2018 Tennessee Code
Title 68 - Health, Safety and Environmental Protection
Health
Chapter 3 - Vital Records Act of 1977
Part 5 - Deaths
§ 68-3-502. Death registration.
(a)
(1) A death certificate for each death that occurs in this state shall be filed with the office of vital records or as otherwise directed by the state registrar within five (5) days after death and prior to final disposition, or as prescribed by regulations of the department. It shall be registered, if it has been completed and filed in accordance with this section.
(2) If the place of death is unknown but the body is found in this state, the death certificate shall be completed and filed in accordance with this section. The place where the body is found shall be shown as the place of death. If the date of death is unknown, it shall be determined by the date the body was found.
(3) When death occurs in a moving conveyance in the United States and the body is first removed from the conveyance in this state, the death shall be registered in this state and the place where it is first removed shall be considered the place of death. When a death occurs on a moving conveyance while in international waters or airspace or in a foreign country and the body is first removed from the conveyance in this state, the death shall be registered in this state; but the certificate shall show the actual place of death insofar as can be determined.
(b) The funeral director, or person acting as funeral director, who first assumes custody of the dead body shall file the death certificate. The funeral director shall obtain the personal data from the next of kin or the best qualified person or source available, and shall obtain the medical certification from the person responsible for medical certification, as set forth in subsection (c).
(c) (1) The medical certification shall be completed, signed and returned to the funeral director by the physician in charge of the patient's care for the illness or condition that resulted in death within forty-eight (48) hours after death, except when inquiry is required by the county medical examiner. In the absence of the physician, the certificate may be completed and signed by another physician designated by the physician or by the chief medical officer of the institution in which the death occurred. In cases of deaths that occur outside of a medical institution and are either unattended by a physician or not under hospice care, the county medical examiner shall investigate and certify the death certificate when one (1) of the following conditions exists:
(A) There is no physician who had attended the deceased during the four (4) months preceding death, except that any physician who had attended the patient more than four (4) months preceding death may elect to certify the death certificate if the physician can make a good faith determination as to cause of death and if the county medical examiner has not assumed jurisdiction; or
(B) The physician who had attended the deceased during the four (4) months preceding death communicates, orally or in writing, to the county medical examiner that, in the physician's best medical judgment, the patient's death did not result from the illness or condition for which the physician was attending the patient.
(2) Sudden infant death syndrome shall not be listed as the cause of death of a child, unless the death meets the definition set forth in chapter 1, part 11 of this title.
(3)
(A) In addition to this section, prior to signing medical certification of the cause of death, the physician, chief medical officer or medical examiner shall require screening x-rays of the skull, long bones and chest of any child who was not subject to an autopsy and who died of unknown causes or whose death is suspected to be from sudden infant death syndrome.
(B) The physician, chief medical officer or medical examiner who orders the x-ray examinations pursuant to this section shall be entitled to a reasonable fee as set by the commissioner of health for the costs of the x-ray examinations, to be paid from the funds allotted to the postmortem examiners program in the department of health.
(d) When inquiry is required, the medical examiner shall determine the cause of death and shall complete and sign the medical certification within forty-eight (48) hours after taking charge of the case. On or before January 1, 2013, the commissioner of health shall establish by rule a protocol for use by medical examiners in cases involving death resulting from opiate, illegal or illicit drug overdose, that requires an appropriate report under § 38-7-108. The commissioner is authorized to promulgate such rules in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
(e) If the cause of death cannot be determined within forty-eight (48) hours after death, the medical certification shall be completed as provided by regulation. The attending physician or medical examiner shall give the funeral director, or person acting as funeral director, notice of the reason for the delay; and final disposition of the body shall not be made until authorized by the attending physician or medical examiner.
(f) If the death occurs in a military or veteran's hospital or in a state veteran's home in the state of Tennessee, the death certificate may be signed by the attending physician who holds a license in another state.
(g) In the event a person is dead on arrival at a military or veteran's hospital or at a state veteran's home in the state of Tennessee, the death certificate may be signed by a physician who is employed by one (1) of these institutions and who holds a license in another state.
(h) The form for a certificate of death shall contain a place for the recording of the deceased's social security number and the social security number shall be recorded on the certificate and on any forms necessary to prepare the certificate.
