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Death Certification and Death Investigation

4. What deaths must be reported to the coroner?

Deaths reportable to the coroner include the following:

(a). Deaths occurring at home or other place of residence:

  • where the deceased was not attended by a doctor during the last illness;
  • where the deceased was not seen and treated by a doctor within one month prior to date of death;
  • where death was sudden or unexpected;
  • where death may have resulted from an accident, suicide or homicide;
  • where the cause of death is unknown or uncertain;
  • where concerns are expressed by any person in relation to a death.

(b). Deaths occurring in hospital:

  • where a patient dies before a diagnosis is made and the general practitioner is also unable to certify the cause;
  • when death occurred whilst a patient was undergoing an operation or under anaesthesia;
  • where death occurred during or as a result of any procedure;
  • where any question of negligence or misadventure arises in relation to the treatment of the deceased;
  • where death resulted from an industrial disease;
  • where death was due to neglect or lack of care (including self-neglect);
  • where death occurred in a Mental Hospital.
  • where death may have resulted from an accident, suicide or homicide.

(c). A death is reported by a member of the Garda Siochana:

  • where death may have resulted from an accident, suicide or homicide;
  • where death occurred in suspicious circumstances;
  • where death is unexpected or unexplained;
  • where a dead body is found;
  • where there is no doctor who can certify the cause of death.

(d). A death is reported by the Governor of a prison;

  • immediately following the death of a prisoner.

(e). Other categories of reportable death include:

  • sudden infant deaths;
  • certain still-births;
  • death of a child in care;
  • where human bones are found;
  • where a body is to be removed out of Ireland.

N.B. A detailed list of reportable deaths is given in Appendix A .

If in doubt as to whether a death is properly reportable please consult with the coroner or his staff who will advise accordingly. The fact that a death is reported to the coroner does not mean that an autopsy will always be required.

5. What happens when a death is reported?

Where death occurred suddenly or unexpectedly the coroner will make inquiries to ascertain if there is a doctor who is in a position to certify the cause of death. The doctor must have seen and treated the person within a month prior to death, the cause of death must be known and must be due to natural causes. If these conditions are satisfied, and there are no other matters requiring investigation, the coroner will permit the doctor to complete the Medical Certificate of the Cause of Death, and the death will be registered accordingly.

Where a Medical Certificate of the Cause of Death is not available the coroner will arrange for a postmortem examination of the body. If the postmortem examination shows that death was due to natural causes, and there is no need for an inquest, a Coroner’s Certificate will be issued to the Registrar of Births and Deaths who will then register the death and issue the Death Certificate. (See note 12).

If death is due to unnatural causes an inquest must be held. The death will be registered by means of a Coroner’s Certificate when the inquest is concluded (or adjourned in some cases).

Prior to inquest (or whilst awaiting the postmortem report) the coroner’s office will provide an Interim Certificate of the Fact of Death which may be acceptable to banks, insurance companies and other institutions.

8. The Postmortem Examination

The postmortem examination (autopsy) is a procedure to establish or clarify the cause of death. All body cavities (head, chest and abdomen)are examined and the organs dissected. Small blocks of tissue and blood samples may be retained for further examination. Occasionally it is necessary to retain a whole organ (or organs) for more detailed examination in order to establish the cause of death.

It should be emphasised that in the majority of cases no organs are retained. Where an organ is retained the family will be informed. (See note 9 and Appendix B ).

All stages of the postmortem examination will be carried out in a professional manner. There is no disfigurement of the body which may be viewed afterwards, and in the same manner, as if no postmortem had been performed.

N.B. It may be several weeks before the postmortem report is received from the pathologist. If a toxicology (drug) screen is required it may be several months before the postmortem report is completed.

Queries relating to postmortem reports should be made to the coroner’s office and not to the hospital concerned.

A death cannot be registered until the postmortem report is received at the coroner’s office.

Prior to inquest (or whilst awaiting the postmortem report) the coroner will provide on request an Interim Certificate of the Fact of Death. (See note 5 ).

