BILL ANALYSIS Ó
SB 658
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Date of Hearing: June 23, 2015
ASSEMBLY COMMITTEE ON JUDICIARY
Mark Stone, Chair
SB
658 (Hill) - As Amended June 15, 2015
SENATE VOTE: 39-0
SUBJECT: AUTOMATED EXTERNAL DEFIBRILLATORS
KEY ISSUES:
1)SHOULD THE REQUIREMENTS IN EXISTING LAW WITH WHICH BUILDING
OWNERS AND TENANTS WHO INSTALL AUTOMATED EXTERNAL
DEFIBRILLATORS (AEDs) ON THEIR PROPERTIES ARE REQUIRED TO
COMPLY IN ORDER TO OBTAIN QUALIFIED IMMUNITY FROM CIVIL
LIABILITY, BE REVISED AND UPDATED TO REFLECT THE TECHNOLOGICAL
ADVANCES IN AED DESIGN THAT HAVE TAKEN PLACE SINCE THOSE
REQUIREMENTS WERE ENACTED?
2)SHOULD THE REQUIREMENTS IN EXISTING LAW WITH WHICH PRINCIPALS
OF K-12 SCHOOLS WHERE AEDs ARE INSTALLED MUST COMPLY IN ORDER
TO OBTAIN QUALIFIED IMMUNITY BE SIMILARLY REVISED?
SYNOPSIS
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An automated external defibrillator, or AED, is a medical device
that is used to administer an electric shock to the heart of a
person who has suffered cardiac arrest through the person's
chest wall. Built-in computers in an AED assess the patient's
heart rhythm, determine whether the person is in cardiac arrest,
and signal whether to administer the shock. Audible cues guide
the user through the process of using the AED. In 1999, in an
effort to encourage the installation and use of AEDs in
commercial buildings, the Legislature provided qualified
immunity to commercial property owners who installed AEDs in
their buildings. That legislation (SB 911 (Figueroa), Ch. 163,
Stats. of 1999) put in place a number of requirements for
property owners who installed AEDs and Good Samaritans who use
them in order to obtain qualified immunity for civil liability
associated with the installation or use of the AED. According
to the author, the requirements from the 1990's were based on
older AED technology that didn't have voice commands, didn't
have pre-connected shock pads, didn't have long-lasting
batteries, and didn't have voice-command CPR coaching. The new
generation of AEDs is so simple and user friendly, according to
the author, that nearly anyone can successfully administer them
without training or practice. Studies seem to support the
position of the author, finding that 90 percent of the time, an
AED detects a heart rhythm that should be defibrillated; and 95
percent of the time an AED is able to recommend not shocking
when the computer shows defibrillation is not indicated. As of
2011, there were no reports to the federal government of AEDs
harming users or bystanders. At the same time, AEDs have proven
to be extremely effective at saving lives.
In order to encourage the installation and use of AEDs in
commercial buildings and K-12 schools, this bill seeks to
revise, streamline and modernize those requirements in light of
the recent improvements to and proven efficacy of AED
technology. The most significant revision is the elimination of
all training requirements for personnel who may need to use an
AED. According to the author, such training requirements are no
longer necessary and, along with other outdated and unnecessary
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requirements, may have deterred building owners and tenants, as
well as school administrators from installing AEDs. This bill,
which passed the Senate by a vote of 39-0, is supported by a
wide-range of health care providers, non-profit organizations,
and business groups. One organization, Rescue Training
Institute, is opposed to the measure.
SUMMARY: Revises the maintenance and training requirements for
placement of automated external defibrillators (AEDs) in
commercial buildings and K-12 schools that are conditions for
obtaining qualified immunity from civil liability for the
selection, installation, placement, and use of AEDs in those
facilities. Specifically, this bill:
1)Provides that a physician and surgeon or other health care
professional that is involved in the selection, placement, or
installation of an AED is not liable for civil damages
resulting from acts or omissions in the rendering of emergency
care by use of that AED.
