| GENERAL INFORMATION
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| KEYWORDS
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Marine medical certificate, heart disease, diabetes, implantable cardioverter defibrillator (ICD)
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| FILE NO.
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MH-0359-28
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| SECTOR (Marine or Aviation)
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Marine
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| SPECIFIC JOB
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Wheelsman
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| DIAGNOSIS (Primary, Secondary, etc.)
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Primary: Type II diabetes
Secondary: Implantable cardioverter defibrillator (ICD)
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| REVIEW
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| DATE OF DETERMINATION
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March 11, 2016
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| MEMBER
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Dr. Christopher Brooks
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| DETERMINATION
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The Minister’s decision is confirmed.
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| REASONS FOR THE DETERMINATION
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Refusal to issue a marine medical certificate (MMC) — The applicant has suffered from type II diabetes for many years. In 2012, following a heart attack at sea, and considered to be at a high risk for a further cardiac event, he was subsequently fitted with an ICD in 2013. The applicant is a wheelsman in a safety-critical position on board the vessel. As a result of the high risk of a further heart attack and the risks associated with the ICD, the applicant was assessed by Transport Canada (TC) as no longer fit to hold an MMC. The TC Physician Guide and IMO/ILO guidelines clearly state that a seafarer who has been fitted with an ICD is disqualified from holding an MMC. The Minister’s expert witness stated that although ICDs are life saving in the majority of patients, in up to 18% of cases, the ICDs can inadvertently cause a shock and incapacitation, and could put the patient’s life at risk. Additionally, this would not only cause a risk to the applicant, but to the crew, his vessel and the cargo. The guidelines specifically advise physicians to deny an MMC to seafarers fitted with an ICD. Therefore, the member concurs with the Minister’s decision to refuse to issue an MMC to the applicant.
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| APPEAL
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| DATE OF DECISION
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| MEMBERS
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| DECISION
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| REASONS FOR THE DECISION
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| OTHER/COMMENTS
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