MONMOUTHCOUNTY
SANE/SART PROGRAM
FORENSIC PHOTOGRAPHY
POLICY:
With the written consent of the patient, it is the policy of the Monmouth County SANE/SART Program to use digital imaging equipment to document findings identified by the examiner during the course of the skin surface assessment and genital inspection of the patient undergoing a forensic sexual assault examination.
All images captured during the course of the examination will be secured as part of the permanent forensic record. It is the policy of the Monmouth County SANE/SART program to allow review of the forensic record, including images, by healthcare professionals for purposes of case evaluation, consultation and professional education.
If legal remedies are pursued in the case, the images may be requested by the prosecuting or defense attorneys involved. In these situations, it is the policy of the Monmouth County SANE/SART Program to notify the patient of possible use of photographic evidence at trial.
PROCEDURE:
I. External Skin Surface Findings
A. Using a hand-held digital camera loaded with an unused media storage device, take 1 picture of the case label sheet or front page of the Forensic Examination Document.
B. Take 1 picture that clearly depicts the patient's face and body.
C. For each finding:
1. take 1 mid-range picture depicting the region of the body on which the finding is located; and
2. take at least 1 close-up picture that clearly depicts the entire finding, including margins. Take additonal pictures as needed to clearly depict the finding; and
3. take an additional close-up picture of the finding which includes a ruler or other object to establish the actual size of the finding.
D. Repeat steps 1 through 3 for each finding.
II. Genital Examination
A. For the female patient, position for examination and visualize anatomy using the following guidelines:
1.visualize clitoral using thumb and index finger to gently apply tension above hood;
2.separate labia majora and inspect inner surfaces; visualize external labia minora;
FORENSIC PHOTOGRAPHY page 2
3.separate labia minora, inspect inner surfaces; inspect periurethral area;
4.seperate labia minora and inspect area at the base of the vaginal opening including posterior fourchette;
5.Using the thumbs and index fingers, gently grasp the labia minora at the 5 and 7 o'clock position and apply light downward and outward pressure; inspect fossa navicularis and edges of hymenal tissue;
6.visualize and inspect perineal tissue;
7.apply lateral traction to buttocks to inspect anal opening; continue applying moderate traction to buttocks and ask patient to relax and breathe deeply. After 30-60 sconds anal sphincter should begin to relax; inspect sphincter and rectal ampulla;
- With patient's consent, insert speculum and visualize cervix including os.
- Use the digital camera to capture images of any findings including injuries, abnormalities, debris or other potential evidence, using increased magnification as necessary to clearly depict injuries, abnormalities or debris.
- After all findings have been photo-documented, remove the media storage device from the camera,place the device in a protective storage case, Place thecase into a small envelop, label the envelop with the case number and the examiner's name, and place in the Forensic Examination Documents envelope.
B. For the male patient, perform visual inspection of the glans, shaft of the penis and the scrotal sac. Capture images of any injuries, abnormalities or debris. Position the patient in either the supine lithotomy or prone position for examination and inspect using the following guidelines:
1.lift testicles and inspect perineal tissue;
2.apply lateral traction to buttocks to inspect anal opening; continue applying moderate traction to buttocks and ask patient to relax and breathe deeply. After 30-60 sconds anal sphincter should begin to relax; inspect sphincter and rectal ampulla.
After the exam is completed, follow steps in Section II. 10 above for the labeling and storage of any digital images captured.