From BALTIMORE (WJZ)  July 20 2009

Drowning–it’s how dozens of Marylanders die every year.  In children 14 and under, it’s the second leading cause of accidental death.  Denise Koch investigates why it keeps happening and what one victim’s family is doing to prevent it.

“I kissed him goodbye.  I told him I loved him,” said Debbie Freed.  “Connor fell in the pool and they’re working on him.  It’s silent.  It’s not kicking and splashing like you see on TV.”

It only takes a moment, and in that moment, a young life was lost.

Connor Freed was five years old when he drowned at the Crofton Country Club in June 2006.  He was with family friends.

“Maybe five minutes went by with him being unnoticed,” Freed said.

Then a child spotted Connor floating in the busy pool.  To this day, why Connor drowned remains a mystery to his parents, Debbie and Tom Freed.

“He was actually very good in the water,” Tom Freed said.

“Another patron of the pool came over, did mouth to mouth.  He threw up and a lot of water came out,” said Debbie.  “Then a lifeguard started performing CPR on him.”

Someone called 911, but the lifeguards were not allowed to use a defibrillator.

“I think it would have restarted his heart,” Debbie said.

In addition, there was only one lifeguard watching the pool when Connor drowned.

“He was about 100 feet to the right of the lifeguard in the chair and there was no way that you could see to that area of the pool,” Debbie said.

In fact, one in five children who drown do so in a public pool with a certified lifeguard present.  Current law requires one lifeguard for every 50 swimmers.

“This one for 50 ratio has got to change,” said Debbie.

So the Freeds have made it their mission to change Maryland law.

“I promised him after this happened that I would honor him, that Mommy would do things to change things and I was not going to let this happen to another family,” she said.

They’re pushing for two bills to pass next session.  One would require more lifeguards.  Specifically, pools larger than 2,500 square feet would need at least two lifeguards.  The other bill would require every public pool to have a defibrillator that lifeguards are trained to use.

Mary and Bill Becker believe if it had been used on their healthy, athletic son when he nearly drowned three years ago, he would not be in a wheelchair now.  Instead, James’ brain, deprived of oxygen, suffered debilitating damage.

And a moment’s failure can break a heart–and a family–forever.

“It’s preventable,” Debbie said.

“It’s brutal to hold your five-year-old son in your arms, knowing he’s gone,” Tom said.

Both bills will be re-introduced to Maryland lawmakers in January.  In the past, funding for more lifeguards and defibrillators has been the challenge.  Sponsors argue you can’t put a price on saving a life.

Our thanks to Denise Koch of Baltimore WJZ

Watch this video about distracted lifeguards.  From ABC News.

”

On January 25, 2004, Benfica travelled to Guimarães to play Vitória S.C.. The game was being broadcast live on television, and Benfica were leading 1-0. Fehér, who had just come on as a substitute and assisted another player brought from the bench, Fernando Aguiar, for the match’s only goal, received a yellow card in injury time and suddenly bent forward, seemingly in pain. He then fell backwards to the ground.

Teammates rushed immediately to aid Fehér before medical personnel arrived on the pitch. CPR was performed as players looked on in visible distress. An ambulance arrived on the pitch, and Fehér was rushed to the hospital. His condition was covered by the Portuguese media throughout the day. However, before midnight, Fehér’s death was confirmed. The Public Prosecutor (the Portuguese agency responsible for the release of autopsy details) announced that Fehér died of a heart attack. He was only 24 years old.^[2]

In his memory, Benfica retired the number 29 shirt, which he wore during his time at the club. This number will never be worn again by any club player. He was remembered by many, and his death caused a profound shock in Portuguese sports. Among others, Reinaldo Teles (director of football of FC Porto) and José Mourinho (Porto’s manager at the time) paid their respects at the Estádio da Luz where the player’s body remained before his burial in native Hungary.

