Chapter 3701-70 | Fetal Infant Mortality Review Program

Rule 3701-70-01 | Definitions.

• Effective: September 2, 2024
• Promulgated Under: 119.03

As used in this chapter:

(A) "Fetal death" means death prior to the complete expulsion or extraction from its mother of a product of human conception, irrespective of the duration of pregnancy, which after such expulsion or extraction does not breathe or show any other evidence of life such as beating of the heart, pulsation of the umbilical cord, or definite movement of voluntary muscles.

(B) "Infant death" means any death at any time from live birth up to, but not including, one year of age (three hundred sixty-four days, twenty-three hours, fifty-nine minutes from the moment of birth).

(C) "Live birth" means the complete expulsion or extraction from the mother of a product of human conception, irrespective of the duration of pregnancy, which, after such expulsion or extraction, breathes or shows any other evidence of life, such as beating of the heart, pulsation of the umbilical cord or definite movement of voluntary muscles whether or not the umbilical cord has been cut or the placenta is attached. Heartbeats are to be distinguished from transient cardiac contractions; respirations are to be distinguished from fleeting respiratory efforts or gasps.

(D) "Child fatality review (CFR) board" means a county or regional board established or appointed to review deaths of children residing in the county or region for the purpose of decreasing the incidence of preventable child deaths.

(E) "Cause of death" means the classification of death as listed in box 30 on the Ohio death certificate, or an equivalent box on future forms. Examples of causes include, but are not limited to, birth defects, drowning and submersion, electrocution, extreme prematurity, falls, fire and burn, firearms and weapons, pneumonia, poisoning, shaken baby syndrome, sudden infant death syndrome, suffocation and strangulation, vehicular, and other cause.

(F) "Infant" means a child who is less than one year of age.

(G) "Fetal infant mortality review (FIMR) board" means a county or regional board established or appointed to review fetal and infant deaths of residents in the county or region for the purpose of decreasing the incidence of preventable fetal and infant deaths.

(H) "Circumstance of death" means any accompanying or surrounding details of the death beyond the cause and manner of death. Examples include, but are not limited to, drowning in a bucket or house fire in rental unit.

(I) "Contributing factors" mean other factors beyond the cause or manner of death that may be partly responsible for the fetal or infant death. Examples of contributing factors include medical factors; alcohol, drug, or tobacco use by parent or caretaker; alcohol, drug, or tobacco exposure to fetus or infant; use or non-use of safety devices; level of supervision; environmental factors; and mental or behavioral factors of parent, caretaker or fetus or infant.

(J) "County of residence" means the county of residence as identified on the Ohio death certificate.

(K) "Department or director" means the director of the Ohio department of health or any official or employee of the department designated by the director of the Ohio department of health.

(L) "Geographic location of death" means the county in which the fetus or infant was pronounced dead.

(M) "Manner of death" means the classification of death listed in box 32 on the Ohio death certificate, or equivalent box on future forms. The classification is limited to natural, accident, homicide, suicide, and undetermined.

(N) "Preventable" means the degree to which an individual or community could have reasonably done something that would have changed the circumstances that led to the fetal or infant death.

(O) "Public record" means any record defined in division (A)(1) of section 149.43 of the Revised Code.

(P) "Review" means a general assessment or examination of the death of a fetus or infant. The review will at least consider the cause of death; manner of death; circumstance of death; contributing factors; age; sex; race and ethnicity; and geographic location of death.

Last updated September 3, 2024 at 9:17 AM

Supplemental Information

Authorized By: 3707.71
Amplifies: Am. Sub. H. B. No. 166: Sec. 3701.049 (A), Sec. 3701.049 (B), Sec. 3701.049 (B) (1), Sec. 3701.049 (B) (2), Sec. 3701.049 (B) (3), Sec. 3701.049 (B) (4)
Five Year Review Date: 9/2/2029

Rule 3701-70-02 | Board members and meetings.

• Effective: September 2, 2024
• Promulgated Under: 119.03

(A) The board, by a majority vote of a quorum of its members, will select an individual to serve as its chairperson. The board may replace a chairperson in the same manner.

(B) A vacancy on a board will be filled in the same manner as the original appointment.

(C) The board will meet at the call of the board's chairperson as often as the chairperson determines necessary for timely completion of fetal infant death reviews.

(D) Each fetal infant mortality review (FIMR) board will choose sampling criteria to select cases for fetal and infant death review. For fetal death, the fetus will be of twenty or more weeks gestation for it to be reportable in Ohio. Each fetal death experienced by a woman who was, at the time of death, a resident of the health district in which the board exercises authority may be reviewed. Each death of an infant who was, at the time of death, a resident of the health district in which the board exercises authority may be reviewed.

(E) The FIMR board may work in conjunction with a county or regional Child fatality review (CFR) team, or combine with other counties for a regional FIMR board.

(F) Each FIMR board will be convened at least once a year to review the selected deaths of the infants who, at the time of death, were residents of the county, and fetuses whose mother was, at the time of death, a resident of the county or, in the case of a regional board, were residents of one of the participating counties.

Last updated September 3, 2024 at 9:18 AM

Supplemental Information

Authorized By: 3707.71
Amplifies: Am. Sub. H. B. No. 166: Sec. 3701.049 (A), Sec. 3701.049 (B), Sec. 3701.049 (B) (1), Sec. 3701.049 (B) (2), Sec. 3701.049 (B) (3), Sec. 3701.049 (B) (4)
Five Year Review Date: 9/2/2029

Rule 3701-70-03 | Confidentiality.

