myself and investigated them. one thing we have found is hollow point ammunition expands as it hits whatever medium it strikes, whether it is closing, flash, and it expands. normally in 38-caliber, it will try to expand in diameter so that it causes a larger temporary wound cavity in the object it hits. that temporary wound cavity causes incapacitation in the target and thus allows the cessation or incapacitation to start and the altercation to cease. that's the efficiency of the whole point and mission, that it expands, what ever it hits opens up, and it is more efficient on the target. we have had numerous shootings

where i investigated, while i was on gang task force, currently i'm with the new violence reduction team, and four persons were shot by one assailant. the person was using full metal jacket ammunition. everyone that was not hit in a vital organ was treated and walked away from sfgh. the person who was injured the most was shot right in the aorta. the surgeons at sfgh, saved the man, patched the young man up, and if it had been hollow point ammunition, opening it up and making a larger temporary wound cavity, they probably would not have been able to save this young man. i think there is a legitimate reason for law enforcement, because we are held to an extremely high regulation about the use of deadly force that, if

we see a threat to our life or someone else's life and we have to seize that threat, hollow point ammunition, which we carry, it does act more efficiently, for less rounds expanded to seas confrontation. we do not want a large amount of rounds launched in that direction because it would cause ancillary damages that would not be accepted by our department. so we want something that is efficient to put the threat down, and one of the other issues, are there legitimate issues for having hollow point ammunition within the city and county of san francisco? there is relatively no particular use for target shooting. hollow point ammunition costs twice as much as full metal jacket ammunition. the shooting ranges we have in

san francisco does not allow you to bring your own ammunition in because of the lead in the indoor range. have to purchase the alleged free ammunition from the range. -- the lead-free ammunition from the range. is full metal jacket ammunition as efficient? for the purposes of self-defense and home defense, i would not want to be shot with either full metal jacket or hollow point ammunition. that is why we were ballistic vest. -- why we where ballistic vests. i believe the ancillary damage to what average hits as well as a way by the fact that full metal jacket can and does the same job, as shot placement is done by the person trying to defend their lives, and familiarization with the

firearm, practice with it, that will help that person in using the right kind of ammunition to acquire the same desire effect. -- the same desired effect. do you have any questions? supervisor mirkarimi: i am sure we have a few. the ballistic vest, are they fortified enough to withstand the impact of a hollow point bullet? >> yes. on the level that we carry, that we wear and the normal types of ammunition we are running into, yes, they will stand up to hall. ammunition. on tests i conducted what i was certifying whether we can allow the 57 around to be sold in california, that very fella -- very fast round coming out of a small pistol was stopped as it expanded on the seventh layer of the 21 layers of the front panel. so, yes, as it grabs the kevlar

material, it does slow the ball down and stop. supervisor mirkarimi: you make a good case in explaining the technical reasons why and public safety reasons why we would want to resist this allowing of hollow point bullets in san francisco. but can you speak to the general trend as to why people feel the need who are gun advocates, who believe in the right to possession, which is of course there second amendment right, why do you think they have to have something that is that much more lethal that is made available or can be accessed? >> i think it is the same reason they feel they need assault weapons. they need what ever is accessible to them without encumbering their second of amorites. we are stepping into an area of

that is limiting them from free access to whatever they want. granted, we're limiting the sales here in the city and county of san francisco, but hollow point ammunition is accessible south of the border on a bimonthly or try monthly basis at the san francisco gun show in daly city. i believe they want the same lethality we desire as a police department to seize the confrontation. that's another issue i believe gun advocates would want. supervisor mirkarimi: i am traversing between both themes and here that are fortifying our gun safety laws. with respect to gun locks, which -- when a gun is not kept safe and locked, such as the

