CONCUSSIONS IN YOUTH SPORTS: EVALUATING PREVENTION AND RESEARCH HEARING BEFORE THE SUBCOMMITTEE ON OVERSIGHT AND INVESTIGATIONS OF THE COMMITTEE ON ENERGY AND COMMERCE HOUSE OF REPRESENTATIVES ONE HUNDRED FOURTEENTH CONGRESS SECOND SESSION MAY 13, 2016 Serial No. 114–145 ( Printed for the use of the Committee on Energy and Commerce energycommerce.house.gov U.S. GOVERNMENT PUBLISHING OFFICE 21–158 PDF WASHINGTON : 2017 For sale by the Superintendent of Documents, U.S. Government Publishing Office Internet: bookstore.gpo.gov Phone: toll free (866) 512–1800; DC area (202) 512–1800 Fax: (202) 512–2104 Mail: Stop IDCC, Washington, DC 20402–0001 VerDate Mar 15 2010 14:08 Apr 25, 2017 Jkt 037690 PO 00000 Frm 00001 Fmt 5011 Sfmt 5011 C:\USERS\WLAUFERT\DESKTOP\114X145CONCUSSIONSPENDING WAYNE COMMITTEE ON ENERGY AND COMMERCE FRED UPTON, Michigan Chairman JOE BARTON, Texas FRANK PALLONE, JR., New Jersey Chairman Emeritus Ranking Member ED WHITFIELD, Kentucky BOBBY L. RUSH, Illinois JOHN SHIMKUS, Illinois ANNA G. ESHOO, California JOSEPH R. PITTS, Pennsylvania ELIOT L. ENGEL, New York GREG WALDEN, Oregon GENE GREEN, Texas TIM MURPHY, Pennsylvania DIANA DEGETTE, Colorado MICHAEL C. BURGESS, Texas LOIS CAPPS, California MARSHA BLACKBURN, Tennessee MICHAEL F. DOYLE, Pennsylvania Vice Chairman JANICE D. SCHAKOWSKY, Illinois STEVE SCALISE, Louisiana G.K. BUTTERFIELD, North Carolina ROBERT E. LATTA, Ohio DORIS O. MATSUI, California CATHY MCMORRIS RODGERS, Washington KATHY CASTOR, Florida GREGG HARPER, Mississippi JOHN P. SARBANES, Maryland LEONARD LANCE, New Jersey JERRY MCNERNEY, California BRETT GUTHRIE, Kentucky PETER WELCH, Vermont PETE OLSON, Texas BEN RAY LUJA´ N, New Mexico DAVID B. MCKINLEY, West Virginia PAUL TONKO, New York MIKE POMPEO, Kansas JOHN A. YARMUTH, Kentucky ADAM KINZINGER, Illinois YVETTE D. CLARKE, New York H. MORGAN GRIFFITH, Virginia DAVID LOEBSACK, Iowa GUS M. BILIRAKIS, Florida KURT SCHRADER, Oregon BILL JOHNSON, Ohio JOSEPH P. KENNEDY, III, Massachusetts BILLY LONG, Missouri TONY CA´ RDENAS, California RENEE L. ELLMERS, North Carolina LARRY BUCSHON, Indiana BILL FLORES, Texas SUSAN W. BROOKS, Indiana MARKWAYNE MULLIN, Oklahoma RICHARD HUDSON, North Carolina CHRIS COLLINS, New York KEVIN CRAMER, North Dakota SUBCOMMITTEE ON OVERSIGHT AND INVESTIGATIONS TIM MURPHY, Pennsylvania Chairman DAVID B. MCKINLEY, West Virginia DIANA DEGETTE, Colorado Vice Chairman Ranking Member MICHAEL C. BURGESS, Texas JANICE D. SCHAKOWSKY, Illinois MARSHA BLACKBURN, Tennessee KATHY CASTOR, Florida H. MORGAN GRIFFITH, Virginia PAUL TONKO, New York LARRY BUCSHON, Indiana JOHN A. YARMUTH, Kentucky BILL FLORES, Texas YVETTE D. CLARKE, New York SUSAN W. BROOKS, Indiana JOSEPH P. KENNEDY, III, Massachusetts MARKWAYNE MULLIN, Oklahoma GENE GREEN, Texas RICHARD HUDSON, North Carolina PETER WELCH, Vermont CHRIS COLLINS, New York FRANK PALLONE, JR., New Jersey (ex KEVIN CRAMER, North Dakota officio) JOE BARTON, Texas FRED UPTON, Michigan (ex officio) (II) VerDate Mar 15 2010 14:08 Apr 25, 2017 Jkt 037690 PO 00000 Frm 00002 Fmt 0486 Sfmt 5904 C:\USERS\WLAUFERT\DESKTOP\114X145CONCUSSIONSPENDING WAYNE CONTENTS Page Hon. Tim Murphy, a Representative in Congress from the Commonwealth of Pennsylvania, opening statement ................................................................... 1 Prepared statement .......................................................................................... 3 Hon. Diana DeGette, a Representative in Congress from the State of Colo- rado, opening statement ...................................................................................... 4 Hon. Richard Hudson, a Representative in Congress from the State of North Carolina, opening statement ............................................................................... 6 Hon. Frank Pallone, Jr., a Representative in Congress from the State of New Jersey, opening statement .......................................................................... 7 Prepared statement .......................................................................................... 9 Hon. Fred Upton, a Representative in Congress from the State of Fred Upton, prepared statement .............................................................................................. 161 WITNESSES Kelli Jantz, Mother of Jake Snakenberg and Concussion Awareness Advocate 10 Prepared statement .......................................................................................... 13 Karen Kinzle Zegel, Mother of Patrick Risha and Chronic Traumatic Encephalopathy (CTE) Awareness Advocate ..................................................... 18 Prepared statement .......................................................................................... 20 Eugene F. (Buddy) Teevens, III, Head Football Coach, Dartmouth College ...... 