RedactedNarrative: On 6/23/18 at approximately 1:08pm, I received a call for a vessel accident involving an unconscious 14 year old male, thrown from a tube, in St. Leonard Creek. OFC. and I responded by water on NRP 874. We arrived on scene at 1:22pm.  The patient had already been transported from the scene by Ambulance 77 to a landing site established at Church by the Chesapeake. 
  OFC. remained at the scene to speak with the operator of the vessel while I continued to the landing site with the Chief from St. Leonard VFD. At the landing site, I made contact with the patient's mother. I obtained information about the patient from Mother and then relayed what information I had regarding the accident to the flight medic from Trooper. At that time, the patient had a low level of consciousness and an increased respiratory rate. The patient was then air lifted to Childrens National Medical Center in Washington DC.  I then made my way back to the scene to interview the other occupants and skiers involved. 
  
  The person acting as the observer at the time of the accident was a 10 year old male, who indicated that he was seated in the front left portion of the vessel and was not wearing a PFD. I then interviewed the operator of the vessel, Operator, who provided a voluntary written statement.  Based on all accounts from the individuals present at the time of the accident I was able to determine the following course of events. At approximately 12:50pm, Operator was operating the vessel at approximately 20 mph, headed south west, near the mouth of St. Leonard Creek, when he made a sharp left turn. The tube began to accelerate outward, to the right, when it flipped ejecting all three skiers. Tuber1 was positioned on the left side of the tube, Tuber2 was positioned in the center, and Victim was positioned on the right side. Victim impacted the water at a high rate of speed and subsequently went unconscious, face down in the water. Operator circled around to pick up the skiers when he noticed Victim face down. Operator called out to Tuber1 to check on Victim, at which time she rolled him onto his back and noticed that he was foaming from the mouth and nose, and his lips were blue. Tuber1 then pulled Victim to the stern of the vessel and Operator lifted him by his PFD onto the swim platform.
  Operator attempted to perform CPR on Victim, but had to abandon his efforts when he realized that he was the only one who was capable of operating the vessel. Operator then proceeded back to the dock from which they left. Once back at the dock, Operator indicated that Victim regained limited consciousness, so he carried Victim up the steps and placed him on the ground on his left side. EMS arrived on scene at approximately 1:11pm and began treating Victim. At the time of the accident the air temperature was 82 degrees, with little to no wind, cloudy skies, and good visibility. The water conditions were calm, at a temperature of 78 degrees, with little to no vessel traffic. Upon surveying the scene, no obstructions were visible in the water. The operator indicated that he had consulted the weather forecast prior to going out. He also had in his possession a Boaters Safety Education card, and indicated that he has in excess of 500 hours of boating experience. A safety inspection of the vessel was completed and all required safety equipment was onboard, with the exception of a Type IV throwable flotation device. Sgt. made his way to Childrens National Medical Center, to follow up on the patient's status and attempt to interview the patient. Based upon my investigation the following violations occured: NR 8-725(b) Skiing without an observer at least 12 years old. NR 8-743(b)(1) Operating a vessel under 21 feet in length while there is present in the vessel a child not wearing a personal flotation device which is securely and properly attached to the child. 08.18.04.03 Insufficient number of USCG approved PFDs (Type IV throwable flotation device) I will follow up with the operator at a later date to issue the appropriate citations. All events occurred in Calvert County, MD.