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 or if the surviving spouse of the deceased requests the coroner to do so in writing. Existing law makes a postmortem examination or autopsy conducted at the discretion of a coroner, medical examiner, or other agency upon an unidentified human body or human remains subject to certain specified provisions of law.

This bill would authorize an agency tasked with the exhumation of a body or skeletal remains of a deceased person that has suffered significant deterioration or decomposition, 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, to perform the exhumation in consultation with a board-certified forensic pathologist and would authorize that board-certified forensic pathologist to suggest to the agency tasked with an exhumation to consider retaining the services of an anthropologist, as specified.

Existing law requires a postmortem examination or autopsy to include certain procedures, including, but not limited to, a dental examination that is authorized to be conducted by a qualified dentist as determined by the coroner. Existing law authorizes the postmortem examination or autopsy of the unidentified body or remains to include full body X-rays.

This bill would instead provide that the dental examination is authorized to be conducted by a qualified dentist as determined by the coroner or medical examiner. The bill would additionally authorize the postmortem examination or autopsy of the unidentified body or remains to include computed tomography scans.

Existing law, unless the coroner, medical examiner, or other agency performing a postmortem examination or autopsy determines the body of the unidentified deceased person has suffered significant deterioration or decomposition, prohibits the jaws from being removed until immediately before the body is cremated or buried and requires the coroner, medical examiner, or other agency to retain the jaws and other tissue samples for a specified period of time.

This bill would require the coroner, medical examiner, or other agency to, instead, retain the appropriate samples of tissue and bone for that specified period of time.

This bill would eliminate that prohibition and would prohibit the unidentified body or human remains from being cremated or buried until the appropriate samples of tissue and bone are retained for future possible use.

By placing new requirements on local governments for performing postmortem examinations or autopsies, this bill would impose a state-mandated local program.

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.

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 or if the surviving spouse of the deceased requests the coroner to do so in writing. Existing law makes a postmortem examination or autopsy conducted at the discretion of a coroner, medical examiner, or other agency upon an unidentified human body or human remains subject to certain specified provisions of law.

This bill would authorize an agency tasked with the exhumation of a body or skeletal remains of a deceased person that has suffered significant deterioration or decomposition, 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, to perform the exhumation in consultation with a board-certified forensic pathologist and would authorize that board-certified forensic pathologist to suggest to the agency tasked with an exhumation to consider retaining the services of an anthropologist, as specified.

Existing law requires a postmortem examination or autopsy to include certain procedures, including, but not limited to, a dental examination that is authorized to be conducted by a qualified dentist as determined by the coroner. Existing law authorizes the postmortem examination or autopsy of the unidentified body or remains to include full body X-rays.

This bill would instead provide that the dental examination is authorized to be conducted by a qualified dentist as determined by the coroner or medical examiner. The bill would additionally authorize the postmortem examination or autopsy of the unidentified body or remains to include computed tomography scans.

Existing law, unless the coroner, medical examiner, or other agency performing a postmortem examination or autopsy determines the body of the unidentified deceased person has suffered significant deterioration or decomposition, prohibits the jaws from being removed until immediately before the body is cremated or buried and requires the coroner, medical examiner, or other agency to retain the jaws and other tissue samples for a specified period of time.

This bill would require the coroner, medical examiner, or other agency to, instead, retain the appropriate samples of tissue and bone for that specified period of time.

This bill would eliminate that prohibition and would prohibit the unidentified body or human remains from being cremated or buried until the appropriate samples of tissue and bone are retained for future possible use.

By placing new requirements on local governments for performing postmortem examinations or autopsies, this bill would impose a state-mandated local program.

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.

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 or if the surviving spouse of the deceased requests the coroner to do so in writing. Existing law makes a postmortem examination or autopsy conducted at the discretion of a coroner, medical examiner, or other agency upon an unidentified human body or human remains subject to certain specified provisions of law.

This bill would require a postmortem examination or autopsy upon an unidentified body or human remains to only be conducted by an attending physician and surgeon, chief medical examiner who is a board-certified forensic pathologist, or a resident physician and surgeon, or a board-eligible forensic pathologist, if the postmortem examination or autopsy is performed under the supervision of a licensed physician and surgeon or the chief medical examiner. The bill would require authorize an agency tasked with the exhumation of a body or skeletal remains of a deceased person that has suffered significant deterioration or decomposition, 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, to perform the exhumation under the direction of in consultation with a board-certified forensic pathologist and would authorize that board-certified forensic pathologist to retain suggest to the agency tasked with an exhumation to consider retaining the services of an anthropologist. anthropologist, as specified.

Existing law requires a postmortem examination or autopsy to include certain procedures, including, but not limited to, a dental examination that is authorized to be conducted by a qualified dentist as determined by the coroner. Existing law authorizes the postmortem examination or autopsy of the unidentified body or remains to include full body X-rays.

This bill would instead provide that the dental examination is authorized to be conducted by a qualified dentist as determined by the coroner, medical examiner, or attending physician and surgeon. coroner or medical examiner. The bill would additionally authorize the postmortem examination or autopsy of the unidentified body or remains to include computed tomography scans.

Existing law authorizes the use of an electronic image system during an autopsy at the sole discretion of a coroner, medical examiner, or other agency tasked with performing an autopsy, except as specified. Existing law requires a coroner, medical examiner, or other agency tasked with performing a postmortem examination or an autopsy to, among other things, submit dental charts, dental X-rays, and the final report of investigation to the Department of Justice, as specified. Existing law, unless the coroner, medical examiner, or other agency performing a postmortem examination or autopsy determines the body of the unidentified deceased person has suffered significant deterioration or decomposition, prohibits the jaws from being removed until immediately before the body is cremated or buried and requires the coroner, medical examiner, or other agency to retain the jaws and other tissue samples for a specified period of time.

This bill would additionally apply those above-described provisions to an attending physician and surgeon. The bill would require the coroner, medical examiner, attending physician and surgeon, or other agency to, instead, retain the appropriate samples of tissue and bone for a specified period of time.

By placing new requirements on local governments for performing postmortem examinations or autopsies, this bill would impose a state-mandated local program.

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.

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 or if the surviving spouse of the deceased requests the coroner to do so in writing. Existing law makes a postmortem examination or autopsy conducted at the discretion of a coroner, medical examiner, or other agency upon an unidentified human body or human remains subject to certain specified provisions of law.

