When a woman went to Baptist Health La Grange earlier this year after being sexually assaulted, she was seeking treatment for her injuries as well as a forensic sexual assault exam.
However, the attending physician in Baptist Health La Grange’s emergency room that day declined to administer the exam because he wasn’t comfortable doing it, according to Oldham County Police Detective Todd Lindner.
Information about the assault, and the women’s subsequent trip to Baptist Health La Grange, comes from a probable cause hearing on May 29 for Eric Johnson, who was later indicted on charges of rape, sodomy and assault against the woman.
Despite the woman’s admission she had been sexually assaulted, the attending physician still declined and the woman had to travel to another hospital for an exam.
Under Kentucky law, such an action is illegal.
State law requires emergency room staff to perform forensic sexual assault exams on-site and free of charge. Hospitals typically prefer a sexual assault nurse examiner, or SANE nurse, be the one to perform the exam because of their specialized training.
Baptist Health La Grange doesn’t have any SANE certified nurses on staff, but this doesn’t mean the hospital is outright unable to perform a forensic exam.
Kentucky law states if a SANE nurse isn’t available then a physician, or another qualified medical professional, such as an advanced practice registered nurse or physician’s assistant, can perform a forensic sexual assault exam.
Elizabeth Cobb, former vice president of Health Policy for the Kentucky Hospital Association, says hospital administrators have a responsibility to understand and implement protocols so emergency personnel are educated on how to provide “high-quality victim centered care” every time a victim of sexual assault presents to the hospital.
“Patients cannot be turned away because the facility doesn’t have specially trained staff,” Cobb says in a video, produced by the Kentucky Association of Sexual Assault Programs (KASAP), outlining the responsibilities of hospitals. “Individuals cannot be denied care or access to evidence collection, period.”
An investigation by the Kentucky Center for Investigative Reporting found that SANE nurses work in just one-third of Kentucky’s 120 counties.
Baptist Health La Grange, the only hospital and emergency room in Oldham County, is one of the many hospitals in the state that doesn’t employ a SANE nurse.
KyCIR’s investigation also found that many of the state’s SANE nurses are clustered at a few hospitals, which leaves large areas of the state without this form of specialized care.
Ashley Parker, Baptist Health La Grange director of emergency services, said in a statement that the hospital has a process in place to examine and treat sexual assault victims in a confidential, sensitive and dignified manner.
“Baptist Health La Grange provides an examination to all patients who present to its emergency department who seek treatment for an emergency medical condition,” she said. “Physicians providing services in the emergency department at Baptist Health La Grange perform sexual assault examinations for sexual assault victims.”
Follow-up questions about the incident the Era found where a sexual assault victim was turned away from the hospital for an exam were unanswered.
On May 2, Johnson, a 36-year-old La Grange resident, approached the woman in question at the Circle K in La Grange asking if she could give him a ride home. He offered her $20 if she did.
Lindner, testifying at the probable cause hearing in Oldham County District Court, said the woman gave Johnson a ride before having her pull into a driveway and stopping the car.
Once the vehicle stopped, Johnson exited the vehicle, walked over to the driver’s side of the car, opened the door, grabbed the woman by her hair and forcibly removed her from the vehicle, Lindner said. At that point, the woman said Johnson began to sexually assault her.
The woman was also stabbed in the leg during the assault and had to receive stitches to her upper thigh. She also received staples to the back of her head, but she’s unaware of how that specific injury occurred.
Linder said the woman was at Baptist Health La Grange receiving treatment for her injuries.
However, Linder was with the woman at Baptist Health La Grange on May 3, at the request of the La Grange Police Department, and testified that the attending emergency room physician declined to administer a forensic sexual assault exam.
Linder also said he brought a forensic evidence collection kit, which are later sent to the state police forensic laboratory, with him in anticipation for an examination.
“I took a kit with me, asked if they were going to do the sexual assault examination kit and the attending physician in the emergency room was not comfortable doing it,” he testified.
