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.
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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:
(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.)
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.
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".