[Congressional Record Volume 144, Number 34 (Tuesday, March 24, 1998)]
[House]
[Pages H1403-H1406]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                AVIATION MEDICAL ASSISTANCE ACT OF 1998

  Mr. DUNCAN. Mr. Speaker, I move to suspend the rules and pass the 
bill (H.R. 2843) to direct the Administrator of the Federal Aviation 
Administration to reevaluate the equipment in medical kits carried on, 
and to make a decision regarding requiring automatic external 
defibrillators to be carried on, aircraft operated by air carriers, and 
for other purposes, as amended.
  The Clerk read as follows:

                               H.R. 2843

       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 ``Aviation Medical Assistance 
     Act of 1998''.

     SEC. 2. MEDICAL KIT EQUIPMENT AND TRAINING.

       Not later than 1 year after the date of the enactment of 
     this Act, the Administrator of the Federal Aviation 
     Administration shall reevaluate regulations regarding (1) the 
     equipment required to be carried in medical kits of aircraft 
     operated by air carriers, and (2) the training required of 
     flight attendants in the use of such equipment, and, if the 
     Administrator determines that such regulations should be 
     modified as a result of such reevaluation, shall issue a 
     notice of proposed rulemaking to modify such regulations.

     SEC. 3. REPORTS REGARDING DEATHS ON AIRCRAFT.

       (a) In General.--During the 1-year period beginning on the 
     90th day following the date of the enactment of this Act, a 
     major air carrier shall make a good faith effort to obtain, 
     and shall submit quarterly reports to the Administrator of 
     the Federal Aviation Administration on, the following:
       (1) The number of persons who died on aircraft of the air 
     carrier, including any person who was declared dead after 
     being removed from such an aircraft as a result of a medical 
     incident that occurred on such aircraft.
       (2) The age of each such person.
       (3) Any information concerning cause of death that is 
     available at the time such person died on the aircraft or is 
     removed from the aircraft or that subsequently becomes known 
     to the air carrier.
       (4) Whether or not the aircraft was diverted as a result of 
     the death or incident.
       (5) Such other information as the Administrator may request 
     as necessary to aid in a decision as to whether or not to 
     require automatic external defibrillators in airports or on 
     aircraft operated by air carriers, or both.
       (b) Format.--The Administrator may specify a format for 
     reports to be submitted under this section.

     SEC. 4. DECISION ON AUTOMATIC EXTERNAL DEFIBRILLATORS.

       (a) In General.--Not later than 120 days after the last day 
     of the 1-year period described in section 3, the 
     Administrator of the Federal Aviation Administration shall 
     make a decision on whether or not to require automatic 
     external defibrillators on passenger aircraft operated by air 
     carriers and whether or not to require automatic external 
     defibrillators at airports.
       (b) Form of Decision.--A decision under this section shall 
     be in the form of a notice of proposed rulemaking requiring 
     automatic external defibrillators in airports or on passenger 
     aircraft operated by air carriers, or both, or a 
     recommendation to Congress for legislation requiring such 
     defibrillators or a notice in the Federal Register that such 
     defibrillators should not be required in airports or on such 
     aircraft. If a decision under this section is in the form of 
     a notice of proposed rulemaking, the Administrator shall make 
     a final decision not later than the 120th day following the 
     date on which comments are due on the notice of proposed 
     rulemaking.
       (c) Contents.--If the Administrator decides that automatic 
     external defibrillators should be required--
       (1) on passenger aircraft operated by air carriers, the 
     proposed rulemaking or recommendation shall include--
       (A) the size of the aircraft on which such defibrillators 
     should be required;
       (B) the class flights (whether interstate, overseas, or 
     foreign air transportation or any combination thereof) on 
     which such defibrillators should be required;
       (C) the training that should be required for air carrier 
     personnel in the use of such defibrillators; and
       (D) the associated equipment and medication that should be 
     required to be carried in the aircraft medical kit; and
       (2) at airports, the proposed rulemaking or recommendation 
     shall include--
       (A) the size of the airport at which such defibrillators 
     should be required;
       (B) the training that should be required for airport 
     personnel in the use of such defibrillators; and
       (C) the associated equipment and medication that should be 
     required at the airport.
       (d) Limitation.--The Administrator may not require 
     automatic external defibrillators on helicopters and on 
     aircraft with a maximum payload capacity (as defined in 
     section 119.3 of title 14, Code of Federal Regulations) of 
     7,500 pounds or less.
       (e) Special Rule.--If the Administrator decides that 
     automatic external defibrillators should be required at 
     airports, the proposed rulemaking or recommendation shall 
     provide that the airports are responsible for providing the 
     defibrillators.

