Miami Dolphins quarterback Tua Tagovailoa was carted off the field on a stretcher during a game on Thursday night after he appeared to experience his second head injury in less than a week when he was thrown to the ground, hitting his head on the turf.
The injury, in a nationally televised prime-time game, came only days after the N.F.L. players union began an investigation into the Dolphins’ handling of another head hit sustained by Tagovailoa in his previous game. The N.F.L. said this week that it welcomed that investigation, but Tagovailoa’s new injury is certain to renew questions about the league’s concussion protocols, and highlight concerns that even the kind of subconcussive hits to the head that are common in football can cause lasting damage to players.
Midway through the second quarter of a game between Miami and the Cincinnati Bengals on Thursday night, Tagovailoa dropped back to pass around midfield. Bengals defensive tackle Josh Tupou grabbed Tagovailoa, spun him around and threw him to the ground. Tagovailoa’s elbow hit the ground first, and then the back of his helmet.
Tagovailoa immediately raised his hands with his fingers splayed, a gesture called a “fencing response” that can be a sign of brain injury. Dolphins trainers ran onto the field and, after several minutes, put Tagovailoa on a stretcher and wheeled him off the field while his concerned teammates stood and kneeled nearby.
A few minutes after the injury, the game’s television broadcasters announced that Tagovailoa had sustained head and neck injuries, was conscious and had been taken to the University of Cincinnati Medical Center. The Bengals won the game, 27-15.
The team said after the game that Tagovailoa was put into the league’s concussion protocol, which guides doctors in determining when a player can safely return to practice and games.
Dolphins Coach Mike McDaniel told a sideline reporter that the injury was a “scary moment.”
“That was an emotional moment that is not part of the deal that anyone signs up for, even though you know it’s a possibility in football to have something that you have to be taken off on a stretcher,” McDaniel said after the game.
“All of his teammates, myself, we’re all very concerned. So the best news we can give is that everything is checked out that he didn’t have anything more serious than a concussion. He’ll be flying back with us here on the plane.”
Chris Nowinski, the chief executive of the Concussion Legacy Foundation, who has often criticized the N.F.L.’s handling of concussions, was unsparing in his criticism of the handling of the player’s health.
“This is a disaster,” he wrote on Twitter soon after Tagovailoa was wheeled off the field. “Pray for Tua. Fire the medical staffs and coaches. I predicted this, and I hate that I am right.”
Nowinski, who had warned before the game about the risks to Tagovailoa if he took the field so soon after hitting his head violently in the previous game, then responded to a Dolphins tweet about the quarterback’s injury by writing “you guys should go to jail for letting him play” so soon after hitting his head violently in the previous game.
Tagovailoa’s new injury raised fresh questions about the Dolphins’ handling of the league’s concussion protocol, which first arose because of the team’s decision to allow him to re-enter a game against the Buffalo Bills on Sunday after a hit in which he appeared to slam his head on the turf and then struggled to stay on his feet.
In the second quarter of that game, in Miami Gardens, Fla., Tagovailoa was pushed to the ground and hit the back of his head on the turf. He immediately grabbed the sides of his helmet, staggered to his feet and, after taking a few steps, briefly collapsed to his knees as he tried to return to the huddle.
Tagovailoa walked off the field and spent the rest of the first half in the locker room, but he returned to play in the second half.
His return prompted the N.F.L. Players Association to begin an inquiry into the Dolphins’ handling of the injury, an option added to the collective bargaining agreement in 2020. The process includes reviewing video and interviewing team and league doctors who evaluated Tagovailoa. The process can take weeks.
The union said on Twitter on Thursday that it hoped Tagovailoa would have “a full and speedy recovery” and that its investigation was ongoing.
On a conference call with reporters on Wednesday, Jeff Miller, the league’s executive vice president for communications, public affairs and policy, said that “every indication” was that the league protocols were followed by the team’s doctors and the league-affiliated neurologists at the game.
The Dolphins listed Tagovailoa as “questionable” on the team’s injury report before Thursday’s game with a “back/ankle” issue.
After Tagovailoa’s exit from a second game, the league’s confidence in its concussion protocols could be scrutinized anew.
Tagovailoa’s injury in a prime time N.F.L. game followed that of Bills cornerback Dane Jackson, who was carted off the field during a Monday night game on Sept. 19 after he inadvertently collided with teammate Tremaine Edmunds. The hit caused Jackson’s head and neck to snap back. He was released from Erie County Medical Center in Buffalo the following day after being cleared by a CT scan.
“It brings us back to the reality of the violence of the game, and I hope it gives people perspective,” said the veteran cornerback Richard Sherman, a commentator for Amazon, which broadcast Thursday’s game. “These are human beings and they have families and they have futures and they’re putting it all out on the line to entertain people.”