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Fingertip pulse oximetry prevented premature declaration of death. OBJECTIVE: We describe a case of persisting readings from a fingertip pulse oximeter (FPO) in an elderly cachectic woman with pancreatic cancer, who fulfilled all classical criteria of death. METHODS: It is an instructive example of a home hospice patient who died during the physician's intervention. Although all classical signs of death had been confirmed several times, a portable FPO continued to indicate satisfactory saturation and pulse readings for the following 30 min. RESULTS: Our case report confirms that the classical criteria of death might sometimes be faulty. The application of a portable FPO prevented a premature declaration of death. CONCLUSION: In exceptional cases, even the most careful physical examination may erroneously indicate that a person is dead. A residual cardiac output and gas exchange may be preserved and revealed by FPO readings. In doubtful situations, FPO can provide additional information and prevent a premature declaration of death.