The Journal of Law, Medicine and Ethics Issue Worth Bookmarking

Twitter is such a wonderful thing!  You can get so much information is such a short time; sure there is a ton of unsolicited information that one may have to weed through, but the benefits outweigh the bad – at least for us here at The Concussion Blog.

Such an instance was getting a tweet at me about a journal and a particular issue.  The Journal of Law, Medicine and Ethics, Volume 42:3 to be exact.  In this volume all of the pages are filled with concussion related issues, after all it was titled: Concussion and Sports.

I cannot speak to the “prestige” or “reach” of this particular journal, however I can post the link here (above) for you to bookmark for some reading on where the tone of med-legal is going in relations to concussion and sport.

Topics include:

  • Youth Concussion Laws
  • Requiring receipt of concussion related materials (a study)
  • Coach Support
  • Informed Consent

At the link you can download, free, the journal and its articles.  It might be worth some time to investigate and look into what we may be facing.

Terry Ott: Canadian Concussion Law Suit Begins Its Slow Crawl To Resolution

In July this blog broke the news that Canada was facing its first law suit based on concussions in their professional football league.  Since that time there has been plenty of information, misinformation and general commentary about this issue in Canada.  The fact remains that this is a long way from getting settled, if you remember correctly the concussion issue in America took over a year to get “settled” and even now it is not completely final/finished.  Although there has been coverage in Canada (which has limited this blogs need to post/present about it) Terry Ott continues to beat the trail and get information to  present in his unique way.  With that backdrop I give you Mr. Ott’s latest filing…
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DEE-FENCE!
“Absence Of CTE” Doctor Files Defense in CFL Arland Bruce Concussion Lawsuit, But Claims to be “Outside The Knowledge Of” On Many Relevant Concussion Issues
HAMILTON
September 23, 2014

Just as it was a long way to Tipperary, it is surely a long way to go before the Arland Bruce III concussion lawsuit against the CFL, its member clubs, CFL Alumni director Leo Ezerins and Dr. Charles Tator and Krembil Neurosciences Center (KNC) ever comes close to a courtroom, or even any kind of resolution.

However, the legal equivalent of a punt has begun, and court documents obtained for this story provide for a very interesting if limited insight as to what can be expected in this first of its kind case in Canada.

On Sept. 10, the Vancouver BC firm of Harper Grey LLP, and attorney Nigel Trevethan filed a defense on behalf of Dr. Charles Tator,  denying or described as “outside the knowledge of the defendant” all but three parts of Bruce’s claim, only excepting that:  1. Tator is affiliated with Krimbil, 2. the KNC is based in Toronto,Ont. and 3. that Dr. Tator is the director of the Canadian Sports Concussion Project; these are the only facts that “are admitted” in Bruce’s 47 page statement of claim.

And while much of the above is pro-forma legal to-and-fro tiddlywinks, some of the “denied” and “outside the knowledge of the defendant” defenses as described in the Tator response to the civil claim are, ah, questionable to this reporter. (See attachments provided below.)

For instance, according to the filed document of defense Dr. Tator denies that he knew or should have known that:  Continue reading

#TheFIFA5 A Recap by Snedaker

Although the news of a concussion lawsuit is not really “new” anymore the fact that it was brought against FIFA was “earth-shattering” in terms of news.  Sure, the football leagues and even the NCAA have been targets, but for soccer to get the proverbial target painted on its back has really shook up the sporting world.  It was big enough news that it was in national sports casts and even was termed “breaking news” in corners of the world.

Perhaps the beginning of football season here in America has swept away most of its “front burner” power; it is mindful to take a look at what this law suit is all about.  Mind you, it is not your normal litigation.  Below is a wonderful recap of #TheFIFA5 suit being brought forth, submitted by Katherine Snedaker-Price (it appears on her blog pinkconcussions.com):

This summary is based on information posted on the Hagens Berman S Shapiro LLP website and is my unofficial review of the lawsuit I have hash tagged as #TheFIFA5. NOTE: I am not a lawyer, and am merely outlining the suit as I read it. I welcome comments and thoughts.

On August 27, 2014, a Class-Action Lawsuit Filed Against FIFA, U.S. Youth Soccer Over Concussions made headlines. This lawsuit pits three mothers and two female college students vs FIFA, soccer’s worldwide governing body—the Fèdèration Internationale de Football Association (FIFA)—and affiliated soccer organizations in the United States

  • US Soccer Federation
  • U.S. Youth Soccer + American Youth Soccer (over 3 US million child and adolescent soccer players)

Note: In 2013, FIFA reported $1.386 billion in revenue.  The 2014 World Cup brought FIFA $1.2 billion from U.S. broadcasters. This lawsuit states FIFA has failed to enact the policies and rules needed to protect soccer players. FIFA and the others mentioned…

  1. Failed to adopt effective policies to evaluate and manage concussions, at all levels of the game
  2. Lacked of effective policies poses a greater danger to women and children players, who may more vulnerable to traumatic and long-lasting brain injury
  3. Ignored medical community called for changes over a decade ago
  4. Ignored simple, best-practice guidelines, which have been updated three times since the initial international conference on concussions (FIFA even hosted)

FIFA has made progress…  Continue reading

Terry Ott — E”TF”A: Now 1 of 7 and Counting

Eric "the Flea" Allen Toronto Argonaults 1972. Photo Ted GrantThe information being brought to The Concussion Blog has been astounding, newsworthy, controversial (to some) and welcome.  We are not paying anyone for their guest posts, rather providing a platform for the information.  The inbox is always open for such things – with me as executive editor.  Just because something is posted here does not mean that I or we generally agree or endorse unless otherwise stated.  I have reached out to many people on the other side of this current CFL issue to open my pages to them and have yet to get a post from them.  Honestly, I don’t know that much about the CFL and its players – Doug Flutie being the only one I remember that well.  I truly appreciate the feedback on this continuing saga, but remember this is one journalist, Terry Ott’s, work.  It is here because he cannot find anyone to publish his information in Canada.  I feel this information is important to share.  What follows is Terry’s most recent filing.

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1970s ERA CFL STAR ERIC “The Flea” ALLEN WILL REPORTEDLY SUE CFL FOR ALLEGED MANY HEALTH PROBLEMS AS A RESULT OF PLAY

Former Toronto Argonaut Player Dealing With “Serious” And Debilitating Concussion Related Issues

Hamilton, Ontario — July 30, 2104

Eric “The Flea” Allen starred with the Toronto Argonauts between 1973-1975, and as noted previously here in Sneer and Loafing, is suffering the effects of what is alleged to be serious brain damage caused by multiple concussions while he was playing for the Toronto team, which at the time, was the highest profile and richest franchise in the league.

Allen, 65, is currently being cared for by his elderly mother in the family home in Rock Hill, South Carolina, along with some help from family and home care workers.

In an interview, Allen’s mother Rebecca Young, 84, said that Eric’s condition had declined precipitously in the last 6 weeks to the point that her son “can hardly walk now,” even with the aid of a walker, and spends most of the day in bed suffering from vertigo and has recently developed bouts of incontinence as well as suffering from worsening memory and mood issues.

Mrs. Young said that she had recently been visited by Canadian lawyer Robyn Wishart who Mrs. Young said will be representing Mr. Allen in a legal action against the Canadian Football League, allegedly for concussion injuries Allen says he suffered while playing in the league for the Toronto Argos for the three seasons in question.

“She said she was going to do her best to get (us) some help,” said Mrs.Young, of lawyer Wishart. “I hope it’s soon…I’m so tired,” added Mrs. Young, who as the principal caregiver for her debilitated son has a multiple hour drive to take Mr. Allen for treatment at the Medical University of South Carolina.

Ms. Wishart was traveling and did not return telephone calls for comment about Allen’s condition.

Two weeks ago, Arland Bruce, also represented by attorney Wishart, was the first 21st century former CFL player to file suit against the CFL member teams and others for concussion injury. Mr. Allen now marks the first from another era to follow a similar path although legal sources expect any lawsuit alleging head injury prior to any officially established CFL concussion protocols to be constructed quite differently than the Bruce pleadings, possibly along the lines of the now settled NFLPA 1 billion dollar suit against the NFL.

Furthermore, according to a source speaking on condition of anonymity, there are now at least a total of 7 former CFL players, some who played over 50 years ago, currently, or intending to, bring suit against the league for concussion injury.

The Arland Bruce III lawsuit story was national news in Canada for several days after it first broke on this Blog July 16, albeit with some of  the coverage taking on a near inquisition tone regarding Mr. Bruce’s motivations and alleged recent actions.

And unfortunately, your correspondent has been hearing about rumblings/grumblings supposedly originating from within The Great White North sports media community that somehow I have embellished, made up, or even peddled “lies” in my episodic and breaking reporting of the emerging concussion crisis in the CFL during the last 9 months.

In case you still don’t get it boys: this is not about me, but rather the wounded former players and common human decency. The players are making nothing up. Mull that scenario over for a while my suspicious, duplicitous friends.

This latest report on Mr. Allen’s troubles and intentions will hopefully give those uninformed and wrong side of history naysayers some pause before they raise questions about Mr. Allen and his family’s motivations and needs, as well as way, way down the line, mine.

#tbt: Eye Opener from 2012: Was it overlooked?

Originally titled “Bombshell Found in Sports Illustrated Vault” this post appeared on July 4, 2012…  To this day, it may be one of the most poignant articles I have written about the road we have been down.  I believe that this post still rings true, two years later, in regards to all the information we knew that we didn’t know…  

Considering where – 2014 – and what has transpired – League of Denial – this article may have been glossed over and was WAY AHEAD OF ITS TIME from SI.  I often find myself wondering why we are not learning from the past to make proactive measures going forward…

Enjoy the read from the past (excellent RT @protectthebrain);

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Thanks to @ConcernedMom9 I was sent an article from Sports Illustrated written by Michael Farber.  Before I tell you the year and provide the link I want so share some quotes from it;

“People are missing the boat on brain injuries,” says Dr. James P. Kelly, director of the brain-injury program at the Rehabilitation Institute of Chicago and an assistant professor of neurology at Northwestern University Medical School. “It isn’t just cataclysmic injury or death from brain injuries that should concern people. The core of the person can change from repeated blows to the head.

“I get furious every time I watch a game and hear the announcers say, ‘Wow, he really got his bell rung on that play.’ It’s almost like, ‘Yuk, yuk, yuk,’ as if they’re joking. Concussions are no joke.”

That sounds very similar to what we are discussing now in 2012.

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•Of the 1.5 million high school football players in the U.S., 250,000 suffer a concussion in any given season, according to a survey conducted for The American Journal of Public Health.

•A player who has already suffered a concussion is four times more likely to get one than a player who has been concussion-free. Quarterbacks, running backs, receivers and defensive backs are most vulnerable, […] that special teams players were at the highest risk per minute spent on the field.

•Concussions are underreported at all levels of football. This is partly because of the subtlety of a mild concussion (unless a player is as woozy as a wino, the injury might go undetected by a busy trainer or coach) but primarily because players have bought into football’s rub-dirt-on-it ethos. “If we get knocked in the head, it’s embarrassing to come to the sideline and say, ‘Hey, my head’s feeling funny,’ ” says San Francisco 49er quarterback Steve Young, who has suffered at least a half dozen concussions. “So I’m sure we’re denying it.”

•Football’s guidelines for players returning after concussions are sometimes more lenient than boxing’s. The New Jersey Boxing Commission requires a fighter who is knocked out to wait 60 days and submit to an electroencephalogram (EEG) before being allowed back into the ring.