This bill would require a postmortem examination or autopsy upon an unidentified body or human remains to only be conducted by an attending physician and surgeon or surgeon, chief medical examiner who is a board-certified forensic pathologist. pathologist, or a resident physician and surgeon, or a board-eligible forensic pathologist, if the postmortem examination or autopsy is performed under the supervision of a licensed physician and surgeon or the chief medical examiner. The bill would require an agency tasked with the exhumation of a body or skeletal remains of a deceased person that has suffered significant deterioration or decomposition, 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, to perform the exhumation under the direction of a board-certified forensic pathologist and would authorize that board-certified forensic pathologist to retain the services of an anthropologist.

Existing law requires a postmortem examination or autopsy to include certain procedures, including, but not limited to, a dental examination that is authorized to be conducted by a qualified dentist as determined by the coroner. Existing law authorizes the postmortem examination or autopsy of the unidentified body or remains to include full body X-rays.

This bill would instead provide that the dental examination is authorized to be conducted by a qualified dentist as determined by the coroner, medical examiner, or attending physician and surgeon. The bill would additionally authorize the postmortem examination or autopsy of the unidentified body or remains to include computed tomography scans.

Existing law authorizes the use of an electronic image system during an autopsy at the sole discretion of a coroner, medical examiner, or other agency tasked with performing an autopsy, except as specified. Existing law requires a coroner, medical examiner, or other agency tasked with performing a postmortem examination or an autopsy to, among other things, submit dental charts, dental X-rays, and the final report of investigation to the Department of Justice, as specified. Existing law, unless the coroner, medical examiner, or other agency performing a postmortem examination or autopsy determines the body of the unidentified deceased person has suffered significant deterioration or decomposition, prohibits the jaws from being removed until immediately before the body is cremated or buried and requires the coroner, medical examiner, or other agency to retain the jaws and other tissue samples for a specified period of time.

This bill would additionally apply those above-described provisions to an attending physician and surgeon. The bill would require the coroner, medical examiner, attending physician and surgeon, or other agency to, instead, retain the samples of tissue and bone for a specified period of time.

Existing law prohibits the body of an unidentified deceased person from being cremated or buried until the jaws and other tissues tissue samples are retained for future possible use.

This bill would require the appropriate samples of tissue and bone to be retained by an attending physician and surgeon or a chief medical examiner who is a board-certified forensic pathologist for future possible use, including, but not limited to, identification purposes. The bill would, for an unidentified body or human remains, require that appropriate samples of tissue and bone be taken before the unidentified body or human remains are cremated or buried, as specified.

This bill would define attending physician and surgeon for the purposes of these provisions as a physician and surgeon licensed to practice medicine in this state performing a postmortem examination or autopsy, as specified.

By placing new requirements on local governments for performing postmortem examinations or autopsies, this bill would impose a state-mandated local program.

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.

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 and or if the surviving spouse of the deceased requests the coroner to do so in writing. Existing law makes a postmortem examination or autopsy conducted at the discretion of a coroner, medical examiner, or other agency upon an unidentified human body or human remains subject to certain specified provisions of law.

This bill would require a postmortem examination or autopsy upon an unidentified body or human remains to only be conducted by an attending physician and surgeon or chief medical examiner who is a board-certified forensic pathologist. The bill would require an agency tasked with the exhumation of a body or skeletal remains of a deceased person that has suffered significant deterioration or decomposition, 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, to perform the exhumation under the direction of a board-certified forensic pathologist and would authorize that board-certified forensic pathologist to retain the services of an anthropologist.

Existing law requires a postmortem examination or autopsy to include certain procedures, including, but not limited to, a dental examination that is authorized to be conducted by a qualified dentist as determined by the coroner. Existing law authorizes the postmortem examination or autopsy of the unidentified body or remains to include full body X-rays.

This bill would instead provide that the dental examination is authorized to be conducted by a qualified dentist as determined by the coroner, medical examiner, or attending physician and surgeon. The bill would additionally authorize the postmortem examination or autopsy of the unidentified body or remains to include computed tomography scans.

Existing law authorizes the use of an electronic image system during an autopsy at the sole discretion of a coroner, medical examiner, or other agency tasked with performing an autopsy, except as specified. Existing law requires a coroner, medical examiner, or other agency tasked with performing a postmortem examination or an autopsy to, among other things, submit dental charts and dental X-rays charts, dental X-rays, and the final report of investigation to the Department of Justice, as specified. Existing law, unless the coroner, medical examiner, or other agency performing a postmortem examination or autopsy determines the body of the unidentified deceased person has suffered significant deterioration or decomposition, prohibits the jaws from being removed until immediately before the body is cremated or buried and requires the coroner, medical examiner, or other agency to retain the jaws and other tissue samples for a specified period of time.

This bill would additionally apply those above-described provisions to an attending physician and surgeon. The bill would require the coroner, medical examiner, attending physician and surgeon, or other agency to, instead, retain the samples of tissue and bone for a specified period of time.

Existing law prohibits the body of an unidentified deceased person from being cremated or buried until the jaws and other tissues samples are retained for future possible use.

This bill would require the jaws and other tissue samples appropriate samples of tissue and bone to be retained by an attending physician and surgeon or a chief medical examiner who is a board-certified forensic pathologist for future possible use, including, but not limited to, identification purposes. The bill would, for an unidentified body or human remains, require that appropriate samples of tissues tissue and bone be taken before the unidentified body or human remains are cremated or buried, as specified.

This bill would define attending physician and surgeon for the purposes of these provisions as a physician and surgeon licensed to practice medicine in this state performing a postmortem examination or autopsy, as specified.

By placing new requirements on local governments for performing postmortem examinations or autopsies, this bill would impose a state-mandated local program.

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.

The California Global Warming Solutions Act of 2006 designates the State Air Resources Board as the state agency charged with monitoring and regulating sources of emissions of greenhouse gases. The act authorizes the state board to include the use of market-based compliance mechanisms. Existing law requires all moneys, except for fines and penalties, collected by the state board as part of a market-based compliance mechanism to be deposited in the Greenhouse Gas Reduction Fund and to be available upon appropriation by the Legislature.

The California Clean Truck, Bus, and Off-Road Vehicle and Equipment Technology Program, upon appropriation from the Greenhouse Gas Reduction Fund, funds zero- and near-zero-emission truck, bus, and off-road vehicle and equipment technologies and related projects, as specified.

This bill would state the intent of the Legislature to enact legislation that creates the Near-Zero-Emission and Low-Emission Ready-Mix Concrete Truck Replacement Pilot Program, as specified.

