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Evaluation and Management of the
Sexually Assaulted or Sexually Abused Patient
Chapter 23
Tiffany Bombard, BA, NREMTP and Shellie Asher, MD, MS, Albany Medical College
Sexual assault examiners are used in court as witnesses and as expert witnesses to describe the physical examination
of the victim and to present their examination findings. High-quality performance in court depends on the
appearance of the sexual assault examiner as an unflappable, well-prepared expert who is able to explain and teach
his/her findings to the judge and jury. For the sexual assault examiner, as for any witness, emanating that confident
demeanor in court includes maintaining eye contact with the questioning attorney, judge and jury members to make
sure that they hear and understand you well, speaking at a moderate pace, dressing appropriately for court and
conveying evidence by working in concert with the examining attorney. The section which follows will describe some
basic ways of achieving this kind of performance.
Order of Events
A basic understanding the order of events usually involved in trying a sexual assault case is helpful in allowing the
sexual assault examiner to be well prepared for testimony. Although this sequence can vary significantly between
jurisdictions, what follows is a general outline.
1. The crime is reported.
2. The victim and/or information/findings obtained by the witnesses are interviewed by police and an assailant is
accused, or the police work in concert with crime scene investigators and/or sexual assault examiner to determine
the identity of the assailant.
3. Charges are filed against the accused perpetrator. The nature of the charges is based on type of crime committed
and the weapons involved in perpetration of the crime (if any). Use of a weapon influences the “degree” of crime
and the resultant penalty. (Each charge against the accused will eventually need to be substantiated in court.
Failure to prove a charge will mean failure to convict on that charge.)
4. The perpetrator is accused, or indicted. This means that the charges against the assailant are reviewed, found
credible and confirmed. In some jurisdictions this process is completed by the district attorney. In others it is done
by a grand jury made up of community members.1 The purpose of indictment is to avoid if possible the leveling of
incorrect charges or the wasting the court’s time with charges which cannot be substantiated. The accurate and
intelligible documentation of injuries by the sexual assault examiner is integral to this process. Most important in
many sexual assault cases is for the prosecution to prove that the victim did not consent to the sexual encounter.2
5. The accused assailant is arrested (this often occurs before formal indictment, however the accused can only be
held for a finite amount of time and must be freed unless indictment occurs promptly).
6. The assailant is called, or arraigned, at a preliminary hearing. This means that the accused perpetrator comes to
court to be formally advised of the charges against him/her. At this hearing, a judge hears brief testimony, most
often from the victim, and makes sure that legal requirements to go forward with the case are met3.
7. Proof of the charges is gathered. This proof usually includes the sexual assault examiner’s documentation of their
patient interview, physical exam and evidence gathering.
8. A court date is scheduled and a jury is selected.
9. Witnesses are subpoenaed by the defense and prosecuting attorneys. Receiving a subpoena means that you are
required by law to appear in court for the purpose of giving testimony. The subpoena will be headed by the name
of the state versus the name of the defendant, and will tell the location of the court and the date(s) upon which
you will be required to appear.
Evaluation and Management of the Sexually Assaulted or Sexually Abused Patient | ACEP