As all eyes in the political spectrum turned to Ohio, and the plight of Youngstown is on every politician’s tongue, a man from nearby Vienna, Ohio quietly dies from carbon monoxide poisoning. In the wake of his death, paramedics put out a call for increased use of CO detectors.
The victim in this case was an aging man. The culprit an aging furnace. The combination, which happens so often with our elderly, is potentially lethal. The older the furnace, the more likely there could be a problem. The older the person, the more likely that where CO typically strikes first, the heart, will be adversely affected.
Check on your parents, check on your shut in friends. See to it that they have CO detectors, and make sure that they have had periodic maintenance on their furnaces.
Carbon Monoxide and Boating?
It is winter, below zero here in Wisconsin this week, and I am warning about boating and carbon monoxide? As I joked to a friend who asked me about sailing – the water is a little hard right now.
Still, the carbon monoxide story of the day is a Washington Supreme Court Decision where a young woman died from carbon monoxide poisoning from swimming near the back of a boat: From that published case:
IN THE SUPREME COURT OF THE STATE OF WASHINGTON
JAY COLBERT,
)
MOOMBA SPORTS, INC.,
MADSEN, J. — Jay Colbert’s daughter, Denise Colbert, drowned after inhaling carbon monoxide fumes while hanging onto a motorboat as it was moving.
FACTS
According to Mr. Colbert, at about 3:00 a.m. on August 3, 2003, he and hiwife Kelly were awakened by a telephone call from Kyle Swanson, the boyfriend of Mr. Colbert’s daughter, Denise. Mr. Swanson was quite upset. He told them
that Denise had disappeared from the back of a boat at Lake Tapps and a search was taking place for her. At about 1:30 a.m. Denise Colbert and others had gone for a boat ride aboard Marc Jacobi’s boat. Ms. Colbert and a friend were in the water holding on to the swimmers platform at the rear of the boat as it headed toward shore.1 After an hour and a half in the water, they decided to go swimming, and, as her friend stated, “[a]ll of a sudden she was gone. We were just swimming, and then she went under. There wasn’t a struggle or anything.”
Neither wore a life jacket. There was a placard on the stern prohibiting people from being on or near the swim platform when the engine was running, but Mr. Jacobi did not take steps to move Ms. Colbert and her friend. Mr. Swanson and others searched for Denise and Mr. Jacobi called 911; the call was received at 2:58 a.m.
A short time later Kyle Swanson called Mr. Colbert who took his other children to a neighbor’s house and then drove to the lake, about five minutes from their home. When he arrived, police cars, ambulances, and the fire department were at the scene. Mr. Colbert saw lights flashing from a boat on the water and knew the search for his daughter was underway. He drove to a friend’s house on the lake and watched the rescue operation from the friend’s dock. He hoped Denise would be found alive because Denise was an outstanding athlete with stamina and endurance, and she was a strong swimmer. Police Chaplain Arthur Sphar traveled back and forth between the rescue site and the dock to update Mr. Colbert about the search.
At some point after 6:00 a.m. rescuers found Denise’s body. Sphar relayed this to Mr. Colbert. About 10 minutes later Mr. Colbert saw a buoy pop to the lake’s surface. Because he could hear the dialogue from rescue workers on the
lake he knew what this meant — it was tied to Denise’s body. Mr. Colbert watched rescue boats move alongside the buoy. He saw Denise’s body pulled over the side of a boat by her arm. He averred that he could see rescue workers move Denise’s body once it was on the boat from about 100 yards away on the dock from which he watched. Mr. Colbert explains it was light enough that he could see this activity. Mr. Colbert saw an ambulance by the water, watched the police bring a
stretcher, put a sheet over Denise’s body, and take her away. He testified at a deposition that he was able to recognize the body as Denise’s. Chaplain Sphar said they could see a body being pulled from the lake, but added it was not
possible to see identifying detail from the dock. Denise had died about three hours before her body was recovered from the water. The cause of Ms. Colbert’s death was “drowning” with “ethanol toxicity” and “carbon monoxide” noted as significant. Her blood alcohol level was 0.12 g/100 ml.
Editors Note: The claim with respect to the death of the daughter was not at issue in the Appellate court decision. The disposition of the issues that were before the court in this decision were that the claims of the father for negligent infliction of emotional distress were dismissed, essentially because he was not at the scene at the time his daughter drowned.
