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Canadian Network for the Prevention of Elder Abuse |
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Réseau canadien pour la prévention des mauvais traitements envers les aîné(e)s
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Deaths in the Community or Long Term Care Institutions
In most Canadian jurisdictions, there is a legal responsibility to report accidental, "unexplained" or violent deaths to the local coroner or medical examiner. This includes the deaths of people of any age who reside in the community, people living in supportive housing such as assisted living or personal care homes, or people living in long term care facilities such as nursing homes or homes for the aged.
In some instances, the death may have occurred as a result of self-harm, the actions of family or others, or it may have occurred as a result of negligence or actions of the staff, administration or others who visit, work or live in that setting.
The coroner or medical examiner, in turn, has a legal responsibility to determine the cause and circumstances of the death, and in some cases may hold or request a public inquiry or inquest. This process is not to determine civil or criminal liability, but to more fully understand the circumstances of the person's death.
This public inquiry or inquest determines the identity of the person who died, where, when and how he or she came to their death. This involves inquiring into more than just the medical cause of death. It often requires a wider examination of the circumstances of the death in an effort to answer 'how' the death occurred. The proceedings are to make inquiries and find the facts, but do not apportion blame for the death. In some instances recommendations are made, which may include ways to prevent similar deaths in the future.
Below are sections of the laws in various Canadian jurisdictions establishing these responsibilities to report and investigate. The list focuses on select sections of the laws which may be relevant for abuse or neglect situations involving older adults in the community or in long term care institutions. Please refer to the full Act in that particular jurisdiction to see the full scope and application of the law.
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Fatality Inquiries Act, R.S.A. 2000 c.F-9
Part 2
Reporting and Investigation of Deaths
Deaths that require notification
10 (1) Any person having knowledge or reason to believe that a person has
died under any of the circumstances referred to in
subsection (2) or section 11, 12 or 13 shall immediately notify a medical
examiner or an investigator.
(2) Deaths that occur under any of the following circumstances require
notification under subsection (1):
(a) deaths that occur unexplainedly;
(b) deaths that occur unexpectedly when the deceased was in apparent good
health;
(c) deaths that occur as the result of violence, accident or suicide;
...
(e) deaths that may have occurred as the result of improper or negligent
treatment by any person;
(f) deaths that occur
(i) during an operative procedure,
(ii) within 10 days after an operative procedure,
(iii) while under anesthesia, or
(iv) any time after anesthesia and that may reasonably be attributed to
that anesthesia
(g) deaths that are the result of poisoning;
(h) deaths that occur while the deceased person was not under the care of a
physician;
... RSA 1980 cF-6 s10;1984 c9 s1;1991 c21 s9;1999 c26 s9
Investigation or
autopsy
20 The Chief Medical Examiner may at any time
(a) direct a medical examiner to make an investigation into any death at
any place in Alberta, or
(b) authorize an autopsy of the body of any person who died under the
circumstances described in section 10, 11, 12 or 13.
RSA 1980 cF-6 s21
Review of
Investigations
Notice to Board
32(1) The
Chief Medical Examiner shall notify the Board of any death that has been the
subject of an investigation if
(a) the
cause of death has not been established;
(b) the manner of death has not been established;
(c) the body is unidentified or has not been located;
(d) a medical examiner, any of the next of kin of the deceased or anyone
that the Chief Medical Examiner considers to be an interested party requests in
writing that the Board review the investigation and provides reasonable grounds
for the review;
(e) the death is one referred to in section 10(2)(i), 11 or 12;
(f) the Chief Medical Examiner considers a review of the investigation to be
necessary or desirable;
(g) the death is one referred to in section 13 and the manner of death is
unnatural or undetermined or the death has occurred under suspicious
circumstances.
(2) Notification by the Chief Medical Examiner under subsection (1) must
be in writing and be accompanied with all reports and
certificates that may be relevant to the death.
RSA 1980 cF-6 s33;1991 c21 s9
Recommendation for public inquiry
33 (1) When the Board receives a notification pursuant to section
32, it shall review the findings of the medical examiner including the
examination report, the autopsy report, if any, and any other material that it
considers relevant, and recommend any further investigation that may be
necessary.
