[Congressional Bills 105th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1670 Introduced in House (IH)]







105th CONGRESS
  1st Session
                                H. R. 1670

   To amend title 49, United States Code, to require air carriers to 
 establish procedures for responding to in-flight medical emergencies, 
                        and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                              May 20, 1997

 Mrs. Kennelly of Connecticut introduced the following bill; which was 
     referred to the Committee on Transportation and Infrastructure

_______________________________________________________________________

                                 A BILL


 
   To amend title 49, United States Code, to require air carriers to 
 establish procedures for responding to in-flight medical emergencies, 
                        and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Airline Passenger Safety Act of 
1997''.

SEC. 2. IN-FLIGHT MEDICAL EMERGENCIES.

    (a) In General.--Chapter 417 of title 49, United States Code, is 
amended by adding at the end the following:

            ``SUBCHAPTER III--IN-FLIGHT MEDICAL EMERGENCIES

``Sec. 41761. Treatment of in-flight medical emergencies
    ``(a) In-Flight Medical Emergency Procedures.--
            ``(1) Establishment.--Each air carrier shall--
                    ``(A) establish a detailed list of procedures to be 
                followed by the air carrier in the event of an in-
                flight medical emergency; and
                    ``(B) submit a copy of such procedures to the 
                Secretary not later than 180 days after the date of the 
                enactment of this subchapter.
            ``(2) Requirements.--
                    ``(A) Steps to be followed in medical 
                emergencies.--The procedures established by an air 
                carrier under paragraph (1) shall ensure that the 
                following steps are taken, in the order specified, in 
                the event of an in-flight medical emergency involving a 
                passenger of the carrier:
                            ``(i) Attending to the passenger.
                            ``(ii) Notifying the pilot in command.
                            ``(iii) Requesting assistance from 
                        medically-qualified passengers.
                            ``(iv) Consulting the in-flight medical 
                        care manual of the air carrier.
                    ``(B) Cardiac emergencies.--In addition to the 
                requirements of subparagraph (A), procedures 
                established by an air carrier under paragraph (1) shall 
                ensure that in the case of a cardiac emergency a 4-step 
                chain of survival plan is implemented which requires, 
                in the order specified, the following:
                            ``(i) Activation of the emergency medical 
                        system (ensuring that emergency call procedures 
                        are in place to summon skilled aid).
                            ``(ii) Cardiopulmonary resuscitation.
                            ``(iii) Defibrillation.
                            ``(iv) Getting the patient to a full care 
                        unit (such as a hospital) as soon as possible 
                        for advanced cardiac support.
                    ``(C) Level of assistance.--The procedures 
                established by an air carrier under paragraph (1) shall 
                afford the same level of assistance to passengers as 
                are afforded to members of the flight crew.
            ``(3) Availability of procedures to the public.--Each air 
        carrier shall provide to a passenger of the air carrier, upon 
        request of the passenger, a copy of the procedures established 
        by the carrier under paragraph (1).
    ``(b) Life-Saving Equipment and Appropriately Stocked First-Aid 
Kits and Medical Kits.--
            ``(1) In general.--On and after the 180th day following the 
        date of the enactment of this subchapter, each aircraft 
        operated by an air carrier in air transportation or intrastate 
        air transportation shall be equipped with--
                    ``(A) at least 1 piece of life-saving equipment 
                (such as an automated external defibrillator) for use 
                in responding to a cardiac emergency;
                    ``(B) at least 1 first-aid kit; and
                    ``(C) at least 1 medical kit;
        The air carrier shall restock such kits, as necessary, before 
        each flight segment.
            ``(2) Access to equipment.--Each member of the flight crew 
        on an aircraft described in paragraph (1) shall have access to 
        the life-saving equipment, first-aid kit, and medical kit 
        required under paragraph (1).
            ``(3) Periodic reviews.--The Secretary shall conduct 
        periodic reviews of the life-saving equipment, first-aid kits, 
        and medical kits required under paragraph (1) and shall require 
        such additional items to be included in the kits as the 
        Secretary determines appropriate.
    ``(c) In-Flight Emergency Procedures Manual.--
            ``(1) Establishment.--Each air carrier shall--
                    ``(A) train flight crew members in cardiopulmonary 
                resuscitation and operation of an automated external 
                defibrillator;
                    ``(B) establish an in-flight emergency procedures 
