Robinson Donovan has established a national reputation as advocates for more widespread use of automated external defibrillators (AEDs). The firm got its start in this field in 1996, when it began to investigate a claim for a long-time client. Her 38 year old husband suffered a cardiac arrest on board a United Airlines flight in 1995 and, for lack of an AED, died. Through its successful handling of that case against United, Robinson Donovan received a thorough education on the subject of cardiac arrest, its treatment, AEDs, and the airline industry. The result was Robinson Donovan’s commitment to Public Access Defibrillation (PAD). AEDs are a nearly miraculous device: the only way to save victims of sudden cardiac arrest -- cheaply, easily and reliably.

Each year in this country, between 250,000 and 350,000 people (almost 1000 per day) die from sudden cardiac arrest (SCA), making it one of the major causes of death, if not the major cause. SCA is not a heart attack; it is the abrupt cessation of the heart’s pumping ability, with the victim becoming breathless, pulseless and unconscious almost immediately. Usually this is due to an abnormal heart rhythm called "ventricular fibrillation" (VF). In VF, the heart’s electrical impulses go awry and the heart begins to quiver out of control. The heart’s electric beat short-circuits and the regular pumping stops. Before AEDs, the problem of timing was usually insurmountable. The only effective treatment for ventricular fibrillation is rapid defibrillation, within a few minutes of the cardiac arrest. Every minute counts. If as many as seven minutes pass without defibrillation, even if CPR is used, the chances of successful resuscitation are slim and, even then, neurological damage is likely, due to the lack of oxygenated blood to the brain. Traditionally, seven minutes was not enough time - to get to a hospital, or even for the ambulance to arrive. Sudden cardiac arrest was usually fatal. Defibrillators send an electrical charge into the heart’s electrical system, ending the paralyzing short-circuit and restarting the heart’s natural electrical beat. The technology has existed since the 1970s. By the 1980s, defibrillation technology found widespread application in hospital settings. By the 1990s, like a lot of computerized electrical devices, AEDs were smaller, better and cheaper. AEDs are now small, lightweight, portable and virtually foolproof. They will not administer a shock unless one is actually required. They can be used with only minimal training and cost between two and three thousand dollars, with prices dropping steadily as AED use becomes more widespread.

CHANGING AWARENESS OF THE NEED FOR PAD

Change in public and corporate behavior often requires three ingredients: publicity, litigation and legislation. Robinson Donovan attorneys have been involved in all three types of work in their PAD efforts.

Publicity
To help increase public awareness of the need for PAD programs, Robinson Donovan attorneys often speak and write on the subject. Robinson Donovan attorney Ronald C. Kidd has been actively involved in PAD efforts through the American Heart Association. As a member of the Greater Springfield YMCA Board, Ron led the campaign to deploy AEDs at Y facilities, including their exercise facility on Chestnut Street in Springfield. On April 10, 2002, that AED saved the life of an 81-year old Y member who had sudden cardiac arrest while she was exercising. Y personnel used their AED within minutes, well before the arrival of EMTs.

In April, 2000, Robinson Donovan donated an AED to the Springfield Tower Square office complex, where its main office is located. This complex includes an office tower, retail shops, restaurants and a hotel. The donation was widely reported in the Springfield area and was part of a commitment by Robinson Donovan to encourage owners and operators of buildings and businesses to deploy AEDs on their premises. The Tower Square AED was used within a month of its deployment.

On March 1, 2002, Ron was awarded the "Heart of Gold" award by the Pioneer Valley Chapter of the American Heart Association for his efforts in increasing public awareness of the need for PAD.

On May 9, 2002, Robinson Donovan attorneys attended and addressed the annual convention of the North American Society of Pacing and Electrophysiology (NASPE). NASPE is the leading national and international organization for professionals specializing in cardiac rhythm disorders and focuses on education and advocacy. They spoke on the legal aspects of AED deployment as part of a program called "Automated External Defibrillators: Clinical Utility, Costs and Legal Ramifications."

Legislation
One of the perceived drawbacks to deployment of AEDs on a widespread basis has been a fear of liability for their misuse. Generally, this fear is unfounded, especially since a victim of sudden cardiac arrest is, for all intents and purposes, already dead. Nevertheless, all states have enacted one form or another of "Good Samaritan" legislation to protect users of AEDs from liability, except where the AED is used in a grossly negligent fashion.