incident of the 8-year-old who found a gun and shot himself, what then do we do with the parents or guardians where the gun was made available or not kept safe? i never hear that side of the story too much about either arrest or prosecution. >> from my experience over these years in law enforcement and dealing with the shootings and the response of the state -- of the safe storage laws in california, which has been on the books for almost 15 years -- if -- there is a variance in punishment, and it is all to the discretion of the district attorney's office. of all the shootings i have investigated and responded to, only one has been prosecuted for the un safe storage act. it was a grandfather who left a 25 auto on the coffee table and the grandson picked the gun up and shot himself with it. that's the only time i've ever seen the un safe storage laws

prosecuted. >> that is of recent memory in san francisco -- supervisor mirkarimi: it is not consistent with news reports you read in the "chronicle" or hear about how a child in particular will find a gun, shoots themselves, or shoot somebody else and that gun was supposed to be kept safe based on laws currently obligatory. what is missing in this picture? >> i truly believe it is very difficult to mandate laws that look into the homes and dictate what a person does inside the house. there is another case where a young kid shot himself with a gun the mother said the boyfriend just pulled out of the safe that afternoon and loaded

and left it in a closet. happened in contra costa county. they are prosecuting the boyfriend. but how do we legislate, when we pass all of the laws, about save storage in the books and now we're going to put one on the san francisco ordinance to restrict the storage of a firearm in the home, how do we look into the house? most of the safe storage gun laws are kind of after the fact, after the gun is used illegally or someone is hurt. supervisor mirkarimi: but the process is when somebody is rushed to san francisco general and aid to the brilliant job of saving somebody's life, any time a weapon is used, there's a normal reporting process. that reporting process that i assume triggers the intervention of the police department to investigate if it was deliberately used or if it was

an accident and how access to the weapon occurred, especially for a child, i would assume is that next step that an investigation or prosecution -- i recall in my district of hearing of children who get guns, shoot themselves or shoots somebody else, and i never hear of anybody being arrested for an investigation resulting in prosecution of those parents at all for the guardians. >> i understand your results. it is the same one i have. the route the bay area and california, it is at the discretion of the district attorney's office after they review the investigation whether or not to prosecute the person, number one who had the obligation to store the weapons faithfully, and, number two,

whether that person reneged on that by bringing the gun out and leaving it loaded in an unsafe area. supervisor mirkarimi: thank you. colleagues, any questions? supervisor campos: thank you. first of all, i want to thank supervisor mirkarimi for bringing this legislation forward and thank you, officer, for your presentation. i think this legislation makes a great deal of sense and i don't see that it is in any way infringing upon anyone's constitutional rights. i think it is a very well thought out public policy approach that ultimately tries to prevent a number of things, including accidental deaths that happen. in terms of what can be expected that in terms of this moving forward, is there a legal

challenge? is that a possibility? is that a concern as we are moving forward? i know that supervisor mirkarimi has drafted this very carefully in coordination with the city attorney's office. have we heard anything? supervisor mirkarimi: them -- this is a good time to insert the city attorney. >> i am the deputy city attorney and i can answer that question. there are a lot of laws under challenge all across the nation in the wake of the decision and a subsequent decision which applied heller to state and localities, announcing the individual right to a firearm in a home for purposes of self- defense. any laws that appear to burden their right in any way, such as even a requirement to have your loaded weapon in a gun save that

you can open in a few seconds are under challenge. or laws that would reduce the sale of incredibly lethal ammunition or reduced the use to law-enforcement. these sorts of things which seem very common sense to a lot of people are under legal challenge. that's true in this city and it's one of the reasons you are being presented with this legislation. the national rifle association is actually suing the city and county of san francisco over these two ordnances. when the city originally adopted them, it was not the case under that law that there was a second amendment right that might be infringed. we did not prepare as would normally be the case, with legislation with a constitutional dimension. we did not prepare findings at

that point because we did not know these laws would be so closely scrutinized by the judiciary. now that we know that, it's important to come back to these laws and explain what the foundation is for them exactly and so, the fact these laws are under challenge right now in this city is one of the primary reasons why it is important for the board of supervisors to express what its rationale was for these laws. supervisor campos: thank you, and i reiterate the point that it is important to clarify the policy reasoning behind these laws and i think the discussion here today and the findings that will come out of it are clearly outlined, why from a public policy standpoint this makes sense.

