NFL will penalize teams that violate medical protocols after Case Keenum incident

On the heels of its decision to not impose discipline on the St. Louis Rams after they permitted an obviously concussed Case Keenum to remain in the game in Week 11, the NFL will issue discipline to teams that violate medical protocols in the future, per NFL Network's Ian Rapoport. The discipline could come in the form of fines or suspensions.

While the discipline applies to any sort of medical protocol violations and is not limited to head injuries, Keenum's concussion and the way it was handled by the Rams was surely a catalyst for this decision.

The NFL's concussion protocol identifies observable signs of a concussion as any loss of consciousness, being slow to get up after a blow to the head, motor coordination or balance problems, a blank or vacant look, disorientation, clutching of head after contact and/or a visible facial injury, in combination with any of the previously listed symptoms.

Keenum exhibited several of these signs, but was not removed from the game by the team or by the ATC injury spotter in the booth. It's a relatively new rule, implemented before the 2015 season began, but the ATC injury spotter does have the authority to stop a game and remove an injured player for medical evaluation. This didn't happen. The Rams' head athletic trainer, Reggie Scott, spoke to Keenum briefly on the field, but that was the extent of medical attention Keenum received immediately following the injury.

NFL commissioner Roger Goodell said on Sirius XM Radio with Shannon Sharpe on Dec. 11 that Keenum should have been removed from the game and that the system failed Keenum in several ways.

"In the Case Keenum case, it was clear that there was somebody giving him medical attention. The problem that we had was the appropriate medical attention wasn't given and there were several gates, frankly, that failed and didn't do the right things through our protocol," Goodell said. "We're trying to make changes to that. We are going to continue to tweak that until we get that right and try to prevent and make sure the game is stopped so the player has the right medical attention."

The first step in that process, it would seem, is for the league to apply discipline to teams that don't adhere to the medical protocols. Rapoport said that the goal of the discipline is to ensure that players who need medical attention are removed from games to receive appropriate medical attention.

Everyone who has an opportunity to intervene when a player is injured on the field of play will be subject to league discipline when protocols aren't followed. This includes players, coaches, officials, the team's medical staff, neurologists and the ATC spotter.