Spread of defibrillators could cut heart attack deaths.

WHEN Los Angeles Times editor and columnist Frank del Olmo collapsed his desk and died, it became a front-page story for the newspaper. It also underscored how heart disease, the leading cause of death in the United States, is a silent killer that most victims don't even know they have. Fatal heart attacks are the first symptom in more than half the 500,000 annual heart-related deaths.

And while it's unclear how many of those deaths occur in the workplace, they can raise liability issues and interfere with overall productivity. There are ways to prepare--both financially and with a new generation of portable defibrillators for faster response to cardiac arrest--but many businesses aren't.

"I suppose it's like all of us, 'It's never going to happen to us.' That seems to be the reaction of businesses," said Mike Reynolds, a spokesman for American Medical Response, an ambulance company that provides emergency services throughout Los Angeles County.

Some companies purchase "key man" insurance that offers protection against financial losses accompanying a sudden death, such as the loss of business and recruitment costs.

More generous, larger companies will also buy corporate life insurance that benefits the families of younger executives, who at middle age may not have adequately prepared for a sudden death, said Tom Morrison, a benefits consultant with Segal.

Still, the larger question remains whether employers are doing enough to prevent sudden cardiac deaths.

Many companies offer wellness programs and employee assistance programs, which teach about exercise, good eating habits and lower stress levels--all keys toward lowering risk for heart disease.

There are some good legal reasons to do this, especially in a blue collar setting where an employee's death from heart attack in the midst of a strenuous activity would likely result in a workers' compensation claim.

Likelihood of claims

Such claims are less likely in the absence of stressful workplace activity, but any workplace death can result in a costly claim, said attorney Mel Owens, a workers' compensation specialist with the Los Angeles office of Seyfarth Shaw.

"If I sit at my desk and keel over after reading some bad news, the family could file a claim. But if I were defending the company I would defend it vigorously," he said.

Even given the potential liability, employers are hamstrung in how they handle employees who may be ripe for a heart attack, such as a heavy, 50-year-old man who smokes and experiences audible shortness of breath and other symptoms of possible heart disease.

"There is a very fine line in what the employer can do and what they cannot do, because of the rights of employees," Morrison said. "At some companies what may be paternalism becomes discriminatory."

A company's best bet may simply be redoubling efforts to train employees to prepare for the possibility of a sudden heart attack at the work site.

The various chapters of the American Heart Association have been offering training in cardiopulmonary resuscitation for years, but CPR has only limited effectiveness in itself--essentially buying time until paramedics arrive with defibrillators which can restart a stopped heart.

Even with the Los Angeles area's generally good emergency response system, it can often take paramedics longer than four or five minutes to get to a patient who goes into cardiac arrest, said Dr. Marc Eckstein, medical

Small: A portable defibrillator. director of the Los Angeles Fire Department.

"Time is of the essence, and if you can get to a patient under four minutes the chance of survival is excellent," he said.

The good news: companies can now purchase their own portable automatic external defibrillators--those new devices that are being advertised on television, resuscitating cardiac arrest victims.

In the last few years their price has come down from as much as $10,000 to as little as $2,000, while at the same time they have shrunk in size from heavy suitcases to handheld devices. More importantly, they are much simpler to use than in the past and require very little training.

"They are virtually idiot proof," Reynolds said. "All you have to do is listen to the voice prompts."

With prices likely to keep dropping, Reynolds envisions the day when defibrillators will be as commonplace in offices as a fire extinguisher, something that could have a significant effect on heart attack survival.

The devices have now become common in Las Vegas casinos, where security guards are trained in their use. A recent study showed the devices increased the survival rate among cardiac arrest victims there to 70 percent from 5 percent, Eckstein said.

Staff reporter Laurence Darmiento can be reached at 323-549-5225 ext. 237 or at [e-mail].