Hospital Procedure for Registration of Death

Regardless of where or how a person dies, the body must eventually be transported to a hospital for an official death certificate to be issued. Even though an individual has passed away, the information contained within his certificate can prove invaluable to the health and well-being of the living. As such, hospitals and states have established a clear, efficient protocol for the registration of death.

Calling Time of Death

• When a patient arrives at the hospital alive, the doctor who oversees her care is referred to as the "attending physician" on the death certificate. Should the patient die during her attending physician's shift, it is this doctor's responsibility to record the time at which he determined that the patient could no longer be resuscitated. If the patient dies when her attending physician is not on duty (e.g. he stabilizes the patient, goes home when his scheduled shift ends and she dies two hours later), another doctor can step in as the "pronouncing physician" to record the time of death.

  If a patient is "dead-on-arrival" (DOA) to the hospital, the time and cause of death must be estimated by the physician, based on physiological signs and first-responder testimony. Depending on the patient's medical history, an autopsy and toxicology report will usually be ordered. In this case, it is up to the medical examiner or coroner to estimate the time of death.

Completing the Medical Certification of Death

• Next, the body is sent to the morgue for storage while the standard death certification form is filled out. Generally, the attending physician will report the place, time and suspected cause of death. Additionally, the physician checks boxes next to certain medical conditions or circumstances which may have contributed to death.

  If the physician is unsure of the cause of death, he can still complete the rest of the report while waiting for toxicology or autopsy reports to return.

  Otherwise, the doctor writes "Unknown" under "Cause of Death" and calls the medical examiner or coroner's office to investigate the body. At this point, the doctor completes everything else on the certificate but transfers responsibility for completing the "Cause of Death" section to the coroner/medical examiner.

Forwarding the Death Certificate to the Funeral Director

• Once the attending physician and/or coroner have completed the medical portion of the form, the death certificate is sent to the funeral director chosen by the deceased's family. The hospital makes a copy of the certificate and the body is transported from the hospital to the funeral home.

  The funeral director, following the family's wishes, embalms or cremates the body, recording the techniques and chemicals used on the certificate. After the interment, the funeral director files the completed death certificate with the state's department of health and human services.

  Finally, the federal government's Vital Statistics Registration System collects state death certificate records annually and compiles the data. This information in turn helps lawmakers and public policy institutes make important decisions on health care spending and the funding of medical research.