     SEC. 5. 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 
     passenger in an in-flight medical emergency, or out of the 
     acts or omissions of the passenger rendering the assistance, 
     if the passenger is not an employee or agent of the carrier 
     and the carrier in good faith believes that the passenger is 
     a medically qualified individual.
       (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 acts or omissions of the 
     individual in providing or attempting to provide assistance 
     in the case of an in-flight medical emergency unless the 
     individual, while rendering such assistance, is guilty of 
     gross negligence or willful misconduct.

     SEC. 6. DEFINITIONS.

       In this Act--
       (1) the terms ``air carrier'', ``aircraft'', ``airport'', 
     ``interstate air transportation'', ``overseas air 
     transportation'', and ``foreign air transportation'' have the 
     meanings such terms have under section 40102 of title 49, 
     United States Code;
       (2) the term ``major air carrier'' means an air carrier 
     certificated under section 41102 of title 49, United States 
     Code, that accounted for at least 1 percent of domestic 
     scheduled-passenger revenues in the 12 months ending March 31 
     of the most recent year preceding the date of the enactment 
     of this Act, as reported to the Department of Transportation 
     pursuant to part 241 of title 14 of the Code of Federal 
     Regulations; and
       (3) the term ``medically qualified individual'' includes 
     any person who is licensed, certified, or otherwise qualified 
     to provide medical care in a State, including a physician, 
     nurse, physician assistant, paramedic, and emergency medical 
     technician.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Tennessee (Mr. Duncan) and the gentleman from Illinois (Mr. Lipinski) 
each will control 20 minutes.
  The Chair recognizes the gentleman from Tennessee (Mr. Duncan).
  Mr. DUNCAN. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, the Subcommittee on Aviation and the full Committee on 
Transportation and Infrastructure unanimously approved the Aviation 
Medical Assistance Act, H.R. 2843, on March 5 and March 11 
respectively. Medical equipment aboard commercial aircraft have not 
been reviewed in over 13 years, until the Subcommittee on

[[Page H1404]]

Aviation held a hearing last year. We heard from several expert 
witnesses in aviation medical equipment, including the FAA air surgeon, 
Dr. Jon Jordan, Dr. Russell Rayman from the Aerospace Medical 
Association, Dr. David McKenas from American Airlines, and several 
other well informed and knowledgeable witnesses. We heard very dramatic 
and moving testimony from family members who had loved ones who had 
died after experiencing medical problems during plane trips.
  From this testimony we basically heard three overriding things: One, 
we need to improve our medical equipment on aircraft; two, there is no 
reliable data on the number of in-flight medical emergencies; and 
three, a Good Samaritan provision should be incorporated into any bill.
  Before I go on, let me say that I am very encouraged by the 
increasing number of U.S. airlines that have voluntarily placed or have 
begun to place defibrillators and other improved medical equipment on 
board their aircraft. American Airlines, Delta, United, Alaska Air and 
American Trans Air should all be commended for their efforts to provide 
passengers with the best possible care and the best medical equipment 
available. In fact, it is my understanding that these defibrillators 
have already saved the lives of at least two passengers just within the 
last few months.
  And I should point out that in 1997, 640 million people flew in the 
United States, and the FAA predicts that almost 1 billion passengers 
will fly commercially in the United States by the year 2007.

