Dead on arrival

For other uses, see Dead on arrival (disambiguation).

Dead on arrival or D.O.A. (also dead in the field) is a term used to indicate that a patient was found to be already clinically dead upon the arrival of professional medical assistance, often in the form of first responders such as emergency medical technicians, paramedics, or police. In some jurisdictions, first responders must consult verbally with a physician before officially pronouncing a patient deceased, but once cardiopulmonary resuscitation is initiated, it must be continued until a physician can pronounce the patient dead.

D.O.A. is also frequently used as slang to indicate a new item that was received broken, or that an idea or concept is a nonstarter.

Medical D.O.A.

When presented with a pulseless patient, medical professionals are required to perform CPR unless specific conditions are met which allow them to pronounce the patient as deceased. For example, in most places, these are examples of such criteria:

• Injuries not compatible with life. These include but are not necessarily limited to decapitation or other catastrophic brain trauma, incineration, severed body, and injuries that do not permit effective administration of C.P.R. If a patient is presenting with any of these conditions, it should be intuitively obvious that the patient is non-viable.
• Rigor mortis, indicating that the patient has been dead for at least a few hours. Rigor mortis can sometimes be difficult to determine, so it is often used reported along with other determining factors.
• Obvious decomposition.
• Lividity, indicating that the body has been pulseless and in the same position long enough for blood to sink and collect within the body, creating purplish discolorations at the lowest points of the body (with respect to gravity).
• Stillbirth. If it can be determined without a doubt that an infant died prior to birth, as indicated by skin blisters, an unusually soft head, and an extremely offensive odor, resuscitation should not be attempted. If there is even the slightest hope that the infant is viable, CPR should be initiated; some jurisdictions maintain that life-saving efforts should be attempted on all infants to assure parents that all possible actions were performed to save their child, futile as the medical professionals may have known them to be.
• Identification of valid Do Not Resuscitate orders.

(Note that the above list may not be a comprehensive picture of medical practice in all jurisdictions or conditions. For example, it may not represent the standard of care for patients with terminal diseases such as advanced cancer. In addition, jurisdictions such as Texas permit withdrawal of medical care from patients who are deemed unlikely to recover.)

Further information: Texas Futile Care Law

Regardless of the patient, pronouncement of death must always be made with absolute certainty and only after it has been determined that the patient is not a candidate for resuscitation. This type of decision is rather sensitive, and can be difficult to make.

Legal definitions of death vary from place to place, for example irreversible brain death, prolonged clinical death, etc.

Popular usage

Colloquially, anything which is received in a non-operational (broken) state can be called DOA or dead on arrival (or, alternatively, defective on arrival). If a new product, such as a computer, arrives "DOA" then it is likely that the recipient will call the supplier to get a Return Merchandise Authorization (RMA), a transaction that acknowledges that (apparently defective) goods will be returned to the supplier for refund, replacement or credit. Sometimes it is difficult to actually detect a defective or DOA product. With computers, for instance, it might require a boot image to be installed and run through a test suite to detect any failed parts.

When, as with computers, product complexity is high and diagnostics are involved, the medical metaphor is perhaps appropriate, as complex diagnostics might be required to determine if the product "is really dead".

In another context, "dead on arrival" may be used to describe an idea or product that is fundamentally flawed, and therefore viewed as an utter failure from the start. For instance, if television producers decided that a pro wrestling tournament were to air on a women-oriented network, the concept would be considered "dead on arrival".

Film and TV

• D.O.A. is the title of a 1950 movie regarded as a classic film noir.
• "D.O.A." was the penultimate of Season Six in NBC's hit crime drama Crossing Jordan.
• "D.O.A." is the title of an episode of Godzilla The Series

Songs

• A live/compilation album by the band Charged GBH was titled Dead on Arrival: A Punk Rock Anthology (2005).
• The Bloodrock song "D.O.A." is told from the point of view of a man dying of injuries suffered in a plane crash, lying in an ambulance with the paramedic standing over him and announcing "there's no hope for you."
• "DOA" was a hit song by the Foo Fighters on the album In Your Honor.
• "Dead on Arrival" is a song by Fall Out Boy on their 2003 album Take This To Your Grave.
• "D.O.A" is the name of a song from the album Mimic47 by Diablo
• Extended name for the song "D.O.A." by The Haunted in their album One Kill Wonder
• "D.O.A. (Death of Auto-Tune)" is a single from hip hop music artist Jay-Z.

Other

• The illegal substance PCP is occasionally slangly termed "Dead-on-arival".
• In Total Nonstop Action Wrestling, the wrestler Suicide names his finishing maneuvre, a Powerbomb variant, the DOA.

References