The NFL and its players’ union are jointly reviewing the medical care given to the Philadelphia Eagles quarterback after a clot in his leg turned into potentially life-threatening clots in his lungs. Days after the league said the team had done nothing wrong, the case is putting player-safety procedures under formal scrutiny.
Jalen Hurts was on the field in London on October 11, leading the Philadelphia Eagles against the Jacksonville Jaguars, hours after a late night of medical evaluation for a blood clot in his left calf. He reportedly did not get back to his hotel until around 3 a.m. local time. He was cleared to play, threw 40 passes and the Eagles lost 19-17. Eight days later, the Eagles and Hurts’ agent confirmed that the clot had become something far more serious: deep vein thrombosis and blood clots in both lungs. Now, with the 28-year-old quarterback expected to miss the rest of the season, the NFL and its players’ union are reviewing how his medical care was handled.
On Sunday, October 25, the league and the NFL Players Association said they were working together to review the matter. The announcement marks a shift. Earlier in the week, the league had said the Eagles would not be disciplined, found no violation of its injury-report policy and pushed back on criticism of the team’s doctors. The union, meanwhile, had called for a full investigation. A joint review does not establish wrongdoing. But it means the decisions surrounding one of football’s most recognizable players will now be examined by both sides of the sport, not just defended by one.
Last week, SSC looked at the culture behind those decisions in Jalen Hurts and the Dangerous Business of Being Tough, which examined how a sport that celebrates playing through pain shapes the choices made around its biggest stars. One week later, the question has moved from culture to process: not why a player would want to play, but how the people responsible for his health decided he could.
How a “Superficial” Clot Became a Season-Ending One
The sequence began on October 4, when Hurts was reportedly struck on the calf by another player’s cleat during a loss to the Los Angeles Rams. According to the Eagles’ own account, released October 15, he asked for treatment after practice on October 8, practiced again the next day and then traveled with the team to London.
There, on October 10, an ultrasound the team said it ordered out of an abundance of caution found a superficial vein thrombosis, a clot in a vein close to the skin’s surface. The team said its medical staff and doctors in London concluded that staying active and mobile was important and that Hurts could play safely. He was cleared with no injury designation on the team’s report. As a precaution, doctors reportedly advised him to stay awake overnight. After the game, he flew back to the United States with the team.
A follow-up ultrasound on October 14, after the team returned to Philadelphia, showed the clot had moved. Hurts was ruled out of the Eagles’ game against the Carolina Panthers and placed on injured reserve. Further testing found deep vein thrombosis and bilateral pulmonary emboli, meaning clot material had traveled from his leg to both lungs.
Each step in that timeline is now a question for reviewers. What did the medical staff know before kickoff in London? Which tests were done, and when? What risks were weighed before he played, and before he boarded two long flights? And who made the final call?
The Medical Timeline Is Central to the Review
Deep vein thrombosis occurs when a blood clot forms in a deep vein, most often in the leg. A pulmonary embolism develops when part of that clot breaks loose, travels through the bloodstream and blocks an artery in the lungs. Depending on the size and location of the blockage, it can cut off oxygen, strain the heart and become life-threatening. A superficial vein thrombosis is generally less dangerous, though the clot’s location and size, the patient’s symptoms and the chance of deeper involvement all shape what doctors decide.
Two other factors complicate the picture. Trauma to a limb, like a cleat to the calf, is a known trigger for clots. So is long-distance air travel, which keeps people seated and still for hours. Hurts experienced both. The NFL’s chief medical officer, Dr. Allen Sills, has said the safety threshold for flying with a superficial clot depends on the specifics of each case.
The gap between Hurts’ first diagnosis and his later condition is what investigators will have to explain. That a serious complication was found later does not, by itself, prove the earlier diagnosis or treatment was wrong. Clots can change quickly, and medicine often works with incomplete information. But it makes the documented record of what was known, and when, especially important.
Two Very Different Responses
The league’s first response was firm. Eagles head coach Nick Sirianni said the team had full faith in its medical experts, according to ABC News, though he did not explain why Hurts was cleared to play. NFL executive Jeff Miller dismissed much of the early coverage as uninformed speculation. Sills went further, calling the suggestion that team doctors’ decisions are shaped by outside pressure “nonsense.” The league also noted that it arranges care with leading medical providers in every international market where it plays.
The NFLPA took a different view. In a statement on October 20, the union said it was not aware of any league investigation and had been told the NFL did not plan to review Hurts’ care. The union argued that conclusions should wait until the facts were established.
The rules both sides are now testing are written into Article 39 of the league’s collective bargaining agreement. As SSC reported last week, it gives the head team physician final authority over whether a player is cleared and says team medical staff owe their primary duty to the player, even though the club pays them. The same article also gives the union the right to open its own investigation into a player’s medical care, a step it had not taken publicly before Sunday’s joint announcement.
