Controversy sparked in Week 3 when the Miami Dolphins cleared quarterback Tua Tagovailoa to start the second half against the Buffalo Bills, despite him suffering an apparent head injury. In a disturbing scene, Tagovailoa left the game and was evaluated for a concussion after a hit from linebacker Matt Milano caused him to hit the back of his head on the ground. Tagovailoa awkwardly stumbled while jogging back to the huddle which prompted the concussion evaluation during halftime.

Yet, Tagovailoa returned to the field after the frightening hit to earn the win against the Bills, with head coach Mike McDaniel maintaining after the game that the quarterback had suffered a hyperextended back rather than a concussion. The former University of Alabama quarterback supported his coach’s comments, claiming that he cleared the league-mandated concussion protocol at halftime and felt okay returning to the game. While Tagovailoa and McDaniel felt comfortable with the move, the NFL Players Association (NFLPA) did not. 

The NFLPA exercised its right to ask for a review of the league’s concussion protocol, questioning whether Tagovailoa should have been allowed back into the game. The NFL welcomed the request, supporting the utmost importance of player safety and concussion protocols. 

However, the situation evolved further in Week 4 when Tagovailoa started against the Cincinnati Bengals on Thursday night. In a seemingly risky move, Tagovailoa suited up only four days after the injury, which many saw as harmful to the quarterback’s health. 

Dr. Chris Nowinski, the founding CEO of the Concussion Legacy Foundation, chimed in on Twitter before the game: “If Tua takes the field tonight, it’s a massive step back for concussion care in the NFL. If he has a 2nd concussion that destroys his season or career, everyone involved will be sued & should lose their jobs, coaches included. We all saw it, even they must know this isn’t right.”

And unfortunately, the worst-case scenario occurred. On Thursday night, The Dolphins standout took another disturbing sack landing him on the back of his head, prompting a “fencing response” from the quarterback. Tagovailoa’s fingers appeared awkwardly bent for several seconds as he laid still on the turf, a response that occurs when a person experiences an impact strong enough to cause traumatic brain injury – according to healthline.com. Tagovailoa was taken off the field in a stretcher and put into an ambulance, which delivered him to the University of Cincinnati Medical Center. There, he was diagnosed with a concussion and was later allowed to travel back to Miami with his team.

The serious injury for Tagovailoa added even more pressure to the joint NFL-NFLPA investigation of concussion protocols. Two days after the game, the NFLPA announced that it had fired the unaffiliated neurotrauma consultant involved in clearing Tagovailoa during concussion protocols. Per ESPN, the investigation revealed that the consultant had made “several mistakes” in allowing Tagovailoa to play only four days after his first injury. At the same time, however, the NFLPA maintains that there were no concrete protocol violations. In his postgame press conference, head coach Mike McDaniel reiterated this sentiment:

“I have 100 percent conviction in our process regarding our players. This is a player-friendly organization, and I make it very clear from the onset that my job here is for the players. I take that very seriously. No one in the building strays from that. … If there would have been anything lingering with his head, I wouldn’t have been able to live with myself if I prematurely put someone out there and put them in harm’s way,” McDaniel said.

“This is a relationship that I have with this human being. I take that seriously. I wouldn’t have put him out there if there was any inclination given to me whatsoever that he was endangering himself from that previous game.”

Certainly, while it appears there was no malicious intent from the Dolphins’ staff, the injury serves as a reminder of the dangerous nature of the NFL. Though the league claims to champion player safety, such a loose concussion protocol seems incompatible with that ultimate goal. As a result, the NFL and its player’s union announced that they are soon expected to agree on modified concussion protocols. The altered protocol, which mandates that any player demonstrating any instability is not allowed to return to the game, could go into effect as early as Week 5. Other amendments could also be added to the protocol, which will be seen in the coming weeks.