ST. N1ARY'S HEALTH CENTER 206 GRAt "lD, ST. MARY'S, KS 66536 PAGE 1 OF 3 CLAUDINE DOMBROWSKI EMERGENCY ROOM TREATl \tfENT S U T 'v u v L J- \R Y DATE OF TREAThf ENT: 12- 15- 00 HOSP # DOB 04/ 1 0/ 65 YEARS 35 S: 35 y/o white femal e pat ien t 'vv ho pre sen ts to Eme rge ncy Roo m by POV att ended by her moth er, all egi ng sexual assault someti me around 11 :00 p.m. on 12/14/00. The patient states that she knows her attac ker. and patient is ext remel y ups et tha t the Pot tawato mie Cou nty She rif f's dep uti es are qu est ion ing her and she Onl y wanted to ha ve tre atment for her eye. as she cou ld not sto p the ble edi ng. On seve ral occasi ons while bei ng quest ioned by de put ies pat ient att emp ted to lea ve the hos pit al: pat ient exh ibi ts gre at anx iet y tal kin g to the deputi es. sta tin g tha t she cannot tel l them who it is. Pa tie nts mot her . calmed the patie nt and tal ked wit h the Dep uties out sid e of tr eat men t roo m whe re patie nt was being treat ed. Pat ient sta tes that someon e she could not te ll to the po lic e ass aul ted her . She sta tes tha t this mal e had gra bbe d her by the hairand drug her a dis tance. and v.:h iledragg ing her , he was striking her in the fac e wit h his tists. I asked if there were any type of objec t or wea pon uti liz ed and she deni ed the s ame. She did sta te a coupl e of times tha t he was weari ng some lar ge jewelr y ove r bot h hands. Pat ient all ege s that this male sex ual ly ass aul ted her in cludin g pen ile pen etr ati on of he r vagin a and pen ile penetration of he r oral cavity. She stated tha t she did not attempt to res ist him. as she knew tha t he wou ld "be at" her mo re if she res ist ed. Aft er thi s all ege d ass aul t, she p lac ed the onl y leg tha t \va s removed out of her jeans pant leg bac k into her jea ns and then put her socks and shoe s bac k on. She stat es she got into her car and drove bac k to he r apa rtment in To peka whe re her mothe r was pres ent and encourag ed her to seek medica l care for the bl eeding above her eye. She stat es 'af rai d ofPolice involvement'and went to her primary car e physic ian's off ice in S1,Mary' s. She do es not reca ll lea vin g any marks on him and is una ware of any type of weap on and tha t she di d not belie ve tha t the mal e was ine bri ated or int oxi cat ed. to the best of her knowle dge. She says to her kno wle dge , her young dau ght er is in th e custody of this male who m all ege dly sex ual ly ass aul ted her . She admits to bei ng abu sed by t his same mal e severa l times in th e past. \Vh en I a ske d her if she wanted to pres s cha rge s aga ins t thi s mal e. she said ye s, but onl y if sh e cou ld be a ssu red of her daught er' s saf ety. She says that she has prev iou sly arr anged to hav e someone pick up her daught er thi s Fri day eve nin g, 12/ 15/ 00, at 6:0 0 p.m. for a we eke nd vis ita tio n. Pat ien t con tin ues to expre ss con cer n for the safe ty of he r dau ght er. Sta tin g tha t there is a Court Order prohi bitin g her fro m calling the author itie s on th is male.
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EMERGENCY ROOM TREATl\tfENT S U T 'v u v L J- \R Y
DATE OF TREAThfENT: 12-15-00
HOSP #
DOB 04/1 0/65
YEARS 35
S: 35 y/o white female patient 'vvhopresents to Emergency Room by POV
attended by her mother, alleging sexual assault sometime around 11 :00 p.m. on
12/14/00. The patient states that she knows her attacker. and patient is extremely
upset that the Pottawatomie County Sheriff's deputies are questioning her and she
Only wanted to have treatment for her eye. as she could not stop the bleeding.On several occasions while being questioned by deputies patient attempted to
leave the hospital: patient exhibits great anxiety talking to the deputies. stating that
she cannot tell them who it is. Patients mother. calmed the patient and talked with the
Deputies outside of treatment room where patient was being treated. Patient states that
someone she could not tell to the police assaulted her. She states that this male had
grabbed her by the hair and drug her a distance. and v.:hiledragging her, he was
striking her in the face with his tists. I asked if there were any type of object or
weapon utilized and she denied the same. She did state a couple of times that he
was wearing some large jewelry over both hands. Patient alleges that this male sexually
assaulted her including penile penetration of her vagina and penile penetration of her oral
cavity. She stated that she did not attempt to resist him. as she knew that hewould "beat" her more if she resisted. After this alleged assault, she placed the only leg
that \vas removed out of her jeans pant leg back into her jeans and then put her socks
and shoes back on. She states she got into her car and drove back to her apartment
in Topeka where her mother was present and encouraged her to seek medical
care for the bleeding above her eye. She states 'afraid of Police involvement' and went to
her primary care physician's office in S1,Mary's. She does not recall leaving any marks
on him and is unaware of any type of weapon and that she did not believe that the
male was inebriated or intoxicated. to the best of her knowledge. She says to her
knowledge, her young daughter is in the custody of this male whom allegedly
sexually assaulted her. She admits to being abused by this same male several
times in the past. \Vhen I asked her if she wanted to press charges against this male.she said yes, but only if she could be assured of her daughter's safety. She says that she
has previously arranged to have someone pick up her daughter this Friday evening,
12/15/00, at 6:00 p.m. for a weekend visitation. Patient continues to express concern for
the safety of her daughter. Stating that there is a Court Order prohibiting her from calling