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Re: NFL Concussion lawsuits
Using the information they would obtain, Pellman, Lovell and the committee planned to look at baseline results and identify a normal range of scores for uninjured NFL players. Then, comparing postinjury scores to baseline data would show the effects of concussions. Comparing data from players with multiple concussions to that of all injured players would show whether concussive effects changed as injuries accumulated.
A lot was riding on the analysis. The committee had never imposed recommendations on team medical staffs. But this was the first study ever to analyze the brain function of NFL athletes. If it showed that concussions were significantly impairing players, the league might be forced to institute new rules for evaluating and treating head injuries. Pellman and Lovell both say they invited all teams to participate in the research (Lovell says 11 teams elected to join the study) and tried to collect as many results as they could. As Lovell puts it, "More data is always better." Several of the doctors involved, however, tell a different story. Barr, for example, conducted 217 baseline tests from 1996 to 2001. Periodically, he forwarded results to the league, but at the time Barr learned the committee was planning to publish its results, he had sent only 149. Barr remembers finding Pellman in the Jets' training room in 2003 and saying, "Elliot, I haven't sent data for a year." According to Barr, Pellman didn't want the additional tests. "I don't want the data to be biased because I'm with the Jets," Barr recalls him saying, suggesting that additional results would skew the data because the Jets would be overrepresented in the sample. That made no sense to Barr. A scientific study should include, or at least address, all available data.
Pellman denies this conversation ever took place. "Bill Barr was a consultant for the Jets who tested individual players to help us make decisions," he says. "I did not discuss the committee's research with him." Whoever is right, the fact is the group didn't have all of Barr's data for its paper.
Barr's wasn't the only research that didn't make the cut. Over the period covered by the committee's research, Christopher Randolph, a Chicago neuropsychologist, collected baselines for 287 Bears players. He says Lovell never asked for his data, either.
Nor did the committee seek complete data from John Woodard, neuropsychologist for the Falcons and associate psychology professor at the Rosalind Franklin University of Medicine and Science in North Chicago. According to Woodard, in December 2003, Lovell said the league was pressuring him to compile team results. "I was asked to provide data on only concussed players," Woodard says. "I had data for slightly more than 200 baseline evaluations. I don't know why I was not asked for them."
In 2004, Lovell also asked Richard Naugle, consultant to the Browns and head neuropsychologist at the Cleveland Clinic, for data on just the players who had already suffered concussions, according to an e-mail Naugle wrote to a colleague in March 2005. Naugle declined to comment for this story, citing a confidentiality deal between his medical group and the NFL, but The Magazine has obtained a copy of that message. "I don't have that sorted out from the results of other testing," Naugle wrote of the request. "I explained that and added that if he could name players, I could send data on those individuals. I recall sending him data on two or three players … I have a few hundred baselines."
This means Pellman, Lovell and their colleagues didn't include at least 850 baseline test results in their research—more than the 655 that ultimately made it into their 2004 Neurosurgery paper. At best, their numbers were incomplete. At worst, they were biased. "That's news to me," Lovell says now. "My job was to collect as much data as I could."
In an Oct. 22 letter to The Magazine he wrote that "at no point was there ever an attempt to exclude teams from participating. Not only is this counterintuitive with regard to the goals of the project, but this assertion seems to suggest that there was an effort to suppress the collection of data for the study." The letter continues, "This is completely baseless. If there is data that was not included, I either did not know about its existence, the team and/or neuropsychologist did not want to participate, or the data fell outside the time parameters."
Barr also claims that in December 2003, Pellman asked him for data on specific Jets. "One day he doesn't want my data, the next he does," Barr thought at the time. He feared that Pellman might be "trying to fill certain cells and not others." According to a fax Barr sent Pellman on Dec. 4, 2003, Pellman had inquired specifically about Fred
Baxter, who last played for the Jets in 2000; about Kyle Brady, who hadn't been with the team since 1998; and about Keyshawn Johnson, whose last season as a Jet was 1999. It's hard to see how Pellman could have wanted the three records for anything that had to do with ongoing care because he was no longer treating those players. Rather than collecting all available information to see where it led, Barr was concerned that Pellman might be picking and choosing what to include to get results that would downplay the effects of concussions.
Pellman denies it all. "Team doctors talk to specialists and ask them for results all the time," he says. "It's part of their job."
PELLMAN, LOVELL and their colleagues published their sixth paper in Neurosurgery in December 2004. It examined baseline data on 655 players and results for 95 players who had undergone both baseline testing and postconcussion testing. It concluded that NFL players did not show a decline in brain function after suffering concussions. Further analysis found no ill effects among those who had three or more concussions or who took hits to the head that kept them out for a week or more. The paper didn't explain where the players in the groups came from specifically or why certain players were included and hundreds of others were not. Neither Pellman nor Lovell has provided those details since.
Like most academic journals, Neurosurgery publishes work that has been peer-reviewed. Other scientists evaluate the design and execution of the studies, though they don't vouch for the accuracy of the data presented. Unlike most academic journals, though, Neurosurgery allows those peers to print their comments directly following the studies. In the case of the committee's sixth paper, even without any evidence of missing tests, the reviews were harsh. "When you look at the comments, what's striking is how strongly they are worded," says Chris Nowinski, author of Head Games: Football's Concussion Crisis. "They're full of phrases like 'perplexing,' 'obvious problems' and 'overinterpreted.' But the media reports what studies find, not what reviewers write."
