The boxing world was shaken last week when two Japanese boxers competing on the same card both tragically passed away from traumatic brain injuries. Dr. Brian Sutterer is a medical professional who analyzes sports injuries. He recently provided crucial insight into what happened and what could potentially be improved for future fighter safety in a recent YouTube video.
Both Shigetoshi Kotari and Hiomasa Urakawa were diagnosed with subdural hematomas. It is a type of brain bleed that occurs when bridging veins beneath the skull’s protective dura layer tear due to rotational forces from repetitive head trauma. This causes blood to accumulate around the brain, creating dangerous pressure that can lead to brain herniation and death if not treated immediately.
Dr. Sutterer emphasized that having two such incidents on one card was extraordinarily rare – “like lightning striking twice.” After reviewing available match footage, he found no obvious signs that either boxer appeared severely compromised during competition. Kotari, in particular, seemed alert and responsive even while walking out of the arena after his bout.
The critical issue appears to have emerged in the post-match medical response. According to social media posts from what Dr. Sutterer believes was Kotari’s brother, the boxer began complaining of head and eye pain in the medical room – early warning signs of a developing brain bleed. However, there were significant delays in emergency response.
The account describes a concerning 40-minute wait for ambulance arrival, with additional complications when emergency personnel couldn’t use the elevator and had to carry the unconscious fighter down stairs. Dr. Sutterer noted that at one point, an AED defibrillator was used, suggesting the fighter boxer have gone into cardiac arrest – a sign of severe brain herniation.
“When somebody’s had a subdural hematoma, everything is down to the minute to the second in terms of urgency to get that pressure off of the brain,” Dr. Sutterer explained. The emergency required immediate surgical intervention through a craniotomy to relieve brain pressure and prevent further tissue death.
The Japanese Boxing Commission has responded by reducing championship rounds from 12 to 10, but Dr. Sutterer believes this change won’t significantly impact safety since a single punch can cause such injuries. Instead, he advocates for comprehensive reviews of emergency action protocols at boxing venues worldwide.
Dr. Sutterer stressed that every venue should have detailed emergency plans specifying who calls ambulances, optimal hospital routes, and equipment access. Many venues may have only one on-site ambulance, leaving gaps in coverage when the first emergency occurs.
