• P Pinto Pastor, A Santiago-Saéz, C Guijarro-Castro, E Dorado Fernández, and E Albarrán Juan.
• Departamento de Medicina Legal, Universidad Complutense de Madrid, Madrid, España; Medicina Forense, Juzgado de Móstoles, Móstoles, Madrid, España. Electronic address: pilarpinto@ucm.es.
• Rev Clin Esp. 2020 May 1; 220 (4): 215-227.

BackgroundThe medical certificate of cause of death is a dual-purpose document: an official registration of an individual's death and a statistical analysis of the populational causes of death. However, the completion of this document in clinical practice creates significant conflicts.ObjectivesTo analyse the completion and detect the main errors that occur when filling in these documents. We then compared the most important variables between the various types of documents analysed.Material And MethodsWe conducted a descriptive cross-sectional study that analysed 513 certificates in the municipality of Madrid, Spain. The analysis included official documents (new and old versions) and hospital documents.ResultsThe study's main finding was that 316 documents employed the term "cardiopulmonary arrest" as the immediate cause of death. In 98 other cases, other poorly defined immediate causes were listed. We were able to conclude that the hospital documents do not always have the required sections for the certificate to be legally functional. In the Professional Medical Association certificates, there is poorer completion of the current document because the document itself hinders its appropriate completion and requires better physician training to complete.ConclusionsWe propose possible improvements to the official document so that it meets the legal requirements, facilitates its completion and fulfils its function. We also offer recommendations for hospitals that have their own document and suggestions for improving its completion.Copyright © 2019 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.

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