FMT Notes
FMT Notes
Social duty, Self jnterwst +p awoid camel (TEAS) of ~@ of reasoroble care & skill by a doctor ain treating a ph resulting ir bodily indwny or death of He patient ~ Ack of owission , Act of Lommission — Essentiol component (40) - Duty, Dereliction , Direct causation , Domoge ~ Dees =F Civil + Criminal + Contributory + Corporate + Lemposite * eticol Ft. no vs Criminal — Doctrines Defenses Neali . : ves gene type Res Foon Leib + No dady «Duby dischor Tiel b + Doctrine of Lommor Knowledge Lontributory * Naloccunence. @ Patios unsent * Calculated risk doctvine “® Tanepou ic miscdventore . : eukkc wasedvew @ Burdon of proof “Tevopentic risednnhos © Error of Judgewent © lentributory @ "Novy actus intenweriens® je 3, trate Trdicatn © Evidence + Res Iudicatn® « Trforwed @ reninat es ahah ered @ Complaint + Products liebility © A. Histonduct ve Negligewe Crimmal * Viconiows liability + Notune + Duty of cane an “Borrowed suaventdoctrire® * Damoge te pt | — 336,334,338 * Doctrive of informed Loser + Trat “by Aes 4» Fall dislosine® © Panishmenk s Last clear chance doctrine * Brpeot tan be filedo Tnguest (enquiry or inveskgat into cause of death estore deoth Was sudden, suspicions , unnotural & canse . Ln known) OMagistrate =) Ducheial magis. 16 (1A) PE @ Police, b) Executive magistrate 770) @ borne @ Procurator Fiscal syste © Medal exariner Folice_vs Magis > londucted by+ U/s « info given te + cases in Pa + Exam of witness (S25-B¥6 EPFL) + Value of statement by pit nes os) * Enhumation + Enom of viscoras Quality of In vestiget O Relive ve Passive Euthanasia Ruma Slaebhiag vertdale.-[7Braas) O Dek. @ Nature of act © Procedune @ Chovactorishe Commission /Omission Bor. K0L. Ms. ralanant ® Counties in which allased ( Belginm, Netherland = Indio) Consent! Living will + Terminally ill » fermanent vegetative state Aruna Sharboug case (7-3 201) + lommen cause. vs Unien of India Gian Kaur vs State of funiab (306 ree) B Consent (2 or more pers are seid to canserd her ey agree Des or the ae thing in We Soe sense) See ls * Tinplied P J Thdion eovdract act + Expressed a ee 7 Free, voluntary Trformed ny procedune dene ih gerd will beynd + Blanket / Open woe eee ee RN Th © waiver BEO Myr 8,8 2 + Dochyine of Pull disclosure Ovtyrs) , 88,82, 40,4 4 w Informed tonsont Consent im Medicoleg ol omar 53(1) br PL (witout consent) | Deviatton > Moss immunization, Thenapentic toaiver, Medico | 53U) CPC, Trerapentic privilege, autopsy Theraportic never lonvicted piseven, Privileg ect tommunicat | Other —> Loco parents , inlornadt vefarsad Gorsont of spouse —9 AT, Spern donat”, Any procedwre D Medical vecord maintainance Peateemar) seared + Trdosr Pt Byrs. on + Records na bo issued widhie 7 bvs ) Thysidan | + Hospital manuel — oulpatiant 5 yrs Trpotient lo yes : Tntegrated opptoachslegol Procedure. { * Bailable (804,323,325) - Non Boiloble (302, 30%, 304-2, 326) : lognizable (eg. Rope, murder 2 (e) core) + Non cognizable (2.0 Grd) * Wasrront case (imprisonment 72 yr#) + Sammon case (kayrs) as tummen (document tampelling the otendance of a witness in Tpes a court of Lars, under poral, on a particuler day, ees Hime place for te purpose ot giving av; don ce) “$ Ubprena duces -tectuin (document) : Subpoena ad testiticondum * Iss * by . ForsonX (ewed By prasclng ofticn — Seok! 61-64 GP 68 fomiyx Wovrant + B¥ (a) » #(b) 66 Heod offi 12, ey, s50crPc, CEA. Gly O Dying dectavation (32 TEA) . cates cre! = 4/t unlawfal ach, veloding do facts of tre - Whe con record — + Anyone with Riirtness + Mogisdrak ~ Pero * Police or Doctor if death ini nod . Ne woth Ne leading q, +o patients nordy Sal ying deposition (spertor- rot dow) re] Evonmin chieh D1 Revording of ovidene in towrt? Oath BI] Cer IEA 37] — Cross enominat - Re- exon Lending question (19) TEA) (tai tae TEA) BE Porwatled m Cyost-enam (143TEA), Host ee 4 . OY Hostile pithess (154 TEA) , Dying cleposiion 3 Lp Jessica Loo 4g pes of Witness => Tntarosted, Chance, New +o cow 7 Stock, eye, Oppea, ss rae O Fvidene (2768) Related, “Expert r Delayed tied © Or0A + Documentary | Steeke witness [ Paes AL. Tp- adeqpnke paymen jaresay +} Tis borae 1 hind Kl Hb back of“ responsibi lity Dive + Thdivect Onfovowroble saitnessDeep and