NOTES AND DEFINITIONS
1. Cause, Mechanism and Manner of Death
a) The cause
of death (proximate cause) is the disease or injury responsible for initiating
the lethal sequence of events. A cause of death should be etiologically
specific.
b) The mechanism of death is the altered physiology and/or biochemistry whereby the cause exerts its lethal effect. Mechanisms of death lack etiologic specificity and are unacceptable as substitutes for causes of death. They may not stand alone on a death certificate. Common mechanisms of death include sepsis, exsanguination, renal or hepatic failure, and disseminated intravascular coagulation. The term “cardiorespiratory arrest” is meaningless for purposes of death certification and should not be used. It means “heart and lungs stopped working” and is merely a description of being dead.
c) The manner of death explains how the cause arose and is classified as natural, accident, suicide, homicide or undetermined. Natural deaths are defined as those which are caused exclusively by disease. All deaths which are not known to be exclusively natural fall under the jurisdiction of the coroner.
2. Proximate versus Immediate Cause of Death
a)The
underlying (proximate) cause of death is that event which produced the fatality
by initiating a natural and continuous sequence of events unbroken by an
effective intervening cause and without which the end result would not have
occurred.
b) Immediate causes of death are complications and sequelae of the underlying cause. There may be one or more immediate causes, and they may occur over a prolonged interval, but none absolves the underlying cause of its ultimate responsibility. For example, a gunshot wound to the abdomen which perforates the bowel may initiate a sequence of events over a period of months which includes infection of the abdominal cavity, infection of the blood, pneumonia, and liver or kidney failure. The gunshot wound is still the underlying or proximate cause of death, and such a fatality must be reported to the coroner.
3. Delayed deaths whose proximate cause is listed in CRS 30-10-606 (1) must be reported even if the actual death occurs months or even years following the precipitating event.