Crash in Stage 2 at ToC (spoilers?)

[Keith A]

I've been listening to the reply of stage two from ToC which took place yesterday. Did anyone see the crash by the Cannondale rider Toms Skujins? This guy got back on his bike while he was still dazed from the crash...crazy. They finally pulled him out of the race, but I can't believe he even got back on his bike when he couldn't even walk :eek:

[nooneline]

Neal Rogers' analysis is definitive:
https://cyclingtips.com/2017/05/california-concussion-incident-raises-questions-done-differently/

Skujins was pulled from the race, which was right. Internet commenters are lighting torches saying that he shouldn't have been "allowed back on his bike," ignoring the fact that there's no way to have medical staff assess every racer involved in every crash.

He got a concussion and was pulled from the race as soon as his team got to him. Everything worked. It's just that we saw some ghastly video for a little bit.

[Jad]

Yeah--it was pretty brutal. He was pretty much KOed on his feet, stumbling and trying to get back on his bike. He came very close to getting obliterated again by passing racers, then he shakily got on his bike, almost rode off the road, and kept pedaling. Scary to watch.

I think it was neutral service who helped get him going again and we were like "DON'T let him ride!!"
Edit: admittedly, not up to the neutral service guy to make that call. I don't know that he could have been prevented from getting back on the bike in that situation, but clearly not fit/safe to be riding.

I think he broke his collar bone and suffered a concussion. Hope he's feeling better.

[GregL]

The internet blame game directed against the neutral service moto mechanic is ridiculous. He is (very likely) untrained to recognize a head injury. Television spectators had the advantage of having a "God's eye" view of the situation from the comfort of their living rooms. The poor mechanic was living the moment, likely with adrenaline pumping. It was an accident and the rider was pulled by his team as soon as possible. That's racing.

Greg

[Pelican]

Neal's article summed up my thoughts. Everyone did what the right thing, you can't even fault Tom for getting back on the bike. It's a racer's first instinct.

The most interesting thing for me is hearing JV say (tweet) it is cheaper for them to fly him back to Europe on business class than to have the surgery here in the States.

[Keith A]

Neal Rogers' analysis is definitive:
https://cyclingtips.com/2017/05/california-concussion-incident-raises-questions-done-differently/

Skujins was pulled from the race, which was right. Internet commenters are lighting torches saying that he shouldn't have been "allowed back on his bike," ignoring the fact that there's no way to have medical staff assess every racer involved in every crash.

He got a concussion and was pulled from the race as soon as his team got to him. Everything worked. It's just that we saw some ghastly video for a little bit.Thanks for the link.

[FlashUNC]

The internet blame game directed against the neutral service moto mechanic is ridiculous. He is (very likely) untrained to recognize a head injury. Television spectators had the advantage of having a "God's eye" view of the situation from the comfort of their living rooms. The poor mechanic was living the moment, likely with adrenaline pumping. It was an accident and the rider was pulled by his team as soon as possible. That's racing.

Greg

Sure, the neutral moto mechanic isn't a neurologist, but when a guy can barely stand and looks like Hitman Hearns in the last moments of his fight with Marvin Hagler....maybe someone should try to protect him from himself? It ain't exactly rocket science in that case.

This is the sport that had Chris Horner ride to a finish line and have no memory of it after all.

[JStonebarger]

Recently a friend of mine had some short-lived but scary health issues while visiting Germany. Several days in the hospital there, the whole time worrying about the cost, but what could they do? A month later, home in the states, they got the bill: $180.

The USA needs universal health care.

[pdmtong]

That descent is filled with little surprises (corners, gravel) and I found myself on the wrong line more times than I care to admit. Now give these guys the whole road width to work with plus add another 15mph+ on top of my speed. yikes. he hit the floor hard. the lower section near to the houses can be as dicey as the upper section from the observatory. there was one year where a few overshot the corners and ran up someones driveway...

hope he will be ok.

[FriarQuade]

Sure, the neutral moto mechanic isn't a neurologist, but when a guy can barely stand and looks like Hitman Hearns in the last moments of his fight with Marvin Hagler....maybe someone should try to protect him from himself? It ain't exactly rocket science in that case.

This is the sport that had Chris Horner ride to a finish line and have no memory of it after all.

The whole time Tom is stumbling around the mechanic is paying attention to the bike, not the rider. If you were to possibly place blame on a member of the neutral program it would be the moto driver who is watching the situation unfold. I wouldn't agree with that blame though. As Neal pointed out in the artical, it's often hard for trained professionals to spot a concision in the moments after. As a result it's completely unreasonable to ask a bike mechanic to spot one, no matter how obvious it might seem from your living room.

These are my thoughts having spent several thousand K's in the race caravan.

