BILL ANALYSIS Ó SB 1189 Page 1 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. SB 1189 Page 2 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. SB 1189 Page 3 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; SB 1189 Page 4 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; SB 1189 Page 5 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; SB 1189 Page 6 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).) SB 1189 Page 7 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 SB 1189 Page 8 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 SB 1189 Page 9 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 SB 1189 Page 10 Analysis Prepared by:Gregory Pagan / PUB. S. / (916) 319-3744