Patchell may be forced out of Rugby World Cup after latest concussion

Outhalf suffered fourth concussion in less than two years during defeat to Ireland

Rhys Patchell may not play in the World Cup even if he travels to Japan with the Wales squad on Wednesday after suffering his fourth concussion in less than two years during Saturday's defeat to Ireland in Dublin, as the tournament organisers have the power to order an independent assessment before he returns to action.

The 26-year old outhalf was injured in the 23rd minute after tackling the back-rower CJ Stander crouching down face on. His head collided with the forward’s knee and he was taken off for a head assessment that he failed.

Warren Gatland said after the match: “He will be fine for the flight. He seemed OK in the changing room. We will talk to the medics and see how he feels over the next dew days.”

Under World Rugby’s concussion guidance, Putting Players First, anyone who suffers multiple concussions, classified as two or more in the past year – Patchell is up to three – “are at greater risk of further brain injury and slower recovery. They should seek medical attention from practitioners experienced in concussion management before returning to play.

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“In addition, a history of multiple concussions or players with unusual presentations or prolonged recovery should be assessed and managed by health care providers with experience in sports-related concussions. No further participation in rugby must take place until the player is cleared by a medical practitioner with experience in concussion management.”

Wales have already lost one outhalf to injury, Gareth Anscombe, who suffered knee ligament damage against England at Twickenham last month and the loss of a second would be keenly felt given the tactical importance of the position.

World Rugby said on Sunday that it would not be able to prevent Wales from taking Patchell with them to the World Cup because the independent guidance from the tournament perspective only begins when a squad arrives in Japan. From then on, the governing body has the power to order an independent assessment before a player who has suffered concussion is cleared to play again. If that process is activated, any decision is taken out of the hands of the country concerned.

(Guardian services)