This version of the form is not currently in use and is provided for reference only. Download this version of the document for the current year.
Outpatient Surgery - Patient Death Reporting Form is a legal document that was released by the Medical Board of California - a government authority operating within California.
Q: What is the Outpatient Surgery - Patient Death Reporting Form?
A: The Outpatient Surgery - Patient Death Reporting Form is a form used in the state of California to report patient deaths that occur during or after outpatient surgery.
Q: Who is required to fill out the form?
A: The form is typically filled out by the surgeon or medical facility where the outpatient surgery took place.
Q: Why is this form necessary?
A: The form is necessary to ensure that patient deaths during or after outpatient surgery are properly reported and investigated, and to help identify any potential issues or trends that may need to be addressed.
Q: How does the reporting process work?
A: Once the form is filled out, it must be submitted to the California Department of Public Health within 24 hours of the patient's death.
Q: What information is included in the form?
A: The form includes details about the patient, the surgery, and the circumstances surrounding the patient's death.
Q: Is the form confidential?
A: The information provided on the form is confidential and protected by law, but certain information may be subject to public disclosure if required by law or regulation.
Form Details:
Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the Medical Board of California.