SB2639

Report Title:

Health; Automatic External Defibrillator

Description:

Requires certain places of employment, physical fitness facilities, and buildings, to be equipped with an automatic external defibrillator. Expands the "Good Samaritan" exemption from liability as it applies to users of automatic external defibrillators.

THE SENATE	S.B. NO.	2639
TWENTY-THIRD LEGISLATURE, 2006
STATE OF HAWAII

A BILL FOR AN ACT

RELATING TO automatic external defibrillators.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

SECTION 1. In 2000, Congress found that over seven hundred lives are lost every day to sudden cardiac arrest in the United States. 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. Once a victim suffers a cardiac arrest, every minute that passes before returning the heart to a normal rhythm decreases the chance of survival. Two out of every three sudden cardiac deaths occur before a victim can reach a hospital.

Congress further found that with current medical technology, up to thirty per cent of cardiac arrest victims could be saved if victims had access to immediate medical response, including defibrillation and cardiopulmonary resuscitation. Automatic 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. The federal "Cardiac Arrest Survival Act" was enacted in 2000 to increase public awareness regarding automatic external defibrillator devices and encourage their use in federal buildings. Subsequent federal legislation provided funds for the purchase and placement of automated external defibrillators in public places, and encouraged private companies to purchase automatic external defibrillators and train employees in cardiopulmonary resuscitation and emergency defibrillation.

The legislature finds that the overall congressional findings are applicable to Hawaii. The purpose of this Act is to increase the availability and use of automatic external defibrillators.

SECTION 2. Chapter 321, Hawaii Revised Statutes, is amended by adding a new part to be appropriately designated and to read as follows:

"Part . automatic external defibrillators

§321-A Definitions. As used in this part:

"Automatic external defibrillator" means a medical device heart monitor and defibrillator that:

(1) Is cleared for market by the Federal Food and Drug Administration;

(2) Recognizes the presence or absence of ventricular fibrillation or rapid ventricular tachycardia;

(3) Determines, without intervention by an operator, whether defibrillation should be performed;

(4) On determining that defibrillation should be performed, automatically charges; and

(5) Requires operator intervention to deliver the electrical impulse or automatically continues with delivery of electrical impulse.

"Defibrillation" means administering an electrical impulse to an individual in order to stop ventricular fibrillation or rapid ventricular tachycardia.

"Department" means the department of health.

"Employee" means a person who performs a service for wages or other remuneration under a contract for hire, written or oral, express or implied.

"Employer" means a person who employs one or more employees.

"Employment" means any service performed by a person for another person under any contract for hire, written or oral, express or implied.

"Health care facility" includes any program, institution, place, building, or agency, or portion thereof, private or public, whether organized for profit or not, that is used, operated, or designed to provide medical diagnosis, treatment, or rehabilitative or preventive care to any person. The term includes health care facilities that are commonly referred to as hospitals, outpatient clinics, organized ambulatory health care facilities, emergency care facilities and centers, health maintenance organizations, other others providing similarly organized services regardless of nomenclature.

"Health care provider" means any person who is licensed, certified, or otherwise authorized or permitted by law to administer health care in the practice of a profession or the ordinary course of business.

"Physical fitness facility" means an indoor facility, public or private, including a swimming pool, stadium, athletic field, track, tennis court, basketball court, or volleyball court, that:

(1) Is supervised by one or more persons, other than maintenance or security personnel, employed to provide supervision, instruction, training, or assistance to persons using the facility; or

(2) Provides services or facilities focusing primarily on cardiovascular exertion.

"Place of employment" means any place where employment is carried on.

"Trained automatic external defibrillator user" means a person who successfully completes a training course that includes cardiopulmonary resuscitation and verifies proficiency in the use of an automatic external defibrillator, or who is licensed to practice medicine under chapter 453 or 460.

§321-B Automatic external defibrillator program. (a) The department shall develop standards for automatic external defibrillator instructors and automatic external defibrillator training courses in accordance with nationally recognized guidelines.

(b) The department shall identify or develop an appropriate curriculum designed for a trained automatic external defibrillator user who is a member of the general public, and a training curriculum designed for a trained automatic external defibrillator user who is a health care provider.

(c) The department shall make educational materials available to the public about the availability and benefit of programs that train individuals as automatic external defibrillator users. The materials shall include information about any exemption from liability for an individual who renders defibrillation, and shall encourage members of the public to become trained automatic external defibrillator users.

§321-C Physical fitness facility. A physical fitness facility shall have at least one automatic external defibrillator on the premises and shall ensure that there is at least one trained automatic external defibrillator user on staff.

§321-D Place of employment. Any employer who has one hundred or more employees in the employer's employment at any one place of employment shall have at least one automatic external defibrillator at that place of employment.

