RIU-T-77-011 C. 2

REPORT NO. URI-SSR-77-11

UNITED STATES UNDERWATERFATALITY STATISTICS � 1975

NOAA GRANT NO. 0-3-1/8-31

MARCH l977

By Hilbert V. Schenck, Jr., Pr ofessor of Mechanical Engineeringand Applied Mechanics, and John J. McAniff, Research Associateand. Diving. Officer, College of Engineering and Special InstructorDepartment of Physical Education, University of Rhode Island,Kingston, Rhode Island 02881

Prepared for the U.S. Department of Commerce, National Oceanicand Atmospheric Administration, Manned Undersea Science andTechnology Office, and the U.S. Department of Transportation,U.S. Coa,st Guard Underwater Safety Prospect Office

CONTENTS

IntroductionPart 1. Source analysis of fatal cases

Section 1. 1 Case location................1.2 Missed cases

Part 2.Section

Nonprofessional scuba victims: training,medical, and rescue aspects3.1 Age distribution...........3.2 Experience, training, and certification...3.3 Diving partners and their activities3.4 Medical and autopsy aspects..-....... ~3.5 Age-linked heart attacks

Part 3.

Section

Equipment aspects, nonprofessional scuba fatalities4.1 Regulators and air supplies4.2 Entanglements, ditching.4.3 Personal flotation devices...................

Part 4.Section 27

28~ ~ ~ ~ ~ ~ ~ ~ 28

Part 5. Causes of nonprofessional scuba fatal accidentsSection 5.1 Definitions

5.2 Proximate causes of scuba deaths3133

Part 6. Professiona'l, semi professional, and military divingfatalities6.1 Cases involving scuba use6.2 Hose-supplied diving fatalities..

Section 3436

Skindiving fatal accidents7.1 Case breakdown...7.2 Environmental accident causes .. ~......... ~...7. 3 Possibl e shallow-water blackout7.4 Other skindiving cases ....

Part 7.Section

41Part 8. eferences........................,... ~ ...,...R

43Figures. Underwater accident report form.

General2.12.22.32.42.5

2.6

,underwater fatality statisticsGeneral diving fatality totalsScuba deaths by State .. ~Distribution by day and month.............,..Environmental aspects of scuba deathsDiving platforms....Work-related fatal accidents............. ~ ...

5

6 71013

~ ~ . ~ ~ ~ ~ .o 14

17182023

25

393939

40

TABLES

..6&1

7&8

8

8&9

12

14

.......... 15

18

19

2l

c 2

23

..... 26

29

31

~ t t ~ 3 2

1 Primary source of data on fatalities in skin diving andcompressed air diving, 1972-75

2 Sumnary of diving fatalities, yearly, 1970-75.3 Nonprofessional scuba diving fatalities by State, U.S ~

Territory, and foreign area, yearly, 1970-75.4 Distribution of fatal nonprofessional scuba accidents,

by weekday, yearly, 1970-75.5 Distribution of fatal nonprofessional scuba accidents,

by month, yearly, 1970-156 Location of nonprofessional scuba fatalities, yearly,

1970-75. ~ ~ 4 ~ ~ ~ t ~ ~ ~ ~ ~ ~ ~

7 Depth of fatal accident dive or depth at which body wasrecovered, nonprofessional scuba, yearly, 1970-75

8 Fatal, nonprofessional scuba cases, involving weatherand environmental conditions, yearly, 1972-75..

9 Type of diving platform in nonprofessional divingfatalities, yearly, 1973-75.

10 Work-related, nonprofessional scuba diving fatalities,yearly, 1972-75.

ll Age, distribution of nonprofessional scuba divingvictims, yearly, 'f970-75.

12 Experience of scuba nonprofessional divers lost in.fatal accidents, yearly, 1970-75.

13 Nonprofessional scuba fatalities during trainingactivities, yearly, 1970-75.

14 Nonprofessional scuba diving partners during a fatalaccident, yearly, 1970-75..

15 Buddy activity during fatal, nonprofessional scubaaccident, yearly, 1971-75.......................

16 Multiple nonprofessional scuba fatalities, yearly,1970-75

17 Results of autopsies of nonprofessional scuba fatalities,yearly, 1970-75.

18 Six-year heart attack totals in sport scuba deaths,U.S. citizens, yearly, 1970-75.

19 Elapsed time between start of nonprofessional scubaaccident and body recovery, year ly, 1970-75

20 Performance of personal flotation devices PFD! innonprofessional scuba fatalities, yearly, 1970-75.

21 - Proximate starting causes of nonprofessional scubafatalities, 1975..............

INTRODUCTION

This analysis of 1975 fatal underwater accidents is produced at the Nationa1Underwater Accident Data Center at the University of Rhode Island. It isfunded by the Manned Undersea Science and Technology Office of the NationalOceanic and Atmospheric Administration, U.S. Department of Commerce, and bythe Underwater Safety Project Office of the U.S. Coast Guard, U.S. Departmentof Transportation.

It will be helpful to note some clarifying definitions used in this report.

Nonprofessional: person who participates in underwater activity as the resultof various scuba training programs basically intended for recreational use,or who has acquired his knowledge from other than industry-oriented sources.

Professional: person who obtains all or a major portion of his income fromdiving and/or is the product of industry-oriented sources.

Semiprofessional: person who uses diving to supplement his major source ofincome.

Skin diving: activity that uses basic gear, mask and/or snorkel and/or fins,but not including compressed gas breathing equipment.

Work related: applies to those who, in the course of their employment, mayuse diving but are not specifically employed as divers, e.g ~ , rescue squads,police, fire and various municipal, State, or Federal positions marine biolo-gist, park service ranger, etc.!, college professor, or student engaged in re-search involving diving.

It should be noted that in some instances the above definitions may not accu-rately apply. In such instances the discretion of the authors must be reliedupon.

PART I

SOURCE ANAL YS I S OF FATAL CASES

l. 1: Case Location

1975 showed a total of 148 accidental deaths involving some form of compressed-air diving activity compared to 156 such cases in 1974. There were 15 skindiving noncompressed a1r diving! cases in 1975 compared to 27 in 1974, al-though no claim is made here that our survey methods discover all such skind1ving fatalities' To be included in this census a case must meet one of thefollowing two criteria:

a! The accident involves a U.S. diver participating in some form of in-wateror diving-related activity using either a mask-snorkel-fins system skindiver! or some form of compressed air either supplied from the surface or fromtanks carried by the diver!.

b! The accident involves a foreign national diving in U.S. waters and includesU.S. participating divers, 1nstructors, or a U.S. organization governmentagency, school, or firm!.

Table 1 shows the "primary source" used to locate these cases. We regard thenewsclipping service as our most basic source, followed by the several"official sources� " which include police, State health department officials,and a var1ety of lists and compilat1ons made by both State and Federal agen-cies in areas- having relatively high d1ving activity. The "solicited and un-solicited" material, which table 1 shows to be of ever-increasing importanceas the years pass, is the result of many hundreds of mai lings and phone callsto persons and organizations who have provided such data in the past, plusthe many new contacts who write or call during the investigation period. Therelative decline in coverage by the clipping service method we interpret asfollows: Oiving accidents attract less press attention than they did in 1970.Unless a diving accident has some unusual features multiple death or spectacu-lar rescue efforts, for example! it is likely to be confined to a few lines orsimply an obituary column.

Table 1, -- Primary source of data on tatalities in skindiving and compressed air diving, 1972-75

1972 1973 1974 1975

Skin Comp. Skin Comp. Skin Comp.air air air

Skin Comp,air

Number of fatalities

ing18 85 12 109 3 868 92

6 8 4 22 13 22 7 38

andd

2 211 17 2 23 5 23

ile

1 n,gse 0 2 0

0 0 0

1 4.

0 2

16 123 24 128 27 156 15 148

be little doubt that local case investigations are becoming more de-more competently handled than was the rule 6 yr ago. There are

sies, and we believe that they are carried out in an increasinglyal and knowledgeable manner. Case i nvestigations in such areas asalifornia, especially when inquests occur, are becoming so detailedide a great variety of insights into not only the development of theut into the mental and physical states of buddy divers, rescue per-d other witnesses. Also the linkage between medical problems andth in various types of accidents is becoming clearer as such com-ics are made available. For example, in this report we are able to6-yr retrospective analysis of the incidence of heart attacks inidents and the relative risk of such events for older divers.

1.2: Missed Cases

s type of survey is accumulative in nature, we have no exact way ofg the number of diving deaths about which we know nothing. However,r activity in locating these cases, we can be reasonably sure thatng group is small in any given year and should have little or no ef-

Iost of the statistical and general conclusions presented herein.'f f% tr 3

Probably the most convincing argument for this view lies in the very smalnumber of new cases that emerge in years following the one under consideration.Following 1970, for example, we were able to add 10 fatal cases to our origin-al totals as the years passed and new data sources became available to us.Later compilations required less adjustment as the data-gathering methods ex-panded and the problems were better understood. In 1975, for example, weadded no new cases to the 1974 census.

The situation with. skin diving and commercial diving deaths is quite different.Many of the commercial fatalities occur in remote areas of the world and aresurrounded by insurance and liability problems that make them difficult to lo-cate and even more difficult to investigate. Skin diving deaths, on the otherhand, involve so litt1e equipment and are so litt1e different than the usualaccidental drowning that we can see no way of a complete census in this areashort of examining al1 U.S. drownings each year over 7,000!.

PART 2

GENERAL UNDERWATER FATALITY STATISTICS

2. 1: General Di v i ng Fa ta 1 i ty Total s

Table 2 compares the 1975 fatal case breakdowns with those of 5 previous years.1974 saw the highest sport scuba death toll in 5 yr l41 victims!, while 1975shows a slight reduction in this category of 9 deaths, for a tota1 of 132.Professional diving recorded 15 deaths in 1975--1 more than reported in 1974,though we are sure some such cases were not discovered. Women make up farless than 10 percent of this total in 1975, and it would be most interestingto discover the relative total diving activity by sex to compare wi th thisfatality percentage.

