The government of Puerto Rico did not follow guidelines from the Center for Disease Control and Prevention (CDC) in Atlanta to fill out death certificates after Hurricane María, which suggests attaching a special form to link the death to a natural disaster. The Center for Investigative Journalism (CPI, for its initials in Spanish) discovered that the federal agency waited 36 days after the hurricane to send the documents, which include the special form, to the Puerto Rico Health Department and the Demographic Registry. “The correct protocol and laws where used,” insisted Héctor Pesquera, Secretary of Public Security, in November, after questions arose about the official numbers of deaths related to the emergency. At that time, when asked about the lack of a clear protocol for accounting deaths, Gov. Ricardo Rosselló told BuzzFeed News: “It’s ok [the protocol], that is not the case. There are clear criteria.” He added that the officials had been “working on that and they have been meeting with hospitals, crematoriums, Forensics Sciences and they have already distributed the protocol.”
However, the CDC guidelines suggest that each standard death certificate have an attached form titled Epidemiological Disaster Mortality Surveillance.