Existing law makes it the duty of a coroner to inquire into and determine the circumstances, manner, and cause of deaths under prescribed conditions, including deaths under such circumstances as to afford a reasonable ground to suspect that the death was caused by the criminal act of another. Existing law provides for the execution of a certificate of religious belief stating that postmortem anatomical dissection or specified procedures would violate the religious convictions of the person, and, except as specified, prohibits a coroner from performing the procedure. Existing law requires a postmortem examination or autopsy to include certain procedures, including, among others, taking available fingerprints and palm prints and a dental examination including dental charts and dental X-rays, as specified. Existing law authorizes the postmortem examination or autopsy of the unidentified body or remains to include full body X-rays.

This bill, except as specified, would authorize a coroner, medical examiner, or other agency required to perform an autopsy in a death under those prescribed conditions to use an electronic image system, including, but not limited to, an X-ray computed tomography scanning system, to fulfill specified postmortem examination or autopsy requirements. The bill would prohibit a coroner, medical examiner, or other agency performing an autopsy in a death under those prescribed conditions from using an electronic image system to conduct the autopsy in any investigation where the circumstances surrounding the death afford a reasonable basis to suspect that the death was caused by or related to the criminal act of another and it is necessary to collect evidence for presentation in a court of law. The bill would require a dissection autopsy to be performed to determine the cause and manner of death if the results of an autopsy performed using electronic imaging provides the basis to suspect that the death was caused by or related to the criminal act of another and it is necessary to collect evidence for presentation in a court of law. The bill would allow an autopsy to be conducted using an X-ray computed tomography scanning system without regard to the existence of a properly-executed certificate of religious belief.

Existing law makes it the duty of a coroner to inquire into and determine the circumstances, manner, and cause of deaths under prescribed conditions, including deaths under such circumstances as to afford a reasonable ground to suspect that the death was caused by the criminal act of another. Existing law provides for the execution of a certificate of religious belief stating that postmortem anatomical dissection or specified procedures would violate the religious convictions of the person, and, except as specified, prohibits a coroner from performing the procedure. Existing law requires a postmortem examination or autopsy to include certain procedures, including, among others, taking available fingerprints and palm prints and a dental examination including dental charts and dental X-rays, as specified. Existing law authorizes the postmortem examination or autopsy of the unidentified body or remains to include full body X-rays.

This bill, except as specified, would authorize a coroner, medical examiner, or other agency required to perform an autopsy in a death under those prescribed conditions to use an electronic image system, including, but not limited to, an X-ray computed tomography scanning system, to fulfill specified postmortem examination or autopsy requirements. The bill would prohibit a coroner, medical examiner, or other agency performing an autopsy in a death under those prescribed conditions from using an electronic image system to conduct the autopsy in any investigation where the circumstances surrounding the death afford a reasonable basis to suspect that the death was caused by or related to the criminal act of another and it is necessary to collect evidence for presentation in a court of law. The bill would require a dissection autopsy to be performed to determine the cause and manner of death if the results of an autopsy performed using electronic imaging provides the basis to suspect that the death was caused by or related to the criminal act of another and it is necessary to collect evidence for presentation in a court of law. The bill would allow an autopsy to be conducted using an X-ray computed tomography scanning system without regard to the existence of a properly-executed certificate of religious belief.

Existing law makes it the duty of a coroner to inquire into and determine the circumstances, manner, and cause of deaths under prescribed conditions, including deaths under such circumstances as to afford a reasonable ground to suspect that the death was caused by the criminal act of another. Existing law provides for the execution of a certificate of religious belief stating that postmortem anatomical dissection or specified procedures would violate the religious convictions of the person, and, except as specified, prohibits a coroner from performing the procedure. Existing law requires a postmortem examination or autopsy to include certain procedures, including, among others, taking available fingerprints and palm prints and a dental examination including dental charts and dental X-rays, as specified. Existing law authorizes the postmortem examination or autopsy of the unidentified body or remains to include full body X-rays.

This bill, except as specified, would authorize a coroner, medical examiner, or other agency required to perform an autopsy in a death under those prescribed conditions to use an electronic image system, including, but not limited to, an X-ray computed tomography scanning system, to fulfill specified postmortem examination or autopsy requirements. The bill would prohibit a coroner, medical examiner, or other agency performing an autopsy in a death under those prescribed conditions from using an electronic imaging system to conduct the autopsy in any investigation where the circumstances surrounding the death afford a reasonable basis to suspect that the death was caused by or related to the criminal act of another. another and it is necessary to collect evidence for presentation in a court of law. The bill would require a dissection autopsy to be performed to determine the cause and manner of death if the results of an autopsy performed using electronic imaging provides the basis to suspect that the death was caused by or related to the criminal act of another. another and it is necessary to collect evidence for presentation in a court of law. The bill would allow an autopsy to be conducted using an X-ray computed tomography scanning system without regard to the existence of a properly-executed certificate of religious belief.

