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Medical experts are the most dangerous witnesses for the state. The majority of sex crime cases do not have any physical evidence. Under Texas Rule of Evidence 803(4), a nurse, paramedic or doctor can testify about medical information. Normally, when there is an allegation of sexual abuse one of the first things that is done is that the child is taken for a medical examination. Normally, what the child says to someone else is hearsay. But there is an exception to the hearsay rule. The exception is that statements that are made for the purpose of medical diagnosis or treatment can come into evidence.
Often times the child will repeat the allegations on the medical reports. So, this is a way for the state to try and show that the child has been consistent about their story. However, these reports can be discredited. Often times, the person who testifies may be different from the person who actually administered the examination. Also, they may not note on the reports who was present with the complainant when they were asked questions or who responded to the questions the guardian who was with the child or the child. I find that the best methodology is to go through the document one item at a time and find an avenue of attack.
If the medical expert says that there is physical evidence of abuse, then we must make sure that we have a defense medical expert to refute the medical expert. Another medical expert will often have a different conclusion than the medical expert who is employed by the state.