moe sciatic notch Features Pelvic inlet Wide and gree sciatic notch Heart shaped Circular shaped? Pelvic cavity Funnel? Flat bowl lliac crest More prominent More rounded Preauricular sulcus Narrow, shallow Broad®, deep Not frequent More frequent? (evidence of Pregnancy) Sub-pubic angle ‘v’ shaped “u’ shaped Acute (<90°) Obtuse® (>90°) Greater sciatic notch (75%) Narrower? & deeper Wider? & shallower Obturator foramen Large and oval Small and triangular a Acetabulum Large, directed laterally Small, directed anterolaterally Ischial tuberosity Inverted Everted Sacrum Long Small Uniform curvature? Upper half straight, lower half curved forward. Promontory more prominent Promontory less prominent. Pubis body ngular | SquareSex Determination from Skull izsr lable) el Architecture Rugged Smooth Muscle markings & | More pronounced? | Less pronounced bony ridges (Glabella, supraorbi- tal ridges, occipital protuberance, zygo- matic arch, mastoid process) Frontal eminence & | Small Large? | parietal eminence Orbits Square? with Rounded with smooth margin Sharp margin Forehead Sloping & steeper® | Vertical Palate Large, broader and | Smaller and U shaped parabola Frontonasal Distinct and Smooth junction angulated Digastric groove More deep Less deep Mastoid process Large and blunt Small and pointed Sex Determination from Mandible reeled Male Pro Appearance Large | Small Prominent muscle Not prominent markings muscle markings Chin Square shaped® Rounded? Angle of body with | Less obtuse <125° More obtuse >125° ramus Angle of mandible | Everted? Inverted® |VITAL INDICES FOR SEX DETERMINATION FROM BONES Name of the Formulae Males Femak index Sciatic notch | Width of notch ————-=* 100 Depth of notch Washburn ischiopubic index Width of notch: Depth of an Body length length of body 7 2X mManubrinn of ” es 7 g KYRTL Ashley’s Rule To determine the sex of the sternum © It js also known as ‘149 rule’. ath Male sternum length is >149 mm and female sternum let! is <149 mm. -: Preauricular sulcus Characteristic of the female pelvis2, Anterior sacroiliac ligament is attached to it, Prominent after childbirth. Useful in differentiating males and females; Nulliparous women and women who have given birth. Chilotic line fiteenteee Anthropometric line extending from the posterior aspect of the iliopectineal eminence to the anterior auricular margin (the pelvic segment) and then from the auricular margin to the iliac crest (the sacral portion). To identify the sex® of human skeletal remains. Pelvic segment is predominant in females? Sacral segment is predominant in males.Age Estimation from Skull Closure of posterior fontanelle (Lambda): 3 months-¢ Closure of anterior fontanelle (Bregma): 1%4- Closure of metopic suture: 9 months-2 years Two halves of mandible fuse together: 1-2 years Basiocciput and basisphenoid: 18-21 years? 2 years Sagittal suture Coronal suture Upper half: 40-50 Tulloch tte Posterior one third: Upper half: 50-69 | 30-40 years years years | Anterior one third: | Lower half: 50-60 Lower half: 60-70 | 40-50 years years years Middle one third: 50-60 years Certain facts regarding skull sutural closure © Sagittal suture is most reliable® for age estimation, followed by lambdoid and then coronal sutures. ¢ Closure of skull sutures begins on the inner side (endocrani ally), 5~10 years earlier than on the outer side (ectocranially Lapsed union®: e Ectocranial suture may not close. ¢ Commonly seen in sagittal suture’.TEMPORARY DENTITION | + Begins by 6 months + Complete by 2 years * 20 in number + In each jaw: 4 incisors, 2 canines, 4 molars AGE ESTIMATION — FROM DENTITION (- BOYDE’S METHOD: INCREMENTAL LINES = STACK’S METHOD: WEIGHT OF THE TOOTH, f PERMANENT DENTITION ) METHODS OF CHARTING THE GUSTAFSON’S METHOD + Begins by 6 years TEETH + Attrition 32 in number « Universal |» Paradentosis in each jaw: 4 incisors, 2 canines, » Paimer notation |+ Secondary dentin 4 premolars & 6 molars »,Haderup system | + Root resorption + First permanent tooth to erupt is + FDI System (internationally |+ Transparency of root (most first molar. | accepted) | reliable) Cementum — Modified FD! System apposition SUPERADDED TEETH SUCCESSIONAL TEETH SALIENT POINTS - Teeth which don’t