Fatalities*

197519741970 1971

M F M F

1972 1973

M FM FM F

Number-

Scuba diving,nonprofessional 101 8 106 7 107 12 113 6 126 15 124 8

Scuba diving,professional andsemiprofessional 4 0 8 03 0 1 0 1 0 4 0

Scuba diving,record attempt 0 0 0 01 1 0 00 0 0 0

Diving with sur-face-supplied air,professional andsemiprofessional

Skin diving

On-duty military

Compressed airexplosion 0 0 0 0 1 0 0 0 1 0 0 0

i63141 152 183133145Total

*M=male, F-female

Table 2. -- Summary of di ving fatalities,yearly, 1970-75

4 0 2 0 2 0 5 0

26 3 17 0 15 1 23 1

0 0 0 0 0 0 0 0

8 0 7 0

26 1 14 1

2 0 1 0

2.2: Scuba Oeaths by State

Table 3 shows a major reduction of sport scuba fatalities in 1975 in ~.'alifor-nia �5 deaths reduced to 17!. florida fatalities remained high, and we willdiscuss these statistics in more detail under the section on environmentalproblems. New York and Mashington showed upward fluctuations in 1975, but nogreater than in previous years. Hawaii and Michigan were about average, andno other State had an important upward trend.

Table 3. -- Nonprofessional scuba diving fatalities by State,U.S. Territory, and foreign area, yearly, 1970-75

Fatalities

19751970 1971 1972 1973 1974

-Number

State:

Al abamaAlaskaArkansasCaliforniaColoradoConnecticutFloridaGeorgiaHawaiiIdahoIl 1 i no i sIndianaIowa

Kansas

KentuckyLoui si anaMaineMar yl andMassachusettsMichiganMinnesotaMissouriNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaOhio

1

0 024 0 022 3 6

0 2 0 0 0 0 2 3 2 5 10 3 0 0 2 10 2 0 1

2 0 029 1

012 0 9 0 0 10 0 1 0 3 14 3 0 3 0 0 0 4 011 0 2

0 0 025 1 2

26 0 5 0 0 20 0

0 1 2 0 34 0 2 1

0 0 2 0 2 0 2

1

4 134 0 031

0 5 0 3 0 0 0 10 0 3 4 0 1 0 10 2 0 4 0 0

0 1 135 1 042 4 3 0 20 0 0 1 1 14 1 3 0 10 3 12 0

0 10

17 10

41

0 6 1 1

0 0 1 0 0 4 20 5

0 0 2 0 0 6 3 3

Ta'hie 3. � Continued

1970 1971 1972 1973 1974 197'~

Nurnber-

0 0GuamForei n areas:A stra 'a 0 0 0 6 1

132141109 113 119 119Total

2.3 Distribution by Day and Month

Weekend diving continues to provide the majority of fatal cases in 1975 table 4!. Monthly totals for sport scuba fatalities table 5! show a modespeak during the summer period, although the 4 winter months still containabout 20 percent of the total. See table 6 for location of fatalities.!

Distribution of fatal nonprofessional scubaaccidents, by weekday, yearly, 1970-75

Table 4.--

Accidents~Da

19741970 1971 1972 1973 1975

Percent

ll5

4

MondayTuesdayWednesday

26

l2

OklahomaOregonPennsylvaniaRhode IslandSouth CarolinaTennesseeTexas

UtahVirginiaWashingtonWisconsinWest VirginiaU.S. ~terri tor:

U 1

BermudaCanadaCaribbean areaMediterraneanMexicoOkinawa

1 1 20 0 1 2 110 1 1

0 0 0 4 0 2 2

0 2 0 2 1 13 0

15 2 0

0 3 2 1 0 0 50

13 10

Table 4. -- Continued

Accidents

1970 197l 1972 1973 1974 1975

Percent-

6112934

3

112836

4 99 5

20 2745 39

6

93133

610

2539

ThursdayFridaySaturdaySunday

Table 5. -- Distribution of fatal nonprofessional scubaaccidents, by month, yearly, 1970-75

AccidentsMonth

1970 1971 1972 1973 1974 1975

Percent

JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember

6 3 9 711 916 9 810 7 5

2 3 53 3 86 7 98 10 12

19 11 810 11 918 6 1315 14 12

3 11 107 3 64 10 65 11 2

3 311 71312

1314

ll 5 53

9

13

1014 9 9 4

Table 6. -- Location of nonprofessional scuba fatalities,yearly, 1970-75

Location

Number

79 837666

1919

2

23 1425 18

6 4

1811

4

818

4

2589

4 1'.

31 0

TotaE

*The location of the fatality for two divers is undetermined.

Ocean, bay,sea

Lake, pond,slough

CaveRiverquarry, pit,

open mineGreat LakesSwimning pool

1970 1971 1972 1973 1974 1975

109 113 117* 119 141 132

2. 4: Environmental Aspects of Scuba Deaths

The most evident change in environmental accident patterns in 1975 is the re-duction of cave deaths to 18 from a high of 25. Two of the 1975 cave deathswere in Missouri, whereas a11 25 such deaths in 1974 were in Florida. Thusthe Flor1da cave totals are reduced from 25 to 16, the lowest in 4 years. !tis possible that the considerable publicity surrounding the several multiplecave accidents 1n 1974 may have had some cautionary effect.We note, however, that another problem is emerging in Florida. When the cavedeaths are subtracted from the tata'l Florida figures, we obtain what might becalled "Florida open-water deaths." Between 1970 and 1974 these totals were11, 5, 7, 13, and 17. In 1975 the total rose to 25. If one compares this se-quence of six numbers wi th similar sequences for other States table 3!, itappears that Florida open-water deaths are almost continuously increasingover the 6-year span unlike an~ other State. The 6-year sequence for Cali-fornia �4, 29, 25, 34, 35, ~17 or for Washington �0, 13, 15, 9, 5, 13!suggest fairly large fluctuations around some mean value. No doubt scuba ac-t1vity is genera'lly increasing in the United States and certa1nly in the warm-er and more favored areas such as Florida, but this should be reflected infatality increases in other areas as well.A study of the 25 Florida "open-water" fatal events for 1975 revealed the fol-lowing : As far as the weather involvement, buddy-pairing and act1vity,depth of dives, and most other factors involved in accidents, the Florida dis-tributions showed no significant deviation from the national figures. In thematter of diving platform table 9!, however, Florida had 18 out of 25 acci-dents occurring off vessels five charter boats, the rest private recreation-al craft and only 7 occurring from shore �8K!. The 1915 national totalsshowed 67 percent of al1 accidents occurring from shore. California, theother major diving State w1th much boat activity, showed 13 out of 17 eventsoccurring from shore �6%!. Of Florida "open-water" fatalities in the years1973-75, 19 happened during a dive from shore �5K! and the remainder wereduring dives from boats. These numbers do not prove that the increasingdeath rate in Florida is in any way related to high boat use, but only thatthose wishing to improve the Florida picture might consider how boat divingcould contribute to the increasing accident rate.

No swimming pool deaths involved compressed-air scuba in 1975, although oneparticipant in a scuba pool class drowned while swimming with mask, fins, andsnorkle. There was no explanation of this accident, and autopsy showed thevictim to be hea'lthy and without apparent physical weakness. We can only pre-sume that this training death involved some form of blackout following abreath-hold swim. An important point about swimming pools and their relationto scuba accidents should be made. Over the 6-yr period, 5 scuba pool fatali-ties have been recorded out of 733 sport scuba fatal accidents �.7~!. Al-though it is impossib'le to know exactly what percentage of compressed air useoccurs in pools, we cannot imagine that this cou'ld be less than 10 percentand might well be as much as 25 percent or more. Many novice divers do verylittle diving after their pool experiences; others need requalification andadvanced train1ng sessions. If 10 percent of a'll compressed air use occursin pools, then pool diving is .007 /.1! or 7 percent as likely to produce

10

a fatal accident as all other types of diving. This suggests that the poolis certainly the most benign environment far the compressed air diver and em-phasizes the safety advantages of the pool in early compressed air experi-ences, themselves the most dangerous in the diver's career table 13!,

7. -- Depth of fatal accident dive or depth atwhich body was recovered, nonprofessionalscuba, yearly,1970-75

De th at or above which ercenta e occurred

1970 1971 1972 1973 1974 1975

Ft

13 14 15 1440 48 46 3782 92 77 70

175 155 130 118

'15

3062

190

20

4075

120

309 268 239 255?97 310

11

Table 7 gives the distribution of sport scuba fatalities as regards "accidentdepth," defined here as the dive depth when known!, or otherwise the depthat which the body was found. This distribution of accident depths has notchanged significantly through the years, and it is still true' that the bulkof scuba accidents occur in less than 100 ft of water and many occur at ornear the surface. Those few accidents in depths greater than 100 ft and in-volving sport diving occur mainly in caves. An example of an open-water acci-dent in which depth might have played a part occurred off Florida during awreck dive to 130 ft by 30 divers after large fish. The victim, in a team offour left his three "buddies" and went off to another part of the wreck, and

card to detonate. The three divers surfaced and could notSome days later a group visited the wreck and found only

un with the fired powerhead still attached. The body wass is true in most such cases, fixing the cause of the acci-but attempts to take large �00 1b or more! fish at suchdiver in intense physical and mental activity where nar-Leaving his buddies under these conditions was certainlyof cases involving some form of weather problem tabIe 8!percent of the total, quite similar to the usual 25 per-

ous years. However, by no means were all these cases theverse weather factors.

