Skip to main content
Top
Published in: Forensic Science, Medicine and Pathology 1/2014

01-03-2014 | Review

Recent modifications to the investigation of diving related deaths

Authors: Carl Edmonds, James Caruso

Published in: Forensic Science, Medicine and Pathology | Issue 1/2014

Login to get access

Abstract

The investigation of deaths that involve diving using a compressed breathing gas (SCUBA diving) is a specialized area of forensic pathology. Diving related deaths occur more frequently in certain jurisdictions, but any medical examiner or coroner’s office may be faced with performing this type of investigation. In order to arrive at the correct conclusion regarding the cause and manner of death, forensic pathologists and investigators need to have a basic understanding of diving physiology, and should also utilize more recently developed technology and ancillary techniques. In the majority of diving related deaths, the cause of death is drowning, but this more often represents a final common pathway due to a water environment. The chain of events leading to the death is just as important to elucidate if similar deaths are to be minimized in the future. Re-enactment of accident scenarios, interrogation of dive computers, postmortem radiographic imaging, and slight alterations in autopsy technique may allow some of these diving related deaths to the better characterized. The amount and location of gas present in the body at the time of autopsy may be very meaningful or may simply represent a postmortem artifact. Medical examiners, coroners, and forensic investigators should consider employing select ancillary techniques to more thoroughly investigate the factors contributing a death associated with SCUBA diving.
Literature
1.
go back to reference Pollock N. Divers Alert Network annual review of recreational scuba diving injuries and fatalities. Durham, NC: Divers Alert Network; 2011. Pollock N. Divers Alert Network annual review of recreational scuba diving injuries and fatalities. Durham, NC: Divers Alert Network; 2011.
2.
go back to reference Edmonds C. Why divers die. In: Edmonds C, Lowry C, Pennefather J, Walker R, editors. Diving and subaquatic medicine. 4th ed. London: Edward Arnold; 2002. p. 473–90. Edmonds C. Why divers die. In: Edmonds C, Lowry C, Pennefather J, Walker R, editors. Diving and subaquatic medicine. 4th ed. London: Edward Arnold; 2002. p. 473–90.
3.
go back to reference Walker D. Report on Australian diving deaths, 1972–1993. Melbourne: DAN Southeast-Pacific; 1996. Walker D. Report on Australian diving deaths, 1972–1993. Melbourne: DAN Southeast-Pacific; 1996.
4.
go back to reference Edmonds C. A forensic diving medicine examination of a highly publicized diving fatality. Diving Hyperb Med. 2012;42:224–30.PubMed Edmonds C. A forensic diving medicine examination of a highly publicized diving fatality. Diving Hyperb Med. 2012;42:224–30.PubMed
5.
go back to reference Wheen LC, Williams MP. Post-mortems in scuba diving deaths: the utility of radiology. J Forensic Leg Med. 2009;16:273–6.PubMedCrossRef Wheen LC, Williams MP. Post-mortems in scuba diving deaths: the utility of radiology. J Forensic Leg Med. 2009;16:273–6.PubMedCrossRef
6.
go back to reference Lawrence C. Interpretation of gas in diving autopsies. Diving Hyperb Med. 1997;27:228–30. Lawrence C. Interpretation of gas in diving autopsies. Diving Hyperb Med. 1997;27:228–30.
7.
go back to reference Edmonds C. Investigations of diving fatalities. In: Edmonds C, Lowry C, Pennefather J, Walker R, editors. Diving and subaquatic medicine. 4th ed. London: Edward Arnold; 2002. p. 517–30. Edmonds C. Investigations of diving fatalities. In: Edmonds C, Lowry C, Pennefather J, Walker R, editors. Diving and subaquatic medicine. 4th ed. London: Edward Arnold; 2002. p. 517–30.
8.
go back to reference Lawrence C, Cooke C. Autopsy and the investigation of scuba diving fatalities. Melbourne: The Royal College of Pathologists of Australia; 2003. Lawrence C, Cooke C. Autopsy and the investigation of scuba diving fatalities. Melbourne: The Royal College of Pathologists of Australia; 2003.
