On May 8th, 2013, Rowan Stringer took to the field near Ottawa, Ontario, to do one of the things she loved most: to play rugby.

Rowan was captain of her varsity high school team. She was a talented, competitive and enthusiastic player. However, for several days prior to that fateful game, she had suffered from headaches. She did not seem quite herself. This was because twice in the previous six days, Rowan had played rugby and been hit in the head.

Rowan suspected she might have a concussion. Certainly, she knew something wasn't right. She confided in a few close friends. However, the only people who might have been able to stop the determined, energetic young athlete from playing rugby that day — her parents, her teachers or her coaches — had no idea that there was even a problem.

On May 8th, Rowan played rugby for the third time in six days. For the third time in six days, she was tackled and hit in the head. She went down on the field, sat back up briefly, and then collapsed. She was taken to the Children's Hospital of Eastern Ontario where, four days later, on May 12th, 2013, she died. Rowan Stringer was 17.

Coroner's Inquest

Rowan died from what is known as Second Impact Syndrome — catastrophic swelling of the brain caused by a second injury that occurs before a previous injury has healed. Simply put, she was concussed but didn't know that her brain needed time to heal, so she played and got hit again. That final impact caused her death. The obvious questions that followed on this tragedy were: How could this have happened? How could this have been prevented?

It would not be fair to say that the system failed Rowan Stringer, because in 2013, there was no concussion system governing youth sport in Ontario, or in the rest of the country. The closest we came was in 2012, when the Ontario government announced a multi-ministry concussion strategy, and tabled Bill 39, The Education Amendment Act (Concussions). However, the bill died on the order paper when parliament was prorogued and a provincial election was called. It was not reintroduced during the next session of parliament. By contrast, all 50 U.S. states have laws dictating the management of youth concussions, some dating back as far as 2009.

The absence of concussion laws and of a coherent youth sport concussion system was noted during a coroner's inquest into Rowan's death in 2015. Over the course of nine days, the coroner's jury heard from 19 witnesses and viewed 36 exhibits. After three days of deliberation, they released a verdict which contained 49 recommendations to, amongst others, the federal government as well as Ontario’s ministries, school boards and sports organizations. Those recommendations can be found in Appendix A of this report.

Rowan's Law Advisory Committee

The very first of the jury’s recommendations is that the government of Ontario pass a law, to be called "Rowan's Law", to govern all youth sport in Ontario. This law would establish a standard of practice in this province for concussion identification and management.

The coroner's inquest established a clear and worthy goal, one which was immediately adopted by the Ontario government. In late 2015, a private Member's bill was introduced in the Ontario Legislature, establishing the Rowan’s Law Advisory Committee. The bill, which had all-party support, received Royal Assent in June 2016, and in September 2016 our Committee was born. We were given one year in which to complete our work and issue this report.

Our Committee's Terms of Reference can be found in Appendix B of this report, and our members and their biographies are shown in Appendix C. Our Committee's mandate is as follows:

  • Review the recommendations made by the jury as part of the coroner’s inquest into the death of Rowan Stringer
  • Review legislation, policies and best practices from other jurisdictions with respect to head injuries, including concussions
  • Make recommendations on how to implement the jury recommendations, and how to prevent, mitigate and create awareness about head injuries in sport in Ontario
  • Make any other recommendations that are advisable with respect to head injury prevention or treatment
  • Within one year of beginning work, provide recommendations in a report to the Minister of Tourism, Culture and Sport

The Rowan’s Law Advisory Committee got to work almost immediately. Over the course of nine months, we met eight times. There were also countless phone conversations and email exchanges. We were supported in our work by the provincial ministries that are most implicated in the concussion issue: Tourism, Culture and Sport; Education; Health and Long-Term Care; Children and Youth Services; and Advanced Education and Skills Development. A working group composed of senior leadership from those ministries was formed to assist us with any research or other support that we needed.

We conducted a jurisdictional scan to ensure that we understood existing concussion legislation and policy frameworks here in Canada and in other countries. We monitored federal initiatives and maintained linkages with the Federal-Provincial/Territorial (F-P/T) Working Group on concussions. We also met with stakeholders such as Public Health Ontario, Sport Canada and the Canadian Institute for Health Information. At the same time, members of our Committee worked to raise public awareness, and solicit public input, about concussions in general and Rowan's story in particular. Over and above all else, we never lost sight of the fact that we were working to change the culture that exists around head injuries in sport through the introduction of guidelines and best practices, and through the creation of a law – one named for a young woman who might have been saved had that law existed back in 2013.