Chris G. Koutures, MD, FAAP Pediatric and sports medicine specialist

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Comprehensive blend of general pediatric and sport medicine care with an individualized approach that enhances the health and knowledge of patients and their families



Proud physician:
USA Volleyball Mens/Womens National Teams
CS Fullerton Intercollegiate Athletics
Chapman University Dance Department
Orange Lutheran High School

Co-Author of Acclaimed Textbook

Pediatric Sports Medicine: Essentials for Office Evaluation

Orange County Physician Of Excellence, 2015 and 2016


Are California Schools and Medical Providers Prepared for New Concussion Law?


California Assembly Bill 2127 authored by  Assembly Member Ken Cooley (D-Rancho Cordova) will take formal effect on January 1, 2015 and will provide that, if a licensed health care provider determines that the athlete sustained a concussion or a head injury, the athlete is required to complete a graduated return-to-play protocol of no less than 7 days in duration under the supervision of a licensed health care provider. This stipulation is an extension of previous California legislative mandates passed in 2011 and 2012 that require:

  • Immediate removal for the remainder of the day of any high school athlete suspected of having a concussion
  • Prohibit the return of the athlete to that activity until he or she is evaluated by, and receives written clearance from a licensed health care provider
  • Each year, a concussion and head injury information sheet must be signed and returned by athletes and parent/guardian
  • Concussion education must now be part of required first aid training of every high school coach

For my initial reaction to this law, click here

In discussions with coaches, administrators, and fellow sports medicine providers, I'll throw out a few questions that have arose regarding several nuances of the law:

  • When is the earliest that the 7-day return protocol begins?
    • Is it potentially at the time of formal diagnosis of a concussion by a licensed provider?
    • Is it when the athlete is fully cleared of post-concussion symptoms?
    • Can the period begin before a formal diagnosis is made?
  • What is the formal definition of supervision?
    • Can an athletic trainer assume the role of supervision under the guidance of a physician?
  • Given that the bill also limits contact football practices to two 90 minute periods per week, if the timing of those two practices is perhaps a day before a player's progression is ready for contact, can he have alternate contact to possibly play in a game if otherwise having an appropriate recovery?
  • Are school and medical providers aware and sufficiently prepared for these new edicts?
    • Is there agreement or clarification on the above terms and concerns?
    • Have concussion management plans, if already in place, been modified or reviewed to address the new mandates?

Certain that there are other questions and thoughts out there- please use this as a forum to share with others.