IP International Journal of Forensic Medicine and Toxicological Sciences

Print ISSN: 2581-9844

Online ISSN: 2456-9615

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IP International Journal of Forensic Medicine and Toxicological Sciences (IJFMTS) open access, peer-reviewed quarterly journal publishing since 2016 and is published under the Khyati Education and Research Foundation (KERF), is registered as a non-profit society (under the society registration act, 1860), Government of India with the vision of various accredited vocational courses in healthcare, education, paramedical, yoga, publication, teaching and research activity, with the aim of faster more...


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Jagtap and Patekar: Study on pattern of medicolegal cases in casualty of government medical college Kolhapur Maharashtra


Introduction

A medico-legal case is any type of case where the accompanying registered medical practitioners (RMP), after obtaining a detail history and examining the patient, thinks that some investigation or procedure by law enforcement agencies is required to establish and fix responsibility for the case in accordance with the law or legal ground.1 Casualty department is that the backbone of each hospital. It deals not only with medical and surgical emergencies around the clock but also deals with an enormous number of medico-legal cases which comprises accidents, assaults, burns, poisoning, and sudden death operative deaths, suicide, homicide, any suspicious deaths and cases referred from police or court.2 It is a responsibility of a registered medical practitioner to judge each and every cases properly and in doubtful cases, it's better to tell the police. This saves the doctor from unnecessary and needless allegations later.1 Medico-legal case is an integral part of medical practice that is frequently encountered by medical officers working in emergency department. For such patients, not only treatment, but exhaustive documentation is additionally mandatory. The on-duty doctor within the casualty department has got to first stabilize the tolerant any emergency. He is also duty sure to register a specific case as a medico-legal case whenever indicated and has got to examine an equivalent. In the present study an effort is formed to understand the workload of medico-legal cases and their pattern. The objectives of the study was to assess the frequency and pattern of medico-legal cases reported at a tertiary care hospital and to spotlight the vulnerable gender, age, residence and the cause.

Materials and Methods

This is a retrospective study of medico-legal cases registered in a casualty of Rajashree Chhatrapati Shahu Maharaj Government Medical College & CPR Hospital Kolhapur, Maharashtra for a period of two years from 1 st Janaury2018 to 31 December 2020. During the study period a total of 2450 medico-legal cases were registered. The collected data was analysed and represented in form of tables by mentioning various parameters and compared with other resembling studies Individuals from both genders and all age groups were included and people with no medico-legal perspective were excluded from study.

Observation

Total number of medico-legal cases included in the study were 2350 from the record of medico-legal cases from 1st Janaury2018 to 31 December 2020 Out of 2350 cases, 1754 (71.59%) were males and 696 (28.40%) were females. In the present study, maximum number of cases 905 (36.93%) were from the age group of 21-30 years followed by 508 (20.73%) from the age group of 31 – 40 years. Majority of cases 1573 (64.20%) reported to casualty within 1 hour after the incidence, whereas 154 (6.28%) cases reported delayed (after 12 hours) of incidence (Table 4). The maximum cases 1154 (47.10%) were of road traffic accident (RTA), followed by fall from height in 415 (16.93%), poisoning in 363 (14.81%)cases and assault accounted for a total of 165 (6.73%) cases while some cases of 157 (6.40%) snake bite were noted during the study. Maximum numbers of cases 1921 (78.40%) were discharge after the completion of required treatment, while 235 cases (9.59%) were dead during the course of treatment and few 115 cases (4.69%) were mentioned higher center for further treatment.

Table 1

Age & sex distribution of patients

Age Group (Yrs)

No of cases

Percentage

0-10

27

1.10%

11-20

405

16.53%

21-30

905

36.93%

31-40

508

20.73%

41-50

315

12.85%

51-60

165

6.73%

61 & above

125

5.10%

Total

2450

100

Table 2

Gender wise distribution of cases

Gender

No of cases

Percentage

Male

1754

71.59

Female

696

28.40

Total

2450

100

Table 3

Pattern of medicolegal cases with sex wise distribution

Medicolegal cases

Male

Female

Total

Poisoning

227 (9.26%)

142 (5.79%)

369 (15.06%)

Assault

131 (5.34%)

34 (1.38%)

165 (6.73%)

Trauma

103 (4.20%)

30 (1.22%)

133 (5.42%)

Road traffic accident

923 (37.67%)

231 (9.42%)

1154 (47.10%)

Burns

9 (0.36%)

18 (0.48%)

27 (1.10%)

Snake Bite

105 (4.28%)

52 (2.12%)

157 (6.40%)

Hanging

9 (0.36%)

12 (0.48%)

21 (0.8%)

Fall

251 (10.48%)

158 (6.44%)

409 (16.69%)

Dog bite

9 (0.36%)

6 (0.24%)

15 (0.61%)