Existing law requires a coroner to perform or cause to be performed an autopsy on a decedent, for which an autopsy has not already been performed, on request of specified relatives. makes it the duty of a coroner to inquire into and determine the circumstances, manner, and cause of deaths under prescribed conditions, including deaths under such circumstances as to afford a reasonable ground to suspect that the death was caused by the criminal act of another. Existing law provides for the execution of a certificate of religious belief stating that postmortem anatomical dissection or specified procedures would violate the religious convictions of the person, and, except as specified, prohibits a coroner from performing the procedure. Existing law requires a postmortem examination or autopsy that is conducted at the discretion of a coroner, medical examiner, or other agency to include certain procedures, including, among others, taking available fingerprints and palm prints and a dental examination including dental charts and dental X-rays, as specified. Existing law authorizes the postmortem examination or autopsy of the unidentified body or remains to include full body X-rays.

This bill bill, except as specified, would authorize the use of an electronic image system, including, but not limited to, an X-ray computed tomography scanning system, to fulfill the requirements of a discretionary postmortem examination or autopsy or the requirements of a postmortem examination or autopsy required by other law. a coroner, medical examiner, or other agency required to perform an autopsy in a death under those prescribed conditions to use an electronic image system, including, but not limited to, an X-ray computed tomography scanning system, to fulfill specified postmortem examination or autopsy requirements. The bill would prohibit a coroner, medical examiner, or other agency performing an autopsy in a death under those prescribed conditions from using an electronic imaging system to conduct the autopsy in any investigation where the circumstances surrounding the death afford a reasonable basis to suspect that the death was caused by or related to the criminal act of another. The bill would require a dissection autopsy to be performed to determine the cause and manner of death if the results of an autopsy performed using electronic imaging provides the basis to suspect that the death was caused by or related to the criminal act of another. The bill would allow an autopsy to be conducted using an X-ray computed tomography scanning system without regard to the existence of a properly-executed certificate of religious belief.

Existing law requires a coroner to perform or cause to be performed an autopsy on a decedent, for which an autopsy has not already been performed, on request of specified relatives. Existing law requires a postmortem examination or autopsy that is conducted at the discretion of a coroner, medical examiner, or other agency to include certain procedures, including, among others, taking available fingerprints and palm prints and a dental examination including dental charts and dental X-rays, as specified. Existing law authorizes the postmortem examination or autopsy of the unidentified body or remains to include full body X-rays.

This bill would authorize the use of an electronic image system, including, but not limited to, an X-ray computed tomography scanning system, to fulfill the requirements of a discretionary postmortem examination or autopsy or the requirements of a postmortem examination or autopsy required by other law.

CONCURRENCE IN SENATE AMENDMENTS

CSA1 Bill Id:AB 2457

Author:(Bloom)

As Amended Ver:May 16, 2016

Majority vote

Original Committee Reference: PUB. S.

SUMMARY: Allows coroners to use an electronic imaging system during the conduct of an autopsy, unless there is a reasonable suspicion to believe the death was caused by a criminal act or a contagious disease. Specifically, this bill allows coroners, medical examiners and other authorized personnel to conduct an autopsy or post-mortem examination to use an electronic imaging system during the conduct of an autopsy or post-mortem examination to either aid in the performance of an autopsy pursuant to an inquest, or to fulfill the performance of an autopsy requested by the surviving spouse or next of kin where there is no suspicion a criminal act or contagious disease was the cause of death.

The Senate amendments make a technical clarification relating to when the autopsy will be used to collect evidence for presentation in a court of law.

EXISTING LAW:

