NFL Players Association executive director DeMaurice Smith sent union representatives to Cleveland on Monday to gather more information related to the treatment of Browns quarterback Colt McCoy.
The Browns' coaching and medical staffs have come under fire for the way they handled the treatment of McCoy following the concussion he sustained during Thursday night's game against the Pittsburgh Steelers.
Under the CBA, the union has the ability to make unannounced visits to team facilities to review health and safety protocols and can consider grievances against clubs based on the findings.
Sources told ESPN senior NFL analyst Chris Mortensen that the league and the union will hold a joint review about the handling of McCoy's concussion with the Browns on Tuesday. According to the sources, Dr. Elliott Pellman will represent the league and Dr. Thom Mayer will handle the union's side of the call.
Members of the NFLPA's executive committee and Browns players are at odds over what the union should proceed. Scott Fujita, a member of the committee, has publicly called for independent neurologists on the sideline. However, according to sources, Charlie Batch, also a member of the committee and teammate of James Harrison, whose hit caused the concussion, has remained silent on the matter.
Also, according to sources, while Fujita has been outspoken in his criticism of the system, Browns union representative Tony Pashos and other Browns players believe the team is not at fault for the incident and the blame falls squarely on the union. Another member of the union's executive committee, Sean Morey, resigned from the NFLPA's Mackey-White Concussion and Traumatic Brain Injury Committee, citing a lack of action on the union's part regarding concussion-related issues.
Player unrest over the incident has raised questions regarding the return-to-play guidelines, or the "Madden Rules," related to concussions.
"I believe our training staff has been ahead of the curve on this issue," Fujita told The Associated Press in an email Monday. "There are leaguewide problems in procedure, and that's what needs to be addressed. You can't point your finger at any one thing. It's the process. We need to continue to strive to find better ways to take care of our players, and I think an independent neurologist on game days is something that should be seriously considered.
"Implementation and details obviously need to be thoroughly discussed, but I think this shouldn't be outside the realm of possibility."
On Monday, coach Pat Shurmur maintained that the team's medical staff followed NFL guidelines before McCoy was cleared to go back into Thursday night's game at after he suffered a concussion following a nasty hit by Pittsburgh's Harrison.
Shurmur was also evasive when pressed on the team's handling of the injury.
Flushed from the pocket, McCoy was laid out on a helmet-to-face mask hit from Harrison, who faces league penalties and possibly a suspension.
McCoy did not show concussion-like symptoms until after the game, and Shurmur was confident the Browns' medical personnel did not put the second-year QB at risk by clearing him to play in the final minutes of a 14-3 loss.
"He was deemed ready to play," Shurmur said. "We followed all the proper medical procedures."
Following practice, Shurmur was specifically asked at least three times if the team administered the standard tests on McCoy for a concussion while he was on the sideline. On each occasion, Shurmur refused to answer with a "yes" or "no" response.
"He came off the field and our medical staff worked with him and I was told he was able to play, so that's where it's at," said Shurmur, who kept his composure during some awkward exchanges. "He was treated like any other player that has an episode on the field."
The initial review of the Browns' handling of McCoy's concussion Thursday night is being labeled as a "blatant system failure" because the team's medical staff did not conduct proper testing before sending him back into the game against the Steelers, a union source told ESPN senior NFL analyst Chris Mortensen.
The NFL and the NFLPA's chief physicians -- Dr. Pellman and Dr. Mayer -- have conducted the initial review, sources said, and both the league and the union will continue the process that one source says will "likely" be the catalyst for the placement of independent neurologists at each game site in time for the 2012 season.
Sources said it wasn't until Friday morning that McCoy was administered the mandatory Sport Concussion Assessment Tool review, commonly referred to as SCAT 2, which doctors determined was abnormal. McCoy was sent home to rest. One source involved in the review said it was troublesome that the test was not administered Thursday night, especially given that McCoy's symptoms were evident when the team's public relations staff asked television cameras not to turn on their lights during a postgame interview. Light sensitivity is one of the symptoms associated with concussions.
Shurmur said he was unaware of the report.
League spokesman Greg Aiello said in an email to The Associated Press that any investigation or discussions with the Browns over the matter will remain confidential.
"We have nothing to further to say publicly," Aiello said. "The prevention, treatment, and management of concussions is an ongoing priority and we will continue to work closely on it with our teams and players."
A Browns spokesman said the team has no immediate plans to make a member of the medical staff available for comment.
Team president Mike Holmgren was not unavailable for comment.
Shurmur said head trainer Joe Sheehan was the one who told him McCoy was ready to go back in the game after sitting out just two plays. From the time McCoy was blasted by Harrison until he returned to the field, less than four minutes elapsed.
Shurmur said he has complete trust and confidence in Cleveland's medical staff, which has had to diagnose and treat concussions all season. The Browns have had at least nine concussions, including three for tight end Benjamin Watson who was ruled out of Thursday's game along with fullback Owen Marecic.
McCoy's concussion, though, is unlike any they've handled.
It happened in the closing minutes of a tight game, condensing the amount of time the Browns' medical team had to evaluate him. Also, it's unclear what -- or if -- McCoy told the Browns as he was being treated.
Shurmur appears to be caught in the middle.
He was told by his medical staff that McCoy was OK, so he re-inserted his starting quarterback into the game.
Complicating matters, McCoy's father, Brad McCoy, said his son didn't remember anything about the hit and the former high school coach criticized the Browns for allowing the 25-year-old to go back in the game. McCoy, who did not practice Monday, threw a costly interception in the end zone after returning.
McCoy came to work on Monday, but was sent home before practice. Shurmur does not know if McCoy will be able to play Sunday at Arizona. If McCoy can't play, backup Seneca Wallace will start against the Cardinals.
Browns tackle Tony Pashos said McCoy appeared OK and in control when he came back into the huddle.
"He was pretty gung-ho," Pashos said. "I'm not a professional. I don't even know, though, how you would begin to evaluate a concussion or look at somebody. Have you guys been in car accidents? Do you look at the guy next to you? I've come up on some pretty bad motorcycle accidents on the highway and people have been talking to me and five minutes later they drop and pass out, too.
"So the guy that I saw I thought was pretty ready and prepared to go out there and win and everything. All I know is my perspective, so I'm staring at his lips trying to get the play 'cause the whole stadium's going bonkers. So I'm not evaluating anybody. I'm not a doctor. I'm the right tackle."
Browns Pro Bowl Joe Thomas revealed he was sick during the Steelers game. Thomas said he had the stomach flu and didn't eat for several days. "It was rough. It was the first time I've ever played sick," Thomas said. "It was not fun. I'm not usually a guy that gets sick much, but I kept telling myself if Alex (Mack) can play with appendicitis I can play with the flu." ... Safety T.J. Ward ran in the indoor field house and could return this week after missing five straight games with a sprained foot. ... WR Josh Cribbs, who played with Harrison at Kent State, doesn't believe his former teammate is a dirty player. "I feel like he's trying to put people out of the game," Cribbs said. "As a linebacker, that's what his job is. That's how he's been in college, he tried to put me out of the game when I was on his team, with a red jersey on. That's why he's been so successful in this league. That's also why he's been highly fined in this league as well, but also successful."