Professional Documents
Culture Documents
eastzon
emedico.com
www.eastzone
medico.in
To Crisis Trauma
To Be Continue........
lawsuits are:
Poor results obtained from treatments.
Improper treatment.
Improper communication/documentation.
Infection.
Diagnostic errors.
Wrong side/level surgeries.
Nerve/vessel injuries and Compartment Syndromes
Common injuries in legal Forums: The top ten conditions that lead to frequent
medico-legal cases in orthopedics are:
1. Fractures of femur.
2. Fractures of tibia.
3. Disc lesions.
4. Osteoarthritis (Arthroplasty).
5. Fractures of radius and ulna.
6. Ankle injuries.
7. Knee ligament/menisci injuries.
8. Back disorders, lubago sciatica.
9. Humerus fractures.
10. Hand injuries.
MEDICAL EMERGENCIES
It is an accepted norm across the world that in injured and critically ill patients, the priority of
the doctor is to save life. However, often there is reluctance on the part of doctors to attend to
the emergency needs of patients who, in medical jargon, are medicolegal cases. This
unwillingness is largely due to medical professionals being unaware of their ethical and legal
duties concerning the treatment of those brought to an emergency department. Also, there is an
instinct among doctors to evade the inconvenience associated with subsequent lengthy and
tiresome legal proceedings. This is despite of the fact that the Supreme Court of India has clearly
stated that the first obligation of a doctor is to save life and documentation and paper work
could be performed later on. The court ruled that zonal regulations and classifications regarding
the jurisdictions of specialized police stations and government hospitals in a given area could
not operate as fetters in the process of discharge of this obligation (to treat an
emergency/injured victim). In a concurring judgment, the court observed that when a man in a
miserable state, hanging between life and death reaches the medical practitioner (either in a
hospital run or managed by the state, public authority, or a private person or a medical
professional doing only private practice), he is always called upon to rush to help such an injured
person and to do all that is within power to save life. It is a duty coupled with human instinct
which needs neither decision nor any code of ethics nor any rule or law.
Another factor for showing reluctance to serious emergency cases is to avoid the mortality in
one's own hospital, particularly in case of private hospitals. More complicated cases are referred
to higher center, particularly the government sector, because death of patient in their own
hospital would bring bad name to the reputation of the hospital. Also, in case of death of their
patient, the relatives often restores to manhandling of doctor/paramedical staff and damaging
the hospital property. The action of police and local government administration like immediate
arrest of doctor under mob/public pressure is another important issue. These kinds of incidences
are increasing day by day and thus are responsible for doctors not handling the emergency
cases (particularly medicolegal cases). This practice further leads to frequent referral of
emergency patients to government hospitals, thus wasting the crucial time during which the
serious patients could have been saved. Also, at government hospitals, there are no clear-cut
demarcation of duties and responsibilities in emergency department. This leads to further delay
in timely emergency services.
India is a country of paradoxes. On one hand, it has new corporate hospitals for
attracting medical tourism and on the other hand, it has not been able to provide the
basic primary health and necessary emergency services to the masses. There is a
serious scarcity of working diagnostic machines, medicines, and infrastructure in its
hospitals. Following are some issues related to emergency services which should be
seriously discussed involving various stake holders without any further delay.
Trauma continues to be one of the major causes of death in India. To avoid
preventable deaths and disabilities, India needs a common effective system that
could provide quality emergency care with equity of access. As compared with
developed countries with proper emergency systems in place, there was no single
system which could play a major role in managing EMS in India. There was a
fragmented system in place to attend the emergencies in the country. In a bid to
address this problem, the Centralized Accidents and Trauma Services were set up by
the Delhi Government in the early 1990s. This service was later expanded throughout
the country. Unfortunately, it did not succeed despite having a toll free number -102
which is the emergency telephone number for ambulance in parts of India.But, there
are different emergency numbers in different states and Union Territories. So, there is
an urgent need of a centralized Medical Emergency body which could provide
guidelines for setting up emergency services with a single telephone number across
the country. The centralized body should be involved in preparing protocols, imparting
technical assistant, training, capacity building, and accreditation of emergency
services. Procedures, protocols, and personal skills need to be standardized along with
formation of legislation in parliament to provide legal protection for the providers of
emergency services. The initiative taken by the Gujarat state government in setting
up the Gujarat Emergency Medical Services Authority is a welcome step in right
direction. This was the first state to actually pass emergency services regulation in the
country. By bringing together government, non-government organizations (NGOs), and
other private agencies, a state-wide system of emergency care has been set up in
Gujarat. If India could have Securities and Exchange Board of India, Telecom
Regulatory Authority of India, and Insurance Regulatory and Development Authority to
regulate share market, telecom, and insurance services, respectively, then setting up
a regulatory body for regulating the health services, particularly emergencies, could
also be considered seriously.
Section 354 : Assault or criminal force to woman with intent to outrage her modesty
Section 354 A (1): Sexual Harassment man committing any of the following acts: (i) Physical
contact or advances which include unwanted sexual overtures, (ii) Request for sexual favors,(iii)
Showing pornography against will, (iv) Making sexually color demarks.
Section 354 B: assault or use of criminal force to any woman or abetment to such act with the
intention of disrobing or compelling her to be naked.
Section 354 C: Voyeurism - Any man who watches, captures or disseminates the image of a
woman engaging in a private act in circumstances where she would usually have the
expectation of not being observed.
Section 354 D: Stalking(1) Any man who: (i) follows a woman and contacts, or attempts to
contact such woman repeatedly despite a clear indication of disinterest or (ii) monitors the use
by a woman of the internet, email or any other form of electronic communication. Such conduct
shall not amount to stalking if (i) it was pursued for the purpose of preventing or detecting crime
by a man entrusted with such responsibility by the State (ii) it was pursued under any condition
or requirement imposed by any person under any law; or (iii) in the particular circumstances
such conduct was reasonable and justified. Imprisonment not less than 1 year but which may
extend to 5 years and fine .
Section 354 A (2): An offence specified in clause (i), (ii) or (iii) of subsection(1) shall be punished
within presentment which may extend to three years and/or fine.
Section 354 A (3): An offence specified in clause (iv) of sub-section(1) shall be punished within
presentment which may extend to one year and/or fine.