2)Requires a person or entity that acquires an AED, as a
condition for obtaining qualified immunity, to do all of the
following:
a) Comply with all regulations governing the placement of
an AED.
b) Notify an agent of the local EMS agency of the
existence, location, and type of AED acquired.
c) Ensure that the AED is maintained and tested according
to the operation and maintenance guidelines set forth by
the manufacturer (rather than guidelines of the American
Heart Association, and the American Red Cross, and
according to any applicable rules and regulations set forth
by the governmental authority under the federal Food and
Drug Administration and any other applicable state and
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federal authority, as provided in existing law).
d) Ensure that the AED is tested at least biannually and
after each use (as opposed to every 30 days, as required by
existing law).
e) Ensure that an inspection is made of all AEDs on the
premises at least every 90 days for potential issues
related to operability of the device, including a blinking
light or other obvious defect that may suggest tampering or
that another problem has arisen with the functionality of
the AED (as opposed to every 30 days, as required by
existing law).
f) Ensure that records of the maintenance and testing
required pursuant to this paragraph are maintained.
3)Requires a building owner, when an AED is placed in a
building, to do all of the following:
a) At least once a year, notify the tenants as to the
location of the AED units and provide information to
tenants about who they can contact if they want to
voluntarily take AED or CPR training.
b) At least once a year, offer a demonstration to at least
one person associated with the building so that the person
can be walked through how to use an AED properly in an
emergency. The building owner may arrange for the
demonstration or partner with a nonprofit organization to
do so.
c) Next to the AED, post instructions, in no less than
14-point type, on how to use the AED.
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4)Provides that a medical director or other physician and
surgeon is not required to be involved in the acquisition or
placement of an AED.
5)Requires the principal of a public or private K-12 school,
when an AED is placed in such a school, to ensure that the
school administrators and staff annually receive information
that describes sudden cardiac arrest, the school's emergency
response plan, and the proper use of an AED and to ensure that
instructions, in no less than 14-point type, on how to use the
AED are posted next to every AED. The principal shall, at
least annually, notify school employees as to the location of
all AED units on the campus.
6)Provides that a school employee or other person is not
prohibited from rendering aid with an AED.
7)Requires the manufacturer or retailer supplying an AED to
provide to a school that acquires an AED all information
governing the use, installation, operation, training, and
maintenance of the AED.
8)Defines "local EMS agency" as an agency established pursuant
to Health and Safety Code Section 1797.200. (All further
statutory references are to the California Health and Safety
Code, unless otherwise indicated.)
9)Clarifies that this section does not apply to facilities
licensed pursuant to subdivision (a), (b), (c), or (f) of
Section 1250 (general acute care hospitals, acute psychiatric
hospitals, skilled nursing facilities, and special hospitals).
EXISTING LAW:
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1)Provides, in order to encourage local agencies and other
organizations to train people in emergency medical services,
that any local agency, entity of state or local government,
private business or nonprofit organization which sponsors,
authorizes, supports, finances, or supervises the training of
people, or certifies those people (excluding physicians and
surgeons, registered nurses, and licensed vocational nurses),
with immunity from all civil liability for injuries alleged to
result from those training programs. (Section 1799.100.)
2)Provides that no person who in good faith, and not for
compensation, renders emergency medical or nonmedical care at
the scene of an emergency shall be liable for any civil
damages resulting from any act or omission other than an act
or omission constituting gross negligence or willful or wanton
misconduct. (Section 1799.102.)
3)Provides that a person or entity that acquires an AED for
emergency use is not liable for any civil damages resulting
from any acts or omissions when the AED is used to render
emergency care, provided that the person or entity has
complied with specified maintenance, training, and notice
requirements of Section 1797.196. (Civil Code Section
1714.21(d).)
4)Provides that any person or entity responsible for the site
where the AED is located, is not liable for any civil damages
resulting from any acts or omissions, other than an act or
omission constituting gross negligence or willful or wanton
misconduct, by a person who uses an AED to render emergency
care provided that the physician, person, or entity has
complied with applicable requirements of Section 1797.196.
(Civil Code Section 1714.21(e).)
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5)Provides that any person or entity that acquires an AED is not
liable for any civil damages resulting from any acts or
omissions in the rendering of the emergency care if that
person or entity complies with all regulations governing the
placement of an AED and ensures each of the following:
a) The AED is maintained and regularly tested according to
the operation and maintenance guidelines set forth by the
manufacturer, the American Heart Association, and the
American Red Cross, and according to any applicable rules
and regulations set forth by the governmental authority
under the federal Food and Drug Administration and any
other applicable state and federal authority;
b) The AED is checked for readiness after each use and at
least once every 30 days if it has not been used in the
preceding 30 days, and records of these checks are
maintained;
c) Any person who renders emergency care using the AED
activates the emergency medical services (EMS) system as
soon as possible, and reports any use of the AED to the
local EMS agency;
d) For every AED unit acquired up to five units, at least
one employee per unit must complete a training course in
cardiopulmonary resuscitation (CPR) and AED use and after
the first five AED units are acquired, for each additional
five units acquired, one employee is trained beginning with
the first unit acquired. Acquirers of AEDs shall have
trained employees who should be available to respond to an
emergency that may involve the use of an AED during normal
operating hours; and
e) There is a written plan describing the procedures to be
followed in the event of an emergency that may involve
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using an AED. (Section 1797.196 (b).)
