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H.R. 2498 (rh) To amend the Public Health Service Act to provide for recommendations [Reported in House] ...

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                                                       Calendar No. 572
  2d Session
                                H. R. 2498



                              May 24, 2000

            Received; read twice and placed on the calendar


                                 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,


    This Act may be cited as the ``Cardiac Arrest Survival Act of 


    The Congress finds as follows:
            (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 
            (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.

              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 section:

     ``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 
            ``(2) Proper maintenance and testing of the devices.
            ``(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 
    ``(c) Consultations; Consideration of Certain Recommendations.--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 
Recommendations.--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 


    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 

       ``liability regarding emergency use of automated external 

    ``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 
                    ``(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 subsection (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; or
            ``(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; or
            ``(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 
                    ``(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 
                            ``(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.
            ``(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;
                            ``(iii) upon determining that 
                        defibrillation should be performed, is able to 
                        deliver an electrical shock to an individual; 
                            ``(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 nonpecuniary losses of any 
                kind or nature.''.

            Passed the House of Representatives May 23, 2000.


                                                 JEFF TRANDAHL,

                                                       Calendar No. 572


  2d Session

                               H. R. 2498


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