Table 8. -- Fatal, nonprofessional scuba cases, involvingweather and environmental conditions, yearly,

1972-75

1972 1973 1974 1975Condition

--- � -------Number

Moderate � to 3 ft! wavesHeavy over 3 ft! wavesHeavy or dangerous surfCurrent, undertow, or riverIce on surface

ll 5 4 4 3 17 4 9 5 16 3ll 7 3

5 611 3 4

293627Total

30

The fourth ice-related fatality in 1975 involved a similar situation. Divingin a partia'lly covered lake, the certified victim surfaced in a hole cutthrough the ice cover to "have his picture taken." He was unable to get outon the ice at this point and submerged, but his bubbles, which could be seen"emanating from the ice", went away from open water rather than towards it.Divers on shore immediately put on tanks and attempted to find the victim butrecovery took 6 days of effort. This diver carried a compass, but quite ob-viously turned the wrong way in spite of it.A typical example of sea-state involvement in a scuba fatal accident occurredin January near Edmonds, Wash., one of the more dangerous areas far scuba onthe West Coast. The victim's buddy, a complete novice, decided the water wastoo rough and stayed on the dock. When his friend failed to reappear he alered local officials and in the ensuing attempts to retrieve the body, two othe

'l2

The first triple fatality produced by ice cover within the scope of our re-cords was in a freshwater quarry in mid-March. All three divers were ex-perienced in basic scuba: The group leader held an assistant instructor'srating, and all three were stated to have completed a course in ice diving.However, the dive was made in open water one-quarter mile from the ice coverwhich, at this time, only blocked the southern 25 percent of the quarry. Thegroup of three were to fol'low a submerged railway track until it terminatedand then turn back into the diving area. Instead they apparently continuedon under the ice, which was 4 to 6 in thick in the center. The three victimswere recovered 2 days later after the ice had been broken out and were foundclose together. One diver still clutched his knife, which rescuers speculat-ed was used to attack the underice surface while the other two men had alsopulled out and then dropped their knives. All three were out of air. Noneof the victims carried a compass, but other divers stated that the dive wasnot an ice dive and no one had considered going near the ice sheet. All threedivers were stated to be mature, steady, capable individuals, and no explana-tion of their apparent wandering from the dive plan could be found.

divers required rescue. Photos of these events show strong surf and inshorewaves running over 6 ft. Recovery of the victim requ1red 8 hr of dangerousactivity by others. The autopsy showed no physical disability, and it is evi-dent that wave conditions kil1ed this diver.

In a Hawai 1 case, a local 1nstructor noted about the dive area, "I have neverseen the bay in rougher condition." Into this went a buddy pair, the victimhaving never dove in Hawaiian waters in his life. The two were separated onthe surface by 50 yd when the victim sank. He had d1tched his belt and wasattempting a tank ditch but, inexplicably, had not inflated his vest, whichwitnesses claimed was in working order. Local experts stressed the necessityof instruction and fami 1iarization in diving these Hawa1ian waters, an obser-vation we have often noted in connection with rough weather diving off Mon-terey as well.

2.5: Diving Platforms

We have commented in the previous section on the high level of boat diving inthe F1orida area compared with California and the entire U.S. census. Out ofthe 10 fata1ities 1nvolving charter boats, 5 were in Florida, 2 in the Carib-bean, 2 in North Carolina, and 1 in California. There does appear to be somerelationship between charter boat acc1dents and deepwater deaths, but thismust be studied in more detail. Also, our impression of boat-related acci-dents in general is that such dives are more likely to involve strong currentsand separated diving partners than shore diving, but this possibility alsorequires more study.

For the first time in 1975, two fatal scuba accidents involved sport diversus1ng offshore platforms table 9!. In each case a primary cause of the ac-cident was the current that swept the vict1ms away from their starting po~ntat the platform. Clearly, an o11 or gas platform in a strong current areawill be a dangerous place for div1ng unless a boat is also present, becausethere is no way to retrieve the diver once he 1s swept down current.

13

Table 9. -- Type of diving p1atform in nonprofessionaldiving fatalities, yearly,1973-75

Fatalities

Platform 1973 1974 1975

Skin Scuba Skin Scuba Skin Scuba

-Number

Share, beach,or pier 20 74 20 92

Shore withsurface float

0 1

0 2

0 'l0

Of'fshore platform

Charter boat

0 0

0 13 0 14

Private recreationalvessel

I

276 26

0 5

4 25

0 4Unknown

15 13224

2.6 Work-Related Fatal Accidents

Total

Giving deaths involving professional, military, and commercia1 activities willbe dealt with separately later in this report. Table 10 shows a substantialreduction in fatalities involving persons whose basic occupation does not in-volve diving, but who occasionally use diving as an adjunct. One police of-ficer case involved a bizarre series of incidents beginning with the drowningdeaths of two persons who fell from a dam. As search for these persons began,a third man capsized in a boat and was lost. At this point the police diversdiscovered a box underwater containing several million dollars worth of stolenmunicipal bonds, Almost immediately, the officer in charge of the scuba team,who had apparently been diving earlier, collapsed and died on shore of a heartattack. He was 40 yr old and had a history of heart problems.

Table 10. -- Work-related, nonprofessional scuba divingfatalities, yearly, 1972-75

Deaths

1972 1973 1974 1975

Number-

College student"Part-time" coaanercial diverPolice or Fire Dept. officerIndustrial employeeOceanographic researcherUnderwater archeologistScuba tour guide

Total

A 41-yr-old fire captain carrying out a body search with a newly formed scubateam was retrieved from 30 ft when it was noted on the surface that his regu-lator was free-flowing. Autopsy showed drowning, but with some bleeding inthe inner ears. It was not clear whether this damage occurred before or dur-ing the accident, but the description of the event is consistent with earrupture during the descent. This was apparently a first open-water dive.The department team had only just completed its pool training and were sched-uled for open-water activity.

The accident involving an oceanographic specialist gathering specimens oc-curred in the Caribbean area. Although this incident .involved research div-ers of the most skilled sort, who had made many such dives together, the casepresents a typical failure of buddy breathing. The victim and buddy were as-cending from 90 ft when the victim indicated zero air on a submersib1e pres-sure gage. Since both divers started with similar amounts of air and thebuddy still had some 700 1b/in in his tank, different air consumption ratescannot be explained. The victim breathed many times before returning theregulator, at which point the buddy was in a partially drowned state, havingswallowed water. He free-ascended and ditched his belt, but, on lookingdown, saw the victim supine on the bottom. Being light now, the buddy couldnot return to depth, but it is evident that he was in no shape to perform arescue. After recovery, the victim's life vest was found to be operable, butlacking the two C02 cartridges required. Two such items were found in thedeceased's effects on the beach. The description of witnesses and the buddy'sdeposition make it evident that this was almost a double accident, eventhough it occurred in clear, warm and quiet waters under almost ideal condi-tions. It is difficult to escape the impression that had the victim attempt-ed an immediate, emergency surfacing maneuver rather than remaining at depthand attempting the regulator exchange, both might have survived. Once again

we stress what has been observed in dozens of shared-breathing cases throughthe years: The possession of one's own regulator is decisive in an air-lackemergency. Seldom does the person with his own regulator die. Even thoughthis buddy was so choked with water that he could not breath, he managed toachieve the surface with the regulator in his mouth. Buddy breathing hassurely saved many lives, but it can and does fail. Had these two personsbeen using octopus units, we be'lieve they would both have lived.

The scuba tour guide lost his life while guiding a group af 20 persons on acharter boat diving trip in the Caribbean. Since the autopsy of this caseshowed 26 percent carbon monoxide saturation we will discuss it in the sec-tion on autopsies.

PART 3

NONPROFESSIONAL SCUBA VICTIMS: TRAINING,MEDICAL, ANO RESCUE ASPECTS

3.1: Age Distribution

As in past years the bulk of the sport scuba victims are found in the 16-to-30-yr age group. The 51-to 60-group had a total of 10 in 1975--3 more thanwere found in this group in any previous year. This is not, however, a sta-tistically significant variation. Age-linked fatal accidents are most evi-dent in those cases involving heart attack as will be discussed in a separatesection in this chapter table 11!.

Table 11.,-- Age distribution of nonprofessional scubadiving victims, yearly, 1970-75

~Ae

1970 1971 1972 1973 1974 1975

-Number

Years

Total l09 8! 113�! 119 �2! 118�! * 141�5! 132 8!

Note 1: Numbers in brackets refer to number of female diversin group.

Note 2: The ages of the professional fatalities in 1974 rangedfrom 21 to 49 '

* The age for one diver is undetermined.

10-15 5�!16-20 27�!21-25 22 l!26-30 18�!31-35 1236-40 541-45 12�!46-50 6 i !51-55 056-60 260-up 0Unknown 0

3�!3i�!23�!18 l!

8 56

7 i!

4 3 1

5 i!22�! 21�!35�! 40�!25�! 19�!

8 ll

9�! 5X l!5 i !4 2

3 i!0 00 0

4 235�! 28�!38�! 29�!ig�! 26 i!15�! 10�!

6 9»�! 8

4 54 5l 43 0

6

3.2: Experience, Training,and Certification

Table 12 shows that 12 percent of the sport scuba victims on which experienc.data were known 86 cases! were either on their very first scuba dive or onthe first such dive outside a swimming pool. In a number of these cases thevictim was under instruction table 13! as well. In a typical, but puzzling,accident involving a first training dive, the victim never actually got underwater. He was seen breathing rapidly from his regulator, then suddenlystopped breathing. Resuscitation was immediately started and continued inwaist-deep water, to no avail. Unfortunately, no autopsy is available toassist in explaining this death. One important point in this accident is thefact that two different groups of trainees were in the water close togetherand one group was involved in rescue drill training. When the actual emer-gency occurred, the local lifeguards ignored it assuming it was part of theexercise. This is only one of the many possible problems arising out of mastraining dives, especially dives involving several groups close together, bu~under different instructors.

