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About Us
Information for Healthcare Practitioners, Hospitals, and Skilled Nursing Facilities
Cases to be Reported to the Coroner’s Office
- All deaths not related to natural causes.
- All natural deaths where the cause of death cannot be determined with a reasonable degree of medical certainty.
If a patient has underlying medical conditions or risk factors for sudden death, the most likely condition(s) which would be responsible for the death should be listed as the cause of death on the death certificate. Other conditions considered as factors contributing to death should be listed in the appropriate area on the death certificate.
If a physician has reason to believe that the manner of death may be related to accident, suicide or homicide, the case must be reported to the Coroner’s Office. Such reasons may include reported circumstances surrounding the death, recent fall or accident, previous suicidal ideation, domestic abuse, etc.
Causes of death may be certified simply by risk factors, such as senescence, inanition, failure to thrive, malnutrition, or natural causes (if multiple medical conditions exist; in such cases, these medical conditions may be listed as factors contributing to death).
The Coroner’s Office will generally perform an autopsy on a reported case only if there is a reason to prove the death was not related to natural causes.
- All deaths involving a fracture regardless of whether or not it is believed to be related to natural causes.
The law defines deaths that occur as complications of a fracture to be classified with the manner of death as “accident”. If a fracture is listed as a cause of death or a factor contributing to death and the death is certified by an attending physician, the Pennsylvania Department of Health will refer the case to the Coroner’s Office to make a ruling regarding the manner of death.
The Coroner’s Office will subsequently subpoena the medical records pertaining to events leading up to the death and, when necessary, discuss these events with caregivers. Unfortunately, the investigation is delayed, memories of events become compromised and the ultimate certification of the death and revision of the death certificate may occur months later. Families are then notified of the Coroner’s findings. This often adds to confusion and delay in closure.
As such, immediate report of all such deaths to the Coroner’s Office is mandated by law.
- Deaths that occur within 24 hours of admission and cannot be certified as a natural death by the attending physician.
Therefore, if the cause of death can be determined with a reasonable degree of medical certainty and manner of death can be determined as natural, such a case does not need to be reported to the Coroner’s Office.
- All intra-operative/intra-procedural, post-operative/post-procedural deaths not related to pre-existing disease.
Deaths due to “therapeutic misadventure” need to be reported as the manner of death may be related to accident.
- Deaths related to previous trauma history
Certification of death requires the acknowledgement that previous trauma may have resulted in conditions which lead to a patient’s death, even if the death occurred many years after the initial trauma.
The example would be that of a veteran rendered quadriplegic in a war due to a gunshot wound to the spine who dies 25 years later of pneumonia. The case must be referred to the Coroner’s Office with the cause of death being certified as “Pneumonia due to Quadriplegia due to Gunshot Wound” and the manner of death being “Homicide”. If such a case were caused by criminal activity in the U.S., the case would be referred to the District Attorney of the county in which the crime occurred as such cases may require further prosecution.
- Unidentified Bodies
It is the duty of hospitals to identify individuals correctly upon admission, but occasionally this cannot be done with certainty. In such cases, law enforcement should be notified to investigate identity. Should death occur prior to verification of identity, the Coroner’s Office will assume jurisdiction.
- Unclaimed Bodies
It is the duty of all healthcare facilities to make a good faith effort to identify a party who will take responsibility for burial or cremation. When next of kin is not available or there are no interested parties willing to claim a decedents remains, the law requires the Coroner’s Office to do so.
When a dispute occurs within families over who will take responsibility of remains, the law defines next of kin based upon the following hierarchy:
- Spouse (except in cases of enduring estrangement)
- Adult children (or emancipated minors)
- Parents
- Adult grandchildren (or emancipated minors)
- Siblings
- Any questionable cases.
Cases Not Requiring Report to Coroner
- Cases where family requests an autopsy.
When the death can be certified by the attending physician, there is no need for the Coroner’s Office to be involved. If reported, the Office will likely decline jurisdiction.
A private autopsy service should be consulted. The family should be informed of the costs of the autopsy prior to their consent as these costs are generally not covered by third party payers.
- Cases of concern for medical liability where therapeutic misadventure is not involved.
Such cases may result in civil action. The Coroner’s Office does not investigate such cases, only those that may result in criminal action.
Content Last Modified on 8/12/2009 12:00:01 PM
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