6)Requires the following, where applicable:
a) If the AED is placed in a building, building owners must
annually provide tenants with a brochure describing the
proper use of an AED, and also ensure that similar
information is posted next to any installed AED;
b) If the AED is placed in a building, building owners must
notify tenants as to the location of AED units in the
building at least once a year; and
c) If an AED is placed in a public or private K-12 school,
the principal must annually provide school administrators
and staff with a brochure describing the proper use of an
AED, post similar information next to the AED, and
designate trained employees to be available to respond to
an emergency that may involve the use of an AED during
normal operating hours. (Section 1797.196(b).)
7)Provides that the above provisions providing immunity from
civil liability for the good faith use of an AED do not apply
in the case of personal injury or wrongful death resulting
from the gross negligence or willful or wanton misconduct of
the person who uses the AED to render emergency care.
(Section 1797.196(e).)
8)Requires that the person or entity supplying an AED must do
the following: (a) notify an agent of the local EMS agency of
the existence, location, and type of AED acquired; and (b)
provide the person who acquires the AED with information
regarding the AED's use, installation, operation, training,
and maintenance. (Section 1797.196(c).)
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9)Provides that a building owner or a building manager is not
required by law to acquire or install an AED in any building.
(Section 1797.196(f).)
10)Defines "'wanton' or 'reckless' misconduct" as conduct by a
person who may have no intent to cause harm, but who
intentionally performs an act so unreasonable and dangerous
that he or she knows or should know it is highly probable that
harm will result." (City of Santa Barbara v. Superior Court
(2007) 41 Cal.4th 747, 753 [emphasis added].)
11)Defines "gross negligence" as an "exercise of so slight a
degree of care as to justify the belief there was indifference
to the interest and welfare of others." (46 Cal. Jur. 3d
Negligence § 100.)
FISCAL EFFECT: As currently in print this bill is keyed
non-fiscal.
COMMENTS: An automated external defibrillator, or AED, is a
medical device that is used to administer an electric shock to
the heart of a person who has suffered cardiac arrest through
the person's chest wall. Built-in computers in an AED assess
the patient's heart rhythm, determine whether the person is in
cardiac arrest, and signal whether to administer the shock.
Audible cues guide the user through the process of using the
AED.
In 1999, in an effort to encourage the installation and use of
AEDs in commercial buildings, the Legislature provided qualified
immunity to commercial property owners who installed AEDs in
their buildings. That legislation (SB 911 (Figueroa), Ch. 163,
Stats. of 1999) put in place a number of requirements for
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property owners who installed AEDs and Good Samaritans who use
them in order to obtain qualified immunity for civil liability
associated with the installation or use of the AED. This
Committee's analysis of SB 911 summarized the "training and
maintenance requirements for qualified immunity," as follows:
For AED operators: For the qualified immunity to apply, SB
911 would require the good samaritan operator to have
completed a basic CPR and AED use course within the preceding
12 months that complies with regulations adopted by the
Emergency Medical Services Authority (EMSA) and the standards
adopted by the American Heart Association or the American Red
Cross for CPR and AED use. Current EMSA regulations call for
a training class of not less than four hours covering, among
other topics: (1) the proper use, maintenance, and periodic
inspection of the AED; (2) the importance of CPR and
defibrillation; (3) assessment of an unconscious patient to
determine if cardiac arrest has occurred and the
appropriateness of using the AED; and (4) information as to
defibrillator safety precautions and training in determining
if further usage is necessary.
