A fire chief recently posted a question that sent me back into the law books for the answer. He asked, “I heard that anyone who acquires an automatic external defibrillator (AED) has to report it under federal law. Is that true and, if so, to whom do I as fire chief have to report it to?”
The short answer is this: There are federal and state laws that require those who acquire an AED to report it. The most likely person to whom you will need to report it is yourself. The long answer requires us to consider a patchwork of state and federal laws that govern AEDs. All 50 states and the federal government have enacted laws pertaining to AEDs. The intent of these laws is to encourage and protect those who acquire, place in the community and use these life-saving devices.
Reporting AED use
The laws contain two sets of legal reporting requirements. The first involve requirements that every use of an AED be reported. The specifics of these laws vary state by state, but any use of an AED will likely have to be reported to either a doctor, state EMS authorities, or local EMS personnel who are called to respond.
Compliance with this first type of reporting requirement is not usually much of a problem for firefighters and EMS personnel since we are the ones who respond. Any use of an AED by emergency responders would inevitably be duly reported to doctors at the emergency room and to state EMS authorities on routine patient care reports.
Compliance may be a bigger challenge for, say, a school/university, an airport, or even a health club where “use” (typically not further defined in the statutes) may be by good Samaritans in situations where a shock is not delivered. For example, a person faints, an AED is deployed, pads are positioned, the patient comes to, gets up and leaves without EMS even being notified. This in turn sets the stage for a problem the next time the device is used if it is not properly restocked and inspected. Typically the laws place responsibility for maintaining the device on the person or entity who acquired it, but the failure to report the use, coupled with a device’s failure at a subsequent event, sets the stage for a legal problem.
Most uses of an AED where an actual shock is delivered will likely be coupled with a 9-1-1 call, and responding personnel will inevitably be notified, thereby meeting the “use” reporting requirement.
Reporting AED locations
The second type of AED reporting requirement applies to any person or entity who “acquires” an AED. These laws require the acquiring party to report or inform state and/or local authorities of its location. The intent behind these laws is to facilitate the creation of a comprehensive registry of AEDs in the community. The theory is that dispatchers at 9-1-1 centers would be able to quickly direct callers to the closest device. Some creative folks have even created smartphone apps to facilitate prompt resuscitation efforts.
Here are two examples of state laws that contain both types of reporting requirements:
New York: NYS Public Health Law
Article 30/3000-B: Automated External Defibrillators—Public Access Providers
3. Possession and operation of automated external defibrillator.
(C) The public access defibrillation provider shall notify the regional council of the existence, location and type of any automated external defibrillator it possess.
(D) Every use of an automated external defibrillator on a patient shall be immediately reported to the appropriate local emergency medical services system, emergency communications center or emergency vehicle dispatch center as appropriate and promptly reported to the emergency health care provider.
(F) The public access defibrillation provider shall post a sign or notice at the main entrance to the facility or building in which the automated external defibrillator is stored, indicating the location where any such automated external defibrillator is stored or maintained in such building or facility on a regular basis.
Illinois: 410 ILCS 4/20
Sec. 20. Maintenance; oversight
(a) A person acquiring an automated external defibrillator shall take reasonable measures to ensure that: …
(4) any person who renders out-of-hospital emergency care or treatment to a person in cardiac arrest by using an automated external defibrillator activates the EMS system as soon as possible and reports any clinical use of the automated external defibrillator.
(b) A person in possession of an automated external defibrillator shall notify an agent of the local emergency communications or vehicle dispatch center of the existence, location, and type of the automated external defibrillator.
While the concept behind creating an AED registry is nice, not all jurisdictions have opted to do so. In addition, funding such a system, the mechanisms for reporting and maintaining the AED data, and what is to be done with that information remain hodge-podge from state to state. State laws typically require notification but are silent as to a penalty for non-compliance.
Cardiac Arrest Survival Act
Along the same lines as the states, Congress enacted the Cardiac Arrest Survival Act of 2000, which contains a reporting incentive as opposed to a reporting requirement. The Cardiac Arrest Survival Act requires a “person” who “acquires” an AED to notify “local emergency response personnel or other appropriate entities” of the placement of the device.
The Act does not penalize the failure to report the location of an AED in terms of imposing a fine or making it a criminal offense. However, the person or entity that acquires an AED and does not report its location would not be entitled to good Samaritan immunity protection if that failure to report contributes to harm to a victim.
Here is the actual language of the Cardiac Arrest Survival Act:
42 U.S. Code § 238q
(a) Good Samaritan protections regarding AEDs. Except as provided in subsection (b) of this section, 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 subsection (a) of this section does not apply to a person if …
(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…
The Cardiac Arrest Survival Act does not define who “local emergency response personnel or other appropriate entities” are, nor does it place any responsibility on these entities to do anything with the information.
In sum
While none of these state and federal AED reporting laws were directed at fire or EMS providers, some may be written so broadly that they may nevertheless apply to emergency responders. As a fire department, chances are that we already comply with both state and federal AED reporting requirements. However, given the state-to-state differences, it certainly would be worthwhile for a department to sit down and examine your state AED reporting requirements.
The following website offers some valuable information on each state’s AED related laws: aeduniverse.com/AED_Laws_by_State_s/97.htm.
Curt Varone
CURT VARONE has more than 40 years of experience in the fire service, including 29 years as a career firefighter with Providence, RI, retiring as a deputy assistant chief (shift commander). He is a practicing attorney who is licensed in Maine and Rhode Island and served as the director of the Public Fire Protection Division at the NFPA. Varone is the author of two books, "Legal Considerations for Fire and Emergency Services" and "Fire Officer's Legal Handbook," and remains active as a deputy chief in Exeter, RI.
