Report on Decompression Illness, Diving Fatalities and Project Dive

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Appendix B: Fatality Case <strong>Report</strong>s03-74 Poorly conditioned diver lost consciousnesson swim back to shore after diveCause of Death: Cardiac Dysrhythmia dueto Hypertrophic CardiomyopathyThe information of the diving-related death ofthis 50-year-old obese male was incomplete.He held open-water certification, but theamount of diving experience was unknown.The diver completed a shore-entry dive to 20fsw (6 msw) for 49 minutes. During the surfaceswim back to shore, he lost consciousnessand could not be resuscitated. The autopsydisclosed mild atherosclerosis of the coronaryarteries, a 600-gram heart with marked thickeningof the wall of the left ventricle andchanges characteristic of hypertrophic cardiomyopathy.This heart problem is known tocause sudden death and is the most commoncause of sudden, non-traumatic death in athletes.03-76 Experienced diver with hypertension,had problem at depth, lost consciousnessafter surfacingCause of Death: Cardiac Dysrhythmia dueto Left Ventricular HypertrophyAn experienced diver with rescue diver certification,this 39-year-old male had a medicalhistory that included both hypertension, forwhich he took medication, and obesity. Thediver and his buddy planned a shore-entrydive to 129 fsw (39 msw), but the buddy couldnot equalize and aborted his dive. The decedenthooked up with other divers at depth,but after five minutes of bottom time, he signaledthat he had a problem and needed toascend. He surfaced and lost consciousness,requiring another diver to bring him to shore.The autopsy disclosed hypertensive heart diseasewith hypertrophy of the left ventricle ofthe heart. Unfortunately the autopsy was performedafter the body was embalmed, addingartifacts and eliminating some possible findings.While an air embolism cannot be excluded,the most likely source of this diver’s problemat depth was cardiac in origin.Proximate Cause: Drowning /Cardiac03-09, Experienced but extremely obesediver, in distress at depth, died before surfacingCause of Death: Drowning due to CardiacDysrhythmiaThis 53-year-old male, an experienced diverwith open-water certification, was morbidlyobese. In his diving history, he had nearlydrowned. On the day before, the diver hadcompleted one dive, but he declined to do asecond dive. He said he did not feel well. Thedecedent apparently felt better the next day,and two dives were planned. For the first dive,he descended with a buddy to 60 fsw (18msw). He seemed fatigued, coughing frequentlywhile at the bottom. Late in the diveand in obvious distress, he was observed grabbinghis chest. He was assisted to the surfacewhere he was unconscious; CPR was performed.Resuscitation efforts were unsuccessful.After an autopsy, the medical examinerruled the death as a drowning due to a cardiacevent.03-26 Student diver in poor physical condition,multiple health problems, lost consciousnessduring ascentCause of Death: Drowning due to CardiacDysrhythmiaThis 57-year-old male was a student in an initialopen-water certification class. His medicalhistory included sleep apnea and a heart valvereplacement. He was also significantly overweight.During the ascent on one of his check-DAN’s <strong>Report</strong> on Decompression Illness, Diving Fatalities and Project Dive Exploration: 2004 Edition 111
Appendix B: Fatality Case <strong>Report</strong>sout dives, the diver lost consciousness. At thattime, the instructor had gone back to depth toassist another student. The decedent wasfound unconscious at the surface. While an airembolism is certainly possibly with this diveprofile, the autopsy revealed coronary arterydisease and a heart that weighed more thanthree times what would be expected for thisman. He also had valvular heart disease. Themedical examiner determined the cause ofdeath to be drowning secondary to a cardiacevent.03-27 Experienced technical diver madewreck dive using a rebreather, separatedfrom buddy team, found unconscious onbottomCause of Death: Drowning due to CardiacDysrhythmiaThis 58-year-old male, an experienced diverwith technical diver certification, was makinga dive on a wreck in a four-person buddyteam. Before the dive, the diver had complainedof fatigue; he did not dive the daybefore with the others in the group. Duringthis dive, the decedent decided to go off on hisown. Since he had a habit of doing this, thebuddy separation did not alarm anyone. Sincethe dive was to 104 fsw (32 msw), the diverused a rebreather apparatus. The decedentwas found on the bottom, unconscious. Anautopsy was not performed. The rebreatherwas out of breathing gas, but an additional"bailout" pony bottle was full.03-42 Advanced certified diver withunknown experience, hypertension, heartproblems and tobacco abuse, made wreckdive and lost consciousness on bottomCause of Death: Drowning due to CardiacDysrhythmiaThis 51-year-old male had a medical historythat was significant for hypertension anddilated cardiomyopathy (a condition wherethe heart muscle becomes weakened and losesstrength to pump blood throughout the body),requiring multiple medications including ananticoagulant. He also continued to smoke.He had had advanced open-water certificationand had been diving for four years, but hisexperience level was not documented. Thedecedent and a buddy made a dive to a wreckat 110 fsw (34 msw) for 10 minutes. He hadd i fficulty ascending, and others witnessedthat he lost consciousness at the bottom. Hewas brought to the surface, but resuscitatione fforts were unsuccessful. The autopsyrevealed dilated card i o m y o p a t h y, focallysevere coronary atherosclerosis and numerouscardiac medicines present on toxicology. Thediver’s equipment was also improperly configured,and he had tucked several of hishoses into his wetsuit.03-43 Student diver in poor health, panickedat depth, brought unconscious to surfaceCause of Death: Drowning due to CardiacDysrhythmiaThis 52-year-old male was a student in an initialopen-water certification class. His medicalproblems included morbid obesity, diabetes,obstructive sleep apnea and hypertension. Thedecedent stopped taking his blood pressuremedication two days before the open-waterdives because he thought he should dive withoutany medications in his system. The divermade three check-out dives that were remarkableonly for his having trouble equalizing hisears. After descending to 51 fsw (16 msw) witha buddy, the decedent appeared to be in distressand panicked on the bottom. He wasassisted to the surface but was unconsciousand could not be resuscitated. The medicalexaminer ruled the death as being due todrowning secondary to a cardiac event. An airembolism cannot be entirely excluded, but thediver appeared to have lost consciousnessat depth, which makes a cardiac event morelikely.112DAN’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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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 62 and 63: Section 3 - Dive InjuriesFigure 3.7
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Page 140 and 141: NotesDAN’s Report</strong
Page 142: The only 24-hour, worldwide dive em
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