# Title 23 — Health and Safety

## Chapter 23-51 — Maternal Mortality Review Committee

### § 23-51-01. Definitions.

As used in this chapter:
1. "Committee" means the maternal mortality review committee.
2. "Department" means the obstetrics and gynecology department of the university of
North Dakota school of medicine and health sciences.
3. "Health care provider" means:
a. An individual licensed, certified, or otherwise authorized to provide health care
services in the ordinary course of business in the state; or
b. A health facility licensed by the department of health and human services.
4. "Maternal mortality" means the death of a pregnant woman or a woman within
one year postpartum.
5. "School" means the university of North Dakota school of medicine and health
sciences.
6. "Severe maternal morbidity" means a condition occurring in a woman during
pregnancy or within one year of the end of pregnancy which results in:
a. Admission to the intensive care unit of a health facility; or
b. Transfusion of four or more units of blood products.
### § 23-51-02. Maternal mortality review committee.

The department shall appoint individuals to serve as members on the maternal mortality
review committee. Committee membership must include representatives of multiple specialties
and disciplines, including forensic pathology. In appointing members, the department shall
endeavor to appoint individuals working in and representing communities affected by
pregnancy-related deaths, severe maternal morbidity, and a lack of access to relevant perinatal
and intrapartum care services.
### § 23-51-03. Powers and duties of committee.

1. The committee shall:
a. Identify maternal mortality cases in the state;
b. Obtain and conduct comprehensive reviews of medical records and other
relevant data using best practices for case reviews to identify factors associated
with the deaths;
c. Consult, as appropriate, with relevant experts to evaluate and interpret the
records and data;
d. Consult, as appropriate, with family members and other affected or involved
persons to collect additional relevant information;
e. Make determinations regarding the preventability of maternal deaths;
f. Develop policy recommendations to improve health care services for women and
reduce the incidence of maternal mortality in the state;
g. Convene annually and provide committee members with the available information
necessary to fully review each case; and
h. Compile annually a state report of fatalities reviewed.
2. The committee may review cases and trends in severe maternal morbidity.
### § 23-51-04. Powers and duties of school - Continuing appropriation.

1. The school shall provide or arrange for administrative services to assist the committee
in performing official duties, including collection and management of case review files,
maintenance of records, collection and analysis of data, and the issuance of an annual
state report on maternal mortality. The school is responsible for the confidentiality and
security of data on the sharing site on which the documents are stored.
2. The school may accept gifts and grants from any source to fund the duties of the
department and the committee under this chapter. The school shall apply for and use

available federal money to fund the duties of the committee under this chapter. All
moneys received by the school under this section are appropriated on a continuing
basis to the school for the purpose of funding the duties of the committee and the
department under this chapter.
### § 23-51-05. Confidentiality.

1. Notwithstanding section 44-04-19, all portions of a meeting of the committee during
which the committee reviews maternal mortality and severe maternal morbidity are
closed to the public. Notwithstanding section 44-04-18, all documentation and reports
of the committee which are related to committee review of maternal deaths are
confidential, except for the annual state report, which may not disclose personally
identifiable information of decedents. Records deemed confidential under this section
are not discoverable as evidence.
2. All proceedings and activities of the committee under this chapter; committee
members' opinions formed as a result of the proceedings and activities; and records
obtained, created, or maintained under this chapter, including records of interviews,
written reports, and statements procured by the department, the committee, or any
other person acting jointly or under contract with the department or committee in
connection with requirements of this chapter, are confidential and not subject to
section 44-04-18, or subject to subpoena, discovery, or introduction into evidence in
any civil or criminal proceeding. This section may not be construed to limit or restrict
the right to discover or use information or records available from another source and
independent of the proceedings of the committee in any civil or criminal proceeding.
### § 23-51-06. Access to records.

1. The presiding officer of the committee may request from a health care provider all
patient records of the provider from the most recent thirty-six-month period which
pertain to an identified maternal mortality. Upon receipt of a written request for the
information, a health care provider shall disclose the records. The presiding officer also
may acquire the information from health care facilities, maternal mortality review
programs, and other sources in other states to ensure the committee's records of
North Dakota maternal mortality cases are accurate and complete.
2. The department of health and human services shall provide a certified copy of a
complete death record to the committee upon request.
### § 23-51-07. Immunity.

A member of the committee or person employed by or acting in an advisory capacity to the
committee and which provides information, counsel, or services to the committee is not liable for
damages for an action taken within the scope of the functions of the committee. Members of the
committee may not be questioned in any civil or criminal proceeding regarding the information
presented in or opinions formed as a result of a meeting or communication of the committee. A
committee member or health care provider providing access to medical records pursuant to this
chapter may not be held liable for civil damages or be subject to any criminal or disciplinary
action for a good-faith effort in providing the records.
### § 23-51-08. Annual state report.

1. The committee's annual state report must include the identification of patterns, trends,
and policy issues related to maternal mortality, but may not disclose personally
identifiable information.
2. The committee shall provide the annual state report to the legislative management, the
department of health and human services, the North Dakota society of obstetricians
and gynecologists, and other entities as determined necessary by the committee to
facilitate the objectives of the committee. The committee's findings and
recommendations must be made available to health care providers and the public.
