The Robert Back Case

Robert Back Case: Athletic Trainer Testifies She Didn’t Know About Concussion Diagnosis.

S. Larson, Great Falls Tribune, March 19, 2018: https://www.greatfallstribune.com/story/news/crime/2018/03/19/robert-back-case-athletic-trainer-testifies-she-didnt-know-concussion-diagnosis/440251002/

The article referenced above relates the testimony of Jessica Klette, ATC, Athletic Trainer for Benefis Health System and Belt High School in Belt, MT. In September 2014, Robert Back, a 16 year old high school football player, suffered head trauma in a football game. It is claimed he should not have been playing in this football game due to a previous concussion diagnosis. Reports and testimony state that he suffered a concussion prior to that game and through communication breakdowns between the coach, athletic trainer, parents, and physicians, was allowed to participate in the game.

Several issues are brought up in this article.

One: Lack of communication between the Athletic Trainer and treating physician. (The AT states she was not told of the diagnosis and treated the athlete as if he had the flu.)

Two: Lack of communication between the Athletic Trainer and the athlete's parents.

Three: Coach was allowed to oversee a post injury ImPact test.

Four: Lack of apparent responsibility per the athletic trainer's contract to communicate with anyone except the school and coach regarding athlete medical issues.

Many lessons can be learned from this incident. Maintaining open lines of communication with everyone directly involved in the athletes’ wellbeing (coach, parents, and physicians) could prevent or at least reduce mistakes such as these. Contractual obligations should not preclude an AT from communicating. Non-medical professionals should not have access or be allowed to administer diagnostic testing on any athlete. Lastly, we should all remember to be an advocate for the athlete.

Protect Your Patients & Yourself

It's a mean world out there, and as much as we want to always believe that our athletes and patients are so happy WE are caring for them, if their return to play or life doesn't go as they expected it to, we can easily become a victim of legal problems.

Kornblau and Starling, in "Ethics in Rehabilitation", remind us to protect yourselfand list some steps we all should review:

  • Put your licensure law on your desk and read it frequently: It’s easy to think we're always doing the right thing.
  • Report ethical and legal violations to the licensure board: It's not "tattling" - It's protecting the integrity of our profession.
  • Open your eyes: If it doesn't seem right it usually isn't.
  • Follow the 4 "C's": Cover yourself with Contemporaneous, Complete and Comprehensive documentation. If it's not on paper it didn't happen.
  • Keep your athletes interest above all else: Do the right thing.
  • Understand the laws and rules that govern our world: JAHCO, Medicare and HIPPA give us important boundaries. Know them.

And finally, my personal advice: retain professional liability insurance. Your employer will protect you, but only if you do what you are legally allowed by your licensure and state laws. Nobody protects you like you.