Bombay Hospital Journal Issue SpecialContentsHomeArchiveSearchBooksFeedback

DEATH CERTIFICATE

Hozie D Kapadia

Family Physician, Byculla, Mumbai 400 027.

Death Certificate (DC) is a legal document which an attending physician must issue, if he is convinced that the death is due to any natural cause. The doctor has to inspect the body and make sure that the person is actually dead and not in a state of suspended animation. He has to mention the exact cause of death, also describing the contributory factors, (giving cardio-respiratory arrest or cardiac arrest as the cause of death is wrong).

• He cannot withhold to issue this certificate even if his own professional fees are not paid.
 The DC should never be issued under pressure from friends or relatives of the patient and without examining the body.
• In case of organ transplantation from dead bodies, two DCs from two separate doctors are required who should not be members from the transplant team.
• DC is required for cremation, burial or any other method of disposal of the body, execution of the Will of the dead, settlement of insurance claims, pension claims, transfer of property etc.
• If the attending physician suspects a foul play like suicide, homicide, violence or accidental poisoning he must not issue a DC but immediately report this fact to the Police for necessary investigation and action before the body is cremated, buried etc.
• Great care must be exercised to avoid issuing a DC for unnatural causes as the doctor runs the risk of being accused as an accessory to the crime.

1. He should carefully examine the body for temperature, postmortem lividity and rigor mortis to ascertain whether they are consistent with the time of death as stated by the relatives. In India (tropical climate) rigor mortis commences in two to three hours after death, takes about 12 hours to develop from head to foot, persists for another 12 hours and takes about 12 hours to pass off.
2. Look for abnormal coloration of body due to poisons.
3. Check the head, scalp for any fractures, bumps or lacerations which may be concealed by hair, injuries on the chest, limbs etc. Always turn the body to look out for any injuries on the back.
4. Examine the face, lips for any bruises, foreign materials in the mouth like poisons, capsules etc. Skin of the neck must be carefully examined for any strangulation or ligature marks.

At times the police may request any nearby doctor, (not the patient’s usual doctor) to certify a patient dead. The doctor after examining the body can give a DC on his letterhead but without volunteering to give the cause of death. The exact cause of death may be ascertained by postmortem.

When not to issue a Death Certificate

1. Any case where cause of death, is not known to the attending doctor. This includes the cases where the doctor has not seen/treated the patient prior to death.
2. If the patient is brought dead to the hospital or, dies unattended.
3. Any case of accidents, homicide, suicide or in any case where foul play is suspected.
4. Any case of burns, particularly in case of married female patients.
5. Any death in police custody, mental asylum of children or destitute home.


Specimen Copy
BRIHANMUMBAI MAHANAGARPALIKA
Public Health Department
FORM NO. 8
(See Rule 8 of the Maharashtra Registration of Births and Deaths Rules 1976)
MEDICAL CERTIFICATE OF CAUSE OF DEATH
1. Name of the deceased - Mr XYZ  
2. Address of normal residence - 012, ABC CHS LTD
OOOA, LMNO RD,CITY PIN
3. Date of death - 26/1/2000         
4. Occupation - LIC AGENT
5. Sex - Male                                        6.Marital Status
(Single/Married/Widowed/Divorced)
7. Date of birth - 1/4/1962
8.Age (in years - 37 years last birthday) If under 1 Yr. If under 24 Hours
Months Days Hours Minutes
9. Cause of death - Natural     Approximate Interval between onset and death
Years Months Days Hours
Immediate cause
State the disease injury or complication which caused death, not the mode of dying such as heart failure, asthenia, etc.
(a) MASSIVE MYOCARDIAL INFARCT 1/2 hr.
due to (or as a consequence of)
Antecedent causes
Morbid conditions, if any, giving rise to the above cause, stating the underlying
condition last
(b) ISCHAEMIC HEART DISEASE
due to (or as a consequence of) 4 yrs 6 months
II. Other significant conditions
but not related to the disease or condition causing it
(c) HYPERTENSION 4 YRS 6 MONTHS
 Obesity > 20 yrs.
10. How did injury occur : NA               Accidento
Suicideo Homicideo
(Tick the relevant cell)
11. If deceased was a female
Was the death associated with pregnancy? (Yes or No)           
If yes, was there a delivery (Yes or No)                                         
If yes, has it taken place within 42 days of delivery

NA
NA
NA    
 Name (Rubber Stamp) of Institution or
                        Medical Practitioner

(i)Allopathic o  (ii) Ayurvedic  o  (iii) Homoeopathic o

(iv) Unani      o (Tick the relevant cell)

Serial No. of Institution

12. Whether the deceased has given willingness for donation of Eyes? (Yes or No) Yes
Date of report - 26/1/2000                  Sd/-
                                                                    OOO CBA CHS LTD,
                                                                    OOOB, RMP RD, CITY, PIN
                                                                    (Signature and Address of Medical Attendant).
Note that : 1. It has been filled in capital letters. 2. Every detail has been filled. Whatever is not applicable NA has been marked. 3. Cause of death (Natural) has to be given along with details of timings asked.



6. Any case of operation table death and death within first 48 hours of the surgical operation.

7. Any death following drug reaction including anaphylaxis following any drug injection even when the anaphylaxis is a known complication of a particular drug.

In such cases even if the patient’s immediate relatives, friends, police officers, politicians, social workers etc., put pressure on the attending doctor to give a DC, legally it cannot be issued.



To Section TOC
Sponsor-Dr.Reddy's Lab