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For deaths involving injury or poisoning, the general format for completing Part I of the cause-of-death statement is to report, if possible, the fatal disturbance of bodily function (fatal derangement), the bodily trauma sustained, and the injury event that initiated the train of events as follows:

Part I
A.  Fatal derangement (e.g., cardiac tamponade)
Due to, or as a consequence of:
B.  Bodily trauma (e.g., penetrating wound of heart)
Due to, or as a consequence of:
C.   Injury event (e.g., sharp force (stab) injury to chest)

Of course, only the causes shown in parentheses would be written on the death certificate. The words "fatal derangement," "bodily trauma," and "injury event" are shown in the example only for illustrative purposes.


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