck' moment. There's no one stakeholder that's responsible for the fatalities. And so there's no one stakeholder who can take responsibility for solving the issue. This is something that we have to do together as an industry and move forward….

“Horses dying is not okay. No one in the industry thinks this is okay,” Lazarus emphasized, noting that current efforts to eliminate equine fatalities have to be viewed against a longer-term backdrop.

“If you look historically, at kind of where we've been and where we are now, we have been making progress repeatedly over the years. But we need to do better, and make more progress faster,” Lazarus said.

Although many of the proposed measures outlined in HISA's strategic plan focus on veterinary protocols, track maintenance, new safety rules, and the incorporation of data analytics to better predict and halt catastrophes before they occur, one potential change that has direct implications for the bloodstock industry stands out: Extending the scope of HISA's medication oversight to Thoroughbred auctions.

“Many have questioned whether the industry would be better served if anti-doping and medication control (ADMC) protocols were consistent throughout the lifetime of a horse,” stated HISA's strategic plan. “For that reason, HISA has initiated discussions with sales companies, Fasig-Tipton, Keeneland, and Ocala Breeders' Sales Company, toward the goal of entering into voluntary agreements to more effectively align and coordinate our respective ADMC programs throughout the lifetime of a horse.”

Lazarus explained that Thoroughbred auctions are currently a gray area of HISA's oversight, but she hoped that a spirit of cooperation might smooth over any gaps relating to how the ADMC rules could be implemented at sales.

Lazarus noted that “a horse becomes a HISA [covered] horse after it's had its first public workout, first timed workout. So some of the 2-year-old sales would certainly fall under HISA's purview. The weanlings and yearlings wouldn't. But I think we're at the point where if HISA leads the way that we should, and the way that we intend to, that we'll be able to motivate the industry to come under one kind of comprehensive, understandable, kind of ADMC approach.”

Another key proposal in the strategic plan is sure to ramp up the already divisive debate over whether synthetic racing surfaces should become more of a mainstay in American racing.

“Current available data suggests that artificial surfaces may be safer for horses than dirt or turf surfaces,” the HISA strategic response stated. “While additional research and analysis is necessary to fully evaluate the potential impact of artificial surfaces on overall equine injury rates, more synthetic surface options should be introduced into Thoroughbred racing.”

HISA has also proposed a new rule requiring a 30-day stand-down time from racing and a 14-day stand-down time from workouts after a horse receives a corticosteroid intra-articular injection into the fetlock joint.

In addition, HISA wants to see more oversight for these types of injections, including the creation of a designated area at the racetrack for intra-articular injections to be administered and/or the requirement for veterinarians to record and upload a video of the intra-articular injection being given along with the standard injection report.

“Oaklawn Park has volunteered to implement the designated treatment area concept for their race meet beginning in December 2023,” the HISA strategic findings stated. “The pilot program will be used to determine the feasibility and value of this approach, as well as to identify challenges that would need to be resolved for it to be successful.”

Although HISA's investigation focused on the Churchill fatalities that caused the track's corporate ownership to abandon the spring meet and move racing to Ellis Park in early June while stabling and training continued at Churchill, the findings also took into account other recent spates of Thoroughbred deaths at Saratoga Race Course and Laurel Park. Lazarus said separate reports on the fatalities at those venues would be forthcoming in the near future.

“The absence of a singular explanation for recent equine fatalities at several racetracks across the country is extremely frustrating for the entire sport of Thoroughbred racing, for fans and the public, and also for HISA,” the strategic plan stated.

“The Fatalities at Churchill Downs, Laurel Park and Saratoga Race Course identify a number of potential factors that warrant implementation or further study and industry discussion,” the strategic plan stated. “The inevitable recognition that horse fatalities are almost always multi-factorial means that the response must similarly be multi-responsive.”

Specific to Churchill, the findings report stated that “The investigation concludes that there was no causal relationship between the racetrack surface at Churchill Downs and the equine fatalities. Similarly, there was not a clear pattern in medical histories or injury profiles across the fatalities that point to a single, causal explanation for the fatalities. Nor were there any medication violations present. However, analysis of training histories did indicate an increased risk profile for some of the horses due to the frequency and cadence of their exercise and racing schedules.”

The causes of the 12 Churchill fatalities were summarized in the report as follows: One traumatic paddock injury; one fracture sustained in training on the dirt track; two cases of exercise-associated sudden death; two soft tissue injuries sustained in racing on the dirt track; two fractures sustained in racing on the turf track; four fractures sustained in racing on the dirt track.

“Of the seven horses with inoperable fractures, six involved the metacarpal or metatarsal-phalangeal joint ('ankles' or 'fetlocks'),” the report stated. “Both soft tissue injuries involved the distal sesamoidean ligament. The nine musculoskeletal fatalities occurred in races ranging from maiden special weight to claiming to graded stakes, and on dirt surfaces listed as fast and good, and on turf surfaces listed as firm.

“In other words, there was no discernible pattern,” the report summed up.

Asked if HISA might have preferred to have found glaring evidence of what caused the deaths at Churchill, Lazarus responded this way:

“Obviously, if you have one 'smoking gun,' one clear answer, that's simpler. You can put all of your resources into dealing with that one issue. That being said, I think the fact that it is multi-factorial gives us an opportunity [as a] national regulator, to say, 'We can't just kick the can down the road.' I think that's the message of the strategic response, is that we're not kicking the can down the road. This is a time where racetracks and horsemen and breeders and consignors and sales companies, we all have to get behind real change, [and] no stakeholder group can decline to participate.”
But the findings did note that in some cases, “procedural and information reporting deficiencies” by industry entities were hampering HISA's safety efforts.

“HISA has not been reliably and consistently receiving fatality notices or necropsy reports as outlined in Racetrack Safety Rules 2131(c)(7) and 2170(e) from many jurisdictions, including Kentucky,” the findings stated.

“In addition, the information and data contained in the necropsy reports have not been sufficiently comprehensive to provide all the information necessary for HISA Veterinarians to conduct a thorough analysis,” the report continued. “Consequently, HISA experts in necropsy reporting have been working since the Churchill Downs fatalities with the relevant necropsy laboratories to expand the information provided and clarify the reporting obligations under HISA's preemptive rules.”

With regard to timely injury reporting, the findings stated that “HISA is not currently receiving reports of 'all equine injuries and fatalities…within 72 hours of injury' as required by HISA Racetrack Safety Rule 2131(c)(7). This is not limited to Kentucky but must be rectified going forward to position HISA for maximum effectiveness.”

Lazarus underscored near the end of the press conference that it is not HISA's job to be shutting down racetracks when clusters of equine fatalities occur.

“There's one permutation and nuance that may not be apparent to everyone,” Lazarus said. “HISA's authority is not to shut down a racetrack. That [power is vested in each] state racing commission. HISA's authority is to prevent a racetrack, if they don't meet our accreditation standards, from running covered horse races, which means they can't send out their signal for betting. We don't control whether or not they actually run on a given day.”