Are you prepared for a medical emergency?

Are you prepared for a medical emergency?

Richard A. Lazar

Prompted by the American Heart Association, the medical equipment industry has developed a lightweight, low-cost and easy-to-use lifesaving device. Known as an automated external defibrillator, or AED, it delivers electric shock to restart the heart–and has the potential to save at least half of the 350,000 people who die of cardiac arrest in the U.S. each year, if it’s administered within minutes.

The AED’s creation leaves employers with the weighty task of deciding whether to keep one or more of these units On hand. What’s stopping many of them isn’t the cost (about $3-4,000 per unit) or the training (less than four hours, according to the AHA).

Rather, it’s the fear of liability. Would-be purchasers worry that stocking up on this and other emergency medical equipment would somehow increase their risk. Tort law, two recent jury verdicts and newly introduced federal legislation suggest otherwise.

Businesses have a legal obligation to prepare for medical emergencies, in accordance with state law and federal Occupational Safety and Health Administration requirements. Until recently, courts have required nothing more than summoning an ambulance in a timely manner. Clinically, that response is often inadequate.

Emergency medical technicians (EMTs) couldn’t save the life of the man whose heart stopped while he worked out in a New York City gym last spring, for example, since it took their ambulance more than 15 minutes to wend its way through the traffic-clogged streets. Similarly, an off-site emergency team might not arrive in time for a shopper who goes into sudden cardiac arrest in a crowded department store or a construction worker at a remote site. Nor could EMTs reach a stricken passenger on a plane, boat or train.

Examples like these, coupled with the new technology and two recent court verdicts, point to a move toward higher standards.

In June 1996, a Florida jury found Busch Gardens negligent for not properly training its employees to provide emergency care–and for failing to have essential medical equipment, including a defibrillator, on the premises. The plaintiff was awarded $500,000 in damages for the death of her teenage daughter. In another recent case, a federal judge found Lufthansa Airlines negligent for failing to provide timely treatment to a passenger who suffered a cardiac emergency. The damage award in that case: $2.7 million.

While these verdicts will certainly by appealed, the availability of AEDs and their demonstrated ability to save lives may persuade more judges and juries to reach similar conclusions. That’s especially likely for industries like the airlines, where the risks of failing to adopt the latest technology may be greater than those associated with the use of portable defibrillators. Indeed, American Airlines announced last year that all its aircraft would be equipped with the devices by the end of 1998, and the Federal Aviation Administration is considering whether to require every airline to follow suit.

While employers–particularly those that deal with the public–should consider buying AEDs and training staffers to use them, the issue is not without controversy. Here are some key points to ponder:

* It’s difficult to misuse AEDs, since they’re designed to distinguish between heart rhythms that require electric shock from those that do not.

* To date, there have been no lawsuits involving the use of a defibrillator in a business setting, and most firms carry liability insurance as protection should such a lawsuit arise. Good Samaritan laws, designed to safeguard people who voluntarily assist in a medical emergency from being sued, may provide further protection.

* Laws on emergency medical care, including defibrillation, vary from state to state. The federal Cardiac Arrest Survival Act, which calls for a model states could adopt to allow widespread use of AEDs and other lifesaving devices–and provide immunity for those who give emergency care–is pending in Congress. Supporters include the AHA, the American Red Cross and cardiologists’ and emergency and critical care nurses’ associations. Other organizations, most notably the National Association of State Emergency Services Directors and the FDA, contend that the push for AEDs should be delayed until the devices have been proven safe and effective for public use.

In the end, it may come down to this: Communities such as Richmond, Va., and Seattle, Wash., where defibrillators are widely used, report that up to 30 percent of cardiac arrest victims survive. In cities without them, like New York and Chicago, the rates are down around 1 to 2 percent. Clearly, automated external defibrillators save lives.

The author, an attorney and consultant based in Portland, Ore., often advises employers on the use of AEDs.

COPYRIGHT 1997 A Thomson Healthcare Company

COPYRIGHT 2004 Gale Group