The first 24 hours after an unexpected death: what families should know.
When someone dies suddenly or unexpectedly, families are asked to make decisions quickly, often before they understand what happened. The most important thing to know is this: some choices, such as embalming and cremation, cannot be undone. Ask questions first, and keep every option open until you have answers.
Medically reviewed by Evan W. Matshes, MD, FRCPC, D-ABP, Medical Director and Chief Forensic Pathologist · Updated
- Unexpected deaths are usually reported to the coroner or medical examiner, who decides whether to investigate and whether to perform an autopsy.
- You can ask the coroner whether an autopsy will be done, who will perform it, and how to obtain the report.
- Before you authorize embalming or cremation, decide whether you want an independent examination. Those steps cannot be reversed.
- Write down what you know while it is fresh: medications, symptoms, recent medical care, and who was present.
- When the coroner does not perform an autopsy, or after an official one, the family can arrange a private autopsy directly.
Who takes charge of my loved one after an unexpected death?
In California, deaths that are sudden, unexpected, violent, or that happen without a recent physician’s care are generally reported to the county coroner or medical examiner. The coroner’s office decides whether the death falls within its jurisdiction and whether an examination is needed. If it takes jurisdiction, your loved one is brought into its care until the investigation is complete and released to the funeral home you choose. If it does not, the attending physician may sign the death certificate and your loved one goes directly to the funeral home.
What should I ask the coroner or medical examiner?
- Is the office taking jurisdiction, and will an autopsy be performed?
- If not, why not, and who will sign the death certificate?
- Who is the investigator assigned to the case, and how can I reach them?
- When will my loved one be released, and to whom?
- Will toxicology be tested, and when will results be available?
- How can the family obtain the autopsy report and other records once they are final?
Keep a note of every name, phone number and case number you are given.
Why should we pause before embalming or cremation?
Embalming introduces chemicals that interfere with toxicology and alter tissue. Cremation ends any possibility of further examination. If there is any chance your family will want an independent autopsy, tell the funeral home before either is performed. Funeral homes can usually hold a loved one for a short time while the family decides. See Private autopsy: a guide for families.
What information should we gather now?
- A list of the person’s medications, including over-the-counter drugs and supplements.
- Recent symptoms, illnesses, injuries or falls.
- Recent medical care: doctors, hospitals, emergency visits, with dates.
- Who found the person, when, and what they saw.
- Any family history of sudden death, heart conditions, seizures or inherited disease.
This information helps any forensic pathologist, whether official or independent, interpret the findings.
When does a private autopsy make sense?
Families often consider a private autopsy when the coroner declines to perform an autopsy, when the explanation given does not fit what they know, when the death followed medical care, when a hereditary condition may affect relatives, or when legal action is likely. A private autopsy can also follow an official one. NAAG’s board-certified forensic pathologists perform private autopsies for families in California and for loved ones brought from anywhere in the world; call 1-800-985-5346 any day.
This is general information, not legal or medical advice for your situation.
Frequently asked questions.
Can the family refuse an autopsy by the coroner?
Where the coroner has jurisdiction, the decision to perform an autopsy rests with the coroner under state law. Families may raise religious or other concerns with the office, and should ask what accommodations are possible.
Can we have our own autopsy if the coroner does one?
Often, yes. Once the coroner releases your loved one, the family may arrange an independent second autopsy before embalming or cremation.
How soon must we decide about a private autopsy?
As soon as possible, and before embalming or cremation. Call NAAG at 1-800-985-5346, seven days a week, and we will explain the options and the timing.
Will a private autopsy delay the funeral?
Usually only briefly. We coordinate directly with your funeral home.
Talk to a forensic pathologist
Every case is different. Tell us about yours and we will tell you honestly what an examination or review can answer.
Start with a conversation.
Tell us who you are and, in general terms, what you need. The right member of our team will respond.
San Diego, CA 92121
Please don't email case records or images. The case request form collects what we need to open your matter; we'll arrange secure transfer of records after that.