See also the Cornell University citation

H. R. 2498

One Hundred Sixth Congress of the United States of America

At the Second Session

AN ACT

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,

TITLE IV—CARDIAC ARREST SURVIVAL

Subtitle A—Recommendations for Federal Buildings

SEC. 401. SHORT TITLE.

This subtitle may be cited as the ‘‘Cardiac Arrest Survival Act of 2000’’.

SEC. 402. FINDINGS.

Congress makes the following findings:

(1) Over 700 lives are lost every day to sudden cardiac arrest in the United States alone.

(2) Two out of every three sudden cardiac deaths occur before a victim can reach a hospital.

(3) More than 95 percent of these cardiac arrest victims will die, many because of lack of readily available

life saving medical equipment.

(4) With current medical technology, up to 30 percent of cardiac arrest victims could be saved if victims

had access to immediate medical response, including defibrillation and cardiopulmonary resuscitation.

(5) Once a victim has suffered a cardiac arrest, every minute that passes before returning the heart to a

normal rhythm decreases the chance of survival by 10 percent.

(6) Most cardiac arrests are caused by abnormal heart rhythms called ventricular fibrillation. Ventricular

fibrillation occurs when the heart’s electrical system malfunctions, causing a chaotic rhythm that

prevents the heart from pumping oxygen to the victim’s brain and body.

(7) Communities that have implemented programs ensuring widespread public access to defibrillators,

combined with appropriate training, maintenance, and coordination with local emergency medical

systems, have dramatically improved the survival rates from cardiac arrest.

(8) Automated external defibrillator devices have been demonstrated to be safe and effective, even when

used by lay people, since the devices are designed not to allow a user to administer a shock until after

the device has analyzed a victim’s heart rhythm and determined that an electric shock is required.

(9) Increasing public awareness regarding automated external defibrillator devices and encouraging their

use in Federal buildings will greatly facilitate their adoption.

(10)Limiting the liability of Good Samaritans and acquirers of automated external defibrillator devices in

emergency situations may encourage the use of automated external defibrillator devices, and result in

saved lives.

SEC. 403. RECOMMENDATIONS AND GUIDELINES OF SECRETARY OF HEALTH AND HUMAN

SERVICES REGARDING AUTOMATED EXTERNAL DEFIBRILLATORS FOR FEDERAL BUILDINGS.

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:

‘‘RECOMMENDATIONS AND GUIDELINES REGARDING AUTOMATED EXTERNAL

DEFIBRILLATORS FOR FEDERAL BUILDINGS”

‘‘SEC. 247.

(a) GUIDELINES ON PLACEMENT.—The Secretary shall establish guidelines with

respect to placing automated external defibrillator devices in Federal buildings. Such guidelines shall take into

account the extent to which such devices may be used by lay persons, the typical number of employees and

visitors in the buildings, the extent of the need for security measures regarding the buildings, buildings or

portions of buildings in which there are special circumstances such as high electrical voltage or extreme heat or

cold, and such other factors as the Secretary determines to be appropriate.

‘‘(b) RELATED RECOMMENDATIONS.—The Secretary shall publish in the Federal Register the

recommendations of the Secretary on the appropriate implementation of the placement of automated

external defibrillator devices under subsection (a), including procedures for the following:

‘‘(1) Implementing appropriate training courses in the use of such devices, including the role of

cardiopulmonary resuscitation.

‘‘(2) Proper maintenance and testing of the devices.

This is an excerpt of the Public Health Improvement Act which includes the Cardiac Arrest

Survival Act in it’s entirety.

‘‘(3) Ensuring coordination with appropriate licensed professionals in the oversight of training of

the devices.

‘‘(4) Ensuring coordination with local emergency medical systems regarding the placement and

incidents of use of the devices.

‘‘(c) CONSULTATIONS; CONSIDERATION OF CERTAIN REC-OMMENDATIONS.— In carrying

out this section, the Secretary shall—

‘‘(1) consult with appropriate public and private entities;

‘‘(2) consider the recommendations of national and local public-health organizations for improving

the survival rates of individuals who experience cardiac arrest in nonhospital settings by

minimizing the time elapsing between the onset of cardiac arrest and the initial medical response,

including defibrillation as necessary; and

‘‘(3) consult with and counsel other Federal agencies where such devices are to be used.

