Death certificates are a significant factor in wrongful death cases of nursing home residents, and can provide important information. It is not always considered that they can be corrected or amended under specific circumstances. In today’s episode, nursing home abuse attorneys Rob Schenk and Will Smith discuss death certificates and their administration with guest Tommy Davis, Coroner for Newton County Georgia.
TRANSCRIPTION OF EPISODE
Schenk: Hello out there and welcome once again to the Nursing Home Abuse Podcast. My name is Rob Schenk.
Smith: And I’m Will Smith.
Schenk: And we are your hosts for this episode, another educational episode in our line of educational episodes, I guess, so to speak? I don’t know. But at any rate, we’re talking about death certificates. Death certificates are often important in nursing home abuse cases because it’s a document that in some ways reveals sometimes the cause of death, important information that could be used in trial or at least in the discovery process in a nursing home abuse case. But sometimes we have clients who come in whose loved ones have recently passed, and they’re clueless in terms of how to get, or if the information is wrong, how to amend that death certificate, at least in the state of Georgia.
Smith: Yeah, because at the end of the day, there’s no autopsy, the death certificate is the final word in somebody’s death.
Schenk: Exactly. So today we’re going to have somebody very special on the show. Will, who is it?
Smith: We’re going to have Mr. Tommy Davis. Tommy started his career with the Newton County Coroner’s Office in 2003. He was appointed as deputy coroner at that time serving under then-coroner Bob Wheeler. Coroner Wheeler retired in 2008, and Tommy decided to seek the office of coroner and was elected in 2008, again, in 2012, and is currently serving his third term having been re-elected in 2016.
Tommy’s background is in the mortuary sciences. He’s a licensed funeral director and embalmer in the state of Georgia since 1989. He’s worked in the funeral industry since 1984, and he currently owns and operates J.C. Harwell & Son Funeral Home in Covington. He’s active in his community and serves on the board of director for the Rotary Club of Covington, where he is past president. He is a Mason, an Elk and a member of the Covington Lion’s Club. He and his family are members of the First Baptist Church of Covington, and Tommy received the Covington Rotary Club’s W.E. Arendell Vocational Excellence Award in 2016. He was Rotarian of the Year in 2017 and received the Robert S. Stubbs 2nd Guardian of Excellence Award in 2018.
The training for the job of coroner is received at the Georgia Public Safety Training Center in Forsyth, where law enforcement also go. Tommy has received almost 400 hours of training at the Center and has investigated several thousand deaths raging from natural deaths to suicide, homicides and even accidental deaths. He has testified in court to his findings and he speaks on a regular basis to forensic classes and students at Newton College and Career Academy, Alcovy High School, Eastside High School, Newton High School and other civic and local groups. So we are extremely excited to have somebody with this breadth of knowledge and experience to talk about something so important to our listeners and their loved ones.
Schenk: Tommy, welcome to the show.
Tommy: Thanks for having me.
Schenk: Great. Well Tommy, just before we get into the crux of this show, which is talking about Georgia death certificates, something was pointed out to me by a fantastic member of our team who does the transcriptions. His name is Dennis. And Dennis pointed out to me, he wanted to ask this question, but is it true that the coroner is the only person that’s allowed to arrest the sheriff in the county?
Tommy: That’s not really the case. That was an old law and the reason it was in place was because the coroner and the sheriff were both elected. If the sheriff had to go to jail for some reason, the coroner would take over as the sheriff until time of either his reinstatement or a special election could be held to replace the sheriff. And so that’s really how it works. If the sheriff refuses to or can’t do his job, according to the Georgia law, then the probate judge would appoint the coroner to complete those duties and tasks.
Smith: Got you.
Schenk: Got you. I thought that was one of those funny little facts you hear sometimes on the Internet or something. But anyways, well thanks for clearing that up and hopefully that answers Dennis’s query as he transcribes this episode. But at any rate, Tommy, thanks so much for coming on the show. This show is going to be dedicated to Georgia death certificates, so just from a preliminary standpoint, what is a death certificate and what is its function?
Tommy: Well Georgia death certificate or any death certificate for that matter is a legal document used for that deceased person from the time of their death forward for legal matters, tax purposes. It does display biographical information for genealogy, but it also lists the cause and manner of death. But that document is certified in the state and used by the family to probate the deceased estate, to handle any legal matters. It’s a proof as death – it can be used as a proof of death for questions that might arise, so that document is vitally important to the process of probate and of the deceased’s estate.
