Report on Decompression Illness, Diving Fatalities - Divers Alert ...

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vacuum test on residual contents showed thecontents had 13 percent oxygen, with theremainder being nitrogen and helium. A smallsticker on the tank designated the contents as100 percent helium. The tank had been filledmonths prior to the dive, according to aninvestigative report. A hypoxic breathing mixcombined with ischemic heart disease to causethis death. Contributing factors/significantdiagnoses included coronary atherosclerosis,left ventricular hypertrophy and focalmyocardial scarring.01-38 Insulin-requiring diabetic with severecoronary artery diseaseCause of Death: Drowning due to cardiacdysrhythmia and coronary atherosclerosisThis 48-year-old male had received his initialopen-water certification six months earlier.His medical history included insulin-requiringdiabetes mellitus and he had been recentlyhospitalized after suffering a seizure. Thedecedent made a dive to 40 fsw (12 msw) for35 minutes and lost consciousness on the surfaceduring the swim back to shore. He complainedof shortness of breath prior to losingconsciousness. Resuscitation efforts wereunsuccessful. The autopsy disclosed severecoronary artery disease with near-total occlusionof the major coronary arteries.Contributing factors/significant diagnosesincluded diabetes mellitus and tobacco abuse.01-39 Experienced diver with severecoronary artery disease was separated frombuddyCause of Death: Drowning due to cardiacdysrhythmia and coronary atherosclerosisThis 59-year-old male was an experienceddiver with open-water certification. He madea shore entry dive to 10 fsw (3 msw) with abuddy and they quickly became separated.The decedent was found unconscious on thebottom, and resuscitation efforts were unsuccessful.The autopsy disclosed evidence ofsevere coronary artery disease and previousmyocardial infarcts. An inspection of theequipment revealed that the autoinflator hoseon the decedent’s buoyancy compensator wasnot attached. Contributing factors/significantdiagnoses included myocardial scarring andtobacco abuse.01-41 Inexperienced, poor-conditioned diverwith heart disease, lost consciousness onsurfaceCause of Death: Drowning due to cardiacdysrhythmia and coronary atherosclerosisThis 55-year-old male had initial open-watercertification and five lifetime dives. He was ona liveaboard and made a dive to 85 fsw (25.5msw) for 30 minutes. The diver had somebuoyancy problems, but he and his buddy hada fairly uneventful dive. He and his buddyseparated on ascent, but witnesses on the boatsaw him surface and signal for pick-up withhis signal sausage. The decedent lost consciousnesswhile waiting to be picked up. Thediver’s size (he was morbidly obese) madegetting him back into the boat extremely difficultand time-consuming. There were severalmedical personnel among the divers on theboat, but the diver could not be resuscitated.The autopsy disclosed coronary atherosclerosisand a large heart, as well as tunneling ofthe left anterior descending coronary artery.The death was attributed to drowning due toa cardiac event. Contributing factors/significantdiagnoses included cardiomegaly, obesity,hypertension and fatty liver.01-66 Open-water student with coronarydisease separated from group and foundnear bottomCause of Death: Drowning due to cardiacdysrhythmia and coronary atherosclerosisThis 40-year-old male was a student in an initialopen-water certification class. Witnessesrecall the decedent being a little apprehensiveprior to the dive. A total of six divers enteredDAN’s <strong>Report</strong> on Decompression Illness, Diving Fatalities and Project Dive Exploration: 2003 Edition 115
the water with the instructor and all except thedecedent came back to shore after the evaluation.He was found near the bottom with theregulator out and unconscious. Resuscitationefforts were unsuccessful. The autopsy disclosedcoronary artery disease, right ventriculardysplasia, and lymphocytic myocarditis.All of these conditions may result in abnormalelectrical activity in the heart. The death wasruled a drowning due to a cardiac event.Contributing factors/significant diagnosesincluded dysplasia of the right ventricle of theheart and lymphocytic myocarditis.01-72 Quarry dive with poor visibilityand buddy separationCause of Death: DrowningThis 44-year-old male had advanced openwatercertification and an unknown amountof experience. He and a dive buddy made ashore entry into a quarry where visibility wasnoted to be poor. There were also two diveinstructors in the group. The decedent’sbuddy was less experienced and began topanic after developing equipment problems.The decedent went to get assistance and wasnot seen again during the dive. Eventually thedive buddy and two instructors surfaced. Thedecedent’s body was found the next day. Anautopsy report was not made available, butthe medical examiner ruled the cause of deathto be drowning. Contributing factor/significantdiagnosis included hypertension.01-73 Diver with coronary artery diseaseused poorly maintained equipmentCause of Death: DrowningThis 40-year-old certified experienced diverwas making a dive with another diver to lookfor fishing lures in a freshwater pond. Thedecedent reportedly was uncomfortable inwater deeper than 20 feet (6 meters). The twodivers went down to 12-15 feet (3.6-4.5 meters)and separated, according to a prearrangeddive plan. Witnesses saw the decedent surfaceand heard him call for help. The diver thenpartially went back below the surface in a“fins up” attitude. Some fishermen came to hisaid, but resuscitation efforts were unsuccessful.An equipment evaluation revealed thatthe decedent’s regulator was in poor repairand failed in the closed position (unusual for aregulator) due to a loose screw. The buoyancycompensator could not be inflated, and therewere weights