FMT CERTIFICATE FAQs

-Rajas Mudgerikar
-Ankit Patil
(GSMC Mumbai)
INDEX
Common questions 02
MCCD 06
Age certificate 13
Potency certificate/Examination of 18
accused
Examination of victim 26
Drunkenness certificate 30
Injury and weapon report 36
Sickness and fitness certificate 43

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 COMMON QUESTIONS
1. What is consent?

Ans: According to Sec 14 of Indian Contract Act, it is agreement between two parties .or
voluntary agreement, compliance or permission.

2. Importance of consent?
Ans: Examination or any procedure done without consent is considered as assault
according to Sec 351 IPC and is punishable with fine & 1mth-2yrs fine.

3. Who can give consent?

Ans: Sec 87 IPC – Any person above 18 yrs can give consent for major procedures
Sec 89 IPC – Child > 12 yrs can give consent for routine physical examination
- For child < 12 yrs parent/legal guardian can give consent
Sec 90 IPC – Consent obtained under influence, intoxication, insanity is invalid.
Sec 92 IPC – In emergency conditions, not required to take consent.
*The person can be examined without consent, if requested by the subinspector of
police
*loco parentis- in emergency involving children,if their parents or guardian not
available,consent is taken from the person in-charge of the child. Eg school principle

4. Importance of identification marks?

Ans: To know if it is the same individual for whom the certificate has been issued when
someone is viewing the certificate afterwards.

5. How to take consent if person does not have limbs?

Ans: Audio-visual

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 6. Types of consent; best type?
Ans: Types
- Expressed
- Implied
- Blanket( not taken in india)
- Written informed (best)

7. Sec 53 CrPC
Ans: According to sec 53(2) CrPC, attendance of female attendant necessary while
• Examination of female
• Administering general anaesthesia to female
• Performing any procedure on a female.
Sec 53(1), police can apply reasonable force for examination of accused male if he
does not give consent.

8. Importance of Registration number

Ans: To trace the RMP in case of any medico-legal issue.

9. With whom will you register after completing your MBBS? Or

Who will give you license to practise after completing MBBS?
Ans: State Medical Council

10.Punishment for issuing false certificates

Ans: Sec 197 IPC- punishment is same as for giving false evidence (Sec 193 IPC) –
Imprisonment upto 7yrs & fine

11. Issuing false certificates is medical negligence or misconduct?

Ans: Misconduct but can be negligence also
Eg. Issuing false mental health certificate can have gross mental impact on patient.
Hence, mental damage, so negligence.

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12. If operating or examining under intoxication but patient is not harmed, it is
professional negligence or misconduct?
Ans: Misconduct & not negligence.
To label it as civil negligence, 4 conditions should be satisfiesd
➢ Duty
➢ Dereliction
➢ Damage
➢ Direct causation

13.If operating or examining under intoxication & patient is harmed, it is professional

negligence or misconduct?
Ans: Both misconduct & negligence.

14. Difference between medical ethics & ettiquetes?

Ans: Ethics are moral values practised by a doctor towards patients & the State.
Violation is punishable. Eg. Towards patient- maintaining professional secrecy
Towards state- reporting cases of homicide, infectious diseases, responding during
emergency
Etiquettes are practised by a doctor towards his colleagues. Violation not punishable. Eg.
Not taking fees from another doctor.

15. Types of professional negligence

Ans:
➢ Civil
➢ Criminal
➢ Contributory
➢ Corporate
➢ Ethical
➢ Comparative to be mentioned only if asked

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 16. Define professional negligence & misconduct.
Ans: Negligence – Lack of reasonable care, skill & knowledge or wilful negligence on part
of the doctor which leads to some damage to the patient. Damage may be physical,
mental or financial.
Misconduct – If a medical man during the practice of his profession does something
which is regarded as highly disgraceful, dishonourable or infamous by his other
colleagues of good repute & competency, then the state medical council holds him
guilty of misconduct. 6A BCDEFG
• Adultery
• Association with unqualified doctor
• Abortion criminal
• Advertisement
• Addiction (t/t under influence of)
• Alcohol (t/t under influence of)
•
• Advertisement
• Bribery
• Covering, commission
• Dichotomy (fee splitting)
• False medical certificates
• Gifts from pharma companies
Imp- take signature of person after taking him/her consent, as consent is invalid
without signature.
Also take signature of medical attendant, if present

It is advisable to go through all theory imps for theory viva with special importance to
Chapter Medical Jurisprudence.

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 MCCD
1.Full form
Ans: Medico-legal certificate of cause of death

2.What is the difference between death certificate, death report and MCCD?
Ans: MCCD
-issued by RMP
-to be submitted to the Registrar of births & deaths by the RMP
Death Certificate
-issued by Registrar of births & deaths
-collected by relatives of the deceased from the office of registrar of births & deaths within
21 days from death.
Death Report
-issued by RMP along with MCCD
-handed over to the relatives

3. Form numbers
Ans:
Form no. Description
4 Institutional death
4(A) Non institutional death
3 Still birth certificate
2 Birth report
6 Death certificate

4. Definition of death
Ans: Irreversible disappearance of all evidence of life at any time after live birth.

5. What is agonal period?

Ans: Period between fatal injury & death.
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6.What are the two types of death?
Ans: Somatic death (stoppage of function of the body) & molecular death (death of the
cells). The period between somatic & molecular death is important for organ harvesting.

