The Forensic Examiner (Sample) - Spring 2008

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Shocking security breaches made the news throughout 2007, a year that many security experts say was the worst in history for the compromise of sensitive information. It started when Massachusetts-based retail-er TJX announced that 45.6 million credit cards belonging to its customers had been compro-mised during an intrusion that reportedly went undetected for 18 months. In the months that followed, banks suing over losses claimed that the actual number of credit cards from which information had been taken was closer to 94 million. The loss was devastating for TJX, which by year’s end was estimating that it had already spent or set aside $250 million to cover its losses from the breach. Some analysts were predicting that the security lapse could even-tually cost TJX more than $1 billion. During the summer, broker Fidelity National lost control over the personal information of 8.5 million customers. A senior database adminis-

trator working at a subsidiary company copied the information and sold it to brokers. In September, TD Ameritrade Holding Corp. admitted that 6.2 million customers had their personal information compromised because of an infiltration. The jeopardized contact infor-mation included names, addresses, and phone numbers, and it was apparently used to target stock-market-related spam. Governments were not immune. In November, the HM Revenue and Customs department of Great Britain announced that the child benefit records of 25 million UK citizens had been lost. Computer disks that had not been encrypted were lost while being transported to the National Audit Office. The information had such details as national ID numbers. The expense just from clos-ing old accounts and opening new ones could cost British banks $500 million. Then came the announcement that the re-cords of 3 million British student drivers had been lost when a hard drive in Iowa City, Iowa

became unaccounted for. The breach was espe-cially dangerous, analysts said, because teenag-ers are among the most vulnerable to ID theft. In November it was reported that a Lebanese immigrant used a fraudulent U.S. citizenship to find employment with the CIA and FBI. She allegedly used her access to look up informa-tion on the terrorist group Hezbollah. Another breach was not nearly as costly, but its irony makes it worthy of mention. In ear-ly October, a vulnerablity in a Department of Homeland Security list-serv was revealed when a subscriber posted an unsubscribe request that was sent out to all the list-serv members. Soon, subscribers were spamming themselves with hundreds of jokes, protests, unsubscribe re-quests, and sales pitches for products or services. Hundreds of security professionals who should have known better wound up sending out their private email addresses for anyone to see. As bad as 2007 was, many experts predict lapses will only grow worse this year.

Security Breaches Hit New High During Dangerous 2007

Certified Trends

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Feature Articles

FORENSICEXAMINER®

THE

The Official Peer-Reviewed Journal of The American College of Forensic Examiners VOLUME 17 • NUMBER 1 • Spring 2008

The American College of Forensic Examiners International (ACFEI) does not endorse, guarantee, or warrant the credentials, work, or opin-ions of any individual member. Membership in ACFEI does not constitute the grant of a license or other licensing authority by or on behalf of the organization as to a member’s qualifications, abilities, or expertise. The publications and activities of ACFEI are solely for informative and educational purposes with respect to its members. The opinions and views expressed by the authors, publishers, or presenters are their sole and separate views and opinions and do not necessarily reflect those of ACFEI, nor does ACFEI adopt such opinions or views as its own. The American College of Forensic Examiners International disclaims and does not assume any responsibility or liability with respect to the opinions, views, and factual statements of such authors, publishers, or presenters, nor with respect to any actions, qualifications, or represen-tations of its members or subscriber’s efforts in connection with the application or use of any information, suggestions, or recommendations made by ACFEI or any of its boards, committees, or publications, resources, or activities thereof.

Write about a fascinating forensic case. Case studies exploring forensic investigations on any topic, case, or crime—including fraud, theft, murder, historical cases, and any others—are welcome. These case studies could discuss serial killers, famous fraudsters, cold cases, or any other type of case. Case studies should focus on how forensic techniques, tools, and investigations were used to break the case or solve a mystery. These could be cases you’ve worked on or simply cases that fascinate you.

Submit an article for peer review. The Forensic Examiner® is always looking for articles on research and new techniques and findings in the various fields of forensics. To submit an article for peer review, or for complete submission guidelines, please visit www.acfei.com or write to [email protected].

How to SubmitWhether you wish to submit an article for peer review, a fascinating case or forensic case profile, or an article on a current issue in the field of forensics, send your writing electronically (either in the body of an email or as an attachment) to [email protected]. Or, send in your writing on a disc or CD to Editor, Association Headquarters, 2750 E. Sunshine, Springfield, MO 65804.

SANE Peer Review: What is it? Do we need it?By Lisa Gorham, BSN, RNC, SANE-A, CFN, and Suzanne L. Brown, MSN, RN, SANE-A, CFN

The Arrogant Chameleons: Exposing Fraud-Detection HomicideBy Frank S. Perri, JD, MBA, CPA, and Terrance G. Lichtenwald, PhD, FACFEI

The Life Development of Gang Members: Interventions at Various StagesBy Mike Meacham, PhD, LCSW, DCSW, DABFSW, and Tony Stokes

Injury Assessment and Management: Controversies and ResolutionsBy Robert H.N. Fielden, MD, FRCS(C), DABFM, DABFE, FACFEI

Stories from the Front: IE (IME) Excesses and How to Counter ThemBy John J. Haberstroh, DC, DABCN, DACAN, FACFEI, and Kevin Mulhern, DC, FICC

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100 Clubs Help Families of Fallen: Organizations Provide Support and Financial GiftsBy John Lechliter, Editor in Chief

He Was Everyone’s Best Friend: Line-of-Duty Death of Close Friend Inspires Dr. Robert O’Block to Support 100 Clubs

Officer Down: Characteristics of Cop KillingsBy Bruce Gross, PhD, JD, MBA, FACFEI, DABFE, DABPS, DABFM, DAPA

The Disability Claim BuyoutBy Arthur L. Fries

Workers’ Compensation: A Broken Medical SystemBy Michael A. Baer, PhD, ScD, FACFEI, DABPS, DABFE, DABFM, CHS-V, FAPA

America’s Most Wanted: Staying on Track and Learning from the BestBy Mark Withrow, DABCHS, CHS-V and Roger Rickman, CHS-V, PI, DABCHS

The Tally Stick: The First Internal Control?By Nicholas Apostolou, DBA, DABFA, CPA, and D. Larry Crumbley, PhD, CP A, DABFE, Cr.FA

The Incomparable Witness: Sir Bernard SpilsburyBy Katherine Ramsland, PhD, CMI-V

Stand Your Ground, Revisited: Measuring Reasonable FearBy Patricia A. Wallace, PhD, FACFEI, DABFE, DABFM, CFC, and Rosalynn Moten-Travis, PhD

Falsely Accused: Justice and the Willing Suspension of Belief

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ACFEI News

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CE Test Pages: Five Continuing Education Credits

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The Forensic Examiner® (ISSN 1084-5569) is published quarterly by The American College of Forensic Examiners International, Inc. (ACFEI). Annual membership for a year in the American College of Forensic Examiners International is $165. Abstracts of articles published in The Forensic Examiner® appear in National Criminal Justice Reference Service, Cambridge Scientific Abstracts, Criminal Justice Abstracts, Gale Group Publishing’s InfoTrac Database, e-psyche database, and psycINFO database. Periodicals Postage Paid at Springfield, Missouri, and additional mailing offices. ©Copyright 2008 by the American College of Forensic Examiners International. All rights reserved. No part of this work can be distributed or otherwise used without the express permission of the American College of Forensic Examiners International. The views expressed in The Forensic Examiner® are those of the authors and may not reflect the official policies of the American College of Forensic Examiners International.

CONTACT US:Publication, editorial, and advertising offices of ACFEI, 2750 East Sunshine Street, Springfield, MO 65804. Phone: (417) 881-3818, Fax: (417) 881-4702, E-mail: [email protected]. Subscription changes should be sent to ACFEI, 2750 East Sunshine, Springfield, MO 65804.

POSTMASTER:Send address changes to American College of Forensic Examiners International, 2750 East Sunshine Street, Springfield, MO 65804.

ACFEI Executive Advisory Board

2008 Editorial Advisory BoardFORENSICEXAMINER®

Louay Al-Alousi, MB, ChB, PhD, FRCPath, FRCP(Glasg), FACFEI, DMJPath, DABFM, FFFFLMNicholas G. Apostolou, DBA, DABFA, CPALarry Barksdale, BS, MA E. Robert Bertolli, OD, FACFEI, CHS-V, CMI-VKenneth E. Blackstone, BA, MS, CFCDavid T. Boyd, DBA, CPA, CMA, CFM, Cr.FAJules Brayman, CPA, CVA, CFD, DABFAJohn Brick, PhD, MA, DABFE, DABFM Richard C. Brooks, PhD, CGFM, DABFEDennis L. Caputo, MS, DABFET, REM, CEP, CHMM, QEP Donald Geoffrey Carter, PE, DABFETDavid F. Ciampi, PhD, FACFEI, DABPSLeanne Courtney, BSN, DABFN, DABFELarry Crumbley, PhD, CPA, DABFEJean L. Curtit, BS, DC Andrew Neal Dentino, MD, FACFEI, DABFE, DABFM Francisco J. Diaz, MDJames A. DiGabriele, DPS, CPA, CFSA, DABFA, Cr.FA, CVAJohn Shelby DuPont Jr., DDS, DABFD Scott Fairgrieve, Hons. BSc, MPhil, PhD, FAAFSEdmund Fenton, DBA, CPA, CMA, Cr.FA Per Freitag, PhD, MD, FACFEI, DABFE, DABFMNicholas Giardino, ScD, DABFEDavid H. Glusman, CPA, DABFA, CFS, Cr.FAKaren L. Gold, PsyD, FACFEI, DABPSRon Grassi, DC, MS, FACFEI, DABFMJames Greenstone, EdD, JD, FACFEI, DABFE, DABFM, DABPS, DABECIRoy C. Grzesiak, PhD, PCRaymond F. Hanbury, PhD, ABPP, FACFEI, DABFE, DABPS, CHS-IIIJames Hanley III, MD, DABFMNelson Hendler, MD, DABFMDavid L. Holmes, EdD, BCAP, BCPS, BCBS, FACFEI, DABFE, DABPSLeo L. Holzenthal, Jr., PE, DABFET, MSE, BSEELinda Hopkins, PhD, CFC John R. Hummel, PhD, CHS-IIIEdward J. Hyman, PhD, FACFEI, DABFE, DABFM, DABPSZafar M. Iqbal, PhD, FACFEI, DABFE, DABFM Nursine S. Jackson, MSN, RN, DABFNPaul Jerry, MA, C.Psych., PhD, DAPA, DABFCScott A. Johnson, MA, DABPS, DAACCEPhilip Kaushall, PhD, DABFE, DABPSEric Kreuter, PhD, CPA, CMA, CFM, DABFA, FACFEI, SPHRRonald G. Lanfranchi, DC, PhD, DABFE, DABFM, DABLEE, CMI-IV

Richard Levenson, Jr., PsyD, DABFE, DABPSMonique Levermore, PhD, FACFEI, DABPS Jonathon Lipman, PhD, FACFEI, DABFE, DABPS, DABFMJudith Logue, PhD, FACFEI, DABFSW, DABPS, DABFE, DABFMJennie Martin-Gall, CMT, CMI-IMike Meacham, PhD, LCSW, DCSW, DABFSWDavid Miller, DDS, FACFEI, DABFE, DABFM, DABFDJohn V. Nyfeler, FAIA, LEED-APJacques Ama Okonji, PhD, FACFEINorva Elaine Osborne, OD, FAAO, CMI-IIITerrence O’Shaughnessy, DDS, FACFEI, DABFDGeorge Palermo, MD, FACFEI, DABFE, DABFMRonald J. Panunto, PE, BSEE Larry H. Pastor, MD, FAPA, FACFEI, DABFE, DABFMTheodore G. Phelps, CPA, DABFAMarc Rabinoff, EdD, FACFEI, DABFEHarold F. Risk, PhD, DABPSSusan P. Robbins, PhD, LCSW, DCSW, LCDC, DABFSW Jane R. Rosen-Grandon, PhD, DABFCDouglas Ruben, PhD, FACFEI, DABFE, DABFM, DABPSJ. Bradley Sargent, CPA, CFS, Cr.FA, DABFAWilliam Sawyer, PhD, FACFEI, DABFE, DABFMVictoria Schiffler, RN, DABFNJohn V. Scialli, MD, FAACAP, DAPA, DABFE, DABFMHoward A. Shaw, MD, DABFMHenry A. Spiller, MS, DABFE, DABAMarylin Stagno, PsyD, RN, DABFE, DABFM, DABPSRichard I. Sternberg, PhD, DABFE, DABPS, FABVE, FFAPPJames R. Stone, MD, MBA, CHS-III, DABFE, DABFMJohann F. Szautner, PE, PLS William A. Tobin, MA, DABFET, DABLEERobert Tovar, BS, MA, DABFE, DABPS, CHS-IIIBrett C. Trowbirdge, PhD, JD, DABPSJeff Victoroff, MA, MD, DABFE, DABFMPatricia Ann Wallace, PhD, FACFEI, DABFE, DABFMRaymond Webster, PhD, FACFEI, DABFE, DABFMDean A. Wideman, MSc, MBA, CFC, CMI-III

Chair of the Executive Board of Advisors: David E. Rosengard, MD, RPh, MPH, PhD, DAPA, FACA, Chair, American Board of Forensic MedicineVice Chair of the Executive Board of Advisors: Michael Fitting Karagiozis, DO, MBA, CMI-V, Chair, American Board of Forensic ExaminersMembers of the Executive Board of Advisors:John H. Bridges III, DSc (Hon.), CHS-V, DABCHS, FACFEI, Chair, American Board for Certification in Homeland SecurityJamie Ferrell, BSN, RN, CFN, CMI-III, Chair, American Board of Forensic NursingDoug E. Fountain, PhD, LCSW, DABFE, DABFSW, Chair, American Board of Forensic Social Workers Raymond F. Hanbury, PhD, FACFEI, DABPS, DABFE, CHS-III, ABPPLee Heath, DABLEE, CHS-V, Chair, American Board of Law Enforcement ExpertsBrian L. Karasic, DMD, MScFin, FACFEI, DABFD, DABFM, DABFE, Chair, American Board of Forensic Dentistry Michael Kessler, Cr.FA, CICA, FACFEI, DABFA, DABFEMarilyn J. Nolan, MS, FACFEI, DABFC, Chair, American Board of Forensic Counselors Thomas J. Owen, BA, FACFEI, DABRE, DABFE, CHS-V, Chair, American Board of Recorded Evidence Gregory Vecchi, PhD, CFC, CHS-V, DABCEM, DABLEE, Chair, American Board of Crisis and Emergency ManagementBen Venktash, DABFET, DABFE, CHSP, REA, FRSH(UK), FIET(UK), Chair, American Board of Forensic Engineering and Technology

Publisher:Robert L. O’Block, MDiv, PhD, PsyD, DMin ([email protected])

Editor in Chief:John Lechliter ([email protected])

Executive Art Director:Brandon Alms ([email protected])

Associate Editor:Kristin Crowe ([email protected])

Associate Editor:Charlyn Ingwerson ([email protected])

Assistant Editor:Amber Ennis ([email protected])

Advertising Representative:Carol Wollard(800) 423-9737 ext. 156 • ([email protected])

6 THE FORENSIC EXAMINER Spring 2008 www.acfei.com (800) 423-9737 Spring 2008 THE FORENSIC EXAMINER 7

The American College of Forensic Examiners Executive Advisory BoardsThe American College of Forensic Examiners Executive Advisory Boards

AMERICAN BOARD OF CRISIS ANDEMERGENCY MANAGEMENTOriginally The American Board of Examiners in Crisis InterventionChair of the Executive Board of Crisis and Emergency Management Advisors: Gregory M. Vecchi, PhD, CFC, CHS-V, DABCEM, DABLEEVice Chair of the Executive Board of Crisis and Emergency Management Advisors: Vincent B. VanHasselt, PhD, DABCEMSecond Vice Chair: Kent Rensin, PhD, DABCEMMembers of the Executive Board of Crisis and Emergency Management Advisors:Sam D. Bernard, PhD, DABCEMMonica Beer, PhD, DABLEMJohn H. Bridges, III, CHS-V, DABCHS, CHMM, DABCEMMarie Geron, PhD, DABCEMRaymond Hamden, PhD, FACFEI, DABPS, DABECI, DABCHS, DAPA, CFC, CMI-V, CHS-V, DABCEMMarilyn Nolan, MS, DABFC, DABCEMRev. Roger Rickman, DABCEM, CHS-V, DABCHS, CFC, CMI-I, FACFEIDebra M. Russell, PhD, CMI-V, CRC, CISM, DABCEMDorriss Edward Smith, Col. U.S. Army, CHS-V, DABCEMAlan E. Williams, MS, CHS-V, DABCEMFounding Members of the Board of Crisis Intervention:James L. Greenstone, EdD, JD, DABCEMW. Rodney Fowler, EdD, PhD, DABCEMSharon C. Leviton, PhD, DABCEM Edward S. Rosenbluh, PhD, DABCEM (1937-2000)

AMERICAN BOARD OF FORENSIC ACCOUNTINGChair of the Executive Board of Accounting Advisors: Michael G. Kessler, Cr.FA, CICA, FACFEI, DABFA, DABFEMembers of the Executive Board of Accounting Advisors:Stewart L. Appelrouth, CPA, CFLM, CVA, DABFA, Cr.FA, ABVGary Bloome, CPA, Cr.FAJules J. Brayman, CPA, ABV, CVA, CFFA, FACFEI, DABFAStephen E. Cohen, CPA, ABV, FACFEI, DABFA, Cr.FA, CVAD. Larry Crumbley, PhD, CPA, DABFA, Cr.FA, CFFA, FCPAJames A. DiGabriele, DPS, CPA, ABV, CFSA, Cr.FA, FACFEI, CVAJune Dively, CPA, DABFA, Cr.FADavid Firestone, CPADavid H. Glusman, CPA, FACFEI, DABFA, Cr.FAEric A. Kreuter, PhD, CPA, CMA, CFM, FACFEI, DABFA, SPHR, CFD, CFFA, BCFTRaimundo Lopez Lima Levi, CPA, DABFADennis S. Neier, CPA, DABFASandi Peters, CPA, Cr.FAJay J. Shapiro, CPA, DABFA

AMERICAN BOARD OF FORENSIC COUNSELORSChair of the Executive Board of Counseling Advisors: Marilyn J. Nolan, MS, DABFCVice Chair of the Executive Board of Counseling Advisors: Steven M. Crimando, MA, CHS-IIIChair Emeritus: Dow R. Pursley, EdD, DABFCMembers of the Executive Board of Counseling Advisors:George Bishop, LPC, LAT, LAC, FACFEI, DABFELaura W. Kelley, PhD, DABFC, LPCRobert E. Longo, FACFEI, DABFCKathleen Joy Walsh Moore, DABFC, CHS-IIIDeeAnna Merz Nagel, MEd, LPC, CRC, DCC, CFCIrene Abrego Nicolet, PhD, MA, DABFCHirsch L. Silverman, PhD, FACFEI, DABFC, DABFE, DABFM, DABPSWilliam M. Sloane, JD, LLM, PhD, FACFEI, DABFC, CHS-III, CMI-I, DACC, DCPC, FAAIM, FACC, MTAPAGary Smith, MEd, FACFEI, DABFEAva Gay Taylor, MS, LPC, DABFC

AMERICAN BOARD OF FORENSIC DENTISTRYChair of the Executive Board of Forensic Dentistry: Brian L. Karasic, DMD, MScFin, DABFD, DABFM, DABFEMembers of the Executive Board of Dental Advisors: Ira J. Adler, DDS, DABFDBill B. Akpinar, DDS, FACFEI, DABFD, DABFE, CMI-VStephanie L. Anton-Bettey, DDS, CMI-VJeff D. Aronsohn, DDS, FACFEI, DABFD, CMI-VSusan A. Bollinger, DDS, CMI-IV, CHS-IIIMichael H. Chema, DDS, FACFEI, DABFD, DABFEJames H. Hutson, DDS, CMI-V, DABFDJohn P. Irey, DDS, CMI-V, LLCChester B. Kulak, DMD, CMI-V, CHS-III, CFCMorley M. Lem, DDS, FACFEI, DABFD, DABFM, DABFEJohn P. LeMaster, DMD, DABFD, CMI-V, CHS-IIIJeannine L. Weiss, DDS

AMERICAN BOARD OF FORENSIC ENGINEERING & TECHNOLOGYChair of the Executive Board of Engineering & Technological Advisors: Ben Venktash, MS, DABFET, DABFE, CHSP, REA, FRSH (UK), FIET (UK)Vice Chair: Cam Cope, BS, DABFET, DABFE2nd Vice Chair: Ronald Schenk, MSc, MInstP, PEng (UK), CHS-IV, CMI-IChair Emeritus: David Hoeltzel, PhDMembers of the Executive Board of Engineering & Technological Advisors:Nicholas Albergo, DABFETKyle J. Clark, DABFETGeorge C. Frank, CFC, DABFE

Robert K. Kochan, BS, DABFET, DABFE, FACFEIJohn W. Petrelli Jr., AIA, NCABB, TAID, DABFETMax L. Porter, PhD, DABFET, DABFE, PE, HonMASCE, Parl, Dipl ASFE, FTMS, FACI, CFCPeter H. Rast, DABFET, DABFE, DABLEE, BS, MSFS, MBAOliver W. Siebert, PE, DABFET, FACFEIKandiah Sivakumaran, MS, PE, DABFETJames W. St. Ville, MD, MS, FACFEI, DABFET, DABFMMalcolm H. Skolnick, PhD, JD, FACFEI, DABFET, DABFE

AMERICAN BOARD OF FORENSIC EXAMINERSChair of the Executive Board of Forensic Examiners: Michael Fitting Kara-giozis, DO, MBA, CMI-VChair Emeritus: Zug G. Standing Bear, PhD, FACFEI, DABFE, DABFMMembers of the Executive Board of Forensic Examiners:Jess P. Armine, DC, FACFEI, DABFE, DABFMPhillip F. Asencio-Lane, FACFEI, DABFEJohn H. Bridges, III, CHS-V, DABCHS, CHMM, FACFEI, DABCEMRonna F. Dillon, PhD, DABFE, DABPS, CMI-V, CHS-IIINicholas J. Giardino, ScD, DABFE, FACFEI, RPIH, MAC, CIHBruce H. Gross, PhD, JD, MBA, DABFE, DABFM, FACFEI, DAPAKenneth M. Gross, DC, FACFEI, DABFE, CMI-IDarrell C. Hawkins, MS, JD, FACFEI, DABFE, DABLEE, CMI-V, CHS-III, F-ABMDII, IAI-SCSA, IAAI-CFIMichael W. Homick, PhD, EdD, DABCHS, CHS-VJohn L. Laseter, PhD, FACFEI, DABFE, DABFM, CMI-IV, CHS-IIIJonathan J. Lipman, PhD, FACFEI, DABFE, DABFM, DABPSLeonard K. Lucenko, PhD, FACFEI, DABFE, CPSIEdward M. Perreault, PhD, DABFEMarc A. Rabinoff, EdD, FACFEI, DABFE, CFCDavid E. Rosengard, RPh, MD, PhD, MPH, FACFEI, DABFE, DABFM, FACAJanet M. Schwartz, PhD, FACFEI, DABFE, DABFM, DABPS, CHS-VRichard Sgaglio, PhD, CMI-IV

AMERICAN BOARD OF LAW ENFORCEMENT EXPERTSChair of the Executive Board of Law Enforcement: Lee Roy Heath, CHS-V, DABLEEVice Chair of the American Board of Law Enforcement Experts: Darrell C. Hawkins, JD, DABLEE, DABFE, CHS-III, CMI-V, Chair Emeritus: Michael W. Homick, PhD, DABCHS, CHS-VMembers of the Executive Board of Law Enforcement Advisors: Alan Bock, CHS-III, DABLEETom Brady, CHS-V, DABLEEGregory M. Cooper, MPA, DABLEEDickson S. Diamond, MD, DABLEE, DABFEJohn E. Douglas, EdD, DABLEELes M. Landau, DO, FACFEI, DABLEE, DABFE, DABFM, CHS-IIIRonald Lanfranchi, PhD, DABLEE, DABFE, CMI-IV, FACFEI, DABFMLeonard Morgenbesser, DABLEEHenry A. Paine, III, PhD, DABFC, CHS-IV, DABLEEJohn T. Pompi, BA, DABLEE, DABFEStephen Russell, DABLEE, CMI-IIGregory Vecchi, PhD, CFC, CHS-V, DABLEE, DABCEMOscar Villanueva, CHS-V, DABLEEDavid E. Zeldin, MA, FACFEI, DABFE, CHS-III

AMERICAN BOARD OF FORENSIC MEDICINEChair of the Executive Board of Medical Advisors: David E. Rosengard, RPh, MD, PhD, MPH, FACFEI, DABFE, DABFM, FACA (apoth.)Vice Chair: Michael Fitting Karagiozis, DO, MBA, CMI-VMembers of the Executive Board of Medical Advisors:Terrance L. Baker, MD, MS, FACFEI, DABFM, CMI-VJohn Steve Bohannon, MD, CMI-IVEdgar L. Cortes, MD, DABFM, DABFE, CMI-V, FAAPAlbert B. DeFranco, MD, FACFEI, DABFM, DABPS, CMI-V, CHS-IIIJames B. Falterman Sr., MD, DABFM, DABFE, DABPS, CMI-IVMalcolm N. Goodwin, Jr., Co. USAF MCFS (Ret.), MD, MS, DABFM, DABFE, FCAP, FACFEIVijay P. Gupta, PhD, DABFMRichard Hall, MD, FACFEI, DABFM, DABFELouis W. Irmisch, III, MD, FACFEI, DABFM, DABFE, CMI-VE. Rackley Ivey, MD, FACFEI, DABFM, DABFE, CMI-VKenneth A. Levin, MD, FACFEI, DABFM, DABFEE. Franklin Livingstone, MD, FAAPM&R, FACFEI, DABFM, DABFE, DAAPMJohn C. Lyons, MD, FACS, MSME, FACFEI, DABFM, DABFET, DABFEManijeh K. Nikakhtar, MD, MPH, DABFE, DABPS, CMI-IV, CHS-IIIJohn R. Parker, MD, FACFEI, DABFM, FCAPAnna Vertkin, MD, CMI-V, DABFMMaryann M. Walthier, MD, FACFEI, DABFM, DABFE Cyril Wecht, MD, JD, FACFEI, CMI-V

AMERICAN BOARD OF FORENSIC NURSINGChair of the Executive Board of Nursing Advisors: Jamie J. Ferrell, RN, BSN, SANE-A, FACFEI, DABFN, DABFE, CFNVice Chair of the Executive Board of Nursing Advisors: Dianne T. Ditmer, PhD, MS, RN, DABFN, CMI-III, CFN, FACFEI, CHS-IIIMembers of the Executive Board of Nursing Advisors:Marilyn Bello, RNC, MS, CMI-V, CFC, CFN, SAFE, DABFN, DABFERose Eva Bana Constantino, PhD, JD, RN, FACFEI, DABFN, DABFE, CFNRenae M. Diegel, RN, SANE-A, CMI-III, CFC, CFN, CEN

Lo M. Lumsden, ANP, GNP, EdD, CFN, DABFN, DABFE, CHS-IIIYvonne D. McKoy, PhD, RN, DABFN, FACFEIDiane L. Reboy, MS, RN, CFN, LNCC, FABFN, CNLCP, LNCC, FACFEI, DABFNSuzette Rush-Drake, RN, BSN, PsyD, DABFN, DABFERussell R. Rooms, MSN, RN, CMI-III, CFN, DABFN, APRNElizabeth N. Russell, RN, BSN, CCM, DABFN, BC, FACFEILeAnn Schlamb, RN-BC, MSN, CFN, DABFNSharon L. Walker, MPH, PhD, RN, CFN

AMERICAN BOARD PSYCHOLOGICAL SPECIALTIESChair of the Executive Board of Psychological Advisors: Raymond F. Hanbury, PhD, DABPS, DABFE, ABPP,FACFEI, CHS-IIIVice Chair of the Executive Board of Psychological Advisors: Raymond H. Hamden, PhD, FACFEI, DABPS, DABCEM, DABCHS, DAPA, CFC, CMI-V, CHS-VChair Emeritus: Carl N. Edwards, PhD, JD, FAAFS, FICPP, FACFEI, DABPS, DABFE Members of the Executive Board of Psychological Advisors:Carol J. Armstrong, PhD, LPC, DABPSRobert J. Barth, PhD, DABPSMonica Beer, PhD, DABLEMJohn Brick, III, PhD, MA, FAPAAlan E. Brooker, PhD, FACFEI, DABPS, DABFM, DABFE, CMI-III, ABPP-CnBrian R. Costello, PhD, FACFEI, DABPS, DABFERonna F. Dillon, PhD, DABPS, DABFE, CMI-V, CHS-IIIBrent Van Dorsten, PhD, FACFEI, DABFE, DABFM, DABPSDouglas P. Gibson, PsyD, MPH, DABPS, CMI-V, CHS-IIIThomas L. Hustak, PhD, FACFEI, DABPS, DABFERichard Lewis Levenson, Jr., PsyD, FACFEI, DABPS, DABFE, CTS, FAAETSStephen P. McCary, PhD, JD, DABFE, DABFM, DABPS, FACFEI, FAACP, DAPAHelen D. Pratt, PhD, FACFEI, DABPSDouglas H. Ruben, PhD, FACFEI, DABPS, DABFE, DABFMRichard M. Skaff, PsyD, DABPSCharles R. Stern, PhD, DABPS, DABFE, CMI-VJoseph C. Yeager, PhD, DABFE, DABLEE, DABPSDonna M. Zook, PhD, DABPS, CFC

AMERICAN BOARD OF RECORDED EVIDENCEChair of the Executive Board of Recorded Evidence Advisors: Thomas J. Owen, BA, FACFEI, DABRE, DABFE, CHS-VCommittee of the American Board of RecordedEvidence Forensic Audio: Ryan Johnson, BA, DABFE, DABREForensic Voice Identification: Ernst F. W. Alexanderson, BA, MBA, FACFEI, DABRE, DABFE Members of the Executive Board of Recorded Evidence Advisors:Eddy B. Brixen, DABFETCharles K. Deak, BS, CPC, DABFE, DABLEEMichael C. McDermott, JD, DABRE, DABFEJennifer E. Owen, BA, DABRE, DABFELonnie L. Smrkovski, BS, DABRE, DABFE

AMERICAN BOARD OF FORENSIC SOCIAL WORKERSChair of the Executive Board of Social Work Advisors: Douglas E. Fountain, PhD, LCSW, DABFE, DABFSWChair Emeritus: Karen M. Zimmerman, MSW, DABFSW, DABFEMembers of the Executive Board of Social Work Advisors:Susan L. Burton, MA, LMSW, MSW, DABFSW, DABFEJudith V. Caprez, MSW, ACS, LSCSW, DABFSWPeter W. Choate, BS, MSW, DABFSW, DABFEJudith Felton Logue, PhD, FACFEI, DABFSW, DABFE, DABFM, DABPSMichael G. Meacham, PhD, LCSW, DCSW, DABFSW, FACFEIKathleen Monahan, DSW, MSW, CFC, DABFESusan P. Robbins, PhD, DABFSW, LCSW, DCSW, BCD, LDCSteven J. Sprengelmeyer, MSW, MA, FACFEI, DABFSW, DABFE, LISW

AMERICAN BOARD FOR CERTIFICATION INHOMELAND SECURITYChair of the Executive Board for Certification inHomeland Security: John H. Bridges, III, D.Sc. (Hon.) CHS-V, CHMM, CSHM, DABCHS, FACFEILt. Colonel Herman C. Statum, United States Army (Ret.), CHS-V, CPP, MS, PI, DABCHSRobert R. Silver, CHS-V, PhD, MS, DABCHSMembers of the Executive Board for Certification in Homeland Security:Chair Emeritus of the Executive Board for Certification in Homeland Secu-rity: Nick Bacon, CHS-V, DABCHSThomas Baines, MA, MPA, JD, CHS-V, CFCE. Robert Bertolli, OD, CHS-V, CMI-V, DABCHS, DABFEPaul P. Donahue, CHS-V, MBA, Cr.FA, CMA, CPP, CBMBilly Ray Jackson, ATS, CSC, CHS-V Andrew Jurchenko, Col. U.S. Army (Ret.) CHS-V, DABCHSRobert McAlister, CHS-V, DABCHSJanet M. Schwartz, PhD, CHS-VEdward W. Wallace, CHS-V, Detective 1st Grade (Ret.), MA, SCSA, LPI, BS CFI I & II, CLEI, CTO, CDHSIEric White, CHS-V, DABCHS, BS


P olice officers, fire fighters, and other public servants seldom receive sala-ries that recognize and fully reward the contributions they make. Their

jobs often carry high risks, and too many make the ultimate sacrifice as they work to protect and serve others. When a chaplain carries out the most dread-ed duty and knocks on a front door to deliver terrible news, a family is left reeling. The line-of-duty death of a spouse, a father, or a moth-er, is a blow to the gut that few can compre-hend. The good news is that families of the fallen have a great resource for support in many com-munities across the country. Service organizations known as “100 Clubs” have been raising money and providing help to grieving families for more than 50 years. But the bad news is that many pub-lic safety servants work in communities that have no such resource. Beside their personal loss, they must deal with the loss of income from a family member killed in the line of duty. Bills can start to mount up, adding financial stress to the un-fathomable emotional strain that grips families. Forensic professionals who work close-ly with law enforcement officers and public safety workers are among those most affected by line-of-duty deaths, and many will want to know how to provide help to families in need. In areas served by 100 Clubs, helping is made easy by the organization. Anyone not residing in an area served by a 100 Club has the option of starting an organization, just as the original clubs were founded.

100 Clubs Arise From Family NeedsMore than a half-century ago, the Saturday Evening Post reported on the formation of the first 100 Club. The Post article, “The Bluecoats’ Best Friends” states that a Detroit businessman, Bill Packer, who owned the larg-est Plymouth dealership in the world, came up with the idea for the organization. The Post reported that Packer’s friend, a po-lice sergeant, had been seriously wounded in a shooting. As his friend lingered between life and death, Packer came to realize that officers often faced danger. He knew that his friend’s family would be financially devastated by the loss of his

income. His friend recovered, but later Packer heard the story of a Detroit officer who was killed while making a routine arrest. The offi-cer’s wife had just sold her small beauty parlor business because she was expecting the couple’s second child. Packer relied on what he knew best and took an entrepreneurial approach to forming an association of business leaders who would join together to provide financial assistance to the family. He wrote to 100 of Detroit’s elite businessmen and enlisted the aid of a local newspaper columnist. The idea was to raise enough funds to pay off all of the family’s bills, and to provide enough financial support to get the family back on its feet. With the generous contribu-tions, the family’s house was more than paid for, with enough money left over to supple-ment the $170 a month pension the widow received. A few years later, the 100 friends of Packer got together again to raise money for a college fund for the widow’s youngest child. Then another Detroit officer died in the line of duty, and the businessmen got together again to provide a helping hand.

Packer saw the need for a permanent and more formal organization, and he helped found the “100 Club” in 1952. Soon more business leaders began to flock to such a worthy cause, and the ranks surpassed 200, then 300. Unfortunately, it didn’t take long for the or-ganization’s services to be needed. A motorcy-cle patrolman died in an accident in a Detroit intersection. The 100 Club responded imme-diately, giving the officer’s widow $7,500 to pay off the mortgage on the family home (ad-justed for inflation, that’s more than $56,000 today). Soon the 100 Club gained notoriety through media reports such as the 1956 article in the Saturday Evening Post. Other communities be-gan to copy the success, and the entrepreneurial associations sprang up in many larger cities.

100 Clubs TodayToday 100 Clubs number more than 100, and they extend from coast to coast. Some clubs, such as the Phoenix 100 Club, serve their en-tire state. Most serve specific communities. The largest and second-oldest 100 Club is Houston’s, which boasts more than 27,000 members.

