I have never fallen out, but did get thrown out while running on Dale Hollow a few years back. It was early April, water temp was at 50 dg, and my partner and I were traveling about 55mph and we must have stuck an underwater log or something. The boat turned sharply and over the side I went, and my partner went out the back. We were wearing auto inflatable life jackets and the did their job of firing. I would have drowned if I had been knocked unconscious or had broken an arm because when I surfaced, my inflatable straps were still under my arms, but the inflated part had been pulled over my head when I hit the water. I was floating with my head under the water and had to slip my head through the opening. My partner had no problem with his because he was wearing his under a large 100mph BPS parka. There was about a 15 mph wind on the lake and we were thrown far enough away from the boat that the wind carried it out of our reach before we could catch on to it.
I discovered another problem with inflatable PFD's on that day. You can't swim well at all, in fact all you can do is the back stroke because you can't turn prone, it is impossible, or was for me. The jacket keeps you from being able to turn your head well from side to side so it is difficult to see anything. Once we lost sight of the boat, we never found it. We floated in the frigid water for 20 minutes until another boater came by and found us. I could not get into the boat but had to be dragged into it. No use of my legs at all and very little arm usage. My pants were ripped off and I lost wallet, keys and everything in my pockets. Went to hospital and was released but my partner had to spend the night because of minor cuts and bumps. Still don't know what we hit, not a scratch could be found on the boat or motor. Everything check out ok with the steering.
I have a regular life jacket for running down the lake and only use the inflatable when fishing or moving slowly. I am 70 so when I get into the boat, I put my pfd on, and take it off when I get into the truck to go home. I feel fortunate to be here to day. Wear those pfd's, they will save your lives. Thank the good Lord, I made it.