Bill Text: CA AB2725 | 2021-2022 | Regular Session | Introduced

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Bill Title: Coroners: anatomical gifts.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Introduced - Dead) 2022-04-26 - In committee: Hearing postponed by committee. [AB2725 Detail]

Download: California-2021-AB2725-Introduced.html

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CALIFORNIA LEGISLATURE— 2021–2022 REGULAR SESSION

Assembly Bill

No. 2725

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Introduced by Assembly Member Low

February 18, 2022

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An act to amend Sections 27491.44 and 27491.45 of the Government Code, and to amend Sections 7151.15 and 7184.5 of, and to repeal and add Section 7151.20 of, the Health and Safety Code, relating to anatomical gifts.

LEGISLATIVE COUNSEL'S DIGEST

AB 2725, as introduced, Low. Coroners: anatomical gifts.

Existing law sets forth the duties and authority of a county coroner, including asking the deceased person’s next of kin, at the time of notification of death, whether the deceased was a donor or a donor family and, if not, informing the next of kin of their option to donate viable parts.

This bill would make it the duty of the procurement organization, upon referral, to inform the appropriate person of the donor’s gift, or the appropriate person’s ability to make an anatomical gift.

Existing law authorizes the coroner to retain parts of the body removed at the time of autopsy or acquired during a coroner’s investigation for scientific investigation and training and to release those parts to hospitals, medical educational research institutions, and law enforcement agencies for noncoroner training, educational, and research purposes with consent or after a reasonable effort has been made to inform a person with authority over the remains, as specified.

This bill would require a reasonable effort to locate a person with authority over the remains to include fingerprinting, as specified, and would require the coroner to assist a procurement organization in the search for a person authorized to make an anatomical gift.

Existing law requires a county coroner to cooperate with procurement organizations to maximize the opportunity to recover anatomical gifts and requires the coroner or designee to conduct a post mortem examination or investigation of the body or the part in a manner and within a period compatible with its preservation for the purposes of the gift if the body is under the jurisdiction of the coroner and a post mortem examination or investigation is going to be performed. Existing law provides the method by which the coroner may release or restrict release of an anatomical gift to the procurement organization.

This bill would authorize the coroner or designee to attend the recovery procedure if they cannot complete the examination prior to recovery of the gift and would require the county coroner to cause a licensed forensic pathologist to be present at the recovery procedure in order to restrict recovery of a donated part. By placing a new requirement on county coroners, this bill would impose a state-mandated local program.

Existing law requires a procurement organization to develop a protocol for organ recovery that provides sufficient information on the medical and injury status of the deceased to permit release and removal of organs without undue prejudice to the coroner’s investigation of, or inquiry into, the cause of death. Existing law makes the protocol subject to the approval of the coroner or medical examiner and requires that it provide specified information, including the organs requested and a brief description of the alleged circumstances surrounding the death, to the extent they are known.

This bill would, instead, authorize the procurement organization and the county coroner to establish a collaborative procurement protocol for anatomical gifts and would authorize that protocol to delineate items of information that may be provided by the procurement organization to the coroner and to identify a liaison with the coroner’s office who shall be available 24 hours per day, seven days a week, for the receipt of that information.

The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.

This bill would provide that, if the Commission on State Mandates determines that the bill contains costs mandated by the state, reimbursement for those costs shall be made pursuant to the statutory provisions noted above.

Digest Key

Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: YES  

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Bill Text

The people of the State of California do enact as follows:

SECTION 1.

 Section 27491.44 of the Government Code is amended to read:

27491.44.

 (a) Notwithstanding any other provision of law, the coroner is authorized to may do all of the following:

(a)

(1) Assist the people of this state, as appropriate, in the implementation of the Uniform Anatomical Gift Act contained in Chapter 3.5 (commencing with Section 7150) of Part 1 of Division 7 of the Health and Safety Code, and in the otherwise lawful utilization of medically proven organ and tissue transplant procedures. Code.

(b)

(2) Cooperate in the authorized removal and timely disposition of human organs and tissue from the bodies of deceased persons, including victims of homicide, in accordance with law and accepted medical practice.

(c)Assist medical and health service agencies in identifying donors of human organs and tissues, for purposes of providing life-enhancing benefits of transplant surgery to recipients under duly sanctioned medical conditions.

(d)Ask the deceased person’s next of kin, at the time of notification of death, whether the deceased was a donor or if the family was a donor family. If not, the coroner is authorized to inform them of their option to donate viable organs and tissues.

(3) Provide procurement organizations with timely referrals of potential organ and tissue donors for the purpose of providing life-saving and life-enhancing benefits of transplant surgery to recipients.

(e)

(4) Enter into agreements with one or more procurement organizations to coordinate organ recovery procedures within that coroner’s jurisdiction or in cooperation with other coroners throughout the state.

