Natasha Richardson's Autopsy Results Revealed, She's Mourned As 'Wonderful Woman'

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HILLEL ITALIE | March 19, 2009 09:50 PM EST | AP

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FILE -- In this April 26, 2005, file photo, actress Natasha Richardson is shown at her opening night performance in the Roundabout Theatre Company's Broadway production of "A Streetcar Named Desire" Studio 54 in New York. Richardson, 45, died Wednesday March 18, 2009 in New York. (AP Photo/Tina Fineberg, File)

NEW YORK — Natasha Richardson died from bleeding in her skull caused by the fall she took on a ski slope, an autopsy found Thursday.

The medical examiner ruled her death an accident, and doctors said she might have survived had she received immediate treatment. However, nearly four hours elapsed between her lethal fall at her admission to a hospital

The Tony-winning actress suffered from an epidural hematoma, which causes bleeding between the skull and the brain's covering, said Ellen Borakove, a spokeswoman for the New York City medical examiner's office.

Such bleeding is often caused by a skull fracture, and it can quickly produce a blood clot that puts pressure on the brain. That pressure can force the brain downward, pressing on the brain stem that controls breathing and other vital functions.

Patients with such an injury often feel fine immediately after being hurt because symptoms from the bleeding may take time to emerge.

"This is a very treatable condition if you're aware of what the problem is and the patient is quickly transferred to a hospital," said Dr. Keith Siller of New York University Langone Medical Center. "But there is very little time to correct this."

To prevent coma or death, surgeons frequently cut off part of the skull to give the brain room to swell.

"Once you have more swelling, it causes more trauma which causes more swelling," said Dr. Edward Aulisi, neurosurgery chief at Washington Hospital Center in the nation's capital. "It's a vicious cycle because everything's inside a closed space."

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Richardson, 45, died Wednesday at Lenox Hill Hospital in Manhattan after falling at the Mont Tremblant resort in Quebec on Monday. Details of her treatment have not been disclosed.

It remained unclear Thursday exactly how she was injured. Resort officials have said only that she fell on a beginner's trail and later reported not feeling well.

A CT scan can detect bleeding, bruising or the beginning of swelling in the brain. The challenge is for patients to know whether to seek one.

"If there's any question in your mind whatsoever, you get a head CT," Aulisi advised. "It's the best 20 seconds you ever spent in your life."

Descended from one of Britain's greatest acting dynasties, including her mother, Vanessa Redgrave, Richardson was known for her work in such plays as "Cabaret" (for which she won a Tony) and "Anna Christie" and in the films "Patty Hearst" and "The Handmaid's Tale."

Mourning continued Thursday with Broadway theaters dimming their lights in Richardson's honor at 8 p.m., the traditional starting time for evening performances.

Praise also came from both tabloid celebrities such as "The Parent Trap" co-star Lindsay Lohan and theater artists like Sam Mendes, who directed the 1998 revival of "Cabaret."

"It defies belief that this gifted, brave, tenacious, wonderful woman is gone," said Mendes, who also directed the Academy Award-winning "American Beauty."

Charlotte St. Martin, executive director of The Broadway League, the trade organization for Broadway theaters and producers, called Richardson "one of our finest young actresses."

"Her theatrical lineage is legendary, but her own singular talent shined memorably on any stage she appeared," she said.

A spokesman for the family, Los Angeles-based Alan Nierob, said he had no information about funeral arrangements. Instead of flowers, the family asked that donations be made to the amfAR foundation for AIDS research, Nierob said. Richardson, whose father died of complications from the disease in 1991, was a longtime supporter of the charity and served on its board of trustees since 2006.

Richardson gave several memorable stage performances, more than living up to some of the theater's most famous roles: Sally Bowles of "Cabaret," Blanche DuBois of "A Streetcar Named Desire" and the title character of Eugene O'Neill's "Anna Christie," a 1993 revival in which she co-starred with future husband Liam Neeson. (They have two sons: Micheal, 13, and Daniel, 12.)

Her final feature film, "Wild Child," has been released internationally but has not been released in the U.S., and Universal Pictures said one had not been scheduled.

The death of Richardson, who was not wearing a helmet, greatly heightened the debate over skiing safety. In Quebec, officials are considering making helmets mandatory on ski hills.

Jean-Pascal Bernier, a spokesman for Quebec Sport and Leisure Minister Michelle Courchesne, said Thursday that the minister met with emergency room doctors this week and will meet with ski hill operators soon.

Emergency room doctors in the province first called for mandatory use of helmets three weeks ago.

Questions also arose about why the first ambulance called to the ski resort was turned away.

Yves Coderre, director of operations at the emergency services company that sent paramedics to the Mont Tremblant resort, told The Globe and Mail newspaper that he reviewed the dispatch records and the first 911 call came at 12:43 p.m. Monday.

Coderre said medics arrived at the hill 17 minutes later. But the actress refused medical attention, he said, so ambulance staffers turned and left after spotting a sled taking the still-conscious actress away to the resort's on-site clinic.

At 3 p.m., a second 911 call was made _ this time from Richardson's luxury hotel room _ as her condition deteriorated. An ambulance arrived nine minutes later.

"She was conscious and they could talk to her," Coderre said. "But she showed instability."

The medics tended to her for a half-hour before transporting her to a hospital a 40-minute drive away.

On Thursday, the ski resort where Richardson had her fatal fall was subdued, as employees refused to speak about the accident.

Still, the sunny slopes were crowded _ and the gentle hill Richardson fell on was teeming with beginners, many of them children.

Dozens of skiers and snowboarders took breaks from the runs to discuss Richardson's death _ and many said they bought a helmet because of Richardson.

"I bought a helmet yesterday after I heard," said Nathalie Beaulieu, 41. "My daughters always wear them, but now my husband and I will, too."

Not everyone said they would change their ways.

"I haven't worn one up to now and I'm OK," said Jacques Garnier, 45. "My kids wear them, for sure, though."

___

Associated Press writers Lauran Neergaard in Washington, Maria Cheng in London, Karen Matthews in New York and Rob Gillies in Toronto contributed to this report.

NEW YORK — Natasha Richardson died from bleeding in her skull caused by the fall she took on a ski slope, an autopsy found Thursday. The medical examiner ruled her death an accident, and doctor...
NEW YORK — Natasha Richardson died from bleeding in her skull caused by the fall she took on a ski slope, an autopsy found Thursday. The medical examiner ruled her death an accident, and doctor...
 
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Why on earth would it ever be left up to an accident victim to decide whether they needed medical attention??? The question should NEVER have been put to her.....th­e medics should have done their duty and examined her!!! If she was on a stretcher, she obviously was not capable of deciding ANYTHING!!!
And helmets must be REQUIRED in any sport where a fall can occur!!!

    Favorite    Flag as abusive Posted 03:29 PM on 03/23/2009
- jerrypl I'm a Fan of jerrypl 54 fans permalink
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I hate to be superficial, but she was so beautiful!!! Her loss is such a waste. People must remember that our skulls are tough but once our brains get jostled around and end up pressing against the inside of the skull bleeding occurs. If she had lived, and even if her thinking remained intact, her motor skills would have been impaired; possibly, in a severe way requiring a tough therapy struggle.

http://eye-on-washington.blogspot.com

    Favorite    Flag as abusive Posted 03:39 PM on 03/21/2009
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Pretty superficial;.

    Favorite    Flag as abusive Posted 04:19 PM on 03/22/2009
- Wiseup2Day I'm a Fan of Wiseup2Day 7 fans permalink

I also heard sometimes a helmet won't necessarily stop that type of injury..it depends on whether you have some weak veins in the brain..the temple area is very susceptable for that type..one thing for sure..if your head takes a pretty bad hit..best to go and get a CT.this is also known as "talk and die syndrome".­.the injured person has no idea that they have a brain bleed.. a friend of mine fell on ice and was fine went home to get ready for work..and was found by her mother on the floor..she had passed away.

    Favorite    Flag as abusive Posted 12:05 AM on 03/21/2009

I really enjoyed watching her on "The Parent Trap".
My prayer goes out to her family.
The Lord had a spot in His flower bed waiting for a beautiful person to bloom in Heaven and the chosen one was Mrs. Natasha Richardson. She will be well missed.

    Favorite    Flag as abusive Posted 08:25 AM on 03/20/2009
- Gidster I'm a Fan of Gidster 218 fans permalink
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The term is subdural hematoma.
An epidural is an anesthetic device.

    Favorite    Flag as abusive Posted 07:58 AM on 03/20/2009

In fact, an Epidural Hematoma is between the skull and the brain, while a subdural hematoma is in the brain. The epidural is connected to where a women in labor gets her anesthetic.

