Drowning without aspiration: is this an appropriate diagnosis?

It has been reported that 10-15% of drowning victims do not aspirate water. We have revisited the original studies quoted to reach this conclusion and find it is without foundation. Sudden cardiac standstill is known to occur on land and, therefore, may also occur when the victim is in water. In the absence of the common finding of significant pulmonary edema in the victim's respiratory system, to conclude his or her death was caused by "drowning without aspiration" is unwise. All causes of sudden death that might occur in which respiration may not take place should receive serious consideration when examining bodies with such findings that are found in water.