Legal Aspects in Medical Practice - DR Rahul Katta

“Challenges Now and Ahead”
M.S., M.Ch.[orth.],
PGDMLE [ Post Graduate in Medical Law & Ethics]
Katta Hospital & Dr.Orthopaedic
Rahul Katta, Jaipur Centre, Jaipur
Police
Politician
Public
Dr. Rahul Katta, Jaipur
Fuzzy laws and frivolous
cases are taking a toll on the
profession.

Laws Governing to the Qualification/Practice
and Conduct of Professionals
• The Indian Medical Council/NMC Act 1956
• Indian Medical Council (Professional Conduct, Etiquette,
and Ethics Regulations 2002)
• Indian Medical degree Act 1916
• NMC Regulations 2022

Law Governing the Hospital Commissioning:
• National Building Act 2005 [Fire Safety]
• Radiation Protection Certificate from BARC
• Society Registration Act
• Urban Land Act 1976
• Indian Boilers Act 1923
• The Clinical Establishment (Registration and
Regulation) Bill 2007

Laws Governing to Sale, Storage of Drugs
and Safe Medication
• Blood Bank Regulation Under Drugs and Cosmetics
(2nd Amendment) Rules 1999
• Drugs and Cosmetics Act 1940 and Amendment Act 1982
• Excise permit to store the spirit, Central Excise Act 1944
• IPC Section 274 (Adulteration of drugs), Sec 275 (Sale of
Adulterated drug), Sec 276 (Sale of drug as different drug
or preparation), Sec 284 (negligent conduct with regard
to poisonous substances)
• Narcotics and Psychotropic Substances Act
Laws Governing Management of Patients
• Birth and Deaths and Marriage Registration Act 1886
• HIV Act 2007
• The Medical Termination of Pregnancy Act 1971
• Transplantation of Human Organ Act 1994
• The Mental Health Act 1987
• Pre-Conception and Pre-Natal Diagnostic
Techniques Act, 1994
• Assisted Reproductive Technology (Regulation) Bill, 2014
Laws Governing Environmental Safety
• Air (prevention and control of pollution) Act 1981
• Biomedical Waste Management Handling Rules 1998
(Amended on 2000)
• Environment Protection Act and Rule1986, 1996
• NOC from Pollution Control Board
• Noise Pollution Control Rule 2000
• Public Health Bye Law 1959
• Water (prevention and control of pollution) Act 1974
• The Cigarettes and Other Tobacco Products (prohibition of
advertisement and regulation of trade and commerce,
production, supply and distribution) Bill 2003
Laws Governing to Medico legal Aspects
• Consumer Protection Act 1986

• Indian Evidence Act
• Law of privileged communication
• Law of torts
• IPC Section 52 (good faith), Sec 80 (accident in
doing lawful act), Sec 89 (for insane & children),
Sec 90 (consent under fear) , Sec 92 (good
faith/consent), Sec 93 (communication in good faith).

CPA: No Limit Liability

Burnt of Healthcare
Very high expectations of the patient
Growing consumerism
Ignorance and lack of knowledge of the doctors
for laws
Doctors ignorance for responsibilities to
patient, state & law

Medical errors and
medical
malpractice are
largely unrelated
phenomena.
Most lawsuits are not the result of errors and

most errors do not result in lawsuits
Even if we could eliminate every medical error, 80%
of lawsuits would remain
Localio AR, Relation between malpractice claims and adverse events due to negligence ? results of the Harvard Medical Practice Study III. N Engl J Med 1991;325:245-251.
Acts held “negligent”
 Surgery without consent
 Surgery on wrong patient or wrong
organ
 Leaving mop or instrument inside
 Transfusing wrong blood
 Performing criminal abortion
(source:Medical Negligence & Compensation Edition II)

Proof of Negligence
4 D’s
The essentials of negligence are four "D"s:
1. There was a Duty towards patients;
2. There was Deficiency in duty
3. This Directly resulted in injury(causa causans )
4. Damage which may be physical, mental or

financial loss to patient or relatives.

Theories of Negligence
Objective theory : carelessness in approach and the

results in injury
(a)Undertaking care beyond one’s skill and experience
(b)Giving harmful drugs un-necessarily to a patient;
(c)Injuries due to faulty techniques
(d)Overdoses of drugs, giving wrong drugs, etc.;
(e)Iatrogenic problems.
Theories of Negligence
Subjective theory,
(i) Failure to attend to patient;
(ii)Failure to examine and investigate carefully
(iii)Failure to obtain proper consent;
(iv)Failure to give standard treatment;
(v)Failure to advise hospitalization; and
(vi)Abandoning treatment without making
alternative arrangements.
(i) Difference of opinion
(ii) Wrong diagnosis in spite of diligence
(iii) Accidents
(iv) Unexpected result
(v)Delegation of duties
(vi) Inherent Risk
(vii ) Known Complication
How doctors can spot patients
likely to sue
“There are individuals in society they're going
to look the other way,”
“The patient who is very demanding.”
• Other legally risky behaviors
include: patients who ask for a
diagnosis beyond a physician's
expertise,
• who complain about being
“mistreated” by other doctors or
• who have sued past physicians
People who have higher social statuses, live in urban areas
and have higher education are more likely to file claims.
Another contributing factor is whether the
patient personally knows a doctor or lawyer.
A study found that poor people

are less likely to sue their
doctors than wealthier
patients.

Legal aspects of emergency medicine
“The treatment of the patient should not wait

for the arrival of the police or completion of
legal formalities. All hospitals and doctors are
required to provide immediate medical aid to
all the cases, whether medico-legal or not.”

Emergency Care: What the Law Says
Liability of the Hospital
The hospital is liable for the patients' life. From the moment a patient
enters the hospital, the responsibility of his/ her life lies with the
hospital staff and thus the hospital.
Transport: Hospital is Responsible
The patient should receive first aid and be stabilized prior to
transportation in ambulance. if a patient dies on the way while being
transported hospital proves that the ambulance was in right condition
and appropriate medical staff was in the ambulance to take care of the
patient, then the hospital cannot be found guilty.

BROUGHT DEAD
Dead on arrival ("brought dead" cases) -

All cases which are pronounced dead on
arrival at hospital must be labeled as MLC
and police be informed.

Unexpected Death

Our worries:
1. Can I give a Death Certificate?
2. Is PM mandatory?
3. Should I inform police?
4. Will the police arrest me?
5. What will happen to the reputation?
6. What will the court decide?
7. What is my indemnity cover?
8. Will relatives ransack the hospital?
INFORM POLICE
(i) Cases of suspected homicide,
(ii)Cases of suicidal deaths,
(iii) Unknown, unconscious patient,
MUST
(iv) Death on operation table,
(v)Suspected unnatural death, (sudden, unexpected, violent
and unexplained death),
(vi) Instant death after treatment/surgery or reaction of
medicine, and
(vii) A married lady dying within seven years of marriage
due to any reason. Dr. Rahul Katta, Jaipur
INFORM POLICE
(i) Undiagnosed death within 24 hrs. of admission,
(ii)Cases of poisoning,
(iii) Accidental deaths, and ADVISABLE
(iv) In cases of hospital deaths if

(a) accidents not related to medical management
like fall from staircase etc.,
(B) unexpected or rare complications
Information to police shall preferably be in writing and the written
acknowledgement should be obtained. If the information is telephonic
one must note down name, buckle number
Dr. Rahul Katta, Jaipur and designation of the police.
INFORM POLICE & ASK FOR POST MORTUM
In most jurisdictions, deaths that occur during or
within a short time after surgical operation, invasive
procedure, become the subject of a medico legal
investigation.
When the family suspect that malpractice has occurred, they

are unlikely to believe the explanations provided by the
specialists to justify his management of the case and in this
situation, an autopsy [Post Mortem] can restore trust and
resolve conflicts by providing data viewed as objective by
the family. Dr. Rahul Katta, Jaipur
ADVERTISING
Canvassing and advertising directly or indirectly to promote
private practice is unethical.
a) Displaying unusually large signboards depicting anything other than
his name, qualification and nature of his specialization (e.g. giving
photographs, diagrams of the equipment).
b) Displaying signboards at other than at his residence and clinic e.g. at
chemists shops, religious places.
c) Guaranteeing a cure for certain ailments.
d) By publicly exhibiting his scale of fees or refund if not cured.
However, writing an article in the lay press or giving a talk on the
Radio/TV on subject matters of public health, Community welfare etc.
are not acts of professional misconduct.
However, clinics/hospitals may advertise.

Suffix to their names only recognized medical degrees
• * 6-A (i) No person shall add to his name any titles description
letters of abbreviation which imply that he holds a degree,
diploma, licence or certificate as his qualification to practice
any system of medicine
• Shall not claim to be a specialist unless he has a special
qualification in that branch
• MRCP, FRCS, FRCR are not recognized by MCI
• MCI does not recognise any Fellowship from any
institution
*THE INDIAN MEDICAL DEGREES ACT,

Dr. Rahul1916
Katta, Jaipur
Can MBBS Perform Surgery?
In an RTI Ref. no. 4898, MCI has answered a query on
application dated 23.02.2014 received in the Council Office
on 28.02.2014.:
Q 1 : A person having qualification of MBBS can perform i)
caesarian surgery, ii) hysterectomy and iii) other general
surgery procedures.
Clarification: A physician shall not claim to be a specialist

unless he has special qualification in the branch. The
special qualification means degree/diploma in the
concerned specialty, however this provision does not debar
a doctor having proper documented/certified adequate
training/exposure in an institution recognized by MCI
thereby gaining/competency and experience to work in any
particular discipline/branch where.
Medical records
 Time period
* OPD records – 3 yrs
* Indoor case records – 5 yrs
* Medicolegal case – 30 yrs
 Confidentiality of records
 Request for medical records by patient or authorized
attendant should be acknowledged and documents
issued within 72 hours
Do Not ALTER The Record
SLIDE
 SL – Single Line through the
entry
 I – Initial the late entry as an
Error
 D – Date the entry
 E – Note “ERROR” in the area.

SC judgments
Crosspathy is “negligence per se” which means it is
negligence ab initio and no further proof of negligence
(causing harm to the patient for which compensation may
be claimed) is necessary.
The law does not allow Allopaths to prescribe

Ayurvedic medicines
Practicing crosspathy can be punishable by rigorous
imprisonment of up to three years and a fine of up
to Rs. 50,000
Medical Certificate
Issue of any medical certificate,
notification, document or report, which is
untrue, misleading or improper
is a misconduct and punishable offence
(MCI Regulations 2002, Section 197 of Indian Penal Code);

Guidelines for issuing Medical Certificate
Documentation should include :
 Should be legible, written on the doctor’s letterhead and should not
contain abbreviations
 Patient signature / thumb impression on the medical certificate
 Identification marks to be mentioned on medical certificate
 Should only be issued in respect of an illness or injury observed by
the doctor
 The date / time range covered by the medical certificate
 The level of incapacity (i.e. unfit for work, light duties, etc within
scope of practice)
 Name, signature, qualifications and registered number of the
consulting Registered Medical Practitioner
 Keep duplicate copy
 An official serially numbered certificate should be utilized.
The records of medical certificate are to be retained for a
period of 3 years from
Dr. Rahul the date of issue.
Katta, Jaipur
CONSENT FOR MINOR PROCEDURES
The only thing one can do without the patient's written
consent is to examine him or her because the patient's
consent is `implied' in such a case.
Do not forget to obtain a written consent even for

the most minor procedure say, lacerated wound
suturing, FNAC, Intra articular injection, close
reduction & plaster, local anesthesia and as on.
In the absence of consent, the doctor may be charged with

what is known in legal jargon as "assault and battery".
Consent must be taken from the patient
himself
No one, not even the next of kin, is not

allowed to give consent on behalf of the
competent adult, under any circumstances
Samira Kohli vs. Dr. Prabha Manchanda and Ors.

Unilaterally executed consents are void
Consent signed only by the

patient and not by the doctor is
not valid.

Surgical consent is not sufficient to cover
anesthesia care
• Separate anesthesia
consent form
•Explain the risks
•Sign by the anesthetist

EMERGING TREND
If any alternative/additional
procedure is anticipated in a planned
procedure, specific consent in
advance must be obtained.
Consent form must carry an authorization
clause to cover deviations.
Saroj Chandoke v. Sir Ganga Ram Hospital, Delhi

Consent for blood transfusion
When Blood transfusion is anticipated, a

specific written consent should be
taken, exception being an emergency situation
where it is needed to save life and consent
cannot be attempted.
M. Chinnaiyan versus Sri. Gokulam Hospital and Anr

Consent for Sterilization
Consent of both the husband and wife

is absolutely necessary in case of
sterilization procedures of a married
couple.

Consent for MTP
Medical Termination of Pregnancy Act, 1971
- Section 4 (b) - No pregnancy shall be
terminated except with the consent of the
pregnant woman.
Where a couple consults for abortion, the

woman's viewpoint must be taken in
isolation and
This fact must be duly recorded:
Given full counseling, opportunity and
proper time to take a proper decision
Consent in Relation to Publication
A registered medical practitioner is not

permitted to publish photographs or case
reports of his/her patients without their
consent, in any medical or another journal in a
manner by which their identity could be
revealed
THE HIV/AIDS BILL 2007
No HIV-related test of a person, shall be undertaken or

performed except with the informed consent of that
person
Informed consent for an HIV test shall be valid only

when the person being tested is provided pre-test
and post-test counseling in accordance with the
Regulations.

Patient Data Sharing
We must remember that
sharing clinical data -
clinical information, external
photographs, radiological
images and other patient
data through which the
identity of the patient may be
revealed could be
considered as a breach of
patient-doctor confidentiality
if consent is not obtained.
Regulatory Guidelines:
Blood & it`s components are “DRUG”
The Indian CDSCO considers
„preparing Platelet Concentrate‟
amounts to „manufacturing‟ of blood
components.
Contraventions are punishable under
section 27 as per the Drugs and
Cosmetics Act 1940, read with rule 122EA
of the Drugs and Cosmetics Rules, 1945.
Notices to Plastic surgeons and
Dermatologists have been served

• NECESSARY INVESTIGATION SHOULD BE CARRIED OUT
• REFUSAL TO CARRY OUT INSTRUCTIONS HAS TO BE RECORDED
If a patient declines to make some investigations ordered, it is

important to take it down in writing with.
For example, "I am not willing to get a Computed Tomography Imaging
(CT scan) as advised by the doctor for so and so reason" Signature.
• SHARING RESPONSIBILITY
enlist the services of a nephrologist, neurologist, cardiologist,
endocrinologist and so on, depending upon the case.
In the past, a surgeon might have controlled diabetes of a patient for
surgery on his own, but this is no longer advisable.
Prerequisites for treatment and admission of a
foreigner in hospital
• Patient is required to produce his passport at the time of
registration in hospital.
• The hospital should maintain a copy of passport (Photo
page and visa page) in hospital record.
The hospitals are also legally bound to provide

particulars of such foreigners in the prescribed “C-
Form” to FRO – CID Intelligence, Zonal office on line
within 24 hrs. of admission but patients coming from
Pakistan or Bangladesh, the same information is to be
sent within 12 hrs
http://boi.gov.in/content/form-c
• COPIES OF ALL REPORTS SHOULD BE KEPT
Request the pathologist, radiologist and sonologist to send two copies
of the report as a routine.
• COPY OF THE DISCHARGE CARD SHOULD BE KEPT
• RECEIPTS FOR THE DISCHARGE CARD/REPORTS SHOULD BE

OBTAINED
• REFERRAL NOTES
Should include the date and time of issue, the patient's general
condition, cause of reference, and the course of action to be taken.
Keep a duplicate copy of the referral note with the patient's
signature.

TELEMEDICINE
Areas of Concern: Critique for Guidelines
1. No Immunity to RMP against litigations

2. Jurisdiction : Doctor Clinic or Patient Residence
3. Storage of data/ data management
4. Patient discloses audio/video without consent of RMP
5. Insurance reimbursement
6. Online platforms may advertise doctors & give ratings
7. If patient want his fee refund for various reasons
8. Strict regulations for list of medicines- need of more
A standard disclaimer paragraph
The telemedicine advice is on the basis of request and
inputs [history, complaints & reports] provided to me. It
would be purely an informal preliminary advice for
immediate relief purposes not intended for full cure,
Patient is advised to visit my clinic at the earliest for
proper clinical examination and related necessary
investigations. In case of any medical emergency visit
nearby hospital/doctor.
Fee Charged is NOT REFUNDABLE
MEASURES
PREVENTION AT
PERSONAL LEVEL
Qualification
Communication
INTERPERSONAL LEVEL
Courteous and polite if
any mishap
ACADEMIC AND TECHNICAL

UP GRADATION
Attend CME, Workshops and
Conferences, Legal Knowledge
DON`T FORGOT TO
RENEW YOUR
MEDICAL COUNCIL REGISTRATION
EVERY 05 YEARS

MANAGEMENT

DO’S
Update with latest management
by attending CME and
conferences
 Employ qualified assistants
 Update facilities and equipment
 Obtain legally valid consent

before any procedure
 Ensure proper post - operative
care Dr. Rahul Katta, Jaipur
Communication
Multiple studies have demonstrated
Honesty
builds
Trust

Conclusion
 Malpractice is by definition avoidable.

 By staying informed and diligent you
reduce the chance of ever being involved
in a claim.

It is the duty of second
doctor to take the patient
into confidence and detail
him/her about the
genuineness of the decision
of first doctor to save the
glory of sacred profession.

'Today, The Indian Doctor is Isolated,
Defensive & Vulnerable'

Saint to Sinner “Beyond
our Ken”
Fear of Court, Mob & Media
Healer
Killer
M
e
d
i
a

Doctor becomes a patient

Violence against doctors is
on the rise worldwide
“Yi Nao” phenomenon

healthcare disturbance: a type of
violence in hospitals to get repayment for
real or apparent medical negligence from
the hospital authority.
in China 73% reported the Yi Nao phenomenon

One wonders….
WHY PUBLIC ENVY DOCTORS
Because we enjoy a very special

social status in the society….in
comparison to rest of the
Professionals
Fear that is Visible:

Fear that is Visible:

VIOLENCE TOWARDS
HOSPITALS & DOCTORS
Over 75% of doctors have faced violence at work:
IMA

The 5 Stages of Grief
1. Denial After Patient’s Death
displacement of anger
2. Anger and denial to cope with
3. Bargaining the situation
4. Depression
Violence
5. Acceptance

Risk factors
Patient
Staff
Situational and
Interaction factors
VIOLENCE TOWARDS WHEN
HOSPITALS & DOCTORS
WORKPLACE VIOLENCE:
During times of high activity
Poor interaction with patients, such
as admission in emergency ward &
Patient transportation.
Patient is involuntarily admitted,
Billing
Hospital Rules

HOSPITALS & DOCTORS
DURING ADMISSIONS:-
EXPLAININIG GRAVE SITUATIONS
BAD PROGNOSIS,
COSTLY SURGERIES OR TREATMENT
ANAPHYLACTIC REACTIONS
UNEXPECTED CONSEQUENCES OF THE
TREATMENT,
COMPICATIONS OF THE CONDITIONS
DEATH
HOSPITALS & DOCTORS
Patient transportation OR
Shifting
 Assaults may occur when service is
denied
 May be a Doctor/Staff is not
accompanying during shifting
 Patient dies before or during shifting
 Patient dies at tertiary centre on or

after shifting

HOSPITALS & DOCTORS
Billing-
Not understanding the
billing procedures
Claiming overcharging
Claiming Unexplained or/
and unwarranted charging
Inability to pay charges
Denial by hospital for
treating the patient or
giving the deadbody for
nonpaymant
HOSPITALS & DOCTORS
Hospital Rules-
 Advance Payment
 „Office Permission‟
 Prescribing Medicines, Appliances & Materials to

be purchased from Hospitals only
 A health care worker attempts to set limits on

eating, drinking, or tobacco or alcohol use.

Background Causes
 Working with volatile people
 Working when understaffed
 Poor communication
 Long waits for service
 Overcrowded, uncomfortable waiting
rooms
 Inadequate Care
 Working alone
 Inadequate security
 Lack of staff training
99.99 % of Our Public
distrust is because of
their wrong, illogical,
impractical
expectation
The mistake has to be
identified and solved
They need to be
educated about
reality
Science of Uncertainty
Expectation of Public:
1. All diseases cured in one day
2. By the treatment of their choice
3. Free of Cost treatment
4. In the Hospital of their choice
5. At the time they like
6. All diseases to be diagnosed at once
7. With the modality of their choice
8. And doctors say what they like.
WHAT STEPS CAN
BE TAKEN……????

Watch for signals that may be
Associated with impending violence
Maintain behavior that helps diffuse anger
Be alert
Be quick to act

Doctors Steps
• Do not overreach
• Consent
• Documentation
• Proper Communication
• Be alert
• Restrict entry
• Standard operating procedure (SOP)
• Insurance
• Security
• Rush Team Dr. Rahul Katta, Jaipur
Sufficient Information Vs Consent
Mere signing of a form is not enough to

say that sufficient information is given
Proper informed Consent by yourself

Challenges in counselling
 How much information is sufficient?
 How to do it without frightening the
patient?
 How to get over the language barrier?
 How to give sufficient time?
 Proper Answer of questions asked

Basics of patient communication:
Active listening
How can you show your patients that:
• Pay attention (face them, make eye

You have heard contact)
them • Repeat what you have heard
• Paraphrase: tell them what you

You have understood from their speech
understood them • Use phrases like; “aap ka matlab hai…,
aap chatey hain”
• Tell them how you think they might be

You have felt feeling
their worry • Communicate/reflect their said or unsaid
feelings
Tips :Managing the violent
relatives

TIPS TO HANDLE
Form a local ‘’Rush Team’’ of doctors

for helping a doctor in distress.
This team should include senior
practitioners (surgeon, Gynaecologist, GP,
anaesthetist etc.). The team should be only
one phone call away in case of impending
suspected mob violence.
LOCAL
RUSH TEAM:
• The teams responsibility is to help the

affected doctor in medical management (if
needed)
and for ensuring proper communication with
the relatives.
• Ideally death should be declared only when
the rush team arrives.
LOCAL
RUSH TEAM:
• The rush team has to conduct itself properly and

with dignity. They should not take charge of the
situation. The owner should take the main chair
and do the talking for communication.
• Team members should interfere only it the

communication is taking a wrong turn.
SECURITY:
during such vandalism, however each

establishment should have CCTV cameras
installed and there should be boards at
conspicuous places saying
‘’you are under electronic surveillance”
 This will curb many such untoward incidents.

CALL POLICE:
• If there is intra-op death or

immediate post-op death avoid
giving DC and put the onus of
explaining (to the relatives) the need
for MEDICO LEGAL POST MORTEM
on to the police…IT IS MUST
Know the law of
DOCTOR’S protections
• As per the act if found guilty of commitment,
attempt to commit and or abetment there can be
imprisonment for three years with fine which can
extend to 50,000/-or both.
• It is COGNIZABLE, NON-BAILABLE
• Recovery of loss for the damage caused to the property
Rajasthan Medicare Service Persons and Medicare

Service Institutions (Prevention of Violence and
Damage to Property) Act, 2008
It is extremely important that the FIR is written in a
clear, comprehensive and elaborate manner,
wherein the crime is fully described.
Writing the FIR carefully can make a difference to
the overall charges framed, the investigation and
the ultimate outcome Dr.ofRahulthe case.
Katta, Jaipur
HOW TO WRITE FIR
•name(s) of the perpetrator of the crime
•relationship of the perpetrator with the victim
•detailed information and narrative pertaining to the commission of the
offense, which explains the following points:
• roles played by the different people who are accused (in case
there is more than one) in the commission of the offense
• the place where the crime took place,
• date and time of the incident,
• whether any weapons were used, the nature of the weapons used
(sharp/blunt),
• description of the injuries caused,
• information about the motives of the perpetrators
• if the property was taken away, then describe the nature and
value of the property that was taken away,
• describe any threats
• traces, articles or left behind by the accused
• articles are broken or damaged
• the number of people involved in the offense,
• if there was any witness
•reasons for the delay in filing Dr.
the RahulFIR,
Katta, Jaipur
if any
The standard for fastening criminal liability on a high
pedestal and required the medical negligence to be
“gross” or “reckless.” Mere lack of necessary care,
attention, or skill was observed to be insufficient to hold
one criminally liable forDr.negligence.
Rahul Katta, Jaipur
CRIMINAL COMPLAINT AGAINST DOCTOR

How to address risky patients
Doctors should use caution when treating patients they believe may ……
•Document patient conversations.