7. What are changes after death?

Ans: Immediate changes
Stoppage of function of Bishop’s triad of life i.e.
• Stoppage of respiration (function of lungs)
• Stoppage of circulation (function of heart)
• Stoppage of sensibility (function of brain)
Immediate signs correspond with somatic death.
Early changes
• Skin changes
• Eye changes
Imp-
➢ Railroad trucking sign/Kevorkian sign on retina- 2-3 min.
➢ Tache noires sclerotic (triangular deposition of dust on conjunctiva) 3-6 hrs
➢ Intraocular pressure becomes zero in 2 hrs.
• Livor mortis
Imp- Onset by 30 min, visible by 2 hrs & becomes fixed 6-12 hrs (avg 8hrs)
• Rigor mortis
• Algor mortis
Late changes
• Decomposition
Imp- Marbling (veins on shoulders, axilla, breast become prominent due to deposition of
blood pigments in the walls) 36 to 72 hrs.
• Mummification
• Adipocere formation
Early & late changes correspond with molecular death.

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Read in detail from textbook.

8. Importance of MCCD?
Ans: Legal-
• Insurance claims
• Inheritance of property
• Hospital reimbursement
• Releasing gratuity & provident fund claims and
• Cremation
Administrative
• Surveillance of diseases & immediate control measures
• Deleting the name of the deceased from ration card, voter’s card.
Statistical
• Mortality statistics
• Developmental plans
• Public health & medical research

9. Who can issue MCCD?

Ans: Any RMP (Registered medical practitioner)
i.e. MBBS, Ayurvedic, Homeopathic, Unani doctor.
Dentist can issue it if the death has occurred during some dental procedure.
3 conditions should be fulfilled for an RMP to issue MCCD
➢ He should have been medical attendant of the deceased during life
➢ Has attended the patient within past 14 days before death
➢ He is satisfied with the cause of death

10. When not to issue MCCD immediately?

Ans:
➢ Injured is brought dead
➢ Crime has already been registered with police
➢ Cause of death is unknown eg. Poisoning cases
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11. What to do if you are not the attending physician & patient is brought dead?
Ans:
a) Don’t fill form 4 or 4(A)
b) Fill only form 2
c) Refer dead body to the police for arranging PM
d) MCCD will be issued by autopsy surgeon

12. Fee for issuing MCCD?

Ans: To be issued free of cost according to Sec 10 of RBD Act.
Should be issued immediately & free even if patient has bill pending with doctor.

13. Within how many days after death MCCD has to be issued?
Ans: Within 21 days

14. What is manner & mode of death?

Ans: Manner of death Natural
Unnatural Accidental
Suicidal
Homicidal
Mode of death- Asphyxia (respiration)
- Syncope (heart)
- Coma (brain)

15. Types of autopsy techniques

Ans:
• Lettule’s – en masse (all organs removed as a single mass- means tongue to rectum
remove in one mass)
• Virchow’s – organ by organ (most common)
• Ghon’s – en block (organs of one cavity removed at a time)
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 • Rokitansky’s – in situ (cases of HIV, Hepatitis, Radiation)

16. Types of autopsy incisions

Ans:
• I shaped – done routinely; chin to pubic symphysis
• Y shaped – shoulder tip (acromian) to xiphisternum to pubic symphysis
• Modified Y shaped – Angle of mandible to Sternoclavicular notch to pubic symphysis;
done in case of hanging & strangulation.
• X shaped – in case of custodial deaths to see deep contusions on the back. In
strychnin posoing
• T shaped – Acromian to Sternoclavicular notch to pubic symphysis

17. Preservation of viscera

Ans: 3 bottles
➢ Bottle 1- Entire stomach & its contents, initial 1/3 of small intestine with its contents
➢ Bottle 2- Liver 1/3 in adults, ½ in children
- Spleen ½ in adults & full in children
- Kidney ½ of each in adults & full in children
➢ Bottle 3- Blood 10mL
Preservative used is saturated salt solution, in acid poisoning it is rectified spirit except
carbolic acid. Overall most commonly used is saturated salt solution preservative is rectified
spirit.

18. Why ID marks are not written in death certificate?

Ans: As body has already been identified by the relatives and is cremated, buried
afterwards.

19. Punishment for not preserving viscera or not preserving gastric lavage fluid?
Ans: According to Sec 201 IPC it amounts to causing disappearance of evidence.

20. What is suspended animation?

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Ans: Due to decreased metabolic rate, the vital signs of life i.e. pulse, BP, respiration cannot
be detected clinically but person is alive.
eg. Suspended animation in new HD TV.
➢ I = Iatrogenic, Insane
➢ N = Neonates
➢ E = Electrocution
➢ W = Wasting diseases like cholera, TB
➢ H = Heat stroke, Hypothermia
➢ D = Drowning
➢ T = Typhoid
➢ V = Voluntary in yoga practitioners

21. What is exhumation?

Ans: Digging out of dead body- procedure given in Sec 176(3) CrPC.
In India, there is no time limit for exhumation.
Presence of doctor, Magistrate & police necessary.
Done early morning to prevent public attention.
500g soil sample taken to see if there is imbibition of any poison in soil. Eg. Arsenic.

22. What are the types of autopsies?

Ans: 6 types
➢ Medicolegal
➢ Pathological
➢ Virtual
➢ Psychological
➢ Negative
➢ Educational

23. What is the purpose of doing autopsy?

Ans: To find out
➢ Cause of death
➢ Time since death
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 ➢ Manner of death

24. Which cavity is first opened during autopsy?

Ans:
➢ Thoracic cavity – routinely opened first and in cases of pneumothorax
➢ Abdominal cavity – in newborns to check level of diaphragm & hence, livebirth or still
birth.
➢ Cranial cavity – poisoning cases
➢ In cases of asphyxia deaths, sequence is
Cranial Abdominal Thoracic Neck to avoid Prinsloo Gordon artefact
(oozing of blood during dissection of skin of neck) & achieve bloodless dissection of
neck.
➢ In cases of air embolism, underwater autopsy performed.

It is advisable to read Chapters Death, Preservation of viscera & Autopsy from textbooks for
MCCD viva.

