There has been a lot to talk about following the conclusion of the Lions series, so much so that one aspect of the last Test is danger of being overlooked.
When George Smith clashed heads with Lions hooker Richard Hibbard, he went down instantly.
Referee Romain Poite was so concerned at what he saw, he called a halt to the game at the earliest opportunity.
Commentators on radio and television, to a man, expected it to be the end of the match for Smith.
Less than 10 minutes later, the Wallaby flanker returned to the pitch to and continued playing.
He was able to do so because he had passed a pitch-side concussion assessment (PSCA), which is a test devised by a team of IRB medical officers.
If anyone wonders just how reliable such a test can really be, rest assured, you aren’t alone.
Barry O’Driscoll (Brian’s uncle) is a former international who held positions on several IRB committees until last summer.
He resigned in protest at the introduction of the new protocols, believing they trivialise concussion.
There’s a good account of O’Driscoll’s views in an article which appeared in The Scotsman earlier this year.
Here’s an excerpt:
“The same player who 18 months ago was given a minimum of seven days recovery time is now given five minutes.
“There is no test that you can do in five minutes that will show that a player is not concussed. It is accepted the world over.
“We have all seen players who have appeared fine five minutes after a concussive injury then vomiting later in the night.
“To have this as acceptable in rugby, what kind of message are we sending out?
“If a boxer cannot defend himself after ten seconds he has to have a brain scan before he comes back.
“And we’re not talking ten seconds for a rugby player, we’re talking maybe a minute that these guys are not sure what’s going on.
“They don’t have to have a brain scan, they have to have five minutes where they have to stand up straight without falling over four times, they have a basic memory test – ‘What’s the score? Who are you playing against? Which half did it happen in? And do you have any symptoms?’
“These questions should serve as a landmark for when you examine them six hours later to see if they’re getting worse or if they’re bleeding into their brain.
“That’s why you ask them, not to see if they can go back on. They are already concussed at that point.”
In North America the NFL and NHL are facing damaging lawsuits which accuse them of failing to put in adequate safeguards to protect players from serious head injuries.
Rugby is in perhaps in danger of suffering a similar fate.
The fact the IRB has a concussion protocol is evidence that it recognises the nature of the problem.
When a player can be cleared to play within minutes of suffering a significant head trauma, it does raise questions the tests are fit for purpose.
More specifically, whether a court would regard the test as an adequate way to ensure player welfare.
johnb747b
Guest
A 5-minute test for obvious & serious concussion is beyond laughable. Screw the test, the medical officer should have refused to OK Smith's return. I assumed as I saw him wobbling off, supported, that he'd be sent to hospital for a scan. I was horrified when he was sent back on. The IRB should pay heed to the evidence emerging from Boston University. There are around 4,000 legal cases pending in the USA. 1 case has already resulted in $8 million damages. By its nature rugby involves head contacts. 99% of them are not concussive. Heads are hard things. Headbutting is now rare & most severe head contacts are accidental. The code has a duty of care to those who suffer concussive contacts. Simple as that. I'm not a doc but I'd suggest a month off the paddock should be the minumum. My GP took 10 minutes recently to diagnose a minor complaint. I didn't present in Disneyland, legs wobbly, eyes glazed for a 5 minute 'consultation'.
Rugby Fan
Roar Guru
Dr Barry O'Driscoll has written to the IRB about this matter: "The latest episode of returning the concussed player to the field of play – Smith against the Lions – has highlighted the massive mistake the IRB have made and are continuing to make. There are many people who believe this legend [Smith] has been treated disgracefully – clearly unconscious and clearly unable to walk off the field, he was shunted back within minutes into an inferno. “He was exposed to traumas to which he had little defence. ‘Rugby treats the welfare of the player as a priority’. I think not! The five-minute assessment of a player who has demonstrated distinct signs of concussion for 60 to 90 seconds, and usually longer, is totally discredited. There is no scientific, medical or rugby basis for the safety of this process. “No sporting body in the world apart from the IRB have suggested that an athlete who has shown signs or symptoms of concussion can be cleared in five minutes. The IRB have refused to accept the significance of CTE, dementia, depression and suicide in NFL players with a history of concussion, as being in any way relevant to our game.” The above is from a follow-up article in The Scotsman. http://www.scotsman.com/sport/rugby/top-rugby-stories/tom-english-rugby-is-risking-its-players-safety-1-2997102
Yawhoa of NSW and now WA
Guest
What would the outcry/outcome of been if George Smith had received a second knock in the same game!.I agree that once a player is down with a head knock (concussed) he should not be be able to return to the field. There is already enough study and concern about the possible long term effects to the brain.
colvin
Guest
Quite frankly, Barnes shouldn't be let near a rugby field for a minimum of six months. It's quite disgraceful how easily he gets knocked out now, and no one talks about it. McCabe's neck re-injury was equally a disgrace.
