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I can see a backlash coming from clients who regularly attend Day Centres , Respite etc , in their powered EPICS and use Transport. Not everyone has level access to a vehicle and have to negotiate steep drive ways and undulating ground. It looks as if the EPIOC derated is a possible answer , but that can compromise use in a small property. Regards tony Lewis sre. -----Original Message----- From: A discussion list for Assistive Technology professionals. [mailto:[log in to unmask]]On Behalf Of Gareth Adkins Sent: 27 June 2006 09:05 To: [log in to unmask] Subject: Re: MDA/2006/036 mis use of EPIC's[Scanned] It doesn't matter whether he had an epic or an epioc, both can be used dangerously as you point out. However, an epioc would have coped with gravel relatively better and therefore been safer. Users who are not safe should either be refused provision or if there is a question of them using the chair inappropriately there are several options: Where user is making active choice to use chair against advice, informed consent approach could prevail, i.e. document that the patient has been informed of the risks. This has been the case for some of our users who insist on using an epic to go to the shops etc, rather than withdraw the chair we advise them they shouldn't be doing this, in extreme cases we do withdraw the chair, but as you can imagine this usually creates a storm of protest from all the patient's advocates. In nursing home situations it would not be unreasonable to ask that adequate supervision is provided to ensure patient uses chair in an environment they can cope with, i.e. indoors or out in garden with direct supervision. Its a controversial subject! -----Original Message----- From: Gary Williams (external) [mailto:[log in to unmask]] Sent: 27 June 2006 08:51 To: [log in to unmask] Subject: Re: MDA/2006/036 mis use of EPIC's[Scanned] The most common EPIC we use is the Invacare Apollo, this is was it states in the user manual: - 'The Apollo Indoor chair is primarily designed for use Indoors, however, Invacare are aware that some users do occasionally take their chairs outdoors. If this is the case, Invacare recommend that the user must ensure that ant-tippers are fitted at all times. Invacare will not accept any liability from any claims that may arise as a result of the chair being used in an outdoor environment.' As prescribers we need to asses the user in the environment they will use the wheelchair and upon issue explain limitations of use, our 'Conditions of Loan' states: - The Wheelchair is provided for indoor use and therefore should be used within the confines of your home/shared care setting or at day care services only (or at school/college for children). It must not be used in roads, pavements, supermarkets or shopping precincts etc. Do Not Attempt To Climb Or Descend Steps, Stairs Etc. When we assess for indoor/outdoor provision we have to judge whether the user has the ability to control the wheelchair safely in various environments, but can't possibly assess every environment they would use it in, therefore we have to judge their ability to judge situations themselves. If the gent who got stuck in gravel 3 times in a short space of time had an Epioc, imagine what other dangerous situations he could get himself into. Gary Williams Rehabilitation Engineer Wirral Wheelchair Service St. Catherines hospital Derby Rd. Birkenhead Merseyside CH42 0LQ Tel 0151 604 7261 or 07733 225606 e-mail [log in to unmask] ________________________________ From: A discussion list for Assistive Technology professionals. on behalf of Geoff Harbach Sent: Mon 26/06/2006 19:15 To: [log in to unmask] Subject: MDA/2006/036 mis use of EPIC's[Scanned] Just read the above alert. My understanding was that "Indoor" included the curtilage of the home, school, day centre etc. but did not include public highways and footpaths. I will need to re read the instructions supplied from the manufacturers, but does this mean the end of supplying EPIC's to children in schools? Recently saw an old gent in an EPIC get stuck in the gravel at the side of the paths in the grounds of a nursing home. Happened three times within a few minutes. Wouldn't have happened if he had been in an EPIOC. Just a thought. Geoff Harbach. LEPMIS ********************************************************************** This email and any files transmitted with it are confidential and intended solely for the use of the individual or entity to whom they are addressed. If you have received this email in error please notify the system manager. This footnote also confirms that this email message has been swept by MIMEsweeper for the presence of computer viruses. www.clearswift.com **********************************************************************