    Favorite    Flag as abusive Posted 09:24 AM on 03/20/2009
- Gidster I'm a Fan of Gidster 218 fans permalink
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Thank you for the clarification! I had only half a clue. :)

    Favorite    Flag as abusive Posted 02:22 PM on 03/20/2009
- Lozange I'm a Fan of Lozange 5 fans permalink
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I was in Tremblant the week after Valentine's. We ski it once a year and I'm also originally from Montreal. Conditions a month ago had ice patches beneath the snow from the mild weather. It was not optimal skiing. What happened to Natasha Richardson is completely heartbreaking. And although it's unclear how she hurt herself so strongly, I can vouch for the concern and professionalism of the resort's local employees. Everyone feels how tragic this was. We would consider it a great personal aberration to lose one person due to improperly caring for them.

    Favorite    Flag as abusive Posted 07:45 AM on 03/20/2009

Ms. Richardson, who was not wearing a helmet, had fallen during a beginner’s skiing lesson, a resort spokeswoman, Lyne Lortie, said Tuesday. “It was a normal fall; she didn’t hit anyone or anything,” Ms. Lortie said. “She didn’t show any signs of injury. She was talking and she seemed all right.”

if it was such a "normal fall" why then was an ambulance called? only to be turned away and now that we know she might have lived if she went to the hospital right away.
very sad, my heart goes out to her family.

    Favorite    Flag as abusive Posted 02:30 AM on 03/20/2009
- GalaxieGal I'm a Fan of GalaxieGal 2 fans permalink

People aren't taken off the mountain in a sled in "normal" accidents. Unusual for a sled to be used on the bunny hill accident at all.

These things happen though. I attended a funeral for a world class snowboarder, Josh Malay, who died the same way (not on a bunny slope however). Took a seemingly easy fall, two hours later, brain dead.

    Favorite    Flag as abusive Posted 01:00 PM on 03/20/2009
- Wiseup2Day I'm a Fan of Wiseup2Day 7 fans permalink

Yep..it appears that it depends on how the jarring of the brain is effected..­.one of the worst falls I ever took was on a flat..caug­ht an edge..this is freak..but in some ways..fate­..if someone would rather go to the clinic than go in an ambulance.­.it's their perogative­..also understandable when you feel ok and don't want the hassle.who would of thought..m­ost times, it's nothing..t­hey probably made her go in a stretcher.­.due to policy..sh­e turned down the amulance.

    Favorite    Flag as abusive Posted 12:13 AM on 03/21/2009

I am concerned that the focus of the post-death discussion is all about helmet use during skiing. I think the focus needs to be on the medical care delivered in this case. There is no reason why anyone should die from this. She had a classic presentation for an epidural hematoma. As an emergency doctor I can tell you that this is a very easy diagnosis to make. I have been through every news article, and there has been nothing about whether she had a CAT scan or whether a neurosurgeon was consulted. I can't believe that she didn't have a scan as soon as she got to a hospital.

Does anybody in Quebec know whether this hospital even has a CAT scanner? I know not every hospital does, unlike here in the US. When she was flown to the NY hospital, was a CAT scan done there? Surely there must be a reporter somewhere who can find the answers...

    Favorite    Flag as abusive Posted 02:19 AM on 03/20/2009

Doc - prevention is the optimal approcah - so this doesn't happen. Helmet would have helped. Ski patrol personnel at a mountain the like this one - and Whistler is yet another example - are EXCELLENT.
When any indiividual, (you, me) agree/decides to participate in any sporting activity they sign an unwritten agreement with themselves that there is ALWAYS the possibilit­y/probabil­ity they can be hurt.

    Favorite    Flag as abusive Posted 10:29 AM on 03/20/2009
- Wiseup2Day I'm a Fan of Wiseup2Day 7 fans permalink

The first hospital didn't have one..they sent her via ambulance an hour or two later to another one that did..but by the time they figured it out she was brain dead.

    Favorite    Flag as abusive Posted 12:17 AM on 03/21/2009
- Chaimirija I'm a Fan of Chaimirija 56 fans permalink
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DrBS--

PuhLease..­.looking to trash Canada's HC system?

If you WERE an ER doc, you would KNOW it is NOT an EZ diagnosis to make!

Yours truly, Dr C

    Favorite    Flag as abusive Posted 09:30 PM on 03/21/2009

"As an emergency doctor I can tell you that this is a very easy diagnosis to make. "

Could the medics have seen there was serious damage just by looking in Natasha's eys? Or would it take a CTscan??