A club delegation, which included the entire squad, travelled to Hungary, presenting Fehér’s parents with the 2004-05 league championship medal, in respect for the player and his time with the club.[

Courtesy of AthleticBusiness.com

Aftershocks

By: John T. Wolohan
May 2008

Any health club that does not have an AED, even in states in which doing so is not a statutory obligation, runs the risk of being seen as acting with indifference to the welfare and safety of its patrons and either negligent or grossly negligent for any deaths that may result from a cardiac event. That was the message handed down earlier this year by the Cook County Circuit Court in Fowler v. Bally Total Fitness [Case No. 07 L 12258], a case that suggests a change in the way courts are viewing such incidents.

As reported in this space ["Med Alert," April 2007, p. 30], at least seven states, including California, Illinois, New York and Massachusetts, have legislatively mandated that health clubs and fitness centers meeting a specified membership threshold not only maintain an automated external defibrillator, but also train employees on how to use such a device in the case of an emergency. The two main rationales legislatures have offered for requiring health clubs and fitness centers to have an AED are:

The sooner a heart attack victim gets medical care, the better his or her chances of survival; and,
The cost of purchasing an AED and training employers on its proper use is relatively low, especially when you consider that a potential result of inaction is the death of a patron.
Also spurring legislatures toward such mandates is the gradual acceptance of AEDs as devices, similar to fire extinguishers, that are meant to be operated by laypeople. AEDs are no longer considered sophisticated medical devices requiring specific training — and, in fact, all 50 states have now enacted Good Samaritan laws protecting AED users and providers.

While exercising at a Bally Total Fitness health club in Gaithersburg, Md., in late 2005, 46-year-old Gary Fowler collapsed from sudden cardiac arrest. This particular club did not have an AED on site, so while the staff at Bally called for emergency assistance, several patrons performed CPR in an attempt to resuscitate Fowler. Despite everyone’s best efforts, Fowler died.

As a result, Fowler’s estate filed a wrongful-death action, arguing that even though Bally may not have been statutorily obligated to have an AED on site, it still had a legal duty under negligence law to maintain an AED at the facility.

In moving for summary judgment, however, Bally argued that it was under no common-law duty to maintain or deploy an AED at its Gaithersburg facility. In support of this position, Bally cited three decisions from other jurisdictions — Salte v. YMCA, Atcovitz v. Gulph Mills Tennis Club Inc., and Rutnik v. Colonie Center Court Club Inc. — where the courts held that health clubs have no duty to maintain AEDs on their premises for the benefit of their patrons.

In considering Bally’s motion for summary judgment, the court ruled that the issue was not whether Bally had a duty to maintain an AED on its premises or a duty to train its employees to deploy such a device, but whether, due to the special relationship between the premises owner and club member, Bally owed a duty to protect Fowler against unreasonable risks of physical harm. Clearly, the court ruled, the club owed him such a duty. What was not clear, however, was whether Bally breached its duty by not maintaining or deploying an AED on its Gaithersburg premises. The court, therefore, ruled that the case must go to trial.

In its ruling, the court did provide some clues as to the standard it would apply in determining whether Bally breached its duty by failing to maintain an AED. For example, the court noted that much has happened in terms of the statutory law regarding AEDs nationwide, and that in the time between the cases cited by Bally (which were decided in 1998, 2002 and 2004) and Fowler’s death, the use of AEDs had become much more common — almost, the court held, bordering on standard practice in certain customer service-heavy industries. Citing Ksypka v. Malden YMCA [22 Mass. L. Rep. 122; 2007 Mass. Super. LEXIS 43], the court also ruled that it “sees no reason why the standard of care, even for emergency services, should not be regarded as an ever-evolving concept, measured in some way by the acceptance of the need for and efficacy of new emergency treatment procedures and equipment.”

