Medical Approval Issues

[redacted]

Unfortunately, scuba is an endeavor in which YOUR risks often become MINE. I simply cannot fathom how people don't understand that.

If your dive op is as open and honest (and timely) in establishing their requirements as you would like divers to be in completing some medical forms, I'm sure we will have no problem.

 

[BRT]

And these several posts just point out another issue I have with the medical questionnaire. Right or wrong I have the impression that it is written more for liability protection of the instructor/agency then for trying to ensure the safety or medical fitness of the diver.

Of course it is!

 

[redacted]

 

[RJP]

Son, we live in a world that has forms, and those form have to be completed by divers with pens. Who's gonna do it? You? You, Lt. Weinburg?

I have a greater responsibility than you could possibly fathom. You weep for the RTSC, and you curse the agencies. You have that luxury. You have the luxury of not knowing what I know. That telling the truth, while tragic, probably saved lives. And the existence of the medical form, while grotesque and incomprehensible to you, saves lives.

You don't want the truth... because deep down in places you don't talk about at parties, you want your doctor to sign that form. You need your doctor to sign that form!

We use words like injury, and death, and liability. We use these words as the backbone of a life spent teaching scuba. You use them as a punchline.

I have neither the time nor the inclination to explain the need for telling the truth on the medical form to a man who ascends and descends under the very instruction that I provide, and then questions the manner in which I provide it.

I would rather you just said "no thank you" and went skiing instead. Otherwise I suggest you pick up a pen, and write "YES" on the form. Either way, I don't give a damn what you think you are entitled to.

:cool2:

 

[redacted]

Son, we live in a world that has forms, and those form have to be completed by divers with pens. Who's gonna do it? You? You, Lt. Weinburg?

I have a greater responsibility than you could possibly fathom. You weep for the RTSC, and you curse the agencies. You have that luxury. You have the luxury of not knowing what I know. That telling the truth, while tragic, probably saved lives. And the existence of the medical form, while grotesque and incomprehensible to you, saves lives.

You don't want the truth... because deep down in places you don't talk about at parties, you want your doctor to sign that form. You need your doctor to sign that form!

We use words like injury, and death, and liability. We use these words as the backbone of a life spent teaching scuba. You use them as a punchline.

I have neither the time nor the inclination to explain the need for telling the truth on the medical form to a man who ascends and descends under the very instruction that I provide, and then questions the manner in which I provide it.

I would rather you just said "no thank you" and went skiing instead. Otherwise I suggest you pick up a pen, and write "YES" on the form. Either way, I don't give a damn what you think you are entitled to.

:cool2:

So you do understand that the majority of divers fully understand how these medical release forms work. They understand that a wrong answer to any question, even if it has been established in coordination with a doctor that the condition has no effect on diving, must result in the denial of service. And you really think folks are going to answer YES to a sinus condition they had 20 years ago?

Maybe you should look for an opening as a ski instructor.

 

[panzerbjorne]

Let's be very, very clear here...

It is extremely easy to sue someone... potentially bankrupting them in the process.

The fact that the plaintiff may not actually prevail in court would be of limited solace.

RJP, can't you be sued as an instructor EVEN IF someone completely fills out their medical forms correctly and honestly just for being there and being responsible for the people you're instructing ANYWAY? Esp if you are CPR or Red Cross certified, you have an obligation to attempt to resuscitate or rescue someone in need. So isn't it true that if a perfectly fit person dies on a dive, you can still be sued for negligence or failure to rescue the person?

How does that change at all if someone lied on their medical form?

Let's say you're instructing me and on my second open water dive of the day during my training, we go down to 30 feet and after 15 minutes I have a pulmonary barotrauma and die. I lied on my medical form and said I don't have asthma, but it winds up that asthma may have been a contributing factor in my death. My medical records are consulted and it turns out that - yep - definitely has asthma, is even on medical for it. You think that for one iota of an instant that the plaintiff has ANY case against you for instructing me despite the fact that I chose to lie in order to convince you to instruct me? And that PADI won't step in to defend you, considering that they have the legal instruments at-hand to prove your lack of negligence?

How many dive instructors do you know who've been wrongfully sued like that and been bankrupted because someone lied on their medical forms? Because my research to date hasn't turned up any such incidents, which is funny because numerous reports from DAN and other third party sources (including many instructors) claim that as much as 50% of divers lie on the medical form. Interesting that's the case when you compare that with the statistics surrounding diver trauma - those reports show that incidents are typically due to diver error and divers diving beyond their training and capacity. Not due to lying on medical forms.

