RedactedNarrative: On June 14, 2014 at approximately 2:40pm driver Operator and rear passenger departed from Elm Hill Recreation Area #2 boat ramp on a Yamaha PWC (tag KY 0524 JB). Subject riding a similar but separate PWC ( tag KY 0524 JC) was following behind them. The passenger on the PWC, Occupant, was holding in his right hand the excess rear slack from a recreational skiing tube they had in tow directly behind the vessel. Also some amount of excess lead slack (the part which was attached to the stern tow eye) was located in the port side gunwale of the PWC near both individual’s left foot. Near Elm Hill Marina, while underway at approximately 25mph, the towed ski tube pulled the slack out from Occupant’s hand and as the PWC continued forward the remaining slack located at the port side gunwale entangled his left foot near his ankle and pulled him from the PWC as the tube reached its maximum length. The force from the rope constricting at his ankle resulted in his left foot being amputated. A make-shift tourniquet from the ski rope itself was applied above and below his left knee to prevent excess blood lose. The depth near the accident site was ~70 feet. The amputated limb was not recovered. Occupant was taken to nearby Elm Hill Marina and transported to Vanderbilt ER by Metro Nashville Fire/ EMS. He was interviewed at Vanderbilt ER.