Re: Question/ Bruising

[<FrampD@xxxxxxx>]

I recently tried an extremely complex child abuse case which was dependent on
proving the age of various bruises on a 3-year old child's body.  We had
several experts testify that:
1.    It is very difficult to age bruises accurately.  Although bruises, as
Dick Sobsey noted, go through a set process of color change as they age, the
timing of that process varies depending on the depth of the bruise, the depth
of the surrounding tissue, and the location of the bruise on the body.  A
bruise on the forehead, for example, cannot involve much tissue depth, while
a bruise on the flank of the thigh has literally inches of muscle and tissue
depth which can be involved in the injury.

2.    It is much easier to compare 2 bruises on a similar part of a body and
tell which one is older, without specifically dating either one.

3.    Bruise aging can be complicated when a new bruise overlays an older
one.  The edges of the bruise may reveal this kind of compound bruising.

4.    If experts are going to compare bruises on the basis of photography, it
is critical that the picture be color-true.  The only way to do this -- and
it is expensive -- is to pick an object of known color in the photograph (a
trauma physician usually has a color scale), digitize the photographs and
color-match them to the known color object.  If this is done professionally,
the processor can testify that no photographic information was added to the
picture in the process, and that the picture accurately reflects the
condition of the bruise at the time it was taken.  That is the burden which
usually must be met to introduce a photograph into evidence.

5.    One trauma doc who testified in my case used the measurable levels of
CPK to help age recent traumatic bruising.  I'm going to butcher the
spelling, but CPK is creotonin phosphokinase, an enzyme secreted by the body
to help heal muscle trauma.  It is measured to determine whether someone has
suffered a heart attack, since the heart is a muscle.  According to this doc,
who had outstanding credentials in trauma medicine, CPK spikes in the body
within a predictable time frame after a traumatic muscle injury and slowly
diminishes down to normal levels, also within a predictable time frame.

6.    As Dick stated, there are some bruises which, by their configuration,
are diagnostic of abuse.  The primary one of these is the "loop bruise,"
which is inflicted when a person is struck with a looped cord, usually an
electrical extention cord.  Hand prints are pretty clear as well,  as are
ligature marks, around the neck, ankles, or wrists.

      There is no substitute, in an investigation or intervention involving
bruising, for a well-qualified trauma expert and a good set of photographs.

Hope this helps.

Frampton Durban, Jr.
Chief Legal Counsel
Charleston County DSS
3366 Rivers Ave.
Charleston, SC 29405
>From ???@??? Wed Apr 28 14:22:28 1999
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From: fcluke51@xxxxxxxxxxxxxxx (Fran Clukey)
To: Child Maltreatment Researchers
Subject: List, Please!
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From: Fran Clukey, MEd., RATh., LCPC
To: CHILD-MALTREATMENT-RESEARCH-L@xxxxxxxxxxx
Sent: 27 April 1999
Subject: Inclusion on list, please!
Background: I am about to begin a descriptive research project for my
doctoral dissertation titled: CHOICES AND USE OF ART MEDIUMS by YOUNG
PEOPLE WHO HAVE BEEN SEXUALLY ABUSED; IMPLICATIONS IN COUNSELING AND ART
PSYCHOTHERAPY. My committee chair is Dr. Laurie Hicks of the University of
Maine Art Department. I would appreciate input from anyone interested and
knowledgeable on the topic.

Cheers, Fran

Fran Clukey
You Gotta Have Art
snailmail:
P.O.Box 819, E. Holden, Me 04429; 207.843-5567
112 Franklin St.D-6, Bangor 04401; 207.947-1255
Veazie Community School,1040 School St, Veazie, Me 04401; 207.947-6573
franc@xxxxxxxxxxxxxxxxxxxxxxx