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Death Certification: Errors and Interventions.

Leah M Schuppener¹, Kelly Olson¹, Erin G Brooks²

¹University of Wisconsin School of Medicine and Public Health, Department of Pathology and Laboratory Medicine, Madison, Wisconsin USA.

Clinical Medicine & Research

|October 11, 2019

Summary

This summary is machine-generated.

Death certificates frequently contain errors, with 85% of cases having at least one mistake. This study proposes a severity scale to improve accuracy in death certification.

Keywords:

Cause of death Death certification Death record Electronic death registration Manner of death

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Area of Science:

Medical Law
Forensic Pathology
Public Health

Background:

Death certificates are crucial legal documents.
Inaccurate death certification is a persistent issue.
Standardized error classification and frequency assessment in US hospitals are lacking.

Purpose of the Study:

Evaluate death certification error frequency at an academic center.
Implement a standardized error severity classification.
Analyze error sources to improve accuracy.

Main Methods:

Retrospective review of 179 autopsy cases (2013-2016).
Comparison of non-pathologist physician-completed certificates with autopsy findings.
Classification of errors using a 5-point severity scale (Grades I-V).

Main Results:

85% of certificates had ≥1 error; 51% had multiple errors.
Most frequent errors: Grade 1 (53%), Grade III (30%), Grade IIb (18%).
Severe Grade IV errors occurred in 23% of cases; no Grade V errors found.

Conclusions:

Autopsies and pathologists are vital for accurate death certification.
Death certification errors may be more common than previously thought.
Recommendations include clinician education and systematic concordance checks with autopsy results.