BILL ANALYSIS
SENATE JUDICIARY COMMITTEE
Senator Ellen M. Corbett, Chair
2009-2010 Regular Session
SB 953 (Walters)
As Amended March 16, 2010
Hearing Date: May 4, 2010
Fiscal: No
Urgency: No
SK:jd
SUBJECT
Podiatrists: Liability for Emergency Services
DESCRIPTION
This bill, sponsored by the California Board of Podiatric
Medicine, would delete a reference to an obsolete provision of
law and would state legislative intent that nothing in the bill
is intended to enlarge, reduce, or otherwise modify the scope of
practice of podiatrists.
BACKGROUND
Podiatrists treat the human foot, including the ankle and
muscles and tendons of the leg governing the functions of the
foot. In order to become certified to practice podiatric
medicine, candidates must complete four years of undergraduate
education, graduate from one of seven approved colleges of
podiatric medicine, and complete at least two years of
postgraduate podiatric medical and surgical training.
In addition to performing foot and ankle surgeries, podiatrists
are also licensed to perform surgical procedures, under the
direct supervision of a physician as an assistant at surgery,
that are otherwise beyond the scope of practice of a podiatrist.
A podiatrist may not, however, function as a primary surgeon
for any procedure beyond his or her scope of practice.
Existing law provides immunity from liability for a podiatrist
who, in good faith, renders emergency care at the scene of an
emergency, except for willful acts or omissions. Existing law
also provides immunity for a podiatrist who fails to inform a
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patient of the possible consequences of a medical procedure, as
specified. This bill would delete a reference to an obsolete
provision of law and would state legislative intent that nothing
in the bill is intended to enlarge, reduce, or otherwise modify
the scope of practice of podiatrists.
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CHANGES TO EXISTING LAW
Existing law defines the scope of "podiatric medicine" as the
diagnosis, medical, surgical, mechanical, manipulative, and
electrical treatment of the human foot and the nonsurgical
treatment of the muscles and tendons of the leg governing the
functions of the foot. (Bus. & Prof. Code Sec. 2472.)
Existing law provides that no podiatrist, who in good faith
renders emergency care at the scene of an emergency, shall be
liable for civil damages as a result of any acts or omissions by
the podiatrist in rendering the emergency care. This immunity
does not apply in the event of a willful act or omission. (Bus.
& Prof. Code Sec. 2395.)
Existing law provides that podiatrists are not liable for civil
damages for injury or death caused in an emergency situation
occurring in the podiatrist's office or in a hospital because of
a failure to inform a patient of the possible consequences of a
medical procedure when the failure was because:
(1) the patient was unconscious;
(2) the procedure was undertaken without the consent of the
patient because the podiatrist reasonably believed that it
should be done immediately and there was insufficient time to
inform the patient; or
(3) the procedure was performed on a patient legally incapable
of giving consent and the podiatrist reasonably believed that
the procedure should be done immediately and there was
insufficient time to obtain the consent of the person
authorized to provide that consent for the patient. This
immunity from liability applies only to actions for damages
for injuries or death arising out of the podiatrist's failure
to inform, and not to actions for damages arising out of the
podiatrist's negligence in rendering treatment.
(Bus. & Prof. Code Secs. 2397(a), (b).)
Existing law provides that nothing in the above-described
provisions shall be construed to authorize practice by a
podiatrist beyond that set forth in Business and Professions
Code Section 2473, which has been repealed. (Bus. & Prof. Code
Sec. 2397(d).)
This bill would delete Section 2397(d), thus deleting this
reference to an obsolete provision of law.
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This bill would state legislative intent that nothing in the
bill is intended to enlarge, reduce, or otherwise modify the
scope of practice of podiatrists.
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COMMENT
1. Stated need for the bill
The author writes, "[d]octors of podiatric medicine are
apparently the only licensed or unlicensed health practitioners
prohibited from assisting beyond their normal scope during a
medical emergency."
