The Feature



Race Car Deaths: The Medical Causes of Racing Deaths with Examples and Resulting Race Car Improvements.

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.

Auto racing is the second most popular form of sports worldwide. 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!

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

  1. 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 today’s 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 24 Hours of Le Mans is a great example of how modern race car design (including a completely enclosed cockpit) saved his life.

  2. 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.

  3. Dan Weldon. Dan Weldon 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. His cause of death was blunt force trauma to the head, again, showing 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.

  4. Jason Leffler. Jason Leffler was a popular NASCAR driver who died only 1 week ago (June 12, 2013). He was running in second place in the first heat race of the program at the 0.625-mile, high-banked dirt oval when his car flipped several times on the front straightaway, hitting the wall twice and “then it was flopping all over.” His autopsy released just 2 days ago shows the cause of death to be blunt force trauma to the neck. Again note that Jason was driving an “open” car, a car without doors and windows that left his upper body exposed to outside objects. A very important aspect of this accident that is now being reported is 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, while protecting 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.

  5. 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.

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

  1. Ayrton Senna. Aryton Senna is widely regarded as the one of the top race car drivers of all time. Senna was leading the 1994 San Marino Grand Prix at Imola, Italy when his car left the track and slammed into the retaining wall at 135 miles per hour. The right front wheel housing was pushed backwards and slammed into his helmet, causing fatal skull fractures. His cause of death was penetrating trauma due to the suspension piece that penetrated his helmet. Had the trajectory of the crash been only a few degrees different, it is likely that the suspension piece would have missed him completely. Since that time, suspension parts are designed differently and in a manner that their components are much less likely to break in such a way as to become a “spear”.

  2. Filepe Massa. In contrast to the many deaths listed on this page, Filepe 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 from Rubens 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). 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.

3) Spinal Cord Injuries / Base of the Skull Injuries

Preventing Race Car Drivers Deaths with Hans Device

HANS device to prevent cervical spine and basilar skull fractures

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.

  1. 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.

  2. Race car driver death due to uncommon c-spine dislocation.

    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.

  3. 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

  1. Race car drivers death: subdural hematoma as a cause

    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.

Race car driver deaths due to sudden deceleration injuries to the aorta.

Aortic dissection as a cause of race car driver's deaths.

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

  1. 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.

  2. 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.

  3. 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.

  • Allan Simonsen Tree at Le Mans causing death.

    Damage to tree where Allan Simonsen was killed at Le Mans, 2013

    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…

Racing Death at entry to Tetre Rouge, Le Mans, 2013

The track enters from top left toward bottom right. This turn is named “Tetre Rouge”, the site of Allan Simonsen’s death at Le Mans, 2013

Armco guard rails adjacent to trees at the exit of Tetre Rouge, Le Mans 2013

Armco guard rails adjacent to trees at the exit of Tetre Rouge, Le Mans 2013. Hitting one of these trees in excess of 110 MPH was the cause of Allan Simonsen’s death (due to sudden deceleration injury).


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. Modern fuels, fueling equipment, race car fuel cells, and car designs have seen deaths from fire become a thing of the past. Fires do injure persons in the pits and occasionally fans, but regulations are always updated and safety measures increased annually to decrease the incidence of all fires in and around race cars and the race track.

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?

During the past week Jim Lowe and I have seen and heard from dozens of our fellow racers who are concerned about their own safety and the safety of those around them. They are questioning why Jason and Allan died this past week, and whether the sanctioning bodies who run these races are doing enough. Our message to them is clear: we are safer than ever before, but we still have work to do — and some of that work is ours. The cars we drive are safer, our pit stalls are safer, our helmets and suits are safer. But equally importantly is that the race tracks are being made safer every year. 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). 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.

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 ourselves or even the fans at risk of injury. In the case of Allan Simonsen, however, the change that might save a life in the future may be as simple as removing all trees that the cars could potentially hit. All racers know that painted surfaces are slick as ice in the rain, but there has to be a better way to delineate the edge of the track–or find a better paint. Likewise, removing immovable objects from the potential trajectory of a race car seems amazingly intuitive–so much that there is no surprise that many of our fellow drivers are frustrated and angry. Each individual’s active involvement, consistent with the standards first demanded by Jackie Stewart, is a better way to proceed, rather that expecting a regional, federal or even global standard to accomplish something that represents an actual improvement for the sport. The authors share the frustration of our peers, but worry that there’s little to be accomplished without the ones at risk — the drivers themselves — taking a stand. Often the best way to do that is through education (the primary purpose of this article).

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:

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








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