By Jay Romano
New York Times
May 14, 2006
In recent years, an increasing number of automated external defibrillators have been provided in office buildings, shopping malls and health clubs and even on commercial airliners. Why, then, are there so few of them in apartment buildings, particularly co-ops and condominiums?
"This issue has come up in a bunch of buildings we manage," said Neil Davidowitz, the president of Orsid Realty in Manhattan. "And the reluctance to install them basically comes down to concerns about potential liability."
It turns out, though, that such concerns may be unwarranted. Modern defibrillators — electronic devices about the size of a briefcase that administer an electric shock to restore heart rhythm — "are basically foolproof," said Dr. Diane Sixsmith, the chairwoman of emergency medicine at New York Hospital Queens, in Flushing. Dr. Sixsmith said that with the models now on the market, the operator has only to attach two pads to the victim's chest and turn on the machine.
"The machine will analyze the heart rhythm and tell you whether or not to administer a shock," she said. "As far as we know, these machines have never shocked someone who didn't need it and never failed to shock someone who did."
And while having defibrillators in commercial buildings is certainly helpful, Dr. Sixsmith said, having them in the buildings where people live is even more important.
"The majority of cardiac arrests happen in the home," she said. "And in 98 cases out of 100, the victim does not survive."
With cardiac arrest, every second counts. "If you restore the rhythm within four minutes, most people survive with no permanent damage," Dr. Sixsmith said. "For every minute beyond that, there is a 10 percent increase in mortality and an increase in the likelihood of brain damage." After about 10 minutes, she said, death is virtually certain.
"And when you live in a place like New York, traffic and other problems usually make it very difficult for an ambulance to get to a victim quickly enough to save him," Dr. Sixsmith said. But having a defibrillator on hand has pushed survival rates from 2 percent to as high as 75 percent, she said.
Sarah Gillen, chief executive of Emergency Skills Inc., a Manhattan company that sells defibrillators, said buildings that want to buy one need a "medical director" — a licensed physician — to provide a purchase authorization, monitor the training and report any use of the machine to the state.
Building employees and others who would use the machine can receive training from the American Heart Association; it takes about four hours, Ms. Gillen said.
Cardiopulmonary resuscitation, aid for choking victims and hands-on practice with the defibrillator are included.
The cost of each machine is about $2,000; training costs $100 a person.
Arthur I. Weinstein, a Manhattan lawyer and the vice president of the Council of New York Cooperatives and Condominiums, said the state's Good Samaritan Law protects from liability anyone who "voluntarily and without expectation of monetary compensation" uses a defibrillator in an attempt to revive someone in an emergency. The law also protects a co-op or condo, as long as it met the training and medical director requirements.
Errol Brett, a co-op and condominium lawyer in Great Neck, N.Y., said that one of his clients, North Shore Towers in Floral Park, Queens, bought five defibrillators several years ago. And last year, he said, a building employee, Deokaran Gunpat, received an award from the New York City Fire Department for using one to save the life of a resident who went into cardiac arrest.
"In my opinion," Mr. Brett said, "it would be negligent not to have one."
