The Florian Fritz concussion incident

Last night Toulouse played Racing Metro with a spot in the play offs at stake.

18 minutes in and Fritz takes an accidental, but sickening knee to the face.



https://www.youtube.com/watch?v=bdNQQFm5tdo

Fritz is clearly in a terrible state, he looks as if he's been in the ring with Tyson for 8 rounds. He's unstable and dazed, having trouble walking and as he tries to leave the pitch he collapses.

Yet despite this, unbelievably 10 minutes later he comes back onto the pitch and plays for the rest of the first half.

What the hell were the Toulouse medical team and coaching staff playing at allowing a player in his state back on to the field? How could he be deemed fit? And where was the duty of care?

There should be a fine for this. He didn't know where he was as he came back on. His eyes were glazed. Couldn't believe he passed a concussion test.

Are you fecking kidding me?  Some motherless bastards let him go back on?  
This will be dealt with.

Considering he had a motor bike accident not that long ago....

Concussion protocol should have been triggered by the ref. however am not sure where the Toulouse medics were looking but Fritz said himself he passed out a few secs and there was no point coming back on the pitch when there was someone fresh on the bench.
The FFR medical comission is already investigating into this.

Yes, there are multiple organisations investigating.

Could see some revoked medical licences here

It gets worse, check out this footage, looks like Noves telling Fritz to get back out on the pitch.

Yes, this is a big issue and is being treated seriously in a number of quarters. This is one we all need to follow. Can't say for sure, but this feels like we may have passed a point of no return.

Coaching license rescinded too? Awful to see

This has to be the end of this nonsense.

Those tests were never intended to be used in these circumstances. If a player is clearly concussed they MUST be removed from the pitch and not be allowed to return. The tests should never be used in these cases.

The IRB lost an excellent doctor over this issue. Maybe it's time to get rid of the eejits who are abusing the protocol and, more importantly, the players.

Disgraceful.

Does anyone know how Fritz is?

I'm not even sure he went through a concusion protocol, i think it was just a 15 min blood substitution.

Shame there's no audio on that second clip, I'd be VERY interested in hearing what Noves had to say to him.

This is just overwhelmingly stupid and negligent from all staff involved, almost to the point of being malicious. Fritz's career or his life could be over if he'd taken a second bang with a long way still to go in the game. Have these guys just had their heads in the sand the whole time the issue has been discussed at length politically and through numerous media outlets?

Heads need to roll for this. Coaching conduct on the matter needs to be looked at and steered away from this unacceptable practice.

I just returned from America and having struck up a conversation about sports with a taxi driver about sports, he said he'd heard that they were thinking of bringing helmets in in rugby to combat the concussion risk. I'm not sure where he heard this from, but I did concede that concussions in rugby was a big issue at the moment. Incidents like this just makes everything worse and does drive us closer to a situation where we'll need helmets, as well as putting a player in serious danger.

Sometimes it's hard to drag off an injured player but the coach and the medical team have to make the decision. As a coach of a (then) under-15 team I had to bring off our captain during a league game who wasn't happy about being subbed off, but he'd taken a knock to the head so we took him off and didn't let him play again until he had seen a doctor. Some things are more important than the result.

Fritz initially tried to fight off the physio and keep playing. Sometimes it can he hard to tell whether someone is concussed and trying to play act or fine to continue but in this situation he was clearly in no state to continue.

Good to hear that it's being taken further.

VinceWLB wrote:I'm not even sure he went through a concusion protocol, i think it was just a 15 min blood substitution.

That's my understanding as well. And yes Noves did slightly push Fritz to get back to the field

Every layman watching that sees a brain injured man.

And, judging by his demeanour, a significantly brain injured man at that.

He is staggering. He is aggressive. And then he falls to the ground.

You do not need a medical degree to see these things. There is no way that anyone can reasonably say that they were only removing him because of blood. The ref probably felt no need to declare a head injury sub as the player was so obviously concussed that there was no way he should have been being considered for a return to the pitch.

I hope Fritz is okay.

And I hope the next Ben Robinson is not encouraged to return to the field because of this idiocy.

In the past few weeks we have seen players banned for play which endangered other players. Whoever let Fritz back on the pitch was much more guilty of endangering a player than all of them put together.

Just heard in the Munster Ulster commentary that Andy Lee (Irish boxer) was talking about the Fritz incident. He said that if someone took a hit like that in boxing then the match would be immediately stopped and the player wouldnt be allowed compete for 90 days.

Crazy to think all Fritz got was 7 minutes. IRB really need too get out from behind their desks and make a stand on this.