Rugby Fan
Roar Guru
It's been claimed that lengthy stand-down periods for concussion injuries leads to players failing to honest about their injuries. Not all concussions look as obvious as the one George Smith sustained. Bernard Jackman,the Leinster and Ireland hooker, says he routinely didn't tell anyone he was hurt and ended up suffering around 20 concussions in his last three seasons. He sometimes couldn't remember anything about games he played. I can understand, then, why you might want to make it easier for players to have an assessment without mandating they stand down but you don't want to go too far the other way and suggest that concussion is something you can just shake off. George Smith wasn't just a bit woozy, his legs had gone completely. It set a bad example to see him back out because it might encourage young players to think they should be doing the same. It's not gutsy to see someone play on in those circumstances, it's reckless.
MrT
Guest
Absolutely Smith should not have come back on. I was devastated when he left the field and I said "no way he's coming back from that" - I thought, stating the obvious! Apparently not... I was deeply disturbed to see him back out running around a few minutes later. I am a big Barnes fan - I have been for years and I still believe he didn't get the opportunities he deserved in the Wallaby team. He would have made a much better 5/8 than QC... But I am pretty concerned about his welfare. I'm no expert but it would seem he's in a fairly precarious position at best. He's a smart rugby player, he'd make a good commentator. Come on, Gordon, take him under your wing!
Justin3
Guest
I think it disgusting that Smith came back on the field. Where is the duty of care to him from the doctor, the officials and the coaches?
peterlala
Guest
RiL, really? Was it over Waterhouse's rugby tips? I would like to think it's more about Waterhouse than Fitzy, who writes like he played rugby; even though he operates to his own agenda, he's worth having in the side.
Minz
Guest
I would think the test needs to be added to viewed signs. If a player's out cold flat on his face, but then passes the concussion test, too bad 'cos he was clearly out cold. Ditto for if they've got the wobbly boots on, like Smith did. Make it such that if they have clear observed signs of concussion they must be removed from the field of play and not return.
Minz
Guest
I would think the test needs to be added to viewed signs. If a player's out cold flat on his face, but then passes the concussion test, too bad 'cos he was clearly out cold. Ditto for if they've got the wobbly boots on, like Smith did. Make it such that if they have clear observed signs of concussion they must be removed from the field of play and not return.
Happy Hoooker
Guest
Well, I wouldn't be going to Fitz for legal advice under any circumstances.
jeznez
Roar Guru
I concur with all of the above. Sheer madness that CL came back as quick as he did and that George retook the field. The IRB need to get serious.
Rugby is Life
Guest
I think Fitzy was saying one thing but means another. If he were to crticize the doctor he would open himself up to being sued. He is already being sued by Tom Waterhouse.
Rugby is Life
Guest
As most people watching the game would have said. He was gaga. It was so clear cut there should have been no question of him returing to the field. it was not heroic just stupid. On the same subject, in my view Barnes should be given an admin job and told he cannot play again. Too much risk.
atlas
Guest
what is the rule, or are following examples just drs being cautious? recently in Super rugby both Conrad Smith and Piri Weepu had concussions, both said they were 'fine' to media but they had to take 2 and 3 weeks off before next game, weepu missing first 2 tests v France as a result
Wally James
Roar Guru
Well done Rugby Fan. I applaud you and Fitzsimons for rasing this. However I disagree with Fitzsimon's take on the liability of the Doctors who administered the test. If they, like, Dr O'Driscoll, were of the view the test is medically unsound, they are most definitely in the wrong. That the IRB requires the test does not make it medically sound. Taking an extreme example, if the IRB says the best way to treat a broken neck is to stand the player up and shake him, a doctor will not be excused if he does what the IRB wants. There are so many variables when it comes to medical negligence it is impossible to deal with them on this site. Suffice to say I agree wholeheartedly with your approach. No player I coach would be allowed to go back on the paddock if what happened to Smith happened to my player.
Jeff
Guest
As I understand it he would have never been allowed back on the field if playing for a NZ team.I also believe they have a mandatory 7 day stand down.
Who Needs Melon
Roar Guru
Yes, I think we can all admit the test is inadequate. Is there any reason the ARU couldn't appoint an independent doctor to impose some other test in addition to the IRB rules? Or at least devise their own test to put in place in addition to the IRB? IRB have obviously gone lowest common denominator on this and their test should be taken as the bare minimum stamdard. We in this country have to find something that is better than the bare minimum.
BennO
Guest
I was surprised they let CL play in the second test and horrified when Smith came back on in the third. The ARU and the IRB clearly have little genuine regard for the players in this matter. It's pathetic.
mania
Guest
agree darwin. ive played thru a few bell ringers in my time and i had some blinders, but i would never allow anyone else to do it. i agree that an independent doctor should be doing the test. too much conflict of interest for the team doctor to do.