FULL TESTIMONY — Nurse Practicioner Heather Waleski testifies in the Salguero-Olivares murder trial

[00:00:00] Speaker 1: Thank you, Madam Clerk, and thank you, Sheriff. [00:00:17] Speaker 2: Ma'am, if you could state your first and last name for the record, please. [00:00:21] Heather Wileski: Sure, it's Heather Wileski. [00:00:23] Speaker 2: If you will spell your first and last name for the record. [00:00:26] Heather Wileski: H-E-A-T-H-E-R. Your last name is W-A-L-E-S-K-I. [00:00:31] Speaker 2: Hey, ma'am, if you want to make sure you do that microphone a little closer to you. Sure. Thank you. I just want to make sure you keep your voice up for the record. Also, be mindful of the fact that the court reporter is taking down everything you say to time not to speak too fast, and that the attorneys ask you a question, and the answer would be yes or no. You have to say yes or no. You can't say mm-hmm or mm-hmm because the court reporter can't take that down. And finally, if you're allowed for the attorney to ask the question, then you can respond in order to avoid talking to each other, okay? Yes, sir. All right. This is with the state of North Carolina. Thank you, Your Honor. [00:01:05] Speaker 4: Yes, ma'am. Good morning, Ms. Wallace. Good morning. How are you employed? [00:01:09] Heather Wileski: So I'm employed with Atrium Health as a family nurse practitioner. I work primarily with our child protection team, which covers four surrounding counties in the Mecklenburg County area, or children's advocacy centers. So I provide medical exams there for children that are sent for concerns of abuse or neglect. I also work through the Atrium Health forensic nursing program at Atrium Health Union as a sexual assault nurse examiner. I've been doing that for quite some time and still maintain my call schedule with them for that. I also teach in two different grants. One is with Novant Health New Hanover Hospital to teach sexual assault nurse examiner training in the Novant Health Systems, and then I also teach at Fayetteville State University through a grant there with the School of Nursing for sexual assault nurse examiners as well. [00:02:04] Speaker 4: Where is Atrium? [00:02:07] Heather Wileski: So it's primarily out of the Charlotte-Mecklenburg area. [00:02:10] Speaker 4: Is that where you live? [00:02:12] Heather Wileski: I do. [00:02:13] Speaker 4: When you say one of your current jobs is working with children, what age does that encompass? [00:02:22] Heather Wileski: Our children's advocacy centers typically see zero to about 18. Sometimes we will see an adult who is maybe developmentally delayed and they need to have a forensic interview done there with a specially trained interviewer. And so sometimes as a family nurse practitioner, I can see throughout the lifespan and I may see children older than that in that capacity. [00:02:45] Speaker 4: You said you work with Novant Health at New Hanover Hospital. Where is that? [00:02:51] Heather Wileski: So that is in the Wilmington, North Carolina area. We do trainings at the multiple Novant Health sites, but the grant itself is out of the New Hanover facility. [00:03:02] Speaker 4: Tell us about your educational background if you wanted. [00:03:06] Heather Wileski: Sure. So I became a nurse in 2003, actually went through the Presbyterian Hospital School of Nursing program and started working in the emergency department as a certified nursing assistant before that and then continued in the emergency department after I graduated. I then went back and got my bachelor's of science in nursing from the University of North Carolina in Charlotte in 2006 and then after many years in the emergency room decided to get my family nurse practitioner and graduated from South University in 2019. [00:03:37] Speaker 4: Are you licensed or certified or both in a particular field of nursing? [00:03:44] Heather Wileski: Yes. So I am licensed and certified as a family nurse practitioner and then I did have a certification test that I took for sexual assault nursing for the adult and the adolescent population and have maintained that for many years. [00:04:02] Speaker 4: Would you explain a bit more about what you teach? You said both at Faithful State and at New Hanover Hospital? [00:04:10] Heather Wileski: Correct. So the sexual assault nursing training is typically conducted and we instruct registered nurses so that they can perform forensic medical exams on patients that primarily present to the emergency department for complaints of sexual assault or sexual violence. And so the training that we do actually teaches across the lifespan from birth until death. For pediatric adult and adolescents and we primarily teach as I said registered nurses. We do get some nurse practitioners and PA physician assistants and doctors that come through who want to have additional training on sexual assault exams. But we'll teach them how to conduct that medical forensic exam on a patient, how to take a history, do a physical assessment, which is a pretty comprehensive head-to-toe exam, and an anogenital exam, and then to collect evidence throughout that exam so that we can do that for the patient in the emergency department. [00:05:13] Speaker 4: Have you ever been in leadership positions in forensic nursing professional organizations? I have. [00:05:22] Heather Wileski: So we had an international association of forensic nursing. That was an international association and from that we had North Carolina chapters. I was a president-elect, then president, and past president so I served a three-year term on our North Carolina chapter and then continued on the education committee with them. That organization has dissolved and we now have a North Carolina forensic nursing association itself. [00:05:51] Speaker 4: So do you continue to do your own education and training in order to maintain your certification [00:05:58] Heather Wileski: and license? I do. So as a nurse practitioner, I definitely have to have continuing education, but also I'm rostered with the Child Medical Evaluation Program with UNC to be able to conduct those child medical evaluations at the CAC, and I have to continue to have education and training specifically on child maltreatment and different forms of that to maintain my rostered license with them. [00:06:23] Speaker 4: And you said CAC. What is that? [00:06:25] Heather Wileski: So the Children's Advocacy Centers. [00:06:27] Speaker ?: Okay. [00:06:28] Speaker 4: How many sexual assault examinations have you conducted over the course of your career, if you know? [00:06:35] Heather Wileski: Over the course of my career in the emergency department and then within the CAC, thousands of exams. [00:06:42] Speaker 4: Have you testified as an expert in sexual assault examination before? I have. Do you know how many times? [00:06:48] Heather Wileski: Roughly about 10 to 12 times. [00:06:50] Speaker 4: Your Honor, at this time the state would tender Heather Walewski as an expert in sexual assault examination. [00:06:57] Speaker 2: Any objection? No, Your Honor. All right. This witness will be deemed an expert in sexual assault examination. [00:07:03] Speaker 4: Your Honor may approach the witness. Yes, ma'am. I'm handing you two different exhibits. The first one has been marked States Exhibit 86 and the second one is States Exhibit 87. Would you look at States Exhibit 86 and tell me if you know what that is? [00:07:41] Heather Wileski: Yes. So this is kind of an internal view of the female reproductive system and the internal structures within the female anatomy. [00:07:50] Speaker 4: Is that, how would you characterize that, is it a photograph, is it a diagram? It's a diagram. Okay. And does it fairly and accurately represent what you know as an expert to be the order of things internally for a reproductive system on a female? Yes. And would it help aid you, illustrate your testimony? Yes. Now if you look at States Exhibit 87, do you know what that is? [00:08:15] Heather Wileski: I do. [00:08:16] Speaker 4: What is it? [00:08:17] Heather