The two organizations have not said who will conduct the review, what it will cover or when it will be finished.
The League Has Been Here Before
The last time a star quarterback’s medical clearance drew this kind of attention, the outcome reshaped the rules.
In September 2022, Miami Dolphins quarterback Tua Tagovailoa hit his head and stumbled during a game against the Buffalo Bills, then returned to play. Four days later, he suffered a frightening head injury against the Cincinnati Bengals. A joint NFL-NFLPA review found that the team’s medical staff had technically followed every step of the concussion protocol. But both sides agreed the result was not what the protocol was meant to produce. The league added “ataxia,” or problems with balance, coordination or speech caused by a neurological issue, to the list of symptoms that automatically keep a player out of a game. The union also removed the independent doctor involved in clearing Tagovailoa.
The lesson from that case applies here. A review can find that the rules were followed and still conclude that the rules were not good enough. Concussions now have a detailed protocol, with independent neurological consultants on every sideline. There is no comparable, standardized process for a player with a diagnosed blood clot who wants to keep playing.
Those protocols also arrived late. As SSC reported this week in Football’s Parkinson’s Question Is Getting Harder to Ignore, former players are still living with the long-term effects of decisions made before the league treated head injuries as a medical issue rather than a toughness test. The Hurts review is a chance to set standards before, not after, the damage is done.
The Pressure Surrounding a Franchise Quarterback
Hurts is not an interchangeable player on Philadelphia’s roster. He is a Super Bowl-winning quarterback, the center of the Eagles’ offense and one of the most visible athletes in the NFL. His availability shapes game plans, playoff hopes, television narratives and the team’s entire season. When a player with that much riding on him is hurt, the decision about whether he can play takes place in an environment where his absence carries enormous costs.
That is the tension SSC explored last week: the pressure on a star to play does not have to be spoken to be felt, and it reaches the people around him too. There is no public finding that Hurts was pressured to play or that his medical team ignored known risks. Those possibilities should not be assumed. But his case shows why independent review matters. Team physicians work in a setting where player welfare and team performance are closely linked. Even when doctors act appropriately, transparent procedures help show whether decisions were made on medical grounds and whether the information available supported them.
The concern reaches beyond Hurts. Players across the league sustain injuries that seem manageable at first, and not every serious complication is obvious right away. A strong player-safety system has to account for that uncertainty, allow a diagnosis to change as new evidence emerges and protect athletes when the safest choice conflicts with competitive pressure.
Why Blood Thinners and Football Don’t Mix
Hurts is now being treated with anticoagulants, commonly called blood thinners, which keep existing clots from growing and lower the risk of new ones. Because his clot is considered “provoked,” meaning it followed a specific injury rather than appearing without a clear cause, sources describe his prognosis as favorable. Treatment is expected to last at least three months.
That treatment is also why his season is over. Blood thinners make it harder for the body to stop bleeding, so a hard hit that would normally cause a bruise could cause dangerous internal bleeding. Sports medicine offers little settled guidance on contact sports during anticoagulation, and the standard approach is to keep athletes out of collision sports until treatment ends. Some cardiologists have proposed individualized plans that time doses around games, but those approaches carry their own risks and require close medical supervision.
Other leagues have faced versions of this problem. In the NBA, Miami Heat star Chris Bosh’s career ended after repeated blood clots, and the team and player publicly disagreed over whether he could safely return while managing his condition. Those cases are different, but they show how clotting disorders force hard choices about risk, consent and who gets the final say.
A Season Ends While the Questions Continue
The Eagles and his agent, Nicole Lynn, have said Hurts is clinically stable, has no significant physical limitations and has a very good prognosis. Lynn has said he is expected to fully recover and return to contact football once he is off blood thinners. In the meantime, Philadelphia will finish the season without its starting quarterback.
His recovery and the league’s review are separate matters, though both now shape how the public understands what happened. A good prognosis is welcome news for Hurts, but it does not remove the need to examine the decisions made before his condition became more serious. Likewise, the existence of a review does not mean the medical staff violated accepted standards of care.
The review could conclude that the Eagles acted appropriately based on what they knew at the time. It could also find gaps in communication, testing or oversight that call for league-wide changes, perhaps including clearer standards for clearing players with diagnosed clots, guidelines for air travel after a vascular injury or a role for independent physicians beyond concussions. Either way, the findings would matter well beyond Philadelphia.
For a league built on athletes performing through extraordinary physical demands, player safety cannot be measured only by whether an injured player eventually recovers. It also depends on the quality of decisions made when the medical picture is incomplete and the pressure to play is immediate.
Hurts’ season has already been cut short by something far more serious than a routine football injury. As he continues treatment, the NFL and its players’ union now share the responsibility of establishing what happened before he took the field in London, and whether the systems meant to protect players worked the way they were supposed to.