Item 22, the Manner of Death is the certifier’s opinion of whether the death was from natural causes, or if an injury reported on the death certificate was the result of an accident, homicide, or suicide.
A death is
usually not “Natural” if an injury is reported anywhere on the certificate
(either in Part I or Part II). If
“Natural” is checked in Item 22 but the underlying cause of death is an injury,
the certifier will be contacted to clarify the manner of death.
If an injury is
reported anywhere on the certificate, Items 25a-g must be completed, even if
the manner of death is checked “Natural.”
“Could Not Be
Determined” and “Pending Investigation” in Item 22 are for
“Could Not Be
Determined” in Item 22 means that after completion of an investigation, it
could not be determined whether the injury was an accident, homicide, or
suicide. It can also mean that, after
the completion of the investigation, it could not be determined whether the
death was caused by natural disease processes or an injury.
Do not check “Could Not Be Determined” if death was due to unknown natural causes. In those cases, check “Natural” even if the specific natural causes were undetermined.
“Pending Investigation” means that an investigation will be done to determine whether the death was from natural disease, an accident, homicide, or suicide. “Pending Investigation” is a temporary statement and must be changed to one of the other Manners when the investigation is complete.
If the cause
of death is known, it should be reported even if the manner is pending
investigation.
When Vital Records receives
a “Pending” certificate (either cause or manner), they will send a form letter
to the certifier instructing how to submit a Supplemental Form to add the
missing information when it becomes available.
See also PENDING CAUSES OR MANNER OF DEATH