The Forensic Nurse

In most cases the EIA (enzyme immunoassay), used on blood drawn from a vein, is the most common screening test used to look for antibodies to HIV. A positive (reactive) EIA must be used with a follow-up (confirmatory) test such as the Western blot to make a positive diagnosis. There are EIA tests that use other body fluids to look for antibodies to HIV. These include:

• Oral Fluid Tests – use oral fluid (not saliva) that is collected from the mouth using a special collection device. This is an EIA antibody test similar to the standard blood EIA test. A follow-up confirmatory Western Blot uses the same oral fluid sample.
• Urine Tests – use urine instead of blood. The sensitivity and specificity (accuracy) are somewhat less than that of the blood and oral fluid tests. This is also an EIA antibody test similar to blood EIA tests and requires a follow-up confirmatory Western Blot using the same urine sample.

Rapid Tests:

A rapid test is a screening test that produces very quick results, in approximately 20 minutes. Rapid tests use blood from a vein or from a finger stick, or oral fluid to look for the presence of antibodies to HIV. As is true for all screening tests, a reactive rapid HIV test result must be confirmed with a follow-up confirmatory test before a final diagnosis of infection can be made. These tests have similar accuracy rates as traditional EIA screening tests. Please visit the rapid HIV testing section for details.

A man who has been unofficially known as the “grim Sleeper” for the past twenty years has finally been arrested. The suspect, Lonnie David Franklin Jr., a 57 year old man from Los Angeles is alledged to have committed at least 11 unsolved murders dating back to 1985.

A judge has denied mr. Franklin bail. He will be arrained in a Los Angeles court in August 2010 on ten counts of murder and one count of attempted murder as of today.

The case has been very long and drawn out process spanning multiple decades. The break in the case finally came using DNA evidence. The DNA match was found using what is sometimes viewed a controverial tactic known as familial DNA Searching.

Everyone has their own unique DNA signature that specificly can be used to identify an individual, family members share enough common DNA markers to help identify family members as potential matches as well. 

In this case one of Mr. Franklins family has a previous unrelated conviction on a felony weapons charge. It has become standard procedure in many jurisdictions now to collect DNA samples on felony offenders.  Investigators were able to run a DNA sample found at a murder scene against the DNA database. a Partial hit was found on Mr. Franklins family member DNA sample.  Because it was only a partial match it ruled that individual out, but also was able to conclusively prove that a very close relative may have been involved in the murder, which drastically narrowed down the search.

The Grim Sleeper is suspected in at least 11 murders . He like most serial killers chose victims within his own ethnic profile, in this case targeting black women, some of which who worked as prostitutes. Prostitutes are often targets of serial killers because of the lower social profile. Friends and Families often don’t report the victim missing for longer periods of time allowing for more evidence to be lost during the critical hours after the murder.

Serveral years ago another arrest was made by police who claimed they had ballistic evidence for the murders, but that case did not lead to a conviction. Margaret Prescod, who founded the Black Coalition Fighting Back Serial Murders and worked with the families of victims in the case said that she is “cautiously optomistic” regarding this latest arrest.

Aerial footage was taken on Wednesday showing police searching cars in the garage of the suspect’s home in south Los Angeles.  The garage was not far from the corridor where the victims’ bodies were dumped.

The close proximity to the body dumping ground is another tell tale sign that the murderer may have personal and intimate knowledge of the area allowing him to elude detection for so many years. Serial killers often tend to be invisible to nearly everyone. Because they do not raise suspision they can lull people into trusting them, and allowing them to get victims to let their guard down, or be placed into vulnerable positions that they may not do with a person they feel uncomfortable with.

Sexual assualt knows no boundries. No matter what race, what nationality, what socio-economic status you hail from can spare you from the potential turmoil. 

 So is the case of Lawrence Taylor, the former NFL linebacker great for the New York Giants. Thursday morning the Hall of Fame linebacker was arrested in his hotel in Rockland County for soliciting sex from a 16 year old girl.