•According to Ken Kutner, a New Jersey neuropsychologist, postconcussion syndrome is far more widespread than the NFL or even those suffering from the syndrome would lead us to believe. […] Kutner says that the players fear that admitting to postconcussion syndrome might cost them a job after retirement from football.

Hmmm, we all thought this was information new to us – new being 2008.

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That, however, doesn’t console Lawrence and Irene Guitterez of Monte Vista, Colo. “He just thought it was something trivial,” Irene says of her son, Adrian, who was a running back on the Monte Vista High team three years ago. “He had a headache and was sore, but it seemed like cold symptoms. He wasn’t one to complain. He wouldn’t say anything to anybody. He wanted to play in the Alamosa game.”

He did play. At halftime Guitterez, who had suffered a concussion in a game two weeks before and had not yet shaken the symptoms, begged teammates not to tell the coaches how woozy he felt. When he was tackled early in the third quarter, he got up disoriented and then collapsed. Five days later he died.

Years later another Colorado high school football player, Jake Snakenberg, would unfortunately repeat history; leading to the concussion legislation passed in that state.

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Do you have a guess on the year… Continue reading

Terry Ott: Personal Observations in the Wake of Suit

Terry Ott files a follow-up regarding the law suit in Canada and Arland Bruce.  This is his commentary on the coverage of the issue; all information, illustrations, pictures and links are his.

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DOES CANADA’S TSN, THE HOST CFL BROADCASTER, APPEAR TO BE “CIRCLING THE WAGONS” OVER ARLAND BRUCE III CONCUSSION LAWSUIT AND SUBSEQUENT NATIONAL HOOPLA AND HOOTIN’ AND HOLLERING, OR IS IT JUST A CASE OF, AND NOW, FOR SOMETHING (REALLY) COMPLETELY DIFFERENT?

“It is difficult to get a man to understand something when his salary depends on him not understanding it.” — Upton Sinclair, author of The Jungle

The irony of the American-based Concussion Blog breaking one of the biggest stories about the Canadian Football League in recent memory when it exclusively revealed the first concussion lawsuit in CFL history, is certainly very rich.

Prior to D-Day, July 16, 2014, much of the Canadian sports media didn’t know too much about concussions, and, well, seemingly, they didn’t wanna know too much. Or, as they also mused in the movie Casino, “ah,why take a chance?”

And of course there is that lovely old Buddhist proverb of “see no evil, hear no evil, speak no evil.” Maybe that’s what most of the big time scribblers and jolly jock-sniffers were up to up here prior to the Bruce legal revelation but since most would not even talk to me, how would I really know?

However, after Andrew Bucholtz of the Yahoo! Canada 55 Yard Line CFL Blog gave the story of the Bruce lawsuit nation-wide coverage mere hours after it first appeared here, the story became a talking point throughout Canada for days as well as shaking the previously comfortably cocooned CFL , who may have been alerted to the Concussion Blog post by a trusty and observant friendly just shortly after it went live from Chicago at 12:32 EDT, on July 16.  Continue reading

Exclusive: First Law Suit Filed in Canada Over Concussions

Terry Ott has filed this BREAKING NEWS in regards to Canadian Football and the Concussion Issue.  We here at The Concussion Blog are pleased to bring this information to you…  You can find the FILED CLAIM HERE.

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FORMER CANADIAN FOOTBALL LEAGUE PLAYER SUES LEAGUE MEMBER TEAMS FOR CONCUSSION RELATED INJURY

Lawsuit on Behalf of Star Arland Bruce III Alleges “Fraudulent Concealment” and “Negligent Misrepresentation” By 9 CFL TeamsLeague Commissioner, CFL Alumni Association and Others

Contrary to (popular) opinion, the sports press likes to fling incense, be part of the show, create stars, and to that end prints and televises a fraction of what it knows.” –Mark Kram, formerly of Sports Illustrated 

July 16, 2014
Hamilton, Ontario

The first lawsuit brought against the CFL member teams and others for concussion injury has been filed in Vancouver, British Columbia in the Supreme Court on behalf of Arland Bruce  III, a veteran of 12 seasons as a speedy wide receiver who last played for the Montreal Alouettes in 2013 and also starred on two different Grey Cup winning teams as well as spending the 2003 season with the San Fransisco 49rs.

Bruce, noted in the claim as an “unemployed football player,” is the holder of the record for most receptions in a CFL game (16) and is a three-time CFL All Star.

The claim, so far for unspecified monetary damages, asks for general damages, special damages, general and special damages “in trust” for the care and services provided by his family, and punitive and aggravated damages.

In the claim filed by the Vancouver law firm of  Slater Vecchio LLP and lawyer Robyn L. Wishart, it is alleged that Bruce suffered a concussion and was knocked unconscious in a game played in Regina, Saskatchewan on September 29, 2012 between the BC Lions — Bruce’s team at the time — and the Saskatchewan Roughriders.

Bruce subsequently returned to play for the Lions in a playoff game on November 18, 2012 and it is alleged that he was still suffering from his previous concussion and it is also alleged he suffered additional concussive and sub-concussive hits during the  Nov. 18 game.

From a copy of the claim, not proven in a court of law, it alleges in part:

  1.  The plaintiff reported concussion signs and symptoms to the BC Lions medical personnel and coaching staff including but not limited to the following:
    1. fogginess;
    2. headaches;
    3. sensitivity to light;
    4. sensitivity to sound;
    5. memory loss;
    6. confusion;
    7. dizziness;
    8. anxiety; and
    9. personality changes.

After the 2012 season, Bruce left the BC Lions and was signed for the 2013 season by the Montreal Alouettes.

