Medico legal documentation in a case of BURNS

Medico legal documentation in a case of BURNS By Dr. Jagadeesh. N MBBS, MD, DNB, LLB, PGDMLE • Professor of Forensic Medicine Vydehi Institute of Medical Sciences, Bangalore • Consultant, CEHAT, Mumbai

Case study �Mrs G reports to you during her antenatal checkups that she sustained those cigarette stub burns & scalds, as a result of constant abuse by her husband pestering for a male child. But you ignored it as you are an Obstetrician concerned to do only ANC. After few months you find that she committed suicide by use of Insecticide unable to bear the abuse. Did you do anything wrong ethically and /or legally? 2

Case study �Mrs K reports to Magistrate in her dying declaration that the burns sustained were due to stove burst accidentally. But later that night she discusses with you(doctor) that it was indeed her husband who poured kerosene and lit her for failing to bring dowry. Next morning she succumbed to death. �What should have been done in this case by you ethically / legally? 3

Role of Doctor �Therapeutic role �Medicolegal role 4

Role of doctor �Brought by whom �History – informant – consciousness – sign �Change of history – stove burst �Surface area of burns �Depth / Degree of burns �Dry flame / Scalds / Chemical / Electrical 5

Type of Burns �Dry Flame - blisters, singeing, blackening �Scalds - reddening, vesication, no singeing, no blackening �Chemical - stains, no red line, no vesicles, no singeing �Electrical - Joule burn, blisters, flame burns 6

Document �Smell of kerosene ? �Singeing of hair �Blackening, Charring �Extent and degree of burns �Collect burnt material on body �If impending death – arrange for recording of Dying Declaration �Is it possible to say whether these are Accidental, Suicidal or Homicidal? 7

Sec 326 A IPC �Whoever causes permanent or partial damage or deformity to, or burns or maims or disfigures or disables, any part or parts of the body of a person or causes grievous hurt by throwing acid on or by administering acid to that person, or by using any other means with the intention of causing or with the knowledge that he is likely to cause such injury or hurt, shall be punished with imprisonment of either description for a term which shall not be less than ten years but which may extend to imprisonment for life and with fine which may extend to ten lakh rupees: �Provided that any fine imposed under this section shall be given to the person on whom acid was thrown or to whom acid was 8

Sec 326 B IPC �Whoever throws or attempts to throw acid on any person or attempts to administer acid to any person, or attempts to use any other means, with the intention of causing permanent or partial damage or deformity or burns or maiming or disfigurement or disability or grievous hurt to that person, shall be punished with imprisonment of either description for a term which shall not be less than five years but which may extend to seven years, and shall also be liable to fine. 9

Physical & Mental Assault �Section 498 A IPC �Whoever being the husband or the relative of the husband of a woman, subjects such woman to cruelty shall be punished with imprisonment for a term which may extend to three years and shall also be liable to fine 10

Burns – dowry deaths �Section 304 B IPC (1)Where the death of a woman is caused by any burns or bodily injury or occurs otherwise than in normal circumstances within seven years of her marriage & it is shown that soon before her death she was subjected to cruelty or harassment by her husband or any relative of her husband for, or in connection with, any demand for dowry, such death shall be called ‘dowry death’ and such husband or relative shall be deemed to have caused her death. (2) Whoever commits dowry death, shall be punished with imprisonment for a term which shall not be less than seven years but which may extend to imprisonment for life. �Dowry Prohibition Act, 1961 11

Domestic violence �Protection of Women from Domestic Violence Act, 2005 & Rules, 2006 �Section 7 – Duties of Medical Facilities Aggrieved person or PO / SP requests for medical aid – shall provide medical aid �Rule 17 – as of Sec 7 - if PO --- Domestic Incident Report (DIR) - No refusal of medical aid for NO prior DIR - Medical facility – DIR in Form I – forward PO - Copy of medical examination report - FREE 12