Savage concussion getting closer look
NFL, players’ union will review if protocol was properly followed
In an impassioned and detailed breakdown of the events surrounding Texans quarterback Tom Savage suffering a scary concussion and briefly going back into the game Sunday, coach Bill O’Brien was emphatic Monday about one thing.
O’Brien said he never would have allowed Savage to resume playing if he had viewed the viral, disturbing video shown during the game broadcast of Savage lying on the ground in the end zone with his arms and hands twitching after absorbing a crushing blow from San Francisco 49ers outside linebacker Elvis Dumervil. O’Brien extended that opinion of not placing Savage into potential danger to head athletic trainer Geoff Kaplan.
“At no point in time is there anything more important to me than the safety of our players,” O’Brien said. “I love our players and I care about them and I cannot stand when players get injured. With benefit of seeing the video that people are seeing, I would’ve never put him back in the game, but I don’t see that.
“I’m not passing the buck. Anybody that’s been on the sideline of a football game knows that, from a coaching standpoint, you really can’t see things like that, especially when the ball’s in certain areas of the field.”
The NFL and NFL Players Association have launched a joint investigation into if the concussion protocol was handled correctly. There’s no specific timetable for when the investigation would conclude.
During a conference call Monday, NFL spokesman Joe Lockhart said the league and the players’ union will work together to “conduct a thorough review of the incident focused on whether the protocol was properly followed, but we’re also continuing looking at the protocol to look for ways to improve and strengthen it.”
The NFL concussion protocol and the league’s response to head injuries are under major scrutiny again in the wake of the Savage head injury.
The way the protocol works involves a team effort between spotters in the press box, independent neurologist consultants and team medical personnel.
Cleared, then ruled out
Savage went to the sideline under the medical tent after the Dumervil hit, was quickly cleared and then went back in the game for one series. A trainer noticed something wasn’t right with Savage, had him checked again, and he was ruled out for the remainder of the game.
What can be done to upgrade the system to prevent future breakdowns like this one? Well, video isn’t allowed on the sideline for coaches. Coaches just have access to tablets for electronic playbooks.
There has been injury video available on the sidelines for medical personnel, including team and unaffiliated since January 2012, according to the NFL.
Two certified athletic trainers are assigned to a stadium booth with access to multiple views of video and replay. They monitor the game and communicate with team medical staff by radio to make sure that a concussion evaluation is conducted on the sideline. Both spotters file a report of all activity after each game for review by the NFL chief medical officer and NFLPA medical director.
“Obviously, this was more than a standard head injury evaluation,” said Dr. Erin Manning, a neurologist for the Hospital for Special Surgery in New York. “What makes it hard for the physician is they’re doing that evaluation on the sideline fairly quickly. You’re doing it based on what the player is reporting and if you find anything. Sometimes, it’s limited information, sometimes people don’t start showing symptoms until long after they’ve had a head injury. “
That was the case with Savage, whose symptoms didn’t kick in until after the roughly five-minute period between when he went back into the game after being hit by Dumervil.
“The way the system is set up is unfortunate because people can have delayed symptoms and there will be people going back in who have symptoms later and can have delayed systems,” Manning said. “In a way, the system works because they realized something was wrong and took Tom Savage out. That part did work.”
There was a major disconnect between Savage taking the scary hit and being allowed to go back in the game that triggered an outcry on social media and in broadcasting with incorrect speculation that the former Pitt standout had experienced a seizure and was coughing up blood.
“The audience feels like if they can see it at home, why can’t the people on the sideline see it?” Manning said. “It’s hard when you’re standing on the sideline and you can’t see everything on the field. That’s why they put in the spotters to try to eliminate some of that.
“Even then, the spotter isn’t necessarily seeing it. One answer might be to have one person designated on the sideline who can see that video and say, ‘This looked really bad.’ ”
Not a seizure
What did the arm movement mean?
“There’s some abnormal movement, but calling it a seizure is an overreaction,” Manning said. “Part of the reason is people have misconceptions of what a seizure looks like.”
After Savage got hit when the offensive line was overwhelmed by a heavy blitz package, he went to the sideline and got checked out inside a medical tent and was quickly cleared and went back into the game for a three-andout series, during which he threw two incompletions. Savage was later ruled out after being rechecked inside the locker room after initially resisting leaving the game. He seemed fine afterward.
“The medical people on the sideline, they come to me and say, ‘We’re going to check Tom for a concussion,’” O’Brien said. “They take him into the tent, they check him, maybe two, three minutes. They say Tom can play, he’s good to go. So, I make the determination, talk to Tom, ‘Hey, here’s the plays we’re going to go with,’ and we put Tom back out there. After that next series, they came back over to me,‘We’re going to check him again.’ I said, ‘Thanks, OK, great.’ I said to Kap at that point, our trainer, ‘Look, I think we need to check him again.’
“It wasn’t anything I particularly saw on the field, just said, ‘Look, that was a quick check. Let’s continue to check him and make sure Tom Savage is OK.’ They were not satisfied with his answers to the questions they were asking him, and they pulled him from the game.”