Travis County Commissioners Court
December 5, 2006
Item 27
27 is consider and take appropriate action on legislative issues and proposed bills before the 80th Texas legislature.
>> good afternoon, judge, Commissioners. Bob cam. And following up on your request last week, judge, we have one item ready for the court this afternoon, and that is from the medical examiner's department. And they have a bill that they would like to introduce during the upcoming legislative session, and they are here to discuss it.
>> and they are beth devery and dr. Dolinek. No drum roll, but a little introduction there.
>> I think that you guys had received the legislative background on this, our proposal, as well as a copy of the bill draft. There have been some minor edits to the bill draft. Do I need to go ahead and get those to them? And simply removing from the draft the language that referred to a complete autopsy versus a limited autopsy, but other than that the text is the same. We had asked that this legislation be looked at to clarify for the county in terms of our office our ability to collect, retain and dispose of specimens that are obtained during autopsy. It's a very limited bill and in that it only addresses medical examiner's office and only addresses the removal, collection tand retention of specimens during autopsies performed under the jurisdiction of the medical examiner's office. But this would help clarify for the public as well as for our office our ability to focus on within the scope of our authority the ability to perform this function.
>> can you explain to me what the difference and what other counties, other jurisdictions are doing with this? Because I don't know how much flack we're going to get on this when you retain certain body parts as far as an autopsy is concerned, but there is maybe an aroma out there of folks that are saying, well, sometimes it's where the family intervention comes into play and the controversy that may brew from that as far as family.
>> well, we would want to be very clear that in the context of a situation in which a family requests an autopsy or if a hospital wants an autopsy performed that family consent would still be required. This is specifically focusing on only those cases that fall under the jurisdiction of the medical examiner's office. So in those specific cases the office has the authority to perform an autopsy without the consent of any family members. And following their of --
>> give us an example of where it falls in the medical examiner jurisdiction without family approval of that type of situation? Could you publicly tell me exactly what you're talking about so there can be some clarity on that?
>> the code of criminal procedures actually outlines specific situations in which the medical examiner's office has jurisdiction over the death. I don't have that list in front of me, but it includes suspicious deaths, unattended deaths, the death of a child six years or under and so forth. And those specific cases, those cases fall under the jurisdiction of our office, and an autopsy can be performed without consent. If a patient dies in a hospital and there's a physician that will sign the death certificate, that may not be a case that falls under our jurisdiction; however, it may be that the hospital would want an autopsy done to further examination for medical purposes. In a n. That case the hospital would go back to the family and obtain consent before that autopsy could be done. And this would not in any way affect that.
>> now, we had a little controversy over different organs that may have been pulled throughout the years. This legislation would cover samples basically. Right? Body fluids, sample of tissues, sample of organs?
>> yeah. It covers -- it's comprehensive enough to cover any tissue, blood, any kind of -- any substance, if you will, that is removed from the body during autopsy.
>> so if a cornea were needed to do -- to perform an autopsy within the law, would that --
>> dr. Dolinek may be able to speak to that. This is not meant to in any way touch on issues regarding organ donation or trans plantation. This is only for evidence ef de cherry procedures.
>> can we put that in there? I think you will adestroyed a whole lot of things by doing that. Just those words you just said. I'm thinking about the cornea removal, other times that organs were pulled for other uses by other entities and not Travis County, but we basically facilitated their work at the eye bank and a lot of families got upset about that when they learned after the fact what had been done.
>> right. Well, what we address here specifically relates to the tissues needed to determine the cause and manner of death, not used for transplants or harvesting purposes.
>> can we put language in that says this legislation is not intended to authorize the taking of organs for whaf the other purposes are? There is other legislation that actually gives the medical examiner thord to do that, but I think we ought to make sure.
>> right. Make it clear that this does not apply to those situations.
>> yeah.
>> okay. What I'm trying to do is anticipate opposition. And really based on what's happened over the last four or five years, we've got a pretty good feel for it. But if we can screen that out, whand we get the phone calls questioning it, we can point to language and say this doesn't cover that. After that period this sentence here basically covers exactly what our intentions are at this time and it's to pull samples for evidence to determine the cause of death.
>> right, determine cause and manner of death.
>> after that the question is what do you do with the sample? And this is saying basically that the medical examiner is free to dispose of it without the consent of family.
>> correct.
>> what we do typically is contract with a third party to dispose of this for us, right?
>> right.
