Why Divers Die: Part Two

In our regular series of articles on diver’s deaths, we cover, month by month, a full spectrum of reasons divers failed to survive a dive. A unifying theme, however, is diver error, which almost always contributes to the tragedy. These cases are based on the latest case reports from the Divers Alert Network, the South Pacific Underwater Medical Society, and other sources.

In the last issue, we wrote about how panic is a stressor and why it can be especially dangerous to a diver with heart disease.

Heart disease, alone, however, is a major cause of death while diving. Because tropical resort diving seems a relatively easy recreation to many people, diving can attract people who are not in shape and unaware of heart problems. Yet the stress of getting suited up, entering the water, struggling with equipment, fighting currents, and climbing up a ladder are each stressors that can affect people with heart conditions. Here are the circumstances of a few deaths where the act of diving seems to have been enough to cause a death.

This 32-year-old experienced diver made an uneventful dive to 113 fsw, followed by a 14-minute slow ascent. Nevertheless, on the surface he developed shortness of breath and went into cardiopulmonary arrest. He lingered for two days before dying.

A diving instructor with extensive experience put a group of students through the required skills tests for open water certification. While helping one student through an emergency ascent, he suddenly lost consciousness, a victim of a heart attack. This 54-year-old certified diver had a history of hypertension and coronary artery disease, but continued to dive. He made a 30- minute dive to 80 fsw but became distressed and began hyperventilating. He ran out of air and buddybreathed to the surface, but died, apparently of a heart attack.

A 41-year-old experienced diver was making deep trimix dives to explore a wreck with a group of divers. He made an uneventful first dive to 180 fsw, following it with a second to 170 fsw. During this dive, he lost consciousness on the bottom. His dive buddies, faced with the difficult situation of having an unconscious diver on the bottom, inflated his buoyancy compensator and sent him directly to the surface. After CPR, he was transferred to a local emergency room where he was pronounced dead. Surfacing while unconscious, he suffered from an embolism, but the cause of the death was a heart attack at depth.

While this 49-year-old certified diver was severely overweighted, he was able to return to the surface just two minutes after descending. He complained of heart palpitations, then lost consciousness and could not be resuscitated; an autopsy discovered valvular heart disease.

The apparent ease of diving allows people to dive who are not physically fit, as was the case of this 49-year diver with an advanced open-water certification. She and her husband made three dives from their boat (101, 88, and 85 fsw) without any support personnel remaining on the boat. On the third dive, her husband surfaced with no air. She surfaced three different times, each in an attempt to get closer to the boat. She finally surfaced a distance from the boat, but the seas were rough, and she was unable to make the swim back and drowned.

Even snorkeling can be too much of a stressor when the snorkeler has a bad ticker. In this Australian case, a fellow was snorkeling on a day trip to the Barrier Reef. After his wife had snorkeled, she returned to the pontoon and gave her husband the mask and snorkel. One of the crew advised him to reposition the mask strap, advice he did not appreciate. His wife and the crew member watched him for a time, then both were distracted. A short time later the lookout saw him drifting at the surface with his head dipping from time to time, not reacting when the end of the snorkel becoming submerged. When they reached him, he was unconscious, and an autopsy uncovered a fatal cardiac event.

Of course, heart disease is the perfect example of the adage about an ounce of prevention being worth a pound of cure. Little divers do while underwater can compensate for time invested in keeping fit prior to making the dive. In our next issue, however, we report on a cause of death that originates within the dive itself and is often entirely within divers’ hands: death by entrapment.

— Ben Davison