1. Requires coroners to determine the manner, circumstances and cause of death in the following circumstances:
   1. Violent, sudden or unusual deaths;
   2. Unattended deaths;
   3. When the deceased was not attended by a physician, or registered nurse who is part of a hospice care interdisciplinary team, in the 20 days before death;
   4. When the death is related to known or suspected self-induced or criminal abortion;
   5. Known or suspected homicide, suicide or accidental poisoning;
   6. Deaths suspected as a result of an accident or injury either old or recent;
   7. Drowning, fire, hanging, gunshot, stabbing, cutting, exposure, starvation, acute alcoholism, drug addiction, strangulation, aspiration, or sudden infant death syndrome;
   8. Deaths in whole or in part occasioned by criminal means;
   9. Deaths associated with a known or alleged rape or crime against nature;
   10. Deaths in prison or while under sentence;
   11. Deaths known or suspected as due to contagious disease and constituting a public hazard;
   12. Deaths from occupational diseases or occupational hazards;
   13. Deaths of patients in state mental hospitals operated by the State Department of State Hospitals;
   14. Deaths of patients in state hospitals serving the developmentally disabled operated by the State Department of Development Services;
   15. Deaths where a reasonable ground exists to suspect the death was caused by the criminal act of another; and
   16. Deaths reported for inquiry by physicians and other persons having knowledge of the death.
2. Requires the coroner or medical examiner to sign the certificate of death when they perform a mandatory inquiry.
3. Allows the coroner or medical examiner discretion when determining the extent of the inquiry required to determine the manner, circumstances and cause of death.
4. Requires the coroner or medical examiner to conduct an autopsy at the request of the surviving spouse or other specified persons when an autopsy has not already been performed.
5. Allows the coroner or medical examiner discretion to conduct an autopsy at the request of the surviving spouse or other specified persons when an autopsy has already been performed.
6. Specifies that the cost of autopsies requested by the surviving spouse or other specified persons are borne by the requestor.
7. Requires that discretionary autopsies include the following:
   1. All available finger and palm prints;
   2. Dental examination;
   3. Collection of tissue including hair sample and DNA sample, if necessary;
   4. Notation and photographs of significant marks, scars, tattoos and personal effects;
   5. Notation of observations pertinent to the time of death; and
   6. Documentation of the location of the remains.
   7. Allows for the use of full body X-rays in conducting a discretionary autopsy.

AS PASSED BY THE ASSEMBLY, this bill allowed coroners to use an electronic imaging system during the conduct of an autopsy, unless there is a reasonable suspicion to believe the death was caused by a criminal act or a contagious disease. Specifically, this bill allowed coroners, medical examiners and other authorized personnel to conduct an autopsy or post-mortem examination to use an electronic imaging system during the conduct of an autopsy or post-mortem examination to either aid in the performance of an autopsy pursuant to an inquest, or to fulfill the performance of an autopsy requested by the surviving spouse or next of kin where there is no suspicion a criminal act or contagious disease was the cause of death.

FISCAL EFFECT: None. This bill is keyed non-fiscal by the Legislative Counsel.

COMMENTS: According to the author, "AB 2457 is a common sense approach that would specifically authorize county coroners or county medical examiners to utilize digital imaging technology when performing an autopsy in cases where an autopsy is needed or mandated by law."

Analysis Prepared by: Stella Choe/ PUB. S. / (916) 319-3744 FN: 0003644

 CONSENT  

Bill No: AB 2457

Author:

:

Vote:

SENATE PUBLIC SAFETY COMMITTEE: 7-0, 6/14/16

AYES: Hancock, Anderson, Glazer, Leno, Liu, Monning, Stone

ASSEMBLY FLOOR: 79-0, 4/21/16 (Consent) - See last page for vote

SUBJECT:

SOURCE: Agudath Israel of California

DIGEST: This bill allows coroners to use an electronic imaging system during an autopsy, unless there is a reasonable suspicion to believe the death was caused by a criminal act.

ANALYSIS:

Existing law:

1. Requires, in Government Code Section 27491, coroners to determine the manner, circumstances and cause of death in the following circumstances:
   1. Violent, sudden or unusual deaths;
   2. Unattended deaths;
   3. When the deceased was not attended by a physician, or registered nurse who is part of a hospice care interdisciplinary team, in the 20 days before death;
   4. When the death is related to known or suspected self-induced or criminal abortion;
   5. Known or suspected homicide, suicide or accidental poisoning;
   6. Deaths suspected as a result of an accident or injury either old or recent;
   7. Drowning, fire, hanging, gunshot, stabbing, cutting, exposure, starvation, acute alcoholism, drug addiction, strangulation, aspiration, or sudden infant death syndrome;
   8. Deaths in whole or in part occasioned by criminal means;
   9. Deaths associated with a known or alleged rape or crime against nature;
   10. Deaths in prison or while under sentence;
   11. Deaths known or suspected as due to contagious disease and constituting a public hazard;
   12. Deaths from occupational diseases or occupational hazards;
   13. Deaths of patients in state mental hospitals operated by the State Department of State Hospitals;
   14. Deaths of patients in state hospitals serving the developmentally disabled operated by the State Department of Development Services;
   15. Deaths where a reasonable ground exists to suspect the death was caused by the criminal act of another; and
   16. Deaths reported for inquiry by physicians and other persons having knowledge of the death.
2. Requires the coroner or medical examiner to sign the certificate of death when they perform a mandatory inquiry. (Government Code § 27491(a).)
3. Allows the coroner or medical examiner discretion when determining the extent of the inquiry required to determine the manner, circumstances and cause of death. (Government Code § 27491(b).)
4. Requires the coroner or medical examiner to conduct an autopsy at the request of the surviving spouse or other specified persons when an autopsy has not already been performed. (Government Code § 27520(a).)
5. Allows the coroner or medical examiner discretion to conduct an autopsy at the request of the surviving spouse or other specified persons when an autopsy has already been performed. (Government Code § 27520(b).)
6. Specifies that the cost of autopsies requested by the surviving spouse or other specified persons are borne by the requestor. (Government Code § 27520(c).)
7. Requires, in Government Code Sections 27521(a) and (b), that discretionary autopsies include the following:
   1. All available finger and palm prints;
   2. Dental examination;
   3. Collection of tissue including hair sample and DNA sample, if necessary;
   4. Notation and photographs of significant marks, scars, tattoos and personal effects;
   5. Notation of observations pertinent to the time of death; and
   6. Documentation of the location of the remains.
8. Allows for the use of full body X-rays in conducting a discretionary autopsy. (Government Code § 27521 (c).)

