Doctors Republic

MLC of an already stitched wound :- *Now i will try to post about real time problems in medicolegal cases which we receive in messages from community. This is very common problem.Patient come to you with a docket from police and the wound is already stitched.  In this case ask from where the stitches are done. If it is done in a gov hospital and from a doctor in that hospital then u can ask the MS of that hospital or incharge to provide you with file or record of that procedure .Remember that attested documents from the hospital is required. attestation must b done by the incharge of that hospital. If it is not done by by a doctor in a gov setup or there are no notes available then do not open stitches. Advise Xray or USG or any other concerned investigation and send patient to surgeon or related specialty for expert opinion. if nothing found then declare with simple A1/F1 whichever is applicable. Never remove stitch. We do not harm patient care over legal cases. Opening ...

Never perform MLC outside the designated building. Never take MLC register with you anywhere outside hospital. Its illegal. Not even secretary health can ask you to do it. Medicolegal officers are under no authority except the court of law when it comes to mlc and postmortem. Anyone asking you to do mlc or postmortem against normal procedure is your enemy.Opponent party can go to court against you for doing mlc in secret or going to specific place. It is considered as biased mlc. And no one will come to your aid at that time. So be very harsh and rude to anyone asking you to do mlc out of the way.Including MS, CEO and DCs.

What if you issued any MLC wrong and realized later about your mistake? In past few days i have received many questions regarding this. So lets clear it out. If you have issued an MLC and did a mistake. For example like in some declaration or in fabrication then what can b done... There are two possibilities. 1st is that you have not handed the carbon copy to the police yet (in many cases to the victim). well in that case its easy. either correct it there and sign on it. Or t ear off that mlc and write a new one. Avoid tearing in front of the party. Take register to some dark place  😁  and tear it there. In second situation you have given the carbon copy to police/victim. In this case you will going to need that carbon copy back to make changes(original and carbon copy both has to bb corrected) . You will write letter to SHO police of that police station and ask him to return the copy as you want to correct error in it. You will not ask victim or party to return the cop...

SC of pakistan banned medco legal officer to describe provision of law,they could only describe the nature of injuries PLD 2017 SC 730

Dispensar during MLC This is something that new doctors working in periphery should know "Dispensar ki shetania"  😁 These guys sell doctors without them knowing during MLC. How that happens? Let me explain.. When someone comes to hospital for MLC they first encounter the local dispensar working in trauma center. In simple words it is the dispensar who usually see the wound 1st hand. They are so much experienced that by looking at wound they immediately determine how serious wound is. So if the doctor is honest then they tell the party that they will talk to the doctor for getting a strong section on the wound although wound is very simple. They say that doctor may ask huge amount. Now when the patient enters and you start declaring section (like A2) which is totally genuine, your dispensar moves out and tell the party that he convinced the doctor to give you non bailable section for 20 thousand but do not ask doctor for money directly as he will deny it in front on oth...

Declaring Fabrication (MLC) This is important post. I have seen many post of young doctors asking about fabrication . This made me write another post about it. Declaring fabrication of a wound is not an easy task. Read carefully and while reading this post stop texting your "love" ones  😁 . (Hum nai chahatay ap ye post tab perho jab aqal ghas chernay gai ho  😜 ). Keep in mind that when you declare an mlc fabricated, it will get challenged. Why it usually get challenged? Its because fabrication is itself a crime. The opponent party will get a very strong case if you declare fabrication. So the party against whom you just declared fabrication will challenge you MLC. This means you should not declare fabrication in simple case of sections A-1, F1 or L-2 even though it looks like fabrication. The reason is these section are negligible and no case will register on these. That is why do not "apnay paon per kulhari marna" in these sections by saying they are fabric...

Simplified Version of Qisas & Diyat Ordinance (For MLCs)

Female Doctors doing male MLCs ... By law female can do male MLCs in presence of a male doctor or dispensar and males can do female MLC in presence of female staff or doctor. Ethically it is highly inappropriate asking females to perform mlcs on males in our society. People will start misbehaving or asking for unnecessary examination if they know a female will attend them. We know our society and i do not think it is appropriate to ask young female doctors to examine the mal e patients for medicolegal if a male doctor is present at the center.SMOs, MS and CEO sometimes are selfish enough to ask females do male mlcs just to avoid doing mlcs themselves. Remember that SMOs, APMOs are not exempted from mlcs. Same goes for male doctors doing mlcs of females. Its highly inappropriate to expose females for examination if a female doctor is available in center. It will b a chaos. The attendents can blame doctor for misbehaving with female victim etc. So u can simply refuse to do mlcs on...

Surgeon Medicolegal punjab is official guidelines for medicolegal. A screenshot of its contents is shown below. I am sharing link to download it. Kindly use laptop or desktop and Google Chrome to open and download it. This is kind of official shortcourse on medicolegal. Click to download File: pdf shared on dropbox public folder.

