BILL ANALYSIS Ó
AB 2457
Page 1
Date of Hearing: April 5, 2016
Consultant: Matt Dean
ASSEMBLY COMMITTEE ON PUBLIC SAFETY
Reginald Byron Jones-Sawyer, Sr., Chair
AB
2457 (Bloom) - As Introduced February 19, 2016
As Proposed to be Amended in Committee
SUMMARY: Allows coroners to use an electronic imaging system
during the conduct of an autopsy, unless there is a reasonable
suspicion to believe the death was caused by a criminal act or a
contagious disease. Specifically, this bill: allows coroners,
medical examiners and other authorized personnel to conduct an
autopsy or post-mortem examination to use an electronic imaging
system during the conduct of an autopsy or post-mortem
examination to either aid in the performance of an autopsy
pursuant to an inquest, or to fulfill the performance of an
autopsy requested by the surviving spouse or next of kin where
there is no suspicion a criminal act or contagious disease was
the cause of death.
EXISTING LAW:
1)Requires coroners to determine the manner, circumstances and
cause of death in the following circumstances:
a) Violent, sudden or unusual deaths;
b) Unattended deaths;
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c) When the deceased was not attended by a physician, or
registered nurse who is part of a hospice care
interdisciplinary team, in the 20 days before death;
d) When the death is related to known or suspected
self-induced or criminal abortion;
e) Known or suspected homicide, suicide or accidental
poisoning;
f) Deaths suspected as a result of an accident or injury
either old or recent;
g) Drowning, fire, hanging, gunshot, stabbing, cutting,
exposure, starvation, acute alcoholism, drug addiction,
strangulation, aspiration, or sudden infant death syndrome;
h) Deaths in whole or in part occasioned by criminal means;
i) Deaths associated with a known or alleged rape or crime
against nature;
j) Deaths in prison or while under sentence;
aa) Deaths known or suspected as due to contagious disease
and constituting a public hazard;
bb) Deaths from occupational diseases or occupational
hazards;
cc) Deaths of patients in state mental hospitals operated by
the State Department of State Hospitals;
dd) Deaths of patients in state hospitals serving the
developmentally disabled operated by the State Department
of Development Services;
ee) Deaths where a reasonable ground exists to suspect the
death was caused by the criminal act of another; and
ff) Deaths reported for inquiry by physicians and other
persons having knowledge of the death. (Gov. Code, §
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27491.)
2)Requires the coroner or medical examiner to sign the
certificate of death when they perform a mandatory inquiry.
(Gov. Code, § 27491, subd. (a).)
3)Allows the coroner or medical examiner discretion when
determining the extent of the inquiry required to determine
the manner, circumstances and cause of death. (Gov. Code, §
27491, subd. (b).)
4)Requires the coroner or medical examiner to conduct an autopsy
at the request of the surviving spouse or other specified
persons when an autopsy has not already been performed. (Gov.
Code, § 27520, subd. (a).)
5)Allows the coroner or medical examiner discretion to conduct
an autopsy at the request of the surviving spouse or other
specified persons when an autopsy has already been performed.
(Gov. Code, § 27520, subd. (b).)
6)Specifies that the cost of autopsies requested by the
surviving spouse or other specified persons are borne by the
requestor. (Gov. Code, § 27520, subd. (c).)
7)Requires that discretionary autopsies include the following:
a) All available finger and palm prints;
b) Dental examination;
c) Collection of tissue including hair sample and DNA
sample, if necessary;
d) Notation and photographs of significant marks, scars,
tattoos and personal effects;
e) Notation of observations pertinent to the time of death;
and
f) Documentation of the location of the remains. (Gov.
Code, § 27521, subds. (a) and (b).)
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8)Allows for the use of full body X-rays in conducting a
discretionary autopsy. (Gov. Code, § 27521, subd. (c).)
FISCAL EFFECT: Unknown
COMMENTS:
1)Author's Statement: According to the author, "AB 2457 is a
common sense approach that would specifically authorize county
coroners or county medical examiners to utilize digital
imaging technology when performing an autopsy in cases where
an autopsy is needed or mandated by law."
2)Electronic Imaging Systems for Autopsies: Electronic imaging
systems, such as computer tomography (CT), magnetic resonance
imaging (MRI) and X-ray computed tomography scanning, have
been used increasingly in recent years to assist coroners and
medical examiners performing autopsies. In certain cases,
these systems can help the coroner determine the cause of
death without performing a post-mortem dissection of the
deceased. This can be especially helpful in cases where the
deceased or the deceased's surviving spouse or next of kin
have religious objections to the post mortem dissections
common in traditional autopsies. This bill would allow
coroners and medical examiners to use these electronic imaging
systems during the performance of an autopsy requested by a
surviving spouse or next of kin.
