NFLPA investigating handling of Dolphins QB Tagovailoa’s concussion check

[Soko]

45 minutes ago, Nabbs4u said:

Then your problem should be with the NFL, it's protocol and whichever "doctors" weren't smart enough to diagnose what you and others assume to be the case. Neither on that Sunday and or the 4 days leading up to the TNF game.

It is, partly. 

It’s also with McDaniel, because he has the authority and the responsibility to protect his players, even from themselves. Again, if this were something that you could guarantee (or virtually guarantee, like a blood test), then it would have to be 100% on the medical staff. But that’s not the case with concussions. You had Tua displaying obvious symptoms. You have a short week. You do the smart thing, the right thing, the safe thing - you sit him.

45 minutes ago, Nabbs4u said:

Curious, given the massive trauma's (plural) Tua obviously endured. Is it normal for any Hospital to release said individuals in order to Fly home on a plane just mere hrs later? 

I mean they too had to be aware of both incidents, No? Honest question.

I have no idea, I don’t recall reading on the hospital stays of other players (sort of remember Shazier’s but obviously a different circumstance, ironically on the same field). I don’t think that was a smart decision either, but obviously a less potentially harmful one than letting a concussed player play in a football game.

[Soko]

24 minutes ago, Kip Smithers said:

How the heck is that a strawman? You just said “we can’t diagnose just by viewing” then in literally the next sentence say “sometimes it’s obvious” lol. If that’s not definitive then I don’t know what it is.

Is it that hard for you? 

- guy takes a hard hit to the head. Gets up, jogs off the field. Is he displaying any obvious concussion signs? No. Later gets checked out, turns out, they think he has a concussion. Thanks, doctors.

- guy takes a hard hit to the head. Can’t walk on his own. Stumbles. Is shaking his head at nothing. Needs assistance off the field. Is he displaying obvious concussion signs? Yes. Does he pass protocol? Also yes. Well, he was still clearly displaying some very dangerous symptoms, so even though the medical staff is clearing him to play, I (the HC) am going to protect my player’s health and approach this cautiously. Thanks anyway, doctors.

Somehow you take that stance as “well why even have doctors then”. So maybe I credit you too much, maybe it’s not a straw man and you just…can’t grasp how amazingly simple the point is. 

24 minutes ago, Kip Smithers said:

So what if that’s what people say. Doctors saw what we all saw and evaluated him. Like I said if we are always gonna go by what we see on the field then remove the protocols all together. What’s the actual point?

Ohhhh, right. “Always go by what we see on the field”. Because…that’s what everyone’s saying…

24 minutes ago, Kip Smithers said:

The only way in which McDaniel would deserve heat and accountability is if he somehow coerced the doctors to put Tua back in the game. Which would mean he would have to undermined a team employee and a league employee. 

Another simple concept for you: McDaniel has the duty, authority, and responsibility to protect his players. Diagnosing concussions is not an exact science. There’s no test that’ll tell you “this person 100% does not have a concussion”. You saw the guy wobbling, shaking, unable to walk. You have a short week. You err on the side of caution and protect your player. The downside is you might lose a football game (that they lost anyway). The upside is you protect a human being from long term brain damage. Yes, there are always risks, but there are times when the risks are severely heightened - like Thursday night. Seems like an easy choice with a little common sense, but I guess this thread shows sense ain’t always common.

Indulge me for a second. Let’s say you’re at your elementary school aged kid’s football game. You’re watching from the stands. He takes a hard hit to the head. He gets up slowly. He reaches up, clutches his head, and “clears the cobwebs”. He tries to slowly wobble off the field before a team mate catches him. So you’re concerned, you’re even scared, you run down to the field. Lo and behold, there’s a doctor nearby because your kid plays in the rich kid’s league. He’s a head doctor because, you’re lucky. He checks out your son and says “he passes concussion protocol, the non-definitive test says his head is fine”. You look at your kid and he says he wants to play. Does anyone here let their son finish that game????

The obvious retort is that Tua is an adult and McDaniel isn’t his freakin’ dad, but it’s still McDaniel’s job to protect his guys from themselves and he has every right to pull someone from a game if he thinks their health is in jeopardy.

[kingseanjohn]

3 hours ago, Nabbs4u said:

I'm seeing a lot of assumptions based off non medical personnel people having opinions. It doesn't matter what you believe to of occured. 

I'm not a doctor, nor do I have a PhD -- yet... if I ever get off my ***...

