Forensic Podiatry in the Forensic Community

CONTINUING MEDICAL EDUCATION

Goals and Objectives

This CME article for podiatrists, residents, interns. and stu- dents will focus on the definition and discipline of forensic podiatry in the forensic community. The article will introduce the reader to the new subspecialty field of forensic podiatry, stressing static barefoot analysis, insole impression analysis, methodologies and expert witness testimony. After reading the article, the reader will have gained knowledge, understanding, and an appreciation of forensic podiatry. At the completion of the ar- Forensic Podiatry ticle, the reader will be able to 141 understand and appreciate the podiatric role in forensic medicine and be able to identify, describe, Podiatrists now play a key role and differentiate the techniques related to barefoot/insole analy- in solving crimes. sis, the methodologies utilized, and expert witness testimony. In addition, the reader will be able By Bryan B. Kagan, DPM to analyze barefoot prints and insole prints.

Welcome to Podiatry Management’s CME Instructional program. Our journal has been approved as a sponsor of Con- tinuing Medical Education by the Council on Podiatric Medical Education. You may enroll: 1) on a per issue basis (at $25.00 per topic) or 2) per year, for the special rate of $195 (you save $55). You may submit the answer sheet, along with the other information requested, via mail, fax, or phone. You can also take this and other exams on the Internet at www.podiatrym.com/cme. If you correctly answer seventy (70%) of the questions correctly, you will receive a certificate attesting to your earned credits. You will also receive a record of any incorrectly answered questions. If you score less than 70%, you can retake the test at no additional cost. A list of states currently honoring CPME approved credits is listed on pg. 150. Other than those entities currently accepting CPME-approved credit, Podiatry Management cannot guarantee that these CME credits will be acceptable by any state licensing agency, hospital, managed care organization or other entity. PM will, however, use its best efforts to ensure the widest acceptance of this program possible. This instructional CME program is designed to supplement, NOT replace, existing CME seminars. The goal of this program is to advance the knowledge of practicing podiatrists. We will endeavor to publish high quality manuscripts by noted authors and researchers. If you have any questions or comments about this program, you can write or call us at: Podiatry Management, P.O. Box 490, East Islip, NY 11730, (631) 563-1604 or e-mail us at [email protected]. Following this article, an answer sheet and full set of instructions are provided (pg. 150).—Editor

Introduction and law and assists in the investiga- disputes between individuals, organi- Forensic science is the compila- tions and adjudications of criminal zations or between the two in which tion of systematic methodologies and civil cases. Criminal law cases punitive fines/compensation is award- to understand the physical world deal with crime and the legal pun- ed to the victim. Examples of civil through observation and experimen- ishment of the offense.1 These can cases include landlord and tenant dis- tation. It links people, places, and involve theft, assault, arson, robbery, putes, divorce proceedings, property things that are involved in and with murder, and trafficking of controlled disputes, and personal injury. criminal activities. It merges science substances. Civil law cases deal with Continued on page 142 www.podiatrym.com JANUARY 2015 | PODIATRY MANAGEMENT CME Continuing

Medical EducationForensic (from page 141)

Many disciplines in forensic science are evolving. Forensic biology includes forensic pathology, archaeology,2 odontol- ogy, entomology, serology, DNA analysis, and blood stain analysis. Forensic chemistry includes drugs, arson, explo- sives, toxicology, and paints. Trace evidence includes hair, fibers, soils, and glass. Physical evidence includes friction ridge examination, questioned documents, firearms, tool marks, tire Figure 1A: Tire Impression. Tire Tread and Tire Track Evi- treads, shoe prints, and any im- dence, Law Enforcement Training Network, p 13 ©2009 pression evidence (Figures 1a- c). Other areas, to name a few, include forensic engineering, botany, sic investigations. It shows linkage Figure 1C: Reading the Soil. Galvin B, “Reading psychology, nursing, accounting, fraud of an individual with a crime scene the Soil” Evidence Technology Magazine, July/ investigation, computer forensics, and through pedal evidence and answers August 2013, 18 jurisprudence.3 any legal questions concerning the 142

Forensic podiatry falls under the main category of physical evidence.

