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Author Topic: Diffuse Edema  (Read 19095 times)
macd
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Diffuse Edema
« on: August 09, 2006, 12:56:18 PM »

The SANE report from Duke Hospital states that the AV had "diffuse edema" of the vaginal walls.
Literally this means "general swelling".

I've seen this described as "trauma" in some articles, and "normal result of sexual activity" in other articles.
Some say that normal sex can cause it, some say that something like vibrator use would be needed.
Some places have it wrong, and translate "edema" to "redness".

Perhaps, if Nifong did see a draft of the report before his public statements, he didn't know what "diffuse edema" was either.

I found a research report (www.ncjrs.gov/pdffiles1/nij/grants/214252.pdf) on SANE reports that showed edema showed up in 4 of 314 routine (non-assault) exams, saying in correlated with sexual activity or tampon use within the last 24 hours.

Does anyone else have a data point on this?  Who has a GYN appointment this week?

On a related note: suppose the edema was caused by penile penetration.  The AV's anus was described as normal.  If the AV was vaginally and anally penetrated, I would expect more trauma to the anus.  That fact that nothing out of the ordinary was noted about her anus, leads me to believe that nothing out the ordinary happened to her anus.
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LTC8K6
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Re: Diffuse Edema
« Reply #1 on: August 09, 2006, 01:00:05 PM »

Edema is a buildup of fluid in the tissues. Watery fluid.

It doesn't mean swelling from injury as far as I know.
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Bob In Pacifica
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Re: Diffuse Edema
« Reply #2 on: August 11, 2006, 11:03:55 PM »

Now we need to know if the AV were having a period around March 14.
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fahrenam
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Re: Diffuse Edema
« Reply #3 on: August 12, 2006, 12:11:23 AM »

I'm a physician.  Edema means swelling.
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maddad
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Re: Diffuse Edema
« Reply #4 on: August 12, 2006, 02:59:23 AM »

The SANE article is a great resource.  Interestingly, the article mentions that SANE examinations result in DNA evidence in 97% of cases.  I don't believe I remember Mr. Nifong mentioning that statistic.
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Alan
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Re: Diffuse Edema
« Reply #5 on: August 12, 2006, 04:06:52 AM »

The pathology in this case is rhetorical oedema, where the thin gruel of swollen tissue gets inflated into a symptom of rape.
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LTC8K6
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Re: Diffuse Edema
« Reply #6 on: August 12, 2006, 08:21:26 AM »

Quote
Edema means swelling.

Yes, from excess fluid accumulation, not necessarily from an injury.
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fahrenam
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Re: Diffuse Edema
« Reply #7 on: August 12, 2006, 09:28:36 AM »

Edema simply describes the fact that there is swelling, it isn't a term that indicates etiology.  So it can be from injury or not be from injury.  Most medical terminology is intended to simply describe what you see or feel not make conclusions about what is causing those symptoms.  There is a portion of any medical note call "assessment" where the doctors will draw conclusions about why a patient has certain symptoms, but that's educated conjecture, not necesarily known fact.
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LTC8K6
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Re: Diffuse Edema
« Reply #8 on: August 12, 2006, 11:10:28 AM »

Hmmm...everywhere I look says that edema is swelling from the accumulation of fluid in the tissues.

However, none of this banterabout the word would seem to change the idea that a report of "diffuse edema" does not indicate that a sexual assault took place.

Assuming that what we have heard about the SANE report is accurate.
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SharonInJax
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Re: Diffuse Edema
« Reply #9 on: August 12, 2006, 12:44:30 PM »

Consider, for a moment, what the term "consistent with" could encompass.

A black eye could be consistent with a woman:  being smacked/hit by someone; could be from walking into a door; could be from being hit by a pitch in baseball or a punch in a boxing ring.  The presenting condition is what the medical professional assesses, not what caused it.  The patient's explanation to the doctor or nurse might or might not be found to be the likely real reason for the injury/condition.

"Diffuse edema" of and in the v*gina is consistent with rape.  It is also consistent with consensual sex.  It is also consistent to using a sex toy for penetration.  It is likely also consistent with a number of other possible medically recognizable causes.

