DAN’s response to failures

Last Updated on July 3, 2024 by Steve Weinman

If you've been scuba diving for any length of time, chances are that you have probably heard of DAN, or the Divers Alert Network. If a diver posts a question about medical safety, the responses normally start with: “You should probably call DAN first.”

I have used DAN for years, and even though it has successfully assisted divers to attain the most appropriate medical treatment for a good 40-something years, on this occasion it seems that things could have been done much better. 

There are a few things that really tied up getting the diver concerned the treatment required after the event. DAN has looked over everything that has happened and released this initial response on what could have been done better and how it is going to change going forward.

I’m going to break down and explain each part. So far, DAN has identified two main areas of improvement and several changes needed to get there. 

WATCH THE VIDEO

YouTube video

Let’s go over DAN’s response and see how it plans to improve itself and what you can do to help prevent what happened to this diver from happening to you.

Just before last Christmas (2023), a DAN member diving in Abaco, Bahamas, experienced an incident that resulted in decompression illness (DCI). When he contacted DAN and tried to access the benefits of his DAN membership and insurance, he did not receive the correct medical care as quickly or as easily as he or DAN would have liked.

DCI diagnosis

The DCI diagnosis is the first improvement point that DAN has highlighted. During the initial call, the member’s dive-buddy reported a provocative exposure and that the member was showing signs and feeling symptoms of DCI. 

DAN’s response to failures

As experienced divers, both recognised these signs and symptoms, so contacted DAN to get them to medical treatment. At the time, the member was under the care of a doctor who was completing his initial examination but had yet to render a diagnosis.

After the call, the DAN medic discussed the case with a supervisor, who decided that there was a high chance of DCI. Seven minutes later, the medic called the member back to let the divers know this, which is standard operating procedure. 

This was not a medical diagnosis by DAN. The responsibility to diagnose rests with the evaluating doctor or other on-site medical staff. DAN is there to support, not replace, the doctor, who makes all medical decisions based on examination of the patient, which DAN cannot do remotely. 

DAN’s response to failures

As skilled and experienced as the DAN team are, they are still only talking over the phone as advisors at this point and can only help doctors out with their specific expertise, not take over.

In this instance the doctor, who lacked diving medicine training, was offered peer-to-peer consultation with DAN’s medical director but, for whatever reason, that offer was declined. 

DAN has reinforced to all its medics that the medical director is available for consultation with the treating doctor if that person lacks the skills or education needed to diagnose a diving injury.

DAN’s response to failures

Recognising DCI is still quite an obscure skill for most doctors who have not come across it before. The DAN medic should strongly recommend an immediate consultation with the medical director to determine what’s best for the injured diver.

Medical evacuation

The second area of concern for DAN in this case was the medical evacuation and payment of costs. Once it became apparent that evacuation to a higher level of care was required, the effort began to complete a medical evacuation from Abaco to Nassau, the location of the hyperbaric chamber. 

To co-ordinate such medical transfers, DAN says it has a contract with the world’s top-rated travel assistance company. In apparent accordance with existing DAN standard operating procedures (SOPs), this case was transferred by the DAN medic to this travel assistance provider to arrange the evacuation. 

DAN’s response to failures

The information we have collected reveals several possible departures from DAN’s SOPs. It seems that, among other things, DAN’s travel assistance provider failed to provide the benefits and services owed to the member under his DAN membership and insurance.

Despite being told that the situation required an immediate medivac, the company failed to find an approved carrier that could conduct a night-time evacuation quickly enough. 

DAN’s response to failures

Luckily, others involved in the incident on site helped the member arrange his own evacuation through a local air ambulance company. So, while DAN is supposed to be able to organise transport at that time of night, in this case it couldn’t. 

It’s not great, but it’s difficult for an organisation to have constant contact with every possible transport provider in all corners of the world. 

Paperwork

The member had been required to complete a DAN claim form before getting his needed assistance. This is a requirement imposed by the insurance carrier, but one which DAN will now no longer enforce while an emergency exists. 

Once the emergency passes there will be plenty of time to complete any necessary paperwork. Even DAN admits that it was a bit absurd, forcing the diver to fill out forms before treatment in an emergency, during which time everything stops.

DAN’s response to failures

This practice might help to reduce wrong information and treatment but, in an emergency, time is of the essence.

The member was required to complete a fitness-to-fly form. This is not a DAN requirement but is needed by most air-ambulance companies before they can initiate a medical transfer. This one-page form must be completed by the treating doctor and is standard operating procedure for medical evacuations. 

DAN’s response to failures

It’s more paperwork, but nothing that DAN can prevent or postpone – an air ambulance won’t leave the ground until it’s completed. 

