§ 142C.4A — Cooperation between medical examiner and organ procurement organization — facilitation of anatomical gift from decedent whose body is under jurisdiction of medical examiner

Iowa § 142C.4A

• Jurisdiction: Iowa
• Title IV: PUBLIC HEALTH
• Ch. 142C: REVISED UNIFORM ANATOMICAL GIFT ACT

Text

—facilitationofanatomicalgiftfromdecedentwhosebodyisunderjurisdictionofmedical
examiner.
1. A medical examiner shall cooperate with procurement organizations to maximize the
opportunity to recover organs for the purpose of transplantation when the recovery of organs
does not interfere with a death investigation.
2. If a medical examiner receives notice from a procurement organization that an
organ might be or was made available with respect to a decedent whose body is under the
jurisdiction of the medical examiner and a postmortem examination will be performed,
unless the medical examiner denies recovery in accordance with this section, the medical
examiner or designee shall conduct a postmortem examination of the body or the organ in
a manner and within a period compatible with its preservation for the purposes of the gift.
Every reasonable effort shall be made to accomplish the mutual goals of organ donation and
a thorough death investigation.
3. An organ shall not be removed from the body of a decedent under the jurisdiction
7 REVISED UNIFORM ANATOMICAL GIFT ACT, §142C.4A
of a medical examiner for transplantation unless the organ is the subject of an anatomical
gift. This subsection does not preclude a medical examiner from performing a medicolegal
investigation pursuant to subsection 5 upon the body or organs of a decedent under the
jurisdiction of the medical examiner.
4. Upon request of an organ procurement organization, a medical examiner shall release
to the organ procurement organization the name and contact information of a decedent
whose body is under the jurisdiction of the medical examiner. If the decedent’s organs are
medically suitable for transplantation, the pathologist or medical examiner shall release to
the organ procurement organization the postmortem examination results, limited to cause
and manner of death and any evidence of infection or other disease process, which might
preclude safe transplantation of recovered organs. The organ procurement organization
may make a subsequent disclosure of the postmortem examination results only if relevant
to transplantation.
5. The medical examiner may conduct a medicolegal examination by reviewing all
medical records, laboratory test results, X rays, other diagnostic results, and other
information that any person possesses about a donor or prospective donor whose body is
under the jurisdiction of the medical examiner, which the medical examiner determines may
be relevant to the investigation.
6. A person who has any information requested by a medical examiner pursuant to
subsection 5 shall provide that information as expeditiously as possible to allow the medical
examiner to conduct the medicolegal investigation within a period compatible with the
preservation of organs for the purpose of transplantation.
7. If an anatomical gift has been or might be made of an organ of a decedent whose
body is under the jurisdiction of the medical examiner and a postmortem examination is not
required, or the medical examiner determines that a postmortem examination is required but
that the recovery of the organ that is the subject of an anatomical gift will not interfere with
the examination, the medical examiner and organ procurement organization shall cooperate
in the timely removal of the organ from the decedent for the purpose of transplantation.
8. a. If an anatomical gift of an organ from a decedent under the jurisdiction of the
medical examiner has been or might be made, but the pathologist or medical examiner
initially believes that the recovery of the organ could interfere with the postmortem
investigation into the decedent’s cause or manner of death, the pathologist or medical
examiner shall consult with the organ procurement organization or physician or technician
designated by the organ procurement organization about the proposed recovery.
b. Ancillary clinical tests such as a magnetic resonance imaging (MRI), a computed
tomography (CT) scan, or skeletal survey may be required by the pathologist prior to
determination of suitability of organ procurement. These tests shall be performed and
interpreted by the appropriate physician at the pathologist’s request, and reported in a timely
fashion. All expenses for such tests shall be the responsibility of the organ procurement
organization regardless of outcome.
c. After consultation pursuant to paragraph “a” and any preliminary investigation
pursuant to paragraph “b”, the pathologist or medical examiner may allow recovery,
depending on the nature of the case and the availability of a pathologist to view the body
prior to recovery.
9. If the manner of death may be homicide or has the potential for litigation, the organ
recovery shall be approved by the forensic pathologist, and the forensic pathologist may
examine the body prior to organ recovery and document by diagrams and photographs all
visible injuries.
10. a. If the medical examiner or designee allows recovery of an organ under subsection
7, 8, or 9, the organ procurement organization, upon request, shall cause the physician
or technician who removes the organ to provide the medical examiner with a record
describing the condition of the organ, a biopsy, a photograph, and any other information and
observations that would assist in the postmortem examination.
b. Arrangements for the examination of bodies of such decedents shall be coordinated
between the organ procurement organization and the state medical examiner.
c. If applicable, and whenever possible, the forensic pathologist who examined the
§142C.4A, REVISED UNIFORM ANATOMICAL GIFT ACT 8
decedent’s body prior to recovery of the organ shall perform the autopsy. If the forensic
pathologist is unable to accommodate examination of the body due to scheduling or staffing,
the request for organ donation may be denied.
11. If a medical examiner or designee is required to be present at a removal procedure
under subsection 9, upon request, the organ procurement organization requesting the
recovery of the organ shall reimburse the medical examiner or designee for the additional
costs incurred in complying with subsection 9.
12. A physician or technician who removes an organ at the direction of the organ
procurement organization may be called to testify about findings from the surgical recovery
of organs at no cost to taxpayers if the decedent is under the jurisdiction of the medical
examiner.
13. a. The medical examiner or pathologist with jurisdiction over the body of a decedent
has discretion to grant or deny permission for organ or tissue recovery.
b. If the recovery of organs or tissues may hinder the determination of cause or manner
of death or if evidence may be destroyed by the recovery, permission may be denied.
c. The medical examiner or a pathologist performing state autopsies shall work closely
with procurement organizations in an effort to balance the needs of the public and the
decedent’s next of kin.