Collecting Medical Evidence

If you wish to have medical evidence collected, you can contact an OSAPR representative to accompany you or go directly to the emergency room of a hospital with a certified Sexual Assault Nurse Examiner (SANE).  These hospitals include: Beth Israel Deaconess Medical Center (BIDMC), Boston Medical CenterBrigham and Women’s HospitalCambridge HospitalChildren’s HospitalMassachusetts General Hospital, and Newton-Wellesley Hospital.  As a point of consistency, OSAPR uses BIDMC.  The entire visit will likely range from 5-8 hours.

  • When you arrive at the emergency room, you or your advocate will need to let the Information Desk know that you are there to be seen for a Sexual Assault.  These individuals are either volunteers or Security Guards.  They will not need more information beyond what has brought you to the hospital.
  • You will then speak to a triage nurse who will take your vitals, name, and birthdate.  You can still request to remain anonymous on the evidence collection kit, even after this step.
  • From triage, hospital staff will escort you and your advocate immediately to a private room.  
  • You may be offered the opportunity to speak with a hospital social worker for additional support―this is entirely up to you.  
  • A hospital nurse will come in to confirm the details ascertained during triage and ask a series of additional questions.  
  • After the nurse, a physician will come in to confirm what prescriptions will be necessary, based on your answers to the nurse's questions.  
  • Prescriptions may include antibiotics to inoculate against STIs, prophylaxis to prevent transmission of HIV, and emergency contraceptives to those who can get pregnant.  You will likely also be offered an anti-emetic to prevent nausea.  You may turn down any or all of these medications.
  • At this point the hospital will page the SANE, a nurse who is specially trained to perform evidence collection and the Boston Area Rape Crisis Center (BARCC) medical advocate.
  • The SANE will ask you if you want to report the assault to the police―again, this decision is entirely up to you. The evidence can also be collected anonymously while you take time to decide.  
  • There are many steps to an evidence collection kit.  You may choose to have your advocate in the room, or to complete the exam in private.  
  • The SANE will discuss each step with you as they conduct the exam and you will have the opportunity to accept or decline each one.  Depending on the details of what happened to you, not all steps will be necessary.  The SANE and your advocate can help provide an explanation as to what each step will cover, giving you the information to make the decision that feels best.
  • Your insurance will not be charged for the exam or the medication―all costs are covered by the state.  The hospital will provide you with forms to complete to route payment to the state as opposed to an insurance company or out of pocket.

Why is evidence collection important?

  • It is important to preserve any physical evidence that could be used to prosecute a rape or sexual assault. You have several months to decide if you wish to prosecute the assault, but having medical evidence may improve the strength of your case.
  • Bathing, douching, changing clothes, and removing anything from the area in which the incident occurred (bed linens, etc.) could diminish evidence. If possible, you should wear or bring the clothes with you to the hospital that you were wearing at the time of (or immediately after) the assault.
  • As soon as possible, try to write down everything that you can recall about the assault, including a physical description and/or name of the perpetrator, specifics about the use of force or threats, the location, time and date and the assault, and any witnesses or others who may have seen you immediately before or after the assault. This written account should be kept in a safe place and may be helpful to you later if you decide to bring charges against the person responsible.

What does evidence collection NOT cover?

  • It does not replace a physical or gynecological exam.  Though the SANE will walk through many steps of evidence collection, including genital swabs, only immediately visible injuries are documented.  To get a physical or gynecological exam, you would follow up with your primary care physician.
  • It does not provide samples of collected evidence to the hospital for testing―all information is stored in the kit and only tested if you decide to pursue a legal case.  This means, unfortunately, you will not find out if bodily fluids (or other types of evidence) were present simply for your own information.
  • It does not include STI testing.  This is in part because it would be too soon for the tests to indicate if an STI had been contracted during the assault.  An STI revealed at this stage would indicate that it was pre-existing and this information could potentially be accessed in a criminal investigation.

There is no right answer about whether or not to pursue an evidence collection kit.  What matters is that you have the information you need to make the decision that feels best for you. And no matter what you decide, you don't have to do it alone.