[House Report 106-634]
[From the U.S. Government Publishing Office]
106th Congress Report
HOUSE OF REPRESENTATIVES
2d Session 106-634
======================================================================
CARDIAC ARREST SURVIVAL ACT OF 2000
_______
May 23, 2000.--Committed to the Committee of the Whole House on the
State of the Union and ordered to be printed
_______
Mr. Bliley, from the Committee on Commerce, submitted the following
R E P O R T
[To accompany H.R. 2498]
The Committee on Commerce, to whom was referred the bill
(H.R. 2498) 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 experience cardiac arrest in
such buildings, and to establish protections from civil
liability arising from the emergency use of the devices, having
considered the same, report favorably thereon with an amendment
and recommend that the bill as amended do pass.
CONTENTS
Page
Amendment........................................................ 2
Purpose and Summary.............................................. 4
Background and Need for Legislation.............................. 5
Hearings......................................................... 6
Committee Consideration.......................................... 7
Committee Votes.................................................. 7
Committee Oversight Findings..................................... 7
Committee on Government Reform Oversight Findings................ 7
New Budget Authority, Entitlement Authority, and Tax Expenditures 7
Committee Cost Estimate.......................................... 7
Congressional Budget Office Estimate............................. 8
Federal Mandates Statement....................................... 8
Advisory Committee Statement..................................... 8
Constitutional Authority Statement............................... 8
Applicability to Legislative Branch.............................. 8
Section-by-Section Analysis of the Legislation................... 8
Changes in Existing Law Made by the Bill, as Reported............ 10
Amendment
The amendment is as follows:
Strike out all after the enacting clause and insert in lieu
thereof the following:
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Cardiac Arrest Survival Act of 2000''.
SEC. 2. FINDINGS.
The Congress finds as follows:
(1) Over 7 lives are lost every day to sudden cardiac arrest
in the United States alone.
(2) Two out of every three sudden cardiac deaths occur before
a victim can reach a hospital.
(3) More than 95 percent of these cardiac arrest victims will
die, many because of lack of readily available life saving
medical equipment.
(4) With current medical technology, up to 30 percent of
cardiac arrest victims could be saved if victims had access to
immediate medical response, including defibrillation and
cardiopulmonary resuscitation.
(5) Once a victim has suffered a cardiac arrest, every minute
that passes before returning the heart to a normal rhythm
decreases the chance of survival by 10 percent.
(6) Most cardiac arrests are caused by abnormal heart rhythms
called ventricular fibrillation. Ventricular fibrillation
occurs when the heart's electrical system malfunctions, causing
a chaotic rhythm that prevents the heart from pumping oxygen to
the victim's brain and body.
(7) Communities that have implemented programs ensuring
widespread public access to defibrillators, combined with
appropriate training, maintenance, and coordination with local
emergency medical systems, have improved the survival rates
from cardiac arrest to as much as 20 percent.
(8) Automated external defibrillator devices have proven safe
and effective, even when used by lay people, since the devices
are designed not to allow a user to administer a shock until
after the device has analyzed a victim's heart rhythm and
determined that an electric shock is required.
(9) Increasing public awareness regarding automated external
defibrillator devices and encouraging their use in Federal
buildings will greatly facilitate their adoption.
(10) Limiting the liability of Good Samaritans in emergency
situations may encourage the use of automated external
defibrillator devices, and result in saved lives.
SEC. 3. RECOMMENDATIONS AND GUIDELINES OF SECRETARY OF HEALTH AND HUMAN
SERVICES REGARDING AUTOMATED EXTERNAL
DEFIBRILLATORS FOR FEDERAL 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 and guidelines regarding automated external
defibrillators for federal buildings
``Sec. 247. (a) Guidelines on Placement.--The Secretary shall
establish guidelines with respect to placing automated external
defibrillator devices in Federal buildings. Such guidelines shall take
into account the extent to which such devices may be used by lay
persons, the typical number of employees and visitors in the buildings,
the extent of the need for security measures regarding the buildings,
buildings or portions of buildings in which there are special
circumstances such as high electrical voltage or extreme heat or cold,
and such other factors as the Secretary determines to be appropriate.
