DAN is an awesome organization, and they are as good as their updated information of chambers that are inservice and online. I wish I could say that divers in Florida using the correct network with DAN and not being recompressed at the hospital they were referred to,only to be shipped off to another facility, was an anomaly,but actually common. You can even add the director of one of the top technical agencies to be added to that list. I am not saying don't use DAN,but I am saying it is prudent to know for yourself what chambers are available in the area where you are diving. Chambers being taken off line is a common occurrence, as well as some facilities not treating divers anymore-know before you go.
Chambers And Insurance
- Thread starter Reku
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Kevrumbo
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That's disconcerting that DAN has its own annoying bureaucratic red tape --you have to be sure that DAN approves and "qualifies" the Recompression Chamber that you plan on using if you have a DCS incident.
In 2013 on a Bikini Atoll Wreck Charter, I chose IWR (In-Water-Recompression) because we were informed before the start of the charter that DAN was in the process of approving but would not reimburse as of yet for the treatment in the Recompression Chamber on the liveaboard M/V Windward --I would have had to wait many hours -in acute pain!!!- while an emergency evacuation flight was arranged through US Coast Guard to fly into Bikini Island to fly me back to Kwajalein or Honolulu. (Also, I didn't want to tie-up the onboard Chamber for my "simple" type I DCS event, just in case someone else came up with a more serious type II DCS/AGE hit. . .)
Ken Kurtis
Contributor
First of all, this is NOT meant t sound antagonistic, but do you remember who told you that? The reason I ask is that I was faced with a similar situation in 2005 in Cozumel (chamber said DAN would not reimburse and demanded $2500 upfront before they would treat) and basically, I was lied to. It also led to a very long (and fruitful) discussion about this at Dan Orr, at the time President of DAN.
Bear in mind that there's a difference between the insurance and the people at DAN who will monitor chamber availability and consult with you on the phone, etc. Dan Orr said that DAN's position was that they didn't want divers to shell out money upfront nor avoid treatment because of pocketbook issues and they would immediately wire funds for any insured DAN diver and then let the insurance companies hash it out post-treatment.
In the Cozumel case, the chamber had a contract with DAN but decided that they had made a bad deal and weren't getting enough so they told my diver (with me standing there as well) that DAN was refusing to pay and that we'd have to pony up. It all got worked out in the end, my diver got reimbursed, the chamber (after our story went public) finally settled with DAN, and all was good.
But your Bikini story sounds eerily similar and that's why I'm curious as to the source of your info. Perhaps things at DAN have changed in the ensuing eight years, but something doesn't sound right here.
- Ken
A ScubaBoard Staff Message...
Moved non incident related posts to a separate thread. This is a very interesting thread so please continue posting about insurance and chambers.
Ken, Would you mind posting the name of the chamber facility that had the problem with DAN? I just purchased DAN insurance for a Friday trip to Cozumel. I was concerned that being secondary insurance, I would get stuck in the beauracracy of primary/secondary obligations while needing treatment.
I contacted DAN and spoke with the claims department and they told me the same thing, DAN would wire funds immediately and hash it out with my primary ins. company later. They did recommend a chamber by name staffed by a specific Doctor....Picollo or something like that.
Should the need arise, I'd like to know where not to go.
Thanks,
Jay
I contacted DAN and spoke with the claims department and they told me the same thing, DAN would wire funds immediately and hash it out with my primary ins. company later. They did recommend a chamber by name staffed by a specific Doctor....Picollo or something like that.
Should the need arise, I'd like to know where not to go.
Thanks,
Jay
Kevrumbo
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Ken, our group at that time June/July 2013 was simply informed and took under advisement by the Leader of our Expedition Charter that the Chamber onboard the M/V Windward was not yet officially approved by DAN, and that any treatment could be subject to full out-of-pocket cost covered solely by the patient. Other than that, we were not privy to the negotiations, consultations or "politics" between DAN and our Expedition Leader, along with the Captain/Boat Owners of M/V Winward. . .
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Kevrumbo
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FWIW,
For my treatment in Truk/Honolulu 2008, DAN reimbursed the foreign health care provider Australian Hyperbaric Health (Truk Recompression Chamber); while for the Honolulu follow-up treatment, my primary insurance from work covered all medical expenses. (DAN also provided for the hotel on Waikiki Beach as I was recovering from my Honolulu Follow-up).
It took a year of email/snail mail correspondence between myself, DAN and their insurance underwriters and Hyperbaric Health Australia however, before I was finally cut a check from DAN which was then bank wired to Australia. My primary health care insurance from work immediately covered all the expenses from Honolulu (Kuakini Medical Center, Hyperbaric Medicine & Ultrasound Dept, and Queen's Hospital Emergency /CT Radiology Dept) within a month -probably because the services were rendered in the US. . .
