Medico legal documentation in a case of POISONING

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

Case study �Mr. X was forcibly made to drink country liquor by his business rivals and was found unconscious at a hotel. By your timely treatment Mr. X recovered completely. Now Mr. X is requesting you to issue a Wound certificate. �What do you do? �Is it simple injury or grievous injury? �Under what section of the Law? 2

Section 328 IPC Causing hurt by means of poison, etc. , with intent to commit an offence — �Whoever administers to or causes to be taken by any person any poison or any stupefying, intoxicating or unwholesome drug, or other thing with intent to cause hurt to such person, or with intent to commit or to facilitate the commission of an offence or knowing it to be likely that he will thereby cause hurt, shall be punished with imprisonment of either description for a term which may extend to ten years, and shall also be liable to fine. 3

GRIEVOUS HURT: Sec. 320 IPC 8 clauses…. 1. Emasculation- Depriving male of masculine power. 2. Permanent privation of either of the eye. 3. , , , , of hearing , , , ear. 4. Privation of any member or joint. 5. Destruction or permanent impairment of power of any member or joint. 6. Permanent disfiguration of head or face. 7. Fracture or dislocation of bone or tooth.

8. Any hurt which………. . a. Endangers the life, b. Which makes the victim to suffer from severe bodily pain, c. Or unable to follow normal ordinary pursuits for a period of 20 days. Member means any organ, limb or part of body capable of performing distinct function. E. g. – Eye, limb, finger, etc.

Role of Doctor �Therapeutic or Medical �Medicolegal role 6

Circumstances of poisoning �Accidental ……… Children �Suicidal / Suicidal gesture �Homicidal – Acute / Chronic 7

Brought to Doctor �With history of Poisoning �Cannot give history of poisoning �Come with history of Snake bite / Hanging / Injuries �Doctor suspects Poisoning �Doctor does not suspect Poisoning 8

Actions by Doctor �In Emergency – Life saving / Acute poisoning / Chronic poisoning �Brought by whom �History – Informant – Consciousness – Sign �Clinical features – Diagnosis �Homicidal poisoning – Second Opinion �Collect Stomach wash / Vomitus / Urine / Faeces / Secretions / Blood / Poison? & or container / Suspected drink or food �Collect / Label / Sealing – FSL / ? Private 9

Case study �Ms B, a recently married lady comes unconscious with history of consumption of excessive sleeping pills to your private nursing home requiring ventilator care, inspite of your treatment for a week, she died in the ICU. What do you do? �After one week police have served you a notice that you have concealed the murder of Ms B by her husband did not allow them to record dying declaration, what next? 10

Information to Police �Compulsorily make MLC �Intimation to Police Private Doctor • Intent - Homicidal – Sec 39 Cr. PC - Inform • Intent - Accidental / Suicide - Sec 309 IPC ? ! • But if called by police – Sec 175 Cr. PC – bound to give information – Sec 202 / 193 IPC Government Doctor Circular – mandates all types – Inform ! 11

If impending Death �Homicidal / Suicidal / Accidental - Arrangements to Record Dying Declaration 12

If Death �Homicidal / Suicidal / Accidental - Arrangements for Medicolegal autopsy 13

Laboratory investigations �Forensic Science Laboratories report - Incorporate and furnish Final Opinion �Private / Clinical Laboratory report - used for clinical judgement and actions 14

Alcohol – Drunkenness exam �Screening test – Breath analyser – positive then sent for medical exam �Requisition �Informed Consent & Informed Refusal - Conscious person - Unconscious person �Medical exam – Clinical exam & Lab inv 15

Drunkenness Opinion �Not consumed Alcohol �Consumed Alcohol But Not under the influence �Consumed Alcohol And under the influence 16