FMT
BONUS-BTR
Injuries
Age of abrasion Age of contusion Livor mortis vs contusion:
RRRBBB
Dependent:
Well defined:
Direction: Blanch:
Vital reaction Extravasation:
Negative and positive zone Colour change:
Antemortem vs Postmortem clot:
Firm, dark red-
Striae of Zahn -
Coralline platelet thrombus-
Chicken fat clot-
Harakiri = Seppuku
Jigai
Skull fractures
Lucid interval:
Valid evidence, will and criminally liable
Thermal injuries
EDH with honeycomb
appearance
Bilateral, diffuse
No bleeding
Intact nerves and vessels
Line of redness+
Red blisters with exudates and hyperemia
Vital reaction
COHb +
Smoke in airway +
RTA injuries
Aortic tears:
Days within which death attributed to RTA
Electrical injuries
.
More dangerous:
Barrier/Resistance to current:
Most important factor for death:
MCC of death:
Rigor mortis-
Ballistics
.
Calvin Goddard:
Rifling Choking
PELLET
BULLET
Ammunition
.
BLACK SMOKELESS SEMI-SMOKELESS
SEM-EDXA: Best to detect GSR
Ballistics
.
Bullet fingerprinting
Primary markings Secondary markings
ENTRY vs EXIT: Keyhole:
Inverted Gutter fracture:
BBT + Kronlein shot:
GC, AC+
Bleeding more:
Larger:
Exit wound not seen with- Rayalasima phenomenon
Except:
Contact shot
Oblique shot
Thin person/part
Medical law-Court proceedings
Magistrate inquest: HIERARCHY OF COURTS Max punishment/fine
Custodial death/ rape/ disappearance:
Dowry death:
Exhumation:
Evidence: Oral VS Documentary
Dying declaration:
Direct-
Indirect-
Circumstantial:
Hearsay:
Oath- Refusal to take oath-
Perjury- Power of commutation:
Fabrication of false evidence- Pardoning death sentence:
Punishment- 416 CrPrc:
Doctor: Common vs expert witness Summons priority:
Medical law-Ethics, negligence, consent
Dichotomy: Euthanasia-
Professional misconduct: Active: Passive:
Professional malpractice/ negligence: Voluntary: Involuntary:
4Ds: Duty - Dereliction - Damages - Direct causation Non-voluntary:
Novus actus intervenes : Consent:
Double jeopardy=Res judicata Implied-
CIVIL vs CRIMINAL Expressed- Verbal/ written
Wrong dose / drug Open/ blanket-
Wrong side surgery BEST:
Criminal abortion Therapeutic privilege:
Extended consent:
Res ipsa loquitor: Therapeutic waiver:
Contributory negligence: Loco parentis:
Res indicate Medicolegal autopsy-
Vicarious liability: Pathological autopsy
Borrowed servant doctrine: Rape accused-
Product liability: Rape victim-
MTP-
Min age for consent: Medical records of inpatient:
Under trial-
General Physical exam –
Convict-
PV/PR/ Surgery/ transplant- Medicolegal case:
Medical law-Liability and Acts
Liable? Transplantation of Human Organs and Tissues act 2014
Delirium Donor authorization:
Mental illness-incapable of understanding nature of Without donor authorization:
act or consequence: Unclaimed bodies:
Sleep walking MLC:
Run amok BRAIN-DEATH:
Involuntary drunkenness
Lucid interval Without authorization:
Voluntary drunkenness
Kleptomania POCSO 2012->2019
Penetrative sexual assault, Sexual assault, Sexual harassment,
Mental healthcare act 2017 Pornography
Advance directive Aggravated:
Nominated representative 164A
ECT without anesthesia (Direct ECT) Girl child: In presence of parents
ECT for minors
Restraints and seclusion Juvenile justice board: 1st class JM + 2 social workers
Sterilisation <7yr:
Decimalization of suicide (309) 7-12yr:
12-18yrs:
>16yrs + Heinous crime
MTP and PCPNDT acts
2021
PCPNDT 2002
<20weeks Prohibit sex selection and prenatal diagnostic tests
20-24 weeks Form B: Certificate of registration
Form D:Genetic Counseling Centre
Form E: Genetic Laboratory
>24 weeks
Form F: Genetic Clinic/Ultrasound Clinic Imaging Centre
Form G: Consent form (invasive tests only)
Therapeutic-life of mother endangered
Eugenic –fetal anomaly
Humanitarian-rape/incest/minor/mentally ill/marital status change
Social – Contraception failure
Age for consent:
Consent of husband?