Wileski: So this is actually a diagram that we use in teaching, the female external genitalia. There are several structures within that, within the anatomy that have different names that are not commonly used and we have to instruct and teach people about those parts. And so this is a diagram that goes through that. [00:08:37] Speaker 4: And does that fairly and accurately represent what that part of the body looks like? It does. And would it help illustrate your testimony? Yes. Thank you. Your Honor, the State moves States Exhibits 86 and 87 into evidence for illustrative purposes. [00:08:50] Speaker 2: Any objection? No, Your Honor. States Exhibit 86 and 87 shall be accepted into evidence for illustrative purposes. [00:08:57] Speaker 4: And the State further moves to publish, excuse me, those exhibits on the screen. [00:09:02] Speaker 2: Any objection? No, Your Honor. Allowed. Do you want the lights on? [00:09:06] Speaker 4: Maybe just a smidge. Okay. Thank you, Mr. Bailiff. Thank you, sir. [00:09:10] Speaker ?: Thank you, sir. [00:09:11] Speaker 4: Ms. Walewski, if you would first just give us a general sense of what parts of the woman's internal organs make up the reproductive system here? Sure. [00:09:32] Heather Wileski: So specifically the reproductive system you're going to have up at top at like 12 o'clock are the ovaries. And there's going to be two, one on each side, along with the fallopian tubes. And those will connect down into the uterus. That is certainly where the lining builds up for a woman to have her period and where if someone were to become pregnant that a baby grows. At the bottom of that, the part that is actually only visible within the vaginal track is the bottom of the cervix. And that's what will dilate and open when someone is pregnant and has a vaginal delivery. The vagina is the only internal structure. And the entrance to the vagina is actually surrounded by a membrane called the hymen. Most people think that that is only there for a short period of time until someone becomes sexually active. It's actually there pretty much our entire lives. It may change and look a little bit different, but it remains. And that's pretty much as far as the reproductive system. Generally, you have the rectum is the internal canal where stool is held. The anus is actually down at the bottom where the sphincter is in the opening. And then your urinary urethra and your bladder. But reproductively, it's really pretty much the other structures. [00:10:53] Speaker 4: What parts of the internal system would you be looking for injuries in? [00:11:02] Heather Wileski: So when we conduct exams, we look at all the external structures. And that's actually the most common area where we would find injury if we were to find injury. If we were to look inside the vaginal tract and at the vaginal walls, we would have to use what's called a speculum to do that. And then even at the end of that, the only part that we would see was the cervix if a female had that. Sometimes it's removed when patients have a hysterectomy. But otherwise, we would see that. [00:11:31] Speaker 4: Have you ever found injuries to the uterus? [00:11:34] Heather Wileski: I cannot visualize the uterus itself in our exams. [00:11:37] Speaker 4: I would like to publish State's Exhibit 87 at this time. What are we looking at here? [00:11:50] Heather Wileski: So this is all of the actual external genitalia within the female anatomy, starting at the top with the mons pubis. Coming down each side, you will have the labia majora, which are the outer lips. Then you'll have your clitoral hood that covers the clitoris. And the following down off the clitoral hood are going to be your labia minora, where those come together down at the bottom, that structure. There's a band of tension that's called the posterior foreshet, where those two labia minora come down. That's actually the most common area that we see injury. And one of the terms that a lot of people, even in medicine, are not aware of as far as the anatomy. Right above that is going to be your fossa navicularis. It's kind of a concave area in between the posterior foreshet and the hymen, which is that membrane surrounding the entrance to the vagina. And then in the internal structure, as I said, is only the vagina. So all of this is kind of what we call the vulva. The only internal structure is the vagina. [00:12:55] Speaker ?: Great. [00:12:56] Speaker 4: I would like to ask you if you would just walk us through how you conduct a sexual assault examination, and when you get to the part where you're examining this part of the body, if you don't mind and if you're able, would you stand up and point on the television screen behind you or the jury to what you're talking about while you're talking about it? [00:13:21] Heather Wileski: Sure. Okay. Just let me know when you want me to stand, I guess. Or just when I get down to that part. [00:13:26] Speaker 4: Yeah. When you start talking about those different parts, if you would just point to them while you're talking, I think that might help us all. [00:13:31] Speaker 2: Okay. And if you do stand, just make sure you keep your voice up for the record. Yes, sir. [00:13:35] Heather Wileski: Thank you. Okay. So when we are called, typically our SANE nurses are called to come into the emergency department when a patient presents for a sexual assault or sexual violence. And they have to be cleared by our emergency medical physicians or nurse practitioners, PAs, to make sure there's no emergency medical condition. When we come in, we'll explain the process to the patient. If it's an adult patient, there are a few options that they have as far as if they want evidence collected along with the medical forensic exam. And that will be an actual what we call sexual assault evidence collection kit that we will collect during that exam. But because it's pretty much voluntary, the patient has a choice on whether they do that as an adult, there are some consents that they have to sign, and we'll go through that with the patient. After they sign the consent, then we will go through what they, to the best of their ability, can remember what they've experienced and why they've presented to the emergency department. Oftentimes, if we are seeing that patient for a sexual assault, it is within a certain time frame that we can collect evidence. And so it may be shortly after someone has been sexually assaulted. And asking what they've experienced can be very difficult to talk through. Why is that? So certainly a traumatic, life-threatening experience, as a sexual assault is and can be, is seen by the body as a life-threatening situation. And because of that, the body can produce certain hormones that help with either fighting, fleeing, or what we call fawn, which is basically allowing things to progress because they know what the outcome would be otherwise, and because of a fear of violence. So, patients also have a difficult time because of when those hormones are released. Once again, ladies and gentlemen, please follow the sheriff's instructions. [00:15:53] Speaker 2: If you have, if you have telephones, metaglasses, any type of device that's capable of recording, that device needs to be turned off. Otherwise, it's going to be retrieved by the sheriff's department. All right. Madam Deye, you may continue. Thank you, Your Honor. So, I was just talking kind of about what we call the neurobiology of trauma, which explains that fight-flight-freezer-fawn reaction that patients can have. [00:16:22] Heather Wileski: When those hormones are released, there are different ones that affect your prefrontal cortex of your brain, and that's kind of where your rational thought process is. And when you are in a traumatic event, the prefrontal cortex of your brain actually gets kind of cut off, and it's not functioning the way that it normally would when you're not in a traumatic experience. Those hormones can last for several hours and days in your system, and they also affect the way our memories are encoded, and you can retrieve