BILL ANALYSIS �
SENATE COMMITTEE ON HEALTH
Senator Ed Hernandez, O.D., Chair
BILL NO: AB 2029
AUTHOR: Cooley
AMENDED: June 17, 2014
HEARING DATE: June 25, 2014
CONSULTANT: Diaz
SUBJECT : Inquests: sudden unexplained death in childhood.
SUMMARY : Requires a coroner to investigate, among other deaths,
a sudden and unexpected death of a child aged one or older, but
younger than 18, or a death suspected to be caused by sudden
unexplained death in childhood (SUDC), as defined. Requires a
coroner to perform specified activities when a death is
suspected to be caused by SUDC. Provides an exemption to a
coroner's investigation of a death suspected to be caused by
SUDC, as specified.
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 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.
2.Requires a coroner to, within 24 hours or a soon as feasible
thereafter, where the suspected cause of death is sudden
infant death syndrome (SIDS), take possession of the body and
make or cause to be made a postmortem examination or autopsy.
Requires the detailed medical findings resulting from an
examination of the body or autopsy by an examining physician
to either be reduced to writing or permanently preserved, as
specified. Defines SIDS as 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.
3.Requires that an autopsy, when the suspected cause of death is
SIDS, be conducted pursuant to a standardized protocol
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AB 2029 | Page 2
developed by the Department of Public Health. Requires that
all coroners throughout the state follow the established
protocol when conducting autopsies where the death is
suspected to be caused by SIDS. Requires a coroner to state on
the certificate of death that SIDS was the cause of death when
the findings are consistent with the definition.
This bill:
1.Requires a coroner to investigate the sudden and unexpected
death of a child aged one year or older, but younger than 18,
or a death in which the suspected cause is SUDC. Defines SUDC
as the sudden death of a child aged one year or older, but
younger than 18, that is unexplained by the history of the
child and where a thorough postmortem examination fails to
demonstrate an adequate cause of death.
2.Requires a coroner to perform an autopsy as soon as feasible
in any death caused by SUDC. Affords discretion to a coroner
to perform an autopsy in a case where an attending physician
desires to certify that the cause of death is SUDC. Requires
the coroner to certify the cause of death if an autopsy is
performed in this case.
3.Allows a coroner to take tissue samples for research purposes
from children who have died from SUDC without consent of the
responsible adult if the tissue removal is not likely to
result in any visible disfigurement. Requires the coroner to
notify the parent or responsible adult of the child about the
importance of taking tissue samples.
4.Prohibits a coroner from being liable for damages in a civil
action for any act or omission in compliance with performing
autopsies on or taking tissue samples from children who have
died from SUDC. Provides that consent is not required from any
person prior to a coroner undertaking the autopsy required on
children who died from SUDC.
5.Provides an exemption to the SUDC autopsy and taking of tissue
samples in a case where a conflict arises with a parent or
guardian's sincerely held religious beliefs or practices,
unless there is an overriding public health concern or a law
enforcement officer reasonably suspects that a crime was
committed.
FISCAL EFFECT : According to the Assembly Appropriations
Committee:
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1. Unknown minor local costs to the extent coroners opt to
take tissue samples for research purposes.
2. Unknown, likely minor potentially reimbursable local
costs to conduct additional autopsies when the suspected
cause of death is SUDC.
PRIOR VOTES :
Assembly Public Safety: 6 - 0
Assembly Appropriations:13 - 0
Assembly Floor: 64 - 0
COMMENTS :
1.Author's statement. According to the author, though there is
existing law that outlines the procedures for investigating
deaths caused by SIDS, there is no existing law outlining the
procedures for cases where the suspected cause of death is
SUDC. 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.SUDC. According to the Sudden Unexplained Death in Childhood
Program's (SUDCP) Web site, SUDC is a rare condition that
occurs in children over the age of 12 months. According to the
SUDCP, SUDC is a diagnosis of exclusion that is given when all
known and possible causes of death have been ruled out, and
when deaths go unexplained after an autopsy, a death scene
investigation, and a medical history review. The SUDCP states
that the incidence of SUCD is approximately 1.2 deaths per
100,000 children, compared to 54 deaths per 100,000 live
births for SIDS. The SUDCP further states that most SUDC
deaths occur in children between the ages of one and three but
that researchers have looked at cases in children as old as
15.
3.Support. Supporters state that it is critical to examine all
child deaths to determine if they are intentional or
unintentional and to what causes they are attributable. They
further state that unexplained deaths in children are rare and
poorly understood in the U.S.
4.Opposition. Taxpayers for Improving Public Safety argues that
this bill fails to respect religious beliefs, including
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interment of the entire body.
5.Oppose unless amended. The California State Coroners'
Association argues that this bill is redundant in nature and
that adding SUDC to statute suggests it is a syndrome, like
SIDS, when it has not been scientifically vetted or validated.
6.Amendments. The author intends to take amendments to address
concerns over language that allows a coroner to take tissue
samples without consent of the responsible adult.
SUPPORT AND OPPOSITION :
Support: Child Abuse Prevention Center
Safe Kids California
Sudden Unexplained Death in Childhood Program
6 individuals
Oppose: Taxpayers for Improving Public Safety
California State Coroners Association (unless amended)
Agudath Israel of California (prior version)
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