Robbo, I didn't think that helmets protected you from concussion and the IRB are generally against extra protection as it usually ends up escalating the contact to more dangerous levels.

Similar incident in the Scarlets v Blues game, young flanker took a blow to the head in the tackle and looked like he wanted to fight the physio who was trying to take him off.

On this occasion though he was replaced and did not come back on!

HammerofThunor wrote:Robbo, I didn't think that helmets protected you from concussion and the IRB are generally against extra protection as it usually ends up escalating the contact to more dangerous levels.

I'll admit to not being hugely knowledgeable on the subject, but my main point was that incidents like this do nothing for the player or the game as a whole.

robbo277 wrote:

HammerofThunor wrote:Robbo, I didn't think that helmets protected you from concussion and the IRB are generally against extra protection as it usually ends up escalating the contact to more dangerous levels.

I'll admit to not being hugely knowledgeable on the subject, but my main point was that incidents like this do nothing for the player or the game as a whole.

You are both right. The scrum caps add zero protection against head trauma. Their purpose is to protect the ears from being torn off and also to protect the scalp from lacerations and other bloody injuries which can occur. But absolutely not against head trauma.

Robbo, I wonder why it is so obvious to people like ourselves this was handled poorly, possibly incompetently. The IRB better go after all the evidence aggressively. Then, as we suspect, if there was any action taken not with the direct medical benefit of the player in mind, people must be sanctioned severely. The video clip looks terrible.

Part of it could be that he passed the concussion test. I read an online article a while back from an old pro saying players purposely lowered their scores on their concussion comparison test so that when they were really concussed they would have a better chance of getting back on.

Rugby never used to be this physical, players are faster, bigger, stronger in pro times. To see what our pros of tomorrow are like in retirement I think we should look at old American footballers. Maybe get medical teams to see what these chaps are like aged 50+... I bet some still say, ah well look at the old warriors like loe, chilcott, Moore, Fitzpatrick, kearns etc, nothing wrong with them and those guys lived in the wars 2 games a week.... And then had a 40hr job on top. Hits simply weren't as big, not a great comparison.

The thing is that he should never have been doing any concussion tests with a view to returning to the pitch.

He was showing clear signs of concussion and so should never have been tested except in a therapeutic sense.

The diagnosis was made by thousands.

No helmets in rugby thanks. Part of the injury problems in gridiron is that players lead with their head in the tackle thinking the helmet will protect them. I don't want to see that in rugby.

1. That headbutt tackle is likely to injure the opposing player, and...

2. In that sort of collision at speed it is the brain bashing into the skull (and not the other way round) that causes the concussion.

I felt sick watching him come off let alone go back on. Shocking behaviour from the management staff.

As someone who has had 2 major concussions it is tough watching that.

I have absolutely no recollection of my injuries (or indeed the week before!) and I certainly wasn't able to make rational decisions at the time - those doctors should be struck off.

Appalling.

He looked like he'd been in a Car Crash, ridiculous he was allowed back on. That second video of Noves, if he is indeed pressuring him to get back on the pitch, could spell the end of him. He's been at Toulouse for a while but they look a spent force domestically and in europe. Could be the end of him.

robbo277 wrote:I just returned from America and having struck up a conversation about sports with a taxi driver about sports, he said he'd heard that they were thinking of bringing helmets in in rugby to combat the concussion risk. I'm not sure where he heard this from, but I did concede that concussions in rugby was a big issue at the moment. Incidents like this just makes everything worse and does drive us closer to a situation where we'll need helmets, as well as putting a player in serious danger.

Sometimes it's hard to drag off an injured player but the coach and the medical team have to  make the decision. As a coach of a (then) under-15 team I had to bring off our captain during a league game who wasn't happy about being subbed off, but he'd taken a knock to the head so we took him off and didn't let him play again until he had seen a doctor. Some things are more important than the result.

robbo whoever that was was talking out of their wrong end as the NFL have their own problems with concussions and helmets do very little to prevent them

I’ve seen the documentary “head games” about concussion in the NFL and I believe it’s been remade with a focus on international sports, there’s a section on rugby in there too, they came over for a 6 nations weekend the week that BOD was concussed against France (and then returned to the field) and there was also a serious concussion in the Wales Scotland game that week. Would be very interested to see the updated version of the film.

The scariest thing here is how aggressive Fritz becomes, he’s clearly not right in the head, and having heard what John Fogarty had to say about the long term effects of concussion even after retirement he could struggle with mood swings for a long time yet.

Kelly Brown was concussed at the Wales-Scotland game and there wasn't any hint of him coming back on.

Of course we are incredibly fortunate to have Dr James Robson in our team - held in very high regard round the world - and there's no way he would allow a concussed player back on the pitch like that.

Former IRB and IRFU medical advisor (and BOD's Uncle) Dr Barry O'Driscoll retired over the IRB's concussion bin rule, he was dead against it.

http://www.thescore.ie/barry-odriscol-interview-brian-concussion-1221614-Dec2013/

Whocares, if you're out there, are the French media saying anything about the Fritz situation and has there been any follow-up by the FFR or whoever - certainly from the TV pictures it looked very bad on two accounts - (i) Fritz was clearly concussed and (ii) Noves seemed to be urging him to get back on the pitch

brennomac wrote:Whocares, if you're out there, are the French media saying anything about the Fritz situation and has there been any follow-up by the FFR or whoever - certainly from the TV pictures it looked very bad on two accounts - (i) Fritz was clearly concussed and (ii) Noves seemed to be urging him to get back on the pitch

yeah the Fritz incident has created probably more buzzz than the end of Clermont home record against Castres, at least from a social media POV.

as wrote above the FFR medical commission is meant to look into this and many people are pointing towards Noves accountability and his medical staff who didnt say no to him. Noves said he himself played after being stunned and that Fritz case could probably wait till HT to be properly assessed...

more on (for the french readers)
http://www.rugbyrama.fr/rugby/top-14/2013-2014/barrage-top-14-stade-toulousain-racing-metro-la-polemique-enfle-autour-du-k.o-de-florian-fritz_sto4244716/story.shtml

The area that coaches seem to miss if you set aside the danger to the player, if someone is concussed they are a liability to the team as they aren't functioning at 100% as their cognitive functions are impaired so their hand eye coordination is off meaning their more like to drop passes, miss tackles and just become a passenger

"Quand le pâté touche le bocal"

Does that translate as,

"Opening a can of worms" or "When the S**** hits the fan"?

fa0019 wrote:Part of it could be that he passed the concussion test. I read an online article a while back from an old pro saying players purposely lowered their scores on their concussion comparison test so that when they were really concussed they would have a better chance of getting back on.

Rugby never used to be this physical, players are faster, bigger, stronger in pro times. To see what our pros of tomorrow are like in retirement I think we should look at old American footballers. Maybe get medical teams to see what these chaps are like aged 50+... I bet some still say, ah well look at the old warriors like loe, chilcott, Moore, Fitzpatrick, kearns etc, nothing wrong with them and those guys lived in the wars 2 games a week.... And then had a 40hr job on top. Hits simply weren't as big, not a great comparison.

Two great points, mate.  Exactly right on, in my experience.  

The concern about players deliberately low-balling the baseline concussion test is a remarkable development.  I know the NFL and a few US universities are investigating statistical methods to try and identify if people are scamming the test, but I don't know their progress.  This is very important.

Your other point that players now are bigger, faster, stronger than players in the not too distant past should not be minimised.  There is really no comparison and all contact has much greater impact on everyone involved.  

I believe we should not compare Rugby to American Football too closely.  In every play in American Football there is collision contact between at least 50% of the players on the field.  The forces involved are staggering.  The 'tackle' in American Football is really simply knocking the player down.  No need to bring the player down.  So some players end up using their bodies like guided missiles and frequently lead with their helmets.  This is why injury rates, including concussion, in American Football have little relationship to Rugby.  What is important are the medical data, advances and injury related treatments piloted in the NFL.  In my opinion, Rugby should avoid helmets at all costs.  

Looking at the Fritz incident again, it is clear the contact was accidental and I am not sure if anything could have been done to prevent it.  However, if the evidence is substantiated that he did not remember aspects of the collision as has been reported, then it clearly irresponsible to allow him back on the pitch and some people will be in serious trouble.  Fritz is already in trouble for his long term health.

Do we even need to know that Fritz had amnesia?

The aggressive attitude and the inability to walk to the touch line are more than enough. he could be pressurised to say he was fine but that aggitation is very worrying. That was a very significant head injury.

MrsP wrote:"Quand le pâté touche le bocal"

Does that translate as,

"Opening a can of worms" or "When the S**** hits the fan"?

well more like a quite specific culinary expression where "paté" would be the brain while "bocal" or jar would be the skull I think...

Ah ha!

Now I understand.

Thanks Whocares!

MrsP has always been a front-runner on this particular area of potential brain injury on this board.

