6 months ago

AD 2016 Q2

As we pointed out in the spring 2013 edition of the Alert Diver, even being a dive buddy has potential legal implications. So, to bump this up a notch, what about the diver training organisations themselves? Where do they stand? How do they relate to South African law? Are they all considered the same under our legal system in spite of the differences in organisational structures and training programmes? How does this affect their respective instructors and trainee divers from a legal perspective? These are not exactly simple questions. It is certainly true that the respective training organisations differ in a number of ways. However, this does not imply that there are necessarily differential legal implications for each of them. In fact, under South African law, the legal principles are common in all matters. Therefore, if you suffer a loss and you (or your estate in the case of a fatality) wish to recover damages, the legal principles would be applied commonly; whether you are driving or diving. Although not a frequent occurrence, there have been quite a number of law suits associated with diving injuries and damages in South Africa. This is not surprising, as the occurrence of law suits is really a function of “numbers”. As training increases, so do the chances of injuries and, with it, the chances of legal recourse. So, it remains wise to insure yourself, your equipment or your business in a proper and effective way. But before getting back to the potential differences amongst the training agencies, let’s first explore the foundational legal principles on which any civil claim would be adjudicated: inherent risk, negligence and duty to take care.


DIVE SLATE DAN OUTREACH in good operational condition. Because of Saba’s small population, however, the island has only two practicing doctors and not much collective clinical experience treating divers. The Fort Bay chamber and its staff required training and support. To provide this support, DAN sent Matías Nochetto, M.D., Marty McCafferty, EMT-P, DMT, and Eric Schinazi, CHT, to Saba for a weeklong site visit. Nochetto, DAN’s director of medical programs, runs DAN America’s regional RCAP program out of DAN headquarters in Durham, N.C. As a DAN medic for the past 13 years, McCafferty is frequently a main point of contact in dive medical emergencies. Schinazi, a certified hyperbaric technician (CHT) at Duke University Medical Center, often works with DAN because of his vast expertise with hyperbaric chamber operations. The RCAP outreach project in Saba had three primary goals: Perform a risk assessment, conduct training for chamber operators and attendants, and establish relationships with the local physicians and chamber staff. Risk assessments are tailored to each facility and allow DAN to make safety recommendations and create a customized plan to help each chamber conduct its own future inspections and basic maintenance. During the Fort Bay inspection, for example, Schinazi discovered that the chamber’s fire extinguisher was out of service — a level-one risk that would prohibit the chamber from reopening. The team was able to service it and leave it in operational condition with instructions for preventative maintenance. 24 | SPRING 2016

MATÍAS NOCHETTO Saba Health Care Foundation’s A.M. Edwards Medical Center Right: The Saba Conservation Foundation’s hyperbaric chamber at Fort Bay MATÍAS NOCHETTO silver The team conducted training modules, introducing, reviewing and practicing essential skills with the chamber operators and attendants. Nochetto also conducted a threehour session for three local doctors and 12 nurses that included lectures about recompression therapy, oxygen first aid for scuba diving injuries and a series of case reviews. According to Dr. Gijs Koot, one of Saba’s two practicing physicians, “I learned more in those three hours than I learned in a week the last time I underwent training.” Establishing relationships with remote chambers is one of the most mutually rewarding elements of the site visit, as it makes future emergency calls run more smoothly. “When you spend a few days with these people, share meals with them and get to know them, you bond with them,” Nochetto explained. “Then when they have a case it is easy for them to pick up the phone and call. That’s great for us because we won’t make blind referrals; it’s great for them because they know we won’t send them a patient they’re not equipped to handle; and last but not least, it’s great for divers because we will only send them where they can be treated effectively.” Koot reiterated Nochetto’s sentiment, saying that the visit “makes future calls for advice much smoother now that we know each other.” When the Fort Bay chamber received its new patient, the RCAP visit was nearing its end. Within 15 minutes of being notified that the diver was demonstrating symptoms, Nochetto was at the pier with the attending physician, Gina Boorsma, M.D., and the EMS crew, McCafferty was in scrubs and ready to join the patient and other attendant in the chamber for the duration of treatment, and Schinazi was helping staff prepare the chamber. It was the first treatment conducted in that chamber in years, and for most of the staff it was their first time treating a patient. “Nobody likes to hear about a diver developing DCS,” Nochetto said, “but this ended up being an extraordinary opportunity. Not only did the staff have the opportunity to put their skills to use immediately after training, but they also demonstrated their commitment to providing exceptional treatment and did a wonderful job.” After a U.S. Navy Treatment Table 6 recompression treatment with two extensions, the patient emerged almost completely free of symptoms. With its chamber now up and running and chamber staff properly trained, Saba can add recompression therapy to its repertoire of medical capabilities. By raising the level of its operation, the clinic serves not only the dive community, but also any members of the Saba community who may require hyperbaric treatment for other medical conditions. Overall, the visit was constructive for the Saba chamber team and the DAN team alike. “It was quite an experience,” McCafferty recounted. “Everything I saw showed me they really wanted to know how to take care of people when necessary. I would feel very confident if one of our members needed treatment in Saba.” Then he added, “And I can’t even remember the last time I ate fish that fresh.” AD cinema of dreams New housings out now! SEACAM silver NIKON D810 SEACAM silver CANON EOS5DS SEACAM prelude CANON EOS7DMKII SEACAM prelude NIKON D750 SEACAM compact SONY A7II 800-451-3737 SEA_016_01 IN USA 2.125x9.125+NewHousings.indd 11.01.161 09:23 ALERTDIVER.COM | 25

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