                              {time}  1545

  These enormous increases in passenger traffic will almost undoubtedly 
lead to an increase in the number of in-flight medical emergencies. 
There are those who prefer to see these defibrillators mandated by the 
FAA. I must admit that we gave this some thought, mainly because the 
American Heart Association tells us that more than 1,000 Americans 
suffer from sudden cardiac arrest each day, and this is bound to 
increase with the aging of the American population.
  We went back and reviewed testimony from our witnesses who expressed 
concerns about the lack of reliable data on medical emergencies and a 
concern about what sizes or types of aircraft could accommodate these 
medical devices.
  So this is basically why we are here today with H.R. 2843, which I 
have sometimes referred to as the Good Samaritan in the Skies bill.
  H.R. 2843 has four components. First, it requires the FAA, not later 
than 1 year after enactment of the bill, to reevaluate regulations 
regarding the equipment required to be carried in medical kits and 
first-aid training, medical emergency training required by flight 
attendants.
  Secondly, it requires air carriers to submit reports to the FAA on 
the number of deaths on board aircraft, age of the person, and whether 
or not the aircraft was diverted as a result of the death or incident.
  Third, it also requires the FAA, based upon data gathered over the 
year period, to determine whether or not automatic external 
defibrillators should be required on commercial passenger airplanes and 
at airports.
  Fourth, and finally, and I think very importantly, the bill limits 
liability for an air carrier, should the flight attendant or crew in 
good faith believe that the passenger rendering assistance is a 
medically qualified individual such as a doctor, nurse, or paramedic.
  It also limits liability for the passenger rendering assistance 
unless he or she is found guilty of gross negligence or willful 
misconduct.
  This legislation will enable the needed information to be properly 
gathered and analyzed so that the FAA can make a proper and informed 
decision on what types of additional equipment should be required for 
air passenger carriers.
  This is a good bill, Mr. Speaker, that every Member of the House can 
support. And I urge its passage.
  Lastly, I want to thank my good friend, the gentleman from Illinois 
(Mr. Lipinski), the ranking member of the Subcommittee on Aviation. He 
is truly a man with a good and kind heart. He really tries to help 
people.
  I have heard it said, and I believe it to be true, that no committee 
or subcommittee in this Congress has a chairman and ranking member who 
get along and work together better than the gentleman from Illinois and 
I do. I thank him for his support on this legislation.
  Mr. Speaker, I reserve the balance of my time.
  Mr. LIPINSKI. Mr. Speaker, I yield myself the amount of time I may 
consume.
  Mr. Speaker, first of all, I want to thank the gentleman from 
Tennessee (Mr. Duncan) for introducing such an important bill. After 
our excellent Subcommittee on Aviation hearing on this issue last 
session, it was obvious that something needed to be done to address the 
increasing number of medical emergencies in the sky. I am proud to be 
an original cosponsor of H.R. 2843, the Aviation Medical Assistance 
Act.
  The number of airline passengers traveling both domestically and 
internationally is growing by leaps and bounds each year. As more 
people fly, and fly longer distances, there is a greater chance of 
serious medical emergencies occurring during flight.
  Unfortunately, because the Federal Aviation Administration does not 
require airlines to report the number of in-flight medical emergencies, 
we can only make an educated guess that the number of medical 
emergencies has increased each year with the number of airline 
passengers.
  Fortunately, the Aviation Medical Assistance Act will require major 
airlines to report their on-board medical incidents to the FAA. This 
reporting requirement will provide data on the number and types of in-
flight medical emergencies.
  This data can then be used to determine exactly what the major 
airlines need to have on board to help prevent the most common types of 
in-flight medical emergencies. Without this data provided by this 
reporting requirement, the airlines and the FAA would have to continue 
to guess about how to best prevent an in-flight medical tragedy.
  H.R. 2843 also directs the FAA to use the in-flight medical incident 
data reported by the airlines to determine whether to require 
defibrillators aboard aircraft and, if so, what type of aircraft.
  Recent technology improvements have made defibrillators portable, 
compact, and easy to use. In fact, at the Subcommittee on Aviation 
hearing last May, we saw the new smaller defibrillator, and it is 
amazing how easy this lifesaving device is to use.
  Several major air carriers have already agreed to voluntarily place 
defibrillators on their aircraft. I want to commend American Airlines, 
Delta Airlines, United, and Alaskan Airlines for voluntarily taking 
this step forward in passenger safety.
  I believe that the FAA will quickly see from the in-flight medical 
data that defibrillators are lifesaving devices that should be required 
on all major carriers and at all major airports. Hopefully, the FAA 
will act quickly and make a decision to require defibrillators on all 
major carriers in the near future.
  Finally, the bill includes a Good Samaritan provision. This provision 
would protect from legal liability the Good Samaritan, such as the 
doctor on board the flight who volunteers to help in a medical 
emergency.
  When a medical emergency happens during flight, the flight crew must 
often rely on the help of passengers who are medical professionals. 
Unfortunately, many doctors on board are often weary of volunteering 
their services for fear of being sued.
  This Good Samaritan provision protects passengers who volunteer to 
help, unless, of course, they are grossly negligent or engaged in 
willful misconduct. The Good Samaritan provision also generally 
protects the airlines from legal liability for the actions of their 
passengers.
  When passengers get on a plane, they assume that they will be safe. 
H.R. 2843, the Aviation Medical Assistance Act, will make sure that all 
passengers are safe when they board a plane. H.R. 2843 will help ensure 
that in-flight medical emergencies do not become in-flight medical 
tragedies.
  Again, I am a proud cosponsor of this bill, and I want to urge all of 
my colleagues to vote yes on this very important piece of legislation.

