East Zone Medico Legal Services Pvt. Ltd is a private company that provides legal services for medical professionals facing malpractice claims or other legal issues. Attending their clinical risk and claims management seminar provides benefits such as free legal representation and education on reducing legal risks. The document outlines common types of medical negligence claims and litigation processes. It also provides guidance for doctors on dealing with adverse events, communicating with patients, and legal obligations around reporting injuries or deaths.

1. EAST ZONE MEDICO LEGAL
SERVICES PVT.LTD
“Soluation for challenging situation”
Why You Should Attend
Across india medical malpractice cases continue to make headlines, as more and more claims are
being brought against health care organizations and the people that work within them. Being on the
receiving end of a lawsuit can be challenging in the extreme, and places great stress on individuals
and their organizations as they position themselves to deal with the fall-out that invariably follows
a negligence claim. Consequently, understanding your legal responsibilities, and being able to
effectively reduce and manage legal risk has never been more critical.
Now in its three year, eastzone medico legal services pvt.ltd Clinical Risk, Negligence and Claims
Management in Health
, “EAST ZONE MEDICO LEGAL SERVICES PVT.LTD” is a private ltd.
company incorporated on 13-11-2013. East zone medico legal services pvt.ltd
corporateidentification number is (CIN)
U66000BR2013PTCO21441 It is classified as Indian Government Company and is
registered under the company’s act.1956 (no. 1 of 1956) and that the company is
private limited in Bihar.
Registration certificate is verified by ministry website (www.mca.gov.in)
It was Established on 13-11-2013 beyond an emerging brand “EAST ZONE
MEDICO legal services .
www.eastzonemedico.com
www.eastzonemedico.in
www.eastzonemedico.org
.
Key Benefits: What You Will Learn
 24@hour cover yourself for every problem which no one
 Soluation for challenging situation.

2.  Free legal services from district court to supreme court
 Legal services by medico legal experts who are doctor cum lawyer to
represent your medico legal cases.
 Cover M.C.I ACT I.P.C ACT & other act as for low.
 MTP,PNDT & personal protection act 2013 cover.
 Coverage for all cases m c I act & other act.
 More over a complete peace of mind & all these services are free of cost to
our member.
 Coverage for all cases society defarmation, land, property, tpa etc.
The main factors to consider in such a case are:
Is there an established, prior diagnosis of epilepsy?
Is the alleged crime compatible with a seizure or automatisms or post-ictal confusion, in
terms of nature and complexity of actions, and duration?
Is a claim of amnesia commensurate with that individual’s seizures?
Was there evidence of motive?
Was there evidence of premeditation?
Was there evidence of attempts to escape, or concealment after the event?
Do investigations suggest a diagnosis of epilepsy
• How to deal with adverse events that can lead to organizational crisis
• Overview of a malpractice claim: what should you expect?
• The litigation process: practical demonstrations
• Defence best practices/mitigation strategies: the importance of documentation and tips
and tools regarding the preservation of evidence
• Learning from past claims, audits, self assessments and inspections
• The rising spectre of class actions in health care: how should your organization respond?
• The impact of being sued: dealing with the pressure of litigation
• Responding to risk in specialty areas, including obstetrics, diagnosis, medication and mental
health, and a practical overview of current litigation trends in these areas
• Setting the stage:current litigation trends in obstetric claims
• What types of claims are being filed?
• Impactof new technology
• Prenatal surveillance:estimated placental volume (EPV)
• Brain injury and perinatal asphyxia
• Fetal monitoring and surveillance
• Perinatal infections
• Shoulder dystocia/Erbs palsy
• Obesity in pregnancy
• Births outside hospitals
• Expert witnesses in obstetric malpractice cases
Medical negligence. Most common claims by patients against doctors involve:
Incorrect diagnosis, e.g. non-epileptic attacks diagnosed as epilepsy, with effect of loss of
driving licence and livelihood; and failure to diagnose another treatable condition such as
episodic cardiac asystole.
Failure to diagnose and treat epilepsy, and possibly avoid sub sequent serious
complications or fatality.
Failure to warn patients adequately about the effects and potential adverse effects of
prescribed medical therapy or of surgical treatment. This includes the need to inform
patients of the risks of discontinuing a medication and to have a ‘fail safe’ plan if the

