An AED/Defibrillator has only one purpose, the resuscitation of an individual in Cardiac Arrest, important when a Cardiac Arrest has only two outcomes.
Nationwide, companies are providing workplace AEDs for staff and visitor wellbeing and this provision is a hugely positive step in the preservation of life. Both Companies and those staff members who volunteer as Guardians should be applauded in their roles, AEDs save lives every day of the year in the UK and a Guardians role is to ensure that each and every device is ready to do so.
This makes a Guardians responsibility substantial and comes with significant corporate faith in the individual and their diligence. To understand this, you only must consider what it means to attempt the deployment of a device in a resuscitation attempt and to find no electrodes, limited battery life or even, that the device is not in its allocated position in a time critical event. This is to risk consequences for casualty, Guardian or company.
No organisation wants to possess an AED that fails to deploy when needed and this leaves a searching question which is now more relevant than ever. Who is responsible if a workplace AED fails to deploy in a resuscitation attempt due to a Guardians failings in maintenance, compliances or procedures?
There are probably a couple of answers to this question and yet rarely if ever are those employees who volunteer as Guardians trained, or receive on-going support & supervision by expert third party specialists in this role. If one considers a simple principal of law, where there is responsibility there is often accountability, this may feel like a somewhat casual approach to this risk – a risk that is about to become heightened.
On the 9th of September this year amendments to the Review of Deaths Legislation come into effect and this now means –
‘Every death in England and Wales will now be reviewed by a Medical Examiner or a Coroner, without exception’.
This is unprecedented scrutiny around death and with one of the three corner stones of these amendments being satisfying questions from the bereaved, there is no room for error in an AEDs operational efficacy.
In the opinion of Ross Severn, MD of Defib Plus Ltd, one of less than a handful of companies who provide a solution to this problem, the time has come for a change. He says –
‘If Guardians are to continue to look after this equipment and someone in a company has to, they must be protected. At the very least they should be trained in procedure, meaning what to do, when, why, how and possibly most importantly, the outcomes if not done comprehensively, otherwise it may be deemed that they are left vulnerable to error. Even so, training of staff alone is still in-house maintenance and if, in the case of errors as you describe, there is no third-party involvement in governance, the buck will still stop in house. Far better to outsource the responsibility to experts, outsource the responsibility and you outsource the accountability. Any supplier in this field must provide ongoing and advisory notifications to Guardians, constantly reminding them of the elements of their role, they must offer prompt and efficient resupply of consumables and comprehensive supervision in the monthly compliance elements, with unit certification to demonstrate that units have passed their monthly mandatory inspection criteria. Only then can a company truly ringfence itself and its staff whilst showing evidential best practice and duty of care. This legislation has been in the making since 2020, we have been offering this service since 2021, so we have been geared up for this for a while because we recognise that it may be considered the end of unsupported in-house governance. There’s now too much at stake for companies here and whilst that may not be a legal consequence for a Guardian, it might be a financial one for their employer particularly if they cannot demonstrate they have provided anything in support of the Guardian in this important duty’
The implications for a Guardian who makes a mistake, human error is part of human nature, may not be legal but with the involvement now of Coroners and Medical Examiners it may reasonably be assumed that there will be many more questions highlighted that need answers, this means more inquests. For a Guardian to be involved in a protracted, jury lead Coroners’ inquest with all that entails must be considered a stressful and undesirable outcome for an employee who has volunteered to help maintain this medical equipment.
Ross Severn again: ‘Just recently an Inquest Report was published on a case of exactly this nature, where a deployment had failed due to the absence of electrodes, part of a Guardians brief to provide. His Honour, Judge Thomas Teague KC was advised in his role as the Chief Coroner of England and Wales of this and of the presiding Coroners concerns around future deaths due to unsafe practices. So, this is not unknown, this case took 9 months, and one must assume that with the additional burden to Coroners Courts that will come down the tracks, means a Guardian may be involved in a great deal lengthier process than in this instance. Horrible for all concerned.
It was identified that an AED location resource had been utilised by the 999-call handler to direct the caller to a device and the device was handed over. Sadly, the outcome was that a 27-year-old man succumbed to a Cardiac Arrest, the Guardian had failed to replace the pads, had failed to inform their colleagues, the AED location resource and in turn the emergency services that the AED was offline. This Guardian represented a company who one would consider a sophisticated provider, with over 400 units and Guardians and yet still this happened, so easily avoided with simple ‘checks and balances’ in place.”
With the arrival of this new legislation, is it now time for management personnel to question whether staff members should undertake this role without professional support and supervision to protect those that are in the role and the organisations that are good enough to provide this equipment.
Last word from Ross: ‘Honestly, if I was a Guardian, I would want a specialist team holding my hand through every step of this process, to negate any errors and God forbid something did go amiss, to mitigate or absolve me of any accountability. This ‘Peace of Mind’ costs less than a Sky package and its 100% tax deductible, why wouldn’t I want this from my employer, I do this voluntarily?’
www.defib-plus.co.uk
