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Evaluation and Management of the
Sexually Assaulted or Sexually Abused Patient
Admissibility of
Digital Photographs
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Federal: Rules of Evidence, Article X, Rule
101(3); Any printout shown to accurately
reflect the data is an “original”
Rule 101(4)/103; a duplicate that
accurately reproduces the original is
admissible
Photographs as Evidence
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The principal legal requirements to admit
a photograph (digital or film-based) into
evidence:
• Relevance (of the image to the issues)
— Determined by the judge
• Authentication (accurate
representation)
— Examiner must testify that photos
accurately portray the scene as
viewed during the exam
Guidelines to Ensure Admissibility
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Develop a Standard Operating Procedure
(SOP), Department Policy, or General
Order on the use of digital imaging
Include:
— Patient consent for photography as
well as the utilization of images
— Chain of custody
— Image security and authorization for
access
— Image enhancement details
— Policy regarding duplication and
release
— Storage and archival policies
— Secure image back-up system
Always preserve the original digital images
(originals are never removed or altered)
Preserve images in the original file format
Images must be recorded in an
unalterable, archival form soon after they
are created
If an image is to be enhanced, create a new
file (original remains unchanged)
— Record all details of the enhancement
Agency must control custody and release
of all image records
Make available image copies in “read-only”
format to those with legitimate access
Huge spectrum of camera complexity and cost
Basic Forensic Photography: Principles and Techniques
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Necessary features:
— At least 6 megapixels
— Macro (close-up) capability
Nice Features:
— Vibration Reduction/Image Stabilization
— Spot Metering
— View finder
Basic Equipment
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Extra Batteries
Media Storage cards
Reference Scales (Basic & Color)
Identification Stickers
Cleaning Supplies
Camera manual
Additional Equipment
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Tripod / Monopod
Off Camera Flash
LED Flashlight
Card reader
Computer
Preparation for Shooting
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Read your camera manual
Plan ahead; anticipate needed equipment and supplies
Clean lens, LCD and view finder
Preform “pre-shoot” checklist of equipment and camera
settings
Avoid environmental extremes
Shooting Menu: Suggested Initial Settings
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File Format: JPEG
Image Quality: Fine
Image Size: Largest
White Balance: Auto
ISO Sensitivity: Auto
Metering: Center Weighted
— (Optional: Spot)
Continuous: Single
Auto Focus Area Mode: Auto
— (Optional: Center)
Engaging Macro Mode
Macro mode allows close-up images that reveal detail
Macro may be accessed:
— By a shortcut using the “tulip” icon
— As a scene mode (also using a “tulip” icon)
Using macro mode requires setting the zoom feature at the
widest angle
Evaluation and Management of the Sexually Assaulted or Sexually Abused Patient | ACEP
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The images should tell the story
The images should stand alone without captions or narration
Complete “forensic” series of photographs
— Overview (includes two anatomic landmarks for orientation)
— Mid-range (closer but still includes one anatomic landmark)
— Overview and midrange may show more than one finding
— Closeups (one image with and one image without reference scale; closeups document only one finding)
“Do not disturb the crime scene”—photograph the injury or finding before it is disturbed or collected
Attention to camera angles (sensor, reference scale and image planes must all be parallel)
All data regarding the image is automatically recorded and imbedded in the image (“EXIF” data)
Sharpness (check by “zooming in” on the review image just after it is taken)
Exposure (automatic in all digital cameras)
Lighting (room lighting is usually sufficient but built-in flash is always an option)
Plan the composition (construct the image)
Compositional Principles
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Goal: accurately document physical and evidence findings
Artistry less important than consistency of technique and reproducibility of results
Must depict findings as realistically (what the examiner’s eyes see) as possible
Vary perspective; use different angles/distances to thoroughly document the finding
Use measuring device (reference scale) to document size of findings (positioned on same plane and
at the same distance from the camera as the finding)
Bite mark photography may require specialized techniques and many images
Background is important—avoid confusing clutter
Practical Tips
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Visualize the intended image in your mind
Scan the entire image in the view finder or on the LCD screen during composition before depressing
the shutter button
An LED flashlight can provide tangential lighting (which highlights three-dimentional features)
Use patient identification sticker on the scale (consider including the anatomic location)
Common Errors
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Out of Focus
Under/over exposed
Distortion of perspective
No anatomical landmarks
Distorted color
Legal Issues
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Obtain written patient consent to be photographed
All images must be reliably linked to the patient being photographed
All images must indicate
— Date and time they were taken
— Basic camera settings
— Digital EXIF data imbeds this information automatically in each image
No image should ever be deleted (image sequence numbers must be unbroken)
Forensic Photography: Overview of Basic Principles for Health Care Professionals
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