29 Dec 10 Fiji Diving Incident (Amy O'Maley Fatality), Part I

[JB]

Failure to have an AED can be a liability issue. (At least one gym had to settle a very large suit on account of not having an AED when a client died on site. Another gym has been sued multiple times and has settled most of the suits with payments.) ]

Sorry to pick a bone on this but just because there was a succsessful lawsuit doesn't make it right! In a first world country it is not unreasonable to have a defib in places where people exercise. The cause of death is usually primary arrhythmia due to ischaemia. This is exactly the situation where early difibrillation will be most effective. The person is on dry land and defib can occur within minutes, no huge oxygen debt. In drowning the cause of arrest is hypoxia, and in diving there is usually a significant delay before the victim is extracted with a huge oxygen debt. Good quality CPR with adequate oxygenation may be necesary before defib will be effective.
The cost is a not a 1 off in purchasing the equipment it is in the ongoing maintenance, checking, replacement. For something that is hopefully/probably going to be used once in 20 years or more on any given dive boat. How would it look if it was there but didn't work!! For every minute that defib is delayed mortality increases by 10%.
I think I agree with other posters the answer is in prevention.

 

[Zodiacdiverdave]

I still haven't heard from the OP but I put a question to him in an earlier responce. I do not mean in any way to lay a guilt trip on him or point any fingers. My intent was only for him to reflect on possible ways he could have prevented the accident from developing in the first place. In reading his very detailed report I can tell this had a profound effect on him and all the rescuers involved. My hart goes out for them as I know how they are feeling.
About 25 years ago I was on a charter with one of my buddies that I always dive with. At this time I had at least 1000 dives or more in some of the most demanding conditions, I would consider myself to be an experienced diver as was my buddy. Also on the boat was a good friend of mine who had got his OW cert. about a year befor but hadn't dove since the course. When we got to the dive site my buddy and I were suited up and ready to hit the water so we were the first ones in. The current was running really good but we knew what to do and headed strait for the bottom. (starting to sound familiar yet) We were in the water for about 10 min. when we heard the diver recall go off. We headed back to the boat and somewhat p1ssed off that we had to cancell the dive because someone screwed up.
When we got back to the boat we found out what had happened, my freind the inexperienced diver tried to go down but did not have enough weight on so he bobed back up but by now he was some distance from the boat and drifting fast. He was beginning to panic and thrash when someone noticed him, I don't know where his buddy was at this time, probably did what we did and went strait to the bottom to get out of the current. The person that noticed him grabbed the drag line and swam to my friend to perform the rescue. This could have turned out with the same results as little Amy's accident, pure luck I would say that it didn't.
I have reflected on this incident many times, I should have taken him under my wing and made sure he was going to be allright or at the very least when I reallized that the current was not good for rookies I should have surfaced and reported this so new divers could have opted out. Now when I dive with other people, regardless if it's a charter or shore dive if they are new to the sport or appear to be new I will offer assistance, the trick is to be tactful and not come off looking like you are some sort of diving god.
In Amy's case when it was noticed that the current was running strong, that maybe just a word of caution from one of the other divers on the boat might have been enouph to get her to thumb the dive.
When you are diving with a group you really are buddies with every one in that group. Don't be afraid to mention something to others if you see something not right, just do it tactfully.
This thread should be a discussion about how to prevent this sort of thing from happening rather then focousing on how to better deal with it when it does happen.
ZDD

 

[Neuatomic]

Where people are very poor, the concept of a $1200 piece of equipment to deal with the very rare near-fatality probably seems absurd.

Indeed. And the concept is, in fact, absurd. I'm always amazed how some folks can travel to the most poverty-stricken areas of the world and be so completely oblivious to the grinding poverty surrounding them. Until of course they need assistance and then its a shocking surprise, and in the very worst cases, an indignity.

 

[2 Big 2 Fail]

I can't really tell if you're for all dive boats having an AED or not.

