Lawsuit: Locked Up Defribulator Could Have Saved Son

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Lawsuit: Locked Up Defribulator Could Have Saved Son

Last Edited: Monday, 10 Nov 2008, 9:46 PM CST

Created: Monday, 10 Nov 2008, 9:46 PM CST

D.J. Chastain SideBar

By Mandy Murphy

(KTVI - myFOXstl.com) -- Two years ago this past October, 15 year old DJ Chastain collapsed on the basketball court and died. He had a heart condition that had never been diagnosed. He appeared perfectly healthy and had just passed his physical. Silex High School had an AED, a defibrillator used to shock the heart back into rhythm but it was in a locked office. DJ's mother Billie Houghton has now filed a wrongful death lawsuit against the school arguing Billie's practice was too long and too hard and that the defibrillator could have saved his life but it was locked in an office. The school's attorney denies any wrongdoing and says the coach is still heartbroken over DJ's death. The coach did CPR until paramedics arrived. Our Fox 2 investigation found many schools don't have AEDs because they fear litigation. Experts say schools worry where to put the device and how that could open them up to lawsuits. Under the sovereign immunity law, a school cannot be held liable. Silex high school offered Billie a nominal settlement and assumed no responsibility. Their attorney said everything possible was done to save DJ and they are saddened by Billie Houghton's loss. Billie would like to see schools be required to have AEDs and limit the time of sports practices.

I read this and wondered if the schools' fears are justified. What are your thoughts?

[crotchitymedic1986]

Probably a realistic fear, but it could easily be solved if the state legislature would just add a clause to their good samaritan law that stated that schools/businesses/residences would not be held liable for the use of a defibrilator (or the failure to be able to use it -- not charged, device failure, location to far away, locked up after hours and no one has a key, or patient or user are registered democrats -- LOL).

[hammerpcp]

WTF is a "difribulator"?

[Just Plain Ruff]

a defribulator is kin to the defibrillator but it's only found in dark locked offices where no-one can get to them.

[hammerpcp]

"He's in venritcular fribulation! quick someone get the defribulator and put a endotrachleal tube in his larnyx!

[Richard B the EMT]

At least he isn't choking on the Peanut Butter Balls. (Phenobarbital mispronunciation)

I'll get back to the string with NYS laws on this topic.

[Chief1C]

Now if it wasn't locked in an office, it would either be tampered with or stolen by kids. [spoil:60176174b1]You know the ones, they get off on making other people suffer because their parents are ignorant nut balls. They were never taught that somethings affect everyone else, not just themselves. The parents who fight to justify their children being addicted to drugs and alcohol, because they were at that age (and still are). Justify shooting out street lights, then someone walking along the road gets hit and killed, but that's okay.. That's what their crack head, boozed up dad did when he was bored. [/spoil:60176174b1]

[TDP]

What is the survival rate of not witnessed cardiac arrest? <1? what would be the percentage per witnessed cardiac arrest ill be generous and say 3%? CPR WAS intiated post boys collapase. The question is does the AED give that life that extra life we need to survive and be healthy? Would an aed in this situtation really make a difference. discuss

[hammerpcp]

emm... TDP your numbers are WAY off.

[Richard B the EMT]

I did not include the paperwork forms, but this is NYS DoH on Public Access Defibrillation...

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Policy Statement 07-04

New York State Department of Health

Bureau of Emergency Medical Services

POLICY STATEMENT

Supersedes/Updates: 98-10, 06-03

No. 07 - 04

Date: 09/27/2007

Re: Public Access Defibrillation

The purpose of this policy is to assist a person, firm, organization or other entity in

understanding the notification process for operating an automated external defibrillator pursuant to a collaborative agreement under the provisions of Chapter 552 of the Laws of 1998 authorizing Public Access Defibrillation. A Public Access Defibrillation (PAD) program is designed to encourage greater acquisition, deployment and use of automatic external defibrillators (AED) in communities around the state in an effort to reduce the numbers of deaths associated with sudden cardiac arrest. Since the enabling legislation’s inception, there have been 4,140 PAD programs established, with over 135,000 people trained. This program has been successful in saving many lives across New York State.

To be authorized to use an AED under this statute an individual or organization needs to make specific notification of intent to establish a PAD program to the appropriate Regional Emergency Medical Services Council (REMSCO) and the New York State Department of Health (DOH).

There are no approvals or certifications required.

