Training agency throws Instructor under the bus while misleading the court

[Jim Lapenta]

So what do you do with this additional information? If a potential student has had a concussion in the past and they mark "yes" to that item do they have to get a medical clearance, or is it just so you know about it? Is there a time frame? What are the contraindications of diving after a concussion? If you say they can't dive until they get a clearance, does that open you up to litigation for excluding participation based on a disability that isn't an industry standard?

I'm not trying to be an ass, btw, just curious.

I run an AAUS scientific diving program, so all my divers have to get medical clearance prior to any in-water work. However, I don't want to even see their test results, I just want the piece of paper that the MD signed saying they are cleared for diving. I have no training or authority to interpret results anyway. I do look at and keep the self-evaluation form though.

-Chris

If they have had one then yes, I want a medical clearance. As an independent instructor I am free to choose who to teach. If they get the medical and the doc says it was long enough ago and they are fine to dive, OK. I'm cool with that. Based on all the stuff that is coming out now regarding head injuries and the delayed reactions I don't want to be underwater with someone who may have been compromised by one and unknown because they didn't lose consciousness. I want a doctor to say they are fit and fine to dive.

I don't have to teach anyone I don't want to train. I've turned down students because of their attitudes towards safety and told them so.

This is not an everyone can or should be able to do it activity. No matter what the agency says. In the water I am responsible for providing a safe experience for my students. I'll use any tools I have to in order to do that. Knowing about conditions that may not be disclosed on the RSTC form is one of those tools.

I have had students with diabetes, autism, down's syndrome, obesity, and some other things that I don't normally see at dive sites. Not all scuba. The autism and Down's were snorkeling. But I knew about them up front and was able to adjust to them. The diabetics had to jump through hoops but did get clearance from dive knowledgeable MD's. They had the clearance so I was ok with that.

Having a concussion without loss of consciousness does not necessarily disqualify a person. I just want an MD to say they are ok. Because I am not one as you said you are not. I want to know that if a person is acting a bit off that it's not because of an undisclosed medical condition. Maybe they are tired. I can tell them to rest. A little dehydrated? Here drink something. I don't know what to do if the stress of being under water and the effects of pressure might have on them if they have had a head injury I didn't know about.
"Hey you ok?"
"Feeling a bit off"
"get enough sleep?"
"Yeah"
"Drinking plenty of water?"
"Yep"
"Hmmm? Wonder what it could be?"
"Don't know? Think it could be that concussion I got last week playing rugby?"
"WTF?!"

Not a scenario I want to encounter.

 

[boulderjohn]

So I suffered a concussion in a high school football game in 1967--not quite 50 years ago. I have not had a concussion since, and I have had no complications that could be tied to that since then. You want me to get a Doctor's OK because of that?

Can you imagine how many much, much more important medical events than that are also omitted from the form? Are you going to include everything imaginable in your form?

 

[tursiops]

So I suffered a concussion in a high school football game in 1967--not quite 50 years ago. I have not had a concussion since, and I have had no complications that could be tied to that since then. You want me to get a Doctor's OK because of that?

Can you imagine how many much, much more important medical events than that are also omitted from the form? Are you going to include everything imaginable in your form?

What Jim ought to do is just demand a doctor's signature (like in Australia), and forget the form. The form's only value is to tell the instructor when to require a signature. If he is going to add on his own view of what constitutes the need for a signture, just get the signature and be done with it. Easier, cleaner, less invasive.

 

[Jim Lapenta]

No, just what I feel raises a flag for me. But if you had one six months ago you either provide a medical or find another instructor. I don't do this for a living. If my requirements turn someone off so be it. I don't need or want to put everyone in the water. My classes, my rules for admission. I took a call today from a woman who wants to give her husband lessons for Christmas. After speaking with her and finding out he has never tried it, rather than take her 400.00 I offered a scuba intro for 50 to make sure he likes it. If he does the intro cost comes off of the class price. This way if he is not sure or just decides it's not for him they are only out 50 bucks. I want to teach, I don't need to teach a lot of ow classes. I'd rather teach advanced, specialties, and non cert workshops.

---------- Post added November 22nd, 2014 at 06:54 PM ----------

And the intro will be done 1 to 1 in an indoor heated pool. He will do a swim test before I put him on scuba and fill out both mine and the agency med forms and the agency waiver.

 

[abnfrog]

bottom line guys 1/ you as the instructor can ask for ANY md sign off that you want to feel safe 2/ you don't have to do dsd in open water (i have chose not to do dsd in ow ) it is not always clear cut in court defending ones self it may come down to what an expert witness has to say "what a prudent instructor would do " ( i have testified in that way ) , as far as cesa is concerned i always have 2 certified assistants or i do them 1 at a time i dont leave students unattended on the bottom OR the surface


way to go jim thats the way i do it too my course my rules ..............

