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Saturday, January 28, 2012

MENTAL HEALTH

Road Traffic Offences
Introduction
The forensic clinician enters a complex world in his/her dealings with the Road Traffic Acts (RTA)
where a knowledge of driver statute and case law may be more important than in any other field.
At first it seems simple, that the FME is called out, turns up, takes blood samples and fills in some
forms, and for the vast majority of cases that is the end of the matter.
It is for the few cases which are not simple that a wider knowledge is required.
RTA case law is full of examples where procedure rather than simple fact has been the lynch pin of
a defended case.
By the "RTA", in this text, reference is being made to the Road Traffic Act 1988, the last in a series
of Acts. The latter act is the source of virtually all the discussion in this chapter. Any other statute
will be cited and described with its full title, but otherwise RTA will mean the '88 Act.
Technical Matters
The current RTA kits involve the doctor transferring blood from a single syringe to two containers
with a "rubberised" membrane through which the blood can be injected. It is hard to conceive of any
other procedure in medical practice today which is designed to be as hazardous to the user from the
point of view of needle-stick injury or aerosol blood spray as this.
In 1994, a sub-committee of the Association of Police Surgeons met with representatives of the
Home Office Forensic Science Services to address this problem amongst others. There appeared to
be no problem in attitude from the scientists with regard to the re-organisation necessary for analysis
using a different and safer venesection process. However the legal advice sought suggested that any
other system available whereby two samples were obtained could not be deemed
to have satisfied the Road Traffic Offenders Act 1988 s15 (5)r until it had been through the courts. It
was not satisfactory therefore to change procedure without a change in statute.
The transfer of the blood to the container is best facilitated by allowing the syringe plunger to be
pushed back up the barrel by the pressure increase of the blood from the first container before filling
the second.
It is equally acceptable to insert another sterile needle into the membrane to allow pressure
equalisation. If this is done the FME should record the presence of two holes in the membrane.
One anecdotal case had the accused specimen container sporting 16 holes whilst the "police"
specimen had 1. Not all cases of interference would be as easy to spot as that, and it is good practice
to record multiple perforation of the membrane.
It is sensible to develop a routine with RTA cases.
As the consent for a blood specimen is requested in front of a police officer who witnesses the
response, there is no real requirement to have the consent to the simple transaction recorded in the
clinician's record. If, however, the case is a more complex one involving examination then written
consent should be obtained.
Many defences appear spurious and it helps to have developed a set notation for the record of the
sampling, so that it can be seen that a detailed procedure was followed.
Recording:
• From which arm the sample was obtained.
• How much blood was obtained (if the syringe was not full).
• Who packaged the specimen.
• Was it "selotaped" and by whom?
• Was the accused given information about approved laboratories?
• The name of the authorised operator or police officer running the procedure.
and such like can all help.
r "Where, at the time a specimen of blood or urine was provided by the accused, he asked to be provided with
such a specimen, evidence of the proportion of alcohol or any drug found in the specimen is not admissable on
behalf of the prosecution unless—
(a) the specimen in which the alcohol or drug was found is one of two parts into which the specimen provided
by the accused was divided at the time it was provided, and
(b) the other part was supplied to the accused."
to have satisfied the Road Traffic Offenders Act 1988 s15 (5)r until it had been through the courts. It
was not satisfactory therefore to change procedure without a change in statute.
The transfer of the blood to the container is best facilitated by allowing the syringe plunger to be
pushed back up the barrel by the pressure increase of the blood from the first container before filling
the second.
It is equally acceptable to insert another sterile needle into the membrane to allow pressure
equalisation. If this is done the FME should record the presence of two holes in the membrane.
One anecdotal case had the accused specimen container sporting 16 holes whilst the "police"
specimen had 1. Not all cases of interference would be as easy to spot as that, and it is good practice
to record multiple perforation of the membrane.
It is sensible to develop a routine with RTA cases.
As the consent for a blood specimen is requested in front of a police officer who witnesses the
response, there is no real requirement to have the consent to the simple transaction recorded in the
clinician's record. If, however, the case is a more complex one involving examination then written
consent should be obtained.
Many defences appear spurious and it helps to have developed a set notation for the record of the
sampling, so that it can be seen that a detailed procedure was followed.
Recording:
• From which arm the sample was obtained.
• How much blood was obtained (if the syringe was not full).
• Who packaged the specimen.
• Was it "selotaped" and by whom?
• Was the accused given information about approved laboratories?
• The name of the authorised operator or police officer running the procedure.
and such like can all help.
r "Where, at the time a specimen of blood or urine was provided by the accused, he asked to be provided with
such a specimen, evidence of the proportion of alcohol or any drug found in the specimen is not admissable on
behalf of the prosecution unless—
(a) the specimen in which the alcohol or drug was found is one of two parts into which the specimen provided
by the accused was divided at the time it was provided, and
(b) the other part was supplied to the accused."
ulation, could be due to a drug and therefore would seem to satisfy the requirements of the act.
What has been tested in the court is that the doctor must give an oral indication to the constable concerning the presence may cause the specimen to be inadmissable.
There appears to be no requirement in the RTA for an accused to consent to a full examination, but there is also nothing practitioner to do a full consensual examination before advising the police officer. It seems perfectly acceptable for accused, record as much as possible of his/her observations and if there is a demonstrable condition satisfying the The police surgeon must record accurately all the findings

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