LRBs0458/1
DAK:lmk:jf
2005 - 2006 LEGISLATURE
SENATE SUBSTITUTE AMENDMENT 1,
TO 2005 SENATE BILL 441
January 17, 2006 - Offered by Senator A. Lasee.
SB441-SSA1,1,6
1An Act to repeal 157.06 (11) and 157.06 (12);
to amend 157.06 (2) (j), 157.06 (4)
2(title), 157.06 (4) (am) (intro.), 157.06 (4) (b) and 157.06 (5) (bm);
to repeal and
3recreate 157.06 (title); and
to create 157.06 (4m), 157.06 (4r) and 157.06 (9m)
4of the statutes;
relating to: anatomical gifts and the powers and duties of
5coroners and medical examiners, granting rule-making authority, and
6providing an exemption from emergency rule procedures.
Analysis by the Legislative Reference Bureau
Currently, an individual who is at least 18 years of age may make an anatomical
gift (donation of all or part of his or her body to take effect at the time or after he or
she irreversibly ceases circulatory and respiratory functions or all functions of the
brain). Also, certain members of a decedent's family or his or her health care agent
under a power of attorney for health care may, under an order of priority, make an
anatomical gift of all or a part of the decedent's body. If a decedent is within the
custody of a coroner or medical examiner and there is no evidence that the decedent
made or refused to make an anatomical gift, under certain circumstances the coroner
or medical examiner may release and permit the removal of a part from the
decedent's body for use in transplantation or therapy.
This substitute amendment creates additional requirements related to removal
of a body part from a decedent who is within the jurisdiction of a coroner or medical
examiner. If the decedent has made an anatomical gift or his or her family or health
care agent has made an anatomical gift of all or part of the decedent's body, a
physician may remove a vascularized organ (a heart, lung, liver, pancreas, kidney,
intestine, or other organ that requires the continuous circulation of blood to remain
useful for purposes of transplantation) within a time period in which the organ may
be preserved for purposes of transplantation if (1) immediately after the hospital in
which the donor, potential decedent, or decedent is located contacts the organ
procurement organization concerning the potential donation, the organ
procurement organization provides notice, by oral conversation, of the referral of the
potential donor to the coroner or medical examiner or his or her designee and
provides notice of the referral to the district attorney or his or her designee; and (2)
the coroner or medical examiner or his or her designee has the opportunity to be
present during the vascularized organ's scheduled removal if in the judgment of the
coroner, medical examiner, or designee the organ may be necessary in determining
the cause of death. However, also if, in the judgment of the coroner, medical
examiner, or designee, the organ may be necessary in determining the cause of death,
the coroner, medical examiner, or designee may order a biopsy of the vascularized
organ or, if he or she is present during the scheduled removal, may deny removal.
If denial of removal is a possibility, the organ procurement organization shall make
a good-faith effort to consult with a forensic pathologist designated by the coroner
or medical examiner as to the pathologist's opinion concerning the necessity of the
vascularized organ in determining the cause of death. If a biopsy is ordered or
removal is denied, the coroner, medical examiner, or designee must specify any
reason in writing as part of the death report. As authorized by the coroner, medical
examiner, or designee with jurisdiction over the decedent, parts or all of the
decedent's body that are anatomical gifts, other than vascularized organs, may be
removed by a physician, any part that is tissue or bone may be removed by a
technician, and tissue may be removed by a tissue bank employee. A physician who
removes an organ from a decedent must complete a form, and a physician,
technician, or tissue bank employee who removes tissue, other than cardiovascular
tissue, from a decedent, must complete a form. The completed forms must be
transmitted to the coroner or medical examiner. The secretary of health and family
services must appoint an advisory committee to assist DHFS in prescribing, by rule,
these forms. A physician, technician, or tissue bank employee who removes
cardiovascular tissue from a decedent must, upon request by a coroner or medical
examiner, file a report with the coroner or medical examiner.
The substitute amendment also requires, for a decedent who is within the
custody of a coroner or medical examiner and whose death occurred in a hospital,
that any release of the decedent for potential use in donating tissue be to the tissue
bank with which the hospital has an agreement, as required under federal law.
However, if that tissue bank is unwilling to receive the release, the tissue bank must
notify the coroner or medical examiner, who then may notify concerning the
availability of the tissue any other tissue bank with which the coroner or medical
examiner has an agreement. A tissue bank that is so notified, if it is willing to receive
the release, must notify an available member of the decedent's family or the
decedent's health care agent, under the order of priority, to request that the member
or agent make an anatomical gift of all or part of the decedent's tissue. If the coroner
or medical examiner informs the hospital that these circumstances exist and that the
gift has been made, the hospital must transfer the decedent to the coroner or medical
examiner, who may remove the decedent's body from the hospital in which the body
is located.
