Forensic Nurse Contributes to Drowning Diagnosis


Recently, a 21-year-old male (DT) was brought into the ER while CPR was being performed. He had been swimming with several family members and friends. He apparently went under and never came back up. Dive rescue teams were summoned. DT was not found until one hour after he was discovered to be missing. He did not have a pulse or blood pressure from that time forward.

DT did not have any medical problems. He did not take any medications or have any allergies. He occasionally complained of leg cramps, but otherwise never complained. DT had not acted out of the ordinary prior to this incident. He had not given any reason to be suspicious or concerned. In addition, DT was a strong swimmer. Originally, there was question of whether or not drugs or alcohol were a factor.

Approximately, 1-1/2 weeks after DT’s death, the autopsy revealed a normal 21-year-old male. No congenital anomalies were found. No medical problem or condition was found to explain DT’s death…just “a drowning”.

It was difficult to hear these results. What would cause an otherwise healthy 21-year-old male to die? I am sure that it would be easier for the family and those involved with DT’s care if there was an explanation of what caused this young man to die.

This case was actually a medical examiner case. Because DT had not any medical problems, his death was certainly not expected. According to my reading, a drowning may occur and have no physical findings on the autopsy (which was the case for DT). If there is a medical condition that causes a loss of consciousness, usually it is caused by a syncopal episode, heart-related condition, or a congenital anomaly. Also, a drowning victim can not be pronounced dead until the body temperature has been brought back to normal body temperature and is unable to be resuscitated. When all other causes have been excluded, the diagnosis of “drowning” may prevail.

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