[Congressional Record Volume 145, Number 165 (Friday, November 19, 1999)]
[Senate]
[Pages S15143-S15144]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                  CARDIAC ARREST SURVIVAL ACT OF 1999

                                 ______
                                 

                       GORTON AMENDMENT NO. 2798

  Ms. COLLINS (for Mr. Gorton) proposed an amendment to the bill (S. 
1488) to amend the Public Health Service Act to provide for 
recommendations of the Secretary of Health and Human Services regarding 
the placement of automatic external defibrillators in Federal buildings 
in order to improve survival rates of individuals who experince cardiac 
arrest in such buildings, and to establish protections from civil 
liability arising from the emergency use of the devices; as follows:

       Strike all after the enacting clause and insert the 
     following:

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Cardiac Arrest Survival Act 
     of 1999''.

     SEC. 2. FINDINGS.

       The Congress finds as follows:
       (1) Each year more than 250,000 adults suffer cardiac 
     arrest, usually away from a hospital. More than 95 percent of 
     them will die, in many cases because cardiopulmonary 
     resuscitation (``CPR''), defibrillation, and advanced life 
     support are provided too late to reverse the cardiac arrest. 
     These cardiac arrests occur primarily from occult underlying 
     heart disease and from drowning, allergic or sensitivity 
     reactions, or electrical shocks.
       (2) Every minute that passes before returning the heart to 
     a normal rhythm after a cardiac arrest causes the chance of 
     survival to fall by 10 percent.
       (3) In communities where strong public access to 
     defibrillation programs have been implemented, survival from 
     cardiac arrest has improved by as much as 20 percent.
       (4) Survival from cardiac arrest requires successful early 
     implementation of a chain of events, known as the chain of 
     survival, which must be initiated as soon as the person 
     sustains a cardiac arrest and must continue until the person 
     arrives at the hospital.
       (5) The chain of survival is the medical standard of care 
     for treatment of cardiac arrest.
       (6) A successful chain of survival requires the first 
     person on the scene to take rapid and simple initial steps to 
     care for the patient and to assure that the patient promptly 
     enters the emergency medical services system. These steps 
     include--
       (A) recognizing an emergency and activating the emergency 
     medical services system;
       (B) beginning CPR; and
       (C) using an automated external defibrillator (``AED'') if 
     one is available at the scene.
       (7) The first persons at the scene of an arrest are 
     typically lay persons who are friends or family of the 
     victim, fire services, public safety personnel, basic life 
     support emergency medical services providers, teachers,

[[Page S15144]]

     coaches and supervisors of sports or other extracurricular 
     activities, providers of day care, school bus drivers, 
     lifeguards, attendants at public gatherings, coworkers, and 
     other leaders within the community.
       (8) The Federal Government should facilitate programs for 
     the placement of AEDs in public buildings, including 
     provisions regarding the training of personnel in CPR and AED 
     use, integration with the emergency medical services system, 
     and maintenance of the devices.

     SEC. 3. RECOMMENDATIONS OF SECRETARY OF HEALTH AND HUMAN 
                   SERVICES REGARDING PLACEMENT OF AUTOMATIC 
                   EXTERNAL DEFIBRILLATORS IN BUILDINGS.

       Part B of title II of the Public Health Service Act (42 
     U.S.C. 238 et seq.) is amended by adding at the end the 
     following section:


      ``recommendations regarding placement of automated external 
                      defibrillators in buildings

       ``Sec. 247. (a) Recommendation for Federal Buildings.--
       ``(1) In general.--Not later than 90 days after the date of 
     the enactment of the Cardiac Arrest Survival Act of 1999, the 
     Secretary shall assist in providing for an improvement in the 
     survival rates of individuals who experience cardiac arrest 
     in Federal buildings by publishing in the Federal Register 
     for public comment the recommendations of the Secretary with 
     respect to placing automatic external defibrillators in such 
     buildings. The Secretary shall in addition assist Federal 
     agencies in implementing programs for such placement.
       ``(2) Agency assessments.--Not later than 180 days after 
     the date on which the recommendations are published under 
     paragraph (1), the head of each Federal agency that occupies 
     a Federal building that meets the criteria described in 
     subsection (a)(1) shall submit to the Secretary an assessment 
     of the ability of each such agency to meet the goals 
     described in subsection (c).
       ``(b) Additional Recommendations.--The Secretary shall 
     publish, as part of the recommendations referred to in 
     subsection (a), recommendations with respect to the placement 
     of automatic external defibrillators in buildings and 
     facilities, or other appropriate venues, frequented by the 
     public (other than the buildings referred to in subsection 
     (a)). Such recommendations shall only be for information 
     purposes for States and localities to consider in determining 
     policy regarding the use or placement of such defibrillators 
     in recommended buildings, facilities or venues.
       ``(c) Consideration of Certain Goals for Survival Rates.--
     In carrying out this section, the Secretary shall consider 
     the goals established by national public-health organizations 
     for improving the survival rates of individuals who 
     experience cardiac arrest in nonhospital settings, including 
     goals for minimizing the time elapsing between the onset of 
     cardiac arrest and the initial medical response.
       ``(d) Certain Procedures.--The matters addressed by the 
     Secretary in the recommendations under subsections (a) and 
     (b) shall include the following:
       ``(1) Procedures for implementing appropriate nationally 
     recognized training courses in performing cardiopulmonary 
     resuscitation and the use of automatic external 
     defibrillators.
       ``(2) Procedures for proper maintenance and testing of such 
     devices, according to the guidelines of the manufacturer of 
     the devices.
       ``(3) Procedures for ensuring direct involvement of a 
     licensed medical professional and coordination with local 
     emergency medical services in the oversight of training and 
     notification of incidents of the use of the devices.
       ``(4) Procedures for ensuring notification of an agent of 
     the local emergency medical system dispatch center of the 
     location and type of device.
       ``(e) Certain Criteria.--In making recommendations under 
     subsections (a) and (b), the Secretary shall determine the 
     following:
       ``(1) Criteria for selecting the public buildings, 
     facilities and other venues in which automatic external 
     defibrillators should be placed, taking into account--
       ``(A) the typical number of employees and visitors in the 
     buildings, facilities or venues;
       ``(B) the extent of the need for security measures 
     regarding the buildings, facilities or venues;
       ``(C) buildings, facilities or other venues, or portions 
     thereof, in which there are special circumstances such as 
     high electrical voltage or extreme heat or cold; and
       ``(D) such other factors as the Secretary determines to be 
     appropriate.
       ``(2) Criteria regarding the maintenance of such devices 
     (consistent with the labeling for the devices).
       ``(3) Criteria for coordinating the use of the devices in 
     public buildings, facilities or other venues with providers 
     of emergency medical services for the geographic areas in 
     which the buildings, facilities or venues are located.''.