Payment

The member was required to pay for both the medivac and the hospital visit, despite DAN having SOPs in place to make these payments when requested. The transcripts will show who advised the member that DAN would not pay, but the fact is that DAN was not able to facilitate these payments. 

This was a deviation from DAN’s standard operating procedures because it is there to pay for the member. Although the member had to self-pay in this situation, he was fully reimbursed by DAN less than a week later. 

So the diver had to pay for both his hospital treatment and the flight to the hyperbaric chamber. His costs were reimbursed by DAN, but DAN should have paid them all upfront. In this case something in the chain of events and the chain of communication broke down, which could have resulted in other costs or complications.

DAN’s response to failures

DAN’s revised SOPs

Because of all this, DAN has changed its standard operating procedures in several ways. It will remain the primary point of contact for case management.

The DAN medic assigned to the case will participate in all calls between DAN’s travel assistance provider and the member to reinforce the urgency of taking action and to make sure the member gets all the benefits and services that come with DAN membership and insurance.

In emergency situations where a medivac delay might affect the medical outcome, the search for available air ambulance providers is being expanded to include local resources not previously known to DAN or the assistance services team. 

DAN medics have been advised to always ask if anyone involved in the incident knows of local medivac options. These will then be considered if medivac is necessary. 

In emergency situations, the requirement that a DAN claim form be completed will be deferred until the emergency passes.

DAN’s response to failures

Where payment is required before or at the time of service, the DAN medic will engage other DAN staff as needed to approve charges, issue guarantees of payments and effect payments by credit card and/or wire transfer, so that no member ever has to make direct out-of-pocket payments.

Further actions

DAN has already implemented these changes, but also plans to implement the following, which will take a little more time. This involves an updates to its systems and databases to allow collection of information on key airports and local air-transport provider options, as well as detailed emergency action plans for key dive-destinations.

DAN will also expand its in-house member assistance services group to replace its travel assistance provider. This change had already been approved but roll-out is being accelerated to allow DAN to assume responsibility for all member-assistance services at the earliest possible date.

The bottom line is that the diver got the treatment he needed but there were several hindrances which, if he hadn’t had the divers around him or the money in his bank account might have caused further delays.

DAN’s response to failures

DAN is focusing on getting better and the important thing is that it hasn’t tried to sweep this under the rug or pass the blame onto anyone else. Before assessing all the call-logs and what did or didn't happen it has already implemented immediate changes and written out several ways to improve in the future.

What all this means for you as as a diver is to first of all invest in some kind of diving insurance if you don't already have it. It can get really expensive but you do want proper experts organising the best care for you wherever you're diving.

Consider your own emergency action plan, including times of day for diving when you’re somewhere remote. We would avoid diving at certain times in certain places, knowing that by the time a casualty is out of the water and has been taken to the airport it could be closed.

Hope for the best but plan for the worst is always a good motto!

Also on Divernet: SUSPECTED DCI? HERE’S HOW TO CONDUCT NEURO CHECKS, DIVERS URGED TO BACK REPRIEVE FOR OBAN CHAMBER, DIVERS TOO READY TO DISMISS DCI SYMPTOMS, DELVING DEEPER INTO DEEP STOPS

@stanleysadventres
#AskMark What are some things you wish you wish you found out before you started diving?

#scuba #scubadiving #scubadiver
LINKS

Become a fan: https://www.scubadivermag.com/join
Gear Purchases: https://www.scubadivermag.com/affiliate/dive-gear 
-----------------------------------------------------------------------------------
OUR WEBSITES

Website: https://www.scubadivermag.com ➡️ Scuba Diving, Underwater Photography, Hints & Advice, Scuba Gear Reviews
Website: https://www.divernet.com ➡️ Scuba News, Underwater Photography, Hints & Advice, Travel Reports
Website: https://www.godivingshow.com ➡️ The Only Dive Show in the United Kingdom
Website: https://www.rorkmedia.com ➡️ For advertising within our brands
-----------------------------------------------------------------------------------
FOLLOW US ON SOCIAL MEDIA

FACEBOOK: https://www.facebook.com/scubadivermag
TWITTER: https://twitter.com/scubadivermag
INSTAGRAM: https://www.instagram.com/scubadivermagazine

We partner with https://www.scuba.com and https://www.mikesdivestore.com for all your gear essentials. Consider using the affiliate link above to support the channel.

The information in this video is not intended nor implied to be a substitute for professional SCUBA Training. All content, including text, graphics, images, and information, contained in this video is for general information purposes only and does not replace training from a qualified Dive Instructor.

@stanleysadventres
#AskMark What are some things you wish you wish you found out before you started diving?

