Friday, September 14, 2012

Informing Families in a Murder Case

This week's medical question comes from South Carolina mystery writer Ellis Vidler. 

"My question is, how would the victim’s family be told of the death in these circumstances? The victim died on the way to the hospital, maybe 30 minutes to an hour after being stabbed and left for dead. The police or paramedics found his ID in his wallet and located his brother, who was called to the hospital. When the brother gets there, I have him directed to a waiting room. Then, almost immediately, the police detective and the doctor come in to inform him of the death. Which one is likely to give him the news and what would they say? Also, the only ID so far is from the victim’s wallet. Would the detective ask him to identify the victim? I’m not sure how the police and medical staff would deal with this."

I sent Ellis the following answer.

If the police were present when the paramedics originally arrived to care for the victim, the police might have already searched the victim for his wallet. If the paramedics got there first, they wouldn't have searched for a wallet, but they could have found it if it was in a piece of clothing they needed to remove in order to get to the wound. 

The police would be the ones to notify the brother. The brother would be directed to the waiting room by the ER registrar, who would then notify the charge nurse of the brother's presence. The charge nurse would notify the doctor and the police, and then either the charge nurse or the nurse assigned to the victim would come out to meet the brother and take him to a private area, usually a small room off the waiting room, used for the express purpose of informing families of the death or critical condition of their loved one. The doctor and the detective would then go to that room. 

The doctor would be the one who told the brother of the victim's death. He would first introduce himself and the police officer, then he'd verbally verify the relationship of the victim to the person with whom he's speaking. If it is the brother, he'll say so. If it isn't the brother, the presence of a policeman would most probably compel the man to state his true relationship -- friend, business partner, etc. -- to the doctor. If he isn't the brother, the conversation with the doctor would end there due to privacy laws concerning the rights to personal information. The police office would then ask any questions he might have for the man.

If the man is the brother, the doctor would then say how sorry he was to have to inform the man that, despite all efforts by the paramedics, his brother died before arriving in the ER. The doctor would explain the victim's injuries and how critical his condition was when help first arrived. He would reiterate the fact that everything possible was done to save the victim, but how his injuries were so severe that he was unable to survive them. He would then tell the brother that the police officer is investigating the victim's death and that he, the doctor, will leave the officer and the brother alone so that they can talk. He would then add that the brother should tell the staff when he is ready to see the victim and a nurse will take the brother to the victim's room in the ER.

 At this point, your detective would ask the brother some questions to verify his relationship to the victim. If the ID from the wallet is a picture ID, he can ask the brother to verify the identity that way. If the ID doesn't include a picture, he can tell the brother the circumstances under which the victim was found and ask the brother to visually identify the victim as the person listed on the ID. The cop would then accompany the brother into the ER and a nurse would take both men to the cubicle where the body rests on a cart. After identification, the victim would be kept in the ER until the medical examiner's -- or coroner's -- van arrived to collect the body. 

Now even if the patient died in the ambulance, the paramedics would continue resuscitation efforts until they reached the hospital and an ER doctor decided further efforts were useless. The victim's clothes would be bagged if any were removed by the paramedics or ER staff, and they would be sent with the body or given to the police per individual system policy. The ER doctor would not sign a death certificate as that's the province of the ME or coroner, but he would pronounce death and give the time of death as the time he pronounced the victim. This time would be relaid to the ME or coroner's office via telephone by the nurse assigned to the patient. The biological time of death used in any court case would be decided by the coroner or ME, who would rely on the paramedic report, the ER doc's pronounced time of death, and the autopsy report to ascertain the time. In this particular case, the ME or coroner would probably use the ER doc's pronounced time of death as the official record time.

Outside of that initial meeting, the doctor would have no further contact with the brother unless the brother had specific questions concerning the wound and demanded to speak with the doctor. The nurse assigned to the victim would answer any other hospital related questions voiced by the brother, and the detective would be able to tell him about release of the body for burial.



  1. Mary, thanks so much. This is exactly the information I need. You may see your words in my book. :-)
    I hate getting things wrong, and much of this is (fortunately) outside my experience.


  2. Mary, you are a priceless gem! Thanks so much for providing invaluable information for your fellow writers.

  3. Glad I could be of service to you, Ellis and Sandra, and to all my fellow writers who include medical scenes in their mysteries.

  4. Oh I have some experience in this -- not murder, but my husband died of a heart attack and this poor doctor who spoke english as a second language said the above speech almost verbatim and at the end he said "Ok" -- now I taught English in Poland for 2 years and I knew that he meant "Ok" as in "do you understand what I said" but I remember my response, "I understand that you did everything you could to save my husband, but it is not OK"

    Poo man will never use that term while speaking to a victim's family!

    1. Lynn, I'm so sorry to hear of your husband's death. How hard that must have been for you. And then to have a doctor say "OK" -- well, it was definitely not the best remark he could have made. It's for sure, not all doctors have great people skills.