Mercy Medical Center in Baltimore City Maryland had a problem.
Hundreds of women were coming into its emergency room claiming they were strangulation victims. But despite witnesses and their own accounts, the victims often lacked any visible marks on their necks to prove in a court of law that strangulation had occurred.
The problem vexed Debra Holbrook. A registered nurse, she is the Forensic Nursing Director with Mercy Medical Center’s Forensic Nursing Program.
A forensic nurse provides specialized care for patients who are victims of trauma. Forensic nurses also have specific knowledge of the legal system and skills in injury identification, evaluation, and documentation. A forensic nurse often collects evidence, provides medical testimony in court, and consults with legal authorities.
Part of that evidence collection was the use of an Alternative Light Source (ALS), like the ones made by SPEX Forensics, a Division of HORIBA Scientific. These sources, at specific wavelengths, made certain materials fluoresce, so they could detect the presence of things like saliva, semen, and lubricants.
Holbrook, who founded a Forensic Nurse Examiner Program in Delaware, found something else. If you changed the wavelength of the alternative light source to a higher wavelength, contusions and injuries unseen to the naked eye went through a process of absorption. That absorption of the light source revealed a visible impression that would uncover the injuries unseen by the naked eye.
What’s more, the effect could be photographed, so a court didn’t have to depend on the testimony of a forensic nurse alone.
“If we changed the wavelength to the lower 400 to 500’s, we found absorption with different colored goggles,” Holbrook said. “We could see absorption under the skin. I could see significant amounts of absorption in the 450 to 500 range using orange or red goggles. The injuries matched how they stated they were assaulted.”
Holbrook found 90 to 95 percent of the hospital’s strangulation victims showed the absorption. Her own published studies linked the absorption phenomena to an injury under the skin.
“The absorption that we are seeing in the 450-500 range mirrors injuries we expected to see in some parts of the body,” she said. “Now it gives patients that are victims something to use in court other than their word.”
Holbrook and her associates testify in court. In many of the cases, Holbrook said, defendants plead guilty because the alternative light source evidence adds to the preponderance of the evidence against the defendant.
“The use of ALS has changed the practice of forensic nursing in Baltimore City,” she said. “It is a staple for our care and investigation.
Holbrook has taught at national conventions and conferences of forensic medical specialists and scientists. She has promoted the process across the county.
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