Oral Forensic Photography Protocol

The goals of this presentation are to demonstrate patient positions to maximize quality of oral images, explain storyboard images of oral photographs and to provide rationale for images and the value of each position. This presentation will impact the forensic community by demonstrating how penetration of the oral cavity with patient reports of sexual assault requires a unique clinician skill set and unique techniques of photography to provide valuable evidentiary photographs of the oral findings. Forensic photography requires special skill and techniques when a patient reporting sexual assault discloses oral penetration. Oral images are of great value especially if the patient is not able to provide the history of the event, has no memory of the event, and there were no witnesses.

For the sexual assault examiner, photography may also include images of the body and images of the oral and genital area looking for injury, no injury, or evidence of pre-existing medical conditions for documentation. Photography allows sexual assault examiners to add images for enhanced documentation and the opportunity to consult and teach in a peer review setting. Defense experts are also able to view the findings and provide valuable consultation in these criminal or civil cases. This presentation will focus on providing a guideline or protocol that can guide the sexual assault examiner, or other clinician, through the process of obtaining the highest quality of oral images possible. The sexual assault examiner typically performs a forensic medical examination, including subjective and objective assessment, and documents the physical findings.  Forensic aspects of care require that the examiner provide documentation of injury or no injury for the record.

Documentation is provided in written form, diagrams, and photographic images. A pictorial presentation of the photographic protocol in this presentation will assist sexual assault examiners with providing the highest quality oral examination with patients reporting oral penetration with sexual assault. Such a protocol will assist the examiner in obtaining maximum value from the oral examination and images in order to have complete high quality evidence following a medical forensic examination. The trend toward digital photography with the magnification software provides extreme detail for all parts of the oral cavity.

This is critical in order for the examiner to be able to identify the micro trauma that is typical of sexual assault, including oral penetration. Magnification plays a major role in determining the size of the depth of field range. Patient and clinician positioning for long-range, mediumrange, and close-range images will be demonstrated for obtaining the best images of external lips, mouth, soft and hard palates, and other oral anatomical sites. Comparison of images with explanations will be provided to explain to participants the rationale for assuring that images meet the criteria for best quality images for use as evidence in legal proceedings.

The expected criteria for high quality images that are expected in the courtroom include:

(1) picture is in focus,

(2) picture is not too light or too dark,

(3) picture is aligned and not twisted,

(4) picture truly represents the subject matter,

(5) picture is not compressed toomuch, and

(6) picture has adequate image resolution to visualize what is necessary. Examples and several images similar in subject matter will be displayed for the participant’s visualization of the difference in resolution and quality of picture. The participant will be able to observe and compare the quality of images and apply the information to their own sexual assault practice.