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Failure of the SAMU organization to train SAMU physicians to suspect internal hemorrhage as a source of a patients hypotension [low blood pressure].4.

Failure of the SAMU physician to insert a chest tube to check for internal chest bleeding as a source of her low blood pressure.

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After administering the drugs and beginning to extract the patient from the car, the SAMU physician noted that Diana went into cardiac arrest [her heart stopped beating].

He performed endotracheal intubation [inserted 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.

The cardiac arrest necessitated the tracheal intubation, placement of Spencer on a respirator, and external cardiac massage.2.

Failure by the SAMU physician to consider internal haemorrage as a source of the patients (recurrent) hypotension [low blood pressure].3.

Despite nearly two hours of manual internal massage, and the application of electroshocks, it was impossible to reestablish a heartbeat.

August 31st 1997."At a press conference one hour later, the doctors read a five sentence communiqu that cited an important wound in the left pulmonary vein as the source of the internal bleeding that killed her.As a result, it took them some The on-duty physician at Pitie-Salpetriere hospital who admitted her said that she arrived alive and with a cardiac [heart] rhythm."Though she had no serious external injuries, X-rays indicated internal haemorraging that was compressing her right lung and heart.The medical dispatcher called the hospital to assess for ICU bed availability, which was normal procedure.The SAMU system prides itself on limiting time in hospital emergency departments, to the extent they then existed in France, and transporting critically injured trauma patients directly to anesthesia-run ICUs or directly to the surgeon-run operating rooms if a surgical lesion is suspected by the SAMU physician-anesthesiologist.Diana was a 36-year-old unrestrained (no seatbelt) female back-seat Mercedes automobile occupant in a motor vehicle accident who sustained blunt chest and probably head trauma at on August 31, 1997.

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