BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  AB 2029
                                                                  Page  1

          Date of Hearing:   April 22, 2014
          Chief Counsel:      Gregory Pagan


                         ASSEMBLY COMMITTEE ON PUBLIC SAFETY
                                 Tom Ammiano, Chair

                    AB 2029 (Cooley) - As Amended:  March 28, 2014
                       As Proposed to be Amended in Committee


           SUMMARY  :   Requires a coroner to inquire into and determine the  
          circumstances, manner, and cause of death where a child, who is  
          one year of age or older but under 18 years of age, dies  
          suddenly or unexpectedly.  Specifically,  this bill  :  

          1)Requires a coroner to inquire into and determine the  
            circumstances, manner, and cause of death where a child, who  
            is one year of age or older but under 18 years of age, dies  
            suddenly or unexpectedly, or where the suspected cause of  
            death is sudden unexplained death in childhood (SUDC).

          2)Defines "sudden unexplained death in childhood" to mean the  
            sudden death of a child one year of age or older but under 18  
            years of age that is unexplained by the history and where a  
            thorough postmortem fails to demonstrate an adequate cause of  
            death.

          3)Provides that a coroner shall within 24 hours, or a soon as  
            feasible thereafter, where the suspected cause of death is  
            SUDC, take possession of the body, and make or cause to be  
            made a postmortem examination or autopsy thereon, and the  
            detailed medical findings resulting from an examination of the  
            body or autopsy by an examining physician must either be  
            reduced to writing, or permanently preserved, as specified. 

          4)Makes an autopsy by a coroner discretionary if an attending  
            physician desires to certifiy 
          that the cause of death is SUDC.  If a coroner performs an  
            autopsy pursuant to the above provisions, he or she shall  
            certify the cause of death.

          5)Provides that a coroner may take tissue samples from children  
            who have died suddenly and unexpectedly without consent of the  
            responsible adult if the tissue removal is not likely to  








                                                                  AB 2029
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            result in visible disfigurement, and a coroner shall not be  
            liable in a civil action for any act or omission in compliance  
            with the sudden unexpected death in childhood autopsy  
            requirement.

           EXISTING LAW  :

          1)Requires a coroner to investigate the circumstances, manner,  
            and cause of specified types of deaths, including violent,  
            sudden, or unusual deaths; unattended deaths; and deaths where  
            the deceased has not been attended to by a physician within 20  
            days before the death occurred.  Affords the coroner with the  
            discretion to determine the extent of the inquiry into a death  
            occurring under natural circumstances, and allows the coroner  
            to authorize a physician to sign the certificate of death if  
            the physician has sufficient knowledge to reasonably state the  
            cause of a death occurring under natural circumstances.  (Gov.  
            Code, � 27491.)  

          2)Provides that a coroner shall within 24 hours, or a soon as  
            feasible thereafter, where the suspected cause of death is  
            sudden infant death syndrome, take possession of the body, and  
            make or cause to be made a postmortem examination or autopsy  
            thereon, and the detailed medical findings resulting from an  
            examination of the body or autopsy by an examining physician  
            must either be reduced to writing, or permanently preserved,  
            as specified.  (Gov. Code, � 27491.4, subd. (a).)

          3)Defines "sudden infant death syndrome" to mean the sudden  
            death of an infant that is unexpected by the history of the  
            infant and where a thorough postmortem fails to demonstrate an  
            adequate cause of death.  (Gov. Code, � 27491.49, subd. (a).)

          4)Requires that an autopsy conducted where it is suspected that  
            the cause of death is sudden infant death syndrome be  
            conducted pursuant to a standardized protocol developed by
          the SDPH.  The protocol shall be developed and approved by July  
            1, 1990.  (Gov. Code, � 27491.41 (d.).)

          5)Requires that all coroners, throughout the state, follow the  
            established protocol when conducting autopsies where the  
            suspected cause of death is sudden infant death syndrome, and  
            requires a coroner to state on the certificate of death that  
            sudden infant death syndrome  was the cause of death when the  
            findings are consistent with the definition of sudden infant   








                                                                  AB 2029
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            death syndrome.  (Gov. Code, � 27491.41 (e).)

          6)Requires a coroner to perform or arrange for an autopsy on a  
            decedent upon a written request of the surviving spouse, or in  
            certain circumstances, a child, parent, or other legal  
            next-of-kin; and requires the cost of the autopsy to be borne  
            by the person requesting the autopsy.  (Gov. Code � 27520.)  

           FISCAL EFFECT  :  Unknown

           COMMENTS  :   

           1)Author's Statement  :  "Though emergency personnel and law  
            enforcement are required to be provided training to handle  
            cases involving Sudden Infant Death Syndrome, they do not  
            receive training on the handling of cases where the suspected  
            cause of death is Sudden Unexplained Death in Childhood. As a  
            result, parents whose children die under these circumstances  
            are often left with little or no information on how to process  
            the death of their children or how to address further  
            investigation.

           2)Argument in Support  :  Hanna C. Kinney M.D. of the  Boston  
            Children's Hospital  states, "This letter is written in the  
            strongest possible support for AB 2029.  The passage of this  
            bill will greatly impact the families who have suffered the  
            sudden and unexplained loss of a child older than 12 months of  
            age (i.e. due to sudden and unexplained death in childhood or  
            SUDC).  I am a pediatric neuropathologist at Boston Children's  
            Hospital and professor of Pathology at Harvard Medical School.  
             I raise my voice as a researcher that has dedicated my 25  
            plus years of my professional career to understand the causes  
            of sudden, unexpected, and unexplained deaths in infants and  
            children."


           3)Argument in Opposition  :  The  California State Coroners'  
            Association  states, "The death of a child is always handled as  
            one of our highest priority cases.  As a matter of practice,  
            these cases receive a very high level of attention, including  
            an autopsy within 24 hours or as soon as feasible, as this  
            bill seeks.  Regardless of age, all 'undetermined' causes of  
            death are taken extremely seriously and investigated by the  
            attending coroner.  For these reasons, we believe the mandate  
            set forth in AB 2029 is redundant in nature and would not  








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            serve to enhance attention brought to cases beyond the great  
            level and care and attention they currently receive.

          "Further, adding 'sudden unexpected death in childhood' to  
            statute suggests it, like SIDS, is a syndrome and creates a  
            new label absent scientific vetting or validation.  While well  
            intentioned, we see this as problematic.  Currently, every  
            Coroner/Medical Examiner correctly classified these cases as  
            'undetermined,' doing so only after exhausting ever possible  
            resource available to reach a more final determination.  We  
            are concerned about adding 'sudden unexpected death in  
            childhood' until and unless further vetting establishes a case  
            for the creation of a new syndrome."

           REGISTERED SUPPORT / OPPOSITION  :   

           Support 
           
          Sudden Unexplained Death in Childhood (SUDC) Program
          Hanna C. Kinney M.D., Boston Children's Hospital
          Two Private Citizens

           Opposition 
           
          California State Coroners' Association
          California State Sheriffs' Association
          Taxpayers for Improving Public Safety
           

          Analysis Prepared by  :    Gregory Pagan / PUB. S. / (916)  
          319-3744