Medico Legal Responsibilities of Doctors
Registered medical practitioner (RMP) i.e. Emergency Medical Officer (EMO)/ Assistant Emergency Medical Officer (Asst. EMO) at Emergency should decide whether the case is to be registered as MLC or not.
Consent of family members NOT required for registration of a case as MLC.
Opinion Should be Crisp and to the Point. Articles Preserved and Should be Enumerated.Prepare Three Copies of The Document, One Copy is Kept at Emergency Room, other as Hospital Record.Original is Given to The Police.
If a MLC, recorded elsewhere (in other hospital) is referred, it should be treated as MLC but NO NEW MLC number should be issued. Treatment should continue in old MLC number. Neither a new MLR should be prepared nor is it needed to inform the police.
If a case is brought several days after the incident, it should be reported and findings to be noted regarding the present condition of the patient.
MLC can be written and signed by (EMO)/Asst. EMO /Faculty. Wherever possible, Faculty member should sign along with SR/JR if the report is prepared by them.
Forensic science PowerPoint presentation on Injury and it's medico-legal importance.
The slide is made for medical students. Mainly for BAMS students. It covers maximum points.
The slide is full of example with pictures which make it easy to understand the concept. It contains post-mortem findings as well as medico-legal importance of the each type of injury.
Following is the detailed description of Dying Deposition and Dying Declaration being followed in Indian Legalities from a Medical students perspective. The presentation should prove to be helpful for educators and primarily for medical students for their understanding and academics.
References - Forensic Medicine And Toxicology (29th edition) By DR. K.S. Narayan Reddy
Forensic science PowerPoint presentation on Injury and it's medico-legal importance.
The slide is made for medical students. Mainly for BAMS students. It covers maximum points.
The slide is full of example with pictures which make it easy to understand the concept. It contains post-mortem findings as well as medico-legal importance of the each type of injury.
Following is the detailed description of Dying Deposition and Dying Declaration being followed in Indian Legalities from a Medical students perspective. The presentation should prove to be helpful for educators and primarily for medical students for their understanding and academics.
References - Forensic Medicine And Toxicology (29th edition) By DR. K.S. Narayan Reddy
In the presentation efforts have been made to guide the medical professionals how to deal with a MLC case in a step by step manner and certain issues relating to medical case records.
infanticide are quite common in India because of illiteracy as well as the female child unwanted . Now a days female sexual assault and murder is getting common in north Indian society
Medical Jurisprudence is the study of medical principles in solving criminal cases.
To know more about medical jurisprudence, click on the link- https://youtu.be/r6OX6xlXOBo
A POWER POINT PRESENTATION BY DR.SANGEETA CHOWDHRY & DR.SUNIL SHARMA, DEPARTMENT OF FORENSIC MEDICINE & TOXICOLOGY, GOVT. MEDICAL COLLEGE, JAMMU (JAMMU AND KASHMIR)
Cases wherever attending doctor after taking history and clinical examination of the patient thinks that some investigation by law enforcing agencies are essential so as to fix the responsibility regarding the case in accordance with the law of land.
consent
Indian Contract Act 1872 defines when two or more persons agree upon the same thing and at the same time in the same sense provided the consent has been taken prior to coercion, not under the influence of fraud or misinterpretation and mistake
In the presentation efforts have been made to guide the medical professionals how to deal with a MLC case in a step by step manner and certain issues relating to medical case records.
infanticide are quite common in India because of illiteracy as well as the female child unwanted . Now a days female sexual assault and murder is getting common in north Indian society
Medical Jurisprudence is the study of medical principles in solving criminal cases.
To know more about medical jurisprudence, click on the link- https://youtu.be/r6OX6xlXOBo
A POWER POINT PRESENTATION BY DR.SANGEETA CHOWDHRY & DR.SUNIL SHARMA, DEPARTMENT OF FORENSIC MEDICINE & TOXICOLOGY, GOVT. MEDICAL COLLEGE, JAMMU (JAMMU AND KASHMIR)
Cases wherever attending doctor after taking history and clinical examination of the patient thinks that some investigation by law enforcing agencies are essential so as to fix the responsibility regarding the case in accordance with the law of land.
consent
Indian Contract Act 1872 defines when two or more persons agree upon the same thing and at the same time in the same sense provided the consent has been taken prior to coercion, not under the influence of fraud or misinterpretation and mistake
MEDICOLEGAL role of MEDICAL OFFICER at a hospital.pdfAngirasSahuAngi
Medicolegal roles of medical officer by nhrc. It includes all the common points a medical officer must be aware of. In case of MLC it can be used for doctor duties.
