ASSEMBLY, No. 1492

 

STATE OF NEW JERSEY

 

INTRODUCED FEBRUARY 5, 1996

 

 

By Assemblywomen WRIGHT and Bark

 

 

An Act concerning sudden infant death syndrome, amending and supplementing P.L.1987, c.331 and P.L.1967, c.234, and amending P.L.1993, c.276.

 

    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), the sudden death of an infant which remains unexplained after a thorough case investigation, including performance of a complete autopsy, examination of the death scene and review of the clinical history, is the major cause of death among infants, claiming the lives of 4,000 to 5,000 infants annually in the United States and the lives of approximately 100 infants annually in the State. Despite extensive research efforts, a cause has not been uncovered, and thus SIDS has accounted for over 700 deaths in the State since 1988.

    b. Because of the lack of a discernible cause and the suddenness of the tragedy as well as the involvement of the legal system, a SIDS death is especially difficult for families. The great sense of loss and the need for understanding demand that families receive direct help through information and supportive counseling services which can alleviate guilt and aid in understanding this devastating syndrome.

    c. In order to determine the cause of SIDS, it is essential that sophisticated laboratory diagnosis take place as part of a centralized autopsy system where autopsies will be performed by experienced pediatric pathologists who can provide rigorous and uniform protocol and diagnostic criteria. Because experience and approach to a SIDS death vary across the State, a centralized system with uniform standards is necessary to discovering the cause of SIDS.

    d. Since the number of SIDS deaths in the State has been decreasing each year, the number of infant autopsies performed by county medical examiners also has been decreasing, making it difficult for these pathologists to maintain the skill level necessary to make a SIDS diagnosis. Thus, as a threshold requirement to learning the cause of SIDS, it is necessary that autopsies of infants suspected to have died from SIDS be regionalized to a center which is staffed by a pediatric pathologist who has developed an expertise in pediatric autopsies.

 

    2. Section 4 of P.L.1987, c.331 (C.26:5D-4) is amended to read as follows:

    4.   The Commissioner of the Department of Health shall establish a "SIDS Resource Center" within a State medical school. The SIDS Resource Center shall, in coordination with the Department of Health, serve as a technical advisory center and may offer diagnostic procedures, medical treatment and counseling, as well as any other services that may be necessary to assist potential SIDS victims and their families.

    In addition, the SIDS Resource Center shall maintain the confidentiality of medical information reported to the center, and maintain a Statewide SIDS data base.

(cf: P.L.1987, c.331, s.4)

 

    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.1993, c.276 (C.52:17B-88.7) is amended to read as follows:

    1. Notwithstanding any provision of law to the contrary, if a deceased person whose death is under investigation pursuant to section 9 of P.L.1967, c.234 (C.52:17B-86) is a donor of all or part of his body as evidenced by an advance directive, will, card or other document, or as otherwise provided in the "Uniform Anatomical Gift Act," P.L.1969, c.161 (C.26:6-57 et seq.), the State Medical Examiner or the county medical examiner, or his designee, or pediatric pathologist, as appropriate, who has notice of the donation 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.

(cf: P.L.1993, c.276, s.1)

 

  

    5. Section 2 of P.L.1993, c.276 ( C.52:17B-88.8) is amended to read as follows:

    2. A health care professional authorized to remove an anatomical gift from a donor whose death is under investigation pursuant to section 9 of P.L.1967, c.234 (C.52:17B-86), may remove the donated part from the donor's body for acceptance by a person authorized to become a donee, after giving notice to the State Medical Examiner or the county medical examiner, or his designee, or pediatric pathologist, as appropriate, if the examination, autopsy or analysis has not been undertaken in the manner and within the time provided in section 1 of this act. The State Medical Examiner or the county medical examiner, or his designee, or pediatric pathologist, as appropriate, shall be present during removal of the anatomical gift if in his judgment those tissues or organs may be involved in the cause of death. In that case, the State Medical Examiner or the county medical examiner, or his designee, or pediatric pathologist, as appropriate, may request a biopsy of those tissues or organs or deny removal of the anatomical gift. The State Medical Examiner or the county medical examiner, or his designee, or pediatric pathologist, as appropriate, shall explain in writing his reasons for determining that those tissues or organs may be involved in the cause of death and shall include the explanation in the records maintained pursuant to section 15 of P.L.1967, c.234 (C.52:17B-92), or in the case of a suspected SIDS death, in the data maintained by the SIDS Resource Center pursuant to section 4 of P.L.1987, c.331 (C.26:5D-4).

