Morticians, Roberti Try to Ease Rules on Death Certificates

California funeral directors and State Sen. David A. Roberti are trying to ease the state’s strict requirements on death certificates, contending that a “bureaucratic maze” forces funeral directors and physicians into routinely violating the law to prevent funerals from being postponed at the last minute.

Roberti (D-Los Angeles), the Senate president pro tem, introduced legislation Friday that would authorize health officials to issue burial permits to funeral directors, even if there were “non-material errors” on death certificates, allowing mistakes or omissions to be corrected later. The bill also would allow doctors to authorize employees, such as office nurses, to sign death certificates.

But State Registrar David Mitchell, whose office is responsible for death certificates, opposes a major part of the proposed change, saying that it would be “a serious step backward,” crippling the certificates’ legal and scientific usefulness.

He will oppose the bill in the Legislature, and “if it got to the governor’s desk in this form, my office would recommend that it be vetoed,” Mitchell said in an interview.

Funeral directors have for many years complained about the insistence on perfect paper work on the death certificate, with rules that specify precise wording and even the color of the ink, with no erasures or changes allowed.

An imperfect certificate currently means that county health officials will not issue a burial permit until the doctor is located to sign another one, even if the error is as small as spelling out “February” in a date instead of abbreviating it to “Feb.” as required, or giving the time of death as “4 p.m.” instead of the required “1600 hours.”

The funeral industry prepared the proposed revisions and submitted them to Roberti after an article in The Times in September, quoting a supervisor at Malinow & Silverman, a Westside Los Angeles funeral home. The supervisor said death certificates were routinely altered there, and some certificates were thrown away and physicians signatures forged to new ones, to avoid the expense of legally mandated coroner’s reviews of some deaths.

Laws ‘Widely Ignored’

His charges were investigated by the state Health Department, which includes the office of Mitchell, the registrar. Mitchell has said the investigation indicated that Malinow & Silverman “widely ignored the laws and did things that were patently fraudulent.”

State authorities in December sent their findings over to the Los Angeles County district attorney’s office, which said the investigation is continuing. An attorney for Malinow & Silverman said that to date “there has been no substantiation of these allegations.”

The accusations, however, prompted action by the county Board of Supervisors, which earlier this month adopted new controls recommended by the auditor-controller’s office, including random checks on the validity of doctors’ signatures on death certificates “to detect illegal activity” by funeral homes.

The proposed new state law would allow bodies to be buried on the strength of incomplete certificates, permitting “non-material” information--such as birth dates, the identity of parents, or marital status--to be completed or amended later.

“I think, in all candor, that a lot of funeral directors change death certificates now,” violating the state regulations, Ron Roy, owner of Woods Mortuary in Glendale, said in an interview.

Roy, a leader in the effort to change the law, is on the board of directors of the California Funeral Directors Assn. and is a member of its legislative committee.

The strict requirements of the current law force funeral directors to engage in “misdemeanor violations,” Roy said, encouraging a casual attitude toward the rules.

The industry does not condone serious alterations to death certificates of the kind allegedly made at Malinow & Silverman--such as changes in the cause of death and forgery of physicians’ signatures--but less important changes and other violations are probably commonplace, Roy said.

Borrowed Typewriter

“I’ve filed illegal death certificates and I’d like to see them try to take me to court for it,” he said. In one case, he borrowed a typewriter from a county registrar to make a minor--but illegal--change in a death certificate “and he watched me do it and then accepted the certificate,” Roy said.

“It’s like learning that you can go past the speed cop at 65 and not get a ticket. Well, why not go 75?”

It is a felony to file a fraudulent death certificate, carrying a penalty of up to three years in prison and a $10,000 fine.

In California, doctors normally fill out only about one third of the one-page certificate, listing the cause of death and contributing medical factors. Funeral homes collect the certificates from physicians and fill in the remainder, including identification of the deceased and his or her parents, occupation and other personal data.

They are not supposed to tamper with the medical portion. But it is the funeral home that suffers the inconvenience if the medical portion is filled out incorrectly, and the physician ordinarily never sees the certificate again after giving it to the funeral home.

Routine Violations

Roy said physicians also routinely violate laws requiring them to sign a death certificate within 15 hours after the death and to leave it at the place of death or deliver it to the funeral home. These requirements are almost never honored, he said.

Prosecutors have long ignored the law covering physicians because infractions carry only a $10 fine, he said. “If funeral directors see these misdemeanors go unpunished every day--and I don’t know of any doctor being prosecuted for this--then it’s like the death penalty. It’s not a threat if it’s never enforced.”

Dr. Fred Armstrong, president of the California Medical Assn., agreed that doctors do not obey the regulation and do not expect to be punished for it.

“The law, as it is now, is impractical and impossible to comply with,” Armstrong said.

“If a patient dies Friday night, most doctors don’t get to it until Monday. And I’m an internist and a lot of my patients have died and I have never, ever delivered a death certificate to a mortuary.” He agreed with Roy that the current law is too strict to be complied with.

‘Patently Ridiculous’

Mitchell, the registrar, called that reasoning “patently ridiculous.”

“It’s difficult for me to take seriously a statement by people saying that the law doesn’t make sense so they have to operate outside the law,” he said. “Most funeral directors are law-abiding,” he said, proving that the regulations can be obeyed.

Roberti said he “agreed 100%” with Roy’s argument.

“I suspect there are an awful lot of death certificates filed now with errors in them that are never changed because of the current system,” he said. “Allowing an easier way to correct them will benefit everyone.”

Mitchell said he opposes relaxation of the requirements on many grounds, including the difficulty of defining “non-material error.” Also, the insistence on perfection reflects the status death certificates have in legal actions, he said, with courts accepting the facts they contain at face value. Less rigid standards “may result in an increase of questions that come before the courts, if the facts on death certificates are questioned because they can be wrong.”

Would Reduce Usefulness

He said that such a change would also reduce the usefulness of statistics, obtained by compiling information from large numbers of death certificates used in epidemiology--the study of the factors that cause mass diseases.

“This change also would effectively make the funeral directors deputy registrars, putting them in a classic conflict-of-interest situation,” Mitchell said.

Funeral directors are under such pressure to carry out burials on schedule that they should not be allowed to judge whether death certificates are properly completed, which may require them to delay the funerals, he said.

Roberti countered that the number of amended certificates probably would be so few that they would have no affect on medical statistics, and said he doubted that a change would lessen the certificate’s legal standing.