Rams Deserve Strong Discipline For Ignoring Case Keenum’s Concussion
On Monday afternoon the NFL announced that they would be launching an investigation into the St. Louis Rams handling, or mishandling, of quarterback Case Keenum's health and safety after he suffered what was very clearly a concussion in the fourth quarter of their Sunday game against the Baltimore Ravens.
After being hit and slamming his head back on the turf, Keenum was clearly injured and shaken and needed to be taken to the sideline and run through concussion protocol. But in a confusing and unexplained turned of events, he stayed in and continued to play, prompting the NFL to an investigation of what happened.
"Promptly after the conclusion of yesterday's game, we began a review to determine the facts of the injury to St. Louis quarterback Case Keenum and why he was not removed from the game for the necessary evaluation by a team physician or the unaffiliated neuro-trauma consultant as required by our concussion protocols. We are continuing that review today, which includes discussions with the Rams and their medical staff, the ATC spotter, the game officials, our medical advisors and the NFLPA. In the meantime, prior to this week's games, we will reinforce with all involved the need to ensure that these injuries are properly identified and addressed in a manner consistent with our protocols."
Here is the hit and consequential injury to which the NFL refers in their statement:
Now obviously none of us are doctors, but it doesn't take a medical professional to tell that Keenum was very obviously in distress and needed to be evaluated. He grabbed his head, went limp as a teammate tried to help him up and crouched on all fours trying to get his bearings. It's disturbing to even watch.
With all the attention that the NFL has placed on player safety and concussion protocol - after years of former players claiming longterm health implications from repeated head trauma, and a succesful lawsuit - one would think that this would be a clear cut decision for the Rams to take Keenum off the field to be assessed.
It turns out that not only did they make the decision to allow Keenum to stay in the game without undergoing concussion protocol, but it looks very much like they took the necessary steps to ensure that he did not get evaluated; the implication there being that they put Keenum at risk because they did not want to have to stop the clock and sub him out for even one play in a tie game with 1:10 left in the fourth quarter.
The loophole that allowed the Rams to do this exists in relation to the independent neurologists that the league mandates be present with the team doctor while they evaluate a player for a concussion. The rule, pictured below in full, states that "An unaffiliated Neurotrauma Consultant shall be present on each sideline during every game and shall be focused on identifying symptoms of concussion and mechanisms of injury that warrant concussion evalutation..."
This seems cut and dry, but the Rams avoided having Keenum looked at by the independent neurologist and/or team doctor by sending the trainer onto the field to evaluate him before he was taken off. Because the trainer deemed him capable of staying in the game, and the ATP spotter never alerted the officials to signs of concussion, the doctors on the sideline were never given a chance to look at him. (Thanks to SB Nation for bringing this to our attention.)
The sad truth here is that the team trainer actually robbed a visually distressed Keenum of the chance to get assessed and treated properly.
On the broadcast, you can see that in the aftermath of the hit and while Keenum was struggling to even sit up, there was a referee standing right there. You will also see Foles on the sideline, clearly getting ready to go into the game. He could tell that Keenum was not okay, but apparently no one else with the power to help him could tell.
As it turns out, the decision to endanger Keenum's brain by keeping him in the game did not work out for the Rams strategically. After throwing one incomplete pass Keenum was sacked again; this time fumbling and turning the ball over to the Rams with 1:00 left on the clock, giving them just enough time to turn the possession into a game-winning field goal.
It should have gone without saying that they couldn't let the fate of the game rest on a guy who was still seeing stars after getting his bell rung. It was an irresponsible and wreckless decision on every level, and the Rams should absolutely face discipline from the NFL; and harsh discipline at that. There is personnel and protocol put in place to protect these guys who legitimately put their short-term and long-term health at rish every day in order to be a cog in a machine that pumps out billions of dollars.
Mike Ditka made a bold statement on Monday Night Countdown when he said this about the implications that Keenum will face after enduring an injury like that and then being hit again:
That may seem a little doomsday to you, but it's far more true than any of us want to believe. Any one who has ever suffered a concussion knows how terrifying it can be, and any doctor will tell you that even one concussion in your lifetime can lead to issues down the road. What Ditka said wasn't an overstatement.
Apparently Ditka's sense of terror for these guys doesn't extend to Rams Head Coach Jeff Fisher, a member of the competiton committee, who on Monday called the ordeal a "combination of unusual events."
“I didn’t see him struggle to get up,” Fisher said. “I didn’t see anything from my vantage point on the sideline of Case’s slow recovery. The shots you’ve seen of him struggling to get up, I didn’t see that.”
Fisher went on to explain that head athletic trainer Reggie Scott saw Keenum struggle, and ran onto the field as the officials called a penalty on the play against the Ravens. “He questioned Case,” Fisher said. “Case said he felt okay.”
Because Scott went ono the field to assess Keenum, Fisher said, the ATC spotter did not find it necessary to alert the officials to stop the game. Apparently the officials spotting the ball never saw Keenum wobble (which we saw in the video is a suspicious claim.) Fisher said that they told Scott he needed to leave the field or there would be a costly 10-second runoff.
“The head trainer was told to leave the field,” Fisher said. “Keep in mind, we’re in a critical point in this game.”
Well as long as you are at a critical point in the game, then I guess endangering someone's brain function is understandable.
According to Fisher, the ATC spotter eventually told officials that Keenum had shown signs of brain trauma, but only after Keenum was already out of the game. Due to the chaotic nature of the way things unfolded according to Fisher, he believes that no one was at fault.
“You cannot, in these circumstances, place blame on anybody,” Fisher said.
YES. YOU. CAN.
I understand the instinct to avoid immediately placing blame in a situation like this. But the entire system set up to protect Keenum failed miserably. And the reason it failed is because it was the end of the fourth quarter and the game was on the line and no one was willing to step up and be the "bad guy" by insisting that a clearly injured man be given the proper medical examination.
This was not a situation that can be chalked up to unfortunate miscommunication amidst the chaos. Everyone involved in taking responsibility for protecting the player was more worried about managing the game and the time on the clock than whether Case Keenum knew his own name.
It's unacceptable. The NFL needs to make an example of the Rams if they want other teams around the league to take notice, and to take seriously the ramifications of letting a concussed player risk his life by staying in the game.
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