Communication - The Missing Link in the Youth Sports Safety

Below are three stories which clearly demonstrate the need for proper documentation and communication.

Story #1: Robert Back

The following story is a horrible tragedy and the result of poor communication. Below is a brief chronology of events based on several articles in the news. (1, 2, 3)

Sept 5, 2014 (Friday): Robert Back played in a high school football game

Sept 6, 2014: Robert experienced nausea and headaches and was brought to an Emergency Room. He was diagnosed with a 'minor closed head injury.'

Sept 7 – 9, 2014(?): Robert stayed home from school.

Sept 10, 2014: Robert saw a Great Falls clinic doctor who "who told him not to play football until Sept. 15 and gave him a note to be given to his coaches."

ImPACT test administered by Coach Grant administered. He administered a baseline test, not a post test.

Coach denied receiving doctor's note from Back.

"Later that night, Graham administered an imPACT test to "rule out" a concussion, he testified last week. He also said Back never gave him the note from the clinician and never knew any doctor had diagnosed a concussion."

"[Head Football coach] Graham had reached out to her on Sept. 10 to ask about doing an imPACT test. She said it was possible he could have the flu, since a few others on the football team did, but added "u can if u want," regarding the testing. Hansen said that exchange happened after Graham already had administered the test, disputing Graham's testimony.

Still, Back family attorney Steve Shapiro said, Hansen also wrote in her email to Graham that he should administer the "post-injury" test rather than the "baseline" test, which was given to Back on Sept. 10. Allowing coaches to test athletes on their discretion, rather than a physician's discretion was against Benefis protocol and procedures, according to the documents shown at trial Monday."(7)

Sept 10, 2014: Robert handed the doctor’s note to his football coach. The athletic trainer instructed the coach to give Robert the IMPACT Test. Robert took the test (the IMPACT test is supposed to be performed as a PRE-INJURY test to be used as a baseline in case of a future concussion).

Sept 11, 2014: the trainer reviews the test and states that Robert passed the test (No one passes this test. Again, it is a baseline indicator which is compared against future testing to determine if there is still a problem).

"After she reviewed the test results on Sept. 11, Hansen emailed Graham to say he looked "OK concussion wise," which led Graham to believe Back was OK to play that Friday, he said. Hansen said Monday that language was not meant to clear Back for play, but that she never knew he was out with a concussion." (7)

Sept 12, 2014: Robert is cleared by the coach/trainer to play in that night’s game. He plays in the game. The father is in attendance! Robert “did not sustain any big hits,” yet he collapsed on the sidelines after halftime. He was taken to the hospital and had an emergency craniotomy.

The "lawsuit says Graham [football coach] or a trainer verbally "cleared" Back to play in the next game. He collapsed on the sideline." "The response says Graham did not receive a medical note or any information from the boy's doctor and did not clear Back to play the night he collapsed." (4)

The chronology of events points to one thing - a lack of communication and proper documentation.

  1. All stakeholders - parents, coaches, trainers, school principal, school athletic director - must be informed of the Remove From Play and Return To Play decisions immediately.

  2. All stakeholders must use the same method of communication. Phone calls, text messages, Facebook messages, emails, written and verbal communication can easily be misplaced, confused, and have little likelihood of being organized and recorded.

  3. Documentation of Remove From Play and Return To Play is necessary for both health and legal reasons.

  4. Stakeholder acknowledgement of each decision must be documented.

Update (5): "Attorneys for Robert Back, the high school football player who received substantial, permanent brain injuries while playing in a Belt High School football game in 2014, are now working to prove an athletic trainer employed through Benefis Health System should be held accountable for Back’s injuries."

Update (6): "Robert Back had been told by two doctors not to play football until cleared by a doctor, and one had given Back a note saying he should not play. "We never had a doctor's note that he was out," Graham said. "(Coach Alan) Lake never saw a note. I never saw a note. We never received it."

1 Legal Counsel for Robert Back family files lawsuit

2 Robert Back fighting for recovery from football injury

3 New lawsuit charges Belt, Benefis ignored concussion

4 Lawyer for Belt High School's Football Coach denies negligence in Back Case

5 Plaintiffs sue athletic trainer in football brain injury case

6 Coach Graham: Coaches never knew doctors had told Back not to play

7 Robert Back case: Athletic trainer testifies she didn't know about concussion diagnosis

Story #2: Shawn Nieto

Here is another story of a player that was hit hard in a football game, was removed from the game, and held out of the state championship game the following week.

The parents sued in order to allow him to play!

School said son suffered a concussion; parents sued to get him back on field

What is the lesson here?

  1. Have a crystal clear concussion policy

  2. Have a documentation and communication system on which all stakeholders participate

If there was a clear concussion policy and the injury was documented immediately and the stakeholders were immediately notified, there would be no questions.

Story #3: William Shogran, Jr.

William Shogran, Jr. died after a football practice in August 2014. See this story:

Father sues Indian River County School District 2 years after teen’s heatstroke death

This timeline of events brings up many questions:

Shogran and the football team arrived at Camp Blanding for training about 6 p.m. Tuesday and conducted about 45 minutes of training.

Shogran participated in this training. They had dinner and then “lights out” at 11 p.m.

  • Was an athletic trainer present at all these practices?

  • Was there a pre-established Emergency Action Plan made?

  • Was there a pre-established heat injury policy?

From about 6:15 a.m. to just before 7 a.m. Wednesday, Shogran had weight conditioning before breakfast.

About 8:45 a.m., the team went to the field and “different team members participated in activities at different times according to their field position,” a Clay County Sheriff’s release states.

Teammates heard Shogran say that he didn’t feel well, but the head and assistant coaches indicated they were unaware of these statements.

  • Were all athletes educated on the importance of communication with the coaches with regard to possible injury?

A short time later, Shogran was observed walking toward the sidelines where water was located. When the head coach asked if was he OK, Shogran replied that he was dizzy. The head coach advised that he began providing him water and removing his shoulder pads and other equipment.

  • At exactly what time did the dizziness start?

  • The actions taken by the coach were insufficient and indicate a lack of training and preparedness.

The head coach said Shogran said he felt as if he were going to pass out.

  • At what time did this occur?

The coach called emergency officials at 10:47 a.m., and made mention of heat issues and said the had player vomited.

Emergency officials arrived within about 5 minutes of the call. As public safety officials started to arrive Shogran became “lethargic and unresponsive.”

CPR was performed and Shogran was taken to a hospital in Bradford County, where he was pronounced dead.

Sheriff’s officials were called at 1:21 p.m. by rescue officials at the hospital and told that Shogran had died.

The school system has a Parent/Coach Communication pamphlet. What if all stakeholders used the same communication method and it was all documented?

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