Black box of diving accidents: Contribution of forensic underwater experts to three fatal cases

Diving is a popular activity, largely practiced worldwide. Diving fatalities are not rare events, with drowning being the most common cause of death, followed by cardiac-related natural causes, immersion pulmonary edema and arterial gas embolism. In such cases, positive signs of drowning are not specific, depending also on the time of submersion of corpses. Moreover, drowning can be the terminal event. Over the years, measures to perform appropriate post-mortem examination in cases of diving fatalities were suggested, including the execution of post-mortem CT-scan, the use of a decompression chamber and the adoption of specific autoptic techniques. Although a multidisciplinary approach in forensic investigations concerning diving fatalities is discussed, poor cases focus on how the analysis of diving computer records and equipment can contribute to determining the cause of death. The present study shows how the cooperation between a forensic underwater expert and a forensic pathologist played a crucial role in interpreting radiological findings, guiding the autopsy and confirming/denying circumstantial data emerging from the investigations. Technical analysis of dive computer records and diving equipment is a fundamental step in the definition of the cause of death in diving fatalities. All diving computer data, not only those related to maximum depth and ascent's profile, should be considered in detail, and the immersion graph carefully studied by both the forensic pathologist and the forensic underwater experts. The diving technical data can often play a crucial role in explaining any legal issue related to the circumstances of death, possibly leading the prosecutor to further investigation.

The Forensic Pathology of Drowning and Pulmonary Overexpansion Injury

Drowning deaths are commonly seen in most forensic pathology practices. Experienced forensic pathologists perform autopsies and assign a cause and manner of death in such cases as a matter of routine. Deaths due to pulmonary overexpansion injury and subsequent air embolism are far less common and typically involve individuals who have been breathing compressed gas at depth, generally SCUBA (self-contained underwater breathing apparatus) divers. This review outlines the pathophysiological basis of these two forensic pulmonary issues and recommends an approach to performing and interpreting the results of a forensic autopsy when faced with such cases.