Purpose

To define the cases that come under medico-legal and to lay down the procedure on how to respond and report if a medico-legal case avail treatment from

Policy 

• The following cases are considered as medico-legal and the medical officer is “duty-bound” to intimate to the police regarding such cases:
  • All cases of road traffic accident
  • All cases of rail accidents
  • All cases where a patient is involved in any instances of explosion
  • All cases of factory accident/ unnatural accident
  • All cases of burns the circumstances of which suggest the commission of /an offence by somebody or involvement of explosives of any kind
  • All cases of assault
  • All cases of suicide including the attempted ones
  • 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 brought dead with improper history creating suspicion of an offence
  • Cases of suspected self-infliction of injuries or attempted suicide
  • Snake bites/ Dog bites
  • Any other case not falling under the above categories but has legal implications
  • All cases of Trauma.
  • All cases of Burns & Scalds.
  • All cases of injuries due to Electricity, Lightning.
  • All cases of Poisoning including Alcohol Intoxication & Food Poisoning.
  • All cases of Unconsciousness where the cause of coma could not be ascertained
  • All cases relating to Starvation including a Hunger strike
  • Cases requiring age estimation.
  • All cases of (victims/accused) of sexual offences including unnatural sexual offences.
  • All suspected cases of criminal abortions
  • All cases of Industrial hazards

Handling Medico-Legal cases

• If the patient refuses the consent or withdraws the consent already given or even leaves the hospital, the doctor has no right to force anything on the patient. In such cases carefully document all findings, note that the consent is not given to register as MLC
• In case the patient is referred from another hospital which has already registered a medico-legal case still this will be registered as MLC case here. But if the police intimation is given from the referring hospital, further police intimation may not be required. The name of the referral hospital shall be clearly mentioned in the case records. The referral letter shall be attached with the case records
• The patient’s request or accompanying person’s request not to register as MLC shall not be accepted by the doctor if he thinks that it is an MLC and same shall be done without fail and delay
• Any case of injury, sexual assault, disease, infirmity or death in which law enforcing agencies have to enquire and fix the responsibility of a person or a group of persons responsible as per the existing law of the land
• A doctor cannot refuse to examine medico-legal cases on the basis of being a private practitioner or citing a jurisdiction problem
• Never delay in examining a medico-legal case, irrespective of day or night time
• If the case brought is a referred case and already registered as a medico-legal case, a fresh report is not necessary
• Always obtain informed consent prior to giving the treatment whenever possible
• Note at least two identification marks, which are individualistic, preferably from the exposed parts of the body.
• A case that is admitted and on treatment, later when found out to be MLC, is made MLC by entering in the MLC register. The certificate here will have to be made by the doctor who sees and labels the case as MLC, by referring to the case sheet and consulting the treating doctor
• Detailed history including the exact cause, time and circumstances of the incident should be taken
• Write down the history given by the patient in his own words. If the translation is not possible to write down it in the vernacular language of the patient
• Emergency Department has to maintain a medico-legal case register in the prescribed format
• Every medico-legal case examined in that institution must be entered simultaneously in this register along with the case papers. Many a time this register is called for while deposing in the court
• Do not forget to sign the register and the case paper at the end of the examination
• Make it a practice to write down your name and registration number below the signature
• If the patient has brought a police requisition along with him, mention so in the papers
• Write the case papers legibly
• Enter the time and date of the examination
• Do not strike out anything on the paper. If such a situation arises make sure that the struck out entry can also be read along with the corrected entry. Make a short signature (an initial) near every corrected entry.
• An unconscious patient is brought for examination; enter the name and address of the person bringing him in.
• Write all the entries including the medical terms in full form
• Remember you are writing a document that may be used as a piece of evidence
• Leave no scope for ambiguity anywhere
• Make it a practice to obtain the signature of the recipient in the register when any medico-legal record is handed over for any purpose
• Medico-legal correspondence must follow the principle of the maintenance of the ‘chain of custody’. That means the travel of a particular medico-legal document or an article must be properly recorded at every step. The confidential documents must be properly sealed and labelled before forwarding them
• In case of discharge or death of an MLC in the hospital, inform the police of respective jurisdiction immediately
• If an MLC is taking discharge against medical advice, inform police prior to discharging. Make it a practice to obtain the signature of the recipient in the register when any medico-legal record is handed over for any purpose.