i do think ultimately, the connection with any constitutional violation is remote, if at all, and hopefully that will prevail in the courts. thank you supervisor mirkarimi, and officers for work. supervisor mirkarimi: i would like to call up san francisco general surgeon, randy smith. >> i am a surgery resident in my fourth year of training, currently working at the san francisco injury center on a violent intervention program. i have a particular interest in trauma surgery after witnessing day after day young people coming in with gunshots, stab wounds, and assaults. as you alluded to earlier, this is a big public health problem nationally and locally. homicide's represent the second leading cause of death for age

15 to 44 years old and, on a local level, firearms represent the third leading cause of all entries at san francisco general hospital. i want to speak to you about my clinical experience with hollow point bullets and the injuries they cause as a result of their severe destruction. destruction. i have operated on a lot of people that have suffered from gunshot wounds and i will tell you is very typical, as a trauma surgeon, to deal with these injuries. most recently, i operated on someone who was shot in both kidneys. if you can imagine, as a trauma surgeon in the moment, you want to do as much as you can to repair whatever injuries are possible to save someone's life so that they can go on and become a productive member of society. hollow point bullets caused

massive destruction that is terrible. i liken it to hamburger meat. everything has exploded in front of you, the kidney is irreparable, you have to remove it. so you have gone from a bullet that can cause a laceration in the kidney that can be repaired, to something that has to be removed. imagine two kidneys gone. someone who is now on dialysis dependent, 20 years of age, that is a considerable cost for the city and county, especially the disability associated with the patient. i have several stories like that, but it stems from what we have already heard from the ballistics expert, that the bill expands. and that is its job, to expand and causing massive destruction and have a larger area of impact inside the body. i also want to say, from a violent intervention standpoint, i have had the opportunity to continue to work with people

outside of the operating room ever ready of projects, and mortality is definitely there, but disability is worse. we see people that are quadraplegic, paraplegic, have colostomy bags that they have to deal with, dialysis dependents. -- dependence. i think that this issue is very important locally. the medical implications are grand, and i believe that you can go from having a patient that can be -- that can recuperate fillet to someone that can die from all of the destruction, or have significant disability as a result of a hollow point bullets. happy to answer any questions you might have . supervisor mirkarimi: thank you for your testimony. on behalf of many of us here

who have heard from repetitive from san francisco general hospital, in the trauma department, just so impressed with what you do saving people's lives. brilliant. i know that the mortality rate would be a hell of a lot higher if it was not for what sfgh has been able to do in pulling out those miracles. but there is no question that there is a growing population of people in wheelchairs, people who are completely disabled, whose lives have been completely crippled because of the gunshots. i see it in so many of the same communities that have been routinely distressed economically as well as public safety, where the violence has been the most pronounced. and that population is really growing. i do not think people think to

themselves and cause and effect as to why this particular pokes are disabled, as if they had been all their lives. i see this now surging. i do not think san francisco is any different than any other city, but it is very conspicuous. stats are always a hard thing that we try to ascertain when we get to this committee process. do you have any idea on the use of hollow point bullets, maybe and vocally, -- anecdotally, what sfgh has had to deal with? >> usually, if we recover any bullets or bullet fragments, we send it to the police department for further examination. we cannot get the results of those examinations. but anecdotally, there is a difference in the destruction that we see visibly with the organ.

in recent operations i have had to partake in, thit seems like there are more cases of destruction, hamburger meat. it seemed to be becoming more prevalent these days. i also do clinical work at highland hospital. the same is true across the bay. this problem is growing locally. that is a front line hospital also. the same thing happens there as well. i think this problem is growing locally, and i think there is an industry that is trying to have more destruction with this bullet. so we are seeing it more in the operating room. supervisor mirkarimi: you mention it, quite right, the costs are internalized to the city. these people who are being affected who were already

reliant on that level of assistance. when they become incapacitated or disabled, that produces a surge in the cost of the responsibility of the city. how to keep up with that, we have not had that conversation yet in city hall. >> sanfrancisco general hospital is unique in that it is the only trauma center in the county. we treat 90% of all penetrating industries. around 80% of our population is either uninsured or underinsured. if you take the hospital costs associated with penetrating injuries and the disabilities that results after, more severe with hollow point bullets, you need rehabilitation, ancillary services to maintain the patient's medical needs.