Forensic podiatry is a subspecial- foot or footwear that requires knowl- ty of podiatric medicine and offers edge of the functioning foot.”4 an exciting new aspect of podiatric medical practice as an evolving dis- History cipline in the forensic sciences. “The The history of American forensic discipline of forensic podiatry ap- podiatry began in September 2000 plies sound and researched podiatric when the “First Annual Forensic Po- knowledge and experience in foren- diatry Seminar” was held in Scott- sdale, Arizona. Eighteen podiatrists and several law enforcement personnel at- tended. For comparison, the first forensic confer- Figure 1B: Shoeprint. Personal photo file ence held by the Inter- national Association for tablished within the structure of the Identification almost 100 International Association for Identi- years ago in California fication (IAI) with the help of ASPF attracted 22 law enforce- members.”5 The role and scope of ment personnel. Member- forensic podiatry practice was delin- ship now stands in the eated by the IAI; “forensic podiatrists thousands. “In September assist in the identification of perpe- 2003, the American Soci- trators of crime evaluating the static ety of Forensic Podiatry and dynamic foot and the footwear (ASFP) was formed (Fig- that housed it, to include barefoot ure 2). By-laws were or- prints (in blood, dirt, dust or in the ganized and accepted, and sock liner), foot wear (outsole and 22 individuals joined as upper wear patterns relative to foot charter members. In July pathology) and Closed Circuit Televi- Figure 2: Forensic Podiatry Discipline. Forensic Podiatry Disci- 2007, a forensic podiatry sion (CCTV) Evidence.”6 pline, International Association for Identification website. sub-committee was es- Continued on page 143

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impression. The forensic podiatrist’s expertise is therefore required 1) to assess the effects of the foot and lower limb function. 2) to evaluate the wear associated with a foot/ shoe interface Figures 3a-c). 3) to compare Figures 3B/3C: Wear Associated with Foot/Shoe Interface. Person- shoe size consid- al Photo File erations (Figures Figure 3A: Wear Associated with Foot/Shoe 4a-b). Interface. DiMaggio J—Instructor, Forensic 4) to compare Podiatry Training Class, Tucson, Arizona, actly the same, no two bare foot- the gait patterns of individuals cap- November 2008 prints or barefoot impressions can tured on CCTV with those of suspect- be identical unless created by the ed individuals (Figure 5). Forensic (from page 142) same individual. “The forensic po- 5) to identify human remains 143 diatrist’s evaluation of the evidence from comparison of podiatry records The Human Foot The human foot is determined initially by its genetic code. The volar pads at approximately 8 embryolog- The volar pads at approximately ical weeks develop into unique fric- 8 embryological weeks develop into unique friction tion ridges, and foot and toe prints. Influenced during growth by the per- ridges, and foot and toe prints. sonal biomechanics of each individual, injuries and other physiological changes and pathologies, the foot is often necessary because of the and x-rays with the feet of deceased develops into an adult structure that complexity of the human foot and individuals. is highly individual in its form, size, the subtle variances inherent to such and shape. Since no two feet are ex- and the footwear housing it”. (John Education and Training DiMaggio-2003 personal corre- A forensic podiatrist must attain spondence) In Crown vs. Ches- a DPM degree or a BSc degree in po- ter-Nash 2006, it was necessary diatry. A level of expertise to practice to determine if more than one in- in a medical-legal context must be de- dividual could have worn a shoe veloped. A Masters degree in forensic that was linked to a murder and podiatry, forensic science, and/or fo- how much wear would be neces- rensic human identification is another sary before leaving a permanent pathway to pursue. The forensic podiatrist must continue his education in expert witness training programs, forensic podiatry, or related training workshops and/or seminars. He/ she must continue his/her professional development with participa- tion in research activities in forensic podiatry, and would be expected to publish in forensic journals or mag- azines, and/or present his research results at forensic conferences/seminars (Figure 6). Figure 4A: Shoe Size Considerations I. JAPMA, March/ Figure 4B: Shoe Size Consideration II. Personal “Evidence is any object that April 2013 vol 103, Nov 114 Photo File Continued on page 144 www.podiatrym.com JANUARY 2015 | PODIATRY MANAGEMENT CME Continuing

