Anyone watching the Rams vs Ravens game on Sunday saw what was clearly a concussed Rams QB Case Keenum stay in the game. Despite new measures by the NFL to have medical spotters alert the teams and officials of such injuries, this one slipped through the cracks. Mike Florio at ProFootballTalk has a good quick summary of it here. This latest (of many) blown call by the medical spotters will lead to another small uproar that will likely resolve nothing. The idea of the medical spotter, aka “the eye in the sky,” is a good one, but the current system has some severe limitations that most people seem unaware of.
One obvious problem here is that the NFL seems to be asking one medical spotter to do too much. This person is located in an upper-level booth, and although they have access to a broadcast feed (as well as a video technician to work the video equipment) they’re being asked to do much more than just watch the same video feed that we watch at home. Since the action that they’re concerned with isn’t always on the broadcast feed, these spotters are also using their naked eye as well as binoculars in order to see what unfolds on the field. So when we at home see seconds of obvious concussion symptoms on video, the spotter might actually not be watching the same feed. It seems like this is a system that could easily be improved by simply adding another set of eyes. One spotter could watch the broadcast feed while the other focuses on what the cameras aren’t capturing.
The second flaw, and I believe the more serious one, is that the spotters have very little power. They do have the power to stop the game, but here are the rules on that from the official NFL Operations page: (bold text in original, not from me)
New in 2015, ATC spotters may use a medical timeout to stop the game to remove a player from the field for medical examination. The spotter can only stop play with clear visual evidence of two very specific criteria:
- A player who displays obvious signs of disorientation or is clearly unstable; and
- If it becomes apparent that the player is attempting to remain in the game and not be attended to by the club’s medical or athletic training staff.
You see the way the NFL printed that, “clear visual evidence,” in bold? Seems like they’re really stressing that these spotters aren’t going to order any medical timeouts unless they’re absolutely, iron-clad certain that they are correct. Plus, the NFL is saying that obvious concussion symptoms aren’t even enough to warrant a medical timeout, as criteria #2 needs to be met as well. In essence, the NFL is saying that the medical spotter cannot call a timeout until a player has already been left in harm’s way.
Shy of this medical timeout, the spotters really have no power. Here’s another quote taken directly from NFL Ops:
When immediate action is required, the spotter can call the bench to speak with the team physician or head athletic trainer and provide details of a potential injury. The spotter can send the video via fiber optic cable to a sideline monitor where the physician or trainer can see the play. The medical staff, assisted by an on-field injury video technician, can ask for slow motion, specific angles, rewind and more.
Do you see what’s missing there? The spotter can call the sideline and talk to a trainer or physician. The spotter can tell that person what he or she witnessed. But there is no mention of a hierarchy or power structure there. There is no obligation for the team’s medical staff to actually follow through and act on what the spotter tells them. Obviously, you would hope that the medical staff would act on this, but history tells us that medical staffs, for a variety of reasons, don’t always follow up properly. For example, a spotter could call the sideline to report a possible concussion, but the sideline medical staff could simply decide that a concussion assessment test is unnecessary, as they don’t suspect that the player suffered a concussion. That’s the same loophole (without the spotter part) that the Steelers sideline staff used to decide that neither Ben Roethlisberger or Heath Miller needed concussion tests during a playoff game against the Ravens last year.
The first step in fixing this system might be to push for spotters to flex their muscle and be more proactive in calling medical timeouts. But there’s a problem here as well. If a timeout is called, the rules state that the player has to go to the sideline for evaluation and stay out, “at least one play.” So again, we’re back to trusting that the team medical staff will be responsible and conservative, and not simply allow a player to return (the same way Roethlisberger and Miller did). So really, the whole system is flawed. It’s easy to blame the one person who really should’ve seen and reported the problem, but the truth is we have no way of knowing whether that person dropped the ball or why. The true problem here is that, despite recent focus, the NFL still has no real accountability when it comes to protecting the safety of the players. For now, all we have are scapegoats.