What You Need To Know

The NFL and the players’ union released their joint inquiry into how the Miami Dolphins‘ medical team handled Tua Tagovailoa’s possible head injury in Week 3.

The tldr version: The Dolphins followed the concussion protocol as written and Tagovailoa exhibited no “signs or symptoms of concussion during his locker room exam, during the remainder of the game, or throughout the following week.”

However, both parties agreed that “the outcome in this case” — Tagovailoa returning to action against the Bills and then playing four days later against the Cincinnati Bengals, when he suffered a frightening, undisputed head injury — “was not what was intended when the Protocol was drafted.”

NFL, NFLPA Release Tua Tagovailoa Investigation Findings

The nearly two-week inquiry was wrapped up late last week after Tagovailoa — who remains in the concussion protocol and will not play Sunday against the New York Jets — met with investigators.

He apparently told them the same thing that both he and the Dolphins have been saying publicly all along — that he didn’t suffer a concussion on Sept. 25, and the gross motor instability he exhibited immediately after the hit was the result of a back injury, not a head injury.

But the matter, which has been the subject of massive national controversy, was more complex, the NFL and NFLPA agree.

The league and union established the following facts, which will quote verbatim from the Saturday news release:

“During the play in question, the player was tackled and fell on his back and then hit his head on the ground. The player grabbed his helmet, shook his head several times, and after he took several steps, he stumbled and fell.

“The Club medical team and the UNC properly viewed the video of the play in question as required by the protocol and engaged in a locker room examination of Mr. Tagovailoa before the player was cleared to return to play. The Team physician cleared Mr. Tagovailoa, following consultation with the UNC. The steps set forth in the Concussion Checklist were, therefore, conducted.

“Mr. Tagovailoa suffered and reported back and ankle injuries earlier in the game. Mr. Tagovailoa told the medical staff involved that he aggravated his back injury on the play in question and that his back injury caused him to stumble.

“Mr. Tagovailoa did not report or exhibit any signs or symptoms of concussion during his locker room exam, during the remainder of the game, or throughout the following week.

“The medical staff involved determined that the Gross Motor Instability (‘GMI’) suffered by Mr. Tagovailoa was not neurologically caused. They concluded the player’s back injury was the cause of his observed instability. However, the team physician and UNC did not conduct an examination of Mr. Tagovailoa’s back during the concussion examination, but instead relied on the earlier examination conducted by other members of the medical staff.”

Conclusions From the Investigation Into the Miami Dolphins

Those findings led the NFL and NFLPA to agree on the following conclusions:

“While the investigation determined that the team medical staff and unaffiliated medical professionals followed the steps of the Protocol as written, the NFL and NFLPA agree that the outcome in this case is not what was intended when the Protocols were drafted. As such, as has been done in previous cases, based on the advice of the parties’ respective medical experts, the Protocol will be modified to enhance the safety of the players. Specifically, the term “ataxia” has been added to the mandatory ‘no-go’ symptoms. ‘Ataxia’ is defined as abnormality of balance/stability, motor coordination or dysfunctional speech caused by a neurological issue. In other words, if a player is diagnosed with ‘ataxia’ by any club or neutral physician involved in the application of the Concussion Protocol, he will be prohibited from returning to the game, and will receive the follow-up care required by the Protocol.

“The Protocol exists to establish a high standard of concussion care for each player whereby every medical professional engages in a meaningful and rigorous examination of the player-patent. To that end, the parties remain committed to continuing to evaluate our Protocol to ensure it reflects the intended conservative approach to evaluating player-patients for potential head injuries.”

On a conference call with members of the media, NFL executive Jeff Miller said that they never supported terminating the Unaffiliated Neurotrauma Consultant (UNC), who was fired by the NFLPA in the days following Tagovailoa’s injuries.

Dr. Allen Sills, NFL Chief Medical Officer, added that it was extremely unfortunate to take action before the full investigation.

In summary, the Dolphins followed the rules as written and presumably will face no punishment. However, the rules as written have now been changed, effective immediately, because of the events of the last two weeks.

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