Tomas Francis: A clear and flagrant breach of HIA protocol
This article is written by Progressive Rugby
An open letter to World Rugby, Wales Rugby Union and Six Nations Rugby.
To whom it may concern,
We write regarding an incident that occurred at 19mins 46secs of the Six Nations International between England and Wales at Twickenham on Saturday, 26th February, 2022.
After England pressure their second row Charlie Ewels carries the ball into contact near the Welsh line. As a result, two Welsh players – Owen Watkins and Tomas Francis are left prone on the field.
Watkins receives a clear and obvious injury with blood flowing from a cut to his head and is correctly removed for a head injury assessment (HIA) which he subsequently passes.
Francis attempts to stand and falls back and struggled to get to his feet. He is seen holding his head. He is then seen using the post for support. He displays clear signs of ataxia and of being dazed. He is seen by a physio/medic – it is not clear which because they all insist on tabards wearing Medic.
Francis displayed clear symptoms/indications under (Criteria 1 see below) of the World Rugby Head Injury Assessment protocol that necessitate the immediate and permanent removal from play. No HIA was needed.
1. What are the indications (Criteria 1) for immediate and permanent removal from play following a head injury?
There are 12 Criteria 1 signs and symptoms with six possibly observed on video and the remaining five identified during the on-field assessment.
Typically observed on video:
Confirmed loss of consciousness
Suspected loss of consciousness
Convulsion
Tonic posturing
Balance disturbance / ataxia
Clearly dazed
While, after a delay, Francis was removed from the field he was, incorrectly, allowed to undergo an HIA assessment and returned to the field, playing until the 56th minute, at which time he was permanently replaced by Leon Brown.
Progressive Rugby is concerned that the events demonstrate that individual who have incurred brain injury have continue to be permitted to play which will place them at likelihood of risk. We consider the above incident demonstrates a clear and flagrant breach of HIA protocol that potentially puts both the short-term and long-term health of an elite athlete at risk.
In addition, we still await the outcome of investigations into the failure to remove Jack Nowell from the field during the game against Italy (13th Feb) and behaviour of the England medical team at the culmination of the Italy v England U20 game (11th Feb).
It is our major concern that the public has observed that in Rugby Union individuals have incurred brain injury and been permitted to continue to play.
Until satisfactory explanations are provided, we remain unable to accept World Rugby’s assertion that player welfare is the game’s number one priority.
Yours sincerely
Professors John Fairclough and Bill Ribbans
Progressive Rugby