Other brain bleed could have caused death

LIAM HYSLOP
Last updated 05:00 08/07/2014

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Northland rugby player Jordan Kemp may have received proper concussion treatment earlier this year and died from an unrelated brain bleed, a former All Blacks doctor says.

The talented hooker collapsed during a game between his Otamatea Hawks side and Old Boys Marist in Whangarei on Saturday. It is believed he suffered a brain bleed after a clash of heads. He died in hospital the next day.

Kemp had been blue-carded under world-standard concussion rules earlier this season, meaning he had to see a doctor immediately after the game and get approval before he took the field again.

He did not play for five weeks after the concussion and Northland Rugby Union chief executive Jeremy Parkinson said Kemp had played for the last six weeks ‘‘symptom-free’’.

Graham Paterson, who has worked for more than 25 years in sports medicine, and was All Blacks doctor from 2004-05, said there were three possibilities regarding Kemp’s death, but the cause would not be known until after an autopsy was carried out.

‘‘People can die from a one-off head injury and it might be that the post-mortem shows he’s got a brand new brain bleed that killed him," he said.

‘‘He’d had a concussion that was treated perfectly and he was just in the wrong place at the wrong time and this had nothing to do with the previous concussion.’’

The next possibility was that the first head knock was more severe than first thought and a CT scan could have shown something more subtle, such as a small bleed.

‘‘Option C is that that the situation was poorly managed and relevant symptoms were not noted but that doesn’t seem to be the case.’’

The fact a small bleed may have been picked up through a CT scan does not mean doctors should be ordering one for every head knock, Paterson added.

‘‘Because of the cost you can’t go round ordering an MRI or CT scan for a little knock to the head to see if there’s any bleeding inside the brain. You use slow resolution of symptoms and neurological signs as the indicators as to whether or not you do expensive investigations.

‘‘If every rugby player who got a knock had a CT scan, ACC levies would go through the roof and we’d be complaining.’’

ACC figures show there were more than 5500 claims for sport-related concussion or brain injuries in 2013 which made for a total cost of more than $3.1 million.

Paterson said a doctor would use a standardised SCAT3 (Sport Concussion Assessment Tool) to assess whether someone could participate in full training but it was up to the individual and coach to decide when the right time to play was.

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‘‘It [the SCAT3 test] is going to pick up some pretty subtle things. But that simple question of ’do you feel right in yourself?’ is the often the strongest indicator.

‘‘I can make you add up numbers and tell me what you had for breakfast yesterday and you can pass all those things but not be right in yourself. It’s such a simple, useful question as long people are honest with their answer.’’ 

The Northland Rugby Union will liaise with the referee from Saturday’s game to put together a ‘‘serious injury report’’, which will be passed on to the New Zealand Rugby Union. Police have referred Kemp's death to the coroner.

 

- Stuff

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