``(b) Related Recommendations.--The Secretary shall publish in the
Federal Register the recommendations of the Secretary on the
appropriate implementation of the placement of automated external
defibrillator devices under subsection (a), including procedures for
the following:
``(1) Implementing appropriate training courses in the use of
such devices, including the role of cardiopulmonary
resuscitation.
``(2) Proper maintenance and testing of the devices.
``(3) Ensuring coordination with appropriate licensed
professionals in the oversight of training of the devices.
``(4) Ensuring coordination with local emergency medical
systems regarding the placement and incidents of use of the
devices.
``(c) Consultations; Consideration of Certain Recommendations.--In
carrying out this section, the Secretary shall--
``(1) consult with appropriate public and private entities;
``(2) consider the recommendations of national and local
public-health organizations for improving the survival rates of
individuals who experience cardiac arrest in nonhospital
settings by minimizing the time elapsing between the onset of
cardiac arrest and the initial medical response; and
``(3) consult with and counsel other Federal agencies where
such devices are to be used.
``(d) Date Certain for Establishing Guidelines and Recommendations.--
The Secretary shall comply with this section not later than 180 days
after the date of the enactment of the Cardiac Arrest Survival Act of
2000.
``(e) Definitions.--For purposes of this section:
``(1) The term `automated external defibrillator device' has
the meaning given such term in section 248.
``(2) The term `Federal building' includes a building or
portion of a building leased by a Federal agency, and includes
buildings on military installations of the United States.''.
SEC. 4. GOOD SAMARITAN PROTECTIONS REGARDING 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) Good Samaritan Protections Regarding AEDs.--Except as
provided in subsection (b), any person who uses an automated external
defibrillator device on a victim of a perceived medical emergency is
immune from civil liability for any harm resulting from the use of such
device; and in addition, any person who acquired the device is immune
from such liability, if the harm was not due to the failure of such
acquirer of the device--
``(1) to notify local emergency response personnel or other
appropriate entities of the most recent placement of the device
within a reasonable period of time after the device was placed;
``(2) to properly maintain and test the device; or
``(3) to provide appropriate training in the use of the
device to an employee or agent of the acquirer when the
employee or agent was the person who used the device on the
victim, except that such requirement of training does not apply
if--
``(A) the employee or agent was not an employee or
agent who would have been reasonably expected to use
the device; or
``(B) the period of time elapsing between the
engagement of the person as an employee or agent and
the occurrence of the harm (or between the acquisition
of the device and the occurrence of the harm, in any
case in which the device was acquired after such
engagement of the person) was not a reasonably
sufficient period in which to provide the training.
``(b) Inapplicability of Immunity.--Immunity under subsection (a)
does not apply to a person if--
``(1) the harm involved was caused by willful or criminal
misconduct, gross negligence, reckless misconduct, or a
conscious, flagrant indifference to the rights or safety of the
victim who was harmed; or
``(2) the person is a licensed or certified health
professional who used the automated external defibrillator
device while acting within the scope of the license or
certification of the professional and within the scope of the
employment or agency of the professional; or
``(3) the person is a hospital, clinic, or other health care
entity, and the harm was caused by an employee or agent of the
entity who used the device while acting within the scope of the
employment or agency of the employee or agent; or
``(4) the person is an acquirer of the device who leased the
device to a health care entity (or who otherwise provided the
device to such entity for compensation without selling the
device to the entity), and the harm was caused by an employee
or agent of the entity who used the device while acting within
the scope of the employment or agency of the employee or agent.
``(c) Rules of Construction.--
``(1) In general.--The following applies with respect to this
section:
``(A) This section does not establish any cause of
action, or require that an automated external
defibrillator device be placed at any building or other
location.
``(B) With respect to a class of persons for which
this section provides immunity from civil liability,
this section supersedes the law of a State only to the
extent that the State has no statute or regulations
that provide persons in such class with immunity for
civil liability arising from the use by such persons of
automated external defibrillator devices in emergency
situations (within the meaning of the State law or
regulation involved).
