'World Rugby are just covering their own a***' - George North concussion process attacked as a 'farce'
The rules concerning the treatment of head injuries to top-level players have been branded a “farce” as the controversy concerning George North’s latest concussion intensifies.
Much of the focus has been placed on the failure of Northampton’s medical team to view the television footage of North apparently losing consciousness in an Aviva Premiership match on Dec 3, but a pertinent point remains unacknowledged: the Wales wing passed the Head Injury Assessment.
Most people accept that North was knocked out when his head bounced off the Welford Road turf - the latest in a series of such injuries he has sustained. That he passed the HIA and returned to the field on this occasion is just as alarming as the Concussion Management Review Group’s decision to hold no one to account for allowing a player with a history of concussion to be exposed to further brain damage
The Wales wing will miss a third match in a row when Northampton host Sale on Friday night despite the club saying he has displayed no concussion symptoms.
Jamie Cudmore, the Canadian second row who spent more than decade at Clermont Auvergne before joining Oyonnax last summer, claims that while at Clermont he passed many HIAs even though he failed to remember the rest of the match. On other occasions, he says he failed the HIA only to be returned to the field of play. He is now in the process of taking legal action against his former employers for allegedly allowing him to return to play after suffering a concussion in the 2015 Champions Cup semi-final against Saracens.
Like many, Cudmore is angry at what he sees as the double standards between the ever-harsher punishments drawn up for players who make contact with an opponent’s head and the lack of so much as a slapped wrist for clubs when they fail in their duty of care to players.
“What came out yesterday was a bit of a farce really,” Cudmore told The Daily Telegraph. “If clubs are not sanctioned when they get things wrong then nothing will change. To hear the medical staff say that they did not see the action you can almost accept, but there were enough enough people on the sidelines who had seen him lying there motionless or seen the replays.
“Are you telling me that not one of those coaches or staff saw that? If they did then they have just as much responsibility to stop George returning to play.”
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Cudmore’s thoughts were echoed by Alistair Hargreaves, the former Saracens captain who retired in October through concussion. He tweeted: “Decision made by CMRG is a disgrace. Is this what we call player welfare @EnglandRugby @premrugby? What a depressing day for rugby.”
However, Cudmore’s greatest frustration lies with World Rugby’s guidelines. “If you read the rules you get two different things out of it: if you pass the HIA then you can go back on the field and the other saying if you get any suspected concussion then you should be removed from the field of play,” Cudmore said.
“World Rugby are just covering their own a---- because of fear of litigation. They see what is happening in the NFL and the NHL, who are paying out big, big money. That’s what they are scared of.”
Cudmore’s greatest concern is that he believes the Head Injury Assessment is not fit for purpose as a tool to prevent concussed players returning to the field of play. This, he says, is born from his own experience. “A 10-minute assessment does not really work,” Cudmore, who has set up the Rugby Safety Network to raise awareness around concussion, said. “I have passed 10-minute assessments and then not remembered the rest of the game. I have failed 10-minute assessments but still been allowed back on the field.
“I went along with that but I didn’t know then what I know now about the long-term dangers or second-impact syndrome. I don’t think a lot of players appreciate those risks, which is why they need to be protected from themselves.
“There is too much of a grey area, which allows players to be put into danger. It is simple enough that, if someone has a suspected concussion, then they need to be removed. You can do the HIA but the player should not be allowed to return to the field.”
The danger of removing the Head Injury Assessment would be raising the threshold at which players would be removed by medical staff.
North, meanwhile, insists he has no intention of calling time on his career. Citing the example of 36-year-old Wales team-mate Gethin Jenkins, North, 24, told The Daily Mail: “Gethin’s body is in absolute tatters. He should be in a home somewhere. As a young professional looking up to an older and more experienced professional, if I could have that level of professionalism towards the end of my career and still want to get out of bed in the morning and go again then that would be pretty amazing.”
The Concussion Management Review Group recommendations
1. George North follows the graduated return to play protocol to optimise his recovery;
2. The pitch side video reviewer (PVR) should remain in their allocated seat;
3 Wireless connectivity should be checked for those allocated seats;
4. Consideration be given to the introduction of a ‘support PVR’ to ensure that the video feeds continue to be monitored and additional clips can be downloaded if the PVR is discussing matters with the medical team (e.g. over radio link) or the development of automatically downloaded clips of incidents;
5. At the forthcoming mid-season Premiership Club medical meetings, planned for February 2017, the reviewing and training team emphasise and re-enforce the necessity to review footage before starting the HIA assessment and the criteria in respect of permanent removal from the field of play;
6. The team doctor must review the video footages for permanent removal criteria both before commencing and after completing the HIA assessment in the medical room (or designated HIA area);
7. Irrespective of whether part of the HIA assessment has or has not been carried out on the pitch, the entire HIA must be completed again once in the medical room by the examining doctor;
8. The maximum permitted time for an HIA process, in the Aviva Premiership in the 2016-17 season is 13 minutes. Given the importance of the HIA assessment in respect of player welfare the HIA should not be unduly shortened without clear reason;
9. Hard wire live feeds should be reinstated to the medical/HIA rooms with recording and play back facility which would add resilience to the wireless MyPlayXplay system both in terms of functionality and also definition if, for any reason, there is an issue with the main (Wi-Fi) system.