 

[boulderjohn]

There is a legal advantage to using a standard form and letting the doctor make the decision as required. That way if anything happens and there is an ensuing lawsuit, your judgment will not be an issue. If you start making your own rules and making your own decisions based on what you see, then your decision-making may be called into play. This will be especially problematic if you are making such decisions with no medical training. If you are comfortable doing that, go for it. I am not comfortable doing that, so I won't.

I have certifications from 5 agencies, and one of them has an unusual policy for these forms. In most medical forms your statement is on paper, and a doctor's signature is good for a year. With this agency, the form--extremely long and detailed--must be filled out anew and online for every class, and there is no place for a doctor's signoff. The agency decides on your fitness to dive based on what you put on the form. The last time I took class with them, it was a one-night academic session, a class for which other agencies do not even require a medical form. I had just gone through that same long and frankly invasive questionnaire a couple months before for a different class, and I was irritated. When it came to the section where I had to list my specific medications and their dosage levels, which was the same as the last time, I just skipped it. Well, on my next diving excursion, I was rooming with an instructor from that agency. It was not a class--we were just diving. As soon as he had a chance, he went into my toilet kit, took out my medications, and wrote down what he saw. He was quite open about it--he felt that was his right to do that. He had obviously been told that I had omitted that information when I had enrolled for that one night classroom session. I do not know what level of training either he or anyone else at the agency headquarters had to determine whether anything I was taking was a problem.

So, as I said, if you are comfortable in that role, go ahead. I'm not. If you want people to be as pissed off at you as I was for getting that far into their lives, go for it. I don't see that as my role myself.

 

[flots am]

There is a legal advantage to using a standard form and letting the doctor make the decision as required. That way if anything happens and there is an ensuing lawsuit, your judgment will not be an issue.

Does it work the other way too?

Is there any liability rejecting someone who has a signed medical form, but doesn't seem to match the checked boxes, for example, no CV/Pulmonay problems checked, but is out of breath walking from the parking lot to the pool?

flots.

 

[Omisson]

Does it work the other way too?

Is there any liability rejecting someone who has a signed medical form, but doesn't seem to match the checked boxes, for example, no CV/Pulmonay problems checked, but is out of breath walking from the parking lot to the pool?

flots.

Yes- your common sense observations must be used to confirm the information. If they clearly show a difference - you could still be on the hook.

 

[boulderjohn]

Does it work the other way too?

Is there any liability rejecting someone who has a signed medical form, but doesn't seem to match the checked boxes, for example, no CV/Pulmonay problems checked, but is out of breath walking from the parking lot to the pool?

flots.

Yes- your common sense observations must be used to confirm the information. If they clearly show a difference - you could still be on the hook.

Additionally, if you tell the diver that you will not let them in the water, there is not much of a possibility that you will be held liable for a scuba accident during instruction.

 

[abnfrog]

There is a legal advantage to using a standard form and letting the doctor make the decision as required. That way if anything happens and there is an ensuing lawsuit, your judgment will not be an issue. If you start making your own rules and making your own decisions based on what you see, then your decision-making may be called into play. This will be especially problematic if you are making such decisions with no medical training. If you are comfortable doing that, go for it. I am not comfortable doing that, so I won't.

I have certifications from 5 agencies, and one of them has an unusual policy for these forms. In most medical forms your statement is on paper, and a doctor's signature is good for a year. With this agency, the form--extremely long and detailed--must be filled out anew and online for every class, and there is no place for a doctor's signoff. The agency decides on your fitness to dive based on what you put on the form. The last time I took class with them, it was a one-night academic session, a class for which other agencies do not even require a medical form. I had just gone through that same long and frankly invasive questionnaire a couple months before for a different class, and I was irritated. When it came to the section where I had to list my specific medications and their dosage levels, which was the same as the last time, I just skipped it. Well, on my next diving excursion, I was rooming with an instructor from that agency. It was not a class--we were just diving. As soon as he had a chance, he went into my toilet kit, took out my medications, and wrote down what he saw. He was quite open about it--he felt that was his right to do that. He had obviously been told that I had omitted that information when I had enrolled for that one night classroom session. I do not know what level of training either he or anyone else at the agency headquarters had to determine whether anything I was taking was a problem.

So, as I said, if you are comfortable in that role, go ahead. I'm not. If you want people to be as pissed off at you as I was for getting that far into their lives, go for it. I don't see that as my role myself.

like usual you missed the point again ... im not making medical decisions i let the md do that ...but if i don't like what i see i don't teach them ...(im sure that's what jim meant too) ..i too dont care if i piss off some student if i dont feel comfortable ....(im not losing everything from diving ive got in the 34 years of actively teaching ).and of COURSE i use the agencies form john , other wise i would be breaking standards ....as far as your 5 whole agencies experience (i do too ) is concerned that doesn't make you a CERTIFIED expert witness up here in Canadian court ..as there are some regional differences ..(i have instructors up here who will not teach Americans (as they can sue in an american court ) because of the differences in judgments ...i also dont like that aspect sooooo i only take on certain divers from the states ......those be my rules