[coffeecake]

I agree with the Friar. This is the biggest race in America and down to the neutral support, everyone wants to get it right. See a rider go down? Get to the bike and get it working again. I doubt he was so focused on Toms stumbling around.

It's easy for me to watch and see that Toms is pretty out of it, but in the moment, I can imagine the neutral mech being distracted.

[FlashUNC]

The whole time Tom is stumbling around the mechanic is paying attention to the bike, not the rider. If you were to possibly place blame on a member of the neutral program it would be the moto driver who is watching the situation unfold. I wouldn't agree with that blame though. As Neal pointed out in the artical, it's often hard for trained professionals to spot a concision in the moments after. As a result it's completely unreasonable to ask a bike mechanic to spot one, no matter how obvious it might seem from your living room.

These are my thoughts having spent several thousand K's in the race caravan.

The guy falls down right in front of the mechanic. And the TV moto who's filming it all. And people standing by the roadside. The mechanic is literally standing at his hip when he flops over. How focused is the mechanic on the bike that he doesn't notice the guy in front of him is in some serious difficulty?

I'll concede its not entirely on the mechanic, but this isn't some subtle diagnosis either. Anyone with eyeballs could see he is in no condition to be getting on a bike immediately without, minimum, someone from the medical staff taking a look at him.

Somebody's got to protect the guy from himself and potentially injuring himself or someone else far worse, and no one did. That's the tragedy of the whole thing. And if we've got people spending thousands of miles in the race caravan who don't see this as something to be prepared for, then we might need new training for the people in the race caravan.

[regularguy412]

The guy falls down right in front of the mechanic. And the TV moto who's filming it all. And people standing by the roadside. The mechanic is literally standing at his hip when he flops over. How focused is the mechanic on the bike that he doesn't notice the guy in front of him is in some serious difficulty?

I'll concede its not entirely on the mechanic, but this isn't some subtle diagnosis either. Anyone with eyeballs could see he is in no condition to be getting on a bike immediately without, minimum, someone from the medical staff taking a look at him.

Somebody's got to protect the guy from himself and potentially injuring himself or someone else far worse, and no one did. That's the tragedy of the whole thing. And if we've got people spending thousands of miles in the race caravan who don't see this as something to be prepared for, then we might need new training for the people in the race caravan.

^^ This

Just ask Johnny Hoogerland.

Mike in AR:beer:

[bikingshearer]

"In the end, what is more constructive than assigning blame is to consider what might be done to minimize the likelihood of these events repeating themselves."

Thank you, Neal Rogers. This is a big piece of wisdom, not just for this particular incident but for examining bad outcomes generally. And it's a lesson that we Americans all too frequently ignore in a rush to find someone to blame.

Focusing on who to blame presupposes that someone is to blame, i.e., that someone did or didn't do what they knew or should have known to do or not to do. That is not always the case. Sometimes sh*t just happens. Often times, sh*t happening leads to improved protocols, improved training and/or improved awareness. That doesn't automatically mean the people on the spot at the time the sh*t happened behaved badly; it is grossly unfair to judge people for not acting up to standards that were not in place at the time.

If you focus on learning how something happened and what can be done to reduce the chances of it happening again, you will find out if there is someone who deserves blame as part of the inquiry. But if all you are looking for is a scapegoat, you run the very real risk of completely missing valuable information that might make it less likely to repeat the bad outcome.

[swaterfall]

That's pretty hard to watch I feel terrible for Skujins and I hope the neutral support guy was focused on the bike didn't see him fall to the ground and stumble through traffic because to me that's an obvious sign that he's suffered a brain injury

[FlashUNC]

"In the end, what is more constructive than assigning blame is to consider what might be done to minimize the likelihood of these events repeating themselves."

Thank you, Neal Rogers. This is a big piece of wisdom, not just for this particular incident but for examining bad outcomes generally. And it's a lesson that we Americans all too frequently ignore in a rush to find someone to blame.

Focusing on who to blame presupposes that someone is to blame, i.e., that someone did or didn't do what they knew or should have known to do or not to do. That is not always the case. Sometimes sh*t just happens. Often times, sh*t happening leads to improved protocols, improved training and/or improved awareness. That doesn't automatically mean the people on the spot at the time the sh*t happened behaved badly; it is grossly unfair to judge people for not acting up to standards that were not in place at the time.

If you focus on learning how something happened and what can be done to reduce the chances of it happening again, you will find out if there is someone who deserves blame as part of the inquiry. But if all you are looking for is a scapegoat, you run the very real risk of completely missing valuable information that might make it less likely to repeat the bad outcome.

