ASSEMBLY, No. 707

 

STATE OF NEW JERSEY

 

PRE-FILED FOR INTRODUCTION IN THE 1996 SESSION

 

 

By Assemblyman ZISA

 

 

An Act concerning sudden infant death syndrome and amending P.L.1967, c.234 and P.L.1983, c.535 and supplementing Title 26 of the Revised Statutes.

 

    Be It Enacted by the Senate and General Assembly of the State of New Jersey:

 

    1. (New section) The Legislature finds and declares that:

    a. Sudden Infant Death Syndrome (SIDS) is a major cause of death among infants, with the disease claiming the lives of 7,000 infants annually in the United States, and the lives of 100 to 130 infants annually in the State;

    b. A SIDS death is an exceptionally tragic loss for a family because the death of an apparently healthy baby is a terrible shock and counters the parents' normal expectations that they will be survived by their children;

    c. Because the public is generally uninformed about this syndrome, and the parents of SIDS infants often mistakenly believe that they somehow could have prevented the death, there is a need to disseminate accurate information about SIDS and offer bereavement counseling to help the surviving family members cope with the infant's death;

    d. In order to provide more significant diagnosis information and determine the cause of SIDS, it is desirable to create regional centers where medical information can be shared, and where forensic pathologists, who have developed an expertise in performing autopsies on SIDS children, hopefully will discover the cause of this syndrome; and

    e. It is necessary that autopsies of SIDS deaths be performed in a manner and within a time period compatible with preservation of tissues and organs for transplantation when the infant's parents choose organ donation and this can best be accomplished if the autopsy is performed at a regional center by forensic pathologists experienced in performing autopsies on young children.

    2. Section 9 of P.L.1967, c.234 (C.52:17B-86) is amended to read as follows:

    9. An investigation shall be conducted in the manner hereinafter described in the case of all human deaths from the following causes:

    a. Violent deaths, whether apparently homicidal, suicidal or accidental, including but not limited to death due to thermal, chemical, electrical or radiation injury and deaths due to criminal abortion, whether apparently self-induced or not;

    b. Deaths not caused by readily recognizable disease, disability or infirmity;

    c. Deaths under suspicious or unusual circumstances;

    d. Deaths within 24 hours after admission to a hospital or institution;

    e. Deaths of inmates of prisons;

    f. Deaths of inmates of institutions maintained in whole or in part at the expense of the State or county, where the inmate was not hospitalized therein for organic disease;

    g. Deaths from causes which might constitute a threat to public health;

    h. Deaths related to disease resulting from employment or to accident while employed; and

    i. Sudden or unexpected deaths of [infants and] children [under 3] two years of age and over and fetal deaths occurring without medical attendance.

(cf: P L.1980, c.167, s. 1)

 

    3. Section 11 of P.L.1967, c.234 (C.52:17B-88) is amended to read as follows:

    11. If the cause of such death shall be established beyond a reasonable doubt, the county medical examiner shall reduce his findings to writing and promptly make a full report thereof to the State Medical Examiner and to the county prosecutor on forms to be prescribed by the State Medical Examiner for such purpose. If, however, in the opinion of the county medical examiner, the State Medical Examiner, an assignment judge of the Superior Court, the county prosecutor or the Attorney General, an autopsy is necessary, [or if, in cases where the suspected cause of death is sudden infant death syndrome and an investigation has been conducted under the provisions of section 9 of this act, and the parent, parents or legal guardian of the child request an autopsy,] the same shall be performed by (1) the State Medical Examiner, or an assistant designated by him or by (2) the county medical examiner or a deputy or assistant county medical examiner provided either has the recognized training or experience in forensic pathology or by (3) such competent forensic pathologists as may be authorized by the State Medical Examiner. A detailed description of the findings written during the progress of such autopsy, and the conclusions drawn therefrom shall thereupon be filed in the offices of the State Medical Examiner, the county medical examiner and the county prosecutor. The county medical examiner shall make available a copy of these findings and conclusions to the closest surviving relative of the decedent within 90 days of the receipt of a request therefor, unless the death is under active investigation by a law enforcement agency. [Where the suspected cause of death of a child under three years of age is sudden infant death syndrome, the findings and conclusions shall be reported to the State Department of Health within 48 hours after the death of the child.] It shall be the duty of any county medical examiner to call upon the State Medical Examiner or an assistant State medical examiner, or other person authorized and designated by the State Medical Examiner, to make an examination or perform an autopsy whenever he deems it necessary or desirable, and it shall be the duty of the State Medical Examiner or assistant State medical examiner to perform such examination, except in such cases as a competent pathologist is so authorized by the State Medical Examiner to perform such autopsy. The necessary expenses for transportation of a body for autopsy by the State Medical Examiner or an assistant State medical examiner or an authorized pathologist and such reasonable fee payable to the authorized pathologist as has been approved by the State Medical Examiner for each autopsy such authorized pathologist may perform shall be paid by the State.