Table 12. � Experience of scuba nonprofessional divers lostin fatal accidents, yearly, 1970-75

Accidents

1970 1971 1972 1973 1974 1975

Percent

First dive ever with scubaFirst dive in open waterEarly open-water diveSome experienceConsiderable experienceYery experiencedUnknown

ll 23132

22 20

9 42935'I3

10 0

12 14 6 39 12 6 5

15 19 21 3l29 28 29 3221 20 32 2314 7 6 60 0 0 0

18

Table 13. -- Nonprofessional scuba fatalities during trainingactivities, yearly, 1970-75

Accidents

1970 1971 1972 1973 1974 1975

Numbe r-

Open-water instruction,formal l5 912

Open-water instruction,friend

Died while instructinganother, regular

Died while instructinga friend

Ta k ing ins truction inpool

1917 11 I 319 15Total

Some impressions of this group of 19 training cases are of interest, ln atleast two cases, the autopsies detected middle-ear hemorrhage. Although thiscan happen during a "normal" drowning, both the case descri ptions suggestedthis disability might have been a causative factor. In a third case, in-volving an advanced class, three divers going to 130 ft were tied together sothat they would not become separated in murky water. As a result, the descentwas uncontrolled and much too rapids The victim was severe'ly effected bynarcosis, having never gone below 50 ft before, and his buddy was incapacitat-ed by ear pain and unable to assist. Another buddy pair almost drownedduring this same exercise.

As table 13 shows, the number of deaths during instruction increased in 1975.The 19 such fatalities during 1975 represent 14 percent of the census of totalsport scuba fatalities. According to a University of California at Las Angel-es study on total training activity in '1975, there were 253,104 students in-vo1ved in training activities by the six major agencies!. This gives deathrate for training accidents of 7.51 per 100,000. For comparison, the 1974fatality report Schenck and McAniff ]974! suggests 23.4 deaths per 'l00,000for the 1972 fatal census including all divers and 103.2 deaths per 100,000for those diving in the Pismo Beach-to-Oregon region in 1972, one of the mostdangerous regions in the United States. Thus, scuba diving during trainingstill appears to be considerably safer than scuba diving as a whole.

In at least one other training dive in deep water 85 ft! the victim eitherembolized or panicked on the way up, began fighting his instructor, «nd thenattempted to share the instructor's mouthpiece, even though his own 'ystemwas in good working order. The two became separated.In at least two of these cases so-called "high risk skill training" was impli-cated. One of these involved open-water divi.ng to 20 ft followed by an equip-ment ditch, swimming to a buddy for shared breathing, and returning to putthe gear on again. The investigation clearly suggests that during his at-tempts to redon his gear, the victim rose in the water column and embolized.In the second case, a diver having 9 yr experience entered a basic scubacourse to obtain a C-card. As part of his training he was required to ditchhis gear and make a free ascent from 33 ft. He embolized on the way up, eventhough witnesses claimed he was exhaling throughout the ascent.A Cari bbean case involving a so-called "short, resort course" consisting of ashort period of pool and lecture instruction and one open-water dive involvedthe following problems: a! Language difficulties existed between the in-structor and his U.S. clients; b! the "student" group actually consi.;ted ofsome beginners and some "friends" of the instructor who were expert and ex-perienced underwater photographers; c! as a result, the dive was made in 40ft of water to satisfy the experienced people; d! no buddy system was attempted, and the victim, a stranger to everyone else on the dive, went off by him-self; e! after the victim's cry for help, 10 min elapsed before the boat wasmoved in an attempt to locate him; f! only two of the diving group wore vestanot including the victim; g! no police investigation was made, nor was an au-topsy performed. The victim really cannot be faulted on any of this. He hadreceived, according to other U.S. witnesses, only 20 min of instruction priorta this dive.

3.3 Diving Partners and Their ActivitiesTables 14 and 15 reveal once again that the problem with the so-cailed "buddysystem" is that divers lose track of each other during the emergency or be-fore it begins. Out of the 117 cases in which buddy behavior could be deter-mined, at least 70 �0%! involved either voluntary or involuntary separationSubtracting those cases �3! in which solo diving was involved leaves 104known cases for 1975, during which separation occurred 67 percent of the timeEven in some of the cases in which buddy breathing was involved, separationoften occurred after or during the shared breathing episode, usually when thebuddy surfaced out of air, leaving the victim to be found later.

20

Table 14. -- Nonprofessional scuba diving partners during afatal accident, yearly, 1970-75

AccidentsNumber with victim

-Number

2112 1013

605447

20272020

1410

1419 33 27

132Tata I

Zero diving alone!

One other buddy!

Two others

Three others

Several others

Unknown

1970 1971 1972 'I 973 1974 1975

109 113 119 119 l 41

Table 15. -- Buddy activity during fatal, nonprofessionalscuba accident, yearly, 1971-75

Accidents~Activist *

1971 1972 19 73 1974 1975

-Number

ZQ4022Buddy stayed with victim 25 27

Buddy lost victimunderwater

52363824 25

Attempted buddybreathing 15 14

Buddy left. water aheadof victim

Buddy lost victim onsurface

1212 15

12 11

26 23

21 1310No buddy

Unknown151924

123 119 119 141 132Total

* There is no overlap in categories.

Table 16 shows there were 8 multiple scuba accidents in 1975 involving 18victims. One of the triple-fatality events involved three men under ice andhas been described in the environment section. The second triple fatalityinvolved a Florida cave. Four men were actually in the dive group, but one

22

In one double fatality, both victims had dual regulator octopus! systems, yetwere last seen fighting for one regulator. On recovery, one victim still had500 lb/in, ample to bring them boCh up on separate regulators, a clear caseof panic. In several other cases, the accident description leaves littledoubt that the usual "two breaths then pass" requirement for shared breathingwas not followed. Typically, the victim finds two breaths entirely insuffi-cient and is reluctant to give up the regulator at all. Alternatively, thevictim breathes rapidly several times from the shared regulator and then risesas rapidly as possible, embolizing on the way up.

had double tanks and got back out. The three with single tanks did not Pi~dtheir way out and were scattered hundreds of feet back inside the cave struc-ture when their bodies were recovered. All four men were visitors from out-side Florida. Their equipment was inadequate; they had one pressure gageamong them, no safety lines, and apparently no depth gages.

Table 16. -- Multiple nonprofessional scuba fatalities,yearly, 1970-75

Accident cases

1970 1971 1972 1973 1974 1975

Number-

10Double

Triple

quadruple

23 20Total 22

All six of the double accidents were in caves or mines. Five of these arelisted here as "cave" accidents, because the victims were found in areas hav-ing no free surface overhead. The double "sink" accident was in an abandonedmine, in which cave diving is also possible. However, these two divers didnot enter the mine drifts, but died in an open section. In one cave "double"in which the divers were more or less adequately equipped, the dive was morethan 200 ft; one diver seriously endangered another by inflating his buddy'svest at depth, thereby slamming this person against the roof. The three sur-vivors of this expedition were fortunate to reach the surface. Three of themultiple fatalities involving six divers were in caves and mines that arecoomercial operations involving equipment rentals and paid admissions.

3.4: Medical and Autopsy Aspects

Table 17 shows that 57 autopsy results were available from the 132 sport scubacases. Out of this group, 37 showed as primary complaint "drowning" �8K!without other findings that would indicate a medical cause of accident,"Drowning" is never regarded as a "cause" of a scuba accident by this office,but as a terminating result of other, earlier problems. In 1975, table 17shows that five 9'l! of the cases were actually produced by detected healthproblems of the victims heart attack, asoi ration of stomach contents!. Lung

23

Table 17. -- Results of autopsies of nonprofessional scubafatalities, yearly, 1970-75

1970 1971 1972 1973 1974 1975

Number

Asphyxiation ordrowning

3929322225 26

Lung overpressure

Injury to head oftenplus "drowning" !

Heart attack

,Aspiration ofstomach contents

Acute decompressionsickness 0 0

0 0

0 0

0 0

Intestinal disorder

Bilateral ear rupture

Gas contamination

575340 4847 42Total

overpressure is a somewhat more ambiguous source of accidental deatn in thatit may be the primary cause of an accident or may be produced by urgent prob-lems at depth and the resulting rapid and uncontrolled rise to the surface.For these tabulations, embolism w~"ll be taken as a proximate cause in Part 51in every case in which it was established. The rationale for this is simplythat most emergency situations requiring ascent can, at least in theory, besafely accomplished by a skilled diver. However, in 2 or 3 of the 12 over-pressure cases, the narrative does not reveal any apparent problem with sur-facing. That is, these accidents did not result from emergencies and the overpressure cannot be explained by any medical or physical factors identifiableat this time. One of the overpressure cases was diagnosed as "spontaneouspneumothorax" which terminated in a partly collapsed lung and death, a uniquecase in the entire 6-yr autopsy census. The "gas contamination" case was dis-covered during autopsy by a blood chemistry test �5.8% carboxyhemoglobin! an<will be discussed under equipment Part 4!.

In 1975, out of 57 cases, 5 9X! showed damage resulting from cardinpuliion-ary resuscitation; out of' 53 cases in 1974, such damage was detected in 9cases �7X!.

Although no accident could be directly attributed to drug use, various drugswere found in autopsy including "Henadryl", "Equagesic", and, in one case,0.11 percent alcohol. Two victims were reported to have "fatty livers," andone showed "adhesive pericarditis" which the prosector noted was contributoryto the accident in. the sense that the victim may have had insufficient bloodcirculation under high stress conditions. One diver was a diabetic, and thiscondition was noted by witnesses and the medical examiner as a possible contri-bution to the progress of the accident. In one case, the victim had recoveredfrom a gas embolism accident involving scuba -less than 1 yr previous tc hisdeath. Autopsy found a second embolism.

3.5: Age-Linked Heart Attacks

Probably the most striking single result of a study of the accumulated autopsydocuments relates to the sharply increased risk of heart attack for diversover age 35. We have studied this effect under the following assumptions:a! That the cases selected for autopsy represent a random sample of the

entire accident population.

b! That any arterial or heart condition serious enough to produce incapaci-tation during scuba would be found by the prosector.

c! That "heart attack" can only be accepted in an accident if an autopsydiscovered it. That is, we rejected from this study all nonautopsy casesin which a "history" of heart problems or siblings who suffered earlydeath was part of the case narrative.

