By Michael Hurley, CBS Boston

BOSTON (CBS) — The complicated aspect of dealing with concussions in sports is that the brain trauma suffered by players is most often not evident to television viewers and even spotters who are trained to keep a close eye on the impact of hits to the heads of players.

But every now and then, even an untrained spectator can tell when a player is dealing with a serious concussion. That was the case on Sunday afternoon in Houston, when Texans quarterback Tom Savage’s head slammed against the turf after he was hit by Elvis Dumervil.

Savage lay motionless on his back, with both arms raised stiffly in the air, unable to move and perhaps unconscious.

It was a frightening scene, and it was one that led to Savage spending some time on the sidelines to be evaluated for a concussion. But the evaluation process apparently led to doctors determining that Savage was A-OK, because the quarterback returned to the field for the Texans’ next series.

During that series, Savage was reportedly seen coughing up blood. On the TV broadcast, he was seen placing his hand over his mouth several times during that series.

(Screen shot from NFl.com/GamePass)

(Screen shot from NFl.com/GamePass)

He threw two incompletions, the Texans punted, and Savage then left the game for good.

The removal from the game is obviously a positive sign for a player in such a condition, but the fact that Savage was allowed to return to the game at all has put the NFL’s “concussion protocol” under fire from all angles — and rightfully so.

The response of Savage’s body to the contact with the turf looked eerily similar to a number of instances in sports where players have been knocked unconscious on the field of play. Locally, Nathan Horton’s body went through the same reaction when he was knocked unconscious during the 2011 Stanley Cup Final. Horton was promptly removed from that game and did not play again for the rest of the series.

In the case of Savage, it appears clear that the quarterback refused to be taken out of the game, as he reportedly tried to get onto the field after doctors determined his day was done.

Adding a troubling wrinkle to the story: As noted by Brian T. Smith of The Houston Chronicle, Savage was evaluated for a concussion last week as well.

Though the NFL’s and the Texans’ process worked eventually, it failed when Savage ended up returning to the game, a moment that put his health — and his life — at risk.

This is not a case like Russell Wilson a few weeks ago, when the quarterback took a shot to the jaw and was forced off the field for a very brief examination to determine if he had a concussion. This was a very serious injury that was treated like a slight pull of a hamstring, and it was clear for everyone to see.

Everyone, that is, except for the doctors.

Of course, when delving into the particulars of concussions and brain trauma, it’s impossible to speak in absolutes. Yet in this case, it is 100 percent true to state that if the doctors could not determine Savage had suffered a concussion in the five minutes they took to examine him, then those doctors needed to spend more time with the player.

As a result, the NFL may punish the Texans if the league determines the team violated the concussion protocol. Yet based on history, that would appear to seem very unlikely.

Just two years ago, then-Rams quarterback Case Keenum suffered a very clear and obvious concussion in the middle of a game after his head was violently slammed against the ground. Keenum stayed in the game, despite being woozy. In fact, a teammate tried to lift Keenum to his feet, but the quarterback slumped back to the turf.

It was an equally disturbing scene.

On an ensuing play, he then fumbled the football to lose the game for the Rams. After an investigation, the NFL deemed that no punishment was necessary. The Rams may not have done everything in their power to protect their player, but they more or less tried. Sort of.

For the NFL, that was enough.

Will the league act differently this time? It’s always difficult to predict how the league will act. But what’s clear after Sunday’s fiasco is that the NFL’s “hard-line stance” to keep players safe is still part of a broken system.

You can email Michael Hurley or find him on Twitter @michaelFhurley.

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