 UNFINISHED BUSINESS  

Bill No: SB 1163

Author:

:

Vote:

SENATE PUBLIC SAFETY COMMITTEE: 7-0, 4/24/18

AYES: Skinner, Anderson, Bradford, Jackson, Mitchell, Stone, Wiener

SENATE APPROPRIATIONS COMMITTEE: Senate Rule 28.8

SENATE FLOOR: 38-0, 5/10/18 (Consent)

AYES: Allen, Anderson, Atkins, Bates, Beall, Berryhill, Bradford, Cannella, De León, Dodd, Fuller, Gaines, Galgiani, Glazer, Hernandez, Hill, Hueso, Jackson, Lara, Leyva, McGuire, Mitchell, Monning, Moorlach, Morrell, Newman, Nguyen, Nielsen, Pan, Portantino, Roth, Skinner, Stern, Stone, Vidak, Wieckowski, Wiener, Wilk

NO VOTE RECORDED: Hertzberg

ASSEMBLY FLOOR: 79-0, 8/30/18 - See last page for vote

SUBJECT:

SOURCE: Author

DIGEST:

This bill places new requirements on local governments when performing an autopsy or post mortem examination upon an unidentified body or human remains.

Assembly Amendments

(1) change the mandate to an authorization for the hiring of an anthropologist; (2) remove the requirement that postmortem examination or autopsy as specified; (3) clarify provisions that coroners or medical examiners may authorize certain processes and not attending physicians and surgeons; and (4) eliminate the prohibition and prohibit the unidentified body or human remains from being cremated or buried until the appropriate samples of tissue and bone are retained for future possible use.

ANALYSIS:

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 Developmental 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. Provides that postmortem examination or autopsy by a coroner, medical examiner or other agency upon an unidentified body or human remains is subject to specified requirements.
8. Requires that a post mortem examination or autopsy on an unidentified body or human remains shall but not be limited to the following procedures:
   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.
9. Provides that a forensic autopsy shall only be conducted by a licensed physician and surgeon, and the results of a forensic autopsy only be determined by a licensed physician and surgeon.
10. Defines a "forensic autopsy" to mean an examination of a body of a decedent to generate medical evidence for which the cause and manner of death is determined.
11. Defines "postmortem examination" to mean the external examination of the body where no manner of death is determined.
12. States that the manner of death shall be determined by the coroner or medical examiner of a county. If a forensic autopsy is conducted by a licensed physician and surgeon, the coroner shall consult with the physician in determining the cause of death.
13. Provides that for health and safety purposes, all persons in the autopsy suite shall be informed of the risks presented by blood borne pathogens and that they should wear personal protective equipment, as specified.
14. States that only persons directly involved in the investigation of the death of the decedent shall be allowed into the autopsy suite.
15. Provides that if an individual dies due to the involvement of law enforcement activity, law enforcement directly involved with the death of that individual shall not be involved with any portion of the post mortem examination, nor allowed into the autopsy suite during the performance of the autopsy.
16. States that at the discretion of the coroner and in consultation with the licensed physician and surgeon conducting the autopsy, individuals may be permitted in the autopsy suite for educational and research purposes.
17. Requires that any police reports, crime scene or other information, videos, or laboratory test that are in the possession of law enforcement and are related to a death that is incident to law enforcement activity be made available to the forensic pathologist prior to the completion of the investigation of the death.
18. States that the above autopsy protocol shall not be construed to limit the practice of an autopsy for educational or research purposes.

This bill:

1. States that an agency tasked with the exhumation of a body or skeletal remains of a deceased person that has suffered significant deterioration or decomposition, 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, may perform the exhumation in consultation with a board-certified forensic pathologist and the board-certified forensic pathologist may suggest to the agency tasked with performing the exhumation consider retaining the services of an anthropologist.
2. Requires that a postmortem dental examination be conducted by a qualified dentist as determined by the coroner or medical examiner.
3. Authorizes the postmortem examination or autopsy of an unidentified body or remains to include computer tomography scans.
4. Requires that the body of an unidentified deceased person shall not be cremated or buried until appropriate sample of tissue or bone is retained. The types of samples of tissue and bone that are taken shall be determined by the coroner or medical examiner, and the handling, processing and storage of these samples shall be within, and guided by, generally accepted standards of forensic pathology and death investigations.

Background

Unlike coroners, medical examiners must possess medical backgrounds. A medical examiner is a medical doctor responsible for examining bodies post mortem to determine cause of death. Coroners have the authority to convene a county to determine a cause of death, and often consult medical examiners to complete examinations. Medical examiners responsibilities may include investigating sudden or unnatural deaths, performing forensic medicine and pathology consultations, counseling families regarding manners and cause of death, testifying in courts, conducting physical examinations and laboratory tests, conducting inquests and serving subpoenas for witnesses.

Currently, the Board of Supervisors can create an independent medical examiner of its own volition. This bill provides that the medical examiner must be allowed to operate independently from any other county agency or official in the conduct of autopsies however, the board may still supervise the conduct of the medical examiner.

SB 1163 requires postmortem examinations and autopsies be performed by an attending physician and surgeon or chief medical examiner who is a board-certified forensic pathologist.

According to the National Commission on Forensic Science, there are less than 600 forensic pathologists currently in the U.S., with a need of as many as 1,200. In August of 2015, the commission voted to adopt a recommendation to increase the number, retention, and quality of board-certified forensic pathologists. In response, the National Institute of Justice released a new grant solicitation entitled “Strengthening the Medical Examiner Coroner System” which supports forensic pathology fellowships and provides resources necessary to achieve accreditation. It is unclear if the number of forensic pathologists has increased since efforts in 2015.

One possible concern for this bill is whether there are enough board-certified forensic pathologists to conduct the volume of postmortem examinations and autopsies in California that this bill would require.

FISCAL EFFECT: Appropriation: Fiscal Com.: Local:

According to the Assembly Appropriations Committee, negligible costs.

SUPPORT: (Verified 8/27/18)

California Public Defenders Association

OPPOSITION: (Verified 8/27/18)

None received

ARGUMENTS IN SUPPORT: According to the California Public Defenders Association:

“In 2009, the National Academy of Sciences prepared a report entitled ‘Strengthening Forensic Science: A Path Forward.’ The report examined a number of forensic disciplines and made recommendations for improving the quality and reliability of the work done by forensic scientists. One chapter of the report was entitled “Medical Examiner and Coroner Systems: Current and Future Needs.” In that chapter the authors of the report examined the existing coroner-medical examiner systems throughout the country and made a number of important recommendations. Specifically, the committee recommended that existing coroner systems be replaced with medical examiners; all medical examiner officers should be accredited and autopsies should only be performed by board certified forensic pathologists. The NAS committee believed it was critical these recommendations be adopted in order to ensure the reliability of death investigations conducted in this country.

