Important Guidelines For Doctors To Handle Medico Legal Cases

medical legal cases

MEDICOLEGAL COMPLAINTS   (MLC)

GUIDELINES TO DOCTORS

Medico-legal cases (MLC) are an integral part of medical practice that is frequently encountered by Medical Officers (MO)/Doctors.

All medical officers working in hospitals/field medical units / non-medical units encounter medico-legal issues. Since law and order is a state subject, there are differences in the legal

procedures being followed by different states. Medical Officers should acquaint themselves with medico-legal procedures that are in vogue in the state in which they are serving.

MLCs in Medical Practice

MLC. An MLC is defined as any case of injury or ailment where the attending

doctor after history taking and clinical examination considers that investigation by law enforcement agencies and also superior military authorities are warranted to

ascertain circumstances and fix responsibility regarding the said injury or ailment according to the law”.

MLCs in Medical Practice

—Section  39 of Cr.PC

—Public to give information about certain offenses

—In case of Medical case Doctor as public

—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

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.

Examples of 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 and battery, 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

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.

The consent for treatment is implied in all emergencies

(b) Emergency medical care will be administered in all cases brought to irrespective of their entitlement.

(b) Emergency medical care will be administered in all cases brought to irrespective of their entitlement.

(d) 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.

(j) The police should be informed. Under Section 39 of Criminal Procedure. Code, 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.

(k) In case of discharge/ transfer/death of such a case in the hospital, the police should be informed.

(l) Medico-legal documents should be considered as confidential records and should be stored in safe custody to avoid tampering. Medical records must be thorough, complete and should document each and every significant event in the course of care of the patient. 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.

(m) Prompt attention, correct triage and safe transfer of a patient from one facility to another as required should be carried out in all cases and not delayed because of the medico-legal nature of the case.

(n) Opinion on the severity of injuries should be given after the X-ray reports are received in cases of injury to bones/joints.

(o) Samples and specimens collected for medico-legal purposes will be properly sealed, labeled and handed over to the investigating officer detailed by the police.

Precautions to be taken in MLCs

(a) The complete available particulars of the patient should be noted down along with two identification marks. Particulars of the person accompanying the patient will also be noted down.

(b) One should not rely on memory while writing reports or during the recording of evidence in a court of law

(b) One should not rely on memory while writing reports or during the recording of evidence in a court of law

(d) 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.

(e) In MLCs, the body will not be handed over to the relatives. The police will be informed and the body handed over to them. The police will, after the medico-legal formalities, handover the body to the relatives

Guidelines for Preservation of Medicolegal Evidence

(a) 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

Guidelines for preservation of Medicolegal documents

(a) Original copies of all medico-legal documents will be produced whenever asked for in a court of law

(b) 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

(c) 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

(d) Documents pertaining to admitted fatal MLCs are to be processed and preserved as laid down in concerned policy letters.

  


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