in the pockets. The decedent didnot have a depth gauge, and the mouthpieceon the second stage of the regulator had holesin it. He apparently did minimal equipmentmaintenance. The autopsy revealed changesconsistent with drowning as well as coronaryartery disease and an enlarged heart.Contributing factors/significant diagnosesincluded cardiomegaly, coronary atherosclerosis,and fatty liver.Proximate Cause: Drowning /Insufficient Air01-01 Experienced cave diver runs out of air,toxicology positive for drugsCause of Death: Drowning due toinsufficient air and entrapment in caveThis 40-year-old male was a very experiencedcertified cave diver who was mapping out acomplex cave system using mixed gas. Thedive was to a maximum depth of 100 feet (30meters), and he ran out of breathing gas. Thedecedent’s body was recovered 150 feet (45meters) from a fresh set of tanks that he hadstaged for use during the dive. In addition tochanges consistent with drowning, the autopsyrevealed toxicology positive for codeineand cannabinoids. Contributing factors/significantdiagnoses included coronary atherosclerosis,toxicology positive for codeine, andtoxicology positive for cannabinoids.116DAN’s <strong>Report</strong> on Decompression Illness, Diving Fatalities and Project Dive Exploration: 2003 Edition
Page 1 and 2:
Report onDecompres
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Dedicated toDr. Peter B. BennettThe
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AcknowledgmentsData for the 2002 <s
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International DAN OfficesDAN Americ
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When divers have questions about th
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Flying After Diving (FAD) StudyIn 1
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In 2002, DAN trained six interns fr
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DAN Training ProgramsOxygen First A
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DAN members are also eligible for d
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DAN Diver Identification System (DI
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Instructors who don’t have access
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Of 522 reports submitted in 2001, 5
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2. Dive Injuries2.1 Injury Data Des
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Arterial Gas Embolism (AGE)• Symp
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The pre-existing medical problems o
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Figure 7 shows the number of self-r
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As shown on Figure 11, most diving
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As in previous years, the largest p
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Figure 19 shows number of days divi
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Figure 23 shows the maximum depth o
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2.4 Signs and Symptoms in Injured D
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Figure 29 shows symptoms reported b
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Fig 32Distribution ofcases by PSI.E
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Figure 35 shows the administration
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Figure 37 shows the type of recompr
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2.6 Therapeutic OutcomeFigure 40 sh
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Figure 43 shows that AGE was more l
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3. Dive FatalitiesDAN is not the pr
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Figure 49 shows the gender and cert
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Figure 53 shows the time of day at
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Figure 57 shows the distribution of
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Figure 61 shows the limited informa
Page 65 and 66: 4. Project DiveExplorationPDE is an
Page 67 and 68: Fig 65Cumulativenumber of PDEdives
Page 69 and 70: Table 10Number ofseries per diver.T
Page 71 and 72: Figure 69 illustrates the certifica
Page 73 and 74: 4.4 DivesMost PDE data (97 percent)
Page 75 and 76: 4.5 Dive SeriesPDE recorded 1,960 d
Page 77 and 78: The maximum depth of the dive serie
Page 79 and 80: The workload reported by divers in
Page 81 and 82: The pre-flight surface interval (PF
Page 83 and 84: Fig 88Percentageof dives bycertific
Page 85 and 86: Figure 90 shows the month in which
Page 87 and 88: All PDE divers were asked to report
Page 89 and 90: The incidence of DCS was different
Page 91 and 92: Figure 94 shows the proportion of m
Page 93 and 94: Fig 98Comparison ofdive purpose byp
Page 95 and 96: Figures 102 and 103 show how the po
Page 97 and 98: 6. Mixed-Gas DivingThis section off
Page 99 and 100: Figure 110 shows that injured diver
Page 101 and 102: GlossaryAGE — Arterial Gas Emboli
Page 103 and 104: Appendix A: Injury Case Rep
Page 105 and 106: During the second day of diving, th
Page 107 and 108: Case 6. Delayed Onset of Mild Neuro
Page 109 and 110: Case 9. One Diver Treated Twice in
Page 111 and 112: Appendix B: Fatality Case R
Page 113 and 114: Proximate Cause: Drowning / AirEmbo
Page 115: Proximate Cause: Cardiac01-05 Divin
Page 119 and 120: 01-22 Public safety diver who was o
Page 121 and 122: dock. Fifteen minutes into the dive
Page 123 and 124: end of the dive, but seemed to be d
Page 125 and 126: 01-67 Inexperienced diver, diving s
Page 127 and 128: 01-61 Novice diver lost control of
Page 129 and 130: entry into a freshwater lake for a
Page 131 and 132: 2002 PublicationsBennett PB, Rostai
Page 133 and 134: Notes132DAN’s Report</str
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