Referral to the Coroner or Medical
Examiner
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The requirements in section 979.01(1) and (4), Stats., specify
circumstances under which a death must be reviewed by the medical examiner
or coroner. These requirements are as follows:
s. 979.01 Reporting deaths required; penalty; taking specimens by
coroner or medical examiner.
(1) All physicians, authorities of
hospitals, sanatoriums, public and private institutions, convalescent
homes, authorities of any institution of a like nature, and other persons
having knowledge of the death of any person who has died under any of the
following circumstances, shall immediately report such death to the
sheriff, police chief, medical examiner or coroner of the county wherein
such death took place.
(1g) A sheriff or police chief shall, immediately upon notification of
a death under sub. (1), notify the coroner or the medical examiner and the
coroner or medical examiner of the county where death took place, if the
crime, injury or event occurred in another county, shall immediately
report all of the following to the coroner or medical examiner of that
county:
(a) All deaths in which there are unexplained, unusual or suspicious
circumstances.
(b) All homicides.
(c) All suicides.
(d) All deaths following an abortion.
(e) All deaths due to poisoning, whether homicidal, suicidal or
accidental.
(f) All deaths following accidents, whether the injury is or is not the
primary cause of death.
(g) When there was no physician, or accredited practitioner of a bona
fide religious denomination relying upon prayer or spiritual means for
healing, in attendance within 30 days preceding death.
(h) When a physician refuses to sign the death certificate.
(i) When, after reasonable efforts, a physician cannot be obtained to
sign the medical certification as required under s. 69.18(2)(b) or (c)
within six days after the pronouncement of death or sooner under
circumstances which the coroner or medical examiner determines to be
emergency.
Important Points regarding the responsibility to report deaths to a
coroner or medical examiner
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The administrator of a health care
facility must develop an effective system for prompt notification of
the coroner or medical examiner for cases covered under section
979.01, Stats., chapter HFS 135, Wis. Adm. Code, and under any
individual coroner or medical examiner guidelines that are applicable.
Critical information to establish cause of death must be collected
immediately. It is recommended that the administrator do the
following:
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Assign specific persons on each shift
who are responsible for legal notification to the coroner or
medical examiner and for release of bodies to funeral directors
and next of kin. Backups should also be assigned;
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Conduct in-service training for all
appropriate staff on proper death notification and release of
bodies, using this document and information from the county
coroner or medical examiner as training tools.
See also: the Vital
Records Handbook for Hospitals/Nursing Homes. All facilities
received this handbook from the former Center for Health
Statistics, now the Bureau of Health Information, Division of
Health Care Financing; and
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Develop effective methods for
recognizing potential cases requiring coroner or medical examiner
notification.
An example would be "red-flagging" the
chart of any patient with injuries that are believed to be causing
or contributing to the decline in that person's health status.
These charts should be reviewed periodically to determine whether
their "red-flagged" status remains appropriate.
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The staff member who contacts the coroner
or medical examiner should know why the report is being made, have the
medical chart in hand and be prepared to answer basic questions that
the coroner or medical examiner may have about the death.
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Section 146.82 (2) (a) 18., Stats.,
requires the facility to provide the coroner or medical examiner with
all health care records for a decedent whose death is being
investigated under section 979.01, Stats. "Following the death of
a patient, to a coroner, deputy coroner, medical examiner or medical
examiner’s assistant, for the purpose of completing a medical
certificate, the health care provider may release information by
initiating contact with the office of the coroner or medical examiner
without receiving a request for release of the information and shall
release information upon receipt of an oral or written request for the
information from the coroner, deputy coroner, medical examiner or
medical examiner’s assistant. The recipient of any information under
this subdivision shall keep the information confidential except as
necessary to comply with section 69.18, section 979.01 or section
979.10, Stats."
If the information is not given to the coroner or
medical examiner, that official may seek a subpoena for the documents
under section 979.015, Stats.
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For cases reported under section 979.01,
Stats., the coroner or medical examiner selects a pathologist to
perform an autopsy in a reportable case.
Do not allow an autopsy to be
performed without the express consent of the coroner or medical
examiner. Some cases require that the autopsy be performed by a
forensic pathologist.
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Section 979.01, Stats., does not set time
limitations with reference to the occurrence of the injury that may
have led to a death. Accordingly, a five-year old injury may be
reportable if it contributed to a death.
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CASE EXAMPLES:
The following first four examples are of deaths that must be reported
to the coroner or medical examiner. The fifth example is a non-reportable
example.
a. A person fractures a hip and over the course of several months,
slowly deteriorates, never fully recovering from the trauma of the
fracture.
The cause of death is diagnosed as congestive heart failure due
to long-term arteriosclerotic heart disease and the hip fracture is deemed
to be a contributory factor, even though it was several months old. This
case is reportable under section 979.01, Stats.
b. An otherwise apparently healthy person has been in a nursing home
after a severe injury (e.g., gunshot wound, near drowning, etc.) that has
left the person in a state of slowly progressive deterioration.
The cause
of death is acute respiratory infection due to complications of an old
spinal injury or semicomatose condition due to near drowning asphyxia. The
trauma may have occurred years before the death. This case is
reportable under section 979.01, Stats.
c. A person suffers from eating and digestive disorders related to
cerebral disease believed to be caused, in some part, by a subdural
hematoma suffered in a series of falls.
The cause of death is severe
metabolic disorder due to hyponatremia due to post-stroke complications.
The subdural hematoma is believed to be contributory to the
cerebrovascular problems. This case is reportable under section 979.01,
Stats.
d. A person under the care of a nursing home, hospital, hospice or home
health agency receives the wrong dose of a medication and dies. This
case is reportable under section 979.01, Stats.
e. A person fractured a hip one year ago, has fully recovered from the
injury and dies expectedly from a diagnosed cancer. There were no other
injuries or poisonings. Unless otherwise stipulated by the coroner or
medical examiner, this case is not reportable under section 979.01,
Stats.
Please note that coroners and medical examiners under section 979.01,
Stats., have the authority to mandate specific guidelines regarding the
reporting of deaths in their counties. These guidelines may be more
stringent than the requirements in the statute.
You should contact the
county coroner or medical examiner in your county for specific guidelines
that are applicable.
Last Updated: March 23, 2011 |