 Taylor was arrested when police were told that the minor had been delivered to his hotel room by another man, Rasheed Davis. Taylor stated at a news conference that he had paid $300 to the man for delivering her. He claims not to have engaged in sex with the minor girl. His Attorney Arthur Aidala state that Taylor is “a loving and family man” and that “My Client did not have sex with anybody. ”

The girl, who has not been identified because she is a minor, was reported missing back in march as a suspected runaway. ESPN.com reported “Early Thursday morning, Davis punched and kicked her, drove her to the hotel against her will and told her she had to have sex with Taylor, police said. When she refused, Davis handed her over to Taylor, who sexually assaulted her, they said. Taylor paid her $300, which she gave to Davis”.

After the alleged incident, she was somehow able to use a cell phone to get a message out. Her uncle received a text message from her with an address and contacted New York Police department to investigate. Officers found the girl along with Rasheed Davis at an address in the Bronx. Davis was charged with unlawful imprisonment, assault and endangering the welfare of a child. It was then when police were directed to Lawrence Taylors whereabouts. The hotel is located  about a half mile from the Spook Rock Golf Course, where Taylor frequently plays.

Mr. Taylor was released after posting a $75,000 bond and subsequently driven away from the courthouse by Mark Lepselter, a friend and business associate.

Ramapo Chief of Police Peter Brower said Taylor was cooperative when police took him into custody at around 4:00AM. Brower would not comment on if Lawrence Taylor knew the age of the girl, but did state that “Ignorance is not an excuse to an individual’s age”. In New York, third-degree rape is a charge levied when the victim is under the age of consent, which is 17 years of age.

Two teenaged girls in Albert Lea Minnesota (19-year-old Brianna Broitzman and 18-year-old Ashton Larson ) are accused of “taunting, spitting on and groping the genitals of residents who suffered from Alzheimer’s”.

The complaint alleges that the girls spat in the residents mouths, poked and grabed at genetalia, and then would at times mock them until they screamed. One other incident involved an aide getting into bed and simulating sex with the resident.

The father of one of the girls is disputing the charges saying that the media is distorting what really happened.  

The two girls worked part-time as aides at the Good Samaritan Society Care Center. Four other juveniles who also worked at the facility are also being charged for failing to report the incidents.

These types of elder abuse are often unreported or difficult to prove since the victims may have Alheimers or dementia.

For more information about types of elder abuse:

http://www.ncea.aoa.gov/NCEAroot/Main_Site/FAQ/Basics/Types_Of_Abuse.aspx

A true Christmas miracle happened for a 9 year old girl in Pharr Texas. The girl wrote a letter to Santa Claus, but instead of asking for toys or dolls, she begged for Santa to get a family relative to stop touching her and her sister.

The girl wrote the letter and it was turned in at Cesar Chavez Elementary School. The school counselor reported the letter to authorities and the man was arrested.

Investigators familiar with the case believe that the molestation occured for as many as four years. The man was charged with continuous sexual abuse of a young child and could face as many as 99 years in prison if convicted.

Lets hope that Santa can see to that as well.

Police in Hollywood Florida today announced that Ottis Toole who had long been the primary suspect in the murder of Adam Walsh. John Walsh the boy’s father came to nation attention back in 1981 as he pleaded and worked with police to find his son.

Fisherman discovered the decapitated head of Adam walsh in a river over 120 miles away from where the boy was abducted. The remains of his body have still not been found to this day.

Police were riduculed for their repeated bungling of the case and the case evidence. The bloodstained carpeting found in Toole’s car that would have provided DNA evidence to tie him to the case was lost.

Following his son’s death, John walsh became obsessed with finding his son’s murderer and helping to be sure that other children and families didnt have to endure what he had gone through. 

He gained national attention when he starred in the America’s Most Wanted television show in the 1980s’. After serveral years of hosting the show and testifying to congress, the Adam Walsh Child Protecion Act was passed.

A 21 year old man in austrailia is claiming that he is innocent of commiting unlawful sexual acts with a 10 year old minor female because the acts were consentual on both of their parts.

The Man, Brodie James Watson  is charged with four counts of sexual penetration of a child under 13, six counts of indecent dealing , and one count of possessing an article with intent to injure.

The defense attorney for mr. Watson, Andrew Parker has asked the local magistrate if Watson could live with a relative if he stipulated not to go near the girl or her mother.

The magistrate has denied the request, stating that the acts commited were serious enough that mr. Watson should remain in custody.

Mr Watson stated during the proceeding: “Can we just sort it out right here and right now … because … I am innocent … it was consensual” The magistrate informed him that  “It can’t be consensual if she’s a 10 year-old girl.”

