Patient Safety due to Administrative Negligence: Neglected Area in India.

Background: Patient safety and security extends beyond due to medical error alone i.e. due to administrative carelessness. This aspect has been neglected or low priority area in India. Many instances if overlooked can be source of potential litigations for which court can award compensation against the hospital. Courts in India have recognized civil rights of right to safety of the patients and awarded compensation. Methods: A descriptive study has been conducted. This paper deals with administrative aspect on patient safety. A critical review of court cases in India and abroad along with review of relevant literature to make the situation understandable and clear for the safety and security of patients in India scenario. Results: Further study (KAP) needed to draw impact on the Health Administrators. Conclusion: An attempt has been made to sensitize the healthcare administrators/managers in both private and public sector hospitals.

The problem of child sexual abuse in india laws, legal lacuna and the Bill - PCSOB-2011.

Child abuse is the physical or psychological maltreatment of a child, can be differentiated into four major categories, physical abuse, emotional abuse, neglect and worst of all; the sexual abuse. Child Sexual Abuse (CSA) is a kind of physical or mental violation of a child with sexual intent, usually by a person who is in a position of trust or power vis-à-vis the child. India is the second largest child population in the world, 42% of India’s total population is below eighteen years. In a shocking revelation, a Government commissioned survey has found that more than 53% of Indian children are subjected to sexual abuse / assault. Majority of these cases were perpetrated by someone known to the child or in a position of trust and responsibility, Not surprisingly, most children did not report the abuse to anyone. There is not a single law aimed at safeguarding children and protecting them against sexual abuse & assault, which is a serious lacuna against this background and is needed urgently. This paper will focus on child sexual abuse, the laws, legal loopholes, and The Protection of Children against Sexual Offences Bill, 2011.

DNA profiling in forensic dentistry.

In last few years, DNA analysis methods are applied to forensic cases. Forensic dental record comparison has been used for human identification in cases where destruction of bodily tissues or prolonged exposure to the environment has made other means of identification impractical, i.e., after fire exposure or mass disaster.Teeth play an important role in identification and criminology, due to their unique characteristics and relatively high degree of physical and chemical resistance. The use of DNA profile test in forensic dentistry offers a new perspective in human identification.DNA is responsible for storing all the genetic material and is unique to each individual. The currently available DNA tests have high reliability and are accepted as legal proofs in courts. This article gives an overview of the evolution of DNA technology in the last few years, highlighting its importance in cases of forensic investigation.

Need for enhanced punishment for outraging the modesty of woman U/S 354 IPC.

Crime against women are rising in India especially in State of Uttar Pradesh, Madhya Pradesh and Delhi and there is a need felt in every corner of India to enhance punishment to deter these crimes. India is signatories to various International treaties including related to protection of human rights of woman and children. Hon’ble Supreme Court of India and various High Courts has taken cognizance of situation on many occasions and recommended to Union of India and state Governments to amend the law to protect the faith of common man especially vulnerable groups like woman and children. A Critical review of decisions of courts has been done for highlighting the legal situation on the issue of meaning and scope of applicability of section 354 IPC. Data base collected and compiled from the National Crime Record Bureau website to understand the rising trend of crime. This paper discusses various reasons for less punishment for molestation and need for enhanced punishment and making it non-bailable to make sense in preventing rising crimes against woman.

An overview of Bite mark analysis.

Human bite mark analysis is by far the most demanding and complicated part of Forensic Dentistry. Although bite marks of an individual do have uniqueness due to specific characteristics and arrangement of the teeth, when it comes to bite mark analysis, it is complicated by numerous factors, being presented as a challenge to the Forensic Odontologists. The aim of this paper is to give a brief overview of bite mark analysis: its usefulness and limitations. The study and analysis of such injuries is challenging and complex. The correct protocol for collection, management, preservation, analysis and interpretation of this evidence should be employed if useful information is to be obtained for the courts. This article throws light on the details of evidence collection techniques and step by step method to analyse the bite mark injury. It also provides insight about the modern methods now implemented in the analysis of bite marks. Conclusions from the analysis of bite mark evidence can assist the justice system to answer crucial questions about interaction between people present at the scene of crime.

Right to emergency care: Consumer court.

Indifference towards victims of accidents and those in emergency medical conditions and even women under labour who are about to deliver is not peculiar to India but is prevalent in other countries also. The SC of India as long back as 1989 observed in Parmanand Katara v. Union of India that when accidents occur and the victims are taken to hospitals or to a medical practitioner, they are not taken care of for giving emergency medical treatment on the ground that the case is a medico-legal case and the injured person should go to a Government Hospital. The SC emphasized the need for making it obligatory for hospitals and medical practitioners to provide emergency medical care. Delhi State Consumer Court first taken up for consideration the question of maintainability of award against the hospital in case of brought dead patient: This paper deals with critical review of recent judgment of State Consumer Court of Delhi on the issue of right to emergency care of common man and deficiency of service in Indian context.

Bacteriological profile of biomedical waste: Management guidelines.

