SB 669, as amended, Huff. Emergency medical care: epinephrine auto-injectors.
(1) Existing law authorizes a school district or county office of education to provide emergency epinephrine auto-injectors to trained personnel, and authorizes that trained personnel to utilize those epinephrine auto-injectors to provide emergency medical aid to persons suffering from an anaphylactic reaction. The Pharmacy Law authorizes a pharmacy to furnish epinephrine auto-injectors to a school district or county office of education if certain conditions are met. A violation of the Pharmacy Law is a crime.
Existing law requires the Emergency Medical Services Authority to establish training and standards for all prehospital emergency care personnel regarding the characteristics and method of assessment and treatment of anaphylactic reactions and the use of epinephrine, and to promulgate regulations therefor.
This bill would authorize a prehospital emergency medical care person, first responder, or lay rescuer to use an epinephrine auto-injector to render emergency care to another person, as specified. The bill would require the California Emergency Medical Services (EMS) Authority to establish or approve authorized training providers and minimum standards for training and the use and administration of epinephrine auto-injectors, in consultation with
begin delete theend delete local emergency medical begin delete system agency, theend delete county health department, begin delete the manufacturerend delete, the State Department of Health begin delete Care Servicesend delete, and other private organizations. The bill would specify components to be included in the minimum training and requirements. begin delete The billend delete would begin delete provide that these minimum standardsend delete apply to a school district or county office of begin delete education for the emergency administration ofend delete epinephrine begin delete auto-injectors, but would permit the adoption of more stringent standardsend delete.
The bill would authorize a pharmacy to dispense epinephrine auto-injectors to a prehospital emergency medical care person, first responder, or lay rescuer for the purpose of rendering emergency care in accordance with these provisions. Because a violation of this requirement would be a crime, the bill would impose a state-mandated local program.
(2) Under existing law, everyone is generally responsible, not only for the result of his or her willful acts, but also for an injury occasioned to another by his or her want of ordinary care or skill in the management of his or her property or person, except so far as the latter has, willfully or by want of ordinary care, brought the injury upon himself or herself.
This bill would provide that a prehospital emergency care person, first responder, or lay rescuer who administers an epinephrine auto-injector to another person who appears to be experiencing anaphylaxis at the scene of an emergency situation, in good faith and not for compensation, is not liable for any civil damages resulting from his or her acts or omissions in administering the epinephrine auto-injector, if that person has complied with specified certification and training requirements and standards. The bill also would provide immunity to a local agency, entity of state or local government, or other public or private organization that sponsors, authorizes, supports, finances, or supervises the training of those persons, or develops standards, for civil damages alleged to result from those training programs or standards.
(3) The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that no reimbursement is required by this act for a specified reason.
Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: yes.
The people of the State of California do enact as follows:
Section 4119.3 is added to the Business and
2Professions Code, to read:
(a) Notwithstanding any other law, a pharmacy may
4dispense epinephrine auto-injectors to a prehospital emergency
5 care person, first responder, or lay rescuer for the purpose
6of rendering emergency care in accordance with Section 1797.197a
7of the Health and Safety Code, if both of the following
8requirements are met:
9(1) A physician and surgeon provides a written order that
10specifies the quantity of epinephrine auto-injectors to be dispensed
11to a person described in subdivision (b) of Section 1797.197a. The physician and surgeon may issue
13the prescription only upon presentation of a current certificate
14demonstrating that the person is trained and qualified under Section
151797.197a of the Health and Safety Code to administer an
16epinephrine auto-injector to another person in an emergency
17situation. The prescription shall specify that the dispensed
18epinephrine auto-injector is for “EMS Purposes Only” and that
19the named recipient is a “Section 1797.197a Responder.” A new
20prescription shall be written for any additional epinephrine
22(2) (A) The pharmacy shall label each epinephrine auto-injector
23dispensed with all of the following:
24(i) The name of the person to whom the prescription was issued.
designations “Section 1797.197a Responder” and “EMS
27(iii) The dosage, use, and expiration date.