``(C) 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.
``(2) Civil actions under federal law.--
``(A) In general.--The applicability of subsections
(a) and (b) 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.
``(d) Federal Jurisdiction.--In any civil action arising under State
law, the courts of the State involved have jurisdiction to apply the
provisions of this section exclusive of the jurisdiction of the courts
of the United States.
``(e) Definitions.--
``(1) Perceived medical emergency.--For purposes of this
section, the term `perceived medical emergency' means
circumstances in which the behavior of an individual leads a
reasonable person to believe that the individual is
experiencing a life-threatening medical condition that requires
an immediate medical response regarding the heart or other
cardiopulmonary functioning of the individual.
``(2) Other definitions.--For purposes of this section:
``(A) The term `automated external defibrillator
device' means a defibrillator device that--
``(i) is commercially distributed in
accordance with the Federal Food, Drug, and
Cosmetic Act;
``(ii) is capable of recognizing the presence
or absence of ventricular fibrillation, and is
capable of determining without intervention by
the user of the device whether defibrillation
should be performed;
``(iii) upon determining that defibrillation
should be performed, is able to deliver an
electrical shock to an individual; and
``(iv) in the case of a defibrillator device
that may be operated in either an automated or
a manual mode, is set to operate in the
automated mode.
``(B)(i) The term `harm' includes physical,
nonphysical, economic, and noneconomic losses.
``(ii) The term `economic loss' means any pecuniary
loss resulting from harm (including the loss of
earnings or other benefits related to employment,
medical expense loss, replacement services loss, loss
due to death, burial costs, and loss of business or
employment opportunities) to the extent recovery for
such loss is allowed under applicable State law.
``(iii) The term `noneconomic losses' means losses
for physical and emotional pain, suffering,
inconvenience, physical impairment, mental anguish,
disfigurement, loss of enjoyment of life, loss of
society and companionship, loss of consortium (other
than loss of domestic service), hedonic damages, injury
to reputation and all other nonpecuniary losses of any
kind or nature.''.
Purpose and Summary
H.R. 2498, The Cardiac Arrest Survival Act, contains two
significant provisions--the creation of guidelines for
placement of automated external defibrillators (AEDs) in
federal buildings, and the establishment of limited immunity
protections for people who use or acquire AEDs. The first part
of the bill encourages the Federal Government to be a role
model for the private sector, directing the Secretary of Health
and Human Services to develop guidelines for placing AEDs in
Federal buildings, and to publish in the Federal Register its
recommendations for appropriate training courses, maintenance
and testing of AEDs, training for AED use, and coordination
with local emergency medical systems (EMS) regarding the
placement and notification of incidents of use of AEDs.
The second part of the bill establishes so-called ``Good
Samaritan'' protections from liability for people who use or
acquire AEDs. Immunity for acquirers applies only if the harm
is not caused by the acquirer's failure to notify local EMS of
the devices' placement within a reasonable period of time, to
properly maintain and test the devices, or to provide
appropriate training in certain instances. Furthermore, the
immunity does not apply if the harm was caused by a person's
willful or criminal or reckless misconduct, gross negligence,
or a conscious, flagrant indifference to the rights or safety
of the victim. It also does not apply if the AED is being used
by a doctor or nurse or other licensed professional in their
scope of employment, if it is being used by a hospital or other
health care entity, or if it is being used by an acquirer
leasing the AEDs to such a health care entity.
H.R. 2498 does not create any new causes of action and does
not impose any new regulations on the private sector, nor does
the bill require that AEDs be placed at any building or
location. State laws are not superseded if the State has or
enacts a statute or regulation providing immunity for the
applicable persons.