Absolutely, 100%. But I would have a lot more sympathy for the "guys we didn't know how to deal with this" if we didn't hear exactly the same excuses six years ago when Horner finished a Tour stage under nearly identical circumstances. What changed? Nothing. No improved protocols from the UCI, no charges ges to training or support make-up. No changes to the rules for clear blows to the head.

http://www.velonews.com/2011/07/news/horner-abandons-tour-team-defends-decision-to-let-him-finish-stage_182840

[bikingshearer]

Absolutely, 100%. But I would have a lot more sympathy for the "guys we didn't know how to deal with this" if we didn't hear exactly the same excuses six years ago when Horner finished a Tour stage under nearly identical circumstances. What changed? Nothing. No improved protocols from the UCI, no charges ges to training or support make-up. No changes to the rules for clear blows to the head.

http://www.velonews.com/2011/07/news/horner-abandons-tour-team-defends-decision-to-let-him-finish-stage_182840

To be clear, I am not arguing that anyone gets an automatic pass, nor am I saying that anyone gets an automatic conviction. I am saying that the investigative net needs to be cast much wider than to simply seek someone to blame lest you miss out on really truly understanding the causes and possible solutions to a problem.

The fact that it damn near takes an act of Congress plus a UN Security Council resolution plus white smoke from the College of Cardinals plus being dealt a royal flush to get the UCI to do anything about anything concerning rider safety or the sport's integrity as a whole 'nother kettle of fish. (But hey, at least they aren't FIFA.:rolleyes:)

[Keith A]

The biggest question I have is why didn't the cameraman or his driver intervene? From the viewers perspective, it certainly seems like they should have been able to discern this guy was in trouble and stopped him from getting on the bike. I realize this isn't their "job" and they are trained as EMTs, but this could have easily ended up much worse than it did.

Maybe they thought they hit the jackpot and everyone would be watching the action they caught on camera.

[pdmtong]

The biggest question I have is why didn't the cameraman or his driver intervene? From the viewers perspective, it certainly seems like they should have been able to discern this guy was in trouble and stopped him from getting on the bike. I realize this isn't their "job" and they are trained as EMTs, but this could have easily ended up much worse than it did.

Maybe they thought they hit the jackpot and everyone would be watching the action they caught on camera.

Flash and you are on the money. and worse, he was walking into 30mph traffic. he gets hit again and maybe is muerta

[shovelhd]

The whole time Tom is stumbling around the mechanic is paying attention to the bike, not the rider. If you were to possibly place blame on a member of the neutral program it would be the moto driver who is watching the situation unfold. I wouldn't agree with that blame though. As Neal pointed out in the artical, it's often hard for trained professionals to spot a concision in the moments after. As a result it's completely unreasonable to ask a bike mechanic to spot one, no matter how obvious it might seem from your living room.

These are my thoughts having spent several thousand K's in the race caravan.

This guy gets it. Everyone has a job. The mechanic's job is to get the bike rideable and the rider back into the race. The moto pilot also has the same directive, get the mechanic to the bike. Now if the moto was an official, or there was a commissaire car in sight of the rider, and they let him go, now that would be a problem. Race officials are responsible for injured riders, not medically, but from a safety standpoint. If it's not safe for the rider or the other racers for that rider to re-enter the race, they are the only part of the caravan besides medical or their team support, that can stop them.

[nooneline]

Maybe they thought they hit the jackpot and everyone would be watching the action they caught on camera.

i can assure you this is not the case.

[MaraudingWalrus]

The guy falls down right in front of the mechanic. And the TV moto who's filming it all. And people standing by the roadside. The mechanic is literally standing at his hip when he flops over. How focused is the mechanic on the bike that he doesn't notice the guy in front of him is in some serious difficulty?

I'll concede its not entirely on the mechanic, but this isn't some subtle diagnosis either. Anyone with eyeballs could see he is in no condition to be getting on a bike immediately without, minimum, someone from the medical staff taking a look at him.

Somebody's got to protect the guy from himself and potentially injuring himself or someone else far worse, and no one did. That's the tragedy of the whole thing. And if we've got people spending thousands of miles in the race caravan who don't see this as something to be prepared for, then we might need new training for the people in the race caravan.

But that can't (maybe should be,but can't) be the race mechanic. What happens to that mechanic if he prevents a rider from getting back on their bike who maybe could be ok getting back on the bike and winning the stage/race/jersey?

Team Sky assassinates the mechanic who prevents Froome from getting back up to chase.

It's literally not that dude's job - his job is to be a race bicycle mechanic and get people back moving as quickly as possible. Anything else and he looses that way he puts food on his table, and maybe never gets to do it ever again. Botch things big enough, you're off the pro circuit, I'm sure.

There was discussion about this on the Pro Bicycle Mechanic forums, and the president of the PBMA pointed out that if there's a Neutral Support Moto, a Camera moto, then there's supposed to be a Race Official's moto - they're supposed to travel together at all times. That's literally the Race Official's job.

