The NFL Players Association has fired a neurologist who was examining Miami Dolphins quarterback Tua Tagovailoa after Tagovailoa hit his head in a game against the Buffalo Bills last Sunday. Tagovailoa was allowed to return for that game, only to be carried off the field during a game four days later after apparently suffering a second head injury.
The dismissal came hours before the players’ union and the NFL announced Saturday they are working to change the league’s concussion protocol, potentially within days.
According to two people familiar with the union’s decision, “it exercised its right” to fire the doctor known as the “independent neurotrauma consultant” who advised the Dolphins’ team doctor during last Sunday’s Tagovailoa evaluation. One person said the outside doctor, who was licensed by the NFL and the union, was removed for violating concussion protocol, leading to an initial diagnosis that Tagovailoa did not have a concussion and he was allowed to play days later.
The doctor’s firing, who has not been publicly identified, came two days after Tagovailoa suffered a second blow to the head during Thursday’s Dolphins game against the Cincinnati Bengals, which resulted in him being removed on a stretcher and put in a hospital was taken hospital. The injury, which aired in prime time, reignited a vocal debate over whether the Dolphins circumvented concussion protocol during last Sunday’s game.
Shortly after last Sunday’s incident, the players’ union said it was working with the league to launch an investigation into how doctors assessed Tagovailoa’s health after his head slammed onto the turf in the second quarter of the Dolphins’ home game against the Bills.
After the play ended, Tagovailoa grabbed his helmet with his hands, struggled to get to his feet, and fell after a few steps. He was taken to the dressing room for an examination.
Under the NFL’s concussion protocol, a player may not return if a team doctor determines “in consultation with” an independent neurologist that a player’s “gross motor instability” was “neurologically caused.” However, the team doctor has the final say on the player’s diagnosis.
The Dolphins initially said during last Sunday’s game that Tagovailoa was being evaluated for a possible head injury. The team later said the quarterback suffered ankle and back injuries and returned for the second half.
The Dolphins’ lead team doctor is Dr. John Uribe, an orthopedist who is also the team doctor for the NHL’s Florida Panthers. It is unclear whether Dr. Uribe or another team doctor made the final decision to allow Tagovailoa to return against the Bills.
An NFL spokesman said Wednesday there was “every indication” that the doctors examining Tagovailoa followed the league’s concussion protocol. But the league and players’ union said in a joint statement Saturday night the investigation has yet to come to any conclusions about possible medical errors or breaches of protocol. They also said talks about changing the concussion protocol were underway within days, particularly around the term “gross motor instability.”
The investigation, which should last no longer than three weeks, is designed to determine “whether a violation has occurred and, if so, the appropriate disciplinary response”. If the league and union cannot agree on whether the protocol has been violated, the complaint is forwarded to an arbitrator.
Neurology consultants work on every sideline at every NFL game to assist team doctors when a player is believed to have sustained a head injury. These neurologists usually work in hospitals in the home team’s town. They will be led by the League’s Chief Medical Officer, Dr. Allen Sills, and NFL Players Association medical director Dr. Thom Mayer, approved.
The union’s request to fire the neurologist could be tantamount to symbolic action because team doctors, not the independent neurologists, make the final decisions about whether players have suffered concussions and whether they can return to the game under the NFL’s concussion protocol.
“For the avoidance of doubt, the responsibility for the diagnosis of concussion and the decision to return a player to a game rests solely with the professional judgment of the team doctor in charge or the team doctor charged with managing TBI,” the minutes read an acronym for traumatic brain injury.
According to the NFL contract, a neurology consultant “may ask his or her own questions or perform additional testing and is intended to assist in the diagnosis and treatment of concussion.”
In response to questions about the status of the team doctor or doctors examining Tagovailoa last Sunday, a Dolphins spokesman said the team is allowing the joint exam to proceed.
The Dolphins have not said Tagovailoa suffered a concussion during last Sunday’s game, but the neurologist’s dismissal suggests the union believes he may have sustained one. Tagovailoa suffered a concussion during Thursday’s game, the Dolphins said. A second concussion suffered before an earlier one has properly healed can lead to significant complications.
On Friday, Dolphins coach Mike McDaniel said Tagovailoa had a headache but was feeling better overall. Later that day, Tagovailoa said on Twitter that he was “feeling a lot better and focused on recovering so I can get back on the field with my teammates.”
The team hasn’t set a timeline for Tagovailoa’s return.