Quinn Hughes, a defenseman for the Vancouver Canucks, was unable to join Team USA for the 4 Nations Face-Off championship game against Canada due to an oblique injury and a lack of medical clearance from his NHL team.

Hughes was expected to be a key player as Team USA's top defenseman, but he was not cleared by the Canucks' medical staff.

The overall chaos surrounding Hughes' absence underscores the need for clearer protocols regarding player medical care and roster management in future tournaments.

The situation was further complicated by Bruins defenseman Charlie McAvoy being hospitalized with an infection, which prompted discussions about Hughes as an emergency standby.

In Hughes' absence, Buffalo Sabres center Tage Thompson and New Jersey Devils defenseman Brett Pesce have been brought in as injury insurance for Team USA.

Although Hughes was cleared for contact in practice, he was not cleared to play, and he expressed gratitude to Team USA's general manager Bill Guerin for understanding his health obligations.

Confusion arose when initial announcements suggested Hughes would join the team, but he practiced in Vancouver instead of traveling to Boston, raising questions about communication between Team USA and the Canucks.

The Canucks prioritized Hughes' long-term health over his participation in the international final, as he had not played since January 31.

Team USA had previously defeated Canada 3-1 to secure their spot in the final, despite facing several health issues, including McAvoy's hospitalization.

Despite Team USA's desire for Hughes to participate, the Canucks' decision ultimately prevented him from traveling to Boston, even though he was willing to support his teammates.

The championship game against Canada is scheduled for 8 p.m. ET at TD Garden in Boston.

This situation highlights the complexities of managing player health and roster decisions in NHL-sanctioned international tournaments, where club interests can conflict with national team goals.