Legislature(2015 - 2016)CAPITOL 120

02/04/2015 01:00 PM House JUDICIARY

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01:03:22 PM Start
01:03:53 PM HB4
02:22:10 PM Adjourn
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
Moved HB 4 Out of Committee
-- Public Testimony --
+ Bills Previously Heard/Scheduled TELECONFERENCED
            HB   4-AUTOMATED EXTERNAL DEFIBRILLATOR                                                                         
1:03:53 PM                                                                                                                    
CHAIR LEDOUX announced  that the only order of  business would be                                                               
HOUSE  BILL  NO.  4  "An   Act  relating  to  automated  external                                                               
1:04:13 PM                                                                                                                    
REPRESENTATIVE  WILSON testified  as prime  sponsor on  behalf of                                                               
the Alaska Fire  Chiefs Association.  She stated that  HB 4 would                                                               
reduce impediment  in state  law to allow  more public  access to                                                               
Automated  External  Defibrillators  (AEDs).    She  stated  that                                                               
sudden cardiac arrest  is a leading cause of death  in the United                                                               
States resulting in approximately 350,000  deaths per year as for                                                               
each   minute    sudden   cardiac   arrest   is    untreated   by                                                               
defibrillation, the  survival chance  decreases seven  percent in                                                               
the  first  three  minutes,  and ten  percent  thereafter.    She                                                               
offered that  AEDs can be  used safely by an  untrained bystander                                                               
to restore  a normal cardiac rhythm  in someone who is  in sudden                                                               
cardiac arrest.  When the device  is turned on, it provides step-                                                               
by-step  verbal and  written instruction  and,  she noted,  these                                                               
devices have  an impressive success rate.   Representative Wilson                                                               
then showed  a video depicting  the verbal  instructions attached                                                               
to an  AED.  She  explained that the  video shows exactly  how it                                                               
will  speak to  an  individual.   She added  that  there are  now                                                               
devices  that  will  also perform  cardiopulmonary  resuscitation                                                               
(CPR) and  walk an  individual through CPR.   She  presented that                                                               
the  use  of  AEDs  are  currently covered  by  the  Alaska  Good                                                               
Samaritan Law and are designed  to encourage would-be rescuers to                                                               
take  action without  fear of  litigation.   However, the  Alaska                                                               
Good  Samaritan Law  attaches conditions  to building  owners and                                                               
institutions  that provide  AEDs.   These conditions  include the                                                               
requirement  of  providing  training,  maintenance,  a  means  of                                                               
notifying 911, and registering the  device with emergency medical                                                               
services (EMS.)  She opined  that removing certain conditions and                                                               
requirements will increase the number of AEDs in communities.                                                                   
1:08:50 PM                                                                                                                    
REPRESENTATIVE  WILSON  showed a  video  entitled  The Future  of                                                               
1:10:21 PM                                                                                                                    
REPRESENTATIVE  WILSON  described  AEDs  as  becoming  easier  to                                                               
utilize  as  was  depicted  on  the video,  and  that  a  medical                                                               
professional  was able  to see  the patient.   Within  big cities                                                               
where the  wait time may be  longer for EMS, these  devices could                                                               
be utilized, she opined.                                                                                                        
1:11:11 PM                                                                                                                    
DOUG SCHRAGE, Fire Chief, University  of Alaska Fairbanks, stated                                                               
he represents  the Alaska  Fire Chiefs  Association and  that the                                                               
association urges  support for  HB 4.   In his  line of  work, he                                                               
noted,  the  speed of  response  is  relied  upon for  fires  and                                                               
medical emergencies.   In order to save  lives emergency services                                                               
rely on  the intervention of  ordinary bystanders to fill  in the                                                               
gaps  before it  arrives on  scene.   He described  bystanders as                                                               
citizens  willing to  step up  and act  to save  another person's                                                               
life.   This is why fire  extinguishers and AEDs are  provided in                                                               
public  places, he  said.   However,  he  explained, the  maximum                                                               
benefits are derived only if  they are immediately available to a                                                               
patient in need.   Evidence shows that untrained  lay persons can                                                               
safely  and effectively  use an  AED without  risk of  accidental                                                               
shock to  the rescuer or  patient, he  noted.  He  expressed that                                                               
this is not  a bill about discontinuing CPR and  AED training and                                                               
maintenance programs, nor  de-emphasizing device registration, or                                                               
emergency notification as it is  about making more AEDs available                                                               
to  the  public.    The  association  believes  strongly  in  the                                                               
importance  of   first  aid,  CPR   and  AED   training,  regular                                                               
maintenance  and  registration of  these  devices.   However,  he                                                               
related, civil  immunity laws have  shown to be an  impediment to                                                               
the acquisition  of AEDs  as it  increases liability  rather than                                                               
provides  immunity  from it.    Furthermore,  he offered,  recent                                                               
