MIAMI GARDENS, Fla. (AP) – The NFL and NFL Players Association have agreed to make changes to the league’s concussion protocol following a joint investigation into the procedures after Miami Dolphins quarterback Tua Tagovailoa suffered what was described as a back injury. against the Buffalo Bills last month.
The league and the players’ union said in a joint statement Saturday that while the Dolphins followed protocol after the injury, the outcome of Tagovailoa’s case “was not what was intended when the Protocol was drafted.” As a result, language addressing a balance/stability anomaly was added to the league’s protocol a list of symptoms that would prevent a player from returning to the game.
In the first half on Sept. 25 against Buffalo, Tagovailoa took a hit from Bills linebacker Matt Milano that sent him crashing to the ground. He seemed confused afterwards and stumbled as he tried to get up.
Tagovailoa was immediately taken to the locker room and to go through the NFL’s concussion protocol, after which he was cleared of any head injury. He started the third quarter, drawing widespread criticism as to why he was allowed to return to the game.
The NFL and NFLPA said they reviewed video and jointly interviewed members of the Dolphins’ medical staff, the head athletic trainer, the Booth ATC Spotter, the now-defunct Unaffiliated Neurotrauma Consultant and Tagovailoa.
Tagovailoa showed no signs or symptoms of a concussion during the locker room exam, the rest of the game or the following week, the league and union said. But right after he took the hit from Milan, gross engine instability was present as Tagovailoa was visibly confused.
After the game, Tagovailoa and Dolphins coach Mike McDaniel said the player suffered a back injury earlier in the contest during a quarterback sneak.
The investigation found that Tagovailoa told the medical staff that he aggravated his back injury when he was hit by Milan and that his back injury caused him to trip. The review also said the medical staff determined the gross motor instability was not due to a concussion.
In their statement Saturday, the NFL and the players’ union said there was no examination of the QB’s back during the concussion check, but medical personnel “instead relied on the earlier examination performed by other members of the medical staff. ” The conclusion then was that the back injury was the reason for Tagovailoa’s instability.
As a result of the joint investigation, the league and union agreed to amend the league’s concussion protocol to include the term “ataxia.” In the statement, ataxia is defined as “an abnormality of balance/stability, motor coordination or dysfunctional speech caused by a neurological issue.”
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 other symptoms 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 each medical professional engages in a meaningful and rigorous examination of the player’s patent. To that end, the parties remain committed continue to evaluate our Protocol to ensure it reflects the intended conservative approach to evaluating player-patients for potential head injuries.”
On October 1, the union fired the Unaffiliated Neurotrauma Consultant who handled the situation of Tagovailoa during the game.
Jeff Miller, the NFL’s executive vice president overseeing health and safety, said in a virtual news conference Saturday that he believes this is the first time UNC has been fired, and that the NFL did not support the decision to 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 exhibited the fencing response after the scary blow. He was pulled from the field and immediately taken to the hospital. He remains in the concussion protocol and will miss Sunday’s game against the Jets.
Dr. Allen Sills, the NFL’s Chief Medical Officer, said with the league’s changed protocol, Tagovailoa would have been diagnosed with a concussion on Sept. 25 under the ataxia period, thus making him ineligible to return to that game.
Sills said there is no exact timetable for a return for a player diagnosed with a concussion, but it would be “extremely unlikely” for a player diagnosed with ataxia to be able to play Thursday night. The average time out with a concussion is nine days, he added.
Sills also alluded to how difficult it is to definitively diagnose concussions. He mentioned that blood and saliva tests could help make concussion screenings more accurate.
Commissioner Roger Goodell said at a fan forum in London Saturday that the NFL will make a “change or two” to its concussion protocol.
McDaniel, asked several times 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 in the building deviates from that.”
More AP NFL coverage: and