Keenum's head was slammed to the turf on the Rams' final drive of the team's 16-13 loss to the Baltimore Ravens. He immediately held his head, and then struggled to stand up when a teammate helped him up. Keenum stayed on his knees, and backup quarterback Nick Foles began to warm up on the sideline.
Keenum then walked away from his teammates slowly, and then spoke with Rams trainer Reggie Scott. The game was briefly held up because of a penalty on the Ravens, but Keenum went back to the huddle and stayed in the game after the conversation. His next two plays were an incompletion, and then a lost fumble that ultimately cost the Rams the game.
Rams coach Jeff Fisher tried to clarify the situation at his news conference Monday, saying that a confluence of events led to the mistake of leaving Keenum in the game.
"And then, for whatever reason, we went on with the two plays," Fisher said.
The NFL started a new rule in 2015 in which an "ATC spotter" employed at each game has the power to stop the game if they see any player struggling with a potential concussion.
Fisher said that the spotter did not press the issue because Keenum had spoken with the Rams' trainer and stayed on the field. But Fisher said the game officials were hurrying Rams head trainer Reggie Scott off the field because the next play was going to start. Fisher said that he never saw Keenum struggling, and would have taken him off the field if he saw him injured.
"Reggie went out there to check on our quarterback and then Case said he felt that he was OK and Reggie was told to leave the field. That's what happened. We have some things to work out and we're communicating with the league, Players Association ... and everybody else, so that we ensure that this doesn't happen again.
"...You can not under these circumstances place blame on anybody," Fisher said.
In a statement released Monday, the league said, "Promptly after the conclusion of yesterday's game, we began a review to determine the facts of the injury to St. Louis quarterback Case Keenum and why he was not removed from the game for the necessary evaluation by a team physician or the unaffiliated neuro-trauma consultant as required by our concussion protocols.
"We are continuing that review today, which includes discussions with the Rams and their medical staff, the ATC spotter, the game officials, our medical advisors and the NFLPA. In the meantime, prior to this week's games, we will reinforce with all involved the need to ensure that these injuries are properly identified and addressed in a manner consistent with our protocols."
George Atallah, the NFLPA assistant executive director of external affairs, confirmed Monday the NFLPA is reviewing the concussion protocol in the Keenum incident.
Fisher, also the league's Competition Committee chairman, seemed unaware of Keenum's concussion during his postgame news conference on Sunday. Now Fisher recognizes Keenum is in the concussion protocol and his status for this week is in question.
This figures to be an uncomfortable week for Fisher. The Post-Dispatch wondered aloud about Fisher's job security on Monday morning, and Bernie Miklasz of ESPN101 asked if Fisher could be fined. Keenum, surprisingly elevated to starter over Foles during the week, completed fewer than half of his passes on the way to 136 yards. The Rams blew a 10-point fourth quarter lead to a two-win Ravens team.