Giving Back

By John Lechliter, Editor in Chief


100 Clubs Help Families of FallenOrganizations Provide Support and Financial Gifts

Rick Hartley has directed Houston’s 100 Club for 14 years and has personally delivered checks and encouragement to many families. He said re-cently from his Houston office that in an average year three Houston-area public safety workers, including law enforcement officers, fire fighters, and paramedics, die in the line of duty. In 2007, the number was five. Hartley explained how the process works. “First, there has to be a line-of-duty death,” he said. “And there have to be dependents of the of-ficer or fire fighter who was killed in the line of duty. The first thing we do, within 24 to 48 hours, is to get them a check for $10,000 to help with any of their immediate financial needs.” “Then when the time is better, and some of the trauma and tragedy has subsided, we will go and meet with the surviving spouse and make a complete needs assessment . . . sadly, there are usually a few youngsters under the age of 12. We take all that under consideration with a goal of trying to eliminate their debt—pay off their mortgage, pay off their vehicle, notes, credit card debt, anything that’s outstanding.”

The 100 Club doesn’t stop there, often go-ing on to pay for the education of the children through college or trade school. The total gifts to a single family average $300,000, Hartley said. The organization will step in and help out even years after the loved one’s death, based on needs of individual families. Families get federal and state funds after a line-of-duty death, but that often is not enough to pay all the bills and pay for the family’s living expens-es. About two-thirds of the membership of the Houston 100 Club is comprised of members who donate $100 a year to the organization. The other third is made up of life members who donated $1,000 to the cause. Helping families of fallen heroes is a reward-ing job, Hartley said. He particularly remembers the case of a Houston officer’s widow, who was stricken with multiple sclerosis. The 100 Club bought the woman a new house and filled it full of handicapped-accessible equipment. Families are often overwhelmed by the support they get from the 100 Club. Many family members

s The families of nine firefighters killed while battling a fire in June 2007 were escorted behind nine fire helmets that were placed on each coffin during memorial service in Charleston, South Carolina. (Gerry Melendez/The State/MCT)


ARKANSAS

The 100 Club of ArkansasBentonville1-479-442-2503

ARIZONA

100 Club of ArizonaPhoenix(602) [email protected]

CALIFORNIA

The Martin C. Kauffman One Hundred Club of Alameda Co.Concord1-510-818-0337

The Hundred Club of Contra Costa [email protected]

The Hundred Club of Los [email protected]

The Hundred Club of Palm SpringsPalm [email protected]

The One Hundred Club of Santa Clara CountyMilpitas1-408-262 0656

COLORADO

The Hundred Club of Colorado SpringsColorado [email protected] & [email protected]

The Hundred Club of [email protected]


CONNECTICUT

The Hundred Club of Connecticut, Inc.Glastonbury1-203-633 [email protected]

DISTRICT OF COLUMBIA

Heroes, Inc.Washington, D.C.1-202-638-6658

FLORIDA

The Hundred Club of Broward County, Inc.Fort [email protected]

The Collier County One Hundred [email protected]

The Hundred Club of Indian River County, Inc.Vero [email protected]

The 200 Club of Jacksonville, Inc.Jacksonville1-904-384-7100

Lee County Hundred ClubFort MyersFlorida1-239-334-9191

The Manatee County Hundred ClubBradenton1-941-749-0005

[email protected]

100 Club of Martin CountyStuart1-772-283 [email protected]

The Two Hundred Club of Greater Miami, Inc.Coral [email protected]

The One Hundred Club of Monroe [email protected]

Committee of One Hundred, Orange CountyOrlando1-407-422 6105At time of a LOD death, $5,000.00 to surviving spouse.

The Osceola County Hundred Club, Inc.KissimmeeFlorida1-407-846-4129

Sarasota County Hundred ClubSarasota1-941-953 5383

The Hundred Club of South Palm Beach CountyDeerfield [email protected]

The 100 Club of St. Lucie CountyPort St. Lucie1-772-340-3500

GEORGIA

The 300 Club of Atlanta, [email protected] or [email protected]

The 200 Club of the Coastal [email protected]

The Shield Club (Macon and Bibb Counties)Macon1-478-750-93381-478-738-9214

The 100 Club of Rabun CountyP.O. Box 18Clayton1-706-782-5034

ILLINOIS

The 100 Club of Chicago - The Hundred Club of Cook County1-312-346 [email protected]

The Hundred Club of DuPage [email protected]

The Hundred Club of East Central Illinois, Inc.Watseka1-815-473-4404

The Hundred Club of Jo Daviess CountyGalena1-815-777-9356

The Hundred Club of Kankakee CountyKankakee1-815-933-5529

The One Hundred Club of Lake CountyLibertyville1-708-681 1700

The Hundred Club of Will [email protected]

INDIANA


KENTUCKY

The One Hundred Club of Eastern Kentucky, Inc.Ashland1-606-324 6905

Bluecoats of Louisville, Inc.Louisville1-502-454 5192

LOUISIANA

The 100 Club of Lafayette, [email protected]

MARYLAND

The One Hundred Club of Anne Arundel County, [email protected]

MASSACHUSETTS

The Hundred Club of Mass. Inc.Boston1-617-536-4410

MICHIGAN


Hundred Club of FlintMetamora1-810-599-3751lpeterman@centurytel,net

The William S. Martens Hundred Club Fund of Grand Rapids Community FoundationGrand Rapids1-616-454 [email protected]


The One Hundred Club of SaginawSaginaw1-989 792 [email protected]

Washtenaw One Hundred, Inc.Ann Arbor1-734-741-0400

MINNESOTA

Minnesota 100 ClubSt. Paul1-651-487-2955

MISSOURI

The Backstoppers, Inc. - Police Officer, Firefighter Fund of St. Louis10411 Clayton Rd., Ste. [email protected]

Greene County 100 ClubSpringfield1-417-864-1782

The Masters (Missouri State Highway Patrol Benevolent Fund), Inc.Doug LiblaPoplar [email protected]

SAFE (Surviving Spouse and Family Endowment Fund)3100 Main Street, Ste. 201Kansas [email protected]

MONTANA


NEBRASKA

100 Club of Omaha Fund of the Metropolitan Police and Fire Foundation of OmahaOmaha1-402-348 6346

NEW HAMPSHIRE

The Hundred Club of New [email protected]

NEW JERSEY

The 200 Club of Bergen [email protected]

200 Club of Burlington [email protected]

Camden County Hero Scholarship FundBerlin1-856-768 [email protected]

Cape May & Atlantic Counties 200 ClubNorthfieldcapeatlantic200club.org

200 Club of Essex CountyP. O. Box [email protected]

200 Club of Hudson CountyBayonne1-201-858-4925

200 Club of Hunterdon County, NJ, Inc.Clinton1-908-730 [email protected]

The 200 Club of Middlesex [email protected]

200 Club of Monmouth CountySpring Lake1-732-449 [email protected]

The 200 Club of Morris [email protected]

200 Club of Ocean CountyPt. Pleasant Beach1-732-244 5900

Passaic County 200 [email protected]

The 200 Club of Somerset CountySomerville1-908-526 2565 x-206member_somersetcounty200club.org

The Two Hundred Club of Union County

Scotch Plains1-908-322-2422

200 Club of Warren [email protected]

NEW YORKThe 100 Club of [email protected]

Silver Shield FoundationNew [email protected]

The Hundred Club of Westchester, Inc.White Plains1-914-948 [email protected]

OHIO

Bluecoats, Inc. (Cleveland)Cleveland1-216-861 [email protected]

The Hundred Club of DaytonDayton1-937-254-2917

Geauga Bluecoats, IncorporatedChagrin Falls1-440-729-4488

The Hillcrest 100, Inc.Mayfield Heights1-440-829-9714

Lake County Blue Coats, Inc.Willoughby1-440-953-1818

Bluecoats of Medina County, [email protected]

Stark County [email protected]

State Troopers of OhioCleveland1-216-267-7100, Ext. [email protected]

Bluecoats, Inc. of Summit [email protected]

Hero Scholarship Fund of [email protected]

RHODE ISLAND

100 Club of Rhode Island, Inc.Providence1-401-421 2500

TENNESSEE

The 100 Club of [email protected]


TEXAS


100 Club of Aransas [email protected]

100 Club of Brazoria CountyLake Jackson1-979-297-5910

The 100 Club of Central Texas*[email protected]

100 Club of Central Texas Harker [email protected]

The 100 Club of Comal CountyNew Braunfels1-830-626-5554

The Dallas Blue FoundationDallas1-214-369-2583

Hundred Club of Denton, TX Support Our Shields [email protected]

Hundred Club of Gillespie [email protected]

The 100 ClubMr. C. F. Kendall IIHouston1-713-952 [email protected]

Hill Country 100 [email protected]

The 100 Club of Jefferson & Hardin [email protected]

The 100 Club of Matagorda CountyBay [email protected]

100 Club of [email protected]

The Hundred Club of San AntonioSan [email protected]

The Victoria 100 ClubVictoria1-361-578-1502

The Hundred Club of Wharton County, Inc.El Campo1-979-543-1040

The Hundred Club of Wichita FallsWichita Falls1-940-767-9256

SOUTH CAROLINA

The Hundred Club of South Carolina, Inc.Mt. Pleasant1-843-559-5764

The 100 Club of Greater GreenvilleMr. Philip J. CarltonGreenville1-864-213-8000

The One Hundred Club Fund The Spartanburg County FoundationSpartanburg1-803-582 0138

WISCONSIN

Blue Coats Foundation, Inc.Milwaukee1-414-962-3918

100 Clubs in the United States

INFORMATION COURTESY 100 CLUB OF CHICAGO

Giving Back


have gone on to join the organization so they can help other families cope with their losses. “It’s very rewarding work,” Hartley said of his job.

Clubs of All SizesMost 100 Clubs are much smaller than the Houston organization. For instance, the Greene County 100 Club based in Springfield, Missouri, formed recently with a mission to provide aid to families of police officers and firefighters who are killed in the line of duty. Police and fire fatalities are rare in Greene County, with years often separating the on-duty loss of public safety personnel. John Rush, president of the organization, said that the hardest tasks in forming the group in-volved finding insurance and filling out all the paperwork and meeting requirements to be rec-ognized as a tax-exempt 5013c organization. After many months of organizing, the group officially formed in June of 2007 and was quickly faced by the loss of a police officer in a traffic accident.

“We heard of the officer’s death around 4 in the morning, and by 8 o’clock we had a check in the hands of the widow,” Rush said. The organization currently provides $5,000 checks to families. Although losing firefighters and police is a rare occurrence, the Greene County 100 Club is raising funds with the goal of being able to respond should a tragedy strike that produces multiple casualties.

More 100 Clubs NeededThe website of the Chicago 100 Club has a directory of 100 Clubs across the nation. According to that listing, there are no clubs serving Alabama, Delaware, Idaho, Iowa, Kansas, Maine, North Carolina, North Dakota, New Mexico, Oklahoma, Oregon, South Dakota, Utah, Vermont, Virginia, Washington, West Virginia, or Wyoming. Many 100 Clubs serve only specific communities, so large portions of many of the remaining states are not served by clubs, either.

There is no national organization that unites the individual clubs, Hartley said. A few years ago a national meeting was held in an effort to foster sharing of information and ideas, but only about 30 clubs sent rep-resentatives. The only things needed to bring 100 Clubs to more areas are people who care and the en-trepreneurial spirit to organize a group where none existed before. Hartley said he would be happy to provide information to anyone who wants to establish a 100 Club in an unserved community. The Houston 100 Club has information packets that can help organizers get started. There will, unfortunately, always be fami-lies in need, but whether they get help from organizations such as 100 Clubs depends on luck and geography. People willing to step forward and establish new clubs can improve the odds and make the lives of more families a little easier after they have experienced the worst losses imaginable.

s A fireman stands alongside the nine caskets of the fallen firefighters during the memorial service on June 22, 2007, in Charleston, South Carolina. A fire that started at a furni-ture store eventually led to the roof collapsing, trapping 16 firefighters and killing nine in the worst firefighting disaster since the Sept. 11, 2001, terrorist attacks. (C. Aluka Berry/The State/MCT)


Giving Back


s Collage is comprised of newspaper articles taken from The Dallas Morning News, showing the coverage of the days that followed the August 21, 1975, shooting death of police officer Alvin Duane Hallum. Officer Hallum died dur-ing a shootout with a man who was suspected of extorting more than $6,000 from his former employer at gunpoint.

He Was Everyone’s Best FriendLine-of-Duty Death of Close Friend Inspires Dr. Robert L. O’Block to Support 100 Clubs


A lvin Duane Hallum was a young cop everyone loved. Not even 30, he was smart, dedicated—and as one Dallas Morning News headline

stated in large type—he had “a bright future.” “He was the kind of person who ev-eryone thought was their best friend,” recalls Dr. Robert L. O’Block, found-er and CEO of the American College of Forensic Examiners Institute, and one of Hallum’s close friends. “He just had that kind of personality.” Hallum never had the chance to live his bright future. His young son lost his father too soon, and his wife lost the support and close relationship her husband had provided. All were taken away on August 21, 1975, in the parking lot of a Dallas gas station. A gunman described as deranged killed Hallum during a shoot-out that also wounded a fellow officer.

Kansas OfficersO’Block and Hallum had met during the early 1970s in Crawford County, a largely rural area in southeast Kansas that contained the small towns of Pittsburg and Frontenac. Both were dispatchers for the Frontenac Police Department, and both were attending Kansas State College of Pittsburg. Hallum had grown up near the southeast Kansas town of Coffeyville, which was made famous as the site of the last ride of the infamous Dalton gang on October 5, 1892. Absorbing tales of the bank-robbing bandits, Hallum became an Old West history buff, and he often entertained his fellow officers with stories of General Custer, Doc Holiday, Wyatt Earp, and other western legends. O’Block recalls riding on patrol with Hallum until 3 a.m., going out to shooting ranges with his friend, and getting together to reload shells. O’Block also remembers the end of an early-morn-ing patrol shift in 1973, when a routine traffic stop could have gone very badly, and Hallum arrived in the nick of time to help. The young O’Block was patrolling at about 3 a.m. when he spotted a car that seemed out of place. The drivers appeared suspicious, so he followed them as they drove out of town. He couldn’t make out the license plate at first, and when he radioed back, Hallum, who was also

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Giving Back


on duty at the time, told him over the radio not to stop the vehicles alone. Later, after O’Block got the license number, the dispatcher reported back that the NCIC system showed that the car was stolen. After following the cars for several miles, O’Block flashed his lights to pull them over. Before he could even put his patrol car in park, two thugs had bounded out of the car and headed for him. It could have been a deadly situation for a lone officer, but Hallum had arrived seconds after O’Block got the suspects stopped. Later they learned that the suspects were from the Kansas City, Missouri area, where they had previously been arrested for robbing a U.S. Post Office and assaulting a police officer. The suspect’s car contained $5,000 worth of stolen goods taken from a store in Pittsburg.

Time in TexasHallum eventually moved to Texas to take a position with the Dallas Police Department. True to his personality, he won many friends during his time in the police academy. One fellow academy graduate recalled to the Dallas Morning News that Hallum quickly became a popular recruit at the academy, and he was elected vice president of his class.

“We have a special place in our hearts for Duane,” officer R. E. Dummer said of Hallum. After graduating in April of 1975, Hallum hit the streets of Dallas. It was a big change from Crawford County, and it took a differ-ent kind of work as an officer to maintain law and order in an urban setting. In August, Hallum was riding with one of the top training officers on the Dallas force. “He couldn’t have been with a better, more experienced officer,” O’Block recalls. The two spotted a white Cadillac in a gas station parking lot that matched the descrip-tion of a stolen car being used by a man who had forced his former boss at gunpoint to withdraw cash from a Dallas bank. Inside the car was Clois Ray Carter, who had been described as paranoid and mentally disturbed. He was armed with a rifle also taken from his former employer. Carter had no intention of being taken qui-etly. He opened fire on the officers, wounding the training officer. Hallum emptied his revolver, wounding Carter, but as he was reloading Carter rushed at him and shot him in the head. The suspect calmly got back in his car and drove off, but he didn’t get far before he was halted by Dallas officers and FBI agents, and

he died in a storm of bullets. O’Block remembers hearing the news of his friend’s death. It was so surreal to him that it took three days to fully sink in. Hallum’s memorial drew more than a thou-sand Texas officers, and those who knew him best buried their faces in their hands and wept. O’Block said that traditionally in Kansas of-ficers each contribute a $100 bill to the family of a fallen officer. The money was gathered into an envelope and passed to Hallum’s widow at the funeral.

In Memory of His FriendDr. O’Block has become a Founding Member of the Greene County 100 Club in Springfield, Missouri, in honor of his friend. He wants to make promoting 100 Clubs the official charity for the ACFEI, and he encour-ages members to seek out and join 100 Clubs in their communities and to organize clubs in areas not served by the existing organizations. There is a need for many more clubs, as well as national support and coordination for the individual clubs. For the Houston 100 Club’s information on how to organize a 100 Club, go to the Examiner website, www.theforensicexaminer.com, and click on the link to this story.

A Day on the JobOn May 15, 1990, Carl Wayne Buntion was released on parole from a 15-year prison sen-tence for the sexual assault of a child (Texas Department of Criminal Justice [TDCJ], 2007; Buntion v. Dretke, 2006; Buntion v. State, 1995; People v. Buntion, 1991). At his release, Buntion was ordered to report to the Texas House in Houston by the end of the week. Failing to do so, he was immediately in direct violation of his parole. Six weeks after his release, Buntion had no stable residence, no job, was carrying a handgun, and was constantly in the company of John Earl Killingsworth (then, age 42), an ex-con who had an older-model Pontiac. On June 27, 1990, Buntion and Killingsworth had cashed in some scrap metal for less than $10. They used the money to buy beer, which they drank as they drove around Houston, looking for someone “easy” to rob. At approximately 7:45 p.m., the two stopped at a red light at the inter-section of Airline and Lyerly, near the Houston Community College’s Northeast College cam-pus and a strip mall. Also at the intersection was James Bruce Irby. Born in Houston on May 25, 1953, Irby joined the Houston Police Department in the fall of 1972, following in his grandfather’s foot-steps. Ten years later, Irby was accepted into the Solo Motorcycle Detail, which was considered an “elite” assignment. On June 27, 1990, he was driving patrol, which brought him to Airline and Lyerly. When the light turned green, Killingsworth (who was driving) “burned rubber,” attracting the attention of Officer Irby. Noting several lighting violations, Irby pulled the Pontiac over, with both vehicles near the parking lot of the community college.

By the time Irby dismounted his motorcycle, Killingsworth had exited, meeting the officer at the rear driver’s side of his car. After talk-ing briefly with Killingsworth, Irby walked up to the driver’s side door, where he leaned into the car and spoke to Buntion for a few mo-ments. Returning to the rear of the car, Irby and Buntion continued talking peacefully. An officer who passed by in a patrol car received an “all okay” signal from Irby, indicating he needed no help with his routine traffic stop. According to witnesses, it was at this point that Buntion got out of the passenger side of the Pontiac. Officer Irby immediately motioned him back into the car. Instead, Buntion leaned into the car, where he retrieved a .357 Magnum re-volver. Holding the gun in both hands, Buntion began walking calmly to the rear of the car, and when he was approximately five feet away from Officer Irby, Buntion shot him once in the fore-head. With Irby lying face-down on the ground, Buntion shot him three more times in the back and head before fleeing on foot. As Buntion ran, two witnesses approached the scene. One, security guard Richard Castillo, picked up Officer Irby’s gun and held it on Killingsworth. The other, Elmore Breaux, used the radio on Irby’s motorcycle to call for help. The officer who had received the “all okay” from Irby returned to the scene and attempted mouth-to-mouth resuscitation. As Buntion fled through the parking lot, he came upon two women in a car who witnessed the shooting. As Buntion approached the car (most likely with the intention to take the ve-hicle for his escape), the driver put the car in re-verse. As she was driving away, Buntion began firing, wounding both females with bullets and/

By Bruce Gross, PhD, JD, MBA, FACFEI, DABFE, DABPS, DABFM, DAPA

A ccording to the most recent research data available from the Bureau of Justice Statistics, an average of 1.7 million non-fatal, violent victimizations occurred in the United States workplace every year between 1993 and 1999 (Duhart, 2001). This figure represents 18% of all violent crime during that period. Along with non-fatal violence, approxi-

mately 900 work-related homicides took place each year, with more than 80% being committed with firearms. White workers had a rate of victimization by workplace violence that was 25% higher than black workers and 59% higher than that suffered by all other races included in the study. In terms of risk-by-profession, law enforcement officers had the highest rate of victimiza-tion at 260.8 per 1,000, followed by corrections officers at 155.7 per 1,000 (see Table 1) (Bureau of Justice Statistics [BJS], 2001).

Officer Down: Characteristics of Cop Killings

Commentary

s Officer James Bruce Irby


or fragments of shattered glass. Buntion then ran into a nearby delivery service business, where he took an employee’s car at gunpoint. Although the car initially started, it almost immediately died and, as Buntion was unable to restart it, he ran back into the delivery store as the employees inside ran out. An officer, who was nearby when the call to as-sist went out, drove by the scene and saw that Irby was being attended to. He also noticed a group of bystanders frantically motioning him to a nearby business. When the officer arrived at the store-front, for unknown reasons, Buntion essentially “gave up” with no more shots being fired.

At the End of the DayOfficer Irby was taken to the hospital, where doctors pronounced him dead on arrival. The autopsy revealed that at least three of the four bullet wounds Irby had suffered would have been fatal on their own. A happily married fa-ther of two children (a son who was just under 2 years old, and a daughter who had just turned 1), Officer Irby was just 37 years old at the time of his death. After Buntion had surrendered to the police, Killingsworth consented to a search of his car, where officers found a container with traces of heroin in the trunk. Although he was not charged in relation to the shooting death of Officer Irby, Killingsworth was charged with possession. In early 1991, he was sentenced to 5 years in prison, but he was released in July 1992 under mandatory supervision. Buntion soon admitted that he shot Officer Irby, but he claimed it was in self-defense. According to Buntion (but contrary to witness reports), Irby was full of rage and shouting that he was going to kill Killingsworth and him for “spinning out.” Saying later that he was afraid that Irby would kill him, Buntion shot first. The following day Buntion was indicted for the capital murder of Officer Irby. Convicted on January 23, 1991, after less than an hour of delib-eration, Buntion was sentenced to death by lethal injection. Received into the Texas Department of Criminal Justice on March 6, 1991, Buntion (now age 63) has been on death row ever since.

Killing a CopThe Federal Bureau of Investigation (FBI) has conducted a series of three, year-long studies of fatal and non-fatal felonious assaults on law en-forcement officers throughout the United States (Pinizzotto, 2006; FBI, 1996–2006). In the most recent study, from a pool of more than 800 in-cidents, the researchers conducted in-depth in-vestigations of 40. Those 40 involved 50 officers and 43 perpetrators (13 of whom admitted gang

By Carl Wayne BuntionHe squealed like a pig caught under a gate This man about evil, corruption and hate For years he led me around by the nose So I came to expect a thorn with a rose I spent my days with the weed and the wine This man-made haze I could kick anytime And I told myself that, every day But that old devil sort’a had his own way My friends were few and far between But I didn’t care, you know what I mean? It was all about the business of staying high You pay for your ticket if you want to fly I rode that horse through the man-made snow A speed-ball jockey with nowhere to go I didn’t care if I crashed and burned That’s the price you pay for the lesson you learn I went to prison, I went to jail I’ve OD’d often at the gates of hell But someone always brought me back I thought I was bullet-proof, and that’s a fact The years went by and my hair turned gray My body grew weak and my mind it strayed Sometimes I’d even forgot my own name Was it Satan, or was it I to blame? I found myself trading lead with a cop And he lay dead before I could stop It took one hour, they convicted me It was self-defense but they couldn’t see So I turned to the Father and the Holy Ghost My long ride was over, when I knew I was toast He comforts me in my final days So remember this tale when you hear someone say, “Psssst, you want’a J?”

This and several other of Buntion’s poems can be seen on his web page, http://www.deathrow-speaks.info/inmates/carl-buntion.html or http://cca-dp.org/carlbuntion.htm.


affiliation/membership and involvement in drug trafficking). These investigations included inter-viewing survivors (officers and perpetrators), re-viewing records, and visiting crime scenes. In terms of the general characteristics of felo-nious assaults on law enforcement officers, an analysis of the data revealed that the vast ma-jority took place after dark, on alleys, streets, or highways. As might be expected, most assaults occurred after the officer had initiated contact with the “to-be” offender. In many of the inci-dents, more than one officer was present.

Victim-OfficersMost of the victim-officers had had approxi-mately 10 years of experience on the job and had made a conscious effort to improve the pub-lic’s perception of law enforcement. They were described by others as being laid back and easy going, which perhaps resulted in their “letting down their guard” too readily. Many of the vic-tim-officers were apt to not follow procedures or departmental policy for traffic stops and arrests. Frequently they did not wait for back up to ar-rive before engaging the to-be offender. Victim-officers were confident in their ability to “read” people and control situations, yet they failed to see the assault coming. Perhaps because of their more “relaxed” ap-proach, victim-officers were not as observant as they might have been regarding concealed weap-ons. Ironically, a number of the officers worked off-duty as security guards at nightclubs. Although they were described as doing a very good job at identifying those club-goers who were carrying weapons, when the officers were back on the job, it was as if they “turned off” that skill and were uni-formly startled when a suspect pulled out a gun. According to the research, those offenders who ultimately assaulted or killed an officer of-ten showed one or more signs of being armed that the victim-officer missed. These indicators included “unnatural” bulges at the waist, small of the back, or crotch; clothing that was inappro-priate for the weather; moving without bending at the waist; and/or a stiff or “odd” gait. Another frequent indication was unconscious touching of the area where the gun was hidden, as if check-ing to be sure it had not slipped. Also, some of the offenders bladed their body, or turned side-ways to the officer. Officers often assume this of-fensive posture to protect the core of their body. When a suspect blades, officers might presume the suspect is anticipating gunfire and immedi-ately conduct a weapons search. In general, the FBI recommends that officers never assume a suspect is unarmed. Of note, male offenders consistently identified female officers, includ-ing female correctional officers, as doing a much

more thorough job of searching for weapons. Those victim-officers who survived assaults were known to be exceptionally determined persons who, in general, do not “give up” eas-ily. Many continued to engage the offender even after being seriously injured. Surviving officers believed their injuries were less severe and/or they were saved because they were wearing soft body armor at the time. The majority of victim-officers had solid work histories with good performance evaluations. Supervisors and colleagues described them as hard workers. Most were physically fit, not fa-tigued at the time of the incident, and their at-tention and concentration were not impaired by preceding personal or professional events. Overall, the victim-officers had stable family lives. Virtually all were well liked, friendly by nature, and most were involved in community activities.

Suspect-Turned-OffenderA little more than 95% of suspects who com-mitted a felonious assault on a law enforcement officer were male. It should be noted that the number of female offenders has been increas-ing across the three FBI studies; that is, more females (and not just gang members/affiliates) are armed today than 20 years ago. Despite this, both male and female officers tended to regard female suspects as “less of a threat” and assumed they would not have a weapon. There was a near-even racial split between white and non-white suspect-offenders, and there was an average age of 26. As might be ex-pected, most offenders came from dysfunctional families, with few-to-no positive adult role mod-els or influences. Most were raised in impov-erished, crime-ridden neighborhoods and had minimal pro-social opportunities. Poorly edu-cated, most had had an unstable work history. A significant number of offenders were diagnosed with an antisocial personality disorder at some time in their life and had an overriding sense of entitlement. More than half of the offenders had criminal histories for which they had received some de-gree of punishment. The most common prior crimes included weapons violations, robbery, as-sault, and other violent crimes. While most of the offenders had histories of drug and alcohol use and abuse, only some were under the influ-ence at the time of their assault on the law en-forcement officer. Many, but by no means all, of the offenders had gang affiliations.

The Offenders and Their WeaponVirtually all of the weapons used to shoot/kill the victim-officers were illegally obtained (on

Occupation Average Annual Rate per 1,000 Workers

Table 1: Workplace violence by profession

260.8155.7128.381.669.068.468.368.254.253.938.238.121.916.212.61.6

Law enforcement officersCorrections officersTaxicab driversBartendersMental health custodiansSpecial education teachersGas station attendantsMental health professionalsJunior high school teachersConvenience store workersBus driversHigh school teachersNursesPhysiciansAll workersCollege teachers

About the Author

About the Author

Bruce Gross, PhD, JD, MBA, is a Fellow of the American College of Forensic Examiners and is an Executive Advisory Board member of the American Board of Forensic Examiners. Dr. Gross is also a Diplomate of the American Board of Forensic Examiners and the American Board of Psychological Specialties. He has been an ACFEI member since 1996 and is a also a Diplomate of the American Psychotherapy Association.


the street or by theft) by the offenders. Only one offender picked a specific gun (because he thought it would inflict the injury) with all others basing their gun choice on availability. While the choice of firearm was random, the most frequently used gun in fatal and non-fa-tal shootings of law enforcement officers was a .38 caliber handgun. While offenders routinely carried one hand-gun, approximately 40% carried at least one backup. The most common place for offend-ers to carry their firearms was the front waist-line, with the groin and small of the back be-ing tied for second. Some of the offenders gave their primary (or backup) gun to someone else to carry, generally a girlfriend. None of the of-fenders used a holster and virtually all practiced pulling out their gun (from their preferred place of concealment) and aiming as if to fire. When the suspect-offenders were in cars (as either the driver or passenger), they gen-erally kept their weapon readily available or, less often, under the car seat. When they were sleeping, most kept their gun hidden under their pillow, on the nightstand, or under the mattress, but within immediate reach from their position in bed. It was rare for the of-fenders to not carry their gun, doing so even when they were socializing. One-third of the offenders also carried their gun to work. Of note, the offenders in the most recent study more readily admitted to carrying a handgun than did the offenders from the previous two studies, conducted in the 1980s and 1990s.

Deadly ForceMost of the offenders who shot an officer had prior experience firing handguns. They typi-cally began carrying a gun when they were between 9 and 12 years old. By the time they were 17, the vast majority of them were carry-ing all of the time. Nearly half of the offenders were involved in shootings (as victim and/or offender) prior to their assault on an officer. Ten offenders (all of whom were considered “street combat veterans” and were from inner city, drug-trafficking neighborhoods) had been involved in five or more shootings. Of note, the offenders had more experience using deadly force on the street than did their victim-officers. Only 8 of 50 victim-officers had participated in a prior shooting (one of-ficer had been involved in 2 prior incidents and another in 3), with 7 of those 8 having killed a perpetrator. Nearly 40% of the sus-pect-offenders had some type of formal train-ing with firearms, primarily from the military. More than 80% of the offenders included in the study practiced shooting on a regular ba-

sis, averaging 23 intentional practice sessions per year. It is significant to note that the of-fenders actually practiced with their firearms more than the victim-officers did. The officers averaged only 14 hours of sidearm training and 2.5 qualifications per year. Only 6 of the 50 victim-officers practiced regularly, beyond that required by their department; most of this was in the context of competitive shooting. In all but 3 cases the suspect-offenders fired first, catching the officers off guard. Approximately 60% described themselves as “instinctive shooters,” pointing and firing without consciously sighting. Despite the fact that they did not intentionally aim, the re-searchers found that the offenders shot with far greater accuracy than the officers did, hit-ting their target 70% of the time, as compared to the victim-officers’ 40%. The offenders’ greater accuracy may be due to their having had more practice/experience or because the offenders, having initiated the incident, were shooting offensively and the of-ficers, defensively. Most of the offenders ac-knowledged they were prepared to shoot in order to avoid arrest, suggesting that on some level, the offenders made a deliberate decision to shoot the officer. With no concern for marks-manship, the offenders tended to shoot for ef-fect, knowing that once injured or down, they could “execute” the officer if they so chose. As described by the researchers, the offend-ers were “surprisingly cold-blooded,” turning instantly to deadly violence. On the contrary, the victim-officers were unwilling to use deadly force as long as they thought they had another option. Thirty-six of the 50 officers had been in situations where “deadly force” would have been an appropriate and legitimate response, “but chose not to shoot.” On average, those 36 officers had been in four such prior incidents. Unlike the officers, the offenders acted from a “shoot or be shot” mentality, with absolutely no hesitation about pulling the trigger. They operated under the presumption that if they hesitated, they would be killed.

Motive to KillAlthough no one knows with certainty why Carl Wayne Buntion shot and killed Officer James Irby, one theory is that Buntion’s ac-tions were related to his brother. Buntion and his twin brother, Kenneth, were born on March 30, 1944, with their younger brother, Bobby Joe, born two years later. All three of the Buntion brothers were subjected to family violence, and all three had extensive criminal histories. In April 1971 Kenneth was running a forgery ring out of a second-floor apartment

in the Houston projects. Seeing Kenneth arrive after a 3-day surveillance, officers approached to execute a search warrant. Kenneth was not yet inside the apartment door, and when he saw the law enforcement officers crossing the parking lot he opened fire. Kenneth continued firing as he ran across the upstairs walkway. Although Kenneth was shot in the neck, he continued firing, with one of his bullets piercing one officer’s arm and continuing on to pierce the femoral artery of another. That officer, Allen Dale Dugger, would have bled to death at the scene had it not been for medical assistance provided by a bystander. Eventually, Kenneth was shot by two officers and killed. Both Carl and Bobby Joe were allowed to leave their respective prisons in shackles to attend their brother’s funeral. When he got back to prison, Carl reportedly threatened to escape and kill those officers involved in Kenneth’s death. Over the next 19 years, he allegedly spoke about his intentions with bravado. At some point, Officer Dugger confronted Carl about his threats, and Carl reportedly recanted and apologized. When he killed Officer Irby, Buntion may have been motivated by revenge. However, like most other suspect-offenders, he may simply have been trying to avoid arrest and a certain return to prison.

References Buntion v. Dretke. (2006). Memorandum and Order

in Civil Action No. H-04-CV-1328. United States Dis-

trict Court for the Southern District of Texas, Houston

Division.

Buntion v. State, No. 71,238. (Tex. Crim. App. Oct.

12, 1995).

Bureau of Justice Statistics (BJS). (2001). Law enforce-

ment officers most at risk for workplace violence. Re-

trieved from http://www.ojp.usdoj.gov/bjs/pub/press/

vw99pr.htm

Duhart, D. T. (2001). Violence in the workplace,

1993–1999. (NCJ 190076). U.S. Department of Jus-

tice, Office of Justice Programs, Bureau of Justice Statis-

tics. Retrieved from http://www.ojp.usdoj.gov/bjs/

Federal Bureau of Investigation (FBI). (Multiple years:

1996–2006). Law enforcement officers killed and assault-

ed. Uniform Crime Reports. Retrieved from http://www.

fbi.gov/ucr/ucr.htm#leoka

People v. Buntion. (1991).

Pinizzotto, A. J., Davis, E. F., & Miller, C. E. (2006).

Violent encounters: A study of felonious assaults on our na-

tion’s law enforcement officers. Washington, D.C.: United

States Department of Justice, National Institute of Justice,

Federal Bureau of Investigation, Criminal Justice Informa-

tion Services Division, Bureau of Justice Assistance.

Texas Department of Criminal Justice, Offenders on

Death Row (TDCJ). (2007). Retrieved from http://www.

tdcj.state.tx.us/stat/offendersondrow.htm


S exual Assault Nurse Examiner (SANE) programs have become established and well recognized in the areas of evalu-ating and treating patients reporting

sexual assaults. According to the International Association of Forensic Nursing website, there are more than 2,500 SANE nurses nationally (www.forensicnurse.org, 2006). In order to maintain a reputation of competence and re-liability, the SANE must adhere to his or her facility’s SANE program protocol. The SANE must also adhere to the nursing scope of prac-tice of the state in which the program resides

and the educational requirements set by the International Association of Forensic Nurses (IAFN). In keeping with these guidelines, a SANE program should have a well-defined and consistent peer review process.

Literature Review Peer review has been defined in various diction-aries as “the concurrent or retrospective review by practicing physicians or other health profes-sionals of the quality and efficiency of patient care practices or services ordered or performed by other physicians or other health professionals”

What is it? Do we need it?

