Twickenham (United Kingdom) (AFP) - The decision to let Wales prop Tomas Francis play on during Saturday's Six Nations match against England has been castigated as a "clear and flagrant breach" of rugby union's head injury assessment procedure by a pressure group.
Francis suffered a head injury in the 20th minute of England's eventual 23-19 win over reigning champions Wales.
In an open letter to World Rugby, the Welsh Rugby Union and Six Nations Rugby, Progressive Rugby, a group that lobbies for the protection of players' welfare, said: "Francis attempts to stand and falls back and struggled to get to his feet.
"He is seen holding his head.He is then seen using the post for support.He displays clear signs of ataxia and of being dazed.He is seen by a physio/medic -- it is not clear which."
The letter added: "Francis displayed clear symptoms/indications under the World Rugby head injury assessment protocol that necessitate the immediate and permanent removal from play.No HIA was needed.
"While, after a delay, Francis was removed from the field he was, incorrectly, allowed to undergo an HIA assessment and returned to the field, playing until the 56th minute, at which time he was permanently replaced by Leon Brown.
"We consider the above incident demonstrates a clear and flagrant breach of HIA protocol that potentially puts both the short-term and long-term health of an elite athlete at risk."
Progressive Rugby said Francis' case was one of several recent examples, including the failure to remove England wing Jack Nowell from the field against Italy earlier this month, of players being allowed to continue in a match despite incurring brain injury.
"Until satisfactory explanations are provided, we remain unable to accept World Rugby's assertion that player welfare is the game's number one priority," the letter added.
Concussion has become a major issue for rugby union as it faces up to the long-term impact of head injuries caused by increasingly fitter and stronger players taking part in a contact sport.
In November, former New Zealand prop Carl Hayman announced he had early-onset dementia aged just 41.
Hayman has joined a concussion legal action launched by several ex-players including England's Steve Thompson and Alix Popham of Wales, against rugby authorities.