[[Page H1405]]

  Mr. Speaker, I yield as much time as she may consume to the young 
gentlewoman from Connecticut (Mrs. Kennelly).
  Mrs. KENNELLY of Connecticut. Mr. Speaker, I thank the gentleman from 
Illinois for that compliment.
  Mr. Speaker, I rise today in support of this legislation which will 
provide American air travelers with a vital margin of safety that they 
need so much.
  It was not that long ago, a little over a year ago, that I was 
traveling on a plane one evening, and a gentleman came down the aisle 
and he fell face forward and was unconscious. It did not seem it was my 
imagination, but it seemed that the flight attendants were going in 
opposite directions. Then a call was put out for a doctor on the plane.
  There was no doctor on the plane, unfortunately. But, fortunately, 
there was a nurse on the plane, and she came to the assistance of the 
passenger. At one point, she called for the first-aid box. The box 
came, she opened it, and there were just a few bandages in it and 
something that looked like something for a toothache, and very little 
else. She found nothing that could help her in her assistance at that 
time.
  It was shortly after this, Mr. Speaker, that I introduced legislation 
to require airlines to carry automatic electronic defibrillators on all 
flights. This legislation was prompted by a visit from one of my 
constituents, Mrs. Lynn Talit, who came to see me in Washington shortly 
after this occasion that happened to me on an airline, to tell me that 
her husband had suffered a heart attack during a flight.
  The facts were devastating, and I felt very badly for Mrs. Talit. She 
told me her husband had died. She had a terrible time finding 
information about exactly when he had died, what were the circumstances 
after his death, what had occurred during the illness. And yet she was 
a very brave woman and she persevered to find out all this information. 
Then she felt that she really should help others who had loved ones who 
suffer heart attacks on an air flight.
  Since then, of course, we have learned that this experience is one 
that happens to others. In fact, newspapers, since this problem has 
come to light, have chronicled both a sudden death of a young woman 
aboard a plane not long ago and the use of an AED to save another 
passenger's life.
  So now that we have highlighted the situation that people do, in 
fact, have heart attacks on planes, as they have heart attacks 
everywhere else, and that if we have an automatic defibrillator on the 
plane, it could save a passenger's life.
  This constituent of mine had the good fortunate to go see the 
gentleman from Tennessee (Mr. Duncan) and told her story to him. He was 
marvelous about making it possible to have a hearing on this situation 
of people becoming ill on airlines, and the fact that if an automatic 
defibrillator is available lives can be saved.
  Chairman Duncan held a hearing and my constituent was able to testify 
at that hearing, and I think now we have evidence to justify requiring 
AEDs on all flights.
  This bill that the gentleman from Tennessee (Mr. Duncan) and the 
gentleman from Illinois (Mr. Lipinski) have brought forth will move 
this decision in the right direction by giving FAA 1 year to make the 
decision. In other words, the added margin of safety passengers deserve 
may be only a year away.
  What I am saying today is that I think we have a situation where we 
should have an automatic electronic defibrillator on every flight. 
American Airlines actually has said that they intend to do this. Other 
airlines are coming to this practical decision.
  But in the meantime, this study that the gentleman from Tennessee 
(Mr. Duncan) and the gentleman from Illinois (Mr. Lipinski) is bringing 
forth will make it possible for us to address the whole idea of health 
and safety on airlines, making sure that first-aid box has in it what 
is necessary to assist passengers.
  By the way, we have come a long way, probably as has been mentioned 
before on the floor, that airline attendants, beginning after World War 
I, when we first had airline attendants, were required to have nurse's 
training. We have gone all the way from having nurse's training as a 
requirement to having a sick person sick on a plane without an adequate 
first aid box. We can understand why the airline attendants are 
concerned when a passenger becomes ill because they do not have the 
training to take care of a sick passenger, and they know it.
  All of us in this room travel by air quite often, and if we are sick 
we certainly hope that there is a doctor on board, but more 
importantly, we hope there is trained personnel to help us till the 
plane lands.
  I hope in the name of my constituent that an automatic electric 
defibrillator gets on every plane so that, in fact, if there is a 
serious heart attack, if, in fact, there is heart failure, every 
individual will have a chance to have the necessary help available to 
