COUNTY OF SAN MATEO

Inter-Departmental Correspondence

BOARD OF SUPERVISORS

DATE:

May 14, 2007

BOARD MEETING DATE:

May 22, 2007

SPECIAL NOTICE/HEARING:

No

VOTE REQUIRED:

Majority

TO:

Honorable Board of Supervisors

FROM:

Adrienne Tissier, County Supervisor

SUBJECT:

Resolution Regarding Notification of Next-of-Kin and Consent when Removal of Organs or Other Tissue is Anticipated During Autopsy

RECOMMENDATION:

Adopt a resolution regarding notification of next-of-kin and consent when removal of organs or other tissue is anticipated during an autopsy.

VISION ALIGNMENT:

Commitment: Responsive, effective and collaborative government

Goal(s): 20. Government decisions are based on careful consideration of future impact, rather than temporary relief or immediate gain. 21. County employees understand, support and integrate the County vision and goals into their delivery of services

BACKGROUND:

In 2006, two young Daly City men died at separate times of the year. In one instance, the Coroner retained samples of tissue and blood, while in a second case the Coroner retained both samples of tissue as well as other tissue- specifically the young man’s heart.

With respect to the second young man, his remains were interred and the family was subsequently informed that the Coroner’s office had retained the young man’s heart in order to further confirm the cause of death. The heart was returned to the family upon request of the family. Earlier this year, the Board added to its legislative agenda a proposed change in state law that would, generally speaking: 1) Require Coroners statewide to inform family members if organs were retained beyond the date of release of remains for interment; 2) Require Coroners to offer to return organs no longer needed for purposes of determining the cause of death; 3) Require consent of the family should an organ be proposed for a purpose beyond that of determining the cause of death; 4) Create an exception from the notification requirement in cases in which notification may impair an ongoing criminal investigation or constitute a public health hazard.

Assemblyman Mullin has introduced AB 1054 at the request of the County of San Mateo. The bill passed its first policy hearing on April 17^th and is presently before the Assembly Appropriations Committee.

Even in advance of a change in state law affecting all counties, San Mateo County’s Coroner has agreed to inform next-of-kin whenever retention of an organ is needed, and he has already done so when circumstances necessitated it during this calendar year. He has also agreed that he will offer to return organs when no longer needed to determine the cause of death. He has stated that he always followed a practice of not retaining organs for any reason other than to determine a cause of death.

DISCUSSION:

The Board is being asked to consider a resolution for its own adoption. The resolution is in support of the Coroner’s proposed policy, and the Coroner’s policy is also before the Board for comment and review. Generally speaking, the resolution does the following:

1) Makes various statements in the “Whereas” section that describe the duties of the Coroner and the nature of existing state law and make note of the need for a new policy regarding the handling of organs and notification of next-of-kin when retention occurs;

2) Makes various statements in the “Resolves” section, including but not limited to strongly encouraging the Coroner to faithfully implement his proposed policy, encouraging the Coroner to offer to return organs as quickly as possible, strongly encouraging the Coroner to conduct formal training of Coroner’s office employees to ensure that the Coroner’s policy is implemented, etc.

The Coroner is in support of the resolution and has been working with Supervisor Tissier and County Counsel to create a policy and resolution that permit the Coroner to perform his duty under current law to determine the cause of death. The resolution and policy are consistent with AB 1054 if it were enacted into law.

The Board is being asked to vote on the resolution. The Coroner is able to adopt the policy under his own authority.

Retaining organs beyond the date of release of remains may cause family members to inter loved ones prior to all organs being with the remains. By informing next-of-kin that retention of organs will be needed to determine the cause of death, and by offering to return the organs after that determination has been made, this proposed resolution and Coroner’s policy provide additional information and reassurance to families who have suffered a loss.

FISCAL IMPACT:

There will be a minimal, but unquantifiable, expense associated with the implementation of the Coroner’s policy.