(cf: P.L.1989, c.323, s.1)

 

    4. Section 1 of P.L.1983, c.535 (C.52:17B-88.1) is amended to read as follows:

    1.   As used in this act:

    a. "Compelling public necessity" means

    (1) That the dissection or autopsy is essential to the criminal investigation of a homicide of which the decedent is the victim; or

    (2) That the discovery of the cause of death is necessary to meet an immediate and substantial threat to the public health and that a dissection or autopsy is essential to ascertain the cause of death; or

    (3) That the death was that of an inmate of a prison, jail or penitentiary; or

    (4) That the death was that of a child over the age of 24 months and under the age of 12 years suspected of having been abused or neglected or suspected of being a threat to public health, and the cause of whose death is not apparent after diligent investigation by the medical examiner; or

    (5) That the need for a dissection or autopsy is established pursuant to the provisions of section 4 of this act; or

    (6) That the death is determined a suspicious death by a forensic pathologist acting pursuant to section 7 of P.L. , c. (C.       )(pending before the Legislature as this bill).

    b. "Friend" means any person who, prior to the decedent's death, maintained close contact with the decedent sufficient to render that person knowledgeable with the decedent's activities, health and religious beliefs; and who presents an affidavit stating the facts and circumstances upon which the claim that the person is a friend is based and stating that the person will assume responsibility for the lawful disposition of the body of the deceased.

(cf: P.L.1983, c.535, s.1)

 

    5. Section 12 of P.L.1967, c.234 (C.52:17B-89) is amended to read as follows:

    12. Any person who may become aware of any death by criminal violence or by accident or suicide or in any suspicious or unusual manner, excluding a sudden or unexpected death of an infant or child under two years of age, shall report such death to the office of county medical examiner, the office of State Medical Examiner, or to the police department of the municipality in which such person died.

    Any person who shall willfully neglect or refuse to report such death, or who, without an order from the office of county medical examiner or the office of State Medical Examiner, shall willfully touch, remove or disturb the body of any such person, or touch, remove or disturb the clothing upon or near such body, is a disorderly person.

(cf: P.L.1967, c.234, s.12)

 

    6. (New section) The Commissioner of Health shall designate three regional Sudden Infant Death Syndrome (SIDS) autopsy centers in the State. Each center shall share medical research concerning SIDS with the other regional autopsy centers in the State and with existing SIDS resource centers, and provide facilities for the performance of an investigation into the cause of death and, when necessary, the performance of an autopsy of an infant or child under two years of age.

 

    7. (New section) a. If a sudden or unexpected death of an infant or child under two years of age occurs in the State, it shall be the duty of the physician in attendance, any law enforcement officer having knowledge of the death, the funeral director, or any other person who becomes aware of the death, to immediately notify the nearest regional SIDS autopsy center as designated by the Commissioner of Health pursuant to section 6 of P.L. , c. (C. )(pending before the Legislature as this bill).

    b. A sudden or unexpected death of an infant or child under two years of age shall be investigated by designated staff at the center. If the cause of the death shall be established beyond a reasonable doubt, the designated staff shall reduce the findings to writing and promptly make a full report to the local registrar of vital statistics on forms prescribed by the Department of Health for this purpose. If, however, in the opinion of a forensic pathologist, trained pursuant to N.J.A.C.13:49-7.1, an autopsy is necessary, the same shall be performed by a forensic pathologist trained pursuant to N.J.A.C.13:49-7.1, at a regional SIDS autopsy center.

    c. If the suspected cause of death of an infant or child under two years of age is sudden infant death syndrome, the findings and conclusions shall be reported to the Department of Health within 48 hours after the death of the child.

    d. If, in the opinion of the forensic pathologist, the cause of death of an infant or child under two years of age is suspicious, the forensic pathologist immediately shall notify the office of the county prosecutor and the State Medical Examiner or an assistant designated by him, or the county medical examiner or the deputy or assistant county medical examiner, who shall authorize the forensic pathologist at the regional SIDS autopsy center to perform any necessary autopsy of the suspicious death at the regional SIDS autopsy center.

    The forensic pathologist who performs the autopsy shall promptly deliver to the county prosecutor of the county wherein the death occurred, copies of all records relating to the suspicious death. The county prosecutor may obtain from the forensic pathologist copies of records or other information which the prosecutor may deem necessary. These records, made by the forensic pathologist himself or by anyone under his direction or supervision, or transcripts thereof certified by the forensic pathologist, shall be received as competent evidence in any court in this State of the matters and facts therein contained. The records which shall be admissible as evidence under this subsection shall be records of the results of views and examinations of or an autopsy upon the body of the deceased infant or child by the forensic pathologist, and shall not include statements made by witnesses or other persons.

    e. A person who willfully fails to notify a regional SIDS autopsy center pursuant to subsection a. of this section, shall be guilty of a disorderly persons offense.

 

    8. (New section) If a parent of a deceased infant or child under two years of age authorizes donation of the infant's or child's body part pursuant to the "Uniform Anatomical Gift Act," P.L.1969, c.161 (C.26:6-57 et seq.), the health care professional shall notify the forensic pathologist at the nearest regional SIDS autopsy center, as designated by the Commissioner of Health pursuant to section 6 of P.L. , c. (C. )(pending before the Legislature as this bill) who shall perform an examination, autopsy, or analysis of tissues or organs only in a manner and within a time period compatible with their preservation for the purposes of transplantation.

