Sexual Assault Evidence Collection and Documentation

Defining sexual assault is challenging as some sources interpret it as rape or general assault, while others conclude that it should serve as a separate classification. According to the National Crime Victimization Survey (NCVS), sexual assault is a crime of unwanted sexual contact occurring between victim and offender, which may or may not involve force. The NCVS definition includes verbal threats but excludes rape or attempted rape. Sexual assault does not discriminate, as victims range from the young to the elderly, regardless of race, gender, or socioeconomic status. However, one study noted that more than half of the sexual assault cases reviewed involved patients 24 years old and younger, with nearly 92% being female. The offender is often known to the victim before the assault. Medical management should be the first and top priority in caring for sexual assault victims. Ensuring the patient’s safety and investigating any acute trauma (e.g., lacerations, head trauma, inebriation) should be completed before evidence collection. After the patient is clinically stable, proper assault protocol can commence. Once the initial examiner explains the options to the patient, an appropriate examiner who may be a physician or a nurse who, with training in evidence collection, obtains consent and evidence via the Sexual Assault Examination Kit (SAEK). The SAEK contains step-by-step procedures for the proper collection, handling, and documentation of specimens such as clothing, bodily fluids, and fingernail scrapings. Ideally, forensic evidence collection should occur within 72 hours of the assault, but many jurisdictions allow collection up to 5 days post-assault. A thorough examination should still take place in the event the patient does not want to complete a SAEK or is outside the window of evidence collection. A proper investigation includes determining if the patient has bathed/showered, urinated, defecated, douched, or changed clothing since the incident. Although the SAEK can is still possible, this information requires adequate documentation as it may alter the forensic analysis. Even so, clothing can offer immense forensic insight as nearly two-thirds of forensic evidence can be discovered on clothing or linens. The following includes general recommendations and guidelines on clothing collection and documentation: : In the event the patient was transferred via EMS, the sheets should be collected from the mode of transportation to preserve any critical evidence. Once ready for collection, the provider sets two layers of examination table paper down on the floor. Linens will suffice if table paper is not available. The patient then removes each item of clothing one at a time and places each item in a separate paper bag. If the patient requires assistance in removing clothing, the examiner should don gloves and replace these gloves with each article of clothing. The examiner should fold the top layer of paper and include it in a separate paper bag as well. Ideally, the patient’s clothes should remain intact. However, if the clothes need to be cut, the examiner should preserve any stains, holes, or tears that may be present. If the patient presents with any ligatures or ties, the integrity of the knot needs to be maintained, as this may indicate the offender’s criminal signature. Following collection, every paper bag should have a label that includes family name, date of birth, date of sample, type of sample, and examiner. Bags should be sealed and should never be left unattended. Law enforcement will then need to sign for the evidence once the SAEK is complete.