Three days after the visceral scene of Tua Tagovailoa's concussion in Cincinnati, questions are swirling about why Cameron Brate was allowed to return to the field after sustaining a head injury Sunday night.
Tampa Bay Buccaneers head coach Todd Bowles explained the decision to reporters on Monday. Per Bowles, the Bucs tight end initially complained of shoulder discomfort after a blow to his head late in the first half of Sunday's game against the Kansas City Chiefs. Only after Brate displayed concussion symptoms at halftime did the Bucs rule him out of the game.
Brate continued to play after blow to head
The injury appeared to take place on Tampa Bay's final drive of the first half with less than two minutes left in the second quarter. Tom Brady completed a pass to Brate, who then ran head-first at full speed into teammate Chris Godwin's shoulder. The blow knocked him backward to the turf.
Brate was slow to get up, but jogged off the field after he did as the Bucs were running a hurry-up offense and seeking to preserve a timeout.
Brate remained on the sideline for Tampa Bay's next two plays. After a timeout, he returned to the field and was targeted on three separate occasions by Brady in the final 46 seconds of the half. His final target on an incomplete pass into the end zone saw safety Bryan Cook tackle Brate to the turf to break up the pass.
The Bucs scored a touchdown on a pass to Mike Evans on the next play, and the game went to halftime after a brief Chiefs possession. The Bucs later announced that Brate had in fact been placed in concussion protocol. He was ruled out for the second half.
Bowles explains why Brate continued to play
The timeline that saw Brate return to the game for multiple plays after the blow to his head raised a glaring question that was magnified in the shadow of Tagovailoa's injury. Why was Brate allowed to continue to play? Here's Bowles' explanation to reporters on Monday, per Joey Knight of the Tampa Bay Times.
"He complained of shoulder discomfort," Bowles said. "He said nothing about his head on the sideline. "Nobody called down, he was checked out three times, and he went back in 'til the end of the half."
Only after Brate complained of symptoms at halftime did the Bucs test him for a concussion before ruling him out.
"At halftime, he started having symptoms," Bowles continued, per The Athletic's Greg Auman. "Obviously they were delayed. He started complaining about that. They tested him. He was in the protocol, and we kept him out the rest of the game. ...
"You can't see a neurologist or talk about concussions if you're only complaining about your shoulder."
So the official explanation is that Brate didn't initially complain about concussion symptoms, so the Bucs let him keep playing. Meanwhile, the league and the NFLPA have procedures in place to protect players from themselves in the event that they don't recognize or self-report concussion symptoms.
What the NFL's concussion procedure states
When a player receives an impact to the head, the player goes into the Concussion Protocol if:
the player exhibits or reports symptoms or signs suggestive of a concussion or stinger (a nerve pinch injury); or,
the team Athletic Trainer, booth ATC spotter, team Physician, NFL game official, coach, teammate, sideline Unaffiliated Neurotrauma Consultant (UNC) or booth UNC initiates the protocol.
Brate didn't initially report symptoms. At that point, the NFL and NFLPA outline that one of several candidates including a booth spotter, trainers, medical experts, a coach or a teammate can then initiate concussion protocol procedures if they suspect head trauma.
In short, almost anyone carrying an official capacity at an NFL game can declare that a player needs to be evaluated for a concussion, including a head coach. In Brate's case, "nobody called down," per Bowles.
In the wake of Tagovailoa's injury, NFL teams appeared to take a more proactive stance regarding head trauma on Sunday as at least a dozen players across the league were ruled out in concussion protocol. By comparison, only three appeared to have been ruled out in Week 3 in concussion protocol.
Brate, meanwhile, continued to play after experiencing head trauma. And the NFL faces more scrutiny for how it manages player safety in a game built on violent collisions.