Medicolegal case

introduction to MLC
Laws related to MLC
General guidelines
Evidence
Legal Requirements of MLC
Preservation of MLC documents
Precautions
Examples of MLC

1. Medical Legal Case Law GRINTY BABU TTGI170306

2. INTRODUCTION “ Medicolegal ” is the term, which incorporates the basics of two sister professions i.e. Medicine and Law, as when medical testing or examination is undertaken for a legal purpose . Medical Jurisprudence , a branch of medicine (Forensic Medicine), it deals with medical aspects of law and medico-legal case management.

3. Medico Legal Cases Any case of injury or ailment where, the attending doctor after taking history and clinical examination, considers that investigations by law enforcement agencies are warranted to ascertain circumstances and fix responsibility regarding the said injury or ailment according to the laws. A doctor has ethical and legal obligations, and he needs to abide by the laws of the land while discharging his duties. In medical practice, most of the doctors would come across which at the time or subsequently, would be called a “ Medico-Legal Case ” ( MLC ).

4. Difference btw MLC & Non-MLC Information to police must be sent. A report must be made in duplicate, one copy of which is handed over to the police, and his signatures taken on doctor’s copy. The other copy is retained by the doctor, which he may have to produce before the court. This copy is retained in a register called a “ Medico legal Register.” This register is a confidential record and should be in the safe custody of the doctor only. No such information to police. A report made as a single copy only.

5. Difference btw MLC & Non - MLC Both copies of the report must be marked “ Medico legal Case” in bold. In X-ray requisition slips and other lab report slips, similar markings should be made . The report, X-rays etc., not to be handed over to the patient. They are handed over to the police. Detailed personal entries must be made. No such mark made. The report, X-rays etc., handed over to the patient. Not required.

6. Medico legal case Example: Stab wounds, lacerated wounds, fractures, bruises, abrasions, etc . Non-Medico legal case Example: Asthmatic attack, Myocardial Infarction, status epilepticus etc.

7. Examples for MLCs The following are some of the examples of MLCs and Medical officers should use their professional judgment to decide any other cases not enumerated in the list: ( a) Assault, including domestic violence and child abuse ( b) Accidents like Road Traffic Accidents (RTA),  industrial accidents etc. ( c) Cases of trauma with suspicion of foul play ( d) Sexual Offences ( e) Death in the operation theatre ( f) Unnatural deaths ( g) Drug overdose ( h) Drug abuse

8. Laws related to MLCs Section 44 of IPC:  Definition of Injury Any harm whatever illegally caused to any person in body, mind, reputation or property . Section 319 IPC:  Hurt means bodily pain, disease or infirmity caused to any person . Section 321 IPC:  Defines “ Voluntarily Causing Hurt ”   Section 322 IPC: Defines “ Voluntarily Causing Grievous Hurt ” Section 323 IPC:  Describes Punishment for Voluntarily Causing Hurt. Shall be imprisonment which may extend for one year with or without fine which may be Rs . 1000 /-.

9. Section 324 IPC:  Describes Punishment for Voluntarily Causing Hurt by dangerous weapon shall be imprisonment for up to 3 years with or without fine . Section 325 IPC:  Describes Punishment for Voluntarily Causing Grievous Hurt. Shall be imprisonment which may extend for 7 years with or without fine . Section 299 IPC:  Defines “Culpable Homicide ” Whoever causing death by doing an act with the intention of causing death, or with the intention of causing such bodily injury that likely to cause death or with the knowledge that he is likely by such act to cause death, commits the offense of culpable homicide . Section 300 IPC:   Culpable Homicide is Murder

10. MLCs in medical practice Section  39 of Cr.PC: - Public(doc) to give information about certain offenses. Section 176 of IPC: - Omission to give notice or information to Public Servant by person Legally bound to give it Section 201  of IPC: - Causing disappearance of evidence of offense, or giving false information to screen offender Section 202 of IPC: - Intentional omission to give information of offense by person bound to inform

11. Labeling a case as MLC a) RMO / Casualty medical officer / MO in charge of MI Room / Duty Medical Officer (DMO) / MO In charge ward who is attending to the case, may label a case as an MLC . (b) The decision to label a case as MLC should be based on sound professional judgment, after a detailed history taking and thorough clinical Examination.

12. General Guidelines for dealing with Medico legal cases:- (a) In emergencies, resuscitation and stabilization of the patient will be carried out first and medico-legal formalities may be completed subsequently . (b) The consent for treatment is implied in all emergencies. (c) All Clinic and hospitals will maintain an MLC register and the MLC will be initiated and documented in the register. Personal particulars, identification marks, fingerprints of the individual will be noted. Particulars of the person accompanying the patient will also be noted.

13. (d) The police should be informed under Sec. 39 of Cr. PC, the attending Doctor legally bound to inform the police about the arrival of an MLC. Any failure to report the occurrence of an MLC may invite prosecution under Sections 176 and/or 202 of I.P.C. (e) In case of discharge/ transfer/death of such a case in the hospital, the police should be informed. (f) MLC documents should be considered as confidential records and should be stored in safe custody to avoid tampering. All the documents including case sheets, X-rays, and investigation reports will be preserved meticulously in the medical record section indefinitely and handed over to the concerned authorities (Police Investigating Officer / Court / Court of Inquiry) as and when required.

14. (g) Opinion on the severity of injuries should be given after the X-ray reports are received in cases of injury to bones/joints . (h) Samples and specimens collected for medico-legal purposes will be properly sealed, labeled and handed over to the investigating officer detailed by the police.

15. Precautions to be taken in MLCs (a) The complete available particulars of the patient should be noted down along with two identification marks. ( b ) One should not rely on memory while writing reports or during the recording of evidence in a court of law ( c ) No cause of death will be mentioned in the death certificate. The statement that “Exact cause is to be ascertained by post-mortem examination” is to be endorsed . (d) In MLCs, the police will, after the medico-legal formalities, handover the body to the relatives.

16. Preservation of Medico legal Evidence Medico-legal evidence should be preserved and subsequently sent or handed over to the investigating authorities for forensic examination and production as evidence in a court of law. All evidence will be identified, sealed and labeled properly. They will be kept in safe custody and handed over to the investigating officer of the case. Once collected, loss/destruction of evidence is a punishable offense. Failure to collect, destruction or loss of such an exhibit is punishable under Sec 201 of I.P.C.

17. P reservation of Medico legal documents Original copies of all medico-legal documents will be produced whenever asked for in a court of law. All original copies of certificates and reports issued for medico-legal purposes are  to be preserved till the finalization of case in the court of law. Doctor , Hospital will ensure that the documents are kept in the custody of an appropriate officer till the case is finally decided or cleared by the police and judicial authorities. In the case of units other than hospitals, the safe custody will be under unit arrangements. Documents pertaining to admitted fatal MLCs are to be processed and preserved as laid down in concerned policy letters.   

18. There is no such reason as a midlife crisis. That’s an excuse for saying, “I’m not responsible for my actions.”

19. Thank you