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Minnesota Health Statutes
Selected Health Laws Relating to Medical Errors and Patient Safety
adapted from Minnesota's Statutes website

TABLE OF CONTENTS

Chapter 144 - Department of Health, §§ 144.7063 to 144.7069 - Adverse Health Care Events Reporting Act of 2003 (statute website and 2003 Session Law, entire Chapter 99 S.F. 1019.
  Section 144.7063. Definition.
  Section 144.7065. Facility requirements to report, analyze, and correct.
  Section 144.7067. Commissioner duties and responsibilities.
  Section 144.7068. Reports from Licensing Boards.
  Section 144.7069. Interstate coordination; reports.
 
Chapter 145 – Public Health Provisions, §§ 145.61 to 145.67 -Management of Information
  Section 145.61. Definitions.
  Section 145.62. Limitation on liability for persons providing information to review organization.
  Section 145.63. Limitation on liability for sponsoring organizations, review organizations, and members of review organizations.
  Section 145.64. Confidentiality of records of review organization.
  Section 145.65. Guidelines not admissible in evidence.
  Section 145.66. Penalty for violation.
  Section 145.67. Protection of patient.
  Section 145.682. Certification of expert review; affidavit.
 
Chapter 147 – Board of Medical Practice
  Section 147.121. Immunity.
  Section 147.155. Reports to the Commissioner of Health.
 
Chapter 147A – Physician Assistants, Registration
  Section 147A.15. Immunity.
  Section 147A.155. Reports to the Commissioner of Health.
 
Chapter 148 – Public Health Occupations - Nursing
  Section 148.264. Immunity.
  Section 148.267. Reports to the Commissioner of Health.
 
Chapter 151 – Pharmacy
  Section 151.301. Reports to the Commissioner of Health.
  Section 151.302. Immunity.
 
Chapter 153 – Podiatry
  Section 153.25. Immunity.
  Section 153.255. Reports to the Commissioner of Health.
 
Chapter 181- Labor and Industry: Employment; wages, conditions, hours, restrictions
  Section 181.275 Regulating nurses' overtime.
 
Laws 2003, chapter 99, section 7, as amended by Laws 2003, First Special Session chapter 14, article 7, section 86 – Adverse Health Care Events Reporting System Transition Period
  2003, Ch 186, Section 13 Transition Period Defined.
 
 

Department of Health
§§ 144.7063 to 144.7069

  • § 144.7063Definitions.
    • Subdivision 1. Scope.

      Unless the context clearly indicates otherwise, for the purposes of sections 144.706 to 144.7069, the terms defined in this section have the meanings given them.

    • Subdivision. 2. Commissioner.

      "Commissioner" means the commissioner of health.

    • Subdivision. 3. Facility.

      "Facility" means a hospital or outpatient surgical center licensed under sections 144.50 to 144.58.

      EFFECTIVE DATE. This section is effective on the date of full implementation of the adverse health care events reporting system as provided in Laws 2003, chapter 99, section 7, provided the commissioner has secured sufficient funds from nonstate sources to operate the adverse health care events reporting system in fiscal year 2005.

      (Subdivision 3 was changed in May 2004 by the passage of 2004 Chapter 198, adding reporting requirements to ‘outpatient surgical centers.’ With 4-months prior notice on August 6, 2004 (as required by law), ‘full implementation’ began December 6, 2004, when the MHA handed the reporting chores over to the MDH.)

    • Subdivision. 4. Serious disability.

      "Serious disability" means (1) a physical or mental impairment that substantially limits one or more of the major life activities of an individual or a loss of bodily function, if the impairment or loss lasts more than seven days or is still present at the time of discharge from an inpatient health care facility, or (2) loss of a body part.

    • Subdivision. 5. Surgery.

      "Surgery" means the treatment of disease, injury, or deformity by manual or operative methods. Surgery includes endoscopies and other invasive procedures.

    • HIST: 2003 c 99 s 2; 1Sp2003 c 14 art 7 s 84
  • § 144.7065Facility requirements to report, analyze, and correct.
    • Subdivision 1. Reports of adverse health care events required.

      Each facility shall report to the commissioner the occurrence of any of the adverse health care events described in subdivisions 2 to 7 as soon as is reasonably and practically possible, but no later than 15 working days after discovery of the event. The report shall be filed in a format specified by the commissioner and shall identify the facility but shall not include any identifying information for any of the health care professionals, facility employees, or patients involved. The commissioner may consult with experts and organizations familiar with patient safety when developing the format for reporting and in further defining events in order to be consistent with industry standards.

    • Subdivision. 2. Surgical events.

      Events reportable under this subdivision are:

