Health | The push for defibrillators in schools is getting personal

Matthew Mangine and MP Andy Barr are united by an unimaginable loss and a single, terrible date: June 16, 2020.

That day, Mangine, a father from Northern Kentucky, lost his 16-year-old son, who collapsed during soccer practice and later died of a heart attack. That day, Barr's wife, Carol, also collapsed during a Zoom call and later died, also of a heart attack. She was 39.

Last month, Mangine visited Barr's office in Washington, DC, and asked him to support a bill that will increase access to automated external defibrillators in schools, arguing that a defibrillator could have saved his son's life. When he mentioned the day of his son's death, Barr seemed stunned.

“This is exactly the day we lost Carol,” said the Kentucky Republican.

This is the third consecutive Congress during which lawmakers have introduced laws to advertise access to emergency defibrillators in schools across the country through grant programs.

But this yr, politicians like Barr, whose lives have been turned the wrong way up by sudden cardiac arrests, could make the crucial contribution to the law's success.

“This is an issue that transcends party affiliation,” said lead House sponsor Sheila Cherfilus-McCormick (D-Florida). “We're getting feedback that it should be passed before the end of the year.”

“But we cannot stress the urgency enough – especially as our children begin playing sports this summer.”

Federal efforts

The bipartisan bill, introduced this session by Cherfilus-McCormick within the House and Cory Booker, D-N.J., within the Senate, would create a federal standard for responding to cardiac arrests in schools by giving students higher access to AEDs and developing emergency response plans.

When the bill was introduced within the 116th and 117th Congresses, it didn’t even make it through committee.

But this Congress, the House's original version had greater than 110 co-sponsors, including Barr, before it was incorporated right into a broader bill to lift awareness of cardiomyopathy and help schools cope with heart disease. The Energy and Commerce Committee passed the broader bill in March.

In addition to promoting AEDs in schools, the broader bill introduced by Rep. Frank Pallone Jr., D-N.J., also includes requirements for training in cardiopulmonary resuscitation. It would also require the Department of Health and Human Services to work with the Centers for Disease Control and Prevention, patient advocacy groups and health care skilled associations to develop educational materials for schools, teachers and fogeys.

The Senate version of the AED bill has not made it out of the Health, Education, Labor, and Pensions Committee. House Democrats hope that passage of the bill within the House could prompt the Senate to act.

The office of Senate HELP Program Chairman Bernie Sanders (I-Vt.) didn’t reply to multiple requests for comment.

House staff said it was difficult to realize momentum for the bill within the Senate due to its high price tag. Pallone's bill would authorize $25 million annually for five years, from fiscal yr 2025 to 2029, including funding for the AED Act.

But Cherfilus-McCormick's office found a loophole within the law so the bill will not be considered a brand new expenditure and is requesting the funds through a defunct grant program.

“Damar-Hamlin effect”

Advocates also attribute recent interest in cardiac arrest-related interventions to what they call the “Damar-Hamlin effect.”

Americans watched live because the Buffalo Bills safety collapsed on the sector in January 2023 and was subsequently resuscitated with cardiopulmonary resuscitation and defibrillation.

In the times following the incident, the American Heart Association saw a 600 percent increase in visits to its CPR instructional website. In the months that followed, the NFL began offering CPR training to groups and native communities, and state legislatures also began to point out interest in equipping schools with defibrillators.

Sudden cardiac arrest, which is different from heart attacks, can occur to anyone and is commonly fatal without intervention. Only 10 percent of people that experience cardiac arrest outside of a hospital survive, but when bystanders know methods to use an AED or perform CPR, the prospect of survival increases to 44 percent, in keeping with the national Cardiac Arrest Registry to Enhance Survival.

About 23,000 children suffer cardiac arrest outside of a hospital annually, and 40 percent of those incidents are related to sports. In schools with AEDs, about 70 percent of youngsters survive cardiac arrest, the American Heart Association found.

One in 200 people has a heart condition that could make them vulnerable to sudden cardiac death, said Dermot Phelan, a sports cardiologist in Charlotte, NC

While not everyone with an underlying medical condition will suffer a heart attack, prolonged stress on the center or a rush of adrenaline can trigger one, which is why Phelan says it's crucial that there may be an emergency protocol in sport.

Phelan described a “training paradox”: individuals who exercise are prone to have a healthy heart and live longer, but the chance of sudden cardiac death is 25 percent higher in athletes than in non-athletes.

Liability concerns

Defibrillators are frequently a bipartisan issue, but state laws to expand their scope have faced resistance from those that fear installing the devices in schools can be too expensive or entail an excessive amount of legal liability. There can also be concern that passersby can be afraid to make use of the devices.

In all 50 states and the District of Columbia, using AEDs is an element of “Good Samaritan” laws that protect bystanders from civil liability for assisting in an emergency. But not all of those laws fully protect people, argues AED compliance expert Richard Lazar, president of Readiness Systems. Depending on the state, a law may only cover limited activities, meaning AED cases gone flawed can find yourself in court.

“It is a myth in the industry and among AED vendors that there is Good Samaritan protection, although for the most part that is not the case,” Lazar said.

Representatives Gerald E. Connolly (D-Virginia) and Scott Franklin (Republican, Florida) have introduced a bill to enhance civil liability protection for using defibrillators. It is meant to supply comprehensive protection for each the user and the owner of the defibrillator. However, the bill has not progressed beyond introduction.

A private problem on Capitol Hill

Barr's wife Carol died in 2020 on the age of 39 from a sudden heart attack brought on by mitral valve prolapse. Carol was diagnosed together with her heart condition at a young age, but doctors told her the condition was benign and there was no cause for concern.

Carol Barr had just finished a piece presentation on Zoom when her colleagues saw her collapse. Barr said that when she left the home within the morning, it was like all other day. No one knew anything was flawed.

“That's the problem with heart attacks. It's like one minute you're perfect and the next minute you're not,” Barr said.

The ordeal prompted Barr to support a bill passed in 2022 authorizing a National Institutes of Health grant program to support research on heart valve disease. That bill also directed the CDC to lift public awareness of sudden cardiac death. The bill is known as the Cardiovascular Advances in Research and Opportunities Legacy Act – CAROL Act.

This yr, Barr, together with 21 other bipartisan House members, co-authored a letter asking the House Labor, Health, and Education Appropriations Committee to allocate $20 million in fiscal yr 2025 for NIH research on heart valve disease as a part of his bill. He also asked the committee to allocate $5 million to expand the cardiac arrest registry to enhance survival rates and $3 million to the CDC's heart valve disease education and awareness campaign.

Barr will not be a cosponsor of Pallone's bill, but he said he’s a supporter. He said he believes the bill could easily pass under suspension on account of the non-public nature of the difficulty and plans to lift the difficulty at their next meeting with Majority Leader Steve Scalise (R-La.).

“I know other members have had children or other family members who have had heart problems,” Barr said. “I've chosen to go very publicly… it's a legacy.”


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