H.R. 1670 (105^th): Airline Passenger Safety Act of 1997

HR 1670 IH

To amend title 49, United States Code, to require air carriers to establish procedures for responding to in-flight medical emergencies, and for other purposes.

May 20, 1997

Mrs. KENNELLY of Connecticut introduced the following bill; which was referred to the Committee on Transportation and Infrastructure

To amend title 49, United States Code, to require air carriers to establish procedures for responding to in-flight medical emergencies, and for other purposes.

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

This Act may be cited as the ‘Airline Passenger Safety Act of 1997’.

SEC. 2. IN-FLIGHT MEDICAL EMERGENCIES.

(a) IN GENERAL- Chapter 417 of title 49, United States Code, is amended by adding at the end the following:

‘SUBCHAPTER III--IN-FLIGHT MEDICAL EMERGENCIES

‘Sec. 41761. Treatment of in-flight medical emergencies

‘(a) IN-FLIGHT MEDICAL EMERGENCY PROCEDURES-

‘(1) ESTABLISHMENT- Each air carrier shall--

‘(A) establish a detailed list of procedures to be followed by the air carrier in the event of an in-flight medical emergency; and

‘(B) submit a copy of such procedures to the Secretary not later than 180 days after the date of the enactment of this subchapter.

‘(2) REQUIREMENTS-

‘(A) STEPS TO BE FOLLOWED IN MEDICAL EMERGENCIES- The procedures established by an air carrier under paragraph (1) shall ensure that the following steps are taken, in the order specified, in the event of an in-flight medical emergency involving a passenger of the carrier:

‘(i) Attending to the passenger.

‘(ii) Notifying the pilot in command.

‘(iii) Requesting assistance from medically-qualified passengers.

‘(iv) Consulting the in-flight medical care manual of the air carrier.

‘(B) CARDIAC EMERGENCIES- In addition to the requirements of subparagraph (A), procedures established by an air carrier under paragraph (1) shall ensure that in the case of a cardiac emergency a 4-step chain of survival plan is implemented which requires, in the order specified, the following:

‘(i) Activation of the emergency medical system (ensuring that emergency call procedures are in place to summon skilled aid).

‘(ii) Cardiopulmonary resuscitation.

‘(iii) Defibrillation.

‘(iv) Getting the patient to a full care unit (such as a hospital) as soon as possible for advanced cardiac support.

‘(C) LEVEL OF ASSISTANCE- The procedures established by an air carrier under paragraph (1) shall afford the same level of assistance to passengers as are afforded to members of the flight crew.

‘(3) AVAILABILITY OF PROCEDURES TO THE PUBLIC- Each air carrier shall provide to a passenger of the air carrier, upon request of the passenger, a copy of the procedures established by the carrier under paragraph (1).

‘(b) LIFE-SAVING EQUIPMENT AND APPROPRIATELY STOCKED FIRST-AID KITS AND MEDICAL KITS-

‘(1) IN GENERAL- On and after the 180th day following the date of the enactment of this subchapter, each aircraft operated by an air carrier in air transportation or intrastate air transportation shall be equipped with--

‘(A) at least 1 piece of life-saving equipment (such as an automated external defibrillator) for use in responding to a cardiac emergency;

‘(B) at least 1 first-aid kit; and

‘(C) at least 1 medical kit;

The air carrier shall restock such kits, as necessary, before each flight segment.

‘(2) ACCESS TO EQUIPMENT- Each member of the flight crew on an aircraft described in paragraph (1) shall have access to the life-saving equipment, first-aid kit, and medical kit required under paragraph (1).

‘(3) PERIODIC REVIEWS- The Secretary shall conduct periodic reviews of the life-saving equipment, first-aid kits, and medical kits required under paragraph (1) and shall require such additional items to be included in the kits as the Secretary determines appropriate.

‘(c) IN-FLIGHT EMERGENCY PROCEDURES MANUAL-

‘(1) ESTABLISHMENT- Each air carrier shall--

‘(A) train flight crew members in cardiopulmonary resuscitation and operation of an automated external defibrillator;

‘(B) establish an in-flight emergency procedures manual, including cardiac medical emergency response procedures; and

‘(C) submit such manual to the Secretary not later than 180 days after the date of the enactment of this subchapter.

