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Car crash kills Munde at prime and shows lethal effect of whiplash injury

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By G.S. MUDUR
  • Published 4.06.14
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New Delhi, June 3: Union minister Gopinath Munde died this morning after his sedan was struck by a hatchback, stunning the political establishment and making many wonder how what was being described as a “minor accident” could end in loss of life.

The untimely death of Munde, 64, appears to be the result of injuries to the cervical spine that he suffered during the accident, trauma specialists familiar with his injuries have said.

The accident killed a public figure who was in the middle of a political comeback that could have put him in a position to vie for the Maharashtra chief minister’s chair later this year. ( )

Doctors at the All India Institute of Medical Sciences (AIIMS), New Delhi, where Munde was taken said the minister was dead when he was brought to the AIIMS trauma centre.

“There was no spontaneous breathing, no pulse, no cardiac activity when the minister was brought here within 15 minutes after the collision,” said Amit Gupta, additional professor of surgery at the AIIMS Jai Prakash Narayan Apex Trauma Centre, who is also spokesperson for the institute. “Doctors here tried cardiopulmonary resuscitation for about 50 minutes, but he could not be revived.”

The doctors expect the post-mortem report, which will be submitted to the police tomorrow, to throw more light on the nature of injuries Munde had suffered. But trauma experts say his sudden death appears consistent with injuries to the cervical spinal bone in the region of the neck.

When a fast-moving car is involved in a collision, any person inside can experience abrupt jerks that could lead to what medical experts call a whiplash injury on the neck.

In extreme circumstances, a whiplash injury could cause a fracture in the cervical bone. “The cervical bone encases the spinal cord that connects to the base of the brain which is a critical region that controls a person’s capacity for breathing and the heart beat,” said Biplab Mishra, additional professor at the AIIMS trauma centre.

“Even without a fracture, the force caused by an abrupt change in the state of motion may at times be transferred to the spinal cord,” Mishra said. “The base of the brain is a delicate zone and severe injury there may cause sudden death.”

What kind of a neck movement might have caused such a cervical bone injury remains unknown. Trauma specialists said it could have been caused by the impact of the collision itself or could have been the result of a “startle response” by the minister.

Although Munde had a medical history of high blood pressure and diabetes — which put him at risk of a heart attack — doctors at the AIIMS said there was no evidence today of a heart attack.

Doctors at AIIMS, who requested not to be named, told The Telegraph that an ultrasound scan performed on the minister when he was brought to the AIIMS did not show any internal bleeding. However, the post-mortem analysis has revealed injuries to his chest and liver.

The doctors said it is possible these injuries might have been caused during the attempts to revive Munde. The standard procedure for cardiopulmonary resuscitation — intended to get a silent heart to spontaneously start beating again — involves compressing the chest 100 times per minute. The trauma centre protocols call on doctors to try to resuscitate for at least 30 minutes. The doctors continued to try to resuscitate Munde for an additional 20 minutes.

The 50-minute resuscitation attempt could have exposed Munde’s body to nearly 5,000 chest compressions which could have led to the injuries to the chest and liver observed in the post-mortem analysis, doctors engaged in the resuscitation attempts said.

But these likely post-mortem injuries in the chest and liver were not serious and could have been easily managed if cardiac activity had been revived, a senior doctor said.