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Earnhardt autopsy report answers, leaves questions
By Mike Fish, CNNSI.com
Speculation surely will persist on whether a head-and-neck restraint device could have saved Dale Earnhardt's life, but it's now apparent that the NASCAR great died from a basilar skull fracture during a crash on the final lap at last month's Daytona 500.
In his final report released Monday, Dr. Thomas Parsons, Volusia County associate medical examiner, described Earnhardt as suffering a "ring fracture of base of [his] skull,'' along with multiple fractured ribs and other none life-threatening fractures.
The significance of the findings is it lumps Earnhardt with three other NASCAR drivers -- Adam Petty, Kenny Irwin and truck racer Tony Roper -- who died from basilar skull fractures or related conditions last season. Thought to be caused by the violent whip-like motion of the head upon impact, the injury has rapidly evolved as the sport's No. 1 killer.
"It sounds like a circular fracture on the underside of the skull, where the skull rests on the upper portion of the spine," said Dr. Randy Hanzlick, president of the National Association of Medical Examiners, after reviewing the seven-page report. "Blood in the ears is typical when you have a basilar skull fracture. A little blood in the lungs. This is all typical of basilar skull fractures."
Robert Hubbard, inventor of a head-restraint apparatus known as the HANS device, was not surprised to learn the findings, adding: "I can't promise that the HANS is going to save everybody in this kind of a crash, but it would have helped him."
The official cause of death is listed as "blunt force injuries of the head," and doesn't waver from the preliminary report. It noted, among other things, that Earnhardt sustained:
•Eight broken ribs on his left side.
•Broken left ankle.
•Fractured breast bone.
•Collarbone and hip abrasions, an indication the seat belts didn't fail.
What's missing here is a cause of the fatal injury.
Dr. Steve Bohannon, who serves as a medical expert for NASCAR, has speculated Earnhardt could have been thrown forward and to the right because of a broken left lap belt, causing his chin to hit the steering wheel and triggering the skull fracture. Others have suggested that he died from injuries caused by his head's whipping forward violently.
The conflicting theories are the reason why the Orlando Sentinel is attempting to have an independent medical expert view the Earnhardt autopsy photographs.
Earnhardt didn't wear a newfangled neck brace, and NASCAR has come under increasing criticism for not mandating drivers use the safety device.
Hanzlick, the Fulton County (Ga.) medical examiner, saw only the written report and refused to speculate on what caused the basilar skull fracture. He did, however, note conflicting details for both theories. One, there was no separation of spine and skull -- which is typical of whiplash. And, as for claims Earnhardt's hitting the wheel triggered the injury, he suffered no broken jaw or facial fractures and only a small scratch on his chin.
"You have a major impact that caused a head fracture," Hanzlick said. "Without looking at the helmet and inside the vehicle, it's hard to say what happened. The key is they've got to pull all this together, along with the damage to the vehicle, the dash, the steering wheel." While acknowledging his own conflict because of his tie to the HANS device, Hubbard pointed out the pattern in NASCAR's four deaths in a 10-month period.
"It's the same story -- basilar skull fracture," said Hubbard, professor of biomechanical engineering at Michigan State. "He had a broken seat belt, that is the confounding variable. ... But the cause of death was the head injury, not chest injuries. Dale didn't have massive internal injuries."
One other issue the final report seems to address is whether Earnhardt's lap belt failed before or after his car collided with the outer wall at Daytona.
Both Dr. Hanzlick and Hubbard suspect the abrasions on Earnhardt's left and right hip likely were caused by the safety belts at impact.
"If the belt had let him go, he'd have just smashed into the instrumental panel," Hubbard said. "He didn't. It appears he got the abrasion and skull fracture before the belt let go