Next, the court considered whether it was foreseeable that someone using the facility might suffer a sudden cardiac arrest. Under negligence law, if the risk were not foreseeable, Bally would have had no duty to protect Fowler from such an injury. In considering whether Fowler’s injury was foreseeable, the court ruled that cardiac events are reasonably foreseeable when people engage in strenuous physical activity. In support of this conclusion, the court cited a study conducted by Bally which found that an average of 35 Bally members die of cardiac events each year.

Additionally, the court looked at the cost such a burden would have on Bally and other health clubs, in comparison to the potential lives saved. Bally’s cost to acquire AEDs for all its facilities nationwide and to train its employees on their use would be approximately $2 million. By comparison, the court found that Bally spends more than $60 million a year on advertising. As such, the court held that the consequences of imposing a duty on Bally to have AEDs at all its facilities and to train its employees on their use are relatively insignificant.

Bally, however, argued that even if the court did find that the Gaithersburg club owed Fowler a legal duty to maintain an AED, it was insulated from any negligence claims by the waiver Fowler signed as part of his membership agreement. While acknowledging that the club’s waiver was valid and enforceable, the court also identified three exceptions where the public interest will render an exculpatory clause unenforceable:
When the party protected by the clause intentionally causes harm or engages in acts of reckless, wanton or gross negligence.
When the bargaining power of one party is so grossly unequal so as to put that party at the mercy of the other’s negligence.
When the transaction involves the public interest.
After considering the three exceptions, the court ruled that Bally’s refusal to maintain an AED at its Gaithersburg facility demonstrated intentional indifference to the welfare of its patrons and rose to the level of gross negligence. In support of this conclusion, the court, citing Taylor v. Harford County Department of Social Services [384 Md. 213, 228 (2004)], held that gross negligence is “the omission of that care which even inattentive and thoughtless men never fail to take of their own property[;] it is a violation of good faith … it implies malice and evil intention.”

Based on this definition, the court held that even though Bally had no statutory obligation, its failure to have such life-saving equipment at its facilities smacks of indifference by Bally to the welfare of its patrons — especially, the court held, given Bally’s own internal study that showed an average of 35 Bally members die of cardiac events each year. Bally’s conscious disregard of this known risk was, the court ruled, the very definition of gross negligence.

While the court’s decision to remand the case for trial may have little value as precedent in future cases, this case is important for the change of opinion it could be signaling in the courts. Not so long ago, the courts and society viewed AEDs as sophisticated devices far beyond the type of first aid contemplated by fitness center personnel. As this case demonstrates, that view may no longer be the norm.

When you consider that more than 350,000 Americans suffer sudden cardiac arrest each year, and that the availability of defibrillators could prevent more than 100,000 deaths, it is clear that defibrillators should be part of all health clubs’ emergency treatment procedures and equipment. To emphasize this point, the court noted that in Montgomery County, Md., during the past two years, AEDs were used on four separate occasions by other health clubs, saving the lives of all four of the individuals.
Attorney John T. Wolohan (jwolohan@ithaca.edu) is a professor of sports law and chair of the Department of Sport Management & Media at Ithaca College.

