Ambulance delay had 'no impact' on Hughes death

Mandatory helmets for batsmen, keepers and close fielders key recommendation of independent review into Phillip Hughes death

Cricket Australia's independent review of the death of former Test opener Phillip Hughes has recommended that all first-class cricketers be compelled to wear a protective helmet that meets stringent British safety standards at all times when facing fast or medium-pace bowling in matches and at training.

The review, undertaken by President of the Australian Bar Association and former Chairman of the Victorian Bar Council David Curtain QC, also recommends that helmets become mandatory for fielders positioned close to the batter (except slips fielders).

WATCH: Curtain Report recommends mandatory helmets

And that wicketkeepers be compelled to don protective eyewear as well as head protection when standing up to the stumps.

In the wake of Hughes's death, CA last season mandated that helmets that meet the most recent British Standard and therefore provide the highest level of protection were to be worn by all elite-level players.

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However the review, which was presented to CA late last year, stopped short of making compulsory the clip-on neck guards that were adopted by a number of players following Hughes's death until such time as their functionality, comfort and safety benefits are fully evaluated.

"This device (neck guard) seems to be capable of being worn without unduly interfering with freedom of movement by a batter, but at the time of writing this report it has not been evaluated for efficacy or safety," Mr Curtain found.

"If it is evaluated as satisfactory, I recommend it, or an equivalent, be required to be worn as part of the helmet."

CA is currently involved with manufacturers, players and other parties to identify design, performance and evaluation criteria for helmet neck guards.

The 62-page report – which can be downloaded in full here – was commissioned in the wake of Hughes's death when he was struck on the neck while batting for South Australia in a Sheffield Shield match against New South Wales at the Sydney Cricket Ground on November 25, 2014.

The 25-year-old died in hospital two days later as a result of a traumatic basal subarachnoid haemorrhage caused by the blow.

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Among the matters Mr Curtain was asked to examine and report on were the causes and circumstances that led to Hughes's injury and death, the policies, practices and systems in place to prevent a similar incident from occurring and CA's approach to mandating and compelling players to wear safety equipment to protect the head and heart.

The report found that Hughes, who played 26 Tests and 25 one-day internationals for Australia, received medical assistance 42 seconds after the incident and that a mobile emergency MediCab arrived on the scene with three minutes of him being struck.

He received medical attention from CA's Chief Medical Officer Dr John Orchard as well as from intensive care specialist Dr Tim Stanley (who was at the SCG as a spectator) until an ambulance arrived at the ground 20 minutes after the incident to rush him to hospital.

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 "Subject to the coronial enquiry (to be held later this year), I am of the opinion that the attention received by Phillip after being struck had no role whatsoever on his subsequent demise, due to the nature and severity of his injury," Mr Curtain says in his review.

"I do not believe any lack of medical attention contributed to Phillip's death."

He also found that while Hughes was wearing a helmet that was compliant with the Australian standard of the time – which has since been withdrawn – the protective device did not meet the more recent British standard which sees the protective facial grille extend further to the back of the helmet.

But Mr Curtain says that even if Hughes had been wearing the English standard helmet, he did not believe it would have saved him given the nature of the blow he sustained.

"I do not believe that the new helmet would have afforded additional protection against the blow given the location of where Phillip was struck, as the protection to the neck, at the rear, is no different (to the helmet Hughes was wearing)," he says.

Cricket Australia Chief Executive Officer James Sutherland said today that a number of recommendations contained in Mr Curtain's review had already been implemented and that further measures will be taken to try and prevent a recurrence of the event that shook the game worldwide.

"The global cricket community was deeply saddened by the tragic death of Phillip Hughes and the great loss his family suffered," Mr Sutherland said.

"We received Mr Curtain's review last season and since that time we have been considering his recommendations and discussing with relevant bodies as to how we best make changes necessary to prevent an accident of this nature happening again.

"While there will always be a small risk we believe that the measures we have already taken and will enact following this review will reduce that risk even further."

In recommending the compulsory adoption of helmets for first-class batters facing all bowlers except spinners and for close-in (within seven metres of the bat) fielders except those behind the wicket on the off-side, Mr Curtain specified that those helmets "should be to the highest standard".

Other recommendations contained in Mr Curtain's report include:

  • Players and coaching staff involved in training sessions within practice nets where fast bowlers are operating should also be required to wear protective helmets, including those operating bowling machines (although the recommendation does not apply to bowlers)
  • A defibrillator be available at all first-class matches in case medical staff need to deal with trauma-related cardiac incidents or coronary conditions, but there was no evidence to show risk of cardiac injury is significantly reduced by players wearing chest protection
  • Protective headwear for umpires should be considered if there is seen to be an increased risk of injury to on-field officials, although statistics show that risk to be minimal at present
  • Any helmet that is struck with force, even if it does not sustain visible damage, be immediately replaced and that players should carry at least one spare helmet as part of their cricket kit

Mr Curtain also described the 'Concussion and Head Injury Policy' introduced by CA as "sensible and commendable" although he noted that a change to the laws of cricket relating to the use of substitute players might help to further safeguard players who have suffered a blow to the head.

Under the CA policy, team medical staff wield sole discretion as to whether any Australia player at national, state or elite pathway level who has been struck in the head can continue to take part in the game, with return to the field ruled out on the day the injury is sustained if concussion is diagnosed.

"Of concern to some is the fact that players who have been struck on the head and have suffered some symptoms (of concussion) may not admit to this as they would not want to prejudice the team by leaving it effectively a man short in batting and/or bowling," Mr Curtain says.

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"In some quarters, there is agitation for the rules to be changed to accommodate a substitute who can bat and/or bowl, in contrast with the existing rules.

"As my terms of reference do not extend to matters involving the rules of the game, I have no suggestions to make in this regard, but merely draw it to Cricket Australia's attention that this may be a matter requiring ongoing consideration."

In response to this issue, Mr Sutherland said that CA was exploring the possibility of allowing a 'concussion substitute' to be permitted during domestic matches, although such a change to playing conditions in international fixtures was the domain of the International Cricket Council.

"It is understood that the ICC Cricket Committee will consider this and related issues at their next meeting on 31 May," Mr Sutherland said.

"ICC approval of the introduction of substitutes is required in order for four-day matches to retain their first class status.

"The Cricket Australia Playing Conditions Advisory Committee will also consider recommendations relating to concussion substitutes in all other domestic cricket competitions under CA's auspices."

Asked by CA to examine their current guidelines for screening contracted players, particularly those with specific vulnerabilities, Mr Curtain found that medical screening is not an efficient means by which susceptibility to risks such as cardiac or head injuries can be diagnosed.

"I have come to the view that it is not appropriate that screening of contracted players be undertaken," he says.

But he recommended that, should Cricket Australia's medical representatives become aware that a player has heightened vulnerability that might place them at risk of serious injury, it should be agreed (in discussion with the player concerned) that they stop playing in order to minimise that risk.

"In the event that the player does not agree not to play, in my opinion the medical practitioner should advise Cricket Australia that the player should not continue to play, for unspecified medical reasons," Mr Curtain says.

"The medical practitioner would thus respect the medical privilege of the player but also discharge his or her obligations to Cricket Australia to report on any impediment to the cricket continuing to play."

Cricket Australia has already indicated it will co-operate fully with the coronial inquest into Phillip Hughes' death that is expected to be held in Sydney in October this year.

"We have had ongoing open dialogue with the New South Wales Crown Solicitor and have indicated that we will be as co-operative as possible with any coronial inquest," Mr Sutherland said.

"Never again do we want to see a tragedy of that nature happen on a cricket field and we have shared the findings of this review with the coroner."