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Pennsylvania State Coroners’ AssociationPennsylvania State Coroners’ AssociationFriday, November 2, 2012Friday, November 2, 2012
State College, PA State College, PA
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Good morning….Good morning….
Topics of Discussion: Topics of Discussion:
Coroner StatutesCoroner Statutes
Certifying a Death CertificateCertifying a Death Certificate
Case ScenariosCase Scenarios
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Coroner StatutesCoroner Statutes
PURDON’S PENNSYLVANIA STATUTETITLE 16 – COUNTIES
ARTICLE XII – SHERIFF AND CORONER
THESE STATUTES MANDATE THETHESE STATUTES MANDATE THE CORONER’S OFFICIAL DUTIES AND
RESPONSIBILITIES
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Coroner StatutesCoroner Statutes
Pennsylvania Statutes Pennsylvania Statutes –– Title 16; CountiesTitle 16; Counties
16 P.S. Section 1237 – Coroner’s Investigations16 P.S. Section 1238 – Autopsy; Inquest; Records16 P.S. Section 1239 Sudden Deaths Defined16 P.S. Section 1241 – Release of Coroner’s Jurisdiction16 P.S. Section 1245 - Power of Subpoena & Attachment
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Coroner StatutesCoroner Statutes
Pennsylvania Statutes Pennsylvania Statutes –– Title 16; CountiesTitle 16; Counties
16 P.S. Section 1237 – Coroner’s Investigations16 P.S. Section 1238 – Autopsy; Inquest; Records16 P.S. Section 1239 Sudden Deaths Defined16 P.S. Section 1241 – Release of Coroner’s Jurisdiction16 P.S. Section 1245 - Power of Subpoena & Attachment
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16 P.S. Section 1237 16 P.S. Section 1237 –– Coroner’s InvestigationsCoroner’s Investigations
The Coroner having a view of the body SHALLSHALL investigate the facts and circumstances concerning deaths which appear to have happened within the County, regardless where the cause thereof may have occurred, for the purpose of determining whether or not an autopsy should be conducted or an inquest thereof SHALLSHALL be had in the following cases:
The purpose of the investigation SHALLSHALL be to determine the Cause of any such death and to determine whether or not there is sufficient reason for the Coroner to believe that any such death may have resulted from Criminal Acts or Criminal Neglect of persons other than the deceased.
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16 P.S. Section 1237 16 P.S. Section 1237 –– Coroner’s InvestigationsCoroner’s Investigations
Sudden Deaths Contagious Disease
Suspicious Circumstances
Violence, Trauma, Injury
Drug Overdose
In-Custody (Police – Prison)
Cremation, Buried at Sea
Sudden Infant Death Syndrome (SUIDI)
Peri / Post Operative
Unidentified or Unclaimed
Stillbirths
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16 P.S. Section 1237 16 P.S. Section 1237 –– Coroner’s InvestigationsCoroner’s Investigations
As a part of the investigation, the Coroner SHALLSHALLdetermine the identity of the Deceased and notify the Next of Kin of the deceased.
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16 P.S. Section 1238 16 P.S. Section 1238 –– Autopsy; Inquest; RecordsAutopsy; Inquest; Records
If, upon investigation, the Coroner SHALL be unable to determine the Cause and Manner of Death, he SHALLperform or order an autopsy on the bodyperform or order an autopsy on the body.
If the Coroner is unable to determine the Cause and Manner of Death following the autopsy, he may conduct an inquest upon a view of the body, as provided by law. At the inquest, the Coroner’s duty SHALL be to ascertain the Cause of Death, to determine whether any person other than the deceased was criminally responsible therefor by act or
l t d if th id tit f th d t ineglect and, if so, the identity of the person and to examine any further evidence and witnesses regarding the Cause of Death
The proceedings at the inquest SHALL be recorded, at the expense of the County, in a manner to be provided by the County Commissioners.
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16 P.S. Section 16 P.S. Section 1239 1239 –– Sudden Deaths DefinedSudden Deaths Defined
The Coroner SHALL regard any death as sudden if it occurs without prior medical
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attendance by a person who may lawfully execute a certificate of death in this Commonwealth, or if within 24 hours of deaths, the decedent was discharged from such medical attendance or a change of such medical attendance had occurred, or if any such medical attendance began within 24 h f d th d th di l tt d thours of death and the medical attendant refuses or is unable to certify the Cause of Death. Medical attendance includes hospitalization.
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16 P.S. Section 16 P.S. Section 1239 1239 –– Sudden Deaths DefinedSudden Deaths Defined
The Coroner SHALL regard any death as sudden if it occurs without prior medical
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attendance by a person who may lawfully execute a certificate of death in this Commonwealth, or if within 24 hours of deaths, the decedent was discharged from such medical attendance or a change of such medical attendance had occurred, or if any such medical attendance began within 24 h f d th d th di l tt d thours of death and the medical attendant refuses or is unable to certify the Cause of Death. Medical attendance includes hospitalization.
