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Pathology and Laboratory Medicine

The Importance of Proper Death Certification During the COVID-19 Pandemic

Educational Objective
To understand the importance of providing a proper death certificate during the COVID-19 pandemic

1 Credit CME

JAMA

Published Online: June 10, 2020

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Article Information and Disclosures

James R. Gill, MD^1,2;

Maura E. DeJoseph, DO^1,2

Author Affiliations

¹Office of the Chief Medical Examiner, State of Connecticut, Farmington
²Department of Pathology, Yale School of Medicine, New Haven, Connecticut

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Death certificate data are used to monitor local, regional, and national mortality trends to improve public health and public safety. Accurate death certification related to coronavirus disease 2019 (COVID-19) is vital to understand the extent and progression of the pandemic. Death certificate data can inform the public and policy makers on the progress of the COVID-19 pandemic and provide important information about who is dying, where they are from, and what were their associated medical conditions. Public health mortality data are only as good as the quality of the death certificates, but proper death certification has been a long-standing challenge in the US.¹^- 3 The COVID-19 pandemic has highlighted shortcomings that may compromise an accurate count of COVID-19 deaths.

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Article Information

Corresponding Author: James R. Gill, MD, Office of the Chief Medical Examiner, State of Connecticut, 11 Shuttle Rd, Farmington, CT 06032 (jgill@ocme.org).

Published Online: June 10, 2020. doi:10.1001/jama.2020.9536

Conflict of Interest Disclosures: None reported.

References

McGivern L , Shulman L , Carney JK , et al. Death certification errors and the effect on mortality statistics. Public Health Rep. 2017;132(6):669-675.PubMed Google Scholar Crossref

Pritt BS , Hardin NJ , Richmond JA , Shapiro SL . Death certification errors at an academic institution. Arch Pathol Lab Med. 2005;129(11):1476-1479.PubMed Google Scholar

Messite J , Stellman SD . Accuracy of death certificate completion. JAMA. 1996;275(10):794-796.PubMed Google Scholar Crossref

Cambridge B , Cina SJ . The accuracy of death certificate completion in a suburban community. Am J Forensic Med Pathol. 2010;31(3):232-235.PubMed Google Scholar Crossref

Richardson S , Hirsch JS , Narasimhan M , et al. Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York City area. JAMA. 2020;323(20):2052-2059.PubMed Google Scholar Crossref

National Center for Health Statistics. Guidance for certifying deaths due to coronavirus disease 2019 (COVID-19). Accessed June 2, 2020. https://www.cdc.gov/nchs/data/nvss/vsrg/vsrg03-508.pdf

AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
1.00 CME points in the American Board of Surgery’s (ABS) Continuing Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.