“Senate Bill 1163 would require postmortem examinations and autopsies be performed by an attending physician and surgeon or chief medical examiner who is a board-certified forensic pathologist. Further, this bill would require an agency tasked with the exhumation of a body or skeletal remains of a deceased person that has suffered significant deterioration caused by or related to the criminal act of another, to perform the exhumation under the direction of a board-certified forensic pathologist and would authorize that board-certified forensic pathologist to retain the services of an anthropologist. In other words, this requires autopsies and other duties conducted by coroners and medical examiners in this state to be performed only by licensed physicians who have the necessary training and education.”

ASSEMBLY FLOOR: 79-0, 8/30/18

AYES: Acosta, Aguiar-Curry, Travis Allen, Arambula, Baker, Berman, Bigelow, Bloom, Bonta, Brough, Burke, Caballero, Calderon, Carrillo, Cervantes, Chau, Chávez, Chen, Chiu, Choi, Chu, Cooley, Cunningham, Dahle, Daly, Eggman, Flora, Fong, Frazier, Friedman, Gabriel, Gallagher, Cristina Garcia, Eduardo Garcia, Gipson, Gloria, Gonzalez Fletcher, Gray, Grayson, Harper, Holden, Irwin, Jones-Sawyer, Kalra, Kamlager-Dove, Kiley, Lackey, Levine, Limón, Low, Maienschein, Mathis, Mayes, McCarty, Medina, Melendez, Mullin, Muratsuchi, Nazarian, Obernolte, O'Donnell, Patterson, Quirk, Quirk-Silva, Reyes, Rivas, Rodriguez, Rubio, Salas, Santiago, Steinorth, Mark Stone, Thurmond, Ting, Voepel, Waldron, Weber, Wood, Rendon

NO VOTE RECORDED: Cooper

Prepared by: Gabe Caswell / PUB. S. /

8/30/18 20:54:30

**** END ****

SENATE THIRD READING

STR Bill Id:SB 1163

Author:(Galgiani)

As Amended Ver:August 24, 2018

Majority vote

SENATE VOTE: 38-0

SUMMARY: Places new requirements on local governments when performing an autopsy or post mortem examination upon an unidentified body or human remains. Specifically, this bill:

1. States that an agency tasked with the exhumation of a body or skeletal remains of a deceased person that has suffered significant deterioration or decomposition, 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, may perform the exhumation in consultation with a board-certified forensic pathologist and the board-certified forensic pathologist may suggest to the agency tasked with performing the exhumation consider retaining the services of an anthropologist.
2. Requires that a postmortem dental examination be conducted by a qualified dentist as determined by the coroner or medical examiner.
3. Authorizes the postmortem examination or autopsy of an unidentified body or remains to include computer tomography scans.
4. Requires that the body of an unidentified deceased person shall not be cremated or buried until appropriate sample of tissue or bone is retained. The types of samples of tissue and bone that are taken shall be determined by the coroner or medical examiner, and the handling, processing and storage of these samples shall be within, and guided by, generally accepted standards of forensic pathology and death investigations.

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. Provides that postmortem examination or autopsy by a coroner, medical examiner or other agency upon an unidentified body or human remains is subject to specified requirements.
8. Requires that a post mortem examination or autopsy on an unidentified body or human remains shall but not be limited to the following procedures:
   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.
9. Provides that a forensic autopsy shall only be conducted by a licensed physician and surgeon, and the results of a forensic autopsy only be determined by a licensed physician and surgeon.
10. Defines a "forensic autopsy" to mean an examination of a body of a decedent to generate medical evidence for which the cause and manner of death is determined.
11. Defines "postmortem examination" to mean the external examination of the body where no manner of death is determined.
12. States that the manner of death shall be determined by the coroner or medical examiner of a county. If a forensic autopsy is conducted by a licensed physician and surgeon, the coroner shall consult with the physician in determining the cause of death.
13. Provides that for health and safety purposes, all persons in the autopsy suite shall be informed of the risks presented by blood borne pathogens and that they should wear personal protective equipment, as specified.
14. States that only persons directly involved in the investigation of the death of the decedent shall be allowed into the autopsy suite.
15. Provides that if an individual dies due to the involvement of law enforcement activity, law enforcement directly involved with the death of that individual shall not be involved with any portion of the post mortem examination, nor allowed into the autopsy suite during the performance of the autopsy.
16. States that at the discretion of the coroner and in consultation with the licensed physician and surgeon conducting the autopsy, individuals may be permitted in the autopsy suite for educational and research purposes.
17. Requires that any police reports, crime scene or other information, videos, or laboratory test that are in the possession of law enforcement and are related to a death that is incident to law enforcement activity be made available to the forensic pathologist prior to the completion of the investigation of the death.
18. States that the above autopsy protocol shall not be construed to limit the practice of an autopsy for educational or research purposes.

FISCAL EFFECT: According to the Assembly Appropriations Committee, negligible costs.

COMMENTS: According to the author, "There are over 25,000 missing and unidentified persons in the California Attorney General's repository of cold cases. Clarifying and updating the law in regards to how to handle investigations and autopsies involving unidentified bodies will also help provide closure to families with missing loved ones.

"With the advancements of science and technology, this bill is necessary to ensure the most accurate information is kept on file in cases of unidentified human remains. In many cases a body can be identified with much less than what was once necessary and required by law. This bill will provide transparency and confidence in the process when an unidentified body or human remains are found.

"Until a few years ago, the only identification process available was to consider the body of evidence gathered from the skeleton, the teeth, and the circumstances, then make a conclusion. Now, however, DNA [deoxyribonucleic acid] matching provides positive identification much more readily (usually). There are two types of DNA: nuclear DNA and mitochondrial DNA (mtDNA). Nuclear DNA is in the nucleus of the cell and it decays as the flesh decays. MtDNA is in the mitochondria, or the wall, of the cell. It survives for a long time and can be recovered from bones.

"Having a forensic pathologist direct the exhumation in the case where the circumstances surrounding the death affords a reasonable basis to suspect that the death was caused by or related to the criminal act of another, helps to ensure maximum recovery and protection of the human skeletal remains; skeletal analysis helps to identify the victim and determine how the victim may have died. Because of the nature of the cases that they work on – victims that are badly decomposed, skeletonized, or when body parts are missing – the forensic pathologist or anthropologist is often the victim's last chance for identification and justice."

