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S. 1488 (106th): Cardiac Arrest Survival Act of 1999

The text of the bill below is as of Jan 27, 2000 (Referred to House Committee). The bill was not enacted into law.

S 1488 RFH1S


2d Session

S. 1488


January 27, 2000

Referred to the Committee on Commerce


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.

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


    This Act may be cited as the ‘Cardiac Arrest Survival Act of 1999’.


    The Congress finds as follows:

      (1) Each year more than 250,000 adults suffer cardiac arrest, usually away from a hospital. More than 95 percent of them will die, in many cases because cardiopulmonary resuscitation (‘CPR’), defibrillation, and advanced life support are provided too late to reverse the cardiac arrest. These cardiac arrests occur primarily from occult underlying heart disease and from drowning, allergic or sensitivity reactions, or electrical shocks.

      (2) Every minute that passes before returning the heart to a normal rhythm after a cardiac arrest causes the chance of survival to fall by 10 percent.

      (3) In communities where strong public access to defibrillation programs have been implemented, survival from cardiac arrest has improved by as much as 20 percent.

      (4) Survival from cardiac arrest requires successful early implementation of a chain of events, known as the chain of survival, which must be initiated as soon as the person sustains a cardiac arrest and must continue until the person arrives at the hospital.

      (5) The chain of survival is the medical standard of care for treatment of cardiac arrest.

      (6) A successful chain of survival requires the first person on the scene to take rapid and simple initial steps to care for the patient and to assure that the patient promptly enters the emergency medical services system. These steps include--

        (A) recognizing an emergency and activating the emergency medical services system;

        (B) beginning CPR; and

        (C) using an automated external defibrillator (‘AED’) if one is available at the scene.

      (7) The first persons at the scene of an arrest are typically lay persons who are friends or family of the victim, fire services, public safety personnel, basic life support emergency medical services providers, teachers, coaches and supervisors of sports or other extracurricular activities, providers of day care, school bus drivers, lifeguards, attendants at public gatherings, coworkers, and other leaders within the community.

      (8) The Federal Government should facilitate programs for the placement of AEDs in public buildings, including provisions regarding the training of personnel in CPR and AED use, integration with the emergency medical services system, and maintenance of the devices.


    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:



      ‘(1) IN GENERAL- Not later than 90 days after the date of the enactment of the Cardiac Arrest Survival Act of 1999, the Secretary shall assist in providing for an improvement in the survival rates of individuals who experience cardiac arrest in Federal buildings by publishing in the Federal Register for public comment the recommendations of the Secretary with respect to placing automatic external defibrillators in such buildings. The Secretary shall in addition assist Federal agencies in implementing programs for such placement.

      ‘(2) AGENCY ASSESSMENTS- Not later than 180 days after the date on which the recommendations are published under paragraph (1), the head of each Federal agency that occupies a Federal building that meets the criteria described in subsection (a)(1) shall submit to the Secretary an assessment of the ability of each such agency to meet the goals described in subsection (c).

    ‘(b) ADDITIONAL RECOMMENDATIONS- The Secretary shall publish, as part of the recommendations referred to in subsection (a), recommendations with respect to the placement of automatic external defibrillators in buildings and facilities, or other appropriate venues, frequented by the public (other than the buildings referred to in subsection (a)). Such recommendations shall only be for information purposes for States and localities to consider in determining policy regarding the use or placement of such defibrillators in recommended buildings, facilities or venues.

    ‘(c) CONSIDERATION OF CERTAIN GOALS FOR SURVIVAL RATES- In carrying out this section, the Secretary shall consider the goals established by national public-health organizations for improving the survival rates of individuals who experience cardiac arrest in nonhospital settings, including goals for minimizing the time elapsing between the onset of cardiac arrest and the initial medical response.

    ‘(d) CERTAIN PROCEDURES- The matters addressed by the Secretary in the recommendations under subsections (a) and (b) shall include the following:

      ‘(1) Procedures for implementing appropriate nationally recognized training courses in performing cardiopulmonary resuscitation and the use of automatic external defibrillators.

