BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 1312
                                                                  Page 1

          Date of Hearing:  May 5, 2009

                           ASSEMBLY COMMITTEE ON JUDICIARY
                                  Mike Feuer, Chair
                AB 1312 (Swanson) - As Introduced:  February 27, 2009
           
                     PROPOSED CONSENT (As Proposed to be Amended)
           
          SUBJECT  :  AUTOMATIC EXTERNAL DEFIBRILLATORS: HEALTH STUDIOS
           
          KEY ISSUES  :

          1)SHOULD THE JULY 12, 2012 SUNSET DATE FOR A PROVISION WHICH  
            ENCOURAGES AVAILABILITY OF AN AED, A LIFESAVING DEVICE IN THE  
            EVENT OF A CARDIAC ARREST, BY REQUIRING MAINTENANCE OF AND  
            STAFF TRAINING FOR AED USE AT HEALTH STUDIOS, BE EXTENDED AN  
            ADDITIONAL 5 YEARS, TO JULY 1, 2014?

          2)SHOULD THE AED MAINTENANCE AND TRAINING REQUIREMENTS ALSO  
            EXTEND TO TWO OTHER PUBLIC PLACES WHERE THE ODDS OF CARDIAC  
            ARREST ARE INCREASED, NAMELY, GOLF COURSES AND AMUSEMENT  
            PARKS?
                                          
           FISCAL EFFECT  :  As currently in print this bill is keyed  
          non-fiscal.

                                      SYNOPSIS

          This bill is part of a continuing effort by policymakers in  
          California to encourage the proliferation and use of automatic  
          external defibrillators (AEDs) in easily accessible public  
          locations.  AEDs are portable medical devices used to administer  
          an electric shock through the chest wall to the heart after  
          someone suffers cardiac arrest.  They are reportedly "fail-safe"  
          and there has been no known successful lawsuit brought against  
          an individual for the use or misuse of these devices.  This  
          Committee has, with the help of the American Heart Association,  
          the Consumer Attorneys of California, and other interested  
          parties, helped fashion several measures over the years to help  
          spur the availability and use of AEDs.  

          This measure seeks to extend the sunset date for the current  
          requirement that health studios purchase and maintain AEDs by an  
          additional 5 years, until July 1, 2014.  In addition, the bill  
          seeks to extend the AED maintenance and training requirement to  








                                                                  AB 1312
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          two other types of public places where an AED could be a vital  
          lifesaving device: golf courses and amusement parks.

           SUMMARY  :  Seeks to extend by 5 years the requirement that all  
          health studios in California have automatic external  
          defibrillators (AEDs) available with AED-trained personnel  
          present to help save the lives of club members who might  
          experience cardiac arrest, and seeks to require that golf clubs  
          and amusement parks also provide visitors with AED assistance in  
          case of a cardiac arrest.  Specifically,  this   bill  :

          1)Extends by 5 years the sunset date of the requirement in  
            Health and Safety Code section 104113, that every health  
            studio, as defined in Civil Code Section 1812.81, acquire AED  
            devices, train personnel in their proper use, and maintain  
            AED-trained personnel on site during all operating hours, such  
            that the new sunset will be July 1, 2014.  

          2)Extends the requirement, to include golf courses and amusement  
            parks, requiring these facilities to acquire AED devices,  
            train personnel in their proper use, and maintain AED-trained  
            personnel on site during all operating hours.  
           
          EXISTING LAW  :  

          1)Provides immunity from civil liability to any person who, in  
            good faith and without compensation or the expectation of  
            compensation, renders emergency care at the scene of an  
            emergency.  (Health & Safety Code section 1799.102.)

          2)Provides immunity from civil liability to any person who  
            completes a designated CPR course and who, in good faith,  
            renders emergency cardiopulmonary resuscitation at the scene  
            of an emergency, without the expectation of receiving  
            compensation for providing the emergency care.  (Civil Code  
            section 1714.2.)

          3)Exempts from civil liability any local agency, entity of state  
            or local government, or other public or private organization  
            which sponsors, authorizes, supports, finances, or supervises  
            the training of citizens in cardiopulmonary resuscitation  
            (CPR).  (Health & Safety Code section 1799.100.)

