SB-0457, As Passed Senate, November 2, 2011

SUBSTITUTE FOR

SENATE BILL NO. 457

     A bill to amend 1953 PA 181, entitled

"An act relative to investigations in certain instances of the

causes of death within this state due to violence, negligence or

other act or omission of a criminal nature or to protect public

health; to provide for the taking of statements from injured

persons under certain circumstances; to abolish the office of

coroner and to create the office of county medical examiner in

certain counties; to prescribe the powers and duties of county

medical examiners; to prescribe penalties for violations of the

provisions of this act; and to prescribe a referendum thereon,"

by amending sections 1c, 2, and 3 (MCL 52.201c, 52.202, and

52.203), section 2 as amended by 2004 PA 153 and section 3 as

amended by 2006 PA 569.

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

     Sec. 1c. (1) The county medical examiner shall be is in charge

of the office of the county medical examiner and may promulgate

rules relative to the conduct of his that office. The county

medical examiner may delegate any functions of his that office to a

duly appointed deputy county medical examiner if the deputy county

medical examiner is a licensed physician. If the deputy county

medical examiner is not a licensed physician, his or her functions

shall be are limited as provided by law.

     (2) The county medical examiner may establish an elderly and

vulnerable adult death review team. The county medical examiner may

develop protocols to be used by the elderly and vulnerable adult

death review team in conducting a preliminary investigation. If

established, the elderly and vulnerable adult death review team

shall consist of the county medical examiner or deputy county

medical examiner, physicians and other health care professionals

specializing in geriatric medicine, physicians and other health

care professionals employed by long-term care facilities, members

of relevant state and local law enforcement agencies, the county

prosecutor's office, and members representing the department of

human services who are involved with issues regarding adult

protective services, adult foster care homes, and homes for the

aged. The elderly and vulnerable adult death review team may

include others as designated by the team, including, but not

limited to, members representing the long-term care ombudsman

program, community mental health, and the department of licensing

and regulatory affairs who are involved with the licensing and

regulation of long-term care facilities.

     Sec. 2. (1) A county medical examiner or deputy county medical

examiner shall investigate the cause and manner of death of an

individual under each of the following circumstances:

     (a) The individual dies by violence.

     (b) The individual's death is unexpected.

Senate Bill No. 457 as amended November 2, 2011

     (c) The individual dies without medical attendance by a

physician, or the individual dies while under home hospice care

without medical attendance by a physician or a registered nurse,

during the 48 hours immediately preceding the time of death, unless

the attending physician, if any, is able to determine accurately

the cause of death.

     (d) The individual dies as the result of an abortion, whether

self-induced or otherwise.

     (2) If a prisoner in a county or city jail dies while

imprisoned, the county medical examiner or deputy county medical

examiner, upon being notified of the death of the prisoner, shall

examine the body of the deceased prisoner.

     (3) <<The county medical examiner or deputy county medical

examiner, upon being notified of the death of an elderly or

vulnerable adult, shall examine the body of the deceased. If the

county medical examiner or deputy county medical examiner determines

that the death is suspicious, or appears to have been caused by

abuse or neglect,the county medical examiner or deputy county medical

examiner>>

shall conduct an investigation into the cause and manner of death

and, if established under section 1c, may report the case to the

elderly and vulnerable adult death review team.

(4) (3) In conducting an investigation under subsection (1),

or (2), or (3), a county medical examiner or deputy county medical

examiner may request the circuit court to issue a subpoena to

produce medical records, books, papers, documents, or other items

related to the death being investigated. The circuit court may

punish failure to obey a subpoena issued under this section as

contempt of court.

(5) (4) Medical records, books, papers, documents, or other

items that a county medical examiner or deputy county medical

examiner obtains in conducting an investigation under this act,

whether in response to a subpoena or otherwise, are exempt from

disclosure under the freedom of information act, 1976 PA 442, MCL

15.231 to 15.246.

(6) (5) As used in this section act:

     (a) "Home hospice care" means a program of planned and

continuous hospice care provided by a hospice or a hospice

residence that consists of a coordinated set of services rendered

to an individual at his or her home on a continuous basis for a

disease or condition with a terminal prognosis.

     (b) "Physician" means a person an individual licensed as a

physician under part 170 or part 175 of the public health code,

1978 PA 368, MCL 333.17001 to 333.17084 and 333.17501 to 333.17556.

     (c) "Registered nurse" means a person an individual licensed

as a registered professional nurse under part 172 of the public

health code, 1978 PA 368, MCL 333.17201 to 333.17242.

     Sec. 3. (1) Any Except as otherwise provided in this section,

a physician, and any person an individual in charge of any hospital

or institution, or any person who shall have other individual who

has first knowledge of the death of any person who shall have any

of the following shall immediately notify the county medical

examiner or deputy of that fact:

     (a) An individual who died suddenly, unexpectedly,

accidentally, violently, or as the result of any suspicious

circumstances. , or

     (b) An individual who died without medical attendance during

the 48 hours prior to the hour of death unless the attending

physician, if any, is able to determine accurately the cause of

death. , or in any case of death due to

     (c) An individual who died as the result of what is commonly

known as an abortion, whether self-induced or otherwise. , shall

notify the county medical examiner or his or her deputy immediately

of the death.

     (2) If the physician, person individual in charge of any

hospital or institution, or other person individual who has first

knowledge of the death of a person an individual as described under

subsection (1) has knowledge that there were 2 or more individuals

involved in the same accident incident who were approximately the

same age, sex, height, weight, hair color, eye color, and race,

then he or she shall make the county medical examiner or his or her

deputy aware of that fact and whether or not any of those

individuals survived that accident incident when notifying the

examiner or deputy of the death as required under subsection (1).

If any of those individuals survived, the county medical examiner

or his or her deputy shall also be informed which hospital or

institution those individuals were taken to and the hospital or

institution shall also be made aware that the accident incident

involved 2 or more individuals with similar attributes.

     (3) If a physician, an individual in charge of any hospital or

institution, or other individual with knowledge of the death of an

individual as described under subsection (1) has knowledge that the

death has already been reported to the examiner or deputy under

subsection (1), the physician, individual in charge of any hospital

or institution, or other individual is not required to notify the

examiner or deputy of the death under subsection (1).

     (4) If an elderly and vulnerable adult death review team is

established under section 1c, a county medical examiner or deputy

who receives notice of a death of an elderly or vulnerable adult

who died unexpectedly or under suspicious circumstances may refer

the case to the elderly and vulnerable adult death review team.

Upon receipt of a referral under this subsection, the elderly and

vulnerable adult death review team shall conduct a preliminary

investigation to determine whether the death is suspicious or

appears to have been caused by abuse or neglect. Information

obtained under this subsection by an elderly and vulnerable adult

death review team established under section 1c is confidential and

may be disclosed by the elderly and vulnerable adult death review

team only to the medical examiner, the county prosecutor's office,

local law enforcement, or another elder death review team, as

appropriate. The information obtained under this subsection by an

elderly and vulnerable adult death review team established under

section 1c is exempt from disclosure under the freedom of

information act, 1976 PA 442, MCL 15.231 to 15.246.