The fight over CTE continues 5 years after Steve Montador's death

Steve Montador's brain smashed against the inside of his skull 19 times in the course of his hockey career, each time hard enough to cause a concussion.

Nineteen times, his brain torqued and twisted.

And after each of those times, heeventually returned to the ice to play the game he loved. But in the end, the brain injuries took a cruel toll.

Montador died five years ago, on Feb.15, after a 14-year professional hockey careerand 571 games in the National Hockey League, including stints with the Calgary Flames and Florida Panthers.

He was 35 years oldand left behind a girlfriend who would give birth to their son only four days after his death. Thechild turned five in February.

An autopsy found Montador's brain had been ravaged by the degenerative brain disease, chronic traumatic encephalopathy (CTE). The only known risk factor for developing CTE is repetitive blows to the head.

Montador, born in Vancouver and raised in Mississauga, was a beloved teammate who played a physical brand of hockey and wasn't afraid to drop the gloves.

After his competitive days were over and his life moved away from the ice, Montador paid the price for all his concussions.

Paul Montador was there to witness his son's downfall. Steve had depression, anxiety, substance use issues, headaches, chronic pain and difficulty sleeping. He became forgetful and struggled to control his emotions and decision-making processes.

"Fortunately he never became violent, but he was very forgetful and then his executive function, his decision-making was erratic and illogical and exaggerated," Paul Montador said. "He became aware ,and everyone else around him became aware, that this was becoming a very serious problem."

Paul remembers a small moment from his son's struggles that highlighted the depth of pain Steve was experiencing.

"He would spend 24 hours [a day] in his bedroom. I was sitting in his living room during that episode. And I was reading the newspaper," Montador said. "He came into the kitchen area and I turned the page in the newspaper and he looked over and he said, 'Dad, please don't do that,' in a very quiet voice. And I said, 'don't do what, Steve?' And he said, 'don't turn the newspaper like that. It kills me.'"

Learnthe science behind concussions and why they can be so dangerous:

How do concussions affect the brain?

5 years ago

Duration 3:22

Neuroscientist Naznin Virji-Babul explains the science behind concussions and why they can be so dangerous.

Paul Montador thinks the National Hockey League didn't do enough to protect his son and to educate him about concussions and the possibility of developing CTE. And that's why he's continuing with a lawsuit against the NHL originally started by Steve in the months before he died.

"His intention and therefore my intention and the family's intention in continuing with the court case is to make a difference in the NHL and hold them accountable for the lack of attention that they've paid to this matter," Montador said.

In a motion to dismiss the claim, the NHL's lawyers wrote that claims like Montador's fall within the scope of the collective agreement and should be addressed via arbitration. The motion also denies the NHL had a duty to study the long-term effects of concussions or to refrain from promoting violence in the game.

This isn't the first time the NHL has faced a lawsuit concerning traumatic brain injuries. In 2018, the league settled a lawsuit with 318 players for $18.9 million in payments and medical treatment. The league did not acknowledge any liability in the settlement.

Montador was originally part of the proposed class action, but his estate chose not to accept the settlement. Neither did his former Chicago Blackhawks teammate, Daniel Carcillo, or Boston Bruin Nick Boynton. Now, each of those three players will face the NHL at trial in federal court in the coming months. In Montador's case, depositions are due by the end of May.

The NHL did not respond to multiple requests for comment on this story.

The NHL'sdefence

The NHL has become accustomed to facing these kinds of tough questions, surrounding concussions, CTE, and the death of some of its former players like Steve Montador.

Derek Boogard, Todd Ewen and Bob Probert are just a few of the players who have died young, post-playing career. All three of them, along with Montador, were found to have been living with CTE. Even Hockey Hall of Famer Stan Mikita was recently diagnosed with CTE after his death.

Throughout the process of defending itself against claims that the league has not adequately educated or protected players from brain injuries and their fallout, the NHL has consistently referred to a medical research paper called the Consensus Statement on Concussion in Sport.

The consensus statement is written by a panel of 36 experts in the field of concussion medicine and it says a cause-and-effect relationship has not been established between sports-related concussions and CTE. But critics say that simply isn't true, pointing to more than 200 studies from Boston Universityand many more around the worldthat have found CTE in post-mortem autopsies of athletes. The only experience common to the subjects of those studies was receiving repetitive blows to the head.

The conference which produces the consensus statement is sponsored by large sports organizations including the International Olympic Committee (IOC), and world soccer body FIFA.

Critics of the consensus paper say big sports organizations are highly represented among authors of the statement. Thirty-two of the 36 panellists who wrote the statement have direct relationships with organizations like the NHL, National Football League, National Collegiate Athletic Association, the International Olympic Committee and more. Many of the affiliations existed at the time of the statement being written. Others developed in the years following the conference, while others predate it.

In his 2019 testimony to the parliamentary subcommittee on sports-relatedconcussion in Canada, NHL commissioner Gary Bettman referred to the consensus statement six times.

Bettman was asked by Liberal MP Darren Fisher:"What is your belief now and what is the league's position these days on whether there is a link between CTE and concussions?"

"I'm not sure that the premise that the link is clear now is one that the scientific and medical communities have embraced," Bettman replied. "The consensus statement, which was subscribed to by 36 practitioners in the field, again has continued to say that there has yet to be the ability to draw the conclusion that one will lead to the other."

The NHL's reliance on the consensus statement was also noted in its defence of the lawsuit from former players that was eventually settled.

"All of the consensus statements played a significant role in the NHL's defence of the case and in particular the defence to our argument that the NHL failed to warn the players of the long-term neurological consequences of repetitive head trauma" said Stuart Davidson, co-lead counsel for the plaintiffs in the NHL case.

"They also relied on the statements where the panel concluded that a cause-and-effect relationship had not yet been demonstrated between CTE and concussions in sports."

'I would like for no one else to go through what my son went through'

Steve Montador's dad, Paul, continues to be concerned about the way the NHL deals with traumatic brain injuries.

"There are still people out there who deny CTE and it hurts me," he said.

"When I see a player being punched or hit violently it's emotionally difficult.," he said. "It upsets me because I immediately flash forward to the potential tremendous negative risk that that player could be subject to. And I would like for no one else to go through what my son went through."

And while a new consensus statement on concussion in sport is expected in 2021, It will be interesting to see whether the NHL continues to employ the last consensus paper in its case against the Montador family andCarcillo and Boynton in U.S. Federal Court, expected to begin in the coming months.

Brain Trust is a CBC Vancouver series that investigates the world of concussions, CTE and the medical research that informs their treatment.