One thing the public may not understand is
there’s no test that definitively tells the doctors examining players on game day whether a player has a concussion. They’re testing for symptoms and using what’s called the SCAT5, short for Sport Concussion Assessment Tool, 5th edition. There are four steps to the test: red flags, observable signs, memory assessment using Maddocks questions and examination using the Glasgow Coma Scale.
Under Step 2, observable signs, there are two check boxes: one for “witnessed” and the other for “observed on video,” meaning either applies. And one of the yes/no categories is balance/gait difficulties/motor incoordination: stumbling, slow/labored movements.
It doesn’t take a neurologist to have watched what happened after Tagovailoa had his head slammed to the turf on Sunday by Bills linebacker Matt Milano and check off the
yes boxes.
Additionally, the NFLPA website’s overview of the protocol has a graphic that states: “
If a player demonstrates gross motor instability that is determined by the team physician, in consultation with the UNC [the independent neurologist], to be neurologically caused,
then the player is designated a No-Go.”
Again, in this case, it’s a slam dunk to say Tagovailoa demonstrated “gross motor instability” on Sunday at Hard Rock Stadium. The larger question, then, is whether that event was “neurologically caused.” In Tagovailoa’s case, the team doctors could make that determination—which, by a strict reading of the policy, they’d be able to do—and which could potentially undermine having an independent neurologist. There would also be the question of whether there was any follow-up testing after the game or during the week to confirm it.
Which is where another problem lies. Once Tagovailoa was cleared and went back into the game on Sunday, there wasn’t a requirement for him to enter the concussion protocol during the week. In fact, on Monday the Dolphins actually said
Tagovailoa wasn’t in the protocol, so unless he complained of symptoms, it’d likely be a nonissue for the team at that point.
So that’s the loophole here. In the heat of the moment, the team doctor (or the independent neurologist) could, on paper, determine that Tagovailoa’s stumbling was caused by his back, and not his head, and send him back into what was a very big game for the Dolphins. And then, because of that result, there’d be no requirement for further testing, with motivation, at that point, for everyone involved (doctors, team, player, league) to confirm the original finding—because if they were wrong on Sunday, what would that say about
them?