Injury Christian Petracca's injury - A disgrace he was allowed to come back on the field

[Lsta062]

This is a bit of an after the event/benefit of hindsight thread
They wouldn't have known at the time the extent of the injury and may have thought he could run it out

Is it though? I think the club could’ve determined this was serious just by looking at who was visibly in agony IMO.

When a no-fuss tough player like Petracca is visibly in agony, then you gotta know something’s really off. Players like that don’t show pain quickly.

Players can say they’re fine all they like, but if their body language doesn’t match, then you have to take it seriously. I think Melbourne didn’t hand his injury well.

 

[blinkd]

An Xray isn't going to show an intraabdominal injury like a kidney, spleen or liver laceration. You really need a CT scanner for this, and then you need to a radiographer available to do the scan, the patient to have an intravenous drip put in so iv contrast can be administered, and if you are going to that extent that you are worried enough to want a CT, the patient should be in the emergency department, not in a cubicle at the back of the MCG.

Oh I know. But you can diagnose fractured rips and a punctured lung from an xray.

 

[Sphynx]

This was posted the morning after his injury on the Demonland Forum before even the nature of the injury was announced, which in hindsight sounds absolutely spot on, as it's since emerged he spent 4 days in ICU following the surgery.

How isn't this an even bigger story than the Port concussion stuff?

 

[fusion]

Oh I know. But you can diagnose fractured rips and a punctured lung from an xray.

Yes you may be able to. But then I think it was obvious he had fractured ribs, and a small pneumothorax may not be visible on xray. And then you'd be falsely reassured, and miss the intra-abdominal injury.

A life threatening pneumothorax ("tension pneumothorax") should be able to able to be diagnosed at the bedside by an experienced doctor.

I disagree that xray machines or CT scanners are needed at the ground. Much better to transfer someone you're worried about to hospital.

 

[The Hobo]

Essentially all this confirms is that the AFL NEED to have independent doctors at each game that can make a ruling on incidents including concussion and injuries such as these.

Give them the ability to talk to the umpires directly, so that they can stop play if they suspect a serious injury, so we don't have the Rowan Marshall

19

Rowan Marshall

Age

29

Ht

201cm

Wt

105kg

Pos.

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Last 5

D

15.4

4star

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8.8

3star

HB

6.6

4star

CL

3.4

5star

HO

20.2

5star

D

12.9

3star

K

9.3

4star

HB

3.6

2star

CL

2.8

4star

HO

17.8

5star

D

10.6

3star

K

5.8

3star

HB

4.8

4star

CL

1.0

3star

HO

7.8

5star

scenario from a few weeks ago where the umpire was trying to get rid of the doctor for a head injury.

It takes away the Jeremy Cameron

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Jeremy Cameron

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31

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196cm

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94kg

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12.5

3star

K

9.0

3star

HB

3.4

3star

M

5.4

5star

T

1.6

4star

G

2.6

5star

D

10.0

3star

K

7.1

3star

HB

2.9

2star

M

4.6

4star

T

2.0

3star

G

1.9

5star

D

8.2

2star

K

5.0

2star

HB

3.2

3star

M

4.6

5star

T

2.4

4star

G

2.0

5star

incident from earlier in the year where he brushed away the club doctor and stayed on.

Independent doctor makes the call, the umpire stops play and player must come off and cleared by both the club doctor and independent doctor before resuming.

There's far too much pressure on the club doctor to get the assessment done quickly, and err on the side of sending the player back out to impact a game. They also have pre-existing relationships with players which also blurs lines etc.

 

[Cam Payne]

Essentially all this confirms is that the AFL NEED to have independent doctors at each game that can make a ruling on incidents including concussion and injuries such as these.

Give them the ability to talk to the umpires directly, so that they can stop play if they suspect a serious injury, so we don't have the Rowan Marshall scenario from a few weeks ago where the umpire was trying to get rid of the doctor for a head injury.

It takes away the Jeremy Cameron incident from earlier in the year where he brushed away the club doctor and stayed on.

Independent doctor makes the call, the umpire stops play and player must come off and cleared by both the club doctor and independent doctor before resuming.

There's far too much pressure on the club doctor to get the assessment done quickly, and err on the side of sending the player back out to impact a game. They also have pre-existing relationships with players which also blurs lines etc.

Cue calls for getting rid of independent doctors after youse teams have a player go off under circumstances youse deem insufficient for going off.

*youse does not apply to The Hobo specifically.

 

[The Hobo]

Cue calls for getting rid of independent doctors after youse teams have a player go off under circumstances youse deem insufficient for going off.

*youse does not apply to The Hobo specifically.

There will be outrage either way - as long as there's consistency in how each of the doctors apply their rulings, it's all we can ask.

