Should Rescuers Be Held Liable for Poor CPR Performance?

Detroit EMTs Fired After Feedback Data Showed Inadequate CPR

In late March, the Detroit Free Press reported that two of the city’s EMTs had been fired after an AED feedback tool indicated they had failed to deliver high-quality CPR. The victim — a 6-foot-3, 280-pound man with a history of pulmonary embolisms — was pronounced dead soon after arriving at the emergency room.  

Here at Cardio Partners, we’re pretty passionate about AEDs and CPR. In fact, we consider it our duty to inform our readers about topics ranging from sudden cardiac arrest to AED legislation to the importance of CPR

The tragic event in Detroit brings up a host of issues and plenty of questions for the industry. Richard Lazar, President of Readiness Systems (which publishes AED Law Center) noted the following in an editorial published on LinkedIn

“If better CPR is the goal of CPR feedback tools, then great, no problem. But in this case, it appears from news accounts that CPR performance data was used as one of the reasons to fire the two EMTs. If the failure to deliver high-quality CPR (however defined) is legally actionable (either administratively as in this case or civilly in a negligence lawsuit), then volunteer bystanders and professional healthcare workers will be placed in legal jeopardy if they use CPR feedback devices that collect and store performance data. This is quite scary and raises a host of questions.

“For ‘bad’ CPR to give rise to a lawsuit or administrative proceeding, ‘bad’ must be adequately defined and enforceable as a legally binding “standard of care.” However, CPR competence is not governed by any existing or binding standards. As far as I am aware, no statute has been passed and no agency regulation adopted in any state requiring strict adherence to CPR performance metrics. Now that the genie is out of the bottle, however, plaintiff’s lawyers may try to use CPR feedback data to prove volunteer bystanders or healthcare professionals are negligent in CPR/AED cases – a messy and nebulous process that leaves standard of care decisions to judges and juries.

“Claiming CPR feedback devices or CPR competence training represents a standard of care is consequential since this very loaded term has more legal than medical meaning. And who, for example, determines what the enforceable standard for CPR quality is? The benchmark – however defined – will undoubtedly change over time as it has consistently since the 1700s. So what standard will apply when? CPR feedback technology will also have to prove itself good enough – and defensible enough – to stand up to the rigors of litigation and advocacy. Finally, makers of CPR feedback technology and CPR competence trainers may find themselves in the litigation/liability target zone alongside those doing the CPR. The potential ramifications hinted at by this case and the notion of CPR quality as a standard of care seem endless.”

We also think it’s worth pointing to a study published by Baylor University Medical Center in 2017. Researchers found that performing successful compressions on obese or morbidly obese manikins (and, based on the aforementioned victim’s BMI of 35, he would have been considered obese) was significantly more difficult than doing so on a manikin with a healthy BMI. In fact, 23 out of 30 compressions on the normal manikin were successful while 0 out of 30 were successful on the obese and morbidly obese manikins.

“High-quality, effective compressions are vital to successful CPR. Results of this study indicate that compression quality is lower when performed on obese and morbidly obese adult simulation manikins…Edelson and associates found that morbid obesity was associated with poor outcomes in comparison to subjects who were not morbidly obese. They also found that morbidly obese patients received shallower chest compressions.”

AEDs and CPR Save Lives

In 2015, the CDC reported that 375,000 people in the US experienced an out-of-hospital cardiac arrest. The American Heart Association estimates that at least 20,000 lives could be saved annually by prompt use of AEDs. The AHA also notes that “communities with AED programs, which include comprehensive CPR and AED training, have achieved survival rates of 40% or higher for cardiac arrest victims.” 

AEDs with automatic feedback are designed to assist rescuers — both professional and untrained bystanders — improve survival outcomes. 

Clearly, more research is needed; however, the Baylor researchers concluded that “CPR training for individuals working in a hospital should be representative of potential situations that they may encounter, and it is likely that health care workers will encounter obese or morbidly obese patients. Implications for healthcare workers include maintaining competency of basic life support skills and being prepared to deliver CPR on obese patients.”

Are EMTs Protected by Good Samaritan Laws?

Given our litigious society, bystanders may feel some reluctance to help out in emergency situations. In fact, some potential rescuers may even choose not to offer assistance to those in need for fear of liability. While proceeding with caution and care is always advised, fortunately, all 50 states and the District of Columbia now include AED usage as part of their Good Samaritan Laws. 

These laws vary by state but they have been enacted to protect organizations and laypersons — and in some cases, first responders — from civil litigation.

Basically, these statutes protect those who help others in a time of crisis or emergency. Often these laws only apply if the rescuer is acting without any expectation of compensation or reward. In other words, if you’re a medical professional getting paid to rescue, then these laws may not apply to you. 

In general, states also extend Good Samaritan protections not only to good faith rescuers but also to AED trainers; to the person responsible for the site where the AED is located (when that person has provided for an AED training program); and to any physician who prescribes an AED. 

Protect Yourself From Civil Liability

First and foremost, always act in good faith. Regardless of the laws in your state, it’s wise to protect yourself from possible liability by acting on behalf of the victim. Here are a few tips to protect yourself from liability:

  • Take a nationally-recognized First Aid course
  • Become AED certified
  • Learn CPR
  • Make sure your certifications are up-to-date
  • Use common sense
  • If possible, ask the victim if you can assist them
  • Don’t try to be a hero, but do try to help
  • Don’t do anything you’re not trained to do
  • Seek professional help as soon as possible
  • Never accept cash, gifts, or other awards for your assistance

While Good Samaritan Laws provide some level of protection if a lawsuit is filed, they do not prohibit or prevent a lawsuit from being filed. In fact, some states, such as Rhode Island, only offer Good Samaritan immunity to individuals who hold up-to-date AED certifications. Virginia, by way of contrast, offers extensive protection and goes so far as to urge the public to receive CPR and AED training.

Ready to hone your CPR and AED skills? We have the info you need about CPR or AEDs and CPR and AED Training. To purchase an AED, visit AED.com or call Cardio Partners at 866-349-4362. You can also email us at customerservice@cardiopartners.com.

DISCLAIMER: The information included in this post and on our website is not intended as legal advice. As legislation changes often, this post may inadvertently contain inaccurate or incomplete information. We urge you to contact your state representative should you require more information about current AED, CPR, and Good Samaritan laws in your state.

DISCLAIMER: Information and resources found on the cardiopartners.com and aed.com websites/blogs is intended to educate, inform, and motivate readers to make their health and wellness decisions after consulting with their healthcare provider. The authors are not healthcare providers. NO information on this site should be used to diagnose, treat, prevent, or cure any disease or condition.

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