Princess Diana's Death Offers Lessons for Health Care Debate, 12 Years Later

The Mercedes 600 carrying Princess Diana and her companion Dodi Fayed was traveling more than 85 miles per hour when it hit a concrete pillar head-on in the Place D'Alma underpass, crumbling like an accordion.

Both were killed, as well as the driver, Henri Paul -- later proven to have been under the influence of alcohol.

The Paris accident -- just before 12:30 a.m. local time 12 years ago today -- ended the life of one of Britain's most celebrated royals, unleashing a torrent of emotion in that historically stoic culture and catapulting Diana to near sainthood status.

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In the days that followed, she was memorialized as the "People's Princess," as those devastated by her loss turned on the nation's out-of-touch monarchy, whom they blamed for her tragedy.

Conspiracy theories, all unsubstantiated, abounded. Had she been assassinated by the royal family so her estranged husband, Prince Charles, could marry his longtime love Camilla Parker-Bowles? Did the British Secret Intelligence Service bump her off because she was pregnant with Egyptian Fayed's Muslim child?

But the most baffling question was whether doctors could have done more to prevent Diana, 36, from dying.

The horrific accident illustrated the difference between the French and U.S. approaches to emergency care -- a relatively small piece of the French medical system, but deemed by some people to be the best in the world and often cited as a model for U.S. health care overhaul.

When rescue workers arrived, Diana was conscious, uttering, "My God" and "Leave me alone" to the swarming paparazzi. Although she had suffered internal injuries, she did not arrive at the Parisian hospital for 110 minutes -- too late for the surgery that some speculated could have saved her life.

Diana's last hour -- in cardiac arrest and bleeding to death -- was spent in a mobile medical unit parked a few hundred yards from Pitié-Salpêtrière Hospital, where an emergency team followed French protocol and administered treatment at the scene of the accident and en route to the hospital.

At the time, many people surmised that had a U.S. ambulance responded, Diana would have been rushed to the nearest emergency room, where a full set of professionals and diagnostic equipment might have revived her.

Colloquially known as "scoop and run," the U.S. system is grounded in studies that show a trauma victim's best chance for survival is reaching the operating room within 10 minutes.

Under the French system, "stay and play," a fully equipped medical ambulance with a doctor stabilizes the patient and then directs him or her to a specialized hospital, even if it is miles away.

Car Crash Victims Served 24/7

"When a patient rolls into the American system, they have a level-one trauma center that runs 24/7, with every specialty and myriad resources for a patient in a car crash," said Dr. Preeti Jois-Bilowich, emergency room doctor at the University of Florida's Shands Hospital.

Two or three paramedics focus on the ABCs of first responder care: airway, breathing and circulation. Each state has different licensing requirements for its emergency workers and ambulance services.

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