TOP 30
MEDICOLEGAL TIPS
FOR DOCTORS
                                    Disclaimer
This document has been compiled by our research team and is solely intended for the
personal use of qualified medical doctors and healthcare institutions. The objective is to
spread awareness about the medicolegal implications of commonly encountered scenarios in
a clinician's daily practice. Please note that this document does not constitute legal counsel
and is not a comprehensive list. When in doubt or in the event of a medicolegal action, the
reader is advised to seek professional legal help. PlexusMD expressly disclaims any liability
arising out of the use of the information provided here.
01                                                          For your safety,
                                  avoid these common pitfalls:
1. Anaesthesia should be administered only by qualified
   anaesthetists and not by the surgeon themselves
  (Source: Dr.G.V.S. Rao v K. Chinna Reddy & ANR. on 20 Sep 2016 - Revision Petition No.
  4436 of 2010)
2. Insist on written proof of a specialist consultation instead of
   relying on the verbal statement of patient
  (Source: Smt. Karuna v Maharaja Agarsen Hospital on 26 May 2016- Complaint Case No.
  60/2009)
3. Giving advice on telephone, messages and email should be
   avoided, except in case of grave emergencies
  (Source: M/S. Sankar Prasad Bose & Anr. v Dr. B.N. Basu Memorial Clinic on 14 Jan 2016-
  First Appeal No. 974 of 2015)
4. In case of an on-table complication or change of the agreed
   course of action during surgery, the surgeon/doctor must
   himself/herself inform the relatives and not communicate
   through a team member, anaesthetist, nurse or any other
   person
  (Source: Tupakula Sankar Rao v Lakshmi Nursing Home on 13 Oct 2012- First Appeal No.
  FA/451/2011)
5. Short forms/abbreviations that are not universally accepted
   and are capable of being misinterpreted should be avoided
  (Source: Dr. Akhilesh Chandra Gaur v Manik Chand on 21 Sept 2016-Appeal No. 685 of
  2006)
02                                               You have the right to
                                           refuse treatment when:
1. The patient seeks discharge in the absence of the in-charge
   doctor or expresses lack of confidence in substitute doctor
  (Source: Ajit Kumar Roy v Dr. Amitabh Mishra & Ors on 14 Aug 2012- Revision Petition
  No.3068 of 2010)
2. The patient insists on a request that is medically
   contraindicated
  (Source: Sanjay Mutha & Ors v Dr. Jayashree Desai & Ors on 1 Feb 2013- Consumer Case
  198 of 2001)
3. The patient is not willing to pay fees (admission can be
   withdrawn)
  (Source: Ajit Kumar Roy v Dr. Amitabh Mishra & Ors on 14 Aug 2012- Revision Petition
  No.3068 of 2010)
4. Necessary infrastructure or proper consultants are not
   available
  (Source: Siliguri Nursing Home Pvt. Ltd v Mr. Aswini Dey Sarkar on 12 Sept 2008- SC Case
  No. 401/A/07)
 01
03                                                                  Precautions
                                                while taking Consent:
1. Consent form must be filled by one doctor/nurse, in one
   sitting, if possible without changing the pen
  (Source: Dr. Ajay Kumar Gupta v Indira Gandhi Institute on 1 May 2008- First Appeal No.
  429 of 2002)
2. Different consent is required for anaesthesia and surgery
  (Source: Dr. Ajay Kumar Gupta v Indira Gandhi Institute on 1 May 2008- First Appeal No.
  429 of 2002)
3. Consent must state name, dose and type of anaesthesia
  (Source: Dr.G.V.S. Rao v K. Chinna Reddy & ANR. on 20 Sep 2016- Revision Petition No.
  4436 of 2010)
4. In case of multiple procedural options, the patient’s consent
   must be taken for all options - you can download consent
   forms for different procedures from - plexusmd.com/consent
  (Source: Dr. Ajay Kumar Gupta v Indira Gandhi Institute on 1 May 2008- First Appeal No.
  429 of 2002)
5. Separate consent must be taken for blood transfusion
  (Source: M. Chinnaiyan v Sri Gokulam Hospital and Anr. on 25 Sept 2006)
6. If the patient is illiterate/not well versed in English, it is
   advisable to explain all information in a language known to
   the patient and get the consent form attested by an
   independent witness who understands the form
  (Source: Subodh Chandra Shah v Rajasthan Hospital. on 4 July 2012-Consumer Case No.
