NVDRS Web Coding Manual

Att 7_NVDRS Coding Manual Version 5.3_0607.pdf

The National Violent Death Reporting System (NVDRS)

NVDRS Web Coding Manual

OMB: 0920-0607

Document [pdf]
Download: pdf | pdf
NATIONAL VIOLENT DEATH REPORTING SYSTEM
WEB CODING MANUAL
VERSION 5.3*

National Center for Injury Prevention and Control, Division of Violence Prevention
Centers for Disease Control and Prevention

*Revision Cleared Date: 12/6/2018

The National Violent Death Reporting System (NVDRS) Coding Manual was developed through an
extensive consultation process. It is published by the National Center for Injury Prevention and Control
of the Centers for Disease Control and Prevention. Use of trade names is for identification purposes only
and does not constitute endorsement by the Department of Health and Human Services. This document
and subsequent revisions can be found at the National Center for Injury Prevention and Control website:
http://www.cdc.gov/injury

Suggested citation:
Centers for Disease Control and Prevention. National Violent Death Reporting System (NVDRS) Coding
Manual Revised [Online] 2018 National Center for Injury Prevention and Control, Centers for Disease
Control and Prevention (producer). Available from URL: www.cdc.gov/injury

1|Page

TABLE OF CONTENTS
INTRODUCTION ................................................................................................................................................ 3
Purpose of the Coding Manual ..................................................................................................... 3
NVDRS Methodology .................................................................................................................... 4
Coding training .............................................................................................................................. 6
Definitions ..................................................................................................................................... 7
SECTION 1: INCIDENT VARIABLES .................................................................................................................... 23
SECTION 2: DOCUMENT TRACKING VARIABLES ................................................................................................ 30
SECTION 3: DEMOGRAPHIC VARIABLES FOR VICTIMS ....................................................................................... 33
Demographics, Race, and Ethnicity............................................................................................. 33
Place of Residence, Birthplace, Industry, Occupation, and Education ....................................... 42
SECTION 4: INJURY AND DEATH VARIABLES ..................................................................................................... 50
Manner of Death Variables ........................................................................................................ 50
Change in Collection of Injury and Death Variables ................................................................. 52
Injury Locations, Time, and Events ............................................................................................. 52
Wounds and Death Certificate .................................................................................................... 63
SECTION 5: CIRCUMSTANCE VARIABLES ........................................................................................................... 73
General Guidance on Coding NVDRS Circumstances .................................................................. 73
Mental Health, Substance Abuse, and Other Addictions ........................................................... 77
Relationships, Abuse and Life Stressors...................................................................................... 83
Crime and Criminal Activity......................................................................................................... 93
Manner Specific Circumstances for Homicide .......................................................................... 100
Manner Specific Circumstances for Suicide .............................................................................. 109
Manner Specific Circumstances for Unintentional Firearm deaths .......................................... 121
Other Circumstances: All Manners ........................................................................................... 128
SECTION 6: WEAPON VARIABLES .................................................................................................................. 131
Weapon Type ............................................................................................................................ 132
Firearm Variables ...................................................................................................................... 133
SECTION 7: SUSPECT VARIABLES ................................................................................................................... 140
SECTION 8: TOXICOLOGY VARIABLES ............................................................................................................. 151
SECTION 9: CHILD FATALITY R EVIEW OPTIONAL MODULE .............................................................................. 159
SECTION 10: INTIMATE PARTNER VIOLENCE OPTIONAL MODULE .................................................................... 181
SECTION 11: APPENDIX ................................................................................................................................ 204

2|Page

INTRODUCTION
1.0

Purpose of the Coding Manual

The NVDRS Coding Manual is a reference document to be used for defining cases, entering data, and
checking data once they are entered. It contains information about all data elements and the way the
data are structured. It should be kept at hand when doing data entry or checking, both in the office and
in the field.
1.1

Companion documents

Starting in 2018, historical information on variables contained in the NVDRS system has been added to a
data dictionary, and description of how each data element can be used in analyses has been added to a
separate analytic manual.
1.2

Background on NVDRS

Public health leaders and others are aware of the long-standing gap in information about violence and
emphasized the need for a national surveillance system for violent deaths since 1989. In 1999, the
Institute of Medicine recommended that the Centers for Disease Control and Prevention (CDC) develop
a fatal intentional injury surveillance system modeled after the National Highway Traffic Safety
Administration’s Fatality Analysis Reporting System. That same year, six private foundations pooled their
funds to demonstrate the importance and feasibility of data collection about violent deaths given
adequate funding. They supported the National Violent Injury Statistics System (NVISS). NVISS was
administered by the Harvard Injury Control Research Center and included 12 participating universities,
health departments, and medical centers.
In 2000, dozens of medical associations, suicide prevention groups, child protection advocates, and
family violence prevention organizations joined a coalition whose purpose was to secure federal funding
to extend NVISS-like surveillance nationwide. Congress approved $1.5 million to start the new system,
called the National Violent Death Reporting System (NVDRS), in fiscal year 2002. The first cooperative
agreements were established with six state health departments in September 2002, including:
Maryland, Massachusetts, New Jersey, Oregon, South Carolina and Virginia. Deaths occurring in 2003
constitute the first year of data collection for NVDRS. Funding for additional states was made available in
fiscal year 2003 and another seven states implemented NVDRS (Alaska, Colorado, Georgia, North
Carolina, Oklahoma, Rhode Island, and Wisconsin). Further funding became available in 2004, and
Kentucky, New Mexico, Utah and four counties in California began data collection in 2005. California
ended data collection for these counties in 2009. Also in 2009, the system was expanded, with two more
states (Michigan and Ohio) joining NVDRS and collecting data beginning in 2010. In 2014, 14 more states
joined NVDRS (Arizona, Connecticut, Hawaii, Iowa, Illinois, Indiana, Kansas, Maine, Minnesota, New
Hampshire, New York, Pennsylvania, Vermont, and Washington) and began collecting data in 2015.
NVDRS expanded again in 2016 with an additional eight states (Alabama, California, Delaware,
Louisiana, Missouri, Nebraska, Nevada, and West Virginia), the District of Columbia and Puerto Rico
joining the system and beginning data collection in 2017. Finally, in 2018, ten states (Arkansas, Florida,
Idaho, Mississippi, Montana, North Dakota, South Dakota, Tennessee, Texas, and Wyoming) joined the
system and will begin collecting data in 2019. Starting with the 2019 data year, NVDRS will be a national
system with all 50 states, the District of Columbia and Puerto Rico collecting data. Availability of data
varies by year and by state. Please refer to the NVDRS Analytic Manual for more details on data

Introduction

3|Page

availability. The NVDRS Analytic Manual is available upon request by emailing [email protected].
1.4.1

Vision

To assist in the prevention of violent deaths in the U.S. through the facilitation of systematically and
routinely collected, accurate, timely, and comprehensive data for prevention program development.
1.4.2

Goals
1. Collect and analyze timely, high-quality data for monitoring the magnitude and
characteristics of violent deaths at the national, state, and local levels.
2. Ensure that violent death data are routinely and expeditiously disseminated to public health
officials, law enforcement officials, policy makers and the public, in accordance with data rerelease plans.
3. Track and facilitate the use of NVDRS data for researching, developing, implementing and
evaluating strategies, programs and policies designed to prevent violent deaths and injuries
at the national, state and local levels.
4. Build and strengthen partnerships with organizations and communities at the national,
state, and local levels to ensure that data collected are used to prevent violent deaths and
injuries.
5. Identify creative strategies for expanding and sustaining NVDRS in all 50 states, the District
of Columbia (DC) and U.S. territories.

2.0

NVDRS Methodology

NVDRS is a population-based active surveillance system that collects information on violent deaths that
occur among both residents and nonresidents of funded U.S. states, the District of Columbia, and Puerto
Rico.
The system uses the World Health Organization (WHO) definition of a violent death: “a death resulting
from the intentional use of physical force or power against oneself, another person, or against a group
or community”.1 The case definition includes suicides, homicides, deaths from legal intervention (a
subtype of homicide where the victim is killed by or died as a result of law enforcement acting in the line
of duty), deaths of undetermined intent, and unintentional firearm fatalities. Deaths of undetermined
intent are included because this category includes deaths with some evidence of intent, but without
enough to definitively classify the death as purposeful. Unintentional firearm injury deaths are included
because the category is likely to include some deaths that are in fact intentional or of undetermined
intent.
1

World Health Organization, World Report on Violence and Health:
http://www.who.int/violence_injury_prevention/violence/world_report/en

Introduction

4|Page

The following deaths are excluded from NVDRS: 1) Legal executions, which are considered to be a form
of death from legal intervention, are excluded from NVDRS as they are beyond the scope of public
health. 2) Legal assisted suicides. 3) Deaths due to acts of war (acts due to terrorism are included,
however)
The system is coordinated and funded at the federal level and depends on separate data collection
efforts in each funded state managed by the state health departments. Unlike most public health
surveillance systems that are based on the individual victim, the NVDRS is incident-based and links all
victims and alleged perpetrators (suspects) associated with a given incident in one record. Decisions
about whether two or more deaths belong to the same incident are governed by the timing of the
injuries, rather than the timing of the deaths. Specifically, deaths that occur within 24 hours of each
other (i.e., the 24-hour rule) and are clearly linked by source documents, as discussed below in the
guidelines on entering a case, would be considered part of the same incident.
Examples of a violent death incident are:




One isolated violent death;
Two or more homicides, including legal interventions, when the deaths involve at least one
person who is a suspect or victim in the first death and a suspect or victim in the second death
and the fatal injuries are inflicted less than 24 hours apart; and
Two or more suicides or undetermined manner deaths, when there is some evidence that the
second or subsequent death was planned to coincide with or follow the preceding death, and
the fatal injuries are inflicted less than 24 hours apart.

Each incident record contains information about victims, suspects, the relationship of the victim to the
suspect, toxicology findings for the victim and any weapon(s) involved in the incident. To fully
characterize the incidents, states collect information about each incident from numerous data sources.
Required primary source documents:
 Death Certificates (DC)
 Coroner/Medical examiner (CME) records, including toxicology reports
 Law enforcement reports (LE); including Supplementary Homicide Reports (SHR) and National
Incident-Based Reporting System (NIBRS) reports, where available
Secondary or optional sources:
 Child Fatality Review (CFR) team data
 Intimate Partner Violence (IPV) expanded data
 Crime Lab Data
 Hospital Data
Supplementary Homicide Reports (SHR) and National Incident-Based Reporting System (NIBRS) reports
were treated as a separate data source prior to the 2009 data year. Information from these sources,
when available, is now entered into the appropriate law enforcement report data elements.
Prior to the launch of the NVDRS web system in August, 2013, CFR circumstances were entered into a
separate screen. After the August, 2013 launch, CFR circumstances should be entered as law
enforcement circumstances. Law enforcement agencies are often a member of a Child Fatality Review

Introduction

5|Page

Board and contribute to developing a CFR report by providing: 1) case status and death scene
investigation information, 2) suspect and family member criminal histories, 3) expertise on law
enforcement practices (e.g., evidence collection) and 4) access to and information from other law
enforcement agencies. When available, CFR reports can be a means to endorse and enhance the
completeness of law enforcement circumstances.
Data collection is done by either abstraction from the records maintained by the primary sources at
their offices or by transfer of data from the primary sources to the health department’s NVDRS office.
Data may be manually entered into the software or electronically imported. Data collection is staged so
that basic demographic information is available for early analyses and more detailed information about
circumstances and potential contributing factors are collected later and can be analyzed later. Death
certificates often provide the earliest information in most states, but other states may identify incidents
(i.e., initiate cases) through the coroner/medical examiner or law enforcement offices. Regardless of the
source(s), information on the number of violent deaths is typically available to the health department
and entered into the system within four months of the occurrence of death. Law enforcement (LE) and
CME data are expected to be available within sixteen months of the occurrence of the death.
For victims, NVDRS collects demographic data and personal characteristics such as marital and
pregnancy status. It also collects data on the injury event (e.g., date, time, and place of injury), the
occurrence of the death (e.g., time, place and cause of death), as well as other related factors such as
toxicology findings. For suspects, basic demographic information is collected as well as the relationship
between the victim and suspect.
NVDRS makes a unique contribution in that it captures information on circumstances for suicide,
undetermined deaths, homicides, and unintentional firearm injury. The circumstances for homicide,
suicide and undetermined death include factors such as mental health history and status, whether a
victim disclosed intent to die by suicide, interpersonal conflicts, and criminal acts. Circumstance
variables for unintentional firearm deaths record the context and specific use of the firearms. For
homicides, details are collected on relationships between victims and suspects, as well as whether there
was a history of abuse or whether the suspect was a caregiver of the victim. The system also collects
data on mechanisms leading to injury and detailed information on firearms and poisons, such as the
type of firearm or substance involved.
The data are entered into a national web system and are stored without personally identifiable
information (PII) in a secure national database maintained by CDC.
Over time, additional data sources that are particularly useful for specific kinds of death may be added
to the system. In the first year of NVDRS, for example, some of the funded state health departments
tested the availability and utility of data from child fatality review teams, using a module specially
designed to take advantage of the detailed information available from that source. An intimate partner
violence module was also subsequently added to the system and is available to states interested in
collecting detailed information on intimate partner violence-related deaths. Other modules may be
developed in the future.
3.0

Coding training

Coding training is required for new states joining NVDRS. Ongoing coding support is provided through an
email helpdesk, monthly conference calls with all states, and conference calls with individual states as

Introduction

6|Page

needed or requested.
This coding manual provides detailed information on every NVDRS data element and should serve as the
standard reference for anyone working with NVDRS.
4.0

Definitions

CDC has developed case definitions specifically for NVDRS. States should collect information about all
cases that meet these definitions. States may also develop their own state-specific definitions. If their
definitions are broader than those shown here, states may enter these cases, but the cases should be
identified as “not an NVDRS case” in the Case Status field. Reports generated by CDC will include only
those cases that meet the CDC definitions. States should cite which definition they are using, statespecific or the federal NVDRS definition, when they cite their own data.
I. Violent Death
A. Conceptual definition
A violent death is a death that results from the intentional use of physical force or power,
threatened or actual, against oneself, another person, or a group or community. The person using
the force or power needs only have intended to use force or power; they need not have intended to
produce the consequence that actually occurred. “Physical force” should be interpreted broadly to
include the use of poisons or drugs. The word “power” includes acts of neglect or omission by one
person who has control over another.
In addition, NVDRS captures unintentional firearm deaths. Such deaths are defined in Section IV.D,
below.
B. Operational definition to be used in case ascertainment
Death certificates that are coded with an underlying cause of death as one of the ICD-10 codes listed
on Table 1 should be included. A death that is not given an appropriate ICD-10 code may be
included, if the death certificate, law enforcement report, or coroner/medical examiner report
characterizes the death as a suicide, homicide, legal intervention death, or death of undetermined
intent, and the death meets the conceptual definition given above.
A death of a fetus prior to birth that is caused by violence is not included in the case definition, and
such deaths should never be included in NVDRS. However, states who want to collect such deaths
may enter these as a separate incident (in instances where there are multiple victims) and follow
the guidance as described in the Definitions section above.
II. Resident and Occurrent Violent Deaths
A. U.S. resident violent death
The decedent was a resident of the United States, including its territories, according to the
death certificate. Please note this also includes residents of American Indian reservations at the
time of injury.
B. State resident violent death
The decedent was an official resident of the state (or territory) including those portions of an
American Indian reservation within the state at the time of injury, according to the death
certificate.

Introduction

7|Page

C. U.S. occurrent violent death
The initial injury must have occurred within the United States, including its territories. Please
note this also includes injuries that occurred on American Indian reservations.
D. State occurrent violent death
The initial injury must have occurred within the state or on those portions of the American
Indian reservations within the state.
Note: The collection of all resident violent deaths is essential for calculating population-based rates. The
collection of all occurrent fatal injuries is essential for designing and evaluating prevention efforts
focused on specific communities. Usually the state of residence and state of occurrence of a fatal injury
will be the same, but every state will have some exceptions. States are expected to collect violent
deaths among their residents, wherever they occur, and fatal violent injuries occurring within their
borders irrespective of residence. If the states of residence and injury occurrence are different, the state
of injury occurrence is responsible for collecting the information. For example, if a resident of state A
dies as a result of a fatal injury in state B, and both state A and B are NVDRS states, state B is responsible
for collecting the information. If a state chooses to collect and enter information into the NVDRS webbased system about a resident death where the fatal injury occurred in a different NVDRS state, the data
abstractor should mark the incident type for these cases as “Other (State-Defined)” to avoid duplication.
For further guidance related to resident and occurrent deaths, please see the decision tree in the
Appendix.
III. Preliminary versus Confirmed Violent Death
A. Preliminary violent death
The underlying cause of death has not yet been officially coded using the International Statistical
Classification of Diseases and Related Health Problems, 10th Revision (ICD-10); and
Review of the uncoded death certificate or official law enforcement (LE), CME records indicate
that the death is likely to be ultimately coded as one of the ICD codes included in the case
definition above.
B. Confirmed violent death
The underlying cause of death has been officially coded using ICD-10. The ICD-10 code assigned
to the death matches the case definition above. Alternatively, the death has been
identified/confirmed as such by abstractors from other data sources (e.g., law enforcement and
CME).
IV. Manners of Death
For public health purposes, violent deaths are assigned to types according to the ICD code assigned to
the underlying cause of death indicated on the death certificate by the CME (per Table 1). However,
CMEs may not uniformly apply the same criteria in assigning manner of death in all states. Therefore,
NVDRS will also try to achieve some standardization of death type through these definitions. Some of
the manners of death are not included as options on a standard death certificate. For instance, a person
dying after being shot by a law enforcement officer in the line of duty may be called a ‘homicide’ on the
death certificate but will be called a ‘legal intervention’ death in NVDRS. Similarly, a self-inflicted firearm
death ruled ‘accidental’ on a death certificate will be included as an ‘unintentional firearm’ death in
NVDRS. NVDRS sites should use the definitions below to identify preliminary cases.

Introduction

8|Page

A. Suicide
A suicide is a death resulting from the intentional use of force against oneself. A preponderance
of evidence should indicate that the use of force was intentional.
Specific scenarios that should be classified as suicide:
 A person engaged in a suicidal act, then changed his mind, but still died as a result of the act
 A person intended only to injure rather than kill himself (e.g., a man shot himself in the leg
with intent to injure but severed the femoral artery and died)
 Assisted suicide involving passive assistance to the decedent (e.g., supplying only means or
information needed to complete the act)
 Intentional, self-inflicted deaths committed while under the influence of a mind-altering
drug taken voluntarily
 Intentional, self-inflicted deaths committed while mentally ill (e.g., acute psychotic episodes
that may impair a person’s judgment)
Specific scenarios that should not be classified as suicide: (The preferred category is shown in
parentheses.)
 The physical consequences of chronic substance abuse, including alcohol or drugs (natural
death)
 Acute substance abuse including alcohol or drugs with less than a preponderance of
evidence to use the substance(s) with intent to harm oneself (undetermined or
unintentional injury death)
 Death as a result of autoerotic behavior, e.g., self-strangulation during sexual activity
(unintentional injury death)
B. Homicide
Homicide is defined as a death resulting from the intentional use of force or power, threatened
or actual, against another person, group, or community. A preponderance of evidence must
indicate that the use of force was intentional. Such deaths resulting from legal intervention are
included in a separate category below. Two special scenarios the National Center for Health
Statistics (NCHS) regards as homicides are included in the NVDRS Definition: (1) arson with no
intent to injure a person, and (2) a stabbing with intent unspecified.
Specific scenarios that should be classified as homicide:
 Deaths when the suspect intended to only injure rather than kill the victim
 Deaths resulting from heart attacks induced when someone uses force or power against the
decedent
 A death resulting from a weapon that discharges unintentionally while being used to control
or frighten the victim
 Deaths that result when a person kills an attacker in self-defense
 Deaths labeled “justifiable homicides” where the person committing the homicide was not a
law enforcement officer
 Death that results from a variation of Russian roulette where one person aims a partially
loaded gun at another person and pulls the trigger knowing that there was at least some
chance that the gun would fire
 Death attributed to “child abuse” without an intent being specified
 Death of a child after birth that results from a direct injury due to violence sustained prior to

Introduction

9|Page



birth
Death that results from an intentional act of neglect or omission by one person against
another

Specific scenarios that should not be classified as homicide: (The preferred category is shown in
parentheses.)









“Vehicular homicide” without a preponderance of evidence of intent to use force against
another (unintentional injury)
Hunting accident with a gun (unintentional firearm injury)
Accidental deaths at shooting ranges (unintentional firearm injury)
A youth kills someone by playing with a gun he believes is unloaded (unintentional firearm
injury)
Deaths that take place in combat in declared or undeclared wars (operation of war – not
collected by NVDRS)
Death of a child after birth that results indirectly from violence sustained by its mother
before its birth, e.g., a death from prematurity following premature labor brought on by
violence (coded as “condition originating in the perinatal period – Not collected by NVDRS”)
Accidental poisoning deaths due to illegal or prescription drug overdose, even when the
person who provided those drugs was charged with homicide (unintentional deaths not
involving firearms are outside the scope of NVDRS; a death of this type might be within the
scope of “undetermined manner of death,” below, if it is impossible to determine whether
the death was intentional or unintentional)

C. Undetermined manner of death
Undetermined death is a death resulting from the use of force or power against oneself or
another person for which the evidence indicating one manner of death is no more compelling
than the evidence indicating another manner of death. Unlike homicide and suicide deaths
which can be detected using the ICD-10 codes and reviewing the manner of death on the
preliminary death certificate, law enforcement report, or CME report, the identification of
undetermined deaths involves looking at the ICD-10 codes and reviewing both underlying cause
of death and the manner of death on the preliminary death certificate, law enforcement report,
or coroner/medical examiner report. The process is described below.
Information should be collected on all deaths assigned a qualifying undetermined ICD-10 code.
Cases can also be identified by reviewing the death certificate (DC), law enforcement (LE) or
CME information and following the three-step procedure below.
Step 1: Before looking at the manner of death, confirm that the cause of death is known and
that it results from the use of force or power against oneself or another person (e.g., gunshot
wound, drug overdose, hanging/suffocation, or fall) or that mechanism of the death is an
unspecified trauma. In other words, the NVDRS weapon type must be known for the death to be
included with an Abstractor Assigned Manner of Death = “Undetermined”. A manner of death of
“could not be determined” on the death certificate, law enforcement report, or
coroner/medical report by itself is not sufficient to classify a death as Undetermined for NVDRS.


Tips on reading the death certificate: To identify the possible cause of death (NVDRS
weapon type), abstractors should review the text or narrative information on the death

Introduction

10 | P a g e






certificate, particularly the text associated with the Cause of Death (Part I and Part II) and
the description for “How the Injury Occurred”.
Tips on law enforcement and CME reports: Confirm the NVDRS weapon is known.
Examples of cases that are potentially undetermined and the abstractor should review the
manner of death (See Step 2)
1) Victim died of a drug overdose
2) Victim died from a fall off a cliff
3) A child asphyxiated
4) A victim died from blunt trauma to the head from a fall
5) A victim died from abdominal trauma
Examples of cases NOT to code as undetermined
1) A body is found in the woods and the cause of death is unknown.
2) A 3-month old child is found dead in his crib by his parents. The cause of death is
unspecified.
3) Deaths due to “Sudden Infant Death Syndrome”, or SIDS.

Step 2: Deaths meeting the criteria for step 1 (i.e., the cause of death is known and it results
from the use of force or power against oneself or another person and the weapon type is
known) can be classified as “Undetermined” in NVDRS if the reason the manner could not be
determined was because the evidence indicating one manner of death is no more compelling
than the evidence indicating another manner of death.







Tips on reading the death certificate: From the “Manner of death” checkbox, identify deaths
with manner of death equal to “Could not be determined”. Inspect other information to
confirm that multiple manners of death are plausible or are being considered.
Tips on law enforcement and CME reports: Confirm the manner of death is “Could not be
determined”.
Examples of cases to classify as Undetermined for NVDRS
1) Victim died of a drug overdose and it could not be determined if it was
unintentional (i.e., accidental) or a suicide.
2) Victim died from a fall off a cliff and it could not be determined if it was
unintentional or a suicide.
3) The victim was found in their home and had died of a head trauma sustained in a
fall. Foul play was not ruled out (Note: It may be unclear from narrative information
what manners the CME are considering. In this case, possibility homicide and
unintentional manners)
Examples of cases NOT to classify as undetermined
1) An adult falls off a cliff while hiking with a group of friends and the manner of death
is listed on all three data sources as “accidental/unintentional”.

Step 3: When the ICD-10 codes for the underlying and contributory causes of death become
available, compare deaths classified as undetermined intent by the ICD-10 codes (i.e., those
with Y10-Y34, Y87.2 or Y89.9) and the deaths identified using the steps above to identify new
cases and possible misclassifications.
D. Unintentional firearm injury death

Introduction

11 | P a g e

A death resulting from a penetrating injury or gunshot wound from a weapon that uses a
powder charge to fire a projectile when there was a preponderance of evidence that the
shooting was not intentionally directed at the victim. Other types of unintentional deaths (e.g.,
accidental overdose) are not covered here.
Specific scenarios that should be classified as unintentional firearm deaths:
 Celebratory firing that was not intended to frighten, control, or harm anyone
 A person shoots himself when using a gun to frighten, control, or harm another person
 A child less than the age of 6 shoots himself or another person
 A soldier who is shot during field exercises in peacetime
 A person mistakenly thinks a gun is unloaded and shoots himself or another person while
fooling around with it
 A child who dies after birth from an unintentional firearm injury that is sustained prior to
birth, i.e., in utero
Specific scenarios that should not be classified as unintentional firearm deaths: (The preferred
NVDRS category is shown in parentheses.)
 A person unintentionally shoots someone while defending himself against an aggressor
(homicide)
 A person unintentionally shoots another person while using a gun to commit a crime
(homicide)
 Firearm injuries caused by unintentionally striking a person with the firearm, e.g., by
dropping it on someone’s head, rather than with a projectile fired from the firearm
(potential homicide or unintentional)
 Unintentional injuries from non-powder guns such as BB, pellet, and other compressed air
or gas-powered guns (outside of system scope)
E. Legal intervention death
A death in which the decedent was killed by or died as a result of a law enforcement officer or
other peace officer (persons with specified legal authority to use deadly force), including military
law enforcement, acting in the line of duty. The term legal intervention is a classification from
ICD-10 codes and does not denote the lawfulness or legality of the circumstances surrounding
the death.
These deaths can occur during the course of a law enforcement officer conducting a random or
targeted traffic stop, issuing a citation, arresting or in pursuit to apprehend a victim (e.g., victim
fleeing or escaping arrest), responding to a call to maintain order, minimizing disturbances
and/or ensuring safety (e.g., domestic disturbances, to circumvent suicide crisis) or other actions
as part of law enforcement duties.
Please note that the following scenarios fall within the definition of legal intervention deaths in
NVDRS:
1. Incidents in which the decedent was killed while fleeing from/being pursued by law
enforcement, including some scenarios in which the victim was not directly injured by law
enforcement officers. Examples include:
o

Introduction

Victim’s death resulting from car crash while being pursued by law enforcement in a

12 | P a g e

o
o

high-speed chase.
Victim’s death resulting from attempting to escape law enforcement contact or arrest
(e.g., Victim runs away from officers, unintentionally falls off a bridge and dies).
Death resulting from a victim being killed by another person unrelated to the event,
while being pursued by law enforcement (e.g., A motorist hits and kills a victim that was
being pursued by law enforcement).

2. Incidents in which the decedent died as the result of force applied by law enforcement
officers without clear lethal intent (e.g., restraint, use of typically nonlethal weapon such as
a Taser).
3. “Justifiable” and “criminal” homicides meeting the above definition.
4. Bystanders who are inadvertently killed by law enforcement acting in the line of duty by
mechanisms such as firearms, explosives, blunt objects (e.g., batons), sharp objects, or
personal weapons.
Please note that the following scenarios should not be classified as legal intervention deaths in
NVDRS:
1. Legal executions and cases of justifiable homicide not involving a law enforcement or other
peace officer.
2. Persons in contact with and wounded by law enforcement, but subsequently died from
some other means (e.g., adult was shot by law enforcement but subsequently died of a drug
overdose).
3. In motor vehicle crash deaths, persons who are not directly involved in a law enforcement
pursuit of a suspect but are inadvertently killed by law enforcement (e.g., law enforcement
hit and kill a pedestrian while in pursuit of a suspected drunk driver; law enforcement
unintentionally hit an unrelated car at a stoplight while pursuing a suspect).
4. A passenger is riding in the car of the person who is being pursued by law enforcement but
is clearly not involved in the perpetration of the crime (or other reason) which led to the
pursuit (e.g., a baby is inadvertently killed when a carjacker being pursued by law
enforcement crashes the car).
F. Terrorism-related death
Terrorism deaths are homicides or suicides that result from events that are labeled by the
Federal Bureau of Investigation (FBI) as acts of terrorism. Terrorism is a mechanism of death
rather than a manner of death. The manner of such death is either homicide or suicide.
G. Unintentional /accidental poisoning death
(Only applicable to certain states that collect this info)
Unintentional poisoning deaths are those that result from unexpected or unplanned ingestion,
inhalation, injection or other exposure to an amount of any substance that interferes with
normal body functions.

Introduction

13 | P a g e

V. Violent Death Incident
Unlike most public health surveillance systems that are based on individual persons, the NVDRS is
incident-based and reports all victims and suspects associated with a given incident in one record.
A violent death incident can be made up of any of the following:
 One isolated violent death
 Two or more homicides, including legal interventions, when:
1. the deaths involve at least one person who is a suspect or victim in the first death and a
suspect or victim in the second death, and
2. the fatal injuries are inflicted less than 24 hours apart
 Two or more suicides or undetermined manner deaths, when:
1. there is some evidence that the second or subsequent death was planned to coincide
with or follow the preceding death, and
2. the fatal injuries are inflicted less than 24 hours apart
 One or more homicides or unintentional firearm deaths combined with one or more suicides
when:
1. the suspect in the first death is the person who dies by suicide, and
2. the fatal injuries are inflicted less than 24 hours apart
 Two or more unintentional firearm deaths when:
1. the same firearm inflicts two or more fatal injuries, and
2. the fatal injuries are inflicted by one shot or burst of shots
Examples of single incidents that involve more than one death:
 Homicide: A member of Gang A kills a member of Gang B and Gang B reciprocates, killing a
member of Gang A, all during a street brawl. (The members of Gang A are suspects in the first
killing, and one of them becomes the victim in the second.)
 Homicide: A man kills his family and then drives to work to kill his supervisor (The suspect in the
first homicide is also the suspect in the second homicide.)
 Homicide and legal intervention: law enforcement kills a suspect as he flees the scene of a
homicide (The first suspect is the victim in the second death.)
 Suicide: An elderly couple dies by suicide together (The deaths were planned to coincide.)
 Homicide-suicide: A man kills his wife at home and then kills himself 12 hours later when pulled
over by law enforcement.
 Unintentional firearm-suicide: A boy unintentionally kills his father while hunting and shoots
himself within 24 hours due to feelings of guilt.
Examples of separate incidents:
 Homicides: A sniper kills a person and two days later returns to the same location and kills
another person (more than 24 hours apart).
 Suicides: Two teenagers agree to die by suicide on the same day. One kills himself a week after
the first victim dies (more than 24 hours apart).
 Homicide-suicide: A woman learns that her son has murdered her husband. She kills herself
from grief. (The suspect in the first death is not the person who dies by suicide.)
Note: Decisions about whether two or more deaths belong to the same incident should be based on the
timing of the injuries, rather than the timing of the deaths and the establishment of a clear link between
victims.

Introduction

14 | P a g e

VI. Resident and Occurrent Violent Death Incidents
A. Resident incident
The majority of the deaths in the incident must be resident (as described in Section II.A-D above)
violent deaths. If no jurisdiction accounts for the majority of victims, the incident would be a
resident incident for the jurisdiction of residence of the first victim.
B. Occurrent incident
The majority of fatal injuries in the incident must be occurrent fatal injuries. If no jurisdiction
accounts for the majority of fatal injuries, the incident would be an occurrent incident for the
place of injury of the first victim.
Note: The responsibility for abstracting an incident falls on the state where the injury occurred
irrespective of where the victim was a resident or died. NVDRS states should cooperate whenever
possible by sending records to the state with responsibility for abstraction when incidents cross state
lines. However, NVDRS are also responsible for abstracting the incident if one of their own residents dies
violently in a state that is not currently part of NVDRS.
VII. Data Year
C. Year of a violent death
The year of death is the calendar year in which the victim died. So, for example, if a victim was
injured at the end of December 2002, but died in early January 2003, the death would be
reported in the 2003 data year. Although the NVDRS software allows for specific month or date
of death to be entered as “Unknown,” the year of death must be filled in. In the case of a true
unknown year of death (as in skeletal remains with unknown year of death, or an unattended
death that may have occurred either shortly before or shortly after January 1), enter the year in
which the body was found as the year of death.
D. Year of a violent death for multiple death incidents
The year of a violent death incident is the first year in which any of the victims in the incident
died. For example, if two people are shot on December 21st 2006 and one dies on December
22nd 2006 and the second dies on January 4th 2007, the year of the incident would be 2006.
The only exception to this rule occurs when any of the deaths occurred in a year prior to 2003,
the first year of NVDRS. In that case, place the incident in the first year of death after 2002. In
other words, incidents with deaths in 2002 and 2003 should be placed in 2003. Incidents with
deaths in 2002 and 2004 should be placed in 2004. Incidents with deaths in 2003 and 2004
should be placed in 2003.
VIII. Annual Violent Death Rate
The violent death rate per year is the number of resident violent deaths recorded during the calendar
year divided by the resident population of the jurisdiction, as defined in official U.S. Census figures,
and multiplied by 100,000 for a rate per 100,000 persons. Preliminary rates include both preliminary
and confirmed deaths. Confirmed rates include only confirmed deaths. Intercensal state population
estimates may be used for intercensal year rates when official U.S. Census figures are not available.
Whether U.S. Census or state estimates are used, the state should specify the source of the population
estimate.

Introduction

15 | P a g e

5.0

Table 1: ICD-10 External Causes of Death Codes for Manners of Death Meeting the
NVDRS Case Definition ICD-10 Codes

Manner of death

Intentional self-harm
(suicide)
Assault (homicide)

Event of undetermined
intent

Death ≤1 year

Death >1 year

Deaths any time after

after injury

after injury

injury

X60–X84

Y87.0

X85–X99, Y00–Y09

Y87.1

Y10–Y34

Y87.2, Y89.9

N/A

W32–W34

Y86

N/A

Y89.0

N/A

U03 (attributable to
terrorism)
U01, U02 (attributable to
terrorism)

Unintentional exposure
to inanimate mechanical
forces (firearms)
Legal intervention
(excluding executions,
Y35.5)

6.0

Y35.0–Y35.4,
Y35.6, Y35.7

Notes on Terminology

Use of the term “homicide” can be a point of confusion in a violent death reporting system. The term
literally means the killing of one person by another, whether intentionally or unintentionally. Law
enforcement and many CMEs adhere to this broader definition of homicide and therefore refer to
unintentional car crash deaths as “vehicular homicides” and the unintentional death of a person which
results from another’s negligence as “negligent homicides.” Examples of the latter category are
unintentional shootings of one person by another (as in two 12-year-old boys playing with a gun they
believe is unloaded) and negligent acts by a caregiver of a dependent person (as in a toddler who is left
unattended in the bathtub briefly while her caregiver answers the phone).
The ICD system, on the other hand, uses the term homicide in its narrower sense to indicate the
intentional or assault-related killing of one person by another. NVDRS also uses this narrower definition
of homicide.
The disjuncture between the law enforcement and public health uses of the term homicide can lead to
coding problems. The ICD system is the basis for coding underlying cause of death on the death
certificate. However, the code is chosen based on the information supplied by the CME on the death
certificate. For example, in the case of the 12-year-old boys playing with the gun they mistakenly
believed was unloaded, the CME is likely to code the manner of death as “homicide” and supply only
medical information in the text fields for underlying cause of death. The information regarding the

Introduction

16 | P a g e

unintentional nature of the shooting will be available only in the narrative report, not on the death
certificate itself. The Vital Statistics coder will likely code the case in the homicide range, not the
unintentional range, because the information that would place it in the unintentional range according to
ICD protocols is not available on the death certificate. This confusion in terms is one reason that the
NVDRS has chosen to include the abstractor-assigned “Type of Death” code in the reporting system. This
code applies a uniform protocol to categorizing violence-related homicides, unintentional deaths,
suicides, and deaths of unknown intent.
One useful piece of information when attempting to distinguish a violence-related homicide from a
negligent homicide is to check how the case was reported on the Supplementary Homicide Report form
(if the state collects SHR data). Violence-related homicides are reported as “1A – Murder/non-negligent
manslaughter” offenses, while unintentional homicides (e.g., “accidental” shooting while hunting,
children playing with a gun) are coded as “1B – Negligent manslaughter” offenses.
(See: Barber C, Hochstadt J, Hemenway D, Azrael D. Underestimates of unintentional firearm fatalities:
Comparing Supplementary Homicide Report data with the National Vital Statistics System. Injury
Prevention 2002; 8:252–6.)
7.0

Entering a Case/Data Structure

An incident involving one or more violent deaths is the unit of surveillance in NVDRS. To understand
how all the variables fit together in one incident, it may be helpful to think of them in a hierarchy with
two levels:
 The first, or incident level, is information about the incident to be described, such as how many
victims were involved and a narrative of the event.
 The second, the victim level, demographically describes the victim, the suspect (when
appropriate), weapon causing the death, and the circumstances related to his or her death.
In addition, the system allows states to track the documents from which data are abstracted.
In outline form, this hierarchy looks like the following:
1. Incident: Incident summary (Site ID, case status, number of persons/documents/weapons and
incident narratives.)
2. Victim(s): Multi-sourced identity or demographics
 Description, location and time of injury
 Suspects involved
 Weapon(s) involved
 Toxicology report
 Circumstance associated with the death (e.g., depressed before a suicide or an
argument preceding the homicide)
 Cause of death
3. Optional Modules
 Child Fatality Review (CFR)
 Intimate Partner Violence (IPV)
4. Documents Used

Introduction

17 | P a g e

Note: Given all the data entry fields available to handle various scenarios, the number of variables in
NVDRS is large. Not every section of NVDRS can be completed for every incident. If one of the persons
involved is a suspect who did not die in the incident, only limited demographic information is collected.
If the weapon was not a firearm, there can be no information from the crime lab. Also, the structure is
designed to handle all types of violent deaths. It allows the use of data from the three primary data
sources (death certificate, law enforcement, and CME including toxicology) and four additional ones
(crime lab/Bureau of Alcohol, Tobacco, Firearms, and Explosives [ATF], hospitals, child fatality review
teams, and additional intimate partner violence information), and provides places for input from the
abstractor. Data from additional data sources (such as press accounts) may be included in the incident
narrative but must be identified in the narrative as not coming from an official NVDRS source (i.e.,
sources used to code circumstances) and the source from which it originated (e.g., a newspaper may
report a circumstance not identified in a CME or LE report).
8.0

Data Sources

A strength of NVDRS is its use of multiple, complementary data sources. Using its knowledge of available
resources, each state integrates data across data sources. Prior work has found that data across sources
on many variables such as victim’s demographics are very similar. By reviewing multiple sources over
time, more comprehensive and accurate information is collected on each incident as more information
becomes available. Information on circumstances is collected by law enforcement and CME because
circumstance information has been found to vary by these sources because each investigates different
aspects of the death. Thus, tracking circumstances by source helps document similarities and differences
between the findings of different agencies.
The table below shows the sources from which data on different topics are to be recorded. No
personally identifiable information (PII) should ever be entered into the web-based NVDRS system.
Data Topic
Case Status
Incident narrative
Document tracking
Person type
Name, zip code, county
Age/sex/race/ethnicity
When and where (injury/death)
Type of medical treatment
(inpatient or Emergency
Department)
Cause of death ICD-10- code(s)
External injury ICD-9-CM
Manner of death
Additional person descriptors
Alcohol and drug tests
Wounds
Associated circumstances
Victim-suspect relationship
Introduction

DC

CME

LE

CFR

X

X

X

LAB

USER
X

HOSP

X
X
X
X
X

X
X
X
X

X
X
X
X
X

X
X
X
X

X
X
X
X
X
X

X

X
X

X
X
X

X
X

X

18 | P a g e

History of victim abuse
Suspect was victim caretaker
Weapon type
Firearm descriptors
Poison details

X

X
X
X
X
X

X
X
X
X
X

X
X
X
X

DC= Death Certificate; CME= Coroner/Medical Examiner; LE= Law Enforcement report; CFR= Child Fatality Review;
LAB= Crime lab; USER= User of NVDRS software/Abstractor(s); HOSP=Hospital
9.0

Hover over text

These brief descriptions of each variable are intended to aid abstractors in accurately entering data.
They contain short one to two sentence descriptions on what to include/exclude when coding/entering
data. These descriptions were updated in August, 2013.
10.0

Auto Filling

Some data are auto filled to ensure accurate data entry. For instance, pregnancy status for males is
auto-filled as “Not applicable”.
11.0

Gray-out

In order to prevent entry of invalid data, the software includes automatic gray-out of fields that are
logically contingent upon another data element. For example, an abstractor cannot complete type of
mental health problem until they identify that the decedent had a mental health problem.
12.0

Additional Features

Data are coded or use lookup tables whenever possible to avoid problems with variant spellings and
valid entries.
13.0

Unknown and Inapplicable Information

Throughout the manual a standard approach is used to code ‘Unknown’. For numerical fields, the
numbers ‘9’, ‘99’, or ‘999’ are mostly used to indicate ‘Unknown’. Similarly, the numbers ‘8’, ‘88’, or
‘888’ are usually used for ‘Not applicable’. It is suggested that ‘Unk’ be entered for ‘Unknown’ in any
relevant text field.
14.0

Tasks associated with starting an Incident

Refer to the Software Manual for instructions on how to start or create an incident, if needed.
Task 1: Decide what constitutes an “incident”
 See the definition of an incident in the definitions section of this coding manual. In
general, deaths that occur within 24 hours and are linked according to the data sources
(e.g., a suicide of the suspect right after killing the victim) are considered part of the
same incident.
Task 2: Open a new incident in the software

Introduction

19 | P a g e

Task 3: Decide how many victims should be included in the incident and enter information
about each victim (e.g., demographics, description of injury and location of death). As part of
this process, the abstractor will be asked to identify suspects for homicides/legal
interventions/unintentional firearms that are not self-inflicted.
 There are no suspects for isolated suicides and self-inflicted unintentional firearm
deaths.
 For homicides, include as suspects people who are listed by the law enforcement or the
CME as suspects.
 For unintentional firearm deaths that are not self-inflicted, include the person who fired
the weapon as a suspect and anyone else listed by the law enforcement as a suspect.
 A person does not have to be arrested or identified to be listed as a suspect. As long as
the number of persons involved in the death is known, (e.g., law enforcement report
that the victim was stabbed by two men), list each as a suspect, even if nothing further
is known about him.
 If there is no information at all about suspects in the source documents, however, do
not include any suspects in the incident.
Task 4: Enter information on the weapon that killed the victim
(See Weapons Section for detailed guidance).





The concept of a weapon in NVDRS combines the concepts of objects used to injure and
actions that lead to injury. Weapons can therefore range from instruments commonly
thought of as weapons, such as a gun or bayonet, to actions such as setting fires, pushing
someone over a cliff, or shaking (as in shaken baby syndrome). Additional descriptive data
elements exist for firearms and poisons.
Only the weapon(s) that caused the death should be entered. For the vast majority of
deaths, only one weapon should be entered.
If a weapon caused a non-fatal injury, do not enter the weapon.

Task 5: Enter information about each document collected to describe the violent incident


Information about documents does not have to be entered to open a case. If states choose
to use these fields as logbooks or to track the completion of a case, the following
information may prove helpful:
o Information about a document should be entered as it is collected (i.e., initiate a
document record when first requesting a document).
o A document was conceived as a piece of paper or a computerized record that
contains information that is used to complete an incident.
o A document referenced within another document would usually not be counted as a
separate document. The minimum expected number of documents per incident is
three: a death certificate, a law enforcement report and a CME report. Also,
toxicology reports are routinely collected as a fourth document. Two deaths in one
incident would have a minimum of five documents: two death certificates, two CME
reports, and a law enforcement report (this is assuming that law enforcement
described both deaths in the incident in one report).
o States can count multiple reports contained within a CME or law enforcement file as
part of one document. Such files often contain autopsy reports, toxicology reports,
gun traces, and the like. States can also record each of these documents separately,

Introduction

20 | P a g e

at their discretion.
Once these Tasks are completed, the software will set up the appropriate number of blank
screens so that the incident can be captured. The user can then complete the case, one source
document at a time. The next section of the coding manual provides details about the data
elements to be completed.
15.0

Reabstraction Guidelines

Reabstraction of cases is an important quality control measure for users of the NVDRS software. It is far
superior to review completed incidents without access to the original source documents. The primary
purpose of reabstraction is to identify errors in the coding of key data elements in a timely way. Another
purpose is to identify data fields that have low reliability (i.e., they are not completed in the same way
by trained independent observers in a significant percentage of incidents, perhaps because of their
inherent subjectivity).
We suggest the following reabstraction guidelines:
 Reabstraction should be done by the person who is most skilled in coding. This does not need to
be the original abstractor’s supervisor. It should not be done by the same person who did the
original coding.
 The reabstractor should have access to all the original records used by the original abstractor.
 The reabstractor should reabstract five percent of incidents completed in the previous quarter or
previous month. By completed incidents, we mean incidents that have had data entered from the
death certificate, law enforcement report, and CME record.
 Reabstractors should select the incident numbers of the incidents they want to reabstract along
with the necessary identifiers.
 Reabstraction should start soon after the end of the first quarter of data collection and be done
on an ongoing basis so that feedback to abstractors is timely.
 State reabstractors will want to compare their results with the original abstractions themselves
manually by printing an incident or by setting up queries to do record comparisons for specified
pairs of incidents. Any discrepancies noted should be reconciled through Discussion with the
original abstractor.
 It is important to distinguish between the two possible sources of error: true coder disagreement
and data entry error.
 Retraining or clarification of coding instructions may help with coder disagreement, while changes
in question format may help with data entry error.
 Reabstracted cases should be entered into the training module of the NVDRS web-based system.
This will avoid duplication of cases within the system and provide a helpful practice environment.
16.0

Data Elements Key

The next sections provide detailed information for each data element captured by NVDRS. The sections
are organized by screens as they appear in the NVDRS software application. Within each section, the
data elements are arranged by location on the screen. Each data element or group of related data
elements begins on a new page and follows the format below:
Variable Label: Variable Name

Introduction

21 | P a g e

Definition:
Short definition of the variable
Response Options:
Lists all valid response options
Discussion:
Provides guidance on how to code the data element or group of data elements
Note: The default response option is built in for each variable in the web-based NVDRS program. With
the exception of variables that have a ‘not applicable’ response option, if data are unavailable, the
variable should be left blank/unchecked.

Introduction

22 | P a g e

SECTION 1: INCIDENT VARIABLES
1.1

Incident Year: IncidentYear

Definition:
Year in which the incident occurred
Response Options:
Date (format: YYYY)
Discussion:
When creating a new record or importing a record, the incident year must be provided. For incidents
involving a single death, the incident year is the calendar year in which the victim died. So, for example,
if a victim was injured at the end of December 2002, but died in early January 2003, the death would be
reported in the 2003 data year. Although the NVDRS software allows for specific month or date of death
to be entered as “Unknown,” the year of death must be filled in. In the case of a true unknown year of
death (as in skeletal remains with unknown year of death, or an unattended death that may have
occurred either shortly before or shortly after January 1), enter the year in which the body was found as
the year of death.
If the incident involved multiple victims who died in multiple years, incident year is the first year in
which any of the victims in the incident died. For example, if two people are shot on December 21st
2006 and one dies on December 22nd 2006 and the second dies on January 4th 2007, the year of the
incident would be 2006. The only exception to this rule occurs when any of the deaths occurred in a year
prior to 2003, the first year of NVDRS. In that case, place the incident in the first year of death after
2002. In other words, incidents with deaths in 2002 and 2003 should be placed in 2003. Incidents with
deaths in 2002 and 2004 should be placed in 2004. Incidents with deaths in 2003 and 2004 should be
placed in 2003.
1.2
1.3

Site Identifier: SiteID
Incident Number: IncidentNumber

Definitions:
 SiteID: indicates which state has abstracted the incident. This may not be the state of injury or the
state of residence of any victim in the incident, as discussed in the Definitions section. The Site ID
number is the Federal Information Processing Standards (FIPS) code assigned to the state or U.S.
territory.
 IncidentNumber: is automatically assigned by the software. Incidents are numbered within a year
and state with the first incident being assigned 1. Each new incident added is automatically
assigned the next sequential number. Consequently, within each state, the first incident in 2007
and the first incident in 2008 will be assigned Incident ID=1. Thus, incident number always needs
to be considered within a state and year.
Response Options:
 SiteID: Automatically generated by the program based on the abstractor’s permission when a new
incident is created
 IncidentNumber: Automatically generated by the program when a new incident is initiated by the
abstractor

Section 1: Incident Variables

23 | P a g e

Discussion:
 Used together, the SiteID, IncidentYear, and Incident Number uniquely identify each incident and
can be used to link incident level information with victims and documents.
 If an incident is merged or deleted, no information will be displayed for that incident number. For
instance, if a 2008 homicide occurring in Maryland assigned IncidentNumber 5 is later found to be
part of a multiple homicide and merged into Maryland 2008 incident 6, no information will be
displayed for incident number 5.
 The SiteID and LocationID should never be missing on a record that is displayed or exported by
the system.

1.4

Incident type: IncidentType

Definition:
Identifies the type of incident collected by various users of the NVDRS web-based system.
Response Options:
1
NVDRS
2
NVDRS Non-Targeted Area
3
SUDORS
9
Other (State-Defined)
Discussion:
 NVDRS: Incidents collected for the National Violent Death Reporting System. Opioid overdose
deaths of undetermined intent should be coded here.
 NVDRS Non-Targeted Area: Incidents collected for NVDRS outside a state’s designated
catchment area. These cases are all optional and to be entered at the state’s discretion. The
following are examples of cases that fall into this category:
o Deaths where the fatal injury occurred within a state’s boundary, but in an area outside
of the state’s pilot county or counties. This applies only to states collecting data on
violent deaths within a selected county or counties during their pilot year(s) as part of
their data collection option.
o Cases that are part of the subset that are only required to have death certificate data
(only applies to states funded under Option 3 for large states).
 SUDORS: Incidents collected for the State Unintentional Drug Overdose Reporting System.
Opioid overdose deaths of undetermined intent should be coded under “NVDRS.”
 Other (State-Defined): Incidents collected by state or other partner organizations, outside of
regular NVDRS case definitions (e.g., sudden infant death syndrome [SIDS]). These cases are all
optional and to be entered at the state’s discretion. Resident deaths where the fatal injury
occurred in another NVDRS state should be coded here. Please note that if the state of
residence and injury occurrence are both NVDRS states, the state of injury occurrence is
responsible for collecting information on the death.
Note: Prior to September 2018, this variable described whether the incident involved a single or multiple
victims and the manner of all the victim’s deaths. Beginning in September 2018, a calculated variable,
Incident Category, identifies whether or not the incident involved a single or multiple victims and the
manner of all the victim’s deaths. Incident category will be calculated automatically based on the
victim(s) in an incident, using the “manner of death” data elements. Manner of Death per Abstractor is

Section 1: Incident Variables

24 | P a g e

checked first, but if it is missing, the software will use the DC Manner, CME Manner, or LE Manner to
assign incident category. The field is updated whenever an incident is saved. The Incident categories
are:
 Single Suicide
 Single Homicide
 Single Unintentional Firearm Death
 Single Legal Intervention Death
 Single Death of Undetermined Intent
 Multiple Suicide
 Multiple Homicide
 Multiple Unintentional Firearm Deaths
 Multiple Legal Intervention Deaths
 Multiple Deaths of Undetermined Intent
 Homicide(s) Followed by Legal Intervention Death(s)
 Mutual Homicide/Shootout
 Multiple Deaths – Other
 Single Homicide Followed by Suicide
 Homicide(s) Followed by Suicide(s), Over 2 Fatalities
 Missing or Other Death Manner

1.5
1.6

Incident Narrative CME: NarrativeCME
Incident Narrative LE: NarrativeLE

Definition:
Narrative accounts of the incident serve multiple purposes:
 To briefly summarize the incident (who, what, when, where, why).
 To provide supporting information on circumstances that the abstractor has endorsed in an
incident.
 To provide the context for understanding the incident.
 To record information and additional detail that cannot be captured elsewhere.
 To facilitate data quality control checks on the coding of key variables.
Response Options:
Text
Discussion:
Incident narratives are written based on a single type data source (e.g., law enforcement or CME) that
may involve single or multiple documents (e.g., CME report and toxicology findings). Consequently,
there is an incident narrative that summarizes the law enforcement findings and a narrative that
describes the CME’s findings. The narratives based on these separate data sources will often vary in the
level of detail they contain, and may even differ from each other on details of the incident.
In referring to persons in the narrative, use “Victim” or “V” to refer to the Victim, or “V1,” “V2,” etc., in
incidents with multiple victims. Similarly, use “Suspect” or “S1,” “S2,” etc. Victim/Suspects may be
designated as “V/S.”

Section 1: Incident Variables

25 | P a g e

At a minimum, the following should be included in all narratives:
 The number of victims, suspects, and victim/suspects described in the source document who was
injured, and by whom
 The relationship between victim and suspect if injury was not self-inflicted
 Where the injury occurred (or the victim was found)—not a specific place or address, but a
description such as “at home,” “at work,” or “on the street,” such as listed in the “Type of location
where injured” data element
 Additional detail on all circumstances coded in the data source tab
 Timing of circumstances (e.g., was the argument right before the suicide or the night before)
 A description of other circumstances not captured in standardized coding
 Sex and age of person(s) involved
 Weapon(s) involved
The following should not be included in any narratives:
 Personally identifying information such as names of people, towns, streets, law enforcement
departments, and hospitals
 Specific dates
 Abbreviations (with the exception of V, S, and V/S for the persons in the narrative or commonly
used abbreviations such as DUI, ADHD)
 Incomplete sentences (as they are hard to understand)
Sometimes you will receive two data sources from one document (e.g., a CME report contains a copy of
the police report) or multiple documents from the same source (e.g., medical examiner report on two
victims in the same incident).
 If two data sources are found in one source (i.e. the LE includes a copy of the CME report),
information from both sources should be entered. In the circumstance section where LE and CME
data are distinguished, the CME information should only be listed in the CME section and the LE
information should only be listed in the LE section regardless of how the information was
collected.
 A LE or CME report may contain information on multiple victims or suspects involved in a violent
incident. In these instances, the information from this report can be used to fill out information
about both victims. LE and CME information, however, should always be requested for all victims.
Sometimes information across or within CME and LE reports may provide different or conflicting
information.
 Because CME and LE circumstances come from different investigations, the CME and LE narratives
are expected to provide unique insights into the violent death. Thus, the differences between the
coding sources provide a more comprehensive understanding of the death. If the CME and LE
narratives are conflicting, please record the information as reported by the data sources and code
the circumstances accordingly.
o The one exception to this rule is when either the CME or LE report clearly has found
through further investigation that a previous description of the event was incorrect
(e.g., witness lied or more evidence comes to light that disproves previous conclusion).
In this case, please indicate in the narrative that provides false information that this
information was disapproved and do not check any circumstance that was found false.
 If multiple law enforcement records conflict about the narrative details, record what you believe
to be in the most accurate narrative. Do the same for multiple CME records. The circumstances

Section 1: Incident Variables

26 | P a g e

coded should be consistent with these decisions.
Note: With the implementation of the NVDRS web in August 2013, please put all narrative details
collected in the Child Fatality Reviews in the law enforcement narrative.

1.7

Number of source documents in incident: NumberOfDocuments

Definition:
Counts the number of source documents in the incident. This number is automatically generated by the
program.
Response Options:
Number of documents
Discussion:
There must be a minimum of one document in each incident and each incident should have at least
three documents, or one for each of the required data sources:
 death certificates
 CME reports
 law enforcement reports
A list of all documents can be found in the variable document type.

1.8

Number of victims in incident: NumberOfVictims

Definition:
Counts the number of victims in the incident. This number is automatically generated by the program.
Response Options:
Number of victims
Discussion:
There must be a minimum of one victim in each incident. Victims in the incident are only those who are
fatally injured. An individual may be both a suspect and a victim, as in the case of a husband who
murders his wife and then kills himself. Identifying the victims in the incident is not difficult once you
have determined how to define an incident (see Definitions section).

1.9

Number of nonfatally shot persons in incident: NumberNonfatallyShot

Definition:
Number of persons who were non-fatally shot in the incident.
Response Options:
Number of non-fatally shot victims
0
None

Section 1: Incident Variables

27 | P a g e

8888
9999

Not applicable
Unknown

Discussion:
 Record the total number of victims who sustained a projectile wound from a firearm during the
course of the incident and survived.
 Victims of pistol whipping should not be counted here.
 Enter “0” if there is no indication of a nonfatal shooting. Enter “9999” if the number of such
persons is unknown.

1.10

Flag this incident for follow-up: FollowUp

Definition:
The user can manually flag an incident for follow-up. These incidents can be located with the search
function.
Response Options:
Check box
Discussion:
This function allows the user to indicate an incident needs further follow-up. For instance, an abstractor
may want to flag incidents that need clarification. Flagged incidents can be retrieved using the search
function.

1.11

Data Abstraction Completion Indicators
1.11.1 Date supervisor checked incident: SupervisorCheckedDate
1.11.2 Date supervisor rechecked incident: SupervisorRecheckedDate

Definition:
Supervisors can use these fields to track whether they have checked or finalized an incident. Problems
or questions noted in the supervisor’s review can be placed in the activity log.
Response Options:
Date (format: MM/DD/YYYY)
Discussion:
Completion of these fields is not required. Their sole purpose is to support the data entry and
verification process. Missing dates are not allowed because exact dates should be known.

1.12

Abstractor Name: AbstractorName

Definition:
List the name(s) of the abstractors working on the record
Response Options:

Section 1: Incident Variables

28 | P a g e

Text
Discussion:
This helps states track who entered their data and can be used to examine data quality by abstractor.
Multiple data abstractors can be tracked by listing their name separated by a delimiter such as a comma
or slash (e.g., Craig / Shane). This field is not required and is provided to support state abstraction and
data quality efforts.

Section 1: Incident Variables

29 | P a g e

SECTION 2: DOCUMENT TRACKING VARIABLES
2.1

Document unavailable: DocumentUnavailable

Definition:
Enter if the document did not exist, was unavailable to NVDRS or could not be obtained for other
reasons.
Response Options:
Checkbox

2.2

Document type: DocumentType

Definition:
Type of document being requested, logged in, or tracked. Death certificate, medical examiner/coroner
and police report are required documents.
Response Options:
1
Death certificate
2
Medical examiner report
3
Coroner report
4
Police report
5
SHR
6
NIBRS
7
Crime lab report
8
Toxicology report
9
Hospital discharge record
10
ED record
11
Gun trace
12
EMS report
13
CFRT report
14
Newspaper article
88
Other
Discussion:
None

Section 2: Document Tracking Variables

30 | P a g e

2.3

Source agency requested from: AgencySource

Definition:
Provides the agency name from which the data are being collected. This allows a record to be kept of
the document sources used for each incident.

Response Options:
Text
Discussion:
This variable is optional, but can be used to help track requests. Do not enter the names of people at the
agency or other personal identifying information in this field.

2.4
2.5
2.6

Date record requested: Date_record_requested
Date record re-requested: Date_record_rerequested
Date record received: Date_record_received

Definition:
These variables allow a record to be kept of the dates each document was requested, re-requested if
necessary, and the date received. This can be useful as an abstractor “logbook” to track the status of
records that have been requested.
Response Options:
Date (format: MM/DD/YYYY)
Discussion:
These variables are optional, but their use is encouraged. Missing dates are not allowed because exact
dates should be known.

2.7
2.8

Date record abstracted/imported: AbstractedDate
Date entered data checked: Date_entered_data_checked

Definition:
These variables record the date documents were abstracted and checked by another abstractor,
supervisor(s), or principal investigators.
Response Options:
Date (format: MM/DD/YYYY)
Discussion:
These variables are optional, but their use is encouraged. They can be used for measuring timeliness by
calculating the interval between date of death and date abstracted. Because the abstractor should
always know the date the incident was finished or checked, partial missing date values cannot be
entered (e.g., 02/99/2013). Please leave blank if you choose not to use this field.

Section 2: Document Tracking Variables

31 | P a g e

2.9

Document notes field: DocumentNotes

Definition:
This variable allows a record to be kept of notes regarding the source document receipt process.
Personal identifying information about the incident, victim and suspect should not be entered.
Response Options:
Discussion:
This variable is optional.

Section 2: Document Tracking Variables

32 | P a g e

SECTION 3: DEMOGRAPHIC VARIABLES FOR VICTIMS
3.1

Demographics, Race, and Ethnicity

3.1.1

Person type: PersonType

Definition:
This variable indicates whether the person was a victim of violence or both a victim and suspect (e.g.,
the person killed someone else and then died by suicide).
Response Options:
1
Victim
3
Both victim and suspect
Discussion:
Victims (Person Type = 1)
Victims are those who died in a suicide, violence-related homicide, legal intervention, as the result of a
firearm injury, or from an undetermined manner.
Note: A fetus who dies as the result of direct, violent injuries sustained before birth (i.e. a fetal death)
should not be recorded as a victim. Only babies who were delivered and lived outside the womb for any
period of time and were issued both a birth certificate and a death certificate OR those who a CME have
conclusively determined to have been born alive and subsequently killed should be included as victims.
However, states who want to collect such deaths may enter these as a separate incident and follow the
guidance as described in the Definitions section (4.0) of this document.


Example of Person Type = 1 Victim
1. Individual died by suicide and found dead in his residence

Both Suspect/Victim (Person Type= 3)
Suspect/Victims are victims of homicide, suicide or legal intervention, or undetermined intent, who also
killed someone else in the incident.


Examples of Person Type = 3 Suspect/Victim
1. A man kills his wife and then kills himself. He is a suspect because he killed someone else,
and a suicide victim because he killed himself; thus he is both suspect and victim (Person
Type = 3).
2. A person robs a store and kills the store clerk. While running from the store he is shot and
killed by a law enforcement officer. The person is a suspect in the killing of the store clerk
and is a legal intervention victim because he is killed by a law enforcement officer; thus he is
both suspect and victim (Person Type = 3).
3. A husband learns his wife is having an affair with a male friend. The husband kills the male
friend in anger. The distraught wife kills her husband. The husband is a suspect because he
killed the male friend, and a victim because he was then killed by his wife; thus he is both
suspect and victim (Person Type = 3).

Section 3: Demographic Variables for Victims

33 | P a g e

DO NOT CODE as a suspect/victim if the victim is a suspect in another violent incident (i.e., occurs 24
hours after the original death). For instance, a man kills a guard during a bank robbery. Two weeks later
the man dies by suicide when he is surrounded by police and refuses to be arrested. The person should
be listed as a suicide victim in a violent incident describing the circumstances of his suicide. Also, the
person should be a suspect in a different violent incident that describes the robbery.
Note: Before August 2013, this variable was also used to collect information on suspects as well as
victims and victim/suspects. As of August 2013, suspect information is collected as part of the victim’s
record and thus no longer captured by this variable.

3.1.2

First initial of last name: LastNameFirstInitial

Definition:
This variable indicates the first initial of the victim’s last name
Response Options:
Text
Discussion/Uses:
This de-identified information can be used to match victims across data sources (e.g., law enforcement
and CME reports) and link with identifying information maintained by states. This is an optional variable.

3.1.3

Day of birth: BirthDayOfMonth

Definition:
This variable indicates the day of the month in which the victim was born.
Response Options:
Please enter the day as a two digit number (e.g., the 6th is entered as 06 and the 21st is entered as 21).
Discussion/Uses:
This de-identified information can be used to match victims across data sources (e.g., law enforcement
and CME reports) and link with identifying information maintained by states. This is an optional variable.

3.1.4

Last 4 of CME: CMENumberLastFour

Definition:
This variable provides the last 4-digits on the CME record associated with the victim. State abstractors
may also choose to enter less than 4-digits to preserve confidentiality.

Response Options:
Text

Section 3: Demographic Variables for Victims

34 | P a g e

Uses:
This de-identified information can be used to match victims across data sources (e.g., law enforcement
and CME reports) and link with identifying information maintained by states. This is an optional variable.

3.1.5

Last 4 of DC: DCNumberLastFour

Definition:
This variable provides the last 4-digits on the death certificate record associated with the victim. State
abstractors may also choose to enter fewer than 4-digits to preserve confidentiality.
Response Options:
Text
Uses:
This de-identified information can be used to match victims across data sources (e.g., law enforcement
and CME reports) and link with identifying information maintained by states. This is an optional variable.

3.1.6

Sex of victim: Sex

Definition:
The victim’s sex at the time of the incident
Response Options:
1
Male
2
Female
9
Unknown
Discussion:
Sex captures the sex of the victim according to the death certificate. If the victim is transgender, please
record the victim’s sex as indicated by at least one of the three primary data collection sources: death
certificate, CME, or law enforcement. A disagreement on the sex of the victim across data sources may
indicate transgender status.

3.1.7

Transgender: Transgender

Definition:
The victim self-identifies as transgender or a friend/family member reports that the victim self-identified
as transgender.
Response Options:
Checkbox
Discussion:

Section 3: Demographic Variables for Victims

35 | P a g e

Transgender is defined as people “who experience incongruence between birth sex and gender
identity”.1 For instance, a person born a male may identify themselves as female. An individual should
be identified as transgender if he or she identified as transgender or family, friends, physician or other
acquaintances identified the individual as transgender. Also, check this variable if the victim was
undergoing or had undergone sex change surgery or hormone therapy to support a sex change.
Note: This variable was added in August, 2013.
1

Badgett & Goldberg (2009). Best Practices for Asking Questions about Sexual Orientation on Surveys.
Los Angeles, CA: The Williams Institute.

3.1.8
3.1.9

Age: Age
Age Unit: AgeUnit

Definitions:
 Age: Age of victim at death
 AgeUnit: Type of unit (e.g., years, hours) used to report age
Response Options:
 Age Numeric
999 Unknown


Age Unit:
1 Years
2 Months
3 Weeks
4 Days
5 Hours
6 Minutes
9 Unknown

Discussion:
Age is reported using the same conventions that vital statistics data uses to facilitate more precise
reporting of newborn and infant ages.
 It is reported in two variables: “Age” identifies the number of years, months, or other units of
the victim and “AgeUnit” identifies the type of unit used. So, for example, a three-month-old
baby has an Age of 3 and an AgeUnit of 2 (months).
 Age should be reported in years for victim’s who are one year or older
 For victims, use the age at the time of death.
 In some cases, the victim’s exact age will not be known. In these cases, please apply the rules
below in coding age.
1. If age is provided within a five-year age range or less, choose the midpoint of the range and
round to the lower year if the midpoint calculation results in a half year. For example, a
suspect reported to be 20 to 25 years of age would be entered as 22.
2. If an age range of > 5 years is provided, enter the age as unknown.
3. Do not calculate age from date of birth and date of incident.
4. If age is not provided, code as 999 for unknown.
Section 3: Demographic Variables for Victims

36 | P a g e

3.1.10 Height feet: HeightFeet
3.1.11 Height inches: HeightInches
3.1.12 Weight: Weight
Definitions:
 HeightFeet & HeightInches: Victim’s height is reported in two variables, feet and inches.
 Weight: Victim’s weight in pounds (If conversion for weight is required, 2.2 pounds =1 kilogram) at
the time of death
Response Options:
Select number of feet and number of inches separately from drop down menus.


Heightfeet:
0 to 9
Feet
99
Unknown



Heightinches:
0 to 11
Inches
99 Unknown



Weight:
Enter number of pounds (range=000-998)
999 Unknown

Discussion:
If the victim’s height is missing for feet or inches, please enter ‘99’ for height and/or ‘99’ for inches. If a
victim’s weight is missing, please enter ‘999’.
Note: These variables were added in August, 2013.

3.1.13 Victim Race Variables
3.1.13.1
White: RaceWhite
3.1.13.2
Black or African American: RaceBlack
3.1.13.3
Asian: RaceAsian
3.1.13.4
Native Hawaiian or other Pacific Islander: RacePacificIslander
3.1.13.5
American Indian or Alaska Native: RaceAmericanIndian
3.1.13.6
Unspecified race: RaceUnspecified
Definitions: Race±
 RaceWhite : Person with origins among any of the original peoples of Europe, North Africa, or
the Middle East
 RaceBlack: Person with origins among any of the black racial groups of Africa
 RaceAsian: Person with origins among any of the original peoples of the Far East, Southeast
Asia, or the Indian subcontinent
 RacePacificIslander: Person with origins among any of the original peoples of the Pacific Islands
Section 3: Demographic Variables for Victims

37 | P a g e





(includes Native Hawaiians)
RaceAmericanIndian: Person with origins among any of the original peoples of North America
and who maintains cultural identification through tribal affiliation or community recognition
(includes Alaska Natives)
RaceUnspecified: If a person’s ethnicity is provided in place of their race, e.g., race is given as
“Hispanic”, and no other valid race value is given, mark their race as “unspecified

Response Options:
Checkbox
Discussion:
For multi-racial decedents, please check each race identified in source documents (e.g., if the decedent
is identified as “white” and “Asian,” please check “white” and “Asian”). If “Asian/Pacific Islander” is
indicated, check both “Asian” and “PacificIslander.” These standards were used by the U.S. Census
Bureau in the 2000 decennial census.
Note: "Other” race category was removed as response choice in 2015.
±

NVDRS follows U.S. Department of Health and Human Services (HHS) and Office of Management and
Budget (OMB) standards for race/ethnicity categorization. HHS guidance on race/ethnicity is available
from: http://aspe.hhs.gov/datacncl/standards/ACA/4302/index.shtml

3.1.14 Hispanic/Latino/Spanish: Ethnicity
Definition:
Ethnicity± is a concept used to differentiate population groups on the basis of shared cultural
characteristics or geographic origins. In NVDRS, victims with Mexican, Puerto Rican, Cuban, Central or
South American, or other Spanish culture or origin should be considered Hispanic or Latino, regardless
of race.
Response Options:
0
Not Hispanic or Latino
1
Hispanic or Latino
9
Unknown
Discussion:
None
±

NVDRS follows HHS and OMB standards for race/ethnicity categorization. HHS guidance on
race/ethnicity is available from: http://aspe.hhs.gov/datacncl/standards/ACA/4302/index.shtml

3.1.15 Marital status: MaritalStatus
Definition:
Victim’s marital status

Section 3: Demographic Variables for Victims

38 | P a g e

Response Options:
1
Married/Civil Union/Domestic Partnership
2
Never Married
3
Widowed
4
Divorced
5
Married/Civil Union/Domestic Partnership, but separated
6
Single, not otherwise specified
9
Unknown (Note: If marital status is not explicitly noted, code as 9, “Unknown”.)
Discussion:
Marital status is regularly completed on the death certificate and often noted in law enforcement or
medical examiner records.
 Marital status should be completed for persons of all ages, including children.
 If a source document describes a person as being in a common-law marriage or civil union
according to the laws of that state, code this as “Married/Civil Union/Domestic Partnership.”
 If a source document describes a person being in a committed relationship with someone of the
same sex, code this as “Married/Civil Union/Domestic Partnership”. Domestic partnership is
defined as a committed intimate relationship between two adults of either the same or opposite
sex, in which the partners are each other’s sole partner, intend to remain so indefinitely,
maintain a common residence, and intend to continue to do so, are not married or joined in a
civil union or the domestic partner to anyone else, and are not related in a way that would
prohibit legal marriage in the U.S. jurisdiction in which the partnership was formed ±.
 Use the “Single, not otherwise specified” option when this term is used in CME records and it is
not clear whether the person was never married, widowed, divorced, or separated.
 In an incident in which a person kills his or her spouse or partner, marital status should be coded
as “Married/Civil Union/Domestic Partnership”, not “Widowed”. Use “Widowed” for a person of
either sex whose spouse has died before the violent death.
Note: “Domestic Partnership” was added to this variable in March 2015
± This definition is based in part on the U.S. Office of Personnel Management (OPM) definition of
Domestic Partnership. Source: http://www.opm.gov/faqs/QA.aspx?fid=3f64bd3d-1107-44e7-9962c8b652848f14&pid=a9bc0ec4-5116-45e4-aff3-baab937208c7

3.1.16 Relationship Status: RelationshipStatus
Definition:
Victim’s relationship status at the time of incident.
Response Options:
1
Currently in a relationship
2
Not currently in a relationship
9
Unknown
Discussion:
This variable is used to identify the victim’s relationship status at the time of the incident. The victim’s
relationship with another person(s) is described as a relationship beyond the level of friendship that may
be serious, casual, short-, or long-term. The relationship also involves some level of intimacy that may or

Section 3: Demographic Variables for Victims

39 | P a g e

may not be sexual in nature. Relationship status should only be inferred from marital status information
on the death certificate or other source documents if the victim is married at the time of the incident;
otherwise, this information must be noted in either the CME or LE report. If information about the
victim being in a relationship is not explicitly stated in either report, code “unknown”.
 If victim’s marital status is “Married/Civil Union/Domestic Partnership”, you can infer that
the victim was in a relationship at time of incident.
 If victim’s marital status is “Married/Civil Union/ Domestic Partnership, but separated”, code
this as “Unknown”, unless information is provided to suggest the victim was in a relationship
at the time of incident.
 If victim is noted to be in multiple relationships, code this as “currently in a relationship”.
 Regardless of the victim’s age, code “unknown” if victim’s relationship status is not
mentioned in the CME or LE record.
 If the time of injury occurs within 24 hours of a break up between the victim and his/her
partner, code “Currently in a relationship”. If the time of injury occurs greater than 24 hours
from a break up, code “Not currently in a relationship”.
Note: Variable was added in March 2015

3.1.17 Sex of Partner: SexOfPartner
Definition:
Sex of the victim’s partner in relation to the victim’s sex
Response Options:
1
Same sex as victim
2
Opposite sex of victim
8
Not applicable
9
Unknown
Discussion:
 If the victim’s marital status is “Married/Civil Union/ Domestic Partnership” and the victim is
also in another relationship (e.g., extra-marital affair), code this variable based on the sex of the
partner to whom the victim is married.
 If the victim is noted to be in multiple relationships at the time of the incident, code “unknown”
unless narrative captures sex of one of the partners. If more than 1 partner is discussed, then
capture the sex of the partner that is most salient, given the context of the incident.
 If relationship status is “unknown,” then sex of partner = “unknown.”
Note: Variable was added in March 2015

3.1.18 Victim was pregnant: Pregnant
Definition:
Victim was pregnant or recently pregnant at the time of death

Section 3: Demographic Variables for Victims

40 | P a g e

Response Options:
0
Not pregnant within last year
1
Pregnant at time of death
2
Not pregnant but pregnant w/in 42 days of death
3
Not pregnant but pregnant 43 days to 1 year before death
4
Not pregnant, not otherwise specified
5
Pregnant, not otherwise specified
8
Not applicable
9
Unknown if pregnant within past year
Discussion:
This variable is used to identify pregnant or recently pregnant victims and to document types of violence
against pregnant and postpartum women. Victim’s pregnancy status is often noted on the death
certificate and in the CME report. Findings are more likely to be authoritative if a full autopsy has been
performed.
 This variable should be coded for all female victims regardless of age.
 The variable will not apply to males and will be automatically coded ‘8’, not applicable.
 This variable is based on the codes used on the new U.S. standard death certificate. As such, it
collects pregnancy status at the time of death, not at the time of injury.
 If your state’s death certificate has a pregnancy variable that does not match the NCHS national
standard, use the 4 and 5 options to capture this information or use another data source to
code this category.
 Regardless of the victim’s age, code “Unknown if pregnant within past year” if the victim’s
pregnancy status is not mentioned on the CME record and not completed on the death
certificate

3.1.19 Sexual orientation: SexualOrientation
Definition:
This variable is used to report sexual orientation which includes heterosexual, gay, lesbian, or bisexual.
Response Options:
0
Straight/Heterosexual
1
Gay
2
Lesbian
3
Bisexual
9
Unknown
Discussion:
Sexual orientation is a multi-component construct that is commonly measured in three ways: attraction
(e.g., the sex of a person one is sexually attracted to), behavior (e.g., ask respondents to report on the
sex of people with whom they had willing sexual experiences), and self-identification (e.g., how would
you describe your sexual orientation).2
In NVDRS, this variable captures whether the victim self-identified as heterosexual, gay, lesbian, or
bisexual based on interviews of friends, family or acquaintances. Only code this variable if the
information is reported in the LE or CME report. Sexual orientation should not be inferred from marital
Section 3: Demographic Variables for Victims

41 | P a g e

status. If the information is not explicitly reported, select “unknown”. Currently, this information is
usually not collected systematically and consequently this variable will likely only detect decedents who
were gay, lesbian or bisexual according to friends, families or acquaintances. Definitive information on
sexual orientation may be unavailable.
Note: This variable was added in August, 2013.
2

Badgett & Goldberg (2009). Best Practices for Asking Questions about Sexual Orientation on Surveys.
Los Angeles, CA: The Williams Institute & Saewyc, E.M., Bauer, G.R., Skay, C.L., Bearinger, L.H., Resnick,
M.D., Reis, E., & Murphy, A. (2004). Measuring sexual orientation in adolescent health surveys:
Evaluation of eight school-based surveys. Journal of Adolescent Health, 35(4), 345e1-e15.

3.1.20 Current or former military personnel: Military
Definition:
Has the person ever served in the U.S. Armed Forces?
Response Options:
0
No
1
Yes
9
Unknown
Discussion:
Military status is indicated on the death certificate in the section captioned, “Ever a member of U.S.
Armed Forces†.” If a state’s death certificate has the variant wording, “If U.S. War veteran, specify war,”
a blank or missing response should be coded as “Unknown” rather than “No”.
Note: Prior to 2010, the label for this data element was “Veteran status.” The label was changed in 2010
to reflect the actual wording on the standard death certificate.
†U.S. Armed Forces comprises five armed service branches: Air Force, Army, Coast Guard, Marine Corps,
and Navy.

3.2

Place of Residence, Birthplace, Industry, Occupation, and Education

3.2.1

Residence Variables
3.2.1.1
Country of residence: Country
3.2.1.2
State of residence: ResidenceState
3.2.1.3
County of residence: ResidenceCounty
3.2.1.4
City of residence: ResidenceCity
3.2.1.5
ZIP code of residence: ResidenceZip
3.2.1.6
US Census tract of residence: ResidenceCensusTract
3.2.1.7
US Census block group of residence: ResidenceCensusBlock

Definitions:

Section 3: Demographic Variables for Victims

42 | P a g e

Residential address information is collected at a number of levels (see below) to help support the
identification of the agency responsible for potential public health interventions, to undertake
geocoding, to better target interventions and to calculate population-based injury rates.
 Country: Residential country of victim
 ResidenceState: Residential U.S. state or territory of victim
 ResidenceCounty: Residential county (or county equivalent) address of victim,
 ResidenceCity: Residential city address of the victim (“place” code)
 ResidenceZip: Residential zip code
 ResidenceCensusTract: U.S. Census tract of victim’s residence
 ResidenceCensusBlock: U.S. Census block group of victim’s residence
Response Options:
 Country:
Start typing country name to activate auto-complete


ResidenceState:
Start typing the state name or INCITS 38-2009 (formerly FIPS code) †
88 Not applicable
99 Unknown



ResidenceCounty:
Start typing the county name or INCITS 31-2009 (formerly FIPS code) ††
888
Not applicable
999
Unknown



ResidenceCity:
Start typing the city name or FIPS 55-3 or Census Code†††
88888
Not applicable
99998
Rural
99999
Unknown



ResidenceZip:
Enter 5-digit zip code
88888
Not applicable
99999
Unknown



ResidenceCensusTract:
Enter 4-digit census tract and when applicable two-digits on right side of the decimal point††††
9999.99
Unknown



ResidenceCensusBlock:
Enter the one-digit block group number††††
Leave blank if Unknown

† State codes are unchanged between FIPS and INCITS 38-2009.
†† County codes from FIPS have been carried over into INCITS 31-2009. For missing codes, search for the
correct code at the following web site: http://www.census.gov/geo/reference/ansi.html

Section 3: Demographic Variables for Victims

43 | P a g e

These codes are provided for U.S. county and ‘county equivalent’ areas (i.e., parishes, boroughs, the
District of Columbia, independent cities.
††† Though the U.S. Geological Survey officially replaced FIPS 55-3 with INCITS 446-2008
http://www.itl.nist.gov/fipspubs/55new/nav-top-fr.htm; NVDRS will continue using the standard FIPS
55-3 in order to facilitate data import and maintain consistency and familiarity.
†††† Census tract and census block group information may be obtained from the following website:
http://factfinder2.census.gov/faces/nav/jsf/pages/searchresults.xhtml?refresh=t#none. From the
toolbar on the left side of the screen (options) select “Geographies”. Then click on the "Address" tab and
type in the street address from the Death Certificate. This will elicit Census Tract and Block Group data
directly.
It is also possible to obtain Census tract and block group information for multiple addresses at one time.
Click on the following link: http://geocoding.geo.census.gov/geocoder/geographies/addressbatch?form.
To perform the batch processing of addresses, create a Comma-Separated Values (CSV) file and upload
the file in the “select address file” field. An example of what the CSV file should contain is listed at the
following link: http://geocoding.geo.census.gov/geocoder/Addresses.csv.
Discussion:
Use place of residence from the death certificate. This should handle tourists, itinerants, part-time
residents, etc.
 The address information should be collected at the local level in a format that meets the local
standards for geocoding.
 If the person is not a resident of a U.S. state or territory, the program will automatically enter “88”
for “Not applicable”.
 An American Indian reservation should be coded as the state in which it is located. If the reservation
spans multiple states, code based on state borders.
 For out-of-state addresses, the following website supplies FIPS place and county codes:
http://www.census.gov/geo/reference/ansi.html.
 Notes on institutionalized individuals:
o If a person is currently residing in a short-term facility (expected to return to his or her
residence after a stay of generally no more than 3 months) such as a rehabilitation hospital,
drug treatment program, jail, etc., use his or her home address as the residential address.
Only use the address of the facility if no home address is noted.
o If a person is residing in a long-term facility, such as a college dormitory, prison, or
residential nursing home, use the facility’s address.

3.2.2

Birth place: BirthPlace

Definition:
Birth state, territory, or country
Response Options:
Start typing U.S. state abbreviation (e.g., GA for Georgia), full state name (e.g., Georgia), or a listed
country name (e.g., Canada, Cuba, or Mexico), or a U.S. territory. Full list of categories is provided
below:

Section 3: Demographic Variables for Victims

44 | P a g e

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21

Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland

22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42

Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota

43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
59

61
62
99

Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Puerto Rico
Virgin Islands
Guam
Canada
Cuba
Mexico
Remainder of the
world (specify in
birthplace text)
American Samoa
Northern Marianas
Unknown

Discussion:
The place of birth is indicated on the death certificate. If the victim was not born in the United States or
one of the listed countries, enter “59,” or “Remainder of the world,” and specify the victim’s country of
birth in the field, “Country of birth, if not listed.”
Note: the code list used for place of birth is not a FIPS code list; it is a National Center for Health
Statistics code list.

3.2.3

Birth Country, if other: BirthCountryOther

Definition:
Victim’s country of birth, if not the U.S. and not on list of other countries in the variable “Birth Place”.
Response Options:
Text

Section 3: Demographic Variables for Victims

45 | P a g e

Discussion:
For victims not born in the United States or one of the countries listed in the code list for “Birth place,”
(i.e., coded “59 – Remainder of world”), please enter the country of birth in this field.

3.2.4

Usual Occupation Variables
3.2.4.1 Kind of business/industry code: Industry
3.2.4.2 Usual industry text: IndustryText
3.2.4.3 Usual occupation code: UsualOccupation
3.2.4.4 Usual occupation text: OccupationText

Definitions:
“Usual industry” is the kind of business or industry to which the victim’s occupation is related, such as
insurance, farming, or government.
 Industry: Victim’s usual business / industry code as recorded on the death certificate
 IndustryText: Victim’s usual business/industry text as recorded on the death certificate
 UsualOccupation: Usual Occupation of the victim as recorded on the death certificate
 OccupationText: Usual occupation text of the victim as recorded on the death certificate
Response Options:
Provide the usual industry and occupation codes of the person as recorded on the death certificate±.
080
090

If text only; indicates the actual code is not available.
"unknown", "N/A" or "blank"

Discussion:
Most states’ registry of vital records encodes the decedent’s usual occupation and industry on the death
certificate. Usual occupation/industry is not necessarily the victim’s current occupation/industry.
Provide information exactly as it appears in the death certificate data. Sites should NOT code the
information themselves, as industry and occupation coding requires special training.
 The codes “999” for occupation and “090” for industry are assigned by the Occupation and Industry
coder to indicate “blank, unknown, or NA”. These codes should only be used if they appear in the
death certificate data.
 If the text descriptor is recorded on the death certificate, and a numeric code is not provided, report
only the text information and use the code “080” to indicate that the actual code is unavailable.
 If the death certificate is blank (e.g., both code and text information is blank or missing), use the
code “080” to indicate unavailable and use the text field to indicate blank, unknown, or not
available.
± Occupation codes recorded on the death certificate are based on the U.S. Census Bureau’s Industry and
Occupation Codes. See
https://www.census.gov/topics/employment/industry-occupation/guidance/code-lists.html

3.2.5

Current occupation: OccupationCurrentText

Definition:
Section 3: Demographic Variables for Victims

46 | P a g e

Occupation is an indicator of socioeconomic status. Certain occupations may also be associated with the
occurrence of suicide or homicide.
Response Options:
Enter victim’s current occupation in free text, OR enter:
 Employed, specific occupation unknown
 Unemployed
 Homemaker
 Retired
 Student
 Disabled
 Self-employed
 NA (under age 14)
 Unknown
Discussion:
Report the current occupation in a text field exactly as it appears in one of the required data sources.
The information can later be coded at the national level using Standard Occupational Classifications.
Note that “current occupation” is different from “usual occupation”, which is recorded on the death
certificate. If the victim is not employed, enter one of the standard text options listed above. These are
not currently available on a drop-down menu, so please be careful to enter them exactly as they appear
under “Response Options,” and not in an abbreviated version.
 People who work 17.5 hours or more per week are considered employed; people who work less
than that are not.
 For victims under the age of 14, the current occupation should be listed as “N/A” unless the
CME report lists an occupation.

3.2.6

Homeless: Homeless

Definition:
Indicator of victims’ homeless status. Homeless persons are those who reside in one of the following: 1)
Places not designed for or ordinarily used as a regular sleeping accommodation for human beings,
including the following: a car or other private vehicle; park, on the street or other outdoor place;
abandoned building (i.e., squatting); bus or train station; airport; or camping ground, or 2) A supervised
publicly or privately operated shelter or drop-in center designated to provide temporary living
arrangements; congregate shelters; temporary accommodations provided by a homeless shelter (e.g., a
motel room provided because the shelter was full); or transitional housing for homeless persons.
Response Options:
0
No
1
Yes
9
Unknown
Discussion:
Marking this variable “Yes” means that there was clear evidence in a document that the victim was
homeless, such as living in a car.


Examples of Coding Homeless “Yes”:

Section 3: Demographic Variables for Victims

47 | P a g e

o
o
o
o


Victim had been living in his car since his wife discovered he had relapsed on meth and
kicked him out of the family home.
Victim had been staying at a local homeless shelter for the past 3 months.
Victim lived in an abandoned house or building along with several other homeless
individuals.
Victim was residing in a tent on a local campground

If you code homeless as “Yes”, you must code “Injured at Victim’s Home” as “No”. A person
cannot be homeless if he or she was injured at home. Being injured at a shelter, on the street, in
their car or makeshift quarters in an outdoor setting is not considered being injured at home.

Victims who have no homes of their own, but are staying indefinitely with friends or family, live in a
hotel, or have a residential address that is not a shelter are not considered homeless.


Examples of Coding Homeless “No”:
o Victim had been staying at a motel after being evicted 2 weeks ago.
o Victim had recently retired and had been residing and traveling in a motor home (i.e.,
RV) that she owns.
o Victim was a long-distance trucker, and lived in a cabin within his truck when he was not
driving.
o Victim and her husband had recently been evicted and were staying with a friend until
they could find housing.
o Victim had recently sold her house and was staying at a hotel until a new house she had
recently purchased was ready.
o Victim was due to be evicted from his apartment in 3 days and did not have any place to
stay once evicted.

Code homeless “Unknown” when the residential address is stated “unknown” and homeless status is
not otherwise known. Otherwise, mark this variable “No”.

3.2.7

Education by degree: EducationLevel

Definition:
Represents victim’s educational level as measured by the highest degree attained.
Response Options:
0
8th grade or less
1
9th to 12th grade; no diploma
2
High school graduate or GED completed
3
Some college credit, but no degree
4
Associate’s degree (e.g., AA, AS)
5
Bachelor’s degree (e.g., BA, AB, BS)
6
Master’s degree (e.g., MA, MS, Mend, Med, MSW, MBA)
7
Doctorate (e.g., PhD, EdD) or Professional degree (e.g., MD, DDS, DVM, JD)
9
Unknown
Discussion:
Section 3: Demographic Variables for Victims

48 | P a g e

The options for the “Education” variables are those on the 2003 death certificate. Since not all states
may have moved to the new format, the pre-2003 education format is provided in the “Number years
education” variable. Only one of the two (either EducationLevel OR EducationYears) has to be
completed.
 Vocational and trade school should be coded as “High school graduate”.
 For very young children who are not in school, code as “0” or 8th grade or less.

3.2.8

Education by number years: EducationYears

Definition:
Represents victim’s educational level as measured by years of formal education completed beyond
kindergarten (e.g., completing 8th grade would be recorded as 8 years of education).
Response Options:
Numeric
0 to 17 Years
99
Unknown
Discussion:
Select the number of years of education completed by the victim beginning with the 1st grade. Do not
count pre-kindergarten or kindergarten. The options for the “Education” variables are those on the 2003
death certificate. Since not all states may have moved to the new format, the pre-2003 education
format is provided in this variable. Only one of the two (either EducationLevel OR EducationYears) has to
be completed.
 For very young children who are not in school, code as “0”.

Section 3: Demographic Variables for Victims

49 | P a g e

SECTION 4: INJURY AND DEATH VARIABLES
4.1

Manner of Death Variables

4.1.1
4.1.2
4.1.3
4.1.4

Manner of death on DC: DeathMannerDC
Manner of death per LE: DeathMannerLE
Manner of death per CME: DeathMannerCME
Manner of death per abstractor: DeathMannerAbstractor

Definitions:
 DeathMannerDC: Manner of death on death certificate
 DeathMannerLE: Manner of death recorded in law enforcement report
 DeathMannerCME: Manner of death recorded in CME report
 DeathMannerAbstractor: Manner of death based on abstractor review of all available data
Response Options:
 DeathMannerDC
 DeathMannerLE
 DeathMannerCME
1
Natural
2
Accident
3
Suicide
4
Homicide
5
Pending investigation
6
Could not be determined
7
Legal intervention
9
Record not available or blank


DeathMannerAbstractor
1
Suicide or intentional self-harm
2
Homicide
3
Unintentional firearm - self-inflicted
4
Unintentional firearm - inflicted by other person
5
Unintentional firearm - unknown who inflicted
6
Legal intervention (by police or other authority)
7
Terrorism homicide
8
Terrorism suicide
9
Undetermined intent
10
Other unintentional death (outside NVDRS case definition)
99
Missing

Discussion:
When completing the manner of death, abstractors must record the Manner of Death exactly as they
are reported on the CME, DC, and LE reports. The abstractor must also select an NVDRS manner of
death, referred to as abstractor manner that must be consistent with the manner of death reported in
at least one of the three required data sources: CME, DC, and LE.
Manner of Death on CME, DC, and LE
Section 4: Injury and Death Variables

50 | P a g e

Manner of death is a broad classification of the cause of death as natural, accidental, suicide, homicide,
pending investigation, or not determined. Manner is determined by the coroner or medical examiner
and, when considered in conjunction with the narrative cause of death statements on the death
certificate, is the basis for how the official underlying cause of death is coded in vital statistics data. Data
describing the manner of death are useful for public health surveillance, health care planning and
administration, clinical and health services, and epidemiologic research. Because the CME’s manner of
death sometimes differ from the manner implied by the death certificate’s underlying cause-of-death
code, or the law enforcement designation of the death, it is useful to document manner by source.






Record the manner of death exactly as it appears on the death certificate and CME report.
If a manner is noted as “Pending investigation,” check back on the case later to update the manner.
“Pending” is considered a temporary designation.
Since states’ death certificates may have a state-added code to indicate “Legal intervention” as the
manner of death, code “Legal intervention” only if it is presented on the death certificate (the
abstractor-assigned type of death variable can capture legal intervention deaths that are not coded
on the death certificate in that fashion).
Do not use the DC manner for the CME manner field even if the DC is found in the ME records.
Record the manner from the CME records.