Coroners Act, R.S.B.C. 1996, c. 72
Deaths to be reported
9 (1) A person must immediately notify a coroner or a peace officer of the facts and circumstances relating to a death if he or she has reason to believe that a person has died
(a) as a result of violence, misadventure, negligence, misconduct, malpractice or suicide,
(b) by unfair means,
...
(d) suddenly and unexpectedly,
(e) from disease, sickness or unknown cause, for which the person was not treated by a medical practitioner,
(f) from any cause, other than disease, under circumstances that may require investigation, ...
Investigative powers
15 (1) A coroner, or a medical practitioner or a peace officer authorized by a coroner to exercise all or any of the coroner's powers under this subsection, may do one or more of the following:
(a) view any dead body;
(b) take possession of any dead body;
(c) enter and inspect any place where a dead body is and any place from which the coroner has reasonable grounds for believing the body was removed;
(d) enter and inspect a cemetery or other place where a dead body may have been interred and disinter or exhume the remains of that body.
(2) A coroner who believes on reasonable grounds that it is necessary to do so for the purposes of the investigation may do the following:
(a) inspect any place in which the deceased person was, or in which the coroner has reasonable grounds to believe the deceased person was, within a reasonable time before his or her death;
(b) inspect information in any records relating to the deceased or the deceased's circumstances;
(c) seize anything that the coroner has reasonable grounds to believe is material to the investigation.
(3) If in the coroner's opinion it is necessary for the purposes of the investigation, the coroner may authorize a medical practitioner or a peace officer to exercise all or any of the coroner's powers under subsection (2) but, if the power is conditional on the belief of the coroner, the belief must be that of the coroner personally.
(4) The coroner must keep anything seized under subsection (2) (c) in safe custody and must return it to the person from whom it was seized as soon as is practicable after the conclusion of the investigation or, if there is an inquest, after the conclusion of the inquest, unless the coroner is authorized or required by law to dispose of it otherwise.
Fatality Inquiries Act, S.M. 1989-90, c. F52, as amended.
Reporting deaths
s. 6 (1) A person who is a witness to or has knowledge of a death to which clause 7(9)(a), (b), (c) or (d) applies shall immediately report the death to a medical examiner, an investigator or to the police.
Inquiry as to deaths
s. 7 (5) Where a medical examiner or investigator learns of a death to which clause (9)(a), (b), (c) or (d) applies and the body is in the province, the medical examiner or investigator shall immediately take charge of the body, inform the police of the death and make prompt inquiry with respect to
(a) the cause of death;
(b) the manner of death;
(c) the identity and age of the deceased;
(d) the date, time and place of death;
(e) the circumstances under which the death occurred; and
(f) subject to subsection 9(2), whether the death warrants an investigation;
and shall submit an inquiry report on the above matters to the chief medical examiner and where the medical examiner or investigator decides that the death warrants an investigation, the medical examiner or investigator shall provide the reasons for the decision.
Deaths to which subsection (5) applies
s. 7(9) Subsection (5) applies to a death where
(a) the deceased person died
(i) as a result of an accident,
(ii) by an act of suicide, negligence or homicide,
(iii) in an unexpected or unexplained manner,
(iv) as a result of poisoning,
(v) as a result of contracting a contagious disease that is a threat to public health,
(vi) suddenly of unknown cause,
...
(viii) while under anesthesia or while recovering from an anesthesia or within 10 days of a surgical operation performed upon the person,
...
(x) as a result of
(A) contracting a disease or condition,
(B) sustaining an injury, or
...
(xi) within 24 hours of admission of the person to a hospital,
(xii) in a place, institution or facility that is prescribed or is of a class of place, institution or facility that is prescribed, or
(xiii) in circumstances that are prescribed;
(b) at the time of death, the deceased person
(i) was not under the care of a duly qualified medical practitioner for the condition that brought on the death, or
(ii) was a resident of an institution or care facility that is licensed, or is required by an Act of the Legislature to be licensed, to operate as a residential institution or care facility;
(c) the deceased person died while a resident in a correctional institution, jail, prison or military guardroom, in a psychiatric facility as defined in The Mental Health Act or in a developmental centre as defined in The Vulnerable Persons Living with a Mental Disability Act; or
(d) the deceased person is a child.
