Understanding Forensic Medical Exams and Survivor Rights

Some survivors may choose to go to the hospital for a Forensic Medical Exam, also known as a rape kit, following an assault. Cleveland Rape Crisis Center has compiled some information about the exam to help survivors learn about the process, their rights, and their choices.

What is a Forensic Medical Exam?

A Forensic Medical Exam (FME) is offered by a specially trained team of nurses and physicians. It provides medical treatment and, with the survivor’s consent, is collected as a sexual assault kit for a possible criminal investigation.

Survivors have the right to decline any part of the exam at any time.

A FME is typically done by a Sexual Assault Nurse Examiner (SANE) who uses a trauma-informed approach and follows strict procedures to secure the sexual assault kit. 

After an assault, FMEs should be done within 72 hours for minors and 96 hours for adults as DNA evidence can fade and become unusable over time. However, medical support is still available to survivors after 72–96 hours. 

In Ohio, a FME is free. If additional medical care is provided, the survivor or their insurance may have to pay for it.

Who’s Involved in a FME?

A SANE who performs the exam, provides one-to-one care, and supports the survivor’s physical and emotional needs.

An Advocate who provides support, guides the survivor through the exam, explains their rights and choices, and connects them with important resources.

Law enforcement who responds to the hospital and documents the report of an assault, keeps all evidence safe, and works on the investigation and possible charges.

What happens during a FME?

• History and Narrative
  The nurse asks the survivor questions to document what happened during the assault, and to assist in safety planning and hospital discharge.

• Physical Examination
  With the survivor’s consent, providers perform a head-to-toe exam based on the details shared. They collect DNA swabs and take photos to document any injuries.

• Medications and Testing
  Survivors may be offered pregnancy testing, emergency contraception, and infection prevention medications. If needed, a toxicology screening for possible drug facilitated assault may be offered and sent out with the sexual assault kit.

Where can I get a FME?

Many hospitals in Northeast Ohio have 24-Hour SANE Units. Visit clevelandrapecrisis.org/FME to find SANE Units in Cuyahoga, Ashtabula, Lake, Geauga, and neighboring counties.

You do not have to go through this alone. CRCC Advocates can be requested by hospital staff or by the survivor. To request an advocate, call the 24/7 Crisis & Support Hotline: (216) 619-6192 or (440) 423-2020.

Do Survivors Have to File a Police Report?

Adult survivors who choose to have a FME do not have to file a police report*, and a police report is not required before receiving a FME.

Survivors aged 18 and older also have the option to submit an unnamed kit. The kit is labeled with a unique identification number that protects the survivor’s privacy while they decide what to do next. If they choose to file a report in the future, the kit can be connected to their name and case.

Due to child protection laws, unnamed kits cannot be submitted for survivors under 18 years old.

Even if a survivor chooses not to make a report, hospitals are required to inform law enforcement of the assault. The survivor’s identity is not shared, and they do not have to speak with police.

*See below for information about mandated reporting.

Mandated Reporting

Survivors are not required to report the assault. However, medical professionals and advocates are mandated reporters.

This means they are required to report instances of abuse against minors, the elderly, and people with disabilities to protective service agencies such as Children’s Services, the Board of Developmental Disabilities, and Adult Protective Services.