BILL ANALYSIS
SENATE RULES COMMITTEE AB 3145
Office of Senate Floor Analyses
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THIRD READING
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Bill No: AB 3145
Author: Granlund (R), et al
Amended: 8/5/96 in Senate
Vote: 21
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SENATE HEALTH & HUMAN SERV. COMMITTEE: 7-0, 6/26/96
AYES: Watson, Haynes, Hughes, Leslie, Maddy, Mello,
Thompson
NOT VOTING: Polanco, Solis
SENATE APPROPRIATIONS COMMITTEE: Senate Rule 28.8
ASSEMBLY FLOOR: 69-0, 5/29/96
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SUBJECT: Coroner's inquests: organ donation
SOURCE: Hoffmann-La Roche, Inc.
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DIGEST: This bill requires organ procurement
organizations to adopt protocols, subject to the coroner's
approval, for organ recovery in coroners' cases.
ANALYSIS: This bill:
1.Makes numerous findings regarding the need for donation
of organs; finds the San Bernardino protocol extremely
beneficial to increasing organ donations and states
intent to encourage similar protocols.
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2.Authorizes coroners to enter into agreements with one or
more procurement organizations to coordinate organ
recovery and permits acceptance of private assistance to
provide education and training for coroner personnel.
3.Requires organ procurement organizations to develop the
protocol in conjunction with entering into any agreement
with any coroner or medical examiner, except in any
county that does not have a Level II trauma facility.
Requires the protocol to include, among other things:
a.Relevant information on the deceased to be given to the
coroner at the time of initial request to recover
organs, as specified;
b.Specific information to be recorded by the organ
procurement coordinator at the time of requesting
permission for organ removal, as specified, including
the coroner's given reason for refusal;
c.A checklist of information relating to the condition of
the deceased's body to be completed by the organ
procurement organization coordinator prior to
recovery; and
d.A form to be completed by those performing the organ
recovery procedure, that describes the state of the
deceased's body, tissues or organs, as specified.
4.Permits a health care provider to release relevant
information described in the bill of the deceased to the
procurement organization, the coroner, or the medical
examiner.
5.Defines "organ" or "organs" as 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.
According to the Senate Health and Human Service Committee:
This bill proposes a methodology intended to increase the
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number of organ and tissue donations recovered from bodies
under the coroner's authority. While the number of
patients receiving transplants increased by 49% between
1988 and 1994 (12,786 vs. 19,017), donors increased by only
37% (5,908 vs. 8,114), and the number of patients on the
waiting list more than doubled (27,644 vs. 56,066,
including those who were transplanted, died, or were
removed from the list for other reasons), according to the
1995 Annual Report of the US Scientific Registry of
Transplant Recipients published by the United Network for
Organ Sharing (UNOS). The report indicated that the
widening gap between donors and those waiting for organs
became even deadlier -- in 1994, 3,072 patients died while
waiting.
Studies indicate that the availability of donated organs
could be significantly increased by recovering organs
currently lost through coroner denial. According to the
Association of Organ Procurement Organizations,
approximately 70% of all potential organ donor cases are
within the jurisdiction of the county coroner/medical
examiner. They also indicate that approximately 40% of
coroner/medical examiner cases were denied in 1992.
In addition to the Uniform Anatomical Gift Act, counties
may have their own guidelines and procedures for organ
recovery in coroner's cases. The level of awareness and
understanding of the Act and relevant guidelines also
varies. According to the author's office, constituents Ron
Ranus and his wife were unable to donate their daughter's
organs after her accidental death because a deputy coroner
was not familiar with organ donation laws and procedures.
As a result of this experience, they established "Cassie's
Friends," an organ donor educational non-profit
organization.
In 1991, San Bernardino County developed and implemented a
protocol for organ recovery for transplantation in
coroner's cases. According to a 1993 evaluation in The
Journal of Heart and Lung Transplantation, San Bernardino
County increased organ donations by 60% as a result of
implementing the protocol. For five years, the protocol
has been in place without significant problems.
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As reported in The Journal of American Medicine, November
1994, several states have laws requiring coroners to
perform autopsies in a manner consistent with preserving
organs and tissues for transplant. These laws specify that
if the coroner believes that the tissues or organs are
involved in the cause of death, he or she may request a
biopsy or deny removal of the organ. In these cases, the
coroner must justify the denial in writing. The same
report determined that in 1992, there were 10 geographic
locations in the U.S. where every medical examiner/coroner
case was released for organ recovery. An extensive review
revealed no case in which a state was unable to adequately
investigate a crime or prosecute a criminal because organ
donation had damaged evidence. There were also no cases
where removing organs for donation rendered a subsequent
autopsy so deficient that the cause of death could not be
determined.
FISCAL EFFECT: Appropriation: No Fiscal Com.: Yes
Local: No
SUPPORT: (Verified 8/5/96)
Hoffmann-La Roche, Inc. (source)
California Dialysis Council
California Healthcare Association
County of San Bernardino
OPPOSITION: (Verified 8/5/96)
California State Sheriffs' Association
Los Angeles County Coroner
Department of Finance
ARGUMENTS IN SUPPORT: Proponents assert that this bill
will result in adoption of protocols that will reduce
denials in coroners' cases, thereby generating a greater
supply of organs for transplant. In addition, it is argued
that allowing the coroner to accept assistance to educate
and train staff in the timely determination of the cause of
death will also promote the release of organs in coroners'
cases.
ARGUMENTS IN OPPOSITION: Opponents argue that this bill
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would eliminate or severely impair efforts of coroners and
law enforcement personnel to document and preserve
evidence. It is argued that the incident in Redlands,
while unfortunate, was an isolated one and that coroners
generally have good working relationships with organ
procurement organizations and make every effort to release
organs for donation as appropriate. It is also asserted
that the additional responsibility of documenting, in
writing, the reason a coroner may not want to release an
anatomical gift is unnecessary and burdensome.
CP:lm 8/7/96 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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