Race car drivers die because of lethal injuries caused by 6 different mechanisms which are examined here in detail. Much has been done, but much more must be done as most of racer deaths in the past few years are preventable with changes to track design.

Today (October 9, 2014) I update this article because of Jules Bianchi terrible accident at the 2014 Japanese Grand Prix. Although Jules has not died of his injuries (he is in very serious condition with severe brain injury), like the injuries of many others drivers discussed here, his accident was avoidable and preventable. The mechanism of Jules injury is discussed below in the appropriate section: Deceleration Injuries.

Previous updates were prompted by the death of another young racer, Sean Edwards. Sean's death, like that of Allan Simonsen 4 months prior, was predictable, avoidable and preventable. Sean died of a sudden deceleration injury just like Allen, Cause of Death number 4 below. It is imperative to understand that deaths due to sudden deceleration injuries are usually preventable with simple changes to track design to allow for a more gradual deceleration instead of a near instantaneous deceleration. A close look at the track design flaws that allowed for the death of Sean and Allen is included below in the section on Sudden Deceleration Injuries.

Allan Simonsen's Aston Martin at the start of the 2013 running of the 24 Hours of Le Mans.

The death of race car driver Allan Simonsen in the early minutes of the 2013 24 Hours of Le Mans, and now the terrible tragedy of Sean Edwards (10/15/13) and the near catastrophe of Dario Franchitti's crash at the Houston Grand Prix (10/6/13) has caused many fans and racers to question the safety of the sport, and to call into question whether the sanctioning bodies are doing enough to keep race car drivers safe. This article will take a close look at what happens to the human body that causes a racer's death, and just how far race car safety has come. In Section 4 (Sudden Deceleration Injuries) we will look at the death of Allen and Sean more closely and conclude that these were foreseeable and predictable crashes that resulted in deaths that were preventable and avoidable.

Six Medical Reasons Race Car Drivers Die.

1) Blunt Force Trauma

Blunt force trauma is the medical term for a blunt object hitting the body with minimal or no penetration of the skin (in contrast to penetrating injuries discussed below). Blunt force trauma can cause injury to many parts of the body, and most frequently this results in broken bones and various soft tissue injuries and not death. This was not always the case, however, as blunt force injuries were extremely common in all forms of racing prior to the implementation of seat belts. The universal use of seat belts, and the improvements in seat-belt design over the past 5 decades has saved the lives of countless racers. The seat belts keep the racers tightly attached to their racecars, preventing them from flying out of the car and hitting stationary objects. Blunt force trauma still is one of the most common causes of racer deaths, but since it requires that some stationary object hit the driver, deaths by blunt force trauma are far more common in open-cockpit racecars where parts of the driver are exposed.

