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edico
legal
knowledge is an essence for a medical
professional, irrespective of their
specialty. Law is common to all.
Knowledge about Medico legal issues is not optional for a treating
Doctor but a mandatory social responsibility. Proper knowledge of
the roles and responsibilities of a
health care provider is of immense importance while handling these cases to facilitate social and legal justice.
A health care provider along
with the medical records called to
the court as an expert witness is of
pivotal importance for the proceedings of the trial and any incompetence by the health care
provider can result in grave consequences for both the Institution
and self.
The health care provider must
therefore exercise vigilance and
proper documentation while
treating a Medico Legal Case. It is
advisable to follow the legal aspects to avoid embarrassment in
the court of law due to the lack of
knowledge or awareness regarding MLCs and their practices.
Hence, this effort is done to
compile a set of basic guidelines
to be practiced in a hospital when
dealing with MLCs. The following is a non-exhaustive list of
Role of Doctor in
Casualty
Remain calm, do not panic,
and treat as a regular case.
Lives saving measures arealways FIRST in priority.
MLC workup is done
SOON after it.
Casualty services are 24x7
CMOs are supposed to register MLC by entering the following in the MLC register.
o Preliminary data:
Name Full name
should be taken with initials,
Age
Sex
Address local and
permanent.
o Identification marks:
Two reliable identification marks have to be
noted preferably from the
peripheral parts of the
body,
If not found then it
could be from private parts
Mole/scar/birth
mark/ deformity/ any other
peculiar mark can be considered.
International Journal of Health Information and Medical Research Vol: 1, Issue: 1, Jan 2014
Case of Assault
All cases of assault have to
be registered as MLC and MUST
be informed to the police without
fail.
Injuries have to noted
down from
o Head to toe or major to
minor
o They have to be numbered
o Description of the injury
size, site, shape, position
from bony landmark should
be noted, preferably take the
measurement using measuring tape.
o Aging of the injury has
to be mentioned.
Fresh / dark brown/
brown/ black/scar.
o Type of weapon inflicted can be assessed and correlated with the type of injury
Injury certificate has to be
issuedonly with the patients or
police request.
International Journal of Health Information and Medical Research Vol: 1, Issue: 1, Jan 2014
Case of Poisoning
All cases should be registered as MLC
Case of Snake
Bite/Scorpion Sting.
Case has to be registered as
MLC
Life saving treatment first
Try to locate the fang/sting
marks
o Number, size, position
from a bony landmark
o Skin color surrounding
the bite mark any signs of reactions to be noted.
Clinical signs suggestive of
type of snake bite should be
noted.
Case of Electrocution/Lightning
Life saving procedures are
first
Case should be registered
as MLC
History
o Time of incident
o Position of the victim at
the time electrocution/ lightning.
o Place of occurrence
domestic / working should be
mentioned.
Examination
International Journal of Health Information and Medical Research Vol: 1, Issue: 1, Jan 2014
Case of Attempted
Hanging
Life saving procedures are
first
Case has to be registered as
MLC
History and other preliminary data should be noted.
Describe the injury
Ligature mark
o Position of the ligature
mark
o Dimension length /
Width / position from bony
land mark
o Skin color
o Is ligature material dimension comparable with the
marks found on the body
should be correlated.
Case of Alleged
criminal abortion
Doctor must be aware of
MTP act 1971 protocols and the
case should be treated as a Medico-Legal Case.
All the records must be preserved.
MLC registration & police
intimation should be made.
Case of Brought
Dead
If PROPER HISTORY available
o If the patient was suffering from any chronic ailment
has been treated in our hospi-
Dying Declaration
In case the patient wishes
to make a dying declaration, the
magistrate needs to be intimated.
If magistrate is unavailable,
CMO can record by himself in the
presence of two independent witnesses whose signature are also
affixed in the document.
Police Intimation
Police has to be intimated
as soon as the MLC registration is
done.
Police intimation has to be
made in writing and countersignature should be taken from the
concerned police authority.
If the Doctor feels the need
to be kept it confidential as in certain cases, need not be informed
to the police.
Eg - A case of suicidal consumption of drug (drug over
Do Remember
There is no role of patient in
deciding whether a case is Medico-legal or not, even if the patient
refuses to get treated.
Practice of making MLC
OR NOT based on patients wish
is not entertained in the court of
law. Taking signature for the
same is again not explained in any
of the Indian laws.
Documentation in
MLC
All cases come under MLC
OPD / IPD has to be mentioned
on the case sheet. The Medico-legal registration number and the
date of registration should be entered.
MLC seal has to be entered
in all the papers of the case sheet
including lab investigations/ radiological investigations/ consent
forms/ OT & other papers/ billing
or activity charts. The seal should
not be placed over any of the values/ findings. (Ideal to place over
the corner of the page)
All the reports along with
case papers are hospitals property.
International Journal of Health Information and Medical Research Vol: 1, Issue: 1, Jan 2014
Housekeeping staff
Do not discard any of the
samples collected in the hospital
without the knowledge of the
Doctor especially in MLC cases.
Purposeful disposal or destruction of the sample or evidence is a punishable offence.
Security
Acknowledgement
We sincerely thank Dr Varghese P S, Dr Manju Prakash for
valuable guidance and Dr Satish
Babu, Dr Govindraju, Dr Brijesh
for support and encouragement.
~~*~~
International Journal of Health Information and Medical Research Vol: 1, Issue: 1, Jan 2014