The NFL said this week that the Philadelphia Eagles handled quarterback Jalen Hurts's blood clots properly and will not be disciplined. Hours later, the players' union asked for a full investigation.
What happened to Hurts
Hurts is on injured reserve and is expected to miss the rest of the season after a blood clot in his left calf travelled to his lungs. The team and his agent said he has deep vein thrombosis and bilateral pulmonary embolisms. He will need blood thinners and cannot take part in football activities until he is off them.
He played against the Jacksonville Jaguars in London on 11 October, three days after telling medical staff about the injury. Specialists in London first diagnosed a superficial vein thrombosis in the calf.
The league's defence
Dr Allen Sills, the NFL's chief medical officer, defended the team at the league's autumn meeting. "I have complete confidence in the Eagles' medical staff and their handling of this situation, and I would characterize their work as very conservative, very patient-focused and appropriately guarded at every step," he said.
Sills said the league had been in contact with team doctors and with the Cleveland Clinic in London, where Hurts was treated, throughout. He said medicine comes before football and rejected any suggestion that outside pressure shaped decisions.
NFL executive vice president Jeff Miller also pushed back on reports that Hurts went more than 30 hours without sleep before the London game. He said Hurts returned to the hotel, slept around seven or eight hours and then went to the stadium.
Why the union wants a review
The NFL Players Association said the league told it no review was planned. "Before conclusions are drawn about how this situation was handled, there must be a full investigation into what occurred," the union said, adding that establishing the facts is needed to protect players.
Dr Caron Rockman, a vascular surgeon at Hackensack University Medical Center who did not treat Hurts, said there is no evidence of wrongdoing based on what she has read. She called the decisions a judgment call made case by case.
The Eagles must now plan the rest of their season without their starting quarterback, and the union's request puts the league's medical review process itself under scrutiny.