have _|- Teeth which replace the | |. From the age of 6-12 year the total deciduous predecessors || deciduous teeth. number of teeth in the jaw is 24, - All permanent molars Incisors, canines and + Period of mixed dentition (12) premolars (20) 12 years’. Sie (LOCARD’S POROSCOPY WN Sweat pores on the ridges asnananstehensnniensnsnnannanantntnsnsnninstninnsnsineninnsitinetie Poroscopy * Poroscopy is the study of pore structure? found on the papillary ridges of the fingers as a means of identification. ¢ Developed by Edmund Locard®, as a means of identification. Principle ¢ Fingerprint ridges on fingers are studded with microscopic pores. © The pores are the openings of sweat glands®. Each millimeter of ridge contains 9-18 pores. The pores’ characteristics are unique to each individual and permanent®,Index = 0.50 or more Index = 0.33 or less Animal hair uman hair Human hair Fine thin Cuticular scales are short, not continuous a mal hair Coarse and thick Cuticular scales are large, step- like projections Cortex thick® (4-10 times as Cortex thin® broad as medulla) Pigment more towards the periphery Pigment more towards the medulla Medulla thin and frag- mented®, sometimes absent Medulla broad, continuous? and always present. Medullary index <0.3% Medullary index >0.5° Precipitin test specific for human Precipitin test specific for animalCheiloscopy? is the study of lip prints. Lip prints are unique and used for personal identification. e Lip prints are traced at the point of direct contact of the individual’s lips with an object at the scene of crime, e.g., cutlery and crockery items, cigarette ends, etc. e Aquaprint and cyanoacrylamide may be also used for developing the prints. Suzuki classification® of lip prints: e Type |: Complete grooves running vertically. e Type |’: Partial vertical grooves e Type Il: Branched grooves e Type lil: Intersected grooves © Type IV: Reticular pattern © Type V: Unidentified pattern. Palatoscopy/Palato-Print/Rugoscopy | e The study of palatal rugae® in the hard palate® to establish identity. Principle: e Rugae are formed by 12-14th week of IU life. e Rugae pattern remains stable throughout life and does not change during growth. Location: Anterior third of the palate, behind the incisive papilla. © Two types of rugae: Primary rugae (>5 mm) and secondary rugae (3-5 mm) © Palatine rugae are unique and can be used for identification. © Can be used even in advanced decomposition. Rugae are protected from trauma due to its situation and from heat by buccal pad of fat and tongue.EXAMINATION OF BITE MARKS Bites are commonly seen in the cases of: e@ Sexual assault e Child abuse e Inthe scene of crime, bite marks on foodstuffs (apples, cheese chocolate), leather (key rings or belts) and wood (pencils) @ Inassaults, where marks may be found anywhere on the body. Nature of Bite Marks Abrasions, bruises and lacerations or a combination of all these. Human bite is semicircular or crescentic caused by the front tee (incisors and canines) with a gap on either side due to separation upper and lower jaw. Investigations Done Photographs from various angles © Swabbing of saliva Tattoo Marks Faint or disappeared tattoo marks can be made out on histological study of the regional lymph nodes®. Drug addicts often imprint tattoos over areas of multiple injection mark, in order to conceal the needle puncture marks. Methods to demonstrate old or faint tattoos: Infrared photography? UV lamp? Magnifying glass High contrast photographyOo Lmpolence Frigieh HMA-~5 : Sy HINA -U12 Null &vola * Paychological (MC) * Vaginisymus BN -13-Divores . Vascuslogemie . fey cholegi col : Newvological Multiple ) * lmgerital STB) Stentily > Srability to beget orde Aeapsred (TB, Castvat*) Concave o child, “Tupotence Quod Hoe 9 Void ab initio —> Bigamy , incest ‘Ground {pr dvore 2 Voidable > Tnnpolence, Trsoity + D Divorce Twolid tensed, Tupregnat Tipersonatt™ Desorth, Violen / Venaveod discare + Offence + Crualty? Resuneto Adulter D Vivgividy 23 : . Veegitily 2 Breast, Nipple, Labia mnaora, wd norer J Fourchette | Posh. Lommissure, Vaginal wall. Vaginal putosn, Sewiluncr Intack hy won Peblovat > x Foseoe novieulorts , Q cS FB/Digi tal —A ng. Corunculae wy rh formis