          4)Provides immunity from liability for certain trained persons  
            who in good faith and without compensation use an AED in  








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            rendering emergency care or treatment at the scene of an  
            emergency.  This qualified immunity does not apply in the case  
            of personal injury or wrongful death resulting from the AED  
            operator's gross negligence or willful or wanton misconduct.   
            Nor does it apply to the manufacturer, designer, developer,  
            distributor, installer, or supplier of an AED or  
            defibrillator.  It only applies to:

             a)   any person who, in good faith and not for compensation,  
               renders emergency care or treatment by the use of an AED at  
               the scene of an emergency, when the person has completed a  
               specified training course within the preceding 12 months;

             b)   a person or entity who provides CPR and AED training to  
               the "Good Samaritan" rendering emergency care with the use  
               of an AED;

             c)   a physician who prescribes the AED and any person or  
               entity responsible for the site where an AED is located,  
               for negligent acts of the "Good Samaritan" in rendering  
               emergency care with an AED, if that physician, person, or  
               entity has complied with certain training and maintenance  
               requirements.  (Civil Code section 1714.21 and Health &  
               Safety Code section 1797.196.)

          5)Substantially relaxes the requirement that building owners and  
            others who acquire AEDs must ensure that expected AED users  
            complete an accepted CPR and AED course as a condition of  
            immunizing that building owner from any liability arising from  
            the use of the acquired AED.  Maintained the requirement that  
            any immunities from civil liabilities in this context would  
            not apply in cases of gross negligence or willful or wanton  
            misconduct.  (Health & Safety Code section 1797.196.)

          6)Requires every health studio, as defined in Civil Code Section  
            1812.81, until July 1, 2012, to acquire an AED, and maintain  
            and train personnel in the use of the acquired AED.  (Health &  
            Safety Code section 104113.)


           COMMENTS  :  This bill is part of a continuing and laudable effort  
          by policymakers in California to encourage the proliferation and  
          use of automatic external defibrillators (AEDs) in easily  
          accessible public locations to save lives.  AEDs are portable  
          medical devices used to administer an electric shock through the  








                                                                  AB 1312
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          chest wall to the heart after someone suffers cardiac arrest.   
          They are reportedly "fail-safe," and there apparently has been  
          no successful lawsuit brought against an individual for the use  
          or misuse of these devices.  This Committee has, with the help  
          of the American Heart Association, the Consumer Attorneys of  
          California, and other interested parties, helped fashion several  
          measures over the years to help spur the availability and use of  
          AEDs.  This measure, following in those earlier bills'  
          footsteps, seeks to extend the sunset date by 5 years for the  
          requirement that health studios purchase and maintain AEDs for  
          possible use by club personnel to potentially save lives, train  
          staff in their proper use, and maintain staff on the premises  
          during all operating hours, such that the new sunset will be  
          July 1, 2014.  The bill would also extend these requirements to  
          golf clubs and amusement parks.  


           AEDs can save lives  .  According to the American Heart  
          Association (AHA), cardiac arrest is a life-or-death situation,  
          and the patient has very little chance of survival without  
          defibrillation.  However, the window of opportunity for saving  
          lives through defibrillation is very small, being only 10-13  
          minutes even if CPR is administered correctly.  According to the  
          AHA, in cases of sudden cardiac arrest, CPR is merely a  
          maintenance tool, and defibrillation must take place to "shock"  
          the patient's heart into a proper working rhythm.  Thus, the  
          public would be better served, and lives could be saved, if  
          businesses and offices across California are better encouraged  
          to have AEDs on site.  

           No risk of accidental misuse, according to the American Heart  
          Association  .  According to the AHA, AEDs contain microcomputers  
          to accurately identify sudden cardiac arrests and make extensive  
          use of audible prompting and signals to provide operators with  
          clear and concise instruction, making their use uncomplicated,  
          intuitive, and nearly foolproof.  Safeguards are built in to  
          protect both operator and victim and to ensure that the AED will  
          only deliver a shock if, in fact, the device affirmatively  
          determines that a victim is in sudden cardiac arrest.  Further,  
          the device does not allow for manual overrides, in the event a  
          panicked operator tries to administer the shock even when the  
          device finds that the victim is not in cardiac arrest.

