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Achieving just outcomes: forensic evidence collection in emergency department sexual assault cases
  1. Katherine A Muldoon1,2,
  2. Allegra Drumm3,
  3. Tara Leach3,4,
  4. Melissa Heimerl5,
  5. Kari Sampsel1,3,4
  1. 1Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
  2. 2School of Epidemiology, Public Health and Preventative Medicine, University of Ottawa, Ottawa, Ontario, Canada
  3. 3Faculty of Medicine, The Ottawa Hospital and University of Ottawa, Ottawa, Ontario, Canada
  4. 4Emergency Medicine, The Ottawa Hospital and University of Ottawa, Ottawa, Ontario, Canada
  5. 5Ottawa Victim Services, Ottawa, Ontario, Canada
  1. Correspondence to Dr Katherine A Muldoon, Ottawa Hospital Research Institute, Ottawa, Ontario K1H-8L6, Canada; kmuldoon{at}ohri.ca

Abstract

Background Achieving just outcomes in sexual assault cases is one of the most serious and complex problems facing the healthcare and justice systems. This study was designed to determine the prevalence and correlates of Sexual Assault Evidence Kit (SAEK) completion and release to police among sexual assault cases presenting to the ED.

Methods Data for this retrospective study come from the Sexual Assault and Partner Abuse Care Programme (SAPACP) case registry (1 January to 31 December, 2015) at The Ottawa Hospital, a unique medical-forensic access point and the only facility offering SAEK collection in Ottawa. Bivariable and multivariable logistic regression models were conducted using ORs, adjusted ORs (AORs) and 95% CIs.

Results In 2015, 406 patients were seen by the SAPACP and 202 (77.1%) were eligible for a SAEK. Among eligible cases, 129 (63.9%) completed a SAEK and 60 (29.7%) released the SAEK to police for investigation. Youth cases (≤24 years) had the highest odds of completing a SAEK (AOR 2.23, 95% CI 1.18 to 4.23). Cases who were uncertain of the assailant (AOR 3.62, 95% CI 1.23 to 10.67) and assaults that occurred outdoors (AOR 3.14, 95% CI 1.08 to 9.09) were most likely to release the SAEK to police.

Conclusion Even with access to specialised forensic evidence collection, many sexual assault survivors do not complete a SAEK, and even fewer release the evidence to police for investigation. The ED is a common entry points into the healthcare system, and this study has highlighted the need to strengthen services and reduce attrition along the health-justice continuum.

  • violence
  • epidemiology
  • violence, domestic
  • violence, interpersonal
  • violence, non-accidental

https://doi.org/10.1136/emermed-2018-207485

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    Footnotes

    • Contributors KAM wrote the first draft and conducted the statistical analyses. AD collected the case registry data. TL and KS administered the SAEK and supervised data collection. AD, TL, MH and KS critically reviewed and revised the manuscript. KAM and KS have primary responsibility for the final content. All authors read and approved the final manuscript.

    • Funding This study is funded by a grant from the Women’s XChange (grant number: 2317). KM is supported by PostDoctoral Fellowship award from the Canadian Institute of Health Research (CIHR).

    • Competing interests None declared.

    • Patient consent Not required.

    • Ethics approval The Ottawa Hospital Research Ethics Board (Protocol number: 20170390-01H).

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement Data may be available under request and approval from The Ottawa Hospital. Sexual assault data are particularly sensitive and standardised procedures will have to be followed to share the data.

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