The NFL and NFLPA have conducted reviews of the application of the Concussion Protocol in the September 8th Panthers-Broncos game and have determined the following. In the fourth quarter, Mr. Newton incurred a helmet-to-helmet hit which drew a penalty. Mr. Newton was slow to get up following that hit. The Panthers medical staff and the Unaffiliated Neuro-trauma Consultant (UNC) were positioned together on the sidelines monitoring the game and were unable to see the point of contact and decided to review the play via the sideline video replay system. In order to facilitate the video review, the team physician and UNC initiated radio contact with the Booth ATC and asked to view the video. Under the current application of the Protocol, once contact between the Booth ATC and the club's medical team occurs, the Booth ATC's responsibilities end (including the ability to call a medical time out). The time it took to actually receive the video following this request was prolonged due to a technology glitch. After reviewing the replay and observing Mr. Newton from the sideline, the Panthers' medical staff and the UNC agreed that no further evaluation of Mr. Newton was necessary as they did not observe signs or symptoms of concussion.
The parties also conducted a review of the application of the Protocol in the September 15th Bills-Jets game. That review showed Bills quarterback Tyrod Taylor sustain a big hit that included helmet-to-helmet contact. Mr. Taylor seemed to be unsteady on his feet. Prior to any actions by the club physician, Booth ATC Spotter and/or UNC, referee Ed Hochuli directed Mr. Taylor to the sideline for the required sideline examination. The club medical team and UNC reviewed the video and conducted the required examination, cleared Mr. Taylor and returned him to the game.
Collaboration between the Team Physician and the UNC, who is jointly appointed by the parties, is a critical aspect of the Concussion Protocol and therefore bears emphasis. In both instances, the reviews of the NFL and NFLPA determined that the club physicians and UNCs worked closely together to review the plays at issue and jointly made medical determinations regarding evaluation and diagnosis; in each instance, the medical determination made revealed that neither player had sustained a concussion. The Team Physicians and UNCs involved in each instance worked closely together to provide medical care for the players involved and their team work should be emulated across the League. Similarly, Mr. Hochuli's decision to send Mr. Taylor to the sideline for evaluation after spotting an observable sign of possible concussion, demonstrates a conservative and therefore appropriate application of the Concussion Protocol.
The NFL and NFLPA, in conjunction with our medical advisors and the NFL Physicians Society, have also taken several steps to further clarify and enhance the Concussion Protocol in an effort to ensure that it is being applied uniformly in all NFL games and that everyone involved in its application understands their roles and responsibilities. Some of the agreed upon enhancements are set forth below.
The Concussion Protocol has been adopted by the parties in order to establish a conservative standard of care and ensure that competitive considerations do not influence healthcare outcomes. The objective of this Protocol is to provide medical staffs responsible for the care of NFL players with a standardized process for identifying and managing potential concussion. The parties recognize that concussion diagnosis and management is often a difficult and complex exercise, compounded by hectic game conditions. Accurate diagnosis and management of concussion requires experienced physicians coordinating with others on the sideline and within the field of play, each acutely aware of his or her responsibilities and all committed to the strict application of the policies implemented in order to protect players.
2016 CONCUSSION PROTOCOL ENHANCEMENTS
- Concussion Protocol to require the Booth ATC Spotter to remain in contact with the club medical team and provide video support until the medical team confirms that a concussion evaluation has occurred;
- The NFL Head, Neck and Spine Committee, together with the NFLPA Medical Director will conduct a conference call with all UNCs to review changes to the Concussion Protocol;
- The NFL, in consultation with the NFLPA, will use Referee Ed Hochuli's actions in Buffalo as an example of the appropriate application of the Concussion Protocol and proactive officiating in this realm as part of its continuing training of game officials;
- The NFL and NFLPA are reviewing the merits of supplementing the Booth ATC program with a Booth UNC program as part of their continuing evaluation of the Protocol to ensure the best possible care of our players.