In 1998, Ron Kidd was one of several speakers who addressed the Massachusetts legislature on the need for Good Samaritan legislation for AED users. The hearings ultimately resulted in an amendment to M.G.L. c. 111C, which was one of several pieces of legislation that have emphasized the need for widespread deployment of AEDs in the Commonwealth of Massachusetts (also see An Act Limiting Liability Resulting From the Use of Automatic External Defibrillation. Similar campaigns led to the Cardiac Arrest Survival Act [HR2498] of 2000, an act passed by the United States Congress which provided "Good Samaritan" immunity on a nationwide basis and which directed placement of AEDs in most federal buildings.

Litigation
In February, 1998, Robinson Donovan attorneys Ronald C. Kidd and John C. Sikorski filed suit against United Airlines on behalf of a client whose husband died in 1995 on a United Airlines flight that did not have an AED. The events surrounding the death of Steven Somes were highlighted by a Pulitzer-Prize winning reporter, John Crewdson, in a Chicago Tribune series called "Code Blue: ER in the Skies." In January, 1999, the United States District Court for the District of Massachusetts rendered an opinion, rejecting United Airlines’ position that lawsuits such as Somes’ were prohibited. This decision, Somes v. United Airlines, 33 F. Supp. 2d 78 (D. Mass. 1999), received widespread publicity, as did the settlement of the Somes litigation. The case has been recognized as a factor in spurring commercial airlines to deploy AEDs. Also see the National Center for Early Defibrillation’s article, "Understanding Legal Issues."

In the summer of 2000, Massachusetts Lawyers’ Weekly recognized Ron Kidd as one of 10 Massachusetts attorneys to receive the "Attorney of the Year" award for his efforts in the Somes litigation.

In April, 2001, after years of inaction on the subject, the Federal Aviation Administration passed a regulation requiring all commercial airlines that had not already done so to deploy AEDs on most of their flights by 2004. By then, all of the larger air carriers had begun carrying AEDs on their passenger flights, in some cases for several years. See, the Federal Register Rules and Regulations, Federal Aviation Administration, 14 CFR Parts 121 and 135, "Emergency Medical Equipment; Final Rule."

Robinson Donovan has successfully concluded three cases against other airlines that, as late as 2000, had not deployed AEDs on their flights. These cases took Robinson Donovan attorneys to Federal Courts in Minneapolis, Chicago and Boston, and involved allegations that the three victims would have survived their sudden cardiac arrests had AEDs been available. The firm is currently pursuing claims involving two large health clubs for negligently failing to deploy AEDs, resulting in profound brain damage in one instance and death in the other. One case is pending in Federal Court in Boston and the other in state court in Cincinnati.

HEALTH CLUBS

AEDs are especially well suited to air travel because, at 30,000 feet, medical assistance was only available by diverting the flight to the nearest airport, usually at least a half hour away. However, the same advantages of AEDs have long been obvious in other public settings. Seventeen years ago, in 1986, the American Heart Association and the Journal of the American Medical Association published recommendations for the widespread use of AEDs, and suggested their use in a wide variety of public settings, including health clubs. Even now, most health clubs still do not have AEDs on premises, despite widespread knowledge that physical exertion results in a dramatically increased likelihood of sudden cardiac arrest in a significant percentage of the population. As membership in health clubs continues to grow, with over 30 million members in 2000, the necessity for AEDs in health clubs is even more urgent. In March, 2002, the American Heart Association and the American College of Sports Medicine (ACSM) published a supplement to previous recommendations applying to health clubs that urged the widespread deployment of AEDs. Studies prior to 2002 indicated that only 3% of health clubs surveyed had AEDs on premises, despite a large percentage of them that had reported cardiac events among their members.

Robinson Donovan attorneys are presently representing a client and his family against a major national health club chain. The man suffered a cardiac arrest in April, 1999 while exercising at a facility which advertises that it specializes in "aging boomers" and "matures." He suffered a cardiac arrest and the staff implemented 911 procedures and began CPR. Because the arrest occurred in a downtown Boston site, during rush hour, the EMS units were not able to reach him before nine minutes had passed. They were able to re-start the man’s heart, but not before he had suffered severe brain damage from being deprived of oxygen, despite having CPR performed. For years, the American Heart Association has recognized timely defibrillation as the most important link in its "chain of survival." This case illustrates the limitations of CPR and the need for rapid defibrillation in order to effectively resuscitate a victim of sudden cardiac arrest.

Anyone who has questions or would like further information should feel free to contact Ronald C. Kidd at rkidobinson-donovan.com or at (413) 732-2301. Our attorneys are available to consult or to partner with you on any cases you might have in this area.