Physicians Frequently Asked Questions

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In many instances, it will be obvious that a case should be reported (homicidal gunshot wounds for example). However, we recognize that certain factors will make the decision less intuitive. Some frequent questions regarding our procedures and reporting deaths to the Medical Examiner Office are answered below:

What is “manner of death” anyway?

For purposes of vital statistics, deaths are classified as: natural, accident, homicide, suicide, or undetermined. In Delaware County only Medical Examiner Office staff are legally permitted to sign a death certificate in cases classified as anything other than natural.

What about cases in which the person lingers for days, weeks, months or even years between an injury and death?

If the person ultimately dies from a complication of the underlying injury (or if there is a suspicion that that is the case), then the death should be reported to our office. For example, a car crash victim with multiple injuries who goes on after a 2-month hospital stay to develop pneumonia, sepsis and multiorgan failure has died from complications of his injuries. The manner of death is still related to the car crash (typically “accident”) and therefore by law, the death must be reported to our office. As a corollary, it is illegal for a physician outside the medical examiner office to sign a death certificate in such a case.

What about cases in which the person has injuries, but also has underlying medical conditions that significantly contribute to death?

For proper death certification, if a non-natural factor contributes to death (even if that contribution is relatively minor), then the manner is determined by the non-natural factor. For example, if a person with severe heart disease is assaulted, and dies shortly thereafter from complications of injuries that would otherwise (in a healthy individual) be relatively innocuous (e.g., a rib fracture or two), then the death is properly classified as a homicide. A frequent saying in forensics is, “you take your victim as you find him.” The same rationale applies to elderly individuals who die of relatively “minor” injuries after a fall- it’s still an accident. Another frequent example is an alcoholic with cirrhosis, who dies of a subdural hematoma after a ground-level fall- again, it’s an accident.

Will an autopsy be performed if the case is reported to the Medical Examiner Office?

Not necessarily. In fact, many cases are reported to our office, but are not accepted as “medical examiner cases.” Furthermore, the law does not specify that all cases in Medical Examiner Office jurisdiction are autopsied. Medical Examiner Office staff have the discretion to do as thorough an examination as is necessary. In Delaware County, we have two categories of examination: 1) complete autopsy, and 2) external examination or inspection of external body.

Which cases will have an external or inspection examination, rather than a complete autopsy?

It should be emphasized that an individual forensic pathologist within the Medical Examiner Office is responsible for the death certification and as such has full discretion to decide- in each case. However, the types of cases that will frequently be classified following external or inspection only examination only are cases in which the individual dies after a few days or weeks in the hospital, in which injuries are well documented clinically, in which there is no suspicion of “foul play” or suicide, and cases in which the cause, manner and mechanism of death are clear.

Does the Medical Examiner Office need consent from the family or next of kin to do an autopsy?

No. Our responsibility is specified by law. If an autopsy is necessary, we can and will perform an autopsy. However, we do make every effort to discuss any objections with the family before our examination. In most cases, once the family understands our rationale, responsibilities, and procedures, they do not persist in their objections. In fact, many of those same families are most interested in the results of the autopsy once it is performed.

What if I don’t report a death that should have been reported?

The law (3 Pa. Cons. Stat. Ann. § 3092) provides for a penalty (which may include fine and/or imprisonment)! However, improper death certification has more practical ramifications. Misclassification may interfere with subsequent insurance settlements, civil proceedings, or even criminal proceedings. Also, the Medical Examiner Office staff is comfortable testifying in legal proceedings. Providing testimony in court is typically not a pleasant experience for those unacquainted with our adversarial legal system. When a non-Medical Examiner Office person signs a death certificate in a Medical Examiner case, he/she is then much more likely to receive a subpoena for subsequent trial.

What If I have Questions about how to Certify the Death?

Please Click the link below
Cause - of - Death

Hhmmm… should I report this case?

When in doubt, report it. Again, many death calls are not within the Medical Examiner jurisdiction. We will let you know, regardless.

Hopefully this short question and answer letter has helped get you acquainted with our role in medicolegal death investigation and the community. We would certainly like to encourage open communication between our staff, and the staff of local hospitals. If you have further questions regarding specific cases and/or our procedures in general, please don’t hesitate to call us.

Contact Us

  •   201 West Front Street,
         Media, PA 19063
  •   8:30AM - 4:30PM
           Monday - Friday
  •   610-891-4000

About Delaware County

Delaware County, presently consisting of over 184 square miles divided into forty-nine municipalities is the oldest settled section of Pennsylvania.

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