Medical Forensic Examination
If you’re a victim of sexual assault, we recommend a Medical Forensic Examination provided by The Sex Abuse Treatment Center at Kapiolani Medical Center.
This procedure ensures proper medical attention, evidence collection, and addresses concerns about the risks of sexually transmitted infections, pregnancy, and HIV. The examination is available to anyone within 120 hours of a sexual assault.
What will happen during the Medical Forensic Examination?
When you arrive at the hospital (Kapiolani Medical Center), you’ll be asked to register as a patient in the emergency room. An emergency room nurse and a physician will then do a brief examination. This is to determine if you need any immediate medical attention. If so, the emergency room physician may provide this care before the SATC medical forensic examination.
A SATC crisis counselor will meet you at the emergency room to assist you. The medical forensic examination takes place in a separate room that is set up specially for this purpose. The SATC crisis counselor will explain the consent forms and the procedures of the examination, then will help you with signing the forms. The SATC crisis counselor is present to counsel you and any friends or family with you. Feel free to discuss any feelings about the assault and ask questions about the medical procedures.
What to expect:
- The medical forensic examination is performed by a SATC physician. This doctor is trained to provide specialized medical care for victims of sexual assault as well as procedures for collecting, preserving, and transferring specimens for evidence. The SATC crisis counselor is also trained in evidence preservation procedures and assists the physician.
- A Hawaii State Sexual Assault Evidence Collection Kit is used in the examination, whether or not a police report has been filed. You can consent to the forensic examination whether or not you contact the police or consent to the release of evidence. In this case, evidence will be collected and stored if you want to report it to the police later. Evidence is stored until the legal time frame for reporting a crime to the police has ended.
- The first step of the forensic examination is collecting clothing that was worn during the assault. The SATC crisis counselor will ask you to disrobe on a large sheet of paper in order to catch and preserve anything that may drop as you disrobe. Your clothing will be placed into evidence. If you do not have extra clothing to change into following the examination, the SATC will provide you with a change of clothes.
- The SATC doctor will then ask for your medical history, including allergies, medications, and medical problems. As part of the exam, you will be asked about the assault and about specific sexual acts. These questions help with medical treatment and document the incident for legal purposes.
- During the physical exam, the doctor will look for physical injuries on your body. The doctor will then examine your genitals for trauma, debris, and any abnormalities. The doctor will take pictures of any injuries and will document findings in a medical-legal record. A speculum examination is not conducted on young girls. It’s important to remember that most times, there may be no injuries or physical findings from the exam. Lack of injury to the genital area does not mean sexual penetration did not happen or that you consented to the sexual activity.
- Depending on the history of the incident, the doctor may take evidence swabs for DNA analysis, hair samples (both head and pubic hair), fingernail scrapings, and a blood sample.
- You will also be offered testing and treatment for sexually transmitted infections (STIs) and for pregnancy. If you choose this, swabbing for laboratory analysis for the STIs and urine for a pregnancy test will be collected. The doctor will discuss preventive treatment for STI's and pregnancy if indicated. Testing and preventive treatment for HIV can also be discussed with the doctor. If you are considered high risk for having been infected, the doctor will discuss your options and treatment may be made available.
- If you suspect that you have been drugged, the physician will offer to do a toxicology urine screen.
- Once the exam is completed, the doctor will discuss the results, advise you on follow-up care, and answer questions you have. The Medical Forensic Examination often takes three to five hours to give the necessary support and care. Child-care arrangements should be made before arrival at the Kapi‘olani Medical Center Emergency Room. Interpreters are available if you have limited English or you are hearing impaired. Information shared with SATC is held confidential unless disclosure is required by law. The Medical Forensic Examination and release of evidence requires consent by you or your legal guardian. Minors 14 to 17 years old can consent to the exam without parental consent.
- Counseling is an important follow-up service after the forensic examination. The SATC offers therapy to any victim of a sexual assault as well as family members and significant others.
Will I be charged for the Medical Forensic Examination?
The Medical Forensic Examination described above is FREE.
If you need medical care beyond the scope of the SATC forensic examination (like x-rays, cat scan, stitches), you will be moved to the Emergency Room for the care you need. Fees for these services are not covered by the SATC. At the time of registration, you will be asked about insurance coverage in case a claim needs to be filed.
If you filed a police report, the SATC crisis counselor will tell you about seeking assistance through the State of Hawaii Crime Victim Compensation Commission (CVCC). You can also call 808-587-1143 directly for information on victim compensation. The CVCC may have financial assistance for those without insurance or for the out-of-pocket expenses for the insured.
If you do not have insurance and did not file a police report, the hospital social worker may be able to help you figure out available options for help.