trends in litigation  suggest that a facility without  an AED may                                                               
be  subject  to  more  liability  than  one  with  an  AED.    He                                                               
highlighted  that   there  is   anecdotal  evidence   that  these                                                               
requirements   are  preventing   Alaskan  building   owners  from                                                               
providing  AEDs in  their facilities.   In  other cases  building                                                               
owners are limiting  the use of their AEDs from  the public where                                                               
they can  most effectively be used.   As a result,  people may be                                                               
needlessly dying  who might otherwise  be revived from  access to                                                               
the AED.                                                                                                                        
1:14:06 PM                                                                                                                    
CHAIR  LEDOUX questioned  whether people  have had  heart attacks                                                               
and building  owners have refused  to allow an individual  to use                                                               
the AED.                                                                                                                        
MR. SCHRAGE  responded in the  affirmative.  He used  the example                                                               
of  this building  wherein  outside this  room,  in the  hallway,                                                               
there is a cabinet with an AED in  it.  On the cabinet is a label                                                               
that  effectively  reads  that  use  by  untrained  personnel  is                                                               
prohibited.  In  that regard, a rescuer would see  that label and                                                               
be deterred from  using the AED and, therefore, a  patient may go                                                               
unattended for a certain amount of  time.  He pointed out that as                                                               
was  shown in  the video,  these devices  can be  used easily  by                                                               
someone without any prior training.                                                                                             
1:15:12 PM                                                                                                                    
MR. SCHRAGE  continued that  there are 80  plus buildings  at the                                                               
University of  Alaska Fairbanks  (UAF) and  barely a  dozen AEDs.                                                               
He  advised  that  its  general  counsel  concluded  there  is  a                                                               
moderate risk  of a  lawsuit due  to the  placement of  AEDs, and                                                               
that  UAF   cannot  adequately  assure   there  will   always  be                                                               
appropriate people  trained to use  the device or able  to comply                                                               
with   maintenance   requirements.      Four   of   the   leading                                                               
manufacturers of  AEDs recommend daily maintenance  checks and in                                                               
a large institution  the ability to ensure  that the manufacturer                                                               
maintenance  recommendations are  complied  with  make it  nearly                                                               
impossible, he stated.  He opined  that the primarily goal of AED                                                               
Good  Samaritan   legislation  should   be  to   offer  liability                                                               
protection  to  all of  the  AED  program constituents  with  the                                                               
objective  of   putting  more  AEDs   in  service.     Model  AED                                                               
legislation should  not condition  immunity upon  compliance with                                                               
any of  those requirements.   He offered that the  association is                                                               
not aware of any opposition to HB 4.                                                                                            
1:17:53 PM                                                                                                                    
REPRESENTATIVE FOSTER  referred to  Ms. Schrage's  statement that                                                               
there  was no  risk of  shock, yet  the video  depicted that  the                                                               
patient should  not be touched  while the shock  is administered.                                                               
He asked the  result if an individual is touched  while the shock                                                               
is administered.                                                                                                                
MS.  SCHRAGE   answered  that  the  conventional   thinking,  and                                                               
programing of  all the current devices  is that there was  a risk                                                               
to the  rescuer being  shocked.  However,  he noted,  research is                                                               
currently  underway in  Washington wherein  researchers performed                                                               
CPR chest  compressions on a  patient while a doctor  delivered a                                                               
shock  and  in  numerous  instances  no shock  was  felt  by  the                                                               
rescuer.  He  expects that the guidance  provided during training                                                               
will be modified to reflect the change                                                                                          
1:18:50 PM                                                                                                                    
REPRESENTATIVE LYNN asked the typical cost of an AED.                                                                           
MR. SCHRAGE  responded that typically  the cost is  $1,500, which                                                               
includes the cabinet and everything that goes in it.                                                                            
1:19:07 PM                                                                                                                    
MR. SCHRAGE, in responding to  Representative Lynn, answered that                                                               
the battery and patches are  all that is involved in maintenance.                                                               
A quick maintenance check is  basically to ensure that the device                                                               
is in place and  charged up.  The batteries have  a shelf life of                                                               
around five years and must be  replaced.  Part of the maintenance                                                               
check to ascertain that the patches  have not been exposed to air                                                               
which affects  the stickiness,  and if they  have they  should be                                                               
replaced as they  will dry out.  Beyond that,  there is really no                                                               
maintenance to the devices, he remarked.                                                                                        
