Ascension St.Thomas Rutherford Hospital in Murfreesboro, Tenn. (Photo: John Partipilo)
Ascension Saint Thomas Rutherford Hospital in Murfreesboro has long served sexual assault survivors who come through its emergency room doors, treating their injuries and — if victims choose — performing forensic exams to recover evidence for possible criminal prosecutions.
But the head of the county’s chief victim advocacy group, which dispatches a support person to the hospital each time a victim is seen, says the hospital abruptly stopped offering the forensic exams early this year.
Ericka Downing, director of the Domestic Violence & Sexual Assault Center in Murfreesboro said she is unaware of a single forensic exam performed since January at the hospital — until now, the main provider of sexual assault forensic exams in Rutherford County.
Rutherford County’s top prosecutor, likewise, says the hospital has refused to provide victims forensic exams, which yield key DNA and injury evidence his office relies on to bring perpetrators to justice. District Attorney Jennings Jones called it a “substantial concern” that has surprised and disappointed prosecutors in the county.
And Rachel Freeman, CEO of Nashville’s Sexual Assault Center, notes her organization has been providing exams to Rutherford County survivors. Since January, local law enforcement officers have transported eight victims from Rutherford County to her facility for the exams, while two victims made their way on their own, she said.
Despite these claims, a hospital spokesperson last week flatly denied the hospital is turning away victims seeking so-called sexual assault nurse examiner exams, or SANE exams — also commonly referred to as rape kit exams.
“Ascension Saint Thomas Rutherford Hospital continues to provide rape kit exams,” said David Leaverton, senior director of external communications. Leaverton noted it has been challenging for the hospital to maintain 24/7 coverage with trained nurses but says the hospital has not changed its services.
By law, all 95 Tennessee counties must have a sexual assault response team. Just 15 do.
Leaverton said he could not provide the specific number of exams performed at the hospital since January, because the information is not queryable through its IT system. He also declined to provide an estimated number of exams performed at the hospital and did not provide the hospital’s current protocol for sexual assault victims who come to the E.R.
No one is disputing that the hospital continues to treat victims’ injuries. Sexual assault exams, however, are evidence-gathering procedures performed by specially trained nurses who carefully extract and catalogue hair, bodily fluids and other physical evidence while photographing injuries that are turned over to police and prosecutors. Nurses who perform the exams also routinely make themselves available to testify in court.
The hospital’s denial it has shifted its response to survivors surprised advocates like Downing. Downing said she has, for months, been in talking to local hospital staff about the cessation of services — a subject also discussed at regular meetings of the county’s sexual assault response team, which guides the county’s collective response to sexual crimes.
“To my knowledge, they have not conducted any exams this year,” Downing said. “I do know, in broad terms, of survivors who were given the option to go to the Sexual Assault Center. I know there have been instances they (victims) have declined to go.”
Similarly Jones, the district attorney, said the hospital’s denial is at odds with what he has seen occurring. Jennings said he, too, had been in discussions with hospital staff about the cessation of services in the hopes they would be restored.
“I have spoken with the hospital and asked them to reexamine their position,” Jones said. Jones said he had been told the hospital planned to resume the services, but has not yet done so.
Ascension Saint Thomas Rutherford has long been the chief provider of SANE exams in Rutherford county. Last year, advocates with the Domestic Violence and Sexual Assault Center in Murfreesboro were called in to assist 69 victims in the hospital’s ER, Downing said. This year, they have not gotten a single call, she said.
A large percentage of sexual assault victims decline to ever make a report. It’s understandable. They’ve been through a horrifying experience. But for the folks who do make a report, it’s a hard decision. And when they reach a hospital and are told to go to Nashville, the percentage of victims making a report goes down.
– Jennings Jones, District Attorney, Rutherford and Cannon Counties
The potential inaccessibility of exams in one of the state’s biggest counties places the wellbeing of victims and the prosecution of perpetrators in jeopardy, advocates said.
“A large percentage of sexual assault victims decline to ever make a report” Jones said.
“It’s understandable. They’ve been through a horrifying experience. But for the folks who do make a report, it’s a hard decision. And when they reach a hospital and are told to go to Nashville, the percentage of victims making a report goes down.”
Jones last week characterized the actions of St Thomas as a “substantial concern,” “surprising” and “disappointing.”
Refusing to provide the specialized exams is a form of re-victimization, Downing said.
“I think it takes a lot of courage for survivors to come forward,” she said. “When they are turned away, they may not want to go to a second location. It’s hard enough to get them to drive ten minutes sometimes.”
Downing’s agency also serves as one small provider of sexual assault exams in the county, but with limited hours and availability of nurses. The Domestic Violence and Sexual Assault Center averages just five to seven exams each year, Downing said. It is Ascension Saint Thomas where victims have traditionally turned in Rutherford County.
The exams are not only critical for obtaining forensic evidence that can be used in prosecution, they also address a victim’s immediate needs, including treatment for prevention of sexually transmitted infections or pregnancy. And they serve as a critical point to linking victims with counseling, shelters and ongoing support when they leave the hospital.
Not all Tennessee emergency rooms provide SANE exams, particularly in rural parts of the state. There aren’t enough specially trained SANE nurses to perform the exams, according to Freeman.
Ascension Saint Thomas continues to employ SANE-qualified nurses, Leaverton — the hospital spokesperson — confirmed.
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