Rowan Stringer inquest jury releases 49 recommendations after rugby death

A jury has made dozens of recommendations to provincial ministries, school boards and sports organizations to prevent concussion-related deaths at the end of a coroner's inquest into the death of Ottawa teen Rowan Stringer.

At the top of the list of 49 recommendations is one asking the Ontario government to create a law to govern all youth sport, in schools and outside of schools, to be known as Rowan's Law and to be in place by the fall of 2015.

"We're hoping ... that when her name comes up [people] will always associate it with a sad story, but a story that will help a lot of children, hopefully ... and that it will change the culture of sport," said Stringer's mother, Kathleen Stringer, after the recommendations were released Wednesday.

Rowan's Law would be largely based on on international concussion guidelines established in Switzerland, will provide education on sport-related concussions to athletes, coaches and parents; outline framework for when to remove an athlete from playing higher-risk sports if a concussion is suspected; ensuring athletes don't return to play until they're medically cleared to do so; and ensuring appropriate return to learn and return to play strategies.

Stringer was 17 when she died in 2013 after suffering three concussions in less than a week.

Other recommendations announced by the jury Wednesday after the 12-day coroner's inquest include:

• Requiring students and their parents to take a mandatory concussion awareness and management session before students are allowed to take part in higher risk youth sports, such as rugby and football. The session would include signs and symptoms of concussion, as well as how and when to return to play following injuries.
• Developing a way to track student concussion injuries to ensure proper treatment and clearer data.
• Adopting a zero-tolerance policy for head hits and high tackles in any level of rugby, with progressive penalties for repeat offenders including expulsion for repeat offenders.
• Determining an optimum, safe length of time between games and practices involving contact to lessen the risk of concussion and other injuries, particularly for athletes competing in more than one league.
• Creating an annual awareness and learning opportunity at all Ontario school boards, such as "Brain Day," to provide students consistent, up-to-date and accurate information.

Stringer's father, Gordon Stringer, said their family is "very pleased" with the set of recommendations, many of which he and his wife had earlier drafted with the help of lawyers.

"The jury has obviously taken into consideration the ideas that we gave them," he said. "They added a few very insightful ones of their own and we're more than pleased with what they've come up with as a set of recommendations."

Details of death

Stringer suffered the last of three concussions on May 8, 2013, when her head and neck struck the ground as she played a high school rugby match in Ottawa for John McCrae Secondary School.

She died in hospital four days later from second-impact syndrome, in which a pre-existing injury followed by another head blow can cause death.

The inquest examined the circumstances surrounding Stringer's death, including areas of head injury recognition in high school field sports.

Kathleen Stringer said the 12-day inquest was sometimes difficult to process for her and her family, but that they're proud of the results.

"In some ways, going home each night felt like right after the accident again," she said.

8 days of testimony

During eight days of testimony, several witnesses — including friends, coaches and her mother — testified on Stringer's actions prior to her death.

Coaches and a referee also spoke of the fatal head blow that knocked the Grade 12 student unconscious for the final time.

Concussion experts and medical professionals also testified.

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In a statement issued Wednesday after the recommendation were released, Rugby Canada said it will "thoroughly review" the inquest jury's findings and recommendations.