By Dr. James Norman, originally published on June 23, 2013 on the Hyperparathyroidism Blog
The death of Allan Simonsen at the 24 Hours of Le Mans and the death of Jason Leffler one week prior prompted a review of the six different medical causes of race car driver deaths, and what is being done to make racing safer.
There are many reasons for racing’s popularity, but the inherent danger of the sport surely plays a role.
The death of race car driver Allan Simonsen in the early minutes of the 24 Hours of Le Mans this past weekend has caused many of our fellow racers to question the safety of the sport, and to call into question whether the sanctioning bodies are doing enough to keep us safe. Our friends and co-drivers / racers feel vulnerable during these times, as they did only one week earlier following the tragic death of Jason Leffler during a race in New Jersey. The feelings of vulnerability and sadness, and the questions about safety expressed by drivers – and fans – today is the same as we saw just over 1 year ago with the tragic death of Dan Weldon. Often, we see anger as they wrestle with these emotions thinking that something should have been done to prevent another racer’s death. This article will take a close look at just how far race car safety has come and the mechanism of driver death that has gotten us here. But at the end of this article, we will look at Allan’s death more closely and conclude that this was likely a foreseeable and predictable crash–and resulting death. This was an unnecessary race car driver death.
Race Car Driver’s Death — Analysis from two surgeons who are also racers
As a current racer in the Grand-Am Rolex series, I called upon my fellow driver and neurosurgeon Dr Jim Lowe to help me put these deaths into perspective, and to review in lay-terms the medical causes of race car driver deaths. We wanted to show the progress that has been made because of some very famous and well publicized racer deaths concluding that it is up to the drivers to demand continued change and further safety measures. What follows here is a review — from a medical point of view — is the six reasons why race car drivers die. We aren’t going to say that they died because of a suspension failure, or brake failure, we are going to tell what happened to the racer’s body that caused the death. We won’t leave it there, however, we will help you understand how the rules were changed to protect drivers so that these injuries and deaths become more and more rare. You will see from Allan Simonsen’s death, however, that there is still work to be done!
Blunt Force Trauma
Penetrating Trauma
Spinal Cord Injuries / Base of the Skull Injuries
Injuries to the cervical (neck) spine and, most commonly, where the spine attaches to the skull are rarer than they ever have been, primarily because of the mandatory use of “head and neck restraining” devices. The authors of this article, like virtually all of our fellow racers use a HANS device which quite simply prevents our head from flexing forward during the deceleration that comes with a forward crash / deceleration. Since our shoulder harnesses cover both shoulders holding them firmly back into our seats, a sudden deceleration injury would allow our head to flex rapidly forward and down, thereby causing fractures to the base of the skull and/or the upper cervical vertebrae. This typically causes death by several means, including damage to the upper spinal cord and/or lower part of the brain resulting in the inability to move and breath.
Famous race car driver deaths from cervical spine and basilar skull fractures.
- Dale Earnhardt. Dale Earnhardt’s death had a huge impact on all racers world wide, bringing to the forefront the dangers of head and neck injuries. Earnhardt died during the final lap of the 2001 Daytona 500 on February 18, 2001. He was involved in an accident during the final lap, in which his car was turned from behind into the outside retaining wall. He was pronounced dead shortly afterwards and as you will read subsequently, sudden death usually has only a few causes. Different types of head and neck restraining devices were in development at that time, and NASCAR approved their use, but did not require drivers to use one. Many drivers (myself included) felt that the devices limited the mobility of their head and thought it to be uncomfortable. Shortly after Earnhardt’s death, all sanctioning bodies worldwide began to mandate the use of one of these devices. From a racer’s point of view, it took about 2 hours to get used to wearing this device and I don’t know a single person who would get into a car without one. It makes us feel safer, and it IS safer. It is too bad that the Intimidator had to die for the rest of us to wake up. As this videoshows, it doesn’t take a huge impact to cause a lethal basilar skull injury; it is the angle of the hit and the lack of support given to his neck that is responsible for Earnhardt’s death.
Adam Petty. On May 12, 2000, Petty was practicing for the Busch 200 NASCAR Nationwide Series (then Busch Grand National Series) race at the New Hampshire International Speedway in Loudon, New Hampshire. While entering turn three, Petty’s throttle stuck wide open, causing the car to hit the outside wall virtually head on. Petty was killed instantly due to a basilar skull fracture. It is highly likely that Adam would have survived this crash had he been wearing a mondern HANS device.
- Jim Fitzgerald. As a young trauma surgeon, the author of this article (Dr Norman) was working as a track physician at this race in 1987 near my home town at the 1987 St. Pete Grand Prix. Fitzgerald died instantly of his injury after hitting one of the cement barriers nearly head-on. His near immediate death without any evidence of physical trauma (he wasn’t bleeding, and had no obvious penetrating or blunt injuries) meant to us that he died of a basilar skull fracture, or a transected aorta. At autopsy he was found to have a basilar skull fracture.
Sudden Deceleration Injuries with Internal Organ Disruption
Sudden deceleration injuries can occur in any person subjected to rapid slowing of their body such as during an head-on car crash. The mechanism of injury is that the body is forcibly stopped but the contents of the body cavities remain in motion due to inertia; the brain is particularly vulnerable to such trauma as is the aorta (the large artery that exits the heart). For this discussion, we will give examples of both types (brain and aorta). Deceleration injuries to the brain typically result in a sub-dural hematoma, while deceleration injuries to the aorta typically result in an “aortic transection”.
