Delayed Complications of Trauma: Legal Perspectives and Medical Solutions

The number of delayed deaths in polytrauma cases of diverse aetiologies has shown a marked increase; that is, motor vehicle accidents, assault, falls from height and so on, have shown a marked increase in recent decades. Such an increase is, of course, altering the number of on-spot deaths or brought-dead to health care facilities. 108 emergency services in most parts of the nation can be attributed as the first factor for these changes in the number of deaths, as ‘Emergency or First Aid Treatment’ is given to the injured on the way to such a facility. Second, the emergency department, well-equipped with life-saving measures, at the majority of facilities, contributes further to reducing the number of immediate deaths at the hospital following polytrauma. Advancements in diagnostic and surgical modalities, coupled with better critical care, further ensure avoiding immediate deaths. However, delayed deaths due to complications of trauma have occupied a reasonable chunk of deaths following polytrauma. Associating delayed complications with trauma sustained earlier is a major challenge for treating clinicians and autopsy surgeons to opine and certify the cause of death in the prescribed format of the Medical Certification of Cause of Death. This aspect is under scrutiny and interpretation most of the time by legal luminaries, as the aetiology is either assault or motor vehicle accident and attracts provisions of The Bharatiya Nyaya Sanhita [Erstwhile Indian Penal Code (IPC)] or/and The Motor Vehicle Act (MVA). The present article is compiled with the aim to articulate various medical and legal aspects with emphasis on ‘Culpability’ of the accused in cases of delayed deaths due to trauma with reference to compensation and/or punishment.