BILL ANALYSIS                                                                                                                                                                                                    Ó



          SENATE COMMITTEE ON PUBLIC SAFETY
                             Senator Loni Hancock, Chair
                                2015 - 2016  Regular 

          Bill No:    AB 2457       Hearing Date:    June 14, 2016    
          
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          |Author:    |Bloom                                                |
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          |Version:   |May 16, 2016                                         |
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          |Urgency:   |No                     |Fiscal:    |No               |
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          |Consultant:|JRD                                                  |
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                    Subject:  Autopsy:  Electronic Image Systems



          HISTORY

          Source:   Author

          Prior Legislation:SB 1196 (Runner) -- Chapter 45, Statutes of  
          2008

          Support:  California State Coroners' Association

          Opposition:None known

          Assembly Floor Vote:                 79 - 0


          PURPOSE

          The purpose of this bill is to allow coroners to use an  
          electronic imaging system during an autopsy, unless there is a  
          reasonable suspicion to believe the death was caused by a  
          criminal act, as specified.  

          Existing law requires coroners to determine the manner,  
          circumstances and cause of death in the following circumstances:

                 Violent, sudden or unusual deaths;








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                 Unattended deaths;
                 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;
                 When the death is related to known or suspected  
               self-induced or criminal abortion;
                 Known or suspected homicide, suicide or accidental  
               poisoning;
                 Deaths suspected as a result of an accident or injury  
               either old or recent;
                 Drowning, fire, hanging, gunshot, stabbing, cutting,  
               exposure, starvation, acute alcoholism, drug addiction,  
               strangulation, aspiration, or sudden infant death syndrome;
                 Deaths in whole or in part occasioned by criminal means;
                 Deaths associated with a known or alleged rape or crime  
               against nature;
                 Deaths in prison or while under sentence;
                 Deaths known or suspected as due to contagious disease  
               and constituting a public hazard;
                 Deaths from occupational diseases or occupational  
               hazards;
                 Deaths of patients in state mental hospitals operated by  
               the State Department of State Hospitals;
                 Deaths of patients in state hospitals serving the  
               developmentally disabled operated by the State Department  
               of Development Services;
                 Deaths where a reasonable ground exists to suspect the  
               death was caused by the criminal act of another; and
                 Deaths reported for inquiry by physicians and other  
               persons having knowledge of the death.  

          (Government Code § 27491.)

          Existing law requires the coroner or medical examiner to sign  
          the certificate of death when they perform a mandatory inquiry.   
          (Government Code § 27491(a).)

          Existing law allows the coroner or medical examiner discretion  
          when determining the extent of the inquiry required to determine  
          the manner, circumstances and cause of death.  (Government Code  
          § 27491(b).)

          Existing law requires the coroner or medical examiner to conduct  
          an autopsy at the request of the surviving spouse or other  









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          specified persons when an autopsy has not already been  
          performed.  (Government Code § 27520(a).)

          Existing law 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.  (Government Code § 27520(b).)

          Existing law specifies that the cost of autopsies requested by  
          the surviving spouse or other specified persons are borne by the  
          requestor.  (Government Code § 27520(c).)

          Existing law requires that discretionary autopsies include the  
          following:

                 All available finger and palm prints;
                 Dental examination;
                 Collection of tissue including hair sample and DNA  
               sample, if necessary;
                 Notation and photographs of significant marks, scars,  
               tattoos and personal effects;
                 Notation of observations pertinent to the time of death;  
               and
                 Documentation of the location of the remains.  

          (Government Code § 27521(a) and (b).)

          Existing law allows for the use of full body X-rays in  
          conducting a discretionary autopsy.  (Government Code § 27521  
          (c).)

          This bill, except as specified, would authorize a coroner,  
          medical examiner, or other agency required to perform an autopsy  
          in a death under those prescribed conditions to use an  
          electronic image system, including, but not limited to, an X-ray  
          computed tomography scanning system, to fulfill specified  
          postmortem examination or autopsy requirements. 

          This bill states that a coroner cannot use an electronic imaging  
          system to conduct an autopsy in any investigation where the  
          circumstances surrounding the death afford a reasonable basis to  
          suspect that the death was caused by or related to the criminal  
          act of another and it is necessary to collect evidence for  
          presentation in a court of law. If the results of an autopsy  









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          performed using electronic imaging provides the basis to suspect  
          that the death was caused by or related to the criminal act of  
          another, and it is necessary to collect evidence for  
          presentation in a court of law, then a dissection autopsy shall  
          be performed in order to determine the cause and manner of  
          death.
               
          The bill would allow an autopsy to be conducted using an X-ray  
          computed tomography scanning system without regard to the  
          existence of a properly-executed certificate of religious  
          belief.