This bill:

1. Authorizes, except as specified, a coroner, medical examiner, or other agency required to perform an autopsy in a death under those prescribed conditions to use an electronic image system, including, but not limited to, an X-ray computed tomography scanning system, to fulfill specified postmortem examination or autopsy requirements.
2. States that a coroner cannot use an electronic imaging system to conduct an autopsy in any investigation where the circumstances surrounding the death afford a reasonable basis to suspect that the death was caused by or related to the criminal act of another and it is necessary to collect evidence for presentation in a court of law. If the results of an autopsy performed using electronic imaging provides the basis to suspect that the death was caused by or related to the criminal act of another, and it is necessary to collect evidence for presentation in a court of law, then a dissection autopsy shall be performed in order to determine the cause and manner of death.
3. Allows an autopsy to be conducted using an X-ray computed tomography scanning system without regard to the existence of a properly-executed certificate of religious belief.

Background

Electronic imaging systems, such as computer tomography (CT), magnetic resonance imaging (MRI) and X-ray computed tomography scanning have been used increasingly in recent years to assist coroners and medical examiners performing autopsies. In certain cases, these systems can help the coroner determine the cause of death without performing a post-mortem dissection of the deceased. This can be especially helpful in cases where the deceased or the deceased’s surviving spouse or next of kin have religious objections to the post mortem dissections common in traditional autopsies. This bill allows coroners and medical examiners to use these electronic imaging systems during the performance of an autopsy requested by a surviving spouse or next of kin.

This bill also allows coroners, medical examiners and other agencies tasked with performing an autopsy to utilize electronic imaging systems to assist in the performance of a mandatory inquest. Existing law requires coroners and others to perform an autopsy when there is reason to believe the death was caused by a criminal act, either by another or by the deceased. This bill does not allow electronic imaging systems to be the sole method by which these mandatory autopsies are performed, but allows them to be used during these autopsies. There are two reasons for this: (1) electronic imaging systems as a method for performing autopsies have not been ruled admissible as evidence by any court of law; and (2) the current electronic imaging system technology has been shown to be unreliable in determining certain causes of death.

FISCAL EFFECT: Appropriation: Fiscal Com.: Local:

SUPPORT: (Verified 6/15/16)

Agudath Israel of California (source)

California State Coroners’ Association

OPPOSITION: (Verified 6/15/16)

None received

ASSEMBLY FLOOR: 79-0, 4/21/16

AYES: Achadjian, Alejo, Travis Allen, Arambula, Atkins, Baker, Bigelow, Bloom, Bonilla, Bonta, Brough, Brown, Burke, Calderon, Campos, Chang, Chau, Chávez, Chiu, Chu, Cooley, Cooper, Dababneh, Dahle, Daly, Dodd, Eggman, Frazier, Beth Gaines, Gallagher, Cristina Garcia, Eduardo Garcia, Gatto, Gipson, Gomez, Gonzalez, Gordon, Gray, Grove, Hadley, Harper, Roger Hernández, Holden, Irwin, Jones, Jones-Sawyer, Kim, Lackey, Levine, Linder, Lopez, Low, Maienschein, Mathis, Mayes, McCarty, Medina, Melendez, Mullin, Nazarian, Obernolte, O'Donnell, Olsen, Patterson, Quirk, Rodriguez, Salas, Santiago, Steinorth, Mark Stone, Thurmond, Ting, Wagner, Waldron, Weber, Wilk, Williams, Wood, Rendon

NO VOTE RECORDED: Ridley-Thomas

Prepared by: Jessica Devencenzi / PUB. S. /

6/15/16 17:24:51

**** END ****

SENATE COMMITTEE ON PUBLIC SAFETY

Senator Loni Hancock, Chair

2015 - 2016 Regular

Bill No: AB 2457 Hearing Date: June 14, 2016

Subject: Autopsy: Electronic Image Systems

HISTORY

Source: Author

Prior Legislation: SB 1196 (Runner) -- Chapter 45, Statutes of 2008

Support: California State Coroners’ Association

Opposition: None known

Assembly Floor Vote: 79 - 0

PURPOSE

The purpose of this bill is to allow coroners to use an electronic imaging system during an autopsy, unless there is a reasonable suspicion to believe the death was caused by a criminal act, as specified.

