While Pensacola has raked in millions of tourism dollars from the world’s largest artificial reef, experts say the area is failing to provide basic medical care for thousands of divers lured here by the USS Oriskany and other dive sites.
“I call it Florida’s dirty little secret,” said Julio Garcia, director of the Hyperbaric Medicine Program at Springhill Medical Center in Mobile. For people diving anywhere off the Florida Panhandle, the Alabama hospital is the nearest location with hyperbaric chambers to treat decompression sickness, which can happen when divers surface too quickly.
The closest Florida hospital willing to treat people with diving-related issues is 600 miles away in Fort Myers. That’s one of just three hospitals in the state — all in South Florida — that offer the life-saving treatments for divers.
“I used to say it would take someone dying for things to change, but someone died and still nothing has changed,” Garcia said.
A Pensacola man died at Garcia’s hospital in November after being transported there following a diving accident on the Oriskany, an aircraft carrier sunk in 212 feet of water as a dive attraction in 2006.
Since the Oriskany’s sinking, at least four people have died from diving-related injuries sustained in the waters off Pensacola, according to area dive and medical experts who are urging local hospitals to open their hyperbaric chambers to divers.
Dr. Frank Butler of Pensacola, a former Navy SEAL who served as the command surgeon for U.S. special operations in Afghanistan, is among those trying to raise awareness. After several fatalities involving Oriskany divers in 2009, Butler helped draft an emergency plan for Oriskany accidents.
At that time, Baptist Hospital provided hyperbaric treatment for divers. But Baptist stopped providing the services in 2010, and the emergency plan has not been updated since.
“Divers in the Pensacola area who require emergent treatment for decompression sickness must now be transported to Springhill Medical Center in Mobile,” Butler said. “God bless this medical center for continuing to treat injured divers from the Pensacola area.”
During dive accidents, treatment time is crucial, Butler said. Decompression sickness, also known as the bends, can cause strokes, paralysis, blood clots and other issues. The hyperbaric chambers treat the dangerous gas bubbles that can form inside the body when divers surface too quickly.
“Delays to treatment can allow the injury to progress and make the outcome much worse,” Butler said.
The problem isn’t just in Pensacola.
For divers farther east along the Florida Panhandle in places including Fort Walton Beach, Destin and Panama City, it is even more serious, Garcia said. It can take injured divers from those areas up to nine hours to reach his treatment chamber.
Lack of access to hyperbaric treatment for divers is a nationwide issue, but it is especially a problem in Florida where diving is a major recreational activity, said Butler, who pointed to work by Richard Clarke, president of the National Board of Diving and Hyperbaric Medical Technology.
In his detailed research, Clarke said the problem comes down to money.
When hospitals began using the chambers for wound care, they developed business models that depended on using the chambers in outpatient settings during weekdays. The system avoided the expenses of having a chamber open 24 hours a day, seven days a week, for dive accidents and paying medical staff to be on call for dive emergencies, Clarke determined.
Butler said the business model also avoided the risks of treating divers who could experience complicated neurological issues.
“Chambers who agree to treat injured divers should have protection from lawsuits,” Butler said. “These divers often have significant neurological deficits that may not get better with hyperbaric oxygen treatment and many of them wind up filing lawsuits against the chambers that treated them.”
Pensacola’s Baptist and Sacred Heart hospitals both have hyperbaric chambers for wound treatment.
Candy McGuyre, a spokeswoman for Baptist Hospital, said the difficulty of finding doctors qualified to treat dive injuries was part of the reason Baptist stop providing the service in 2010.
“Facilities that offer emergent hyperbaric services for critical or unstable patients have dedicated chambers for trauma level cases. Additionally, those facilities have specially trained physicians available 24 hours per day, 7 days per week. Not enough of these physicians were available in our area to provide this care,” McGuyre said in an emailed statement.
In a similar statement, Mike Burke, a spokesman for Sacred Heart Hospital, said his hospital’s hyperbaric chamber has never been used to treat diving injuries.
“Our Wound Care Center does not have the equipment, 24-hour staffing or on-call staffing to provide emergency care to divers with serious decompression sickness. Our chambers are designed for wound care and they are not large enough to accommodate the administration of IV therapy,” he wrote.
Following the November death of the Pensacola man who had been diving the Oriskany, local diving and medical officials began looking at solutions. They failed to make any significant changes before the busy 2017 summer dive season.
Eilene Beard, owner of the Scuba Shack dive shop and a longtime member of Escambia County’s Marine Advisory Committee, was among those involved in the effort.
Beard said there are no easy solutions.
Hyperbaric chambers and medical staff needed to treat decompression sickness are “very, very, very expensive,” she said.
Beard said it is crucial that dive charters educate divers about the risks and encourage them to disclose any medical issues and medications they are taking before they dive.
But not everyone listens to the advice.
“People break the rules or they don’t care,” she said. “They dive too deep or stay under too long.”
Dr. Jim Chimiac, medical director of the worldwide Divers Alert Network, said divers need to be aware of the risks and of their proximity to emergency treatment.
Chimiac, who has supported the local efforts to improve treatment, said the lack of treatment facilities should make the Pensacola area less desirable for divers.
“And you have the Oriskany, which is a deeper wreck,” he said.
Deeper dives carry greater risks, he said.
“There is really no way to provide treatment without a chamber and you want to do it quickly,” he said.
While Pensacola Naval Air Station has a decompression chamber, it is normally reserved for military, said Garcia, of the Mobile hospital.
Back in 2014, at Garcia’s urging, U.S. Rep. Bradley Byrne, R-Alabama, wrote to the Department of Defense’s secretary for health affairs and asked about opening chambers at Panhandle military bases for civilian emergencies.
Air Force Lt. Gen. Douglas Robb said the Navy’s facilities in Pensacola and Panama City can treat civilian emergencies, “but are not staffed for 24/7 operations and are not designed for patients with other medical illnesses such as heart disease.”
“The current focus is on increasing the availability of civilian emergent hyperbaric services,” Robb wrote.
That was three years ago, and Garcia said nothing has changed in that time.
“The problem has gotten worse,” he said.
The lack of hyperbaric chambers isn’t just an issue for recreational divers. Garcia has also treated Panhandle law enforcement divers.
Florida officials have been unresponsive to pleas from many people to do something to improve access in the state to hyperbaric chambers, he said.
“I am trying to figure out a way to make these people do the right thing, but I cannot force them to do it,” he said.
Garcia said the state of Florida and its tourism industry need to step up and make the issue a priority.
“Right now, we have two doctors in the city of Mobile on call for your (Florida’s) tourism industry,” he said.