As per records of Government Rajaji Medical College and Hospital, Madurai, from April 1 2019 to April 15 2019, there were 178 post-mortems conducted by doctors there. Of these 178 post-mortems, there were 57 of different cases (road accident, murder, poisoning, etc.) which had almost same findings - cut and paste from earlier reports. “Very few findings varied in the certificates. Further, as per the CCTV footage, measurements were not taken in any of these bodies. So, it is clear that all these 57 post-mortem certificates were cut and pasted,” noted the bench consisting Justice N Kirubakaran and Justice SS Sundar in a recent order.
The court’s observation came while issuing an order on a petition by RM Swaminathan with a prayer to strictly follow the Tamil Nadu Medical Code when conducting autopsies, to implement video-graphing of all autopsies across the State in order to avoid issues and re-post mortems and the same video-graph be sent to the jurisdictional magistrates, post-mortem certificates be sent to the jurisdictional magistrates on the same day of the post-mortem as stipulated in Article 621 of the Tamil Nadu Medical Code.
The court found that even details of identification marks on bodies were cut and pasted in the report. “A perusal of the said certificates would reveal that the identification and caste marks of four different persons are one and the same namely (i) black mole on left side chest (ii) clack mole over right side abdomen even though the persons who died were different,” the court observed.
One more shocking revelation found from the records of Madurai medical college, was that even though more doctors were said to be on duty, the reports gave details as to how only one doctor conducted more than 10 autopsies in a single day, which is impossible. A tabular column given in the report would fortify the allegations made by the petitioner that the doctors were not conducting autopsies themselves scientifically as it was impossible for a single doctor to do autopsies ranging from 10 to 17 per day.
The records would prove the contention of the petitioner that almost, all the findings given in one post-mortem was being used in another case even without any post-mortem, which goes against the very purpose of post-mortem and it is as good as not doing a post-mortem at all. In most medico-legal cases, the outcome of the criminal case depends upon the findings in the autopsy certificate and also the doctor’s evidence. If in this shabby and unscientific manner and without actual performance of autopsies by doctors, the autopsy reports are prepared, it will lead to the collapse of the criminal justice delivery system in this country. The doctors are the most respected citizens of this country and also aid in the justice delivery system in medico-legal cases. Therefore, corrective measures have to be taken as otherwise, criminals would escape from the clutches of the law because of the negligence and deliberate failure on the part of the doctors conducting post-mortems.
The HC bench also noted that the two scientific officers K Loganathan from Stanley Medical College and Hospital, Chennai, and J Ramesh, from Madurai Medical College were bold enough to come out with true facts in the court despite threats from their senior officials.
The scientific officers explained in detail about what was happening in medical colleges, including performance of dissection unscientifically by mortuary assistants and other persons who are present in the mortuary without following scientific methods. They submitted that forensic experts are not personally performing autopsies most of the time. Also, post-mortem certificates were not being issued as per the format issued by the National Human Rights Commission, the court observed.
Sometimes, even in the absence of medical experts, autopsies were being done by others. Forensic experts have made examinations without even checking bodies and many a times, cut and paste methods have been followed. In fact, Loganathan submitted that when he raised questions against all this, he was threatened and complaints were made against him, court noted.
It was submitted that the doctors’ attendance was irregular, and they would sign the register, giving proxy for other days as well. Though many doctors were supposed to attend hospital work, in turn, they themselves would allot another doctor to look after the work on a single day. The post-mortem certificates, as stated above, were pre-drafted or prepared on dotted lines and not sent to the magistrate through police as mandated under Article 621 of Tamil Nadu Medical Code and many post-mortem certificates were not submitted to the Head of the Department to be sent to the Magistrate and they were belatedly sent, sometimes even after months together, thus paving the way for manipulations.
The respondents including Health Secretary, Directorate of Medical Services and Director of Medical Education went to the extent of making a statement before the court that the scientific officers namely, K Loganathan and J Ramesh were appointed only on contract basis and were not permanent employees, which were later found to be untrue.
Some of the 57 autopsy certificates that had identical findings, indicating they were copied and pasted from the same report
Court’s surgical strike on autopsy system
The Madurai bench issued the following order on post -mortem protocol in TN hospitals
- CCTV cameras shall be placed at all important points in the mortuaries as well as in the dissection halls, and shall be operational at all times
- The Health Secy shall issue a circular directing doctors to follow Article 621 of Tamil Nadu Medical Code in letter and spirit
- The doctors shall send the post-mortem certificate as soon as it is over to the judicial magistrate with a copy to the HoD on the same day failing which departmental proceedings shall be initiated against them
- The post-mortem certificates should be issued based on the NHRC model
- Based on the biometric attendance only, salary should be proportionately paid, subject to their leave entitlement
- The govt shall ensure that all hospitals where post-mortem are done are provided with sufficient set of equipment, tools within a period of six months
- There shall be a notice in the hospitals especially in the mortuaries, dissection halls and newspaper ads informing that there will be videographing of post-mortem at the request of relatives
- K Loganathan, scientific officer, Stanley Medical College and Hospital, Chennai and J Ramesh, scientific officer, Madurai Medical College, Madurai, who assisted the court by giving out true facts shall not be victimised by the respondents or government authorities.
- The web-based system namely, MedLeaPR developed by NIC, Haryana, shall be followed by all doctors in Tamil Nadu, in government health institutions, private nursing homes and hospitals with effect from January 1, 2021.
- The govt should appoint scientific officers in all government medical college hospitals and in every district headquarter
- Four copies of post-mortem certificates have to be made ready, one original and three copies. The original has to be sent in a sealed cover to the Magistrate concerned, the second one to the Police, the third one to the District Medical Officer and the fourth one has to be retained in the institution for record purpose