Schenk: And upon the time of death, what are the factors that go into generating that document. Like who is the person that gets called? How do they go about filling out the information? How do they get the information, that kind of thing? Can you walk us through that?
Tommy: Sure. The death certificate is created by the funeral home. The funeral home generates the death certificate. They basically sit down with the family or the informant at that point and gather all the information necessary to complete the death certificate. They send that form to the doctor or hospice group or medical examiner/coroner, whoever is going to sign and place the cause and manner of death there, they send that document home to that person. The death certificate medical certification or medical portion is done by that person and then certified by the county of death in the state of Georgia.
So the death certificate originates with the funeral home, then to the medical provider, then once those, the biographical and medical portions are together, the demographical and medical portions are together, then it’s certified by the county and the state actually as a certified death certificate.
Schenk: And who at the funeral home is – I understand how the person at the funeral home would get the biographical information. You probably get that from the family. However, what about the basically the cause of death? First of all, who at the funeral home is doing it? The funeral home that’s generating this document, how do they get cause of death information?
Tommy: They get the cause of death from – the medical provider actually puts the cause of death on the document, not the funeral home. The funeral home just initiates the form and then sends it to the medical provider, and then the medical provider then places the cause and manner of death on that document and signs off on it as well. So the medical portion is put on there by the medical provider, whether it be a doctor, a coroner or medical examiner, the hospice group, which has a doctor as well, those are the people who would place the cause or manner of death on the document.
Smith: And how do they determine what the cause and manner of death is?
Tommy: The cause and manner of death can be determined several ways, one of course by medical record. If the person has an extensive medical history, the death is expected. They’ve been diagnosed with cancer or heart disease or congestive heart failure, diabetes, complications, all of those things would be contributing to the cause of death. The doctor would have a documented medical history on the person. I know we’re talking about nursing home cases, so most of your nursing home people would have a documented medical history with a primary care provider, and that documented history can be used to determine the cause and manner of death.
Schenk: Generally, Tommy, start to finish, how long does that process take from the time of the initiation of the document at the funeral home itself?
Tommy: Well the state of Georgia did something here just a couple of years ago. They instituted an electronic death certificate, the GAVERS system. The funeral home can actually sit down after they gather the information from the family, they can sit down and input this into the GAVERS system. It will generate the death certificate at that point. You can designate the medical provider, and it can all be electronic straight to the medical provider. They get it, place cause or manner, it comes back to the funeral home for demographic verification and then released to the county.
Or you can drop that form to paper, send it from the funeral home to the medical provider by fax or by hand. The doctor will then sign off, place some cause or manner on there and his signature, and then you would take that form and fax it onto the county of death so they can begin the process.
I have had that process take as little as 30 minutes and I’ve had it take as long as 120 to 140 days. It depends on the situation around the death.
Schenk: Right. So what are some of the causes or instances that would cause it to take 30 minutes and what are some of the instances that would cause it to take the 120 days?
Tommy: If you were getting a death certificate turned around quickly, say 30 minutes or so, the doctor already has the known cause or manner at hand. They’re ready to sign off on it. You contact them, “Hey, I need this back,” send it to them. They place cause and manner on there, and it’s a natural death, it’s usually a death looking back over the medical records – they’ve been diagnosed and it’s an expected death, if you will.
If you’re looking at extended turns, 100 to 120 days or so, those cases are through your medical examiner and coroner’s offices typically when there are histology and toxicology testing that we’re awaiting on to come back so the medical examiner can determine the cause and manner of death based off of autopsy findings and those test returning. So those can be delayed because of toxicology and histology testing being delayed.
Smith: And in cases where it’s mandatory or it has been requested or approved that there’s an autopsy, does the death certificate need to wait for the autopsy?
Tommy: In most cases, it should. There is a place on a death certificate where you can list or you can check a box that says “pending investigation.” You can check that and mark the death certificate as pending, however that does nothing for the family. Insurance companies won’t accept it because they don’t know the cause or manner of death, so they won’t pay off on insurance policies to cover funeral expenses or move forward with the deceased estate.