Existing law requires coroners to determine the manner, circumstances and cause of death in the following circumstances:

• • Violent, sudden or unusual deaths;
  • Unattended deaths;
  • When the deceased was not attended by a physician, or registered nurse who is part of a hospice care interdisciplinary team, in the 20 days before death;
  • When the death is related to known or suspected self-induced or criminal abortion;
  • Known or suspected homicide, suicide or accidental poisoning;
  • Deaths suspected as a result of an accident or injury either old or recent;
  • Drowning, fire, hanging, gunshot, stabbing, cutting, exposure, starvation, acute alcoholism, drug addiction, strangulation, aspiration, or sudden infant death syndrome;
  • Deaths in whole or in part occasioned by criminal means;
  • Deaths associated with a known or alleged rape or crime against nature;
  • Deaths in prison or while under sentence;
  • Deaths known or suspected as due to contagious disease and constituting a public hazard;
  • Deaths from occupational diseases or occupational hazards;
  • Deaths of patients in state mental hospitals operated by the State Department of State Hospitals;
  • Deaths of patients in state hospitals serving the developmentally disabled operated by the State Department of Development Services;
  • Deaths where a reasonable ground exists to suspect the death was caused by the criminal act of another; and
  • Deaths reported for inquiry by physicians and other persons having knowledge of the death.

(Government Code § 27491.)

Existing law requires the coroner or medical examiner to sign the certificate of death when they perform a mandatory inquiry. (Government Code § 27491(a).)

Existing law allows the coroner or medical examiner discretion when determining the extent of the inquiry required to determine the manner, circumstances and cause of death. (Government Code § 27491(b).)

Existing law requires the coroner or medical examiner to conduct an autopsy at the request of the surviving spouse or other specified persons when an autopsy has not already been performed. (Government Code § 27520(a).)

Existing law allows the coroner or medical examiner discretion to conduct an autopsy at the request of the surviving spouse or other specified persons when an autopsy has already been performed. (Government Code § 27520(b).)

Existing law specifies that the cost of autopsies requested by the surviving spouse or other specified persons are borne by the requestor. (Government Code § 27520(c).)

Existing law requires that discretionary autopsies include the following:

• • All available finger and palm prints;
  • Dental examination;
  • Collection of tissue including hair sample and DNA sample, if necessary;
  • Notation and photographs of significant marks, scars, tattoos and personal effects;
  • Notation of observations pertinent to the time of death; and
  • Documentation of the location of the remains.

(Government Code § 27521(a) and (b).)

Existing law allows for the use of full body X-rays in conducting a discretionary autopsy. (Government Code § 27521 (c).)

This bill, except as specified, would authorize a coroner, medical examiner, or other agency required to perform an autopsy in a death under those prescribed conditions to use an electronic image system, including, but not limited to, an X-ray computed tomography scanning system, to fulfill specified postmortem examination or autopsy requirements.

This bill states that a coroner cannot use an electronic imaging system to conduct an autopsy in any investigation where the circumstances surrounding the death afford a reasonable basis to suspect that the death was caused by or related to the criminal act of another and it is necessary to collect evidence for presentation in a court of law. If the results of an autopsy performed using electronic imaging provides the basis to suspect that the death was caused by or related to the criminal act of another, and it is necessary to collect evidence for presentation in a court of law, then a dissection autopsy shall be performed in order to determine the cause and manner of death.

The bill would allow an autopsy to be conducted using an X-ray computed tomography scanning system without regard to the existence of a properly-executed certificate of religious belief.

RECEIVERSHIP/OVERCROWDING CRISIS AGGRAVATION

For the past several years this Committee has scrutinized legislation referred to its jurisdiction for any potential impact on prison overcrowding. Mindful of the United States Supreme Court ruling and federal court orders relating to the state’s ability to provide a constitutional level of health care to its inmate population and the related issue of prison overcrowding, this Committee has applied its “ROCA” policy as a content-neutral, provisional measure necessary to ensure that the Legislature does not erode progress in reducing prison overcrowding.

On February 10, 2014, the federal court ordered California to reduce its in-state adult institution population to 137.5% of design capacity by February 28, 2016, as follows:

• 143% of design bed capacity by June 30, 2014;
• 141.5% of design bed capacity by February 28, 2015; and,
• 137.5% of design bed capacity by February 28, 2016.