Why did this drowning happen? Why did a strong swimmer drown within a few feet of safety? Why would a BAC of .12 cause such a result?
This happened for the same reason that almost all of the other cases discussed on this blog occurred: because Denise was in the wake of the exhaust of an engine, an engine that was spewing carbon monoxide fumes. Boating accidents are a surprisingly large segment of the carbon monoxide deaths. Boats are clearly one of the largest risk factors for carbon monoxide poisoning outside of the winter heating season. Manufacturers of boats put swim platforms on the back of boats, the same part of the boat such manufacturers funnel the engine exhaust. If people swim off the the swim platform, when the engine is running, they are a serious risk of carbon monoxide exposure. Unlike on land, where a moment of unconsciousness still leaves a chance of rescue, when swimming it can quickly turn deadly.
Is a mere warning about the risk enough? We think not. Swim platforms should no more be put where exhaust is vented, than boiler exhaust should be vented into swimming pools, another major CO risk factor. When swimming and CO mix, there is no margin for error.
Still, the carbon monoxide story of the day is a Washington Supreme Court Decision where a young woman died from carbon monoxide poisoning from swimming near the back of a boat: From that published case:
IN THE SUPREME COURT OF THE STATE OF WASHINGTON
JAY COLBERT,
)
MOOMBA SPORTS, INC.,
MADSEN, J. — Jay Colbert’s daughter, Denise Colbert, drowned after inhaling carbon monoxide fumes while hanging onto a motorboat as it was moving.
FACTS
According to Mr. Colbert, at about 3:00 a.m. on August 3, 2003, he and hiwife Kelly were awakened by a telephone call from Kyle Swanson, the boyfriend of Mr. Colbert’s daughter, Denise. Mr. Swanson was quite upset. He told them
that Denise had disappeared from the back of a boat at Lake Tapps and a search was taking place for her. At about 1:30 a.m. Denise Colbert and others had gone for a boat ride aboard Marc Jacobi’s boat. Ms. Colbert and a friend were in the water holding on to the swimmers platform at the rear of the boat as it headed toward shore.1 After an hour and a half in the water, they decided to go swimming, and, as her friend stated, “[a]ll of a sudden she was gone. We were just swimming, and then she went under. There wasn’t a struggle or anything.”
Neither wore a life jacket. There was a placard on the stern prohibiting people from being on or near the swim platform when the engine was running, but Mr. Jacobi did not take steps to move Ms. Colbert and her friend. Mr. Swanson and others searched for Denise and Mr. Jacobi called 911; the call was received at 2:58 a.m.
A short time later Kyle Swanson called Mr. Colbert who took his other children to a neighbor’s house and then drove to the lake, about five minutes from their home. When he arrived, police cars, ambulances, and the fire department were at the scene. Mr. Colbert saw lights flashing from a boat on the water and knew the search for his daughter was underway. He drove to a friend’s house on the lake and watched the rescue operation from the friend’s dock. He hoped Denise would be found alive because Denise was an outstanding athlete with stamina and endurance, and she was a strong swimmer. Police Chaplain Arthur Sphar traveled back and forth between the rescue site and the dock to update Mr. Colbert about the search.
At some point after 6:00 a.m. rescuers found Denise’s body. Sphar relayed this to Mr. Colbert. About 10 minutes later Mr. Colbert saw a buoy pop to the lake’s surface. Because he could hear the dialogue from rescue workers on the
lake he knew what this meant — it was tied to Denise’s body. Mr. Colbert watched rescue boats move alongside the buoy. He saw Denise’s body pulled over the side of a boat by her arm. He averred that he could see rescue workers move Denise’s body once it was on the boat from about 100 yards away on the dock from which he watched. Mr. Colbert explains it was light enough that he could see this activity. Mr. Colbert saw an ambulance by the water, watched the police bring a
stretcher, put a sheet over Denise’s body, and take her away. He testified at a deposition that he was able to recognize the body as Denise’s. Chaplain Sphar said they could see a body being pulled from the lake, but added it was not
possible to see identifying detail from the dock. Denise had died about three hours before her body was recovered from the water. The cause of Ms. Colbert’s death was “drowning” with “ethanol toxicity” and “carbon monoxide” noted as significant. Her blood alcohol level was 0.12 g/100 ml.