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 AGE CERTIFICATE
1. What are the parameters of age estimation?
Ans: 4 parameters

Bones Teeth Hair Secondary

Sexual characters
-Apperance & fusion -Gustafson’s method
of ossification centres -Boyde’s method
Tanner staging
Dental charting

Order of appearance:
Scalp Pubic

Facial Axillary

Fusion of ossification centres

Upper limb: 18 – 16 – 18 yrs for shoulder – elbow – wrist
Lower limb: 16 - 18 - 17 yrs for hip – knee – ankle
Carpal bones: Capitate – 1 yr
Hamate – 2 yrs (Remember 2 vertical lines of H)
Triquetral – 3 yrs (Remember TRIquetral, so 3)
Lunate – 4 yrs (Remember L resembles of )
Scaphoid – 5 yrs (5 resembles S)
Trapezium & Trapezoid – 6 yrs
Pisiform – 10-12 yrs
From 2-6 yrs no. of carpal bones = age
Other ossification centres to be read from textbook. Above ones are most important.
Teeth

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 a) Gustafson’s method
Based on SCRIPT
S = Secondary dentine apposition
C = Cementum deposition
I = attrItion by mastication
P = Peridontosis
T = loss of root Translucency

b) Boyde’s method: based on incremental lines on teeth.

c) Temporary & permanent teeth

Temporary teeth follow rule of 12
Permanent teeth: Mama Is In Pain Papa Can Make Medicine
Molar 1 – 6 yrs
Incisor central – 7 to 8 yrs
Incisor lateral – 8 to 9 yrs
Premolar 1 – 9 to 10 yrs
Premolar 2 – 10 to 11 yrs
Canine – 11 to 12 yrs
Molar 2 – 12 to 14 yrs
Molar 3 – 17 to 25 yrs

Dental charting methods:

a. Palmar’s/Zigmondy’s
b. Cunningham’s/Universal
c. Hardrup’s
d. FDI (Federation Dentaire Internationale) – currently used
17 16 15 14 13 12 11 21 22 23 24 25 26 27
47 46 45 44 43 42 41 31 32 33 34 35 36 37
Stands for unerupted teeth.

Secondary sexual characters

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 Tanner staging for breast & pubic hair of female is very important. Rest can be
done if you wish.

In fetus, age is determined on basis of length (rule of Haase), appearance of eyes, nails,
external genitalia, meconium, etc.

2. What is the importance of age determination?

Ans:
Age Importance
12 wks IUL MTP can be done with opinion of 1 doctor
20 wks IUL MTP can be done with opinion of 2 doctors
7 months IUL Age of viability
Infanticide cannot be claimed if fetus<7 months age
1 yr Killing of child below 1 yr is infanticide
3 yrs ½ fare in public transport bus
5 yrs Criminal responsibility as per Sec 130 of Indian Railways Act
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 ½ fare in railways
7 yrs No criminal responsibility under 7 yrs age as per Sec 82 IPC
7- 12 yrs Sec 83 IPC if criminally responsible if mature enough to understand
the nature & consequences of the act. Maturity decided by the
court.
10 yrs Kidnapping
12 yrs Person <12 yrs cannot give consent for routine physical
examination. Oath not necessary for <12 yrs age.
14 yrs <14 yrs cannot be employed in factory acc to Factories Act (except
helping family in non-hazardous task).
15 yrs 14-15 yrs can be employed in non-hazardous job in daytime.
>15 yrs can be employed in any job.
16 yrs Sexual intercourse with any female <16 yrs even if with consent
or wife is punishable. Kidnapping
18 yrs Attainment of majority, person called as adult
Can give consent for major procedures.
Age 16-18 yrs will be tried as adults if involved in heinous crime.
Girl >18 yrs can marry.
Right to vote.
Can make a will.
21 yrs Boy can marry. Minimum age for holding senior govt posts
25 yrs Minimum age for contesting elections as MP or MLA
35 yrs Minimum age for appointment as President, vice President or
Governor

3. What are the routinely advised Xrays for age estimation?

Ans: Pelvis, knee, wrist, elbow.

4. Importance of eye colour?

Ans: In old age there maybe white opacities due to cataract.
5. Importance of skin colour?
Ans. To determine age – in case of prisnors ( at the time of there release from the jail)
6. POCSO Act
Ans:
• Came into force on 19th June 2012.
• Full form – Protection of children against sexual offences
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 • Child is anyone <18 yrs age
• The Act seeks to protect children from offences such as sexual assault, sexual
harassment, and pornography.
• Recent amendment in 2019.
Penetrative sexual assault: Under the Act, a person commits “penetrative sexual
assault” if he: (i) penetrates his penis into the vagina, mouth, urethra or anus of a child,
or (ii) makes a child do the same, or (iii) inserts any other object into the child’s body, or
(iv) applies his mouth to a child’s body parts. The punishment for such offence is
imprisonment between seven years to life, and a fine. The Bill increases the minimum
punishment from seven years to ten years. It further adds that if a person commits
penetrative sexual assault on a child below the age of 16 years, he will be punishable
with imprisonment between 20 years to life, with a fine.

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 POTENCY CERTIFICATE / EXAMINATION OF ACCUSED
1. What is impotency & infertility?
Ans: Impotence, in male, is defined as “persistent inability to develop or maintain a
penile erection sufficient to conclude coitus to orgasm and ejaculation”.
Or
It is the inability to participate in sexual intercourse.
Frigidity is a psychological defect in female having an abnormal aversion to sexual
intercourse.
Infertility is the inability to beget or conceive a child.
Both male & female can be infertile or impotent.

2. What is quoad Hoc?

Ans: Impotency only towards a particular female.
3. What is frigidity?
Ans: inability to start or maintain the sexual arousal pattern in the female.
4. What is bridegroom impotence?
Ans: Excessive sexual excitement leads to premature termination of penile erection
before orgasm.

5. What is effect of alcohol on sex?

Ans: Increases the desire but hampers the performance.

