Sexual Assault and Forensic Exam Offers in the Emergency Department: A Retrospective Study
Kirsten Walton, Maria Diaz, Colton Hood, Neal Sikka, Philip Ma, Sonal Batra

TL;DR
This study finds that patients with signs of mental illness or substance use are less likely to be offered a forensic exam after reporting sexual assault in the emergency department.
Contribution
The study identifies clinician concern for acute mental illness or substance use as a key barrier to offering forensic exams for sexual assault survivors.
Findings
Patients with clinician concern for mental illness or substance use were significantly less likely to be offered a forensic exam.
Uninsured patients were overrepresented in the study compared to the local population.
Younger patients and those arriving ambulatory were more likely to be offered a forensic exam.
Abstract
Patients who report sexual assault in the emergency department (ED) have a legal right to a forensic exam. Emergency departments that do not provide such exams must offer transfer to a forensic site. Little is known about the factors influencing whether patients are offered a forensic exam and complete the transfer. In this study we aimed to identify patient characteristics associated with being offered a forensic exam in an ED that does not perform them on site. We conducted a retrospective chart review of adult patients presenting to a single, urban, academic ED between January 2017–December 2019. The ED receives over 75,000 visits annually and refers patients to an external site for forensic exams. Using keywords “sexual assault” or “rape” we identified charts that included whether the visit involved an initial report of sexual assault. Charts were abstracted for demographics,…
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Taxonomy
TopicsSexual Assault and Victimization Studies · Psychopathy, Forensic Psychiatry, Sexual Offending · Workplace Violence and Bullying
