Why Some Funeral Directors Ask About Pacemakers
For Canadian families considering cremation, funeral directors routinely ask about pacemakers and other implanted medical devices. The reason — these devices must be removed before cremation to prevent explosion in the cremation chamber.
Why removal is necessary for cremation
The risk: Lithium-battery powered implanted devices can explode at cremation temperatures (typically around 760-980°C, or 1400-1800°F).[1]
Consequences if not removed:
- Damage to cremation chamber (significant repair costs)
- Potential injury to crematorium workers
- Specific safety incident
- Specific operational disruption
Industry standard: All implanted lithium-battery devices removed before cremation. Required by most Canadian crematoria.
Devices requiring removal
Most common:
- Pacemakers — most common implanted device
- Implantable Cardioverter Defibrillators (ICDs) — combine pacing and defibrillation
- Cardiac Resynchronization Therapy devices (CRT) — for heart failure[2]
Other lithium-battery implants:
- Insulin pumps (implanted versions)
- Neurostimulators (for pain, Parkinson's, depression treatment)
- Drug infusion pumps (intrathecal pain pumps)
- Bone growth stimulators (implanted versions)
- Bladder/bowel stimulators
- Cochlear implants (specific versions)
- Hearing aids (typically external; some implanted versions)
Specific devices without lithium battery:
- Joint replacements (artificial hips, knees) — no removal needed
- Stents (cardiac, vascular) — no removal needed
- Plates and screws — no removal needed
- Surgical clips and staples — no removal needed
- Breast implants — typically no removal needed
- Most cosmetic implants — no removal needed
- Dental implants — no removal needed
The rule: If it has a battery (especially lithium), it needs to come out.
The removal process
Who removes:
- Funeral home staff (typically embalmer or funeral director) trained for this procedure
- Sometimes hospital removes before body release to funeral home
- Some funeral homes contract specialists
- Specific procedure but typically straightforward for trained funeral staff
What's involved:
- Specific surgical procedure
- Body preparation
- Specific incision
- Device removal
- Wound closure
- Specific to device location
Time: Typically 15-45 minutes added to body preparation.
Cost: $200-500 added to funeral home services typically.
What happens to the removed pacemaker
Disposal:
- Medical waste protocols (Canadian provincial regulations apply)
- Specific handling required for lithium battery
- Specific environmental considerations
- Specific to provider's protocols
Specific programs:
- Some pacemakers donated to veterinary programs (used in animals)
- Some donated to third-world medical programs
- Specific organizations facilitate (when device condition appropriate)
- Specific consent and documentation
Lithium specific:
- Lithium batteries require specific disposal
- Specific environmental regulations
- Specific to medical waste handling
How funeral home finds out about devices
Multiple information sources:
Family informs funeral director:
- Direct question typically asked during arrangements
- Family should know and inform
- Specific to medical history awareness
Hospital records:
- If death was hospitalized
- Medical records show implants
- Specific to discharge summary
Physical examination:
- Visual examination during body preparation
- Surgical scars indicate implants
- Specific to chest scars for pacemaker
Pacemaker ID card:
- Pacemaker recipients typically carry ID card
- Specific to wallet documentation
- Specific manufacturer and model information
Medical history review:
- Specific to deceased's medical history
- Specific medical records review
Specific to burial
Pacemakers in burial: Generally not required to remove.
Why:
- No risk in burial setting
- Lithium battery degrades over years
- No standard removal requirement
Some specific considerations:
- Some cemeteries may have specific preferences (rare)
- Specific environmental concerns (some advocates argue for removal for environmental reasons)
- Specific to specific cemetery policies
Most Canadian burials: No removal needed.
Telling the funeral home
If you know the deceased had implanted devices:
- Tell funeral director during arrangements
- Specific information helpful (type, location, manufacturer)
- Pacemaker ID card or documentation if available
- Specific medical history
If you're not sure:
- Funeral home will check medical records and physical examination
- Specific to body preparation process
- Funeral home asks if uncertain
- Specific to ensuring all devices identified
Pre-planning consideration:
- Document implanted devices in funeral pre-planning
- Specific to family awareness
- Specific to records location
Pacemaker types and removal
Modern pacemakers: Single chamber, dual chamber, biventricular — all require removal.
Older pacemakers: Less sophisticated but typically still lithium-battery — require removal.
Recent specific models:
- Leadless pacemakers (small capsule, no leads) — still require removal
- Subcutaneous ICDs (no leads in heart) — still require removal
- Specific to device manufacturer guidelines
Specific to crematorium policies
Most Canadian crematoria require:
- Confirmation of removal before accepting body
- Specific paperwork
- Specific to operator protocols
Some crematoria:
- Will refuse cremation if devices not removed
- Specific to operator standards
- Specific to liability concerns
Funeral home coordinates:
- Specific to facilitating removal
- Specific to documentation for crematorium
- Specific to coordinating with crematorium operator
What about cremation done abroad
If body is cremated in another country:
- Specific to that country's regulations
- Specific to international removal standards
- Funeral home consults with international destination
- Specific to repatriation considerations
Alternative — aquamation
Aquamation (alkaline hydrolysis):
- Lower temperature process (chemical rather than flame)
- Specific pacemaker handling may differ
- Specific to specific operator standards
- Limited availability in Canada
- Specific provincial regulations
What we focus on at It's Simple Will
The Funeral Pre-Planner captures specific preferences and medical information including implanted devices — useful for funeral home coordination at time of need.
Related guides
Citations & sources
- [1]Cremation Association of North America — Cremation Association of North America
- [2]Heart and Stroke Foundation of Canada — Heart and Stroke Foundation of Canada
Frequently asked questions
What devices need removal before cremation?
Lithium-battery powered implanted devices — pacemakers (most common), implantable cardioverter defibrillators (ICDs), insulin pumps, neurostimulators, drug infusion pumps, some hearing aids with lithium batteries. Each can explode at cremation temperatures. Standard requirement.
Who removes the pacemaker?
Funeral home staff (typically embalmer or funeral director) trained for this procedure. Sometimes hospital removes before body release to funeral home. Specific medical procedure but typically straightforward for trained funeral staff. Some funeral homes contract specialists.
How much does removal cost?
Typically $200-500 added to funeral home services. Specific to funeral home pricing. Comparable to other medical-related funeral services. Generally less expensive than potential damage to cremation chamber if not removed.
What happens to the removed pacemaker?
Disposed of as medical waste through specific protocols. Some pacemakers are donated to specific veterinary programs or third-world medical programs (specific organizations facilitate). Lithium batteries specifically handled per environmental regulations.
Do I need to remove pacemaker for burial?
Generally no — pacemakers don't pose risk in burial setting. Some cemeteries may have specific preferences or requirements (rare). Lithium battery degrades naturally over years in soil. No standard removal requirement for burial.
How does funeral home find out about devices?
Family informs funeral director (specifically asked). Hospital records (if death was hospitalized). Visual examination during body preparation may reveal surgical scars indicating implant. Sometimes pacemaker ID card or wallet documentation. Specific medical history review.