II

106TH CONGRESS

1ST SESSION S. 1488

To amend the Public Health Service Act to provide for recommendations

of the Secretary of Health and Human Services regarding the placement

of automatic external defibrillators in Federal buildings in order to improve survival rates of individuals who experience cardiac arrest in such

buildings, and to establish protections from civil liability arising from

the emergency use of the devices.

IN THE SENATE OF THE UNITED STATES

AUGUST 4, 1999

Mr. GORTON introduced the following bill; which was read twice and referred

to the Committee on Health, Education, Labor, and Pensions

A BILL

To amend the Public Health Service Act to provide for

recommendations of the Secretary of Health and Human

Services regarding the placement of automatic external

defibrillators in Federal buildings in order to improve

survival rates of individuals who experience cardiac arrest

in such buildings, and to establish protections from civil

liability arising from the emergency use of the devices.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,
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1 SECTION 1. SHORT TITLE.

2 This Act may be cited as the ‘‘Cardiac Arrest Sur3 vival Act of 1999’’.

4 SEC. 2. FINDINGS.

5 The Congress finds as follows:

6 (1) Each year more than 250,000 adults suffer

7 cardiac arrest, usually away from a hospital. More

8 than 95 percent of them will die, in many cases be9 cause cardiopulmonary resuscitation (‘‘CPR’’),

10 defibrillation, and advanced life support are provided

11 too late to reverse the cardiac arrest. These cardiac

12 arrests occur primarily from occult underlying heart

13 disease and from drowning, allergic or sensitivity re14 actions, or electrical shocks.

15 (2) Every minute that passes before returning

16 the heart to a normal rhythm after a cardiac arrest

17 causes the chance of survival to fall by 10 percent.

18 (3) In communities where strong public access

19 to defibrillation programs have been implemented,

20 survival from cardiac arrest has improved by as

21 much as 20 percent.

22 (4) Survival from cardiac arrest requires suc23 cessful early implementation of a chain of events,

24 known as the chain of survival, which must be initi25 ated as soon as the person sustains a cardiac arrest
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1 and must continue until the person arrives at the

2 hospital.

3 (5) The chain of survival is the medical stand4 ard of care for treatment of cardiac arrest.

5 (6) A successful chain of survival requires the

6 first person on the scene to take rapid and simple

7 initial steps to care for the patient and to assure

8 that the patient promptly enters the emergency med9 ical services system. These steps include—

10 (A) recognizing an emergency and acti11 vating the emergency medical services system;

12 (B) beginning CPR; and

13 (C) using an automated external

14 defibrillator (‘‘AED’’) if one is available at the

15 scene.

16 (7) The first persons at the scene of an arrest

17 are typically lay persons who are friends or family

18 of the victim, fire services, public safety personnel,

19 basic life support emergency medical services pro20 viders, teachers, coaches and supervisors of sports or

21 other extracurricular activities, providers of day

22 care, school bus drivers, lifeguards, attendants at

23 public gatherings, coworkers, and other leaders with24 in the community.
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1 (8) The Federal Government should facilitate

2 programs for the placement of AEDs in public build3 ings, including provisions regarding the training of

4 personnel in CPR and AED use, integration with

5 the emergency medical services system, and mainte6 nance of the devices.

7 SEC. 3. RECOMMENDATIONS OF SECRETARY OF HEALTH

8 AND HUMAN SERVICES REGARDING PLACE9 MENT OF AUTOMATIC EXTERNAL

10 DEFIBRILLATORS IN FEDERAL BUILDINGS.

11 Part B of title II of the Public Health Service Act

12 (42 U.S.C. 238 et seq.) is amended by adding at the end

13 the following section:

14 ‘‘RECOMMENDATIONS REGARDING PLACEMENT OF AUTO15 MATED EXTERNAL DEFIBRILLATORS IN FEDERAL

16 BUILDINGS

17 ‘‘SEC. 247. (a) IN GENERAL.—Not later than 90

18 days after the date of the enactment of the Cardiac Arrest

19 Survival Act of 1999, the Secretary shall assist in pro20 viding for an improvement in the survival rates of individ21 uals who experience cardiac arrest in Federal buildings by

22 publishing in the Federal Register for public comment the

23 recommendations of the Secretary with respect to placing

24 automatic external defibrillators in such buildings. The

25 Secretary shall in addition assist Federal agencies in im26 plementing programs for such placement.
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1 ‘‘(b) CONSIDERATION OF CERTAIN GOALS FOR SUR2 VIVAL RATES.—In carrying out this section, the Secretary

3 shall consider the goals established by national public4 health organizations for improving the survival rates of

5 individuals who experience cardiac arrest in nonhospital

6 settings, including goals for minimizing the time elapsing

7 between the onset of cardiac arrest and the initial medical

8 response.

9 ‘‘(c) CERTAIN PROCEDURES.—The matters ad10 dressed by the Secretary in the recommendations under

11 subsection (a) shall include the following:

12 ‘‘(1) Procedures for implementing appropriate

13 nationally recognized training courses in performing

14 cardiopulmonary resuscitation and the use of auto15 matic external defibrillators.

16 ‘‘(2) Procedures for proper maintenance and

17 testing of such devices, according to the guidelines

18 of the manufacturer of the devices.

19 ‘‘(3) Procedures for ensuring direct involvement

20 of a licensed medical professional and coordination

21 with local emergency medical services in the over22 sight of training and notification of incidents of the

23 use of the devices.
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1 ‘‘(4) Procedures for ensuring notification of an

2 agent of the local emergency medical system dis3 patch center of the location and type of device.