"Not under the care"
s. 7(10) In subclause (9)(b)(i), "not under the care of a duly qualified medical practitioner" means the deceased, in the period of 14 days preceding the death, is not seen, attended or treated by a duly qualified medical practitioner, or, where use of a delegate is approved by the chief medical examiner, by a delegate of the duly qualified medical practitioner, for an illness or condition related to the cause of death. S.M. 1993, c. 29, s. 182.
Coroners Act, R.S.N.B. 1973, c. C-23
s. 4 Every person who has reason to believe that a person died
(a) as a result of
(i) violence,
(ii) misadventure
(iii) negligence,
(iv) misconduct, or
(v) malpractice;
(
a.2) suddenly and unexpectedly;(a.3) from disease or sickness for which there was no treatment given by a medical practitioner;
(b) from any cause other than disease or natural causes; or
(c) under such circumstances as may require investigation;
shall, unless he knows that a coroner has already been notified, immediately notify a coroner of the facts and circumstances relating to the death. R.S., c.41, s.4; 1971, c.20, s.3; 1999, c.11, s.2.s. 7 A coroner shall hold an inquest when required to do so in writing by a Judge of The Court of Queen’s Bench of New Brunswick, a member of the Executive Council or the Chief Coroner. R.S., c.41, s.6; 1979, c.41, s.26.
Fatalities Investigations Act, S.N.L. 1995, c. F-6.1,
as amended: 1997 c23 s14; 2001 c42 s15
Notice of death
s. 5. A person having knowledge of or reason to believe that a person has died under one of the following circumstances shall immediately notify a medical examiner or an investigator:
Deaths that occur in a facility
s. 6. (1) Where a person dies while in a health care facility, or another place where patients are received for treatment or care and there is reason to believe that
(a) the death occurred as the result of violence, attempted suicide or accident, no matter how long the patient had been hospitalized;
(b) the death occurred as a result of suspected misadventure, negligence or accident on the part of the attending physician or staff;
(c) the cause of death is undetermined;
...
(f) the death occurred within 10 days of an operative procedure or the patient is under initial induction, under anaesthesia or during the recovery from anaesthesia,
the person responsible for that facility shall immediately notify a medical examiner or an investigator.
(2) Where a person is declared dead on arrival or dies in the emergency department of a health care facility as a result of a condition referred to in section 5, the person responsible for that facility shall immediately notify a medical examiner or an investigator.
Coroners Act, R.S.N.W.T. 1988, c. C-20, amended by S.N.W.T. 1995,c.11; S.N.W.T. 2000.c.15; S.N.W.T. 2003,c.12
Duty to Notify
s. 8. (1) Every person shall immediately notify a coroner or a police officer of any death of which he or she has knowledge that occurs in the Territories, or as a result of events that occur in the Territories, where the death
(a) occurs as a result of apparent violence, accident, suicide or other apparent cause other than disease, sickness or old age
(b) occurs as a result of apparent negligence, misconduct or malpractice;
(c) occurs suddenly and unexpectedly when the deceased was in apparent good health;
(d) occurs within 10 days after a medical procedure or while the deceased is under or recovering from anesthesia
...
(g) occurs while the deceased is detained or in custody involuntarily pursuant to law in a jail, lock-up, correctional facility, medical facility or other institution...
s. 9. (1) A coroner who becomes aware that a reportable death has occurred shall
(a) where the body is in the Territories, issue a warrant in the prescribed form to take possession of the body of the deceased; and
(b) conduct an investigation of the death that will enable the coroner to determine the cause of death and the circumstances surrounding the death.
17. No person shall knowingly hinder, obstruct or interfere with a coroner in the performance of his or her duties or with a person authorized by a coroner in connection with an investigation or inquest.
18. No person, other than a police officer performing his or her duty, who has reason to believe that a reportable death has occurred shall in any way interfere with or alter the body of the deceased or its condition unless a coroner authorizes that person to do so.
s. 21. (1) Subject to this Act, a coroner shall hold an inquest where, after conducting an investigation, the coroner is of the opinion that an inquest is necessary
(a) to identify the deceased or determine the circumstances of the death;
(b) to inform the public of the circumstances of the death where it will serve some public purpose;
(c) to bring dangerous practices or conditions to the knowledge of the public and facilitate the making of recommendations to avoid preventable deaths; or
(d) to inform the public as to dangerous practices or conditions in order to avoid preventable deaths.