9. When is an organ retained?

Occasionally it is necessary to retain an organ (or organs) for detailed examination.

An organ may be retained after a coroner’s autopsy only for the purpose of establishing or clarifying the cause of death. Where the examination of an organ is necessary to determine the cause of death it must be retained. The consent of the spouse or next-of-kin is not required for such retention, but the family will be informed, and will be requested to express their preference for ultimate disposition (disposal) of the organ. (See note 8 and Appendix B ).

Retention of an organ for any other purpose by a hospital or pathologist (e.g. for teaching, research or therapeutic purposes) requires specific consent from the spouse or next-of-kin. A consent form must be signed by the family in such cases.

N.B. Doctors should not seek consent from the next-of-kin for autopsy where the cause of death is unknown. Such cases must be discussed with the coroner. Where an autopsy is (or will be) directed by the coroner in relation to an unnatural death consent is not required and must not be sought. Doctors should understand that the Organ Retention Form (see Appendix B) is not a consent form for autopsy. The Organ Retention Form is required to establish the wishes of a spouse or next-of-kin in regard to ultimate disposal of a retained organ after a coroner’s autopsy. This should be carefully distinguished from any consent for a hospital (‘house’) or academic autopsy in a non-coroner case.

11. When is a body released?

The body will normally be released to the spouse or next-or-kin immediately after the postmortem examination has been completed (irrespective of whether or not an inquest is to take place) (See note 10 ). In homicide cases a body may not be released from the Dublin City Mortuary for up to five days.

N.B. In these cases funeral directors should contact the coroner’s office or mortuary before funeral arrangements are made.

12. How is a death registered?

A death is registered by the Registrar of Births and Deaths for the registration district in which death occurs. A relative or other eligible person must obtain a Medical Certificate of the Cause of Death from the medical practitioner who attended the deceased during the last illness. A death is registered when a qualified informant (often a spouse or next-of-kin) attends at the office of the Registrar of Births and Deaths and provides the following information:

  • Date and place of death
  • Full name and surname of deceased
  • Marital status of deceased (married, bachelor, spinster, widowed or divorced)
  • Sex of deceased
  • Age or date of birth of deceased
  • Occupation of deceased

The person registering the death must also produce a Medical Certificate of the Cause of Death signed by a doctor who treated the deceased within one month prior to death. A death is registered in the district in which death occurred and not where the deceased was resident.

Where a death is reported to the coroner and is the subject of a postmortem examination or inquest, registration will be effected by means of a Coroner’s Certificate after the postmortem or inquest. The Death Certificate will then be available from the District Registrar’s office.

13. The Medical Certificate of the Cause of Death

The Medical Certificate is completed by a doctor who has seen and treated the deceased person within one month prior to the date of death. The doctor must know the cause of death which must be due to natural illness or disease. No unnatural cause of death can be certified by a doctor. All unnatural deaths must be reported to the coroner and only the coroner may certify an unnatural cause of death. Where a doctor is uncertain that a death is natural he/she must discuss the case with the coroner.

The form of the Medical Certificate is as follows:

CAUSE OF DEATH

I

Disease or condition directly leading to death

I

(a)……………………………

due to (or as a consequence of)

II.

Antecedent causes

Other significant conditions

II

(b)…………………………….

due to (or as a consequence of)

(c)…………………………….

N.B. No unnatural cause of death should appear on the certificate. A medical certificate which refers to any unnatural cause of death will be rejected by the Registrar and the case will be referred to the coroner. Such late referral will cause difficulties for all concerned.

The certificate is brought to the District Registrar’s office where the death is registered and the Death Certificate issued.

Where death occurs in hospital, registration may be effected by a member of the hospital staff in cases where the coroner is not involved.

Information on registration may be obtained from: Superintendent Registrar’s Office, Joyce House, 8 - 11 Lombard Street East, Dublin 2.

Tel:- 01 6711968, 01 6711974

Hours: Monday - Friday 9.30 a.m. - 12.30 p.m. 2.15 p.m. - 4.30 p.m.