Opinion ID: 1425788
Heading Depth: 1
Heading Rank: 11

Heading: physical and emotional corroboration of b.a.'s abuse

Text: This category of evidence includes testimony regarding B.A.'s two medical examinations and the views of an expert witness regarding those examinations. Thomas Ritter, a nurse practitioner, examined B.A. on October 7, 1985. He was asked to check out her coughing and also to examine her for signs of sexual abuse. B.A. became very distraught when Ritter told her he wanted to do a genital examination. She clung to her foster mother and said repeatedly, Please don't hurt me. When she finally agreed to be examined, she wouldn't let Ritter completely remove her underpants. She then assumed a position that Ritter said he had never seen in his 4 years of practice with children. She lay on her back, drew her knees up to her chest, and put her arms around her knees, thus leaving her genitalia and buttocks exposed. She was crying at the time and intermittently attempted to guard her genitalia by putting her hand between her legs. Ritter also found that the inside of the labia contained blood vessels that were more dilated than usual, and saw that the area around the introitus (the opening of the vagina) was reddened. He estimated the size of the introitus to be 1 to 1.2 centimeters. During the examination, Ritter did not check on whether a hymen was present, but he was able to see into B.A.'s vagina. After the examination, B.A. asked Ritter two or three times not to take any pictures of her, and was overall very distraught. On October 9, 1985, the Swans' family physician, Dr. Lawrence Parris, examined B.A. at the request of CPS. Dr. Parris testified that B.A. was very fearful and didn't want her underpants pulled down. Dr. Parris observed that the vaginal introitus was slightly red, and noticed a slight discharge. He did not note whether the hymen was intact. He found no definite evidence of physical injury, but recommended that B.A. be evaluated at a sexual assault center because of her fearfulness. Dr. Carol Jenny, Medical Director of the Sexual Assault Center at Harborview Medical Center, was accepted by the court as an expert on sexual abuse of children, and testified about her observations regarding the Ritter and Parris findings. Dr. Jenny testified that an introitus of 1 to 1.2 centimeters is abnormally large for a 3-year-old (the normal size is .4 cm). She noted that Ritter's ability to see the tissue inside the vagina indicated that he could see through the hymenal opening, even though neither Ritter nor Dr. Parris specifically recorded the presence or absence of a hymen. She also observed that it is unusual to find a vaginal discharge in a child, and such a discharge might result from infection caused by sexually transmitted disease. In assessing her testimony, the Court of Appeals considered Dr. Jenny's opinion, which had been ruled inadmissible by the trial court, [40] that B.A.'s fearfulness during the examination was probably a sign of sexual abuse. There was no medical evidence to document R.T.'s claims of abuse. A physician examined her on October 5, 1985 and found no signs of physical trauma. [8] Medical evidence similar to that regarding B.A. was considered corroborative of abuse in State v. Gitchel, 41 Wn. App. 820, 706 P.2d 1091, review denied, 105 Wn.2d 1003 (1985). Such evidence in Gitchel included a doctor's finding of partial vaginal penetration and the child's inappropriate behavior during the medical examination. [41] The New York Supreme Court also concluded that redness in a child's genital area partially corroborated her allegations of abuse in Kerri K., 135 A.D.2d at 633. We thus observe in this case, as did the Court of Appeals, that the medical evidence regarding B.A. is sufficient to permit a logical and reasonable inference that she was abused. Whether that evidence corroborates R.T.'s abuse is another matter. Strictly speaking, B.A.'s physical and emotional status during the examinations does not establish that R.T. was assaulted. B.A.'s physical and emotional conditions do lend at least some measure of support, however, to R.T.'s statements that B.A. played the games with her parents and, accordingly, that R.T. was present and was abused as well.