Oklahoma Code § 63-1-738l

Title 63. Public Health And Safety: Complications of Induced Abortion Report - Sample form
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A.  Complications of Induced Abortion Report.  By March 1, 2012,
the State Department of Health shall prepare and make available, on
its stable Internet website, a Complications of Induced Abortion
Report for all physicians licensed and practicing in the State of
Oklahoma.
B.  Subsection C of this section shall become operative on the
later of:
1.  April 1, 2012; or
2.  Thirty (30) calendar days following the date on which the
State Department of Health posts on its stable Internet website the
Individual Abortion Form and instructions concerning its electronic
submission referenced in Section 3 of this act.
C.  Any physician practicing in Oklahoma who encounters an
illness or injury that a reasonably knowledgeable physician would
judge is related to an induced abortion shall complete and submit,
electronically or by regular mail, a Complications of Induced
Abortion Report to the Department as soon as is practicable after
the encounter with the induced-abortion-related illness or injury,
but in no case more than sixty (60) days after such an encounter.
Nothing in the Complications of Induced Abortion Report shall
contain the name, address, hometown, county of residence, or any
other information specifically identifying any patient.  Knowing or
reckless unreasonable delay or failure to submit a Complications of
Induced Abortion Report shall be sanctioned according to the
provisions of the Statistical Abortion Reporting Act.

D.  The Complications of Induced Abortion Report shall contain a
notice containing an assurance that in accordance with subsection F
of Section 5 of this act, public reports based on the form submitted
will not contain the name, address, hometown, county of residence,
or any other identifying information of any individual female, that
the State Department of Health will take care to ensure that none of
the information included in its public reports could reasonably lead
to the identification of any individual female about whom
information is reported in accordance with the Statistical Abortion
Reporting Act, or of any physician providing information in
accordance with the Statistical Abortion Reporting Act, and that
such information is not subject to the Oklahoma Open Records Act.
E.  Complication(s) of Induced Abortion Report.  The
Complications of Induced Abortion Report shall be substantially
similar to, but need not be in the specific format of, the following
form:
Complications of Induced Abortion Report
1.  Name and specialty field of medical practice of the
physician filing the report: _________________________________
2.  Did the physician filing the report perform or induce the
abortion? ________________________________________________
3.  Name, address, and telephone number of the health care
facility where the induced abortion complication was discovered or
treated: __________________________________________________________
4.  Date on which the complication was discovered: ________
5.  Date on which, and location of the facility where, the
abortion was performed, if known: _________________________________
6.  Age of the patient experiencing the complication: _____
7.  Describe the complication(s) resulting from the induced
abortion: ______________________________________________________
8.  Circle all that apply:
a. Death
b. Cervical laceration requiring suture or repair
c. Heavy bleeding/hemorrhage with estimated blood loss of
greater than or equal to 500cc
d. Uterine Perforation
e. Infection
f. Failed termination of pregnancy (continued viable
pregnancy)
g. Incomplete termination of pregnancy (Retained parts of
fetus requiring re-evacuation)
h. Other (May include psychological complications, future
reproductive complications, or other illnesses or
injuries that in the physician’s medical judgment
occurred as a result of an induced abortion.  Specify
diagnosis.): _______________________________

9.  Type of follow-up care, if any, recommended:
______________________
10.  Will the physician filing the Complications of Induced
Abortion Report be providing such follow-up care (if not, the name
of the medical professional who will, if known)?
_____________________________
11.  Name and license number of physician filing the
Complications of Induced Abortion Report: _________________________
Added by Laws 2010, c. 276, § 4, eff. Nov. 1, 2010.
NOTE:  The conditional repeal of this section by Laws 2021, c. 308,
§ 2, was itself repealed by Laws 2022, c. 133, § 2, emerg. eff.
April 29, 2022.

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