them. So, when patients may have those higher levels of hormones because of a traumatic experience, sometimes it's difficult for them to recall exactly what they've experienced in a chronological order. And what we have found is that actually sleep will help them to encode those memories and be able to retrieve them in a chronological order. It's not that when they provide them to us initially that they're being inconsistent or that they're not accurate memories. They may just not be able to formulate them in a "this happened, then this happened" kind of order, and we know that sleep can help with that. Now, the only other thing that affects that is alcohol, and we know that alcohol in certain higher levels can affect the way you actually are not able to recall those memories at times. And so, that can be challenging for the history taking if a patient happened to have any alcohol in their system and may not remember what has happened. Patients that were completely incapacitated and can certainly not tell us what they've experienced is difficult as well. And so, in those cases, we're trying to gather the information from the patient in the most trauma-informed way that we can. But the information that they provide us about the assault and what they've experienced helps us guide our medical exam on where to look on their bodies for injuries, potential disease processes, risk of transmission of sexually transmitted infections, and then where we could potentially get evidence. So, the history is really the most important part of our exam and helps guide the rest of that. When we do our exam and we get the history, we also need to know about their past medical history, surgical history, reproductive history, or any sort of delays developmentally, mental health complications, or mental health services in the past that they've received. We'll also then kind of go through how their body's feeling in that moment and in what we call a review of systems through all of their body parts. And then, once we start kind of getting through that information, we'll start the physical exam. When we do the physical exam, we are looking head to toe every inch of skin that the patient will allow us to look. We do not do like charting by exception, which is based off of just the chief complaint. So, it's not just an anogenital exam. It really is an exam of the whole body looking for any past or present injuries and then potential areas of the body where we might find evidence. One of the parts with that is we will use what's called an alternative light source to look at the body and the clothing that they potentially were wearing during the assault or right after. That helps us screen for any bodily fluids. I can't say by just looking at it what the what the presence there is, whether it's a bodily fluid or sometimes deodorant will illuminate with our light source as well. But we'll just note that on the on our chart and to the crime lab and send that off so that they can further test that for the presence of either bodily fluids or something else. [00:20:29] Speaker 4: Do you use what's called a wood lamp? [00:20:32] Heather Wileski: We don't. So the woods lamp is actually not very accurate in detecting bodily fluids. It's very just a general light spectrum. The only time that I would use that as a nurse practitioner if I was worried about like a corneal abrasion and I put some dye in someone's eye to look for that. But we do not use it in these exams. [00:20:53] Speaker 4: I just am curious. How does the alternative light source work? [00:20:56] Heather Wileski: So there's a spectrum of light, you know, across the whole spectrum and so it kind of focuses more on a certain range that would illuminate bodily fluids. But again, ours is actually not as sophisticated as the crime labs is in detecting bodily fluids. We have just kind of a general one to look and scan the body and clothing. [00:21:22] Speaker 4: What do you do next? [00:21:23] Heather Wileski: So after we've looked at the body and the clothes with the alternative light source, we'll start the physical exam head to toe. We kind of assess for any injuries visually. We will ask the patient if they know what parts of the body were touched by someone else's body, whether that's hands or any other part, we have to start thinking about potentially collecting evidence. And so we won't actually touch that part of the body to palpate for tenderness or pain until we determine if we need to collect any sort of swabs. Within the kit itself, we're looking for known samples, which are going to be the DNA of the patient, and that's going to be a cheek scraping that we do of the patient. And most of the rest are going to be looking for someone else's DNA, what we call unknown samples. We'll also take some hair samples of the patient if they will allow of their head hair and potentially their pubic hair if they have pubic hair long enough. And so throughout our physical assessment, we will determine whether there are concerns for someone else's DNA present and take those swabs before, like in the middle of our assessment. So if someone reported that they were forced to perform fellatio and had a penis to their mouth or in their mouth, then I would collect those swabs first, have them drink some water, wait a few minutes before I then collected their known cheek scraping so that there were no unknown samples on the known samples to the patient's cheek scraping. We pretty much will do that through the whole body system, head to toe, front and back, looking at areas. So if there was an area that glowed or illuminated with that ALS on the body, then we're going to do what's called a wet-to-wet swabbing of that, where we'll moisten some swabs with sterile water. We don't use sterile saline because it will degrade the DNA, the salt in that will, but sterile water. And we'll swab that area very softly. If we rub too hard, then there is the chance that we could get too much of the patient's DNA on that and not as much of an unknown sample. So it's a gentle kind of rolling back and forth over the area. Even if something doesn't illuminate, but a patient reports contact in an area, such as if someone reports being strangled, then we can do that over the neck. If the patient reports that the assailant had ejaculated somewhere on their body, even if we don't see that with the light, then we can swab that area. And we'll go through the whole body system that way. We leave the anogenital exam to the end and kind of move in a least invasive to most invasive sort of manner. We also use a digital camera system that magnifies so that we can take photos throughout the exam and magnify those to look at any potential injuries. [00:24:21] Speaker 4: Can I ask you two questions? Yes, ma'am. First, this may be silly. You've said anogenital a couple times. Yes, ma'am. I think I know what that means, but will you tell me? [00:24:29] Heather Wileski: Yes. So when we're talking about the anogenital exam of a female, I'm basically talking about these structures and looking at this. What would be considered under the underwear in that area. Okay. Yes. And the anus as well. Did you say anus? Oh, the anus. [00:24:45] Speaker 4: Okay. And could you say something more about what you just said about using magnification? Yes. Could you explain how that works? [00:24:55] Heather Wileski: Yes. So for years, we used to use what's called a colposcope. OBGYNs typically would use that to magnify and look inside the vaginal vault at the cervix. And it just helps us to see things that we can't necessarily see with the naked eye. And so we have progressed in technology to where we use what's called a magnification camera system. At our facilities, we use what's called a cortex flow. And it's a digital camera, but it has a magnification and a big screen on it so that we can actually magnify that area and look for any microscopic injuries, tears to the anogenital area that I would not necessarily be able to see with a naked eye. [00:25:39] Speaker 4: How is that different from