An Orford man who drowned off Maria Island in July last year was an experienced seaman, but was not wearing a life-jacket when his body was found.
And the finding that the man was not wearing the jacket has prompted Coroner Simon Cooper to suggest regulatory changes to commercial vessel operations.
Kevin Bruce Haigh was found floating in the water about 1.5 nautical miles north-east of Ile du Nord, a small island part of the Maria Island group, at 3.25pm on July 5.
Mr Cooper wrote it was likely had Mr Haigh been wearing a personal flotation device he would not have drowned.
If Mr Haigh had been wearing a PFD, and two were in the wheelhouse of his vessel, it is highly unlikely he would have drowned.- Coroner Simon Cooper
"The need for him to have worn a PFD, working alone as he did, was to my mind obvious."
Mr Cooper recommended "appropriate regulatory authorities give consideration to making ... all domestic commercial vessel operators, operating "single-handed" wear an appropriate PFD and carry an appropriate PLB on their person at all times when outside the wheelhouse or superstructure of the vessel".
As part of his investigation Mr Cooper found the experienced fisherman only really wore a flotation device with a personal location beacon "to keep warm".
Mr Cooper ruled it was impossible to know exactly how Mr Haigh fell into the water, whether he slipped or tripped, or whether a medical episode made have contributed - although none were detected in an autopsy.
But considering the experience of Mr Haigh, Mr Cooper discussed a possibility as to how Mr Haigh ended up in the water in the first place. He had been exhibiting signs of unusual health in the lead up to him falling overboard.
Mr Cooper ruled there were two particular events "which possibly cast light on his death".
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In February Mr Haigh collapsed in a toilet in a hotel, but no ongoing medical condition was determined. And on March 31 the experienced boater ran his boat, the FV Yimbala, aground north of Triabunna.
Mr Haigh had said he had no recollection of running the boat aground and was reviewed by a cardiologist, but no ongoing medical conditions were determined.
Mr Cooper found on the day of his drowning Mr Haigh was rock lobster fishing in the Narrows when he fell into the water. He had managed to drop five of 51 baited lobster pots in an ocean described as "benign", "relatively speaking".
Mr Cooper commended the efforts of other fishermen in the area who called emergency services and helped search for Mr Haigh after finding the boat drifting without her captain.
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