BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                    SB 1189


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          Date of Hearing:  June 28, 2016


          Chief Counsel:     Gregory Pagan








                         ASSEMBLY COMMITTEE ON PUBLIC SAFETY


                       Reginald Byron Jones-Sawyer, Sr., Chair





          SB  
          1189 (Pan) - As Amended June 22, 2016





          SUMMARY:  Requires that a forensic autopsy, as defined, be  
          conducted by a licensed physician and surgeon.  Specifically,  
          this bill:  



          1)Provides that a forensic autopsy shall only be conducted by a  
            licensed physician and surgeon, and the results of a forensic  
            autopsy only be determined by a licensed physician and  
            surgeon.









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          2)Defines a "forensic autopsy" to mean an examination of a body  
            of a decedent to generate medical evidence for which the cause  
            and manner of death is determined.



          3)Defines "postmortem examination" to mean the external  
            examination of the body where no manner of death is  
            determined.



          4)States that the manner of death shall be determined by the  
            coroner or medical examiner of a county.  If a forensic  
            autopsy is conducted by a licensed physician and surgeon, the  
            coroner shall consult with the physician in determining the  
            cause of death.



          5)Provides that for health and safety purposes, all persons in  
            the autopsy suite shall be informed of the risks presented by  
            blood borne pathogens and that they should wear personal  
            protective equipment, as specified.



          6)States that only persons directly involved in the  
            investigation of the death of the decedent shall be allowed  
            into the autopsy suite.



          7)Provides that if an individual dies due to the involvement of  
            law enforcement activity, law enforcement directly involved  
            with the death of that individual shall not be involved with  
            any portion of the post mortem examination, nor allowed into  
            the autopsy suite during the performance of the autopsy.









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          8)States that at the discretion of the coroner and in  
            consultation with the licensed physician and surgeon  
            conducting the autopsy, individuals may be permitted in the  
            autopsy suite for educational and research purposes.



          9)Requires that any police reports, crime scene or other  
            information, videos, or laboratory test that are in the  
            possession of law enforcement and are related to a death that  
            is incident to law enforcement activity be made available to  
            the forensic pathologist prior to the completion of the  
            investigation of the death.



          10)States that the above autopsy protocol shall not be construed  
            to limit the practice of an autopsy for educational or  
            research purposes.



          11)Makes conforming changes to other provisions of law relating  
            to the conduct of an autopsy.





          EXISTING LAW:  



          1)Requires coroners to determine the manner, circumstances and  
            cause of death in the following circumstances:

             a)   Violent, sudden or unusual deaths;








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             b)   Unattended deaths;

             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;








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             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, §  
               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;








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             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).)

          8)Provides that a coroner shall within 24 hours, or a soon as  
            feasible thereafter, where the suspected cause of death is  
            sudden infant death syndrome, take possession of the body, and  
            make or cause to be made a postmortem examination or autopsy  
            thereon, and the detailed medical findings resulting from an  
            examination of the body or autopsy by an examining physician  
            must either be reduced to writing, or permanently preserved,  
            as specified.  (Gov. Code, § 27491.4, subd. (a).)

          9)Defines "sudden infant death syndrome" to mean the sudden  
            death of an infant that is unexpected by the history of the  
            infant and where a thorough postmortem fails to demonstrate an  
            adequate cause of death.  (Gov. Code, § 27491.49, subd. (a).)

          10)Requires that an autopsy conducted where it is suspected that  
            the cause of death is sudden infant death syndrome be  
            conducted pursuant to a standardized protocol developed by
          the SDPH.  The protocol shall be developed and approved by July  
            1, 1990.  (Gov. Code, § 27491.41 (d.).)

          11)Requires that all coroners, throughout the state, follow the  
            established protocol when conducting autopsies where the  
            suspected cause of death is sudden infant death syndrome, and  
            requires a coroner to state on the certificate of death that  
            sudden infant death syndrome  was the cause of death when the  
            findings are consistent with the definition of sudden infant   
            death syndrome.  (Gov. Code, § 27491.41 (e).)










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          FISCAL EFFECT:  Unknown





          COMMENTS:  



          1)Author's Statement:  According to author, "Autopsy reports are  
            valuable documents that should be accurate and unbiased.  
            Current law presents grey areas which could undermine public  
            confidence in autopsy findings by allowing non-medically  
            trained individuals, who are often elected or appointed, to  
            conduct the autopsies. Current law also allows law enforcement  
            involved with the death of the individual inside the autopsy  
            suite during the procedure which could create the appearance  
            of influence on the findings and create public distrust in our  
            criminal justice system. Not only do families deserve to know  
            what happened to their loved ones, but the public and juries  
            need to trust that they received accurate objective  
            information to make the correct verdict on a criminal case. SB  
            1189 is important to clarify and codify the best practices  
            taking place in an autopsy room to guarantee an objective and  
            trustworthy autopsy system."  

          2)Argument in Support:  The Union of American Physicians and  
            Dentists writes, "Elected officials lack the medical expertise  
            necessary to perform a postmortem examination to the same  
            degree as a forensic pathologist, and this bill seeks to add  
            further legitimacy and authority to death investigations in  
            coroner cases.  NAME writes that determining the cause and  
            manner of death should be performed by a medical professional  
            with the expertise to make those medical diagnoses. NAME  
            furthers states that MEs and forensic pathologists and deaths  
            in custody or associated with law enforcement personnel are  
            some of the most highly contentious deaths and can generate a  








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            tremendous amount of public interest, and all affected parties  
            must be able to trust that the professionals investigating  
            these deaths are free of undue influence from the law  
            enforcement personnel who may have been involved in that  
            individual's death. Consumer Attorneys of California writes  
            that it is a conflict of interest to allow the law enforcement  
            personnel, a potential defendant in a civil or criminal  
            action, to be allowed inside the autopsy room during the  
            performance of an autopsy."



          3)Argument in Opposition:  The California State Sheriffs'  
            Association (CSSA) writes, "Limiting law enforcement access to  
            an autopsy suite causes significant issues especially because  
            many autopsies are conducted because the death is potentially  
            the result of a criminal act. CSSA states that in such a case,  
            the body being examined is, and/or contains, evidence and the  
            presence of law enforcement is crucial to maintain care and  
            custody of that evidence.  CSSA contends that while a  
            physician generally determines the cause of death, the manner  
            of death is a determination often made by the coroner in  
            concert with other individuals, including the pathologist, and  
            the coroner's role in making this determination should not be  
            removed."


           


          REGISTERED SUPPORT / OPPOSITION:





          Support










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          California District Attorneys Association


          California Society of Pathologists


          College of American Pathologists


          Consumer Attorneys of California


          Medical Board of California


          National Association of Medical Examiners


          Union of American Physicians and Dentists


          Ventura County District Attorney's Office





          Opposition


          


          California State Coroners Association


          California State Sheriffs' Association









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          Analysis Prepared by:Gregory Pagan / PUB. S. / (916)  
          319-3744