I'm not advocating lying on the medical form, which is funny considering so many people do advocate it here. But I don't see any rational link between falsifying the medical form and diver trauma based on the materials out there on the web right now. And I don't see how, as an instructor, you'd be any more at-fault for taking on a diver that has lied on their forms.

 

[RJP]

So you do understand that the majority of divers fully understand how these medical release forms work. They understand that a wrong answer to any question, even if it has been established in coordination with a doctor that the condition has no effect on diving, must result in the denial of service.

Wait, what?

I have trained a great many divers who had "YES" responses on their medical forms.

---------- Post added August 17th, 2015 at 04:25 PM ----------

How does that change at all if someone lied on their medical form?

Increased likelihood - however small - of a negative outcome caused by an underlying medical condition.

Early on in my dive pro career there was a local case where a diver died during a fairly benign training dive -- no one could figure out what happened. He was completely healthy... look at all the "NO's" written on his medical form. That is until the instructor and other divers on the trip went to get his personal effects from his hotel room to bring home to his [-]wife[/-] widow and three kids. Needless to say everyone was surprised to find his CPAP machine and all kinds of cardiac and pulmonary medications.

Also keep in mind what ELSE those forms might be used for. I've put divers in CG baskets and ambulances and you know what goes with them to the hospital? Their medical form. So now that diver (potentially unresponsive) is in a situation where the medical staff treating them has inaccurate medical information about the diver.

---------- Post added August 17th, 2015 at 04:27 PM ----------

And I don't see how, as an instructor, you'd be any more at-fault for taking on a diver that has lied on their forms.

Again, you're confusing being found "at fault in a law suit" with being at an increased risk of being sued.

 

[panzerbjorne]

Wait, what?

I have trained a great many divers who had "YES" responses on their medical forms.

Because they were lucky (or unlucky, depends on how you see it) enough to have stupid docs who were willing to make themselves liability targets.

Increased likelihood - however small - of a negative outcome caused by an underlying medical condition.

Also keep in mind what ELSE those forms might be used for. I've put divers in CG baskets and ambulances and you know what goes with them to the hospital? Their medical form. So now you're in a situation where the medical staff treating an injured diver (potentially unresponsive) has inaccurate medical information about the diver.

Interesting that this second part of your response above didn't appear until I hit Reply With Quote... But you mean to tell me that when you take folks out on training dives you take their forms with you? That's a more organized dive instructor than I've ever heard of, good on you!

As for me, whether I wind up telling the truth on my forms or not, I plan to verbally inform my dive instructors and buddy divers of my asthma and show them in my bag where my emergency inhaler is just in case they need to help me with it. Since I'm persistently medicated and haven't had an attack in years I doubt it will ever be an issue - but that doesn't stop me from making sure the right people know about it. I'd like a doc's sign-off, but the dark reality is that I may not be able to find a doc who is willing to get into the liability loop. As someone who used to be married to a doc, I can understand the desire to keep out of that - malpractice insurance was the biggest cost of doing business for my spouse at the time and the fewer legal cases you get involved with the lower your rates will be.

Everyone wants to cover their ass and tell you what you can't do in life. I can definitely relate to those in this thread who speak about society denying us personal accountability anymore.

---------- Post added August 17th, 2015 at 01:43 PM ----------

Wait a second, I also sleep on a CPAP machine, but the medical form doesn't ask anything even related to that. What does using a CPAP machine have to do with diving? The CPAP machine is for people with chronic sleep apnea or snoring - the medical questionnaire asks nothing about that. I have excess soft palette tissues and the only thing docs can do about that is to perform a palettectomy or put you on a CPAP machine - since a palettectomy is a very invasive surgery with a lot of potential complications that can lead to death (and the inability to do things like ever dive again in your life), they tend to opt for the CPAP machine as it completely alleviates the symptoms without invasive surgery or follow-up complications.

 

[RJP]

But you mean to tell me that when you take folks out on training dives you take their forms with you? That's a more organized dive instructor than I've ever heard of, good on you!

Absolutely. It would be asinine to NOT bring the student's folder with you. In fact, I believe it would be negligent. I don't know of a single instructor who does NOT bring the student's paperwork with them. (It might be a requirement... not sure.)

 

[uncfnp]

As someone potentially on the receiving end of the injured diver, I would prefer a form that gives medical info such as allergies and current medications and perhaps contact information. The form as it stands now, assuming a medical focus and not liability, is purely a screening tool that attempts to identify those at risk. Except for very isolated events, it is too broad to be of significant help except for the most extreme of cases and those individuals have likely either lied or been denied clearance.

I am not saying it could never be of help. Only that, to me, it seems very limited in that respect and a much better form could be designed if that was the intent.