Example: The patient has no memory of the time between ingesting a drink handed to her in a club and waking up in a parking lot. In response to the SANE’s questions about her voluntary alcohol consumption, the patient reports having several drinks before the drink in question. In response to the SANE’s question as to whether she vomited, the patient reports that she vomited copiously. The SANE’s examination of the patient’s mouth reveals that the back of the upper part of the mouth called the soft palette was very reddened and appeared to be irritated.

During trial, the prosecutor elicits the information about redness and irritation from the SANE, who has been qualified as an expert (explained below) and asks if she has an opinion as to the cause. The SANE responds that the findings are consistent with blunt force trauma. The prosecutor thus creates the implication that the patient was subjected to forced oral penetration by the defendant’s penis.

On cross-examination defense counsel asks the SANE if the redness and irritation at the back of the patient’s throat could also have been caused by her copious vomiting, and the acid coming up from her stomach. The SANE replies that it could.

This is as much as the SANE is able to tell the court based on the examination: the redness and irritation on the patient’s soft palette are, in the SANE’s opinion, consistent with blunt force trauma, but they may also have been caused by copious vomiting. It is now up to the prosecution and defense to integrate the SANE’s testimony into the narrative each presents in its closing, placing it in the context of all the other facts addressed. The jury or, in a bench trial, the judge, decides which explanation of this particular injury to the patient they find most credible.