There are some cases where the pending status of the death certificate will help the family, but in most cases, it won’t. Most cases, the pending status causes the coroner or medical examiner to have to go back in once the determining cause or manner is made and write an amendment letter or a request to the state to amend the death certificate to show the cause and manner of death. And like I said, that could be 90 to 120 days later that that amendment is being done. And then it’s a process of getting that letter from the medical examiner or the coroner or doctor to the state, and then the state taking it and going in the system and placing cause and manner and then re-issuing the death certificate. And the family will have to pay for the death certificate again, which in the state of Georgia is $25 for the first copy and $5 for each additional copy. Most family say five to 10 copies take care of their business matters. So you’re talking about $45 to $75 that would have to be done again once the cause and manner is determined.
Schenk: Tell me, are you aware of any instances, and if so, what happens in a case in which the coroner’s office or the medical examiner, maybe there’s a disagreement to the cause of death? Like who has the final say in this is what’s actually going to go on this document?
Smith: Hold on. Tommy, are you feeding a bunch of birds?
Tommy: No, I’m sitting on the front porch of my funeral home. Do you hear the birds?
Smith: Yeah, I’m sorry, man. The microphone – I thought you were in a bird cage or something.
Tommy: Oh, I’m just sitting on the front porch here at the funeral home talking to you guys on the phone. Let me step inside to maybe cut down on some of these background noise.
Schenk: It’s kind of pleasant because sometimes when I’m working, I listen to jungle sounds or rain.
Tommy: Sure. Sounds of the rivers or streams, right?
Schenk: It’s a pleasant morning in Covington, Georgia, I’d imagine.
Tommy: Yeah, it is. Nice day. Is that better?
Smith: Oh yeah, absolutely.
Schenk: Okay. And so Tommy, I think the question was what happens when there’s a disagreement as to the cause of death by the medical examiner’s office, if there is ever? I don’t know who has the final say. Maybe the family is disputing what the medical examiner says?
Smith: Yeah, can they go back and amend and change the document?
Tommy: Well the death certificate, the ruling by the medical examiner is what we base as the coroner’s office. If there’s an autopsy done, if there are things like that done, then their findings during that process are what we depend on to place on the death certificate as cause and manner.
If the coroner and the medical examiner disagree, then they would sit down and review the case from its beginning all the way through the findings of the autopsy so that they can both understand fully what’s going on. And then if that happens, then there’s some clarity made. There are some clarifications made on one side or the other, whoever is in disagreement. And then if it needs to be changed, you can change it before it goes to the death certificate.
If a death certificate is completed with the cause and manner of death and the family disagrees with it, they can definitely meet with the coroner or the medical examiner or the doctors in that cause and go over why the medical examiner, coroner or doctor determined that to be the cause and manner of death.
In the state of Georgia and every state across the country, there are only five manners of death. There are accidents, homicides, suicides, natural deaths and then deaths that are undeterminable. Those are the five manners, but there are unlimited causes. Anything could be listed as a cause of death.
Smith: I got you. And homicide is a word that I think most of us misunderstand and misuse. What does homicide mean?
Tommy: Homicide by definition is death at the hands of another.
Tommy: So a police unfortunately has to take the life of someone during the duties of his job. Murder is a criminal charge. Homicide is a manner of death. So the death would be gunshot wound, homicide. Murder is a criminal charge that the courts deal with.
Smith: I got you. So a police officer rolls up on a bank robbery and the robber is about to kill a bunch of people. And he saves them. He shoots this guy. He has committed – he kills him. He has committed a homicide. That is not a legal determination though. That’s just a manner of death.
Tommy: Well and you’re not actually committing that homicide. Homicide is just the manner of death.
Smith: I got you.
Schenk: It’s a manner.
Schenk: So – oh, I lost my train of thought, what my question was going to be. Oh, it was how can the family request that meeting with the medical examiner or the coroner’s office to talk about the manner and the cause of death on a death certificate? Is that an easy process, just calling them up? Or how do they do that?
Tommy: It’s very simple. In the state of Georgia, there are 159 counties – 154 of those counties operate under the coroner system. The coroner in those counties is an elected official. He has a deputy coroner or more – one or more deputy coroners that work under him. The coroner being in the community, being an elected official, should always be available for people to make contact with, call, email, talk with them, understand better about what they or why they determined the cause and manner to be this. The coroner should always be available.