1:20:11 PM                                                                                                                    
MR.  SCHRAGE  responded to  Representative  Millett  that to  his                                                               
knowledge AED devices do not have  to be replaced and do not have                                                               
a shelf  life.  He  stated that Biphasic Technology  is currently                                                               
being  used which  is  a  more effective  way  of delivering  the                                                               
electrical shock.                                                                                                               
1:20:46 PM                                                                                                                    
REPRESENTATIVE CLAMAN inquired  as to the survival  rate with CPR                                                               
versus CPR combined with AEDs.                                                                                                  
MR.  SCHRAGE said  that it  is partly  determined by  the cardiac                                                               
dysrhythmia   being  experienced.     The   AED  only   works  on                                                               
ventricular  fibrillation wherein  the electrical  signal doesn't                                                               
follow the normal  pathways that cause the muscle  to contract in                                                               
an organized way.   He explained that when  the machine instructs                                                               
the user to  stand back it is analyzing rhythm  and attempting to                                                               
sense the  presence of the fib,  in the absence of  that, it will                                                               
recommend CPR only.                                                                                                             
1:22:07 PM                                                                                                                    
REPRESENTATIVE CLAMAN  questioned the statistical  improvement of                                                               
survivability of  heart events when an  AED is use versus  not in                                                               
use.   He  stated his  memory is  that there  is a  significantly                                                               
increased success rate when an AED is in the mix.                                                                               
MR. SCHRAGE  advised he  could not cite  the exact  statistic but                                                               
would  say  the improvement  goes  well  beyond that  statistical                                                               
REPRESENTATIVE CLAMAN related that part  of what is being written                                                               
out  in  this statute  is  broadly  described as  a  registration                                                               
requirement.  For  example, he described, a  restaurant owner has                                                               
an AED  in the building and  the owner is supposed  to notify the                                                               
fire department  in his community that  he has an AED  - which is                                                               
being taken  out of the  statute under this  bill.  He  asked how                                                               
reliable business  owners were in  notifying the  fire department                                                               
of an  AED and  whether there  is there a  program in  place that                                                               
businesses would  routinely let the  fire department know,  if it                                                               
is not part of the statutory requirement.                                                                                       
MR.  SCHRAGE answered  that virtually  no one  complies with  the                                                               
requirement of notifying  the fire department of the  AED.  There                                                               
is a registry and people  promoting improvement in cardiac arrest                                                               
survival rates  feel strongly that  the registry is  an important                                                               
component of  that improvement  effort.   There is  an app  for a                                                               
telephone that will  allow an individual to enroll  in the system                                                               
and be  alerted if  they know  CPR to the  location of  a patient                                                               
nearby  and the  location of  the nearest  AED.   The association                                                               
believes  the registry  is very  important, but  stipulating this                                                               
requirement as  a condition for  immunity is misplaced, so  it is                                                               
launching other  efforts to promote compliance  for the registry,                                                               
he offered.                                                                                                                     
1:25:36 PM                                                                                                                    
REPRESENTATIVE  CLAMAN   noted  a  reference  in   the  bill  for                                                               
basically Good Samaritan  application to the owner of  an AED, to                                                               
be  put  on  the  wall.   He  requested  an  example  that  would                                                               
constitute gross  negligence in which  a business owner  could be                                                               
exposed to liability.                                                                                                           
MR. SCHRAGE  offered that he  has had no  training in law  and is                                                               
not  qualified but  could envision  few  circumstances where  the                                                               
failure of  an AED  to operate,  or even if  an AED  does operate                                                               
that it would rise to the level of gross negligence.                                                                            
1:26:40 PM                                                                                                                    
REPRESENTATIVE  CLAMAN  assessed  that  the  biggest  maintenance                                                               
issue was  batteries and  patches and  noted that  checking daily                                                               
probably  doesn't happen  anywhere.    He asked  if  there was  a                                                               
potential for an AED being unused  and on the wall for ten years,                                                               
the batteries would  be dead and someone tried to  use it later -                                                               
is that an issue.                                                                                                               
MR. SCHRAGE  said that  modern AEDs  have, like  smoke detectors,                                                               
when the  battery gets low it  chirps to alert people  it is time                                                               
to replace the battery.                                                                                                         
1:27:51 PM                                                                                                                    
CHAIR  LEDOUX  clarified  that  HB   4  does  not  eliminate  the                                                               