6. What is smegma? Importance?

Ans: Smegma is the secretion from the male genital tract, deposited below the prepuce.
Presence of smegma indicates no sexual intercourse in the past hrs. However, if a man
cleans it daily during bath, it can lead to false interpretation. Smegma contains the
bacteria Mycobacterium smegmatis.

7. What is Locard’s principle of exchange?

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 Ans: Whenever two bodies come in contact, there is exchange of material between the
two bodies.

8. What is mens rea & actus reus?

Ans: Mens rea is the intent a person has behind committing a crime. Actus reus is the
action the person takes to perform the criminal act. This is the physical action behind
the crime. Both should be present to hold a person guilty of an offence.

9. Importance of asking bath, micturition, defecation changing clothes after the

incident?
Ans: It may cause disappearance of evidence like blood, seminal stains, foreign objects,
etc.

10.What is sexual aversion syndrome?

Ans: Aversion to sexual practice in general i.e. with all females. This condition is called as
sexual aversion disorder.

11. Causes of impotence

Ans: Learn 2 from each category
Endocrine causes – Testicular failure (primary or secondary)
– Hyperprolactinemia
Disease of penis – Peyronie’s disease
– Previous priapism
– Penile trauma
Disorders of CNS and spine – Anterior temporal lobe lesions
Disease of spinal cord – Tabes dorsalis
-Disease of dorsal root ganglia
Vascular disorders – Leriche syndrome
– Atherosclerotic occlusion or stenosis of the pudendal and/or
cavernosa arteries
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 – Arterial damage from pelvic radiation
– Venous leak
– Disease of sinusoidal spaces
Drug induced – Histamine (H2) blockers e.g. cimetidine, Spironolactone, Ketoconazole,
Clonidine, Beta blockers, Monoamine oxidase inhibitors, Tricyclic antidepressants,
Barbiturates, Diazepam, Alcohol, Heroin, Tobacco, Methadone
Age – impotence is generally observed at the extreme of age.
Malformations and local acquired causes – presence of malformations or congenital
anomaly or local acquired causes renders a person impotent. The malformations are:
– Absence of male genital organ1
– Klinefelter’s syndrome
– Cryptorchidism
– Phimosis
– Epispadias
– Partial or total amputation of penis
– Pre-pubertal castration – Inflammatory hydrocele
– Filariasis of scrotum
– Carcinoma of penis
– Lesion of CNS or spinal cord including injury to spinal cord
– Chronic disease – diabetes mellitus, autonomic neuropathy
Functional or psychological cause
– This is the most common cause of temporary impotence
– Fear, timidity, anxiety, guilt sense, hypochondrias, sexual over indulgence etc. may be
the reasons
Also includes impotence quad hanc, sexual aversion syndrome & bridegroom impotence.

12. What is bulbocavernosus reflex?

Ans: The bulbocavernosus reflex is mediated through the S2–S4 spinal cord segments
that is elicited by electrical/mechanical stimulation of the dorsal penis/clitoris nerves
20
with the reflex response recorded from any pelvic floor muscles (constriction of anal
sphincter).

13.What is cremasteric reflex?

Ans: When the inner part of the thigh is stroked, stroking of the skin causes the
cremaster muscle to contract and pull up the ipsilateral testicle toward the inguinal
canal. Nerve roots L1 L2.
Afferent limb: genital branch of genitofemoral nerve
Efferent limb: femoral branch of genitofemoral nerve

14.Other tests for checking potency?

Ans: Cavernosography – Radioopaque dye injected in corpora cavernosa with the help of
needle. Radiological images obtained to see if there is any leak, abnormal curvature in
pathway of dye.

15.Importance of potency certificate

Ans: In Civil Cases
1. Nullity of marriage and divorce
– Legally, marriage is a contract between male and female and it is presupposed that it
will be consummated by act of sexual intercourse. Thus, marriage gives implied consent
for natural and complete sexual intercourse.
– Under Section 12 of Hindu Marriage Act 1955 or Section 24 of Special Marriage Act
1954, a wife may seek divorce on the ground that her husband was impotent at the
time of marriage and continues to be impotent therefore he is incapable of fulfilling the
rights of consummation of marriage by an act of sexual intercourse.
2. In cases of disputed paternity – a man may claim that, he being impotent has not
fathered the child.
3. Compensation cases – a man may claim higher compensation for an injury that has
caused him impotent.
In Criminal Cases
1. Impotence may be taken as plea for rape cases, unnatural sexual offenses.

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2. Impotence may be stated as plea for adultery.

16. Tests done on seminal stains

Ans: Physical examination: greyish white/yellow, starchy, UV light – bluish white
fluorescence due to choline
Chemical tests:
a) Florence test
b) Barberio’s test
c) Acid phosphatase test
Enzyme tests:
a) Acid phosphatase> 100 BU suggestive of intercourse within 12 hrs; semen levels are
310-340 BU/Ml
b) Creatinine Phosphokinase 660 IU/ ml in semen; can detect even 6-month old stain
Antigens: positive even in semen with no sperm
a) PSA (p30 Ag)
b) Mab 4 Eb
c) Seminal vesicle specific antigen (SVSA)
d) Seminogelin 1 & 2
e) Sperm specific LDH

17. Samples to be collected

Ans:
➢ Clothes and undergarments
➢ Foreign evidentiary material – like hair, fiber, button etc.
➢ Fingernail scrapings – For skin or flesh of victim DNA profiling to match it
➢ Scrapings from suspected stain marks from body surface
➢ Scalp hairs – for comparison with scalp hairs found over body/clothes of victim
➢ Swab from teeth bite mark
➢ Combing of pubic hairs
➢ Pubic hair clipping of accused
➢ Urethral swab
➢ Swab from glans
➢ Blood for
– Serology – For presence of drug/intoxicant
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 – DNA profiling
– For venereal disease.