Editors Note: The claim with respect to the death of the daughter was not at issue in the Appellate court decision. The disposition of the issues that were before the court in this decision were that the claims of the father for negligent infliction of emotional distress were dismissed, essentially because he was not at the scene at the time his daughter drowned.
Why did this drowning happen? Why did a strong swimmer drown within a few feet of safety? Why would a BAC of .12 cause such a result?
This happened for the same reason that almost all of the other cases discussed on this blog occurred: because Denise was in the wake of the exhaust of an engine, an engine that was spewing carbon monoxide fumes. Boating accidents are a surprisingly large segment of the carbon monoxide deaths. Boats are clearly one of the largest risk factors for carbon monoxide poisoning outside of the winter heating season. Manufacturers of boats put swim platforms on the back of boats, the same part of the boat such manufacturers funnel the engine exhaust. If people swim off the the swim platform, when the engine is running, they are a serious risk of carbon monoxide exposure. Unlike on land, where a moment of unconsciousness still leaves a chance of rescue, when swimming it can quickly turn deadly.
Is a mere warning about the risk enough? We think not. Swim platforms should no more be put where exhaust is vented, than boiler exhaust should be vented into swimming pools, another major CO risk factor. When swimming and CO mix, there is no margin for error.
Winter Kills – Carbon Monoxide Claims Many More
This winter of 2008, there have been two well publicized mass shootings in my part time home state of Illinois, and many more mass killings from Carbon Monoxide. Even the election cycle news had to take a pause for the Northern Illinois tragedy. Nary a peep, except in the local media, about Carbon Monoxide’s rampages.
The first string of cases, was so predictable, I almost blame myself for not having found a bigger mountain top to have raised my cry of alarm: household generators. Any time there is a flame, and it is in an unventilated place, there will be a risk of CO exposure. Well the last few weeks has seen many storms. With storms, comes power outages. With power outages, comes the use of portable electric generators. My father spent his life designing such generators. Electric generators, when used properly, should not be a serious risk. But they were never intended to be set up in the kitchen, to operate the microwave.
More severe weather is sweeping across the nation this week. I fear that will be more power outages, more death from this silent killer. If you are in the business of selling portable generators, I believe you must include a CO detector with each purchase. That should be the law. I am sure the good businessmen who sell them warn people, but you can buy the little portable units almost anywhere now, and the corporate executives at Home Depot or Walmart, ought to just package the CO detector right with the product.
For more information on the dangers of portable generators, click here: http://www.usfa.dhs.gov/citizens/all_citizens/co/generator.shtm
Here are the basic rules to avoid CO exposure when using a portable generator:
Always use generators outdoors.
Keep generator exhaust away from air that flows into a building. But also make sure it is away from windows, doore and vents. The venting part can be critical. Many of the tragic stories we have heard this winter was from indirect exposure because an engine source (like a generator) was too close to an air intake vent.
Garages, basements, crawl spaces, are not OUTDOORS.
Follow manufacturer’s instructions. This presumes you can still find the instructions. Hopefully they are printed right on the generator itself. If not, look them up online. Keep in mind that exhaust that can get into your living area can kill you.
Use CO detectors, and make sure they are working, that the batteries are replaced when needed. Remember that smoke detectors, are not CO detectors. You can have CO exposure with no smell of smoke and without a smoke detector going off.
The first string of cases, was so predictable, I almost blame myself for not having found a bigger mountain top to have raised my cry of alarm: household generators. Any time there is a flame, and it is in an unventilated place, there will be a risk of CO exposure. Well the last few weeks has seen many storms. With storms, comes power outages. With power outages, comes the use of portable electric generators. My father spent his life designing such generators. Electric generators, when used properly, should not be a serious risk. But they were never intended to be set up in the kitchen, to operate the microwave.
More severe weather is sweeping across the nation this week. I fear that will be more power outages, more death from this silent killer. If you are in the business of selling portable generators, I believe you must include a CO detector with each purchase. That should be the law. I am sure the good businessmen who sell them warn people, but you can buy the little portable units almost anywhere now, and the corporate executives at Home Depot or Walmart, ought to just package the CO detector right with the product.
