Scuba diver dies after being found floating at Kurnell, NSW, Australia

[DevonDiver]

I'd go further (hypothetically/as general learning points)

- not getting separated. Having access to a buddy's air and/or assistance in reaching the surface. As painful is it is, it seems that staying together as a team could have avoided the outcome. It seems that attempts to that end were made but that Marcia herself didn't take it as seriously as could have been. That said, while it may have allowed for mitigation, the root cause is not being separated. Being solo in itself, especially to a highly experienced diver and in 3 meters of water isn't directly life threatening. Perhaps risks are somewhat increased but not to the point that I would describe it as a cause.

In addition to failure of the buddy/team system, especial note should be made of the difficulties dealing with more experienced divers (especially those of 'pro' status). It can be very hard for a lesser experienced diver to communicate their misgivings when confronted with an experienced buddy who is circumventing 'Safe Diving Practices'. If/when diving with 'professionals' (fun diving or on courses), the less experienced diver should realistically confront the potential issues that can arise... and must determine how they might seek to influence a more experienced diver who they are concerned about.

Higher experience and qualification are not any guarantee that the diver will make appropriate decisions. Indeed, the issue of complacency should be firmly understood by divers - so they can guard against it forming in their own mindset.... and so they can deal with it, when apparent in other divers.

As a dive pro myself, I am fully aware that experience leads to complacency. I catch myself making inappropriate decisions all the time. Those decisions always, and only, impact on my personal safety. I am much more risk-adverse when carrying responsibility for others. I do try and guard against them. I also make a point of briefing buddies/students that I too can experience difficulties in the water. Whilst I don't think I would get into trouble on a dive, I don't want my students to assume that I couldn't... and consequently remain inactive if I needed assistance...

- not getting OOA. It's unclear if she could have controlled being OOA or not. There seems to be two possibilities here. Either (a) there was an equipment malfunction that caused a free flow or (b) she went OOA without an equipment malfunction. In either case I would describe this as a trigger. However, in normal circumstances -- regardless of the cause -- she would have just swam to the surface.

I think the real issue isn't how/why the diver went OOA... more fundamentally, it is about the need to preserve a safe reserve. On this forum there is much discussion about gas management...rock-bottom etc etc... and the emphasis seems to be on the volume needed to 'reach the surface'. Gas reserves are maintained for reasons beyond 'safe ascent times'. Maintaining an ample, and pre-agreed, reserve is a fundamental 'Safe Diving Practice'.

In any gas-volume related accident, the 'accident chain' continues when the diver chooses to remain submerged when the reserve is impinged. If the diver chooses to abort/surface in order (to attempt) to maintain that reserve then the chain is often broken immediately. In the worst case scenario, the chain might continue - but at least the diver is made immediately aware that an emergency does exist... and that gives them time to start dealing with it. Gas is time... time if life.

.... if she *hadn't* been using new gear that she wasn't familiar with that going OOA would have been an inconvenience at that depth.....new gear seems to have created a severe complication.

If you're using new/unfamiliar equipment, you're a noobie. If inexperienced in the kit you are using... you are in an inexperienced situation all-round. i.e. you are only as strong as your weakest link.

In some instances, a diver's previous experience may actually work against them. Extensive experience in one configuration creates instinctive responses/reliances that may not apply to new equipment or environments. This is most obviously demonstrated when open-circuit divers transition to rebreathers. To a lesser, but still significant, extent; wetsuit to drysuit...

If otherwise highly experienced, it can be hard to discipline oneself to make adequate safe-guards given that temporary 'noobie' status. Whilst an experience dive pro may accumulate new skills on new equipment quite rapidly, it is not instantaneous. Diving in safe, controlled environments is the obvious safe-guard... but so is close buddy supervision. That is what was needed.

 

[clownfishsydney]

As far as I have seen, NSW (where we live) does not use experts unless they are police or similar. In most cases, the police who are offered as experts (eg in the Queensland inquest into Tina Watson's death) were divers who I would consider to be novices and had no idea of dive physics or recreational diving. It is something I have been trying to get people interested in, having the police call in independent diving experts when there is an accident. The trouble is, I doubt that very few experts could be considered "independent" in the true sense of the word. For example, of the last five diving deaths in NSW, I for one know either the person who died, the people who were diving with the one who died or the dive operator. There is only one where I have no connection at all.

 

[Mr. Black]

Her gauge showed 10 bar but the tank was empty.

:shocked2: That's like the gauge DD showed me once. Happily reporting 20 bar when in fact theres like -1 left OK if it's your own gauge and you are aware of the calibration issue and keep reserves. If you unknowingly borrow gear that is out of calibration like this and you are cutting your reserves short due to some irregular event... :shocked2:

Also, she had about 26 lbs weight using a 10 litre (80 cf) steel tank and trilaminate drysuit. If this is the case, then I believe she was grossly overweighted for someone her size.