Also from the claim: “Further, despite the fact that the plaintiff was displaying the ongoing effects of concussion to medical professionals  and coaching staff, he was permitted to return to play in the 2013 season for Montreal.”

In a 2011 Yahoo! Canada  Sports 55 Yard Line  article by Andrew Bucholtz,  and so noted in the claim, commissioner Mark Cohon said “I am convinced that every concussion is being reported and dealt with. I trust our  doctors. I trust our therapists. I trust our teams to report that.”

And in the 2011 Canadian Football League  concussion “Campaign” directive to the CFL clubs from Cohon advised to “err on the side of extreme caution” when dealing with suspected concussion injury.

Those familiar with my series “3rd Down, CTE To Go,” for the Concussion Blog in 2013 will recall former CFL player Leo Ezerins, now communications director for the Canadian Football League Alumni Association, and Dr. Charles Tator, of the University of Toronto, Krembil Neuroscience Centre, and the Canadian Sports Concussion Project. 

Both Tator and Ezerins believed there were “more questions than answers” between concussion and brain trauma and that “extreme caution” be used in any subsequent diagnosis of CTE.

Accordingly, Ezerins and Tator are named as defendants in the lawsuit and perhaps the most revelatory allegations — again not proven in a court of law — made in the claim are that Bruce continued to play CFL football after suffering concussion  and sub-concussive injuries because:  Continue reading

“League of Denial” (Part 2)

Coming to a bookstore and TV near you today is “League of Denial” a book and documentary about one of the dirty little secrets the NFL has been avoiding for some time.  Fortunately, I have been provided with advance copies of both; the Frontline film was easy to digest, as for reading a book, well we can just say I am trying to read as fast as possible.

I was reminded quickly, yesterday via Twitter, that I may lack valuable perspective when it comes to concussion information (and that I am not normal – this is not breaking news).  Will Carroll of Bleacher Report let me know that this information will be new to a lot of people out there.  He is exactly right, not only that, this documentary will be easily digestible for the fan of football.  For any person just wading into this, when you tune into PBS tonight to view “League of Denial” you will be absolutely hooked from the start.

The sounds of the crowd, visuals of big hits grab your football part of the brain IMMEDIATELY, over those sounds you will quickly discover the problem NFL players have faced with brain injuries playing their sport.  Harry Carson saying “and then they are gone” when talking about former players.  A bold statement that the level of denial was “just profound.”  An NFL lawyer saying “we strongly deny those allegations that we withheld information or misled the players.”  And more video and sound of punishing hits that used to fill the highlight reel bring the opening curtain of this very important documentary.

This problem is real – it’s not just real for the professionals – and from the get go Frontline makes you understand, vividly and personally, why this is.  After listening to old radio calls of the Steel Curtain it all begins with the story of Mike Webster and the forensic pathologist who studied his brain, Bennet Omalu.

The discovery of a possible reason one of the most respected and lauded players in Pittsburgh sports pantheon fell from grace and eventually found and early demise.  If the football portion of your brain does not connect to what is being presented then I would haphazardly guess that you are not ingrained within the fabric of football.

As Harry Carson explains how the game was played and to some extent how it’s still played you can begin to understand the issue at hand.  This is hammered home when Robert Stern, PhD tells the audience blows to the brain are at forces 20 times greater than the force of gravity (20 G’s); or as he so eloquently put it “driving into a brick wall at 35mph”, 1,000 times or more in a season.

In the first 11 minutes of this 2 hour presentation you are at full attention and want to understand the “whats”, “whys” and “whos”.  If you are not engaged and ready for further explanation I can only say that you don’t care or want to bury your head in the sand.

Contributions in the film include Continue reading

“League of Denial” (Part 1)

Coming to a bookstore and TV near you tomorrow is “League of Denial” a book and documentary about one of the dirty little secrets the NFL has been avoiding for some time.  Fortunately, I have been provided with advance copies of both; the Frontline film was easy to digest, as for reading a book, well we can just say I am trying to read as fast as possible.

In all honesty, if you have followed any part of this issue nothing revealed in either medium (thus far in the book) is seen as “BREAKING NEWS” rather an illustration of what has been happening with the research arm and policy makers of the National Football League, with regards to concussions.

“League of Denial” the Book:

In what I have been able to read thus far both Steve Fainaru and Mark Fainaru-Wada have done a good job of telling the hidden secret.  The Fainau’s went as deep as they possibly could without the help of the league itself, even as far as getting one of the original researchers to recount some of the possible misgivings in the past.

By utilizing the real stories of players that met an early demise (Mike Webster most notably) the information has an emotional connection with the reader.  While reading this you understand why this information may have been so valuable to the families and friends of those that could have been effected by repeated head trauma.

It doesn’t take a brain surgeon to tell you that repetitive brain trauma is bad for you, but the problem here is Continue reading

NFL Concussion Litigation Settled Out of Court

Twitter and my in box is exploding at this very moment…  The NFL and the players who have filed suit against the league have come to a settlement of $765,000,000, Judge Brody’s statement can be found HERE.  This works out to about $170,000/player or estate if there were only 4,500 plaintiffs (numbers are not clearly known).

This is a good thing for the league, and for some players this is well needed cash flow.  If the promise of establishing a better future with study and plans for players hold true it will be a great day.  But excuse me if I’m a bit reserved on the confetti and marching bands…

The 88 plan was supposed to be the answer, then the new Head Neck & Spine Committee, then the Mackey Council within the league (headed by Sean Morey).  There have been many band aids placed on this gashing wound before, perhaps just throwing money at it will clot it up?

Moreover, the fact that the NFL does not have to go through discovery in the litigation process makes those in Manhattan pop the champagne!

Doesn’t it seem a bit coincidental that this has come on the heels of the release of “The United States of Football” and the upcoming release of the Frontline (formerly co-partnered with ESPN)  “League of Denial“?

