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Jerry Atcovitz suffered a heart attack while playing tennis at Gulph Mills Tennis Club in Pennsylvania. He later filed suit against the club, claiming that damage to his heart could have been mitigated if the club had used an automated external defibrillator (AED). Gulph Mills claimed that a Pennsylvania statute, the Emergency Medical Services Act, did not permit employees at the facility to use the AED, and the trial court judge granted summary judgment on behalf of Gulph Mills.

The appellate court, in reviewing the case, determined that the trial court had misinterpreted the Emergency Medical Services Act, and declared that the regulations place no prohibition on the first aid use of AEDs by laypeople. The court went on to point out that the 1998 Good Samaritan statute provides immunity to anyone who “in good faith uses an AED in an emergency as an ordinary, reasonably prudent individual would do.” The case was remanded for trial to determine if the club was negligent.

How likely are you to have a client suffer a heart attack in your fitness facility? That is impossible to answer precisely, but more than 250,000 people in the U.S. die each year of sudden cardiac arrest. In one large database of more than 2.9 million commercial health club members, 71 deaths were reported in a two-year period. In a survey of 65 randomly selected Ohio health clubs, 17 percent reported a club member having a sudden cardiac death or heart attack during a five-year period. Also, consider that health club demographics are changing rapidly. More than half of all fitness centersnowhave a membership base of people 35 years and older. In fact, the fastest growing membership segment is in the 55-and-older age group.

How serious is sudden cardiac arrest? Serious enough that more than 95 percent of its victims die when defibrillation is not prompt. Studies show that any delay between cardiac arrest and defibrillation is critical — for every one minute of delay, chances of recovery drop by 7 to10 percent. It is estimated that as many as 50 percent of cardiac arrest victims could be saved if they were defibrillated within seven minutes or less. Evidence of AED effectiveness is provided by the experience of Chicago’s O’Hare and Midway airports. During the first 10 months after 49 AEDs were placed in the two airports, 14 cardiac arrests occurred (12 going into ventricular fibrillation). Nine of the victims were revived with an AED with no neurological damage. Further, in nine of the incidents, airport travelers — not staff personnel — successfully oper- ated the devices.

Liability and AEDs

Some health club owners are concerned about the legality of employees using an AED. This is no longer a viable issue. All 50 states have passed AED Good Samaritan legislation for lay people. In addition, Congress passed the Cardiac Arrest Survival Act, which augments state Good Samaritan legislation by providing federal liability protection.

The use of AEDs is growing rapidly, and the fitness industry is leading the way. Among organizations endorsing or encouraging their use are the American Medical Association (AMA), the American College of Sports Medicine (ACSM), IHRSA and the YMCA of the USA. The AMA and ACSM have published a joint position statement that encourages the use of AEDs in 1) facilities with more than 2,500 members; 2) clubs with special programs for older adults or people with medical conditions; and 3) fitness centers where the local emergency medical services response is likely to be five or more minutes. TheYMCA of the USA, in a Technical Advisory Paper, stated, “… it now seems almost certain that AEDs will become an essential part of the standard of care for health/fitness facilities.”

The question is no longer, “Could I be liable if one of my employees uses it?” The question now is, “Could I be liable if my employees do not use it?” At present, the AED has not been established as the required standard of care; however, it seems to be only a matter of time. Ask yourself what reasonable, prudent club managers would do to fulfill their duty regarding the safety of their members considering the following: 1) the evidence regarding the benefits is overwhelming; 2) the device is inexpensive and easy to use; and 3) both the medical profession and health and fitness organizations are united in favor of the device. Good risk-management procedure mandates the acquisition and use of AEDs in health and fitness facilities.