She mentioned to me around 2 Oct that she was going to try a Lavacore as an undergarment to start off. I told her I did this in tropical water but for Botany Bay it may not suffice. With a tri lam, steel plate and Lavacore UG I use about 6 pounds with twin AL80s. I think you are onto something here. If she was still in the Lavacore (not fluffy at all), then the 26 lbs would have been very much on the high side. The numbers don't look like they'd make for a balanced rig.

Then again others spoke with her after I had spoken to her and she had already mentioned being too cold. Perhaps she had a fluffier undergarment that day.

 

[DevonDiver]

If she was still in the Lavacore (not fluffy at all), then the 26 lbs would have been very much on the high side.

If her BCD was "fully inflated" and she was found on the bottom then she was over-weighted. Indisputable. That's a given (unless entangled, but that hasn't been mentioned).

 

[Diver0001]

Some people are using the term "balanced rig". I know what that means when I am using it in reference to wetsuit / tropical diving but I suspect it means something different here with a drysuit. I could guess but I would appreciate hearing your definition. Thanks.

It means that the inherent positive buoyancy of the kit (suit, AL tanks when empty etc) and the inherent negative buoyancy of the kit (weight of negatively buoyant gear + ballast) is about equal..... in other words, you're not carrying too much weight.

In practice the litmus test for a balanced rig in the eyes of most divers is if you can float all your gear (core kit plus weights, lights and other paraphernalia) on the surface with only the positive buoyancy of the BCD. There is reason to believe in this case that the rig was not balanced..... which means that even with the BCD inflated that the whole was still negatively buoyant.

R..

---------- Post added October 11th, 2013 at 01:43 PM ----------

I'd go further (hypothetically/as general learning points)

difficulties dealing with more experienced divers ...

Higher experience and qualification are not any guarantee that the diver will make appropriate decisions.

I believe it's possible that both of these points played some role.

the need to preserve a safe reserve.

I don't believe that 50 bar in 3 meters of water with an expectation of a few minutes of bottom time would indicate an unsafe reserve. This conclusion goes too far as far as I'm concerned. There is no doubt, it would seem, that the tank was empty when she was found but there is an unresolved question about how the tank came to be empty.

R..

---------- Post added October 11th, 2013 at 01:47 PM ----------

If her BCD was "fully inflated" and she was found on the bottom then she was over-weighted. Indisputable.

At this point I'm edging to the same conclusion but I would be cautious of assuming that eye-witness accounts are 100% accurate. They usually are not. To my way of thinking it's possible that the BCD was partially inflated and reported by witnesses as fully inflated.

R..

 

[gypsyjim]

It means that the inherent positive buoyancy of the kit (suit, AL tanks when empty etc) and the inherent negative buoyancy of the kit (weight of negatively buoyant gear + ballast) is about equal..... in other words, you're not carrying too much weight.

In practice the litmus test for a balanced rig in the eyes of most divers is if you can float all your gear (core kit plus weights, lights and other paraphernalia) on the surface with only the positive buoyancy of the BCD. There is reason to believe in this case that the rig was not balanced..... which means that even with the BCD inflated that the whole was still negatively buoyant.

R..

---------- Post added October 11th, 2013 at 01:43 PM ----------


I believe it's possible that both of these points played some role.



I don't believe that 50 bar in 3 meters of water with an expectation of a few minutes of bottom time would indicate an unsafe reserve. This conclusion goes too far as far as I'm concerned. There is no doubt, it would seem, that the tank was empty when she was found but there is an unresolved question about how the tank came to be empty.

R..

---------- Post added October 11th, 2013 at 01:47 PM ----------



At this point I'm edging to the same conclusion but I would be cautious of assuming that eye-witness accounts are 100% accurate. They usually are not. To my way of thinking it's possible that the BCD was partially inflated and reported by witnesses as fully inflated.

R..

I am no tech diver, but as I recall, a balanced rig is one you can easily swim to the surface without any assistance from the bcd. But, I admit that my training in this area is a lot lighter than many on this board who have actively pursued and trained in that facet of diving. With steel tanks this concept of a balanced rig can become a real issue, but the redundant flotation that a dry suit adds to the bcd, is part of the equation (if one is in an OOA situation, though redundant flotation may have little value, but I have no idea at all if this was a factor here)

A lot of divers really want to know the details about this accident, and there has been an awful lot of speculation based on rumor, 1/2 truth, poor reporting, and as Jim Lapenta said just plain wild ass-ed guessing. That type of feeding frenzy benefits no one, and makes the truth less evident in the end because it muddies the waters too much with raw emotion and errors.

Every diver hopes to learn from any dive accident, to hopefully improve their own chances for survival, and that of their loved ones, but in the days right after a horrible accident such as Marcia's, I ask everyone to remain patient. It has only been a couple of days, and everyone involved is still in horrible shock.

