Current through Register Vol. 51, No. 19, September 20, 2024
A. The victim shall be considered an
emergency patient with special needs. The victim shall be taken immediately to
a quiet private area where tests and examinations will be performed on the
victim. The following measures are indicated under certain circumstances:
(1) Prophylactic medication shall be
discussed and offered to the victim who is at risk for pregnancy as a result of
the alleged rape or sexual assault;
(2) Prophylactic medication shall be
discussed and offered to the victim who is at risk for sexually transmitted
infections and recommended initial tests and follow-up tests shall be
performed, if indicated;
(3) After
the victim has been properly informed as to the significance of testing for the
presence of the human immunodeficiency virus (HIV), the victim shall be
referred to the appropriate anonymous or confidential, and free HIV counseling
and test sites for potential baseline and follow-up testing and support
services;
(4) Injuries suffered by
the victim shall be treated with appropriate consultation, as necessary;
and
(5) Tetanus prophylaxis may be
administered, if indicated.
B. Sexual Assault.
(1) A sexual assault forensic examination
shall be performed if:
(a) The victim is seen
within 120 hours of the alleged sexual offense; and
(b) Either:
(i) A police report has been filed with the
appropriate law enforcement jurisdiction; or
(ii) A property-held number is assigned to
the case in the event that a victim does not wish to file a police report
immediately but still seeks to have evidence collected and held.
(2) A sexual assault
forensic examination shall be performed only by a:
(a) Physician; or
(b) Forensic nurse examiner.
(3) When performing a sexual
assault forensic examination, a physician or a forensic nurse examiner shall
use the Maryland State Police victim sexual assault evidence collection kit or
a comparable evidence collection kit and shall follow the kit instructions
including:
(a) Packaging the victim's
clothing in paper bags; and
(b)
Collecting the following specimens:
(i) Blood
sample (lavender cap);
(ii) Vaginal
swabs (a minimum of four);
(iii)
Oral swabs (a minimum of two);
(iv)
Pubic hair combings;
(v) Pulled
pubic hair;
(vi) Pulled head hair;
and
(vii) If indicated, anal swabs,
bite mark swabs, and fingernail scrapings.
C. A physician or forensic nurse
examiner shall follow the procedures as indicated to establish evidence of
alleged rape or sexual offense, depending on the specifics of the crime as
described by the victim:
(1) Obtain from each
of the following areas, if indicated, a smear to be fixed and stained according
to the Papanicolaou technique:
(a)
Endocervical canal;
(b) Vaginal
pool;
(c) Vulva;
(d) Mouth; and
(e) Anal area;
(2) Obtain culture for gonorrhea from cervix,
rectum, and nasopharynx, if indicated, and plate it immediately;
(3) Obtain vaginal, oral, or rectal aspirate
for acid phosphatase testing, if indicated;
(4) Obtain a blood sample for syphillis
testing and refer patient to a healthcare provider of choice for repeat sample
in 4-6 weeks;
(5) Obtain X-rays
necessary to establish evidence of physical injuries sustained as a direct
result of the alleged rape or sexual offense; and
(6) Obtain either a urine sample or a blood
sample for beta subunit of human chorionic gonadotropin for a pregnancy test
and recommend and refer the victim to a healthcare provider of choice for a
second test in 4-6 weeks, if indicated.
D. A physician or forensic nurse examiner
shall submit the evidence collected to the appropriate law enforcement
jurisdiction.