When a death occurs, an official ruling regarding the cause must be documented on the death certificate. The term “deferred cause of death” is a temporary status assigned by a Medical Examiner or Coroner. This designation indicates that the immediate examination did not yield a conclusive answer. It functions as a placeholder, signaling that a final determination requires additional investigation and analysis. This initial certificate allows necessary procedures, such as funeral arrangements, to move forward while the forensic inquiry continues.
Defining the Deferred Status
The status of “deferred” means the medical-legal authority has jurisdiction over the case but has not yet established the precise cause or manner of death. This is not a final finding of “unknown” but rather a designation of “pending investigation.” A Medical Examiner or Coroner assigns this status when an immediate physical examination, such as an autopsy, is insufficient to make a definitive ruling. The deferred status is entered onto the death certificate, which must be filed within a statutory time limit after death, usually a few days. This temporary documentation permits the family to proceed with the disposition of the remains without waiting for the completion of laboratory tests.
Circumstances Requiring Deferral
Deferral is required when the circumstances surrounding the death are complex, non-natural, or medically unclear. One common reason is the need for comprehensive forensic toxicology screening, often suspected in cases of drug overdose. Even when an autopsy is performed, the internal examination may not reveal the presence or concentration of drugs or other chemical substances necessary for a final ruling. Deaths involving trauma, where the extent of internal injury or the sequence of events is not immediately clear, also necessitate a deferred status. This also applies to cases requiring specialized analysis, such as microscopic tissue examination (histology), to identify disease or cellular damage that may have contributed to the death.
The Investigative Process and Final Ruling
The deferred period is dedicated to the collection and analysis of necessary forensic evidence and background information. Specialized laboratory procedures, like toxicology analysis, are initiated on samples of blood, urine, or tissue collected during the post-mortem examination. These tests often involve complex methods to identify and quantify a wide range of substances. Because these analyses are different from clinical screenings, they can take several weeks or even months to complete. Investigators also gather police reports, review the deceased person’s medical records, and interview witnesses to establish the full context for the death.
Once all laboratory results, investigative reports, and microscopic analyses are complete, the Medical Examiner or Forensic Pathologist reviews the entire case file. This review establishes the medical cause of death, such as a specific injury or disease. It also determines the manner of death, which is categorized as natural, accident, suicide, homicide, or undetermined. After this final determination, the Medical Examiner’s office amends the original death certificate on file with the state vital statistics office. The family can then obtain certified copies of the final death certificate showing the conclusive cause and manner of death.