The legal duties of a doctor. 1. Emergency medical services 2. Disclosure of 3. What are MLC? What is the duty of the doctor in MLC, medical records preservation, proper documentation, valid is very important for saving the doctors consent from legal actions under IPC and actions for negligence.
For info log on to www.healthlibrary.com. "Rights and Duties of Doctors - Part 2" By Dr. Ghazala Shaikh held on 3 Nov 2015.
The time period for maintaining medical or medico legal records(fmt)Ritam Sahu
The time period for Medical or Medico Legal records to be maintained by Hospital or Medical Practitoner Forensic Medicine Project in Colleges and also Medical Issues
MEDICAL JURISPRUDENCE
FORENSIC MEDICINE
INDIAN PENAL CODE
CRIMINAL PROCEDURE CODE
CODE OF CIVIL PROCEDURE
INDIAN LEGAL SYSTEM
INQUEST - Police & Magistrate
COURTS OF LAW
JUVENILE JUSTICE BOARD
MEDICAL EVIDENCE
Medical Certificate
Medicolegal certificate
Dying Declaration & Dying Deposition
SUMMONS
RECORDING OF EVIDENCE IN A COURT
WITNESS
DOCTOR IN THE WITNESS BOX
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"whenever any medico-legal case comes to the hospital, the medical officer on duty should inform the Duty Constable, giving the name, age, sex of the patient and the place of occurrence of the incident and should start the treatment of the patient.
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micro teaching on communication m.sc nursing.pdfAnurag Sharma
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Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
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i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
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2. Definition of Medico-legal
Case
Cases wherever attending doctor after taking history and
clinical examination of the patient thinks that some
investigation by law enforcing agencies are essential so as to
fix the responsibility regarding the case in accordance with
the law of land.
3. Duty of Registered Medical
Practitioner (RMP) in MLC
• To save the life of a patient and to give primary treatment
• Registered medical practitioner (RMP) i.e. Emergency Medical Officer (EMO)/
Assistant Emergency Medical Officer (Asst. EMO) at Emergency should decide
whether the case is to be registered as MLC or not. .
• Consent of family members NOT required for registration of a case as MLC.
4. List of MLC
• Injuries due to Accidents and Assault.
• Suspected or evident cases of suicides or homicides (attempted).
• Confirmed or suspected cases of Poisoning.
• Burns.
• Cases of injuries with likelihood of death.
• Sexual Offences.
• Suspected or evident Criminal Abortion.
5. List of MLC
• All Patients Brought to The Hospital In Suspicious Circumstances/ Improper History (Ex:
Found Dead On Road).
• Unconscious Patients Where Cause of Unconsciousness Is Not Clear.
• Child Abuse, Domestic Violence.
• Person Under Police Custody or Judicial Custody.
• Patients Dying Suddenly on Operation Table or After Parenteral Administration of a Drug
or Medication.
• Case Of Drunkenness., Brought Dead, Natural Disaster.
6. Work Flow For Medico-legal
Cases Brought To Emergency
7. Protocol for Filling The Medico-
Legal Report (MLR) is as Under.
• Preliminary
• Information to the police should be sent in proper form.
• Take Consent for examination of the patient on the MLR Form.
• If less than 12 years or brought unconscious take the consent of
the guardian/accompanying person/ Police Constable.
• The Preliminary entries should be complete.
• Two Identification Marks have to be noted preferably on accessible
parts.
8. • Time and date of examination should be indicated clearly.
• If the patient is under observation to decide the severity of injury/condition, same
should be indicated in Medico-legal Report.
• Take proper history in patient/guardian’s own words and document correctly.
• In cases of poisoning and other cases, General Examination and other signs should
be mentioned in detail.
• Use standard formats wherever possible.
• Details of police constable who brought the case should be noted.
