Coroner’s office complains of backlogs caused by unsigned death certificates

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INDIANAPOLIS - The Marion County Coroner's office is speaking out to FOX59 about a jump in the number of non-coroner cases passed onto them by physicians who do not want to sign the death certificate. Chief Deputy Coroner Alfarena Ballew spoke with FOX59's Aishah Hasnie about the extra workload that has become an issue.

"We've seen an increase of probably about 20 percent to 30 percent of cases that we are reviewing that have not actually been coroner cases," said Ballew.

Coroner cases involve suspicious deaths, explained Ballew. Those include homicides, suicides, accidental deaths; not usually deaths that occur under a physician's care.

But the office has been receiving case after case and closing them is not a simple process. The coroner has to request, obtain, and review the decedent's medical records before ruling a cause of death. It's a process that can take up to six to eight weeks.

"It does cause a significant backlog," said Ballew. "We review and consult on about 1,500 death investigations a year. And so when we have these types of cases it just adds additional work.”

This week, FOX59 reported the story of an Indianapolis mother who has been waiting two months for a death certificate for her daughter. In January, Nicole Bonds had complications with her pregnancy and delivered a stillborn girl at St. Vincent Women's Hospital. A spokeswoman for St. Vincent told FOX59, the responsibility to sign the death certificate belonged to the physician who delivered the baby. That doctor is not a St. Vincent employee.

Earlier this year, Randy Stokes called FOX59 to share a similar experience when his older brother died at Eskenazi Hospital.

"We could not have him cremated, because the death certificate wasn't signed," said Stokes. “We couldn’t get any insurance, funeral home couldn’t get paid, nothing without a death certificate.”

He explained how he made repeated calls to hospital staff, administration, and the chaplain for nearly a month, but got nowhere.

"The excuse that they kept giving me was, the doctor wasn't registered with the State of Indiana to sign the death certificate. I kept telling them... 'Do you not have somebody else?'"

FOX59 discovered countless Hoosier families are facing the same delays.

Mike Moffitt, director of funeral operations at Leppert Mortuary and Crown Hill blames the delays on certain doctors and the Indiana Death Registration System.

"We're seeing 2-3 month delays in getting the death certificate signed and that should be done within a seven-day period," complained Moffitt.

He said doctors will refuse to sign a certificate for various reasons. The primary care physician may not have been present at the time of death. The emergency doctor may not know the medical history of the patient who died in their care. And sometimes, the doctor may just be afraid of a possible malpractice lawsuit if their name is on the certificate.

He thinks the online system overseen by the State Department of Health is a lengthy process which may give doctors another reason to avoid the task.

“It’s not efficient at all. And this system was put in place to be efficient. And it hasn’t turned out that way,” he said. "It’s very frustrating. We can’t conduct our business without the death certificate.”

For Stokes, closure finally came after three-and-a-half weeks of waiting.  He wants to know why it had to take so long.

"He had to just lay there in that freezer," he said.

FOX59 reached out to Eskenazi Hospital. A spokesman said he could not comment on Stokes' case, because of patient privacy laws. While he admitted the process of signing off on a death certificate using IDRS is "cumbersome" for some doctors, he noted some funeral homes can also be blamed for taking too long to send a request to the physician.

He added the issue is important to Eskenazi and that the hospital is constantly educating and working with its physicians about getting death certificates signed as quickly as possible.

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