Process of certifying death, role of HM coroner and inquest process Flashcards

1
Q

According to the Births & Deaths Registration Act 1953 (S.22), who can sign a death certificate, and what piece of info must they include?

A

Registered medical practitioner

Fulfil to the best of their knowledge and belief: CAUSE OF DEATH

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2
Q

Give 2 reasons why the Medical Certificate as to Cause of Death (MCCD) helpful for family members?

A

Allows them to register death

Provides explanation of how/why patient died

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3
Q

Why is the Medical Certificate as to Cause of Death (MCCD) helpful in research?

A

Informs research into health effects of exposure to risk factors

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4
Q

Give 3 criteria that must be completed by the doctor with the statutory duty to complete the Medical Certificate as to Cause of Death (MCCD)?

A

Saw patient in last 14 days and saw body after death

Cared for patient in the illness that led to death

Knows past medical history, investigations and treatments

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5
Q

After the attending doctor with the statutory duty (fulfils 3 criteria) diagnoses death, who investigates the case to help certify it?

A

Medical Examiner Office

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6
Q

What is the role of the Medical Examiner Office in helping the statutory attending doctor, regarding the MCCD?

A

Agree proposed cause of death with MCCD statutory doctor

eg. what did this person die from?

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7
Q

Where are Medical Examiner Officers based, and what are their 2 main roles to aid MCCD completion?

A

Senior doctors in Acute Trusts that extend support to hospital to complete MCCD by:

improving communication with family

appropriately referring to HM coroner

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8
Q

Why does the Medical Examiners Office discuss the cause of death with the next of kin?

A

To establish any questions, concerns with care before death

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9
Q

Who informs local mortality arrangements of deceased patients eg. funeral care?

A

Medical Examiners Office

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10
Q

If the statutory attending doctor doesn’t fulfil the 3 criteria to complete the MCCD and the proposed cause of death isn’t agreed on, who must the patient case be referred to by the Medical Examiner Office?

A

HM coroner

All deaths undergo MEs or HM coroners investigation

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11
Q

How is section 1 of the cause of death section on the MCCD completed?

A

Immediate, direct cause on line 1a

On each line below go through prior sequence of events/conditions that led to death

Lowest line has event/condition that caused all conditions above i

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12
Q

Give examples of vague terms that should be avoided when completing the cause of death section of the MCCD?

A

‘old age’, ‘natural causes’, ‘organ failure’, ‘cardiovascular event’

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13
Q

Which 2 guidance frameworks are used to determine if a post mortem/autopsy can be performed?

A

Human Tissue Act 2004

Code of Practice

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14
Q

What are the 2 situations in which a post mortem is done?

A

Coroner orders it to determine cause of unknown, unnatural, suspicious, violent death

Agreed upon by hospital and family to understand deceased illness/cause of death and/or enhance future healthcare

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15
Q

If a post mortem is ordered by a coroner, do they need the family’s consent to proceed?

A

No

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16
Q

How soon after the death must the coroner perform the post mortem?

A

Done by suitable practitioner as soon as reasonably possible

17
Q

When a coroner performs a post mortem, what standards must they comply with?

A

Human Tissue Authority standards

18
Q

How soon after the post mortem must the coroner release the body for burial/cremation?

A

As soon as possible (usually within 28 days)

19
Q

After what finding must the coroner hold an inquest?

A

post mortem doesn’t confirm natural cause of death

20
Q

According to Coroners & Justice Act 2009 (S.1), in which 3 situations does the coroner have a duty to investigate a death?

A

body is within coroner’s area

has reason to suspect violent/unnatural/unknown cause of death

patient died in state detention/custody

21
Q

Who are HM coroners employed by?

A

Independent Judicial Officer of the Crown (employed by the Local Authority), all new coroners are lawyers

22
Q

What is a coroner inquest hearing, and is anyone blamed?

A

A fact-finding, public hearing (no blame) that states who deceased person was, how, when, where death occurred

23
Q

At a coroner inquest hearing, who decides who will attend and give evidence?

A

Coroner

24
Q

At a coroner inquest hearing, can relatives attend?

A

Yes

Relatives can attend, ask questions and be legally represented

25
Q

At a coroner inquest hearing, why would a Trust solicitor/barrister attend?

A

requested by staff to provide written statement/oral evidence

26
Q

At a coroner inquest hearing, give examples of the verdict that a coroner can come to?

A

natural causes, accident/misadventure, killed himself, narrative verdict (brief description of factual events)

27
Q

At a coroner inquest hearing, who can challenge the coroner’s verdict?

A

Judicial review

28
Q

At a coroner inquest hearing, why would the coroner refer the doctor to their regulatory body?

A

Refers doctor to their regulatory body (eg. GMC, NHS England) if they think it would prevent recurrence of incident that caused death

29
Q

Give 2 examples of common adverse findings/verdicts in a coroner inquest hearing?

A

Neglect: Gross failure over period of time to provide basic care and nourishment that overlooks clinical judgement

Regulation 28 Report: Coroner’s duty to issue report to public authorities about circumstances which pose risk of more deaths, copy sent to chief coroner to be published

30
Q

Does a body have to be buried in an authorised place eg. graveyard?

A

No

31
Q

In order to bury a body in a garden, what 3 requirements are there?

A

Consent from burial register

Consent from Local Authority

Certainty that body (clinical waste) won’t poison water supply

32
Q

According to the Cremation (England and Wales) Regulations 2008, what is the role of the Cremation 4 and 5 doctors, and the medical referee?

A

Cremation 4 form: Statutory attending doctor who cared for patient in last illness before death

Cremation 5 form: Confirmation certificate mostly by ME after discussing with Crem 4 doctor

medical referee at crematoria approves medical documentation before consenting to cremation

33
Q

Is it lawful to cremate a body in a garden?

A

No