On 25th January 1988, a patient was brought to a hospital with a history of chest pain, difficulty in breathing, giddiness and profuse sweating, as relayed by their concerned relatives. The attending doctor conducted a thorough examination of the patient and discovered that the pupils were dilated and unresponsive to light with no discernible heartbeat or pulse. The ECG also showed a straight line. All of these made the doctor suspect that the patient might have passed away on the way to the hospital. In light of this, the doctor recorded that the probable cause of death was ‘Acute Myocardial Infarction’ based on history’ and allowed the relatives to take the body for the final rites.
Around three months later, a complaint was filed claiming that the patient died of unnatural causes. Hence, the police initiated an investigation and ordered the exhumation of the body for post-mortem examination. The findings of the examination revealed that the actual cause of the patient’s death was poisoning. A case was filed against the doctor for issuing a false certificate.
This tragic incident highlights the importance of conducting a thorough investigation prior to issuing MCCD. Erroneous recoding of the cause of death can lead to severe legal repercussions and it is the duty of all doctors to exercise the utmost care and attention to detail while fulfilling this responsibility.
In the present case, the doctor declared the cause of death based solely on a superficial examination of the deceased’s body and the history provided by their relatives, without any supporting medical evidence or clinical examination. Here are some of the things that the doctor could have done differently to avoid legal complications.
- First and foremost, the doctor should not have made a definitive declaration about the cause of death if there is a lack of medical evidence to support the diagnosis.
- Secondly, since the doctor had no supporting medical evidence, it would have been prudent to involve the police and inform them of the circumstances leading up to the patient’s death. This could help ensure that the case was thoroughly investigated and all relevant information was taken into account.
As a healthcare professional, it is essential to gather medical evidence to substantiate the cause of death. It is critical to avoid relying solely on a patient’s history while issuing MCCDs.
Medical research suggested that a staggering 80% of the MCCDs issued by medical practitioners showed errors. It was revealed that 99% of them were incorrectly written, and 21% were incomplete. These findings further underscore the need to address this issue with urgency and seriousness.
Let’s get into the basics and understand this better.
Are MCCDs and Death Certificates the same?
Who is legally obliged to issue MCCDs?
According to Section 10 (3) RBD Act-1969, the medical practitioner who had attended to the deceased in his/her last illness is responsible for issuing the certificate of the cause of death immediately. Later, the same doctor should also forward a “Death Report” to the Death Registry Authority along with the MCCD.
What happens if a doctor refuses to issue MCCD or issues a false certificate?
According to RBD Act The Section 23(3) any medical practitioner who neglects or refuses to issue a certificate under section 10(3) shall be punishable with a fine, which may extend to fifty rupees. Whereas, issuance of a false certificate may get medical practitioners imprisonment of 3 to 4 years (Section 197 of IPC).