ProFootballDoc: Justin Fields Injection In Tent Leads To Career Day And Controversy

A celebration has turned to controversy. Behind the six TD and 385 passing yards record performance by QB Justin Fields, Ohio State dominated and proved they belonged in the National Championship game versus Alabama. On a targeting call Fields took a big hit in the right flank/low back area and returned for the heroics. Post-game, Fields' comments raised concern. 

"They didn't really tell me anything ... I took like a shot or two in in the tent and just ran back out there ... they didn't really give me a diagnosis at all."

Certainly this is not a good look. After all this is college athletics. Even in the professional ranks there needs to be more conversation.

Informed consent is the key. An explanation of the risks and benefits of any treatment or return to play and an expression of understanding is mandatory. Maybe it was given. Certainly, athletes in the heat of battle hear what they want to hear and patients sometimes have selective memory. Or possibly he is playing coy as there is still a game to be played and he didn't want to give away his injuries. With HIPAA guidelines, the medical staff is not allowed to give their side of the story so we will be left to wonder.

What adds to the controversy is clearly no X-rays were done in the tent. This is also not the first time as the medical staff had injection supplies in the tent ready to go. I am not saying this is bad form. During my time as a NFL team physician, there was no tent, but we did do injections sometimes even in the stadium tunnel. As long as informed consent was given and understood this is considered appropriate but I get that some may ask if that is possible so quickly in a tent without X-rays and our standards may be different for "amateur" players.

A rib block injection (intercostal nerve block) is common. Tyrod Taylor's punctured lung after is a known but rare complication. The shot (or shots) certainly worked well enough to allow the completion of the game. In fact his performance has vaulted Fields to the discussion at the top of the draft with Trevor Lawrence. A trending topic is now either the Jaguars thinking twice or Fields to the Jets at No. 2. One could argue what the doctor did was the best thing for the young QB as it likely made him extra millions of dollars in the pro ranks.

The key here is whether there was no internal organ damage. The kidney would be the biggest concern. As long as the medical staff was diligent in monitoring any potential internal damage their actions could be considered proper.

Some may argue that this situation is another reason team doctors need to be independent and away from the team. That sounds good in theory but can a stranger really know players well enough to have informed consent on a moment's notice? Long term rapport with players is a key to the team physician job. Familiarity leads to better communication and decision making in time of crisis.

Unless there is information of delayed kidney injury, this seems to be an exercise in semantics. The results have turned out to be a win/win so far. I hope informed consent was obtained and that Fields will be healthy for the National Championship game.