Ponile O Fimbridded vs torn hymén *G Posh Lod. Situoth of wot Sp “pio peuplery Shope 4 size of hymen, Asymmetrical Mincus womb. ovan wotches Brn Cours ' Senwal gitus /AB Se 5 co 7 Mnile -voginal — Rape- Treest. ded tery & — Now penile - vaginal — §, » Bostials OD Sodo yn (Knee elbow Position) P ‘J ree ey coitus | Nemhab possive Hob passive Ground fer Livere — | + Dightl exam — Fonigngl shin ° . See SFR os obrasion Ys clued K < eae: keratinized pom frclet 2 ~ Funnel shaped dopiess” of ante = Anal losenat ot buttoule darned” Jou. - Fresh [dried semen Anus in alleged * Dilated £ Patulous shaft of penis shows *Loss of rogosity of ynnewy merb. Fecal matter : Rol apse ot- Veco muncosrO Rope — Types: Statatbory, Marital, hrang Crstodial, Date, 7 Stronger Th camera trial 32%(2) Cr PE , Treatment Fliutritya 166 B, 223n BBY GPL zepon Medical enom of vicky 164(A) Gree = of Accused 5 3(A) (re S54 (APL ~ Generel, Local = Pubic hair = Pen vaginun Seat eat imeem Vag wall WL sterile apacmlu Twosmab ee . Contusion lower 3°* Ant. — Upper 3”! Pash. Hunan tear — Gloister Keen vods Rsk. lat 4- Bo’ eloek, 2-34 swollen, congested ~ Immediate /Fvesh + Bleeding» reddish, tender — lnk = moxtgi ns shes merking Tastdee — iateeeae " Tolwidire bhe . Colposcopy , Woods brine = + “inv Jpn Foreign debries ti nm y ‘ellect? SAFE Kit ( Sexnal Assaulb ean pie atl Ca Evidences) aginol , Anal , Oral, Body Sbab ' : Within 46 bys | Ustlan PERK Kit ( Physical avidente 3 Yetovery kit) F Crom of acomad Geveral, Local | $ rn | Logal’s ioctre 3, | Brown colowr ll 4 doySEXUAL PARAPHILIAS ACHIEVING SEXUAL GRATIFICATION BY ACTS OTHER THAN INTERCOURSE + Infiction of pain or physical cruelty ‘on the + Observing unsuspecting people undress or partner: Sadism + Having sex with the dead body: Necrophilia + Eating the dead body: Necrophagia * Receiving painful stimulus from the partner for Sexual pleasure: Masochism + Wearing the dress of opposite sex: Transvestism * Exposure of genitalia in a public place to obtain Sexual pleasure: Exhibitionism * Sexual arousal tesulting from objects: naked, taking bath: Voyeurism/Peeping tom + Self-stimulation which effects sexual arousal: Masturbation + Female amputates penis of her male partner: Bobbit syndrome + Inducing his wife to have sexual intercourse with another man and by observing the same: Troilism + Sight of others engaged in sexual intercourse: Mixoscopla + Sexual activity involving enemas: Klismaphilia + Sexual arousal by using Obscene language over phone: Telephone Scatologia Fetishism * Rubbing the private parts of a woman in a public Crowded place: Frotteurism © Stalking®: 354 D IPC (up to 3 years jail) Legally Punishable Perversions e Frotteurism®: 290 IPC (fine) and 291 IPC (6 months’ jail) © Exhibitionism: 294 IPC (3 months’ jail) e Necrophagia and First offence of Voyeurism and Stalking Cognizable and | Bailable Necrophilia: 297 IPC (1-year Second Cognizable Jail) offence of and non- © Use of criminal force to voyeurism and | bailable disrobe a woman: 354 BIPC_| | stalking (3-7 years’ jail) © Voyeurism: 354 C IPC (1-3 years Jail)signs of Pregnancy Desai) shea bo ¢ Vaginal discoloration Jackquemier’s or Chadwick's sign © Urinary disturbances Sympathetic disturbances e Amenorrhea e Morning sickness e Quickening e Breast changes e Pigmentation of skin Probable signs e Changes in abdomen e Hegar’s sign © Goodell’s sign © Braxton-Hick’s sign © Ballotment ¢ Uterine soufflé Immunological tests mT ierede ytainnil aaa Fetal parts® Fetal movements® Fetal heart sounds® Xray diagnosis (not done now) Ultrasound Placental soufflé tl L Umbilical souffléoL: fferences between Nulliparous Uterys and Di A parous Uterus in Autopsy features TT EIU LCL Telnet size | Small, 40-50g___| Large, 80-100 g Length Body and cervix Body twice the length of same length cervix roe i Q External OS Circular’ Transverse slit? Internal OS Circular, well Ill defined defined Upper surface | Less convex and More convex and at of fundus in line with broad higher level than the line ligament 4 of broad ligament Uterine cavity | Triangular cavity Rounded cavity and inner and inner walls walls concave? convex? | Arbor vitae Present? | Absent Scar from Absent Present Placental