The impact of crime on innocent victims can be a life-transforming event in many ways, but particularly for those who become physically injured as a consequence. From one moment to the next, as individuals innocently go about their lives, they can suddenly be affected by the result of a crime that they didn't ask for or deserve. They may have to deal with its consequences for a temporarily long time frame or, in some cases, for the remainder of their lives. Though any type of crime, undoubtedly, has an emotional impact on victims, the effect of physical injuries that are sustained not only can enhance the trauma but can have additional repercussions as well. Therefore, it is important for law enforcement officers, victim service professionals, prosecutors, social workers, and all medical professionals to have a clear understanding of the nature and types of injuries that can occur as a result of various crimes, and the appropriate referral sources and treatment vital to meeting their needs.
Despite the fact that victims of any type of crime can be injured, there are some crimes that commonly produce injuries on a consistent basis due to the nature, frequency, and severity of the crime. The presentation of injuries is frequently observed in cases of assault and domestic violence. Though both women and men can be victims of domestic abuse, women usually report the crime more often than men and, thus, the injuries depicted are usually observed in female victims. Domestic violence is not a one-time occurrence and because it is fueled by the components of power and control, the escalation of the violence can be intense and the injuries severe. Victims are often punched in the face, choked, stabbed, slapped, thrown across a room, thrown down to the ground, kicked, spit on, or beaten severely with an object. When police arrive on scene, they often encounter not only an emotionally traumatized victim but one who may be seriously injured and require transport to a hospital emergency room or nearby trauma center.
"I've seen numerous types of injuries from bruised and bloody to just discolored swelling," says Officer Donald Rickert of the Prince George's County (MD) Police Department. Officer Rickert recently responded to a domestic call in which the female victim had been allegedly attacked and choked by her live-in boyfriend. The victim displayed visible signs of injury that included red marks on her neck coupled with facial swelling, and she complained of feeling ill in the aftermath of the incident. She was transported by ambulance to a nearby hospital. The offender was charged with second degree assault and is awaiting trial.
Orbital fractures
Assault victims commonly incur eye and facial injuries. In early January 2009, 40 miles northwest of Bismarck, North Dakota, a male patron in a bar was attacked, and he suffered severe facial injuries as a result. In cases such as these, victims who have been punched repeatedly in the face or who may fall hard to the floor as a result of the attack may suffer serious injuries to the eyes. It is not that unusual for a victim to sustain an orbital fracture or multiple fractures within the orbit, the ridge of bone that surrounds each eye. The orbit of the eye contains seven facial bones, and one or more of them can be fractured as a result of a hard blow to the face or eye area. A CT scan can diagnose the injuries. An orbital fracture is often accompanied by a significant bleeding upon initial impact, severe bruising, and a very swollen eye lid that causes the eye to shut. Effects of an orbital fracture can include double vision, inability of the eye to freely move up or down or side-to-side, and if the injury is allowed to remain too long without required surgery, the eye can sink. Moreover, if there are multiple fractures, muscles within the eye can become entrapped in the fractures and promote double vision.
Depending upon the severity of the orbital fracture, the victim may require surgery, and if necessary, it should be done soon after the injury has occurred. The professional expertise of an oculoplastic ophthalmologist should be used, rather than a general ophthalmologist or plastic surgeon. In severe cases such as this, if surgery is not performed in a timely manner generally a week following the onset of the injuries a period of waiting too long may complicate matters and impede the ability to correct the problems effectively without leaving permanent damage.
The Wilmer Eye Institute at John Hopkins University School of Medicine in Baltimore, Maryland is a nationally renowned medical center that is staffed with expert medical doctors who are specialized in treating various types of eye maladies and injuries. Nationwide, patients travel for treatment at this facility. Dr. Michael P. Grant, Assistant Professor of Ophthalmology and Plastic Surgery, who is also a board-certified ophthalmologist and plastic surgeon, has seen many cases of orbital fractures. He has performed a significant number of surgeries of this type and, during the summer of 2008 alone, he performed a minimum of 100 orbital fracture surgeries. Highly skilled and an expert in the field, Dr. Grant is able to provide his patients initial optimism usually followed by successful surgical results in which the patient can have a normal looking eye with substantial or total resolution of the injuries and combined complicated visual difficulties.
Dental injuries
Victims of violence can also suffer from dental damage. On Christmas Eve, 2007, Cody Gibbons, who was 14 years old at the time, was attacked without provocation in McLean, Virginia by two teenagers he didn't know. Cody, who had just completed seven years of orthodontia, was attacked by a 16-year-old male. One punch to Cody resulted in three of his teeth being knocked out. His dentist testified in court that he would require years of surgery as a result of the injuries. Cody was also hit on the back of the head and the forehead. "I only want to make sure that Cody is able to be properly restored to his state of physical and mental health prior to this brutal assault," said his father, Clifford Gibbons.
Dental injuries can require a number of specialists to be involved including a general dentist, an oral surgeon, an orthodontist, and possibly even an ear, nose, and throat (ENT) physician. There may be multiple problems that ensue as a result of the mandible injuries necessitating consultation and collaboration with varied applicable medical personnel. In cases similar to that of Cody, years of ongoing treatment may be required.
There are numerous and varied injuries that victims of crime can incur through no fault of their own. Many of them can have debilitating effects and some can cause enduring disabilities. The repercussions for crime victims can be tremendous and affect their lives in a profound manner.
It is imperative, therefore, that injured victims receive expert medical care and the highest degree of emotional support. The initial response of on-scene police officers and emergency medical personnel to injured victims should be one of sensitivity and understanding coupled with the clear message that help and hope is on the way.