By Lisa Gorham, CFN, BSN, RNC, SANE-A, and Suzanne L. Brown, CFN,MSN, RN, SANE-A

AbstractSexual Assault Nurse Examiner (SANE) programs are well established throughout the United States. To maintain competency and accurate documentation, a peer review system must be an established part of all SANE programs. Currently, there are no published articles on the peer review system for SANE programs, even though the National Guidelines for SANE practice note that peer review should be done. The peer review process should be a positive compo-nent of all SANE programs. Although some SANE nurses may feel intimidated by having their work reviewed and scrutinized, a well-formed peer review program should encourage the learning process. A well-documented peer review process can lead to better documenta-tion and ultimately to better patient outcomes.

Key Words: Sexual Assault Nurse Examiner (SANE), peer review, competency

SANE Peer Review:

CE Article: (CERTIFIED FORENSIC NURSES, CFN) 1 CE credit for this article

A good quality assessment program rec-

ognizes that effective peer review reduc-

es error, failure, and potential liability.”This article is approved by the follow-ing for continuing education credit:

(ACFEI) The American College of Forensic Ex-aminers International provides this continuing education credit for Diplomates.

(CFC) The American College of Forensic Exam-iners International provides this continuing edu-cation credit for Certified Forensic Consultants.

(CFN) The American College of Forensic Ex-aminers International provides this continuing education credit for Certified Forensic Nurses.

(CABRN) The American College of Forensics Examiners International is approved by the California Board of Registered Nursing, Provider Number 13133 for 1 contact hour.

After studying this article, participants should be better able to do the following:1. Describe the peer review process.2. Identify the reasons why a peer review

should be done.3. Identify resources in particular practice

arenas that can validate the peer review process.


s“Confidential: Prepared by FACT Center QA Committee to peer review cases. Privileged under VA Code ANN. 8.01-581.17.”

(Dictionary Barn, 2005); “scrutiny by one’s peers” (MedicineNet.com, 2006); and “an examination and evaluation of the perfor-mance of a professional or technician by a board or

committee made up of peo-ple in the same occupation”

(TheFreeDictionary.com, 2006). There is a plethora of articles on physician peer review, but there is

minimal mention in the scientific lit-erature of peer review specific to SANE

practice. Davidson (2006) stated, “A good quality assessment program recognizes that effec-tive peer review reduces error, failure, and poten-tial liability. Such a system has a positive effect—as long as the provider has the ability to improve without fear of precipitous punitive action” (p. 1). Hancox and Lynch (2002) also describe peer review: “Clinical supervision is a formal process of consultation between two or more profes-sionals. The focus is to provide support for the supervisee(s) in order to promote self-awareness, development, and growth within the context of their professional environment.” Dr. Adams (1999), a leader in child abuse evaluations, stated, “Today, registered nurses, in addition to physicians, nurse practitioners, and physician assistants, are being trained to do child sexual abuse examinations. There is a great need for standardization of this training, with some type of certification offered when the clinician has completed the training and documented con-tinuing education and ongoing peer review of cases.” Adams continues by saying, “Maybe the time has finally come to work together to estab-

lish standards of training, certification, designat-ed referral centers in every state, and a system of peer review” (1999, p. 3). Though peer review is of the utmost importance for responsible SANE practice, only two literature sources mention the process. “As part of the forensic evaluation pro-cess, all cases should be reviewed by the team members to ensure consistency in the interpreta-tion of the findings and as a continued learning experience. Feedback is also given regarding the written and photo-graphic documen-tation of exami-nations” (Across the Life Span: A Clinical Guide, 2004, p. 45).

Table 1: Sample Peer Review Report

Male X Female Case 2005.04.02.sb3Patient reported she was sitting in the living room on a couch on the lap of a 10-year-old female. Patient reported the 10-year-old pulled the patient's panties to the side and touched her vaginal area. Occurence approximately 2 weeks ago.No acute or chronic injuries noted to the genitalia. Hymen annular in appearance, symmetrical, without evidence of penetrating trauma. Anus with good anal tone, without acute or chronic injuries.

X Normal ExamNon-specificSupportive of allegationSANE Director X Concur Do not concur Inadequate photosMedical Director X Concur Do not concur Inadequate photosPhotographs entered here

Patient's SexPatient's Age:Summary ofthe History

Allegation:Acute

X Non-acute

Conclusions:

Reviewed By:

Comments:

Rather than fearing

peer review, SANE

programs should

embrace the process.”


The National Training Standards for Sexual Assault Examiners state: “Be familiar with quality assurance plans of the jurisdiction/facility/examiner program and relevant juris-dictional regulations or interpretations related to SAFE documentation, such as peer review, meeting activities, attendants, incident reports, and supervision” (Department of Criminal Justice Services [DCJS], 2005, p. 16). Guidance concerning peer review still is not adequately addressed in the current lit-erature. For purposes of this article, we have defined a SANE peer review as the review of the sexual assault report by an expert in the field of sexual assault that would include review of the photo-documentation.

Peer Review ProcessThe most positive reason for doing peer review is for the educational benefit to the individual SANE and/or the entire team. SANEs typically function autonomously and may need an av-enue to discuss difficult cases and to share and receive knowledge and experience. Most SANE programs contain a variety of nurses with varied backgrounds and levels of experience. When cases are peer reviewed, the entire team is in agreement with the outcomes and conclusions, and less experienced SANEs are brought up to the level of the entire program as a whole. Inclusion of a peer review process in the SANE program will result in the increased confidence of the judicial system, and the program’s ac-countability and credibility will soar. The second positive reason for peer review is that the program will become well-respect-ed for its production of a non-biased and well-prepared report. The report generated is both an internal and external example of quality as-surance. When cases are peer reviewed, the process of compiling and sending out a report may be-come extended. In the past, at Inova Fairfax Hospital in Virginia, the sexual assault report was written while the detective or law enforce-ment officer waited, which could have resulted in a report that contained errors or mistakes in the documentation. The report is now writ-ten after both the patient and law enforcement leave, a change that is conducive to less distrac-tion, more time to think about word choices and descriptions of injury, and increased abil-ity to check scientific resources, affording peer review by a more experienced practitioner. All of these positive effects will decrease er-rors and bolster confidence when presenting a document in court. Although mistakes are still possible, peer review decreases the num-

ber of inaccurately documented records. Finally, peer reviewers have increased ob-jectivity, which is pivotal to the process. The peer reviewer(s) did not witness and, therefore, cannot be subject to the affects of an emo-tional patient. The professional performing peer review only views the photographs and the documentation of the examining SANE, eliminating the “advocate” or “bias” role with which SANEs are so often labeled in court. Two changes made to the documentation at Inova Fairfax Hospital were replacing the word victim with patient, and exchanging the word assailant for suspect or reported assailant. This has decreased bias in the documentation. So our saying holds true, “100% of the people we see are patients, 100% of our patients are not victims.” The sole barrier to peer review to be con-sidered is that, as medical professionals, there often exists a fear of judgment when discuss-ing peer review. SANEs are compared nega-tively with their physician counterparts and are confronted with statements from attorneys, as well as fellow medical professionals, dismissive of both their education and experience. Peer review opens to scrutiny the SANE’s practice, and this can be intimidating. However, be-cause it is a great way to share skills with oth-ers, a positive way to learn from the team, and a valuable way to increase experience, rather than fearing peer review, SANE programs should embrace the process.

Where to StartOn the small budgets of SANE programs, finding and obtaining an experienced reviewer can seem impossible. Performing peer review will take more time, and protocols and proce-dures will have to be altered to accommodate a new standard of practice; further, there might be pressures from other disciplines to receive immediate results from an exam. While all of these are valid concerns, with dedication to a higher level of practice, they can be eas-ily overcome. The question of who should peer review can be answered by referring to the Virginia Medical Forensic Task Force Report issued by the Department of Criminal Justice Services (DCJS). These unpublished guidelines, sent to attorneys for reference, state that a child abuse specialist who reviews the cases should be a physician or a nurse practitioner with suf-ficient subspecialty training in pediatric medi-cine, emergency medicine, family medicine, pediatric gynecology, or obstetrics and gyne-cology, who must either evaluate a minimum of 35 children per year who are suspected vic-

tims of physical abuse, sexual abuse, or ne-glect, or have cumulative clinical experience exceeding 150 such cases. They must also be able to demonstrate substantial experience in the specific subcategory of abuse about which he or she is consulting. This individual should be readily available to testify in court and dem-onstrate ongoing continuing education units in child-abuse related issues. He or she should demonstrate knowledge of current medical lit-erature and must possess a minimum of the following criteria:

Hold a teaching or faculty position and/•or provide training on child-abuse re-lated issuesPublish articles or research on child-•abuse topicsHold committee membership in hos-•pitals or professional organizations on child-abuse related issuesBe affiliated with a Center of Excellence•

In order for SANE programs to take ac-countability for their practices, it is essential to have an individual of this caliber review-ing cases. A SANE program can either look to the guidelines of the state in which it is es-tablished, or create its own. Although the above guidelines are written for child sexual abuse examinations, similar guidelines can and have been written and ad-opted for the adult/adolescent peer review system. Adams’ article discusses child abuse examinations, but many of the same points hold true for adult examinations. For example, Adams (1999) stated, “In this field, the stakes are too high and the outcome resulting from over-diagnosis is too extreme for the medical profession and child protection community to continue dragging their feet about establishing some type of credentialing system for examin-ers.” The IAFN has developed a national cer-tification examination for the adult/adolescent sexual assault patient and is currently working on a certification examination for the pediatric practitioner. The American College of Forensic Examiners developed a certification including training and an examination for the Forensic Nurse. Addressing the needs of a peer review system is the second step in Adams’ article.

ProcedureA SANE program should have an actual policy or procedure outlining the peer review process for the program. For example, at Inova Fairfax Hospital/Inova Fairfax Hospital for Children, 100% of the cases are peer reviewed. The first step is for the entire report to be reviewed by the SANE coordinator/director, whose responsibility it is to check for an accurate description of in-


About the Authors

Suzanne L. Brown has been a Registered Nurse since 1980. From 1981 un-til 1996, she worked at Inova Fairfax Hospital in the Emergency Department. In 1991, she be-

came the coordinator and founder of the Sexual Assault Nurse Examiner (SANE) program to provide forensic ex-aminations of adult sexual assault vic-tims in Fairfax County. This was the first SANE program in the state of Virginia. In 1993, she expanded the program to all Northern Virginia jurisdictions and includ-ed the pediatric sexual abuse population and examinations of alleged suspects of crimes. Brown is a founding member of the International Association of Forensic Nurses (IAFN) and the Virginia Chapter of IAFN. She is also a member of the ACFEI and is a Certified Forensic Nurse (CFN). She has assisted in developing SANE programs throughout Virginia; Georgia; Pennsylvania; Washington, D.C.; Maryland; West Virginia; Idaho; and the U.S. Virgin Islands, and she has provided training throughout the United States.

Lisa Gorham has been a Registered Nurse since 1996. She graduated from Northern Virginia C o m m u n i t y College with an Associate Degree in Nursing and

then attended Old Dominion University where she completed her BSN. Gorham completed SANE training in 2002 at Inova Fairfax Hospital in Virginia and has been working with that program since. She has worked for SANE programs in the state of Maryland as well, and in vari-ous areas of nursing such as long-term care, mental health, research, and pe-diatrics. She keeps current certifications as a SANE-A and in mental health nurs-ing. She is a CFN. Currently, Gorham guest lectures forensic biology students at George Washington University.

juries, and this documentation is checked against the photographs taken. Photographs are checked for clarity and visibility of documented injury. Documentation must be clear and understandable, not just to the examining SANE, but to a third-party review. Any variances are addressed with the examining SANE, after which a final report is created and submitted to law enforcement. The second person to do a peer review is the medical director of the program. Again, 100% of the cases are peer reviewed. The medical director receives a peer review sheet that contains the circumstances of the reported assault, the age and gender of the patient, and a set of photographs of the examina-tion (See Table 1). The medical director reviews the case, makes any comments, and returns it to the SANE coordinator/director. Unusual or diffi-cult cases are reviewed at staff meetings. The ex-amining SANE receives the peer review sheet con-taining the documentation of the circumstances of the assault, photographs, and suggestions. All peer review sheets are confidential and do not contain any identifying patient information. Most QA/QI (Quality Assurance/Quality Improvement) forms are hospital-protected documents. For example, in Virginia, the footer of all peer review sheets con-tains: “Confidential: Prepared by FACT Center QA Committee to peer review cases. Privileged under VA Code ANN. 8.01-581.17.”

Next StepsInitiating a peer review process can be a daunt-ing task, but the value of implementing it far outweighs the difficulties. Ultimately, this pro-cess will assist in the development of higher quality SANE nurses who care for this very specific patient population. Begin the journey by identifying the skills, knowledge, and abilities of the nurses in the program to assess skill gaps in staff performance and to provide baseline data so that actual per-formance improvement can be documented as the peer review process ensues. To embark on a peer review plan, decide who will coordinate the process and who will be involved. Evaluate avail-able internal resources to accomplish the review, and if there are insufficient internal resources, or the total number of cases is low, consider what external resources can be utilized to accomplish the goal of a 100% peer-review process. From there, emphasize a non-punitive envi-ronment, and stress the ongoing skill develop-ment of the nurse examiners. Following review, talk with staff concerning their experience with the process to find out what would make it more effective, and request suggestions for future re-views. After this evaluation, make needed ad-justments, continually assessing successes along with the areas that need improvement.

The first step for a SANE program that does not have a peer review process is to find an ex-pert. Then change policies and procedures to ac-commodate the new level of practice to include peer review, remembering that the positives of an enhanced standard of practice outweigh the negatives. Educate the staff, police, CPS, and other agencies involved in the new endeavor to raise the level of accountability. Change is difficult, but the lives of patients, suspects, and their families, as well as the prac-tice of forensic nursing depend upon a com-mitment to a higher level of accountability. Returning a guilty perpetrator to a home or imprisoning someone under false evidence is serious business, and, unfortunately, the prac-tice of forensic nursing may wield that power. Such responsibility should encourage SANEs to produce accurate, reliable reports based on science and peer reviewed by qualified medi-cal professionals. The ultimate reason for peer review is to improve patient outcomes, and by improving the assessment and documentation of a sexual assault examination, better outcomes for the patient are achieved, whatever the legal or medical follow-up.

Bibliography Adams, J. A. (1999). Medical evaluations of suspected

child sexual abuse. Archives of Pediatrics & Adolescent Medi-

cine, 153(11), 1121–1122.

Davidson, J. (2002). Take a positive approach to peer

review. American Academy of Physician Assistants. Retrieved

July 16, 2006, from http://www.aapa.org/gandp/peer.

html

DictionaryBarn.com. (2006). Retrieved August 26,

2006, from http://www.medterms.com/script/main/art.

asp?articlekey=4820

FreeDictionary.com. (n.d.). Retrieved August 26, 2006,

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com/peer+review

Hancox, K., Lynch, L., Happell, B., & Biondo, S. (2004,

September). An evaluation of an educational program for

clinical supervision. International Journal of Mental Health

Nursing, 13(3), 198–203.

U. S. Department of Justice, Office on Violence Against

Women. (2006, June). National training standards for sex-

ual assault medical forensic examiners. NCJ213827. Re-

trieved from http://www.ncjrs.gov/pdffiles1/ovw/

213827.pdf

Earn CE CreditTo earn CE credit, complete the exam for this ar-ticle on page 78 or complete the exam online at www.acfei.com (select “Online CE”).


The Science of Cold Case Files®

By Katherine Ramsland, PhD

Many who are interested in the field of foren-sics are familiar with Cold Case Files®, an A&E documentary-style television series. The series examines longstanding unsolved cases, relying on investigators willing to go above and beyond to seek justice for the victim. In her book, The Science of Cold Case Files®, Katherine Ramsland investigates many of the stories behind some of the televised cases and delves deeper into the methods used in forensic detection. Included are blood spatter and handwriting analysis, facial reconstruction, informatics and odor detectors, fingerprints and K-9 detectives, and state-of-the-art DNA technology. Each chapter provides several case studies and links them together with a common thread. The cases range from the very old to more recent myster-ies, and the resolution of each brings the reader to believe more strongly in the power of foren-sic science to make a difference in the criminal world. The book looks not only at the methods, but also at the individual problems that each unique case brings to the table. Ramsland’s book offers something for every-one fascinated by this exciting field. A gripping read, it provides a chilling look at real-life crimi-nal investigations.

Katherine Ramsland, PhD, has published 30 books. Currently, she teaches forensic psychol-ogy at DeSales University in Pennsylvania and consults on criminal investigations. She has been a member of the ACFEI since 1999.

Veterinary Forensics: Animal Cruelty InvestigationsBy Melinda D. Merck, DVM

To date, little has been written on the subject of veterinary forensics. In her book, Veterinary Forensics: Animal Cruelty Investigations, Melinda D. Merck aims to remedy the information short-age as she provides a reference for veterinarians, pathologists, students, animal cruelty investiga-tors, and prosecutors. Veterinary forensics, which refers to the application of veterinary medical knowledge to matters of law, is a growing field much needed because of the increased attention to animal cruelty worldwide. Veterinary Forensics provides the background and resources needed to address animal cruelty cases. It offers chapters on the legal system, crime scene investigation, the animal as evidence, spe-cial considerations in animal cruelty cases, pat-terns of non-accidental injury, sexual assault, animal fighting, and time of death. The book

also contains several resources in the appendix section: worksheets, evidence logs, report-writ-ing forms, entomology collection forms, forensic kits, and several other helpful items. Primarily focused on dogs and cats, the principles and techniques can easily be applied to other ani-mals as well. Through Veterinary Forensics, Merck attempts to equip veterinarians with the forensic knowl-edge to handle such animal abuse cases. More importantly, it offers guidance on handling evi-dence and conducting evaluations that will hold up in court. The book is well organized and acts as a quick and convenient reference for those needing to assist in animal cruelty cases.

Melinda D. Merck, DVM, is a Forensic Veterinarian with the ASPCA. She received her veterinary medicine degree in 1988 and ran a private practice from 1990 to 2007, selling the practice after receiving a full-time appointment to the ASPCA’s Anticruelty Initiatives. She has been a member of the ACFEI since 2005.

Inside Forensic Science: Forensic PharmacologyBy Beth E. Zedeck, MSW, RN, MSN, and Morris S. Zedeck, PhD

The Inside Forensic Science series explores a large quantity of subjects within the forensics realm. Each book takes an in-depth look at one area of forensics. The series boasts readable text and full-color graphics. Sidebars, references, a glos-sary, and index assist in further research. As part of the Inside Forensic Science series, Forensic Pharmacology looks at one aspect of forensic science: forensic pharmacology and toxicology of drugs of abuse. The reader is in-troduced to the daily work of the scientists, the principles of pharmacology and toxicology, the technical analysis of drugs, and the characteris-tics of eight major categories of drugs of abuse. It provides information on prescription drugs, illegal drugs, inhalants, and others, and it details the effects of each drug. The book also provides case studies and statistics of individuals involv-ing forensic pharmacology and drug abuse. The concluding chapter gives readers a chance to test their own knowledge of drugs of abuse and of the procedures used to solve cases. Answers and explanations are provided for the three hy-pothetical scenarios. Colorful and informative, this text is a handy reference source for people of all ages interested in the solving of drug-related crimes.

Morris S. Zedeck, PhD, received a degree in pharmacy from the Brooklyn College of

Books by ACFEI Members


Pharmacy, Long Island University; a PhD in pharmacology from the University of Michigan; and an MBA from Bernard M. Baruch College, City University of New York. He is a Fellow of the ACFEI and has been a member since 1994.

Beth E. Zedeck, MSW, RN, MSN, received a BA in psychology and an MSW degree in so-cial work with a specialization in alcohol and substance abuse.

The Myth of the Out of Character CrimeBy Stanton E. Samenow

Nothing, it would seem, could push an other-wise stable and respected human being ‘over the edge’ into the criminal world. What provokes an individual to make this abrupt jump? In his book, The Myth of the Out of Character Crime, Stanton E. Samenow answers this question and others as he recounts his many observations in-terviewing and treating this sort of offender. The case studies Samenow offers in the text follow years of firsthand experience that involved ev-eryday people committing unthinkable crimes. He examines the ordinary clues that may pos-sibly help uncover these criminals, revealing is-

sues such as finances, marital conflict, job his-tory, sexual history, alcohol abuse, interests and hobbies, reading preferences, ambitions and goals, and reactions to frustrations, all of which can help to predict whether a person is capable of committing a crime. Samenow concludes the book by asserting that there is no such thing as an out-of-character crime. The crime itself is only a manifestation of that which is there al-ready, lurking beneath the surface. By studying the characteristics of these individuals, Samenow suggests we can identify these individuals before it is too late.

Stanton E. Samenow is a forensic psychologist and the author of Inside the Criminal Mind, Straight Talk about Criminals, and a three-vol-ume set on criminal personality. He has been a longtime member of the ACFEI.

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T he story of Timothy Wicks is a story of friendship, betrayal, and murder. His friend, Dennis Gaede, worked various jobs—including tax preparer. While

preparing Timothy Wicks’ taxes, using informa-tion Wicks had disclosed for his return, Gaede fraudulently obtained Wicks’ identity. With this information, Gaede left his home in Milwaukee and moved to North Dakota with his wife, Diana Fruge, and his new identity—representing him-self as Timothy Wicks in the hopes of avoiding a felony sentencing in Wisconsin. Gaede stayed in contact with the real Timothy Wicks, and shortly after moving to North Dakota, Wicks contacted Gaede and confided in him that someone was fraudulently using his identity and committing credit card fraud. As fraud detection closed in, threatening to expose Gaede’s new iden-tify, Gaede lured Wicks to North Dakota from Wisconsin with the promise that they could play

together in a band. While Wicks was staying with Gaede and Fruge, in their home, Gaede shot Wicks. Fruge later testified that after Gaede shot Wicks, he suffocated Wicks, who was still breathing, by putting a garbage bag over his head (Barton, 2006). Subsequently they decapitated Wicks and cut off his hands to prevent identification of the body. Then Gaede and his wife dumped the na-ked body over the side of a bridge in Michigan, and they dumped the victim’s head, which was later discovered, in a river in Wisconsin. After the murder, they emptied out Wicks’s bank account and used the $17,000 to buy a vehicle. However, Wicks was eventually identified through dental records. Shortly after the murder, Gaede stopped show-ing up for work and his employer discovered mon-ey missing from the business where Gaede worked as bookkeeper and office manager.

This article is approved for continuing education credit:


(CFC) The American College of Forensic Exam-iners International provides this continuing edu-cation credit for Certified Forensic Consultants.

By Frank S. Perri, JD, MBA, CPA, and Terrance G. Lichtenwald, PhD

AbstractThis study is the second in a series devoted to understanding red-collar criminals. The first study, “Fraud Detection Homicide: A Proposed FBI Criminal Classification” (Perri & Lichtenwald, 2007) advanced the proposition that there is a sub-group of white-collar criminals who are ca-pable of vicious and brutal violence against individuals whom they believe have detected their white-collar crimes. The sub-group is referred to as red-collar criminals. This study examines why red-collar criminals are not capable of committing violence against their victims without exposing both their white-collar crime and the violent crime. The de-scriptive data suggests that the evidence trail left by the red-collar criminal both illustrates the red-collar criminal’s failure in avoiding detection and reveals his or her motive for the murder. Further, the findings related to red-collar criminals correlate with the behavioral traits of psy-chopathy. The authors analyze the law enforcement interrogation of Christopher Porco and offer sug-gestions as to how investigators should approach interviews with psychopathic defendants. The transcript is a critical tableau demonstrating that traditional methods of interrogation may not suffice when it comes to the interrogatation of red collar criminals and that an alternative ap-proach may be required.

The Arrogant Chameleons:

CE Article: (CERTIFIED FORENSIC CONSULTANT, CFC) 1 CE credit for this article

Key Words: red-collar crime(s), white-collar crime(s), fraud, motive, detection, homicide, murder, psychopath, chameleon, Perri’s Red-Collar Matrix, interrogation, interview

Exposing Fraud-Detection Homicide

After studying this article, participants should be better able to do the following:

1. Understand the psychological character-istics of red-collar criminals.

2. Assist law enforcement and attorneys in their interviews and investigations as to possible murder suspects.

3. Consider forensic accountants and fraud examiners as members of a homicide investigation team to uncover a motive to commit murder.


The Arrogant Chameleons:


When the employer confronted him about the fraud, Gaede failed to give an explanation for the financial anomalies. The employer con-tacted the authorities about his bookkeeper, re-ferring to him as Timothy Wicks, and was in-formed by police that the real Timothy Wicks was dead. Eventually, Gaede was found guilty of murder and the prosecution argued that the fraud detection initiated by Wicks himself had been the motive for Gaede to kill him (Barton, 2007). A unique aspect of this study is that it builds upon findings drawn from homicide cases where white-collar criminals became violent and turned into red-collar criminals when their victims detected their fraudulent behav-ior. In a previous study of fraud-detection ho-micide, Perri and Lichtenwald (2007) exam-ined the available data from 27 criminal cases, organizing the data into a matrix referred to as Perri’s Red-Collar Matrix (the Perri-RCM). Here, the authors analyze case-specific mur-der evidence derived from the previous study for identifiable psychological traits or behav-ioral tendencies typical of identified red-collar criminals. The hypothesis is that identifica-tion of psychological traits and/or tendencies of red-collar criminals might be beneficial in proposing an explanation of how red-collar criminals, who have engaged primarily in white-collar crime, come to believe they are able to successfully engage in murder and es-cape detection. Further, if there is a set of behavioral ten-dencies, then awareness of that set might be of benefit to forensic examiners during their in-terviews and investigations of future red-collar crimes. The Arrogant Chameleon Syndrome: A Behavioral ProfileA chameleon is a reptile that has the ability to change color to match its surroundings in or-der to avoid detection. White-collar criminals thrive on being able to avoid detection in or-der to carry out their fraud schemes; they have the ability, like a chameleon, to adapt to a giv-en environment. What happens, then, when white-collar criminals attempt to become vio-lent criminals? Do they have the ability, like the chameleon, to change their complexion to avoid detection? Or do they fail—exposing their true colors because their white-collar criminal skill set is inadequate when applied to violent criminal acts? The murder case data reveals certain behav-ioral traits that explain why red-collar criminals think their white-collar crime skill set can be duplicated as violent criminals. The behavioral

traits are the effect of their psychopathic charac-teristics (Perri & Lichtenwald, 2007). Although psychopaths try to “blend in,” the deficits in their psychopathic natures, i.e., grandiosi-ty, poor impulsive controls, etc., hinder their ability to accurately foresee the consequences of their behavior. Psychopaths have difficulty projecting into the future, which is to say they have trouble understanding how their actions play out in (real) life, and they also have defi-cits in reflecting upon their past; “[t]hey are prisoners of the present” (Meloy, 2000). The red-collar criminal’s inability to think through a plan that would take into account the potential risks of being caught, and the evidence trail left behind, is another hallmark of their behavior (Meloy, 2000). The descriptive data is consistent with Dr. Hare’s conclusion that because of these defi-cits, the red-collar criminal’s self-perceived re-ality is distorted (Hare, 1993). Put another way, as Edelgard Wulfert, forensic psychologist and professor at the University of New York at Albany, stated, “A psychopath invents reality to conform to his needs” (Grondahl, 2006). The red-collar criminal’s grandiose belief that hav-ing committed murder, he or she will somehow avoid detection is proven false. In fact, the data reflects the exact opposite. The egocentrism characteristic of these chameleons produces an overconfident view of their ability to avoid detection, thus they do not bother to conceal incriminating evidence.

Robert Petrick CaseJanine Sutphen underestimated her husband; Robert Petrick was, in fact, capable of harm-ing her financially, emotionally, and physically. After Sutphen became aware of Petrick’s fraud-ulent schemes affecting her bank accounts, Petrick began to plan her murder. According to the prosecution, Petrick killed his wife after she’d detected his fraud schemes and subse-quently reported her missing as a way to divert attention away from him (Lewis, 2005). Janine Sutphen was found near her home, wrapped in a tarp, sleeping bag, blankets, and chains, and floating in Raleigh’s Falls Lake. She’d died of asphyxiation. The prosecution offered evidence of a murder plan recovered from the defendant’s computer searches. The defendant had searched under “22 ways to kill a man with your bare hands,” and other Google searches included the words “neck,” “snap,” and “break” (Jones, 2005). It is interesting to note that the defendant was, allegedly, a computer consultant who should have known that searches are saved and retriev-able. Petrick’s response to the prosecution’s use

of this evidence was that his wife had martial arts training, and she could have been searching the Internet. There were other searches regard-ing the water level in the lake where Sutphen’s body was found, and he appeared to have no good explanations for those searches. Nor did he appear to have any credible reasons for Google searches on the topic of “body decom-position,” “rigor mortis,” and other websites that explain how the human body deteriorates (Lewis, 2005c). According to detectives, the Google searches occurred several weeks before Petrick reported his wife missing and one day after she was last seen by witnesses. Moreover, a cadaver dog detected smells of human remains in both the bedroom and the trunk of the defendant’s car. Of further omi-nous inference, the defendant ordered a stun gun prior to his wife’s disappearance. During the period of time that his wife was allegedly missing, one witness, a man befriend-ed by Petrick, recalled that when asked about his wife, Petrick appeared upset and indicated that she died of cancer (Lewis, 2005a). Petrick fooled people with outward signs of emotions learned by watching others, and apeing how they behaved, emotionally, in a given set of circumstances (Meloy, 2000). The prosecu-tion found another woman known to Petrick who claimed that he had fraudulently emptied her bank accounts in order to buy computer equipment. Another female witness testified that she and Robert had been going through pre-marital counseling and had set a wedding date—even before he’d killed his wife (Lewis, 2005b). Mary Grigolia, a minister at the Eno River Unitarian Universalist Fellowship Church in Durham, North Carolina, testified that while visiting Petrick in jail, he was told that the po-lice were searching a small lake near his home for Sutphen’s body. She says he stated with “great disdain and arrogance, ‘they’ll never find her’” (Lewis, 2005c). Although Petrick was charged with (and found guilty of ) murder, he’d decided to represent himself.

Irwin Margolies CaseIrwin Margolies, head of now bankrupt Candor Diamond Company, was found guilty of mur-der for the deaths of his controller, Margaret Barbera, and her co-worker Jenny Chin, by murder for hire. Chin’s body was never found, though she was presumed murdered. According to Barbera, Margolies generated fictitious invoices to create the appearance of revenue in order to get advance payments on bills from a financing company (Raab, 1982b). According to the reports, fraud proceeds were laundered to foreign countries, and the amount


of embezzlement was estimated at $6 million (Raab, 1982a). Barbera had pleaded guilty to fraud and had agreed to testify in a fraud inquiry involving the diamond company. According to the prosecutor, Margolies conceived the scheme to have Barbera and Chin killed in order to “si-lence witnesses”(Raab, 1983a). Margolies wanted Barbera killed first because she had the records that verified the fraud he’d committed, though according to witnesses, Margolies wanted to “get rid of two people” (Chambers, 1984b). Margolies’s attorney, Henry Oestricher, received prosecutorial immunity when he agreed to tes-tify against his client; according to Oestricher, Margolies ordered the murders of Barbera and Chin, adding that he had helped Margolies hire the “hit man,” Donald Nash, whom Margolies had paid $2,000 to kill Barbera (Chambers, 1984a). Prior to the murder, Nash stalked the fed-eral witness for 4 months learning her routine. Barbera’s brother indicated that she had been ter-rified for her safety the last 3 months of her life. Barbera was abducted, and three civilians who at-tempted to come to her aid were killed. Barbera was found dead in an alley in lower Manhattan with bullet wounds to the back of her head. Fortunately, Nash left behind an extraordinary amount of forensic evidence, including, but not limited to, DNA, as a result of blood retrieval, ballistic tests, telephone records, shell casings, tire tracks, license plates, and other incriminating evidence that led to his murder conviction (Raab, 1983b).

Exposing the Red-Collar PsychopathThe Hare Psychopathic Checklist is an essential tool for an interviewer, not only in the investiga-tion of white-collar crimes, but also of red-collar crimes. Investigators exposed to Hare’s findings can focus on both the tangible aspects of mur-der investigations and the intangible qualities of psychopathic behavior that may surface during an interview, the detection of which will require a trained eye. An interviewer familiar with the traits can ask questions, evaluate answers, and ob-serve behavior to determine whether the interview should be shaped to accommodate a psychopathic mindset. The interviewer must be cognizant of the fact that the red-collar criminal is investing mental energy in understanding what the inves-tigator represents. One’s ability to interpret psychopathic behav-ior is increased if the interviewer is not seen as a threat to the red-collar criminal. During the first interview, an interviewer may not have the time to explore these psychopathic traits: a) the need for stimulation, b) shallow affect, c) callousness, d) poor behavioral controls, e) early behavioral prob-

lems, and f ) juvenile delinquency; therefore, the authors recommend the use of an Identification Grid as a tool for assessing whether the interview-er is in the presence of a psychopath by revealing those traits that are probably most crucial.

Interviewing the Chameleon Among the most devastating pieces of evidence that defendants can reveal about themselves are statements made to law enforcement or third par-ties. Obtaining a statement is critical because the defendant may reveal his or her motives, state of mind, “facts” inconsistent with the physical evi-dence, and other implausibilities. In the major-ity of the American murders, the defendants gave statements that are incriminating, implausible, and inconsistent, or some combination thereof. Although the strength of the psychopath is his or her ability to talk and appear charming in order to exert manipulative behavior, this strength is also a weakness in the investigation of a murder. The “chameleonesque” red-collar criminals be-lieve because of their embellished views of their own manipulative abilities that they are capable of creating factual scenarios that others will ac-cept. The fact that they are talking to a trained investigator does not diminish the psychopath’s self deceit, and they may enjoy the interview and attempt to be charming. However, red-collar criminals begin to lose their ability to blend in and avoid detection when the evidence begins to point to them as the murderer. The fact that red-collar criminals will not be truthful is not as important as getting these “cha-meleons” to talk. However, interviewers must be aware that interviewing the psychopath may prove to be challenging if the interview is not advanced with the goal of eliciting inconsistent, implausible information as opposed to getting the “chameleon” to speak the truth. As one in-terviewing expert stated, “When dealing with the pathological interviewee, give him the facts and details that will refute his assertions, but don’t expect him to acquiesce or recant previous state-ments. . . . Confronting the pathological person with facts and details that are contrary to his as-sertions is like nailing Jell-o to a wall” (Rabon, 2006). Furthermore, even if the suspect is confront-ed with evidence that contradicts his assertions, do not expect the pathological suspect to display anxiety or emotional discomfort. Such outward displays of emotion that a non-psychopath would exhibit if confronted with incriminating evidence is not characteristic of psychopaths (Hare, 1993). Yet, by getting the psychopath to talk, a trail of statements that make no sense will come forth and produce a powerful image of deception and lack of credibility at trial.

Exposing the Psychopathic

Trait Identification

Superficial CharmAssess the suspect’s interpersonal style. He may be friendly and straightforward, with very little useful information. He may give the impression that he is answering a ques-tion, when in fact he says nothing. He may appear at ease, showing few, if any signs of anxiety, embarrassment, or discomfort.

Lack of RemorseLook for evidence of past remorse in situ-ations that may not be connected to the reasons for the present interview. Ask questions about past relationships. Assess whether there is any capacity for remorse, concern about how others are impacted by his behavior, and whether such impact is of relevance to him. The interviewer must be careful to distinguish between whether the suspect is simply stating what should be said or whether his actions back up his statements.

Pathological LyingAssess whether the suspect continues to lie even after confronted with the truth. The in-terviewer will find it remarkable that even after the suspect has been caught in a lie, the truth seldom appears to embarrass the suspect. He simply goes on to another lie or attempts to shape a lie as consistent with the truth.

ManipulationLook for signs of fraudulent behavior, both financial and non-financial. In addition, look for signs of taking advantage of fam-ily members, organizations, impersonations, and identity theft.

IrresponsibilityAssess whether the suspect has little or no sense of duty or loyalty to family or friends, displays behavior that puts others at risk, fails to maintain promises and obligations, fails to take to responsibility for his or her own actions, blames others or the system for their misfortunes, and feeds on others to support his needs.

GrandiosityAttempt to explore his self-perception and self-image. He may appear self-assured and cocky during an interview. His inflated ego and exaggerated regard for his own abili-ties are remarkable.

