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Cremation approval
(Florida Statutes 406.11(1)(c))

A. All requests for cremation, burial at sea, or donations must be approved by the medical examiner prior to the actual cremation.

1. Before authorizing the irretrievable disposal of a body by cremation, the medical examiner must be assured that no future question will arise about the cause or circumstances of the death of the individual. 
2. The death, if previously unreported to the medical examiner, must first be verified as a non-medical examiner case according to Florida Statutes, 406.11.

B. Approval of a cremation, and accepting the responsibility for irretrievably destroying potential evidence, is a decision based on the quality of the information on the death certificate. The death certificate should be accompanied by a CREMATION APPROVAL FORM filled out by the attending physician to demonstrate that the death was due to natural causes. The cause of death on the death certificate must be sufficient to: 

1. rule out trauma; 
2. identify the immediate cause(s) of death, i.e. septicemia, peritonitis, bronchopneumonia, renal failure, etc.; and 
3. identify the underlying or proximate cause of death - the "due to" disease or injury responsible for initiating the lethal sequence of events. 

C. The most common pitfalls this office encounters with causes of death are: 

1. failure to state the underlying cause of death; 
2. scrambling of immediate and underlying causes of death; and 
3. listing extraneous data in the section entitled "Other Significant Conditions." The section, "Other Significant Conditions" (Part II), should be used only for those conditions that contribute to death, but are unrelated to the cause(s) listed in Part I. 

D. The CREMATION APPROVAL FORM is often helpful in clarifying the cause of death as well as providing additional medical history that assures that the death was not by violence. 
Words like subdural, fracture, sepsis, fall, trauma, cardiac arrest, heart failure, hemiplegia, quadriplegia, paraplegia and shock typically do not explain a natural death and often indicate a traumatic origin. It is necessary to rule out traumatic underlying causes or identify the natural disease processes, 

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Volusia County, Florida.