9. • Examination:
• Mention The Examination Of Injuries in Detail (Type, Site, Size, Shape,
Color, Age of Injury, Direction, Nature, Duration). Use Diagram Wherever
Necessary.
10.
11.
12.
13. Opinion
• Opinion Should be Crisp and to the Point.
• Articles Preserved and Should be Enumerated.
• Prepare Three Copies of The Document, One Copy is Kept at
Emergency Room, other as Hospital Record.
• Original is Given to The Police.
14. General Guidelines
• If a MLC, recorded elsewhere (in other hospital) is referred, it should be treated as MLC but
NO NEW MLC number should be issued. Treatment should continue in old MLC number.
Neither a new MLR should be prepared nor is it needed to inform the police.
• If a case is brought several days after the incident, it should be reported and findings to be
noted regarding the present condition of the patient.
• MLC can be written and signed by (EMO)/Asst. EMO /Faculty. Wherever possible, Faculty
member should sign along with SR/JR if the report is prepared by them.
15. • All treatment papers, investigation reports etc. to be labeled as MLC & record should
be maintained for future Medico-legal use (same may be required by court for the
case).
• Belongings of the Medico-legal cases should be handed over to the police officer and
proper receipt must be obtained in every case.
• If a Medico-legal case is not admitted, entry shall be made in the MLC Register.
16. • Consent for emergency surgery, when no attendant is available can be given
by the Medical Superintendent of the hospital.
• In case of taking away a patient or body of a Medico-legal case forcibly by
the attendant, the Medical Officer should record the same on the file of the
patient and Police Station/Post of the area and security staff should be
informed immediately.
17. • X rays, blood reports, microbiological, pathological investigations etc in Medicolegal
case should be labeled as MLC & kept along with other documents of the case.
• When Medico-legal case is to be discharged from hospital, police should be informed
and information should also be sent to the Emergency to make an entry in Medico-legal
register.
18. RECORD KEEPING
• Always prepare three copies of the Medico-legal report, one is kept as hospital
record, other is kept in the office of Medical Superintendent and the original is
given to police after getting proper receipt.
• Hospital records or file of MLC should be kept as confidential in Record Section till
judgment by the court of law pertaining to the case has been issued (for practical
purposes, no time limit).
• If Medico-legal report has already been issued, then duplicate Medico-legal
reports should not be issued unless specifically requested by the police in writing
or by the order of the court.
19. DEATH IN MEDICO-
LEGAL CASE
• Whenever there is a death in a Medico-legal case, the police officer should be
informed and body must be sent for Medico-legal autopsy after filling the
appropriate format.
• In all the cases brought dead, police is informed and body is sent to Mortuary.
• Cause of death certification in cases other than MLC can only be issued by
Emergency Medical Officer (EMO)/ Assistant EMO/ treating doctor who has
attended the case within 7 days and is sure about the cause of death.
20. DYING DECLARATION
• In case of impending death in MLC, the Medical Officer should immediately ask
the police officer on duty in writing to call a magistrate. If there is no time to call a
magistrate, the dying declaration should be recorded by the doctor himself in the
presence of another doctor or staff member.
• The primary duty of a doctor in dying declaration is to ascertain and document
Compos Mentis(alert mental state ) 0f the patient at the beginning and at the end
of the statement.
21. SPECIFIC CASES
• Fire Arm Injuries
• Bullets, lead shots etc recovered from the wounds or body in fire arm injury
should be air dried then put in a bottle(s), padded with cotton, documented
sealed and handed over to the police.
• Always try to mention about the entry and exit wound.
• Always take X-Ray of the track or whole body.
• Never pick the bullet using a metal/ toothed forceps, rather use fingers or
rubber tipped forceps.
• Never wash the bullet.
22. • Burns:
• Proper history and documentation
• Give primary treatment.
• Extent and degree of the burns to be noted.
• Make a proper sketch showing areas involved and state in percentage.
• Inflammable agents on the body/cloth are recorded and preserved.
• Dying declaration if required should be taken especially in young married females.
23.
24. Hanging/Strangulation
• Ligature mark- Describe its position, nature, width, direction and extent whether
complete or incomplete.
• Ligature material in-situ should be cut away from the knot so as not to disturb the
knot. Then the cut ends and knot have to be secured with threads separately.
