BILL ANALYSIS                                                                                                                                                                                                    







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        |Hearing Date:March 22, 2010        |Bill No:SB                         |
        |                                   |953                                |
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                      SENATE COMMITTEE ON BUSINESS, PROFESSIONS 
                               AND ECONOMIC DEVELOPMENT
                         Senator Gloria Negrete McLeod, Chair

                         Bill No:        SB 953Author:Walters
                     As Amended:March 16, 2010          Fiscal: No
        
        SUBJECT:  Podiatrists:  liability for emergency services. 
        
        SUMMARY:  Removes reference to a deleted provision which would limit  
        the care provided by a podiatrist in an emergency situation.  States  
        legislative intent that nothing in this bill is intended, nor shall it  
        be interpreted to enlarge, reduce, or otherwise modify the scope of  
        practice of doctors of podiatric medicine, as specified, and is  
        intended to delete a reference to an obsolete provision of law.

        Existing law:
        
        1) Establishes the Medical Practice Act to govern the licensure and  
           regulation of physicians and surgeons by the Medical Board of  
           California, and for the licensure and regulation of podiatrists by  
           the California Board of Podiatric Medicine (Board).

        2) Exempts the following medical emergency care from liability:

           a)   A physician and surgeon, who in good faith renders emergency  
             care at the scene of an emergency, shall not be liable for any  
             civil damages as a result of any acts or omissions by such person  
             in rendering the emergency care.  Defines the scene of an  
             emergency to include, but not be limited to, the emergency room  
             of hospitals in the event of a medical disaster.

           b)   A physician and surgeon who serves on an on-call basis to a  
             hospital emergency room, who in good faith renders emergency  
             obstetrical services to a person while serving on call shall not  
             be liable for civil damages for any negligent act or omission in  
             rendering the emergency obstetrical services.

           c)   A physician and surgeon, who in good faith upon request of  





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             another person so licensed, renders emergency medical care to a  
             person for medical complication arising from prior care by  
             another person so licensed, shall not be liable for any civil  
             damages as a result of any acts or omissions by such licensed  
             person in rendering such emergency medical care.

           d)   A physician and surgeon shall not be liable for civil damages  
             for injury or death caused in an emergency situation occurring in  
             the licensee's office or in a hospital on account of a failure to  
             inform a patient of the possible consequences of a medical  
             procedure where the failure to inform is caused by any of the  
             following:  1) the patient was unconscious; 2) the medical  
             procedure was undertaken without the patient's consent because  
             the licensee reasonably believes that a medical procedure should  
             be undertaken immediately, as specified; 3) a medical procedure  
             was performed on a person legally incapable of giving consent,  
             and the licensee reasonably believed that a medical procedure  
             should be undertaken immediately.  Specifies that these  
             provisions apply only to actions for damages for injuries or  
             death arising because of a licensee's failure to inform, and not  
             to actions for damages arising because of a licensee's negligence  
             in rendering or failing to render treatment.

        3) States that nothing in the article containing the provisions  
           specified in item # 2) above, shall be construed to authorize  
           practice by a podiatrist beyond that set forth in the provisions  
           detailing its scope of practice.

        4) Defines podiatric medicine as the diagnosis, medical, surgical,  
           mechanical, manipulative, and electrical treatment of the human  
           foot, including the ankle and tendons that insert into the foot and  
           the nonsurgical treatment of the muscles and tendons of the leg  
           governing the functions of the foot.  Specifies the type of  
           services that a doctor of podiatric medicine who is ankle certified  
           by the Board on and after January 1, 1984, may perform.

        5) Provides that nurses, licensed vocational nurses, and physician  
           assistants who in good faith render emergency care at the scene of  
           an emergency which occurs outside the place and course of their  
           employment are not liable for civil damages as the result of the  
           acts or omissions in rendering that care.  Provides that no  
           immunity exists for acts that constitute gross negligence.

        6) Provides that a veterinarian who on his or her own initiative, at  
           the request of an owner, or at the request of someone other than  
           the owner, renders emergency treatment to a sick or injured animal  





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           at the scene of an accident shall not be liable in damages to the  
           owner of that animal in the absence of gross negligence.

        7) Provides that no disaster service worker who is performing disaster  
           services ordered by lawful authority during a state of war  
           emergency, a state of emergency, or a local emergency, as defined,  
           shall be liable for civil damage on account of personal injury to  
           or death of any person or damage to property resulting from any act  
           or omission while performing disaster services, unless the act or  
           omission is willful.

