BMC directs hospitals to strictly maintain medico-legal case registers

Mumbai: The Brihanmumbai Municipal Corporation (BMC) has issued a fresh circular directing hospitals to strictly maintain medico-legal case (MLC) registers. The directive follows several instances in which patients involved in accidents or violence reportedly faced delays or were asked to visit another hospital solely to register their medico-legal cases.

In the circular, the BMC emphasised that maintaining MLC documentation is a key responsibility in hospital emergency departments. “All MLCs are vital records,” the BMC noted, adding that the duty of recording such cases lies with the casualty medical officer. The circular also notes that MLC records must clearly mention details such as the nature of injuries, the age of the wound, and the probable weapon responsible for the injury. 

According to a report by TOI, the civic body issued the circular after repeated complaints of procedural lapses in accident, disaster, or violence-related cases where patients were referred elsewhere just to complete MLC documentation. Such practices often create unnecessary delays in treatment and legal processing.

A former medical officer at Sant Muktabai Hospital said that although maintaining medico-legal registers is mandatory, some institutions do not always follow the requirement strictly. “That is not accurate. Keeping all these records aids in police investigations and further court proceedings,” the officer said.

Earlier, TOI had reported a case involving a nine-year-old boy who was hit by a two-wheeler in Malad and was taken to MW Desai Hospital for treatment. While doctors at the hospital treated him promptly, the family was reportedly asked to go to a trauma hospital to obtain the medico-legal certificate. 

However, a medical superintendent from a suburban hospital said that issuing a circular alone may not resolve the underlying issue. “A casualty ward needs general specialities; most of the smaller hospitals either do not have them or have them infrequently,” the doctor said to TOI.

The official added that patients may continue to be referred from one hospital to another for paperwork unless casualty departments operate 24x7 with well-staffed trauma specialists, such as orthopaedic surgeons.

The circular also reiterates that when a patient needs to be shifted to another hospital, the initial hospital must register the patient as an indoor case and arrange an ambulance for transfer. However, another doctor from a suburban hospital pointed out that in practice, patients are often asked to sign discharge against medical advice (DAMA) documents because tertiary hospitals sometimes hesitate to accept referred cases.

“If patients instead make their own arrangements and reach the respective hospital, they have no choice but to accept,” the doctor said.