Heavy Currents Contribute to Serious Head Injury

Heavy seas create problems for a diabetic diver who nearly drowns after a ladder hits his head.
(2012,USA)

Reported Story

I took part in a wreck-diving excursion on a charter boat in the Atlantic. Waves were 5-6 feet, and the captain said there was a half-knot current. Several divers, including myself, were seasick and decided not to dive. Some divers entered the water but cut their dives short. Several other overweight divers, however, completed their dives. I felt if they could, I could do it, too. Someone advised that I’d feel better as soon as I was in the water, so I decided to try it. I used a drysuit and double 108s with wing.

I entered the water last, just as the boat was calling off a second dive. I was advised to “get below the current immediately,” so I had no air in the drysuit or wing. The current was strong enough that divers went in holding a rope, and the first mate pulled them to the hang bar. I believe the current was closer to 3 or 4 knots at that time.

After a giant-stride entry, I was pulled to the hang bar but could not swim into the current and realized I was in trouble. My inflator (on the wing) had gone over my back, and I could not reach it. I did not think about using the drysuit inflator. I was kicking toward the surface and telling the mate I needed help. He wanted to pull me back to the hang bar. Finally the boat captain heard me and entered the water to assist me to the ladder. I could not make him understand that I needed my inflator.

The seas seemed huge; I was seeing the starboard side prop from the port side of the boat. I have no recollection of the journey to the ladder, but I must have missed it because I was on the current rope, on my back and “zooming” to the end of it. Something was tugging my regulator, and I was inhaling a mist of water and air.

After a tremendous effort by the operator and my dive buddy, I had the ladder. However, the boat took a large wave, turned me sideways, and the ladder hit me on the temple. I saw my vision narrow to a yellow-tinged tunnel; I remember only my loss of the current line, sinking, a mighty push on my feet and reacquisition of the line. I remember hearing shouts to get ropes on me, continued struggling and finally I was on the rear platform. I was exhausted and could not move to help myself onto the boat. Somehow others got me onto the boat, removed my drysuit and gave me oxygen immediately and for the duration of the return trip.

A Coast Guard craft intercepted us on the way and put medics on board; we continued to the USCG station to a waiting ambulance. At the hospital I was diagnosed as a saltwater “partial” drowning and given continuous oxygen therapy. Later, I was transferred to another hospital, where treatment continued; medical personnel noted I had numbers indicating a kidney issue. They adjusted my existing medications — I am an insulin-dependent diabetic taking Humulin R500 as well as Naproxin for joint pain. I was released the next day, went home to my own doctor and was immediately admitted to the local hospital, where they continued treatment for drowning, then renal failure and finally atrial fibrillation. I was in the hospital for about 10 days and continued to convalesce for nearly a month.

This incident was my fault entirely, as I made poor decisions at each point. I was seasick, dehydrated, overheated, diving with the wrong gear, determined to dive simply to avoid wasting the money, ignoring the experience of other divers who chose not to dive, accepting the notion that I’d feel better in the water and, finally, diving with no buoyancy. I have recovered completely, have made some dives since then and plan to continue diving, using this experience as a guide for future decisions.

Comment

Bad judgments, both on the diver’s side and the dive operator’s side, contributed to this accident. If the sea was so heavy and the current so strong, the operator should have raised a yellow flag, which would warn divers to abstain from diving if they are not healthy and fit for the occasion (e.g., overweight divers, older divers, diabetics, unfit divers and beginners). Unfortunately, there is no established system in diving similar to the one used on public beaches or on the ski slopes that could help divers make proper decisions.

In this case, the diver was aware of all the issues yet still used bad judgment. He is a 67-year-old, experienced diver with 18 years of diving, completely able to make responsible calls. Severe seasickness may have affected his judgment. That is another reason for dive operators to assist divers with their decisions.

There were no details in the report about medical fitness to dive for this diver. Developing renal (kidney) failure may indicate that he already had end-organ damage, which comes with diabetes, including heart diseases. However, when explicitly asked, he said he had a cardiac physical including stress tests and an echocardiogram about six months prior to the incident and was cleared to dive. His blood pressure was 115/75 without medication. Regardless of medical fitness, it is not very likely that a 5’9″ tall diver weighing 275 pounds is physically fit for the challenges of the wreck diving in the Graveyard of the Atlantic.

Petar Denoble, M.D., D.Sc.

English