Cause of Death Quick Fact Sheet

CAUSE OF DEATH QUICK FACT SHEET
Responsibility in regard to death registration:

Verify the date and time of death entered on the certificate.
Complete the CERTIFIER section (items 24a through 25d) and sign the certificate in
item 25a. The physician should not sign the death certificate in item 25e, nor complete
items 25f-25g. These items are reserved for the County Coroner.
Complete the CAUSE OF DEATH section (items 26a through 30). Note that item 30
refers only to pregnancies of deceased females within a year preceding death. It does not
ask if a deceased female had ever been pregnant.
Deliver the signed death certificate to the appropriate funeral home within 72 hours of the
death.
Responsibility in regard to death certification:
PART I
The purpose of this section of the death certificate is for the physician to indicate what the
underlying cause of death was and what intervening conditions, if any, led to the immediate
cause of death. Enter only one disease or condition on each line in this section and do not use
abbreviations. For each condition, indicate at the end of the line the approximate interval
between the date of onset and the date of death.
Report the immediate cause of death on line 26(a). This should be the final disease or
complication directly causing the death. This condition should not just indicate the mode
of dying, which merely attests to the fact of death and is not specifically related to the
disease process. The following are examples of modes of dying which should not be
listed as the immediate cause of death:
Cardiac Arrest
Cardiopulmonary Arrest
Respiratory Arrest
Respiratory Failure
Failure to Thrive
Multi Organ/System Failure
The following terms are examples of acceptable immediate causes of death. However,
these conditions would probably not be the underlying cause of death and would require
the physician to list their underlying cause on the next line below:
Bronchopneumonia
Pulmonary Embolism
Acute Myocardial Infarct
Coagulopathy
Intercerebral Hemorrhage
Congestive Heart Failure
Liver Failure
Metastases
After assigning an immediate cause of death, ask yourself, What was the immediate
cause due to? If another disease or condition gave rise to the immediate cause of death,
report that condition on line 26(b). If this in turn resulted from another condition, enter
that condition on line 26(c), and if this condition was caused by another condition, enter
it online 26(d). For as many conditions as were involved, enter the full sequence, one
condition per line, in reverse sequential order. Lines can be inserted, if needed, by
marking them as 26(e), 26(f), etc.
Enter the condition that has been determined to be the underlying cause of death on the
lowest line in Part I.
Use as many lines in Part I as necessary to show the sequence of events that led to the death. If
the sequence to be entered consists of more than four causes, see illustration below for the
method to be used in recording the causes.
CAUSE OF 26. PART I. Enter the chain of events diseases, injuries or complications that directly caused the death. DO NOT enter terminal events such as cardiac arrest, shock,
DEATH
or heart failure without showing the etiology. List only one cause on each line. DO NOT USE ABBREVIATIONS.
IMMEDIATE CAUSE
(final disease or condition
resulting in death)
Sequentially list conditions,

if any, leading to immediate
cause. Enter UNDERLYING
CAUSE (disease or injury
that initiated events resulting
in death) LAST
(a)
Asphyxia
Interval between
onset and death
Minutes
DUE TO, OR AS A CONSEQUENCE OF (Enter one cause only)

(b)
Cerebellar hemorrage
Hours

(c)
Cerebral arteriosclerosis
About 3 yrs

(d)
(d) Hypertension
(e) Heart disease
3 years +
15 years
PART II
Enter in item 27, Part II, any other important diseases or conditions that may have contributed to
death but did not lead to the underlying cause of death.
DEATHS REPORTABLE TO THE COUNTY CORONER

A death affecting the public interest includes, but is not limited to, any of the following:
Violent death, including homicidal, suicidal or accidental death.
Death caused by thermal, chemical, electrical or radiation injury.
Death caused by criminal abortion, including self-induced abortion, or abortion related to or
by sexual abuse.
Death related to disease thought to be virulent or contagious that may constitute a public
hazard.
Death that has occurred unexpectedly or from an unexplained cause.
Death of a person confined in a prison, jail or correctional institution.
Death of a person where a physician was not in attendance within thirty-six (36) hours
preceding death, or in prediagnosed terminal or bedfast cases, within thirty (30) days
preceding death.
Death of a person where the body is not claimed by a relative or a friend.
Death of a person where the identity of the deceased is unknown.
Death of a child under the age of two (2) years where death results from an unknown cause or
where the circumstances surrounding the death indicate that sudden infant death syndrome
may be the cause of death.
Where a body is brought into this state for disposal and there is reason to believe either that
the death was not investigated properly or that there is not an adequate certificate of death.
Where a person is presented to a hospital emergency room unconscious and/or unresponsive,
with cardiopulmonary resuscitative measures being performed, and dies within twenty-four
(24) hours of admission without regaining consciousness or responsiveness, unless a
physician was in attendance within thirty-six (36) hours preceding presentation to the
hospital, or in cases in which the decedent had a prediagnosed terminal or bedfast condition,
unless a physician was in attendance within thirty (30) days preceding presentation to the
hospital.
Death that is caused by drug overdose or which is believed to be caused by drug overdose.
When a stillborn fetus is delivered and the cause of the demise is medically believed to be
from the use by the mother of any controlled substance as defined in Section 41-29-105.
DEATHS FROM ANY OF THE ABOVE CAUSES CAN ONLY BE CERTIFIED BY THE
COUNTY CORONER.

Cause of Death Quick Fact Sheet

Uploaded by

Copyright:

Available Formats

Cause of Death Quick Fact Sheet

Uploaded by

Document Information

Original Description:

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Cause of Death Quick Fact Sheet

Uploaded by

Copyright:

Available Formats

CAUSE OF DEATH QUICK FACT SHEET

Responsibility in regard to death registration:

Sequentially list conditions,

DUE TO, OR AS A CONSEQUENCE OF (Enter one cause only)

DUE TO, OR AS A CONSEQUENCE OF (Enter one cause only)

DUE TO, OR AS A CONSEQUENCE OF (Enter one cause only)

DEATHS REPORTABLE TO THE COUNTY CORONER

You might also like

Pfad - The Proxy pFad of © 2024 Garber Painting. All rights reserved.