General Medical Officer (GMO) Manual: Administrative Section
Decedent Affairs for the Medical Officer
Department of the Navy
Bureau of Medicine and Surgery
Operational setting Active Duty Deaths at an MTF Death of a fetus/newborn MTF/clinic setting Death certificate
When a death occurs within a command, the medical officer/senior medical department representative (MO/SMDR) shall immediately furnish the commanding officer with a memorandum report providing required documenting as per MILPERSMAN 4210100 for naval personnel and Decendent Affairs Manual, paragraph 3, chapter 3 (NAVMEDCOMINST 5360.1), for other than Naval personnel. An entry should documented in the Medical Department Journal describing all available information concerning the death.
- Chapter 17 of MANMED provides information concerning death certificates and the submission of certificate of death DD 2064 (for deaths that occur outside the United States). An American civilian or military medical doctor must sign an outside of the continental United States (OCONUS) death certificate.
- After the required health record entries have been completed and the death certificate incorporated into the record, the health record shall be closed and forwarded to the command holding the service record of the deceased.
- As soon as possible, remains shall be transferred to the nearest naval or armed forces medical facility for further disposition. Remains must be accompanied by the following:
- Medical and dental records with dental x-rays.
- DD 2064 certificate of death.
- Two (2) DD 565s (statements of recognition) signed by shipmates who knew the deceased, if remains are recognizable. In all cases, see NAVMEDCOMINST 5360.1 and MILPERSMAN 4210100. regarding requirements for death certificates.
There are five categories of individuals who will be pronounced dead at an MTF:
- Active duty personnel.
- Retired/retained personnel.
- Retired personnel.
- Dependents of active duty personnel.
- All others.
Each MTF should have a death packet that covers required notifications of each category of personnel. This packet must be as complete as possible even if the family does not want to deal with the issue at the time of notification.
- Physicians should make initial notification to the primary next of kin (PNOK) of an active duty member only, if the PNOK is physically in the MTF at the time of death. If the PNOK is not in the MTF, the physician will not contact the PNOK by telephone, as notification will be done in person by the assigned casualty assistance calls officer (CACO).
- The command duty officer/officer of the day (CDO/OOD) will release a casualty report to BUPERS or CMC as appropriate. If the deceased was an active duty member, permission for an autopsy is not required from the PNOK. Do not approach this topic with the PNOK.
- All other death categories require a signed SF 523, Authorization for Autopsy.
Location specific requirements for a death certificate
Each State, U.S. Territory, or overseas location has specific requirements for its death certificate. Check withyour patient administration department for those requirements. Although you pronounce an individual dead, the medical examiner will be notified if death occurred by:
- Violence.
- Suicide.
- Casualty.
- Suddenly, in apparent good health, or unattended by a physician.
- Suspicious or unusual manner.
A medical examiner shall investigate the death of a human fetus if:
- Regardless of the duration of the pregnancy, the death occurs before expulsion or extraction of the fetus from the mother.
- The mother is not attended by a physician at or after the delivery.
When in doubt, call the medical examiner's office and ask if they would like to review the case.
Reviewed by LCDR Robert A. Rahal, MSC, USN, Assistant Specialty Leader for Patient Administration, Bureau of Medicine and Surgery, Washington, D.C. (1999).