ImpulsivityAsk the individual whether he or she gen-erally thinks before acting, and ask him to describe the circumstances leading up to an offense. Attempt to elicit his views on planning and spontaneity. This trait is ex-tremely important in observing impulsivity in crimes and is one of the reasons that red-collar criminals are not apt to successfully conceal their crimes.


The Christopher Porco Case One case that exemplifies this point is the Christopher Porco homicide. In this case, the defendant, Christopher Porco, used a fireman’s ax to cleave his father to death while he was sleeping. The son murdered his father, who had both discovered his son’s fraudulent behavior and had confronted his son. He attempted to murder his mother who had been sleeping next to her husband as well, but she lived. The police interrogated Christopher Porco in an attempt to elicit the truth; yet, during the 6-hour interro-gation, he showed no emotion, never flinched, and never confessed to the murder. The incon-sistencies elicited were important, but the inter-viewers never properly exploited them. There were warning signs of Christopher Porco’s psychopathic qualities: He’d left a trail of deceitful behavior, he’d fraudulently obtained loans using his parents as co-signers without their knowledge, and there were several email correspondences between Porco and his par-ents demonstrative of the tension between the parties. His parents eventually confronted him concerning his fraudulent behavior and threatened to go to the authorities to take ac-tion against him. In one email, his father wrote: “Did you forge my signature as a co-signer? What the hell are you doing? You should have called me to discuss it. . . . I’m calling Citibank this morning to find out what you have done and I am going to tell them I’m not to be on it as co-signer.” Amazingly, the next day, Citibank noti-fied Peter Porco that his son had also ob-tained a line of credit to purchase his new Jeep Wrangler. Again, Christopher had used his father’s name as co-signatory to secure the auto loan. The parents tried to contact Christopher via the phone, but Christopher would not talk to them. In another email, the father wrote, “I want you to know that if you abuse my credit again, I will be forced to file forgery affidavits in order to disclaim liability and that applies to the Citibank college loan if you attempt to reactivate it or use my credit to obtain any other loan.”

Behavioral Assessment “Christopher Porco fits the profile of a psycho-path” (Grondahl, 2006). Several Albany, New York, area psychologists and mental health professionals familiar with the case focused on Porco’s continued pattern of lying and de-ceit and stated that Porco’s behavior was con-sistent with that of a psychopath (Grondahl). Furthermore, these professionals pointed to his pattern of grandiose perceptions of himself as a member of a wealthy and influential family.

Porco was known to have lied to friends and acquaintances about a fictitious inheritance worth millions of dollars from his grandmother. Even his father was reported to have told a co-worker that his youngest son was a sociopath (Lyons, 2006c). Having made bail, and out of police cus-tody, many people found Christopher Porco’s behavior strange given the gravity of the mur-der charges against him. While awaiting trial, he was found to be arrogant, drinking in bars, attending concerts, going out to entertainment establishments, and driving around the yellow Jeep that witnesses state was used to drive to his parent’s home on the night of the murder. This behavior fits the traits of a psychopathic individual in need of grandiosity and embel-lishment (Grondahl, 2006). Forensic psycholo-gist Wulfert stated: “There’s an overlap between psychopathic and narcissistic tendencies. . . . He [Porco] believes that the rules do not apply to him, and he has a need to show off in front of people” (Grondahl, 2006). It is interesting to note that during an inter-view with CBS, in response to a question about visiting his mother at the hospital, Porco stated: “I saw her—she was swollen and covered in tubes, and my reaction was, I burst into tears. I fell on the floor right there” (Bell, 2007). Yet, the for-mer youth minister, Joseph Catalano, who had gone to the hospital to be with Porco claimed to be “struck by Christopher’s odd behavior, because he did not seem to exhibit any grief ” (Bell). The psychopath’s use of the “chameleon strategy” is not surprising in that he or she will attempt to read a situation and determine the ap-propriate or expected emotional response to ap-pear to be properly sympathetic to others (Perri & Lichtenwald, 2007). When Porco was inter-viewed by the police one day after the homicide, he showed no emotion at all, which is remarkable given that the interview was more than 4 hours long. It is fortunate someone was present to ob-serve his true behavioral response.

The Interview and Interrogation of Porco The Porco case is an important illustration of how not to conduct an interview when the sus-pect is a red-collar criminal. Although there were aspects of the interview that proved use-ful, the investigator’s approach did not match the interviewee’s psychological makeup. Too often, violent crimes investigators attempt to overwhelm the suspect by playing into his or her emotional mindset. This approach is ex-tremely effective, especially with a non-psycho-pathic suspect. It is not transferable to a true red-collar criminal.

Throughout the interview, the investigators elicited testimony that, to a trained interviewer, would have revealed psychopathic traits. For example, during the interview, Porco admitted that he was impulsive, irresponsible, a liar, had an inflated view of himself, engaged in grandi-osity, and enjoyed impressing others with ficti-tious facts. Most important was the lack of any exhibition of emotional affect. Many non-psy-chopathic murder defendants break down emo-tionally because of a need to bare their souls, crying, shaking, and displaying other kinetic at-tributes expected of someone thrust into such a scenario. Yet, this was not the case. Assuming that it was not to late to do so, once the interviewers suspected that their sus-pect had strong characteristics of a psychopath, their strategy should have reflected a non-con-frontational approach. One observes the in-terviewers attempting to turn “up the heat” on Porco with a barrage of questions aimed to break him down emotionally so that he will confess to the murder. Though the questions and answers outlined here do not reflect the order in which they were asked, they illustrate how the investigator’s strategy was not as effi-cient as it could have been.

Investigator: Listen to me. It’s not—it’s not—it’s a crime of passion, okay? Like an emotional thing. You know, that’s what it is.Porco: That’s not the (inaudible one word)—Investigator: An emotional flare up or something, you know, maybe. That’s what I’m looking for. Give me something to grasp here. Let me get through the night.Porco: Nothing happened.Investigator: And you understand what I’ve been tell-ing you, that this is not a robbery. This is a crime of emotions.Porco: I know what you are telling me. I—I don’t know. I have absolutely no idea.Investigator: I mean, like I told you, in my estimation, that situation, the way I’m seeing it, was something that happened out of a passionate moment.Porco: You told me they were in bed, so I don’t know how passionate that could be, honestly.Investigator: And then afterwards, those emotions subside and the thought is, what’s happened? What have I done? What has happened here? What an awful thing.Porco: I agree it’s an awful thing.Investigator: Sometimes your emotions get the best of you, overtake you.Porco: True.Investigator: Your stomach is going to burn a hole in it. The only way to stop it is to be a man.Porco: I can’t help you.

The investigator attempted to play into Porco’s emotions and manhood as a strategy to elicit a confession, but the strategy got him nowhere. Porco gives bland answers, absent of emotion;


neither do his responses offer any insight into the murder itself. The investigator did ask questions about the fraud Porco had commit-ted, but he failed to press for greater detail, which is precisely the area that should have been thoroughly examined in order to reveal the de-fendant’s true motive for the murder. The in-vestigator should have confronted him about the email correspondence with his father that exposed his fraudulent behavior shortly before the murder. The goal of the investigators, in this case, should have been to expose the inconsisten-cies and implausibilities of Porco’s responses. Instead of attempting to get him to feel guilty about his actions in the hope of a confession, the investigator should have remained calm, like Porco, to ask questions. When Porco’s responses did not match the evidence col-lected, the investigator should have–calmly–confronted Porco about the inconsistency and further allowed him the opportunity to bury himself with more lies. Each investiga-tor incorrectly transferred a non-psychopathic explanation onto the murder by attempting to inure an emotion to the killing to suggest that somehow Porco’s anger was the impetus for the killing. The investigators failed to un-derstand that the issue was not about anger or any other emotion, but about using murder as a solution to a problem. Porco did not engage in an internal moral debate about whether murder was an option. The horrific manner in which he performed the murder does not necessarily correlate to the amount of anger Porco felt. Yet, throughout the interview, the investigator tried to attach Porco’s emotions to the murder. About midway through the interview, a detec-tive from the New York State Police was brought in. He was very matter of fact in his inquiry, and non-threatening in his approach. He questioned Porco about his trait of grandiosity. Detective: I’m still not quite understanding why you go around telling people that you have all this money. That kind of baffles me.Porco: No, I—Detective: --you put on this façade.Porco: It is. And I’ve done it for a couple of years now.Detective: What does that say about your charac-ter—Porco: Exactly.Detective:--Chris? Seriously. What—no tell me, what does it say about your character?Porco: I guess it’s insecurity in a way.Detective: Does it tell you that you’re an honest per-son?Porco: Not in that respect, no.Detective: Trustworthy?

Porco: I think of myself as trustworthy, I guess. If we’re going to respond in reference to this, no, I guess I’m not.Detective: I mean, if I—if I’m a student and I meet you and you’re telling me you’re going to buy a house be-cause you’ve got millions of dollars from your grand-mother.Porco: True.Detective: You’re basically lying to these people, right?Porco: Well, it kind of steamrolled away.Detective: No, let’s not color code it.Porco: I know it’s wrong.Detective: Do you consider it lying?Porco: Oh, definitely, yeah. You know, I’m telling them something that’s not really true.Detective: Are you a pathological liar?Porco: I don’t think so. I mean, maybe in that respect.Detective: What other things have you lied about?Porco: Really one thing. I’m trying to think of anything else. Just money. I don’t really know why I got started on it. It was in high school.

This is the style the detective should have con-tinued with Porco. The detective did not have to browbeat Porco into the admission that he lies. Yet, as the interview progressed, he, too, fell into the same strategy the other detectives followed, which was to use an emotional and confrontational approach. When he inquired into the forgery issue, he did not go to any depth that would have been fertile ground for Porco to bury himself. The lead author had the opportunity to speak to retired FBI profiler John Douglas at the ACFEI’s annual conven-tion and Mr. Douglas indicated that it is im-portant to approach the interview in a relaxed, non-threatening manner given that psychopaths come in different packages. Think of how a prosecutor could use that admission in a trial for impeachment purposes during cross examination of a defendant who is professing innocence. If a defendant is will-ing to lie about the most mundane and innocu-ous facts, what is he willing to lie about when it comes to important facts about a murder? The investigator must keep in mind that catching a red-collar criminal in a lie will not emotionally unhinge the red-collar criminal so as to cause a confession. The red-collar criminal will simply go on to another lie. Contrary to the usual inves-tigative strategy, remorse, emotion, and passion are irrelevant, and the interviewer must skillfully exploit this psychopathic attribute. The investi-gator should be able to visualize how the psycho-path’s illogical, inconsistent answers will play out in a court of law for the benefit of the prosecu-tion. Yet, the red-collar criminal is not thinking in advance about how his or her responses will be perceived; the criminal is too narcissistic to be sufficiently introspective, or to consider how others will perceive their answers.

Red-collar criminals are not good planners, an observation derived from the amount of direct, physical, and circumstantial evidence they leave behind. An investigator should seize the oppor-tunity to confront the suspect with evidence in order to lock the suspect into a story, an oppor-tunity the investigator may not have again, espe-cially if the suspect requests a lawyer. Therefore, it is crucial that the investigator understand what kind of person he or she is interviewing and construct an effective strategy. Unfortunately, Porco’s statement to the investigators was not used in court because the interviewers violated his constitutional right to have an attorney rep-resent him upon his request for one.

Modification of the Interview StrategyMany law enforcement agencies in North America use the Reid Technique as a meth-od of interviewing and interrogating suspects. Supporters of the technique argue that it helps to extract information from unwilling partici-pants. The technique detectives used in the Porco case appears to be the Reid Technique, and although generally useful, there are limits to its success depending on the type of individual being interviewed. The Reid method includes nine steps of interrogation, but some of these techniques can backfire when dealing with psy-chopathic personalities. Techniques are often anecdotally endorsed by those who can point to success stories, however, there are be times when a technique can fail, actually curtailing the investigation of a very serious charge. One of the premises of the Reid Technique is that the interviewer should be in control of the interview, preventing the suspect from denying guilt by cutting off unsatisfactory explanations and ultimately working toward a confession. The interrogator offers two contrasting motives for some aspect of the crime, sometimes beginning with a minor aspect to seem less threatening to the suspect, for example, one suggested motive might appear to be somewhat socially accept-able, such as to call an act “a crime of passion;” the contrasting or morally unacceptable motive would suggest that “one kills for the money.” The psychological manipulation begins before the interrogator opens his or her mouth. The physical layout of an interrogation room is de-signed to maximize a suspect’s discomfort and sense of powerlessness. The goal is to create a sense of exposure, unfamiliarity, and isolation. Once the questioning begins, the interrogator can use real or made-up evidence to confront the suspect with the goal of getting the suspect to see how futile it is not to confess. However, if the suspect asks for a lawyer, the interview must


stop. Many interviewing techniques such as the Reid Technique also involve the use of emotions as a tool to be used by the interviewer to get a suspect to give truthful information about a par-ticular crime, whether fraud or violent crime. When it comes to interviewing the red-collar suspect, traditional approaches must be radically modified to address both the behavior and the perspective of the psychopath. In cases where the interviewer suspects that he or she is in the presence of a true psychopath, it is reasonable to begin the interview using tactics appropri-ate for a psychopathic suspect. If the inter-viewer begins using a strategy more appropri-ate for a non-psychopath, upon realizing that the strategy is not working, he or she may not be able to switch strategies effectively midway through questioning the suspect. With respect to Christopher Porco, it was probably too late to shift strategies and use a psychopathic strat-egy as discussed. He would have been savvy enough to sense that the police were shifting gears and using a different strategy on him. The fact that the detectives kept trying to prevent his denials in the interview did not at any time induce Porco to confess or invoke his right to counsel. The Reid Technique opines that if one prevents the suspect from denying the facts, the interviewer can reduce the probability that he or she will invoke the right to an attorney. Porco’s sophistication may have derived from the knowledge that he could end the conversa-tion at any time by demanding attorney rep-resentation. It is probable that he participated in the interview for as long as he did in an ef-fort to find out what the police knew, just as the police wanted him to disclose information. Further, Porco probably anticipated the inter-viewer’s questions and rehearsed the answers he would give. Considering that his father was an attorney, Porco’s understanding of Miranda warnings was no doubt greater than that of the average suspect. In fact, it is not surprising that he invoked his Miranda Rights, which the po-lice subsequently ignored. Furthermore, because the traditional ap-proach to interviewing a non-psychopath may involve power plays between the interviewer and the interviewee, a psychopath will see through the interviewer’s strategy and probably refuse to speak to the investigator. This is why it is important for an investigator, to the best of his or her ability, to assess whether he or she is conversing with a psychopath prior to select-ing an interview strategy. The psychopath is intensely evaluating every move and word that the investigator utters. The psychopath is a true intra-species predator with hunter-like instincts even when he or she does not openly exhibit

those qualities. In the Porco case, modification of the Reid Technique that would have actual-ly allowed the suspect to think that he was in control, allowing him to reveal inconsistent and implausible explanations without stopping the denials, would have produced more evidence for the detectives and ultimately the jury. Some strategies an interviewer should consid-er implementing when interrogating a suspected psychopath might appear to be in opposition to techniques he or she has used in the past:

Avoid confronting the red-collar criminal with the 1. style that the authors observed in the Christopher Porco case. The investigators gained little informa-tion from the brow-beating approach they used.If it is evident that the suspect being interviewed is 2. likely the culprit, the interviewer’s goal is to collect as many inconsistent and implausible facts as pos-sible. Presenting incriminating evidence to the red-collar criminal does not increase the probability of a confession.If the psychopath does show emotion, the interview-3. er must be aware that they are emotions learned from observing how others behave in a given situ-ation. Do not alter the strategy believing that the psychopath will give a confession to the crime. The psychopath may be using this strategy for any num-ber of reasons (i.e., to test the interviewer’s strategy, evaluate how clever interviewer is, probe the inter-viewer for personal weakness).The interviewer should not make threats that he can-4. not carry out. For example, if the interviewer says that there is evidence that points to the red-collar criminal’s guilt and the interviewer does not pro-duce it when the red-collar criminal asks to see it, the interviewer has lost any chance of getting use-ful information. Attempting to play mind games will backfire for the interviewer.The interview of the red-collar criminal cannot be 5. based on appeals for sympathy, remorse, regret, or social obligations. The interview has to be based on a non-emotional format and the dialogue must re-volve around facts and specific evidence. Threats of punishment are of no consequence to this suspect.An interviewer should consider safety issues when 6. interviewing these suspects. Remember that these are not the typical non-violent white-collar criminals. Consider where the interview will take place (i.e., home, office, in public, etc.) and the time of day.

Interview SuccessMany individuals, especially those in law en-forcement, believe that in order to consider the interview a success, it is imperative to get the confession. However, the definition of a success-ful interview must be altered for psychopathic suspects. The fact that a detective does not get a confession does not mean that the interview was not a success. In fact, the inconsistent and implausible responses the detective elicits from the red-collar criminal are devastating when disclosed in court. Thus, if there is physical evidence, whether direct or circumstantial, the inconsistent explanations volunteered by the de-fendant are invaluable to the prosecution.

Imagine the jury in the Porco case viewing 6 hours of illogical, inconsistent and implausible testimony from the defendant. Would the fact that he did not confess really make a difference to a jury observing a person who shows no re-morse or feeling for what has happened to his father? Furthermore, if a defendant decides to testify on his or her own behalf, those statements can be used to further impeach his credibility in the event he or she gives further inconsistent testimony in court. Remember, in court, the red-collar criminal is not in a position to avoid those he cannot manipulate. Consider also the fact that defense attorneys attempt to project an image to the jury to the effect that their client was tricked, intimidated, and eventually coerced into giving a confession to interrogators. This defense strategy is virtu-ally non-existent as the jury views a video-taped conversation of the defendant speaking freely, voluntarily, and without coercion or force. Instead, the jury views an investigator simply collecting facts and giving the suspect the op-portunity to tell his side of the story even if it does not make sense.

The Role of Forensic Accountants and Fraud ExaminersForensic accountants should be part of a homi-cide investigation team if the evidence suggests that fraud detection may have been the motive for the murder. Although other types of physi-cal evidence may assist in developing possible suspects, these examiners may be in a unique position to uncover a motive that the physi-cal evidence does not reveal. Many such mur-ders revealed little in terms of motive until the evidence exposed an underlying fraud scheme that pre-dated the murder. Furthermore, by uncovering fraudulent behavior pre-dating the murder, forensic examiners may be able to nar-row the potential field of suspects in a way that other evidence is not capable of doing. Consider again the Porco interview and how much more effective the interview might have been had the interview included a qualified fo-rensic account or a white-collar crime detective to ask Porco about the specifics of the fraud. As a trial attorney, I have observed how many witnesses fall apart when cross-examined about the details of their testimony. Many witnesses believe that the way they think about their tes-timony in their minds will suffice for outsiders, but that is not the case, especially when they give inconsistent and implausible explanations. In essence, they have come to the conclusion that if they have convinced themselves of their lies, they should be able to convince others as well. Because they think so highly of their abil-


ity to manipulate others, the psychopath’s trait of grandiosity prohibits him or her from understand-ing how they are perceived by others, and this is their downfall. Though the entire Porco inter-view does not appear here, it is apparent that the detectives were not qualified to do any real fraud investigation interrogation follow-up. Interview expert Rabon would not have stopped Porco’s denials as the Reid Technique suggests, be-cause Rabon understands that pathological suspects must be handled differently. Not stopping the de-fendant’s denials does not mean that the interview-er is not confronting the suspect—it is a question of form, not substance. Rabon would have con-fronted Porco with incriminating evidence, but in a non-threatening, non-confrontational approach intended to get the lies out, and then move on to more lies. For example, the detective could have asked Porco why he never called his parents after he received the email where the parents were prac-tically begging him to call. What was Porco’s reac-tion when he read that his father would go to the authorities? Does he have documentation for the loan his father allegedly approved? And why did he buy a new Jeep when his parents were so upset after learning of his fraud? Although such questions had nothing to do with the murder, the answers might have filled volumes about his character. The link to the fraud detection was crucial to establishing a motive for the murder when the prosecution had weak direct evidence, but sup-portive circumstantial evidence of guilt. The case facts reveal that the victims were in a unique po-sition to detect fraud, which explains why they were the homicide targets. It would behoove fo-rensic accountants to examine what areas of the victim’s occupation or personal life would place him or her in a position to detect fraud, such as in the Petrick, Gaede, and Margolies cases. Forensic accountants must attempt to put themselves in the victim’s shoes and ask what he or she knew that might be threatening to someone. Did the victim do anything with his or her knowledge of the defendant’s fraud that could have increased the probability that he or she would be a target of violence? If forensic examiners are part of an interrogation team to present what they have learned to the suspect, then the suspect may be provoked to disclose lies that will be used against him or her in court, where he or she is less apt to be successful using the chameleon strategy.

ConclusionThe data derived from this study reveals that al-though red-collar criminals are psychopathic, their psychological strength is also a weakness to be exploited in the investigative stage of the mur-der. The incompetence exhibited by the red-collar criminals is observed by the amount of evidence

they create, which is ultimately used against them in a court. By understanding the chameleon-like qualities of red-collar criminals, the evidence trail they leave behind actually exposes both their white-collar crimes, a motive for the murder, and their participation in the murder. It is imperative for in-terviewers to become acquainted with the traits of a psychopath in order to plan an interview strategy that will assist future red-collar prosecutions.

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About the Authors

Frank S. Perri, JD, MBA, CPA, has worked as a tri-al attorney in the criminal law field for more than 10 years. As lead author of this re-search project, Mr. Perri was the

defense attorney for George Hansen. Areas of concentration include white-collar crimes, homicide, and narcot-ics. Mr. Perri received his Juris Doctor from the University of Illinois in 1991. He received his Master in Business Administration from Case Western Reserve University and his Bachelor of Arts in economics from Union College. In addition, Mr. Perri is a Certified Public Accountant. You may contact Mr. Perri via email at [email protected].

Terrance G. Lichtenwald, PhD, is a Life Fellow and Diplomate in the ACFEI. As part of the pre-trial prep-aration, the sec-ond author of this study completed a behavioral sci-

ence study of George Hansen. He earned his Doctorate in clinical psychol-ogy from an American Psychological Association (APA) approved program and completed an APA-approved in-ternship. He has a masters degree in clinical psychology and a second mas-ters in school psychology. He earned his bachelors degree in broad field social studies and psychology. Dr. Lichtenwald has spent 18 years com-pleting forensic, behavioral, psycho-logical, and security evaluations, as well as threat assessments. Research interests are in smuggling, white-collar crime, and security/threat assessments. You may contact Dr. Lichtenwald via email at [email protected].

Earn CE CreditTo earn CE credit, complete the exam for this article on page 78 or complete the exam on-line at www.acfei.com (select “Online CE”).


Key Words: gangs, interventions with gang members, agency cooperation on gangs

By Mike Meacham, PhD, LCSW, DCSW, DABFSW, and Tony Stokes

AbstractThe growing problem of gang activity continues to plague clinicians, human services, commu-nities, schools, law enforcement, corrections, and public policy. Many interventions assist in helping gang members change, or attempt to control gang activity, and their focus is on gang members in middle and secondary schools (or the few years following). This paper proposes that the growth of a gang member continues through a lifetime of changes, and it suggests in-tervention at various levels of a gang member’s development.

Many anthropologists believe that societies have been plagued by and have reacted to gangs since ancient times (Expertwitness.com, 2006). Certainly, gangs have been on the American landscape since early in its

history. Among the first gangs were “The Forty Thieves,” founded about 1826 (Sachs, 1997). Ashbury (2001) and Haskins (1974) have chronicled the early growth of gangs. Thrasher (1927) studied over 1300 gangs in Chicago during the 1920s, and although most of these gangs were Caucasian, the majority became prominent in groups considered white-im-migrant minorities (e.g., Irish, Italian). By the 1940s there were organized non-Caucasian groups. and by the 1950s, Hollywood was making movies about gangs, such as “The Wild One” and the film “West Side Story,” re-leased in 1961. David Wilkinson (1963) wrote an account of the 1950s gang The Mau Maus and its leader, Nicky Cruz, who later founded the “Nicky Cruz Outreach” to help troubled teenagers. During the 1960s, partly from the political unrest of the times, gang membership skyrock-eted (Sachs, 1997). By the 1970s, the Crips and the Bloods had formed. Historically, and in the present, a majority of gangs have formed as a reaction to oppression and social ostracism (see Spergel & Curry, 1993; Goldstein & Kodluboy, 1998). Few doubt that early gangs and many contemporary gangs developed as a backlash to denial of access to resources, and a response to social injustice. However, at least some gangs have formed in order to take advantage of illegal means to wealth, even when members have legal options to maintain at least a middle-class lifestyle. In our experience with nationwide gangs, it seems that the business side of the gang becomes at least as important as any reaction to oppression, which may have been the original reason for the formation of the gang and the method by which it drew members. By the 1980s, a suppression policy had emerged as the prominent intervention against gangs (Spergel, 1991).

CE Article: (CERTIFIED FORENSIC CONSULTANT, CFC) 1 CE credit for this article

The Life Development of Gang Members: Interventions at Various Stages

After studying this article, participants should be better able to do the following:1. Distinguish between the various levels of

development of gang members.2. Identify various interventions for each level.3. Discuss how different agencies approach

gang problems


This article is approved by the following for continuing education credit:


(CFC) The American College of Forensic Examin-ers International provides this continuing educa-tion credit for Certified Forensic Consultants.

(CBBS) The American College of Forensic Ex-aminers International is an approved provider of the California Board of Behavioral Sciences, approval PCE 1896. Course meets the qualifica-tions for 1 hour of continuing education credit for MFTs and/or LCSWs as required by the Califor-nia Board of Behavioral Sciences.

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(ASWB) This organization, American College of Forensic Examiners International Approval Number 1052, is approved as a provider for continuing education by the Association of Social Work Boards 400 South Ridge Parkway, Suite B, Culpeper, VA 22701. www.aswb.org. ASWB Approval Period: 9/13/2004 to 9/13/2007. Social workers should contact their regulatory board to determine course approval. Social work-ers will receive 1 continuing education clock hours in participating in this course.

By the 1980s, most of America was aware that gangs were more than a group of troubled youths riding motorcycles. Much like their early predecessors, gangs were forming and growing as social and economic entities. Colors, hand-signs, particular clothing, street graffiti, and tattoos were among the many identifiers. By the late 1980s and early 1990s, service agencies had become involved (Sachs, 1997), and social scientists (e.g., Cummings & Monti, 1993) were studying gangs intensely. However, many Americans still believe that gangs and their memberships occur in middle and secondary schools, and that as members enter young adulthood, they may continue for a while, but eventually they are either driven out or drop out. A review of the recruitment and develop-ment of gang members is called for that might challenge prevailing myths and suggest inter-ventions. The data here spans nearly a decade and is drawn both from literature and from discussions and interviews with police officers, correctional workers, social service workers, gang members, and prisoners. Of course, differences exist among gangs. There are gangs that wish specifically to de-fend an area such as a neighborhood, gangs that seek friendship and excitement, and gangs whose members have become international criminals in drug trafficking and other illegal activity. People become gang members for myriad reasons, and people choose to become in-volved at different times in their lives, com-plicating the task of prevention.

Primary Intervention It is probable that prevention is most ef-fective among youths. Primary interventions are designed to encourage people to avoid be-coming involved in gangs. These interventions may include direct work, such as establishing community meetings to discuss gang prob-lems and addressing suggestions, educational programs in schools and media, law enforce-ment programs, and human services efforts. However, the complexities of peer pres-sure, the dream of quick wealth, and the sta-tus, comradeship, and safety provided by gangs makes prevention more difficult. True interventions require assistance in develop-ing opportunities. These include after-school programs and events, job possibilities, career-training opportunities, funding to assist in higher education, neighborhood watch pro-grams, and close work with institutions in the community, including businesses, the police, schools, churches and other voluntary asso-

ciations, as well as the community-at-large. Prevention means long-term and difficult work in establishing trust in the community, reassuring people that the programs will have a positive impact, and developing the human and fiscal resources needed to establish and maintain the programs.

Gang FamiliesIt is not likely that there was a time when gangs did not exist. Gangs that have become fairly well known (e.g., Aryan Brotherhood, Chinese Tongs, Bloods, Crips, Hell’s Angels, Latin Kings, Vice Lords, Black Gangster Disciples, and many others) have been in the news since before the early 1980s. And since their beginnings there have been members who fit the newsreel stereotypes. They join in their teen years, wear gang-related cloth-ing, and continue developing other means of advertising their membership. However, those who did so in the 1980s now are mid-dle-aged adults. This means that some mem-bers are now rearing families of their own, re-sulting in children who are born into a gang lifestyle. Carlie (2000) writes that many new members are now “blessed in” because they have a brother, cousin, father, or mother who already belongs to the gang. Gottfredson (1997) has noted the lack of well-researched or well-conceived intervention programs for gangs. Though most anti-gang programs begin at the school level, these pro-grams will not be helpful to a child reared by loyal gang parents. On the other hand, most parents tend to want a better life for their children than what they have had. Gang par-ents who have witnessed violence, been under police investigation, or spent time in prison may work strongly to keep their children from some activities. To address this level of involvement, we turn to secondary intervention. The parent or par-ents are already involved in the gang lifestyle, placing the child in a situation in which he or she is raised to be involved, as well. Those gang-member parents who wish to keep their children from becoming involved must coun-ter the social learning and modeling behaviors that increase the chances of their children be-ing influenced by gangs. Intervention focusing on this group of gang parents may begin with community education. Programs to help children become involved in non-gang activities, parenting classes, group therapy, family therapy, and community or-ganizing may be beneficial. Those involved in the intervention process must establish needed programs and make efforts to ensure that the

community knows about them. Part of the ef-fort for this group is to encourage parents who are gang members to leave the gang; however, just leaving the gang will not suffice. There must be an opportunity to build another life, and for many this may require adjusting to a less affluent lifestyle after years of working in the underground economy. Furthermore, leav-ing a gang with which one has associated for many years presents dangers. Gang members fear that those leaving may become sources of information for the police or that they may threaten the gang in other ways. Violence against members who choose to leave is both institutionalized within the gang (known as “beating out”), and ad hoc or informal, where some are injured or killed to protect gang ac-tivities from becoming known to the outside. Although there is little systematic evaluation of opportunities to decrease gang involvement (see Thompson & Jason, 1968), Spergel et al. (1989) find better success when opportuni-ties are well supported and organized, which is necessary for any intervention. There is another group of parents who are quite satisfied with the gang lifestyle. Throughout much of their lives they have benefited in many ways from being a part of a gang, and they may have accumulated more wealth and prestige than they ever could have through legitimate methods. These parents may purposely train their children to become part of the gang, perhaps beginning by merely attending gang gatherings, becoming known, and participating in petty gang acts. These children may attend school and have many le-gitimate activities, but the lure of quick wealth and the status already afforded them presents a strong temptation. The parents of these chil-dren may have introduced them into the gang formally or may have informally modeled the lifestyle in a manner that socialized their chil-dren to join without direct solicitation. The interventions in this situation will be much more difficult. We may ask community leaders to address the members and the prob-lems for their children, or we may reach some through education efforts in the community; however, both of these options are unlikely to be effective for the majority of these fami-lies. Interventions may occur during a crisis, such as a parent being arrested, wounded, or in need of police protection. Gang members live with these dangers daily, and during the crisis we may approach them concerning the negative aspects of their lifestyle. This may af-fect some, and others may be more likely to respond to programs to keep their children out of gangs. The complexities and dangers


of the gang lifestyle are likely to create times when young members may be more open to interventions. Violence, ostracism by teachers and peers, and legal interventions are among the possible incentives. These interventions have merit in address-ing issues of children reared in the families of gang members, but they are not likely to re-direct large numbers from their predilection toward gang banging. Many of the people in this group are inducted formally into gangs by the time they are in secondary school and have participated in them with at least par-tial success for years. Because of the lifestyle of violence and illegal activity associated with gangs, law enforcement and human services inevitably become involved. For these chil-dren, all the alternatives are fraught with dif-ficulties. On the one hand, the systemic factors within families associated with gangs (Horne & Sayger, 1990) result in highly dysfunction-al families—a situation that may be alleviated by placing the child with a stronger family model either in foster or relative care. On the other hand, family disruption is a real source of concern in the lives of developing children (Littner, 1950). We must try. Many gang members now are being trained by their own parents, though education programs and increasing legitimate opportunities will mitigate this influence at times. Horne (1991) suggests intervention goals for this stage, including social compe-tence enhancement, peer counseling, behav-ioral self-control strategies, parent training in child management skills, social learning theory in family therapy, parent individual therapy, couple/single parent counseling, and parent education, career-vocational, and financial case management.

Youngest Active “Members”Young children, sometimes as young as 6 years old, are solicited for important roles in the gang structure. They may be part of the “front” business—the legitimate enterprise hiding illegal activity in other parts of the building. Grocery stores, barbershops, and other small businesses are used, and having children participate in legitimate transactions strengthens the façade. Other young children may be “scouts” who watch for law enforce-ment and other people who may interfere with gang activity. Also, young children make excellent “mules,” carrying illegal items from one place to another. There are more ways to discover a potential problematic child at this stage. Many times community organizations (e.g., the Boys and Girls Clubs) detect these

children in gang activity. Government agencies (i.e., Division of Family Services) and schools frequently discover or suspect children as be-ing involved. Truant officers, social service workers, and law enforcement officers may be mandated to report some activities, and individuals in the community may be encouraged to report sus-pected activity as well. However, therapeutic interventions may focus on areas other than discovery. Individual therapy may, of course, take many forms, but an eclectic intervention strategy has shown promise, using moral and cognitive interventions (Gibbs et al., 1991a, 1991b), as well as an even wider mix of thera-pies (Kazdin, 1987). There are several family therapies that may prove useful at this stage in a child’s life. Minuchin (1981) intervenes to restructure the family, assuring that the parents have more control and authority over children. Kerr and Bowen (1988) use genograms to search for

familial patterns over generations, including alcoholism, drug use, family feuds, and other problems. Haley (1990) assesses the family and creates a specific intervention, stated in mea-surable terms. Should an initial intervention prove unsuccessful, the therapist will imple-ment another. All of these interventions have proven useful, and others are reviewed in the literature. Schools assist the effort by remain-ing alert to absentees, use of gang symbols, and other indications that particular children may be involved in gang activities. School coun-selors, psychologists, and social workers may then intervene. At this stage, again, many lev-els are involved in effective intervention. The discovery of involved or at-risk children may come from multiple sources. To review, in gang families, while there may be some gang bangers who seek out assistance to ensure that their children stay out of that lifestyle, we believe the majority will become involved with human services as the result of

s San Mateo Sheriff’s detectives question a youth with “500 Block Sac Street” tattooed on his wrists. Despite a crack-down by police, gangs are still prevalent including members of the Sacramento Street gang. KRT PHOTO BY TOM VAN DYKE/SAN JOSE MERCURY NEWS


a crisis such as a shooting or an arrest. Truant officers, community leaders, business people, families, neighbors, law enforcement, and school officials may assist in both discovery and intervention for these at-risk children.

The Core of Recruitment: Middle and Secondary School AgeAt this age, entering puberty and working their way through adolescence, the conflict-ing needs of independence and of belonging become strong. With nascent social skills, de-velopment in the arts or athletics, education, wealth, or other forms of status, gang mem-bership may become quite seductive. Gangs provide a sense of belonging. Symbols such as dress, tattoos, hand-gestures, and spe-cial codes promote bonding and deliberate-ly exclude those not able to understand the meanings. A child who has grown from birth to middle school in a gang environment is now ready to become a member. He or she will generally be blessed in and begin participating in activities with the other gang members—these young people now become full-fledged problems within the school system. Stephens (1992) developed the Gang Assessment Tool to assist school officials in gaining some idea of how big the problem is within their schools. Stephens (1993) further recommends in-clusion of a gang prevention curriculum; gang awareness among faculty, staff, and stu-dents; education of faculty and staff through frequent in-service training on gang-related dress and graffiti, etc; a dress code accompa-nied by clear behavioral expectations; quality adult supervision; and outreach to the com-munity. McConnell (1990) recommends that measurable goals be established that are clearly defined, so the school can determine the ef-fectiveness of any program. Parents may become involved as well through education, parenting classes, and the use of tests that may indicate their child’s involvement. School and parent programs should be working with law enforcement and other community agencies closely. Reporting gang activities to police is essential in control-ling activity by this age. At this age, “easy” money is another at-traction for members. How to make money through drug deals, pay-for-violence actions, prostitution, theft rings, and other enterprises are learned. To the uncritical teenage mind, this may appear easy because it is quick; how-ever, it is anything but easy. Retribution for poor performance is swift and often deadly if the punishment comes from the gang or rivals. Police intervention is a constant threat, and

many gang members enter the justice system at this time. In juvenile detention centers and in prisons, activities and skills learned on the street are practiced and honed.

