Iowa team doctor in Costa Rica while players were ill

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While 13 Iowa football and players were hospitalized with a muscle disorder, the team's top doctor was attending a weeklong meeting at a luxurious Costa Rican resort known for its stunning beaches and championship golf course, according to records obtained by The Associated Press.

Dr. Ned Amendola, director of the UI Sports Medicine Center and head physician for the football team and other sports since 2001, attended a meeting of the American Board of Orthopaedic Surgery at the Four Seasons Resort in Guanacaste, Costa Rica, between Jan. 23 and Jan. 29. He is a director of the group, which is in charge of setting educational standards for the profession and spent more than $200,000 sending Amendola and two dozen others on the trip.

The meeting's itinerary, released to the AP under the state public records law, shows participants adjourned by noon most days and didn't have any business Jan. 26, the day the university confirmed the players were hospitalized with rhabdomyolysis. On that day and during the free afternoons, some played golf at the resort's Arnold Palmer-designed golf course, relaxed on the beach, read by the pool and did other recreational activities, said Shepard Hurwitz, the group's executive director.

"I know some people are going to look at this like Nero fiddling while Rome is burning, but I'm sure that's not the case," Hurwitz said. "I have great faith in Ned that he was dealing with it in the appropriate manner."

Amendola was in California on business and did not return phone and e-mail messages seeking comment Thursday and Friday, but UI spokesman Tom Moore provided written answers to questions.

Moore said university officials weren't concerned that Amendola was in Costa Rica while the football players were hospitalized.

"A health care plan is in place for all the athletes at all times, including when a member of the health care team is absent, i.e. due to illness, travel or other circumstances," the UI statement said.

Amendola, who is paid $385,000 a year, continued to earn his salary during the trip.

"Because Dr. Amendola's service on the board fulfills the mission of the UI to advance the profession of orthopaedics and to benefit the public, the UI paid Dr. Amendola for his service to the board during his trip," the statement said.

Asked why Amendola didn't return to Iowa City after the players were admitted to the hospital, the UI said he was available to consult with the "world-class physicians who took excellent care of the student-athletes."

The UI added, "He returned to Iowa City as soon as his duties at the meeting were concluded."

Hurwitz said he had no idea Amendola's program was facing a crisis during the meeting until contacted Friday by the AP. Like other participants, Amendola was making phone calls and working on laptops during the week. "I'm sure he would have left" if asked, Hurwitz said, but Amendola was likely able to delegate to others.

The university refused to release copies of four e-mail exchanges involving Amendola during his trip, saying they were considered confidential medical records because they mentioned players and their conditions. Two e-mails that were released show he was sent research about past cases of rhabdomyolysis.

Twelve Iowa players checked into the hospital Jan. 24 complaining of discolored urine and extreme soreness after participating in intense winter workouts, and a 13th entered the next day. They checked out after several days of treatment between Jan. 28 and Jan. 30. The university is investigating the cause of the rhabdomyolysis, which forces muscle fibers to release into the blood stream and can cause kidney damage.

Amendola is the third university official whose travel during the ordeal has been questioned. Iowa Coach Kirk Ferentz has said he used bad judgment in refusing to delay an out-of-state recruiting trip while the players were hospitalized. Athletics Director Gary Barta has defended his decision to leave for an annual fundraising golf event with alumni in Florida.

At a Feb. 2 news conference, Ferentz said UI doctor Kyle Smoot led a team of medical professionals who responded to the case "and did a great job" making sure players received the right care. He also praised trainer Russ Haynes but made no mention of Amendola, a professor of orthopaedic surgery.

As team physician, Amendola attends all football games and is responsible for the care of players, according to his university biography. He directs the sports medicine center that includes specialists in orthopaedics, athletic training, rehabilitation and other areas and aims to improve the prevention and treatment of sports-related injuries.

Hurwitz called the winter meeting "a mixture of work and play" for 27 directors and staff members who stayed at the resort on western Costa Rica's coast along the Pacific Ocean. He said the trip was paid for with revenue from exams and certifications, and cost at least $220,000. Rooms typically go for $795 or more per night at the resort, which boasts of having "two unspoiled beaches, an indigenous spa, championship golf and the magic of the tropical dry forest."

The golf course has been ranked among the "Best 100 Courses Outside the United States" by Golf Digest and gives players a chance to see exotic plants, trees, birds and animals, including monkeys. Hurwitz said Amendola is known to golf, but he's not sure whether he played.

Hurwitz said the annual meeting is a tradition, and Amendola attended the past two at a resort near Puerto Vallarta, Mexico. He said the directors view the trip as a reward for their unpaid service helping write exams and set standards for their profession, but they also do work.

Amendola, whose wife joined him on the trip at the family's expense, sits on several committees and presented research about standards for certifying those trained in other countries, he said.

Amendola is also treasurer of the American Orthopaedic Society for Sports Medicine, and he's assistant treasurer of the International Society of the Knee Arthroscopy and Orthopaedic Sports Medicine, which has a meeting in Rio de Janeiro, Brazil, in May. Amendola is expected to present research at the meeting in Brazil.

The players' hospitalization came just as Amendola was featured on the cover of a monthly newsletter for university alumni under the headline, "Keeping Hawkeyes Healthy." He touted the school's state-of-the-art sports medicine center and offered advice for staying safe when exercising.

"I think moderation is the best advice," he said. "For athletes, I think it's important to not over-train."

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