18. Definition of rape

Ans: Legal definition: According to sec 375 IPC a person is said to commit rape if he
a. Penetrates his penis into the vagina, mouth, urethra or anus of another person or
makes another person to do so with him or any other person
b. Inserts any object or part of the body into the vagina, urethra or anus of another
person or makes another person to do so with him or any other person
c. Manipulates any part of the body of another person so as to cause penetration into
the vagina, mouth, urethra or anus of another person or makes another person to
do so with him or any other person
d. Applies his mouth to the vagina, urethra or anus of another person or makes
another person to do so with him or any other person
1. Against her will;
2. Without her consent;
3. With her consent, when her consent has been obtained by putting her or any other
person in whom she is interested in fear of death or hurt;
4. With her consent, when the man knows that he is not her husband and that her
consent is given because she believes that he is another man to whom she is or believes
herself to be lawfully married;
5. With her consent, when at time of giving such consent, by reason of unsoundness of
mind or intoxication or the administration by him personally or through another of any
stupefying or unwholesome substance, she is unable to understand the nature and
consequences of that to which she gives consent;
6. With or without her consent, when she is under 16 years of age.
Explanation: Penetration is sufficient to constitute the sexual intercourse necessary to
the offense of rape.
Exception: Sexual intercourse by a man with his own wife, the wife not being less than
16 years of age, is not rape. Any medical procedure done with consent in presence of
female attendant is not rape.
Medical definition: Even slight penetration of vulva is enough to call it as sexual
intercourse.

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 Exception – A medical procedure done with consent shall not constitute rape.

19. Punishment for rape

Ans: Punishment for the offense of rape is prescribed under Sec 376 of IPC
Subsection 1: The minimum punishment prescribed for rape is 7 years (which may be
extended to 10 years) and shall also be liable to fine.
Section of IPC Description
376 (A) Resulting in death or vegetative state of
survivor
376 (AB) Female being <12 yrs
376 (B) Forceful sexual intercourse with wife
upon separation
376 (C) Custodial rape (Rape by a person in
authority)
376 (D) Gangrape
376 (DA) Gangrape <16 yrs female
376 (DB) Gangrape <12 yrs female
376 (E) Repeat offence

17. Classify sexual offences.

Ans: Sexual offences Natural- Rape
-Incest
Not sexual offences in India
-Adultery
Unnatural – Bestiality (sexual intercourse with lower
animal)
-Forceful anal intercourse with minor
Sodomy/ buggary has been decriminalised in 2018.

18. Name incest complexes

Ans: Incest is sexual intercourse with close relatives.
a) Electra – daughter & father
b) Oedipus – son & mother
c) Pharon – brother & sister
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19. Name some sexual perversions.
Ans:
➢ Sadism – sexual gratification by inflicting pain, humiliation or torture to partner
➢ Masochism – sexual gratification by inflicting pain on himself
➢ Bondage – both sadism & masochism
➢ Fetishism – sexual gratification by articles belonging to opposite sex
➢ Eonism/Transvestism – sexual gratification by wearing garments of opposite sex
➢ Exhibitionism – Displaying private parts in public; punishable under Sec 294 IPC
➢ Voyeurism – sexual gratification by seeing or capturing image of woman naked or
performing activities like bathing, undressing or having sexual intercourse; punishable
under Sec 354 (C) IPC
➢ Necrophagia - sexual gratification by eating flesh of dead body
➢ Necrophilia - sexual gratification by having sex with dead body
➢ Frotuerism - sexual satisfaction is obtained by touching the body or body parts of
person of opposite sex
➢ Masturbation – sexual gratification is obtained by deliberate self-stimulation of own
genital organ. It is offense when practiced in public place under Sec 294 IPC.
➢ Pornographomania - Sexual pleasure obtained by watching or referring pornographic
material or literature.
➢ Coprophilia – Sexual gratification achieved by smelling or touching fecal matter
(stool) of opposite sex.
➢ Undism - Sexual satisfaction obtained by watching the act of urination of another
person.
➢ Satyriasis - Excessive sexual desire and drive in males.
➢ Nymphomania - Excessive sexual desire and drive in females.
➢ Fellatio – Male sex organ is stimulated by oral coitus.
➢ Cunnilingus – Vulva/Clitoris stimulated with oral coitus.

20. Why do we check bilateral femoral artery pulsations?

Ans: To check blood supply to muscles of penile erection.

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 EXAMINATION OF VICTIM /SURVIVOR OF SEXUAL
ASSAULT
1. What samples to collect?
Ans: Procedure: Request the victim to stand on a large clean, white sheet of paper and
undress herself. The purpose is to collect any material evidence that falls on the paper
1. Clothes and undergarments
2. Foreign evidentiary material – like hair, fiber, button etc.
3. Fingernail scrapings
4. Scrapings from suspected stain marks from body surface
5. Scalp hairs – for comparison with scalp hairs found over body/clothes of alleged
accused
6. Swab from teeth bite mark
7. Combing of pubic hairs
8. Hair clipping of victim
9. Vaginal swab/smears, cervical smears
1st swab- to determine spermatozoa
2nd swab- for DNA analysis
3rd swab- semen
10. Washings of posterior fornix of vagina for
– Detection of spermatozoa
– Presence of mycobacterium smegmatis (smegma bacilli)
– Presence of sexually transmitted disease
11. Blood for
– Serology
– Pregnancy test
– For presence of drug/intoxicant
– DNA profiling
– For venereal disease
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 12. Urine for
– Pregnancy test
– Detection of alcohol
13. Condom if found at scene of crime – laboratory examination of condom may reveal
presence of blood/vaginal epithelial cells on one side and semen on the other. Pubic hair
may also be present. DNA profiling of semen may be of help.