Total

1767

677

2450

Table 4

Distribution according to outcome of the cases at casualty and sex

Disposal of cases

No of cases

Total

Brought dead

35

1.42%

Discharged after treatment

1921

78.40%

LAMA

155

6.32%

Referred to higher centre

115

4.69%

Hospital death

224

9.14%

Total

2450

100%

Table 5

Time period between incidence & reporting to casualty

Time period

No of cases

Percentage

< 1 hr

1573

64.20%

1 - 2 hr

335

13.67%

2-4 hr

215

8.77%

4-12 hr

173

7.06%

> 12 hr

154

6,28%

Total

2450

100%

Discussion

In our study it was observed that most of the victims were males (71.59%). Our findings are consistent with study conducted by Trangadia MM et al.3 Hussaini SN et al.4 Yatoo GH et al.5 The predominance of males over females may be attributed to the male dominance in the society and males who work outside to earn their daily bread are more vulnerable, while females usually stay at home and look after the house hold work. In present study majority of victims (36.93%) from age group 21 – 30 years followed by 31 – 40 years (20.73%) and 11 – 20 years (16.53%). Our results were also similar with the study conducted by Trangadia MM et al.3, Hussaini SN et al.4, Yadav A et al.6 Result shows that the people of the most active and productive age group involve themselves in outdoor activities, so they are more prone to accidents.

In the present study road traffic accidents constituted 47.10%, poisoning and fall constituted 15.06% & 16.69% respectively followed by assault in 6.73% of cases. The findings related to majority of medicolegal cases of our study are according to the studies conducted by Trangadia MM et al.3, Yatoo GH et al.5 where road traffic accidents constituted majority of medico-legal cases. Poor road condition prevailing for a decade in both urban and rural areas, increasing population in the city day by day contributes maximum number of road traffic accidents. Yadav A et al.6 & Malik Y et al.7 Studies finding showed that maximum cases reported to casualty were of poisoning which differ from present study. Majority of the victims were discharged from hospital after treatment (78.40%) while in 6.32% of the victims had absconded or took LAMA (Leave against medical advice), 4.69% of cases were referred to higher centre and death was noted in 9.59% of cases which were subjected for medico-legal autopsy. Our observations are according to study conducted by Trangadia MM et al.3, Yadav A et al.6 This shows the notice and health consciousness among the population, effectiveness of early initiation of treatment in emergency cases and also sophisticated facilities to affect medical emergencies.

Conclusion

Casualty or emergency department of a medical college receives different types of emergency cases including medico-legal cases. In the present study maximum number of medico-legal cases was of road traffic accident, seen among young individuals or adults such incidences can be prevented or minimize by giving proper education, awareness, training of safety standards by law enforcement agencies. In this study maximum number of patients were discharged successfully after treatment and on the other hand referral to higher centers and the number of hospital deaths were very minimum. Medico-legal expert giving training to the medical officers to hold out medico-legal works safely and scientifically can definitely decrease the problems of negligence cases during a developing country like India. In this present study the maximum number of medico-legal cases are accidental in nature, seen among young individuals. Such incidences are often prevented by giving proper education, awareness and training of safety standards by administrators, health officials, social workers and NGOs to the overall population. Suitable measures have to be taken such as separating casual attendees & emergency cases at the entry point of casualty & channelizing the casual care seekers to OPD, thereby to minimize the burden on staff.8

Conflict of Interest

None.

Source of Funding

None.

References

1 

S S Agarwal L Kumar K Chavali Legal medicine manual1/e2008310

2 

A Aggarwal Textbook of Forensic Medicine and Toxicology2014636

3 

M M Trangadia R A Mehta N H Rada B D Gupta Profile of medico-legal cases in tertiary care hospital in Jamnagar, Gujarat: Retrospective study of one yearJ Res Med Dent Sci2014245762

4 

S N Hussaini C S Kulkarni A K Batra Profile of medico- legal cases coming to casualty of Government Medical CollegeJ Forensic Med201322215

5 

G H Yatoo S Jalali A Malik A Khan Profile and pattern of medico-legal cases attending tertiary care hospital in North IndiaInt J Med Pharm Sci20155518

6 

A Yadav N K Singh Pattern of medico-legal cases in rural area of FridabadJ Indian Acad Forensic Med2013351602

7 

Y Malik R Chawla G Sharma P Malik R Singh A Tripathi Profile of medico legal cases in causality of a rural medical college of HariyanaJ Indian Acad Forensic Med201335436775

8 

A G Davison A C Hildrey M A Floyer Use and misuse of an accident and emergency department in the East End ofJ Royal Soc Med19837613741



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© This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Article type

Original Article


Article page

75-77


Authors Details

Nikhil Jagtap, Manoj B Patekar


Article History

Received : 06-09-2021

Accepted : 10-09-2021

Available online : 30-09-2021


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