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The following opinion is presented on-line for informational use only and does not replace the official version. (Mich Dept of Attorney General Web Site - www.ag.state.mi.us)



STATE OF MICHIGAN

FRANK J. KELLEY, ATTORNEY GENERAL


Opinion No. 5983

September 28, 1981

MEDICAL EXAMINERS:

Death certificates

Notification of medical examiner

MORTUARY SCIENCE:

Death certificates

Notification of medical examiner

PHYSICIANS AND SURGEONS:

Death certificates

PUBLIC HEALTH:

Death certificates

VITAL STATISTICS:

Death certificates

The state registrar of vital statistics may not instruct local registrars to decline to accept medical certification of the cause of death by the attending physician who has determined the cause of death in cases where the deceased expired without medical attendance during the 48 hours prior to the hour of death.

In cases where the deceased expired suddenly, unexpectedly, accidentally, violently, as the result of suspicious circumstances, or without medical attendance within 48 hours prior to the hour of death and where the attending physician cannot accurately determine the cause of death, the county medical examiner shall be notified of such death by (1) any physician or person in charge of any hospital or institution, or (2) by the funeral director, embalmer or other person, prior to: (a) removal of the body from the place where death occurred; or (b) preparation of the body for burial or shipment.

Bailus Walker, Jr.Ph.D.

Director

Michigan Department of Public Health

3500 North Logan

Lansing, Michigan

Your predecessor had requested my opinion on the following question:

May the Department of Public Health instruct local registrars to refuse to accept death certificates where the cause of death was determined and the medical certification completed by the attending physician, where the deceased had not received medical attendance within 48 hours of death?

The Public Health Code, 1978 PA 368; MCLA 333.1101 et seq; MSA 14.15(1101) et seq, Sec. 2813(2)(c), authorizes the state registrar, who is appointed by the Director of the Department of Public Health, to control and supervise local registrars in the operation of the system of vital statistics.

The Public Health Code, 1978 PA 368, supra, Sec. 2815(2)(c), authorizes a local registrar to:

'Examine each vital record before accepting it for registration. If the record is incomplete or unsatisfactory, the local registrar shall require the submission of additional information necessary to complete the record before accepting it for registration.'

Therefore, where a vital record is incomplete or unsatisfactory, the local registrar is empowered to require the submission of such additional information as is necessary to complete the record prior to accepting such record for registration.

Pursuant to the Public Health Code, 1978 PA 368, supra, Sec. 2843, the funeral director is responsible for reporting a death and gathering requisite information and medical certifications for the death certificate, which shall be filed with the local registrar within 72 hours after the death. See OAG, 1945-1946, No 0-3424, p 320 (April 26, 1945). Prior to disposition of the body, the funeral director must obtain an authorization for final disposition (burial permit). The Public Health Code, 1978 PA 368, supra, Secs. 2848, 2850. In most cases, a burial permit may not be issued until a death certificate has been filed with the local registrar. OAG, 1973-1974, No 4770, p 60 (July 18, 1973).

Further, it must be noted that Public Health Code, 1978 PA 368, Sec. 2843, supra, provides:

'(1) . . ..

'(a) The medical certification [of death] shall be completed and signed not later than 48 hours after death by the attending physician; or in the absence of the attending physician, by a physician acting as his or her authorized representative; or in the absence of an authorized representative, the county medical examiner; or in the absence of the county medical examiner, the county health officer or the deputy county medical examiner. If the death occurred in an institution, the medical certification shall be completed and signed not later than 48 hours after death by the attending physician. . . .

'(b) . . ..

'(2) The medical certification shall be completed and signed not later than 48 hours after the death by the physician, as described in subsection (1)(a).

'(3) A death record shall be filed with the local registrar of the district where the death occurred not later than 72 hours after the death.'

See also the Public Health Code, 1978 PA 368, supra, Sec. 2844(1).

The Public Health Code, 1978 PA 368, supra, Sec. 2844(2), provides:

'When an investigation is required under Act No. 181 of the Public Acts of 1953 . . ., the county medical examiner shall determine the cause of death and shall complete and sign the medical certification within 48 hours after taking charge of the case.'

1953 PA 181, as amended; MCLA 52.201 et seq; MSA 5.953(1) et seq, creates the office of county medical examiner in certain counties, and provides for investigations and autopsies in certain instances, regardess of consent, where an individual's death is due to violence, negligence, or other acts or omissions of a criminal nature. OAG, 1979-1980, No 5828, p 1112 (December 12, 1980). 1953 PA 181, supra, provides for an investigation as to the cause of death in sections 2, 5 and 7. Pertinent to your inquiry is 1953 PA 181, Sec. 2, supra, which provides:

'County medical examiners or deputy county medical examiners shall make investigations as to the cause and manner or death in all cases of persons who have come to their death by violence; or whose death was unexpected; or without medical attendance during the 48 hours prior to the hour of death unless the attending physician, if any, is able to determine accurately the cause of death; or as the result of an abortion, whether self-induced or otherwise. If any prisoner in any county or city jail dies while so imprisoned, the county medical examiner, upon being notified of the death of the prisoner, shall make an examination upon the body of the deceased prisoner.' [Emphasis supplied.] Further, 1953 PA 181, supra, Sec. 3, states:

'Any physician and any person in charge of any hospital or institution, or any person who shall have first knowledge of the death of any person who shall have died suddenly, unexpectedly, accidentally, violently, or as the result of any suspicious circumstances, or without medical attendance during the 48 hours prior to the hour of death unless the attending physician, if any, is able to determine accurately the cause of death, or in any case of death due to what is commonly known as an abortion, whether self-induced or otherwise, shall notify the county medical examiner or his deputy immediately of death.' [Emphasis supplied.]

