MIAMI GARDENS, Fla. (AP) – The NFL and NFL Players Association agreed to modify the league’s concussion protocol following a joint investigation into the league’s procedures after Miami Dolphins quarterback Tua Tagovailoa suffered an injury against the Buffalo Bills last month.
The league and players’ union said in a joint statement Saturday that the outcome of the Tagovailoa case “was not what was intended when the protocol was drafted.” As a result, language addressing balance/stability abnormality was added to the league’s protocol list of symptoms that would prevent a player from returning to action.
In the first half of the Sept. 25 game against Buffalo, Tagovailoa was hit by Bills linebacker Matt Milano, knocking him to the ground. He then appeared disoriented and stumbled as he tried to stand up.
Tagovailoa was immediately taken to the locker room and put through the NFL’s concussion protocol, after which he was cleared of any head injury. He started the third quarter, prompting criticism from spectators as to why he was allowed back into the game.
The NFL and NFLPA said they reviewed the video and jointly interviewed members of the Dolphins’ medical staff, the head athletic trainer, Booth ATC Spotter, the unaffiliated neurotrauma consultant and Tagovailoa.
They found that Tagovailoa showed no signs or symptoms of a concussion during the locker room exam, for the rest of the game or for the week that followed. But immediately after receiving the blow from Milan, there was great motor instability.
After the game, Tagovailoa and Dolphins coach Mike McDaniel said the quarterback had suffered a back injury earlier in the game on a quarterback tackle.
The review said Tagovailoa told medical staff that he aggravated his back injury on the play in question and that his back injury caused him to trip. He also said medical staff determined the gross motor instability was not due to a concussion.
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In their statement Saturday, the NFL and players union said an exam of the QB’s back was not performed during the concussion exam, but “instead was based on the ‘previous examination carried out by other members of the medical staff’. The conclusion then was that the back injury was the cause of Tagovailoa’s instability.
As a result of the joint investigation, the league and union agreed to change the league’s concussion protocol to include the term “ataxia.” In the release, they defined ataxia as “an abnormality of balance/stability, motor coordination, or dysfunctional speech caused by a neurological problem.”
Ataxia replaced the term “gross motor instability” and was added to the list of symptoms that would prohibit a player from returning to the game. The others are confusion, amnesia, and loss of consciousness.
“The protocol exists to establish a high standard of concussion care for each player,” the league and union statement said, “by which all medical professionals commit to a meaningful and rigorous examination of the patent of the player. To that end, the parties remain committed to continuing to evaluate our protocol to ensure that it reflects the conservative approach intended to evaluate patient players for possible head injuries.”
On Oct. 1, the union fired the unaffiliated neurotrauma consultant who handled Tagovailoa’s condition during the game.
Jeff Miller, the NFL’s executive vice president who oversees health and safety, said in a virtual news conference Saturday that he believes it’s the first time a UNC has been fired and that the NFL did not support the decision fire him
Less than a week after the injury, Tagovailoa started against the Cincinnati Bengals in a Thursday night game. He suffered a concussion in the first half after taking a hard sack and showed the fencing response after the scare. He was carted off the field and immediately taken to the hospital. He remains in concussion protocol and will miss Sunday’s game against the Jets.
Dr. Allen Sills, the NFL’s chief medical officer, said that under the league’s amended protocol, Tagovailoa would have been diagnosed with a concussion on Sept. 25 under the term ataxia, making him ineligible to return to this game
Sills said there is no exact timetable for the return of a player diagnosed with a concussion, but it would be “extremely unlikely” that a player diagnosed with ataxia would be able to play Thursday night. The average time with a concussion is nine days, he added.
Sills also alluded to the difficulty of definitively diagnosing concussions. He mentioned that blood and saliva tests could help make concussions more accurate.
Commissioner Roger Goodell said Saturday at a fan forum in London that the NFL will make a “change or two” to its concussion protocol.
McDaniel, asked repeatedly in the days after the incident about the decision to allow Tagovailoa to return, emphasized his confidence in the team’s handling of the situation.
“This is a player-friendly organization that I’ve been very clear from the beginning,” McDaniel said last week, “that my job as a coach is here for the players. I take that very seriously, and nobody else building moves away from that.”