‘‘(d) DATE CERTAIN FOR ESTABLISHING GUIDELINES AND REC-OMMENDATIONS.— The

Secretary shall comply with this section not later than 180 days after the date of the enactment of the

Cardiac Arrest Survival Act of 2000.

‘‘(e) DEFINITIONS.—For purposes of this section:

‘‘(1) The term ‘automated external defibrillator device’ has the meaning given such term in section

248.

‘‘(2) The term ‘Federal building’ includes a building or portion of a building leased or rented by a

Federal agency, and includes buildings on military installations of the United States.’’.

SEC. 404. GOOD SAMARITAN PROTECTIONS REGARDING EMERGENCY USE OF

AUTOMATED EXTERNAL DEFIBRILLATORS.

Part B of title II of the Public Health Service Act, as amended by section 403, is amended by adding at

the end the following:

‘‘LIABILITY REGARDING EMERGENCY USE OF AUTOMATED EXTERNAL DEFIBRILLATORS

‘‘SEC. 248.

(a) GOOD SAMARITAN PROTECTIONS REGARDING AEDS.—Except as provided in subsection (b), any

person who uses or attempts to use an automated external defibrillator device on a victim of a perceived medical

emergency is immune from civil liability for any harm resulting from the use or attempted use of such device;

and in addition, any person who acquired the device is immune from such liability, if the harm was not due to the

failure of such acquirer of the device—

‘‘(1) to notify local emergency response personnel or other appropriate entities of the most recent

placement of the device within a reasonable period of time after the device was placed;

‘‘(2) to properly maintain and test the device; or

‘‘(3) to provide appropriate training in the use of the device to an employee or agent of the acquirer

when the employee or agent was the person who used the device on the victim, except that such

requirement of training does not apply if—

‘‘(A) the employee or agent was not an employee or agent who would have been reasonably

expected to use the device; or

‘‘(B) the period of time elapsing between the engagement of the person as an employee or

agent and the occurrence of the harm (or between the acquisition of the device and the

occurrence of the harm, in any case in which the device was acquired after such engagement

of the person) was not a reasonably sufficient period in which to provide the training.

(b) INAPPLICABILITY OF IMMUNITY.—Immunity under sub-section (a) does not apply to a person if—

‘‘(1) the harm involved was caused by willful or criminal misconduct, gross negligence, reckless

misconduct, or a conscious, flagrant indifference to the rights or safety of the victim who was

harmed;

This is an excerpt of the Public Health Improvement Act which includes the Cardiac Arrest

Survival Act in it’s entirety.

‘‘(2) the person is a licensed or certified health professional who used the automated external

defibrillator device while acting within the scope of the license or certification of the professional

and within the scope of the employment or agency of the professional;

‘‘(3) the person is a hospital, clinic, or other entity whose purpose is providing health care directly

to patients, and the harm was caused by an employee or agent of the entity who used the device

while acting within the scope of the employment or agency of the employee or agent; or

‘‘(4) the person is an acquirer of the device who leased the device to a health care entity (or who

otherwise provided the device to such entity for compensation without selling the device to the

entity), and the harm was caused by an employee or agent of the entity who used the device while

acting within the scope of the employment or agency of the employee or agent.

(c) RULES OF CONSTRUCTION.—

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

‘‘(A) This section does not establish any cause of action, or require that an automated external

defibrillator device be placed at any building or other location.

‘‘(B) With respect to a class of persons for which this section provides immunity from civil

liability, this section supersedes the law of a State only to the extent that the State has no

statute or regulations that provide persons in such class with immunity for civil liability arising

from the use by such persons of automated external defibrillator devices in emergency

situations (within the meaning of the State law or regulation involved).

‘‘(C) 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 pro-vided by the United States where the availability of such benefits precludes a

remedy under section 1346(b) of title 28.

‘‘(2) CIVIL ACTIONS UNDER FEDERAL LAW.—

‘‘(A) IN GENERAL.—The applicability of subsections (a) and (b) 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.

