Medical conditions, Disease and Diving
// June 28th, 2010 // Medical
Setting the Stage
A group of certified divers and student divers got together, through a dive store, to charter a dive boat. The dive store supplied two instructors to work with the students, and the boat had a crew of three, all of whom were instructors. One buddy pair–a man and a woman who were friends–had come on the trip for fun and to gain more experience toward upgrading their certifications. Both were medical professionals.
The trip to the dive site was rough, and several of the divers became seasick on the way. After anchoring, both the crew and the store instructors told the ailing divers that they did not have to dive and only to do so if they were feeling well enough. They also pointed out that divers often feel better under water, rather than on the surface, given the conditions.
The Dive and the Rescue
All divers opted to make the dive. The man and woman buddy team dived around some small coral heads in 60 to 70 feet of water. Although they were not diving with the instructors, they were observed by both instructors during the course of the dive. During each of these observations they seemed to be doing fine and enjoying themselves.
Near the end of their planned dive time, the male diver indicated discomfort to his female buddy and they started their ascent a few minutes early. There was a surge near the bottom and it became rougher as they approached the surface, yet the ascent remained normal and under control until they were within five feet of the surface. At this point, the male buddy rejected his regulator, pointed with his finger into his mouth and bolted to the surface.
When he arrived on the surface, near the boat, closely followed by his buddy, he was in major distress. The store instructors and boat crew immediately went into action and brought the diver on board. They began full CPR while the Coast Guard was being called for an evacuation.
Before the helicopter transfer, the CPR had been successful, and the diver was breathing and circulating on his own, but was still unconscious. At the hospital, aggressive medical procedures were performed to no avail, and he died the next day.
The Investigation
Due to a complex legal action, extensive investigations were conducted by the several parties to the lawsuit. Based on past medical records, final hospital treatment, an autopsy, the conduct of the dive and rescue, plus information on the diver’s lifestyle, the following possible causes or contributing factors came to light:
- At first, it was thought that the diver had become seasick while under water, vomited, held his breath, surfaced and embolized. This theory was later rejected because no vomit was seen by the buddy or the rescuers, none was found in the regulator and none was found during the hospital treatment or during the autopsy.
- The autopsy found extensive evidence of lung scarring and other past pulmonary changes. Even without holding his breath, the diver could have embolized during the pressure change of an ascent.
- A number of factors indicated the possibility of a heart irregularity: a family history of heart attacks, the fact that the diver was overweight, an enlarged heart and the possible use of cocaine, which can cause heart arrhythmia.
- His heart did stop, more than once, and he did have an air embolism, but it was not clear which came first. Did he have a heart attack, hold his breath and embolize? Or was the flow of air out of his lungs interrupted by the medical condition of his lungs or by him holding his breath?
The case was settled out of court, so the investigations were not carried to completion and no legal rulings were ever made.
Lessons For Life
- Lesson: Be fit for diving, particularly with respect to your respiratory and circulatory systems.
- Lesson: Dive only when you’re feeling well. If you are seasick, it’s your call whether to dive or not. You should not ever feel forced to dive against your will.
- Lesson: Breathe in a slow, deep relaxed manner with emphasis on the exhale.
- Lesson: Ascend slowly and under control.
- Lesson: Maintain buoyancy control; normally using neutral buoyancy for underwater swimming and ascents.
- Lesson: Do not use illegal medicals. If you have used illegal medicals in the past, check with your doctor about the possible consequences.
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