For more information on the dangers of portable generators, click here: http://www.usfa.dhs.gov/citizens/all_citizens/co/generator.shtm
Here are the basic rules to avoid CO exposure when using a portable generator:
Always use generators outdoors.
Keep generator exhaust away from air that flows into a building. But also make sure it is away from windows, doore and vents. The venting part can be critical. Many of the tragic stories we have heard this winter was from indirect exposure because an engine source (like a generator) was too close to an air intake vent.
Garages, basements, crawl spaces, are not OUTDOORS.
Follow manufacturer’s instructions. This presumes you can still find the instructions. Hopefully they are printed right on the generator itself. If not, look them up online. Keep in mind that exhaust that can get into your living area can kill you.
Use CO detectors, and make sure they are working, that the batteries are replaced when needed. Remember that smoke detectors, are not CO detectors. You can have CO exposure with no smell of smoke and without a smoke detector going off.
Winter Heart Attack and Carbon Monoxide Poisoning
Winter Heart Attack. I have coined a term, “winter heart attack”, to describe what I believe to be a large number of carbon monoxide related cardiac arrests and heart attacks, that are caused by carbon monoxide poisoning. It is highly likely, that in most of those cases, the true triggering phenomenon: poisoning, is never identified.
The term “Winter Headache” has long been used to describe the situation of getting headaches in the winter flu season, not because of a virus, but because of carbon monoxide exposure. For the same reasons that carbon monoxide is grossly undiagnosed in winter headache, I believe it is undiagnosed in winter heart attack. See http://codamage.com/carbon_monoxide_poisoning/carbon_monoxide_unexplained_heart_attacks.html
A recent study by researchers at the Rhode Island Hospital, while it doesn’t make my connection to the Winter Heart Attack, does provide further backup to my hypothesis that carbon monoxide poisoning is a much bigger culprit in heart problems during the winter, than doctors diagnose.
See http://www.sciencecodex.com/carbon_monoxide_may_cause_long_lasting_heart_damage
The common thinking about the mechanism of Carbon Monoxide Poisoning is oxygen deprivation (hypoxia). Since CO interferes with the blood’s capacity to carry oxygen, insufficient oxygen reaches the bodies organs, including the heart, causing damage. But according to this study published in the January issue of Academic Emergency Medicine, CO also causes a more toxic damage to the heart muscle, not related to oxygen deprivation. This can not only cause a heart attack, but could also cause long term damage.
Perhaps there is a cart and the horse issue here. I have been saying that Winter Heart Attack, is misdiagnosed, because no doctor thinks to look for a complex diagnosis, when someone with known heart disease, has a heart attack. But the CO may actually have created the defect as well.
“These findings suggest that heart damage caused by carbon monoxide may have long-lasting effects even after its been eliminated from the blood, making the diagnosis of carbon monoxide poisoning even more critical,” said lead author Selim Suner, M.D., M.S., director of emergency preparedness and disaster medicine at Rhode Island Hospital.
“While this research puts us one step in the right direction, there is still much more we need to know about the underlying mechanisms if we hope to someday develop targeted treatments,” added Suner, who’s also an associate professor of emergency medicine, surgery and engineering at The Warren Alpert Medical School of Brown University.
The study is the first to show that CO’s effect on heart muscle is unrelated to oxygen deprivation in the recovery phase, even when all CO is out of the system.
THIS MEANS WE MUST LOOK CLOSER, LOOK AT MORE THAN JUST THE BRAIN, WHEN THERE IS A KNOWN CARBON MONOXIDE EXPOSURE.
I realize that I am a lawyer, one of those people who are always accused of drumming up lawsuits. But our civil justice system is about compensating individuals for all of the damages wrongfully caused by others, even the damages missed by others. What this study is telling us is that Carbon Monoxide poisoning cannot only cause death, heart attack, brain damage, but it can also cause permanent heart damage, ultimately shortening life expectancy.
Every day, there is another story about a group of people who were hospitalized for CO poisoning. Every day, those people are treated and released, with a seemingly clean bill of health. If they hired a lawyer, the lawyer would likely be scratching his head, trying to determine why this particular case merited any real effort. The lesson of this Rhode Island Hospital study, of the delayed effects theme I have repeated often on here, is that don’t judge the extent of damage from CO poisoning, based upon the 24 hour window.
