BILL ANALYSIS Ó
AB 1297
Page 1
Date of Hearing: April 16, 2013
ASSEMBLY COMMITTEE ON HEALTH
Richard Pan, Chair
AB 1297 (John A. Pérez) - As Amended: April 10, 2013
SUBJECT : Coroners: organ donation.
SUMMARY : Facilitates the sharing of information between
coroners and organ procurement organizations (OPOs) regarding
cases in which an anatomical gift may be available from a person
whose demise is imminent and that person's body will be subject
to a death investigation by the coroner post mortem.
Specifically, this bill :
1)Requires a county coroner, in cases in which the coroner has
been notified by an OPO that an anatomical gift might be
available or was made with respect to a decedent whose body
will be subject to a death investigation, to conduct the
investigation of the body or part in a manner and time period
compatible with the body or part's preservation for purposes
of the gift.
2)Permits an OPO to notify the coroner in cases when an
anatomical gift might be available or has been made by a
person whose death is imminent due to the lawful withdrawal of
medical treatment and that person's body, post mortem, will be
subject to a death investigation by the coroner.
3)Requires the coroner to accept the notification authorized in
2) above if such notification will facilitate the coroner's
ability to conduct a post mortem examination or investigation
of the body or part in a manner and time period compatible
with its preservation for purposes of the gift.
EXISTING LAW :
1)Establishes the Uniform Anatomical Gift Act (UAGA) to govern
organ and tissue donation in California and specify who may
make an anatomical gift, how to document a gift or refusal,
how to amend or revoke a gift, to whom a gift may be made, and
delivery of a gift.
2)Requires a coroner or medical examiner (ME) to assist in
implementation of the UAGA; cooperate with OPOs to maximize
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the opportunity to recover anatomical gifts for the purpose of
transplantation, therapy, research, or education; permit the
authorized and lawful removal and timely disposition of
donated organs and tissue from the bodies of deceased persons;
ensure anatomical gifts do not interfere with an autopsy or
investigation; and, enter into agreements with OPOs to
coordinate gift recovery procedures within that coroner's or
ME's jurisdiction or in cooperation with other coroners or MEs
throughout the state.
FISCAL EFFECT : This bill has not yet been analyzed by a fiscal
committee.
COMMENTS :
1)PURPOSE OF THIS BILL . According to the author, OPOs are often
made aware of cases where individuals have agreed upon their
death to make an anatomical gift. The author maintains that
UAGA authorizes OPOs to discuss information related to an
anatomical gift, but state law does not clearly allow coroners
to discuss information with OPOs about those individuals who
are on life support and who have agreed to make an anatomical
gift. The author states that this bill is intended to allow
this information to be shared in order to facilitate the
ability of the coroner to conduct a post mortem examination or
investigation in a manner and time frame compatible with the
body or part's preservation for purposes of the gift. The
author points out that time is of the essence when it comes to
organ transplants and when a donated organ is not recovered in
a timely manner, such as within four to six hours for a heart
or lung and between 12-24 hours for a liver or pancreas, its
chances of surviving long enough to serve a needy patient
diminish.
2)BACKGROUND . A county coroner/ME plays an important role in
the organ and tissue donation process. Since all unexpected
deaths require coroner/ME review, their cooperation and
support is vital for ensuring successful organ and tissue
donations to benefit thousands of transplant recipients each
year. OPOs collaborate with coroners/MEs in the referral and
evaluation of potential organ and tissue donors to broaden the
donation options for donor families, while preserving evidence
for death investigations to determine the cause and manner of
death. OPOs usually have a coroner liaison to work closely
and serve as a dedicated resource regarding donation with
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coroners and MEs. After the OPO staff determines organ and
tissue recovery will take place, the coroner/ME is notified
and clearance is obtained for transplantation to occur in
accordance with UAGA.
Currently, consultation between coroners/MEs and OPOs takes
place after a potential donor has died. However, in cases
where OPOs communicate information to coroners/MEs about the
gift wishes of a donor who is on life support prior to death,
coroners/MEs are currently prevented from doing anything more
than taking the information. This bill seeks to formalize the
communication between coroners/MEs and OPOs in cases where a
person who wishes to donate is facing imminent death and his
or her body after death would be subject to a death
investigation by the coroner/ME, such as a person who has been
taken off life support, in order to facilitate timely recovery
of the donated organs.
3)SUPPORT . The sponsor of this bill, Donate Life California
(DLC), writes in support that, in unique cases where
individuals have expressed their intent to donate, but they do
not technically fall under a coroner's jurisdiction yet, such
as persons on life support who have not yet died, there is a
very narrow time window between declaration of death and the
commencement of organ recovery by OPOs. DLC states that these
circumstances require the OPO to consult with the coroner/ME
prior to declaration of death since the body is deemed likely
to fall under the coroner's jurisdiction post mortem.
According to DLC, by formally addressing the relationship
between OPOs and coroners in these particular instances, this
bill would enshrine in statute and make uniform a practice
that is currently occurring to ensure all interested parties
are able to perform their responsibilities and honor the
donor's wish to save lives after he or she dies. The
California State Coroners' Association adds in support that
this bill set up a process between OPOs and coroners/MEs in
these particular cases to ensure that the donor's wish to save
lives after his or her death can be honored.
4)PRIOR LEGISLATION .
a) SB 1395 (Alquist), Chapter 217, Statutes of 2010,
authorizes establishment of an Altruistic Living Donor
Registry to promote and assist live kidney donations and
requires, by July 1, 2011, an applicant for an initial or
AB 1297
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renewal driver's license or identification card to
designate whether or not he or she wishes to become an
organ and tissue donor.
b) AB 1689 (Lieber), Chapter 629, Statutes of 2007, revises
UAGA, which regulates anatomical gifts and the disposition
of donated bodies and body parts.
c) AB 777 (Dutton), Chapter 309, Statutes of 2003, provides
procedures for removal of organs for transplant when
requested by an OPO in the case of an anatomical gift from
a decedent whose death requires an inquest by the
coroner/ME.
REGISTERED SUPPORT / OPPOSITION :
Support
Donate Life California (sponsor)
California State Coroners' Association
Opposition
None on file.
Analysis Prepared by : Cassie Royce / HEALTH / (916) 319-2097