With the prevention, recognition and treatment of concussions re-entering the national spotlight a few weeks ago, NFL Commissioner Roger Goodell was asked about the breakdowns and issues associated with the Case Keenum situation back in late November on SiriusXM NFL Radio's "Opening Drive" program Friday morning.
In the fourth quarter of a Ravens-Rams game on Nov. 22, Keenum clearly sustained a head injury on the field and struggled to get up off the turf after his head hit the ground. He remained in the game, though, and gave up a fumble that cost the Rams the game.
"For clarity, we have the spotter upstairs that is a former athletic trainer and their job is, if they see a player that's in some type of distress, is to buzz down," Goodell said. "In the Case Keenum case, it was clear that there was somebody giving him medical attention and that that was already done. The problem we had was that the appropriate medical attention wasn't given and there were several gates that, frankly, failed and didn't do the right things for our protocol. So we're trying to make changes to that."
He added: "We're going to continue to tweak that until we get it right and try to prevent ... make sure the game is stopped so the player has the right medical attention. That's always the issue. The independent neurologist is involved and will be always be involved once the player comes to the sideline."
Goodell emphasized that the failure in Keenum's case does not rest with the certified athletic training spotter. The spotter's job is only to alert the medical personnel on the field to any potential issues.
"He should have been removed from the play, but it wasn't the ATC spotter," Goodell said. "The ATC spotter is just to make sure the medical personnel sees (these) individuals ... We did not want the ATC spotter, making some type of evaluation from the top of a stadium.
"What we want to do is make sure the ATC spotter is alerting medical personnel on the field when there is an issue and some player is either in distress, disoriented, or something that we think requires medical attention. And in that case, they go to the sideline and the proper medical people go through the protocol, and that's doctors as well as trainers and the independent neurologists."
The issue with Keenum stood in contrast with a later situation involving Steelers quarterback Ben Roethlisberger, who ended up exiting a game against the Seahawks with self-reported concussion symptoms. Roethlisberger went on to extol the league's process, though there was some concern that the symptoms had to be self-reported.
Roethlisberger encouraged all players to be open and honest with the training staff. The league, in a joint venture with the NFL Players Association, recently issued an anonymous survey on player safety and health processes to every player in football in an effort to improve conditions.