requirement for  reporting to the  registry, the bill  just reads                                                               
that  not  reporting  is  not  something  that  will  deprive  an                                                               
individual  of  immunity.    She   questioned  if  the  reporting                                                               
provisions are in another place of the statute.                                                                                 
MR.  SCHRAGE stated  that  to  his knowledge  it  does not  exist                                                               
anywhere else.                                                                                                                  
1:28:29 PM                                                                                                                    
CHAIR  LEDOUX  referred to  the  shock  delivered from  the  AED,                                                               
assuming  research  does not  indicate  an  individual would  not                                                               
receive a  shock, and questioned  whether an accidental  shock is                                                               
MR. SCHRAGE speculated that it would  not be a lethal shock.  The                                                               
AED typically  starts at 200 joules,  which is a small  amount of                                                               
electricity,  and the  placement of  the electrode  pads is  such                                                               
that it directs the energy  straight through the heart muscle and                                                               
most of the  energy is contained between the two  electrodes.  He                                                               
pointed  out  that  the  machine  is  sophisticated  in  that  it                                                               
recognizes a normal sinus rhythm and would not deliver a shock.                                                                 
1:29:53 PM                                                                                                                    
REPRESENTATIVE WILSON  said she recognizes that  unintended shock                                                               
was a  concern at schools with  AEDs and with technology  it just                                                               
does not happen.                                                                                                                
1:30:27 PM                                                                                                                    
REPRESENTATIVE KELLER  asked if Alaska  would be the  first state                                                               
as far as  removing the potential liability or  have other states                                                               
gone ahead.                                                                                                                     
MR. SCHRAGE answered that  California introduced nearly identical                                                               
REPRESENTATIVE  KELLER inquired  what the  procedure is  after an                                                               
AED is used, whether batteries are replaced, and the cost.                                                                      
MR.  SCHRAGE  offered that  the  batteries  can be  recharged  or                                                               
replaced,  and  the  electrodes  must   be  restored.    The  EMS                                                               
providers must  be able  to upload  from the  device the  data it                                                               
recorded regarding the cardiac rhythm.                                                                                          
1:31:37 PM                                                                                                                    
REPRESENTATIVE  KELLER  pointed out  that  the  use of  the  word                                                               
"gross negligence" is  a word that is not  defined and questioned                                                               
the meaning of gross negligence.                                                                                                
MR. SCHRAGE  advised he  does not feel  qualified to  answer that                                                               
REPRESENTATIVE  WILSON read  the Department  of Law's  definition                                                               
for gross  negligence.  "I  will now define gross  negligence for                                                               
you.  First, you must  understand what ordinary negligence means.                                                               
Negligence is  the failure  to use reasonable  care which  is the                                                               
amount of care a reasonable careful  person would use in the same                                                               
situation.   Gross negligence is  an extreme departure  from this                                                               
standard.      Gross   negligence  means   more   than   ordinary                                                               
inadvertence or inattention but  less than conscious indifference                                                               
or consequences."                                                                                                               
1:32:52 PM                                                                                                                    
REPRESENTATIVE LYNN assumed  that in the event  an individual was                                                               
experiencing  blockage  of the  heart,  that  the AED  would  not                                                               
administer the shock.                                                                                                           
MR. SCHRAGE answered in the affirmative.                                                                                        
1:33:20 PM                                                                                                                    
REPRESENTATIVE LYNN asked whether there are age limitations.                                                                    
MR. SCHRAGE  advised that  AEDs are  designed for  any age  of an                                                               
adult patient, 15,  16, 17 and on  up.  They are  not designed to                                                               
be  used on  children and  there  is virtually  no occurrence  of                                                               
ventricular fibrillation in child patients, he opined.                                                                          
1:34:08 PM                                                                                                                    
REPRESENTATIVE FOSTER asked when an AED  is used and the pads are                                                               
not  replaced  and  dry  out,  whether  there  is  some  kind  of                                                               
protection built in for gross negligence.                                                                                       
MR. SCHRAGE stated "not that I am aware of."                                                                                    
1:34:49 PM                                                                                                                    
REPRESENTATIVE  FOSTER asked  if statistically  there is  a heart                                                               
event  where  the  AED  will   apply  and  be  helpful  in  those                                                               
MR.  SCHRAGE  replied  that  in the  case  of  witnessed  cardiac                                                               
arrest,   approximately  35   percent   of   the  instances   are                                                               
ventricular fibrillation.                                                                                                       
