                                 CODE OF VIRGINIA

FILING DEATH CERTIFICATES; MEDICAL CERTIFICATION; INVESTIGATION BY OFFICE OF THE
CHIEF MEDICAL EXAMINER (§ 32.1-263)

A. A death certificate, including, if known, the social security number or
control number issued by the Department of Motor Vehicles pursuant to §
46.2-342 of the deceased, shall be filed for each death that occurs in the
Commonwealth. Non-electronically filed death certificates shall be filed with
the registrar of any district in the Commonwealth within three days after such
death and prior to final disposition or removal of the body from the
Commonwealth. Electronically filed death certificates shall be filed with the
State Registrar of Vital Records through the Electronic Death Registration
System within three days after such death and prior to final disposition or
removal of the body from the Commonwealth. Any death certificate shall be
registered by such registrar if it has been completed and filed in accordance
with the following requirements:

   1. If the place of death is unknown, but the dead body is found in the
   Commonwealth, the death shall be registered in the Commonwealth and the place
   where the dead body is found shall be shown as the place of death. If the date
   of death is unknown, it shall be determined by approximation, taking into
   consideration all relevant information, including information provided by the
   immediate family regarding the date and time that the deceased was last seen
   alive, if the individual died in his home; and

   2. When death occurs in a moving conveyance, in the United States of America
   and the body is first removed from the conveyance in the Commonwealth, the
   death shall be registered in the Commonwealth and the place where it is first
   removed shall be considered the place of death. When a death occurs on a
   moving conveyance while in international waters or air space or in a foreign
   country or its air space and the body is first removed from the conveyance in
   the Commonwealth, the death shall be registered in the Commonwealth but the
   certificate shall show the actual place of death insofar as can be determined.

B. The licensed funeral director, funeral service licensee, office of the state
anatomical program, or next of kin as defined in &#xA7; 54.1-2800 who first
assumes custody of a dead body shall complete the certificate of death. He shall
obtain personal data of the deceased necessary to complete the certificate of
death, including the social security number of the deceased or control number
issued to the deceased by the Department of Motor Vehicles pursuant to &#xA7;
46.2-342, from the best qualified person or source available and obtain the
medical certification from the person responsible therefor.
			If a licensed funeral director, funeral service licensee, or representative
of the office of the state anatomical program completes the certificate of
death, he shall file the certificate of death with the State Registrar of Vital
Records electronically using the Electronic Death Registration System and in
accordance with the requirements of subsection A. If a member of the next of kin
of the deceased completes the certificate of death, he shall file the
certificate of death in accordance with the requirements of subsection A but
shall not be required to file the certificate of death electronically.

C. The medical certification shall be completed and filed electronically with
the State Registrar of Vital Records using the Electronic Death Registration
System within 24 hours after death by the physician or autonomous nurse
practitioner in charge of the patient&#8217;s care for the illness or condition
that resulted in death except when inquiry or investigation by the Office of the
Chief Medical Examiner is required by &#xA7; 32.1-283 or 32.1-285.1, or by the
physician or autonomous nurse practitioner who pronounces death pursuant to
&#xA7; 54.1-2972. If the death occurred while under the care of a hospice
provider, the medical certification shall be completed by the decedent&#8217;s
health care provider and filed electronically with the State Registrar of Vital
Records using the Electronic Death Registration System for completion of the
death certificate.
			In the absence of such physician or autonomous nurse practitioner or with his
approval, the certificate may be completed and filed by the following: (i)
another physician or autonomous nurse practitioner employed or engaged by the
same professional practice; (ii) a physician assistant supervised by such
physician; (iii) an advanced practice registered nurse who is not an autonomous
nurse practitioner practicing in accordance with the provisions of &#xA7;
54.1-2957; (iv) the chief medical officer or medical director, or his designee,
of the institution, hospice, or nursing home in which death occurred; (v) a
physician or autonomous nurse practitioner specializing in the delivery of
health care to hospitalized or emergency department patients who is employed by
or engaged by the facility where the death occurred; (vi) the physician who
performed an autopsy upon the decedent; (vii) an individual to whom the
physician or autonomous nurse practitioner has delegated authority to complete
and file the certificate, if such individual has access to the medical history
of the case and death is due to natural causes; or (viii) a physician who is not
licensed by the Board of Medicine who was in charge of the patient&#8217;s care
for the illness or condition that resulted in death. A physician described in
clause (viii) who completes a certificate in accordance with this subsection
shall not be required to register with the Electronic Death Registration System
or complete the certificate electronically.
			As used in this subsection, &#8220;autonomous nurse practitioner&#8221; has
the same meaning as provided in &#xA7; 54.1-2972.

D. When inquiry or investigation by the Office of the Chief Medical Examiner is
required by &#xA7; 32.1-283 or 32.1-285.1, the Chief Medical Examiner shall
cause an investigation of the cause of death to be made and the medical
certification portion of the death certificate to be completed and filed within
24 hours after being notified of the death. If the Office of the Chief Medical
Examiner refuses jurisdiction, the physician last furnishing medical care to the
deceased shall prepare and file the medical certification portion of the death
certificate.

E. If the death is a natural death and a death certificate is being prepared
pursuant to &#xA7; 54.1-2972 and the physician, autonomous nurse practitioner,
or physician assistant is uncertain about the cause of death, he shall use his
best medical judgment to certify a reasonable cause of death or contact the
health district physician director in the district where the death occurred to
obtain guidance in reaching a determination as to a cause of death and document
the same.
			If the cause of death cannot be determined within 24 hours after death, the
medical certification shall be completed as provided by regulations of the
Board. The attending physician or autonomous nurse practitioner, as defined in
&#xA7; 54.1-2972, or the Chief Medical Examiner, an Assistant Chief Medical
Examiner, or a medical examiner appointed pursuant to &#xA7; 32.1-282 shall give
the funeral director or person acting as such notice of the reason for the
delay, and final disposition of the body shall not be made until authorized by
the attending physician, autonomous nurse practitioner, the Chief Medical
Examiner, an Assistant Chief Medical Examiner, or a medical examiner appointed
pursuant to &#xA7; 32.1-282.

F. A physician, autonomous nurse practitioner, physician assistant, or
individual delegated authority to complete and file a certificate of death by a
physician who, in good faith, files a certificate of death or determines the
cause of death shall be immune from civil liability, only for such filing and
determination of causes of death on such certificate, absent gross negligence or
willful misconduct.

HISTORY: Code 1950, § 32-353.20; 1960, c. 451; 1978, c. 308; 1979, c. 711;
1983, c. 240; 1993, c. 965; 1997, cc. 794, 898; 2003, c. 484; 2004, c. 124;
2008, c. 137; 2011, c. 613; 2012, c. 213; 2013, c. 799; 2014, c. 583; 2017, c.
784; 2018, cc. 207, 208, 776; 2019, cc. 213, 224; 2022, c. 184; 2023, c. 183.