Personally knowing some of those involved I know a couple things for certain:

They are devastated by what has happened.
They had more than adequate medical expertise and diving experience to assist a diver in stress if that diver remained in buddy contact, to help prevent an accident, or deal with a medical emergency.
They are safe divers that I would dive with anywhere, anytime, and let one that I loved dive with.
There will be lessons learned and lessons shared with those who seriously want to learn, even if this thread is not the forum chosen for such discussion.
It is their choice what forum they choose to use to discuss, analyze, and dissect this accident and not ours.
Since one party in this is deeply involved in medical emergency training, we can all be assured that a very thorough analysis of what failed here will be explored.

OH ya, and they are devastated right now, and need a bit of time to absorb and recover before they open themselves to the inevitable public debate that always follows one of these incidents. Other than legal authorities who have to investigate, no one's right to know trumps another person's right to mourn and heal.

Be patient. Like everyone else here, I know very very little so far, but I can wait till people are better able to share what happened, once they are less emotionally drained themselves.
We will eventually learn more when nerves are not as raw.

 

[Diver0001]

I am no tech diver, but as I recall, a balanced rig is one you can easily swim to the surface without any assistance from the bcd.

I think that the goal may be the same. IN main lines the idea is that a balanced rig can keep the diver and all the gear positively buoyant on the surface with only the use of the BCD.... How you "gauge" that may differ but the result should be the same... keeping positive buoyancy on the surface.

During our tech training this was a big deal and there were even drills to train for a compromised BCD because of the weight of tech gear.... Given what I've read, and as painful as it is, I believe this topic may be of central importance in this case.

R..

 

[gypsyjim]

When I was undergoing my Fundies training, which I never completed, I recall the discussion of the balance rig discussion with Bob Sherwood revolved around how much more difficult it is to swim even just a slightly overweighted rig to the surface, than divers expect, and even if you could get the heavy rig to the surface, you would be exhausted, and it would be a horribly difficult job to maintain your buoyany on the surface if you had a flotation failure of any sort. As I say, this is not my field of expertise, and I was simply adding my impression of what it means to have a balanced rig.

 

[Duke Dive Medicine]

What happened to Accident Analysis? I realize that we are hurting because Quero is a SB member and close to many of our members but there are some things to learn from this incident. JAX did a great job detailing possible causes. We have somebody diving new equipment ( drysuit) and one of the most common causes of diving injury/death is uncontrolled ascent. Even if it wasn't the case in this particular incident, it's something deserving of analysis and something that we can learn from. It certainly can prompt discussion of why a drysuit class needs to be taken, why you shouldn't go straight out on a 100 foot dive in a rough ocean with currents in your brand spanking new drysuit without practicing in a swimming pool and quarry. Some SB members might not know that. I remember, 10-12 years ago, when I first considered getting a drysuit, I had no idea why I needed a class. I thought the dive shop just wanted to sell me another silly cert card.
That lethal little jelly fish in Australia, well, I for one learned a lot from that. Who knew? Not to mention, doesn't Australia have a large population of highly lethal, regular box jelly fish?
These types of things can be discussed and don't have to be the ACTUAL cause of Quero's death. They are possible causes and lead to learning.
Medical-I bet there are a lot of SB members who know nothing about deep venous thrombosis, risk factors, how they lead to pulmonary embolism and death. What to look for and when to run/not walk to the hospital for testing. ( figuratively, don't run with a DVT!)
Please don't shut this healthy discussion down with "let's wait for the official report" because that will do so little for the learning value of these tragic events.

---------- Post added October 10th, 2013 at 10:52 AM ----------


So often, when we here of a well-known technical divers death it is #5. Usually this is on more complicated,technical dives like the recent death of the cave diver who took a mismarked bottle of O2 and breathed it at 100 feet for his bottom gas. But, this is absolutely another possibility.

An accident can't be analyzed without facts, and there don't appear to be any at this point. The drysuit issue was brought up early on in the thread, and somehow the leap was made from "she had leg pain" to "DVT". It's very reasonable to have a discussion about both, but it can't be in the context of accident analysis in this case, because then it goes from discussion to speculation. In true accident analysis the two need to be clearly separated. I think Andy said the same thing earlier.

Best regards,
DDM

 

[Jax]

I cannot buy into the OOA / panic. An instructor who, for years, demonstrates to and trains students to get in and out of their gear in and out of water, could certainly do so while holding her breath after OOA.

Something happened.

Perhaps the excitement of the weedy sea dragon caused her heart to accelerate and something broke loose.

She's been diving the same gear for three days. She's way more practiced in drills than a regular diver, so the "forgetting" does not jive.

She got to the end of dive, reported her gas, so I cannot perceive of complacency.

Unless it's a jellyfish, I surmise medical.

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