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Briefing on New Service Model in Handling Adult Sexual Violence Cases 2007-02-14. Forensic Examination for Victims of Sexual Violence . Dr SHUM Shui-fung, Bobby Head of NT Division, Forensic Pathology Service, Department of Health. Forensic Pathology Service. Department of Health

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briefing on new service model in handling adult sexual violence cases 2007 02 14

Briefing on New Service Model in Handling Adult Sexual Violence Cases2007-02-14

Forensic Examination for

Victims of Sexual Violence

Dr SHUM Shui-fung, Bobby

Head of NT Division,

Forensic Pathology Service,

Department of Health

forensic pathology service
Forensic Pathology Service
  • Department of Health
  • Provides forensic pathology and clinical forensic medicine services to government departments
forensic pathology service3

Victims

  • Suspects
  • Sexual offences
  • Serious Wounding Cases
  • Child Abuse
  • CAT (Convention Against Torture) Claimant
Forensic Pathology Service
  • Operate public mortuaries
  • Attend scenes of crimes
  • Clinical medico-legal examinations
  • Consultation
  • Court proceedings

Scope of Service

forensic pathology service4
Forensic Pathology Service
  • Medical Staff
    • 15 Forensic Pathologists + 1 Pathologist
    • FP: 13 male, 2 female
  • Assistants to Forensic Pathologists
    • 8 Police Officers: 5 male, 3 female

Staff

forensic pathology service5
Forensic Pathology Service
  • Public Mortuaries
  • Histopathology Laboratories
  • Offices with Clinical Examination Facilities
    • HKI (PHQ) Tel 28602466
    • K (KWRPHQ) Tel 27612405
    • NT (NTNRPHQ) Tel 26664224

Facilities

forensic pathology service6
Forensic Pathology Service
  • 11/F, NTN Regional Police HQ
  • On Po Lane, Tai Po
  • Tel 26664224

NT Office

forensic pathology service18
Forensic Pathology Service
  • 6/F, Arsenal House West Wing, Police HQ
  • Arsenal Street, Wanchai
  • Tel 28602466

HKI Office

forensic pathology service24
Forensic Pathology Service
  • 3/F, KW Regional Police HQ
  • Argyle Street
  • Tel 27612405

Kln Office

sexual offence
Sexual Offence
  • Rape, attempted rape
  • Indecent assault
  • Unlawful sexual intercourse with girl under 13/16
  • Unlawful sexual intercourse with mentally defective
  • Buggery…
slide26
Rape
  • Cap 200 Crimes Ordinance:
  • A man commits rape if-
    • (a) he has unlawful sexual intercourse with a woman who at the time of the intercourse does not consent to it; and
    • (b) at that time he knows that she does not consent to the intercourse or he is reckless as to whether she consents to it
forensic examination of victims of sexual violence
Forensic Examination of Victims of Sexual Violence
  • Evidence (physical / laboratory)
    • Sexual intercourse
      • injury to private parts
      • presence of semen
    • Non-consensual
      • pattern of injuries
      • toxicological examination
forensic examination of victims of sexual violence28
Forensic Examination of Victims of Sexual Violence
  • Medical treatment must take priority

SAFETY OF VICTIM COMES FIRST!!

examination suite
Examination Suite
  • Accessibility (24 hour)
  • Security (restricted, lock)
  • Cleanliness / Comfortableness (warm)
  • Privacy (view & sound, entry & exit)
  • Enough space
examination suite30
Examination Suite
  • Waiting area (family, SW, police)
  • Examination area (forensic pathologists, chaperone / nurse, interpreter)
  • Equipment (couch, lighting, magnifying glass, swabs, specimen containers, water)
  • Toilet
forensic examination of adult rape victims
Forensic Examination of Adult Rape Victims
  • Consent
  • History
  • Physical Examination
    • general examination
    • genito-anal examination
  • Sample collection
  • Documentation and reporting
consent33
Consent
  • Informed
  • Voluntary
  • Capacity - MIP
    • guardian
    • invoke Part IVC
    • guardianship board
history
History
  • What signs to look for
  • What samples to take
  • How to interpret findings
history35
History
  • Routine background
  • Medical
  • Gynaecological
  • Sexual
  • What happened
    • “…The victim should not be asked to describe the assault repeatedly …”
physical examination
Physical Examination
  • General examination
  • Genito-anal examination
general examination38
General Examination
  • General appearance
  • Upper arms, forearms and hands
  • Face, ears, lips
  • Scalp
  • Neck
  • Breasts
  • Abdomen
  • Thighs and Legs
  • Hips and Buttocks
non genito anal injuries
Non genito-anal injuries
  • Bruises and contusions (e.g. inner aspect of thighs, scalp, face, lips);
  • Lacerations (e.g. scalp, forearm);
  • Ligature marks (e.g. ankles, wrists and neck);
  • Pattern injuries (i.e. fingertip marks, scratch marks, bite marks, factitious self-inflicted injuries)
genito anal examination
Genito-anal Examination
  • Inspection, labial traction
  • Swabs
  • Speculum
  • Anal +/- digital +/- proctoscope
forensic specimens
Forensic Specimens
  • Vulval / vaginal / endocervical swabs
  • Buccal swabs – for DNA profiling Other swabs (e.g. anal, oral, breasts)
  • Fingernail (clipping / scraping)
  • Pubic hair
  • Clothing / debris
  • +/- Toxicological samples (blood, urine)
forensic specimens51
Forensic Specimens
  • Vulval / vaginal / endocervical swabs
  • Buccal swabs – for DNA profiling Other swabs (e.g. anal, oral, breasts)
  • Fingernail (clipping / scraping)
  • Pubic hair
  • Clothing / debris
  • +/- Toxicological samples (blood, urine)
forensic specimens52
Forensic Specimens
  • Oral swab: up to 1 day (usually few hours
  • Drugs and alcohol:
    • blood up to 4 days (usually half-day)
    • urine up to 7 days
  • Rectal swab: 3 days (usually 1 day)
  • Vaginal swab: up to 7 days (usually < 72 hours)
  • Skin swab: before washing
  • Dry material (panties): before washing
arrangement availability
Arrangement - Availability
  • Through police
  • Office hours (~ 9-5): offices of respective regions
    • HKI (PHQ) Tel 28602466
    • K (KWRPHQ) Tel 27612405
    • NT (NTNPHQ) Tel 26664224
  • Outside Office (after 5, public holidays: Forensic pathologist on-call)
arrangement timing
Arrangement - Timing
  • Drug-facilitated cases: ASAP
  • Fresh/recent cases < 72 hours: earliest time practicable (usu. < 2 hours or so)
  • Cold cases: earliest convenience
arrangement place
Arrangement - Place
  • Hospitals (A&ED, Wards - if indicated e.g. admitted/for joint examination)
  • Rain Lily
  • CAIU Examination Suites (child, vulnerable victims)
  • Forensic Pathologists’ Offices (if mobile, esp. cold cases)
forensic evidence fp s role
Forensic Evidence & FP’s role
  • Factual evidence v Expert evidence
  • Impartial, for court and justice, not for either side
  • Non-judgmental (we are not jurors)
  • Objective, disinterested, independent, uninfluenced
  • Opinion: scientific method applied on available data
  • Limited to field of expertise
further reading
Further Reading

Available for free download at WHO > WHO sites > Injuries and Violence Prevention > Publications > Violence publications

http://www.who.int/violence_injury_prevention/publications/violence/med_leg_guidelines/en/index.html