Thus, under 1953 PA 181, Secs. 2 and 3, supra, where an individual is without medical attendance during the 48 hours prior to the hour of death and where the attending physician is able to accurately determine the cause of death, no investigation by the county medical examiner is required.

Therefore, where a person expires who had received medical attendance within 48 hours prior to the hour of death, and where the attending physician, if any, has determined the cause of death, notification of the county medical examiner is not required. In such instances, medical certification of death shall be completed and signed by the attending physician within 48 hours after such death. See OAG, 1947-1948, No 50, p 185 (January 27, 1947) which construed the predecessor provisions to the Public Health Code, 1978 PA 368, Sec. 2843, supra, and 1953 PA 181, Sec. 3, supra.

Where the other causes of death specified in 1953 PA 181, Sec. 3, supra, exist and where the attending physician is unable to determine accurately the cause of death of any person who expired without medical attendance during the 48 hours prior to death, 1953 PA 181, Secs. 2 and 3, supra, require that the county medical examiner be notified so that the medical examiner may determine whether to conduct an examination or investigation. OAG, 1932-1934, p 166 (January 20, 1933); OAG, 1945-1946, No 03061, p 188 (January 22, 1945). Also pertinent is 1953 PA 181, supra, Sec. 4:

'It shall be unlawful for any funeral director, embalmer or other person to remove the body from the place where death occurred or to prepare the body for burial or shipment, when such funeral director, embalmer or other person knows or upon reasonable investigation should know that death may have occurred in a manner as indicated in section 3, without first notifying the county medical examiner or his deputy and receiving permission to remove, prepare for burial or ship such body. Any person who violates the provisions of this section is guilty of a misdemeanor and may be imprisoned not exceeding 1 year, or fined not exceeding $500.00, or both.' [Emphasis supplied.]

Further, 1953 PA 181, supra, Sec. 5, as last amended by 1980 PA 401, in pertinent part, provides:

'(1) When a county medical examiner has notice that there has been found within his or her county or district the body of a person who is supposed to have come to his or her death in a manner as indicated in section 3, the medical examiner shall take charge of the body, and if, on view of the body and personal inquiry into the cause and manner of the death, the medical examiner considers a further examination necessary, the county medical examiner or a deputy may cause the dead body to be removed to the public morgue. If the investigation is for the reason only that the dead person had no medical attendance during 48 hours before the hour of death, and if the dead person had chosen not to have medical attendance because of his or her bona fide held religious convictions, removal shall not be required unless there is evidence of other conditions stipulated in section 3. . . .'

The purpose of 1953 PA 181, Secs. 3 and 4, supra, in imposing upon a funeral director, embalmer, and other persons the obligation to notify the county medical examiner is:

'. . . to prevent the disturbance of the body of a person dying under any of the circumstances named in the statute (1) without first notifying the coroner and getting his consent. This will, in many instances, aid in the discovery of crime. Any other interpretation of the term would, in my opinion, thwart the very purpose of the statute. The evident intent of the Legislature was to require the action of a coroner in all cases of death where a physician has not seen the patient within thirty-six hours of death.' OAG, 1932-1934, p 166, 168-169, supra, [Emphasis supplied.]

It is my opinion, therefore, that the state registrar of vital statistics may not instruct local registrars to decline to accept medical certification of the cause of death by the attending physician who has determined the cause of death, where the deceased had not received medical attendance within 48 hours of death.

It is further my opinion that in cases where the deceased expired suddenly, unexpectedly, accidentally, violently, as the result of suspicious circumstances, or without medical attendance within 48 hours prior to the hour of death and where the attending physician is unable to accurately determine the cause of death, the county medical examiner shall be notified of such death by (1) any physician or person in charge of any hospital or institution, or (2) by the funeral director, embalmer or other person, prior to: (a) removal of the body from the place where death occurred; or (b) preparation of the body for burial or shipment.

Frank J. Kelley

Attorney General

(1) The Code of Criminal Procedure, 1927 PA 175, ch XIII, Sec. 19; MCLA 773.19; MSA 28.1187, repealed by 1980 PA 506, section 2, contained essentially the same circumstances of death presently set forth in 1953 PA 181, Sec. 3, supra, which require notification of the county medical examiner. 2 OAG, 1956, No 2471, p 98. (February 27, 1956).

 


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