The forensic medical examination findings as they relate to the judicial outcomes in cases of non-fatal strangulation

Non-fatal strangulation (NFS) occurs in various contexts. Victims of NFS may face barriers to disclose, resulting in underreporting and subsequent police charges not proceeding. This study aims to explore the relationship between the court outcomes, the forensic medical examination findings, and the provision of a medicolegal report in patients who are referred by police to a forensic medical service in NFS cases that do not involve sexual assault. This is an exploratory case series of 167 non-sexual assault patients aged 14 and over who reported NFS following referral by Australian Capital Territory Police (ACTP). The cases were retrospectively examined by the ACT Director of Public Prosecutions and legal outcomes were incorporated. Statistical comparisons were performed using linear regression to calculate p-values via t-tests for continuous variables and Pearsons Chi-squared test for binary and categorical variables. Conviction for any offence occurred in 73.9% of NFS cases. Early presentation within 12 hours was common (65.8%) and associated with conviction (p 0.04). Physical injuries to the face or legs significantly increased the association with conviction. Medicolegal reports were written in 112/167 (67%) cases and forensic images taken in 160/167 (95.8%). There was no statistically significant association between requesting a medicolegal report and conviction. Most accused were current or former partners, and a substantial proportion had a history of prior strangulation incidents. Early presentation to a forensic medical service was associated with conviction, highlighting the importance of timely assessment and comprehensive documentation. Medicolegal reports, while not independently increasing conviction rates, remain a valuable source of evidence that informing the legal system’s understanding of NFS. These findings point to the need for system level responses including structured case review, interagency collaboration, and specialised NFS training to improve consistency, safety, and justice outcomes in NFS cases. • Convictions occurred in nearly 74% of non-fatal strangulation cases. • Early presentation (<12 hrs) were associated with conviction. • Facial or leg injuries significantly increased association with conviction. • Medicolegal reports were not independently associated with conviction.