Medical Certificate of Death

The medical certificate of death must be signed by the physician or advanced practice registered nurse, if any, last in attendance on the deceased, or pursuant to regulations adopted by the Board, it may be signed by the attending physician’s associate physician, the chief medical officer of the hospital or institution in which the death occurred, or the pathologist who performed an autopsy upon the deceased. (NRS 440.380)

NRS 440.380  Medical certificate of death: Signature; contents.

      1.  The medical certificate of death must be signed by the physician or advanced practice registered nurse, if any, last in attendance on the deceased, or pursuant to regulations adopted by the Board, it may be signed by the attending physician’s associate physician, the chief medical officer of the hospital or institution in which the death occurred, or the pathologist who performed an autopsy upon the deceased. The person who signs the medical certificate of death shall specify:

      (a) The social security number of the deceased.

      (b) The hour and day on which the death occurred.

      (c) The cause of death, so as to show the cause of disease or sequence of causes resulting in death, giving first the primary cause of death or the name of the disease causing death, and the contributory or secondary cause, if any, and the duration of each.

      2.  In deaths in hospitals or institutions, or of nonresidents, the physician or advanced practice registered nurse shall furnish the information required under this section, and may state where, in his or her opinion, the disease was contracted.

      [Part 7:199:1911; A 1941, 381; 1931 NCL § 5241] — (NRS A 1977, 352; 1981, 466; 1997, 2340; 2017, 1754)

 NAC 440.160  Certification of cause of death; completion of rejected certificate. 

     1.  The person who is required to certify the cause of death shall complete the portions of the death certificate pertaining to the cause of death and the certification of death within 48 hours after being assigned as the certifier.

     2.  If the death did not occur in a hospital or other institution and the death was attended by a physician or advanced practice registered nurse who will not be available within 48 hours after the death, the certificate must be presented or assigned to an associate physician or advanced practice registered nurse who has access to the attending physician’s or advanced practice registered nurse’s medical files on the deceased. The associate physician or advanced practice registered nurse shall complete and certify the death certificate within 48 hours after such presentation or after being assigned as the certifier.

     3.  If the death occurred in a hospital or other institution and the death was attended by a physician or advanced practice registered nurse who will not be available within 48 hours after the death, the certificate must be presented or assigned to the chief medical officer of the institution or an associate physician or advanced practice registered nurse who has access to the medical records of the deceased. The chief medical officer or associate physician or advanced practice registered nurse shall complete and certify the death certificate before the end of the next business day after such presentation or after being assigned as the certifier.

     4.  Any certificate rejected for not containing a certification of cause of death, lack of information or lack of certifier signature must be completed by the certifier within 24 hours after such rejection.

     [Bd. of Health, Births and Deaths Art. 7, eff. 2-24-78] — (NAC A by R066-16, 11-2-2016; R150-18, 1-30-2019)

 NAC 440.162  Time for initiation of certificate of death or fetal death. (NRS 440.120)

     A person completing a certificate of death or fetal death must initiate the certificate:

     1.  If initiated by a certifier, not later than 24 hours after the death occurred; or

     2.  If initiated by a funeral director, not later than 24 hours after the funeral director receives the corpse.

     (Added to NAC by Bd. of Health by R150-18, eff. 1-30-2019)

NAC 440.165 Statement of the cause of death; electronic submission to approved electronic death registry system. (NRS 440.120, 440.380, 440.410)

     1.  The statement of the cause of death in a medical certificate of death is the certifier’s best medical opinion and must be:

     (a) Written legibly, when completed on a paper certificate; and

     (b) Expressed clearly and concisely.

     2.  The State Registrar or local registrar shall return a medical certificate of death to the certifier to be corrected or made more definite if the statement:

     (a) Consists of only the term “natural causes”;

     (b) Consists solely of mechanisms of death which merely attest to the fact of death or contains any other indefinite or obsolete term which denotes only the symptom of a disease or the conditions resulting from a disease;

     (c) Is illogically or confusingly written; or

     (d) Contains abbreviations, misspellings or is written in shorthand or in all capital letters.

     3.  Part I of the statement of the cause of death in the standard certificate of death approved by the United States Public Health Service may contain only the sequence of disease or the injury or other trauma directly resulting in death, as follows:

     (a) Line “A” must show the immediate (primary) cause of death;

     (b) Lines “B” and “C” must show the contributory or intermediate cause of death; and

     (c) Line “D” must show the underlying cause of death.

The underlying cause of death must be the last cause listed. If there are no intermediate causes, the underlying cause must be entered on line “B”. If the immediate cause and the underlying cause are synonymous, only one entry is necessary. It is permissible for a certifier to qualify a cause of death as “probable” or “presumed,” even if the cause has not been definitively diagnosed.

     4.  Part II of the statement of the cause of death must show the diseases, injuries or other factors which are medically or statistically significant but not directly related to the cause of death.

     5.  The statement of the cause of death must be submitted electronically by the certifier to an electronic death registry system approved by the Division of Public and Behavioral Health of the Department of Health and Human Services and attested to by the certifier by means of an electronic signature.

     6.  As used in this section, “electronic signature” means an electronic sound, symbol or process attached to or logically associated with a document and executed or adopted by a person with the intent to sign the document.

     (Added to NAC by Bd. of Health, eff. 12-3-84; A by R126-12, 2-20-2013; R066-16, 11-2-2016)