Part X. Procedures for Filing Death Certificates
12VAC5-550-350. A proper and complete medical certification of cause of death defined.
A complete and properly executed medical certification of cause of death shall mean the entry by a physician or medical examiner of a definite medical diagnosis of the underlying cause of death and related conditions following the instructions indicated on the death certificate. This may be variously:
1. Supported by clinical findings of the physician who attended the deceased for the illness or condition that resulted in death;
2. Supported by tentative clinical findings that may or may not be supported by the gross findings of an autopsy; or
3. Supported by autopsy findings where necessary to establish a definite medical diagnosis of cause of death.
In cases where an autopsy is to be performed, the physician or medical examiner shall not defer the entry of the cause of death pending a full report of microscopic and toxicological studies. In any case where the autopsy findings significantly change the medical diagnosis of cause of death, a supplemental report of the cause of death shall be made by the physician or medical examiner to the registrar as soon as the findings are available. (As examples: If it is clear that a patient dies of "cancer of the stomach," report the cause while a determination of the histological type is being carried out. Similarly, if it is clear that a death is from "influenza," do not delay the medical certification while a laboratory test is being carried out to determine the strain).
Statutory Authority
§ 32.1-273 of the Code of Virginia.
Historical Notes
Derived from VR355-29-100 § 10.1, eff. April 1, 1995.
12VAC5-550-360. Responsibility of the attending physician.
When a patient dies, the physician in charge of the patient's care for the illness or condition shall be responsible for executing and signing the medical certification of cause of death as follows:
1. The physician shall execute and sign the medical certification of cause of death on the death certificate form prescribed by the State Registrar.
2. In an case where an autopsy is scheduled and the physician wishes to await its gross finding to confirm a tentative clinical finding, he shall give the funeral service licensee notice that he attended the patient and when he expects to have the medical data necessary for the certification of cause of death. If the provisions of 12VAC5-550-350 cannot be adhered to, he shall indicate that the cause is pending and sign the certification. Immediately after the medical data necessary for determining the cause of death have been made known, the physician shall, over his signature, forward the cause of death to the registrar.
3. If the physician is unable to establish the cause of death or if a death is within the jurisdiction of the medical examiner, he shall immediately report the case to the local medical examiner and advise the funeral service licensee of this fact. If the medical examiner does not assume jurisdiction, the physician shall sign the medical certification noting special circumstances and exception.
4. An associate physician who relieves the attending physician while he is on vacation or otherwise temporarily unavailable may certify to the cause of death in any case where he has access to the medical history of the case, provided that he views the deceased at or after death occurs and that death is from natural causes. In all other cases in which a physician is unavailable, the funeral service licensee shall contact the medical examiner.
5. When the attending physician shall have given the person in charge of an institution authorization in writing, the person in charge of such institution, or his designated representative, may prepare the medical certification of cause of death in cases where all pertinent aspects of the medical history are a part of the official medical records and the death is due to natural causes. In such instances, the signature shall be that of a physician.
Statutory Authority
§§ 32.1-12 and 32.1-250 of the Code of Virginia.
Historical Notes
Derived from VR355-29-100 § 10.2, eff. April 1, 1995; amended, Virginia Register Volume 19, Issue 26, eff. October 8, 2003.
12VAC5-550-370. Responsibility of the medical examiner.
When a medical examiner assumes jurisdiction in a death or when a medically unattended death occurs without medical attendance a known medical history or information, the medical examiner shall be responsible for executing and signing the medical certification of cause of death as follows:
1. The medical examiner shall, at the time of releasing a body to a funeral service licensee or person who first assumes custody of a dead body, or as soon as practicable thereafter, execute and sign the medical certification of cause of death on the death certificate form prescribed by the State Registrar.
2. In any case where an autopsy is scheduled and the medical examiner wishes to await its gross findings to confirm a tentative clinical finding, he shall give the funeral service licensee notice as to when he expects to have the medical data necessary for the certification of cause of death. If the provisions of 12VAC5-550-350 cannot be adhered to, he shall indicate that the cause is pending and sign the certification. Immediately after the medical data necessary for determining the cause of death have been made known, the medical examiner shall, over his signature, forward the cause of death to the registrar.
3. In any case where a death has been referred to the medical examiner because a physician in attendance is deceased or physically incapacitated and there was no associate physician, the medical examiner shall prepare and sign the medical certification of cause of death.
Statutory Authority
§§ 32.1-12 and 32.1-250 of the Code of Virginia.
