Introduction To Medicolegal Case

WHAT IS A MEDICO-LEGAL CASE?

A Medico-Legal Case can be defined as a case of injury or ailment, etc., in which investigations by the law-enforcing agencies are essential to fix the responsibility regarding the causation of the injury or ailment. In simple language, it is a medical case with legal implications for the attending doctor where the attending doctor, after eliciting history and examining the patient, thinks that some investigation by law enforcement agencies is essential. It may be a legal case requiring medical expertise when brought by the police for examination

EXAMPLE OF A MEDICOLEGAL CASE: Parmanand Katara v. Union of India (Supreme Court, 1989).

The case was filed by the family of a scooterist who was severely injured in a road accident. He was refused admission when taken to the nearest hospital because the hospital claimed that it was not equipped well enough to handle medico-legal cases. The scooterist succumbed to his injuries before he could be taken to the nearest hospital that was authorized to handle medico-legal cases, which was situated 20 kilometers away. Here is a look at what has changed over the years, and what to expect when you register a medico-legal case.

HEALTHCARE PROVIDER’S DUTY

The law states that concerns like legal formalities, monetary considerations or even the infrastructural restraints of the institution should not prohibit the institution or hospital from providing basic and emergency medical treatment. Here are a few things you should know :

  1. A hospital cannot deny emergency medical care to an accident victim under Article 21.
  2. It cannot deny treatment on the pretext of lack of facilities. They have to provide emergency care and then transfer the patient safely (via their ambulance) to the nearest facility. This includes government and private hospitals; it also includes private clinics and nursing homes.
  3. They cannot deny a patient emergent treatment on the basis that he/she is unable to pay the required fees or that there is no close relative to sign for consent (consent is overridden in an emergency)
  4. In the case of a rape or criminal abortion the lady cannot be examined by a doctor without written consent from the victim.
  5. In both cases the doctor is bound by law to keep the patients information including her name confidential.
  6. In cases where a woman is being examined another woman must be present during the examination. In the case of males a male has to be present at all times.
  7. In the case of suicide causing death the doctor is obligated to report the matter to the police for further investigation.
  8. If the patient is alive and suicide is suspected the doctor is not obligated to report the matter to the police.

LIST OF MEDICO-LEGAL CASE

  • All cases of injuries and burns -the circumstances of which suggest the commission of an offense by somebody. (irrespective of suspicion of foul play)
  • All vehicular, factory, or other unnatural accident cases especially when there is a likelihood of patient’s death or grievous hurt.
  • Cases of suspected or evident sexual assault.
  • Cases of suspected or evident criminal abortion.
  • Cases of unconsciousness where its cause is not natural or not clear.
  • All cases of suspected or evident poisoning or intoxication.
  • Cases referred from a court or otherwise for age estimation.
  • Cases brought dead with improper history create suspicion of an offense.
  • Cases of suspected self-infliction of injuries or attempted suicide.
  • Any other case not falling under the above categories but has legal implications.

PROCEDURE FOR REGISTERING A MEDICO-LEGAL CASE

  • TREATMENT (All legal formalities to be suspended till the patient is resuscitated)
  • IDENTIFICATION (Whether the said case falls under Medico-Legal Case or not)
  • INTIMATION TO POLICE (if it does fall in this category, then he must register the case as an MLC and/ or intimate the same to the nearest police station, either by telephone or in writing.)
  • ACKNOWLEDGEMENT RECEIPT (From the police should be received for future reference.)

REPORTING OF MEDICO-LEGAL CASE

  • Reports must be prepared in duplicate on proper Pro-forma giving all necessary details
  • Avoid abbreviations, and overwriting. Correction if any, should be initialed with date and time.
  • Reports must be submitted to the authorities promptly.
  • Medico-legal documents should be stored under safe custody for 10 years
  • Age, sex, father’s name, complete address, date and time of reporting, time of the incident, brought by whom.
  • Identification marks and finger impressions
  • All MLC to be informed to the police for taking legal evidence
  • If the patient is dying, inform the magistrate to record ‘dying declaration’.

CONCLUSION

  • In any of the medico-legal cases, it is the legal duty of the treating doctor to report it to the nearest police station immediately after completing primary lifesaving medical care.
  • This is in accordance with Section 39 of the Criminal Procedure Code of India.
  • The idea is to initiate the legal proceeding as the earliest as so that maximum evidence can be collected by the police officer.
  • Quick action by the police also helps to avoid the destruction of evidence by the treating physician.
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