Volume 49, Issue 6 (November 2004)
A Mobile System for Postmortem Genital Examinations with Colposcopy: SART-TO-GO
The interpretation of genital findings in the deceased is a vital and timely issue. A paucity of information exists on the nature and appearance of the anogenital tissues in the postmortem interval. The traditional postmortem genital examination consists of gross visualization, which may preclude detection of the subtler trauma that usually constitutes injury in sexual assault. The mobile system grew out of a need to bring the examiner to the patient, e.g., in jurisdictions that lack a centralized morgue. The theoretical framework of the methodology lies in the sexual activity that culminates in the death of the sexual homicide victim. This sequential methodology was based on the Sexual Assault Response Team (SART) model, with adaptation to the autopsy milieu. Colposcopy is well-established for the medical-legal investigation of living sexual assault victims. During the author's initial rape-homicide examinations, only gross visualization was available. It soon became apparent that a system that facilitated detailed scrutiny of the anogenital tissues at various postmortem intervals was needed. Colposcopy was selected as the examination method because of its magnification, photodocumentation, and peer review potential. The sequential protocol was developed and refined during an ongoing accumulation of baseline cases. The role of the forensic nurse examiner is described within a defined scope of expertise and as a collaborative member of the homicide investigative team.