      • (1) surgery performed on a wrong body part that is not consistent with the documented informed consent for that patient. Reportable events under this clause do not include situations requiring prompt action that occur in the course of surgery or situations whose urgency precludes obtaining informed consent;
      • (2) surgery performed on the wrong patient;
      • (3) the wrong surgical procedure performed on a patient that is not consistent with the documented informed consent for that patient. Reportable events under this clause do not include situations requiring prompt action that occur in the course of surgery or situations whose urgency precludes obtaining informed consent;
      • (4) retention of a foreign object in a patient after surgery or other procedure, excluding objects intentionally implanted as part of a planned intervention and objects present prior to surgery that are intentionally retained; and
      • (5) death during or immediately after surgery of a normal, healthy patient who has no organic, physiologic, biochemical, or psychiatric disturbance and for whom the pathologic processes for which the operation is to be performed are localized and do not entail a systemic disturbance.
    • Subdivision. 3. Product or device events.
      Events reportable under this subdivision are:
      • (1) patient death or serious disability associated with the use of contaminated drugs, devices, or biologics provided by the facility when the contamination is the result of generally detectable contaminants in drugs, devices, or biologics regardless of the source of the contamination or the product;
      • (2) patient death or serious disability associated with the use or function of a device in patient care in which the device is used or functions other than as intended. "Device" includes, but is not limited to, catheters, drains, and other specialized tubes, infusion pumps, and ventilators; and
      • (3) patient death or serious disability associated with intravascular air embolism that occurs while being cared for in a facility, excluding deaths associated with neurosurgical procedures known to present a high risk of intravascular air embolism.
    • Subdivision. 4. Patient protection events.
      Events reportable under this subdivision are:
      • (1) an infant discharged to the wrong person;
      • (2) patient death or serious disability associated with patient disappearance for more than four hours, excluding events involving adults who have decision-making capacity; and
      • (3) patient suicide or attempted suicide resulting in serious disability while being cared for in a facility due to patient actions after admission to the facility, excluding deaths resulting from self-inflicted injuries that were the reason for admission to the facility.
    • Subdivision. 5. Care management events.
      Events reportable under this subdivision are:
      • (1) patient death or serious disability associated with a medication error, including, but not limited to, errors involving the wrong drug, the wrong dose, the wrong patient, the wrong time, the wrong rate, the wrong preparation, or the wrong route of administration, excluding reasonable differences in clinical judgment on drug selection and dose;
      • (2) patient death or serious disability associated with a hemolytic reaction due to the administration of ABO-incompatible blood or blood products;
      • (3) maternal death or serious disability associated with labor or delivery in a low-risk pregnancy while being cared for in a facility, including events that occur within 42 days postdelivery and excluding deaths from pulmonary or amniotic fluid embolism, acute fatty liver of pregnancy, or cardiomyopathy;
      • (4) patient death or serious disability directly related to hypoglycemia, the onset of which occurs while the patient is being cared for in a facility;
      • (5) death or serious disability, including kernicterus, associated with failure to identify and treat hyperbilirubinemia in neonates during the first 28 days of life. "Hyperbilirubinemia" means bilirubin levels greater than 30 milligrams per deciliter;
      • (6) stage 3 or 4 ulcers acquired after admission to a facility, excluding progression from stage 2 to stage 3 if stage 2 was recognized upon admission; and
      • (7) patient death or serious disability due to spinal manipulative therapy.
    • Subdivision. 6. Environmental events.
      Events reportable under this subdivision are:
      • (1) patient death or serious disability associated with an electric shock while being cared for in a facility, excluding events involving planned treatments such as electric countershock;
      • (2) any incident in which a line designated for oxygen or other gas to be delivered to a patient contains the wrong gas or is contaminated by toxic substances;
      • (3) patient death or serious disability associated with a burn incurred from any source while being cared for in a facility;
      • (4) patient death associated with a fall while being cared for in a facility; and
      • (5) patient death or serious disability associated with the use or lack of restraints or bedrails while being cared for in a facility.
    • Subdivision. 7. Criminal events.
      Events reportable under this subdivision are:
      • (1) any instance of care ordered by or provided by someone impersonating a physician, nurse, pharmacist, or other licensed health care provider;
      • (2) abduction of a patient of any age;
      • (3) sexual assault on a patient within or on the grounds of a facility; and
      • (4) death or significant injury of a patient or staff member resulting from a physical assault that occurs within or on the grounds of a facility.
    • Subdivision. 8. Root cause analysis; corrective action plan.

      Following the occurrence of an adverse health care event, the facility must conduct a root cause analysis of the event.
      Following the analysis, the facility must:

      • (1) implement a corrective action plan to implement the findings of the analysis or
      • (2) report to the commissioner any reasons for not taking corrective action. If the root cause analysis and the implementation of a corrective action plan are complete at the time an event must be reported, the findings of the analysis and the corrective action plan must be included in the report of the event. The findings of the root cause analysis and a copy of the corrective action plan must otherwise be filed with the commissioner within 60 days of the event.
    • Subdivision. 9. Electronic reporting.
      The commissioner must design the reporting system so that a facility may file by electronic means the reports required under this section. The commissioner shall encourage a facility to use the electronic filing option when that option is feasible for the facility.
    • Subdivision 10. Relation to Other Law
      • (a) Adverse health events described in subdivisions 2 to 6 do not constitute “maltreatment,” “neglect,” or “a physical injury that is not reasonably explained” under section 626.556 or 626.557 and are excluded from the reporting requirements of §§ 626.556 and 626.557, provided the facility makes a determination within 24 hours of the discovery of the event that this section is applicable and the facility files the reports required under this section in a timely fashion.
      • (b) A facility that has determined that an event described in subdivisions 2 to 6 has occurred must inform persons who are mandated reporters under section 626.556, subdivision 3, or 626.5572, subdivision 16, of that determination. A mandated reporter otherwise required to report under section 626.556, subdivision 3, or 626.557, subdivision 3, paragraph (e), is relieved of the duty to report an event that the facility determines under paragraph (a) to be reportable under subdivisions 2 to 6.
      • (c) The protections and immunities applicable to voluntary reports under section sections 626.556 and 626.557 are not affected by this section.
      • (d) Notwithstanding section 626.556, 626.557, or any other provision of Minnesota statute or rule to the contrary, neither a lead agency under section 626.556, subdivision 3c, or section 626.5572, subdivision 13, the commissioner of health, nor the director of the Office of Health Facility Complaints is not required to conduct an investigation of or obtain or create investigative data or reports regarding an event described in subdivisions 2 to 6. If the facility satisfies the requirements described in paragraph (a), the review or investigation shall be conducted and data or reports shall be obtained or created only under sections 144.706 to 144.7069, except as permitted or required under sections 144.50 to 144.564, or as necessary to carry out the state's certification responsibility under the provisions of sections 1864 and 1867 of the Social Security Act.
      • (e) Data contained in the following records are nonpublic and, to the extent they contain data on individuals, confidential data on individuals, as defined in section 13.02:
        • (1) reports provided to the commissioner under sections 147.155, 147A.155, 148.267, 151.301, and 153.255;
        • (2) event reports, findings of root cause analyses, and corrective action plans filed by a facility under this section; and
        • (3) records created or obtained by the commissioner in reviewing or investigating the reports, findings, and plans described in clause (2). For purposes of the nonpublic data classification contained in this paragraph, the reporting facility shall be deemed the subject of the data.
    • HIST: 2003 c 99 s 3; 1Sp2003 c 14 art 7 s 85

    This subdivision 10 was changed in May 2004 by the passage of 2004 Chapter 198. In part, this subdivision defines the relationship between the reporting law and the Maltreatment of Minors Act. The 2003 legislation provided that an adverse health event, if properly reported under the new reporting system, was excluded from the reporting requirements of the Vulnerable Adults Act (VAA). These paragraphs and others extend that exemption to apply to the Maltreatment of Minors Act. In addition, the law added subsection (e) that extended confidentiality to all information and documents in the adverse events reporting program.