The Young Adult Gang MemberBy young adulthood, a gang member has de-veloped a social identity. He or she may be adept in intelligence, violence, business, and other activities important to the gang. The member has survived the streets, wounds, ostracism by the larger society, and perhaps incarceration. At this time, membership be-comes a career. Drug deals are no longer just a way to get party money. They become in-volved in national and international drug rings. Gun running, white slavery, human traf-ficking, money laundering, and other activi-ties are added to their enterprises (see GTA-SanAndreas.com, 2003). Generally, human service work is not ef-fective at this level, except for victims. By this time, gang members are loyal to the gang, and should they become disillusioned, they will seek protection instead of emotional and material support. Police have developed a na-tional gang data bank, and gang task forces are a part of many police agencies. Though they are developing new anti-gang and gang-control methods all the time, these tend to be efforts to identify gang members and activity and to increase community involvement in anti-gang efforts. Many members already have been part of the juvenile justice system, and more will become part of the prison system. Each prison system has different levels of gang control, but there seem to be primarily two lifestyles awaiting gang members in prison. For some, their youth results in almost immediate planned exploita-tion by older inmates. Other younger members may know, or be known by, established mem-bers in the prison who may protect them. Corrections officials focus on identifying gang members, and, generally, at orientation, inmates are told of the problems that may occur by relating as gang members. Duxbury cites the GANGS (Gang Awareness Necessary for Growth in Society) program developed by John Berge in Chino, California, where youth-ful members are taught the negative influenc-es of gangs in the community, in the lives of their families, and in their own lives. These approaches, as well as cognitive-behavioral interventions, are frequently used in prisons. Gang members, however, have many reasons to remain members while in prison. For one, gangs are so well organized and strong with-in the prison that the new gang inmate has a

group ready to support him or her, though new arrivals frequently must prove their met-tle to the gang, especially if they do not know anyone at that facility.

Adult MembersSome adult members—violent members un-able to keep their acts private—become dan-gers to the gang, drawing unnecessary atten-tion both from rivals and law enforcement. These are eliminated either by murder or by going to prison. Others develop their skills, possibly including military service, and learn to use violence in ways to promote gang needs and their own careers in the gang (United Press International, 2007). A similar situation occurs for members with other skills. Mistakes in drug dealing or any other enterprise may end in death or prison. Gang members/deal-ers develop their skills in much the same man-ner as others do their careers. Older gang members have little in common with their teenage counterparts. While teen-age members make every effort to demonstrate gang membership, older gang members learn to hide it. Their goal is to appear as though they are persons of social importance; their skills have been honed, and their accumulated wealth has been directed to this end. There appear to be four possibilities. One, gang wars continue, mistakes happen; therefore, some are killed. Two, others are caught in acts that end their careers with long prison sentenc-es. A third type is the local neighborhood leader. This member resembles the gang member of the nineteenth century, building a reputation in the community using a “carrot-and-stick” ap-proach. They provide protection, develop local economies and facilities, and earn respect and appreciation in the area; however, they know when to use violence, which members are able to provide it, and how to keep it secret. More importantly, they are able to use it while keep-ing their names separated from it. The members who seek wealth and have the savvy to get it may establish national and in-ternational underworld reputations and prove their skills through success. They too know how to use violence and who can provide it, but they are just as interested in knowing who is intel-ligent and who has the social skills to defend their economic interests. They may contribute by attending business school, law school, ac-counting school, etc. Further, they may send members through school for this purpose. At this level, any resemblance to the street thug is gone. They seek to appear as an aver-age, albeit wealthy, society member. They are


well protected from street violence, although well-planned, expert assassinations may oc-cur. They worry little about local law enforce-ment, sometimes even having co-opted some of them or having members on the force. They are concerned with national and international agencies, and may even have protection from them. They are rich and able to add to the wealth of legitimate business people, at times co-opting them, while at other times, estab-lishing legitimate businesses of their own. There will be continued interventions at this level by police, but they are hampered in gath-ering evidence on neighborhood gang leaders who have the ability to contribute to the com-munities they control. Frequently, because of rifts within the organization, feuds without, and other mistakes, these leaders are incarcer-ated. Intervention beyond law enforcement and corrections lies in community awareness programs and in developing alternatives to gang activity within the community. Obviously, these gang members will not be affected by school programs and are not like-ly to become involved in clinical programs. Community advocacy and education is the best intervention for gang members at this stage. The fourth group is comprised of gang members who go beyond the community. These members likely have survived street violence, police detection, or at least arrest and long-term incarceration, and have proven their illicit skills to others. Their affiliations become at least national and perhaps inter-national. These members have reached such a level of sophistication at their “profession” that they are very difficult to arrest or to link with criminal activity. They have little or no desire for clinical interventions and are beyond community programs. Specialized law enforcement units work on the national and international levels to control the activities of these members. Those incarcer-ated may work with prison therapists or parole planners, but the work of these interveners is very difficult. After a lifetime in a gang lifestyle, few people have the motivation to change.

ConclusionBy adulthood, the majority of gang members have families of their own. Some strive to re-tire from criminal activities or raise their chil-dren in lifestyles of legitimate wealth. Others begin to rear their children in the ways of their own path. As new generations are reared into the underground system, new methods of achieving their ends develop. Law enforce-ment and human services react, and the circle becomes a spiral.

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Earn CE CreditTo earn CE credit, complete the exam for this article on page 79 or complete the exam on-line at www.acfei.com (select “Online CE”).

About the Author

Mike Meacham is an Associate Professor of Social Work and an Forensic Social Worker at Valdosta State University. He has worked with gangs since he was a pris-on therapist in

1987. He has written several arti-cles on gangs, including articles about school gangs and prison gangs. His present interest is international gang developments.


T his article is proposed as a treatise on the management of injuries sustained in a workplace or vehicular accident. It is from the perspective of an orthopaedic

surgeon who has spent more than 45 years man-aging injuries of all kinds. In the past 25 years, I have evaluated 15,000 accident patients and the management of their injuries by a variety of prac-titioners, including orthopaedic surgeons. This article was inspired by several discussions and a presentation with Dr. John Haberstroh on injury assessment and management. Our presen-tation was at an annual meeting of the American College of Forensic Examiners in Orlando, September 21–23, 2006. In our discussions, Dr. Haberstroh expressed his concern regarding the manner in which independent assessments of injuries from motor vehicle accidents are be-ing performed. As an orthopaedic surgeon and independent evaluator, I have a similar concern and a desire to resolve some of the conflicts that are inherent in the system. In my opinion, it is important to clarify not only the controversies in this field, but also their causes. One difference of opinion concerns the criterion necessary to determine the occurrence of an injury. This in turn affects the diagnosis of the specific injury, and subsequently, the treatment of

that injury. The criterion necessary to determine the occurrence of an injury, from a medical point of view, is as follows: An injury is tissue damage resulting from an energy source applied to the body (Stedman’s Medical Dictionary, 1995). It is important to understand that an injury is con-sidered not to have occurred if no damage to the tissue has resulted from the force. Also impor-tant to note is that the tissue of muscles can be strained, yet not damaged. A strained muscle will become stiff and painful; that result is an inherent physiological response. Most of us have experi-enced such a response after performing strenuous work or engaging in a new physical activity. As a surgeon, I have operated on the neck and back. In order to approach the spinal column, I have had to dissect through the major muscles. Most certainly, the degree of pathology resulting from the surgical disruption to the muscles will be far more than can be demonstrated to arise from muscle strain or sprain injuries due to a motor vehicle accident. I have observed that following surgery, once the muscle tissue has healed, there is usually no problem for an individual to return to a fully functioning status. However, in the case of a muscle strain, many patients have difficulty returning to full function. The reasons for this are addressed further on in the treatise.

Injury Assessment and Management

CE Article: (CERTIFIED MEDICAL INVESTIGATOR, CMI) 1 CE credit for this article

AbstractA combined presentation by Dr. John Haberstroh and Dr. Robert H.N. Fielden in 2006 at the Annual Meeting of the American College of Forensic Examiners resulted in this article, where Dr. Fielden discusses the importance of certain principles for the management of musculo-skeletal injuries. He also examines some sources of controversies that tend to develop around the treatment and management of these injuries. Dr. Fielden suggests that many controversies could find resolution in the adoption of suggested principles by professionals involved in in-jury assessment and management of both workplace and motor vehicle accidents.

By Dr. Robert H.N. Fielden, MD, FRCS(C), FACFEI, DABFM, DABFE

Key Words: treatment, diagnosis, focus, goals


(ACFEI) The American College of Forensic Exam-iners International provides this continuing educa-tion credit for Diplomates.

(CMI) The American College of Forensic Examin-ers International provides this continuing educa-tion credit for Certified Medical Investigators.

(ACCME) The American College of Forensic Ex-aminers International is accredited by the Accredi-tation Council for Continuing Medical Education to provide continuing medical education for physi-cians. This activity has been planned and imple-mented in accordance with the Essential Areas and Policies of the Accreditation Council for Con-tinuing Medical Education (ACCME). The Ameri-can College of Forensic Examiners International designates this educational activity for a maximum of 1 hour AMA PRA Category 1 Credits TM. Physi-cians should only claim credit commensurate with the extent of their participation in the activity.

After studying this article, participants should be better able to do the following:1. Distinguish between an injury and a

muscle strain.2. Understand the importance of the initial

diagnosis and treatment regimen.3. Recognize the point in the treatment pro-

gram at which the injury has healed and the ongoing symptoms are no longer due to tissue damage, but are influenced by other factors surrounding the injury.


Injury Assessment and Management


Another source of controversy concerns the determination of a diagnosis for a specific type of injury. I have observed that the more severe the injury, the less likely a difference in the diagnosis by the treating practitioner. It is the more subtle “soft tissue” injuries that create the difficulty in diagnosing. In my opinion, this problem can be resolved if the diagnosis, or the lack of one, is determined before treatment is initiated. It is important to remember that if no injury can be demonstrated by objective evidence, both the patient and the treating practitioner must understand and acknowledge this fact and deal with the situation accordingly. Although sev-eral opinions may be held regarding a specific diagnosis, in fact, there can be only one correct opinion; this is the one that accurately describes the specifics of the injury and its extent. A third source of controversy that I wish to address concerns the treatment of the injury. From my experience, I would recommend that the treating practitioner not formulate a treat-ment plan until a well-documented diagnosis has been established for the injury. I would further suggest that the diagnosis reflect the dynamics of the accident that could have caused the injury in question. Following this, the injury should be dealt with by a method the practitioner has been trained to use, designated by his or her profes-sional degree. If this regimen is followed, the majority of patients with soft tissue strain and/or resulting injury should recover to pre-accident status within a few weeks. Having said this, I wish to point out that in some cases there is a point in the treatment pro-gram when a subtle, but definite, change occurs. The patient initially expresses relief as a result of the treatment. However, this is soon followed by the patient’s report of having pain and a request for more treatment, such as medication, massage adjustments, or physiotherapy. Unfortunately, the practitioner often continues to try to alle-viate the pain by means available within his or her expertise. Here is the crucial point where the practi-tioner must stop and ask the following ques-tions: Has the injury healed? Is there evidence of significant ongoing pathology to explain these continued symptoms of pain? If the an-swers are no, more questions must be posed: Is it responsible practice to continue to treat a healed injury as if there has been a failure to heal? Are both the treating practitioner and patient caught in a web of believing that there is a significant problem that has not been ad-dressed, and if untreated, might cause perma-nent harm? Should not the patient be advised that, based on the objective findings, there is no longer a physical problem? Finally, might con-

tinued treatment cause more harm than good to the patient? It is understandable that both practitioner and patient are reluctant to stop treatment. However, at some point one must allow the patient to take responsibility for the next step in his or her life. Compliance with the patient’s request for additional or different treatment is necessary only if there has been a new or missed finding suggesting an ongoing physical problem. In this case, an additional, thorough re-evaluation would be in order. My experience has been that in some cases, the reason for the request for more treatment is that it is beyond the expertise of the professionals involved, and it is more like-ly in the realm of a psychologist or psychiatrist (Heffner & Walker, 2006). It is understandable that as practitioners, we are tempted to comply with our patients’ requests; because our role is that of healer; however, we must remember that in some cases, acquiescing to such requests may cause harm to the patient. This, too, we are dedi-cated to avoiding. Herein lies our dilemma. To quote Shakespeare, “I must be cruel in order to be kind.” All practitioners are aware that there are many methods of treating injuries, even within the same discipline. This is acceptable, provided that no harm is inflicted on the patient as a result and that the goal of the treatment is the satisfactory healing of the diagnosed injury. I do not intend to delve into the methods of injury treatment here; however, it is necessary that I address the manner in which a patient is approached to ob-tain the best possible outcome for that patient. One strategy to attain this outcome is to ensure that the focus of the treatment is directed at the injured area and that the rehabilitation of the patient begins at the outset. This is a criti-cal period, because it affects the patient’s view of his or her accident and response to the phys-iological and/or psychological trauma. In my experience, patients who have been injured in accidents invariably express this trauma as pain. The degree of pain usually varies with the in-dividual and derives from a number of factors; understandably, one is anxiety. This factor can be eased significantly by helping the patient to understand the following: the exact nature of the injury, expected period of the healing pro-cess, type of treatment, and duration until full recovery. In addition, the patient should be reas-sured and encouraged to continue to use all the uninjured areas and should be made aware that rehabilitation of the injured part(s) must com-mence as soon as it is reasonably safe to do so. If treatment focuses only on the pain response, and not on the injury, neither is likely to be al-leviated.

Motor vehic le - re lated injuries can be arbitrarily divided into: 1) Collision between the patient and the external environment (the vehicle, or a stationary object if the occupant has been ejected) 2) Acceleration or deceleration forces acting on the patient’s internal organs

CollisionsIn a frontal collision, the unrestrained occupant of a vehicle continues to move forward as the vehicle comes to an abrupt stop. This forward motion is ar-rested as the patient connects with the, by now, stationary vehicle chassis. The initial impact point is often the lower extremities, resulting in fracture/dislo-cation of the ankles, knee or hip dislo-cations, and femoral fractures. As the body continues moving, the head, cervi-cal spine, and torso impact on the wind-screen and steering column. In a lateral impact, the victim is ac-celerated away from the side of the vehicle. Compressive pelvic injuries, pulmonary contusion, intra-abdominal solid organ injury, and diaphragmatic rupture are common. Rear impacts also accelerate the victim; if head restraints are incorrectly fitted, the inertia of the head makes the cervical spine vulner-able to injury. Ejection from a vehicle is associated with a significantly greater incidence of severe or critical injury.

Deceleration/acceleration injuriesSuch injuries occur when differential movement occurs between adjacent structures; for example the distal aorta is anchored to the thoracic spine and decelerates much more quickly than the relatively mobile aortic arch. Shear forc-es are generated in the aorta by the con-tinuing forward motion of the arch in re-spect to the distal thoracic aorta. Similar situations occur at the renal pedicles, the junction of the cervical with the thoracic spine and also between the white and grey matter within the brain. Bowley, D., & Boffard, K. (2002). Pattern of injury in

motor vehicle accidents. Retrieved January 14, 2008,

from http://www.worldwidewounds.com/2002/oc-

tober/Bowley/Patterns-Of-Injury-MVAS.html.

Motor vehicle injuries


As perception of pain is personal, each pa-tient responds to an injury in a different man-ner. Further, an individual’s perception of the character and the degree of pain can fluctuate, even though there has been no change to the in-jured area. Hence, it is most important not to use the patient’s pain response as a measure of treatment effectiveness or as an indication of a need for additional treatment. To reiterate, it is important that the treating practitioner remem-ber the following guidelines: Treatment must be focused on the healing of the existent injury rather than on all the symptoms described by the patient, as some may not be relevant to the injury in question and its stage of healing. The last, but not least, area of contention is the role of the independent evaluator. The eval-uator, too, must focus on the diagnosis and on the stage of recovery from the injury. Should there be residual objective findings from the injury, the evaluator must enumerate the spe-cific facts and determine whether the problems are due to the accident in question. If there are such findings, the evaluator is obliged to make a statement of opinion to that effect, in spite of the patient’s report of severe symptoms. The evaluator’s opinion is deemed to be based on professional qualifications, experience, and ob-jective findings (Haberstroh, Henry, & Mulhern, 2005). I cannot emphasize enough that neither the treating practitioner nor the independent eval-uator should become a party to the claimant’s case should a dispute arise. Independent Medical Reports should be based on objective findings and opinions emanating from these findings. The treating practitioner has a duty to provide the best treatment for the injury, issue well-doc-

umented and timely reports, and in these areas only, be the patient’s advocate. The same rule must apply to the independent evaluator in re-gard to advocacy. If both professionals concerned follow these guidelines of injury management, the treating practitioner and the independent evaluator will be working towards the same goal: the return of the patient to the pre-accident sta-tus and lifestyle as quickly as is deemed reason-able for the specific injury. In closing, I must reiterate that both the treat-ing practitioner and independent evaluator are examining the same patient; hence, their ob-jective findings and conclusions should be in reasonable agreement. I truly believe that if the aforementioned suggestions are applied, when assessing and treating patients of motor vehicle and work accidents, many of the disagreements among the professionals involved will, in all probability, be eliminated.

References Haberstroh, J., Henry J.R., & Mulhern, K.J. (2005). Properly documenting a file and foren-sic examination or IME doctors. The Forensic Examiner, 14(4), 20–31. Heffner, F., & Walker, J. (2006). Disability, dysfunction, or deception: Explaining acquired occupational disability. The Forensic Examiner, 15(1), 12–23. Stedman, T.L. (1995, March). Stedman’s medical dictionary. (26th ed.). Williams and Wilkins.

About the Author

Dr. Fielden earned his medi-cal degree in 1957 from the University of Toronto Medical School. He ob-tained his Fellowship in Orthopaedic Surgery in 1963

and was later appointed a clinical teacher at the University of Toronto. He also obtained his American Board Certification in Orthopaedic Surgery. In 1978, he moved his practice to Minnesota, where he became an Assistant Professor at the University of Minnesota. Although his prac-tice was in general orthopaedics, he was drawn gradually towards the specialty of spine surgery and back pain management. Dr. Fielden also began administering Independent Medical Examinations in Minnesota and other states, and after returning to Canada in 2000, he continued to provide this service. He estimates that he has performed more than 15,000 evaluations during the past 25 years. One of Dr. Fielden’s interests lies in the medicolegal field, so he has been a member of The American College of Forensic Examiners for the past 10 years.

Earn CE CreditTo earn CE credit, complete the exam for this article on page 80 or complete the exam online at www.acfei.com (select “Online CE”).



Stories From the Front:IE (IME) Excesses and How to Counter Them

T his paper will demonstrate true sto-ries of IE excess. It will move forward to suggest strategies, both clinical and legal, to deal with these excesses. As al-

ways, the main thrust of this essay, like its two predecessors, is to bring a realization of a major problem to the forefront of forensic analysis and public awareness and to offer reasonable coun-ter-measures to address the problem.

PART I—“But Doctor, I really do have these problems. My pain is real!”

*This article again is written by chiropractors. As such, it slants somewhat towards chiropractic prac-tices. Interestingly, our first story coincidentally in-volves a chiropractor “victim.”

Joan Hangarter was a successful chiropractor in California. She was building a busy practice. She

owned a nice home in Marin County, and she had two small children. One day in 1997, she was attempting a difficult lumbar adjustment on a large male patient and felt a burning, ripping pain in her right forearm. The pain seemed to radiate up to her neck. Like most people, she thought a little rest would clear it right up. How wrong she was. The pain got worse. Months later, after numerous attempts to treat the pain with physical therapy, chiropractic care, medi-cal intervention, and numerous tests including MRIs, she was diagnosed with a permanent disability and was told she would no longer be able to practice (Bourhis, 2005). *She had cervi-cal disc disease and lateral epicondylitis. It wasn’t elaborated on in the book, but I gather she had at least one frank disc herniation in her lower cervi-cal spine. Years before, Joan had bought a disability plan that was supposed to cover her in the event she


(ACFEI) The American College of Forensic Exam-iners International provides this continuing educa-tion credit for Diplomates.

(CMI) The American College of Forensic Examin-ers International provides this continuing educa-tion credit for Certified Medical Investigators.

(ACCME) The American College of Forensic Ex-aminers International is accredited by the Accredi-tation Council for Continuing Medical Education to provide continuing medical education for physi-cians. This activity has been planned and imple-mented in accordance with the Essential Areas and Policies of the Accreditation Council for Con-tinuing Medical Education (ACCME). The Ameri-can College of Forensic Examiners International designates this educational activity for a maximum of 1 hour AMA PRA Category 1 Credits TM. Physi-cians should only claim credit commensurate with the extent of their participation in the activity.

Key Words: IE, Independent Contractor, interrogatory

AbstractIn two prior papers, “Properly Documenting a File and Forensic Examination of IME Doctors” and “Qualifications and Paradigms for the Independent Examiner,” we first explained how field practitioners can better document case files to withstand challenges, including those made by Independent Examiners (IEs, a.k.a. IMEs, ICE, DME, QME), and addressed forensically ex-amining the IE, as well. The second paper sought to establish reasonable standards and proto-cols to which IEs should be held. It is thought that, in this way, the examiner’s credibility can be established, to say nothing of actuating fair and accurate examinations. Still, despite na-tionwide protest and outrage among practicing doctors and angry patients, the reality is that in a vast majority of jurisdictions in the U.S., any doctor can become an IE merely by making application with an insurance company or intermediary; for most states, there are simply no standards or guidelines to organize this process. We have always spoken out against this. The previous two papers represent two of the few published works on this subject. This paper will demonstrate the excesses some IEs go to in cutting claims. While we has-ten to add that this is not an indictment against all Independent Examiners, these are stories that need to be told because they shed light on what is becoming alarmingly commonplace in health care: IEs who ignore patients, ignore factual medical realities, and ignore sworn tes-timony, downgrading real injuries under the fiction of being “independent.” When called to task, the IE has only to say, “That’s my opinion,” without threat of lawsuit, discipline, or any form of sanction. We consider such scenarios a moral outrage and an injustice to patients who suffer as the result of biased “independent” examinations. Many IEs do “reviews” and “inde-pendent examinations” full time and do not actually treat patients anymore. Although busi-ness is booming, it’s the patients who lose out.

By John Haberstroh, DC, and Kevin Mulhern, DC


After studying this article, participants should be better able to do the following:1. Quickly understand the immense gravity

of an IE performed on a patient, client, or friend and better prepare the patient for the encounter.

2. Formulate a forensic plan to adjudicate either the IEs and/or the report submit-ted.

3. Identify the legal aspects and remedies available to combat the more egregious fraud perpetrated by the IEs in the name of “cost containment.”


couldn’t work again. Although Joan was deeply saddened by the medical condition, she was glad she had disability coverage. Following an investi-gation by Paul Revere Insurance, she was deemed disabled, and disability payments followed. This allowed her to maintain her home, pay the bills, and with some frugal budget pinching, maintain her basic lifestyle. All was well until Paul Revere was swallowed up by its chief rival, Provident. Suddenly, her benefits stopped. Shortly thereaf-ter, her life spiraled out of control. She couldn’t work. She sold her practice to a young chiro-practor who couldn’t afford to make payments to her, her car was repossessed, she and her chil-dren were eventually thrown out of her house, and she finally wound up on welfare and food stamps (Bourhis, 2005). Disability insurance is about peace of mind. It doesn’t replace a car or house, but it makes up for one’s inability to work. Barring a medical examination that speaks to the contrary, a person in Joan’s position, one with a viable policy and a legitimate claim, should have the peace of mind he or she was paying for. Understand that insurance companies don’t make big money on the premiums they collect. The big money that floats most, if not all, of these companies is in the investments the in-surance company makes. They earn interest and capital gains on investments in stocks, bonds, and real estate. The 1980s were the decade of double-digit interest rates and returns on invest-ments. The first blow to the insurance industry was in the 1980s when the structure for depreci-ation on real estate investments changed, which precipitated the savings and loan crisis that then spilled over into the banking and insurance in-dustry. This is when a number of “performing loans” became non-performing loans, and fore-closures and bankruptcies tripled. The second blow came when health-care insurance carriers cut reimbursements to doctors and dentists, and claims by these professionals nearly put the long-term disability carriers like UNUM out of busi-ness. The third blow arrived in the 1990s with the bust of the dot-com boom. The investments weren’t bringing in nearly the revenue they had been, and claims were still pouring in from policyholders. Provident alone had to post a $430 million loss in 1993 out of its reserve fund to cover incoming claims. Provident hired a new CEO by the name of J. Harold Chandler. He had an MBA and no experience in the insurance world. However, he did know how to operate a calculator. What would follow was shocking. Shortly after Chandler’s arrival, Provident hired Ralph Mohney to take over Provident’s claims department. Mohney’s background was that of a tax accountant. He, too, had not han-dled a single insurance claim. But, like Chandler,

Mohney did know numbers. The end result of this corporate shake up: the thrust of the com-pany became finding ways to refuse claims. Since interest rates on investments had dropped pre-cipitously and couldn’t be changed, the com-pany altered its bottom line by denying claims. Joan Hangarter was one person caught up in this seismic paradigm shift. Oddly, Joan had already had an independent examination with a Paul Revere doctor who had initially authorized disability payments. But Paul Revere, Inc. no longer existed. Provident bought Paul Revere, Inc. in 1997, and the deal was hailed as being worth more than $1 bil-lion. Provident was now going to conform to Chandler’s vision. In March of 1999, Provident demanded a new independent examination by a doctor they approved of. This was a handpicked orthopedist named Aubrey Swartz. Joan brought in her MRIs, treatment notes from all the other

Understand that

insurance companies

don’t make big money

on the premiums they

collect. The big money that

floats most, if not all, of

these companies is in the

investments the insurance

company makes.”


doctors, and most importantly, herself, for the “independent” examination. Dr. Swartz didn’t say a word throughout the “exam,” and Joan left assuming his findings would be consistent with the other examinations. A few weeks after the “independent” examination, a claims represen-tative named Ken Seaman arrived at her door. He told Joan that upon reviewing Dr. Swartz’s report, it was clear to Provident that Joan had no disability and could perform her chiroprac-tic duties with no hindrance. Joan next received her official termination letter from an adjuster named Joseph Sullivan informing her she was not entitled to any aspect of her benefits, and they were, indeed, terminated immediately. The decision had been reached using a number of factors, but primarily on the IE doctor’s report (Bourhis, 2005). Joan sued UnumProvident. She used Ray Bourhis, Esq. as legal council out of San Francisco. During pre-trial depositions, and later in ac-tual trial testimony, it became clear that anoth-er medical specialist had been enlisted to cut claims. Joseph Sullivan often referred case files to the UnumProvident in-house medical specialist Dr. John Bianchi. It was Dr. Bianchi who read Dr. Swartz’s report and opted to recommend to

Sullivan that Joan Hangarter’s benefits be termi-nated. His findings were completely contrary to all the gathered medical evidence in Joan’s case. Sullivan also admitted that UnumProvident so-licited doctors through an intermediary company (Brokerage Firm) called Genex, Inc. The initial strategy was to insinuate that Aubrey Swartz was totally “independent.” It came to light during cross-examination that UnumProvident actually owned Genex, Inc. Thus, the “independent” doc-tors that “independently” examined patients were, in effect, working for the main insurance compa-ny. Records indicated Dr. Bianchi had never met Joan Hangarter, much less examined her. Upon further testimony at trial, Dr. Bianchi referred to himself as an “independent contractor.” He performed “claims reviews” for UnumProvident as follows: A couple of times per week he would come to work and face a stack of files and at-tendant medical reports. He also had a page of written questions to answer on each file posed by the adjuster. He was paid extremely well for his “opinions” and he provided written answers on each file he was given. He never spoke to the patients, nor did he speak to the IE doctors who did the “independent examinations.” He re-viewed records. Interestingly, Bianchi admitted

Sadly, this is not an iso-

lated case. Big compa-

nies do pay many claims,

but paying some claims is

a part of their defense.”


that UnumProvident normally did not provide information on the “usual and customary” du-ties of the people he was evaluating. In this case, he was ignorant of exactly what chiropractors did and how they performed their services. How could someone that had no idea what people actu-ally did for a living make an informed assessment about the claimant’s ability to return to normal duties? He reviewed the report of hired gun Dr. Aubrey Swartz and made an uninformed decision that negatively affected Joan’s life. Joan Hangarter eventually won her suit against the insurance company, which predictably ap-pealed the decision immediately. The appeal add-ed another year to her case, but in the end, Joan was awarded more than $7 million (Bourhis, 2005). Sadly, this is not an isolated case. Big compa-nies do pay many claims, but paying some claims is a part of their defense. While they pay many of the day-to-day medical claims that come in, they save the most money on the denial of long-term disability claims. The mechanism of these denials is built and supported entirely around the “opinions” of IME (IE) doctors and “inde-pendent contractors” that may be far from inde-pendent. They save even more money on denials of personal injury and workers’ compensation claims. The denials are again based on the opin-ions of “independent medical examinations.” The authors have observed IME (IEs) reports and their validity since the early 1980s, primarily in the personal injury (PI) arena. We recognize that some IMEs perform their work fairly and reason-ably. In our opinion, the workers' compensation system has similar problems. We foresee that these abuses will spread into the routine major medical/health insurance system, which may further limit care. As we see it, the current abuses and failures in the IME system must be taken to task and cleaned up for the benefit of the public.

*Note: The authors are in no way trying to suggest that it’s only the medical orthopedists who cause all the problems. Our next two stories involve chiro-practor IEs. As stated in our previous essay, with the average everyday claim review/IE, at least here in Massachusetts, the medical orthopedists have been refreshingly fair, generally speaking, compared to chiropractor IEs.

PART II—“Ask me no questions, I’ll tell you no lies.”

In late 2004, Jerry Blackwood, a Doctor of Chiropractic practicing in Boston, contacted this author to review and, if possible, rebut a rather strenuous report rendered by one of the better-known chiropractic IEs in Massachusetts. We’ll

call the IE doctor Dr. D. In short, we found this to be one of the most preposterous “reports” ever written by anyone. The IE report is allegedly supported by available critical literature. This appears to be an attempt to add scientific valid-ity to the report and thus render it more “legiti-mate.” A closer look at this report shows that of the 12 pages included therein, more than eight pages are references. The first two pages of the report are more or less a table of contents, leav-ing about two pages of actual report writing. In those two pages, the IE manages to debunk lit-erally everything in the entire chiropractic can-on. According to this chiropractic IE, literally everything that chiropractors do (and for that matter, have ever done) is unsubstantiated and clinically irrelevant; thus, most, if not all, treat-ment should not be reimbursed. The rebuttal, written by me, dissects and fo-rensically examines the literature and, more im-portantly, the doctor. In our previous essays, the authors have spoken about obtaining the CV of IE doctors. In an early draft of our first article, we mentioned a bogus CV that we had obtained. This was the actual case and the CV we have referred to. My forensic rebuttal explains the dishonesty and exaggerations in this CV. Some of you may be thinking, “Why not inform the Chiropractic Board of Registration and have them discipline this doctor?” The Board heard about the CV and did nothing. It seems most of the Board members are IE doctors or “insurance consultants” also. Final outcome: Dr. Blackwood was paid in full on his case, based entirely on my forensic examination of the IE doctor and his report (Haberstroh Rebuttal, 2004). Another strange case involves a different chiro-practic IE doctor (Dr. M.) who was involved in a report with the other author of this article. In his report, Dr. M. stated, “As anyone knows, the chiro-practic subluxation* has not yet been determined to be a clinical entity that is either reproducible or detectable amongst practitioners with any degree of consistency or reliability . . . None of my opinions as stated in my . . . report have changed in this matter . . . under the pains and penalties of perjury.” How odd then, that this same chiropractor, who is an IME and an insur-ance consultant, had a website that discussed sub-luxations in numerous areas. Furthermore, this same Dr. M. does not remember that we as chiropractic physicians, Doctors of Chiropractic, or chiroprac-tors are licensed in Massachusetts and maintain that the term subluxation does exist. The term sublux-ation is actually cited on the Massachusetts Board website. Notwithstanding, this individual is certain this is not a clinical entity. (*Subluxation is a term used to describe vertebrae slightly out of place.) Dr. Mulhern rebutted this IE vigorously with a favorable outcome. So, what can be done about all of this?

Definitions of Key Words

1) IE: Independent Examiner or Independent Exam. A simple abbreviation of the more commonly used “IME” (IE, a.k.a. ICE, IME, DME, QME, etc.) contraction. A patient is, actually, physically examined by an exam-iner. The examiner is called an IE. 2) Paper Review: A review of a case file, not the actual patient. In this event, the re-view is still conducted by an IE. He or she may also be called a Peer Reviewer. The terms IE and Peer Reviewer are interchange-able here. 3) Forensic Exam: An examination that may ultimately lead to a discovery of detail in a legal setting. 4) Outcome Measures: These are generally questionnaires that are periodically handed to patients by the treating physician. They ask specific questions about how patient are feeling and their ability to perform activi-ties of daily living (ADLs) throughout their treatment. The doctor, after the fact, tabu-lates the “values” of the answers via a point system not available to patients. These re-sponses are considered to be valid indica-tors as to how a patient feels in an ongoing format that is suggestive of the efficacy of the treatment protocol the doctor is using. Oswestry is probably the oldest and most well known of these. However, one of the better measures of outcome is the actual return to work. Another is the reduced use of scripted meds. Both of these issues are quantifiable, and both save money for the insurance company. 5) Independent Contractor: Refers to another level of IEs that often review reports submit-ted by IEs and render a second opinion on a medical case on behalf of an insurance company. 6) Adjustment: This is the word used by chi-ropractors to describe the manual manipu-lation they perform on someone’s spine or extremities. “I gave Ms. Jones an adjustment to the neck today.” 7) Interrogatories: A set of questions that one party sends to another party during a lawsuit. Typically, both parties send inter-rogatories to the principles on either side. The answers are in affidavit form. They have to be honest and truthful in lieu of the responding individual committing perjury. 8) Brokerage Firms: The term “brokerage firm” in the insurance arena denotes a sep-arate company that employs doctors and a support staff usually comprised of former insurance company employees. Thus, the strategy here is to make all parties (patients, unsuspecting attorneys, treating doctors, and judges) believe that the firm and its doc-tors are separate entities from the insurance companies. One key benefit was to coin the word “independent” for their contractors, even though these firms are at arm’s length from the insurance companies.


First, the everyday treating doctors (like your authors), regardless of discipline, need to meticulously document each and every case file. We’ve said this before, but it bears repeat-ing. Second opinions are often helpful, but as we saw with Joan Hangarter’s case, several second opinions were ignored, and it took a lengthy lawsuit to bring justice to her cause. Nevertheless, in a particularly involved case, a second opinion is not only a good idea but nearly always indicated. With an extremely detailed and well-authored first day report, detailed treatment notes, use of outcome mea-sures (*Oswestry Disability Index, SF36, SIP—this is becoming a highly important aspect of all practices at this point and should be done by all practitioners), occasional re-examinations to check progress or lack thereof, advanced imag-ing where indicated, and the possible inclusion of a second opinion and/or secondary treat-ment, the clinical case picture becomes more solid, harder to attack, and easier to defend, especially if the case goes to court. If an inde-pendent examination is scheduled and your patient does go, as the authors suggested in the first two papers, there is a checklist of things to do to level the playing field (Haberstroh et al., 2005; Haberstroh et al., 2006).

