MEDICO-LEGAL EXAMINATION

MEDICO-LEGAL EXAMINATION

Medical case with legal implications where

the attending doctor, after eliciting history
and examining the patient, thinks that some
investigation by law enforcement agencies is
essential
it is the legal duty of the treating doctor
to report it to the police immediately
 MEDICO-LEGAL EXAMINATION
• authority for medico-legal examination
• carried by government medical officers
• informed written consent
• history in medico legal examination
• general clinical examination
• description of injuries
• investigations
• referrals and review
 THE AUTHORITY FOR MEDICO-LEGAL
EXAMINATION

1. Police – MLEF (Police 20)

2. Order by the Magistrate.
3. Order by Supreme Court
4. Order by the High Court
5. Order by the District Court
6. Human right Commission
 MEDICO-LEGAL EXAMINATIONS MUST
BE CARRIED OUT ONLY BY

1. Government medical officers (MBBS or

equivalent qualification) with full registration
in the medical council

Consultant JMO / Assi JMO / DMO / Mo

Medico-legal / Medical officers
( Consider as Experts in F. Medicine)
 MEDICO-LEGAL EXAMINATIONS MUST
BE CARRIED OUT ONLY BY

2. Prof / Lectures (with full registration)

who are serving in the department of
Forensic medicine department

( Consider as Experts in F. Medicine)

 MEDICO-LEGAL DOCUMENTS
1. Bed head ticket,
2. MLEF
3. MLR, Health1135,
4. PMR, Health 42,
5. Medical certificate
6. Declaration of death form
 MEDICO-LEGAL EXAMINATION

1. Begin the examination by introducing

yourself

2. indicating your professional position

and explaining the need for such
examination
 MEDICO-LEGAL EXAMINATION

3. Suitable health worker of the same sex

as the examinee (patient) is present as
a chaperone throughout the
examination.

4. Limit the number of people to a

minimum in the examination room.
 MEDICO-LEGAL EXAMINATION

5. When suspects are produced by

police they must wait out of the
examination room during the
examination but in close vicinity
to prevent escape of the suspect
 MEDICO-LEGAL EXAMINATION

6. Informed written consent should be

obtained from the examinee prior to
medico legal examination
 Difficulties in Consent

1. Consent is not valid

2. Not willing to give consent
3. Consent given with conditions
 Instances where the consent is not
valid

1. Under influence of liquor

2. Minors
3. Mentally retarded / unsound
4. When examinee was not properly
informed
 Not willing to give consent
1. Not benefited by Examination
Eg. Drunkard driver / accomplice

2. Scared
Eg. Assaulted by police / Assailant is a
strong person in the area / husband /
Close relation
History in Medico legal examination

Identification of the Examinee:

1. Name, age, address

2. Date of admission, Ward No:, Bed
head ticket No: Date of discharge
3. MLEF No: / Police
History in Medico legal examination

History of the incident

1. Date and time
2. Place of the incident (scene)
3. Who were there – Number /name
4. Identification – Assailants
5. Weapons used
6. What happened to you
 Difficulties in history taking
1. Unconscious at the time of incident
2. Unable to express – minor , mentally
retarded ,
3. Language – (interpreter)
4. Deaf & dumb –(sign
language interpreter)
5. Fear of the assailant
 Difficulties in history taking
History given by another person:

Document it in your notes

Details of the interpreter
This might ask in the Courts
 General Clinical examination

1. Height & weight

2. General build & appearance
3. Blood pressure & pulse ( injured
person)
4. Presence of scars
5. Clothing (Rape- RTA- Firearms )
 Description of injuries

Complete examination should be done

from head to toe

There may be injuries which are not

known to the patient
 Description of injuries
1. Nature of the injury and shape
2. General position in the body
3. Exact dimension
4. Exact position & direction
5. Significant positive and negative
factors
 Description of injuries
simple description
without technical terms

1. Nature of the injury and shape

Linear abrasion , sutured laceration

Oval shape contusion
 Description of injuries
2. General position in the body

Front of left forearm

Back of the chest
Outer aspect of abdomen
 Description of injuries
3. Exact dimension
5 cm long , 6cm x 3 cm
Circular with diameter of 1.5cm

Depth should be measured in relation to

the tissue planes
Superficial, skin deep, involving muscles
 Description of injuries
4. Exact position & direction
General land marks:
Root of neck
Bridge of nose
Tip of nose
Tip of shoulder
Angle of mouth
4. Exact position & direction
It should be referred
in two dimensions
at right angles to land
mark
2cm away and 3cm
above the left angle
of the mouth
 4. Exact position & direction