    Favorite    Flag as abusive Posted 03:54 PM on 03/23/2009
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Who wears a helmet when they ski?

    Favorite    Flag as abusive Posted 01:37 AM on 03/20/2009
- bushlies I'm a Fan of bushlies 5 fans permalink

Where I live I see people riding bicycles, motor scooters, and motorcycles all the time without the proper headgear. When I was younger and skied, no one ever wore helmets. These days, really excellent protection is quite affordable and readily available. Terrible accidents like Vanessa's remind us it's just too much of a risk to not use such protection. Hopefully, the one good thing that may come out of this horrible tragedy may be that helmets will become mandatory at all ski venues. They should be required for bicyclists and motor bikers too, whether some think it's "macho" to go without them or not.

My heart goes out to Vanessa's family, especially to Liam and their two young sons. Just a terrible loss.

    Favorite    Flag as abusive Posted 12:00 AM on 03/20/2009
- Wiseup2Day I'm a Fan of Wiseup2Day 7 fans permalink

Who's Vanessa?

    Favorite    Flag as abusive Posted 12:18 AM on 03/21/2009

That would be Natasha's mother, Vanessa Redgrave

    Favorite    Flag as abusive Posted 02:17 PM on 03/24/2009
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I guessed here a couple of days ago when the news first broke that that was what happened. I further guessed that the impact that caused the injury was probably one of her skis hitting her in the head as she tumbled. (And I'm no medical expert, folks.) I learned to ski when the only people who wore helmets were Olympic competitors. The idea wasn't even mentioned, as I recall, and you would have been laughed off the slopes if you wore one. No more, I think.

    Favorite    Flag as abusive Posted 11:37 PM on 03/19/2009
- Lochmon I'm a Fan of Lochmon 82 fans permalink
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This made me very sad.

A horrible auto accident, that's something easy to understand.

Bumping your head, getting up and joking about it, then being in a coma four hours later, that's in a completely different category.

I did not know of this woman's work before this accident. When the story started, I was paying attention because for years Liam has been one of my favorite actors. Now, I'm sad that I didn't know her better before this.

There's so much talent in this world, and we see so little of it.

    Favorite    Flag as abusive Posted 11:20 PM on 03/19/2009

She was a woman of remarkable class and talent. She'll be missed.

    Favorite    Flag as abusive Posted 11:19 PM on 03/19/2009
- MsIrisMG I'm a Fan of MsIrisMG 20 fans permalink
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My dog got a hematoma in his ear as the result of a stroke. His ear blew up like a balloon! The vet slit his ear and drained it. I'm wondering, if they knew there was pressure building on Natasha's brain, why someone didn't poke a hole small hole and drain it?? I know hindsight is 2020 but, I wonder why this wasn't an obvious course of action...

    Favorite    Flag as abusive Posted 11:07 PM on 03/19/2009

You know better than doctors, obviously. If only you had been on the scene.

    Favorite    Flag as abusive Posted 04:02 AM on 03/20/2009
- MsIrisMG I'm a Fan of MsIrisMG 20 fans permalink
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Sigh. No, I don't know, that's why I'm asking. Reading comprehension is your friend!

    Favorite    Flag as abusive Posted 11:03 PM on 03/20/2009

I am a 49 year old, healthy woman. Last Friday, I had a slip and fall resulting in contusions to the top and side of my head, but no visible blood. Within several hours, I developed severe vertigo with nausea and vomiting over the next 24 hours. On Sunday, I began to feel better although I felt muscle soreness in my neck and shoulder as well as tenderness from the contusions. That evening, the vertigo set in again throughout the night.

On Monday, I visited my doctor where she performed a series of minor tests. Her diagnosis was that I had a mild concussion. At first, she suggested a CT Scan, but I asked if it were really necessary since I was feeling better and was able to drive and function. She left the room to obtain a second opinion and came back stating that I should monitor my condition and asked if I wanted to come back in a week.

Almost a week later and I am still lightheaded with occasional nausea, and tired--just not quite myself. From doing research the last few days, it could take up to another week or more before I am completely healed. Fortunately, I fell into the 90% category who end up recovering without serious complications. My heart goes out to those families who have loved ones dealt a less fortunate fate.

    Favorite    Flag as abusive Posted 10:40 PM on 03/19/2009
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