REPRESENTATIVE  WILSON   mentioned  that  more  AEDs   are  being                                                               
produced that  include the  CPR portion where  it counts  for the                                                               
rescuer, and indicates when to take the breath.                                                                                 
1:36:20 PM                                                                                                                    
REPRESENTATIVE FOSTER inquired whether  the AED will instruct the                                                               
rescuer in a defibrillation and CPR situation.                                                                                  
REPRESENTATIVE  WILSON responded  to Representative  Foster "that                                                               
is  correct."   She responded  to Representative  Lynn that  when                                                               
AEDs were  placed in  the schools "we"  bought pads  for children                                                               
and there was a  case where a fifth grader in  Texas went down in                                                               
the hallway, and  the school had a  defibrillator and fibrillated                                                               
that child's  life.   There was  an additional  cost "we"  had to                                                               
raise so "we"  had pads for children because most  come with pads                                                               
for adults.                                                                                                                     
1:37:06 PM                                                                                                                    
REPRESENTATIVE GRUENBERG  noted that  the text  of the  bill will                                                               
change  from citing  specific examples  "where they  would remain                                                               
negligent liability"  to simply  a standard of  gross negligence.                                                               
He  opined  the  court  could  interpret  the  change  two  ways,                                                               
allowing more  examples of gross  negligence and not  limiting it                                                               
to  A, B  and C,  but anything  that could  be gross  negligence.                                                               
Another way  would be  to interpret  it as  a higher  standard so                                                               
that these  things currently  listed would  no longer  fall under                                                               
the definition  of gross  negligence but  simple negligence.   He                                                               
stated  it  is ambiguously  written  because  it doesn't  clarify                                                               
which way is intended.                                                                                                          
REPRESENTATIVE  WILSON  stated  that  current law  is  such  that                                                               
building owners  must basically  say they  know that  everyone in                                                               
the building  is trained.  The  intent is to require  "people who                                                               
are  maybe trained,  or just  know how  to follow  direction when                                                               
being spoken."                                                                                                                  
REPRESENTATIVE GRUENBERG  advised he  is attempting  to ascertain                                                               
that a court or lawyer who  has never seen this before, opens the                                                               
[statutes]  and   clearly  understands   Representative  Wilson's                                                               
REPRESENTATIVE WILSON  said that anyone  can sue and go  before a                                                               
judge, but this bill clarifies the intention.                                                                                   
1:43:48 PM                                                                                                                    
REPRESENTATIVE  GRUENBERG referred  to  a statement  that one  or                                                               
more manufacturers has recommended that  AEDs be tested daily and                                                               
if that  is standard  then probably anyone  who installs  them is                                                               
violating the standard and, he  opined, that standard may be used                                                               
by a court as setting the standard of due care.                                                                                 
REPRESENTATIVE WILSON  offered that in  a perfect world  the more                                                               
an individual checks on any  electronic device the better it will                                                               
be.    Also, she  remarked,  the  manufacturer probably  did  not                                                               
update  its recommendations  because it  would rather  be on  the                                                               
safer side.                                                                                                                     
REPRESENTATIVE  GRUENBERG offered  that  in  court the  plaintiff                                                               
would  sue  the  building  owner and  the  manufacturer  and  the                                                               
question becomes who  is liable.  The manufacturer  would say the                                                               
building  owner  is liable  because  the  AED is  not  maintained                                                               
properly.   He  explained that  there  is the  concept of  strict                                                               
liability  against  some  of the  people  who  manufacture  these                                                               
products and in those cases  negligence doesn't have to be shown,                                                               
just that there was a causal relationship.                                                                                      
CHAIR LEDOUX  stated she  has practiced  personal injury  law and                                                               
does not have any problem understanding the bill.                                                                               
1:47:41 PM                                                                                                                    
REPRESENTATIVE  CLAMAN   asked  Mr.  Schrage  in   terms  of  the                                                               
maintenance and  the batteries, when  an individual is  in de-fib                                                               
and EMS  takes the  AED to  the hospital  with them,  whether the                                                               
maintenance  is that  it would  need new  pads and  the batteries                                                               
checked for charge.                                                                                                             
MS. SCHRAGE  agreed and  stated that the  scenario is  subject to                                                               
variations in  EMS systems.   Some EMS technicians may  choose to                                                               
service the  device at the scene  as they are able  to upload the                                                               
REPRESENTATIVE CLAMAN  remarked that  the building owner  in that                                                               
setting should not  expect the AED to stay in  the building as it                                                               