using just a speculum? [00:25:42] Heather Wileski: Sure. So the speculum is really only used to look at the internal structure of the vagina and the cervix. All of the external genitalia, which is the most common area for injury, we will use that magnification device. [00:25:56] Speaker 4: Can I ask you a side question? Yes, ma'am. You mentioned, obviously, that you teach around the state how to do sex assault examinations. Yes, ma'am. And you mentioned that some of the people that you teach are, most of them are nurses. Correct. I think I heard you say some of them are doctors. Yes. Have you ever, do you know if you've ever had a forensic pathologist, a doctor who performs autopsies in one of your trainings? [00:26:19] Heather Wileski: Not to my knowledge. [00:26:27] Speaker 4: Can you tell me, like, have you, maybe, do you have personal experience having looked at a patient and not been able to see any injuries, but then using the, what did you, a vortex? Cortez. [00:26:42] Heather Wileski: Ours is the cortex flow. [00:26:43] Speaker 4: Yes. Cortez flow with the magnification and then being able to see injuries. [00:26:48] Heather Wileski: Yes. So there's a couple of different techniques that we use to look for injuries, not just with the naked eye. After we are, once we get down to the anogenital exam, it's a very systematic way that we conduct the exam and collect evidence so that we are following an order and looking for injuries. If we jump to the speculum exam before we do an exam of the external genitalia, we may miss that. And then the speculum very rarely, but it can cause injuries. And so we have to make sure that we're looking at all of that before we do the speculum exam. There's also a blue, kind of blue-purple dye called toluidine blue dye that we use. Once we've looked and collected all of our external DNA swabs for someone else's DNA, we'll then do some labial separation and traction to be able to visualize those areas. Do you want me to get up and show those areas now? [00:27:48] Speaker 4: I really do, but before you do that, if you would for Madam Court Reporter, Ms. Constantino, would you mind spelling the dye that you just mentioned? [00:27:56] Heather Wileski: So it's T-O-L-I-D-I-N-E. No, there's a U in there. U-D-I-N-E. Excuse me. U. Taludine. [00:28:06] Speaker 4: Okay. [00:28:07] Heather Wileski: T-O-L-U-I-D-I-N-E. [00:28:11] Speaker 4: Okay. Thank you. Yes. And now, if you would, point away. Okay. Okay. [00:28:17] Heather Wileski: So, when we are looking at the external structures, as I said, the cloral hook comes down, and where they meet at the bottom is that band of tension called the posterior forchette. Right up above that is the kind of concave area called the fascia navicularis, and then this is, like, the hymenal tissue that goes around. When we do labial separation, so we're just kind of pulling the labia apart, we may not be able to fully see the fossa, and so then we'll do what's called traction, where you kind of gently pull the labia out and down or up to see that fossa. The posterior forchette is actually your most common area of injury because there's such tension where those labia minora come together, and then followed by the fossa. We do occasionally see injury to the hymen, but it's not as often as the posterior forchette. So, we've done all that before we actually do an assessment of the hymenal tissue. In the acute exam, we will use either what's called a Q-tip or a Foley catheter. If it is an adult patient or adolescent that's fully estrogenized, so they've completely gone through puberty, that hymenal tissue is very sensitive in young children and children in puberty, so we have to wait until they've completed puberty and are fully estrogenized to touch that hymenal tissue. But it does start to fold on itself, and so we use a Q-tip or a Foley catheter to look at the whole rim of it to make sure we're not missing any acute injuries. And then lastly, we do the speculum exam. So, the speculum is really just that last part to be able to look at the walls of the vagina, the cervix, and then collect our samples from the cervix and behind the cervix in what we call the posterior fornix. [00:30:10] Speaker 4: Speaking of that, are there certain areas when you're swabbing inside where you stand a better chance of yielding DNA? [00:30:19] Heather Wileski: We do. So, there have been changes to our timeline as far as how far out we can go with collecting evidence with the advancements in DNA and research that was done. So, there was a study done on consenting adults who participated in a study, male and female partners engaged in unprotected sex, and there was an abstinence period that they had. And so, they would come in and have samples taken in four days, seven days, and then I believe at 10. And so, what they found was that the presence of that consenting partner's DNA was there longer than the original three days that we had traditionally been using for DNA collection. So, we used to have a 72-hour timeframe that we would collect a kit up to. Now, for adolescents and adults that we can do internal swabs on, we have moved that to about 120 days in North Carolina. Some states have moved a little bit further past that, based specifically off of that study, but it was done on consenting partners. And what they also found was that having a female have her menstrual cycle, or being on birth control, actually decreases the potential of getting that partner's DNA. [00:31:45] Speaker 4: Ms. Walusky? Yes. I'm sorry to interrupt you. This is so fascinating. I heard you say 120 days. I'm sorry. 120 hours. Thank you. Okay. How many days is that? Five days. Five days. [00:31:59] Speaker ?: Gotcha. [00:32:00] Heather Wileski: Thank you. Thank you. Yes. No. 120 hours. So, what the study also showed was when they had a swabbing done on the cervix, so that portion inside the vaginal canal, if you hold our Q-tip there for five to 10 seconds, and then you sweep underneath it, which is called the posterior fornix of the cervix, kind of that posterior side of it. If you sweep behind there, they had the highest yield of DNA collection when we combined those two swabs. We used to actually swab the vaginal walls and then the cervix. And so, in that study, they showed the highest yield when we did it that way. And so, that's how we now teach nurses and physicians and nurse practitioners and PAs to collect those samples. [00:32:50] Speaker 4: You're saying doing the swabbing the walls and the cervix is not where you're going to get the highest yield? [00:32:56] Heather Wileski: Correct. Okay. Yes. So, we've changed practice based off of that study. Okay. [00:33:01] Speaker 4: Did I hear you say something about menses while I was trying to figure out 120 hours? [00:33:13] Heather Wileski: Yes. Okay. So, that study showed a decrease in the ability to collect the partner's DNA when that female had had her menses. [00:33:25] Speaker 4: And, for those of us who don't know what menses means? Her period. Okay. Why would that be? Do you know? [00:33:33] Heather Wileski: I would have to speculate that it would be because the fluid is coming out. [00:33:40] Speaker 6: She's going to speculate that I would object and move to strike. [00:33:43] Speaker 2: And I think she already indicated she would have to speculate and was not going to. Okay. [00:33:47] Speaker 6: Right. [00:33:48] Speaker 2: Thank you. Yes. [00:33:50] Speaker 6: She did not speculate. Okay. I felt like she had an answer after saying she'd have to speculate and then she gave an answer. But if I'm wrong about that, I apologize. You did not give an answer. [00:33:59] Speaker 2: Is that correct? [00:34:00] Heather Wileski: I did start to. [00:34:01] Speaker 2: Yes, sir. Well, you did not give an answer. [00:34:03] Heather Wileski: I did not complete my answer, but I started to. [00:34:05] Speaker 2: Yes, sir. Any part of the answer that she has given is restricted. [00:34:09] Speaker 4: The study that you just referred to, you said it was consenting adults. Correct. Are you aware of any