Story URL: http://news.medill.northwestern.edu/chicago/news.aspx?id=113219
Story Retrieval Date: 5/20/2013 12:28:39 PM CST
Sean Wieber and Rashidi Wheeler stepped onto a Northwestern University football practice field on an August morning back in 2001, Lake Michigan sparkling to the east and their senior season stretched out in front of them.
The two were close, even by teammate standards.
They had come in together as part of former coach Gary Barnett’s final recruiting class as defensive backs and spent much of the next three years lifting weights, sitting through position meetings and palling around.
And they had spent the summer training together for the brutal conditioning drills about to begin. The day was hot and the stakes were high: Finish in time, or lose your starting spot.
“We hugged and he asked me to be his pace man, to run with him through the drills,” Wieber remembers.
Sometime over the next few minutes, Wheeler fell to the back of the pack. Minutes later, he was on the sidelines, asking for water and gasping for air. Within an hour, he was pronounced dead at Evanston Hospital.
The Cook County medical examiner’s office said Wheeler died of exercise-induced asthma. Northwestern claimed Wheeler’s use of dietary supplements killed him, and a bitter legal battle between Wheeler’s family and the university ensued.
But none of that changes the fact that when Wheeler’s heart stopped beating, the simple device that might have saved him was nowhere on the field.
Now, a law that requires these heart-saving devices – automated external defibrillators, known as AEDs – at facilities like that lakeside practice field is on the books in Illinois, written by Wieber, now a lawyer, and named for his friend and former teammate.
The Rashidi A. Wheeler law, which went into effect Jan. 1, requires AEDs at outdoor fitness facilities beginning in July 2009. Previously, state law had required AEDs only at certain indoor facilities.
“Whether it would have saved him for sure or not, I don’t know, but it wasn’t available to Rashidi then and there,” Wieber said. “It is now, and it can save other people’s lives.”
Wieber drafted the bill for a class assignment in 2005, during his third year at Chicago-Kent School of Law. With the encouragement of his professor and the help of former Gov. James R. Thompson, Wieber worked with state Rep. Daniel Burke (D-Chicago) to get the bill introduced and passed in October 2007.
After some political wrangling and an amendatory veto from then-Gov. Rod Blagojevich, the bill was signed into law last April.
“For so long, I just couldn’t see a way that any good could come out of what happened,” said Wieber, 29, now an associate at Winston & Strawn. “Now I can.”
“A preventable death”
More than 250,000 people die every year in the United States from cardiac arrest, which occurs when a sudden change to the heart’s rhythm causes it to spasm or, in some cases, stop beating completely. For every minute the heart is not pumping blood, the survival rate falls by about 10 percent.
“Within 10 minutes, we lose almost everybody,” said Dr. Vincent Bufalino, CEO of Midwest Heart Specialists in Naperville. “We’re not kidding when we say time is everything. And the thing is, cardiac arrest is, in most cases, a preventable death. We know how to do it.”
The most common form of cardiac arrest occurs when the heart begins to quiver in the chest, a condition called ventricular fibrillation.
A simple electric shock is usually enough to reset a normal heartbeat, and when it is delivered quickly – ideally within three minutes of collapse – survival rates approach 75 percent, according to a 2000 study. Without it, survival rates are between 5 and 8 percent.
But the vast majority of cardiac arrests occur outside a hospital, and six in 10 patients never make it to the emergency room.
Enter the AED.
The device, about the size of a desk phone, guides the user through the steps with voice prompts, text messages and lighted buttons. It quickly analyzes the heart rhythm and will deliver a shock only if one is needed.
“No other piece of equipment we have makes it more likely that we’re going to deliver that patient to the hospital alive,” said Lt. Mark Thurow, director of Naperville’s emergency medical services. “And the sooner that shock is given, the better.”
Illinois out in front
The Rashidi Wheeler Law is the latest legislative triumph for Illinois, which has been a leader in promoting the public AED model over the past decade.
Chicago’s O’Hare and Midway Airports were the first public places to be outfitted with the devices.
In 1999, 49 AEDs were placed throughout the terminals and, in that first year, 11 of 18 victims survived.