  • § 144.7067Commissioner duties and responsibilities.
    • Subdivision 1. Establishment of reporting system.
      • (a) The commissioner shall establish an adverse health event reporting system designed to facilitate quality improvement in the health care system. The reporting system shall not be designed to punish errors by health care practitioners or health care facility employees.
      • (b) The reporting system shall consist of:
        • (1) mandatory reporting by facilities of 27 adverse health care events;
        • (2) mandatory completion of a root cause analysis and a corrective action plan by the facility and reporting of the findings of the analysis and the plan to the commissioner or reporting of reasons for not taking corrective action;
        • (3) analysis of reported information by the commissioner to determine patterns of systemic failure in the health care system and successful methods to correct these failures;
        • (4) sanctions against facilities for failure to comply with reporting system requirements; and
        • (5) communication from the commissioner to facilities, health care purchasers, and the public to maximize the use of the reporting system to improve health care quality.
      • (c) The commissioner is not authorized to select from or between competing alternate acceptable medical practices.
    • Subdivision. 2. Duty to analyze reports; communicate findings.
      The commissioner shall:
      • (1) analyze adverse event reports, corrective action plans, and findings of the root cause analyses to determine patterns of systemic failure in the health care system and successful methods to correct these failures;
      • (2) communicate to individual facilities the commissioner's conclusions, if any, regarding an adverse event reported by the facility;
      • (3) communicate with relevant health care facilities any recommendations for corrective action resulting from the commissioner's analysis of submissions from facilities; and
      • (4) publish an annual report:
        • (i) describing, by institution, adverse events reported;
        • (ii) outlining, in aggregate, corrective action plans and the findings of root cause analyses; and
        • (iii) making recommendations for modifications of state health care operations.
    • Subdivision. 3. Sanctions.
      • (a) The commissioner shall take steps necessary to determine if adverse event reports, the findings of the root cause analyses, and corrective action plans are filed in a timely manner. The commissioner may sanction a facility for:
        • (1) failure to file a timely adverse event report under section 144.7065, subdivision 1; or
        • (2) failure to conduct a root cause analysis, to implement a corrective action plan, or to provide the findings of a root cause analysis or corrective action plan in a timely fashion under section 144.7065, subdivision 8.
      • (b) If a facility fails to develop and implement a corrective action plan or report to the commissioner why corrective action is not needed, the commissioner may suspend, revoke, fail to renew, or place conditions on the license under which the facility operates.
    • HIST: 2003 c 99 s 4
  • § 144.7068Reports from Licensing Boards.
    • (a) Effective upon full implementation of the adverse health care events reporting system, the records maintained under sections 147.155, 147A.155, 148.267, 151.301, and 153.255, shall be reported to the commissioner on the schedule established in those sections.
    • (b) The commissioner shall forward these reports to the facility named in the report.
    • (c) The facility shall determine whether the event has been previously reported under section 144.7065. The facility shall notify the commissioner whether the event has been reported previously. If the event has not been previously reported, the facility shall make a determination whether the event was reportable under section 144.7065. If the facility determines the event was reportable, the date of discovery of the event for the purposes of section 144.7065, subdivision 10, paragraph (d), shall be as follows:
      • (1) if the commissioner determines that the facility knew or reasonably should have known about the occurrence of the event, the date the event occurred shall be the date of discovery. The facility shall be considered out of compliance with the reporting act, and the event shall be subject to sections 626.556 and 626.557; or
      • (2) if the commissioner determines that the facility did not know about the occurrence of the event, the date the facility receives the report from the commissioner shall serve as the date of discovery.
        If the facility determines that the event was not reportable under section 144.7065, the facility shall notify the commissioner of that determination.

    This section of the Adverse Event Act was changed in May 2004 by the passage of 2004 Chapter 198. This section of law requires the health licensing boards that regulate physicians, physician assistants, nurses, pharmacists, and podiatrists to report to MDH events that come to their attention that may qualify as adverse health care events.

  • § 144.7069Interstate coordination; reports.
    • The commissioner shall report the definitions and the list of reportable events adopted in this act to the National Quality Forum and, working in coordination with the National Quality Forum, to the other states. The commissioner shall monitor discussions by the National Quality Forum of amendments to the forum's list of reportable events and shall report to the legislature whenever the list is modified. The commissioner shall also monitor implementation efforts in other states to establish a list of reportable events and shall make recommendations to the legislature as necessary for modifications in the Minnesota list or in the other components of the Minnesota reporting system to keep the system as nearly uniform as possible with similar systems in other states.

    • HIST: 2003 c 99 s 5

Public Health Provisions
§§ 145.61 to 145.67

  • § 145.61Definitions.
    • 145.61 Definitions.
      • Subdivision 1. Scope
        As used in sections 145.61 to 145.67 the terms defined in this section have the meanings given them.
      • Subdivision 2. Professional.
        "Professional" means a person licensed or registered to practice a healing art under chapter147 or 148, to practice dentistry under chapter 150A, to practice as a pharmacist under chapter 151, or to practice podiatry under chapter 153.
      • Subdivision 3. Professional service.

        "Professional service" means service rendered by a professional of the type such professional is licensed to perform.

