A man who was trapped in a Utah cave for 28 hours before dying Thanksgiving eve had a limited chance of survival because he was stuck upside down, doctors told ABC News.
At least 100 rescue workers tried to free 26-year-old John Jones of Stansbury Park, Utah after Jones became stuck in a tiny section 150 feet below the surface in the Nutty Putty Cave in Utah County Tuesday evening. The hard rock and narrow walls severely limited rescue options, Utah County Sheriff's spokesperson Sergeant Spencer Cannon told ABCNews.com.
Doctors say the head-down position Jones endured made the rescue operation a race against the clock.
"It sounds just absolutely terrifying," said Dr. Wendy Wright, assistant professor of neurology and neurosurgery at Emory University Hospital in Atlanta.
Wright explained hanging upside down for a long period of time could lead to death in a variety of ways and within less than a day -- a fact exploited by the ancient Romans who crucified people upside down more often than right side up.
"It actually was a form of torture and a quick way to kill somebody," said Wright.
Cannon said Jones' position was nearly "straight up and down" -- close to 160 to 170 degree angle. At that position, Wright said it would have been very difficult for Jones to breathe.
"The rib cage is built from the top-down so the lungs expand into the body cavity," said Wright. But when someone is upside down, the lungs "are working against the weight of your liver, of your intestines and the breathing muscles have a difficult time overcoming that."
Eventually, Wright said people in a head-down position will most likely die of suffocation.
Cannon said rescue workers stayed beside Jones in the 18-inch wide and 10-inch high space throughout the ordeal. The small space limited the rescue methods, so volunteers resorted to securing anchors in the cave's walls and tried to pull Jones out by ropes.
Rescue workers were briefly able to lift Jones' high enough to pass him some food and water, but "when they were able to get him raised from where he was stuck, we had a ceiling anchor give way and he fell again," said Cannon.
Volunteers from two cave exploration associations and 10 fire departments fought to free Jones but, Cannon said the hard rock of the cave's walls slowed drilling efforts.
"It is very, very hard rock that is difficult to do anything with," said Cannon. Rescuers who were trying to chip away at the rock "had a five inch section they drilled away and it took them an hour and a half."
Eventually Jones started slipping in and out of consciousness. Rescue workers frequently radioed-up Jones's vital signs to a doctor on the surface. But, according to Cannon, near midnight Jones' lost a pulse and the doctor on site pronounced him dead.
As time went on, doctors say Jones's body must have been fighting to breathe, as well as fighting to pump blood against the forces of gravity.
"The blood vessels in the legs are endowed with fibers which constrict them when we stand upright, but the brain's arteries do not have that capacity," said Dr. Jay N. Cohn, a professor of medicine at the University of Minnesota Medical School in Minneapolis.
In other words, our body is designed to prevent blood from pooling at our feet when we stand up, but it isn't designed to prevent blood from pooling in our head if we are turned upside down.
"Therefore you could get brain swelling and brain hemorrhages," said Cohn.
That pooling of blood can cause a variety of problems before a brain hemorrhage. Wright explained the heart may not be able to get enough blood to the kidneys, causing kidney failure and death.
The pooling blood in the brain may also cause someone to go unconscious, or even go into a coma.
"Deep brain swelling can lead to coma," said Cohn. "If the brain centers that control your heart and your circulation and your breathing are damaged, then of course you lose your ability to breath and your circulation may fail."
Wright said she just hoped Jones was unconscious for much of the ordeal.
Officials will continue efforts to retrieve Jones' body today. In light of the tragedy, the Utah County Sheriff Jim Tracy has decided to close the cave until further notice.
"Sheriff Jim Tracy is declaring the cave a public hazard and restricting all public use of the cave," said Cannon. "There will be uniformed deputies there to enforce that for the next couple of days."