Public Access Defibrillation Program Requirements

Original Notification Process

To be authorized to have a PAD program and utilize an AED, the following steps must be

completed:

• Identify a New York State licensed physician or New York State based hospital knowledgeable and experienced in emergency cardiac care to serve as Emergency Health Care Provider (EHCP) to participate in a collaborative agreement;

• Select an AED that is in compliance with the Article 30, section 3000-B (1)(A). The AED must be programmed to the current Emergency Cardiovascular Care (ECC) Guidelines, capable of defibrillating both adult and pediatric patients. Please check the shaded box on the Notice of Intent to Provide PAD (DOH-4135) if the machine is approved for pediatric use;

• Select and use a DOH approved PAD training course for AED users. The approved programs are listed on the Notice of Intent Form;

• Develop with the EHCP, a written collaborative agreement which shall include, but not be limited to the following items:

Written practice protocols for the use of the AED;

Written policies and procedures which include:

Training requirements for AED users;

A process for the immediate notification of EMS by calling of 911;

A process for identification of the location of the AED units;

A process for routine inspection of the AED unit(s) as well as regular maintenance and

which meet or exceed manufacturers recommendations;

Incident documentation requirements, and

Participation in a regionally approved quality improvement program.

• Provide written notice to the 911 and/or the community equivalent ambulance dispatch entity of the availability of AED service at the organization’s location,

• File the Notice of Intent to Provide PAD (DOH 4135) and a signed Collaborative Agreement with the appropriate Regional Emergency Medical Services Council (REMSCO), and

• File a new Collaborative Agreement with the REMSCO if the EHCP changes.

Signs notifying public of AED location

In July 2007, 3000-b of the New York State Public Health Law, Section 1 - Subdivision 3, was amended by adding paragraph (f) requiring a sign or notice to be posted at the main entrance of a facility or building in which the AED is stored or maintained on a regular basis.

The law is silent as to the specifications of the sign or notice used to communicate the location of the AED(s) within the structure. However, it is expected that the size, type and language(s) of the sign will be easily legible upon entrance to the structure. If there are multiple entrances that could be considered a main entrance then a sign or notice must be placed at each of those entrances.

It is the choice of the Public Access Defibrillation Provider as defined in Article 30 Section 3000-b to determine if multiple languages are necessary and where the sign or notice will be posted.

The sign can be posted inside the entrance of the building, in a foyer or another location as appropriate.

Reporting a PAD AED Use

In the event that the PAD program uses the AED to defibrillate a person, the program must report the incident to the appropriate REMSCO. The REMSCO may request additional

information regarding the incident, but the PAD must report, at a minimum, the following

information:

• Provide written notification of AED usage to the REMSCO within 48 hours of the incident;

• The name of the PAD program;

• Location of the incident;

• The date and time of the incident;

• The age and gender of the patient;

• Estimated time from arrest to CPR and the 1st AED shock;

• The number of shocks administered to the patient:

• The name of the EMS agency that responded; and

• The hospital to which the patient was transported.

A copy of the usage report should also be provided to the EHCP.

Regional EMS Council Responsibility in Public Access Defibrillation

Each REMSCO is responsible for receiving and maintaining notification and utilization

documentation. The REMSCOs must develop and implement the following policies and

procedures:

• Insure that a copy of each new or updated Notice of Intent (DOH 4135) is forwarded to the Bureau of EMS;

• Maintain a copy of the Notice of Intent and the Collaborative Agreement;

• Collect utilization documentation and information;

• Provide detailed quarterly reports to the DOH on PAD programs in the region, and

• Develop Quality Assurance participation, data submission and documentation requirements for participating organizations.

Data Collection Requirements

REMSCO quality improvement programs are encouraged to use the data elements from the Utstein Guidelines for Prehospital Cardiac Arrest Research (Cumming RO, Chamberlain DA, Abramson NS, et al, Circulation 1991; 84:960-975).

The following minimum data set is to be developed and collected as a part of the regional PAD QI process. A copy of the data set is to be provided by each region to the DOH Bureau of EMS quarterly:

• Name of organization providing PAD

• Date of incident

• Time of Incident

• Patient age

• Patient gender

• Estimated time from arrest to 1st AED shock

• Estimated Time from arrest to CPR

• Number of shocks administered to the patient

• Transport ambulance service

• Patient outcome at incident site (remained unresponsive, became responsive, etc)

Ambulance and ALS First Response Services

Ambulance or ALSFR services may not participate in PAD programs for emergency response.

Certified EMS agencies must apply for authority to equip and utilize AEDs through their local Regional Emergency Medical Advisory Committee (REMAC).

Please note that the Prehospital Care Report (PCR) has a check box for EMS providers to

indicate that a patient has been defibrillated prior to EMS arrival by a community or by-stander PAD provider. Documenting this information is required so that the DOH may monitor the effectiveness of these community based programs

Attachments

1. Notice of Intent to Provide Public Access Defibrillation

2. Regional EMS Council Listing

Issued and Authorized by:

Edward G. Wronski, Director

Bureau of EMS

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Richard B, again. Most of the PADs I have seen are in wall boxes like fire extinguishers, with an alarm going off to building security and audible alarm at the box if opened. I think most are FR2s, like what FDNY, NYPD and other local agencies seem to be using in the field anyway, with built in visual indicator if the defib is "good".