<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".11" citation="COMAR 10.52.12.11" title_num="10" subtitle_num="52" chapter_num="12" heading="Referral Procedures.">
  <text>The individual in charge of a birthing facility or the individual’s designated representative, or the home birth attendant shall:</text>
  <paragraph num="A.">
    <text>Develop collection and transport procedures to ensure against collecting and submitting unsatisfactory blood-spot specimens for each of the categories of newborn infant listed in §B of this regulation.</text>
  </paragraph>
  <paragraph num="B.">
    <text>Collect or otherwise have collected:</text>
    <paragraph num="(1)">
      <text>An additional blood-spot specimen before the newborn is 7 days old for newborn infants discharged before 24 hours of milk feeding in addition to the blood-spot specimen collected before discharge, as set forth in Regulation .07C(2) of this chapter.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>The blood-spot specimen before the newborn is 7 days old if a newborn infant is discharged from a birthing facility before a newborn screening blood-spot specimen is collected.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>An additional blood-spot specimen within 7 days after notification if the laboratory reports to a birthing facility or a home birth attendant that the initial blood-spot specimen was unsatisfactory.</text>
    </paragraph>
    <paragraph num="(4)">
      <text>A blood-spot specimen to be tested for hemoglobins, biotinidase, and galastose -1 phosphate uridyl transferase (GALT) only, four months after the last transfusion if the initial blood-spot specimen was not collected until after the infant was transfused.</text>
    </paragraph>
  </paragraph>
</regulation>