Concussion Litigation: The NFL and Beyond How We Got Here and What’s Ahead Paul D. Anderson, Esq.

1. Concussion Litigation: The NFL and BeyondHow We Got Here and What’s Ahead Paul D. Anderson, Esq. Summa Cum Laude, University of Missouri-Kansas City School of Law

2. Concussion • Most common head injury in sports • Mild trauma-induced alteration of mental status • May or may not be associated with LOC • Functional injury • Acceleration-deceleration, shearing or impact forces

3. Anatomy of a Concussion Terry Rosenberg

4. Second-Impact Syndrome (SIS)Multiple concussive events before first concussion is resolved: • After sustaining a concussion: • “brain cells that are not irreversibly destroyed remain alive, but exist in a vulnerable state” - The Second Impact in Catastrophic Contact Sports Head Trama • Are significantly vulnerable for recurrent, cumulative, and even catastrophic consequences of a second concussive injury - Validity of ImPACT for Measuring Attention & Precessing Speed Following Sports-Related Concussion • Until recently, most athletes have been unaware of the long-term consequences of concussions and lacked an adequate understanding of concussion symptoms.

5. Chronic Traumatic Encephalopathy (CTE) CTE is a type of neurodegenerative disease or dementia caused by repeated concussive or sub-concussive blows (hits just below the force required to cause concussion). • Also known as Punch-Drunk Syndrome, Dr. Harrison Stanford Martland stated in the October 13, 1928 issue of the Journal of the American Medical Association: • “[S]ome time fight fans and promoters have recognized a peculiar condition occurring among prize fighters which, in ring parlance, they speak of as "punch drunk." Fighters in whom the early symptoms are well recognized are said by the fans to be "cuckoo," "goofy," "cutting paper dolls," or "slug nutty." Frequently it takes a fighter from one to two hours to recover from a severe blow to the head or jaw.”

6. Pathophysiology of CTE • Repetitive trauma triggers degeneration of brain tissue • Accumulation of protein, tau • Neruofibillary/astrocytic tangles • Spindle shaped threadlike neurites • Different from Alzheimer’s Dementia • Superficial cortical layers of frontal & temporal lobes w/o beta amyloid

7. Stages of CTEFOUR Stages of Deterioration • Affective changes & psych problems • Social issues & erratic behavior with memory loss • Early Parkinson’s like symptoms • Gross cognitive dysfunction • Dementia • Late Parkinson’s like symptoms • Speech & gait abnormalities • 4. Full-blown encephalopathy

8. Traumatic Encephalopathy Related to Sports InjuryChin, Toshkezi and Cantu Sports-related Chronic Traumatic Encephalopathy Tau-immunoreactive Neurofibrillary Tangles

9. Football Didn’t Cause Your Problems You can be safely returned to play after suffering a concussion Take some smelling salts – this will allow you to return to play There is no causal effect between football and neurodegenerative diseases The evidence of CTE is so flawed, it is unlikely CTE exists Dr. No – Ira Casson – HBO Real Sports Video: http://www.youtube.com/watch?v=R4NbU_HaB3Y The ‘League of Denial’

10. First NFL Concussion Lawsuit On July 19, 2011, seventy-five plaintiffs filed a mass action lawsuit in the Superior Court of California in Los Angeles for cognitive Injury from multiple concussions received during play in the NFL.

11. Pandora’s Box Busted Wide Open • First Federal Class Action filed August 19, 2011: Ray Easterling et al v. NFL • Lawsuits started to be filed throughout the United States • To date, 225+ concussion-related lawsuits v. NFL • More than 4,400 former players • 30+ wrongful death complaints

12. MDL IS FORMED • On January 31, 2012, the United States Judicial Panel on Multidistrict Litigation (MDL) issued a Transfer Order, finding that the various concussion suits filed, “involved common questions of fact, and that centralization under Section 1407 in the Eastern District of Pennsylvania [would] serve the convenience of the parties and witnesses and promote the just and efficient conduct of the litigation.” • MDL Transfer Order (Docket No. 31), MDL No. 2323 • Currently close to 200 lawsuits are pending in Philadelphia • Master Complaint filed June 2012 • NFL filed Motion to Dismiss Aug. 30th • Preemption issue has been fully briefed • Arguments took place on April 9th

13. Master Complaint • Defendants: NFL • NFL Properties, Riddell Helmets, and subsidiaries • Claims asserted: • Negligence • Negligent Misrepresentation • Negligent Hiring and Retention • Fraud • Fraudulent Concealment • Wrongful Death and Survival Actions • Civil Conspiracy (member clubs, indp. contractors, etc.) • Loss of Consortium • Medical Monitoring

14. Primary Claims Asserted • Elements of Negligence: • Duty – to protect health and safety of players • Breach – failing to implement concussion standards • Causation (but for and proximate cause) • Damages • Elements of Fraud: • Misrepresentations made • Knew they were false • Made with the intent to defraud • Players justifiably relied on said misrepresentations • Players were damaged

15. The NFL Steals Big Tobacco’s Playbook: Manufacture Doubt

16. American Football Coaches Assoc.1937 “During the past 7 years the practice has been too prevalent of allowing players to continue playing after a concussion. Again this year is true. Sports demanding personal contact should be eliminated after an individual has suffered a concussion.”

