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. Or a legal case requiring medical expertise when brought by the police for examination.
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 Criminal Procedure Code of India. The idea is to initiate the legal proceeding at the earliest is 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.
The following cases should be considered as medico-legal and as such the medical officer is “duty-bound” to intimate to the police regarding such cases:
· All cases of injuries and burns -the circumstances of which suggest commission of an offense by somebody. (irrespective of suspicion of foul play)
· All vehicular, factory or other unnatural accident cases specially 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 creating 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.
In a country where 130,000 deaths occur annually due to road traffic accidents and 53% women suffer from domestic violence leading to grave injuries, it is important that hospitals and the law work hand in hand to help the injured. Our legal system has grown in leaps and bounds from 1989 when people would lose their lives waiting for treatment and the ‘right to life’ act was formed in the same year. 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.
It was not long back a youth, severely injured after being hit by a speeding KSRTC bus at Koppal, Karnataka died in hospital simply because he didn’t get timely help from the public. Even though the hospital was just a stone’s throw from the accident spot, but people watched Anwar writhing in pain and some even used their cell phones to shoot pictures and videos. None of them tried to shift him to a hospital. Common people still have the fear that they will be tied in these cases due to unawareness in MLC. Instead of merely berating such callous and inhuman attitude among the public, there is an urgent need to create awareness that almost 50% of the accident victims have excellent chances of survival if they get immediate attention and treatment. Anyone near the accident site can call helpline 108 or 104 for ambulance, and the victim will be taken to the nearest hospital for emergency treatment free of cost. Hospitals are required to make admission irrespective of whether it is a medico-legal case and the government will reimburse the cost of treatment up to Rs 25,000.
Lately, Indian society is experiencing a growing awareness regarding patient’s rights. This trend is clearly discernible from the recent spurt in litigation concerning medical professional or establishment liability, claiming redressal for the suffering caused due to medical negligence, vitiated consent, and breach of confidentiality arising out of the doctor-patient relationship. In order to prove that medical malpractice occurred, the patient must be able to show all of these things:
· A doctor-patient relationship existed.
· The doctor was negligent.
· The doctor’s negligence caused the injury.
· The injury led to specific damages.
· Failure to diagnose.
· Improper treatment.
· Failure to warn a patient of known risks.
The complaint against medical negligence can be filed as mentioned below.
· In The District Forum if the value of services and compensation claimed is less than 20 lakh rupees,
· Before the State Commission, if the value of the goods or services and the compensation claimed does not exceed more than 1 crore rupees.
· In the National Commission, if the value of the goods or services and the compensation exceeds more than 1 crore rupees.
Medico-legal cases have to be dealt with properly, following the institution’s prevailing guidelines. Usually, all the big hospitals and the teaching institutions have an ‘institutional medico-legal manual’ which gives, in a step-wise detail, the correct procedure for dealing with the various kinds of MLCs. Even if such manuals are not available, these cases pose no problem if one uses proper caution and due care and attention, while dealing with them. Proper documentation, timely information, a methodical and thorough examination including all relevant investigations and referrals, etc, are all that are necessary to see such cases completed successfully.
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