March 20, 2020
In general, state laws require that a physician file a death certificate stating the cause and manner of death for each individual who passes away. The death certificate becomes the presumptive cause of death moving forward. The cause of death can affect the legal rights of the surviving spouse, children, next-of-kin, or other beneficiaries in a number of circumstances. In some cases, the cause of death set forth in a death certificate can be erroneous. Most state laws provide a procedure for changing the cause of death.
Determining Cause of Death
Cause of death is usually determined by an attending physician or family physician based on the outcome of the decedent’s last known medical illness. In many instances, the specific cause of death is not really known without an autopsy, so the certifying physician will use generic language to explain the cause of death. For example, the signs and symptoms of two common causes of death — cardiac arrest (i.e., heart attack), and pulmonary embolism (i.e., blood clots in the lungs) — are very similar. When a hospitalized patient suffers a cardiopulmonary arrest, it may not be possible to determine whether the arrest occurred as a result of a primary pulmonary event, such as pulmonary embolism, or a primary cardiac event, such as myocardial infarction, in the absence of an autopsy. Thus, the certifying physician may simply list “cardiopulmonary arrest” as the cause of death without being more specific.
Requesting an Autopsy
In unusual circumstances, or when requested by a physician, an autopsy is performed. Autopsies can be performed by pathologists who work within a hospital system or by a county coroner. In some instances, family members may request a private autopsy if the coroner refuses to perform an autopsy or if there are concerns about the validity of autopsy results, particularly where the autopsy is performed by a hospital that is suspected of committing medical malpractice that led to a wrongful death.
The scope and extent of an autopsy will vary depending on who is performing it and the reason for the autopsy. For example, a thorough coroner’s autopsy might include an investigation into the clinical circumstances leading up to the death, a gross description of the body and its organs, and a description of microscopic findings that may be incorporated into the coroner’s verdict. Toxicology results are sometimes obtained, depending on the circumstances of the death. Private or hospital autopsies may not be as complete.
The manner and cause of death contained in a death certificate can affect legal rights. For example, a life insurance policy may preclude payment when the deceased individual dies as a result of suicide. In medical malpractice litigation, the cause of death is often a controversy. Most state laws provide a procedure for contesting the findings of a death certificate. These procedures vary from state to state. Often, state law provides a separate procedure in which the cause of death can be litigated before trial since the official cause of death is presumed to be the cause of death, and that presumption can have a significant evidentiary effect at trial. If you are concerned about the cause of a loved one’s death, you should contact a wrongful death lawyer or medical malpractice lawyer, like a medical malpractice lawyer in Cleveland, OH, for advice.
Thanks to Mishkind Kulwicki Law for their insight into the cause of death in injury litigation.