But I am currently certified with the Red Cross for first aid, DOD for TCCC, as well as certified in a few other related subjects. It was clear as day that he wasn't right and that it was a brain injury of some form. In no way should he have been allowed back into the Bills game, let alone playing the Dolphins game. It's been said ad nauseam that a player sometimes needs to be protected from themselves. The Dolphins and the league have failed Tua. Tua flying home the same night with the team and watching a movie on the way is a further proof of that. Quite frankly, it's embarrassing that this is happening in a multi-billion dollar company.

[Hunter2_1]

19 hours ago, dll2000 said:

I would say the video evidence is overwhelming that he was concussed first time.

The safety is relative and the danger is always real. 

But had they followed their own rules, pulled him and then made him sit for a handful of weeks his brain heals and he is in far, far less danger from second impact.

There is NO excuse for what happened.  He should have been pulled from first game following hit and no way he should have played on Thurs.

All this talk of ending game is unnecessary IMO.   It is in inherently dangerous game, but the risk is not so extreme it requires banning the sport.   

The risks can be mitigated a great deal IF you follow common sense procedures in place.   Dolphins and NFL didn't do it.

Tua has a large law suit IMO if he wants it.

 

 

 

I think it’s obvious he was concussed, yeah. Agree with the above 100%

[sammymvpknight]

I do sports med…know tons of sports med docs. Not a single one of them would have returned Tua after the first head injury. 
 

concussion testing was never intended to be a definitive determination of whether a player can return after a head injury  it’s used as a tool in borderline cases.

Ex 1. Player takes a hard hit and sees stars or lose their breath momentarily  but otherwise they are themselves and have normal neurological function through the process. They have a normal neuro exam This is a great case to use concussion testing, which compares mental faculties to that players preinjury baseline  

Ex 2 (Tua part 1). Player takes a big hit by striking the back of his head on the turf in a wipelash fashion. Player holds his heads multiple times, shakes out the cobwebs multiple times, his legs go limp on his teammates must support him to stand and walk. The player has clear neurological impair and symptoms fitting with a concussion. A back injury cannot explain any of those symptoms. Absolutely, he can also have back pain, but that back pain can’t explain those concerning symptoms. The differential diagnosis is head or neck injury, and either way, you don’t return the player to play that game. Enormous risk for second impact syndrome. You don’t use the concussion screening to determine return to play in their scenario, because a negative will be a false negative. 

So what went wrong? Before I cast blame on the medical staff, let me explain sports coverage a little. Doctors aren’t only sitting around and watching the game. There is a lot going on…you are tending to other injured players. So it is possible that they simply missed the mechanism of injury and symptoms presented immediately afterward. Tua looks like a decent guy but he’s a guy who’s career has been riddled by injury…it’s very possible that he lied about his symptoms to stay in the game. So if you miss the video, you miss an obvious concussion. It is a question of how can the medical team not watch the video with our available technology…that’s a good question. Perhaps the medical staff was incompetent or bias. Maybe they relied too heavily on the sideline concussion testing and allowed it to override decent clinical judgement. 

Ex 3 (Tua part 2). Player takes a hard hit with a similar mechanism as before. Patient is unconscious and goes into a fencing posture. This is a clear concussion, and suggestive of a major head trauma. Again, sideline testing shouldn’t be used to return to play. It would only result in false negatives. Tua was brought to the ER where he was evaluated for two conditions. One, they had to exclude bleeding within the brain, which is done through another thorough neuro exam and a CT head. They also evaluate for a cervical injury. Again, neuro exam plus/minus CT neck. They released him from the hospital after ruling out those conditions. That’s fine. They likely have him instructions to avoid screen time. According to McDaniels, Tua was watching McGruber on the flight home. Stupid.

Anywho…this should be Tua’s second concussion (and at last a moderate traumatic brain injury) at that. Hopefully better common sense and medical decision making prevails so that we don’t see Tua get his third concussion in three weeks about a week from now. Insane.

A good friend of mine puts these together. I think he’s the best in the business at these types of things. I’d recommend watching both videos.

 

 

[MKnight82]

I know absolutely nothing about medical stuff, but is it possible for his body’s reaction to have been from spinal compression instead of a head concussion?  Like a nerve response?  Just curious.

[sammymvpknight]

1 minute ago, MKnight82 said:

I know absolutely nothing about medical stuff, but is it possible for his body’s reaction to have been from spinal compression instead of a head concussion?  Like a nerve response?  Just curious.

