"Cardiac Arrest" is NOT a cause of death...

It’s an effect.

In this otherwise splendid response:

Hawkeye, makes the statement “Michael Jackson’s case, on the other hand, was more complicated: the cause of his death (cardiac arrest) was known, but the manner (homicide, suicide, accidental, or natural) was not.”

Cardiac arrest simply means the heart has stopped. If the heart has not stopped there is a huge problem if an autopsy is performed.

In other words, “cardiac arrest” must be present in every single death. Therefore is useless in defining the cause of death. In fact the instructions for completion of death certificates in my state specifically advise not to list either cardiac arrest or respiratory arrest. That being said it is common to see “cardiac arrest” on the “Line A” of the death certificate. However, the wording then follows “due to or as a consequence of”, and then Line “B”, and if necessary Line “C”. I’ve not seen Michael Jackson’s death certificate, but speaking in general terms, a sudden death due to a drug overdose could correctly be certified as “(insert name of drug implicated) overdose”. If there was a specific injury it could be specified. An example would be the case of liver damage resulting from acetaminophen overdose. In that case it should read (Line A) “Liver Failure due to or as a consequence of (Line B) acetaminophen toxicity”.

The article does a wonderful job of differentiating between the cause and manner of death. In fact it’s a great article, which only made the “cardiac arrest” line more of a turd in the punchbowl.

It would not surprise me to see ‘cardiac arrest’ listed as the cause of death on an official death certificate. My own father died under circumstances requiring an autopsy, and the medical examiner listed the cause of death as ‘complications of heart disease’. That is no more a cause of death than cardiac arrest, yet there it was, as the official cause of death.

Heart disease is very much a valid cause of death.

That being said it is commonly used as a catch all for what is commonly referred to as “old age”. Often older people are not autopsied, when it’s clear their death was natural. Lacking a specific diagnosis “heart disease”, “generalized atherosclerosis”, and others are used.

In a case such as your father’s, where an autopsy was performed, then heart disease could very well have been conclusively shown as the likely cause of death, as histology would reveal evidence of ischemia, or other particular damage to the heart muscle from disease.

This is very different from “cardiac arrest” which means nothing more than the heart has stopped.

If cardiac arrest is listed as the cause of death on the death certificate, with no further explanation, the state agency responsible for recording the death certificate will send an inquiry to the certifying doctor asking that the death certificate be amended to list a valid cause. Occasionally a death certificate will have a cause listing something like " cardiac arrest of unclear etiology" when an autopsy failed to reveal evidence of a specific cause. Typically in those cases the manner of death will be listed as “undetermined”.

Could have, but wasn’t. I was troubled by the vague conclusion, so I called the ME, and pressed him for more information. My father had never had a heart attack, and the ME said there was no blockage of any cardiac artery, though all were narrowed by atherosclerosis. He was not incapacitated in any way prior to his death, and could walk a golf course with the best of them.

In this case, I think it was just laziness. “Undetermined” would have been more acceptable, but I think that goes against the professional ego of some ME’s.

Nice Staff Report, but I don’t understand, or maybe believe, the last sentence. Seems pure supposition.

In the end, isn’t there only one cause of death? Lack of oxygen to the brain.:smiley:

Well, the autopsy “work” is almost always done during the procedure itself. Typically not more than a few hours. At that point the body can be released to the family so arrangement’s can be made. After that, blood and other fliuids are sent off for toxicologic studies, and small pieces of various tissues are sent to be prepared on slides for microscopic examination. When those slide come back, the pathologist examines them for evidence of abnormality. When the toxicology results come back the findings are considered, and the results incorporated into the final report.

That gets back to my original post. The goal is to determine the cause. Lack of oxygen to the brain is the mechanism. If a person were strangled; or if they suffered a myocardial infarction (heart attack), they would suffer an “anoxic brain injury”. I suspect you’d be dissatisfied to see that listed as the cause of death.

One of my favorite lines in William Poundstone’s Big Secrets is in his chapter investigating the rumor of Walt Disney’s cryogenic preservation (referenced in this classic column). He looked up ol’ Walt’s death certificate and found that the official cause of death was ‘acute cardio-respiratory failure’. Poundstone’s comment: “This is medical jargon for ‘he stopped breathing and his heart stopped beating’, which is presumably how they found out he was dead in the first place.” (Quote is from memory, but it’s pretty well-seared.)

Yeah, sloppy flash-freezing does that sometimes.

Shoulda ziplocked 'im.

Peruvian death certificates state “Cardiac arrest is not a cause of death, it is a way of dying”. As a doctor friend told me: “for almost every death you could say carduac arrest and it would no be informative, you have to say WHY the heart stopped”.

While we’re in the neighborhood, doesn’t “autopsy” mean “self (auto)- seeing (opsis)”? How does that work? I would think if any operation would be a poor candidate for DIY surgery, it’s this one.

I worked in hospital administration in the 80s and became a physician in the 90s. One of my more clerical tasks jobs was to make sure the death certificates would pass muster with the local ME (who was famous for making certifying physicians completely redo death certificates because they didn’t use black, medium point ball pen – or even didn’t look like they had. The Plastic-ball and gel pens were just coming out around then, and he rejected those too)

While the Chiefs of Staff and most senior physicians constantly carped that “cardiopulmonary arrest” (the preferred local lingo) was not an acceptable cause of death, and the funeral directors or ME would snark at me (as if I had any say) if they saw it, several of the community physicians persisted out of habit (or for lack of any better idea of the actual cause of death in an elderly, severely ailing patient). I don’t recall any of those being sent back.

Autopsies weren’t (and aren’t) nearly as common as they were in the 1960s/70s. [I think that’s a real shame, because they taught us a lot.] In most cases (‘old and multiply-ill’, with ‘younger and stupid’ running second – including multiple blunt force trauma or motor vehicle accident), the exact cause of death is actually known with far less specificity than the CSI franchise would have you believe.

Word originally meant “seeing for yourself”. Narrowed down to this one particular case of seeing for yourself several centuries ago.