Ariz. Admin. Code § R9-19-305 - Fetal Death Registration
A.
Before requesting the registration of a fetal death, a hospital, an abortion
clinic, a physician, a nurse midwife, or a midwife shall:
1. Obtain, in a written format:
a. The information in subsections (B)(1)(a)
through (f), (v), and (w) and (2)(a) through (f) from a parent of the deceased
or another family member who is of legal age; and
b. A statement attesting to the validity of
the information in subsections (B)(1)(a) through (f), (v), and (w) and (2)(a)
through (f), signed and dated by the individual providing the information;
and
2. Provide, in a
Department-provided format, the information in:
a. Subsections (B)(1)(g) through (o) and
(2)(g) through (u); and
b. Unless a
funeral director is responsible for the final disposition of the human remains,
subsections (B)(1)(p) through (u).
B. Except as provided in subsection (D) and
R9-19-306, a hospital, an abortion clinic, a physician, a nurse midwife, or a
midwife shall submit to the State Registrar or a local registrar, according to
A.R.S. §
36-329
and in a Department-provided format:
1.
Information for the deceased's certificate of fetal death registration:
a. The name of the deceased, if
applicable;
b. Location where
delivery occurred, including:
i. The city or
town, zip code, and county where the delivery occurred; and
ii. Whether delivery occurred in a residence
or another facility;
c.
If delivery occurred at a residence, the street address of the residence or, if
the residence where the delivery occurred does not have a street address,
another indicator of the location at which the delivery occurred;
d. If delivery occurred in a facility, the:
i. Name of the facility where delivery
occurred, and
ii. Type of facility
where delivery occurred;
e. The following information about the
deceased's father:
i. Name;
ii. Date of birth; and
iii. State, territory, or foreign country
where the father was born;
f. The following information about the
deceased's mother:
i. Current name;
ii. Street address, apartment number if
applicable, city or town, state, zip code, and county of the mother's usual
residence;
iii. If the mother's
usual residence is not in the United States, the country of the mother's usual
residence;
iv. Date of
birth;
v. Name before first
marriage; and
vi. State, territory,
or foreign country where the mother was born;
g. The deceased's sex;
h. Plurality of delivery;
i. If plurality involves more than one, the
deceased's order of birth;
j. Date
of delivery;
k. Hour of delivery;
l. Any cause or condition that
contributed to the fetal death, specified according to the applicable standards
incorporated by reference in
R9-19-303(C)(3)
or
R9-19-304(C), as applicable;
m. Any other
significant causes or conditions related to the fetal death;
n. If a medical examiner of the registration
district where the fetal death occurred took charge of the human remains under
A.R.S. §
11-594,
the name and health professional license number of the medical
examiner;
o. The name and, if
applicable, professional credential of the individual attending the delivery
and
p. The anticipated final
disposition of the human remains, including one or more of the following:
i. Hospital or abortion clinic
disposition;
ii. Burial;
iii. Entombment;
iv. Cremation;
v. Anatomical gift, except for an anatomical
gift of a part;
vi. Removal from
the state; and
vii. Other final
disposition of the human remains;
q. If an anticipated final disposition is
anatomical gift, except for an anatomical gift of a part, another anticipated
final disposition other than removal from the state;
r. If an anticipated final disposition is
removal from the state:
i. Whether removal
from the state includes removal from the United States; and
ii. Another anticipated final disposition
specified in subsection (B)(1)(p)(ii), (iii), (iv), or
(vii);
s. If an
anticipated final disposition of the human remains is another means of final
disposition, a description of the anticipated final disposition;
t. The name and location where each final
disposition of the human remains took place, and the date of each final
disposition;
u. If a funeral
establishment is responsible for the final disposition of the human remains:
i. The name and address of the funeral
establishment and
ii. The name and
license number of the funeral director;
v. If a person is responsible for the final
disposition of the human remains, the name and address of the responsible
person; and
w. The name and title
of the individual providing the information;
2. Other information for the deceased's fetal
death record:
a. If delivery occurred at a
residence, whether the delivery was planned to occur at the
residence;
b. The following
information about the deceased's father:
i.
Race;
ii. Whether the father is of
Hispanic origin and, if so, the type of Hispanic origin; and
iii. Highest degree or level of education
completed by the father at the time of the deceased's
delivery;
c. The
following information about the deceased's mother:
i. Race;
ii. Highest degree or level of education
completed by the mother at the time of the deceased's delivery;
iii. Whether the mother's usual residence is
inside city limits;
iv. Whether the
mother's usual residence is in a tribal community and, if so, the name of the
tribal community; and
v.
Height;
d. Whether the
deceased's mother:
i. Is of Hispanic origin
and, if so, the type of Hispanic origin;
ii. Received food from WIC for herself during
the pregnancy; or
iii. Was married
at the time of delivery;
e. The deceased's mother's history of
i. Smoking before or during the
pregnancy,
ii. Prenatal care for
this pregnancy, and
iii. Previous
pregnancies and pregnancy outcomes;
f. The deceased's mother's:
i. Pre-pregnancy weight;
ii. Weight at delivery; and
iii. Date the last normal menses
began;
g. The principal
source of payment for the delivery;
h. If applicable, the National Provider
Identifier of the facility where delivery occurred;
i. Estimation of the deceased's gestational
age;
j. Weight in grams of the
deceased at delivery;
k. Whether:
i. The deceased was dead at first assessment
with no ongoing labor,
ii. The
deceased was dead at first assessment with ongoing labor,
iii. The deceased died during labor after
first assessment, or
iv. It is
unknown when the deceased died;
l. The following medical information about
the deceased's mother:
i. Medical risk
factors during this pregnancy;
ii.
Characteristics of the labor and delivery; and
iii. Medical complications during labor or
delivery;
m. Whether the
deceased's mother was transferred from one facility to another facility for a
maternal medical condition or fetal medical condition before the
delivery;
n. If the deceased's
mother was transferred from one facility to another facility before the
delivery, the name of the facility from which the deceased's mother was
transferred;
o. Whether the
prenatal record was available for completion of the fetal death
report;
p. Any congenital anomalies
of the deceased;
q. Whether an
autopsy was planned or performed;
r. Whether a histological placental
examination was performed;
s.
Whether autopsy or histological placental examination results were used in
determining the cause of the fetal death;
t. Whether the placenta appearance was normal
or abnormal; and
u. A description
of the fetal appearance at delivery; and
3. A written statement attesting to the
validity of the submitted information, signed and dated by the designee of the
person submit-ting the information.
C. To request the registration of a fetal
death more than seven days after the fetal death, a hospital, an abortion
clinic, a physician, a nurse midwife, or a midwife shall submit, in a
Department-provided format, to the State Registrar:
1. The information required in subsections
(A)(1) and (2);
2. A description of
the circumstances causing the delay; and
3. A written statement attesting to the
validity of the information required in subsections (B)(1) and (2), signed and
dated by the person making the request.
D. Within seven days after receiving the
human remains from a fetal death from a hospital, an abortion clinic, a
physician, a nurse midwife, or a midwife, a responsible person or funeral
director who is responsible for the final disposition of the human remains
shall submit to the State Registrar or the local registrar of the registration
district in which the fetal death occurred, in a Department-provided format,
any information specified in subsections (B)(1)(a) through (f) and (p) through
(w) and (2)(a) through (e) that had not been submitted by the hospital,
abortion clinic, physician, nurse midwife, or midwife, according to subsection
(B).
E. If a fetal death occurs in
this state and is not registered within one year after the date of the fetal
death, the State Registrar or a local registrar shall establish and register a
delayed fetal death record.
F. When
the State Registrar or a local registrar or deputy local registrar of the
registration district where a fetal death occurred receives a request to
register the fetal death, the State Registrar, local registrar, or deputy local
registrar shall review the request according to
R9-19-103.
G. A hospital, an abortion clinic, a
physician, a nurse midwife, or a midwife responsible for submitting the
information in subsection (B) to the State Registrar or a local registrar or
deputy local registrar shall:
1. Maintain a
copy of the evidentiary document in subsection (A) for at least 10 years after
the date on the evidentiary document, and
2. Provide a copy of the evidentiary document
in subsection (A) to the State Registrar for review within 48 hours after the
State Registrar's request.
Notes
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