The gynaecologist as an expert witness in cases of sexual abuse.

The High Criminal Court of Kirklareli province of Turkey dealt with a sexual abuse case where the victim was a 14-year-old girl. She was abducted and abused by her boyfriend with her consent, which was legally invalid because of her age. Medical examination was required in order to bring an accusation against the perpetrator. The girl was sent for hymen examination three times because two gynaecologists and one forensic expert produced different witness reports, confusing the court. This caused psychological damaged to the victim. It is proposed that gynaecologists should be made aware of their potential input into sexual assault cases and be informed of the way in which these cases should be handled. In addition, photo-documentation should be established in the Turkish legal system to avoid re-examination of the victim.

DNA analysis as a tool for breast cancer malpractice determination: an interdisciplinary approach.

Malpractice in breast cancer can be seen as false-negative or false-positive findings which may result in either late or incorrect therapies. Biopsy material can be unintentionally interchanged, leading to incorrect treatment, and psychological damage to the patient. There is an obvious need for individualization of the tissue samples in such cases. In this study we used a multidisciplinary approach to integrate DNA technology that has been standardized and used in forensic science for other purposes, mainly to prove malpractice that has been the result of interchanging tissue samples in breast cancer. The main focus of the study was to evaluate the applicability of the technique, therefore we studied the samples of a 58-year-old female for whom the result of pathological analysis was reported as 'invasive ductal carcinoma'. The patient was surgically treated by a modified mastectomy technique and referred for chemotherapy. Prior to chemotherapy we found that the tissue samples analyzed did not belong to the patient in question. We used a battery of 15 polymorphic STR loci to identify the sample and we had strong evidence for exclusion of the patient. The analysis was done on both blood and buccal swab of the patient and on the tissue sample. We concluded that the technique is applicable and useful; however care should be taken in the interpretation of the results because the mutations in the tumoral tissues are very well known. Therefore, the maximum of informative loci should be studied and loss of heterozygosity should always be considered. We should also have in mind the possibility of intentional interchange which gives the results value in medico-legal investigations.