August 6, 2004
RESTAURANTS AND THE HEIMLICH MANEUVER
By: Daniel Duffy, Principal Analyst
You asked if any other state has a law requiring restaurant employees to be trained in or be aware of procedures to remove food lodged in a person's throat.
We identified 14 states with laws specifically relating to providing aid to a choking victim in a restaurant or a similar establishment that serves food for consumption on the premises. The most common feature requires restaurant owners or operators to post a sign depicting techniques, such as the Heimlich maneuver, to remove food from a choking victim's throat. Ten states require the state or a local public health agency to design or approve the signs. A few prohibit the signs from containing removal methods that require the use of an instrument or device. Seven states require the state public health agency to distribute signs to restaurants. Three of these have statutory provisions stating that there is no charge for the signs.
One state, Oregon, does not specifically require a sign. Instead, it requires restaurants to have certain employees trained to provide aid to a choking victim “within a reasonable time” of being hired.
Almost all have provisions specific to these requirements that establish immunity from criminal or civil liability for someone who, in good faith, removes, helps to remove, or attempts to remove food from someone's throat. Some also have provisions immunizing a restaurant if it fails to post a required sign properly. In Illinois, the immunity provision states that it is the same as that established by the state's Good Samaritan Act. Information about Connecticut's Good Samaritan Law is in OLR report 2003-R-0285.
Arkansas requires the state health director to study and approve (1) instructions and a poster stating and depicting first aid techniques designed for use by a person without medical training to remove food lodged in a choking victim's throat. The director must publish the instructions and make them available to each food service business in the state.
The law requires food service businesses to post the instructions and the poster in places conspicuous to employees and managers to familiarize them with the techniques and enable them to consult the instructions when helping a choking victim.
The law provides that (1) a business that does not post the instructions and the poster is not subject to any criminal penalty or to civil liability for personal injury or wrongful death arising from any choking emergency; (2) it does not obligate a business, its managers, and employees, or any other person to remove, attempt to remove, or help to remove food been lodged in a choking victim's throat; (3) a business, its managers, and employees are not liable for personal injury or wrongful death for not removing, attempting to remove, or helping to remove food lodged in a choking victim's throat; and (4) a business, its managers and employees or any other person is not liable for personal injury or wrongful death for any acts or omissions of any individual removing, attempting to remove, or helping to remove food lodged in a choking victim's throat (Ark. Code Ann § 20-57-207).
California requires its health department to establish first aid instructions for removing food stuck in someone's throat. The instructions must not include techniques that use physical instruments inserted into the victim's mouth or throat. The department must give a copy of them to the proprietor of every on-site eating establishment. Proprietors must post them in a conspicuous place, which may include an employee notice board, to enable them to be consulted by anyone attempting to provide relief.
The law states that, in the absence of other evidence of noncompliance, the fact that the instructions were not posted does not in and of itself subject the proprietor or employees to liability for personal injuries or wrongful death arising from a choking emergency. It also states that it does not obligate anyone to remove, assist in removing, or attempt to remove food stuck in another person's throat. In an action for damages for personal injuries or wrongful death, neither the proprietor nor any person who removes, helps remove, or attempts to remove the food in accordance with instructions is liable for civil damages as a result of any acts or omissions (Cal. Health & Safety Code § 114180).
Florida requires every public food establishment to post a sign illustrating and describing the Heimlich maneuver to provide emergency first aid to a choking victim. The sign must be posted in a conspicuous place accessible to employees. Further, the establishment must familiarize employees with the method.
The law provides that (1) it must not be construed to obligate an establishment or its employees to provide such assistance and (2) an establishment or employee is not liable for civil damages from an act or omission when the establishment or employee acts as an ordinary reasonably prudent person (Fla. Stat. Ann. § 509.213).
Georgia requires a state agency to print and distribute notices to every food service establishment explaining the proper procedures to assist a choking victim. The notices must include appropriate information and be posted conspicuously.
The law states that anyone who provides emergency aid in good faith to a choking victim, without charging for services, is not liable for any act or omission in rendering the emergency aid or as a result of any act or failure to act to provide further treatment or care (Ga. Code Ann. § 26-2-374).
Illinois requires the health department to design and distribute without charge placards containing approved methods for laymen to safely and effectively remove food lodged in a person's throat. The instructions must be limited to first-aid procedures that do not use instruments or devices. They must be of a size and design suitable for posting in food service establishments. The instructions must, to the extent practicable, be expressed in words and illustrations that are not offensive to restaurant patrons.
The law requires the department to develop and publish guidelines for training programs that food service establishments may use voluntarily to train employees in the approved methods.
The law requires on-premises food-service establishments to post the placard in a conspicuous location, visible to patrons and employees, but not necessarily in an actual dining area.
The law establishes that the exemption for liability for providing emergency assistance is the same as that established by the state's Good Samaritan Act.
Except as provided by other law, no one is obligated to remove, help to remove, or attempt to remove, food from another person's throat, nor is anyone who in good faith removes or attempts to remove food in an emergency liable for any civil damages as a result of any acts or omissions (410 Ill. Comp. Stat. Ann. 10/1 et seq.).
