APPLIED FORENSIC MEDICINE

Applied Forensic Medicine

Applied Forensic Medicine, also known as Forensic Pathology or Legal Medicine, is a branch of medicine that deals with the application of medical knowledge and principles to legal issues and cases. It primarily focuses on the examination of deceased individuals in order to determine the cause and manner of death, especially in cases that involve potential criminal activity or where the circumstances surrounding the death are unclear.

Here are key aspects of Applied Forensic Medicine in the medico-legal context:

• Examination and Documentation
• Cause and Manner of Death Determination
• Evidence Analysis and Interpretation
• Expert Testimony
• Identification and Profiling
• Forensic Psychiatry and Psychology
• Forensic Anthropology

Regulations of MLC Register Filling

1. Consent

The attending physician oversees obtaining the patient's consent. Even if such documentation is left to the nursing staff, a doctor must make sure that the right steps are being taken.

The patient's consent is not necessary to register a case as a medico-legal case (MLC). MLC should be registered even if the patient is a victim of violence and does not desire a police report. However, unless the patient is being detained by police, agreement is needed before an examination of a patient in a medico-legal proceeding can take place.

The following circumstances do not call for consent.

• Emergency medical situations: consent to emergency care is implied.
• In the interest of public health, treat diseases that need to be reported.
• A person may be forced to be fully interrogated at the police's request of the Criminal Procedure Code.
• Every time a female is to be examined, it must be done by or under the supervision of a female doctor.
• Court-ordered psychiatric evaluation and therapy.

When the patient is competent to do so, consent must be gained from them as much as feasible. Legal guardian consent should be obtained in cases when the patient is a minor, unconscious, or mentally unstable. When a patient is unconscious, permission to emergency care is assumed.

2. Marks of Identification

For future identification, two identification marks must be documented. Identification marks should be placed on easily visible body portions where they can be exhibited in court without the patient feeling embarrassed. On the medico-legal case (MLC) form, fingerprints are also obtained for identification.

3. General Assessment of the Patient

A person is externally examined by looking at their appearance, actions, and general physical examination (GPE). Vomit, blood, and seminal stains are checked on clothing. Clothing that has been torn or has faults that correspond to injuries is noted.

Vital signs including blood pressure, temperature, and pulse are noted in GPE. Any signs of shock are noticed, regardless of whether a person is conscious or unconscious, tense, anxious, or quiet. It is inspected if there is any bleeding from the mouth, nose, ears, or genitalia.

Conduct in general, particularly considering medication effects. Alcohol or toxins are highlighted. In suspected poisoning situations, the eyes and pupils are inspected. In cases of suspected alcohol poisoning or intoxication, specific rules must be followed. Alcohol odour in the breath, mouth, posture, and demeanour are significant indicators of alcohol drunkenness.

4. Injury Analysis

A record is kept of every injury that occurred. Injuries that seem minor or unimportant should also be documented. Existing injuries from the past are also noted.

Only the reported injuries are regarded as present in a legal sense. Any injuries that are not noted or thought to be present at the time of examination are not documented. Therefore, it's necessary to take note of both minor and ancient injuries. If required, pictures of the wounds are obtained for later use.

• A Thorough Inspection for Injuries: Injury examination and recording should be done according to a systematic method. The head and neck should typically be examined first, then the right upper and lower limbs, before moving to the left side and inspecting the left lower and upper limbs. Then the chest, abdomen, and genitalia are examined. A thorough check helps to ensure that no injuries are missed.
• Foreign Material: Any foreign material found in or near the wound, such as a weapon fragment, bullet fragments, pellets, dirt, fibres, hair, etc., is noted. If necessary, samples of foreign material can be taken and stored. These samples are tagged, sealed, and given to the police for further review.

5. The Nature of the Injuries

• Location: The injury's location is specified in respect to physical landmarks. For ease of reference, the distance between the injury and markers, ideally bony prominences, is noted. Both the "X" and "Y" planes should be used to describe the location. Avoid using technical words when explaining the anatomical position. Investigators and the court should be able to understand the language used. To describe the place in more detail, technical terminology might be used in brackets.
• Size, Shape, and Direction: Each injury's size is determined using a scale. Avoid estimating size in any way. Shape must be indicated, whether it is linear, circular, elliptical, or another form. No matter how the injury occurs—vertically, horizontally, obliquely, or in another way—the direction in relation to the spot is crucial. If present, bevelling of the edges should be noted. For future convenience, a sketch diagram of the injuries should be created.

A verdict on the type of injury is provided for each injury separately. If there are several wounds, different weapons may have been used to cause the various wounds.

One of the three opinions listed below is offered:

• Simple
• Grievous
• Harmful to human life

Sometimes a patient needs lab and radiological findings or to be kept under surveillance, as in the case of a brain injury. When an immediate opinion cannot be made under such circumstances, the opinion is expressed as "pending further investigation" or "under observation". In these situations, after obtaining the reports, a "subsequent opinion" is provided. A second opinion might be supplied on a separate piece of paper or on the forms the hospitals provide. These assessments must be done twice and be related to the victim's serial number and injury.

6. Injury’s Age

Each injury's age needs to be tracked separately. By observing colour variations in bruises, vital response in abrasions, incised and lacerated wounds, one can determine the age of an injury. Finding the age of fractures may need a radiological study. In delicate circumstances, histological investigation can be performed.

7. Used Weaponry

Sharp or blunt weapons can be used to inflict wounds. Sharp objects can have a single or double edge. Weapons might be weapons or pointed, piercing implements. Opinions are expressed against each injury independently regarding the sort of weapon employed.

When expressing an opinion about the type of weapon, lacerated wounds that appear to be incised must be distinguished from incised wounds.

If the wounds and clothing are examined, it can be determined if the weapon was blunt or sharp-edged, or if it was sharp-edged, whether it was single-edged or double-edged.

Remarks

This section can be used to note any pertinent information that was left out of the report. It could be the state of the clothing or any stains that are visible. Any flaw in the clothing should be examined to see if it might be connected to the wounds the sufferer has. If there is a foreign body present, a sample has been kept, or the injury has any other unique characteristics, they might be described in the note’s column.

Also Read:- Episodes of Applied Forensic Medicine