Analysis Prepared by: Gregory Pagan / PUB. S. / (916) 319-3744 FN: 0004786

SENATE THIRD READING

STR Bill Id:SB 1163

Author:(Galgiani)

As Amended Ver:June 25, 2018

Majority vote

SENATE VOTE: 38-0

SUMMARY: Requires that all postmortem examinations and autopsies conducted upon an unidentified body or human remains be conducted by an attending physician and surgeon or chief medical examiner that is a board-certified pathologist. Specifically, this bill:

1. Requires that a postmortem examination or autopsy upon an unidentified body or human remains to only be conducted by an attending physician and surgeon or chief medical examiner who is a board-certified forensic pathologist.
2. States that an agency tasked with the exhumation of a body or skeletal remains of a deceased person that has suffered significant deterioration or decomposition, 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, shall perform the exhumation under the direction of a board-certified forensic pathologist and would authorize that board-certified forensic pathologist to retain the services of an anthropologist.
3. Requires an attending physician or surgeon conducting a post mortem examination or autopsy to comply with the same procedural requirements that are required to be observed by a coroner or medical examiner.
4. Requires that the body of an unidentified deceased person shall not be cremated or buried until appropriate sample of tissue or bone is taken by an attending physician and surgeon or the chief medical examiner who is board certified forensic pathologist for future possible use, including, but not limited to, identification purposes, and allows the above persons to determine the appropriate sample types to be taken.
5. Defines "attending physician or surgeon" for the purposes of the above provisions as ''a physician or surgeon licensed to practice medicine in the state performing a postmortem examination or autopsy, as specified.''

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. Provides that postmortem examination or autopsy by a coroner, medical examiner or other agency upon an unidentified body or human remains is subject to specified requirements.
8. Requires that a post mortem examination or autopsy on an unidentified body or human remains shall but not be limited to the following procedures:
   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.
9. Provides that a forensic autopsy shall only be conducted by a licensed physician and surgeon, and the results of a forensic autopsy only be determined by a licensed physician and surgeon.
10. Defines a "forensic autopsy" to mean an examination of a body of a decedent to generate medical evidence for which the cause and manner of death is determined.
11. Defines "postmortem examination" to mean the external examination of the body where no manner of death is determined.
12. States that the manner of death shall be determined by the coroner or medical examiner of a county. If a forensic autopsy is conducted by a licensed physician and surgeon, the coroner shall consult with the physician in determining the cause of death.
13. Provides that for health and safety purposes, all persons in the autopsy suite shall be informed of the risks presented by blood borne pathogens and that they should wear personal protective equipment, as specified.
14. States that only persons directly involved in the investigation of the death of the decedent shall be allowed into the autopsy suite.
15. Provides that if an individual dies due to the involvement of law enforcement activity, law enforcement directly involved with the death of that individual shall not be involved with any portion of the post mortem examination, nor allowed into the autopsy suite during the performance of the autopsy.
16. States that at the discretion of the coroner and in consultation with the licensed physician and surgeon conducting the autopsy, individuals may be permitted in the autopsy suite for educational and research purposes.
17. Requires that any police reports, crime scene or other information, videos, or laboratory test that are in the possession of law enforcement and are related to a death that is incident to law enforcement activity be made available to the forensic pathologist prior to the completion of the investigation of the death.
18. States that the above autopsy protocol shall not be construed to limit the practice of an autopsy for educational or research purposes.

FISCAL EFFECT: According to the Assembly Appropriations Committee, negligible costs.

COMMENTS: According to the author, "There are over 25,000 missing and unidentified persons in the California Attorney General's repository of cold cases. Clarifying and updating the law in regards to how to handle investigations and autopsies involving unidentified bodies will also help provide closure to families with missing loved ones.

"With the advancements of science and technology, this bill is necessary to ensure the most accurate information is kept on file in cases of unidentified human remains. In many cases a body can be identified with much less than what was once necessary and required by law. This bill will provide transparency and confidence in the process when an unidentified body or human remains are found.

"Until a few years ago, the only identification process available was to consider the body of evidence gathered from the skeleton, the teeth, and the circumstances, then make a conclusion. Now, however, DNA [deoxyribonucleic acid] matching provides positive identification much more readily (usually). There are two types of DNA: nuclear DNA and mitochondrial DNA (mtDNA). Nuclear DNA is in the nucleus of the cell and it decays as the flesh decays. MtDNA is in the mitochondria, or the wall, of the cell. It survives for a long time and can be recovered from bones.

"Having a forensic pathologist direct the exhumation in the case where the circumstances surrounding the death affords a reasonable basis to suspect that the death was caused by or related to the criminal act of another, helps to ensure maximum recovery and protection of the human skeletal remains; skeletal analysis helps to identify the victim and determine how the victim may have died. Because of the nature of the cases that they work on--victims that are badly decomposed, skeletonized, or when body parts are missing--the forensic pathologist or anthropologist is often the victim’s last chance for identification and justice."

Please see the policy committee analysis for a full discussion of this bill.

Analysis Prepared by: Gregory Pagan / PUB. S. / (916) 319-3744 FN: 0003882

Date of Hearing: August 8, 2018

ASSEMBLY COMMITTEE ON APPROPRIATIONS

Lorena Gonzalez Fletcher, Chair

SBPCA Bill Id:SB 1163

Author:(Galgiani) – As Amended Ver:June 25, 2018

Urgency: No State Mandated Local Program: Yes Reimbursable: No

SUMMARY:

This bill requires that all postmortem examinations and autopsies conducted on unidentified bodies or human remains be conducted by an attending physician and surgeon, chief medical examiner that is a board-certified pathologist, or a resident physician and surgeon, or a board-eligible forensic pathologist, if the examination is performed under the supervision of a licensed physician and surgeon or the chief medical examiner. In addition, this bill requires an agency tasked with exhuming the remains of a deceased person, where there is reason to believe the person’s death was related to a criminal act, to perform the exhumation under the direction of a board-certified forensic pathologist. This bill also specifies that a forensic pathologist overseeing an exhumation has the authority to retain the services of an anthropologist.

FISCAL EFFECT:

Negligible costs.

