American tourist dies while diving Cozumel caves.....

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Ok,inline CO monitors are great for the compressor operator, but not for the diver. Each diver needs to test his own tank.


CO has been a well known and long identified culprit in diving operations for many years.

Earlier this summer I wrote an article for "Underwater Speleology"; Volume 38 Number 2; April/May/June 2011 This article has some good information about "bad" gas, some causes and preventative measures as well as things for the consumer to look for. The link to that article is HERE

I hope you will read this article and learn from it.

Those of you who would like to purchase a CO monitor may do so for around $300-$320. Analox makes one as well as Oxycheq as shown in Dandy Don's signature line.

Cave Country Dive Shop's online store has them listed for $320.00. You can see that store link HERE
 
Thanks very much for the translation which does suggest that the cause of death was based on the clinical signs of CO poisoning rather than direct measurement of blood carboxyhemoglobin (COHb) or a tank CO concentration. It may be difficult to access the former in Cozumel but one would hope that the dive team could at least locate a CO detector on the island and measure the actual CO concentration in the diver's two tanks in order to confirm the cause of death with incontrovertible evidence.

The autopsy report also stated elevated levels of carboxyhemoglobin were found in the blood. While I understand you posted earlier that they couldn't test for that, you were either incorrect or they've since upgraded their equipment.
 
Re: Cozumel Fatality Cocodrillo
Report on accident at Sisteme Cocodrilo
by Michael Angelo Gagliardi


Cave Diver's Forum - Cave Diving Resource

Rebreather Pro: Report on Mexico Rebreather Fatality



I am writing this today as a chosen representative of the
Cocodrilo/Dos Coronas Exploration and Mapping Expedition. On Sun
October 16 we had a member of our team (Brendan Lee Nappier) die
during a survey dive in the Sisteme Cocodrilo System on the island of
Cozumel. The team has asked me to post this report to prevent and
dispel any misinformation or misconceptions of this tragic accident.
The team is understandably distraught about the loss of our good
friend. I will use no names in this report other then the victim's.


The Expedition was to survey, map and document the Sisteme Cocodrilo
cave system. Sisteme Cocodrilo is a land locked system that contains
several thousand feet of passage most never getting deeper than 40
feet. The Cocodrilo team arrive onsite at approximately 10 am and
began gearing up in the parking lot of the dive site. The team
consisted of 5 divers. The dive plan was to swim to the "Air Dome "
approximately 4200 feet into the cave and video map the room. The
plan was cut very short.


Two divers were using Passive Semi-closed Rebreathers driven by two
Al 80's. One Al 80 had 32% nitrox while the other contained air. The
32% drove the rebreathers while the air was bail out. The other 3
divers were on open circuit side mount. Each open circuit diver
carried an addition stage. All open circuit tanks contained air. The
day before the dive 3 more 80 cubic foot tanks containing air were
staged along the dive route. These were placed as additional
emergency bailouts bottles.


At 11:19 am the team entered the water. The victim led the team. The
team planned on a slow paced swim. At about 15 minutes in to the dive
the victim began to accelerate his swim pace causing the team to
string out into two groups, two divers in front trying to kept pace
with the leader, followed by the second pair falling behind. At
approximately two minutes later, the victim had outpaced the second
and third diver and began convulsing, he then drifted to the ceiling.
When the two closest buddies got to him he was unconscious and his
regulators were out of his mouth. The victim's bailout regulator was
observed to be deployed and dangling. His Rebreather loop and his
bailout tank had been closed, however neither buddy saw when he
closed it. Both buddies, each, deployed and attempted to get a
regulator in the victim's mouth. The victim's jaw was clenched and
had to be pried open to insert the regulator. The regulator was
purged into his mouth. By this point all 5 members had got to the
victim and began a coordinated rescue attempt. Three divers began
swimming the victim out of the system while also keeping the
regulator in his mouth and purging it. The last team member kept the
line out well lit and guided the team out of the system. It took
approximately 18 minutes to get the victim to the surface. His gear
and suit was cut away and CPR was administered in round robin by
three team members. The last member called for help and got people on
the surface to call for EMTs. After about 20 minutes an ambulance and
local police arrived and took control of the body.


An autopsy was performed and the team was informed by local officials
that the cause of death was carbon monoxide poisoning. Both Brandon's
rebreather and one other teammate's rebreather were found to be in
working order. We, the team have now been led to believe (but we have
no way of verifying ) that this is not the first case of "bad" nitrox
fills on the island. We have halted all diving till we can be certain
of what we are breathing. We also urge anyone going on any similar
expedition to please add a carbon monoxide analyzer to their dive
kit. We all are buying one now. We all are emotional, stressed, and
angry by Brendon's passing. We ask out of respect for the victim and
his family, to please refrain from any online speculation or comments
that might cause additional stress. Brendon was young, intelligent
and in shape, he did nothing wrong nor was any rules broken. There is
no good reason why Brendon was taken from us. He died because he had
the misfortune of breathing "bad" air. Brendon was our friend and he
was taken from us too soon.


