Ignore brain injury with impunity!

First topic message reminder :

So a player gets 3 week ban for foul language but keeping a Brain Injured Player in the game no sanctions whatsoever.
Player Welfare ?????

That is the view of Peter Robinson whose 14 year old son died because he was allowed to continue to play in a rugby match despite being head injured.

After yet another example of terrible mismanagement of an obvious and serious head injury in the professional game the review has decided that no sanction is necessary. This despite them concluding..

"The CMRG’s view is that there was sufficient evidence to conclude not only from the video evidence but also George North’s history and risk stratification that he should not have returned to the field of play. Northampton Saints medical team has accepted that North may have lost consciousness and therefore should not have returned to play."

The message?

Go ahead and ignore an obvious brain injury, no problem. And when it happens in a grassroots game or school boy game they can point to the fact that the CMRG said...

"The CMRG considered the welfare of North was always at the centre of Northampton’s actions, and does not consider that the medical team (or the club) failed to complete the HIA protocol..."

What a disgrace!

No 7&1/2 wrote:Or because he thought in his own words he had seriously damaged his neck.

Na he's a liar, I saw the clip. Neck looked fine. Hang them all.

I don't think he was lying, just brain injured!

You guys realise you are now arguing against your own medics, right?

They say they would not have allowed North back on the pitch if they had been able to see the footage we have seen.

MrsP wrote:I don't think he was lying, just brain injured!

You guys realise you are now arguing against your own medics, right?

They say they would not have allowed North back on the pitch if they had been able to see the footage we have seen.

I'm not, it's just perhaps too subtle a point...

You say he was definitely KOed, I say there is enough suspicion that he was to remove him from the pitch.

The medics are covering their own backs nothing more and their comments have to be taken with a pinch of salt.

Hammersmith harrier wrote:I'm not refusing to accept anything, I do however refuse to accept that anyone can have any real input into something like this when they're only watching it on a TV screen, those who were there are the only ones who's opinion i'd listen to.

There are risks and minimizing them is right but crucifying a teams medical team when you're no there yourself is beyond belief.

"The medics are covering their own backs nothing more and their comments have to be taken with a pinch of salt.




So you are not refusing to accept anything except what you refuse to accept.

And the only opinions you will listen to you are taking with a pinch of salt?

Okay...

No 7&1/2 wrote:Sorry if this has been mentioned above but the latest info coming out now.seems 100% that North was knocked out as I think the vast majority would agree with. But North did tweet that he was fully concious but hurt his neck in the fall hence lay absolutely still. Haven't heard anything on this since though.

So, your position has changed since yesterday?

But, my comments were not really directed at you anyway, more at those who don't seem to accept that there was enough evidence to remove him.

Even though I think sanctions would have sent a stronger message, at least we are talking about it.

Mind you, we talked about it after Ben Robinson, Fritz, North the last time...

MrsP wrote:

Hammersmith harrier wrote:I'm not refusing to accept anything, I do however refuse to accept that anyone can have any real input into something like this when they're only watching it on a TV screen, those who were there are the only ones who's opinion i'd listen to.

There are risks and minimizing them is right but crucifying a teams medical team when you're no there yourself is beyond belief.

"The medics are covering their own backs nothing more and their comments have to be taken with a pinch of salt.




So you are not refusing to accept anything except what you refuse to accept.

And the only opinions you will listen to you are taking with a pinch of salt?

Okay...

You've ignored the context completely there.

I think it would be stupid on reflection Mrs p to ignore it. I've looked for more north quotes on it but can't. At the time it looked bad but surprising to me he was knocked out as he doesn't hit his head but assumed the jolt could do it. Now reading as much as I can it seems to me that saints don't really think he was out and are indeed playing to the crowd. I may well be wrong and they are north have just been playing to that tune but I'm verging to say I'm not sure he was knocked out. I do think there is a more general problem but more about players not even receiving these protocols when getting heavy hits. Hope that makes sense.

He does hit his head.

Around 1.48 on this video.

https://www.youtube.com/watch?v=8q78YPBDv78

Just after that you can see him bounce with no muscle tone and land with no muscle tone.