I’m not going to tell you that they’re always going to agree, especially in cases like suicide – suicide being the death at your own hand. A lot of times no one wants to believe the person had been a victim of homicide and a lot of people say they committed suicide – I mean suicide, but they committed suicide. I sometimes tend to believe you’re a victim of it. So the families don’t want to sometimes believe that could happen when all the evidence and all the facts of the case point to it being suicide. It’s kind of a dragnet theory if you will. Years ago, dragnet shows just the facts, right?
Smith: Right. Just the facts, ma’am.
Tommy: That’s right. So it’s a “just the facts” type of thing. We have to do our due diligence. We have to do an investigation and the biggest part of any investigation is following the evidence as you have, as it’s presented to you.
Smith: I imagine that’s got to be pretty hard because our job is the same thing. At the end of the day, if it looks like a duck, talks like a duck, quacks like a duck, we know it’s a duck, and the family members, I would imagine, are just as emotional in your line of work as they are with ours, and they may not accept the evidence. They may have a pre-disposed perspective about why their loved one dies, but at the end of the day, you guys are following the evidence.
Tommy: That’s correct. I’ve had a family that actually brought in a retired medical examiner investigator that they were friendly with or knew from a church setting.
Smith: Of course.
Tommy: And he had retired and they were in question with our findings, which is fine. We don’t mind that. And he came in with them. He asked – they gave us permission to discuss in front of him what had taken place because I don’t discuss any particular case with anyone outside of the family, unless it’s approved by them or a legal situation where I have to, but they brought in this gentleman and we talked about everything. He asked a few questions. We gave all the information we could give and he turned to the family and he said, “Tommy’s right. This is exactly what happened.” But we welcomed their questions because people just don’t understand in most cases, and I don’t mind people asking at all. I can sit and talk to them for hours if I have to.
Schenk: That’s good to know, Tommy. That’s fantastic and I hope that attitude is the attitude of most of the 159 county coroners. That’s great.
Tommy: I hope so, yes sir.
Schenk: And Tommy, you mentioned a few minutes ago that the family would pay $5 per copy of the death certificate. Can you tell us where does the family go – how would they know it’s ready and where do they go to pick it up?
Tommy: The 25 for the first copy, five for each additional copy, same fees as a birth certificate. The funeral home is the originator of that document. They’re the one that saw that document and it can be just simply arranged through the funeral home that the funeral home would get their certified copies for them and deliver them to them either by hand or mail at the time of it’s completion.
Smith: And – go ahead Tommy, I apologize. Go ahead.
Tommy: We try to get them done as quickly as possible and get them to the family within a day or two in most cases because we know how vital that certificate is for them to start moving forward.
Smith: And the word “family” is pretty expansive. It could be children. It could be siblings. It could be second cousin, twice removed. Who has a right to request and get a death certificate in Georgia? Like in other words, can I go down right now and get a death certificate from anybody who’s passed away?
Tommy: No, I don’t believe you could. The vital records registrar in the county, and most of those are your probate court – sometimes health departments are your vital records registrar, but in most counties, a probate court handles that. Probate court would have a set of rules that you have to abide by. It has to be a close next of kin like the spouse or the children in order to receive a completed death certificate.
Now information can be redacted from that death certificate if you’re doing something for genealogy sake. They can strike through the cause and manner of death or any information about injuries and things like that, and just provide them with the demographic information on the death certificate. But that would be, again, up to the registrar of the county and state as to what information could be released.
Schenk: So that means, I guess, would the family member or the next of kin that is requesting the document from the funeral home, they would need to show a driver’s license to show, or would they need some other type of identification to get the death certificate?
Tommy: They fill out a little request there at the probate’s office or the vital records request office, and state the fact that they are this person. I’m sure that they have to have their ID. In most cases, it’s the informant that would be going to get the death certificate, and the informant is actually listed on the death certificate.
Smith: Now who is the informant and what does that mean?
Tommy: The informant is typically the person who provided the information to the funeral home. Most cases it would be the spouse or the children or the grandchildren of the deceased. It can be designated by a Georgia healthcare advanced directive to be anyone. And a Georgia healthcare advanced directive supersedes everybody, who writes the disposition and all of that comes into play, but this legal document that just says, “I signed giving someone else permission to take care of all my affairs after my death,” that person would then be the informant and the one entitled to things as far as legal matters move forward and have all the rights to say how the person, the body is disposed of or about burial or cremation. So that’s a very important document in the state of Georgia.
