A fifteen-year-old boy collapsed during a high school soccer game. When the boy was unable to rise, his coach immediately ran onto the field to check his player. The boy tried to speak to his coach, but within three minutes of the collapse, he appeared to stop breathing and lost consciousness. The coach was unable to detect a pulse. An administrator from the host high school called 911. Two parents in the stands, who were nurses, joined the coach on the field. The coach and one nurse began to perform cardiopulmonary resuscitation (CPR) on the boy. The coach, who was certified in the use of an automated external defibrillator (AED), testified that he yelled for an AED. The AED in the possession of the host high school was actually at the game facility located at the end of the soccer field, but it was never brought on the field to the coach to assist in reviving the boy.
Emergency responders from the fire department arrived at approximately ten minutes after the boy collapsed and applied their semi-automatic AED to revive him, but that was unsuccessful. Next, responders from the Emergency Medical Service (EMS) arrived and utilized a fully automatic AED on the boy and also administered several drugs in an attempt to restore his heartbeat. After application of shocks and drugs, emergency responders revived the boy, but not until approximately twenty-six minutes after his initial collapse. Although the boy survived, he suffered a severe brain injury due to a lack of oxygen over the time delay involved. As a result, he now remains in a nearly persistent vegetative state that will require full-time care for the remainder of his life.
The boy’s parents retained a medical expert who determined that the boy suffered from a previously undetected underlying heart condition. The medical expert further opined that if shocks from an AED had been administered earlier, oxygen would have been restored to the boy's brain sooner and he would not have suffered the brain injury that left him in the current permanent vegetative state. The boy’s parents filed an action against the county school board, as both the host school and the boy’s school belong to the county school district. The complaint alleged that the school board breached both a common law duty and a statutory duty as imposed by section 1006.165, Florida Statutes (2008), which requires all public schools that participate in the Florida High School Athletic Association to acquire an AED, train personnel in its use, and register its location with the local EMS, when it failed to apply an AED on the boy after his collapse. The Lee County Circuit Court granted summary judgment in favor of the school board.
The Second District Court of Appeal affirmed. The appellate court concluded that reasonably prudent post-injury efforts did not require the school board to provide, diagnose the need for, or use an AED. Moreover, the appellate court held the school board was immune from civil liability under section 768.1325(3), Florida Statutes (2008).
The Supreme Court of Florida reversed and remanded. The court held that the school board owed a common law duty to supervise the boy, and that once injured, the school board owed a duty to take reasonable measures and come to his aid to prevent aggravation of his injury. Also, the court held the school board was not entitled to immunity from suit under the Cardiac Arrest Survival Act, section 768.1325, Florida Statutes.
The school board owed a common law duty to supervise the boy, and that once injured, the school board owed a duty to take reasonable measures and come to his aid to prevent aggravation of his injury. As a general principle, a party does not have a duty to take affirmative action to protect or aid another unless a special relationship exists which creates such a duty. When this relationship exists, the law requires the party to act with reasonable care toward the person in need of protection or aid. A special relationship exists between schools and their students based upon the fact that a school functions at least partially in the place of parents during the school day and school-sponsored activities. Mandatory education of children also supports this relationship. This special relationship requires a school to reasonably supervise its students during all activities that are subject to the control of the school, even if the activities occur beyond the boundaries of the school or involve adult students. This duty to supervise requires teachers and other applicable school employees to act with reasonable care under the circumstances. The duty to supervise creates the following specific duties owed to student athletes: (1) schools must adequately instruct student athletes; (2) schools must provide proper equipment; (3) schools must reasonably match participants; (4) schools must adequately supervise athletic events; and (5) schools must take appropriate measures after a student is injured to prevent aggravation of the injury. In this case, the boy was a student who was injured while he participated in a school-sponsored soccer game under the supervision of school officials. The school board owed the boy a duty of supervision to act with reasonable care under the circumstances. Specifically, the school board owed the boy a duty to take appropriate post-injury efforts to avoid or mitigate further aggravation of his injury. “Reasonable care under the circumstances” is a standard that may fluctuate with time, the student's age and activity, the extent of the injury, the available responder(s), and other facts. Therefore, the court concluded that it was a matter for the jury to determine under the evidence whether the school board's actions breached that duty and resulted in the damage that the boy suffered.
The school board was not entitled to immunity from suit under the Cardiac Arrest Survival Act, section 768.1325, Florida Statutes. Under a plain reading of the statute, two classes of parties that may be immune from liability arising from the misuse of AEDs: users (actual or attempted), and acquirers. Users are “immune from civil liability for any harm resulting from the use or attempted use” of an AED. § 768.1325(3), Fla. Stat. Additionally, acquirers are immune from “such liability,” meaning the “liability for any harm resulting from the use or attempted use” referenced in the prior sentence. The court reasoned that acquirers are not immune due to the mere fact that they have purchased and made available an AED which has not been used; rather, they are entitled to immunity from the harm that may result only when an AED is actually used or attempted to be used. It is undisputed that no actual or attempted use of an AED occurred in this case until emergency responders arrived. Therefore, the court concluded that the school board was not entitled to immunity under section 768.1325, Florida Statutes.
The Supreme Court of Florida reversed the appellate court’s judgment that affirmed the trial court’s grant of summary judgment in favor of the school board.
See: Limones v. School Dist. of Lee County, 2015 WL 1472236 (Fla., April 2, 2015) (not designated for publication).
See also Medical Law Perspectives, February 2013 Report: Emergency Medical Services: Liability and Immunity for Medical Rescue
See also Medical Law Perspectives, February 2014 Report: Congenital Heart Conditions: How Infants, Adults, and Healthcare Providers Handle the Risks
See also Medical Law Perspectives, November 2013 Report: Diagnosis and Treatment of Heart Attacks: Liability Issues