World Rugby have once again condemned Northampton’s handling of the head injury George North suffered against Leicester last month but have stopped short of applying any sanction in its review of the incident.
t is the second time that Northampton have escaped punishment after a joint Rugby Football Union and Premiership Rugby investigation found that the Wales wing should not have returned to the field of play after appearing to lose consciousness in an aerial collision with Adam Thompstone. World Rugby subsequently launched its own investigation over the apparent non compliance with its concussion protocols. Any player suspected of losing consciousness should be removed immediately without being subjected to the Head Injury Assessment that North, who has a long history of head injuries, passed.
It found that the mistake occurred because North complained of a neck injury which led to “prioritisation by the medical staff given to evaluating a potential spinal injury to North.” In a statement, World Rugby said: “While it is impossible to completely remove the risk of error, World Rugby remains disappointed that there was a failure in this case to identify and manage the injury appropriately, in particular considering North's medical history.”
Despite initially expressing dissatisfaction with the outcome of the initial, World Rugby has now said that the RFU and Premiership Rugby “acted swiftly and appropriately to implement measures with Northampton Saints and other clubs to reduce the probability of future non-compliance.”
Indeed it is hard to detect what World Rugby’s review has added. No individual has been held responsible for the decision to return a potentially brain injured player to the field. Instead the emphasis has been placed on following protocols – in particular that any player showing a symptom of a suspected concussion should be removed without undergoing an HIA – and further education, which was very much the thrust of the RFU and Premiership Rugby review.
World Rugby Chairman Bill Beaumont said: "While we acknowledge that errors in the correct application of the process may happen from time to time, we must continue to strive to make our game as safe as possible for players at all levels of the game. The head injury management process, including the HIA, is successfully protecting players and what this case shows is that all stakeholders must redouble their efforts to ensure they are implemented fully and correctly.
“I'd like to thank our colleagues at the RFU for their full cooperation in this matter and for conducting a thorough review. World Rugby will continue to work closely with all unions to ensure an environment of compliance in this important area.”
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.