If a decedent is within the custody of a coroner or medical examiner, the death
occurred outside a hospital or the decedent's body was removed from a hospital, and
the coroner or medical examiner refers the decedent as a potential tissue donor, the
substitute amendment requires that any such referral be made to one or more tissue
banks with which the coroner or medical examiner has a written general referral
agreement. The agreement may be made only after the coroner or medical examiner
has considered a number of factors concerning the tissue bank, and the agreement
is subject to review and approval by the corporation counsel of the applicable county
and by the applicable county board, and any tissue bank to which referral is made
must be accredited by the American Association of Tissue Banks or audited at least
once every two years by an organization that is accredited by the American
Association of Tissue Banks. Any agreement entered into after the date on which the
bill becomes an act must conform to these requirements; and any existing agreement
must conform to the requirements by October 1, 2007.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
SB441-SSA1, s. 1
1Section
1. 157.06 (title) of the statutes is repealed and recreated to read:
SB441-SSA1,3,2
2157.06 (title)
Anatomical gifts.
SB441-SSA1,3,74
157.06
(2) (j) In the absence of contrary indications by the donor, an anatomical
5gift of a part of a human body is neither a refusal to give other parts of the body nor
6a limitation on an anatomical gift under sub. (3) or on a removal or release of other
7parts of the body under sub. (4)
, (4m), or (4r).
SB441-SSA1, s. 3
8Section
3. 157.06 (4) (title) of the statutes is amended to read:
SB441-SSA1,3,109
157.06
(4) (title)
Notification and authorization Authorization by coroner
10or medical examiner; no evidence of anatomical gift
.
SB441-SSA1, s. 4
1Section
4. 157.06 (4) (am) (intro.) of the statutes is amended to read:
SB441-SSA1,4,52
157.06
(4) (am) (intro.) The coroner or medical examiner may release and
3permit the removal of a part from, a decedent
specified in par. (ag) within that
4official's custody, for transplantation or therapy,
including to a tissue bank under the
5requirements of sub. (4r), if all of the following apply:
SB441-SSA1,4,117
157.06
(4) (b)
An official releasing, and permitting A coroner or medical
8examiner who releases, and permits the removal of a part of, a human body
under
9this subsection shall maintain a permanent record of the name of the decedent, the
10name of the person making the request, the date and purpose of the request, the part
11of the body requested
, and the name of the person to whom it was released.
SB441-SSA1,4,2013
157.06
(4m) Authorization by coroner or medical examiner; potential
14donations of organs and tissue. (a) Subject to par. (b), for a decedent who meets the
15criteria for a determination of death under s. 146.71, who is a donor or of whom an
16anatomical gift has been made under sub. (3), and who is within the jurisdiction of
17a coroner or medical examiner under ch. 979, any vascularized organ that is an
18anatomical gift may be removed by a physician, within a time period compatible with
19preservation of the organ for purposes of transplantation, if all of the following take
20place:
SB441-SSA1,5,221
1. Immediately after the hospital in which the donor, potential decedent, or
22decedent is located contacts the organ procurement organization designated for the
23region of which the hospital is a part concerning the potential donation, the organ
24procurement organization shall, by oral conversation, provide notice to the coroner
25or medical examiner or his or her designee of the referral of the donor, potential
1decedent, or decedent and shall provide notice of the referral to the district attorney
2or his or her designee.
SB441-SSA1,5,63
2. The coroner or medical examiner or his or her designee has the opportunity
4to be present during the scheduled removal of the vascularized organ if, in the
5judgment of the coroner, medical examiner, or designee, the organ may be necessary
6in determining the cause of death.
SB441-SSA1,5,187
(b) If, in the judgment of the coroner, medical examiner, or designee specified
8in par. (a) the vascularized organ may be necessary in determining the cause of
9death, the coroner, medical examiner, or designee may order a biopsy of the
10vascularized organ or, if the coroner, medical examiner, or designee is present during
11the scheduled removal, he or she may deny removal of the vascularized organ. If
12denial of removal is a possibility, the organ procurement organization shall make a
13good-faith effort to consult with a forensic pathologist designated by the coroner,
14medical examiner, or designee as to the pathologist's opinion concerning the
15necessity of the vascularized organ in determining the cause of death. If the biopsy
16is ordered or the removal is denied, the coroner, medical examiner, or designee shall
17specify, in writing as part of any death report required under ch. 979, any reasons
18for determining that the vascularized organ may be involved in the cause of death.
SB441-SSA1,5,2419
(c) For a decedent specified under par. (a), as authorized under the
20requirements of this section by the coroner, medical examiner, or designee with
21jurisdiction over the decedent, any part other than a vascularized organ that is an
22anatomical gift may be removed by a physician and any part that is tissue or bone
23may be removed by a technician or tissue bank employee, within a time period
24compatible with preservation of the part for purposes of transplantation.
SB441-SSA1,6,6
1(d) A physician, technician, or tissue bank employee who removes
2cardiovascular tissue from a decedent under this subsection shall, upon request of
3the coroner or medical examiner, file with the coroner or medical examiner with
4jurisdiction over the decedent a report detailing the condition of the cardiovascular
5tissue and its relationship to the cause of death. The report may include a biopsy or
6medically approved sample, if available, from the part.