Famous Race Car Driver Deaths Due to Blunt Force Trauma

The remains of Jim Clark's Lotus after his fatal crash. Jim Clark. On 7 April 1968, Clark died in a racing accident at the Hockenheimring in Germany. Clark's Lotus 48 veered off the track and crashed into the trees. He suffered a broken neck, skull fracture and a number of other chest and abdominal injuries. Clark died before reaching the hospital. As you will learn from reading further, these types of injuries are much more common for "open wheel" and more-specifically, "open cockpit" type race cars. The head, neck, and shoulders are exposed outside of the protective roll cage and bodywork of the car. As discussed later, all sanctioning bodies have required higher and higher side pods on open-cockpit cars over the years so that the driver's bodies are exposed much less than in years past. In fact, the past few years has seen the fastest of the prototype sports cars going away from open cockpit designs to those that are completely covered. The most obvious examples are the latest Audi R-18s that won the 2013 24 Hours of Le Mans, compared to the "same" car that won the race 10 years ago-the new one has the driver completely enclosed. Allan McNish's spectacular crash during the 2011 Le Mans is a great example of how modern race car design (including a completely enclosed cockpit) saved his life. There is simply no comparison in the overall safety between the Formula cars of the 1960's and modern "open cockpit" Formula cars. However, open cockpit cars by their very nature leave part of the human body exposed and therefore more vulnerable to certain types of injuries. Joe Weatherly. Joe Weatherly was the defending NASCAR series champion when he was killed in 1964, at Riverside International Raceway during the fifth race of the season. Upon impact with the wall, his head had come out of the window and been crushed against the wall, killing him instantly. His death lead to the development of window nets, which are now commonly used in many race car series across the world. Now you know why all sedan-type race-cars are mandated to have either a side window, or a window net. Dan Wheldon. Dan Wheldon was the reigning Indy 500 champion who's death caused tremendous anxiety and concern in all of our fellow racers. At the IZOD IndyCar World Championship at Las Vegas Motor Speedway on 16 October 2011, Wheldon was involved in a 15-car accident during lap 11 of the race, in which Wheldon's car flew approximately 325 feet (99 m) into the catch fence with the cockpit area first into a pole lining the track (supporting fencing to keep fans safe and to keep the cars from exiting the track). His cause of death was blunt force trauma to the head, measured at 250-G by the G-meters in the car ( YouTube video). This again, shows the increased vulnerability of open-cockpit cars to this type of injury. The new Dallara chassis used exclusively by all IndyCar teams since 2012 is named in honor of Dan (DW12) and includes changes to the cockpit and the front wing to help prevent these cars from lifting into the air and to provide better protection to the head/neck area. As horrific as Dan's crash was, a nearly identical crash occurred almost exactly 2 years later (10/6/13) when Dario Franchitti's car was launched into the air and into the catch fence at the Houston Grand Prix. The fence clearly saved the lives of many fans, and the design of the car saved the life of Dario who came away with several significant injuries, none of which was life-threatening. Watch YouTube Video Typical NASCAR seat provides lateral support and protection to head, neck, torso, and upper thighs. Jason Leffler. Jason Leffler was a popular NASCAR driver who died only 1 week prior to Allan Simonsen (June 12, 2013). Jason was running in second place in a heat race at a 0.625-mile, high-banked dirt oval when his car flipped several times on the front straightaway, hitting the wall twice and rolling. His autopsy showed the cause of death to be "blunt force trauma to the neck" (no other specifics are available at this time). Again note that Jason was driving an "open" car, a car without doors and windows that left his upper body exposed to outside objects. An important aspect of this accident that the car Jason was driving did not have the most modern type of seat that prevented lateral (side to side) movement of the head. This type of seat also protects the neck from blunt and penetrating trauma. The modern racing seat has "walls" along the bottom and sides of the seats which extend to the side of the helmets. These seats are the result of progressive improvements over many years with the purpose of supporting the body from flexing movements and torsional rotation. They also provide protection from blunt and penetration injuries (see below). Other noted racers dying from Blunt Force Trauma: Gilles Villenueve, Eddie Sachs, and Bruce McLaren. Again recognize that blunt force trauma as a cause of race car driver's death is much more common when the driver is exposed and not completely protected by roll cage and body work. Blunt force trauma was also much more common before the use of modern 5-point seat belts.

2) Penetrating Trauma

Penetrating trauma is the medical term for an injury sustained when a projectile (such as a bullet) or stationary object (such as a tree limb) penetrates the body. Penetrating trauma (lethal and non-lethal) is also less common for race car drivers who are racing sedan-type race cars where they are protected by the body of the car from objects which could potentially penetrate their body. Just like blunt force trauma, the universal use of seatbelts has dramatically decreased the number of injuries and deaths from penetrating trauma compared to the early years of racing. The design of the interior of the car also reflects safety measures taken to eliminate sharp objects, or items that are not well secured within the cockpit of all race cars. Penetrating trauma to an extremity is a non-lethal injury, but penetrating trauma to the abdomen, chest, neck and head can often be fatal.

Famous race car driver deaths / injuries due to penetrating trauma

HANS device to prevent cervical spine and basilar skull fractures

3) Spinal Cord Injuries / Base of the Skull Injuries

In contrast to the many deaths listed on this page, Felipe Massa is alive and very well, currently driving for the Scuderia Ferrari Formula-1 team. His inclusion here illustrates how the many sanctioning bodies that govern the sport of racing are looking out for racers and how one accident can cause the re-design of a piece of equipment. On 25 July 2009, in the second round of qualifying for the Hungarian Grand Prix, Massa was struck in the head by a suspension spring that had fallen fromRubens Barrichello's Brawn , on a high-speed part of the track. Though wearing the most modern helmet, the spring hit with sufficient force that it actually penetrated the helmet causing a penetrating injury to his left eye. He subsequently crashed head-on into a tire barrier (which caused no injuries and can be seen in this video of the accident to absorb tremendous energy). Massa recovered completely to race for Ferrari the following year, but within 1 year virtually all sanctioning bodies that govern the rules of racing changed the requirements for helmets that are used in professional racing world wide. So my fellow drivers, when you were told in 2011 that the helmet you had been using was no longer legal for the 2011 season, requiring you to buy a new FIA 8860 approved helmet-now you know why. They are trying to protect our pretty noggins! The newer helmets are designed to help prevent penetration by flying objects and are thicker and made of stronger components.

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 video shows, 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. Cervical spine injury (at arrow) showing dislocation of the 6th vertebra with spinal cord transection causing 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.

