<- Home <- Arhive <- Vol. 26, Issue 4, December 2018

Rom J Leg Med26(4)437-440(2018)
© Romanian Society of Legal Medicine

What is not immediately written-down it is non-existent

S. Andjelic

Abstract: Introduction. According to the doctrine of medical profession, the obligation of each emergency physician in Belgrade is to completely fill in the medical report (MR) after performed examination. A copy of the MR must be given to the patient. The physician breaks his obligation by not allowing the patient to be fully informed about its content. Case report. Judicial proceedings have been started against physician EMS because of the negligent treatment of a patient. The dilemma was if something that was not immediately written-down also did not exist. The lawsuit was filed claiming that after completed medical intervention the physician didn't leave a copy of the MR of the patient who was 3 hrs later transported to a cardiologist where myocardial infarction was registered. Conclusion. In the legal sense, if something is not written-down and is not handed to the patient it is the same as if it is non-existent.
Keywords: filling in, physician’s report, negligent treatment.

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