Historical Notes
Derived from VR355-29-100 § 10.3, eff. April 1, 1995; amended, Virginia Register Volume 19, Issue 26, eff. October 8, 2003.
12VAC5-550-380. Responsibility of the hospital or institution.
When a patient shall die in a hospital or institution, and the death is not under the jurisdiction of the medical examiner, the person in charge of such institution, or his designated representative, shall where feasible and where the cause of death is known, aid in the preparation of the death certificate as follows:
1. Place the full name of the deceased on the death certificate form and obtain from the attending physician the medical certification of cause of death.
2. If authorized in writing by the attending physician, the person in charge, or his designated representative, may prepare the medical certification of cause of death in cases where all pertinent aspects of the medical history are a part of the official hospital records and the death is due to natural causes. The signature shall be that of a physician.
3. Present the partially completed death certificate identified by the name and the complete medical certification to the funeral service licensee.
4. In a case of long-term residence by a patient in a state institution, a death certificate including personal particulars of the deceased may be prepared for presentation to the funeral service licensee.
Statutory Authority
§§ 32.1-12 and 32.1-250 of the Code of Virginia.
Historical Notes
Derived from VR355-29-100 § 10.4, eff. April 1, 1995; amended, Virginia Register Volume 19, Issue 26, eff. October 8, 2003.
12VAC5-550-390. Responsibility of the funeral service licensee.
Each funeral service licensee who has been authorized to take custody of a dead human body shall exercise the following responsibilities with respect to the preparation and filing of the death certificate:
1. When he arrives to take custody of the body, he shall first ascertain whether an attending physician or local medical examiner has established the cause of death as follows:
a. The funeral service licensee shall obtain the medical certification of cause of death from the physician if the death is from natural causes. An associate physician or person in charge of an institution may prepare the medical certification as outlined in 12VAC5-550-360.
b. If a physician attended the deceased but did not complete the medical certification of cause of death, the funeral service licensee shall immediately contact such physician in person or by telephone to be certain that he was the attending physician and to ascertain whether the physician is to assume responsibility for the medical certification or to refer the case to the medical examiner.
c. When a medical examiner assumes jurisdiction in a death, or when a physician in attendance is incapacitated, the funeral service licensee shall obtain the signed medical certification of cause of death from the medical examiner as required by subdivision 3 of 12VAC5-550-370.
2. The personal history of the deceased and the facts of the death shall be obtained from the best source possible. This source may be variously: a member of the immediate family of the deceased who possesses the necessary information; a hospital records custodian whose records contain the necessary information; or the local medical examiner having jurisdiction over a case. The name of the informant, his address and relationship to the decedent shall be entered on the death certificate. The facts required as to the manner and place of disposal of the body or its removal from the Commonwealth shall be entered over the signature of the funeral service licensee. He shall personally sign the certificate and print or type the name of his firm.
3. Except as outlined in 12VAC5-550-410, a satisfactory death certificate shall be filed with the city, county, or special registrar in the city or county where death occurred, or a dead body is found, prior to final disposal of the body or its removal from the Commonwealth, and within three days. In cases where a completed medical certification is not available when the funeral service licensee takes possession of a body, he shall not move the body from the place of death until so authorized by the local medical examiner or until the attending physician has advised him that death is from natural causes and the physician is able to prepare the medical certification of cause of death. In every case, the removal of a dead human body from the city or county of death is unlawful unless notice is given to the city, county, or special registrar by telephone or in person. Such notice shall consist of the name of the deceased, date and place of death, and the name of the attending physician or of the medical examiner, as the case may be, and, if the body is to be removed, the destination within the Commonwealth. Such notification shall be made during the next available business hours of the registrar following the time of death. After business hours, in independent cities and in designated counties, such notification shall be made immediately on assumption of custody of the deceased to the registrar's representative.
Statutory Authority
§§ 32.1-12 and 32.1-250 of the Code of Virginia.
Historical Notes
Derived from VR355-29-100 § 10.5, eff. April 1, 1995; amended, Virginia Register Volume 19, Issue 26, eff. October 8, 2003.
12VAC5-550-400. Out-of-state transit permits.
A. The body of any person whose death occurs in Virginia or whose body shall be found dead therein shall not be removed from the Commonwealth unless an out-of-state transit permit on a form prescribed by the State Registrar has been issued by the city, county, or special registrar of the city or county where the death occurred or the body was found except as outlined in 12VAC5-550-410.
