Medicolegal Death Investigation System Workshop Summary (2003) / Chapter Skim
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8. Medicolegal Death Investigation, Public Health, and Health Care
8. Medicolegal Death Investigation, Public Health, and Health Care
Pages 38-48
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From page 38... ...
But barriers stand in the way of adopting a national surveillance system that uses common data elements from ME/C offices. Understanding the value of ME/C data for public health and surveillance and the barriers to developing a national system might be appropriate for an IOM study.
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From page 39... ...
surveillance can be actively translated into a new public health intervention, once a risk factor is found. If the case cluster had not been i(ientified by pooling data from many jurisdictions, an opportunity to prevent deaths of children would have been lost.
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From page 40... ...
This linked dataset is a treasure trove for understanding trends and risk factors associated with firearm homicides and suicides and for evaluating the impact of different prevention strategies in curbing firearm deaths. Quality of Death Certificate Data Robert Anderson Data frown death certificates have welI-recognized strengths and weaknesses.
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From page 41... ...
Other types of certification errors are an implausible sequence in the listed causes of death, late or unfired amendments to original death certificates, and incorrect diagnoses. Various studies have attempted to determine the frequency of incorrect diagnoses.
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From page 42... ...
was designed to examine the relationship between death investigation and the infor~nation-collection activities used for surveillance. The assessment found common processes and information content but wide variability in the vocabulary used to capture the same content and in the expertise and resources devoted to information technology.
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From page 43... ...
Overall, the findings from the CDC program and Wisconsin suggest the importance of systematic activities to define data requirements, in recognition that there are different responsibilities across law enforcement, public safety, and public health, to standardize data quality through cleath-investigation methods and data standards; and to integrate and coordinate data through information nanage~nent, data interchange, and information resources. The best and most efficient approach is to leverage money from different agencies that track many of the same data elements rather than to proceed health outcome by health outcome.
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From page 44... ...
Every Medicare patient is entitled to a prepaid autopsy, as long as tile hospital accepts Medicare patients. The overwhelming majority of hospital administrators are either unfamiliar with the policy or disbelieve it, partly because the Centers for Medicaic!
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From page 45... ...
In the past, those organizations failed to support autopsies, because of concern that results would give ammunition to families in lawsuits against them; but they are now beginning to recognize that autopsies may offer a shield to protect them against liability claims. Medicolegal Death Investigation and Medical Malpractice and Other Civil Suits Carry Peterson Medical examiners often find themselves ill-equipped for malpractice cases and other civil suits.
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From page 46... ...
Attorneys often badger the medical examiner and ask aggressive questions that are rarely asked in front of a jury, because the attorney would lose tl~e jury's sympathies. Medical examiners are thus highly uncomfortable at the prospect of a deposition.
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From page 47... ...
DISCUSSION Hospital Autopsies Medical errors increasingly fall under the purview of the medical examiner as a result of the forces working against hospital pathology, especially the broader cultural issue of death denial. The ME/C system is the last bastion of people who know how to do autopsies and know how to do them well.
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From page 48... ...
. If their awareness were increased, tiled would slave greater motivation to code certificates accurately; greater and more sustained training of medical students anti residents in filling out death certificates correctly is needed (Robert Anderson, Kathleen Toomey, Steve Hargarten)
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