Bill Would Close Loophole in State Cornea Collection Law

A Los Angeles lawmaker introduced legislation Tuesday aimed at plugging a loophole that had allowed the Los Angeles County coroner’s office to harvest thousands of corneas from cadavers without the consent of the next of kin.

Democratic state Sen. Richard G. Polanco introduced the bill in response to The Times’ disclosure that the coroner used an obscure “implied consent” law to let the Doheny Eye & Tissue Transplant Bank remove corneas from bodies without the knowledge of family members. In many cases, the relatives were easily reachable by phone or at death scenes.

The Times also reported that Doheny paid the coroner’s office $215 to $335 per pair of corneas and resold them to transplant institutions at markups of more than 1,200%. Critics called the arrangement a virtual cornea mill.

Immediately after the Times story ran in November, the coroner’s office changed its policy to require that field investigators seek family permission for removal of corneas, the clear tissues that cover the colored part of the eye, or iris. Cornea collections from the coroner’s office subsequently fell 70%.

But the loophole still exists on the books, and Polanco said his measure is intended to close it.

“The most alarming factor in the L.A. County coroner’s practices was that it appeared to be driven by profit,” the veteran legislator said in a written statement. “That is unacceptable.”

Coroner’s office Director Anthony Hernandez declined to comment Tuesday, saying that the legislation has yet to be studied by the statewide association representing coroners and medical examiners.

Ronald E. Smith, chairman of USC’s ophthalmology department and medical director of Doheny, a nonprofit institution affiliated with the university, warned that the legislation would “ensure that waiting lists and waiting times for corneas in Southern California will continue to increase.

“It will no doubt negatively impact the lives of Californians who desperately need corneas for restoration of vision,” Smith said in a statement released Tuesday.

Polanco’s measure would require written permission from the next of kin for any cornea harvesting, an authorization currently enforced for all other organ or tissue donations.

The bill would effectively undo a 1983 statute that allowed county coroners and medical examiners to “donate” the corneas if there was “no known objection” from family members. The bill--passed after lobbying by Doheny’s management firm, the nonprofit Tissue Banks International of Baltimore--had no requirement that families be informed of an impending cornea harvest, creating what critics called a Catch-22 for unknowing relatives.

Eye bank professionals said the exemption was needed to salvage highly perishable corneas that would otherwise decompose in the time it took to locate family members. As intended, the law dramatically increased the supply of corneas and reduced waiting lists for transplant operations.

But over the years, eye bank professionals in California and 21 other states with similar “implied consent” laws moved away from those statutes in favor of public pleas for increased donations.

Most of California’s big-city medical examiners refused to use the 1983 law because of ethical considerations or fears of lawsuits.