Description

ABSTRACT

Doğan M, Atan Y, Dağ MA, Üzün İ. Multifactorial Determinants of Diving-Associated Deaths in

Turkey: Autopsy-Based Insights and the Imperative of Integrated Forensic Assessment. Undersea

Hyperb Med. 2026 First Quarter; 53(1):1-14.

Introduction: This autopsy-based study aims to investigate the underlying causes and forensic

characteristics of fatal diving incidents in Turkey, emphasizing the autopsy-based strategies employed to

distinguish drowning from other diving-related pathologies such as decompression illness and arterial

gas embolism.

Methods: A retrospective analysis was conducted on 11 fatal diving cases evaluated by the First

Forensic Medicine Specialization Board between 2002 and 2023. Data were retrieved from judicial

records, including detailed autopsy reports, histopathological findings, toxicological analyses, and scene

investigations.

Results: The decedents consisted of ten males and one female (median age: 45), reflecting the male-

dominant profile of diving activity. Diving modalities included SCUBA (n=7), breath-hold (n=2), and

surface-supplied compressor diving (n=2). The leading cause of death was drowning (n=5), followed

by arterial gas embolism (AGE; n=2), sudden cardiac death (n=2), subarachnoid hemorrhage (n=1), and

asphyxia due to mechanical entrapment (n=1). AGE cases demonstrated intravascular gas via specialized

autopsy techniques. Cardiovascular comorbidities were identified in four cases, while medications—

primarily prescribed—were detected in five. Alcohol and illicit drugs were absent in all cases.

Discussion: Diving fatalities pose complex medicolegal challenges that require a multidisciplinary

approach. Drowning and AGE were the most frequent causes, often accompanied by cardiovascular

pathology. Proper autopsy techniques, scene correlation, and pre-dive medical screening remain critical

for accurate diagnosis and prevention. The findings underscore the need for standardized forensic

protocols, especially in regions with limited access to postmortem imaging.

Keywords: arterial gas embolism; autopsy; cardiovascular disease; compressor diving; decompression

illness; diving fatalities; drowning; forensic pathology; postmortem diagnosis; SCUBA

DOI: 10.22462/877