Fatal concussion spurs probe of teen players' care

Jaquan Waller, a football player at J.H. Rose High School in Greenville, should not have been allowed to play in a game Sept. 19 that resulted in his death, a leading concussion researcher and several licensed athletic trainers say.

During a home game against Wilmington's Hoggard High, Waller, a junior running back, collapsed on the sideline shortly after being tackled. The blow caused severe brain swelling. By the next morning, he was brain-dead, according to a state medical examiner's report. He was removed from life support the same day at Pitt County Memorial Hospital.

Waller had suffered a concussion during practice on Sept. 17, the medical examiner's report showed. Dr. M.G.F. Gilliland determined that Waller had died accidentally as the result of "second impact syndrome," a rare condition that can occur when two relatively minor head injuries occur within a short period. It typically happens to young athletes.

In Waller's case, "neither impact would have been sufficient to cause death in the absence of the other impact," Gilliland stated in a written report released last week. According to the report, Waller had suffered "a mild (Grade 1) concussion, a brief change in the level of consciousness," during the practice.

Pitt County school system officials say they did not know Waller had suffered a concussion Sept. 17 until the medical examiner's report came out.

Waller's death, the third in seven weeks involving a high school football player in North Carolina, has raised concerns about whether athletes at some schools are getting adequate care.

At all levels of football last year, there were four fatalities directly related to the game and nine indirect deaths involving such factors as heat stroke, according to the National Center for Catastrophic Sport Injury Research, based at the University of North Carolina.

North Carolina law allows local schools to hire unlicensed personnel to act as trainers at athletic events.

About half of the state's 460 public high schools employ or have access to licensed athletic trainers, compared with a national rate of 42 percent, said James Scifers, president of the N.C. Athletic Trainers' Association, which urges that all high schools use licensed trainers.

Among Wake County's 21 public high schools, Sanderson is the only one without a licensed trainer. In Durham County, six of seven schools have licensed trainers. Of Pitt County's six high schools, only one does.

The Pitt County school system refers to Bill Grimm, the teaching assistant who evaluated Waller's condition Wednesday, as an "injury management specialist," or what other schools call a "first responder." Grimm declined to be interviewed for this story.

"The role of a first responder -- and they can call it whatever they want -- does not include assessment of concussions, nor does it include diagnostic procedures, nor does it include return-to-play decisions," Scifers said. "The role of the first responder is to provide first aid and refer the patient for further medical care."

Many concussion guidelines call for an athlete to be symptom-free for at least seven days after suffering a Grade 1 or Grade 2 concussion, according to the National Athletic Trainers' Association's position statement on managing concussions. The NATA position statement also makes clear that anyone who shows concussion-like signs has suffered at least a mild concussion and that anyone under 18 "should be managed more conservatively."

"Can someone suffer a concussion on Wednesday and be healed on Friday?" said Dr. Kevin Guskiewicz, who co-authored the position statement. "Possibly.