Diving Fatality

[Salt_Water_Cowboy]

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

 

[DiveGolfSki]

Dr Deco,
....The primilary autopsy determined the cause of death as Nitrogen Toxicity due to DCI.

First of all, condolences on your loss. As for the cause of death, I've never heard of Nitrogen Toxicity. Nitrogen causes narcosis, yes. Excess Nitrogen causes DCI, yes. DCI is an inexact science and they're have been numerous posts on SB where someone followed all protocols VERY conservatively and they still get DCI. Do you have a log of all the dives he made and the specifics (depth, time, ST, Gas used, altitude, etc.)?

As you said, even if everything shows he had done everything "by the book", doesn't guarantee not getting DCI.

Perhaps (a big qualification on this one) you may be right about the embolism but I would imagine that any competent coroner would see that.

 

[paolov]

Dr Deco,
(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.


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

Thanks
Gerry

severly contaminated air/tank complicated by previously damaged lungs due to smoking.

just an opinion from general info.

 

[DiveGolfSki]

severly contaminated air/tank complicated by previously damaged lungs due to smoking.

just an opinion from general info.

Contaminated Air/tank? That's a stretch but you MAY have a point with the smoking issue.

BTW, isn't kinda late for you paolov (your time, I mean :snore: ) ?

 

[mrobinson]

I'm not a doctor... what about a drug or allergic reaction as variables?

 

[paolov]

actually it's midnight. am just awaiting developments here, we might have a new pres. of the republic... am not hi-jacking this thread with this response, just responding

 

[H2Andy]

The primilary autopsy determined the cause of death as Nitrogen Toxicity due to DCI.

i've never heard of Nitrogen Toxicity. this sounds like an unusual cause of death
to me.

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.

what difference would this have made? would you mind explaining?

 

[Salt_Water_Cowboy]

Contaminated Air/tank? That's a stretch but you MAY have a point with the smoking issue.

BTW, isn't kinda late for you paolov (your time, I mean :snore: ) ?

This air and tank was fine and I know this for a fact because the tank is mine and the entire group had been filled by the same fill station the evening before and no one else had any sort of problem, nor have the police testing revealed anything that I am aware.

The smoking, even though he did quit a couple of years ago could be a factor. It is also supports the embolism theory as his lung could have developed a weak spot.

 

[Salt_Water_Cowboy]

First of all, condolences on your loss. As for the cause of death, I've never heard of Nitrogen Toxicity. Nitrogen causes narcosis, yes. Excess Nitrogen causes DCI, yes. DCI is an inexact science and they're have been numerous posts on SB where someone followed all protocols VERY conservatively and they still get DCI. Do you have a log of all the dives he made and the specifics (depth, time, ST, Gas used, altitude, etc.)?

As you said, even if everything shows he had done everything "by the book", doesn't guarantee not getting DCI.

Perhaps (a big qualification on this one) you may be right about the embolism but I would imagine that any competent coroner would see that.

Thank You for your condolensces, like I said, he will be missed...

 

[Dr Deco]

Hello Gerry:

My condolences to you for the death of your diving partner.

Embolism

Noticing that froth was coming from his mouth is an indication of embolism, especially is it was pink or red. That would indicate that blood entered into the air passage, normally something that does not occur.

Embolism is the result of some trapped gas that expands. It is possible that your friend held his breath while rising in the air column. If one is very shallow, the expansion is most pronounced, though most divers believe that it is trivial since they are so shallow. [The record for this type of injury - and death - is about three feet of depth.]

Smoking, I have been taught, is generally not recognized as a big danger unless one has a definite problem such as emphysema.

Nitrogen Toxicity

The “Cause of Death” being Nitrogen Toxicity [nitrogen itself is not toxic] could not of occurred. It also does not occur in conjunction with Decompression Sickness [as we generally understand it as a dissolved nitrogen problem].

Gas loadings were too low for DCS in this situation (a short ascent to the surface). The problem almost certainly did not arise as a result of dissolved nitrogen from the dives.

Dr Deco :doctor: