BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 818
                                                                  Page  1

          CONCURRENCE IN SENATE AMENDMENTS
          AB 818 (Hernandez)
          As Amended July 23, 2009
          Majority vote
           
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          |ASSEMBLY:  |77-0 |(May 21, 2009)  |SENATE: |35-1 |(August 31,    |
          |           |     |                |        |     |2009)          |
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           Original Committee Reference:    HEALTH

          SUMMARY  :  Delays the prohibition on a health facility using a  
          tubing connection that would fit into a connection port other  
          than the type for which it was intended until the earlier of  
          January 1, 2014 or 36 months after the International  
          Organization for Standardization (ISO) publishes a new  
          applicable design standard for epidural connections, and the  
          earlier of January 1, 2013, or 24 months after ISO publishes an  
          applicable design standard, for intravenous or enteral  
          connections.
           
          The Senate amendments  change the effective dates for the  
          prohibitions and require a health facility to include in its  
          patient safety plan measures to prevent adverse events  
          associated with tubing misconnections, until the prohibitions on  
          interchangeable tubing connections become operative. 
           
           EXISTING LAW  prohibits, beginning January 1, 2011, a health  
          facility from using an intravenous connection, epidural  
          connection, or enteral feeding connection that would fit into a  
          connection port other than the type for which it was intended. 
           
          AS PASSED BY THE ASSEMBLY  , this bill delayed until the earlier  
          of January 1, 2014 or 36 months after the publication of a new  
          applicable design standard by ISO, the prohibition on a health  
          facility using a tubing connection that would fit into a  
          connection port other than the type for which it was intended.

           FISCAL EFFECT  :  According to the Senate Appropriations  
          Committee, pursuant to Senate Rule 28.8, negligible state costs.

           COMMENTS :  According to the author, health facilities depend on  
          a variety of catheters, tubing, and syringes to deliver  
          medications and other substances to patients through vascular,  








                                                                  AB 818
                                                                  Page  2

          enteral, respiratory, epidural (outer part of the spinal canal),  
          and other delivery systems.  These delivery systems frequently  
          employ fittings to link various system components.  Thousands of  
          these connections are used in hospital environments in  
          California daily and are critical to the care of patients.  The  
          author states that changing an industry standard for very  
          commonly used enteral and epidural connections will not be  
          accomplished within the next two years, as required by SB 158  
          (Florez), Chapter 294, Statutes of 2008.  This bill provides  
          time for the industry to meet this important mandate through a  
          common design format, without which hospitals will have to  
          purchase proprietary products and accessories at high cost.  The  
          author also argues that without a common design format, each  
          hospital might use different equipment, leading to confusion and  
          possibly risking patient safety.  Finally, the author argues  
          this bill will give ISO and the federal Food and Drug  
          Administration (FDA) time to harmonize their efforts to create a  
          global standard, as well as give industry time to develop  
          manufacturing processes for the new products.   


          Analysis Prepared by  :    Allegra Kim / HEALTH / (916) 319-2097  
          FN: 0002404