Assigning Abstractor Manner of Death
The abstractor assigns this manner of death based on reading the DC, CME reports and law enforcement
information about the death as well as applying the NVDRS case definitions. In general, the data sources
will agree on the manner of the death (e.g., CME, LE, and DC indicate homicide) and the abstractor
manner should match or be consistent with the three reports. When the case is initiated, often with the
DC, the abstractor should immediately enter an abstractor manner consistent with the available data
source and then update the manner as more information becomes available. Do NOT wait to receive all
three data sources before completing the abstractor manner.
In some cases, the manner of death may vary across the data sources (e.g., law enforcement reports
homicide and CME reports suicide) or the manner assigned to the death may be different than the
manner indicated by the NVDRS case definition.
The points below provide guidance on how to handle these types of situations.
 If an abstractor assigns a manner of death that does not coincide with the CME’s manner of death,
it must be consistent with a manner of death on at least one other document.
 There may be incidents when the manner used by the CME does not exactly match the NVDRS cases
definitions. The protocol for defining NVDRS Death Type is included in the Definition section of the
manual. Please read this section.
o If the facts of the case are clear and not in dispute, apply the NVDRS definitions in
assigning Death Type. For instance, a clear unintentional shooting of one child by
another, for example, may be categorized as an accident by one medical examiner and a
homicide by another. In both these cases, the abstractor manner for the victim should
be “Unintentional firearm – inflicted by another person”
o If the facts of the case are unclear or in dispute, default to the CME’s determination of
manner. For example, the CME manner is “homicide” and the CME report states, “A 13year-old teenager shot another 13-year-old; conflicting reports exist as to whether the
shooting was intentional.” In this instance, the abstractor should use CME’s
classification of manner of death (e.g., homicide) because the CME intentionally
Section 4: Injury and Death Variables

51 | P a g e





selected “homicide” over an “unintentional” death explanation.
There may be a few cases where the ICD-10 code listed in the DC indicates a death was “natural” or
“unintentional” even though the CME and LE report indicate the death was a “homicide” or
“suicide”. This can occur for a variety of reasons, including the ICD-10 code recording the intent
without the manner or an investigation leading to updated findings about the death. In these cases,
the abstractor should use the manner recorded by the CME and LE report instead of the DC.
Some states define all ‘legal intervention’ deaths (e.g., the victim was killed by law enforcement
acting in the line of duty) as homicides. In contrast, NVDRS distinguishes between legal intervention
deaths and homicides. Consequently, if after reviewing the CME and law enforcement reports an
abstractor is able to determine that a homicide was due to legal intervention, the abstractor
assigned manner should be coded legal intervention.

In conclusion, the purpose of the abstractor manner is not to second-guess the CME or to enable an
abstractor to come to his or her own conclusion about the case; rather the purpose is to characterize
the conclusions of the official death investigation about the intent type of the incident in a manner that
is consistent with the CME, DC, and/or law enforcement records AND is consistent with the NVDRS case
definitions.

4.2

Change in Collection of Injury and Death Variables

The remaining injury and death variables have traditionally been obtained from death certificates.
Beginning in 2013, these variables may be abstracted from any source when appropriate. While death
certificates can continue to be used to collect these variables, the best sources for each variable may
vary across states.

4.3

Injury Locations, Time, and Events

4.3.1 Injury Address Variables
4.3.1.1
State or territory where injury occurred: InjuryState
4.3.1.2
County where injury occurred: InjuryCounty
4.3.1.3
City where injury occurred: InjuryCity
4.3.1.4
ZIP code where injury occurred: InjuryZip
4.3.1.5
US Census tract where injury occurred: CensusTract
4.3.1.6
US Census block group where injury occurred: CensusBlock
Definitions:
 InjuryState: State in which injury was inflicted
 InjuryCounty: County (or county equivalent) in which injury was inflicted
 InjuryCity: City/town in which injury was inflicted
 InjuryZip: Postal ZIP code in which injury was inflicted
 CensusTract: Census tract in which injury was inflicted
 CensusBlock: Census block group in which injury was inflicted

Section 4: Injury and Death Variables

52 | P a g e

Response Options:
 InjuryState:
Start typing the name of the state or INCITS 38-2009 (formerly FIPS code) †
88
Not applicable
99
Unknown


InjuryCounty:
Start typing the name of the county or INCITS 31-2009 (formerly FIPS code)††
888
Not applicable
999
Unknown



InjuryCity:
Start typing the name of the city or FIPS 55-3 or Census Code †††
88888 Not applicable
99999 Unknown



InjuryZip:
5-digit zip code of injury
88888 Not applicable
99999 Unknown



CensusTract:
4 to 6-digit census tract††††
9999.99
Unknown



CensusBlock:
1-digit description of block group††††
Leave blank if Unknown

† State codes are unchanged between FIPS and INCITS 38:2009.
†† County codes from FIPS have been carried over into INCITS 31:2009. For missing codes, search for the
correct code at the following web site: http://www.census.gov/geo/reference/ansi.html
These codes are provided for U.S. county and ‘county equivalent’ areas (i.e., parishes, boroughs, the
District of Columbia, independent cities
††† Though the U.S. Geological Survey officially replaced FIPS 55-3 with INCITS 446-2008
http://www.itl.nist.gov/fipspubs/55new/nav-top-fr.htm; NVDRS will continue using the standard FIPS
55-3 in order to facilitate data import and maintain consistency and familiarity.
†††† Census tract and census block group information may be obtained from the following website:
http://factfinder2.census.gov/faces/nav/jsf/pages/searchresults.xhtml?refresh=t#none. From the
toolbar on the left side of the screen (options) select “Geographies”. Then click on the "Address" tab and
type in the street address from the Death Certificate. This will elicit Census Tract and Block Group data
directly.
Section 4: Injury and Death Variables

53 | P a g e

Discussion:
 If the address of injury covers more than one address, code the address where the first injury was
inflicted.
 If there is no explicit address for the injury incident (e.g., in a field or park), record the injury location
variables using the nearest address or cross streets. If the nearest street address or intersection is
not available from the records, enter the injury location information for the smallest geography that
the name (e.g., park or beach) falls within. For example, if a city park falls entirely within a zip code,
enter that zip code but enter unknown for smaller geographies like census tract.
 Reporting sites that geocode their data at the local level using address information (Note: specific
address information should never be entered into the web system) can generate the census block
group and tract where the incident occurred from a geocoding program. In some states, the vital
statistics registry or law enforcement department will have already geocoded the address and will
have census tract and block group information available.
 The county and city/town are coded using standard Federal Information Processing Standards (FIPS)
codes. These codes are provided in drop-down menus in the NVDRS software.
Note: Vital Statistics data use two coding systems for states: FIPS and their own system. Please use the
FIPS version here.

4.3.2

Date and Time of Injury Variables
4.3.2.1 Date of injury: InjuryDate
4.3.2.2 Time of injury: InjuryTime

Definition:
 InjuryDate: Date of injury leading to death
 InjuryTime: Time of Injury leading to death
Response Options:
 InjuryDate
Date (format: MM\DD\YYYY)
You must enter “MM” and “DD” as two-digit numbers (e.g., “06” for June, not “6”). If month or day is
missing enter ‘99’. Enter ‘9999’ if year of injury is missing.
06/99/2007
99/99/2007
99/99/9999

for June 2007 with the day unknown
for 2007 with the month and day unknown
for the year, month and day unknown

 InjuryTime
Code using 24-hour format or military time, with midnight as “0000” and noon as “1200” and 2 PM as
“1400”.
Discussion:
Date of injury can be used to examine trends over time in violent deaths, to detect epidemics, and to
test for seasonal effects on violent death. Time of injury can be used to identify times of day incidents
may be more likely to occur. Date and time of injury can also be used to interpret toxicology test results.
Section 4: Injury and Death Variables

54 | P a g e

Exact date and time of injury are sometimes unknown, as in an un-witnessed suicide or homicide.
 Do not enter the date that the victim was last seen if actual date of injury is unknown. The
software allows for partially known date information to be entered. Specifically, enter “99” if
the month or day is unknown and “9999” if the year is unknown.
o For instance, if month and day of injury are unknown, but the year is known, code the
date as, 99/99/2003. If no information is known about when the incident occurred (as in
when skeletal remains are found), it is acceptable to code date of injury as 99/99/9999.
 Sometimes the injury will be described as occurring within a time range (e.g., between 1 and 2
PM).
o If a range of less than an hour is given (e.g., “around 9:30 a.m.” or “between 9:30 and
10:30”), code that as the lowest time in the range (0930 in both cases).
o If a range of greater than one hour is noted for the time of injury (e.g., “sometime
between 9:30 a.m. and noon”), treat time as unknown.

4.3.3

Type of location where injury occurred: InjuryLocationType

Definition:
Type of place at which the injury occurred
Response Options:
1
House, apartment, rooming house, including driveway, porch, yard, garage
2
Street/road, sidewalk, alley
3
Highway, freeway
4
Motor vehicle, regardless of where motor vehicle is located (excluding school bus (15), and
public transportation (21)); includes motor homes
5
Bar, nightclub
6
Service station
7
Bank, credit union, ATM location
8
Liquor store
9
Other commercial establishment (e.g., grocery store, restaurants, retail outlet, Laundromat),
including parking lot
10
Industrial or construction areas (e.g., factory, warehouse)
11
Office building
12
Parking lot/public parking garage (e.g., parking lot at mall, parking lot shared by four or more
households)
13
Abandoned house, building, or warehouse
14
Sports or athletic area (e.g., stadium, baseball field, gymnasium, recreation center)
15
School bus
16
Child care center, daycare, preschool
17
Elementary school, middle school (i.e., K-8) including school dormitory, residential school
18
High school, including school dormitory, residential school
19
College/University, including dormitory, fraternity/sorority
20
Unspecified school
21
Public transportation or station (e.g., bus, train, plane, airport, depot, taxi)
22
Synagogue, church, temple
23
Hospital or medical facility
24
Supervised residential facility (e.g., shelter, halfway house, group home)
Section 4: Injury and Death Variables

55 | P a g e

25
26
27
28
29
30
31
32
66
99

Farm
Jail, prison, detention facility
Park, playground, public use area
Natural area (e.g., field, river, beaches, woods)
Hotel/motel
Railroad tracks (other than on public transportation (21) or within station)
Bridge
Cemetery, graveyard, or other burial ground
Other
Unknown

Discussion:
Data on the type of place at which an injury occurred help to describe the injury-producing event and
are valuable for planning and evaluating prevention programs.
 If a victim was injured in a variety of locations (e.g., the victim was stabbed on a bus and was
pursued by the attacker off the bus and into a store and stabbed a second time), code the
location at which the victim was first injured.
 Designations of specific buildings (such as “House, apartment” or “Bar, nightclub”) include both
the building itself and the area directly outside, such as a driveway, porch, front walk, or garage.
 Events that occur on public sidewalks should be coded as “2 - Street”, with the exception of
those occurring on sidewalks that are the private property of an adjacent building. Those should
be coded as the adjacent building.
 If an incident occurs while the victim is in a motor vehicle (e.g., died in a motor vehicle at home),
please code “4 – Motor vehicle” rather than the location of the motor vehicle. Injury “site”,
injury “location”, and injury “scene” can all be used as synonyms.
 If a victim was fatally injured falling from a bridge, code the injury location as “31 – Bridge” and
not the location of impact.
 If a victim was fatally injured in a nursing home or assisted living, code the injury location as “24
– Supervised Residential Facility.”
 If a victim was fatally injured in a park, playground, ball field, etc. on school property, code as a
“17 – elementary, middle school” or “18 – high school,” as appropriate.
Note: The category “31”, or bridge, was added in August 2013.

4.3.4

Injured at work: InjuredAtWork

Definition:
Injury occurred at work or while the person was working
Response Options:
0
No, injury did not occur at work or while the victim was working
1
Yes, injury occurred at work or while the victim was working
8
Not applicable (e.g., child, unemployed, retiree)
9
Unknown
Discussion:
“InjuredAtWork” includes those incidents that occur while the victim is at work or on official work
Section 4: Injury and Death Variables

56 | P a g e

business; regardless of whether they are working at the time the injury occurs. These injuries could
occur at the victim’s place of work or off-site during the course of work-related activities. The
InjuredAtWork definition applies only to current jobs.
The “Injured at work” item on the death certificate is supposed to be filled out for all injury victims with
the exception of those less than age 14 (unless warranted for a younger child injured at work). “Not
applicable” can therefore be coded for victims ages 13 years and younger.
 If the victim is injured while they are working as a volunteer fireman or police officer, the death
should be coded as occurring at work.
 Students injured while going to school or on school ground should not be considered injured at
work.

4.3.5

Injured at victim’s home: InjuredAtVictimHome

Definition:
Injury occurred at the person’s residence
Response Options:
0
No
1
Yes
9
Unknown
Discussion:
This variable is completed for each victim in an incident and is victim-specific (e.g., two victims are killed
in a home. The first victim lived there –code “Yes”. The second victim was visiting for dinner – code
“No”. The victim’s residence includes any homes they own (e.g., vacation/second homes).
A victim who resides in an institution (e.g., jail, locked mental health facility, long-term care facility, etc.)
should be coded ‘no’ even though he/she resides in the institution.

4.3.6

EMS at scene: EMSPresent

Definition:
Emergency medical services were present at the scene of the injury incident
Response Options:
0
No
1
Yes
9
Unknown
Discussion:
EMS status describes the involvement of emergency medical services in violent injury cases. This may
assist in planning and evaluating EMS services and in capturing costs associated with violence. Code
"EMSPresent" only to indicate the presence of medical services at the scene, not to indicate whether
any medical services were delivered. If the victim was transported from the scene via ambulance, this
variable should be coded “Yes.”
Section 4: Injury and Death Variables

57 | P a g e

4.3.7

Victim in custody when injured: VictimInCustody

Definition:
Person was in public custody when injury occurred
Response Options:
0
Not in custody
1
In jail or prison
2
Under arrest but not in jail
3
Committed to mental hospital
4
Resident of other state institution
5
In foster care (i.e., child-in out-of-home placement, etc.)
6
Injured prior to arrest
8
Other (including house arrest, electronic monitoring, legal home confinement)
9
Unknown
Discussion:
A victim is in public custody if he or she is under arrest, in foster care (i.e., out of home placement), or
remanded by law to an institution such as a jail, prison, detention center, psychiatric ward, psychiatric
hospital, or other institution. Custody is coded on the basis of when the fatal injury was inflicted or
when the death occurred.
 If the injury was inflicted while the person was not in custody, but they died in custody, code “Victim
in Custody” as “Yes”.
 The response “In jail or prison” also covers incarcerations in juvenile detention facilities and other
detention facilities.
 When coding this variable, abstractors must distinguish between voluntary and involuntary
commitments
o The response, “Committed to mental hospital or ward” includes involuntary commitments
and involuntary observations at psychiatric wards within standard hospitals or at psychiatric
institutions. These types of commitments should be coded with the appropriate institution
(e.g., mental hospital would be “3”)
o People who voluntarily commit themselves should not be coded as in custody, or “Not in
Custody”.

4.3.8

Recent release from institution: RecentRelease

Definition:
Deaths that occurred within a month of the decedent being released from or admitted to an
institutional setting.
Response Options:
0
No evidence of recent release
1
Jail, prison, or a detention facility
2
Hospital
3
Psychiatric hospital
Section 4: Injury and Death Variables

58 | P a g e

4
5
6
7
9
99

Other psychiatric institution
Long term residential health facility (e.g., nursing home)
Supervised residential facility related to alcohol or substance abuse treatment (e.g., residential
treatment facility, sober house or group home)
Supervised residential facilities not related to alcohol or substance abuse treatment (e.g.,
halfway houses or work-release homes)
Other
Unknown type of institution

Discussion:
If there is no evidence of a release within the past month from an institutionalized setting in the data
sources, this variable should be coded as ‘0’. In contrast, if there is evidence that the victim was released
from an institutionalized setting in the last month; the type of institution (e.g., jail, hospital, or
psychiatric hospital) should be coded. The decedent is considered institutionalized if they spent one or
more nights in the institution. For instance, if a victim was released three days ago from an overnight
institutional stay or a stay of over a year, the abstractor would record the type of institution from which
they were released. If an individual was recently released from more than one facility/institution, code
the one from which they were MOST RECENTLY released.
 In contrast to the variable “victim in custody when injured”, code both voluntary and involuntary
commitments. The death should be coded as “0” if a decedent visits an institution for medical care
(e.g., emergency department) and does not stay overnight or is arrested and not held overnight.
 Deaths that occur while the decedent is living at the institution should not be coded. The type of
institution, however, should be coded in the variable, “Victim in custody when injured”.
 If the document(s) state that the victim was “just” or “recently” released and provides no specific
timing on the release, the abstractor should consider the victim recently released and record the
type of institution from which he or she was released.
 If the victim was hospitalized in a psychiatric ward of a non-psychiatric hospital, code type of
institution as "Psychiatric Hospital"
When this code is endorsed, the narrative should include information on the reason for being
institutionalized (e.g., incarcerated for aggravated assault, hospitalized for a broken hip or released from
court mandated drug treatment), the type of institution (e.g., hospital or prison), the length the
decedent was institutionalized and problems related to the release, if applicable (e.g., unable to find a
job after release or financial difficulties after release).
Note: This variable was added in August, 2013.

4.3.9

Alcohol use suspected when injured: AlcoholUseSuspected

Definition:
Victim’s suspected alcohol use in the hours preceding the incident
Response Options:
0
No
1
Yes
8
Not Applicable
Section 4: Injury and Death Variables

59 | P a g e

9

Unknown

Discussion:
“AlcoholUseSuspected” can be coded as “Yes” based on witness or investigator reports (e.g., Law
enforcement note that the victim “had been drinking heavily”), or circumstantial evidence (e.g., empty
six pack scattered around suicide victim). This variable refers only to alcohol use and not drug use. The
phrase “in the hours preceding the incident” can be interpreted relatively broadly.
 If there is no evidence of alcohol use, code this variable as “No”.
 Use the “Unknown” option only if the source does not have a narrative that could provide the
evidence of alcohol use. For instance, if the narrative does not mention use of alcohol in any way,
code “No”.
 This code should be based solely on the scene investigation and should not refer to toxicology
reports. This is important because it allows a comparison and integration of scene investigation
information with toxicology information.

4.3.10 Survival time (no. of units): SurvivalTime
4.3.11 Unit of time used in survival time: SurvivalTimeUnit
Definitions:
 SurvivalTime: Interval between injury and death
 SurvivalTimeUnit: Unit used to report interval between injury and death
Response Options:
 SurvivalTime
888
Not applicable
999
Unknown


SurvivalTimeUnit
1
Minutes
2
Hours
3
Days
4
Years
5
Months
8
Not applicable
9
Unknown

Discussion:
Survival time is noted on the death certificate in the section called “Approximate interval between onset
and death” to the right of the cause of death text. It is often either explicitly mentioned in the CME’s
report or it can be calculated based on date and time of injury and death.




Use only the survival time listed for the violent injury.
o Do not use the survival time listed for the consequences or complications of injury.
o Do not add the survival times listed next to each cause of death listed on the death certificate.
If date and time of injury of death are unknown, do not calculate survival based on the interval
between the time the person was last seen and the body found (unless that was less than two
hours).

Section 4: Injury and Death Variables

60 | P a g e








4.4

Indicate the length of survival interval in SurvivalTime and the units of measurement for the interval
(e.g., minutes, hours, days) in SurvivalTimeUnits.
o For under two hours, use minutes;
 for two hours through 47 hours, use hours;
 for 48 hours and over, use days;
 for 365 or more days, use years;
 Round to the nearest whole number.
If survival time was noted as a range, use the high end of the range (e.g., 15–30 minutes, use 30).
If survival time is not precisely noted, indicate 999 in SurvivalTime and the applicable unit in
SurvivalTimeUnits (e.g., “patient survived a few minutes” would be 999 in SurvivalTime and 1 in
SurvivalTimeUnits).
If death is described as “immediate,” “sudden,” or “instantaneous,” indicate 0 in SurvivalTime and 1
in SurvivalTimeUnits.

Hospital Codes

4.4.1

Victim seen in emergency department: EmergencyDepartment

Definition:
Victim was seen in emergency department following the fatal incident.
Response Options:
0
No
1
Yes
9
Unknown
Discussion:
Victims who arrived at the emergency department should be coded as “Yes,” regardless of whether they
were dead or alive on arrival and regardless of whether they received treatment.
 If the victim was admitted to inpatient care, also code as “Yes”. Most violent injury patients will
have been seen in the emergency department if they were later admitted to inpatient care.

4.4.2

Victim admitted to inpatient care: HospitalAdmit

Definition:
Victim was admitted to the hospital for inpatient care following fatal incident.
Response Options:
0
No, Not Collected, Not Available, Unknown
1
Yes
Discussion:
Victims who were admitted to inpatient care should be coded as “Yes”.
 If a victim was admitted for an “observation only” overnight stay and not admitted as an inpatient,
code as “No”.
Section 4: Injury and Death Variables

61 | P a g e



If the victim was noted as having been in the operating room, code as “Yes” even if the victim died
in the operating room.

4.4.3

ICD-9-CM Hospital Code Variables
4.4.3.1 First external cause of injury ICD9 code by hospital: ExternalCause1ICD9
4.4.3.2 Second external cause of injury ICD9 code by hospital: ExternalCause2ICD9

Definitions:
E-codes are specialized ICD-9-CM codes used to identify the cause of the fatal injury and are identified
by an ‘E’ before the number.
Response Options:
Codes are provided by hospital in ICD format: E###. #
000.7 Not collected by reporting site
000.8 Not applicable
000.9 Unknown or missing
Discussion:
These variables should be coded as they appear in the hospital discharge data, or, if unavailable, in the
emergency department records.
 E-codes are assigned by the medical records department using the International Classification of
Diseases, 9th Revision, Clinical Modification (ICD 9 CM), to describe the external cause of an
injury. Thus, the codes supply information on whether a hospital visit involved suicidal behavior
or being assaulted as well as mechanism of injury (e.g., poison or gun).
 Be sure to type in the ‘E’ when entering the code, unless the “Not collected by reporting site”,
“Not applicable or “Unknown or missing” codes are being used.
 DO NOT ENTER other ICD-9-CM codes that are not e-codes (i.e., these codes will not have an “E”
as the first digit.
 Do not use trailing zeroes after the decimal point (unless a true zero is part of the actual code).
 These codes will eventually be phased out and replaced by the ICD-10-

4.4.4

ICD-10-CM Hospital Code Variables
4.4.4.1 First external cause of injury ICD10 code by hospital: ExternalCause1ICD10
4.4.4.2 Second external cause of injury ICD10 code by hospital: ExternalCause2ICD10

Definitions:
The US hospitals will eventually be moving from the ICD-9-CM codes to the ICD-10-CM codes. These
variables allow the user to enter these codes as hospitals transition to them.
Response Options:
Codes are provided by hospital in ICD format: ###. #
000.7 Not collected by reporting site
000.8 Not applicable
000.9 Unknown or missing
Discussion:
These variables should be coded as they appear in the hospital discharge data, or, if unavailable, in the
Section 4: Injury and Death Variables

62 | P a g e

emergency department records.
 Do not use trailing zeroes after the decimal point (unless a true zero is part of the actual code).
 These codes will remain inactive until hospitals start to use them.

4.5

Wounds and Death Certificate

4.5.1

Underlying Cause of Death Variables
4.5.1.1 Underlying cause of death ICD-10 code: UnderlyingCauseCode
4.5.1.2 Underlying cause of death ICD-10 code 4th digit: UnderlyingCauseCode4thDigit
4.5.1.3 Underlying cause of death ICD-10 code 5th digit: UnderlyingCauseCode5thDigit

Definitions:
 UnderlyingCauseCode:
Underlying cause-of-death code (ICD-10)
4th_ICD: 4th character
5th_ICD: 5th character
Response Options:
 UnderlyingCauseCode:
ICD-10 Format: L##. ## (the first character must be a letter, followed by at least two and up to
four digits)
Use “99999 - L99.99” for missing values.


UnderlyingCauseCode4thDigit:
ICD-10 coding of 4th character (type of place of occurrence) — applies only to codes in the W32
to Y34 range, except Y06 and Y07.
0
Home
1
Residential institution
2
School, institution, public administrative area (e.g., courthouse, hospital, daycare
center)
3
Sports and athletic area
4
Street and highway
5
Trade and service area
6
Industrial and construction (e.g., factory, shipyard)
7
Farm
8
Other
9
Unspecified



UnderlyingCauseCode5thDigit:
ICD-10 coding of 5th character (type of activity when injured) — applies only to codes in the
W32 to Y34 range.
0
While engaged in sports activity
1
While engaged in leisure activity
2
While working for income
3
While engaged in other types of work (e.g., chores, school)

Section 4: Injury and Death Variables

63 | P a g e

4
5
6
9

While resting, sleeping, eating, or engaging in other vital activities
While engaged in other specified activities
While engaged in unspecified activities
Unspecified

Discussion:
The underlying cause of death assigned on the death certificate is the basis for the nation’s official count
of deaths due to homicide, suicide, and other causes. A comparison of this variable and the CME
variable “Manner”, and the abstractor variable “Type of Death”, will indicate the degree to which data
sources vary in classifying deaths.
Cause of death is coded using the system established by the World Health Organization’s International
Classification of Diseases (ICD), the most recent version of which is ICD-10. The variable should be coded
exactly as it appears in the underlying cause of death field in the death certificate data and should never
be determined by the abstractor. Use the decimal point following the second digit. Do not use trailing
zeroes after the decimal point (unless a true zero is part of the actual code).
 If death certificate data are not available at the time that the reporting site is gathering data on the
case, code as Unknown. The ICD-10 codes are added after the preliminary death certificate is
created and consequently these data may not be available until months after the death or when you
first receive the death certificate.
 The fourth ICD-10 digit in the underlying cause of death code is used with some external cause code
categories to identify the place of occurrence of the external cause where relevant. If not available,
please leave blank.
 The fifth ICD-10 digit is provided for optional use in a supplementary character position with some
categories to indicate the activity of the injured person at the time the event occurred. This subclassification should not be confused with, or be used instead of, the recommended fourthcharacter subdivisions provided to indicate the place of occurrence. If not available, please leave
blank.

4.5.2
4.5.2.1
4.5.2.2
4.5.2.3
4.5.2.4

Cause of Death Variables
Immediate cause of death text: DeathCause1
Cause leading to immediate cause text: DeathCause2
Next antecedent cause of death text: DeathCause3
Underlying cause of death text: DeathCause4

Definitions±:
 DeathCause1: Immediate cause of death (text from death certificate): the final disease, injury, or
complication directly causing death
 DeathCause2: Cause leading to the immediate cause of death (text from death certificate): Next
sequential cause of death, if any leading to the immediate cause of death.
 DeathCause3: Next antecedent cause of death (text from death certificate): Next sequential cause
of death, if any, leading to the immediate cause of death.
 DeathCause4: Underlying cause of death (text from death certificate): the disease or injury that
initiated the chain of morbid events that led directly and inevitably to death
Response Options:
Text as it appears on death certificate
Section 4: Injury and Death Variables

64 | P a g e

Discussion:
The text that the death certifier supplies on the death certificate regarding the causes of death can be
used to identify reportable cases in a timely manner.
 Enter the text exactly as it appears on the death certificate.
 The letters in the variable names correspond to the lettered lines appearing on the death certificate.
 Some death certificates will not have an entry on all four lines. In this case, the abstractor should
only complete the lines with available data and leave the others blank.
 While coded data that captures the underlying cause of death using ICD-10 codes is an efficient
means of identifying confirmed cases, these coded data will not be available in some states for many
months. Consequently, this text information may help in identifying cases.
± As defined by Centers for Disease Control/National Center for Health Statistics, Instructions for
Completing the Cause-of-Death Section of the Death Certificate. Source:
http://www.cdc.gov/nchs/data/dvs/blue_form.pdf Causes of death are typically listed top to bottom in
the order seen here, with immediate cause of death listed first.

4.5.3

Place of death: DeathPlace

Definition:
Victim’s place of death
Response Options:
1
Hospital inpatient
2
ED/outpatient
3
Dead on arrival
4
Hospice facility
5
Nursing home, long-term care facility
6
Decedent’s home
7
Other (specify)
9
Undetermined
Discussion:
The code list the same list used on the current standard U.S. death certificate. The place of death may
be useful for emergency response planning and to assist in evaluating hospital or EMS services. The
older death certificate standard certificate uses slightly different codes (e.g., there is no separate code
for “Hospice,” and “residence” is used rather than “Decedent’s home”.)
 Some deaths will be coded on the death certificate as “Other” for place of death. This will usually
refer to “scene” deaths (e.g., a homicide victim who dies on the street). If “Other” is coded on the
death certificate, enter the place of death in the free text field if the place is specified on the death
certificate. If it is not, leave the text field blank. In the free text field, do not enter an address or
proper name that could identify the location. Only enter a general description of the place (e.g.,
bridge, road, forest, field, etc.)
 Do not enter the information supplied in the death certificate’s item, “Place of injury”, in this field as
this may be a different location than the place where the victim actually died and is captured in
another variable.
 “Body location” can be used as place of death if there is no indication that the person died
elsewhere.
 If your state uses the older code list, “residence” should be coded as “Decedent’s home” (although
Section 4: Injury and Death Variables

65 | P a g e

this may sometimes be incorrect).

4.5.4 Place of death if other: DeathPlaceText
Definition:
Text if place of death is “Other”
Response Options:
Text
Discussion:
Some deaths will be coded on the death certificate as “Other” for place of death. This will usually refer
to “scene” deaths (e.g., a homicide victim who dies on the street). If “Other” is coded on the death
certificate, enter the place of death in the free text field if the place is specified on the death certificate.
If it is not, leave the text field blank. In the free text field, do not enter an address or proper name that
could identify the location. Only enter a general description of the place (e.g., bridge, road, forest, field,
etc.)

4.5.5 Date pronounced dead: DeathPronouncedDate
Definition:
Date on which the victim was found or pronounced dead
Response Options:
Date (format: MM/DD/YYYY)
Use ‘99’ if the day or month is unknown and 9999 if the year is unknown:
06/99/2007
99/99/2007
99/99/9999

for June 2007 with the day unknown
for 2007 with the month and day unknown
for the year, month and day unknown

Discussion:
This variable is useful when a person is found dead and the actual date of death is unclear. It provides a
date that the death must have preceded. This field is found on the standard death certificate as Item 24,
“Date pronounced dead”. It should differ from the actual date of death only when death was not
observed and may have occurred prior to the date the body was found. This date should be known in
every case, whereas the day, month, or even year of actual death may be unknown.
 If your state does not report a date pronounced, please notify CDC and leave the field blank.

Section 4: Injury and Death Variables

66 | P a g e

4.5.6 Date of death: DeathDate
Definition:
Date of victim’s death
Response Options:
Date (format: MM/DD/YYYY)
Use ‘99’ if the day or month is unknown:
06/99/2007
99/99/2007

for June 2007 with the day unknown
for 2007 with the month and day unknown

Note: The system will not accept an unknown year of death. Year of death governs which year an
incident should be entered in (See Discussion).
Discussion:
Date of death determines the data year in which the victim will be counted in conjunction with date and
time of the incident and with survival time. When recording the information from the death certificate,
enter the date of death exactly as it appears in the “Date of Death” field, even if the word “found” or
“pronounced” precedes it on the hard copy.
 If the date on the CME report is referred to as an actual date of death, record it.
 If the date is referred to as the date on which the body was found or the death was pronounced,
and it is unknown on which date the death actually occurred, enter only that portion of the date
that is known.
The process for placing violent deaths in the appropriate year is described below:
 Year of a violent death. The year of death is the calendar year in which the victim died. So, for
example, if a victim was injured at the end of December 2002, but died in early January 2003, the
death would be reported in the 2003 data year. Although the NVDRS software allows for specific
month or date of death to be entered as “Unknown,” the year of death must be filled in. In the case
of a true unknown year of death (as in skeletal remains with unknown year of death, or an
unattended death that may have occurred either shortly before or shortly after January 1), enter the
year in which the body was found as the year of death.
 Year of a violent death for multiple death incidents. The year of a violent death incident is the first
year in which any of the victims in the incident died. For example, if two people are shot on
December 21st 2006 and one dies on December 22nd 2006 and the second dies on January 4th
2007, the year of the incident would be 2006. The only exception to this rule occurs when any of the
deaths occurred in a year prior to 2003, the first year of NVDRS. In that case, place the incident in
the first year of death after 2002. In other words, incidents with deaths in 2002 and 2003 should be
placed in 2003. Incidents with deaths in 2002 and 2004 should be placed in 2004. Incidents with
deaths in 2003 and 2004 should be placed in 2003.

4.5.7 State or territory of death: DeathState
Definition:
State in which the death occurred
Response Options:
Section 4: Injury and Death Variables

67 | P a g e

Start typing the state or territory to activate auto-complete
Discussion:
Identifies the state in which the death certificate was filed. This variable will be used to facilitate data
sharing across states when state of injury and state of death differ.
State of death will usually be the same as state of injury; however, on occasion the two will differ. For
instance, a victim who is injured in one state may be transported to another state for emergency
medical care.
 If the state of death is unknown, enter the state in which the person was pronounced dead (i.e., the
state that issued the death certificate)
 If the person was pronounced dead in a U.S. territory, enter the FIPS code for that territory.
 If the person was not pronounced dead in any U.S. state or territory, enter 88, for “Not applicable.”
This can still be an NVDRS case if the victim was fatally injured within a participating NVDRS state.
 A death on an American Indian reservation should be coded as the state in which it is located or, if
the reservation spans multiple states, based on state borders.

4.5.8 Autopsy performed: AutopsyPerformed
Definition:
Autopsy performed on the person
Response Options:
0
Not autopsied
1
Autopsied (full or partial)
9
Unknown
Discussion:
Autopsies are not performed on every case that comes to the attention of a CME, but decedents who
have been autopsied are likely to have more reliable cause of death codes and pregnancy findings. A
yes/no item appears on the death certificate to indicate if an autopsy was performed. However, the
same criteria in determining whether or not an autopsy was performed may not uniformly be applied
across jurisdictions. Therefore, NVDRS attempts to achieve some standardization of this variable
through the definitions below.
External examination consists of measuring and recording body length and weight and examining
external aspects of the body before internal examination. The external examination documents
identifying features, signs of or absence of disease and trauma, and signs of death. External examination
(including post-mortem imaging) does not qualify as an autopsy. Toxicology testing alone (i.e., without
an internal examination) also does not qualify as an autopsy.
An autopsy is defined as the examination and dissection (i.e., internal examination) of a dead body by a
physician for the purpose of determining the cause, mechanism, or manner of death, or the seat of
disease, confirming the clinical diagnosis, obtaining specimens for specialized testing, retrieving physical
evidence, identifying the deceased or educating medical professionals and students.* A full autopsy
typically includes the removal and examination of all internal organs, including the organs of the central
nervous system, pelvis, and abdomen.**
When the main concern is limited specifically to one organ or tissue disease process, the CME may focus
Section 4: Injury and Death Variables

68 | P a g e

their examination to that specific tissue. Partial autopsy consists of internal examination of only those
body cavities where the CME expects some findings to explain the cause of death.***
*National Association of Medical Examiners (NAME). Forensic Autopsy Performance Standards. 2015.
**Zarbo RJ, Baker PB, Howanitz PJ. Quality assurance of autopsy permit form information, timeliness of
performance, and issuance of preliminary report: a college of American pathologists q-probes study of
5434 autopsies from 452 institutions. Arch Pathol Lab Med 1996;120:346-352.
***Chattopadhyay S. Partial Autopsy—A second thought. Int J Forensic Sci Pathol 2014;2(2):1.

4.5.9 Wound Count Variables
4.5.9.1 Number of penetrating wounds: NumberWounds
4.5.9.2 Number of bullets: NumberBullets
Definitions:
 NumberWounds : Number of wounds to the victim
 NumberBullets: Number of bullets that hit the victim
Response Options:
Number of wounds/bullets up to 75
75
75 or more
76
Multiple, unspecified
88
Not applicable (no firearm or sharp instrument wounds)
99
Unknown
Discussion:
These data elements apply to firearm injuries and sharp instrument wounds (including shrapnel from
explosions) only. Only the wounds of the weapon(s) that caused the death should be entered. For
victims fatally injured by both a gun and a knife, and it is unclear which one inflicted the fatal injury,
count all wounds from both weapon types and code all wound locations.
 For “NumberWounds,” code the total number of penetrating wounds on the victim. Count both
entry and exit wounds.
o If the victim was reported as having multiple wounds, but no numbers is provided, please
use the code “76 – Multiple, unspecified”.
o If the record refers only to a “wound” in the singular, the number of wounds is one. If it
refers only to “wounds,” the number of wounds is “Multiple, unspecified”.
 For “NumberBullets” (for gunshot wound victims only), code the total number of bullets that hit the
victim.
o When determining the number of wounds and bullets for shotgun injuries, treat each
shotgun blast as one injury and each shotgun shell as one bullet.
o If the victim was reported as having multiple bullet wounds, but no numbers is provided,
please use the code “76 – Multiple, unspecified”.
4.5.10 Wound Location Variables
4.5.10.1
Wound to the head: WoundToHead
4.5.10.2
Wound to the face: WoundToFace
4.5.10.3
Wound to the neck: WoundToNeck
4.5.10.4
Wound to an upper extremity: WoundToUpperExtremity
Section 4: Injury and Death Variables

69 | P a g e

4.5.10.5
4.5.10.6
4.5.10.7
4.5.10.8

Wound to the spine: WoundToSpine
Wound to the thorax: WoundToThorax
Wound to the abdomen: WoundToAbdomen
Wound to a lower extremity: WoundToLowerExtremity

Definitions:
 WoundToHead: Presence of wound to the head
 WoundToFace: Presence of wound to the face (e.g., mouth, nose, eyes, ears, and chin/under chin
[between chin and neck])
 WoundToNeck: Presence of wound to the neck
 WoundToUpperExtremity: Presence of wound in the upper extremities (shoulders, arms, hands)
WoundToSpine: Presence of wound to the spine
 WoundToThorax: Presence of wound to the thorax (between the neck and the diaphragm, partially
encased by the ribs and containing the heart and lungs; the chest), or upper back
 WoundToAbdomen: Presence of wound to the abdomen (the part of the body that lies between the
thorax and includes the pelvis) and encloses the stomach, intestines, liver, spleen, and pancreas,
pelvic contents (including genital area), or lower back
 WoundToLowerExtremity: Presence of wound to the lower extremities (feet, hips, legs)
Response Options:
0
Absent (not wounded)
1
Present (wounded)
8
Not applicable
9
Unknown
Discussion:
These codes help describe the relationship between incident circumstance and wound locations on the
victim’s body.
These data elements apply to firearm injuries and sharp instrument wounds (including shrapnel from
explosions) only.
 Code the wound locations of penetrating wounds only; do not code the locations of superficial
grazing wounds or blunt trauma wounds.
 Code only the location of the external entrance or exit wound.
 For victims fatally injured by both a gun and a knife, and it is unclear which one inflicted the fatal
injury, count all wounds from both weapon types and code all wound locations.
 If the record refers only to a “wound” in the singular, the number of wounds is one. If it refers
only to “wounds,” the number of wounds is “Multiple, unspecified”.
 If a wound is described as being to the “back,” with no reference to “upper” or “lower” back,
code as “thorax.”

Section 4: Injury and Death Variables

70 | P a g e

WOUND LOCATION DIAGRAM

Section 4: Injury and Death Variables

71 | P a g e

4.5.11 Multiple Condition Codes 1-10: MultipleConditionCode01ICD10MultipleConditionCode10ICD10
Definition:
Describes the nature of the injury and other conditions leading to death. Up to 10 multiple condition
codes can be entered
Response Options:
Format:
L##. ## (the first character must be a letter, followed by at least two and up to four
digits)
L88.88
Not applicable +
L99.99
Unknown or missing +
+ Not an ICD-10 code, but used by NVDRS to identify missing cases
Discussion:
The “nature of injury” (or “multiple condition”) codes assigned to the death certificate specify the
anatomic location and nature of the injuries. This information may assist in evaluating emergency
medical response. Multiple condition codes are assigned by the registry of vital records to death
certificate records to indicate the nature of injuries and diseases leading to death. Codes are based on
the International Classification of Diseases 10th edition coding protocols, thus “MultiCondxxICD10”. The
MultiCondxxICD10 elements should be entered into NVDRS exactly as they are coded in the multiple
cause of death fields in death certificate data. These codes can include both diagnosis codes (nature of
injury and disease) and external cause of injury codes. Codes should be entered with decimal points in
the fourth position. No more than 10 codes can be entered.

Section 4: Injury and Death Variables

72 | P a g e

SECTION 5: CIRCUMSTANCE VARIABLES
5.1

General Guidance on Coding NVDRS Circumstances

NVDRS collects information on the specific circumstances that are reported or perceived in the
investigative reports (i.e., CME report, law enforcement and death certificate as being related to the
violent death. For the vast majority of circumstances, inclusion in the investigation reports and/or
occurring before or right after the fatal injury (e.g., preceding or impending events) is sufficient to code
a circumstances. Specific guidance is provided below. These circumstances will help to identify, develop,
and evaluate preventive interventions. This section describes these circumstances and general guidance
on coding circumstances is provided below.

5.1.1

Circumstances Describe the Victim

Circumstance data elements in NVDRS are part of the victim’s record and apply to victims in an incident.
This is important to keep in mind when coding homicide incidents—circumstances must be interpreted
as they apply to the victim, not to the suspect. For example, if a person is fired from a job and later kills
the manager who fired him, this would not lead to endorsing the “Job problem” circumstance: the
victim in this case is the manager who fired him.
Also, in incidents with multiple victims, please make sure to check the circumstances specific to that
victim. For instance, one victim of an incident may have been killed as part of a robbery while the
second victim was killed by law enforcement responding. The circumstances for these two victims
should be different.

5.1.2

Coding Mental Health, Alcohol and Substance Abuse Problems

For circumstances related to mental health, alcohol or substance abuse problems or other addictions,
abstractors should code these “Yes” if there is any indication of these problems in investigation reports.
A direct link to the death is not required. These circumstances are coded for all victims.

5.1.3

Coding Circumstances Not Related to Mental Health, Alcohol, and Substance Abuse
Problems

For other circumstances, the circumstance should be endorsed if there is an indication that it was
perceived by investigators as related to the death based on interviews or the investigation (e.g.,
mentioned in suicide note, family reports the victim was upset about financial problems, or argument
was perceived by witnesses to escalate into the homicide). Because law enforcement and CME reports
are investigative reports, inclusion in the report and/or the circumstance closely preceding or occurring
right after the fatal incident (e.g., preceding or impending events) is sufficient to code the circumstance
as “Yes”. For instance, a victim going bankrupt a few days before a suicide, a homicide occurring during a
robbery, or a suicide occurring the day before a court appearance should be coded (i.e., inclusion in the
investigative report does indicate its perceived involvement).

Section 5: Circumstance Variables

73 | P a g e

There are two exceptions to this rule. Health problems and criminal history are sometimes listed as a
routine part of the investigation. Criminal legal problems and health problems should not be endorsed if
they are simply listed as part of the routine investigation (e.g., victim had diabetes and heart disease or
victim had criminal history of burglary) and there is no indication they were related to the death.

5.1.4

Changing Some Circumstances to Suicide or Homicide Only Circumstances

Due to low use and/or lack of clarity in coding, several circumstances currently coded for all deaths will
now only be coded for homicide or suicides. Please review the guidance on each variable.

5.1.5

New Format for Crisis Variables

Prior to August 2013, abstractors were asked to indicate whether the event was related to a crisis by
checking a crisis variable and then indicating in the narrative which circumstances related to a crisis. In
order to better identify which circumstances were related to the crisis, the crisis option is now available
as a checkbox for several circumstances for which it is appropriate. For each of these, the root
circumstance must first be endorsed based on established criteria (See above for guidance). Once the
root circumstance is endorsed, one can consider whether to also endorse a crisis related to that
circumstance based upon the timing of the circumstance in relation to the incident. For instance, a
victim may have an alcohol problem reported by their family. This would lead to checking the “alcohol
problem” circumstance. The “alcohol” crisis circumstance would then be checked if the victim had a
crisis related to their alcohol problem within two weeks of the death (e.g., a relapse a week before the
death or losing their job due to the alcohol problem the day before the death) or an impending crisis
within two weeks of death (e.g., was to be disciplined the day after the suicide for drinking on the job).

5.1.6

Coding the Crisis Variables

The crisis variable is important to identify deaths that appear to involve an element of impulsivity and be
related to a crisis. Consistent with previous coding manual versions, a “Crisis” is a current/acute event
(within 2 weeks of death) that is indicated in one of the source reports to have contributed to the death.
Inclusion in the source document and indication that the event occurred within two weeks of the death
is sufficient to code a circumstance as a crisis. Direct language that the event caused or contributed to
the death is not required to code “Yes”.
The following guidance will assist in identifying crises:
 A crisis can precede the death (e.g., had a bad argument the day before the incident, divorce papers
served that day, or victim laid off the week before) or be an impending event (e.g., house was to be
foreclosed on the day after the incident or court date for a criminal offense three days after the
suicide).
 Crisis should be interpreted from the eyes of the victim. This is particularly relevant for young
victims whose crises, such as a bad grade or a dispute with parents over a curfew, may appear to
others as relatively minor.
 An actual time period for the crisis may not be mentioned in the records, so use language as a clue.
o “Decedent was experiencing financial difficulties after losing his job” would not trigger
coding a recent crisis because the timeframe is unclear
Section 5: Circumstance Variables

74 | P a g e

o






“Decedent had just received a pink slip at work” would be coded because the word “just”
indicates that the crisis occurred right before the death, or within two weeks.
Ongoing/chronic problems should not be coded as crises unless there was an acute change in the
status (change in prognosis of chronic illness). Coding a case as being related to a crisis does not
mean that there aren’t also chronic conditions that have contributed to the victim’s death.
A homicide followed by a suicide should always be coded as “Yes” for “Crisis” for the suicide victim
unless the two deaths were both clearly consensual and planned in advance (i.e., a double suicide).
Crisis Not Related to an Existing Circumstance: If a crisis is related to a death AND not captured by
any of the circumstances, the abstractor should code: “Crisis in past two weeks or upcoming two
weeks (legacy data element)” and provide comments in the “other circumstance” field. Please note
that in the analytic data file, the legacy data element “CrisisRecent” has been archived as of the
2016 dataset in order to avoid confusion. All cases endorsed as having a recent crisis in the legacy
data, as well as current cases with a specific or “other” crisis as described above are captured
under the calculated variable “AnyCrisis_c” in the analytic data file.

Examples of events that should and should not be coded as crises are provided below:


Code “Yes” for Crisis
o The victim’s husband announced the day of her suicide that he was divorcing her.
o A 15-year-old adolescent had a heated argument with his mother, stormed out of the room,
and shot himself.
o The decedent killed his ex-wife and then himself.
o Five days prior to the suicide, the victim was questioned about his suspected sexual abuse of
his two nephews by police.
o The victim was about to be returned to prison in a few days before the suicide.
o After a recent break-up, the decedent went to his girlfriend’s house to attempt
reconciliation. She refused, and he shot himself in her driveway (the crisis, in this case,
would be the refused reconciliation, even if the break-up was not within the past two
weeks).
o An elderly man fell in the bathtub breaking his hip. The next day, his doctor told him that he
would need to go to a nursing home. A week later, he dies by suicide.
o Police were pursuing a suspect. As they drew near, the man turned the gun on himself and
fired. Victim had just received a lay-off notice at work.
o The victim was laid off from work. The next day the victim went back to his office and shot
at his coworkers wounding two of them, before being fatally shot by police.
o The decedent was despondent over recent job loss.



Code “No” for Crisis
o A 45-year-old man was unemployed and experiencing financial difficulties. (Had this
statement been added to his case, “was to be evicted from his apartment the following
weekend” the case would qualify as a “Yes”). The victim had emphysema and the condition
was worsening.
o The victim was in the process of divorcing her husband.

Unless otherwise noted, the response options for crisis variables are:
Response Options:
0
No, Not Available, Unknown
Section 5: Circumstance Variables

75 | P a g e

1

Yes

5.1.7

Export Format of Circumstances

When the circumstance variables are exported into .csv, the variable label for each circumstance will be
preceded by its data source (i.e., “LE_” for law enforcement and “CME_” for CME). For instance, the
circumstance job problem from law enforcement will be exported as “LE_jobproblem” and from CME as
“CME_jobproblem”.

