Automated external defibrillator, AED Legislation and the case for-and-against ACTIVE ABSTINENCE

In Hong Kong, there is currently no restriction on the usage, ownership and sales of AEDs.

Being a leading international financial centre and world city, many overseas visitors do expect similar "heart safe" environments like they are used to in their home country.

Liability is placed on whether places such as leading businesses, hotels, convention centres and places of high human traffic, are equipped with such AED devices, more than the responsibility of a failed resuscitation attempt. Family members of visitors with SCA incidents will ask the question, "was an AED deployed during the resuscitation attempts?" If it wasn't your will be found liable.

In plain speak, if you have a failed resuscitation attempt on your premises, then there is a small chance that your emergency response procedures could be picked apart and any failings will be highlighted and this could lead to legal action. YOUR WHOLE EMERGENCY PROCEDURE WILL BE SCRUTINIZED, NOT JUST THE AED.

On the other hand, if you have a failed resuscitation attempt, and you do not have an AED on site, you will almost definitely be sued and face significant payouts. Take for example Caritas hospital, which is now in the process of being sued for millions of dollars for the death of a man outside its premises. A significant factor in this case is that an AED could not reach the person in time - because the hospital didn't have any! We will see if this case goes to court, I doubt that it will and the H.A will probably settle. Without an AED onsite, this is what you can expect as the most likely course of any failed resuscitation attempt.

Often businesses are worried that if they stock an AED, and it doesn't get there on time then they will be sued.

The answer to this problem is quiet simple - If your emergency procedures are that weak that you can't guarantee getting an AED to a victim quickly, then it's your procedure that is lacking, and not the AED. After all an AED is just an inanimate object and can't get to an emergency by itself. It needs human interaction to save a life. The only difference in the outcome will be that if you have an AED and it doesn't get to the emergency on time, at least you can say you had attempted to provide adequate cover, but on this occasion your emergency plan failed. However, if you have no AED and your emergency plan fails, you will be sued and almost certainly lose, as your failed to offer the best emergency plan available, depsite having both the means and the knowledge to do so.

If you think you can win a court case against you for not stocking an AED then you will be bucking a serious trend. As Dirty Harry might say, "You feelin lucky?"

The AED is only as good as your emergency response program, if the procedures are bad, then you're likely to get sued regardless.

AEDs just enhance your emergency program, they don't define it, make it or carry it out.

In an emergency that has a a bad outcome, the investigators are going to want to tick all the boxes

Was the emergency services called in time?
Did a CPR trained person attend as quickly as possible?
Were their first aid certificates up to date?
Did they practice their skills properly?
Was the AED brought to the scene quickly?
Was it used properly according to the training?
Were security informed and allow quick easy access for the ambulance?

These and other such questions will be asked.... the weak link in all this is the human element. 99.99999% of the time the AED will work absolutely like it should. And that 0.00001% of the time it fails, it's probably not going to be your fault.

Sometimes legal teams advise against stocking AEDs. On occasions like this, you should ask your legal team to provide you with cases where companies who were being sued for not stocking an AED and have won. Compare this to the amount of companies that have lost legal cases for not stocking an AED, then make an informed choice. Ostrich theory, ie, sticking your head in the sand and hoping it doesn't happen to you is not a legal defense.

Ultimately, the choice of whether to stock or not stock an AED is about saving a life not liability.

If you take time to break down the steps of a CPR emergency you will find that the chances of being sued are incredibly small, whereas the chances of being sued if you do not have an AED gets bigger everyday. I'll say that one more time, the chances of being sued if you do not have an AED gets bigger everyday.

Another argument against not stocking AEDs roughly goes like this - Calling the emergency services is the only thing that can be done for a patient, anything else could possibly endanger the victim. So as to avoid any further complications in the life-saving process, do as little as possible, then you can't be found responsible or at fault.

This argument is seriously flawed. If this argument were true, then first-aid would never have been created. Samaritan laws, or the likes, exist to protect people from being sued when they come to a person's aid. In an emergency it is essential that we offer as much assistance through first aid as possible. First-aid has been developed by medical professionals, and really makes a critical difference in an emergency. The process has been broken down into steps and in order to save a life we simply follow our training. Using a defibrillator is just one recommended step in the process. This step has been sanctioned by all governing bodies. globally. If your emergency procedure only includes CPR and no AED then what you're effectively doing is saying, "Well, I'll follow these steps here, but I don't want to follow that one." Which is overriding professional advice.