(f)

(5) Contract with or receive assistance of any kind from any public or private entity for the purpose of providing education and training to his or her their personnel in pathology or any other area of the healing arts and sciences that will assist in timely determination of the causes of death.

(b) Upon referral of a potential donor to the procurement organization, the procurement organization has the duty to inform the appropriate person under the Uniform Anatomical Gift Act (Chapter 3.5 (commencing with Section 7150) of Part 1 of Division 7 of the Health and Safety Code) of the donor’s gift, or the appropriate person’s ability to make an anatomical gift.

SEC. 2.

 Section 27491.45 of the Government Code is amended to read:

27491.45.

 (a) (1) The coroner shall have the right to retain parts of the body, as defined in subdivision (g) of Section 7150.1 Section 7150.10 of the Health and Safety Code, removed at the time of autopsy or acquired during a coroner’s investigation as may, in the opinion of the coroner, be necessary or advisable for scientific investigation and training. This right may be exercised solely through the provisions of subdivision (c) of Section 7151.15 of the Health and Safety Code, which requires any research or educational use to be authorized by the appropriate person under the Uniform Anatomical Gift Act (Chapter 3.5 (commencing with Section 7150) of Part 1 of Division 7 of the Health and Safety Code). The coroner may employ or use outside laboratories, hospitals, or research institutions in the conduct of the coroner’s scientific investigation or training.

(2) Parts of the body retained pursuant to paragraph (1) may be released by the coroner to hospitals, medical educational research institutions, and law enforcement agencies for noncoroner training, educational, and research purposes, either upon consent of the decedent or other person, as specified in Section 7151 7150.40 of the Health and Safety Code, or after a reasonable effort has been made to locate and inform persons listed in subdivision (a) of Section 7151 of the Health and Safety Code of their option to consent or object to the release, and the appropriate person consents or that effort has been unsuccessful. A reasonable effort shall be deemed to have been made when a search for the persons has been underway for at least 12 hours. The search shall include fingerprinting performed by authorized law enforcement or coroner personnel, a check of local police missing persons records, examination of personal effects, and the questioning of any persons visiting the decedent before his or her their death or in the hospital, accompanying the decedent’s body, or reporting the death, in order to obtain information that might lead to the location of any persons listed in subdivision (a) of Section 7151 of the Health and Safety Code.

(b)The coroner may, in his or her discretion, allow removal of parts of the body by a licensed physician and surgeon or trained transplant technician for transplant, or therapeutic, or scientific purposes pursuant to Chapter 3.5 (commencing with Section 7150) of Part 1 of Division 7 of the Health and Safety Code, only if the following conditions are met:

(1)The provision of the part will not unnecessarily mutilate the body or interfere with the autopsy.

(2)The decedent or other person, as specified in Section 7151 of the Health and Safety Code, has consented to the provision of the part, as prescribed by Section 7154 of the Health and Safety Code, or after a reasonable effort has been made to locate and inform persons listed in subdivision (a) of Section 7151 of the Health and Safety Code of their option to consent or object to the release, and the appropriate person consents, or that effort has been unsuccessful.

(b) The coroner shall assist a procurement organization in its search for the person or persons in the highest category available to authorize an anatomical gift pursuant to subdivision (a) of Section 7150.40 of the Health and Safety Code. A reasonable effort shall be deemed to have been made when a search for the persons has been underway for at least 12 hours. The search shall include a check of local police missing persons records, examination of personal effects, and the questioning of any persons visiting the decedent before his or her their death or in the hospital, accompanying the decedent’s body, or reporting the death, in order to obtain information that might lead to the location of any persons listed in subdivision (a) of Section 7151 of the Health and Safety Code. In obtaining this gift, the coroner shall notify the donor of the specific part or parts requested and shall obtain the donor’s informed consent, as provided in Section 7150.5 or 7151 of the Health and Safety Code.

(c)Nothing in this section shall be construed as limiting any right provided for in Section 7152 of the Health and Safety Code.

(d)For purposes of this section, “trained transplant technician” means a person who has completed training in tissue removal for transplant or therapeutic, or scientific purposes, which the coroner determines to be adequate for the purposes.

SEC. 3.

 Section 7151.15 of the Health and Safety Code is amended to read:

7151.15.

 (a) A county coroner shall cooperate with procurement organizations to maximize the opportunity to recover anatomical gifts for the purpose of transplantation, therapy, research, or education.

