Ultimately, Ramirez was brought down by his own private medical records -- records that the Major League Baseball Players' Association turned over on his behalf, as required under the sport's Joint Drug Prevention and Treatment Program.
The Ramirez saga, as described by three sources with direct knowledge of the case, began to play out in spring training when the 36-year-old outfielder provided a urine sample for testing.
The test came back showing elevated levels of testosterone. Every individual naturally produces testosterone and a substance called epitestosterone, typically at a ratio of 1:1. In Major League Baseball, if the ratio comes in at 4:1 during testing, a player is flagged. In Ramirez's case, his ratio was between 4:1 and 10:1, according to one source.
Within the records was a prescription written for the drug human chorionic gonadotrophin (hCG) -- No. 55 on the list of banned performance-enhancing substances in the policy. The drug is mainly used for female fertility issues, but it is best known among male steroid users as a substance that can help kick-start the body's production of natural testosterone, which is stymied when using synthetic testosterone (aka steroids).