Bad Mistakes Dead Divers Make: Part II

For many years, we've discussed why divers die, relying in large part on cases presented by the Divers Alert Network (DAN). It has discontinued its reporting, so we are turning to other sources, in this case, DAN's Asia-Pacific division in Australia and its Asia-Pacific Dive Fatality Reporting Project. We hope by explaining these cases, divers will understand better how they might contribute to their own demise, and exercise proper judgment throughout their diving career.

No Drinking or Drugs Before Diving

We know alcohol impairs, but it also masks symptoms of decompression sickness until your blood alcohol concentration level drops to zero percent. So the more partying one does, the greater the risk for injury as a hungover diver. A 44-year-old snorkeler was with three friends on a Great Barrier Reef liveaboard when he decided to down a seasickness pill with a shot of Jagermeister after breakfast. They then went snorkeling, and 100 feet from the boat, the man snorkeled back. He looked fine, but when he tried to board, he fell back into the water, landed face down and was unconscious. Life support techniques were applied for 17 minutes until the doctor contacted by phone advised stopping. Cause of death was aspiration pneumonitis, which essentially means that he choked on his own barf.

After an evening of drinking and drug use, this 41-year-old guy decided to go for a solo dive, even though he was uncertified and inexperienced. He surfaced, looking exhausted, then became unconscious during the swim back to shore. CPR was unsuccessful. The coroner ruled his death a probable cardiac arrest.

On the night before going on his first snorkeling outing, a 51-year-old tourist had a number of drinks, including a bottle of wine, two vodkas and a Cointreau. On the day trip to the Great Barrier Reef, he was swimming easily with the current, then turned back to the boat, 30 feet away. He took six wild, ineffective strokes, then raised his hand as if requesting help. When the boat reached him, he was asked to hold on, but his head tilted to one side and he became unconscious. When brought on board, he had no pulse and wasn't breathing. After 65 minutes of trying supplemental oxygen, shock by defibrillator and intravenous adrenaline, the doctor who was radioed in to help called off the attempts.

No Flag, But Would It Have Been Recognized?

This 51-year-old experienced diver planned a solo dive off his yacht anchored in a bay near Hong Kong. He had positioned a shotline marked by a white fender 30 feet from his boat to indicate he was diving, but there was no dive flag flying from the yacht. Shortly after he submerged, his friend driving a small motorboat approached from the yacht's stern. While the boat driver circled the yacht, he heard a loud thud, and the dive marker was propelled outward and upward. The diver's body was found several hours later, lying face-up on the bottom with bleeding from head lacerations. His lungs were waterlogged with symptoms consistent with drowning.

Sometimes You're Just Too Hefty to Dive

We've frequently commented on how obesity is a primary factor in many dive injuries and fatalities. And we'll keep commenting on it: The more weight you carry on you, the less fit you may be to dive. Take this 46-year-old diver -- while she was very experienced, she was also very overweight, and had been noted to be breathless preparing for previous dives. On her last dive, she was diving with a buddy to 90 feet in a familiar site with a weak current and choppy waves. Toward the end of the dive, she indicated to her buddy that she wanted to ascend. She left the safety stop prematurely and just as soon as she was close to the boat, she became unconscious. She was brought on board for CPR, but to no avail. Cardiac death was the ruling.

This 23-year-old diver had been certified two years prior, but she too was very overweight. About 20 minutes into a dive, she was seen at 70 feet, slowly sinking, unresponsive and not breathing. She initially responded after being rescued and was given oxygen, but she died en route to the hospital. She died from pulmonary barotrauma, typically caused by holding one's breath on ascent, which causes the compressed air to expand on ascent to more than the lung volume, and obesity is a risk factor.

It's Your Body

A 57-year-old man had been certified four years earlier and dived on weekends. He had a history of epilepsy, bipolar disease and chronic obstructive airways disease, and was taking medications ranging from sodium valproate (for the epilepsy) to Vardenafil (for erectile dysfunction),. He was also overweight, and had told his doctor that he felt anxious when it came time to ascend at the end of a dive. Because of his medical problems, he knew he would fail Australia's required dive medical, so he sent a substitute in his place.

On a dive the day before his death, another diver saw him break the surface rapidly, then lie motionless until the boat picked him up. He cancelled his next dive. The next morning, a friend said he looked unwell. Regardless, he decided to go through with a dive that required entering a cave at 72 feet and finning 410 feet to the exit at 30 feet. He had dived this cave 12 times and had no problems before, but nearing the exit, he rested on a rock, holding his chest and patting it. When his buddy made the OK signal, there was a delay before he responded. His buddy took him by the arm and towed him into open water, where he rested again before ascending. At 30 feet, grabbing the dive boat's mooring rope, the man spat out his regulator, then fell unconscious. They pulled him onboard, but he was not breathing and looked gray. Basic life support was given on the 20-minute trip back to shore, but there was no oxygen on board. His death was due most likely to a combination of DCS and an embolism. DAN thinks his rapid ascent the day before could have caused a pulmonary barotrauma that precipitated this problem on what would have been a routine dive.

None of these deaths should have happened, and in many cases, dive buddies should have had a firm talk with the deceased before the dive or snorkel trip. Keep that in mind. You might do a friend -- or stranger -- a favor someday.

- - Vanessa Richardson