In December of 2015 the administration reported that as “of December 9, 2015, 112,510 inmates were housed in the State’s 34 adult institutions, which amounts to 136.0% of design bed capacity, and 5,264 inmates were housed in out-of-state facilities. The current population is 1,212 inmates below the final court-ordered population benchmark of 137.5% of design bed capacity, and has been under that benchmark since February 2015.” (Defendants’ December 2015 Status Report in Response to February 10, 2014 Order, 2:90-cv-00520 KJM DAD PC, 3-Judge Court, Coleman v. Brown, Plata v. Brown (fn. omitted).) One year ago, 115,826 inmates were housed in the State’s 34 adult institutions, which amounted to 140.0% of design bed capacity, and 8,864 inmates were housed in out-of-state facilities. (Defendants’ December 2014 Status Report in Response to February 10, 2014 Order, 2:90-cv-00520 KJM DAD PC, 3-Judge Court, Coleman v. Brown, Plata v. Brown (fn. omitted).)

While significant gains have been made in reducing the prison population, the state must stabilize these advances and demonstrate to the federal court that California has in place the “durable solution” to prison overcrowding “consistently demanded” by the court. (Opinion Re: Order Granting in Part and Denying in Part Defendants’ Request For Extension of December 31, 2013 Deadline, NO. 2:90-cv-0520 LKK DAD (PC), 3-Judge Court, Coleman v. Brown, Plata v. Brown (2-10-14). The Committee’s consideration of bills that may impact the prison population therefore will be informed by the following questions:

• Whether a proposal erodes a measure which has contributed to reducing the prison population;
• Whether a proposal addresses a major area of public safety or criminal activity for which there is no other reasonable, appropriate remedy;
• Whether a proposal addresses a crime which is directly dangerous to the physical safety of others for which there is no other reasonably appropriate sanction;
• Whether a proposal corrects a constitutional problem or legislative drafting error; and
• Whether a proposal proposes penalties which are proportionate, and cannot be achieved through any other reasonably appropriate remedy.

COMMENTS

1. Need for This Legislation

According to the author:

Existing law requires coroners to perform post mortem dissection in certain cases prescribed by law or in cases where the autopsy on a decedent is requested by specified relatives. Current law also provides a coroner with certain discretionary authority to perform an autopsy during a postmortem examination. The legislation would allow the coroner, if he/she deems it adequate, to perform digital imaging in lieu of a full autopsy.

In 2015, the Los Angeles County Board of Supervisors authorized the purchase of a digital imaging device to be used by the Los Angeles Medical Examiner-Coroner in cases where an autopsy is needed or mandated by law.

A digital imaging device can be used in cases where, at the request of the family of the deceased, the device be used instead of an autopsy through dissection. AB 2457 would specify that digital imaging can be used, at the discretion of the coroner or medical examiner, to perform an autopsy in California.

AB 2457 would add subsection (d) to Government Code 27521 to authorize the use of an electronic imaging system, including, but not limited to, an X-ray computed tomography scanning system, to fulfill the requirements of a discretionary postmortem examination.

2. Electronic Imaging Systems for Autopsies

Electronic imaging systems, such as computer tomography (CT), magnetic resonance imaging (MRI) and X-ray computed tomography scanning have been used increasingly in recent years to assist coroners and medical examiners performing autopsies. In certain cases, these systems can help the coroner determine the cause of death without performing a post-mortem dissection of the deceased. This can be especially helpful in cases where the deceased or the deceased’s surviving spouse or next of kin have religious objections to the post mortem dissections common in traditional autopsies. This bill would allow coroners and medical examiners to use these electronic imaging systems during the performance of an autopsy requested by a surviving spouse or next of kin.

This bill would also allow coroners, medical examiners and other agencies tasked with performing an autopsy to utilize electronic imaging systems to assist in the performance of a mandatory inquest. Existing law requires coroners and others to perform an autopsy when there is reason to believe the death was caused by a criminal act, either by another or by the deceased. This bill would not allow electronic imaging systems to be the sole method by which these mandatory autopsies are performed, but would allow them to be used during these autopsies. There are two reasons for this: (1) electronic imaging systems as a method for performing autopsies have not been ruled admissible as evidence by any court of law;^[1] and (2) the current electronic imaging system technology has been shown to be unreliable in determining certain causes of death.

