Natural Deaths Investigated by the DuPage County Coroner
Natural Death Investigations
Most people are under the care of a physician and have no suspicious circumstances at the time of their death. In these situations the attending physician will certify the death certificate at the approval of the Coroner.
When a person does not have an attending physician and dies in a hospital emergency room, or within 24-hours after being admitted to a hospital, or at home, or at any public place, or under any other kind of unknown circumstance, the Coroner’s office is notified. The circumstances and details of the death are reviewed. If it appears to be a death of natural causes the attending physician will be contacted. The circumstances are reviewed with the attending physician. If the deceased has a medical history that supports a cause of death that is consistent with the circumstances surrounding the death and the physician agrees, the case is released to the doctor to sign the death certificate. If the attending physician does not have enough medical history to support the cause of death, or if the attending physician is not available, or if the attending physician refuses to certify the death, the death is investigated by the Coroner.
Many methods are involved in proper death investigation. Toxicology samples are obtained and sent to a laboratory for analysis. A decision is made as to the necessity for an autopsy. Medical records may need to be subpoenaed from a hospital or doctor.
When the necessary medical records have been obtained and the toxicology and autopsy reports are complete, and it is evident that the death being investigated is from natural causes, the death certificate is signed and filed by the Coroner.
The Coroner also reviews all deaths certified on a Medical Certificate of death when a cremation permit is requested to assure that the death should have been certified as a natural cause of death and there is no need for further investigation.
Do Not Resuscitate (DNR)
The purpose of cardiopulmonary resuscitation (CPR) is the prevention of sudden, unexpected death. Sometimes people feel they do not want CPR to be initiated, such as cases of terminal, irreversible illness, when death is expected. A physician can issue an order to the effect that no CPR measures be initiated on behalf of the patient. This is usually a decision made by a physician and patient or the physician and the patient’s family. The physician and the patient or the physician and the family member that has Medical Power of Attorney for the patient must sign this order. This order is referred to as a DNR, or DO NOT RESUSCITATE ORDER. If the patient is in the hospital the staff is made aware of this order. If the patient is at home they should have this order readily available so that if 911 is called, the responding agency knows about the order and does not initiate CPR.
Home Deaths When Enrolled with a Hospice Program
Some people who have been diagnosed with a terminal illness choose to enroll in a hospice program and stay at home rather than a hospital setting. There are many hospice programs serving DuPage County. A hospice staff member can help the patient and family cope with managing care in a home setting. They can also provide support during this stressful and emotional time. They will often be in attendance at the time of death, or immediately after, and will call the doctor and funeral director the family has chosen. The hospice patient must have a valid DNR (Do Not Resuscitate) order on file. The funeral director arranges for the removal of the remains in a quiet manner. A police agency is not called to respond to the scene in this type of situation and the Deputy Coroner must be called but may not respond to the residence. Either the hospice nurse or the funeral director reports the death to the DuPage County Coroner’s Office. The report is taken over the phone and the Deputy Coroner taking the call releases the body to the funeral director.
Home Deaths Without Hospice
Some people choose to take care of a loved one at home and do not want to enroll in a hospice program. Usually some type of home health professional is involved in their case and visits the home on a regular basis, usually reporting to the attending physician. As the subject’s condition deteriorates, they may be hospitalized shortly before death, or, they may die at home. If they die at home under these circumstances, 911 should be called and when death has been confirmed the Coroner’s Office will be contacted and requested to respond to the scene. The circumstances of the death will be reviewed and the body examined to confirm that there were no suspicious aspects. The attending physician will be contacted. If all appears in order and the physician is willing to certify the death, the funeral director is called for removal and the remains are released to the funeral home.
If a person dies at home and the death was not expected, the Coroner’s Office will be notified and will investigate the death. When the investigation is completed, the body will be released to the funeral home chosen by the family.
Nursing Home Deaths With Hospice
Those who reside in a nursing home may also have the option of enrolling in a hospice program. The hospice agency can provide support for the family and patient in a nursing home setting. If the family cannot visit the patient very often because of distance or other factors, the hospice nurse can serve an invaluable service of providing support for both the family and the patient. If a person is enrolled in a hospice program and dies in a nursing home the hospice nurse reports the death to the Coroner.
Nursing Home Deaths Without Hospice
If the nursing home is considered a state facility they must report all deaths. Most deaths in private nursing homes in DuPage County report are reported. However, if a person is in a nursing facility because of injury or they have sustained a recent fall or injury, or any other trauma, the death must be reported.
The DuPage County Coroner’s Office is mandated to monitor nursing home deaths in such a way as to monitor neglect and abuse. We take this responsibility very seriously while also understanding that most nursing homes are excellent facilities who take the care of these elderly patients very well. The investigation may include testing and autopsy dependent on the circumstances.