I was privileged yesterday to attend a sobering debrief of Andy Schwenk's mid-Pacific medevac while returning from the 2022 Pacific Cup aboard his Express-37 SPINDRIFT. Andy was suffering from Necrotizing Fasciitis
(flesh eating bacteria) of his lower leg of which 1/3-1/5 of victims succumb.
The principles to the rescue all presented including Michael Moradzadeh, Mary Lovely, crew member Peter English, Rowena Carlson, and Andy himself. All gave first hand, factual, and at times shocking and emotional information how close Andy came to dying.
Some takeaways in no particular order of importance: Andy's leg wound began during the Pacific Cup, days before delivery departure. It was a common cockpit "boat bite" during a squall, possibly a puncture from a cotter pin or sharp corner. The small wound was exacerbated by contact with suspect and likely polluted water in Hawaii, especially at Ala Wai.
Two days before return delivery departure, Andy's wound was already red and developing into something serious. Andy had had similar injuries before and had always healed over time. In denial, the crew of SPINDRIFT pressed on when, in hindsight, they probably should have turned back. There were no appropriate antibiotics for Necrotizing Fasciitis either aboard SPINDRIFT or any other returning boats. It is a rare infection.
Despite ship to shore communication difficulties and initial Cost Guard hesitation and misdiagnosis, the role of George Washington University providing 24/7 Maritime Medical Access remote medical consultation for offshore sailors requiring medical advice cannot be overstated in Andy's case. This access, contracted by the Pacific Cup, cost racers $70. For Andy, GW recognized the seriousness of the situation. Once the Coast Guard heard GW's professional analysis that Andy could die within 48 hours, they stepped in with the full force of their assets including two C-130's, two Jayhawk helos, refueling planes, and a mid ocean parachute team. All this saved Andy. But it began with GW.
Particular emphasis at the presentation was given to the importance of every one in the crew of racers and delivery crews understanding the use of the communication system(s) aboard. As well, emphasis was placed on water ingress degrading cell phone charging cords,and VHF, and AIS masthead signals. Despite PacCup skipper denials, 80% of racers flunked their initial inspection requirement that their AIS signal be seen on Marine Traffic. These VHF failures were primarily due to water degradation and corrosion, often hidden at the masthead or internally, and was a debilitating problem for SPINDRIFT during Andy's emergency. Primarily thanks to MM's expertise and persistence, as well as an emergency VHF antenna onboard SPINDRIFT, they made their compromised coms work. But proactive maintenance and testing would have eased this particular concern, and not just on SPINDRIFT, but throughout the fleet.
It was wonderful to see Andy walk to the podium yesterday after months or rehab at Stanford. Thanks to all who made his recovery and this meeting possible.
https://www.cdc.gov/groupastrep/diseases-public/necrotizing-fasciitis.html