5.1.8

Handling Discrepancies across Data Sources

The circumstances between the CME and LE may not exactly match. This is expected because the
different investigations may reveal different circumstances. For this reason, the circumstances from the
different sources should be coded independently. In a rare instance, one investigation may disprove the
circumstances listed from another data source. For instance, a legal investigation may find a suspect
who killed a spouse originally misled authorities by blaming the death on a robbery. However, the CME
report lists robbery as the precipitating circumstance because it was collected right after the death. In
this rare instance where a circumstance is specifically listed and proved as false in a later report, please
do not check the circumstance that was proved false. Instead, please note in narrative that that the
circumstance was proved false (e.g., CME: Robbery was reported as precipitating circumstance, but later
LE investigation revealed this was a false report).

5.2

Circumstances Known Variables

5.2.1 Circumstances from CME: CME_CircumstancesKnown
5.2.2 Circumstances from LE: LE_CircumstancesKnown
Definitions:
 CME_CircumstancesKnown: Indicates if any information is available in the CME record about the
circumstances, including other circumstances, associated with this violent death.
 LE_CircumstancesKnown: Indicates if any information is available in the LE report about the
circumstances, including other circumstance, associated with this violent death. For victims 17 years
of age or less, states should enter in CFR circumstances in the LE section.
Response Options:
0
No
1
Yes
Discussion:
This variable operates as a stem question. Checking the circumstances known box causes the individual
circumstances to appear on the screen. Un-checking the circumstances known box causes the
circumstances to disappear and implies that the circumstances preceding the incident are not known.
Section 5: Circumstance Variables

76 | P a g e

Important Note: If the abstractor has entered circumstances and un-checks circumstances known box,
the program will delete the entered circumstances when the abstractor presses save.

5.3

Mental Health, Substance Abuse, and Other Addictions

5.3.1

Current diagnosed mental health problem: CME/LE_MentalHealthProblem

Definition:
Current mental health problem
Response Options:
0
No, Not Available, Unknown
1
Yes
Discussion:
Code a victim as “Yes” for “CME/LE_MentalHealthProblem” if he or she has been identified as currently
having a mental health problem. There does not need to be any indication that the mental health
condition directly contributed to the death.








Mental health problems include those disorders and syndromes listed in the Diagnostic and
Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) with the exception of alcohol and other
substance dependence (as these are captured in separate variables).
Examples of disorders qualifying as mental health problems include diagnoses such as major
depression, schizophrenia, and generalized anxiety disorder, as well as neurodevelopmental
disorders (such as intellectual disability, autism, attention-deficit /hyperactivity disorder), eating
disorders, personality disorders, and organic mental disorders (such as Alzheimer’s and other
dementias).
Also indicate “Yes” if it is mentioned in the source document that the victim was being treated for a
mental health problem, even if the nature of the problem is unclear (e.g., “was being treated for
various psychiatric problems”).
It is acceptable to endorse this variable on the basis of past treatment of a mental health problem,
unless it is specifically noted that the past problem has been resolved. However, do not code this
circumstance based only on a positive toxicology test for psychiatric medications (such as
antidepressants). There must also be some indication that the victim was actually being treated for a
mental health condition, such as a current prescription, the report of a family member, etc.

Also code: At least one Mental Health Diagnosis variable should also be coded if this is coded. If the type
of mental health diagnosis is unknown, please code “Type of first mental illness diagnosed” as unknown
or 99.
Manner of Death: All manners

5.3.2 Current diagnosed mental health problem was crisis: CME/LE_CrisisMentalHealth
Examples of possible mental health crises include, but are not limited to: 1) receives diagnosis within
Section 5: Circumstance Variables

77 | P a g e

two weeks of a suicide; 2) condition abruptly changes or worsens within two weeks of the violence (such
as, victim experiencing a psychotic episode or victim fails to comply with medication and
symptomatology increases); and 3) changes in care within two weeks of care (such as victim was
hospitalized, victim’s therapist moves).
Manner of Death: All manners.
Note: This variable was added in August, 2013.

5.3.3

Mental Health Diagnosis Variables
5.3.3.1. Mental health diagnosis 1: CME/LE_MentalHealthDiagnosis1
5.3.3.2. Mental health diagnosis 2: CME/LE_MentalHealthDiagnosis2
5.3.3.3. Other mental health diagnosis: CME/LE_MentalHealthDiagnosisOther

Definitions:
 CME/LE_MentalHealthDiagnosis1/2: Type of mental illness diagnosis
 CME/LE_MentalHealthDiagnosisOther: Other type of mental illness
Response Options:
 CME/LE_MentalHealthDiagnosis1/2:
1 Depression/dysthymia
2 Bipolar disorder
3 Schizophrenia
4 Anxiety disorder
5 Post-traumatic stress disorder
6 Attention Deficit/Hyperactivity Disorder (ADHD)
7 Eating disorder
8 Obsessive-compulsive disorder
66 Other (specify in diagnosis text), including autism, personality disorders, Alzheimer’s, etc.
88 Not applicable
99 Unknown


CME/LE_MentalHealthDiagnosisOther:
Text

Discussion:
This variable indicates the nature of the victim’s mental health problem (the diagnosis), if available.







Code up to two diagnoses and then write in additional diagnoses (i.e., three or more diagnoses) in
the “MentalHealthDiagnosisOther” field. When using the “MentalHealthDiagnosisOther” field,
please separate diagnoses with a comma (e.g., personality disorder, autism).
For cases in which the victim was noted as being treated for a mental health problem, but the actual
diagnosis is not documented, code “Mental health diagnosis 1” as “Unknown”.
If a diagnosis is not on the code list, code “Other” and record the diagnosis in the text field,
“MentalHealthDiagnosisOther”.
Do not attempt to infer a diagnosis based on reading the symptoms.
While it is acceptable to endorse “Mental health problem” based on the victim’s prescription for a

Section 5: Circumstance Variables

78 | P a g e






psychiatric medication, please do not infer or code a specific mental health diagnosis based on the
medication.
Please note that bipolar disorder may be referred to as “manic depression” or similar terms (e.g.,
“manic depressive”) in source documents. While these are outdated terms, please code these cases
as ‘2- Bipolar Disorder.’
Obsessive Compulsive Disorder may be referred to as “OCD” in source documents. Please code
these cases as “8-Obsessive Compulsive Disorder.”
Post-traumatic Stress Disorder may be referred to as “PTSD” in source documents. Please code
these cases as “5-Post-traumatic Stress Disorder.”

Manner of Death: All manners.

5.3.4

Current depressed mood: CME/LE_DepressedMood

Definition:
Victim was perceived by self or others to be depressed at the time of the injury.
Response Options:
0
No, Not Available, Unknown
1
Yes
Discussion:
Only code this variable when the victim had a depressed mood at the time of injury. There does NOT
need to be a clinical diagnosis and there does not need to be any indication that the depression directly
contributed to the death. Other words that can trigger coding this variable besides “depressed” are sad,
despondent, down, blue, low, unhappy, etc. Words that should not trigger coding this variable are
agitated, angry, mad, anxious, overwrought, etc.
 If the victim has a known clinical history of depression, but had no depressive symptoms at the time
of the incident, this variable should NOT be selected.
 Depressed mood should not be inferred by the coder based on the circumstances (e.g., because the
person reports a bankruptcy); rather it must be noted in the record.
Manner of Death: All manners.

5.3.5

Current mental health/substance abuse treatment:
5.3.5.1 CME_MentalIllnessTreatmentCurrnt
5.3.5.2 LE_MentalIllnessTreatmentCurrnt

Definition:
Currently in treatment for a mental health problem or substance abuse problem
Response Options:
0
No, Not Available, Unknown
1
Yes
Discussion:
Section 5: Circumstance Variables

79 | P a g e

This should be coded “Yes” if the victim was in current treatment (e.g., had a current prescription for a
psychiatric medication, saw a mental health professional within the past two months or participated in
treatment for substance abuse such as outpatient treatment or alcohol anonymous) at the time of the
injury.






Treatment includes:
o Seeing a psychiatrist, psychologist, medical doctor, therapist, or other counselor (including
religious or spiritual counselors) for a mental health or substance abuse problem;
o Receiving a prescription for an antidepressant or other psychiatric medicine;
o Attending anger management classes;
o Residing in an inpatient, group home, or halfway house facility for mental health or
substance abuse problems; or
o Alcohol or narcotics anonymous.
Do not code this circumstance based only on a positive toxicology test for psychiatric medications
(such as antidepressants). There must also be some indication that the victim was actually being
treated for a mental health condition, such as a current prescription, the report of a family member,
etc.
Note that a diagnosis does not imply that treatment was received. A victim may have been out of
compliance with treatment for a diagnosed condition.

Also code: If you code “Yes” for “current mental health/substance abuse treatment”, you MUST code
“Yes” for “Ever treated for mental health/substance abuse”.
Also, code “Yes” for either “Current Mental Health Diagnosis”, “Alcohol problem” or “Other substance
problem” as well.
Manner of Death: All manners.

5.3.6 Ever treated for mental health/substance abuse problem:
5.3.6.1 CME_HistoryMentalIllnessTreatmnt
5.3.6.2 LE_HistoryMentalIllnessTreatmnt
Definition:
History of ever being treated for a mental health or substance abuse problem
Response Options:
0
No, Not Available, Unknown
1
Yes
Discussion:
The variable indicates whether the victim was noted as ever having received treatment (e.g., had a
current prescription for a psychiatric medication, saw a mental health professional within the past two
months or participated in self-help program such as alcohol anonymous) for a mental health problem
(including alcohol and other substance abuse problems), either at the time of death or in the past.



If a victim is in current treatment, by definition ever in treatment should be endorsed as well.
Do not code this circumstance based only on a positive toxicology test for psychiatric medications

Section 5: Circumstance Variables

80 | P a g e



(such as antidepressants). There must also be some indication that the victim was actually was
treated for a mental health condition, such as a current prescription, the report of a family member,
etc.
Note that a diagnosis does not imply that treatment was received. A victim may have been out of
compliance with treatment for a diagnosed condition.

Manner of Death: All manners.

5.3.7

Alcohol problem: CME/LE_AlcoholProblem

Definition:
Person has alcohol dependence or alcohol problem
Response Options:
0
No, Not Available, Unknown
1
Yes
Discussion:
Code as “Yes” if the victim was perceived by self or others to have a problem with, or to be addicted to,
alcohol. There does not need to be any indication that the alcohol problem directly contributed to the
death.
 A victim who is noted as participating in an alcohol rehabilitation program or treatment — including
self-help groups and 12-step programs — should be coded as “Yes” for “AlcoholProblem” even if the
victim was noted as being currently sober.
A problem from the past (i.e., five years or more ago) that has resolved and no longer
appears to apply should not be coded.
 Do not code if victim was using alcohol in the hours preceding the incident and there is no evidence
of dependence or a problem.
Manner of Death: All manners.

5.3.8

Alcohol problem was a crisis: CME/LE_CrisisAlcoholProblem

Examples include an alcoholic who relapsed two days before the death after being sober for six
months or an alcohol problem causes a conflict at work (e.g., getting fired for drinking) or home just
before the death.
Note: This variable was added in August, 2013.
Manner of Death: All manners.

5.3.9

Other substance problem: CME/LE_SubstanceAbuseOther

Definition:
Section 5: Circumstance Variables

81 | P a g e

Person has a non-alcohol related substance abuse problem
Response Options:
0
No, Not Available, Unknown
1
Yes
Discussion:
Code as “Yes” if the victim was perceived by self or others to have a problem with, or to be addicted to
drugs other than alcohol. There does not need to be any indication that the addiction directly
contributed to the death. “SubstanceAbuseOther” can be endorsed if a victim was noted as using illegal
drugs (such as heroin or cocaine), abusing prescription medications (such as pain relievers or Valium), or
regularly using inhalants (e.g., sniffing gas).
 A victim who is noted as participating in a drug rehabilitation program or treatment — including
self-help groups and 12-step programs — should be coded as “Yes” for “SubstanceAbuseOther”
even if the victim was noted as being currently clean.
 A problem from the past (i.e., five years or more ago) that has resolved and no longer appears to
apply should not be coded.
 If the victim is mentioned as using illegal drugs — even if addiction or abuse is not specifically
mentioned — code “SubstanceAbuseOther” as “Yes”.
 The exception to this is marijuana use. For marijuana, the use must be noted as chronic, abusive, or
problematic (e.g., “victim smoked marijuana regularly,” “victim’s family indicated he had been
stoned much of the past month”).
 If marijuana was used at the time of the incident, and there is no evidence of regular use, addiction,
or abuse, code to “Other circumstance”.
 The phrase “history of drug abuse” is sufficient to justify endorsing “SubstanceAbuseOther”, unless
it is noted that the victim is no longer a drug user.
 Previously attempting suicide via overdose is not sufficient justification for endorsing
“SubstanceAbuseOther” in the absence of other information.
 Do not code based on toxicology findings because multiple reasons could explain the presence of
the substances.
Manner of Death: All manners.
Note: As of August, 2013, a victim who takes methadone is no longer assumed to be in treatment for
heroin addiction and should be coded as “No” unless other information is available (e.g., taking
methadone as part of substance abuse treatment). Please note that the victim is taking methadone on
the toxicology page.

5.3.10 Other substance problem was crisis: CME/LE_CrisisSubstanceAbuse
Definition:
Examples include a victim who experiences a relapse just before the death or a victim whose (nonalcohol related) substance abuse problem causes a conflict at work (e.g., fired from job due to substance
use) or home just before the death.
Note: This variable was added in July, 2013.
Section 5: Circumstance Variables

82 | P a g e

Manner of Death: All manners.

5.3.11 Other addiction: CME/LE_OtherAddiction
Definition:
Person has an addiction other than alcohol or other substance abuse, such as gambling, sexual, etc., that
appears to have contributed to the death.

Response Options:
0
No, Not Available, Unknown
1
Yes
Discussion:
Code as “Yes” if the victim was perceived by self or others to have an addiction not related to alcohol or
other substance abuse such as gambling or sexual addictions, and there is some indication that this
addiction may have contributed to the death.
The incident narrative should describe the nature of the addiction.
Note: This variable was added in 2009.
Manner of Death: All manners.

5.3.12 Other addiction was crisis: CME/LE_CrisisOtherAddiction
An example is a victim whose gambling problem causes a conflict at work or home just before the death.
Note: This variable was added in July, 2013.
Manner of Death: All manners.

5.4

Relationships, Abuse and Life Stressors

5.4.1

Intimate partner violence related: CME/LE_IntimatePartnerViolence

Definition:
Identifies cases in which the homicide or legal intervention is related to immediate or ongoing conflict or
violence between current or former intimate partners. This includes all deaths where a victim is killed by
their current or former intimate partner.
Response Options:
Section 5: Circumstance Variables

83 | P a g e

0
1

No, Not Available, Unknown
Yes

Discussion:
 Definition of Intimate Partner±:
For all intimate partner-related variables intimate partner ±is defined as a current or former
girlfriend/boyfriend, dating partner, ongoing sexual partner, or spouse. It DOES NOT include
instances of sex/intimacy in exchange for money/goods. There must be evidence of an intimate
relationship (this does not apply to instances where there is simply attraction/infatuation between
two individuals or in cases where one person is romantically interested in the other, but the feelings
are not returned). The definition of intimate partner does not require sexual intimacy. This definition
includes same-sex partners.
 This should be coded to represent a fatal incident in which an intimate partner kills their current or
former intimate partner (e.g., husband kills wife) or where intimate partner conflict contributed to
the death of the victim.
 Use this code for ‘domestic disputes’ or ’domestic violence’ homicides or legal interventions. The
narrative should indicate the nature of the dispute (e.g., end of relationship, divorce, or custody
dispute) and who was involved in the dispute.
 In some instances, this code will be applied in cases associated with intimate partner violence, but
are not deaths of the intimate partners themselves.
o Use this code for cases in which one intimate partner kills their partner’s new or former
intimate partner (e.g., Ex-husband kills his ex-wife’s new boyfriend), or the person the
partner is having an affair with (e.g., husband kills the man his wife had an affair with).
o Use this code for cases in which someone is killed when someone intervenes in an intimate
partner violence incident. For instance, a bystander witnessed a man assaulting his wife. The
bystander tried to intervene and was shot by the husband. Use this code when the suspect
retaliates in response to an intimate partner violence incident (e.g., Son killed his mother’s
boyfriend after finding out that the boyfriend had assaulted her).
o Use this code if other people are also killed (a child, friend of the victim, a bystander), and
even if the intimate partner is not (e.g., boyfriend kills his girlfriend’s child because he is
angry at her).
o Use this code when the perpetrator of intimate partner violence is killed by law
enforcement (e.g., victim was attacking spouse when police responded and victim then
attacked police and was killed).
o Remember not to code cases where the suspect had a romantic interest, but never dated
the victim or his/her intimate partners. Code the following violent incident “No”. The
suspect and his friend began arguing over a girl at party that they both were interested in,
but neither had ever dated. The argument escalated and the suspect pulled out a knife and
killed his friend.
Manner of Death: Homicide and legal intervention
± This definition is based on the CDC/National Center for Injury Prevention and Control standard
definition of Intimate Partner Violence. Source:
http://www.cdc.gov/violenceprevention/pdf/ipv_surveillance_definitions.pdf

5.4.2

Intimate partner problem: CME/LE_IntimatePartnerProblem

Section 5: Circumstance Variables

84 | P a g e

Definition:
Problems with a current or former intimate partner appear to have contributed to the suicide or
undetermined death.
Response Options:
0
No, Not Available, Unknown
1
Yes
Discussion:
Code as “Yes” if at the time of the incident the victim was experiencing problems with a current or
former intimate partner, such as a divorce, break-up, argument, jealousy, conflict, or discord, and this
appears to have contributed to the death.


Definition of Intimate Partner:
 For all intimate partner-related variables intimate partner± is defined as a current or former
girlfriend/boyfriend, dating partner, ongoing sexual partner, or spouse. It DOES NOT include
instances of sex/intimacy in exchange for money/goods. There must be evidence of an intimate
relationship (this does not apply to instances where there is simply attraction/infatuation
between two individuals or in cases where one person is romantically interested in the other, but
the feelings are not returned). The definition of intimate partner does not require sexual
intimacy. This definition includes same-sex partners.



The burden of caring for an ill spouse or partner should NOT be coded as an intimate partner
problem unless there is also evidence of relationship problems.
Phrases such as “victim was having relationship problems” can be assumed to indicate intimate
partner problems.



Manner of Death: Suicide and undetermined deaths
± This definition is based on the CDC/National Center for Injury Prevention and Control standard
definition of Intimate Partner Violence. Source:
http://www.cdc.gov/violenceprevention/pdf/ipv_surveillance_definitions.pdf

5.4.3

Intimate partner problem was crisis: CME/LE_CrisisIntimatePartnerProblem

Examples include the victim found out the morning of her suicide that her husband had filed for a
divorce, the victim had a very bad argument with his wife about his drinking problem two days before
the suicide, or the victim found out a week ago that his spouse was having an affair and moved out of
their house.
Note: This variable was added in August, 2013.
Manner of Death: Suicide and undetermined deaths

Section 5: Circumstance Variables

85 | P a g e

5.4.4

Family relationship problem: CME/LE_FamilyRelationship

Definition:
Victim had relationship problems with a family member (other than an intimate partner) that appear to
have contributed to the death.
Response Options:
0
No, Not Available, Unknown
1
Yes
Discussion:
Code as “Yes” if at the time of the incident the victim was experiencing a relationship problem with a
family member other than an intimate partner (e.g., a child, mother, in-law), and this appears to have
contributed to the death. This variable does NOT capture problems related to the family environment
that do not explicitly pertain to the victim’s relationship with a family member (e.g., the stress of caring
for a sick family member).



Suicide example: The victim is despondent over his argument with his parents and dies by
suicide.
Homicide example: The victim and his brother are estranged and get into a fight at a family
reunion in which the victim is killed.
o If the report indicates that the victim was “having relationship problems”, these should
be assumed to be intimate partner problems, and not problems with other friends or
family.
o This code should not be endorsed for custody disputes when the victim is a child
because the relationship problem in these instances is typically not with a child or other
non-intimate partner family member. If the custody dispute affects the relationship of
the parent and child, then this should be coded “Yes”.
o Narrative should contain an explanation of the relationship problem and identify the
family member with whom the victim had a problem.

Note: This variable was added in August, 2013 and replaced family stressor but also changed the coding
guidance associated with that variable. It also changed the focus of “Other relationship problem” (see
below, 5.4.6) to exclude relationship problems with family, which are now captured here.
Manner of Death: All manners

5.4.5 Family relationship problem was crisis: CME/LE_CrisisFamilyRelationship
Examples include the victim has a bad argument with his brother the day before his brother attacks and
kills him or the victim has an argument with his parents about a school suspension the night before the
suicide.
Note: This variable was added in August, 2013.
Manner of Death: All manners

Section 5: Circumstance Variables

86 | P a g e

5.4.6

Other relationship problem: CME/LE_RelationshipProblemOth

Definition:
Problems with a friend or associate (other than an intimate partner or family member) appear to have
contributed to the death.
Response Options:
0
No, Not Available, Unknown
1
Yes
Discussion:
Code as “Yes” if at the time of the incident the victim was experiencing a relationship problem with
someone other than an intimate partner or other family member (e.g., a friend or schoolmate), and this
appears to have contributed to the death.
 Suicide example: The victim was upset because she had a falling out with her childhood friend who
would no longer talk to her.
 Homicide example: The victim was having a problem with one of his friends (i.e., the suspect) who
kept stealing things from his house due to a drug problem. When the victim tried to take one of the
items back from his house, the suspect shot him.
o Do not code relationship problems co-work or supervisors (e.g., boss) with whom the victim
is not friends or had a romantic relationship. Consider coding these as “job problems”.
o If the report indicates that the victim was “having relationship problems”, these should be
assumed to be intimate partner problems, and not problems with other friends or family or
other relationship problems.
o Narrative should contain an explanation of the relationship problem and identify the person
with whom the victim had a relationship problem.
Note: Before August 2013, this included any relationship except intimate partners. After August 2013,
this includes any relationship except intimate partner or family relationships.
Manner of Death: All manners

5.4.7

Other relationship problem was crisis: CME/LE_CrisisRelationshipProblemOther

Examples includes a close friend telling the victim the night before the suicide that he can no longer be
friends with him or the victim kicks a friend out of his house because he cannot pay rent and the friend
comes back the next day and shoots him.
Note: This variable was added in July, 2013.
Manner of Death: All manners

5.4.8

Abuse/neglect led to death: CME/LE_DeathAbuse

Definition:
The victim experienced abuse± (physical, sexual, or psychological) or neglect (physical, including
Section 5: Circumstance Variables

87 | P a g e

medical/dental, emotional, or educational neglect; or exposure to violent environments or inadequate
supervision) by a caretaker that resulted in death.
±Source: Leeb RT, Paulozzi L, Melanson C, Simon T, Arias I. Child Maltreatment Surveillance: Uniform
Definitions for Public Health and Recommended Data Elements, Version 1.0. Atlanta (GA): Centers for
Disease Control and Prevention, National Center for Injury Prevention and Control; 2008.
Available from: http://www.cdc.gov/ViolencePrevention/pub/CMP-Surveillance.html
Response Options:
0
No, Not Available, Unknown
1
Yes
Discussion:
This variable identifies homicides where the victim died as a result of injuries sustained due to abuse or
neglect and suicides related to ongoing or past experiences of abuse or neglect. This includes all sources
of abuse/neglect including child abuse, elder abuse, and other abuse by a caretaker. Indicate the nature
of the abuse in the incident narrative.
 Abuse can be physical, psychological, sexual, or another type as long as the source document refers
to ‘abuse’.
 Intimate partner violence or intimate partner problems should NOT be coded when using this code.
These should be coded as “Intimate partner violence”.
 Homicides
o Code “Yes” if the victim died as a result of injuries from a single or multiple episodes of
abuse or because of ongoing abuse by a caretaker.
o Code “Yes” if the suspect was a caretaker of the victim
 Suicides
o Code “Yes” if a single incident or ongoing or past abuse by a caretaker was seen as a
precipitating factor for the suicide (e.g., victim despondent over being abused by his
grandfather the week before the suicide).
o If there is evidence of abuse (e.g., victim was abused by father as a child), but no clear
indication that this abuse led to the death then do NOT code “DeathAbuse”. Instead, you
should code “History of abuse/neglect as a child”.
 Examples that should be coded “Yes”:
o The victim was an elderly man who died of multiple wounds received as a result of physical
abuse by his paid caretaker.
o The day before the suicide the victim was despondent and depressed about confronting her
parents about past abuse.
Also code: History of abuse/neglect as a child if applicable.
Note: The variable was added in August, 2013.
Manner of Death: All manners

5.4.9

History of abuse or neglect as a child: CME/LE_AbusedAsChild

Section 5: Circumstance Variables

88 | P a g e

Definition:
The victim had a history of abuse± (physical, sexual, or psychological) or neglect (physical, including
medical/dental, emotional, or educational neglect; or exposure to violent environments or inadequate
supervision) as a child.
±Source: Leeb RT, Paulozzi L, Melanson C, Simon T, Arias I. Child Maltreatment Surveillance: Uniform
Definitions for Public Health and Recommended Data Elements, Version 1.0. Atlanta (GA): Centers for
Disease Control and Prevention, National Center for Injury Prevention and Control; 2008.
Available from: http://www.cdc.gov/ViolencePrevention/pub/CMP-Surveillance.html
Response Options:
0
No, Not Available, Unknown
1
Yes
Discussion:
This variable more broadly captures victim’s experiences of abuse and neglect irrespective of its
relationship to the violent death. Code “Yes” if the victim experienced abuse or neglect, but there is no
direct link to the violent death or the link is unknown.







Do NOT code if the abuse or neglect directly causes or precipitated the death, instead code
abuse/neglect led to death.
Code as “Yes” if the victim had been the victim of child abuse at any point in the past even if the
victim is currently an adult.
Code “Yes” if the evidence of ongoing abuse is suspected, but not confirmed. Code “Yes” if autopsy
evidence reported an indication of previous abuse.
Abuse can be physical, psychological, sexual or others as long as the source document refers to
‘abuse’. Neglect may be physical or emotional.
Indicate the nature of the abuse or neglect in the incident narrative.
Abuse could have been perpetrated by a caretaker or other individual.

Note: This variable was added in 2009. Before August, 2013, this variable was used to collect deaths
related to abuse and deaths related to intimate partner violence that had a history of abuse. As of
August 2013, this variable captures any history of abuse as a child outside the fatal incident.
Manner of Death: All manners

5.4.10 Previous perpetrator of violence in the past month:
CME/LE_InterpersonalViolencePerpet
Definition:
Victim was a perpetrator of violence within the past month that was distinct and occurred before the
violence that killed the victim.
Response Options:
0
No, Not Available, Unknown
1
Yes
Section 5: Circumstance Variables

89 | P a g e

Discussion:
This variable refers to all violence (e.g., a robbery of a stranger or an assault in a bar).





There does not need to be any causal link between the earlier violence and the death itself.
This variable should also be coded “Yes” if a restraining order has been filed against the victim
within the past month.
This should NOT be coded to represent the fatal incident. For instance, if the victim is killed while
assaulting another person, this variable would be coded “No”.
A victim/suspect who perpetrates a homicide and then dies by suicide (e.g., homicide followed by
suicide) should be coded as “Yes”. Also code: Intimate partner violence or intimate partner problem,
if applicable.

Manner of Death: All manners

5.4.11 Previous victim of violence in the past month: CME/LE_InterpersonalViolenceVictim
Definition:
Victim experienced violence in the past month that was distinct and occurred before the violence that
killed the victim.
Response Options:
0
No, Not Available, Unknown
1
Yes
Discussion:
This variable refers to all violence (e.g., a robbery targeting the victim or the victim is assaulted in a bar
two weeks before the incident).
 Intimate partner violence should be coded as “Yes”. For instance, code” Yes” if a victim was
assaulted by her husband two weeks before she was killed by him.
 There does not need to be any causal link between the earlier violence and the death itself (e.g.,
victim experienced a robbery by a stranger two weeks before being killed by his spouse).
 This should NOT be coded to represent the violence involved in the fatal incident. For instance, the
victim dies of a result of a fight in a bar.
Manner of Death: All manners

5.4.12 Physical fight between two people: CME/LE_FightBetweenTwoPeople
Definition:
Immediately before the violent death, there was a physical fight between two individuals which resulted
in the death of individuals involved in the fight, bystanders, or individuals trying to stop the fight.
Response Options:
0
No, Not Available, Unknown
1
Yes
Section 5: Circumstance Variables

90 | P a g e

Discussion:
This code is meant to capture violent deaths that appear unplanned and occur in the heat of a physical
confrontation. Code all physical confrontations (e.g., slapping, pushing, punching, kicking, scratching,
etc.).











This should NOT be coded when the suspect attacks the victim as part of a crime (e.g., an attempted
robbery or burglary) or in an unprovoked manner (e.g., walks up and attacks the person or
ambushes them from a hiding place) even if a physical fight results. Consider coding 'Precipitated by
another crime' and 'first other crime in progress' or 'walk-by assault'.
Most physical fights will be preceded by arguments. In these cases, the abstractor should also code
arguments and timing of arguments.
When this code is endorsed, the narratives should provide information on what the physical fight
was about, whether the conflict was new or was related to a series of arguments, and whether the
fight occurred in a private or in public setting.
When a Supplemental Homicide Report (SHR) indicates a “brawl”, it may be a physical fight (i.e.,
physical confrontation among two people) or a brawl (i.e., physical confrontation among three or
more people) in NVDRS. Please review the narrative and code appropriately.
Suicide example: The victim was arguing with his father and got into a pushing match which resulted
in the victim being pushed to the ground. The victim was very upset and went into the next room
and killed himself with a handgun.
Homicide examples:
o The suspect was asking to see his ex-wife and a new boyfriend would not let him in to see
her. They scuffled and the boyfriend threw the suspect out of the house. At that point, the
suspect pulled a gun and shot and killed the boyfriend.
o The suspect and his friend began arguing over a girl at party that they both were interested
in. The argument escalated and the suspect pulled out a knife. The friend and suspect began
scuffling. The victim attempted to break up the fight between the suspect and his friend and
was stabbed.

Also code: Almost always an argument will precede the physical fight. Thus, consider coding “argument”
and “Timing of the most recent argument” when coding this variable.
Manner of Death: All Manners
Note: This variable was added in August, 2013.

5.4.13 Argument: CME/LE_Argument
Definition:
An argument or conflict that led to the victim’s death.
Response Options:
0
No, Not available, unknown
1
Yes
Discussion:
Section 5: Circumstance Variables

91 | P a g e

This variable identifies violent deaths where a specific argument was perceived as related to the death.
There must be a specific argument or disagreement that is related to the violent death (e.g., an
argument over money, a relationship problem or an insult) to code this variable “Yes”.








The following should be coded “Yes”:
o Homicide Example: If a verbal argument immediately escalates into a physical confrontation
(e.g., a bar argument leads to a fight where the victim is killed), code argument as “Yes”.
o Suicide Examples: If a child has an argument with their parent, becomes distraught and then
dies by suicide that night, code “Yes”.
 A principal expels the victim from school after which victim dies by suicide
 Victim has an argument with his boss over poor performance then goes to a local
park and dies by suicide
The following should be coded “No”:
o A relationship problem is insufficient to code this variable. A specific argument prior to the
death must be noted in the investigative reports.
o Code “No” if it was only reported the child argued constantly with his parents, but no
specific argument was noted in the investigative reports (Note: this should be coded using
the “family relationship problem”).
o Ongoing conflicts (e.g., a husband and wife argue a lot, but no specific argument was noted
prior to death) should be coded “No” (Note: this information should be coded using the
intimate partner problem or family relationship problem variable).
o If there are chronic arguments, code “Yes” if a specific argument is noted (e.g., child and
parent argued a lot and they had a very upsetting argument the night before the suicide).
If the victim had a history of abuse by the suspect, argument would be coded “No” unless there was
a specific argument related to victim’s death (e.g., victim, an elderly man, told his caretaker that he
was going to report him to the police for abuse before the caretaker killed him).
The following types of death should also be coded as “No”:
o The victim is killed committing a crime such as robbery or burglary not motivated by a
previous argument with the victim
o The victim is killed by law enforcement acting in the line of duty
o The victim is killed while committing a crime (e.g., robbery, assault) by sanctioned security
or a person acting in self-defense

Also code: Always complete “Timing of the most recent argument” when this variable is checked.
Note: This variable was modified in two ways in August, 2013. First, the “other argument” and
“argument over money and property” were combined into a single variable. Second, the previous
prohibition not to use this code when “intimate partner violence” and “jealousy between intimate
partners” are coded has been removed. Code based on the guidance above regardless of other
circumstances checked.
Manner of Death: All manners

5.4.14 Timing of the most recent argument: CME/LE_ArgumentTiming
Definition:
Timing of the argument that led to victim’s death
Section 5: Circumstance Variables

92 | P a g e

Response Options:
1
Injury occurred during argument
2
Injury occurred within 24 hours, but not during argument
3
Injury occurred between 24 hours and 2 weeks
4
Injury occurred more than 2 weeks after argument
9
Timing unknown
Discussion:
This variable can help determine what percent of violent deaths are immediately preceded or occur
within two weeks of an argument.



This variable is only completed when “argument” is checked.
Violence is considered as occurring during an argument if the violence occurs immediately following
an argument (e.g., the victim shoots himself right after arguing with his wife) or the suspect leaves
the argument to grab a weapon that they immediately use to kill the suspect.
 If the argument is described as “leading to the violence” or occurring “just” before violence, code
“1”, or injury occurred during argument.
 If there is a pause between the argument and the violence (e.g., suspect comes back the next day to
attack the victim with which he argued or the suicide occurs the morning after the argument), this
should be coded as occurring within 2 weeks of the argument.
 If the argument was described as occurring “recently” or using similar terminology that denotes an
unspecified timeframe in the recent past (i.e., the victim has been very upset since his recent
argument with his boss), code as “3”, or injury occurred between 24 hours and 2 weeks after
argument.
Note: This variable was added in August, 2013.
Manner of Death: All manners

5.5

Crime and Criminal Activity

5.5.1

Precipitated by another crime: CME/LE_PrecipitatedByOtherCrime

Definition:
The death was precipitated by another serious crime (e.g., drug dealing, robbery)
Response Options:
0
No, Not available, Unknown
1
Yes
Discussion:
This variable identifies the proportion of violent deaths that are related to other criminal activity,
specifically felonies (e.g., robbery or drug-trafficking). It uses a somewhat broader definition than that
used by the Supplementary Homicide Report system — which only counts felony-related deaths as
those that occur while another felony is in progress.
Section 5: Circumstance Variables

93 | P a g e

Code a victim as “Yes” for “Crime” if the incident occurred as the result of another serious crime. Note
that the crime must occur prior to the violent injury, and not after it.










Serious crimes (such as drug trafficking, robbery, burglary, motor vehicle theft, arson, resisting
arrest, and witness intimidation/elimination) are felonies. These are crimes that carry a sentence of
one or more years in prison.
Misdemeanors such as traffic infractions, shoplifting, petty larceny (e.g., stealing someone’s jacket),
public drunkenness, and minor assaults (no injury or deadly weapon involved) are not considered
serious crimes.
The simple existence of an additional crime other than the homicide in an incident is not sufficient
grounds for endorsing “PrecipitatedCrime”, as homicide suspects are frequently charged with more
than one crime (e.g., carrying a gun without a permit, destroying evidence). The other crime must
be a precipitating factor in order for a “Crime” to be endorsed.
A bystander inadvertently killed during the commission of another crime should be coded.
If you check “PrecipitatedCrime”, you must indicate what the precipitating crime was “Nature of
first other crime” and if it was “in progress” at the time of the violent injury.
“PrecipitatedCrime” must be checked for all incidents involving “Legal Intervention” as the
abstractor- assigned type of death because law enforcement applied force in response to a crime.

Manner of Death: All manners

5.5.2 Nature of Other Precipitating Crime Variables
5.5.2.1 Nature of first other crime: CME/LE_NatureOtherCrime1
5.5.2.2 Nature of second other crime: CME/LE_NatureOtherCrime2
Definitions:
 Nature of first other crime: Nature of the first crime that precipitated the incident (Applies only to
crime-related deaths)
 Nature of second other crime: Nature of the second crime that precipitated the incident (Applies
only to crime-related deaths with more than one precipitating crime)
Response Options:
1
Drug trade
2
Robbery
3
Burglary
5
Motor vehicle theft
6
Arson
7
Rape, sexual assault
9
Gambling
10
Assault, homicide
11
Witness intimidation/elimination
66
Other (specify in narrative)
88
Not applicable
99
Unknown
Discussion:
For cases in which the incident was precipitated by another serious crime, these two variables identify
Section 5: Circumstance Variables

94 | P a g e

the specific type of crime involved. The information is used to better characterize the types of criminal
violence that lead to violent death. When multiple crimes are committed, please list crimes in progress
first and then other crimes. For instance, the victim robs a store earlier in the day and police come to
arrest him later that day on a tip. The victim shoots at the police and is killed. This should be coded
“Nature of first crime: Assault, homicide” (i.e., shooting at police) and “Nature of second crime:
Burglary” (i.e., police trying to arrest for a robbery).
Response definitions:
 Drug trade – The buying, selling, or passing of drugs from one person to another in exchange for
goods or money.
 Robbery – Taking, or attempting to take, anything of value from another person or persons by force
or threat of force or violence. If money or goods are stolen without force or threat of force (e.g.,
thieves stealing equipment from a loading dock), the theft is not a robbery, but larceny, and should
be coded as “Other”.
o Remember, shoplifting and petty larceny (e.g., stealing someone’s jacket) should NOT be
coded because these are not felonies.
 Burglary – The unlawful entry into a building or other structure without the owner’s consent and
with the intent to commit a felony or a theft.
 Motor vehicle theft – The theft or attempted theft of a motor vehicle includes the stealing of
automobiles, trucks, buses, motorcycles, motor-scooters, snowmobiles, etc. Does not include taking
a motor vehicle for temporary use by those persons having lawful access, nor does it include stealing
motor vehicle parts. Stealing motor vehicle parts without force or the threat of force is larceny and
should be coded as “Other”.
 Arson – To unlawfully and intentionally damage, or attempt to damage, any building, real estate, or
personal property by fire or incendiary device. An arsonist or building owner burns down a building
for economic advantage and someone dies in the fire. Victims are considered victims of a criminal
homicide even if their deaths were not intended.
o Do not code arson when it is used to cover up a homicide (because the arson was not a
precipitating event).
 Rape, sexual assault (i.e., sexual violence±) – Sexual violence is defined as a sexual act that is
committed or attempted by another person without freely given consent of the victim or against
someone who is unable to consent or refuse. It includes: forced or alcohol/drug facilitated
penetration of a victim; forced or alcohol/drug facilitated incidents in which the victim was made to
penetrate a perpetrator or someone else; nonphysically pressured unwanted penetration;
intentional sexual touching; or non-contact acts of a sexual nature. Sexual violence can also occur
when a perpetrator forces or coerces a victim to engage in sexual acts with a third party.
 Gambling – To illegally play games of chance for money or other stakes with the hope of gaining
something beyond the amount played. This includes dealing, operating, or maintaining any game.
 Assault/homicide – An unlawful fatal or nonfatal attack by one person upon another. To qualify as a
serious crime, the assault should be an aggravated assault (one that involves bodily injury or threat
with a deadly weapon).
 Witness intimidation/elimination – To prevent a witness from providing information to the
authorities about a crime either by killing, harming, or removing the witness, or by intentionally
saying or doing something that would cause the witness to be fearful of providing information.
Manner of Death: All manners
± This definition is based on the CDC/National Center for Injury Prevention and Control standard
Section 5: Circumstance Variables

95 | P a g e

definition of Sexual Violence. Source:
http://www.cdc.gov/violenceprevention/pdf/sv_surveillance_definitions.pdf

5.5.3

First crime in progress: CME/LE_OtherCrimeInProgress

Definition:
The precipitating crime was in progress at the time of the incident
Response Options:
0
No, Not Available, Unknown
1
Yes

Discussion:
An “in-progress crime” is a serious or felony-related crime, as discussed under “Precipitated by another
crime,” that is being committed or attempted at the time of the incident.








For deaths that are precipitated by felony- criminal activity (as discussed in, “Precipitated by another
crime”), this variable identifies whether the crime listed for “first other crime in progress” was in
progress when the victim died.
The Supplementary Homicide Report (SHR) system defines felony-related only in terms of inprogress felonies. Because NVDRS uses a broader definition for felony crime-related, this variable
can be used to distinguish violent deaths where the precipitating felony was in progress (i.e., the
SHR definition) or violent deaths that occurred after the precipitating felony crime was committed.
Homicide examples:
o A law enforcement officer responded to a robbery and shot the victim when he shot at the
officer (Note: the precipitating crimes are robbery and assault of the officer and both were
in progress). Precipitated by another crime should be checked for all legal interventions
unless the shooting was accidental.
o The victim during a robbery is shot by a bystander.
o An argument breaks out over a drug deal involving five people. Two are killed and one other
is shot.
Suicide example:
o The victim assaults a store owner and is pursued by law enforcement. Once law
enforcement corners him in a building, the victim dies by suicide (Note: Also, code criminal
legal problem).

Manner of Death: All manners

5.5.4

Stalking: CME/LE_Stalking

Definition:
Stalking behaviors precipitated the violent incident. Stalking involves a pattern of harassing or
threatening tactics used by a perpetrator that is both unwanted and causes fear or safety concerns in
the victim. A person may be considered a stalking victim if they experienced multiple stalking tactics or a
Section 5: Circumstance Variables

96 | P a g e

single stalking tactic multiple times by the same perpetrator±. Examples of stalking tactics include:








Unwanted phone calls, voice or text messages, hang-ups
Unwanted emails, instant messages, messages through social media
Unwanted cards, letters, flowers, or presents
Watching or following from a distance, spying with a listening device, camera, or global
positioning system (GPS)
Approaching or showing up in places such as the victim’s home, workplace, or school when it
was unwanted
Leaving strange or potentially threatening items for the victim to find
Sneaking into victims’ home or car and doing things to scare the victim or let the victim know
the perpetrator had been there

± This definition is based on the CDC/National Center for Injury Prevention and Control standard
definition of stalking, from the National Intimate Partner and Sexual Violence Survey (NISVS) 2010
Summary Report. Source: http://www.cdc.gov/violenceprevention/pdf/nisvs_report2010-a.pdf
Response Options:
0
No, Not Available, Unknown
1
Yes
Discussion:
This variable identifies the proportion of violent deaths that are related to stalking or in which stalking
facilitated a suspect in committing violence against a victim. Stalking is not limited to intimate partners
and can involve stranger, friends, or co-workers.




Code “stalking” as “Yes” if there is indication that stalking precipitated the incident. This can occur in
situations that involved intimate partner violence (e.g., victim had taken out a restraining order
because the suspect was stalking her), sexual violence (e.g., suspect had stalked the victim before
raping and killing her), a serial killing (e.g., suspect stalked victim prior to attack) or bullying.
Code “stalking” as “Yes” if the victim was the stalker (e.g., law enforcement killed the stalker during
a shootout).

Manner of Death: Homicide and legal intervention
Note: This variable was added in August, 2013.

5.5.5

Stalking was crisis: CME/LE_CrisisStalking

Examples include the victim confronting the stalker the night before being killed or the victim filing a
restraining order on the stalker the week before being killed.
Manner of Death: Homicide and legal intervention
Note: This variable was added in August, 2013.
Section 5: Circumstance Variables

97 | P a g e

5.5.6

Prostitution: CME/LE_Prostitution

Definition:
Prostitution or prostitution-related activities played a precipitating role in the incident.
Response Options:
0
No, Not Available, Unknown
1
Yes
Discussion:
Prostitution includes the prostitutes, pimps, clients, and other persons who are involved in such activity
(e.g., prostitution ring, sex trafficking).
 Code “Prostitution” as “Yes” if the police or CME report indicates that the death resulted, or is
suspected to have resulted, from prostitution-related activity.
 This code also applies in incidents where victim(s) appear to have been targeted because they
engage in prostitution.
 Do not endorse “Prostitution” if the victim or suspect is a sex worker or pimp, but the death did not
appear to be related to prostitution activity.
Manner of Death: Homicide and legal intervention
Note: This variable was added in August, 2013.

5.5.7

Prostitution was crisis: CME/LE_CrisisProstitution

Examples include the victim, a prostitute, having a fight with pimp and threatening to leave the day
before being killed.
Note: This variable was added in August, 2013.
Manner of Death: Homicide and legal intervention

5.5.8

Terrorist attack: CME/LE_TerroristAttack

Definition:
The death resulted from a terrorist attack
Response Options:
0
No, Not Available, Unknown
1
Yes
Discussion: The victim was injured in a terrorist attack, whether with conventional, chemical, biological,
or other weapons.
Section 5: Circumstance Variables

98 | P a g e







The NVDRS uses the FBI definition of terrorism: “Injuries resulting from the unlawful use of force or
violence against persons or property to intimidate or coerce a government, the civilian population,
or any segment thereof, in furtherance of political or social objectives.”
Terrorism is not limited to terrorism by foreign nationals but includes domestic terrorism as well
(e.g., abortion clinic bombing, anti-war bombing).
This code includes those who died while assisting in rescue operations from the attack.
Code suicides as “Yes” if the person or people committing the terrorist act died by suicide during or
immediately after the attack.

Manner of Death: All manners

5.5.9

Gang-related: CME/LE_GangRelated

Definition:
Definitions for gang-related homicide can vary by law enforcement agency or CME and tend to capture
deaths that are classified as gang motivated (i.e., motive of the incident was gang-related) or had
suspected involvement of a gang member (i.e., a gang member was a suspect or victim in the incident).
This variable captures both types of gang-related deaths reported by agencies.
Response Options:
0
No, not available, unknown
1
Yes, gang motivated
2
Yes, suspected gang member involvement
3
Yes, gang-related not otherwise specified
4
Organized crime including motorcycle gangs, mafia, and drug cartels
Discussion:
This variable identifies the proportion of violent deaths that are gang-related. A drop down menu is
provided to describe the type of gang activity.






Definition of Gang-Related: Although the definition of gangs vary across agencies, most definitions
identify gangs as having a street presence that perpetrate violent street crime such as rape, robbery,
aggravated assault, gun crimes, and murder. According to the National Gang Center, the following
criteria are widely accepted among researchers for classifying groups as gangs
o The group has three or more members, generally aged 12–24.
o Members share an identity, typically linked to a name, and often other symbols. Members
view themselves as a gang, and they are recognized by others as a gang. The group has
some permanence and a degree of organization.
o The group is involved in an elevated level of criminal activity.3
The term “street gang” is often used interchangeably with “youth gang” as well as “criminal street
gang,” with the latter explicitly denoting the element of criminal activity found almost universally in
gang-related legislation.4
Tips on abstracting gang-related deaths
o Definitions for gang-related homicide can vary by law enforcement agency. It may be
necessary to ask agencies for clarification on how they define gang-related homicides. Also,
some law enforcement agencies, especially those with specialized gang units, have

Section 5: Circumstance Variables

99 | P a g e

o

o

3, 4

databases of individual gang members that can be cross-referenced to provide these data. If
a homicide is reported as “gang-related” and the definition used to make this distinction is
unknown and not clear from the narrative, please classify as “3” or “gang- related not
otherwise specified”.
Gangs predominantly include 12 to 24 year olds, but may have members that are older or
younger and deaths involving members outside the 12 to 24 year age range should be coded
gang-related. If no information on gang type is provided, assume it is a youth gang.
Violent deaths involving adult criminal organizations (i.e., members are predominantly
adults) or associations such as organized crime, adult motorcycle gangs, or hate or ideology
groups should not be coded as gang-related because the risk factors and organizations of
these groups is distinct from street gangs.

