Medico-legal considerations of deaths from watersports among Caribbean tourists

Abstract Watersports are the dominant recreational sporting activity in the Caribbean islands. The economy of many of these islands is tourist-oriented and millions of tourists take part in such sports annually with some fatalities. A total of 13 watersport-related deaths observed in the Cayman Islands over a 2-year period are presented. Complete autopsies with toxicological and histological studies were carried out in each case. Preexisting cardiovascular disease such as hypertension, coronary artery disease (or relative insufficiency) and cardiomyopathies were observed to be significant risk factors and the mean age at death was 53.7 years. Sudden cardiac deaths predominate. One fatal jet skiing accident also occurred. Tourists are advised to undergo complete medical investigations (including ECG and stress tests) prior to engaging in watersports. Drugs of abuse are to be avoided for medical reasons and insurance considerations. Watersports operators must ensure that their clients complete a medical checklist. All equipment and accessories must be functioning optimally to avoid accidents contributed to by such negligence. Consideration should be given to introducing medical tests prior to signing on their clients and there must be adequate supervision. Some form of governmental regulation and enforceable supervision is necessary.