Errors on death certificates requiring amendments: the Broward County experience.

Area of Science:

• Forensic Pathology
• Medical Toxicology
• Public Health Statistics

Background:

• Medical examiner offices issue death certificates, which may require amendments for corrections.
• Amendments address misinformation in death certificates and autopsy reports, impacting official records.

Purpose of the Study:

• To investigate the primary causes for amendments to death certificates and autopsy reports.
• To develop strategies for preventing future errors in death certification.

Main Methods:

• Analysis of 128 cases requiring amendments between 2006-2007, with 103 cases used for detailed data analysis.
• Calculation of amendment rates based on 3790 issued death certificates over the study period.

Main Results:

• An amendment rate of 3.37% was observed, with changes made to cause (n=30) and manner (n=21) of death.
• Top reasons for amendments included delayed laboratory findings (35%), additional medical history (22.5%), and typographic errors (15.5%).
• Toxicological analysis led to significant reclassifications, such as natural deaths to accidental overdoses, often months after initial certification.

Conclusions:

• Delayed findings and data inaccuracies are key drivers of death certificate amendments.
• Complete toxicological analysis is vital for accurate cause of death determination, potentially uncovering missed overdoses.
• Strategies to improve data accuracy and reduce turnaround times are needed to minimize amendments.