Without the AEDs, Bufalino said, “We might have saved one of those.”
There are now 93 AEDs in the two airports, and, as of last week, a total of 51 people have been saved.
The 2003 Colleen O’Sullivan Law, named for a legislative aide who died of cardiac arrest at her gym, required AEDs at all indoor fitness facilities, and was the first of its kind in the country.
Almost immediately, Peysakhovich said his phone started ringing with advocates and legislators from other states, wanting to know how Illinois had done it.
“It wasn’t just that we passed the law, but the way we did it, the legislative playbook, if you will, paved the way for a lot of other states,” he said.
Illinois also has comparatively strong so-called Good Samaritan laws when it comes to AED use.
These laws, which protect people without medical training who try to help in an emergency, have existed in most states since the early 1990s, and usually cover CPR and first aid.
But Illinois was one of the states first to expand its law to AEDs, doing so about a decade ago – a vote of confidence in the devices’ ability to be used safely and effectively by almost anyone, said Mark Peysakhovich, senior director of advocacy in Illinois for the American Heart Association.
“These machines are as close to a miracle as I’ve ever see,” Peysakhovich said. “Having them around, in as many places as possible, is a no-brainer.”
So why don’t more places have them, and why don’t more states have laws like Illinois’?
The issue is partly one of funding, partly one of bureaucracy, and partly one of leadership, said Dr. Mickey Eisenberg, head of the AED program in King County, Wash., where there are more than 2,200 AEDs and the survival rate for witnessed ventricular fibrillation is almost 40 percent.
“There’s no secret to what we do here,” said Eisenburg, medical director of King County’s emergency services. “It takes a kind of a collective will and requires initiative, whether it be from physicians or politicians or emergency medical personnel. Someone has to stand up and say, ‘We can do better.’”
The cost of saving lives
Illinois’ new law is an unfunded mandate, which means there is no dedicated money in the state budget to pay for it.
Though the cost of the devices has come down drastically in the past decade, AEDs still cost between $1,000 and $1,500, and training courses cost between $25 and $45 per person.
Yet government funding has been in increasingly shorter supply.
Illinois has relied largely on federal grant money over the past six years to pay for AEDs. Between 2003 and 2006, more than $640,000 in federal grants bought about 450 AEDs for schools, health clubs and other facilities, said Carolyn Brown-Hodge, director of rural affairs for Gov. Pat Quinn, who has long been a supporter of AED programs.
But federal funding dropped by nearly half since 2006. Illinois got just $87,000 in both 2007 and 2008, according to Brown-Hodge. The state is in the process of applying for $100,000 grants for the next two years, but even that is less than half the money received in 2005 and 2006.
Although the price of AEDs has come down, the drop has not kept pace with the decline in funding, leaving facilities bearing the costs. “Ultimately, any real opposition to this is a money issue,” Peysakhovich said.
The Chicago Park District said putting AEDs in its more that 500 facilities would be prohibitively expensive. It is exempt from the new law, as are other park districts and forest preserves around the state.
Still, proponents of AEDs say they are worth every penny.
“When you think about it in terms of dollars per life saved, this is one of the best technologies out there,” Bufalino said. “Talk about a bang for your buck.”
With prices dropping and quality rising, the American Heart Association sees a future in which AEDs are like fire extinguisher – commonplace and used regularly.
“An AED should not be a maybe; it should always been a yes,” Peysakhovich said. “It’s the difference between watching your buddy die on the sideline and being able to go run and grab the kit off the bench.”
Back in the huddle
That’s a lesson Sean Wieber knows all too well.
He has talked a lot about that August morning – to the media, to lawyers representing Wheeler’s family and Northwestern University, and to the state legislature. It never got easier, he says, and watching the ugly legal battle between Wheeler’s family and the university he loved was difficult.
“It was like this gloom, this gray cloud lingered over my experience there,” he said.
With the Rashidi A. Wheeler law now putting more AEDs around Illinois, those clouds are starting to lift. “It means a lot to see, and it’s something I’m proud to have had a hand in. Every one of these devices that goes out there has a chance to save a life.”