PATTERN OF MEDICO-LEGAL CASES PRESENTING TO A TERTIARY CARE HOSPITAL: A RETROSPECTIVE STUDY

Abstract

Background: Medico-legal cases (MLCs) are a critical link between emergency healthcare and the court system, necessitating prompt clinical management, precise documentation, forensic evidence preservation, and appropriate legal reporting. However, their epidemiological patterns differ according on demographic, socioeconomic, regional, and healthcare-related variables. This systematic review compiled published data on the demographics, distribution, injury patterns, and primary causes of MLCs presenting to tertiary care hospitals.

Methods: A systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) criteria. PubMed, Google Scholar, Scopus, Web of Science, and ScienceDirect were searched with terms such as medico-legal cases, tertiary care hospitals, emergency rooms, traffic accidents, assault, poisoning, burns, and forensic medicine. We considered eligible English-language hospital-based observational, retrospective, prospective, and cross-sectional studies that reported demographic or epidemiological characteristics of MLCs. Six studies out of 1,610 identified records met the eligibility criteria and were included in the narrative synthesis. Due to significant heterogeneity among trials, no meta-analysis was undertaken.

Results: All six included investigations were carried out in India, with sample sizes ranging from 455 to 12,789 cases. Young adults were over-represented, with people aged 21 to 30 accounting for 35.0% of reported cases, followed by those aged 31 to 40 (21.8%). Males predominated in the key medico-legal categories. Road traffic accidents (RTAs) accounted for 15.1-70.7% of MLCs and were the most commonly reported major category, followed by physical assaults (28.9-63.1%), poisoning (4.3-19.5%), and burns (5.8-13.2%). In assault situations, hard or blunt weapons caused 86.0% of injuries. Organophosphorus compounds were the most commonly reported poisoning agents (37.2%), followed by organochlorine compounds (23.7%) and paraquat (11.8%); roughly 86% of poisoning cases were linked to suicidal intent. Thermal burns accounted for 44.9% of burn-related MLCs, affecting 31-70% of total body surface area.

Conclusion: Most medical-legal cases presented to tertiary care facilities are trauma-related, and they disproportionately impact young, economically productive males. RTAs and physical attacks bear the majority of the medico-legal load, whereas pesticide poisoning and burn injuries continue to be significant causes of morbidity and medico-legal complexity. The findings advocate for improved road safety initiatives, violence prevention measures, pesticide control and poison prevention programs, burn prevention, emergency trauma treatments, and standardized medico-legal documentation.