  171 of 1997)
7. In case is doubt regarding patient’s capacity, it is advisable to
   take the signature of a near relative
  (Source: Rajesh Taneja v Kaiser Hospital & Ors on 17 May 2016- First Appeal No. 145 of
  2015)
04                                                          or prescription:
                                                                             Advice
1. Investigation reports must always be in writing except in
   emergencies
  (Source: Anoop Awasthi v Dr. T. Kataria on 18 March 2016- Consumer Case No. 84 of 2002)
2. Avoid asking a patient to purchase medicines, disposables,
   implants, etc. from a particular chemist/dealer only
  (Source: Dr. H.R. Nayyar Memorial Hospital v Gurbachan Singh Bhatia on 5 Oct 2010-First
  Appeal No.821 of 2004)
3. Avoid referring patient to a facility/hospital which can cause
   conflict of interest like your own private clinic
  (Source: Veena Batra v Ram Lal Kundan Lal on 13 May 2008 – Complaint No. C-297 / 1999)
4. Standard instruction cards about pre- and post-intervention
   precautions should be issued in English or even local language
  (Source: Mrs. Sucheta Sanyal v Dr. M. Bhowmik & Anr on 5 May 2014- Consumer Case No.
  25 of 2002)
05                                    transfers and emergencies:
                                                                     Procedures,
1. While transferring a patient, the sender must mention the
   reasons for transfer and condition during transfer while the
   receiver must record the condition on arrival
  (Source: Dr.G.V.S. Rao v K. Chinna Reddy & ANR. on 20 Sep 2016- Revision Petition No. 4436
  of 2010)
2. In case the doctor or Institute is not comfortable/competent in
   attending to an emergency patient, legal duty involves
   selecting a proper hospital/doctor for transfer, providing all
   facilities for transfer, providing proper care, and managing the
   patient during the transfer
  (Source: Orchid Hospital v Savita Gulyani on 12 July 2010 -Appeal No. A-2008/752)
3. In any emergency, procedural formalities must be put aside
   and patient must be provided treatment first
  (Source: Gurunath Donkappa Keri & Ors v State Of Karanataka on 6 May 2009- Criminal
  Appeal No. 341 of 2006)
4. In case of difference in opinion with other doctor, the principal
   surgeon should personally remain present during the surgery
  (Source: P.B.Desai v State Of Maharashtra & Anr on 13 Sept 2013- Criminal Appeal No.
  1432/2013)
06                                                 Maintaining Records
                                  and Preventing Legal action:
1. When legal action is anticipated, doctor is advised to re-order
   test or seek opinion from another doctor/hospital/lab and
   document the second professional opinion/test result
  (Source: G. Ravender Rao & Ors. v Ghulam Dastagir & Anr. on 21 Jan 2013-First Appeal
  No. 176 of 2006)
2. It is mandatory to preserve the medical records of a
   deceased patient for a period of three years
  (Source: Siliguri Nursing Home Pvt. Ltd v Mr. Aswini Dey Sarkar on 12 Sept 2008- SC Case
  No. 401/A/07)
3. It is advisable to send the dead body for post mortem rather
   than not sending it, if a medico legal problem is foreseen
  (Source: Dr.Janak Kantimathi Nathan v Murlidhar Eknath Masane on 17 April 2002- First
  Appeal No. 739 of 1994)
4. In case the patient makes a request for his/her medical
   reports, it should be provided within 72 hours
  (Source: MCI Code of Ethics Regulations, 2002)
07   l
                          In case of an act of violence,
                                   cite the Medicare Act:
1. Any act of violence against doctors/hospital staff or any act of
  damage to a hospital/clinic is prohibited under the Medicare
  Service Persons and Medicare Service Institutions (Prevention
  of Violence and Damage to Property) Act
2. Sensitise your patients and their relatives about this Act by
   displaying the poster related to the Act in your Hospital/Clinic
   OPDs and waiting rooms – you can download the poster from
   plexusmd.com/medicalprotectionact
3. In case of any act of violence against you, lodge an FIR with
  the nearest police station under the Medicare Act and not as
  physical assault
  Under this Act, any such act of violence is a non-bailable
  cognisable offence with up to three years’ imprisonment
  and/or maximum fine of Rs.50000
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