COMMENTS:

1. Background. In California, 41 of the 58 counties have elected sheriff-coroners who assume the responsibilities of both the sheriff and coroner. In the remaining counties, some counties have separately elected coroners or appointed coroners or medical examiners who perform the functions of a coroner. As public officials, coroners are not required to have any medical training and most coroners do not have a medical degree, however coroners are tasked with determining cause of death. Coroners have the authority to retain the services of medical examiners to complete investigations into the cause of a death. Unlike coroners, medical examiners are licensed medical doctors with training in examining bodies.
2. Purpose. This bill requires autopsies of unidentified bodies or human remains to be conducted by a licensed medical doctor. According to the author:

There are over 25,000 missing and unidentified persons in the California Attorney General's repository of cold cases. Clarifying and updating the law in regards to how to handle investigations and autopsies involving unidentified bodies will also help provide closure to families with missing loved ones.

Analysis Prepared by: Jessica Peters / APPR. / (916) 319-2081

Date of Hearing: June 12, 2018

Chief Counsel: Gregory Pagan

ASSEMBLY COMMITTEE ON PUBLIC SAFETY

Reginald Byron Jones-Sawyer, Sr., Chair

SBPCA Bill Id:SB 1163

Author:(Galgiani) – As Amended Ver:April 16, 2018

SUMMARY: Requires that all postmortem examinations and autopsies conducted upon an unidentified body or human remains be conducted by an attending physician and surgeon or chief medical examiner that is a board-certified pathologist. Specifically, this bill:

1. Requires that a postmortem examination or autopsy upon an unidentified body or human remains to only be conducted by an attending physician and surgeon or chief medical examiner who is a board-certified forensic pathologist.
   
2. States that an agency tasked with the exhumation of a body or skeletal remains of a deceased person that has suffered significant deterioration or decomposition, 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, shall perform the exhumation under the direction of a board-certified forensic pathologist and would authorize that board-certified forensic pathologist to retain the services of an anthropologist.
3. Requires an attending physician or surgeon conducting a post mortem examination or autopsy to comply with the same procedural requirements that are required to be observed by a coroner or medical examiner.
   
4. Requires that the body of an unidentified deceased person shall not be cremated or buried until appropriate sample of tissue or bone is taken by an attending physician and surgeon or the chief medical examiner who is board certified forensic pathologist for future possible use, including, but not limited to, identification purposes, and allows the above persons to determine the appropriate sample types to be taken.
   
5. Defines "attending physician or surgeon" for the purposes of the above provisions as “a physician or surgeon licensed to practice medicine in the state performing a postmortem examination or autopsy, as specified.”

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. Provides that postmortem examination or autopsy by a coroner, medical examiner or other agency upon an unidentified body or human remains is subject to specified requirements. (Pen. Code, § 27521, subd. (a).)
   
8. Requires that a post mortem examination or autopsy on an unidentified body or human remains shall but not be limited to the following procedures:
   
   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, subd. (b).)
      
9. Provides that a forensic autopsy shall only be conducted by a licensed physician and surgeon, and the results of a forensic autopsy only be determined by a licensed physician and surgeon. (Pen. Code, § 27522 (subd. (a).)
   
10. Defines a "forensic autopsy" to mean an examination of a body of a decedent to generate medical evidence for which the cause and manner of death is determined. (Pen. Code, § 27522 (subd. (b).)
    
11. Defines "postmortem examination" to mean the external examination of the body where no manner of death is determined. (Pen. Code, § 27522 (subd. (c).)
    
12. States that the manner of death shall be determined by the coroner or medical examiner of a county. If a forensic autopsy is conducted by a licensed physician and surgeon, the coroner shall consult with the physician in determining the cause of death. (Pen. Code, § 27522 (subd. (d).)
    
13. Provides that for health and safety purposes, all persons in the autopsy suite shall be informed of the risks presented by blood borne pathogens and that they should wear personal protective equipment, as specified. (Pen. Code, § 27522 (subd. (e).)
    
14. States that only persons directly involved in the investigation of the death of the decedent shall be allowed into the autopsy suite. (Pen. Code, § 27522 (subd. (f)(1).)
    
15. Provides that if an individual dies due to the involvement of law enforcement activity, law enforcement directly involved with the death of that individual shall not be involved with any portion of the post mortem examination, nor allowed into the autopsy suite during the performance of the autopsy. (Pen. Code, § 27522 (subd. (f)(2).)
    
16. States that at the discretion of the coroner and in consultation with the licensed physician and surgeon conducting the autopsy, individuals may be permitted in the autopsy suite for educational and research purposes. (Pen. Code, § 27522 (subd. (f)(3).)
    
17. Requires that any police reports, crime scene or other information, videos, or laboratory test that are in the possession of law enforcement and are related to a death that is incident to law enforcement activity be made available to the forensic pathologist prior to the completion of the investigation of the death. (Pen. Code, § 27522 (subd. (g).)
    
18. States that the above autopsy protocol shall not be construed to limit the practice of an autopsy for educational or research purposes. (Pen. Code, § 27522 (subd. (h).)

FISCAL EFFECT: Unknown

COMMENTS:

1. Authors Statement: According to the author, "There are over 25,000 missing and unidentified persons in the California Attorney General's repository of cold cases. Clarifying and updating the law in regards to how to handle investigations and autopsies involving unidentified bodies will also help provide closure to families with missing loved ones.
   
   "With the advancements of science and technology, this bill is necessary to ensure the most accurate information is kept on file in cases of unidentified human remains. In many cases a body can be identified with much less than what was once necessary and required by law. This bill will provide transparency and confidence in the process when an unidentified body or human remains are found.
   

"Until a few years ago, the only identification process available was to consider the body of evidence gathered from the skeleton, the teeth, and the circumstances, then make a conclusion. Now, however, DNA matching provides positive identification much more readily (usually). There are two types of DNA: nuclear DNA and mitochondrial DNA (mtDNA). Nuclear DNA is in the nucleus of the cell and it decays as the flesh decays. MtDNA is in the mitochondria, or the wall, of the cell. It survives for a long time and can be recovered from bones.

"Having a forensic pathologist direct the exhumation in the case where the circumstances surrounding the death affords a reasonable basis to suspect that the death was caused by or related to the criminal act of another, helps to ensure maximum recovery and protection of the human skeletal remains; skeletal analysis helps to identify the victim and determine how the victim may have died. Because of the nature of the cases that they work on--victims that are badly decomposed, skeletonized, or when body parts are missing--the forensic pathologist or anthropologist is often the victim’s last chance for identification and justice."

1. Prior Legislation:
   1. SB 1189 (Pan), Chapter 787, Statutes of 2016, required that a forensic autopsy only be conducted by a licensed physician or surgeon, and the results of forensic autopsy only be determined by a licensed physician or surgeon
      
   2. SB 1066 (Galgiani), Chapter 437, Statutes of 2014, revised, recast, and renumbered several provision of law relating to missing or unidentified persons.

