Physicians' FAQS continued

cont'd from "When does a case fall under the jurisdiction of the Medical Examiner?"

Additionally, if the patient has a current prescription from a physician for a disease that might have caused death, the patient is considered to be “attended.” Therefore, unless there is an injury that directly results in death or contributes to the death (see above), these deaths do not fall under medical examiner jurisdiction.

“Suddenly, when in apparent good health” means a person has no known disease that might cause death, and has died suddenly. Those who have hypertension, diabetes and/or arteriosclerotic cardiovascular disease (to cite the most frequently encountered) are not “in good health”, no matter how “well-controlled” their disease may be. Sudden cardiac deaths in this patient population are common. If the circumstances of their terminal event are not suspicious for foul play and are consistent with sudden cardiac death, these deaths would not be medical examiner cases.

When do I need to report a death to the Medical Examiner’s Office?

Pursuant to F.S.S. 406, the medical examiner’s offices in each of Florida’s 24 medical examiner districts investigate all unexpected/unattended deaths and deaths due entirely to or contributed to by trauma. Under certain circumstances, a District Medical Examiner’s Office is compelled by statute to assume jurisdiction and issue the death certificate. There has been some confusion as to what cases fall under medical examiner jurisdiction and must be reported.

Most deaths that occur in District 5, which includes Marion, Lake, Citrus, Sumter and Hernando Counties, that are due to traffic accidents, homicides and other types of obvious trauma are reliably reported to the Medical Examiner’s Office by law enforcement. However, in some cases the Office must depend on physicians, hospitals, and other medical facilities to report deaths that occur under the care of a physician where trauma, drug overdose, or other injurious event contributed to the death. Statute 406 (specifically 406.12) compels any person in the District who becomes aware of a case falling under medical examiner to report the case to the Medical Examiner’s Office in the district in which the death occurred,

If a patient’s death is directly due to trauma, the death would automatically fall under medical examiner jurisdiction. In cases where trauma contributed to the death, many physicians are unaware of the medicolegal approach to the determination of the manner of death when both natural and unnatural causes of death coexist. A simple rule of thumb states that if an unnatural cause of death (trauma, drug overdose, electrocution, drowning, etc.) plays a contributory role in the death, then the manner of death is unnatural (i.e., accidental, suicidal or homicidal), and, therefore, the case falls under the jurisdiction of the medical examiner. Hip fractures are typical contributors of death.

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