OBG
RMP with 6mon internship/ 1yr house job/ 25 cases MTP
Basics of reproduction and sexual offences
Satyriasis Intrauterine death signs:
Nymphomania Earliest-
Robert sign-
Surrogacy-Altruistic Spalding sign
Close relative Ball sign
Married with one child Ribs overcrowding
25-35yr
Only once Maceration- Intact sac
Earliest-
Lochia Mummification-ROM
Live born vs Still born
Hymenal tear: Autopsy:
Posterolateral (4-7) Foder’s test:
Anterior: Plocquet’s test:
Intact despite intercourse:
Vagitus uterinus/vaginalis:
Wredin test:
Breslau’s second life test:
False positive hydrostatic test:
Hydrostatic test
False negative:
Autopsy and thanatology
Incisions:
I–
Y-
Modified Y-
Inverted Y-
X-
Embalming fluid:
Preservative:
Eye changes: Germicide:
Minutes: Buffer:
2hrs: Anticoagulant:
3-6hrs: NOT ETHANOL
6hrs: Putrefaction:
Best indicator TSD- Larynx/trachea-> Prostate,
nongravid uterus, bone, teeth
Late rigor mortis:
Asphyxia, Hemorrhage, pneumonia Putrefaction delay:
Bulky muscles Strychnine, metallic poison,
Maggots >48hrs Not in fetus <7mon Carbolic acid
Human identification
Race: Milk/temporary teeth Permanent teeth
Best bone to identify: CI-LI-C-M1-M2 CI-LI-C-P1-P2-M1-M2-M3
70-75:
75-80: I M1 C M2 M1
80-85: CI
LI
Teeth: PM1
Carabelli’s cusp- PM2
Gustafson criteria C
Most reliable- M2
M3
Mixed dentition:
Total:
Stains for fluids
BLOOD SEMEN
SCREENING TEST SCREENING TEST
Adler’s test/ benzidine test 1) Florence stain
Orthotuluidine blue test 2) Barberio test
Combur test/ Tetramethyl benzidine 3) Brentamine / Walker test
Kastle-Meyer / Phenolphthalein 4) MUP test
Leukomalachite green 5) ICT-Semenogenelin, LDH
Luminol stain-UV light CONFIRMATORY TEST
CONFIRMATORY TEST MICROSCOPY
1) MICROCRYSTAL TEST Crystal violet:
TEICHMANN:
TAKAYAMA: Edelman’s agent:
2) MICROSCOPY
3) ABSORPTION SPECTROSCOPY
Motility:
100%- 3hrs
50%-8hrs
10%-24hrs
General Toxicology
SMELLS: Organs preserved:
Garlic: Blood
Kerosene: Urine
Bitter almonds: Entire stomach
Proximal 30cm SI
Rotten egg: 500g liver
Burnt rope: Half of each kidney
Fruity:
Acrid pear: SPECIAL CASES:
Mousy: Heart-
Brain-
Stomach mucosa CSF/vitreous-
Black/ Blotting paper- Spinal cord-
Yellow- Lungs-
Leather /Grey- Bone, hair, nail-
Blue-green- Abdominal fat-
Red velvet-
Yellowish brown- Role of a doctor: 1. First Aid
Slate gray- 2. Preserve samples
3. Police intimation
4. Dying declaration
Toxicology-Corrosives, asphyxiants, cardiac
CORROSIVES ASPHYXIANTS CARDIAC POISONS:
General Mx Carbon monoxide:
Gastric lavage/emetics- MOA:
Neutralisation:
Demulcent Pulse oximetry:
CXR-PA Cutaneous blisters+ Cherry red lividity
Endoscopy CYANIDE:
Calcium gluconate: Drug-
Lee Jones test Lilley kit
Gastric lavage:
Time:
Position:
Toxicology-Snakes and plants
CARRY NO RIGHT
No
torniquet/incision/cautery/sucking/coffee/alcohol
R-Reassure
I-Immobilize
G-Go to
H-Hospital Neostigmine + Atropine:
T-Tell symptoms
Toxicology-Metallic and non-metallic poisons
Old house, Painter’s colic Protoplasmic poison CHELATORS:
Plumbism=Saturnism Garlic odour BAL-
A Luminiscent vomit, feces
B Smoking stool syndrome DMSA/Succimer-
C Yellow fatty liver D-penicillamine-
D Diwali poison EDTA-
E Desferioxamine-
F
G
