DATE: January 15, 2002
TO: Board of Supervisors
SUBJECT: Common Sense Protection for Users and Purchasers of Automated External Defibrillators (AEDs)

SUMMARY:
Overview
On September 25, 2001, this Board approved our recommendation to establish a Public Access Defibrillation (PAD) Program in the County of San Diego. It is our hope that these devices, strategically placed throughout the County, will provide much needed life support to those who suffer sudden cardiac arrest.

The rate of participation in acquiring and using these devices will determine the success of this program. The County has committed to purchasing 100 of the machines, and possibly more later. Other entities, particularly in the private sector, have expressed interest in purchasing these machines for their buildings, but some have concerns due to limited liability protection afforded under California law.

Current California law does not provide for immunity from liability for purchasers of automated external defibrillators (AEDs) unless the purchaser ensures that expected users complete training courses in cardiopulmonary resuscitation (CPR) and AED use. Similarly, people who operate the AED in good faith are not provided with immunity from liability unless they too have completed training courses in CPR and AED use. Because of this, insurers are also concerned about the liability impact to their policyholders. These concerns have had a chilling effect on private participation in the program. Current law needs to be amended so that more people participate and thus increase our reach throughout the County.

Recommendations
CHAIRMAN RON ROBERTS AND SUPERVISOR DIANNE JACOB
Direct the Chief Administrative Officer to add to the County legislative agenda the policy to amend California law to provide immunity from liability to any entity or person who provides or uses in good faith an Automated External Defibrillator (AED) regardless of whether the person using the AED has completed courses in cardiopulmonary resuscitation (CPR) and AED use.

Fiscal Impact
None by this action.

BACKGROUND:
Imagine yourself playing a round of golf with a friend on any golf course in San Diego County. Suddenly and without notice, your friend is on the ground suffering a sudden cardiac arrest. You are panicked but you notice an orange colored machine, titled AED (Automated External Defibrillator), which is used for moments like these. Although you are untrained in AED use, you open up the box and it takes you step-by- step through the process of operation. You follow the steps, the machine works properly, and you call for help. Your friend is saved because you acted quickly and properly under the circumstances. Minutes are critical in times like these.

However, let's say that your friend was not revived, and for whatever reason the AED machine did not work properly in this case, though you followed the process as outlined. Although you acted in good faith, under California law you may not be protected from liability. This can also be the same for the golf course that purchased the AED because the user was untrained in CPR or AED use. This is wrong.

The current technology is light years ahead of what we're familiar with on television dramas from years past. These machines sense the condition of the victim's heart and determine whether a shock should be given. Only then can a responder, under verbal direction from the device, deliver the shock to the victim to help restore their heart to a normal rhythm. According to proponents, the AED cannot shock where the victim is in any other rhythm, so there is protection built into the device.

It was largely due to these advances, that the County of San Diego recently started its own Public Access Defibrillation (PAD) Program. It is our hope that we will put 100 of these devices at various County parks, buildings, or other facilities. That's a good start, but for this program to have a significant impact in preventing deaths in the County, we need participation from the private sector to acquire them for their facilities countywide. Some of the many places we foresee the machines being placed are shopping malls, office and commercial/industrial buildings, ball fields and golf courses and other places where large numbers of people congregate. In order to do this the private sector needs to be involved. In our discussions with representatives from the private sector, they have expressed concerns about California's "Good Samaritan" protections and their reluctance to acquire these devices for fear of litigation. According to these representatives, insurance carriers have similarly expressed concern about liability exposure as a result of California law.

A number of states have passed AED immunity statutes that protect trained and untrained users acting in good faith, as well as the purchaser of the device. California's law should similarly protect these individuals. As a state we should not expect wide spread acceptance of AEDs until we're willing to adopt common sense protections of those we're encouraging to use them.

In an effort to improve private participation in the PAD program, we are asking this Board to make part of our County legislative agenda for 2002, the policy to amend California law to provide immunity from liability to any entity or person who provides or uses in good faith an AED regardless of whether the person using the AED has completed training courses in CPR and AED use.

Only when we have broad participation from both the public and private sector can it ever be successful. This is a common sense approach to the law. We urge your support of the recommendation.

Respectfully Submitted,

RON ROBERTS
Chairman

DIANNE JACOB
Supervisor, Second District