(b) If a county coroner receives notice from a procurement organization that an anatomical gift might be available or was made with respect to a decedent whose body is under the jurisdiction of the coroner and a post mortem examination or investigation is going to be performed, unless the coroner denies recovery in accordance with Section 7151.20, the coroner or designee shall conduct a post mortem examination or investigation of the body or the part in a manner and within a period compatible with its preservation for the purposes of the gift. If the coroner or designee cannot complete the examination prior to recovery of the gift, the coroner or designee may attend the recovery procedure. This section does not preclude the right of a forensic pathologist to deny or restrict the recovery of the part pursuant to the procedures outlined in Section 7151.20.

(c) A part shall not be removed from the body of a decedent under the jurisdiction of a coroner for transplantation, therapy, research, or education unless the part is the subject of an anatomical gift. The body of a decedent under the jurisdiction of the coroner shall not be delivered to a person for research or education unless the body is the subject of an anatomical gift. This subdivision does not preclude a coroner from performing the medicolegal investigation upon the body or parts of a decedent under the jurisdiction of the coroner.

(d) Notwithstanding any other law, when an anatomical gift might be available or has been made by a person whose death is imminent due to the lawful withdrawal of medical treatment and if that person’s body, post mortem, will be subject to the coroner’s jurisdiction pursuant to Section 27491 of the Government Code, a procurement organization may notify a coroner of the anatomical gift, and a coroner shall accept the notification, whenever that notification will facilitate the coroner’s ability to conduct a postmortem examination or investigation of the body or the part in a manner and within a period compatible with its preservation for the purposes of the gift.

SEC. 4.

 Section 7151.20 of the Health and Safety Code is repealed.

7151.20.

(a)On request from a qualified procurement organization, the county coroner may permit the removal of organs that constitute an anatomical gift from a decedent who died under circumstances requiring an inquest by the coroner.

(b)If no autopsy is required, the organs to be removed may be released to the qualified procurement organization.

(c)If an autopsy is required and the county coroner determines that the removal of the organs will not interfere with the subsequent course of an investigation or autopsy, the organs may be released for removal. The autopsy shall be performed following the removal of the organs.

(d)If a county coroner is considering withholding one or more organs of a potential donor for any reason, the county coroner, or his or her designee, upon request from a qualified organ procurement organization, shall be present during the procedure to remove the organs. The county coroner, or his or her designee, may request a biopsy of those organs or deny removal of the organs if necessary. If the county coroner, or his or her designee, denies removal of the organs, the county coroner may do any of the following:

(1)In the investigative report, explain in writing the reasons for the denial.

(2)Provide the explanation to the qualified organ procurement organization.

(e)If the county coroner, or his or her designee, is present during the removal of the organs, the qualified procurement organization requesting the removal of the organ shall reimburse the county of the coroner, or his or her designee, for the actual costs incurred in performing the duty specified in subdivision (d), if reimbursement is requested by the county coroner. The payment shall be applied to the additional costs incurred by the county coroner’s office in performing the duty specified in subdivision (d).

(f)The health care professional removing organs from a decedent who died under circumstances requiring an inquest shall file with the county coroner a report detailing the condition of the organs removed and their relationship, if any, to the cause of death.

SEC. 5.

 Section 7151.20 is added to the Health and Safety Code, to read:

7151.20.

 (a) A procurement organization that intends to facilitate the recovery of an anatomical gift from a donor whose death is under investigation pursuant to Section 27491 of the Government Code may remove the donated part from the donor’s body for acceptance by a person authorized to become a donee after giving adequate notice to the county coroner.

(b) The county coroner shall complete any required post mortem examination of the body or the part in a manner, and within a period, compatible with preservation for purposes of the gift.

(c) In order to deny or restrict the recovery of a donated part, the county coroner shall cause a licensed forensic pathologist to be present at the recovery procedure.

(d) A county coroner shall not deny recovery of a donated part except upon the reasonable finding of a licensed forensic pathologist, present at the recovery procedure and who has seen the specific part to be recovered, that the part was involved in the cause of death. For purposes of this section, a part is involved in the cause of death when disruption to that part’s structure is a required element of the fatal sequence or provides the means of diagnosing the cause of death.

(e) A preliminary finding that a part is reasonably believed to be involved in the cause of death shall be provided by a forensic pathologist in both of the following ways:

(1) Orally, at the time of denial.

(2) Explained in a written report to the requesting procurement organization within 30 days of the denied recovery. This report is not an investigatory report under the California Public Records Act (Chapter 3.5 (commencing with Section 6250) of Division 7 of Title 1 of the Government Code), but shall not be disclosed by the procurement organization to any outside third party without the express written authorization of the county coroner’s office. For purposes of this paragraph, disclosure during a judicial proceeding shall not be deemed a disclosure and the procurement organization shall consent to the terms of any reasonable protective order sought by the county coroner’s office.

