Using Death Certificate while in the area that generates from using it consumes the item without doing anything.
Using this item multiple times in the same floor will always teleport to the same areas, without respawning the items that were taken or destroyed.
Since taking an item only destroys the other ones in the current room, you still have a lot of items available.
You can be softlocked by using Death Certificate while having already taken/destroyed all items that were in the area.
Using this item during the fight against The Beast resets the fight after Isaac leaves the special area.
If you are teleported to a Devil Room or an Angel Room, you will be teleported to the room you used Death Certificate in after taking a deal.
Red Key: Using the Red Key in this area has a chance of spawning special rooms from Home. If Mom's bedroom is spawned and Isaac sleeps in the bed, the cutscene usually preceding the Dogma fight will play, but nothing will change.
Metronome: Can invoke the effect of Death Certificate as normal, even if it is not unlocked.
Sacred Orb: The area will contain significantly fewer rooms and items to choose from, as Sacred Orb prevents items with low quality from appearing.
Diplopia: Has no use inside of the Home area, as Isaac can only take 1 item. However, it can be used to duplicate the Death Certificate item, allowing Isaac to enter the area twice.
Schoolbag: Allows Isaac to hold another Activated item into the area along with Death Certificate.
Void/Abyss/Black Rune: Allows the consumption of items without forcing Isaac to leave the area.
Moving Box: Allows an additional 10 items to be taken without forcing Isaac to leave the area.
? Card: Mimics the effect of Death Certificate without consuming it.
Wild Card: Will use Death Certificate if it was the item/card Isaac most recently used.
The Forgotten + Birthright: If timed correctly, switching from The Soul to The Forgotten can cancel the teleport out of the area, allowing for multiple items to be picked up. This can be done even if Birthright is not acquired before Death Certificate, as there is enough time to exit the room with The Soul and switch to The Forgotten after picking up Birthright.
Using a Hermit Card while in this area crashes the game.
Attempting to access this area again using Ventricle Razor crashes the game.
PC 9HPQ QQ4D (First Floor Secret Room, up and left to spawn)