The league and union jointly oversee the protocols, and either side can choose to terminate the participation of one of the independent physicians — called unaffiliated neurotrauma counselors or UNCs — involved in the player concussion evaluation process. The NFL did not immediately respond to a request for comment on the NFLPA’s decision on Saturday.
Facing Criticism Dolphins and NFL Defend Decisions on Tua Tagovailoa
Tagovailoa is in NFL protocols for concussion after suffering a head injury during Thursday night’s game in Cincinnati. He hit the back of his head on the turf on a first half sack. Tagovailoa was taken off the field on a stretcher and transported by ambulance to a hospital. He was diagnosed with a concussion, according to the Dolphins. Tagovailoa was released from the University of Cincinnati Medical Center that evening and accompanied the team on the flight back to Miami. He underwent further tests on Friday.
He played in Thursday’s game four days after being cleared by the team doctor and the UNC, as required by protocols, to return to a game Sunday against the Buffalo Bills in Miami Gardens, Fla. The UNC involved in the decision has not been publicly identified.
The joint investigation is still ongoing and the doctors involved have been heard, according to a person familiar with the case. The NFLPA believes that that person has made errors of judgment.
NFL, NFLPA to assess whether concussion protocols were followed with Tua Tagovailoa
“Until we have an objective and validated method of diagnosing brain injury, we must do everything possible, including adjusting protocols, to further reduce the potential for human error,” said former Cleveland Browns center JC Tretter, the NFLPA -President, in a statement Friday. “A failure in medical judgment is a failure of protocol when it comes to the well-being of our players.”
Tagovailoa left Sunday’s first half after being pushed to the ground by a play from Bills linebacker Matt Milano. Tagovailoa got up after the game, but stumbled. He walked off the field with members of the medical staff. But Tagovailoa was cleared and returned to start the second half. He and Dolphins Coach Mike McDaniel said afterwards that Tagovailoa had injured his back, not his head.
The protocols outline a step-by-step process for evaluating a player suspected of having suffered a head injury. A player may return to a match if he has been cleared by both the team doctor and the UNC after several tests. Protocols state that a player should not return to a match if he exhibits “gross motor instability” which is “determined by [the] team physician, in consultation with the UNC, are neurologically caused.”
Tretter said in his statement Friday: “What everyone saw both Sunday and… [Thursday] night were ‘no-go’ symptoms within our concussion protocol. … We need to figure out how and why the decisions were made last Sunday to get a player with a ‘no-go’ symptom back on the pitch.”
The NFLPA exercised its right on Sunday to begin the joint review with the NFL as to whether concussion protocols were being followed properly. The league said on Wednesday that the review was underway, but it had “all indications” that protocols had been followed correctly.
Allen Sills, the NFL’s chief medical officer, said in a televised interview Friday that Tagovailoa underwent a lengthy exam in the locker room last Sunday, the Sports Concussion Assessment Tool (SCAT). After returning to that game, Sills told the league-owned NFL Network, he was assessed daily for a concussion leading up to Thursday’s game.
“It’s something we look at together,” Sills said Friday. “What I can tell you is to reiterate that when a player is evaluated, these evaluations are examined and interviewed in real time by both the team physician and this independent neurospecialist. And those two consult, and they both have to agree together in real time that a player is cleared to return to the game.
It seems likely that even if the joint investigation finds that protocols have not been violated, the league and union will close the loophole, allowing a player with gross motor instability to return to a game if the doctors conclude that it is not neurologically related.
Dolphins Tua Tagovailoa leaves field on stretcher with head injury
“We want to be as transparent and open as possible about this,” Sills said Friday. “We definitely want to learn, improve, get better. …And so if we find that we’re falling short or if we find that there are things that we need to change, then we’ll definitely be on the front line to do that.”
George Atallah, the NFLPA’s assistant executive director of external affairs, said: in a statement Friday: “The whole point of our advocacy for more than a decade on the issue of concussion is to shift the culture of our game from one that was previously focused on the quickest way back to the field, to one that primarily focuses on the care for the player emphasized. .
“When the first set of protocols were implemented in 2011, they were designed with that goal in mind and since then we’ve improved those protocols every year to the point where today’s concussion protocols are much more comprehensive and safer for players than ever before.[.] But they are only effective if the people who use them and make decisions put patient/player care above checkboxes to get someone back to work as quickly as possible.”