Perhaps I am skeptical, fine, but who has really won in this?

NOCSAE Press Release Clarifies

NOCASE sent me the most recent press release; pertaining to the aftermarket/third-party additions to helmets. Here it is in full;

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Certification to NOCSAE Standards and Add-on Helmet Products

OVERLAND PARK, Kansas – August 8, 2013 – The National Operating Committee on Standards for Athletic Equipment (NOCSAE) has released the following statement regarding equipment certified to NOCSAE standards and add-on helmet products.

“Products designed to be added to a football helmet are being marketed and sold; some are intended to measure impacts, while others are expressly marketed as improving a helmet’s performance. Some products claim the ability to protect against concussions. Regardless of the truth of such claims, the addition of those products to a certified helmet changes the model, by definition, under the NOCSAE standards.

“For many years NOCSAE standards have defined a helmet model as a helmet “intended to be identical in every way, except for size.” Any changes, additions or alterations of the model, except for size, color or graphics, even if made by the original manufacturer, require that a new model name be created and a separate certification testing process begin for that new model. This concept of limiting certification to a specific model is commonly found in national and international helmet standards.

  • NOCSAE itself does not certify any product, it does not “approve” or “disapprove” of any product, and has no authority to grant exemptions or waivers to the requirements imposed by the standards it writes.
  • The addition of an item(s) to a helmet previously certified without those item(s) creates a new untested model. Whether the add-on product changes the performance or not, the helmet model with the add-on product is no longer “identical in every aspect” to the one originally certified by the manufacturer.
  • When this happens, the manufacturer which made the original certification has the right, under the NOCSAE standards, to declare its certification void. It also can decide to engage in additional certification testing of the new model and certify the new model with the add-on product, but it is not required to do so.
  • Companies which make add-on products for football helmets have the right to make their own certification of compliance with the NOCSAE standards on a helmet model, but when that is done, the certification and responsibility for the helmet/third-party product combination would become theirs, (not the helmet manufacturer). That certification would be subject to the same obligations applicable to the original helmet manufacturer regarding certification testing, quality control and quality assurance and licensure with NOCSAE.
  • Products such as skull caps, headbands, mouth guards, ear inserts or other items that are not attached or incorporated in some way into the helmet are not the types of products that create a new model as defined in the NOCSAE standards and are not items which change the model definition.”

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I read it simply as this;  Continue reading

A Chuckle and Video

I really don’t have much for this quote found in this article;

“I have a theory on concussions,” he said. “I think the reason there’s so much more of them — obviously the impact and the size of the equipment and the size of the player — but there’s another factor: everyone wears helmets, and under your skull when you have a helmet on, there’s a heat issue.

“Everyone sweats a lot more, the brain swells. The brain is closer to the skull. Think about it. Does it make sense? Common sense?” said Carlyle, who said he’d never talked to a doctor about his premise, which he was introduced to by Jim Pappin, the former Leaf who also played his career helmet free.

“I don’t know if it’s true, but that would be my theory. Heat expands and cold contracts. The brain is like a muscle, it’s pumping, it swells, it’s a lot closer to the outside of the skull.”

Stick to coaching hockey, eh!

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The ESPN article and video (click link or below) regarding the NFL Concussion Litigation; Continue reading

ESPN OTL Article Sparking Quite A Debate

On the surface this article may be innocuous to many, but the the minutia of concussion research and information is coming to a head very quickly, especially pertaining to the NFL.  Tomorrow is the first hearings in front of the judge – and the possibility of total dismissal – for the concussion law suits filed by thousands of former NFL players.

ESPN and its Outside the Lines department (in conjunction with Frontline) filed this article taking a look at two of the most prominent people in the concussion research/awareness arena, Dr. Robert Cantu and Chris Nowinski;

Two prominent concussion researchers — including a senior adviser to the NFL — served as paid consultants to law firms suing the league for allegedly concealing the link between football and brain damage, according to interviews and documents obtained by “Outside the Lines” and “Frontline.”

The article written by Steve Fainaru and Mark Fainaru-Wada sheds light on the very issues the research community faces with this problem.  Some of this information can be classified as “not new” to people who participate in the constantly shifting arena of litigation and research, while some information can be deemed as scathing.  There is a very tight and ubiquitous line in this matter;

Researchers often are asked to appear as expert witnesses in legal proceedings related to their fields. The NFL suit, with the potential for billions of dollars in damages, has created a large demand for researchers with expertise in the science of concussions.

But some researchers said they have turned down such requests despite the potentially lucrative payoff out of concern the perceived conflict could compromise their research.

Conflict of interest (COI) is something we all need to pay attention to, although it applies to this current article, the COI in this field is rampant and often unchecked.  This is nothing new, players have talked about COI, other journalists have noted it, and one of our prominent commentators (Dr. Don Brady) on the site has even devoted some of his dissertation to COI.

It would seem this is nothing “new” in the world Continue reading

Zurich 2012 In Writing

If you all recall I went to Zurich in November to attend the “Concussion Conference”; mainly as an observer, but there was enough time and opportunity to impart my questions/knowledge as a practicing athletic trainer.  Here are the links to DAY 1 and DAY 2 of my live blogging.  By the way, the live blogging was WELL received and continues to provide great insight into what went on.  I hope that I am asked back for the next conference, or any other conference that wouldn’t mind my attendance.

Now the information gathered at the conference has been hashed and rehashed and now appears as the 4th Consensus Statement (tweeted previously).

As part of the initiative the Standardized Concussion Assessment Tool (SCAT) was looked at and changes were made to the 2nd version from 2008.  You can now find the new version by clicking SCAT3.

A new wrinkle was an assessment tool for the younger ages, the group decided on the “Child” version of the new SCAT3, that can also be found by clicking Child SCAT3.

Also included in the addendum of the Consensus Statement was a recognition pocket card, found by clicking Recognition Pocket Card.