SB441-SSA1,6,87
(e) 1. A physician who removes an organ from a decedent under this subsection
8shall complete a form, as specified in sub. (9m) (a).
SB441-SSA1,6,119
2. A physician, technician, or tissue bank employee who removes tissue, other
10than cardiovascular tissue, from a decedent under this subsection shall complete a
11form, as specified in sub. (9m) (b).
SB441-SSA1,6,1412
3. After completing a form under this paragraph, the physician, technician, or
13tissue bank employee shall transmit the form to the coroner or medical examiner
14with jurisdiction over the decedent.
SB441-SSA1,6,2116
157.06
(4r) Authorization by coroner or medical examiner; tissue banks. (a)
171. If a decedent is within the custody of a coroner or medical examiner, and the death
18occurred in a hospital, any release of the decedent for potential donation of tissue
19shall be to the tissue bank with which the hospital has an agreement under
42 CFR
20482.45 (a) (2). However, if such a tissue bank is unwilling to receive the tissue
21donation, the tissue bank shall so notify the coroner or medical examiner.
SB441-SSA1,6,2522
2. Upon receipt of a notification under subd. 1., the coroner or medical examiner
23may notify any other tissue bank with which the coroner or medical examiner has
24an agreement under par. (b) of the availability of the decedent as a potential tissue
25donor.
SB441-SSA1,7,4
13. Upon receipt of a notification under subd. 2., the tissue bank so notified, if
2willing to receive the tissue donation, shall contact an available individual, under the
3priority established in sub. (3) (a), to request that the individual make an anatomical
4gift of all or a part of the decedent's tissue.
SB441-SSA1,7,75
4. If the coroner or medical examiner informs the hospital that subds. 2. and
63. apply and that consent has been given for an anatomical gift, the hospital shall
7transfer the decedent to the coroner or medical examiner.
SB441-SSA1,7,128
(b) When a decedent is within the custody of a coroner or medical examiner, the
9death occurred outside a hospital or the decedent was transferred to the coroner or
10medical examiner under par. (a) 4., and the coroner or medical examiner refers the
11decedent as a potential tissue donor, any such referral shall be made under the
12following conditions:
SB441-SSA1,7,1913
1. Subject to subds. 2., 3., and 4., the coroner or medical examiner, after
14considering a tissue bank's history, services, traditional referral patterns,
15geographic service area, and tissue distribution record and any other criteria
16required for consideration by the corporation counsel of the applicable county, enters
17into a written, general referral agreement with one or more tissue banks to which
18the coroner or medical examiner shall refer decedents for potential donation of
19tissue.
SB441-SSA1,7,2120
2. Any agreement under subd. 1. is subject to review and approval by all of the
21the following:
SB441-SSA1,7,2222
a. The corporation counsel of the applicable county.
SB441-SSA1,8,223
b. The county board of the applicable county. Within 60 days after any approval
24by the corporation counsel and transmittal of the agreement to the county board, the
1county board may approve or disapprove the agreement. If the county board takes
2no action, the agreement is approved.
SB441-SSA1,8,53
3. A tissue bank under this paragraph is accredited by the American
4Association of Tissue Banks or audited at least once every 2 years by an organization
5that is accredited by the American Association of Tissue Banks.
SB441-SSA1,8,86
4. All of the following applies to an agreement by a coroner or medical examiner
7with one or more tissue banks to which the coroner or medical examiner refers
8decedents for potential donation of tissue:
SB441-SSA1,8,119
a. Any such agreement that is entered into after the effective date of this
10subdivision unit .... [revisor inserts date], shall conform to the requirements of subds.
111. to 3.
SB441-SSA1,8,1512
b. Any such agreement that exists on the effective date of this subdivision unit
13.... [revisor inserts date], shall conform to the requirements of subds. 1. to 3. by
14October 1, 2007, unless the agreement expires before that date and is not
15renegotiated or renewed under subd. 4. a.
SB441-SSA1, s. 8
16Section
8. 157.06 (5) (bm) of the statutes is amended to read:
SB441-SSA1,8,2517
157.06
(5) (bm) If at or near the time of death of a patient a hospital knows that
18an anatomical gift of all or a part of the patient's body has been made under sub. (3)
19(a), that a release and removal of a part of the patient's body has been permitted
20under sub. (4)
or (4m) or that a patient or an individual identified as in transit to the
21hospital is a donor, the hospital shall notify the donee if one is named and known to
22the hospital. If a donee is neither named nor known to the hospital, the hospital shall
23notify an appropriate procurement organization. The hospital shall cooperate in the
24implementation of the anatomical gift or release and removal of a part of the body
25of the patient or individual.
SB441-SSA1,9,42
157.06
(9m) Forms for removal of organs and certain tissues; rules. The
3department of health and family services shall promulgate rules prescribing all of
4the following:
SB441-SSA1,9,55
(a) A form for removal of organs for use under sub. (4m) (e) 1. and 3.
SB441-SSA1,9,76
(b) A form for removal of tissue, other than cardiovascular tissue, for use under
7sub. (4m) (e) 2. and 3.