On March 22, 2006, a 40-year-old male career Captain (victim) died from complications of a drowning incident that occurred two days prior. The victim was in a training class with another student to become certified on a personal watercraft/waverunner (PWC) to conduct surf rescue operations for his jurisdiction. While the victim participated in training evolutions as a passenger on the back of the PWC, he fell off and reboarded numerous times while the engine was running. After a wave knocked both trainees from the PWC, the victim reported that he was too tired to re-board and seemed confused. The instructor attempted to drag the Captain into shore using an 18-inch tow strap attached to the rear of the PWC, but this was very difficult due to the surf conditions and the engine's water propulsion hitting the victim's upper body. After numerous attempts to hang on, the Captain became lost in the surf. A few minutes later, the instructor found the Captain and swam him to shore. The victim was retrieved from the surf and advanced life-saving efforts were initiated until the ambulance arrived on the scene and transported him to a local hospital. He was airlifted to a regional medical center where he died two days later from the injuries received during the incident. NIOSH investigators consider the drowning episode to have been triggered by a combination of exhaustion, hypothermia [rectal temperature less than 95.7 degrees Fahrenheit (F)], and carbon monoxide poisoning (carboxyhemoglobin level estimated to be 20%). To minimize the risk of similar occurrences, fire departments, police departments, and/or agencies with surf rescue teams should: 1. ensure that PWC are never boarded by an operator or a passenger while the engine is running; 2. enhance current standard operating procedures to include requirements for rescue boards on all PWC during emergency responses and training; 3. enhance current standard operating procedures to include requirements for issued personal protective equipment (PPE); 4. enhance current standard operating procedures for training operations to duplicate the same level of response as an actual emergency; 5. provide an emergency medical services unit at all training sessions; and, 6. consider conducting a job analysis of surf rescue to determine its fitness and strength requirements. Additionally, manufacturers should assess the significance of carbon monoxide exposures and carbon monoxide poisoning among operators of PWC during simulated rescue operations.