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If a decedent has no known medical history and/or lack of medical records, the cause and manner of death determination may be undetermined, meaning that the doctor could not reliably conclude that the death resulted from natural or unnatural causes.
Reportable Deaths Any death that occurs suddenly and unexpectedly, that is, when the person has not been under medical care for docHub heart, lung or other disease. Any death suspected to be due to violence, i.e., suicidal, accidental or homicidal injury, regardless of when or where the injury occurred.
The classifications are natural, accident, suicide, homicide, undetermined, and pending. Only medical examiners and coroners may use all of the manners of death. Other certifiers must use natural or refer the death to the medical examiner.
Practical definition of death in primary care There are no spontaneous movements. There is no respiratory effort (examine for at least one minute). There are no heart sounds or palpable pulses (examine for at least one minute). There is an absence of reflexes - eg, corneal. The pupils are fixed and dilated.
Although State laws vary in specific requirements, deaths that typically require investigation are those due to unusual or suspicious circumstances, violence (accident, suicide, or homicide), those due to natural disease processes when the death occurred suddenly and without warning, when the decedent was not being
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Sudden unexplained death syndrome (SUDS): Sudden death in an otherwise healthy individual with no cause identified following a complete and detailed autopsy and death investigation; also known as sudden adult death syndrome or sudden arrhythmogenic death syndrome (SADS)
Responsibilities of Physicians Determining Brain Death The diagnosis of brain death is primarily clinical, and consists of three essential findings: irreversible and unresponsive coma, absence of brain stem reflexes, and apnea.
In a nationwide setting, up to 31% of SCD victims below age 50 years remain undiagnosed after autopsy [1]. However, even though the autopsy does not provide a cause of death, unspecific cardiac findings with questionable causality to the occurred death are often reported.
If the post mortem shows an unnatural cause of death, or if the cause of death is not found at the initial examination, the Coroner will open an investigation or inquest. They will also need to do this if the deceased died in custody or otherwise in the care of the State.
There are however limitations to what the autopsy can answer, and sometimes the circumstances surrounding a death, despite our best efforts, are simply unable to be determined. Approximately 5% of cases reportedly remain unknown after a complete autopsy.

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