Spa pool bubbles led to death

Bubbles in a spa pool contributed to the death of a 4-year-old boy, says the Wellington coroner.

Troy Julius Matthews of Titahi Bay, Porirua, died in hospital after almost drowning at the Porirua Trust Aquatic Centre in January last year when he climbed into a spa pool unsupervised, Coroner Gerry Evans said in his verdict on the death.

The spa pool's water level was greater than Troy's height and the bubbles in the pool meant he could not be seen underwater when he got into trouble.

George Mason, lawyer for the Labour Department, said when spa pools were operating with their bubbles at full power they "might as well have been filled with black ink".

Mr Evans said Troy's mother had not read the pool rules and had not been watching him when he got into the spa for adults and children on January 18.

However, the Porirua City Council-owned swimming centre had failed to make clear the rule that a person aged 15 or older must accompany children under 8.

The rule was displayed in a photocopied notice on the counter at reception, but the only other indication was a sign standing at the mixed spa pool.

When Ms Matthews searched for Troy, she looked into the spa pool, but it was foamy and she could not see anything.

Lifeguard Hayden Collins, 17, was alerted when a 14-year-old ran to his post and told him there was a boy floating in the spa pool.

Troy was given resuscitation but died in Wellington Hospital the next day.

The council said the bubbles in the mixed pool had since been permanently disabled, its water turbulence was reduced and visibility improved.

A user height minimum of 130cm had applied since April 2002.

The heads of children of this height would be above water level.

More water safety notices had also been posted.

Mr Evans said there were not enough lifeguards on duty at the time of the incident and there was inadequate communication about which parts of the centre each lifeguard was responsible for.

Mr Collins had been employed as a lifeguard for only 3 1/2 months and another lifeguard on duty, aged 19, had two weeks' practical experience. Mr Evans said the pair were not given the close supervision they needed.

Council leisure and recreation general manager Gary Simpson said that as a result of the death it had carried out an extensive internal review of the centre's operations.

In addition, three separate external investigations were undertaken last year.

Other recommendations implemented after these investigations included:

* Most poolside staff and receptionists now carry two-way radios to improve poolside communications.

* All lifeguard positions have been made mobile rather than static to ensure better coverage of poolside areas.

* Lifeguards must carry bags containing essential first aid equipment, including a whistle, during their poolside shift and reach poles or rescue tubes are now in every guard position.

* Only one staff member is allowed a break at any time. A team leader or senior lifeguard must be at the poolside at all times.

* All lifeguards must be aged 16 or older and have a mature attitude to work.

* All poolside staff are required to hold current certificates in the minimum qualifications of Comprehensive First Aid and the National Lifeguard Award. The qualifications must be valid at all times and refresher training is provided.

* A more comprehensive induction system has been put in place, including a buddy system for all new staff before they are put into a lifeguard role.

* The full-time roster has been changed to include training time for team leaders and senior lifeguards.

* Performance agreements have been redeveloped for management, team leaders and senior lifeguards to ensure a methodical approach is taken to safety management and hazard identification.

- NZPA