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 medical 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
begin delete person, first responder,end delete 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 approve authorized training providers and to establish and approve minimum standards for training and the use and administration of epinephrine auto-injectors. The bill would specify components to be included in the minimum training and requirements. begin delete Under the bill, theseend delete
provisions would not apply to a school district or county office of education, or its personnel, that provides and utilizes epinephrine auto-injectors to provide emergency medical care, as specified.
begin delete Thisend delete bill would provide that nothing in these provisions shall be construed to limit or restrict the ability of prehospital emergency medical care personnel to administer epinephrine, including the use of epinephrine auto-injectors, or to require additional training or certification, if the administration of epinephrine is part of their scope of practice.
The bill would authorize a pharmacy to dispense epinephrine auto-injectors to a prehospital emergency medical care
begin delete person, first responder,end delete 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 medical care
begin delete person, first responder,end delete or
lay rescuer who administers an epinephrine auto-injector, in good faith and not for compensation, to another person who appears to be experiencing anaphylaxis at the scene of an emergency situation 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, except as specified. begin delete 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, except as specified.end delete
(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
begin delete person, first responder,end delete or lay rescuer for the
6purpose of rendering emergency care in accordance with Section
71797.197a of 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 of
12the Health and Safety Code. 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
P4 1epinephrine auto-injector to another person in an emergency
2situation. The prescription shall specify that the dispensed
3epinephrine auto-injector is for
begin delete “EMSend delete Purposes Only”
4and that the named recipient is a “Section 1797.197a Responder.”
5A new prescription shall be written for any additional epinephrine
7(2) (A) The pharmacy shall label each
8dispensed with all of the following:
9(i) The name of the person to whom the prescription was issued.
10(ii) The designations “Section 1797.197a Responder” and
begin delete “EMSend delete
11 Purposes Only.”
12(iii) The dosage, use, and expiration date.
13(B) Each dispensed prescription shall include the manufacturer’s
14product information sheet for the epinephrine auto-injector.
15(b) The person described in subdivision (b) of
16of the Health and Safety Code receiving epinephrine auto-injectors
17pursuant to this section shall make and maintain a record for five
18years reflecting dates of receipt, use, and destruction of each
19auto-injector dispensed, the name of any person to whom
20epinephrine was administered using an auto-injector, and the
21circumstances and manner of destruction of any auto-injectors.
22(c) The epinephrine auto-injectors dispensed pursuant to this
23section may be used only for the purpose, and under the
24circumstances, 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
28definitions shall apply:
29(1) “Anaphylaxis” means a potentially life-threatening
30hypersensitivity or allergic reaction to a substance.
31(A) Symptoms of anaphylaxis may include shortness of breath,
32wheezing, difficulty breathing, difficulty talking or swallowing,
33hives, itching, swelling, shock, or asthma.
34(B) Causes of anaphylaxis may include, but are not limited to,
35insect stings or bites, foods, drugs, and other allergens, as well as
36idiopathic or exercise-induced anaphylaxis.
37(2) “Epinephrine auto-injector” means a disposable drug delivery
38system with a spring-activated concealed needle that is designed
39for emergency administration of epinephrine to provide rapid,
40convenient first aid for persons suffering from anaphylaxis.
P5 1(b) Any person described in subdivision (b) of Section
21797.197a of the Health and Safety Code who administers an
3epinephrine auto-injector, in good faith and not for compensation,
4to another person who appears to be experiencing anaphylaxis at
5the scene of an emergency situation is not liable for any civil
6damages resulting from his or her acts or omissions in
7administering the epinephrine auto-injector, if that person has
8complied with the requirements and standards of Section 1797.197a
9of the Health and Safety Code.
10(c) The protection specified in subdivision (b) shall not apply
11in a case of personal injury or wrongful death that results from the
12gross negligence or willful or wanton misconduct of the person
13who renders emergency care treatment by the use of an epinephrine
15(d) (1) In order to encourage training of persons described in
16subdivision (b) of Section 1797.197a of the Health and Safety
17Code in the emergency administration of epinephrine
18auto-injectors, and to encourage that emergency care, a local
19agency, entity of state or local government, or other public or
20private organization that sponsors, authorizes, supports, finances,
21or supervises the training of those persons, or develops standards
22in accordance with Section 1797.197a of the Health and Safety
23Code, including, but not limited to, the California Emergency
24Medical Services (EMS) Authority, the local emergency medical
25system agency, the county department of health, the State
26Department of Public Health, the American Academy of Allergy,
27Asthma & Immunology, the American Academy of Pediatrics, the
28American Heart Association, the American Red Cross, and the
29California Medical Association, shall not be liable for civil
30damages alleged to result from those training programs or
32(2) The protection specified in paragraph (1) shall not apply
33when it is alleged that the personal injury or wrongful death was
34proximately caused by an authorized training provider’s failure to
35meet the minimal statutory training requirements and standards
36established pursuant to subdivision (c) of Section 1797.197a of
37the Health and Safety Code, or it is alleged that the authorized
38training provider otherwise demonstrated gross negligence in the
39training or certification of an individual whose subsequent actions
40caused personal injury or wrongful death in the rendering of
P6 1emergency care treatment by the use of an epinephrine
4 Nothing in this section relieves a manufacturer, designer,
5developer, distributor, or supplier of an epinephrine auto-injector
6of liability under any other applicable law.