Biomedical waste (BMW) is generated in hospitals, research institutions, health care teaching institutes, clinics, laboratories, blood banks, animal houses and veterinary institutes. Hospital waste management has been brought into focus in India recently, particularly with the notification of the BMW (Management and Handling) Rules, 1998. This study was conducted in Sharda hospital, Greater Noida with the aim to find out bacteriological profile of BMW with study of practices being followed in management and disposal of this waste with standard procedure. Total 500 cases of biomedical waste samples were taken in the study for bacterial culture, 136 samples of biomedical waste showed growth of bacterias. Pseudomonas species was the predominant bacteria isolated from these cultures. This study also suggests about the optimum practice which is to be followed in management of biomedical waste.

Broder scope of COPRA, 1986 & medical profession.

Negligence is the breach of a duty caused by the omission to do something which a reasonable man, guided by those considerations which ordinarily regulate the conduct of human affairs would do, or doing something which a prudent and reasonable man would not do. The definition involves three constituents of negligence: (1) A legal duty to exercise due care on the part of the party complained of towards the party complaining the former's conduct within the scope of the duty; (2) breach of the said duty; and (3) consequential damage. Cause of action for negligence arises only when damage occurs; for, damage is a necessary ingredient of this tort. Hon’ble Supreme Court Bench comprising B.N. Agrawal, P.P. Naolekar & Dalveer Bhandari, pronounced a Judgment on May 8, 2007 on this issue. Other relevant decisions of various Consumer Forums including National Consumer Disputes Redressal Commission are discussed. This paper will help in enlightening medical fraternity on new dimensions of scope of COPRA 1986, meaning and interpretations of term ‘service’ ‘consumer’ and ‘jurisdiction’.

Issue of consent for MTP by orphan, major and 'mentally retarded': A critical review.

An orphan, mentally retarded woman, above 18 years age, when suffered pregnancy as a result of rape posses a serious challenge before the Chandigarh Administration on the issue of MTP. Law on abortion in India as per the MTP Act, 1971, (Amendment 2002) prohibits MTP without consent, if the woman is above 18 years of age. Several subject-experts to contend that with the advancement of Medical Science, universal recognition of the Fundamental Rights of the mentally retarded persons, recent theory of mixing them in the main social stream instead of barricading at a secluded place. The legislative transformation has also taken place whereby purposefully and knowingly, the competence to give consent for MTP in the cases of mentally ill pregnant woman on one hand and mentally retarded pregnant woman on the other hand, has now been distinguished. A critical review of prolife and prochoice support for abortion, statutory provisions in India and abroad, views of Hon’ble Court are discussed in detail. Paper tried to raise the debate for policy makers, higher judiciary and medical fraternity especially dealing with MTP.

Suicide in youth: shifting paradigm.

In today’s scenario high occupational mobility, high ambition and desire for high standard of living is leading to high incidence of suicidal deaths. Nowadays suicidal gesture, attempted suicide & well successful suicide cases are seen in the society often on. A prospective cum retrospective study is carried out in the Department of Forensic Medicine and Toxicology, Mahatma Gandhi Medical College & Hospital, Jaipur w.e.f. 2004- 2008. In this period out of total 627 autopsies performed, 223 were found as suicidal deaths. In these 223 cases , 88 cases ended their life by poisoning, rest of them in the decreasing order are as follows – Train Run-over (55), Hanging (43), Drowning (20), Alcohol (9), Burn (4), Celphos Poisoning (3), Insecticides Poisoning (1). This clearly indicates that availability of highly lethal suicidal method and rate of suicide are interrelated. During the study we have found three new innovative methods of committing suicide. All three victims were pursuing their professional qualification and will be discussed in this study.

Mode of death shifting from coma to syncope sports utility vehicle (SUV) accidents.

Road traffic accident is a major cause of death assuming epidemic proportion worldwide. After America, India has the largest network of roads. The total length of the road is about 33, 44,000km, out of which national highways occupies only 2% of total road length, whereas they bear 20% of the traffic load. One of the main reasons of the overcrowding of the roads is the tremendous rise in number of vehicles due to increasing distance from residence to workplace, intensive marketing campaign of newer sports utility (SUV) cars by depicting them in movies, media advertisements and easy finance availability has developed a craving to possess these sports utility vehicles in youths (both in males and females). These sports utility vehicles are nowadays becoming the rapid killer of the victims met with road traffic accidents (pedestrians, pedal cyclist and motor cyclist). The present study is based on prospective and retrospective cases of road traffic accidents involving SUV’s, since January 2005 to December 2006. The present study has shown that young adults predominantly males in their most productive year of life (21-30 years) are especially prone to road traffic trauma2. Pedestrians constitute the largest group of victims 78 cases (65%) followed by cyclist 18 cases (50%), spot death unavoidable in 83 cases (55.33%) and the thoraco-abdominal trauma found in 97 cases (80.83%)2,4. The findings of study under score the continue need for preventive strategies; aim to reduce trauma related mortality, particularly those regarding road traffic safety. The study also suggest that the large proportion of death were preventable, if underlying lesion or sequelae of injuries had been promptly addressed but unfortunately the front design of these sports utility vehicles is responsible for causing thoraco-abdominal trauma, leading to rapid death by causing haemorrhagic shock generated from involvement of the structures of thoraco-abdominal region.