4) 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

Sudden deceleration injuries can cause veins in the covering of the brain (the dura) to break, leading to a blood clot between the brain and skull: Subdural Hematoma, an uncommon cause of race car driver death. 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. Mark Donohue Crash Video. Michael Schumacher. Of course Michael Schumacher did not die from his head injury, nor did he suffer a head injury while racing a car. I put his injury here to show that injuries occurring during a race can happen in other areas of life. The goal is to minimize the opportunity for these to happen. Michael suffered a subdural hematoma after hitting his head on a rock while skiing on December 29, 2013. He was wearing a helmet and there was no external signs of injury. The injuries were to his brain due to a sudden deceleration exactly like Donohue's injury above. And, like Donohue, he was conscious for a while, even communicating appropriately at first. It was not until some time later at the first hospital he was taken to did he become unconscious and the seriousness of the injury was recognized. He was then transferred to a second hospital by helicopter where he was able to undergo a CAT scan which showed his injuries, and then with no neuro surgeon available, more time was lost while one could be flown into the hospital to provide the necessary surgery to relieve the pressure on his brain. Time is of the essence, in both recognition of the injury and it's prompt treatment. The system failed Michael that day. this accident was avoidable and probably should not have happened. He ran into the back of a crane that should not have been in an area that could be hit by another car, and certainly not under the conditions present. F1 and the FIA will no doubt make some changes in this regards, because we simply must protect racecar drivers better. (Watch video of the crash)

Race car driver deaths due to sudden deceleration injuries to the aorta and other solid organs (Liver, vena cava, pulmonary hilum).

Sudden deceleration can cause the aorta to rip from its attachments in the upper chest.

