Saturday, November 27, 2010

Evidence for Prior Sexual Abuse

Medical Opinions

  • Autopsy Findings. The autopsy report took no position on the issue of whether there was prior sexual abuse; however, all such claims are based on autopsy findings.

  • Normal Hymenal Opening Size 0.6 cm.
  1. "Girls with no definitive signs of genital trauma exhibited a mean transhymenal diameter of 2.3 mm and in general showed an increase of approximately 1 mm per year of age. Girls with definitive signs of genital trauma exhibited a mean transhymenal diameter of 9.0 mm and no significant variance with age. Correcting for age differences, the transhymenal diameter was highly significant as a differentiating factor (F=1079, P<.001). When compared against the criterion standard, the transhymenal measurement is 99% specific and 79% sensitive as a screening tool." Genital Findings in Prepubertal Girls Evaluated for Sexual Abuse: A Different Perspective on Hymenal Measurements. Perry A. Pugno, MD, MPH. Arch Fam Med. 1999;8:403-406. Full Text for those with access
  2. These findings imply an "expected" hymenal opening size of 6 mm for someone JBR's age; her actual opening size, 1 cm, placed her in the mid-range of sizes observed in this study among six-year olds known to have been abused (see Fig. 3 of the study). 99% specific means that using this reference standard (1 mm per year of age), 99% of those with hymenal opening sizes above this standard were actually abused (i.e., the test is 99% accurate in identifying such individuals: only 1 percent are incorrectly labeled as abused). 79% sensitive means that 21% of victims of abuse were missed using this standard.

  • Expert Opinion. Cyril Wecht, along with 4 other doctors concurred that the injury to hymen "dated from an old injury," including Dr. David Jones, Professor of Preventative Medicine and Biometrics at University of CO Health Sciences Center; Dr. James Monteleone, Professor of Pediatrics at St. Louis University School of Medicine (and Director of Child Protection Cardinal Glennon Children's Hospital); Dr. John McCann (see below); and Dr. Ronald Wright, former Medical Examiner, Cook County Illinois (Schiller 1999:437 according to Internet poster The Punisher). Forensic pathologist Robert Kirschner also said that the injuries to JonBenet were consistent with long-term sexual abuse. Virginia Rau of Dade County, Florida said she believed JonBenet had been sexually abused over time (Bonita Papers).

  • Cyril Wecht, MD. Wecht's detailed analysis of the autopsy report explains the forensic evidence supporting his view there had been prior sexual abuse.

  • Robert Kirschner, MD. University of Chicago, Department of Pathology.
  1. 1997 Statement. "The vaginal opening, according to Dr. Robert Kirschner of the University of Chicago's pathology department, was twice the normal size for six-year-olds. "The genital injuries indicate penetration," he says, "but probably not by a penis, and are evidence of molestation that night as well as previous molestation."
  2. Alternative Version of Statement. contains a different wording for what Dr. Kirschner is alleged to have said: "Dr. Robert Kirschner of the University of Chicago's pathology department went even further, pointing out that her vaginal opening was twice the normal size for six-year-olds. He stated, "The genital injuries indicate penetration, not only (previously) by a penis, but by another instrument and are evidence of molestation that night as well as previous molestation." "If she had been taken to a hospital emergency room, and doctors had seen the genital evidence, her father would have been arrested" [highlighting of word differences added].

  • John McCann, MD Clinical Professor of Medicine, Dept of Pediatrics at University of California at Davis.
  1. McCann Assisted BPD. "In August, the Boulder police department contacted Dr. John McCann, one of the nation’s leading experts on child sexual abuse. McCann had agreed to assist the police department in determining if JonBenet had been a victim of sexual abuse during or before her murder. McCann was sent the autopsy report and photos (Bonita Papers).
  2. General Findings. "According to McCann, examination findings that indicate chronic sexual abuse include the thickness of the rim of the hymen, irregularity of the edge of the hymen, the width or narrowness of the wall of the hymen, and exposure of structures of the vagina normally covered by the hymen. His report stated that there was evidence of prior hymeneal trauma as all of these criteria were seen in the post mortem examination of JonBenet" (Bonita Papers).
  3. Specific Evidence of Prior Abuse. "There was a three dimensional thickening from inside to outside on the inferior hymeneal rim with a bruise apparent on the external surface of the hymen and a narrowing of the hymeneal rim from the edge of the hymen to where it attaches to the muscular portion of the vaginal openings. At the narrowing area, there appeared to be very little if any hymen present. There was also exposure of the vaginal rugae, a structure of the vagina which is normally covered by an intact hymen. The hymeneal orifice measured one centimeter which is abnormal or unusual for this particular age group and is further evidence of prior sexual abuse with a more recent injury as shown by the bruised area on the inferior hymeneal rim. A generalized increase in redness of the tissues of the vestibule was apparent, and small red flecks of blood were visible around the perineum and the external surface of the genitalia" (Bonita Papers).

  • Expert Panel. "In mid-September, a panel of pediatric experts from around the country reached one of the major conclusions of the investigation - that JonBenet had suffered vaginal trauma prior to the day she was killed. There were no dissenting opinions among them on the issue, and they firmly rejected any possibility that the trauma to the hymen and chronic vaginal inflammation were caused by urination issues or masturbation. We gathered affidavits stating in clear language that there were injuries 'consistent with prior trauma and sexual abuse' 'There was chronic abuse'. . .'Past violation of the vagina'. . .'Evidence of both acute and injury and chronic sexual abuse.' In other words, the doctors were saying it had happened before. One expert summed it up well when he said the injuries were not consistent with sexual assault, but with a child who was being physically abused." (Thomas 2000a:253; quote and source provided by Internet poster The Punisher).

  • JBR's Pediatrician Cannot Be Relied Upon. Internet poster koldkase has noted that if Dr. Beuf had known about possible abuse and not reported this to Social Services, he would have been in serious trouble with the law; hence he has no incentive after the killing to concede that abuse was a possibility. In addition, Internet poster Candy has noted that Ricky Holland's pediatrician also saw no signs of child abuse [Ricky Holland's parents have been [|convicted] of Ricky's death and the father has apologized for his role, leaving little doubt about their culpability.].

Other Supporting Evidence

  • Bedwetting. Some have speculated that JonBenet's known history of bedwetting may reflect distress over sexual abuse.

  • Soiling. Holly Smith, head of Boulder County Sexual Abuse team, stated had found fecal staining in all of JBR's panties on the 3rd day of the investigation; in 2006 she stated: "There is this dynamic of children that have been sexually abused sometimes soiling themselves or urinating in their beds to keep someone who is hurting them at bay," explains Smith....While Smith points out there could be innocent explanations, this was the kind of information that raised questions."

  • 911 Call Hang-up. Someone mistakenly called 911 from the Ramsey's house during the party on December 23. Some wonder whether it might have been a child calling about sexual abuse of self, sibling or friend.