A. Inform patients what is in store for them

when they go to an insurance exam. Most patients seem to think that it is a friendly part of the process. The fact is, the IE is there to determine whether or not contin-ued care is indicated. If the IE is more of a “hired gun” type of doctor, this encounter could lead to abridged care. The patient should be admonished to go to it but to understand it is not a “friendly” exam. The patient should be carefully instructed by the treating doctor to not attempt to exaggerate his or her condition in any way, but to just be truthful about the situation. B. If at all possible, bring a witness to the IE. The witness can verify what went on, take notes, and most importantly, make a foren-sic timeline as to when the exam started, how much of it was talking, how much was actual examination, and when it ended. The witness can provide another opinion as to what hap-pened at the exam (or should we say, what didn’t happen). C. Have patients fill out a sworn affidavit after they return to you from the IE. In that sworn affidavit they should, among other inventories, describe the timeline of the exam. We urge that the witness, if there was one, fill out the affidavit as well. Too many people like Joan Hangarter simply

trust the IE and think things will be okay. Not necessarily, we say. D. The treating doctor should also exam-ine the patient the same day as the IE. He or she can render a report as to what his/her findings were that may or may not be consistent with the IE “findings.”

Second, the field doctors are urged to re-fute any IME report they feel is in error. Explain what symptoms supported the clini-cal treatment regime, describe the outcome measures used, highlight and summarize re-examinations, and make available second opinions and/or imaging/testing, if appli-cable. One of the best ways to attack biased IME (IE) reports is to cite your own collec-tion of literature and articles from peer-re-viewed medical journals supporting your own treatment regime and/or debunking the opin-ions offered by the IME. Be advised: This technique works both ways as we saw with Dr. D. A classic IME fall-back position is to say, “Well, in my opinion . . .” We now know with the advent of the Daubert Criteria, this kind of ad hoc opinion won’t stand up well in court. Again, outcome studies are crucial for the practicing doctor of any discipline to document care, progress, and to substantiate the choices a doctor makes in treatment in-

1) Playing the Float: This is a banking and insurance company term for using other people’s money to earn interest. By withholding pay-ments as long as possible, the insurance company has more money available to earn interest. Even though the insurance company knows it has to pay the claim, by using stalling techniques, it may hold the money for a longer period of time. As an example, if the company holds the money for 3 years earning 12% a year on the money, and inflation is 4% a year compounded over 3 years, the company has earned 50% on the money it withheld, paying, in actuality, only 50 cents on the dollar that it owes.

2) Setting Reserves: This is an insurance company term that involves the estimated cost of settling a claim. When a claim comes into the insurance company, an adjustor looks at the type of injury and claim, and based on actuarial tables, “sets a reserve.” This reserve is a pre-paid expense, according to GAAP (Generally Accepted Accounting Principles). Now, here is the important part: If the insurance company can settle the claim for less than the reserve, the difference comes to the income side of the ledger statement and drops to the bottom line as profit. As an example, if a claim for reflex sympathetic dystrophy (RSD) is received, most insurance actuarial tables have the reserve listed as $1 million. However, with proper diagnosis, it turns out 71% of RSD cases are really nerve entrapments that can be treated for $50,000 (Hendler, 2002). If the RSD case turns out to be nerve entrapment and is properly treated, the insurance company can then move $950,000 ($1 million minus $50,000) to the income side of the

Claim Concepts


ventories. Do a forensic examination of the IE doctor. In Joan Hangarter’s case, it was found that Dr. Swartz was not a practicing doctor, but only engaged in examinations for the insurance company. Dr. Bianchi also did not practice, nor did he perform examina-tions. Both doctors worked for the broker-age firm Genex, owned by UnumProvident, which is a conflict of interest. Dr. Bianchi merely looked at files, and made relatively quick decisions on lifetime disability issues without meeting the patients. These details matter. Find out who is paying the IME; you may uncover the real motivation behind a denial of benefits (Bourhis, 2005). Third, many of the IE’s opinions will re-main “unchanged” no matter what you are able to substantiate or how compelling the clinical case. If Daubert arguments don’t work in paper rebuttals, the patient or doctor should consider contacting a lawyer to seek reim-bursement for services rendered. If a lawsuit is filed, the insurance company will be notified of the suit. If the lawsuit is big enough (larg-er than small claims), a set of interrogatories are sent out to the principles at the insurance company, the plaintiff, and the doctor. This is where meticulous care and well-documented case notes become crucial for the plaintiff. As

the lawsuit progresses, depositions may en-sue. Depositions, although they appear “in-formal,” should be approached as seriously as an actual trial. They are legally binding sessions with the plaintiff ’s and defendant’s attorneys present and a court stenographer. The court stenographer will record every-thing that is asked and answered during the deposition. Depositions are known for being “fishing trips.” The latitude in questioning is vast and often the questioning lawyer(s) will keep pressing on a variety of issues to see what they can “catch” to weaken the depo-nent. After the deposition, the court reporter will create a written record of everything that was said. This transcript will be given to the deponent to read. The deponent may make corrections to the transcript at this point if they are needed. Once corrections are made, the witness signs the transcript. Make certain the deposing attorney understands you want a copy and your signature on the transcript. Both the original and corrected version will be available to be used as evidence in future court actions (Israel, 2001). Occasionally, a settlement may be offered by the defendant. In Joan Hangarter’s case, UnumProvident con-tinually offered $500,000 to settle the case to make her go away (Bourhis, 2005). She held

out for more on the strength of the forensic medical data in her case and what Attorney Bourhis had uncovered via interrogatories and trial testimony. It was a good thing that she did. All cases are different and a settlement offer, if it comes, can sometimes be satisfying to all concerned. An offer like that should be carefully considered. If the case goes to trial, remember one main point: You must convince the jury of your cause and your issues. Jurists are people like you and me. They are affected by seemingly little things, like whether or not an expert wit-ness smiled at them. When jurors were inter-viewed about which expert witness impressed them the most during the O.J. Simpson trial, they responded that they liked Dr. Henry Lee because he smiled at them as he approached and left the witness stand (Bugliosi, 1996). At some point the treating doctor/forensic examiner will be called to testify. You will be able to refer to your notes, so do so, and be confident of your case. Few experts have ever testified where a few points didn’t have to be conceded here and there during cross-exami-nation. Speak the truth; if you can’t remember something, say you don’t remember. Stay away from terms like “never” and “always,” and do not speak in a condescending manner. Later,

ledger and report $950,000 in additional profit. On the other hand, if a “whiplash” claim comes in, and the typical reserve is $12,000, but later it turns out to be a C5–6 herniated disc that requires an an-terior cervical fusion, which costs $60,000, the insurance company has “under-reserved” the case, by $48,000. If this occurs multiple times, the insurance commissioner in the state where the insurance company is licensed can fine the company for being under-reserved. If there is a consistent pattern of “under-reserving” cases, the insur-ance commissioner can declare the company insolvent and revoke its license to operate. Setting the proper reserve is the single most important concept in the insurance industry.

3) Bad Faith: This refers to an intentional failure to honor contractual obligations, such as paying on a claim that the company is obliged to pay. If convicted of “bad faith” activity, the insurance company must pay triple damages. For example: A $60,000 claim is filed to pay for an operation following an accident, but the insurance com-pany denies the operation is related to an accident. If it is proved in court that the operation was accident related, then the company has to pay $180,000.

Legal Note:Daubert Criteria: Daubert v. Merrell Dow Pharmaceuticals (1993) was first filed in the Southern District Court of California in 1989. Eventually, it wound up in front of the Supreme Court of the United States, who decided that the more modern “Federal Rules of Evidence”

criteria comprised the proper standard to which scientific evidence and testimony must comply. Rule 702 of the “Federal Rules of Evidence” governs evidentiary issues such as expert testimony, and, furthermore, affirms what is minimally necessary in order for a judge to fulfill what has become essentially a gatekeeper role when screening and filtering scientific evidence trying to be entered in court. Thus, according the court’s ruling on the Rules of Evidence (including Rule 702), the stan-dard is such that (1) it intends a grounding in the scientific method, (2) “knowledge” means a set of facts or ideas accepted as true on “good” grounds, and (3) the scientific data/testimony may be tested by applying several more rigorous criteria than heretofore appreci-ated in the federal system. Therefore, concerning the testimony of an IE who says merely, “In my opinion…”: this testimony is inadmissible in a federal court (Rast, 2006).

References Hendler, N. (2002, October). Differential diagnosis of complex regional pain syndrome, Type I (RSD). The Pan Arab Journal of Neurosurgery, 6(2). Rast, P. (2006). The Daubert decision: Accident reconstruction con-siderations. The Forensic Examiner, 15(4), 37–41.


upon re-direct, your lawyer will be able to reha-bilitate you on whatever points may have arisen that clouded an issue. Just make sure everything is as clear as possible to the jury as you explain the case file. If the jury understands your case, the chances are good that you and your patient will prevail when the jury returns a verdict. In smaller court actions, such as small claims court, there is a court magistrate who will hear both sides of an issue in an anteroom somewhere in the courthouse. While expedient, magistrates may not be educated in your field of work. Again, it is crucial to get your points across and make the case as clear as humanly possible. There are no exceptions to a well-documented case file. For the treating doctor, this should include an extensive and detailed case history, all relevant orthopedic/neurological findings (where applicable), a differ-ential DX, final DX, treatment plan, consent to treat form, and prognosis.

ConclusionAs it stands, the general public is unaware of the occasionally contemptuous, fraudulent na-ture of some IEs. Even an educated, intelligent, practicing doctor like Joan Hangarter went to her IE blithely unaware of the agenda-driven nature of the faux exam and its harmful con-clusions. All people, treating doctors and their patients, need to be aware of what may go on in the IME (IE) arena and prepare for the worst. If a reasonable examination is conducted with reasonable conclusions, so be it. If not, pre-cautions need to be taken. As stated, having a witness who can corroborate what happened at the IME (IE) and a signed IME affidavit are good strategies. There is no Federal pro-tection from this behavior, either. According to the McCarran-Ferguson Act of 1945, the Federal government is prevented from enact-ing any consumer protection laws with regard

to insurance companies. State regulations, or lack thereof, are largely handled by the ap-pointed or elected Insurance Commissioner. The McCarran-Ferguson Act does not itself reg-ulate insurance, nor does it mandate that states regulate insurance. However, it does empower Congress to pass laws in the future that will have the effect of regulating the “business of insurance.” However, Federal acts that do not expressly claim to regulate the “business of in-surance” will not trump state laws and regula-tions that do (U.S. CODE, Title 15). Everyone benefits from being educated to the realities of the insurance industry. If all else fails, then a lawsuit may be the only final option.

References Bourhis, R. (2005). Insult to injury: Insurance, fraud and the

big business of bad faith. Berrett-Koehler Publishers, Inc.

Bugliosi, V. (1996). Outrage: The five reasons O.J. Simpson got

away with murder. Island Books (through Dell Publishers).

Dr. D. (2003, October). IME Report on patient RH.

Dr. D. (2003, October). CV.

Haberströh, J. (2004, May). Rebuttal of Dr. D. IME

Report on patient RH.

Haberströh, J., & Mulhern, K. (2005). Properly docu-

menting a file and forensic examination of IME doctors.

The Forensic Examiner, 14(4), 26–39.

Haberströh, J., & Mulhern, K. (2006). Qualifications

and paradigms for the independent examiner. The Forensic

Examiner, 15(3), 24–32.

Hendler, N. (2002, October). Differential diagnosis of

complex regional pain syndrome, Type I (RSD). The Pan

Arab Journal of Neurosurgery, 6(2).

Israel, S.M. (2001). 130 Rules for Every Deponent. Liti-

gation, 27(4), 46.

Rast, P. (2006). The Daubert decision: Accident reconstruc-

tion considerations. The Forensic Examiner, 15(4), 37–41.

Spitzer, E. (2004, October 14). Investigation reveals wide-

spread corruption in insurance industry. Office of the New

York State Attorney General. Press Release.

U.S. CODE, Title 15, Ch. 20, Sec. 101

Earn CE CreditTo earn CE credit, complete the exam for this article on page 80 or complete the exam online at www.acfei.com (select “Online CE”).

About the Authors

John J. Haberströh, DC: Private prac-titioner-Somer-ville/Boston, Massachusetts, U S A , Diplomate of the American Board of Chiropractic Neurology, D i p l o m a t e

of the American Chiropractic Academy of Neurology, Fellow of the American College of Forensic Examiners Institute, Certified Medical Investigator-Level 5, Certified Forensic Consultant, Certified: Spinal Trauma/Sports Physician/Rehab. Methods and IME/Peer Reviewing. You may access his website at www.boston-spineclinics.com

Kevin Mulhern, DC, FICC, is a private practitioner in Waltham/B o s t o n , Massachusetts.


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The Disability Claim Buyout

Case Study

By Arthur L. Fries

D isability insurance companies sometimes offer a disability claim-ant a settlement in the form of a buyout. Rather than pay a month-

ly benefit over what might be a period of many years, the company offers a lump sum settlement in the form of a single check. If the claimant agrees to the settlement, he or she relinquishes any rights or additional benefits other than the specific terms of the settlement.

Finding HelpAlthough few and far between, there are disability claim consultants who can assist claimants with a buyout offer. Consultants with the most expertise provide only claim consulting advice and do not sell a product or provide financial advice. Seek out a consultant who is experienced both in disability claims and in negotiating buyouts.

Who Approached Whom?There are varying company attitudes toward buyouts. Some disability carriers or adminis-trators prefer to approach a claimant about a buyout. Sometimes clients approach compa-nies that do not initiate buyout offers, pre-sumably in a fashion in which the client does not reveal a clear preference for a buyout. Revealing such a weakness would unduly serve the carrier in negotiations. Other companies simply do not engage in buyouts. Some companies provide initial offers that are fair and based on sound actuarial principles, and they most likely will not deviate from the initial offer. Other companies tend to use the initial offer to test whether they can pay the lowest possible figure. There have even been extreme cases where companies send their home office personnel to clients’ residences and indicate that they would like to buy out the claim, offering 10 or 12 cents on the dollar of the actual value of the claim. Some representatives have pres-sured clients, including threatening them with another Independent Medical Evaluation or a Functional Capacity Evaluation. Clients often fear additional evaluations will cause pain as a result of their injuries. The representatives might also propose an additional neuropsychological exam or

a variation including several or all of these components. The mention of additional vid-eo surveillance, which sometimes makes the claimant feel as if “big brother” is watching, is also used as a threat to try to get the claim-ant to cave in. Often in negotiating with a claimant, in-surance company representatives will open with a request that the claimant provide them with a figure of what it will take to have the claim bought out. How the claim-ant responds at that point could be a cru-cial aspect of the buyout process. Claimants should always be advised to secure an offer in writing from an insurance company. In the offer letter, insurance companies nor-mally cite the figure they are prepared to pay and discuss the present value of antici-pated future benefits. The carrier often ne-glects to mention the future potential benefit of how much the monthly benefit is worth to age 65 or to the point of the individu-al’s life expectancy. The present value takes into consideration the insurance company reserves and a discount factor is applied, re-ducing the amount paid to the claimant by an amount that represents unearned inter-est for future years. Not knowing what the future potential benefit is makes it harder for the claimant to figure out what the claim is worth. A cost of living adjustment (COLA) benefit might also be included in the policy,

which the insurance company sometimes deletes from its calculations in coming up with an offer to the claimant. The COLA benefit might be paid on the basis of “simple interest” or “compound inter-est,” and it’s important to know which interest factor is applied in the application calculation. Almost all COLA benefits level out at age 65 and then, if a lifetime payout, continue at that level amount for life. On some rare occasions, there are COLA benefits that do not level out at age 65 and continue to increase for life. After reducing the future potential benefit down to the present value and applying an in-terest factor, an additional reduction is made for mortality in which the company estimates when it believes the claimant will die, as well as a morbidity factor, if the insurance com-pany believes the claimant has a potential to return to work. Finally, companies often ap-ply a further discount to give the insurance company a profit margin so that the buyout makes sense to them. Obviously, the lower the offer the company makes, the higher the profit margin.

Who Does the Calculations?In assessing such a proposed buyout, an ac-tuary experienced in disability claims should be brought in to work up numbers for your client. Finding an actuary with expertise in such an area may be difficult because those


currently working for insurance companies are usually not available to claimants. However, such experienced actuaries are out there, and the right actuary can make a vast difference in attaining the correct numbers for a cli-ent. CPAs are sometimes involved, but they typically lack the required background and experience in this niche area. Attorneys will sometimes offer to represent your client in a buyout, but will usually charge a contingen-cy fee that often is at a very high percentage of the claim and that does not accurately re-flect the minimum amount of time involved in the process. Some disability claim consultants have access to disability actuaries and can provide assistance to a client either unbeknown to the carrier, or with the insurance company aware of their in-volvement. There are many reasons to consider a buyout and all are unique to each personal situation emotionally and financially. It is wise to seek out a consultant who has handled many disability claims and is thoroughly familiar with the disability buyout negotiation process. The claimant may flounder trying to handle such negotiations on his or her own, but the help of an appropriately trained and expe-rienced consultant can significantly reduce the anxiety involved and one will, most likely, find the consultants’ fees quite a bargain. Even when such a disability buyout turns out not to be in the claimant’s best interest, the consultant will be paid for his or her time, enabling the claim-ant to secure the most sound and objective pro-fessional consultation.

Actuarial CalculationsThe following are figures from an actuary relat-ed to an actual disability buyout the author was involved in this past year. Consider this claim-ant example: The 45-year-old claimant had been disabled by carpal tunnel and cervical problems since August 1996. He had lifetime benefits with cost of living adjustments (COLA) to age 65. His original monthly benefit, before COLA, was $18,550. Financial figures related to his annu-ity of benefits were also calculated. The claimant had a life expectancy to age 79.2, according to recent Society of Actuaries standard mortality tables. With COLA already applied, his current benefit is $25,228. COLA is related to CPI, has a 4% minimum increase, and has been assumed to be 4% in the future. His maximum payout, including future 4% COLA increases, would be $14,383,240. If these benefits were received today, discount-ing at a 5.50% interest rate, the value would be

reduced to $5,940,352, or 41.3% of his maxi-mum anticipated payout. The reduction in value is significant because of his young age and long expected lifetime. An insurance company will hold reserves based on the 1987 Commissioner’s Group Disability Table and is allowed to include additional mor-bidity factors. This reduces the value of bene-fits to $4,058,169 or 28.2% of his full payout. Again, this reduction reflects his young age, which according to the standardized insurance table, projects a chance of recovery from dis-ability. That prognosis may or may not apply to this claimant. Finally, an insurer might settle this liability for approximately 80% of the re-serve, or $3,246,535, or 22.6% of his maximum payout. When a disability buyout can potentially pro-vide substantial immediate funds, it is also com-plex and requires exact calculations to enable you to secure the most precise and meaningful information.

ConclusionIn the final analysis, a disability buyout offer should be taken seriously and proper research conducted to determine if a buyout makes sense for your particular situation.

About the Author

Arthur Fries is a nationally acclaimed disabili ty claim con-s u l t a n t . Prior to retir-ing, he spe-cialized for many years in the sale of individu-al disability insurance to

attorneys in the Los Angeles/Beverly Hills area of California. His experi-ence also includes having achieved first place nationally in the sale of health insurance six years in a row for a major health insurance compa-ny. He is located in Newport Beach, California and can be reached at (800) 567-1911 or www.afries.com.


Workers’ Compensation: A Broken Medical System

Commentary

I believe even the least interested citizen is aware that we have a broken medical sys-tem in this country. Millions of our chil-dren are without medical insurance and the

cost of treatment has skyrocketed. Currently, we don’t have enough health-care providers, and the long wait for treatment and the quality of servic-es by the health-care industry is discouraging. As we tackle the issues of how to repair or change this medical nightmare, I would like to look at one aspect of the mismanaged system. The aspect I would like to examine is the New York Workers’ Compensation (WC) System, but one could just as easily select another state, or the Federal Workers’ Compensation System. The system is run by the state bureaucracy; it has become political and has been handed over, dishonestly, to the insurers to manage, much like the HMOs that have destroyed medical treat-ment for Americans by pure greed. The large insurance companies inserted themselves into the patient-doctor two-part system, and began making decisions—taking a chunk of the mon-ey for themselves, while denying needed treat-ment to the patient and reaching deep into the provider’s pocket. These companies promised to control the rising “out-of-control medical costs,” which was a big lie. Now they are just another failed part of the system that still has its hand out. Treatment is at an all-time low for patients, and the HMOs have failed to stop waste in the system. Specifically, what is required in the WC System for a patient to receive attention for an injury? I believe that there are two major prob-lems that riddle the system. The first is the be-lief of the insurers that all who apply for benefits are fakers. That is, all who have been allegedly injured are faking the injury or are at least exag-gerating their symptoms for monetary gain. The second belief is that the insurers should act as judge and jury by withholding treatment, cre-ating, thereby, an additional crisis. Allow me to provide an example that I believe is representative. A rehabilitation physician is treating a man who may have suffered a head injury when the bus that he was driving was forced off the road and hit a pole. He was treated at the emergency department of the hospital, bandaged, and sent home. He then went to see his primary care phy-sician two days later, as he had been instructed to do by the hospital emergency department.

By Michael A. Baer, PhD, ScD


Seen, examined, and treated for his physical injuries by his primary-care physician, he is ei-ther referred to a physiatrist or sent directly for a neuropsychological evaluation. He has numerous complaints and symptoms that suggest a brain injury. He had a CT scan at the hospital, but it was negative. He chooses to visit my psycho-therapy office; however, when my office contacts the insurer about permission to see this man, the insurer is non-committal. They will not give us permission for the examination we are request-ing, but state that they will look into it after we submit the report and bill. Thirty years of dealing with these companies has taught us that if we do eventually get paid for our work, the wait may be as long as 3 years. Payment is likely to depend on the ambition of the patient’s lawyer. Is he or she willing to fight for the doctors’ payment? There is no guarantee that the provider will ever be reimbursed for the evaluation of the workers’ compensation client. Most clients are anxious to return to work or, at least, to have their wounds repaired. The in-surance companies, along with denying reason-able evaluations, also deny treatment to the cli-ent, creating an additional set of problems. The client has to enter into long litigation, employ-ing an attorney, who gets paid out of his workers’ compensation benefits. The patient, meantime, still not receiving proper treatment, is suffering, causing other problems—chronic pain onset, de-pression, iatrogenic attitudes, and family turmoil. The patient, while waiting for needed, but denied, treatment, is likely to become dependent on or addicted to pain medications. The other problem is the serious depression and financial hardship that the family endures during this long wait. First, the client may be denied benefits while the insurer questions his injuries. Second, even if the insurer is paying part or all of the money allotted, compensation under this outmoded system is not enough for a family to live on while the worker waits to receive treatment. The worker may be de-nied treatment, benefits, and may lose the family home, as well. Such a system robs the worker of dignity and self-esteem—he or she sits at home waiting for this crippled system to adjudicate his case through its slow, overwhelmed process. Many have lost hope as the years drag on. The worker also becomes someone who now has to prove that he or she is injured or in pain from the untreated injury. He or she must attend numerous Independent Medical Examinations and be examined by the insurance companies’ doctors. Some of these doctors have reputa-tions for being brutal in their handling of the patients. Others have actually handled the pa-tients so roughly as to create additional injuries

or exacerbate the existing ones. Either way, the patient is thrust into the role of someone who must “act” the part of the suffering patient. If a physician or therapist chooses to treat one of these patients with pain interventions, or attempts to relieve their depression, the treating physician or therapist has no way of knowing whether he or she will ever receive payment for the work for which he or she bills, seriously reducing the num-ber of eligible health-care professionals willing to take on these WC cases, thus driving providers out of the market. This is what the HMOs, Medicaid and Medicare, and systems hijacked by the “clerk/physicians” practicing medicine without a license at insurance companies have left us with. They have assumed the role formerly held by health-care professionals who, in the past, decided whether a patient required a medical procedure. Those who possess the proper training, credentials, and licenses to evaluate and treat the injured worker have been marginalized by this crooked system. Health-care professionals must submit opinions to high school clerks who ultimately decide who has treatment or surgery and if the professional complains about this system, there are reprisals against him or her. A couple of years ago the governor of New York made a stab at reforming the Workers’ Compensation System. I sent a letter to the governor requesting to participate in the reform process. A very polite letter from a functionary informed me that outside assistance would not be required, as they had it all under control. When all of us have had enough of this failed health system, we will agree to skip watching American Idol one night and instead we will have a revolution to change the corrupted sys-tem into one that works for patients.

About the Author

Mike Baer, PhD, ScD, CRS, was chair of the American Psychotherapy Association’s Executive Ad-visory Board for 9 years. He is a Life Fellow of the Associa-

tion and has been a member since 1997. He was awarded APA’s Mas-ter Therapist designation in 2005.

Treatment is at an all-

time low for patients, and

the HMOs have failed to

stop waste in the system.”

The federal government offers four workers’ compensation programs for its employees, which provide wage replacement benefits, medical treatment, vocational rehabilita-

tion, and other benefits to federal workers or their dependents who are injured at work or acquire an occupational disease. The programs include the following, each of which deals spe-cifically with their relevant groups of employees:

• the Energy Employees Occupational Illness Compensation Program• the Federal Employees’ Compensation Program• the Longshore and Harbor Workers‘ Compensation Program• the Black Lung Benefits Program

Workers’ compensation laws for the private sector are covered by individual states. The contact information for each state’s workers’ compensation official can be found by visiting http://www.dol.gov/esa/regs/compliance/owcp/wc.htm.

Federal Government Programs


Staying on Track and Learning from the Best

H e’s wanted by the FBI, Special Forces, the Border Patrol, sheriff departments, SWAT teams, and at least a dozen police agencies

within California and Nevada. Law enforce-ment personnel are aware that he camps in the mountain ranges near Reno and that he uses “Grasshopper” as an alias. What makes him so hard to find is his ability to cover his tracks, never leaving a trail. By looking at him, you would never suspect he is capable of doing what he has done: His dark, peaceful eyes, gentle smile, warm laugh, and calm demeanor are his most notable traits. But like the strategic chess player, his mind is al-ways several moves ahead of you. The dictionary describes him to a tee under the word stealth. His name is Fernando Moreira, the most sought-after tracking instructor in the United States. In 1988, he was awarded the distin-

By Mark Withrow, DABCHS, CHS-V and Roger E. Rickman, DABCHS, CHS-V

guished title of World’s Best Tracker. His cer-tifications, merit letters, and commendations would fill an oversized notebook and include such honors as the American Red Cross Real Hero Award (2005, 2006), Rescuer of the Year (2001), Excellence in Search and Rescue Medal (1999), and recent nominations for the Jefferson Award (2005, 2006) and the America’s Most Wanted All Star Award (2006, 2007). Moreira became interested in the art of track-ing while serving in the Portuguese Army. The year was 1976, and as a 16-year-old boy living in Portugal, he was required to join the military due to mandatory enlistment. After 9 months of

training, he was deployed to Angola to fight in the war against Africa. Over the next 2 years, he received specialized instruction in tactical track-ing from the Rhodesian military, as they tracked enemy forces and provided crucial intelligence for ground and air attacks. Each day, the lives of numerous soldiers relied on trackers’ abilities to gather precise information about the enemy’s movements and position. After an honorable discharge, Moreira moved to the United States, where he lived with his grandmother and continued to hone his track-ing and wilderness survival skills. Throughout history, man has used tracking as a part of his daily survival. Prehistoric man, for example, had to track animals for food. Today, tracking has become increasingly utilized by Search and Rescue (SAR), and is being used by hunters, law enforcement agencies, and the military. It has recently gone through a rebirth,

thanks to Moreira and his hard-working associates, who strongly believe that the more people they can train, the more

lives they can save. The time-honored tradition of tracking is an art that has proven its worth many times over. Not only is this skill used to find lost or missing subjects, it can also be used to track fugitives and escapees, as well as discovering, identifying, and interpreting various types of evidence at a crime scene. Tracking involves following sign (traces) or footprints, monitoring the subject’s course, and carefully observing and pursuing that target to a successful end. A tracker is one who has the dis-cipline needed to develop these skills, and like most specialties in the field of Search and Rescue, tracking uses skills that must be regularly prac-ticed and perfected, or they risk becoming stale and lost. The use of a specific type of tracking called mantracking is an invaluable ability to the ground searcher. It involves the art of tracking man-made


t Moreira demonstrates the use of a mirror to harness the sun, a technique used to highlight tracks during peak hours of sunlight.

types of sign, the most common example being the footprint. Man-made sign is physical evidence, which means that mantracking yields important results for law enforcement. A person’s actions, gender, and intentions can be read from the signs they leave—this can often link a specific subject to a crime scene and validate a criminal act. It’s important to note that when a search is initiated and rescue efforts are in full swing, the coordinator cannot merely flood the area with warm bodies and expect instant results; he must rely on a few highly trained volunteers—among them are a small group commonly referred to as trackers—to use their skills in finding the subject. These trained searchers can locate and differenti-ate sign in order to establish a direction of travel from a point last seen or last known. By pointing the SAR Coordinator in the right direction, the trackers can assist the search effort by placing other volunteers into a quadrant of higher probability during the initial stages of the operation, thereby saving valuable time and increasing the chances for success. Anything that moves will leave some kind of sign that shows its journey across terrain. Animals, people, and machines all leave sign. It is an es-tablished fact that the average adult male leaves at least one clue every 18 to 20 inches. A trained and highly skilled tracker can detect and follow this sign, often when the untrained person sees nothing at all. “If it moves over the ground it must leave sign. A tracker is able to identify and follow sign,” says Moreira to a group of sheriff deputies who recently participated in his P.O.S.T. certified course on Crime Scene and Evidence Preservation. For many law enforcement officers, it’s an entirely new learning experience—one that is life-changing because anyone can benefit oth-ers using Moreira’s skill set. “For those who think that distinguishing a single footprint from another and following it is a simple task, I recommend they go to a lo-

cal park and try it. If you can follow a single set of tracks for a distance of one mile in less than 30 minutes, then you are exceptional in-deed. A tracker who has developed and prac-ticed these skills can easily do that and much more. Just imagine being able to tell your SAR Coordinator not only a subject’s direction of travel, but also his or her approximate speed, height, weight, and mental attitude, as well as other various tendencies. Pretty cool, huh?” Moreira quips as he adjusts one of the straps of his tactical vest and checks the contents of his rear pouch. Whether it is a bent branch, a broken twig, or something that has been dropped, the tracker’s duty is to find and follow this sign. A leaf that has been crushed may appear bruised and turn a dark color from damage. A log that is stepped on may show dirt transfer or scuffing. Even rocks show marking and disturbance. For example, a branch of crushed needles becomes transferred to a shoe, which, in turn, is transferred to a rock. These are important clues to look for. Consider a crime scene: A common myth is that the subject (or suspect) has left several clues, making the initial search effort rather straight-forward. In actuality, however, most scenes are contaminated because first responders have other priorities during their response efforts. Their main concern is to save a life, examine a corpse, put out a fire, set up a barrier, and so on. Tracking a suspect takes a professional like Moreira, who knows the procedures of docu-menting crime scene evidence: making sketches

s The author pictured here with instructor Moreira during an excursion near Tracy, CA.

s During a recent course on Crime Scene and Evidence Preservation, Moreira teaches law enforcement officers the proper chain of custody techniques.

Photos courtesy of Peggy Siers and Kim Hernandez


of sign, completing a track report for each set of tracks, establishing a perimeter, recording all personnel who have entered the scene, process-ing and photographing, and marking trails and tracks with flagging and GPS coordinates. This is the stuff that solves cases and puts offenders behind bars. “Taking really accurate notes has its advantages because they [notes] may be used in court years later. Your careful documentation can lead to a conviction,” remarks Moreira, re-calling just such a case. During his travels to different counties and states teaching the art of mantracking, Moreira offers his services at an affordable cost to ensure that volunteers are properly trained. “I feel vol-unteers should not have to pay too much for their own education in order to help save a life. After all, they are already spending their own money to purchase equipment, food, gas, and maintenance expenses.” Moreira is no stranger to news crews—he’s been interviewed by the media so many times re-garding his searches in Washoe County, Nevada, that he practically has a camera and microphone with his name on them! For liability reasons, a local law enforcement agency must request Moreira prior to his involvement with a search; he cannot just show up at the scene and an-nounce his arrival. An example among many that illustrates why Moreira has been the two-time recipient of the American Red Cross Real Hero Award occurred this past year while he and team member Travis

Osterhout were en route to teach a class. They came upon a traffic accident in which an elderly retired surgeon had fallen asleep at the wheel, striking an RV head on. The two took immedi-ate action and notified the Highway Patrol, ren-dered first aid to the victims, assisted paramedics and fire personnel, then remained at the crash site for over an hour until an inbound helicop-ter arrived to medivac the injured parties to a hospital. Though the types of cases Moreira has solved is expansive, the development stage of each case determines the kinds of details that can be dis-closed. He explains further, “For cases that are pending, meaning the investigation is still con-tinuing and there has been no resolution as yet, then I am not at liberty to discuss any details.” His hand re-positions his boonie hat as he con-siders the frustrations encountered on the recent search for billionaire (and world-record hold-er) Steve Fossett, which was more of an aerial search than a tracking exercise. Then there was the 1977 high-profile case against Siaosi Vanisi, who brutally murdered campus police officer George Daniel Sullivan. Moreira discovered key evidence that ultimately led to a conviction and sentencing that may not have been possi-ble otherwise. The judicial system is still talking about that case! Although many believed it was impossible to track a fugitive on concrete and asphalt, Moreira managed to re-trace Vanisi’s movements from the crime scene, through the city of Reno, along sidewalks, across the univer-

‘In my experience,’

says Moreira, ‘I have

taught and used the

art of mantracking

successfully countless

times to assist agencies

in need. . . . Together

we can save lives.’”

s Top: Moreira instructs students on the proper meth-ods of measuring a lost subject's footprint. Middle: A group of students pose after a 4-day Tactical Tracking course near Reno, NV. Bottom: Tactical Snow Tracking is one of the most demanding courses offered, especially when con-ditions become subzero.


sity campus, over parking lots and busy streets, and eventually to Vanisi’s residence. In fact, it was during the courtroom trial when Moreira amazed everyone. The presiding judge decided to put Moreira to the test with a little dem-onstration. During a court recess, the judge took the jury outside, and, for the next several minutes, walked around on pavement to see if Moreira could validate his skills. When asked to come outside and re-trace the judge’s steps, Moreira did just that—right down to the last print. Officials who witnessed the demonstra-tion were so impressed, Moreira was deemed an expert witness by the court system. One of Withrow’s favorite tracking cases from Moreira’s repertoire deals with the armed robbery of a U-Haul truck from Reno, Nevada. On a November evening in 2004, the Nevada Highway Patrol initiated a routine traffic stop with two subjects, only to be met with gunfire. As the subjects sped away, they continued to fire at the officer, who was able to take cover, radio dispatch, and request backup. Nearly 20 minutes into the pursuit, the subject’s vehicle crashed into a guardrail near Lake Tahoe. One subject was apprehended while the other fled the scene on foot, running into thick brush and a heavily forested area. An APB (all points bulletin) listed the subject evading capture as armed and dangerous. Moreira and the county SWAT team were assigned to track the subject, who now had been at large for nearly 6 hours. A background check of the subject revealed prior military training and evasive tactics. Somehow, the subject became privy to the information that a tracker had been called to assist in the search, so he began using several methods to throw searchers off the trail—removing his shoes and walking in socks, stepping on rocks and logs instead of the forest floor, doubling back to leave false clues—anything to aid his escape. Although he traveled through heavy vegetation that did not leave prints, Moreira was able to successfully track his movements, leading the SWAT team into position and surrounding the subject just 3 miles from the crash site. He surrendered and was taken into custody without incident. Another case involved a child molesta-tion. The FBI contacted the Washoe County Sheriff ’s office regarding a divorced male with federal warrants who was wanted for pornog-raphy and child abuse in another state. He had crossed the Nevada state line and abandoned his vehicle in a remote mountain area. Once Moreira was assigned to the case, he was able to identify faint traces of the subject’s prints and began to track sign for more than 2 miles.