The decision to publish the paper was controversial. "I highly doubt this study would have seen the light of day at this journal were it not for the subject matter of NFL players," says Robert Cantú, chief of neurosurgery and director of sports medicine at Emerson Hospital in Concord, Mass., and a senior editor at Neurosurgery. "The extremely small sample size and voluntary participation suggest there was bias in choosing the sample. The findings are extremely preliminary at best, and no conclusions should be drawn from them at this time."
One of the scientists who reviewed the committee's work is equally blunt. "They're basically trying to prepare a defense for when one of these players sues," he says. "They are trying to say that what's done in the NFL is okay because in their studies, it doesn't look like bad things are happening from concussions. But the studies are flawed beyond belief."
The same month the sixth paper was published, Barr gave a lecture at a conference sponsored by the Brain Injury Association of New York at Madison Square Garden. By then, he had joined the Comprehensive Epilepsy Center at NYU. In addition to his work there and with the Jets, he recently had been part of a research team that looked at concussions in nearly 3,000 college athletes. At the Garden, Barr talked about some of the findings from that NCAA study. He said the research indicated that the best time to do neuropsychological tests on players with concussions was after their symptoms had completely cleared, usually five to 10 days after the trauma.
A week or so later, Barr says Pellman called him and said, "I understand you're badmouthing the league." Barr realized Pellman was referring to the remarks he had made at the conference. Although that speech had been about college athletes, Pellman didn't like Barr's recommendations. NFL teams, Barr understood, preferred testing players just one to two days after a concussion, allowing for quicker diagnoses and returns to play.
"In the future," Barr says Pellman told him, "if you have anything to present or publish about sports concussions, you will have to put it through me." Barr protested that as a professor and a scientist, he couldn't be expected to clear material that wasn't Jets-related with Pellman.
"Then your time with the Jets is over," Pellman said. And, Pellman added, if Barr ever tried to publish any of his NFL data, he would hear from the league's lawyers. Barr was so concerned about the conversation that on April 29, 2005, he detailed it in a two-page letter to Richard Levin, his dean at the NYU School of Medicine.
Pellman heatedly denies Barr's account. "I never, never, never told Bill Barr he would have to clear all his work through me," he says. "I have people working for me all over the country, and I haven't put restrictions on them like that. It's ridiculous." Pellman confirms that he fired Barr but won't say why. "He was terminated because of certain events, which I will not go into other than to say he was a good neuropsychologist," Pellman says. "I do not need to air my dirty laundry in public."
But others too have felt Pellman's wrath. In November 2003, UNC's Guskiewicz was scheduled to appear on HBO's Inside the NFL to discuss his research that showed a link between multiple concussions and depression in 2,488 former pro football players. Pellman, who was also going to be on the show, called Guskiewicz. "I had never spoken with him before, and he attacked me from the getgo," Guskiewicz says. "He questioned whether it was in my best interest to do the show. He was a bull in a china shop."
On the program, Pellman said flatly, "When I look at that study, I don't believe it." Later, however, Pellman announced the league would begin to look into the long-term effects of concussions. "It's typical for them to say they will do their own study," says West Virginia's Bailes. Adds one of the scientists researching the long-term effects of concussions: "It has to be Elliot's idea for it to be a good idea."
In January 2005, Pellman's committee published its seventh research paper on concussions. It stated: "Return to play does not involve a significant risk of a second injury either in the same game or during the season."
Back at NYU, Barr was disappointed. "Their conclusions were totally at odds with my experience," he says. "I can't believe you could have Wayne Chrebet on your team and conclude there is no increased risk of concussions." Barr is criticizing the committee publicly now for the first time because he thinks its recommendations are dangerous. "I believe the findings of the NFL, as published, are definitely putting players at risk," he says. "The wrong message is getting out."
Wayne Chrebet's head whiplashes and smashes into the ground after he makes a six-yard catch on third and five in the fourth quarter of a tight game, Jets vs. Chargers on Nov. 6, 2005, at the Meadowlands.
He has a faraway look in his eyes as he hobbles off the field. After the game, a trainer has to help him take off his uniform. A day later, the Jets put Chrebet on IR again. The injury is at least the sixth time in his NFL tenure that Chrebet has taken a blow to the head serious enough for him to miss a game.
By 2006, Chrebet will own a bar across the street from the Jets' practice field and do postgame analysis for Jets games on local cable.
But he never plays again.
PELLMAN'S COMMITTEE is up to 13 papers now, and the league continues to disregard what other researchers are finding. "If the NFL ever had to bring their practices in line with the rest of the literature, they'd have to change everything about the way they operate," says Head Games author Nowinski. "They could no longer make heroes of the guys who go back in after getting concussions. It would turn their game on its head."
Meanwhile, players risk serious, lasting head injuries each week. Last year's Wayne Chrebet is this year's Dan Morgan. The NFL has to decide how much longer it can afford to send players back into games after they've been knocked out. How much longer it wants to tell players that multiple concussions pose no threat to their future mental health. And how much longer it wants to keep relying on Elliot Pellman's research to make its calls.
All generalizations are dangerous.