(1) (a) A certificate of death for each death, including a stillborn death, that occurs in Colorado must be filed with the state registrar, or as otherwise directed by the state registrar, within seventy-two hours of assuming custody of a dead body, stillborn fetus, or dead fetus and prior to final disposition, except when inquiry is required by subsection (5.5) of this section or any provision of section 30-10-606 other than section 30-10-606 (1)(b) or when a coroner, a medical examiner, a forensic pathologist, or other qualified individual determines that additional time is necessary to make a proper inquiry to determine the cause and manner of death. In such a situation, the coroner, medical examiner, forensic pathologist, or other qualified individual shall complete and sign the certificate of death as soon as practicable. The state registrar shall register the certificate if it has been completed in accordance with this section. Every certificate of death must identify the decedent's social security number, if available. If the place of death is unknown but the dead body is found in Colorado, the certificate of death must be completed and filed in accordance with this section. The place where the body is found must be shown as the place of death. If the date of death is unknown, the date must be determined by approximation. (b) (I) The department of public health and environment shall create and the state registrar shall use an electronic death registration system for the purpose of collecting death information from funeral directors, coroners, physicians, local registrars, health facilities, and other authorized individuals, as determined by the department. Death information submitted electronically by a funeral director, coroner, physician, local registrar, health facility, or authorized individual, as determined by the department, to the electronic death registration system for purposes of fulfilling the requirements of this section satisfies the signature and filing requirements of this section and section 30-10-606, C.R.S. (II) Repealed. (III) Except as otherwise provided in subsection (4.5) of this section, any individual, other than a family member of the decedent or other individual acting in a nonprofessional capacity as the funeral director for the decedent, who is required to initiate, complete, respond to, or file a certificate of death pursuant to this section must use the electronic death registration system used by the state registrar. (IV) The state registrar shall provide a report to the department of regulatory agencies on a monthly basis that identifies any certificates of death for which a medical certification was not completed in a timely manner using the electronic death registration system or, before March 1, 2024, only, completed as otherwise allowed by this section, and the department shall promptly provide the report to the Colorado medical board created in section 12-240-105 (1)(a). Beginning in 2025, the department of regulatory agencies shall prepare a report to the joint committee of reference during its annual hearing held pursuant to section 2-7-203 of the "SMART Act", part 2 of article 7 of title 2. The report must include the number of complaints that the department of regulatory agencies received and the number of disciplinary actions taken against a licensee in each calendar year. (c) Once a certificate of death has been filed pursuant to paragraph (a) of this subsection (1), a verification of death document may be used by local offices of vital statistics and the office of the state registrar of vital statistics when verifying a vital event to a person or organization that has requested a verification of fact-of-death. A verification of death document must include the name and address of the decedent, the date of death, the place of death, the date the document is filed, the state file number, and the name of any spouse of the decedent. A verification of death document is not required to contain a social security number of the deceased as is otherwise required of a certificate of death under paragraph (a) of this subsection (1). (d) [Editor's note: Subsection (1)(d) is effective July 1, 2025.] If a certificate of death, copy of certificate of death, certified copy of a certificate of death, or verification of death is recorded into the real estate records of a county clerk and recorder, the document is a public record. (2) When a death occurs in a moving conveyance in the United States and the body is first removed from the conveyance in Colorado, the death shall be registered in Colorado, and the place where it is first removed shall be considered the place of death. When a death occurs on a moving conveyance while in international air space or in a foreign country or its air space and the body is first removed from the conveyance in Colorado, the death shall be registered in Colorado, but the certificate shall show the actual place of death insofar as can be determined. (3) (a) The funeral director or person acting as such who first assumes custody of a dead body, stillborn fetus, or dead fetus is responsible for the filing of the certificate of death required by subsection (1) of this section within seventy-two hours after receipt of the electronic death registration request unless the physician, their associate physician, the chief medical officer of the institution in which the death occurred, or the physician who performs an autopsy upon the