I have a question about the Dr. note procedure to allow an unconscious player back into the game. Ok, player knocked out. Unconscious. After halftime, the coach hands me a note from a physician stating player can come back in.

First of all, do I accept this note from a coach, player, or parent? For all I know, the school janitor could have thrown the letters DR in front of his name and said 'sure, you can go back in'. Or, do I accept this from a physician hand to hand.

Second, disregarding worrying about the above scenario, once I get this Dr's note, what do I do with it? Do I keep it and file it in a safe place after the game for liability issues? Do I give it to someone else?

Where, if any, does liability lye with the official? Once I see doctor's note signed by 'Dr. John Doe, MD', I just accept it and go on, or do I need to worry about authenticity? Do I keep the note and put it in safekeeping?

Any clarification would be great. Maybe I am overly scared over this, but having a background in the medical field, we take an entire course in legal liability and I have seen how stringent the law can become as far as determining liability.

1. Make sure you get the name of the doctor and if possible, his address and telephone number and write that down on the note if it isn't already there. If there is any ambiguity, tell the coach you want to talk to the doctor before allowing the player to return. If he refuses, don't let him in. I would also have the coach sign the note as well, saying something like (at the bottom), agreed to by coach ______, signed _____.

2. Keep the note/info above in your pocket or lock it up in your dressing room if that's available. Have a copy made to stay with the scorer.

3. Unless you are negligent in accepting the note or being willfully ignorant, there isn't a great deal of potential liability.

Medical issues are actually one of the few things that will get you in serious legal trouble on the court. However, most potential problems are more related to interfering with treatment rather than actually being present when something bad happens. Remember, you are there to officiate the game, not provide medical treatment. If you feel the kid is going to die or be seriously injured without your input and you are trained, go ahead only with the understanding that you are putting yourself at a huge liability risk. Otherwise, get everyone else away and let the medical providers do their job.

I wouldn't worry too much about this. No doctor is going to let anyone play who's been unconcious.

I agree, the doctor would have to be nuts to allow an knocked-out player to return to the floor after a half-hour's rest(as well as the coach for that matter.) In the odd event that the note is real, I'd want to keep the name of that Doctor for future reference - I won't be letting any of my family schedule appointments at his office!

QUOTE]Originally posted by Texas Aggie
I wouldn't worry too much about this. No doctor is going to let anyone play who's been unconcious. [/QUOTE]

Not true...had one in a boy's Varsity game several years back...two kids from home team slam heads together - one top of head to other's chin going for rebound...chin-boy hits ground and doesn't move - he is out cold. That was in the first quarter...paramedic in stands comes down and takes care of him...when we come out of locker room for 3rd quarter, coach is waiting with a note from a doctor (kid's dad took him down the street to an office) and wants the kid to play. Kid had an obvious concussion, but he tried to play...during a dead ball, I asked him who he was guarding and he told me #53...there was no #53 on the other team...coach overheard and finally took him out.

As far as the note - we had BOTH coaches and the scorer sign it, and then stapled it to the page of the scorebook.

Not true...had one in a boy's Varsity game several years back...two kids from home team slam heads together - one top of head to other's chin going for rebound...chin-boy hits ground and doesn't move - he is out cold. That was in the first quarter...paramedic in stands comes down and takes care of him...when we come out of locker room for 3rd quarter, coach is waiting with a note from a doctor (kid's dad took him down the street to an office) and wants the kid to play. Kid had an obvious concussion, but he tried to play...during a dead ball, I asked him who he was guarding and he told me #53...there was no #53 on the other team...coach overheard and finally took him out.

As far as the note - we had BOTH coaches and the scorer sign it, and then stapled it to the page of the scorebook. [/QUOTE]

Sheesh! Talk about really bad parenting!!!

I can only wonder if this same zeal is used when the kid wakes up and claims he's "sick" and has to stay home. "Sick? Damn, let's rush you over to the Doc's office so you won't have to miss any school." Yep, I wonder...

No doctor in his right mind would sign a note allowing a player who had lost consciousness to go back in a game. Your choice is pissed off coach or dead kid. A no brainer, so to speak . . .

You guyys are crazy. The bok says they gotta produce a note. If they do, who are we to tell em he can't play.

I believe this month's issue of Referee has some good discussion on this type of thing.

The only 'doctor' who would sign a note to let a kid play after losing consciousness would be a quack. Sometimes it's necessary to consult a higher authority.

I think you need to read my post above...it happens, and there really isn't anything we can do to stop it.

I appreciate your earlier post.

I want to encourage you to not permit a player who has been unconscious to participate. You might have to stick your neck out and say you're not convinced it's safe. Then the coach points to the rule. Then you say, coach, I'm not convinced it's safe. Better some jib flapping than the kid dies in his sleep that night.

If you personally ever have a child in that situation, I would encourage you to watch the child while he or she is sleeping at least through the first night - and, if you want to err on the side of caution, for several nights.

No doctor in his right mind would sign a note to let a child participate under the conditions you describe.

Thanks for the posts. Very helpful discussion. The sad thing is that, even though some of your are pointing towards a doctor NEVER allowing it (not to mention someone posted an actual story where it happened), I can see it happening because high school basketball has become about wins and losses. If this happened to a Kobe-esque player in the state semi's or something, I could definately see it happening.

Next question. I know the book says unconscious= must have doctors note. What about major concussive symptoms. The player is not on the floor with the eyes closed, but he or she has no clue where they are, etc. Is that worty of the doctor note procedure?

Basically, if the eyes are not closed on the while the player is laying on the floor, do I still need to require a Dr. note? A major concussion might as well be unconsious, IMO.

I just want to make myself perfectly understand this situation. In my short time as an official, I have learned that as soon as there is something I am not 100% clear on, it seems to find me on the court. Thanks.

Whistles & Stripes,
I agree with you on this one. However, I would take the note from the coach. I would then place said note in my pocket and after the game complete a special report to send to the state discussing the situation and have the school answer to the state on the legitimacy of the note.

Here's my advice.
I would file a report with your state association and include a copy but keep the original and file it for safe keeping. Keept it until the statute of limitations runs.

Do not staple it in the score book, dont let anyone else have it.

If there is litigation it is the one thing that may save you. Accepting the note places the MD in in the position of liability. You will have to show reasonable reliance on appropriate medical advice. However if it is not reasonable or appears to be bogus you can and should question it. When officiating football we have ahad notes come out of the stands and we always ask the basic questions so we know the guy is a MD and that he understands the liability is now on him.

It cant be anything less than a physician... No PA's. no nurses, no Physical therapists, etc

Is there a statute of limitations on liability claims? I always thought it only applied to criminal acts.