he last issue of the Boatman’s Quarterly Review provided an update on an important piece of legislation sponsored by Arizona Representative Doug Quelland that would allow an untrained individual to administer epinephrine to anyone suffering from a severe allergic reaction. Progressing rapidly through the House, Senate, and relevant caucuses, we are pleased to announce that az House Bill 2110 was signed into law on April 11, 2006 by Arizona Governor, Janet Napolitano. However, be advised that this Good Samaritan “epi law” will not go into effect until ninety days after the end of this legislative session. Considering that the session may not end until mid-June, the law may not be officially “on the books” until very late this river season. Nevertheless, it represents a very significant step forward and one that should help dispel much of the ambiguity and liability concerns surrounding this difficult issue.

Title 36 of the Arizona Revised Statutes will be revised to add section 36-2226, to read as follows:
36-226. Emergency administration of epinephrine by good Samaritans; exemption from civil liability
A. Notwithstanding any other law, a person may administer epinephrine to another person who is suffering from a severe allergic reaction if the person acts in good faith and without compensation for the act of administering the epinephrine and a health professional who is qualified to administer epinephrine is not immediately available.
B. A person who administers epinephrine pursuant to subsection A is not subject to civil liability for any injury that results from that act unless the person acts with gross negligence, willful misconduct or intentional wrongdoing.

It is immensely gratifying to see how an issue can move from concern, to action and implementation, and finally to an end result that benefits this industry and indeed all citizens of this state. Gcrg had been very concerned about the lack of medical control in the commercial river industry for many, many years. It became increasingly evident that most discussions of the issue were framed in terms of the protocols for anaphylaxis, the only medical crisis requiring an authorizing physician that can swiftly become a life or death situation. The simple fact is, not only is medical control generally unavailable to river guides in the field, but even if it existed, the immediate action required by this situation could preclude using it.

Refusing to believe that this seemingly untenable situation would have no solution, azra guide Kevin Greif took the issue to the next level by researching legal precedents, discovering the Oregon law and the American Medical Association’s model epi legislation. Dr. Michelle Grua then took the significant initiative to contact Representative Doug Quelland, Chairman of the House Health Committee, whose own personal experience with a severe allergic reaction led to his deep commitment to sponsor a law addressing that emergency situation. Michelle wrote letters, made phone calls, and monitored the law’s progress. Her regular contact with Representative Quelland throughout the legal process ensured that the law would contain wording bearing particular relevance to this industry.
Input from gcrg board members, our conversations with recreation law specialist (and gcrg life member) Jim Moss, and ongoing dialogue with “river docs” such as Dr. Michelle Grua, Dr. Walt Taylor, and Dr. Tom Myers, helped provide considerable clarity about liability concerns and the need for action. However, gcrg’s most important role has been to take this issue beyond our board meetings to a more public forum. As an organization, we have a strong commitment to a balanced presentation of the pressing issues facing this river community and we hope that our series of articles in this newsletter has accomplished that goal. This victory is really the story of a quite a number of concerned individuals who took it upon themselves to delve into the heart of this issue, understand it from all viewpoints, disseminate it publicly, engage members in that dialogue, and support positive action.
And really, it all boils down to advocacy. Collective concerns fueled the momentum necessary to craft and enact a Good Samaritan law specifically addressing the administration of epinephrine in emergency situations where a licensed health care professional is not available. Volume 18:4 of the Boatman’s Quarterly Review characterized anaphylactic shock as the “life and death situation that strikes at the heart of the [medical control] issue that drives liability concerns for river guides and outfitters alike.” The Good Samaritan “epi law” sponsored by Representative Quelland simply yet effectively addresses this critical problem by providing the requisite clarity and legal protection so sorely needed when acting in good faith to save a life. The end result represents both a strong lesson about the power of individuals to enact change and a significant victory for all of us.

Lynn Hamilton
Executive Director gcrg