Clinical Negligence & Medico- Legal Law

Medico Legal Cases Laws

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.

Medicolegal is something that involves both medical and legal aspects, mainly:. Any case of Injury or ailment where some criminality is involved is called a Medico-Legal Case (MLC)”

WHAT IS 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.
• 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.

DOCTOR’S DUTY

• Every doctor under law bound by a contract to serve its patient and can not refuse treatment.
• Every doctor has to fulfill certain legal requirements in service by compulsion or voluntarily as defined under law.
• Medico legal case (MLC) examination and reporting is one of the legal responsibility of all doctors working in a hospital.

In the judgment of case Parmananda Katara Vs Union of India, the apex court said:

“ Every doctor is bound to provide medical aid to the victims irrespective of the cause of injury; he cannot take any excuse of allowing law to take its course”.

LIST OF MEDICO-LEGAL CASE

• 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.

Advisory to Doctors and Safeguards in Criminal Prosecution by Supreme Court
Supreme Court noted broadly the precautions which ought to be taken, and the same are reproduced herein below:

“Precautions which doctors/hospitals/nursing homes should take:

Current practices, infrastructure, paramedical and other staff, hygiene, and sterility should be observed strictly. Thus, in Sarwat Ali Khan v. Prof. R. Gogi (OP No. 181 of 1997 decided on July 18, 2007 [NC]) the facts were that out of 52 cataract operations performed between September 26, 1995, and September 28, 1995, in an eye hospital, 14 persons lost their vision in the operated eye. An enquiry revealed that in the operation theater, two autoclaves were not working properly. This equipment is absolutely necessary to carry out sterilization of instruments, cotton, pads, linen, etc., and the damage occurred because of its absence in working condition. The doctors were held liable

No prescription should ordinarily be given without actual examination. The tendency to give prescription over the telephone, except in an acute emergency, should be avoided

A doctor should not merely go by the version of the patient regarding his symptoms but should also make his own analysis including tests and investigations where necessary

A doctor should not experiment unless necessary and even then he should ordinarily get a written consent from the patient

An expert should be consulted in case of any doubt. Thus, in Indrani Bhattacharjee (OP No. 233 of 1996 decided on 9-8-2007 [NC]), the patient was diagnosed as having ‘mild lateral wall ischemia.’ The doctor prescribed medicine for gastroenteritis but he expired. It was held that the doctor was negligent as he should have advised consulting a cardiologist in writing

Full record of the diagnosis, treatment, etc., should be maintained.”

The above are in the nature of broad advisory.

Keeping in the view the rise in criminal prosecution of doctors, which is both embarrassing and harassing for them, and to protect them from frivolous and unjust prosecutions Supreme Court laid certain binding guidelines till statutory rules or instructions by the government in consultation with MCI are issued, which are as follows:34

Private complaint may not be entertained unless the complainant has produced prima facie evidence in the court in the form of a credible opinion given by another competent doctor

Investigation officer should obtain an independent and competent medical opinion preferably from a doctor in government service qualified in that branch of medical practice who can normally be expected to give an impartial and unbiased opinion applying Bolam test to the facts collected in the investigation

Doctor may not be arrested in a routine manner unless the arrest is necessary for furthering the investigation or for collecting the evidence or if the investigation officer is satisfied that doctor may flee.

The necessity for obtaining independent medical opinion was insisted upon considering that the knowledge of medical science to determine whether the acts of medical professional amounts to negligent act within the domain of criminal law could not be presumed. This requirement was subsequently sought to be made a necessity by the Supreme Court even for initiating the action seeking imposition of civil penalties but was done away with thereafter for civil actions.

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