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MANUAL
OF
llr!I,STR UCTIONS
GN
tl1edico-lega,l Examination
-----
2
Civil Surgeons are required to supervise
great care the medico-legal work done
by Government medi~al officers and to bring
to the notice of this office any medico-legal
case .in which the conduct of a medical officer
. is found to be of.suspicious nature or displays
n~gligence or carelessness.
No. 11706/G
g9~9?38.
with
No. 9440 _0
aated
.
~~~1-] 1;410
.
If a Civil . Surgeon is suspicious of the
conduCt of a medical officer in a police case
and desires to examine the case himself he
should always do so in his official capacity and
should not charge any fee for it.
No, ll~O/G,
3
A woman when broughJt for medico-legal No. 5765/G,
examination . by the police should not be ~~~~~4o.
examined without. her consent and without a
written order from the Magistrate addressed
to the medical officer to this effect.
Medical Practitioner attached 1to subsi- No.6 138-G-I
. d d.1spensanes
. are d eb arre d f rom und er- dated
d1ze
:o-4-4o.
taking medico-legal of any description but
they must tre.at suspected cases of POISONING
AND ALL SERIOUSLY INJURED CASES
requiring immediate treatment whenever
called upon to do so.
Copies of injury reports recorded in the ~f.' ~~;?~u
outdoor register should not be issued by the I0-7-40.
Medical .Practitioner attached to suhsidized
dispensaries.
Government medical Officers may examine
medico-legal cases brought by the police
which have already been examined by a
Private Medical Practitioner and it does not
matter if the opinion of the Government
Medical Officer c-onflicts with that of the
private doctor.
All medico-legal cases of se.rious , i~jl.lry j;':,>:
o: of poisonine: admitted to. a hospitaL .ot~:~ .. 115101,
dispensary whether brought In by the pollee aated 5/4.
or not. shouJd be reported to the police, in to all c. Ss
writing at the nearest thana as soon as
possible and in any case within 24liours_ of
aCfriliSSion.
An acknowledgement of the
nolice official receiving the report should" be
kept in the hospital record.
4
'
No. 1369/GI,
dated
8-11-41.
No. 17389/
G-1. dated
2-11-42.
No. 6597/GI,
1;~;~43..
5
Medical ofiice,rs shall ndt interest them- No. 10477. any way in t h e nego t'Ia~wns
.4-'
f or com- GI
dated
selves m
3-7-1944
promiSe between the parties involved in t 0 all C.Ss.
medico-legal cases and will not wait for their
decisions before sending their reports to the
police.
If injured persons are brought at night ~~~Jg~7i 0
their medico-legal examination should not 1944 to all
be delayed until the next morning.
If, c. ss.
owing to the lack of day light definite opinion
on certain injuries cannot be given a note to
this effect shall be made by .the medical
officer in the medico-legal report.
Such
cases shall be examined again invariably,
sent to the police if a change of opinion is
made or new confusion etc. found.
No.l73lGM dated
4-2-1950.
No. 3070/GI
dated
4-1950
10 au c. ss.
No. t3oso-.
GIIKasauh '
dated 19-7I95J.
No. szs3HB-s3/342t
1~~~~ 24 _1_
7.
: 69 - 81 1
In some of the medico-legal
post-mortem Gli
No. 4dated
cases the medical officers on subsequent 18-::.-195~. :EJ
interrogation by the police, give revised
opinion as to the nature of the injury or
about the cause of death and do not send
information to that effect to the Civil Surgeon.
This practice is mosit objectionable from
administrative point of view as the Civil
Surgeon being the representative of the
Health Department in the District must be
kept informed of all the developments at all
stages in medico-legal and post-mortem cases.
It may, therefore, please be :impressed upon
all concerned that they should s,upply the
Civil Surgeon with a copy of any information which may be supplied to the police
authorities on their subsequent interrogation
If
,an
'iniured is.. kept
unoer observati_on No. 14739
.