      • Subdivision 4. Health care.
        "Health care" means professional services rendered by a professional or an employee of a professional and services furnished by a hospital, sanitarium, nursing home or other institution for the hospitalization or care of human beings.
      • Subdivision 4a. Administrative staff.
        "Administrative staff" means the staff of a hospital, clinic, nursing home, nonprofit health service plan corporation, or health maintenance organization.
      • Subdivision 4b. Consumer director.

        "Consumer director" means a director of a health service plan corporation or health maintenance organization who is not a licensed or registered health care professional.

      • Subdivision 4c. Preferred provider organization.

        "Preferred provider organization" means an organization that contracts with insurance carriers or other entities to arrange a network of health care providers whose services are offered to the insureds or other covered persons.

      • Subdivision 5. Review organization.

        "Review organization" means a nonprofit organization acting according to clause (l), a committee as defined under section 144E.32, subdivision 2, or a committee whose membership is limited to professionals, administrative staff, and consumer directors, except where otherwise provided for by state or federal law, and which is established by one or more of the following: a hospital, a clinic, a nursing home, an ambulance service or first responder service regulated under chapter 144E, one or more state or local associations of professionals, an organization of professionals from a particular area or medical institution, a health maintenance organization as defined in chapter 62D, a community integrated service network as defined in chapter 62N, a nonprofit health service plan corporation as defined in chapter 62C, a preferred provider organization, a professional standards review organization established pursuant to United States Code, title 42, section 1320c-1 et seq., a medical review agent established to meet the requirements of section 256B.04, subdivision 15, or 256D.03, subdivision 7, paragraph (b), the Department of Human Services, or a nonprofit corporation that owns, operates, or is established by one or more of the above referenced entities, to gather and review information relating to the care and treatment of patients for the purposes of:

        • (a) evaluating and improving the quality of health care;
        • (b) reducing morbidity or mortality;
        • (c) obtaining and disseminating statistics and information relative to the treatment and prevention of diseases, illness and injuries;
        • (d) developing and publishing guidelines showing the norms of health care in the area or medical institution or in the entity or organization that established the review organization;
        • (e) developing and publishing guidelines designed to keep within reasonable bounds the cost of health care;
        • (f) developing and publishing guidelines designed to improve the safety of care provided to individuals;
        • (g) reviewing the safety, quality, or cost of health care services provided to enrollees of health maintenance organizations, community integrated service networks, health service plans, preferred provider organizations, and insurance companies;
        • (h) acting as a professional standards review organization pursuant to United States Code, title 42, section 1320c-1 et seq.;
        • (i) determining whether a professional shall be granted staff privileges in a medical institution, membership in a state or local association of professionals, or participating status in a nonprofit health service plan corporation, health maintenance organization, community integrated service network, preferred provider organization, or insurance company, or whether a professional's staff privileges, membership, or participation status should be limited, suspended or revoked;
        • (j) reviewing, ruling on, or advising on controversies, disputes or questions between:
          • (1) health insurance carriers, nonprofit health service plan corporations, health maintenance organizations, community integrated service networks, self-insurers and their insureds, subscribers, enrollees, or other covered persons;
          • (2) professional licensing boards and health providers licensed by them;
          • (3) professionals and their patients concerning diagnosis, treatment or care, or the charges or fees therefor;
          • (4) professionals and health insurance carriers, nonprofit health service plan corporations, health maintenance organizations, community integrated service networks, or self-insurers concerning a charge or fee for health care services provided to an insured, subscriber, enrollee, or other covered person;
          • (5) professionals or their patients and the federal, state, or local government, or agencies thereof;
        • (k) providing underwriting assistance in connection with professional liability insurance coverage applied for or obtained by dentists, or providing assistance to underwriters in evaluating claims against dentists;
        • (l) acting as a medical review agent under section 256B.04, subdivision 15, or 256D.03, subdivision 7, paragraph (b);
        • (m) providing recommendations on the medical necessity of a health service, or the relevant prevailing community standard for a health service;
        • (n) providing quality assurance as required by United States Code, title 42, sections 1396r(b)(1)(b) and 1395i-3(b)(1)(b) of the Social Security Act;
        • (o) providing information to group purchasers of health care services when that information was originally generated within the review organization for a purpose specified by this subdivision;
        • (p) providing information to other, affiliated or nonaffiliated review organizations, when that information was originally generated within the review organization for a purpose specified by this subdivision, and as long as that information will further the purposes of a review organization as specified by this subdivision; or
        • (q) participating in a standardized incident reporting system, including Internet-based applications, to share information for the purpose of identifying and analyzing trends in medical error and iatrogenic injury.
    • HIST: 1971 c 283 s 1; 1974 c 295 s 1,2; 1975 c 73 s 1; 1976 c 173 s 49; 1982 c 424 s 133; 1982 c 546 s 1; 1985 c 184 s 1; 1989 c 282 art 3 s 30; 1991 c 137 s 1-3; 1992 c 400 s 1,2; 1992 c 549 art 7 s 6; 1993 c 345 art 3 s 18; 1994 c 497 s 1,2; 1996 c 305 art 1 s 37; 1996 c 451 art 4 s 24; 1999 c 51 s 2; 1999 c 84 s 2; 2001 c 7 s 33; 2001 c 120 s 1
  • § 145.62Limitation on liability for persons providing information to review organization.
    • No person, firm, or corporation providing information to a review organization shall be subject to any action for damages or other relief, by reason of having furnished such information, unless such information is false and the person providing such information knew, or had reason to believe, such information was false.
    • HIST: 1971 c 283 s 2
  • § 145.63Limitation on liability for sponsoring organizations, review organizations, and members of review organizations.
    • Subdivision 1. Members, directors, and officers.