is more likely to go with the EMS.                                                                                              
MR. SCHRAGE opined that was a reasonable expectation.                                                                           
1:49:05 PM                                                                                                                    
REPRESENTATIVE CLAMAN asked  if 12 is the adult  age for purposes                                                               
of CPR.                                                                                                                         
MR. SCHRAGE responded that for purposes  of CPR an adult is eight                                                               
years  old.    He  stated   that  the  incidents  of  ventricular                                                               
fibrillation  in children  is not  non-existent but  is virtually                                                               
1:49:47 PM                                                                                                                    
REPRESENTATIVE CLAMAN asked that in  terms of the entire statute,                                                               
subsection (a), which  is not being amended  basically reads that                                                               
a person  using an AED  has the Good Samaritan  protections under                                                               
subsection (a).                                                                                                                 
MR. SCHRAGE responded "that is our intent."                                                                                     
REPRESENTATIVE  CLAMAN  noted  that  what is  being  modified  is                                                               
subsection  (b) which  is essentially  that a  business owner  is                                                               
subject to a  gross negligence standard for how the  AED is or is                                                               
not maintained at its place of business.                                                                                        
REPRESENTATIVE WILSON stated "that is correct."                                                                                 
REPRESENTATIVE CLAMAN  further noted  that subsection (c)  is not                                                               
being changed  that would apply  an ordinary  negligence standard                                                               
for the manufacturer.                                                                                                           
REPRESENTATIVE WILSON advised "that is correct also."                                                                           
1:50:42 PM                                                                                                                    
REPRESENTATIVE   CLAMAN    surmised   that   with    respect   to                                                               
Representative  Gruenberg's  questions,  the intent  between  the                                                               
manufacturer and  the business owner  is that the  business owner                                                               
is essentially  being told to  rely on the manufacturer  to build                                                               
the  machines  correctly as  long  as  there  is  an AED  in  the                                                               
business owners  shop.  The business  owner will not be  held out                                                               
to knowing more  than the AED manufacturer does  and the business                                                               
owner  will be  held to  a lesser  standard.   He inquired  as to                                                               
whether that is the intent of the legislation.                                                                                  
REPRESENTATIVE  WILSON  agreed  and  opined  that  most  building                                                               
owners believe the Good Samaritan Act already covers them.                                                                      
1:51:28 PM                                                                                                                    
REPRESENTATIVE CLAMAN stated that  gross negligence would be when                                                               
the building  owner had repeatedly  been told the  batteries were                                                               
dead, and was  aware of it for  a couple of years  and never took                                                               
the AED  out of the public  place or replaced the  batteries.  In                                                               
that scenario  there may be a  claim for gross negligence  but it                                                               
would  be up  to the  court as  to whether  it would  succeed, he                                                               
REPRESENTATIVE WILSON opined  that a building is  not required to                                                               
have an  AED, so for  the building owner to  go to the  extent of                                                               
putting them in  and yet not perform any  training or maintenance                                                               
made no sense to her.   She further opined that most constituents                                                               
believe they are covered by statute, and are not.                                                                               
1:53:20 PM                                                                                                                    
REPRESENTATIVE   GRUENBERG   questioned   if  the   standard   in                                                               
subsection  (c),  dealing  with   the  manufacturer,  raises  the                                                               
standard that  would normally be  required to sue  a manufacturer                                                               
regarding  a  potentially  dangerous   instrument.    He  further                                                               
questioned if  this insulates the [AED]  manufacturer where other                                                               
manufacturers would not be so insulated.                                                                                        
REPRESENTATIVE WILSON  responded there may be  assistance on-line                                                               
to answer Representative Gruenberg's question.                                                                                  
REPRESENTATIVE   GRUENBERG   reiterated  whether   the   existing                                                               
standard  in   subsection  (c),  which  imposes   a  standard  of                                                               
negligence by statute, raises the standard of strict liability.                                                                 
CHAIR LEDOUX opened public testimony.                                                                                           
1:56:14 PM                                                                                                                    
WENDY  MACNAUHPON, American  Heart  Association, American  Stroke                                                               
Association, stated that the  American Heart Association realizes                                                               
that every  minute counts when  an individual  experiences sudden                                                               
cardiac  arrest.   She  opined  it  is  important to  remove  the                                                               
impediment  provisions  of  AEDs  in public  places  as  it  will                                                               
provide more  opportunities for Good  Samaritans to act  and more                                                               
lives saved.                                                                                                                    
