Friday March 12, 2004

To the Diving Community:

We are writing to update you on two key decisions taken by University Health Network (UHN) Senior Management team this afternoon. Both decisions were made in response to today's conclusions of a safety assessment of the UHN Hyperbaric interim chamber by the UHN Occupational Health and Safety Department. A full report will follow today's conclusions. The assessment indicates that there are safety concerns for our staff only; the concerns do not have a direct affect on our patients, but our staff do need to be in the chamber with our patients.

Key UHN decisions:

1.) As of Thursday March 11, we have stopped treating Hyperbaric patients who need to be placed on a stretcher in our interim chamber. This involves about 4 - 6 patients a year. From this date, all patients who need to be on a stretcher and who also need Hyperbaric treatment will be triaged by CritiCall, which has been notified of this change. This could mean that the patient on a stretcher may need to be transported to another Hyperbaric facility in Hamilton, Ottawa or Buffalo. The Ministry of Labour has been notified in accordance with UHN policy and Dr. DeMajo is communicating with these Hyperbaric facilities to let them know of these changes. Any further developments and changes will be communicated to you as soon as we are aware of them;

2.) UHN Senior Management agreed today to purchase a new Hyperbaric chamber to replace the current interim chamber. The purchase order for this chamber is expected to be generated quickly.

The UHN Occupational Health and Safety assessment concluded that the risk to staff is due to their inability to move within the interim chamber when there is a patient on a stretcher. Since staff must remain in cramped positions for long periods of time (from 2 - 6 hours), there is a risk of back injury along with the potential for deep vein thrombosis and decompression illness. As a result of this conclusion, UHN Senior Management acted swiftly, since we are committed and obligated to ensure that our staff deliver care in a safe environment.

In the last several months, our staff have treated a small number of patients on stretchers in our interim multiplace chamber. It became apparent with each subsequent treatment that the amount of space available in the chamber for both patients on stretchers and the staff treating them was not adequate. As a result, UHN initiated an assessment through the UHN Occupational Health and Safety Department. As already noted, the key conclusion of that assessment was communicated to Senior Management on Thursday.

Please let us assure you that UHN remains committed to Emergency Hyperbaric Medicine, and that we will communicate with you proactively to ensure that you are aware of any new developments and of our ongoing plans. We would like to thank you for your continued support as we develop our plans to ensure that our new Hyperbaric chamber meets the optimal needs of our patients and staff.

We are willing to answer any questions you may have about this, and we encourage you to call us directly with any of your concerns.

Best regards,

University Health Network (Toronto General, Toronto Western and Princess Margaret Hospitals)

Dr. Wilf DeMajo Janet Newton Alex Radkewycz

Acting Hyperbaric Med Director Allied Health Manager TGH Public Affairs

Locating: 416 - 340 - 3155 416 - 340 - 4800, ext. 6318 416 - 340 -

3895

Day Pager: 416 - 980 - 0752