Table lB shows all the heart attack cases found in autopsy grouped in variousways, Summarizing its most important conclusion we note that out of 287 au-topsied cases �970-76! 19 detected heart or arterial problems and 268 didnot. Thus the entire autopsy sample indicates that about 7 percent of all ac-cidental scuba deaths will involve heart or circulatory problems. If, how-ever, we segregate the entire autopsy sample into two groups those 3S yrof age or less and those 36 or older !,a completely different picture emerges.There are 204 autopsied cases involving victims under 36, but in only 1 ofthese cases was a heart problem detected �.5%!. There were 83 autopsied

~ ~

cases for those 36 or over; a heart problem was detected in 18 �25! of thesecases.

j t 'l

4

25

~Auto sies Heart attackHeartattacks

incidencevictim

~in rou

� --Percent-------------Number-----------

0.5204

39

1020

44

21

Total over 35!

228318

When these figures are broken down into 5-yr age groups, a more puzzlingpicture emerges. The age group 36-to 40-yr has the highest rate of heart artack �9K!; the 41-to 50-yr group has the lowest 9X! of the older group,Above 50 yr, the rate is similar to the 36-to 40-yr group. However, we aredealing with rather small numbers of cases in these classifications and theunexpectedly high rate in the 36-to 40-yr age group is based on only sevenevents.

The very large difference between the 35-and-under and over-35 groups is hi-ly significant statistically. The fact that one in five deaths in the over-35 group can be assigned to heart or circulatory disease suggests that apprcpriate medical examinations for divers in this group is well justified.After "drowning", which autopsy most often finds table 11!, some form of oA,pressure accident is most often detected as the medical cause of accident aror death. We might expect that such accidents, dependent as they are on apossible failure of a weak part of the lung, might show some linkage to agethe victim. Out of 281 autopsy cases there were 55 detected embolisms �9'KOut of the 83 autopsy cases involving divers over 35 yr, 10 involved emboli�2%!. These numbers are statistically similar, and it is reasonable to stwithin the limitations of the sample sizes given, that the ability of the 1to withstand overpressure does not appear to change with age.

26

Under 36

36-40

41-45

46-50

51-55

Over 55

Table 18. -- Six-year heart attack totals in sport scubadeaths, U.S. citizens, yearly, 1970-75

PART 4

EQUIPMENT ASPECTS, NONPROFESSIONAL SCUBA FATALITIES

4.1: Regulators and Air Supplies

There were no cases involving detected regulator failure during a dive in 'l975.One regulator was noted to "breathe hard," but the investigator did not sug-gest this as an important factor in the accident. Another regulator had beenset for such a low demand suction that it tended to free-flow readily. Inthis accident, however, there was air left in the tank at the time of death.In at least three accidents, regulators were found clogged with sand, :,hells,and bottom material. !n each case, the unit was flushed and found to be oper-able and the acci dent narratives indicate clearly that such clogging occurredafter the victim had become unconscious and was being moved along the bottomby wave and current forces. The only case in which the condition of the airsupply gear was definitely implicated in a death involved a 38 ft surplus re-port: "The regulator had rust and salt water residue in the first stage.The tank had five quarts of rusty salt water in i, with one hali' inch rustsediment present." Since this tank had 700 lh/in remaining and the victimwas diving alone, our presumption is that the victim performed some maneuverin the water that dumped residue into his regulator and either locked it upor flooded his mouth and 'lungs with rust and water. In another case, the in-vestigator poted that the J-valve was jammed by a submersible pressure gage.However, since this victim breathed his tank empty, it seems unlikely thatthis caused the accident.

There were 41 cases of sport scuba divers who were out of air �1%!, but thetrue percentage must be higher than this because not every accident investi-gation includes a check of the equipment. About half �0! of these no-aircases also involved loss of a free surface caves, ice!. It should be noted,however, that there are always a few cave cases in which the victim died be-fore exhausting his tank.

A single case of apparent "bad air" was detected by autopsy as noted in theautopsy section. This case, however, presents problems. The victim was swim-ming at 60 ft with companions when he signaled that he was surfacing, At thesurface he was seen swimning in "erratic circles" and goon stopped breathing.He was wearinq triples, and they contained 1,000 lb/in~ at the time of death.Autopsy showed "drowning", but a crime laboratory noted "25.8X carboxyhemo-globin or carbon monoxide saturation based on total hemog'lobin concentration."In his book, "Medical Aspects of Sport Diving", Dueker notes: "Unconscious-ness occurs at approximately 30 percent carboxyhernoglobin with death at 70 per-cent." And also, "Equilibration at 700 ppm �.7 percent! would give approxi-mately 30 percent carboxyhemoglobin the level for collapse." Dueker alsonotes that although the relation between CO and depth is still disputed, someworkers maintain that CO of a given concentration becomes more toxic as depthincreases. Thus both the autopsy and the description of the accident point toCO poisoning. However, severa'l other divers supposedly pumped their tanksfrom the same source and suffered no toxic effects. Thus the source of thecarbon monoxide remains a mystery.

27

Two divers descended to 225 ft on a prepared helium-oxygen mixture. ''-t 50 ftthey switched to pure oxygen using tanks left at that level. After 7 min, oneof the men convulsed and collapsed. His partner described him as "twitching"and "shaking," clearly an oxygen seizure. The buddy then began to corivu Iseand surfaced at once. Neither man was experienced with mixed gas diving;neither had been tested for oxygen tolerance.

4.2 Entanglements, Ditching

There were 12 reported cases of ditching of equipment during an emergency; 9by the victim and 3 by the buddy or attempted rescuer. In every case, atleast the belt was ditched; in 6 of the 12 cases the tanks were dropped. Inat least two cases, the investigators reported that the victim was "overweight-ed;" each of these cases involved a beginning or untrained diver. In severalothers, the weight given for the belt seemed excessive, but this is impossibleto determine without knowledge of the diver's body type, suit, and other fac-tors.

In at least four cases entanglement in kelp was a factor in starting or ad-vancing the course of' the accident. No case in 1975 was directly caused bytangling in line or rope. However, one accident, already discussed, startedwhen three divers, roped together, descended too rapidly to the 100-ft level.This type of situation has the same fatal potential as the so-called "bail-out" exercise in which a diver is forced to descend at a pace other than, andprobably faster, than the one he would have chosen.

4.3: Personal Flotation Devices

Table 20 suggests that the use pattern of Personal Flotation Devices PFD! insport scuba accidents is not changing significantly. In 26 out of 46 cases�7%! no use of the PFD was involved whatever, although in some of these casesit is possible that the inflatable did not work or lacked a cartridge. Onlyone case of a faulty PFD was noted--a slight leak--but this did not ;.ontributeto the accident. The victim, wearing 35.5 11 of weights, was found sittingon the bottom with the vest inflated and leaking slowly, But, it was theweight belt and not the PFD that prevented him from rising in the water column.In at least two cases, the sudden inflation of a large bouyancy compensatorproduced a rapid ascent that terminated in lung overpressure. Each of thecases, however, also involved lack of air or mouthpiece so that the ascent wasuncontrolled and might well have produced a problem with an even smaller vol-ume PFD.

The following direct quote from a surviving buddy describes one PFD-relatedaccident far better than any comments by us: "We both were getting low onair. Later we both went up. The boat was about 200 ft away. We both panick-ed and tried to blow up our safety vests. We got choked. I finally pulledmy CO2 and kept telling her to pull hers. She said where is it. I told herit was at the bottom of the vest. She put her mouthpiece in her mouth andfloated. After seconds, I looked back at the boat and saw the people comingtowards us. I turned around and she was gone. Jim took my tanks and wentdown after her." The body was recovered in 20 ft of water, and the autopsysho~ed "drowning" only.

28

Table 19. -- Elapsed time between start of nonprofessionalscuba accident and body recovery. yearly,1970-75

Recoveries

1970 1971 1972 1973 1974 1975

Number

Immediate, victimalive, died later

7 17

Immediate, victimdead

15 17 20

5 minutes or less

Over 5 to 10 minutes

Over'10 to 15 minutes 8

Over 15 to 60 minutes 11 14 9

Over 1 hour to 4 hours 10 13 14

Over 4 hours to12 hours

7 10 12 10

Over 12 hours to1 day

6 4

4 10

18 9 7

4 5 10

8 10 10 7

7 10

6 7

6 11

9 23 16 20 16

109 113 120 119 141 132Total

29

Over 1 day to 2 days

Nore than 2 days

Yictim never found

Unknown

9 25 2

9 6 18

6 6 6

1 6 6

11 16 19

25 12 18

Table 20. -- Performance of personal flotation devices PFD! in nonprofessional scuba fatalities,yearly, 1970-75

Sleeaeloe

9 20 13 2116 14

9 15 10 14

3 20

PFD, no cartridge

Total

30

PFD not used,not checked

PFD inflatedduring accident

PFD not used,checked O'K later

PFD not used,found faulty

PFD malfunctionduring accident

Cases

1970 1971 1972 1973 1974 197!!

