UPSC MainsMEDICAL-SCIENCE-PAPER-I201520 Marks
Q24.

Write hypothetical medicolegal report of an injured person having sustained stab wound penetrating lung deep on right side of chest.

How to Approach

This question requires a detailed medicolegal report mimicking what a forensic physician would produce. The approach should be systematic, covering all essential components of such a report: patient details, history of injury, external examination findings, probable cause, and potential implications. Focus on precise medical terminology and objective observations. The report should be structured logically, resembling a real-world document. Avoid speculation and stick to factual findings.

Model Answer

0 min read

Introduction

A medicolegal report is a crucial document in forensic medicine, serving as an objective record of injuries sustained by an individual, particularly in cases of suspected crime or negligence. These reports are vital for legal proceedings, insurance claims, and public health monitoring. Stab wounds, especially those penetrating the chest cavity, are potentially life-threatening injuries requiring meticulous documentation. This report details the findings of an examination conducted on an injured person presenting with a penetrating stab wound to the right side of the chest, potentially affecting the lung.

Medicolegal Report

Report Number: 2024-FM-007

Date: October 26, 2024

Time: 14:35 hours

Referring Authority: Police Station – Sector 12, City X

I. Patient Information

  • Name: John Doe
  • Age: 28 years
  • Gender: Male
  • Address: 123 Main Street, City X
  • Occupation: Unemployed

II. History of Injury

The patient alleges he was assaulted at approximately 13:00 hours today, October 26, 2024, at a location near the city market. He states he was attacked by an unknown assailant wielding a sharp object. He reports feeling a sharp pain in his right chest and subsequently experiencing difficulty breathing. The patient was brought to the hospital by ambulance. He denies any pre-existing medical conditions.

III. External Examination

The patient is conscious and oriented but appears anxious and in moderate respiratory distress. Vital signs are as follows: Blood Pressure – 110/70 mmHg, Pulse Rate – 110 bpm, Respiratory Rate – 28 breaths/min, Temperature – 98.6°F.

  • Wound Description: A single stab wound is present on the right side of the chest, approximately 6 cm in length. The wound is located in the 5th intercostal space, mid-axillary line. The edges of the wound are clean-cut with minimal bruising.
  • Surrounding Area: There is a small amount of blood staining the surrounding skin. No other external injuries are noted.
  • Palpation: Palpation reveals crepitus around the wound site, suggestive of subcutaneous emphysema.

IV. Internal Examination (Based on Preliminary Radiological Findings - X-Ray Chest)

A chest X-ray was performed, revealing the following:

  • Lung: The right lung appears partially collapsed (partial pneumothorax).
  • Pleural Cavity: Evidence of fluid accumulation in the right pleural cavity (hemothorax).
  • Ribs: No obvious rib fractures are visible on the initial X-ray, but further investigation with CT scan is recommended.

V. Probable Cause of Injury

Based on the wound characteristics and the patient’s history, the injury is consistent with a stab wound inflicted by a sharp, pointed object, such as a knife. The penetration of the chest wall and the resulting pneumothorax and hemothorax indicate that the wound has penetrated the right lung.

VI. Opinion on Nature of Injury

The injury sustained by the patient is grievous hurt as defined under Section 320 of the Indian Penal Code, 1860, due to the potential for life-threatening complications such as respiratory failure and hypovolemic shock. The injury is likely to require immediate surgical intervention (thoracostomy and potentially thoracotomy) to restore lung function and prevent further complications.

VII. Samples Collected

  • Blood samples for blood grouping and alcohol testing.
  • Swab from the wound for DNA analysis.
  • Clothing of the patient preserved as evidence.

Physician Signature: Dr. Anya Sharma, MD, Forensic Medicine

Hospital Stamp: City General Hospital

Conclusion

This medicolegal report provides a detailed account of the injuries sustained by the patient, John Doe, following a stabbing incident. The findings indicate a serious injury requiring immediate medical attention and potentially involving legal ramifications. Further investigations, including a CT scan and detailed surgical exploration, are recommended to fully assess the extent of the damage and guide appropriate treatment. The report serves as crucial evidence for law enforcement and the judicial system.

Answer Length

This is a comprehensive model answer for learning purposes and may exceed the word limit. In the exam, always adhere to the prescribed word count.

Additional Resources

Key Definitions

Pneumothorax
A pneumothorax is a buildup of air in the space between the lung and the chest wall, causing the lung to collapse.
Hemothorax
Hemothorax is the accumulation of blood in the pleural cavity, the space between the lung and the chest wall.

Key Statistics

According to the National Crime Records Bureau (NCRB) data for 2022, approximately 2.5% of all reported violent crimes involved the use of sharp objects, resulting in grievous hurt or death. (Source: NCRB Crime in India Report, 2022 - Knowledge Cutoff 2023)

Source: NCRB, Crime in India Report 2022

Globally, approximately 1.4 million people die each year from trauma-related injuries, with penetrating injuries accounting for a significant proportion of these deaths. (Source: World Health Organization, 2018 - Knowledge Cutoff 2023)

Source: World Health Organization, 2018

Examples

The Nirbhaya Case (2012)

The brutal gang-rape and assault of a physiotherapy student in Delhi in 2012 highlighted the importance of thorough forensic evidence collection and medicolegal reporting in cases of violent crime. The detailed medical examination and documentation played a crucial role in the investigation and prosecution of the perpetrators.

Frequently Asked Questions

What is the significance of documenting the exact location and size of a stab wound?

Precise documentation is crucial for reconstructing the events of the assault, determining the angle of attack, and potentially identifying the type of weapon used. This information is vital for both the investigation and potential legal proceedings.

Topics Covered

Forensic MedicineSurgeryStab WoundsMedicolegal ReportingChest Trauma