 

    9. (New section) A health care professional authorized to remove an anatomical gift from a donor infant or child under two years of age whose death is determined suspicious pursuant to subsection d. of section 7 of P.L. , c. (C. )(pending before the Legislature as this bill), may remove the donated part from the donor infant or child's body for acceptance by a person authorized to become a donee, after giving notice to the forensic pathologist acting pursuant to section 7 of P.L. , c. (C. )(pending before the Legislature as this bill), if the examination, autopsy or analysis has not been undertaken in the manner and within the time provided in section 8 of P.L. , c. (C.       )(pending before the Legislature as this bill); except that, a health care professional shall not remove an anatomical gift, if in the judgment of the forensic pathologist, those tissues or organs may be involved in the cause of death.

 

    10. (New section) The health care professional performing a transplant from a donor infant or child under two years of age whose death is determined suspicious pursuant to subsection d. of section 7 of P.L. c. (C. )(pending before the Legislature as this bill), shall file with the forensic pathologist acting pursuant to section 7 of P.L.    , c. (C. )(pending before the Legislature as this bill) a report detailing the condition of the part of the body that is the anatomical gift. If appropriate, the report shall include a biopsy or medically approved sample from the anatomical gift.

 

    11. (New section) Notwithstanding any provision of law to the contrary, an autopsy of an infant or child under two years of age whose suspected cause of death is sudden infant death syndrome, shall not be performed over the objection of a member of the deceased's immediate family that the procedure is contrary to the religious belief of the decedent or his immediate family, or if there is an obvious reason to believe that an autopsy is contrary to the religious belief of the decedent or his immediate family.

 

    12. (New section) Notwithstanding any provision of law to the contrary, if a forensic pathologist acting pursuant to section 7 of P.L.    , c. (C. )(pending before the Legislature as this bill).

 

    13. The Commissioner of Health, pursuant to the "Adminstrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.) shall adopt rules and regulations to implement the provisions of this act.

 

    14. This act shall take effect 120 days after enactment.


STATEMENT

 

    This bill requires the Commissioner of Health to designate three regional Sudden Infant Death Syndrome (SIDS) autopsy centers in the State. Each center shall share medical research concerning SIDS with the other regional autopsy centers in the State and with existing SIDS resource centers, and provide facilities for the performance of an investigation into the cause of death, and when necessary, the performance of an autopsy of an infant or child under two years of age.

    It is believed that by requiring autopsies of all SIDS infants to be performed at the regional SIDS autopsy centers, the forensic pathologists at these centers will develop expertise in this area, and hopefully, will discover the cause of this syndrome. Furthermore, preservation of tissues and organs for transplantation will be facilitated if the autopsies are performed at the regional centers by forensic pathologists who are experienced in performing autopsies on young children.

    The bill requires that all sudden or unexpected deaths of an infant or child under two years of age be referred to the regional SIDS autopsy centers, where the death shall be investigated by designated staff at the center. If the cause of death is established beyond a reasonable doubt, a report shall be filed with the local registrar of vital statistics. If, however, in the opinion of a forensic pathologist, trained pursuant to N.J.A.C.13:49-7.1 (which is the same training required under the "State Medical Examiner Act"), an autopsy is necessary, it shall be performed by the forensic pathologist at the regional SIDS autopsy center. The findings that the suspected cause of death is SIDS shall be reported to the Department of Health within 48 hours after the child's death.

    If, in the opinion of the forensic pathologist, the cause of death of an infant or child under two years of age is suspicious, the forensic pathologist shall notify the office of the county prosecutor and the State or county medical examiners or their assistants, who shall authorize the forensic pathologist to perform any necessary autopsy of a suspicious death at a regional SIDS autopsy center. This procedure will eliminate any unnecessary transporting of bodies.

    The bill also requires the forensic pathologist to promptly deliver to the county prosecutor copies of all records relating to a suspicious death. The county prosecutor may obtain from the forensic pathologist copies of records or other information which the prosecutor may deem necessary. These records shall be received as competent evidence in any court in this State.

    In cases where the cause of death is suspicious and the deceased is a donor of body parts, the forensic pathologist shall follow procedures similar to those set forth in the "State Medical Examiner Act," P.L.1967, c.234 (C.52:17B-78 et seq.). The anatomical gift may be removed by an authorized health care professional prior to an examination, autopsy or analysis after giving notice to the forensic pathologist at the regional SIDS autopsy center, if the examination, autopsy or analysis is not undertaken in the manner and within a time period compatible with their preservation for the purposes of transplantation. However, there shall be no removal of an anatomical gift, if in the judgment of the forensic pathologist, those tissues or organs may be involved in the cause of death.

    Lastly, the bill provides for a religious objection to the performance of an autopsy of an infant or child under two years of age whose suspected cause of death is SIDS.

 

 

                             

 

Establishes three regional SIDS autopsy centers.