QuickTips

Tips in Brief

1. Only ONE condition is listed per line in Part I.
2. Each condition in Part I can cause the one above it.
3. Conditions in Part II contribute to death but do not result in the underlying cause in Part I.
4. A complete sequence is reported that explains why this patient died.
5. If it seems that two or more conditions "added together" or were temporally inseparable--that is, it might seem appropriate to report them together on one line in Part I-- the most important ONE should be listed in Part I, and the others should be listed in Part II.
6. It is acceptable, and often needed, to report more than one condition in Part II.
7. Mechanistic terminal events such as respiratory arrest, asystole, cardiac arrest, cardio-respiratory arrest, ventricular fibrillation, and electromechanical dissociation should not be included in cause-of-death statements.
8. When necessary, and when conditions are integrally and causally related, it is acceptable to combine related conditions into one entity for reporting in Part I-- such as "pneumonia with systemic sepsis," or "myocardial infarction with rupture." This should not be done unless absolutely necessary, however, and is usually done because of space limitations in Part I. This method may be referred to as "the with method."
9. Although rarely needed, extra lines may be added in Part I.
10. It is acceptable to qualify a condition with words such as "probable." For example, "probable peptic ulcer disease."
11. Sometimes, citing a specific underlying cause of death is difficult because sufficient information is lacking, as might occur when someone dies of gastrointestinal hemorrhage due to a natural, but otherwise unknown cause. In such instances, it is helpful to write Part I as Gastrointestional hemorrhage due to: Undetermined natural cause. Using this technique lets a reader of the cause-of-death statement know that a specific underlying cause of death was considered and was not omitted through an oversight. Of course, one should be reasonably certain that only natural causes are involved.
12. Deaths known or suspected as having been caused in whole or in part by injury or poisoning should be reported to the medical examiner or coroner, and the death certificate should not be completed by you unless the ME/C instructs you to do so.

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