Thank you


Michael Angelo Gagliardi
 
Re-read the report. There was not a rapid progression into the cave. The increased pace began about 15 minutes into the dive.

Intoxicación por monóxido de carbono



For those of you who do not understand spanish here is a translation: The forensic doctor of the PGJE, Juan Carlos Gongora Ake, said the cause of death of the tourist Brendan Nappier, 35 years of age, electrical engineer, from St. Louis, Missouri, was from suffocation and intoxication from carbon monoxide, which caused his skin to present in a red color.

Actually "rosado" is pink and "rojo" is red correct? I had read that both CO and CO2 had symptoms of either "pink" or "cherryred" or "flush" skin which I think are all similar and is why I asked for further explanation. I asked that before any blood tests were known or gas results etc. If what you are saying is true then there is no confusion of what the cause was based on that autopsy report. It is not stated in that article though did you see that in a link somewhere or get that info from another source? Thanks.
 
Red or pink skin is a notoriously poor diagnostic tool for CO; I've taken care of many patients with gross CO intoxication, and all had normal skin tones.


All the best, James
 
So I see these 2 go together:

The autopsy report also stated elevated levels of carboxyhemoglobin were found in the blood.

An autopsy was performed and the team was informed by local officials
that the cause of death was carbon monoxide poisoning.
Michael Angelo Gagliardi

And this:

We, the team have now been led to believe (but we have
no way of verifying ) that this is not the first case of "bad" nitrox
fills on the island.

Is very disconcerting to say the least.

Very sad for the loss of your friend.
 
CO has been a well known and long identified culprit in diving operations for many years.

Earlier this summer I wrote an article for "Underwater Speleology"; Volume 38 Number 2; April/May/June 2011 This article has some good information about "bad" gas, some causes and preventative measures as well as things for the consumer to look for. The link to that article is HERE

I hope you will read this article and learn from it.
:confused: Very nice article with regard to compressors. Was there a point to the tone of your post to me? Not much there for the consumer.


Quarterly testing is great except such is usually done at compressor start up and right after a filter change, rather when the compressor is hottest and right before the filters are changed. Good test results are only indirectly related to tank gas quality.

Bad smelling air should never be dived of course, but nice smells are false security - as is using trusted compressor operators.
 
Oddly, we pull the test sample right before the filter change.


All the best, James
 
Actually "rosado" is pink and "rojo" is red correct? I had read that both CO and CO2 had symptoms of either "pink" or "cherryred" or "flush" skin which I think are all similar and is why I asked for further explanation...
Hypercapnia (CO2 poisoning) usually results in cyanosis (blue lips/skin) rather than the "cherry red" ascribed to CO poisoning. Note, however:
fdog:
Red or pink skin is a notoriously poor diagnostic tool for CO; I've taken care of many patients with gross CO intoxication, and all had normal skin tones.
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The autopsy report also stated elevated levels of carboxyhemoglobin were found in the blood. While I understand you posted earlier that they couldn't test for that, you were either incorrect or they've since upgraded their equipment.


We inquired at the chamber well over a year ago as to whether a blood COHb could be done on a presenting diver and was told no, however we did not inquire at the IMSS public hospital.

The technology for testing COHb levels has changed dramatically in the last couple of years with the recent availability of CO-oximetry units which do not require a blood sample to be drawn, and in fact can be used right out in the field by non-medical staff. I have seen these units being field tested on some of the fire service vehicles in order to get a rapid COHb level at the scene. Duke University has serveral of these in their emergency department and can screen divers and other cases where CO poisoning is suspected within seconds on presentation. If one examines the emergency medicine literature once these units are introduced to the emergency dept. many cases of occult CO poisoning previously diagnosed as gastroenteritis are identified particularly in northern latitudes during winter time when people are using propane heaters and the like in enclosed spaces.

Our academic emergency departments here have only had these Masimo Rad-57 CO oximetry units for just over a year now and I wonder if this is what might be available on Cozumel? If the local chamber does not have one of these I'd certainly donate towards the $3500 in order to purhase one in order to screen for suspected CO exposure.

http://www.masimo.com/rad-57/

Thanks for updating me on the current situation regarding COHb testing.
 
https://www.shearwater.com/products/peregrine/

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