All hospitals in Mumbai must maintain medico-legal case registers, orders BMC; insiders say ‘not possible’

Mumbai: Following reports of patients being caught in bureaucratic loops, BMC issued a fresh circular demanding that hospitals strictly maintain medico-legal case (MLC) registers to streamline paperwork.The circular came after repeated instances of lapses in cases of accidents, disasters, or violence where patients were asked to visit another hospital just to have their MLC registered.
"All MLC are vital records," the BMC circular stated, adding that the responsibility of maintaining it falls on the casualty medical officer. It added that all such MLCs need to include details of injuries, the age of the wound, and the probability of the weapon causing the mentioned injury.A former medical officer at Sant Muktabai Hospital in Ghatkopar said that while hospitals are required to maintain such records, the larger belief within the system is that one can make do without them. "That is not accurate. Keeping all these records aids in police investigations and further court proceedings," the officer said.TOI earlier reported a case of a nine-year-old boy who was struck by a two-wheeler in Malad and was rushed to MW Desai Hospital. While the hospital treated him promptly, his family was told to rush to the trauma hospital just for a medico-legal certificate.A medical superintendent of one of the suburban hospitals, however, said that the BMC circular may still not make a difference where needed. "A casualty ward needs general specialties; most of the smaller hospitals either do not have them or have them infrequently," the doctor said.He added that patients will continue to be bounced from one hospital to another for paperwork until there are 24x7 casualty services with well-staffed trauma specialists like orthopaedics. Dr Chandrakant Pawar, Chief Medical Superintendent (Peripheral Hospitals), remained unavailable for comment.The circular also reiterated that all patients to be transferred to another hospital should be registered as indoor patients, and ambulance arrangements fall upon the initial hospital. However, another suburban hospital doctor said patients are made to sign DAMA documents as tertiary hospitals sometimes hesitate to accept transferred patients. "If patients instead make their own arrangements and reach the respective hospital, they have no choice but to accept," said the doctor.