A ScubaBoard Staff Message...
Storker
SB Moderator
I am not going to read through this whole thread, but I have a question for all you advanced, technical, cave divers who make decompression dives. I will preference the question with a statement; one of the first things Jacques Cousteau did with his Undersea Research Group was to outfit his first ship with a recompression chamber. My question is why technical recreational divers feel they can safely make decompression dives without a recompression chamber on-site? And, why do facilities who foster technical training suc as cave diving involving decompression dive feel they can offer on-site services without providing a recompression chamber and trained personnel to operate it? Cousteau felt it imperative to do so in the 1950s, and showed its use in the film The Silent World. Why has the diving industry not followed suit?
SeaRat
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Jacques Cousteau put his chamber on his ship and took it with him wherever he went. When I went to the Bahamas, they had a very strict weight allowance on my luggage that would not have allowed me to bring a chamber with me if I had owned one. So that is one big difference--it is simply not practical to bring a chamber with us wherever we go.
Cousteau also had funding to pay for that very important chamber. As for me, this retired teacher does not have enough money in the diving budget for a chamber.
A third big difference is knowledge. After 6+ decades of learning, we have a far greater understanding of decompression. Cousteau was diving on air and decompressing on air using pretty primitive tables for that work. We dive the best mixes of gas for both our bottom times and for our decompression processes. The algorithms we use for planning the dives and decompressing are far more accurate and far more sophisticated. That means our risks for a particular dive are far less than Cousteau's were. It is simply far less likely that we will get bent.
Our equipment is also far more sophisticated and far more reliable than his. What does equipment have to do with recompression? Plenty. When we train, most of our training is focused on preventing problems that will force an early ascent. A friend of mine recently underwent a very much unplanned ascent due to an equipment related emergency, and while heading to the surface, he assumed he was going to die. He didn't. He was only paralyzed for a few months. That sort of an event is extremely rare today. That brings me back to the first point--he had arrived at the dive site in the Andes Mountains on the back of a horse, and bringing a recompression chamber was not a good option.
We like to think that we have better, more reliable equipment than Cousteau did in the 1950s and 1960s, but we don't so far as reliability goes. Our equipment has gotten immensely more complex, but each layer of complexity adds to it more failure points. Cousteau in the 1950s was diving either the DA Aqualung (two stage, double hose regulator) or the Mistral (single stage, double hose regulator), without any BCD. In my professional safety work, we were required under Process Safety Management for Highly Hazardous Chemicals to write up different types of analyses of the processes. One of these was a Failure Modes and Effects Analysis (FMEA) for our processes. That meant we looked at each component in a system and looked at the failure modes for that component, and then looked at the effects upstream and downstream (systems wise) of that failure.
If we were to do that with today's technical diving equipment, it would be a rather complex analysis. If we were to do that with Cousteau's equipment, it would be a rather simple analysis. The Mistral had six moving parts, and he used that on his dives on the Brittanica to 300+ feet. Of course, he also used a submersible decompression chamber, as he decided that simply diving on it from the Calypso would be too hazardous.
When diving at a remote site, how many dive masters set up diver evacuation procedures in advance? You mention the a person who went to the Andes; was there a procedure for contacting a helicopter rescue organization set up in advance of the dive? I did this for one dive site I was working with in the 1970s.
Concerning preventing unwanted ascents, and training for that, I don't recall hearing about any unwanted ascents from the Cousteau teams. It may have happened, but that was either not discussed or actually did not happen under their diving protocols.
Now, the biggest question I have isn't about individuals taking a recompression chamber, but about commercial diving outfits, with live-aboard boats, being so outfitted, or facilities at known diving destinations being so outfitted. That cost could be written off as a business expense, and be situated at the dive location.
Looking at this thread, and others here, I'm not so sure that the rate of decompression accidents is lower now than in the 1960s and 1970s. It seems that recreational diving has taken to the more challenging areas of technical diving, which involves more risk without the safety of having a chamber available. You mentioned a person you know having gotten a "hit," and there is the one on this thread, as well as the one about which this thread was written. That's three right here. Does that in itself say something about these risks? I have now been diving since 1959, and even in the USAF we were not allowed to do decompression diving. I did one set of decompression dives at the Warm Mineral Springs Underwater Archaeological Project (the one for which I set up the protocol for helicopter evacuation), and we did not experience any decompression "hits."
My impression for recreational technical diving is not good in relation to decompression sickness, and all the training in the world doesn't necessarily make it safer. In our professional safety work, we use the Heirarchy of Controls, and training as a control comes under the "Administrative Controls" area, which is less effective than Engineering Controls.
SeaRat
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