Dr. Uschi Traub, Head of Health Promotion and Health Reporting at the District Office, cited a study by the Institute of Forensic Medicine at Rostock University Medical Centre, which evaluated 10,000 death certificates from the local crematorium. Death certificates are only error-free in two percent of cases. Around a third of the certificates even contain at least one serious error, Traub found. "Death certificates are so important to us because they generate data that serves as the foundation for action in the prevention and treatment of diseases," said Traub.
There are fundamental problems because coroner's inquests are not in the hands of specialists. A multi-center study by the University of Münster found that at least 1,200 homicides go undetected every year. In a study in Görlitz, there was only a 50 percent match between the diagnosis on the death certificate and the autopsy. Frequent errors occur in cardiovascular and endocrinological diseases. In the case of cancer and respiratory diseases, the information is more valid.
Prof. Peschel brought along interesting case examples - an unrecognized case of shaking trauma in a three-month-old baby that passed as "sudden infant death syndrome" until the twin brother was admitted to hospital with cerebral haemorrhages. The exhumation revealed broken ribs and missing brain matter. A woman from Landsberg/Lech who was thought to be dead but was still alive, overlooked gunshot wounds, chemical burns in the mouth from "Rohrfrei" in beer, overlooked knives discovered by the mortician, an 18-year-old with a ruptured spleen due to glandular fever and other shocking examples.
Professor Peschel, Deputy Director of the Institute of Forensic Medicine at Ludwig Maximilian University in Munich, has performed autopsies on well over 10,000 corpses. As bodyguard, personal physician and nurse to the world-famous glacier mummy Ötzi in Austria, he regularly looks after his preservation. Peschel has been involved in many cases, such as identifying the bodies of 155 victims of the fire in a cog railroad in Kaprun, the victims of the tsunami in Thailand and the exhumations ordered by the UN war crimes tribunal in the former Yugoslavia. He was also consulted during investigations into how drunk Beate Zschäpe was when she set fire to the Zwickau apartment of the NSU trio.
Dr. Winkelmann has been working in various areas of the State Statistical Office for over 20 years and has been responsible for the Health Division in Department 21 (Population, Health, Administration of Justice, Insolvencies) since 2015. This includes cause of death statistics and hospital statistics. She explained the process of the cause of death statistics and what needs to be considered when entering the death certificates.
Info:
According to § 11 para. 6 and 7 of the Baden-Württemberg Burial Ordinance, the public health department checks the medical details of the confidential part of the death certificate and sends the confidential parts of the death certificate electronically to the Baden-Württemberg State Statistical Office for evaluation. In Germany, autopsies are only carried out in less than one percent of deaths; in Sweden the figure is 30 percent. The post-mortem examination can be improved by a medical coroner's service with a group of experienced doctors, as in Munich.
