Report on Decompression Illness, Diving Fatalities and Project Dive

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Appendix B: Dive Fatality Case <strong>Report</strong>sAppendix B: Fatality Case <strong>Report</strong>sProximate Cause: Air Embolism03-25 Inexperienced diver with progressivesymptoms and death long after exitingwaterCause of Death: Air embolismThis 42-year-old female had been diving fortwo years and had made fewer than 20 lifetimedives. She had taken an introductorycave diving course but had not received formalcertification. She was taking pseudoephedrinefor cold symptoms. On the secondday of diving to explore a freshwater cavesystem, the decedent completed two dives.The dive profiles included obligated decompressionstops and appeared to be uneventful,except for possibly a rapid ascent toward theend of the second dive. While carrying equipmentup a hill after the completion of diving,the diver experienced chest and leg pain. Asshe lifted her equipment into a truck, she lostconsciousness. An autopsy was performedand demonstrated a patent foramen ovale.While the dive profile and initial symptomsw e re more consistent with decompre s s i o nsickness, the timing of symptoms and the terminalevent most likely represented an airembolism, possibly as a result of arterializingvenous bubbles.03-66 Solo night dive on rebreather inunderwater mine systemCause of Death: Air EmbolismThis 48-year-old male was an experiencedtechnical diver. Diving without a buddy, hemade a night dive using a rebreather in anunderwater mine system. After a dive to 115feet (35 meters) for 15 minutes, the diver wasfound unconscious. The coroner determinedthe cause of death to be an air embolism. Anautopsy was performed, but the report wasnot made available.03-86 Diver ran out of air, switched tosnorkel, lost consciousness at surfaceCause of Death: Air EmbolismThis 58-year-old male held open-water certificationhe had received two years earlier. Hemade a 30-minute dive to 30 fsw (feet of seawater; 9 msw, or meters of sea water) and signaledto his buddy that he was out of air. Thedecedent ascended, switched over to hissnorkel and grabbed the ladder; he then lostconsciousness. At autopsy, the medical examinerruled the death had been due to a cardiacevent based on negative findings (usinga p p ropriate special pro c e d u res) for airembolism. However, the history was just toocompelling for an air embolism, and theautopsy findings may be minimal in suchcases. The autopsy did disclose coro n a r yartery disease, fatty change of the liver andpatchy myocardial fibrosis, so a cardiac eventwas certainly possible.03-02 Inexperienced diver panicked, maderapid ascent to the surface without buddyand lost consciousnessCause of Death: Air Embolism due to RapidAscentThis 41-year-old female had been a certifiedopen-water diver for five months and hadmade 16 lifetime dives. She was making a divefrom a boat with a buddy. The diver descendedwith her buddy, but panicked and went tothe surface without her buddy. At the surface,the decedent called for help and then lost consciousness.An autopsy was performed andthe medical examiner determined the deathwas due to atherosclerosis (where an arterynarrowed by plaque buildup blocks or limitsblood flow, also known as coronary artery disease)of the artery that supplies blood to a partof the heart that controls conduction of theheartbeat (the atrio-ventricular node). WhileDAN’s <strong>Report</strong> on Decompression Illness, Diving Fatalities and Project Dive Exploration: 2004 Edition 107
Appendix B: Fatality Case <strong>Report</strong>sthis is known to be potentially fatal, the historyof a panicked ascent — calling for help onthe surface prior to losing consciousness – andthe dive profile (30 fsw for less than 4 minutes)were more consistent with an air embolism.From toxicology studies, the anti-seizure medication,phenytoin, was found. While it is amedication that is prescribed to pre v e n tseizures, it is also used in resuscitation.03-12 Inexperienced diver lost consciousnessat surface after solo quarry diveCause of Death: Air Embolism due to RapidAscentThis 38-year-old male possessed initial openwatercertification and had made fewer than20 lifetime dives. Diving without a divebuddy, he made a shore-entry dive into aq u a r r y. The dive was to 30-40 feet (9-12meters) for approximately 25 minutes. Afterascending, the diver had some type of problemat the surface and lost consciousness. Hiswife pulled him to shore, but resuscitationefforts were unsuccessful. An autopsy wasperformed, but the report was not made available.According to the investigative report, theautopsy did not show evidence of coronaryartery disease, but the pathologist thought acoronary artery spasm may have occurred.That opinion would have been made withoutan appreciation for diving physiology. In thiscase, the most likely cause of death was airembolism.03-19 Experienced technical diver maderapid ascent, lost consciousness at surfaceCause of Death: Air Embolism due to RapidAscentThis 47-year-old female was an experienceddiver with technical diving certification. Sheand a buddy made a dive from a boat to 55 fsw(17 msw). For an unknown reason, the decedentmade an unplanned, rapid ascent to thesurface after seven minutes of bottom time. Atthe surface, she was visibly distressed andthen quickly lost consciousness. The autopsydisclosed abundant intracardiac gas and gasin the coronary arteries. She also had pulmonaryadhesions. The medical examinerdetermined the cause of death to be an airembolism.03-29 Inexperienced diver, separated frombuddy, made rapid ascent, lost consciousnessat surfaceCause of Death: Air Embolism due toCardiac Rapid AscentThis 51-year-old male had advanced openwatercertification with 18 lifetime dives completed.He had a known cardiac problem forwhich he took medication, but the details ofhis medical history are incomplete. With abuddy, the diver made a dive to a wreck to amaximum depth of 95 fsw (29 msw). He separatedfrom his buddy early in the dive andmade a rapid ascent to the surface. At the surface,the diver was witnessed to lose consciousnessafter removing his mask. The coronerdecided not to perform an autopsy andconcluded the cause of death was drowningdue to a cardiac event, even with the loss ofconsciousness witnessed at the surface. In alllikelihood, this represented an air embolismwith possibly some contributing natural diseasefactors. An autopsy in this case wouldhave been useful.03-60 Resort course student, panicked aftermask flooded, made rapid ascent and lostconsciousness at surfaceCause of Death: Air Embolism due to RapidAscentThis 23-year-old female was taking an introductionto scuba "resort course." She had hadno previous diving experience. The instructorfor the course was newly certified as aninstructor. The dive, which included a groupof four divers, was to 30 fsw for 22 minutes.Her mask flooded and she panicked, resultingin a rapid ascent to the surface. Once there, she108DAN’s <strong>Report</strong> on Decompression Illness, Diving Fatalities and Project Dive Exploration: 2004 Edition
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1. INTRODUCTIONDivers Alert Network
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Section 1. Introduction1.3 Diving F
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2.2 PDE 2003This report includes da
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Section 2 - Project Dive Exploratio
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Figure 2.4-2 describes the breathin
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Figures 2.5-2 and 2.5-3 indicate th
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Towards the end of the series, PDE
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Case #2The diver was a 29-year-old
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3. Dive InjuriesSection 3 - Dive In
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Section 3 - Dive InjuriesFigure 3.1
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Section 3 - Dive Injuriesmost sever
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Section 3 - Dive Injuries3.3 Physic
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Section 3 - Dive Injuries3.4 Charac
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Section 3 - Dive InjuriesDays in Di
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Page 68 and 69: 4. Dive FatalitiesDeath while divin
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Page 84 and 85: Section 4 - Dive FatalitiesConclusi
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Page 134 and 135: Glossarymatical models to compute d
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Page 140 and 141: NotesDAN’s Report</strong
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