County Agrees to Tighten Controls on Death Certificates

Los Angeles County supervisors agreed Tuesday to tighten controls on the issuance of death certificates and adopted recommendations aimed at streamlining a process that had been criticized as confusing and vulnerable to abuse.

The board, without discussion, adopted the recommendations of a county auditor-controller’s report concluding that problems with death certificates and burial permits have frustrated the public and the funeral industry.

Among the changes will be, on a trial basis, stationing a part-time public health registrar at the medical examiner-coroner’s office as part of a “one-stop program” to reduce the time required to issue a burial permit.

The board also called for a closer check on the authenticity of death certificates by the county’s Department of Health Services in an effort “to detect illegal activity” by funeral homes.

The county audit was prompted by a story last September in The Times reporting allegations that at one funeral home death certificates had been routinely altered to avoid delays in funeral services or avert the expense of legally mandated coroner’s reviews.

Paul Sanders Jr., a night supervisor for the Malinow & Silverman funeral home at 1500 S. Sepulveda Blvd., related more than 100 instances in which he said death certificates were altered. In some cases, physicians reported that their signatures had been forged by Malinow & Silverman employees before the certificates were filed with county health authorities.

However, two physicians, whose names had been signed to certificates checked by The Times, expressed sympathy earlier for funeral homes that must contend with what they viewed as the county’s unrealistic insistence on time-consuming paperwork before death certificates can be approved.

The problem is especially acute for a Jewish funeral home like Malinow & Silverman because of Jewish traditions calling for rapid burial, said one of the doctors.

The California Department of Health Services launched an investigation into the funeral home at the request of the coroner’s office. David Mitchell, chief of the state registrar’s office, said the results of that investigation now rest with the district attorney’s office.

“What you have here is that most of the people were playing by the rules, but one funeral director appears to have, in a number of situations, out of convenience, widely ignored the laws and did things that were patently fraudulent,” Mitchell said.

Executives for Malinow & Silverman could not be reached Tuesday for comment, and their attorney, Donald Smaltz, was out of town.

In California, funeral homes usually collect death certificates from physicians, complete them and present them to the county health department, which must issue a “permit for disposition of human remains” before a body can be buried or cremated.

By state law, the coroner must review all “violent, sudden or unusual deaths,” and the health department can withhold the disposition permit until the coroner’s office clears the case.

The county issues about 65,000 burial permits annually and does not attempt to determine whether the physician’s signature is legitimate, according to the auditor-controller. The board agreed with the auditor-controller that a “monitoring system to spot-check the accuracy” of the information is needed.

The report also said that in 15% of cases sampled, death certificates were not signed by the attending physicians within 15 hours after death--as required by state code.