City Health Information
December 2012 New York City Department of Health and Mental Hygiene Vol. 31(6):41-49
Improving Cause of Death Reporting: Update 2012
  • Accurate and detailed cause of death reporting is critical for disease surveillance, public health research, and forensic investigations.
  • Cause of death reporting requires:
    • Review of the medical record
    • Identification of all conditions and events leading or contributing to the death
    • Ordering the conditions and events in a medically probable sequence



In cases of missing or limited information, use other records such as reports from emergency medical services personnel attending the decedent and available medical records. Make every attempt to contact the attending physician and the family if you need information. You may use terms such as "probable," "presumed," "unspecified," "likely," "suspected," or "undetermined" to indicate an unconfirmed diagnosis. Only if the etiology is unknown should you enter "etiology unknown."

If you are uncertain of the time intervals between conditions, use your best estimate. Entries such as "3-5 years," "less than 5 years," and even "years" are acceptable and will inform the underlying cause of death. Only enter "unknown" if no approximation can be made.