Death certificate hitch

‘Business Dilemmas’

Dr Catherine Wills

Dr Catherine Wills responds to a private GP’s query about providing additional information following completion of a Medical Certificate of Cause of Death.

Dilemma 1

Was death due to something else?

Q One of my elderly patients has recently died. She had terminal cancer and was receiving palliative care at home.

I had seen her about five days before her death and had prescribed some antibiotics for a chest infection. Her symptoms deteriorated during the night and she was taken to the A&E department by her son.

She sadly died not long after her arrival. I was asked by the Coroner’s office to sign the death certificate and after discussion with the doctor who treated her that night, her son and the Coroner, it was agreed appropriate for me to sign the certificate and provide a cause of death.

I have just spoken to her niece who was also present at the time of death. She told me the doctor had diagnosed pneumonia and prescribed intravenous antibiotics. A nurse had begun to administer these when the patient said she felt unwell and deteriorated very suddenly, before suffering a cardiac arrest.

No attempts at resuscitation were made, as a DNAR order was in place and the family agreed with this. The niece was concerned that her aunt’s deterioration seemed to coincide with the administration of the antibiotics and that these contributed to her death, but there was no reference to this in the notification of death form I got from the hospital.

The niece did not want me to speak to the Coroner about it and the son and other close family members did not want a post mortem examination carried out.

I do have sympathy for the niece, but I am not sure what my obligations are now that I have been told this information.

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