P4 1(B) Each dispensed prescription shall include the manufacturer’s
2product information sheet for the epinephrine auto-injector.
3(b) The person described in subdivision (b) of Section 1797.197a
4of the Health and Safety Code receiving epinephrine auto-injectors
5pursuant to this section shall make and maintain a record for five
6years reflecting dates of receipt, use, and destruction of each
7auto-injector dispensed, the name of any person to whom
8epinephrine was administered using an auto-injector, and the
9circumstances and manner of destruction of any auto-injectors.
10(c) The epinephrine auto-injectors dispensed pursuant to this
11section may be used only for the purpose, and under the
12circumstances, described in Section 1797.197a of the Health and
Section 1714.23 is added to the Civil Code, to read:
(a) For purposes of this section, the following
16definitions shall apply:
17(1) “Anaphylaxis” means a potentially life-threatening
18hypersensitivity or allergic reaction to a substance.
19(A) Symptoms of anaphylaxis may include shortness of breath,
20wheezing, difficulty breathing, difficulty talking or swallowing,
21hives, itching, swelling, shock, or asthma.
22(B) Causes of anaphylaxis may include, but are not limited to,
23insect stings or bites, foods, drugs, and other allergens, as well as
24idiopathic or exercise-induced anaphylaxis.
auto-injector” means a disposable drug delivery
26system with a spring-activated concealed needle that is designed
27for emergency administration of epinephrine to provide rapid,
28convenient first aid for persons suffering from anaphylaxis.
29(b) Any person described in subdivision (b) of Section
301797.197a of the Health and Safety Code who administers an
31epinephrine auto-injector to another person who appears to be
32experiencing anaphylaxis at the scene of an emergency situation,
33in good faith and not for compensation, is not liable for any civil
34damages resulting from his or her acts or omissions in
35administering the epinephrine auto-injector, if that person has
36complied with the requirements and standards of Section 1797.197a
37of the Health and Safety Code.
38(c) This section does not grant immunity from civil damages to
39any person whose conduct in rendering emergency care constitutes
40 gross negligence.
P5 1(d) In order to encourage training of persons described in
2subdivision (b) of Section 1797.197a of the Health and Safety
3Code in the emergency administration of epinephrine
4auto-injectors, and to encourage that emergency care, a local
5agency, entity of state or local government, or other public or
6private organization that sponsors, authorizes, supports, finances,
7or supervises the training of those persons, or develops standards
8in accordance with Section 1797.197a of the Health and Safety
9Code, including, but not limited to, the California Emergency
10Medical Services (EMS) Authority, the local emergency medical
11system agency, the county department of health, the State
12Department of Health Care Services, the American Academy of
13Allergy, Asthma & Immunology, the American Academy of
14Pediatrics, the American Heart Association, the American Red
15Cross, and the California Medical Association, shall not be liable
16for civil damages alleged to result from those training programs
18(e) Nothing in this section relieves a manufacturer, designer,
19developer, distributor, or supplier of an epinephrine auto-injector
20of liability under any other applicable law.
Section 1797.197a is added to the Health and Safety
22Code, to read:
(a) For purposes of this section, the following
24definitions shall apply:
25(1) “Anaphylaxis” means a potentially life-threatening
26hypersensitivity or allergic reaction to a substance.
27(A) Symptoms of anaphylaxis may include shortness of breath,
28wheezing, difficulty breathing, difficulty talking or swallowing,
29hives, itching, swelling, shock, or asthma.
30(B) Causes of anaphylaxis may include, but are not limited to,
31insect stings or bites, foods, drugs, and other allergens, as well as
32idiopathic or exercise-induced anaphylaxis.
auto-injector” means a disposable drug delivery
34system with a spring-activated concealed needle that is designed
35for emergency administration of epinephrine to provide rapid,
36convenient first aid for persons suffering from anaphylaxis.
