A bloodied Art Santore lost to Ivan Salaverry in a World Fighting Alliance fight on July 22 in Los Angeles. Photo by The Associated Press.

The men who love mixed martial arts the most are the ones who also say that tragedy is an inevitability.

There has only been one verified death in mixed martial arts competition, which occurred on March 18, 1998, in Kiev, Ukraine.

After he had been stopped in a March 16, 1998, bout with Yevgeni Zolotarev, American Douglas Dedge fell over in the ring and died of brain injuries two days later.

Dedge's death remains the only fatality directly attributable to competition in an MMA event, though there have been unconfirmed reports that Dedge had a pre-existing medical condition.

T. Jay Thompson, a successful promoter in Hawaii, believes another death is inevitable.

"MMA is a very safe sport relative to other combat sports," Thompson said. "But, of course it's inevitable. It's a combat sport and when highly skilled men fight, sometimes something bad happens.

"We only have one verified death, but there isn't a fair sample size. The sport's only been around for 12, 15 years. I just hope the sport is really entrenched when it does happen, because will there ever be hell to pay when that happens."

Dana White, the president of the Ultimate Fighting Championship, said he dreads the day one of his fighters dies. But he said that despite its reputation as barely controlled mayhem, mixed martial arts fights are safer than boxing.

Because an MMA fight is an amalgamation of styles, one man isn't continually punching at the other, as in boxing, White said.

There are far fewer blows to the head and that reduces the risk of injury substantially, he said. It doesn't, however, eliminate it.

"In any kind of sports competition, whether it's football, basketball, baseball, auto racing, whatever, there is a risk of serious injury or death," White said. "We have better numbers when it comes to that than those sports do. One (death) is too many, but let's be honest: We're not going to completely prevent it.

"We do everything we can to make the fights as safe as possible, but it's always a possibility."

The Journal of Combative Sport reported that as of April, there have been 1,326 deaths related to boxing. There were two in Nevada in 2005, prompting the Nevada Athletic Commission to form a Boxer Health & Safety Panel.

Keith Kizer, the commission's executive director, said he is pleased with the commission's safety rules. New Jersey's State Athletic Control Board adopted mixed martial arts regulations on April 3, 2001, and Nevada ratified the same standards on July 23, 2001.

California actually had agreed upon a set of rules before New Jersey, but the rules weren't implemented at the time because of budget problems. California subsequently didn't sanction mixed martial arts fights until earlier this year.

"The rules have worked out well," said Kizer, who expressed mild concern about cuts caused by elbow strikes. "I don't see anything now that is a glaring issue."

Perhaps the biggest issue facing mixed martial arts from a regulatory standpoint is steroid usage. Of the 11 positive tests for steroids in Nevada, nine of the positives have been from mixed martial artists.

Kizer said he has begun more aggressive testing, including unannounced tests while fighters are in camp preparing for a bout.

White said flatly, "No," when asked if the sport has a steroid problem.

"As a company, we don't condone it, but I also don't think this is some kind of rampant problem," White said.