EAST RUTHERFORD, N.J. -- The NFL pledged to err on the side of caution when it came to implementing its amended concussion protocol and stayed true to its word Sunday.
Miami Dolphins quarterback Teddy Bridgewater was placed into concussion protocol during their 40-17 loss to the New York Jets, despite passing a locker room examination, after a booth ATC spotter believed Bridgewater stumbled after he was hit on his first snap of the game. The perceived stumble triggered the recently added "ataxia" clause in the league's concussion protocol -- a "no-go" symptom that requires players be taken to the locker room and prohibited from returning to the game under any circumstances.
The NFL and NFL Players Association announced the amendment to the protocol late Saturday afternoon after a nearly two-week long investigation into whether protocol was properly followed with Tua Tagovailoa on Sept. 25. Bridgewater was making his first start of the season in place of Tagovailoa, who sustained a concussion in the Dolphins' loss to the Cincinnati Bengals on Sept. 29 and is currently in concussion protocol.
Bridgewater's removal from Sunday's game forced rookie Skylar Thompson into the first game action of his career and left the Dolphins without their top two quarterbacks.
"It's rough but the whole team has confidence in Skylar and I think our team in general doesn't look at it like we're a one-man savior at any spot," Dolphins coach Mike McDaniel said. "It's a new set of circumstances of adversity so early but I didn't think that the rest of the team's response to losing Teddy had anything to do with losing the game."
Bridgewater was in the Dolphins' locker room after the game and will return to Miami with the team, as will wide receiver Tyreek Hill, who left MetLife Stadium wearing a walking boot on his left foot after it was stepped on in the fourth quarter. Left tackle Terron Armstead left the game with a toe injury and did not return; McDaniel said Armstead would remain in New York and was scheduled to see a specialist to get another opinion on the injury that's lingered since Week 1.
Sunday marked the first instance of the NFL implementing the ataxia rule, which is defined as "abnormality of balance/stability, motor coordination or dysfunctional speech caused by a neurological issue." In a joint statement, the NFL and NFLPA said that any player diagnosed with ataxia will be prohibited from returning to the game and receive follow-up care, as is required by the protocol.
Dolphins running back Raheem Mostert said Bridgewater's absence was "a little discouraging" but that the team displayed a "next man up attitude" throughout the remainder of the game. Mostert, who ran for a season-high 113 yards and a touchdown, added that while he disagrees with the rules to an extent, they are to be taken seriously and followed.
"The rules are the rules," he said after the game. "If a guy does pass the protocol concussion and if he's able to play, I believe that he should be back. But, you know, we still can't make any excuses, especially when you lose. I'm not saying that he's the reason why we lost or anything like that, because at the end of the day, we gotta step up and do our part. But when it comes to those protocols, we've gotta take those things seriously."
During the Dolphins' game against the Buffalo Bills on Sept. 25, Tagovailoa hit his head on the ground and stumbled while trying to return to the huddle. The stumble was considered a display of gross motor instability, which is another one of the protocol's "no-go" symptoms.
Tagovailoa was immediately taken to the locker room for a concussion evaluation, but he informed both the team physician and the unaffiliated neurotrauma consultant jointly hired by the NFL and the NFLPA that a back and ankle injury caused him to stumble; the joint investigation found that Tagovailoa had previously reported both injuries before hitting his head on the ground.
Once it was determined that his observed instability was not neurologically caused, Tagovailoa passed his evaluation and was allowed to return to the game. However, neither the team physician nor the neurotrauma consultant examined his back during the evaluation, "but instead relied on the earlier examination conducted by other members of the medical staff." The NFLPA exercised its right to terminate the neurotrauma consultant who performed Tagovailoa's initial evaluation after the union found he made "several mistakes" during the process, beyond following the step-by-step process of the protocol, multiple sources told ESPN.
Both parties agreed Saturday to amend the protocol, adding ataxia to the list of "no-go" symptoms. The changes were implemented immediately before Sunday's games began.
"I'm happy that there's some policy that the medical experts deem is more safe for the players, collectively," McDaniel said after the game. "So that's a positive thing."
Thompson finished the game with 166 yards and an interception on 16-of-33 passing. While he did some positive things throughout the game, he lost a critical fumble midway through the fourth quarter that set the Jets up for a game-sealing touchdown on the following play. With two quarterbacks in concussion protocol, Thompson will have to prepare for at least another role as the Dolphins' starter unless both Bridgewater and Tagovailoa clear protocol by Saturday afternoon.
McDaniel said Thompson had a "rough rookie outing" but it isn't cause for concern at this point. When asked whether the amended protocol rules will convince the Dolphins to activate more than two quarterbacks on their gameday roster, McDaniel mentioned the unprecedented nature of their new situation.
"It's gonna be tricky because you don't want to leave things up to chance," he said. "It's impossible to say whether or not someone's, you know, the timeline of when they're going to clear protocol. So, this particular situation, obviously with the new rule change as of yesterday, is unique and slightly uncharted. I think we're comfortable having two quarterbacks on the gameday roster. So we're gonna have to kind of assess those situations and we might have to make a move as a result."