All of the above is free and intended to be used as a resource for better concussion assessment and even early management of concussion.  Please read the Statement regarding best practices.  As always this blog is NEVER to be used to diagnose or treat a concussion.  There is a lot to be absorbed and read; one thing is for sure we as athletic trainers and concerned/educated individuals now have the most recent information at our fingertips.  I guess this blog is actually doing some good work 🙂  A side note; how about this appearing during National Athletic Trainers Month?  It might be a coincidence, but I find it serendipitous.

Moorad Sports Law Symposium: Concussion Conundrum

The concussion issue has permeated every facet of life and sport.  Now policies, products, rules and law are starting to address the issue head on (pun intended), and one of the most renowned groups is taking a look at this issue as well;

The 2013 Jeffrey S. Moorad Sports Law Journal Symposium—Concussion Conundrum—explores, debates, and informs on the key issues facing players, teams, leagues, doctors, and lawyers regarding head injuries and brain trauma in sports.

Panels include commentary from well-known retired professional athletes about concussion awareness and prevention amongst players; an examination of both sides of the NFL Concussion Injury Litigation—the concussion injury class action suit brought by former NFL players against the league; an exploration of the science and concussion-related liability facing professional and amateur sports; and a look at where we are and where we are going with media personalities commenting on the state of sports and concussions.

Andrew Brandt, Director of the Jeffrey S. Moorad Center for the Study of Sports Law and NFL Business Analyst, has covered the concussion issue for ESPN and moderates all panels.

The Symposium takes place on Friday, March 15, from 9 a.m. to 12 p.m., in the Arthur M. Goldberg Commons at Villanova University School of Law. This program is approved by the Pennsylvania Continuing Legal Education Board for 2 substantive CLE credits. The event is free for non-CLE attendees.

The panel and the topics are top notch; this event should be on the “to-do” list of  anyone interested in sports law.  Below is the topics and panels (check the website for more deets – also notice our partners at stopconcussions.com (Keith Primeau) and our good friend Paul Anderson);

  • Panel 1: Framing the Issue
    • Keith Primeau
    • Jim Nelson
    • Taylor Twellman
    • Brian Westbrook
  • Panel 2: Building the Case — A Legal and Medical Background of Concussions  Continue reading

Matt Chaney – Tireless Worker

SpringGame1984Sideline
If you have been around enough you have seen the stylings of Matt Chaney on this blog, he is someone I call a friend.  In some circles that discounts me as a professional, which is both stupid and dumb.  I don’t always agree with Matt, heck him and I have been known to battle via electronic and phone communications.  However, his opinion is a valuable one – often his work is based in so much fact it makes your head spin as to why some of its missed.  Regardless, Matt has published two recent articles on his blog, for all to consume, here are some excerpts.

Part 1, published January 7th;

Historic football excuses thrive in modern debate over brutality

Lawsuits, criticism explode and officials project blame onto individuals

Old talking points of football apology resonate yet as officials tout anti-concussion measures like trainers along sidelines, new rules for safer play, injury reduction and expert consultation—same type of promises heard from gridiron leaders during the Victorian Era

American football gets lambasted in public for maiming and killing, denounced by an influential movement of critics, and game officials pledge safer play based on their new concepts of prevention, including:

*Qualified trainers and doctors will patrol sidelines.

*State-of-art medical response will treat the rare severe casualties.

*Limits will govern length of practices.

*Injury tracking will cut rates already on decline.

*Coaches will properly train players.

*Every player will undergo medical prescreening.

*Experts will lead safety reform in rulemaking and research.

*Referees and coaches will enforce new rules of experts.

*Players will follow new rules of experts.

Sounds familiar, these steps, a practical recitation of talking points for contemporary “safer football” promoted by the NFL and commissioner Roger Goodell, in face of lawsuit frenzy against the league and sport in general, along with festering disgust in the public.

Except the football rhetoric is 119 years old, from 1894, a packaged response during the game’s initial siege against formidable opposition seeking abolishment. Continue reading

Coach & AD Magazine Cover Story

cover picIn January’s edition of Coach and Athletic Director Editor-in-Chief, Michael Austin wrote the cover story on concussions; titled “What you’re missing when it comes to brain injuries”.  A very well researched and written article on concussion issues at the high school level.  Austin looked at the changing protocols, safety issues and legal concerns that will be facing the sports of our community schools now and in the future.  Here are some excerpts;

This isn’t just a football problem.  Media coverage focuses on the gridiron, but any time a player’s head is placed in harm’s way, a brain injury is a potential result.  “From what I see, football leads the pack by far but we’re also seeing more girls and boys soccer players sustaining concussions,” says Dr. Michael C. Koester, MD, ATC, who is the director of the Slocum Sports Concussion Program within the Slocum Center for Orthopedics and Sports Medicine in Eugene, Ore. “Interestingly this year, and this could just be a statistical blip, but it’s worth noting we are seeing more girls volleyball players as well.”

That comment struck me as in the fall I saw more junior high school volleyball concussion (5) than high school football concussions (4), I have no idea what that means.

In the area of classification, Austin does a good job of trying to put ‘mild’ to rest with concussions;

Dr. Gerard Gioia, the director of the Pediatric Neuropsychology Program at Children’s National Medical Center and the director of the hospital’s Safe Concussion Outcome, Recovery & Education (SCORE) Program, says the medical community has “dropped the grading system” when it comes to concussions.  He adds a common misnomer is the
suggestion you must have loss of consciousness to sustain a concussion, which is not true.  “You can’t call a concussion
‘mild’ just because someone isn’t knocked out for 10 minutes. Most concussions do not involve a loss of consciousness,” Gioia says.

