dive buddy got bent

[jimmy71]

It is sort of a long story and one that i feel bad about enough already. My long time dive buddy is also my long time girlfriend. She lets me handle all the technical aspects of the diving. I take care of the gear and is usually the person educating/reminding her about any risk and such. End result is that there was no uncontrolled assent or radical deviation from the planned dive. We could have been safer. If you want to exact details I am happy to supply them. Her computer acted screwy the night before and we decided to ignore it and have both of us "dive my computer." A mistake I know. I tried to increase our safety by tripling our safety stop and adding nitrox into the dive but not the N2 calculations. I also believe that dehydration and altitude play a big part in this. I am not bent. We dove the same dive.

My real question/discussion with what/how we were handled after we realized there was a problem. The dive shop i was with was stellar. I can not say enough good things about them. She had mild DCS that consisted as mod-mod severe shoulder pain, Nausea (without vomiting), and rash/itching on her chest. All the symptoms promptly resolved within 5 mins of 100% o2. We than placed her on 100% and transported her to the nearest hospital equipped and trained for DCS. This hospital is 1hr 45min away. We are both medical and trained in BLS/ACLS/PALS. I have advanced airway management training have no trouble giving O2. I do not question our decision on how we transported her. The dive shop contacted the hospital to notify them of the situation and of our ETA. They also contacted DAN to inform them as well as most of our trip is out of cell phone range. DAN contacted us via phone en route and gave us a couple names of MDs that were qualified in HBO treatment, advising us that often ER docs are not trained in such things. Wonderful info to have. The ER than contacted us and had me advise them of her condition. Perfect.

She was asymptomatic during the transport but was never off O2. When we arrived at the hospital were were triaged by the ER staff (RNs), because she was asymptomatic on O2 she was placed on the bottom of the list. I did request a NRB and an O2 tank as during all this time she was breathing through a reg. We sat in the ER for 2.5 HOURS and was still not seen my an MD. I contacted DAN at hr 1 and asked if they had contacted one of the MDs who's names they had given me. DAN informed me that they could/would not do that and it was the responsibility of the ER MD to do that after their assessment. I informed them that we had not currently been seen MD. They voiced that that troubled them but stated there was little they could do. I asked if they had spoken with the hospital we transported to on their recommendations and the answer was no.

I made a call to DAN after approx every hr of wait time in the ER. I also tried to contact the MDs DAN had told us about and was shut down by there answering service. One of them was on call but they do not page them for patients. It has to be at the request of someone higher up the food chain than us. I asked DAN to call them on my behalf but they stated they could not. If those doctors were aware of our presence in the ER i will never know. At the 4 hr mark of 02 administration, we personally made the decision to d/c it. Our thought process was that we were going to soon be leaving this ER and we needed to know her condition. It was at this time that I also indicated to the ER staff that we would be leaving shortly. They told me that there was an ER doc who was a diver who wanted to see her but would they had no beds available. I asked when that might be and there were unable to answer so we continued our plan. 15 min later we saw a doc in the waiting room who listen to her lungs (no neuro) and our dive profiles. She informed us that the real problem with DCS is AGE and that my buddy was probably fine. She said she wanted to find out who were the HBO docs at the hospital talk to them. I told her their names and gave them the phone number to their answering service. I even let her know which one was on-call that night.

At about 30 min off O2 my buddy had an ache return to her shoulders but no other symptoms. When we placed he back on O2 the symptoms did not resolve. They ache never escalated like it had before. At an hour after the MD had seen and never seeing anyone again, us we decided to leave to hospital. I do not know if she was ever able to speak with anyone. Guess I never will.

We went home off O2. We had plenty with us to make it through the night if any problems returned with any altitude changes on the drive home. The next morning she had no shoulder pain or residual signs. We looked in our yellow pages and made an appointment with a HBO doc whos website says he deals with divers The earliest his secretary could get us an appointment is this Thursday (7/29/10). We also called DAN and asked them who they recommended she see. They only had 1 MD listed in our area and it was not the person we spoke with. We left a message on his voice mail and have still not heard from them. She was bent on 7/25/10.

I thought I had DAN insurance for 2 reasons. One was to pay for accidents. The more important thing was to help us navigate the system. They have done nothing to help us in the system which makes me very sad. When I get into a wreck and contact "OnStar," they do not tell me the phone numbers of the ambulance and police and tell me good luck. This is what DAN did. I have no weight, leverage, or ability to enter that hospital as anyone other than man next to us who "felt dehydrated." I thought that is what DAN can do. What does a call to DAN do? It did nothing to change or help our treatment. I hope I am able to find a better insurance because this is not what I wanted. I guess it is somewhat fortunate but unfortunate that I will probably how have a phone number for a MD that will be able to help me in an emergency. His job can be nothing more than to let people know I need help. No one was able to do that for me when I needed it.

Sorry for the long email. I just wanted to be thorough.

 

[a22shady]

Sorry for the Situation, Is she still suffering symptoms at this point or was it resolved

 

[jimmy71]

currently she is symptom free. Sorry i forgot to put that when she woke up this morning she had no residual symptoms. She did have some numbness and tingling in her fingers when she took a colder shower, but it is hard to tell. We dive in <50 degree temps and we always have some pain in our fingers from the cold. (so much to type)

I am just really frustrated with how this played out. I thought I had situations like this covered as well as I could with DAN insurance. Accidents happen. As it stands right now, DAN insurance has not helped the situation any.