Background and Need for Legislation
Sudden cardiac arrest is one of the leading causes of death
in the United States, killing more than 250,000 Americans every
year. Unlike a heart attack, which is the death of a muscle
tissue from loss of blood supply, many victims of sudden
cardiac arrest have no prior symptoms. Unfortunately, two out
of every three sudden cardiac deaths occur before a victim can
reach a hospital, and more than 95 percent of these cardiac
arrest victims will die because of lack of readily available
life saving medical equipment.
At the May 9, 2000 hearing on H.R. 2498 in the Subcommittee
on Health and Environment, Mr. Robert T. Adams, Esq., testified
that he had been in perfect health, as certified by numerous
doctor examinations for his part-time work as an NCAA
basketball referee, when he was victimized by a sudden cardiac
arrest at Grand Central Station in New York. He testified that
he probably would not be alive today if the station had not
purchased an automated external defibrillator just one day
before, which was used to save his life while emergency medical
services personnel were in transit.
Once a victim has suffered a cardiac arrest, every minute
that passes before returning the heart to a normal rhythm
decreases the chance of survival by 10 percent. Most cardiac
arrests are caused by abnormal heart rhythms called ventricular
fibrillation. Ventricular fibrillation occurs when the heart's
electrical system malfunctions,causing a chaotic rhythm that
prevents the heart from pumping oxygen to the victim's brain and body.
Automated external defibrillators are medical devices that
can restart a heart that has stopped beating effectively. AEDs
are subject to FDA approval, and can only be sold with a
prescription by a licensed individual. AED devices have been
shown to be safe and effective, even when used by lay people,
since the devices are designed so as not to allow a user to
administer a shock until after the device has analyzed a
victim's heart rhythm and determined that an electric shock is
required. AED training courses are provided by the American Red
Cross, the American Heart Association, local emergency medical
services groups, and other public health and safety
institutions.
Richard Hardman, Ph.D., NREMT-P, and EMS Training
Coordinator for the Clark County Fire Department, testified at
the May 9th hearing that after widespread placement of AEDs and
implementation of AED training in Las Vegas casinos, survival
rates for sudden cardiac arrest increased from less than 10% to
an astounding 57%. Other experts estimate survival rates
increasing to 30--40% where victims have access to immediate
medical response including defibrillation and cardiopulmonary
resuscitation.
Mr. Richard A. Lazar and other witnesses at the
Subcommittee hearing testified that unfortunately, AED usage
has been hindered by fears of liability exposure. People who
design and implement training programs may be reluctant to
volunteer or otherwise offer their services if they are thereby
exposing themselves to significant financial liability.
Similarly, acquirers and users of AEDs may be reluctant to
purchase or use the devices if subjected to liability. Mr.
Lazar testified that,
We are not seeing [AEDs] widely deployed,
notwithstanding their ease of use, their relatively low
cost, and the clear public health interest in them
being widely deployed. One of the critical reasons why
that is is because there is this perception among
would-be purchasers and users of AEDs that if they do
this they are going to get sued. Now, statistically,
and if you look in the courts, that is not really
justified. But you know what, perception is reality,
and perception is, indeed, creating a huge barrier to
the widespread deployment and adoption of AED programs.
In 1997, Congress enacted the Volunteers Protection Act
(P.L. 105-19; 42 U.S.C. Sec. 14501) to grant immunity from
liability for Americans who volunteered their services for a
nonprofit organization or a governmental entity. The Cardiac
Arrest Survival Act will extend similar liability protections
to people who voluntarily acquire or use AEDs to help save
victims of sudden cardiac arrest. This immunity from unfair
lawsuits will help protect ``Good Samaritans'' who use AEDs to
help save the lives of our fellow Americans, as well as
businesses and land owners who acquire the devices to make
their buildings or offices safer for the public.
Hearings
The Subcommittee on Health and Environment held a hearing
on H.R. 2498 on May 9, 2000. The Subcommittee received
testimony from: Richard Hardman, Ph.D., NREMT-P, EMS Training
Coordinator, Clark County Fire Department, Las Vegas, Nevada;
Robert T. Adams, Esq., Partner, Wilson, Elser, Moskowitz,
Edelman, & Dicker, L.L.P., New York City; Mr. Scott Conner,
Vice President, Health, Safety, & Community Services, American
Red Cross, Washington, DC; and Richard A. Lazar, Esq.,
Portland, Oregon.