attachment ee ee 1Abortion © Medical definition: Expulsion of the products of conception up to the period of viability © Legal definition: Expulsion of the products of conception any time before the full term (BB WEEKS Wiability) eo <> Medical abortion Full term —< Legal abortion Unlawful abortion is criminal abortion Methods of Criminal Abortion e Abortifacient drugs = Ecbolics: Drugs which increase uterine contractions (Ex: Quinine, Ergot, Estrogen) = Emmenagogues: They increase menstrual blood flow Examples: = Borax = Estrogen Emmenagogues pepoeva BOSS = Sanguinarine © GIT irritants, Genitourinary tract irritant (cantharides) and heavy metals (lead and mercury) Violence Course daites [RereV WIT) Violent exercises like Syringing running, jumping, lifting * Injecting air or soap heavy weight can cause water into the uterus expulsion « Higginson's syringe is Any intentional trauma to commonly used abdomen Rupture of the membranes © Cupping by using any pointed things Abortion stick castor/ Calotropis (Laminaria stick })@ Dilatation of cervix = By drugs « Slippery elm barkArtificial Insemination lonor © Process of introduction of semen from the husband or @ donot by instruments into the genital tract of a female to bring pregnancy, Types © Artificial insemination homologous/husband (AIH): Semen of husband used. © Artificial insemination donor (AID): Semen of donor used Fallopian tube Ovary with an egg Washed sperm Cervix Vagina Indications of Artificial Insemination Husband is impotent Husband is sterile Husband is unable to deposit semen due to hypospadiasis Husband is suffering from hereditary disease Rh incompatibility between husband and wife Medicolegal Aspects © Nullity of marriage and divorce: ™ If artificial insemination is done without the consent of the husband, the husband can file for divorce. ™ Artificial Insemination (AI) due to impotence isa ground for divorce. = AI due to sterility is not a ground for divorce. (Remember: Impotency is a valid ground for divorce; while sterility is not) © Legitimacy: = Child born out of Al is considered to be the biological child. © Adultery: = Recipient of AI cannot be held guilty of adultery? because there is no actual physical union by coitus between the donor and the recipient. © Incest: Remote risk of incest possible.THE SURROGACY (REGULATION) ACT, 299 FE TS © ‘The Bill has been passed in The Rajya Sabha as well and re, cei, Presidential consent on December 29th, 2021, hence magg’¢ king it an Act. . @ The Act prohibits commercial surrogacy but allows altruigie surrogacy. Who can Avail Surrogacy? Intending couple and intending woman © “Intending couple” means a couple who intend to become parent through surrogacy due to medical indications. © “Intending woman” means an Indian woman who is a widow or divorcee between the age of 35-45 years and who intends to avait the surrogacy) ‘The intending couple should have a ‘certificate of essentiality’ and q certificate of eligibility issued by the appropriate authority. Criteria for Certificate of Eligibility © ‘The couple should be Indian citizens and married for at least five years. © Age of wife- 23-50 year-old and husband- 26-55 year-old. © They do not have any surviving child. Eligibility Criteria for Surrogate Mother © A close relative of the intending couple @ A married woman having a child of her own, © Age—25-35 year-old © A surrogate only once in her lifetime © The Act does not permit live-in couples and single parents for surrogacy National Surrogacy Board (NSB) and the State Surrogacy Boards’ (SSB) to be established by the governments. Parentage and Abortion Rules © A child born out of a surrogacy will be deemed to be the biological child of the intending couple. Offences and Penalties © Undertaking or advertising commercial surrogacy © Exploiting the surrogate mother © Abandoning, exploiting or disowning a surrogate child Selling or importing human embryos or gametes for surrogacy: ‘The penalty for such offences is imprisonment up to 10 years and a fine of up to 10 lakh rupees, SEMINAL STAIN EXAMINATION Physical Tests for Seminal Stains © Dried seminal stains 7 on clothes can be examined by UV light®. luotescence noted, which is nonspecific.