See http://www.nationalgangcenter.gov/About/FAQ#q1



Process for categorizing a gang-related deaths
Step 1: Identify if the motive of the incident is gang-related (i.e., the death serves to further the
goals or functions of a gang). These deaths include those occurring from gang rivalry,
territoriality, or activity.
*** Example incident: The victim (V) was standing on the street when a male suspect (S)
approached and began questioning the V about his gang affiliation. S then shot V and ran from
the location. This incident involves gang territoriality and rivalry as a motive.
Step 2: If the incident is not gang motivated or it is unknown if it is gang motivated, then identify
whether the incident involved a suspected gang member as either the victim or the suspect. In
the narrative, describe whether the victim or the suspect was the gang member.
*** Example incident: The victim had gang-related tattoos. If this is reported, then the victim is
suspected to be a gang member.
Step 3: Code gang-related not otherwise specified, when the incident is described as gangrelated but the narrative does not provide any detail on what this means. Use this response
option when the SHR code “juvenile gang killing” is used.
*** Example incident: The victim was shot during a gang-related shooting.

Manner of Death: Homicide and legal intervention
Note: Before August, 2013, this variable only had two response categories, “Yes” and “No, unknown,
unavailable”. This variable also included both youth gangs. In August 2013, more response options were
added to better define the type of gang activity involved in the incident.

5.6

Manner Specific Circumstances for Homicide

5.6.1

Justifiable self-defense: CME/LE_JustifiableSelfDefense

Definition:
The homicide was committed by a law enforcement officer in the line of duty or was committed by a
Section 5: Circumstance Variables

100 | P a g e

civilian in legitimate self-defense or in defense of others.
Response Options:
0
No, Not Available, Unknown
1
Yes
Discussion:
This code includes homicides that are committed by a law enforcement officer in the line of duty. It also
includes homicides by a civilian in self-defense or in defense of others. Only use this code when SHR
codes the case as a justifiable homicide or law enforcement records indicate that law enforcement and
prosecutors have classified the case as a justifiable homicide. It is not enough that the record notes that
the civilian suspect claims that they acted in self-defense. The law enforcement report must explicitly
indicate that the death resulted from justifiable homicide (e.g., that the victim was killed by another
person who was acting in self-defense or that the victim died as a result of legal intervention). The
report may use the term “justifiable homicide” or some equivalent such as homicide ruled self-defense.
Whether the killing was truly justifiable is not something that the coder should interpret.
Definition of Self-Defense: the right of a civilian to repel by force, even to the taking of life, in defense of
his person or property against anyone who attempts by violence or surprise to commit a forcible felony.
Essential elements of self-defense are that the civilian does not provoke the difficulty and that there must
be impending peril without a convenient or reasonable mode of escape.



Code “Yes” for all legal interventions (i.e., any killing by a law enforcement officer in the line of
duty).
Code “Yes” for a death where the victim attempted to rob the suspect by gunpoint and the suspect
killed the victim in self-defense and the police report indicates that this is a “justifiable homicide”.

Also code: Code the precipitating event that led to the killing under the “Precipitating crime,” “Nature of
the crime,” and “Crime in progress” variables, if available.
Manner of Death: Homicide and legal intervention

5.6.2

Victim was a police officer on duty: CME/LE_VictimPoliceOfficerOnDuty

Definition:
The victim was a law enforcement officer killed in the line of duty
Response Options:
0
No, Not Available, Unknown
1
Yes
Discussion:
At the time of the incident, the victim was a law enforcement officer killed in the line of duty. Also code
the precipitating event and describe in the narrative


This circumstance should not be endorsed for victims in other occupations, such as bail bondsmen,

Section 5: Circumstance Variables

101 | P a g e

private security guards, or emergency responders such as firefighters or emergency medical
technicians.
Also code: Code the precipitating event that led to the killing under the “Precipitating crime,” “Nature of
the crime,” and “Crime in progress” variables, if available.
Manner of Death: Homicide and legal intervention

5.6.3

Victim was a bystander: CME/LE_Bystander

Definition:
The victim was a bystander, not the intended target

Response Options:
0
No, Not Available, Unknown
1
Yes
Discussion:
The victim was a bystander and not directly involved in the incident (e.g., pedestrian walking past a gang
fight, customer in a convenience store at the time of a robbery, or victim struck by stray bullet).






Also code the precipitating event (e.g., gang-related, robbery).
Do not code if the bystander intervened to try to stop the violence and was killed (e.g., customer
during a robbery was shot while trying to tackle the robber). In this case, code “Victim was
intervener assisting crime victim”
Do not code if the intended target was unknown or there was a case of mistaken identity.
Do not code if a place was targeted even if individual people were not. For instance, a suspect
returning to the job from which he was recently fired and killed several people would not be coded
or a suspect shooting into a house.

Also code: Code the precipitating event that led to the killing under the “Precipitating crime,” “Nature of
the crime,” and “Crime in progress” variables, if available.
Manner of Death: Homicide and legal intervention

5.6.4

Random violence: CME/LE_RandomViolence

Definition:
The victim was killed by a random act of violence
Response Options:
0
No, Not Available, Unknown
1
Yes
Discussion:
Section 5: Circumstance Variables

102 | P a g e

Code as “Yes” if the victim was killed by a random act of violence. A random act is one in which the
suspect is not concerned with who is being harmed, just that someone is being harmed, such as a
person who shoots randomly at passing cars from a highway bridge or opens fire in a crowded shopping
mall.
 Examples of when to code ‘Yes' for random violence:
o A group of active duty servicemen drove around a neighborhood looking for victims of
opportunity to shoot and kill at random. Two persons were killed.
o An 18-year-old suspect encountered a homeless man asleep on a bridge, went home to
retrieve a weapon and came back and killed him because he “thought he could get away
with it”
o A young pregnant woman was killed by 2 teenage boys throwing heavy rocks off an
overpass at the cars below
o A middle-aged male suspect ambushed a group of teenagers swimming in a local river and
began shooting into the group at random, killing several victims
o A young man armed with a semi-automatic rifle shoots several victims at random in a local
shopping mall until law enforcement intervenes, killing suspect
This code should not be used for cases in which the target such as a place or group of people was chosen
intentionally (e.g., white supremacist group opened fire in a daycare center that served African
American children, a suspect who was fired from a workplace attacks co-workers, or any terrorist
incident). Also, this code should not be used to indicate that a homicide is unsolved, for homicides in
which the motive is simply unknown, for acts of terrorism, or for bystander deaths.


Examples of when not to code random violence:
o A young male suspect approached the middle-aged male victim’s vehicle at a red light and
shot and killed the victim in either an attempted carjacking or “road rage” incident. Victim
was on the way to pick up his wife from work and is unknown to the suspect.
o A young victim and suspect were drinking together, when the suspect picked up what he
reportedly believed was an unloaded gun from the table. He pointed the weapon at the
victim and fired, shooting the victim in the head.
o A person delivering newspapers found a 40-year-old man suffering from several gunshot
wounds in a parking lot. The victim subsequently died of his injuries.
o A female victim was stabbed to death by her neighbor’s boyfriend (suspect). The neighbor
would not answer her boyfriend’s persistent knocking because she was with another male.
The victim answered the door to their shared duplex and was assaulted by the suspect.
o When visiting his girlfriend, the victim confronted one of the girlfriend’s neighbors (suspect),
whose dog was barking loudly. The conflict escalated, resulting in a fistfight between the
two men. The suspect pushed the victim, who fell over the stairwell railing and died from
injuries sustained in the fall.
o Officers were investigating a shooting in the area when they located the body of the victim
suffering from a gunshot wound to the head. No witnesses were identified. The victim is a
known gang member. This homicide is classified as gang related.

There are instances where the abstractor must decide if the preponderance of evidence indicates that
this meets the case definition for random violence vs. simply an unknown motive vs. a bystander
shooting.
 Examples of ambiguous cases:
o Officers responded to a report of shots fired. On arrival, they found the victim lying
Section 5: Circumstance Variables

103 | P a g e

o

o

o

o

unresponsive in his doorway. The victim was shot by an unknown suspect who came to the
door of his home. Reports indicate that the incident may have been drug related and was a
random act of violence.
The victim, a 21 year old white female, and another male were shot in a parking lot of an
apartment building. The victim died in surgery. Her sister said the victim was ‘just in the
wrong place at the wrong time.’
The victim died at the scene from a gunshot. Officers found a car with bullet holes in the
side, where the victim and another passenger suffered gunshot wounds. A third passenger
told the police that a man started shooting at their car while they were driving.
Two black females, one 15 years old and one 24 years old, died of multiple gunshot wounds.
The victims were standing along a highway when the suspect pulled up and got out of his
vehicle firing a shotgun. No other information is given.
Officers responded to a call of shots fired. Upon arrival the victim, was located lying in the
street; he had been shot several times. The victim is known for drug possession and
possible sales. A suspect has been identified.

Note: This variable was added in 2009.
Manner of Death: Homicide and legal intervention

5.6.5

Victim was intervener assisting crime victim: CME/LE_IntervenerAssistingVictim

Definition:
An intervener other than a law enforcement officer was killed while assisting a crime victim
Response Options:
0
No, Not Available, Unknown
1
Yes
Discussion:
The victim was attempting to assist a crime victim at the time of the incident (e.g., the victim tries to
stop a fight and is killed or the victim tries to stop a robbery and is killed). Also code the crime in which
the victim was intervening (e.g., assault/homicide, robbery, or burglary) and whether it was in progress.
Also code: Code the precipitating event that led to the killing under the “Precipitating crime,” “Nature of
the crime,” and “Crime in progress” variables, if available.
Manner of Death: Homicide and legal intervention

5.6.6

Victim used weapon: CME/LE_VictimUsedWeapon

Definition:
The victim used a weapon during the course of the incident
Response Options:
0
No, Not Available, Unknown
1
Yes
Section 5: Circumstance Variables

104 | P a g e

Discussion:
Code as “Yes” if the victim was armed with a weapon such as a gun, knife, or blunt instrument and used
the weapon either to attack or to defend against the suspect or another person during the incident.






Any object that could be reasonably perceived as life-threatening that is used to threaten, harm,
or kill another person could be coded as a weapon (e.g., a victim/suspect being pursued by law
enforcement intentionally used a motor vehicle to hit and kill a law enforcement officer, and
then was subsequently shot by other officers).
Do not endorse for victims who resisted an attacker by kicking, punching, etc., without wielding
some kind of object as a weapon.
Please also code this variable as “Yes” when a person made an attempt to use a weapon. For
example, if a person made an attempt to pull a gun, but did not actually fire a round.
An unloaded, inoperable, or fake weapon (such as a realistic-looking toy) that is used by the
victim to threaten or defend against attack should be coded as “Yes.”

Manner of Death: Homicide and legal intervention

5.6.7

Mercy killing: CME/LE_MercyKilling

Definition:
Victim was killed, at the victim’s request, out of compassion in order to end his or her pain or distress
Response Options:
0
No, Not Available, Unknown
1
Yes
Discussion:
The suspect acted to bring about immediate death allegedly in a painless way and based on a clear
indication that the dying person wished to die because of a terminal or hopeless disease or condition.



Do not assume that a murder/suicide by a sick, elderly couple is a mercy killing.
Code as “Yes” only when there is documentation that the victim wanted to be killed (e.g., left a
note, told a relative or friend) and the law enforcement are not charging the suspect with an
intentional homicide.

Manner of Death: Homicide

5.6.8

Hate crime: CME/LE_HateCrime

Definition:
The homicide was associated with a hate crime.
Response Options:
0
No, Not Available, Unknown
1
Yes
Section 5: Circumstance Variables

105 | P a g e

Discussion:
This variable identifies the proportion of deaths that are associated with hate crimes.
Definition:
A hate crime is an aggravated assault, arson, burglary, criminal homicide, motor vehicle theft, robbery,
sexual assault, or crime involving bodily injury in which the victim was intentionally selected because of
his or her actual or perceived race, gender, religion, sexual orientation, ethnicity, or disability. Specify
the type of hate crime in the incident narrative.
Examples:
 Code “Yes” if a cross was burned in the front yard of the victim's home and several racial slurs spray
painted on the home’s exterior.
 Code “No” if the victim was stabbed to death by his wife when he told her he was bisexual (code
‘intimate partner problem’ as ‘yes’).
Manner of Death: Homicide

5.6.9

Jealousy (lovers’ triangle): CME/LE_Jealousy

Definition:
Identifies cases in which jealousy or distress over a current or former intimate partner’s relationship or
suspected relationship with another person led to the incident.
Response Options:
0
No, Not Available, Unknown
1
Yes
Discussion:
This variable categorizes violence that is directed against any individual that is involved in the love
triangle, such as the current or former intimate partner or the romantic interest.
Do NOT apply this code to others who may have been present at the time of the incident (e.g.,
bystander, child) and killed, but were not part of the love triangle. Someone in the jealous incident has
to have an intimate relationship with another person in the incident for it to qualify as jealousy.
Because jealousy is a type of intimate partner violence, always code “intimate partner violence-related”
for these cases. Code if jealousy is part of the incident, regardless of whom the jealous party is.
Examples to code:
 Male suspect killed his ex-wife and her new boyfriend because he was angry that she was dating.
Code “Yes” for both the ex-wife and her new boyfriend.
 Male suspect killed his girlfriend and his friend because he believed they were romantically involved.
Code “Yes” for both the girlfriend and his friend.
 Male suspect killed a man in a bar because he was angry that the victim was flirting with his
girlfriend. Code “Yes” for the man flirting with the suspect’s girlfriend.
Also code: Code “Intimate partner violence related” as “Yes” because the death was related to an
Section 5: Circumstance Variables

106 | P a g e

immediate or ongoing conflict or violence between current or former intimate partners.
Manner of Death: Homicides and legal interventions

5.6.10

Jealousy (lovers’ triangle) was crisis: CME/LE_CrisisJealousy

Examples include:
 Suspect killed his wife after finding out the previous day that she was cheating on him.
 Suspect killed his friend and girlfriend after seeing his friend flirting with his girlfriend during a party
an hour before the homicides occurred.
 Suspect killed her husband after coming home and finding him in bed with another woman.
 Suspect killed his girlfriend after looking at her phone and seeing text messages to another guy that
he suspected she was seeing.
Manner of Death: Homicide and legal intervention
Note: This variable was added in August, 2013.

5.6.11 Brawl (3 people or more): CME/LE_Brawl
Definition:
Immediately before the violent death, there was a mutual physical fight between three or more
individuals which resulted in the death of individuals involved in the fight or, bystanders or individuals
trying to stop the argument.
Response Options:
0
No, Not Available, Unknown
1
Yes
Discussion:
Three or more persons were involved in a mutual, physical fight. The brawl may or may not escalate to
involve weapons.




Do not code Brawl if the attack was one-sided (e.g., a group beats a single victim to death) or a
person or people were ambushed (e.g., two people were walking along and jumped by 5 suspects).
Do not code as Brawl if only two people were fighting, instead code physical fight between two
people.
When a Supplemental Homicide Report (SHR) indicates a “brawl”, it may be a physical fight (i.e.,
physical confrontation among two people) or a brawl (i.e., physical confrontation among three or
more people) in NVDRS. Please review the narrative and code appropriately.

Manner of Death: Homicide and legal intervention

5.6.12

Walk-by Assault: CME/LE_WalkbyAssault

Section 5: Circumstance Variables

107 | P a g e

Definition:
A targeted attack, such as an ambush, where the suspect(s) approached and fled on foot.
Response Options:
0
No, Not Available, Unknown
1
Yes
Discussion:
This variable accounts for deaths where the victim appeared to be jumped or ambushed. The attack
should have been targeted such that there was no or minimal interaction between suspect and victim
just prior to incident. Walk-up is the mechanism by which the victim was shot. Also choose a
precipitating circumstance code to document why the walk-up occurred (e.g., gang-related), if known




Do not code walk-up in incidents where the only victim was a bystander (e.g., walk-ups include at
least one targeted victim).
Code deaths that use non-motorized transportation such as a skateboard or bicycle and meet the
other requirements of the definition as a walk-up shooting
Do not code deaths that occur during criminal acts (e.g., store employee surprises and shoots an
armed robber or law enforcement pursue and kill a suspect fleeing a burglary).

Examples:
 Code “Yes”:
o If the victim was shot right as they left their house and the suspect fled the scene on foot.
o If the two victims were walking home and shot by two opposing gang members who were
hiding in alley.
o If two suspects walked up to a house opened fire killing the victim and then fled the scene.
o If a suspect killed his ex-wife by hiding in the bushes then shooting her when she returned
from work.
 Code “No”:
o If the victim and the suspect were arguing before the suspect pulled out a gun and shot the
victim.
o If a fight broke out during a drug deal and the victim was killed.
Manner of Death: Homicide
Note: This variable was added in August, 2013.

5.6.13

Drive-by shooting: CME/LE_DrivebyShooting

Definition:
Victim was killed in shooting where the suspect or group of suspects drives near the victim or target and
shoots while driving, or uses a car to approach and flee the scene of a homicide, but steps out of the car
just long enough to use a weapon.
Response Options:
0
No, Not Available, Unknown
1
Yes
Section 5: Circumstance Variables

108 | P a g e

Discussion:
Drive-by shootings must involve a motorized vehicle, such as a car, motorcycle, truck, and does not
include other modes of transportation, such as bicycles, scooters, or skateboards. For all incidents, note
the mode of transportation and the precipitating circumstance in the narrative. For deaths involving
bicycles, scooters, or skateboard note this as an “other circumstance”.
Also code: “Bystander” if the victim was a bystander and not the intended victim.
Note: This variable was added in 2009.
Manner of Death: Homicide

5.6.14

Drug involvement: CME/LE_DrugInvolvement

Definition:
Drug dealing, drug trade, or drug use is suspected to have played a role in precipitating the incident.

Response Options:
0
No, Not available, Unknown
1
Yes
Discussion:
Code “Drug” as “Yes” if the death was related to illegally trafficking a controlled substance (e.g., drug
deal gone bad, drug market turf battle, theft of drugs or money from a dealer during a drug deal, etc.) or
a drug habit (e.g., addict committing robbery to obtain money for drugs, arguments over drugs).
 This variable can be coded based on suspicion of drug-relatedness (e.g., law enforcement suspected
drugs were involved).
 Code “Drug” as “Yes” if there is evidence of drug involvement (e.g., Victim’s body was found in a
crack house, the victim had a substantial amount of illegal drugs on his or her person at the time of
death) and there is not any other indication of the incident not being related to drugs.
 Drugs or drug paraphernalia found on the victim’s body should not be used to automatically code
this variable unless other information suggests the victim was dealing drugs or had just bought
drugs.
 Illegal drugs found elsewhere in the victim’s home should NOT trigger coding this circumstance (e.g.,
victim was shot on porch in drive-by shooting and small amounts of illegal drugs were found in
bedroom) unless the source documents indicate that the illegal drugs were involved in the death
(e.g., attempted theft of drugs, argument over drugs, or victim or suspect selling drugs)
Manner of Death: Homicide and legal intervention

5.7

Manner Specific Circumstances for Suicide

5.7.1

History of suicidal thoughts or plans: CME/LE_SuicideThoughtHistory

Section 5: Circumstance Variables

109 | P a g e

Definition:
Victim had a history of suicidal thoughts or plans. Disclosure of suicidal thoughts or plan can be verbal,
written or electronic.
Response Options:
0
No, Not Available, Unknown
1
Yes
Discussion:
Use this code for victims who have at any time in their life expressed suicidal thoughts or plans. The
victim may or may not have disclosed suicidal thoughts and/or plans close to the time of the suicide.
 Suicidal ideation can be expressed directly (e.g., “I am thinking of killing myself”) or indirectly (e.g., “I
don’t know if I want to go on living”).
 When the timing is unclear (e.g., timing not mentioned) or if the suicidal thoughts were described as
occurring in the “past”, “a few years ago”, or “just”, history of suicidal thoughts should be “Yes”.
 Also code “Recently disclosed suicidal thoughts/plans” in addition to this item if the victim disclosed
suicidal thoughts and/or plans close to the time (within one month) of the suicide.”
 Code “No” for the previous suicide attempts. Previous suicide attempts should be coded as “History
of Suicide Attempts”.
Note: This variable was added in August, 2013.
Manner of Death: Suicide and undetermined deaths

5.7.2

History of suicide attempts: CME/LE_SuicideAttemptHistory

Definition:
Victim has a history of attempting suicide before the fatal incident
Response Options:
0
No, Not Available, Unknown
1
Yes
Discussion:
Code as “Yes” if the victim was known to have made previous suicide attempts before the fatal incident,
regardless of the severity of those attempts or whether any resulted in injury. Per the CDC uniform
definition of suicide attempt± (A non-fatal, self-directed, potentially injurious behavior with any intent
to die as a result of the behavior; which may or may not result in injury), the V must engage in a
POTENTIALLY INJURIOUS BEHAVIOR. A potentially injurious behavior is one which in and of itself has the
ability to cause injury and/or death
 Russian roulette: pulling the trigger on a firearm IS considered potentially injurious regardless of
whether the weapon fires when the victim pulled the trigger. Code as “Yes”.
 Swallowing a lethal dose of pills then calling 911 IS potentially injurious. Code as “Yes
 If the V is making a suicidal gesture (placing ligature around their neck, standing on a bridge
preparing to jump, holding a gun to his head) but is stopped before taking action (e.g., does not pull
the trigger after talking to family or pulled from bridge by law enforcement before jumping),
Section 5: Circumstance Variables

110 | P a g e

consider this potentially injurious behavior a suicide attempt. Code as “Yes”.
Evidence of a history of suicide attempts includes self-report and report or documentation from others
including family, friends, and health professionals.
± Reference: Crosby AE, Ortega L, Melanson C. Self-directed Violence Surveillance: Uniform Definitions
and Recommended Data Elements, Version 1.0. Atlanta (GA): Centers for Disease Control and
Prevention, National Center for Injury Prevention and Control; 2011
Manner of Death: Suicide and undetermined deaths

5.7.3

Recent Disclosed Suicidal Thoughts or Intent to Commit Suicide:
CME/LE_SuicideIntentDisclosed

Definition: Victim disclosed to another person their thoughts and/or plans to die by suicide within the
last month. Disclosure of suicidal thoughts or plan can be verbal, written or electronic.
Response Options:
0
No, Not Available, Unknown
1
Yes
Discussion:
This variable helps identifies suicides for which opportunities to intervene and prevent the death may
have been present near the time of the suicide. It is also useful for exploring the association between
stated intent and actual death.
 Code as “Yes” if the victim had disclosed suicidal thoughts or plans to another person recently or
within the last month, whether explicitly (e.g., “I have been thinking about suicide lately” or “I plan
to go to my cabin with my gun and never come back”) or indirectly (e.g., “I know how to put a
permanent end to this pain”). Include in the narrative any available details about whom the intent
was disclosed to, how long before the death the intent was disclosed, and what was said during the
disclosure.
 Code this variable as “Yes” if there was opportunity to intervene between the time the person
disclosed intent and the injury event.
o Do not code this variable” if the victim disclosed the intention to kill him or herself only at
the moment of the suicide (i.e., when there was no opportunity to intervene to stop the
suicide). For instance, sending an email or text message right before the victim shot herself.
This would be considered a suicide note.
 Do not endorse this variable if the victim had talked about suicide sometime in the distant past, but
had not recently disclosed a current intent to commit suicide to anyone. This would be coded as
“History of disclosed suicidal thoughts/plans”.
 A separate suicide attempt by the victim within a month of the suicide should be coded as “Yes”. In
this case, “History of suicide attempts” should also be coded, “Yes”.
 The timing of when the victim disclosed the suicidal intent may be unclear (e.g., recently or some
time ago) or not mentioned. Please use the following rules to code these cases:
o Code “Yes” if the narrative states the victim “just” or “recently” told someone about his
suicidal intent.
o If the record indicates disclosure of intent, but is unclear about the timeframe (i.e., does not
Section 5: Circumstance Variables

111 | P a g e

o

o

mention it all), code as “Yes”.
Law enforcement or CME documents may be unclear about timing of the disclosure. If the
record indicates disclosure of intent in the past, but states that there was no disclosure for
the current incident, do not code, instead use the “History of suicidal
thoughts/plan/attempts”.
If the victim disclosed suicidal intent “a long time ago”, “more than a month ago” or in the
“past”, code as “No” and code “History of disclosed suicidal thought/plans/actions”.

Manner of Death: Suicide and undetermined deaths

5.7.4

Disclosed to whom: CME/LE_DisclosedIntentToWhom

Definition:
Person to whom victim recently disclosed suicidal thoughts and/or plans to commit suicide (i.e., coded
“Recent Disclosed Suicidal Thought and/or Plan” as “Yes”.

Response Options:
1
Previous or current intimate partner
2
Other family member
3
Health care worker
4
Friend/colleague
5
Neighbor
6
Healthcare worker and intimate partner
7
Healthcare worker and other
8
Other person
9
Unknown
Discussion:
If the victim disclosed the intent to multiple people, please use the following rules:
 If the person disclosed to an intimate partner and a healthcare worker, please indicate “7” If the
person disclosed to a healthcare worker and someone else, please indicate “8”
 For any other combination, please select the person who had the closest relationship to the victim
based on the narrative (e.g., intimate partner over a family member and a family member over
friend).
Note: This variable was added in August, 2013.
Manner of Death: Suicide and undetermined deaths

5.7.5

Left a suicide note: CME/LE_SuicideNote

Definition:
Victim left a suicide note (or other recorded communication). Note can be written or electronic.
Response Options:
Section 5: Circumstance Variables

112 | P a g e

0
1

No, Not Available, Unknown
Yes

Discussion:
 A will or folder of financial papers near the victim does not constitute a suicide note.
 If the record states the person left a “note”, you can infer it was a suicide note in the absence of
information indicating that the note had some other purpose.
 A suicide “note” can be any essentially durable message; it does not have to be on a piece of paper.
Emails, text messages, voice mail, or writing on any object (such as a wall or table) all qualify.
 A text or electronic message sent right before the suicide occurred should be labeled a suicide note
if there was no time between the sending/receipt of the message and the suicide. If there was time
to intervene, this should be coded as “disclosed suicidal thought or intent”.
 If the contents of the suicide note are included or described in your source documents, summarizing
this information in the narrative is helpful to provide further context for the incident. If you choose
to do so, do not include verbatim text and do not include identifying information, but a summary of
what was said. This information may be helpful in noting themes related to the suicide that go
beyond standard NVDRS circumstances and are one of the only means of accessing the decedents’
thoughts about their suicide more directly.
Manner of Death: Suicide and undetermined deaths

5.7.6

Contributing criminal legal problem: CME/LE_RecentCriminalLegalProblem

Definition:
Criminal legal problems appear to have contributed to the death
Response Options:
0
No, Not Available, Unknown
1
Yes
Discussion:
Code as “Yes” if at the time of the incident the victim was facing criminal legal problems (recent or
impending arrest, Law enforcement pursuit, impending criminal court date, etc.), and this appears to
have contributed to the death. Code military crimes such as AWOL as “Yes”.
 Criminal legal problems, as opposed to civil legal problems, are those resulting from conduct
considered as harmful to society as a whole that it is prohibited by statute and prosecuted by the
government. Driving while intoxicated offenses should be considered a criminal offense.
 Committing a crime alone is not sufficient basis for endorsing this variable; there must be evidence
of negative legal or law enforcement consequences (e.g., about to enter jail, facing a court date, on
the run from law enforcement) that appear to be associated with the death.
Manner of Death: Suicide and undetermined deaths

5.7.7

Contributing criminal legal problem was crisis: CME/LE_CrisisCriminal

Examples include the victim being upset about having to start a prison term for robbery in a week, a
Section 5: Circumstance Variables

113 | P a g e

victim despondent over a DWI court date scheduled for a day after the suicide, or a criminal who dies by
suicide when law enforcement appears at their house to arrest them for an assault.
Note: This variable was added in August, 2013.
Manner of Death: Suicide and undetermined deaths

5.7.8

Civil legal problems: CME/LE_LegalProblemOther

Definition:
Civil legal (non-criminal) problems appear to have contributed to the death
Response Options:
0
No, Not Available, Unknown
1
Yes
Discussion:
Code as “Yes,” if at the time of the incident the victim was facing civil legal problems, such as a divorce,
custody dispute or civil lawsuit, or legal problems that were unspecified as either criminal or civil, and
these problems appear to have contributed to the death.
Manner of Death: Suicide and undetermined deaths.

5.7.9

Civil legal problems were crisis: CME/LE_CrisisCivilLegal

Examples include the victim being upset because they lost custody of their child the day before the
suicide or the victim losing a civil lawsuit the week before the suicide.
Note: This variable was added in August, 2013.
Manner of Death: Suicide and undetermined deaths

5.7.10 Contributing physical health problem: CME/LE_PhysicalHealthProblem
Definition:
Victim’s physical health problem(s) appear to have contributed to the death
Response Options:
0
No, Not Available, Unknown
1
Yes
Discussion:
The victim was experiencing physical health problems (e.g., terminal disease, debilitating condition,
chronic pain) that were relevant to the event.
Section 5: Circumstance Variables

114 | P a g e








Endorse this variable only if a health problem is noted as contributing to the death (e.g., despondent
over recent diagnosis of cancer or complain that he could not live with the pain associated with a
condition).
The simple mention of a health problem should not trigger coding the death as health-related. CME
reports generally include the decedent’s existing medical problems (e.g., diabetes, asthma, cancer).
Do not endorse this variable based simply on a list of conditions.
“Debilitating” conditions would leave the victim confined to bed, oxygen dependent, or requiring
basic daily care from a third party.
Health conditions are coded from the perspective of the victim. If the victim believed him- or herself
to be suffering from a physical health problem, and this belief was contributory to the death, it does
not matter if any particular health problem was ever treated, diagnosed, or even existed. For
instance, code “Yes” if the victim only suspected he might have AIDS and killed himself before he
received his test results.

Manner of Death: Suicide and undetermined deaths

5.7.11 Contributing physical health problem was crisis: CME/LE_CrisisPhysicalHealth
Examples include the victim being despondent over being diagnosed with cancer two days before the
suicide, a victim finding out the day before the suicide that their condition got significantly worse, or a
victim just went bankrupt due to treatment for a chronic mental illness the day before the suicide.
Note: This variable was added in August, 2013.
Manner of Death: Suicide and undetermined deaths

5.7.12 Job problem: CME/LE_JobProblem
Definition:
Job problem(s) appear to have contributed to the death
Response Options:
0
No, Not Available, Unknown
1
Yes
Discussion:
Code “Job” as “Yes” if at the time of the incident the victim was either experiencing a problem at work
(such as tensions with a co-worker, poor performance reviews, increased pressure, feared layoff) or was
having a problem with joblessness (e.g., recently laid off, having difficulty finding a job), and this appears
to have contributed to the death.




Simply being unemployed is not sufficient—there must be an indication that the victim was
experiencing difficulty finding or keeping a job.
Code “Yes” if the victim experienced a recent major job problem such as being fired from their job,
being demoted or having a serious conflict with his/her boss.
Code “No” if a person left his or her job as part of a suicide plan (e.g., “Victim left work four days ago

Section 5: Circumstance Variables

115 | P a g e

and checked into a hotel; the body was found after co-workers contacted the victim’s family to try
to locate him”).
Manner of Death: Suicide and undetermined deaths

5.7.13 Job problem was crisis: CME/LE_CrisisJob
Examples include the victim being fired from work two days before the suicide, being upset about being
scheduled to lose unemployment benefits the day after the suicide, and being turned down for a job the
day before the suicide.
Manner of Death: Suicide and undetermined deaths
Note: This variable was added in July, 2013.

5.7.14 Financial problem: CME/LE_FinancialProblem
Definition:
Financial problems appear to have contributed to the death
Response Options:
0
No, Not Available, Unknown
1
Yes
Discussion:
Code as “Yes” if at the time of the incident the victim was experiencing a problem such as bankruptcy,
overwhelming debts, or foreclosure of a home or business, and this appears to have contributed to the
death. Inclusion in the investigative reports is sufficient to code “Yes”.
Also code: “Eviction or loss of housing”, if applicable.
Manner of Death: Suicide and undetermined deaths

5.7.15 Financial problem was crisis: CME/LE_CrisisFinancial
Examples include the victim had a bankruptcy hearing a week after the date of their death, the victim
had their car re-possessed the day before the suicide, and the victim was to be evicted from their house
on the day of their death due to their inability to pay the mortgage (Note: Also, should code
‘eviction/foreclosure’).
Note: This variable was added in August, 2013.
Section 5: Circumstance Variables

116 | P a g e

Manner of Death: Suicide and undetermined deaths

5.7.16 School problem: CME/LE_SchoolProblem
Definition:
Problems at or related to school appear to have contributed to the death
Response Options:
0
No, Not Available, Unknown
1
Yes
Discussion:
 Code as “Yes” if at the time of the incident the victim was experiencing a problem such as poor
grades, difficulty with a teacher, bullying, social exclusion at school, school detention/suspension, or
performance pressures, and this appears to have contributed to the death.
 Code “No” if the victim was only noted as having low grades, but no specific problem was cited (e.g.,
received a failing grade recently) or victim was not described as being upset about the low grades.
Manner of Death: Suicide and undetermined deaths

5.7.17 School problem was crisis: CME/LE_CrisisSchool
Examples include the victim failing a test the day before the suicide, the victim having a suspension
hearing scheduled the day after the suicide, and the victim was beat-up the week before and was afraid
to go to school.
Note: This variable was added in August, 2013.
Manner of Death: Suicide and undetermined deaths

5.7.18 Eviction or loss of housing: CME/LE_EvictionOrLossOfHome
Definition:
A recent eviction or other loss of the victim’s housing, or the threat of it, appears to have contributed to
the death.
Response Options:
0
No, Not Available, Unknown
1
Yes
Discussion:
Code as “Yes” if at the time of the incident the victim had recently been, was in the process of being
evicted or foreclosed on, or was confronted with an eviction, foreclosure, or other loss of housing (e.g.,
Section 5: Circumstance Variables

117 | P a g e

kicked of house by a relative), and this appears to have contributed to the death. Inclusion in the
investigative reports is sufficient to code “Yes”.
Also code: If the victim’s home was lost due to Disaster, consider coding “DisasterExposure”.
Note: This variable was added in 2009.
Manner of Death: Suicide and undetermined deaths

5.7.19 Eviction or loss of home was crisis: CME/LE_CrisisEviction
Examples includes the victim was to be evicted from their apartment the day after the suicide, a mother
kicked her son out of the house due to his drug problem the day before the suicide and the victim
received a final foreclosure notice two days before the suicide.
Note: This variable was added in July 2013.
Manner of Death: Suicide and undetermined deaths

5.7.20 Suicide of friend or family contributed to death: CME/LE_RecentSuicideFriendFamily
Definition:
Suicide of a family member or friend appears to have contributed to the death.
Response Options:
0
No, Not Available, Unknown
1
Yes
Discussion:
There is no time limit for when the suicide of the family or friend occurred, except that it occurred
during the victim’s lifetime and that it is noted to have contributed to the victim’s death. In the
narrative, note the source of this information, the relationship to the family member or friend, and the
time frame (e.g., last month).
 Code as “Yes” if at the time of the incident the victim was distraught over or reacting to a suicide of
a friend or family member.
 Code “Yes” if the victim was distraught over an anniversary of the suicide.
Also code: Consider coding “Anniversary of traumatic event” if applicable.
Note: Before August 2013, abstractors only coded a suicide of friend or family member that occurred
within five years of the decedent’s death. Beginning in August 2013, abstractors could code cases where
the death occurred more than five years before the victim’s suicide as long as the deaths were perceived
as contributing to the suicide.
Manner of Death: Suicide and undetermined deaths
Section 5: Circumstance Variables

118 | P a g e

5.7.21 Suicide of friend or family was crisis: CME/LE_CrisisRecSuicideFriendFamily
Examples include the victim being upset or distraught over a suicide of the friend or family member
occurring within two weeks of his or her death.
Note: This variable was added in August, 2013.
Manner of Death: Suicide and undetermined deaths

5.7.22 Other death of friend or family: CME/LE_DeathFriendOrFamilyOther
Definition:
Death of a family member or friend due to something other than suicide appears to have contributed to
the death.
Response Options:
0
No, Not Available, Unknown
1
Yes
Discussion:
Code “Yes” if at the time of the incident the victim was distraught over, or reacting to a death of a friend
or family member. The death could have been recent or many years ago.
 If a source document indicates that the victim’s suicide took place on the anniversary of the death of
a friend or family member, code this variable “Yes”.
 If the death happened long before the incident, only endorse if the victim was very upset about the
incident because of an anniversary or some other factor that made their feelings about the death
stronger.
Also code: “Anniversary of traumatic event”, if applicable.
Note: Before August 2013, abstractors only coded a suicide of friend or family member that occurred
within five years of the decedent’s death. Beginning in August 2013, abstractors could code cases where
the death occurred more than five years before the victim’s suicide as long as the deaths were perceived
as contributing to the suicide.
Manner of Death: Suicide and undetermined deaths

5.7.23 Other death of friend or family was crisis: CME/LE_CrisisDeathFriendOrFamilyOth
Examples include the victim being upset over the death of a parent who died four days before the
suicide or the victim being distraught on the year anniversary of the death of their spouse (Note: Also
code anniversary of traumatic event).
Note: This variable was added in August, 2013.
Section 5: Circumstance Variables

119 | P a g e

Manner of Death: Suicide and undetermined deaths

5.7.24 Anniversary of a traumatic event: CME/LE_TraumaticAnniversary
Definition:
Incident occurred on or near the anniversary of a traumatic event in the victim’s life and was perceived
as a contributing factor.
Response Options:
0
No, Not Available, Unknown
1
Yes
Discussion:
This variable identifies deaths that may be related to the anniversary of a traumatic experience in the
victim’s life, such as the death of a relative or friend. Other traumatic experiences include: sexual or
physical victimization, community violence, mass shooting/killings, natural disasters, etc. •
 Code as “Yes” if the incident occurred on or near the date of a traumatic event in the victim’s life,
regardless of how far in the past the event was, as long as the incident was perceived as a
contributing factor to the death. Indicate the nature of the event in the incident narrative.
Note: This variable was added in 2009.
Manner of Death: Suicide and undetermined deaths

5.7.25 Disaster exposure: CME/LE_DisasterExposure
Definition:
Exposure to a disaster was perceived as a contributing factor in incident
Response Options:
0
No, Not Available, Unknown
1
Yes
Discussion:
The variable identifies the proportion of violent deaths that are a consequence of exposure to a natural
or man-made disaster of any kind. In narrative, specify the type of disaster: nuclear accident,
earthquake, bombings, hurricanes, floods, tornadoes, or wild fires.


Example: A victim was distraught over losing their house to flooding which was uninsured. The
suicide occurred a month after the flood.

Note: This variable was added in August, 2013.
Manner of Death: Suicide and undetermined deaths
Section 5: Circumstance Variables

120 | P a g e

5.7.26 Disaster exposure was crisis: CME/LE_CrisisDisasterExposure
Examples includes the victim lost a relative in a tornado the day before the suicide, the victim found out
their insurance would not cover damage to their business due to a forest fire the week before the
suicide and the victim died a week after a nuclear accident where they received a heavy dose of
radiation that caused numerous physical symptoms.
Note: This variable was added in August, 2013.
Manner of Death: Suicide and undetermined deaths

5.8

Manner Specific Circumstances for Unintentional Firearm deaths

This section relates to deaths resulting from a penetrating injury or gunshot wound from a weapon that
uses a powder charge to fire a projectile when there was a preponderance of evidence that the shooting
was not intentionally directed at the victim. Other types of unintentional deaths (e.g., accidental drug
overdose) are not collected by NVDRS core modules.

5.8.1

Hunting: CME/LE_Hunting

Definition:
The shooter or victim was hunting or on a hunting trip.
Response Options:
0
No, Not Available, Unknown
1
Yes
Discussion:
 Include any incident that occurs after leaving home and before returning home from hunting.
 The shooting itself need not have been during an active hunt to be considered hunting-related. For
example, a hunter who has finished hunting and accidentally shoots himself while loading his rifle in
the truck for the return trip home is considered a hunting accident.
 If an injury occurs before or after the hunting trip (e.g., while cleaning a gun in preparation for a
hunting trip), the incident should not be coded as hunting-related.
Manner of Death: Unintentional firearm

5.8.2

Target Shooting: CME/LE_TargetShooting

Definition:
The shooter was aiming for a target and unintentionally hit a person.
Response Options:
Section 5: Circumstance Variables

121 | P a g e

0
1

No, Not Available, Unknown
Yes

Discussion:
Target shooting can occur either in the setting of a formal shooting range or in an informal “backyard”
setting (e.g., teenagers shooting at signposts on a fence accidentally hits a person).
Manner of Death: Unintentional firearm

5.8.3

Self-defensive shooting: CME/LE_SelfDefense

Definition:
Victim was attempting to defend him or herself with a gun and inadvertently shot him or herself.

Response Options:
0
No, Not Available, Unknown
1
Yes
Discussion:
Endorse only if the shooting was self-inflicted.
If the victim is shooting at law enforcement officers who are trying to arrest him/her when they
accidentally shoot himself/herself, this circumstance be coded “No”. Please put this information in the
narrative.
Manner of Death: Unintentional firearm

5.8.4

Celebratory firing: CME/LE_CelebratoryFiring

Definition:
The shooter was firing the gun in a celebratory manner with no intention of threatening or endangering
others (e.g., revelers on New Year’s Eve shooting their guns in the air at midnight).
Response Options:
0
No, Not Available, Unknown
1
Yes
Discussion:
Firing warning shots in the air (for example to break up a fight) should not be coded as celebratory if the
shot unintentionally strikes a bystander, but should be coded as homicide for Type of Death (since the
gun was used in a threatening manner to control others).
Manner of Death: Unintentional firearm
Section 5: Circumstance Variables

122 | P a g e

5.8.5

Loading or unloading gun: CME/LE_GunFiredLoadingUnloading

Definition:
Shooter was loading or unloading ammunition from the gun when it discharged.
Response Options:
0
No, Not Available, Unknown
1
Yes
Discussion:
None
Manner of Death: Unintentional firearm

5.8.6

Cleaning gun, repair and assembling: CME/LE_GunCleaning

Definition:
The shooter pulled the trigger or the gun otherwise discharged (e.g., bumped gun while cleaning) while
cleaning, repairing, or assembling/disassembling the gun.
Response Options:
0
No, Not Available, Unknown
1
Yes
Discussion:
None
Note: Before August, 2013, this variable was only coded for deaths that occurred when the victim was
cleaning the gun. After August, 2013, the variable was expanded to include unintentional deaths that
occurred while the victim was also repairing or assembling/disassembling the gun.
Manner of Death: Unintentional firearm

5.8.7

Showing gun to others: CME/LE_GunShowing

Definition:
The shooter was showing the gun to another person when the gun discharged.
Response Options:
0
No, Not Available, Unknown
1
Yes
Discussion:
Section 5: Circumstance Variables

123 | P a g e

None
Manner of Death: Unintentional firearm

5.8.8

Playing with gun: CME/LE_GunPlaying

Definition:
Shooter was playing with gun when it discharged.
Response Options:
0
No, Not Available, Unknown
1
Yes
Discussion:
 Other phrases that would trigger coding this context include “horsing around” and “fooling around.”
 This variable is not limited to children. For example, this could include suicide play (i.e., an adult
pointing a gun believed to be unloaded at her and pulling the trigger).
Manner of Death: Unintentional firearm

5.8.9

Other context of injury: CME/LE_OtherContextInjury

Definition:
The shooting occurred during some context other than those described by the existing codes.
Response Options:
0
No, Not Available, Unknown
1
Yes
Discussion:
Always describe the other context of injury in the narrative.
Manner of Death: Unintentional firearm

5.8.10 Thought safety was engaged: CME/LE_GunThoughtSafetyEngaged
Definition:
Shooter thought the safety was on and the firearm would not discharge.
Response Options:
0
No, Not Available, Unknown
1
Yes
Discussion:
Section 5: Circumstance Variables

124 | P a g e

None
Manner of Death: Unintentional firearm

5.8.11 Thought gun was unloaded, magazine disengaged:
CME/LE_GunThoughtUnloadedMagazDisen
Definition:
Shooter thought the gun was unloaded because the magazine was disengaged.
Response Options:
0
No, Not Available, Unknown
1
Yes

Discussion:
 This circumstance would not apply to revolvers, derringers, or certain long guns that do not use a
magazine.
 Frequently when the magazine is removed from a semi-automatic pistol, the gun handler believes it
is unloaded when in fact a cartridge may remain in the firing chamber.
Manner of Death: Unintentional firearm

5.8.12 Thought gun was unloaded, other: CME/LE_GunThoughtUnloadedOther
Definition:
Shooter thought the gun was unloaded for a reason other than the magazine being disengaged, or for an
unspecified reason
Response Options:
0
No, Not Available, Unknown
1
Yes
Discussion:
None
Manner of Death: Unintentional firearm

5.8.13 Unintentionally pulled trigger: CME/LE_GunUnintentPulledTrigger
Definition:
Shooter unintentionally pulled the trigger
Response Options:
Section 5: Circumstance Variables

125 | P a g e

0
1

No, Not Available, Unknown
Yes

Discussion:
None
Manner of Death: Unintentional firearm

5.8.14 Bullet ricochet: CME/LE_BulletRicochet
Definition:
Bullet ricocheted off course from its intended target and struck the victim.

