Death certification

NCEPOD asked for details of the mode of death, and the cause of death, as stated on the death certificate. As might be expected, the main modes of death included cardiac failure, multi-organ dysfunction syndrome and respiratory failure, but the variability of responses did not allow any detailed analysis.

Similarly, the way in which death following aneurysm repair was described on death certificates was very varied. Some entries would include conditions such as haemorrhage or cardiac failure, with aortic aneurysm entered under (b) or (c) of Part 1 of the death certificate; other entries would have “Ruptured aortic aneurysm” alone. Some entries would have “Aortic aneurysm” in Part 1, others in Part 2. Most worryingly, there were some death certificates that made no mention of “Aortic aneurysm” in the death certificate at all, although it was quite clear that the patient would not have died at that time unless they had had an operation for repair of an aneurysm.

NCEPOD has commented on inadequacies in the formulation of the cause of death in death certificates before ^10,11. These data provide further evidence of failings in the completion of the medical certificates of cause of death. The Office of National Statistics derives data for the main causes of death from the bottom line of Part 1 in the medical certificate of the cause of death. If doctors complete the certificate wrongly they are misleading relatives and distorting national statistics on the causes of death of the population.