38 34 40 35 52 46

PART 5

CAUSES OF NONPROFESSIONAL SCUBA FATAl. ACCIDENTS

5.1: Definitions

Cause not determined: These are generally accidents involving a man div-g ho has become separated from his buddy before any emer-

gency is apparent. Either the equipment was not involved, an inspectionwas not made, or the inspection found nothing. Where autopsy is available,"drowning" is the only finding. If, however, witnesses or police discoverthat the man's tank was empty, and if the victim was not seen on the sur-face, the case is listed under "out of air at depth", something of a catch-all designation for such cases when no other problem is detected. Thiscategory also includes a number of cases in which the body was notrecovered.

b! Possible exhaustion, embolism, or anic: This is also something of acatch-all designation for cases that show one or more of the following as-pects: �! excited and panicky behavior, either underwater or on the sur-face; �! "sinking" or "fading" on the surface following a dive; �! state-ments from the buddy or witnesses that the victim seemed "tired", "con-fused", "disoriented", etc. These cases very often involve some buddybreathing that terminates in the victim's sudden rise to the surface orhis abandonment by his buddy when the victim refuses to return the regula-tor. They often also involve lack of air, but are put in this categorywhen witnesses specifically mention panicky behavior. It should be realiz-ed that it is impossible to distinguish between simple. panic and the pre-unconscious phase of an air embolism trauma. In the great majority ofoverpressure cases, the victim is immediately aware that he has injuredhimself seriously and either panics or, owing to brain injury, acts as ifhe were panicking. In perhaps 20 percent of overpressure cases, the vic-tim is stuporous, unresponsive, and unable to accomplish even the simplesttasks. Victims in such a condition appear to remain conscious a few mo-ments longer than those in a violent phase, and some actually get ashorebefore-collapse. As already noted, all those having detected embolismsare included in the "diagnosed air embolism" category. There may well beone or two undiagnosed heart attacks in the "possible exhaustion, embo-lism, or panic" category as well.

c! Head in 'ur with ossible unconsciousness: Three cases involved both anoted head injury p us witness descriptions that tend to suggest this as apossible ini tiating factor in the accidents. In some few autopsies, headand body damage is mentioned, especially if the body has been in the watersome time, but the case narrative makes it clear that these injuries oc-curred after death.

Once again this office has attempted to define a "starting cause" of all 1975sport scuba accidents. Since the material in table 21 will be most useFul tothose who understand the selection process, several of these categories willbe discussed in this section.

Table 21 ~ -- Proximate starting causes ofnonprofessional scuba fatalities, 1975

CasesEstimated cause

Total medical causes 52

B! Environmental causes

46

102Total

30

32

A! Medical and in'ur causes

Diagnosed air embolismDiagnosed heart attackPossible exhaustion, embolism, or panicPossible nitrogen narcosisHead injury with possible unconsciousnessAspiration of stomach contentsPossible intoxicationPossible diabetic seizure

Lost or out of air in caveOut of air at depthDiving in dangerous waves or surfCarried off by strong currentTangled in kelpLost under iceSucked into intake pipeStruck by boat propeller

Total environmental causes

C! E ui ment-related causes

Unsafe breathing airOverweightedExcessive water in air tankOxygen seizure during compression

Total equipment-related causes

Proximate cause not determined

12 4

28 1 3 2 1 1

ll6I'!

3I

PART 5 Continued!

d! Lost or out of air in cave: There are 15 cases in this category, but 1Rcave deaths all together table 6!. The discrepancy involves three cavecases in which embolism was detected, and in which some air remained tothe divers. In these three cases, we are assuming that the victims mighthave escaped if they had not suffered lung injury.

0th cat o ies: Most of the remaining causes are fairly well establish-e and most y s lf-explanatory. The nitrogen narcosis case involved anovice diver at 130 ft who was noted to be "1aughing" and who refused tocome up. Intoxication is assumed if the blood has over 0.1 percent alco-hol and the case narrative suggests confusion. The diabetic victim wasnot seen to suffer a seizure, but the prosector in autopsy urged this asa reasonable explanation of' the event, because the victim had previouslysuffered such seizures. Most of the other "unusual" cases have alreadybeen discussed in prior sections of this report.

e!

5.2: Proximate Causes of Scuba Deaths

t.'I'.44

33

Table 21 summarizes these investigations. Medical problems represent abouthalf the starting causes, problems with the environment almost half, and on-ly four cases involve equipment. However, equi pment contributes much mor esubstantially to the progress of an accident, as table 20 suggests. Inabilityof the victim or buddy to inflate a vest, ditch tanks, or share air is commonin many of these acci dents . Running out of' air is very common in embolism and,of course, cave accidents, and is probably the most common source of panicamong novice or beginning divers. In past years we have tended to segregatesome of the diagnosed embolism cases into two groups, those in which embolismwas the only problem detected and those in which the cause of rapid ascent wassome other problem, and this problem was noted to be the proximate cause.With the increase in skilled autopsy and the general improvement of on-sceneinvestigations in many cases, we have noted several embolisms that did notfollow from an emergency, rapid rise, ar other predisposing factors. Thus,in table 21 embolism is not regarded as a "result" of anything, but as thebase cause af the accident, when it was detected. We should note, however,that at least half of the 12 diagnosed embolism cases involved rapid or un-controlled ascent due to air lack, lost mouthpiece, or panic.

s

PART 6

PROFESSIONAL, SEMIPROFESSIONAL, AND MILITARY DIVING FATALITIES6.1: Cases Involving Scuba Use

Eight of the 15 cases in these categories involved self-contained breathingequipment, 6 involved hose diving of one sort or another, and in 1 case wehave not yet been able to determine the equipment used.Of the eight scuba cases, two would be classified by this office as "semi-professional" in that the divers were self-employed with no particular indica-tion that diving was their sole occupation, five involved "professionalm ac-tivity the men were employed as "divers" by large organizations!, and one in-volved a U.S. Navy Reserve Officer on active duty.In one of the "semiprofessional" cases, a black-coral diver using double tankswent into 200 ft of water and was never found. The day was calm, and thediver was alone. This diver and his partner had made similar dives duri ng theprevious 4 days, according to the police investigation. In the second case,a man diving over a treasure wreck in 25 ft of water ran out of air afid fai'ledto surface behind his buddy. He was found later on the bottom. Water con-ditionss were stated to be "rough", and the buddy diver noted that he was hav-ing trouble getting air through his snorkel because of the waves. The vi ctimwas seen to surface and head for the dive boat, but then was found later onthe bottom.

A double fatality occurred dur ing the launch of the small submersible Star II,a boat that was being used by a commercial company for collecting deep coral.Star II is launched under water from a submersible platform to avoid the prob-lems small submersibles often have in attempting to launch during high seas.The platform was supposedly set to halt its downward motion at 60-ft depth,and the three outside support divers accompanying the sub and.platform were tounhook the boat, which contained two crewmen. Instead, the platform and boatcontinued down past the 60-ft stopping place, and the three divers rode thesystem, attempting to arrest the dive. Somewhere between 200 and 300 ft oneof the three support divers abandoned the system and surfaced along the tow-line that was still attached to the launch unit. The other two outside menwere not seen again, but the sub got free and also surfaced. The survivingsupport diver was recompressed and recovered without injury. The platformhung off the tow boat at 600 ft unti 1 its negative buoyancy became so largethat it snapped the line and went on down to the bottom at lsZOO ft. Althoughthis is an unusual accident, it shares a conmon element with other scuba acci-dents in the past, namely the danger of a diver becoming too engrossed withsome technical problem underwater as to fail to detect his movements withinthe water column. When this happens with a photographer, he may rise and em-bolize without realizing he has been moving upwards. In this case, it wouldappear that the two men failed to note how rapid'ly the system was going downand were probably overcome by narcosis below 200 ft.In a third, coneercial, scuba accident, two divers were repairing a waterlinefor a construction company when the buddy signaled he was law on air. The

victim signaled he would wait to tighten three more bolts; the buddy surf ~ceo.As the buddy was leaving the water, he stated that he heard a sound of metalhitting the underside of the metal work barge, The buddy then noted that thevictim's bubbles had stopped. When the victim was located at the 15-ft deeplocation, he had apparently ditched his tank, which was never found, but .tillhad on his weight belt. It is possible that the metallic noise was the ditch-ed tank hitting the underside of the barge or the diver himself coming upunder the barge and h1tting it. The autopsy showed only "drowning."

Two commercial divers wearing "daub'les" were surveying a wreck in more than200 ft of water when the victim apparently complained of air lack. The twomen buddy-breathed to the 100-ft level, when the victim was lost. The buddysurfaced and required recompression and medica! treatment, but recovered with-out injury. The victim was not found. It is not clear from the limited ac-count ava1lable whether the pair was using mixed gas or air at this depth andwhether the buddy was out of air or not.

The fifth professional fatality involved a German citizen diving with a U.S,research team off New England in the German habitat ~Hel eland. The completeteam had decompressed from their saturated state on the bottom inside a partof the habitat! and were ascending in the water column up a line. Surface seastate was very rough with waves 10 to 12 ft high, and when the team membersrealized this, they swam to the surface and were recovered by the support boat.The victim, however, left the line and clung to a ri gid gas exhaust pipe thatconnected the, habitat to the open atmosphere at the surface. This effectivelyheld him at a fixed depth below mean water level as the waves passed overhead

-' and he was apparently close enough to the surface so that the pressure changesfrom the waves were enough to produce lung rupture when he held his breath

Following this accident, the Scuba Safety Project searched through the approxi-' mately 1,200 fatal cases in its files to attempt to discover another diving

accident in which wave-induced pressure changes might have produced a similaroutcome, or in whi ch the case narrati ve suggested such a possibility. No suchcase was found, so this occurrence would appear to be unique. We would note,however, that such wave-induced embolisms are theoretically possible in highsea states in any situation in which a diver is held at a given depth as wavespass overhead. For example, a scuba diver planning a decompression stop at 10ft under high sea-state conditions and using a descending line to hold himselfat th1s depth is risk1ng this outcome.

In the single on-duty U.S. Navy fatality, two divers were attaching recoverypennants to gear on the bottom at between 65 and 90 ft when the victim notedhe was not getting air and attempted to buddy-breathe. The pa1r reached 40 ft

l when the victim's vest was accidentally inflated, and both rose rapidly. The' buddy managed to free himself at 20 ft and rose more slowly, but the victimI surfaced unconscious, received recompression treatment twice, but never r e-

~ ~ ~

gained consciousness and died some months later. The buddy also requ1red re-. compression, but recovered with no injury. What is not clear in this accident',,-is th~ cause of the initial air. lack. The victim's tanks conta1ned 1,600

lb/in , and his gear tested OK.

