QUEENS — When grieving widower Jim Peveraro first received his wife, Jane’s, death certificate in September 2013, he didn’t check out the fine print right away.
But when he took a closer look at the official city document, and noticed “natural causes” listed as the reason Jane died, Peveraro was upset.
“When you die at 57, there’s nothing natural about that,” Peveraro said about the mother of his five children, who had waged a valiant 2 1/2 year fight against ovarian cancer, undergoing multiple rounds of chemo.
Peveraro contacted Pamela Esposito-Amery, co-founder of T.E.A.L — a support group she started with her sister, Louisa McGregor, who succumbed to ovarian cancer when she was just 45 years old. T.E.A.L. stands for “Tell Every Amazing Lady” about ovarian cancer.
“We realized on her death certificate, it said ‘natural causes,’” Esposito-Amery told PIX11 about her sister’s paperwork. “I immediately thought: ‘This has to affect things in a big picture way.’ It must affect funding and statistics.”
Esposito-Amery consulted with City Councilman Rafael Espinal, who lost his own mother to ovarian cancer.
“I always questioned why it wasn’t stated what she passed away from,” Espinal said.
Jim Peveraro didn’t let the matter go.
He knew the grim statistics.
About 22,000 women are diagnosed every year with ovarian cancer, which is difficult to detect, because symptoms like bloating and back pain mimic other medical ailments. Fourteen to 16,000 of these women will ultimately die.
Peveraro is upset there’s no reliable blood test to screen for ovarian cancer, like the PSA test that helps with early detection of prostate cancer in men.
Peveraro didn’t want a vague death certificate to negatively impact funding for ovarian cancer research.
So he called the funeral home where Jane was waked, and then he was referred back to Long Island Jewish Hospital, where Jane suffered a cardiopulmonary arrest on September 16, 2013.
“And L-I-J said, ‘She didn’t die in an accident, so you’ll have to take it up with the city.’”
Peveraro spent months on the phone, trying to get answers from the 3-1-1 helpline and the Health Department. He said he wasn’t making much headway. Then, he contacted PIX11.
At one point, Peveraro called Jane’s oncologist, who had treated her at Memorial Sloan Kettering Cancer Center. When the doctor was told about the death certificate, Peveraro said the physician said to him, “‘ Well, that’s not right. She died from ovarian cancer.’”
After Peveraro did an interview with PIX11, he paid another visit to the local funeral director and got a major break in his journey. Peveraro learned many death certificates get updated online…to reflect the illnesses that led to a patient’s expiration. The funeral director found an online update for Jane’s death, stating the immediate cause of death was cardiopulmonary arrest, with ovarian cancer and tumor lysis syndrome being the factors that led to her death.
“I really applaud this man….for beginning the dialogue,” said Dr. Alex Williamson, a forensic pathologist at Northwell LIJ in Queens.
Williamson is passionate about the importance of death certificates being highly specific. It disturbs him that not every doctor in the United States takes the time—or training—to make sure a death certificate gets updated online.
“A cause of death listing ‘natural causes’ is a generic ‘place holder,’ if you will,” noted Dr. Williamson. “Death certificates can and should me amended,” the doctor said, “as more information becomes available.”
“I think we tend, in this country, to ignore post mortem care,” Williamson observed. “If we’re not documenting what’s actually killing the people,” Dr. Williamson said, “it has ramifications. Death certification is incredibly important for the public health.”
Jim Peveraro has started The Jane Fund in his wife’s memory, and a key goal is developing an accurate blood test to screen for ovarian cancer, a killer disease that’s often not discovered until Stage 3.
“Survival rates for Stage 1 are 92 percent,” Peveraro noted.
Pamela Esposito-Amery is working with the tools available now to screen for ovarian cancer, and asks her doctor for three things every year.
“I ask for a pelvic abdominal sonogram, I ask for a vaginal rectal exam, and a CA-125 blood test.”
“There are so many symptoms that ovarian cancer allows doctors to miss,” Esposito-Amery explained. “We ask that people go to the doctor if they have these symptoms for more than two weeks,” she said of common signs like bloating, back pain, and bleeding.
T.E.A.L has helped fund a research program in Pennsylvania, where dogs have actually been able to sniff out ovarian cancer in tissue that’s presented to them. It’s the hope of groups like T.E.A.L.—and individuals like Jim Peveraro—that this research will lead to a more accurate test for ovarian cancer.
When we asked the New York City Department of Health about the situation, we received the following information from the press office:
- Families can request an additional report of a death certificate online, by mail or in person at the Health Department located at 125 Worth St. Within the first year of death, they can contact the funeral home.
- Death certificates can be updated at the facility in which the person dies within a year of the death. After a year, families should contact the Health Department’s Corrections Unit at 125 Worth St.