Completing an MCCD
As a doctor, you should follow the World Health Organization (WHO) recommendations in the International Classification of Diseases (ICD) when stating opinion on a cause of death:
- on the MCCD (Medical Certificate of Cause of Death)
- in a statement
- in evidence.
Start with the immediate, direct cause of death on line Ia.
On the following lines, go back through the sequence of events or conditions that led to the death, until you’ve reached the one that initiated the fatal sequence.
If you’ve completed the certificate properly, the condition on the lowest completed line of part I will have caused all of the conditions on the lines above it.
If you need to include more than three steps in the sequence, write more than one condition on a line, indicating clearly that one is due to the next.
If the direct cause of death arose as a complication of, or from an error or accident in, surgery or other procedure or treatment, enter this as an antecedent cause. Make sure you include a note of the circumstances and a statement of the condition for which the procedure or treatment was being carried out.
In part two of the certificate you should enter, in order of significance, any other diseases, injuries, conditions or events that contributed to the death, but which were not part of the direct sequence.
Example cause of death (parts one and two)
An example cause of death entry should be structured in the following way:
- I(a) - Disease or condition leading directly to death, ie Intraperitoneal haemorrhage
- I(b) - other disease or condition, if any, leading to I(a), ie Ruptured metastatic deposit in liver
- I(c) - other disease or condition, if any, leading to I(b), ie From primary adenocarcinoma of ascending colon
- II - Other significant conditions Contributing to death but not related to the disease or condition causing it, ie Non-insulin dependent diabetes mellitus