Death certificates

[Guest guest]

I complete death certificates so rarely that I have forgotten

what little I once knew about what should be on them. Does anybody

(anybody named Locke unless I miss my guess) have a link to some concise

hints on how to decide what to put down as a cause of death when you really don’t

know why someone died?

50 year old lady….bad habits (smoked, drank) but not obese

and no known chronic disease. Got admitted with alcoholic pancreatitis

(lipase only like 220..not terrible) went home next day, got in a fight with

her daughter who didn’t want mom in the house for her 18th birthday

party, so she went and spent the night in a hotel. Next morning she awoke

with SOA, cough and temp of 102. Wanted me to phone in a Zpack for crying

out loud. I made her come in and promptly made her go back to the

hospital when I saw how sick she was. That was on 12/23. On Christmas

day she had a massive stroke, with midline shift evident on the first CT and

by that night had herniated. Nobody seems to have much idea why this

happened. Blood cultures negative, sputum with only garden variety pneumococcus,

no klebsiella or anything weird. No valve problems on echo….

I’ve know the lady for 5 years and she’s been

wishing she was dead every time I ever saw her, but I don’t think I can

put that on this death cert. Coroner turned down the case,

being as she died in the hospital and was sick..

Cause of death? Cerebral infarction, that much is clear, but

as a consequence of…..?? OK, so a septic smoker is probably hypercoagulable…and

her platelet count was >700 and but still, I guess I better stay

away from trying to write fiction..I can’t even bring myself to make a

guess. The hospitalist was just as puzzled…I guess that’s

why she gave this to me.

Thanks, as always, for your help.

Annie

[Guest guest]

Cerebral infarct and don’t put anything as secondary to,

unless you want to put thrombocytosis. For contributing factors you can

add pneumonia and smoking.

Certainly don’t put anything you aren’t sure of.

It’s only for statistical purposes anyway.

Kathy Saradarian, MD

Branchville, NJ

www.qualityfamilypractice.com

Solo 4/03, Practicing since 9/90

Practice Partner 5/03

Low staffing

From:

[mailto: ] On Behalf Of Annie Skaggs

Sent: Monday, January 14, 2008 12:27 AM

To:

Subject: Death certificates

I complete death certificates so

rarely that I have forgotten what little I once knew about what should be

on them. Does anybody (anybody named Locke unless I miss my guess)

have a link to some concise hints on how to decide what to put down as a cause

of death when you really don’t know why someone died?

50 year old lady….bad habits

(smoked, drank) but not obese and no known chronic disease. Got admitted

with alcoholic pancreatitis (lipase only like 220..not terrible) went home next

day, got in a fight with her daughter who didn’t want mom in the house

for her 18th birthday party, so she went and spent the night in a

hotel. Next morning she awoke with SOA, cough and temp of 102.

Wanted me to phone in a Zpack for crying out loud. I made her come in and

promptly made her go back to the hospital when I saw how sick she was.

That was on 12/23. On Christmas day she had a massive stroke, with

midline shift evident on the first CT and by that night had herniated.

Nobody seems to have much idea why this happened. Blood cultures negative,

sputum with only garden variety pneumococcus, no klebsiella or anything

weird. No valve problems on echo….

I’ve know the lady for 5 years and

she’s been wishing she was dead every time I ever saw her, but I

don’t think I can put that on this death cert. Coroner

turned down the case, being as she died in the hospital and was sick..

Cause of death? Cerebral

infarction, that much is clear, but as a consequence of…..?? OK, so

a septic smoker is probably hypercoagulable…and her platelet count was

>700 and but still, I guess I better stay away from trying to

write fiction..I can’t even bring myself to make a guess. The

hospitalist was just as puzzled…I guess that’s why she gave this to

me.

Thanks, as always, for your help.

Annie