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McCoy situation confirms need for dramatic changes to in-game concussion procedures

Colt McCoy

In this photo taken Thursday, Dec. 8, 2011, Cleveland Browns quarterback Colt McCoy (12) is checked out by the trainers as he gets ready to go back into the game after taking a hit from Pittsburgh Steelers linebacker James Harrison during the fourth quarter of an NFL Football game in Pittsburgh. McCoy injured his hand and was wobbled by a hit from Harrison during the Steelers’ 14-3 win. Two other Browns sustained concussions in the Browns’ 21st loss in 23 games against their AFC North rival. (AP Photo/Don Wright)

AP

The NFL’s fairly recent requirement that players who have been diagnosed with concussions remain out of action until cleared by an independent neurologist caused some (including me) to assume that independent neurologists have a permanent seat at the table, present at every game in order to help team-hired physicians over whose shoulders the head coach is peering to determine whether a player has suffered a concussion in the first place.

But as the league conceded earlier this year, independent neurologists aren’t present during games. (Indeed, the league doesn’t even require that the team neurologist attend games.) Independent neurologists should be present, and hopefully the one positive development coming from the case of Cleveland Browns quarterback Colt McCoy is that, in the near future, they will be.

McCoy absorbed a devastating helmet-to-facemask hit from Steelers linebacker James Harrison on Thursday night. After missing only two plays, McCoy was back in the game.

“He actually, on the field, was talking about his hand and we go through the strict protocol to evaluate whether there is concussion like symptoms,” coach Pat Shurmur told reporters on Friday. “Seneca [Wallace] was in the game for two plays, I was told that Colt could go back in the game. He came up right next to me and said, ‘I’m ready to roll,’ so he went back in.”

As Peter King pointed out during last night’s episode of NBC SportsTalk, McCoy’s subjective belief that he was fine and his desire to return to the game shouldn’t matter. What should matter is whether a properly trained medical professional -- preferably fully independent of the team -- believes that McCoy definitely doesn’t have a concussion.

Besides, how can the supposedly “strict protocol” to which Shurmur referred be implemented so quickly, especially when by all appearances the trainers were checking out McCoy’s hand?

The Browns have declined our request to identify the specific tests that were conducted in clearing McCoy to return to the field. (Given that McCoy actually suffered a concussion, the tests apparently didn’t work.) Though not quite as tight-lipped as the Steelers when we posed various questions following an apparent concussion suffered by Hines Ward, the Browns fell far short of the Jets in the candor department when responding to a detailed inquiry regarding McCoy’s status. The Browns simply forwarded to us some of Shurmur’s quotes from Friday, acknowledged generally that the “medical team” checked out McCoy before he re-entered the game (without saying who is on the “medical team” and, more importantly, whether a neurologist was involved), and forwarded news items regarding other players who have suffered concussions praising the team for its handling of their own situations.

“I felt like the management from the point that it happened through yesterday was just fantastic,” linebacker Scott Fujita, a member of the NFLPA Executive Committee, said in October after Fujita was diagnosed with a concussion. “So that makes me feel really, really good. I couldn’t be happier with the way [trainer] Joe Sheehan and our doctors handled everything.” (I wonder what Fujita thinks about the manner in which McCoy’s situation was handled?)

A significant gap remains between the manner in which a team deals with a player who has been diagnosed with a concussion and the process implemented during the stresses and demands of a game to determine whether a player should be kept out of action due to a possible concussion. As to the former, the league is doing well. As to the latter, the league is failing not only its players, but also the men and the boys who play football at any level, since every lower level takes its cues from the NFL.

To close the gap, here’s what the league needs to do. A safety official should be stationed in the replay booth. The safety official would have the ability, based on a monitoring of the live action, replays, and activity on the sidelines, to initiate an evaluation of any player who possibly has suffered a concussion. The safety official would buzz down to an independent neurologist stationed on each sideline, and the independent neurologist would evaluate the player. The evaluation would occur not on the sideline, but in the locker room, in a warm, quiet environment, with the player’s shoulder pads removed. And the independent neurologist would not allow the player to return to the game unless the independent neurologist determines there is no concussion, concussion-like symptoms, or concussion-like concussion.

Coaches may not like this approach very much, because it could keep a player who actually doesn’t have a concussion from being available during a key sequence of a game. To that we say, “So what?” Either the NFL is serious about dealing with this issue, or the NFL isn’t. Right now, the league’s procedures contain a gaping hole regarding one of the most significant hazards of concussions -- exposing players to a second concussion immediately after they have suffered an initial one.

Two years ago, the league took the concussion problem seriously after Congress showed an interest in the issue. Maybe Congress now needs to let the league know that Congress believes more needs to be done to ensure that players who suffer concussions during a game aren’t able to make their way back onto the field.

If Congress would do that, the situation would be resolved within two weeks.

While the league may not prefer that outcome, it’s far better than having a player die on national television, in HD.