Finding into death of Shane Michael Tuck

Contributing factors

• chronic traumatic encephalopathy (CTE) stage III
• repetitive head trauma from AFL career
• head trauma from professional boxing career
• severe knockout with subdural hematoma from boxing
• progressive psychiatric symptoms including auditory hallucinations
• depression and anxiety
• cognitive and memory impairment
• substance abuse including cocaine and methylamphetamine
• psychotic symptoms resistant to treatment

Coroner's recommendations

1. AFL consider implementing rules limiting contact training sessions in off-season, pre-season and during season, with implementation by 2025 pre-season
2. AFL implement rule empowering concussion spotters to mandate player removal from field for medical assessment based on live/video review
3. AFL employ independent medical practitioners at all elite AFL/W games to assist club doctors in concussion assessment, with independent opinion prevailing if disagreement arises
4. AFL review educational material on concussion and repeated head trauma to expressly address acute signs/symptoms, response/management, and short/long-term risks of head trauma
5. AFL develop and disseminate educational materials on repetitive head trauma to prospective players and families, including explicit CTE risk information, through multiple platforms and community levels
6. RACGP expand education for general practitioners on short and long-term effects of repetitive head trauma in contact sports including CTE
7. AFL continue to disseminate evidence-based education on concussion and repetitive head trauma to club doctors, coaches, trainers and volunteers
8. AFL promote extended use of mouthguard accelerometer technology to 80% player uptake in 2024 season
9. AFL develop and implement standardised neurological baseline testing for all elite AFL/W players at beginning of season, linked to clinical profile and used for longitudinal research
10. AFL develop educational material for players on benefits of neurological baseline testing and use of deidentified data for research
11. AFL and AFLPA expedite communications with past and present players encouraging brain donation with information on repetitive head trauma and CTE risks
12. Commonwealth Department of Health facilitate adequate funding of brain banks nationally
13. AFL explore with AFLPA how they may assist with education and training on concussion and repetitive head trauma
14. DJSIR extend regulatory review to include amateur boxing and align training/education regimes between amateur and professional boxing
15. DJSIR and Board work with interstate counterparts to develop national database of registered boxers including name, age, trainer, gender, serology results, injuries, medical suspensions and fight history
16. Board and DJSIR continue developing baseline neurological testing systems for boxers with longitudinal data collection
17. DJSIR and Board restrict persons under 14 from boxing activities involving head hits and develop age-appropriate education for child boxers and parents on repetitive head injury and CTE risks
18. DJSIR and Board undertake research on viability of amending rules including reducing round length, fight length, and changing scoring system to reduce head trauma
19. Board explore ways to reduce sparring for professional boxers including restricting sparring before bouts
20. Board develop educational material on repetitive head impact, traumatic brain injury and CTE in boxing including sparring
21. Board and DJSIR develop longitudinal research project on mouthguard accelerometer technology to monitor head knocks in boxers and develop education on sparring injury risks