If the examination and tests reveal the existence of preventable/inheritable disorders or conditions in an infant, the provider or hospital attending or assisting at the birth of the infant shall report to the State's Chief Medical Officer, and local county health officers. Upon notification by the State Public Health Laboratory that a test is abnormal or questionable, the child’s physician or the person who is legally responsible for registering the birth of the child shall cause to have taken an additional blood sample and any additional tests which are required to evaluate the possible abnormality and shall report that action to the State Public Health Laboratory. A hospital or obstetric center shall complete a newborn screening collection form obtained from the State Public Health Laboratory if a blood sample is not taken from an infant before his or her discharge from the hospital or obstetric center, unless the infant is transferred to a hospital that provides a higher level of neonatal care. The hospital or obstetric center shall send the newborn screening collection form indicating that a blood sample was not taken from an infant to the State Public Health Laboratory within 2 working days after the infant is discharged from the hospital or obstetric center.
The physician, midwife, nurse, obstetric center or hospital attending or assisting at the birth of the infant
Immediately
(The hospital or obstetric center shall send the newborn screening collection form indicating that a blood sample was not taken from an infant to the State Public Health Laboratory within 2 working days after the infant is discharged from the hospital or obstetric center.)
Report the condition to:
NRS 442.008 Examination of infants: Regulations; performance of tests by State Public Health Laboratory; duties of physician, midwife, nurse, obstetric center or hospital; exemption. [Effective January 1, 2020.]
1. The State Board of Health shall adopt regulations governing examinations and tests required for the discovery in infants of preventable or inheritable disorders, including tests for the presence of sickle cell disease and its variants and sickle cell trait.
2. Except as otherwise provided in this subsection, the examinations and tests required pursuant to subsection 1 must include tests and examinations for each disorder recommended to be screened by the Health Resources and Services Administration of the United States Department of Health and Human Services by not later than 4 years after the recommendation is published. The State Board may exclude any such disorder upon request of the Chief Medical Officer or the person in charge of the State Public Health Laboratory based on:
(a) Insufficient funding to conduct testing for the disorder; or
(b) Insufficient resources to address the results of the examination and test.
3. Any examination or test required by the regulations adopted pursuant to subsection 1 which must be performed by a laboratory must be sent to the State Public Health Laboratory. If the State Public Health Laboratory increases the amount charged for performing such an examination or test pursuant to NRS 439.240, the Division shall hold a public hearing during which the State Public Health Laboratory shall provide to the Division a written and verbal fiscal analysis of the reasons for the increased charges.
4. Except as otherwise provided in subsection 7, the regulations adopted pursuant to subsection 1 concerning tests for the presence of sickle cell disease and its variants and sickle cell trait must require the screening for sickle cell disease and its variants and sickle cell trait of:
(a) Each newborn child who is susceptible to sickle cell disease and its variants and sickle cell trait as determined by regulations of the State Board of Health; and
(b) Each biological parent of a child who wishes to undergo such screening.
5. Any physician, midwife, nurse, obstetric center or hospital of any nature attending or assisting in any way any infant, or the mother of any infant, at childbirth shall:
(a) Make or cause to be made an examination of the infant, including standard tests that do not require laboratory services, to the extent required by regulations of the State Board of Health as is necessary for the discovery of conditions indicating such preventable or inheritable disorders.
(b) Collect and send to the State Public Health Laboratory or cause to be collected and sent to the State Public Health Laboratory any specimens needed for the examinations and tests that must be performed by a laboratory and are required by the regulations adopted pursuant to subsection 1.
6. If the examination and tests reveal the existence of such conditions in an infant, the physician, midwife, nurse, obstetric center or hospital attending or assisting at the birth of the infant shall immediately:
(a) Report the condition to the Chief Medical Officer or the representative of the Chief Medical Officer, the local health officer of the county or city within which the infant or the mother of the infant resides, and the local health officer of the county or city in which the child is born; and
(b) Discuss the condition with the parent, parents or other persons responsible for the care of the infant and inform them of the treatment necessary for the amelioration of the condition.
7. An infant is exempt from examination and testing if either parent files a written objection with the person or institution responsible for making the examination or tests.