        8) States that no person who in good faith, and not for compensation,  
           renders emergency medical or nonmedical care at the scene of an  
           emergency shall be liable for any civil damages resulting from any  
           act or omission.  States that the scene of emergency does not  
           include emergency department and other places where medical care is  
           usually offered, and that this provision applies only to medical,  
           law enforcement, and emergency personnel, as specified.

        9) Provides that any person, other than medical, law enforcement, and  
           emergency personnel, who in good faith and not for compensation  
           renders emergency medical or nonmedical care or assistance at the  
           scene of an emergency shall not be liable for civil damages  
           resulting from any act or omission other than an act or omission  
           constituting gross negligence or willful or wanton misconduct.

        10)Specifies the intent of the Legislature to encourage other  
           individuals to volunteer, without compensation, to assist others in  
           need during an emergency, while ensuring that those volunteers who  
           provide care or assistance act responsibly.

        This bill, removes reference to a deleted provision which would limit  
        the care provided by a podiatrist in an emergency situation.  States  
        legislative intent that nothing in this bill is intended, nor shall it  
        be interpreted to enlarge, reduce, or otherwise modify the scope of  
        practice of doctors of podiatric medicine, as specified, and is  
        intended to delete a reference to an obsolete provision of law.

        FISCAL EFFECT:  None.  This bill has been keyed non-fiscal by  
        Legislative Counsel.

        COMMENTS:
        
        1. Purpose.  According to the Sponsor of this measure, the  California  
           Board of Podiatric Medicine  (Board), this measure is necessary to  
           delete limitations on the ability of podiatrists to provide care in  





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           an emergency situation.  The Board points out that doctors of  
           podiatric medicine (DPMs) are the only licensed health  
           professionals prohibited from assisting beyond their normal scope  
           of practice during a medical emergency.  The Board states that  
           there is no basis for excluding one of the more highly trained  
           provider groups and this could cost the lives of Californians,  
           unnecessarily, in the event of a disaster.  The Board further  
           indicates that no other state is known to restrict DPMs in the  
           event of medical disasters.

        The Board points out that the Governor's Office initiated a healthcare  
           surge project coordinated by the Department of Public Health.   
           Health licensing boards were encouraged to identify and correct  
           barriers to the provision of assistance during an emergency and to  
           prepare their licensees to be ready.  A medical disaster might  
           significantly impact the number of available providers just when  
           caseloads could skyrocket.  Good Samaritan statutes are intended to  
           allow health professionals to assist beyond their normal scope of  
           practice during an emergency.  Currently, there are over 2,000  
           highly-trained DPMs who could provide necessary care in an  
           emergency.

        2. Background.  Good Samaritan statutes are laws which protect from  
           liability those individuals who choose to aid others who are  
           injured or ill.  The Business and Professions Code contains several  
           provisions limiting the civil liability, except in cases of gross  
           negligence, of certain health care practitioners including nurses,  
           licensed vocational nurses, and physician assistants who in good  
           faith render emergency care at the scene of an emergency which  
           occurs outside the place and course of their employment.   
           Similarly, the Medical Practice Act contains exemptions from  
           liability for physicians and surgeons under certain circumstances,  
           as described above in item #2) of existing law.  These provisions  
           were adopted to encourage these professionals to render care during  
           an emergency.

        Similarly, Health and Safety Code Section 1799.102, amended by  AB 83   
           (Feuer, Chapter 77, Statutes of 2009) provides that no person who  
           in good faith, and not for compensation, renders emergency  medical   
            or   nonmedical  care at the scene of an emergency shall be liable for  
           any civil damages resulting from any act or omission.  AB 83  
           amended Health and Safety Code Section 1799.102 in response to a  
           California Supreme Court decision in Van Horn v. Watson (2008) 45  
           Ca.4th 322, which limited the application of the immunity from  
           civil liability only for those individuals who render emergency  
           medical care.





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        According to the Board, current limitations on DPMs to provide care  
           during an emergency were enacted in 1980, when DPMs were viewed to  
           be less trained and less competent that medical doctors, and were  
           added without question or debate.  The Board points out that these  
           limitations are now without merit and with the current emphasis on  
           emergency preparedness, it is necessary to remove barriers for one  
           of the more highly-trained medical professionals in the state.

        3. Related Legislation this Session.   SB 1489  (Committee on Business,  
           Professions & Economic Development), an omnibus bill, mirrors the  
           provisions of this bill.  However, 
        SB 1489 will be amended to remove the duplicate provision.  SB 1489 is  
           currently awaiting hearing in this Committee. 

        
         NOTE  :  Double-referral to Judiciary Committee (second.)
        

        SUPPORT AND OPPOSITION:
        
         Support:  California Board of Podiatric Medicine (Sponsor)

         Opposition:  None on file as of March 31, 2010



        Consultant:Rosielyn Pulmano