How Does a Coroner Determine the Cause of Death?

A coroner has the primary legal responsibility of ascertaining the cause of death in certain circumstances. A coroner or medical examiner has a typically standard course of action this followed to determine the cause of death.

Cause of Death Versus Manner of Death

Oftentimes, the terms “cause of death” and “manner of death” are used interchangeably. In fact, technically speaking, these are not synonymous terms.

Cause of death is defined as:

The underlying cause of death refers to the disease or injury that initiated the train of morbid events leading directly to death or the circumstances of the accident or violence that produced the injury.

In simple terms, cause of death can be defined as the root cause of a person’s death.

Manner of death is defined as:

The fashion or circumstances that result in death, which are designated either natural or unnatural.

In other words, what happened to bring o the cause of death. The primary charge of a coroner is to determine a cause of death. If an autopsy and associate forensics investigation are connected with a possible crime, law enforcement officials may also seek advisement from a coroner as to the manner of death. A coroner typically makes one of four types of determinations when it comes to manner of death:

  • Accident
  • Suicide
  • Homicide
  • Undetermined

Medical Examiner’s Process to Ascertain Cause of Death

As mentioned at the beginning of this discussion, a coroner typically has a set process by which the cause of death is determined. (As an aside, the manner of death is also investigated through this same process.) There are three phases to a standard coroner’s investigation into the cause of death:

  • Death scene investigation
  • Autopsy
  • Post-autopsy analysis and investigation

Death Scene Investigation

The work of a medical examiner to determine the cause of death sometimes commences at the scene of death itself. The types of suspected deaths to which a coroner will be dispatched to the scene include:

  • Unattended deaths (undiscovered deaths)
  • Homicides
  • Suicides
  • Accidents
  • Drug overdoses

A coroner’s investigatory team can ascertain a great deal about the cause and manner of death by examining an undisturbed death scene. An unattended death provides a solid example of the importance of a coroner’s on-scene investigation.

An unattended death, also known as an undiscovered death, is one in which a person dies with no witnesses in attendance. In addition, the remains of the deceased individual are not discovered for what can prove to be an extended period of time of days, weeks, or even months.

A variety of underlying circumstances can be associated with an unattended death, including suicide, homicide, drug overdose, or an accident. If an extended period of time has passed from point of death to discovery of the remains, the corpse itself may not immediately reveal a cause of death. Indeed, the state of the body may render making a cause of death determination via an autopsy challenging, which underscores the importance of gleaning evidence from the death scene.

If the remains were undiscovered for many months, and are high if not completely decomposed, the discovery of dried blood splatter on the walls and a firearm at the scene narrows the probable cause of the death. If decomposition is complete, an analysis of the trajectory of blood splatter and the location of the firearm will aid significantly in ascertaining whether the manner of the cause of death by firearm more likely was an accident, suicide, or homicide.


An autopsy technically is defined as:

An autopsy is a surgical procedure that consists of a thorough examination of a corpse by dissection to determine the cause, mode, and manner of death or to evaluate any disease or injury that may be present for research or educational purposes. Autopsies are usually performed by a specialized medical doctor called a pathologist. In most cases, a medical examiner or coroner can determine the cause of death and only a small portion of deaths require an autopsy.

An autopsy on many levels is the primary investigatory phase of ascertaining the cause of death. The close “inspection” of the remains that occurs via an autopsy oftentimes reveals the cause of death. Deaths caused by disease, illness, physical trauma many times are identified via the autopsy process. The combination of an on-scene investigation and an autopsy may be able to identify the manner of death as well.

Post-Autopsy Analysis and Investigation

An on-scene investigation combined with an autopsy may not render a cause of death (or a manner of death, in some instances). Thus, additional forensics analysis, testing, and the investigation becomes necessary. Moreover, than not, this is in the form of laboratory testing or blood, bodily fluids, and tissue samples. These biological samples typically are sent to specialized laboratories for analysis.

Once this post-autopsy analysis is completed, including lab testing, the medical examiner completes a final report. Ideally, the report includes a cause and manner of death. With that said, these are situations in which a cause of death cannot be ascertained. When that occurs, the coroner notes that the cause of death is “undetermined” on the final report and on the death certificate.