BILL ANALYSIS
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|SENATE RULES COMMITTEE | AB 818|
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THIRD READING
Bill No: AB 818
Author: Hernandez (D)
Amended: 7/23/09 in Assembly
Vote: 21
SENATE HEALTH COMMITTEE : 10-1, 7/8/09
AYES: Alquist, Strickland, Cedillo, Cox, DeSaulnier, Leno,
Maldonado, Negrete McLeod, Pavley, Wolk
NOES: Aanestad
SENATE APPROPRIATIONS COMMITTEE : Senate Rule 28.8
ASSEMBLY FLOOR : 77-0, 5/21/09 - See last page for vote
SUBJECT : Health facilities: connection ports
SOURCE : Hospira, Inc.
DIGEST : This bill delays the January 1, 2011 date for
implementation of a prohibition against hospitals using
intravenous, epidural, and enteral feeding connection
devices that fit into connection ports other than the type
they are intended, as specified.
ANALYSIS : Existing law establishes various programs for
the prevention of disease and the promotion of the public
health under the administration of the State Department of
Public Health, including, but not limited to, a program for
the licensure and regulation of health facilities.
CONTINUED
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Existing law, to become operative January 1, 2011,
prohibits certain health facilities from using an
intravenous, epidural, or enteral feeding connection that
would fit into a connection port other than the type it was
intended for, unless an emergency or urgent situation
exists and the prohibition impairs the ability to provide
health care.
This bill, instead, for epidural connections, makes the
operative date of this prohibition 36 months after
prescribed standards are developed, or January 1, 2014,
whichever occurs first, and for intravenous and enteral
connections, makes the operative date 24 months after
prescribed standards are developed, or January 1, 2013,
whichever occurs first. The bill requires the Advanced
Medical Technology Association to report annually to the
Legislature on the progress of the development of those
standards. The bill requires measures to prevent adverse
effects be included in the health facility patient safety
plan, as prescribed.
Background
According to the FDA, hospitals and other health care
facilities depend on a variety of catheters, tubing and
syringes to deliver medications and other substances to
patients through vascular, enteral, respiratory, epidural
and intrathecal (spinal) delivery systems. These delivery
systems frequently employ fittings called Luer connectors
to link various system components. The male and female
components of Luer connectors join together to create
secure yet detachable leak-proof connections. Multiple
connections between medical devices and tubing are common
in patient care. Today, Luer connectors are used worldwide
to connect a variety of vascular, enteral, respiratory,
epidural, and intrathecal medical devices, components, and
accessories.
Unfortunately, the ubiquitous nature of the Luer connector
design allows for connection between unrelated delivery
systems (e.g., vascular, enteral, respiratory, epidural,
and intrathecal medical devices, components, and
accessories). Because Luer connectors are ubiquitous,
easy-to-use and compatible between different delivery
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systems, patient care staff can inadvertently connect wrong
systems together, causing medication or other fluids to be
delivered through the wrong route. Numerous such errors
have been documented, including many that have caused
serious patient injuries and deaths.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: No
SUPPORT : (Verified 8/19/09)
Hospira, Inc. (source)
Abbott Nutrition
Advanced Medical Technology Association
Baxter Healthcare
California Healthcare Institute
ARGUMENTS IN SUPPORT : Hospira, Inc. states that it is
important for standards for connectors to be in place to
allow the manufacture of low-cost, safe devices for
hospitals. Without standards, there is potential that
emergency health care providers could be faced with
multiple proprietary devices, for example, there is a
potential that the IV connector used by the ambulance will
not be the same as the one used by the emergency room. In
the meantime, important steps can be taken to mitigate the
risk of misconnections, including labeling catheters,
worker training on the importance of tracing lines to the
point of origin prior to making connections, and color
coding of tubing and connectors.
ASSEMBLY FLOOR :
AYES: Adams, Ammiano, Anderson, Arambula, Beall, Bill
Berryhill, Tom Berryhill, Blakeslee, Block, Blumenfield,
Brownley, Buchanan, Caballero, Charles Calderon, Carter,
Chesbro, Conway, Cook, Coto, Davis, De La Torre, De Leon,
DeVore, Duvall, Emmerson, Eng, Evans, Feuer, Fletcher,
Fong, Fuller, Furutani, Gaines, Galgiani, Garrick,
Gilmore, Hagman, Hall, Harkey, Hayashi, Hernandez, Hill,
Huber, Huffman, Jeffries, Jones, Knight, Krekorian, Lieu,
Logue, Bonnie Lowenthal, Ma, Mendoza, Miller, Monning,
Nestande, Niello, Nielsen, John A. Perez, V. Manuel
Perez, Portantino, Price, Ruskin, Salas, Silva, Skinner,
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Smyth, Solorio, Audra Strickland, Swanson, Torlakson,
Torres, Torrico, Tran, Villines, Yamada, Bass
NO VOTE RECORDED: Fuentes, Nava, Saldana
RJG:CTW:nl 8/19/09 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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