North Carolina law states (under section 2600, rule 2609, part E) that ground beef must be cooked to at least 155°F—the medium well/well done range. This law has been in place since 1993 when undercooked meat from Jack in the Box resulted in a deadly E. coli outbreak that killed four children and made hundreds of customers sick. Although restaurants in North Carolina aren't automatically shut down for undercooking burgers, they risk losing points on their (publicly displayed) sanitation scores, and a low-enough score could result in being shut down.
But now North Carolina is looking to ease the ban and adopt the U.S. Food and Drug Administration's (FDA) guideline that allows undercooked meat to be served as long as the restaurant accompanies it with health warnings about the effects of undercooked meat. The change isn't expected to take place until July 2012. Until then, a restaurant in North Carolina may serve you a black market rare burger "if you're someone they recognize or someone they deem as hip," says Stephen Elliot of rareburger.com, during this Fox News interview.