1:57:09 PM                                                                                                                    
JAMIE  MORGAN,   American  Heart  Association,   American  Stroke                                                               
Association,  affirmed that  the  associations are  very much  in                                                               
support of  HB 4 as  they believe  increased access to  AEDs will                                                               
result in more lives saved.                                                                                                     
1:57:49 PM                                                                                                                    
KRISTIN  LUBY,   American  Heart  Association,   American  Stroke                                                               
Association, stated she supports HB  4 as it will remove barriers                                                               
that  inhibit current  businesses from  installing AEDs  in their                                                               
building.  "Time  is muscle" as every minute an  individual is in                                                               
cardiac  arrest and  not being  treated  or receiving  assistance                                                               
counts, and  time is the  heart muscle  dying.  She  related that                                                               
passage of HB 4 will result  in increased access to AEDs and help                                                               
provide more opportunities  for Good Samaritans to  act, and more                                                               
lives saved.                                                                                                                    
1:59:13 PM                                                                                                                    
SHERRY  MODROW, advised  she is  representing herself  and agrees                                                               
with Mr.  Schrage.  She  supports the American  Heart Association                                                               
and  would  like  to  see  AEDs installed  in  many  places,  and                                                               
bystanders be encouraged to use AEDs.   She offered that she is a                                                               
full time volunteer  at UAF and would like to  see AEDs available                                                               
on campuses as well as across Alaskan communities.                                                                              
2:00:52 PM                                                                                                                    
RON TEMPLETON,  University Fire Department, University  of Alaska                                                               
Fairbanks,  Alaska Fire  Chiefs Association,  stated his  support                                                               
for HB 4 is more of a personal  nature in that his wife passed of                                                               
heart disease  in 2007.   Unfortunately, he noted, when  his wife                                                               
passed she was  not somewhere that AEDs would have  been any good                                                               
- she was at  home.  He stated he has come  to realize that heart                                                               
disease is  a profound killer of  women in America and  HB 4 will                                                               
remove  impediments  that  corporations and  businesses  have  of                                                               
putting AEDs  in communities to  be utilized.  He  expressed that                                                               
if only one life can be saved it  is worth all of the effort - it                                                               
is  important  AEDs are  available  for  use and  that  [building                                                               
owners] do not have to worry about liability.                                                                                   
2:02:52 PM                                                                                                                    
JILL  LEWIS,   Deputy  Director,   Division  of   Public  Health,                                                               
Department  of Health  & Social  Services, stated  that Emergency                                                               
Medical Service  (EMS) is  under the  Division of  Public Health,                                                               
and   it   certifies   EMS  technicians,   and   also   has   the                                                               
responsibility  for promoting  and  ensuring competent  workforce                                                               
and  infrastructure for  EMS.   The division  is responsible  for                                                               
training in  terms of approving  training and trainers  for AEDs.                                                               
She  clarified  that EMTs  would  still  be required  to  receive                                                               
training and the division would continue to perform as above.                                                                   
CHAIR LEDOUX  closed public testimony  after ascertaining  no one                                                               
further wished to testify.                                                                                                      
2:04:15 PM                                                                                                                    
REPRESENTATIVE   GRUENBERG  referred   to   subsection  (c)   and                                                               
paraphrased, "The immunity provided by  (b) if this section which                                                               
we are  amending here,  does not  apply to  a manufacturer  of an                                                               
automated external  defibrillator" which,  he opined,  means that                                                               
the rest  of common law and  statutory law in Alaska  does apply.                                                               
He  said he  assumes  that would  include  strict liability  and,                                                               
therefore, is already covered.                                                                                                  
2:05:30 PM                                                                                                                    
REPRESENTATIVE  CLAMAN  offered  that   the  question  of  strict                                                               
liability  and  not  strict  liability   is  what  constitutes  a                                                               
dangerous product  that may make  it subject to  strict liability                                                               
which is part  of common law.   He added that where an  AED is or                                                               
is  not a  dangerous product  and whether  that would  qualify as                                                               
strict liability or  not strict liability is  something best left                                                               
to the courts.                                                                                                                  
2:06:33 PM                                                                                                                    
REPRESENTATIVE  MILLETT advised  that the  incentive behind  this                                                               
bill  is to  take  liability away  and  make Alaskan  communities                                                               
safer places  to live.   As a woman,  she offered, she  likes the                                                               
legislation as it serves its purpose  very well, is signing on as                                                               
