KORONER’s KORNER: Autopsies and Death Certificates

My apologies for missing several weeks of articles as I wanted to write this at the beginning of December. We have had several tragic deaths lately that delayed my writing as I conducted more in-depth investigations into the causes and manners of death. I have written about both autopsies and death certificates before, but these recent cases prompted me to repeat and reinforce some of the aspects of each, especially how long it may take to get results.

During this time, I also decided to pull my deceased son’s belongings out of the closet they were stored in. It has been over fifteen and a half years since my son, Richard Leo died. It is not that I thought I was over his death, but I did not realize how much pain the memories would bring back. It reinforced that while we may move on from the deaths of our loved ones, we never truly forget or get over them.

It also underlines the unpleasant fact that death is not a ‘one-time’ and done circumstance. Dealing with death consists of more than the death itself and the mourning process. It goes way beyond the family division and pain of sorting out and distributing personal effects; there is a lot of paperwork that must be done that will stretch the grieving process out far longer than you want it to.

Insurance policies need to be settled; property, ownership, and titles need to be reassigned, and accounts need to be finalized. Some states’ vehicle registration offices and private businesses will accept my signed and notarized letter stating my finding that a death has occurred and my intention to sign the death certificate. Most will want an actual death certificate, and insurance companies want a death certificate with a cause of death listed. When I am unsure of the cause and manner of death, I order an autopsy or at a minimum, toxicological testing to help me ascertain if drugs, alcohol, or other chemicals had contributed to the death. That means that I normally will not sign a death certificate until all the testing results are back so I can determine the cause and manner of death.

An autopsy consists of several steps. The first phase, the medical examination of the body, is sometimes completed in days. But the associated microscopic examination of tissue samples and the laboratory tests of various body fluids will take weeks to months. The forensic pathologist has a full schedule, doing autopsies one or two days a week, examining the histological and cytologic samples of the cells, and testifying in court. All of these take many more hours than the physical examination of the body.

After receiving the results of laboratory findings, the pathologist weighs the evidence of everything, including the coroner’s report on the context of the death, and makes a final diagnosis of what he believes the manner of death was. Then he writes a long technical report that is checked for errors, edited, simplified, and sent to the coroner’s office.

It is only at that point that I, as a coroner, can be sure that I have all the information needed to make an informed decision to legally certify the cause and manner of death. That is why it sometimes takes six to eight weeks to get a death certificate signed. For my own son’s death on 20 May, the death certificate wasn’t signed and entered into vital records until 16 August: almost three months. The final settlement of properties and other issues stretched out almost a year. Many businesses don’t realize their customer has died and wait months before sending notices, which require written answers and sometimes notarized copies of death certificates to close the accounts.

That means you are never quite free of the thought that there is something you have yet to do. So, after all the extended pain of settling things, we put Richard’s things away in boxes, closets, and on shelves. At one point, we donated some of his clothes to those who could wear them. But the other day, maybe because I was seeing so many others in pain losing their loved ones, I decided to go through all of Richard’s things again.

Talk about opening a wound. I think when you lose someone close, you never quite get over it. I would hate to think I would ever get to the point where I did not shed a tear for someone I had loved and lost.

I hope that this addition to my previous articles on death certificates and autopsies has helped you understand that things may not only take a while, but they may also take a long while. Many times, if not most, there is nothing we can do to hurry up the process. We just have to pray for patience to get through.

Respectfully and sadly submitted for your reading,

Danny Leo Green,

Coroner, Cedar County