So, too, would aberrant, unusual or agitated behavior be "consistent with" a recent sexual assault, or a drug/alcohol combination, or an underlying mental condition, or many other things.

But Nifong seems not to want to understand this:

April 13, 2006
FoxNews
"My conviction that a sexual assault actually took place is based on the examination that was done at Duke hospital," Nifong countered Wednesday.
http://www.foxnews.com/story/0,2933,191535,00.html

He wants the results of the exam to be consistent with his view of the case, and has closed his eyes to alternative, equally or more likely than the brutal rape he is prosecuting.


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Alan
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Re: Diffuse Edema
« Reply #10 on: August 12, 2006, 01:17:11 PM »

'consistent with' is actually really interesting language. It is very lawyerly language. In the courts I'm familiar with a prosecutor who has evidence of something says they have evidence of something. Why then, as early as the first applications lodged by the prosecution in this case, were we reading about 'consistent with', language which incidentally, seems to have been invented by the prosecution and not actually used by the SANE nurse it was attributed to?

Sharon's right. The only symptom, oedema, is consistent with multiple events other than rape. At some stage the Fongster has to produce some evidence that goes beyond 'consistent with' to 'probative of'. I wonder what a fly on the wall would have heard when the initial applications were discussed between the DA and the police.

Jones v City of Chicago is bad news for the police involved in this investigation, although in that case, unlike this one, the prosecutors were not part of the conspiracy to charge the defendant without probable cause..

Quote
By parallel reasoning, a prosecutor's decision to charge, a grand jury's decision to indict, a prosecutor's decision not to drop charges but to proceed to trial-- none of these decisions will shield a police officer who deliberately supplied misleading information that influenced the decision.   See, e.g., Myers v. Morris, 810 F.2d 1437, 1457 (8th Cir.1987);  Hand v. Gary, supra;  Smiddy v. Varney, 665 F.2d 261, 266-67 (9th Cir.1981);  Dellums v. Powell, supra, 566 F.2d at 192-94;  Ames v. United States, 600 F.2d 183, 185 (8th Cir.1979) (dictum);  cf. McLaughlin v. Alban, 775 F.2d 389 (D.C.Cir.1985) (per curiam).
 

http://www.law-forensic.com/cfr_furlong_1.htm

When the sh*t hits the fan they will need a better shield than the Fongster to hide behind. My guess is we'll see an awful lot of 'consistent with' evidence from the police involved in this case.
« Last Edit: August 12, 2006, 01:21:00 PM by Alan » Logged
Bob In Pacifica
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Re: Diffuse Edema
« Reply #11 on: August 12, 2006, 02:13:12 PM »

So far all the evidence in this case is more consistent with a hack DA needing to win a close primary election than with an actual gang rape occurring.
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fahrenam
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Re: Diffuse Edema
« Reply #12 on: August 12, 2006, 04:20:57 PM »

LTC8K6, anytime you have swelling, whatever the reason--trauma, mosquito bite, infection, consensual sex--it is a collection of fluid in the tissues.  Sometimes the fluid is blood, sometimes it is pus, sometimes it is just serous fluid that seeps out of the blood vessels in that area.  My point is that we use the word edema for ANY swelling, no matter what the cause.  It's the desriptions that go along with it that help with etiology--redness (erythema) and warmth for infection, ecchymosis (bruising) for trauma, etc.  There is nothing about edema in and of itself that means trauma.
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Newport
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Re: Diffuse Edema
« Reply #13 on: August 12, 2006, 05:29:05 PM »

Thanks, fahrenam, that is a definitive answer. 
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Tony Soprano
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Re: Diffuse Edema
« Reply #14 on: August 12, 2006, 07:26:02 PM »

Common infections cause this type of Edema.   Tampon use can cause this type of Edema.   Normal sexual relations can cause this type of Edema. 

No bruising was noted, No tears, No abrasions, No bleeding     -   and a normal rectal exam.

« Last Edit: August 12, 2006, 07:28:21 PM by Tony Soprano » Logged
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