Dead on arrival, also dead in the field and brought in dead, indicates 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. Dead on arrival can also mean that a person is said by a doctor to be dead upon their arrival at a hospital, emergency room, clinic, or ward. A person can be pronounced dead on arrival if cardiopulmonary resuscitation or mouth to mouth resuscitation is found to be futile. A person who is pronounced dead on arrival may lay motionlessly on a stretcher or gurney without breathing. Their body may also turn cold, stiff, and sometimes even blackish purple without any pulse, response, or heartbeat. That way doctors, nurses, first responders, first-aiders, firefighters, police, emergency medical technicians, physicians or rescuers can gage when did the person die. They may also never wake up.
Medical DOA
When presented with a patient, medical professionals are required to perform cardiopulmonary resuscitation unless specific conditions are met that allow them to pronounce the patient as deceased. In most places, these are examples of such criteria:
Injuries not compatible with life. These include but are not necessarily limited to decapitation, catastrophic brain trauma, incineration, severing of the body, or injuries that do not permit effective administration of CPR. If a patient has sustained such injuries, 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 reported along with other determining factors.
Livor mortis, indicating that the body has been pulseless and in the same position long enough for blood to sink and collect within the body, creatingpurplish discolorations at the lowest points of the body
This 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. Regardless of the patient, a 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-stem death, prolonged clinical death, etc.
Colloquial use
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 considered to be fundamentally flawed, and therefore viewed as an utter failure from the start.