29 Prepared statement .......................................................................................... 32 Andrew Gregory, M.D., Medical Advisory Committee Member, USA Football, and Associate Professor of Orthopedics, Neurosurgery and Pediatrics, Van- derbilt University Medical Center ...................................................................... 35 Prepared statement .......................................................................................... 37 Additional information submitted for the record ........................................... 51 Kevin Margarucci, Manager, Player Safety, USA Hockey ................................... 61 Prepared statement .......................................................................................... 63 Steve Stenersen, CEO, US Lacrosse ...................................................................... 76 Prepared statement .......................................................................................... 78 Terry O’Neil, Founder/CEO, Practice Like Pros ................................................... 89 Prepared statement .......................................................................................... 91 R. Dawn Comstock, Ph.D., Associate Professor, Department of Epidemiology, Colorado School of Public Health ........................................................................ 102 Prepared statement .......................................................................................... 104 Thomas M. Talavage, Ph.D., Professor of Electrical and Computer Engineer- ing, Weldon School of Biomedical Engineering, Purdue University ................ 122 Prepared statement .......................................................................................... 124 SUBMITTED MATERIAL Subcommittee memorandum .................................................................................. 162 Brochure, ‘‘REAP The Benefits of Good Concussion Management,’’ Rocky Mountain Hospital for Children at Presbyterian/St. Luke’s, submitted by Ms. DeGette .......................................................................................................... 169 Brochure, ‘‘Flag Until 14,’’ Patrick Risha CTE Awareness Foundation, sub- mitted by Ms. DeGette ......................................................................................... 189 Report, ‘‘Sports-Related Concussions in Youth: Improving the Science, Chang- ing the Culture,’’ Institute of Medicine and National Research Council of the National Academies, 1 submitted by Mr. Hudson 1 The information has been retained in committee files and also is available at http://docs.house.gov/meetings/IF/IF02/20160513/104914/HHRG-114- IF02-20160513-SD099.pdf. (III) VerDate Mar 15 2010 14:08 Apr 25, 2017 Jkt 037690 PO 00000 Frm 00003 Fmt 5904 Sfmt 5904 C:\USERS\WLAUFERT\DESKTOP\114X145CONCUSSIONSPENDING WAYNE VerDate Mar 15 2010 14:08 Apr 25, 2017 Jkt 037690 PO 00000 Frm 00004 Fmt 5904 Sfmt 5904 C:\USERS\WLAUFERT\DESKTOP\114X145CONCUSSIONSPENDING WAYNE CONCUSSIONS IN YOUTH SPORTS: EVALUATING PREVENTION AND RESEARCH FRIDAY, MAY 13, 2016 HOUSE OF REPRESENTATIVES, SUBCOMMITTEE ON OVERSIGHT AND INVESTIGATIONS, COMMITTEE ON ENERGY AND COMMERCE, Washington, DC. The subcommittee met, pursuant to call, at 9:33 a.m., in room 2123, Rayburn House Office Building, Hon. Tim Murphy (chairman of the subcommittee) presiding. Members present: Representatives Murphy, McKinley, Burgess, Griffith, Bucshon, Hudson, Collins, Cramer, DeGette, Schakowsky, Castor, Tonko, Yarmuth, Clarke, Green, Welch, and Pallone (ex officio). Staff present: Leighton Brown, Deputy Press Secretary; Rebecca Card, Assistant Press Secretary; Jay Gulshen, Staff Assistant; Kelsey Guyselman, Counsel, Communications and Technology; Brittany Havens, Legislative Associate, Oversight; Charles Ingebretson, Chief Counsel, Oversight and Investigations; John Ohly, Professional Staff Member, Oversight and Investigations; Chris Santini, Policy Coordinator, Oversight and Investigations; Gregory Watson, Legislative Clerk; Jeff Carroll, Democratic Staff Director; Ryan Gottschall, Democratic GAO Detailee; Tiffany Guarascio, Democratic Deputy Staff Director and Chief Health Ad- visor; Christopher Knauer, Democratic Oversight Staff Director; Ukna Lee, Democratic Chief Oversight Counsel; Elizabeth Letter, Democratic Professional Staff Member; Matt Schumacher, Demo- cratic Press Assistant; and Andrew Souvall, Democratic Director of Communications, Outreach, and Member Services. OPENING STATEMENT OF HON. TIM MURPHY, A REPRESENTA- TIVE IN CONGRESS FROM THE COMMONWEALTH OF PENN- SYLVANIA Mr. MURPHY. Good morning, and welcome to the Oversight and Investigations hearing. We are here today to continue the commit-