Committee Consideration
On May 9, 2000, the Subcommittee on Health and Environment
met in open markup session and approved H.R. 2498 for Full
Committee consideration, as amended, by a voice vote. On May
17, 2000, the Full Committee met in open markup session and
approved H.R. 2498, as amended, by a voice vote.
Committee Votes
Clause 3(b) of rule XIII of the Rules of the House of
Representatives requires the Committee to list the record votes
on the motion to report legislation and amendments thereto.
There were no record votes taken in connection with ordering
H.R. 2498 reported. A motion by Mr. Bliley to order H.R. 2498
reported to the House, as amended, was agreed to by a voice
vote.
Committee Oversight Findings
Pursuant to clause 3(c)(1) of rule XIII of the Rules of the
House of Representatives, the Committee held a legislative
hearing and made findings that are reflected in this report.
Committee on Government Reform Oversight Findings
Pursuant to clause 3(c)(4) of rule XIII of the Rules of the
House of Representatives, no oversight findings have been
submitted to the Committee by the Committee on Government
Reform.
New Budget Authority, Entitlement Authority, and Tax Expenditures
In compliance with clause 3(c)(2) of rule XIII of the Rules
of the House of Representatives, the Committee finds that H.R.
2498, the Cardiac Arrest Survival Act of 2000, would result in
no new or increased budget authority, entitlement authority, or
tax expenditures or revenues.
Committee Cost Estimate
Pursuant to clause 3 of rule XIII of the Rules of the House
of Representatives, the Committee provides the following
estimate of the costs of H.R. 2498:
H.R. 2498 directs the Secretary of Health and Human
Services to develop guidelines for placing AEDs in Federal
buildings, and to publish in the Federal Register its
recommendations for appropriate training courses, maintenance
and testing of AEDs, training for AED use, and coordination
with local emergency medical systems (EMS) regarding the
placement and notification of incidents of use of AEDs. The
bill also establishes so-called ``Good Samaritan'' protections
from liability for people who use or acquire AEDs.
The Committee estimates that enacting H.R. 2498 would have
no significant impact on the Federal budget. Implementing the
bill would require far less than $500,000 a year in
discretionary spending during the 2000-2005 period. The
Committee also finds that H.R. 2498 would not affect direct
spending, so pay-as-you-go procedures would not apply.
Congressional Budget Office Estimate
The cost estimate provided by the Congressional Budget
Office pursuant to section 402 of the Congressional Budget Act
of 1974 was not timely submitted to the Committee.
Federal Mandates Statement
An estimate of Federal mandates prepared by the Director of
the Congressional Budget Office pursuant to section 423 of the
Unfunded Mandates Reform Act was not timely submitted to the
Committee. Accordingly, the Committee finds that H.R. 2498
contains no intergovernmental or private-sector mandates as
defined in the Unfunded Mandates Reforms Act and would not
affect the budgets of State, local, or tribal governments.
Advisory Committee Statement
No advisory committees within the meaning of section 5(b)
of the Federal Advisory Committee Act were created by this
legislation.
Constitutional Authority Statement
Pursuant to clause 3(d)(1) of rule XIII of the Rules of the
House of Representatives, the Committee finds that the
Constitutional authority for this legislation is provided in
Article I, section 8, clause 3, which grants Congress the power
to regulate commerce with foreign nations, among the several
States, and with the Indian tribes.
Applicability to Legislative Branch
The Committee finds that the legislation does not relate to
the terms and conditions of employment or access to public
services or accommodations within the meaning of section
102(b)(3) of the Congressional Accountability Act.
Section-by-Section Analysis of the Legislation
Section 1. Short title
Section 1 designates the short title of the legislation as
the ``Cardiac Arrest Survival Act of 2000.''
Section 2. Findings
Section 2 sets forth certain findings.
