An Act To Amend the Laws Relating to Medical Certification of the Cause of Death and the Medical Examiner Act
Maine Legislature, Session 121, LD 1211
Committee: Judiciary
Sponsors: NORBERT, PENDLETON
Amends: 22 MRSA §2842, 22 MRSA §3025

Legislative Document 
No. 1211 
H.P.885 
House of Representati ves, March 6, 2003 
An Act To Amend the Laws Relating to Medical Certification of the 
Cause of Death and the Medical Examiner Act 
Submitted by the Department of the Attorney General pursuant to Joint Rule 204. 
Reference to the Committee on Judiciary suggested and ordered printed. 
Presented by Representative NORBERT of Portland. 
Cosponsored by Senator PENDLETON of Cumberland. 
Printed on recycled paper 
'77/~/J7.~ 
MILLICENT M. MacFARLAND 
Clerk 
Be it enacted by the People of the State of Maine as follows: 
Sec. 1. 22 MRSA §2842, sub-§2-A is enacted to read: 
2-A. 
Medical certification. 
Notwithstanding subsection 2, 
with respect to a person who dies within the State naturally and 
for whom the physician was the attending physician the medical 
certification of the cause of death may be completed and signed 
by 
a 
physician 
authorized 
to 
practice 
at 
the 
Veterans 
Administration Hospital at Togus or at another federal medical 
facility within the State or by a physician licensed to practice 
in New Hampshire, Vermont or Massachusetts, who, at the request 
of the Chief Medical Examiner, is willing to do so. 
Sec. 2. 22 MRSA §3025, sub-§I, as amended by PL 2001, c. 222, 
§4 and c. 354, §3, is further amended to read: 
1. 
Circumstances of death that must be reported. 
A medical 
examiner case eHist::s may exist and must be reported as provided 
in section 3026 when remains are found wRieR that may be human 
and raise suspicion that death has occurred under any of the 
following circumstances: 
A. 
Death is suspected of having been caused by any type of 
physical injury, including poisoning, regardless of whether 
the 
suspected 
manner 
of 
death 
is 
homicide, 
suicide 
or 
accident.,.. 
This circumstance must be reported irrespective 
of whether the deceased had been attended by a physician, 
was 
a patient in a hospital, survived for 
a considerable 
time following the physical injury or died from terminal 
natural 
causes 
consequent 
to 
and 
following 
the 
physical 
injury; 
B. 
Suddenly when the person is in apparent good health and 
has no specific natural disease sufficient to explain death; 
C. 
During 
diagnostic 
or 
therapeutic 
procedures 
under 
circumstances indicating gross negligence or when clearly 
due to trauma or poisoning unrelated to the ordinary risks 
of those procedures; 
D. 
Death when the person is in custody pursuant to an 
arrest, confined in a state correctional facility, county 
institution, 
facility 
or 
local 
lockup, 
unless 
clearly 
certif iable by an attending physician as due to specific 
natural causes; 
E. 
Death while t:he person is a patient or resident of a 
facility of the Department of Behavioral and Developmental 
Services or residential care facility maintained or licensed 
by 
the 
Department 
of 
Human 
Services, 
unless 
clearly 
Page l-LR18l7(1) 
certifiable by an attending physician as due to specific 
natural causes; 
F. 
Death suspected of being due to a threat to the public 
health when the authority of the medical examiner is needed 
to adequately study the case for 
the protection of the 
public health; 
G. 
Death suspected of not having been certified, including, 
but not limited to, bodies brought into the State and any 
buried remains uncovered other than by legal exhumation; 
H. 
Deaths suspected of being medical examiner cases which 
may have been improperly certified or inadequately examined, 
including, but not limited to, bodies brought into the State 
under those circumstances; 
I. 
Sudden infant death syndrome deaths and all other deaths 
of children under the age of 18 unless clearly certifiable 
by an attending physician as due to specific natural causes 
unrelated to abuse or neglect; 
J. 
Whenever human or possibly human remains are discovered 
not 
properly 
interred 
or 
disposed 
of, 
for 
which 
the 
responsibility to do so cannot be readily determined; or 
K. 
