One concern many people have when deciding to purchase an automatic external defibrillator (AED) is regarding their liability. Are you liable if a victim of cardiac arrest doesn’t survive, even if the AED is used properly? Are you liable if a rescuer does not use the AED properly? What about when the only rescuer(s) is/are not trained to use the AED? Are you or the rescuers liable if they use the AED improperly? Are you liable if your AED if not in working order when it is needed in an emergency? The United States has a reputation for being a litigious society, and understandable that you may be concerned about your liability and the liability of those around you. Thankfully, the laws tend to protect those who own and use the AEDs.
In 2000 the Public Health Service Act was amended to add a section that specifically dealt with the liability of using AEDs. It provided immunity from civil liability to both the person who acquired the AED and the person who used or attempted to use the AED on a victim. However, there are some stipulations that must be met for a person to obtain this immunity. The law requires the person who acquires an AED to notify local emergency response personnel of the location of the device, to properly maintain and test the device, and to provide training in the use of the device to employees who may reasonably be expected to use the device. If a person who uses the AED causes harm to a victim due to “willful or criminal misconduct, gross negligence, reckless misconduct, or a conscious, flagrant indifference to the rights or safety of the victim” they will not be protected under this law. A rescuer who tries to save a victim to the best of their ability and with the best of their intentions, however, will be granted civil immunity. It should be noted that this law does not provide protection to health professionals who use an AED while performing duties of their employment.
Since this federal law was enacted, there have been three bills introduced in the House, in 2011, 2013, and most recently in 2015, that have sought to expand and clarify the liability protections in the original law. The first two bills died in committee and were never enacted into law. The most current bill, H.R. 4152, also was referred to the Health Energy and Commerce Subcommittee on Health. At the time of this article’s publication the bill has not yet passed the committee and gone to the floor for a vote. If this bill were to pass the House and Senate and be signed by the President, it would give immunity in certain circumstances that are not clearly stated in the original bill. For example, the bill specifies that immunity from civil liability would apply even if the person who used the AED had never received training.
Each state has different laws that pertain to AEDs. Some states have “Good Samaritan” laws that provide additional liability protection for owners and / or users of AEDs. When purchasing an AED it’s a good idea to check out your state’s laws, not only to ensure that you are abiding by any legal requirements specific to your state, but to also see if there is any additional liability protection provided to you as the owner or to the people who may end up using your AED.
It would be nice if you could just purchase your AED, store it away somewhere, and never think about it again, but unfortunately that’s just not the case. AED ownership requires a bit of ongoing maintenance. As we’ve just discussed, proper maintenance of your AED is required in order to be protected from civil liability under the federal law, and your state may have more stringent maintenance requirements.
The cost of replacement supplies varies by manufacturer and model. In addition to the upfront cost, the costs of routine maintenance should be an important consideration when you are looking to purchase an AED. When comparing models, research the price of replacement batteries and pads, and find out how frequently they will need to be replaced. In general, batteries and pads should be replaced every 2 to 5 years, but the exact frequency will depend on the device. Pads can cost anywhere from $40 to $170. Some owners choose to purchase pads made for children in addition to the standard adult pads. The extra pads for children may not be included in the original purchase price of the AED, and they will become an extra maintenance cost to replace when they expire. Adding these extra child-sized pads may be an easy decision if the AED is to be placed in a location such as a school, but they may not be necessary the AED is going to be located in a place where children are rarely or never present, such as a factory. The battery is the other component of an AED that will require routine replacement, and the cost can vary widely from around $100 to almost $400.
Given that replacing pads and batteries can get expensive, you might wonder why it is necessary, especially if the device has never been used. Even when not in use, the battery can wear down over time. There have been cases when an AED was available to use in the case of sudden cardiac arrest (SCA) but the machine either would not work or shut down due to a low or dead battery. Owners of AEDs will also discover that the pads have expiration dates. This is because the pads are coated with gel when they are manufactured. The gel coating is the reason why pads need to stay in their packaging, and the packaging needs to checked to ensure in remains intact until they are needed for use. The gel functions to help the pad “stick” to the victim’s skin, which is very important for several reasons. The pads are responsible for both analyzing the victim’s heart rhythm (to determine if a shock should or should not be given) and for giving the patient a shock. Good contact between the skin and the pads in imperative for the device to function properly. The “stick” factor is also important in making sure the pads stay attached properly while CPR is performed, an activity which could easily dislodge the pads without good adhesion. Unfortunately, the gel breaks down over time and eventually the pads will no longer stick well enough to provide the lifesaving information and shock that a victim needs.
Maintenance of an AED is not limited to occasionally replacing some parts. The American Heart Association recommends that AEDs be inspected visually on a weekly or monthly basis. It is recommended that a single person be designated to perform this duty, and that this designated person should also come up with a checklist that will ensure the AED is equipped with supplies and is ready to use at a moment’s notice. Checklist items can include making sure there are no cracks or loose parts, that the cable wires are intact and not cut or exposed, and that the device is clean and generally in good repair. The pads should remain sealed in their packages, and the expiration date of the pads and battery should be checked and noted. In addition to these visual checks, the manufacturer of the AED may recommend a schedule for more detailed inspections. You will also need to check with the manufacturer to ensure your device has the most recent software updates and upgrades.
Training in both CPR and the use of an AED is imperative when you make the decision to obtain an AED. After all, what’s the point of investing in a lifesaving tool if no one knows how to use it? It is a good idea to train as many people as possible, because it is almost impossible to predict who might be available to respond in an emergency situation. While AEDs are relatively intuitive devices, training will increase the responder’s confidence and comfort level.
The American Heart Association and the Red Cross are the two most well-known providers of CPR and AED training. Between the two organizations, it is fairly easy to find an instructor or class in most areas of the country. Some classes cover CPR and AED use in both adults and children, and others will only provide training for adults. Make sure you pick a class that best suits your needs. Classes are often combined with basic first aid training and certification. If you are interested in training a group of people, it is possible to find instructors who will come to your location with the necessary supplies to provide training classes and certification at convenient times. Often these group classes are offered at a discount rate. Certifications are valid for two years. For people wishing to renew their training near the end of the two-year period, there are retraining classes that are shorter than the standard classes will allow individuals to obtain recertification for an additional two years. It is also possible to obtain certification through online classes. These virtual classes do not allow for the same hands-on skills training that is available in the classroom setting, although the convenience of being able to obtain certification at a time that best fits your schedule is an advantage for people who are particularly busy.