Pronouncement of Death
The following points need to be observed when pronouncing a person dead and when removing a corpse from the place of death for purposes of appropriate disposition.
Section 979.01, Wisconsin Stats., addresses the reporting of deaths and the taking of specimens by the coroner or medical examiner.
If a physician is present or responds in person to a summons to observe the condition of an individual who appears to have expired, the date and time of death is the date and time the physician actually made the pronouncement of death.
Only physicians, coroners, medical examiners or deputy medical examiners may pronounce death.
A nurse, physicians assistant, paramedic or emergency medical technician may not pronounce a person dead and may not be listed on the Notice of Removal Form as a pronouncer of death.
A registered nurse or licensed practical nurse may report observations that indicate an apparent death to a physician by telephone.
The nurse should report to the physician immediately upon observation of the apparent death. The physician may then exercise professional judgement in pronouncing the individual dead.
There should be no unnecessary delay in reporting to the physician. The nurse should record the information given to the physician and the physician's response in the persons medical record.
The date and time of death that is recorded in the medical record must reflect the date and time of the pronouncement of death by the physician, coroner, deputy coroner, medical examiner or deputy medical examiner.
This is the same date and time of death that must be placed on the death certificate.
Section 69.01(6g), Stats., which takes effect on January 1, 2003, defines "date of death" in accordance with this current standard of practice. A death certificate requires the "time of pronouncement" of death rather than an estimated "time of death."
If the situation necessitates immediate reporting to a coroner or medical examiner, that official may choose, at his or her discretion, to make the pronouncement of death.
Staff of home health agencies, hospices and other licensed care facilities need to contact the coroner or medical examiner in the county where clients expire to obtain procedures for the legal pronouncement of deaths that occur outside a nursing home or hospital.
If a coroner or medical examiner determines that a case requires an actual scene investigation (e.g., when an incident such as a restraint death or suicide occurs at a facility), it is important that no one inadvertently alters potential evidence at the death scene.
The coroner or medical examiner will determine if the body may be moved or removed, if the family or others may enter the death scene, and what, if any, of the items at the death scene should be preserved.
If death is not apparent and if resuscitative measures are taken, it is understood that there will be alteration of the death scene.
However, if signs of death are apparent and it is obvious that resuscitative efforts will be futile, the death scene must be preserved and the coroner or medical examiner must be called immediately to initiate the death investigation.
Any medical device attached to or introduced into the body should be left in its original position. The coroner or medical examiner will need to document all of the medical intervention rendered.
This information is important for the pathologist who performs the autopsy and is especially important for trauma cases, no matter how long the person has been in the facility.