A patient dies unexpectedly two hours after an elective operation in an English hospital. What must happen before a death certificate is issued?
Answer and explanation
Correct answer: C. Discuss with the medical examiner, with coroner referral if criteria are met
- Step 1: Deaths soon after surgery usually meet coroner referral criteria.
- Step 2: The statutory medical examiner system in England and Wales, in place since September 2024, scrutinises deaths not investigated by a coroner.
Answer
Discuss with the medical examiner, with coroner referral if criteria are met.
Why not the others: The certificate is issued by the nurse in charge on the ward that evening: Nurses do not issue the medical certificate of cause of death. The family sign the certificate once they have agreed the cause of death: Families do not certify death. The operating surgeon signs the certificate immediately without any other review: Immediate certification without review is no longer acceptable.
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