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Volume 27 Number 4 Winter 2016 THE JOURNAL OF egal Nurse Consulting FORENSICS

PROTECT YOUR MOST VALUABLE ASSET Your ability to earn a paycheck. Income Protection is available to you on a discounted basis for being an association member. Your income protection program will prov


PURPOSE American Association of Legal Nurse Consultants 330 North Wabash Ave. Suite 2000 Chicago, IL 60611 8774022562 3123215177 Fax 3126736655 Email Web site The purpose

ARTICLE SUBMISSION The Journal of Legal Nurse Consulting JLNC, a refereed publication, is the official journal of the American Association of Legal Nurse Consultants AALNC. We invite interested nurses

FROM THE PRESIDENT A Message from the President Dear AALNC Members JLNC readers, riting this message gives me the opportunity to remind everyone of the tremendous benefits of being an AALNC member.

FROM THE EDITOR Editors Note I was in Chicago in September and happened to have a day free, so I put on my old Kevin Youkilis Red Sox jersey and cap and went over to Wrigley Field to take in a ball

LETTERS TO THE EDITOR LACK OF VETTING SANE SINKS CASE In this issue there are several references to sexual assault cases. Recently I saw a ruling out of the U.S. 10th Circuit Court of Appeals, where

SCREENING SKILLS Test Your Case Screening Skills Youre an inhouse LNC in a medmal firm, and your secretary took these notes from phone calls and passed them along. You decide reject, or investigate A

LEGAL EAGLE A Case with Nursing and Medical Experts E. Kenneth Snyder, JD, BSN EditorPublisher Legal Eagle Eye Newsletter for the Nursing Profession A recent case from the Court of Appeals of Texas s

A court will accept a physician as an expert on the standard of care for nurses if and only if the physician can show that he or she has sufficient expertise. nurses cannot testify as to the standard

FEATURE North Americas Evolving Nursing Specialty Sheila Early RN, BScN F orensic nursing as a nursing specialty has been evolving at warp speed over the past two decades. The beginnings of what we

FEATURE Since the American Nurses Association recognized forensic nursing as a specialty in 1995, the concept has spread to several countries and has developed many subspecialties that speak to the ne

of the sexually assaulted patientclient in the 1970s. Now there are many forensic nursing roles within the health care system and beyond. Some are well known, while others struggle for recognition. Lo

FEATURE enter emergency departments, the staff members have the unique opportunity to recognize, collect, and preserve forensic evidence. In light of current research in the ED, it follows that foren

to a neonatal ward when tracking donated breast milk becomes a risk management issue. A forensic nurse examiner FNE is asked to assess a patient in the ICU after staff s concerns of possible elder ab

The care of those who have undergone sexual violence as children, adolescents, adults, or elders will not go back to what it was before forensic corrections and forensic psychiatric nurses have also c

FEATURE The Role of the Forensic SANE Nurse in Pediatric Sexual Assault Jennifer L. Orr, BSN, RN, CLNC L egal nurse consultants LNC reviewing pediatric sexual assault cases should have advanced tra

HISTORY AND DEFINITION OF PEDIATRIC SEXUAL ASSAULT NURSE EXAMINER The first use of sexual assault nurse examiners SANEs began in the late 1970s in Minnesota, Tennessee, and Texas. In 1992, members fro

SANEPs testify as experts, provide emotional support to the child and family, and make referrals to appropriate crisis and community counseling centers vital for future emotional and psychological rec

Withdrawing from social events a change from regular activity Fears, more than just a typical developmental anxiety or fear children and adolescents frequently encounter COLLECTION OF FORENSIC EVID

patient, the American Academy of Pediatric guidelines will be followed these suggest using a speculum for intravaginal examination. Speculum examination is only required after an acute sexual assault

FEATURE Il iuntiberum aborem sequae nisi officit iatiant et rerati doluptate consequid ma ad mosa voluptat est ped ut qui blamus evelese optur aut arum simpostion porit laborrum eos exped que quiatqu

experienced without exaggeration, editorializing, or speculation on the historys veracity. The forensic nurses role is not whether to believe or not to believe the patient it is to document what the p

Forensic exam record, unredacted Exam photosvideos on disc or flash drive All documentation related to exam Reported victim statementsinterviews Forensic examiners curriculum vitae Additional me

FEATURE The goal of reviewing the forensic examiners report is to provide an analysis of the examiners work with scrutiny for correct terminology, correct identification of anatomical structures, and

FEATURE Il iuntiberum aborem sequae nisi officit iatiant et rerati doluptate consequid ma ad mosa voluptat est ped ut qui blamus evelese optur aut arum simpostion porit laborrum eos exped que quiatqu

FEATURE how to care for and about a diverse group of individuals, any of whom could be suffering with one or frequently more psychiatric disorders, can be challenging. Individuals with a diagnosable p

Emergency Medical Services EMS records including call transcripts Toxicology results from the medical examinerscoroners office Case 2 The Medically Compromised Aggressive Psychiatric Patient Mr. M.