study regarding people who are deceased? I am not aware of any. Okay. Have you ever performed a sexual assault examination on someone who is deceased? I have not. [00:34:33] Speaker ?: Okay. And when was that particular study published? [00:34:33] Heather Wileski: That study was published in 2014. [00:34:34] Speaker ?: Okay. So after 2012. [00:34:36] Speaker 4: Yes, ma'am. Does it, does that particular study also enumerate some of the common physiological conditions that may influence recovery of DNA, unknown DNA? Yes. [00:35:00] Heather Wileski: So specifically it talks about menses and birth control, but then it also mentions past other studies where you may have a decrease in the collection of unknown samples for a multitude of different reasons. And certainly the type of assault that has occurred, whether it is an oral assault. So there's a mouth on the genitalia. If there's another sort of object that wouldn't potentially have DNA too. And then it also talks about the, the potential of whether someone fully ejaculates, ejaculates at all, if a condom was used or other reasons why there may not be DNA there. [00:35:44] Speaker 4: Is it possible for women to sustain injuries also from consensual sexual intercourse? It is. Yes. Is it possible for someone to have been sexually assaulted and not sustain injuries? Yes. [00:36:14] Heather Wileski: So it is quite often that depending on the history the patient has given that we may not find injuries. Most of the research supports about 20 to 40% of the time that we'll find injuries in acute sexual assault. And the higher the chance is going to be, the sooner the patient comes in. There's other things that play a part in that as far as whether there was any lubricant used. And when I mean lubricant, it can be an external kind of water-based lubricant or certainly menstrual blood can be considered a lubricant. The type of assault, as I said, whether it's an oral, digital, penile penetration or with an object, the force that was used within the assault. There's lots of reasons that we might be able to explain there not being any injury. And then also, as I mentioned before, patients may be incapacitated either from drugs or alcohol or some other reason. And in those cases, it's very unlikely that we actually do find injuries. [00:37:15] Speaker 4: Is that because of the alcohol or the drugs in their system or is that because they are unconscious? It can be a multitude of reasons. [00:37:28] Heather Wileski: Certainly, we know that alcohol is a muscle relaxant, same with some drugs. But if the muscles aren't being constricted because a patient is unconscious, then it would be less likely that we would potentially have injury. [00:37:41] Speaker ?: And then we would have to do that. And then we would have to do that. And then we would have to do that. [00:37:44] Speaker 4: And then we would have to do that. [00:37:45] Speaker ?: And then we would have to do that. [00:37:46] Speaker 4: And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. [00:37:55] Heather Wileski: And then we would have to do that. [00:37:56] Speaker 4: And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. [00:38:16] Speaker ?: And then we would have to do that. [00:38:17] Heather Wileski: And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. [00:38:22] Speaker 2: And then we would have to do that. [00:38:23] Speaker ?: And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. [00:38:59] Heather Wileski: And then we would have to do that. [00:39:00] Speaker ?: And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. [00:39:41] Speaker 4: And then we would have to do that. [00:39:42] Heather Wileski: And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. [00:39:47] Speaker 4: And then we would have to do that. And then we would have to do that. [00:39:49] Speaker ?: And then we would have to do that. And then we would have to do that. And then we would have to do that. [00:39:52] Speaker 4: And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. [00:39:57] Heather Wileski: And then we would have to do that. And then we would have to do that. And then we would have to do that. [00:40:00] Speaker ?: And then we would have to do that. And then we would have to do that. [00:40:12] Speaker 4: And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. [00:40:24] Speaker 2: And then we would have to do that. [00:40:25] Speaker 6: And then we would have to do that. And then we would have to do that. And then we would have to do that. [00:40:28] Speaker 2: And then we would have to do that. And then we would have to do that. [00:40:30] Speaker 4: And then we would have to do that. And then we would have to do that. [00:40:41] Speaker 2: And then we would have to do that. And then we would have to do that. [00:40:43] Speaker 4: And then we would have to do that. And then we would have to do that. And then we would have to do that. [00:40:46] Speaker 6: And then we would have to do that. And then we would have to do that. [00:40:48] Speaker ?: And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. [00:40:53] Speaker 4: And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. And then we would have to do that. [00:41:11] Heather Wileski: So this is the patient's in what we call supine position. So laying flat on her back. It's difficult to tell if her feet are actually in what we call footrests or not. But separated so that we can see some of the external genitalia. So we're able to visualize the mons pubis at the top. The outer labia majora. Some of the labia minora. Kind of coming down to the inner aspects of her bottom and into the crease. But I can't see any of those internal structures past that labia minora. So I can't see her posterior frechette, her fossa, or her hymenal tissue. Along with any of the inner aspects of the labia majora or minora. [00:41:56] Speaker 4: And so what did you do in reviewing this? [00:42:00] Heather Wileski: Sure. So I reviewed the report of the autopsy that they did not see any external genital injuries or vaginal injuries or injuries to her cervix. I reviewed this photo and one other. That's kind of just a wider view where you can see a little bit more of her abdomen. And was not really able to see whether or not there was any injury on this photo. [00:42:33] Speaker 4: And based on your observations of that photo, limited though they were, and your review of the autopsy, did you form an opinion? Yes. What is your opinion? [00:42:45] Heather Wileski: So the lack of any anogenital findings in this report, as in others, is not inconsistent with a sexual assault. And any unknown DNA that may have been collected on any of those swabs from the internal vagina or the anus and rectum are medically diagnostic or what we would call confirming for sexual contact. [00:43:10] Speaker ?: Thank you so much, Ms. Wallace. [00:43:11] Speaker 4: That's super helpful. No further questions. [00:43:13] Speaker ?: All right. [00:43:14] Speaker 4: Cross-examination? [00:43:15] Speaker 2: Yes, Your Honor. Good morning. [00:43:17] Speaker 6: Good morning. When were you first retained by the state to offer an opinion in this case? [00:43:31] Heather Wileski: Probably a month or two ago. A month or two ago. [00:43:33] Speaker 6: So prior to that, you hadn't spoken with anyone in the district attorney's office about this case? No, sir. [00:43:39] Heather Wileski: I was contacted initially to make connections with a retired police officer to get me in touch with the prosecution, but that's it. [00:43:51] Speaker 6: Yes, sir. Who's that police officer? [00:43:53] Heather Wileski: That would be Troy Armstrong. [00:43:55] Speaker 6: What did Dr. Scott tell you about the exam that she performed? [00:44:02] Heather Wileski: I did not speak with Dr. Scott. [00:44:04] Speaker 6: You've never spoken to Dr. Scott about the postmortem exam she performed? No, sir. And we heard testimony from Dr. Scott on Friday that the chief medical examiner at the time, Dr. Deborah Radish, was also in the room when the autopsy was being performed. Have you