As for gyms being sued, it's a completely different scenario. People have a reasonable expectation not to die in a gym. Arguably, that is also the case for diving, but there is a much higher "reasonable expectation" that if something happens you will die diving, which is not the case of working out in a gym. Basically apples and oranges comparison so the liability is questionable at best for operators who don't carry an AED on boat.

There's no question having one would be beneficial if ever needed, and the salt-water issue can be easily dealt with though it will make them even more expensive.

Sorry. Of course I would like to see them on all dive boats. And in many other public places where there is a higher than usual likelihood of need, either because of the number of people there, the nature of what they do there, or their demographics. My first-responder organization buys, places, and maintains AED's in sheriff's patrol cars, as well as with our own responders who live in more remote areas. It is, of course, a matter of economics. We can't afford to place all we would like.

I see the analysis of expectations you use in a different way. True, unless it's a truly rotten gym, they're fairly safe places. You probably bring your own death with you, so to speak. Diving is certainly more dangerous. But I think both the gym and the dive boat operator know or should know that the activities they are selling both carry a relatively greater likelihood of cardiac emergency. Neither (hopefully) are responsible for causing a death. But torts analyze the duties of respondents. Legal commentators acknowledge that in the gym AED suits, the fact that duties can evolve is apparent. We know that, of course, since all sorts of organization's duties and standards change all the time.

I suspect that those gym operators (some of whom were actually in the process of installing AED's when their incidents happened) would love to go back in time and place them earlier. Even though there's an insurer taking up the direct burden, the cost to the business in lost time and effort dealing with the suit over years is real. I can't say that the cost of maintaining an AED will be seen as good business by every dive operator. But anyone in business who doesn't think about all sorts of potential liabilities and all their costs and just figures it doesn't matter because they have insurance is being a poor business operator.

I don't have any particular interest in the dive operators' exposures. But if an operator thinks about it and decides it's a wise move to carry an AED, even if the likelihood of it being needed is low, there's one more where it could do some good.

 

[Zodiacdiverdave]

AEDs, if you don't take an AED with you every time you dive why would you expect that the charter ops would?
ZDD

 

[DandyDon]

AEDs, if you don't take an AED with you every time you dive why would you expect that the charter ops would?
ZDD

I'm sure that it'd be nice to have a well serviced AED on every plane, bus, ferry, park trail, cowboy round-up, farm tractor, passenger car, etc. How many have them in your homes? Getting real here tho, this was a case of a poor lady who shouldn't have drowned as better training is available, and it's much more effective to not drown in the first place.

I just got back from a whirlwind tour with my daughter and kids to the Grand Canyon and several other mind boggling sites in the area. The GC alone has 250 rescues and a dozen body recoveries a year, mostly from people not listening to the cautions offered all over. Some accidents just happen but many can be prevented, or at least prepared for. Then I read about the guy who spent 7 days last week stuck on a ledge in Utah, who amazingly survived in spite of poor planning.

Leaving the US for adventures, you are even less likely to find band-aid fixes for poor training, poor planning, and poor self rescues. Prepare accordingly.

 

[Qnape]

I'm sure that it'd be nice to have a well serviced AED on every plane, bus, ferry, park trail, cowboy round-up, farm tractor, passenger car, etc. How many have them in your homes? Getting real here tho, this was a case of a poor lady who shouldn't have drowned as better training is available, and it's much more effective to not drown in the first place.

I just got back from a whirlwind tour with my daughter and kids to the Grand Canyon and several other mind boggling sites in the area. The GC alone has 250 rescues and a dozen body recoveries a year, mostly from people not listening to the cautions offered all over. Some accidents just happen but many can be prevented, or at least prepared for. Then I read about the guy who spent 7 days last week stuck on a ledge in Utah, who amazingly survived in spite of poor planning.

Leaving the US for adventures, you are even less likely to find band-aid fixes for poor training, poor planning, and poor self rescues. Prepare accordingly.

