Defib Machines and the Law
It is important to make sure your workplace, home or educational institute has adequate access to a defib machine so that in the event of a cardiac arrest, the victim has a better chance of surviving. Defib Machines understand that that when it comes to defibrillators, there can be some confusion as to whether or not anyone can use them and what happens when things go wrong. Whilst our team can’t give legal advice, there are many frequently asked questions that we can help answer so that you’re clear about owning a defibrillator.
1. I’m not a healthcare professional. Will I be liable if I use a defib machine on someone?
Anyone who attempts resuscitation could only be liable for damages if intervention leaves the victim in a worse position than they would have been in had no proper action been taken. In the case of sudden cardiac arrest (“SCA”) it is difficult to see how intervention by a rescuer (certainly one who is not a healthcare professional) could leave someone worse off, since without intervention death is inevitable. Defib machines can recognise whether the cause of a collapse is due to SCA, and so the machine will not deliver unnecessary treatment. This would limit any argument that harm had been caused.
It is therefore not surprising that there are no reported cases of any such claim.
2. The victim can’t consent to opening their clothes, performing CPR and applying a shock. Why am I allowed to do these things when I’m not a paramedic?
Fewer than one-in-ten people survive an out-of-hospital SCA but CPR and the use of a defib machine can significantly increase survival rates if performed promptly. It is generally accepted that defib machines can be safely used by members of the public whilst awaiting an ambulance.
As time is of the essence in this situation, bystander intervention to save a life benefits from the legal defence of “necessity” – and (probably) “implied consent”. It is reasonable to carry out CPR and use a defib machine on someone who has suffered an SCA, even though they cannot consent.
When the victim is under 16yrs there are other technicalities (and the position is slightly different in Scotland and in Northern Ireland) but unless a parent/guardian is present and refuses consent (and possibly even if they do) the position would generally be the same as for an adult.
3. What is the SARAH Act? Does it help me?
The Social Action Responsibility and Heroism Act (England & Wales) Act 2015 was introduced to encourage involvement in social action. It requires that, when considering a claim for negligence or breach of statutory duty, the Court must have regard (amongst other things) as to whether the rescuer was demonstrating a predominantly responsible approach towards protecting the safety or interests of others; or was acting heroically. The Courts have always looked benevolently on those who have gone to the assistance of others.
4. Is there a law that says I have to have a defib machine?
Unlike many other countries, there is no UK legislation stipulating that a defib machine must be provided but their use by laypeople is now widely recommended in UK and international guidelines. This has given rise to concerns that failing to provide a defib machine might lead to a claim for negligence against owners of public premises, or employers.
It is therefore important to consider the pros and cons of defibrillators in accordance with the Risk Assessment provided by the Resuscitation Council UK.
The Risk Assessment should also consider the need and appropriateness of providing: suitable wall signs; AED awareness training; and the location and availability of the defib machine. If it is considered good practice to have a defib machine, then alerting people to its presence and location is entirely reasonable.
If a machine was not provided within an organisation, the family of a person who died from SCA there might point to common practice among such organisations to have a defibrillator, or suggest that people who work at or visit that location are at particular risk. These would be relevant considerations in deciding whether there could be a legal duty to provide defib machines in certain places.
Defib Machines offer training, signage and maintenance amongst other things when you rent an AED at £1 a day from us.
5. I have a defibrillator. Is that enough?
Having decided that it would be appropriate to have a defibrillator, further steps would assist in its use: the location should be clearly marked (or communicated to staff or other users); it should be readily accessible; it should be regularly checked (to ensure it is still in its location and not indicating a fault); the pads and battery are changed when needed; and if it is used, it is replaced or serviced.
When provided, it becomes work equipment under the Provision and Use of Work Equipment Regulations: A failure to maintain it or train staff in its use would be a breach of these Regulations. These Regulations do not now give rise to civil liability or damages claims. A breach of the Regulations giving rise to criminal sanctions could result if the defibrillator had not been correctly maintained, leading directly to harm (for example if this was the reason for an unsuccessful resuscitation attempt.)
6. Will I be negligent for not having a defib machine?
The use of defib machines by laypeople has been successful and potential liability for not having one has been questioned. To succeed, a claimant (perhaps the victim’s family) would have to show that there was a failure to take appropriate safety precautions which a reasonable employer or occupier would have taken. Certain premises might fall below the standard if they were not equipped with a defib machine, with signs, training and maintenance, in the same way as if fire extinguishers were not made available.
A lack of resources to incur this cost may not be a complete defence, if there was a clear risk of SCA. Failing to adopt common safety practice can be evidence that appropriate precautions were not taken.
There are particular rules for some locations, for example dentists in England who see patients are required, in order to pass a CQC inspection, to have a defib machine available for use by the entire dental team, who must be trained in its use.
A lack of resources to incur this cost would not be a reasonable defence. Failing to adopt common practice can be strong evidence that appropriate precautions were not taken. If you think you can’t afford a defibrillator, then consider renting an AED for £1 a day from Defib Machines. Failing that, you can also find out how to how to get funding for a community defibrillator here.
7. There’s a defib machine in a nearby shopping centre. Is that enough?
To increase any chance of survival, the SCA must be recognised promptly and defibrillation carried out within a critical time period. One major reason so few people survive SCA is that defibrillation is not provided quickly enough. The victim’s chance of survival falls by about 10% with every minute that an AED is delayed. Only rarely are emergency services able to attend early enough, so the best way of ensuring prompt defibrillation is for someone nearby to use a defib machine.
This timescale can be extended if the SCA is recognised, the emergency services called and CPR performed at the request or under the instruction of the ambulance control team.
8. What if I try to shock someone who hasn’t suffered a cardiac arrest, or if the person using the defibrillator gets a shock?
Modern equipment will not allow a shock to be given unless one is needed, so if a normal heart rhythm is detected no shock will be delivered. They are also safe and present virtually no risk to the rescuer. These features make defib machines suitable for use by members of the public who have little or no training – but training and awareness of using a defib machine makes their use in an emergency more familiar and therefore less of a worry to the rescuer.
9. Am I legally obliged to intervene if I see someone suffering an SCA?
There is generally no legal obligation to help a person in need, other than by a healthcare professional or first aider in the workplace who willingly accepted that role as part of their employment.
Once a rescuer intervenes he undertakes a duty of care. The standard of care expected depends on the level of training, so no liability could arise unless the standard of care falls below that which could be reasonably expected of a responsible person in the rescuer’s position. In the case of SCA the risk of incurring liability for negligence in the use of a defib machine is very small, as the resuscitation process is guided by the machine. The risk of causing additional harm is low, as without intervention the victim of an SCA will almost certainly die.
10. What is the best way for my business to avoid liability?
The best way to avoid liability is to follow good practice. This means:
- Consider the pros and cons of providing a defib machine, awareness training and appropriate signs in accordance with a proper Risk Assessment;
- Act in good faith for the benefit of the person with SCA to improve their chances of survival;
- Follow instructions from ambulance controllers, from the defib machine or from a trained person at the scene;
- Follow the guidelines recommended by authoritative bodies such as the Resuscitation Council UK;
- Keep training up-to-date;
- Use the correct equipment and keep it in an appropriate location and well maintained in accordance with the manufacturer’s recommendations.
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If you can’t find the answer to a question you have about AEDs, or if you would like to find out more about our range of defibrillators, then feel free to get in touch with our friendly team. You can call our experts directly on 0800 0852 733, or contact us online and we will get back to you at your request.