-- END –

1. For scientific evidence and expert testimony, the court will conduct either a Daubert or Frye style hearing –depending on whether the case is before federal or state court, respectively) to determine the reliability of the particular type of evidence before the court. (see Daubert v. Merrell Dow Pharms., Inc. (1993) 509 U.S. 579; People v. Leahy (1994) 8 Cal.4th 587.) To date, no federal or California court has ruled on the admissibility of autopsies performed using an electronic imaging system. ↑

Date of Hearing:

Consultant: Matt Dean

ASSEMBLY COMMITTEE ON PUBLIC SAFETY

Reginald Byron Jones-Sawyer, Sr., Chair

ABPCA Bill Id:AB 2457

Author:(Bloom) – As Introduced Ver:

As Proposed to be Amended in Committee

SUMMARY:

Allows coroners to use an electronic imaging system during the conduct of an autopsy, unless there is a reasonable suspicion to believe the death was caused by a criminal act or a contagious disease. Specifically, this bill: allows coroners, medical examiners and other authorized personnel to conduct an autopsy or post-mortem examination to use an electronic imaging system during the conduct of an autopsy or post-mortem examination to either aid in the performance of an autopsy pursuant to an inquest, or to fulfill the performance of an autopsy requested by the surviving spouse or next of kin where there is no suspicion a criminal act or contagious disease was the cause of death.

EXISTING LAW:

1. Requires coroners to determine the manner, circumstances and cause of death in the following circumstances:
   
   1. Violent, sudden or unusual deaths;
      
   2. Unattended deaths;
      
   3. When the deceased was not attended by a physician, or registered nurse who is part of a hospice care interdisciplinary team, in the 20 days before death;
      
   4. When the death is related to known or suspected self-induced or criminal abortion;
      
   5. Known or suspected homicide, suicide or accidental poisoning;
      
   6. Deaths suspected as a result of an accident or injury either old or recent;
      
   7. Drowning, fire, hanging, gunshot, stabbing, cutting, exposure, starvation, acute alcoholism, drug addiction, strangulation, aspiration, or sudden infant death syndrome;
      
   8. Deaths in whole or in part occasioned by criminal means;
      
   9. Deaths associated with a known or alleged rape or crime against nature;
      
   10. Deaths in prison or while under sentence;
       
   11. Deaths known or suspected as due to contagious disease and constituting a public hazard;
       
   12. Deaths from occupational diseases or occupational hazards;
       
   13. Deaths of patients in state mental hospitals operated by the State Department of State Hospitals;
       
   14. Deaths of patients in state hospitals serving the developmentally disabled operated by the State Department of Development Services;
       
   15. Deaths where a reasonable ground exists to suspect the death was caused by the criminal act of another; and
       
   16. Deaths reported for inquiry by physicians and other persons having knowledge of the death. (Gov. Code, § 27491.)
       
2. Requires the coroner or medical examiner to sign the certificate of death when they perform a mandatory inquiry. (Gov. Code, § 27491, subd. (a).)
   
3. Allows the coroner or medical examiner discretion when determining the extent of the inquiry required to determine the manner, circumstances and cause of death. (Gov. Code, § 27491, subd. (b).)
   
4. Requires the coroner or medical examiner to conduct an autopsy at the request of the surviving spouse or other specified persons when an autopsy has not already been performed. (Gov. Code, § 27520, subd. (a).)
   
5. Allows the coroner or medical examiner discretion to conduct an autopsy at the request of the surviving spouse or other specified persons when an autopsy has already been performed. (Gov. Code, § 27520, subd. (b).)
   
6. Specifies that the cost of autopsies requested by the surviving spouse or other specified persons are borne by the requestor. (Gov. Code, § 27520, subd. (c).)
   
7. Requires that discretionary autopsies include the following:
   
   1. All available finger and palm prints;
      
   2. Dental examination;
      
   3. Collection of tissue including hair sample and DNA sample, if necessary;
      
   4. Notation and photographs of significant marks, scars, tattoos and personal effects;
      
   5. Notation of observations pertinent to the time of death; and
      
   6. Documentation of the location of the remains. (Gov. Code, § 27521, subds. (a) and (b).)
      
8. Allows for the use of full body X-rays in conducting a discretionary autopsy. (Gov. Code, § 27521, subd. (c).)
   

FISCAL EFFECT:

Unknown

COMMENTS:

1. Author's Statement: According to the author, "AB 2457 is a common sense approach that would specifically authorize county coroners or county medical examiners to utilize digital imaging technology when performing an autopsy in cases where an autopsy is needed or mandated by law.”
   
2. Electronic Imaging Systems for Autopsies: Electronic imaging systems, such as computer tomography (CT), magnetic resonance imaging (MRI) and X-ray computed tomography scanning, have been used increasingly in recent years to assist coroners and medical examiners performing autopsies. In certain cases, these systems can help the coroner determine the cause of death without performing a post-mortem dissection of the deceased. This can be especially helpful in cases where the deceased or the deceased’s surviving spouse or next of kin have religious objections to the post mortem dissections common in traditional autopsies. This bill would allow coroners and medical examiners to use these electronic imaging systems during the performance of an autopsy requested by a surviving spouse or next of kin.
   
