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.

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· 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

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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.

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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.

Law points

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. This
year saw the formation of the ‘right to life’ act, which was formed after the monumental
ruling in Parmanand Katara v. Union of India (Supreme Court, 1989). The case was filed
by the family of a scooterist who was severely injured in a road accident. He was refused
admission when taken to the nearest hospital, because the hospital claimed that it was not
equipped well enough to handle a medico legal cases. The scooterist succumbed to his
injuries before he could be taken to the nearest hospital that was authorized to handle
medico-legal cases, which was situated 20 kilometers away. Here is a look at what has
changed over the years, and what to expect to when you register a medico legal case.

What does the law say?

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 It cannot deny treatment on the pretext of lack of facilities. They have to provide
emergency care and then transfer the patient safely (via their ambulance) to the nearest
facility. This includes government and private hospitals; it also includes private clinics
and nursing homes.
 They cannot deny a patient emergent treatment on the basis that he/she is unable to pay
the required fees or that there is no close relative to sign for consent (consent is
overridden in an emergency)
 In the case of a rape or criminal abortion the lady cannot be examined by a doctor
without written consent from the victim.
 In both cases the doctor is bound by law to keep the patients information including her
name confidential.
 In cases where a woman is being examined another woman must be present during the
examination. In the case of males a male has to be present at all times.
 In the case of suicide causing death the doctor is obligated to report the matter to the
police for further investigation.
 If the patient is alive and suicide is suspected the doctor is not obligated to report the
matter to the police.
Read: Treating accident victims could become compulsory for hospitals
Procedure for filing a medico legal case:
On visiting a hospital for a medico legal case, once you or your loved one has received
treatment, your doctor or hospital will inform the police about your case, an
acknowledgement of receipt is taken for future reference. If the intimation is given orally
or via the phone, a docket number is provided which can be used as proof of intimation and
is documented in the patient’s records.
Once the patient is stabilised you will be directed to the medico legal desk. Here you will
be asked to fill out a form and sign it . Your signature is required to authenticate the
information you have provided. At this point your case sheet will be kept in the hospital
and you will be visited by the police. They will take down your statement, and confirm if
you want to file a case. The treating physician will fill out the medical details in the form.
Your doctor is responsible to give accurate information to the police which will assist them

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in their investigation. After your case is filed you will get a receipt stating your file number
and case number. If required you will need to employ a lawyer to take the case forward.
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