With the passing of Ordinance #19820 San Diego has now become one of  the most progressive cities in the nation in terms of AED Legislation.  Many wonder how important early access to public AEDs really is.  As stated in the Ordinance, “defibrillation or shock using an automated external defibrillator (AED) is the only effective therapy for sudden cardiac arrest”, and “for each minute that passes without CPR and defibrillation, the chance of survival from sudden cardiac arrest decreases by 7-10%”.  As a San Diego City Firefighter Paramedic I witness this devastating statistic play out in real life on a disturbingly frequent basis.  The fact of the matter is that 8 minutes or more will often pass from the time of a witnessed sudden cardiac arrest to our arrival at the patient’s side.  You can do the math on the remaining chances of survival for these patients.  A sobering thought when considering that more people die from sudden cardiac arrest than from breast cancer, prostate cancer, AIDS, Traffic Accidents, Handguns, and House Fires combined.

While we can all agree that this new legislation is a positive step towards saving lives here in our city, there has been considerable resistance centered around well founded concerns of increased costs and liability exposure to property owners and managers.  Now that the law has passed, it can be confusing to navigate through the language of the law and determine exactly what one needs to do to comply, while keeping costs and liability at a minimum.  In this article I will try to simplify the process of setting up a Public Access Defibrillation (PAD) Program in your building or property, while addressing some of the liability concerns. Although there may be some initial costs associated with compliance, there are many ways to meet the requirements of the law while keeping costs and liability exposure to a minimum.

The California Good Samaritan Law provides blanket liability protection to purchasers and enablers of AED’s.  Such far reaching liability protection is not found in many other states.  In fact, all four possible areas of protection are granted under California’s Good Samaritan Law including immunity for Rescuers, Immunity for Acquirers and Enablers, Immunity for Medical Director’s, and Immunity for AED Trainers.  By following some straightforward and simple steps, outlined below, you can ensure protection under the California Good Samaritan Law, minimizing any possible liability.

• AED location should be centrally located and easily accessible.
• AED Unit must be visually inspected on a monthly basis at minimum to ensure that it is in good working order.
• Site Location must have a PAD (Public Access Defibrillation) Program Liaison (can be anyone you designate) to maintain and perform duties of PAD Program on site.  This primarily consists of performing monthly visual checks, as noted above, and serving as a point of contact in case of emergency.
• Site location must have one CPR/AED certified person on the premises during normal business hours, and certifications must be maintained.  This can be an employee, tenant, or resident.  American Heart Association CPR/AED Certifications cost on average $50, take 3 hours to complete, and last for two years.
• PAD program must be under the oversight and prescription of a Medical Director and said Director must be notified in case of AED deployment.  Medical Direction is usually supplied through the company from whom you purchase your AED (see below), and consists of an approximately $100 annual fee paid to the physician who serves as your Medical Director.
• Tenants of your property must annually receive an American Heart Association or American Red Cross approved brochure on the proper use of an AED, which must also be posted next to all AEDs, and tenants must be notified of the location of all AEDs in the building.
• You must ensure that there is a written plan in place which describes the procedures to be followed in the event of an emergency that may involve the use of an AED, including 911 activation and notification of trained rescuers.  This plan is usually created by your Medical Director, in collaboration with you.

The initial outlay for purchase of an AED has fallen in recent years to levels of affordability never before seen, generally ranging from $1,200 – $1,500.  Maintenance costs associated with your AED PAD program run approximately $180 per year, including annual Medical Direction and Prescription, renewal of CPR certification, and replacement of AED pads and batteries.  A small cost to pay when weighed against the life of your tenant or employee.

As you can see, the steps necessary to conform to AED legislation while minimizing your liability are relatively simple and affordable.  In fact, history shows that the risks of litigation associated with AED ownership and use is relatively insignificant.  According to the American Heart Association, to date, no known judgments have been rendered against the operator of an AED for negligent or improper use of AEDs.  By contrast, recent news indicates that building owners and property managers may face liability for failing to have an AED available to treat a victim of sudden cardiac arrest.  For example, a Florida jury found Busch Gardens negligent for not properly training its employees to provide emergency care and for failing to have essential medical equipment, including a defibrillator, on the premises, resulting in significant damages paid.

In summary, the benefits of AEDs, the relative manageable cost of implementation, and the lack of other effective treatment alternatives can present a compelling argument that building owners and property managers might soon have a duty of care toward their tenants or employees who may suffer from sudden cardiac arrest.  The initial impact of this new legislation will be relatively minor considering its current applicability to only newly constructed buildings.  However, in the not too distant future failure to purchase and use AEDs could conceivably subject Building owners and managers to an increasing liability risk in this rapidly evolving legal arena.  Especially in light of the fact that publicly placed AED’s have been proven to save more lives than identically placed Fire Extinguishers, which have already been in place in public buildings for decades.

Learn more about AED defibrillators and our AED training in San Diego.