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Fisher's handling of QB Keenum's concussion simply not good enough

Jeff Fisher's handling of his QB Case Keenum's concussion in Week 11 of the NFL season, and his subsequent explanation for it, were simply not good enough.  

As a general rule, football coaches are obsessive almost beyond reason. Ask one about a specific play from a specific game, and odds are he'll be able to walk you through the exact call. Coaches usually can produce that same level of detail about controversial officiating decisions or personnel moves or the format of a practice schedule.

So when a head coach is asked to explain something that occurred during his team's game and answers with some variation of “I don't know,” it's either bull---- or negligence.

When it comes to how Jeff Fisher explained the handling of Case Keenum's concussion, probably a little of both were at play.

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With about a minute left in the Rams' game at Baltimore on Sunday, Keenum was thrown down by defensive lineman Timmy Jernigan. His head snapped back and slammed into the turf. Keenum grabbed his helmet and stayed down, then appeared to go limp when his teammate, Garrett Reynolds, attempted to help him up. He rolled over onto his knees, slowly got to his feet and took a couple of wobbly steps toward the sideline.

After the game ended Keenum was diagnosed with a concussion. It was obvious to anyone watching on TV that he had been injured, badly.

Yet, he stayed in the game. Because of a penalty call against Baltimore, Keenum had a few extra beats to gather himself. He spent a few of those seconds talking to the team's trainer, as backup Nick Foles warmed up. But neither the Rams nor the officials nor the game's independent concussion spotter pulled him from action.

The sequence was dangerous for Keenum, and disgusting for a league that continues to preach its concern over player safety.

When asked Monday why Keenum was allowed to stay on the field, why the ATC (certified athletic trainer) did not tell the Rams to run Keenum through concussion tests, Fisher essentially answered with a shrug of the shoulders.

“[The ATC] didn't feel it was necessary to make the call,” Fisher said. “And then for whatever reason we went on with the two plays.”

Fisher claimed he didn't know at the time that Keenum might have an injury. “I saw Case go down, but I didn't see anything else that took place. I didn't see him struggle to get up,” he said. “I was in the game-management mode at that point, with less than a minute left.”

Sorry, Jeff. Not good enough.

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True, there was a lot happening at the time. The game was tied 13–13, the Rams were trying to march for a game-winning score and there was a flag on the field. But we're to believe that Fisher saw Foles start to get ready, saw the team's trainer talking to his starting quarterback ... and never wondered why those things were happening?

The troublesome ignorance here extends beyond Fisher, of course. Part of the reason the spotter program is in place to begin with is for the very reason Fisher tried to lean on as an excuse: the sideline does not offer much of a vantage point toward injuries. Players have been known to beat the concussion test, too.

The ATC is the fail safe, even more so this season because that medical expert has the ability to call down and stop play if he or she feels a player needs further evaluation. However, per the NFL's football operations website, “the spotter can only stop play with clear visual evidence (emphasis theirs) of two very specific criteria:

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1. A player who displays obvious signs of disorientation or is clearly unstable; and

2. If it becomes apparent that the player is attempting to remain in the game and not be attended to by the club’s medical or athletic training staff.

Keenum without question checked off that first box. The NFL head, neck and spine committee lists seven observable signs of a potential concussion. Keenum displayed no fewer than three (slow to get up following a hit to the head, motor coordination/balance problems, clutching of head after contact).

The spotter should have seen those and buzzed the sideline, at which point Rams trainer Reggie Scott would have been alerted to that evidence. Somewhere, the system fell apart.

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The NFL released a statement on the matter Monday: “Promptly after the conclusion of yesterday’s game, we began a review to determine the facts of the injury to St. Louis quarterback Case Keenum and why he was not removed from the game for the necessary evaluation by a team physician or the unaffiliated neuro-trauma consultant as required by our concussion protocols. We are continuing that review today, which includes discussions with the Rams and their medical staff, the ATC spotter, the game officials, our medical advisors and the NFLPA. In the meantime, prior to this week’s games, we will reinforce with all involved the need to ensure that these injuries are properly identified and addressed in a manner consistent with our protocols.”

Keenum had a responsibility to inform Scott that he was hurt, as well. Brian Hoyer did this in a recent game, alerting the coaching staff that he was having trouble remembering plays after taking a hit to the head.

It is hard to blame Keenum, though. Hoyer reclaimed the Houston starting job earlier this year only after Ryan Mallett pulled himself from a game for one play. Mallett has not seen game action since (and has since been released). Keenum, making his first start of the year and just the 11th of his career, found himself in a critical late-game situation. He obviously had no desire to take a seat.

Which is why the NFL has taken those decisions from the players' hands, by asking coaches and officials and especially the ATC spotters to keep an eye on things.

No one fulfilled his responsibility in this instance. That includes Fisher, for as much as he tried to pass the buck Monday.

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Football fans might recall former Michigan coach Brady Hoke going a similar route last season, after he came under fire for leaving QB Shane Morris on the field when it was apparent that Morris was hurt. Like Keenum, Morris later was diagnosed with a concussion. 

“I don't make decisions who plays, who doesn't play, as far as when there's injuries—in particular, if there were any head or head trauma,” Hoke said at the time. “Those of you who know or don't know, I would never put a kid in that situation.”

Hoke made a couple of important points: 1. The doctors and trainers have to lead the way in these cases; and 2. No coach (well, few coaches) willing put their players in harm's way. 

But it is not enough for a coach to throw up his hands and say,“not my area” when players are hurt, particularly not when something as serious as a head injury is involved.

That Fisher had no answers Monday, more than 24 hours after Keenum suffered his concussion. Fair or not that comes across as wanton disregard for a serious issue. The head coach has to be better. He has to accept more of the responsibility. 

The stakes were too high on Sunday for everyone around Keenum to turn the other way.