BILL ANALYSIS Ó
SENATE COMMITTEE ON HEALTH
Senator Ed Hernandez, O.D., Chair
BILL NO: AB 1297
AUTHOR: John A. Pérez
AMENDED: June 4, 2013
HEARING DATE: June 12, 2013
CONSULTANT: Robinson-Taylor
SUBJECT : Coroners: organ donation.
SUMMARY : Authorizes information sharing between coroners and
organ procurement organizations regarding cases in which an
organ or tissue donation may be available from a person whose
death is imminent, when specified circumstances are present.
Existing law:
1.Establishes the Uniform Anatomical Gift Act (UAGA) to govern
organ and tissue donation in California and specifies 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 organ procurement
organizations (OPOs) to maximize 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.
This bill:
1.Authorizes an OPO to notify a coroner, prior to the donor's
death, of an organ or tissue donation, and requires a coroner
to accept the notification, if the notification will
facilitate the coroner's ability to conduct a post-mortem
examination or investigation of the body in a manner and
within a time period compatible with its preservation for the
purposes of the gift under the following circumstances:
a. When an organ or tissue donation might be
available or has been made by a person whose death is
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imminent due to the lawful withdrawal of medical
treatment; and,
b. If the body, post-mortem, will be subject to
the coroner's jurisdiction.
FISCAL EFFECT : According to the Assembly Appropriations
Committee analysis, this bill will result in negligible state
costs.
PRIOR VOTES :
Assembly Health: 19- 0
Assembly Appropriations:17- 0
Assembly Floor: 75- 0
COMMENTS :
1.Author's statement. OPOs are often made aware of cases where
a person has agreed upon their death to make an organ or
tissue donation. The UAGA authorizes OPOs to discuss
information related to the donation. California law, however,
does not clearly allow coroners to discuss information with
OPOs about those individuals who are not yet deceased who have
agreed to make an organ or tissue donation.
This bill would allow information to be shared, prior to the
donor's death, facilitating the ability of the coroner to
conduct a post-mortem examination or investigation in a manner
and time frame compatible with its preservation for purposes
of the donation.
2.Organ Donation Process. According to Donate Life California
(DLC), most organ donors are accident victims who have
suffered severe and eventually fatal injuries - often a severe
head injury. After arriving at the scene of such an accident,
emergency medical personnel immediately begin life-saving
procedures while the patient is transported to a hospital
where every effort is made to save the patient's life.
Once a patient is determined brain dead by two different
doctors, the hospital must refer the patient to the local OPO.
An OPO is a non-profit organization that is responsible for
the evaluation and procurement of deceased-donor organs for
organ transplantation. The individual OPOs represent the
front-line of organ procurement. There are currently four
OPOs that have been designated in California (California
Transplant Donor network, Golden State Donor Services,
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LifeSharing, and OneLegacy).
The OPO conducts an evaluation to determine if organ donation is
an option. If the patient is eligible to donate, the OPO will
speak to the family. Once consent is granted, the OPO works
with the DLC Registry to identify the best candidates for the
available organs and coordinates with the surgical team for
each organ recipient.
3.Coroner/ME's Role. 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 serve as a
dedicated resource regarding donation, and who works closely
with 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 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.
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
renewal driver's license or identification card to
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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.
5.Support. DLC, the sponsors of this legislation, and the
California State Coroner's Association (CSCA) write in support
that this bill recognizes and clarifies in UAGA the
relationship between OPOs and the coroners in what is known as
"imminent" coroner jurisdiction cases. These cases relate to
those individuals who have expressed their intent to donate,
but who do not technically fall under the coroner's
jurisdiction quite yet. DLC and CSCA state what makes these
cases unique is that there is a very narrow time window
between declaration of death and the commencement of organ
recovery by the OPOs. These circumstances require the OPO to
consult with the coroner prior to declaration of death in
cases where the body is deemed likely to fall under the
coroner's jurisdiction post mortem. DLC and CSCA maintain
this bill will 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.
SUPPORT AND OPPOSITION :
Support: Donate Life California (sponsor)
California State Coroners' Association
Oppose: None received.
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