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16 P.S. Section 1245 16 P.S. Section 1245 –– Power of Subpoena & Power of Subpoena & Attachment Attachment
The Coroner SHALL have the power to issue subpoenas to obtain the attendance of any personsubpoenas to obtain the attendance of any person whom it may be necessary to examine as a witness at any inquest, and to compel attendance by attachment in like manner and to the same extent as any court of common pleas of this commonwealth may or can do in cases pending before them, and also to compel in like manner the production of all papers and other things relative to such inquest. Such subpoena and attachment SHALL be served & executed by the sheriff or by the Coroner himself or his Deputy , as the case may require.
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Manners of DeathManners of DeathNatural
Accident
Suicide
Homicide
Could Not Be Determined
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Manners of DeathManners of DeathNatural – due to Natural Disease process
Accident
Suicide
Homicide
Could Not Be Determined
PendingPSCA - CRNP 15
Manners of DeathManners of DeathNatural – due to Natural Disease process
Accident – Unfortunate incident / event
Suicide
Homicide
Could Not Be Determined
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Manners of DeathManners of DeathNatural – due to Natural Disease process
Accident – Unfortunate incident / event
Suicide – Death at one’s own hands
Homicide
Could Not Be Determined
PendingPSCA - CRNP 17
Manners of DeathManners of DeathNatural – due to Natural Disease process
Accident – Unfortunate incident / event
Suicide – Death at one’s own hands
Homicide – Death at the hand’s of another
Could Not Be Determined
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Manners of DeathManners of DeathNatural – due to Natural Disease process
Accident Unfortunate incident / eventAccident – Unfortunate incident / event
Suicide – Death at one’s own hands
Homicide – Death at the hand’s of another
Could Not Be Determined – Can not determine if death was due to Accident, Suicide or Homicide
PendingPSCA - CRNP 19
Manners of DeathManners of DeathNatural – due to Natural Disease process
Accident – Unfortunate incident / eventAccident – Unfortunate incident / event
Suicide – Death at one’s own hands
Homicide – Death at the hand’s of another
C ld N t B D t i d C t d t i ifCould Not Be Determined – Can not determine if death was due to Accident, Suicide or Homicide
Pending – Further investigation or testing is needed or being performed
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Manners of DeathManners of DeathNatural – due to Natural Disease process
Accident – Unfortunate incident / eventAccident – Unfortunate incident / event
Suicide – Death at one’s own hands
Homicide – Death at the hand’s of another
C ld N t B D t i d C t d t i ifCould Not Be Determined – Can not determine if death was due to Accident, Suicide or Homicide
Pending – Further investigation or testing is needed or being performed
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Pronouncing Death Pronouncing Death
Who can pronounce death in the Commonwealth of Pennsylvania:Commonwealth of Pennsylvania:
Coroner / Medical ExaminerPhysician DentistRegistered NurseCertified Registered Nurse Practitioner
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Certifying the Death Certificate Certifying the Death Certificate
Who can certify a Death Certificate in the Commonwealth of Pennsylvania:the Commonwealth of Pennsylvania:
Coroner / Medical ExaminerPhysicianDentistCertified Registered Nurse Practitioner
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35 P.S. 35 P.S. §§ 450.507 450.507 –– Professional Nurses Professional Nurses Pronouncing DeathPronouncing Death
(c) If circumstances surrounding the nature of death are not anticipated and require a Coroner’s investigation, the professional nurse SHALL SHALL notify the County Coroner, and the authority to release the body of the deceased to the funeral director SHALLSHALL be that of the Coroner.
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Two things to remember in a death investigationTwo things to remember in a death investigation
What started the Chain of events that led toWhat started the Chain of events that led to the death…
Sepsis due to paralysis due to motor vehicle accident
If the patient did not fall and sustained a head injury would he/she have died today….