spoken with Dr. Radish about what she observed? No, sir. [00:44:26] Heather Wileski: Why? [00:44:27] Speaker 6: I wasn't asked to. [00:44:28] Heather Wileski: I guess the same question, Dr. Scott, why you didn't talk to her. [00:44:32] Speaker 6: Correct. I was not asked to speak to them. I looked at your report, one of the things I saw was, do you have in front of you a number 88? [00:44:47] Heather Wileski: Yes, sir. [00:44:48] Speaker 6: Okay. Thank you. The primary attention, I guess, and this is in the third full paragraph. [00:44:55] Heather Wileski: On the first page? [00:44:58] Speaker 6: Yes, ma'am. Okay. That when you reviewed this with primary attention on the anal genital examination and specimens collected for the sexual assault kit, correct? [00:45:09] Speaker 1: Correct. [00:45:10] Speaker 6: So, starting with the specimens collected, I'd like to ask you some questions. My review of this is based on the U.S. Department of Justice Office on Violence Against Women's third edition of the National Protocol for Sexual Assault Medical Forensic Examinations. Are you familiar with that? [00:45:31] Heather Wileski: I am familiar with it, yes. I brought copies just because I didn't think of it. [00:45:35] Speaker 6: Okay, perfect. [00:45:36] Heather Wileski: It's a long file, I guess. [00:45:37] Speaker 6: Right. It's not fair to ask so many questions about it. And I have a copy for my fellow counsel, and I have a copy for the court if the court wants one. And I'm not entering into evidence, obviously. It's just for examination with learning treaties, essentially, with an expert witness. You're going to still have to mark that. Yes, Your Honor. [00:45:54] Speaker ?: I am. Thank you. [00:46:38] Speaker 6: May I approach the bench? Yes, sir. And I have shared a copy of counsel with what we've marked as defendants exhibit six. I'm handing a copy to the court. Thank you. And if I may approach the witness, your honor. Yes, sir. I'll hand you a copy of it. [00:46:55] Speaker ?: Yep. [00:46:56] Heather Wileski: Thank you. [00:46:57] Speaker 6: Yes, ma'am. I have a few questions about it. So, if you could, if you would go to page 111. [00:47:28] Heather Wileski: Yes, sir. [00:47:29] Speaker 6: You mentioned use of an alternative light source when you're looking at, looking for bodily fluids on a patient's body, correct? [00:47:37] Heather Wileski: Correct. [00:47:38] Speaker 6: And these bodily fluids would also include seminal fluid. [00:47:41] Heather Wileski: It would include that, yes, sir. [00:47:42] Speaker 6: Okay. And I'm the one that used the woods light term on Friday, and I should have used alternative light source, so I appreciate you clarifying that. Oh, no, probably. But in an investigation, if somebody wanted to look to see if there was seminal fluid on a person's body, an alternative light source is the tool that could be used to identify possible seminal fluid, correct? [00:48:01] Heather Wileski: Correct. We use it as a screen. Yes, sir. [00:48:04] Speaker 6: And in collecting vaginal swabs, care has to be taken, correct? Great care, so you don't contaminate a specimen? Correct. [00:48:18] Speaker ?: Okay. [00:48:18] Speaker 6: And I guess specifically, and this is a question that I asked Dr. Scott on Friday, whether or not, between taking the vaginal samples and taking the rectal samples, I asked if she cleaned the peri-anal area before taking the rectal swabs. She said she did not, but would you agree that that is something that should be done? [00:48:44] Heather Wileski: So we don't clean the area, but we do swab the area. [00:48:49] Speaker 6: Can you go to page 114? [00:48:55] Heather Wileski: 114? Yes, ma'am. [00:48:56] Speaker 6: Yes, sir. Do you see footnote 261? [00:49:02] Heather Wileski: Yes. [00:49:03] Speaker 6: Okay. And this is from the Department of Justice. Yep. So it seems like the recommendations from the DOJ are that after the collection of vaginal samples, the peri-anal area should be cleaned thoroughly to avoid contaminating rectal swabs with vaginal drainage. Would you agree with that? [00:49:27] Heather Wileski: So in North Carolina, we do it a little bit differently because we do external genitalia swabs of that area. And so we are actually cleaning that area with a swab included in the external genitalia, and we package that separately as an external genitalia swab. So we do clean that area first before the anal samples. We just don't throw that away as a cleaning product. We send it with swabs. [00:49:51] Speaker 6: Well, Dr. Scott said she didn't clean the area. [00:49:54] Heather Wileski: Okay. [00:49:55] Speaker 6: But if you'd done the examination, you would have cleaned the peri-anal area before the rectal samples? [00:50:01] Heather Wileski: I would have collected those as a sample and sent them with my kit in the external genitalia envelope. Yes, sir. [00:50:07] Speaker 6: Well, I'm just asking about the cleaning specifically. [00:50:10] Heather Wileski: Right. When you say cleaning to me, I am interpreting that as to be cleaning the area and not sending that as evidence. That would be something that you would eliminate, and I would never want to do that. So I would be swabbing that area with the two wet, moistened swabs and then packaging that in the external genitalia, since that's the area, or the peri-anal swabs. We do peri-anal swabs and then anal swabs. [00:50:35] Speaker 6: Okay. So I guess if I understand it, you're saying that when you're taking the peri-anal swabs, that is essentially cleaning the area? Correct. Okay. So would you agree that if somebody didn't perform it that way, then there would be that danger of the rectal samples being possibly contaminated by vaginal drainage? [00:50:57] Heather Wileski: Correct. [00:50:57] Speaker 6: And do you know how long it was between the time Ms. Hedgbath was discovered until the time the swabs were taken by the medical examiner? [00:51:07] Heather Wileski: I do not. [00:51:09] Speaker 6: Do you know how many, what position Ms. Hedgbath's body had been in prior to getting to the medical examiner's office? [00:51:16] Heather Wileski: I do not. [00:51:17] Speaker 6: Do you know how many times it had been moved in the apartment prior to being transported to the medical examiner's office? [00:51:23] Heather Wileski: I do not. [00:51:24] Speaker 6: Now you mentioned the swabbing here. The exterior swabs, the vaginal exterior swabs, you would take two of those? [00:51:35] Heather Wileski: So the external genitalia that includes the mons and the labia majora and then the perineum, we now collect swabs for that. And there's two moistened swabs that we do for that. And then we do two inner genital, external genitalia swabs in the labia minora, fossa, and posterior foreshad. [00:51:57] Speaker 6: So would you put those in separate packaging? [00:51:59] Heather Wileski: Yes, sir. Okay. [00:52:01] Speaker 6: And that would be because you would want to be able to identify which swabs came from which area, correct? Correct. And then for the, there's a difference between, I guess, swabbing, well let me ask it this way, rectal swabs and then anal swabs. There's a difference, correct? There is, yes. Okay. And would you package rectal swabs and anal swabs in the same packaging? [00:52:27] Heather Wileski: So we, primarily on patients that come to the emergency department that we see that are alive, we actually don't get all the way into the rectum because it would be pretty uncomfortable. So pass the anal verge into the anus that we will collect anal swabs. You don't get to the rectum until you've passed what's called like the pectinate line inside, past the anus. So we don't go that far into the anus, into the rectum on patients that we see. [00:53:00] Speaker 6: In the autopsy report that we discussed earlier, it was noted in there that there were rectal swabs taken. And there were four total swabs taken in the rectal area in this case. Are you aware of that? [00:53:14] Heather Wileski: I did not know how many swabs, no, sir. [00:53:16] Speaker 6: Do you know if they