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Defibrillators

5th September 2010

In the years since their introduction, the use of AEDs by lay persons has proved so successful that fears have been expressed that failing to provide an AED might lead to a claim for negligence should a member of the public suffer a cardiac arrest while on the premises. The problem was highlighted when two airline companies were successfully sued in the USA because an AED was not available to treat passengers who suffered cardiac arrests during a flight.

AEDs are being widely provided in busy public places by a government led initiative, and many other organisations have acted on their own initiative to make the equipment available. The police have equipped custody suites with AEDs and many patrol cars also carry the equipment. The first aid societies have deployed AEDs at many of the functions that they attend. There is, therefore, widespread public awareness of the purpose of such equipment, but so far there have been no cases in the UK brought against those who have not equipped themselves with AEDs.

 

Several US states now require AEDs to be placed in particular buildings, including schools, health clubs, day care centres, places of public assembly, and swimming pools. There is currently no such legislation in the UK.


Under English law, there can be liability in negligence for failing to take appropriate safety precautions on your premises, for example the case of Lips v Older [2004] All ER (D) 168, where a landlord was found to be negligent for not arranging for a handrail to be put up by a staircase with a steep drop to one side. Whether precautions are appropriate will depend on balancing the cost and benefit of the precaution. When considering the benefit, one must consider the likelihood of harm, the severity of the potential harm, and the vulnerability of potential victims that the Defendant knew or should have known about. In that and similar cases, the hazard was inherent in the premises, but it can be seen by analogy that the time might come (although it has probably not yet arrived) where certain types of premises would be considered defective if they were not equipped with AEDs.


In relation to AEDs, the likelihood of harm will depend on the type of people who use the facility, and how likely they are to have a cardiac arrest. The severity of potential harm is clearly very high. The vulnerability of potential victims will very much depend on the circumstances and the type of people attending the defendant's facility. The cost of purchasing an AED and training staff to use it may be quite high. However, when looking at the cost, lack of resources will not be a relevant factor. Failing to adopt common practice can be strong evidence that appropriate precautions were not taken. Where an AED is provided in a workplace, and used by a member of staff, it becomes work equipment to which the Provision and Use of Work Equipment Regulations 1998 apply. Failure to maintain the equipment and to train persons in its use would be a breach of the 1998 Regulations by the employer.


It may be possible to use this basis of liability to found a claim against an organisation that did not equip itself with AEDs. For any such claim to succeed, it may well have to be shown, at the least, either that the people who generally used the organisation's premises were at a particular risk of cardiac arrest (i.e. that there was a fairly high risk of potential harm), or that it was common practice amongst such organisations to have an AED available. An example could be a gym or health club where cardiac arrests have been reported with some frequency. In addition, many such facilities (but not all) have already equipped themselves with AEDs and lives have been saved. Some states in the USA do actually require health clubs to be equipped with AEDs.


August 2010 - This updated report was written by Michael Colquhoun and Edward Martineau. From Resus UK

 

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