When the death certificate omits the true cause of death
In one research review published in Today’s Geriatric Medicine magazine, Dr. Emily Carter, a geriatrician affiliated with the Maine Medical Center, and co-authors noted that data submitted on death certificates can affect families regarding life insurance, estate settlement, genetic risk factors and closing conclusions. They estimate that major errors, such as an incorrect cause or manner of death, occur in 33-40% of death certificates that are completed at academic institutions like theirs in the United States.
An analysis of death certificates at their own facility found that cardiac or respiratory arrest had been incorrectly listed as the immediate cause of death on 11 of 50 documents reviewed. As Dr. Gill said, “Everyone who dies dies from cardiopulmonary arrest. The crucial question is: why did this happen? Let’s say someone dies of a gastric hemorrhage. What caused it? Stomach cancer, ulcer or what?
There are many reasons for the high rate of inaccurate or incomplete death certificates, starting with the little attention given to the subject in medical school and the frantic pace in many medical settings. Speed is sometimes dictated by the need to deliver a body to a funeral home for burial or cremation.
the The CDC estimated that 20-30% of death certificates, while not necessarily inaccurate, “have completeness issues”. The agency said heavy workloads, insufficient information about a death or inadequate training can lead to incomplete or inaccurate death certificates.
Additionally, many deaths are certified by coroners, who are elected or appointed to their positions and may hold a bachelor’s degree in forensic science, but are usually not physicians. They may be subject to political or family influences and may fail, for example, to mention opioid overdose as the cause of death. Even when death certificates are completed by medical examiners, who are usually medical doctors, they may not be trained in forensic pathology and may not know the true cause of death. Death from a fall, for example, can be accidental or result from an underlying disease or even homicide.
According to a blog post by Womble Bond Dickinson, a transatlantic law firm headquartered in London, “the the death certificate can be essential in a lawsuitto help determine “the nature of death”, contributing factors, when it occurred, and illnesses that may have played a role.
If the death was the result of a medical illness, the death certificate is usually completed by the responsible physician, Dr. Carter and colleagues wrote in their review. However, they pointed out, a medical examiner should certify all other causes, including deaths related to a hip fracture that could have resulted from an accident, and deaths related to a history of malicious injuries that could be a homicide.