Amanda Van Nest

She is a Forensic Nurse Examiner at UC Health Memorial Hospital.

FNE is a registered nurse that sees patients who are exposed to violence.
She has been doing this for 6.5 years.
She has a Bachelors of science in nursing, a registered nurse license through state of CO, a 64 hour course specific to forensic nursing, attended a full time 12 week orientation; is affiliated with International Association of Forensic Nurses, has SANE adult/adolescent and pediatric certifications; and completes 30 continuing education credits every 2 years.
She has qualified as an expert in El Paso County courts roughly 6 times.
Patients are exposed to violence meaning domestic violence, sexual assault, child abuse, human trafficking, physical assault, and strangulations.
FNEs perform suspect evidence collection.
The primary nurse caring for them notifies FNE or if they have reported a sexual assault it is provided at intake.
This witness is qualified for the purposes of this trial.
FNE gets minimal information from the primary nurse or provider.
She relies on other people to tell her when someone has been exposed to violence.
This can be self-reported or police can report that the person was exposed to violence.
She became involved on January 29th 2020.
The primary nurse notified her Letecia Stauch came to the hospital reporting chest pain and a sexual assault.
She was brought to the hospital by ambulance.
Her condition was stable, nothing life-threatening.
Van Nest did not get a report from the EMS staff but read it later. She had not spoken a lot about the sexual assault.
Exhibits 340 - 353 are photographs.
EMS noted that she would speak with them when law enforcement was not present but would pretend to be asleep when they were present.
She did not mention any neurological issues.
HIPAA is a patient's right to privacy.
Van Nest asked Letecia to sign the form after going over it with her. She understood her rights and signed the form with no issues. She signed the medical release form Tecia.
She identifies the defendant as Letecia, the person she interacted with.
The majority of the time there was no detective in the room.
I’m a FNE, I specialize in caring for patients who are exposed to violence, DV, SA, CA, elder abuse, strangulation, human trafficking. You’re here today for ____. For Letecia it was “you were sexually assaulted”. Then gives her options; a patient does not have to let her do anything, everything is up to them.
Letecia wanted to continue speaking with Van Nest.
Letecia reported to her that a construction worker came into the home, sexually assaulted her, and kidnapped her 11-year-old step son.
The process is to give a history of what happened, the physical exam is a collection of evidence based on what was stated to have happened, and medications to prevent pregnancy and sexually transmitted diseases are offered.
This exam can be shocking and invasive to someone who has already gone through a traumatic event. Letecia wanted to go through with the process.
Van Nest obtained a psychosocial history; who they lived with, kids in the home, firearms, drug use, domestic violence, additional safety concerns. This is a self-report. They do not pull other records.
Letecia reported a history of generalized anxiety disorder; worry that would cross into your everyday life, excessive or unrealistic worry.
She was prescribed Lorazepam or Ativan as needed for generalized anxiety disorder.
At 6:45PM on January 29th 2020 Van Neste explained a suspect exam, which is not voluntary and a SANE exam, which is voluntary.

(It sounds like there was a search warrant and Van Neste was going to perform the exam for both reasons)

She still wanted to move forward with the process.
Evidence collection is done in an exam room.
Van Nest discussed collecting evidence and specimens from her body during the SANE exam.
Letecia said Harley was in the waiting room and was a good source of support for her and wanted her to be there during the exam.
After the search warrant potion of the exam was finished Letecia walked out of the exam room to go to the waiting room and get Harley.
Letecia never returned for the SANE exam.
Evidence collected from the search warrant was: buccal swabs (inside of cheek) for DNA, fingernail scrapings, blood for her DNA, direct visualization of her head and hands with photos.
Exhibit 371 is the buccal swabs and fingernail scrapings from the suspect exam.
Letecia said the assault happened at her home on January 27th between 2:45 and 4 PM; it was a construction worker named Eguardo.
She also reported Gannon had jumped on the man’s back to try to get him off of her.
She said “I don’t think so” when asked if the assailant had ejaculated.
Sexual assault victims commonly want to clean themselves right away. She said she had showered since it occurred but she did not appear to have bathed or showered.
Her hair was very greasy; did not appear to have showered recently.
She had changed and washed her clothing since the assault.
She made eye contact and communicated regularly; there was no indication she didn’t understand what was happening.
She did not give a long description of the attack but she said:

“I don’t know any other way to explain it. He was waiting at our home and he grabbed me. Well, it was leading up to all of that. He grabbed me and pushed me down in my son’s room. I was kind of like fighting back because he wasn’t much bigger than me, you know. Then at that point he started forcing himself on me and taking off my pants. He didn’t never take off my shirt but i was saying no and I remember like a little bit of my back started hurting and my head was hitting the floor, the concrete. Then I could tell I had to give in, just basically give up.”

Part of the exam was to search for injuries; photographs were taken.
Exhibits 340 - 353: portrait, left side profile, right side profile, back of head, top of head, closeup of scalp.

No injuries apparent in any of them.
Photo of her hands - abrasions and a bruise are noted on her hands.
Right hand, palm down - injury on her pinky.
Left hand, palm down - pinpoint abrasion - abrasion is another word for scrape; superficial injury.
Right hand, palm up - abrasion on middle finger at 2nd knuckle; she said her dog bit her.
Left hand, palm down - abrasion between pinky and ring finger. Also an abrasion at the base of the index finger below the knuckle of the left hand.

She had seen roughly 600 patients as a forensic nurse examiner; only a handful of patients have left before the SANE exam.
She has seen a handful of patients who were unable to sign informed consent; with Letecia, she had no concern she did not understand things. She gave informed consent.
If someone is so severely mentally diseased or defective they can’t give informed consent and could be a danger to themselves or others she would have notified the emergency room physician for a mental health hold.
Letecia never got anywhere close to that in their interactions.
Her opinion is that Letecia was sane on January 29th 2020 and able to give consent; this was 2 days after her stepson went missing and she was purportedly sexually assaulted.

Cross examination

She has no training in forensic psychiatry. She did not try any mental exam on Letecia.
She is competent in assessing them for consent matters but cannot diagnose mental health issues.

Judge followup with attorneys

Letecia did not have the right to not consent to the suspect exam - if necessary she could have been held down. It was clear she left before the voluntary portion.
Defense wants to make a record regarding lay people giving opinion on "mentally diseased or defective".