Funeral home personnel and the Medical Examiner

The funeral home employees need to be aware of the types of death that should be reported to the Medical Examiner (See pp. 1:1 - 1:4). Whenever it becomes apparent that a death should be reported, it is incumbent upon the funeral home personnel to report the death to the Medical Examiner at once. Medical Examiner notification must be done before embalming. Such deaths should be reported even though the decedent's physician may have agreed to certify death. Early reporting will prevent needless disruption or inconvenience to the family and the funeral director. Funeral home personnel should not assume that a hospital, nursing home, etc. has already notified the Medical Examiner in such instances, but should notify the Medical Examiner directly for assessment.

When death comes under the jurisdiction of the Medical Examiner, funeral personnel may not remove a body from the place of death, without permission of the Medical Examiner. It is an unacceptable practice to make a removal of the body on the verbal opinion of the family that the doctor will sign the death certificate. The doctor should be contacted as well as the jurisdictional Police Agency in order to learn whether or not the death will be certified. In addition to his/her own observations, funeral home personnel should inquire of both family and physician whether there was any accident or injury associated with the death.

In some instances family physicians will be willing to certify death because the cause of death is consistent with the previous medical condition even though the physician did not visit or attend the patient in the thirty-six (36) hours before death.

In these cases, in order to meet the legal requirements of the reporting statute, the Medical Examiner's Office must be contacted. A "No Jurisdiction Assumed" number will be assigned to the case.

There are deaths involving injury that can be certified by the attending physician. This occurs most commonly in falls in the elderly. It is the policy of the Medical Examiner's Office to consider all significant fractures sustained by the elderly in a fall as contributing to death and therefore accidental in character. These deaths require an investigation.

The attending physician may complete the certificate as long as the circumstances under which the injury was sustained are clearly identified. Such deaths are given a regular investigative case number, and a record of the injury and the circumstances surrounding the injury is prepared. Frequently these deaths are not reported directly to the Medical Examiner's Office by the physician because they are unaware of the requirement to do so.

Consequently, it is necessary that the funeral director immediately notify the Medical Examiner of the injury-related death so that the physician or funeral home can accurately complete the death certificate. The completed original certificate is to be brought to the Medical Examiner's Office for review. A Medical Examiner case number must appear on the death certificate for filing with Vital Statistics.

This process is separate from the "NJA" procedure where it is not necessary that the certificate be reviewed by the Medical Examiner. The NJA reporting only requires that the NJA number appear on the certificate when filed with Vital Statistics.

If at any time there is confusion regarding the administrative processing of death certificates, the Medical Examiner's Office should be contacted as soon as possible, in order that any delay associated with filing of a completed death certificate can be avoided.

Burial/transit permits

A permit is required from Vital Statistics before a body can be buried, cremated, or removed to another county or state. In accordance with Vital Statistics, the Medical Examiner's Office will issue permits on weekends, holidays, after business hours, in emergency situations only. It is stressed that this service is provided to augment and not to replace the burial-transit permit function of Vital Statistics.

Indigent remains

In accordance with RCW 68.50.010 the King County Medical Examiner has jurisdiction over unclaimed human remains.

In most instances, the Medical Examiner staff is able to locate next-of-kin. However, in those few deaths where a representative cannot be located, the King County Medical Examiner has been given authority under Executive Ordinance #11073 to authorize cremation.

Where there is no known legal next-of-kin or representative, or when the funeral director determines that the next-to-kin does not have the ability to pay for disposition, the funeral director is eligible to apply directly to the King County Indigent Remains Program (206-731-2887) for financial assistance including payment for cremation.