ELBURN, Ill. -- This year's Daytona 500 marked the somber 10-year anniversary of Dale Earnhardt's death. That dark day, Feb. 18, 2001, ultimately led NASCAR officials to mandate the use of the Head and Neck Support (HANS) device to prevent basilar skull fractures. Since that time, the use of the HANS device has saved numerous drivers in all forms of racing, and while the data cannot quantify how many lives it has saved because that would be attempting to prove a negative, the 10 years since that "Black Sunday" have ushered in a remarkable era of safety in all forms of racing.
Jim Downing, who, along with his brother-in-law, Dr. Jim Hubbard, developed the device in 1986 and began to sell them to racers in 1991, can't attend a race without a driver telling him, "You saved my life.
"Jeff Gordon, a few years ago at the All-Star Race, thanked God and thanked HANS for saving his life in a crash," he said.
"When Earnhardt was killed his legacy was starting to develop and it was bringing safety to racers around the world. It brought soft walls and safer seats and more attention to how safety belts are mounted [and] attention on wear and tear to your equipment so it wasn't too old."
Dr. Terry Trammell, a partner in Orthopedics Indianapolis Inc., who has more than 35 years of experience in medical service in motorsports, is one of the most noted orthopedic surgeons in the world and a major proponent of the HANS device is all forms of racing, beginning with young drivers at the karting ranks. Last December, Trammell spoke at a youth safety seminar at the International Motorsports Industry Show (IMIS) in Indianapolis and demonstrated the effectiveness of the HANS device using an olive and a toothpick.
"With no HANS in a frontal crash, the olive is your head and the toothpick is your neck and your head comes off your neck and smashes into the window," Trammell told SI.com. "If you fasten the olive to the toothpick with tethers like the HANS does, nothing happens. It stays there and it won't come off. The HANS basically fastens your head to your neck."
An instantaneous basilar skull fracture causes the driver to suffer sudden death when the brainstem snaps loose from the spine. The suddenness of such an impact had a lasting effect on Dr. Trammell when he was serving on the CART safety team at a race in Laguna Seca, Calif., in 1999. During that race, Gonsalo Rodriguez, an aspiring race driver from Uruguay who was driving for Team Penske, died from a basilar skull fracture.
"I was sitting up in Turn 9 in the safety truck and the car went off in front of me and it was like, `Oh, this is nothing. He flipped over the fence and he'll be fine,'" Trammell recalled. "I was astounded when we got to the car [and] he was dead. It completely blew me away that such a trivial accident had such a catastrophic outcome.
"That's what the HANS has done -- taken away that kind of injury."
Rodriguez's death on Sept. 11, 1999 began an ugly era of fatalities in racing. CART star Greg Moore died from massive trauma in a horrific crash in a race at Fontana, Calif., on Oct. 31, 1999, when his car flipped and his helmet hit the corner edge of a wall at high speed in the final race of the season.
But it was NASCAR that was hit hardest, beginning with Adam Petty, the grandson of "The King" Richard Petty. The younger Petty was killed when his car crashed in Turn 3 at New Hampshire on May 12, 2000. Less than two months later, on July 7, NASCAR Cup driver Kenny Irwin crashed in the same turn at the same track and was killed. Instead of addressing the impact of such a crash on the driver's body, NASCAR officials implemented the use of a "kill switch" to shut off the car when the throttle hung on a race car -- something that happened in both crashes.
A third NASCAR driver would die that same season when Tony Roper slammed hard into the wall during a NASCAR Truck Series race at Texas on Oct. 14, 2000.
Three deaths in the same series in six months and NASCAR still did not mandate the use of the HANS device.
That would all change during "Black Sunday" when the biggest name in the sport -- a man considered to be a herculean figure -- would die in a crash on the last turn of the last lap of the Daytona 500.
Earnhardt was a "bigger than life" stock car racing hero. He was the last driver to wear an "open-face" helmet long after all of his competitors wore the much safer full-face helmets, which completely enclosed and protected a driver's head and face. The seat in his race car was also an old seat out of a Ford Econoline van instead of the purpose-built Butler racing seats.