     SEC. 4. IMMUNITY FROM CIVIL LIABILITY FOR EMERGENCY USE OF 
                   AUTOMATED EXTERNAL DEFIBRILLATORS.

       Part B of title II of the Public Health Service Act, as 
     amended by section 3 of this Act, is amended by adding at the 
     end the following section:


       ``liability regarding emergency use of automated external 
                             defibrillators

       ``Sec. 248. (a) Persons Using AEDs.--Any person who 
     provides emergency medical care through the use of an 
     automated external defibrillator is immune from civil 
     liability for any personal injury or wrongful death resulting 
     from the provision of such care, except as provided in 
     subsection (c).
       ``(b) Other Persons Involved With AEDs; Special Rules for 
     Acquirers.--
       ``(1) In general.--With respect to a personal injury or 
     wrongful death to which subsection (a) applies, in addition 
     to the person who provided emergency medical care through the 
     use of the automated external defibrillator, the person 
     described in paragraph (2) is with respect to the device 
     immune from civil liability for the personal injury or 
     wrongful death in accordance with such paragraph, except as 
     provided in subsection (c).
       ``(2) Person described.--A person described in this 
     paragraph is the person who acquired the device for use at a 
     nonmedical facility (in this paragraph referred to as the 
     `acquirer'). Such person shall be immune from liability as 
     provided for in paragraph (1) if the following conditions are 
     met:
       ``(A) The condition that the acquirer notified local 
     emergency response personnel of the most recent placement of 
     the device within a reasonable period of time after the 
     device was placed.
       ``(B) The condition that, as of the date on which the 
     emergency occurred, the device had been maintained and tested 
     in accordance with the guidelines established for the device 
     by the manufacturer of the device.
       ``(C) In any case in which the person who provided the 
     emergency medical care through the use of the device was an 
     employee or agent of the acquirer, and the employee or agent 
     was within the class of persons the acquirer expected would 
     use the device in the event of a relevant emergency, the 
     condition that the employee or agent received reasonable 
     instruction in the use of such devices through a course 
     approved by the Secretary or by the chief public health 
     officer of any of the States.
       ``(c) Inapplicability of Immunity.--Immunity under 
     subsections (a) and (b) does not apply to a person if--
       ``(1) the person engaged in gross negligence or willful or 
     wanton misconduct in the circumstances described in such 
     subsections that apply to the person with respect to 
     automated external defibrillators; or
       ``(2) the person was a licensed or certified medical 
     professional who was using the automated external 
     defibrillator while acting within the scope of their license 
     or certification, and within the scope of their employment as 
     a medical professional.
       ``(d) Rules of Construction.--
       ``(1) In general.--The following applies with respect to 
     this section:
       ``(A) This section is not applicable in any State that 
     (before, on, or after the date of the enactment of the 
     Cardiac Arrest Survival Act of 1999) provides through statute 
     or regulations any degree of immunity for any class of 
     persons for civil liability for personal injury or wrongful 
     death arising from the provision of emergency medical care 
     through the use of an automated external defibrillator.
       ``(B) This section does not waive any protection from 
     liability for Federal officers or employees under--
       ``(i) section 224; or
       ``(ii) sections 1346(b), 2672 and 2679 of title 28, United 
     States Code, or under alternative benefits provided by the 
     United States where the availability of such benefits 
     precludes a remedy under section 1346(b) of title 28.
       ``(C) This section does not require that an automated 
     external defibrillator be placed at any building or other 
     location.
       ``(2) Civil actions under federal law.--
       ``(A) In general.--The applicability of subsections (a) 
     through (c) includes applicability to any action for civil 
     liability described in subsection (a) that arises under 
     Federal law.
       ``(B) Federal areas adopting state law.--If a geographic 
     area is under Federal jurisdiction and is located within a 
     State but out of the jurisdiction of the State, and if, 
     pursuant to Federal law, the law of the State applies in such 
     area regarding matters for which there is no applicable 
     Federal law, then an action for civil liability described in 
     subsection (a) that in such area arises under the law of the 
     State is subject to subsections (a) through (c) in lieu of 
     any related State law that would apply in such area in the 
     absence of this subparagraph.''.

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