Folks,
On the general theme of out-of-shape divers (I realise we don't yet know if that was the case with this poor guy): in the States, is it possible to dive at a course or with commercial operation without having a medical certificate? Here in France, I am required to see a dive doctor every year: he checks out EVERYTHING: my ears, nose, teeth, joints, etc., not just the obvious stuff. For my heart and lungs, I have to do 30 deep knee-bends in about 45 seconds - then he checks my pulse and respiration. It's a ***** to have to do this each year, but I must say, it makes you stay in shape. Afterwards, the doc gives you a certificate staying that you are in physical shape to dive.