There is no doubt that everything you said is true, but part of the problem seems to be the conflicting signals sent by dive operators (and even fellow divers) in various regions. For example, it seems to be considered "OK" to dive in cenotes / caverns in Mexico as an OW diver in groups of 5 or 6, as long as the group is led by a full cave certified instructor. This is a trust-me dive IMHO; the divers frequently have zero overhead experience and often 20 or less total dives. In the event of multiple problems, what chance do those divers have at self-rescue? Is there an AED at every cenote open for diving? If someone gets in trouble (and they will, sooner or later, says Murphy), do we simply blame the individual and say, well - poor training, poor planning? It's true, but does nothing to prevent the next incident. Better training is fantastic, and there is no substitue for being responsible for your own choices, but if divers are encouraged by operators or regional organizations to participate in dives they do not have the skills for, and do not understand the risks of, that practice should also be questioned.

In the Mexico forum, the thread seeking answers to the question "which cenotes are good for beginning divers" drew lots of responses, mainly identifying which cenotes are used most frequently by escorted OW divers. My response (and that of one or two others) urging caution and suggesting the trust-me nature of the activity was not popular, I am sure.

 

[DandyDon]

Oh hell, we could go on and on there. Touring the Yucatan some, it can be pretty evident if you watch for the differences but you won't see medi-vac helicopters or state of the art ambulances in operation, nor rangers on the Coba ruins trail - even that is pretty much on your own. Then halfway thru Coba my bud tells me that he only carried one quart of water in his backpack! :silly:

 

[sydney-diver]

While $1500 may not seem like much to us in the USA, in places like Fiji that's a huge amount of money for a "mom and pop" style business to lay out. In places where the average salary for a day is less than many US citizens make in half an hour, expecting top rate medical facilities and equipment is just not realistic. Dive operators are a niche market and we expect them to operate on shoestring budgets--paying ~$100 for two tank dives doesn't leave a lot of room for operators to pay operating costs in many places. We often expect food/snacks between dives, gas to breath during dives, transportation to and from dive sites, and personnel support during dives. That all adds up very quickly, even in low cost of living environments.

I agree that everyone diving should learn CPR.

I don't agree with the "mom and pop" comment. In my experiance most dive operations in Fiji are owned/operated by resorts, often ex-pats from the US, Australia and/or New Zealand. They should know better - there's no excuse not to run an operation to the same standards as we would expect in Australia. In particular I believe they have a responsibility to ensure their staff are capable at identifying divers who need additional assistance and either providing it or not allowing that diver on the boat, and they must be competant at rescue and resucitation. Fiji is not a 3rd world country (although it's on the way if it's current leader has his way). The dive guides (and they mostly are guides, not dive masters) I've dived with in Fiji have always been fit, strong and very good divers and any failings they may have in an accident can only be attributed to a lack of training and certainly not a lack or care or ability.

 

[fjpatrum]

I don't agree with the "mom and pop" comment. In my experiance most dive operations in Fiji are owned/operated by resorts, often ex-pats from the US, Australia and/or New Zealand. They should know better - there's no excuse not to run an operation to the same standards as we would expect in Australia. In particular I believe they have a responsibility to ensure their staff are capable at identifying divers who need additional assistance and either providing it or not allowing that diver on the boat, and they must be competant at rescue and resucitation. Fiji is not a 3rd world country (although it's on the way if it's current leader has his way). The dive guides (and they mostly are guides, not dive masters) I've dived with in Fiji have always been fit, strong and very good divers and any failings they may have in an accident can only be attributed to a lack of training and certainly not a lack or care or ability.

I can't speak of the dive shops in Fiji, my comments were primarily intended to mean that those of us fortunate enough to live in "first world" countries and have enough disposable income to travel around the world to "third world" countries for the purposes of diving often seem to overlook how much more we have than the locals in those places. It's really amazing to me sometimes how those more fortunate can so easily overlook how poor the locals really are. Expecting people who make $10-$20 a day (much less in some places) to afford $1500 for an AED they may never use is unreasonable.

If the shops are run by ex-pats that have much higher incomes, I would agree with your assessment, but I haven't been to Fiji and don't know. I was speaking in the generic, though I did mention Fiji because that's where this all went down.