Sunday Times 2
Could Princess Diana have survived the crash?
Princess Diana and her boyfriend Dodi Al Fayed departed from the rear entrance of the Ritz Hotel around 12:20 am on August 31, 1997, heading for Dodi’s apartment in Rue Arsène Houssaye in Paris. They were the rear passengers. Trevor Rees-Jones, a member of the Fayed family’s personal protection team, was in the right front passenger seat.
Princess Diana (left) and the wreckage of the Mercedes-Benz S280
Henri Paul, the deputy head of security at the hotel drove the Mercedes-Benz S280 to elude the paparazzi following the Princess and Dodi. They drove along the embankment road along the right bank of the River Seine into the underpass.
Around 12:23 a.m. at the entrance to the tunnel, Paul lost control. The car swerved to the left of the two-lane carriageway before colliding head-on with the 13th pillar supporting the roof at an estimated speed of 105 km/h (65 mph). It then spun and hit the stone wall of the tunnel backwards, finally coming to a stop.
As the victims lay in the wrecked car, the photographers, who were following the car rejoined, rushed to help, tried to open the doors and help the victims, while some of them took pictures. Critically injured, 36-year-old Diana was reported to murmur repeatedly, “Oh my God.” Fayed had been sitting in the left rear passenger seat and appeared to be dead.
None of the occupants was wearing seat belts.
Paul and Dodi were taken to the Institut Médico-Légal (IML), the Paris mortuary, not to a hospital. Autopsy examination concluded that Paul and Fayed had both suffered multiple injuries.
Rees-Jones, who had suffered multiple serious facial injuries was conscious. Princess Diana, who had been sitting in the right rear passenger seat, was also conscious. It was first reported that she was crouched on the floor of the vehicle with her back to the road. It was also reported that a photographer described her as bleeding from the nose and ears with her head resting on the back of the front passenger seat. He tried to remove her from the car but her feet were stuck. Then he told her that help was on the way and to stay awake; there was no answer, just blinking.
A physician of France’s emergency medical service SAMU (Service d’Aide Médicale Urgente), which arrived soon after said in a deposition that Princess Diana was crying out. When he could not reassure her, he started an intravenous drip in her arm and at 12:45 am infused intravenous midazolam (a sedative) and fentanyl (an opioid analgesic 80 times more potent than morphine), to “calm her down”.
After administering the drugs and beginning to extract the patient from the car, the physician noted that Princess Diana went into cardiac arrest (her heart stopped beating). He performed endotracheal intubation (inserting a tube into her windpipe to open and maintain her airway), placed her on a respirator (to ventilate her lungs with oxygen through the tube in her windpipe), and performed external cardiac massage to reestablish her cardiac rhythm. There apparently was no appreciation for the seriousness of her internal blunt injuries. The SAMU team spent about 30 more minutes (from around 12:50 a.m. — after the cardiac arrest — to 1:19 a.m.) tending to Princess Diana in the tunnel.
At 1:19 am, the SAMU team contacted the SAMU de Paris medical dispatcher to request permission to take her to a hospital four miles away. The medical dispatcher called the hospital to assess for ICU bed availability, which was normal procedure. Emergency departments at the time were not equipped to deal with critically injured patients!
At 1:29 am, the hospital agreed to the SAMU medical dispatcher’s request. Thus, by the time the SAMU medical dispatcher had finalised the decision for the SAMU ambulance to proceed to the hospital, Princess Diana had been at the scene bleeding internally into her chest for 64 minutes (12:25 am-1:29 am). The “golden hour” was used up, but she was still alive, attesting to the potential survivability of her injuries.
Princess Diana was treated at the scene for a heart attack and only after two hours was taken to hospital. By the time she arrived, she was unconscious under artificial respiration, and her blood pressure was low, but her heart was still beating.
At 2.10 a.m., she suffered a second heart attack, after which she received large doses of adrenaline to keep her heart beating. Following surgery, her heart was massaged by hand to keep it beating. Her torn pulmonary vein was stitched and the internal haemorrhaging was controlled. Finally, the princess received electric-shock therapy to try to keep her heart beating. When that failed, she was pronounced dead at 4 a.m.
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At a news conference one hour later, the doctors read a five-sentence communiqué that cited an important wound in the left pulmonary vein as the source of the internal bleeding that killed her. The communiqué made no specific mention of other lesions. Nor did the French coroner’s report, which listed the cause of death as internal hemorrhaging due to a major chest trauma and a phenomenon of deceleration which caused a rupture of the left pulmonary vein.
An 18-month French judicial investigation concluded in 1999 that the crash was caused by Paul, who lost control of the car at high speed while drunk. His inebriation may have been made worse by the presence of an anti-depressant drug and traces of a tranquilising anti-psychotic drug in his body.
Since February 1998, Dodi’s father, Mohamed Al-Fayed (the owner of the Hôtel Ritz, for which Paul worked) claimed that the crash was a result of a conspiracy, and later contended that the crash was orchestrated by MI6 on the instructions of the Royal Family. (The Secret Intelligence Service, commonly known as MI6, is the foreign intelligence arm of the UK government). His claims were dismissed by a French judicial investigation and by “Operation Paget”, a Metropolitan Police Service inquiry that concluded in 2006.
In the UK, an inquest headed by Lord Justice Scott Baker into the deaths of Diana and Dodi began at the Royal Courts of Justice, London, on October 2, 2007. This was a continuation of the inquest that began in 2004. On April 7, 2008, the Coroner’s jury concluded that Diana and Dodi were unlawfully killed by the “Grossly negligent driving of the following vehicles and of the Mercedes” adding that additional factors were “the impairment of the judgment of the driver of the Mercedes through alcohol” and “the death of the deceased was caused or contributed to by the fact that the deceased was not wearing a seat-belt, the fact that the Mercedes struck the pillar in the Alma Tunnel, rather than colliding with something else”.
The pioneering heart surgeon Professor Christiaan Barnard, who considered himself a friend of the princess, said in a book that he can no longer keep quiet about his views on the tragedy. “Her death stunned me all the more as I was able to get a look at the particulars of the autopsy findings very soon after her death,” he wrote in the book. “I think she could have been saved because, according to the report which I have seen, she died of internal bleeding. The injury which caused the bleeding was to a (pulmonary) vein which doesn’t bleed particularly quickly. In fact, it bleeds rather slowly. What I want to say here is that, if Princess Diana had been brought to hospital within 10 minutes of the accident — something which should easily have been possible — and, once there, had been cared for properly, she could have survived.”