In the trial of Grant Snowden, a doctor from the rape treatment center testified that two children in the Snowdens' care had contracted sexually transmitted venereal diseases. The testimony was powerful not only because of its shocking nature, but also because of the certainty with which the doctor testified.

But it now appears that the medical findings themselves, and their proof of sexual abuse, is a good deal less than certain. This important distinction raises questions about how medical evidence was handled in molestation cases - particularly in courtrooms - during the 1980s, where findings that may have been acceptable for therapeutic purposes were relied upon as legal evidence.

In child sexual abuse investigations, suspected victims routinely undergo physical examination. Often, overt signs of traumatic abuse may not be present though doctors may conduct testing for sexually transmitted diseases. In the Snowden case, one such doctor was Dorothy Hicks, director of the Rape Treatment Center at Jackson Memorial Hospital in Miami.

Dr. Hicks examined 5 year-old Leslie Blandes, the central witness in the case, and testified at trial that Leslie had a sexually transmitted condition known as Gardnerella vaginitis, an imbalance of vaginal bacteria. Dr. Hicks diagnosed the condition by identifying "clue cells" under a microscope, did no further confirmatory testing and then discarded the evidence slide.

Medical research now suggests that Gardnerella vaginitis (also known as bacterial vaginosis) may not be a sexually transmitted disease. Research indicates that Gardnerella occurs in women that have not been sexually active and that some women have "clue cells" as a normal condition.

Dr. Hicks also testified that one of Snowden's alleged victims, a four-year old boy, had gonorrhea of the throat. Prosecutors argued that the doctor's gonorrhea finding proved further evidence of Snowden's guilt. But during the mid-1980s, at the time of the Snowden trial, researchers at the Centers for Disease Control had become quite concerned about the potential for misidentification of venereal diseases, particularly gonorrhea, in sex abuse investigations.

Will Whittington, a researcher at the CDC, says there was growing alarm that investigations were being initiated based on incomplete science. "What was shocking was the fact that there wasn't an intellectual filter that had people question the results." explains Whittington. Yet several research studies were indeed raising questions.

In a suspected sexual abuse case involving an 8 year-old boy, four laboratories had identified positive findings of gonorrhea. Yet under further testing, researchers found that the organism identified was, in fact, not gonorrhea but rather one that is closely related to and can be virtually indistinguishable from gonorrhea.

Whittington's research showed that in 40 cases where gonorrhea had been identified, 14 of the cases had been misidentified. The results prompted the CDC to issue recommendations that gonorrhea testing for children, particularly with throat cultures, undergo two separate confirmatory tests. "This wasn't the standard of care in 1985," says Whittington, "though it should have been."

Sources:

"Proctitis Associated with Neisseria cinerea Misidentified as Neisseria gonorrhoeae in a Child," Journal of Clinical Microbiology, Vol. 21, No. 4, pp.575-577, April 1985..

"Incorrect Identification of Neisseria gonorrhoeae from Infants and Children,"

Pediatric Infectious Disease Journal, Vol. 7, No. 1, January, 1988.

"Identification of Problem Neisseria gonorrhoeae Cultures by Standard and Experimental Tests," Journal of Clinical Microbiology, Vol. 15, No 3, pp 435-438, March 1982.