Fabrications

Fabrication

(MLCs Part 3)

This is a part of MLC that will annoy you the most in a hospital.Out of 100 MLCs 90 are fabricated.I will explain in point below how to detect them and save your neck but first some overview.

There are people in hospital usually hospital staff who take heavy money to fabricate wounds on body.They are so expert that it will b hard for you to detect original wound from a fabricated one.They even create bruises, swellings and blisters and take thousands in payment.Unfortunately Most of the time its your dispensars who are involved in such practice and they brought patients to doctors who are less expert and to those who they knew will be forced to bend.If you start declaring fabricated wound then they will start making propaganda against you and send people to threat you .

In many hospitals seniors are involved in issuing fake MLC and sometime MS and higher authorities took bribe so they will make ur life hell if you stand against them.

Now there are two basic problems in taking bribe and bending to such practices.First is that it will b the shortest shortcut to Hell.Innocent people suffer and i do not think of any other way more efficient than putting someone in jail and to police in bringing the wrath of ALLAH.Second problem is even if u do not take money and give single favor then the person or party who made that fabricated wound will blackmail you for that favor .They will threat you to make more fake MLC or else expose or challenge your previous MLC in court.So never ever compromise on this. You may loose ur licence over it

There are two main type of fabrications.Completely fabricated one.Patients came to you with these wound.Either your dispensar is involved in which case he will tell you that these are poor people and He personally asked around and the party is very poor etc.. Or they come to hospital with an original wound but then dispensar manipulate that wound right there and then.For example he may deepen a wound with fingers to expose bone (the most common).

Now how to detect these.

Its based on experience to detect a fabricated wound.You have to detect a wound as fabricated on medical grounds.For example patient tell you that he is hit by a brick on head but the wound is surgically cut with blade.Or the blood stains on clothes or torn part of clothes does not match with wound location. Or local anesthesia is there and patient shows no sign of pain on touch .How to save yourself from these?

1.Try to involve specialties in making your opinion.A doctor taking bribe for fake MLC always try to avoid involving other experts.

2.If you are suspecting a fabrication then do not declare it immediately.The party who fabricated the wound paid a handsome amount for it.they will shout and threat and the dispensar will further ignite

it.Usually there are many people with them when they first come.So Our goal is to stall the declaration.This can be done by ordering investigations.For example Xray for every blunt weapon injury of a bony part below.USG for any injury to body cavity below .And KUO (kept under observation)the fabrication.Remember to ask expert opinion of radiologist regarding fabrication and age of fracture.This will give you two benefits.One is u have many opinions and investigations to support ur decision and second is that party will go back and next day they will come alone and heat of the moment is died.

3.  You can also ask other expertise for fabrication suspicion in written.never do anything verbal.Ask surgeon to give his opinion on injury.Or ent ,dentistry .Never declare a teeth injury by urself.its job of dentist to tell u what type of injury it is and his comment on fabrication.

4.Never declare fabrication yes or no untill all investigation and expert opinions are back.then mention those in ur MLC and declare fabrication.untill then KUO the fabrication.

5.If u see that the movement of arm is normal but xray declared it as fracture then send it back to do the xray again or u can declare it as fabricated by saying that "clinical picture on examination and the investigation do not match so injury may b fabricated".

6.You can say that possibility of fabrication cannot b completely ruled out so subject to police for further investigation.

7.Out of 4 injuries 3 can b genuine and 4th can b fabricated.u can declare them separately