Yes. If it’s not a head injury it almost has to be a neck injury. It is common for brain injuries and spinal cord injuries to coincide. That’s why he was spine boarded as he was leaving the field. There is a condition called transient quadriparesis, which is essentially a spinal cord injury with brief symptoms. Cervical injuries usually don’t result in the player grabbing their head and shaking out the cobwebs. That’s pretty suggestive of concussion. But the body going limp and having an ataxic gait…absolutely.

But whether it’s a head or neck injury…Tua doesn’t return to play. Low back injuries don’t present the way Tua presented. Hope that helps

[MKnight82]

6 minutes ago, sammymvpknight said:

Yes. If it’s not a head injury it almost has to be a neck injury. It is common for brain injuries and spinal cord injuries to coincide. That’s why he was spine boarded as he was leaving the field. There is a condition called transient quadriparesis, which is essentially a spinal cord injury with brief symptoms. Cervical injuries usually don’t result in the player grabbing their head and shaking out the cobwebs. That’s pretty suggestive of concussion. But the body going limp and having an ataxic gait…absolutely.

But whether it’s a head or neck injury…Tua doesn’t return to play. Low back injuries don’t present the way Tua presented. Hope that helps

Ya that’s why I asked.  Years ago I had two herniated disks c5-c7 in my neck, and I have permanent nerve damage in my left arm from it.  Anyways, when I was getting diagnosed for surgery I was sent to both an orthopedic surgeon and a neurosurgeon for their medical opinions because they are so interrelated.  So it made me wonder if Tua could of had a “back/neck” injury to the spine that didn’t set off the concussion protocol, then he reinjures the same spot on the spine which causes the nerve response we saw.  Honestly it looked to me like he was thrown down on his neck harder than on his head.

Edited October 1, 2022 by MKnight82

[sammymvpknight]

1 hour ago, MKnight82 said:

Ya that’s why I asked.  Years ago I had two herniated disks c5-c7 in my neck, and I have permanent nerve damage in my left arm from it.  Anyways, when I was getting diagnosed for surgery I was sent to both an orthopedic surgeon and a neurosurgeon for their medical opinions because they are so interrelated.  So it made me wonder if Tua could of had a “back/neck” injury to the spine that didn’t set off the concussion protocol, then he reinjures the same spot on the spine which causes the nerve response we saw.  

Spinal cord yes…run of the mill disc herniation with nerve root impingement no. Nerve root injury in the neck will commonly give one pain/numbness/weakness to a single upper limb. It’s not going to cause gait imbalance unless the cord is affected. 

Edited October 1, 2022 by sammymvpknight

[NinerFever]

As mentioned by a few..Brian Sutterer is a sports medicine doctor and imo he is worth watching. Sometimes he uploads a video just minutes after a bad injury happened. He uploaded a new one and it is very interesting...

 

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Edited October 1, 2022 by NinerFever

[Deadpulse]

On 9/30/2022 at 11:57 AM, INbengalfan said:

Legit question:  Since the majority of us believe that this was his second concussion in less than 100 hours, how was he

a. released from the hospital

b.  allowed on the team flight

hospitals arent prisons my guy. You can leave under your own power whenever you damn well please. What they do is confirm that you know, or if you are unable to your proxy (wife, legal rep, etc), that leaving would be Against Medical Advice (AMA). They mark it down as AMA absolving the hospital of any and all liability. 

[Deadpulse]

17 hours ago, Nabbs4u said:

Had he played uninjured the entire game not one of you would be up in awe. Not one.

This has to be the dumbest Fing thing I have ever read. Like ever. 

If the thing that happened DIDNT happen then no one would care!

Wow, real insight there. Close the Holocaust museums guys, cuz honestly, if it didn't happen would we really care? Probably not, lets let it slide then. This guy killed three people in cold blood? Wow thats not good. However, what if he didnt? Would we even be here talking about it? Probably not. Cut him loose!

 

like seriously, should we check you for neuro damage? 

[ET80]

12 hours ago, Nabbs4u said:

I'm seeing a lot of assumptions based off non medical personnel people having opinions. It doesn't matter what you believe to of occured. 

...can you say for certain these are non-medical personnel? Because I know four members who ARE medical personnel, disagreeing with you in this thread.

[Forge]

 

[ninjapirate]

12 minutes ago, Forge said:

 

Yeah more heads will probably fall from this.