#scuba #scubadiving #scubadiver
LINKS

Become a fan: https://www.scubadivermag.com/join
Gear Purchases: https://www.scubadivermag.com/affiliate/dive-gear
-----------------------------------------------------------------------------------
OUR WEBSITES

Website: https://www.scubadivermag.com ➡️ Scuba Diving, Underwater Photography, Hints & Advice, Scuba Gear Reviews
Website: https://www.divernet.com ➡️ Scuba News, Underwater Photography, Hints & Advice, Travel Reports
Website: https://www.godivingshow.com ➡️ The Only Dive Show in the United Kingdom
Website: https://www.rorkmedia.com ➡️ For advertising within our brands
-----------------------------------------------------------------------------------
FOLLOW US ON SOCIAL MEDIA

FACEBOOK: https://www.facebook.com/scubadivermag
TWITTER: https://twitter.com/scubadivermag
INSTAGRAM: https://www.instagram.com/scubadivermagazine

We partner with https://www.scuba.com and https://www.mikesdivestore.com for all your gear essentials. Consider using the affiliate link above to support the channel.

The information in this video is not intended nor implied to be a substitute for professional SCUBA Training. All content, including text, graphics, images, and information, contained in this video is for general information purposes only and does not replace training from a qualified Dive Instructor.

YouTube Video UEw2X2VCMS1KYWdWbXFQSGV1YW84WVRHb2pFNkl3WlRSZS41MkJFMDEwMDIxMkRDREQ3

What Do You Wish You Knew Now When You Started Diving? #askmark

@jaketarren
#askmark, Heyo! Longtime listener, first time caller, etc. Went with a BP/W for my first set and I'm having a really hard time keeping the power inflator on my shoulder; the corrugated hose keeps flipping off my shoulder and getting twisted up or just ending up behind the backplate and dangling down the back of the wing. Is there something I can add to my harness to keep it in place? I don't want to tie it to the D ring since I wouldn't be able to lift it to deflate. I'm using the cheap DGX Gears wing for reference. Thanks!

#scuba #scubadiving #scubadiver
LINKS

Become a fan: https://www.scubadivermag.com/join
Gear Purchases: https://www.scubadivermag.com/affiliate/dive-gear 
-----------------------------------------------------------------------------------
OUR WEBSITES

Website: https://www.scubadivermag.com ➡️ Scuba Diving, Underwater Photography, Hints & Advice, Scuba Gear Reviews
Website: https://www.divernet.com ➡️ Scuba News, Underwater Photography, Hints & Advice, Travel Reports
Website: https://www.godivingshow.com ➡️ The Only Dive Show in the United Kingdom
Website: https://www.rorkmedia.com ➡️ For advertising within our brands
-----------------------------------------------------------------------------------
FOLLOW US ON SOCIAL MEDIA

FACEBOOK: https://www.facebook.com/scubadivermag
TWITTER: https://twitter.com/scubadivermag
INSTAGRAM: https://www.instagram.com/scubadivermagazine

We partner with https://www.scuba.com and https://www.mikesdivestore.com for all your gear essentials. Consider using the affiliate link above to support the channel.

The information in this video is not intended nor implied to be a substitute for professional SCUBA Training. All content, including text, graphics, images, and information, contained in this video is for general information purposes only and does not replace training from a qualified Dive Instructor.

@jaketarren
#askmark, Heyo! Longtime listener, first time caller, etc. Went with a BP/W for my first set and I'm having a really hard time keeping the power inflator on my shoulder; the corrugated hose keeps flipping off my shoulder and getting twisted up or just ending up behind the backplate and dangling down the back of the wing. Is there something I can add to my harness to keep it in place? I don't want to tie it to the D ring since I wouldn't be able to lift it to deflate. I'm using the cheap DGX Gears wing for reference. Thanks!

#scuba #scubadiving #scubadiver
LINKS

Become a fan: https://www.scubadivermag.com/join
Gear Purchases: https://www.scubadivermag.com/affiliate/dive-gear
-----------------------------------------------------------------------------------
OUR WEBSITES

Website: https://www.scubadivermag.com ➡️ Scuba Diving, Underwater Photography, Hints & Advice, Scuba Gear Reviews
Website: https://www.divernet.com ➡️ Scuba News, Underwater Photography, Hints & Advice, Travel Reports
Website: https://www.godivingshow.com ➡️ The Only Dive Show in the United Kingdom
Website: https://www.rorkmedia.com ➡️ For advertising within our brands
-----------------------------------------------------------------------------------
FOLLOW US ON SOCIAL MEDIA

FACEBOOK: https://www.facebook.com/scubadivermag
TWITTER: https://twitter.com/scubadivermag
INSTAGRAM: https://www.instagram.com/scubadivermagazine

We partner with https://www.scuba.com and https://www.mikesdivestore.com for all your gear essentials. Consider using the affiliate link above to support the channel.