People don't lose muscle tone if they are conscious.

You've convinced me. North lied to the staff

I don't think for one second that he lied.

I think he did not know he had been KO'd. Our brains will fill in the blanks to make sense of the situation.

People will frequently not know they have had a brief period of unconsciousness.

That is why we don't give huge weight to anyone saying they did not lose consciousness.

Ok. Bit of a shame he hasn't come out and said he wasn't worried about his neck though. He now mist know 100% he was knocked out and is being very quiet.

I am sure his neck was sore when he regained consciousness. It must have been after that degree of whiplash.

I would think he is reluctant to allow himself to believe he was KO'd. Wasn't it the same after the incidents in a Welsh jersey?

I do find this interview a bit disturbing though.

‘Gethin is half-man, half-rehab. He does his extras and everything he needs to keep getting himself ready. If I can keep getting myself ready then I’ll always keep doing it.
‘If a player decided to pack the game in tomorrow, the question I ask is, who pays their mortgage? No one will, except that person. No one’s going to pay his mortgage or look after his family. He’s got to do it somehow. What’s important is looking after them (family). That’s all I think about.’


Read more: http://www.dailymail.co.uk/sport/rugbyunion/article-4059832/George-North-speaks-controversy-head-injuries-rages-Quit-want-play-12-years.html#ixzz4Tgds70qm
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Someone need to get along side that young man and explain that there are ways to pay the mortgage and maintain brain function.

Hmm. Sounds like some questions need to turn to players rather than clubs.

But not about what happened that day.

You can not hold North responsible for being allowed to play while brain injured that day.

Well if he didn't mislead peple during the match hr certainly did after and continues through his silence doesn't he. Those quotes above seem to confirm he'd rather cover and continue to plat no matter what.

I see World Rugby have got involved.

http://www.bbc.co.uk/sport/rugby-union/38422727

I can't help but think it will be another window dressing exercise.

I have no doubt his neck was hurting but he could still have been unconscious.

The shut eye and the lose of muscle movement that Mrs P mentioned are key here

Regarding the difference between this and the Watson situation I think there are key reasons this has a higher profile.
North is a bigger name in the sport and has multiple instances of the same situation occurring.

No sanction for Saints because they were judged to have followed the protocols. However, the following comments and recommendations were made. Critically, a video review of any incident which results in a player being evaluated for head trauma is now going to be part of the evaluation. Seem rather obvious and should have been so a long time ago..............

---------------------

From an article in the Northampton Chronicle

Julian Morris, independent chairman of the Concussion Management Review Group said: “This is the first review into a head injury incident we have seen following the introduction of the concussion management system this season in the Aviva Premiership.

The CMRG released nine recommendations, which are as follows...

1. George North follows the graduated return to play protocol to optimise his recovery.

2. The pitch side video reviewer (PVR) should remain in their allocated seat.

3. Wireless connectivity should be checked for those allocated seats.

4. Consideration be given to the introduction of a ‘support PVR’ to ensure that the video feeds continue to be monitored and additional clips can be downloaded if the PVR is discussing matters with the medical team (e.g. over radio link) or the development of automatically downloaded clips of incidents.

5. At the forthcoming mid-season Premiership Club medical meetings, planned for February 2017, the reviewing and training team emphasise and re-enforce the necessity to review footage before starting the HIA assessment and the criteria in respect of permanent removal from the field of play.

6. The team doctor must review the video footages for permanent removal criteria both before commencing and after completing the HIA assessment in the medical room (or designated HIA area).

7. Irrespective of whether part of the HIA assessment has or has not been carried out on the pitch, the entire HIA must be completed again once in the medical room by the examining doctor.

8. The maximum permitted time for an HIA process, in the Aviva Premiership in the 2016-17 season is 13 minutes. Given the importance of the HIA assessment in respect of player welfare the HIA should not be unduly shortened without clear reason.

9. Hard wire live feeds should be reinstated to the medical/HIA rooms with recording and play back facility which would add resilience to the wireless MyPlayXplay system both in terms of functionality and also definition if, for any reason, there is an issue with the main (Wi-Fi) system.

I fully believe the medics at Saints are great guys with the players best interest at heart.

