The death of a Silver Spring man who collapsed in police custody and later died has sparked a debate over whether police officers should carry life-saving devices to treat heart failure.

“This should be a wake-up call to the county, that they should do something promptly,” said Mike Mage, chairman of the Montgomery County chapter of the American Civil Liberties Union.

Mage was talking about Kareem Ali, a 65-year-old mentally disabled Silver Spring man who died in 2010 after a scuffle with police. Police claimed he was “unresponsive” in a stairwell and were trying to move him outside, sparking the conflict.

Police used a Taser stun device and pepper spray to subdue him. He cleared an initial medical check with Montgomery County Fire & Rescue personnel, who left the scene after that.

But Ali then passed out in the back of a police van and had to be hospitalized. He was pronounced dead on Oct. 14 at Holy Cross Hospital in Silver Spring.

Ali’s official cause of death was schizophrenia-induced agitated delirium complicated by police restraint, an enlarged heart and obesity. The manner of death was ruled undetermined, said Bruce Goldfarb, a spokesman for the state medical examiner’s office.

On March 10, Montgomery County agreed to pay Ali’s family $450,000, a settlement to a $150 million lawsuit Ali’s father and sister filed in 2012.

The ACLU was not involved with the case.

“If the police officer had a defibrillator, Mr. Ali would have lived and there would have been no lawsuit,” Mage said.

Montgomery County police Capt. Paul Starks said 40 to 50 Montgomery County squad cars have automated external defibrillators, or AEDs. The county plans to add more each year until every marked police car has one.

“We think this is a worthwhile effort,” said Starks, a department spokesman.

But state Del. Ana Sol Gutiérrez (D-Dist. 18) of Chevy Chase said the county is moving too slowly.

Gutiérrez, a board member of the Montgomery County ACLU, prepared a bill that would require that any law enforcement vehicle on patrol in the county — regardless of where the agency is based — be equipped with an AED. She said police would have three years to equip on-duty vehicles.

“Time is of the essence,” Gutiérrez said during a hearing for the bill in February. “After 10 minutes, after cardiac arrest, whatever you do is not going to be able to save a life or prevent serious damage.”

According to the National Institutes of Health, AEDs are portable devices that can send an electric shock to the heart to restore a normal rhythm after sudden cardiac arrest, or heart failure.

A built-in computer checks a victim’s heart rhythm through adhesive electrodes. The computer calculates whether defibrillation is needed and tells the rescuer whether to push the shock button to jump-start the heart.

Citing a police report, Mage said police who arrested Ali in 2010 did not have an AED and it took Montgomery County Fire & Rescue personnel 10 minutes to arrive at the scene.

Starks said personnel tried to use an AED on Ali when they arrived, but backed off after getting a “do not shock” reading. He was unable to corroborate how long it took MCFRS to arrive.

All MCFRS units are equipped with AEDs or a cardiac monitor defibrillator.

Montgomery County police were among several agencies to oppose Gutiérrez’s bill. Law enforcement complained that the bill was an unfunded mandate and would cause logistical problems to implement and enforce, particularly for agencies that operate in more than one county.

“One of the major issues that we are concerned with is that there’s no funding attached to this current legislation and really no incremental implementation plan,” Capt. Bob Bolesta said during the hearing.

Bolesta directs Montgomery County police’s special operations division, which oversees distribution of AEDs. He said the department wants to equip police cars with defibrillators within three years.

According to his testimony at the hearing, equipping the police department’s 926 vehicles with defibrillators would cost more than $2 million.

Takoma Park Police Chief Alan M. Goldberg said equipping its 42 police cars with AEDs would cost $70,000 — a strain on the city if they all had to be implemented at once.

The ACLU argued that less-expensive units would cut the cost in half, but local police leaders said they prefer buying the same units MCFRS uses.

Last month, after Gaithersburg-based Rescue One Training for Life donated 100 AEDs to Laurel, city officials said the machines would be placed in all police cars, city facilities and some other city vehicles.

Gutiérrez said her bill is unlikely to pass this session. She’s proposed similar legislation before, but it has failed.

Montgomery County Executive Isiah Leggett set aside $70,000 for 30 more police AEDs in his proposed fiscal year 2015 budget, which begins July 1, 2014.

Gutiérrez said this was good news.

“If it can be done without a bill, that’s fine with me,” she said. “I just think that it needs to be made a priority.”

Ultimately, Mage said, taxpayers wind up paying for the county’s lack of AEDs through civil suits.