A Study of Cause of Death Certificates in India

In the present study a total of 890 Cause of Death Certificates were examined Retrospectively from Eight different Centers during the period 2008-2013 ,of which 258 were retrieved from Hospital records and 632 from the Autopsy records ,were examined for appropriateness of completion and the ability to construct a logical cause of death cascade. None of the Autopsy reports had a provision for the Standard Cause of Death recordings. Though Medico Legal Autopsy Contributed to only 15% of the minimal standards and rest 75% deviated from the accepted Standards and concluded with Mechanism or Mode of Death. Similarly in Hospital death cases 30.4% satisfied minimal Standards and 69.8% of it were inappropriate in its completion and deviated from the Standards. The Demographic characters were inadequate in 72% of the Certificates. Only 14% of the Cause of Death statement after Medico Legal Autopsy were satisfying the ICD 10 Codes [2] and 98% of the certificates lacks information on Contributing factors responsible for the Death and none of the Certificates had information about the Time interval between the Sequence of Events leading to death. Similarly Only 19% of the Cause of Death statement in Hospital deaths were satisfying the ICD 10 Codes[2] and none of the certificates lacks information on Contributing factors and the Time interval between the Sequence of Events leading to death. The Autopsy information in the Certificate were also found to be incomplete as only 1% indicated the place of Autopsy and only 36% informed the Date and time of Autopsy. Even the maternal death information was inadequate, with only 42% of the certificates informing the same. The Certificate Authors information was also inadequate with only 35% of the Certificates had information about the Designation, and Qualification and bore the Stamp.