Autopsy
The FIA and Italian authorities still maintain that Senna was not killed instantly, but rather died in hospital, where he had been rushed by helicopter after an emergency tracheotomy and IV administration were performed on track. There is an ongoing debate as to why Senna was not declared dead at the track. Under Italian law when a person dies at a sporting event, that death must be investigated, causing the sporting event to be cancelled. The former Director of the Oporto (Portugal) Legal Medicine Institute, Professor José Eduardo Pinto da Costa, has stated the following:
From the ethical viewpoint, the procedure used for Ayrton's body was wrong. It involved dysthanasia, which means that a person has been kept alive improperly after biological death has taken place because of brain injuries so serious that the patient would never have been able to remain alive without mechanical means of support. There would have been no prospect of normal life and relationships. Whether or not Ayrton was removed from the car while his heart was beating or whether his supply of blood had halted or was still flowing, is irrelevant to the determination of when he died. The autopsy showed that the crash caused multiple fractures at the base of the cranium, crushing the forehead and rupturing the temporal artery with haemorrhage in the respiratory passages. It is possible to resuscitate a dead person immediately after the heart stops through cardio-respiratory processes. The procedure is known as putting the patient on the machine. From the medical-legal viewpoint, in Ayrton's case, there is a subtle point: resuscitation measures were implemented. From the ethical point of view this might well be condemned because the measures were not intended to be of strictly medical benefit to the patient but rather because they suited the commercial interest of the organisation. Resuscitation did in fact take place, with the tracheotomy performed, while the activity of the heart was restored with the assistance of cardio-respiratory devices. The attitude in question was certainly controversial. Any physician would know there was no possibility whatsoever of successfully restoring life in the condition in which Senna had been found.
Professor Jose Pratas Vital, Director of the Egas Moniz hospital in Lisbon, a neurosurgeon and Head of the Medical Staff at the Portuguese GP, offered a different opinion:
The people who conducted the autopsy stated that, on the evidence of his injuries, Senna was dead. They could not say that. He had injuries which led to his death, but at that point the heart may still have been functioning. Medical personnel attending an injured person, and who perceive that the heart is still beating, have only two courses of action: One is to ensure that the patient's respiratory passages remain free, which means that he can breathe. They had to carry out an emergency tracheotomy. With oxygen, and the heart beating, there is another concern, which is loss of blood. These are the steps to be followed in any case involving serious injury, whether on the street or on a racetrack. The rescue team can think of nothing else at that moment except to assist the patient, particularly by immobilising the cervical area. Then the injured person must be taken immediately to the intensive care unit of the nearest hospital.
Rogério Morais Martins, creative director of Ayrton Senna Promotions (which became the Ayrton Senna Institute after Senna's death), stated that:
According to the first clinical bulletin read by Dr. Maria Teresa Fiandri at 4:30pm Ayrton Senna had brain damage with haemorrhaged shock and deep coma. However, the medical staff did not note any chest or abdomen wound. The haemorrhage was caused by the rupture of the temporal artery. The neurosurgeon who examined Ayrton Senna at the hospital mentioned that the circumstances did not call for surgery because the wound was generalised in the cranium. At 6:05pm Dr. Fiandri read another communiqué, her voice shaking, announcing that Senna was dead. At that stage he was still connected to the equipment that maintained his heartbeat. The release by the Italian authorities of the results of Ayrton Senna's autopsy, revealing that the driver had died instantaneously during the race at Imola, ignited still more controversy. Now there were questions about the reactions of the race director and the medical authorities. Although spokespersons for the hospital had stated that Senna was still breathing on arrival in Bologna, the autopsy on Ratzenberger indicated that his death had been instantaneous. Under Italian law, a death within the confines of the circuit would have required the cancellation of the entire race meeting. That, in turn, could have prevented Senna's death. The relevant Italian legislation stipulates that when a death takes place during a sporting event, it should be immediately halted and the area sealed off for examination. In the case of Ratzenberger, this would have meant the cancellation of both Saturday's qualifying session and the San Marino Grand Prix on Sunday. Medical experts are unable to state whether or not Ayrton Senna died instantaneously. Nevertheless, they were well aware that his chances of survival were slight. Had he remained alive, the brain damage would have left him severely handicapped. Accidents such as this are almost always fatal, with survivors suffering irreversible brain damage. This is a result of the effects on the brain of sudden deceleration, which causes structural damage to the brain tissues. Estimates of the forces involved in Ayrton's accident suggest a rate of deceleration equivalent to a 30 metre vertical drop, landing head-first. Evidence offered at the autopsy revealed that the impact of this 208 km/h crash caused multiple injuries at the base of the cranium, resulting in respiratory insufficiency. There was crushing of the brain (which was forced against the wall of the cranium causing oedema and haemorrhage, increasing intra-cranial pressure and causing brain death), together with the rupture of the temporal artery, haemorrhage in the respiratory passages and the consequent heart failure. There are two opposing theories on the issue of whether the drivers were still alive when they were put in the helicopters that carried them to hospital. Assuming both Ratzenberger and Senna had died instantaneously, the race organisers might have delayed any announcement in order to avoid being forced to cancel the meeting, thus protecting their financial interests. Had the meeting been cancelled, Sagis – the organisation which administers the Imola circuit – stood to lose an estimated US$6.5 million.
Read more about this topic: Death Of Ayrton Senna