Before Hamlin’s collapse, he was involved in a tackle and appeared to absorb a blow to his chest in the process. After briefly standing up, he crumpled to the ground before medical providers attended to him on site. The team has said that Hamlin received CPR and his heartbeat was restored before he was taken off the field in an ambulance.
League officials on Wednesday declined to pin down a specific cause of the incident, but Dr. Allen Sills, the league’s chief medical officer, said a condition called commotio cordis “certainly is possible.”
In commotio cordis—Latin for “agitation of the heart”—a sudden blunt force trauma to the chest affects the electrical system of the heart, causing an arrhythmia and cardiac arrest.
Experts on the phenomenon have said they saw many of the signs of a commotio event on Monday night, while also cautioning that the condition is in part defined by the absence of any underlying disease, which could only be ruled out with subsequent hospital testing.
“There’s still a lot of investigation that needs to happen to understand that,” Sills said.
NFL officials also said on Wednesday they believed their emergency action plan, which every club is required by the league to have, had been effectively implemented on the field in Cincinnati—preventing Hamlin from dying there.
“It’s certainly not an exaggeration to say that the skilled and the immediate response by all of these talented caregivers prevented a very tragic outcome at that moment,” Sills said. “We never want to see events like this occur. But if there were to be a medical emergency, there was absolutely the right team with the right equipment and the right training on site able to provide care.”
When Hamlin went down, the game was paused as a dramatic scene unfolded on the field, with players watching one of their peers receive life-or-death medical care. Some players cried and others seemed to struggle to process the situation. Opponents embraced one another and Bills personnel gathered together and prayed.
Both teams eventually headed to their respective locker rooms. Just over an hour after the incident, the game was suspended. The NFL said Tuesday that the game will not be resumed “this week” and it is unclear if or when that will happen.
But the game hasn’t been canceled at this point. Jeff Miller, the NFL’s executive vice president of communications, public affairs and policy, said discussions with commissioner Roger Goodell about what to do are ongoing, with numerous scenarios still in play.
Those options could include canceling the Bills-Bengals game, which would have enormous playoff implications as both teams are in contention with the Kansas City Chiefs for the No. 1 seed in the AFC and a first-round bye. Another possibility is rejiggering the schedule to accommodate a make-up date. The NFL has wiggle room in its playoff calendar with the extra week between the conference championship games and the Super Bowl.
“Everything is being considered,” said Troy Vincent, the league’s executive vice president of football operations.
The NFL has yet to speak with the Bills about whether they feel prepared and ready to play Sunday’s game against the New England Patriots, Vincent said. He didn’t rule out the possibility of postponing it and said the focus of his conversations with Buffalo coach Sean McDermott have been about Hamlin’s health and the team’s well-being. The Bills-Patriots game has additional weight in the playoff race with the Patriots fighting for a playoff berth.
The question of return to play has emerged as a particularly touchy subject, amid increasing demands for sports officials to treat athletes’ mental health on a par with their physical well-being.
Sills said clubs also had mental health emergency action plans, including a crisis response team that they had identified, and pledged that support would continue from the league for what he expected would be “an ongoing need.”
“I think it is certainly key that we acknowledge how great a strain this places on everybody involved,” he said. “This is not just for Buffalo or Cincinnati, but across all of our teams.”
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