Rationale:

• The patient needs to know that officer collection of a history and evidence does not always lead to an arrest or legal actions against a suspect.
• During the immediate postassault period patients may not be able to absorb all the legal information provided; it is critical that they have a knowledgeable advocate or a sensitive law enforcement contact for legal follow-up information.
• Reporting an assault to law enforcement and obtaining an order of protection may decrease the risk of repeated sexual assault by an intimate partner.

Evidence:

• Mainly consensus.
• In a case series of 888 female sexual assault patients, prosecutors filed charges in only 15%. Characteristics positively associated with filing charges included examination within 24 hours after assault, partner or spouse as an assailant, oral assault, and anogenital trauma (88).
• One nonrandomized study of 148 female victims of intimate partner sexual assault found a 59% and 70% decrease in repeated sexual assault when the women reported the first assault to police and applied for a protective order (15).

Comments:

• Follow-up legal processes, including the statute of limitations for filing of charges, vary tremendously by state law and local protocol. Practitioners must be familiar with local policies or refer patients to appropriate sources to obtain such information.
• Typically, an on-duty officer will respond to the medical setting when called about a sexual assault. The officer will take the history from the patient and the evidence collected by the examiner. The officer will then turn over the case to a detective to complete the investigation. If there is sufficient evidence, the case is submitted to the prosecutor and the suspect is arrested. Prosecutors review cases to determine whether charges can be proven beyond a reasonable doubt. If so, a case will be filed; if not, the case is returned to the original police agency for more evidence or is rejected.