George North: Northampton Saints avoid sanction over head injury

The tackle on George North led to Leicester's Adam Thompstone being sin-binned

Northampton Saints will face no sanction following the investigation into their treatment of Wales wing George North's latest head injury.

However, the concussion review panel concluded that the 24-year-old should not have returned to the field of play after he fell in a mid-air tackle against Leicester on 3 December.

The panel's 17-page report stated that head injury assessment (HIA) protocol was followed correctly, but the Saints medical team have accepted that North may have lost consciousness.

"The Concussion Management Review Group's (CMRG) view is that there was sufficient evidence to conclude not only from the video evidence but also George North's history and risk stratification that he should not have returned to the field of play," said the report.

"The CMRG considered the welfare of North was always at the centre of Northampton's actions, and does not consider that the medical team [or the club] failed to complete the HIA protocol nor intentionally ignored the player's best interests."

The report states that, although North appeared to lie motionless after the incident, he told medics he had stayed still because he was "concerned about his neck".

North also "continued to deny any loss of consciousness with immediate recall of events", with the "only symptom recorded being neck pain".

North's concussion history

The Northampton back suffered four head blows in five months between November 2014 and March 2015, leading to a spell on the sidelines that lasted from 27 March until 29 August.

• 22 November 2014: North suffers first concussion in Wales' 34-16 defeat by New Zealand

• 6 February 2015: Suffers accidental kick to the head during first half of 21-16 loss to England, but after assessment returns to the field

• 6 February 2015: Receives second blow to the head in second half of same Six Nations game

• 27 March 2015: North is knocked unconscious scoring a try in Northampton's 52-30 win over Wasps

What are the rules?

• With suspected concussion, club doctors have 13 minutes to decide if a player can return to the field.

• All Premiership grounds and Twickenham have medical teams with access to replays to help that decision.

• Any player with confirmed or suspected concussion will be permanently removed.

What else does the report say?

The review - the first of its kind since the concussion management system was introduced in the Premiership at the start of this season - also made nine recommendations.

These include consideration being given to the introduction of a pitchside video reviewer to ensure video feeds continue to be monitored throughout the match.

It has also recommended that the entire HIA assessment must be completed off field, even if part of it had already taken place on the pitch.

And it re-enforced "the necessity to review footage before starting the HIA assessment and the criteria in respect of permanent removal from the field of play".

'We wanted to be thorough and rigorous'

North has been capped 65 times by Wales since making his international debut in 2010

Since the concussion review panel first met to assess the incident on 6 December, it has taken 15 days for their findings to be published - with North having been stood down from playing in the meantime.

"We wanted the review - which was primarily around the medical management and treatment of George North - to be thorough and rigorous to ensure that we fully understood the circumstances of this case," said the group's independent chairman Dr Julian Morris.

"While the challenges in the consistent delivery of best practice in the on-field management of head injuries in professional sport are recognised, player welfare is paramount to the game of rugby."

North has since resumed training and, according to Saints director of rugby Jim Mallinder, is set to return to the Northampton side for their league match against Sale Sharks on Friday.

How have Northampton responded?

After the report was published on Wednesday, Northampton said in a statement that they "accept the conclusion that George should not have been allowed to return to the field of play, but are pleased that the CMRG has reflected our concerns about the current technologies and processes available to medical teams when assessing concussion".

The statement added: "The club believes that this is now an opportunity for the whole rugby community to reflect on the CMRG's recommendations to ensure the highest levels of player safety and well-being.

"In the meantime, the club continues to offer George its full support and looks forward to seeing him on the pitch again as soon as he is ready."

North investigation timeline

• 3 December: North falls heavily in a mid-air tackle but returns to play after passing pitch-side assessment. Northampton release post-match statement saying North was "fit to play on"

• 6 December: Premiership and RFU officials hold urgent meeting to assess handling of head injury. Concussion panel review is set up to investigate the incident

• 14 December: Northampton boss Mallinder says "all North wants to do is get back and play rugby"

• 15 December: Ex-Saints team manager Lennie Newman says club would be "frustrated" by time taken to conclude investigation

• 20 December: Mallinder says North set to play against Sale on Friday

• 21 December: Concussion panel review opt not to sanction Northampton, but say North should not have returned to the field of play

Analysis

BBC Radio 5 live's rugby union reporter Chris Jones

"The decision not to sanction Northampton will inevitably be met by widespread scepticism, especially as it is accepted that the club didn't manage the incident properly.

"The Rugby Football Union and Premiership Rugby have long vaunted their approach to concussion and head injuries, and there is no doubt they have been at the front of the field.

"But for a situation like this to occur is highly unsatisfactory and, while the governing bodies will want this to be a line in the sand when it comes to managing such injuries, it is clear there is still some way to go.

"And amongst it all is a lingering feeling that while players are culpable for their actions - especially when it comes to acts of foul play - other bodies in rugby are not being held to account in the same way."

No sanction for weakened team

Meanwhile, Northampton have also discovered they will receive no punishment for fielding an under-strength team in their 60-13 European Champions Cup defeat by Leinster on Saturday.

European Professional Club Rugby (EPCR) officials have assessed the matchday squads and ruled that Saints did not break any tournament regulations.

"It is the obligation of the participating clubs to select the best possible squads for matches," said an EPCR spokesman.

"EPCR reserves the right to take action in the interests of the integrity of the tournaments."