The world players’ union, FIFPro, has accused FIFA of failing to protect Uruguay midfielder Alvaro Pereira after he returned to the pitch having been knocked out in his team’s 2-1 win over England in Sao Paulo.
Pereira was left unconscious on the pitch after being struck in the head by Raheem Sterling's knee while attempting a sliding tackle on the Liverpool winger in the 30th minute of the clash on Thursday.
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Uruguay’s team doctors wanted to substitute him but, after waking up, the fullback pushed away medical staff before eventually completing the Group D fixture.
Despite Pereira admitting after the game that he did not do the right thing in playing on, FIFPro has urged football’s world governing body “to conduct a thorough investigation” into its concussion protocols and begin “urgent talks” to satisfy the union that FIFA can guarantee the safety of the players.
“Football is awash with incidents in which players suffer potentially concussive blows to the head and stay on the pitch. In Pereira’s case, he demanded to play on, overruling advice from Uruguay’s team physician for him to be immediately substituted,” Fifpro said in a statement.
“Fifpro understands that in certain moments, faced by the pressures of such an important international stage, many players would react in this way. There are times, however, when the players also require greater protection against the prospect of making any rash decisions.”
Pereira himself apologized for ignoring doctors’ advice after the victory.
"It was a moment of madness... I've apologized to the doctor because I know it's his job to look after the players," he said. "I went back on dizzy but, in the heat of the moment, with a hot head, you don't think properly.
"Still, it was a time to help the team and to get a result. And the most important thing is that we got the result."
Soon after returning to the pitch, Pereira crunched England defender Glen Johnson from behind but escaped a booking – an action that sports medicine physician at the University of Missouri, Dr Aaron Gray, said was a clear symptom of concussion.
"No one in right mind makes that challenge on ball rolling out of bounds. Irritability, anger, confusion (are) all concussion symptoms," Gray wrote on Twitter.
"Pereira's rash tackle after returning likely caused by effects of concussion and could have caused him to be sent off."