Acute Forensic Examination

(Examination done within 120 hours of the sexual assault)

What will happen at the Kapi`olani Medical Center for Women and Children at the time of the Acute Forensic Examination?

Upon arrival at the hospital, you will be asked to register as a patient. An emergency room nurse and a physician will then do a brief examination. This is to determine if you need any medical attention other than the SATC acute forensic examination. Should you need medical care, the emergency room physician may provide this care before the SATC examination.

A SATC worker will arrive at the emergency room to assist you during the examination and to counsel you and any friends or family with you. Feel free to discuss with this worker any feelings and reactions about the assault and ask questions about the medical procedures.

The SATC worker will meet you in an exam room set up for the acute forensic examination. The SATC worker will explain the procedures of the examination and consent forms, and help you with signing the consent forms.

What is included in the Acute Forensic Examination?

The acute forensic examination is performed by a SATC physician. This doctor is trained to provide medical care specialized for victims of sexual assault. Also, this doctor is trained in the procedures for collecting, preserving and transferring specimens for evidence. The SATC worker is also trained on evidence procedures and works with the physician to preserve the evidence.

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 but still not contact the police or consent to the release of evidence. In this case, evidence will be collected and stored so if you change your mind and want to report to the police the evidence will be available. Evidence is stored until the time for reporting a crime to the police has ended.

The first step of the forensic examination is collecting clothing (if it was worn during the assault). The SATC worker will have you 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 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 are needed to find out how to best help you medically and for evidence of the incident.

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 is important to remember that most times, there will 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, for evidence the doctor may take:

  • 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 cultures for the STIs and urine for a pregnancy test will be collected. The doctor will discuss preventive treatment for STI's and pregnancy if you are not protected by birth control.

Testing and treatment for HIV is NOT done as a standard part of the acute forensic examination, but testing is available later through the SATC office, which is an anonymity-guaranteed testing site. But 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 urine test for drugs. Common rape drugs are GHB and Rohypnol.

Once the exam is completed, the doctor will discuss the results, advise you on follow-up care, and answer questions you have.

Counseling is an important follow-up service after the forensic examination. The SATC offers therapy to any victim of a sexual assault and to family members and significant others.

Other useful Information:

  • The acute 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 acute 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.

Will I be charged for the acute forensic examination?

The acute forensic examination described above is free to you.

If you need medical care beyond the scope of the SATC forensic examination (e.g., 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 worker will tell you about seeking assistance through the State of Hawaii Crime Victim Compensation Commission (CVCC). You can also call 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.