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> > Bill Mee -- assuming hypoxia is the cause of death, wouldn't the body > show signs of cyanosis -- blue nail beds, lips, skin, etc. -- that are > detectable by the ME and which wouldn't be present if Dr. Kendall had > died from other causes? Let me start by saying that I know next to nothing about rebreathers, but having been an assistant medical examiner for Newport News Virgina for a year, I do know a bit about postmortem examination. Unfortunately, after death from almost any cause, the majority of oxygen in the blood is dissapated into cells, thus causing almost all dead bodies to appear either "cyanotic" immediately after death if the heart pumps long enough after the terminal event, or grey if the heart stops rapidly, or after several minutes have past and blood begins pooling due to gravity . There are a few exceptions as death from CO poisoning, but aside from these toxins it is not possible to determine by coloration whether a body became hypoxic before or after death. With extended hypoxia before death (greater than 10 minutes or so) other lung findings may occur, most often pulmonary edema--water in the lungs--but when the body is found in water, even with regulator in place, this finding would not be considered reliable. There is, however, a very reliable stain technique that can be applied to heart tissue to see if a person had a myocardial infarction, commonly a "heart attack" . That is a blockage of an artery to the heart which caused a piece of heart tissue to die. Combining this with other examination, it can be definitely determined if the direct cause of death was a "heart attack" that could have occured in Wal-Mart. Obviously, a stressful activity like diving or becoming hypoxic is more likely to stimulate the actual "attack" than is shopping, but the finding of a myocardial infarction on a postmortem is not something that could be confused by amy medical examiner, diver or not, with simple hypoxic death. On the other hand, there can be sudden cardiac death from arrhythmias, for which there is no special test and it is quite possible that in a case with an apparently healthy older male, death could be erroneously attributed to a "natural" arrhythmia as opposed to another less obvious cause that the examiner had not considered. Marcia Oliver, MD AAFP MRO
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