THE CT100 SEXUAL ASSAULT EVIDENCE COLLECTION KIT

General Information

• The CT100 Sexual Assault Evidence Collection Kit (Kit) shall be used whenever completion of a sexual assault evidence collection kit is deemed appropriate.
• Completing of the Kit is appropriate according to the following:

• Whenever a patient presents with a complaint of sexual assault within 120 hours of the sexual assault, and
• The patient or the patient’s representative consents to the completion of the Kit;
• Whether or not the patient wants police notified at that time;
• Unless it is determined by health care personnel that the patient’s medical need mitigate against it. (See below.)

• See pages 52 through 54 for information regarding the examination of child/adolescent sexual assault/abuse patients.
• If a patient’s special medical needs indicate that completion of the Kit is not appropriate, the examiner should determine what, if any, evidence can and should be collected, and by what means the collection can and should be accomplished.
• A reasonable supply of Kits should be maintained by each health care facility. Until the Kit is used for evidence collection, it requires only shelf storage.
• The expiration date on the Kit box pertains only to the blood vacutainers. If the expiration date has passed, substitute appropriate blood vacutainers from health care facility stock, and note    such replacement on the Checklist (line # 6).
• The sealed Kit contains a complete set of Forms and all materials needed for the completion of Steps 1 -13. (See pages 32 through 50 for specific information regarding completion of these steps.)
• Additional materials such as paper bags, envelopes, swabs, etc., may be used as needed. The addition of any materials should be noted on the appropriate step envelope and on line 6 of the Checklist.

Integration with Care and Treatment

• Medical care and treatment and evidence collection procedures should be integrated in order to save examination time and reduce the patient’s discomfort.
• Any cultures for STIs should be taken immediately after specimens are collected from the oral, vaginal or anal orifices.
• In order to minimize patient trauma, blood needed for the hospital laboratory should be drawn at the same time as blood needed for the Kit.

Attending Personnel

• Generally, only the examining and attending health care providers and, with the consent of the patient, a sexual assault counselor, should be in the examining room during the examination.  If the patient requests the presence of a close friend or family member, this request should be honored, if possible.
• There is no medical or legal reason for a police officer (male or female) to observe the examination procedures. Subjecting patients to the observation of law enforcement personnel is an invasion of the patient’s privacy and an unnecessary practice.
• It is recommended that at least one health care person remain with the Kit from the time the Kit’s original seal is broken until the Kit is completed, closed and sealed.  (See page 30 for instructions if constant attendance cannot be maintained)

Preparation for the Examination

• It is recommended that a private examining room be designated as the sexual assault examining room.
• A pre-assembled sexual assault tray stored in the designated examining room will eliminate the need to gather essential examining equipment after the patient has arrived.

Recommended Tray Contents:

• Arranging all necessary materials on table/counter area prior to beginning the examination can facilitate orderly and complete specimen collection.
• Be sure to have stable table/counter space available for air drying specimens.
• Briefly explain the evidence collection process to the patient prior to beginning the examination. Provide detail about each step prior to completing that step. The examination may be very frightening and demeaning for the patient. The more understanding the patient has of the procedure, the easier it will be.

Chain of Custody

• Special care must be taken to maintain the chain of custody of all evidence collected from the patient.  For examiners, this means that once the Kit is unsealed for use for sexual assault evidence collection, someone (or a series of persons, if necessary) must have actual and continuous custody of the Kit contents and any evidence collected until the evidence is placed in the Kit, and the Kit is resealed.
• If circumstances require that the person with custody of the Kit and evidence must leave the examining room after the seal on the Kit has been broken, one of the following actions must be taken:

• Transfer temporary custody of the Kit to another health care person and record the transfer on the appropriate line on the Kit cover and chain of custody label on the brown clothing bag; or
• Seal all collected specimens in the Kit and brown clothing bag prior to leaving, and upon returning, open a new Kit to collect any remaining evidence.  If more than one Kit is used for a patient, be sure to note the existence of additional evidence containers in the upper right corner of all chain of custody labels.
• After the evidence has been sealed inside the Kit and/or clothing bag, it is no longer necessary for someone to have actual physical custody of the sealed evidence containers, although its storage must be secure and whereabouts must be fully documented on the chain of custody section of the labels.
• If the evidence is transferred directly to police (see pages 62 through 65 for information about transfer procedures), the transfer should be documented in the appropriate places on the chain of custody section of the labels.
• If the evidence is temporarily stored prior to transfer to police (see page 63 for information about temporary storage procedures), the storage and subsequent transfer should be documented in the appropriate place on the chain of custody section of the labels.

 

The Evidence Collection Examination

General Instructions

• Use non-lubricated gloves at all times during the examination.
• Break the Kit seal with a sharp implement (e.g., a scissor blade).  Once the seal is broken, the chain of custody must carefully be maintained. (See above.)
• Inside the Kit box you will find:

• A complete set of Forms;
• One folded paper sheet, three white paper bags, and one medium and one large brown paper bag for clothing collection in Step 1;
• Twelve step envelopes (for Steps 2 -13);
• Four red “EVIDENCE” seals (two for the Kit box and two for the brown clothing bag);
• One orange “BIOHAZARD” sticker.
• All materials needed for each step are contained in the appropriate step envelope (except the scissors and tweezers contained in Step 4 that will also be used in Step 9). The materials for each step are listed IN THE STEP BY STEP INSTRUCTIONS SECTION. Any materials found loose in the Kit box should be reunited with the appropriate step materials, as suggested above.
• The directions for completion of each step are printed on the step envelope. (SEE THE STEP BY STEP SECTION)
• The steps are arranged in a sequence that progress from less-invasive to more-invasive procedures, and end with a less-invasive procedure. If this sequence is not followed, note any sequence changes on any step envelope/s involved.
• Provide all requested information on each step and specimen envelope. If a specimen is not collected, briefly note the situation/reason why it was not. (eg., “patient declined,” “child – no pubic hair available.”)
• All moist specimens (e.g., swabs, smears, clothing stains, etc.) should be air-dried prior to being sealed in the appropriate envelope/bag. (See Appendix I for information regarding air-drying techniques.)
• Seal all clothing bags by double-folding the opening, and securing with staples and/or tape.
• Seal all envelopes with a dampened cotton ball, gauze or paper towel. Never use saliva.

Questions Regarding Evidence Collection

• Consult the following agency with questions regarding evidence collection and/or storage:

• Department of Public Safety, Division of Scientific Services Forensic Science and Toxicology Laboratory: (203) 639-6400 (Monday-Friday, 9:00am – 4:00pm)

Step Instructions

• The following information is provided below for each step in the CT100 Kit:

• A copy of the step directions exactly as they appear on the step envelope;
• An itemized list of step contents;
• Special instructions and helpful information for the completion of each step.