Commonwealth v. Allison

NEWMAN, Justice,

concurring.

I join the Majority Opinion, but I write separately to emphasize the importance of reference to fundamental anatomical information in the decision of this case.

The Commonwealth bases its argument on the mistaken belief that the existence of a hymen is a physical condition readily observable to a lay person. Jurists are not physicians. Because there is no expert anatomical evidence in the record, this Court cannot resolve this issue without looking to reference materials and taking judicial notice of professional information concerning female genital anatomy. An appellate court cannot consider facts that are not in the record. Commonwealth v. Casper, 481 Pa. 143, 392 A.2d 287 (1978). However, courts can take judicial notice of scientific and medical facts that are generally known. Hoffman v. Misericordia Hospital of Philadelphia, 439 Pa. 501, 267 A.2d 867 (1970).

We must look to scholarly articles in medical journals, which confirm that examination and determination of the condition of the hymen requires complex application of medical and anatomical knowledge by physicians. Because of the importance of understanding this aspect of female anatomy, it is appropriate for this Court to take judicial notice of the description of the hymen contained in “Gray’s Anatomy,” which .states the following:

*13The hymen is a thin fold of mucous membrane situated at the orifice of the vagina; the inner edges of the fold are normally in contact with each other, and the vaginal orifice appears as a cleft between them. The hymen varies much in shape. When stretched, its commonest form is that of a ring, generally broadest posteriorly; sometimes it is represented by a semilunar fold, with its concave margin turned toward the pubes. Occasionally, it is cribriform, or its free margin forms a membranous fringe. It may be entirely absent, or may form a complete septum across the lower end of the vagina; the latter condition is known as an imperforate hymen. It may persist after copulation, so that its presence cannot be considered a sign of virginity. When the hymen has been ruptured, small rounded elevations known as the carunculae hymenales are found as it remains. Between the hymen and the frenulum of the labia is a shallow depression, named the navicular fossa.

Henry Gray, Anatomy Of The Human Body, p. 1319 (Lea & Febiger, 30th ed.1985). Thus, recognition and examination of the hymen requires highly specialized medical training. Furthermore, identification of this small mucous membrane would be especially difficult in this case because the victim is only seven years old.

Thus, medical expertise clearly teaches us that the appearance of the hymen varies so considerably among individuals— sometimes it is entirely absent—that one who is not trained cannot ascertain the condition of a hymen. Indeed, Ms. Harvey’s own testimony is the best evidence that she was not qualified to testify concerning the condition of her niece’s hymen. Ms. Harvey mistakenly described the hymen as “the thin layer of skin over the opening of the vagina.” This is incorrect because the hymen is not skin. According to the above quoted portion of Gray’s Anatomy, the hymen is a thin fold of mucous membrane.

The trial court also permitted Ms. Harvey to testify that the victim’s hymen was “open” and not “normal.” However, Ms. Harvey could not possibly recognize whether or not the hymen was “normal” because the appearance of the hymen varies so *14considerably in size and shape. Thus, Ms. Harvey’s inaccurate testimony completely undermines the Commonwealth’s assertion that the condition of the hymen is a “physical condition readily observable to a lay person.”

Moreover, I question whether a physician that does not have specific training in gynecology could even offer such testimony. In a case from New York, People v. Hobot, 200 A.D.2d 586, 606 N.Y.S.2d 277 (1994), affirmed, 84 N.Y.2d 1021, 622 N.Y.S.2d 675, 646 N.E.2d 1102 (1995), that state’s highest appellate court held that a family practice physician could not testify concerning the appearance of a rape victim’s hymen because she was not a gynecologist. The defendant in Hobot was charged with sexual assault of a nine-year-old girl. During his trial, the prosecution presented the testimony of a gynecologist with specialized training in treating adult and child victims of sexual abuse. After the trial court accepted him as an expert in the field of gynecology, the expert witness testified that he observed two small tears in the complainant’s hymen after an internal examination of the child’s pelvis.

After his conviction, the defendant in Hobot filed a post-trial motion alleging that he was denied effective assistance of counsel because his attorney did not review a report prepared by a general practitioner who examined the victim before the gynecologist. The report described the doctor’s observations of contusions on the child’s face and body, as well as a genital rash, and a notation that the victim’s hymen was intact.

During the hearing on trial counsel’s effectiveness, the general practitioner testified that she had graduated from medical school nine years before she examined the victim. She was engaged in the general practice of medicine, and her only training in gynecology consisted of a rotating internship in that field prior to her graduation from medical school. The doctor did not regularly conduct gynecological examinations of children and had never before examined a child claiming child abuse. Most significantly, the general practitioner testified that an experienced gynecologist using a speculum (a medical instrument used to examine the vagina) might be able to detect tears in the hymen that she did not see. She told the *15victim’s parents to take her to a hospital emergency room where a gynecologist could examine the child.

The trial court in Hobot held that because the general practitioner had extremely limited experience in the field of gynecology, she was not qualified to testify concerning the condition of the victim’s hymen. The Court of Appeals of New York, that state’s highest appellate court, affirmed the trial court’s decision. People v. Hobot, 84 N.Y.2d 1021, 622 N.Y.S.2d 675, 646 N.E.2d 1102 (1995). Clearly, if we applied the rationale of Hobot to this case, testimony by a nonprofessional about the condition of the hymen would be inadmissible.

The condition of the victim’s hymen in this case was a matter that could only have been presented through the testimony of a doctor with specialized training in gynecology or pediatric gynecology. Only the examining physician in this case was competent to testify about his observations concerning the condition of the victim’s hymen. Accordingly, the trial court erred when it permitted the Commonwealth to introduce this testimony.

I join the decision to reverse the decision of the Superior Court.