BILL ANALYSIS                                                                                                                                                                                                    



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          ASSEMBLY THIRD READING
          AB 1116 (Carter)
          As Introduced  February 27, 2009
          Majority vote 

           BUSINESS & PROFESSIONS     7-0  HEALTH              19-0        
           
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          |Ayes:|Hayashi, Eng, Hernandez,  |Ayes:|Jones, Fletcher, Adams,    |
          |     |Nava,                     |     |Ammiano, Block, Carter,    |
          |     |John A. Perez, Price,     |     |Conway, De La Torre,       |
          |     |Ruskin                    |     |De Leon, Emmerson, Gaines, |
          |     |                          |     |Hall, Hayashi, Hernandez,  |
          |     |                          |     |Bonnie Lowenthal, Nava, V. |
          |     |                          |     |Manuel Perez, Salas,       |
          |     |                          |     |Audra Strickland           |
          |-----+--------------------------+-----+---------------------------|
          |     |                          |     |                           |
           ------------------------------------------------------------------ 
           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 licensed 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 physician examination that includes the complete  
            evaluation of medical history by, and written clearance for the  
            procedure from either of the following:

             a)   A licensed physician and surgeon; or, 

             b)   A licensed dentist who holds a permit to perform elective  
               facial cosmetic surgery.

          2)Prohibits a physician and surgeon from performing a cosmetic  
            surgery procedure on a patient unless prior to surgery the  
            patient has received a physical examination that includes the  
            complete evaluation of medical history and written clearance  
            for the procedure from any of the following:

             a)   The physician and surgeon who will be performing the  
               surgery;








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             b)   Another licensed physician and surgeon;

             c)   A certified nurse practitioner; or,

             d)   A licensed physician assistant.

          3)Specifies that a violation of these provisions is not a  
            misdemeanor.

          4)Defines cosmetic surgery as 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.

           FISCAL EFFECT  :   Unknown.  This bill is keyed non-fiscal.

           COMMENTS  :  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.  The author's office states that this bill comes from  
          the author's constituent, Yolanda Anderson, the winner of the  
          Assemblymember'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 pre-existing coronary  
          artery disease and multiple postoperative factors following  
          surgery.  

          A January 10, 2008, AP article stated, "According to the Los  
          Angeles County Coroner's official report, Donda West most likely  
          died of heart disease coupled with complications after plastic  
          surgery, but the exact cause of death can't be known.  Donda  
          West, 58, died November 10th at a Los Angeles-area hospital, a  
          day after she had breast reduction, tummy tuck and liposuction  








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          procedures.  A long autopsy report noted that West had coronary  
          artery disease, including blockages of 50% to 70% in two  
          arteries.  The 5-foot-2-inch, 188-pound woman also was overweight  
          and had developed several complications after surgery, including  
          bronchopneumonia in one lung, according to the report.

          "The investigation found 'therapeutic levels of medication' in  
          West's body but no unusually high levels and no internal  
          bleeding.  Dr. Louis A. Pe?a, a deputy medical examiner, stated  
          in the report, "It is my opinion Ms. West died from some  
          pre-existing coronary artery disease and multiple postoperative  
          factors following surgery.  A representative for Kanye West  
          declined to comment."

          "Studies have shown serious complications from plastic surgery  
          are rare, with death occurring in 1 in 58,810 procedures."

          According to a 2007 study by the American Society of Plastic  
          Surgeons, almost 12 million cosmetic plastic surgery procedures  
          were performed in 2007, a 7% increase from 2006 and a 59%  
          increase from 2000.  The study also found that the top five  
          surgical procedures were breast augmentation, liposuction, nose  
          reshaping, eyelid surgery and tummy tuck.  The study concludes  
          that, as with all surgical procedures, cosmetic surgery carries  
          with it certain risks-if performed poorly, it can be disfiguring  
          or life-threatening.

           
          Analysis Prepared by  :    Ross Warren / B. & P. / (916) 319-3301 

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