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A prospective study about the discrepancy between postmortem inspections conducted by emergency physicians and
Ji Yeon Lim1, Koo Young Jung2, Duk Hee Lee2
1Department of Emergency Medicine, Cheju Halla General Hospital, Jeju, Republic of Korea.
Journal of Forensic and Legal Medicine
|July 14, 2020
Summary
Discrepancies exist in death certificate accuracy between emergency physicians and forensic pathologists. The National Forensic Service
Area of Science:
- Forensic Pathology
- Medical Education
- Public Health
Background:
- Emergency departments (EDs) in South Korea issue most death certificates.
- ED overcrowding hinders physician training and quality control for death certificates.
- The National Forensic Service (NFS) initiated an on-site postmortem inspection (OPI) project to address these issues.
Purpose of the Study:
- To analyze discrepancies in death certification between emergency physicians and forensic pathologists.
- To evaluate the impact of the NFS's OPI project on death investigation quality.
Main Methods:
- Compared case reports from emergency physicians with postmortem examination certificates from NFS medical examiners.
- Analyzed discrepancies in cause and manner of death for patients who died in the ED.
- Examined 75 cases undergoing OPIs.
Main Results:
- Agreement on cause of death was 56%; agreement on manner of death was 73.3%.
- Most OPIs were requested when the presumed natural cause of death was unclear.
- Significant discrepancies highlight challenges in accurate death certification.
Conclusions:
- Discrepancies in postmortem examinations stem from various factors.
- Improving the death investigation system and physician quality control is crucial.
- Enhanced training and oversight are needed for reliable death certification.