REGISTERED SUPPORT / OPPOSITION:

Support

California Public Defenders Association
Medical board of California

Opposition

California State Coroners' Association

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

 CONSENT  

Bill No: SB 1163

Author:

:

Vote:

SENATE PUBLIC SAFETY COMMITTEE: 7-0, 4/24/18

AYES: Skinner, Anderson, Bradford, Jackson, Mitchell, Stone, Wiener

SENATE APPROPRIATIONS COMMITTEE: Senate Rule 28.8

SUBJECT:

SOURCE: Author

DIGEST:

This bill requires that all postmortem examinations and autopsies conducted upon an unidentified human body or human remains be conducted by an attending physician and surgeon or chief medical examiner who is a board-certified forensic pathologist.

ANALYSIS:

Existing law:

1. 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 and if the surviving spouse of the deceased requests the coroner to do so in writing. (Gov. Code, § 27520, et seq.)
2. Makes a postmortem examination or autopsy conducted at the discretion of a coroner, medical examiner, or other agency upon an unidentified human body or human remains subject to certain specified provisions of law. (Gov. Code, § 27521, subd. (a).)
3. Requires a postmortem examination or autopsy to include certain procedures, including, but not limited to, a dental examination that is authorized to be conducted by a qualified dentist as determined by the coroner. (Gov. Code, § 27521, subd. (b)(2).)
4. Authorizes the use of an electronic image system during an autopsy at the sole discretion of a coroner, medical examiner, or other agency tasked with performing an autopsy, except as specified. (Gov. Code, § 27521, subd. (d)(1).)
5. Requires a coroner, medical examiner, or other agency tasked with performing a postmortem examination or an autopsy to, among other things, submit dental charts and dental X-rays and the final report of investigation to the Department of Justice, as specified. (Gov. Code, § 27521, subd. (g).)
6. States that, unless the coroner, medical examiner, or other agency performing a postmortem examination or autopsy determines the body of the unidentified deceased person has suffered significant deterioration or decomposition, prohibits the jaws from being removed until immediately before the body is cremated or buried and requires the coroner, medical examiner, or other agency to retain the jaws and other tissue samples for a specified period of time. (Gov. Code, § 27521, subd. (f).)
7. Prohibits the body of an unidentified deceased person from being cremated or buried until the jaws and other tissues samples are retained for future possible use. (Gov. Code, § 27521, subd. (f).)

This bill:

1. Requires a postmortem examination or autopsy upon an unidentified body or human remains to only be conducted by an attending physician and surgeon or chief medical examiner who is a board-certified forensic pathologist.
2. Requires an agency tasked with the exhumation of a body or skeletal remains of a deceased person that has suffered significant deterioration or decomposition, 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, to perform the exhumation under the direction of a board-certified forensic pathologist and authorizes that board-certified forensic pathologist to retain the services of an anthropologist.
3. Allows the postmortem examination or autopsy of an unidentified body or remains to include a full body x-ray.
4. Provides that the dental examination is authorized to be conducted by a qualified dentist as determined by the coroner, medical examiner, or attending physician and surgeon.
5. Applies specified provisions to an attending physician and surgeon.
6. Requires the appropriate samples of tissue and bone be retained by an attending physician and surgeon or a chief medical examiner who is a board-certified forensic pathologist for future possible use, including, but not limited to, identification purposes.
7. Requires, for an unidentified body or human remains, that appropriate samples of tissue and bone be taken before the unidentified body or human remains are cremated or buried, as specified.
8. Defines “attending physician and surgeon” for the purposes of these provisions as a physician and surgeon licensed to practice medicine in this state performing a postmortem examination or autopsy, as specified.

FISCAL EFFECT: Appropriation: Fiscal Com.: Local:

SUPPORT: (Verified 5/7/18)

California Public Defenders Association

OPPOSITION: (Verified 5/7/18)

None received

Prepared by: Gabe Caswell / PUB. S. /

5/9/18 13:39:26

**** END ****

SENATE COMMITTEE ON PUBLIC SAFETY

Senator Nancy Skinner, Chair

2017 - 2018 Regular

Bill No: SB 1163 Hearing Date: April 24, 2018

Subject: Postmortem Examination or Autopsy: Unidentified Body or Human Remains: Medical Examiner: Attending Physician and Surgeon

HISTORY

Source: Author

Prior Legislation: SB 1189 (Pan), Ch. 787, Stats. 2016

SB 1066 (Galgiani), Ch. 437, Stats. 2014

Support: California Public Defenders Association

Opposition: None known

PURPOSE

The purpose of this bill is to require that all postmortem examinations and autopsies conducted upon an unidentified human body or human remains be conducted by an attending physician and surgeon or chief medical examiner who is a board-certified forensic pathologist.

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 and if the surviving spouse of the deceased requests the coroner to do so in writing. (Pen. Code, § 27520, et seq.)

Existing law makes a postmortem examination or autopsy conducted at the discretion of a coroner, medical examiner, or other agency upon an unidentified human body or human remains subject to certain specified provisions of law. (Pen. Code, § 27521, subd. (a).)

This bill would require a postmortem examination or autopsy upon an unidentified body or human remains to only be conducted by an attending physician and surgeon or chief medical examiner who is a board-certified forensic pathologist.

This bill would require an agency tasked with the exhumation of a body or skeletal remains of a deceased person that has suffered significant deterioration or decomposition, 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, to perform the exhumation under the direction of a board-certified forensic pathologist and would authorize that board-certified forensic pathologist to retain the services of an anthropologist.

This bill would allow the postmortem examination or autopsy of an unidentified body or remains to include a full body x-ray.

Existing law requires a postmortem examination or autopsy to include certain procedures, including, but not limited to, a dental examination that is authorized to be conducted by a qualified dentist as determined by the coroner. (Pen. Code, § 27521, subd. (b)(2).)

This bill would instead provide that the dental examination is authorized to be conducted by a qualified dentist as determined by the coroner, medical examiner, or attending physician and surgeon.

Existing law authorizes the use of an electronic image system during an autopsy at the sole discretion of a coroner, medical examiner, or other agency tasked with performing an autopsy, except as specified. (Pen. Code, § 27521, subd. (d)(1).)

Existing law requires a coroner, medical examiner, or other agency tasked with performing a postmortem examination or an autopsy to, among other things, submit dental charts and dental X-rays and the final report of investigation to the Department of Justice, as specified. (Pen. Code, § 27521, subd. (g).)