(cf: P.L.1993, c.276, s.2)

  

    6. Section 3 of P.L.1993, c.276 (C.52:17B-88.9) is amended to read as follows:

    3. The health care professional performing a transplant from a donor whose death is under investigation pursuant to section 9 of P.L.1967, c.234 (C.52:17B-86) shall file with the State Medical Examiner, or SIDS Resource Center established pursuant to section 4 of P.L.1987, c.331 (C.26:5D-4), as appropriate, a report detailing the condition of the part of the body that is the anatomical gift and its relationship to the cause of death. If appropriate, the report shall include a biopsy or medically approved sample from the anatomical gift. The report shall become part of the Medical Examiner's report, or the data maintained by the SIDS Resource Center, as appropriate. (cf: P.L.1993, c.276, s.3)

 

    7. (New section) In a case under investigation pursuant to section 9 of P.L.1967, c.234 (C.52:17B-86) where the suspected cause of death is sudden infant death syndrome, the county medical examiner, or a deputy or assistant county medical examiner, the State Medical Examiner or an assistant State medical examiner or other person authorized and designated by the State Medical Examiner shall notify the SIDS Resource Center established pursuant to section 4 of P.L.1987, c.331 (C.26:5D-4) of the name, address and telephone number of the family of the deceased and the clinical history of the deceased and the family, within 48 hours of learning of the suspected SIDS death. The county medical examiner or a deputy or assistant county medical examiner shall transport the body of the deceased to the SIDS Autopsy Center established pursuant to section 8 of P.L.     , c. (C. )(pending before the Legislature as this bill) within 48 hours of learning of the suspected SIDS death for performance of an autopsy by an experienced pediatric pathologist. The necessary expenses for transportation of the body for autopsy shall be paid by the State.


    8.   (New section) The Commissioner of Health shall establish a "SIDS Autopsy Center" for Sudden Infant Death Syndrome victims within a medical school or affiliate of a medical school in the State. The center shall be staffed with an experienced pathologist who has developed an expertise in performing pediatric autopsies. The pathologist shall perform an autopsy at the center on an infant up to two years of age whose death is sudden, unexpected and non-accidental, shall provide rigorous and uniform protocol and diagnostic criteria for a SIDS diagnosis, and shall act as a consultant to the SIDS Resource Center established pursuant to section 4 of P.L.1987, c.331 (C.26:5D-4).

 

    9. (New section) When a body is transported to the SIDS Autopsy Center, the SIDS Autopsy Center shall notify the SIDS Resource Center of the name, address and telephone number of the family of the deceased and the clinical history of the deceased and the family within 48 hours. The pediatric pathologist at the SIDS Autopsy Center shall determine the anatomical diagnosis based on information obtained from the autopsy, death scene investigation and clinical history.          

    10. This act shall take effect immediately.

 

 

STATEMENT

 

    This bill requires the Commissioner of Health to establish a Sudden Infant Death Syndrome (SIDS) Autopsy Center within a medical school or affiliate of a medical school in the State. The center shall be staffed with an experienced pathologist who has developed an expertise in performing pediatric autopsies. The pathologist shall perform autopsies at the center on infants up to two years of age whose deaths are sudden, unexpected and non-accidental, shall provide rigorous and uniform protocol and diagnostic criteria for a SIDS diagnosis, and shall act as a consultant to the already existing SIDS Resource Center established pursuant to section 4 of P.L.1987, c.331 (C.26:5D-4).

    In a case under investigation pursuant to section 9 of P.L.1967, c.234 (C.52:17B-86) where the suspected cause of death is SIDS, the county medical examiner, or a deputy or assistant county medical examiner, the State Medical Examiner or an assistant State medical examiner or other person authorized and designated by the State Medical Examiner shall notify the SIDS Resource Center of the name, address and telephone number of the family of the deceased and the clinical history of the deceased and the family, within 48 hours of learning of the suspected SIDS death. The county medical examiner or a deputy or assistant county medical examiner shall transport the body of the deceased to the SIDS Autopsy Center within 48 hours of learning of the suspected SIDS death, for performance of an autopsy by an experienced pediatric pathologist. The necessary expenses for transportation of the body shall be paid by the State.

    When a body is transported to the SIDS Autopsy Center, the SIDS Autopsy Center shall notify the SIDS Resource Center of the name, address and telephone number of the family of the deceased and the clinical history of the deceased and the family within 48 hours. The pediatric pathologist at the SIDS Autopsy Center shall determine the anatomical diagnosis based on information obtained from the autopsy, death scene investigation and clinical history.

    In addition, the bill amends P.L.1993, c.276 (C.52:17B-88.7 et seq.) so that the current law concerning the autopsy of a deceased person who is a donor for organ and tissue transplantation, applies to an autopsy performed by a pediatric pathologist.

 

 

                            

 

Establishes SIDS Autopsy Center.