I wonder what they would have done if the HIA did not exist?

Would they have just seen a player with a frightening history of brain injury who fell from a considerable height, banging his head and used their clinical judgement to remove him?

Instead of being drawn into a dangerous protocol which seemed to give them permission to put him back on the pitch.

Good point.  I would want to think the best of them.

Yesterday afternoon, I was seeing an NFL player who is a patient of mine and I brought up concussion (he has had two in the last few years, so has personal experience).  He believes the rules in the NFL are now finally good, but as recently as a few years ago limited the medical staff freedom of action and minimised their ability and incentive to make independent decisions.  

I showed him the replay of North's injury, and he thought his medical staff (on his NFL team), if they saw the replay, would not have allowed North back on.  And North's medical history would be a factor.  He also made the point that North initially landed on his shoulder so it is possible in real time many people didn't see his head bounce off the turf.  Again, making the case for video replay available to medical staff in real time.  For every injury.  This is now the current process in the NFL.  Unfortunately, Rugby is still in the Dark Ages by comparison.  

He also said he thinks Rugby players are probably nuts - and wants to play when after he retires.......

No 7&1/2 wrote:Well if he didn't mislead peple during the match hr certainly did after and continues through his silence doesn't he. Those quotes above seem to confirm he'd rather cover and continue to plat no matter what.

One of the symptoms of concussion is that the victims are confused and sometimes have no memory of the whether they were knocked out or not. It's very possible that George still has no memory of being knocked out, which if he has watched the video is a concern!

This incident has been dealt with very poorly by all involved. There were endless slowmo replays of George clearly being knocked out, what possible excuse can Northampton have for not making this vital footage available to the medics? And how can this obvious detail have been ignored in the review of events? As for the HIA, he did not need one as he was knocked unconscious, so he should have been taken off the field permanently. "We let him back on the field because he said he couldn't remember being knocked unconscious," is just not an acceptable excuse!

So he does really need to come put and say he was wrong. He's not doing anyone any favours.

No 7&1/2 wrote:So he does really need to come put and say he was wrong. He's not doing anyone any favours.

He wasn't wrong, he said what he truly believed to have happened after receiving a brain injury. It's not up to the player to diagnose himself, particularly after receiving a head injury, it's Northampton who got it wrong sending him back onto the field when it should have been clear that it was unsafe for him to do so.

Merry Christmas.

You either believe he was knocked out so he was wrong or he was right and wasn't knocked out. I suppose enforced retirement should be considered for his own safety a bit like boxing revoking a licence.

It's possible that North lied. Northampton lied.

I remember in a schoolboy match getting kneed in the head by a fat prop. I played like a complete idiot for the rest of the match but probably would have said I was OK if asked. I should not have been playing.

When your brain is scrambled you don't necessarily make sensible decisions or are capable or working out if you are OK or not.

No 7&1/2 wrote:Merry Christmas.

You either believe he was knocked out so he was wrong or he was right and wasn't knocked out. I suppose enforced retirement should be considered for his own safety a bit like boxing revoking a licence.

Merry Christmas to you too!

Back to the debate: I have no doubt that he was knocked out, as would pretty much anybody (outside the Northampton management) who saw the video footage.

How ever it's clear that George in his confused brain scrambled state, believed he was not unconscious. So is he wrong in thinking he was not knocked out? Yes, without doubt! But is he lying? No, he is just saying what he believes to be the truth.

Northampton failed in their duty of care to protect their employee, both moral and legal (particularly considering the new guidance). I really hope that World Rugby make a example of both Northampton and the review body who have swept this disgraceful issue under the carpet.

Seagultaf wrote:

No 7&1/2 wrote:Merry Christmas.

You either believe he was knocked out so he was wrong or he was right and wasn't knocked out. I suppose enforced retirement should be considered for his own safety a bit like boxing revoking a licence.

Merry Christmas to you too!

Back to the debate: I have no doubt that he was knocked out, as would pretty much anybody (outside the Northampton management) who saw the video footage.

How ever it's clear that George in his confused brain scrambled state, believed he was not unconscious. So is he wrong in thinking he was not knocked out? Yes, without doubt! But is he lying? No, he is just saying what he believes to be the truth.