‘‘(d) FEDERAL JURISDICTION.—In any civil action arising under State law, the courts of the State involved

have jurisdiction to apply the provisions of this section exclusive of the jurisdiction of the courts of the United

States.

‘‘(e) DEFINITIONS.—

‘‘(1) PERCEIVED MEDICAL EMERGENCY.—For purposes of this section, the term ‘perceived

medical emergency’ means circumstances in which the behavior of an individual leads a reasonable

person to believe that the individual is experiencing a life-threatening medical condition that

requires an immediate medical response regarding the heart or other cardiopulmonary functioning

of the individual.

‘‘(2) OTHER DEFINITIONS.—For purposes of this section:

‘‘(A) The term ‘automated external defibrillator device’ means a defibrillator device that—

‘‘(i) is commercially distributed in accordance with the Federal Food, Drug, and Cosmetic

Act;

‘‘(ii) is capable of recognizing the presence or absence of ventricular fibrillation, and is

capable of determining without intervention by the user of the device whether

defibrillation should be performed;

This is an excerpt of the Public Health Improvement Act which includes the Cardiac Arrest

Survival Act in it’s entirety.

‘‘(iii) upon determining that defibrillation should be performed, is able to deliver an

electrical shock to an individual; and

‘‘(iv) in the case of a defibrillator device that may be operated in either an automated or a

manual mode, is set to operate in the automated mode.

‘‘(B)(i) The term ‘harm’ includes physical, nonphysical, economic, and noneconomic losses.

‘‘(ii) The term ‘economic loss’ means any pecuniary loss resulting from harm (including

the loss of earnings or other benefits related to employment, medical expense loss,

replacement services loss, loss due to death, burial costs, and loss of business or

employment opportunities) to the extent recovery for such loss is allowed under applicable

State law.

‘‘(iii) The term ‘noneconomic losses’ means losses for physical and emotional pain,

suffering, inconvenience, physical impairment, mental anguish, disfigurement, loss of

enjoyment of life, loss of society and companionship, loss of consortium (other than loss

of domestic service), hedonic damages, injury to reputation and all other non-pecuniary

losses of any kind or nature.’’.

H. R. 2498

One Hundred Sixth Congress

of the United States of America

At the Second Session

AN ACT

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,

TITLE IV—CARDIAC ARREST SURVIVAL

Subtitle A—Recommendations for Federal Buildings

SEC. 401. SHORT TITLE.

This subtitle may be cited as the ‘‘Cardiac Arrest Survival Act of 2000’’.

SEC. 402. FINDINGS.

Congress makes the following findings:

(1) Over 700 lives are lost every day to sudden cardiac arrest in the United States alone.

(2) Two out of every three sudden cardiac deaths occur before a victim can reach a hospital.

(3) More than 95 percent of these cardiac arrest victims will die, many because of lack of readily available

life saving medical equipment.

(4) With current medical technology, up to 30 percent of cardiac arrest victims could be saved if victims

had access to immediate medical response, including defibrillation and cardiopulmonary resuscitation.

(5) Once a victim has suffered a cardiac arrest, every minute that passes before returning the heart to a

normal rhythm decreases the chance of survival by 10 percent.

(6) Most cardiac arrests are caused by abnormal heart rhythms called ventricular fibrillation. Ventricular

fibrillation occurs when the heart’s electrical system malfunctions, causing a chaotic rhythm that

prevents the heart from pumping oxygen to the victim’s brain and body.

(7) Communities that have implemented programs ensuring widespread public access to defibrillators,

combined with appropriate training, maintenance, and coordination with local emergency medical

systems, have dramatically improved the survival rates from cardiac arrest.

(8) Automated external defibrillator devices have been demonstrated to be safe and effective, even when

used by lay people, since the devices are designed not to allow a user to administer a shock until after

the device has analyzed a victim’s heart rhythm and determined that an electric shock is required.

(9) Increasing public awareness regarding automated external defibrillator devices and encouraging their

use in Federal buildings will greatly facilitate their adoption.

(10)Limiting the liability of Good Samaritans and acquirers of automated external defibrillator devices in

emergency situations may encourage the use of automated external defibrillator devices, and result in

saved lives.