3. change of drug does not go well.
The most common of these are: allergic reactions to medication, other chronic effects of
medication (e.g. effects of retigabine on the skin and retina, vigabatrin on visual fields,
effect of phenytoin on teeth and gums, effect of valproate on weight and menstrual cycle),
interaction of antiepileptic drugs (AEDs) with other medication (e.g. oral contraceptive
pill, warfarin), and teratogenic potential of AEDs, especially valproate.
Failure to convey important information, e.g. the need to inform the DVLA of condition;
safety issues, particularly drowning in a bath, burns from cooking; risk of death from
seizures. This is a difficult area, as other professionals, such as GPs and nurses may also
have a role in patient education and information.
Medical reports may be sought by firms of solicitors, fr CIVIL MATTERS
i) When he has treated the case as a second expert – when
Either the patient is referred by first ophthalmologist for
opinion or further treatment or the patient has came of his
own to the second expert for treatment and the case goes
in court under CPA. Then the first or second Doctor treating
the case may be called in the court as witness or to provide
opinion.
ii) When the patient is referred or came himself for examination
and a Certificate for compensation purposes is required.
If there is loss of vision causing disability or blindness or
disfiguration.
a) Under Employees Compensation Act – when there are
damages during the working in the organization. The
treating Dr. has to certify the extent of damage to the
concerned authority or the Court.
b) For insurance & reimbursement – in insurance cases
the Dr. has to certify the extent of damage to insurance
company or the court.
c) In CPA when he has treated the patient as a second expert
doctor and the court requires the extent of damages to
calculate the loss and compensation.
d) As a certifying expert after examination of a case – The
Court may send a case for examination and certification of
the condition of the patient.
B) CRIMINAL MATTERS
Accidental Trauma
When caused in vehicle accident case, doctor may be required
to give certificate to court or insurance company indicating
amount of loss of function. Record has to be kept for 3 years.
Trauma by Assault
• Patient may give history of Assault and when it is taken
on record, or when Patient is referred by police or court,
the doctor has to note the injuries in detail, in a separate
register called as MLC register, it’s simple or grievous
nature, and amount of loss of function (vision).
• When fracture is suspected X-ray, CT scan or MRI is advised
and record is kept for 3 years.
• Certificate of injury is given to patient on demand if injury
is simple injury.

4. • If it is grievous injury it is necessary to inform police done.
certificate is given to police or court on demand.
• Record should be kept for 3 years or till case is decided by
the court.
• The Grievous injury in Ophthalmology is defined in Section
320 of the Indian Penal Code as the Grievous injury is –
a) Permanent privation (loss)of the sight of either eye
b) Permanent disfiguration of the head or face
(Here disfiguration due to injury to lids, orbit, eye ball
etc.)
c) Fracture or dislocation of a bone or tooth
(Here Fracture of orbital bones)
d) Any hurt which endangers life or which causes the
sufferer to be during the space of twenty days in severe
body pain or unable to follow his daily routine.
As a legal expert in court of law, when he has treated the
case of criminal assault. The patient may come of his own
or may be sent by police or court for examination and or
treatment and for certificate. If the patient has come on
his own and the injury is grievous then the doctor has to
inform the police. The injury may be
a) Mechanical injury
b) Chemical injury (acid or alkali burn)
c) Heat or electrical burns.
Doctor has to make a note of every injury in detail on his
record and the investigations done with it’s record and
the treatment given and the results in detail. Doctor has
to keep the record and has to give certificate to police or
court. Injury should be noted as simple or grievous injury
and amount of loss of function TABLE DEATH
IN SOLO PRACTISE
a) Stop the surgery and try to resuscitate with the help of
Anesthetist. Call physician or shift to ICU if possible.
b) Inform Police. Insist on Post mortem.
c) Inform relations and try to take them in confidence and do
consoling.
d) If possible do not insist on bill payments.
TABLE DEATH
IN SOLO PRACTISE
a) Stop the surgery and try to resuscitate with the help of
Anesthetist. Call physician or shift to ICU if possible.
b) Inform Police. Insist on Post mortem.
c) Inform relations and try to take them in confidence and do
consoling.
d) If possible do not insist on bill payments.
INFORMATION TO POLICE -Inform the Police If death of the
patient occurs within 24 hrs from the admission in the hospital
or Where cause of death cannot be certified or During surgical or
interventional procedure death occurs
• Cognizable case – (cognizable offence ) – means a case in which,

