Six Nations 2022: Progressive Rugby questions Tomas Francis playing on after head injury
- Published
Tomas Francis (L) reels after colliding with Owen Watkin (R) while they attempt to tackle Charlie Ewels
Leading head injury organisation Progressive Rugby has questioned prop Tomas Francis being allowed to continue to play during Wales' 23-19 Six Nations defeat by England.
Francis was involved in a collision of heads with Wales team-mate Owen Watkin in the 20th minute at Twickenham.
Both players were allowed to return to play with Francis passing a head injury assessment (HIA).
Welsh rugby chiefs and World Rugby say the incident will be reviewed.
Progressive Rugby has published an open letter, signed by Professor Bill Ribbans and Professor John Fairclough - who has previously worked with the Welsh Rugby Union (WRU) - saying Francis should have been removed from the field.
The letter to the WRU, Six Nations and World Rugby states the injury suffered by Francis meant he should have been withdrawn immediately from the game without undergoing the HIA.
After the pair attempted to stop England lock Charlie Ewels scoring, Watkin and Francis received immediate treatment from different Welsh medics.
Watkin left the field immediately with a cut head before Francis followed a minute later, just before a scrum was set after referee Mike Adamson was told the Wales prop needed to leave and be assessed.
The Welsh medics did not initially see the Francis incident, but asked for it to be reviewed via video by the independent match-day doctor.
The Ospreys prop returned to the field after passing his assessment before being replaced permanently by Leon Brown in the 56th minute.
The Progressive Rugby statement said: "Watkin receives a clear and obvious injury with blood flowing from a cut to his head and is correctly removed for a head injury assessment which he subsequently passes.
Owen Watkin suffered a cut head during the clash of heads with Tomas Francis
"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 and is seen by a physio or medic, it is not clear which.
"Francis displayed clear symptoms/indications under criteria 1 of the World Rugby Head Injury Assessment protocol that necessitate the immediate and permanent removal from play. No HIA was needed.
"There are 12 Criteria 1 signs and symptoms with six possibly observed on video and the remaining five identified during the on-field assessment.
"The typical observation on video are confirmed loss of consciousness, suspected loss of consciousness, convulsion, tonic posturing, balance disturbance/ataxia and 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.
"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."
Concussion concerns
Progressive Rugby is an independent rugby union lobby group demanding better protection for players to ensure the game continues to thrive.
It is comprised of current and former players (amateur and professional), medics, academics, referees, coaches, teachers, administrators and fans.
The members include former Canada international Jamie Cudmore, ex-England back-rower James Haskell, former Wales flanker Alix Popham, while currently-injured Wales player Josh Navidi and former star Jonathan Davies are also signed up members.
Nine former rugby players, including Popham and Steve Thompson, launched legal action in December 2020 against World Rugby, the RFU and the WRU for alleged negligence.
The nine players have been been diagnosed with, or assessed to be on the trajectory towards diagnosis of, traumatic brain injury, early onset dementia and probable CTE.
Tomas Francis has played 63 internationals for Wales
The letter continued: "It is our major concern the public has observed that in rugby union individuals have incurred brain injury and been permitted to continue to play.
"Progressive Rugby is concerned the events demonstrate individuals who have incurred brain injury continue to be permitted to play which will place them at likelihood of risk.
"Until satisfactory explanations are provided, we remain unable to accept World Rugby's assertion that player welfare is the game's number one priority."
When asked about the incident after the game, Wales coach Wayne Pivac said: "They go through some testing behind the scenes.
"They [Francis and Watkin] both passed the testing so they're allowed to play on. They'll go through more testing after and if they clear that, they'll be allowed to train."
World Rugby response
The WRU says it will not be providing any further statement, pointing instead to the World Rugby comments which say the incident will be reviewed after the game in line with the normal protocols.
The authorities were understood to be aware of the incident well before Progressive Rugby's letter and say every match is reviewed as per World Rugby's tournament player welfare standards, undertaken by the tournament organiser Six Nations.
A World Rugby statement read: "Player welfare is paramount for everyone involved in rugby and a collaborative approach is at the heart of ensuring all processes, such as the Head Injury Assessment (HIA) operational in elite competitions, are followed for the good of the game.
"As with other elite international competitions, World Rugby works alongside Six Nations Rugby, who conduct reviews following every championship game, to identify and address any potential issues that arise from these matches.
"This approach is supported by a dedicated HIA review process, which is available to tournament organisers where required.
"World Rugby can confirm all match officials involved in the current Six Nations participated in an education workshop delivered by the chief medical officer last week to reaffirm their critical role in supporting the HIA process."
