This report was requested regarding the death of Mr. Br following a helicopter crash in the Gulf of Mexico in 12/04. In particular I was asked to comment on pain and suffering that Mr. Br experienced during the time he was adrift in a life jacket prior to being pulled into a rescue boat.
1. These facts are available concerning the incident:
A. Per the deposition of the helicopter pilot, Eh:
i. The aircraft fell into the water at noon after plunging approximately 100 -125 feet from a landing pad.
ii. The men aboard the helicopter were in the water 2.25 hours.
iii. The seas were 8-10 feet from trough to crest.
iv. The wind was strong enough to blow spray off wave tops.
v. The air temperature was estimated between 40-50 degrees F.
vi. Br was having a hard time breathing or speaking.
vii. The pilot believed that he was hypothermic due to the water being “so cold.”
viii. Br moved around and was swimming.
ix. They were totally immersed by wave crests.
x. Br was heard talking as they were pulled into the rescue boat.
2. National Oceanic Data Center records show that coastal waters off Alabama and Louisiana averaged 58.6 degrees F. on the date of the crash, or forty degrees less than the average human oral temperature of 98.6 degrees F.
3. Autopsy results indicate that 61 year old Br died from aortic trauma with massive mediastinal hemorage. His lungs were also noted as weighing 1100 and 1050 grams.
4. Hypothermia occurs when the body has either a slowed or insufficient response to cold through: conduction, evaporation, respiration and other factors, hence the body loses heat faster than it can be produced. Additionally:
A. Heat loss to water is much faster than to air. Authorities state the heat loss rate to water is 25 to 32 times that of air of the same temperature.* Moving water passing a stationary person greatly magnifies heat loss. Movements in cold water such as swimming rather than remaining still produce a similar effect.
B. Heat Escape Lessening Position or HELP is a motionless, in-water fetal position. HELP normally requires the wearing of a personal flotation device (PFD). A person trained to do HELP initially lies on their back, then slowly crosses their ankles and draws their knees as tightly as possible to their chest. The arms are crossed over the chest. This results in a backward inclined position similar to sitting with the head and neck out of the water. By doing HELP the three main heat loss areas: head/neck, armpits and groin are insulated.
C. Medical authorities divide hypothermia into three stages: mild (body temperature between 90-95 degrees F.), moderate (between 82-90 degrees) and severe or major (between 68-82 degrees).** As a victim passes through each state their physiological ability to respond to stress induced by cold diminishes. During the last stage consciousness is lost and body organs begin to shut down to the point of non-functionality resulting in death.
5. A person immersed in cold water doing HELP and not moving increases their survival time, or conversely decreases their heat loss rate by approximately 60%. Many variables are at play in determining survival time. Roughly, on the average a 50 year old male immersed in 50 degrees F. water has about 50 minutes before reaching a 50/50 life/death point.*** Decreasing water temperature speeds the process as do injury/trauma to the immersed individual, as well as increased age/slowed metabolic response. Older people such as Mr. Br chill faster than younger individuals, experiencing the onset of hypothermia at a relatively expedited rate. Being buffeted by swells and struck by breaking ways so as to require movement to regain balance or the surface, even when wearing a PFD, decreases survival time and accentuates heat loss. Conversely, as Mr. Br was 6’4’ tall and weighed approximately 250 pounds, his size would act to slow heat loss. Since he was conscious and apparently functioning when reached by rescuers, he had not progressed into major/severe hypothermia and should have been in or approaching the termination of the vigorous shivering mode.
6. Shivering or involuntary exercise is medically called auto-thermogenesis. It is both the primary physiological defense to heat loss and the gross indicator of the onset of hypothermia. In mild hypothermia the victim shivers and notices an increasing numbness and stiffening of fingers and limbs. As heat loss deepens the shivering becomes violent and in many cases the numbness turns into increasing pain. In the severe stage, the body senses that it must conserve energy, causing shivering to cease, with warmer blood being drawn toward internal organs from skin and muscles. The brain also begins to shut down and an unresponsive stupor develops. Victims found unconscious as a result of hypothermia are in extreme peril.