5. a police officer can arrest without warrant
• TO MAKE DOCTOR SAFE – see before operation
a) Take physical fitness from a M.D. Physician.
b) Always have a qualified stand by Anesthetist
c) O.T. should have oxygen cylinder
d) Written informed consent in patient’s language.
• Table Death - Inform Police. Insist on Post mortem
• The table death is generally inquired under 304-A of Indian Penal
Code in which FIR is registered. It is a Bailable offence.
• Supreme court has given guide lines that – Dr. should not be
arrested under Section 304-A unless opinion is taken from expert
Doctor or committee of doctors expert in that field
• PROTECTIONTO DOCTERS & HOSPITALS
Government of Maharashtra has passed an ordinance No V 2009
Dated 30 March 2009
• Section 88 and 92 of IPC protects doctor in criminal liabilities.
• No consent protects the doctor from CPA but it protects him
from criminal liability
• Records OPD papers should be preserved for 2 years; and papers
regarding indoor surgical matter should be preserved for 3 years
(Sec. 24 A CPA Act 1986)
1Whateverthe contextin which medical decisionsare made,you mustworkin partnership with your
patientsto ensuregood care.In so doing,you must:
a) listen to patientsand respect their viewsabouttheir health
b) discuss with patientswhattheir diagnosis,prognosis,treatmentand careinvolve
c) sharewith patientstheinformation they wantorneed in orderto makedecisions
d) maximisepatients’opportunities,and theirability,to makedecisionsfor themselves
e) respectpatients’decisions.
If patientshavecapacityto makedecisionsfor themselves,a basic modelapplies:
a The doctorsand patientmakean assessmentof thepatient’scondition,taking into accountthe
patient’smedicalhistory,views,experienceand knowledge.

6. b The doctorusesspecialist knowledgeand experienceand clinical judgement,and thepatient’sviews
and understanding of theircondition,to identify which investigationsortreatmentarelikely to result in
overall benefitforthe patient. The doctorexplainstheoptionsto thepatient,setting outthe potential
benefits,risks,burdensand sideeffectsof each option,including theoption to haveno treatment.The
doctormay recommend a particularoption which they believe to be bestfor thepatient,but they must
notput pressureon the patientto accepttheir advice
c The patient weighsup the potentialbenefits,risksand burdens
of the variousoptionsaswell as any non-clinicalissuesthat are relevantto them.The patientdecides
whetherto acceptany of the optionsand,if so, which one.They also havethe right to accept or refuse
an option for a reason thatmay seem irrational to the doctor,or forno reason at all.
d If the patientasksfor a treatmentthat thedoctorconsiderswould
notbe of overallbenefitto them,the doctorshould discusstheissues with the patientand explorethe
reasonsfortheir request.If,afterdiscussion,thedoctorstill considersthatthe treatmentwould notbe of
overall benefitto thepatient,they do nothaveto providethe treatment.Butthey should explain their
reasonsto the patient,and explain any otheroptionsthatare available,including the option to seek a
second opinion. discussionswithpatientsaccording to:
a their needswishesand priorities
b their level of knowledgeabout,and understanding of,theircondition,prognosisand thetreatment
options
c the natureof their condition
d the complexityof thetreatment,and
e the natureand level of risk associated with the investigation ortreatment. In the case of minoror
routineinvestigationsortreatments,if you are satisfied the patientunderstandswhatyou proposeto do
and why,it is usually enough to haveoralor implied consent
Informed Consent in Studies with Human Subjects
For studies with human subjects include the following statement:
All procedures followed were in accordance with the ethical standards of the responsible
committee on human experimentation (institutional and national) and with the Helsinki
Declaration of 1975, as revised in 2008 (5). Informed consent was obtained from all
patients for
being included in the study.
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