MLC general tips. 1. Attend MLC as quickly as possible. The more you wait, more they will start gathering crowd and sifarish. 2. Kick everyone out while doing MLC from your room including dispensar. Legally it should be only doctor and the victim unless its a minor or opposite sex. 3. Try not to declare sections on spot. Delay by suggesting investigations and KUO sections and fabrication. The next time patient will come, there will not be so many people with him/her. Usually parties settle things once it gets cool down. 4. Do not listen to dispensars or anyone else suggesting authenticity of the woud by saying they asked witness. Your job is to declare fabrication on medical grounds. Policing is work of police.Do not let dispensar do initial examination. He will expose the bone my fingers. 5. If someone give you a fone and there is someone asking for favor for the victim then either say "Koi masla hi nai" and after call is disconnected do as you think is genuine ...

One month training mandatory for medicolegal work for new doctors according to notification dated 18-05-2018. Last point in notification.  You can refuse MLC and postmortem If you have not taken practical 1 month training. P&S healthcare department notification.

MLC of Acid throw /Attack {What to do in MLC of an Acid Attack} It is mostly done to Kill,Mutilate,disfigure and hurt/injure a person.One should be very carefully examine nature of acid if used,degree of burn and for signs of permanent disfigurement/tissue loss which has very hard sections in law. It could be acute or can be presented after many days,we cannot/should not conclude it as acid/corrosive unless proven otherwise. If victim presents within few hours ,you will have different signs symptoms. 1.Write like normal mlc ,fill in History as given by victim.You can write patient gives history of some acid. 2.In acute case save the clothes if you smell any corrosive ,u have to pack it in parcel paper/wrap it double as paper may corrode for PFSA lahore.Note any discoloration,stiffness,burning/holes in clothes.Write if u smell any acid on clothes. #Examination You can see signs of inflammation on local examination. ~Redness ~swelling ~tende...

MLC of Alcohol intake Police mostly brings accused people because of they arent paying off\party busted\sometimes just to punish some innocent ,so you have to give your opinion on MLC paper nomatter what police says,you can get them out of ur room or tell them to sit quietly in the corner and let u do ur job,u have authority. But if u find they are drunk , dont let go ,write ur preliminary report. 1.   See docket ,if its not there ask them to produce them 2.   Make sure the culprits named in papers and those infront of u are same persons, sometimes you examine other person,in that case ask police to attach their CNICs. 3.Write in history time period of intake and when they are brought to u, if its few days ,nothing will come out of it ,means police ne karwae daali hy . 4.   Ask police to go wherever and bring you sample bottles,if they dont get it ,postpone it unless they provide u,if they comes at midnite 5.If u have got the bottles then procee...

MLC of Firearm injury Patient is mostly serious if bullet hits chest or abdomen/head/neck, you dont have time to wait and keep the victim, In that case : 1.   Vitally stable the victim,dont stitch or remove the bullets ,only apply pressure bandage. 2.   Write 2 marks of identification by yourself ,you see with your eyes(its important). 3.   Color of clothes and note down number/size of holes u see at entry and exit sites. Roughly write at a rough paper what u think bullets corresponds to respective holes in the clothings. Note any soot/ blacking / burning at cloth fibers at site of entry of bullet. You write it all as your record to further copy it on MLC page . 4.Now examine the wounds, Make a drawing on rough paper,this drawing you will draw on the mlc paper later on. 1stly you make sure its a bullet or not/superficial /deep/single entry wound in chest, blacking/ sooting /hair burn. Is there exit? Make trajectory of path and if u don...

MLC of Sodomy This is very important from mlc point of view because there is #DeathPenalty for the accused in case of Minor(child) ,so we should do it carefully as some innocent can get hanged. #1 .Victim comes to you with police docket ,its done on same mlc register like normal fight mlcs. #2.Start filling the name address etc , you should write 2 marks of identification carefully,, in last Thumb of both the child and his guardian must be there at page of mlc. #3. You will take complete #history from victim,time,place,either he was on gound/standing,did he resisted,has he passed stool how many times,duration of incident and coming to u ,depth etc ,from this you will have a view about the event if its right or fake.You will write all on brief history,it will help you in coming examinations. #4. #Examination points : Now you will just examine victim with one guardian/father( its not compulsory,upto u) ~ Examine oral cavity for signs of bruises ,bleeding,lips ch...

MLC of Rape Victim/Sexual assault on female 1.   This case is done by WMO. Male doctors are not allowed to do examination on rape victim (female). So never attend a rape MLC if u r a male doctor. 2.   Be very careful in these cases as 90% of these are fake.Usually males of those family are also involved . 3.   There are cases where husband actually performed sex with the wife before bringing her to the doctor as a raped by an opponent. 4.   In case of unmarried females you should know the points of vaginal examination and hymen ruptures of fresh or recent tears.You can google these so m not gonna explain these here. 5.   You should know that the timing between rape and the arrival of victim to hospital for examination is very critical . when i was in training at PFSA Dr nasir (head of PFSA) told us that if victim came after 2 days and she has bathed ,urinated ,defecated then u can write on MLC that sample taking is not necessary as c...

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. ...