Kaufman: “A sad start for Chelsea and in particular Petr Cech. You can see that knee from Stephen Hunt is still affecting him, and he’s hardly come around.”
In the bowels of the Madejski Stadium, English could see Cech was deteriorating—fast.
“I knew within about 10 to 15 mins it was serious,” he says. “As quickly as that. Because normally, if a player’s just concussed, they recover quite quickly. Anybody who is relatively conscious and then the conscious level deteriorates, they’re going in the opposite direction, and you need to get them to hospital as quickly as possible—you’re worried about an internal bleed.
“I said: ‘We’re going to have to get an ambulance for this guy. I don’t think he’s going to be stable.’ He was starting to go downhill—he was getting more agitated. Sometimes, when you have a player who’s had a head injury, they can be very aggressive towards the doc, and that would make me think that he’s not normal. They want to go back on to the pitch.”
English had to return to the pitch because Paulo Ferreira hurt his elbow. “I came back in, and he was getting worse. Again I asked them, ‘Where’s the ambulance? Why is it not around?’ My colleague told me that he’d heard the paramedic say, ‘It’s just a light concussion. We don’t have to call the ambulance.’ The fact is there was only one ambulance at the Reading ground, and there should have been two. Therefore, they were waiting for another to come from the hospital, so they were delaying it.
English says it took “something like 27 minutes” for the ambulance to turn up, “which is far too long in a situation like that.” Cech was taken to see neurosurgeons in Oxford and had an operation on his fractured skull.
A collision course had been set: Chelsea and Jose Mourinho versus Reading and the South Central Ambulance Service (SCAS). Both parties were blaming each other.
Reading and SCAS state Chelsea initially decided the injury was not serious enough to require an ambulance. Reading said it was 24 minutes after the injury when Chelsea asked paramedics to call for an ambulance, which was done at 5:45 p.m.
Reading, SCAS and Chelsea did agree that an ambulance arrived at 5:52 p.m., left at 6:04 p.m. and that Cech arrived at the Royal Berkshire Hospital at 6:11 p.m. He was later transferred to the specialist unit in Oxford.
"I knew within about 10 to 15 mins it was serious."
The contention is that Chelsea asked for an ambulance to be called. Chelsea say they asked paramedics to call for one at 5:35 p.m., five minutes earlier than Reading said.
Mourinho, with the belligerence for which he is renowned, stated that it took 30 minutes. In a fierce verbal attack on Reading and SCAS, he effectively accused them of dereliction of duty and putting Cech’s life in danger.
Hunt’s leg dented Cech’s skull and pushed pieces of bone towards the brain. It was these pieces that threatened his life. One wrong move, and the fragments were in danger of lacerating or bruising the brain and damaging blood vessels. There were even reports from medical sources that Cech’s injury was consistent with that of a car crash.
As Cech waned, English’s initial concern was a risk of increased pressure on the brain, which could cause a seizure. This can also crush soft tissue, which can be fatal. When it became clear following a brain scan at the Royal Berkshire that the broken pieces of bone were more than five millimeters deeper than the skull, the decision was made to operate.
He was transferred to Oxford at 1 a.m. In an operation lasting hours, surgeons at the neurological unit inspected the brain’s outer casing, moved the pieces of bone away and then reassembled the skull, inserting two metal plates just above his left ear.
Mourinho: “The ambulance couldn’t go in the direction of the dressing room. He couldn't leave the dressing room properly. He had to go in a wheelchair in a lift, and he left the ground 30 minutes after my doctor was calling for an urgent ambulance. If my goalkeeper dies in that dressing room or in that process, it's something English football has to think about.”
Mark Ainsworth was the officer in overall charge for the South Central Ambulance service. He’d been attending games for his job for 10 years. He’s still doing it today. “I’ve seen it all now,” he says. Quite. It is rare for emergency medical workers to be criticised for unprofessionalism and incompetence—rarer still to be accused by one of the most famous football managers in the world.
Mourinho was used to being at the centre of a media storm. Ainsworth was not. He was grilled by Sky News. But in what should have been a mismatch, Ainsworth stood firm. “I have a great face for radio,” he says.
Criticism of ambulance staff was not a laughing matter for Ainsworth, however: “It was not fair. It was concerning. People join the ambulance service to care for patients, no matter who they are."
Why did Mourinho say what he did? “I don’t know,” Ainsworth says. “He’s passionate, and he was upset about what happened to his goalkeeper. He’s a good manager who is very good at playing the press. He’s never apologised. Chelsea have never apologised. But they got the facts wrong.”
According to Ainsworth, it was a breakdown in communication. This led to the delay to Cech receiving the attention Chelsea wanted. “I was confident with the service that we provided,” he says. “It was frustrating being challenged around the delayed response, but there was evidence from the football club that they weren’t clear on how they should have requested the ambulance and the fact we had the ambulance there.
“It put the ambulance service in a negative light, which was unnecessary. Obviously, our focus was to treat the patient and get them to hospital as quickly as possible—that was Cech and then Cudicini after that but not so seriously. I’m still frustrated today.”
Ainsworth explains the paramedic ambulance crew at Reading sits by the away bench. “Both teams are briefed around the medical cover by the referee and the safety steward at the start of the game.” he says. “It’s part of the FA rules that you have to have a paramedic ambulance on site for the players, so my personal feeling was disappointment about the lack of communication that should have happened immediately after the injury.”
Ainsworth says the media storm in the aftermath did not help: “I [was] happy to defend the service on TV. I just think it shouldn’t have come to that. It could have all been sorted out by the relevant parties face-to-face rather than the open forum of the media.”