“he had it comin’”
From my years in Texas and Oklahoma, I was going to say, “He needed killin’.”
My grandfather’s cause of death was “failure to thrive,” which amounts pretty much to the same thing.
Did they have progeria?
Silly would be 25. Is it still silly at 75?
Hm. Could ‘progeria’ reasonably be put down as a cause of death? (“He had progeria n years ago and it didn’t kill him then.”)
Your question is silly.
I’m not asking for a bright line, but there does have to be a line.
A straight line, maybe, but that’s what we have smartasses for.
Sixty-six. The line for me was at age 66. I’m now at old age +1.
Did I mention that , so far, I love aging? For one thing I get to play the senior card at will.
Ah, so that’s the wrinkle I was missing. Well, my point with picking 55 was that the average lifespan is well beyond that age; however, somewhere between 55 and 90 is an age where people begin to feel comfortable with the idea of a person dying of “old age” at that age. Is there any consensus for where that line is?
I think old age is when the government tells you that by way of calling you eligible for ‘old age benefits’. It is 65 I think.
Three score and ten are the years given to man.
Which completely debunks the idea that people were dropping dead in their fifties back before modern medicine. The average lifespan was shorter, but once you survived childhood making it to “three score and ten” (70) was entirely possible.
Anyway, it seems that the maximum human lifespan is six score (120 years); beyond that is, well, let’s say it is definitively beyond the warranty period.
I am 83 now and still kicking. Have some problems, but heart is still good. Don’t know what my cause of death will be but I really don’t care much about that.
Short answer: No and yes.
Per the specific and simple instructions on the DC itself for how to fill it out, such a DC doesn’t cut it. In particular, to be complete, every DC needs to have an etiologically specific disease or injury listed as the underlying cause of death - that is, as the cause that initiated the chain of events (or intermediate causes) that terminated in the cessation of life (or the immediate cause of death).
Thus: Cardiac arrest (immediate cause) due to heart failure (intermediate cause) due to myocardial infarct (or heart attack; another intermediate cause) due to atherosclerotic cardiovascular disease (underlying cause, considered etiologically specific, even though multiple risk factors, such as diabetes, smoking, etc, are commonly associated with it). The underlying cause is really where the money is. All the other “causes” can be dispensed with and the DC, as a one liner underlying cause, would be considered complete, although less informative.
Heart failure, as can be seen, is not etilogically specific, as it could equally well fit into this:
Cardiac arrest due to heart failure due to myocardial scarring due to stab wound of the chest. A formulation with very different implications. The one liner “complications of heart failure” does not distinguish between these two scenarios.
If I was reviewing DCs, and came across this one, which is actually not untypical of what gets done, and the person was “older”, I would probably let it pass. I’m not reviewing for quality or completeness (I’m not, thank god, a vital statatician, but a medical examiner). I’m reviewing DCs to see if there is anything about the death that the ME may need to be involved in. That is, if there is any indication that a Non-natural process may have been involved in the death. If decedent was older and the DC was “completed” as “heart failure” full stop, I’d assume it was the very very common garden variety of heart failure due to natrual disease and let it go. If the person was “younger”, it would be uncommon to die of heart failure, so I’d request more information from the person who certified the death and require them to include an underlying cause on the DC.
I’d like to see at least 4 score and change.
Thank you for this information. My dad was 76, in generally good health, and was being treated for heart disease. He was physically active, and had never had a heart attack. He died when he had some kind of event while driving, and lost control of the car, which crashed. Because of the nature of the accident in which passengers were injured, an autopsy was performed. There was no cardiac infarction, and no evidence of stroke. I am still unsatisfied that the cause of death was determined; I suspect an inadvertent medication overdose, though I have no evidence for that. The whole autopsy report was suspect to me, as it identified him as “uncircumcised”, which my mother found disconcerting, as he was most certainly circumcised.
Was the cause determined or undetermined?
When someone has potentially fatal natural disease, and then is a driver involved in a car crash and suffers potentially fatal injury (a not at all uncommon situation), it is usually difficult and often impossible to tell whether they were dead before or after the crash. It may be the practice of some MEs or coroners to just call the cause “undetermined”. Where I practice, our standard approach to this ambiguity is to give the benefit of the doubt to the external (or non-natural) event, and attribute the COD to the injuries and include the disease as possible contributors.
In any case, you have my condolences.
If I had been the ME, I would have answered yes to the question about heart attack. That term can mean different things to different people. A pathologist sticking to a pedantic hard line (in my opinion) may consider heart attack only as synonymous with myocardial infarct, which generally does require full occlusion of a coronary artery. To me, and I think most non medical people, heart attack means that the heart suddenly stops working. Sometimes that’s due to a frank infarct, but most often it is not. In fact, most of the autopsies I sign out as “heart attack” (the actual wording is the jargonistic stand in “atherosclerotic cardiovascular disease”) do not have complete blockage of an artery, but severe narrowings of one or more. The idea is that transient decrease in blood flow by virtue of the narrowing trips the heart off into an arrhythmia that perpetuates in a kind of positive feedback way to become fatal. It’s estimated that for up to a third of people who die of a heart attack, sudden death of this sort is the first “symptom.”