Acquiring the legal declaration of death is an important step that can usually only be done by a physician or coroner, and not, for example, by paramedics. However, some states allow registered nurses or even paramedics to make a declaration of death based on the person`s nursing attitude. It is difficult to understand why the hospice nurse could not come four to five hours after the call to inform him of the death of one of his patients. However, without knowing more, it is difficult to determine what your role would be in this situation. Surely it would have been a good idea to call the doctor and describe what you noticed, that there are no vital signs. The California Code also deals with the other type of unsupervised death, the one in which a physician did not take charge of the death. The California Code lists what a coroner must do if a death is not supervised by a physician, as described above. The coroner must conduct the same type of examination as in the case of an unsupervised death and the absence of immediate discovery of a body. The first step a coroner must take when notified of any type of unsupervised death is to send a deputy coroner or a member of the agency`s investigative team to the location of the deceased`s remains. The coroner`s office, usually in collaboration with local law enforcement, conducts an on-scene investigation to gather evidence of the underlying cause of death of the deceased.
If a doctor or coroner pronounces death, he or she may ask if an autopsy is desired. People usually only perform an autopsy if there is evidence of trauma, if the death occurred under unusual circumstances, or if it was unexpected in some way. The California Code allows a physician to confirm the cause of death of a person in his or her care, even if the death occurs outside the physician`s presence. This type of certificate assumes that the doctor saw the person within 20 days of death. This type of scenario is one in which a person dies alone, but death is detected immediately. My sister`s stepfather died at home. The hospice nurse was called at 10 a.m., but said she couldn`t come until four to five hours. It was horrible for me. As a registered nurse, could I have spoken or called her doctor and noticed the absence of vital signs, as I do in my work at the hospital? Or should we call 911, explain that it was not an emergency, and the emergency medical staff should have said that it certainly didn`t take them five hours.
The funeral home would not accept the body without announcing death, which I understand. What should have happened? The concept of an unattended death can be confusing. The main reason for this confusion is that California law deals with different scenarios when the term “unsupervised death” is used. When they are ready to receive the legal declaration of death, many people turn first to their loved one`s doctor. Your doctor knows your medical history, knows exactly how best to proceed in your area, and will advise you on next steps. Key to the situation is what your state law allows a nurse when it comes to determining death. There are about 20 states that allow nurses to do this (e.g., Nevada, New York, California, Florida), but the laws vary widely. For example, the law may require two nurses to make the advertisement or that it can only be made if a physician has issued an order to do so and the state Nursing Practice Act or other law permits it. The place of death also differs in these laws. Again, the law can only allow a nurse to pronounce a death in an acute care facility where no doctor is available, or it can only be allowed in nursing homes or home care facilities.
The other factor that may exist in these laws is that they can only apply to a nurse caring for the deceased patient and/or the nurse is an employee of a long-term acute care facility, hospice or home care organization. For the purposes of review, the coroner shall, within 24 hours or as soon as practicable thereafter if the suspected cause of death is sudden infant death syndrome and, in all other cases, may, at his or her discretion, take possession of the body, including the power to exhume it, and order that it be moved to an appropriate place. and perform or cause to be performed an autopsy or autopsy and perform or cause to be analyzed the stomach, stomach contents, blood, organs, fluids or tissues of the body. The coroner is entitled to retain only those body tissues removed at the time of the autopsy that he considers necessary or desirable for the investigation of the case or for the review of his findings. Nothing in this section prevents a coroner from performing at his or her discretion the autopsy of a victim of a sudden, unexpected or unexplained death or of a death known or suspected to have resulted from an accident, suicide, apparent criminal means or other death as described in section 27491. California Government Code § 27491.4. In general, only doctors or coroners can make a legal declaration of death. Surgical procedures by all California coroners require that the remains of the deceased remain in place until the initial examination of the place of death. Currently, California law requires that remains be transferred from the place of death to the coroner`s office from the place of death to the coroner`s office.
What types of deaths need to be autopsied? The coroner will conduct an autopsy within 24 hours or as soon as possible thereafter if an infant has died suddenly and unexpectedly. However, if the attending physician wishes to confirm that the cause of death is sudden infant death syndrome, an autopsy may be performed at the discretion of the coroner. If the coroner performs an autopsy in accordance with this section, the coroner must also confirm the cause of death. California Government Code § 27491.41. Once this is done, death can be confirmed, which is a separate step after proclamation. Certification includes determining the cause of death and signing the death certificate. A common example of medical personnel and family members of a deceased person trying to evade reporting and other requirements related to death laws is the death of flamboyant pianist and performer Liberace. (At the height of his career, Liberace was the highest-paid artist in the world.) Liberace`s heirs, his publicity team and his doctor made concerted efforts to hide the true cause of death.