SEC. 403. RECOMMENDATIONS AND GUIDELINES OF SECRETARY OF HEALTH AND HUMAN

SERVICES REGARDING AUTOMATED EXTERNAL DEFIBRILLATORS FOR FEDERAL BUILDINGS.

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:

‘‘RECOMMENDATIONS AND GUIDELINES REGARDING AUTOMATED EXTERNAL

DEFIBRILLATORS FOR FEDERAL BUILDINGS”

‘‘SEC. 247.

(a) GUIDELINES ON PLACEMENT.—The Secretary shall establish guidelines with

respect to placing automated external defibrillator devices in Federal buildings. Such guidelines shall take into

account the extent to which such devices may be used by lay persons, the typical number of employees and

visitors in the buildings, the extent of the need for security measures regarding the buildings, buildings or

portions of buildings in which there are special circumstances such as high electrical voltage or extreme heat or

cold, and such other factors as the Secretary determines to be appropriate.

‘‘(b) RELATED RECOMMENDATIONS.—The Secretary shall publish in the Federal Register the

recommendations of the Secretary on the appropriate implementation of the placement of automated

external defibrillator devices under subsection (a), including procedures for the following:

‘‘(1) Implementing appropriate training courses in the use of such devices, including the role of

cardiopulmonary resuscitation.

‘‘(2) Proper maintenance and testing of the devices.

This is an excerpt of the Public Health Improvement Act which includes the Cardiac Arrest

Survival Act in it’s entirety.

‘‘(3) Ensuring coordination with appropriate licensed professionals in the oversight of training of

the devices.

‘‘(4) Ensuring coordination with local emergency medical systems regarding the placement and

incidents of use of the devices.

‘‘(c) CONSULTATIONS; CONSIDERATION OF CERTAIN REC-OMMENDATIONS.— In carrying

out this section, the Secretary shall—

‘‘(1) consult with appropriate public and private entities;

‘‘(2) consider the recommendations of national and local public-health organizations for improving

the survival rates of individuals who experience cardiac arrest in nonhospital settings by

minimizing the time elapsing between the onset of cardiac arrest and the initial medical response,

including defibrillation as necessary; and

‘‘(3) consult with and counsel other Federal agencies where such devices are to be used.

‘‘(d) DATE CERTAIN FOR ESTABLISHING GUIDELINES AND REC-OMMENDATIONS.— The

Secretary shall comply with this section not later than 180 days after the date of the enactment of the

Cardiac Arrest Survival Act of 2000.

‘‘(e) DEFINITIONS.—For purposes of this section:

‘‘(1) The term ‘automated external defibrillator device’ has the meaning given such term in section

248.

‘‘(2) The term ‘Federal building’ includes a building or portion of a building leased or rented by a

Federal agency, and includes buildings on military installations of the United States.’’.

SEC. 404. GOOD SAMARITAN PROTECTIONS REGARDING EMERGENCY USE OF

AUTOMATED EXTERNAL DEFIBRILLATORS.

Part B of title II of the Public Health Service Act, as amended by section 403, is amended by adding at

the end the following:

‘‘LIABILITY REGARDING EMERGENCY USE OF AUTOMATED EXTERNAL DEFIBRILLATORS

‘‘SEC. 248.

(a) GOOD SAMARITAN PROTECTIONS REGARDING AEDS.—Except as provided in subsection (b), any

person who uses or attempts to use an automated external defibrillator device on a victim of a perceived medical

emergency is immune from civil liability for any harm resulting from the use or attempted use of such device;

and in addition, any person who acquired the device is immune from such liability, if the harm was not due to the

failure of such acquirer of the device—

‘‘(1) to notify local emergency response personnel or other appropriate entities of the most recent

placement of the device within a reasonable period of time after the device was placed;

‘‘(2) to properly maintain and test the device; or

‘‘(3) to provide appropriate training in the use of the device to an employee or agent of the acquirer

when the employee or agent was the person who used the device on the victim, except that such

requirement of training does not apply if—

‘‘(A) the employee or agent was not an employee or agent who would have been reasonably

expected to use the device; or

‘‘(B) the period of time elapsing between the engagement of the person as an employee or

agent and the occurrence of the harm (or between the acquisition of the device and the

occurrence of the harm, in any case in which the device was acquired after such engagement

of the person) was not a reasonably sufficient period in which to provide the training.

