BEREA, Ohio — Although James Harrison's devastating, illegal hit on Colt McCoy was witnessed by millions on television and thousands at Heinz Field, Cleveland's medical staff did not realize the severity of the blow when they treated the Browns quarterback.
That was the explanation given by team president Mike Holmgren on Wednesday, one day after NFL medical officials and representatives of the Players Association met with the Browns to discuss the team's controversial handling of McCoy's head injury and possible changes to the league's policies on concussions.
Holmgren does not expect the league to penalize the Browns, who did not know McCoy had a concussion when they sent him back into Thursday night's game.
Union chief DeMaurice Smith said the meetings allowed the NFLPA to learn more about McCoy's treatment.
"We will review the findings with our team and take into consideration the public comments made by the Browns," Smith said in a statement.
During a nearly one-hour news conference, Holmgren explained that McCoy was not checked for a concussion on the sideline after the hit because he wasn't showing symptoms. Also, the team's medical and training staffs were unaware of the impact of Harrison's helmet-to-face mask hit because they were on the sideline working on other injured players.
McCoy was evaluated by medical personnel and trainer Joe Sheehan, who told Browns coach Pat Shurmur the QB was "good to go."
Holmgren defended the decision but acknowledged the injury may have been handled differently if the medical staff had seen McCoy get laid out by Harrison, who has been suspended one game by the league for his fifth illegal tackle on a quarterback in three years.
"I want to make something very, very clear here," said Holmgren, who was at times emotional when discussing the topic and several others. "No coach that I know, certainly not our head coach, would ever overrule a doctor and put a kid in a game where a doctor said you can't play. I never did it. Pat will never do it. It's not happening.
"If anybody had that in the back of their mind because it's a big game, it's the Steelers, we had a chance to win the game, we're going to roll the dice a little bit and throw him in, that's not what happened.
"That will never happen."
Holmgren said one of the issues raised at the meeting was having the league observer at games — or someone — notify the field if there's a big hit and a player should be evaluated more thoroughly.
Holmgren called the Browns' medical staff "the absolute best in football" and praised the club's handling of head injuries. Earlier in Thursday night's game, tight end Benjamin Watson and fullback Owen Marecic were both ruled out by the staff with concussions. The Browns have had nine concussions this season.
McCoy was sent home before practice on Wednesday with a headache and it's doubtful he will play this Sunday when the Browns visit Arizona. Holmgren has not yet spoken to the second-year quarterback, who was scrambling from pressure and had flipped the ball to running back Montario Hardesty when Harrison drilled him in the chin.
In giving a detailed breakdown "to set the record as straight as I can," Holmgren explained that when McCoy was hit, Sheehan and Dr. Mark Schickendantz ran on the field not knowing exactly what had happened.
"They were all working on other injured players, either in the bench area or behind players, so they did not see the play," Holmgren said. "Then, they heard a crowd reaction. Someone said, 'Colt's down.'"
Holmgren said McCoy was "lucid and talking" when he was being treated and did not show any signs of having a concussion. Holmgren said Schickendantz "was looking at his face and his eyes, Joe was looking at the rest of him and he was complaining of his hand." McCoy sustained a badly bruised hand.
Holmgren said McCoy was not unconscious and responded to everything the medical staff asked him to do. When McCoy got to the sideline, Holmgren said Dr. Tom Waters joined the others to check on McCoy, who also answered questions to satisfaction.
At that point, Holmgren said McCoy was not showing any concussion symptoms so the standardized SCAT2 (Sport Concussion Assessment Tool) was not given.
"Their reaction to the way Colt was acting did not dictate that," he said. "They had not seen the play and he was talking, answering, knew how much time was left. So his response, following our normal protocol, did not dictate they administer the test."
McCoy returned to the game after missing just two plays and threw a costly interception in the end zone. Pittsburgh scored moments later and won 14-3. It was only after McCoy, who was in for 18 plays after he sustained the concussion, had showered and was preparing for postgame interviews when he told doctors that he was feeling "funky."
McCoy said a loud noise in the locker room startled him, and that's when the Browns began testing and treating him for a concussion. McCoy asked for the TV lights to be dimmed before doing interviews and he was allowed to fly back to Cleveland with the team.
Holmgren said Shurmur should not be blamed for putting McCoy back in.
"I'm not going to second guess Pat on that," he said. "Pat's in the front lines. He's got to make that decision. I've been there before with every quarterback I've ever coached. Pat made a judgment there and I think Colt probably displayed to him what he displayed to the doctors. He's the coach. He's got to make that call."
Holmgren described the meetings with the league's medical personnel as "healthy." McCoy did not take part in the discussions. Holmgren expects "some tweaks" to the league's procedures on concussions.
"Anytime you have a situation like this it's pretty visible," he said. "It allows every opinion known to man to pile in. Then you've gotta be careful and do the right stuff. That's why I said we want to be very involved with the league, with the union and deciding what that is. I would fully expect more conversations and more meetings to take place in the future in trying to make this as safe as we can for the players."
Browns offensive tackle Tony Pashos, the team's union representative, said McCoy's injury revealed aspects of concussions and their treatment that haven't been previously discussed.
"We got so caught up in the offseason on the union side as well as the NFL side of things with the lockout that we didn't get as in depth with some of these procedural things," he said. "We are the NFL. We have some of the best resources on the planet. The more we dive into this thing and get more knowledge and research we'll change things."