[CW: The following article contains multiple references to suicide]

Last week the family of Tim Hague filed a wrongful death lawsuit seeking over $5 million CAD in damages for what they claim is gross negligence leading up to Hague’s death.

Hague passed away at age 34 after suffering a cerebral hemorrhage in a bout against Adam Braidwood at the Shaw Conference Centre in Edmonton, AB. In their lawsuit the Hague family names the City of Edmonton, the Edmonton Combat Sports Commission (ECSC), and K.O. Boxing Canada among the defendants.

Also named as defendants are former ECSC executive director Pat Reid (who the lawsuit suggests committed criminal negligence), David Aitkin (who is believed to have hired Reid), Len Kovisto (the referee for Hague’s final contest), and Dr. Shelby Karpman and Dr. Shirdi Nullah (who are named as ringside officials in the lawsuit).

The lawsuit alleges all these individuals and entities played a role in allowing Hague to fight Braidwood despite Hague having suffered a number of losses via KO and TKO which should have resulted in medical suspensions. The lawsuit claims that Reid failed to submit results from Hague’s fights and that if this were done it would have prevented Hague from being licensed outside of Edmonton, and thus would have reduced the cumulative amount of brain trauma Hague suffered in the last couple of years of his life.

The lawsuit also claims that the ringside physicians did not secure adequate medical records and that these records might have prevented Hague’s ability to get licensed.

In supporting their argument for Hague’s medical status not being appropriate for combat sports in Edmonton, the Hague family revealed that the former UFC fighter was suffering from chronic traumatic encephalopathy (CTE). Their lawsuit states that Hague was diagnosed with CTE after an autopsy.

CTE was first described by forensic pathologist Bennet Omalu at the University of Pittsburgh in 2005. Among the many symptoms of CTE are confusion, headaches, memory loss, impulsive behaviour, poor judgement, dementia, tremors, vertigo, depression and suicidality.

CTE is caused by the clumping of tau protein in the brain. This protein is released in the brain as a result of head trauma. The clumps or tangles of tau inhabit the brain’s ability to regulate and cause atrophy to brain tissue. The process is extremely similar to what is observed in suffers of Alzhemier’s disease.

Rotational acceleration of the brain has been shown to cause abnormal releases of tau protein. The brain undergoes rotational acceleration any time it is caused to rattle or swivel within the cerebrospinal fluid that exists between the brain and the inside of the skull. The brain often moves in this way as a result of impact to the head. However, rotational acceleration of the brain can occur as a result to impacts to other parts of the body, which in turn cause the head or neck to violently jerk or ‘whiplash’.

Previously it was believed that only head trauma that was sufficient enough to elicit symptoms associated with concussion — such as light sensitivity, headaches, nausea, dizziness, irritability — were responsible for the releases of tau protein. However, evidence from multiple studies now shows that impacts to the head, which do not result in concussion associated symptoms, also cause tau protein releases.

Hague is the second professional MMA fighter to be officially and publicly diagnosed with CTE. The first was former Bellator fighter Jordan Parsons, who died on May 4th, 2016 days after he was struck by a drunk driver at an intersection in Delray Beach, FL.

CTE has been diagnosed in over 50 former NFL players including Junior Seau, Jason Hairston, and Terry Long (all of whom died by suicide). Dozens more former NFL players report experiencing symptoms commonly associated with CTE.

A number of former NHL players have also been official diagnosed with CTE, including Bob Probert, Derek Boogaard, Rick Rypien, and Wade Belak. Rypien and Belak died from suicide.

In professional wrestling Chris Benoit, who died of suicide after killing his wife and son, suffered from CTE. Andrew Martin, who wrestled under the name ‘Test’, was also diagnosed with CTE after he died from what was ruled an accidental overdose. Former ECW wrestlers Axl Rotten and Balls Mahoney were both diagnosed with CTE.

CTE has also been diagnosed in athletes who played professional soccer, rugby, and baseball. CTE was also diagnosed in BMX pioneer Dave Mirra and professional bull rider Ty Pozzobon. Both Mirra and Pozzobon died of suicide.

There is no current cure for CTE. There is also no widely accepted method for diagnosing CTE without a post-mortem autopsy of the brain. In recent months scientists at various institutions have devised methods to isolate potential biomarkers for CTE. Discovering biomakers for CTE may lead to blood tests being devised that could determine the CTE risk factors for an individual as well as whether or not their brain is already exhibiting signs of tau entanglements.