‘(2) REQUIREMENTS- The manual established by an air carrier under paragraph (1) shall include, at a minimum, the following:

‘(i) Instructions for the use of all items in first-aid kits and medical kits.

‘(ii) Procedures for handling cardiac emergencies and other immediately life-threatening medical emergencies.

‘(iii) Basic emergency procedures, including cardiopulmonary resuscitation, operation of life-saving equipment (such as an automated external defibrillator), mouth-to-mouth resuscitation, and administration of oxygen.

‘(3) EQUIPPING OF MANUALS ON AIRCRAFT- On and after the 180th day following the date of the enactment of this subchapter, each aircraft operated by an air carrier in air transportation or intrastate air transportation shall be equipped with the manual of the air carrier established under paragraph (1), including at least 1 copy of the manual in the cockpit and at least 1 copy of the manual next to each first-aid kit and medical kit on the aircraft.

‘(d) EMERGENCY MEDICAL CARE- Each air carrier shall take such actions as may be necessary to ensure that--

‘(1) each member of the flight crew on an aircraft operated by the air carrier in air transportation or intrastate air transportation has received training in cardiopulmonary resuscitation, operation of life-saving equipment (such as an automated external defibrillator), and emergency medical training and first-aid procedures, including the use of each supply in a first-aid kit; and

‘(2) at least 1 member of the flight crew on such aircraft is authorized to operate an automated external defibrillator (or similar life-saving equipment) and to use a first-aid kit and medical kit.

‘(e) ON-GROUND MEDICAL CONTRACTOR- Each air carrier shall enter into a contract with a clinic, hospital, or other accredited medical care provider to provide the air carrier with medical advice at any time in the case of an in-flight medical emergency. Upon entering into such contract, the carrier shall submit the name of the medical care provider to the Secretary.

‘(f) ASSISTANCE OF MEDICALLY-QUALIFIED PASSENGERS- Each air carrier shall take such actions as may be necessary to ensure that when an in-flight medical emergency takes place on an aircraft operated by the air carrier, the flight crew assigned to the aircraft will solicit the assistance of medically-qualified passengers. In soliciting such assistance, the flight crew shall announce that passengers who provide such assistance will be exempt from liability, as provided in section 41768 of this title.

‘(g) RESPONSIBILITIES OF PILOT IN COMMAND- Each air carrier shall take such actions as may be necessary to ensure that when an in-flight medical emergency takes place on an aircraft operated by the air carrier, the pilot in command will solicit and consider the advice of a medical responder as to the condition of the passenger that is the subject of the emergency and, as appropriate, will take necessary actions for rerouting the aircraft to the nearest airport.

‘(h) LAVATORIES- Each air carrier shall take such actions as may be necessary to ensure that a member of the flight crew on an aircraft operated by the air carrier in air transportation or intrastate air transportation will check on any passenger that is inside a lavatory on the aircraft for more than 10 minutes.

‘Sec. 41762. Ground procedures

‘(a) MEDICAL PERSONNEL- Not later than 6 months after the date of the enactment of this subchapter, the Secretary shall establish procedures to ensure that appropriate medical personnel, including a coroner in the event of the death of a passenger, are present to meet an aircraft upon the notification of an air traffic controller of an in-flight medical emergency.

‘(b) PROCEDURES-

‘(1) IN GENERAL- Not later than 6 months after the date of the enactment of this subchapter, the Secretary shall establish procedures for in-flight medical emergencies requiring an emergency landing, including--

‘(A) establishing a medical facility to be contacted when it is determined that an aircraft will be landing at the airport after an in-flight medical emergency; and

‘(B) designating an airport ground crew that will meet the plane, including medical personnel assigned to the airport.

‘(2) LEVEL OF PRIORITY- The procedures established by the Secretary under paragraph (1) shall ensure that an aircraft that is rerouted as the result of an in-flight medical emergency will be afforded the same level of priority for landing as an aircraft that is experiencing mechanical malfunctions.

‘(c) FACILITIES IN TERMINALS- Each air carrier providing air transportation or intrastate air transportation shall establish a plan, and adequate facilities and pathways in the terminal on the ground, to facilitate attending to, and as necessary transferring, patients who are removed ill from an aircraft or who become ill in the terminal.

