Published on October 01, 2021

Trauma Team Provided Lifesaving Care to Rugby Star

Photo of Toti Manufekai and Registered Nurse Brian Howell, R.N., B.S.N., standing in front of the Emergency Department at MidMichigan Medical Center - Midland in Midland, Michigan.

Professional rugby player Toti Manufekai credits his trauma care team, including Registered Nurse Brian Howell, R.N., B.S.N., for saving his life after a serious car crash.

Siaosi (Toti) Manufekai is a professional rugby player originally from the island of Tonga near New Zealand. He came to the United States to play in Utah where he met his wife, Wyn. They decided to move to Bay City to be near her family and to start their own.

Things were going well until Manufekai was involved in a rollover car crash that left him in critical condition. The MidMichigan Health trauma team provided life-saving care that has Manufekai on the road to recovery.

Manufekai was holding two jobs during the rugby off-season as he and Wyn were expecting their second child in June 2021. He was driving to work when the accident occurred. “I don’t remember many details from the crash,” said Manufekai. “I’m not sure whether I was ejected from the vehicle or pulled myself out, but I do remember hearing sirens and telling a woman who was there to let my wife know I love her.”

Manufekai was transported to MidMichigan Medical Center – Midland’s Emergency Department. Asha Shah, M.D., trauma medical director, was present upon his arrival. Upon her initial evaluation, it was clear that he sustained significant chest and abdominal injuries. He was immediately taken to the Operating Room and was found to have a shattered spleen that required a splenectomy and a hole in his diaphragm, the large muscle located below the lungs allowing for respiration.

“I was coming off 72 hours of call and was hopeful for a quiet morning; however, soon the pager went off for a Level 1 trauma, which is the most serious,” said Dr. Shah. “When I came to the trauma bay, I saw a young, healthy male unstable and in distress. There were points when his blood pressure was so low, I didn’t think he would make it. The entire ER and trauma crew worked hard as a team to save this man’s life.”

Manufekai also suffered multiple rib fractures with bruising to both lungs, an injury to his kidney and a spinal fracture in the lumbar region. His family in the U.S. and Tonga were all praying for recovery. “When I woke up in the hospital, I wasn’t sure where I was and didn’t understand the extent of my injuries and surgeries,” he said. “Was it a dream? Once things became clearer, I understood that I had been fighting to get through this. I was determined to live and get better.”

Many credit Manufekai’s survival to the excellent condition he was in prior to the accident. He agrees that it probably helped but also believes that the care he received was an important factor. “Everyone at MidMichigan Health was amazing,” he said. “The doctor and nurses were fantastic. They took such good care of me. Brian Howell, a registered nurse in the Neuro/Trauma Intensive Care Unit, was especially great to me.”

Family and friends near and far came to the aid of Manufekai and Wyn, both during his extensive time in the Medical Center and when he was released to go home. He continues to focus on healing and carefully rebuilding his strength. “I’m not thinking about rugby right now,” Manufekai said. “I am concentrating on my family and getting myself stronger.”

Manufekai is now back to work and hopes to get back on the rugby field next year. With thanks to God, his doctor and trauma team, and his own personal drive, he is confident that his chances are good. Whatever happens, he is grateful to be alive to have welcomed his daughter into the world. “It is a very interesting feeling, coming through something like this,” Manufekai reflected. “I believe angels were watching over while the hospital cared for me. I feel truly blessed.”

MidMichigan Medical Center – Midland is designated as a Level II Trauma Center and is able to provide comprehensive trauma care for injured adult patients. Those who are interested in learning more about MidMichigan’s trauma services may visit