Incorrectly certified natural death after medical inspection of the corpse

The quality of post-mortem external examinations of corpses has been criticized as unsatisfactory for many years. The municipal public health and environment department of Munich showed in a review of death certificates from 2010 to 2013 that 1 out of 10 death certificates was incorrect. Our investigation in 2014 and 2015 focused on the falsely certified natural deaths, as here serious consequences, also in the field of criminal liability, are possible. All death certificates issued in Munich from 2014 and 2015 were screened and encoded and a statistical analysis was performed. A total of 27,164 death certificates were included of which 61% were from hospitals and 39% from private practitioners. In 2014, 14% of the death certificates were incorrect and 12% in 2015. Of the incorrect death certificates 70% were issued in hospitals and 30% by practitioners. For approximately every 400 death certificates 1 (0.25% of all death certificates, 67 cases) was certified as a natural death although an unclear or unnatural manner of death would have been correct. In 48 an accident was stated and in 36 the field indications for unnatural death was filled in. Data from a survey by a public health department of a major city are now available which allow a realistic estimation of the dimension of the problem of incorrect certification of the manner of death (natural death versus unclear/unnatural). A systematic error could be identified: not all members of the medical community seem to be familiar with the correct definition of natural versus unnatural manner of death.