Reporting a Death

A death that is required to be reported to the DCOME will typically have one or more of the following attributes:

Death occurred in a medical facility less than 24 hours after admittance.
All deaths that occur in a medical facility less than 24 hours after being admitted to that facility must be reported. If the patient has only been in your unit (i.e. PCU) for less than 24 hours but the patient was admitted to a prior unit (i.e. ER) in the same facility more than 24 hours before the death, then the death does not need to be reported.

The patient has obvious or observable injuries or trauma to their body.

The patient had a recent fall(s) in their history.
A fall that occurred in the past 30 days, even if it is not believed to be contributory to the death, should be reported. An example of this would be a decedent who had a witnessed fall at a nursing home 2 weeks prior to the death, but the fall resulted in only minor abrasions, and the decedent passed away from congestive heart failure. This death should still be reported as the fall occurred within 30 days of the death.

Delayed death after a suspected overdose or other trauma/injury.
If a patient was admitted to the facility as a suspected overdose of any substance (illicit/prescription/alcohol), or tested positive on pre-admittance screenings, and then passed away greater than 24 hours since admittance, this is not a natural death and needs to be investigated by the DCOME. The DCOME will also need pre-admission specimens (blood, urine, etc.) held for quantifiable testing if possible.
An example of a delayed injury/trauma that contributed to the death would be a pelvic fracture after a fall that occurred 3 months prior to the death, but the patient did not return to baseline (activity level/health) before their death. This also includes delayed deaths after motor vehicle collisions or other traumatic injuries in which the decedent did not return to baseline, or the injury caused a medical condition that caused the death.

There are concerning/suspicious circumstances surrounding the death.
Police or another agency (i.e. Dept of Aging, OSHA) are involved in investigating the death, or there are concerns from family or staff about the circumstances surrounding the death. Suspicion or allegations of domestic abuse, elder abuse, drug/alcohol abuse in history, concerning marks on the patient, etc. should be reported. A death that occurs after the patient is transported to the hospital from a place of employment should be reported even if it appears to be natural in origin.

The patient had surgery in the 24 hours prior to death (perioperative).
This includes patients that were admitted to the facility greater than 24 hours prior to the death, but the surgery occurred less than 24 hours before the death.

The death is known or suspected to be due to a contagious disease.
This includes all Influenza types, COVID-19, HIV, TB, Meningitis, and other diseases that are considered to be contagious, communicable, or a public health hazard (i.e. a pandemic).

Per the PA Statue Title 35 Health and Safety, Chapter 2. Registration of Vital Statistics Law of 1953, Article I. General Provisions, a Fetal Death is defined as “… the expulsion or extraction from its mother of a product of conception after sixteen (16) weeks gestation, which shows no evidence of life after such expulsion or extraction.”

If a fetus is past 16 weeks gestation and perished in utero, it is considered a reportable death.

If a fetus is past 16 weeks gestation and perished in utero, it is considered a reportable death to the Medical Examiner.

If there are ANY vitals detected at birth it is NOT a fetal demise, and a traditional death certificate will need to be completed instead of the fetal demise certificate.

The Delaware County Office of the Medical Examiner at (DCOME) will determine if the case will be accepted or terminated. Please contact the Delaware County Office of the Medical Examiner at (610) 891-5953 and inform them that you are reporting a fetal death.

Please try to have the following information for the forensic investigator:

Incident Description
What was the reason the mother came to the hospital?
Date and time mother admitted to hospital

Mother Information
Name, DOB, home address, and phone number
OBGYN name and the date of the mother’s last prenatal appointment
Gravida/Para/Abortus history of mother, and outcome of all past pregnancies (any living children, past fetal abnormalities, etc.)
Any complications during this pregnancy
Recent falls or injuries to the mother
Drug, alcohol, or tobacco use during pregnancy

Decedent’s Information
Name (if parents have chosen one)
Gestation (weeks and days)
Ethnicity and sex
Fetal abnormalities (if any)
Any injuries or anything suspicious about this death?
Date of birth/death and time of death
Pronouncing physician

Fetal Demise Certificate
Cause of death
Manner of death
Physician certifying
Funeral home or crematory service information

Reasons for Jurisdictions Accepted by the DCOME
Suspicious Circumstances
Fetal deaths delivered at non-medical facilities and followed up later at a medical facility

When the hospital’s fetal demise certificate is completed, please fax the full form (front and back) to the Delaware County Office of the Medical Examiner at (610) 891-5985.

The DCOME needs a copy for our records.