                manual, including cardiac medical emergency response 
                procedures; and
                    ``(C) submit such manual to the Secretary not later 
                than 180 days after the date of the enactment of this 
                subchapter.
            ``(2) Requirements.--The manual established by an air 
        carrier under paragraph (1) shall include, at a minimum, the 
        following:
                            ``(i) Instructions for the use of all items 
                        in first-aid kits and medical kits.
                            ``(ii) Procedures for handling cardiac 
                        emergencies and other immediately life-
                        threatening medical emergencies.
                            ``(iii) Basic emergency procedures, 
                        including cardiopulmonary resuscitation, 
                        operation of life-saving equipment (such as an 
                        automated external defibrillator), mouth-to-
                        mouth resuscitation, and administration of 
                        oxygen.
            ``(3) Equipping of manuals on aircraft.--On and after the 
        180th day following the date of the enactment of this 
        subchapter, each aircraft operated by an air carrier in air 
        transportation or intrastate air transportation shall be 
        equipped with the manual of the air carrier established under 
        paragraph (1), including at least 1 copy of the manual in the 
        cockpit and at least 1 copy of the manual next to each first-
        aid kit and medical kit on the aircraft.
    ``(d) Emergency Medical Care.--Each air carrier shall take such 
actions as may be necessary to ensure that--
            ``(1) each member of the flight crew on an aircraft 
        operated by the air carrier in air transportation or intrastate 
        air transportation has received training in cardiopulmonary 
        resuscitation, operation of life-saving equipment (such as an 
        automated external defibrillator), and emergency medical 
        training and first-aid procedures, including the use of each 
        supply in a first-aid kit; and
            ``(2) at least 1 member of the flight crew on such aircraft 
        is authorized to operate an automated external defibrillator 
        (or similar life-saving equipment) and to use a first-aid kit 
        and medical kit.
    ``(e) On-Ground Medical Contractor.--Each air carrier shall enter 
into a contract with a clinic, hospital, or other accredited medical 
care provider to provide the air carrier with medical advice at any 
time in the case of an in-flight medical emergency. Upon entering into 
such contract, the carrier shall submit the name of the medical care 
provider to the Secretary.
    ``(f) Assistance of Medically-Qualified Passengers.--Each air 
carrier shall take such actions as may be necessary to ensure that when 
an in-flight medical emergency takes place on an aircraft operated by 
the air carrier, the flight crew assigned to the aircraft will solicit 
the assistance of medically-qualified passengers. In soliciting such 
assistance, the flight crew shall announce that passengers who provide 
such assistance will be exempt from liability, as provided in section 
41768 of this title.
    ``(g) Responsibilities of Pilot in Command.--Each air carrier shall 
take such actions as may be necessary to ensure that when an in-flight 
medical emergency takes place on an aircraft operated by the air 
carrier, the pilot in command will solicit and consider the advice of a 
medical responder as to the condition of the passenger that is the 
subject of the emergency and, as appropriate, will take necessary 
actions for rerouting the aircraft to the nearest airport.
    ``(h) Lavatories.--Each air carrier shall take such actions as may 
be necessary to ensure that a member of the flight crew on an aircraft 
operated by the air carrier in air transportation or intrastate air 
transportation will check on any passenger that is inside a lavatory on 
the aircraft for more than 10 minutes.
``Sec. 41762. Ground procedures
    ``(a) Medical Personnel.--Not later than 6 months after the date of 
the enactment of this subchapter, the Secretary shall establish 
procedures to ensure that appropriate medical personnel, including a 
coroner in the event of the death of a passenger, are present to meet 
an aircraft upon the notification of an air traffic controller of an 
in-flight medical emergency.
    ``(b) Procedures.--
            ``(1) In general.--Not later than 6 months after the date 
        of the enactment of this subchapter, the Secretary shall 
        establish procedures for in-flight medical emergencies 
        requiring an emergency landing, including--
                    ``(A) establishing a medical facility to be 
                contacted when it is determined that an aircraft will 
                be landing at the airport after an in-flight medical 
                emergency; and
                    ``(B) designating an airport ground crew that will 
                meet the plane, including medical personnel assigned to 
                the airport.
            ``(2) Level of priority.--The procedures established by the 
        Secretary under paragraph (1) shall ensure that an aircraft 
        that is rerouted as the result of an in-flight medical 
        emergency will be afforded the same level of priority for 
        landing as an aircraft that is experiencing mechanical 