Section 3. Recommendations and guidelines of Secretary of Health and
Human Services regarding automated external defibrillators for
Federal buildings
Section 3 encourages the Federal government to be a role
model for the private sector in implementing automated external
defibrillator programs by directing the Secretary of Health and
Human Services to develop guidelines for placing AEDs in
Federal buildings, and to publish in the Federal Register its
recommendations for appropriate training courses, maintenance
and testing of AEDs, training for AED use, and coordination
with local emergency medical systems regarding the placement
and notification of incidents of use of AEDs. The Secretary is
required to consult with appropriate public and private
entities, such as other Federal agencies where AEDs may be
recommended to be placed, entities that own buildings or land
rented or leased by Federal agencies, and various local and
private sector health care groups that have traditionally been
involved or that may become involved under the Secretary's
guidelines in promoting or implementing AED use. The Secretary
is also directed to consider various recommendations of
national and local public-health organizations to achieve
additional improvements in the survival rates of individuals
experiencing cardiac arrest, and to minimize the time elapsing
between the onset of cardiac arrest and the initial medical
response of such individuals. The Secretary is directed to
issue such guidelines and publish such recommendations within
180 days after the date of enactment of this legislation.
Section 4. Good Samaritan protections regarding emergency use of
automated external defibrillators
Section 4 establishes so-called ``Good Samaritan''
protections from liability for people who use or acquire AEDs.
Users of AEDs are protected from liability for using an AED on
an individual so long as the individual's behavior could lead a
reasonable person to believe that such individual is
experiencing a life-threatening medical condition that requires
an immediate medical response regarding the heart or other
cardiopulmonary functioning of the individual. This provision
is intended by the Committee to be a reasonable good faith
test, since there are very few outward symptoms of a cardiac
arrest for which victims require immediate medical attention,
and the AEDs will not administer a shock until after an
individual's heart rate is measured and a shock determined
appropriate. Thus, if a person reasonably believes that an
individual is suffering cardiac arrest, this provision is
intended to provide immunity from liability to encourage such
person to utilize an AED on such individual. If a person uses
an AED on an individual whom a reasonable lay person could
clearly recognize was not suffering from a heart condition
requiring immediate medical attention, then the liability
protections of this Act do not apply.
Physicians and other licensed or certified health
professionals who are using an AED within the scope of their
health employment or agency are also excluded from immunity
protection. Thus, a nurse using an AED at the nurse's place of
employment while on duty would not be covered, but the same
nurse if acting in a lay capacity as a bystander outside of a
hospital would receive protection.
The immunity provision is further limited to cases where
any harm caused by improper use of an AED is not due to the
user's willful or criminal misconduct, gross negligence,
reckless misconduct, or conscious and flagrant indifference to
the rights or safety of the harmed individual. This standard is
taken from the Volunteers Protection Act, and is intended to
reflect a good faith standard that provides significantly more
protection for Good Samaritans than the regular negligence
standard common in most States.
Acquirers of AEDs are also granted immunity from liability
related to the AEDs, so long as any harm caused by the use of
an AED is not a result of the acquirer's failure to notify
local emergency medical systems personnel or other appropriate
entities of the devices'placement within a reasonable period of
time after a placement of the device, failure to properly maintain and
test the AED, or failure to provide appropriate AED training to an
employee or agent who used the device on the victim in cases where the
employee or agent would have been reasonably expected to use the device
and the acquirer had a reasonable opportunity to train the user from
the time at which the person could reasonably be expected to use the
device.
Acquirers are subject to the same standard as good faith
users (the harm was not caused by willful or criminal
misconduct, etc.). However, the immunity provision does not
protect hospitals and other health care entities where the harm
from an AED use was caused by an employee or agent of the
health entity using the AED while acting in the scope of their
employment. This exclusion is similar to that for doctors and
nurses acting within the scope of their employment, and is
intended to exclude from immunity those entities holding
themselves out as health care providers who are accordingly
held to a higher standard of care then a person not acting in
an official health care capacity.