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. Accident Video. 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. Accident Video. Allan Simons en . Alan Simonson was a popular and very successful young racer who died at the 2013 running of the 24 Hours of Le Mans. 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 (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 cause of this terrible tragedy is related to a sudden deceleration injury, either to the brain, or to the aorta. As of this revision (10/15/13) official autopsy reports are not available. Crash video from American television. The real tragedy is that this was a preventable death. The details are discussed at the end of this article along with details about Sean Edwards crash and death due to sudden deceleration injuries. but cars moving at a high rate of speed often skip over the gravel without slowing substantially (or at all). There are multiple excellent examples of this including Allan McNish's accident at Le Mans 2011, and Gunter Schaldach's crash at Road America 2011. Gunter's crash at Road America (with Joe Foster who also went through the gravel trap without slowing) could have been lethal as Sean's was except that the tire wall at Road American turn 1 is not backed by a cement wall and Gunter was allowed to continue past the tire wall slowing (decelerating) at a rate that is tolerated by the human body. Obviously this turn can be improved so that the car cannot leave the track, but it illustrates beautifully that gravel traps do not slow cars that are going at a high rate of speed, and the ultimate key to surviving a high speed crash is to provide for a mechanism to slow the car gradually and not suddenly. Sudden deceleration is simply not tolerated by the human body, and gravel traps are not an adequate mechanism at the end of a high speed straight. Similarly, tire walls are a very simply yet very effective solution to slowing cars gradually, but it is well known now that multiple layers of tire walls (often separated by a few meters) provides a much better means of slowing cars than a single row of tires. Furthermore, as Sean's crash points out very well, tire walls (and armco barriers) are not effective for high speed crashes when they are immediately adjacent to an immovable object (i.e., cement wall, tree). There are a number of ways that car in which Sean was riding could have been slowed prior to hitting the wall at an estimated 160 MPH. Several rows of staggered tires is a very simple solution that allows the energy of the car to be dissipated into other objects thus slowing the car. Having multiple rows of tire walls also helps in those uncommon cases where a car can go under or over one barrier without stopping, since there is an opportunity for the second tire wall to catch the car. 5) Fire as a cause of race car driver death. Fire is an obvious cause of race car driver deaths, but this is extremely uncommon. One of the most horrific fire deaths was that of Roger Williamson who died in the 1973 Dutch Grand Prix when his March Formula 1 car flipped and caught fire after a tire failure. Williamson was uninjured from the physical crash of the car, but succumbed to fire/smoke inhalation. This gripping and very sad video shows his friend and fellow driver David Purley try in vain to flip the car back on its wheels to free Williams, and then try to extinguish the fire. Sadly, no safety team arrives within any reasonable period of time and other observers fail to help. IndyCar and NASCAR travel with their own safety teams who are highly trained and can respond to accidents very quickly. Other forms of racing are sorely lacking in this department and need considerable work, including Grand-Am and ALMS (soon to be USCAR). Modern fuels, fueling equipment, race car fuel cells, and car designs have seen deaths from fire become quite rare. Fires do injure persons in the pits and occasionally fans, but regulations are frequently updated and safety measures increased regularly to decrease the incidence of all fires in and around race cars and the race track. Formula 1 has gone so far as to eliminate (ban) refueling during the race beginning in 2012 after numerous fueling accidents over the years. 6) Medical Deaths - Race Car Driver Deaths Unrelated to Trauma The same day that Allan Simonsen died at the 2013 running of the 24 Hours of Le Mans, two-time German VLN Endurance Racing Champion Wolf Silvester died because of a heart attack suffered during the VLN race at the Nurburgring. Safety marshalls at Saturday's race said Silvester apparently lost control of his Opel Astra OPC, and when they approached the stopped car on the track they found him sitting motionless in the seat. Race car drivers are under considerable stress during these races. All sanctioning bodies require EKG's of their drivers every 2 years, with annual EKG's required for us older guys over 50. It may seem like a pain in the butt to my fellow drivers (and myself), but the reasons for having our tickers checked out is clear. Several times per year a driver dies while driving a race car without ever hitting a wall or crashing. Racing is stressful on our hearts! Can Racing Be Made Safer? Do Race Car Drivers Need to Die? Ayrton Senna had grown very concerned about the safety of Formula 1 during the few months preceding his death. In the days following the tragedy at the 2013 Le Mans, we heard from dozens of racers who are concerned about their own safety and the safety of those around them. Four months later my fellow drivers are asking what we have accomplish now that another friend, Sean Edwards has died. They are questioning whether the sanctioning bodies who run these races are doing enough. They are waking up to the fact that many tracks still have one or two turns that are far too risky that must be addressed. Race car drivers are safer than ever before, but there is still work to do - and some of that work is for the drivers themselves to do. The cars are safer, the pit stalls are safer, the helmets and suits are safer. Race tracks are being made safer every year, but unfortunately, these changes seem to occur only after a serious-if not lethal-crash. There is no greater example of the changes to race tracks to make them safer than the addition of the two chicanes along the Mulsanne straight within the Circuit de la Sarthe (home of the 24 Hours of Le Mans), however it took a number of high-speed crashes before this obvious change was made. In NASCAR, the addition of SAFER barriers at most tracks adds a degree of "flexibility" to the outside wall which serves to decrease the G-forces imparted on a race car driver-obviously to decrease the impact of deceleration-type injuries. However, it appears that Allan and Sean would still be alive today had several very simple things been done differently at their respective tracks. Track officials, owners, and race promoters / organizers evaluate tracks on a regular basis. Unfortunately, this is often because of insistence of the racers themselves, or by the track's insurer. When these tracks change, the reason they do is so that we have less of a chance of hitting something head-on or at an angle that could put a driver or even the fans at risk of injury. Removing immovable objects from the potential trajectory of a race car seems amazingly intuitive-so much that there is no surprise that many drivers are frustrated and angry. Each individual racer's active involvement, consistent with the standards first demanded by Jackie Stewart, is the way to proceed, rather that expecting a regional, federal or even global standard to accomplish something that represents an actual improvement for the sport. Often the best way to accomplish necessary change is through education (the primary purpose of this article). Has the time come for a universal driver's group to come forward to provide a louder and unified voice advocating change in the name of safety? In Summary: Ultimately, as in any type of accident with severe results, the required elements are the deadly combination of extreme forces applied at a critical time with the inability of the body and/or the equipment (usually both) to protect against severe damage. In other words, driving a race car at 200 mph is inherently more dangerous, because of that inability to control all amplified factors of risk perfectly, than other low-speed, low risk activities. We can work to improve the courses we race upon, the cars we race in, and the gear we wear while racing, but at the end of the day, we still require a dose of good fortune to survive a big crash. Our bodies remain the most fragile part of the race car, and excessive forces absorbed by the human brain, spine and torso ultimately will cause deadly harm if the wrong combination of factors occurs at impact. For sure, there's reason to continue to strive to make all aspects of our sport as safe as possible, but the human element can never be strengthened to the point of invincibility. Because human flesh is so vulnerable, all efforts must be made to prevent the 6 distinctly different external forces from being applied. No effort should be overlooked. Race hard, enjoy the thrill of our sport, but give a thought to those who have made our lives and careers safer and longer by what we have learned, and continue to learn, with each tragic loss. Let's work together to improve the sport we so dearly love. Additional References:

Dr Norman's bio on Grand-Am.com

Wikipedia list of race car drivers deaths

Complete report of the Dan Wheldon accident.

The authors note that the information contained within this article comes from dozens of sources online. Multiple links are included within the text to the origin of the information.

Note that this article was published within the Parathyroid Blog of Dr Norman's website parathyroid.com. Please feel free to link, copy, and otherwise distribute this article as you see fit, provided a link back to this site is maintained.