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Na, Lee, Kim, Min, Kim, Chung, Na, and Park: Discrepant Causes of Death between Medical Death Certificates and Autopsy Reports (II)
Original Article
Korean Journal of Legal Medicine

Korean Journal of Legal Medicine 2012; 36(1): 27-33.

Published online: 29 May 2012

DOI: https://doi.org/10.7580/KoreanJLegMed.2012.36.1.27

Discrepant Causes of Death between Medical Death Certificates and Autopsy Reports (II)

Jong In Na1, Young Jik Lee1, Hyung Seok Kim1, Byeong Woo Min1, Hye Jung Kim1, Seung Hyun Chung1, Joo Young Na2, Jong Tae Park1, 3

1Department of Forensic Medicine and the Research Institute of Forensic Science, Chonnam National University Medical School, Gwangju, Korea.

2Division of Forensic Medicine, National Forensic Service, Seoul, Korea.

3Chonnam National University Law School, Gwangju, Korea.

Corresponding author (comaforever@naver.com, jtpark@jnu.ac.kr)

Received 20 April 2012       Accepted 10 May 2012

Copyright © 2012 The Korean Society for Legal Medicine

Abstract

The postmortem examination certificate and death certificate provide proof of death and supply important data used to establish health statistics. However, the format of the form and the accuracy of postmortem examination and death certificates yield errors that must be corrected by comparison with postmortem studies. We reviewed 401 autopsies performed in the Department of Forensic Medicine of Chonnam National University Medical School from January 1, 2009 to December 31, 2011 and compared the reports with their postmortem examination certificates and death certificates. Of the 252 cases submitted with death certifications, 60 cases were concordant with the cause of death on the autopsy report. Eighty-nine cases had clear descriptions of the cause of death. Of these cases, 47 were from postmortem examination, 42 were from death certificates; 17 were natural deaths, 72 were unnatural. Concordance in each group was 59.6% (28/47 cases), 76.2% (32/42 cases), 41.2% (7/17 cases), and 73.6% (53/72 cases). We thus identified various types of errors in postmortem examination and death certificates. This study reveals a high rate of discrepancy between causes of death reported on death certificates and postmortem examination certificates. There are a few useful death certificate and postmortem examination certificates that can be used as a model, based on which we propose several remedies to increase the accuracy of death and postmortem examination certificates.

Keywords: postmortem examination certificate, death certificate, death, discrepancy, autopsy

Figures and Tables

Table 1
Discrepancy of Cause of Death between Medical Death Certificates and Autopsy Reports
kjlm-36-27-i001

PEC1): Postmortem examination certificate; DC2): Death certificate

p-value: by Chi-square test

Table 2
Discrepancy of COD1) between Medical Death Certificates and Autopsy Reports in the Cases in which COD1) was Clearly Described. The Cases which COD1) are Unclearly Described or Autopsy is Recommended are Included to the 'Uncertain'
kjlm-36-27-i002

COD1) : Cause of death; PEC2) : Postmortem examination; DC3) : Death certificate

p-value: by Chi-square test

Table 3
Discrepancy of COD1) between Medical Death Certificates and Autopsy Reports in the Cases which COD1) is Clearly Described, According to Manner of Death
kjlm-36-27-i003

COD1) : Cause of death; PEC2) : Postmortem examination; DC3) : Death certificate

p-value: by Fisher's exact test

Table 4-1
Cases of Natural Death after Autopsy which are Discordant with Medical Certificates
kjlm-36-27-i004

PEC1) : Postmortem examination, COD2) : Cause of death; HCMP3) : Hypertrophic cardiomyopathy; IHD4) : Ischemic heart disease; COPD5) : Chronic obstructive pulmonary disease

Table 4-2
Cases of Unnatural Death after Autopsy which are Discordant with Medical Certificates
kjlm-36-27-i005

PEC1) : Postmortem examination, COD2) : Cause of death; SAH3) : Subarachnoid hemorrhage; SDH4) : Subdural hemorrhage

Notes

This work was supported by the NAP (National Agenda Project) of the Korea Research Council of Fundamental Science & Technology.

References

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