“We concluded there was not a violation of the protocol,” Allen Sills, the NFL’s chief medical officer, said by phone Friday. “But with that being said, the outcome was unacceptable. The player should have been removed from the game. So we modified the protocol to reflect what we’ve learned from this review.”
The NFL and NFLPA, under a policy announced last year, jointly investigate possible violations of the sport’s policies for identifying and dealing with concussions suffered by players. A team is subject to potential disciplinary measures, determined by NFL Commissioner Roger Goodell, if it is determined that a violation of the concussion protocol occurred. The Seattle Seahawks were fined $100,000 last week for a violation of the protocols involving quarterback Russell Wilson during a Nov. 9 game.
In this case, the NFL and NFLPA concluded that the medical personnel complied with the existing protocol in dealing with Savage’s concussion.
Savage was hit as he threw a pass during a Dec. 10 game against the San Francisco 49ers. On television replays, Savage’s hands could be seen shaking as he was on the ground.
Savage was sent to the sideline and was examined in the medical tent there. He was cleared by the unaffiliated neurotrauma consultant to re-enter the game. Savage played one more series before being taken to the locker room for further evaluation and later was ruled out of the game with a concussion.
“The review showed that following a hard tackle, Mr. Savage was immediately removed from the game and evaluated for a concussion,” the NFL and NFLPA said in a joint written statement about their conclusions. “The Unaffiliated Neurotrauma Consultant (‘UNC’) and team physician reviewed the initial broadcast video, saw the play and Mr. Savage’s response and followed the Protocol by performing a complete sideline concussion evaluation on Mr. Savage, which he passed.
“The slow-motion video, which focused more directly on the fencing posture, was not broadcast until after the doctors had begun the sideline evaluation and thus was not seen by the medical staff prior to the evaluation. The Texans medical staff continued to monitor Mr. Savage after the initial evaluation and shortly after his return to the game, identified symptoms that had not been present during the sideline evaluation and took him to the locker room for further evaluation.”
The TV replay that more clearly showed Savage’s reaction to the hit was not available until after Savage’s initial evaluation was underway, according to the league and union.
“The people who were responsible for examining him were examining him,” Thom Mayer, the NFLPA’s medical director, said by phone Friday. “And they were examining him at precisely the time those views came through. The doctor who did the examination did say that had he seen it, he would have removed him from the game … You can say: Was this a weakness [of the protocol]? Maybe. But we hadn’t had the experience before to dictate these changes.”
The statement by the league and union said: “The NFL and NFLPA recognize that Mr. Savage’s return to the game did not reflect the expected outcome of the Protocol. As such, the parties have agreed that no discipline will be assessed, but have already implemented several improvements to the Protocol to prevent such an unacceptable outcome in the future.”
The changes enacted to the concussion protocols, according to the league and union, include having an unaffiliated neurotrauma consultant stationed at the NFL’s offices during games to monitor the broadcasts of all games; immediately removing from a game any player who exhibits signs of “defined impact seizure and fencing responses” as Savage did; requiring a locker room concussion evaluation of any player who stumbles or falls when attempting to stand; requiring any player who undergoes a concussion evaluation on game day to have a followup evaluation the next day; and adding a third unaffiliated neurotrauma consultant to be on hand for post-season games in case one of the two others is occupied with another injured player.
The league and union also reemphasized a change made after the Wilson review: that any player sent to the sideline for a concussion evaluation must be taken directly to a member of the medical staff.
The NFL and NFLPA said they reviewed the changes via conference call with teams’ medical staffs and other medical personnel.
According to Sills, the Wilson and Savage cases are the only formal reviews conducted by the league and union this season of the approximately 560 concussion evaluations performed, although all of the evaluations are reviewed outside the formal process.
“I think the 2017 version of the protocol is the best we’ve had,” Sills said. “But I certainly hope the 2020 version is even better.”