Death Certification – When to Call the Coroner

Dr. Louise McNaughton-Filion
Eastern Region Supervising Coroner
2018

Death Certification

• An important legal document. WHO, ICD-10 classification
• List causes of death in reverse chronological order. Must be related, with underlying cause last
  • Standard of probabilities, not “beyond a reasonable doubt”
  • Not a “shopping list”
• List contributory factors
• No “modes of death” (ie cardiac arrest, respiratory arrest)
• If you have to complete: suicide/accident/homicide on the certificate……it’s a coroner’s case
• If you have to mention: fall, fracture, non-natural event on the certificate…it’s a coroner’s case
• If it’s a coroner’s case, don’t complete a death certificate

When to call the coroner

• Any non-natural death
• Any death where non-natural event contributed…….no expiry date (ie paraplegic from MVC years earlier, hip fracture in a person with multiple medical issues)
• Any natural death with family concerns, care concerns
• Any during or related to pregnancy (ie post-partum PE, ectopic)
• Any psychiatric patient, prisoner/custody, group home, Children’s Aid, restraints
• Unexpected natural child’s death

When not to call the coroner

• None of the above applies
• The family or the physician wishes an autopsy, but not a coroner’s case
• Nursing home deaths, unless the above criteria apply