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Funeral directors concerned about reliability of death certificate information

State funeral directors are deeply concerned about the reliability of cause-of-death determinations on many Oklahoma death certificates.
BY RANDY ELLIS Modified: November 6, 2010 at 12:24 am •  Published: November 6, 2010

State funeral directors are concerned about a lack of integrity in cause-of-death determinations on a growing number of Oklahoma death certificates, said Richard Dugger, president-elect of the Oklahoma Funeral Directors Association.

Because of a huge backlog of cases, the Oklahoma City office of the state medical examiner's office increasingly has been waiving jurisdiction in cases that appear to be natural deaths and leaving it up to local physicians to sign off on the causes of those deaths, Dugger said.

"We've got physicians, who haven't seen patients in 14 months, in some cases ... who are being asked to sign documents when they truly don't know an actual cause of death," Dugger said.

Some of those doctors are refusing to sign, and rightfully so, he said.

"What we're concerned about is this doctor-shopping scenario where a doctor is the attending physician on record, but hasn't seen a patient in 30 days and is not going to sign the document," Dugger said.

"So now, I'm going to go find a doctor who is going to sign the document. There's no integrity to that — none at all. And that's going on in rural Oklahoma all over the state. It's very concerning."

A cause of death determination often has important ramifications, he said.

Because insurance policies often cover only specific things or have exclusions, the cause of death on a person's death certificate can make a difference of hundreds of thousands of dollars in how much money the deceased person's family receives, he said.

"That family has to have some peace of mind," he said. "The medical examiner's office has a responsibility to the taxpayers of Oklahoma to be sure that the cause of death is accurate on that document."

Dugger said he believes it is the responsibility of the medical examiner's office to determine causes of death when individuals die who haven't seen a doctor within 30 days. He said board rules require that.

Timothy Dwyer, chief investigator for the medical examiner's office, sees things differently.

"It's a touchy subject and we have to look at these on a case-by-case basis," he said. "The recurring theme is that the primary care physicians simply don't want to sign a death certificate, even though it's their legal responsibility to do so."

Dwyer said it is the medical examiner's job to establish a medical history and make sure there has been no trauma or suspicion of foul play. Once it is determined the death is natural, it is proper for the office to waive jurisdiction and leave it up to the person's attending physician to determine a cause of death, he said.

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