Most people would probably say "Henri Paul" the drunken, speeding limo driver who was also on Prozac and Tiapridal. Both medications are potentiated by alcohol. There is also forensic evidence from two separate blood samples that showed Henri Paul’s blood to contain almost 200 PPM of carbon monoxide. This in itself is a nearly lethal dose of the colorless odorless gas. There is no explanation for this blood result. The driver’s brainstem was severed. He died instantly and so did not inhale any poisonous gas from the wreckage. He didn’t smoke. He had a pilot’s license physical approximately a week before with no unusual findings reported relating to his carboxyhemaglobin level or liver enzymes that indicated alcoholism. But, he was going very fast on that night in a semi-poisoned condition with alcohol and psychiatric medicine on board.

So, Henri Paul was at fault. On one level this is right of course. Perhaps if a sober driver had been at the wheel, they wouldn’t have been going so fast. Perhaps his reflexes would have been better, and he could have avoided the loss of control that caused the car with Diana, her bodyguard and her fiancé to smash into a solid concrete pillar in the Pont de l’Alma Tunnel, perhaps. Or perhaps carbon monoxide was the principal problem. Henri Paul may well have passed out behind the wheel with that level of carbon monoxide in his system. Certainly a level of carbon monoxide high enough to make a healthy adult male pass out would be a level sufficient to cause him to lose control of his perceptions and his ability to control an automobile. Regardless of the reason, if we remove Henri Paul from the equation that night, Lady Diana might still be alive.

If we leave it at that, we get no farther in our understanding of the "accident," and driver error becomes a convenient and palatable reason for this unfortunate incident. It is a safe bet that the majority of the world sees it this way. But it is not the only way to see it. Making sure that all royal limousine drivers are always sober and medication free may protect the royal family, but it doesn’t do a thing for the rest of the road users.

On the day of the crash, from network TV coverage, it was immediately clear to me that the cement support pillars in the tunnel are a glaring, major hazard. They are very close to the edge of the left lane. They rest on a raised median, approximately three feet in width, bounded by a low sloping curb immediately adjacent to the traffic flow. The curb offers no protection at all from a vehicle coming in at an acute angle.

Looking at the crash site from different network camera angles shows that there are other pillars nearby that clearly bear the marks of other direct impacts, and there is also what appears to be old debris lying at the base of at least one of them.

The pillars themselves are massive, solid cement structures parallel to the road, and positioned close together. Any vehicle losing control to the left will be at severe risk of hurtling the low sloping curb and smashing directly into the corner of one of the pillars, as Diana’s limo did. There is no barrier along the sides of the pillars to prevent the crash vehicle from coming to a sudden stop as Diana’s did. Anyone who has seen the frontal impact tests that are put on yearly by the Insurance Institute for Highway Safety, knows the violence of a vehicle impacting a crushable barrier at 40 miles per hour. Impacting a solid barrier at that speed is going to be very damaging to the vehicle and the occupants.

Although this unsafe situation leaped out at me, at the time there were no comments at all on the obvious hazardous design of the tunnel. Even the experts seemed focused on the driver, the speeding, the Mercedes S280 limousine itself, ("the safest car in the world", complete with "intelligent steering") and the motorcycle paparazzi. The only comment on the tunnel came from a brief interview with Jackie Stewart, an ex Grand Prix race car driver, who stated that even he could not have negotiated the tunnel at the limo’s reported speed of 100 miles per hour.

The roadway leading up to the tunnel is a two-lane, freeway type thoroughfare, with a probable speed limit of 30 to 50 miles per hour (I could not find any report of the tunnel’s actual speed limit). There is a long straight stretch (the "Cours la Reine", leading up to the tunnel. The tunnel begins at the bottom of a descending gradient with a slight dogleg to the left at the lip of the descent. From pictures of the tunnel approach gleaned on the web, the signage for the tunnel entrance is slightly below the level of the approach and appears difficult to see until a vehicle is in transit from grade to below grade.

There is a short and abrupt merge lane entrance from the "Cours Albert" on the right just before the descent. Any vehicle approaching the tunnel must avoid traffic merging suddenly from the right, negotiate a sudden descent, and make an off camber turn to the left at the same time. There was eyewitness testimony of a white Renault that suddenly merged from the right near the apex of the turn and there were white Renault "Uno" paint scuffs on the right side of the limousine that indicated a brushing sideswipe. A passenger side mirror from the Mercedes was found on the roadway near the lip of the descent into the tunnel. The mystery Renault was never found.