Northampton failed in their duty of care to protect their employee, both moral and legal (particularly considering the new guidance). I really hope that World Rugby make a example of both Northampton and the review body who have swept this disgraceful issue under the carpet.

The point being is that he is in no condition to make a statement like that. It shouldn't be up to him and he should have no responsibility to determine his own fitness under those conditions.

lostinwales wrote:

Seagultaf wrote:

No 7&1/2 wrote:Merry Christmas.

You either believe he was knocked out so he was wrong or he was right and wasn't knocked out. I suppose enforced retirement should be considered for his own safety a bit like boxing revoking a licence.

Merry Christmas to you too!

Back to the debate: I have no doubt that he was knocked out, as would pretty much anybody (outside the Northampton management) who saw the video footage.

How ever it's clear that George in his confused brain scrambled state, believed he was not unconscious. So is he wrong in thinking he was not knocked out? Yes, without doubt! But is he lying? No, he is just saying what he believes to be the truth.

Northampton failed in their duty of care to protect their employee, both moral and legal (particularly considering the new guidance). I really hope that World Rugby make a example of both Northampton and the review body who have swept this disgraceful issue under the carpet.

The point being is that he is in no condition to make a statement like that. It shouldn't be up to him and he should have no responsibility to determine his own fitness under those conditions.

Absolutely agree, which is why Northampton should not have been able to use this in their defence!

To be fair to the Northampton medics, North was able to answer all the "orientated" (Maddocks) questions on the pitch.

My criticism of them would be that they should have had a very high index of suspicion of head injury in any player who fell like that. They should have raised that index given it was a player with a worrying history of brain injury. And they should have been aware that this player has a history of passing HIAs despite being brain injured.

My other criticism of the club is that someone at the club must have seen what everyone else saw, that North was KO'd, and queried why he was back on the pitch.

North has done nothing wrong.

This does not need to be a witch hunt but there was a great opportunity to warn clubs that they must do better, and back it up with meaningful deterrents.

In the end we have the same thing as we had after the incidents with Wales.

The player is the only one suffering consequences when he is completely blameless.

MrsP wrote:To be fair to the Northampton medics, North was able to answer all the "orientated" (Maddocks) questions on the pitch.

My criticism of them would be that they should have had a very high index of suspicion of head injury in any player who fell like that. They should have raised that index given it was a player with a worrying history of brain injury. And they should have been aware that this player has a history of passing HIAs despite being brain injured.

My other criticism of the club is that someone at the club must have seen what everyone else saw, that North was KO'd, and queried why he was back on the pitch.

North has done nothing wrong.

This does not need to be a witch hunt but there was a great opportunity to warn clubs that they must do better, and back it up with meaningful deterrents.

In the end we have the same thing as we had after the incidents with Wales.

The player is the only one suffering consequences when he is completely blameless.

Generally agree with what you say, but a few points:

North was knocked out, so he should not have been subject to a HIA, he should have been removed from play, so the fact that he could or could not answer questions, is irrelevant.

I cannot accept in this age of mobile phones, digital media, etc., that the footage that showed North clearly unconscious, could not have been made available to the medics. You have to question that if video footage of the incident was not available how could he been deemed fit to return.

When he has returned to play, there were further views of the incident broadcast and numerous negative comments from the TV commentators. So why didn't Northampton realise that they has made a mistake and sub him?

For me a shocking lack of care for their employee!

Finally the guidance relating to this type of incident has changed since the Wales incident. Northampton ignored the new guidance.

I think we are in agreement Seagultaf.

The HIA was completely inappropriate.

I was trying to put myself in the place of a medic who had not seen the LOC and arrived to a player who I did not know had suffered a brief LOC. Giving the medics the benefit of as many doubts as possible.

It would then be appropriate to ask the Maddocks questions.

However, I feel that even if they somehow never saw the LOC they still should have been more cautious and, failing that, someone else from the management team should have insisted North be permanently removed.

So now we really do need to see north come out and say he was knocked out rather than worrying about his neck. Full disclosure.

You're really going to keep repeating that?