For businesses having AEDs on site: In order to qualify for
the bill's immunity protections, a business acquiring an AED
must satisfy all of the following conditions: (1) comply
with all regulations governing the training, use, and
placement of an AED; (2) notify the local EMS agency of the
existence, location and type of AED acquired; (3) ensure all
of the following: (i) that expected AED users annually
complete the required training for AED operators to qualify
for the immunity; (ii) that the defibrillator is maintained
and tested according to the manufacturer's operational
guidelines; (iii) that the owner conduct a readiness check
after each usage, and at least once every 30 days if the AED
has not been used in the preceding 30 days, and to keep
records of such checks; (iv) that the emergency medical
services system is activated as soon as possible when an
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operator uses an AED, and that usage is reported to the local
EMS agency and the authorizing medical authority; and, (v)
that a licensed physician is involved in developing a program
to ensure compliance with the regulations and the
requirements for training, notification and maintenance.
At the time the Legislature passed (and the governor signed) SB
911, AEDs were an emerging technology and not nearly as
user-friendly as they are today. According to the author:
The requirements from the 1990's were based on older AED
technologies that didn't have voice commands, didn't have
pre-connected shock pads, didn't have long-lasting
batteries, didn't have voice-command CPR coaching. The new
generation of AEDs is so simple and user friendly that
nearly anyone can successfully administer them without
training or practice. They even have a built in computer
that monitors the heart rhythm of the cardiac arrest victim
to determine if a shock should be administered.
Improvements in AED Design and Function. State of the art AEDs
are lightweight portable devices that run on internal batteries.
A built-in computer checks a victim's heart rhythm through
adhesive electrodes. A computer within the AED calculates
whether defibrillation is needed. If so, a recorded voice tells
the rescuer to press the shock button on the AED. The AED
literally "talks" a rescuer through the process of using an AED
by providing a series of audible voice prompts, making it easy
for virtually anyone to correctly use an AED. At the same time,
it is difficult to misuse an AED because the device is able to
analyze the heart rhythm of a sudden cardiac arrest victim and
independently determine if a shock is needed, based on the
regularity (or irregularity) of the victim's heart rhythm. When
appropriate, the AED delivers a shock through electrodes in a
pad placed on the victim's chest which can stop an irregular
rhythm and allow a normal rhythm to resume. The AED will not
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administer a shock to a victim whose heart is beating and will
override an operator who attempts to administer a shock to such
a victim.
Importance of Immediate Medical Intervention to Victims of
Cardiac Arrest. Only 10 percent of victims who suffer cardiac
arrest outside of a hospital survive the events. Among young
victims, the survival rate is even lower: only about five
percent. (Source: AHA Heart Disease and Stroke Statistics-2014
Update.) Sudden cardiac arrest kills nearly 1,000 people per
day in the U.S. and kills 350,000 Americans annually. It can
happen to anyone, anytime, anywhere and at any age. During a
sudden cardiac arrest, the heart function ceases abruptly and
without warning. When this occurs, the heart is no longer able
to pump blood to the rest of the body. The average emergency
response time for a 911 call is 8-12 minutes. Each minute that
defibrillation is delayed reduces a person's chance of survival
by approximately 10 percent.
Success of AEDs in Saving Lives and Performing as Designed and
Intended. A study by Johns Hopkins University found that Good
Samaritan access to AEDs doubles survival from sudden heart
attack. The report found that at least 522 lives can be saved
annually in the United States and Canada by the widespread
placement of AEDs. Researchers found - in real-life, emergency
situations - that use of AEDs by random bystanders more than
doubled survival rates among victims felled by a sudden heart
stoppage due to a heart attack or errant heart rhythm.
(Weisfeldt, Bystander-administered AED shock improves survival
from out-of-hospital cardiac arrest in the U.S. and Canad
(2007), found at
http://www.hopkinsmedicine.org/news/media/releases/results_of_def
initive_study_are_in_lives_are_saved_when_defibrillators_are_plac
ed_in_large_public_spaces.)
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According to the American Heart Association, studies have shown
that 90 percent of the time, an AED detects a heart rhythm that
should be defibrillated; and 95 percent of the time an AED is
able to recommend not shocking when the computer shows
defibrillation is not indicated. (American Heart Association,
Answers by Heart (2012), found at
http://www.heart.org/idc/groups/heart-public/@wcm/@hcm/documents/
downloadable/ucm_300340.pdf.)
Furthermore, according to the U.S. Department of Health & Human
Services--National Heart, Lung and Blood Institute, there have
been no reports of AEDs harming users or bystanders. (What Are
the Risks of Using an Automated External Defibrillator? (2011),
found at
http://www.nhlbi.nih.gov/health/health-topics/topics/aed/risks.)
Despite Improvements in Technology and Ease of Use, AEDs Not
Commonly Installed in Commercial Buildings or Schools.
