Need of Guidelines to Deal With Unclaimed and Accumulated Medico-legal Samples

Hospitals are expected to provide a variety of patient care services depending upon the level as well as expertise available. However, all the hospitals especially in the public sector are obligated to provide medico legal services. These include conducting medico legal examination, generating medico legal reports, preserving samples for forensic examination and conducting postmortems. The importance of medico legal samples increases manifold in cases where they are the only piece of evidence. These may include clothes worn by the patients, gastric lavage samples, urine and blood samples etc. The importance of methodology of collection, preservation and handing over of such samples to appropriate authorities is of paramount importance to maintain the chain of evidence.[1] The methodology of collection is described in the books of medico legal jurisprudence as well as manuals brought out to standardize the medico legal procedures.[2] Recent focus on examination of victims of sexual abuse has generated a lot of discussion on the subject. Guidelines have been issued detailing the mechanisms to deal with such cases including examination and collection of evidence.[3]

However, we face a peculiar problem of disposal of the samples at Accident & Emergency Department at PGIMER, Chandigarh. It has been seen that of a large number of samples collected in the emergency by the medical officers on duty, a number of them are not taken by the concerned investigating officials. Since, these are piece of evidence; they cannot be simply thrown away. On the other hand their safe storage pose a challenge. These continue to pile on for years eating away precious space in the emergency department and often generate foul smell once they start decomposing. It is our belief that other hospitals may also be facing similar situation as reported by a newspaper being case in point.[4] The Kerala medico legal code specifies the time limit to which the samples collected need to be preserved.[5] However we could not find any other document which deliberates about the period for which such samples need to be preserved by the hospital. This has led to the situation of accumulation of such samples.

We would like to highlight the issue and generate debate through this letter and solicit possible solutions for the betterment of all the silent suffering hospitals within the ambit of law.

References

1. Guidelines for handling medicolegal specimens and preserving chain of evidence [internet]. London. The Royal College of Pathologists and Institute of Biomedical Science. c2008 – [cited 2015 March 9]. Available from: https://www.ibms.org/includes/act_download.php?...chainofevidence.pdf
2. Haryana Medico Legal Manual 2012 [internet]. Health Department Haryana. c2012 – [cited 2015 March 9]. Available from: http://www.haryanahealth.nic.in/userfiles/file/pdf/PM%20Branch/Medico%20Legal%20Manual/2.%20Haryana%20Medicolegal%20Manual%202012%2031.1.2012.pdf
3. Guidelines & Protocols Medico-legal care for survivors/victims of sexual violence [internet]. New Delhi. Ministry of Health & Family Welfare Government of India. c2014 – [cited 2015 March 9]. Available from:www.mohfw.nic.in/showfile.php?lid=2737
4. Toxic forensic samples pile up in Delhi’s LokNayak Hospital [internet]. New Delhi. Mail Today. cDecember 28, 2014 – [cited 2015 March 7]. Available from: http://indiatoday.intoday.in/story/toxic-forensic-samples-pile-up-in-delhis-government-hospitals/1/409183.html
5. Kerala Medico-legal Code [internet]. Thiruvananthapuram. Government of Kerala. c2011 – [cited 2015 March 7]. Available from: http://dhs.kerala.gov.in/docs/orders/code.pdf