Keoghs Insight


Libby Ferrie

Libby Ferrie


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Rugby Authorities forced to tackle a whole new ball game?


As has been widely reported in recent days, the Rugby Cup Winner Steve Thompson and seven other former rugby players are sending a letter of claim to the governing bodies of English and Welsh Rugby and World Rugby.

The test group of eight players, all under 45, have recently been diagnosed by neurologists at King’s College, London with early onset dementia and probable Chronic Traumatic Encephalopathy (CTE). 

CTE is a progressive degenerative disease of the brain found in people with a history of repeated brain trauma. A neuropathologist, Dr Bennet Omalu, first identified CTE in an American football player. This ultimately led to a class action by other former American players achieving a settlement of $765 million.

The letter of claim submitted by the former rugby players argues that the governing bodies owed them “a duty to take reasonable care for their safety by establishing and implementing rules in respect of assessment, diagnosis and treatment of actual or suspected concussive and sub-concussive injuries”.

Another 80 former players are allegedly showing neurological symptoms and lawyers for the group are said to be considering a class action.

This news comes weeks after reports of thirty former footballers signing up to a study into the early signs of dementia led by Dr Willie Stewart, Consultant Neuropathologist at Glasgow University, amid concerns for footballers’ health. His research revealed footballers had 3.5 times greater rates of dementia than the wider population.

By contrast, a long running study by Michael Turner of the International Concussion and Head Injury Research Foundation, found that jockeys, despite multiple concussions, were not seeing a rise in incidence of dementia. In a recent interview he questioned the possibility of genetic susceptibility playing a part. His first report after a six year study is expected in 2021.


For those insurers and defendant lawyers handling traumatic brain injury (TBI) claims, the argument that a TBI could lead to earlier onset of dementia is an issue that they will have already seen. In single impact injuries causation presents a major obstacle, especially given the multi-factorial cause of the condition in the population at large. The importance of this spike in sporting cases in the wider claims arena will be the fresh impetus around subtle brain injuries and the early onset of dementia.  Defendant practitioners need to be alive to the risk of long term, serious and more costly cognitive decline going undetected until too late.

If the Turner study points towards underlying genetic susceptibility playing a part, does this raise the prospect of early testing to identify those at particular risk in any head trauma, however minor, maximising the treatment and rehabilitation opportunities?

At a claim level three forensic steps remain paramount:

  1. A full forensic history is critical to explore pre-accident potential head trauma, albeit undetected, from any “innocuous” sporting activities.
  2. Early base line neuropsychological testing
  3. In appropriate cases, base line neuro radiology

With accelerating research around dementia and the impact of reduced cognitive reserve we would hope to see much improved treatment protocols and better injury outcomes. However, what is certain is that we have a long way to go before even the experts truly understand the array of head injury outcomes from what might appear very similar trauma.

For more info please contact Libby Ferrie.