‘Sec. 41763. Aircraft specifications

An air carrier may not purchase or lease any aircraft manufactured after the 180th day after the date of the enactment of this subchapter unless the aircraft is equipped with an emergency call button in each lavatory on the aircraft.

‘Sec. 41764. Incident reports

‘(a) REPORTS BY AIR CARRIERS-

‘(1) IN GENERAL- Each air carrier shall transmit to the Secretary, within 48 hours of any in-flight medical emergency occurring on an aircraft operated by the carrier, a report containing a description of the emergency. Upon receipt of a report, the Secretary shall make the report available to the public.

‘(2) CONTENTS- A report transmitted under paragraph (1) shall contain, at a minimum, the following:

‘(A) A statement of the time that the emergency was first made known to a member of the flight crew.

‘(B) A detailed description of the actions relating to and taken in response to the emergency, including the time each action occurred.

‘(C) A detailed description of the symptoms of the passenger that experienced the emergency, including the time each symptom was recognized.

‘(D) A detailed description of any medical treatment provided to the passenger, including a list of any equipment used in providing such treatment from a first-aid kit or medical kit and the name, title, and address of any person providing such treatment.

‘(E) A detailed description of any communication initiated by the pilot in command to an air traffic controller or an on-ground medical contractor, including the time of the communication.

‘(F) A detailed description of any medical advice provided by an on-ground medical contractor or a medically-qualified passenger.

‘(G) A statement of the time of any decision to reroute the aircraft as a result of the emergency.

‘(H) A statement of the name and qualifications of any medically-qualified passengers who assisted in the emergency.

‘(I) An assurance that all records concerning the emergency (including records concerning actions taken in-flight and on the ground) were filed by the air carrier with appropriate Federal, State, and local authorities within 24 hours of the emergency.

‘(b) REPORTS BY AIR TRAFFIC CONTROL- Each air traffic controller shall transmit to the Secretary, within 48 hours of any in-flight medical emergency reported to the controller, a report on any actions taken by the controller in response to an in-flight medical emergency that required an emergency landing.

‘(c) CONSULTATION WITH MEDICAL FACILITY- After receiving a report from an air carrier under this section concerning an in-flight medical emergency, the Secretary shall--

‘(1) consult with the medical facility to which the passenger was transferred after the flight to determine whether the passenger was released from the facility and the final condition of the passenger; and

‘(2) include information obtained pursuant to paragraph (1) in the report.

‘Sec. 41765. Family notification

‘(a) RESPONSIBILITIES OF AIR CARRIER-

‘(1) INITIAL NOTICE- As soon as practicable after the time of an in-flight medical emergency involving a passenger of an air carrier, the air carrier shall notify the family of the passenger about the emergency.

‘(2) COPY OF REPORT SUBMITTED TO SECRETARY- Not later than 1 week after the date of the emergency, the air carrier shall provide to the family of the passenger a complete copy of the report concerning the emergency submitted to the Secretary pursuant to section 41764(a) of this title.

‘(b) RESPONSIBILITIES OF THE SECRETARY-

‘(1) APPOINTMENT OF LIAISON- Not later than 48 hours after an in-flight medical emergency, the Secretary shall appoint an individual within the Department of Transportation to serve as a liaison to family members of the passenger.

‘(2) COPY OF REPORT SUBMITTED BY AIR TRAFFIC- Not later than 1 week after the date of the medical emergency, the Secretary shall provide to the family of the passenger a copy of any report concerning the emergency submitted to the Secretary by an air traffic controller pursuant to section 41764(b) of this title.

‘Sec. 41766. Compliance

‘(a) REVIEW OF AIR CARRIER COMPLIANCE-

‘(1) IN GENERAL- Not later than 1 year after the date of the enactment of this subchapter, the Secretary shall conduct a review of the compliance of each air carrier with the requirements of this subchapter.