23. (1) Where a coroner decides that an inquest is not necessary, a next of kin or other interested person may request that the coroner hold an inquest by
(a) submitting a written request to the coroner stating his or her reasons; or
(b) appearing before the coroner in person or by agent to explain his or her reasons.
Fatality Inquiries Act, R.S.N.S. 1989, c. 164
Inquiry by chief medical examiner
5 (1) Where a chief medical examiner is informed that there is lying within the territory to which he is appointed the dead body of any person, and it appears that
(a) there is reasonable cause to suspect that the person died by violence, undue means or culpable negligence;
(b) the person died in a place or under circumstances requiring an inquest under any statute;
(c) the cause of death is undetermined; or
(d) the person died in jail or prison,
the chief medical examiner shall forthwith take charge of the body and shall make diligent inquiry respecting the cause and manner of the death of the person.
Report
(2) Immediately upon completing this inquiry, he shall reduce to writing every circumstance respecting the condition of the body and tending to show the cause and manner of the death, together with his own opinion as to the cause of the death, and shall sign the writing and file it with the clerk of the Crown for the county in which he found the body.
Inquest may be directed
10 Notwithstanding that the chief medical examiner has failed to state in his report that in his opinion an inquest is expedient respecting the cause of the death of any person, or has stated his opinion that an inquest is not expedient, the Attorney General or the prosecuting officer of the county in which the report is filed may direct a judge of the provincial court to hold an inquest. R.S., c. 164, s. 10.
Inquest by judge
11 Upon receipt of a notice under Section 8, the judge may, if he considers it necessary for the full investigation of the cause of the death, and shall, if so directed by the Attorney General or the prosecuting officer for the county, or if required by statute, proceed to hold an inquest respecting the cause of the death. R.S., c. 164, s. 11.
Crown counsel permitted to attend
13 (1) Any prosecuting officer or any counsel appointed by the Attorney General to act for the Crown may attend the inquest and may examine witnesses called at the inquest.
Others permitted to attend
(2) Any person claiming to be interested may, by permission from the presiding judge, attend the inquest and may be represented by counsel and examine any witnesses. R.S., c. 164, s. 13.
Coroners Act, R.S.O. 1990, C.37
Duty to give information
10. (1) Every person who has reason to believe that a deceased person died,
(a) as a result of,
(i) violence,
(ii) misadventure,
(iii) negligence,
(iv) misconduct, or
(v) malpractice;
(b) by unfair means;
...
(d) suddenly and unexpectedly;
(e) from disease or sickness for which he or she was not treated by a legally qualified medical practitioner;
(f) from any cause other than disease; or
(g) under such circumstances as may require investigation,
shall immediately notify a coroner or a police officer of the facts and circumstances relating to the death, and where a police officer is notified he or she shall in turn immediately notify the coroner of such facts and circumstances. R.S.O. 1990, c. C.37, s. 10 (1).
Deaths to be reported
(2) Where a person dies while resident or an in-patient in,
(a) a charitable institution as defined in the Charitable Institutions Act;
...
(h) a public or private hospital to which the person was transferred from a facility, institution or home referred to in clauses (a) to (g),
the person in charge of the hospital, facility, institution, residence or home shall immediately give notice of the death to a coroner, and the coroner shall investigate the circumstances of the death and, if as a result of the investigation he or she is of the opinion that an inquest ought to be held, the coroner shall issue his or her warrant and hold an inquest upon the body. R.S.O. 1990, c. C.37, s. 10 (2); 1994, c. 27, s. 136 (1); 2001, c. 13, s. 10.
Deaths in nursing homes and homes for the aged
(2.1) Where a person dies while resident in a home for the aged to which the Homes for the Aged and Rest Homes Act or the Charitable Institutions Act applies or a nursing home to which the Nursing Homes Act applies, the person in charge of the home shall immediately give notice of the death to a coroner and, if the coroner is of the opinion that the death ought to be investigated, he or she shall investigate the circumstances of the death and, if as a result of the investigation he or she is of the opinion that an inquest ought to be held, the coroner shall issue his or her warrant and hold an inquest upon the body. 1994, c. 27, s. 136 (2).
