Senate Bill 2457

AN ACT CREATE A NEW SECTION WITHIN TITLE 41, CHAPTER 61, MISSISSIPPI CODE OF 1972, TO PROVIDE THAT THE AUTOPSY IN THE CASE OF A SUDDEN AND UNEXPECTED DEATH OF AN INFANT OR CHILD, INCLUDING CASES OF SUDDEN INFANT DEATH SYNDROME (SIDS), SUDDEN UNEXPECTED INFANT DEATH (SUID) OR SUDDEN DEATH IN THE YOUNG (SDY), MUST INCLUDE MICROSCOPIC AND TOXICOLOGY STUDIES AND A REVIEW OF THE CHILD'S IMMUNIZATION AND MEDICAL RECORDS; TO REQUIRE THAT THE MEDICAL EXAMINER DOCUMENT IN THE AUTOPSY REPORT ANY IMMUNIZATIONS AND EMERGENCY COUNTERMEASURES ADMINISTERED TO THE INFANT OR CHILD WITHIN 90 DAYS BEFORE THE INFANT'S OR CHILD'S DEATH AND REPORT THE CASE TO THE SUID AND SDY CASE REGISTRY; TO PROVIDE THAT THE AUTOPSY IN THE CASE OF A SUDDEN AND UNEXPECTED DEATH SUSPECTED TO BE CAUSED BY SUDDEN ARRHYTHMIC DEATH SYNDROME (SADS) IN AN INDIVIDUAL OF ANY AGE MUST INCLUDE MICROSCOPIC AND TOXICOLOGY STUDIES AND A REVIEW OF THE INDIVIDUAL'S IMMUNIZATION AND MEDICAL RECORDS; TO REQUIRE THAT THE MEDICAL EXAMINER DOCUMENT IN THE AUTOPSY REPORT ANY IMMUNIZATIONS AND EMERGENCY COUNTERMEASURES ADMINISTERED TO THE INDIVIDUAL WITHIN 90 DAYS BEFORE HIS OR HER DEATH AND REPORT THE CASE TO THE SUID AND SDY CASE REGISTRY IF THE INDIVIDUAL WAS YOUNGER THAN 20 YEARS OF AGE AT THE TIME OF DEATH; TO ESTABLISH ADMINISTRATIVE PENALTIES TO BE IMPOSED AGAINST A COUNTY MEDICAL EXAMINER WHO FAILS TO REPORT A CASE OF SIDS, SUID OR SDY, OR OF SADS FOR INDIVIDUALS YOUNGER THAN 20 YEARS OF AGE, TO THE SUID AND SDY CASE REGISTRY WITHIN 30 DAYS AFTER COMPLETING THE AUTOPSY REPORT; TO DESIGNATE COMPLIANCE WITH SUCH REPORTING AND DOCUMENTATION REQUIREMENTS AS A PERMISSIBLE DISCLOSURE UNDER STATE AND FEDERAL MEDICAL PRIVACY LAWS; TO DEFINE TERMS; TO BRING FORWARD SECTIONS 41-61-59, 41-61-63 AND 41-61-65, MISSISSIPPI CODE OF 1972, FOR THE PURPOSE OF POSSIBLE AMENDMENT; AND FOR RELATED PURPOSES.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI:

SECTION 1. The following shall be codified as a separate section within Title 41, Chapter 61, Mississippi Code of 1972:

41-61- . (1) (a) As used in this section, the following words and phrases shall have the meanings ascribed herein unless the context clearly indicates otherwise:

(i) "Sudden arrhythmic death syndrome" or "SADS" means the sudden and unexpected death due to cardiac arrhythmia, as determined by performance of an autopsy or a clinical investigation, of a young, apparently healthy individual with no previously diagnosed structural heart disease.

(ii) "Sudden death in the young" or "SDY" means the sudden and unexpected death of an individual younger than twenty (20) years of age due to natural causes, including, but not limited to, sudden cardiac death or sudden unexpected death in epilepsy, which death remains unexplained after initial investigation.

(iii) "Sudden infant death syndrome" or "SIDS" means the sudden death of an infant younger than one (1) year of age which remains unexplained after a thorough case investigation, including performance of an autopsy, scene investigations and a review of clinical history.

(iv) "Sudden unexpected infant death" or "SUID" means the sudden and unexpected death of an infant younger than one (1) year of age, whether explained or unexplained, including, but not limited to, death caused by SIDS, accidental suffocation and other potential causes.

(v) "Sudden Unexpected Infant Death and Sudden Death in the Young Case Registry" or "SUID and SDY Case Registry" means the national surveillance system coordinated by the Centers for Disease Control and Prevention and the National Institutes of Health that collects standardized data on sudden and unexpected deaths in individuals younger than twenty (20) years of age.