B. No out-of-state transit permit shall be issued until a proper certificate of death is filed except as outlined in 12VAC5-550-410.
C. A certificate of death shall be considered to be properly filed:
1. When all items thereon have been answered in the manner prescribed by the State Registrar; and
2. When the certificate has been presented for filing with the city, county, or special registrar of the city or county where the death occurred or the body was found, or, in emergency cases, with the city or county registrar of the area to which removal was made within the Commonwealth.
Statutory Authority
§ 32.1-273 of the Code of Virginia.
Historical Notes
Derived from VR355-29-100 § 10.6, eff. April 1, 1995.
12VAC5-550-410. Emergency cases: Filing of death certificates elsewhere.
A. Under the conditions of § 32.1-266 of the Code of Virginia, the following situations are declared to be proper reasons for emergency extensions of time periods for filing a completed death certificate:
1. A completed or pending medical certification is unavailable.
2. Personal data concerning the deceased is temporarily unavailable.
3. The body must be moved immediately out of the Commonwealth.
B. If one or more of the above situations exists and the conditions of subdivision 3 of 12VAC5-550-390 have been complied with by the funeral service licensee when the body is to be moved, any authorized registrar, or registrar's representative, may issue an out-of-state transit permit. Such permit shall be issued upon application by a funeral service licensee and the presentation by the funeral service licensee, over his signature only, of a death certificate form complete in as many known details as possible.
C. The incomplete death certificate form originally furnished to the registrar as outlined in subsection B of this section is to be placed by the funeral service licensee with a completed death certificate as soon as the missing data become known or the medical certification is obtained, or within 10 days, whichever occurs first.
D. Under emergency provisions and the conditions of subdivision 1 c of 12VAC12-550-390, the death certificate may be filed with a registrar other than the registrar at the place of death. When a registrar of an area other than the place of death receives a completed death certificate, he shall not sign nor number the certificate, but shall make a notation in the left-hand margin indicating his name and whether or not an out-of-state permit has been issued. The registrar receiving the death certificate shall immediately forward the death certificate to the city or county registrar at the place of death.
Statutory Authority
§§ 32.1-12 and 32.1-250 of the Code of Virginia.
Historical Notes
Derived from VR355-29-100 § 10.7, eff. April 1, 1995; amended, Virginia Register Volume 19, Issue 26, eff. October 8, 2003.
12VAC5-550-420. Forwarding "pending cause" death certificates.
A death certificate received by a city or county registrar which contains a signed medical certification of cause of death, but the cause is not complete by reason of a pending inquest, investigation, or autopsy should be sent to the State Registrar on the regular reporting date with completed records. If the cause of death is completed by the presentation of a second and complete certificate before the original certificate is sent to the State Registrar, the original incomplete certificate should be marked "VOID." The completed death certificate should be processed as a current certificate and should be forwarded to the State Registrar. If the cause of death is completed by a properly signed query form or other statement, the cause of death information may be added to the incomplete death certificate by the State Registrar.
Statutory Authority
§ 32.1-273 of the Code of Virginia.
Historical Notes
Derived from VR355-29-100 § 10.8, eff. April 1, 1995.
12VAC5-550-430. Disinterment permits.
A. Unless so ordered by a court of competent jurisdiction, a body shall not be disinterred for removal or transportation until an application for disinterment has been submitted to the city or county registrar or to the State Registrar.
B. The city or county registrar at the place from which disinterment is to be made shall issue a disinterment permit in triplicate. One copy shall be retained by the funeral service licensee to whom issued, one copy filed with the sexton or person in charge of the cemetery in which disinterment is to be made, and one copy to be used during transportation and filed with the sexton or person in charge of the cemetery of reinterment. The State Registrar may issue a letter of authorization in lieu of individual permits when numbers of bodies are to be moved in one operation from the same place of disinterment to the same place of reinterment.
C. A disinterment permit shall not be required if a body is to be disinterred and reinterred in the same cemetery; however, the sexton or other person in charge of the cemetery shall establish a record relative to the facts of disinterment and reinterment within the cemetery.
D. A body kept in a receiving vault shall not be regarded as a disinterred body until after expiration of 30 days.
Statutory Authority
§§ 32.1-12 and 32.1-250 of the Code of Virginia.
Historical Notes
Derived from VR355-29-100 § 10.9, eff. April 1, 1995; amended, Virginia Register Volume 19, Issue 26, eff. October 8, 2003.