Minister may direct coroner to hold inquest
22. Where the Minister has reason to believe that a death has occurred in Ontario in circumstances that warrant the holding of an inquest, the Minister may direct any coroner to hold an inquest and the coroner shall hold the inquest into the death in accordance with this Act, whether or not he or she or any other coroner has viewed the body, made an investigation, held an inquest, determined an inquest was unnecessary or done any other act in connection with the death. R.S.O. 1990, c. C.37, s. 22.
Request by relative for inquest
26. (1) Where the coroner determines that an inquest is unnecessary, the spouse, same-sex partner, parent, child, brother, sister or personal representative of the deceased person may request the coroner in writing to hold an inquest, and the coroner shall give the person requesting the inquest an opportunity to state his or her reasons, either personally, by the person’s agent or in writing, and the coroner shall advise the person in writing within sixty days of the receipt of the request of the coroner’s final decision and where the decision is to not hold an inquest shall deliver the reasons therefor in writing. R.S.O. 1990, c. C.37, s. 26 (1); 1999, c. 6, s. 15 (3).
Purposes of inquest
31. (1) Where an inquest is held, it shall inquire into the circumstances of the death and determine,
(a) who the deceased was;
(b) how the deceased came to his or her death;
(c) when the deceased came to his or her death;
(d) where the deceased came to his or her death; and
(e) by what means the deceased came to his or her death. R.S.O. 1990, c. C.37, s. 31 (1).
Idem
(2) The jury shall not make any finding of legal responsibility or express any conclusion of law on any matter referred to in subsection (1). R.S.O. 1990, c. C.37, s. 31 (2).
Authority of jury to make recommendations
(3) Subject to subsection (2), the jury may make recommendations directed to the avoidance of death in similar circumstances or respecting any other matter arising out of the inquest. R.S.O. 1990, c. C.37, s. 31 (3
Coroners Act, R.S. P.E.I. 1988, c. C-25
INQUEST
5. (1) When the coroner is informed that a dead body of a person is lying within his jurisdiction, and there is reasonable cause to suspect that such person has died
(a) as a result of violence, misadventure, unfair means;
(b) as a result of negligence or misconduct or malpractice on the part of others;
(c) from any cause other than disease or under such circumstances as may require investigation;
(d) a sudden death of which the cause is unknown;
(e) in prison;
(f) in any hospital within twenty-four hours after admission to such hospital;
(g) in a hospital during an operation;
(h) under such circumstances as to require an inquest, in pursuance of any Act; or
(i) after being admitted to a hospital suffering injuries as a result of negligence, misconduct or malpractice on the part of others and dies without being discharged from the hospital,
the coroner, whether the cause of death arose within his jurisdiction or not, shall as soon as practicable issue his warrant to take possession of the body and shall view the body and make such further investigation as may be required to enable him to determine whether or not an inquest is necessary.
6. (1) Every person, who has reason to believe that a deceased person died in any of the circumstances mentioned in subsection 5(1) shall immediately notify a coroner having jurisdiction in the place where the body of the deceased person is of the facts and circumstances relating to the death.
(2) The notice required by subsection (1) shall be given in every case where a medical practitioner, funeral director or embalmer or a person occupying a house in which a deceased person was residing is aware that the deceased had been suffering from disease or sickness and had not been treated or attended by a legally qualified medical practitioner.
Determination of the Causes and Circumstances of Death Act, R.S. Q. R-O.2
1) in a reception centre classified as a rehabilitation centre within the meaning of the Act respecting health services and social services for Cree Native persons (chapter S-5) and the regulations made thereunder;
1.1) in a facility maintained by an institution within the meaning of the Act respecting health services and social services (chapter S-4.2) which operates a rehabilitation centre;
2) in a sheltered workshop within the meaning of the Act to ensure the handicapped in the exercise of their rights (chapter E-20.1);
3) in a facility maintained by a health and social services institution, where the person in whose respect death occurred was under confinement.