September 24, 2008

Dear Friend,
I am writing to request your help for my nephew, James Becker.
On July 29, 2006, James, then 15 years old, went into sudden cardiac arrest and suffered a near-fatal drowning at a community pool. Within 15 minutes after James was pulled from the water paramedics arrived and brought him back with the use of an automated external defibrillator. Unfortunately, the CPR that was used did not supply the brain with sufficient oxygen and he suffered severe anoxic brain damage. James is making progress. Unfortunately, he is still confined to a wheelchair, but has shown improvement with the use of this arms and legs. He is currently attending Maryland School for the Blind and is fully aware of the daily events that take place. He laughs at our jokes, cries at the heartbreaks, but through it all, he continues to keep his chin up and keeps fighting for his recovery. James is now able to enjoy small amounts of pureed food by mouth, but still gets the majority of his nourishment via a feeding tube. James continues to require extensive care and medical treatment.
On October 18, 2008, the Third Annual William James Becker, IV Golf Tournament will be taking place at Pleasant Valley Golf Club in Stewartstown, Pennsylvania to benefit James. The majority of the rehabilitation equipment is not covered by insurance. All proceeds from this event will help provide for some of the necessary equipment and medical treatment that are not covered by insurance. Through the generous support and prayers of those who contribute to this event, James has a great fighting chance.
I am asking for your company to donate something to be used as a silent auction item or a door prize for those who will be golfing or attending the dinner afterwards. Some donations in the past have included Ravens tickets, spa gift certificates, Home Depot or Lowe’s gift certificates, hotel gift certificates, restaurant Gift Certificates, golf apparel or equipment and/or autographed items for an auction. Donations can be sent to my attention at 7415 Rock Jim Road, Stewartstown, PA 17363.
If making a monetary donation is preferred, please make the check payable to “William James Becker IV Discretionary Trust”.
Hole sponsorships are also available for $100.00 each. Your company’s name will appear on a sign for a particular hole on the golf course and again on the sponsor sign in the clubhouse on the day of the event. We also have premier hole sponsorships available for $500.00 (1st or 18th hole).
Please feel free to contact me with any questions you may have. I can be reached via e-mail at Rchamb1060@aol.com or by phone at 717.993.6818 or 443.824.4301. I look forward to hearing from you.
On behalf of James and his parents, thank you very much for your time and consideration.
Sincerely,

Dawn Chamberlain
Fundraising Coordinator

Cheryl Anne DeHart is currently working on getting an AED at every pool in Maryland. If you wish to donate, please contact Ms. DeHart. And, thank you.

Even though it has been almost a year since America lost him, some question whether Tim Russert would still be with us had an AED beed used in a timely fashion.  from the New York Times:

“June 19, 2008,  4:01 pm
Could a Defibrillator Have Saved Tim Russert?
A nagging question has emerged in the wake of the death of NBC’s Tim Russert. Where was the defibrillator?

NBC News has declined to comment on whether an automated external defibrillator, or A.E.D., was nearby at the time of Mr. Russert’s collapse or why a defibrillator wasn’t immediately used.

Cardiac arrest typically is caused by a chaotic heart rhythm called ventricular fibrillation, which can be restored to normal if treated early with electric shock.

Many public spaces, including airports, casinos, office buildings and even golf courses, are now equipped with A.E.D.’s, which are the only real hope for surviving a cardiac arrest. An A.E.D., which is about the size of a laptop computer, is a computerized device that analyzes the heart rhythm and prompts even an untrained rescuer to deliver an electrical shock if needed.

Although paramedics carry defibrillators, they typically arrive several minutes or longer after a person collapses, which often is too late to make a difference. Automated defibrillators allow anyone to administer the life-saving shock within minutes after the arrest occurs. Not all abnormal heart rhythms are responsive to the shock treatment.
Survival rates for out-of-hospital cardiac arrest are only 1 percent to 5 percent and usually are predicted by how quickly emergency workers arrive at the scene. But in studies in which defibrillation was applied almost immediately, survival rates have reached as high as 80 percent. With each minute of delay in defibrillation, survival chances drop by about 10 percent.

In June 1999, A.E.D.’s were installed throughout Chicago’s O’Hare and Midway Airports so that response time would be about one minute at any location. In the first 10 months, 14 cardiac arrests occurred, and 9 of the 14 victims, or 64 percent, survived.
According to Washington physician Dr. Michael Newman, who was Mr. Russert’s doctor, NBC had a portable defibrillator on site; however, it’s not clear how soon after the collapse it was retrieved. Just as paramedics were arriving, NBC employers were preparing to use it, Dr. Newman said. Instead, the E.M.S. workers took over, defibrillating Mr. Russert three times before his arrival at Sibley Memorial Hospital.
In an interview, Dr. Newman said he did not know the exact amount of time between Mr. Russert’s collapse and the first effort at defibrillation; however, he said it was “significant — more than you would want.”
One of the many lessons from Mr. Russert’s death is that everybody should find out whether their building has a portable defibrillator and where it is located, and then learn how to use it. In the event that someone collapses, the first step is to call 911. If more than one person is present, one should start CPR while someone else quickly retrieves the defibrillator.
A.E.D.’s are surprisingly easy to use. Once they are turned on, a voice gives you detailed instructions on what to do…”