Case 3 The DuallyDiagnosed Patient Who Overdosed Ms. S., aged 23, had a long history of selfcutting, bulimia, alcohol, cocaine, and amphetamine abuse, and post traumatic stress disorder PTSD arising

As in the hospital and halfway house, case management communication was virtually nonexistent. For example, the probation department thought random drug screens were being conducted at the halfway hou

FEATURE critical to understanding a case. The ability of the forensic psychiatric nurse to review a multitude of critical records can provide the depth and breadth of a case for either the plaintiff

FEATURE Il iuntiberum aborem sequae nisi officit iatiant et rerati doluptate consequid ma ad mosa voluptat est ped ut qui blamus evelese optur aut arum simpostion porit laborrum eos exped que quiatqu

FEATURE A death certificate requires a cause of death statement, the opinion of the certifier of death that to the best of his or her knowledge the person died from the cause listed. It is not legally

SCENE AUTOPSY CIRCUMSTANCES Circumstances are surrounding events that may or may not have an affect on what happened relationships divorce, marriage, fight, child custody issues, breakups, abusive

the scene, hhow did tthe body ccome o o e e found, how was access gained to he body, and so forth. o forth. the scene, ow did he b ody om

Scene Fig. 7 Case 2 Circumstances Issue was Act of God vs. insurance Driver talking to wife at time of accident, told her to Hold on coverage Winding rural road, no streetlights,

FEATURE prior to PD arrival, gave story that passenger had been driving Autopsy Multiple traumatic injuries associated with motor vehicle vs. pedestrian accident Head trauma scalp laceration, commi

FEATURE The Continuing Enigma of Sudden Unexpected Infant Death Thomas Andrew, MD, FCAP, FAAP Keywords SIDS, SUID, triple risk model, sleep environment, diagnostic shift, autopsy Sudden unexpected i

FEATURE T he tragedy of the sudden, unexpected death of a previously healthy infant has been described since antiquity. One of the first recorded cases can be found in the Old Testament Book of I Ki

INFANT VULNERABILITY DEVELOPMENT S I D S prone sleeping as a risk factor. Based on research findings, AAP formally recommended that U.S. babies be placed on their backs or sides to sleep in 1992 AA

FEATURE 1.6 1.4 Sudden infant deaths per 1000 1.2 New Zealand Buenos Aires SIDS vs Cosleeeping 1 Germany Australia Manitoba, Canada 2 cities, Austria Scotland Ireland Ukraine Graz, Austria Copenhag

Image 1 2 Inflatable bed in which a 10monthold was found wedged between a soft headboard and mattress Image 3 Pulmonary edema foam observed in scene investigation SUIDI INVESTIGATIVE TOP 25 Case

FEATURE Image 5 Position of mother and sevendayold infant when breast fed Image 6 Mother woke with infants head wedged between her breast and right arm Image 4 SUID scene investigation doll. Image

At some point during the external survey and before any internal examination takes place a radiological skeletal survey should be conducted. Note the term used here is not random or nonspecific. A soc

FEATURE Image 17 Respiratory syncytial virus RSV bronchiolitis Image 18 Viral myocarditis. Note inflammation about conduction fiber at lower right Image 19 Confluent bronchopneumonia as toxicologi

ILLDEFINED AND UNKNOWN CAUSES OF MORTALITY R95R99 Excludes fetal death of unspecified cause 95, obstetric death NOS O95 R95 Sudden infant death syndrome R98 Unattended death Death in circumstances

FEATURE the CDC in 2009 and published a proposed classification system based on analysis of these cases in 2014. ShapiroMendoza et al., 2014 This group categorized unexplained infant death by accompan

gation of sudden, unexplained infant deaths recommendations of the interagency panel on sudden infant death syndrome. MMWR, 45 RR10 Jones, AM, Weston, JT. 1977 The examination of the sudden infant dea

FEATURE Death Investigation in Maryland Bruce Goldfarb, BS T he history of death investigation in Maryland dates nearly to its founding in 1634. Under the authority of King Charles I, provincial Go

FEATURE We find that this Indian ladd named Edward came to his death by a bullet shott by John dandy, which bullet entered the epigastrium neare the navel on the right side, obliquely descending, pie

The unceremonious treatment of Baltimores deceased, particularly the unknown dead, was fueled by a burgeoning demand for cadavers for medical education. University of Maryland was one of Americas firs

work to his own district he does not care even in an emergency to accept a case which may be just over the border line. To get the most efficient service from such an important office as the coroners

Examiner with the authority to conduct forensic investigations without the need for permission of the States Attorney or law enforcement agencies MedChi member were of the consensus that two years of

revision was made by lawmakers subsequent to passage of the bill the Director of the Maryland State Police was substituted for the Attorney General on the Post Mortem Examiners Commission. The composi

fully equipped with water, electrical, data lines and other utilities necessary to set up a temporary morgue or autopsy stations in event of a mass fatality incident. The space is scaled to allow acce

THE JOURNAL OF egal Nurse Consulting Looking Ahead... XXVIII.1, March 2017 Niche Roles in LNC XXVIII.2, June 2017 Interventional Radiology XXVIII.3, September 2017 Brain Injury XXVIII.4, Decembe