• Effective: September 2, 2024
• Promulgated Under: 119.03

(A) Except as provided in sections 5153.171 to 5153.173 of the Revised Code, all records, documents, reports, or other information presented to the FIMR board or a person abstracting such materials on the board's behalf, all statements made by board members during board meetings, all work products of the board, and data submitted by the board to the department of health or a national fetal-infant death review database, other than the reports described in section 3707.77 of the Revised Code, are confidental and not a public record pursuant to section 3707.75 of the Revised Code.

(B) Materials presented to the board or a person abstracting the materials on the board's behalf are to be stored securely as specified in section 3707.75 of the Revised Code.

(C) All information accessible to each board member and used during a review, including information provided by the deceased's mother, will be de-identified as provided in section 3707.75 of the Revised Code.

Last updated September 3, 2024 at 9:18 AM

Supplemental Information

Authorized By: 3707.71
Amplifies: Am. Sub. H. B. No. 166: Sec. 3701.049 (A), Sec. 3701.049 (B), Sec. 3701.049 (B) (1), Sec. 3701.049 (B) (2), Sec. 3701.049 (B) (3), Sec. 3701.049 (B) (4)
Five Year Review Date: 9/2/2029

Rule 3701-70-04 | Reporting.

• Effective: September 2, 2024
• Promulgated Under: 119.03

(A) When applicable and available, each FIMR board will use the director's data collection tool or the national fetal-infant death review database to record the following information:

(1) Demographic information that includes:

(a) Age of the child;

(b) Sex of the child, identified as male or female;

(c) Race of the child, identified as black, white, American Indian, Asian, Alaskan native, native Hawaiian, Pacific islander, unknown or multiple; and

(d) Ethnicity of the child, identified as Hispanic or Latino origin.

(2) Infant death information that includes:

(a) Gestational age;

(b) Birth weight;

(c) Multiple gestation;

(d) Mother's number of pregnancies;

(e) Mother's number of live births;

(f) Mother's number of living children;

(g) Prenatal care provided during pregnancy of deceased infant;

(h) Access or compliance issues related to prenatal care;

(i) Medical conditions/complications during pregnancy;

(j) Medical complications in previous pregnancies;

(k) Medication, drug or substance use during pregnancy;

(l) Infant born drug exposed;

(m) Infant neonatal abstinence syndrome (NAS);

(n) Level of birth hospital;

(o) At hospital discharge, was a case manager assigned;

(p) Whether mother attended postpartum visit;

(q) Did the infant stay in NICU more than one day;

(r) Did mother smoke in three months before pregnancy;

(s) Did mother smoke any time during pregnancy;

(t) Was mother injured during pregnancy;

(u) Did mother have postpartum depression;

(v) Was infant ever breastfed;

(w) Did infant have abnormal metabolic newborn screening results; and

(x) Prior to last seventy-two hours of life, did infant have history of medical conditions, symptoms, injury, vaccine administration, medications, feeding.

(3) Fetal/infant death information that includes:

(a) Was mother using birth control in 3 months prior to this pregnancy;

(b) Where was prenatal care most frequently provided for this pregnancy;

(c) Which type of provider most frequently provided prenatal care for this pregnancy;

(d) Were there any signs of fetal distress;

(e) Were any birth defects noted; and

(f) Maternal interview completed.

(4) Death related information that includes:

(a) Year of child's death;

(b) Geographic location of death; and

(c) Cause of death.

(5) Contributing factors to death that includes death related to sleeping environment:

(a) Was death related to sleeping/sleep environment;

(b) Incident sleep space;

(c) Position of child when put to sleep;

(d) Position of child when found;

(e) Usual sleep position;

(f) Availability of suitable sleep location;

(g) Usual sleep space;

(h) Child in new or different environment;

(i) Child placed to sleep with pacifier;

(j) Child wrapped or swaddled in blanket;

(k) Child overheated;

(l) Child exposed to second-hand smoke;

(m) Position of child's face when found;

(n) Position of child's neck when found;

(o) Status of child's airway;

(p) Objects in child's environment and relation to airway obstruction;

(q) Caregiver/Supervisor fell asleep when feeding child;

(r) Child sleeping in same room as caregiver/supervisor;

(s) Child sharing sleep surface with person(s) or animal(s);

(t) Reasons for sharing sleep surface; and

(u) Scene re-creation photo available.

(6) Data quality information that includes:

(a) Was a home interview conducted;

(b) Data entry completed for the case; and

(c) Preventability of the death.

(B) By April first of each year, each FIMR board will prepare and submit an annual report to the department of health in a manner and format that is prescribed by the director. The report will include all of the following with respect to the fetal or infant deaths in the calendar year specified by the director.

(1) The total number of fetal and infant deaths in the county or region, whichever is applicable to the FIMR board submitting the report;

(2) The total number of fetal death reviews completed by the FIMR board;

(3) The total number of infant death reviews completed by the FIMR board;

(4) The total number of fetal and/or infant death reviews not completed by the FIMR board; and

(5) A summary of the demographic and death related information as specified in paragraph (A) of this rule.

(C) The annual report may include recommendations on how to decrease the incidence of preventable fetal and infant deaths in the board's jurisdiction and the state, as well as any other information the board determines should be included.

Last updated September 3, 2024 at 9:18 AM

Supplemental Information

Authorized By: 3701.049
Amplifies: 3701.049; R.C. 3707.74; 3707.75, 3707.77
Five Year Review Date: 9/2/2029