Reporting Rh status of women in California

A blood banker in California comments that at her facility they have always attached an Rh comment to all Rh results released on women of childbearing age. She wants to know if this is a California requirement.

Editors' note: According to the CALIFORNIA HEALTH AND SAFETY CODE SECTION 125050-125119.5:

(a) As early as possible during prenatal care, a blood specimen obtained pursuant to Section 125080 shall be submitted to a clinical laboratory licensed by the department or to an approved public health laboratory for a determination of rhesus (Rh) blood type and the results shall be reported to both of the following:

(1) The physician and surgeon or other person engaged in the prenatal care of the woman or attending the woman at the time of delivery.

(2) The woman tested.

(b) (1) In addition, as early as possible during prenatal care, a blood specimen obtained pursuant to Section 125080 shall be submitted to a clinical laboratory licensed by the department or to an approved public health laboratory for a test to determine the presence of hepatitis B surface antigen and the human immunodeficiency virus (HIV), and the results shall be reported to both of the following:

(A) The physician and surgeon or other person engaged in the prenatal care of the women or attending the woman at the time of delivery who ordered the test, and who shall subsequently inform the woman tested.

(B) A positive test result shall be reported to the local health officer, with the information required and within the timeframes established by the department, pursuant to Chapter 4 (commencing with Section 2500) of Title 17 of the California Code of Regulations.

(2) In the event that other tests to determine hepatitis B infection or HIV infection become available, the department may approve additional tests.

ADDENDA Dec. 27, 2009

1. The inquiring colleague who initiated this discussion reports that at her hospital the Rh comment currently attached to all Rh results of women of childbearing age is: " Women must be informed of RHESUS (Rh) test result". They attach the aforementioned comment to all Rh prenatal results as well as to all compatibility testing Rh results, and to any Rh-only results from their emergency room. She wonders if their reporting protocol exceeds what is actually required, since they have found the following information in the California Code of Regulations:
   
   17 CA ADC § 1057
   17 CCR § 1057
   Cal. Admin. Code tit. 17, § 1057
   BARCLAYS OFFICIAL CALIFORNIA CODE OF REGULATIONS
   TITLE 17. PUBLIC HEALTH
   DIVISION 1. STATE DEPARTMENT OF HEALTH SERVICES
   CHAPTER 2. LABORATORIES
   SUBCHAPTER 1. SERVICE LABORATORIES
   GROUP 2. CLINICAL LABORATORY REGULATIONS
   ARTICLE 6. LABORATORY REPORTS
   This database is current through 5/2/08, Register 2008, No. 18
   § 1057. Prenatal Blood Typing Reports.
   Licensed clinical laboratories or approved public health laboratories performing tests on pregnant women as required by Sections 290 and 291 of the California Health and Safety Code shall provide the requesting physician with a copy of the report to be stamped or imprinted as follows: "State law requires that the woman tested be informed as to the rhesus (Rh) typing test results."
   
   Every licensed physician and surgeon or other person engaged in the prenatal care of a pregnant woman, or attending such woman at time of delivery after receiving such report, shall be responsible for notifying the woman tested of the results of the test.

ADDENDA Dec. 29, 2009

2. In the opinion of Mr. Robert Hunter of the Calif. Dept of Public health, Lab Field Services (attribution used with permission) the sections of the California laws and regulations apply only to prenatal testing scenarios. An Emergency Room request for Rh type, if related to prenatal care, may apply to these reporting requirements. In addition, the statement referring to the Rh testing must be quoted exactly as is worded in the law - "State law requires that the woman tested be informed as to the rhesus (Rh) typing test results." It is the attending physician’s responsibility to relay the information.
   
   Mr. Hunter has graciously stated that he would be available to address specific questions from the submitting colleague, (Robert.Hunter@cdph.ca.gov), and he would treat such calls anonymously if preferred, and he would review any related SOP's.

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