        malfunctions.
    ``(c) Facilities in Terminals.--Each air carrier providing air 
transportation or intrastate air transportation shall establish a plan, 
and adequate facilities and pathways in the terminal on the ground, to 
facilitate attending to, and as necessary transferring, patients who 
are removed ill from an aircraft or who become ill in the terminal.
``Sec. 41763. Aircraft specifications
    An air carrier may not purchase or lease any aircraft manufactured 
after the 180th day after the date of the enactment of this subchapter 
unless the aircraft is equipped with an emergency call button in each 
lavatory on the aircraft.
``Sec. 41764. Incident reports
    ``(a) Reports by Air Carriers.--
            ``(1) In general.--Each air carrier shall transmit to the 
        Secretary, within 48 hours of any in-flight medical emergency 
        occurring on an aircraft operated by the carrier, a report 
        containing a description of the emergency. Upon receipt of a 
        report, the Secretary shall make the report available to the 
        public.
            ``(2) Contents.--A report transmitted under paragraph (1) 
        shall contain, at a minimum, the following:
                    ``(A) A statement of the time that the emergency 
                was first made known to a member of the flight crew.
                    ``(B) A detailed description of the actions 
                relating to and taken in response to the emergency, 
                including the time each action occurred.
                    ``(C) A detailed description of the symptoms of the 
                passenger that experienced the emergency, including the 
                time each symptom was recognized.
                    ``(D) A detailed description of any medical 
                treatment provided to the passenger, including a list 
                of any equipment used in providing such treatment from 
                a first-aid kit or medical kit and the name, title, and 
                address of any person providing such treatment.
                    ``(E) A detailed description of any communication 
                initiated by the pilot in command to an air traffic 
                controller or an on-ground medical contractor, 
                including the time of the communication.
                    ``(F) A detailed description of any medical advice 
                provided by an on-ground medical contractor or a 
                medically-qualified passenger.
                    ``(G) A statement of the time of any decision to 
                reroute the aircraft as a result of the emergency.
                    ``(H) A statement of the name and qualifications of 
                any medically-qualified passengers who assisted in the 
                emergency.
                    ``(I) An assurance that all records concerning the 
                emergency (including records concerning actions taken 
                in-flight and on the ground) were filed by the air 
                carrier with appropriate Federal, State, and local 
                authorities within 24 hours of the emergency.
    ``(b) Reports by Air Traffic Control.--Each air traffic controller 
shall transmit to the Secretary, within 48 hours of any in-flight 
medical emergency reported to the controller, a report on any actions 
taken by the controller in response to an in-flight medical emergency 
that required an emergency landing.
    ``(c) Consultation With Medical Facility.--After receiving a report 
from an air carrier under this section concerning an in-flight medical 
emergency, the Secretary shall--
            ``(1) consult with the medical facility to which the 
        passenger was transferred after the flight to determine whether 
        the passenger was released from the facility and the final 
        condition of the passenger; and
            ``(2) include information obtained pursuant to paragraph 
        (1) in the report.
``Sec. 41765. Family notification
    ``(a) Responsibilities of Air Carrier.--
            ``(1) Initial notice.--As soon as practicable after the 
        time of an in-flight medical emergency involving a passenger of 
        an air carrier, the air carrier shall notify the family of the 
        passenger about the emergency.
            ``(2) Copy of report submitted to secretary.--Not later 
        than 1 week after the date of the emergency, the air carrier 
        shall provide to the family of the passenger a complete copy of 
        the report concerning the emergency submitted to the Secretary 
        pursuant to section 41764(a) of this title.
    ``(b) Responsibilities of the Secretary.--
            ``(1) Appointment of liaison.--Not later than 48 hours 
        after an in-flight medical emergency, the Secretary shall 
        appoint an individual within the Department of Transportation 
        to serve as a liaison to family members of the passenger.
            ``(2) Copy of report submitted by air traffic.--Not later 
        than 1 week after the date of the medical emergency, the 
        Secretary shall provide to the family of the passenger a copy 
        of any report concerning the emergency submitted to the 
        Secretary by an air traffic controller pursuant to section 
        41764(b) of this title.
``Sec. 41766. Compliance
    ``(a) Review of Air Carrier Compliance.--
            ``(1) In general.--Not later than 1 year after the date of 
        the enactment of this subchapter, the Secretary shall conduct a 
