The mother of a recently deceased patient has just phoned Dr K. She is angrily insisting Dr K must amend the death certificate to remove references to her daughter’s history of COPD related to smoking as a secondary significant condition. She says it’s not relevant since her daughter died of cervical cancer and the insurance company is using it as an excuse not to pay on her daughter’s policy. She’s threatening to complain to the hospital and to Ahpra.*
Completing a Medical Certificate of Cause of Death (MCCD or death certificate), frequently generates calls to Avant’s Medico-legal Advisory Service.
While the scenario described is particularly challenging, queries about amending the death certificate form are not unusual. Addressing even minor errors can be stressful when you are also dealing with a distressed family and unsure of what you can and cannot amend.
Does an error invalidate a death certificate?
In most cases – no. A death certificate can be corrected, and all state and territory Registries of Births, Deaths and Marriages have processes to allow the certificate to be amended.
The process does change however, depending on the nature of the error and the stage the certification process has reached.
What sort of error?
Errors relating to the cause of death
There have been cases where information emerged that made a doctor question whether the patient had died of the natural causes they had recorded on the death certificate. The doctor had not been advised a patient had recently had a fall, for example.
If you believe the cause of death recorded was incorrect and the death should have been reported to the coroner, the error needs to be brought to the coroner’s attention. Contact Avant for advice in this situation.
You may have made a typographical error or omitted underlying conditions that should have been included. Such errors, as long as they do not change your ability to issue the death certificate, can be corrected using the steps below.
Names, dates and other details
Typographical errors in patient details can also be corrected using the steps below. In some cases you may need additional documentary evidence of the patient’s correct name or other details. This can become complex where a patient used different names. The patient’s name on their medical record will usually be the same as their Medicare card. If you are informed that the patient’s legal name is different to their Medicare card, ask for documentation to confirm this and then follow the steps below if the name on the certificate does need to be changed.
When was the error discovered?
Before it was provided to anyone
The death certificate is a medical record, even if it has not yet been provided to anyone. Do not destroy or make the original illegible.
Instead strike through the certificate, mark the incorrect entry and note that it was written in error. Add your printed name, signature, designation, date, and time.
Keep that version in the patient’s medical record, along with a copy of the corrected version.
After it is provided to the family
If the certificate has already been provided to the family or funeral director, they may discover the mistake and bring it to your attention. If you become aware of an error in other ways, you need to let the family know about the error. Be aware that families can be distressed in this situation, so manage it sensitively.
Ask them to return the incorrect certificate so you can issue a new one.
Again, strike through the incorrect certificate, mark the incorrect entry and that it was written in error. Issue a new corrected certificate to the funeral director and/or the family and keep a copy of both documents in the patient’s records.
After it has been sent to the Registry of Births, Deaths and Marriages
Errors discovered at this stage can still be corrected. Each state and territory has a process for notifying the registry of an error on a death certificate and correcting the record. (See the list of resources below).
Who can correct the error?
In most cases, the original certifying medical practitioner, or the coroner, needs to apply to amend the cause of death. It would usually be inappropriate to amend the cause of death on a certificate completed by another practitioner. If you are asked to amend a death certificate and the original certifying practitioner is unable to make the amendment, contact Avant for advice.
What if it’s not an error?
Remember that the death certificate is a legal document. Legally, and professionally, you must not sign a report or certificate, including a death certificate, if you do not believe it to be accurate. Good medical practice: a code of conduct for doctors in Australia also specifically states that you must not omit relevant information deliberately.
In the scenario, if Dr K believes the information she has included is correct, she must not amend it even if the family insists. Always seek advice in this situation as it can clearly be challenging and sensitive.
ACT Registry of Births, Deaths and Marriages
View information on the application process to correct an entry.
NSW Registry of Births, Deaths and Marriages
The Application to Correct an Entry (Form 18) is available here.
Births, Deaths and Marriages Victoria
Details on the process to correct the form is available here.
Queensland Registry of Births, Deaths and Marriages
For details on the process to correct a submitted record or certificate see https://www.qld.gov.au/law/births-deaths-marriages-and-divorces/deaths-wills-and-probate/registering-a-death
Northern Territory Births, Deaths and Marriages Office
There is no online form available, you can contact one of the Births, Death and Marriages offices, listed at https://nt.gov.au/law/bdm/register-a-death
South Australia Births, Deaths and Marriages Register
For details on the process to correct a submitted record or certificate see https://www.sa.gov.au/topics/family-and-community/births,-deaths-and-marriages/corrections-to-certificates
Tasmania Registry of Births, Deaths and Marriages
For information on the process for amending a certificate see https://www.justice.tas.gov.au/bdm/correcting-details-on-a-certificate
Western Australia Registry of Births, Deaths and Marriages
The form for an application to correct a certificate is available here.
Resources and further reading
The rules around certifying death are different in every state, and they are contained in a variety of pieces of legislation, regulations. There may also be guides and policies which are not always consistent.
All states and territories also require permits to be issued before the body of a deceased person can be cremated. These requirements vary considerably between jurisdictions.
It is complicated and often confusing.
To assist members, Avant has produced some new resources – factsheets and decision guides for each jurisdiction – which we hope will help clarify some of the most common issues.
For more information or immediate medico-legal advice, call us on 1800 128 268, 24/7 in emergencies.
*This scenario is based on Avant claims experience to date. Details have been amended for privacy reasons and issues have been summarised for the sake of discussion.
*IMPORTANT: This publication is not comprehensive and does not constitute legal or medical advice. You should seek legal or other professional advice before relying on any content, and practise proper clinical decision making with regard to the individual circumstances. Persons implementing any recommendations contained in this publication must exercise their own independent skill or judgement or seek appropriate professional advice relevant to their own particular practice. Compliance with any recommendations will not in any way guarantee discharge of the duty of care owed to patients and others coming into contact with the health professional or practice. Avant is not responsible to you or anyone else for any loss suffered in connection with the use of this information. Information is only current at the date initially published.