§321-E Residential buildings. Any residential building or portion thereof in which space is let by the owner or operator to one hundred or more unrelated persons shall have at least one automatic external defibrillator on the premises.

§321-F State buildings; new or renovated. Any state building that is constructed or that undergoes a major renovation at a cost of $250,000 or more shall have at least one automatic external defibrillator on the premises.

§321-G Maintenance and oversight. (a) Any person who acquires an automatic external defibrillator pursuant to this part shall take reasonable measures to ensure that the automatic external defibrillator is:

(1) Used by a trained automatic external defibrillator user;

(2) Maintained and tested according to the manufacturer's guidelines; and

(3) Readily accessible for use.

(b) Any person in possession of an automatic external defibrillator shall register with the local emergency medical service the existence, location, and type of the automatic external defibrillator unless it was acquired for use in a private residence or a health care facility.

(c) Any person who renders out-of-hospital emergency care or treatment to a person by using an automatic external defibrillator shall activate the emergency medical service system as soon as possible and report any clinical use of the automatic external defibrillator.

§321-H Administrative rules. The department shall adopt rules pursuant to chapter 91 necessary for the purposes of this part."

SECTION 3. Section 453-2, Hawaii Revised Statutes, is amended by amending subsection (b) to read as follows:

"(b) Nothing herein shall:

(1) Apply to so-called Christian Scientists so long as they merely practice the religious tenets of their church without pretending a knowledge of medicine or surgery;

(2) Prohibit service in the case of emergency or the domestic administration of family remedies;

(3) Apply to any commissioned medical officer in the United States armed forces or public health service engaged in the discharge of one's official duty, nor to any practitioner of medicine and surgery from another state when in actual consultation, including but not limited to, in-person, mail, electronic, telephonic, fiber-optic, or other telemedicine consultation with a licensed physician of this State, if the physician from another state at the time of such consultation is licensed to practice in the state in which the physician resides; provided that:

(A) The physician from another state shall not open an office, or appoint a place to meet patients, or receive calls within the limits of the State; and

(B) The licensed physician of this State retains control and remains responsible for the provision of care for the patient; and

provided further that the laws and regulations relating to contagious diseases are not violated;

(4) Prohibit services rendered by any person certified under part II of this chapter to provide emergency medical services, or any physician assistant, when the services are rendered under the direction and control of a physician licensed in this State except for final refraction resulting in a prescription for spectacles, contact lenses, or visual training as performed by an oculist or optometrist duly licensed by the State. The direction and control shall not be construed in every case to require the personal presence of the supervising and controlling physician. Any physician who employs or directs a person certified under part II of this chapter to provide emergency medical services, or physician assistant, shall retain full professional and personal responsibility for any act which constitutes the practice of medicine when performed by such person or physician assistant; or

(5) Prohibit automatic external defibrillation by:

(A) Any first responder personnel certified by the department of health to provide automatic external defibrillation when it is rendered under the medical oversight of a physician licensed in this State; [or]

(B) Any person who successfully completes training under an automatic external defibrillator program [~~administered by a physician~~]. An "automatic external defibrillator program" means [~~an appropriate~~] a training course that includes cardiopulmonary resuscitation and verifies proficiency in the use of an automatic external defibrillator[.]; or

(C) An individual attempting in good faith, without remuneration or expectation of remuneration, to resuscitate a person by administering any automatic external defibrillator."

SECTION 4. Section 663-1.5, Hawaii Revised Statutes, is amended by amending subsection (e) to read as follows:

"(e) [~~Any person who successfully completes training under any automatic external defibrillator program administered by a physician~~] An individual shall not be liable for any civil damages resulting from any act or omission while attempting in good faith, without remuneration or expectation of remuneration, to resuscitate a person in immediate danger of loss of life, or reasonably believed by the individual to be in immediate danger of loss of life, when administering any automatic external defibrillator, regardless of where the automatic external defibrillator that is used is located, except as may result from the person's gross negligence or wanton acts or omissions.

Any person, including an employer, who establishes an automatic external defibrillator program shall not be liable for any civil damages resulting from any act or omission of the [~~persons or employees~~] individuals trained under the program who, in good faith and without remuneration or the expectation of remuneration, attempt to resuscitate a person in immediate danger of loss of life, or reasonably believed by the individual to be in immediate danger of loss of life, by administering an automatic external defibrillator."

SECTION 5. This Act does not affect rights and duties that matured, penalties that were incurred, and proceedings that were begun, before its effective date.

SECTION 6. In codifying the new sections added by section 2 of this Act, the revisor of statutes shall substitute appropriate section numbers for the letters used in designating the new sections in this Act.

SECTION 7. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.

SECTION 8. This Act shall take effect on January 1, 2007.

INTRODUCED BY:	_____________________________