For example, there was outrage from opposition fans when Marshall and Cameron didn't go off when they should have

 

[Cool Kangas]

After given pain relief. The guy has four broken ribs, a punctured lung and lacerated spleen. Like they wouldn't have known the extent of his injury after he was given the all clear to come back on the field. Win at all costs is all clubs care about and not the players well being.

A disgrace.

Wtf are you talking about? If the medical team knew the extent of the injuries, trac would never have been going back on. What a ridiculous comment

 

[fusion]

Essentially all this confirms is that the AFL NEED to have independent doctors at each game that can make a ruling on incidents including concussion and injuries such as these.

Good luck finding 9 doctors to essentially do this over the weekend. We don't even have full time umpires, or the same setup for goal reviews at each ground. I just don't think there's enough money in the game that can afford this.

Those doctors are going to have their own practices to attend during the week, and are unlikely to be employed full time by the AFL. My medical colleagues (including relatives who have done the occasional AFL game) in the 2010s essentially did it out of love for the game, and not for money. I just don't see it being something the game will be able to achieve. The NFL can have this kind of setup, but their budget is huge. However, the "independence" has been questioned in the NFL, as the doctors aren't truly independent.

Tua Tagovailoa: Insider Says NFL's 'Independent Neurologists' Aren't Truly Independent - Sportscasting | Pure Sports

There are many questions for the NFL after the Tua Tagovailoa concussion, including about the independence of the 'independent neurologists.'

www.sportscasting.com

They may be team unaffiliated, but not league unaffiliated. What level of independence do you want?

 

[blinkd]

Yes you may be able to. But then I think it was obvious he had fractured ribs, and a small pneumothorax may not be visible on xray. And then you'd be falsely reassured, and miss the intra-abdominal injury.

A life threatening pneumothorax ("tension pneumothorax") should be able to able to be diagnosed at the bedside by an experienced doctor.

I disagree that xray machines or CT scanners are needed at the ground. Much better to transfer someone you're worried about to hospital.

Ok, as it stands there is nothing on site and a player was allowed to continue with multiple fractures, punctured lung and a lacerated spleen.

My point is if imaging is available, you can confirm a suspected injury. Petracca doesn't return to the field if it is confirmed that he has multiple rib fractures and a punctured lung. It's off to hospital he goes instead of delaying treatment.

 

[BringFevBack2021]

Essentially all this confirms is that the AFL NEED to have independent doctors at each game that can make a ruling on incidents including concussion and injuries such as these.

Give them the ability to talk to the umpires directly, so that they can stop play if they suspect a serious injury, so we don't have the Rowan Marshall scenario from a few weeks ago where the umpire was trying to get rid of the doctor for a head injury.

It takes away the Jeremy Cameron incident from earlier in the year where he brushed away the club doctor and stayed on.

Independent doctor makes the call, the umpire stops play and player must come off and cleared by both the club doctor and independent doctor before resuming.

There's far too much pressure on the club doctor to get the assessment done quickly, and err on the side of sending the player back out to impact a game. They also have pre-existing relationships with players which also blurs lines etc.

Hard agree, even if it was “just” broken ribs, that increases the risk of a punctured lung or cardiac episode from trauma given the fragility of the thorax

Imagine he copped another knee, or he copped a shirtfront

I understand we want our best players out there winning us football matches but jeez this could’ve been a dark day in football if there was even one more significant collision to Trac

 

[BringFevBack2021]

Good luck finding 9 doctors to essentially do this over the weekend. We don't even have full time umpires, or the same setup for goal reviews at each ground. I just don't think there's enough money in the game that can afford this.

Those doctors are going to have their own practices to attend during the week, and are unlikely to be employed full time by the AFL. My medical colleagues (including relatives who have done the occasional AFL game) in the 2010s essentially did it out of love for the game, and not for money. I just don't see it being something the game will be able to achieve. The NFL can have this kind of setup, but their budget is huge. However, the "independence" has been questioned in the NFL, as the doctors aren't truly independent.

Tua Tagovailoa: Insider Says NFL's 'Independent Neurologists' Aren't Truly Independent - Sportscasting | Pure Sports

There are many questions for the NFL after the Tua Tagovailoa concussion, including about the independence of the 'independent neurologists.'

www.sportscasting.com

They may be team unaffiliated, but not league unaffiliated. What level of independence do you want?

Fairly confident one on field death would cost the AFL significantly more in commercials and compensation than the cost of 9 doctors per round for 20 years

 

[fusion]

Ok, as it stands there is nothing on site and a player was allowed to continue with multiple fractures, punctured lung and a lacerated spleen.

My point is if imaging is available, you can confirm a suspected injury. Petracca doesn't return to the field if it is confirmed that he has multiple rib fractures and a punctured lung. It's off to hospital he goes instead of delaying treatment.

