•  Immediately inform Susan Culican, DIO, at 314-749-4078.  She will identify a Crisis Response Team leader to begin mobilizing the Crisis Response Team.   

Find the contact information for the emergency contact in RMS.  There is implied consent that this person can be notified in the case of an emergency.

In the event of a possible death of a trainee it is imperative to obtain accurate facts: 

• Sometimes the family learns of the death first and informs someone at the institution, such as the PD: in other cases, the death of a trainee comes to light after the trainee does not report for duty or after a phone call from local authorities, emergency room personnel, or others.  

• Depending on the situation, facts may be obtained or clarified by contacting the coroner, medical examiner’s office, or local law enforcement.

• Obtaining as much information from knowledgeable sources  as possible helps alleviate speculation and rumors that can fuel emotional turmoil within a training program. 

• The cause of death should not be disseminated without first speaking with the family about their preferences. Full discussion of this can be found in Sharing the News.

Individuals within the training program may be the first to know a trainee has been declared deceased.  In such a situation the crisis response leader or a delegate (e.g, DIO or Residency/Fellow training PD) should contact the emergency contact person immediately. Every trainee should have emergency contact information on file (phone numbers, email address, and names of parents, spouse/partner, or other emergency contact person). Such information should be updated yearly.

In other situations the police may know first, and they will have their own protocol for managing this and notifying the next of kin. If the trainee was brought to the Emergency Room, it will be the physician who declares the individual deceased who would likely make the call. In situations where another individual has disclosed the death of a trainee, it is still important that the crisis response leader or a designated individual from the institution call the emergency contact person.

Prior to calling the emergency contact person it is helpful to obtain as much information as is currently available (see below) as well as information about what, if anything, has already been conveyed to the emergency contact person by others (e.g., police, emergency dept., physician.) This initial call should focus on condolences and extending support. Ask what the trainee program can do to assist and discuss the family’s preference regarding what information is provided to the faculty and trainees. The family may ask what happened. Sometimes it is not clear early on if the death was by suicide, accidental, or from natural causes. Starting by asking what they have heard or what they understand about what happened may be helpful. Be careful about sticking to the known facts and avoiding any conjecture. Ask if they have thought about funeral arrangements and if trainees and faculty from the program can attend. Some families wish for the funeral to be private.

Although difficult, it is vital to discuss what information can be relayed to faculty and trainees. If the death is determined to be a suicide and the family does not want it disclosed, the emergency contact person should be informed that it would be helpful for fellow trainees to know the cause of death. It is important to tell the emergency contact person that faculty and trainees are deeply affected by the passing of their loved one and would benefit from honest disclosure of the cause of death.  Doing so enables peers, faculty and support staff to fully process and grieve the death of the trainee, to learn more about suicide and its causes, and, importantly, is an important step to keeping the trainees safe and avoiding more tragedy. That said, it should be kept in mind that the family may be in a state of shock immediately following the death, and may not be ready to accept suicide as the cause of the death; it is advisable not to push too hard, with the understanding that acceptance may arise within 24-48 hours.

End the conversation by providing information about how the emergency contact person can reach one particular contact person (typically the caller) if questions arise following the initial call. If the person is not the individual making the initial call be sure that is clearly conveyed to the emergency contact person. Let them know to expect a follow up phone call within a few days. It may be relevant to inform the family of potential media attention surrounding the death of their loved one. Although accidents and suicides happen every day, the death of a trainee from those circumstances may draw unwanted media attention. The caller can help them prepare.