1983, c. 41, s. 37; 1991, c. 44, s. 1; 1992, c. 21, s. 282, s. 375; 1994, c. 23, s. 23; 1997, c. 75, s. 48.
DIVISION I
POWERS
AND DUTIES OF THE CORONER IN AN INVESTIGATION
Investigation required.
45. An investigation must take place every time notice is given to the coroner under Chapter II.
Investigation required.
The Minister of Public Security or the Chief Coroner may also require an investigation.
1983, c. 41, s. 45; 1986, c. 86, s. 38; 1988, c. 46, s. 24.
REPORT OF INVESTIGATION
1) the identity of the deceased person, or indications that may lead to it;
2) the date and place of death;
3) the probable causes of death;
4) a description of the circumstances of death;
5) any recommendation directed towards better protection of human life, where applicable.
GROUNDS FOR HOLDING AN INQUEST
Inquest.
1) to obtain information for establishing the probable causes or circumstances of death;
2) to enable a coroner to make recommendations directed to better protection of human life;
3) to inform the public on the probable causes or circumstances of death.
1983, c. 41, s. 105.
RECOGNIZED RIGHTS OF INTERESTED PERSONS
Summons of a witness.
Coroners Act, 1999, S.S. 1999, c. C-38.01
PART III Duty to Notify Coroner of a Death
General duty to notify coroner
7(1) Every person shall immediately notify a coroner or a peace
officer of any
death that the person knows or has reason to believe:
(a) occurred as a result of an accident or violence or was self-inflicted;
(b) occurred from a cause other than disease or sickness;
(c) occurred as a result of negligence, misconduct or malpractice on the part of
others;
(d) occurred suddenly and unexpectedly when the deceased appeared to be in good
health;
...
(2) Every peace officer who is notified of a death pursuant to subsection (1)
shall immediately notify a coroner of the death.
1999, c.C-38.01, s.7.6 c. C-38.01
CORONERS
Duty of institutions to notify coroner
8 (4) Where an involuntary patient admitted pursuant to section 23 or 24, or
detained pursuant to section 24.1, of The Mental Health Services Act to an
in-patient facility within the meaning of that Act dies, the person in charge of
that facility shall immediately notify a coroner of the death.
(5) The duty mentioned in this section applies whether or not:
(a) the
person died on the premises or in actual custody; or
(b) the person was an
inmate, resident or patient at the time of death if the death was caused at that
place.
(6) Where a person dies while in a hospital to which the person was transferred
from a place mentioned in this section, the person in charge of the hospital
shall immediately notify the coroner of the death.
1999, c.C-38.01, s.8.
PART V
Inquests
Where inquest necessary
19 A coroner, with the approval of the chief coroner, shall hold an inquest where, after conducting an investigation, the chief coroner is of the opinion that an inquest is necessary to:
(a) ascertain the identity of the deceased and determine how, when, where and by
what means he or she died;
(b) inform the public of the circumstances surrounding a death;
(c) bring dangerous practices or conditions to light and facilitate the making
of recommendations to avoid preventable deaths; or
(d) educate the public about dangerous practices or conditions to avoid
preventable deaths.
1999, c.C-38.01, s.19.
Coroners Act, R.S.Y. 2002, c. 44
Duty to notify coroner of death
5 A medical practitioner, undertaker, embalmer, peace officer or any person residing in the house in which the deceased resided immediately before death or any other person who has reason to believe that a deceased person died as a result of violence, misadventure or unfair means, from any cause other than disease or sickness, as a result of negligence, misconduct or malpractice on the part of others or under any other circumstances that require investigation shall immediately notify the coroner who ordinarily has jurisdiction in the locality in which the body of the deceased person is found, of the circumstances relating to the death. R.S., c.35, s.5.
Further Reading
B.A.M. Patton. The Fatality Inquiries Act: A Discussion Paper. www.gov.ns.ca/just/2fatality.pdf
College of Physicians and Surgeons of Ontario. Mandatory Reporting. www.cpso.on.ca/Policies/mandatory2.htm
Canadian Network for the Prevention of Elder Abuse. Page last updated Friday April 24, 2009
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