A young woman approximately 16 years of age was thrown from a horse during a riding competition. The young woman has sustained a neck injury occurring from extreme hyper-extension. There was an onsite paramedic who was able to stabilize the patient and transported her through proper supportive technique. She was pronounced dead upon arrival to the hospital. After proper examination of the patient, she was found to have a fracture at the first cervical vertebra. The spinal cord was severely damaged and there was extensive bleeding in the soft tissue around the neck.