California Code of Regulations
Title 16 - Professional and Vocational Regulations
Division 4 - State Board of Chiropractic Examiners
Article 2 - Practice of Chiropractic
Section 318.1 - Standard of Care Regarding Manipulation Under Anesthesia (MUA)

Universal Citation: 16 CA Code of Regs 318.1

Current through Register 2022 Notice Reg. No. 14, April 8, 2022

(a) Manipulation Under Anesthesia (MUA) may only be performed in either:

(1) A hospital that is licensed by the California Department of Public Health Licensing and Certification Program; or

(2) An ambulatory surgery center that is licensed by the California Department of Public Health Licensing and Certification Program and that is either:
(A) Operating pursuant to section 1248.1 of the Health and Safety Code or

(B) Accredited by an agency approved by the Medical Board of California pursuant to Chapter 1.3 of Division 2 of the Health and Safety Code (commencing with section 1248).

(b) Notwithstanding subsection (a), above, MUA shall not be performed in a mobile van as defined in subdivision (h) of section 1248.1 of the Health and Safety Code.

(c) MUA may only be performed if the patient is administered anesthesia by a California licensed physician and surgeon or other health care provider authorized under California law to administer anesthesia.

(d) MUA may only be performed following an appropriate prior examination of the patient by a California licensed physician and surgeon.

(e) The chiropractor may not direct, instruct, interfere, or make any orders to the physician and surgeon or other health care provider who is administering and maintaining the anesthesia.

(f) MUA shall be performed by two licensed and competent chiropractors. The "primary chiropractor" shall formulate the chiropractic portion of the MUA treatment plan and shall be responsible for performing the chiropractic manipulation for that procedure. The "second chiropractor" shall insure that all movements are accomplished with patient care and safety as his or her primary focus and shall assist the "primary chiropractor" when necessary. The chiropractic portion of MUA is limited to techniques within the scope of practice of a chiropractor.

(g) For the purpose of this section, the primary chiropractor and the second chiropractor may not be involved in nor interfere with the physician and surgeon or other health care provider in the discharge of the patient following the MUA procedure.

(h) Failure by a chiropractor to follow the standard of care contained in this section when performing MUA shall constitute unprofessional conduct.

(i) "Manipulation Under Anesthesia" or "MUA" means the manipulation by a licensed chiropractor of a patient who is sedated by the administration of anesthesia by a physician and surgeon or other health care provider who is legally authorized to administer anesthesia.

Cal. Code Regs. Tit. 16, § 318.1

Note: Authority cited: Sections 1000- 4(b) and 1000- 10, Business and Professions Code (Chiropractic Initiative Act of California, Stats. 1923 p. 1xxxviii). Reference: Sections 1000- 4(b), 1000- 7 and 1000- 10, Business and Professions Code (Chiropractic Initiative Act of California, Stats. 1923, p. 1xxxviii).

1. New section filed 2-16-2010; operative 3-18-2010 (Register 2010, No. 8).

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