Carbon monoxide poisoning is called the great mimicker for a reason. It acts like flu at first. It can put on the veil of so many other diseases, heart disease, dementia, headache – because it is a toxin, let loose in the blood stream capable of damaging any part of the body. We must think about all of the places this toxin could cause damage. We must think about the possibility that CO could be the culprit, when someone reports symptoms consistant with simple diagnosis, but are coming from an environment with the risk of CO poisoning.
As I think of what that means, it means all situations, especially in the winter. So how could that practically be included in the standard medical diagnosis: Would it be so hard to start all inquiries with: do you have a carbon monoxide detector in your living space? In some places like Chicago, it is the law.
The term “Winter Headache” has long been used to describe the situation of getting headaches in the winter flu season, not because of a virus, but because of carbon monoxide exposure. For the same reasons that carbon monoxide is grossly undiagnosed in winter headache, I believe it is undiagnosed in winter heart attack. See http://codamage.com/carbon_monoxide_poisoning/carbon_monoxide_unexplained_heart_attacks.html
A recent study by researchers at the Rhode Island Hospital, while it doesn’t make my connection to the Winter Heart Attack, does provide further backup to my hypothesis that carbon monoxide poisoning is a much bigger culprit in heart problems during the winter, than doctors diagnose.
See http://www.sciencecodex.com/carbon_monoxide_may_cause_long_lasting_heart_damage
The common thinking about the mechanism of Carbon Monoxide Poisoning is oxygen deprivation (hypoxia). Since CO interferes with the blood’s capacity to carry oxygen, insufficient oxygen reaches the bodies organs, including the heart, causing damage. But according to this study published in the January issue of Academic Emergency Medicine, CO also causes a more toxic damage to the heart muscle, not related to oxygen deprivation. This can not only cause a heart attack, but could also cause long term damage.
Perhaps there is a cart and the horse issue here. I have been saying that Winter Heart Attack, is misdiagnosed, because no doctor thinks to look for a complex diagnosis, when someone with known heart disease, has a heart attack. But the CO may actually have created the defect as well.
“These findings suggest that heart damage caused by carbon monoxide may have long-lasting effects even after its been eliminated from the blood, making the diagnosis of carbon monoxide poisoning even more critical,” said lead author Selim Suner, M.D., M.S., director of emergency preparedness and disaster medicine at Rhode Island Hospital.
“While this research puts us one step in the right direction, there is still much more we need to know about the underlying mechanisms if we hope to someday develop targeted treatments,” added Suner, who’s also an associate professor of emergency medicine, surgery and engineering at The Warren Alpert Medical School of Brown University.
The study is the first to show that CO’s effect on heart muscle is unrelated to oxygen deprivation in the recovery phase, even when all CO is out of the system.
THIS MEANS WE MUST LOOK CLOSER, LOOK AT MORE THAN JUST THE BRAIN, WHEN THERE IS A KNOWN CARBON MONOXIDE EXPOSURE.
I realize that I am a lawyer, one of those people who are always accused of drumming up lawsuits. But our civil justice system is about compensating individuals for all of the damages wrongfully caused by others, even the damages missed by others. What this study is telling us is that Carbon Monoxide poisoning cannot only cause death, heart attack, brain damage, but it can also cause permanent heart damage, ultimately shortening life expectancy.
Every day, there is another story about a group of people who were hospitalized for CO poisoning. Every day, those people are treated and released, with a seemingly clean bill of health. If they hired a lawyer, the lawyer would likely be scratching his head, trying to determine why this particular case merited any real effort. The lesson of this Rhode Island Hospital study, of the delayed effects theme I have repeated often on here, is that don’t judge the extent of damage from CO poisoning, based upon the 24 hour window.
Carbon monoxide poisoning is called the great mimicker for a reason. It acts like flu at first. It can put on the veil of so many other diseases, heart disease, dementia, headache – because it is a toxin, let loose in the blood stream capable of damaging any part of the body. We must think about all of the places this toxin could cause damage. We must think about the possibility that CO could be the culprit, when someone reports symptoms consistant with simple diagnosis, but are coming from an environment with the risk of CO poisoning.
As I think of what that means, it means all situations, especially in the winter. So how could that practically be included in the standard medical diagnosis: Would it be so hard to start all inquiries with: do you have a carbon monoxide detector in your living space? In some places like Chicago, it is the law.