Written by Adarsh Tripathi
For individuals pursuing a career in sports, including medical practitioners who work directly for sports clubs or receive private referrals, the risks at elite levels are substantial. Some professional indemnity insurers even decline coverage for practitioners at the highest levels due to the potential financial repercussions if something goes wrong.
With top footballers earning over £100,000 per week and even lower league players receiving a healthy £20,000 per week, the potential for significant loss of earning claims arises when liability is attributed to a medical practitioner for a career-ending injury.
While not a case of medical negligence, the example of Collett v Smith demonstrates the settlement figures medical practitioners may be held liable for if damages are awarded against them. In this case, 18-year-old Collett suffered a fractured leg during a match, pursuing damages against Middlesborough FC, arguing their liability for their employee's actions as a professional footballer. The court awarded a settlement exceeding £4.3 million, including damages for past and future loss of earnings. It is crucial for medical practitioners to understand the rules regarding clinical negligence and the areas where sports practitioners are likely to face challenges. Similarly, clubs and governing bodies should be aware of the legal risks they may encounter in this context.
Considering the potential earnings of superstar players like Messi or Ronaldo, it becomes evident how significant the financial consequences could be if something goes wrong and results in a permanent injury. Therefore, awareness of clinical negligence regulations is vital for medical practitioners, and clubs and governing bodies must also recognize the legal risks involved in order to safeguard the well-being of athletes.
In most cases, negligence is seen as a breach of duty to care. The essential elements of general negligence are the duty of care, breach of duty, the breach or a violation that originate injury and damage. A profession in sport is definitely a fantasy portrayal for many and this is no variant for medical practitioners who are either engaged by the sports clubs themselves or seize referrals, on an individual basis[i].
The risks for practitioners working at first-class levels of sport are very important, with some professional reimbursement insurers even declining to indemnify practitioners who work at the first-class levels due to the monetary ramifications if something goes amiss or a skilled sportsman or anyone in fact to have a chance of commencing a profitable claim for any personal injury it is significant for the Claimant to show that there was a violation of a legal duty to take care which ends in damage.
In every negligence witnessed, it is important that the claimant must be capable to prove that the defendant owed him a duty of care. Due to the increasing negligence witnessed on the side of medical practitioners, the law strictly made it mandatory for every doctor to have a minimum number of qualifications, skills knowledge. This subsequently led to the hike of consumer rights(protection) and medical liability of course.
The appearing synergy between sports and medicine has cooked a new need for a better understanding of how medicine connects to the sporting world. The cases of medical negligence in sports are as follows:
HAMED V MILLS & TOTTENHAM HOTSPUR[ii]
In a recent case, young footballer Radwan Hamed suffered a catastrophic brain injury due to cardiac arrest during a youth-team match. The cardiologist involved accepted liability for failing to follow up on a recommended clinical review, while the club doctor was found negligent for reaching incorrect conclusions and withholding crucial information from Hamed and his parents. The court apportioned 70% blame to the club doctor and 30% to the cardiologist.
Hamed was awarded damages of around £7 million in October 2016, with Tottenham Hotspur, being 70% liable, covered by indemnity insurers. The compensation included pain and suffering, loss of earnings, and future care.
This case highlights the importance of heart condition screening in safeguarding athletes' health, with cardiomyopathy being a particular concern. Calls for cardio screening at all levels of sport have been renewed following similar incidents, including the death of non-league footballer Daniel Wilkinson.
The issue of cardiac screening has been raised in Parliament, but the implementation of protocols for athletes in non-elite roles remains uncertain.
HARVEY V. OUCHITA PARISH SCHOOL BOARD[iii]
During his sophomore and junior years, Michael Harvey had established himself as a star player on the West Monroe High School football team in Ouachita Parish, Louisiana. Before the start of his senior year, he sustained two minor neck injuries during football. Harvey's father, a chiropractor, treated his son for these injuries and told Michael's coach that Michael had to wear a neck roll in all practices and games for an indefinite period of time to protect his neck from further injury.
During the second game of his senior season, Michael's neck roll was torn off his shoulder pads and was damaged to the extent it could not be reattached. During halftime of the game, Michael inquired about an extra neck roll with the student trainer, who indicated that there were none. Michael did not ask any of the coaches for a neck roll and returned to play in the third quarter without a neck roll. After making an interception, Michael was tackled by the face mask during the return and sustained a ruptured disc at C4-5. Michael was treated with a discectomy and fusion.
Michael filed suit against his high school football coach and the school board as a result of the injuries he sustained. At trial, the court found the coach and staff negligent for failing to require a "player to wear available protective equipment to minimize the risk of a player being injured when tackled, even by actions that violate game rules, such as the â€˜face mask' and â€˜late hit' infractions for which penalty flags are thrown." The judgment totaled $215,000 including $35,000 for "loss of opportunity to play college football." The total judgment was reduced by 20% for Michael's portion of his comparative fault.
MALDONADO V. GATEWAY HOTEL HOLDINGS, L.L.C.[iv]
A 23-year-old professional boxer, Fernando Maldonado, was knocked out in a fight at the Gateway Hotel in St. Louis in 1999. After being revived, Maldonado walked to his dressing room, where he lost consciousness. There was no ambulance on-site or on standby, nor was medical monitoring provided. Maldonado alleged that the hotel, as the landowner, failed to have an ambulance and medical monitoring on-site, which delayed his treatment, thereby causing significant brain injury and numerous motor and cognitive deficits. The jury found the hotel negligent and awarded $13.7 million in compensatory damages. Although a request for punitive damages was not made, the jury, on its own, assessed punitive damages in the amount of $27.4 million to the verdict, which was later struck by the judge.