      No review organization and no person who is a member or employee, director, or officer of, who acts in an advisory capacity to, or who furnishes counsel or services to, a review organization shall be liable for damages or other relief in any action brought by a person or persons whose activities have been or are being scrutinized or reviewed by a review organization, by reason of the performance by the person of any duty, function, or activity of such review organization, unless the performance of such duty, function or activity was motivated by malice toward the person affected thereby. No review organization and no person shall be liable for damages or other relief in any action by reason of the performance of the review organization or person of any duty, function, or activity as a review organization or a member of a review committee or by reason of any recommendation or action of the review committee when the person acts in the reasonable belief that the action or recommendation is warranted by facts known to the person or the review organization after reasonable efforts to ascertain the facts upon which the review organization's action or recommendation is made, except that any corporation designated as a review organization under the Code of Federal Regulations, title 42, section 466 (1983) shall be subject to actions for damages or other relief by reason of any failure of a person, whose care or treatment is required to be scrutinized or reviewed by the review organization, to receive medical care or treatment as a result of a determination by the review organization that medical care was unnecessary or inappropriate.


      The protections from liability provided in this subdivision shall also apply to the governing body of the review organization and shall not be waived as a result of referral of a matter from the review organization to the governing body or consideration by the governing body of decisions, recommendations, or documentation of the review organization.

    • Subdivision. 2. Organizations.

      No state or local association of professionals or organization of professionals from a particular area shall be liable for damages or other relief in any action brought by a person whose activities have been or are being scrutinized or reviewed by a review organization established by the association or organization, unless the association or organization was motivated by malice towards the person affected by the review or scrutiny.

    • HIST: 1971 c 283 s 3; 1974 c 295 s 3; 1985 c 184 s 2; 1986 c 444; 1987 c 152 art 2 s 1; 1989 c 282 art 3 s 31; 1991 c 137 s 4
  • § 145.64Confidentiality of records of review organization.
    • Subdivision 1. Data and information.
      • (a) Except as provided in subdivision 4, data and information acquired by a review organization, in the exercise of its duties and functions, or by an individual or other entity acting at the direction of a review organization, shall be held in confidence, shall not be disclosed to anyone except to the extent necessary to carry out one or more of the purposes of the review organization, and shall not be subject to subpoena or discovery. No person described in section 145.63 shall disclose what transpired at a meeting of a review organization except to the extent necessary to carry out one or more of the purposes of a review organization. The proceedings and records of a review organization shall not be subject to discovery or introduction into evidence in any civil action against a professional arising out of the matter or matters which are the subject of consideration by the review organization. Information, documents or records otherwise available from original sources shall not be immune from discovery or use in any civil action merely because they were presented during proceedings of a review organization, nor shall any person who testified before a review organization or who is a member of it be prevented from testifying as to matters within the person's knowledge, but a witness cannot be asked about the witness' testimony before a review organization or opinions formed by the witness as a result of its hearings. For purposes of this subdivision, records of a review organization include Internet-based data derived from data shared for the purposes of the standardized incident reporting system described in section 145.61, subdivision 5, clause (q), and reports submitted electronically in compliance with sections 144.706 to 144.7069.
      • (b) Notwithstanding paragraph (a), a review organization may release non-patient-identified aggregate trend data on medical error and iatrogenic injury and a facility may file the reports, analyses, and plans required by sections 144.706 to 144.7069 without violating this section or being subjected to a penalty under section 145.66 and without compromising the protections provided under sections 145.61 to 145.67 to the reporter of such information; to the review organization, its sponsoring organizations, and members; and to the underlying data and reports.
      • (c) The confidentiality protection and protection from discovery or introduction into evidence provided in this subdivision shall also apply to the governing body of the review organization and shall not be waived as a result of referral of a matter from the review organization to the governing body or consideration by the governing body of decisions, recommendations, or documentation of the review organization.
      • (d) The governing body of a hospital, health maintenance organization, or community integrated service network, that is owned or operated by a governmental entity, may close a meeting to discuss decisions, recommendations, deliberations, or documentation of the review organization. A meeting may not be closed except by a majority vote of the governing body in a public meeting. The closed meeting must be tape recorded and the tape must be retained by the governing body for five years.
    • Subdivision. 2. Provider data.

      The restrictions in subdivision 1 shall not apply to professionals requesting or seeking through discovery, data, information, or records relating to their medical staff privileges, membership, or participation status. However, any data so disclosed in such proceedings shall not be admissible in any other judicial proceeding than those brought by the professional to challenge an action relating to the professional's medical staff privileges or participation status.

    • Subdivision. 3. Hennepin County emergency medical services data.

      Data collected, created, or maintained by the quality committee of the Hennepin County Emergency Medical Services Advisory Council when conducting a health care review activity of the emergency medical services function or services are private data on individuals or nonpublic data not on individuals, as defined in section 13.02.

    • Subdivision. 4. Standardized incident reporting system data.

      A review organization that is participating in a standardized incident reporting system described in section 145.61, subdivision 5, clause (q), may release data for purposes of the reporting system, provided that the data do not identify an individual and are not released in a manner in which an individual can be identified.

    • Subdivision. 5. Commissioner of health.

      Nothing in this section shall be construed to prohibit or restrict the right of the commissioner of health to access the original information, documents, or records acquired by a review organization as permitted by law.

    • HIST: 1971 c 283 s 4; 1974 c 295 s 4; 1975 c 73 s 2; 1986 c 444; 1991 c 137 s 5; 1992 c 549 art 7 s 7; 1994 c 497 s 3; 1994 c 625 art 8 s 47; 1996 c 440 art 1 s 37; 1997 c 225 art 2 s 62; 2001 c 120 s 2-4; 2003 c 99 s 6
  • § 145.65Guidelines not admissible in evidence.
    • No guideline established by a review organization shall be admissible in evidence in any proceeding brought by or against a professional by a person to whom such professional has rendered professional services.
    • HIST: 1971 c 283 s 5
  • § 145.66Penalty for violation.
    • Any disclosure other than that authorized by section 145.64, of data and information acquired by a review committee or of what transpired at a review meeting, is a misdemeanor.
    • HIST: 1971 c 283 s 6
  • § 145.67Protection of patient.
    • Nothing contained in sections 145.61 to 145.67 shall be construed to relieve any person of any liability which the person has incurred or may incur to a patient as a result of furnishing health care to such patient.
    • HIST: 1971 c 283 s 7; 1986 c 444
  • § 145.682Certification of expert review; affidavit.
    • Subdivision 1. Definition.

