James Kramer was experienced in child sex abuse examinations. He examined the complaining child, a girl who had been seven and eight years old at the times of the charged abuse. According to the court of appeals, "He found no physical evidence of sexual abuse. But he used a diagnostic method attributed to Dr. Sally Adams. And he concluded that because of [the girl's] 'clear, concise, and explicit, and detailed' disclosures, sexual abuse was 'probable.'"

Washington courts use the Frye test to determine the admissibility of scientific testimony. This requires the testimony to be based on theory and technique generally accepted in the scientific community.

In the trial court, Mr. Kramer testified that Dr. Adams was nationally recognized and that her classification system for child sex abuse assessment, extending from "no evidence of abuse" to "definite abuse or sexual contact," had been published. "And to the best of my knowledge," Kramer testified, "that has been accepted by the sexual examination community as a legitimate methodology…." Dr. Adams' methodology was used, he said, in the Denver area, and a similar one was used at the San Diego Children's Hospital. (See post script for more on Dr. Adams.)

Aside from Mr. Kramer's testimony, the court of appeals found nothing to show that Dr. Adams' technique had achieved general acceptance in the scientific community as a way to diagnose child sex abuse solely from the child's statements. It ruled the technique did not meet the Frye test.

It also ruled Mr. Kramer's testimony inadmissible because it was an expert's opinion on an ultimate issue of fact that was based solely on the expert's perception of a witness' truthfulness. Admitting his opinion thus took an ultimate issue of fact from the jury and was a constitutional error. Since "this was a credibility contest," the court reasoned, the error was not harmless, and the conviction had to be reversed.

In connection with this, the court noted that this was the second trial of Mr. Dunn. The first, at which Mr. Kramer did not testify, resulted in a hung jury.

The court found support for its conclusion in United States v. Azure, 801 F.2d 336, 339 (8th Cir. 1986). There, too, allowing a medical witness "to put his stamp of believability on the child's story" was held reversible error.

Post Script

I could not find Dr. Sally Adams via Google. I asked another Dr. Adams, Joyce Adams, an eminent pediatrician and child sex abuse expert in San Diego, if she could help me find her.

Joyce Adams responded that she believes she is the person Mr. Kramer had in mind. She explained to me, "I do have a proposed classification system which people have used incorrectly to 'diagnose' sexual abuse based on the child's statement." She is revising her classification system, she said, partly in the hope that people will cease using it for diagnosis.