NATURAL DEATHS UNDER THE CARE OF A PHYSICIAN:
INVESTIGATION BY THE DUPAGE COUNTY CORONER
NATURAL DEATH INVESTIGATIONS
Most people are under the care of a physician and have no suspicious circumstances at the time of their death. In these situations the attending physician will certify the death certificate at the approval of the Coroner. The Physician attending the patient for the condition that caused patients' death is responsible, by law, to sign the death certificate.
When a person has an attending physician and dies in a hospital emergency room, or within 24-hours after being admitted to a hospital, or at home, or at any public place, or under any other kind of unknown circumstance, the Coroner’s office is notified. The circumstances and details of the death are reviewed. If it appears to be a death of natural causes the attending physician will be contacted. The circumstances are reviewed with the attending physician. If the deceased has a medical history that supports a cause of death that is consistent with the circumstances surrounding the death and the physician agrees, the case is released to the doctor to sign the death certificate.
If the attending physician does not have enough medical history to support the cause of death the death is investigated and the death certificate is signed and filed by the Coroner.
The Coroner also reviews all deaths certified on a Medical Certificate of death when a cremation permit is requested to assure that the death should have been certified as a natural cause of death and there is no need for further investigation.
DO NOT RESUSCITATE (DNR)
The purpose of cardiopulmonary resuscitation (CPR) is the prevention of sudden, unexpected death. This decision to Do Not Resuscitate (DNR) is made by a physician and patient or the physician and the patient’s family. The physician must sign this order and therefore is responsible as the treating physician authorizing that no extraordinary means will be deployed. As the treating physician attending the patient for the condition that caused patients' death you are responsible, by law, to sign the death certificate.
HOME DEATHS WHEN ENROLLED WITH A HOSPICE PROGRAM
Patients diagnosed with a terminal illness and choose to enroll in a hospice program whether at the hospital or home require an attending physician. The hospice patient must have a valid DNR (Do Not Resuscitate) order on file. A police/fire/emergency agency is not called to respond to the scene in this type of situation and the Deputy Coroner on-call may not respond to the residence. Either the hospice nurse or the funeral director reports the death to the DuPage County Coroner’s Office. The report is taken over the phone and the Deputy Coroner taking the call releases the body to the funeral director. The Physician attending the patient for the condition that caused patients' death is responsible, by law, to sign the death certificate.
HOME DEATHS WITHOUT HOSPICE:
If your patient dies at home under these circumstances, 911 should be called and when death has been confirmed the Coroner’s Office will be contacted and requested to respond to the scene. The circumstances of the death will be reviewed and the body examined to confirm that there were no suspicious aspects. You, as the attending physician will be contacted. If all appears in order and you are willing to certify the death, you may sign the death certificate. If you do not feel comfortable making that decision the Coroner's office will certify the Death Certificate but will greatly value your input into the the probabilities as to the cause of death.
If a person dies at home and the death was not expected, the Coroner’s Office will be notified and will investigate the death. When the investigation is completed, the body will be released to the funeral home chosen by the family.
NURSING HOME DEATHS:
If a person is enrolled in a hospice program and dies in a nursing home the hospice nurse reports the death to the Coroner.
If the nursing home is considered a state facility they must report all deaths. Most deaths in private nursing homes in DuPage County report are reported. However, if a person is in a nursing facility because of injury or they have sustained a recent fall or injury, or any other trauma, the death must be reported.
The DuPage County Coroner’s Office is mandated to monitor nursing home deaths in such a way as to monitor neglect and abuse. We take this responsibility very seriously while also understanding that most nursing homes are excellent facilities who take the care of these elderly patients very well. The investigation may include testing and autopsy dependent on the circumstances.
The Physician attending the patient for the condition that caused patients' death is responsible, by law, to sign the death certificate.