37(3) “First responder” means a police officer, firefighter, rescue
38worker, or any other person who provides emergency response,
39first aid care, or other medically related assistance either in the
40course of the person’s occupational duties or as a volunteer.
P6 1(4) “Lay rescuer” means any person not otherwise licensed or
2certified to use an epinephrine auto-injector on another who has
3met the training standards and other requirements of this section.
4(5) “Prehospital emergency medical care person” has the same
5meaning as defined in paragraph (2) of subdivision (a) of Section
7(b) A prehospital emergency medical care person, first
8responder, or a lay rescuer may use an epinephrine auto-injector
9to render emergency care to another person if all of the following
10requirements are met:
11(1) The epinephrine auto-injector is legally obtained by
12prescription from an authorized health care provider. An authorized
13health care provider may issue a prescription for an epinephrine
14auto-injector to a person described in this subdivision for the
15purpose of rendering emergency care to another person, upon
16presentation of current certification demonstrating that person is
17trained and qualified pursuant to this section to administer an
18epinephrine auto-injector as a prehospital emergency medical care
19person, first responder, or lay rescuer.
20(2) The epinephrine auto-injector is used on another, with the
21 expressed or implied consent of that person, for the indicated
22purpose described in paragraphs (1) and (2) of subdivision (a).
23(3) The epinephrine auto-injector is stored and maintained as
24directed by the manufacturer’s instructions for that product.
25(4) The person using the auto-injector has
26successfully completed a course of training with an authorized
27training provider, as described in subdivision (c), and has current
28certification of training issued by the provider.
29(c) (1) The authorized training providers and minimum
30standards for training and the use and administration of epinephrine
31auto-injectors pursuant to this section shall be established and
32approved by the California Emergency Medical Services (EMS)
33Authority in consultation with
begin delete theend delete local
begin delete systemend delete agency, begin delete theend delete
county health department, manufacturers, the State
begin delete Health Care Services,end delete the American
37Academy of Allergy, Asthma & Immunology, the American
38Academy of Pediatrics, the American Heart Association, the
39American Red Cross, and the California Medical Association.
P7 1(2) The minimum training and requirements shall include all of
2the following components:
3(A) Techniques for recognizing circumstances, signs, and
4symptoms of anaphylaxis.
5(B) Standards and procedures for proper storage and emergency
6use of epinephrine auto-injectors.
7(C) Emergency followup procedures, including activation of
8the Emergency Medical System, by calling the emergency 911
9telephone number or otherwise alerting and summoning more
10advanced medical personnel and services.
11(D) Compliance with all regulations governing the training,
12indications, use, and precautions concerning epinephrine
14(E) Written material covering the information required under
15this provision, including the manufacturer product information
16sheets on commonly available models of epinephrine auto-injectors.
17(F) Completion of a training course in cardiopulmonary
18resuscitation and the use of an automatic external defibrillator
19(AED) for infants, children, and adults that complies with
20regulations adopted by the EMS Authority and the standards of
21the American Heart Association or the American Red Cross, and
22a current certification for that training.
23(G) Training certification for no more than two years, after
24which recertification with an authorized training provider is
26(3) The minimum standards established and approved pursuant
27to this subdivision apply to a school district or county office of
28education, which may adopt more stringent standards for training
29and the use and emergency administration of epinephrine
30auto-injectors pursuant to Section 49414 of the Education Code.
No reimbursement is required by this act pursuant to
4Section 6 of Article XIII B of the California Constitution because
5the only costs that may be incurred by a local agency or school
6district will be incurred because this act creates a new crime or
7infraction, eliminates a crime or infraction, or changes the penalty
8for a crime or infraction, within the meaning of Section 17556 of
9the Government Code, or changes the definition of a crime within
10the meaning of Section 6 of Article XIII B of the California