As he got closer to where the trail was leading him, he could smell a campfire. Tracking care-fully into the camp, Moreira noticed the fire was still warm and contained a melting pot of plastic and paper. He was so intent on his find and so focused on the evidence in front of him that he forgot to look up. There, in a tree just a few yards away was the subject, who had hanged himself after attempting to destroy a collection of incriminating photographs. Moreira tells each episode with such gusto, one can’t help but get excited. “He has the wonderful ability to take your imagination, sprinkle it with flavor, and make you feel as though you are actually there as part of the search team,” says Roger Rickman, Regional Director for NEMT Region 9. “He is one of the most humble people I have met in a long time. He lives his life according to the SAR creed—So that others may live—and doesn’t search because of the money or publicity,” says Dave Moezzi, DSS Officer for the U.S. Department of State. Despite his many accolades, Moreira gives much of the credit to his tracking staff, the search team members who have proven their loyalty by remaining with him through the years, assisting in a variety of tasks that promote the art of mantracking. The staff is available 24/7/365, and, with Moreira’s leadership, will travel wherever their services are requested. Moreira has this to say to those who are interested in Search and Rescue training: “Tracking is a specialized skill that needs to be a part of every SAR organization. The tools required are few to none; this skill is successful where modern technology has been known ei-ther to fail, or at least create unnecessary com-plications. There is much to learn in order to become a competent and reputable tracker. “In my experience,” says Moreira, “I have taught and used the art of mantracking suc-cessfully countless times to assist agencies in need. If you have the dedication and time, I strongly suggest you become involved and make a difference. Together we can save lives.” In his spare time, Moreira is compiling the materials necessary to publish the first of two books on Search and Rescue Tracking and Crime Scene and Evidence Preservation for the SAR Tracker. The anticipated release date is set for June 2008. These texts will include plenty of photos, along with numerous tracking tech-niques and exciting stories from Moreira’s ad-ventures during his 30 years as a tracker, both in the military and as a civilian. The only thing better than reading his books is registering for a class and being taught by him in person.

For more information, refer to Moreira’s website: www.searchandrescuetrackers.com. Take time to view the site, schedule a training class, or contact him with questions.

Mark Withrow, NEMT Regional Coordinator for Region 9, grew to love the outdoors through his involvement in Scouting, re-ceiving the Eagle Scout award while in high school. His passion for flying encouraged him to join the Civil

Air Patrol, and he became active in Search and Rescue as a cadet in Mendocino County, California. Since meeting instruc-tor Moreira, he became certified as a tracker and plays an active role in promot-ing the art of tracking to law enforcement personnel, and continues to hone his skills by attending Moreira’s P.O.S.T. courses. He can be reached at [email protected]

Rev. Roger Rickman, NEMT Region 9 Regional Director, is a CHS Life Member, pri-vate investigator, and church pas-tor. Raised in the Ozark Mountains, he achieved Scouting’s highest honor, the Eagle Scout award, and

later went on to serve his country in the U.S. Air Force. He devotes his time pro-moting the CHS program, and offers his skills to the SAR community. He can be reached at [email protected]

About the Authors


The Tally Stick: The First Internal Control?

Case Study

O ne of the most important aspects of the Sarbanes-Oxley Act of 2002 (SOX), the most signifi-cant securities legislation passed

since the Securities Exchange Act of 1934, is the strong emphasis on an effective system of internal control. Under SOX, all public compa-nies are required to have an adequate system of internal control, and company officers who fail to comply are subject to fines and even impris-onment. SOX section 404 requires companies to include a report of management on the com-pany’s internal control over financial reporting in their annual reports. In addition, SOX re-quires companies to develop sound principles of control over financial reporting and con-tinually assess that these controls are working. Finally, external auditors are required to present a report attesting to the level of internal con-trol. The internal control requirements of SOX mean that external and internal auditors must understand how internal controls are designed and operated so that they can be assured that the controls have been implemented.

What Are Internal Controls?Although internal controls have been an integral part of business for centuries, confusion exists over the exact meaning and scope of the term. Historically, the term internal control applied to the domain of accounting. The term was ap-plied to the effort to safeguard assets and ensure

the accuracy of the accounting records. More recently, the definition of the term has evolved into a broader concept that extends beyond the accounting functions of an enterprise. The Committee of Sponsoring Organizations of the Treadway Commission (n.d.) defines inter-nal control as a process, affected by an entity’s board of directors, management, and other per-sonnel, designed to provide reasonable assurance regarding the achievement of objectives in the following categories:

Effectiveness and efficiency of operations•Reliability of financial reporting•Compliance with applicable laws and •regulations.

Before Luca PacioliTraditionally, the history of accounting begins with the invention and recording of double-entry bookkeeping focusing upon Luca Pacioli as the author of the first text (published in 1494) describing basically the same account-ing cycle we learn today. But this history omits the centuries-old evolution of accounting sys-tems beginning with the earliest known records of commerce in the Mesopotamian Valley in about 3500 BC and continuing through the Middle Ages. Interestingly enough, the earliest form of writ-ing dating from more than 30,000 years ago is represented on tally sticks in the absence of pa-per. A tally stick is a stick on which notches are

By Nicholas Apostolou and D. Larry Crumbley

Tally Stick Languages

Many languages have their own names for tally sticks:Chinese—chi-chiGerman—kerbholz (notched wood)Hebrew—teomin (twins)Greek—symbolon (put together)

Adams, L. C. (n.d.). Fraud in other words:

Professional jargon and uncensored street slang.

Retrieved 9 January 2008, from http://www.

larry-adams.com/200509_article.htm


cut to keep a count or score. Notches have been found cut on a variety of animal bones from ancient times, including those from wolves and baboons. A baboon bone found in Swaziland called the Lebombo bone dates from approxi-mately 35,000 BC and is marked by 29 clearly defined notches. This particular bone may have served as a lunar phase counter and ranks with the oldest mathematical artifacts known to exist. This ancient tally stick is similar to the calendar sticks still in use by Bushmen families living in Namibia (Williams, 2005). More recent his-torical references to tally sticks are represented by Pliny the Elder (23–79 AD), describing the best wood to use for tally sticks, and Marco Polo (1254–1324), who mentions the Chinese use of tally sticks (Baxter, 1989).

Earliest Internal Control ToolUnsplit tally sticks started as mathematical ob-jects serving as mnemonic aids to counting, but they eventually found another use as commerce developed. Because so few people could read and write, tallies provided the earliest form of bookkeeping for recording both physical quan-tities and money. By the medieval period, tallies had really come into their own as the English equivalent of today’s credit card and as an in-strument of internal control. King Henry I, son of William the Conqueror, assumed the throne of England in 1100 AD, and in an effort to en-hance his power, invented a unique money sys-tem called the tally stick system. Tally sticks were made of polished hazel or willow wood, and transactions were recorded by notches carved into the square tally with a knife. The size of the notch indicated the denomina-tion. A tally was officially described as follows:

The distance between the tip of the forefin-ger and the thumb when fully extended . . . The manner of cutting is as follows. At the top of the tally a cut is made, the thickness of the palm of the hand, to represent a thou-sand pounds; then a hundred pounds by a cut the breadth of a thumb; twenty pounds, the breadth of the little finger; a single pound, the width of a swollen barleycorn; a shilling rather narrower than a penny is marked by a single cut without removing any wood.(Treasures from The National Archives)

Internal control was implemented by splitting the tally stick lengthwise through the notches, leaving one half of the notches on each piece. Each party to a transaction kept one half of each tally stick, and the accounts were audited by fitting the two pieces together to determine if they would “tally.” According to Axel Grandell (1977, p. 103):

For later verification of the transaction the two halves were put together so that the notch cut across the peg was in exactly the same place on each half of the peg. If the tally was made out of a wood with a very clear grain, usually pine, it was furthermore impossible to falsify either half of the tally without detection. The grain in the wood served the same function as the watermark in today’s paper money.

By splitting the tally it had become a means of proof. The notches in the tally provided evi-dence of each piece of work done. The tally’s function as verification, even as acknowledge-ment of debt, can be seen in many documents (court registers and deeds) from the 17th and 18th centuries in Sweden and Finland.

The tally stick was used also for verification in bookkeeping. There is a 1662 Swedish de-cree that states that the bookkeeper on the Crown’s estates should verify the bailiffs’ reg-isters with the threshers’ tally sticks (Grandell, 1977). Monasteries in medieval Italy would ac-cept deposits of money or goods for safekeep-ing, giving the depositor part of the split tally. This portion had to be presented at withdrawal (Edler, 1934). But King Henry expanded the role of tally sticks beyond simple record keeping. Because tally sticks could be used to pay the taxes im-posed by the king, he created a demand for tal-ly sticks. This demand for tally sticks expanded their role, and they began to circulate as a form of money (Carmack, 2003). Some might ask the question: Why would sticks of wood ever be accepted as money? History shows us that anything of value or per-ceived value was accepted as money. Salt, silver, copper, gold, cowry shells, whales’ teeth, and pa-per have all been accepted as currency. In other words, anything can be money as long as people accept it as having value. In England, tally sticks continued to be used until 1826, when they were officially abolished. The tally sticks were then taken out of circula-tion and stored in the Houses of Parliament. In 1834, the burning of the huge number of ac-cumulated tally sticks in an overburdened stove resulted in a fire that started with the paneling, and eventually destroyed the old Houses of Parliament (Holzmann, 2000).

Then Came the Term StockholderTally sticks had been used as a recording or counting device virtually since the dawn of re-corded history. By the Middle Ages under the reign of King Henry I, the role of tally sticks had expanded to include records of financial trans-

Ishango Bone

The Bank of England

The Ishango Bone is a bone tool han-dle that was first thought to have been a tally stick. It was found c. 1960 and dated to c. 9000 BC. At one end of the bone is a piece of quartz for writing, and the bone has a series of notches carved in groups on three rows running the length of the bone. The markings on two of these rows each add to 60. The first row is consistent with a number system based on 10, because the notches are grouped as 20 + 1, 20 - 1, 10 + 1, and 10 - 1, while the second row con-tains the prime numbers between 10 and 20. A third seems to show a meth-od for multiplying by 2 that was used in later times by the Egyptians. Additional markings suggest that the bone was also used as a lunar phase counter. Darling, D. (n.d.). The Internet encyclope-

dia of science. Retrieved 9 January 2008, from

http://www.daviddarling.info/encyclopedia/I/

Ishango_bone.html

The Bank of England, being a sensible and conservative institution naturally suspicious of new technologies, con-tinued to use wooden tally sticks until 1826: some 500 years after the inven-tion of double-entry bookkeeping and 400 years after Johann Gutenburg’s invention of printing. The tally sticks were then taken out of circulation and stored in the Houses of Parliament un-til 1834, when the authorities decided that the tallies were no longer required and that they should be burned. As it happened, they were burned rather too enthusiastically and in the resulting conflagration the Houses of Parliament were razed to the ground Birch, D. (n.d.) Tallies & technologies.


arraydev.com/commerce/JIBC/9811–11


actions. Splitting a tally stick in half lengthwise prevented either party from adding notches on his half of the tally stick. This control mea-sure ensured that any attempt at fraud would be recognized as soon as the two halves were combined. Although this internal control pro-cedure might seem primitive, history records its effectiveness for hundreds of years. It was accepted as proof in medieval courts under the Napoleonic Code. According to Thomas Madox, “when the two parts came afterward to be joined, if they were genuine they fitted so exactly that they appeared evidently to be parts the one of the other” (1711, p. 709). This split tally was almost fraud proof—“an intricate but robust form of record not re-placeable readily till carbon copying” (Baxter, 1989, p. 50). A refinement of the split tally was to make one-half of the marked stick shorter. The lon-ger half was called the stock and was given to the party advancing the money to the receiver (e.g., the stockholder or stock market) (“Tally Stick,” 2007). The shorter part, the foil, went to the debtor, who “got the short end of the stick.” If holes were placed at one end, many tallies could be strung on a rod or thong. A sixteen-sided tally of 1863 served a Swedish mine foreman as an output record with one side per employee (Baxter, 1989).

ConclusionThe tallies reached their peak in the four-teenth century, but their decline was slow even with the introduction of paper. The role of tally sticks was mentioned by Shakespeare in Sonnet 122.2 from Henry VI: “nor need I tallies thy dear love to score” and “whereas before, our forefathers had no other books but the score and tally” (as cited in Baxter, 1989, p. 63). Although tallies were not the ancestors of double-entry accounting, tallies did foster credit transactions and multi-sized transfers (Baxter). In addition, tally sticks were a crude but effective tool of internal control for centuries. Although, we currently define internal control more broadly to include pro-moting the efficiency of operations and com-plying with regulations, the use of tally sticks provides a useful illustration of the essence of internal control.

References Baxter, W. T. (1989). Early accounting: The tally

and checkerboard. Accounting Historians Journal, 16(2),

43–83.

Carmack, P. S. J. (2003, December 2). The money chang-

ers. Retrieved November 27, 2007, from http://reactor-core.

org/money-changers.html

The Committee of Sponsoring Organizations of the

Treadway Commission. (n.d.). Internal control—integrat-

ed framework executive summary. Retrieved November 9,

2007, from http://www.coso.org/publications/executive_

summary_integrated_framework.htm

Edler, F. (1934). Glossary of medieval terms of business:

Italian series, 1200–1600. Cambridge, MA: The Medieval

Academy of America.

Grandell, A. (1977). The reckoning board and tally stick.

Accounting Historians Journal, 4(1), 101–105.

Holzmann, G. J. (2000, June). Tallying up. Inc. Maga-

zine. Retrieved November 27, 2007, from http://pf.inc.com/

magazine/20000615/19392.html

Madox, T., Fitzneale, R., & Gervase, of Tilbury. (1711).

History and antiquities of the exchequer of the kings of Eng-

land. London: J. Matthews.

Tally Stick. (2007, November 13). Wikipedia, the free

encyclopedia. Retrieved November 27, 2007, from http://

en.wikipedia.org/wiki/Tally_stick

Treasures from The National Archives. (n.d.). Thir-

teenth century tally sticks. Retrieved November 27, 2007,

from http://www.nationalarchives.gov.uk/museum/item.

asp?item_id=6

Williams, S. W. (2005). Mathematicians of the African

diaspora. The Mathematics Department of The State Uni-

versity of New York at Buffalo. Retrieved November 9, 2007,

from http://www.math.buffalo.edu/mad/Ancient-Africa/

lebombo.html

About the Author

Great Roll of the Exchequer

The oldest surviving accounting record in the English language is the Pipe Roll, or “Great Roll of the Exchequer,” which provides an annual description of rents, fines and taxes due the King of England, from A.D. 1130 through 1830. Compiled from valuations in the Domesday Book and from statements of sheriffs and others collecting for the royal treasury, the Pipe Roll was the final record on parchment of a “prof-fer” system which extensively used a wooden stick as a basis of account-keeping. Twice a year, at Easter and Michaelmas (September 29), the vari-ous county sheriffs were called before the Exchequer at Westminster. At Easter, a sheriff would pay about half of the to-tal annual assessments his county owed. In accepting a sheriff's payment on ac-count (the proffer), the treasurer would have a wooden tally stick prepared and cut as a record of the transaction. . . . At Michaelmas, each sheriff returns for the final accounting, at which he pays the whole year's revenues. The treasurer reads the amount due from the Pipe Roll, and the sheriff must jus-tify any unusual expenses claimed. Final settlement occurs at a table cov-ered by a checkered cloth, for which the Exchequer is named. “Counters” are placed on the squares to visu-ally represent the amount due the king from that county. Another row of counters represents the Easter pay-ment, which is verified by fitting to-gether the sheriff’s tally stock with the Exchequer’s foil to demonstrate that the notches and cuttings correspond. Alexander, J. R. (n.d.) History of accounting.


acaus.org/acc_his.html

s A pipe roll from 1194

Dr. D. Larry Crumbley, CPA, Cr.FA, is KPMG Endowed Professor at Louisiana State University. He is the co-author of a new book entitled Forensic and Investigative Accounting, published by Commerce Clearing House.

Dr. Nicholas G. Apostolou, CPA, Cr.FA, is U.J. LeGrange Professor at Louisiana State University. He is the co-author of a book published by Barron’s Educational Series Inc., Keys to Investing in Common Stocks.


The American College of Forensic Examiners, Institute (ACFEI) is a name that has long been associat-ed with excellence in foren-sic science.

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ACFEI News

Management Executives, Inc: A Name You May Not Know

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Disgruntled employees, unsta-ble or insecure areas—even terror-ism—can put buisness executives in danger. How do security personnel go about establishing a plan to pro-tect key individuals in an organi-zation? When facing a need to estab-lish protection programs for des-ignated individuals, how does one approach this task? What are the components of such a program? Is there a way to measure and quantify the risk factors? If so, how are those used in the development process of such a program? A new online course of-fered by the American Board for Certification in Homeland Security will help companies pro-tect vulnerable staff. Establishing Executive Security Programs has been written by a

top professional in the field, David L. Johnson, CHS-V. The course presents a threat assessment-based method of de-termining resource requirements necessary to establish, or modify, an executive security program. Executive security operations, methodology, and goals will be discussed. The conduct of threat assess-ments will be outlined, sources of information and other resources will be identified, and the student will gain an understanding of how to apply the results of such assess-ments to the design of the security program. There are no prerequisites to take the course. To find out more, call 1-800-423-9737, or go to www.acfei.com/ees and click on the online catalog link.

Executive Security Focus of New Course

THIS LAND IS YOUR LAND“Victory at all costs, victory in spite of all terror, victory however long and hard the road may be; for without victory, there is no survival.”

—Winston Churchill

“There is a mysterious cycle in human events. To some generations much is given. Of other generations much is expected. This generation of Americans has a rendezvous with destiny.”

—Franklin Delano Roosevelt

“Freedom is never more than one generation away from extinction.”—Ronald Reagan

Protect Your Homeland. Become Certified in Homeland Security today.Call 1-800-423-9737 or go online at chs.acfei.com.

D id you know that a chaplain was the first confirmed fatal-ity of the terrorist attacks of 9/11/2001?

While chaplains serve in many organiza-tions, they are united in their devotion to serving others through faith. They minister in police and fire departments, in the mili-tary, in schools, and in many other settings. A new division is forming to unite chaplains and to advance and advocate for the profes-sion. The Academy of Certified Chaplains seeks to provide a unified front for devotion, edu-cation, and training within the area of chap-laincy and to provide a voice for the dedicated chaplains of this nation.

Many benefits of membershipThe Academy will provide resources, continu-ing education opportunities, and chances to network with colleagues. Academy members will be members of the American Psychotherapy Association, shar-ing common threads of service, devotion, and counseling.

Academy members will receive Certified in Homeland Security Level-I Certification. Additional benefits of the American Psychotherapy Association and the Academy

of Certified Chaplains include an option-al free 1-year membership with a Certified in Homeland Security National Emergency Management Team, a discounted National Conference membership registration (prom-inent keynote speakers featured), and free subscriptions to three quarterly publica-tions: Annals of the American Psychotherapy Association, Inside Homeland Security, and The Forensic Examiner.

Three membership levelsThe Academy of Certified Chaplains offers three membership categories based on the member’s qualifications. During this limited grandfathering period, minimum qualifications have been revised to provide opportunities for the maximum number of interested prospective mem-bers. Don't delay! Join like-minded profes-sionals dedicated to the service of others, and call (800) 205-9165 to become an Academy Certified Professional Chaplain today!

Academy of Certified Chaplains Forms to Provide Support

The National Criminal Justice Reference Service (NCJRS), one of the many services offered by the Office of Justice Programs, is an online resource covering a wide range of topics involving criminal justice. The NCJRS, founded in 1972, offers information on justice and substance abuse for world-wide use in “research, policy, and program development.” Federally funded, it is sponsored by sev-eral agencies from both the Department of Justice and the Executive Office of the President. The NCJRS website offers a mul-titude of free full-text articles, related links, and a knowledge base of questions and an-swers. These topics range from corrections and drugs to juvenile justice and law enforce-ment. The online articles are provided by the sponsoring Federal agencies and can be viewed in text, HTML, and PDF formats. Hard copies of publications and products can also be searched and purchased direct-

ly from the site. Comprehensive online resources called Spotlights are also avail-able. The Spotlights cover information involving data, legislation, and training and technical assistance. Additionally, the website offers a library of criminal justice abstracts for quick-er referencing and research.

Large database The database is one of the largest in the world, with more than 190,000 abstracts of criminal justice publications from the 1970s to the present. Each abstract provides a 100- to 200-word summary, publication information, and instructions on how to purchase a copy of the article. If they are available, links to the full-text articles appear with the ab-stract.

For those interested in attending conferenc-es, seminars, or workshops on various crimi-nal topics, a comprehensive list of the events is posted under Justice Events. The list is easy to navigate and can be searched by topic, lo-cation, or date. Organizations are encouraged to post their upcoming events on Justice Events. Pending approval from the NCJRS, anyone will be able to view the event information on the calendar. The resources on the NCJRS site are available to anyone interested in criminal justice, law enforcement, or legislative poli-cies. This includes educators, professionals, or the general public. For more information about NCJRS, vis-it the NCJRS website at http://www.ncjrs.gov. Information retrieved from the National Criminal Justice

Reference Service (NCJRS) website at

http://www.ncjrs.gov

National Criminal Justice Reference Service Offers Information on Wide Range of Topics



New Diplomates, Fellows, and Life Members

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Nicholas AlbergoBarbara L. AyersBarry R. BermanJames C. BonkRon L. BorelVaia DelidimitropuluGeorge V. DelsonTimothy R. DetamoreStephen E. DoyneTherese E. FinnJohn C. FlatowiczDavid A. FrederickWilliam W. FridayPhilip GeronNicholas J. GiardinoVinobha GooriahLogan L. GreenTheodore M. HankinMichael HaymesSamuel C. KlagsbrunEugene M. KornhaberDebra A. KrichauAntonio J. LarranagaAbraham M. Lazar

Edwin J. LowdJoseph Kelly MorenoRichard B. MorganRichard E. MosesGlenn V. NazarenoHenry A. PaineCarol A. ParasAlcides PintoRebecca A. PowersMike RaperC. David RhoadesJose R. Rodriguez-GomezJohn W. SalmMartin ShafferMichael D. ShinnickSandra S. Smith-HanenKenneth Alvin SolomonMarjean S. SpayerCyla Trocki-VidellW. Roy WilkinsonDaniel R. Wynn

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Attention Forensic EducatorsThe Commission on Forensic Education

The Commission on Forensic Education, developed by The American College of Forensic Examiners, emphasizes the importance of forensic science programs in education and is committed to their expansion. The Commission offers guidance on instruction, provides help to those who teach or study forensic science, and reviews professional certification programs. The Commission is an effective and essential network that helps educators and students stay informed of the latest innovations, breakthroughs, and important research in the field. Commissioner membership is open to college and university administrators and full time, part-time, and adjunct professors; Associate Commissioner membership is open to high school science teachers. The Commission helps educators advance the field and inspire future forensic professionals through providing supportive services:

Helping educators network with fellow teaching professionals and top experts in the •field.Teaching potential students about the importance and the benefits of studying foren-•sic science.Giving members a highly visible forum to publish and distribute their research.•Helping members stay current in a constantly evolving field by providing quality •continuing education.Providing certification programs that recognize achievement.•

Welcome New ACFEI Members!

New Members

Paul AdedigbaCharles Y. AkinmadeHengameh G. AllenSantiago M. AlzugarayKelley ArmbrusterOkunola BabatundeBrett Baggett David J. BarrettJohn M. BartleyAnthony J. BaumgartnerJames E. Beakley Edward David BiedaJohn W. BlanksEdward H. BlockThomas J. BonsaintJennifer Ann Bourgouin Temitayo S. BoyejoFrank M. BrannonJoseph Hamrick BrigatiWanda S. BronerPamela K. BrowndJimmie BryantKenneth Burkhardt, Sr.Frank Cagnina, Jr.Paul G. CarrDavid C. ClemensRobert L. Cloninger Kristal I. Clugston

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Thomas S. MinotaGlen E. MooreJohn D. MooreMolly E. MooreJesse R. MortonAra D. NalbandianJohn E. NeldebergNina NicholasRichard A. Norton, Jr.Simon Patrick OddyBowman M. OldsJennifer PaddonStephen P. Panczak, Sr.Paula PerronRichard E. PoeAaron ReadAnna H. Resnick, Esq.James RichardsonAaron Lewis RobertsJacqueline Rogers-TriceErik C. RomitoHomer Rose, IIIMari Elizabeth RoweJason C. RussoJean M. SavickLouis M. SchlesingerNancy A. SchmidtLance C. Siemen

Kimberly A. SipesMichael R. SissonKevin SmithRebecca A. SnappCarla S. SosaJohn R. Stephens, Jr.Steven StromJohn J. TamezViviane I. ThompsonRonald H. TisdellJeffrey T. TorgalskiMichael A. TorresTommy TullyRichard Wayne Vaughn Sherri L. VaughanGregory M. VergesAmy L. VolkPeggy WallaAaron Joseph WellsJulie Michelle WestChad A. WheatleyErica Jo WirtzCharlene WojcikMatthew D. WrightEmily Zeigler


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The Incomparable Witness: Sir Bernard Spilsbury

Case Study

O n October 18, 2007, interna-tional headlines announced the possibility that Hawley Harvey Crippen, a patent salesman con-

victed of the 1910 murder of his wife, had been wrongly executed for this crime. Two foren-sic scientists, John Trestrail and David Foran, claimed to have proven with DNA analysis that the headless human remains found in Crippen’s basement could not have been those of Cora Crippen (a.k.a. Belle Elmore). While a debate has ensued, one name has cropped up in many media accounts: that of Sir Bernard Spilsbury, the eminent pathologist who had testified so confidently that the remains were those of Crippen’s wife. It had been his first important case and had made him a forensic celebrity in his day. Over the course of Spilsbury’s 40-year career (some 25,000 autopsies), he had privileged access to so many cases, others had difficulty scoring points against him in court—even when he was wrong. His critics called him ar-rogant, territorial, and smug, while those who recognized his contributions said Spilsbury was among the century’s geniuses in forensic science. For this, he was even knighted. Spilsbury got his start when another British pathologist, Dr. Augustus Joseph Pepper, viewed him as a promising protégé. The stu-dent then surpassed the teacher, raising the bar in their field. It was a judge who recognized Spilsbury’s implacable courtroom skills and dubbed him “that incomparable witness.” When he came to Pepper’s attention, Bernard Spilsbury was a medical student in 1905 at St. Mary’s Hospital in London. His fascination with “necropsies” soon involved him in the “beastly science” of pathology. A colleague de-scribed him as a thorough professional with “no room for half-truths.” Because Spilsbury spoke in a quiet, deliberate manner about only the facts he knew, in contrast to predecessors who often made unsupported speculations, he com-manded immediate respect in the courtroom. A handsome man over six feet tall, he dressed well and appeared entirely self-contained. Among his skills was the ability to address ju-rors in simple terms, so they could understand difficult medical concepts. His method “was to implant in the mind of the other person that which he believed to be the truth, and this in-volved making that person understand even to

a limited extent.” He thought carefully about what he would say, strove for excellence, and soon set the standard in England by which autopsies should be performed and explained (Browne & Tullett, 1952). The introverted Spilsbury worked quietly at St. Mary’s, inconspicuous to all but his closest colleagues, until he made a distinct impres-sion as an expert witness in the controversial Crippen case. Then everything changed. In July 1910, Crippen boarded the S.S. Montrose in the company of a slender person who resembled a boy—his disguised mistress, Ethel le Neve. They were bound for Quebec. A tele-graph to the ship’s captain trapped him, and he was arrested on board for his wife’s murder and returned to England for trial. Because his capture had been so unique, news media focused on the case, making it an international sensation. Cora, a bossy woman who fancied herself an opera singer, had been Crippen’s second wife, and they had moved from America to England in 1900. Reportedly, at some point, she became involved with a man named Bruce Miller. Around the same time, Crippen hired le Neve as a typist, and they eventually became lovers. She, too, was domineering, as well as a hypochondriac and documented liar (Wilson & Wilson, 2003). The Crippens resided at 30 Hilldrop Crescent, living beyond their means. Crippen,

48, was a bespectacled, mild-mannered man, but Cora was reportedly abrasive and demean-ing. After a dinner party at their home on January 31, she vanished and Crippen soon pawned some of her jewelry. He also sent res-ignation letters in her name to various orga-nizations and by February 2 had moved his mistress into the house. She was seen wearing Cora’s furs and jewelry. When asked, Crippen said that Cora had gone to visit friends in America, and soon he was adding that she had grown ill and died there. People who knew Cora were aware that she had learned about her husband’s affair and had threatened to drain their joint savings ac-count and leave. A friend of Cora’s eventually reported her disappearance to Scotland Yard, where an investigator reported that there was no record of Cora’s having sailed to America in February. Chief Inspector Walter Dew, from the famed Murder Squad, questioned Crippen, who then changed his story. Now it was the embarrass-ing fact that Cora had run off to be with Bruce Miller, and they were together in Chicago. Dew searched the house but observed nothing to in-dicate foul play, so Crippen was not detained. Yet, when Dew returned to the house to ver-ify a date, he discovered that Crippen had fled. Suspicious, he and his team performed a thor-ough search. In the coal cellar, beneath some bricks, they found a decomposing torso, sans bones, some organs, and the genitalia. Crippen was caught before the ship docked in Quebec and brought back. A tissue analy-sis indicated that the dismembered victim had ingested a lethal dose of hydrobromide of hyo-scin—the same substance that Crippen had purchased earlier. He picked it up on January 19, and shortly thereafter, Cora “ran off.” Despite the incriminating circumstances, the identity of the torso became the key issue at the trial. While Crippen’s counsel, Arthur Newton, insisted that no one could prove that the remains found in the cellar were those of Cora Crippen, he nevertheless offered nothing that proved she was alive after February 1. He also could not explain why she would take a journey during the winter without her jewels, clothing, and furs. In any event, a body had certainly been found in the cellar, which had to be explained. Newton said it was a victim placed there before Crippen moved in.

By Katherine Ramsland


s Hawley Harvey Crippen

It fell to Spilsbury, Pepper, and two other physicians to tell the court just why they were certain the remains provided firm proof that Cora had been murdered, dismembered, and stashed beneath bricks. In Spilsbury’s card file, the remains were thus described: “Medical or-gans of chest and muscle removed in one mass. Four large pieces of skin and muscle, one from the lower abdomen, with old operation scar 4 in. long—broader at lower end” (Browne & Tullett, 1952). In court, he and Pepper both stated that Cora had endured a surgical procedure that would result in a scar in precisely the area on the mass of abdominal skin that bore it. Shoring up this testimony were circumstantial items, such as Crippen’s purchase of poison, his odd behavior after Cora’s disappearance, and the fact that the remains had been buried with a man’s pajama jacket identical to two others that Crippen owned. (Three had been delivered to his home.) While a defense expert said the skin in question was actually from a thigh and called the “scar” a crease where skin had folded over, the consensus was that he made a poor show-ing against Spilsbury, who supported his own finding with a microscope demonstration. There were glands at both ends of the skin fragment, he stated, but none in the middle, which proved it was a scar and not a fold. He also pointed out the arrangement of certain muscles and tendons that made the skin sec-tion more likely to be from the abdomen than a thigh. Spilsbury made a significant impres-sion on the court that day, right down to the red carnation in the buttonhole of his suit—which would become his trademark. As he left the witness box, people remarked, “There is a coming man.” After five days of testimony, the jury took only 27 minutes to convict Crippen and, in short order, he was hanged. (In a separate trial for accessory after the fact, Ethel le Neve was acquitted.) Spilsbury was soon in demand as a Home Office pathologist for other cases. Detached and imperturbable on cross-examination, he came to expect that his word was as good as the truth. He believed his own press, and ap-parently, had decided he was never wrong. He was offended if contradicted by other profes-sionals in his field, and did not forgive easily. Nevertheless, he did make an impressive show-ing in a number of sensational cases. In 1914, Margaret Lloyd died in her bath in Highgate, England. A relative of a victim of a similar drowning spotted her obituary and brought the matter to the police, who noted the criminal record of her husband, George Joseph

Smith. He had not only married Margaret Lloyd under an assumed name, but had also married three times and each of his wives had drowned in her bath. Despite the apparent im-possibility that this was coincidence, it seemed unlikely that someone could assault a woman in a bathtub without her having struggled fiercely. Yet there had been no marks from violence on any of the bodies. Smith was arrested, and Spilsbury supervised the exhumations of the remains of his two pre-vious wives’ bodies for autopsy. On the first vic-tim, for whose murder Smith was to be tried, Spilsbury found evidence from “gooseflesh” on her skin indicating that she had died sudden-ly. Analyzing her organs, he found no defect or disease that might have killed her while she was bathing. (There was none in the other two victims either.) The defense attorney claimed she had experienced an epileptic fit. Spilsbury effectively dismissed the possibility that the five-foot-seven woman could have gone into an epileptic fit in a five-foot-long tub that would place her head under water. Spilsbury then set up a demonstration to show the jury outside the court how Smith could have com-mitted murder without leaving a mark. Detective Inspector Arthur Neil Young and he had already tried some experiments. Women in bathing outfits had agreed to sit in bathtubs and allow Young to try to drown them. After repeated failures, it seemed impossible to ac-complish it without an incredible struggle. But then the detective deduced the answer: Smith had killed them by raising their knees into the air, which pulled their heads down. The quick action and the rush of water made them help-less. Thus, as the jury looked on, the experiment was performed and the female participant went unconscious at once. She had to be revived. As risky as this demonstration had been, it paid off. Since Smith had benefited financially from all three deaths, his motive was clear as well. Within 20 minutes, the “Brides-in-the-Bath Killer” was convicted, going to the gal-lows in 1915. Spilsbury admitted to the difficulty of a 1924 case in which he had been involved. It took place in a rented bungalow along a two-mile strip of the Sussex shore known as the Crumbles. Emily Kaye, a 34-year-old secretary, was involved with an Irish crook and philander-er named Patrick Herbert Mahon. When she became pregnant, he invited her for a “roman-tic” weekend at the Crumbles. In the bunga-low, he killed and dismembered her. He used a knife and saw to carve her up and tried boiling pieces of her over the fire. The rest he placed into a trunk, locking it in the bedroom. He

then brought back another woman with whom he had made a date, and they spent the week-end there. When Mahon returned to London, he left a bag at the luggage office of Waterloo train station and went home to see his wife. Mahon’s wife found a ticket for the bag and asked a former member of the railway police to check it out. Inside, he found blood-soaked women’s underwear, a case with Emily’s ini-tials on it, and a bloody carving knife. These items were turned over to the police, who placed Mahon under arrest. He quickly contrived a story about how he and Emily had quarreled, whereupon she had come at him with a hatchet. He’d pushed her away, killing her accidentally when she fell and hit her head against a coal pot. He’d worried that he would be charged with murder, so he had dismembered her body. Spilsbury traveled to the bungalow to look at the body and found pieces literally every-where, including some that had been partial-ly boiled over the fire. There were organs in a biscuit tin, and body grease and human blood splashed all over the place. He would say later that this was the most gruesome crime scene he had ever encountered. His task was rather odious as well: He had to collect the hundreds of fragments, already several days decomposed, and reconstruct the body to prove identity and ascertain the cause of death. He found a bruised shoulder that indicated a sharp blow inflicted ante-mortem. However, once the body was as-sembled, he discovered that the victim’s head, uterus, and right leg were all missing. Police took dogs all along the train route, in case these items had been tossed out the window as Mahon returned to London. They did not find any of the missing parts. Since Mahon claimed that Emily had hit her head, without it, Spilsbury could not es-tablish a cause of death. Nevertheless, he did determine from the condition of her breasts that Emily had been pregnant. He also found that she could not have died from hitting her head on the coal bucket, as it showed no sign of blood, hair, or damage. But there was more. Mahon claimed to have burned Emily’s head in the fire and broken up the charred remains with a poker. In his usual thorough manner, Spilsbury burned a sheep’s head to try to duplicate these conditions and see if the ashes from the fireplace matched those in the bungalow’s grate. It did turn out to be possible to use fire to turn a head into something brittle enough to smash into pieces. Nevertheless, when Mahon claimed he had pur-chased a knife and saw after the “accident,” he caused his own undoing, as the police proved he had purchased these items before Emily


died. Thus, his intention to kill her was clear. That she had been pregnant provided motive, and the jury took 40 minutes to convict. Always thinking, Spilsbury then performed a complete autopsy on Mahon’s executed corpse—the first of many he would use to study the results of this type of sudden death. Since the time of death was known with accu-racy, he believed a comparative analysis of many such corpses would yield useful information. In 1940, Spilsbury suffered a stroke from which he never fully recovered. He also lost two sons to early deaths, a personal blow that further debilitated him. His mental alertness declined and his reflexes grew slower, while ar-thritis made his postmortem work more diffi-cult. However, his need to control the cases he was involved in remained unabated. He refused to surrender to the realities of aging. After two milder strokes, his insomnia worsened and his friends noticed an alteration in his personality. He seemed to know his work was at an end—something he could hardly endure. In December 1947, Spilsbury penned a letter to a friend, Dr. Eric Gardner in Switzerland, telling his friend that by the time he read the letter, “it would all be over.” Spilsbury had no intention of watching himself decline and become a burden. On the 17th of December,

Spilsbury performed a postmortem as usual, distributed Christmas gifts to his staff, and spent the afternoon destroying his papers. He then dined at his club and said a few words to close friends. No one guessed what was on his mind, but no one should have been surprised, given his lifelong exercise of control. At 7:30 P.M., Sir Bernard Spilsbury went to his private laboratory, turned on gas burners, and lay down to die, ending a remarkable era of impor-tant strides in forensic pathology. His competi-tors, who had gone well beyond him with mod-ern tools, recognized that he had inspired them to rise to the challenge. Some thought Spilsbury’s belief in his own infallibility caused some mis-carriages of justice, but many hailed him as the very embodiment of Sherlock Holmes.