Lady Diana Spencer, Henri Paul-the driver, and Dodi Fayed were all unbelted. The only survivor was a belted front seat passenger (Trevor Reese Jones), Diana’s bodyguard. He survived the crash with major facial injuries from the violence of the deceleration and debris intrusion.

By ATLS standards the medical care Diana received from the EMS personnel was dismal at best. The Paris Fire Brigade was on scene within six minutes of the dispatch. Access to her was made through an undamaged rear passenger side door, clearly visible in the network news coverage. She was not pinned in any way. There was a physician on scene immediately who reported that she was conscious and moaning on his arrival. This indicates some brain perfusion and an unobstructed airway. It took 28 minutes to extricate her from the vehicle.

It took 66 minutes to transport Lady Diana to a hospital that was 10 miles away. The physician in the back of the ambulance reportedly ordered the driver keep the speed to 25 miles per hour to give her a "Smooth ride." The nearest Trauma Center designated for the royals, was five miles away. The treatment that Lady Diana received from the physician on scene and in the ambulance was defended by the French medical establishment as, "Stabilizing on scene".

COURT OF THE FIRST INSTANCE

Public Prosecutor of the French Republic

Dept.: P5 GENERAL CRIMINAL LAW
No. of entry: GG
No. of case: 97 245 3009/9
No. of preliminary investigation: 65/97

(D706 -D709)
At 0.26 hrs on August 31, 1997, the switchboard at Paris fire brigade headquarters received a code-18 emergency call informing them of a serious traffic accident in the Pont d'Alma tunnel in Paris's 8th arrondissement.

- The first Paris fire brigade crew arrived at the scene at 0.32 hrs.

- Lady Diana SPENCER, who had been sitting in the rear right passenger seat, was still conscious and crouched on the floor of the vehicle with her back to the road.

- At her side, stretched out on the rear seat, was Emad AL FAYED, who had been sitting in the rear left passenger seat and appeared to be dead. Nevertheless, fire officers were still trying - in vain - to resuscitate him when he was pronounced dead by a doctor at 1.30hrs.

- In the front of the vehicle was the driver, Henri PAUL, the deputy security manager at the Ritz hotel, who had been killed immediately and was declared dead on removal from the wreckage.

- The front passenger was Trevor REES JONES, a body guard in the employment of the Al FAYED family, who was still conscious and had suffered serious multiple injuries to the face.

The two forward passengers' airbags had functioned normally.

(D789 - D6858)
Autopsy examination concluded that Henri PAUL and Emad AL FAYED had both suffered a rupture in the isthmus of the aorta and a fractured spine, with, in the case of Henri PAUL, a medullar section in the dorsal region and in the case of Emad AL FAYED a medullar section in the cervical region.

(D6833 - D6821)
Lady Diana Spencer received pre-hospital intensive care treatment, both while she was trapped in the wreckage, from which she was finally released at 1am, and during her transfer by ambulance, until her arrival at Pitie Salpetriere hospital at 2.06hrs.

As is the case with most fatal traumatic events, a series of mistakes and complications killed her. A sober driver, a vehicle traveling at a safe speed, a safety belt and quicker EMS transport to a trauma center could all have saved her, perhaps. However, when looking at the total picture, the tunnel itself plays the biggest part. Subsequent investigation indicates that 13 people had been killed in the Pont d’Alma tunnel during the preceding decade. Even in a high traffic area that is excessive.

Marks on adjacent columns clearly show that previous impacts have taken place. Because they are so close to the traffic lane and there is only a low sloping curb with a narrow median between the vehicles and the columns, any minor collision in the tunnel can easily result in a vehicle careening over the curb and into the pillars with deadly force. Ironically, on further review of pictures, you can see small sections of the tunnel that have guardrail protection. Apparently the hazard of the columns was recognized at these locations, but for some reason, they were not applied to all the pillars. Perhaps there is a trigger mechanism for safety related improvements that had not yet been reached at the site of Lady Diana Spencer’s fatal crash. This is a common practice in the United States, i.e. "We don’t make safety improvements on a roadway site until there have been (x number of) deaths there." (The movie "Ronin" has a chase scene that goes through the Pont d’Alma tunnel against traffic. If you want an interesting look at the tunnel and at a lot of streets in France that are an injury prevention professional’s nightmare, I strongly recommend watching it.)

The obvious solution to protect not only royalty, but also all the roadway users at this cluster site, is to place a barrier between the traffic and the columns themselves that will keep all vehicles from impacting the fixed object head on. This will result in a more glancing blow that dissipates the energy more slowly instead of transferring it directly to the passengers. There will be no reduction in the incidence of collisions in the tunnel, but there will be a large reduction in lethality. (DS 2002)