      For purposes of this section, "health care provider" means a physician, surgeon, dentist, or other health care professional or hospital, including all persons or entities providing health care as defined in section 145.61, subdivisions 2 and 4, or a certified health care professional employed by or providing services as an independent contractor in a hospital.

    • Subdivision. 2. Requirement.

      In an action alleging malpractice, error, mistake, or failure to cure, whether based on contract or tort, against a health care provider which includes a cause of action as to which expert testimony is necessary to establish a prima facie case, the plaintiff must:

      • (1) unless otherwise provided in subdivision 3, paragraph (b), serve upon defendant with the summons and complaint an affidavit as provided in subdivision 3; and
      • (2) serve upon defendant within 180 days after commencement of the suit an affidavit as provided by subdivision 4.
    • Subdivision. 3. Affidavit of expert review.
      The affidavit required by subdivision 2, clause (1), must be by the plaintiff's attorney and state that:
      • (a) the facts of the case have been reviewed by the plaintiff's attorney with an expert whose qualifications provide a reasonable expectation that the expert's opinions could be admissible at trial and that, in the opinion of this expert, one or more defendants deviated from the applicable standard of care and by that action caused injury to the plaintiff; or
      • (b) the expert review required by paragraph (a) could not reasonably be obtained before the action was commenced because of the applicable statute of limitations. If an affidavit is executed pursuant to this paragraph, the affidavit in paragraph (a) must be served on defendant or the defendant's counsel within 90 days after service of the summons and complaint.
    • Subdivision. 4. Identification of experts to be called.
      • (a)The affidavit required by subdivision 2, clause (2), must be signed by each expert listed in the affidavit and by the plaintiff's attorney and state the identity of each person whom plaintiff expects to call as an expert witness at trial to testify with respect to the issues of malpractice or causation, the substance of the facts and opinions to which the expert is expected to testify, and a summary of the grounds for each opinion. Answers to interrogatories that state the information required by this subdivision satisfy the requirements of this subdivision if they are signed by the plaintiff's attorney and by each expert listed in the answers to interrogatories and served upon the defendant within 180 days after commencement of the suit against the defendant.
      • (b) The parties or the court for good cause shown, may by agreement, provide for extensions of the time limits specified in subdivision 2, 3, or this subdivision. Nothing in this subdivision may be construed to prevent either party from calling additional expert witnesses or substituting other expert witnesses.
      • (c) In any action alleging medical malpractice, all expert interrogatory answers must be signed by the attorney for the party responding to the interrogatory and by each expert listed in the answers. The court shall include in a scheduling order a deadline prior to the close of discovery for all parties to answer expert interrogatories for all experts to be called at trial. No additional experts may be called by any party without agreement of the parties or by leave of the court for good cause shown.
    • Subdivision. 5. Responsibilities of plaintiff as attorney.

      If the plaintiff is acting pro se, the plaintiff shall sign the affidavit or answers to interrogatories referred to in this section and is bound by those provisions as if represented by an attorney.

    • Subdivision. 6. Penalty for noncompliance.
      • (a) Failure to comply with subdivision 2, clause (1), within 60 days after demand for the affidavit results, upon motion, in mandatory dismissal with prejudice of each cause of action as to which expert testimony is necessary to establish a prima facie case.
      • (b) Failure to comply with subdivision 2, clause (2), results, upon motion, in mandatory dismissal with prejudice of each cause of action as to which expert testimony is necessary to establish a prima facie case.
      • (c) Failure to comply with subdivision 4 because of deficiencies in the affidavit or answers to interrogatories results, upon motion, in mandatory dismissal with prejudice of each action as to which expert testimony is necessary to establish a prima facie case, provided that:
        • (1) the motion to dismiss the action identifies the claimed deficiencies in the affidavit or answers to interrogatories;
        • (2) the time for hearing the motion is at least 45 days from the date of service of the motion; and
        • (3) before the hearing on the motion, the plaintiff does not serve upon the defendant an amended affidavit or answers to interrogatories that correct the claimed deficiencies.
    • Subdivision. 7. Consequences of signing affidavit.

      The signature of the plaintiff or the plaintiff's attorney constitutes a certification that the person has read the affidavit or answers to interrogatories, and that to the best of the person's knowledge, information, and belief formed after a reasonable inquiry, it is true, accurate, and made in good faith. A certification made in violation of this subdivision subjects the attorney or plaintiff responsible for such conduct to reasonable attorney's fees, costs, and disbursements.

    • HIST: 1986 c 455 s 60; 1992 c 549 art 8 s 1; 2002 c 403 s 1

Board of Medical Practice
Chapter 147 (website)

  • § 147.121Immunity.
    • Subdivision 1. Reporting.

      Any person, health care facility, business, or organization is immune from civil liability or criminal prosecution for submitting a report to the board pursuant to section 147.111 or for otherwise reporting to the board violations or alleged violations of section 147.091. All such reports are confidential and absolutely privileged communications.

    • Subdivision 2. Investigation; indemnification.
      • (a) Members of the board, persons employed by the board, consultants retained by the board for the purpose of investigation of violations, the preparation of charges and management of board orders on behalf of the board are immune from civil liability and criminal prosecution for any actions, transactions, or publications in the execution of, or relating to, their duties under sections 147.01 to 147.22.
      • (b) Members of the board and persons employed by the board or engaged in maintaining records and making reports regarding adverse health care events are immune from civil liability and criminal prosecution for any actions, transactions, or publications in the execution of or relating to their duties under section 147.155.
      • (c) For purposes of this section, a member of the board or a consultant described in paragraph (a) is considered a state employee under section 3.736, subdivision 9.
      • HIST: 1985 c 247 s 15,25; 1991 c 199 art 2 s 1; 1993 c 21 s 10; 1995 c 18 s 9

    Section (b) of Board of Medical Practice was added in May 2004 by the passage of 2004 Chapter 198.

