Medico-legal aspects of Poisoning
Medico-legal aspects of Poisoning
(a) Poison may be defined as any substance which when absorbed into the body or by local action on the tissues injures health or destroys life.
(b) Medicolegal aspects of Poisons
Sections 284, 299, 300, 304A, 324, 326 and 328 of IPC deal with offences relating to handling and administration of Poisonous substances. As per Indian law, administration of any substance with the intention of causing hurt or death is punishable.
(c) Guidelines in case of Poisoning
(i) When poisoning is suspected, every attempt must be made to save the patient’s life. The patient shall be shifted immediately to the hospital / MI room nearby.
(ii) Case sheet shall be initiated, noting personal particulars of the victim, along with date and time of reporting. The particulars of the person accompanying the patient will also be noted.
(iii) The victim will be protected from further exposure of poisoning but no clothing shall be thrown away, as they might be useful for chemical analysis.
(iv) MLC will be initiated after filling the MLC Register available at MI Room.
(v) The patient will be admitted if the medical condition is serious.
(vi) Civil police must be informed.
(vii) The CO / Registrar of the hospital, CMP, Station HQ and CO of the unit will also be informed.
(viii) The treating doctor / authorized nursing staff will only be permitted to administer food and medicines to the patient.
(ix) A careful history is to be elicited including relationship of food or medicine taken and the toxic manifestations. All signs and symptoms are to be noted carefully.
(x) The vomitus, urine, faeces, stomach wash, sample of food or medicine taken should be preserved in a sterile bottle. Any suspicious bottle or utensil seen near the victim, the clothes and bed clothes used last by the victim are all to be preserved for chemical analysis. Suitable preservatives may be used for these purposes depending upon the nature of the sample. The name and concentration of preservative used should invariably be mentioned in the label and / or accompanying documents. The proforma for sending samples other than viscera is enclosed as Enclosure 7.
(xi) It is advisable to take the second opinion and advice of a senior professional colleague in all matters regarding diagnosis and treatment. Use of Poison information services may also be made.
(xii) If there is any indication of danger to the general public, for example, food poisoning from a hotel, the public health authorities must be notified at once so that suitable remedial measures are taken.
(xiii) In case of food poisoning from unit cookhouse, the AMA has to inform the incident to SHO/ SEMO/ DADH/ADH and administrative authorities.
(xiv) Where required, a magistrate should be called to take down the dying declaration.
(d) Precautions to be taken in cases of poisoning
(i) Emergency medical treatment will be administered. Senior colleagues will be consulted and Poison Information Services will be made use of wherever available.
(ii) Medical certification and cause of death will be issued with mention that ‘Cause of death to be ascertained after chemical analysis’.
(iii) Various samples of medicolegal importance will be preserved and handed over to the police for forensic examination.
(iv) A receipt shall be obtained from the police for all samples that are handed over for forensic examination.
REF : Guidelines by Ministry of Health & Family Welfare, Government Of India