What's in a Ball?
A lacrosse player’s near-death experience and a mother’s search for answers shed light on enforcement of NOCSAE standard.
By Paul Ohanian
This story has a happy ending, but Donna Prigmore didn’t know that on March 11, 2011 — the day her then 17-year-old son Nate almost died from a bleeding brain.
Nate Prigmore was a junior midfielder for King’s Way Christian School, a high school club team in Battle Ground, Wash. At practice that day, he absorbed a shot from about five yards away. The ball struck him in the helmet near his left temple.
Donna got a call from one of the other moms who attended the practice.
"She told me, ‘Nate’s OK, but you’ll have to come pick him up. We think he may have a concussion,’" she said. "When I got to the field and saw him, he looked really strange."
A Washington state law requires coaches to pull players with suspected concussions or worse.
"I just felt dazed," Nate explained. "I had never had a concussion before, but I knew something was messed up in my head."
Nate never lost consciousness and had no visible signs of head trauma, but he complained of a radiating pain on the side of his head. To be safe, Donna took him to the emergency room at nearby Southwest Washington Medical Center. Although Nate passed neurological tests, the attending doctor suggested he get a CT scan before being released.
That test may have saved Nate’s life.
While his family waited for the results in the emergency room, Nate grew increasingly uncomfortable. He started grabbing his head and told the doctor the pain was intensifying.
"I knew something horrific was going on," Donna said. "His condition was deteriorating quickly."
Nate had arterial bleeding in his brain. The impact of the ball had ruptured an artery, causing bleeding into the brain cavity. He needed immediate surgery, a craniotomy, to cauterize the artery.
The neurosurgeon later told the family that had Nate gone home without the CT scan and subsequent surgery, he would have gone to sleep and never woken up. Donna gets emotional when realizing how close she came to losing her son.
"We would have walked away," she said, "and that would have been the end."
An Unlikely Culprit
Nate remained in the hospital for three days. He missed a week of school, and dealt with headaches and pain for a couple of months. His brain took about six months to recover fully.
"My whole body just felt off for a while," he said. "I was sleeping a lot."
During this period, Donna became more reflective on everything — what happened that day, what could have happened and what might have been prevented.
"Knowing that I came so close to losing my son drove me toward finding some answers," she said. "He was injured while being outfitted with the safest equipment available, including a new helmet."
What Donna did not realize was the culprit in this case was not the helmet, but the ball. Motivated by the desire to keep similar incidents from happening to others, Donna began doing some research.
That research eventually led her to Dave Halstead of the Southern Impact Research Center in Tennessee. The organization conducts testing on sporting goods and personal protection products, such as helmets. Halstead asked her to send the helmet Nate was wearing when he suffered the head injury and any lacrosse balls that she could find from that day. He asked questions about weather and other factors she had never previously considered in her search for answers.
Halstead, one of the nation’s leading authorities in protective equipment, helps develop the products standards typically adopted by the National Operating Committee of Standards for Athletic Equipment (NOCSAE) and the American Society for Testing and Materials (ASTM).
"I was so impressed with his desire to figure out what happened and impressed with his process," Donna said.
Halstead’s lab discovered through its testing that the balls being used by Nate’s team — and several more Donna collected and sent to Tennessee — did not meet the established NOCSAE standard. They were either too heavy, too stiff or had bad compression ratios, thus negating any protective value provided by Nate’s NOCSAE-approved helmet.
"Players must be playing with a certain ball for the helmet to be effective," Donna said. "How can that information not be shared with us as consumers? I was mad."
Donna took these findings to US Lacrosse, among others.
"The problem lies with the enforcement of this standard in the manufacturing process," said Ann Carpenetti, managing director for games administration at US Lacrosse.
While many lacrosse balls are marked with the words "meets NCAA specs," for instance, that does not necessarily mean the ball meets NOCSAE standards. NCAA specs are not as stringent as those outlined by the National Federation of High Schools (NFHS).
Armed with Halstead’s test results, US Lacrosse led a joint effort with the NCAA, NFHS and lacrosse industry to better enforce the NOCSAE lacrosse ball standard. All three major governing bodies have since mandated that only NOCSAE-approved balls can be used beginning in 2014.
"Nobody could understand how we got to this point," Carpenetti said of the previous absence of such a mandate, "but all parties were willing to move quickly to rectify the situation."
By mutual agreement, the process of visually identifying balls that meet NOCSAE standards will become much easier. Beginning in January 2014, the only balls deemed legal for play will be those that state "Meets NOCSAE Standard" in type size that will be simple for consumers and game officials to read.
"US Lacrosse will be working with our various safety education subcommittees to develop additional messaging and education materials for consumers about ball safety," Carpenetti said.
In addition to its pursuit of a women’s headgear standard, US Lacrosse is working closely with ASTM to further examine the physical properties of a lacrosse ball, how it responds to certain conditions and if its mass can be decreased without affecting performance.
Carpenetti praised Donna Prigmore for her persistence in bringing the existing ball standard to light.
"She was a real catalyst," Carpenetti said. "This shows the power that parents can wield in terms of advocacy."In Prigmore’s view, her reward was simply knowing that she was able to make a difference.
"It was so gratifying to get Ann’s email telling me that things were going to change," Donna said. "You don’t mind working hard on a cause when you get the results you want. This is perhaps the most rewarding thing I’ve done."
The Comeback Kid
The happy ending?
Nate’s recovery allowed him to return to his team for his senior season in 2012. King’s Way Christian earned its first-ever trip to the Washington state semifinals. The Knights finished 11-10 and upset Issaquah in the quarterfinals before bowing out with a 13-8 loss to Eastside Catholic.
Now a freshman at Hillsdale College in Michigan, Nate has begun an effort there to organize a club lacrosse team. And when he sees a ball marked with a NOCSAE stamp of approval, he’ll know who to thank.
"I’m kind of surprised that she was that convicted about the whole thing," Nate said of his mom. "I’m very proud of all that she has accomplished."