were packaged, you know, the two anal swabs packaged separately from the rectal swabs? [00:53:23] Heather Wileski: I do not know. I only know that it had been documented as far as that they were collected. [00:53:28] Speaker 6: Okay. But the collection practices themselves, that would be something Dr. Scott or Dr. Raj would be more familiar with? [00:53:35] Heather Wileski: Correct, yes. And some of the kits have changed over the years as well as far as the envelopes go. So the labeling might be a little different than they are now. [00:53:43] Speaker 6: Will the swab itself get labeled or do the packaging? The packaging. In your report, you wrote that exam findings, and this is on page two of your report. Okay. Exam findings must be based on what the examiner visualizes at the time of the exam and not solely on review of the photographs. [00:54:04] Heather Wileski: That is correct. [00:54:04] Speaker 6: Okay, so the person who's in the best position, I guess, to do the, to visualize whether or not there are any injuries on gross examination, that would be the person performing the analysis, or the exam, correct? [00:54:17] Heather Wileski: Correct. [00:54:18] Speaker 6: Okay, in this case, that would have been Dr. Scott. [00:54:20] Heather Wileski: Yes. [00:54:21] Speaker 6: Okay, and supervised by Dr. Raj. [00:54:23] Heather Wileski: Yes, to my knowledge. [00:54:25] Speaker 6: Okay. You haven't spoken to her? [00:54:30] Heather Wileski: I have not. [00:54:31] Speaker 6: Do you know her? [00:54:32] Heather Wileski: I don't. I know her name, Dr. Radish, just from working in the state, but we've never met. [00:54:38] Speaker 6: Do you know, so you don't know whether or not she's attended any sexual assault training courses like you spoke about earlier? [00:54:44] Heather Wileski: Not ones that I've taught. [00:54:46] Speaker ?: Okay. [00:54:47] Speaker 6: But if she attended other of those training courses, that's not something you're aware of? [00:54:52] Speaker 1: Correct. [00:54:53] Speaker 6: Okay. And the same question, Dr. Scott, whether or not she's attended these specific courses, you're not aware of one way or the other? [00:54:59] Heather Wileski: Correct. [00:55:04] Speaker 6: Do you have any reason to doubt that Dr. Scott didn't see injuries on her examination? [00:55:11] Heather Wileski: No. [00:55:12] Speaker 6: And do you know how long Dr. Scott took to do her examination, her visual examination? I do not. Okay. And I guess the same thing with Dr. Radish? [00:55:22] Speaker 4: Correct. [00:55:23] Speaker 6: And in your report, and this is on the, I guess, second, I'm always bad at this, but the second full paragraph on page two, Okay. You wrote that during a medical forensic examination by a SANE, there are several techniques used to help visualize injuries during the examination of the anogenital area, correct? [00:55:45] Heather Wileski: Correct. [00:55:46] Speaker 6: These include labial separation and traction to visualize all the tissue included in the vulva. [00:55:52] Heather Wileski: Correct. [00:55:53] Speaker 6: Do you know if Dr. Scott did that? [00:55:55] Heather Wileski: I do not. [00:55:56] Speaker 6: Okay. And what about whether Dr. Radish did that? [00:55:59] Heather Wileski: I do not. [00:55:59] Speaker 6: Okay. Do you have any reason to doubt that they didn't do that? [00:56:04] Heather Wileski: Um, I don't. It just wasn't documented, so I can't say one way or the other. [00:56:08] Speaker ?: Okay. [00:56:08] Speaker 6: But, I guess if you asked him. Correct. [00:56:13] Speaker ?: Mm-hmm. [00:56:14] Speaker 6: And then the next thing you write in that same sentence, visualization of the posterior forshet and fossa navicularis. Those are the most common areas of injury in a sexual assault, you say? Correct. Okay. And you don't know how long Dr. Scott or Dr. Radish spent examining that area, correct? Correct. The last full paragraph on page two, in the first sentence you said, Unfortunately, this provider was unable to visualize all the external genital structures in the photos provided and is unable to provide an opinion on whether injuries were present at the time of the exam. [00:56:57] Heather Wileski: Correct. [00:56:58] Speaker ?: Okay. [00:56:59] Speaker 6: But there is an opinion as to whether or not there were injuries at the time of the exam, correct? [00:57:05] Heather Wileski: Yes. It just was not my opinion. [00:57:07] Speaker 6: Right. Why do you use the word unfortunately? [00:57:10] Heather Wileski: Unfortunately, I wasn't able to see that as far as the photos that I was sent to actually look for the injuries in the most common areas. [00:57:17] Speaker ?: Okay. [00:57:17] Speaker 6: Nothing prevented you from talking to the provider that did the exam. [00:57:23] Speaker ?: No. [00:57:25] Speaker 6: Going further down in that paragraph, you note that, actually, you know what? Let me take it to the last page because you talked about something that I don't want to. My counsel wrote a note here and I don't know what it says. Somebody ignore it. You talked a lot about this 120-hour look-back period, correct? [00:57:49] Heather Wileski: Look-back period. How we've extended to the 120 hours? Exactly. Yes, sir. [00:57:53] Speaker 6: Okay. And that's because if somebody came in and said that they had been a victim of a sexual assault, but it had been five days ago, there would still be the opportunity and possibility to collect DNA evidence, correct? [00:58:06] Heather Wileski: Yes. [00:58:07] Speaker 6: And that would include sperm, correct? [00:58:10] Heather Wileski: Correct. [00:58:11] Speaker 6: Okay. And I guess looking at, can you go to page 75 of the Department of Justice manual that we're looking at? Or the, I guess I should, the National Protocol for Sexual Assault Medical Forensic Examinations. [00:58:23] Heather Wileski: You said page 75? [00:58:25] Speaker 6: Yes, ma'am. [00:58:33] Speaker ?: Okay. [00:58:35] Speaker 6: And in here, and it's the, I guess this is Section 5, timing considerations for collecting evidence. Would you agree that samples should be collected regardless of the patient's post-assault activities, including showering, urinating, douching, swimming, sexual activity, eating, drinking? [00:58:53] Heather Wileski: Yes, sir. Okay. [00:58:55] Speaker 6: So if any of those things, and a patient gives you a history, they've done those things, you would still collect samples, correct? Correct. And you still may find DNA evidence despite those activities having occurred, correct? Correct. And that DNA evidence would include still being able to find sperm within that, you know, up to the 120-day mark, correct? [00:59:14] Heather Wileski: So it does degrade a little bit over time, but there is the chance of still getting some part of it, yes. [00:59:19] Speaker 6: Okay. And that's the reason that they have extended the period and why you take the swabs, correct? [00:59:25] Speaker 4: Correct. [00:59:27] Speaker 6: And going to page 76, another question I have. These time frames, this 120 hours, that's a benchmark for consideration, but that's not the basis to deny care to somebody who says they've been a victim of assault, correct? [00:59:44] Heather Wileski: Correct. [00:59:45] Speaker ?: Okay. [00:59:45] Speaker 6: In the sample collection period, that 120-day cutoff, would you agree that it's conceivable and maybe warranted in particular cases to still take a sample after the 120 days to see if you could collect evidence? [00:59:58] Heather Wileski: After the 120 hours, so. 120 hours. No, I know. Yes, there are extenuating circumstances that we will go past that five-day benchmark in cases. Yes, absolutely. [01:00:12] Speaker 6: And I don't have very many questions left. If I can look at my notes, that will help it so I don't go around in circles. So if I may have just a moment, Your Honor, to look at my notes. Thank you, Your Honor, to look at your notes, Your Honor, to look at your notes. [01:00:32] Speaker ?: The study that she talked about a good bit with my fellow counselor. [01:00:44] Speaker 