•Use secure communication.
•Build trust.
•Be transparent.
•Encourage inquires.
•Say you're sorry.
SAYING “NO” WHEN IT IS IMPORTANT
The decision to
say “No” is
based on the
clinical facts and
circumstances of
the case.
CONCLUSION
• Increasing materialism and eclipse of
humanitarian values,
• Media-created-violence,
• Negative image of medical profession,
• Patient-physician-distrust,
• Zero-protection for doctors,
• Apathetic governments and
• Deficiencies in the process of justice
CONCLUSION
Mob violence will continue

• Till doctors get back the lost respect
• Till our general population become literate
• Till there is a socio-economic rift between us and
the general population
• Till violence remains and inseparable part of our
existence is country

DEFENSIVE MEDICINE
“Better To Play Safe Than Sorry”
The essence of being a doctor - to do the best we can to

heal - is being taken away from us because now we
need to be on the defensive.

THE BEST WAY TO PREDICT
YOUR FUTURE IS TO CREATE IT
Doctors unite
for your protection !


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“Challenges Now and Ahead”

Dr. Rahul Katta, Jaipur

• The Indian Medical Council/NMC Act 1956

• Indian Medical Council (Professional Conduct, Etiquette,

and Ethics Regulations 2002)

• Indian Medical degree Act 1916

• NMC Regulations 2022

Dr. Rahul Katta, Jaipur

Dr. Rahul Katta, Jaipur

• Consumer Protection Act 1986

Dr. Rahul Katta, Jaipur

Dr. Rahul Katta, Jaipur

Very high expectations of the patient

Ignorance and lack of knowledge of the doctors

Doctors ignorance for responsibilities to

patient, state & law

Most lawsuits are not the result of errors and

 Transfusing wrong blood

 Performing criminal abortion

(source:Medical Negligence & Compensation Edition II)

2. There was Deficiency in duty

3. This Directly resulted in injury(causa causans )

4. Damage which may be physical, mental or

Dr. Rahul Katta, Jaipur

Objective theory : carelessness in approach and the

(a)Undertaking care beyond one’s skill and experience

(b)Giving harmful drugs un-necessarily to a patient;

(c)Injuries due to faulty techniques

(d)Overdoses of drugs, giving wrong drugs, etc.;

A study found that poor people

Dr. Rahul Katta, Jaipur

“The treatment of the patient should not wait

Dr. Rahul Katta, Jaipur

Dr. Rahul Katta, Jaipur

Dead on arrival ("brought dead" cases) -

Dr. Rahul Katta, Jaipur

Dr. Rahul Katta, Jaipur

(iv) In cases of hospital deaths if

When the family suspect that malpractice has occurred, they

However, clinics/hospitals may advertise.

*THE INDIAN MEDICAL DEGREES ACT,

Clarification: A physician shall not claim to be a specialist

 E – Note “ERROR” in the area.

Dr. Rahul Katta, Jaipur

The law does not allow Allopaths to prescribe

(MCI Regulations 2002, Section 197 of Indian Penal Code);

Dr. Rahul Katta, Jaipur

Do not forget to obtain a written consent even for

In the absence of consent, the doctor may be charged with

No one, not even the next of kin, is not

Samira Kohli vs. Dr. Prabha Manchanda and Ors.

Dr. Rahul Katta, Jaipur

Consent signed only by the

Dr. Rahul Katta, Jaipur

Dr. Rahul Katta, Jaipur

Saroj Chandoke v. Sir Ganga Ram Hospital, Delhi

When Blood transfusion is anticipated, a

M. Chinnaiyan versus Sri. Gokulam Hospital and Anr

Consent of both the husband and wife

Dr. Rahul Katta, Jaipur

Where a couple consults for abortion, the

A registered medical practitioner is not

No HIV-related test of a person, shall be undertaken or