      ‘(2) Procedures for proper maintenance and testing of such devices, according to the guidelines of the manufacturer of the devices.

      ‘(3) Procedures for ensuring direct involvement of a licensed medical professional and coordination with local emergency medical services in the oversight of training and notification of incidents of the use of the devices.

      ‘(4) Procedures for ensuring notification of an agent of the local emergency medical system dispatch center of the location and type of device.

    ‘(e) CERTAIN CRITERIA- In making recommendations under subsections (a) and (b), the Secretary shall determine the following:

      ‘(1) Criteria for selecting the public buildings, facilities and other venues in which automatic external defibrillators should be placed, taking into account--

        ‘(A) the typical number of employees and visitors in the buildings, facilities or venues;

        ‘(B) the extent of the need for security measures regarding the buildings, facilities or venues;

        ‘(C) buildings, facilities or other venues, or portions thereof, in which there are special circumstances such as high electrical voltage or extreme heat or cold; and

        ‘(D) such other factors as the Secretary determines to be appropriate.

      ‘(2) Criteria regarding the maintenance of such devices (consistent with the labeling for the devices).

      ‘(3) Criteria for coordinating the use of the devices in public buildings, facilities or other venues with providers of emergency medical services for the geographic areas in which the buildings, facilities or venues are located.’.


    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:


    ‘SEC. 248. (a) PERSONS USING AEDS- Any person who provides emergency medical care through the use of an automated external defibrillator is immune from civil liability for any personal injury or wrongful death resulting from the provision of such care, except as provided in subsection (c).


      ‘(1) IN GENERAL- With respect to a personal injury or wrongful death to which subsection (a) applies, in addition to the person who provided emergency medical care through the use of the automated external defibrillator, the person described in paragraph (2) is with respect to the device immune from civil liability for the personal injury or wrongful death in accordance with such paragraph, except as provided in subsection (c).

      ‘(2) PERSON DESCRIBED- A person described in this paragraph is the person who acquired the device for use at a nonmedical facility (in this paragraph referred to as the ‘acquirer’). Such person shall be immune from liability as provided for in paragraph (1) if the following conditions are met:

        ‘(A) The condition that the acquirer notified local emergency response personnel of the most recent placement of the device within a reasonable period of time after the device was placed.

        ‘(B) The condition that, as of the date on which the emergency occurred, the device had been maintained and tested in accordance with the guidelines established for the device by the manufacturer of the device.

        ‘(C) In any case in which the person who provided the emergency medical care through the use of the device was an employee or agent of the acquirer, and the employee or agent was within the class of persons the acquirer expected would use the device in the event of a relevant emergency, the condition that the employee or agent received reasonable instruction in the use of such devices through a course approved by the Secretary or by the chief public health officer of any of the States.

    ‘(c) INAPPLICABILITY OF IMMUNITY- Immunity under subsections (a) and (b) does not apply to a person if--

      ‘(1) the person engaged in gross negligence or willful or wanton misconduct in the circumstances described in such subsections that apply to the person with respect to automated external defibrillators; or

      ‘(2) the person was a licensed or certified medical professional who was using the automated external defibrillator while acting within the scope of their license or certification, and within the scope of their employment as a medical professional.


      ‘(1) IN GENERAL- The following applies with respect to this section:

        ‘(A) This section is not applicable in any State that (before, on, or after the date of the enactment of the Cardiac Arrest Survival Act of 1999) provides through statute or regulations any degree of immunity for any class of persons for civil liability for personal injury or wrongful death arising from the provision of emergency medical care through the use of an automated external defibrillator.

        ‘(B) 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.

        ‘(C) This section does not require that an automated external defibrillator be placed at any building or other location.


        ‘(A) IN GENERAL- The applicability of subsections (a) through (c) 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.’.

Passed the Senate November 19, 1999.