BILL ANALYSIS
SB 953
Page 1
Date of Hearing: June 22, 2010
ASSEMBLY COMMITTEE ON JUDICIARY
Mike Feuer, Chair
SB 953 (Walters) - As Amended: May 19, 2010
PROPOSED CONSENT
SENATE VOTE : 32-0
SUBJECT : PODIATRISTS: LIABILITY FOR EMERGENCY SERVICES
KEY ISSUE : SHOULD EXISTING LAW BE CLARIFIED TO ENSURE THAT
PODIATRISTS ENJOY THE SAME LIABILITY PROTECTION AS OTHER
PHYSICIANS WHEN RENDERING CARE IN AN EMERGENCY SITUATION?
FISCAL EFFECT : As currently in print this bill is keyed
non-fiscal.
SYNOPSIS
This non-controversial bill, sponsored by the California Board
of Podiatric Medicine (BPM), seeks to clarify that specified
immunity from liability that generally applies to physicians
rendering emergency care should also apply to doctors of
podiatric medicine. The sponsor contends that Section 2397(d),
which references an obsolete provision of law repealed in 1998,
unnecessarily limits a podiatrist's ability to act in an
emergency because immunity from liability granted to doctors for
rendering emergency care is not similarly extended to
podiatrists under Section 2397(d). The author reasonably
contends that because podiatrists are highly-skilled doctors
with training and education equivalent to that of other medical
specialists, there is no justification to specifically exclude
podiatrists from immunity from liability that, if withheld, may
limit their ability to render care in emergency situations.
This bill also specifically states it is intended to clarify
that Good Samaritan immunity for medical, law enforcement, and
emergency personnel who render emergency medical or non-medical
care at the scene of an emergency, provided by last year's AB
83, also apply to doctors of podiatric medicine rendering
emergency care. At the same time, the bill reiterates that it
may not be construed to expand or modify the scope of practice
of podiatrists under existing law. This bill passed the Senate
by a 32-0 vote and passed the Assembly Business, Professions and
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Consumer Protection Committee by a 11-0 vote. There is no known
opposition to this bill.
SUMMARY : Seeks to clarify that specified immunity from
liability that generally applies to physicians rendering
emergency care also apply to doctors of podiatric medicine.
Specifically, this bill :
1)Deletes a provision of law which provides that immunity from
liability conferred on doctors in general shall not be
construed to authorize practice by a podiatrist beyond that
allowed by Business and Professions Code Section 2473, which
has been repealed.
2)States legislative intent that nothing in this bill is
intended or shall be construed to enlarge, reduce, or
otherwise modify the scope of practice of podiatrists. States
that this act is intended to clarify that specified exemptions
from liability apply to podiatrists rendering emergency care
and to delete a reference to an obsolete provision of law.
EXISTING LAW :
1)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. (Business & Professions Code Section 2472. All
further references will be to this code unless otherwise
noted.)
2)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.
(Section 2395.)
3)Provides that medical, law enforcement, and emergency
personnel, as defined, who in good faith, and not for
compensation, render emergency medical or non-medical care at
the scene of an emergency shall not be liable for any civil
damages resulting from any act or omission. Further provides
that the scene of an emergency shall not include emergency
departments and other places where medical care is usually
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offered. (Health and Safety Code Section 1799.102(a).)
4)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:
a) the patient was unconscious;
b) the procedure was undertaken without the consent of the
patient because the podiatrist reasonably believed that it
should be performed immediately and there was insufficient
time to inform the patient;
c) the procedure was performed on a patient legally
incapable of giving consent and the podiatrist reasonably
believed that the procedure should be undertaken
immediately and there was insufficient time to obtain the
consent of the person authorized to provide that consent
for the patient. (Section 2397(a).)
5)Limits the above immunity from civil liability 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 or
failing to render treatment. (Section 2397(b).)