The information in this video is not intended nor implied to be a substitute for professional SCUBA Training. All content, including text, graphics, images, and information, contained in this video is for general information purposes only and does not replace training from a qualified Dive Instructor.

YouTube Video UEw2X2VCMS1KYWdWbXFQSGV1YW84WVRHb2pFNkl3WlRSZS4xODVDRjcwQzY3NkIxNjYz

How Do You Keep Your Corrugated BCD Hose in Place? #askmark

#scuba #scubadiving #scubadiver
LINKS
Ear Treatments at Scuba.com:
https://imp.i302817.net/Mm9qL3

Become a fan: https://www.scubadivermag.com/join
Gear Purchases: https://www.scubadivermag.com/affiliate/dive-gear 
-----------------------------------------------------------------------------------
OUR WEBSITES

Website: https://www.scubadivermag.com ➡️ Scuba Diving, Underwater Photography, Hints & Advice, Scuba Gear Reviews
Website: https://www.divernet.com ➡️ Scuba News, Underwater Photography, Hints & Advice, Travel Reports
Website: https://www.godivingshow.com ➡️ The Only Dive Show in the United Kingdom
Website: https://www.rorkmedia.com ➡️ For advertising within our brands
-----------------------------------------------------------------------------------
FOLLOW US ON SOCIAL MEDIA

FACEBOOK: https://www.facebook.com/scubadivermag
TWITTER: https://twitter.com/scubadivermag
INSTAGRAM: https://www.instagram.com/scubadivermagazine

We partner with https://www.scuba.com and https://www.mikesdivestore.com for all your gear essentials. Consider using the affiliate link above to support the channel.

The information in this video is not intended nor implied to be a substitute for professional SCUBA Training. All content, including text, graphics, images, and information, contained in this video is for general information purposes only and does not replace training from a qualified Dive Instructor.
00:00 Introduction
01:17 Ears
05:13 Scuba.com
06:05 Hydrate
08:12 Clean

#scuba #scubadiving #scubadiver
LINKS
Ear Treatments at Scuba.com:
https://imp.i302817.net/Mm9qL3

Become a fan: https://www.scubadivermag.com/join
Gear Purchases: https://www.scubadivermag.com/affiliate/dive-gear
-----------------------------------------------------------------------------------
OUR WEBSITES

Website: https://www.scubadivermag.com ➡️ Scuba Diving, Underwater Photography, Hints & Advice, Scuba Gear Reviews
Website: https://www.divernet.com ➡️ Scuba News, Underwater Photography, Hints & Advice, Travel Reports
Website: https://www.godivingshow.com ➡️ The Only Dive Show in the United Kingdom
Website: https://www.rorkmedia.com ➡️ For advertising within our brands
-----------------------------------------------------------------------------------
FOLLOW US ON SOCIAL MEDIA

FACEBOOK: https://www.facebook.com/scubadivermag
TWITTER: https://twitter.com/scubadivermag
INSTAGRAM: https://www.instagram.com/scubadivermagazine

We partner with https://www.scuba.com and https://www.mikesdivestore.com for all your gear essentials. Consider using the affiliate link above to support the channel.

The information in this video is not intended nor implied to be a substitute for professional SCUBA Training. All content, including text, graphics, images, and information, contained in this video is for general information purposes only and does not replace training from a qualified Dive Instructor.
00:00 Introduction
01:17 Ears
05:13 Scuba.com
06:05 Hydrate
08:12 Clean

YouTube Video UEw2X2VCMS1KYWdWbXFQSGV1YW84WVRHb2pFNkl3WlRSZS42QTlDMjkyRjNGMEYwQzcz

Post Dive Body Care #scuba #howto

LET’S KEEP IN TOUCH!

Get a weekly roundup of all Divernet news and articles Scuba Mask
We don’t spam! Read our privacy policy for more info.


Subscribe
Notify of
guest

1 Comment
Most Voted
Newest Oldest
Inline Feedbacks
View all comments
Ken Blakely
Ken Blakely
13 days ago

“The bottom line is that the diver got the treatment he needed but there were several hindrances which, if he hadn’t had the divers around him or the money in his bank account might have caused further delays.”

In this case, “hindrances” should be “incompetent behavior by DAN”, and “further delays” should be “permanent injury or death”.

It’s very nice that DAN seems to have learned from this experience and is improving. I’ve had my own experience with incompetent support from DAN, so it remains to be seen how effective DAN’s effort at improvement will be.

Recent Comments
Recent News

Connect With Us

1
0
Would love your thoughts, please comment.x
()
x