A Medical Practitioner may certify “Life Extinct”. They may also issue a “Cause of Death” certificate where they believe the death had a known cause and the deceased is known to them.

Ambulance Officers may be called to a scene where a death has occurred. Deaths involving trauma or other “unnatural” causes (e.g. electrocution), sudden death of unknown cause and/or unidentifiable deceased must be reported to the police, (e.g. drowning, suicides, shootings, stabbings, traffic accidents, workplace deaths etc).

Ambulance Officers may also certify “Life Extinct” under the provisions of the Coroner. Police will usually require Ambulance Officers to complete a “Life Extinct” form where after proper examination Ambulance Officers decide that no life exists. This should be done on the ePCR at the time of the case unless there is another patient to treat or an outstanding urgent call. A paper form can be completed when ePCR is not available, but this should not be routine.

Provisions for certification include: decapitation, rigor mortis, body decomposition or putrification.

Obvious Deaths:

This is the ONLY category in which Police Officers may issue a “Life Extinct” form.

"Obvious deaths" associated with trauma are reportable to the Coroner.

"Obvious deaths" are those where the state of the body is clearly incompatible with life:

• Extensive trauma has caused decapitation, severance of the torso, disruption of a vital organ (e.g. brain), or fragmentation of the body; or
• Well established decomposition has caused extensive discolouration of the skin, bloating of the body, and, in some cases, larval infestation and partial exposure of bones; or
• Advanced decomposition has exposed most of the skeleton, so called “skeletal remains”.

Reportable Deaths:

Deaths in these categories require notification to the coroner.

Appears to have been unexpected, unnatural or violent or to have resulted, directly or indirectly, from injury.

• Person who immediately before death was a person held in care. (*)
• Appears to have been caused or contributed to by any action of a member of the Police Force.
• A person whose identity is unknown.

(*) The term “person held in care” means a person held:

• Under the Child Welfare Act.
• In custody under the Prisons Act.
• In any centre under the Alcohol and Drug Authority Act 1974.
• As an involuntary patient or apprehended or detained within the meaning of the Mental Health Act 2014.
• As a detainee under the Young Offenders Act 1994.

An important point to understand is that once the decision has been made to report the death to the Coroner, all evidence of medical intervention in the deceased must remained untouched.

Suspicious Deaths:

Suspicious deaths may include a criminal act, suicides, stabbings, shootings, overdoses or where the information gathered does not make sense. Where Officers suspect a suspicious death, the police need to be called immediately and the scene secured. Documentation is important and any details you gather should be included. This is evidence and may be required by a court.

Patient care to others should not be delayed. If CPR is stopped please leave the scene as is. Should this happen, officers need to be aware that they will contribute to evidence at the scene and may inadvertently contaminate the scene.

Suicidal Deaths:

All suicidal deaths should be treated as suspicious. Notes left at the scene are to be treated as confidential and evidence. The knot used to form a noose must be left tied and the rope cut away from the knot where possible. Do not cut down the deceased if there is an obvious death and CPR is not considered. Protect the scene and call the police.

Non-Suspicious Deaths:

Non suspicious circumstances may include deaths at home of natural causes. Officers will need to establish a need to contact coronial / police.

If there are no suspicious circumstances, officers may phone the deceased’s Medical Practitioner. They should detail the circumstances surrounding the death and ask the Medical Practitioner if there will be a "Cause of Death" Certificate forthcoming. If so, there is no need to contact police. The relatives may be advised to contact a funeral service of their choice and make all further arrangements with them (i.e. collecting the deceased etc). This needs to be documented (time of call and name of Medical Practitioner).

Should a Medical Practitioner be unavailable, then the police should be called and advised of the situation. Usually the Officers will be called back once the Police have tried to contact the Medical Practitioner. If no contact is made and /or the “Cause of Death” Certificate is not forthcoming, then the Police must attend.

Should Police attend, they will usually convey the deceased via a contracted funeral service. If a contractor is not available or death is in a public place, Ambulance Officers may then be required to take the deceased to the requested mortuary (often located at hospitals).

Support:

Officers who attend scene where someone has died are at risk of stress, particularly when the circumstances are complicated, or the case protracted. Officers should be mindful of their mental wellbeing and seek support from their colleagues and/or Community Paramedic. Furthermore, the Wellbeing and Support Team are available at all times, and officers should have a low threshold for engaging with them.

All hours contact: 08 9373 3827
wellbeingandsupport@stjohnambulance.com.au