Clearing the Panthers of any wrongdoing, the NFL announced in a Wednesday statement that "Newton was properly evaluated for a concussion in the sideline medical tent and did not sustain a concussion."
The NFL and NFLPA deemed that Newton "did not display 'gross motor instability,' which would have necessitated a locker room evaluation."
"The medical facts are clear and straight forward. Mr. Newton had an injury to his eye, which is very clear in the video and he complained of that at impact. He testified to that and so did the medical staff," Dr. Allen Sills, the NFL's chief medical officer, told NFL Network Insider Ian Rapoport on Wednesday.
"He started jogging, displayed no gross motor issues, was instructed by the coaches on the sidelines to take [a knee], and he was told that through the communication in his helmet, as well. You can see people pointing to the ground, to go to the ground, so he could be evaluated and so his backup could warmup."
Per the investigation, when "Newton elected to 'take a knee' while coming off the field, he did so in an awkward fashion because he could not bend his right knee normally."
"He had an MRI a day later and it showed substantial damage and a lot of swelling, that's the reason he can't fully bend it as he goes to the ground," Sills told Rapoport. "Those are the medical facts -- he showed no gross motor problem, at no time did he complain of concussion symptoms, I would say the medical staff was being thorough by doing the evaluation. And also, the coaches stayed out of the decision, they simply handed him over to the medical staff."
The Panthers announced Wednesday that Newton will not require knee surgery. The NFL concluded that Carolina's medical team "acted with an abundance of caution."
"This points out something important that armchair doctors at home cannot make a concussion diagnosis on video alone," Sills told Rapoport. "There are two things that allow concussion diagnosis based on video -- a seizure on the field or the so-called fencing posture. If you don't have that, you cannot say with any certainty that he had a concussion. ... I think this shows how irresponsible people can be in offering an opinion without the facts. People are quick to jump on social media and make a diagnosis without the facts. And some people aren't even medically trained. We think that's reckless and irresponsible."
The league revamped the concussion protocol after Houston quarterback Tom Savage was examined for a concussion and cleared to return during a Week 14 game against the 49ers. The Texans were cleared of any wrongdoing, but the NFL-NFLPA review concluded that "further improvements in the protocol are necessary."
The improvements included:
» Implementation of a pilot program utilizing a centralized UNC based at the league office to monitor the broadcast feeds of all games. The UNC will contact the team medical staff on the sideline should they observe any signs or symptoms warranting further evaluation.
» Defined impact seizure and fencing responses as independent signs of potential loss of consciousness, representing "No-Go" criteria under the current Protocol. Players who display either of these signs at any time shall be removed from play and may not return to the game.
» Requiring locker room concussion evaluation for all players demonstrating gross or sustained vertical instability (e.g., stumbling or falling to the ground when trying to stand).
» Officials, teammates, and coaching staffs have been instructed to take an injured player directly to a member of the medical team for appropriate evaluation, including a concussion assessment, if warranted.
» Requiring all players who undergo any concussion evaluation on game day to have a follow-up evaluation conducted the following day by a member of the medical staff.
» A third UNC to all playoff games and the Super Bowl to serve as a backup who can step in immediately should one of the original two UNCs be absent from the sideline for a time to attend to a more severely injured player.
The NFL has made 47 rule changes since 2002 to protect players, improve practice methods, better educate players and personnel on concussions and strengthen the league's medical protocols. The NFL deploys 29 medical professionals on the sidelines for each game. Working with the NFLPA, the league enforces a concussion protocol for players that has been instrumental in immediately identifying and diagnosing concussions and other head-related injuries.