  • § 147.155Reports to the Commissioner of Health.
    • (a) The board shall maintain a record of an event that comes to the board's attention that, in the judgment of the board or a committee of the board, qualifies as an adverse health care event under section 144.7065.
    • (b) Within 30 days of making a determination under paragraph (a) that an event qualifies as an adverse health care event, the board shall forward to the commissioner of health a report of the event, including the facility involved, the date of the event, and information known to the board regarding the event. The report shall not include any identifying information for any of the health care professionals, facility employees, or patients involved.

This entire section of Board of Medical Practice was added in May 2004 by the passage of 2004 Chapter 198.

Physician Assistants, registration
Chapter 147A (website)

  • § 147A.15Immunity.
    • Subdivision 1. Reporting.

      Any person, health care facility, business, or organization is immune from civil liability or criminal prosecution for submitting a report to the board pursuant to this chapter or for otherwise reporting to the board violations or alleged violations of this chapter. All such reports are confidential and absolutely privileged communications.

    • Subdivision 2. Investigation; indemnification.
      • (a) Members of the board, persons employed by the board, and consultants retained by the board for the purpose of investigation of violations or the preparation and management of charges of violations of this chapter on behalf of the board are immune from civil liability and criminal prosecution for any actions, transactions, or publications in the execution of, or relating to, their duties under this chapter.
      • (b) Members of the board and persons employed by the board or engaged in maintaining records and making reports regarding adverse health care events are immune from civil liability and criminal prosecution for any actions, transactions, or publications in the execution of or relating to their duties under section 147A.155.
      • (c) For purposes of this section, a member of the board or a consultant described in paragraph (a) is considered a state employee under section 3.736, subdivision 9.
    • Subdivision 3.

      Physician assistant cooperation. A physician assistant who is the subject of an investigation by or on behalf of the board shall cooperate fully with the investigation. Cooperation includes responding fully and promptly to any question raised by or on behalf of the board relating to the subject of the investigation and providing copies of patient medical records, as reasonably requested by the board, to assist the board in its investigation. The board shall pay for copies requested. If the board does not have a written consent from a patient permitting access to the patient's records, the physician assistant shall delete any data in the record which identifies the patient before providing it to the board. The board shall maintain any records obtained pursuant to this section as investigative data pursuant to chapter 13.

    • HIST: 1995 c 205 art 1 s 14

    Subdivision 2., Section (b) of Physician Assistants, registration was added in May 2004 by the passage of 2004 Chapter 198.

  • § 147A.155Reports to the Commissioner of Health.
    • (a) The board shall maintain a record of an event that comes to the board's attention that, in the judgment of the board or a committee of the board, qualifies as an adverse health care event under section 144.7065.
    • (b) Within 30 days of making a determination under paragraph (a) that an event qualifies as an adverse health care event, the board shall forward to the commissioner of health a report of the event, including the facility involved, the date of the event, and information known to the board regarding the event. The report shall not include any identifying information for any of the health care professionals, facility employees, or patients involved.

    This entire section of Physician Assistants, registration was added in May 2004 by the passage of 2004 Chapter 198.

Public Health Occupations - Nursing
Chapter 148 (website)

  • § 148.264Immunity.
    • Subdivision 1. Reporting.

      Any person, health care facility, business, or organization is immune from civil liability or criminal prosecution for submitting in good faith a report to the board under section 148.263 or for otherwise reporting in good faith to the board violations or alleged violations of sections 148.171 to 148.285. All such reports are investigative data as defined in chapter 13.

    • Subdivision 2. Investigation.
      • (a) Members of the board and persons employed by the board or engaged in the investigation of violations and in the preparation and management of charges of violations of sections 148.171 to 148.285 on behalf of the board or persons participating in the investigation or testifying regarding charges of violations are immune from civil liability and criminal prosecution for any actions, transactions, or publications in the execution of, or relating to, their duties under sections 148.171 to 148.285.
      • (b) Members of the board and persons employed by the board or engaged in maintaining records and making reports regarding adverse health care events are immune from civil liability and criminal prosecution for any actions, transactions, or publications in the execution of or relating to their duties under section 148.267.
      • HIST: 1989 c 194 s 15

    Subdivision 2., Section (b) of Public Health Occupations was added in May 2004 by the passage of 2004 Chapter 198.

  • § 148.267Reports to the Commissioner of Health.
    • (a) The board shall maintain a record of an event that comes to the board's attention that, in the judgment of the board or a committee of the board, qualifies as an adverse health care event under section 144.7065.
    • (b) Within 30 days of making a determination under paragraph (a) that an event qualifies as an adverse health care event, the board shall forward to the commissioner of health a report of the event, including the facility involved, the date of the event, and information known to the board regarding the event. The report shall not include any identifying information for any of the health care professionals, facility employees, or patients involved.

    This entire section of Public Health Occupations was added in May 2004 by the passage of 2004 Chapter 198.

Pharmacy – Chapter 151
(website)

  • § 151.301Reports to the Commissioner of Health.
    • (a) The board shall maintain a record of an event that comes to the board's attention that, in the judgment of the board or a committee of the board, qualifies as an adverse health care event under section 144.7065.
    • (b) Within 30 days of making a determination under paragraph (a) that an event qualifies as an adverse health care event, the board shall forward to the commissioner of health a report of the event, including the facility involved, the date of the event, and information known to the board regarding the event. The report shall not include any identifying information for any of the health care professionals, facility employees, or patients involved.

    This entire section of Pharmacy was added in May 2004 by the passage of 2004 Chapter 198, §9.

  • § 151.302Immunity.

    Members of the board and persons employed by the board or engaged in maintaining records and making reports regarding adverse health care events are immune from civil liability and criminal prosecution for any actions, transactions, or publications in the execution of or relating to their duties under section 151.301.