--,....--,- -.------- .... - , Gil dated
and 1s sent fOr ~n X-ray the inJured .Will 7o-s-J 9ss.
depOsittilefee in __!_he 'firsf}ils"Th_ri;ce and in
case the Tnfu:rV is "C1edared 'sim.Pl~:tneree
willbe rete1ined and If -it -is declared greVious,
thex=-Rai f~ll af.l ~he fee charged by
the first examfiiiii~f -medfcaT-officer ---is .!fO -be
refunded and 'the polrce-rmormed.---This
procedure is aaopre-aonk_in_caseE._where theinjured has not come ~hrough the police.
8
No. 2579725811-GII,
dated 209
'19.55.
No. 382-461/
.. :
r .
-~
10675-GII
:1 ared 24-41957.
. 32, dateu
to supp y t e copies of post-mortem reports m 4-1-1958.
the cases of deaths in mines to the officers of
the Mines :Department free of cost as and
when required.
Sometimes railway employees,
their No. tG Med
families aJ?d passei?!!ers when injuredd. _as a :~~~~5~atr.d
result of r::nJwav accJdent are removed 1rect- from the
ly to the Civil Hospit<:tls by the Police or the ~l~:~n
?tatioTl staff. without having b~en previously Baroda
ex::Jmined by the Railway Doctors.
The ~~~h~~ New
Railway Doctors in such cases h<we to submit Endst. No.
iniurv medical reuort to the railway adminis- ~~'%9~?.oo2,
IntraHon. I shflll be f!)::Jd if vo11 olease issue dated 24-2instructions to the MPdical Officers Inch:uge 1958
of Civil Hospitals to afford necessary facilities
10
to the Railway Doctors for examination of
such cases and where the case had already
been discharged from the hospital a copy of
the medical report including X-ray findings
if any may please be given on demand t 0 the
Railway Doctors.
No. JGII58/5855-93
dated 24-31958.
~o.
34T93GII-58,
8936-86
No. 2552GII-59/
3484-3584
dated 21-21959.
No. 31622GTI-59/
8824-74
dated 9-41959.
CivH Assistant Surf!eon r:lass IT (Nongazetted) are not authorizcd to conduct tht'
post-mortem examination.
11
It is emphas'ized on all Medical Officers
that in all cases of head lllJUries, whilst
examining these cases, they should pay particular attention to ascertain, if at ~the time of
examination there were any symptoms of
brain injury and for this purpose they should
note the detailed history of the case.
12
No. 3GII.... ..... ............ The issue .of this circular
, 60/38572-621
dated 21-12- do not realise the seriousness of concomitant
1960
injury to the brain in cases of head injury.
No. 4695
The medical officer to whom a Govern3GII-60/
. 40786-s 27
ment
employee approaches for recommenddated 26-12 ing a spell of 4 days leave or less should
1960
.
d ec IaraLIOn f rom a
G overnmen
.
t
obt am
employee on a certificate issued to 'h im in the
following manner : ,!.
13
According to the standing department No. 392!3.mstruciwns
..
.
92-GII( 3)41,
a ll me d'1co- l ega l cases of ser1ous
c.ated 27-U.nature injury or of poisoning admitted to a i?_ 6~ 8' 0 a11
hospital or dispensary whether brought in
14
No. IOrS4-
15
cannot be given.
The reports should be drawn in third
person singular using the past-tense and
passive voice e.g. instead of saying "I noted"
say un was noted" and so on. Before drawing a report refresh your knowledge of the
subject by consulting text-books and do not
cut, scratch, erase or over write your reports.
This vitiates your report and places y~u in
an embarrassing position. If on postmortem examination the prior to death of
that description of the injuries do not tally
(e.g. contused would might have been described as sharp-edged ones by mistake) with the
16
description given by the doctor who conducted the medico-legal examination prior to
death of that individual then in such like
cases the Civil Surgeon should be called in to
perform the post-mortem examination.
The following poih ts should be observed
while giving testimony : 1. Assume a comfortable but dignified
position in the witness box.
2.