9.
go back to reference Caruso JL. Autopsy protocol for recreational diving fatality. In: Proceedings of the Divers Alert Network workshop on recreational scuba diving fatalities. Durham: Divers Alert Network; 2011. Caruso JL. Autopsy protocol for recreational diving fatality. In: Proceedings of the Divers Alert Network workshop on recreational scuba diving fatalities. Durham: Divers Alert Network; 2011.
10.
go back to reference Caruso JL. Pathology of diving accidents. In: Brubakk AO, Neuman TS, editors. Physiology and medicine of diving. 5th ed. Philadelphia: WB Saunders; 2003. p. 729–43. Caruso JL. Pathology of diving accidents. In: Brubakk AO, Neuman TS, editors. Physiology and medicine of diving. 5th ed. Philadelphia: WB Saunders; 2003. p. 729–43.
11.
go back to reference Teather RG. Encyclopedia of underwater investigations. Flagstaff, AZ: Best Publishing; 1994. Teather RG. Encyclopedia of underwater investigations. Flagstaff, AZ: Best Publishing; 1994.
12.
go back to reference Hanson RG, Young JM. Diving accidents. In: Bennett P, Elliot D, editors. Physiology and medicine of diving and compressed air work. Baltimore: Williams and Wilkins; 1975. p. 554. Hanson RG, Young JM. Diving accidents. In: Bennett P, Elliot D, editors. Physiology and medicine of diving and compressed air work. Baltimore: Williams and Wilkins; 1975. p. 554.
13.
go back to reference Cole AJ, Griffiths D, Lavender S, Summers P, Rich K. Relevance of postmortem radiology to the diagnosis of fatal cerebral gas embolism from compressed air diving. J Clin Pathol. 2006;59:489–91.PubMedCrossRef Cole AJ, Griffiths D, Lavender S, Summers P, Rich K. Relevance of postmortem radiology to the diagnosis of fatal cerebral gas embolism from compressed air diving. J Clin Pathol. 2006;59:489–91.PubMedCrossRef
14.
go back to reference Brown CD, Kime W, Sherrer EL Jr. Postmortem intravascular bubbling: a decompression artifact? J Forensic Sci. 1978;23:511–8.PubMed Brown CD, Kime W, Sherrer EL Jr. Postmortem intravascular bubbling: a decompression artifact? J Forensic Sci. 1978;23:511–8.PubMed
15.
go back to reference Laurent PE, Coulange M, Bartoli C, et al. Appearance of gas collections after scuba diving death: a computed tomography study in a porcine model. Int J Leg Med. 2013;127:177–84.CrossRef Laurent PE, Coulange M, Bartoli C, et al. Appearance of gas collections after scuba diving death: a computed tomography study in a porcine model. Int J Leg Med. 2013;127:177–84.CrossRef
16.
go back to reference DeMaio VY, DeMaio D. Forensic pathology. 2nd ed. Boca Raton, FL: CRC Press; 2001. DeMaio VY, DeMaio D. Forensic pathology. 2nd ed. Boca Raton, FL: CRC Press; 2001.
17.
go back to reference Denoble PJ, Caruso JL, Dear GL, Peiper CF, Vann RD. Causes of recreational diving fatalities. Undersea Hyperb Med. 2008;35:393–406.PubMed Denoble PJ, Caruso JL, Dear GL, Peiper CF, Vann RD. Causes of recreational diving fatalities. Undersea Hyperb Med. 2008;35:393–406.PubMed
18.
go back to reference Edmonds C. Reappraisals of a diving disaster. Royal Australian Navy School of Underwater Medicine Report 4/68. RAN. SUMU. 1968. Edmonds C. Reappraisals of a diving disaster. Royal Australian Navy School of Underwater Medicine Report 4/68. RAN. SUMU. 1968.
19.
go back to reference Levy AD, Harcke HT, Getz JM, Mallak CT, Caruso JL, Pearse L, Frazier AA, Galvin JR. Virtual autopsy: two- and three-dimensional multidetector CT findings in drowning with autopsy comparison. J Radiol. 2007;243:862–8.CrossRef Levy AD, Harcke HT, Getz JM, Mallak CT, Caruso JL, Pearse L, Frazier AA, Galvin JR. Virtual autopsy: two- and three-dimensional multidetector CT findings in drowning with autopsy comparison. J Radiol. 2007;243:862–8.CrossRef
20.