 

[a22shady]

definetly sucks, Luckily I have not had any issue's but I feel what your saying if I should I dont want that situation. You would think that there is something more they could do to assist in your situation.

What actually happened to cause the DCS hit any Idea

 

[tonka97]

jimmy71,

I have DAN insurance for the same reasons and expectations as you.

You were not served in the advertised manner, and your buddy's health may have been jeopardized.

Thanks for sharing your experience. I will invite a representative of DAN to post on this thread.

 

[jimmy71]

A22 - We have to ascend to 1000ft after the dive to leave the lake. This is something that has always concerned me but after speaking to the shop and people and reading up on altitude, I deemed it safe enough. It often takes a good 45-60 min to get off the site and pack the gear. She states she felt fine until the car ride up the hill and that is when symptoms started. I also know she was dehydrated. We dive drysuits and she hates taking it off to pee so she does not drink as much as normal. She also had some trouble with her BCD before the first dive. When she stood up in full gear (weights and drysuit and undergarment to <50 degree temps with 85-90 air temps) the tank slide out. It is an older BCD and the webbing is a bit stiff and makes it very hard to adjust them. It took about 10 mins with her in full gear to fix. I also blame us both diving my computer. It is stupid and I know and I regret it. I would still say any change in her depth from mine was covered by extra stops. In the end we may never know.

Tonka- we are a little hesitant to talk to DAN at the moment as they frown on walking out of an ER untreated. It is often an excuse to stop any possible claim payments. It worries us. Granted the ER never had any information more than a DOB and a name. I will be shocked if I see a bill from them.

Obviously i have been shopping around for a different insurance (if there is one better) ran into this. Just wish it was more recent. http://www.undercurrent.org/UCnow/dive_magazine/2006/RightDiveInsurance200606.html

 

[Dirty-Dog]

It sounds like a very frustrating experience. It's unfortunate that she didn't get a more complete evaluation, but sadly that is sometimes an unavoidable fact of ER life. Given that she was stable and asymptomatic on O2, it's not unreasonable to triage her as a lower risk. But she shoud have been re-evaluated periodically by the triage nurse. Did this happen?

Why do things like this happen? That's complicated, but mostly boils down to inadequate resources. And that is a problem that is only getting worse.

It's also true that from the waiting room, you're unlikely to have any idea what is going on in the back. Let me give you an example.

Had you shown up in our ER last night, you'd have most likely had a similar long wait. Why? Because in the 12 hours I was there, we had 3 people shot (one of which I flew in - the only flight I made last night. The rest of the shift I spent in the ER). One stabbed. One who cut his own throat. Two cardiac arrests. Two respiratory failures who had to be placed on ventilators. Not to mention the average of 8-10 beds occupied by homeless drunks who are basically just sleeping it off. Plus I don't know how many people being worked up for more routine things. None of this madness is apparent from the waiting room, where all seems peaceful and (relatively...) quiet.

That's not a typical shift, but the point is that it's worth remembering that the people you dealt with were, in all probability, doing the best they could with the resources they had.

An unpleasant stat: on average in the US you will spend 4 hours in an ER waiting room before you get into the back.

 

[jimmy71]

dirty - i completely understand what you are saying. The ER was the only entry into the system i had. I had no need to see an ER doc. I did have a need to speak to the doctors that only they can contact. I understand EMTALA and the rules it creates. I also understand the limited resources the ER works within. Sadly i was not fighting with the other people in the waiting room for those resources. I needed a different set all together. That is where i thought that DAN would step in and they did not. The ER operated the same way it would operate every day of the week. Some days are good and others are bad but no one is ever happy. I know. I am not faulting the hospital nor ER. The problem is that was not able to see nor communicate with the people i need to. In my area, all the docs that know anything about DCS all work normal daytime jobs at wound care clinics. That is how they make their money. I am not allowed to touch base with them. It seems DAN is unable to as well. I work in the system. I also know how you can politically get done the things that need to get done. I can promise you that one call from DAN could have solved this problem. It did not have to be much just a "I was checking on the status of a patient that we directed to you with DCS for our records." That leads to a statement such as "what patient that has WHAT? and starts the ball rolling from the back. I will feel better once we are able to see someone who can tell us where we stand. To date we have spoken to no one that seems to know what is going on. Thank you internet for at least giving me information on how to treat her, because that is what we are using. how sad is that.

 

[cdolphin]

I'd like to see a comment from DAN on this incident. I don't know what their procedures were that caused them to deal with it in this fashion.

If we all have the insurance, and they did nothing to help you except give you the name of the doctors, I'd like to know why.

 

[Hetland]

Dan's not going to pull a doc off his sailboat, or make him answer the phone on a holiday. If you can find any insurance company that can, then let me know.

Of greater concern is that your partner couldn't manage her own gear, and seems from your description to be totally dependent upon you for basic scuba safety while doing a cold water, altitude dive in a drysuit without a computer. What would have happened if you had become separated????

I'm not trying to kick a man while he's down, but this could have been much, much worse.