Regarding the state legislation and protocols;

“The No. 1 goal is to get the student-athlete back to school without symptoms or ramifications before even thinking about a return to the sport,” Fink says. For coaches anxious to have the player return to the field, Fink tells them every athlete Continue reading

NFL Concussion Litigation – The Science of Sport

That is the title given to the upcoming webinar/teleconference sponsored by Perrin Conferences.  These events are mainly geared toward attorneys/lawyers and offer continuing education credits (CLE) for attending.  Below is the press release;

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Experts in NFL Concussion Suits join together to tackle industry trends, litigation challenges, and the science in sports injuries on Jan. 8.

Berwyn, PA – Perrin Conferences‘ teleconference series presents “NFL Concussion Litigation – The Science of Sport,”  a program bringing together leading attorneys, doctors and other experts to discuss the issues dominating the headlines of the concussion cases against the NFL, NCAA and equipment manufacturers.  The teleconference will be hosted on Jan. 8 at 2:00 p.m.- 4:00 p.m. EST.

The program provides an overview of the current allegations and defenses in NFL concussion litigation, an update on the latest scientific studies, and tackles other issues including:

  • The potential legal and economic impact of concussion litigation for players, sports leagues and uniform equipment manufacturers
  • Chronic Traumatic Encephalopathy – what is it and how does the science fit into the current litigation strategies?
  • The history of the dangers of head injuries and the timeline of NFL-sponsored studies/concussion rules
  • Medical monitoring and other potential damages
  • Duty to defend, trigger, occurrence and other insurance issues

Speakers include Continue reading

In Case You Missed It, the NFL/NFLPA Agree on Neuro Benefits

nflpaI caught this from Paul D. Anderson, apparently Darren Rovell had it as well; the NFL and the NFLPA finally agreed on neurocognitive benefits for NFL players as part of the 2011 collective bargaining agreement.  Obviously this was long overdue, but it is now a done deal.  You can read the nuts and bolts on Anderson’s blog HERE.

The gist of the agreement is that players who are fully vested and played one season after 1994 can get compensation for documented neurocognitive disabilities, something that has been missing from coverage since the beginning of time.  But, and its a HUGE BUT, there is a caveat (from Anderson’s blog);

In order to receive the benefits, the player must sign a release promising not to sue the NFL. In other words, if a player accepts the benefits he cannot join the NFL concussion lawsuits. Stated differently, if a player is currently a plaintiff in the concussion lawsuits, in order to receive the benefits, he will likely have to dismiss his lawsuit. The release will not waive any future workers’ compensation claim he may have against a team.

The plaintiffs in the concussion lawsuits, that played after 1994, have a decision to make: Continue reading

NFL players: They’re not doing it for their health

With the NFL season getting started last Wednesday night, player health, at all levels, comes to the front of my mind. I have recently been thinking about health insurance with respect to sports. Living in Canada, it is definitely less of concern than in the U.S., but I thought I would share some thoughts about the college and pro levels of sport.

There is no way that I’m the first person, after all this time, to talk about what colleges and pro teams are doing about health insurance for players. I know there are a bunch of questions about whether or not concussions are pre-existing conditions, and other reasons players can’t be insured, but it should be a legitimate issue at the college and pro-level for contact sports. The NFL, NHL and NCAA have enough financial wherewithal to encourage some forward thinking insurance company to insure the players who are, perhaps unwittingly, putting their future well-being in jeopardy on the field of play.

As has been reported countless times, concussions are caused in a number of ways and the symptoms are diverse. So why should it be forced into the same insurance categories as other injuries with the “pre-existing” condition clause? If there was enough demand for some type of concussion insurance, a new category for a specific league/sport could be created. Taking care of players once Continue reading

The Fight Within The Fight

As the NFL and its former players do battle in the courts, the NFL is also battling to find out who was/is covering them from an insurance perspective.

The answer is not so simple and really could be the tipping point in the sports concussion issue we are facing today.  The simple reason is this, if insurance companies refuse to indemnify leagues, schools, clubs, etc. for whatever reason related to injury, then how will the get coverage?  If they cannot get coverage then they cannot afford to provide the sport.

The National Football League is seeking coverage from insurers that it says have refused to provide a defense as the league faces hundreds of concussion-related lawsuits from former players—but insurers are claiming they have no duty to indemnify or defend the NFL.The list of defendants in a civil case filed Aug. 15 by the NFL and NFL Properties in California Superior Court includes companies from insurance groups such as Chartis, Chubb, Fireman’s Fund, Travelers, Hartford, OneBeacon, Ace, Allstate, XL, Transatlantic, Crum & Forster and Alterra.

Alterra filed papers with the Supreme Court Continue reading

Banning of football as a whole is NOT the answer

The goal of a writer is to bring eyes to their information/opinion to draw eyes for advertisers who in turn pay for the publishing of the article – in a very cut and dry manner.  With the troubles facing sports, particularly football, more and more articles have hit the interweb; often the most cited are those that trample on our beliefs of sport.

George Will penned an article that did just that as he opined that football should be ended because it cannot be “fixed”, a growing belief amongst some.  I am here to tell you that although football has its issues and concussions are high on the list, this is the case with many other sports; hockey, lacrosse and soccer being some off the top of my head.  Will does have some salient points;

After 20 years of caring for her husband, Easterling’s widow is one of more than 3,000 plaintiffs — former players, spouses, relatives — in a lawsuit charging that the NFL inadequately acted on knowledge it had, or should have had, about hazards such as CTE. We are, however, rapidly reaching the point where playing football is like smoking cigarettes: The risks are well-known.[…]

Furthermore, in this age of bubble-wrapped children, when parents put helmets on wee tricycle riders, many children are going to be steered away from youth football, diverting the flow of talent to the benefit of other sports.[…]

The lawsuits have nothing to do with the risk of injury, they have everything to do with whether the league knew about the long-term risks during that time and did not disclose that to the players.  The injury of concussion can occur outside of sports, in fact the majority of concussions come from recreational activities like: skate boarding, back yard touch football, playgrounds, bike riding and driving.  Even if the lawsuits are a reason for Continue reading

Quick Hits

The Ivy League once again takes proactive steps in regards to concussions.  After reducing contact days in football last year, the league Presidents approved similar changes for lacrosse and soccer;

The league announced Monday that its presidents accepted a series of recommendations made by a committee, including the possibility of suspension for hits to the head. The changes, which also will limit the amount of contact in practice, will take effect this fall for men and women.

