BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                     SB 658


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          SENATE THIRD READING


          SB  
          658 (Hill)


          As Amended  June 15, 2015


          Majority vote


          SENATE VOTE:  39-0


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          |Committee       |Votes|Ayes                  |Noes                |
          |                |     |                      |                    |
          |                |     |                      |                    |
          |                |     |                      |                    |
          |----------------+-----+----------------------+--------------------|
          |Judiciary       |10-0 |Mark Stone, Wagner,   |                    |
          |                |     |Alejo, Chau, Chiu,    |                    |
          |                |     |Gallagher,            |                    |
          |                |     |                      |                    |
          |                |     |                      |                    |
          |                |     |Cristina Garcia,      |                    |
          |                |     |Holden, Maienschein,  |                    |
          |                |     |O'Donnell             |                    |
          |                |     |                      |                    |
          |                |     |                      |                    |
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          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  








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          selection, installation, placement, and use of AEDs in those  
          facilities.  Specifically, among other things, this bill:


          1)Eliminates a number of requirements in existing law for a  
            person or entity that acquires an AED, as a condition for  
            obtaining qualified immunity, including the following:
             a)   To ensure that 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.  
             b)   To ensure that every AED is tested every 30 days.


          2)Revises the existing requirements for a person or entity that  
            acquires an AED, as a condition for obtaining qualified  
            immunity, requiring the person or entity to ensure the  
            following: the AED is maintained and tested on a regular basis  
            according to standards of the manufacturer; all regulations  
            governing the placement of an AED are satisfied; an agent of  
            the local EMS agency is notified of the existence, location,  
            and type of AED acquired; the AED is tested at least  
            biannually and after each use; all AEDs on the premises are  
            inspected at least every 90 days for potential issues related  
            to operability of the device; and all  records of the  
            maintenance and testing required pursuant to this paragraph  
            are maintained.
          3)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.









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          EXISTING LAW:  


          1)Among other things, 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.  


          2)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.  


          3)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  
            complies with applicable requirements.  


          4)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 laws governing the maintenance and  
            testing of the AED.  


          5)Provides that if an AED is placed in a public or private K-12  
            school, the principal must annually provide school  








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            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.  


          6)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.  


          FISCAL EFFECT:  None


          COMMENTS:  An 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), Chapter  
          163, Statutes 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.  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.  










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          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  
          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% of victims who suffer cardiac arrest  
          outside of a hospital survive the events.  Among young victims,  
          the survival rate is even lower: only about 5%.  Sudden cardiac  
          arrest kills nearly 1,000 people per day in the United States  
          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 eight to 12 minutes.  Each minute that  
          defibrillation is delayed reduces a person's chance of survival  
          by approximately 10%.




          Success of AEDs in Saving Lives and Performing as Designed and  








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          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.  
          Furthermore, according to the United States Department of Health  
          and Human Services - National Heart, Lung and Blood Institute,  
          there have been no reports of AEDs harming users or bystanders. 
          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).  




          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.










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          Analysis Prepared by:                                             
                          Alison Merrilees / JUD. / (916) 319-2334  FN:  
          0001066