Coroner Referral with Chain-of-Custody Evidence Pack

Overview#

When a patient dies on scene, in an ambulance, or shortly after handover from a DFB ambulance crew, the Coroner needs a complete, verifiable account of what happened. Assembling that pack by hand from CAD logs, ePCR systems, call recorders, and paper handover sheets has historically taken days and risked gaps that erode evidential weight.

The Coroner Referral with Chain-of-Custody Evidence Pack module assembles that complete record automatically from the canonical incident record, hashes and signs every artefact, anchors the pack into an immutable witness ledger, and produces a single signed container a clinical lead can review, justify, and release in minutes rather than days.

Last Reviewed: 2026-05-05 Last Updated: 2026-05-05

Key Features#

• One-Click Pack Assembly From the Canonical Incident: A clinical lead initiates a Coroner pack against the single incident record and the platform gathers timeline events, the ePCR encounter, call recordings, transcripts, handover artefacts, vehicle telemetry, and witness signatures without re-keying.

• Per-Artefact Cryptographic Integrity: Every file in the pack is hashed with SHA-256 and digitally signed using Ed25519, so any later alteration of any single artefact is detectable.

• Trusted Timestamping for Evidential Weight: Each signed artefact and the assembled container are timestamped through an RFC 3161 Time-Stamp Authority, fixing the moment of assembly in a way an external party can verify.

• Caller PII Redaction Before Release: Call audio passes through the existing redaction pipeline so caller-identifying details that are not relevant to the Coroner inquiry are removed before the pack is sealed.

• Immutable Witness Ledger Anchoring: The pack manifest, hashes, and signatures are written into the Ed25519 witness ledger, producing a tamper-evident chain a court can rely on to confirm the pack existed in this exact form at the stated time.

• Dual-Control Review and Sign-Off: Pack release requires a reviewer and an approver, each recorded with identity, role, justification, and timestamp, so chain-of-custody includes the human decision to release.

• Long-Term Validation Ready: Signatures and timestamps are packaged following ETSI long-term validation patterns so the pack remains verifiable years after the incident, when certificates may have rotated.

Use Cases#

• Death on Scene Following Cardiac Arrest: A clinical lead assembles the full timeline, ePCR with drug administrations and ECG, and bystander 999 audio for the Coroner within the same shift.

• Death in Ambulance During Transport: Vehicle telemetry, intervention timestamps, and crew handover notes are bundled with the call recordings into a single signed container ready for inquest.

• Death Shortly After Hospital Handover: The pack carries the signed electronic handover and links to the receiving facility's acknowledgement, evidencing exactly what was transferred and when.

• Court-Ready Disclosure for Inquest: Counsel for the Coroner receives a single ASiC container whose every artefact can be independently verified for integrity and time of assembly.

• Internal Clinical Governance Review: The same pack supports morbidity and mortality review without forcing a separate evidence-gathering exercise.

Integration#

• Canonical Incident Record: The pack builder treats the incident as the single source of truth and pulls timeline, encounter, recordings, handovers, and telemetry from it directly so what is sealed matches what was operationally true.

• ePCR Encounter and Witness Ledger: The assembled clinical record is produced as a HL7 FHIR R4 Bundle and every artefact is logged through the existing immutable audit service that already underpins the ePCR.

• SIPREC Call Recording Source: Call audio and transcripts are read from the NG911 SIPREC capture path, so the Coroner pack contains the same recordings retained for emergency communications compliance.

• Existing Redaction Pipeline: Caller-PII redaction reuses the platform's governance redaction service rather than introducing a parallel mechanism.

• RFC 3161 Time-Stamp Authority Client: A new TSA integration submits artefact and pack hashes to a trusted authority and stores the returned timestamp tokens alongside the signatures.

• Evidence Attachments Extension: Each finalised pack is recorded as a row in the incident evidence attachments extension with an evidence class that marks it as a signed evidence pack, so it is discoverable from the incident itself.

• Clinical Review UI: A Coroner pack builder view in the ePCR application lets the clinical lead inspect each artefact, capture justification, and route the pack for dual-control sign-off before release.

• Event Bus Notifications: Pack lifecycle events are published as CloudEvents so downstream systems, governance dashboards, and audit consumers can react to assembly, signature, and delivery without polling.

Open Standards#

• Ed25519 (RFC 8032): digital signatures over every artefact and the pack manifest use the modern, widely supported elliptic-curve signature scheme.

• SHA-256: content hashing of every artefact and the pack manifest uses the standard cryptographic hash function expected by court and audit reviewers.

• RFC 3161 Time-Stamp Protocol: trusted timestamps are obtained from a Time-Stamp Authority so the moment of assembly is independently verifiable.

• HL7 FHIR R4 Bundle: the assembled clinical record is expressed as a FHIR Bundle so the Coroner pack remains interoperable with healthcare information exchange standards.

• HL7 FHIR R4 Provenance: every artefact carries a Provenance resource describing its source, agent, and chain so the pack documents how each piece of evidence was produced.

• ETSI EN 319 102-1: long-term validation profiles are followed so signatures and timestamps remain verifiable across the lifetime of a Coroner inquiry and any subsequent legal process.

• ETSI EN 319 162 (ASiC): the pack is delivered as an Associated Signature Container so a single file carries the artefacts, signatures, and timestamps in a recognised legal-evidence format.

• GDPR Article 9: special-category health data handling is governed by an explicit lawful basis and recorded justification for every Coroner release.

• Coroners Act 1962 (Ireland, as amended): the module is built around the Irish statutory framework for Coroner referrals and inquests so the pack supports the inquiries that law actually requires.

• CloudEvents 1.0: pack lifecycle is emitted using argus.evidence.pack_assembled, argus.evidence.pack_signed, and argus.evidence.pack_delivered events so downstream systems can integrate without bespoke webhooks.