The speed of Earnhardt's car when it lost control along with the unusual angle at which Ken Schrader's car ran into the back of Earnhardt's Chevrolet after Schrader's car was hit by Sterling Marlin's car were all key factors in Earnhardt's death
NASCAR conducted a $1 million investigation into his death that included investigation experts Dr. James H. Raddin and Dr. Dean L. Sicking of the University of Nebraska. The six-month inquiry was the most comprehensive investigation of safety in NASCAR's then 53 years.
The results of the investigation were announced at the Hyatt Regency in downtown Atlanta on Aug. 21, 2001, and they concluded that a broken seat belt and subsequent blunt force trauma to the head resulted in a ring fracture to the base of the skull, which instantly killed Earnhardt. His head actually hit the steering wheel causing the fatal injury.
The report suggested that the HANS Device may have helped save Earnhardt, but NASCAR had yet to make the HANS mandatory.
"We think there's still some things we need to understand completely," NASCAR president Mike Helton said on Aug. 21, 2001. "Mandating [the HANS] completely at this point is not a wise thing to do based on production schedules of the parts and pieces themselves and the understanding of the entirety of their uses."
Earnhardt had a "violent head whip" which played a role in the fatal injury and that likely would have been reduced dramatically with the use of a HANS Device. But at the time of the report it was concluded that "no single factor can be isolated as the cause of Dale Earnhardt's death."
After much debate, NASCAR finally made the HANS Device and its rival, the Hutchens Device, mandatory in Oct. 2001. Earnhardt's death was the wake-up call the sport needed and the mandate has become one of the defining moments in safety in auto racing.
While most drivers willingly accepted the decision, Tony Stewart was adamantly against using any such device because he was "claustrophobic."
"The hardest part for me is I'm claustrophobic, so having something else added at the time that was a little bit restrictive took getting used to," Stewart told SI.com last Friday at Indianapolis. "Once we got used to it we wouldn't imagine getting into one of these cars without one."
The HANS Device became the exclusive head and neck support device in 2005 and wearing it is like second nature for most drivers.
"It seems so normal now," Dale Earnhardt Jr. told SI.com at Indianapolis last week. "It seems like something I have had all my life. ... You grow accustomed to it and it seems normal.
"When I first put it on it was a pain in the ass. It took a while to get used to but now I wouldn't think of running without it."
CART first made the HANS device mandatory on the oval tracks in 1999 and 2000, but after Rodriguez's crash, they were mandated at all tracks.
"It took the death of those two men [Dale Earnhardt and Ayrton Senna, the last driver to die at the wheel of a Formula 1 car] to change the way we think about racing safety from `Oh my God, we've had a terrible tragedy. We can't let that ever happen again' to saying `We don't want to ever have that tragedy again, be prospective to figure out what the risks are and mitigate those before they kill or maim somebody. That has been the focus," Trammell said.
The roots of the HANS device go back to the mid-1980s when Downing was the Mazda factory driver in the International Motor Sports Association (IMSA) series. Dr. Bob Hubbard had married Downing's sister and would attend the IMSA races where Downing was one of the top factory drivers in that series. Hubbard worked for General Motors and designed the head of the Hybrid 3 Dummy -- the same dummy used today in most of the crash testing. By designing the head structure he recognized there was a problem in this area of basilar skull fractures at high impact.
"A driver [who raced on the IMSA series in 1982] was killed at Mid-Ohio ... [and he] died of a basilar skull fracture and there wasn't a mark on his body," Downing recalled. "After that Bob put his head down and came up with the basic idea.
"We started to market them in 1991 after I had been wearing one for five years. I was wearing one in 1986 -- the first time it was out in public. Everybody just sort of stared and laughed behind my back. It was a time I had to suck it up and believe in it and wear it and that's what I did."
The original HANS device was big and a bit bulky compared to today's lighter versions that offer the same protection.
"The one I had been wearing before  was pretty big and bulky and looked like a Darth Vader collar," Downing said. "By the time the world was ready -- and that was that awful nine months starting in 2000 -- we had a product that could be worn by anybody in any series."