           Other states' AED requirements  .  Several other states require  
          AEDs (and trained staff) at health studios, including Illinois,  








                                                                  AB 1312
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          Indiana, Massachusetts, Michigan, New Jersey, and New York.   
          None of these states' statutes have sunset provisions, therefore  
          it is reasonable for California to extend the sunset provision  
          in Health and Safety Code section 104113.

          Some states require AEDs at facilities other than health  
          studios.  Illinois and New York require AEDs at certain school  
          (fitness) facilities and events.  New York state additionally  
          requires AEDs at "places of public assembly," defined as places  
          with an occupancy capacity of 1,000 or more, including stadiums,  
          ballparks, and similar sporting event facilities; as well as  
          concert halls and other facilities where musical concerts are  
          given; but does not include churches or libraries.  (NY Public  
          Health Law section 225, 5-b(c)).  New York City has very broad  
          AED requirements, mandating that they be provided by operators  
          of all "public places," "in quantities and locations deemed  
          adequate," in a manner such that the AEDs be "readily accessible  
          for use during medical emergencies."  (NY Administrative Code  
          section 17-188.)  "Public places" include public buildings,  
          parks, nursing homes, ferry terminals, senior centers, golf  
          courses, and sports arenas.  Given that other states have done  
          so, it is reasonable for California to extend its AED  
          requirements to public places other than health studios.

           Need for AEDs at golf clubs and amusement parks  .  According to  
          the Golf Course Superintendents Association of America's  
          website, "Sudden cardiac arrest is the number one killer on golf  
          courses, and according to Golf Digest, golf courses rank fifth  
          in places where sudden cardiac arrest is most likely to occur."   
          The Red Cross website states, "Golf courses and sports stadiums  
          are two of the top five most likely spots for cardiac arrest"  
          and that, "although sudden cardiac arrest can happen anywhere,  
          the odds skyrocket in busy locations such as airports and train  
          stations."  According to the International Association of  
          Amusement Parks and Attractions' website, "Most large amusement  
          parks and aquatic facilities already have AEDs on site in  
          multiple locations."  Neither the GCSAA nor the IAAPA recommends  
          that their respective facilities be required to maintain AEDs,  
          but they do recommend voluntary AED acquisition and training.   
          Therefore, given the prevalence of cardiac arrest on golf  
          courses, the busy nature of amusement parks, and the fact that  
          professional organizations for both types of facilities are  
          recommending AED acquisition and training, it does seem  
          reasonable to require AEDs in those places. 









                                                                  AB 1312
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           PRIOR LEGISLATION  :  AB 2041 (Vargas) of 2002, Ch. 718 of 2002,  
          broadened the current immunity for the use or purchase of an AED  
          in an effort to encourage their purchase and use, repealed the  
          CPR and AED use training requirement for a Good Samaritan user  
          of an AED in rendering emergency care, and substantially relaxed  
          the requirement that building owners and others who acquire AEDs  
          ensure that expected AED users complete an accepted CPR and AED  
          course as a condition of immunizing the building owners from  
          liability arising from the use of the AED. 

          SB 911 (Figueroa) of 1999, Ch. 163 of 1999, provided for  
          qualified immunity to "Good Samaritans" who voluntarily apply  
          AEDs at the scene of an emergency to try to save heart victim's  
          lives, so long as those persons had training in the use of an  
          AED.  

          AB 1507 (Pavely) of 2005, Ch. 431 of 2005, required every health  
          studio, as defined, to acquire an AED, provided immunity for  
          providing the devices, and established standards for providing  
          the devices, including training and maintaining staff as to AED  
          use; required health studios that chose to voluntarily acquire  
          AEDs on or after the sunset date of July 1, 2012 to maintain and  
          train personnel in AED use and provided for related immunity.

           REGISTERED SUPPORT / OPPOSITION  :   

           Support 
           
          None on file

           Opposition 
           
          None on file

           Analysis Prepared by  :  Drew Liebert and Rachel Anderson / JUD. /  
          (916) 319-2334