According to the author, AEDs are not commonly installed in
buildings because of numerous requirements that building owners
must satisfy under current law in order to be exempt from civil
liability associated with the use (or non-use of an AED).
According to El Camino Hospital, writing in support of SB 658:
We worked closely with fire departments throughout Santa
Clara County, local governments and businesses on the
implementation of this technology, and learned there are
far too few AEDs available in our communities. In
addition, we learned that California law contains outdated,
unnecessary and expensive requirements and confusing
liability language which discourages business owners and
government entities from installing AEDs.
Hanging an AED on a wall should be as common as installing
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a fire extinguisher, a first aid station or similar
equipment designed to save lives and protect health in
emergencies. We applaud the fact that SB 658 modernizes and
simplifies California's AED law-a vital step to increasing
the number of these lifesaving devices available to the
public.
The same problem may exist in schools. According to Dr. Cindy
Chang of Racing Hearts, a nonprofit organization that works to
increase awareness of and improves access to AEDs in schools and
elsewhere, SB 658 will "make it easier for the districts and
school boards to support getting AEDs in the schools. Current
law places an incredible burden on them to train and track
personnel during the entire day and evening and weekends too."
Qualified Immunity for Good Samaritans. In 2009, the
Legislature amended Section 1799.102 to provide that persons who
provide emergency care or assistance, whether medical or
non-medical, shall not be liable for damages caused by their
acts or omissions while rendering emergency care, so long as
their conduct does not constitute "gross negligence" or "willful
or wanton misconduct." (AB 83 (Feuer), Chap. 77, Stats. 2009.)
AB 83 was the Legislature's response to a decision by the
California Supreme Court, Van Horn v. Watson (2008) 45 Cal.4th
322. In the Van Horn case, Lisa Torti pulled her friend and
co-worker, Alexandra Van Horn, from a crashed vehicle in Los
Angeles, fearing the vehicle was about to catch fire or even
explode. Tragically, in doing so, Torti may have worsened Van
Horn's injuries. Van Horn later sued the driver, who in turn
sued Torti for exacerbating Van Horn's injuries. The Court held
that the state's "Good Samaritan" statute, when read as part of
the overall statutory scheme, only provided immunity to persons
with respect to medical care at the scene of an emergency and
did not apply to "non-medical" emergency assistance, such as
pulling a person from a potentially exploding automobile or a
burning building.
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AB 83 clarified the general Good Samaritan statute (Section
1799.102), which provides immunity to all rescuers who render
emergency care at the scene of an emergency, so that immunity
applied as long as the care was rendered "in good faith and not
for compensation," regardless of whether the care is found to be
of a medical or non-medical nature. However, AB 83
appropriately clarified that such broad immunity is unavailable
to rescuers who engage in grossly negligent or willful or wanton
misconduct. The limited or "qualified" immunity adopted by AB
83 is a compromise meant to encourage altruistic behavior, but
still protect the public from grossly negligent or deliberately
harmful behavior.
Like AB 83, this bill seeks to encourage laypersons to provide
emergency medical care by limiting their civil liability for
doing so. It requires that care is rendered "in good faith and
not for compensation," and exempts conduct that is either
grossly negligent, or that constitutes willful or wanton
misconduct. It also slightly expands the qualified immunity
provisions to cover a "physician and surgeon or other health
care professional" who is involved in the "selection, placement,
or installation of an AED," whereas existing law only provides
such protection to a "physician" who is involved in the
"placement" of an AED. Medical professionals are ordinarily not
given the same protection from liability as laypersons for
providing emergency medical care. However, given that advice
about the selection, placement, or installation of an AED does
not constitute medical advice or treatment, such protection from
liability seems appropriate.
Changes to Requirements on Tenants, Property Owners and Other
Parties Associated with Selection and Placement of AEDs in
Commercial Buildings and in Public Schools. In order to qualify
for limited immunity, current law requires tenants, property
owners, and school personnel to comply with various
requirements. This bill makes a number of changes to those
requirements, as explained below.