Schenk: Understood. Very good. Well Tommy, this has been very informative. We really appreciate you coming on the show and sharing your knowledge about this. Again, a lot of our audience members are family members of loved ones who have passed away in a nursing home, so this information is very useful to them.
Tommy: Sure. Most all nursing homes have a medical director, and that medical director typically signs the death certificates on nursing home deaths, that medical doctor who is the medical director, unless they’re moved into hospice or a hospital when they die. But that medical director is a very important person at that facility.
Smith: Well excellent. Tommy, you going to be running – I don’t know how this works in Covington or how it works in general – you going to be running for a fourth term as coroner?
Tommy: I hope so. Yes, it’s every four years. We run for office and hopefully we’ll be elected again. I enjoy the job. People look at me funny when I say that, but I take it very serious and it’s a job that you have to be very compassionate towards people, you have to be able to follow the evidence as is presented to you, keep your professionalism always up front. It’s just a job I enjoy doing. I just enjoy serving my community like that. I think it’s very important to the community.
Schenk: And so that would be 2020 right?
Tommy: Yes sir, the next one. Yes.
Schenk: So this means in – this is your first public announcement that you will be seeking re-election in 2020. We get the scoop here at the Nursing Home Abuse Podcast.
Schenk: Well very good, Tommy. We appreciate it very much and good luck to you in 2020. We don’t live in Covington, but to any listener out there in Covington, look up Tommy Davis and give him your vote.
Tommy: I appreciate you guys. Thank you very much.
Smith: Yes sir, you too. Have a good day.
Schenk: Okay. And this is going to be one of those instances in which I could be making this up, but there was a movie that came out in the early ‘80s called Cannonball Run featuring Burt Reynolds, Dean Martin, Sammy Davis Jr.
Smith: I can tell you right now you’re not making that up. That is 100 percent true.
Schenk: That’s not what I’m talking about.
Schenk: There’s a scene in that movie where – Cannonball Run is a race, it’s an auto race across the country. It’s illegal. And oftentimes the participants need to disguise their vehicles as something else because you can’t have a racecar go across the country. You’ll get stopped by the cops. So in the beginning of the movie, Burt Reynolds and Dom DeLuise are drivers, and they’re trying to brainstorm how they can hide their vehicle, which eventually they decide on an ambulance, so they’re going to ride an ambulance across the country. But anyways, there’s a montage of them, they’re in a boat going fast, they’re in an airplane, blah-blah-blah, and so they’re talking about that. But at any rate, while they’re in the airplane, Burt Reynolds’s character is drinking a Budweiser or Coors or whatever the sponsorship was, and he chucks it out the window and goes, “We need more beer.” In the plane – they’re in a little prop plane. And so Burt Reynolds lands the airplane in a little town square, and I think that town square where they filmed that was Covington.
Smith: Oh, okay. I didn’t know where this extremely setup was going.
Schenk: And I could be wrong about that, but I think it’s true, that whatever the town square is in Covington, that’s where they filmed the plane hitting the ground and Dom DeLuise getting out, buying beer, and getting back in the plane.
Smith: Well I know the setup for that tidbit of information is itself as long as a normal episode, so we may just make this another episode. Episode 88.2: Rob has a point to make.
Schenk: Okay. At any rate, that’s a really good movie by the way. It’s the first American movie featuring Jackie Chan.
Schenk: Yes. It’s also – they did bloopers at the end of the movie during the credits, and that’s where Jackie Chan got his idea to do bloopers.
Smith: And I think you’re right – it is Covington, Georgia. Cannonball Run was in Covington, Georgia. In 1981, it was filmed in Atlanta and Covington, Georgia.
Schenk: That’s right. So vindication. Thank you. At any rate, that’s going to conclude this week’s episode of the Nursing Home Abuse Podcast. You can consume each and every episode, which comes out Monday mornings, via whatever podcast application you use, be it Spotify, Stitcher, iTunes, Google, Podcast Puppies, whatever you use, or you can watch us. You can actually see our faces, see information brought to you on the screen on our website, NursingHomeAbusePodcast.com, or on our YouTube channel. And with that, we will see you next time.
Smith: See you next time.