A similar experience happened to a person in my group at our houseboat in May of 2020, On our first afternoon out in Rock Creek, we were catching multiple species in a slot canyon in my 18 foot Ranger. My friend thought that my raised big motor was getting too close to the canyon wall so he decided to put his foot on the wall and push the boat away. What happens when you do that? the boat goes out from underneath you, and he fell out of the boat hitting the canyon wall with his shoulder. I was busy in the front operating the boat and catching fish, but I heard the splash; I thought that he had jumped in the water to cool off until I heard his cries for help. He was floundering in the water without his PFD which he had taken off. Only one shoulder worked; the other was dislocated and. although we didn't know it at the time, he had also torn his rotator cuff. I kicked the ladder down and managed to grab his hand and pull him to the ladder, but at 275 pounds, I could not drag him into the boat...he was like a dead weight. After struggling for 15 minutes, together we finally got him into the boat and I made it back to the houseboat. we called for help on my Garmin Inreach 660i sat device and the NPS arrived within 20 minutes with paramedics who gave him meds, which he supplemented with Jack Daniels, howling in pain the whole time. The wind had come up significantly and he faced a 50 mile boat ride back to Page, which did not seem to be a good plan. I'm a healthcare CEO and I knew that Page Hospital did have orthopedic surgery capabilities, so we made the decision to call for life flight. They arrived out of St. George in about 60 minutes, landing on the bank near the houseboat. They administered meds and stressed that it would be very expensive (they estimated $40k) to fly him to St. George and much more to Provo. I made a different call; the distance from where we were was the same to Flagstaff as it was to St. George, and my friend lives in Arizona. They finally agreed to fly him to Flagstaff, where he underwent surgery for his injuries a couple of hours later. The bill was $78k and the same insurer, Cigna, negotiated it down to $58k and paid it in full. There are several key learnings from this experience. Bring a satellite device; it can save a life. Never assume that a passenger in your boat isn't going to do something stupid. It's always best to keep a PFD on even if you're just fishing, but I don't make that a requirement. It is a requirement when the boat is under speed; no exceptions. That said, the charges by the Life Flight companies are beyond outrageous, and to balance bill the patient after insurance paid way more that a reasonable amount just isn't right.