6: Was that study, the post-poidal DNA recovery study from October 31, 2014? Yes, sir. And I just, I don't, I, we were trying to figure out what study you were talking about, but we- Yes, that is the one, correct. Okay, so in that study, would you agree that in the research they had successfully demonstrated the ability to obtain full and probative partial DNA profiles from enhanced YSTR methods from the cervix, posterior, fornix, and the combined samples of the cervix and posterior fornix samples collected up to nine days after intercourse, and 78.8% are participating couples? Correct. [01:01:48] Heather Wileski: And also, oh, I'm sorry, go ahead. No, no, I was just going to say that's the study I was referring to, yes. [01:01:54] Speaker 6: And surprisingly, after 10 days of abstinence, there was recovery in 67.7% of participating couples? [01:02:02] Heather Wileski: Correct. They didn't determine whether there was actually sperm found or just usable DNA. [01:02:09] Speaker 6: Detection does not drop to zero on day 11, correct? [01:02:13] Heather Wileski: Correct. [01:02:14] Speaker 6: And when measured, there were no differences found between those with and without DNA detection on day 10. Would you agree? [01:02:22] Heather Wileski: Can you repeat the question? [01:02:23] Speaker 6: Yeah, just looking at the study, when measured, there was no difference found between those with and without DNA detection at day 10. [01:02:31] Heather Wileski: The only difference they found was menses and birth control in that study, correct? [01:02:37] Speaker 6: So that's an interesting point. I'm just on the same part of the study. Yeah. Didn't they found that even with menstruating women on hormone birth control and using enhanced YSTR, DNA detection is greater than 50% on day 10? [01:02:52] Heather Wileski: They did still find some, yes. [01:02:54] Speaker 6: And that study supports evidence collection consideration of until a completed menstrual period and women having periods, correct? [01:03:03] Heather Wileski: Correct. Until the completed period and that would be the cutoff. [01:03:06] Speaker 6: All right. So DNA detection greater than 50% on day 10, even if somebody is menstruating? [01:03:13] Heather Wileski: With enhanced and not standard, correct? [01:03:15] Speaker ?: Okay. [01:03:19] Speaker 6: And that article is from 2014, correct? Correct. And the DOJ, I'll keep shortening it, the protocol for sexual assault that you're looking at in front of you, that's from September of 2024, correct? [01:03:34] Heather Wileski: Correct. Correct. [01:03:43] Speaker 6: And the photograph that we looked at, and I don't want it published again, one of the things that you're looking for in the photographs and in an examination is whether there is bruising on the inner thighs of the individual, correct? [01:03:59] Heather Wileski: We do look for that, yes, sir. [01:04:00] Speaker 6: And then looking at the photograph that was up there, and I don't want to publish it again, there was no bruising on the inner thighs, correct? [01:04:07] Heather Wileski: Not that I could see, there was some blood-like substance covering some of the area, but I did not visualize any. [01:04:13] Speaker 6: Dr. Scott's opinion on that was that was menstrual blood. Do you have any reason to disagree with that? [01:04:18] Heather Wileski: I don't, no. [01:04:21] Speaker 6: And I guess the, in coming to your opinion in this case, you're not giving an opinion that there was a sexual assault, correct? [01:04:36] Speaker 4: Correct. [01:04:37] Speaker 6: And, and given the opinion in this case about unknown DNA, you're not giving an opinion on how long that particular DNA was located, or had been the time since deposit? [01:04:53] Heather Wileski: Sure, no, I can't determine the time when it was deposited. [01:04:56] Speaker 6: Okay, so, could have been several days prior? [01:05:00] Heather Wileski: There is the potential, I have no way of knowing that. [01:05:06] Speaker 6: They asked you about uterus injury because of a stupid question I asked on Friday, just to clarify things. So, it doesn't sound like there's any way that, that's one way or the other that you can study that. [01:05:21] Heather Wileski: We, we don't typically do that on our patients, no sir. [01:05:24] Speaker 6: That was the reason for the question, I think. But, one more moment, Your Honor, and I think I'm, I've asked all of my questions, but I just want to open my outline. Yes, sir. Thank you, Your Honor. Those are my questions. Thank you. Redirect. [01:05:53] Speaker 4: Can you ever tell how long ago the DNA was deposited? [01:05:59] Heather Wileski: I cannot. We actually don't even look at that. The crime lab would be looking at that sample at the lab. [01:06:06] Speaker 4: And the study that, that you've been talking about, that you relied on, is the same study that this particular federal guideline also relies on? Is that right? [01:06:17] Heather Wileski: It's one of them, yes. [01:06:17] Speaker 4: Okay. And, one of the things you were just talking about with defense counsel was the enhanced or advanced YSTR testing. Correct. Right. But, you don't know whether or not that was used in this case. I do not. And, the other question I have is about, you've mentioned that the, um, the sex assault kits have changed over time. They have. And, um, would you say it's fair to presume that the best practices in 2012 were different from what they are today? [01:07:02] Heather Wileski: Yes. So, this study in particular certainly wasn't published until 2014. And so, in 2012, we, uh, across the state typically used the 72-hour time frame to collect evidence and to take samples of consenting partners. [01:07:18] Speaker 4: And just to clarify, because the, the double negative language is confusing for all of us humans. Um, but your opinion in this case, you can't say, as, as a person, no matter how expert you are, um, whether or not someone was sexually assaulted. Is that fair? [01:07:35] Heather Wileski: That is fair. Correct. [01:07:37] Speaker 4: And so, what I understood your opinion to be is that the absence of injuries also is not evidence that she was not sexually assaulted. [01:07:47] Heather Wileski: Correct. You can have injuries with a sexual assault, and you cannot have injuries, and the sexual assaults still have occurred. Uh, and so, it is a little bit, we certainly weren't there at the time, so I can't say whether an assault has happened or not. And we do see injuries in consenting patients as well. So, I can't make a determination on that. [01:08:08] Speaker 4: And one more question. Just in terms of, as a, as a medical practitioner, when you are conducting an examination like this, um, do you include in your report, your findings, and everything that you've done, as a matter of course? Yes. [01:08:23] Speaker ?: Okay. [01:08:24] Speaker 4: Thank you so much. No further questions, Your Honor. [01:08:26] Speaker 2: All right. Recross? [01:08:28] Speaker 6: Briefly. [01:08:28] Speaker 2: All right. [01:08:29] Speaker 6: The, I guess the, I guess the opinion that you can, you can never give, that you just discussed with my fellow counselor, the same question, uh, if you recover sperm on a sample, that doesn't mean that a sexual assault occurred, correct? [01:08:42] Heather Wileski: Correct. It's just the sexual contact. [01:08:47] Speaker 6: And the collection, the collection of sperm on one of those swaps doesn't tell you when the sperm was introduced, correct? [01:08:54] Speaker 4: Correct. [01:08:55] Speaker 6: I think that, those are my questions. [01:08:57] Speaker 2: Recross? I'm sorry, redirect? [01:08:58] Speaker 4: No, Your Honor, thank you. [01:08:59] Speaker 2: Now, is she under subpoena? [01:09:01] Speaker 4: She is. Yes. Now, are you asking if she is? [01:09:03] Speaker 2: We are respectfully under. Any objection? No, Your Honor. All right. Ma'am, you are releasing subpoena. You are free to go. Thank you, Judge. We can actually turn the, the defense exhibit back to the defense council, if you wouldn't say.