        review of the compliance of each air carrier with the 
        requirements of this subchapter.
            ``(2) Contents of review.--In conducting a review of an air 
        carrier under subsection (a), the Secretary, at a minimum, 
        shall--
                    ``(A) review the in-flight medical emergency 
                procedures of the air carrier;
                    ``(B) review the in-flight medical emergency 
                procedures manual of the air carrier;
                    ``(C) conduct checks to determine whether life-
                saving equipment are in proper working order and 
                whether first-aid kits and medical kits of the air 
                carrier are fully stocked; and
                    ``(D) conduct checks to determine whether emergency 
                call buttons on aircraft operated by the air carrier 
                are operational.
    ``(b) Review of Airport Compliance.--Not later than 1 year after 
the date of the enactment of this subchapter, the Secretary shall 
conduct a review of the procedures established at each airport for 
meeting passengers with medical emergencies.
``Sec. 41767. Studies
    ``(a) Statistics on In-Flight Medical Emergencies.--
            ``(1) In general.--The Secretary shall keep statistics on 
        the number of in-flight medical emergencies occurring each year 
        based on reports submitted to the Secretary by air carriers and 
        air traffic controllers and shall make such statistics 
        available to the public.
            ``(2) Annual list.--The Secretary shall publish on an 
        annual basis in the Federal Register a list of the number of 
        in-flight emergencies occurring in the preceding year. Such 
        list shall categorize such emergencies by type of illness, type 
        of treatment afforded, whether or not the aircraft was 
        rerouted, and the final condition of the passenger.
    ``(b) Use of Satellite Communications.--
            ``(1) Study.--The Secretary shall conduct a study of the 
        feasibility of using satellite communications of Global 
        Position Satellites as a method of improving communications 
        between pilots, ground medical personnel, and air traffic 
        controllers.
            ``(2) Report.--Not later than 1 year after the date of the 
        enactment of this subchapter, the Secretary shall transmit to 
        Congress a report on the results of the study conducted under 
        paragraph (1).
``Sec. 41768. Limitations on liability
    ``(a) Liability of Air Carriers.--An air carrier shall not be 
liable for damages in any action brought in a Federal or State court 
arising out of the performance of the air carrier in obtaining or 
attempting to obtain the assistance of a medically-qualified passenger 
in the case of an in-flight medical emergency.
    ``(b) Liability of Individuals.--An individual shall not be liable 
for damages in any action brought in a Federal or State court arising 
out of the performance of the individual in providing or attempting to 
provide medical treatment in the case of an in-flight medical 
emergency.
``Sec. 41769. Definitions
    In this subchapter, the following definitions apply:
            ``(1) First-aid kit.--The term `first-aid kit' means a kit 
        that includes standard supplies commonly found in a physicians 
        bag, including endotrachial tubing, bicarbonate of soda, and 
        such additional items as the Secretary determines appropriate.
            ``(2) In-flight medical emergency.--The term `in-flight 
        medical emergency' means a medical emergency occurring during a 
        flight in air transportation or intrastate air transportation.
            ``(3) Medical emergency.--The term `medical emergency' 
        includes--
                    ``(A) heart emergencies, including cardiac arrest;
                    ``(B) lack of breathing or shortness of breath;
                    ``(C) loss of consciousness;
                    ``(D) stroke;
                    ``(E) profuse bleeding;
                    ``(F) shock; and
                    ``(G) such other emergencies as the Secretary 
                determines appropriate.
            ``(4) Medical kit.--The term `medical kit' means a kit that 
        includes--
                    ``(A) a portable defibrillator;
                    ``(B) portable oxygen bottles (or canisters) and 
                tubing (with necessary endotrachial masks);
                    ``(C) lidocaine;
                    ``(D) epinephrine;
                    ``(E) nitroglycerine tablets; and
                    ``(F) such additional items as the Secretary 
                determines appropriate.
            ``(5) On-ground medical contractor.--The term `on-ground 
        medical contractor' means a medical care provider with which an 
        air carrier has entered into a contract under section 41761(e) 
        of this title.
            ``(6) Secretary.--The term `Secretary' means the Secretary 
        of Transportation.''.
    (b) Conforming Amendment.--The table of sections for such chapter 
is amended by adding at the end the following:

            ``SUBCHAPTER III--IN-FLIGHT MEDICAL EMERGENCIES

``41761.  Treatment of in-flight medical emergencies.
``41762.  Ground procedures.
``41763.  Aircraft specifications.
``41764.  Incident reports.
``41765.  Family notification.
``41766.  Compliance.
``41767.  Studies.
``41768.  Limitations on liability.
``41769.  Definitions.''.
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