35

6.2: Hose-Supplied Diving Fatalities

It should be apparent from the brief descriptions of the scuba accidents in-volving professional divers in the previous section that such accidents arepart of the overall continuum of scuba diving deaths. That is, professiona1scuba divers suffer from the same errors and failures as do sport . cuba diveiloss of air at great depth, buddy separation, panic or inattention during ernegencies, and so on. Deaths involving hose diving usually fa11 into differentacci dent categories. Here hose entanglements, tender failure or inattention,sudden loss of. air due to boat problems, and "blowup" of inflated . uits aretypical starting causes of' ace~dents.

Of the six hose-supplied commercial deaths located by this office, four in-volved problems with equipment and a fifth involved hose entanglement on thebottom. Thus out of a sample of 132 fatal sport scuba accidents, only 4 in-volved equipment-related starting causes, whereas out of only 6 hose-suppliedaccidents in 1975, 5 involved equipment problems at critical points in thestart or development of the fatal event.

Two men diving with hooka masks and supplied from a compressor on the anchoresupport boat were attempting to bring up a net filled with sea urchHs, a conmercial enterprise. The net became tangled, and one of the divers returned tthe water to untangle it. At this point, two events began the fatal chain ofevents. The victim became entangled in the kelp and the boat, in stiff seas.began to drag anchor. When all 250 ft of hose had been paid out to counteracthis dragging, the hose came against the spinning flywheel of the compressorand was cut in two. The buddy diver required 10 min to dress again and cutthe victim out of the kelp, too late for any resuscitation to be effective.It seems extraordinary to us that a commercial dive boat would not have en-closed the motor-compressor flywheel system with a metal guard.

A second fatal accident involving both kelp and equipment involved what prob-ably should be called a "semiprofessional" diver, in that he was a beginnercommercial abalone diving. The victim, using a hooka system pumped by a sur-face compressor was in the water less than 10 min when he became entangled ',.kelp at only a few feet of depth. After his body was retrieved by a buddydiver, autopsy showed "drowning" as cause of death with no other implicatedmedical factors. When the equipment was tested in a university laboratory iwas found to requi re a maximum of 17.37 cm of water inhalation resistance wi~an upstream pressure of 80 psi compared to a "normal" maximum of 7.62 cm ofwater. Further, the investigators noted that as upstream pressure to thehooka regulator decreased, the inhalation resistance increased. Now if seve:al divers are working hard off a single compressor, it is possibl~ that thenormal upstream pressure may fall below the normal 80 to 90 lb/in hose pres-sure and thus this hooka system might show even higher inhalation resistance.In any case, the investigators note, "From the results of the test on the "hooka"! regulator, an inexperienced diver would become extreme1y overtaxedin breathing to the point of hyperventilation and anoxia causing the operatorto black out."

A third case implicating equipment involved an apparent air stoppage to twodivers harvesting seaweed for a commercial company that sells the weed for

36

medical purposes. One diver had reached the boat, either before or after tnestoppage, and the victim was then seen floating on the surface. Autopsyshowed only "drowning." The equipment was inspected by a local commercialdiving school, and various problems in the gear detected. The most importantis quoted, "Air hose to diver was very soft and flexible, therefore easy tocrush or kink, shutting off air to diver...hose will crush with only the 1oadof the weight belt �0 lb! from the hose." In addition to this, the engineexhaust was only 23 in from the compressor air intake, the copper air linefrom filter to volume tank was kinked, and the so-called air filter did nothave a drain and could not be emptied of trapped water and oil.

In a fourth equipment-implicated death, a commercial diver in the Far East wasworking in 280 ft for 30 min and began a decompression ascent. At 140 ft he"blew up" to the surface and immediately suffered a seizure, either from im-mediate "bends" or from an air embolism. Either or both! results are reason-able for this dive. Presumably this "blowup" was due to either a mistake ora malfunction involving the suit or life vest, but other details are notavailable.

A fifth case involving a trainee diver was unusual in that the diver suffereda head "squeeze" in a "hard hat" deepwater suit!, even though later investi-gation revealed no problem with the return valve on the helmet. A "squeeze"normally results from one of two basic causes. If the nonreturn valve of a"hard hat" allows leakage from the helmet back up the hose, the canvas, deep-water suit may partially collapse and "squeeze" the diver up into the helmet.Alternatively, if the diver falls from a shallow to a deeper depth faster than

.the surface compressor can keep the suit filled, a similar result obtains.

.;The progress of this diver was as follows: The victim made a 3-min descent to135 ft. He called his tender that he had reached the bottom. Then "a fewminutes later" he suddenly called to be brought up. The telephone volume was

'.--too low, and the tender asked the diver to say again. This time the tender..-.heard the request "in a high, excited voice" and attempted to get him up. How-.-ever, the diver was caught and a second diver, fortunately dressed, went down::,imtiediately. The victim was found, upright, f1oating a few feet off the bot-,I-tom. His air line had gotten under the descending line, and the man was not

thing. The rescue diver returned the man to the surface, and he was re-ressed. His neck and face was so swollen that his eyes and mouth couldbe opened. Autopsy showed a massive embolism, plus the signs of the headeze already noted. A very careful investigation of the equipment andts showed nothing. The gear was tested and found to be fine, including thern valve of the helmet. Although it will never be possible to establishtly what happened in this case, we suggest the following pattern of events:victim reached the bottom, but was not heard to "vent" his suit, that is,ake himself heavy. At this point we speculate that he "blew up" but, hav-his line caught under the descending line, did not reach the surface butstopped in midwater. He now shut off or decreased the inflow of gas anded his suit. This produced three things--a sudden loss of gas from theem, a fall back to 135 ft due to the decreased buoyance, and a reductionessation of gas from the surface. The squeeze occurred at this point indive. It is possible that an embolism occurred during the "blow up" as

8ack on the bottom and severely injured, the diver closed his vent,ed the input air valve, called for help, and passed out. The tender had

37

now taken up the slack in the line so that the victim could not "'.ilawup" ag�Even if he had not embolized during the initial rise, he could be expected tdo so during rescue since the squeeze had made any gas loss from the lungsunlikely, his mouth being held shut by the great amount of blood fori ed intothe face tissues by the squeeze. We can see no other reasonable explanatiorof this accident, but it is once again clear that a hose entanglement may haplayed an important part in the accident.

In the sixth commercial fatal case, a professional abalone diver in 60 Ft ofwater surfaced suddenly after 20 min. He was using a hooka rig and surfaceair compressor. He then went down again, but the buddy-tender noted that aiwas not being drawn From the surface volume tank. The buddy attempted to drthe diver up and felt resistance. The buddy then dove, and found the victimon the bottom with his regulator out of his mouth and copious amounts of bioand foam issuing from it. Autopsy showed "generalized air embolism." Apparently, the victim had suffered overpressure injury on his ascent, had fallenback to the bottom dead, and lost his mouthpiece in the process.

38

PART 7

SKINDIVING FATAL ACCIDENTS

7.1: Case Breakdown

The 15 skindiving fatal accidents detected in 1975 have been divided intothree groups: a! those in which weather, sea state, or currents played acentral role, b! those in which the case narrative suggested shallow-waterblackout as a cause of the accident, and c! those in which the data are in-sufficient to suggest a cause of the accident. The swimming pool accidentdiscussed in Section 2.4 will not be included here.

There were 6 autopsies in this group of 15 cases, but in none of these did theexamination supply a medical reason for the accident or death, other thandrowning. No heart, drug, or other problems were found, nor did any of thesesix autopsied cases involve head or other injury.

T.2: Environmental Accident Causes

Five of the 15 deaths definitely involved wave, current, or weather factors asthe accident-starting cause. In one double fatality, the first double skin-diving death of which we have knowledge, four young men were snorketing in achannel between two qf the Florida Keys, an area well known for strong cur-rents. When the weaker swimmer was caught in a current, his buddy attemptedto save him and was also swept away. Both drowned. A local marine patrolrescued the other two divers. These four young men were visitors to the Keysfrom a northern State.

In a Caribbean incident, a young man was diving alone in "rough surf." Afriend on the beach alerted authorities, the body was recovered, and oxygenadministered for 90 min, to no avail.

Two brothers, diving in Hawaii, were separated by 40 yd when the victim beganto shout that he was being carried off by a current. The brother went to the

, rescue and also began to cry for help. Four persons on the beach retrievedthe pair, but the vi ctim could not be revived.

In the final, weather-related accident, the victim, diving alone, was seen to"go limp" by his friend on the beach and was swept out to sea by a current.The Coast Guard responded and actually sighted the body, but could not catchit before it sank. From the narrative, it would appear that this diver suffer-ed some problem almost as soon as he entered the water, so that the currentwas probably not the precipitating cause of this death. Because the body wasnot recovered for 6 months, no further conclusions are possible at this time.The victim was an employee of a dive shop.

7.3: Possible Shallow-Water Blackout

There were three cases in which the case narrative suggested the possibilityof "shallow-water blackout." This problem, unique to breath-ho1d diving todepth, is caused by the metabolic uptake of the oxygen stored in the lung at

depth, followed by a rapid rise to the surface and the resulting decr ease ofgas partial pressure within the lung. This decrease has two physiolagicaleffects. It reduces the already low partial pressure of oxygen, creating apotential for anoxia and unconsciousness, and it reduces the carbon dioxidepartial pressure, which is a natural source of warning that the body requiresnew air, Since oxygen want does not produce physiological warning signs, thevictim feels no great need for air and tends to remain underwater or to risemore slowly than he should. Unconsciousness. can occur almost instantaneously.

This temporary anoxic condition cannot, as far as we are aware, be detected byautopsy. Thus shallow-water blackout can only be inferred from the account ofwitnesses to the accident. Me suspect this problem when an accident meets atleast some of the following criteria: a! The victim does not surface afterthe dive, or he surfaces in an unconscious state; b! the victim has beenmaking dives without difficulty; and c! the victim is described as a goodswimmer, experienced skindiver, or otherwise competent at what he i., doing.This is important since novice divers do not appear to push themselves to theblackout point, unless they suffer entrapment or delay in surfacing..

