Concussion to Texans' Savage leads to protocol changes

Jan 2, 2018 - 4:28 AM HOUSTON -- An investigation by the NFL and NFLPA into the concussion Houston Texans quarterback Tom Savage suffered earlier this month cleared the Texans, but resulted in immediate changes designed to improve the league's concussion protocol.

Led by Dr. Allen Sills, the NFL's chief medical officer, and Dr. Thom Mayer, the NFL Players Association's medical director, an investigation was launched the day after the Texans' Dec. 10 loss to San Francisco at NRG Stadium.

In a joint statement released Friday, the NFL and NFLPA said, "The parties have both concluded that while the medical staff followed the Protocol, the outcome was unacceptable and therefore further improvements in the Protocol are necessary.

"The NFL and NFLPA recognize that Mr. Savage's return to the game did not reflect the expected outcome of the Protocol. As such, the parties have agreed that no discipline will be assessed, but have already implemented several improvements to the Protocol to prevent such an unacceptable outcome in the future."

In a conference call Friday morning, Dr. Sills and Dr. Mayer said they had reviewed "more than 560" reports on concussions, and two resulted in investigations.

Seattle was fined $100,000 for violating the concussion protocol earlier this season with quarterback Russell Wilson.

Savage was injured after an incompletion in the second quarter. He released the ball and was hit by defensive end Elvis Dumervil, who landed on top of Savage.

Savage's head hit the turf. He turned on his left side and had what's called a fencing response -- extending his arms and twitching for a few seconds.

Savage was removed from the game and was taken into the medical tent on the sideline for evaluation by the league's Unaffiliated Neurotrauma Consultant (UNC) and a team doctor. He was examined for a few minutes, was cleared and returned on the Texans' next series.

After Savage threw two incompletions and the Texans failed to get a first down, he was taken to the dressing room for more evaluation. He didn't return this season and was placed on injured reserve.

Dr. Mayer pointed out Friday that while the NFLPA and NFL are known to have their differences, the union had "zero differences with the NFL on this issue."

The reason Savage was allowed to return to the game was addressed in the statement that said, "The slow-motion video, which focused more directly on the fencing posture, was not broadcast until after the doctors had begun the sideline evaluation and thus was not seen by the medical staff prior to the evaluation."

After concluding the investigation, changes have been implemented to strengthen the protocol.

The statement continued: "Working in conjunction with the NFL's independent Head, Neck and Spine Committee, these improvements include:

--Implemented a pilot program utilizing a centralized UNC base at the league office to monitor the broadcast feeds of all games. The UNC will contact the team medical staff on the sideline should they observe any signs or symptoms warranting further evaluation.

--Defined impact seizure and fencing responses as independent signs of potential loss of consciousness, representing "No-Go" criteria under the current Protocol. Players who display either of these signs at any time shall be removed from play and may not return to the game.

--Require a locker-room concussion evaluation for all players demonstrating gross or sustained vertical instability (e.g., stumbling or falling to the ground when trying to stand).

--Officials, teammates, and coaching staffs have been instructed to take an injured player directly to a member of the medical team for appropriate evaluation, including a concussion assessment, if warranted.

--Require all players who undergo any concussion evaluation on game day to have a follow-up evaluation conducted the following day by a member of the medical staff.

--Added a third UNC to all playoff games and the Super Bowl to serve as a backup who can step in immediately should one of the original two UNCs be absent from the sideline for a time to attend to a more severely injured player."

While implementing the changes to the concussion protocol, Sills and Mayer hosted conference calls with every UNC, independent spotters who work in the press box and staff members from each team's medical department to review the changes, signs and symptoms, according to the league.

"The NFL Head, Neck and Spine Committee, NFL and NFLPA will conduct a comprehensive offseason review of all aspects of the protocol with an emphasis toward continued improvement in detection and diagnosis," the statement said.

--Texans defensive coordinator Mike Vrabel is already in heavy demand as a head-coaching candidate during this hiring cycle. The Indianapolis Colts and Detroit Lions both requested permission to interview the former New England Patriots All-Pro outside linebacker, according to league sources not authorized to speak publicly.

Vrabel was linked to the Los Angeles Rams' job that went to Sean McVay last year.

He turned down the San Francisco 49ers' defensive coordinator opening two years ago before later being promoted from linebackers coach to running the Texans' defense.

In his first season as defensive coordinator after being promoted from linebackers coach, the defense ranked last in the NFL in points allowed per game. The Texans were ranked first in total defense a year ago, but had injuries this season that affected their ability to rush the passer as defensive end J.J. Watt broke his leg and outside linebacker Whitney Mercilus tore his pectoral. The Texans also were unable to adequately replace cornerback A.J. Bouye after he signed with the Jacksonville Jaguars.

"Whatever he does, he's a great coach," Texans inside linebacker Benardrick McKinney said. "He pushed me to my limits, puts me in spots to make great plays. He brings the best out of everybody."

Vrabel has ascended quickly in the coaching ranks. First, he was a position coach at Ohio State. Then, he coached the Texans linebackers. Now, he's in charge of an entire defense.

"I think when you get into coaching I think that everybody aspires to lead at the highest level, and clearly being a head coach in the National Football League is the opportunity to do that," Vrabel said during the season about head-coaching ambitions. "You try to do as good a job as you can in the role that you have and then you go from there."

Texans Pro-Bowl pass rusher Jadeveon Clowney said he believes Vrabel is head coaching material.

"He's a smart guy," Clowney said. "High-energy guy. He brings the best out of his players and he's a good coach."

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