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1)Tenants who Install AEDs: SB 658 eliminates a number of
requirements (that are conditions for obtaining qualified
immunity in current law) for persons or entities that install
an AED on their properties:
a) To ensure that the AED is maintained and regularly
tested according to the operation and maintenance
guidelines set forth by the manufacturer, the American
Heart Association, and the American Red Cross, and
according to any applicable rules and regulations set forth
by the governmental authority under the federal Food and
Drug Administration and any other applicable state and
federal authority.
b) To ensure that the AED is checked for readiness after
each use and at least once every 30 days if the AED has not
been used in the preceding 30 days, and maintain records of
these checks.
c) To report any use of the AED to the licensed physician
and to the local EMS agency.
d) To ensure that for every AED unit acquired up to five
units, no less than one employee per AED unit shall
complete a training course in cardiopulmonary resuscitation
and AED use that complies with the regulations adopted by
the Emergency Medical Service Authority and the standards
of the American Heart Association or the American Red
Cross.
e) To have a written plan that describes the procedures to
be followed in the event of an emergency that may involve
the use of an AED including, but not be limited to,
immediate notification of 911 and trained office personnel
at the start of AED procedures.
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However, SB 658 still requires tenants to do the following:
a) Comply with all regulations governing the placement of
an AED.
b) Notify an agent of the local EMS agency of the
existence, location, and type of AED acquired.
c) Ensure that the AED is maintained and tested according
to the operation and maintenance guidelines set forth by
the manufacturer.
d) Ensure that the AED is tested at least biannually and
after each use.
e) Ensure that an inspection is made of all AEDs on the
premises at least every 90 days for potential issues
related to operability of the device, including a blinking
light or other obvious defect that may suggest tampering or
that another problem has arisen with the functionality of
the AED.
f) Ensure that records of the maintenance and testing
required pursuant to this paragraph are maintained.
Given the fact that modern AEDs are so easy to use, a training
course may not be necessary for building personnel.
Furthermore, there is no guarantee that trained personnel will
be on duty, or at the scene, when an emergency occurs.
Therefore, simplifying the training and notification
requirements on tenants who install AEDs does not appear to
endanger public safety and may increase the availability of
AEDs in buildings that are open to the public.
2)Building Owners: AB 658 also revises the list of things that
building owners must do in order to obtain qualified immunity
from civil liability associated with AEDs placed in their
buildings. Current law requires that no less than once every
year, a building owner must ensure that tenants receive a
brochure, approved as to content and style by the American
Heart Association or the American Red Cross, describing the
proper use of an AED and also to ensure that similar
information is posted next to any installed AED.
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SB 658 puts additional requirements in place, requiring a
building owner to do all of the following:
a) At least once a year, to notify the tenants as to the
location of the AED units and provide information to
tenants about who they can contact if they want to
voluntarily take AED or CPR training.
b) At least once a year, to offer a demonstration to at
least one person associated with the building so that the
person can be walked through how to use an AED properly in
an emergency. The building owner may arrange for the
demonstration or partner with a nonprofit organization to
do so.
c) Next to the AED, to post instructions, in no less than
14-point type, on how to use the AED.
These revised requirements - for annual notices regarding
location of the AEDs, annual demonstrations, and written
instructions - appear to be more helpful to tenants and
potential users than the provisions in existing law, which
only require that brochures be made available.
1)School Administrators and Employees: Current law requires the
principal of a public or private K-12 school where an AED is
installed to ensure that the school administrators and staff
annually receive a brochure, approved as to content and style
by the American Heart Association or the American Red Cross,
that describes the proper use of an AED and to ensure that
similar information is posted next to every AED. Current law
also requires the principal, at least annually, to notify
school employees of the location of all AED units on the
campus. Finally, the principal must designate the employees
who are trained to use an AED and those employees must be
available to respond to an emergency that may require use of
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an AED during normal operating hours (defined as the hours of
classroom instruction and any school-sponsored activity
occurring on school grounds).
This bill merely requires the principal of a public or private
K-12 school, when an AED is placed in such a school, to ensure
that the school administrators and staff receive information
that describes sudden cardiac arrest, the school's emergency
response plan, and instruction for the proper use of an AED on
an annual basis and to ensure that instructions, in no less
than 14-point type, on how to use the AED are posted next to
every AED. The principal is also required, at least annually,
to notify school employees as to the location of all AED units
on the campus. The bill also provides that a school employee
or other person is not prohibited from rendering aid with an
AED.
Like the training requirements for staff in commercial
buildings, the efficacy of the training requirements for
school personnel are premised on the assumption that trained
personnel will be on duty, or at the scene, when an emergency
occurs. However, the current training requirements for school
personnel go much further by requiring that "employees who are
trained to use an AED . . . must be available to respond to an
emergency that may require use of an AED during normal
operating hours (defined as the hours of classroom instruction
and any school-sponsored activity occurring on school
grounds)." (Section 1797.196 (b)(5).)