The liability immunity protections do not apply to
acquirers who lease, or rent, or otherwise hold title to an AED
provided to a health care entity in cases where the AED is used
by an employee or agent of a health care entity while acting
within the scope of their employment or agency for such entity.
This exclusion is intended to cover instances where hospitals
and other health entities are using AEDs as part of the health
care services they are providing, but where they are not the
actual acquirers of the AED.
The rules of construction provide that this bill does not
create any new cause of action, and does not require that an
AED be placed at any building or other location. State laws are
not superseded if the State has or enacts a statute or
regulation providing immunity for the applicable class of
persons. Additional existing protections from liability for
Federal employees are not affected by this Act, including those
in the Federal Tort Claims Act. However, the additional
protections provided by this Act do apply to any action for
civil liability arising under Federal law. The protections also
apply to users and acquirers in military bases and other
Federal jurisdictions that have adopted the laws of a
surrounding State regarding matters where no other applicable
Federal law exists.
Changes in Existing Law Made by the Bill, as Reported
In compliance with clause 3(e) of rule XIII of the Rules of
the House of Representatives, changes in existing law made by
the bill, as reported, are shown as follows (existing law
proposed to be omitted is enclosed in black brackets, new
matter is printed in italic, existing law in which no change is
proposed is shown in roman):
PUBLIC HEALTH SERVICE ACT
* * * * * * *
TITLE II--ADMINISTRATION AND MISCELLANEOUS PROVISIONS
* * * * * * *
Part B--Miscellaneous Provisions
* * * * * * *
recommendations and guidelines regarding automated external
defibrillators for federal buildings
Sec. 247. (a) Guidelines on Placement.--The Secretary shall
establish guidelines with respect to placing automated external
defibrillator devices in Federal buildings. Such guidelines
shall take into account the extent to which such devices may be
used by lay persons, the typical number of employees and
visitors in the buildings, the extent of the need for security
measures regarding the buildings, buildings or portions of
buildings in which there are special circumstances such as high
electrical voltage or extreme heat or cold, and such other
factors as the Secretary determines to be appropriate.
(b) Related Recommendations.--The Secretary shall publish in
the Federal Register the recommendations of the Secretary on
the appropriate implementation of the placement of automated
external defibrillator devices under subsection (a), including
procedures for the following:
(1) Implementing appropriate training courses in the
use of such devices, including the role of
cardiopulmonary resuscitation.
(2) Proper maintenance and testing of the devices.
(3) Ensuring coordination with appropriate licensed
professionals in the oversight of training of the
devices.
(4) Ensuring coordination with local emergency
medical systems regarding the placement and incidents
of use of the devices.
(c) Consultations; Consideration of Certain
Recommendations.--In carrying out this section, the Secretary
shall--
(1) consult with appropriate public and private
entities;
(2) consider the recommendations of national and
local public-health organizations for improving the
survival rates of individuals who experience cardiac
arrest in nonhospital settings by minimizing the time
elapsing between the onset of cardiac arrest and the
initial medical response; and
(3) consult with and counsel other Federal agencies
where such devices are to be used.
(d) Date Certain for Establishing Guidelines and
Recommendations.--The Secretary shall comply with this section
not later than 180 days after the date of the enactment of the
Cardiac Arrest Survival Act of 2000.
(e) Definitions.--For purposes of this section:
(1) The term ``automated external defibrillator
device'' has the meaning given such term in section
248.
(2) The term ``Federal building'' includes a building
or portion of a building leased by a Federal agency,
and includes buildings on military installations of the
United States.
