04/21/2011

SHOULD YOUR FUNERAL HOME HAVE AN AED?

By T. Scott Gilligan, OFDA General Counsel

In the middle of a visitation at the funeral home, an attendee collapses.  Those rushing to his aid announce that he is not breathing.  Funeral home personnel call “911” and someone administers CPR to the victim.   A frantic relative asks whether the funeral home has an AED (Automated External Defibrillator) since it appears that the victim is suffering from sudden cardiac arrest.  You indicate that the funeral home does not have an AED device, but that paramedics are on their way.  You hold your breath and pray that the paramedics get there in time. 

Does the above scenario make you think twice about purchasing an AED?  An AED is a portable electronic device which automatically diagnoses whether someone is suffering cardiac arrhythmia and administers a shock (defibrillation) to reestablish the correct heart rhythm.   It is estimated that about 450,000 adults die every year in the United States from sudden cardiac arrest.  If an AED is administered to someone stricken with sudden cardiac arrest in a timely manner, the survival rate approaches 70%.  But time is of the essence.  The American Heart Association advocates that an electric shock from an AED be administered within 3 to 5 minutes from the onset of sudden cardiac arrest.  According to the American Heart Association, without defibrillation, the survival rate drops 7% per minute in the first 3 minutes and 10% per minute thereafter.

For most businesses, there are three concerns with purchasing an AED - - fear of using the device, cost of the device and potential liability for improperly administering the device.  However, as seen below, none of these factors should prevent a funeral home from considering the purchase of an AED. 

Operating an AED.  As far as operating the AED, the current generation of the devices can be easily used by untrained lay persons.  Once the AED device is turned on, it will instruct the user to apply the electro pads to the bare chest of the victim.  The device will then analyze the electrical output for the heart and determine if the victim is in a shockable rhythm.  If the victim is, the device will deliver an electric shock to correct the rhythm of the victim’s heart.

Throughout this process, the device gives verbal or text prompts to the user.  The device will also prevent a shock from being given if it determines that the victim’s condition does not warrant a shock.  According to some experts, the AED and its ease of use are touted as the single greatest advance in the treatment of cardiac arrest since the introduction of CPR.

Cost of an AED.  According to the American Heart Association, most AEDs cost between $1,500 and $2,000.  Since AEDs are medical devices regulated by the U.S. Food and Drug Administration, a funeral home will require a physician’s prescription to purchase an AED.  As far as potential models, the American Heart Association advises that most models have similar features and that there are not specific differences among them.  The American Hospital Association recommends that a business speak to the local EMT responders to obtain their opinion as to a recommended model.

Liability of Using an AED.  Although many businesses hesitate to purchase an AED for fear of being sued if a victim dies after the AED is used, Ohio law (and the Good Samaritan Laws in most states) greatly alleviate these concerns.  Section 2305.235(D) of the Ohio Revised Code provides immunity against lawsuits for any lay person using an AED in good faith, regardless of whether the person is trained in AED usage.  The only requirement is that as part of the AED usage, a good faith attempt is made to contact emergency medical services. 

While many businesses focus on the potential liability of having an AED, the larger concern may be not having an AED.  There have been successful lawsuits against airlines, health clubs and amusement parks that were not equipped with AEDs and could not assist victims.  So far, there are no reported cases against ordinary businesses, such as funeral homes, that did not possess an AED.  However, with the widespread availability and ease of use of AEDs, there is a growing recognition that businesses that customarily host large gatherings of people, especially elderly people who are more at risk of sudden cardiac arrest, should consider the purchase of an AED.  

If a funeral home is pondering the purchase of an AED, it should be aware that Ohio law does impose certain requirements.  According to Section 3701.85(B) of the Ohio Revised Code, a business that purchases an AED is required to have expected users of the device complete a course in automated external defibrillation and cardiopulmonary resuscitation (CPR) that is offered or approved by the American Heart Association or a nationally recognized organization.  In addition, that section requires the business to maintain and test the defibrillator according to manufacturer guidelines and to consult a physician regarding compliance with the above two requirements.  It is also recommended that the business notify its local EMT responders that the business has purchased an AED so the EMTs have a record of which AED device the business has. 

OFDA members with questions regarding this article may contact General Counsel Scott Gilligan at 513-871-6332.