This report was prepared by Dr. Rick Mann, Chairperson of the Maternal and Perinatal Death Review Committee, and Ms. Kathy Kerr, Executive Lead, Committee Management.  

Questions and comments regarding this report may be directed to:

Maternal and Perinatal Death Review Committee
Office of the Chief Coroner
25 Morton Shulman Avenue
Toronto, ON
M3M 0B1
occ.inquiries@ontario.ca

A PDF version of this report is available upon request.