7. Since shivering is an autonomic response to cold, there is nothing the individual can do to slow or moderate it, save getting out of the water into a drier, warmer environment. Similarly, pain induced in the skin and muscles can not be prevented or reduced by the victim.
8. As there is no evidence that Mr. Br was familiar with, had been instructed in, or attempted HELP, his heat loss would be expected to have proceeded at a rate normal for his age and physical characteristics. Since he was heard to speak upon being rescued, he was conscious and had not descended into the stupor stage of severe hypothermia. However, by being in the water for up to two and a quarter hours, he would have been exposed for an appreciable amount of time to moderate hypothermia which involves vigorous shivering. Mr. Hollier had massive damage to the internal area between his lungs and lungs/aorta as the result of impact during the crash sequence. Simply breathing would have been extremely painful. Increasing the activity of his muscles by shivering violently could have only grossly worsened and intensified his pain. This suffering would be in addition to the initial numbness, and following pain induced by hypothermia in his skin and limbs.
9. Another aspect of the derogation induced by hypothermia is psychological. A person awaiting and/or unsure of rescue can do little to improve their situation and is confronted by an increasing inability to control their muscles. I have been personally involved in rescuing men immersed in near freezing water who, although wearing PFD’s were conscious but rigid and immobile. Moreover, in this particular instance, the victims had settled downward through their loose fitting PFD’s and when found had only an inch or so of clearance between the water surface (which was thankfully calm) and their chins. They undoubtedly were contemplating what would definitely happen if rescuers did not shortly appear. Hence, pain and anguish in such conditions is both physiological and psychological. Similarly, autopsy results present Mr. Br’s lungs as much heavier than normal, (normal adult lung weights are approximately 525 grams**** and Mr. Br’s averaged 1075 grams) indicating that he had ingesteded water into them and was undoubtedly suffering extensive breathing difficulties as supported by the pilot’s testimony. In fact, were it not for the report of his being active during the rescue, the amount of water in Mr. Br’s lungs should have drowned him.
10. Based on the foregoing it is my opinion that Br was subject to extensive/intensive pain and suffering as he awaited rescue.
11. As indicated in my accompanying resume, I have extensively written for and lectured numerous fire, police and EMS personnel regarding hypothermia, water rescue and related subjects throughout North America. My seminars were accredited by organizations such as the National EMT Registry, National Safety Council, various state nursing associations and a number of state and provincial health departments. I have also been honored to share in presentations by many of the pioneer researchers in hypothermia including Drs. John Hayward, Martin Nemiroff, Robert Pozos and (RADM) Alan Steinman, USCG. I was additionally honored to assist in the organization and initiation of the first national/international hypothermia conferences at the University of Rhode Island. The term “You are not dead until you are re-warmed and still dead,” which is a standard/universal watchword to water related rescuers, first appeared on a chalk board at the First International Hypothermia Conference -as I wrote it. More information concerning my educational and training background is presented in the attached curriculum vitae.
This concludes my preliminary report. I reserve the right to supplement this report based on further discovery and/or evidence. My qualifications are set forth in the attached materials. The foregoing opinions are stated to a reasonable degree of probability and reflect my training, experience, education and understanding of the standards and science of aquatic safety, especially as they relate to hypothermic injury. I am being compensated for my participation in this litigation.
Sincerely,
David S. Smith, Ph.D.
Commander, USCG (RET)
*United States Search and Rescue Task Force, Cold Water Survival.
**“Immersion Into Cold Water,” RADM Alan G. Steinman, USCG (RET).
***Stearns manufacturing Company (North America’s largest manufacturer/distributor of Personal Flotation Devices).
****Wiki Answers (internet source) from “Human Anatomy, Human Physiology.”
