BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  SB 1436
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          Date of Hearing:   June 19, 2012

                           ASSEMBLY COMMITTEE ON JUDICIARY
                                  Mike Feuer, Chair
                    SB 1436 (Lowenthal) - As Amended:  May 8, 2012

                                  PROPOSED CONSENT

           SENATE VOTE  :  37-0
           
          SUBJECT  :  Automatic External Defibrillators (AED's): Sunset 
          removal

           KEY ISSUE  :  SHOULD THE EXISTING QUALIFIED IMMUNITY AND TRAINING 
          AND OTHER REQUIREMENTS RELATED to the USE OF AEDs BE MADE 
          PERMANENT?

                                      SYNOPSIS

          Under existing law, which sunsets January 1, 2013, a person or 
          entity who acquires an automated external defibrillator (AED) is 
          not liable for any civil damages resulting from any acts or 
          omissions when the AED is used to render emergency care, so long 
          as the person or entity has complied with specified maintenance, 
          training, and notice requirements.  This bill would delete the 
          approaching sunset date, thus making permanent the existing 
          qualified immunity, training and other requirements related to 
          the use of these lifesaving tools.

          Proponents of this bill, including the American Heart 
          Association and the California Medical Association, note that 
          placing AEDs in buildings can and does save lives, and that 
          building owners should not be deterred from buying and 
          installing AEDs out of any fear of potential liability if the 
          AED is used or not used during a medical emergency.  This bill 
          will encourage the continuing purchase and placement of AEDs in 
          public and private buildings by providing a permanent qualified 
          immunity to the building owner for the provision and use of an 
          AED.  The bill is sponsored by the American Heart Association 
          and supported by emergency personnel organizations and building 
          and business property associations with no known opposition.

          SUMMARY  :  Incentivizes facilities to obtain and make available 
          life-saving AEDs.  Specifically,  this bill  makes permanent the 
          existing protections, which would otherwise sunset on January 1, 








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          2013, that provide general immunity from civil damages in 
          connection with the use of AEDs as long as specified 
          maintenance, training, and notice requirements are met.

           EXISTING LAW  :

          1)Provides for immunity from liability for any person who, in 
            good faith and not for compensation, renders emergency care 
            using an AED at the scene of an emergency.  (Civil Code 
            Section 1714.21(b).)

          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 the maintenance, training, and notice requirements 
            described in more detail below.  (Civil Code Section 
            1714.21(d).)

          3)Provides that the qualified immunity described above does not 
            apply in the case of personal injury or wrongful death that 
            results from the gross negligence or willful or wanton 
            misconduct of the person who uses the AED to render emergency 
            care.  (Civil Code Section 1714.21(f).)

          4)Until January 1, 2013, 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 does all of the following:

             a)   Complies with all regulations governing the placement of 
               an AED; 
             b)   Ensures all of the following:
               i)     the AED is maintained and regularly tested as 
                 specified; 
               ii)    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.  Records of these checks must be 
                 maintained;
               iii)   that any person who renders emergency care using the 
                 AED activates the emergency medical services system as 
                 soon as possible, and reports any use of the AED to the 
                 licensed physician and to the local EMS agency;
               iv)    for every AED unit acquired up to five units, at 
                 least one employee per unit must complete a training 








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                 course in cardiopulmonary resuscitation and AED use.  
                 After the first five AED units are acquired, for each 
                 additional five units acquired, one employee shall be 
                 trained beginning with the first unit acquired.  
                 Acquirers of AEDs must have trained employees who should 
                 be available to respond to an emergency that may involve 
                 the use of an AED during normal operating hours;
               v)     there is a written plan describing the procedures to 
                 be followed in the event of an emergency that may involve 
                 using an AED as specified.
             c)   Building owners must annually provide tenants with a 
               brochure describing the proper use of an AED as specified, 
               and also ensure that similar information is posted next to 
               any installed AED;
             d)   Building owners must notify tenants as to the location 
               of AED units in the building at least once a year; and 
             e)   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.  (Health & Safety Code Section 
               1797.196(b).)

          5)Until January 1, 2013, requires any person or entity that 
            supplies an AED shall: (1) notify an agent of the local EMS 
            agency of the existence, location, and type of AED acquired; 
            and (2) provide the AED acquirer with information regarding 
            the AED's use, installation, operation, training, and 
            maintenance.  (Health & Safety Code Section 1797.196(c).) 

          6)Until January 1, 2013, provides that the qualified immunity 
            described above does not apply in the case of personal injury 
            or wrongful death that results from the gross negligence or 
            willful or wanton misconduct of the person who uses the AED to 
            render emergency care.  (Health & Safety Code Section 
            1797.196(e).)

