ICD-10

It is not widely known, but there are statistical codes to describe every cause of death. And if you think that you would only need a few codes, since heart disease and cancer are the leading causes of death, you'd be sorely mistaken.

Of course, if you're Pete Hamill, you would only need one code, because Mr. Hamill has so succinctly summed up death that he correctly states that life is the leading cause of death. But Mr. Hamill is a writer and therefore not a heath statistician, so he's only going to count once he passes away. And believe me, they'd find a code for it.

Consider that in the latest International Classification of Diseases-Version 10, (ICD-10) there is a code for being killed by an alligator. But not just one code. There are numerous subdivisions off a base that goes off into the branches of bitten, struck, contact, crushed, and that old standby, other.

There is a whole new numerical system, highly revised, with granular wording that gets down to a grain of sand to describe a cause of demise. I initially became fascinated with ICD-9, which was not so specific, but did allow for numerous codes for getting whacked by a trolley. It can happen.

So, consider the latest contretemps regarding a coroner's ruling that a man, who was in a kayak and drowned, was a victim of a homicide caused by a "kayak drain plug intentionally removed by other."

I don't think there is yet a morbidity code for this occurrence, or if there will be an item in a committee's agenda to consider it, but for now there are lawyers screaming foul that a coroner went what is considered to be way beyond stating a cause of death to include a form of the word "intent" in their ruling.

"Intent" is a big legal issue and leads to the creation of certain charges. The coroner is considered to have crossed the line into the courtroom.

The episode that gave birth to this series of disputes involves the drowning of Vincent Viafore in the Hudson River, NY, this past May. He was kayaking with his fiancé Angelika Graswald, and it is alleged she caused the sinking of his kayak and didn't do squat to save her betrothed, who wasn't wearing a life vest, because if he croaked she could collect on the insurance policy. It is not 'Double Indemnity' but certainly a variation of it.

Ms. Graswald is in custody, being held while awaiting the ruling on a bail hearing in New York's Orange County. There are numerous links to the story from its outset, including an early one that a body found in the Hudson was not that of the then missing kayaker Vincent Viafore. You really never know what you might find in a river until you start to look. Especially in waters in and around New York City.

So, how will Mr. Vincent Viafore's cause of death be classified? He's no less not breathing no matter what someone codes it, or proposes to code it. Apparently though, it is going to make for great courtroom theater.

Consider that in the aftermath of 9/11 there was extensive debate on how to classify the deaths of the victims, which ultimately neared 3,000. Were they caused by a homicide? An act of war? Terrorists? Was a new code needed?

My guess is ICD-10 probably covers the events causing demise on 9/11. It might however be lacking in assigning a numerical code to intentionally yanking kayak plugs while the kayak is in the water and occupied.

Stay tuned. It can only get better.

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