Time to Shock Schools into Deploying Defibrillators
Last week a Florida jury delivered a $2 million verdict in the case of a high school athlete who died in winter baseball tryouts. While the boy’s parents were found partly at fault, his pediatrician and the school district also shared blame.
- High school athlete’s death prompts deployment of AEDs at athletic events
- AEDs can save lives, yet few states require schools to have them
- Schools’ immunity a barrier to safer environments for students
$2 Million Judgment Spotlights High School Athletics Risks
Matt Miulli was born with a heart defect. His parents, his pediatrician and the school district knew that. He passed an extra physical that cleared him to play, although his cardiologist recommended against it. This recommendation never reached Miulli or his parents.
When he collapsed during a one-mile run in the tryouts, CPR wasn’t enough to revive him. The school was equipped with an Automated External Defibrillator (AED), but it was inside a school building and not accessible for use on the practice field. Had it been, it might have saved Miulli’s life.
200,000 Americans die each year from sudden cardiac arrest, according to the American Heart/American Stroke Association. One in 40,000 athletes, including student athletes, will also suffer sudden cardiac arrest. An AED, if used within three-to-five minutes of arrest, could save as many as 25 percent of these victims.
Miulli’s parents used their grief as a springboard to make kids’ athletics safer. The result was a new Florida law requiring AEDs in a number of sports settings. Now it’s increasingly common for high school sports safety standards to be regulated by law.
For example, a majority of states have passed youth concussion laws. This follows medical science showing just how dangerous concussions can be in the short-term, and how long-lasting the effects of concussions are. Despite such research, it often takes a tragic and avoidable injury to a youth for lawmakers to act.
Short of laws, many schools or school athletics associations have policies covering sports safety. For example, the Florida High School Athletics Association requires at least two AEDs at all sanctioned events. Heat-related injuries also are common, and schools and associations usually have policies on heat and hydration.
AEDs Save Lives, but Deployment Held up by Funding Gap
But the coverage of these potentially life-saving measures is spotty. According to the National Conference of State Legislatures, just nine states require AEDs in schools.
"Sadly, that sounds about right," says Allyson Perron, Senior Government Relations Director at the American Heart/American Stroke Association, in comment to the lack of AED laws. "The biggest barrier to deployment of AEDs in schools right now is funding."
Perron points to a legislative initiative in Massachusetts. It’s in two pieces. One piece would require defibrillators at schools. That’s a costly proposition, and school budgets are being reduced, not expanded. The other piece requires schools to develop emergency medical response plans. It requires no funding. As a part of this bill, schools would identify whether they have any AEDs currently. With this, legislators could find out what it takes to make up the shortfall.
AEDs are now widely available, and they can be found in many public places. As the market has expanded, the price of an AED has fallen by about two-thirds. An AED can cost as little as $1,000, notes Perron. The price may be less for purchases in volume, like by an education department for school systems. "In Massachusetts though, the only public places AEDs are required by law are health clubs," says Perron.
Perron also notes that schools are not just places of learning. They are places where the general population regularly gathers for events and civic functions. So having AEDs there may save the life of not just a student but of a parent or a grandparent. Perron points out that AEDs can be effective for any cardiac arrest, whatever the cause – be it an abnormality, or something as common as heat stroke. And there are types of injuries, like when a kid is struck in the chest by a hockey puck or a baseball, stopping the heart, where CPR is ineffective and only an AED can restore a normal heart rhythm.
School Immunity: "Sacred Cows" Safer Letting a Kid Die
In the Miulli case, the jury found the school district just five percent liable for the boy’s death. The school had an AED, but it was inside a building and not readily available for use. Still, the assessment of any liability surprised Illinois school law attorney Matt Keenan.
School districts remain "largely immune from liability for all but the most outrageous conduct," he says. "It’s partly a matter of the immunity they have as a government entity. But as a practical matter too, juries are really reluctant to impose liability on their own schools, just they like they’re hesitant to blame their police or firefighters for wrongdoing."
Could this immunity actually work against better safety standards in schools and school athletics? Perron recalls a school in western Massachusetts where an enrolled student had a known cardiac condition. She says the school declined the offer of an AED because it was afraid it might then become liable for its misuse, or for failure to use it. This is despite the existence of good Samaritan laws protecting AED rescuers from these types of claims, the very simple and essentially foolproof nature of the devices, and the almost certain alternative to not using them – the death of the victim. Talk about a perversion of the typical safety incentive that’s built into the American torts principle.
"It absolutely is," says Keenan. "The system tends to encourage schools to do nothing. It’s less legally risky for a school to let someone die than to take the risks incumbent in trying to save them. I abhor the social cost, and it’s something legislatures could address. But schools are like sacred cows."
Should AEDs be a required part of the standard of care schools owe to their students and student athletes? Just ask any parent.
Art Buono co-authors the Lawyers.com blog.
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