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ProFootballDoc: Justin Fields Injection In Tent Leads To Career Day And Controversy

A celebration has turned to controversy. Behind the six TD and 385 passing yards record performance by QB Justin Fields, Ohio State dominated and proved they belonged in the National Championship game versus Alabama. On a targeting call Fields took a big hit in the right flank/low back area and returned for the heroics. Post-game, Fields’ comments raised concern. 

“They didn’t really tell me anything … I took like a shot or two in in the tent and just ran back out there … they didn’t really give me a diagnosis at all.”

Certainly this is not a good look. After all this is college athletics. Even in the professional ranks there needs to be more conversation.

Informed consent is the key. An explanation of the risks and benefits of any treatment or return to play and an expression of understanding is mandatory. Maybe it was given. Certainly, athletes in the heat of battle hear what they want to hear and patients sometimes have selective memory. Or possibly he is playing coy as there is still a game to be played and he didn’t want to give away his injuries. With HIPAA guidelines, the medical staff is not allowed to give their side of the story so we will be left to wonder.

What adds to the controversy is clearly no X-rays were done in the tent. This is also not the first time as the medical staff had injection supplies in the tent ready to go. I am not saying this is bad form. During my time as a NFL team physician, there was no tent, but we did do injections sometimes even in the stadium tunnel. As long as informed consent was given and understood this is considered appropriate but I get that some may ask if that is possible so quickly in a tent without X-rays and our standards may be different for “amateur” players.

A rib block injection (intercostal nerve block) is common. Tyrod Taylor’s punctured lung after is a known but rare complication. The shot (or shots) certainly worked well enough to allow the completion of the game. In fact his performance has vaulted Fields to the discussion at the top of the draft with Trevor Lawrence. A trending topic is now either the Jaguars thinking twice or Fields to the Jets at No. 2. One could argue what the doctor did was the best thing for the young QB as it likely made him extra millions of dollars in the pro ranks.

The key here is whether there was no internal organ damage. The kidney would be the biggest concern. As long as the medical staff was diligent in monitoring any potential internal damage their actions could be considered proper.

Some may argue that this situation is another reason team doctors need to be independent and away from the team. That sounds good in theory but can a stranger really know players well enough to have informed consent on a moment’s notice? Long term rapport with players is a key to the team physician job. Familiarity leads to better communication and decision making in time of crisis.

Unless there is information of delayed kidney injury, this seems to be an exercise in semantics. The results have turned out to be a win/win so far. I hope informed consent was obtained and that Fields will be healthy for the National Championship game.

Written by Pro Football Doc

David Chao, MD -- known digitally as Pro Football Doc -- is an expert contributor for Outkick. Chao spent 17 seasons as the team doctor for the San Diego Chargers (1997-2013) and is part of the medical team at OASIS in San Diego where he treats and specializes in orthopedic sports injuries, working with high-profile professional athletes from the NFL, NBA, and MLB.

14 Comments

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  1. “proved they belonged in the National Championship game versus Alabama.”

    No they didn’t. They didn’t earn their playoff spot. They played half a season, so everyone was nice and well-rested and injury free. They took a spot away from another team that DID earn it through playing every game. Two different rules were just cast aside to admit them to the CFP.

    The only thing they “proved” is that our society loves corruption as long as my team or my party benefits from it. Ohio State fans should hang their heads in shame.

    • No tears. The rest of us just shake our heads in frustrated disgust, and wonder why OSU fans are such homers that they will not admit that they were the beneficiaries of administrative largess. The only position of integrity is to say “no; we didn’t earn the playoff spot and yes we cheated other teams that did, but now that we are here, go Bucks.” Instead, you act like you deserve it. You do not.

    • What an idiot. You really think doctors don’t settle suits all the time? They’re not robots and they’re constantly accused by people who don’t understand medicine at all of malpractice.

      And how fucking dare you imply blame of Seau’s suicide on anybody but Seau. In his right mind or not, he pulled the trigger, and HE decided to play football. The better question is: YOU paid money to troll Outkick’s medical expert?

      • I implied nothing about Seau. I linked to an article – you’ll note I’m not the author of said article.

        However, I could easily link to another 100 articles about this guy. Worked 30 years in the San Diego market as a reporter and editor – you’re right, docs get sued all the time. Few get sued this often, or have this many state medical licensing board hearings, or get hauled in front of the NFLPA quite as often.

        Them’s facts, not trolling.

        OutKick can do better …

        • Further, there’s this: This article by the ex-football doc DOESN’T HAVE ANY FACTS. He says that “IF” Fields wasn’t asked for consent, it could be a problem.

          There is ZERO controversy – since ex-football doc wasn’t in the tent. The whole thing is just empty crap.

  2. College Football is a huge business and the only people not making money out of it are the players. This is the one aspect of the whole deal that is going to crater the sport at some point. You can’t have these players putting it all on the line without the related compensation. Justin Fields is one injury away form never getting to cash in. Does OSU really care about that? Nope. And this is not a hit against OSU, every major program has the same problem.

    • The sad thing is that except for the top schools – Ohio State, Alabama, Texas, USC, Notre Dame, etc. – they all are losing money on athletics. As much money as comes in in TV revenue, they spend that much on upgrading facilities, improving travel, hiring additional staff, etc. It’s like a mirage – they’re all chasing some big payday that never quite comes. And those top schools that do make money? A lot of that is off of licensing – this report is from 2014, but nothing has changed: https://www.al.com/sports/2014/08/ncaa_study_finds_all_but_20_fb.html

  3. I’m not sure what Fields is complaining about. (or maybe he’s not complaining at all, just inarticulate when asked about what treatments he received in the “injury tent.”)

    Dr. Chao is certainly correct in pointing out the requirement of informed consent before any procedures. However, it is perfectly acceptable for a player to VERBALLY consent, it doesn’t necessarily require a written form – and obviously Fields is not claiming that he was held down and given “shots” against his will? (or is he?) again, not sure of the point he is trying to make. That the OSU team doctors don’t have x-ray vision? There are no x-ray machines in tents.

    MOST LIKELY, Fields was given a shot of intramuscular Toradol (ketorolac) which is an incredibly safe, non-narcotic non-steroidal anti-inflammatory agent (NSAID). This is given in the buttock or arm. It is widely used in the NFL and college sports because it works well, isn’t a controlled substance, has few to almost no side effects, and doesn’t cause drowsiness, etc. I tell my patients it is like getting a shot of powerful motrin. It is extremely effective in treating severe pain from kidney stones, post surgical pain, dental pain, and other acutely painful conditions (such as a broken or bruised rib).

    It is also possible that Fields was given a “local” injection of lidocaine or xylocaine, this is infiltrated into the tissues and causes localized anesthesia of the nerves. It’s what most people are given in the dentist’s office and what makes your jaw numb after you have your teeth worked on, or if you have ever had a laceration sewn up, it’s what the doctor injects into your wound so he can sew it up painlessly.

    Neither of these would really require a specific “informed consent” process, of course, Fields is a grown man and fully alert and can easily tell the team physicians he doesn’t want to get a shot.

    I’m sure that AFTER the game, Fields had x-rays or possibly a CT scan (a computer-generated three dimensional image from x-rays) to determine his actual injuries. Again, so what, but I’d be curious as a medical professional to learn what his actual injury (if any) was.

    That Fields is clueless about his diagnosis or medical procedure isn’t much of a surprise. He’s a gritty kid for sure, but obviously isn’t majoring in pre-med. Coach should tell him to avoid discussions with the media about stuff he doesn’t understand.

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