Medical EducationForensic (from page 143) gy (Analysis, Compari- son, Evaluation—Veri- fication). Analysis is the assessment of the footprint to determine if the detail quality is reasonably sufficient to classify and evaluate. In Bare Footprint/ Outline (Figure 9), the foot length/width, height approximation, Figure 6: Training Seminars. digital pattern, pressure zones, morphology, shoe size, gender, skin creases, and papillary Figure 5: Gait Patterns. Personal Photo File ridge pattern are all analyzed. The basic foot can establish that a crime has been is comprised of three committed or that can link a crime zones: forefoot-40%, and its victim or perpetrator.”7 “In- mid-foot-30% and rear- formation is whether in the form of foot-30%. The percent- 144 personal testimony, the language of ages are also useful documents, or the production of ma- when a partial print is terial objects, that is given in a legal presented for analysis 8 investigation,” to establish the fact Figure 7: Forms of Barefoot Impression Evidence. DiMaggio J, Kagan to determine approxi- or point in question. Whenever two BB, “Pedal Evidence”, Chesapeake Bay Division of the IAI Spring mate height. In addi- objects come in contact, an exchange Conference, April 2013. tion, there are multi- of matter or information occurs. This ple identification lines is the definition of the Locard Ex- form of footprints either bare (Figure (heel lines, arch line, lateral arch change Principle. That information 7) or in socks, in blood, dust, or dirt, line, web ridge line, and web space may be too small to analyze or to (mud/dry) and can be patent (visible outline) that are analyzed for further detect, but that transfer has occurred to the naked eye), plastic (in clay, identification. nonetheless. It is those transfers that gum), or latent (requiring additional Depending on the specifics of the establish the links and associations processing to be viewed). case, exemplars will be required for between victims, suspects, weap- Footwear-related identification re- comparison. These may be bare foot- ons, crime scenes, and/or anything garding sizing issues, ownership, and prints of known individuals, their involved in a crime. There are two assisting the footwear examiner, gait gait pattern, photographs, or foam impressions. At times, footprints and im- The basic foot Continued on page 145 is comprised of three zones: forefoot-40%, mid-foot-30% and rearfoot-30%.

types of evidence in forensic scienc- pattern characteristics observed on es. Real (physical) Evidence is recov- CCTV (Figure 8) and mass disaster ered from the crime scene or another identification are also other forms of location where the victim or suspect pedal evidence. has been. Demonstrative Evidence is not recovered at the crime scene ACE-V Methodology but is created by an expert witness A general methodology outline to help explain the real evidence that for the identification process has is found (i.e. shooting scene recon- been developed to assist the podia- struction, blood stain pattern analy- trist in making and justifying deci- sis, recreation of a crime scene). sions. The acronym for the steps in Pedal evidence may be in the this process is the ACE-V Methodolo- Figure 8: CCTV. Personal Photo File