6)Provides that nothing in these provisions for immunity from
liability shall be construed to authorize practice by a
podiatrist beyond that set forth in Business and Professions
Code Section 2473 (which was repealed in 1998.) (Section
2397(d).)
COMMENTS : This non-controversial bill, sponsored by the
California Board of Podiatric Medicine (BPM), seeks to clarify
that specified immunity from liability that generally applies to
physicians rendering emergency care should also apply to doctors
of podiatric medicine. According to the sponsor, this bill is
needed to remove a barrier enacted 30 years ago to prevent
podiatrists from providing Good Samaritan emergency care beyond
their regular foot and ankle scope as defined by Section 2472
(previously Section 2473.) The sponsor explains the need to
remove this barrier, known as Section 2397(d), writing:
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Following Hurricane 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.
The author also states in support of the bill:
Doctors of podiatric medicine are apparently the only
licensed or unlicensed health practitioners prohibited
from assisting beyond their normal scope during a
medical emergency. There is no basis for excluding
one of the more highly trained provider groups. It
could cost the lives of Californians, unnecessarily,
in the event of a disaster.
Background on podiatric medicine. 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 under Section 2475.
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. Surgical
treatment by a podiatrist of the ankle and tendons at the level
of the ankle are specifically restricted to certain venues,
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including licensed general acute care hospitals, licensed
surgical clinics, and ambulatory surgical centers, as provided.
This bill deletes limitations on the ability of a podiatrist to
render emergency care. The sponsor contends that Section
2397(d) unnecessarily limits a podiatrist's ability to act in an
emergency because immunity from liability granted to doctors for
rendering emergency care is not similarly extended to
podiatrists by Section 2397(d), which reads "Nothing in the
article shall be construed to authorize practice by a podiatrist
beyond that set forth in Section 2473." Section 2473 was
repealed in 1998 (SB 1981, Chapter 736), making this reference
obsolete, but the same legislation re-enacted many of its
provisions into Section 2472, which outlines the scope of
practice of podiatric medicine today. It is unknown what the
specific rationale for singling out podiatrists was in 1980 when
Section 2397 became law, but the author contends that Section
2397(d) is "an unnecessary, imprudent anachronism" that does not
reflect good public policy.
To remove this limitation, this bill would delete this sentence
to clearly permit podiatrists to provide care in an emergency
situation that may go beyond their defined scope of practice.
The intent is to simply provide podiatrists with the same
liability protection that other doctors and fellow licensees
enjoy under Section 2397, and also delete a reference to an
obsolete provision of law. The author reasonably contends that
because podiatrists are highly-skilled doctors with training and
education equivalent to that of other medical specialists, there
is no justification to specifically exclude podiatrists from
immunities that may limit their ability to render emergency care
for fear of being sued.
Interaction with recent immunity from liability provisions under
AB 83 (2009) . In addition to liability protections afforded to
doctors in emergency situations occurring in the licensee's
office or in a hospital under Section 2397, recent changes in
Good Samaritan law also provide protection from liability to
medical and other personnel at emergency scenes away from the
hospital or office. Last year, AB 83 (Feuer, Ch. 77, Stats.
2009) revised Health and Safety Code Section 1799.102(a) 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 (as
defined) are not liable for any civil damages resulting from any
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act or omission. Under AB 83, the scene of an emergency
excludes emergency departments and other places where medical
care is usually offered.
This bill specifically states it is intended to clarify that
both types of exemptions from liability discussed above (i.e.
under Article 17 (commencing with Section 2395) of Chapter 5 of
Division 2 of the Business and Professions Code, and under
Section 1799.102 of the Health and Safety Code) apply to doctors
of podiatric medicine rendering emergency care.
REGISTERED SUPPORT / OPPOSITION :
Support
California Board of Podiatric Medicine (BPM) (sponsor)
Opposition
None on file
Analysis Prepared by : Anthony Lew / JUD. / (916) 319-2334