Tuesday 10 February 2015 07:50, UK
Wales wing George North was knocked out during the Six Nations defeat to England, WRU medical officials have confirmed.
The Welsh team's national medical manager has admitted that had they seen the second-half collision with Richard Hibbard – either live or on a television replay – they would have removed him from the match.
North has started his return-to-play protocol after suffering two blows to the head during the game at the Millennium Stadium.
The wing took an accidental boot to the head from England lock Dave Attwood in the first half, and he was temporarily replaced by Liam Williams while he underwent mandatory concussion assessment.
North subsequently returned to the field, but he then clashed heads with team-mate Hibbard during the second half in what appeared to be a worse incident, and which attracted attention from rugby union's global governing body World Rugby.
North did not go off a second time, playing on as England started their campaign with a 21-16 victory.
In an interview to WRU TV that was posted on the Welsh Rugby Union's official website on Monday night, WRU national medical manager Prav Mathema said: "In the first incident, George took a blow to the head from an accidental boot. Following that, we attended to him on the field of play, and we weren't quite sure as a medical team at that point about his diagnosis.
"Because of that, we decided to use the head injury assessment protocol, and he went off for 10 minutes for a review. That was deemed negative, so he returned to the field of play.
"In the second incident, regrettably I was unsighted at that moment. The other pitch-side medic on the far side of the pitch was also unsighted.
"All I saw was George North getting up off his knees. When I arrived at the scene, as it were, he was completely lucid and was conversing spontaneously with me. I undertook some on-pitch evaluations, and that point I deemed him fit to continue.
Regrettably, we didn't get a chance to see the incident, and had I been given that opportunity, there is no doubt that he would have been removed from the field of play.
"Regrettably, we didn't get a chance to see the incident, and had I been given that opportunity, there is no doubt that he would have been removed from the field of play.
“There is no pitch-side replays available currently, and the independent match-day doctor was unable also to aid us in that process.
"We unfortunately didn't see it, but having seen it since, obviously, there is no doubt that he looks like he has a momentary loss of consciousness, and in that case he should definitely be removed from the field of play.
"Part of the head injury assessment process is that he (North) has a secondary more in-depth evaluation, and this was done again by the independent match-day doctor.
"Again, he was deemed to be negative for any signs and symptoms of concussion.
"However, as a medical team we always get together afterwards and evaluate. The first time as a group we were able to evaluate the video footage, at that moment it was clear to see he had a momentary loss of consciousness.
"Because of that, irrespective of him having no signs and symptoms, we will be dealing with George as a concussion."
North has shown no symptoms of concussion since the match and could be in line to start against Scotland at Murrayfield on Sunday.
But the Welsh medical team has changed its procedures and will have replays available to them on match days.
"Since the incident, certainly we've seen where our protocols need to improve," Mathema said. "For the next four games of the Six Nations, we are certainly going to have instant video replay for both our home and away matches.
"We've also had this discussion with World Rugby, and we are hopeful that our discussions will spark some form of global intervention as well with regards to this."