    This section of Pharmacy was added in May 2004 by the passage of 2004 Chapter 198, §10.

Podiatry – Chapter 153
(website)

  • §153.25Immunity.
    • Subdivision 1. Reporting.

      Any person, health care facility, business, or organization is immune from civil liability or criminal prosecution for submitting a report to the board under section 153.24 or for otherwise reporting to the board violations or alleged violations of section 153.19.

    • Subdivision 2. Investigation.
      • (a) Members of the board and persons employed by the board or engaged in the investigation of violations and in the preparation and management of charges of violations of this chapter on behalf of the board are immune from civil liability and criminal prosecution for any actions, transactions, or publications in the execution of, or relating to, their duties under this chapter.
      • (b) Members of the board and persons employed by the board or engaged in maintaining records and making reports regarding adverse health care events are immune from civil liability and criminal prosecution for any actions, transactions, or publications in the execution of or relating to their duties under section 153.255.

    This entire section of Podiatry was added in May 2004 by the passage of 2004 Chapter 198.

  • § 153.255Reports to the Commissioner of Health.
    • (a) The board shall maintain a record of an event that comes to the board's attention that, in the judgment of the board or a committee of the board, qualifies as an adverse health care event under section 144.7065.
    • (b) Within 30 days of making a determination under paragraph (a) that an event qualifies as an adverse health care event, the board shall forward to the commissioner of health a report of the event, including the facility involved, the date of the event, and information known to the board regarding the event. The report shall not include any identifying information for any of the health care professionals, facility employees, or patients involved.

    This entire section of Podiatry was added in May 2004 by the passage of 2004 Chapter 198, §9.

Employment; wages, conditions, hours, restrictions
Chapter 181

  • § 181.275Regulating nurses' overtime.
    • Subdivision 1. Definition.
      For purposes of this section, the following terms have the meanings given them:
      • (1) "emergency" means a period when replacement staff are not able to report for duty for the next shift or increased patient need, because of unusual, unpredictable, or unforeseencircumstances such as, but not limited to, an act of terrorism, a disease outbreak, adverse weather conditions, or natural disasters which impact continuity of patient care;
      • (2) "normal work period" means 12 or fewer consecutive hours consistent with a predetermined work shift;
      • (3) "nurse" has the meaning given in section 148.171, subdivision 9; and
      • (4) "taking action against" means discharging; disciplining; threatening; reporting to the Board of Nursing; discriminating against; or penalizing regarding compensation, terms, conditions, location, or privileges of employment.
    • Subdivision. 2. Prohibited actions.

      Except as provided in subdivision 3, a hospital or other entity licensed under sections 144.50 to 144.58, and its agent, or other health care facility licensed by the commissioner of health, and the facility's agent, is prohibited from taking action against a nurse solely on the grounds that the nurse fails to accept an assignment of additional consecutive hours at the facility in excess of a normal work period, if the nurse declines to work additional hours because doing so may, in the nurse's judgment, jeopardize patient safety. This subdivision does not apply to a nursing facility, an intermediate care facility for persons with mental retardation, a licensed boarding care facility, or a housing with services establishment.

    • Subdivision. 3. Emergency.

      Notwithstanding subdivision 2, a nurse may be scheduled for duty or required to continue on duty for more than one normal work period in an emergency.

    • Subdivision. 4. Exception.

      Section 645.241 does not apply to violations of this section.

    • HIST: 2002 c 272 s 3

Laws 2003, chapter 99, section 7, as amended by
Laws 2003, First Special Session chapter 14, article 7, section 86
Adverse Health Care Events Reporting System Transition Period

  • (a) Effective July 1, 2003, limited implementation of the Adverse Health Care Events Reporting Act shall begin, provided the commissioner of health has secured sufficient nonstate funds for this purpose. During this period, the commissioner must:
    • (1) solicit additional nonstate funds to support full implementation of the system;
    • (2) work with organizations and experts familiar with patient safety to review reporting categories in Minnesota Statutes, section 144.7065, make necessary Clarifications, and develop educational materials; and
    • (3) monitor activities of the National Quality Forum and other patient safety organizations, other states, and the federal government in the area of patient safety.
  • (b) Effective July 1, 2003, facilities defined in Minnesota Statutes, section 144.7063, subdivision 3, shall report any adverse health care events, as defined in Minnesota Statutes, section 144.7065, to the incident reporting system maintained by the Minnesota Hospital Association. The association shall provide a summary report to the commissioner that identifies the types of events by category. The association shall consult with the commissioner regarding the data to be reported to the commissioner, storage of data received by the association but not reported to the commissioner, and eventual retrieval by the commissioner of stored data. Data reported to or retrieved by the commissioner under this section, and data created or obtained by the commissioner in reviewing or investigating reports under this section, are nonpublic data and confidential data on individuals as defined in Minnesota Statutes, section 13.02, except as necessary for the commissioner to communicate with facilities and publish the annual report as required by Minnesota Statutes, section 144.7067, subdivision 2.
  • (c) The commissioner shall report to the legislature by January 15 of 2004 and 2005, with a list of the number of reported events by type and recommendations, if any, for reporting system modifications, including additional categories of events that should be reported.
  • (d) From July 1, 2003, until full implementation of the reporting system, the commissioner of health shall not make a final disposition as defined in Minnesota Statutes, section 626.5572, subdivision 8, for investigations conducted in licensed hospitals under the provisions of Minnesota Statutes, section 626.557. The commissioner's findings in these cases shall identify noncompliance with federal certification or state licensure rules or laws.
  • (e) Effective July 1, 2004, The reporting system shall be fully implemented, provided (1) the commissioner has secured sufficient funds from nonstate sources to operate the system during fiscal year 2005, and (2) the commissioner has notified facilities by April 1, 2004 at least four months prior to full implementation, of their duty to report.
  • (f) Effective July 1, 2005, the reporting system shall be operated with state appropriations.
  • Presented to the governor May 7, 2004
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