This page describes the worked example provided in this IG — a complete MCCoD document bundle representing a real-world death certification scenario. The example demonstrates all mandatory Frame A elements and selected optional Frame B elements, using ICD-10 coding (non-DORIS country).

Clinical Scenario

A 45-year-old male is admitted to Dhaka General Hospital following an acute cardiac event. He is found to have acute myocardial infarction (AMI) with a background of long-standing coronary artery disease (CAD). Despite resuscitation efforts, he dies within 2 hours of admission. His medical history includes hypertension of 15 years' duration, which the certifying practitioner records as a contributing condition.

The certifying physician completes the MCCoD form. No surgery was performed within the last 4 weeks. No autopsy was requested. The manner of death is Disease. The hospital uses ICD-10 (WHO reference version) for mortality coding. DORIS is not in use in this jurisdiction.

All names, identifiers, and dates in this example are entirely fictional and are provided for illustrative purposes only.

Frame A — Cause of Death

The certifying practitioner documents the following causal chain:

Line	Cause	ICD-10 Code	Interval	Profile
a — Immediate cause	Acute myocardial infarction	I21.9	2 hours	MCCoDCauseOfDeathCondition
b — Due to	Coronary artery disease	I25.1	10 years	MCCoDCauseOfDeathCondition

The mortality coder applies ICD-10 mortality coding rules and selects Coronary artery disease (I25.1) as the underlying cause of death — the same as line b, which is the expected result when the general principle of ICD-10 selects the condition on the lowest used line. The dorisDerived extension is set to false.

The certifying practitioner also records Hypertension (I10) as a contributing condition (Frame A, Part 2) with a 15-year interval.

Frame B — Other Medical Data

The certifying practitioner completes the following Frame B General elements:

Element	Value	Profile
Manner of death	Disease	MCCoDMannerOfDeath
Autopsy requested	No	MCCoDAutopsyPerformed
Surgery within last 4 weeks	No	MCCoDSurgeryPerformed

Since the deceased was an adult male aged 45 years:

• The Fetal or Infant Death sub-section is present with emptyReason = #not-applicable and a narrative explanation.
• The Women of Reproductive Age sub-section is present with emptyReason = #not-applicable and a narrative explanation.

Both empty sections include a section.text narrative as required by the FHIR cmp-1 invariant (a section must contain at least one of text, entries, or sub-sections).

Document Bundle Structure

The complete MCCoD document is represented as a FHIR Bundle of type #document containing 11 resources:

#	Resource Type	Profile / Base	Content
1	Composition	MCCoDComposition	MCCoD document structure with Frame A and Frame B sections
2	Patient	Base FHIR	Deceased: Mohammad Ali Rahman, male, born 1980-03-15, died 2026-05-19
3	Practitioner	Base FHIR	Certifying physician: Dr. Sadia Hossain, BMDC-A-45678
4	Organization	Base FHIR	Certifying institution: Dhaka General Hospital
5	Condition	MCCoDCauseOfDeathCondition	Line a: Acute myocardial infarction (I21.9), 2 hours
6	Condition	MCCoDCauseOfDeathCondition	Line b: Coronary artery disease (I25.1), 10 years
7	Condition	MCCoDUnderlyingCauseOfDeath	Underlying cause: Coronary artery disease (I25.1), dorisDerived = false
8	Condition	MCCoDContributingCondition	Part 2: Hypertension (I10), 15 years
9	Observation	MCCoDMannerOfDeath	Manner: Disease
10	Observation	MCCoDAutopsyPerformed	Autopsy requested: No
11	Observation	MCCoDSurgeryPerformed	Surgery within 4 weeks: No

Invariants Exercised by This Example

This example is designed to exercise all error-level invariants defined in this IG:

Invariant	Satisfied By
mccod-comp-line-a-required	Condition with linePosition = #a present
mccod-comp-ucod-required	MCCoDUnderlyingCauseOfDeath present
mccod-comp-empty-reason-fetal	Fetal section present with emptyReason and text
mccod-comp-empty-reason-pregnancy	Pregnancy section present with emptyReason and text
mccod-cod-text-required	code.text present on lines a and b
mccod-cod-line-position-required	linePosition extension present on lines a and b
mccod-ucod-text-required	code.text present on underlying cause
mccod-ucod-doris-flag-required	dorisDerived = false present
mccod-contrib-text-required	code.text present on contributing condition
mccod-manner-value-required	Manner of death valueCodeableConcept present
mccod-autopsy-value-required	Autopsy valueCodeableConcept present
mccod-surgery-value-required	Surgery valueCodeableConcept present

Example Artifacts

View the individual FHIR resources generated from this example:

• MCCoD Document Bundle
• MCCoD Composition
• Line a — Acute Myocardial Infarction
• Line b — Coronary Artery Disease
• Underlying Cause of Death
• Contributing Condition — Hypertension
• Manner of Death
• Autopsy
• Surgery