4 ‘‘(d) CERTAIN CRITERIA.—In making recommenda5 tions under subsection (a), the Secretary shall determine

6 the following:

7 ‘‘(1) Criteria for selecting the Federal public

8 buildings in which automatic external defibrillators

9 should be placed, taking into account the typical

10 number of employees and visitors in the buildings,

11 the extent of the need for security measures regard12 ing the buildings, buildings or portions of buildings

13 in which there are special circumstances such as

14 high electrical voltage or extreme heat or cold, and

15 such other factors as the Secretary determines to be

16 appropriate.

17 ‘‘(2) Criteria regarding the maintenance of such

18 devices (consistent with the labeling for the devices).

19 ‘‘(3) Criteria for coordinating the use of the de20 vices in public buildings with providers of emergency

21 medical services for the geographic areas in which

22 the buildings are located.’’.
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1 SEC. 4. IMMUNITY FROM CIVIL LIABILITY FOR EMERGENCY

2 USE OF AUTOMATIC EXTERNAL

3 DEFIBRILLATORS.

4 Part B of title II of the Public Health Service Act,

5 as amended by section 3 of this Act, is amended by adding

6 at the end the following section:

7 ‘‘LIABILITY REGARDING EMERGENCY USE OF AUTOMATED

8 EXTERNAL DEFIBRILLATORS

9 ‘‘SEC. 248. (a) PERSONS USING AEDS.—Any person

10 who provides emergency medical care through the use of

11 an automated external defibrillator is immune from civil

12 liability for any personal injury or wrongful death result13 ing from the provision of such care, except as provided

14 in subsection (c).

15 ‘‘(b) OTHER PERSONS INVOLVED WITH AEDS; SPE16 CIAL RULES FOR ACQUIRERS.—With respect to a personal

17 injury or wrongful death to which subsection (a) applies,

18 in addition to the person who provided emergency medical

19 care through the use of the automated external

20 defibrillator, the following persons are with respect to the

21 device immune from civil liability for the personal injury

22 or wrongful death in accordance with the following, except

23 as provided in subsection (c):

24 ‘‘(1) Any person who maintained the device,

25 tested the device, or provided training in the use of

26 the device is immune from such liability.
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1 ‘‘(2) Any physician who provided medical over2 sight regarding the device is immune from such li3 ability.

4 ‘‘(3) The person who acquired the device (in

5 this paragraph referred to as the ‘acquirer’) is im6 mune from such liability if the following conditions

7 are met:

8 ‘‘(A) The condition that the acquirer noti9 fied local emergency response personnel of the

10 most recent placement of the device within a

11 reasonable period of time after the device was

12 placed.

13 ‘‘(B) The condition that, as of the date on

14 which the emergency occurred, the device had

15 been maintained and tested in accordance with

16 the guidelines established for the device by the

17 manufacturer of the device.

18 ‘‘(C) In any case in which the person who

19 provided the emergency medical care through

20 the use of the device was an employee or agent

21 of the acquirer, and the employee or agent was

22 within the class of persons the acquirer ex23 pected would use the device in the event of a

24 relevant emergency, the condition that the em25 ployee or agent received reasonable instruction
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1 in the use of such devices through a course ap2 proved by the Secretary or by the chief public

3 health officer of any of the States.

4 ‘‘(c) INAPPLICABILITY OF IMMUNITY.—Immunity

5 under subsections (a) and (b) does not apply to a person

6 if the person engaged in gross negligence or willful or wan7 ton misconduct in the circumstances described in such

8 subsections that apply to the person with respect to auto9 mated external defibrillators.

10 ‘‘(d) RULES OF CONSTRUCTION.—

11 ‘‘(1) IN GENERAL.—The following applies with

12 respect to this section:

13 ‘‘(A) This section does not supersede the

14 law of any State that (before, on, or after the

15 date of the enactment of the Cardiac Arrest

16 Survival Act of 1999) provides through statute

17 or regulations any degree of immunity for any

18 class of persons for civil liability for personal in19 jury or wrongful death arising from the provi20 sion of emergency medical care through the use

21 of an automated external defibrillator.

22 ‘‘(B) This section does not waive any pro23 tection from liability for Federal officers or em24 ployees under—

25 ‘‘(i) section 224; or
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1 ‘‘(ii) sections 1346(b) and 2672 of

2 title 28, United States Code, or under al3 ternative benefits provided by the United

4 States where the availability of such bene5 fits precludes a remedy under section

6 1346(b) of title 28.

7 ‘‘(C) This section does not require that an

8 automated external defibrillator be placed at

9 any building or other location.

10 ‘‘(2) CIVIL ACTIONS UNDER FEDERAL LAW.—

11 ‘‘(A) IN GENERAL.—The applicability of

12 subsections (a) through (c) includes applica13 bility to any action for civil liability described in

14 subsection (a) that arises under Federal law.

15 ‘‘(B) FEDERAL AREAS ADOPTING STATE

16 LAW.—If a geographic area is under Federal

17 jurisdiction and is located within a State but

18 out of the jurisdiction of the State, and if, pur19 suant to Federal law, the law of the State ap20 plies in such area regarding matters for which

21 there is no applicable Federal law, then an ac22 tion for civil liability described in subsection (a)

23 that in such area arises under the law of the

24 State is subject to subsections (a) through (c)

25 in lieu of any related State law that would
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1 apply in such area in the absence of this sub2 paragraph.’’.

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