Press Release
MDU issues advice on the dos and don'ts of death certificates
11 December 2012
The commonest cause of complaints about death certificates notified to the Medical Defence Union (MDU) s that they contained an inaccuracy, according to an analysis published today.
Of 130 cases notified bythe MDU’s doctor members over a recent five-year period, over a fifth (29) were due to complaints about alleged inaccuracies, while in 24 cases doctors neededadvice about completing the certificate, such as how to declare the death. In 21 cases, complaints arose because of alleged delays in issuing certificates, with one doctor being referred to the GMC and another complaint reaching the Ombudsman. Other queries included when to refer a death to the coroner and how to deal with a complaint from a relative about the cause of death on the certificate.
Most queries were raised by GPs, although a minority were from hospital doctors and consultants. As a result of the analysis, the MDU, which indemnifies over 50% of UK doctors, has issued advice to its members about completing death certificates.
Dr Carol Chu, MDU medico-legal adviser, said:
“When you consider that over 490,000 deaths were registered in England and Wales in 2010, most of which will have required a doctor to sign a certificate, it is inevitable that problems will sometimes arise. Nonetheless difficulties can be avoided by completing the death certificate promptly and accurately and seeking advice from your medical defence organisation if you are unsure about whether the death needs to be reported to the coroner. It is also important to deal sensitively with bereaved relatives.
“Plans are underway to review the death certification system in England and Wales and new medical examiners are due to be introduced in April 2014. When appointed, the examiners will be another source of information and advice for doctors with queries about death certificates.”
Some examples of cases from the MDU’s files include:
- A GP received a complaint about the cause of death on the certificate which was stated as Alzheimer’s disease when the family had been told the death was caused by vascular dementia.
- A coroner ordered a hospital investigation into the accuracy of a death certificate for a patient who died after surgery.
- A coroner referred a doctor to the GMC for an apparent lack of knowledge when signing a certificate and not seeing the patient within the last 14 days of life.
- A coroner criticised a consultant for issuing a certificate for a patient who died of a drugs overdose instead of reporting the case to him.
- A patient’s relative complained that a delay in issuing a certificate had led to the cancellation of the funeral.
Tips on completing death certificates
The MDU advises members to:
- Complete the death certificate promptly.
- Be accurate and careful when completing the medical certificate of cause of death.
- Be aware of when to report a death to the coroner. If you are in doubt, you can ask the MDU or the coroner for advice.
- Be aware of your ethical obligations. GMC guidance End of Life Care (2010) says that if there is any information on the death certificate that those close to the patient may not know about, may not understand or may find distressing, you should explain it to them sensitively and answer their questions, taking account of the patient's wishes if they are known.
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