Kentucky requires food service establishments that seat 25 or more patrons to post a sign on choke-saving techniques in a location conspicuous to employees. The sign must depict, through illustration and description, procedures to remove food lodged in a person's throat. These must include the procedure in which the choking person is grasped around the lower chest and upper abdomen and given a quick jerk, thereby increasing inter-abdominal lung pressure and expelling the food. The law requires the state health department to produce the poster and supply copies to local health departments for free distribution (Ky. Rev. Stat. Ann. § 217.285).
The law requires each food service facility that prepares food and provides seating for patrons to post a diagram or illustrative directions on the use of manual maneuvers to prevent asphyxiation due to choking.
A person who applies the maneuvers depicted in the diagram is liable only if his actions amount to gross negligence (MD. Code Ann. § 21-326).
The law requires a food service establishment that sells solid food for on-premises consumption to display prominently a poster in the kitchen diagramming and explaining anti-choking techniques that are safe for both adults and children and approved by the health department for dislodging foreign obstacles caught in a choking victim's throat.
The law states that it does not obligate the owners or employees of a food service establishment to apply the anti-choking techniques.
By law, a restaurant, employee, or owner is not be liable for civil damages if an employee or owner in good faith attempts to remove, removes, or assists in the removal or attempted removal of food which is lodged in an individual's throat, unless the employee or owner was grossly negligent in his or her actions (Mich. Comp. Laws Ann. §§ 289.6141, 691.1522).
New Hampshire requires commercial eating establishments serving food for on-premises consumption to post a graphic display of the Heimlich maneuver in a conspicuous place. The sign must be at least 8.5” by 11” and contain (1) a picture and word description of what to look for when a person is choking, (2) a picture and word description of how to perform the Heimlich maneuver to expel an object from a victim's breathing passages, and (3) any other information necessary to instruct a rescuer in the proper procedure (NH RSA § 155:43).
New Jersey requires the health department to prepare instructional posters and pamphlets that illustrate choke prevention techniques, like the Heimlich maneuver, and to distribute them to local health boards for distribution to food-serving facilities. The proprietor of a facility that serves food for on-premises consumption must ensure that these posters are prominently displayed in food preparation and service areas.
Except as provided by other law, no one is obligated to remove or help to remove food lodged in a person's throat (N.J.Stat. Ann. § 26:E-3 et seq.).
The law requires the public health commissioner to adopt first aid instructions intended for use in removing food lodged in the throat. The instructions must be limited to first aid techniques that do not require a physical instrument to be inserted into the throat. The commissioner must give a copy of the instruction to the proprietor of every restaurant.
The law requires restaurant proprietors to post the instructions in a conspicuous place to allow employees to become familiar with them and enable them to be consulted by anyone attempting to provide relief to a choking victim.
The fact that the instructions were not posted as required does not in and of itself subject a proprietor, or his employees or agents, to liability in any civil action for damages for personal injuries or wrongful death arising from such choking emergency. The law provides that it does not obligate a proprietor, employee or other person to remove, assist in removing, or attempt to remove food from a choking victim's throat.
A proprietor, employee, or anyone else who voluntarily and without expectation of monetary compensation removes, helps to remove, or attempts to remove food from a choking victim's throat in accordance with the instructions is not be liable for damages for injuries alleged to have been sustained by the victim or for damages for a victim's death alleged to have occurred because of an act or omission in providing the assistance, unless it is established that the injuries or death were caused by gross negligence (N.Y. Pub. Health Code, § 1352-b).
Oregon requires restaurants that serve food for on-premises consumption to require that their food service employees, within a reasonable time after date of employment, be trained to provide first aid to help a choking victim in accordance with a training program approved by the local public health authority, or as described in Red Cross Manual § 32-1138 as the “abdominal thrust” procedure.
The law requires local public health authorities to provide or cause to be provided the necessary training program at reasonable intervals in the training for food handlers. They may charge reasonable fees to cover actual expenses. They may waive the training requirements in cases of undue hardship, or if they determine that an employee's assignment makes the training impracticable or unnecessary.
The law provides that civil or criminal liability to the restaurant or restaurant employees may not result from the good faith application of first aid by a trained person (Or. Rev. Stat. § 624.130).
The law requires the state public health director to require food-service establishments to post in conspicuous locations diagrams and illustrations that demonstrate choke-saving techniques that do not use an instrument or device.
Except as provided by other law, no one is obligated to remove, help to remove, or attempt to remove, food lodged in a choking victim's throat, nor is anyone who negligently under the circumstances removes or attempts to remove such food in an emergency be liable for any civil damages as a result of any acts or omissions by the person in rendering the emergency assistance (R.I. Gen. Laws § 23-20.5-1 et seq.).
Texas requires food service establishments that have on-premises dining to post a sign depicting the Heimlich maneuver in a place conspicuous to employees or customers. The statute requires the state health board to adopt implementing regulations specifying the design, size, and graphics of the sign. The law requires the sign to be in English and Spanish (Tex. Health & Safety Code § 438.051).