   This bill would also allow coroners, medical examiners and other agencies tasked with performing an autopsy to utilize electronic imaging systems to assist in the performance of a mandatory inquest. Existing law requires coroners and others to perform an autopsy when there is reason to believe the death was caused by a criminal act, either by another or by the deceased, and when the coroner or other agency tasked believes a contagious disease constituting a public health hazard may be the cause of death. This bill would not allow electronic imaging systems to be the sole method by which these mandatory autopsies are performed, but would allow them to be used during these autopsies. There are two main reasons for this: first, electronic imaging systems as a method for performing autopsies have not been ruled admissible as evidence by any court of law; and second, the current electronic imaging system technology has been shown to be unreliable in determining certain causes of death.
   
3. Admissibility Concerns: Any evidence submitted before a court of law must be deemed admissible. For scientific evidence and expert testimony, the court will conduct either a Daubert or Frye style hearing –depending on whether the case is before federal or state court, respectively) to determine the reliability of the particular type of evidence before the court. (see Daubert v. Merrell Dow Pharms., Inc. (1993) 509 U.S. 579; People v. Leahy (1994) 8 Cal.4th 587.) To date, no federal or California court has ruled on the admissibility of autopsies performed using an electronic imaging system. Without such a ruling, we cannot be sure that autopsies performed using solely electronic imaging systems will be admissible evidence. Given the importance of autopsies in many criminal investigations and prosecutions, it would be wise to wait until electronic imaging system technology advances to the point where it would be admissible. In one study, one in three autopsies performed using both electronic imaging systems and traditional dissection autopsies resulted in finding different causes of death. <http://blogs.scientificamerican.com/observations/will-ct-scans-and-mris-kill-the-autopsy/> However, the study also found that for certain causes of death, the electronic imaging systems were sufficient. Allowing coroners to use electronic imaging systems for the limited purposes herein described is a good first step in advancing the utility of these promising technologies.
   
4. Summary of Amendments: The amendments before the Committee accomplish the mutual goals of allowing coroners, medical examiners and other tasked with performing autopsies the ability to use electronic imaging systems in an autopsy, while maintaining the requirement that whenever there is any suspicion the death was caused by a criminal act or contagious disease, a dissection autopsy is used to determine the cause of death. This will also achieve the goal of allowing people of faith with religious objections to dissection to receive an electronic imaging autopsy on request.
   
5. Argument in Support: According to Agudath Israel of California, “AB 2457 will allow the use of digital radiologic technology in lieu of an autopsy by dissection. In many coroners’ cases, the use of digital radiologic technology is more than adequate to establish a cause of death without the performance of traditional autopsy by dissection. Coroner’s offices throughout the country are installing such technology because it assists with completion of their caseloads in a more cost-effective and efficient manner. This is not to say that such technology replaces dissection autopsy, however, at the discretion of the coroner, when such technology is sufficient for their needs, it should be utilized.

“There are a number of situations in which some feel that there may be a California state legal mandate for a physical autopsy. This legislation would allow coroners, at their discretion, to utilize digital radiology to fulfill their responsibility. For the Jewish community as well as other communities of faith, autopsies are generally prohibited with certain exceptions. This bill would allow coroners who have access to such radiologic technology to accommodate religious concerns in cases where they see fit to do so.”

1. Related Legislation:
   
   1. SB 1189 (Pan), requires that the results of an autopsy conducted by a coroner be subject to review by a licensed surgeon who is duly qualified as a specialist in pathology. If the coroner and pathologist disagree about a cause of death, this bill would require that the cause of death be subject to review by a separate qualified pathologist. This bill would authorize a coroner who is a qualified pathologist to review and approve his or her own autopsy. SB 1189 is pending in the Senate Committee on Health.
      
   2. AB 1737 (McCarty), requires each county to establish an interagency child death review team to assist local agencies in identifying and reviewing suspicious child deaths and facilitating communication among persons who perform autopsies and the various persons and agencies involved in child abuse or neglect cases. AB 1737 is pending in the Assembly Committee on Local Government.
      
2. Prior Legislation:
   
   1. SB 1196 (Runner), Chapter 45, Statutes of 2008, requires coroners or medical examiners to perform an autopsy at the request of the deceased’s next of kin and requires coroners or medical examiners to inquire into deaths when the deceased was not attended to by a physician or registered nurse in the 20 days prior to death.
      

REGISTERED SUPPORT / OPPOSITION:

Support

Agudath Israel of California
California State Coroners’ Association

Opposition

None

Analysis Prepared by:

Matt Dean / PUB. S. / (916) 319-3744