Any cause when there is no attending physician capable 
;:: R 
of certifying the death as due to natural causes. When a 
person 
dies 
who 
is 
under 
the 
care 
of 
a 
religious 
practitioner who uses prayer and spiritual means of healing, 
the fact that the deceased has been under such religious 
care 
does 
not 
warrant 
suspicion 
of 
foul 
play 
or 
investigation beyond that warranted by the other facts of 
the case. 
In any case in which the necessity of a report is questionable, a 
report must be made. 
\ 8 
Sec. 3. 22 MRSA §3025, sub-§l-A is enacted to read: 
I-A. 
Medical examiner case determination. 
Notwithstanding 
that a case must be reported under subsection 1, the acceptance 
of 
any reported death as 
a 
medical 
examiner 
case is to be 
determined by the Chief Medical Examiner unless acceptance is 
specifically ordered by the Attorney General or district attorney 
having jurisdiction. 
<i8 
The following deaths that must be reported need not be accepted 
by the Chief Medical Examiner as a medical examiner case: 
l4 
A. 
Deaths due to the consequences of long-term alcohol use, 
long-term exposure to environmental or occupational toxins 
or long-term exposure to carcinogens; 
B. 
Deaths in the elderly who have sustained limb or axial 
fractures, excluding the head, for which they are or have 
been hospitalized; or 
C. 
Sudden natural deaths in the elderly who have not had 
previous specific symptoms or who were not under treatment 
by 
a 
physician for 
the 
specific natural 
cause that is 
considered to be the cause of death. 
These reportable deaths may be referred back to the attending 
physician by the Chief Medical Examiner for certification of the 
death, even though the attending physician has not treated the 
patient for 
the specific natural disease that the 
attending 
physician will enter as the physician's diagnosis. 
Sec. 4. 22 MRS A §3025, sub-§2, as amended by PL 2001, c. 222, 
§5, is repealed. 
Sec. 5. 22 MRS A §3025, sub-§4, as amended by PL 2001, c. 222, 
§6, is repealed. 
SUMMARY 
This bill does 4 things. 
1. 
It creates an exception to the Maine Revised Statutes, 
Title 
22, 
section 
2842, 
subsection 
relative 
to 
medical 
{4 
certification of cause of death that requires the certifying 
physician to be "authorized to practice in the State." 
The 
exception would 
allow, 
at the 
request of the 
Chief Medical 
Examiner of Maine, a willing attending physician of a person who 
dies within Maine of natural causes to complete and sign the 
medical certification if that physician is authorized to practice 
at the Veterans Administration Hospital at Togus or at another 
federal medical facility in Maine or is a licensed physician from 
New Hampshire, Vermont or Massachusetts. 
2. 
It amends the Maine Revised Statutes, Title 22, section 
3025 
to clarify that 
although 
deaths 
must 
be 
reported, 
as 
prescribed in Title 22, section 3026, when remains are found that 
may be human and raise suspicion that death has occurred under 
one 
or 
more 
of 
the 
listed 
circumstances, 
the 
ultimate 
determination 
as 
to 
whether 
a 
reported death constitutes 
a 
medical examiner case is to be determined by the Chief Medical 
Examiner, 
barring 
a 
directive 
from 
the 
Attorney 
General 
or 
district attorney having jurisdiction. 
3. 
It reconfigures, Title 22, section 3025. 
Specifically, 
subsection 2 is now incorporated into subsection 1, paragraph A, 
!) 
and that portion of subsection 4 addressing questionable cases is 
now incorporated into subsection I-A. 
Both subsections 2 and 4 
are repealed. 
4. 
It adds a new category of death that must be reported 
but need not be accepted by the Chief Medical examiner as 
a 
medical examiner case. 
The added category is found in Title 22, 
section 3025, subsection I-A, paragraph B and addresses deaths in 
the elderly who 
have sustained an 
arm or leg fracture or 
a 
fracture to the spine, ribs or pelvis and who are hospitalized at 
the time of death or prior thereto because of such fracture.