• Ligature material should be preserved.
• Examination of ligature material in respect of its nature, position, type of knot,
circumference of loop, length of short and long free ends, foreign bodies and
stains.
25.
26. Injury Cases
• Give primary treatment.
• Examine and record all injuries properly.
• Proper documentation
• Opinion should include injury by type of weapon ( sharp/blunt ) , manner (Self-
inflicted, homicidal, accidental) and duration of injury.
27. Drunkenness
• Take proper history and document correctly in the form provided
• Consent should be taken but under Sec 53 (1) Cr PC, examination of an accused can be
carried out by a doctor at the request of the police, even without his consent.
• Examine properly and collect urine, blood sample in a proper way.
• Mention the starting and ending time of examination.
• Never use rubber stopper in collection of sample. Use screw — capped bottle.
• Spirit must not be used for cleaning the skin and the syringe must be free from any trace of
alcohol. Chlorhexidine can be used instead.
28. Poisoning
• Give primary treatment. Take proper history.
• History of Substance consumed, amount consumed, when, where
& number of people consumed.
• Proper documentation of history, treatment and articles sealed.
• Send properly sealed, labeled samples of vomitus /stomach wash
and blood sample to the police and make record wherever
possible.
• Never allow the entry of unauthorized person near the Victim in a
case of homicidal poisoning.
29. Child Abuse
• All children should be approached with extreme sensitivity and their
vulnerability recognized and understood.
• Give proper treatment.
• Usually medical examination should be done within 24 hrs or as soon as
possible.
• Consent from parents/guardians in written should be taken.
• Consent from child in form of verbal, expressed or written is to be taken.
• Record the child’s weight , height and sexual development,
• Take proper history and document it correctly.
30. • Always prepare the child by explaining the examination and showing equipment;
this has been shown to diminish fears and anxiety. Encourage the child to ask
questions about the examination.
• If possible, interview the child alone (separately from the attendants) in a
separate room.
• Psychiatric counseling is advised.
• Never put undue pressure on a child for medical examination, if he/she denies
even after convincing. But in conditions requiring medical attention, such as
bleeding or a foreign body is suspected, consider sedation or a general anesthesia.
• Avoid unnecessary painful and invasive procedures.
31. Criminal Abortion
• Give proper treatment.
• Always perform examination of clothes and take blood sample.
• Proper history and documentation.
• If patient dies, send for Medico-legal autopsy.
• Preserve the remains of product of conception (POC) for Chemical Analysis and
DNA Analysis if required.
• Clothes are recorded and preserved
32. Rape/Sexual Assault Cases
(suspect and survivor)
• Be polite to the suspect and Victim.
• Always take consent. In case of suspect, medical examination can be done even if he
declines to give consent.
• Take a detailed history and document it in person’s own words.
• Examine them properly and fill the prescribed form for suspect and survivor
• Always provide information regarding psychiatric counseling to the Victim.
• All male and female Registered Medical Practitioners are eligible to examine the Victim.
• Always examine the Victim in presence of female attendees. Victim can have a female
acquaintance/relative with her if she wants.
33. • If she refuses to make a statement, the doctor should not pursue the matter. He
must consult a senior professional colleague.
• In case of children, sedative or analgesic may be needed for examining genitalia in
painful condition.
• Do not delay the examination. Exact time of commencement and completion must
be noted in the report.
• Never attempt to undress the Victim for examination. Convince her to undress
herself.
• Never pass judgmental remark or comments that might appear unsympathetic.
• Denying examination of the rape Victim is unlawful.
34. Following Instructions
to be Followed
• Take history whether she has taken bath and changed the clothes.
• With cotton swab collect vaginal secretion from posterior fornix and prepare 4
slides.
• Place loose pubic hair in a labeled envelope.
• Obtain fingernail scrapings.
• Preserve garments for seminal and blood stain.
• Collect blood sample (15 ml).
35. • If age estimation required then refer to the Department Of Forensic Medicine.
• If clothes are to be preserved and sealed, always provide proper clothing or
inform the relatives to bring one set of clothes.
• The slide can be prepared, dried and forwarded to Department Of Forensic
Medicine for needful.
• Treatment of Victim should be given when needed.