She's a star and should be applauded for her work here. :applause: :applause: :applause:

The injury to Fritz is clear and obvious and if some action is not taken by the FFR an the entire Toulouse management/medical team then the IRB ought to become involved.

Another disgrace to our sport.

Someone said above that the MO should be struck off and I'm inclined to agree particularly as the Quins (physio?) was after the Bloodgate affair.

Portnoy's Complaint wrote:MrsP has always  been a front-runner on this particular area of potential brain injury on this board.

She's a star and should be applauded for her work here. :applause: :applause: :applause:

The injury to Fritz is clear and obvious and if some action is not taken by the FFR an the entire Toulouse management/medical team then the IRB ought to become involved.

Another disgrace to our sport.

Someone said above that the MO should be struck off and I'm inclined to agree particularly as the Quins (physio?) was after the Bloodgate affair.

Correct.

http://www.telegraph.co.uk/sport/rugbyunion/club/8002256/Harlequins-Bloodgate-physio-Steph-Brennan-struck-off-by-Health-Professions-Council.html

What the Blood gate did show is that saying that your head coach told you to do it isn't a good enough excuse.

So if the Toulouse Doctors say they were under pressure from the coach, it shouldn't make any difference to their case.

MrsP wrote:Do we even need to know that Fritz had amnesia?

The aggressive attitude and the inability to walk to the touch line are more than enough. he could be pressurised to say he was fine but that aggitation is very worrying. That was a very significant head injury.

Yes, we do need to know he lost memory for a short period. The direct questions about what he remembered would have been asked by medical professionals under controlled conditions. Puts the legal case beyond challenge.

Fritz looked worse than George Smith in the Lions series. And I am sure none of use would have let him back near the pitch, nor frankly, outside near any bright light based upon his appearance and actions. But in this case, we need a high level example. Everything must be open-and-shut. I thought raising awareness was enough. Clearly I was wrong. Examples must be made.

I think the physio was reinstated on appeal???

This is a very different issue though.

If I remember correctly, the major problem for the physio was that he instigated the cheating and lied to the panel set up to investigate.

You know what they say about us docs being more likely to be struck off for sleeping with a patient than for killing one!

I know I have said that I would be willing to stand on the pitch and refuse to leave until a young head injured player was removed, if necessary. Thankfully this has never been necessary.

What exactly can a doctor do if the coach says he is putting a player back on and the player says he wants to play?
He can certainly say it is wrong. He can say it is unsafe. He can express his concerns at the time and afterwards but I am not sure he can do very much else at the time if the coach insists the player goes back on.
He could resign if he is not happy with how the players are treated but I don't see how he stops the thing in real time?

MrsP wrote:I think the physio was reinstated on appeal???

This is a very different issue though.

If I remember correctly, the major problem for the physio was that he instigated the cheating and lied to the panel set up to investigate.

You know what they say about us docs being more likely to be struck off for sleeping with a patient than for killing one!

I know I have said that I would be willing to stand on the pitch and refuse to leave until a young head injured player was removed, if necessary. Thankfully this has never been necessary.

What exactly can a doctor do if the coach says he is putting a player back on and the player says he wants to play?
He can certainly say it is wrong. He can say it is unsafe. He can express his concerns at the time and afterwards but I am not sure he can do very much else at the time if the coach insists the player goes back on.
He could resign if he is not happy with how the players are treated but I don't see how he stops the thing in real time?

Erm, he could "stand on the pitch and refuse to leave until a young head injured player was removed"

There is always that!

  

MrsP wrote:What exactly can a doctor do if the coach says he is putting a player back on and the player says he wants to play?

The position of the medical professional on any sports team is based upon proper judgement which cannot be blithely overridden.  In other words - trust - trust that the medic is balancing all permutations and makes good sober judgement.  The moment the coach tries to override a medical judgement or decision, the relationship between coach and medic is threatened or destroyed.  Given that, in professional sport the medic says he/she will go straight to the media after the match.  Clearly this is the nuclear option, but in the case of severe and life threatening injury, what choice exists?  This potentially terminates the medic, but it also puts the coach's job and future opportunities in clear jeopardy.

Again to go back to Dr James Robson, I remember from watching Living with Lions DVDs that he said he just walked players off the pitch and took his ear piece out so he couldn't hear the coaches shouting at him to keep them on!

Grey.

I agree that it would be "cast iron" if Fritz will say he had amnesia but I meant that we should not have to rely on that. He could be persuaded to say he was fine but the evidence we all saw is, in my opinion, more than enough to say he was clearly concussed.