it actually becomes quite costly for the city and county. supervisor mirkarimi: the other thing we are focusing on, and guns not kept safe, getting into the wrong hands. anything that you would like to reflect on that? >> we see self-inflicted gunshot wounds all the time. usually, we will get some information. by and large, there was a gun that was left unlocked. we do not have any hard-core statistics for that, it is all anecdotal, but that is what we usually hear from the people bringing in the patient at the time. supervisor mirkarimi: supervisor campos? supervisor campos: i think, in terms of making the policy case, explaining why something like this is needed, i think the testimony and comments from our

public health staff, personnel, is compelling. it is not just a public safety issue, it is a public health issue. not only is it about saving lives, but making sure you also improve the quality of the lives that you do save, and that you also minimize the impact that additional expenditures that come with these kinds of incidents have on the rest of the system. for money that you spend on one critically injured patient, that is money that you are not going to have for other needs within the system. i think it is very compelling, and i hope that there is more of an effort, not only within san francisco, but nationwide, to

see this as a public health issue. that is really what it is. if the testimony from our doctors who are doing this work and saving lives on a daily basis is not compelling, i do not know what is. i do want to be on the record, thinking -- thanking sf general hospital, the doctors, personnel, for daily polling of so many miracles. i do not think people understand how that has changed the mortality rate around it while in crime in san francisco, -- violent crimes in san francisco. our homicides would be much higher without the tremendous work that is done at sf general. we are very lucky that we live in this city because we do have,

i think, one of the top hospitals in the world. i certainly saw that with the police commission, a big reason why the homicide rate was going down, because of the great work that goes on at general. you continue that and i do not think you can say enough about that. so i just want to say thank you for doing that. supervisor mirkarimi: well said, supervisor. thank you very much. is there anybody else -- we can go to public comment if that is ok. >> i think that the rest of the people who are here to speak are members of the public. those were the two city employees, other than myself, to talk about the legislation. supervisor mirkarimi: ok, i know

that there are some people who are eager to get into our dcyf item. let's go ahead and open this up to public comment. i mentioned a few names, but if there is anyone else, please feel free to come up and joined. >> good morning, i am a staff attorney at legal communities against violence. we are a separate disk-based national law center that works with state and local governments working on gun prevention issues. we have worked with the city of san francisco on a number of projects over the years. we are founded out of the 1993 assault weapons massacre that is cited in the founding. we strongly support these ordinances, strong support the proposed findings. these findings speak both to the

nation's gun violence epidemic and to the epidemic's impact on our communities in san francisco. the findings demonstrate clearly why the ordinances are needed to help protect public safety. for me, personally, i did not need the findings to be convinced of the need for these ordnances, but the findings go a long way through the inclusion of important research and evidence to support the importance of these ordinances. legal community against violence has worked with local governments across california since our conception. we recognize the value and importance of local leadership on this issue. federal firearms laws are weak. they are far too weak. state laws in california are better, but they are not complete. local governments in california have both the capacity, and i think, the obligation to enact in ordnances that are reactive

to the needs of their communities. different communities will have different needs with respect to the guns and gun violence. different crime problems in different communities, different law strategies employed. the use of firearms for sport are hunting might be different between communities. so it is important to enable communities to enact local ordinances that are responsive. i commend the city of sanfrancisco for adopting these ordnances, and work as well. at the same time, local government can show leadership in sacramento. we have seen a trickle up affect where local ordinances -- jurors diction will adopt ordnances and are later adopted by the state legislature. in summary, i find these ordinances important and entirely consistent with the second amendment right that the supreme court recognized. thank you for your time. supervisor mirkarimi: