PHOENIX — The family of a rape victim who gave birth at a Hacienda Healthcare facility in Phoenix last December filed a notice of claim this week, a precursor to a possible lawsuit against the state.
The notice of claim cites medical records that go into great detail about the alleged sexual assault and the possibility of a previous pregnancy.
There is a lot of medical terminology in the documents we wanted to make sure we understood and portrayed correctly, so we had Dr. Andrew Carroll take a look at the notice of claim for a second opinion. It should be noted that he has not examined the victim himself.
There were three allegations we wanted to specifically look at.
Can a doctor really tell if a woman has been pregnant before just by examining?
"I think that the words that they are using are probably incorrect," he said.
Dr. Carroll said what doctors are looking for is scarring, but that scarring doesn't always mean a baby was delivered.
"If you're looking at a perineal scar, you might also think there would be trauma due to a forcible rape that produced the laceration."
Phoenix police issued a statement saying they don't think there was a previous pregnancy either, based on a separate review.
Why was no pelvic exam done?
Next, in the April physical exam, there was no pelvic exam done.
The paperwork says it wasn't needed.
"There may not be a reason because you don't suspect sexual activity, which is what puts most women at risk for any pelvic abnormalities."
And Dr. Carroll said that may be the problem: He believes the staff may never have considered pregnancy because they didn't think it could happen.
Problems with victim's medical care
According to the notice of claim, her doctor ordered laxatives, thinking she had constipation problems and tried to get her to lose weight.
"This would not have been a normal process if we knew a mom was in her third trimester," Dr. Caroll said.
And Dr. Carroll noticed two more warning signs in the medical records.
First, the same responses to questions were apparently copied and pasted.
"That's concerning. That means what's being done is a template is being applied to that note rather than an actual note being written each time distinct to what the exam was," he said.
And second, Dr. Carroll says the woman's physical exam should have triggered a warning.
"A woman in her third trimester who has elevated liver function tests like this woman did, along with lower extremity swelling, those are signs of preeclampsia. And again, if you don't know the woman is pregnant, maybe you don't think it, but preeclampsia is potentially dangerous," he said.
Dr. Carroll said he does not give the medical staff a pass for not considering a pregnancy either. He said doctors are trained to think of everything because patients rarely tell the doctor the whole truth.
In this case, based on the medical records cited in the notice of claim, we know that the patient could not speak for herself at all.