Consultant involved in Tua Tagovailoa’s concussion check fired by NFL players union

David Santiago/dsantiago@miamiherald.com

The unaffiliated neurotrauma consultant involved in Dolphins quarterback Tua Tagovailoa’s concussion check last Sunday has been fired by the NFL Players Association, a source confirmed to the Miami Herald, after the union found the person made multiple mistakes in the evaluation.

The NFLPA launched an investigation into the Dolphins’ handling of Tagovailoa’s injury against the Buffalo Bills on Sept. 25 after Tagovailoa hit his head on the ground and stumbled upon returning to his feet. Tagovailoa was listed as questionable to return with a head injury and came back into the game at the start of the second half. Dolphins coach Mike McDaniel said Tagovailoa was evaluated for a concussion and cleared to return to the game.

According to NFL Network, the union exercised its right to fire the consultant and cited several reasons, including “failure to understand his role and hostility during the investigation.”

In a joint statement Saturday night, the NFL and NFLPA said their investigation “remains ongoing. Therefore, we have not made any conclusions about medical errors or protocol violations.“

The two sides also said they anticipate changes to the concussion protocol in the coming days and that discussions have taken place regarding a provision in the protocol that has become a point of contention with Tagovailoa’s circumstance.

The protocols include a provision for “gross motor instability,” which disqualifies a player from returning to the game if the team physician and a neurotrauma consultant determine it is caused by neurological issues. Because Tagovailoa’s back injury was deemed to be the reason for his fall against the Bills, he was able to reenter the game, which many have said is a loophole that put him in harm’s way.

According to ESPN, the NFL and NFLPA are expected to agree to new protocols that would prevent a player from returning to a game if he demonstrates any instability after a hit to the head.

During an NFL game, each team has a consultant who is on the sideline and assists in the evaluation of head injuries with the team doctor. The consultants are assigned by the league’s Head, Neck and Spine Committee and jointly approved by the NFL’s Chief Medical Officer, Allen Sills, and the NFLPA Medical Director, Thom Mayer. While the consultant provides an independent outlook on the situation, the team physician still has the final say on any diagnosis of a concussion and a player’s return to play.

Tagovailoa sustained a concussion and was carted off the field on a stretcher in the Dolphins’ loss to the Cincinnati Bengals on Thursday night, sparking more questions about why he played just four days after hitting his head against the Bills. His hands tensed up in a manner consistent with a fencing response — a classic symptom of a concussion — and he lay motionless for several minutes while trainers attended to him.

The Dolphins said Tagovailoa was conscious and had movement in all his extremities as he was taken to the University of Cincinnati Medical Center. He was later discharged from the hospital and flew back to Miami with the team Thursday night.

McDaniel on Friday continued to defend playing Tagovailoa, saying the third-year quarterback was “cleared by several layers of medical professionals ... of any head injury whatsoever.”

“If I were to sit someone for a medical issue going against medical people abstractly, then when do I play him again?” McDaniel said. “The timing of all of it, how things played out, I get the optics. I get exactly what it looks like. I understand all this and I understand people’s concern. But the one thing that I can exude with 100 percent conviction is that every person in this building had 100 percent the correct process and diligence. That’s why there’s not a player or person that you’d be able to talk to in the building that would think otherwise, because it is clear, contrite and not something that is negotiable, in any way, shape or form.”

Sills said Tagovailoa was evaluated for concussion symptoms after the Bills game and in the days that followed, as part of the league’s concussion protocol. He also said that once a review of the protocols is finished, the league will make its findings public.

“We want to be as transparent and open about this as possible,” he said.

Initial test results revealed Tagovailoa had no broken bones or fractures, according to a league source, and when McDaniel spoke to reporters Friday afternoon, he said Tagovailoa was in the process of finishing an MRI. McDaniel also said Tagovailoa had a headache Thursday night and Friday morning but “his personality was definitely normal Tua.”

Tagovailoa on Friday gave an update on his status for the first time since sustaining the concussion, writing on Twitter that he’s “feeling much better.”

McDaniel said there is no timetable on a return for Tagovailoa, who is in the concussion protocol. If Tagovailoa has to miss any time, Teddy Bridgewater will start at quarterback, McDaniel said.

“There’s no sort of one size fits all after a concussion,” Dr. Simon Buttrick, a neurosurgeon at Memorial Neuroscience Institute, told the Miami Herald in a phone interview. “And there’s not a whole lot of specific treatments that we have. ... The main thing that helps is time. The brain has to somehow heal itself.”

Amid a heightened sensitivity to concussions and chronic traumatic encephalopathy, the degenerative brain disease believed to be caused by multiple blows to the head, the NFL — which has also been at the center of multiple lawsuits involving head injuries — has undertaken rule changes and initiatives to better protect players, such as the introduction of guardian caps in training camp.

However, Buttrick said the topic of concussions still remains a “vague concept.”

“You get hit in the head all the time if you’re a football player, and you’re usually going to brush it off,” he said. “Obviously if you lose consciousness or you have something else really traumatic happen like [Thursday], then that’s a big deal. But there are so many cases in between when someone gets hit in the head and brushes it off. Does that matter? Probably, in some way. But we don’t really know.”