>> so what we're trying to do is get around the requirement of having to contact family members with the sample, not a whole lot you can do with a sample of human body anyway, but some families want it.
>> well, it's not the standard in the industry to obtain consent prior to disposition of what we term medical waste. So yes, we would just clarify that we don't need to have that consent.
>> do we thai the other medical examiner offices in Texas would welcome something like this?
>> I believe so.
>> there's, I guess -- to further follow along what the judge has just stated, is there similar conserve concern I guess from other counties regarding this particular legislation?
>> it's concern about taking tissues that surfaced last time. Articles similar to articles written here about tissues taken here.
>> yeah. In our discussions with bob I think the plan was to -- once we had met with the court, with the court's approval then farm this out to other medical examiner's office so they could then work out what we're proposing and if there's any feedback get back to us. But just from our discussions with other offices, they very much are in support of clarifying that in fact this is a function of the office and can be performed without obtaining consent from the family.
>> we need then to let their delegations know, right? Because it amazes me how something-- the simplest of intentions can get over to the legislature and before you know it there's a fire storm of opposition.
>> very true.
>> if we want to get this done, I would get their support, and if they see problems, I'd try to get them to let us know what they are and try to address them up front. Otherwise I see no problem with it. I'm in support of it.
>> judge, I can circulate the draft of the bill to all the other major counties so they can look at it.
>> can we tweak that language, though, then get with them, maybe we fine it and come up with a finished product?
>> that's good. I had another question too for beth. She had done an excellent summary or background piece on this. There was a class action lawsuit against the county in ohio and apparently that litigation was settled, but I was just -- if you've got any more information on that in terms of if that relates in any way to what we're trying to do here or if it's a different issue.
>> well, it certainly was something that we were already looking at prior to this moving forward, but I did bring copies of the article.
>> isn't that where dr. Dolinek came from? I know you used to work in ohio. Are you familiar with what this case is about?
>> it was a different city in ohio, but I was aware of it while I was in cleveland.
>> now, the mentioning of the lawsuit is not to encourage Travis County residents to line up a lawyer. It enables us to fix what really a little problem, right?
>> correct.
>> move that we tweak and further refine the language, get with the other medical examiner offices in Texas and try to put this on a fast track. If we catch the legislature during one of the slow periods and get it quickly passed or try to?
>> passed or redrafted?
>> redraft first.
>> we'll get it redrafted fairly quickly, but once we file the bill, you never know who is going to come up and say something? That's one advantage of getting the bill out there, at least you will see what the problems are or if there are going to be problems and then we can try to address them as they come up.
>> I think it's better to let them see it up front and not later.
>> but if we have to pull a sample to conduct the investigation and determine the cause of death, afterwards we would like to dispose of that sample is what this is all about.
>> that's right.
>> and this is if the body is not under medical care, physician's care, right?
>> right. Those typically would not be cases that would fall under our jurisdiction, so no, it would not apply to that.
>> well, we pull a lot of samples for lab work and stuff like that, don't we?
>> we do. Every case. It's the standard of practice really.
>> that's what you legally have the ability to do.
>> right.
>> and it amazes me how long have you to keep some of those samples just until the investigation is over.
>> the practice in our office is to retain them for 12 months before we schedule them for disposition.
>> so after that 12 month period we would like to go ahead and dispose of the sample.
>> that is our current practice.
>> okay. If we're doing it already, I don't know why we wouldn't be able to get us a law that authorizes it.
>> just clarifying.
>> [ laughter ]
>> all that tweakage.
>> right.
>> all in favor? Did that get a second?
>> I seconded it.
>> that passes by unanimous vote. Thank you very much.
>> that's all we have. We hope to have two more legislative issues for you next Tuesday as well. That's all we have this week as best I know.
>> can you give me an idea as to what those two might be.
>> for next week can we send you a little memo to see who's record. I think one of them is going to be the issue from the risk management office on the early retirees, not gasb 45, but tweaking the language over there on the type of benefits that you can offer early retirees.
>> okay.
>> speaking of tweaking, did we tweak that language yet?
>>
>> [inaudible - no mic].
>> okay.
>> and I guess that information that we talked to on the phone as far as dealing with harris county on --
>> I've contacted them and they're going to try to get someone in touch with me that runs their program. So I just have some information.
>> okay. Just those questions that was asked on that and just get that back.
>> we'll have it back on next week.
>> thank you.
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Last Modified:
Wednesday, December 6, 2006 9:34 PM