a co-sponsor,  and hopes the  bill passes out of  committee today                                                               
as is.                                                                                                                          
2:07:25 PM                                                                                                                    
CHAIR LEDOUX said  she intended to pass out but  is now wondering                                                               
whether  this  should say  "civil  damages  resulting from  gross                                                               
negligence,   or  intentional,   or  reckless   conduct."     She                                                               
questioned whether the bill sponsor had a comment.                                                                              
REPRESENTATIVE  WILSON  responded that  [HB  4]  has been  vetted                                                               
through the fire  department council as well as  the American Red                                                               
Cross and others who were  supportive or neutral on the language.                                                               
She advised  she is comfortable  with the current language  as it                                                               
does accomplish the intent.                                                                                                     
2:08:39 PM                                                                                                                    
The committee took an at-ease from 2:08 p.m. to 2:14 p.m.                                                                       
The committee treated public testimony as being open.                                                                           
2:14:30 PM                                                                                                                    
MICHAEL  LEVY,  Medical   Director,  Anchorage  Fire  Department,                                                               
Anchorage  Areawide Emergency  Medical  Services,  advised he  is                                                               
President  of   the  Loren  Marshall   Foundation,  which   is  a                                                               
foundation  that provides  opportunities  for  citizens to  learn                                                               
CPR; he  is on  the Board of  Directors, National  Association of                                                               
EMS Physicians;  and is the  principal investigator of  the Heart                                                               
Rescue Project in  Alaska.  Therefore, he said,  he has extensive                                                               
ongoing experience with  cardiac arrest.  He offered  that if any                                                               
barriers  could be  lowered regarding  AEDs in  the community  it                                                               
would benefit Alaskan  citizens.  He related that  AEDs should be                                                               
as  widely distributed  as are  fire  extinguishers, and  readily                                                               
available to any  individual witnessing a cardiac  arrest.  There                                                               
is no question  AEDs are an important  and relatively inexpensive                                                               
life  saving  measure  that  when  applied  early  has  the  best                                                               
opportunity for  success.  He  highlighted that  when individuals                                                               
feel  they are  at  risk  of legal  ramifications  by having  the                                                               
device or  any other  sort of encumbrances,  it does  not promote                                                               
the availability  of AEDs.   He offered  that the devices  can be                                                               
safely used by the public.                                                                                                      
2:16:51 PM                                                                                                                    
REPRESENTATIVE  GRUENBERG questioned  whether  there is  evidence                                                               
that  changing the  standard will  cause more  people to  install                                                               
DR. LEVY remarked that he is  unaware of any study in Alaska that                                                               
this  would  cause  a change,  however,  nationwide  people  have                                                               
declined being involved due to the threat of litigation.                                                                        
REPRESENTATIVE GRUENBERG  asked whether  there was  evidence that                                                               
anything else  could be performed,  other than changing  the tort                                                               
standard of liability, to encourage people to install AEDs.                                                                     
DR. LEVY  responded that possibly  from a  legislative standpoint                                                               
it could  be required that  places where the public  gathers must                                                               
have AEDs, in full public view, as a public safety measure.                                                                     
REPRESENTATIVE  GRUENBERG  inquired  as   to  whether  any  other                                                               
jurisdiction  had  done  anything  else to  either  encourage  or                                                               
require the installation of AEDs.                                                                                               
DR. LEVY stated he is "unaware  of anyone doing that," but is not                                                               
an expert.                                                                                                                      
CHAIR LEDOUX  closed public testimony  after ascertaining  no one                                                               
further wished to testify.                                                                                                      
2:19:52 PM                                                                                                                    
REPRESENTATIVE KELLER advised he was ready to make a motion.                                                                    
REPRESENTATIVE GRUENBERG objected.                                                                                              
2:20:42 PM                                                                                                                    
REPRESENTATIVE CLAMAN noted that an earlier witness stated only                                                                 
California has enacted a statute similar to this legislation.                                                                   
REPRESENTATIVE GRUENBERG advised that his question was whether                                                                  
any other jurisdiction had done anything else.                                                                                  
REPRESENTATIVE GRUENBERG withdrew his objection.                                                                                
2:21:48 PM                                                                                                                    
REPRESENTATIVE KELLER moved to report  HB 4 out of committee with                                                               
individual  recommendations and  the  accompanying fiscal  notes.                                                               
There being  no objection,  HB 4 moved  from the  House Judiciary                                                               
Standing Committee                                                                                                              
2:22:10 PM