County Seeks End to Confusion Over Hospital Tests of Rape Victims

To prosecute rape cases, law enforcement officers often need evidence that can only be obtained through a detailed medical examination. But many hospitals in San Diego County don’t perform such tests--and that can cause problems both for the law enforcement officers and the victims they are trying to help.

But, after a highly publicized incident in which a rape victim had to wait nine hours for a test because two local hospitals refused to administer it, county officials are taking steps to solve the problem.

San Diego County Supervisor Susan Golding was among those who had a strong emotional response to the case.

“I was horrified,” Golding said. “I think that any woman can at least come close to imagining how traumatic becoming a rape victim must be. To think of essentially being carted from hospital to hospital after that . . . would be monstrous.”

Last week, the Board of Supervisors directed its staff to analyze the way sheriff’s deputies handle the medical tests of rape victims.

But the tests, in which medical personnel gather forensic evidence, have several problems and no easy solutions.

For one, law enforcement officers don’t always know which hospitals are willing and able to perform the tests.

In the case that caught Golding’s attention, paramedics first took the victim, a 37-year-old Rancho Santa Fe woman, to Scripps Memorial Hospital in Encinitas, said Sheriff’s Detective Tom Field.

Deputies learned that Scripps doesn’t test rape victims, Field said, so they then called Tri-City Hospital.

Tri-City had administered the exams before, but they refused in that case because the victim lived outside the hospital’s service district, Field said.

Finally, the victim was treated at Sharp Cabrillo, Field said.

“It does get somewhat problematic to admit rape victims into emergency rooms,” said Gavin McCluskey, a senior program specialist with the state Office of Criminal Justice Planning. “It’s a time-consuming exam to begin with. Then, you’ve also got a priority of need in the emergency rooms.”

For example, a doctor might be called away during the middle of the two-hour procedure to treat a gunshot victim, McCluskey said.

Two hospitals in the county have pooled their efforts in an attempt to remedy that problem.

Sometime next month, Palomar Community and Pomerado hospitals will activate a team of six nurses who are specially trained to administer the tests, said Patty Seneski, nursing unit director at Pomerado Hospital.

Those nurses will be on call to handle rape tests while they aren’t handling emergency room responsibilities, Seneski said.

“We’re finding that it’s difficult to do the exams in an emergency environment,” Seneski said. “The care is very fragmented. We wanted to get the exams out of the emergency rooms.”

The nurses will work closely with sexual-assault investigators, Seneski said. And the county will reimburse the hospitals for the cost of the tests.

The testing teams will accept patients from areas outside their hospital service districts, and the effectiveness of the program will be evaluated after three months, Seneski said.

However, the problem of locating hospitals that do perform the tests still remains.

State law requires all counties with a population of more than 100,000 to have a formal agreement with at least one hospital to perform the tests, said Marilyn Strachan-Peterson, former chief of the sexual assault branch at the Office of Criminal Justice Planning.

Areas of more than 1 million population must formally designate one hospital to do the tests for every 1 million people, Strachan-Peterson said.

“It’s really up to local criminal justice officials to do that,” Strachan-Peterson said.

The San Diego Police Department has a formal agreement with two hospitals--Sharp Cabrillo and Physicians & Surgeons Hospital. But the Sheriff’s Department has only informal agreements with three hospitals, according to Gail Cooper, director of the county’s emergency medical services division.

“I don’t think the situation has been taken care of,” Cooper said. “There needs to be a formal mechanism in place.”

The Board of Supervisors’ staff is scheduled to report back to the board about the problem within 90 days.