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
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:
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;
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
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.
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.
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 examiners 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 examiners 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.
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.
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.
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.