‘(2) CONTENTS OF REVIEW- In conducting a review of an air carrier under subsection (a), the Secretary, at a minimum, shall--

‘(A) review the in-flight medical emergency procedures of the air carrier;

‘(B) review the in-flight medical emergency procedures manual of the air carrier;

‘(C) conduct checks to determine whether life-saving equipment are in proper working order and whether first-aid kits and medical kits of the air carrier are fully stocked; and

‘(D) conduct checks to determine whether emergency call buttons on aircraft operated by the air carrier are operational.

‘(b) REVIEW OF AIRPORT COMPLIANCE- Not later than 1 year after the date of the enactment of this subchapter, the Secretary shall conduct a review of the procedures established at each airport for meeting passengers with medical emergencies.

‘Sec. 41767. Studies

‘(a) STATISTICS ON IN-FLIGHT MEDICAL EMERGENCIES-

‘(1) IN GENERAL- The Secretary shall keep statistics on the number of in-flight medical emergencies occurring each year based on reports submitted to the Secretary by air carriers and air traffic controllers and shall make such statistics available to the public.

‘(2) ANNUAL LIST- The Secretary shall publish on an annual basis in the Federal Register a list of the number of in-flight emergencies occurring in the preceding year. Such list shall categorize such emergencies by type of illness, type of treatment afforded, whether or not the aircraft was rerouted, and the final condition of the passenger.

‘(b) USE OF SATELLITE COMMUNICATIONS-

‘(1) STUDY- The Secretary shall conduct a study of the feasibility of using satellite communications of Global Position Satellites as a method of improving communications between pilots, ground medical personnel, and air traffic controllers.

‘(2) REPORT- Not later than 1 year after the date of the enactment of this subchapter, the Secretary shall transmit to Congress a report on the results of the study conducted under paragraph (1).

‘Sec. 41768. Limitations on liability

‘(a) LIABILITY OF AIR CARRIERS- An air carrier shall not be liable for damages in any action brought in a Federal or State court arising out of the performance of the air carrier in obtaining or attempting to obtain the assistance of a medically-qualified passenger in the case of an in-flight medical emergency.

‘(b) LIABILITY OF INDIVIDUALS- An individual shall not be liable for damages in any action brought in a Federal or State court arising out of the performance of the individual in providing or attempting to provide medical treatment in the case of an in-flight medical emergency.

‘Sec. 41769. Definitions

In this subchapter, the following definitions apply:

‘(1) FIRST-AID KIT- The term ‘first-aid kit’ means a kit that includes standard supplies commonly found in a physicians bag, including endotrachial tubing, bicarbonate of soda, and such additional items as the Secretary determines appropriate.

‘(2) IN-FLIGHT MEDICAL EMERGENCY- The term ‘in-flight medical emergency’ means a medical emergency occurring during a flight in air transportation or intrastate air transportation.

‘(3) MEDICAL EMERGENCY- The term ‘medical emergency’ includes--

‘(A) heart emergencies, including cardiac arrest;

‘(B) lack of breathing or shortness of breath;

‘(C) loss of consciousness;

‘(D) stroke;

‘(E) profuse bleeding;

‘(F) shock; and

‘(G) such other emergencies as the Secretary determines appropriate.

‘(4) MEDICAL KIT- The term ‘medical kit’ means a kit that includes--

‘(A) a portable defibrillator;

‘(B) portable oxygen bottles (or canisters) and tubing (with necessary endotrachial masks);

‘(C) lidocaine;

‘(D) epinephrine;

‘(E) nitroglycerine tablets; and

‘(F) such additional items as the Secretary determines appropriate.

‘(5) ON-GROUND MEDICAL CONTRACTOR- The term ‘on-ground medical contractor’ means a medical care provider with which an air carrier has entered into a contract under section 41761(e) of this title.

‘(6) SECRETARY- The term ‘Secretary’ means the Secretary of Transportation.’.

(b) CONFORMING AMENDMENT- The table of sections for such chapter is amended by adding at the end the following:

‘SUBCHAPTER III--IN-FLIGHT MEDICAL EMERGENCIES

‘41761. Treatment of in-flight medical emergencies.

‘41762. Ground procedures.

‘41763. Aircraft specifications.

‘41764. Incident reports.

‘41765. Family notification.

‘41766. Compliance.

‘41767. Studies.

‘41768. Limitations on liability.

‘41769. Definitions.’.

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