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Doctor Taking Notes


Here are the official handbooks that guide the industry norms behind the death investigation process, as well as educational and practical resources offered by others and our own organization to assist you in navigating the cause-of-death determination process to achieve an accurate record

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Medical Examiners' and Coroners' Handbook on Death  Registration and Fetal Death


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Physicians' Handbook on Medical Certification of Death


Both CDC handbooks on death certification state that the cause of death provided by a medical certifier is merely a medical opinion that can change from provider to provider.

"Most individuals will eventually experience the death of a loved one; when this occurs, knowledge of death certification and registration processes can help people deal with death by having advance knowledge of what to expect—or even what should be expected—when a death certificate is prepared..."
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Cause of Death and The Death Certificate

From: Randy Hanzlick, MD, FCAP, Editor

According to the CDC, each state has different requirements for which deaths require investigation or autopsy. Here is the list of characteristics of death requiring investigation in each state:



The unfortunate reality is that a national shortage of medical examiners certified to perform autopsies or in depth medical record investigations exists. This means that most of our deceased loved ones do not get the benefits of a more thorough investigation into the direct causes or contributing factors that led to their death. The consensus in the scientific and medical literature is that an average of 1/3 of causes recorded on death certificates are inaccurate. Read some of the research yourself, in our educational archive of scholarly articles on the subject:

During the first few days or weeks after the death, being in communication with the medical certifier that is determining causes of death for your loved one can help ensure that the most thorough investigation of medical facts is being considered and included on the final death certificate. Reach out to one of our accuracy advocates if you need more information on how best to navigate this communication process with a medical certifier.



If the death  certificate has already been registered with the State in which the death occurred, a family can still reach out to the medical certifier listed on the record and request that they amend the record to reflect a more accurate cause of death or include contributing factors that were missing on the original certificate. See our State-by-State amendment resource guide by clicking the link below:



For families that have the financial resources, an autopsy or medical record investigation can be provided by private practice medical examiners. If the county or State medical examiner did not deem your loved ones' death a required investigation or the family feels the investigation performed by the state medical examiner/coroner office was unsatisfactory, they can always seek a second opinion from private practice medical examiners.

See the resource link below for fee-for-service private autopsy companies that might be available to assist.  

Operation Room


"This list is offered as a service to members of the public seeking a pathologist to perform an autopsy or perform forensic consultation. The list consists of members of the NAME who expressed an interest in performing autopsies on a fee-for- service basis. All list members are pathologists, and none has paid to be included on this list.

This list is provided in the hopes of providing families with opportunities and options."

Below are a few educational videos we could find on cause-of-death reporting and inaccuracy issues.

Here at Factual 
Reporting Advocacy Network, we know this issue needs more attention and we are on a mission to create the subject-specific, concise educational content that meets the publics needs.

Please consider learning more about our vision and supporting our mission for increased educational content on this issue here:

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