Recognizing that every minute following sudden cardiac arrest results in 10% deterioration Stockholm Hospital Södersjukhuset has allied with taxis, providing them with over 100 AEDs, the idea being that cabs without passengers can respond to emergency calls as well as anyone.

AEDs, especially the Powerheart AED G3 Plus, are fully functional on their own. They are able to immediately assess cardiac activity, deliver shocks when needed, and even are able to reassess the need to deliver a shock in critical moments.  Some experts liken the Powerheart AED  G3 Plus as a “mirror” to hospital treatment given that it can indeed assess not only the shock, but the amount of electricity needed.

According to the Local, Sweden’s English newspaper:

“…One Taxi Stockholm driver taking part in the project, Joakim Svendsen, said the defibrillator was simple to use.

“It’s incredibly easy. You just lift the lid, push the on-off button, and it starts giving you instructions,” he told SR, adding that with his own background as a nursing assistant he hoped to be able to help someone in an emergency.

“I would probably be incredibly nervous. You’re standing there and have the chance to save a life,” he said.

The defibrillators will only be used when the patient’s heart has stopped and there is no pulse.

Several dozen security guards and their vans will also be equipped with defibrillators.”

There is no intent for taxi drivers to replace regular medical attention; the goal is to reduce treatment time.  A Powerheart AED is already recording cardiac activity and shock activity for the 2nd responders.

Staffordshire, England has trained 80 firefighters and boasts 54 Powerheart AEDS, with the help of Cardiac Science.  The company provided 50% of the funding.

“Defibrillators need to become as common as fire extinguishers in all public places and work environments; this is a great step forward having them on fire appliances,” said Andy Relf, Business Corporation Manager at Cardiac Science.

Residents of Delaware, Maryland, D.C., please contact your territory manager, Ms. DeHart, to learn how your community may qualify for funding.  Cheryl Anne DeHart has several alliances on a regional and national level.

Call Ms. DeHart at (443) 350-7500, or fill out this form:

It is Cheryl Anne DeHart’s hope that AEDs will be as prevalent in American communities as they are in Straffordshire England.

Ever since Japan relaxed its AED laws and started allowing their deployment by regular people in 2004, statistics have proven it is a good idea:  the survival rate has soared to over 42% compared to 9% before the law changed.

Japan has over 90,000 AEDs in public stations and schools; in fact, they are sold out of appliance stores.

Famous Japanese comedian Kunihiro Matsumara has made a full recovery after collapsing during a marathon in Tokyo this March.  First aid workers were prepared; they had saved the lives of 2 runners in the same marathon in 2007.

Please think about adding an AED to every place people…ARE.

Hopefully if there are enough stories about the benefits of having AEDs, more people will remember.  Rita saved one life, and went the extra step to be sure more people survive sudden cardiac arrest:

Rita Hanegraff thought she was on hand only to serve as an elections judge during last fall’s primary elections in Rose Creek, Texas. Later in the day Rita found herself using CPR to assist a voter who collapsed from a heart attack in the town hall.

Ms. Hanegraff is also a trained Red Cross volunteer, and realized that the town meeting hall and the town fire department desperately needed automated external defibrillators.

AEDs are more effective than CPR (cardio-pulmonary resuscitation), and are much easier for people to use who have little or no training.

As a result of Hanegraff’s advocacy, the Worth County Development Authority and the township has provided funds for 2 AEDs

More on this story of AEDs saving lives From the Austin Daily Herald:

“…

“It was such a heart-warming story how Rita saved the lady’s life,” Deb Hanson said. “It touched my heart and brought tears to my eyes.”

