Barbara Warren, one of San Diego's most accomplished endurance athletes, died Tuesday night in a Santa Barbara hospital after being paralyzed in a bike accident. She was 65.

Warren was competing in the Santa Barbara Triathlon last Saturday when she crashed during the 34-mile bike portion of the event. There were no details of how the accident occurred.

Warren broke her ondontoid bone, which sits atop the spine, and the C2 cervical vertebrae, just below the ondontoid. By Tuesday, according to Warren's husband, doctors determined her paralysis would be permanent.

Warren's injuries required her to breathe via a ventilator. She was conscious, according to family members, communicating by nodding her head and blinking her eyes.

Warren's twin sister, Angelika, said Barbara determined she wanted to be taken off the ventilator.

“She still had the courage to communicate and said she didn't want to go on like that,” Angelika said. “She would never have liked that. No athlete would like to have a life with only their eyes talking.”

Warren was born in Austria and moved to Florence, Italy, in her late teens to study art. She would subsequently model, appear in Mexican films, become a psychologist and endurance athlete.

Warren raced at the Ford Ironman Triathlon World Championship in Kona, Hawaii, 13 times, winning her age group in 2003. Paired with Angelika, the sisters set a women's doubles record in the nearly 3,000-mile Race Across America bike event in 2001.

In addition to her sister, Warren is survived by daughters Ingrid, 33, Katrin, 27, and her husband, Tom.

Tom Warren won the second Ironman Triathlon World Championship in 1979.

Services are pending.

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