go back to reference Shiotami S, Kohno M, Ohashi N, et al. Cardiovascular gas on non-traumatic postmortem computerized tomography (PMCT): the influence of cardiopulmonary resuscitation. Radiat Med. 2005;23:225–9. Shiotami S, Kohno M, Ohashi N, et al. Cardiovascular gas on non-traumatic postmortem computerized tomography (PMCT): the influence of cardiopulmonary resuscitation. Radiat Med. 2005;23:225–9.
21.
go back to reference Shiotami S, Ueno Y, Atake S, et al. Nontraumatic postmortem computed tomographic demonstration of cerebral gas embolism following cardiopulmonary resuscitation. J Radiol. 2010;28:1–7. Shiotami S, Ueno Y, Atake S, et al. Nontraumatic postmortem computed tomographic demonstration of cerebral gas embolism following cardiopulmonary resuscitation. J Radiol. 2010;28:1–7.
22.
go back to reference Imanishi M, Nishimura A, Tabuse H, et al. Intracranial gas on CT after cardiopulmonary resuscitation. Neuroradiology. 1998;40:154–7.PubMedCrossRef Imanishi M, Nishimura A, Tabuse H, et al. Intracranial gas on CT after cardiopulmonary resuscitation. Neuroradiology. 1998;40:154–7.PubMedCrossRef
23.
go back to reference Plattner T, Thali MJ, Yen K. Virtopsy—post mortem multislice computed tomography (MSCT) and magnetic resonance imaging (MRI) in a fatal scuba diving incident. J Forensic Sci. 2003;48:1–9. Plattner T, Thali MJ, Yen K. Virtopsy—post mortem multislice computed tomography (MSCT) and magnetic resonance imaging (MRI) in a fatal scuba diving incident. J Forensic Sci. 2003;48:1–9.
24.
go back to reference Edmonds C, Lippmann J, Lockley S, Wolfers D. Scuba divers’ pulmonary edema: recurrences and fatalities. Diving Hyperb Med. 2012;42:40–4.PubMed Edmonds C, Lippmann J, Lockley S, Wolfers D. Scuba divers’ pulmonary edema: recurrences and fatalities. Diving Hyperb Med. 2012;42:40–4.PubMed
25.
go back to reference Edmonds C, Lowry C, Pennefather J, Walker R. Diving and subaquatic medicine. 4th ed. London: Edward Arnold; 2002. Edmonds C, Lowry C, Pennefather J, Walker R. Diving and subaquatic medicine. 4th ed. London: Edward Arnold; 2002.
26.
go back to reference Boycott DM, Damant GCC, Haldane JS. The prevention of compressed air illness. J Hyg. 1908;8:342–443.PubMedCrossRef Boycott DM, Damant GCC, Haldane JS. The prevention of compressed air illness. J Hyg. 1908;8:342–443.PubMedCrossRef
27.
go back to reference Hill L. Caisson sickness and the physiology of work in compressed air. New York: Longmans, Green and Company; 1912. Hill L. Caisson sickness and the physiology of work in compressed air. New York: Longmans, Green and Company; 1912.
28.
go back to reference Hoff EC. Decompression sickness, pathological lesions, post-mortem findings: a bibliographical sourcebook of compressed air, diving and submarine medicine, NAVMED 1191. Washington, DC: Department of the Navy; 1948. Hoff EC. Decompression sickness, pathological lesions, post-mortem findings: a bibliographical sourcebook of compressed air, diving and submarine medicine, NAVMED 1191. Washington, DC: Department of the Navy; 1948.
29.
go back to reference Gersh I, Catchpole HR. Decompression sickness: physical factors and pathological consequences. In: Fulton JF, editor. Decompression sickness. Philadelphia: WB Saunders; 1951. p. 165–81. Gersh I, Catchpole HR. Decompression sickness: physical factors and pathological consequences. In: Fulton JF, editor. Decompression sickness. Philadelphia: WB Saunders; 1951. p. 165–81.
30.
go back to reference Ackles KN. Blood bubble interaction in decompression sickness. In: Proceedings of DCIEM Symposium. Canada, Toronto: DCIEM; 1973. Ackles KN. Blood bubble interaction in decompression sickness. In: Proceedings of DCIEM Symposium. Canada, Toronto: DCIEM; 1973.
Metadata
Title
Recent modifications to the investigation of diving related deaths
Authors
Carl Edmonds
James Caruso
Publication date
01-03-2014
Publisher
Springer US
Published in
Forensic Science, Medicine and Pathology / Issue 1/2014
Print ISSN: 1547-769X
Electronic ISSN: 1556-2891
DOI
https://doi.org/10.1007/s12024-013-9491-x

Other articles of this Issue 1/2014

Forensic Science, Medicine and Pathology 1/2014 Go to the issue