Physicians who do not sign death certificates "in a timely fashion" face a $500 fine per violation from the Texas Medical Board (TMB), the board warns in its spring TMB Bulletin [ PDF ]. TMB says it currently has more than 150 complaints against doctors. If you are cited, consider contacting your own attorney for legal advice, because a quick response is necessary.
The easiest way to avoid TMB discipline is to register with the state's Texas Electronic Registrar (TER) Death Registration system. Since 2007, state law requires that all cause-of-death information and medical certifications to the Texas Department of State Health Services (DSHS) be submitted electronically. A DSHS handbook on the law says a "Certificate of Death (VS-112) must be filed within ten (10) days of the date of death for every death in Texas" and that the "certifier must complete the medical certification not later than five (5) days after receiving the death certificate or provide notification to the funeral director, or person acting as such, explaining the reason for the delay."
The law applies to physicians who certify death. The statute says a person required to file a death certificate or fetal death certificate "shall obtain the required medical certification from an attending physician if the death occurred under medical attendance for the care and treatment of the condition or disease process that contributed to the death."
Other provisions are:
- The attending physician shall complete the medical certification not later than five days after receiving the death certificate.
- An associate physician, the chief medical officer of the institution where the death occurred, or the physician who performed an autopsy on the decedent may complete the medical certification if:
- The attending physician is unavailable;
- The attending physician approves; and
- The person completing the medical certification has access to the medical history of the case and the death is due to natural causes.
- If a death or fetal death occurs without medical attendance or is otherwise subject to Chapter 49, Code of Criminal Procedure, the person required to file the death or fetal death certificate shall notify the appropriate authority of the death.
The recommended computer system requirements to file electronic death certifications include:
- Computer with a 1.0 GHz processor or faster,
- 512 MB or more of RAM,
- Web browser with Flash Player,
- Internet access at 56K or better, and
- Adobe Acrobat Reader.
Physicians may register to use the system and obtain their PIN online. In addition, free training is available online.
For additional questions, email help-TER@dshs.state.tx.us, or go to the TER website.
DSHS Commissioner David Lakey, MD, said in a letter to physicians that the system "allows physicians to quickly complete cause-of-death information and death certification via the Internet. As a former practicing physician, I appreciate this convenience."
Dr. Lakey says TER also "allows physicians to delegate completion of the death certificate to office staff, while still requiring the physician to enter a personal identification number to complete the actual electronic certification. This system is available at no charge to you."
In addition, he says, the speed of the electronic death registration will give medical researchers valuable mortality data faster than previously possible. "Based on cause-of-death data, public health resources can be best directed towards prevention and education. Ultimately, use of TER will benefit the health of all Texans."
Action , Sept. 1, 2010