2. Examination of hymen
Ans:
• The hymen may be conveniently examined by inserting a specially designed glass
globe on a stem, which is then partially withdrawn so that the hymen is spread
around its circumference.
• However, in most instances, a conventional examination using a speculum is
carried out. Note the state of hymen whether torn or intact, thin or thick, elastic or
loose.
• If torn, its extent, position, fresh or old. It is said that tears of the hymen due to
rupture with fingers are usually lateral, whilst rupture with the penis are usually
posterior.
• In children hymen may not be ruptured but becomes red and congested because
hymen is deeply situated.
Hymen tear at 5 to 8 o clock position in case of rape
And 11 to 1 o clock position in case of masturbation
3. What is hymen? Types. Causes of rupture.
Ans: Hymen is fold of mucosal tissue at the vaginal opening.
Depending on the shape & position of the hole in the hymen, it can be
- Circular
- Oval
- Imperforate
- Fimbriate
- Septate
- Cribriform
- Crescentic
Causes of rupture
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 - Sexual intercourse
- Instrumentation
- Fall on pointed object
- Masturbation
- Tampons

4. Importance of checking mental status of survivor of sexual assault.

Ans: To see if history given is relevant.
To check for complications like mental disturbances, rape trauma syndrome.

5. What are the complications of rape?

Ans: 1. Hemorrhage and shock due to injuries sustained to genitals or perineum
2. Death may occur due to:
– Assault to obtain consent or put her in fear
– By suffocation – to prevent shouting
– Strangulation – to hide the crime
– Suicide – due to depression or frustration of being raped
– Intoxicants – overdose or adulteration
3. Mental agony, which disrupts the victim’s physical, social, mental and sexual life.
4. Rape trauma syndrome: The syndrome includes behavioural, somatic or psychosocial
reaction to the act of forceful sexual intercourse. It is regarded as post-traumatic stress
disorder.

6. Types of rape
Ans:
➢ Statutory rape - It is a forcible sexual intercourse by a man with a woman, who is
less than 16 years of age.
➢ Marital rape – forcible sexual intercourse by a man with his wife without her
consent if:
– Wife is living separately from him under a decree of separation OR
– Wife is living separately from him under any custom or usage
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 ➢ Custodial rape - It is done by persons taking advantage of their custodial positions
and has forceful sexual intercourse with woman in their custody.
➢ Gang rape - When rape is committed on a female by more than one person
➢ Date rape - It is a forcible sexual intercourse by a boyfriend with girlfriend when
they are on date (for stay or vacation). In such cases, the girl may allege that her
boyfriend had given her some intoxicant and proceed with the act. Date rape drugs
are- GHB, Rohypynol (flunitrazepam), ketamine.
➢ Stranger rape - It is the rape committed by a male on a female who had no
previous contact with the victim.

7. What is vaginismus?
Ans: Spasmodic contraction of the vagina due to hyperaesthesia.

8. What is dyspareunia?
Ans: Painful sexual intercourse.
9. What is matted pubic hair or matting of hair?
Ans: stickiness of the pubic hairs due to semen.
Related legal sections
354 IPC Indecent assault/molestation
354 (A) IPC Sexual harrasment
354 (B) IPC Criminal force causing a woman to disrobe
354 (C) IPC Voyeurism
354 (D) IPC Stalking
375 IPC Definition of rape
376 IPC Punishment of rape
377 IPC Unnatural sexual offences
- Forceful anal intercourse with minor
- Bestialty
497 IPC Adultery
498 (A) IPC Cruelty towards a female by husband & in laws
509 IPC Punishment for word, gesture, action, sound insulting modesty of a
woman

Note- write opinion same as word to word as you written in your journal.

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DRUNKENNESS CERTIFICATE
1. What is drunkenness?
Ans: Drunkenness is a condition produced in a person who has taken alcohol in a
quantity sufficient to cause him to lose control of his faculties to such an extent that he is
unable to execute the occupation in which he is engaged at the material time.

2. How do we collect of blood to test for alcohol?

Ans: Clean skin with soap & water or mercuric chloride. Spirit should not be used as it can
contaminate the sample leading to wrong estimation of blood alcohol levels.
Preservative – 10 mg sodium fluoride & 30 mg potassium oxalate per 10 mL of blood

3. What do we mean by under the influence?

Ans: It means that due to drinking alcohol, a person has lost the clearness of mind & self-
control that he normally possesses.

4. Imp Medical terminology

Ans: Blood alcohol level
<10 mg% Sober
10 – 70 mg% Drinking
80 - 15 mg% Under the influence
150 – 300 mg% Drunk/Intoxicated
300 – 400 mg% Stupor
>400 mg% Coma & death

5. Windmark’s formula
Ans: It is used to measure quantity of alcohol consumed from the blood or urine alcohol
concentration.
a = cpr for blood
Where a = amount of alcohol in grams absorbed in body,
c= concentration of alcohol in blood in grams/kg,
p = weight of person in kilogram and
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r = constant. In men, the constant is 0.68 and in women it is 0.55
For urine analysis, the formula is – a = ¾ qpr. The other factors are same and q =
concentration of alcohol in urine in grams/liter.

6. Fatal dose & fatal period of alcohol

Ans: Fatal dose is 150-200 ml consumed in 1hr. May be higher in chronic alcoholics.
Fatal period is 12 to 24 hrs.

7. How do police do roadside analysis of alcohol levels?

Ans: Drunkometer test/ Alcohol breath test
Breath analyser- Potassium zirconate crystal
Infrared

Principle – 2100 mL of alveolar air contains the same amount of alcohol as 1 mL of blood
at 34 C. (based on henry’s law)
Sources of errors in breath analyzer
• Gargling with alcohol can give false higher result.
• Variation in ratio between different individuals
• Use of ethanol containing products
• Belching or regurgitation of gastric alcohol contents
• Inadequate expiration (in unconscious or un-cooperative subject)
• COPD disease
• Use of metered dose inhalers
• Poor technique.

