![]() In most states, this process now occurs electronically. For instance, an individual expiring alone in a secured residence may not actually be discovered and pronounced dead until days afterward ( table 1).Īfter pronouncement of death, the funeral director can initiate the death record and fill-in the non-medical portions of the death certificate. The term ‘pronouncement’ refers to the date and time when the individual was found to be legally dead and, particularly in ME/C cases, may not always correspond to the time death is actually suspected to have occurred. 10 While in some states medical examiners are required to be medical doctors, in Wisconsin this is not necessarily so. For instance, in the state of Wisconsin, death can be pronounced by a physician, hospice nurse, medical examiner/coroner (ME/C), or deputy ME/C. 1, 2 Only certain individuals are qualified to officially pronounce death. cremation, cemetery site), and death information (eg, date and time, cause, manner). ![]() ![]() 1 There are three main categories of information contained on the standard death certificate: demographics/statistics (eg, name, social security number, race, occupation), method/place of bodily disposition (eg, funeral home, burial vs. While there may be some minor variability between states, most death certificates conform in content and structure to the US Standard Certificate of Death ( figure 1). While some of the principles discussed herein apply to perinatal deaths, the general topic of perinatal (ie, fetal and infant) death certification has very different practical considerations and challenges that are beyond the scope of the current review. 9 The following review is intended to educate medical certifiers about basic principles and common pitfalls of electronic death registry and certification in order to improve accuracy. Following either a workshop or review of printed guidelines, 84.5% could correctly identify the cause of death. 7, 9 For instance, in one study of 200 resident physicians asked to complete a cause-of-death statement from a sample hospital death case, only 15.5% correctly identified the cause of death. When brief educational interventions such as didactic seminars or distribution of printed guidelines are made, error rates have been shown to decrease markedly. 8, 9 Among the reasons most commonly cited for major errors in certification are physician inexperience (eg, resident physicians) and lack of appropriate death certification training. Studies at various academic institutions have found errors in cause and/or manner of death certification to occur in approximately 33% to 41% of cases, 5 – 7 with disproportionate overrepresentation of cardiovascular causes of death. 4 Despite the importance of accurate death certification, errors are common. For instance, in the State of Wisconsin, physicians are required to complete and return the medical certification portion of the death certificate within a maximum of 6 days of the date of death pronouncement, 3 and it is considered a Class I felony to “willfully and knowingly” supply false information on a death certificate. In most states, there is a specified time within which the death certificate must be filed. 1, 2 For these reasons, it is important that death certificates be filled out completely, accurately, and promptly. ![]() At both the state and national level, mortality data compiled from death certificates is used to track disease trends, set public health policies, and allocate health and research funding. In many states, death certification is required prior to cremation or burial services. Death certificates may be required to settle decedents’ estates and obtain insurance or other pensions/benefits. In addition to providing the decedent’s family with a cause of death, it has critical administrative and epidemiologic applications. The death certificate is an important legal document.
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