Medico Legal Affairs

A complaint may be filed by :

• a Consumer
• a registered voluntary consumer organisation
• the Government – central or state
• one or more consumers having a common interest

• The District Forum - where the cost of goods or services and compensation sought is less than Rs.5 lakhs
• The State Commission - where the cost of goods or services and compensation sought is over Rs. 5 lakhs but below Rs.20 lakhs and
• The National Commission - where the cost of goods or services and compensation sought is more than Rs.20 lakhs.

Yes ; the following categories of services are covered :

i. services rendered by a doctor to a patient by way of consultancy, diagnosis and treatment.

ii. services rendered at hospitals / nursing homes, where charges are required to be paid by persons availing such services, irrespective of whether such payment is made directly by the patient or by an insurance company under a policy for medical care or by the employer for the medical treatment of an employee or his dependent family members.

The following categories of services, however, are specifically excluded :

i. services rendered free of charge by a medical practitioner

ii. services rendered at a Nursing Home or Hospital, whether governmental or non governmental, where no charges at all are levied.

While each case would have to be dealt with separately, the following general guidelines may be observed :

• Maintain a precise and meticulous record of the patient's case history together with your diagnosis / findings.
• Record the date and time of each consultation.
• Clearly record drug allergies
• Give clear instructions to the patient and ensure that he/she has understood them.
• Do not hesitate to refer the patient to a specialist if you deem it necessary.
• Do not attend to patients if you are unwell, exhausted or under the influence of alcohol.
• If the patient is under the effect of alcohol this should be noted on his case record.
• Obtain written consent of the patient for diagnostic procedures such as endoscopy, CT scan, etc. Ensure that the patient has fully understood the procedure and accompanying risks, if any, before giving the consent. Such consent should particularly be insisted upon in cases involving administration of general anaesthesia, surgery, intimate examinations and major diagnostic procedures.
• In case of a child or a person of unsound mind the written consent should be taken from a parent or guardian.
• In case of surgeries the surgeon must personally perform the same and not leave it to his assistants or juniors
• Ensure the attendance of a qualified anaesthetist at all times during the course of surgery
• The surgeon should also make himself available for post-operative care
• Medical certificates issued to patients must be carefully and accurately word

In defending such actions a Doctor can raise the following

• Inaccurate or incomplete disclosure of case history by the patient.
• Failure of patient to take the prescribed medication or to follow instructions regarding rest, diet, follow-up treatment, etc.
• Refusal of the patient to carry out pathological or radiological or other investigations advised by the Doctor.
• Failure of the patient to discuss important information such as past history, allergies, etc.