An analysis of South African mortality data for 2014 reveals that unusable codes are used for up to 44% of all deaths. Almost half of these are insufficiently specified causes of death, such as cancer with no primary site specified. Symptoms and signs – like headache, cough and so on - which provide no clues on the underlying cause of death, account for 12.3% of all deaths.   Invalid causes of death such as glaucoma or warts account for 1%.  And intermediate and immediate causes of death – such as heart failure or renal failure - account for 11% of total deaths. Since many conditions can cause heart failure or renal failure it is important that the underlying cause of death for these are stated on the death certificate.