HACE, INADEQUATE COMMUNICATION—CLIENT TO GUIDE

Alaska, Mount McKinley, West Buttress

An Alaska Denali Guiding Party led by Blaine Smith took ten days to reach the 14,200 foot camp on the West Buttress of Mount McKinley arriving May 23. Jack Miller (45), a client in the party, experienced Acute Mountain Sickness his third night at 11,000 feet and his first night at 14,200 feet on May 23. He did not communicate the extent of his problem with the guides. Another client in the party developed Pulmonary Edema which was diagnosed at the 14,200 foot Ranger Camp on May 24. Miller spent an equally miserable night over the 24th. By the morning of the 25th, Miller told Smith of his condition. Miller was very hypoxic when he was taken to the 14,200 foot Ranger Station and examined by volunteer physician Ken Zafren at 1230. Miller said that he had blood in his urine two previous days after making carries. Zafren recommended that Miller not go any higher soon and spend the day taking it easy, possibly walking around camp. The party spent the day in practice just a short distance from camp. For the remainder of the day, Miller walked around camp, but became increasingly ill from AMS. Several times he collapsed, experiencing extreme headache, nausea, and vomiting. Smith returned from practice about 1830. Miller stated, “I’m feeling better, I’ve been walking around today.” One hour later, Miller said, “I don’t feel so good,” so Smith took Miller back to see Dr. Zafren at 2000. Miller was mildly ataxic and was told that he may have to go down. Miller returned to his camp and in one hour he became extremely ataxic. Miller was assisted back to see Dr. Zafren where he collapsed outside of the medical tent at 2115. Miller was diagnosed with extreme High Altitude Cerebral Edema requiring an immediate evacuation to a lower elevation. Ranger Roger Robinson requested the contract LAMA helicopter for the evacuation from Talkeetna. Miller's condition continued to deteriorate over the next hour. Miller was flown straight to Talkeetna where he was transported by ambulance to Valley Hospital in Palmer. Miller’s condition improved dramatically upon descent to sea level, but it took him ten days to get back his coordination and most of his memory of the incident.

Analysis

Jack Miller had never ascended above 7,000 feet prior to his climb so his ability to acclimatize was an unknown. Most people will acclimatize to 14,000 feet if given ten days to reach this height. Miller should have confided with Blaine Smith his difficulty with acclimatizing. This life threatening evacuation could have been avoided since he could have descended with the other clients and guide on the 24th. (Source: Roger Robinson, Mountaineering Ranger)