Death Investigation Guidelines
Criteria for Reportable Deaths
After a death is reported to the Medical Examiner's Office, the Medical Examiner will determine whether the office will or will not assume jurisdiction and responsibility for signing the death certificate. In order to make this decision, an investigation is performed. Investigation may include review of medical records (the office can review records, by law, without family permission), interviews, an investigation at the place of death, clarification of prescriptions, etc. If jurisdiction is assumed, a forensic pathologist will determine if an autopsy will be performed. The law allows Medical Examiners to perform autopsies without family permission or signature on a consent form. Autopsies are not performed in all cases.
In certain deaths, the pathologist will sign a death certificate based on the decedent's medical records, without an autopsy. An example of this situation would be an elderly person who falls and sustains a hip fracture; the patient becomes hospitalized, a surgery is performed to repair the fracture, and postoperatively the patient develops pneumonia and dies. Because the chain of events that lead to death is well documented in the medical records, and no foul play is suspected, the Medical Examiner may sign the death certificate without performing an autopsy, even though the office assumed jurisdiction.
Deaths which may come under the jurisdiction of the Spokane County Medical Examiner are defined by state statute and include, but are not limited to the following criteria. Any such death should be reported to the Office of the Medical Examiner as soon as possible.
- Persons who die suddenly when in apparent good health and without medical attendance within 36 hours preceding death
- Circumstances which indicate death was caused in part, or entirely, by unnatural or unlawful means (i.e. accident, traffic, suicide, homicide), or when death occurs within one year following a bad accident
- Deaths that occur outside of a hospital or skilled nursing facility from unknown or obscure causes
- Deaths caused by any violence whatsoever, whether the primary cause or any contributory factor in the death
- Where there is good reason to believe that death was the result of a violent contagious disease or contagious disease representing a major Public Health hazard and the diagnosis cannot be made without involvement of the medical examiner
- When no next of kin can be reached and the decedent remains unclaimed by family, friends, or church organizations
- Prematurely born neonates and infants, where death was a direct result of prematurity, and there is medical evidence of the premature birth being the result of maternal physical injury or maternal drug abuse
- Cases of fetal demise occurring at or beyond 20 weeks of gestation and there is medical evidence of the fetal demise being the result of maternal physical injury or maternal drug abuse
Note: Fetal deaths when gestation is less than 20 weeks do not need to be reported
Related State Statutes
- RCW 68.08.010 Coroner's [Medical Examiner's] jurisdiction over remains
- RCW 70.58.150 "Fetal Death," "evidence of life," defined
- RCW 70.58.160 Certificate of death or fetal death required