The oldest horse in the race, Ball Four, pulled a major upset in Keeneland's closing-day feature, the $150,000, Grade III Fayette Stakes.
The 7-year-old gelding took the lead at the start of the 11⁄8-mile race and never relinquished it while cruising to a 1¼-length victory under jockey Julio Garcia. He ran the distance in 1:48.37.
"It was my idea to go right to the front," Garcia said. "I know the horse goes better when he's in front. On the backside, I was very relaxed. I hit him only one time at the eighth pole. He's a good horse."
Dominican, the upset winner of the 2007 Toyota Blue Grass Stakes, closed strong to finish second, 1¼ lengths in front of third-place Stream Cat. Mambo in Seattle, runner-up in the Travers Stakes and the 6-5 favorite, never threatened and finished seventh in the 11-horse field.
Dr. Pleasure, who pressed the leader to the top of the stretch, clipped heels with Secret Getaway and fell at the three-sixteenths pole, throwing jockey Otto Thorwarth to the track.
Thorwarth was removed from the track on a stretcher. Medical personnel reported that he was awake, alert and stable before sending him to the University of Kentucky Medical Center.
Dr. Pleasure apparently did not suffer serious injury and walked off the track.
Ball Four had only one start — an eighth-place finish in the Marfa Stakes on Sept. 13 at Turfway Park — in more than a year prior to the Fayette.
Ball Four, a 21-1 outsider trained by Derek Galvin, won for the sixth time in 22 career starts and increased his earnings to $609,520.