Maybe the race mechanic should be empowered to do that, maybe even as a good person he should do it, but it also runs contrary to his contractual obligations. Maybe he could have dragged his feet some, and fiddled around getting the bike moving until somebody showed up...but again, that puts their ability to put food on the table in jeopardy....

And there was supposed to be someone nearby whose job it was to do that.

Crap situation for all, though. Glad Cannondale/Slipstream have such a concussion protocol.

Also the mechanic did try and abscond with the bike..dragged it off to the side of the road. If we're raging against the mechanic, why not rage at the TV camera operators focussing on it, too?

[Keith A]

One little tidbit I picked up listening to yesterday's stage at work today is that the race doctor was able to get to Toms in 102 seconds after his crash. That's good to hear.

[Bostic]

Quimby road, in addition to being one of the most difficult climbs in the area, is a treacherous descent. The road where he went down (near the start of the climb going the other way) is not in terrible shape but sometimes the leaves from nearby trees are on the ground. It was also not designed for people riding down at 40mph.

[kevinvc]

I was at an MLS soccer game this weekend. One of the Atlanta players got blasted right on the side of the head from close range with the ball. He dropped like a rock- didn't put his arms out or do anything to break his fall. When he hit the ground he didn't move at all for a couple of seconds. The Atlanta team doctor came out, helped him up and got him right back into the game. This happened right in front of the Portland bench and their team doctor was screaming at the fourth official and the Atlanta doctor that the player clearly needed to go through the concussion protocol before returning, but was ignored.

The whole thing happened exactly along league rules. It's the injured player's team doctor who decides if the player needs further evaluation. Of course, that means the team plays down a man until that's completed, or they burn one of their three substitutions. It highlights the need for an independent league doctor to be at every match to make that decision. But, considering the way MLS is run, that is unlikely to happen.

It was a scary situation and, if I'm that player, I'd be pretty pissed at the team doctor once I recovered enough to know what happened. One more shot to the head and he could very well have ended up with permanent brain damage.

[MaraudingWalrus]

This (http://www.velonews.com/2017/05/commentary/commentary-helmet-technology-has-a-head-injury-solution_438587)is also an interesting proposition.

[Onno]

Everybody watching that live on TV, as I was, was screaming NO as Skujins was trying to get on his bike. People on the sidelines must also have been screaming no. It was that obvious that the guy should not get back on the bike. OK, so the mechanic was doing his job. I hope that if I'd been in that situation, as the mechanic, I'd have said fck my official duties, I'm saving this guy's life. I hope one change race organizers make is to give support staff the right to make that choice. Ask they guy if he knows what his name is, what year it is. If he can't answer, hold him until the doctor gets there. As others have said, this is not rocket science. It's a no brainer to save the brains.

[GregL]

Even subject matter experts falter when put in situations they are not familiar with. True story: a tree fell on a workman in my neighbor's yard. My wife heard/saw the accident and ran into our house to call 911. I ran over to help. The workman's leg was pinned under the tree and he was trying to start his chainsaw to cut the tree and escape. I grabbed the chainsaw away from the man and explained that it was more dangerous to move the tree than to wait for help. Just then, the home owner ran over to the scene. In panic, he tried to start the chainsaw to get it off the man. I stopped him and explained that if the tree shifted, the injury could be worse - or even fatal! I suggested that the home owner triage the injured man and offer him any assistance he could while we waited for the first responders. WHY did I suggest this to the home owner? Because he is the director of emergency services for a local hospital. The chief ER doc.

A few moments later, the fire and rescue personnel arrived. They made sure the injured man wasn't in imminent danger and stabilized the tree. Once the paramedics were ready to administer treatment, they lifted the tree and pulled the man out. Fortunately, his only injury was the broken leg. The soft ground prevented the tree from crushing any circulatory tissue. He recovered fully. When the whole episode ended, the doc and I had a beer and talked about the lessons learned. He told me that within his element (the ER), he knew exactly what to do. Outside of his area of expertise, he was definitely very challenged. I was impressed by his frankness and honesty. And he is a great ER doc, having treated several of my family members.

My point in this long-winded post: you just can't judge the actions of well-intentioned people in stressing, unfamiliar situations.

Greg

[nooneline]

that's a great and tough story, Greg.

One of the hardest things to do in a crisis is to stop, breathe, look around, and assess the situation - especially if something extremely dramatic is happening.

Another hard thing to do is to stop, look around, and determine whether or not something is actually a crisis. It can be really hard to determine sometimes.

[pdmtong]

http://www.mercurynews.com/2017/05/17/amgen-tour-route-tragedy-an-amateur-bicyclists-death/