Widow sues medical doctor and training company

[Ayisha]

As a new student, Burns would have no way of knowing that his medical conditions were not compatible with diving.

Even though the victim himself had medical training? Surely he would have a more informed opinion of the interactions of his various conditions and medications than many others?

 

[drrich2]

Even people who have intensely studied a subject (e.g.: Anatomy, Physiology, general Pathology) in the past may have substantial deterioration of knowledge base over an extended time in subject matter they rarely use or think about. There is some retention of 'generalist' knowledge, but how much is hard to call. How much do most Dentists know about asthma? Only the Dentists know... That said, medical questionnaires can cue divers to potential problematic conditions, and the Internet is a readily available access tool for a treasure trove of info.

In the matter of the documentation provided to healthcare professionals who 'sign off' on prospective scuba student/diver clearances, and recognizing that many of these people have busy office practices, know little of diving, documentation is often extensive & impractical to sit down & read every last word of...I wonder how many Physicians carefully read those things?

If that sounds odd, be aware Physicians are often asked to 'clear' patients to return to work (in environments and with duties the Physician has little knowledge of), to drive (yet I've never met a Physician who claimed to be a trained driving instructor or got in a car with a patient to assess ability), etc... If a healthy looking patient shows up reporting he feels fine and confidently endorses readiness to participate in the activity, a caregiver might be tempted to sign off on it.

I'm not arguing it's right, and BoulderJohn posted this earlier:

"The doctor did not have to be an expert on diving. The article said that the doctor failed to read the PADI (RSTC) statement on asthma. Here is what it says on page 4 of the medical form the doctor signed:
The 1996 Undersea and Hyperbaric Medical Society (UHMS) consensus on diving and asthma indicates that for the risk of pulmonary barotrauma and decompression illness to be acceptably low, the asthmatic diver should be asymptomatic and have normal spirometry before and after an exercise test. Inhalation challenge tests (e.g.: using histamine, hypertonic saline or methacholine) are not sufficiently standardized to be interpreted in the context of scuba diving.
Did the doctor see page 4, or did the diver give him only pages 1 and 2? Is it possible the dive shop only gave out pages 1-2?"

I just wonder what % of those medical releases presented to health care providers are done 'right?' Again, no way to know...

Richard.

P.S.: Busy day at the office, waiting rooms are packed, healthy-looking patient wants a clearance for a hobby that sounds like swimming around, the pertinent information was on page 4...

 

[gcarter]

Geez, I can't agree with you John, although I completely agree with your sentiment.

As a new student, Burns would have no way of knowing that his medical conditions were not compatible with diving. The Instructor and the shop followed the correct protocol and required that he have a Physician complete a medical assessment prior to Burns entering the course. The problem is, IMHO, that the Doctor apparently knew little or nothing about diving. He signed off on Burns, so Burns would have believed he was medically fit to dive.

Burns was failed again when he returned to the shop and they accepted him into the class. Any OW cerified diver knows that asthma and diving don't go together. The shop should have sat Burns down and explained to him that should be suffer an asthma attack at depth, he would likely embolize and die on assent. Presumably, he would have decided to take up golf at that point.

So the Doctor failed Burns because he signed off on his patients suitability for diving, something he knew nothing about. He should have referred his patient to a Physician who knew diving, or simply said, "I can't help you."

As well, the shop, and the Instructor failed him because they should have explained to Burns that he could easily perish in pursuit of a frivolous pastime.

I think Burns did everything that an "uninformed consumer" could do, and these other parties failed him.

If I was on the jury, I would certainly find the suit has merit and award his family a good chunk of cash.

Dentists receive fairly extensive medical training as well- including anesthesia, respiratory, etc.. Did he review the guidelines himself and choose to ignore them? Did he initiate a guideline based discussion with his physician? Or did he just not bother to read them and instead ask his physician for a favor and just get the sign off?

The standard on the student should be higher in this case, because he was NOT just another uneducated consumer relying on the expert advice of others.

 

[Bert van den Berg]

I'm not a doctor or a lawyer but in my opinion if you pay anyone to do a job, they should do it. Irregardless of how many people are waiting in the waiting room, the doctor has a responsibility to his patient to do the work in a competent manner. The patient's desire for a certain result should not sway a professional's judgement. After all, we're talking of lives here, not some trivial matter. Time will tell if the jury agrees.

 

[KeithG]

so now i am curious: how much "medical training" do dive instructors receive?

A) Does dive instructor training include anything related to identifying medical conditions that would preclude diving?

OR

B) Are they simply taught that their responsibility ends with making sure the student replies NO to all questions on the standard form?

 

[Shotmaster]

so now i am curious: how much "medical training" do dive instructors receive?

A) Does dive instructor training include anything related to identifying medical conditions that would preclude diving?

OR

B) Are they simply taught that their responsibility ends with making sure the student replies NO to all questions on the standard form?

This was partly my point as well, the Dentist (Dr.) certainly had more medical knowledge than the LDS/instructors and was intimate with his own health status. The LDS/instructors are in no position to make that evaluation and who defer medical status to the student's own doctor. The doctor is to determine if the student is allowed to receive training based on his/her medical profile.

 

[Serge Tao]

so now i am curious: how much "medical training" do dive instructors receive?

A) Does dive instructor training include anything related to identifying medical conditions that would preclude diving?

OR

B) Are they simply taught that their responsibility ends with making sure the student replies NO to all questions on the standard form?

B

At least, that's unfortunately the reality. I have seen numerous instructors say "fill out no on the line before each question". My instruction has always been: read the question, understand the question and then answer it. If you don't understand the question, ask me. Once I criticized another instructor for her instructions to simply fill out no everywhere. Her comment: I have been teaching for 17 years. And since she was the girlfriend of the baseleader......

The opposite is possible as well: in one place the doctor would call the divecenter after we sent off a diver with a yes on the form. In case he cleared the diver, he'd always tell us what the risks were and what to watch while under water.

Deciding about a medical condition is beyond the instructor's expertise. Understanding each medical condition and evaluating the consequences for diving.....debatable but to my opinion it should be.

 

[kelemvor]

I made my comment because if his wife was truly concerned for his well being, is counter-intuitive to encouraging him to undertake a risky, physically demanding underwater sport by purchasing him diving lessons for an asthmatic with an enlarged heart and who knows what other medical conditions.

I've seen many dive shops/instructors advertising how extremely safe and easy diving is. Some shops even teach kids as young as 10. There's no reason to believe that either he or his wife thought it was risky or demanding.

 

[Cali_diver]

This is a tough one and without all the facts it is really hard to pass any kind of judgement here. I can say this... I have been an athletic coach and/or sports photographer for over 2 decades and have been around many adult and kids who use inhalers for asthma. Everyone of them, from the 10 year olds to the College students, knew when they should get off the field or not play a game. They didn't leave it up to the coaches or the parents to make those decisions for them. It seems like if a 10 year old can figure out that they need to sit out of a game, then a 40 something dentist should be able to do so as well. So there has to be more to this than just asthma....

 

[Mark Guccione]

The effect of scuba diving on airflow obstruction in divers with asthma. - PubMed - NCBI

Here is one study on asthma.