Damar Hamlin incident places NFL under the spotlight again

Buffalo Bills safety Damar Hamlin was showing “substantial improvement” on Thursday after suffering a cardiac arrest during an NFL game against the Cincinnati Bengals three days earlier. According to doctors at University of Cincinnati Medical Center, where Hamlin was taken after his heart stopped on the field of play at the Paycor Stadium on Monday, the 24-year-old was able to communicate and grip people’s hands after waking up on Wednesday evening. “So we know that it’s not only that the lights are on. We know that he’s home. And it appears that all the cylinders are firing within his brain, which is greatly gratifying for all of us,” Dr. Timothy Pritts said. “He still has significant progress he needs to make, but this marks a really good turning point in his ongoing care.”

Upon regaining consciousness, Hamlin was able to communicate by writing. The first thing the former University of Pittsburgh star asked his nurse was whether the Bills had won the game. “You won. You’ve won the game of life,” doctors replied.

The match-up between the Bills and Bengals was suspended after Hamlin’s collapse and the NFL confirmed on Thursday that the game won’t be resumed. While the Bills may be relieved they don’t have to return to Cincinnati, removing a game from their schedule creates a new obstacle in their pursuit of the top seed in the AFC. Kansas City (13-3) would now lock up the No. 1 seed by beating Las Vegas on Saturday.

Buffalo had hoped all year to earn home-field advantage and avoid another playoff trip to Kansas City, where it lost a thrilling, back-and-forth divisional playoff matchup in overtime last season. The Bills did their part by beating the Chiefs on the road on October 16.

Under a proposal Thursday from NFL Commissioner Roger Goodell that was pending approval by clubs, the Bills would indeed escape that return trip. Goodell proposed that potential AFC Championship meetings between the three teams affected by the canceled game – Buffalo, Kansas City and Cincinnati (11-4) – be played at neutral sites if the team that earned home-field advantage benefited from playing an unequal number of games.

In the meantime, the entire league is focused on Hamlin’s recovery. The player’s uncle said Tuesday that Hamlin had been revived twice by a defibrillator, once at the stadium and again on arrival at the University of Cincinnati Medical Center. The incident has caused consternation in the United States, where the NFL is the most popular sports league in the country and valued as an industry worth $130 billion, according to a report by Sportico based on the assets of the 32 NFL franchises. Viewing figures last year rose by 10%, representing the highest ratings levels in six years. However, the NFL has faced criticism for its response to Hamlin’s cardiac arrest.

ESPN confirmed that NFL officials initially ordered Buffalo and Cincinnati players to warm up for five minutes ahead of resuming the game, which was still in the first quarter and while Hamlin was receiving treatment on the field. However, NFL executive vice president of football operations Troy Vincent said that was not the case and there had been no discussion with NFL commissioner Roger Goodell about resuming play. “What was most important was that it wasn’t about proceeding with the game,” Vincent said. “Frankly, that aspect never crossed my mind.”

Hamlin was hurt while tackling Bengals receiver Tee Higgins on a seemingly routine play that didn’t appear unusually violent, in a game televised in primetime and one of the most-anticipated match-ups of the penultimate week of the regular season.

Higgins was running with the ball on a 13-yard pass from Joe Burrow when he led with his right shoulder, hitting Hamlin in the chest. Hamlin then wrapped his arms around Higgins’ shoulders and helmet to drag him down. Hamlin quickly got to his feet, appeared to adjust his face mask with his right hand, and then fell backward about three seconds later and lay motionless.

It was the most serious incident of the season to date, although there have been other scares. On September 25, Miami Dolphins quarterback Tua Tagovailoa was sacked while playing against the Bills. He fell backward, hitting the back of his head on the ground. When he got up, his knees buckled and he struggled to stand. The images generated panic in the stadium but Tagovailoa was checked by team doctors and returned to the field minutes later. The leg weakness was caused, they said, by a previous back injury.

Four days later, Tagovailoa started against the Bengals. He was hit again and suffered another blow to the head. While on the turf, his fingers tightened backwards, a reflex that experts consider an involuntary response to a brain injury. The incident was also caught on television cameras, prompting criticism of the NFL and the Dolphins for fielding their quarterback so soon after the first injury.

Tagovailoa’s case forced the NFL to modify its rules on the medical protocol to be followed by teams and led the league to include ataxia, a condition that deteriorates muscles and causes clumsy movements and slurred speech, on the list of injuries that prevent a player from continuing in a game. Only a week later this protocol was enacted in the case of Teddy Bridgewater, Tagovailoa’s backup at the Dolphins. Two weeks ago, Tagovailoa was placed in the concussion protocol again despite playing the full game against the Green Bay Packers.

Two more examples occurred during last Sunday’s games: Philadelphia Eagles linebacker Josh Sweat was left lying face down for several minutes with a neck injury after colliding with a New Orleans player and Indianapolis Colts quarterback Nick Foles left the game after convulsing following a hit in a game against the New York Giants.

The largest study ever carried out on brain injuries in the NFL was published in Science in 2017. Researchers at Boston University analyzed brains donated to medicine from more than 200 former football players who had displayed symptoms of mental disorders and motor impairments during their lifetimes: 87% showed traces of chronic traumatic encephalopathy, a neurodegenerative disease associated with repetitive head trauma. That percentage, however, rose to 99% among those who had played professionally in the NFL.

The NFL has taken some steps to address the issue. As well as the concussion protocol, during preseason offensive and defensive linemen, the players most-exposed to heavy hits, started using guardian caps, a padded covering that fits over a regular NFL helmet. During the 2022 preseason, 11 players suffered concussions compared to over 20 in previous preseasons. However, NFL players have complained that the guardian caps are uncomfortable and the league did not make their use mandatory in the regular NFL season.

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