The MotoGP paddock was embroiled in a fresh concussion protocol saga across the week spanning the Australian and Thailand Grand Prix, one that left a leading expert alarmed at the potential consequences of a rider being cleared to race after a crash that was initially described by his team as concussive.
'No one knew that he had lost consciousness' - What happened at Phillip Island
MT Helmets MSI Moto3 rider Diogo Moreira was one of four to crash on the sighting lap ahead of the very wet Phillip Island race last Sunday.
He made it back to the grid and was allowed to start, but retired moments later and was then quoted as having made highly concerning comments about the state in which he tried to race.
The 19-year-old’s crash happened off-camera, although the aftermath was caught, and Moreira's movement in the gravel trap prompted MotoGP's in-house broadcast commentary to describe him as "unsteady on his feet".
Moreira rushed back to the pits along with his damaged bike and arrived just four minutes before the scheduled start of the race. His mechanics (with the assistance from those from multiple other teams) were able to repair the damage to his KTM and allow him to start the slightly delayed race from pitlane, seven minutes after he first arrived back.
At no point during the seven minutes he spent in pitlane was he checked over by any of MotoGP’s medical team.
Allowed to join the race from pitlane, he was only able to complete four laps of it due to dizziness before retiring to the pits, at which point he then voluntarily attended the circuit medical centre for further examination.
“Diogo fell during the warm-up lap,” his team explained on Sunday evening on social media. “No one knew that he had lost consciousness. He returns to the pitlane, gets on the bike and four laps later decides to abandon.
“When he went down, he said he felt dizzy and that's when they reviewed the images and it was confirmed that he lost consciousness.”
“During the warm-up lap,” Moreira added in the team’s press release, “I crashed and hit my head, which made me lose consciousness, and I have to thank everyone for their help and concern.”
Following examination by the MotoGP medical director Dr Angel Charte, Moreira was then sent to Melbourne to undergo a CT scan - something that, while it can diagnose associated injuries such as brain bleeds and fractures, cannot rule out a concussion.
However, with no further injuries showing on that scan, it was then accepted by Charte that Moreira was uninjured. He was cleared fit to ride at this weekend’s Thai Grand Prix, in which he qualified second and finished 13th, at the tail of the pack fighting for victory.
There was a second incident on the sighting lap at Phillip Island that also required medical intervention on the grid but this one was seen by race control and medics were able to attend to it.
Dani Holgado fell shortly after Moreira, and sliced his eyebrow open badly enough to require stitches after the race, seemingly when his visor came loose from his helmet in the fall and cut his face open as it detached.
His bleeding facial injury was spotted and repeatedly shown by Dorna's TV cameras. Race control sent grid medics to the Spaniard and they were able to help clean him up before ultimately also passing him fit to ride again for the restart.
'At no time did he lose consciousness' - How the picture changed
In the days after the race Dr Charte told Spanish daily newspaper AS that he still believed Moreira was uninjured in the fall despite conceding his actions were "a little strange" when he was examined.
“When Moreira falls, he takes the motorcycle and goes to the pitlane," said Dr Charte.
"He speaks with the mechanics and returns to the track, but at no time, even though a highside has happened, does he request any type of medical intervention.
“On the fourth or fifth lap, he doesn't feel well and stops.
"He told me that he had some strange feeling. He went to the health centre, where he was examined, and at no time did he lose consciousness. Yes, he seemed a little strange.
“At no time did they notify me of anything, nothing, and then they told me about it from the health centre, and I asked for a CT scan to be done at a hospital in Melbourne, which turned out to be completely normal.
“Moreira did not have any craniocerebral trauma, because I saw the helmet, and he had no cranial nerve involvement and no obvious neurological involvement.
"Otherwise, we would have stopped him. Everything was normal.”
When questioned by The Race at this weekend’s Thai round, Charte admitted that had he been given a chance to examine Moreira before the restart at Phillip Island, it’s possible that he would have excluded the Brazilian.
But he said that without race control alerting him to Moreira's crash while he was on the grid, he didn’t at the time understand the severity of the fall.
And shortly after we spoke to Charte, the initial comments from Moreira and his team post-race were rolled back by a team member speaking to The Race.
The claim of a loss of consciousness while in the gravel trap was quickly downgraded to a "potential" knockout blow that couldn't be accurately determined.
The blame for that was placed on a miscommunication between on-site personnel and the team's Europe-based press team, with a suggestion that initial comments made to Moreira by the medics who eventually examined him were taken at face value rather than placed in the context of his subsequent examination and CT scan.
It’s not the first time that something similar has happened in the MotoGP paddock. After the 2021 Misano event, Tech3 KTM team boss Herve Poncharal quick to state that his rider Deniz Oncu’s claim of failing to remember a crash was simply the Turkish racer misspeaking.
'This should not be happening in 2023' - An expert's concerns
According to Dr Jack Hardwicke, a senior lecturer and concussion expert at Nottingham Trent University, even if Moreira hadn’t been knocked out, his subsequent diagnosis is counter to established medical science in the field.
With concussion unable yet to be accurately diagnosed despite advances in saliva testing, the standard protocol in most contact sports is to exclude any athlete showing concussion symptoms, with rugby in particular recently extending the period in which a player who fails post-impact screening is excluded from games to 12 days.
That kind of ban is something that is particularly important in motorsport for two reasons. Firstly, the diminished cognitive ability that comes from concussions can mean that riders are an increased danger to themselves and others, something demonstrated last year at Mandalika when a concussed Raul Fernandez admitted that he missed his braking marker and crashed heavily to bring his three-day test to a premature end.
Secondly, though, is the even scarier risk of second impact syndrome. The result of suffering a second concussion on top of an unhealed previous one triggers catastrophic swelling, and is often fatal, with almost all cases that don’t result in death causing permanent disability. Riders remain at risk for days after a first injury.
With athletes often able to hide some of their symptoms, those rules on mandatory benching are something that have come into place in recent years in an attempt to save them from themselves by passing the duty of care onto those around them.
But, with MotoGP’s protocol already lagging behind other sports by only specifying a mandatory exclusion from the current event in which the injury is sustained, Dr Hardwicke argued that both the outdated policies and doubts over whether they're being followed are cause for alarm.
"This event shows MotoGP is far behind other sports in dealing with sport-related concussion appropriately and the protocols are not in line with current medical understanding," he told The Race.
“Incidents like this should not be happening in 2023."
He emphasised that any situation in which a rider was allowed "to continue handling a vehicle at high speeds following a clear concussive injury places the rider and their competitors at significant risk due to the decreased cognitive function following a concussion".
MotoGP and Moreira's team are now adamant that wasn't the case in his Phillip Island crash, despite what initial communications implied. The fact there was even scope for it to be a question shows MotoGP still has a lot of ground to make up on other sports when it comes to protocols around traumatic brain injuries.