(b) INAPPLICABILITY OF IMMUNITY.—Immunity under sub-section (a) does not apply to a person if—

‘‘(1) the harm involved was caused by willful or criminal misconduct, gross negligence, reckless

misconduct, or a conscious, flagrant indifference to the rights or safety of the victim who was

harmed;

This is an excerpt of the Public Health Improvement Act which includes the Cardiac Arrest

Survival Act in it’s entirety.

‘‘(2) the person is a licensed or certified health professional who used the automated external

defibrillator device while acting within the scope of the license or certification of the professional

and within the scope of the employment or agency of the professional;

‘‘(3) the person is a hospital, clinic, or other entity whose purpose is providing health care directly

to patients, and the harm was caused by an employee or agent of the entity who used the device

while acting within the scope of the employment or agency of the employee or agent; or

‘‘(4) the person is an acquirer of the device who leased the device to a health care entity (or who

otherwise provided the device to such entity for compensation without selling the device to the

entity), and the harm was caused by an employee or agent of the entity who used the device while

acting within the scope of the employment or agency of the employee or agent.

(c) RULES OF CONSTRUCTION.—

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

‘‘(A) This section does not establish any cause of action, or require that an automated external

defibrillator device be placed at any building or other location.

‘‘(B) With respect to a class of persons for which this section provides immunity from civil

liability, this section supersedes the law of a State only to the extent that the State has no

statute or regulations that provide persons in such class with immunity for civil liability arising

from the use by such persons of automated external defibrillator devices in emergency

situations (within the meaning of the State law or regulation involved).

‘‘(C) 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 pro-vided by the United States where the availability of such benefits precludes a

remedy under section 1346(b) of title 28.

‘‘(2) CIVIL ACTIONS UNDER FEDERAL LAW.—

‘‘(A) IN GENERAL.—The applicability of subsections (a) and (b) 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.

‘‘(d) FEDERAL JURISDICTION.—In any civil action arising under State law, the courts of the State involved

have jurisdiction to apply the provisions of this section exclusive of the jurisdiction of the courts of the United

States.

‘‘(e) DEFINITIONS.—

‘‘(1) PERCEIVED MEDICAL EMERGENCY.—For purposes of this section, the term ‘perceived

medical emergency’ means circumstances in which the behavior of an individual leads a reasonable

person to believe that the individual is experiencing a life-threatening medical condition that

requires an immediate medical response regarding the heart or other cardiopulmonary functioning

of the individual.

‘‘(2) OTHER DEFINITIONS.—For purposes of this section:

‘‘(A) The term ‘automated external defibrillator device’ means a defibrillator device that—

‘‘(i) is commercially distributed in accordance with the Federal Food, Drug, and Cosmetic

Act;

‘‘(ii) is capable of recognizing the presence or absence of ventricular fibrillation, and is

capable of determining without intervention by the user of the device whether

defibrillation should be performed;

This is an excerpt of the Public Health Improvement Act which includes the Cardiac Arrest

Survival Act in it’s entirety.

‘‘(iii) upon determining that defibrillation should be performed, is able to deliver an

electrical shock to an individual; and

‘‘(iv) in the case of a defibrillator device that may be operated in either an automated or a

manual mode, is set to operate in the automated mode.

‘‘(B)(i) The term ‘harm’ includes physical, nonphysical, economic, and noneconomic losses.

‘‘(ii) The term ‘economic loss’ means any pecuniary loss resulting from harm (including

the loss of earnings or other benefits related to employment, medical expense loss,

replacement services loss, loss due to death, burial costs, and loss of business or

employment opportunities) to the extent recovery for such loss is allowed under applicable

State law.

‘‘(iii) The term ‘noneconomic losses’ means losses for physical and emotional pain,

suffering, inconvenience, physical impairment, mental anguish, disfigurement, loss of

enjoyment of life, loss of society and companionship, loss of consortium (other than loss

of domestic service), hedonic damages, injury to reputation and all other non-pecuniary

losses of any kind or nature.’’