Top medic demands stronger leadership
WORLD Rugby has reacted to renewed medical criticism over the alarming issue of brain injuries by claiming to lead the way in ‘concussion management’.
The governing body issued a statement to The Rugby Paper yesterday in response to demands that they ‘demonstrate strong and clear leadership’ following another highprofile example of an international player being allowed to remain on the pitch in a clearly concussed state.
“Rugby is a recognised leader in sport’s concussion management,’’ says World Rugby. “The Head Injury Assessment has an accuracy of more than 85 per cent in identifying and removing concussions, better than any process in sport.
“While mistakes can sometimes occur in identifying incidents, they are rare in the context of the number of matches. We work hard with our Unions and competitions to make the process the best it can be within the busy match setting.’’
Professor John Fairclough, one of two eminent specialists who wrote an open letter to World Rugby on behalf of the influential lobby group, Progressive Rugby, said: “For the governing body of the sport to suggest that all is well defies belief. It’s unsurprising but quite ridiculous.’’
Professor Fairclough and Professor Bill Ribbans had been provoked into a written protest over Lyon’s failure to withdraw their teenaged Georgian wing Davit Niniashvili following a ‘brutal’ clear-out from Toulon’s Springbok lock Eben Etzebeth during the Challenge Cup final.
“Niniashvili had clearly suffered a traumatic brain injury which under World Rugby’s own protocol demanded his immediate, and permanent, withdrawal. This is not the first such case,’’ said Professor Fairclough.
“Tomas Francis suffered a traumatic brain injury playing for Wales against England at Twickenham in the Six Nations and yet he was unforgivably allowed to return after a Head Injury Assessment. This was found to have been an error and potentially put him at extreme risk.
“That should never have happened. Just a week ago, Niniashvili should have been removed immediately but he was allowed to stumble around the pitch with little idea of what was going on. This was a distressing watch for many.
scious boxer, unable to protect himself and the referee says: ‘Carry on.’ Were Niniashvili and Francis able to defend themselves? No. Therefore both were at risk.
“World Rugby’s answer seems to be that everything is under control when it is quite obviously not. They should be holding their hands up, acknowledging that this must not be allowed to happen and asking: ‘What more can we do to make sure this doesn’t happen again?’’
“They have to demonstrate that player safety is paramount, irrespective of the occasion, who the player is or the importance of the result.’’
The World Rugby statement concludes: “Progressive Rugby is calling for an accountability mechanism within the Head Injury Assessment process. This is already in place as a condition of operating the process in elite rugby.
While it is easy to call for sanctions to individuals, it is more important to learn and act as errors, while rare, are usually not down to one specific action.’’
Professor Fairclough said: “We at Progressive Rugby have welcomed the concern of World Rugby in ensuring a focus on player welfare. But the ongoing spectacle of players incurring traumatic brain injuries with such an obvious failure of medical management represents an existential threat to the game.’’
The Progressive Rugby letter states: “If players are permitted to continue playing despite glaring evidence of traumatic brain injury, it demonstrates a clear failure of the practice of the on-field and off-field assessment and suggests a prioritisation of the game over the players’ well-being.
“It’s past time for niceties. This is too important. It’s time for World Rugby to demonstrate strong and clear leadership for the good of the players and the future of this great game.’’
Progressive Rugby has long pushed for a change to the Graduated Return to Play for elite players. At amateur level, concussed players are stood down for a minimum of 19 days, 23 days at U19 level and below. An elite level players can and do return in just six days, a fact that the group say is a stain on the game.