SUDDEN UNEXPECTED CARDIAC DEATH IN THE EMERGENCY DEPARTMENT: NAVIGATING THE MEDICO-LEGAL DILEMMA OF DEATH CERTIFICATION AND AUTOPSY WAIVER UNDER THE BHARATIYA NAGARIK SURAKSHA SANHITA, 2023

Sudden cardiac death (SCD) presenting to an emergency department without prior medical history creates profound legal and ethical dilemmas for physicians in India. We report the case of a 62-year-old male who suffered a terminal collapse due to acute coronary syndrome/ventricular fibrillation within an hour of symptom onset. Despite robust resuscitative measures, the patient could not be revived. Due to the lack of baseline medical records, the treating emergency physician appropriately invoked statutory provisions under Section 194 of the Bharatiya Nagarik Suraksha Sanhita, 2023, shifting the authority for determining the necessity of an autopsy to the states legal apparatus. This report details the medical management, the statutory obligations governing modern Indian clinical practice, and the ethical parameters involved.