BILL ANALYSIS
AB 1116
Page 1
Date of Hearing: May 5, 2009
ASSEMBLY COMMITTEE ON HEALTH
Dave Jones, Chair
AB 1116 (Carter) - As Introduced: February 27, 2009
SUBJECT : Cosmetic surgery.
SUMMARY : Enacts the Donda West Law, which would prohibit
elective cosmetic surgery on a patient unless, prior to surgery,
the patient has received a physical examination and clearance
for surgery, as specified. Specifically, this bill :
1)Prohibits a dentist who holds a permit to perform elective
facial cosmetic surgery from performing elective facial
cosmetic surgery on a patient unless the patient has received
a physical examination by, and written clearance for, the
procedure from either a licensed physician and surgeon or the
dentist performing the surgery.
2)Prohibits a cosmetic surgery procedure from being performed by
a physician and surgeon unless, prior to surgery, the patient
has received a physical examination by, and written clearance
for, the procedure from either the physician and surgeon who
will be performing the surgery or another licensed physician
and surgeon.
3)Defines "cosmetic surgery" to mean an elective surgery that is
performed to alter or reshape normal structures of the body in
order to improve the patient's appearance, including, but not
limited to, liposuction and elective facial cosmetic surgery.
4)Provides that a violation of the provisions of this bill does
not constitute a crime.
EXISTING LAW :
1)Establishes under the Department of Consumer Affairs (DCA),
the Medical Board of California (MBC) which licenses
physicians and surgeons and regulates the practice of
medicine.
2)Establishes under DCA, the Dental Board of California (DBC)
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which licenses dentists and regulates their practice.
Authorizes DBC to issue a permit to a dentist to perform
elective facial cosmetic surgery, if that dentist meets
specified requirements, including proof of successful
completion of an accredited oral and maxillofacial surgery
residency program.
3)Requires specified disclosures to patients undergoing
procedures involving collagen injections, defined as any
substance derived from, or combined with, animal protein.
4)Requires MBC to adopt extraction and postoperative care
standards in regard to body liposuction procedures performed
by a physician and surgeon outside of a general acute care
hospital, and makes a violation of these provisions a
misdemeanor.
FISCAL EFFECT : None
COMMENTS :
1)PURPOSE OF THIS BILL . According to the author's office, this
bill will better protect individuals who are not physically
fit from unnecessary bodily trauma that could result from
elective cosmetic surgery. The author states that this
measure is not directed at the many good plastic surgeons who
require their patients to have a medical clearance before
elective cosmetic surgery. The author believes that
explicitly requiring in law a physical examination prior to
surgery will reduce the risk of complications, including
death, during or after cosmetic surgical procedures.
2)BACKGROUND . The author's office states that this bill comes
from the author's constituent, Yolanda Anderson, the winner of
the author's district wide, "It Ought to Be a Law" contest.
Ms. Anderson is the niece of Donda West, who died on November
10, 2007, due to complications that resulted from cosmetic
surgery. According to the West family, a physical examination
was not performed prior to surgery. A January 10, 2008
Associated Press (AP) article, citing the Los Angeles County
Coroner's official report, stated that Ms. West died from
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pre-existing coronary artery disease and multiple
postoperative factors following surgery.
3)DEATH ASSOCIATED WITH COSMETIC SURGERY . The incidence of
death and other serious complications associated with cosmetic
surgery is not readily available. The previously cited
January 10, 2008 AP article states the following, without
attribution: "Studies have shown that serious complications
from plastic surgery are rare, with death occurring in 1 in
58,810 procedures." New York Magazine, in a 2004 story
reporting on the deaths of two women following cosmetic
surgery, quotes the National Safety Council as stating that a
patient's chances of dying during surgery are 1 in 90,000, and
that, by comparison, a person's chances of dying in a car
accident in any given year are about 1 in 18,000.
4)National Clearinghouse of Plastic Surgery Statistics .
According to the 16-page "National Clearinghouse of Plastic
Surgery Statistics," published by the American Society of
Plastic Surgery (ASPS), 11.8 million cosmetic plastic surgery
procedures were performed by ASPS members in 2007, a 7%
increase from 2006 and a 59% increase from 2000. Of these
procedures, 1.8 million were surgical cosmetic procedures and
10 million were minimally-invasive cosmetic procedures
(primarily injections and chemical peels). The ASPS report
also found that the five most frequently performed cosmetic
surgical procedures were breast augmentation, liposuction,
nose reshaping, eyelid surgery, and tummy tuck, for which $4.9
billion was spent in 2007. The report does not include the
incidence of death or other complications associated with
cosmetic surgery.
5)PREVIOUS AND RELATED LEGISLATION .
a) AB 832 (Jones) would require the Department of Public
Health to convene a workgroup with specified membership no
later than February 1, 2010, to consider and develop
recommendations for state oversight and monitoring of
ambulatory surgical centers, as defined, to ensure public
health and safety. AB 832 is pending in the Assembly
Appropriations Committee.
b) AB 2968 (Carter) of 2008, was identical to this bill,
and would have enacted the Donda West Law, to prohibit
elective cosmetic surgery on a patient unless, prior to
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surgery, the patient received a physical examination and
clearance for surgery, as specified. AB 2968 was vetoed
by Governor Schwarzenegger with the following veto message:
The historic delay in passing the 2008-2009 State
Budget has forced me to prioritize the bills sent
to my desk at the end of the year's legislative
session. Given the delay, I am only signing
bills that are the highest priority for
California. This bill does not meet that
standard and I cannot sign it at this time.
c) SB 1454 (Ridley-Thomas) of 2008 would have imposed
specific advertising requirements on certain healing arts
licensees, and would have required health care
practitioners to disclose, while working, his or her name
and license status, on a specified name tag. SB 1454 also
would have required physicians and surgeons performing
procedures in an outpatient setting to establish specified
standardized procedures and protocols, and would have
required MBC to investigate unlicensed activity and other
specified violations in clinics using laser or intense
pulse light devices. SB 1454 stalled on the Assembly
floor.
6)SECOND COMMITTEE OF REFERENCE . This bill was heard in the
Assembly Business and Professions Committee on April 15, 2009,
and was approved on a 7-0 vote.
REGISTERED SUPPORT / OPPOSITION :
Support
None on file.
Opposition
None on file.
Analysis Prepared by : Deborah Kelch / HEALTH / (916) 319-2097