Existing law, unless the coroner, medical examiner, or other agency performing a postmortem examination or autopsy determines the body of the unidentified deceased person has suffered significant deterioration or decomposition, prohibits the jaws from being removed until immediately before the body is cremated or buried and requires the coroner, medical examiner, or other agency to retain the jaws and other tissue samples for a specified period of time. (Pen. Code, § 27521, subd. (f).)

This bill would additionally apply those above-described provisions to an attending physician and surgeon.

Existing law prohibits the body of an unidentified deceased person from being cremated or buried until the jaws and other tissues samples are retained for future possible use. (Pen. Code, § 27521, subd. (f).)

This bill would require the appropriate samples of tissue and bone be retained by an attending physician and surgeon or a chief medical examiner who is a board-certified forensic pathologist for future possible use, including, but not limited to, identification purposes.

This bill would, for an unidentified body or human remains, require that appropriate samples of tissue and bone be taken before the unidentified body or human remains are cremated or buried, as specified.

This bill would define “attending physician and surgeon” for the purposes of these provisions as a physician and surgeon licensed to practice medicine in this state performing a postmortem examination or autopsy, as specified.

COMMENTS

1. Need for This Bill

According to the author:

In current law, it is the duty of the coroner to determine cause of death and to decide whether to conduct an autopsy upon an unidentified body or human remains. This bill would require an autopsy upon an unidentified body or human remains to only be conducted by an attending physician and surgeon or chief medical examiner who is a board-certified forensic pathologist. The bill would also require an agency tasked with the exhumation of a body or skeletal remains of a deceased person that has suffered significant deterioration or decomposition, where the circumstances surrounding the death afford a reasonable basis to suspect that the death was caused by the criminal act of another, to perform the exhumation under the direction of a board-certified forensic pathologist and would authorize that board-certified forensic pathologist to retain the services of an anthropologist.

There are over 25,000 missing and unidentified persons in the California Attorney General's repository of cold cases. Clarifying and updating the law in regards to how to handle investigations and autopsies involving unidentified bodies will also help provide closure to families with missing loved ones.

With the advancements of science and technology, this bill is necessary to ensure the most accurate information is kept on file in cases of unidentified human remains. In many cases a body can be identified with much less than what was once necessary and required by law. This bill will provide transparency and confidence in the process when an unidentified body or human remains are found.

Until a few years ago, the only identification process available was to consider the body of evidence gathered from the skeleton, the teeth, and the circumstances, then make a conclusion. Now, however, DNA matching provides positive identification much more readily (usually). There are two types of DNA: nuclear DNA and mitochondrial DNA (mtDNA). Nuclear DNA is in the nucleus of the cell and it decays as the flesh decays. MtDNA is in the mitochondria, or the wall, of the cell. It survives for a long time and can be recovered from bones.

Having a forensic pathologist direct the exhumation in the case where the circumstances surrounding the death affords a reasonable basis to suspect that the death was caused by or related to the criminal act of another, helps to ensure maximum recovery and protection of the human skeletal remains; skeletal analysis helps to identify the victim and determine how the victim may have died. Because of the nature of the cases that they work on--victims

that are badly decomposed, skeletonized, or when body parts are missing--the forensic pathologist or anthropologist is often the victim’s last chance for identification and justice.

1. Medical Examiners

Unlike coroners, medical examiners must possess medical backgrounds. A medical examiner is a medical doctor responsible for examining bodies post mortem to determine cause of death. Coroners have the authority to convene a county to determine a cause of death, and often consult medical examiners to complete examinations. Medical examiners responsibilities may include investigating sudden or unnatural deaths, performing forensic medicine and pathology consultations, counseling families regarding manners and cause of death, testifying in courts, conducting physical examinations and laboratory tests, conducting inquests and serving subpoenas for witnesses.

Currently, the Board of Supervisors can create an independent medical examiner of its own volition. This bill provides that the medical examiner must be allowed to operate independently from any other county agency or official in the conduct of autopsies however, the board may still supervise the conduct of the medical examiner. SB 1303 requires six counties to change their sheriff-coroner investigations including San Joaquin, Riverside, Contra Costa, Kern, Stanislaus, and Sonoma.

SB 1163 would require postmortem examinations and autopsies be performed by an attending physician and surgeon or chief medical examiner who is a board-certified forensic pathologist.

1. Shortage of Forensic Pathologists

According to the National Commission on Forensic Science, there are less than 600 forensic pathologists currently in the U.S., with a need of as many as 1,200.^[1] In August of 2015, the commission voted to adopt a recommendation to increase the number, retention, and quality of board-certified forensic pathologists. In response, the National Institute of Justice released a new grant solicitation entitled “Strengthening the Medical Examiner Coroner System” which supports forensic pathology fellowships and provides resources necessary to achieve accreditation.^[2] It is unclear if the number of forensic pathologists has increased since efforts in 2015.

One possible concern for this bill is whether there are enough board-certified forensic pathologists to conduct the volume of postmortem examinations and autopsies in California that this bill would require.

4. Argument in Support

According to the California Public Defenders Association:

In 2009, the National Academy of Sciences prepared a report entitled “Strengthening Forensic Science: A Path Forward.” The report examined a number of forensic disciplines and made recommendations for improving the quality and reliability of the work done by forensic scientists. One chapter of the report was entitled “Medical Examiner and Coroner Systems: Current and Future Needs.” In that chapter the authors of the report examined the existing coroner-medical examiner systems throughout the country and made a number of important recommendations. Specifically, the committee recommended that existing coroner systems be replaced with medical examiners; all medical examiner officers should be accredited and autopsies should only be performed by board certified forensic pathologists. The NAS committee believed it was critical these recommendations be adopted in order to ensure the reliability of death investigations conducted in this country.

Senate Bill 1163 would require postmortem examinations and autopsies be performed by an attending physician and surgeon or chief medical examiner who is a board-certified forensic pathologist. Further, this bill would require an agency tasked with the exhumation of a body or skeletal remains of a deceased person that has suffered significant deterioration caused by or related to the criminal act of another, to perform the exhumation under the direction of a board-certified forensic pathologist and would authorize that board-certified forensic pathologist to retain the services of an anthropologist. In other words, this requires autopsies and other duties conducted by coroners and medical examiners in this state to be performed only by licensed physicians who have the necessary training and education.

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1. “National Commission on Forensic Science,” 2017, 180. ↑

2. National Research Council (U.S.), National Research Council (U.S.), and National Research Council (U.S.), Strengthening Forensic Science in the United States. ↑