(b) In the case of an infant or child who dies suddenly and unexpectedly, including cases of SIDS, SUID or SDY, the autopsy must include microscopic and toxicology studies and a review of the child's immunization and medical records, as available through the state's immunization registry established pursuant to Section 41-88-3, from the child's pediatrician or primary care practitioner or from other sources. The medical examiner shall document in the autopsy report any immunizations and emergency countermeasures administered to the infant or child within ninety (90) days before the infant's or child's death and report the case to the SUID and SDY Case Registry in accordance with protocols established by the State Department of Health and the Centers for Disease Control and Prevention.

(c) In the case of a sudden and unexpected death suspected to be caused by SADS in an individual of any age, the autopsy must include microscopic and toxicology studies and a review of the individual's immunization and medical records, as available through state health databases or other sources. The medical examiner shall document in the autopsy report any immunizations and emergency countermeasures administered to the individual within ninety (90) days before his or her death and report the case to the SUID and SDY Case Registry if the individual was younger than twenty (20) years of age at the time of death, in accordance with protocols established by the State Department of Health and the Centers for Disease Control and Prevention.

(2) The Mississippi Department of Public Safety shall impose the following administrative penalties against a county medical examiner or county medical examiner investigator who fails to report a case of SIDS, SUID or SDY, or of SADS for individuals younger than twenty (20) years of age, to the SUID and SDY Case Registry within thirty (30) days after completing the autopsy report:

(a) For the first unreported case, a fine of up to One Thousand Dollars ($1,000.00).

(b) For the second unreported case, a fine of up to Five Thousand Dollars ($5,000.00).

(3) Compliance with the reporting and documentation requirements of this section is deemed a permissible disclosure under state and federal medical privacy laws, including the Health Insurance Portability and Accountability Act of 1996.

SECTION 2. Section 41-61-59, Mississippi Code of 1972, is brought forward as follows:

41-61-59. (1) A person's death that affects the public interest as specified in subsection (2) of this section shall be promptly reported to the medical examiner by the physician in attendance, any hospital employee, any law enforcement officer having knowledge of the death, the embalmer or other funeral home employee, any emergency medical technician, any relative or any other person present. The appropriate medical examiner shall notify the municipal or state law enforcement agency or sheriff and take charge of the body. When the medical examiner has received notification under Section 41-39-15(6) that the deceased is medically suitable to be an organ and/or tissue donor, the medical examiner's authority over the body shall be subject to the provisions of Section 41-39-15(6). The appropriate medical examiner shall notify the Mississippi Bureau of Narcotics within twenty-four (24) hours of receipt of the body in cases of death as described in subsection (2)(m) or (n) of this section.

(2) A death affecting the public interest includes, but is not limited to, any of the following:

(a) Violent death, including homicidal, suicidal or accidental death.

(b) Death caused by thermal, chemical, electrical or radiation injury.

(d) Death related to disease thought to be virulent or contagious that may constitute a public hazard.

(e) Death that has occurred unexpectedly or from an unexplained cause.

(f) Death of a person confined in a prison, jail or correctional institution.

(g) Death of a person where a physician was not in attendance within thirty-six (36) hours preceding death, or in prediagnosed terminal or bedfast cases, within thirty (30) days preceding death.

(h) Death of a person where the body is not claimed by a relative or a friend.

(i) Death of a person where the identity of the deceased is unknown.

(j) Death of a child under the age of two (2) years where death results from an unknown cause or where the circumstances surrounding the death indicate that sudden infant death syndrome may be the cause of death.

(k) Where a body is brought into this state for disposal and there is reason to believe either that the death was not investigated properly or that there is not an adequate certificate of death.

(l) Where a person is presented to a hospital emergency room unconscious and/or unresponsive, with cardiopulmonary resuscitative measures being performed, and dies within twenty-four (24) hours of admission without regaining consciousness or responsiveness, unless a physician was in attendance within thirty-six (36) hours preceding presentation to the hospital, or in cases in which the decedent had a prediagnosed terminal or bedfast condition, unless a physician was in attendance within thirty (30) days preceding presentation to the hospital.

(m) Death that is caused by drug overdose or which is believed to be caused by drug overdose.

(n) When a stillborn fetus is delivered and the cause of the demise is medically believed to be from the use by the mother of any controlled substance as defined in Section 41-29-105.

(o) Death of any person under the age of eighteen (18).