          7)Until January 1, 2013, specifies that nothing in Health and 
            Safety Code Section 1797.196 or Civil Code Section 1714.21 may 
            be construed to require a building owner or a building manager 
            to acquire and install an AED in any building.  (Health & 
            Safety Code Section 1797.196(f).)









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          8)Provides that the above-described provisions sunset on January 
            1, 2013 and, after that date, are replaced by other provisions 
            that do not provide for immunity, but require maintenance of 
            the unit and training for expected AED users.  (Health & 
            Safety Code Section 1797.196(g).)

           FISCAL EFFECT  :  As currently in print this bill is keyed 
          non-fiscal.

           COMMENTS  :  In 1999, the Legislature passed and the Governor 
          signed SB 911 (Figueroa, Ch. 163, Stats. 1999) which created a 
          qualified immunity from civil liability for trained persons who 
          use AEDs in good faith and without compensation when rendering 
          emergency care or treatment at the scene of an emergency.  The 
          bill also provided qualified immunity from liability for 
          building owners who installed AEDs as long as they ensured that 
          expected AED users completed a training course.  AB 2041 
          (Vargas, Ch. 718, Stats. 2002) expanded this immunity by 
          repealing the training requirements for good faith users and 
          also relaxed the requirement that building owners must ensure 
          that expected users complete training as a condition of 
          immunity.  AB 2041 was enacted with a five-year sunset which was 
          extended another five years to January 1, 2013 by AB 2083 
          (Vargas, Ch. 85, Stats. 2006).  This bill finally deletes the 
          sunset, thus making these provisions permanent.

          In support, the author states:

               Each year 295,000 sudden cardiac arrests occur in the 
               United States that are treated outside of hospitals with 
               emergency services.  Approximately 20% of these events 
               occur in the presence of a witness.  The key to surviving a 
               sudden cardiac arrest is to administer CPR and the use of 
               an AED by a bystander.  The AED returns a person's heart to 
               a normal rhythm.

               Studies show that when CPR and AEDs are used within three 
               to five minutes from the onset of collapse, the survival 
               rate of a sudden cardiac arrest victim is as high as 50 to 
               70 percent.  For every minute without a shock to the heart, 
               the chance of survival decreases by 7 to 10 percent?

               Under current law, in order to be granted immunity from 
               liability, voluntary acquirers of AEDs, which include 
               building owners, schools, churches, senior centers and 








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               others, must adhere to requirements governing the placement 
               of AEDs.  The requirements address, among other subjects, 
               training, maintenance, and written plans.

               On January 1, 2013, current law - which has been in effect 
               for more than ten years - sunsets and different 
               requirements will take effect that are less clear and are 
               problematic in other respects.

          An AED is a medical device which is used to administer an 
          electric shock through the chest wall to the heart after someone 
          suffers cardiac arrest.  Built-in computers 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. 
           
           The American Heart Association, sponsor of the measure, writes 
          that "removing the sunset entirely creates more certainty 
          related to requirements that building owners and other voluntary 
          acquirers of AEDs must meet in order to be immune from civil 
          liability, likely resulting in more AED installations and 
          greater Good Samaritan access."
           
          Good Samaritan protection already provided to laypersons; this 
          bill applies to those who acquire an AED, such as building 
          owners  .  To be clear, existing law already provides immunity 
          protection to laypersons who use an AED to render emergency 
          care, provided that they do not act with gross negligence or 
          willful or wanton misconduct.  When this provision was first 
          enacted, it contained a training requirement for these 
          laypersons.  However, in 2002, the Legislature passed and the 
          governor signed AB 2041 (Vargas), which removed this training 
          requirement and substantially relaxed the training requirement 
          for building owners.  It was thought to be appropriate to treat 
          these two parties differently with respect to training since it 
          would be difficult to train every potential rescuer, but much 
          less difficult to train every anticipated rescuer (i.e., 
          specified employees).  

          According to the California Medical Association, without 
          extending existing provisions as this bill does, "�t]hese 
          changes could lead to confusion and lack of compliance on the 
          part of facilities that currently maintain the devices, possibly 
          leading them to get rid of their AED altogether for fear of 
          violating the new requirements."








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          REGISTERED SUPPORT / OPPOSITION  :

           Support 
           
          American Heart Association (sponsor)
          Building Owners and Managers Association of California
          California Ambulance Association
          California Apartment Association
          California Business Properties Association
          California Chapter of the American College Cardiology
          California Chapters of the American Red Cross
          California Medical Association
          California Professional Firefighters
          California State PTA
          California State Sheriffs' Association
          CDF Firefighters Local 2881
          City of Ventura
          Civil Justice Association of California
          League of California Cities
           
            Opposition 
           
          None on file


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