Monthly Archives: June 2014

Parties Reach Revised Settlement in NFL Concussion Litigation by Uncapping Funds

The National Football League and counsel for the retired player-plaintiffs have announced a revised settlement agreement in the NFL concussion litigation pending in the U.S. District Court for the Eastern District of Pennsylvania. In the revised agreement the NFL’s obligations under the monetary award fund will not be capped at any specified amount. This means that once the compensation program is established funds will be available to any retired player who develops a qualifying neurocognitive condition.

The revised settlement agreement is the result of several months of intensive work under the supervision of presiding Judge Anita B. Brody and the Court’s special master, Perry Golkin. The parties are grateful to Judge Brody and Special Master Golkin for their guidance in helping to reach the agreement submitted for preliminary approval today. Consistent with the settlement announced last year, the revised agreement provides a wide range of benefits to retired NFL players and their families, including a separate fund to offer all eligible retirees a comprehensive medical exam and follow-up benefits, and an injury compensation fund for retirees who have suffered cognitive impairment, including dementia, Alzheimer’s, Parkinson’s or ALS. Where the retiree is deceased or unable to pursue his claim, a family member may do so on his behalf. While actuarial estimates from both parties supported the $765 million settlement that was announced in August, this new agreement will ensure funds are available to any eligible retired player who develops a compensable injury.

“This agreement will give retired players and their families immediate help if they suffer from a qualifying neurocognitive illness, and provide peace of mind to those who fear they may develop a condition in the future,” said co-lead plaintiffs’ counsel Christopher Seeger and Sol Weiss. “This settlement guarantees that these benefits will be there if needed, and does so without years of litigation that may have left many retired players without any recourse.”

“Today’s agreement reaffirms the NFL’s commitment to provide help to those retired players and their families who are in need, and to do so without the delay, expense and emotional cost associated with protracted litigation. We are eager to move forward with the process of court approval and implementation of the settlement,” said NFL Senior Vice President Anastasia Danias.

The agreement also provides that the NFL will set aside $10 million for education on concussion prevention, as well as pay the costs of providing notice to the class and for administration of the settlement. If the Court grants preliminary approval, retired players will be formally notified of the settlement, with a final approval hearing likely to occur later this year.

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Prolonged Recovery from Concussion Could Lead to Psychiatric Disorders

A recent report from the American College of Sports Medicine (ACSM) Annual Meeting, held last month in Orlando, has suggested that “prolonged recovery from concussions may signal further psychiatric disorders in athletes.”

A Website called HCP Live cited research from St. Vincent Sports Performance (SVSP) and the Datalys Center for Sports Injury Research and Prevention in Indianapolis, which studied 76 athletes aged 8-23 years who had sports-related concussions and had been referred to neuropsychological specialists for further evaluation after an average of 4.4 months.

“While the majority of concussions resolve within 7-10 days, some of athletes enrolled in the study experienced a concussion that lasted up to a year,” according to the article. “The majority of the study participants (73.7%) met the formal diagnostic criteria for at least one psychiatric disorder. Additionally, some of the athletes (64.3%) fulfilled the criteria for one comorbid psychiatric condition, 23.2% fulfilled it for 2, 8.9% for 3, and 3.6% for 4.

“The researchers found 27 athletes had adjustment disorders, which were the most prevalent among the participants. Attention-deficit/hyperactivity disorder (ADHD) was present in 21 athletes, while 18 had anxiety disorders, 10 had learning disabilities, and 9 had depression and/or mood disorders.”

“Although the patients were evaluated with the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) database, the test did not always reflect the patients’ underlying issues.”

See more at: http://www.hcplive.com/articles/Prolonged-Concussion-Potentially-Linked-to-Psychiatric-Disorders#sthash.LXhwXFxi.dpuf

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World Cup Incident Draws Criticism, Demands for Change

The world was abuzz this weekend about the World Cup, with all the scintillating match play and high stakes drama.