(3) The State Medical Examiner is empowered to investigate deaths, under the authority hereinafter conferred, in any and all political subdivisions of the state. The county medical examiners and county medical examiner investigators, while appointed for a specific county, may serve other counties on a regular basis with written authorization by the State Medical Examiner, or may serve other counties on an as-needed basis upon the request of the ranking officer of the investigating law enforcement agency. If a death affecting the public interest takes place in a county other than the one where injuries or other substantial causal factors leading to the death have occurred, jurisdiction for investigation of the death may be transferred, by mutual agreement of the respective medical examiners of the counties involved, to the county where the injuries or other substantial causal factors occurred, and the costs of autopsy or other studies necessary to the further investigation of the death shall be borne by the county assuming jurisdiction.

(4) (a) In criminal trials where the testimony of a current or former State Medical Examiner, Deputy State Medical Examiner, or member of the Mississippi Forensics Laboratory is needed, the use of audiovisual communications equipment to present such testimony remotely is allowed when the state has provided written notice to the defendant at least ninety (90) days prior to trial of its intent to present such remote testimony, and the defendant provides no written objection within fourteen (14) days of receiving such notice. Should the defendant object, the remote testimony shall only be permitted upon a finding by the court that the rights of the defendant to confront the witness against the defendant is not violated, that compelling circumstances exist to allow such remote testimony, and that the remote testimony can be provided with appropriate safeguards so as to assure the reliability of the testimony of the witness during the trial.

(b) All persons qualified to administer an oath in the State of Mississippi may swear a witness remotely by audiovisual communication technology, provided they can positively identify the witness and they are able to both see and hear the witness via audiovisual communications equipment.

(5) The chief county medical examiner or chief county medical examiner investigator may receive from the county in which he serves a salary of One Thousand Two Hundred Fifty Dollars ($1,250.00) per month, in addition to the fees specified in Sections 41-61-69 and 41-61-75, provided that no county shall pay the chief county medical examiner or chief county medical examiner investigator less than Three Hundred Dollars ($300.00) per month as a salary, in addition to other compensation provided by law. In any county having one or more deputy medical examiners or deputy medical examiner investigators, each deputy may receive from the county in which he serves, in the discretion of the board of supervisors, a salary of not more than Nine Hundred Dollars ($900.00) per month, in addition to the fees specified in Sections 41-61-69 and 41-61-75; however, no county shall pay the deputy medical examiners or deputy medical examiner investigators less than Three Hundred Dollars ($300.00) per month as a salary in addition to other compensation provided by law. For this salary the chief shall assure twenty-four-hour daily and readily available death investigators for the county, and shall maintain copies of all medical examiner death investigations for the county for at least the previous five (5) years. He shall coordinate his office and duties and cooperate with the State Medical Examiner, and the State Medical Examiner shall cooperate with him.

SECTION 3. Section 41-61-63, Mississippi Code of 1972, is brought forward as follows:

41-61-63. (1) The State Medical Examiner shall:

(a) Provide assistance, consultation and training to county medical examiners, county medical examiner investigators and law enforcement officials.

(b) Keep complete records of all relevant information concerning deaths or crimes requiring investigation by the medical examiners.

(c) Promulgate rules and regulations regarding the manner and techniques to be employed while conducting autopsies; the nature, character and extent of investigations to be made into deaths affecting the public interest to allow a medical examiner to render a full and complete analysis and report; the format and matters to be contained in all reports rendered by the medical examiners; and all other things necessary to carry out the purposes of Sections 41-61-51 through 41-61-79. The State Medical Examiner shall make such amendments to these rules and regulations as may be necessary. All medical examiners, coroners and law enforcement officers shall be subject to such rules.

(d) Cooperate with the crime detection and medical examiner laboratories authorized by Section 45-1-17, the University of Mississippi Medical Center, the Attorney General, law enforcement agencies, the courts and the State of Mississippi.

(e) Promulgate rules and regulations regarding the manner in which county medical examiner investigators are required to enter electronically the information for all deaths that occur in the investigator's county.

(2) In addition, the medical examiners shall:

(a) Upon receipt of notification of a death affecting the public interest, make inquiries regarding the cause and manner of death, reduce the findings to writing and promptly make a full report to the State Medical Examiner on forms prescribed for that purpose. The medical examiner shall be authorized to inspect and copy the medical reports of the decedent whose death is under investigation. However, the records copied shall be maintained as confidential so as to protect the doctor/patient privilege. The medical examiners shall be authorized to request the issuance of subpoenas, through the proper court, for the attendance of persons and for the production of documents as may be required by their investigation.

(b) Complete the medical examiner's portion of the certificate of death within seventy-two (72) hours of assuming jurisdiction over a death, and forward the certificate to the funeral director or to the family. The medical examiner's portion of the certificate of death shall include the decedent's name, the date and time of death, the cause of death and the certifier's signature. If determination of the cause and/or manner of death are pending an autopsy or toxicological or other studies, these sections on the certificate may be marked "pending," with amendment and completion to follow the completion of the postmortem studies. The State Medical Examiner shall be authorized to amend a death certificate; however, the State Medical Examiner is not authorized to change or amend any death certificate after he has resigned or been removed from his office as the State Medical Examiner. Where an attending physician refuses to sign a certificate of death, or in case of any death, the State Medical Examiner or properly qualified designee may sign the death certificate.

