New Death Certificate System Takes Toll on Efficiency, Adds to Grief

January 9, 2011
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imageThe first shock was her father’s death the day before New Year’s Eve. But Sonia Ardeel was even more surprised to discover how difficult getting a death certificate — necessary to grant her father’s wish to be cremated — would be.

A new system that transformed the death certificate from a paper document to an electronic record lies behind the nightmare that Ardeel, 40, and her family have experienced. The system, which went into effect Jan. 1, requires funeral homes and doctors to sign up for a four-digit PIN to enter a record.

In announcing its new Indiana Death Registration System, state health officials said the Web-based process would speed up the issuing of death certificates.

But as the case of Robert Martinez, Ardeel’s father, shows, not every doctor has signed up. If the doctor responsible for declaring a patient’s death or the funeral home handling the body is not in the state system, the death certificate likely will be delayed.

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For a family in Muncie, the switch to the new system meant a man who died Dec. 24 was not cremated until 14 days later.

For Ardeel, the delay has lasted more than a week. Since a heart attack claimed Martinez’s life, his death certificate has not been finalized; his body is in a morgue, awaiting cremation. On Saturday afternoon, the hospital called Ardeel and said it signed the death certificate. She is now waiting to hear from the funeral home.

Without his ashes, Ardeel and her mother, Faith, held off on scheduling the funeral Mass.

“This is a mess,” Ardeel said Friday. “It’s certainly costing us more grief. We would like some closure.”

State health officials say doctors received ample warning to register in the system.

Of the state’s approximately 25,000 physicians, about 3,000 sign the majority of death certificates, said Erin Kellam, registrar for the Indiana State Department of Health. More than 5,000 have registered.

About 200 death certificates were signed in the first week of the year, in keeping with the average number filed before the new system. Doctors who requested a PIN had it in a day, Kellam said. The typical turnaround time is about 48 hours.

“We are cognizant of how important these records are,” Kellam said.

But something went wrong in Martinez’s case.

The 68-year-old Hancock County man died Dec. 30 at Indiana Heart Hospital, a few days after cardiac surgery, Ardeel said.

The funeral director entered an initial record for Martinez, which he sent to a Heart Hospital doctor to sign.

If all went well, the doctor would have entered his electronic signature, and the record would have gone back to the funeral director. Each party has five days to sign off.

Instead, the doctor who received Martinez’s record said he was not familiar enough with the case to sign it, Ardeel said. The certificate was then routed to another doctor, who was not in the state database.

Heart Hospital officials declined to comment on Martinez’s case Friday.

“Our hearts go out to any family who experiences the loss of a loved one and is caught up in the logistics of the state’s new process regarding death certificates,” Leah Campbell, a hospital spokeswoman, said in an e-mail. “(We) understand there have been problems with the system statewide. Like other hospitals, we are actively working with physicians and the state to improve this new process.”

Doctors had more than a year to sign up for the new system, Kellam said. Birth certificates already have gone electronic.

The new system, which cost about $1 million and was funded by state and federal money, improves on the paper document, Kellam said. In the past, funeral directors had to track down a doctor personally, then take the certificate to the local health department, which sent it to the state.

“The way the system works now, it’s much more efficient, because we don’t have all that paper flying around,” Kellam said.

Eight days after her father’s death, Ardeel was wishing for a piece of paper.

“We are here more than a week later,” she said. “This is not appropriate when you’re trying to grieve.”

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