ABSTRACT
To illustrate how a typical death investigation might occur in an institution such as a hospital, let’s review a sample case on which we can base the discussion.
Mr. Smith is a 67-year-old man who had no remarkable previous medical history. He began experiencing discomfort in his chest and became weak, and one day the weakness and dizziness was severe enough that he called 911 for emergency services. The emergency personnel responded to the scene and transported Smith to the local hospital. Initial suspicions in the emergency room were that he may have been having a heart attack (myocardial infarction) or possibly some sort of an arterial problem in which the blood dissects along the blood vessel wall (aortic dissection). Unfortunately, about 2 hours after being seen in the emergency room, the patient died before a diagnosis could be made. In the state in question, the death was reportable to the medical examiner because it occurred shortly after admission to the hospital. The death was reported to the medical examiner, but with no indication of foul play and all of the findings indicating that a heart attack was the likely cause of death, the medical examiner declined to investigate the case.
