BILL ANALYSIS Ó SB 658 Page 1 SENATE THIRD READING SB 658 (Hill) As Amended June 15, 2015 Majority vote SENATE VOTE: 39-0 ------------------------------------------------------------------ |Committee |Votes|Ayes |Noes | | | | | | | | | | | | | | | | |----------------+-----+----------------------+--------------------| |Judiciary |10-0 |Mark Stone, Wagner, | | | | |Alejo, Chau, Chiu, | | | | |Gallagher, | | | | | | | | | | | | | | |Cristina Garcia, | | | | |Holden, Maienschein, | | | | |O'Donnell | | | | | | | | | | | | ------------------------------------------------------------------ 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 SB 658 Page 2 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. SB 658 Page 3 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 SB 658 Page 4 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. SB 658 Page 5 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 SB 658 Page 6 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. SB 658 Page 7 Analysis Prepared by: Alison Merrilees / JUD. / (916) 319-2334 FN: 0001066