The first fight of the night on Saturday at Romulo Lobo’s Remulus Fight in Manaus, Brazil ended in tragedy. Amateur bantamweight Mateus Fernandes, 22, lost to Obed Pereira via TKO in Round 3, after having been dropped by a flurry and hit one more time on the ground.

Fernandes was conscious when the fight ended, but appear to pass out moments after the stoppage. A doctor checked on him and Fernandes was transported to the hospital, where he suffered multiple heart attacks before dying at 11:45 p.m. local time. He died hours later.

The final moments of the fight can be seen below in footage from M2 News.

The event sanctioned by the Amazonas Athletic Commission (CAMMA). As the bout was amateur, medical clearance was minimal, requiring HIV and Heo B C, but not a brain scan or heart test. This is the norm in many areas.

Circumstances behind the death are unusual.

The deceased fights out of Formando Campeoes, a social project that helps people with drug addiction through martial arts. A spokesperson for the project told Guilherme Cruz for MMA Fighting that the coroners’ report identified the cause of death as drugs, not head trauma associated with the fight.

He did exams on Friday and was clean, but ex-students told us later that he spent the night using drugs, said Project coordinator Vanderluce Cantuarias, wife of coach Valmir Dieb. He didn’t appear to have used anything. He was sweating a lot, but that is common, the adrenaline of the fight. He did great in the first couple of rounds, but was rocked in the third round and went down, and then he started having seizures caused by the drugs.

CAMMA president Wallace Alves expressed his grief.

I’m feeling numb right now, really upset, he said. He was rushed to the hospital and had his eyes open the entire time. He was dizzy, but still awake. He was examined in the hospital and then suffered the first heart failure. They tried to save him for two hours, but he ended up dying.

Further details will undoubtedly be coming over the next several days

DEATHS IN MMA

Mixed martial arts is a combat sport and combat sports can be dangerous, even when reasonable precautions have been taken. Our hearts go out to the family, team, and friends of Joao Carvalho.

Every death of an athlete is an extraordinary tragedy. And too, the danger in mixed martial arts has to be viewed within the larger context of death in sports.

American high school football is dangerous. Eleven high school football players died in 2015 alone. Seven athletes have died from injuries sustained while competing in the Olympics – one runner, one cyclist, a boxer, one speed skater, one downhill skier, and two lugers.

Boxing has recorded nearly 1,500 deaths since its inception in the 1700s. Auto racing has killed countess drivers, and spectators are not immune. A single accident in 1955 killed approximately 60 spectators, and the driver. 110 school children in Japan died playing Judo in the last 30 years, and hundreds have suffered catastrophic injury.

28 people are believed to have died running, in marathons alone, in the USA alone, from 2000-2009. In 2005, four runners died, in a single event, the Great North Run half marathon in the UK.

Cheerleading in the USA killed 42 between the fall of 1982 and the spring of 2007.

Mixed martial arts is not immune. Fourteen people are now believed to have died during or shortly after MMA competitions from 1993 to the present.

Douglas Dedge • March 16, 1998 • Kiev, Ukraine • Unregulated • Chief emergency room doctor attributed death to severe brain injuries. • First MMA death in the modern era. • Dedge is reported to have passed out in training previous to the fight, and is believed to have had a preexisting medical condition.

Korean identified only as Lee • May 12, 2005 • Samsong-dong, South Korea • Entirely unregulated bout took place in a bar. • Cause of death was heart attack.

Sam Vasquez • October 20, 2007 • Houston Texas • Cause of death was subdural hemorrhage due to blunt trauma of the head, following a KO loss in the third round • First death in a sanctioned MMA event.

Michael Kirkham • June 26, 2010 • Aiken, South Carolina • Regulated bout • Cause of death was subarachnoid hemorrhage of the brain • Kirkham lost his previous fight on April 24 by TKO; Dr. Joe Estwanik believes this could have been second-impact syndrome.

Mike Mittelmeier • April 27, 2012 • Bolivia • Unregulated bout allowing face kicks to grounded opponent; there was no ambulance standing by. • Mittlemeier got kicked in the head while attempting a leg lock, illegal under the Unified Rules. • Cause of death was cerebral hemorrhage.

Dustin Jenson • May 24, 2012 • Rapid City, South Dakota • Unregulated bout • Jenson tapped without appearing to take any severe blows. • Cause of death was subdural hemorrhage resulting from blunt force trauma to the head.

Tyrone Mims • August 11, 2012 • Mount Pleasant, South Carolina • Regulated bout • Autopsy results were inconclusive, with no evidence of a concussion or brain trauma detected, no drugs or alcohol detected by toxicology tests. (Mims) might have had an irregular heart because of some electrical dysfunction, said Coroner Rae Wooten. That obviously isn’t seen after death. Once that’s completed, there’s no evidence of that…. There’s just nothing here that explains his death.

Felix Elochukwu Nchikwo, fought under the name Felix Pablo Elochukwu • April 7th, 2013 • Port Huron, Michigan • Unregulated bout • According to the Michigan coroner’s office, there is no evidence that the fighter died from trauma he sustained during an unregulated mixed martial arts match.

Booto Guylain • 24 June 1984 – 5 March 2014 • Johannesburg, South Africa • Unregulated bout • Death was a result of complications related to the swelling of the brain.

Ramin Zeynalov • 29 March 2015 • Azerbaijan • Unregulated bout • Death was a result of brain hemorrhage.

Joao Carvalho • 13 April 2016 • Dublin, Ireland • Unregulated bout • Death was a result of brain hemorrhage.

Donshay White • 25 July 2017 • Louisville, Kentucky • Unregulated but sanctioned responsibly • In the middle of the fight, fighter had a “cardiac event” linked to hypertensive/atherosclerotic cardiovascular disease. 

Rondel Clark • 15 August 2017 • Plymouth, Massachusetts • Regulated bout • Fighter died three days after collapsing on 8/12 in a fight; death has been attributed to an extreme weight cut.

Mateus Fernandes • 30 March 2019 • Manaus, Brazil • Sanctioned bout • Cause of death reportedly due to recreational drug use.

There are going to be more deaths in mixed martial arts.

MMA competition can, like countless other sports, lead to fatality. As such, safety precautions must be adhered to rigorously. There will undoubtedly be an investigation, that can come to a conclusive investigation, but at the outset, it can be said that TEF appeared to be promoting responsibly in terms of fighter safety.

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