Abstract
ALL IT TOOK was one case. After an older woman from a prominent family was raped in 1989 in northern San Diego County, California, her family was outraged at spending hours in a hospital emergency department, only to be told she could not be examined there. The woman had to find another hospital; her case found its way into the media spotlight. The ensuing controversy prompted the county's Department of Health Services and Board of Supervisors to investigate. Among their findings: rape survivors generally spent 4 to 6 hours waiting for an examination that took another 2 to 3 hours; responses of police, medical professionals, and advocates for victims of reported rapes weren't coordinated; and the collection of evidence during the sexual assault examination often was inadequate. "There was no standardized protocol," says Diana Faugno, RN, a forensic nurse at Palomar Pomerado Health System in Escondido, Calif. "If you were

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