Given all of the demands on the time of teachers and school
administrators, these training and availability requirements
could very well act as a disincentive to installing an AED in
a K-12 school. Given the ease of using an AED, eliminating
these training and designation requirements may increase the
availability of AEDs in public and private K-12 schools.
2)Manufacturers and retailers of AEDs. This bill modestly
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expands the duties on retailers who supply AEDs to K-12
schools. Current law requires the manufacturer supplying an
AED to provide to the school all information governing the
use, installation, operation, training, and maintenance of the
AED. This bill extends that requirement to the retailer that
supplies the AED.
According to the author, the changes in SB 658 "will lead to
more AEDs in the community and save lives." The author further
clarifies that SB 658 will:
[increase] the likelihood that Automated External
Defibrillators (AEDs) will be installed in buildings
throughout the state by reducing outdated requirements
imposed on building owners who voluntarily install AEDs.
More AEDs installed in buildings throughout the state means
that more lives will likely be saved from those suffering
sudden cardiac arrest.
ARGUMENTS IN SUPPORT: In support, the American Heart
Association states that:
Every year there are almost 424,000 out-of-hospital cardiac
arrests in the United States, and of this figure an
estimated 10,200 out-of-hospital cardiac arrests happen to
children. Sadly, only 10 percent of victims who suffer a
cardiac arrest outside of a hospital setting survive,
largely in part because many victims do not receive timely
CPR or AED application. Unfortunately, businesses and
institutions are not voluntarily installing AEDs because
current law mandates numerous requirements relating to
training, maintenance, and reporting in order to qualify
for liability exemption. . . . While the AHA believes that
requirements in current law are important, we know that
sudden cardiac arrest is 100 percent fatal if not treated
quickly. For every minute without CPR and defibrillation,
the chance of survival decreases by 7 to 10 percent.
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Also in support, a coalition of the California Business
Properties Association, the Building Owners and Managers
Association of California, the Commercial Real Estate
Development Association, NAIOP of California, and the
International Council of Shopping Centers writes that:
Existing law provides for rigorous standards for training
in the use of AEDs, regular testing of equipment and
liability for businesses that make them readily available.
These provisions, may have made sense over a decade ago,
but due to evolving technology and ease of AED use, have
since become an anachronism and are an impediment to
installation. SB 658 updates the statute to recognize the
fact that AEDs have proven to be safe and reliable.
Because of the life-saving potential of AEDs and their
proven efficacy, the state should encourage accessibility
in public places where cardiac arrest may be a significant
risk. SB 658 maintains appropriate liability where wrongful
death resulting from negligence or misconduct occurs and
does not excuse producers of AED equipment from their duty
to produce and distribute safe, life-saving equipment.
ARGUMENTS IN OPPOSITION: In opposition, Rescue Training
Institute, which provides CPR and AED training programs, argues
that, "Only through approved national training programs can one
learn how to confidently and competently perform CPR and utilize
an AED."
Similar Pending Legislation. SB 287 (Hueso) - Requires certain
structures that are not owned or operated by the state or any
local government entity and are constructed on or after January
1, 2016, to have an AED on the premises, require a person or
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entity that supplies an AED to comply with specified existing
law regarding AEDs, and exempt a person or entity supplying the
AED from liability for civil damages resulting from certain use,
attempted use, or nonuse of an AED. SB 287 is currently pending
hearing in the Assembly Business and Professions Committee.
REGISTERED SUPPORT / OPPOSITION:
Support
American Heart Association
American Red Cross
Association of California Healthcare Districts
Building Owners and Managers Association of California
California Ambulance Association
California Apartment Association
California Business Properties Association
California Chamber of Commerce
California District Attorneys Association
California Hospital Association
California Retailers Association
California State Firefighters' Association
California State Sheriffs' Association
Commercial Real Estate Development Association, NAIOP of
California
Civil Justice Association of California
El Camino Hospital
International Council of Shopping Centers
League of California Cities
Philips
Pulse Point Foundation
Racing Hearts
Santa Clara County Board of Supervisors
Santa Clara County Fire Chiefs' Association
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Silicon Valley Leadership Group
Stanford Children's Health - Lucile Packard Children's Hospital
Stanford Health Care
(One individual)
Opposition
Rescue Training Institute
Analysis Prepared by:Alison Merrilees / JUD. / (916)
319-2334