By Robert Shannon
Hinshaw & Culbertson
Toradol (ketorolac tromethamine): a member of the pyrrolo-pyrrole group of nonsteroidal, anti-inflammatory drugs; available for intramuscular administration; for the short-term management of pain.
What's the story behind this drug that appears to have split the ranks of professional football players? On one side, Chicago Bears linebacker Brian Urlacher recently touted his use of ketorolac tromethamine (marketed under the trademark Toradol) and the drug's benefits. On the other side, a group of former NFL players, including former New Orleans Saints Pro Bowl wide receiver Joe Horn, have sued the NFL based in part on the league's alleged administration of Toradol.
Toradol is described as a nonaddictive, nonnarcotic drug that serves as an anti-inflammatory that is administered to patients to reduce swelling. The players' lawsuit says Toradol is administered orally or through intravenous injections and works to reduce hormones that cause inflammation and pain in the body, and has the effect of masking symptoms. Athletes describe using Toradol to help play through injury and pain. Since Toradol is not a steroid, it's never been on the banned substance list.
Some players have publicly discussed Toradol and some seem undeterred by the warnings. As the Chicago Tribune recently reported, Urlacher acknowledged using Toradol in an edition of "Real Sports" on HBO. The Tribune saysUrlacher explained that Toradol has been available to players leaguewide throughout his career. Urlacher estimates that he has been administered Toradol about 40 to 50 times, but denies being a habitual user. Urlacher acknowledges that some players claim it makes them feel "high" for hours, but states that he never felt like that after taking Toradol. Urlacher says it simply makes him feel loose and assists in reducing pain. Urlacher apparently took Toradol twice last year during the playoffs — once during the Seattle Seahawks game and once before the Green Bay Packers game — to help relieve hip pain from a hit he took during the Seattle game.
The former players' lawsuit attempts to paint a different picture. The class-action complaint, Finn, et al., v. National Football League, 11 cv 07067, was filed in the U.S. District Court for the District of New Jersey on Dec. 5, 2010, by Seeger Weiss. In addition to Horn, 11 other former players are named plaintiffs, including Jim Finn (New York Giants), Jerome Pathon (Indianapolis Colts and others), Scott Dragos (Chicago Bears and others), Isaiah Kacyvenski (Seattle Seahawks and others), Brad Scioli (Colts), Matt Joyce (Dallas Cowboys and others), Dan Collins (Cowboys), Paul Zukauskas (Cleveland Browns, San Francisco 49ers), Sean Berton (Giants, Minnesota Vikings), Sean Ryan (Cowboys and others) and Chris Walsh (Buffalo Bills, Vikings).
While much of the complaint focuses on the concussion controversy, its claims against the NFL also are based on the alleged regular administration of Toradol without warning players of the alleged side effects such as anxiety, depression, short-term memory loss, severe headaches, sleeping problems and dizziness. The plaintiffs allege they each suffer from the onset of brain impairment and other maladies, including short-term memory loss and headaches. The counts in the lawsuit are plead as negligence, fraud, fraudulent concealment, negligent misrepresentation and conspiracy. The plaintiffs seek compensatory damages from the NFL and punitive damages to deter future wrongful conduct.
The plaintiffs claim that NFL protocol was to return players who suffered concussions back to the field shortly after receiving the injury and that the NFL's Mild Traumatic Brain Injury Committee was chaired by a league "puppet."
They also claim that the routine use of Toradol increased the possibility of cerebral bleeding in players with head injuries because of the drug's blood thinning effects. The plaintiffs allege that as many as 10 to 20 players would line up before games in a "cattle call" to receive en masse injections of Toradol without regard to medical conditions. The complaint cites several studies, including one in 2002 that noted the risks associated with Toradol should be "discussed with every athlete prior to use" and argues that it was known that Toradol was not to be used if the recipient had a closed head injury. The players claim that they received no warnings regarding the use of Toradol as it pertained to head injuries and that they were at an increased risk of suffering even greater injuries from concussions because of the drug's blood thinning effect.
The NFL immediately issued a statement disputing the plaintiffs' claims. The NFL spokesperson said, "(T)he NFL has long made player safety a priority and continues to do so. Any allegation that the NFL intentionally sought to mislead players has no merit. It stands in contrast to the league's actions to better protect players and advance the science and medical understanding of the management and treatment of concussions."
Some observers have suggested that this and other lawsuits directed at players' brain injuries really are about the NFL's health insurance and questions over whether collision-related injuries are entitled to league benefits. For the time being, it appears that the concussion controversy is far from resolved.