save his or her life. It makes good sense to have automatic electronic 
defibrillators on all planes. Thank you Mr. Speaker.
  Mr. LIPINSKI. Mr. Speaker, I yield myself as much time as I may 
consume to close for our side.
  I simply want to say this is really a very important piece of 
legislation and a piece of legislation that will help make the skies 
much safer than they are at the present time.
  I want to compliment the gentleman from Tennessee (Mr. Duncan), 
chairman of the Subcommittee on Aviation. As usual, he has been 
enormously generous in sharing the credit on this bill with everybody 
else on the subcommittee. His usual cooperation has once again been 
there. It is a pleasure and a great opportunity, really, for me to 
continue to work with him on the Subcommittee on Aviation.
  Mr. Speaker, I yield back the balance of our time.
  Mr. DUNCAN. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I want to close by once again thanking the gentleman 
from Illinois (Mr. Lipinski), but also I want to thank the gentlewoman 
from Connecticut (Mrs. Kennelly), who is a cosponsor of this 
legislation.
  I mentioned in my statement a few minutes ago the very moving and 
dramatic testimony that we heard from two family members, one of whom 
was her constituent. I can tell my colleagues that I do not believe we 
would be as far along on this legislation today, where we are at this 
moment, if it was not for the gentlewoman from Connecticut (Mrs. 
Kennelly). And I appreciate her work.
  This is a good bill. This bill is going to lead to better medical 
equipment on airlines throughout this Nation. It is going to lead to 
better medical training for airline personnel. It is going to lead to 
the first ever Good Samaritan law in the skies so that passengers who 
have medical training can provide much-needed assistance during medical 
emergencies.
  When we add all of those things together, I think this is very 
important legislation. It is very good legislation. It is legislation 
that all Members of this Congress can point to with pride and support 
enthusiastically.
  Mr. OBERSTAR. Mr. Speaker, I support H.R. 2843, the Aviation Medical 
Assistance Act, and I urge our colleagues to vote for it today. I 
commend Chairman Duncan and Congressman Lipinski for working closely 
together in a nonpartisan fashion to develop a bill that was reported 
out of the Committee with no dissenting votes.
  Other speakers have done a good job of explaining the legislation. 
This bill will move us along the road to an industry standard that will 
require the carriage of heart defibrillator equipment on airliners.
  I firmly believe that if there is safety technology available and 
some in the industry are utilizing it to good benefit, then there is 
little reason not to require all of the industry to take similar steps. 
The traveling public expects that when they board an airliner that 
there will be equivalent levels of safety.
  I want to strongly commend those airlines, Delta, American, Alaska, 
and United, for recognizing the need, being forward-thinking enough to 
recognize new developments in medical technology, and taking the 
initiative to carry defibrillators without waiting for the government 
to require them. It is because of these sorts of steps that these 
particular airlines are widely recognized and appreciated as leaders in 
aviation safety.
  This bill, if enacted this year, will likely lead us to a rule about 
two years from now, requiring defibrillators on airline aircraft. Given 
the fact that the three largest carriers and Alaska Airlines are 
already instituting programs for this life-saving equipment, I believe 
that the

[[Page H1406]]

rest of the industry and the Federal Aviation Administration need not 
and should not take all of this time to decide that all aircraft be 
equipped.
  In the area of liability, this bill takes a very reasoned and narrow 
approach in protecting airlines from liability. An airline will not be 
liable for its selection of a passenger to use the defibrillator 
equipment, if the airline, in good faith, believed that the person was 
qualified to use the equipment. Other than that, the airline's 
liability remains the same as it is today.
  The bill also provides ``Good Samaritan'' protections for the 
individual using the equipment, so long as they are not grossly 
negligent or engaged in willful misconduct.
  Again, Mr. Speaker, I urge an ``aye'' vote on this bill.
  Mr. DUNCAN. Mr. Speaker, I yield back the balance of my time.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from Tennessee (Mr. Duncan) that the House suspend the rules 
and pass the bill, H.R. 2843, as amended.
  The question was taken; and (two-thirds having voted in favor 
thereof) the rules were suspended and the bill, as amended, was passed.
  A motion to reconsider was laid on the table.

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