How to Decipher a Hard-to-Read Cause of Death

It's more than a cliché that doctors have bad handwriting. It's a genuine problem for anyone building their family tree. When you get to the "cause of death" section of a death certificate, the medical term can seem impossible to read. And it's not as if we're all familiar with medical terms.

But someone else may have written a number in that section. You can read the number, right?

There is a simple tool to help you decipher a cause of death on an official death certificate. A company in the UK called Wolfbane Cybernetic Ltd. has published the International Classification of Diseases (ICD) decoder online.

Here's how you can use it:

1. Find a number written in the cause of death section of a death certificate.
2. Consult the Wolfbane website and click the link for the current ICD at the time of death.
3. Find the number from the death certificate to see the cause of death.
4. If it's a medical term that's unfamiliar to you, Google it.

Let's look at a few examples to make this process easy to use.

When the cause of death is too hard to read on a death certificate, there is one clue, and one website, that makes it clear.

1937 Cause of Death Example

James M. Williams (born Gennaro Muollo) was a 59-year-old retired railroad foreman. He died at home in Pennsylvania on 29 Jun 1937. The family began calling themselves Williams because Muollo is hard to pronounce.

The cause of death on Gennaro's death certificate is hard to read. The first word looks like Encephalitis, but I can't make out the second word.

The good news is, there's also a number written there: 17. On the Wolfbane page I click the link for the most recent ICD as of 1937. I scroll down to find the number 17 and it says "Encephalitis lethargica".

I had to stare at the death certificate a long time before I could spot "lethargica" in that one mystery word. But that's what it says! Next I searched for a definition of "Encephalitis lethargica". I learned this was a neurological syndrome that began in Europe 20 years earlier. At the time, doctors thought it had a connection to the Spanish flu. But today, it's still unknown what caused this epidemic. Cases showed it could take a short time, or even years, for symptoms to develop in the patient.

All-in-all, poor Gennaro died an unpleasant death.

1953 Cause of Death Example

The cause of death on Pietro Pozzuto's Pennsylvania death certificate is typewritten. It says Cirrhosis of the liver. But this is a less straightforward example of an ICD number, so let's take a look.

The number used on Pietro's 1953 death certificate is 5810. The Wolfbane website has several links for ICD codes as of 1948. (The next update was in 1955.) I clicked the link labeled "4-digit codes" and searched the page for 5810.

What I found leads me to believe whoever wrote 5810 meant to write 581.0. The number 581 is Cirrhosis of liver, while 581.0 is for Cirrhosis of liver without mention of alcoholism. There's also a 581.1 which is Cirrhosis of liver with alcoholism.

An online search confirmed that you can get Cirrhosis of the liver other than from alcohol abuse. Because of this distinction, I can conclude that Pietro did not drink himself to death.

1959 Cause of Death Example

The doctor printed the cause of death on Antonio Coratto's 1959 death certificate. I can read it, but let's look at the ICD number for verification.

The ICD number is 331X. On the Wolfbane site, I clicked the link for 3-digit codes in effect as of 1955. Number 331 is Cerebral haemorrhage. Whoever wrote 331X may have used the X to signify there was no extension—no 331.1 or 331.2.

It's clear to me the immediate cause of death says cerebral vascular hemorrhage. It also says that's due to arteriosclerosis generalized. If that had been hard to read, the ICD number would have made it plain.

And speaking of death certificates:

• How to Find State-Specific Death Indexes and Records
• 27 Key Facts to Extract From a Death Certificate
• A Startling Family Tree Discovery

In my own collection of downloaded U.S. death certificates, most have an easy-to-read cause of death. The first example in this article is the only one that had stumped me. I do have many New York City death certificates, but the majority have no code number on them. I did find one example to share.

1909 Cause of Death Example

Marietta Piacquadio was a baby aged one year and four months who died in the Bronx, New York. There are two causes of death, and one word is eluding me. This death certificate has a code number 105 written on it.

In the ICD that was current in 1909, code 105 has 8 variations labeled 105A through 105H. There is no letter on the death certificate. The descriptions for 105A through 105H all say "age over 2 years", but Marietta was under 2 years old.

These descriptions include enteritis, gastro-enteritis, dyspepsia, colic, ulceration of intestines, and duodenal ulcer.

They wrote the 105 next to the second cause of death, which I can read as Acute Entero-Colitis. That checks out. But the primary cause of death is Cardiac something. There's nothing in the 1909 ICD list with the word cardiac; only carditis. None of those match what I see on the death certificate.

My best guess is that it says Cardiac Asthema. I looked up that phrase and found nothing with that spelling (asthema). I did find Cardiac Asthma, which is a fluid buildup in the lungs. That doesn't seem like it's related to acute entero-colitis, so all I know is this was a very sick baby.

I hope the Wolfbane list of ICD codes will help you solve some mysteries in your family tree. Be sure to add it to your genealogy bookmarks.