Death certification & coroner referral
What it means
The MCCD (medical certificate of cause of death) is completed by a DOCTOR who attended the deceased during their last illness — under the reformed (2024) system ANY attending doctor may complete it (the old 28-day/last-seen rule was removed), and EVERY death is now independently scrutinised by an INDEPENDENT MEDICAL EXAMINER before registration. Refer to the CORONER (and do NOT complete an MCCD) if: cause unknown; violent/unnatural/accidental/suspicious; during/after an operation or anaesthetic; industrial disease/poisoning; in custody/detention; or no attending doctor. Cremation forms are separate.
Worked example
A patient who dies unexpectedly soon after surgery must be referred to the coroner — the death is potentially unnatural/procedure-related, not for a routine MCCD.
In the exam
A patient dies a day after an operation from an unclear cause; the doctor cannot simply certify a natural cause and must refer to the coroner.
What settles it
An attending doctor completes the MCCD (now medical-examiner-scrutinised); a coroner referral is for unnatural/unknown/violent/procedure-related/custodial deaths. This is the certificate of the CAUSE of death — distinct from DIAGNOSING death by neurological criteria (which needs two doctors, see that card).
Classically confused with
Death by neurological criteria & donation
Source: Coroners and Justice Act; medical examiner system