Week 5 - Module - Funeral Director - Medical certificate of cause of death

Question 1

In the medical certificate of cause of death (MCCD), can a FY1 complete the form?

Answer 1

An FY1 should involve the senior doctor in completion of a medical certificate of cause of death

Question 2

Who can sign the medical certificate of cause of death form?

Answer 2

The doctor who has attended the disease during their last illness or A doctor who is in knowledge of the patient or who can access their medical records

Question 3

What section in the medical certificate of cause of death is for the doctor to state the patients cause of death?

Answer 3

This would be section C of the certificate Section A is simply details of the deceased whilst Section B is details of the certifying doctor

Question 4

Part C of the medical certificate of cause of death of the patent is where the cause of death is filled in There is part 1a,1b-d and part II Where does the direct cause of death of the patient go?

Answer 4

The direct cause of death of the patient is filled in as part 1a

Question 5

What is filled in for parts 1-d?

Answer 5

This is where any antecedent cause of death are filled in goes

Question 6

Part 1 - condition leading directly to cause of death Part 1 b-d should list any antecedent causes of death Part II is other conditions contributing to death but to leading to or causing the conditions that caused death Could diabetes or OA go in part II?

Answer 6

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Question 7

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Answer 7

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Question 8

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Answer 8

Your answer : Influenza A Correct! This is an antecedent cause which led directly to cause Ia Continue

Question 9

82 year old Mrs SR admitted with confusion and fever 2 days ago. Past medical history of type 2 diabetes (non insulin dependent). Investigation results included a raised CRP and white cell count, and a chest x ray revealed a left lower lobe pneumonia. Viral swabs were positive for influenza A and sputum for pneumococcus. She became increasingly unwell despite treatment and died overnight. Choose the correct condition for part II of the death certificate?

Answer 9

Your answer : Non-insulin dependent diabetes mellitus (type 2) Correct! Non-insulin dependent diabetes mellitus ( type 2), this may have contributed to death but did not directly cause death

Question 10

The medical certificate of cause of death generates statistical information on the cause of death of the patient. Timely and accurate completion of the MCCD enables family to register the death and make funeral arrangements. Who should the deaths on the left be reported to?

Answer 10

Deaths should be reported tot the procurator fiscal under the circumstances shown in the image Procurator fiscal is the independent prosecution service for Scotland

Question 11

If referral to the procurator fiscal is not required, what is the process for sending the medical certificate of cause of death to the national review service (NRS) in both primary and secondary care?

Answer 11

Primary care The MCCD is sent electronically to the national review service Secondary care The certificate is given to the representatives of the deceased and they attend a registrar who sends it to the national review service

Question 12

New process introduced May 2015 in response to The Certification of Death (Scotland) act 2011. Four aims f the two reviews: * to introduce single system of independent scrutiny of death certificates in Scotland, * to improve quality and accuracy of MCCDs, * to strengthen clinical governance in relation to death certification, * to improve public health information. What are the two types of review that were introduced?

Answer 12

Level 1 review - looks over 10% of MCCD that are randomised to review and is completed within 1 working day Level 2 reviews - 1000s per year and completed within 3 working days

Question 13

Level 1 and Level 2 reviews of the MCCD are selected randomly A level 1 review can be escalated to a level 2 review however When can it be escalated?

Answer 13

• * If the medical review and certifying doctor disagree on the
• * The sequence to the recorded death is illogical
• * The registrar has referred the case where they have a concern about the MCCD1
• * There is feedback from ISD of trends meriting investigation1
• * The cause of death on the MCCD is not appropriate for the circumstances
• * Gender or age of the deceased.

Question 14

If the medical reviewer of the level 1 review is happy with the MCCD, what happens?

Answer 14

There is no further action and the MCCD is passed MR picks up discrepancies (e.g. non standard cause of death, illogical sequence of cause of death, feedback from ISD on relevant trends) > level 2 review triggered.