What is a SANE Examination and How Does It Affect My Case?

If you are facing charges of rape or sexual assault, understanding the evidence the prosecution intends to use against you is one of the most important steps you can take. In many of these cases, that evidence will include a Sexual Assault Examination, and knowing what that examination can and cannot establish could make all the difference in building a winning defense.

This article breaks down everything you need to know about the SANE examination and how it may affect your case.

What Is A SANE Examination?

When a person reports sexual assault, law enforcement will typically recommend that the reporting person submit to a physical examination with a specially trained health professional to identify and preserve physical evidence.

The professional conducting this examination is often a Sexual Assault Nurse Examiner, referred to as a SANE Nurse. During the examination, the SANE Nurse will look for physical injuries consistent with the reported sexual activity and collect samples for DNA testing.

Is There A SANE Exam Conducted In Every Sexual Assault Or Rape Case?

As a general rule, DNA evidence can persist for up to seven days after unprotected sexual activity. Additionally, most physical injuries that result from sexual activity are superficial, meaning no medical or surgical intervention is necessary. More than this, they heal quickly. The likelihood of identifying visible injuries of any kind after seven days is low.

For these reasons, if someone is reporting a sexual assault that occurred within the previous week, law enforcement is likely to recommend a SANE examination. If someone is coming forward to report an assault that occurred a week or more in the past, law enforcement may determine that a SANE examination would not be warranted.

What Types Of Injuries Might A Sexual Assault Nurse Examiner See During A SANE Exam?

There is an acronym used to summarize the types of soft tissue injuries a SANE Nurse looks for during an examination: T.E.A.R.S.

• T: Tearing of the soft tissues of the female anatomy
• E: Ecchymosis, the medical term for bruising or disruption of blood vessels below the surface of the tissue, causing visible discoloration
• A: Abrasion, similar to bruising, but where the top dermal layer is scraped away
• R: Redness, generalized erythema from inflammation or irritation of the tissue
• S: Swelling, more localized erythema, often resulting from trauma

The vast majority of these injuries arise from typical sexual activity and require no medical intervention. Most heal on their own without the person ever knowing they occurred.

Even after completely consensual sexual activity, the vast majority of women likely have one or more of these injuries and are wholly unaware of them because they have no reason to submit to a SANE exam following consensual activity, and because these superficial injuries tend to resolve quickly on their own.

Paul Cramm of Cramm Law Firm in Kansas has defended enough rape and sexual assault cases to know that most attorneys underestimate SANE evidence, and that underestimation has cost defendants their freedom. He doesn't just understand how to challenge this evidence in court; he requires every client in a sexual assault case to retain an independent SANE examiner as a condition of his representation. That's not a standard practice. It's a standard born from hard-won experience.

If you're facing these charges, contact Paul Cramm today.

What About DNA Evidence?

The most obvious type of DNA evidence a SANE Nurse looks for is semen, seminal fluid, and sperm cells. The female vagina and cervix are near-ideal environments for preserving male DNA in this form, and it can persist there for up to a week after sexual activity.

Beyond semen and sperm cells, the human body constantly sheds microscopic skin cells called epithelial cells.

After simply handling a pen, a person has likely left enough epithelial cells on it to produce a DNA profile. During unprotected intercourse, the parties very likely exchange epithelial cells through close contact and friction between exposed body parts. DNA can also be found from oral contact, where saliva and epithelial cells from inside the mouth may have transferred to a partner’s body.

How Would You Defend A Rape Case When There Is A SANE Exam?

The existence of a SANE exam does not automatically mean the results will benefit the prosecution. Not all sexual activity results in superficial injury. If the accuser was a willing participant and experienced a normal arousal response, it is entirely possible that there would be no observable injury at all.

Moreover, the presence of superficial injury is not diagnostic of force or lack of consent. Completely consensual sexual activity between married or otherwise monogamous couples will, in all likelihood, result in some superficial injury, an injury that goes wholly undiscovered because the woman feels no reason to submit to a SANE exam, and the injuries heal quickly without intervention.

Similarly, if the couple used protection, or if the accuser used the restroom, showered, or bathed between the activity and the examination, it is entirely possible that there would be no genetic material to collect at all.

Can You Defend A Case With DNA Evidence?

It is common for prosecutors and law enforcement to refer to a SANE exam as a “Rape Kit.” Prior to trial, I typically file a Motion in Limine asking the Court to prohibit the State and its witnesses from using that term in front of the jury.

While a SANE examination may be able to establish that sexual intercourse or other sexual activity occurred, there is nothing in a SANE examination that supports a conclusion about the presence or absence of consent to that activity.

This is especially true in date rape or acquaintance rape cases, where the defendant does not deny that sexual activity occurred. The only issue is whether it was consensual. In those cases, DNA evidence neither proves nor disproves consent.

There are also cases where the DNA evidence is inconclusive from an identification standpoint because the reporting party delayed coming forward or bathed between the event and the examination. The DNA report may reflect only a partial male profile, insufficient for identification.

In my practice, I have handled several cases where the SANE exam revealed a mixture sample containing male DNA from two different contributors. A second, unidentified male contributor found in a vaginal or cervical swab is never favorable to the prosecution.

What Is The Best Strategy In A Rape Or Sexual Assault Case With SANE Evidence?

The best strategy is to retain your own independent Sexual Assault Nurse Examiner to review the SANE exam, advise defense counsel for more effective cross-examination of the prosecution’s SANE Nurse, and testify for the defense if necessary.

SANE evidence is complex. No lawyer can understand the medical, physiological, physical, and genetic dimensions of this evidence with the depth and precision that a Board-Certified Sexual Assault Nurse Examiner can. Criminal convictions have been overturned on grounds of Ineffective Assistance of Counsel because trial lawyers underestimated the complexity of SANE evidence.

Defending these cases successfully is a team effort, and no attorney, regardless of experience, can substitute for the depth and precision that a qualified independent expert brings to the table.

I tell every client who consults with me in a rape or sexual assault case that hiring an independent Sexual Assault Nurse Examiner is a requirement of hiring me as counsel. There is simply no substitute for it.

Still Have Questions? Ready To Get Started?

For more information on a SANE examination, an initial consultation is your next best step. Get the information and legal answers you are seeking by calling (913) 322-3265 today.