(i)
(1) When a county medical examiner suspects that suicide may be a potential manner of death, the medical examiner is encouraged to consult the decedent's treating mental health professional, if known or applicable, prior to determination of manner of death.
(2)
(A) If, after inquiry by the county medical examiner pursuant to title 38, chapter 7, part 1, the medical examiner determines a decedent's manner of death to be suicide and the deceased's next of kin disputes the manner of death determination on the death certificate, the next of kin may seek reconsideration of the manner of death determination.
(B) To seek reconsideration pursuant to subdivision (i)(2)(A), the next of kin must submit a written request for reconsideration to the county medical examiner who signed the death certificate, the chief medical examiner of the regional forensic center where the autopsy was performed, and the commissioner of health, stating the nature and reasons for the reconsideration. If the county medical examiner who signed the death certificate is no longer the county medical examiner, then the notice shall be sent to the current county medical examiner instead. The written request for reconsideration must be submitted within one (1) year of the date the death certificate is filed with the office of vital records and must be supported by a signed affidavit.
(3) Within thirty (30) days after receiving written notice of the reconsideration request pursuant to subdivision (i)(2)(B), the county medical examiner shall meet with the requesting next of kin. The meeting shall be either in person or via teleconference, at the discretion of the requesting next of kin. At the meeting, each party shall present the reasons supporting their position with respect to the manner of death, including any relevant documentation. The county medical examiner shall make a written determination on the reconsideration within thirty (30) days after the reconsideration meeting and shall notify the requesting next of kin, the chief medical examiner of the regional forensic center where the autopsy was performed, and the commissioner of health in writing. If the medical examiner who signed the medical certification is no longer in a position as county medical examiner, then the current county medical examiner shall participate in the reconsideration meeting and issue the written determination on the reconsideration instead.
(4) If, after reconsideration made pursuant to subdivision (i)(3), the county medical examiner finds a change in the manner of death determination is warranted, the county medical examiner shall file an affidavit within thirty (30) days directing the office of vital records to issue an amended death certificate to reflect the county medical examiner's findings as to manner of death.
(5)
(A) If, after reconsideration made pursuant to subdivision (i)(3), the county medical examiner does not find that a change in the manner of death is warranted and the determination of manner of death is still disputed by the requesting next of kin, the requesting next of kin may seek further review of the determination by petitioning the chief medical examiner of the regional forensic center in which the autopsy was performed, on a form prescribed by the department of health, to review the medical records, hospital records, death certificate, investigative reports, and any other documentary evidence deemed necessary of the deceased. The chief medical examiner of the regional forensic center shall respond to the requesting next of kin detailing the findings within thirty (30) days with a written report. The report shall state whether the chief medical examiner of the regional forensic center agrees with the determination of manner of death on the death certificate, and, if the chief medical examiner of the regional forensic center disagrees with the determination of manner of death on the death certificate, the report shall detail those findings and the basis for the disagreement. The report shall be sent to the next of kin and the commissioner of health.
(B) If the chief medical examiner of the regional forensic center finds a change in the manner of death determination is warranted, the chief medical examiner shall file an affidavit within thirty (30) days directing the office of vital records to issue an amended death certificate to reflect the chief medical examiner's findings as to manner of death.
(6)
(A) If, after review by the chief medical examiner of the regional forensic center made pursuant to subdivision (i)(5), the determination of manner of death is unchanged, then the requesting next of kin may seek mediation with the chief medical examiner of the regional forensic center with a Rule 31 mediator under the Rules of the Supreme Court of Tennessee, at the sole expense of the requesting next of kin.
(B) If the chief medical examiner of the regional forensic center finds a change in the manner of death determination is warranted following mediation, the chief medical examiner shall file an affidavit within thirty (30) days directing the office of vital records to issue an amended death certificate to reflect the chief medical examiner's findings as to manner of death.
(7) The department of health shall maintain a notice of decedents' next of kin rights with regard to this subsection (i) on its public website.
(8) As used in this subsection (i), "next of kin" means the person who has the highest priority pursuant to § 62-5-703.
(9) This subsection (i) applies only when the manner of death is determined to be suicide.
(10) Unrelated parties have no liability for relying on the original death certificate, without regard to subsequent revision under this part.
