Diving Fatality

[DiveGolfSki]

Dr. Deco,

Thanks for that post. Guess that rules out the coroner's report and, for that matter, the coroner's qualifications. Funny, all the coroners on CSI were spot on ...

I hope a more complete and accurate autopsy is conducted particularly with someone with diving experience?

 

[paolov]

if there is sever corosion in the tank ...... or contamination or now just pure speculations........ so sorry for your friend.

 

[Dive-aholic]

Nitrogen toxicity is a bad diagnosis. Like Dr Deco said, it doesn't exist. If you can, and even want to, you can always request another autopsy, or maybe just to have a dive doc review the findings of the first one.

I have to ask this - is there any kind of dispute over insurance payment for the death? Could this be the reason for the dianosis?

 

[Salt_Water_Cowboy]

Nitrogen toxicity is a bad diagnosis. Like Dr Deco said, it doesn't exist. If you can, and even want to, you can always request another autopsy, or maybe just to have a dive doc review the findings of the first one.

I have to ask this - is there any kind of dispute over insurance payment for the death? Could this be the reason for the dianosis?

No, not that I am aware of, his family just wanted to know what happened. Plus I believe he had ins from a company that deals with Cdn Military and if so scuba diving is covered, I know this because I have the same coverage.

In my opinion, as far as his family are concerned this was the best autopsy report they could have recieved - drowning would have given his wife nightmares and heart attack would have given her the guilts about not insisting that he take better care of himself. However I am not as easy to please, especially since I was his "divemaster" dive buddy and I want to make sure that there was nothing that I could/should have done.

As for the diagnosis, I agree that it is all bad. Not to defend poor work however, the autopsy was done on the weekend probably by an on-call pathologist that as soon as he noticed an elavation in the nitrogen level and knowing that it was a scuba diving victim, may have just jumped to the wrong conclusion. And not being a diver or familiary with the physiology of diving probably does not know any better.

But hopefully once they run further tests hopefully they will straighten everything out.

 

[DiveGolfSki]

... the autopsy was done on the weekend probably by an on-call pathologist that as soon as he noticed an elavation in the nitrogen level and knowing that it was a scuba diving victim, may have just jumped to the wrong conclusion. And not being a diver or familiary with the physiology of diving probably does not know any better.

I'm not a doctor nor am I pathologist but does the equation ELEVATED NITROGEN LEVELS always = NITROGEN TOXICITY? Are you sure that a pathologist conducted the autopsy?

Either way, please keep posting if you get a more definitive answer but, understanding the family's sensitivities, I'd understand if the autopsy stands and nothing further goes forward. Further, if the insurance carrier accepts this cause of death, what more can be done?

 

[Saturation]

I concur with Dr.D's analysis and his death was not likely preventable. On the surface, N2 can kill only as an asphyxiant so a repeat autopsy can be called for. If AGE or DCI was a cause of death, that's what is should be called. Dissovled N2 does not cause fatal or severe problems, its the bubbles.

How tall was the decedent?

For the diver to die suddenly on surfacing common reasons are:
AGE from various reasons; free gas could enter arterial circulation from a pneumothorax or a ruptured alveoli

For divers at risk due to age and weight:
'heart attack'
irregular heart rhythm

Dr Deco,

My question is based on a diving fatality that happened recently in which my dive buddy died on the surface.

As I know it, his dive log indicated that he had dove 7 times in the previous 8 days - 2 the previous sunday, 1 mid week, 2 the day before, and one just before his last (1 hour 15 min surface interval). He was 15 mins into his second when we surfaced.
The first 3 dives I don't remember the depths except that I know they were not below 60 ft. The 2 dives the previous day were approx 80 ft max and 50 ft. The dive just prior was 70 ft as was the second and last dive with over 1 hour surface interval. The diver was just about to turn 58 yrs old. He was in reasonable shape, he had gained about 40lbs during the previous 2 years (semi-retirement & quitting smoking). The primilary autopsy determined the cause of death as Nitrogen Toxicity due to DCI.

We had prematurely come to the surface due to a gear malfunction that I had. I had spoken to him on the surface. When I eventually turned him over in the water both pupils were blown, fixed and dialated. There were large white froathy bubbles coming from his mouth.
My wife is an experience ICU nurse, I am a First Aid Instructor, we are both Divemasters and even though we understand that everyone's body reacts and operates differently, we can't figure out how he would have gotten that much nitrogen in his system? Our estimation is that he embolized. And since the autopsy was done on the weekend by whoever was on duty maybe they did not know that an autopsy is best started by cracking the head rather than the chest. The lungs where the correct weight and the heart was in good shape.

From this brief and general information, what do you think?

Thanks
Gerry

 

[redrover]

snippet....How tall was the decedent?

How does height relate or is a factor?

 

[paolov]

height . this should be interesting

 

[Saturation]

How does height relate or is a factor?

Hi

A common cause for sudden death is heart disease. In the highlighted segments of my quote I marked that he had stopped smoking, gained 40#, was 58 y/o.

His height is the minimum I need to guestimate how overweight he is. The shorter he is, the more the 40# means something, in most folks it would throw them from normal weight to obese. but it shorter folks it would make them 'morbidly' obese.

If the poster also knows his weight before weight gain or actual weight at time of accident it would help and how much he smoked before stopping.

That he gained 40# after quitting suggests he did nearly 1 pack/day, the quantity most likely to cause harm. PPD smokers do not happen overnight, it takes years to develop such a habit. By probability, not certainty, he had heart disease ... but this would be seen at autopsy.

 

[paolov]

height is an issue. i recall that was the way i was found out to be 20# overweight for my height. LOL.... not really funny when you take the health concerns issue.

i still wonder how that nitrogen in his system was determined as the cause of death?