decedent is unable to complete the medical certification for the certificate of death within the required time frame. The funeral director shall obtain the personal data required by the certificate from the next of kin or the best qualified person or source available. The funeral director shall obtain the medical certification necessary to complete the portion of the certificate pertaining to the cause of death from the best qualified person or source available, pursuant to subsection (4) of this section. (a.5) (I) Except as otherwise provided in subsection (3)(a.5)(II) of this section, if a decedent had an established primary care physician, the primary care physician is responsible for completing the medical certification for the certificate of death in accordance with subsections (1)(a) and (4) of this section if: (A) The death appears to be due to natural causes and is determined as such with a reasonable degree of medical certainty; (B) The decedent received medical care from the primary care physician within a year of the death; (C) The death occurred when the decedent was not under the direct care of another physician charged with the patient's care during the illness or condition that resulted in death; and (D) An inquiry is not required by section 30-10-606. (II) If, within a year of the death, the decedent had been treated by a physician other than the decedent's established primary care physician for a chronic condition or terminal illness related to the decedent's death and the conditions set forth in subsections (3)(a.5)(I)(A) and (3)(a.5)(I)(D) of this section are met, that physician is responsible for completing the medical certification for the certificate of death in accordance with subsection (4) of this section. (b) In the case of a stillborn fetus, notwithstanding the provisions of paragraph (a) of this subsection (3), the physician, nurse, or other medical personnel attending to the stillborn death may assume responsibility for filing the death certificate required by paragraph (a) of this subsection (3). The person filing the death certificate in the case of a stillborn fetus shall obtain the personal data required by the certificate from a parent and shall include a name on the death certificate if a parent desires to identify a name. (c) If a death certificate is not filed in the case of a stillborn death as required by paragraph (a) of this subsection (3), a parent may inform the state registrar of the information necessary to complete the death certificate. The state registrar shall confirm such information and complete the death certificate accordingly. (4) Except when inquiry is required by any provision of section 30-10-606 other than section 30-10-606 (1)(b), the physician in charge of the patient's care for the illness or condition that resulted in death shall complete the medical certification for the certificate of death within seventy-two hours after receipt of the electronic death registration request or, before March 1, 2024, only, for a physician who is not yet registered to use and using the electronic death registration system used by the department of public health and environment and the state registrar pursuant to subsection (1)(b)(I) of this section, within seventy-two hours after receiving notice that a medical certification for a certificate of death must be completed. In the absence of said physician or with the physician's approval, the certificate may be completed and signed by an associate physician, by the chief medical officer of the institution in which the death occurred, or by the physician who performed an autopsy upon the decedent, if such individual has access to the medical history of the case, if said individual views the decedent at or after the time of death, and if the death is due to natural causes. If the death is or may be due to unnatural causes, a physician required to complete a medical certification for a certificate of death in accordance with this subsection (4) shall notify the coroner or the medical examiner when an inquiry or an autopsy is required to be performed pursuant to sections 30-10-606 and 30-10-606.5. On and after March 1, 2024, a physician's repeated or willful failure without reasonable cause to comply with timely completion of a medical certification for a certificate of death in accordance with subsection (1)(a) of this section and this subsection (4) constitutes unprofessional conduct, as defined in section 12-240-121 (1)(hh). If an autopsy is performed, the certification shall indicate whether the decedent was pregnant at the time of death, and said information shall be reported on the death certificate as required by subsection (9) of this section. Except as otherwise provided in subsection (4.5) of this section, the physician or, in their absence, their designee in accordance with this subsection (4), shall complete the medical certification for a certificate of death required by this subsection (4) using the electronic death registration system used by the department of public health and environment and the state registrar pursuant to subsection (1)(b)(I) of this section. (4.5) The department of public health and environment shall ensure that all physicians are registered to use the electronic death registration system created and used pursuant to subsection (1)(b)(I) of this section on or before March 1, 2024. A physician shall use the system for all medical certifications for certificates of death