An example of such a case was in California. The victim and buddy wei e shar-ing an inner tube and making surface dives alternately. quoting the buddy,..." the victim! usually stays down a long time. When he disappeared he took hisbreaths apparently hyperventilating, a predisposing factor to shallow-waterblackout! as usual. When he didn't come up, I made several dives trying tofind him... the victim! was an experienced diver and a strong swimmer." Thevictim was not found for 3 months, and the autopsy found only "drowning."Everything in this account leads to a hypothesis af blackout, due either tothe victim miscalculating his oxygen situation or being momentarily distractedon the way up.

In a second, similar case, a man diving off a boat made a routine dIve andfailed to surface. His body was never found.

The third case involved two brothers, one in a boat and the other diving. Thebrother noted that the victim had made four dives before the fatal one, fol-lowing which he "floated to the surface unconscidus." He then sank and was recovered later by a rescue squad. Although an autopsy here might have detectedother things, the narrative clearly suggests a blackout: followed by drowning.

7.4: Other Skindiving Cases

Omitting the swimming pool case already discussed, there were six deaths inwhich no conclusions about cause could be reached. In five of these cases,the victim was alone when his emergency occurred. One victim was 8 yr old andusing mask and snorkel; his death appears to be a typical drowning. Three ofthe victims were simply found floating on the surface. One 22-yr-old woman iiia Caribbean accident was stated to have "suffered an attack," but no medicaldata were available. Although heart attack is mentioned by the press in manydiving accidents, our data section 3.5! cast suspicion on any such diagnosisfor a 22-yr-old not backed up by autopsy.

40

PART 8

References

BAYLISS, G.J.A.1966. Diving fatalities in Australia - illustrative cases. Med. J. Au..t:

1,262-1,264.COOPERMAN, E.M., et al.

1968. Mechanisms of death in shallow-water scuba diving. Can. Med.Assoc. J. 99: 1,128-1,131.

DENNY, M., AND R. READ.1965. Scuba diving deaths in Michigan. J. Am. Med. Assoc. 192:9-11.

DESAUT~.I S, O.1970. A ten year survey of skin and scuba diving fatalities in the State

of Florida. Unpubl. manuscr. 10 p.JUGEL, M.K.

1973. An analysis of civi 1 diving in the United States and the implicationsof the results of diver training. Mar. Tech. Soc. 9th 'Annu. Conf., Wash..D.C., p. 279-288.

KINDWALL, E., H.V. SCHENCK, JR., AND J.J. McANIFF.- 1971. Non-fatal, pressure-related scuba accidents, identification and

emergency treatment. Scuba Safety Rpt. No. 3, Univ. R. I., 21 p.LANSCHE, J.

1972. Deaths during skin and scuba diving in California in 1970. Calif.Med. 116:18-22.

LEGGIERE, T., et al.1970. Sound localization and homing of scuba divers. Mar. Tech. Soc. J.

4�!:27-340.McANIFF, J.J., AND H.V. SCHENCK, JR.

1974. Investigation of scuba deaths. J. Sports Med. 2�!:199-208.MILLER, O.J., et al.

1974. Results of the 1972 skindiving assessment survey. Pismo Beach toOregon. Calif. Dep. Fish Game, Mar. Res. Tech. Rpt. No. 23., 61 p.

MILLER, JAMES W. editor!1975. An analysis of the civil diving population of the United States.

U.S. Dep. Commer., NOAA, Manned Undersea Sci. Tech. Of., Wash., D.C.,48 p.

NOGUCHI, T.T., AND S.M. MOORE.1962. Scuba diving fatalities. Med. Arts Sci., Third Quarter: 81-87.

PEYSER, R., et al.1970. Corrosion of steel scuba tanks. Scuba Safety Rpt. No. 1, Univ. R. I.,

k'" SCHENCK, H.V., JR., AND J.J. McANIFF.

1971. Skin and scuba diving fatalities involving U.S. citizens. 1970.Scuba Safety Rpt. No. 2, Univ. R.I., 39 p.

SCHENCK, H.V., JR., AND J.J. McANIFF.1971. Diving accident survey, 1946-1970, including 503 known fatalities.

Scuba Safety Rpt. No. 5, Univ. R.I., 39 p.SCHENCK, H.V., JR., AND J.J. McANIFF.

~ ~ ~ ~ ~ ~ ~ ~1942. Mortality rates for skin and scuba divers. Scuba SafetyRpt. No. 7, Univ. R.I., ll p.

41

SCHENCK, H.V., JR., AND J.J. McANIFF.1972. An analysis of fatal skin and scuba diving accidents. Mar, Tech,

Soc. J. 6�!: 41-48.SCHENCK, H.V., JR., AND J.J. McANIFF.

1973. United States Underwater Fatality Statistics � 1972. U.S. Dep.Corrmer., NOAA, Manned Undersea Sci. Tech. Of., Wash., D.C., 38 p.

SCHENCK, H.V., JR., AND J.J. McANIFF.1975. United States Underwater Fatality Statistics � 1973. U.S. Dep.

Commer., ROAA, Manned Undersea Sci. Tech. Of., Wash., D.C,, 49 p.SCHENCK, H.V., JR., AND J.J. McANIFF.

1976. United States Underwater Fatality Statistics - 1974. U.S. Dep.Comner., NOAA, Manned Undersea Sci. Tech. Of., Wash., D.C., 76 p.

SINGER, R.1971. A study of southern California scuba and free diving fatalities.

County of Los Angeles, Calif., Parks Recreation Dep., 21 p,TENNEY, J.B.

1971. 2400 hours of saturation diving, a statistical analysis of TektiteII. Scuba Safety Rpt. No. 4, Univ. R. I., 64 p.

WALLER, S.D.1970. Autopsy features in scuba diving fatalities. Med. J. Aust. 1�2!:1,106-1,108.

WEBSTER, D.1966. Skin and scuba diving fatalities in the United States. Public Health

Rpt. 81 8!: 703-711.WEETH, J.B.1965. Management of underwater accidents. J. Am. Med. Assoc. 192�!:6-11.

FOrward report to:

NATIOHAl UNDERWATER ACCIDENT DATA CENTERUNDE RWATf R

ACCIDENT REPORT P.O. 8ox 68 � Kingston, R. I. 0288I

Victim's Sex . Age .. Hgt..htar ta Statue: lf ... S ... D ... W UNK

Name of V ct m:fiat

Address: Occupation .

EmployerState

CIRCLE LOCATIONrgy Cods fvumbsr!l. Ocean. Bay, Sea2. M nor Lake, Pond, Slough3. Quarry. Pit, Open Mine3A. .'ave

S. RiverS. Major Lake, I'ondB. Swimming Ptxtl7. Great LakesStats

l ljury rendertltg personunable to perform normal acttvltlce aswalking or diving or to leave scene with-out asststanoe.

fL Nonineapacltatlng evident Injury as lossof blOOd, abraslons, lump on head, etc.

At Ume of Incident,Activities engaged ln:Recreational

Description of ail dives within previous l2 hoursincluding accident dive.

seats ci«a Ovva set et ~ Ia «vs CommercialUnder instructionInstructingCave divingSpear SshlngPhotographyNight diving

fsL0

0 e

Type of Diving: Explain If Necessary Scuba..... Skin,.... Other ..... Unicnown Vessels involved

V«««vtU.S, Coast Guard aid sought

r«« tivt Cire Details In Doser ption of Accident',Name, Captain. Address, Phone, etc.!

Others in accident vtt « tts!

Separate report Sled Y«««s!

Fuaclk«t/Ifo eName

Oiler Co«far s:Name .NameAddress

tx

JqE

CityCity

43

Location of Accidentlust landmarks,distance frompronilnent terrainfeatures A.ttachChart or MapIf available I

CODE IrOB NON-FATAL INCIDENTCircle one only A, B, C, or D! which bestdescribes ser oneness of incident. It«portent.Report all "Incidents", however minor. De-scribe in data I on page B. inc ude equip-ment factors.

C Pea«lb e injury indicated by comp a n ngof pain, blackout, limping, nausea, ctc.

D. Incident with no apparent injury, incormiss. etc.!

At time of Incident,Buddy recordDiving aloneDiving with buddyBuddy distanceDiving with morcthan oneDistance to nestneareet diver

Courses end Agenct Swtmming Expertence: Years

Skindtv ntf Rxpertence: Years

Scuba Expertence: Years

Certi >ca > c DaleD DD-

Hours of sleep in pest 24 hours

Ttme of last meal .

T me of last a cohottc drink

Any known physical atlrncnts. dlsabtllty or ltnpulrment?

What and hOW muene

What and how mush'.

44

Dlustrate all vtstbte njurtes cu s, abrasions, fractures. etc l

KQUIPMKNT DATA

NOTE; Bee p»taut Br»»d, Type aed ger!el bfumber data «esd be lec!edsd eely <f eaalfeertloe ar fauere acescoa ribs!ory lo the !so»lent.

Flotntlon Devise. UsedTenn: Alr Lett, tello!Last Hydro-Test Date .Lest Visual inspect!on Dele .Internal Condition: Clean,

SI!g!d Corroe}onExtensive ~on

ivan o ns!

Tested after event 1

Regulator Teebed v lv»I e us!

peoes

Special Comments ou Equipment

Kqutysnsnt D!speeted by: . ruout

Equipment; Released to/Or Hald by. paous

45

nmTajr.b ~ II nKSCftff ~ TfOW OF ACafnrh T

Describe tn detail bow the accident happened, Includlnif what the person wae dotntf, any speeidc marine life cr oh' actsand the ection or movement which led to the event. Include detaits of drat aid or reeuscttation efforts Desrribe any"Decompression" and/or "ftecompresston-Treatment" tn descrtptton of accident.

* U. S. COVERNMSnr Fsufrlnu Orl'ICE: '977--iso e~ehte