Death certificates must be signed accurately and promptly to ensure bodies can be released to funeral homes and avoid adding to a family’s grief and funeral expenses.
During a webinar entitled The Role Of The Doctor In Coroner Investigations And Other Coronial Matters Of Interest on Zoom yesterday, Dr La-Tonia Arthur reminded doctors that the certificates had to be signed within 48 hours.
“A lot of the times the coroner will have to hold on releasing bodies if the medical certificate of death is not clear. Sometimes persons will indicate that they will write the certificate but then take a prolonged period.
“Once you have indicated that you are going to write a medical certificate of death, it should be done within 48 hours of the patient dying and received by the coroner’s office . . . . It is actually illegal for bodies to be buried without a warrant to bury, and you can’t issue a warrant to bury without a medical certificate of death. So we would like to improve the statistical validity of our medical certificate of death forms,” Arthur said.
Emergency care physician Dr Harold Watson, who presented a list entitled A-Z Of Causes Of Death, said although the forms can be time-consuming, they should be filled out accurately.
“The problem I have is that everyone is busy and the paperwork is somewhat laborious, especially from the coroner’s side.
“We have to realise that charges are incurred by having a body kept in a funeral home awaiting a death certificate. To me, that is an issue. As professionals we are here to serve the public and give them the best we can,” he said.
Garbage codes
Watson stressed that all of the information, including identification, full names and several items should be listed while several “garbage codes” should be avoided.
Garbage code refers to a concept introduced in the first Global Burden of Disease Study for causes that should not be considered as the underlying cause of death or are non-specific and considered insufficient.
Coroner Graveney Bannister agreed there was a need for greater efficiency and communication between funeral directors, doctors and the police.
“Quite often the undertaker will move in after the scene. I’m not informed. The undertaker has the body for some three or four days and sometimes even a week without me knowing. The problem comes when it comes to the burial and registration of the body when there is no warrant.
“The undertakers are well aware of this. I don’t know if it is a lack of knowledge or a business decision to delay the reporting of certain matters because storage fees are quite high. The longer people go on, the
more the fees are racked up,” he said.
“Although there are reporting guidelines which are brought to the coroner and the police almost immediately when there is an unnatural death, sometimes, especially when it’s a high-profile death or murder, I tend to get the paperwork some three or four days after.
“If I do not hear about it or I’m not called and I see it in the paper, I make a request for it and I have been sharing that with the Commissioner of Police. He’s aware of it, so the communication issue is being improved,” Bannister said.
He also spoke about issues with postmortems which he said were not always done in a timely fashion.
“Sometimes we have a real influx of people, so we can’t always blame the pathologist for that. Sometimes we have a small amount, then we have 15 people at one time, but we would appreciate it if we could get the postmortem in a timely manner.
Prelim report
“However, the preliminary would do until we get the final report. You cannot register the prelim report. It’s just for the coroner to know what the person died from and if it is something that requires further investigation. If it does not require further investigation or if there are no red flags, then I can go ahead and ask the family member ‘who is the undertaker?’, or if that is on the police form, we can clear the body for burial,” he said.
The Coroner acknowledged that the delays could have a ripple effect on other processes.
“It is very important for estates, and insurance, that these certificates be written in a timely fashion and that they are clear. What has been happening is that 48 hours would pass, the police might not have a contact number and then I have to go and investigate to find out who is the family member.”
He said the officers who worked at night and responded to fatalities might need to be retrained or informed of all the necessary procedures.
“What is important is to get officers on night shift to do what is required and to do it in a timely fashion. Quite often you have to hunt down especially after a weekend, to get these sudden unnatural death reports.
“Then there are some doctors who go on holiday for two weeks and there is no one in the office to access the report or who is willing to communicate with the doctor to get the notes to write the certificate.” (TG)
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