The sponsor of this bill, the California Board of Podiatric
Medicine (BPM), writes:
In the event of a duly-proclaimed medical disaster, this bill
removes a barrier enacted 30-years ago to highly-trained
Doctors of Podiatric Medicine providing Good Samaritan
emergency care beyond their regular foot and ankle scope in
B&P Code Section 2472 (previously 2473). Following Katrina,
the Governor's Office initiated the Healthcare Surge project
in 2007 to ensure California would be better prepared in the
event of a medical disaster. The Departments of Public Health
and Consumer Affairs directed health licensing boards to alert
licensees to be ready. They also asked that we remove
barriers now that could slow medical response when caseloads
are soaring, and provider ranks are thinned, immobilized and
overwhelmed.
BPM reviewed the Good Samaritan statutes . . . which
[provide] exemptions from liability during medical disasters.
We were surprised to find Section 2397(d), . . . During 2007
interagency meetings, there was agreement that Section 2397(d)
is an unnecessary, imprudent anachronism that does not reflect
good public policy.
SB 953 does not alter the Doctor of Podiatric Medicine's
normal scope of practice in Section 2472. It does provide
DPMs can assist during an emergency as specified in Article 17
(Sections 2395-2398) without regard to Section 2472.
2. Deleting limitations on podiatrists' ability to provide care
in an emergency
This bill would delete a provision of law which provides that
specified sections providing for immunity from liability shall
not be construed to authorize practice by a podiatrist beyond
that set forth in Business and Professions Code Section 2473,
which has been repealed. This change is intended to delete
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limitations on the ability of a podiatrist to provide care in an
emergency situation.
Last year, AB 83 (Feuer, Ch. 77, Stats. 2009) revised existing
law to provide that medical, law enforcement, and emergency
personnel who, in good faith and not for compensation, render
emergency medical or non-medical care at the scene of an
emergency are not liable for any civil damages resulting from
any act or omission. The scene of an emergency does not include
emergency departments and other places where medical care is
usually offered.
Existing law further provides immunity from liability to
physicians and surgeons and podiatrists who, in good faith,
provide emergency care at the scene of an emergency. That
immunity does not apply in the event of a willful act or
omission. And, existing law provides that podiatrists are not
liable for civil damages for injury or death caused in an
emergency situation occurring in the podiatrist's office or in a
hospital because of a failure to inform a patient of the
possible consequences of a medical procedure when the failure
was because of specified circumstances. Section 2397(d), which
this bill would repeal, provides that nothing in these two
provisions shall be construed to authorize practice by a
podiatrist beyond that set forth in Business and Professions
Code Section 2473, which has been repealed.
The sponsor reads Section 2397(d) as limiting a podiatrist's
ability to act in an emergency. As a result, this bill would
delete this sentence in order to clearly permit podiatrists to
provide care in an emergency situation that may go beyond their
defined scope of practice. The intent is to provide podiatrists
with the same liability protection as doctors.
3. Clarifying amendment needed
As noted above, the sponsor indicates that this bill is intended
to permit podiatrists to provide services beyond their normal
scope of practice in an emergency situation, consistent with
existing immunity provisions applicable to other licensees
subject to this area of law (i.e., physicians and surgeons).
This bill, however, contains legislative intent language
providing that nothing in the bill is intended to enlarge,
reduce, or otherwise modify the scope of practice of
podiatrists. Because this language is confusing given the
sponsor's stated intent, the author has agreed to amend the bill
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to clarify that the bill is not intended to enlarge, reduce, or
otherwise modify the scope of practice except in situations
covered by Article 13, which provides for exemptions from
liability. The following amendment would achieve this:
Suggested amendment :
1.On page 2, delete lines 1-5
2.On page 3, after line 6, insert "The amendments made to this
section at the 2009-10 Regular Session of the Legislature by
the act deleting subdivision (d) are not intended, nor shall
they be interpreted, to enlarge, reduce, or otherwise modify
the scope of practice of doctors of podiatric medicine as set
forth in Section 2472 of the Business and Professions Code,
except in situations covered by this article. This act is
intended to delete a reference to an obsolete provision of
law."
Support : None Known
Opposition : None Known
HISTORY
Source : California Board of Podiatric Medicine
Related Pending Legislation : None Known
Prior Legislation : None Known
Prior Vote : Senate Business, Professions, and Economic
Development Committee (Ayes 7, Noes 0)
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