introduction to MLC Laws related to MLC General guidelines Evidence Legal Requirements of MLC Preservation of MLC documents Precautions Examples of MLC

1. Medical Legal Case
Law
GRINTY BABU
TTGI170306

2. INTRODUCTION
◈ “Medicolegal” is the term, which incorporates the basics of
two sister professions i.e. Medicine and Law, as when
medical testing or examination is undertaken for a legal
purpose.
◈ Medical Jurisprudence, a branch of medicine (Forensic
Medicine), it deals with medical aspects of law and medico-
legal case management.

3. Medico Legal Cases
◈ Any case of injury or ailment where, the attending doctor
after taking history and clinical examination, considers that
investigations by law enforcement agencies are warranted to
ascertain circumstances and fix responsibility regarding the
said injury or ailment according to the laws.
◈ A doctor has ethical and legal obligations, and he needs to
abide by the laws of the land while discharging his duties. In
medical practice, most of the doctors would come across
which at the time or subsequently, would be called a
“Medico-Legal Case” (MLC).

4. Difference btw MLC & Non-MLC
◈ Information to police must be
sent.
◈ A report must be made in
duplicate, one copy of which
is handed over to the police,
and his signatures taken on
doctor’s copy. The other copy
is retained by the doctor,
which he may have to produce
before the court. This copy is
retained in a register called a
“Medico legal Register.” This
register is a confidential
record and should be in the
safe custody of the doctor
only.
◈ No such information to
police.
◈ A report made as a single
copy only.

5. Difference btw MLC & Non - MLC
◈ Both copies of the report must
be marked “Medico legal
Case” in bold. In X-ray
requisition slips and other lab
report slips, similar markings
should be made.
◈ The report, X-rays etc., not to
be handed over to the patient.
They are handed over to the
police.
◈ Detailed personal entries must
be made.
◈ No such mark made.
◈ The report, X-rays etc.,
handed over to the patient.
◈ Not required.

6. “
Medico legal case
Example: Stab wounds, lacerated
wounds, fractures, bruises, abrasions,
etc.
Non-Medico legal case
Example: Asthmatic attack,
Myocardial Infarction, status
epilepticus etc.

7. Examples for MLCs
◈ The following are some of the examples of MLCs
and Medical officers should use their professional judgment
to decide any other cases not enumerated in the list:
(a) Assault, including domestic violence and child abuse
(b) Accidents like Road Traffic Accidents
(RTA), industrial accidents etc.
(c) Cases of trauma with suspicion of foul play
(d) Sexual Offences
(e) Death in the operation theatre
(f) Unnatural deaths
(g) Drug overdose
(h) Drug abuse

8. Laws related to MLCs
◈ Section 44 of IPC: Definition of Injury Any harm whatever
illegally caused to any person in body, mind, reputation or property.
◈ Section 319 IPC: Hurt means bodily pain, disease or infirmity
caused to any person.
◈ Section 321 IPC: Defines “Voluntarily Causing Hurt”
◈ Section 322 IPC: Defines “Voluntarily Causing Grievous Hurt”
◈ Section 323 IPC: Describes Punishment for Voluntarily Causing
Hurt. Shall be imprisonment which may extend for one year with or
without fine which may be Rs. 1000/-.

9. ◈ Section 324 IPC: Describes Punishment for Voluntarily Causing
Hurt by dangerous weapon shall be imprisonment for up to 3 years
with or without fine.
◈ Section 325 IPC: Describes Punishment for Voluntarily Causing
Grievous Hurt. Shall be imprisonment which may extend for 7 years
with or without fine.
◈ Section 299 IPC: Defines “Culpable Homicide”
Whoever causing death by doing an act with the intention of causing
death, or with the intention of causing such bodily injury that likely to
cause death or with the knowledge that he is likely by such act to cause
death, commits the offense of culpable homicide.
◈ Section 300 IPC: Culpable Homicide is Murder

10. MLCs in medical practice
Section 39 of Cr.PC:
- Public(doc) to give information about certain offenses.
Section 176 of IPC:
- Omission to give notice or information to Public
Servant by person Legally bound to give it
Section 201 of IPC:
- Causing disappearance of evidence of offense, or
giving false information to screen offender
Section 202 of IPC:
- Intentional omission to give information of offense by
person bound to inform

11. Labeling a case as MLC
a) RMO / Casualty medical officer / MO in charge of MI
Room / Duty Medical Officer (DMO) / MO In charge ward who
is attending to the case, may label a case as an MLC.
(b) The decision to label a case as MLC should be based on
sound professional judgment, after a detailed history taking and
thorough clinical Examination.

12. General Guidelines for dealing with Medico
legal cases:-
(a) In emergencies, resuscitation and stabilization of the patient
will be carried out first and medico-legal formalities may be
completed subsequently.
(b) The consent for treatment is implied in all emergencies.
(c) All Clinic and hospitals will maintain an MLC register and
the MLC will be initiated and documented in the register.
Personal particulars, identification marks, fingerprints of the
individual will be noted. Particulars of the person accompanying
the patient will also be noted.

13. (d) The police should be informed under Sec. 39 of Cr. PC, the
attending Doctor legally bound to inform the police about the arrival of
an MLC. Any failure to report the occurrence of an MLC may invite
prosecution under Sections 176 and/or 202 of I.P.C.
(e) In case of discharge/ transfer/death of such a case in the hospital, the
police should be informed.
(f) MLC documents should be considered as confidential records and
should be stored in safe custody to avoid tampering. All the documents
including case sheets, X-rays, and investigation reports will be
preserved meticulously in the medical record section indefinitely and
handed over to the concerned authorities (Police Investigating Officer /
Court / Court of Inquiry) as and when required.

14. (g) Opinion on the severity of injuries should be given after the
X-ray reports are received in cases of injury to bones/joints.
(h) Samples and specimens collected for medico-legal purposes
will be properly sealed, labeled and handed over to the
investigating officer detailed by the police.

15. Precautions to be taken in MLCs
(a) The complete available particulars of the patient should be noted
down along with two identification marks.
(b) One should not rely on memory while writing reports or during
the recording of evidence in a court of law
(c) No cause of death will be mentioned in the death certificate.
The statement that “Exact cause is to be ascertained by post-mortem
examination” is to be endorsed.
(d) In MLCs, the police will, after the medico-legal formalities,
handover the body to the relatives.

16. Preservation of Medico legal Evidence
 Medico-legal evidence should be preserved and subsequently
sent or handed over to the investigating authorities for
forensic examination and production as evidence in a court
of law.
 All evidence will be identified, sealed and labeled properly.
They will be kept in safe custody and handed over to the
investigating officer of the case.
 Once collected, loss/destruction of evidence is a punishable
offense. Failure to collect, destruction or loss of such an
exhibit is punishable under Sec 201 of I.P.C.

17. Preservation of Medico legal documents
◈ Original copies of all medico-legal documents will be
produced whenever asked for in a court of law.
◈ All original copies of certificates and reports issued for
medico-legal purposes are to be preserved till the
finalization of case in the court of law.
◈ Doctor, Hospital will ensure that the documents are kept in
the custody of an appropriate officer till the case is finally
decided or cleared by the police and judicial authorities. In
the case of units other than hospitals, the safe custody will be
under unit arrangements.
◈ Documents pertaining to admitted fatal MLCs are to be
processed and preserved as laid down in concerned policy
letters.

18. “
There is no such reason as
a midlife crisis.
That’s an excuse
for saying,
“I’m not responsible
for my actions.”

19. Thank you