(f) If the county coroner, or their designated licensed forensic pathologist, is present during the removal of a part, the qualified procurement organization requesting the removal shall reimburse the coroner’s county for the actual costs incurred in performing the duty specified in subdivision (d), if reimbursement is requested by the county. The payment shall be applied to the additional costs incurred by the county coroner’s office in performing the duty specified in subdivision (d).

(g) The health care professional removing the organs from a decedent who died under circumstances requiring an inquest shall file a report with the county coroner detailing the condition of the organs removed and their relationship, if any, to the cause of death.

SEC. 6.

 Section 7184.5 of the Health and Safety Code is amended to read:

7184.5.

 (a)  In conjunction with entering into any agreement with any coroner or medical examiner for release and removal of organs from bodies within that official’s custody and to To further the purposes of Section 27491.45 of the Government Code, a procurement organization shall and a coroner’s office may develop a collaborative protocol for organ anatomical gift recovery, as appropriate, that provides sufficient information on the medical and injury status of the deceased to permit release and removal of organs parts without undue prejudice to that official’s investigation of, or inquiry into, the cause of death. death, and that allows for the recovery and transplant of every anatomical gift.

(b) The protocol described in subdivision (a) shall be subject to approval by the coroner or medical examiner before release or removal of organs and shall provide for the following:

(1) Relevant information on the deceased to be given to the coroner or deputy coroner at the time of the initial request for permission to recover internal organs, including, but not limited to:

(A) Information identifying the deceased.

(B) Date and time of pronouncement of brain death.

(C) Name of procurement organizations and coordinator.

(D) Organs requested.

(E) Organ donor number and hospital.

(F) Apparent cause and manner of death.

(G) A brief description of alleged circumstances surrounding the death to the extent they are known at the time.

(H) The law enforcement agency and the name of the investigating officer handling the case.

(2) The following information, to be recorded by the organ procurement coordinator at the time of requesting permission for organ removal:

(A) The name of the deputy coroner contacted.

(B) The name of the pathologist contacted by the deputy coroner.

(C) Whether permission for removal was obtained at the time, including the date and time if permission was obtained.

(D) The coroner’s case number assigned by the deputy coroner.

(E) If the request for organ removal is refused, the reason given for the refusal.

(3) A checklist to be completed prior to recovery of any organ by the procurement organization coordinator with the assistance, if necessary, of a physician attending the deceased, that includes, at a minimum, all of the following:

(A) medical record review to insure documentation of external injuries, fractures, and internal injuries.

(B) In cases of suspected child abuse, whether:

(i) A child abuse consult was obtained.

(ii) A computerized axial tomographic scan or magnetic resonance image of the head was obtained.

(iii) A radiological skeletal survey was done.

(iv) The presence or absence of visible injury to the back of the scalp, ears, nose, and mouth, or retinal hemorrhage has been documented.

(v) A coagulation screen report was in the deceased’s records.

(C) A photographic record of visible external injuries.

(D) Admitting blood sample, if available, and the date and time the sample was drawn.

(4) A checklist of items to be provided to the coroner’s office when the deceased’s body is released after completion of organ recovery, including, but not limited to, all of the following:

(A) A copy of the deceased’s medical records.

(B) Film documenting abnormal findings, if used.

(C) The information recorded pursuant to the requirements of this subdivision.

(D) A sample of the deceased’s blood, if taken on admission.

(5) A form, completed by the physician and surgeon, technician, or team performing the organ recovery procedure and signed by the physician and surgeon, that describes in sufficient detail all of the following:

(A) Tests used to determine the suitability for transplantation of all organs recovered.

(B) Documentation of injuries and other abnormalities, if any, noted or occurring during the organ recovery procedure.

(C) The date and time organ recovery was started.

(D) Any other information on the state of the deceased’s body or organs that the physician and surgeon, technician, or team believes may assist the coroner in his or her investigation or inquiry.

(c) The requirements of subdivision (a) shall not apply in any county that does not have a Level II trauma facility, as defined in Section 1798.160 and the regulations adopted pursuant thereto.

(d) Notwithstanding any other provision of law, a health care provider may release the information described in this section to the procurement organization, the coroner, or the medical examiner.

(e) For purposes of this section, “organ” or “organs” means internal whole organs, including, but not limited to, the heart, kidneys, the liver, and lungs, but does not include eyes, skin, or other similar tissue.

(b) The protocol may delineate items of information that may be provided by the procurement organization to the coroner, and may identify a liaison with the coroner’s office, who shall be available 24 hours per day, seven days per week, for the receipt of that information and for communication regarding any information that may assist the coroner in their investigation.

SEC. 7.

 If the Commission on State Mandates determines that this act contains costs mandated by the state, reimbursement to local agencies and school districts for those costs shall be made pursuant to Part 7 (commencing with Section 17500) of Division 4 of Title 2 of the Government Code.