We can have different points. But as a surgeon who treats injuries similar to these, I'll disagree with you about the need for xrays at the ground.

The most recent player who I can recall with a life threatening splenic injury was Matthew Lloyd in 1996. I don't think xrays would have picked up his injury, and then you'd be falsely reassured with your algorithm. I'm of the strong belief that if you're worried enough to want to xray a player, then you're worried enough that they should be sent to the emergency department.

'I would’ve died that night': Lloyd's other 1996 prelim nightmare

With Sydney and Essendon's Friday night meeting scrapped, Bombers legend Matthew Lloyd recalls one of their greatest clashes - but not for the reasons you might think.

www.theage.com.au

I think this is a safe approach for Dusty when he had a kidney laceration:
"
“Really unfortunate for Dustin, and obviously the team. The incident (was) just before three-quarter time. He came off the ground, and it looked pretty bad on the field, and he was obviously in a bit of pain,” he said.

“He ran off, and he said he was just winded, but the doctors took him down to the rooms for further assessment, and they were a little bit suspicious there was a bit more going on.

“He was taken to hospital for further scans and observation, and obviously the result was a lacerated kidney, which is fairly serious, and it will mean he can’t take any further part in the season. He is not allowed to have any contact for three months."

Tigers reveal full extent of Dusty injury as three month lay-off looms

Tigers reveal full extent of Dusty injury as three month lay-off looms

www.foxsports.com.au

 

[fusion]

Fairly confident one on field death would cost the AFL significantly more in commercials and compensation than the cost of 9 doctors per round for 20 years

I kind of agree - can't put a cost on a life but I doubt the AFL head office is going to fund it. And I still feel that we can trust the club doctors, and I don't think a neutral doctor is going to necessarily make a different assessment to the club doctor.

 

[Cyclops]

Regardless of what happened and who did what, or who didn't do what, it's tragic to see this happen to any player. It's sad a star is out for the season and I hope he makes a speedy and full recovery.

Yeah agreed. Absolutely love him, any club would be proud to have him on the list. edit: purely based on his character, not suggesting he should be valued more as a life because he's also a star.

Really not sure about the criticism, I'm no doctor. If a commentator said he can't come back on well that's the media, their opinions are mostly not worth the poo it would take to fill their mouths and stop their yammering.

Melbourne should look into it obviously and I am sure they will, if only to reassure the supporters and players they are looking after their boys.

I do know the Pies have had blokes injure themselves trying to stay on the pitch. Craig Kelly did a knee vs West Coast and refused the stretcher, IIRC he injured himself even more by hobbling on it. Jack Riewoldt trying to sneak back out when he was concussed shows the drive these blokes have.

Petracca wasn't concussed and was a cement head like Kelly (that was his actual nickname) so that's not the issue here I guess.

 

[BringFevBack2021]

I kind of agree - can't put a cost on a life but I doubt the AFL head office is going to fund it. And I still feel that we can trust the club doctors, and I don't think a neutral doctor is going to necessarily make a different assessment to the club doctor.

Yeah your latter points I agree with you on, I don’t think we are going to necessarily get significantly better outcomes but in my unadvised opinion I just think it’s a safeguarding exercise worthwhile looking at

I don’t know the logistics either, I am just a nuffy with an opinion after all but I am just reasonably confident we narrowly avoided a real on field tragedy on the weekend and would hate to ever bare witness to that

 

[The Hobo]

I kind of agree - can't put a cost on a life but I doubt the AFL head office is going to fund it. And I still feel that we can trust the club doctors, and I don't think a neutral doctor is going to necessarily make a different assessment to the club doctor.

I don't think a neutral doctor puts him back on. It was blatantly obvious to most people that he was not right to go back on, and Christian has somehow convinced his team doc that he's good to go and give it a try.

It was obvious immediately that he was not ok, and yet he stayed on for much longer than he should have.

Club doc doesn't want to overrule as Christian is such a key player and there comes the conflict of interest.

 

[FreoGirl]

All clubs will learn from it - I hope

 

[Bunk Moreland]

It’s between him and his doctors. Everybody has a lot to say about it but I don’t think they have a clue or it’s any of their business.

 

[Handsuper47]

He shouldn't have been out there at all, poor form on the club as a whole. It would not surprise me if players leave Melbourne when they realize the staff don't care about player welfare - but then again, I do wonder how much of these situations are player responsibility.

 

[Hollow Knight]

It’s between him and his doctors. Everybody has a lot to say about it but I don’t think they have a clue or it’s any of their business.

Overly-reductionist.

We are by no means entitled to know private information but this is clearly a monumental stuff-up.

By your logic, club doctors should never be held accountable for their actions/decisions/advice.

I’m not for a second suggesting that there was undue pressure (implied or explicit) on the doctors to send Petracca back out there, but the mere possibility of a conflict of responsibility between player and club is already a reason why there needs to be scrutiny of the role of club doctor.