                    RECEIVERSHIP/OVERCROWDING CRISIS AGGRAVATION

          For the past several years this Committee has scrutinized  
          legislation referred to its jurisdiction for any potential  
          impact on prison overcrowding.  Mindful of the United States  
          Supreme Court ruling and federal court orders relating to the  
          state's ability to provide a constitutional level of health care  
          to its inmate population and the related issue of prison  
          overcrowding, this Committee has applied its "ROCA" policy as a  
          content-neutral, provisional measure necessary to ensure that  
          the Legislature does not erode progress in reducing prison  
          overcrowding.   

          On February 10, 2014, the federal court ordered California to  
          reduce its in-state adult institution population to 137.5% of  
          design capacity by February 28, 2016, as follows:   

                 143% of design bed capacity by June 30, 2014;
                 141.5% of design bed capacity by February 28, 2015; and,
                 137.5% of design bed capacity by February 28, 2016. 

          In December of 2015 the administration reported that as "of  
          December 9, 2015, 112,510 inmates were housed in the State's 34  
          adult institutions, which amounts to 136.0% of design bed  
          capacity, and 5,264 inmates were housed in out-of-state  
          facilities.  The current population is 1,212 inmates below the  
          final court-ordered population benchmark of 137.5% of design bed  
          capacity, and has been under that benchmark since February  
          2015."  (Defendants' December 2015 Status Report in Response to  
          February 10, 2014 Order, 2:90-cv-00520 KJM DAD PC, 3-Judge  
          Court, Coleman v. Brown, Plata v. Brown (fn. omitted).)  One  
          year ago, 115,826 inmates were housed in the State's 34 adult  









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          institutions, which amounted to 140.0% of design bed capacity,  
          and 8,864 inmates were housed in out-of-state facilities.   
          (Defendants' December 2014 Status Report in Response to February  
          10, 2014 Order, 2:90-cv-00520 KJM DAD PC, 3-Judge Court, Coleman  
          v. Brown, Plata v. Brown (fn. omitted).)  
           
          While significant gains have been made in reducing the prison  
          population, the state must stabilize these advances and  
          demonstrate to the federal court that California has in place  
          the "durable solution" to prison overcrowding "consistently  
          demanded" by the court.  (Opinion Re: Order Granting in Part and  
          Denying in Part Defendants' Request For Extension of December  
          31, 2013 Deadline, NO. 2:90-cv-0520 LKK DAD (PC), 3-Judge Court,  
          Coleman v. Brown, Plata v. Brown (2-10-14).  The Committee's  
          consideration of bills that may impact the prison population  
          therefore will be informed by the following questions:

              Whether a proposal erodes a measure which has contributed  
               to reducing the prison population;
              Whether a proposal addresses a major area of public safety  
               or criminal activity for which there is no other  
               reasonable, appropriate remedy;
              Whether a proposal addresses a crime which is directly  
               dangerous to the physical safety of others for which there  
               is no other reasonably appropriate sanction; 
              Whether a proposal corrects a constitutional problem or  
               legislative drafting error; and
              Whether a proposal proposes penalties which are  
               proportionate, and cannot be achieved through any other  
               reasonably appropriate remedy.


          COMMENTS

          1.  Need for This Legislation

          According to the author: 

            Existing law requires coroners to perform post mortem  
            dissection in certain cases prescribed by law or in cases  
            where the autopsy on a decedent is requested by specified  
            relatives.  Current law also provides a coroner with certain  
            discretionary authority to perform an autopsy during a  
            postmortem examination.  The legislation would allow the  









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            coroner, if he/she deems it adequate, to perform digital  
            imaging in lieu of a full autopsy.

            In 2015, the Los Angeles County Board of Supervisors  
            authorized the purchase of a digital imaging device to be used  
            by the Los Angeles Medical Examiner-Coroner in cases where an  
            autopsy is needed or mandated by law.  

            A digital imaging device can be used in cases where, at the  
            request of the family of the deceased, the device be used  
            instead of an autopsy through dissection.  AB 2457 would  
            specify that digital imaging can be used, at the discretion of  
            the coroner or medical examiner, to perform an autopsy in  
            California.

            AB 2457 would add subsection (d) to Government Code 27521 to  
            authorize the use of an electronic imaging system, including,  
            but not limited to, an X-ray computed tomography scanning  
            system, to fulfill the requirements of a discretionary  
            postmortem examination.  

          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.  This  
          bill would not allow electronic imaging systems to be the sole  









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          method by which these mandatory autopsies are performed, but  
          would allow them to be used during these autopsies.  There are  
          two reasons for this:  (1) electronic imaging systems as a  
          method for performing autopsies have not been ruled admissible  
          as evidence by any court of law;<1> and (2) the current  
          electronic imaging system technology has been shown to be  
          unreliable in determining certain causes of death.

                                      -- END -





          















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          <1> 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.