17
you admit that a book is authoritative it cannot be introduced in
evidence
or
quoted in crossexamining by you. Whenever you
read a passage from a reference
book you should always insist toread the lines yourself and that too
alongwith few lines preceding, the
quoted lines and also the lines
thereafter so that the proper meanings of the para are understood.
6.
\iVhen a doctor willingly or otherwise No. 868"becomes involved in a professional respect for ~i;~~~~ 8
appearance in a court, he has to .undergo a 3-1962.
public ordeal which he should endeavour to
view with perfect quanimity. In courts the
evidence of facts and opinion elicited by
counsel's questions during eaxmination-inchief is bound to be tested by cross-examina:..
tion when a witness may be questioned
closely and persistently.
Once in witness
box the doctor is, therefore, likely to find that
a straight forward examination-in-chief will
be followed by questions which \Vill require
knowledged, rapid but careful, thought, if
helpful and clear answers are to be given
and all this in pub]ic. with the full attention
of the court and press, so that incautious
remarks aFe apt to resound for more than
similar remarks made in the seclusion of the
consulting room.
18
It is needless to emphasise the importance
of keeping complete and detailed records so
that, if litigations arise, reliable reference
may be made to the documents. Abbreviation
in records are abazard because counsels are
not slow to seize upon possible ambiguities
or any other apparent defects in case records,
sometimes using them with
devastating
effect in cross-examination. To quote an
example of abbreviation of C. may be used as
Civil Surgeon/Chief Secretary and so forth.
It has been noticed in a large number of
cases that the doctors who perform postmortems or do medico-legal examination do
not fill in the charts showing the exact location of injuries received by the deceased or
the victim of the assault. It is of utmost
importance that the exact location of injuries
should be noted down by the doctors at the
time makes the examination of the victim.
Filling up of the charts accurately and elaborately will help the doctor to explain the
position to the court at the time of evidence.
All medical officers while filling in their
medico-legal and post-mortem examination
report~ should invariably fill in the diagramatic sketches so that exact location and direction 'of the injuries can be known to answer
q llPstions in the Courts.
In this behalf
attention of the medical officers is also invited
to Appendix XL of the Punjab Medical
Manual,. which e!lumerates the various types
of questwns, whJch may usually be .put to
them in the course of cross examination.
19
crossexamination is a rigorous t'est for any
doctor is undergo. Yet unless he is willing
and unless he delivers testimony effectively,
he fails in an important service to his community and to his patient. The above instructions should be brought
to the n< tice of all the medical officers for
their guidance and strict compliance in
future.
It has been found that in Hospitals post- ~~1 <43~~J
morteni work js divided on Sex basis i.e. 26780-798,
female dead bodies by the Women Assistant 19~e2~ 25 8Surgeons and male dead bodies by the male
Assistant Surgeons. This distribution of Sex
basis is wrong. Since Woman Assistant
Surgeon are now promoted to the Rank of
Civil Surgeon and any day may take charge
of Civil Surgeon. The postmortem work is
essential.
20
~~~if~~<4 >
Reference your letter No. 1359 dated 11th
dat~d tJ-9. August, 1962, on the subject noted above.
196;! to C.S.
Nabha.
In this connection the following instructions may please be kept in view while dealing
with such cases which do not normally fall
within the jurisdiction of Civil Hospital, Nabha.
1.
3.
No 3s 46 s.
3Ssoo-GU{4)
63.11-1963
dated
14
to ail c.ss.
&DMH.
be
<I.nd
21
The Chief
Medical Officer is the. GovernNo. PMND
.
(2)64-/58
men t medico-legal expert of the D1stnct. He dated 4-l is required to supervise the medico-legal
work conducted by the Medical Officers
working under him in his jurisdiction. If
the Chief Medical Officer /Principal Medical
Officer is suspecious of the conduct of a
Medical Officer in a police case and 'desires to
examme the case himself on the approach of
the aggrieved party(s) he should always do
so in his official capacity and should not
charge any fee for it.
Issued by :
Directorate of Health & Family Welfare,
Punjab, Chandigarh.