| History | Mechanism | Immediate cause | Proximate cause (underlying cause) | Cause of death statement on certificate (Part 1) | Contributing conditions (Part 2) | Reportable to the medical examiner or coroner? | Comments | |
| 1 | A 55-year-old male with a history of hypertension and hyperlipidemia complains of chest pain and suddenly collapses. Resuscitation was attempted in ED. Hospital toxicology was negative. History of diabetes mellitus. | Arteriosclerotic and hypertensive cardiovascular disease | Arteriosclerotic and hypertensive cardiovascular disease | Diabetes mellitus | Maybe, because death occurred in ED or patient was DOA. Varies by jurisdiction. Medical examiner or coroner would likely decline investigation. | This is 100% due to natural disease. | ||
| 2 | A 75-year-old male presents with a bilateral bronchopneumonia and viral testing confirms an influenza infection. He has a history of pulmonary emphysema. | Bronchopneumonia | Influenza A respiratory infection | Bronchopneumonia due to/as a consequence of influenza A respiratory infection | Pulmonary emphysema | No. | This is 100% due to natural disease. | |
| 3 | A 65-year-old female develops acute dyspnea 1 week after an elective hip replacement for osteoarthritis. Radiologic studies detected a pulmonary thromboembolism shorty before her cardiac arrest. She has severe obesity (BMI = 48). | Pulmonary thromboembolism | Deep venous thrombosis | Degenerative osteoarthritis | To be issued by the medical examiner: Pulmonary thromboembolism due to deep venous thrombosis following hip replacement surgery for degenerative osteoarthritis | Obesity | Yes (a complication of therapy contributed to the death). | The surgery hastened the fatal outcome. Without surgery, she would not have been immobilized and developed the deep venous thrombosis/pulmonary thromboembolism. |
| 4 | A 45-year-old male with chronic alcohol use disorder has a large upper gastrointestinal hemorrhage. He has a history of cirrhosis and esophageal varices. | Hemorrhage | Esophageal varices due to cirrhosis of liver | Chronic alcohol use disorder | Gastrointestinal hemorrhage due to esophageal varices due to cirrhosis of liver due to chronic alcohol use | No. | This is not a death due to intoxication but rather to the effect of chronic alcohol use. | |
| 5 | A 60-year-old male with longstanding diabetes mellitus dies of end-stage kidney disease. | Hyperkalemia | End-stage kidney disease | Diabetes mellitus | Hyperkalemia due to end-stage kidney disease due to diabetes mellitus | No. | This is 100% due to natural disease. | |
| 6 | A 30-year-old male is brought to the hospital from home with anoxic brain injury. He survives in the ICU for 5 days and is then terminally extubated. He has a history of substance use disorder. | Anoxic brain injury | Acute fentanyl and cocaine intoxication | To be issued by the medical examiner: Anoxic brain injury due to an acute fentanyl and cocaine intoxication | Yes. The medical examiner performs toxicology testing on the admission blood samples. | This death is a sequela of a drug intoxication. | ||
| 7 | A 70-year-old female, residing in a nursing home due to debility following a fall with subdural hematoma, develops seizures. She is found dead in her bed. | Posttraumatic seizure disorder | Blunt injury of head | To be issued by the medical examiner: Posttraumatic seizure disorder due to recent blunt injury of head | Yes. | This death is a sequela of a traumatic head injury. |