Sources Browne, D. & Tullett, E.V. (1952). The scalpel of Scot-

land Yard: The life of Bernard Spilsbury. New York: E. P.

Dutton and Company.

“Crippen mystery remains despite DNA claim.” (2007,

October 18). BBC News.

Evans, C. (2004). The second murder 2 casebook. New

York: John Wiley & Sons.

Larson, E. (2006). Thunderstruck. New York: Crown.

Thorwald, J. (1964). The century of the detective. New

York: Harcourt, Brace & World.

Wilson, C. & Wilson, D. (2003). Written in blood: A history

of forensic detection. New York: Carroll and Graf Publishers.


About the Author

Katherine Ramsland, PhD, CMI-V, has published 22 books, in-cluding The CSI Effect and Beating the Devil’s Game: A History of Forensic Science and C r i m i n a l

Investigation. Dr. Ramsland is an assistant professor of forensic psy-chology at DeSales University in Pennsylvania and has been a mem-ber of the American College of Forensic Examiners International since 1998.

Find the crime they’re trying to hide.F orensic Accountants track the money and solve the crimes. The best of the best belong to an

elite organization that has rigorous standards and works constantly to advance the important profession of forensic accounting. Becoming a Certified Forensic Accountant (Cr.FA) puts you in good company, helps you to hone your skills, and recognizes your training, experience, and dedication.

Log on to www.acfei.com/crfa for details.Call 1-800-423-9737 to talk to a CrFA specialist.Act now to start enjoying the benefits of certification.

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FThe Certified Forensic Nurse program helps forensic nurses get the respect they deserve and unites them in a supportive community of fellow professionals who are dedicated to their field.

If you are a forensic nurse, join the CFN team today by becoming certified. Tell the forensic nurses you know about the CFN program. Go to www.acfei.com/cfn or call 1-800-423-9737.

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CERTIFIEDFORENSIC NURSE

orensic nurses are often the bridge that spans medicine and justice. They tend to needs of victims and help gather and protect the evidence that can lead to a conviction and ultimate justice.

Stand Your Ground, Revisited: Measuring Reasonable Fear

Case Study

T his commentary follows the expan-sion of the new laws characterized as Stand Your Ground (SYG) since their introduction in Florida in 2005. Both

proponents and opponents agree that there is a dire need for clarity and uniformity as the emergent SYG Laws are being rapidly enacted throughout the United States. Presently, the laws tend to be flawed in two critical ways: First, the laws are ambiguous and second, they are being promulgated without univer-sally accepted standards for authenticating the concept of reasonable fear. Here, the need for standardization of the concept of reasonable fear is addressed, and a procedure for doing so is recommended.

IntroductionDawn is breaking and Marguerite W., an emergency room nurse, is leaving her home for work. As she approaches her car, she no-tices two young males walking toward her. She wrestles with her keys, the chain snaps in her pocket, and she drops several of the keys. She begins to walk rapidly toward her home. As her pace quickens, she reaches into her jacket pocket and feels a key, relieved when she re-alizes it is her house key. The two men follow her in the same direction and step on the edge of her property. With her spare house key, she unlocks the door, enters her house, and imme-diately reaches for the gun kept near the front door. She points the gun and fatally shoots one of the young men just as the other man tries to hand her the car keys she dropped. The questions for the police officers re-sponding to the scene include the following: Is Marguerite acting within her legal rights? Does she have the right of self-defense, allow-ing her to use deadly force in situations that might have otherwise subjected her to pros-ecution for murder? Are her fearful presump-tions of impending harm insufficient for a claim of justifiable homicide due to reasonable fear? Equally unclear is the decision regarding who will ultimately determine her level of fear and by what criteria her perceptions will be assessed. Depending upon which of the 50 United States she is in, the legality of Marguerite’s behavior in response to a perceived fear of personal harm differs substantially. In about

two-thirds of this country (34 states), she is expected to make every effort to get away from the situation and abide by the “duty to retreat” principle. However, across certain state lines, she may have a right to stand her ground and use deadly force to protect herself in response to her perceived fear of impending harm. Throughout the remaining 16 states, where the SYG Laws have been passed, the right of the individual is still unclear. The dilemma lies not only in the location at the time of the act, but also more specifically in determining the legitimacy of perceived fear. There is no standardized or accepted method of authenti-cating one’s claim of reasonable fear for clarifi-cation in the new SYG Laws. What then, con-stitutes a circumstance of genuine fear? Is it the situation, the location of the actor, or the behavior of others who happen to be in the environment? How much fear is reasonable?

What does the genuine perception of fear of impending harm look like?

The LawFounded on the premise that there is a univer-sally accepted understanding of the concept of reasonable fear, the SYG Law gives potential victims the right to use deadly force against a presumed attacker, providing the victim has reasonable fear of the “assailant.” Since first en-acted in Florida in October 2005, 14 addition-al states have adopted variations of the SYG Law bringing the total to 15 as of November 2007. Those 15 states are Alabama, Alaska, Arizona, Florida, Georgia, Idaho, Indiana, Kansas, Kentucky, Louisiana, Michigan, Mississippi, Oklahoma, South Carolina, and South Dakota. Utah had no need to consid-er the new legislation, since historically the state law has provided that “a person does not

By Patricia A. Wallace


have a duty to retreat from where a person has lawfully entered or remained.” The Utah law also specifically indicates that a person is justi-fied in the use of deadly force to defend one’s own property. Across all of these 16 states, the modified Castle Doctrine Laws include a number of pro-visions that vary for each state. Some state laws actually expanded the circumstances where force could be used in self-defense without a duty to retreat, and some also adopted provisions re-garding criminal or civil immunity for using force in self-defense within the limits of the law. The original intent of the Castle Doctrine Law (also referred to as the Castle Law or the Defense of Habituation Law), as derived from English Common Law, was to provide citizens the rights to protect their homes, including the use of deadly force. However, the rapid expan-sion of the law extends the rights of citizens from home to place of work to any place the citizen has a right to be. Generally, the SYG Laws allow people to de-fend themselves with deadly force even in pub-lic places when they perceive a situation as life threatening for themselves or others. The law protects individuals by assuring that they would not be held criminally liable, even if spectators were wounded during the act of self-defense. The Florida law, which served as a model for others, gives citizens the right to use deadly force against intruders entering their homes, when it can be shown that the intruder entered unlawfully or forcefully. The law also extends this principle to vehicles and other places where the individ-ual had a right to be. In addition, the law does away with an earlier requirement that a person attacked in a public place must retreat if possi-ble. Currently, citizens “have no duty to retreat” and have the right to self-defense in reaction to a reasonable perceived “fear of harm” in states with SYG provisions. Some citizens may construe the new SYG Laws as a right to engage in proactive behavior to avoid the possibility of harmful actions by another. In the emotion-laden attempt to ward off potential injury, a person could conceivably be inaccurately predicting the actions of anoth-er. Should this fear be considered unreasonable or merely unfounded? Is the action of a citi-zen using deadly force based on an unfounded fear equally as justified as one using such force based on the legally defined reasonable fear? This brings to question the need to distinguish between unfounded fear and unreasonable fear. This perplexing issue could raise questions re-garding proactive attacks versus reactive behav-ior; in either case there would likely be a claim of fear. Thus, responding police officers would

The Castle Doctrine is an extension of citizens’ basic rights. However, many do not know or understand some of the ba-sic rights already granted. One of these is the right to enact a citizen’s arrest. All states except North Carolina al-low citizens’ arrests under certain cir-cumstances specific for that state. There are no national guidelines for a citi-zen’s arrest, so every person should research his or her state laws. In most cases, state laws allow citizens to fol-

low the directions of a law enforcement officer to act or react in a certain way in a particular situation. The state-specific circumstances include information such as type of crime, wheth-er the arresting person actually saw the crime being committed, whether or not the arresting person is a citizen, and whether the arrest took place immediately follow-ing the crime. In Washington D.C. any “private person” may initiate an arrest, regardless of their citizenship status, while Tennessee law states that the arresting person must be a “private citizen” (emphasis added). In Tennessee, the private citizen may arrest another when “a felony has been committed and he has reasonable cause to be-lieve that the person arrested committed it. Reasonable grounds will justify the arrest, whether the facts turn out to be sufficient or not” (Citizens’ Justice Programs, 1994). Thus, the the person making the arrest does not have to see the arrested commit the offense, he or she must only have “reasonable cause to believe” that the arrested did commit such act. Also, if the reasonable cause is not sufficient to prosecute, the arrested does not have the right to sue the arresting party. However, this is not true in Massachusetts. There, a person may arrest another for committing a felony, but if the arrested is acquitted of the felony charge, he or she is permitted to sue the ar-resting for false imprisonment or false arrest. In Kentucky, the law expects a person who witnesses a felony to prevent the fel-ony if possible, and citizens are allowed to kill fleeing felons if the citizen is in the process of making a citizen’s arrest. Utah law explicitly prohibits the use of deadly force, but does allow citizens’ arrest. In Missouri, a private person is justified in us-ing deadly force “in effecting an arrest or in preventing escape from custody” only when “he reasonably believes such use of deadly force is immediately necessary to effect the arrest of a person who at the time and in his presence (a) committed or attempted to commit a class A felony or murder; or (b) is attempting to escape by use of a deadly weapon” (563.051). However, the witness may use physical force (not deadly force) to arrest or detain a person who has committed a crime (not lim-ited to felonies). In Washington state, a private person may arrest someone who has committed a misdemeanor if it was committed in the person’s presence and constituted a breach of the peace. The person may also arrest another for a felony. In addition, if an offense is committed in the presence of a district judge, the judge may require, through verbal direction, a citizen to arrest the offender and to hold him or her in custody for up to one hour. These are just a few of the differences between state laws concerning citizens’ arrest. Be sure to research and understand your state laws. Also understand that it is safer in many respects to call the police and be a good witness rather than to un-dertake a citizen’s arrest procedure. The possibility for physical harm is great, as is the possibility for lawsuit if the procedure is not exactly and correctly carried out. Know your rights and the limitations to them, and use them wisely.

Citizen’s Arrest

By Kristin Crowe, Associate Editor


be responsible for differentiating between (1) reasonable fear, (2) unfounded but reasonable fear, and (3) unreasonable fear. Examples of these designations of fear can be evaluated by looking again at the perplex-ing scenario of Nurse Marguerite W. Let’s suppose that she had just watched a live TV news show before leaving for work and that the news commentator had cautioned resi-dents of her neighborhood to be on an alert for two dangerous male criminals who were presumed armed and who had recently at-tacked a citizen. Let’s further presume that the demographics (height, weight, and eth-nic origin) of the dangerous criminals fit the profile of the two men Marguerite observed walking toward her at the time she dropped her keys, and whom she perceived as chasing her toward her home. If, because of the newscast and demograph-ic match, her assumptions were that the men were indeed the dangerous criminals being sought by police and that they were chasing her to harm her, then her behavior would be determined as (1) reasonable, based on legiti-mate fear. However, if the similarity of the de-mographics was only vague and coincidental, then Marguerite’s fear could be characterized as overzealous and her violent reaction could be identified as (2) unfounded. Finally, the sto-ry takes a new turn if Marguerite had recently been robbed and this was her first day back to work after a lengthy recovery. Based on that recent experience, she immediately assumed that any two males she saw had intentions to harm her and she was set on deterring them. Because of that, she pulled her gun despite hearing the two males try to explain that they were on their way to school, but happened to see her drop her keys on the ground and were trying to give them to her. In this situation, her claim of fear could be deemed as genuine, but her proactive behavior could be regarded as (3) unreasonable. Both proponents of the new law (such as the National Rifle Association) and opponents (such as the Brady Campaign to Prevent Gun Violence) would likely both agree on the need for clarity of the parameters of perceived fear before the courts become inundated with cas-es using these types of defenses for justifiable homicide. Thus far, the utilization of the SYG defense strategy is not yet known. There are no empirically developed published studies concerning the impact of these laws. An ar-ticle in the June 11, 2006, publication of the Orlando Sentinel stated that it was too early to determine the impact of Florida’s new law, which took effect October 1, 2005, and that

there were no statewide statistics available as of yet regarding the number of self-defense claims before or after that date. The Orlando Sentinel found 13 people who used justifiable homicide as a defense in central Florida over a 5-month period, resulting in six deaths and four injuries. In the investigation of the 13 people who used the SYG defense, three were charged with a crime, five were exonerated, and the five remaining cases were still under review. According to the Orlando Sentinel, po-lice and prosecutors handled investigations of these cases in a variety of ways. The array of ways that a claim of reasonable fear can be interpreted and processed provides extraordinary opportunities for misinterpreta-tion or errors of false positives. Given the dis-parity of handling claims of reasonable fear, it is apparent that there is a great need for uni-formity in defining and assessing reactions to genuine reasonable fear. To ascertain wheth-er an individual’s claim of fear of harm is in-genuous requires an objective examination of how the actor’s cognitive abilities and personal history affect his judgment of reasonable fear. To date there is no clear, generally accepted methodology designed specifically for clarifi-cation or validation of one’s claim of use of deadly force precipitated by reasonable fear of impending harm. Advocates of the SYG Laws would likely view standardization of the con-struct of reasonable fear favorably. They would realize that by employing a standard delinea-tion, the possibilities of feign or misuse of the genuine intent of the law are lessened tremen-dously. Hopefully, opponents of the law would be confident that the law could not be used in illegitimate situations. The answer for both sides of the issue resides with fairness and ob-jectivity in the execution of the law. The ini-tial steps toward unifying the positions for and against the SYG Laws can be the development and implementation of a valid, fair, and clear psychological assessment tool, which examines genuine and reasonable fear in reaction to im-pending harm. Trained forensic psychologists are best qualified to offer opinions relevant to determining this issue, given their expertise in assessing cognitive ability and its influence on decision-making and actions.

Objective Measure of Reasonable FearIn the body of psychological research, fear is defined as an emotion composed of five fun-damental components—the composite of the interaction of five identifiable elements. In this interaction, fear is (1) induced by an ambigu-ous stimulus, (2) exhibited by physical arousal,

thereby (3) giving rise to cognitive appraisal of the source of the arousing stimulus and (4) re-sulting in a subjective feeling (usually learned), precipitating a reaction to the stimulus, which (5) brings about behavioral expression in ac-cordance with the feeling. As a broad construct, fear is generally de-scribed as a basic emotion occurring in re-sponse to an arousal or sensation that invokes a unique response set within each individual. Fear of certain people or situations can be learned and is easily explained by theories of conditioning. The level or degree of fear an individual perceives is dependent on per-sonal history and the circuitry of the brain. Specifically, fear is an emotion that neurolo-gists identify as linked to the amygdalate neu-rons. Personal fear ranges in degrees from mild caution to extreme phobias that could cause disassociation reaction. Psychological theorem has lead investiga-tions of the concept of fear, but the character-ization of the concept of reasonableness has been in the domain of courts and lawmakers. Typically courts have distinguished between standards of reasonableness by characterizing them as either objective or subjective. An objec-tive standard of reasonableness requires the fact finder to view the circumstances surrounding the accused at the time force was used from the standpoint of a hypothetically reasonable and prudent person. Under the subjective stan-dard, the issue is not whether the circumstanc-es surrounding the accused use of force would be sufficient to create in the mind of a reason-able and prudent person the belief that the use of force is necessary, but rather whether the circumstances are sufficient to induce in the mind of the accused a reasonable belief that he must use force to defend himself. These new SYG Laws require law enforcers to assess and determine the underlying intent of human behavior in claims of self-defense based on reasonable fear. In several states, the potential victim who finds it necessary to use deadly force may not be arrested unless the of-ficers responding to the scene have reason to believe that the actor was not operating out of genuine fear when he attacked his “assailant.” In these instances, it is the officer respond-ing to altercations, including those involving deadly force, who must be able to substanti-ate that reasonable fear actually existed and that any violent or deadly action was in direct response to that reasonable fear. But how do law enforcement officers assess perceived fear? Is that method of assessing reasonable fear in accordance with the intent of the legal doc-trine?


This dilemma evidences the need for an in-vestigative tool to assess basic human patterns of behavior in response to fear. Recognizing this need, Dr. Rosalynn Moten-Travis joined with this writer and initiated development of the Reasonable Fear Inventory (RFI©), a screening device designed to objectively assess individual perceptions of fear. The method of investigating a scene where the nexus of reasonable fear and deadly force is involved requires expertise in as-sessing basic human patterns of behavior. The Reasonable Fear Inventory can be the essential tool necessary for objectively ascertaining an in-dividual’s motive, mood, and perception of fear when administered following initiation of an act of violence. Much like the introduction of the lie detec-tor test or other innovative investigative tool, the new Reasonable Fear Inventory will be hailed by some and criticized by others. The cynics will complain that it is too easy and lacks the so-phistication of certain traditional measurement instruments. While enthusiasts may recognize the significance of the ease of administration and reliability of this validated assessment sys-tem, law enforcement and judicial agencies will, hopefully, recognize the value of the Reasonable Fear Inventory as supportive forensic evidence either to move for a dismissal of or to initiate procedures for prosecution of criminal or civil charges. The impetus for the Reasonable Fear Inventory was the early and precise understanding of the implications of the rapid promulgation and passage in state legislatures of the SYG Laws. Beginning by surveying a stratified sample of law enforcers, mental health practitioners, clergy, medical professionals, forensic specialists, college students, lawyers, judges, and convicted crimi-nals, in addition to undertaking an in-depth analysis of archival data found in appellate court cases where definitions of justifiable self-defense were based on claims of perceived fear, rigorous statistical analysis was applied in validating the construct variables contained in the RFI. On the RFI, reasonable fear is characterized as “the global capacity of a person to act appropri-ately, to think rationally, and to deal effectively with his/her fear.” The inventory contains 24 core items and is designed for administration by trained clinical practitioners or law enforcement officers to measure and assess possible manifes-tations of fear. The measurement constructs in-clude state of mind, emotional stability, cultural influence, mental competency, safety assessment, criminal recidivism, and personal history. The RFI form is user-friendly, uncomplicated, and cost effective. Clinical interpretation of the RFI is performed by obtaining a raw score and com-

piling ratings for each of the constructs. The response patterns of inventory respondents are then categorized into four rankings of reason-able fear. The categories provide law enforcement or courts the ability to incorporate this score as additional information to be used in reaching decisions and recommendations of further in-vestigation. The scored assessment form is designed to be used as an objective gauge of the use of deadly force and empirically define the evaluator’s per-ceptions of how reasonable the fear was. The scores further suggest the need for intervention and/or additional investigation. The RFI manual provides detailed instructions on the expeditious administration, objective scoring, and interpre-tation of the assessment form. The form can be completed by hand or generated by using op-tional software. The RFI manual also discusses the development, validity, and reliability of the program.

SummaryTo revisit the scenario concerning Nurse Marguerite W., imagine that as the police offi-cers respond to the scene, Marguerite explains that she shot a man she perceived as an intruder who was on her property and who, she feared, intended to harm her. The issue at hand for po-lice and the court concerns how reasonable her fear was. Were Marguerite’s actions reasonable in comparison to the general population or were they reasonable actions for her, given her indi-vidual history? Was her fear genuine? Drawing on the scores from the RFI, Marguerite’s fear analysis could be more adequately measured and assessed. The score profile would dictate to the police officers what the next step might be. Bringing together the police officers’ training, the results of the standard case interview, and the results of the RFI would yield a fair and im-partial examination of the situation.

About the Author

Patricia A. Wallace, PhD, FACFEI, DABFE, DABFM, is a member of the Editorial Advisory Board for The Forensic Examiner® and has been an ac-tive ACFEI mem-

ber since 1996. She has extensive experience as an expert witness in thousands of civil and criminal court cases as a Michigan licensed psy-chologist. Dr. Wallace is a gradu-ate of Wayne State University. Her experience includes service as chief psychologist for the Recorder’s Court Psychiatric Clinic for Wayne County, Michigan. In cooperation with the Family and Law Program of the University of Michigan Medical Center, Child and Adolescent Psychiatric Hospital, Dr. Wallace prepared and facilitated training programs for psychiatric residents focusing on issues related to under-standing psychological testing, foren-sic evaluations, and expert witness testimony. She is also a psycho-logical consultant with the Detroit Police Department, Detroit Public Schools Public Safety Department, and Selfridge Air National Guard Base in Mt. Clements, Michigan. Dr. Wallace is founder/president of Wallace & Associates, Forensic and Psychological Consultants in Southfield, Michigan.


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For each exam passed with a grade of 70% or above, a certificate of completion for 1.0 continuing education credit will be mailed. Please allow at least 2 weeks to receive your certificate. The participants that do not pass the exam are notified as such and will have a second opportunity to complete the exam. Any questions, grievances or comments can be directed to the CE Department at telephone (417) 881-3818, fax (417) 881-4702, or email: [email protected]. Continuing education credits for participation in this activity may not apply toward license renewal in all states. It is the responsibility of each participant to verify the requirements of his/her state licensing board(s).

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ARTICLE 1 (PAGE 20) LEARNING OBJECTIVES“SANE PEER REVIEW: WHAT IS IT? DO WE NEED IT?”

After studying this article, participants should be better able to do the following:1. Describe the peer review process.2. Identify the reasons why a peer review should be done.3. Identify resources in particular practice arenas that can validate the peer review process.

1. True or false: SANE nurses must adhere to their State Board of Nursing scope of practice,

the International Association of Forensic Nursing scope of practice, and their individual insti-

tutions' policies and procedures.

a. True

b. False

2. Peer review should NOT be done to

a. Assure competency in documentation.

b. Embarrass the SANE nurse.

c. Prepare a non-biased report.

3. The nursing process for peer review includes all EXCEPT

a. Assessment.

b. Evaluation.

c. Interpretation.

d. Implementation.

4. The ultimate reason to perform a peer review is to

a. Improve patient outcomes.

b. Increase job responsibility for the coordinator/director.

c. Allow someone else to fix the errors in documentation.

d. Write a good report.

5. A peer reviewer has increased objectivity because

a. He/she does not witness and cannot be subject to the affects of an emotional patient.

b. He/she takes all the photographs and therefore knows all the particular injuries in the case.

c. He/she also works as an advocate in addition to peer reviewing.

d. He/she has interviewed the suspect and therefore has heard both sides of the case.

6. True or false: Peer review is recommended, but it will not ultimately lead to better patient

outcomes.

a. True

b. False

ARTICLE 2 (PAGE 26) LEARNING OBJECTIVES“THE ARROGANT CHAMELEONS: EXPOSING FRAUD-DETECTION HOMICIDE”

After studying this article, participants should be better able to do the following:1. Understand the psychological characteristics of red-collar criminals.2. Assist law enforcement and attorneys in their interviews with possible murder suspects.3. Consider forensic accountants and fraud examiners as members of a homicide investigation team

to uncover a motive to commit murder.

1. True or false: Psychopathological criminals are sincere and truthful.

a. True

b. False

2. True or false: The interview of the red-collar criminal cannot be based on appeals for sym-

pathy, remorse, regret, or social obligations.

a. True

b. False

3. True or false: When interviewing a psychopath, it is better to begin with a specific strategy

and not try to elicit an emotional confession.

a. True

b. False

4. True or false: Red-collar criminals are nonviolent.

a. True

b. False

5. Murder for hire red-collar criminals are more apt to

a. Be found guilty at a trial.

b. Give statements to the police.

c. Avoid detection.

d. Provide the weapon to commit murder.

6. True or false: Red-collar criminals are psychopathological.

a. True

b. False


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Information was relevant and applicable.1. Learning objective 1 was met.2. Learning objective 2 was met.3. Learning objective 3 was met.4. You were satisfied with the article.5. ADA instructions were adequate.6. The author's knowledge, expertise, and 7. clarity were appropriate.

Article was fair, balanced, and free of com-8. mercial bias. The article was appropriate to your educa-9. tion, experience, and licensure level. Instructional materials were useful.10.

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For each exam passed with a grade of 70% or above, a certificate of completion for 1.0 continuing education credit will be mailed. Please allow at least 2 weeks to receive your certificate. The participants that do not pass the exam are notified as such and will have a second opportunity to complete the exam. Any questions, grievances or comments can be directed to the CE Department at telephone (417) 881-3818, fax (417) 881-4702, or email: [email protected]. Continuing education credits for participation in this activity may not apply toward license renewal in all states. It is the responsibility of each participant to verify the requirements of his/her state licensing board(s).

ARTICLE 3 (PAGE 34) LEARNING OBJECTIVES“THE LIFE DEVELOPMENT OF GANG MEMBERS: INTERVENTIONS AT VARIOUS

STAGES”

After studying this article, participants should be better able to do the following:1. Distinguish between the various levels of development of gang members.2. Identify various interventions for each level.3. Discuss how different agencies approach gang problems.

1. Socialization into gang culture may begin as early as

a. Middle school.

b. Young adulthood.

c. Infancy.

d. Secondary school.

2. Gang members who survive to middle age and remain members usually follow two courses.

They are

a. Drug dealers and hit men for the gang.

b. Neighborhood "leaders" or part of a national/international criminal organization.

c. Protectors and recruiters.

d. Informants and bookkeepers for the gang.

3. Many gang members never reach the highest levels due to

a. Long-term Incarceration or violent death.

b. The lifestyle becoming boring.

c. Finding legitimate employment that pays better.

d. Becoming informants for the police.

4. Primary school children may be used by the gang as

a. Witnesses during trials.

b. Keeping the parents too busy to attend to the gang member.

c. Scouts and runners.

d. A means to learn the basics the older gang member missed in school.

5. The older, established gang members

a. Help select the style and signs of street gang members.

b. Frequently are overthrown or killed by younger gang members.

c. Lose interest and inform on the gang.

d. Distance themselves from any obvious gang connections.

6. True or false: “Easy” money is a selling point for attracting middle and secondary school age

members.

a. True

b. False

ARTICLE 4 (PAGE 40) LEARNING OBJECTIVES“INJURY ASSESSMENT AND MANAGEMENT: CONTROVERSIES AND RESOLUTIONS”

After studying this article, participants should be better able to do the following:1. Distinguish between an injury and a muscle strain.2. Understand the importance of the initial diagnosis and treatment regimen.3. Recognize the point in the treatment program at which the injury has healed and the ongoing

symptoms are no longer due to tissue damage, but are influenced by other factors surrounding the injury.

1. When assessing a person involved in an accident, what is the first thing to do?

a. Give him an appropriate injection for pain.

b. Establish a diagnosis.

c. Give him something to eat or drink.

d. Obtain his insurance number.

2. To manage the pain of an accident victim, which order would be best?

a. Give appropriate medication, diagnose the injury, splint the area, and explain the treatment

plan.

b. Explain the diagnosis and treatment plan, give medication, and splint the injured area.

c. Splint the injured area, explain the diagnosis and treatment plan, and give medication.

3. What is the most important role of the treating practitioner?

a. Filling out forms for the attorney.

b. Relieving the patient's pain.

c. Treating the injury.

4. What is the purpose of treatment of the injury?

a. To relieve the patient's pain.

b. To aid and facilitate the healing of the injury.

c. To return the patient to his or her work and family.

d. To aid the patient in his or her lawsuit.

5. Who is ultimately responsible for the return to function from the injury?

a. The insurance company.

b. The treating doctor.

c. The patient's attorney.

d. The patient.

6. True or false: The treating practitioner and independent evaluator’s objective findings and

conclusions need to be in reasonable agreement.

a. True

b. False






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ARTICLE 5 (PAGE 44) LEARNING OBJECTIVES“STORIES FROM THE FRONT: IE (IME) EXCESSES AND HOW TO COUNTER THEM”

After studying this article, participants should be better able to do the following:1. Quickly understand the immense gravity of an IE performed on a patient, client, or friend and better

prepare the patient for the encounter.2. Formulate a forensic plan to adjudicate either the IEs and/or the report submitted.3. Identify the legal aspects and remedies available to combat the more egregious fraud perpetrated

by the IEs in the name of “cost containment.”

1. Insurance companies make the bulk of their profits througha. Policyholder’s premium payments.

b. Denying claims and through various investments such as T-bills, real estate, interest on CDs,

etc.

c. Lawsuits.

2. Intermediary companies that hire and temp out (IE) doctors are

a. Completely independent.

b. Owned by the federal government.

c. Often owned by an insurance company.

d. There for the good of the patients.

3. True or false: The general idea is that IME doctors are trusted to be objective and render a

fair and objective report.

a. True

b. False

4. True or false: A doctor’s CV should be accurate, un-embellished, complete, and up to date.

a. True

b. False

5. Outcome measures are useful because

a. The insurance companies enjoy reading them.

b. They make the patients feel better about treatment.

c. They are considered valid indicators of how a patient feels and responds during a treatment

regime, and they help document a case file, especially treatment protocols.

6. True or false: It is strongly advised to bring a witness along to an IE.

a. True

b. False


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For each exam passed with a grade of 70% or above, a certificate of completion for 1.0 continuing educa-tion credit will be mailed. Please allow at least 2 weeks to receive your certificate. The participants that do not pass the exam are notified as such and will have a second opportunity to complete the exam. Any questions, grievances or comments can be directed to the CE Department at telephone (417) 881-3818, fax (417) 881-4702, or email: [email protected]. Continuing education credits for participation in this activity may not apply toward license renewal in all states. It is the responsibility of each participant to verify the requirements of his/her state licensing board(s).




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Case Study

Falsely Accused: Justice and the Willing Suspension of Belief

I n 1987, Larry Peterson was 36 years old, divorced, and living with his mom in Pemberton, New Jersey (population [in 2000] around 1,200). Peterson’s

problems included the abuse of both alcohol and drugs, and NPR journalist Robert Siegel notes, “he had a record for petty crimes” (“Exoneration,” 2007). Peterson admits, “I became involved with the wrong people” (“Exoneration”). In 1987, Larry Peterson “made his living in the woods, collecting and coiling vines that stores [sold] as ornamental wreaths” (“Exoneration”). Locals recall the morning of August 24, 1987, when the body of Jacqueline Harrison was found raped and strangled in the woods. The news-paper report included sordid details hard for a grieving family to read—it was believed her death had followed “a night of partying: Police found evidence of crack cocaine in her system and of sex with more than one man” (Siegel, “Exoneration,” 2007)—hard for the mother who will raise her two small granddaughters, hard for the sister who sees her sister’s reputa-tion and memory reduced to a forensic report. Peterson had not been identified as a sus-pect, but Peterson’s neighbor saw scratches on his arms [recall his woodsman livelihood] and called the police. Peterson “denied any involve-ment” (Seigel, “Exoneration,” 2007), but im-mediately found himself the object of police attention anyway. Three weeks later, they ar-rested him. Seventeen months later, months Peterson spent in jail, his trial began. Gail Tighe, a forensic scientist at the New Jersey State Police crime laboratory, “testified at Peterson’s 1989 trial that the hairs found on the victim physically ‘compared’ or ‘matched’ to those of Peterson” (“Key players,” 2007). Siegel reports that this evidence was “the heart of the prosecution’s case” (“Exoneration,” 2007). Particularly damning was the inexpli-cable testimony of Peterson’s friend Robert Elder, who told the police that on the morning of the murder’s discovery, “during a car ride together, Peterson bragged about the crime” (“Key players”). Though sentenced to 40 years in New Jersey’s Trenton State Prison, Peterson main-tained his innocence, and in 2003, with the help of the Innocence Project, he won the right to DNA testing of the hair used as evidence at his 1989 trial. “The DNA tests showed that the hairs from Peterson’s trial belonged not to him but to the victim,” and further, the

tests “turned up the tissue and semen of an unidentified man—a ‘Mr. X’ whose DNA, so far, has not turned up in any criminal da-tabase” (Siegel, “Exoneration,” 2007). Further DNA testing found “there was no DNA evidence linking Peterson to the crime” (Siegel, “Exoneration,” 2007). In July 2005, Judge Thomas Smith vacated Peterson’s 1989 conviction declaring, “The strength of the [state’s case] is different at this point. We’ve got substantial biological evidence that would tend to indicate that, in fact, Mr. Peterson was not involved in the offense” (Siegel, “Exoneration”). That should be the happy ending to a wretched story with no winners, but it is not over. The current Burlington County Prosecutor, Robert Bernardi, “told reporters that the case was weaker but that it was certainly ‘not an untriable case’” (Siegel, “Exoneration,” 2007). Immediately upon Peterson’s release from pris-on, the county rearrested him with intent to retry him. His mother’s joy at his release cut short, she managed, over a month’s time, to scrimp and borrow to post his $20,000 bail. August 27, 2005, 18 years after his conviction, Peterson was free on bail; awaiting trial (again); he was unemployed; and his mother was 20 grand in debt. Then came April, 2006. Robert Elder reappeared to recant his 1989 testimony. To get out of an interrogation that had gone on for three days, he said he had told the police what clearly they wanted to hear. The police, he said, discussed the details of the case outside his interrogation room, leav-ing the door open. He said he had merely re-peated their own story back to them, throw-ing in a few details he had made up. It took prosecutor Bernardi, who had “fought Peterson’s claim to have his DNA tested” (“Key players,” 2007), 2 more months to admit that he did not have a case, and even then, in June 2006, he would admit only that “there was not enough evidence to persuade a jury beyond a reasonable doubt” (Siegel, “Larry Peterson,” 2007). He wasn’t the only one who wouldn’t change his mind. William Buckman is a civil rights attorney who has filed litigation to have Peterson’s record expunged; he is also suing, under New Jersey law, for monetary compensation for Peterson’s wrongful conviction, though it will take several years for Peterson, now 56, to see any compen-sation. Harrison’s daughters responded with an eloquence and dignity beyond their years: “We don’t know all the facts . . . someone out there

is not giving all the information they know” (“Voices,” 2007). They have determined not to set their minds until all of the facts can be known, even in the face of the possibility that such a day may never come.

References Key Players in the Larry Peterson Case. (2007, June

15). National Public Radio (NPR). Retrieved June

15, 2007, from www.npr.org/templates/story/story.

php?storyld=10956464.

New Jersey Association of Forensic Scientists (NJAFS).

(2006-2008). Retrieved June 19, 2007, from www.njafs.

org/administration.html.

Pemberton, New Jersey. (2003-2007). City data. Re-

trieved June 18, 2007, from www.city-data.com/city/

Pemberton-New-Jersey.htm.

Siegel, Robert. (2007, June 13). The Exoneration of

Larry Peterson. National Public Radio (NPR). Retrieved

June 13, 2007, from www.npr.org/templates/story/story.

php?stroyld=10961075.

Siegel, Robert. (2007, June 15). Larry Peterson: Life

After Exoneration. National Public Radio (NPR). Re-

trieved June 15, 2007 from www.npr.org/templates/story/

story.php?storyld=10974437.

Siegel, Robert. (2007, June 15). DNA, Exoneration

and Compensation: A Discussion. National Public Ra-

dio (NPR). Retrieved June 15, 2007, from www.npr.org/

templates/story/story.php?storyld=11012152.

Voices from the Case. (2007, June 15). National Public

Radio (NPR). Retrieved June 15, 2007, from www.npr.

org/templates/story/story.php?storyld=10974437. Link

to Voices from the Case.

s A mugshot of Larry Peterson


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