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Certifying the Death CertificateCertifying the Death Certificate
In the Commonwealth of Pennsylvania, Physicians, Dentists and Certified Registered y , gNurse Practitioners can ONLY certify,
NATURAL DEATHSNATURAL DEATHS
Everything else falls directly under the Jurisdiction of the CoronerJurisdiction of the Coroner
Accident, Suicide, Homicide, Could not be determined & Natural
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Death CertificatesDeath Certificates
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Death CertificatesDeath Certificates
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Death CertificatesDeath Certificates
Pronouncer
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Death CertificatesDeath Certificates
PronouncerLicense #
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Completing a Death CertificateCompleting a Death Certificate
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Completing a Death CertificateCompleting a Death Certificate
23a – Date Pronounced
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Completing a Death CertificateCompleting a Death Certificate
23a – Date Pronounced23b Signature23b – Signature
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Completing a Death CertificateCompleting a Death Certificate
23a – Date Pronounced23b Signature23b – Signature23c – License Number
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Completing a Death CertificateCompleting a Death Certificate
23a – Date Pronounced23b Signature23b – Signature23c – License Number23d – Date Signed
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Completing a Death CertificateCompleting a Death Certificate
23a – Date Pronounced23b Signature23b – Signature23c – License Number23d – Date Signed24 – Time of Death
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Completing a Death CertificateCompleting a Death Certificate
23a – Date Pronounced23b Signature23b – Signature23c – License Number23d – Date Signed24 – Time of Death25 – Was ME/Coroner Contacted
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Completing a Death CertificateCompleting a Death Certificate
23a – Date Pronounced23b Signature23b – Signature23c – License Number23d – Date Signed24 – Time of Death25 – Was ME/Coroner Contacted26 – Cause of Death
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Completing a Death CertificateCompleting a Death Certificate
23a – Date Pronounced23b Signature23b – Signature23c – License Number23d – Date Signed24 – Time of Death25 – Was ME/Coroner Contacted26 – Cause of Death27 & 28 – Autopsy performed & findings
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Completing a Death CertificateCompleting a Death Certificate
23a – Date Pronounced23b – Signature23b Signature23c – License Number23d – Date Signed24 – Time of Death25 – Was ME/Coroner Contacted26 – Cause of Death26 – Cause of Death27 & 28 – Autopsy performed & findings29 – If Female: pregnancy information
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Completing a Death CertificateCompleting a Death Certificate
30 – Tobacco Use
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Completing a Death CertificateCompleting a Death Certificate
30 – Tobacco Use31 Manner of Death31 – Manner of Death
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Completing a Death CertificateCompleting a Death Certificate
30 – Tobacco Use31 Manner of Death31 – Manner of Death
Remember: Can only certify Natural Deaths
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Completing a Death CertificateCompleting a Death Certificate
30 – Tobacco Use31 Manner of Death31 – Manner of Death
Remember: Can only certify Natural Deaths
39a-c: Certifier’s Information
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Completing a Death CertificateCompleting a Death Certificate
By Law, only the Coroner or Medical Examiner canor Medical Examiner can complete injury information on the Death Certificate along with boxes 23a through 30.
We will complete box 2We will complete box 2 (Sex of Decedent) and box 4 (Date of Death)
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Case Scenario # 1Case Scenario # 1
81 year old MaleHospitalized for 6 daysNo InjuryMedical History: Past MI, HTN, CHF, COPDCause of Death: End Stage COPD
Can you certify the Death Certificate?
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Case Scenario # 1Case Scenario # 1
81 year old MaleHospitalized for 6 daysNo InjuryMedical History: Past MI, HTN, CHF, COPDCause of Death: End Stage COPD
Can you certify the Death Certificate?
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Case Scenario # 2Case Scenario # 2
20 year old Female Presents @ Emergency DepartmentMultiple injuries due to Motor Vehicle CollisionPronounced 30 minutes after arrival
Can you Certify the Death Certificate?
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Case Scenario # 2Case Scenario # 2
20 year old Female Presents @ Emergency DepartmentMultiple injuries due to Motor Vehicle Collision Pronounced 30 minutes after arrival
Can you Certify the Death Certificate?
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Case Scenario # 3Case Scenario # 3
45 year old MaleAdmitted to hospital 48 hours agoPast History: Subdural Hematoma, Admit Blood + heroin & cocainePronounced but no immediate Cause of DeathDeath
Can you certify the Death Certificate?
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Case Scenario # 3Case Scenario # 3
45 year old MaleAdmitted to hospital 48 hours agoPast History: Subdural Hematoma, Admit Blood + heroin & cocainePronounced but no immediate Cause of DeathDeath
Can you certify the Death Certificate?
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Case Scenario # Case Scenario # 44
51 year old MaleShot 19 ¾ years agoAt time of incident, working and healthySince then, paralyzed & direct medical treatment for sepsis, paralysis and injuriesinjuriesCan you certify the death?
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Case Scenario # Case Scenario # 44
51 year old MaleSh t 19 ¾Shot 19 ¾ years agoAt time of incident, working and healthySince then, paralyzed & direct medical treatment for sepsis, paralysis and injuriesCan you certify the death?
NO
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Contact InformationContact InformationSusan M. Shanaman
Attorney / PSCA Lobbyist240 N Third St
Scott M. Grim, D-ABMDILehigh County Coroner501 W Hamilton St240 N. Third St
Harrisburg, PA [email protected]
Patricia Ross, D-ABMDIBlair County Coroner920 25th Avenue
501 W. Hamilton StAllentown, PA [email protected]
Altoona, PA [email protected]
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