Race Car Driver Deaths due to Sudden Deceleration Injuries to the Brain
- Mark Donohue was killed during a practice session for the 1975 Austrian Grand Prix. On his second lap, while at about 260 km/h a rear tire of his March 751 – Ford suddenly blew, the out of control car went through the fence for about 180 feet, over a guard-rail and into a ravine. Donohue was hit in the head by a fence post and knocked unconscious. Several minutes later Donohue regained consciousness. There is film of him speaking to his rescuers and looking quite un-injured. He was taken to the hospital for observation. During the day he became confused and slipped into a coma, classic signs of a sub-dural hematoma that every nurse and doctor knows today. He was operated on later that night by a neurosurgeon but he died of his injuries two days later. This type of death is extremely unlikely today with much more knowledge of closed head injuries and better training of track medical staff that can recognize the early signs of brain injuries and blood clots. The universal use of CAT scans for any racing driver who is even suspected of having a closed head injury is another reason why racecar driver’s deaths from this cause are rare and should probably never happen. If you complain of a headache or a loss of consciousness after a crash, my fellow racers, you can expect a trip to the local hospital for a CAT scan of your brain. You can thank Mr Donohue for helping save many future racers.
Race car driver deaths due to sudden deceleration injuries to the aorta.
- Scott Kalitta. Scott Kalitta was a Top Fuel racer from the famous Kalitta racing family. On June 21, 2008, Kalitta was fatally injured during the final round of qualifying for the Lucas Oil NHRA SuperNationals. His car was traveling at about 300 mph when the engine exploded into flames near the finish line. The parachutes were damaged and failed to slow the vehicle and he hit a concrete-filled post that supported a safety net. He was transported to the hospital and was pronounced dead on arrival.
- Roland Ratzenberger. Roland Ratzenberger died during practice for the same race where Ayrton Senna lost his life the following day. Ratzenberger had several lethal injuries, including a transection of the aorta and a basilar skull fracture.
- Allan Simonsen. Although we do not know the actual cause of death of Alan Simonson at yesterday’s 24 Hours of Le Mans, reports are that he was conscious and talking when rescue workers first tended to him, only to have him become unconscious a few moments later, to be pronounced dead a short time later. He was driving in one of the most modern sedan-type cars (not open-cockpit) and his factory sponsored Aston Martin had every possible modern piece of safety equipment. This in car video from the car behind shows the likely cause (our opinion) of Allan’s crash was acceleration of the car while the left rear tire was on the “painted” (and very slick in the wet) blue line. His car veered suddenly to the right and then back to the left in an attempt to correct (opinion), but by then the car was out of control and it hit the armco (guard railing) on the outside of the track at a near-head-on trajectory (keep reading below). There was no evidence of penetrating injuries, and no evidence of blunt force trauma. Thus the likely cause of this terrible tragedy is almost certainly to be related to a sudden deceleration injury, either to the brain, or to the aorta.
HOWEVER, the real tragedy here appears to be not the “painted” curb, but the fact that the armco (guard rail) is immediately adjacent to a large mature tree. Guard rails have an inherent “give” to them that is part of the design, making them much more “forgiving” and accepting of imparted forces than a brick wall (or mature tree). The reason to have guard rails instead of brick walls and cement barriers is because the design of the guard rail is such that it is fixed to the ground at 3-4 meter (6-10 foot) intervals. The intervening “railing” can dent and be depressed inwards thereby absorbing some of the impact that otherwise would be imparted onto the driver. Having the armco guard railing next to the tree is not much different than having no guard rail whatsoever, or having the guard rail bolted to a cement wall. Understandably, the Circuit de la Sarthe has shown few official photos, and pictures from TV cameras are limited but clearly the fans know what happened and quickly erected a memorial at the site–shown in the picture on the right. The authors of this article have seen sufficient evidence to show that the armco at this turn is immediately adjacent to a mature tree, and therefore, Allan’s death is apparently due to his car hitting a tree at some 110 or so MPH. (Note: entry to Tetre Rouge in a GT car is approximately 129, 103 at the apex, and 121 at the exit).
- Yes, the Circuit de la Sarthe, the site of the 24 Hours of Le Mans, is a “historical” venue, hosting this most famous race on “public” roads that anybody can drive upon for 50 weeks of the year. Notwithstanding this fact, it is most reasonable for racers to expect, if not demand, that there is no opportunity to hit a stationary object (such as a tree) at any reasonable rate of speed. Thus, it is most likely that the “painted” blue stripe caused Allan’s car to become out of control, however it is the sudden impact with an immovable object (mature tree) that imparted tremendous deceleration injuries to Allan’s body that ultimately caused his death. Of course it does not go unnoticed that the armco was repaired in front of the tree and the race continued. Could there have been a second death at that turn? The rain persisted on and off throughout the entire event, as did the blue paint, and the tree…
Fire as a cause of race car driver death
Medical Deaths — Race Car Driver Deaths Unrelated to Trauma
Can Racing Be Made Safer? Do Race Car Drivers Need to Die?