Hanson was the right person to take notice of the act of heroism. She is the chief financial officer for the Worth County Development Authority, which is responsible for distributing a share of the gambling proceeds at Diamond Jo’s Casino in Northwood, Iowa.

Hanson and her husband, Gary, himself a volunteer firefighter at Kensett, Iowa, drove to Rose Creek last Thursday night to present Hanegraaf with the grant check for the AED’s purchase.”

We need more stories like this.

Cardiac Science, one of 7 manufacturers of AEDs, is in the business of helping our clients create heart-safe environments, by providing a single point of contact for all equipment and services.  Our AED Programs are built around the industry’s first maintenance free device.

Some of the most popular capabilities of the Powerheart G3 Automatic AED consist of:

*    Easy to use-

When an employee suffers a sudden cardiac arrest the first responder team will within seconds open the AED and with voice prompts are directed to apply the already attached, non-polarized pads to the patient (the pads are inter-changeable).

The AED then makes the determination to shock or not shock.  When it is determined that the rhythm is shockable, the first responder will be told to stand clear as the unit counts down from 3 to 1 and then automatically administers the shock.

*    Rescue Ready-

Once a day the AED tests the internal circuits, battery strength and the electrodes for presence and functionality. If any critical component is determined non-operational a loud alarm sounds every 30 seconds alerting appropriate personnel to fix the device and put it back into operation.  The first responder team always knows the AED is ready to use in the event of a massive heart attack.
*    Text Display Screen-

When using the AED all voice prompts are printed out on a text display screen so the device can be used in a loud environment or by a hearing impaired employee (ADA Compliance).  The screen also tells the arriving emergency responders 2 critical pieces of information: The total time of rescue, and the number of shocks administered.
*    Warranty-

When selecting an AED unit it is important to consider the costs of maintenance going forward.  Cardiac Science offers the industry’s first 7 year AED and battery warranty for defects in materials or workmanship and a 4 year unconditional replacement battery guarantee. The Powerheart G3 is a maintenance-free device. The only additional cost to the owner is the replacement of the electrodes after 2 years, (an FDA requirement).

The Cardiac Science Program Management Option offers a single point of contact for all aspects of setting up and maintaining an AED program, such as Medical Direction, Training and Documentation.  The Program is scripted and designed to maintain a level of service across your corporation.  By contracting with Cardiac Science to provide these services you can be assured we will notify you when any action is needed on your part to remain compliant with the laws and regulations that govern AED programs.
Overview of Cardiac Science Program Management

§        Medical Direction

o      Written prescription to receive AED

o      Development of emergency response protocols

o      Medical Director to oversee AED program protocols as required by each state

o      Assistance with preparation of state(s) registration

o      24-hour toll-free telephone access to non-critical medical consultation

o      Submission of post event paperwork according to MD state legislation

o      Post-event Support and Data Review

§        Onsite Training

o      Conducted by Cardiac Science educator at location of your choice

o      One 3 hour session with up to 10 people per location

o      1:1 ratio of student to CPR Mannequin

o      Classes consist of: CPR Training and AED Training (optional First Aid, O2, BBP)

o      Take Home Course Materials (AHA HeartSaver AED book, skills sheet, certification card, pocket CPR mask and alcohol wipes)

§        Data Capture and Storage

Cardiac Science inputs all information into MasterTrak Database for:

o      Equipment Location, Serial Numbers, and Expiration Dates

o      Training Roster and Certification Dates and Expirations

o      Post Incident Reports

§        MasterTrak Database Sends E-Minders via E-mail

o      E-mail reminder notices sent to site contact

o      Reminders to schedule training prior to certification expiration

o      Notice with course roster and QA results once training is complete

o      Reminder to order/change electrodes and/or batteries prior to expiration