Ryan Briscoe drives for Team Penske in IndyCar and is living testimony to the power of the HANS device. When he was driving for Target/Chip Ganassi Racing in 2005 he had a horrific crash at Chicagoland that engulfed his car in flames and sent it airborne. Briscoe was briefly unconscious, but without the HANS, it may have been far worse.
"You never know what could have been ... but I believe the HANS device probably saved my life in 2005 when I went into the fence in Chicago," Briscoe told SI.com at Edmonton two weeks ago. "I probably owe my life to the HANS device and the advancements to all the safety features in IndyCar. The HANS device has been a big step forward in safety. In the beginning it was so uncomfortable you couldn't even turn your head. A few times I've gotten into the car for driver fits without the HANS device on and I feel naked. It's become a standard part of the uniform.
"I wouldn't go out on the racetrack without the HANS Device on."
One of Briscoe's teammates -- Will Power -- suffered a serious crash in practice at Infineon in 2009 when he spun out and Nelson Philippe slammed into him. Power suffered a broken lower back but the HANS device kept him from suffering far more severe injuries.
"The HANS device saved my life," Power told SI.com. "It's ability to do its job is the main thing. It works very well. It's a great design and a great idea. ... I would never go into a car without one."
Back in NASCAR the drivers have also seen the positive impact of the HANS Device.
"The HANS device was the first step and the SAFER Barrier was the second step, but the Head and Neck restraint device in any form has been a big bonus to us in safety without a doubt," said Ryan Newman. "You never know what kind of crash is going to lead to which situation."
Kyle Busch has worn a HANS device for practically his entire career.
"I've worn a HANS device [since] my second year in racing when my brother sent me one," Busch said. "Even in Legends cars I wore one, so I've had one since 1999. We don't feel like we are immortal, but we feel a better standing with the way safety has come since then. The SAFER Barrier and the new car and the HANS device are included in that. Since it has been mandated it has helped a lot of drivers walk away from big crashes. Daytona in July last year and the year before I've had pretty big wrecks, so I'm glad I had the HANS device on."
Drivers in all forms of racing realize their chance for survival and avoiding serious injury has been dramatically improved with the HANS.
"The HANS device is one of those things you will never know how valuable it is when you are wearing it," said three-time IndyCar Series champion and two-time Indy 500 winner Dario Franchitti. "Every accident you are happy you have it on because you never know when you will need it."
And Gordon, a driver who once "thanked God and the HANS device for saving my life," understands the simple protective value of the HANS.
"Look at what it does -- the proof is in the results; the HANS device does exactly what it is supposed to do," Gordon said. "If you look at any type of wreck where your head is going to get thrown forward, your body is not strong enough to hold it back."
Trammell has been first at the scene of many crashes and works today on the IndyCar safety team specializing in oval crashes. He's a firm believer in the ability of the HANS device to save lives.
"You don't know how many guys down the line have been impacted," Trammell said. "We are [only] watching NASCAR and IndyCar and Formula 1. That's 22 drivers in Formula 1 and 26 in IndyCar and 44 in NASCAR or so. How about the thousands of others running all these other racing series that have these things on that you never hear anything about? I would say it has probably saved hundreds of lives since its introduction.
"As far as we know, to date, it has neither contributed to nor caused any other kind of injury. There were a bunch of guys with folklore that thought something bad would come from wearing it, and I have reviewed every case of everything that has ever happened with the HANS that I can get my hands on and we have never been able to link the HANS ... to an injury."
Tom Gideon is NASCAR's Safety Director and continues to work with the HANS device at NASCAR's Safety Center in Charlotte, N.C.
"We don't know how often it saves a life," Gideon said, "but we can tell from our data that some of these accidents -- the frontal accidents -- would cause injury without the HANS."
Back in Atlanta, at the offices of HANS Performance Products, Downing knows that his product is more than a life saver.
"It's not just getting killed -- it's going back to work on Monday morning," Downing said. "There are only a handful of drivers that totally make a living doing this. It's the thousands and thousands of guys that pay for their own racing that need this so they can go back to work."