8. What is Hooch tragedy?

Ans: Mass methanol poisoning due to adulteration of ethanol with methanol.

9. In which states & union territories of India is alcohol banned?

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Ans: States - Bihar, Gujarat & Nagaland, some districts of Manipur, Wardha, Gadchiroli &
Chandrapur in Mahrashtra.
Union territory - Lakshadweep

10.In which countries is alcohol banned?

Ans:
• Afghanistan
• Bangladesh
• Iran
• Kuwait
• Libya
• Saudi Arabia
• Sudan
• UAE (Sharjah only)
• Yemen
• Pakistan (only for Muslims)
• India ( in states 1- bihar , 2 – Gujrat )

10.Difference between head injury & drunkenness

Ans: simple logical difference- smell of alcohol in drunkenness not in case of head injury.

11. Café coronary syndrome

Ans: Obese alcohol drinker

Depressed cough reflex

Food bolus obstructing trachea

Death due to choking (asphyxia) & not due to cardiac arrest.

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Clinically presents as person drinking alcohol & taking food simultaneously suddenly
becomes breathless, cyanosed & dies.

12. Punch drunk syndrome

Ans: Repeated blowing in boxing over the head induces repeated subdural hemorrhages
leading to traumatic encephalopathy known as “punch drunk syndrome”. This syndrome
is characterized by deterioration in speed and coordination, slurred speech, defective
memory, slow thoughts, stiff-limbs, ataxia, unsteady gait, parkinsonian like dementia etc.
These symptoms resemble alcohol intoxication, hence, called punch drunk syndrome.

13. Minimum age for alcohol consumption

Ans: Maharashtra – 21 yrs for beer, 25 for others
Goa – 18 yrs

14. License for alcohol consumption

Ans: In Maharashtra, a liquor license has to be obtained from a Government Civil
Hospital. In other states not required.

15. Dry day

Ans: Day when the sale of alcohol is not permitted.
Republic Day 26th Jan
Independence Day 15th Aug
Gandhi Jayanti 2nd Oct

16.What is a liquor license?

Ans: Permit to sell alcohol issued by the state government.

17. Symptoms of acute alcohol intoxication

Ans: 3 stages – excitement, incoordination & coma

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Imp – Mc Ewan’s sign - Pinching of the skin or light slapping of a person causes the
constricted pupil of person to be dilated. It is seen in stage of coma at about 300 mg% of
blood alcohol level.

18. Wernicke’s & Korsakoff’s syndrome?

Ans: It is chronic alcohol-induced persisting amnestic disorder and occurs due to thiamine
deficiency.
Korsakoff’s syndrome presents with:
• Profound anterograde amnesia (inability to learn new things)
• Milder retrograde amnesia
• Impairment in visuo-spatial, abstract and conceptual reasoning
• Most of the patient demonstrates an acute onset of Korsakoff’s syndrome in association
with Wernicke’s syndrome whereas rest person shows gradual onset.
Wernicke’s Syndrome Wernicke’s syndrome or encephalopathy is an acute form of
syndrome characterized by drowsiness, disorientation, amnesia, ataxia, peripheral
neuropathy, horizontal nystagmus, and diplopia due to ophthalmoplegia.

19. Why does alcohol cause Thiamine deficiency?

Ans:
- Gastritis due to alcohol
- Poor nutrition
- Improper utilization of thiamine by the cells
Chronic alcoholism also causes megaloblastic anemia due to folate deficiency.

20. Statutory blood alcohol level for driving

Ans: The statutory limit of blood alcohol is 30 mg% in India (as per Sec 185 of Motor
Vehicle Act 1988). Driving a vehicle under the influence of alcohol is an offense in India
under the Motor Vehicle Act 1988. A fine up to Rs. 2000 can be imposed or
imprisonment can be awarded that can be extended up to 6 months or both.

21. Related legal sections

34
Ans: Sec 85 IPC – no criminal responsibility if act done under involuntary intoxication
Sec 86 IPC – criminally responsible if act done under voluntary intoxication
Sec 509 IPC — misconduct by a drunken person in public place is punishable with
imprisonment up to 24 hours.

22. Why does alcohol damage occur at lower blood alcohol levels in females than
males?
Ans: Alcohol is highly hydrophilic, so once it enters the systemic circulation; it is
distributed evenly throughout total body water. Because women have more body fat
compared with men and fat contains no water, higher peak alcohol levels are achieved in
women than in men of the same weight.

It is advisable to read chapter Inebriant poisons from Reddy.

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 INJURY & WEAPON REPORT
Related legal sections: IPC
44 Definition of injury - Any harm done illegally to a person’s body, mind,
reputation & property.
45 Definition of life
46 Definition of death
319 Definition of simple hurt – any bodily pain, disease, infirmity
320 Definition of grievous hurt
323 Punishment for voluntarily causing hurt – 1 yr
324 Punishment for voluntarily causing hurt with dangerous weapon – 3
yrs
325 Punishment for voluntarily causing grievous hurt – 7 yrs
326 Punishment for voluntarily causing grievous hurt with dangerous
weapon – 10 yrs
326 (A) Vitriolage. Punishment minimum 10 years to life + fine
326 (B) Attempt to vitriolage. Punishment- 5-7 year jail + fine

1. Why to classify the injury as simple or grievous?

Ans: To give punishment to the offender & compensation to the victim accordingly.

2. Grievous hurt
Ans: Learn all points by heart & in order
• Firstly – emasculation
• Secondly – permanent privation of the sight of either eye
• Thirdly – permanent privation of the hearing of either ear
• Fourthly – privation of member or joint
• Fifthly – destruction or permanent impairing of the powers of any member or joint
• Sixthly – Permanent disfiguration of the head or face
• Seventhly – fracture or dislocation of a bone or tooth
• Eighthly – any hurt which endangers life or which causes the sufferer to be during the
space of twenty days in severe bodily pain or unable to follow his ordinary pursuits.

