Ethiopian marathon runner Ruti Aga has been banned for a total of six years after testing positive for a prohibited substance and submitting a fake prescription from a nonexistent clinic to explain the result, the Athletics Integrity Unit said.

The 32-year-old former Tokyo Marathon champion received a two-year suspension for the presence and use of methylprednisolone and another four years for tampering with the anti-doping process. The AIU announced the sanctions Oct. 22. “Aga received a two-year sanction for the Presence/Use of a Specified Substance and four years for Tampering,” the AIU statement revealed.

Aga tested positive after winning the Meishan Renshou Half Marathon in China on March 15. Investigators subsequently found that the prescription she provided had been issued by a family member who had no medical registration with the relevant authority, according to the AIU release.

How the Ruti Aga prescription investigation unfolded

Aga attributed the positive test to treatment for a knee injury. But the clinic named on the prescription did not exist, the AIU said.

When questioned, the family member claimed to have used an old prescription pad from a former workplace. That clinic told investigators the individual had never worked there and the prescription was not its own, according to the AIU.

The investigation, supported by the Ethiopian Anti-Doping Authority, established that the document was forged, the unit said.

Investigators also found that Aga provided false information during an April 21 interview with AIU representatives. On May 4, she produced what the AIU described as a “forged/manipulated document” purporting to verify her prescription as an outpatient at a medical facility.

Aga did not respond to the charges, and the sanction was imposed without a hearing, according to The Associated Press.

Why the ban totals six years

The positive test resulted in violations of anti-doping rules covering the presence and use of a prohibited substance. Methylprednisolone belongs to the glucocorticoid class on the World Anti-Doping Agency’s prohibited list, the AIU said in its release.

The separate tampering violation accounted for four years of the combined six-year sanction — twice the penalty imposed for the prohibited-substance violations.

“We have made significant progress against doping in marathon running over the past six to seven years, but much remains to be done. Investigations are vital to uncovering doping and exposing false explanations. Protecting clean competition takes resources, but this case sends a clear message: attempts to cheat will be exposed,” said Chief Executive of the AIU, Brett Clothier.

Former Tokyo Marathon champion

Aga won the 2019 Tokyo Marathon and had recorded six top-four finishes at World Marathon Majors events. She’s currently ranked 32nd in the world, according to her World Athletics profile.

The Ethiopian also won the two most recent editions of the Xiamen Marathon before the sanction was announced.