Response Options:
0
No, Not Available, Unknown
1
Yes
Discussion:
None
Manner of Death: Unintentional firearm

5.8.15 Gun defect or malfunction: CME/LE_GunDefectMalfunction
Definition:
Firearm discharged due to some defect or mechanical malfunction
Response Options:
0
No, Not Available, Unknown
1
Yes
Discussion:
Code as “Yes” if the shooting resulted from a gun defect or malfunction. Because it is difficult for a nonexpert to judge whether a shooting resulted from operator error vs. a true defect or malfunction, this
code should be based on a finding by a trained firearm and tool-mark examiner.
Manner of Death: Unintentional firearm

5.8.16 Fired while holstering/unholstering : CME/LE_GunFiredHolstering
Definition:
Firearm discharged while it was being placed in or removed from its holster or clothing
Section 5: Circumstance Variables

126 | P a g e

Response Options:
0
No, Not Available, Unknown
1
Yes
Discussion:
 Code as “Yes” if the gun was being placed in or removed from its holster or clothing when it
discharged.
 Do not code if the gun discharged after falling out of a holster accidentally (code “Dropped gun”
instead).
Manner of Death: Unintentional firearm

5.8.17 Dropped gun: CME/LE_GunDropped
Definition:
Gun was dropped and unintentionally discharged upon impact.
Response Options:
0
No, Not Available, Unknown
1
Yes
Discussion:
 This code applies to situations in which the impact of the crash causes the gun to discharge.
 It does not apply to situations in which a gun starts to fall and is fired when the handler grabs for it
and unintentionally pulls the trigger. That situation should be coded as “Unintentionally pulled
trigger”.
Manner of Death: Unintentional firearm

5.8.18 Fired while operating safety/lock: CME/LE_GunFiredOperatingSafetyLock
Definition:
Gun unintentionally discharged while the gun handler was attempting to open or close the lock.
Response Options:
0
No, Not Available, Unknown
1
Yes
Discussion:
This variable will be important in detecting any unintended injuries that result from using safety
equipment.
Also code: “Unintentionally pulled trigger” because the fatal injury occurred due to pulling the trigger.
Section 5: Circumstance Variables

127 | P a g e

Manner of Death: Unintentional firearm

5.8.19 Gun mistaken for toy: CME/LE_GunThoughtToy
Definition:
Gun was mistaken for a toy and discharged during handling/play
Response Options:
0
No, Not Available, Unknown
1
Yes
Discussion:
 Code as “Yes” if a person (usually a child) thought the gun was a toy and was firing it without
understanding the danger.
 This code applies to the shooter’s understanding of the gun that he or she was handling.
 It does not apply to situations in which a person kills another person because they thought the
victim was aiming a gun (in reality, a toy) at them. These situations would be coded as homicides.
Manner of Death: Unintentional firearm

5.8.20 Other mechanism of injury: CME/LE_OtherMechanismInjury
Definition:
The shooting occurred as the result of a mechanism not already described by one of the existing codes.
Response Options:
0
No, Not Available, Unknown
1
Yes
Discussion:
Always describe the mechanism in the narrative.
Manner of Death: Unintentional firearm

5.9

Other Circumstances: All Manners

Other circumstance was crisis: CME/LE CrisisOther
Definition:
Victim experienced a crisis within two weeks of the incident, or a crisis was imminent within two weeks
of the incident that was not associated with another circumstance variable.
Response Options:
Section 5: Circumstance Variables

128 | P a g e

Text
Discussion:
This variable captures crises not associated with a standard NVDRS circumstance. Please note that in the
analytic data file, the legacy data element “CrisisRecent” has been archived as of the 2016 dataset in
order to avoid confusion. All cases endorsed as having a recent crisis in the legacy data, as well as
current cases with a specific or “other” crisis as described above are captured under the calculated
variable “AnyCrisis_c” in the analytic data file.
Consistent with previous coding manual versions, a “Crisis” is a current/acute event (within 2 weeks of
death) that is indicated in one of the source reports to have contributed to the death. Inclusion in the
source document and indication that the event occurred within two weeks of the death is sufficient to
code a circumstance a crises. Direct language that the event caused or contributed to the death is not
required to code “Yes”.
The following guidance will assist in identifying crises:








A crisis can precede the death (e.g., had a bad argument the day before the incident, divorce papers
served that day, or victim laid off the week before) or be an impending event (e.g., house was to be
foreclosed on the day after the incident or court date for a criminal offense three days after the
suicide). Crisis should be interpreted from the eyes of the victim. This is particularly relevant for
young victims whose crises, such as a bad grade or a dispute with parents over a curfew, may
appear to others as relatively minor.
An actual time period for the crisis may not be mentioned in the records, so use language as a clue.
o “Decedent was experiencing financial difficulties after losing his job” would not trigger
coding a recent crisis because the timeframe is unclear
o “Decedent had just received a pink slip at work” would be coded because the word “just”
indicates that the crisis occurred right before the death, or within two weeks.
Ongoing/chronic problems should not be coded as crises unless there was an acute change in the
status (change in prognosis of chronic illness). Coding a case as being related to a crisis does not
mean that there aren’t also chronic conditions that have contributed to the victim’s death.
A homicide followed by a suicide should always be coded as “Yes” for “Crisis” for the suicide victim
unless the two deaths were both clearly consensual and planned in advance (i.e., a double suicide).

Manner of Death: All Manners

5.9.1

Other circumstance: CME/LE_CircumstancesOtherText

Definition:
Other specified problems contributed to the death
Response Options:
Text
Discussion:
Should only be used if a noted contributory circumstance is not already covered by existing variables in
Section 5: Circumstance Variables

129 | P a g e

the reporting system.
 Be sure to describe the circumstance in the text field provided and in the narrative.
 Please indicate if the other circumstance is a crisis.
Manner of Death: All Manners

Section 5: Circumstance Variables

130 | P a g e

SECTION 6: WEAPON VARIABLES
The concept of a weapon in NVDRS combines the concepts of objects used to injure and actions that
lead to injury. Weapons can therefore range from instruments commonly thought of as weapons, such
as a gun or bayonet, to actions such as setting fires, pushing someone over a cliff, or shaking (as in
shaken baby syndrome). Only the weapon(s) that caused the death should be entered. When there are
multiple weapons in an incident and the fatal weapon can be determined, only enter the weapon that
caused the fatal injury. If a weapon caused a non-fatal injury, do not enter the weapon. For example, if a
victim was shot in the head and stabbed in the foot, and the foot wound was known to be non-fatal,
enter only the firearm. For the vast majority of deaths, only one weapon should be entered.
General guidance on coding weapons is provided below:




If the weapon that caused the fatal injury cannot be determined, then enter all of the weapons that
contributed to the death of the victim. For example, if a victim was shot in the chest and also
stabbed in the chest, and it cannot be determined which wound was fatal (if not both); enter a
firearm and a sharp instrument as separate weapons.
Legal intervention deaths represent a unique situation. How to code these incidents is described
below. Sometimes an individual officer with a single firearm can be identified as firing the fatal shot.
For those situations, one weapon (firearm) should be entered.
o For situations where multiple officers fired and hit the victim, and the number of officers is
specified, enter the number of weapons equal to the number of firearms causing injury. For
example, for a report listing two officers known to have struck the victim, load two firearms.
Do not count firearms associated with officers at the scene who did not fire their weapons.
For example, if six officers were on scene but only two fired their weapons causing injury,
load only two firearms.
o If a report indicates multiple officers fired at the victim, but it is not known how many
officers or how many firearms were involved, load only one firearm.
 Coding deaths involving firearms
o Details are collected on individual firearms, such as make, model, caliber, and gauge. If a
victim was fatally injured by multiple firearms, and it is not possible to identify a single
firearm as being responsible for the victim’s death, enter information all of the firearms.
o If a gun is not recovered, but the victim died of a gunshot wound, code the number of
weapons as “1”. Guns on the scene that were not used to shoot the victim (e.g., a gun
on the person of the victim), are not counted as weapons in the incident.
 For poisonings, NVDRS tracks information on individual poisonous substances in the toxicology
section, including the poison that killed the victim, while tracking the weapon type on the
weapons screen.
o For an incident where a single poison killed the victim, record the weapon type as
“Poisoning” and identify the substance that killed the victim in the toxicology section by
checking the “Cause of Death” box next to the substance on the toxicology screen. If
multiple poisons resulted in the death of the victim, please record the weapon type as
“Poisoning” and identify the substances suspected of killing the victim in the toxicology
section by checking the “Cause of Death” box next to each substance that killed the
victim. If it is unknown which poison killed the victim, do not check any of the “Cause of
Death” boxes.
o Poisons or drugs on the scene that were not ingested by the victim and not found in

Section 6: Weapon Variables

131 | P a g e



toxicology should not be entered.
Weapon types that are not firearms or poisons
o For all other weapon types involved in a violent death, list the weapon only once per
incident. For example, if multiple sharp objects or knives are used to kill one or more
persons in an incident, enter only one weapon to represent all these sharp objects. If
multiple knives and multiple blunt objects are used, one “sharp instrument” and one
“blunt instrument” weapon should be entered.
o If a knife is not recovered, but the victim died from wounds inflicted by a sharp object,
code the number of weapons as 1.

NOTE: Before August, 2013, the number of weapons was limited to three. As of August, 2013, there is no
longer a limit of three weapons. Enter data for as many weapons as were involved in inflicting fatal
injuries.

6.1

Weapon Type: WeaponType

Definition:
Type of weapon or means used to inflict the fatal injury
Response Options:
1
Firearm
5
Non-powder gun
6
Sharp instrument
7
Blunt instrument
8
Poisoning
9
Hanging, strangulation, suffocation
10
Personal weapons
11
Fall
12
Explosive
13
Drowning
14
Fire or burns
15
Shaking (e.g., shaken baby syndrome)
16
Motor Vehicle, including buses, motorcycles
17
Other transport vehicle, (e.g., trains, planes, boats)
18
Intentional neglect, (e.g., starving a baby or oneself)
19
Biological weapons
66
Other (e.g., Taser, electrocution, nail gun, exposure to environment/weather)
99
Unknown
Discussion:
Weapon type reports the broad category of weapon(s) or means used to inflict the fatal injury. Objects
(such as knives), actions (such as jumping from a height), hostile environments (such as fire, water), and
even the lack of action (such as neglect of a child or disabled person) are all weapons in NVDRS. Only
code more than one weapon when multiple weapons were known to have inflicted fatal injuries.
Otherwise, if it is possible to determine, code only the primary weapon that resulted in death. When
faced with choosing multiple possible weapon types, enter first the weapon that exerted the most force
to the body or deprived it of essentials such as oxygen.
Section 6: Weapon Variables

132 | P a g e

















6.2

“Sharp instrument” refers not only to knives, but also to razors, machetes, or pointed instruments
(e.g., chisel, broken glass, bow and arrow).
“Blunt instrument” refers to clubs, bats, rocks, etc. or a general statement of “blunt force trauma.” If
a victim is killed by the weight of a heavy object or objects, rather than by the force of impact, code
“other weapon” rather than “blunt instrument.”
Carbon monoxide poisoning should be coded as a poisoning. For deaths where carbon monoxide
due to a fire was also contributory, code “Carbon monoxide poisoning” as a secondary weapon and
“Fire or burns” as the primary weapon. Also code: “carbon monoxide source”.
Deaths involving asphyxiant (non-toxic) gases should be coded as suffocation. Asphyxiant gases are
not normally harmful in the breathing air but become hazardous when elevated concentrations of
these gases displace the normal oxygen concentration, occurring in either confined spaces (e.g.,
refrigerator) or direct, exclusive administration (e.g., inhaling contents of balloon filled with helium).
Some common examples of asphyxiant gases are helium, nitrogen, argon, butane, propane.
“Personal weapons” include fists, feet, and hands in actions such as punching, kicking or hitting. If
the victim is manually strangled, code “Hanging, strangulation, suffocation” instead of “Personal
weapon”.
“Fall” covers both being pushed (as in a homicide) or jumping (as in a suicide). Generally, if a person
is at standing height, is pushed by another, and falls backward hitting his head, code weapon as
“Personal weapons” due to the push. If a person is higher than standing height, as in a two-story
balcony or on a roof, code weapon as “Fall”.
For fires that cause deaths by burns or carbon monoxide poisoning, code “Fire or burns”.
If a victim is noted to have died by an external force (e.g., hanging, gunshot wound, stab wound,
etc.), but also was noted to have a lethal level of alcohol or drugs in his or her system, code the
weapon of external force and not the poisoning.
If a victim is fatally injured falling from a bridge into a body of water, the weapon type should reflect
the information in the CME report. That is, if the victim was noted to have drowned, weapon type
should be coded as “Drowning.” If the victim was noted to have died from injuries sustained on
impact from hitting the water, weapon type should be coded as “Fall.”

Other Weapon Information: WeaponOther

Definition:
Please put additional descriptive information about the weapon in this text box. If the weapon type is
checked as “Other”, please describe the weapon here.
Response Options:
Text
Discussion:
 If the weapon type was classified as “Other”, please use this text box to describe the weapon. A
weapon type should only be classified as “Other” after it has been determined that the weapon type
does not match any of the standard categories.
 Additional descriptive information about any type of weapon can also be placed in this field. For
instance, modifications to firearms or a description of a sharp weapon can be entered.

6.3

Firearm Variables

Section 6: Weapon Variables

133 | P a g e

The following twelve variables will only be completed when the weapon type is “firearm”. These
variables will not display for all other weapon types.

6.3.1

Firearm type: FirearmType

Definition:
Specific type of firearm used to inflict injury
Response Options:
1
Submachine Gun
2
Handgun, Unknown Type
3
Handgun, Pistol- Bolt Action
4
Handgun, Pistol- Derringer
5
Handgun, Pistol- Single Shot
6
Handgun, Pistol- Semi-automatic
7
Handgun, Revolver
8
Rifle, Unknown Type
9
Rifle, Automatic
10
Rifle, Bolt Action
11
Rifle, Lever Action
12
Rifle, Pump Action
13
Rifle, Semi-automatic
14
Rifle, Single Shot
15
Rifle-Shotgun Combination
16
Shotgun, Unknown Type
17
Shotgun, Automatic
18
Shotgun, Bolt Action
19
Shotgun, Double Barrel (Over/Under, Side by Side)
20
Shotgun, Pump Action
21
Shotgun, Semi-automatic
22
Shotgun, Single Shot
23
Long gun, Unknown type
66
Other (e.g., handmade gun)
99
Unknown

6.3.2
6.3.3

Firearm caliber: FirearmCaliber
Firearm gauge: FirearmGauge

Definitions:
 FirearmCaliber: Caliber of the firearm used to inflict the injury
 FirearmGauge: Gauge of firearm used to inflict the injury

Section 6: Weapon Variables

134 | P a g e

Response Options:
Caliber:
556 5.56 mm
6
6 mm
635 6.35 mm
65
6.5 mm
7
7 mm
735 7.35 mm
75
7.5 mm
762 7.62 mm
763 7.63 mm
765 7.65 mm
8
8 mm
9
9 mm
10
10 mm
11
11 mm
17
.17 in
22
.22 in
221 .221 in
222 .222 in
223 .223 in
243 .243 in
25
.25 in
250 .250 in
256 .256 in
257 .257 in
264 .264 in
270 .270 in
280 .280 in
284 .284 in
30
.30 in (including 30-06)
300 .300 in
303 .303 in

308
32
338
35
351
357
36
375
38
380
40
401
405
41
44
444
455
458
460
50
54
58
60
1000
1001
1002
1003
6666
8888
9999

.308 in
.32 in
.338 in
.35 in
.351 in
.357 in
.36 in
.375 in
.38 in
.380 in
.40 in
.401 in
.405 in
.41 in
.44 in
.444 in
.455 in
.458 in
.460 in
.50 in
.54 in
.58 in
.60 in
Undetermined whether .38 or .357
Small, unspecified (<=32)
Medium, unspecified (>32, <10mm/.40)
Large, unspecified (>=10mm/.40)
Other
Not applicable (shotgun or unknown gun type)
Unknown

Discussion:
These variables are designed to capture the caliber/gauge or estimated caliber/gauge of the firearm
used in the fatal event.
 Firearms have a caliber or a gauge, but not both. Caliber is used with handguns and rifles. Gauge is
used with shotguns.
 The codes correspond to calibers, measured in fractions of an inch or in millimeters, or gauges in the
case of shotguns.
 Recovered cartridge casings, the firearm itself, and the bullet are sources for indicating or estimating
the firearm caliber.
Section 6: Weapon Variables

135 | P a g e






Some firearms will fire more than one type of cartridge. For example, firearms designed to fire the
.357 Magnum will also fire .38 (Smith & Wesson) Special cartridges.
Unless a cartridge casing is recovered, it may be impossible to tell which cartridge type was involved
in the incident. Consequently, this field should be coded from cartridge casings when they are
available, from the markings stamped onto the firearm when cartridge casings are not recovered,
and from recovered bullets when neither a casing nor a firearm is recovered.
A special code (1000) has been created for cases when a bullet has been recovered and the absence
of a cartridge or firearm makes it impossible to determine the difference between a .38 and a .357.

The “caliber” of a rifle or handgun is the diameter of the bore before the rifling grooves were cut.
 Caliber may also be given in terms of bullet, land, or groove diameter.
 In some cases, the caliber specification associated with particular cartridge types is neither accurate
nor consistent. For example, the caliber of the .38 Special cartridge is actually .357, not .38 as the
cartridge type suggests.
The term “gauge” is used to describe the size of the bore of a shotgun.
 The term refers to the number of lead balls of the given bore diameter that make up a pound. In a
12-gauge, for example, it takes 12 bore-diameter lead balls to make up a pound.
 The most common exception to this nomenclature is the .410, which has a bore diameter of 0.410
inches.

6.3.4
6.3.5

Firearm make or NCIC code: FirearmMake
Other Firearm make text: FirearmMakeText

Definitions:
 FirearmMake: Manufacturer of the firearm used to inflict the injury (e.g., Colt, Glock, Remington,
Sig-Sauer) or NCIC code
 FirearmMakeText: Text field to indicate manufacturer of the firearm if “Make” is coded as “Other”
Response Options:
 FirearmMake: Make from system
666
Other make of firearm
888
Not applicable
999
Unknown


FirearmMakeTexts: Text

Discussion:
These data elements use a 3-character manufacturer code developed by the National Crime Information
Center (NCIC) of the Federal Bureau of Investigation. A code list covering make and model is supplied in
a separate document in the software’s Help utility. The NVDRS software includes a list for the NCIC make
codes.
 If a manufacturer does not appear in the code list, please mark “Other make of firearm” and enter
the manufacturer in “MakeText”.
 Use “Unknown” when make is unknown.

Section 6: Weapon Variables

136 | P a g e

6.3.6
6.3.7

Firearm model: FirearmModel
Other Firearm model text: FirearmModelText

Definitions:
 FirearmModel: Model of the firearm that was used to inflict the injury (e.g., 1911, 17, 870 Express
Magnum, P226)
 FirearmModelText: Text field to indicate model of the firearm if Model was coded as “Other”
Response Options:
 FirearmModel
Text
 Other model of firearm
“Not applicable”
“Unknown”
 FirearmModelText:
Text
Discussion:
These data elements are coded using a list of models (sorted by manufacturer). A combination of make
and model must be used to uniquely identify the firearm type, as some models are made by more than
one manufacturer.
 If a specific model is not known, choose “Unknown”.
 If a model does not appear in the code list, please mark “Other model of firearm” and enter the
model in “ModelText”. When completing “ModelText”, capitalize all text, avoid using dashes and
decimals, and omit spaces.
 Completely spell out the model name; do not use abbreviations.

6.3.8
6.3.9

Gun stored loaded: GunLoaded
Gun stored locked: GunStoredLocked

Definition:
 GunLoaded : Was the firearm used in the violent death stored loaded
 GunStoredLocked : Was the firearm used in the violent death stored locked
Response Options:
 GunLoaded
0
Stored Unloaded
1
Stored Loaded
6
Other (specify in gun access narrative)
8
Not applicable
9
Unknown

0
1
6
8

GunStoredLocked
Not locked
Locked (stored with trigger lock on or in locked enclosure like closet)
Other (specify in youth access narrative)
Not applicable

Section 6: Weapon Variables

137 | P a g e

9
Unknown
Discussion:
The variables are to be coded when firearms were used by a victim or suspect to inflict the fatal injury in
suicides, homicides, undetermined deaths, and unintentional firearm deaths. Although this information
may not be known for a substantial percent of homicides and some suicides, this information is useful to
collect in violent deaths; especially those involving youth (e.g., 17 years of age or younger) and suicides
or homicides where a gun was accessed quickly by the victim/suspect right before the incident.
 In the narrative, include a brief summary of where and from whom the firearm was obtained and
whether the youth had authorized access to the firearm.
Note: Before August, 2013, this variable primarily collected information on youth victims and suspects
and was optional to collect on adult violent deaths involving a firearm. After August, 2013, this
information is collected on all firearm deaths where data is available.

6.3.10 Gun access narrative: GunAccessNarrative

Definition:
The narrative provides details about how the victim or suspect got access to the firearm used to inflict
the injury.
Response Options:
Text
Discussion:
Complete this variable when firearms were used by a victim or suspect to inflict the fatal injury in
suicides, homicides, undetermined deaths, and unintentional firearm deaths. The narrative should
include a brief summary of where and from whom the firearm was obtained. For incidents involving
youth include whether or not the youth had authorized access to the firearm. Although this information
may not be known for a substantial percent of homicides and some suicides, this information is
especially useful to collect in violent deaths involving youth (e.g., 17 years of age or younger) and
suicides or homicides where a gun is accessed quickly by the victim/suspect right before the incident.
Note: Before August, 2013, this variable primarily collected information on youth victims and suspects
and was optional to collect on adult violent deaths involving a firearm. After August, 2013, this
information is collected on all firearm deaths where data is available.

6.3.11 Gun owner: GunOwner
Definition:
Owner of the firearm used to inflict the fatal injury
Response Options:
1
Shooter
2
Parent of shooter
3
Other family member of shooter
6
Friend/acquaintance of shooter
Section 6: Weapon Variables

138 | P a g e

7
66
99

Stranger to shooter
Other (specify in gun access narrative)
Unknown

Discussion:
Code this variable when firearms were used by a victim or suspect to inflict the fatal injury in suicides,
homicides, undetermined deaths, and unintentional firearm deaths. This variable can be used to better
understand how victims and suspects gain access to the firearms they use to injure themselves or
others.
Note: Before August, 2013, this variable primarily collected information on youth victims and suspects
and was optional to collect on adult violent deaths involving a firearm. After August, 2013, this
information is collected on all firearm deaths where data is available.

6.3.12 Firearm stolen: FirearmStolen
Definition:
Firearm listed or reported as stolen
Response Options:
0
No
1
Yes
8
Not applicable
9
Unknown
Discussion:
Code this variable when firearms were used by a victim or suspect to inflict the fatal injury in suicides,
homicides and undetermined deaths. Code as “Yes” if the gun was formally reported as stolen in ATF
trace results, law enforcement records, or if law enforcement or CME learned that the gun had been
stolen during the course of the death investigation.
 If a household member takes a gun from another household member and uses it without his or her
permission, do not code that gun as stolen unless the owner had reported the gun as stolen to law
enforcement.

Section 6: Weapon Variables

139 | P a g e

SECTION 7: SUSPECT VARIABLES
A suspect is defined as a person believed to have committed a crime and who is, therefore, being
investigated by the police.







There are no suspects for isolated suicides and self-inflicted unintentional firearm deaths.
For homicides, include as suspects people who are listed by the law enforcement or the CME as
suspects.
For unintentional firearm deaths that are not self-inflicted, include the person who fired the weapon
as a suspect and anyone else listed by the law enforcement as a suspect.
A person does not have to be arrested or identified to be listed as a suspect. As long as the number
of persons involved in the death is known, (e.g., law enforcement report that the victim was stabbed
by two men), list each as a suspect, even if nothing further is known about him.
If there is no information at all about suspects in the source documents, however, do not include
any suspects in the incident.

Note: Before August 2013, a victim could only be associated with three suspects. After August, 2013, a
victim can be associated with any number of suspects. The program automatically links a victim to
associated suspects and each suspect will be assigned its own row in the suspects table.

7.1

Suspect age in years: AgeYearsSuspect

Definition:
Age of the suspect at the time of the incident in years.
Response Options:
Age Years:
1 to 125
999
Unknown
Discussion:
Unlike age of victim, age for suspects should be reported in years because very young children are very
unlikely to be suspects.



7.2

If age is not provided, code as “999” for unknown.
Sometimes the suspect’ age will be reported as a range
o If age is provided within a five-year age range or less, choose the midpoint of the range;
round to the lower year if the midpoint calculation results in a half year. For example, a
suspect reported to be 20 to 25 years of age would be entered as 22.
o If an age range of greater than 5 years is provided, enter the age as unknown. For instance,
a suspect whose reported age was between 20 and 30 would be entered as 999

Suspect sex: SexSuspect

Definition:
Sex of the suspect is the person’s sex as listed in the source documents.
Section 7: Suspect Variables

140 | P a g e

Response Options:
1
Male
2
Female
9
Unknown
Discussion:
None

7.3

Victim to Suspect relation 1: VictimSuspectRelationship1

Definitions:
Description of the primary relationship of the victim to the suspect
Response Options:
1
Spouse
2
Ex-spouse
3
Girlfriend or boyfriend
7
Ex-girlfriend or ex-boyfriend
8
Girlfriend or boyfriend, unspecified whether current or ex
10
Parent
11
Child
12
Sibling
13
Grandchild
14
Grandparent
15
In-law
16
Stepparent
17
Stepchild
18
Child of suspect’s boyfriend/girlfriend (e.g., child killed by mom’s boyfriend)
19
Intimate partner of suspect’s parent (e.g., teenager kills his mother’s boyfriend)
20
Foster child
21
Foster parent
29
Other family member (e.g., cousin, uncle, etc.)
30
Babysitter (e.g., child killed by babysitter)
31
Acquaintance
32
Friend
33
Roommate (not intimate partner)
34
Schoolmate
35
Current/former work relationship (e.g., co-worker, employee, employer)
36
Rival gang member
44
Other person, known to victim
45
Stranger
50
Victim was injured by law enforcement officer
51
Victim was law enforcement officer injured in the line of duty
99
Relationship unknown

Section 7: Suspect Variables

141 | P a g e

Discussion:
These variables will be assigned by the abstractor for each suspect for a given victim.
 Use the following sentence as a guide for selecting the appropriate description of the relationship:
“The victim is the ____________ of the suspect”. For example, when a parent kills a child, the
relationship is “Child” not “Parent.” (“The victim is the child of the suspect.”)


Prioritization in coding:
1) intimate partner relationships (spouses, girlfriend/boyfriend, ex-partners) or law enforcement
2) other family relationships
3) rival gang member
4) any other relationship
5) strangers



Gay and lesbian relationships should be coded in the same way as heterosexual relationships (e.g.,
“Girlfriend” or “Boyfriend”). The nature of the relationship will be indicated by the sex of the victim
and suspect.
A “babysitter” includes child care providers such as nannies or relatives of a child other than a
parent or guardian.
An “acquaintance” is someone with or about whom the victim has had some prior interaction or
knowledge.
A “stranger” is someone with whom the victim has had no prior interaction before the event that
culminated in the violent injury.
Where there is more than one offender working together in an incident (as in a drive-by shooter and
his or her driver), code the victim’s relationship to each offender individually (e.g., the victim may
have known one suspect, but not known two other suspects).
If it is unknown whether the victim and suspect were strangers or not, code as “99” unknown.
If the victim and suspect knew each other, but the exact nature of their relationship is unclear, code
as “44” other person known to victim.









7.4

Victim to Suspect relation 2: VictimSuspectRelationship2

Definitions:
Description of the secondary relationship of the victim to the suspect
Response Options:
1
Spouse
2
Ex-spouse
3
Girlfriend or boyfriend
7
Ex-girlfriend or ex-boyfriend
8
Girlfriend or boyfriend, unspecified whether current or ex
10
Parent
11
Child
12
Sibling
13
Grandchild
14
Grandparent
15
In-law
16
Stepparent
Section 7: Suspect Variables

142 | P a g e

17
18
19
20
21
29
30
31
32
33
34
35
36
44
45
50
51
88
99

Stepchild
Child of suspect’s boyfriend/girlfriend (e.g., child killed by mom’s boyfriend)
Intimate partner of suspect’s parent (e.g., teenager kills his mother’s boyfriend)
Foster child
Foster parent
Other family member (e.g., cousin, uncle, etc.)
Babysitter (e.g., child killed by babysitter)
Acquaintance
Friend
Roommate (not intimate partner)
Schoolmate
Current/former work relationship (e.g., co-worker, employee, employer)
Rival gang member
Other person, known to victim
Stranger
Victim was injured by law enforcement officer
Victim was law enforcement officer injured in the line of duty
All relevant information about relationship is already provided in Relation 1 (entered in the
Relationship 2 field)
Relationship unknown

Discussion:
If the victim has two or more relationships with the suspect (e.g., co-workers and intimate partner), this
variable should be completed.
 Use the following sentence as a guide for selecting the appropriate description of the relationship:
“The victim is the ______________ of the suspect”. For example, when a parent kills a child, the
relationship is “Child” not “Parent.” (“The victim is the child of the suspect.”)


Prioritization in coding:
1) intimate partner relationships (spouses, girlfriend/boyfriend, ex-partners) or law enforcement
2) other family relationships
3) rival gang member
4) any other relationship
5) strangers



Gay and lesbian relationships should be coded in the same way as heterosexual relationships (e.g.,
“Girlfriend” or “Boyfriend”). The nature of the relationship will be indicated by the sex of the victim
and suspect.
A “babysitter” includes child care providers such as nannies or relatives of a child other than a
parent or guardian.
An “acquaintance” is someone with or about whom the victim has had some prior interaction or
knowledge.
A “stranger” is someone with whom the victim has had no prior interaction before the event that
culminated in the violent injury.
Where there is more than one offender working together in an incident (as in a drive-by shooter and
his or her driver), code the victim’s relationship to each offender individually (e.g., the victim may
have known one suspect, but not known two other suspects).
If it is unknown whether the victim and suspect were strangers or not, code as “99” unknown.








Section 7: Suspect Variables

143 | P a g e




7.5

If the victim and suspect knew each other, but the exact nature of their relationship is unclear, code
as “44” other person known to victim.
If all relevant information regarding the relationship is captured in “Relation 1”, then code “Relation
2” as 88 for: “All relevant information about relationship is already provided in Relation 1.

History of abuse of victim by this suspect: AbuseHistory

Definitions:
History of abuse of victim by this suspect
Response Options:
Checkbox
Discussion:
For each victim-suspect pair in which (1) the offender was a caretaker of the victim including children
taking care of their parents or (2) the offender was a current or ex-intimate partner, indicate whether
the data sources document a history (or suspected history) of abuse of this victim by the suspect.



The evidence of ongoing abuse may be suspected but not confirmed.
Abuse can be physical, psychological, sexual or others as long as the source document refers to
‘abuse’.

Other Codes: If the suspect was a caretaker and abuse/neglect is ongoing, consider coding
“Abuse/neglect led to death”. If the abuse involved child maltreatment consider coding “History of
abuse or neglect as a child”

7.6

This suspect was caregiver for the victim: CareGiver

Definition:
Suspect was a caregiver for this victim
Response Options:
0
No, Not Collected, Not Available, Unknown
1
Yes
Discussion:
After indicating the relationship for each victim-suspect pair, determine whether the offender was a
caregiver for the victim. Caretaker includes children taking care of their parents.
Other Codes: Consider coding “Abuse/neglect led to death” if the abuse caused the victim’s death or
“History of abuse or neglect as a child” if the abuse involved child maltreatment.

Section 7: Suspect Variables

144 | P a g e

7.7

Suspect attempted suicide after incident: AttemptedSuicide

Definition:
Suspect attempted suicide (fatally or non-fatally) after the death of the victim
Response Options:
0
No, Not Collected, Not Available, Unknown
1
Yes
Discussion:
This variable is suspect specific.
 Code as “Yes” if a suspect attempted suicide after the death of the victim during the incident,
whether the attempt was fatal or non-fatal.
 Refer to the Violent Death Incident section of this document for guidance on whether a suicide
involving the suspect is to be considered as part of the same NVDRS incident as the homicide.

7.8

Suspect is also a victim in the incident: SuspectAlsoVictim

Definition:
This indicates that the suspect for this victim is also a victim of homicide, suicide or legal intervention, or
undetermined intent in the incident (e.g., a suspect/victim).
Response Options:
Checkbox
Discussion:
In incidents involving a victim/suspect, this variable can help link the suspect and victim information.
Examples of when a suspect is also a victim in the incident:

A man kills his wife and then kills himself. He is a suspect because he killed someone else, and a
suicide victim because he killed himself; thus he is both suspect and victim.

A person robs a store and kills the store clerk. While running from the store he is shot and killed by a
law enforcement officer. The person is a suspect in the killing of the store clerk and is a legal
intervention victim because he is killed by a law enforcement officer; thus he is both a suspect and a
victim.

A husband learns his wife is having an affair with a male friend. The husband kills the male friend in
anger. The distraught wife kills her husband. The husband is a suspect because he killed the male
friend, and a victim because he was then killed by his wife; thus he is both a suspect and a victim.

Note: This variable was added in August, 2013.

7.9

Suspect Mentally Ill: SuspectMentallyIll

Section 7: Suspect Variables

145 | P a g e

Definition:
The suspect’s attack on the victim is believed to be the direct result of a mental illness
Response Options:
Checkbox
Discussion:
Code as “Yes” if the suspect’s attack on the victim is believed to be the direct result of the suspect’s
mental illness. A suspect that is undergoing psychiatric care or has been ordered to receive a
psychological evaluation by a court may be considered “mentally ill” for purposes of this variable.
This circumstance may only be endorsed for homicide victims. Victims of suicide do not have “suspects”
in NVDRS, so this circumstance will never be endorsed for a suicide victim. Mental health problems,
diagnoses and treatment of suicide victims are captured by other variables.

7.10
Suspect had developmental disability at time of incident:
SuspectDevelopmentalDisability

Definition:
Suspect had developmental disability at time of incident.
Response Options:
0 No, Not available, Unknown,
1 Yes
Discussion:
Developmental disability (as expressed by terms that may be found in source documents, such as
autism, intellectual impairments, “mentally challenged," “mental retardation,” “special needs,” etc.)
implies a chronic cognitive or developmental deficit that has a substantial, long-term effect on day-today function. The developmental disability can be perceived or diagnosed.
 If the suspect was not specifically diagnosed with or documented to have a developmental
disability, answer “No.”
 The answer “No” may thereby include “Not available” and “Unknown.”
 The information used to complete this data element may come from law enforcement, medical
records, and/or autopsy.
Note: This variable was added in August, 2016.
_____________________________________________________________________________________
7.11

Suspected alcohol use by suspect: SuspectAlcoholUseSuspected

Definition:
Suspected alcohol use by the suspect in the hours preceding the incident.
Response Options:
Section 7: Suspect Variables

146 | P a g e

0 No, Not available, Unknown,
1 Yes
Discussion:
“SuspectAlcoholUseSuspected” can be coded as “Yes” based on witness or investigator reports (e.g.,
Law enforcement note that the suspect “had been drinking heavily”), or circumstantial evidence (e.g.,
empty six pack scattered around the suspect). This variable refers only to alcohol use and not drug use.
The phrase “in the hours preceding the incident” can be interpreted relatively broadly.
 If there is no evidence of alcohol use, code this variable as “No”.
 The answer “No” may thereby include “Not available” and “Unknown.”
 Use the “Unknown” option only if the source does not have a narrative that could provide the
evidence of alcohol use. For instance, if the narrative does not mention use of alcohol in any
way, code “No”.
 This code should be based solely on the scene investigation and should not refer to toxicology
reports.
Note: This variable was added in August, 2016.
_____________________________________________________________________________________
7.12

Suspected substance use by the suspect: SuspectSubstanceUseSuspected

Definition:
Suspected substance use by the suspect in the hours preceding the incident.
Response Options:
0 No, Not available, Unknown,
1 Yes
Discussion:
“SuspectSusbstanceUseSuspected” can be coded as “Yes” based on witness or investigator reports (e.g.,
Law enforcement note that the suspect was “under the influence of drugs”), or circumstantial evidence
(e.g., used syringes scattered around the suspect). This variable refers only to drug use and not alcohol
use. The phrase “in the hours preceding the incident” can be interpreted relatively broadly.
 If there is no evidence of substance use, code this variable as “No”.
 The answer “No” may thereby include “Not available” and “Unknown.”
 Use the “Unknown” option only if the source does not have a narrative that could provide the
evidence of substance use. For instance, if the narrative does not mention substance use in any
way, code “No”.
 This code should be based solely on the scene investigation and should not refer to toxicology
reports.
Note: As of August 2013, a person who takes methadone is no longer assumed to be in treatment for
heroin addiction and should be coded as “No” unless other information is available (e.g., taking
methadone as part of substance abuse treatment).
Note: This variable was added in August, 2016.
_____________________________________________________________________________________
7.13

Suspect recently released from an institution: SuspectRecentRelease

Section 7: Suspect Variables

147 | P a g e

Definition:
Suspect injured victim within a month of being released from or admitted to an institutional setting.
Response Options:
0 No evidence of recent release
1 Jail, prison, or a detention facility
2 Hospital
3 Psychiatric hospital
4 Other psychiatric institution
5 Long term residential health facility (e.g., nursing home)
6 Supervised residential facility related to alcohol or substance abuse treatment (e.g., residential
treatment facility, sober house or group home)
7 Supervised residential facilities not related to alcohol or substance abuse treatment (e.g., halfway
houses or work-release homes)
9 Other
99 Unknown type of institution
Discussion:
If there is no evidence of a release within the past month from an institutionalized setting in the data
sources, this variable should be coded as ‘0’. In contrast, if there is evidence that the suspect was
released from an institutionalized setting in the last month; the type of institution (e.g., jail, hospital, or
psychiatric hospital) should be coded. The suspect is considered institutionalized if they spent one or
more nights in the institution. For instance, if a suspect was released three days ago from an overnight
institutional stay or a stay of over a year, the abstractor would record the type of institution from which
they were released. If an individual was recently released from more than one facility/institution, code
the one from which they were MOST RECENTLY released.
 Code both voluntary and involuntary commitments. The death should be coded as “0” if a
suspect visits an institution for medical care (e.g., emergency department) and does not stay
overnight or is arrested and not held overnight.
 If the document(s) state that the suspect was “just” or “recently” released and provides no
specific timing on the release, the abstractor should consider the suspect recently released and
record the type of institution from which he or she was released.
 If the suspect was hospitalized in a psychiatric ward of a non-psychiatric hospital, code type of
institution as "Psychiatric Hospital"
When this code is endorsed, the narrative should include information on the reason for being
institutionalized (e.g., incarcerated for aggravated assault, hospitalized for a broken hip or released from
court mandated drug treatment), the type of institution (e.g., hospital or prison), the length the suspect
was institutionalized and problems related to the release, if applicable (e.g., unable to find a job after
release or financial difficulties after release).
Note: This variable was added in August, 2016.
_____________________________________________________________________________________
7.14

Suspect recently in contact with law enforcement: SuspectContactWithPolice

Definition:
Section 7: Suspect Variables

148 | P a g e

Suspect had contact with Law enforcement in the past 12 months.
Response Options:
0 No, Not available, Unknown
1 Yes
Discussion:
This variable refers to whether the suspect had contact with law enforcement in the 12 months prior to
the fatal incident. An arrest does not need to have been made to endorse this variable. This may include
scenarios where police were called but no charges were filed. The answer “No” may include “Not
available” and “Unknown.”
Note: This variable was added in August, 2016.

7.15

Suspect Race Variables

7.15.1
7.15.2
7.15.3
7.15.4
7.15.5
7.15.6

Suspect White: RaceWhiteSuspect
Suspect Black or African American: RaceBlackSuspect
Suspect Asian: RaceAsianSuspect
Suspect Native Hawaiian or other Pacific Islander: RacePacificIslanderSuspect
Suspect American Indian or Alaska Native: RaceAmericanIndianSuspect
Suspect Unspecified race: RaceUnspecifiedSuspect

Definitions: Race±
 RaceWhiteSuspect: Person with origins among any of the original peoples of Europe, North Africa,
or the Middle East
 RaceBlackSuspect: Person with origins among any of the black racial groups of Africa
 RaceAsianSuspect: Person with origins among any of the original peoples of the Far East, Southeast
Asia, or the Indian subcontinent
 RacePacificIslanderSuspect: Person with origins among any of the original peoples of the Pacific
Islands (includes Native Hawaiians)
 RaceAmericanIndianSuspect: Person with origins among any of the original peoples of North
America and who maintains cultural identification through tribal affiliation or community
recognition (includes Alaska Natives)
 RaceUnspecifiedSuspect: If a person’s ethnicity is provided in place of their race, e.g., race is given
as “Hispanic”, and no other valid race value is given, mark their race as “unspecified
Response Options:
Checkbox
Discussion:
For multi-racial decedents, please check each race identified in source documents (e.g., if the decedent
is identified as “white” and “Asian”, please check “white” and “Asian”). If “Asian/Pacific Islander” is
indicated, check both “Asian” and “PacificIslander”. These standards were used by the U.S. Census
Bureau in the 2000 decennial census.
±

NVDRS follows HHS and OMB standards for race/ethnicity categorization. HHS guidance on
race/ethnicity is available from: http://aspe.hhs.gov/datacncl/standards/ACA/4302/index.shtml
Section 7: Suspect Variables

149 | P a g e

7.16

Suspect Hispanic/Latino/Spanish: EthnicitySuspect

Definition:
Ethnicity± of the suspect of Mexican, Puerto Rican, Cuban, Central or South American, or other Spanish
culture or origin, regardless of race.
Response Options:
0
Not Hispanic or Latino
1
Hispanic or Latino
9
Unknown
Discussion:
None
±

NVDRS follows HHS and OMB standards for race/ethnicity categorization. HHS guidance on
race/ethnicity is available from: http://aspe.hhs.gov/datacncl/standards/ACA/4302/index.shtml

Section 7: Suspect Variables

150 | P a g e

SECTION 8: TOXICOLOGY VARIABLES
Toxicology information is important to collect in order to understand the role of alcohol, illegal drugs,
and prescription drugs in violent deaths.

8.1

Instructions for Entering Toxicology Information

In the Toxicology Findings section:
 For each substance that tested positive, enter the matching substance name, that it was tested, and
that the results were present. Also, enter whether or not the substance caused the death and the
person the substance was prescribed for.
 (Optional Step) Enter the names of substances with negative results.
 Review your entries and hit “Save”. This will auto-populate the Toxicology Summary section. If you
edit the Toxicology Findings section after you first “Save”, it will no longer auto-populate and you
will need to manually verify the changes to the Toxicology Summary.
In the Toxicology Summary section:
 Enter responses to tested and results fields for all of the summary categories (e.g., alcohol, carbon
monoxide, amphetamines, anticonvulsants, antidepressants, antipsychotics, barbiturates,
benzodiazepines, cocaine, marijuana, muscle relaxants, and opiates) that were not completed with
the auto fill.
 Enter Blood Alcohol Content and Source of Carbon Monoxide, if applicable.

8.2

No toxicology report: NoToxicologyAvailable

Definition:
A toxicology report was not available.
Response Options:
Checkbox
Discussion:
Checking this variable will prevent you from being able to enter any toxicology information. This variable
is exported to the victim’s file and not the toxicology file.

8.3

Date specimens were collected: SpecimensDate

Definition:
Date that body specimens were collected.
Response Options:
Date (format: MM/DD/YYYY)
06/99/2007

for June 2007 with the day unknown

Section 8: Toxicology Variables

151 | P a g e

99/99/2007
88/88/8888
99/99/9999

for 2007 with the month and day unknown
Not applicable (no specimens collected)
Unknown (Use ‘99’ for unknown day/month and ‘9999’ unknown year).

Discussion:
Date and time of collection of body specimens, in conjunction with date and time of death and injury,
can be used to assess the validity of alcohol and drug testing results and the possible contribution of
drugs or alcohol to the injury. For example, blood specimens drawn long after death will not accurately
reflect intoxication level at the time of death. The date of the postmortem exam can be used as the date
specimens were collected in the absence of other information.

8.4

Time specimens were collected: SpecimensTime

Definition:
Time that body specimens were collected.
Response Options:
0000 to 2359 24-hour format (2:00 PM coded as 1400)
7777
Not collected by reporting site
8888
Not applicable
9999
Unknown
Discussion:
Time is in the military time format HHMM and can be 0000 (midnight) to 2359 (11:59 pm). See “Date
specimens were collected” for further discussion.

8.5

Substance Name: SubstanceName

Definition:
Substance name in toxicology report. The presence of a metabolite of a substance is considered
sufficient evidence that the substance itself was present.
Response Options:
Look-up table
Discussion:
Many labs report test results as both the specific substance that a person was tested for (e.g., Prozac)
and the category (e.g., antidepressants) that the substance falls under. Some, however, report only the
substance or only the category. The look up table will help identify, which broad categories the
substance falls under. The order of the substances is not important—there is no implication that
“Substance Name 1” is more significant than “Substance Name 2,” for example. However, to simplify
data entry, it is recommended to enter the substances in the same order they are mentioned in the
source document.
Each substance is entered as a row in the toxicology table and there is no limit on the number of
substances that can be entered.
Section 8: Toxicology Variables

152 | P a g e

Note: Questions about whether a chemical is a metabolite can be referred to CDC. If a substance cannot
be found in the look up table,
 Code “Other” in the substance field,
 Record the name of the substance in “Comments” field, and
 Contact CDC scientist so the substance can be added to the list.
Reference: The look-up table is based upon data from the Lexi-Comp drug database: Lexi-Comp
OnlineTM, Hudson, Ohio: Lexi-Comp, Inc.; August 14, 2012 and reports of the data should recognize the
license appropriately.

8.6

Substance Tested: SubstanceTested

Definition:
Substance was tested for in toxicology report.
Response Options:
1
Tested
2
Not tested
9
Unknown
Discussion:
These variables indicate whether the victim’s blood, urine, vitreous humor (ocular fluid), bile, or other
tissues were tested for a variety of drugs or their metabolites by any standard toxicology screening
method. Each substance is entered as a row in the toxicology table and there is no limit on the number
of substances that can be entered.

8.7

Substance Result: SubstanceResult

Definition:
Toxicology test results for the substance.
Response Options:
1
Present (e.g., “positive,” “presumptive presence,” or having a numeric level greater than 0)
2
Not present
8
Not applicable (e.g., Testing was not done)
9
Unknown
Discussion:
When Substances Tested is “Unknown” or “Not Tested”, the program will automatically code the
Substance Result as “Not applicable”. Each substance is entered as a row in the toxicology table and
there is no limit on the number of substances that can be entered.

Section 8: Toxicology Variables

153 | P a g e

8.8

Substance Caused Death: SubstanceCausedDeath

Definition:
Substance clearly identified as the cause of death.
Response Options:
0
No / Unknown
1
Yes
Discussion:
If a source document clearly identifies a single substance as the cause of death, code only that
substance as causing the death. If multiple substances are identified with no indication as to which one
caused the death of the victim, code all listed substances that are suspected of being involved as cause
of death.
When victims have been exposed to multiple toxic substances, data providers may not be able to
determine which of them was primarily responsible for causing death. Therefore, this code
accommodates the entry of multiple substances. Each substance is entered as a row in the toxicology
table and there is no limit on the number of substances that can be entered.

8.9

Person Prescribed for: DrugObtainedFor

Definition:
For prescription drugs, this describes the relationship between the victim and the person to whom the
prescription medications were prescribed.
Response Options:
1
Self
2
Intimate Partner
3
Family (non-intimate partner)
4
Other
8
Not applicable (e.g., not a prescribed drug)
9
Relationship unknown
Discussion:
This variable can be used to better understand how the victim or suspect obtained prescription
medications. Please record the person for whom the drug(s) taken were prescribed. Over-the-counter
medications are by definition not obtained through prescription, and may be coded “Not applicable”.
Each substance is entered as a row in the toxicology table and there is no limit on the number of
substances that can be entered.

8.10

Substance Categories: SubstanceClass

Definition:
Substance categories
Section 8: Toxicology Variables

154 | P a g e

Response Options: (auto-populated)
1
Alcohol
2
Amphetamine
3
Antidepressant
4
Antipsychotics
5
Benzodiazepines
6
Barbiturates
7
Cocaine
8
Carbon Monoxide
9
Marijuana
10
Anticonvulsants
11
Muscle relaxant
12
Opiate
88
Not Applicable
Discussion:
The substance category will match the name of the category in the toxicology summary when
applicable. For drugs that do not fall into any of the summary categories, the category “Not Applicable”
will be displayed. Each substance is entered as a row in the toxicology table and there is no limit on the
number of substances that can be entered.

