Medical Certification of Cause of Death: FAQs for Queensland

What is the purpose of a MCCD?

To notify deaths to the Registrar of Births, Deaths and Marriages in the relevant state or territory in which the death occurred. It enables an authority to be provided to the funeral director to arrange disposal of the body[1].

When should I not issue a MCCD?

You should not write a MCCD if the death must be reported to the Coroner. In other words, reporting a death to the Coroner and writing a MCCD are mutually exclusive activities. 

When should I report a death to the Coroner?

Depends on the State and Territory. There is jurisdictional coronial legislation that outlines the circumstances in which a person’s death must be reported to the Coroner. These deaths are sometimes referred to as ‘reportable deaths’. In general, deaths should be reported to the Coroner when[2]:

• As a medical practitioner you are not “comfortably satisfied” with the cause of death (cause of death is unknown) 
• Cause of death is unnatural, violent, suspicious, or unusual.
• Death resulted directly or indirectly from an accident or injury (in NSW, only if the person was less than 72 years of age)
• Death occurred when the person was in police, or other lawful, custody; or where the person was held in care (mental health facility or residential service, including children)
• Death was within 24 hours (in the ACT within 72 hours) of a surgical procedure, or invasive medical or diagnostic procedure, or under or because of an anesthetic.

Also in QLD:

• The deceased person was a child or person in care or custody. This includes patients under an involuntary treatment order under the Mental Health Act 2000, who was being taken to or detained in an authorised mental health service, detained because of a court order or undertaking limited community treatment
• Healthcare-related deaths, in which the provision or failure to provide healthcare, caused or contributed to the death, and the death was an unexpected outcome of the clinical intervention.

If you are unsure if a death should be reported to the Coroner, contact MIPS. 

Who can complete a MCCD?

A medical practitioner who is either responsible for a patient’s care immediately prior to their death, or who examined the deceased body after death and is comfortably satisfied with the cause of it.

You may also get asked to complete a MCCD for a patient you have not met or have not had contact with for a long time. While you are not legally obliged to have had recent contact with the deceased person before death, you must have enough information based on their medical history or an examination to complete and sign a MCCD.

Where should I record the information associated to the death?

In the patient’s medical records. This is especially important of you are not comfortably satisfied with the cause of death and decide not to complete a MCCD. 

Health records remain confidential after death. Third parties can generally access them only with  permission of the executor/administrator of the estate of the deceased or by a Court order.

Do I need to see the body before signing a MCCD?

It depends on the State and Territory, jurisdictional legislation applies. In general, the following advice is relevant:

• VIC: you must examine the deceased body to issue a MCCD. The only exception is when you have recently cared for the person as a treating medical practitioner.
• ACT, NSW, QLD, WA: you do not need to examine the deceased body of a person to issue a MCCD.
• SA: You must examine the body to issue a MCCD if you did not care for the deceased person as a treating medical practitioner immediately before their death. If you did, you do not need to examine the body. 

What is the MCCD format and what information do I need to record?

The MCCD format was developed by the World Health Organisation (WHO) for international use. It consists of two sections:

Part I - related to the disease/condition that directly caused death, and any precedent conditions that may have contributed to the disease/condition which caused death.

Part II - any other important diseases/conditions related to the death, but not associated to the disease/condition that directly caused it.

Where should I send the completed MCCD?

To the State or Territory Registry of Birth, Deaths and Marriages office (except in WA) 

Are MCCD formats different in each Australian State?

Each State and Territory have comparable but not identical formats. They are all derived from the form recommended by the World Health Organisation for international use.

Where can I obtain a blank MCCD form to use?

Blank Medical Certificate of Cause of Death forms can be obtained from the Registry of Births, Deaths and Marriages in each State and Territory.

How should I proceed if I am dealing with a perinatal death?

Each States and Territory has a different “Perinatal Death Certificate”. This form should be completed for:

• stillbirths of at least 20 weeks gestation or 400 g of weight, or
• an infant who dies within 28 days after birth.

A flowchart describing the steps involved in perinatal death reporting in QLD can be found here.

Where can I find further information about completing a MCCD?

In QLD:

Forms required: MCCD 

Relevant legislation: Coroners Act 2003 & Births, Deaths and Marriages Registration Act 2003

Queensland Coroners Court

Registry of Births, Deaths, Marriages and Divorces