The recommendations call for continued emphasis on educational initiatives. Consistent with current protocols, preseason meetings will emphasize learning and recognizing the signs of concussions, as well as the importance of reporting symptoms of concussions.

The Ivy league will next turn its attention on hockey.

I truly appreciate what the Ivy League is doing; non-radial with little to no cost moves that will be reassessed as time goes on.  I don’t know why it takes the smartest schools to make simple changes.  Honestly do you think they were the first to figure out that decreasing exposure will decrease concussions?

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Lester Munson of ESPN gives a insiders perspective of the law suits the former NFL players have filed;

The numbers are reaching the point where the litigation now qualifies as “mass tort,” a legal term that has been used to describe litigation on tobacco, asbestos and toxic medications.

The players are also demanding in a separate class action lawsuit that the NFL fund a program of medical monitoring for all former players (even those who did not play enough to qualify for retirement benefits), a program that would provide periodic examinations for early signs of concussion damage. The number of retired NFL players is uncertain, but players’ lawyers and their union estimate that there are at least 20,000 players who Continue reading

Players and Owner Perspectives on Concussions in the NFL

Time in the summer has seemingly been slipping away from me fast.  Honestly, most of the traffic ’round here tails off in June, July and August.  However I do feel an obligation to make sure y’all keep informed.  Today here are some links from the past few days;

Priest Holmes explains that some of the concussions caused some weird side-effects/symptoms;

In some instances, the concussed can feel very much like he’s on another planet. The sky itself can change to colors the sky shouldn’t be at a particular time.

“This color obviously isn’t going to be blue. It can be a color that can be orange. It can be red. The sky could turn green,” Holmes told Chris Corbellini. “There’s even an episode where you see a clear light, like light at the end of the tunnel.”[…]

“As much as I loved it [football], that same love now has put me in situations that I have to live with,” he said.”The frontal headaches, the migraines. Laying in bed, it’s tough to get out mornings just because of the pain that is setting in with an arthritic condition, it’s things like that that you never would have really thought about.”

Accepted risk by Holmes, no doubt, however not grasping the long-term effects and really just wanting to play a sport he loved has put him in a position that makes it tough.  In related news Stephen Davis, also a former running back, recently made statements about concussions in his time as a player; Continue reading

Bombshell Found in Sports Illustrated Vault

Thanks to @ConcernedMom9 I was sent an article from Sports Illustrated written by Michael Farber.  Before I tell you the year and provide the link I want so share some quotes from it;

“People are missing the boat on brain injuries,” says Dr. James P. Kelly, director of the brain-injury program at the Rehabilitation Institute of Chicago and an assistant professor of neurology at Northwestern University Medical School. “It isn’t just cataclysmic injury or death from brain injuries that should concern people. The core of the person can change from repeated blows to the head.

“I get furious every time I watch a game and hear the announcers say, ‘Wow, he really got his bell rung on that play.’ It’s almost like, ‘Yuk, yuk, yuk,’ as if they’re joking. Concussions are no joke.”

That sounds very similar to what we are discussing now in 2012.

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•Of the 1.5 million high school football players in the U.S., 250,000 suffer a concussion in any given season, according to a survey conducted for The American Journal of Public Health.

•A player who has already suffered a concussion is four times more likely to get one than a player who has been concussion-free. Quarterbacks, running backs, receivers and defensive backs are most vulnerable, […] that special teams players were at the highest risk per minute spent on the field.

•Concussions are underreported at all levels of football. This is partly because of the subtlety of a mild concussion (unless a player is as woozy as a wino, the injury might go undetected by a busy trainer or coach) but primarily because players have bought into football’s rub-dirt-on-it ethos. “If we get knocked in the head, it’s embarrassing to come to the sideline and say, ‘Hey, my head’s feeling funny,’ ” says San Francisco 49er quarterback Steve Young, who has suffered at least a half dozen concussions. “So I’m sure we’re denying it.”

•Football’s guidelines for players returning after concussions are sometimes more lenient than boxing’s. The New Jersey Boxing Commission requires a fighter who is knocked out to wait 60 days and submit to an electroencephalogram (EEG) before being allowed back into the ring.

•According to Ken Kutner, a New Jersey neuropsychologist, postconcussion syndrome is far more widespread than the NFL or even those suffering from the syndrome would lead us to believe. […] Kutner says that the players fear that admitting to postconcussion syndrome might cost them a job after retirement from football.

Hmmm, we all thought this was information new to us – new being 2008.

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That, however, doesn’t console Lawrence and Irene Guitterez of Monte Vista, Colo. “He just thought it was something trivial,” Irene says of her son, Adrian, who was a running back on the Monte Vista High team three years ago. “He had a headache and was sore, but it seemed like cold symptoms. He wasn’t one to complain. He wouldn’t say anything to anybody. He wanted to play in the Alamosa game.”

He did play. At halftime Guitterez, who had suffered a concussion in a game two weeks before and had not yet shaken the symptoms, begged teammates not to tell the coaches how woozy he felt. When he was tackled early in the third quarter, he got up disoriented and then collapsed. Five days later he died.

Years later another Colorado high school football player, Jake Snakenberg, would unfortunately repeat history; leading to the concussion legislation passed in that state.

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Do you have a guess on the year… Continue reading