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Tom Savage returned to the field before being diagnosed with a concussion. The NFL is looking into it.

The Texans QB suffered a bad hit in the second quarter and suffered a concussion that doctors missed the first time.

Houston Texans v Tennessee Titans Photo by Frederick Breedon/Getty Images

Tom Savage suffered a concussion against the 49ers that forced T.J. Yates to come in at quarterback. He would later be ruled out after further evaluation, but not before coming back into the game for a series, somehow, before doctors properly diagnosed him.

The handling of the incident is sure to bring questions. Savage was clearly hurt, and even displayed the “fencing response” which is commonly associated with head trauma injuries. After the game, CBS reported that the NFL’s chief medical officer, Dr. Allen Sills, will be talking to the team and looking into the incident.

The review will include interviews with all relevant team personnel and scrutiny of reports made by unaffiliated neurotrauma consultant & spotters.

Monday, the NFLPA also said they would be reviewing the situation, and Savage tweeted out a message about the entire ordeal, and how he feels about head coach Bill O’Brien:

Here’s what happened.

Savage took a hit from Elvis Dumervil that left him stiff and shaking on the ground. He would be taken to the injury tent to be evaluated. On the Texans’ next possession, Savage came back out onto the field without missing game time.

He threw two incomplete passes on the following possession. He was checked out again by the team’s doctors on the sideline after that, and when he tried to go back onto the field on the Houston possession after that, the doctors would not allow him to go.

This was the scary hit that sidelined Savage:

However, Yates would later enter the game as Savage went to the locker room to be further evaluated for a concussion.

How was he allowed to go back onto the field?

According to the league’s concussion protocol, any potential concussion that is identified gets the player removed from the field. After that, the unaffiliated neurotrauma consultant and the team doctor review the video of the play and administer the neurological exam to the player.

If a player is diagnosed with a concussion, they are not allowed to play again that day. If they are not diagnosed with a concussion, they’re monitored closely throughout the game.

There are also two medical spotters in the booth who watch the game with binoculars and video replay to identify injuries that others missed. The league added a rule in 2015 allowing for the medical spotters to stop the game with a medical timeout to remove an injured player.

After the game, head coach Bill O’Brien explained what happened.

That’s when they pulled him.

Together, they appeared to have missed Savage doing what’s called the fencing response in the end zone after that, i.e. the moment with his hands shaking. The fencing response happens after a hit to the head, after force on the person’s brainstem their arms or forearms extend and stiffen for several seconds in response to the impact.

What does this mean for the Texans?

The Texans’ quarterback situation was never going to be good after Deshaun Watson went down with an injury. Yates hasn’t played in a game since 2015 when he went 2-0 as Houston’s starting quarterback.

Upon entering the game, Yates threw a touchdown pass to DeAndre Hopkins to narrow the gap against the 49ers. The Texans eventually lost, 26-16.

Savage had been benched earlier in the season in favor of Watson and has been 1-5 in his starts during the 2017 season. Last season, Savage had been sidelined for a concussion before entering the game to take a kneel down, prior to exiting the game again.

If the league finds that the Texans violated the concussion protocol, they could punish them. In 2016 the NFL passed a rule that allows the league to punish teams that violate the concussion protocol with fines or even loss of draft picks.

The Seahawks violated the concussion protocol in a Thursday night game in November this year when they allowed Russell Wilson to return to play. The player who hit Wilson, Karlos Dansby, was fined, but the league investigation into the Seahawks, as far as we know, are still waiting to hear the results of the joint NFL-NFLPA investigation. Results from that were expected at the end of November.

Given the NFL’s track record on holding teams responsible for protocol violations, precedent seems to suggest that they won’t be punished even if they did violate it.