EXAMPLES
Part I: Immediate
cause a) Pulmonary
embolism few
hours
due to or as a
consequence of
b) Coronary thrombosis 2-3 weeks
due to or as a
consequence of
c) Arteriosclerotic heart disease several
yrs
due to or as a
consequence of
d) (blank)
Part II: Other significant
conditions contributing to death but not resulting in the underlying cause
given in Part I: Emphysema and
alcoholism
Pulmonary embolism is
reported as the immediate cause of death.
It is reported as “due to” coronary thrombosis.
Coronary thrombosis is the
intermediate cause of death. It is the
complication of the underlying cause (arteriosclerotic heart disease) that
caused the immediate cause (pulmonary embolism.)
Arteriosclerotic heart
disease is reported as the underlying cause of death. It is the condition that started the train of
medical events that resulted in the pulmonary embolism. Line (d) may be blank if the complete
sequence takes less than four lines.
Emphysema
and alcoholism are reported as contributing causes. They contributed to death but did not cause
arteriosclerotic heart disease (the underlying cause of death.)