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State laws and regulations that affect your medical practice

1. When may a physician declare a pronouncement of death, based upon traditional cardio-respiratory criteria?

Determination of death means observation and assessment that a person has ceased bodily functions irreversibly including, but not limited to, the following: pulse, respiration, heartbeat and pupil reaction.

CT ADC § 7-62-1

(a) An attending physician who has determined that the prognosis for a patient is for an anticipated death shall:

(1) Document such determination in the patient's medical or clinical record; and

(2) At the time of such determination and documentation, authorize in writing a specific registered nurse or nurses to make a determination and pronouncement of death, except when an anticipated death occurs in an institution which has adopted its own policies and procedures, in which case the physician may authorize registered nurse employees in such institution to make a determination and pronouncement of death.

(b) The determination and documentation by an attending physician that the prognosis for a patient is for an anticipated death shall be valid for a period of time not to exceed 120 days.

( c ) A registered nurse who has determined and pronounced death should document the clinical criteria for such determination and pronouncement in the patient's medical or clinical record and notify the physician who determined that the prognosis for such patient was for an anticipated death pursuant to subsection (a) of this section. The registered nurse shall indicate on the death certificate the name of the deceased and the date and time of death, and shall sign the death certificate.

CT ADC § 7-62-2

2. Where a registered nurse has determined and pronounced the death of a patient, must a licensed physician view and examine the body when preparing the medical certification portion of the death certificate?

Yes. A licensed physician must personally view and examine the body of the person to whom the medical certification relates, in order to ensure that such person is, in fact, dead.

1991 WL 529799 (Office of the Attorney General, Opinion No. 91-037)

3. Within what period of time of death must a physician sign a death certificate?

A physician must sign the medical certification on the death certificate within twenty-four hours of death.

C.G.S.A. § 7-62b

4. How may a physician make a determination concerning the continuation or removal of any life support system?

A life support system means any mechanical or electronic device utilized by any medical facility in order to replace, assist or supplement the function of any human vital organ or combination of organs.

For purposes of making a determination concerning the continuation or removal of any life support system, an individual who has sustained either (1) irreversible cessation of circulatory and respiratory functions, or (2) irreversible cessation of all functions of the entire brain, including the brain stem, is dead. Determination of death shall be made in accordance with accepted medical standards.

C.G.S.A. § 19a-504a

Copyright Kern Augustine Conroy and Schoppmann, P.C. Used with permission.

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