BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 818
                                                                  Page  1

          Date of Hearing:   May 13, 2009

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                Kevin De Leon, Chair

                  AB 818 (Hernandez) - As Amended:  April 28, 2009  

          Policy Committee:                              Health Vote:19-0

          Urgency:     No                   State Mandated Local Program:  
          No     Reimbursable:              

           SUMMARY  

          This bill prohibits hospitals' use of non-standard medical  
          connections 36 months after the publication, or by January 1,  
          2014, whichever is earliest, of a new design standard per  
          requirements of the International Standards Organization (ISO).  
          In addition, this bill requires a medical supply trade  
          association to submit a report to the Legislature annually until  
          a new standard is required by ISO. 

           FISCAL EFFECT  

          1)No direct fiscal impact for hospitals to eventually comply  
            with the standardization of medical connections required by  
            this bill.

          2)Once adopted, significant savings to payers, including  
            Medi-Cal, Healthy Families and CalPERS, may accrue to the  
            extent the standardization of medical connections reduces  
            morbidity and mortality in in-patient settings. 

           COMMENTS  

          1)       Rationale  . This bill is sponsored by Hospira, a global  
            medical specialty supply company that manufactures some of the  
            technology addressed in this bill. This bill clarifies a  
            provision of AB 158 (Florez), Chapter 294, Statutes of 2008.  
            SB 158 required hospitals to change to a uniform connection  
            standard by 2011. This bill extends the deadline for this  
            requirement to allow the ISO to release standards. This bill  
            subjects acute care hospitals, skilled nursing facilities,  
            intermediate care facilities, and psychiatric hospitals to the  
            standardization requirements of this bill. Because patients in  
            psychiatric hospitals are most often administered medication  
            orally, the author may wish to remove these hospitals from  
            this bill. 





                                                                  AB 818
                                                                  Page  2

           
           3)Background  . This bill requires health facilities to conform to  
            a national standard for medical connections and ports.  
            Hospitals and medical providers depend on a variety of  
            catheters, tubing, and syringes to deliver medications and  
            other substances to patients. Medical equipment is used to  
            deliver medications to vascular, enteral, respiratory,  
            epidural (outer part of the spinal canal), and intrathecal  
            (spinal canal or fluid) delivery systems.  These delivery  
            systems frequently employ fittings called Luer connectors to  
            link various system components. Under current law,  
            misconnections between non-standard fittings have resulted in  
            medical errors such as a baby's feeding tube being placed in  
            the tracheotomy tube. The child died. This bill, once  
            implemented, will reduce such errors. 
           
          Analysis Prepared by  :    Mary Ader / APPR. / (916) 319-2081