CERNY V. CEDAR BLUFFS JUNIOR/SENIOR PUBLIC SCHOOL[v]
In September 1995, Brent Cerny struck his head against the ground while attempting to make a tackle in a football game. Reports indicated that Cerny was dizzy and disoriented but remained in the game for a couple of plays before taking himself out. Cerny returned to the game in the third quarter and played to its conclusion. He participated in practice the following week and was injured again when his helmet struck another player during practice drills. Cerny's doctor testified that he suffered a closed head injury with second concussion syndrome.
In his lawsuit, Cerny advanced several theories of negligence against his coach, including failing to adequately examine, failing to obtain qualified medical attention, and improperly allowing him to return to play. Critical testimony during the trial was conflicting. The judge found that the coach's conduct in evaluating Cerny and permitting him to reenter the game and participate in subsequent practices was consistent with what a reasonable coach would do under like or similar circumstances. The judge's verdict found that the coach was not negligent.
PINSON V. STATE OF TENNESSEE[vi]
In 1984, Michael Pinson received a blow to his head in a football practice. Shortly afterward, he collapsed and remained unconscious for 10 minutes. The school's athletic trainer examined Pinson and found facial palsy; no control on the left side of the body; unequal pupils; and no response to pain, sound, or movement. Pinson was thereafter immediately rushed to the hospital. The team trainer did not accompany Pinson to the hospital and instead sent a student trainer. Hospital records revealed that the student trainer informed hospital personnel that Pinson had been unconscious for 2 minutes. The school's trainer later appeared at the hospital but never conveyed to hospital personnel the significant neurological findings he had made on the field. Pinson's subsequent symptoms of headache, known by the trainer, together with the trainer's original findings, were never relayed to Pinson's treating doctor, who ultimately allowed Pinson to return to play.
Three weeks after the concussion, Pinson was "kicked in the head" and collapsed unconscious at practice. Surgery revealed a chronic subdural hematoma that had been present likely for 3 to 4 weeks. Pinson remained in a coma for several weeks following his brain surgery and became hemiparetic.
At a commissioner's trial, the school's trainer was found negligent for failing to communicate Pinson's neurological signs and symptoms to the emergency room and treating physician. Damages of $300,000 were assessed against the school trainer and the school.
HALL V THOMAS[vii]
The claimant in this case pursued a claim against three defendants: the independent doctor, the club physiotherapist, and the club he played for.
The claim arose from a knee injury sustained by the claimant, Hall, and subsequent medical treatment. Hall underwent surgery and rehabilitation provided by the club physiotherapist. However, further complications arose, including damage to the knee, a post-operative infection, and subsequent unsuccessful operations, rendering the claimant unable to continue his professional career.
Hall brought two claims: one against the club physiotherapist for inadequate rehabilitation and one against the independent doctor for a delay in treating the post-operative infection.
The independent doctor admitted negligence, and the court determined the issue of causation. The court concluded that while the doctor was responsible for a delay in treating the infection, significant permanent damage was already present, and the doctor could only be held liable for 50% of the injury. The court also considered whether the meniscus repair would have been successful if not for the delay in treating the infection. Expert evidence suggested it was impossible to definitively prove the success of the repair, and pre-existing degenerative changes would have impacted the claimant's career.
The club physiotherapist denied negligence, and the court ruled in his favor. The claimant failed to demonstrate that the physiotherapist's care fell below the standard of a reasonably competent physician. The claimant's argument regarding inadequate records was not sufficient to establish negligence, as it required proving that warning signs were present.
This case emphasizes the importance of keeping accurate and comprehensive records for medical practitioners. The judge considered the records in this case to be inadequate, and had the claimant been viewed as credible, the outcome may have been different. Previous cases have established that practitioners must bear the risk of adverse factual findings when records hinder the extraction of relevant evidence.
ROSADA V. STATE OF NEW YORK[viii]
John Rosado, a state detainee, filed suit against the state as a result of a fractured skull he sustained when he fell while playing basketball at the detention center. Rosado alleged that the state was negligent for using concrete floors instead of hardwood. The court found that no duty existed to use wooden basketball floors, and judgment was entered against Rosado.
REGAN V. STATE OF NEW YORK[ix]
In Regan v. State of New York, a young college rugby player suffered a broken neck while practicing as a member of the rugby club and was rendered quadriplegic. The player filed a lawsuit against the state university alleging inter alia, negligent supervision of the practice. The court dismissed the claim, finding that the player had assumed the risk of "those injury-causing events which are known, apparent, or reasonably foreseeable consequences of their own participation."
From the above cases, it is evident to note the significance of having a productive emergency plan to avoid medical negligence. The law has to become more stringent and reasonable so as making the medical professionals alert in order to avoid negligence.
*The author is a law scholar from Army Institute of Law, Mohali.
(The image used here is for representative purposes only)
[i] Handbook of Neurological Sports Medicine by Anthony L. Petraglia, Julian E. Bailes, and Arthur L. Day. [ii] https://www.12kbw.co.uk/hamed-v-mills-and-tottenham-hotspur-football-and-athletic-club-ltd-2015-ewhc-298-qb/ [iii] https://casetext.com/case/harvey-v-ouachita-parish-28 [iv] https://caselaw.findlaw.com/court/mo-court-of-appeals/1092582.html [v] https://www.quimbee.com/cases/cerney-v-cedar-bluffs-junior-senior-public-school [vi] http://mason.gmu.edu/~jkozlows/lawarts/02FEB04.pdf [vii] https://casetext.com/case/hall-v-thomas-21 [viii] https://casetext.com/case/rosa-v-state-of-new-york [ix] https://casetext.com/case/regan-v-state-of-new-york