A starting point when discussing liability issues and AED technology is to point out the fact that the sudden cardiac arrest victim is, in effect, already dead. However, rapid CPR and defibrillation may successfully resuscitate them. AEDs raise the victim’s chances of survival to as high as 40 percent. The use of these devices doesn’t guarantee survival, but gives a chance where close to none previously existed. To withhold the use of an AED because of an unfounded fear of liability is to issue death warrants to thousands of Americans each year. In fact, medico-legal experts foresee a time in the near future when not having an AED program may bring lawsuits against businesses; this has already occurred to Busch Gardens Amusement Park and Lufthansa Airlines.

A good article addressing the liability concerns is “Defibrillators Enter the Business Marketplace” by Richard A. Lazar. It can be accessed at www.padl.org/articles.php3?id=business.htm. The Public Access Defibrillation League has been instrumental in passing AED-friendly legislation, and in fact most states now have laws protecting the lay rescuer from liability when using an AED. Effective in 1999, Texas HB 580 explicitly extended and broadened Good Samaritan protection for the AED providers, their medical director, AED manufacturers, and training providers as well as the person who in good faith administers emergency care using an AED.

There are several things that can reduce risk and insure your AED program will run smoothly.

• Implement a responsible training and retraining plan for the AED as well as CPR. An individual can be properly trained in CPR and in the use of an AED in just a few hours.

• Obtain physician oversight for your AED program.

• Maintain up-to-date device maintenance and training records. Maintenance and testing must be performed according to the manufacturer’s guidelines. NIOSH states that it is important to follow manufacturer’s instructions to replace battery packs immediately when the unit indicates a low battery or replace battery message, regardless of the battery’s expiration date. The operator should not attempt to troubleshoot the warning message by reinserting the old battery. A spare battery pack should always be available.

• Let all employees know about the AED, where it is located, who is trained to use it, and how to call for on-site emergency help, as well as the importance of immediately calling 911.

The AED acquirer shall ensure that each user receives approved CPR and AED training per rules established by the Texas Department of Health.

Medical Liaison. A licensed physician must be involved in the training program to ensure compliance. A doctor’s prescription is required to order the device.

Notification Requirements. The AED acquirer shall notify local EMS provider of the location and type of AED, and promptly notify EMS of each use.

Good Samaritan Protection. Texas law provides civil immunity for the prescribing physician, the person or entity providing training, and the person or entity acquiring AED, except for negligence.

On the Web

For a copy of HB 580, visit www.capitol.state.tx.us/tlo/76r/billtext/HB00580F.HTM. For more information about AEDs, check the following websites, which were the source of information contained in this article:

• American College of Emergency Physicians — www.acep.org
• American Heart Association — www.americanheart.org
• American Red Cross — www.redcross.org
• National Center for Early Defibrillation — www.early_defib.org
• National Institute for Occupational Safety and Health — www.cdc.gov/niosh/
• Occupational Safety and Health Administration — www.osha.gov
• Public Access Defibrillation League — www.padl.org
• San Antonio Red Cross — www.saredcross.org
• Texas Department of Health — www.tdh.state.tx.us