8.11

Summary: Substances Tested For

8.11.1 Tested for alcohol: AlcoholTested
8.11.2 Tested for carbon monoxide: CarbonMonoxideTested
8.11.3 Tested for amphetamine: AmphetamineTested
8.11.4 Tested for anticonvulsants: AnticonvulsantTested
8.11.5 Tested for Antidepressants: AntidepressantsTested
8.11.6 Tested for Antipsychotics: AntipsychoticsTested
8.11.7 Tested for barbiturates: BarbituratesTested
8.11.8 Tested for benzodiazepines: BenzodiazepinesTested
8.11.9 Tested for cocaine: CocaineTested
8.11.10 Tested for marijuana: MarijuanaTested
8.11.11 Tested for muscle relaxant: MuscleRelaxantTested
8.11.12 Tested for opiate: OpiateTested
Definition:
Summary of substance results.
Response Options:
1
Tested
0
Not tested
9
Unknown
Discussion:
This set of variables identifies whether certain types of substance were tested for. This can help identify
jurisdictions that routinely run toxicology tests on victims.
Section 8: Toxicology Variables

155 | P a g e

Note: The following summary categories were added in August, 2013: anticonvulsants, antipsychotics,
barbiturates, benzodiazepines and muscle relaxants.

8.12

Summary: Results Substances Tested For

8.12.1 Alcohol results summary: AlcoholResult
8.12.2 Carbon monoxide results summary: CarbonMonoxideResult
8.12.3 Amphetamine results summary: AmphetamineResult
8.12.4 Anticonvulsants results summary: AnticonvulsantResult
8.12.5 Antidepressants results summary: AntidepressantsResut
8.12.6 Antipsychotics results summary: AntipsychoticsResult
8.12.7 Barbiturates results summary: BarbituratesResult
8.12.8 Benzodiazepines results summary: BenzodiazepinesResult
8.12.9 Cocaine results summary: CocaineResult
8.12.10 Marijuana results summary: MarijuanaResult
8.12.11 Muscle relaxant results summary: MuscleRelaxantResult
8.12.12 Opiate results summary: OpiateResult
Definition:
Summary of substance results.
Response Options:
1
Present
2
Not present
8
Not applicable (e.g., Testing was not done)
9
Unknown
Discussion:
This set of variables identifies whether the tests for various drugs or their metabolites were positive or
negative. Findings can assist in exploring the relationship between drug use and violent death. The
variables can also be used to document the presence of certain psychiatric medications among suicide
victims in jurisdictions that test for these substances. If a test result for a substance was “Not tested” or
“Unknown”, the program will automatically auto-fill the results for this variable as “Not applicable”.
This information will be auto-populated based on the substances entered in the Toxicology Findings
section.
Note: The following summary categories were added in August, 2013: anticonvulsants, antipsychotics,
barbiturates, benzodiazepines and muscle relaxants.

8.13

Blood Alcohol Level: AlcoholLevel

Definition:
Blood alcohol level

Section 8: Toxicology Variables

156 | P a g e

Response Options:
Please enter all three digits of the blood alcohol concentration (BAC), if available. Trailing zeroes are
added for all values that are not three digits (e.g., .08 becomes .080).
0. ###
0.010
0.000
0.888
0.999

Blood alcohol level in mg/dl
BAC report indicates “trace” amounts without numeric value
Below the detection limit of the test (“<0.01%” or “Non-detectable”)
Not applicable, no testing
Unknown

Discussion:
These data will assist in exploring the relationship between alcohol intoxication and violent death when
interpreted in conjunction with data on time of injury, time of death, and time at which body specimens
were drawn.
 Blood alcohol levels are coded in terms of percent by volume (serum %). Percent by volume equals
the milligrams of alcohol found per deciliter of blood (mg/dl) divided by 1000. For example, a level
of 30 mg/dl would be 0.030% alcohol. How labs report blood alcohol concentrations (BAC) varies.
Many use the format used here (serum %), while others report BAC as milligrams of alcohol per
deciliter of blood (mg/dl) — as in 30 mg/dl. To convert mg/dl results to serum % results, divide by
1,000. Only BAC levels should be entered here; levels based on other body fluids such as vitreous
fluid should not. Use caution when interpreting BAC levels because variation in the time elapsed
between ingestion of substances, time of death, and time of drawing body specimens for
toxicological analysis will affect the outcome.
 BAC reported less than 0.01% should be interpreted as “Not present” in the alcohol test results field
and entered as 0.000
 Alcohol that appears in the blood as a result of decomposition rather than ingestion does not
generally measure more than 0.040%. If source documents attribute a BAC level entirely to
decomposition, do not record it. If source documents attribute it “partially” or “possibly” to
decomposition, record it and add an appropriate note to the incident narrative.
 BAC should only be entered for ethanol (e.g., alcohol, ethyl alcohol, or drinking alcohol) and not for
other substances such as methanol.

8.14

Carbon Monoxide Source: CarbonMonoxideSource

Definition:
Source of carbon monoxide
Response Options:
1
Motorized vehicle (e.g., car, truck, bus, motorcycle, boat)
2
Other
3
Gas tool/appliance/heater
4
Grill or barbeque (gas or charcoal, includes hibachi grills)
5
Fire (e.g., house fire)
8
Not applicable
9
Unknown
Discussion:
Section 8: Toxicology Variables

157 | P a g e

The information may be used to understand carbon monoxide sources to prevent suicides and homicide
related to fire.

8.15

Comments: ToxicologyComments

Definition:
Enter comments about substances or toxicology tests in this field, including substances not included in
the substance look-up field.
Response Options:
Text
Discussion:
If a substance is not on the substance look-up table, please put the information in this field. Also,
contact CDC so they can update the substance list.
Note: This variable was added in August, 2013.

Section 8: Toxicology Variables

158 | P a g e

SECTION 9: CHILD FATALITY REVIEW OPTIONAL MODULE
9.1 Witness and Scene Investigation

9.1.1

Witness(es) to fatal incident: CFR_Witness

Definition:
Were there any witnesses to the incident?
Response Options:
0
No
1
Yes
7
Not collected by reporting site
8
Not applicable
9
Unknown
Discussion:
Witness(es) include any person(s) other than a suspect who was present and observed the incident that
led to the child’s death. The caregiver can be considered a witness, but only if that person was not also
the perpetrator.

9.1.2

Child Witness(es) to fatal incident: CFR_ChildWitness

Definition:
Were there any child witnesses to the incident?
Response Options:
0
No
1
Yes
7
Not collected by reporting site
8
Not applicable
9
Unknown
Discussion:
A child witness is defined as a person less than 18 years of age who was present and observed the fatal
incident.

9.1.3

CFR additional information: CFR_AdditionalInformation

Definition:
Text field for describing additional relevant information provided by the Child Fatality Review data
source
Response Options:
Section 9: Child Fatality Review Optional Module

159 | P a g e

Text
Discussion:
As a text field, use this area to clarify circumstances surrounding the death that may not be clear from
the CFR data elements or other NVDRS data sources. For example, unusual circumstances surrounding
the death, household composition, supervision, or CFR committee decisions would be helpful in this text
box. Also, coding options for several variables require further explanation in the incident narrative; that
information should be included here. This box should only reflect unique information gathered from
CFR, as it is a document-based system.

9.1.4

CFR records available on victim: CFR_CFRRecordsAvailable

Definition:
Describes whether Child Fatality Review (CFR) records are available for this victim
Response Options:
0
No
1
Yes
7
Not collected by local CFR team
8
Not applicable
9
Unknown
Discussion:
Code CFR_CFRRecordsAvailable as “No” if the records have been requested for a child victim and the
CFR program either does not have a record for the victim or is unable to supply the record.

9.1.5

Scene investigation by law enforcement/CME: CFR_SceneInvestigationLE/CME

Definition:
Describes whether or not there was a scene investigation conducted by Law Enforcement or the CME.
Response Options:
0
No
1
Yes
7
Unknown
8
Not collected by local CFR team
9
Not applicable
Discussion:
None

9.2

Physical illness, Disability, Prenatal Variables

Section 9: Child Fatality Review Optional Module

160 | P a g e

9.2.1
9.2.2

Victim had a physical illness at time of incident: CFR_VictimPhysicalIllness
If yes, specify diagnosis: CFR_Diagnosis

Definitions:
 VictimPhysicalIllness: Victim had an acute or chronic illness at the time of the incident
 Diagnosis: Free text field to indicate diagnosis if victim was ill at the time of the incident
Response Options:
 VictimPhysicalIllness
0 No, Not Available, Unknown
1 Yes


Diagnosis: Text

Discussion:
Physical illness may be acute (e.g., viral gastroenteritis, pneumonia) or chronic (e.g., diabetes, asthma,
sickle cell anemia).
 If the chronic illness did not impose increased care demands at the time of the incident, do not code
“Yes.”
 The severity of the illness should not be considered when coding CFR_VictimPhysicalIllness.
 Any mention in the record of the victim being physically ill at the time of the incident is sufficient to
warrant coding CFR_VictimPhysicalIllness as “Yes”.
 Examples
o For example, if a child had a history of asthma, but had no acute exacerbation at the time of
the incident, code “No.”
9.2.3
9.2.4
9.2.5
9.2.6

Victim had disability at time of incident: CFR_VictimDisability
If yes, disability was physical: CFR_VictimDisabilityPhysical
If yes, disability was developmental: CFR_VictimDisabilityDevelopmntal
If yes, disability was sensory: CFR_VictimDisabilitySensory

Definitions:
 VictimDisability: Victim had a disability at the time of the incident
 VictimDisabilityPhysical: Victim’s disability was physical (e.g., paraplegic, cerebral palsy)
 VictimDisabilityDevelopmntal: Victim’s disability was developmental (e.g., intellectual disability,
autistic)
 VictimDisabilitySensory: Victim’s disability was sensory (e.g., blind, deaf)
Response Options:
0
No, Not Available, Unknown
1
Yes
Discussion:
Physical disability implies a chronic physical impairment that has a substantial, long-term effect on the
child’s day-to-day function (e.g., cerebral palsy, traumatic brain injury). Developmental disability implies
a chronic cognitive or developmental deficit that has a substantial, long-term effect on the child’s dayto-day function (as expressed by terms that may be found in source documents, such as autism,
intellectual impairments, “mentally challenged," “mental retardation,” “special needs,” etc.). Sensory
Section 9: Child Fatality Review Optional Module

161 | P a g e

disability implies a chronic sensory deficit that has a substantial, long-term impact on the child’s day-today functioning (e.g., blindness, deafness).
Prematurity in and of itself should not be considered an illness or a disability unless it resulted in a
condition that fits into one of those categories (e.g., chronic lung disease, visual impairment).





Please see Prenatal History variables to code for prematurity.
If a child was not specifically diagnosed with or documented to have one of the listed disabilities,
answer “No.”
The answer “No” may thereby include Missing and Unknown and “Known not to be present.”
The information used to complete this data element may come from parental history (as per law
enforcement or CPS records), medical records, and/or autopsy.

9.2.7

Infants: Prenatal care prior to the 3rd trimester: CFR_InfPrenatCarePri3rdTrim

Definition:
Victim’s (birth) mother received prenatal care prior to 3rd trimester
Response Options:
0
No
1
Yes
7
Not collected by local CFR team
8
Not applicable
9
Unknown
Discussion:
Do not collect for victims one year of age or older. Prenatal care is defined as pregnancy-related medical
care delivered by a doctor, nurse, or other healthcare professional with the goal of monitoring the
pregnancy, providing education, and increasing the likelihood of a positive maternal and fetal outcome.
Answer “Yes” only if there are documented prenatal visits before the third trimester.
9.2.8 Infants: Maternal recreational drug use: CFR_InfantsMaternRecDrugUse
9.2.9 Infants: Maternal alcohol use: CFR_InfantsMaternAlcoholUse
9.2.10 Infants: Maternal tobacco use: CFR_InfantsMaternTobaccoUse
Definitions:
 CFR_InfantsMaternRecDrugUse: Victim was exposed to recreational drugs in utero
 CFR_InfantsMaternAlcoholUse: Victim was exposed to alcohol in utero
 CFR_InfantsMaternTobaccoUse: Victim was exposed to tobacco in utero
Response Options:
0
No
1
Yes
7
Not collected by local CFR team
8
Not applicable
9
Unknown
Section 9: Child Fatality Review Optional Module

162 | P a g e

Discussion:
Do not collect these items for victims one year of age or older. Prenatal care is defined as pregnancyrelated medical care delivered by a doctor, nurse, or other healthcare professional with the goal of
monitoring the pregnancy, providing education, and increasing the likelihood of a positive maternal and
fetal outcome.
 Maternal recreational drug use includes all drugs (except alcohol and tobacco) that are either nonprescription, or are being used in a manner inconsistent with safe prescribing practices.
 Answer “Yes” only if there is documented evidence or clear reports of substance, alcohol or tobacco
use during pregnancy with the victim.
 Despite history of maternal substance, alcohol, and/or tobacco use with prior pregnancies, if it is not
documented or evident during her pregnancy with the victim, the data element should be coded
“No.”

9.2.11 Infants: Victim born prematurely: CFR_InfantsBornPrematurely
Definition:
Victim was born prematurely
Response Options:
0
No
1
Yes
7
Not collected by local CFR team
8
Not applicable
9
Unknown
Discussion:
Do not collect for victims one year of age or older. Prematurity is defined as an estimated gestational
age less than 37 weeks. Code ‘Yes’ if prematurity is listed in the source documents.

9.3

CPS Report Variables

9.3.1
9.3.2
9.3.3

Prior CPS report on the victim‘s household: CFR_PriorCPSReportVicHhold
If yes, CPS report filed on whom: CFR_SexualAbuseReportedOn
If yes, report substantiated: CFR_SexualAbuseReported

Definitions:
 CFR_PriorCPSReportVicHhold : Prior CPS report was filed on the victim’s household
 CFR_SexualAbuseReportedOn: Person on behalf of whom or against whom a CPS report was filed
 CFR_SexualAbuseReported: At least one prior CPS report filed on the victim’s household was
substantiated
Response Options:
 CFR_PriorCPSReportVicHhold
 CFR_SexualAbuseReported
0 No
Section 9: Child Fatality Review Optional Module

163 | P a g e

1
7
8
9


Yes
Not collected by local CFR team
Not applicable
Unknown

CFR_SexualAbuseReportedOn
1 Victim
2 Other child in household
3 Both
4 Adult in household
6 Other, or unspecified
7 Not collected by local CFR team
8 Not applicable
9 Unknown

Discussion:
These variables refer to CPS (Child Protective Services) contacts prior to the current incident, and not
contacts that resulted from the current case. “Household” is defined as the residence where the victim
lived the majority of the time when the fatal incident occurred. “Household” was chosen as the unit for
this question in an attempt to characterize the victim’s environment.
 In the case of a victim living with a foster family or in an institution at the time of the fatal incident,
answer regarding the family of origin.
 If known maltreatment existed in the foster family, describe in incident narrative. Please note that a
report or referral can be in reference to a child or an adult living in the household.
 When the only information available is that a report was filed on the household, indicate
“Unknown” for “CFR_SexualAbuseReportedOn”.
 If a report was not made on behalf of a child in the household, but a report was filed against an
adult who currently lives in the household (e.g., no reports against the victim’s mother, but the
mother’s boyfriend was previously investigated for abuse), code “CFR_SexualAbuseReportedOn” as
“adult in household.”
 Any substantiation ever should be coded as “Yes” even if some of the reports/referrals were
substantiated and others were not.

9.3.4

CPS case opened on other children due to this death: CFR_CPSCaseOpened

Definition:
A CPS case was opened on other children in the victim’s household as a result of this death
Response Options:
0
No
1
Yes
7
Not collected by local CFR team
8
Not applicable
9
Unknown
Discussion:
Refers to CPS contacts that resulted from the current case. “Household” is defined as the residence
Section 9: Child Fatality Review Optional Module

164 | P a g e

where the victim lived the majority of the time when the fatal incident occurred. “Household” was
chosen as the unit for this question in an attempt to characterize the victim’s environment.
 In the case of a victim living with a foster family or in an institution at the time of the fatal incident,
answer regarding the family of origin.
 If known maltreatment existed in the foster family, describe in incident narrative. Please note that a
report or referral can be in reference to a child or an adult living in the household.

9.4

Abuse/ Neglect Substantiation Variables

9.4.1. Physical abuse substantiated: CFR_PhysicalAbuseSubstant
9.4.2. Sexual abuse substantiated: CFR_SexualAbuseSubstant
9.4.3. Neglect substantiated: CFR_NeglectSubstantiated
Definitions:
 CFR_PhysicalAbuseSubstant: At least one substantiated CPS report filed on the victim’s household
was for physical abuse
 CFR_SexualAbuseSubstant: At least one substantiated CPS report filed on the victim’s household
was for sexual abuse
 CFR_NeglectSubstantiated : At least one substantiated CPS report filed on the victim’s household
was for neglect
Response Options:
0
No
1
Yes
7
Not collected by local CFR team
8
Not applicable
9
Unknown
Discussion:
These variables refer to CPS contacts prior to the current incident, and not contacts that resulted from
the current case. “Household” is defined as the residence where the victim lived the majority of the time
when the fatal incident occurred. “Household” was chosen as the unit for this question in an attempt to
characterize the victim’s environment.
 In the case of a victim living with a foster family or in an institution at the time of the fatal incident,
answer regarding the family of origin.
 If known maltreatment existed in the foster family, describe in incident narrative. Please note that a
report or referral can be in reference to a child or an adult living in the household.
 Any substantiation ever should be coded as “Yes” even if some of the reports/referrals were
substantiated and others were not.

9.5

Victim Contact with Formal System/Services

Section 9: Child Fatality Review Optional Module

165 | P a g e

9.5.1
9.5.2
9.5.3
9.5.4

Victim contact with Law enforcement: CFR_VictimContactPolice
Victim contact with juvenile justice system: CFR_VictimContactJuvJusticeSys
Victim contact with the health care system: CFR_VictimContactHlthCareSystem
Victim contact with mental health services: CFR_VictimContactMentalHlthServ

Definitions:
 CFR_VictimContactPolice: Victim had contact with Law enforcement in the past 12
months
 CFR_VictimContactJuvJusticeSys: Victim had contact with juvenile justice system in the
past 12 months
 CFR_VictimContactHlthCareSystem: Victim had contact with health care system in the
past 12 months
 CFR_VictimContactMentalHlthServ: Victim had contact with mental health services in
the past 12 months
Response Options:
0
No
1
Yes
Discussion:
These variables all refer to whether the child/victim had contact with these points in the system prior to
the fatal incident.

9.5.5

Household‘s contact with Law enforcement: CFR_HouseholdContactPolice

Definition:
Household had contact with Law enforcement in the past 12 months
Response Options:
0
No
1
Yes
Discussion:
Refers to the household’s history of contact with law enforcement (e.g., Law enforcement being called
by neighbors secondary to domestic disturbance).

9.5.6
9.5.7
9.5.8

Victim/primary caregiver contact with social services:CFR
CFR_VicCaregiverContactSocServ
Victim/primary caregiver contact with WIC: CFR_VicCaregiverContactWIC
Victim/primary caregiver contact with Medicaid: CFR_VicCaregiverContactMedicaid

Definitions:
 CFR_VicCaregiverContactSocServ: Victim/primary caregiver had contact with social
services in the past 12 months
 CFR_VicCaregiverContactWIC: Victim/primary caregiver had contact with WIC (Special
Section 9: Child Fatality Review Optional Module

166 | P a g e



Supplemental Nutrition Program for Women, Infants and Children) in the past 12
months
CFR_VicCaregiverContactMedicaid: Victim/primary caregiver had contact with
Medicaid in the past 12 months

Response Options:
0
No
1
Yes
Discussion:
These variables ask if either the child or the primary caregiver had contact with these points in the
system in the year prior to the incident. The social services system can include health educator home
visits or voluntary services, such as parenting support or respite services.

9.5.9

Primary caregiver on welfare/financial assistance: CFR_CaregiverFinancialAssistance

Definition:
Primary caregiver was on welfare/financial assistance in the past 12 months
Response Options:
0
No
1
Yes
Discussion:
This variable refers to whether the primary caregiver of the victim was on welfare or receiving
governmental financial assistance.

9.6

Suspect Charge, Arrest, Etc.

9.6.1
9.6.2
9.6.3
9.6.4
9.6.5
9.6.6
9.6.7
9.6.8

Specific person suspected: CFR_SuspectIdentified
Suspect arrested as perpetrator in this death: CFR_SuspectArrested
Suspect charged as perpetrator in this death: CFR_SuspectCharged
Suspect prosecuted: CFR_SuspectProsecuted
Suspect convicted: CFR_SuspectConvicted
Suspect convicted of original charge: CFR_SuspConvictedOrigCharge
CPS report or referral ever filed on the suspect: CFR_CPSReportReferralFiled
Suspect ever charged with a prior homicide: CFR_SuspChrgedPriorHomicide

Definition:
 CFR_SuspectIdentified: Law enforcement identified the suspect by name
 CFR_SuspectArrested: Suspect was arrested as a perpetrator in this death
 CFR_SuspectCharged: Suspect was charged as a perpetrator in this death
 CFR_SuspectProsecuted: Suspect was prosecuted as a perpetrator in this death
 CFR_SuspectConvicted: Suspect was convicted as a perpetrator in this death
Section 9: Child Fatality Review Optional Module

167 | P a g e





CFR_SuspConvictedOrigCharge: Suspect was convicted of original charge
CFR_CPSReportReferralFiled: Child Protective Service report had previously been filed
on this suspect
CFR_SuspChrgedPriorHomicide: Suspect had ever been charged with a prior homicide

Response Options:
 CFR_SuspectIdentified
 CFR_SuspectArrested
 CFR_CPSReportReferralFiled
 CFR_SuspChrgedPriorHomicide
0 No
1 Yes
7 Not collected by local CFR team
8 Not applicable
9 Unknown



CFR_SuspectCharged
CFR_SuspectProsecuted
0 No
1 Yes
3 Pending/In progress
7 Not collected by local CFR team
8 Not applicable
9 Unknown



CFR_SuspectConvicted
0 Acquitted
1 Convicted
3 Pending/In progress
7 Not collected by local CFR team
8 Not applicable
9 Unknown



CFR_SuspectConvictedOriginalCharge
0 No, convicted of lesser charge
1 Yes, convicted of original charge
7 Not collected by local CFR team
8 Not applicable
9 Unknown

Discussion:
Code “Yes” to SuspectIdentified if a specific person was identified by law enforcement as a suspect.
 If law enforcement does not know the identity (i.e., name) of the suspect, or if they only have a
physical description, code “No”.
 When answering suspect arrested, charged, prosecuted, convicted and convicted of original charge
consider whether the suspect was arrested as a perpetrator in this death (i.e., not only charged with
lesser offenses such as the possession of a firearm without a permit, or reckless endangerment).
Section 9: Child Fatality Review Optional Module

168 | P a g e





9.7

CFR_CPSReportReferralFiled refers to a prior Child Protective Services report filed on the suspect as
a perpetrator of child abuse or neglect.
CFR_SuspectChargedPriorHomicide refers to charges of homicide perpetration prior to this victim,
regardless of outcome. Homicide in this case can be of an adult or child.
If ‘CFR_SuspectConvicted’ is coded “Acquitted” or “Pending,” code
’SuspectConvictedOriginalCharge’ as “Not applicable.”

Victim Household Characteristics

9.7.1
9.7.2
9.7.3
9.7.4

Type of residence in which victim lived: CFR_ResidenceType
Length of time in residence: CFR_ResidenceTimeIn
Unrelated adult living in victim’s household: CFR_HouseholdAdultUnrelated
Other children <18 years in household: CFR_OtherChildrenUndr18Household

Definitions:
 CFR_ResidenceType: Victim’s type of primary residence
 CFR_ResidenceTimeIn: Length of time in residence
 CFR_HouseholdAdultUnrelated: Unrelated adult living in victim’s household
 CFR_OtherChildrenUndr18Household: Presence of other children under 18 years living in the
victim’s household
Response Options:
 CFR_ResidenceType
1 Victim’s family home
2 Foster family home
3 On own, e.g., living w boyfriend
4 Residential group home
5 Shelter
6 Juvenile detention facility, jail, prison
7 School/college
66 Other
77 Not collected by local reporting site
88 Not applicable (homeless or adult)
99 Unknown


CFR_ResidenceTimeIn
0 One week or less
1 Within the past month
2 Within the past 6 months (but greater than one month)
3 Between 6 months and 1 year
4 Between 1 to 5 years
5 More than 5 years
6 Other
7 Not collected by local CFR team
8 Not applicable
9 Unknown

Section 9: Child Fatality Review Optional Module

169 | P a g e




CFR_HouseholdAdultUnrelated
CFR_OtherChildrenUndr18Household
0 No
1 Yes
7 Not collected by local CFR team
8 Not applicable
9 Unknown

Discussion:
These questions are to be asked of all child victims. Primary residence is the place where the victim lived
the majority of the time when the incident occurred (not at the time of death if the residences were
different). For example, if a child is injured in his or her own family home and dies four months later in
the hospital, answer questions regarding his or her own family home.
With regard to CFR_ResidenceType: “Victim’s family home” is defined as victim’s self-identified family
where applicable; this may be biologic parents, other relatives, adoptive or stepparents. “On own”
indicates that the decedent was living separately from his/her family (e.g., living with boyfriend or
peers). If the victim was known to be moving from place to place without a permanent residence (i.e.,
“on the run”), or if the victim was a newborn who was still in the hospital, code as “Not applicable” and
describe in the incident narrative.
For length of time in residence, code the approximate length of time that the victim had been living at
the residence indicated in ‘ResidenceType’. All time frames listed are with respect to the timing of the
fatal incident. For example, if the victim was known to have come back to live with family of origin after
foster care stay and commits suicide within two weeks of returning, code “Within the past month.”
‘CFR_HouseholdAdultUnrelated’ and ‘CFR_Other children <18 years in household’ apply to children
who lived with their own family, on their own, or with a foster family at the time of the fatal incident. An
unrelated adult is defined as a person 18 years or older who was living in the household at the time of
the incident, including primary caregivers (e.g., mother’s boyfriend, stepmother, friend of family, tenant,
nanny, etc.).
 Adoptive parents should not be considered unrelated.
 If the victim lived in an institution (e.g., shelter, school, juvenile detention facility) at the time of the
fatal incident, mark “Not applicable.”
 If there were circumstances in the decedent’s household at the time of death that contributed to
the child’s death, explain that separately in the incident narrative.
 If a child is in a vegetative state secondary to shaken baby syndrome and dies of pneumonia three
years later, answer ‘CFR_HouseholdAdultUnrelated’ and ‘Other children <18 years in household’
regarding the household at the time of the shaking.
 If something about the quality of the child’s foster care at the time of death was also contributory to
its death, note that in the incident narrative.

9.7.5

Marital relationship of victim’s biological parents: CFR_VicBioParentMaritalRel

Definition:
Marital relationship of victim’s biological parents at the time of incident
Section 9: Child Fatality Review Optional Module

170 | P a g e

Response Options:
1
Married
2
Never married
3
Widowed
4
Divorced
5
Married, but separated
6
Single, not otherwise specified
7
Not collected by local CFR team
8
Not applicable
9
Unknown
Discussion:
Code the response option that best fits the marital relationship of the victim’s biological parents to one
another at the time of the fatal incident.
Example:
 If the victim’s biological mother and father were never married, but the biological father was
married to another woman at the time of the fatal incident, marital relationship should be coded as
“Never married”.

9.7.6
9.7.7

Intimate partner violence in victim‘s household: CFR_IPVVictimHousehold
Intimate partner violence in victim‘s foster home: CFR_IPVVictimFosterHome

Definitions:
 CFR_IPVVictimHousehold: Evidence of intimate partner violence in victim’s household
 CFR_IPVVictimFosterHome: Evidence of intimate partner violence in victim’s foster family (if
applicable)
Response Options:
0
No
1
Yes
7
Not collected by local CFR team
8
Not applicable
9
Unknown
Discussion:
These questions about intimate partner violence are to be asked about all children regarding their
household at the time of the fatal incident.





For children who lived with their families or who were institutionalized (either temporarily or
permanently), answer the questions regarding the family of origin.
For permanently institutionalized children with no family to return to, the answer will be “Not
applicable”.
For children in foster care at the time of the fatal incident, answer the questions regarding both the
foster home and the family of origin.
If there were circumstances in the decedent’s household at the time of death that contributed to

Section 9: Child Fatality Review Optional Module

171 | P a g e



the child’s death, explain that separately in the incident narrative. For example, if a child is in a
vegetative state secondary to shaken baby syndrome and dies of pneumonia three years later,
answer the following household questions regarding the time of the shaking.
However, if something about the quality of the child’s foster care at the time of death was also
contributory to death, note that in the incident narrative.

9.7.8
9.7.9

Substance abuse in victim‘s household: CFR_SubAbuseVictimHousehold
Substance abuse in victim‘s foster home: CFR_SubAbuseVictimFosterHome

Definitions:
 CFR_SubAbuseVictimHousehold: Evidence of substance abuse in victim’s household
 CFR_SubAbuseVictimFosterHome: Evidence of substance abuse in victim’s foster family (if
applicable)
Response Options:
0
No
1
Yes
7
Not collected by local CFR team
8
Not applicable
9
Unknown
Discussion:
Substance abuse refers to all drugs (including alcohol) that are either non-prescription or being used in a
manner inconsistent with safe prescribing practices. Questions are to be asked about all children
regarding their household at the time of the fatal incident.









9.8

For children who lived with their families or who were institutionalized (either temporarily or
permanently), the abstractor should answer the questions regarding the family of origin.
For permanently institutionalized children with no family to return to, the answer will be “Not
applicable”.
For children in foster care at the time of the fatal incident, answer the questions regarding both the
foster home and the family of origin.
In any kind of household, if the victim was a substance abuser, but no one else in the household
was, code “No” for victim’s household and/or victim’s foster home.
However, if anyone else in the household was abusing substances, including other children <18,
code “Yes” for household and/or victim’s foster home.
If there were circumstances in the decedent’s household at the time of death that contributed to
the child’s death, explain that separately in the incident narrative. For example, if a child is in a
vegetative state secondary to shaken baby syndrome and dies of pneumonia three years later,
answer the following household questions regarding the time of the shaking.
However, if something about the quality of the child’s foster care at the time of death was also
contributory to death, note that in the incident narrative.

Supervisor Characteristics

Section 9: Child Fatality Review Optional Module

172 | P a g e

9.8.1
9.8.2
9.8.3
9.8.4
9.8.5
9.8.6
9.8.7
9.8.8
9.8.9

Perpetrator was supervisor: CFR_SupervisorPerpetrator
Quality of supervision a factor: CFR_SupervisorQuality
Supervisor’s relationship to victim: CFR_SuperRelationshipVictim
Supervisor’s age: CFR_SupervisorAge
Supervisor’s sex: CFR_SupervisorSex
No supervision: CFR_SupervisorNone
Supervisor drug/alcohol impaired: CFR_SupervisorDrugAlcohlImpaired
Supervisor distracted/asleep: CFR_SupervisorDistractedAsleep
Other supervisory factor: CFR_SupervisorOther

Definitions:
 CFR_SupervisorPerpetrator: Perpetrator responsible for supervision at time of incident?
 CFR_SupervisorQuality: Did the quality of supervision contribute to the death of the victim?
 CFR_SuperRelationshipVictim: Relationship of supervisor to the victim
 CFR_SupervisorAge: Age of supervisor
 CFR_SupervisorSex: Sex of supervisor
 CFR_SupervisorNone: No supervision of the victim
 CFR_SupervisorDrugAlcohlImpaired: The supervisor was drug- or alcohol-impaired
 CFR_SupervisorDistractedAsleep: The supervisor was distracted or asleep
 CFR_SupervisorOther: Other supervisory factor contributed to victim’s death
Response Options:
 CFR_SupervisorPerpetrator
0 No
1 Yes
7 Not collected by local CFR team
8 Not applicable
9 Unknown


CFR_SupervisorQuality:
0 No, supervision was appropriate
1 Yes, supervisor was NOT the perpetrator
2 Yes, supervisor was the perpetrator
3 Supervision not needed/expected
4 CFRT could not determine
7 Not collected by local CFR team
8 Not applicable
9 Unknown



CFR_SupervisorRelationshipVictim
1 Primary caregiver
2 Other adult relative
3 Babysitter/child care provider
4 Primary caregiver’s boy/girlfriend
5 Sibling/step-sibling
6 Other, specify in incident narrative
7 Not collected by local CFR team
8 Not applicable

Section 9: Child Fatality Review Optional Module

173 | P a g e

9

Unknown



CFR_SupervisorAge
Age of supervisor in years



CFR_SupervisorSex
1 Male
2 Female
7 Not collected
8 Not applicable
9 Unknown






CFR_SupervisorNone
CFR_SupervisorDrugAlcohlImpaired
CFR_SupervisorDistractedAsleep
CFR_SupervisorOther
0 No, Not collected by local CFR team, Unknown
1 Yes

Discussion:
The supervisor is the person with the primary responsibility for the care and control of the child at the
time of the fatal injury. If there were two supervisors at the time of the fatal incident, but one clearly
had primary responsibility, code the person with the primary responsibility. If the responsibility of
supervision was equally divided between two people, code the person whose supervision quality
seemed most contributory to the child’s death.
If the perpetrator/suspect was responsible for the victim’s direct supervision at the time of the incident
(i.e., in the case of a homicide), then code CFR_SupervisorPerpetrator “Yes” and code the rest of the
supervision variables as “Not applicable”.
Determining supervision adequacy is purposefully left to the Child Fatality Review Team (CFRT) by this
group of data elements. “CFR_SupervisorQuality” refers specifically to the quality of supervision at the
time the fatal injury occurred, not to parenting style in general. “CFR_SupervisorNone” should be
indicated if no arrangements for supervision were apparently made (e.g., leaving a 3 year old
unattended for half an hour). If an inappropriately young or old supervisor was appointed, specify the
circumstances under “Other”. Any additional exceptional circumstances may be coded by endorsing
CFR_SupervisorOther and including a description in the CFR incident narrative. All of the variables are
based on the CFRT’s findings, even though the information to support the CFRT’s findings may well
originate from multiple sources.
If the quality of the supervision did not contribute to the child’s death (as determined by the CFRT) or it
is unknown, code “No” or “Unknown” and the remainder of the supervisor variables as “Not applicable”.

9.9

Caregiver Characteristics (1st and 2nd)

Section 9: Child Fatality Review Optional Module

174 | P a g e

9.9.1
9.9.2
9.9.3
9.9.4
9.9.5
9.9.6
9.9.7
9.9.8
9.9.9

Primary caregiver is a victim or suspect in the incident:
CFR_CaregiverVictimOrSuspect1/2
If yes, caregiver‘s ID in the incident: CFR_CaregiverID1/2
Relationship to victim: CFR_RelationshipToVictim1/2
Person lived with victim: CFR_LivedWithVictim1/2
Primary Caregiver’s Age at time of incident: CFR_AgeAtIncident1/2
Primary Caregiver’s Sex: CFR_Sex1/2
Had legal custody of victim at time of death: CFR_CustodyOfVictim1/2
Had documented history of maltreating: CFR_HistoryOfMaltreating1/2
Had a previous child die in his/her care: CFR_PreviousChildDie1/2

Definitions (refers to 1st and 2nd primary caregivers):
 CFR_CaregiverVictimOrSuspect1/2: Is the victim’s primary caregiver a victim or suspect in the
incident?
 CFR_CaregiverID1/2: Caregiver’s Person ID in the incident
 CFR_RelationshipToVictim1/2: Caregiver’s relationship to the victim
 CFR_LivedWithVictim1/2: Caregiver lived with victim at the time of the incident?
 CFR_AgeAtIncident1/2: Age of Caregiver at the time of the incident
 CFR_Sex1/2: Sex of Caregiver
 CFR_CustodyOfVictim1/2: Caregiver had legal custody of victim at time of death?
 CFR_HistoryOfMaltreating1/2: Caregiver had documented history of maltreating a child
 CFR_PreviousChildDie1/2: Caregiver had a previous child die in his/her care?
Response Options:
 CFR_CaregiverVictimOrSuspect1/2
0 No
1 Victim or victim/suspect
2 Primary suspect
3 Secondary suspect
4 Other suspect
7 Unknown
8 Not collected by CFR team
9 Not applicable





CFR_LivedWithVictim1/2
CFR_CustodyOfVictim1/2
CFR_HistoryOfMaltreating1/2
CFR_PreviousChildDie1/2
0 No
1 Yes
7 Not collected by local CFR team
8 Not applicable
9 Unknown



CFR_CaregiverID
Number of the Person in the incident

Section 9: Child Fatality Review Optional Module

175 | P a g e



CFR_AgeAtIncident
Age of caregiver in years



CFR_Sex
1 Male
2 Female
9 Unknown



CFR_RelationshipToVictim
1 Biologic parent
2 Stepparent
3 Adoptive parent
4 Other relative
5 Parent’s intimate partner
6 Other non-relative
7 Not collected by local CFR team
8 Not applicable
9 Unknown

Discussion:
The victim’s primary caregiver is defined as the person or persons (up to two) who had responsibility for
the care, custody, and control of the child the majority of the time.
 The primary caregiver(s) may be the child’s parent or parents (biological, step, adoptive parents) or
another relative.
 If the child was living with his/her biological or adoptive parents, assume that they were the primary
caregivers and had legal custody of the decedent unless otherwise specified in the records.
 The primary caregiver(s) may also be the state child protective services agency/foster parent(s) or
another institution in some cases.
 In the instances when the child is residing in foster care or an institution, complete this information
for the primary caregiver(s) in the family of origin if known (not for the foster family or institutional
caregivers).
 In the case of neonaticide, assume that the biological mother was the primary caregiver unless there
is evidence that another person (e.g., father, grandmother) had assumed control of the child as a
caregiver at the time of the incident.
 If the primary caregiver(s) at the time of death was different from the primary caregiver(s) at the
time of the incident, answer regarding the primary caregiver(s) at the time of the incident.
 For example, if a baby is shaken by its biological mother as an infant and survives in a vegetative
state in foster care until three years of age, code the biological mother.
 “Documented history of child maltreatment” indicates a substantiated CPS report/referral or rights
termination.

9.10

Records Consulted in CFRT Review

9.10.1 CME records: CFR_RecordCME
9.10.2 SS/CPS records: CFR_RecordSSCPS
Section 9: Child Fatality Review Optional Module

176 | P a g e

9.10.3 Law enforcement/Law enforcement records: CFR_RecordPoliceLE
9.10.4 School records: CFR_RecordSchool
9.10.5 EMS records: CFR_RecordEMS
9.10.6 Health Provider/Hospital records: CFR_RecordHealthProviderHospital
9.10.7 Public Health Department records: CFR_RecordPublicHealthDepartment
9.10.8 Mental Health Records: CFR_RecordMentalHealth
9.10.9 Juvenile Justice Records: CFR_RecordJuvenileJustice
9.10.10 Death Certificate: CFR_RecordDeathCertificate
9.10.11 Other records: CFR_RecordOther
9.10.12 Specify (what other records): CFR_RecordOtherText
Definitions:
Records from each agency indicated were consulted in the CFRT review of victim’s death
Response Options:
0 No, Not collected by local CFR team, Unknown
1 Yes


CFR_RecordOtherText
Text

Discussion:
The primary data sources used to review a child death vary from CFR program to program and often
from death to death. Code the data source as “Yes” if the records were consulted about the death, even
if the given agency ended up having no information about the victim. Do not code a source as “Yes” if
the only information gathered was secondary (e.g., the DSS records indicate that law enforcement
performed an investigation, but the actual law enforcement records were not consulted).

9.10.13 History of inpatient psychiatric treatment: CFR_HistoryPsychiatricTreatment
9.10.14 Taking psychiatric medication at time of death: CFR_PsychiatricMedication
9.10.15 Barriers to accessing mental health care: CFR_BarriersAccessMntlHealthCare
Definitions:
 CFR_HistoryPsychiatricTreatment: Victim has ever been treated as an inpatient for psychiatric
problems
 CFR_PsychiatricMedication: Victim had a current prescription for a psychiatric medication at the
time of the incident
 CFR_BarriersAccessMntlHealthCare: Victim experienced barriers to accessing mental health care
(applicable only to victims coded as having a mental health problem and not being in treatment)
Response Options:
0
No
1
Yes
Discussion:
These variables will provide more in depth information about mental health treatment for children who
commit suicide than is currently collected by the main reporting system for adult victims.
Section 9: Child Fatality Review Optional Module

177 | P a g e







These variables supplement the basic Suicide Circumstances related to mental health. Indicate that
the child received inpatient psychiatric care if there is a documented history of inpatient psychiatric
treatment ever, not just at the time of death. These includes an overnight or longer stay at a
psychiatric hospital or institution, psychiatric halfway house or group home, or psych unit within an
acute care hospital.
PsychiatricMedication refers to whether the patient had an active prescription for psychiatric
medication at the time of death. They need not have actually been taking the medication. When
available, toxicology results will help assess whether the decedent was taking the medication
prescribed
If a child victim was noted as having a mental health problem and as not being in mental health
treatment, the CFR_BarriersAccessMntlHealthCare variable will document whether any evidence in
the record indicates that the victim encountered barriers in accessing mental health treatment.
o Code “Yes” if there were specific obstacles or if it was known that treatment was either
recommended by a health professional and/or identified by the family yet care was not
received. Examples of specific obstacles include lack of insurance coverage, transportation
problems, or long waiting lists. Another example would be parental awareness of their
child’s suicidal ideation, but inability to establish care because of immigration status.
o Please describe the nature of the barrier in the Incident Narrative.

9.11

9.11.1
9.11.2
9.11.3
9.11.4
9.11.5
9.11.6

CFR Concluding Variables

CFR conclusion matches Death Certificate: CFR_CFRConclusionMatchedDC
If no, manner the CFR designated: CFR_CFRDesignated
Text to specify other manner: CFR_MannerOther
Action taken to change the official manner: CFR_ActionChgOfficialManner
Result of action: CFR_ResultOfAction
CFR determination of preventability: CFR_DeathPreventability

Definitions:
 CFR_CFRConclusionMatchedDC: Did the CFR designation of the child’s manner of death match the
death certificate manner?
 CFR_CFRDesignated: Manner of death designated by the CFR
 CFR_MannerOther: Text field for CFR manner of death if “other”
 CFR_ActionChgOfficialManner: If CFR designation did not match death certificate manner, was
action taken by the CFR to change the manner of death?
 CFR_ResultOfAction: Result of action taken by the CFR to change the manner of death
 CFR_DeathPreventability: CFR conclusions regarding the preventability of the death
Response Options:
 CFR_CFRConclusionMatchedDC
 CFR_ActionChgOfficialManner
0 No
1 Yes
7 Not collected/CFR team does not make this comparison
8 Not applicable
Section 9: Child Fatality Review Optional Module

178 | P a g e

9

Unknown



CFR_CFRDesignated
1 Natural
2 Accident
3 Suicide
4 Homicide
5 Pending investigation
6 Could not be determined
66 Other
77 Not collected/CFR team does not designate manner
88 Not applicable
99 Unknown



CFR_MannerOther
Text



CFR_ResultOfAction
0 No change
1 Manner changed to agree with CFRT
3 Pending
6 Other
7 Not collected by local CFR team
8 Not applicable
9 Unknown



CFR_DeathPreventability
0 Probably not preventable
1 Possibly preventable
2 Unable to determine preventability
7 Not collected/CFR team does not determine preventability
8 Not applicable
9 Unknown

Discussion:
The CFRT’s conclusions are being compared with the officially-designated manner of death as originally
specified on the death certificate (or, if the death certificate was unavailable to the committee at the
time of their review, the CME report).
 Code CFR_CFRConclusionMatchedDC as “Yes” if the CFRT’s manner of death matched the manner
of death originally designated on the death certificate.
 Code CFR_CFRConclusionMatchedDC as “No” if the CFRT determined that the manner of death was
something other than that assigned in the death certificate data.
 Supply the manner chosen by the CFRT in CFR_CFRDesignated. “Could not be determined” under
CFR_CFRDesignated refers to the affirmative designation of undetermined as the CFRT’s manner of
death.
 “Unknown” is to be used if the information is not available at the time of data entry. Please use the
text box to explain coding “Other” for CFR_CFRDesignated.
 CFR_ActionChgOfficialManner and ResultOfAction will be enabled only if
Section 9: Child Fatality Review Optional Module

179 | P a g e



CFR_CFRConclusionMatchedDC is coded as “No”.
Some CFRTs designate the degree to which a child’s death was preventable (e.g., “definitely
preventable”, “probably preventable”, “probably not preventable”, etc.). Respondents should
collapse the levels they use to answer the question as “Probably not preventable,” “Possibly
preventable” or “Unable to determine”. If the teams indicate any possibility of prevention then code
“Possibly preventable.” “Unable to determine preventability” is an affirmative designation (i.e. it is
specifically noted on the CFRT form) otherwise, code “Unknown”.

Section 9: Child Fatality Review Optional Module

180 | P a g e

SECTION 10: INTIMATE PARTNER VIOLENCE OPTIONAL MODULE
This module allows states to capture additional information on homicide incidents classified as intimate
partner violence (IPV) incidents. IPV incidents are defined as incidents in which violence or the threat of
violence by a person against his or her current or former intimate partner results in the violent death of
one or more people. This may involve cases in which there is a death of a third party that is directly
linked to the intimate partner (IP) relationship (e.g., the child of the intimate partner, friend of the
victim, a bystander).

10.1

Definition of Intimate Partner

For all intimate partner-related variables intimate partner ±is defined as a current or former
girlfriend/boyfriend, dating partner, ongoing sexual partner, or spouse. It DOES NOT include instances of
sex/intimacy in exchange for money/goods. There must be evidence of an intimate relationship (this does
not apply to instances where there is simply attraction/infatuation between two individuals or in cases
where one person is romantically interested in the other, but the feelings are not returned). The
definition of intimate partner does not require sexual intimacy. This definition includes same-sex
partners.
±. This definition is based on the CDC/National Center for Injury Prevention and Control standard
definition of Intimate Partner Violence.
Source: http://www.cdc.gov/violenceprevention/pdf/ipv_surveillance_definitions.pdf

10.1.1 IPV Incident Type: IPV_IncidentType
Definition:
Type of IPV homicide incident
Response Options:
1
Type 1: IPV
2
Type 2: IPV-Related
3
Type 3: IP-Associated
4
Other (specify)
99
Unknown
Discussion:
The Incident Type IPV should be determined using Law enforcement reports or other available
information on the relationship history of the intimate partners. The IPV module is designed to collect
information on intimate partners and the circumstances that contributed to the violent death. The
following categories should be used for coding the incident type:
Type 1: IPV: Incidents in which an individual is killed by a current or former intimate partner. (Other
persons may also be involved in the NVDRS incident, as either victims or suspects. The IPV Module
should only be completed for the actual intimate partners.)
Section 10: Intimate Partner Violence Optional Module

181 | P a g e

Type 1 Case Examples
 A woman’s ex-boyfriend walks up to the woman and shoots her on the street.
 A man and woman are out on their first date. They go back to her apartment after the date. The
man tries to force the women into bed and strangles her to death.
 A woman and her lawyer are getting into a car; the woman’s ex-boyfriend walks up to the woman
and shoots her and the lawyer (the lawyer is an NVDRS victim, but would not have the IPV module
completed).
Type 2 and Type 3 incidents do not involve a person killing a current or former intimate partner, but do
include a homicide that is directly related to a current or former intimate relationship. That is, the
homicide would not have occurred in the absence of the intimate partner relationship. Type 2: IPVRelated: Incidents that do not meet the definition of Type 1, but where the homicide is directly related
to violence in the intimate relationship. For Type 2 incidents, the IPV module should be completed for
the intimate partners, not the third party.
Type 2 Case Examples
 A woman kills her ex-husband's new wife. The suspect has a history of previously threatening her exhusband.
 A man confronted, and then killed, another man he believed was having an affair with his girlfriend.
The suspect had a history of physically assaulting his girlfriend and had told her on multiple
occasions that he would kill her if she was ever with anybody else.
 A husband shoots and kills his child while attempting to attack his wife during an argument.
Type 3: IP-Associated: Incidents that do not meet the definition of Type 1, but where the homicide is
directly related to an intimate partner relationship, and there is no evidence of violence in the intimate
partner relationship itself. The homicide can be committed by or against any of the third parties
involved but must involve at least one of the intimate partners as the victim or the suspect. For Type 3
incidents, the IPV module should be completed for the intimate partners, not the third party.
Type 3 Case Examples
 A man sees another man flirting with his wife in a bar; the two men argue and one stabs the other to
death. No evidence of previous violence or threats between the man and wife.
 A grandmother is murdered by her teenage granddaughter and her granddaughter’s lover because
the grandmother was trying to keep the two young women apart.
 A man shot his landlord to death. In his confession, the suspect stated that the landlord habitually
touched or made sexual comments about his (the suspect’s) wife and that he got tired of it.