required by subsection (4) of this section immediately upon being registered but is not required to do so before being registered. (5) (a) When inquiry is required by section 30-10-606, the coroner shall determine the cause of death and shall complete and sign the medical certification within forty-eight hours after receipt of the electronic death registration request, except as permitted by subsection (5.5) of this section. If an autopsy is performed, the certification must indicate whether the decedent was pregnant at the time of death, and the information must be reported on the certificate of death as required by subsection (9) of this section. Except as otherwise provided in subsection (4.5) of this section, a coroner, medical examiner, forensic pathologist, or other qualified individual that determines the cause of death and completes the medical certification for a certificate of death in accordance with this subsection (5) must use the electronic death registration system used by the department of public health and environment and the state registrar pursuant to subsection (1)(b)(I) of this section. (b) A coroner, medical examiner, forensic pathologist, or other qualified individual who completes the medical certification for a certificate of death pursuant to this subsection (5) or subsection (5.5) or (6) of this section shall not register "excited delirium" as the cause of death. (c) For purposes of this subsection (5), "excited delirium" means a term used to describe a person's state of agitation, excitability, paranoia, extreme aggression, physical violence, and apparent immunity to pain that is not listed in the most recent version of the Diagnostic and Statistical Manual of Mental Disorders. "Excited delirium" also includes excited delirium syndrome, hyperactive delirium, agitated delirium, and exhaustive mania. (5.5) A coroner is not required to comply with subsection (5) of this section if the coroner, in good faith, determines that additional time is needed to make a proper inquiry to determine the cause and manner of death of any individual in the coroner's jurisdiction who has died under any circumstance specified in section 30-10-606 (1) or if the coroner is required to perform a forensic autopsy as required by section 30-10-606.5. In these situations, a coroner shall determine the cause of death and shall complete and sign the medical certification for a certificate of death as soon as is practicable and in accordance with subsection (6) of this section. (6) If the cause of death cannot be determined within forty-eight hours after a death, the medical certification shall be completed as provided by rule. If an autopsy is performed, the certification shall indicate whether the decedent was pregnant at the time of death, and said information shall be reported on the death certificate as required by subsection (9) of this section. The attending physician or coroner shall give the funeral director or person acting as such notice of the reason for the delay, and final disposition of the body shall not be made until authorized by the office designated or established pursuant to section 25-2-103 in the county where the death occurred or, if such an office does not exist in the county where the death occurred, final disposition of the body shall not be made until authorized by the coroner or the coroner's designee. (7) When a death is presumed to have occurred within Colorado but the body cannot be located, a death certificate may be prepared by the state registrar upon receipt of an order of a court of competent jurisdiction which shall include the finding of facts required to complete the death certificate. Such a death certificate shall be marked "presumptive" and shall show on its face the date of registration and shall identify the court and the date of decree. (8) Every funeral establishment shall maintain registration with the office of the state registrar and shall act in accordance with the provisions of this article. (9) (a) If an autopsy is performed, a certificate of death shall identify whether the decedent was pregnant at the time of death. (b) The requirement in this subsection (9) and subsections (4), (5), and (6) of this section to indicate whether the decedent was pregnant at the time of death shall be complied with when the person required to make the designation has access to the certification form that permits compliance. (10) Whenever in the Colorado Revised Statutes the terms "certificate of death" or "death certificate" are used, except as to the initial certificate of death required pursuant to paragraph (a) of subsection (1) of this section, the same two terms include a verification of death document that is certified by the state registrar and issued pursuant to paragraph (c) of subsection (1) of this section. (11) A deadline set forth in this section by which an individual is required to complete an action relating to a certificate of death or a medical certification for a certificate of death is extended by one day per day of closure if the business or facility at which the individual is employed is actually closed for an entire calendar day that is a weekend day or a legal holiday. Such a deadline is not extended if the business or facility is open for any portion of such a calendar day or if the business or facility is closed for an entire calendar day that is not a weekend day or a legal holiday.
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