NFL toughens concussion protocol in wake of Miami star Tua Tagovailoa's injury

The NFL will toughen its concussion protocols to prevent a repeat of the situation that led to Miami star Tua Tagovailoa's concussion, the league said Saturday.

In a joint statement with the NFL Players Association on a review into Tagovailoa's injury, the league and union said that steps of the protocol were followed as written.

"The NFL and NFLPA agree that the outcome in this case is not what was intended when the protocols were drafted," their statement said.

"As such, as has been done in previous cases, based on the advice of the parties' respective medical experts, the protocol will be modified to enhance the safety of the players."

The term "ataxia" -- defined as abnormality of balance/stability, motor coordination or dysfunctional speech caused by a neurological issue -- will be added to the mandatory symptoms that will result in a player being removed from a game.

If either a team physician or a neutral physician involved in concussion protocol finds a player is suffering from ataxia, the player will not return to the game and will be placed into concussion protocols.

Whether or not the change would be made before Sunday's NFL games was not explicitly stated. Indianapolis beat Denver on Thursday in the first game of the week.

The change will tighten a loophole that allowed Dolphins' quarterback Tagovailoa to play on after his head struck the turf on a September 25 game against Buffalo.

Tagovailoa struggled to leave the field and was checked for a concussion but declared to have only a back injury and returned for the second half.

He passed testing over the next four days and was controversially allowed to play against Cincinnati, where had his had slammed against the turf. He spent several minutes on the field before being carried off on a stretcher.

Tagovailoa was diagnosed with a concussion and neck injury after that. He will not play for Miami on Sunday against the New York Jets.

The joint investigation found that protocol was followed. Tagovailoa was examined after his injury in the Buffalo game and the Miami team physician cleared him after talking with an unaffiliated neurological consultant.

Tagovailoa told the medical staff he had aggravated a back injury on the play and that caused his stumble as he tried to leave the field, according to the report.

The medical staff found that the gross motor instability displayed by Tagovailoa was not caused by a neurological issue, which would have required him to be pulled from the game, but was instead from a back injury.

The team doctor and consultant, however, did not conduct their own exam of Tagovailoa's back during the concussion examination, instead relying on the prior exam by other medical staff, the joint statement said.

Tagovailoa showed no signs or symptoms of a concussion during his locker room exam, the remainder of the game or the four days before the Cincinnati kickoff, according to the statement.