10.1.2 IPV Victim: IPV_Victim
10.1.3 IPV Perpetrator: IPV_Perpetrator
Definition:
 IPV_IPV Victim: Identification of whether the IPV Victim is the NVDRS Suspect, Victim, or neither
 IPV_IPV Perpetrator: Identification of whether the IPV Perpetrator is the NVDRS Suspect, Victim, or
neither
Response Options:
Section 10: Intimate Partner Violence Optional Module

182 | P a g e

1
2
3
4
99

NVDRS Suspect
NVDRS Victim
Both NVDRS Suspect and Victim
Neither NVDRS Suspect nor Victim
Unknown

Discussion:
For this module, the terms IPV Victim and IPV Perpetrator are used to identify persons on whom
information is collected as opposed to victim and suspect as are used in the general NVDRS. These
elements identify the role that the IPV Victim and IPV Perpetrator had in the homicide incident. The
definitions for IPV Victim and IPV Perpetrator terms are as follows:
The IPV Victim is the partner in the intimate relationship who is the target of violence perpetrated by
his/her intimate partner. This person may be the victim, suspect, or neither in the NVDRS. In cases of
mutually combative violence where the target of the violence cannot be determined, the IPV victim
should be listed as the partner who was killed. Coders should list the NVDRS identification number for
the individual listed as the IPV Victim.
The IPV Perpetrator is the partner in the intimate relationship who has committed violence against
his/her intimate partner. This person may be the victim, suspect, or neither in the NVDRS. Coders should
list the NVDRS person identification number for the individual listed as the IPV Perpetrator.

10.2

Data Sources Used to Complete Module

10.1
10.2
10.3
10.4
10.5
10.6
10.7
10.8
10.9
10.10
10.11
10.12
10.13

Death Certificate: IPV_SourceDeathCertificate
CME Report: IPV_SourceCME
Law enforcement report: IPV_SourcePoliceReport
SHR or NIBRS Data: IPV_SourceSHRorNIBRS
Crime Lab Report: IPV_SourceLab
Gun Trace Report: IPV_SourceGunTrace
Hospital/ED Report: IPV_SourceHospitalEmergencyRoom
Court or Prosecutor Records: IPV_SourceDistrictAttorney
Restraining Order Records: IPV_SourceRestrainingOrder
Criminal History Database: IPV_SourceCriminalHistory
DVFRT Report: IPV_SourceDomestViolFatalRevTeam
Newspaper Reports: IPV_SourceNews
Other Data Sources: IPV_SourceOther

Definitions:
Indicator of whether each of the above record types was used as a data source to complete module
Response Options:
0
Data source not used
1
Data source used
Discussion:
Section 10: Intimate Partner Violence Optional Module

183 | P a g e

Select all of the data sources used by the coder to complete the IPV data module. The following should
be coded as “data source used” if the sources were used the complete the module:
IPV_SourceDeathCertificate (death certificate);
IPV_SourceCME (medical examiner, coroner report, or toxicology report);
IPV_SourcePoliceReport (law enforcement report)
IPV_SourceSHRorNIBRS (data from the FBI’s Supplementary Homicide Reports or National
Incident Based Reporting Reports);
IPV_SourceLab (crime laboratory reports);
IPV_SourceGunTrace (gun trace data);
IPV_SourceHospicalEmergencyRoom (Hospital records including hospital discharge and
emergency department records);
IPV_SourceDistrictAttorney (prosecution or court records);
IPV_SourceRestrainingOrder (national or state restraining order databases);
IPV_SourceCriminalHistory (national or state criminal history databases);
IPV_SourceDomestViolFatalRevTeam (Domestic Violence Fatality Review Team report);
IPV_SourceNews (newspaper article or other print media source); and
IPV_SourceOther (specify any other sources used).

10.3

Evidence of Premeditation: IPV_Premeditated

Definition:
Homicide appears to have involved premeditation or advance planning
Response Options:
0
No
1
Yes
9
Unknown
Discussion:
Evidence of premeditation includes signs such as the suspect’s lying in wait for the victim(s) or taking
precautions before the incident to avoid discovery. Most state laws differentiate levels of homicide, with
homicide in the first degree involving premeditation or malice aforethought, and other homicide
charges (homicide in the second degree, country manslaughter) showing no evidence of premeditation.
Examples
 Yes
o
o
o
o

10.4

Suspect arrived at the victim’s house with two handguns and extra clips.
Suspect was waiting outside the victim’s workplace; when she arrived, he shot her.
Suspect was aware of when her husband was meeting with his lawyer; she arrived at the
office and shot both.
Suspect was charged with first degree murder.

Homicide during argument: IPV_HomicideDuringArgument

Definition:
Section 10: Intimate Partner Violence Optional Module

184 | P a g e

Homicide occurred in the midst of an argument or altercation
Response Options:
0
No
1
Yes
9
Unknown
Discussion:
It is difficult to ascertain whether a homicide was impulsive; this variable instead captures objective
information about whether a verbal altercation of some sort immediately preceded the homicide.
Although some of these cases may also involve advance planning (e.g., suspect lies in wait for the victim
armed with a weapon and intending to kill him; upon seeing him, they argue, she produces the weapon
and shoots him), the variable is likely to serve as a rough proxy for more impulsive homicides (see also
“Premeditation” on the previous page). This information will frequently be unknown. Legally,
differentiating homicides involving premeditation versus those occurring in the “heat of passion” is a
major point as this distinction, in part, informs whether the suspect is charged with homicide in the first
degree, homicide in the second degree, or manslaughter.
Examples
 Yes
o
o


Husband and wife had been drinking during a party; after the guests left, they began arguing
and wife stabbed husband.
Victim told suspect that she wanted him out of the apartment; he became angry and beat
her to death.

No
o
o

10.5

Victim and sister were sitting in the moving van when victim’s husband pulled alongside the
vehicle and shot her.
Suspect shot the victim while she was sleeping and then shot himself.

During child drop-off/pick-up: IPV_ChildrenDropoffPickup

Definition:
Homicide occurred during drop-off or pick-up of children
Response Options:
0
No
1
Yes
9
Unknown
Discussion:
This variable refers to those periods of overlap when one partner in a couple sharing custody of children
is picking up or dropping off children to or from the other partner or a court-supervised visit.

10.6

Suspect Legal Actions

Section 10: Intimate Partner Violence Optional Module

185 | P a g e

10.6.1
10.6.2
10.6.3
10.6.4
10.6.5
10.6.6
10.6.7

Warrant issued for suspect: IPV_SuspectWarrant
Suspect arrested in this incident: IPV_SuspectedArrested
Suspect arrested but fled: IPV_SuspectFled
Suspect charged as perpetrator: IPV_SuspectCharged
Suspect convicted: IPV_SuspectConvicted
Suspect convicted of original charge: IPV_SuspectConvictedOrigCharge
Suspect died following incident: IPV_SuspectDied

Definitions:
 IPV_SuspectWarrant: Warrant issued for the suspect in this incident
 IPV_SuspectedArrested: Suspect arrested in this incident
 IPV_SuspectFled: Suspect arrested but fled while on bond or escaped custody
 IPV_SuspectCharged: Suspect charged in this incident
 IPV_SuspectConvicted: Suspect convicted in this incident
 IPV_SuspectConvictedOrigCharge: Suspect convicted of the original charge
 IPV_SuspectDied: Suspect died following the incident
Response Options:
 IPV_SuspectWarrant
 IPV_SuspectedArrested
 IPV_SuspectFled
0 No
1 Yes
7 Not collected in data sources
8 Not applicable
9 Unknown




IPV_SuspectCharged
IPV_SuspectConvicted
IPV_SuspectConvictedOrigCharge
0 No
1 Yes
3 Pending/In progress
7 Not collected in data sources
8 Not applicable
9 Unknown



IPV_SuspectDied
0 No
1 Yes
9 Unknown

Discussion:
These variables originated with the Child Fatality Review module. Code variables with reference to the
intimate partner who was arrested, charged, prosecuted, etc. as a suspect for the death. Arrests or
prosecution on lesser charges only, such as possession of a firearm without a license or other unrelated
charges, should not trigger endorsing these variables. If the individual died following the incident then
the other information does not have to be completed.
Section 10: Intimate Partner Violence Optional Module

186 | P a g e














IPV_SuspectWarrant indicates that a warrant was issued for the arrest of the suspect in the
incident. Code as “yes” if a warrant for the suspect’s arrest has been issued.
IPV_SuspectedArrested indicates that the suspect was arrested by law enforcement. If a suspect is
arrested, the arrest record will indicate the criminal statutes the person is suspected of having
violated (e.g., first-degree homicide, second-degree homicide, etc.). If the suspect has not been
arrested, or if the arrest charges do not include perpetration of the victim’s death, code as “no.”
Also code as “no” if a warrant for the suspect’s arrest has been issued but the arrest has not yet
been made.
IPV_SuspectFled indicates that the suspect was arrested by law enforcement as a suspected
perpetrator in the victim’s death; however, the suspect fled while on bond or escaped from custody
prior to any closure to the case.
IPV_SuspectCharged indicates that a prosecutor such as the district attorney or federal prosecutor
issued charges against the suspect. These charges are not to be confused with the initial charges on
which law enforcement arrested a suspect. Rather, they refer to the charges filed by the prosecutor
that initiated the prosecution process. If the records reflect that the suspect is being prosecuted,
code as “yes.” Reasons to endorse “no” include that the case was never presented to prosecutors,
the suspect was administratively released by Law enforcement prior to charging (which means that
the Law enforcement no longer consider the person a suspect and s/he can be dropped as a suspect
from the incident), or the prosecutor did not issue charges (because of lack of evidence, witness
difficulties, defendant granted immunity, jurisdictional problem, constitutional defects, or physical
evidence difficulty).
IPV_SuspectConvicted: If prosecution is complete, this indicates whether the IPV Victim or
Perpetrator suspect was convicted as a perpetrator in the victim’s death. Code “no” if the IPV
Perpetrator or Victim was acquitted or the case was dismissed. Also code “no” if the IPV Perpetrator
or Victim was convicted only of lesser charges (e.g., a weapons charge) but not as a perpetrator in
the victim’s death (e.g., convicted of homicide, murder, or manslaughter). Assume the IPV
Perpetrator or Victim has been convicted if she/he has been sentenced or is awaiting sentencing.
IPV_SuspectConvictedOrigCharge: If the IPV Victim or Perpetrator suspect was convicted of a lesser
charge and not the original charge (e.g., charged with first degree murder but convicted of second
degree), code as “No.”
IPV_SuspectDied: If the IPV Victim or Perpetrator suspect died at any time during the legal
proceedings.

10.7

Cohabitation Status: IPV_CohabitationStatus

Definition:
Cohabitation status of the IPV Perpetrator and IPV Victim at the time of the incident, i.e., living together
in the same household, irrespective of marital status
Response Options:
0
No
1
Yes
9
Unknown
Discussion:
If indication is provided through Law enforcement narratives or other data sources that the IPV
Section 10: Intimate Partner Violence Optional Module

187 | P a g e

Perpetrator and IPV Victim shared a primary residence at the time of the incident, then
“CohabitationStatus” should be coded as “yes.” If the IPV Perpetrator and IPV Victim are listed as having
the same address and there is no information contrary about their having separated, code as “yes” even
in the absence of an affirmative statement about cohabitation status. If the IPV Perpetrator and IPV
Victim lived together fairly consistently, but there had been a recent change of status (e.g., less than 1
week of living in separate households) or they have separate addresses, then “CohabitationStatus”
should still be coded as “yes.” For example, if it was reported that an IPV Victim had been staying with
her parents for a few days or the IPV Victim had a separate mailing address, but primarily resided with
the IPV Perpetrator, they should be coded as cohabitating.

10.8
10.9

Relationship length number of units: IPV_RelationshipLength
Unit of time used in relationship length: IPV_RelationshipLengthUOM

Definitions:
 IPV_RelationshipLength: Length of time the IPV Perpetrator and IPV Victim were involved in a
romantic relationship
 IPV_RelationshipLengthUOM: Unit of time for IPV Perpetrator and IPV Victim involvement in a
romantic relationship
Response Options:
 IPV_RelationshipLength
888
Not applicable
999
Unknown


IPV_RelationshipLengthUOM
1 Years
2 Months
3 Days
4 Hours
9 Unknown

Discussion:
This variable provides information on the length of time the IPV Perpetrator and IPV Victim were
involved in a romantic relationship. This time period should be estimated from information drawn from
CME or Law enforcement narrative reports. It should reflect the total time the couple have been in a
relationship and not just, in the case of married couples, the length of the marriage.
It is coded using a numerical indication of the number of years, months, weeks, and days the
relationship lasted. First the coder should provide information on the unit that best describes the
amount of time of the IPV Perpetrator and IPV Victim relationship in terms of years, months, or less than
1 month. Indicate the length of the romantic relationship in IPV_RelationshipLength and the units of
measurement for the interval (e.g., hours, days, weeks) in IPV_RelationshipLengthUOM.
For any length that is 47 hours or less, use hours; for 48 hours and to 29 days, use days. For 30 or more
days, the abstractor should use months. For 12 or more months, use years. Round to the nearest unit
(e.g., 1 hour and 35 minutes would be recorded as 2 hours). If relationship length was noted as a range,
use the high end of the range (e.g., 15–29 days, use 29). If relationship length is not precisely noted,
Section 10: Intimate Partner Violence Optional Module

188 | P a g e

indicate 999 in RelationshipLength and the applicable unit in IPV_RelationshipLengthUOM (e.g., “couple
dated for a few days” would be 999 in IPV_RelationshipLength and 3 in IPV_RelationshipLengthUOM).

10.9

Relationship Break-Up

10.9.1 Breakup or breakup in progress: IPV_RelationshipBreakup
10.9.2 Breakup length number of units: IPV_BreakupLength
10.9.3 Unit of time used in breakup length: IPV_BreakupLengthUOM
Definitions:
 IPV_RelationshipBreakup: Indication of a breakup or in-process breakup of IPV Perpetrator and IPV
Victim
 IPV_BreakupLength: Unit of time for IPV Perpetrator and IPV Victim breakup
 IPV_BreakupLengthUOM: IPV Perpetrator and IPV Victim relationship breakup length
Response Options:
 IPV_RelationshipBreakup
0 No, there was no indication of a breakup between the IPV Perpetrator and IPV Victim
1 No, a breakup was threatened by the IPV Perpetrator or IPV Victim but did not happen
2 Yes, a breakup occurred immediately preceding or during the incident
3 Yes, a breakup occurred at some point prior to the incident but not during or immediately
preceding the incident
9 Unknown


IPV_BreakupLength
88 Not Applicable
99 Unknown



IPV_BreakupLengthUOM
1 Years
2 Months
3 Weeks
4 Days
5 Hours
8 Not Applicable
9 Unknown

Discussion:
These variables provide information drawn from CME or Law enforcement narrative reports that
provide information whether a breakup occurred or was occurring between the IPV Perpetrator and IPV
Victim.
 IPV_RelationshipBreakup should be coded as “yes” if there is information in the reports indicating
the IPV Perpetrator and IPV Victim had broken up or were in the process of breaking up. This should
include cases in which the partners recently divorced or one of the partners filed for divorce or
threatened divorce.
 IPV_BreakupLengthUOM and IPV_BreakupLength time period should be estimated from
Section 10: Intimate Partner Violence Optional Module

189 | P a g e

information drawn from CME or Law enforcement narrative reports. It is coded using a numerical
indication of the number of years, months, weeks, and days of how long ago the breakup occurred.
First the coder should provide information on the unit that best describes the amount of time that
has passed since the IPV Perpetrator and IPV Victim breakup in terms of years, months, or less than
1 month. This is then followed by the number that best describes the time length of the breakup. If
the IPV Perpetrator and IPV Victim relationship is described as having numerous breakups, the
length should be measured using the most recent breakup. Information on the status of the
relationship and timing of relationship termination may provide insight into precipitating events that
may have contributed to the incident.

10.10 Children in Victim’s Home

10.10.1 Children under 18 living at home: IPV_ChildrenHome
10.10.2 Number of children under 18 living at home: IPV_ChildrenNumberLiving
10.10.3 Any children not offspring of IPV Perpetrator: IPV_StepChildPerpetrator
10.10.4 Any children not offspring of IPV Victim: IPV_StepChildVictim
Definitions:
 IPV_ChildrenHome: Indicator of whether or not there were children under 18 living at the home.
 IPV_ChildrenNumberLiving: How many children under age 18 were living at the victim’s home at
the time of the incident
 IPV_StepChildPerpetrator: Were any of those children not the IPV Perpetrator’s offspring
 IPV_StepChildVictim: Were any of those children not the IPV Victim’s offspring
Response Options:
 IPV_ChildrenHome
 IPV_StepChildPerpetrator
 IPV_StepChildVictim
0 No
1 Yes
9 Unknown


IPV_ChildrenNumberLiving
88 Not Applicable
99 Unknown

Discussion:
This set of variables is only for IPV Victims or IPV Perpetrators who are killed by an intimate partner.





IPV_ChildrenHome: Code “yes” if there were children under age 18 living in the IPV Victim’s home
at the time of the incident.
IPV_ChildrenNumberLiving: Code the number of children under age 18 living in the IPV Victim’s
home at the time of the incident. If a report indicates that children were living in the home but does
not specify their age, it is acceptable to code this variable.
IPV_StepChildPerpetrator: Code “yes” if any of the children at home were not the IPV Perpetrator’s
from a previous or subsequent relationship.

Section 10: Intimate Partner Violence Optional Module

190 | P a g e



IPV_StepChildVictim: Code “yes” if any of the IPV Perpetrator’s children at home were not the IPV
Victim’s offspring. For example, if the perpetrator had one child with an ex-spouse (the IPV Victim)
and one from a previous or subsequent relationship, code “yes.”

Because we are attempting to describe the problem of children who are exposed to the violent death of
a parent by a partner, please answer these questions with reference to the IPV Victim’s or IPV
Perpetrator’s children and not with reference to other children who may be living in the house (such as
cousins or neighbors) or witnessed the incident (such as a passer-by).

10.11 Children Present During Incident

10.11.1
10.11.2
10.11.3
10.11.4

Number of children exposed to homicide: IPV_ChildrenNumberExposed
Number of children 5 or under exposed to homicide: IPV_ChildrenNumberUnder5
Use of child as shield during incident: IPV_ChildrenShield
Child intervened during incident: IPV_ChildrenIntervened

Definitions:
 IPV_ChildrenNumberExposed: Number of children directly exposed to the incident (i.e., saw it,
heard it, or discovered the body)
 IPV_ChildrenNumberUnder5: Number of children age 5 or younger who witnessed the incident
 IPV_ChildrenShield: Use of child as shield during the incident
 IPV_ChildrenIntervened: Child intervened during the incident
Response Options:
 IPV_ChildrenNumberExposed
 IPV_ChildrenNumberUnder5
Numeric
9 Some, but unknown number
99 Unknown



IPV_ChildrenShield
IPV_ChildrenIntervened
0 No
1 Yes
9 Unknown

Discussion:
 IPV_ChildrenNumberExposed: Code the number of children (under the age of 18) who were directly
exposed to the homicide. For example, they saw it, they heard it through the walls, they witnessed
the suspect abducting the victim, they were attacked or threatened during the incident or were
used as a shield, or they discovered the body.
 IPV_ChildrenNumberUnder5: Code the number of children (age 5 and younger) who were directly
exposed to the homicide. For example, they saw it, they heard it through the walls, they witnessed
the suspect abducting the victim, they were attacked or threatened during the incident or were
used as a shield, or they discovered the body.
Section 10: Intimate Partner Violence Optional Module

191 | P a g e




IPV_ChildrenShield: Code “yes” if a person in the incident attempted to use a child as a physical
shield to prevent or end an attack.
IPV_ChildrenIntervened: code “yes” if a child attempted to intervene during the homicide incident.
For example, if a child tried to in some way prevent the IPV Perpetrator from harming the IPV Victim
by stepping between them, made verbal threats, etc.

10.12 Restraining Order Variables

10.12.1 Restraining order ever: IPV_RestrainingOrderHistory
10.12.2 Restraining order at time of incident: IPV_RestrainingOrder
10.12.3 Restraining order type: IPV_RestrainingOrderType
10.12.4 Restraining order issue date: IPV_RestrainingOrderIssueDate
10.12.5 Restraining order served: IPV_RestrainingOrderServed
10.12.6 Persons protected by restraining order: IPV_RestOrderPersonsProtect
Definitions:
 IPV_RestrainingOrderHistory: Refers to whether there was ever a restraining order between the
members of the couple (IPV Victim and IPV Perpetrator)
 IPV_RestrainingOrder: Refers to whether there was a restraining order between the members of
the couple at the time of incident
 IPV_RestrainingOrderType: The type of restraining order in place
 IPV_RestrainingOrderIssueDate: The date the restraining order was issued
 IPV_RestrainingOrderServed: Indication of whether the restraining order was served
 IPV_RestOrderPersonsProtect: Individual(s) protected by the restraining order
Response Options:
 IPV_RestrainingOrderHistory
 IPV_RestrainingOrder
0 No
1 Yes
9 Unknown


IPV_RestrainingOrderType
1 Emergency
2 Temporary
3 Permanent
8 No restraining order
9 Unknown



IPV_RestrainingOrderIssueDate
Date (format: MM/DD/YYYY)



IPV_RestrainingOrderServed
0 No
1 Yes
8 No restraining order

Section 10: Intimate Partner Violence Optional Module

192 | P a g e

9


Unknown

IPV_RestOrderPersonsProtect
1 IPV Victim
2 IPV Perpetrator
3 Both
8 Other
9 No restraining order
88 Not applicable
99 Unknown

Discussion:
Code “IPV_RestrainingOrder” as “yes” if a restraining order involving both the IPV Perpetrator and IPV
Victim was issued at the time of the incident. Data sources for this information will likely vary by state.
Some states can utilize statewide restraining order databases, while other states must rely on contacting
county courthouses where the fatal incident took place. The Law enforcement report is another possible
source for this information. Restraining orders may be referred to in a number of ways including
restraining order, protective order, or by specific state statute number. Restraining orders that are not
abuse prevention orders do not qualify and should not be included. For example, a restraining order not
to spend money from a joint account filed as part of divorce proceedings should not be included.
Information may also be available on the date that the restraining order was issued, and served
documentation of the restraining order should indicate the date on which it was issued. This should be
entered with month, day, and year. The date served may not be as readily available. This information
may be found in Law enforcement, Domestic Violence Fatality Review Team (DVFRT) report, or court
records. The element only requires a yes, no, or unknown response.
Documentation for the restraining order should also include information on the individual(s) protected
by the order. While most restraining orders will include only one of the partners, some may also include
other child dependents. The information requested for the restraining orders provides more detail on
the timing and coverage of the restraining order and may provide insight into precipitating events of the
incident. If multiple restraining orders exist, record only the most recent between the intimate partners.

10.13 Prior Arrests/Convictions

10.13.1 Prior arrest(s): IPV_PriorArrestPerpetrator, IPV_PriorArrestVictim
10.13.2 Type of arrest(s): IPV_ PerpetratorArrestType, IPV_VictimArrestType
10.13.3 Type of arrest(s) if other: IPV_PerpetratorArrestTypeText, IPV_VictimArrestTypeText
10.13.4 Prior conviction(s): IPV_PriorConvictionsPerpetrator, PriorConvictionsVictim
10.13.5 Type of conviction(s): IPV_ConvictionTypePerpetrator, IPV_ConvictionTypeVictim
10.13.6 Type of conviction(s) if other: IPV_ConvictionTypeOtherPerp,
IPV_ConvictionTypeOtherVictim
Definitions:
 IPV_PriorArrest: IPV Perpetrator/Victim had prior arrest(s)
 IPV_ArrestType: Type of arrests for IPV Perpetrator/Victim
Section 10: Intimate Partner Violence Optional Module

193 | P a g e






IPV_ArrestTypeText: Text describing other type(s) of arrest for IPV Perpetrator/Victim
IPV_PriorConviction: IPV Perpetrator/Victim had prior criminal conviction(s)
IPV_ConvictionType: Type of convictions for IPV Perpetrator/Victim
IPV_ConvictionTypeOther: Text describing other type(s) of conviction for IPV Perpetrator/Victim

Response Options:
 IPV_PriorArrest
 IPV_PriorConviction
0 No
1 Yes
9 Unknown



IPV_ArrestType
IPV_ConvictionType
1 Homicide
2 Robbery
3 Sexual assault (forcible)
4 Assault offenses (other than sexual assault)
5 Property offenses
6 Weapons offenses
7 Drug abuse violations
8 Offenses against family or children
9 Alcohol-related offenses
10 Restraining order violations
11 Other (specify)
12 Other unspecified
99 Unknown

Discussion:
The data elements provide information from state criminal history records. The coder should first
indicate if an arrest or conviction occurred and then indicate the category. If a person has arrests and/or
convictions in more than one category, list the most severe type of offense (homicide, then sexual
assault, other assaults, offenses against family or children, robbery, property offenses, weapons
offenses, drug abuse violations, and alcohol-related offenses). If this data element is coded from the
criminal history records of a specific municipal or county Law enforcement department, the variable
should be coded “unknown” if no arrest is found, because these records do not include other law
enforcement departments in the state.
Definitions for all Part I and Part II offenses can be found in the UCR handbook (FBI, 2004):
http://www.fbi.gov/about-us/cjis/ucr/additional-ucr-publications/ucr_handbook.pdf/view.
Prior arrests or convictions for homicide offenses include murder/non-negligent manslaughter,
negligent manslaughter, and justifiable homicide. Sex offenses include forcible rape, forcible sodomy,
sexual assault with an object, and forcible fondling. Assault offenses include aggravated assault, simple
assault, and intimidation. Property offenses should include the crimes of: burglary, larceny/theft, fraud,
possession of stolen property, embezzlement, and vandalism. Weapons offenses include any crimes
related to the manufacture, sale, or possession of deadly weapons. Drug abuse violations are defined as
“the violation of laws prohibiting the production, distribution, and/or use of certain controlled
Section 10: Intimate Partner Violence Optional Module

194 | P a g e

substances and the equipment or devices utilized in their preparation and/or use.” Offenses against
family or children are defined as “unlawful nonviolent acts by a family member (or legal guardian) that
threaten the physical, mental, or economic well-being or morals of another family member and that are
not classifiable as other offenses, such as assault or sex offenses.” Alcohol-related offenses include
driving under the influence and drunkenness.

10.13.7 Prior IPV Arrest(s): IPV_PriorArrestPerpetratorIPV, IPV_PriorArrestVictimIPV
Definitions:
IPV Perpetrator/Victim had prior arrest for violence against an intimate partner
Response Options:
0
No
1
Yes
9
Unknown
Discussion:
This variable provides information that is most likely to be included in the Law enforcement reports.
Some state criminal history databases explicitly identify domestic violence offense, but some do not, so
this variable may be difficult for some states to code. Prior IPV arrests should be defined as any UCR Part
I crimes—homicide, forcible rape, robbery, and aggravated assault—or the Part II crime of simple assault
when committed against a former or current intimate partner.

10.14 Disability Variables±

10.14.1 Physical illness: IPV_PhysicalIllnessPerpetrator, IPV_PhysicalIllnessVictim
10.14.2 Diagnosis of physical illness: IPV_DiagPhysicalIllnessPerp,
IPV_DiagPhysicalIllnessVictim
10.14.3 Disability: IPV_DisabilityPerpetrator, IPV_DisabilityVictim
10.14.4 Disability was physical: IPV_DisabilityPhysicalPerp, IPV_DisabilityPhysicalVictim
10.14.5 Disability was developmental: IPV_DisabilityDevelopmentalPerp,
IPV_DisabilityDevelopmentalVic
10.14.6 Disability was sensory: IPV_DisabilitySensoryPerp, IPV_DisabilitySensoryVictim
Definitions:
 IPV_PhysicalIllness: IPV Perpetrator/Victim had an acute or chronic physical illness at the
time of the incident
 IPV_DiagPhysicalIillness: Free text field to indicate diagnosis if IPV Perpetrator/Victim was
physically ill at the time of the incident
 IPV_Disability: IPV Perpetrator/Victim had a disability at the time of the incident
 IPV_DisabilityPhysical: IPV Perpetrator’s/Victim’s disability was physical (e.g., paraplegia,
cerebral palsy)
 IPV_DisabilityDevelopmental: IPV Perpetrator’s/Victim disability was developmental (e.g.,
intellectual disability)
Section 10: Intimate Partner Violence Optional Module

195 | P a g e



IPV_DisabilitySensory: IPV Perpetrator’s/Victim’s disability was sensory (e.g., blindness,
deafness)

Response Options:
0
No
1
Yes
9
Unknown
Discussion:
Physical illness may be acute (e.g., viral gastroenteritis, pneumonia) or chronic (e.g., diabetes, asthma,
sickle cell anemia). However, if the chronic illness did not impose increased care demands at the time of
the incident, do not code “yes.” For example, if an individual had a history of asthma, but had no acute
exacerbation at the time of the incident, code “no.” The severity of the illness should not be considered
when coding; any mention in the record of the individual being physically ill at the time of the incident is
sufficient to warrant coding “PhysicalIllness” as “yes.” Physical disability implies a chronic physical
impairment that has a substantial, long-term effect on the individual’s day-to-day functioning (e.g.,
cerebral palsy). Developmental disability implies a chronic cognitive or developmental deficit that has a
substantial, long-term effect on the individual’s day-to-day functioning (e.g., autism, intellectual
disability). Sensory disability implies a chronic sensory deficit that has a substantial, long-term impact on
the individual’s day-to-day functioning (e.g., blindness, deafness). If an individual was not specifically
diagnosed with or documented to have one of the listed disabilities, answer “no.” The information used
to complete this data element may come from medical records and/or autopsy.
±For information about CDC and WHO definitions of disability, see:
http://www.cdc.gov/ncbddd/disabilityandhealth/types.html

10.14.7 Alcohol use suspected: IPV_SuspectedIntoxicatedPerp,
IPV_SuspectedIntoxicatedVictim
10.14.8 Drug use suspected: IPV_SuspectedDrugUsePerpetrator, IPV_SuspectedDrugUseVictim
Definitions:
 IPV_SuspectedIntoxicated: IPV Perpetrator/Victim suspected to be under the influence of alcohol at
the time of the incident
 IPV_SuspectedDrugUse: IPV Perpetrator/Victim suspected to be under the influence of an illicit drug
at the time of the incident
Response Options:
0
No
1
Yes
9
Unknown
Discussion:
SuspectedIntoxicated is asked of victims only. In the IPV module, it is also asked of both the IPV Victim
and IPV Perpetrator. SuspectedDrugUse is a new variable also asked of both IPV Victims and
Perpetrators.

Section 10: Intimate Partner Violence Optional Module

196 | P a g e

Alcohol use suspected should be coded “yes” using information from witness or investigator reports
(e.g., Law enforcement note that the IPV Perpetrator or Victim had been drinking), circumstantial
evidence (e.g., empty six pack scattered around IPV Perpetrator or Victim), or test results (e.g., Law
enforcement breathalyzer).
This variable refers only to alcohol use and not drug use. Therefore, if an IPV Perpetrator or Victim was
said to have been smoking crack on the day of the incident, but tested negative for alcohol and there is
no evidence of drinking, should be coded as “no.” The phrase “in the hours preceding the incident” can
be interpreted relatively broadly. For example, if friends report that an IPV Perpetrator or Victim was
drinking heavily at a party, and returned home that evening and was killed sometime later that night,
should be coded as “yes.” The level of intoxication is not relevant in coding this variable. If there is no
evidence of alcohol use, code this variable as “no.” Use the “unknown” option only if the source does
not have a narrative that could provide the evidence of intoxication.
Drug use suspected should be coded “yes” based on witness or investigator reports or test results from
the IPV Perpetrator or Victim. Illicit drugs include not only street drugs like heroin, cocaine, marijuana,
and methamphetamine, but also illicitly obtained prescription drugs like oxycodone and substances that
are sniffed for their mood-altering effects (e.g., sniffing glue, “huffing” gasoline). Prescription drugs
believed to be taken in accordance with the prescription directions should not be included as illicit drug
use.
Both SuspectedIntoxicated and SuspectedDrugUse will include some false positives, since they are not
necessarily based on test results. For a more conservative evaluation of drug and alcohol use in
suspects, use toxicological testing if available.
Note: As of August, 2013, a perpetrator/victim who takes methadone is no longer assumed to be in
treatment for heroin addiction and should be coded as “No” unless other information is available (e.g.,
taking methadone as part of substance abuse treatment). Please note that the victim is taking
methadone on the toxicology page (for perpetrator taking methadone, please note this in the narrative).

10.14.9 Mental health problem: IPV_MentalHealthProblemPerp,
IPV_MentalHealthProblemVictim
Definitions:
IPV Perpetrator /Victim had a mental health problem
Response Options:
0
No
1
Yes
9
Unknown
Discussion:
If the case involves a suicide, this information will be captured in the general NVDRS system for the
suicide victim. Code a person as “yes” for if he or she has been identified as having a mental health
problem. Mental health problems include disorders and syndromes listed in the DSM-5 (Diagnostic and
Statistical Manual of Mental Disorders, 5th Revision) with the exception of alcohol and other substance
disorders (as these are captured in separate variables). Examples of disorders qualifying as mental
Section 10: Intimate Partner Violence Optional Module

197 | P a g e

health problems include not only diagnoses such as major depression, schizophrenia, and generalized
anxiety disorder, but developmental disorders (e.g., intellectual disability, autism, attention deficit
hyperactivity disorder), eating disorders, personality disorders, and organic mental disorders such as
Alzheimer’s and other dementias. Also code “yes” if the person was being treated for a mental health
problem including treatment through involuntary mechanisms such as an Emergency Order of
Detention, even if the nature of the problem is unclear (e.g., “was being treated for various psychiatric
problems”). It is acceptable to endorse this variable on the basis of past treatment of a mental health
problem, unless it is specifically noted that the problem has been resolved. For example, “IPV Victim or
Perpetrator was hospitalized twice for mental problems,” is adequate basis for coding as “yes.” Code yes
if a mental health problem is noted even if the timeframe is unclear (as in “history of depression”), or if
the person was seeking mental health treatment or someone was seeking treatment on his or her behalf
(e.g., “family was attempting to have him hospitalized for psychiatric problems”). This should also be
coded as “yes” if the IPV Victim or Perpetrator has a prescription for an antidepressant or other
psychiatric medication. The drug list provided in the training notebook identifies drugs that can be
considered psychiatric medications. We have separate questions for substance use problems.
Therefore, do not include substance abuse as a “current mental health problem.”
Coding “no” (as opposed to “unknown”) means that the record explicitly stated that the person had no
known mental health problems. Code “unknown” if there is no information about the person’s mental
health status or if the information is unclear.
Examples
 Yes
o
o
o
o



Toxicology report from medical examiner indicates that the IPV Victim or Perpetrator tested
positive for Sertraline (an antidepressant)
Person had posttraumatic stress disorder (PTSD)
History of depression
Was under the care of a psychiatrist

No
o Record states “no known mental disorders”
Unknown
o Neighbor indicates that the person was not acting normally. Was depressed over a recent
break-up.

10.15 Mental Health Diagnoses

10.15.1 Mental health diagnosis 1: IPV_MentalHealthDiagPerp1,
IPV_MentalHealthDiagVictim1
10.15.2 Mental health diagnosis 2: IPV_MentalHealthDiagPerp2,
IPV_MentalHealthDiagVictim2
10.15.3 Mental health diagnosis 3: IPV_MentalHealthDiagPerp3,
IPV_MentalHealthDiagVictim3
10.15.4 Other mental health diagnosis: IPV_MentalHealthDiagOtherPerp,
IPV_MentalHealthDiagOtherVictim

Section 10: Intimate Partner Violence Optional Module

198 | P a g e

Definitions:
 IPV_MentalHealthDiagnosis1: IPV Perpetrator/Victim mental health diagnosis
 IPV_MentalHealthDiagnosis2: IPV Perpetrator/Victim mental health diagnosis 2
 IPV_MentalHealthDiagnosis3: IPV Perpetrator/Victim mental health diagnosis 3
 IPV_MentalHealthDiagnosisOther: IPV Perpetrator/Victim other mental health diagnosis
Response Options:
 IPV_Mentalhealthdiagnosis1/2/3
1
Depression/dysthymia
2
Bipolar disorder
3
Schizophrenia
4
Anxiety disorder
5
Posttraumatic stress disorder
6
ADD or hyperactivity disorder
7
Eating disorder
8
Obsessive-compulsive disorder
9
Mental retardation
10
Autism
11
Personality disorders (e.g., borderline, schizoid, histrionic, avoidant, etc.)
12
Alzheimer’s
88
Not applicable
99
Unknown


IPV_MentalHealthDiagnosisOther
Text

Discussion:
Code up to three diagnoses. If a diagnosis is not on the code list, code “other” and record the diagnosis
in the text field. If the record indicates more than three diagnoses, note the additional diagnoses. For
cases in which the person was noted as being treated for a mental health problem, but the actual
diagnosis is not documented, code” as “unknown.” If the person had a mental health problem but the
nature of the problem has not been diagnosed (e.g., “was hearing voices and having paranoid delusions;
family was attempting to have her committed”), code as “not applicable” since she/he had not been
treated or diagnosed. Do not attempt to apply a diagnosis based on reading the symptoms. While it is
acceptable to code “mental health problem” based on the IPV Victim’s or Perpetrator’s prescription for
a psychiatric medication, do not infer a specific diagnosis based on the medication.

10.15.5 Currently in treatment for mental health problem:IPV_TreatmentMentalHealthPerp,
IPV_TreatmentMentalHealthVictim
10.15.6 Ever treated for mental health problem: IPV_HistoryMentalIllnessPerp,
IPV_HistoryMentalIllnessVictim
Definitions:
 IPV_TreatmentMentalHealth: IPV Perpetrator/Victim currently in treatment for a mental health
Problem
 IPV_HistoryMentalIllness: IPV Perpetrator/Victim ever treated for a mental health problem
Section 10: Intimate Partner Violence Optional Module

199 | P a g e

Response Options:
0
No
1
Yes
9
Unknown
Discussion:
This should be coded “yes” if the IPV Victim or Perpetrator was in current treatment (that is, had a
current prescription for a psychiatric medication or saw a mental health professional within the past 2
months). Treatment includes seeing a psychiatrist, psychologist, medical doctor, therapist, or other
counselor for a mental health or substance abuse problem; receiving a prescription for an
antidepressant or other psychiatric medicine (see training notebook for list of psychiatric drugs); or
residing in an inpatient or halfway house facility for mental health problems. This variable indicates
whether the IPV Perpetrator or Victim was noted as ever having received professional treatment for a
mental health problem, either at the time of death or in the past. If an IPV Perpetrator or Victim is in
current treatment, by definition this variable (ever in treatment) should be endorsed. If a decedent died
as the result of an overdose from multiple medications and it is not clear whether the medications were
his or her own (as in an IPV Victim or Perpetrator swallowing everything in the family’s medicine
cabinet), the existence of an antidepressant or other psychiatric medication in the IPV Victim’s or
Perpetrator’s bloodstream is not sufficient evidence of mental health treatment. For IPV Perpetrators
and Victims who die by other means than drug overdose (e.g., shooting, hanging), toxicology test results
indicating the presence of a psychiatric medication is sufficient evidence of mental health treatment.
Examples
1. Current treatment for mental illness
 Yes
o A recently filled, unopened prescription belonging to the IPV Victim or Perpetrator for
an antidepressant is found in the medicine cabinet.
o In treatment for depression for the last 10 years.
o Released from inpatient care for bipolar disorder a week ago.


No
o
o
o

Records indicate not in mental health treatment
Taking St. John’s Wort (nonprescription herb) for depression because of a magazine
article s/he had read.
Taking over-the-counter sleeping pills for insomnia (but note that a diagnosed sleep
disorder would qualify).

2. Ever treated for mental illness
 Yes
o Several years ago the IPV Victim or Perpetrator was treated for bipolar disorder.
o The IPV Victim or Perpetrator had begun seeing a psychiatrist recently, but had
previously never been in treatment.

10.15.7 Alcohol problem: IPV_AlcoholProblemPerpetrator, IPV_AlcoholProblemVictim
10.15.8 Other substance abuse problem:IPV_SusbstanceAbusePerpetrator,
IPV_SusbstanceAbuseVictim
Section 10: Intimate Partner Violence Optional Module

200 | P a g e

Definitions:
 IPV_AlcoholProblem: IPV Perpetrator/Victim had alcohol dependence or alcohol problem
 IPV_SusbstanceAbuse: IPV Perpetrator/Victim had other illicit or prescription drug abuse problem
Response Options:
0
No
1
Yes
9
Unknown
Discussion:
Code “yes” for if the IPV Perpetrator or Victim was perceived by self or others to have a problem with,
or to be addicted to, alcohol or other drugs. An IPV Perpetrator or Victim who is noted as participating in
a drug or alcohol rehabilitation program or treatment—including self-help groups and 12-step programs
—should be coded as “yes” even if the IPV Perpetrator or Victim was noted as being currently clean and
sober. A problem from the past that has resolved and no longer appears to apply should not be coded.
Can be endorsed if an IPV Perpetrator or Victim was noted as using illegal drugs (such as heroin or
cocaine), abusing prescription medications (such as pain relievers or Valium), or regularly using inhalants
(e.g., sniffing gas). If the IPV Perpetrator or Victim is mentioned as using illegal drugs—even if addiction
or abuse is not specifically mentioned—code as “yes.” The phrase “history of drug abuse” is sufficient to
justify endorsing unless it is noted that the IPV Perpetrator or Victim is no longer a drug user. Previously
attempting suicide via overdose is not sufficient justification for endorsing in the absence of other
information.
Examples
1. Alcohol problem
 Yes
o CME report indicates the IPV Victim or Perpetrator was in an alcohol rehabilitation
program last year. Called AA sponsor the day before the incident.
o Noted in CME report that the IPV Perpetrator or Victim had been drinking a lot lately
and family was concerned.


No
o

CME report indicates that 20 years ago the IPV Perpetrator or Victim had trouble with
drugs and alcohol as a teenager, but not since then.

2. Other substance abuse problem
 Yes
o CME report indicates that the perpetrator or victim abuses his/her own painkiller
prescription. IPV Perpetrator or Victim made regular visits to a methadone clinic.
o IPV Perpetrator or Victim had track marks and drug paraphernalia at his/her apartment.
o IPV Victim or Perpetrator shot him/herself after a fight with spouse over drug use and
mounting debts.
 No
o IPV Perpetrator or Victim smoked marijuana occasionally.
o IPV Perpetrator or Victim attempted suicide via medication overdose on two previous
occasions. No evidence of substance use or abuse.

Section 10: Intimate Partner Violence Optional Module

201 | P a g e

10.15.9 Disclosed intent to commit suicide:IPV_SuicideDisclosedIntentPerp,
IPV_SuicideDisclosedIntentVictim
Definitions:
IPV Perpetrator/Victim disclosed to another person intentions to die by suicide
Response Options:
0
No
1
Yes
9
Unknown
Discussion:
Code as “yes” if the IPV Perpetrator or victim had previously expressed suicidal feelings to another
person, whether explicitly (e.g., “I’m considering killing myself”) or indirectly (e.g., “I think everyone
would be better off without me” or “I know how to put a permanent end to this pain”). Do not code this
variable as “yes” if the IPV Perpetrator or Victim disclosed his/her intention to kill him/herself only at
the moment of the suicide (i.e., when there was no opportunity to intervene to stop the suicide). Also,
do not endorse this variable if the IPV Perpetrator or Victim had talked about suicide sometime in the
distant past, but had not disclosed his/her current intent to die by suicide to anyone. When the Law
enforcement or CME document whether the IPV Perpetrator or Victim stated his/her intent to die by
suicide, they are doing so less for the purpose of documenting a missed opportunity for intervention and
more for the purpose of indicating why the death is being treated as a suicide and not a potential
homicide. Therefore, the records may be unclear about timing. For example, the record may state, “IPV
Perpetrator or Victim has spoken of suicide in the past,” and it is not entirely clear whether the talk
about suicide was only in the past or was related to the current incident. This will frequently be a gray
area for coding. If the record indicates disclosure of intent in the past but affirmatively states that there
was no disclosure for the current incident, code as “no.” If the record indicates disclosure of intent, but
is unclear about the time frame, code as “yes.” This will sometimes be incorrect; however, the specificity
to allow precise coding is too often missing in the records to justify using a narrower interpretation.
Examples
 Yes
o
o



No
o



The IPV Perpetrator or Victim told a spouse that s/he was planning to end his/her suffering
and was going to stop being a burden.
The IPV Perpetrator or Victim has mentioned on and off to friends that s/he was considering
suicide; no one thought s/he would do it.

The IPV Perpetrator or Victim has spoken of suicide in the past, but not in the past few
months when things seemed to be going better for him/her.

Unknown
o Had previously threatened to kill his family. No further information available on mental
health history.

10.15.10
10.15.11

History of suicide attempts: IPV_HistorySuicideAttemptsPerp,
IPV_HistorySuicideAttemptsVictim

Section 10: Intimate Partner Violence Optional Module

202 | P a g e

Definitions:
IPV_HistorySuicideAttemptsPerpetrator: Perpetrator had a history of attempting to die by suicide
IPV_HistorySuicideAttemptsVictim: Victim had a history of attempting to die by suicide
Response Options:
0
No
1
Yes
9
Unknown
Discussion:
Code HistorySuicideAttempts as “yes” if the IPV Perpetrator or Victim was known to have made
previous suicide attempts, regardless of the severity of those attempts.

Section 10: Intimate Partner Violence Optional Module

203 | P a g e

Appendix. The following decision-tree is intended to assist states in determining which state enters an
incident in the NVDRS web-based system when the incident crosses state lines or a resident was fatally
injured in another state. The decision-tree can be used by states collecting statewide data and states
with pilot years.

Section 11: Appendix

204 | P a g e

----END OF CODING MANUAL----

205 | P a g e


File Typeapplication/pdf
File TitleNational Violent Death Reporting System
SubjectCoding Manual, v5.1
AuthorNational Center for Injury Prevention and Control, Division of V
File Modified2018-12-10
File Created2018-12-10

© 2024 OMB.report | Privacy Policy