2023 Maryland Statutes › Health - General › Title 4 - Statistics and Records › Subtitle 2 - Vital Statistics and Records › Section 4-212 - Certificates of Death; Notice to Medical Examiner

(a)    This section does not apply to a fetal death.
(b)    (1)    A certificate of death regardless of age of decedent shall be filled out and signed by:
(i)    The medical examiner, if the medical examiner takes charge of the body; or
(ii)    If the medical examiner does not take charge of the body, the physician, physician assistant, or nurse practitioner who last attended the deceased.
(2)    The medical examiner, physician, physician assistant, or nurse practitioner shall fill in only the following information on the certificate of death:
(i)    The name of the deceased;
(ii)    The cause of death and medical certification;
(iii)    The date and hour of death; and
(iv)    The place where death occurred.
(3)    Any other information that is required on the certificate of death regardless of age of decedent shall be filled in:
(i)    By the person who has charge of the body; or
(ii)    If the State Anatomy Board has charge of the body, by the person who last had charge of the body before it was sent to the State Anatomy Board.
(4)    The medical certification shall be completed within 24 hours after receipt of the death certificate by the physician, physician assistant, or nurse practitioner in charge of the patient’s care for the illness or condition which resulted in death, except when inquiry is required by the medical examiner.
(5)    In the absence or inability of the attending physician, physician assistant, or nurse practitioner or with the attending physician’s, physician assistant’s, or nurse practitioner’s approval, the certificate may be completed by:
(i)    The attending physician’s associate;
(ii)    The chief medical officer or designee of the institution in which death occurred;
(iii)    The physician who performed an autopsy upon the decedent, provided the individual has access to the medical history of the case and death is due to natural causes; or
(iv)    A physician designated by the State Anatomy Board, only if within 72 hours after the State Anatomy Board takes charge of the body, the State Anatomy Board has failed after a good faith effort to make contact with any of the individuals described in items (i), (ii), or (iii) of this paragraph or paragraph (4) of this subsection.
(6)    The person completing the cause of death and medical certification shall attest to the accuracy by signature or by an approved electronic process.
(7)    The funeral director or person acting as the funeral director shall in all cases obtain the medical certification from the person responsible for its completion or obtain assurance that the medical certification has been provided to the Secretary by an approved electronic process.
(c)    Each individual concerned with carrying out this subtitle promptly shall notify the medical examiner if:
(1)    The deceased was not under treatment by a physician, physician assistant, or nurse practitioner during the terminal illness;
(2)    The cause of death is unknown; or
(3)    The individual considers any of the following conditions to be the cause of death or to have contributed to the death:
(i)    An accident, including a fall with a fracture or other injury;
(ii)    Homicide;
(iii)    Suicide;
(iv)    Other external manner of death;
(v)    Alcoholism; or
(vi)    Criminal or suspected criminal abortion.
(d)    (1)    (i)    If, within 24 hours after taking charge of a body, the medical examiner has not determined the cause of death, the medical examiner shall enter “investigation pending” in the cause of death section of the death certificate.
(ii)    As soon as the medical examiner determines the cause of death, the medical examiner shall send to the Secretary a report of the cause of death, for entry on the certificate.
(2)    (i)    A physician who completes a death certificate under subsection (b)(5)(iv) of this section shall enter “unspecified natural causes” in the cause of death section of the death certificate.
(ii)    The State Anatomy Board shall send to the Secretary a report of the cause of death for entry on a death certificate completed under subsection (b)(5)(iv) of this section if the State Anatomy Board receives information about the cause of death from an individual described in subsection (b)(4) or (5)(i), (ii), or (iii) of this section.
(e)    (1)    A physician, physician assistant, or nurse practitioner who fills out a certificate of death shall give it or transmit it by approved electronic media, including facsimile, to the mortician within 24 hours after the death occurred.
(2)    A medical examiner who fills out a certificate of death shall give it or transmit it by approved electronic media, including facsimile, to the mortician within 24 hours after the medical examiner took charge of the body.
(f)    (1)    If a death occurs on a common carrier in the United States and the body is removed from the carrier in this State, the death shall be registered in this State, and the place where it is first removed shall be considered the place of death. When a death occurs on a common carrier while in international waters or air space or in a foreign country or its air space and the body is first removed from the carrier in this State, the death shall be registered in this State, but the certificate shall show the actual place of death insofar as can be determined.
(2)    The individual in charge or the owner of the common carrier or a designee shall file a certificate of death within 24 hours after the body is removed from the carrier.
(3)    If the death occurred under any of the conditions or circumstances set forth in subsection (c) of this section, the medical examiner shall be notified.
(g)    A mortician who obtains a certificate of death under this section shall file the certificate within 72 hours after the death.
(h)    (1)    Except as authorized under this subtitle, an individual who has a duty to fill out and sign a certificate of death may not execute more than one certificate for a death.
(2)    The attending physician, the physician assistant, the nurse practitioner, or a medical examiner who takes charge of a body may file a replacement death certificate if a correction that the physician, the physician assistant, the nurse practitioner, or medical examiner authorizes cannot be entered legibly on the original certificate.