Not going to happen, let's drop this now ffs. Talked about it more than North has.

No 7&1/2 wrote:So now we really do need to see north come out and say he was knocked out rather than worrying about his neck. Full disclosure.

North has no idea what happened........because he was unconscious at the time!

But we all now know definitively know he was 100% so he knows now the tweet he sent was wrong. Don't follow him but can't find any further quotes after his post March mistake tweet. Is there some responsibility for a role model like him to be putting out that message?

No 7&1/2 wrote:But we all now know definitively know he was 100% so he knows now the tweet he sent was wrong. Don't follow him but can't find any further quotes after his post March mistake tweet. Is there some responsibility for a role model like him to be putting out that message?

Sorry......disagree.

He doesn't have a responsibility to bring more public clarity yo his mistaken tweet; set the record straight on how this could have serious consequences? Why?

No 7&1/2 wrote:He doesn't have a responsibility to bring more public clarity yo his mistaken tweet; set the record straight on how this could have serious consequences? Why?  

Read my posts, I have clearly made my case.

He has that responsibility then as a major role model in the game.

No 7&1/2 wrote:He has that responsibility then as a major role model in the game.

Sorry don't understand.......what responsibility?

You don't think that players have a responsibility to the game in a wider sense and helping push forward the safety aspect to amateurs, kids etc?

No 7&1/2 wrote:You don't think that players have a responsibility to the game in a wider sense and helping push forward the safety aspect to amateurs, kids etc?

No, I don't understand the point you are trying to make.

The point is that there's much more to the game than the top level. He surely needs to come out and say there's more important things than pretending you'd just hurt your neck. Make a statement to say mistakes were made he wouldn't have continued had he or the staff realised.

No 7&1/2 wrote:The point is that there's much more to the game than the top level. He surely needs to come out and say there's more important things than pretending you'd just hurt your neck. Make a statement to say mistakes were made he wouldn't have continued had he or the staff realised.

Yes. but.

You can understand why the guy might not want to badmouth his employers/ admit to acting like an idiot cos his brain was scrambled when thinking of his current and future employment

There's also the possibility that both happened. The unconscious bit perhaps he doesn't remember (obviously) and then perhaps when he regained consciousness he had a very sore neck so stayed still.

Happy Holidays to everyone.  

I think you might find this interesting - the NFL Concussion protocol:
http://images.nflplayers.com/mediaResources/lyris/pdfs/NFL_Diagnosis_Mgmt_Concussion.pdf

That's the thing lost. More than likely there's a fair few players playing down concussion for career prospects. There's will come a situation when a current player still at the top says something though for the benefit of the wider population.

Moving on from this specific and enlightening incident, I think we can all agree that Brain injury is the most serious issue facing the game, far beyond any other.

So the question is where does the game go with this?

I have no doubt that there will be 'class actions' against the various authorities and employers in the not so distant future - we only have to look at the NFL to understand this is the next step.

But we need to understand where the game is currently at in terms of its development, how did we get here and most importantly where we are going - what sort of a game do we want?

Obviously in the last 20 years of the pro game we've witnessed the incredible change in player physique and fitness and this I believe is where the game can and must change.

The various new protocols being introduced around the shoulder high tackle are all well meaning enough however they don't actually go to the heart of the issue which is that players are and will continue to legally engage in far to many car crash type tackles where the forces involved can only produce a violent effect upon the players.

So the answer is this we have to reduce the number and force of tackles by producing a game that provides more space, that is suited to smaller players - or at least learner players acting with less physical force.

So how do you do that? We can't make the pitch bigger and I'm not in any way suggesting we reduce the number of players on the pitch - it is and always should be a 15 player game - however I am absolutely suggesting that we reduce the size of the bench from the current 8 too 3 (the 3 consisting of a prop, a hooker and another) and that counter intuitively we only allow replacements in the professional game on the advice of a single non aligned medical team and not the coach or the teams medical staff.

By doing this you will bring back the element of fatigue that will at once reduce the force of tackles and their number by creating more space (and tries) for the game to be played in.

These changes will also I hope force coaches to focus on skills far more instead of reverting to the physical aspects which have brought us close to the abyss.