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 3. Classify injuries
Ans: I) According to Causative Forces
A) Mechanical injuries
i) Blunt force injuries
– Abrasion
– Contusion
– Laceration
– Fracture and dislocations of teeth/bone (generally included in lacerations)
ii) Sharp-edged weapon injuries
– Incised wounds
– Chop wounds
iii) Piercing weapons – stab wounds
iv) Firearm weapons – firearm wounds.
B) Thermal Injuries
1. Due to cold
– Frost bite
– Trench foot
– Immersion foot
2. Due to heat
– Burns
– Scalds
C) Chemical injuries
• Corrosion – corrosive acid/alkali/metal salts
• Irritation – weak acids or alkali
D) Miscellaneous injuries
• Electricity
• Lightning
• X-rays
• Radioactive substances.
II) Medico legal Classification
o Suicidal injury or self-inflicted injury
37
 o Homicidal injury
o Accidental injury
o Defence wounds
▪ Fabricated wounds.
III) Injuries in Relation to Death
• Antemortem injury
• Postmortem injury
IV) Legal Classification
• Simple injury
• Grievous injury.

4. Importance of size & situation of injury

Ans: To determine whether simple or grievous

5. Why to determine type of weapon?

Ans: To give punishment accordingly.
Punishment for causing hurt by simple & dangerous weapon is different.

6. How to determine age of injury?

Ans: Abrasion
Colour of scab R3 B3 12, 12, 234567
Red (no scab) <12 hrs
Reddish >12 hrs
Reddish brown 2-3 days
Brown 4-5 days
Black 6-7 days

Contusion
Healing of contusion – colour change – depends on pigment present at site
Oxy Hb Red Few hrs
Deoxy Hb Blue Few hrs – 3 days
38
 Hemosiderin Brown 4 – 5 days
Biliverdin Green 6 – 7 days
Bilirubin yellow 7 – 12 days

Incised wound

Fresh Neutrophils margination, migration

12 hrs Monocytes
24 hrs Endothelial layer appearance
2-3 days Granulation tissue
4-5 days Fibrils
>7 days scar

7. Importance of hilt mark

Ans: Hilt mark is a patterned abrasion produced by the hilt. It indicates complete
penetration of the weapon.

8. Types
Ans: Abrasion – scratch, graze (gravel rash/brush burn), pressure, patterned
Stab wounds – puncture, penetration, perforation
Lacerated wounds – Split, tear, cut, avulsion

9. What is Kennedy phenomenon?

Ans: Suturing of the bullet wound of President of USA, John Kennedy, before medico-
legal examination & investigation made it difficult to interpret the injury afterwards.
Hence, any wound in a medico-legal case should not be sutured before proper
examination.

10. What is Rayalaseema phenomenon?

Ans: Inserting a bullet in a stab wound to mislead investigation.

11.What is weapon?
39
 Ans: Weapons are the means or mechanical devices which when applied in a hostile
manner, will produce injury.

12. What is dangerous weapon?

Ans: Section 324 and 326 of IPC defines danger weapon as “any instrument used for
shooting, stabbing or cutting, or any instrument which, if used as a weapon of offense is
likely to cause death; or by means of fire or any heated substance, or by means of any
poison or any corrosive substance, or by means of any explosive substance or by means
of any substance which is deleterious to human body to inhale, to swallow or to receive
into blood or by means of any animal.”

11. Classify weapons

Ans: The weapons of offense can be grouped into:
- 1. Hard and blunt weapons
- 2. Sharp cutting weapons
- 3. Pointed weapons
- 4. Mixed variety
- 5. Firearms

12. Difference between PM lividity & contusion.

Ans:

40
13.Difference between laceration & incised wound.
Ans:

14. If person with hemophilia is slapped with friend unaware of the illness & the person
dies, is it homicide?
Ans: Yes, it is excusable homicide.

15. If a person trains a dog to kill another person & he does it then is the dog a
dangerous weapon?
Ans: Yes, according to defination of dangerous weapon.

16. What is pneumtaic gun?

Ans: A pneumatic tool, air tool, air-powered tool or pneumatic-powered tool is a type of
power tool, driven by compressed air supplied by an air compressor.

17. Why should we sign on the weapon we examine?

Ans: So that if we are asked to comment on that weaponin the court, we will know it is the
same weapon which we have examined.

18. Tailing of wound

41
 Ans: Incised wounds are deeper at the head end of the wound, as more pressure is
exerted on the knife at this point, & towards the end of the cut, the wound becomes
shallow & skin alone is cut. It indicates direction of the wound.

19. What is incised looking laceration?

Ans: Produced by hard, heavy, blunt weapon on bony prominences. Due to scanty
subcutaneous tissue, bony prominence & excessive crushing of the skin, it has sharp
margins & resembles incised wound. Can be distinguished from an incised wound by
examination by magnifying glass.
20. What is hara kiri?
Ans. It is an unusual type of suicide, in which the victim inflicts a single large wound on the
abdomen with a short sword while in a sitting position or falls forward upon a ceremonial
sword and pulls out intestines.
Traditional method of suicide in Japan.

Advisable to read chapter injuries, weapons & ballistics from textbooks for this viva.

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SICKNESS FITNESS CERTIFICATE
1. Importance of hospital no.?
Ans: To trace the hospital & ,thus, the doctor in case of any medicolegal issue.

2. Importance of sickness & fitness certificate?

Ans: Sickness – for application of leave
Fitness – for resuming work eg.
1 . In school and colleges
2 . In institutions
3 . For insurance purposes
4 . Excuse attendance of the witness before a court of trial

3. Issuing false certificate ,punishable under?

Ans. Sec 197 IPC , imprisonment upto 7 years

ALL THE BEST

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