(d) In all investigations of deaths affecting the public interest where an autopsy will not be performed, obtain or attempt to obtain postmortem blood, urine and/or vitreous fluids. Medical examiners may also obtain rectal temperature measurements, known hair samples, radiographs, gunshot residue/wiping studies, fingerprints, palm prints and other noninvasive studies as the case warrants and/or as directed by the State Medical Examiner. Decisions shall be made in consultation with investigating law enforcement officials and/or the State Medical Examiner. The cost of all studies not performed by the Mississippi Forensics Laboratory shall be borne by the county. County medical examiner investigators shall be authorized to obtain these postmortem specimens themselves following successful completion of the death investigation training school.

(e) In all investigations of deaths occurring in the manner specified in subsection (2)(j) of Section 41-61-59, a death investigation shall be performed by the medical examiners in accordance with the child death investigation protocol established by the State Medical Examiner. The results of the death investigation shall be reported to the State Medical Examiner on forms prescribed for that purpose by the State Medical Examiner and to appropriate authorities, including police and child protective services, within three (3) days of the conclusion of the death investigation.

(f) Electronically report all deaths, and all associated toxicology reports, that occur in the examiner's county to the State Medical Examiner in a manner prescribed by the State Medical Examiner.

(3) The medical examiner shall not use his position or authority to favor any particular funeral home or funeral homes.

SECTION 4. Section 41-61-65, Mississippi Code of 1972, is brought forward as follows:

41-61-65. (1) If, in the opinion of the medical examiner investigating the case, it is advisable and in the public interest that an autopsy or other study be made for the purpose of determining the primary and/or contributing cause of death, an autopsy or other study shall be made by the State Medical Examiner, or the State Medical Examiner may choose a competent pathologist who is designated by the State Medical Examiner or the Department of Public Safety as a pathologist qualified to perform postmortem examinations and autopsies to perform the autopsy or study. To be eligible to be designated under this section, a pathologist must be an M.D. or D.O. who is certified in ~~forensic~~ anatomic pathology by the American Board of Pathology unless a certified ~~forensic~~ anatomic pathologist is not available to perform a postmortem examination or autopsy within a reasonable time. The State Medical Examiner or designated pathologist may retain any tissues as needed for further postmortem studies or documentation. When the medical examiner has received notification under Section 41-39-15(6) that the deceased is medically suitable to be an organ and/or tissue donor, the State Medical Examiner or designated pathologist may retain any biopsy or medically approved sample of the organ and/or tissue in accordance with the provisions of Section 41-39-15(6). A complete autopsy report of findings and interpretations, prepared on forms designated for this purpose, shall be submitted promptly to the State Medical Examiner. Copies of the report shall be furnished to the authorizing medical examiner, district attorney and court clerk. A copy of the report shall be furnished to one (1) adult member of the immediate family of the deceased or the legal representative or legal guardian of members of the immediate family of the deceased upon request. In determining the need for an autopsy, the medical examiner may consider the request from the district attorney or county prosecuting attorney, law enforcement or other public officials or private persons. However, if the death occurred in the manner specified in subsection (2)(j) of Section 41-61-59, an autopsy shall be performed by the State Medical Examiner or a designated pathologist who is qualified as required by this subsection, and the report of findings shall be forwarded promptly to the State Medical Examiner, investigating medical examiner, the State Department of Health, the infant's attending physician and the local sudden infant death syndrome coordinator. In addition to the authority granted under this section, medical examiner investigators, under the supervision of the State Medical Examiner, may assist with the performance or completion of autopsies or other duties of the Office of the State Medical Examiner.

(2) Any medical examiner or duly licensed physician performing authorized investigations and/or autopsies as provided in Sections 41-61-51 through 41-61-79 who, in good faith, complies with the provisions of Sections 41-61-51 through 41-61-79 in the determination of the cause and/or manner of death for the purpose of certification of that death, shall not be liable for damages on account thereof, and shall be immune from any civil liability that might otherwise be incurred or imposed.

(3) Family members or others who disagree with the medical examiner's determination shall be able to petition and present written argument to the State Medical Examiner for further review. If the petitioner still disagrees, he may petition the circuit court, which may, in its discretion, hold a formal hearing. In all those proceedings, the State Medical Examiner and the county medical examiner or county medical examiner investigator who certified the information shall be made defendants. All costs of the petition and hearing shall be borne by the petitioner.

SECTION 5. This act shall take effect and be in force from and after July 1, 2026.