How many ex-players whose lives are ruined by CTE are the result of poor regulation and oversight of club medicos over time?

Again, I’m not suggesting that the Melbourne doctors are guilty of this, in fact, I think it’s a classic case of “never attribute to malice what can be more easily attributed to incompetence”.

But in any instance, this is a disturbing event, and I don’t like how quickly the AFL circled the wagons.

Logically it seems that one of the following must have happened (in order from most likely to least likely)


1. Petracca overruled the doctor,

2. The doctor misdiagnosed him

3. The doctor diagnosed him correctly but then gave him bad advice

4. The doctor diagnosed and advised him correctly, but was overruled by another club official.

Some are clearly more serious than others, but none of them are acceptable in a professional sporting body or compatible with the AFL’s finding of no-fault.

 

[BringFevBack2021]

It’s between him and his doctors. Everybody has a lot to say about it but I don’t think they have a clue or it’s any of their business.

By your estimations we should ignore every injustice we see unless it pertains to us directly?

Lol

 

[blinkd]

We can have different points. But as a surgeon who treats injuries similar to these, I'll disagree with you about the need for xrays at the ground.

The most recent player who I can recall with a life threatening splenic injury was Matthew Lloyd in 1996. I don't think xrays would have picked up his injury, and then you'd be falsely reassured with your algorithm. I'm of the strong belief that if you're worried enough to want to xray a player, then you're worried enough that they should be sent to the emergency department.

'I would’ve died that night': Lloyd's other 1996 prelim nightmare

With Sydney and Essendon's Friday night meeting scrapped, Bombers legend Matthew Lloyd recalls one of their greatest clashes - but not for the reasons you might think.

www.theage.com.au

I think this is a safe approach for Dusty when he had a kidney laceration:
"
“Really unfortunate for Dustin, and obviously the team. The incident (was) just before three-quarter time. He came off the ground, and it looked pretty bad on the field, and he was obviously in a bit of pain,” he said.

“He ran off, and he said he was just winded, but the doctors took him down to the rooms for further assessment, and they were a little bit suspicious there was a bit more going on.

“He was taken to hospital for further scans and observation, and obviously the result was a lacerated kidney, which is fairly serious, and it will mean he can’t take any further part in the season. He is not allowed to have any contact for three months."

Tigers reveal full extent of Dusty injury as three month lay-off looms

Tigers reveal full extent of Dusty injury as three month lay-off looms

www.foxsports.com.au

I understand that an x-ray is not going to detect every injury.

All I am stating is that if we did it would prevent Petracca returning to the field. Therefore, not risking further damage to injury and receiving treatment earlier. Once at hospital they will do their differential diagnosis, repeat imaging, run routine bloods, can check Hb & clotting factors etc. Nothing to do with an algorithm.

I understand that you believe if imaging is warranted then it should be done at hospital but how the Petracca situation transpired is not good enough.

 

[Bunk Moreland]

Overly-reductionist.

We are by no means entitled to know private information but this is clearly a monumental stuff-up.

By your logic, club doctors should never be held accountable for their actions/decisions/advice.

I’m not for a second suggesting that there was undue pressure on the doctors to send Petracca back out there, but the mere possibility of a conflict of responsibility between player and club is already a reason why there needs to be scrutiny of the role of club doctor.

How many ex-players whose lives are ruined by CTE are the result of poor regulation and oversight of club medicos over time?

Maybe they just got it wrong. Doctors get things wrong all the time, they’re just doing the best they can. They don’t get hanged for it unless there clear evidence they were actually trying to do harm, which is incredibly rare.

If clubs have issues or need to make changes with their employees (doctors, players) etc then that’s their call, I’ve got no problem with that.

But it’s the one area of footy where people clearly know absolutely **** all, yet there’s nonstop commentary about what should happen… new measures to put in place, everything.

Medicine is a highly complex and specialised field.

If the doctors, club and the player themselves are okay with how it all took place, how is it anybody else’s place to make comment?

The doctors know their role and their ethical obligations. Petracca pretty clearly insisted on going back on the field and coach put him out there.

What’s the doctor supposed to do?

Cigarettes slowly kill people, but it’s not a doctor’s role to follow you around and rip them out of a patient’s gob.

I think the doctors probably know their role far better than all the nuffies commenting.

 

[Bunk Moreland]

By your estimations we should ignore every injustice we see unless it pertains to us directly?

Lol

No, I think people should have some trust in the processes and experts put in place when they clearly don’t have the knowledge.

If there’s things they can do better I’m sure they’ll do them. They are medical professionals and they do the job for a reason.

I don’t think they owe an explanation to footy nuffies in the media or on the internet who don’t actually understand the role and actually don’t know how it played out.