Direction of a stab, gunshot should be

given in three planes

Upwards
Inwards
Backwards
 5.Significant positive and negative
factors

a. Timing – healing, infection, bleeding

b. Weapon – both sides sharp (knife)
c. Force – mild, moderate, severe
d. Effect of injury – Haemothorax, EDH
Description of injuries
Grazed abrasion in the left
side of face, 3cmx1cm.
Mid point of the injury
is situated 2cm away
and 3cm above the
angle of the mouth, and
it is directed outward
and to the left. A scab is
present. There is no
evidence of infection.
There is no evidence of
underlying injury.
Description of injuries
Stab injury in the left side of the
front of the chest. 3cm in
length, mid point of the injury is
situated 3cm from the midline
and 144cm above the left sole
of the foot. Sharp end of the
stab is placed at 2.30 position
and blunt end placed at 8.30
position corresponds to a clock
face. It had penetrated into the
chest cavity penetrating upper
lobe of left lung and cause
bleeding into the chest cavity.
Direction of the stab, front to
back, downwards and
outwards.
Description of injuries
 Description of injuries

Gunshot entrance wound in the left of the forehead. The wound of

entrance consist of central hole measuring10x 8mm. It is situated
2cm from the midline, above the left eye brow,167cm from the left
sole of the foot. The wound track enters the cranial cavity through
the frontal bone and traverses the brain with complete disruption of
frontal third of the left frontal lobe, right parietal and occipital lobes.
Bullet exited through right side of the occipital bone.
Exit wound in the back of the head on right side, measuring 20 x
25mm, situated 2.5 cm from midline and 152 cm from right sole of
the foot. The wound track direction is towards right, downwards and
backwards.
 Investigations

1. X rays - suspicious of fracture

2. Ultrasound scan – Hidden contusions
3. Nail scraping – Identification of assailant
4. Blood – identification of assailant
 Investigations

5. Vomitus – alleged poisoning

6. Vaginal smear – spermatozoa
7. Vaginal swab – vaginal secretions
8. Audiogram - hearing
 Referrals and review
ENT Surgeon – hearing impairment / loss
Injuries in the nose

Eye Surgeon - Visual impairment / loss

Injuries to eye
Psychiatrist - Rape victims / Child abuce
Expose to tragedy situation
 Referrals and review

General Surgeon
General physician
Orthopaedic surgeon
 MEDICO LEGAL EXAMINATION
FORM
The MLEF is a Police referral form for
medico legal examination
It has 3 parts
Two parts are send to the Doctor
The doctor fills it an returns the ‘police
copy’ and retains to ‘medical officers
copy’
 MEDICO LEGAL EXAMINATION
FORM
1) Detail history of the injuries according to the
patient’s account
2) Identify the injury types
3) Classify/ categorize the injuries according to
severity, direction number etc

4) Assess circumstances in which it happened –

weapons used, drugs, alcohol, fight, car accident etc

5) Give an opinion as to the cause of the injuries

 MEDICO LEGAL EXAMINATION
FORM

• Based on the information in the MLEF

police decides under what offence the
assailant should be prosecuted.
 MLEF - ISSUED FOR

1. Assaults
2. Child abuse
3. Road traffic injuries
4. Sexual assaults
5. Examination for alcohol
6. Torture
 Police 20
Medical Officer’s Copy
Medico – Legal Examination Form

1. Police Station : 2. Date of Issue: 3.No.

4.Full Name and Address of the examinee ………………………………. 5.DOB……..

6.Age …….

M
F
7.Reason for referring for examination …………………………………………
8. Police Officer Issuing: …………………………………………. Signature:
………………………………………….
Rank/ Reg No: …………………………………… Name :
……………………………………..........

Part B: (9-22) To be filled by Medical Officer

9. Produced by …………………………………………………………………………

10.Admission: 11. Examination: 12. Date of discharge:

Hospital: Ward: Data and Time:

Date:
Place:
Time: B.H.T.No.
13.Nature of the bodily harm:
Abrasion: Contusion Laceration Stab

Cut Fracture Firearm inj. Burns

Bite Dislocation/Subluxation Explosive inj. None

Internal injuries
………………………………………………………………………………………………………………

Other ………………………………………………………………..

14.Nature of Causative Weapon

Blunt Sharp Firearm Explosive devices

Other…………

15. Category of Hurt :

Non- grievous Grievous Fatal in ordinary course of nature

If Grievous , does it endanger life ? yes No

 16.Examinationa for 17. Examinationa for Consumption of
Consumption of alcohol: drugs :
Breathing smelling
Consumed Under influence
Under influence
Negative
Negative

18. Examination of alleged sexual assault ……………………………………………………………

a. Brief history given by examinee …………………………………………………………………..
b. Findings of examination relevant to given history:
i. Signs of vaginal/ hymen penetration present
ii. Signs of anal penetration present
iii. Signs of Consistent with inter labial penetration present

19. Investigations…………………………………………………………

20.Referrals …………………………………………………………………

21. Other opinions / Recommendation ……………………………………………..

22. Remarks ………………………………………………………………………………………………..

Ref. No.
Signature:
Full Name, qualifications ,SLMC Reg No, Designation of the Medical
officer
MEDICO LEGAL EXAMINATION FORM
 MEDICO LEGAL REPORT

• Medico-Legal Report (MLR) is a detailed

expansion of the MLEF.

• The Magistrate's Court will summon the

JMO to send the report to court.
MEDICO LEGAL REPORT
MEDICO LEGAL REPORT
MEDICO LEGAL REPORT
THANKS