If the best path legally and morally was to do nothing or just half of the steps recommended before the ambulance arrived, then first aid wouldn't exist, and would have been annihilated by the lawyers years ago.

There are an ocean of doctors and medical professionals that actively support AEDs and are happy to stake their professional reputations on them. Contrary to this, there are how many professional bodies that actively encourage people NOT to have AEDs? I think none. How many lawyers actively promote, in public, that AEDs should not be used. How many lawyers stake their careers on this kind of advice. I think none.

The day I see a large law firm come out and say that AEDs should NOT be used by any reasonably, confident citizen is the day I will take the ACTIVE ABSTINENCE argument seriously and probably get out of the life-saving business.

Until then, I recommend that you get an AED. Your liability does not increase if you own one but your chances of saving someone significantly increases. It really is a no brainer. Throughout history, medical development has been plagued by "nay-sayers" who have worked tirelessly behind the scenes to thwart good ideas. The AED is no different.

For the original piece please see http://www.defibchina.com/content13.html

Defibrillators TRUE or FALSE ?

You can be sued for using a defibrillator - FALSE

This is a complete myth, no-one has ever been sued for using a defibrillator anywhere in the world.

You can be sued for not having a defibrillator in your place of work, public area etc - TRUE

This is absolute fact. Even though there are no such cases which have been to court here in HK yet, anyone who has a business that employs staff or interacts with the general public is liable to a large lawsuit if someone suffers from an SCA on their premises. It is just as matter of time.

Defibrillators haven't saved anyone I know before, so they can't save anyone in the future - FALSE

Completely false, as soon as defibrillators are introduced into communities they start saving lives, even if they haven't been there in the past.

Defibrillators are just for old people - FALSE

Anyone can suffer from a Sudden Cardiac Arrest (SCA). Not just old people. SCAs can be caused by shock, electric shock, near drownings, falls or any number of accidents.

Defibrillators can save everyone whose heart has stopped - FALSE

Some people just die, defibrillators can improve a person's chance of recovery, but they can't start every heart.

If I use a defibrillator and the person does not recover I can get sued - FALSE

Totally false, no-one has ever been sued for a victim not being revived by a defibrillator. The unit also records all the data of the incident, so it can be shown that everything was done to try and save the victim.

It is impossible for a defibrillator to hurt someone - FALSE

If you pick up a defibrillator and smack someone around the head with it, it will probably hurt them, but it wont give them an electrical shock!

The defibrillator can only shock dead people - TRUE

Absolutely true, the units software can only advise a shock on someone who is dead, so what have they got to lose?

Our legal department advises us not to get an AED, and they know what they're talking about -FALSE

Legal departments are surprisingly ignorant about defibrillators in Asia and often know next to nothing about them. When considering getting a unit, ask your legal department for hard evidence on why you shouldn't get one.... you may be surprised to find that they can't produce anything.
p.s.. if they can produce something, please send it to us and we will publish it.

Defibrillators are expensive - FALSE

We at Asia Safety Management Ltd are the first in the region to offer these life-savings products at "published" affordable prices.
See our packages and costs page.

We don't need one because the emergency services are so good here - FALSE

It's true, ambulances are good, but they still operate well outside the optimum time for defibrillation. If you can use a defibrillator within less than 12 mins, preferably less than 4mins, then the chances of that person surviving are drastically increased.
An ambulances can usually get to an address within 18mins. Well outside the time window for recovery. The ambulance arrives just in time to bring out the body-bag.
NOTE: Ambulance times are recorded from the time they are despatched, until the time they reach the address, not the time they reach the casualty. Lifts, stairs etc.. all add on valuable time.

In the future defibrillators will be as common as fire-extinguishers - TRUE

This is actually a mis-leading fact, as comparing a defibrillator to a fire-extinguisher is a little unfair.
Sudden Cardiac Arrest kills more people than fire, car wrecks, handguns, cancer and aids combined. So it goes without saying that they will be more common than a fire-extinguisher.

Defibrillators are hard to use? - FALSE