liability regarding emergency use of automated external defibrillators
Sec. 248. (a) Good Samaritan Protections Regarding AEDs.--
Except as provided in subsection (b), any person who uses an
automated external defibrillator device on a victim of a
perceived medical emergency is immune from civil liability for
any harm resulting from the use of such device; and in
addition, any person who acquired the device is immune from
such liability, if the harm was not due to the failure of such
acquirer of the device--
(1) to notify local emergency response personnel or
other appropriate entities of the most recent placement
of the device within a reasonable period of time after
the device was placed;
(2) to properly maintain and test the device; or
(3) to provide appropriate training in the use of the
device to an employee or agent of the acquirer when the
employee or agent was the person who used the device on
the victim, except that such requirement of training
does not apply if--
(A) the employee or agent was not an employee
or agent who would have been reasonably
expected to use the device; or
(B) the period of time elapsing between the
engagement of the person as an employee or
agent and the occurrence of the harm (or
between the acquisition of the device and the
occurrence of the harm, in any case in which
the device was acquired after such engagement
of the person) was not a reasonably sufficient
period in which to provide the training.
(b) Inapplicability of Immunity.--Immunity under subsection
(a) does not apply to a person if--
(1) the harm involved was caused by willful or
criminal misconduct, gross negligence, reckless
misconduct, or a conscious, flagrant indifference to
the rights or safety of the victim who was harmed; or
(2) the person is a licensed or certified health
professional who used the automated external
defibrillator device while acting within the scope of
the license or certification of the professional and
within the scope of the employment or agency of the
professional; or
(3) the person is a hospital, clinic, or other health
care entity, and the harm was caused by an employee or
agent of the entity who used the device while acting
within the scope of the employment or agency of the
employee or agent; or
(4) the person is an acquirer of the device who
leased the device to a health care entity (or who
otherwise provided the device to such entity for
compensation without selling the device to the entity),
and the harm was caused by an employee or agent of the
entity who used the device while acting within the
scope of the employment or agency of the employee or
agent.
(c) Rules of Construction.--
(1) In general.--The following applies with respect
to this section:
(A) This section does not establish any cause
of action, or require that an automated
external defibrillator device be placed at any
building or other location.
(B) With respect to a class of persons for
which this section provides immunity from civil
liability, this section supersedes the law of a
State only to the extent that the State has no
statute or regulations that provide persons in
such class with immunity for civil liability
arising from the use by such persons of
automated external defibrillator devices in
emergency situations (within the meaning of the
State law or regulation involved).
(C) 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.
(2) Civil actions under federal law.--
(A) In general.--The applicability of
subsections (a) and (b) 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.
(d) Federal Jurisdiction.--In any civil action arising under
State law, the courts of the State involved have jurisdiction
to apply the provisions of this section exclusive of the
jurisdiction of the courts of the United States.
(e) Definitions.--
(1) Perceived medical emergency.--For purposes of
this section, the term ``perceived medical emergency''
means circumstances in which the behavior of an
individual leads a reasonable person to believe that
the individual is experiencing a life-threatening
medical condition that requires an immediate medical
response regarding the heart or other cardiopulmonary
functioning of the individual.
(2) Other definitions.--For purposes of this section:
(A) The term ``automated external
defibrillator device'' means a defibrillator
device that--
(i) is commercially distributed in
accordance with the Federal Food, Drug,
and Cosmetic Act;
(ii) is capable of recognizing the
presence or absence of ventricular
fibrillation, and is capable of
determining without intervention by the
user of the device whether
defibrillation should be performed;
(iii) upon determining that
defibrillation should be performed, is
able to deliver an electrical shock to
an individual; and
(iv) in the case of a defibrillator
device that may be operated in either
an automated or a manual mode, is set
to operate in the automated mode.
(B)(i) The term ``harm'' includes physical,
nonphysical, economic, and noneconomic losses.
(ii) The term ``economic loss'' means any
pecuniary loss resulting from harm (including
the loss of earnings or other benefits related
to employment, medical expense loss,
replacement services loss, loss due to death,
burial costs, and loss of business or
employment opportunities) to the extent
recovery for such loss is allowed under
applicable State law.
(iii) The term ``noneconomic losses'' means
losses for physical and emotional pain,
suffering, inconvenience, physical impairment,
mental anguish, disfigurement, loss of
enjoyment of life, loss of society and
companionship, loss of consortium (other than
loss of domestic service), hedonic damages,
injury to reputation and all other nonpecuniary
losses of any kind or nature.