death certificates

Tom Benzoni benzonit at GMAIL.COM
Fri May 6 13:17:31 UTC 2016

Permission to ask a poking question?
All on this list who actually, today, fill out death certificates?
I do, and I can't believe how archaic they are. And how much useless
nonsense they contain and don't contain.

I'm an old ER doc. Permission to rant?
I remember when GP's knew their patients and didn't mind having their names
in the family bible. (That's where death records were stored.)
When I'd declare a patient dead, I'd fill out the certificate that they
were, indeed, dead, and the GP would fill out their history. (I don't have
the history, so I can't attest to any more than their heart stopped.)

Now, no one but me talks to the family, offers condolences, and fills out
the certificate.
I put in what little nonsense I know and the family must be content to see
some stranger's name for generations to come.
See a problem? And I hear this from all the ER docs with whom I speak.
I'd like to hear if this is common cause or special cause variation.

And I don't think data from death certificates is worth the paper they're
on, whether physical or electronic paper.


PS: anyone done a study on death certificates comparing entered data to
Medicare Diagnosis Database, non-deidentified? I.e., are the diagnoses
Medicare has on their beneficiaries appearing on death certs?

On Thu, May 5, 2016 at 12:39 PM, Elizabeth Regan <lizregan53 at>

> I would not favor adding medical error to death certificates for a variety
> of reasons but the chief one being that it is so hard to define and while
> is obvious to those who want to see improvement, it is less obvious to
> those who want to avoid the concept.  At the point where there is broader
> consensus on how to identify and reduce medical error (especially
> diagnostic error) I think it will be easier to record and track the event.
> I believe strongly that it is critical to do that, but we are not there
> yet.
> I have just completed a project to adjudicate cause of death in nearly a
> 1000 deaths for a large cohort study.  The project involves reviewing both
> death certificates and medical records.  At that level of review I did not
> see evidence of diagnostic error or other errors.  Now that I consider the
> project in light of this discussion - I guess that is interesting.
> I don’t interpret this to mean that none of those subjects experienced
> error, but rather to reflect on the invisibility of error in our record
> keeping.
> I wonder about the feasibility of re-reviewing the data with a more
> critical eye and finding more.  However, I don’t really think I would find
> much.
> Liz Regan
> Moderator: David Meyers, Board Member, Society to Improve Diagnosis in
> Medicine
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Moderator: David Meyers, Board Member, Society to Improve Diagnosis in Medicine

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