By Aisling Swift
Naples Daily News
NAPLES, Fla. — If a school does the right thing and purchases defibrillators to save lives, then locks them up, is it responsible if a man dies?
A Collier Circuit judge ruled Community School of Naples can’t be held liable under the Good Samaritan law because access wasn’t required to a defibrillator the nurse had locked in her office on April 12, 2007, when 13-year-old George tried to save his father, Tony Hiller, 38. He died of a heart attack while playing basketball with a staff member at the North Naples school’s fieldhouse.
So Hiller’s widow, Georgia, then sued Naples Community Hospital and the Community School’s registered nurse, Lisa Arnold, an NCH employee who drew up the school’s Public Access Defibrillator plan. That lawsuit alleged that once a decision was made to place an automated external defibrillator, or AED, at the school, the school had a duty to use and maintain them with reasonable care and not lock them up - which was against school policy.
Last week, Circuit Judge Hugh Hayes ruled they also couldn’t be held liable for Hiller’s death under the state’s Automatic External Defibrillator Act, the Good Samaritan Act or the federal Cardiac Arrest Survival Act, all of which provide immunity to anyone who tries to save a life with a defibrillator.
Hayes wasn’t willing to set a legal precedent that would prompt fears of liability involving AEDs, which often can jump-start a heart if used within minutes after cardiac arrest.
“We want businesses and public places to use AEDs,” Hayes said, before dismissing Hiller’s second lawsuit. “I think it’s a dimension I don’t want to go into.”
“AEDs would dry up because no one would want the liability to do it,” he said of any court decision on liability after a failed attempt. “When we start talking public policy, I think the courts have to be very careful in getting into that realm. I don’t think it’s wise for courts to go there. ... The public, in general, would be in jeopardy.”
It’s a case that could have set a legal precedent in Florida - and the nation.
Attorneys cited cases involving negligence and reasonable duty of care involving fire extinguishers, street lights and landowners. But there were only a few rulings nationally they could find involving defibrillators and one involved gross negligence.
In that 2006 ruling, Thompson vs. Rochester Community Schools, a Michigan appeals court found a high school and its employees grossly negligent for doing nothing in February 2002 as they watched 15-year-old Cady Elkins turn blue on the cafeteria floor. The court ruled they breached their duty of care to the student. No one attempted CPR or tried to get the school’s defibrillator - and it took 14 minutes to call 911. Her mother arrived before emergency workers.
The school denied liability, claiming immunity and the court ruled a jury should decide the case.
In a Florida case, the parents of a 12-year-old Indian River County boy sued after he died in March 2006 when he collapsed on the field during a middle school gym class. School officials said the defibrillator, which was in the nurse’s office, was on its way when EMS responded.
In that 2007 Circuit Court lawsuit, Michael and Taffi Fisher Abt alleged the district and defibrillator manufacturer were negligent in not ensuring that the defibrillator was accessible and that school staff wasn’t trained on when and how to use it. As Hiller’s attorney did, the Abts’ attorney argued it wasn’t reasonable to lock it up. The trial judge agreed, denying a defense motion to drop the lawsuit.
A month after Hiller’s first lawsuit was dismissed in March 2008, Florida’s Fourth District Court of Appeal reversed a jury verdict that found L.A. Fitness International negligent and awarded Julianna Tringali Mayer $600,000 for her husband’s death on a treadmill. Among her allegations were that the health club failed to have a defibrillator and didn’t properly train employees in handling medical emergencies.
The court ruled the health club had no legal duty to have a defibrillator. Defense attorneys in the Hiller case contend that’s the same reason the Hiller lawsuits shouldn’t be allowed to proceed.
In Rotolo vs. San Jose Sports and Entertainment, the California Court of Appeal in 2007 affirmed a lower court ruling that an ice hockey rink owner who voluntarily acquired a defibrillator couldn’t be held liable for failing to provide notice that it was available. The Rotolos’ lawsuit contended their 17-year-old son could have been saved if two medically trained bystanders who provided first aid had been aware an AED was located in a nearby penalty box.
None of those rulings is binding here, in the 20th Circuit, meaning they don’t have to be adhered to and offer only guidance to judges.
Hiller’s attorney, David Eaton of Tampa filed an appeal of the Community School ruling with the Second District Court of Appeal in July. Now, he will appeal the second ruling, enjoining the two cases in one appeal.
“We’re going to keep fighting for access for AEDs,” Eaton said after the Jan. 21 hearing, when he argued immunity didn’t apply in the second lawsuit because the nurse failed to follow her own school policy. “It makes no sense to have these devices without accessibility.”
Georgia Hiller said it will be her mission to prove accessibility is required. “The American Heart Association has made it clear that AEDs have to be accessible,” Hiller said.
Attorney Kevin Crews, who represented the defendants with co-counsel Ashley Withers, said he was pleased the court agreed with the defense arguments.
In April 1997, Florida became the first state to enact a broad public access law and by 2001, all 50 states had enacted defibrillator laws or adopted regulations. Florida is one of eight states that require AEDs in public schools; The Community School, a private school, voluntarily purchased them.
State law says potential users must be trained, that the devices be maintained and tested, and allows a “Good Samaritan” exemption from liability for anyone who provides emergency treatment with a defibrillator. That exemption also is part of the Cardiac Arrest Survival Act.
Currently, there are 988 AEDs in Collier County, including at police stations, fire and EMS stations, and the Sheriff’s Office, which has about 250, according to Noemi Fraguela of Collier County Emergency Medical Services. She said there could be more, but some may not be registered with EMS, which can direct 911 callers to AED locations, tell them how to use it and alert owners to any recalls. Other registered AEDs include 60 in businesses, 28 in clubhouses, 77 in condominiums, 115 in golf and country clubs, 37 in religious facilities, 40 in private homes, and four in hotels and resorts; there are none in restaurants.
Hiller died during his after-school daily routine with his children as he played basketball while his 8-year-old daughter Ana watched and his son was in a rock climbing class. Tony Hiller dropped to the floor and went into cardiac arrest.
School staff called for help and two bystanders called 911 as employees began CPR. The lawsuit says the 911 operator asked if the school had an AED and employees sent Hiller’s son to the nurse’s office to get it. It was locked, he ran back and staff told him to run to the athletic field to see if a coach had access to one or a key to the nurse’s office.
“Precious minutes were lost in a frantic hunt for an AED or a key to the locked nurse’s office,” the lawsuit said, noting that the fire department arrived 10 minutes after the 911 calls, but it was too late.
Hearings showed there also was an AED near the gym, but the boy wasn’t sent there.
Hiller’s lawsuit against the school alleged it was negligent because it failed to appropriately train staff to respond to a heart attack; provide adequate and appropriate notice to staff, students and faculty about AED locations; place AEDs in places where heart attacks were likely to occur, including the field house; or ensure AEDs were always accessible, including after school hours.
The school’s attorney, Jeff Blaker, argued the school had no duty to provide an AED or make it accessible. “Just because we had an internal policy that was based on a recognition that people could have heart attacks doesn’t mean that there was a duty for us to keep it unlocked,” Blaker argued.
Hayes dismissed that lawsuit last March, ruling the Legislature intended to promote the devices in public places. “They made a trade-off that some people will expire in unfortunate circumstances, but on the other hand, it won’t be negligence because there is a greater good by promoting their dissemination,” Hayes ruled, noting that the majority of courts nationally took that stance.
However, Hayes agreed that someday, once defibrillators become common in public places, the Legislature may decide that laws providing immunity aren’t needed.