8. As used in this section, “sickle cell disease and its variants” has the meaning ascribed to it in NRS 439.4927.
(Added to NRS by 1967, 208; A 1977, 114, 960; 1989, 1893; 1999, 1062, 3511; 2011, 461; 2019, 812, 2161, effective January 1, 2020)
NAC 442.030 Taking of blood sample required; mailing of newborn screening test kit.
1. Except as otherwise provided in NAC 442.035, every hospital or obstetric center in which an infant is born must take a heel stick blood sample from the infant before he or she is discharged from the hospital or obstetric center. The sample must be taken not later than the seventh day of the infant’s life regardless of the feeding status of the infant. If an infant is discharged before he or she is 48 hours of age, the hospital or obstetric center must take a heel stick blood sample as close as possible to the time of the infant’s discharge from the hospital or obstetric center.
2. The sample must be placed in a newborn screening test kit obtained from the State Public Health Laboratory and must be mailed to the address indicated on the kit within 24 hours after the sample is taken.
3. If an infant is not born in a hospital or obstetric center, the person who is legally responsible for registering the birth of the child must have a physician, hospital, public health nurse or the State Public Health Laboratory take the first blood sample between the 3rd and 7th day and the second blood sample between the 15th and 56th day of the infant’s life.
4. As used in this section, “heel stick blood sample” means a small amount of blood obtained by means of a small puncture made to the heel of an infant.
[Bd. of Health, Metabolic Error Screening of Newborns Reg. §§ 2.1-2.3, eff. 12-27-77] — (NAC A 10-23-87; 10-10-90; R033-16, 11-2-2016)
NAC 442.046 Abnormal or questionable blood test: Additional blood sample and tests required; evaluation of child by physician.
1. Upon notification by the State Public Health Laboratory that a test is abnormal or questionable, the child’s physician or the person who is legally responsible for registering the birth of the child shall cause to have taken an additional blood sample and any additional tests which are required to evaluate the possible abnormality and shall report that action to the State Public Health Laboratory.
2. The parent or guardian of an infant with an abnormal or questionable test result shall upon notification promptly take the child to a physician who shall ensure that a quantitative evaluation of the problem indicated by the test result is performed.
3. The person taking the blood sample shall:
(a) Provide all available information including:
(1) The name and gender of the infant and the name and address of the mother;
(2) The feeding history of the infant;
(3) The gestational age of the infant at birth;
(4) The age of the infant at the time of testing;
(5) The use of antibiotics or hyperalimentation; and
(6) Any additional information the State Public Health Laboratory may require.
(b) Obtain a sufficient blood sample to ensure adequate diagnostic testing on the infant.
(Added to NAC by Bd. of Health, eff. 10-23-87; A by R033-16, 11-2-2016)
NAC 442.050 Duties of nurse in charge or person legally responsible for registering birth of child; completion of newborn screening collection form required when blood sample not taken.
1. The nurse in charge or the person legally responsible for registering the birth of the child shall:
(a) Determine that a blood sample has been properly drawn, executed and placed in a newborn screening test kit obtained pursuant to NAC 442.030 before an infant is discharged from the hospital.
(b) Ensure that the blood sample is mailed within 24 hours after it is drawn.
(c) Record on the infant’s medical chart the fact that the sample was taken and the date it was taken.
(d) Ensure that the report required by NRS 442.040 is completed and signed by the parent or guardian.
2. A hospital or obstetric center shall complete a newborn screening collection form obtained from the State Public Health Laboratory if a blood sample is not taken from an infant before his or her discharge from the hospital or obstetric center, unless the infant is transferred to a hospital that provides a higher level of neonatal care. The hospital or obstetric center shall send the newborn screening collection form indicating that a blood sample was not taken from an infant to the State Public Health Laboratory within 2 working days after the infant is discharged from the hospital or obstetric center.
[Bd. of Health, Metabolic Error Screening of Newborns Reg. §§ 4.1 & 4.2, eff. 12-27-77] — (NAC A 10-23-87; 10-10-90; R033-16, 11-2-2016)
Originating Regulations: R033-16