Its quite disturbing that someone is incapable of being able to see that it would ever be acceptable to engage in such acts with an elementry school aged child. Most children of this age can barely decide what to have for breakfast, let alone be able to give an informed consent to engage in sexual acts. We have an age of consent for a reason.

Many people know that the color of your skin can have an effect on almost every aspect of your life. But what about being raped?

Researchers at the University of Pennsylvania School of Nursing have released a new study that shows dramatic results when it comes to identifying injuries that may have occurred during a sexual assault depending on the color of the victims skin.

The Researchers conducted a study of 120 volunteers who were predominatly white or african-american and conducted examinations after they had engaged in consentual sex. They found that 68% of the white women had incurred at least one external injury (tearing, abrasions, or swelling), but only 43% of the darker skinned women showed the same levels of injury.

Because physical injury as a result of sexual assualt is usually the exception rather than the norm, being able to clearly show an injury often has a positive effect on people “believing” the victims story.

Being a Sexual Assault Nurse Examiner or SANE, I have heard countless times from law enforcement officers, social workers, other nurses, and even the victims own family members that they dont believe the victims story.

Sexual Assualts usually happen one on one, in a private setting with no other witnesses, cameras, or other ways to try and help determine if the sex was consentual or not.

Because most of these cases come down to a he said / she said scenario the ability to produce accurate forensic evidence is critical. There may or may not be DNA evidence and if injuries are harder to detect on darker skinned victims that puts them at a distinct disadvantage both clinically and in the criminal justice system.

The Los Angeles Daily News recently reported that the LAPD is a backlog of more than 7,000 rape kits waiting for processing by the LAPD DNA lab.  Some of these cases are nearing the ten year mark, at which time they become inadmissible as evidence due to the statute of limitations law in california with regard to evidence testing. In California, if the kit is tested within two years of the sample collection date, then there is no statute of limitations for it.

The main reason that these kits haven’t been tested yet, is simply manpower and funding. In just five years the demand for kits to be tested has doubled.  According to the article. “In about 2000, the department ordered analysts to keep every shred of cell evidence in rape cases, just in case they might need to test it. Before the change, rape kits were regularly purged from the property division, with the permission of an investigating officer.”

The City of Los Angeles recently approved the hiring of 16 addtional criminalists, but these positions have yet to be funded.

I was recently asked about a case in which an adult male was raped and during the sexual assault had an ejaculation. Often the topic of male rape is forgotten when we talk about sexual assaults.

While rarely reported, male rapes do actually occur.  Perhaps it is male pride or ego, but reporting statistics for survivors of male sexual assault are even lower than that of women. One FBI statistic estimated that close to 3% of adult males will be raped at some point in their lives.

As for why the reporting statistics are so low, it may be due to the fact that this type of event may be even more shameful and traumatic to men than it is to women. Society in general tells men that in order to be respected and seen as desirable that they must be seen as strong, tough, and powerful.

All the experts agree that rape is almost never about the sex. Its about power and control. Excercising your will over someone elses. Essentially proving that you are the one in control. That you are stronger than the other person.

Bringing this type of shame to a man can be exceptionally devastating to their emotional self concienience. By not being able to fend off an attackers the victim may view himself as weak, undesireable, or even homosexual. 

These feelings of homosexuality can be even more confusing if the victim experiences an erection or even ejaculates. Both of these situations are very common and are often used as tools of shame by an attacker to make the victim think that they wanted or enjoyed being raped. In reality these types of reactions are more physiological than anything.

Often people believe that an erection equals sexual arousal. There are many reasons why a man may experience an erection during a sexual assault. The simple friction of touching the millions of tiny nerve endings on the penis could cause an erection, even if the touch was unwanted or unpleasant.

Being penetrated anally can also cause an involuntary erection. The application of pressure on to the prostate gland from digital, penile, or foreign object insertion to the anus can often cause an erection. Any proctologist will tell you that this type of reaction is very typical while performing a Digital Rectal Exam for prostate screening.  

Bringing the victim to the point of ejaculation is also quite common. Rapists will often make every effort possible to ensure that the victim does ejaculate to add the the feelings of guilt, shame, and homosexuality. This can add another layer of power, and dominance, and even increased pleasure for the rapist for having such control over the other person. Remember in most cases its about power not the actual sex.