In her statement, Parker said nursing staff in the emergency department have been trained to assist in the collection of evidence of sexual assault using the Kentucky State Police assault evidence collection kit, although they are not SANE-certified.
An exam in Louisville
Oldham County Police Major Neil Johnson said the woman ultimately received a forensic examination at University of Louisville Hospital.
As far as the county police have been involved, Johnson said Baptist Health La Grange has had physicians in the past conduct the forensic exam. However, he said exams are normally conducted in Louisville due to the availability of SANE nurses.
Johnson said police contacted UofL Hosptial so they could coordinate a forensic exam. UofL Hospital also works in tandem with the Center for Women and Families to conduct forensic exams and provide other medical services for victims of sexual assault.
Amanda Corzine, UofL Hosptial’s registered nurse coordinator, manages 18 SANE nurses. Last year, she said they served 827 sexual assault victims.
Corzine is aware of the gaps that exist at hospitals that lack a SANE nurse because UofL Hospital and the Center for Women and Families are often the go-to place for victims in the surrounding area. But Corzine doesn’t think victims of sexual assault should be made to jump through hoops for proper care.
“The burden should not be on the victim to know what hospital to go to after their traumatic event,” Corzine said.
She said making victims travel from one hospital to another is cumbersome because they often want to receive an exam where they first presented and are more comfortable at a hospital in their local community.
Corzine recognized the challenges hospitals face to maintain support for a 24/7 SANE nurse. If a hospital doesn’t have staff exclusively for SANE services then other nurses can be pulled to do that on top of their other work.
“If a hospital doesn’t have staff that are knowledgeable for proper care for sexual assault victim it can result in a hands-off approach,” she said.
The end result of this is nurses experiencing burnout very quickly; something she says is a contributing factor to the shortage of SANE nurses around the state.
Corzine has been working on a community SANE model where nearby hospitals can contract with them to perform exams at their facility. They’re making progress, she said, but getting programs like these up and running takes time, money and effort.
What is a SANE nurse?
A SANE nurse is a registered nurse who obtained specialized training in the forensic examination of sexual assault victims and is credentialed by the Kentucky Board of Nursing (KBN).
Baptist Health La Grange doesn’t have any SANE-certified nurses employed and follow-up questions to hospital officials about if they would consider pursuing certification for nurses or employing SANE certified nurses went unanswered.
According to the KBN, Kentucky is one of the few states that has legislated a SANE credential, a result of the 2016 Sexual Assault Forensic Act. The law, also known as the SAFE Act, outlines the necessary procedures law enforcement, hospitals and the courts have to follow for victims of sexual assault.
In its annual report published in July, the Sexual Assault Response Team Advisory Committee, overseen by KASAP, found there are 283 active SANE nurses practicing in the state, which is the highest number to date.
The report states the presence of a SANE nurse makes a victim more likely to receive information regarding consent to a forensic exam, privacy, sexually transmitted infections and pregnancy prevention.
While the number of active SANE nurses is at a high, the report states a shortage of nurses exists and that results in knowledge gaps.
“It is difficult to gauge the information passed on and the care that the victims receives if an advocate is not notified,” the report states. “There is a major knowledge gap in what the law requires in care and response for sexual assault victims seeking care in hospitals.”
Resources for victims of sexual assault
While there are currently no SANE-certified nurses in Oldham County, Corzine said the Center for Women and Families’ services covers the county and provides 24/7 advocacy services for rape crisis and domestic violence.
The center’s Louisville location is 927 South 2nd Street; their 24-hour crisis hotline number is 502-581-7222. There is also a Shelbyville location at 500 Main Street.
KASAP provides resources for victims of sexual assault, domestic violence, stalking and child abuse both in Kentucky and nationally. A list can be accessed online at https://www.kasap.org/get-info/resource-library/resource-library—home.
The 24-hour rape crisis line is 1-800-656-HOPE (4673).
Andrew Henderson 