This bill would also allow coroners, medical examiners and other
agencies tasked with performing an autopsy to utilize
electronic imaging systems to assist in the performance of a
mandatory inquest. Existing law requires coroners and others
to perform an autopsy when there is reason to believe the
death was caused by a criminal act, either by another or by
the deceased, and when the coroner or other agency tasked
believes a contagious disease constituting a public health
hazard may be the cause of death. This bill would not allow
electronic imaging systems to be the sole method by which
these mandatory autopsies are performed, but would allow them
to be used during these autopsies. There are two main reasons
for this: first, electronic imaging systems as a method for
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performing autopsies have not been ruled admissible as
evidence by any court of law; and second, the current
electronic imaging system technology has been shown to be
unreliable in determining certain causes of death.
3)Admissibility Concerns: Any evidence submitted before a court
of law must be deemed admissible. For scientific evidence and
expert testimony, the court will conduct either a Daubert or
Frye style hearing -depending on whether the case is before
federal or state court, respectively) to determine the
reliability of the particular type of evidence before the
court. (see Daubert v. Merrell Dow Pharms., Inc. (1993) 509
U.S. 579; People v. Leahy (1994) 8 Cal.4th 587.) To date,
no federal or California court has ruled on the admissibility
of autopsies performed using an electronic imaging system.
Without such a ruling, we cannot be sure that autopsies
performed using solely electronic imaging systems will be
admissible evidence. Given the importance of autopsies in
many criminal investigations and prosecutions, it would be
wise to wait until electronic imaging system technology
advances to the point where it would be admissible. In one
study, one in three autopsies performed using both electronic
imaging systems and traditional dissection autopsies resulted
in finding different causes of death.
< http://blogs.scientificamerican.com/observations/will-ct-scans
-and-mris-kill-the-autopsy/ > However, the study also found
that for certain causes of death, the electronic imaging
systems were sufficient. Allowing coroners to use electronic
imaging systems for the limited purposes herein described is a
good first step in advancing the utility of these promising
technologies.
4)Summary of Amendments: The amendments before the Committee
accomplish the mutual goals of allowing coroners, medical
examiners and other tasked with performing autopsies the
ability to use electronic imaging systems in an autopsy, while
maintaining the requirement that whenever there is any
suspicion the death was caused by a criminal act or contagious
disease, a dissection autopsy is used to determine the cause
of death. This will also achieve the goal of allowing people
of faith with religious objections to dissection to receive an
electronic imaging autopsy on request.
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5)Argument in Support: According to Agudath Israel of
California, "AB 2457 will allow the use of digital radiologic
technology in lieu of an autopsy by dissection. In many
coroners' cases, the use of digital radiologic technology is
more than adequate to establish a cause of death without the
performance of traditional autopsy by dissection. Coroner's
offices throughout the country are installing such technology
because it assists with completion of their caseloads in a
more cost-effective and efficient manner. This is not to say
that such technology replaces dissection autopsy, however, at
the discretion of the coroner, when such technology is
sufficient for their needs, it should be utilized.
"There are a number of situations in which some feel that
there may be a California state legal mandate for a physical
autopsy. This legislation would allow coroners, at their
discretion, to utilize digital radiology to fulfill their
responsibility. For the Jewish community as well as other
communities of faith, autopsies are generally prohibited with
certain exceptions. This bill would allow coroners who have
access to such radiologic technology to accommodate religious
concerns in cases where they see fit to do so."
6)Related Legislation:
a) SB 1189 (Pan), requires that the results of an autopsy
conducted by a coroner be subject to review by a licensed
surgeon who is duly qualified as a specialist in pathology.
If the coroner and pathologist disagree about a cause of
death, this bill would require that the cause of death be
subject to review by a separate qualified pathologist. This
bill would authorize a coroner who is a qualified
pathologist to review and approve his or her own autopsy.
SB 1189 is pending in the Senate Committee on Health.
b) AB 1737 (McCarty), requires each county to establish an
interagency child death review team to assist local
agencies in identifying and reviewing suspicious child
deaths and facilitating communication among persons who
perform autopsies and the various persons and agencies
involved in child abuse or neglect cases. AB 1737 is
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pending in the Assembly Committee on Local Government.
7)Prior Legislation:
a) SB 1196 (Runner), Chapter 45, Statutes of 2008, requires
coroners or medical examiners to perform an autopsy at the
request of the deceased's next of kin and requires coroners
or medical examiners to inquire into deaths when the
deceased was not attended to by a physician or registered
nurse in the 20 days prior to death.
REGISTERED SUPPORT / OPPOSITION:
Support
Agudath Israel of California
California State Coroners' Association
Opposition
None
Analysis Prepared
by: Matt Dean / PUB. S. / (916) 319-3744