Section 1797.197a is added to the Health and Safety
8Code, to read:
(a) For purposes of this section, the following
10definitions shall apply:
11(1) “Anaphylaxis” means a potentially life-threatening
12hypersensitivity or allergic reaction to a substance.
13(A) Symptoms of anaphylaxis may include shortness of breath,
14wheezing, difficulty breathing, difficulty talking or swallowing,
15hives, itching, swelling, shock, or asthma.
16(B) Causes of anaphylaxis may include, but are not limited to,
17insect stings or bites, foods, drugs, and other allergens, as well as
18idiopathic or exercise-induced anaphylaxis.
19(2) “Epinephrine auto-injector” means a disposable drug delivery
20system with a spring-activated concealed needle that is designed
21for emergency administration of epinephrine to provide rapid,
22convenient first aid for persons suffering from anaphylaxis.
23(3) “First responder” means a police officer, firefighter, rescue
24worker, or any other person who provides emergency response,
25first aid care, or other medically related assistance either in the
26course of the person’s occupational duties or as a volunteer.
28 “Lay rescuer” means any person who has met the training
29standards and other requirements of this section but who is not
30otherwise licensed or certified to use an epinephrine auto-injector
31on another person.
33 “Prehospital emergency medical care person” has the same
34meaning as defined in paragraph (2) of subdivision (a) of Section
36(b) A prehospital emergency medical care
begin delete person, first lay rescuer may use an epinephrine
37responder, or aend delete
38auto-injector to render emergency care to another person if all of
39the following requirements are met:
P7 1(1) The epinephrine auto-injector is legally obtained by
2prescription from an authorized health care provider. An authorized
3health care provider may issue a prescription for an epinephrine
4auto-injector to a person described in this subdivision for the
5purpose of rendering emergency care to another person, upon
6presentation of current certification demonstrating that person is
7trained and qualified
begin delete pursuant to this sectionend delete to administer an
8epinephrine auto-injector as a prehospital emergency medical care
begin delete person, first responder,end delete or lay begin delete rescuerend delete.
11(2) The epinephrine auto-injector is used on another, with the
12 expressed or implied consent of that person, to
begin delete address the .
13conditions described in subparagraph (A) of paragraph (1) of
14subdivision (a)end delete
15(3) The epinephrine auto-injector is stored and maintained as
16directed by the manufacturer’s instructions for that product.
17(4) The person using the epinephrine auto-injector has
18successfully completed a course of training with an authorized
19training provider, as described in subdivision (c), and has current
20certification of training issued by the provider.
28(c) (1) The authorized training providers shall be approved,
29and the minimum standards for training and the use and
30administration of epinephrine auto-injectors pursuant to this section
31shall be established and approved, by the California Emergency
32Medical Services (EMS) Authority. The authority may designate
33existing training standards for the use and administration of
34epinephrine auto-injectors by
begin delete first responders andend delete prehospital
35emergency medical care personnel to satisfy the requirements of
37(2) The minimum training and requirements shall include all of
38the following components:
39(A) Techniques for recognizing circumstances, signs, and
40symptoms of anaphylaxis.
P8 1(B) Standards and procedures for proper storage and emergency
2use of epinephrine auto-injectors.
3(C) Emergency followup procedures, including activation of
4the Emergency Medical System, by calling the emergency
begin delete 911end delete telephone number or otherwise alerting and summoning
6more advanced medical personnel and services.
7(D) Compliance with all regulations governing the training,
8indications, use, and precautions concerning epinephrine
10(E) Written material covering the information required under
11this provision, including the manufacturer product information
12sheets on commonly available models of epinephrine auto-injectors.
13(F) Completion of a training course in
14resuscitation and the use of an automatic external defibrillator
15(AED) for infants, children, and adults that complies with
16regulations adopted by the EMS Authority and the standards of
17the American Heart Association or the American Red Cross, and
18a current certification for that training.
19(3) Training certification shall be valid for no more than two
20years, after which recertification with an authorized training
21provider is required.
27 This section shall not apply to a school district or county
28office of education, or its personnel, that provides and utilizes
29epinephrine auto-injectors to provide emergency medical aid
30pursuant to Section 49414 of the Education Code.
32 This section shall not be construed to limit or restrict the
33ability of prehospital emergency medical care personnel, under
34any other statute or regulation, to administer epinephrine, including
35the use of epinephrine auto-injectors, or to require additional
36training or certification beyond what is already required under the
37other statute or regulation.
No reimbursement is required by this act pursuant to
39Section 6 of Article XIII B of the California Constitution because
40the only costs that may be incurred by a local agency or school
P10 1district will be incurred because this act creates a new crime or
2infraction, eliminates a crime or infraction, or changes the penalty
3for a crime or infraction, within the meaning of Section 17556 of
4the Government Code, or changes the definition of a crime within
5the meaning of Section 6 of Article XIII B of the California