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Reporting Child Abuse and Neglect: Other Mandated or Authorized Actions

Medical Records

In the event that there are allegations of suspected child abuse or neglect it is crucial that the reporter record the physical findings with a view toward the potential adversarial proceedings of a trial. Careful records such as photos and accurate reporting of medical examination findings are invaluable. The specific language used in medical examination reports — language that is not open to misinterpretation — can circumvent difficulties in proving a case during a legal proceeding. For example, in a case prosecuted in Family Court by The New York Society for the Prevention of Cruelty to Children, a mandated reporter alleged that a four-year-old girl had been sexually abused. However, another physician, who examined her after the report had been filed, found no physical evidence of sexual contact; thus he could not substantiate the reporter's allegation. Since the physician found no physical evidence of sexual abuse as a result of the examination, he wrote on the patient's chart "no physical indications consistent with the allegations," thus allowing that the allegations may be true.  But if the physician had written that he "found no evidence to indicate sexual abuse," that would have created a powerful record to undermine the mandated reporter's assertion of sexual abuse.

Photographs and X-Rays

The law clearly sets forth that a mandated reporter may take or have someone take, at public expense, color photographs of the area of trauma visible on the child. You may also ask the local child protective service agency to take such photographs. If it is medically indicated you may direct that X-rays be taken as well. Photographs of visible trauma and x-rays (if medically indicated) must be taken if a report is made by a staff member of a medical or other public or private institution, school, facility, or agency.

Should a case of suspected child abuse or neglect go to trial, it is necessary that a witness be able to recognize and identify photographs and X-rays in order for them to be admissible as evidence. Due process mandates that all evidence favoring the subject must be disclosed. Evidence that is damaging to the subject, such as photos or X-rays of physical trauma, must be divulged prior to admission in court.

Photographs are extremely effective evidence to support allegations of child abuse or neglect. By the time a case is presented in court physical trauma can have had ample time to heal and fade.

Examples of forensic photographs include photos of marks, bruises, and fractures allegedly caused by excessive corporal punishment, assaults, cigarette burns, and immersion burns.

Photographs of the child's injury are crucial in that they can effectively undercut a perpetrator's self-serving testimony at trial.  Photographs or X-rays must accompany the Report of Suspected  Child Abuse or Maltreatment (DSS-2221-A) or be sent to the local
child protective service investigator or to the prosecuting attorney, if known, as soon as possible after the report has been submitted. To be effectively used as evidence in a court of law, all photographs and X-rays should be appropriately labeled.

In photographing trauma, the proper procedure is as follows:  

  • Take overview photos of the front, back, and right and left sides of the child's entire body. Take mid-range photos of the areas of trauma with their surrounding anatomic landmarks. Take close-ups of the areas of trauma.
If possible, the areas of trauma should be photographed before and after they have been cleansed and dried.
  • Record the name of the child; the chart number; the place, date, and time; the name of the photographer and anyone else present when the photos were taken; the f-stop and speed at which the photos were taken; and the measurements of the
    area of trauma. If a standard color scale is not available, use a ruler. Save the measuring instrument as evidence.

 ACCESS TO RECORDS

After making a report, mandated reporters are required to comply with all requests for records made by a child protective services relating to such report. Such a request includes records relating to diagnosis, prognosis or treatment, and clinical records, of any patient or client that are essential for a full investigation of the allegations in the report. Disclosure of substance abuse records, however, shall be made pursuant to the standards and procedures delineated in applicable federal law.

 

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