17. ‘Doubt is Our Product’ • The industry template of deception • Big Tobacco, Asbestos, Big Pharma, etc. • Internal Memo from Big Tobacco Executive • “Doubt is our product it is the best means of competing with the ‘body of fact’ that exists in the minds of the general public. • It also the means of establishing controversy.” • Debating the science is much easier than debating the logic • E.g. Hit Counts

18. The MTBI Committee is Formed to Perpetuate Doubt – Backed by “Science” • The NFL created the Mild Traumatic Brain Injury Committee in 1994, and appointed a rheumatologist • Pellman was Taglibue’s personal physician • In 2004 this Committee published their findings that showed “no evidence of worsening injury of chronic cumulative effects” from multiple concussions. • In fact, the Committee concluded that “many NFL players can be safely allowed to return to play” on the same day they sustain a concussion if a doctor clears them.

19. Pellman, Casson, Waeckerle, et al • From 1994 – 2007 published 14 studies that were fatally flawed. The summary was published in 2006: • It can be concluded that mild TBIs in professional football are not serious injuries • No NFL player experienced second-impact syndrome, chronic cumulative injury or chronic traumatic encephalopathy from repeated injuries • No signs of CTE in active, contemporary football players. • Our studies support that arbitrary return to-play guidelines may be too conservative for professional football • The results of our studies indicate that many NFL players can be safely allowed to return to play on the day of the injury after sustaining a mild TBI. • Far-reaching negative implications

20. Congressional Beat down • 2007 Hearing on NFL Retirement System • Brent Boyd – “This is fraud, corruption, collusion. It’s rampant in the NFL. • The late Dave Duerson (is fed lies from the NFL and NFLPA) denies the link between football and chronic brain damage – my dad had Alzheimer's and he never played football • Gayle Sayers – “The NFL is a $7-plus billion industry, yet it struggles to do right by the retired players whose sacrifices built this game. I believe this failure is at the core of a general crisis in the game.” • 2009 Concussion in Sports • Goodell scolded - http://www.youtube.com/watch?v=rcHZ_kUsjfQ • Greg Aiello – “It’s quite obvious from the medical research that’s been done that concussion can lead to long-term problems.”

21. NFL’s Complete About Face • 2009 memo to all teams re: concussions and RTP • Poster telling players about concussions • 2011 Indp. Trainer to watch for concussions • Indp. Neurologist to clear players. • 2011 Kick off moved back • Millions of $$$ donated

23. NFL’s Complete About Face • NFLEvolution.com • NFL Donates $30 million • Independent Neurologist on Sidelines • Concussion Assessment Tools • Madden Rule • X2 Impact: Concussion Software • Ipad

24. Oral Arguments • Took place April 9 at 10:00am • Paul Clement (NFL) v. David Frederick (Players)

25. Two Years of Litigation • No Discovery • NFL tries to slam courtroom door shut – Motion to Dismiss • April 9, 2013 – Oral Arguments on NFL’s Motion to Dismiss • July 8, 2013 – Judge Brody Orders parties to mediation • August 29, 2013 – Proposed Settlement Announced • Now, WE wait.

26. Settlement Denied • Judge Brody notes her concerns • Not enough money to pay all claimants for 65+ years • Orders the production of data • Concerned about NCAA Release • Report from Special Masterforthcoming • We, continue to, wait.

27. $765 Million - Breakdown

28. Qualifying Neurological Injury($675 million) • Diagnosed with any of the following diseases: • Alzheimer's - $3 million • Dementia - $3 million • Parkinson’s - $3 million • ALS - $5 million • Post-mortem CTE - $4 million • Severe Cognitive Impairment – to be determined • Sliding-scale determinations based on several factors: • Age; number of years you played in the league • If the player died prior to 2006, his family will be excluded • If the funds are deemed insufficient, a one-time payment of $37.5 million will be paid.

29. NCAA Concussion Litigation • September 2011 – FirstClass Action filed v. NCAA • Seeks to represent all former student athletes • 65 + college athletes & 13 lawsuits pending • MDL is formed in Chicago • Mediation talks ongoing

30. MLS CONCUSSION LITIGATION • Bryan Namoff v. DC United • Eddie Johnson files suit v. Portland Timbers • BU announces CTE found in soccer & rugby player

31. NHL Concussion Litigation • Boogaard wrongful death suit • NHL Class Action filed Nov. 2013 (Gary Leeman, Scott Parker & 11 others) • Fighting • Is it an essential part of the game? • Enforcers (e.g. Boogaard, Rick Rypien, Wade Belak) all showed signs of CTE

32. Major League Baseball • MLB Implements Rule 7.13 – Eliminating egregious collisions at home plate • Ryan Freel (36) – suicide; history of multiple concussions • CTE found • New helmets in place this year, per CBA • Rawlings S100 Pro Comp • Lining inside hats to prevent skull fractures • Brandon McCarthy

33. The End! Questions