Skip to main content
Log in

Recent modifications to the investigation of diving related deaths

  • Review
  • Published:
Forensic Science, Medicine, and Pathology Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Pollock N. Divers Alert Network annual review of recreational scuba diving injuries and fatalities. Durham, NC: Divers Alert Network; 2011.

  2. 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.

    Google Scholar 

  3. Walker D. Report on Australian diving deaths, 1972–1993. Melbourne: DAN Southeast-Pacific; 1996.

    Google Scholar 

  4. Edmonds C. A forensic diving medicine examination of a highly publicized diving fatality. Diving Hyperb Med. 2012;42:224–30.

    PubMed  Google Scholar 

  5. Wheen LC, Williams MP. Post-mortems in scuba diving deaths: the utility of radiology. J Forensic Leg Med. 2009;16:273–6.

    Article  PubMed  Google Scholar 

  6. Lawrence C. Interpretation of gas in diving autopsies. Diving Hyperb Med. 1997;27:228–30.

    Google Scholar 

  7. 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.

    Google Scholar 

  8. Lawrence C, Cooke C. Autopsy and the investigation of scuba diving fatalities. Melbourne: The Royal College of Pathologists of Australia; 2003.

    Google Scholar 

  9. 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. 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.

    Google Scholar 

  11. Teather RG. Encyclopedia of underwater investigations. Flagstaff, AZ: Best Publishing; 1994.

    Google Scholar 

  12. 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.

    Google Scholar 

  13. 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.

    Article  CAS  PubMed  Google Scholar 

  14. Brown CD, Kime W, Sherrer EL Jr. Postmortem intravascular bubbling: a decompression artifact? J Forensic Sci. 1978;23:511–8.

    CAS  PubMed  Google Scholar 

  15. 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.

    Article  Google Scholar 

  16. DeMaio VY, DeMaio D. Forensic pathology. 2nd ed. Boca Raton, FL: CRC Press; 2001.

    Google Scholar 

  17. Denoble PJ, Caruso JL, Dear GL, Peiper CF, Vann RD. Causes of recreational diving fatalities. Undersea Hyperb Med. 2008;35:393–406.

    CAS  PubMed  Google Scholar 

  18. Edmonds C. Reappraisals of a diving disaster. Royal Australian Navy School of Underwater Medicine Report 4/68. RAN. SUMU. 1968.

  19. 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.

    Article  Google Scholar 

  20. 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.

    Google Scholar 

  21. 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.

    Google Scholar 

  22. Imanishi M, Nishimura A, Tabuse H, et al. Intracranial gas on CT after cardiopulmonary resuscitation. Neuroradiology. 1998;40:154–7.

    Article  CAS  PubMed  Google Scholar 

  23. 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.

    Google Scholar 

  24. Edmonds C, Lippmann J, Lockley S, Wolfers D. Scuba divers’ pulmonary edema: recurrences and fatalities. Diving Hyperb Med. 2012;42:40–4.

    PubMed  Google Scholar 

  25. Edmonds C, Lowry C, Pennefather J, Walker R. Diving and subaquatic medicine. 4th ed. London: Edward Arnold; 2002.

    Google Scholar 

  26. Boycott DM, Damant GCC, Haldane JS. The prevention of compressed air illness. J Hyg. 1908;8:342–443.

    Article  CAS  PubMed  Google Scholar 

  27. Hill L. Caisson sickness and the physiology of work in compressed air. New York: Longmans, Green and Company; 1912.

    Google Scholar 

  28. 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.

    Google Scholar 

  29. Gersh I, Catchpole HR. Decompression sickness: physical factors and pathological consequences. In: Fulton JF, editor. Decompression sickness. Philadelphia: WB Saunders; 1951. p. 165–81.

    Google Scholar 

  30. Ackles KN. Blood bubble interaction in decompression sickness. In: Proceedings of DCIEM Symposium. Canada, Toronto: DCIEM; 1973.

Download references

Acknowledgments

The authors wish to acknowledge: Ted Harcke, M.D., Office of the Armed Forces Medical Examiner, Dover, DE, John Lippman, OAM, Divers Alert Network Australia, and Jeanette Moore, Divers Alert Network, Durham, NC.

Disclaimer

The opinions expressed here are those of the authors and do not reflect official policy of the United States Navy, The Department of Defense, or the United States Government.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to James Caruso.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Edmonds, C., Caruso, J. Recent modifications to the investigation of diving related deaths. Forensic Sci Med Pathol 10, 83–90 (2014). https://doi.org/10.1007/s12024-013-9491-x

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12024-013-9491-x

Keywords

Navigation