Legal support for school AEDs.

AEDs are clearly effective and needed in schools, yet few schools currently possess them. A brief look at the legal landscape helps explain why this is true--and why it may change.

Generally, schools might buy and deploy AEDs for three reasons:

Voluntary deployment. Schools may choose to deploy AEDs voluntarily for both risk management and public health reasons or because of grassroots efforts precipitated by the sudden cardiac death of a student. Examples of schools voluntarily implementing AED programs are found in Pennsylvania, West Virginia, Wisconsin and Washington state, among others. Yet, probably due to the absence of funding and the lack of a perception that AEDs should be a high priority, this voluntary movement is not yet widespread.

Legislative action. Schools may also deploy AEDs because of a legislative mandate or because funding is made available by a state. An example of a legislative mandate is the Aviation Medical Assistance Act of 1998, which requires that all commercial aircraft that carry passengers have AEDs by April 2004. Some state legislatures are beginning to consider mandating or encouraging the placement of AEDs in schools. New York, for example, passed a law specifically mandating AEDs in schools: "School districts [and other school related entities] shall provide and maintain on-site in each instructional school facility automated external defibrillator (AED) equipment in quantities and types deemed ... to be adequate to ensure ready and appropriate access for use during emergencies."

Among other things, the New York law also requires that at least one staff member trained in AED use be present for events using public school facilities. Officials must also ensure that an AED is available at school-sponsored athletic events held away from school.

In contrast to New York, Pennsylvania and Delaware created voluntary school AED programs that provide funding for purchase of the devices. Each law imposes a number of conditions that must be met in order to obtain funding. Examples include training, maintenance, device accessibility, and EMS system involvement. Neither state requires schools to obtain AEDs.

Legislative activity related to AEDs in schools appears to be on the rise. However, there seems to be no consistency in approach or public-policy rationale surrounding these initiatives.

Common law mandate. A third reason schools may choose to deploy AEDs is because of a perceived "standard of care" mandate created by negligence law. The primary driver here is the fear of being sued if a student suffers sudden cardiac arrest and no defibrillator is available. Olmstead Falls High School (Ohio) is subject to just such a claim. The parents of a 15-year-old student who died from SCA after a track event sued the local school district and board of education, claiming their daughter died because no AED or phone was immediately available after she collapsed. The case is pending.

Given the publicity surrounding the death of students in schools, coupled with a growing awareness of AEDs and their benefits, it is likely more lawsuits against school districts will arise. Schools, as public entities, have special immunity defenses not available to private parties, so it remains to be seen how successful these claims are. However, the fear of negligence suits will certainly drive some schools to initiate AED programs.

Attorney Richard A. Lazar is president and CEO of the Early Defibrillation Law & Policy Center.