NON-NATURAL DEATHS
144.28 Medical Certification.
1. a. For the purposes of this [Iowa Code] section, “non-natural cause of death” means the
death is a direct or indirect result of physical, chemical, thermal, or electrical trauma, or drug or
alcohol intoxication or other poisoning.
b. Unless there is a non-natural cause of death, the medical certification shall be completed
and signed by the physician, physician assistant,* or advanced registered nurse practitioner* in
charge of the patient’s care for the illness or condition which resulted in death within seventy-
two hours after receipt of the death certificate from the funeral director or individual who initially
assumes custody of the body.
c. If there is a non-natural cause of death, the county or state medical examiner shall be
notified and shall conduct an inquiry.
d. If the decedent was an infant or child and the cause of death is not known, the medical
examiner’s inquiry shall be conducted and an autopsy performed as necessary to exclude a
non-natural cause of death.
e. If upon inquiry into a death, the county or state medical examiner determines that a pre-
existing natural disease or condition was the likely cause of death and that the death does not
affect the public interest as described in [Iowa Code] section 331.802, subsection 3, the medical
examiner may elect to defer to the physician, physician assistant,* or advanced registered nurse
practitioner* in charge of the patient’s pre-existing condition the certification of the cause of
death.
f.
When an inquiry is required by the county or state medical examiner, the medical
examiner shall investigate the cause and manner of death and shall complete and sign the
medical certification within seventy-two hours after determination of the cause and manner of
death.
2. The person completing the medical certification of cause of death shall attest to its accuracy
either by signature or by an electronic process approved by rule.
NOTE:
On the death certificate, the Medical Examiner should enter their case number in item #31b if
the death falls within the jurisdiction of the Medical Examiner.
If the Medical Examiner is deferring certification back to the physician, physician assistant,*
or advanced registered nurse practitioner* in charge of the patient’s care or condition that
resulted in death, the ME should provide the physician, physician assistant,* or advanced
registered nurse practitioner* with the case number to be entered in item #31b on the death
certificate form.
* Effective with July 1, 2011, death events pursuant to H.F. 393, 2011 legislative session.
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