But some of the drama was not at all flattering to the game and the organizational body that manages it – FIFA.

When Uruguay defender Álvaro Pereira went down in a heap after taking a knee to the head, those of us who track the concussion issue fully expected him to be removed from the match with England and be questionable for future matches.

After all, Pereira said felt “like the lights went out,” a sure fire sign of a significant concussion. But minutes after lying motionless on the floor, the player jumped up and demanded that he be returned to the game. Astonishingly, he was.

Here’s the video of the incident: http://www.smh.com.au/fifa-world-cup-2014/world-cup-news-2014/alvaro-pereira-knocked-out-then-raring-to-go-20140620-zsfqt.html

The players union, FIFPro, was critical of the decision, urging FIFA “to conduct a thorough investigation into its own competition concussion protocol which failed to protect Uruguayan footballer Álvaro Pereira.”

Experts Weigh In

Some industry experts weighed in immediately.

“FIFA clearly has a problem on its hands,” Dr. Andrew Blecher (http://www.scoi.com/our-experts/andrew-m-blecher-md), of the Southern California Orthopedic Institute, told Concussion Policy and the Law. “As a sponsor and host of the Zurich International Consensus Conference on Concussion they are acutely aware of what the current accepted guidelines are for evaluating a potentially concussed athlete.Andrew_Blecher

“Such mismanagement of a clearly concussed player on the worldwide stage for all to see sends the wrong message to all soccer players and organizations around the world.  The ‘Do as I say and Not as I Do’ attitude that has also been adopted by the NFL cannot continue.  For FIFA to comply with its own recommendations there will need to be rule changes to allow for substitutions so that players who suffer any head trauma can be properly evaluated.  The evaluations must also be performed by independent trained specialists in head trauma and concussion that are free from the conflict of interest that so commonly goes along with being a team physician.  Until these changes are made the ‘Beautiful Game’ will continue to be scarred by the mismanagement of head trauma.”

Dr. Michael J. Perrotti, a concussion expert with 30 years of experience in practice of forensic neuropsychology and clinical psychology, echoed the point about having an independent concussion expert on the sideline.

“This is why the NFLPA wanted its own doctors on the sideline,” he told Concussion Policy and the Law. “Team doctors would send them back in.”

michael-j-perrotti-phdOne of the problems “is there is NO standardized return to play protocol in FIFA. At least football has the SLAM criteria for return to play. What concerns me is the so-called second injury, physiological changes in the brain AFTER the concussion. What if he had had a micro bleed? This was very negligent of FIFA. Lax policies like this place players at great risk!”

Dr. Perrotti (http://www.drmichaelperrotti.com/) added that FIFA has an opportunity to get it right.

“FIFA has no return to play criteria to prevent a concussed, unstable player from re- entering the game.  Now is the time to institute this — neuropsychological assessment as the NFL has and comparison of baseline neuropsych functioning scores. More restrictions, such as these, need to be in place to protect the players.”

FIFPRO’s Statement

Meanwhile, FIFPro issued the following statement:

“Football is awash with incidents in which players suffer potentially concussive blows to the head and stay on the pitch. In Pereira’s case, he demanded to play on, overruling advice from Uruguay’s team physician for him to be immediately substituted.

“FIFPro understands that in certain moments, faced by the pressures of such an important international stage, many players would react in this way.

“There are times, however, when the players also require greater protection against the prospect of making any rash decisions. He must be subjected to further evaluation and follow-up procedures that help determine if and when he can return to training.

“The World Cup must set the standard for player health and safety to educate the international football community.

“Medical evidence shows that a person faces the risk of very serious brain injury, or worse, if he or she suffers a severe head trauma from a concussive blow.

“Furthermore, FIFPro states any sideline concussion assessment must not be conducted solely by a national team physician.

“In order to ensure real independence, FIFPro’s involvement, as the international authority representing the interests of the players, would ensure they are insulated at all times.”

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