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Forensic (from page 144) Cyanoacrylate (super glue) fuming amino acids that give a pur- which can be further enhanced by ple reaction. Another chemi- pression “although visible and pho- dye staining with visible or lumines- cal, Luminol (Figure 11) “reacts tographable with existing natural cence-inducing dyes, i.e. Gentian by producing light, chemo-lumines- light does not allow the maximum violet, Rhodamine 6G, Ardrox 970- cence, rather than color when ap- detail to be recorded with that light- P10, Ninhydrin which reacts with plied at a crime scene to detect latent blood.”9 Many other newer chemicals are being developed currently to enhance visualization of impressions. Levels of Certainty were devised During the Comparison stage of to address the confusion in terminology such as investigation, the “unknown” evidence is analyzed side-to-side, su- “possible” and “probable.” per-imposing and measuring with the known entity. After comparing the two, the forensic podiatrist must ing. Greater contrast and detail can amino acids, proteins and peptides come to a conclusion. There are sev- be recorded in photographs with to form a dark purple product known eral possibilities, Non-Identification Oblique lighting. Oblique lighting as Ruhemann’s purple, and Diazaflu- (to include also probable non-iden- creates shadowing between the high orenone (DFO) which is sensitive to tification), Identification (to include and low areas of the impression probable and very probable) which provides greater contrast in Continued on page 146 the impression photograph (Figure 10). For two-dimensional impressions, such as found in dust or res- 145 idue, the light should be held very close to the ground to photograph. In three-dimensional impressions, such as found in sand, soil and snow, the light should be adjusted as needed as to create the best contrast impression. The camera should be placed on a tripod with the film plane par- allel to the impression to prevent movement.”9 Forensic light sources are also widely used to reveal images that may not be readily visible to the eye. “The use of this equipment has been valuable in highlighting faint images that may be present on shoe insoles Figure 10: Oblique Lighting. Personal Photo File or sock liners. These light sources Figure 9: Bare Footprint Outline. DiMaggio J—Instructor, cover a wide range of wavelengths Forensic Podiatry Training Class, Tucson, Arizona, No- within the ultraviolet, visible and in- vember 2008 frared spectrums and require safety features to protect the operator from eye damage. More cost effective LED light sources are now available and are gaining in popularity.”10 The objective of these light sources is to maximize the contrast in the impressions to effectively reveal detail for later analysis. Many chemical methods have been developed to enhance the de- tailed visualization of latent impressions left at the crime scene. “Most of the chemical processes are not suitable to use at the crime scene but are Figure 11: Luminol Enhanced. DiMaggio J—Instructor, very useful on the items submitted Forensic Podiatry Training Class, Tucson, Arizona, No- Figure 12: Is It a Footprint? Personal to the laboratory.”1 These include vember 2008 Photo File www.podiatrym.com JANUARY 2015 | PODIATRY MANAGEMENT CME Continuing

Medical EducationForensic (from page 145)

and Inconclusive. To address the confusion with different terminology such as probable, possible, etc., and to increase the comprehension by juries, judiciary, and attorneys. Dr. John DiMaggio devised a logical methodology in 2005 to confirm the Evaluation findings in a stepwise manner. “Levels of Certainty” are conclusions for pedal evidence. The findings are expressed in the affirmative, ranging from Level I (least) to Level V (most) that can be adapted Figure 13: Level II Digital Positions (B). DiMaggio J, Kagan BB, to other disciplines in forensic sci- “Pedal Evidence”, Chesapeake Bay Division of the IAI Spring Figure 14: Level III Web Space ences as well. Verification is the final Conference, April 2013. Outline (B). DiMaggio J, Kagan BB, step where a colleague with an un- “Pedal Evidence”, Chesapeake Bay Division of the IAI Spring Confer- derstanding of the process will per- ence, April 2013. form the ACE steps on the same “unknown” evidence. The outcome of the first forensic podiatrist’s com- affirmative, then the exam- parison should not be known to the iner proceeds to the next 146 second until after he has completed level (Figure 14). the process. They should both agree Level IV: This is the level on the conclusion. It is a quality where the forensic podia- check of the work undertaken. It is trist’s clinical experience especially important because of the and knowledge of patho- subjective element involved in reach- logical, morphological, and ing forensic conclusions. Verification biomechanical imbalances confirms that the work is replicable are drawn upon. This is the by other competent examiners. level of Class characteristics Figure 15: Class Level Characteristics. DiMaggio J, Kagan BB, “Pedal Evidence”, Chesapeake Bay Division of the IAI Spring (Figure 15). “Physical evi- Levels of Certainty (DiMaggio 2005) Conference, April 2013. dence can express different Level I: Is it a footprint? If the levels of individuality; from answer is in the affirmative, subse- hand, when a foot is determined not those features that a large proportion quent questions will follow. Is it a to have made the impression based of the population demonstrates, and partial or full footprint (Figure 12)? Is on confirmable and significant differ- from those features that the probabil- it a dynamic or static impression? Is ences, it is excluded. ity of a chance match is so remote as there sufficient quality to continue? If Level II: (Foot Zones) Is there an to be considered impossible. the answer is still in the affirmative, agreement in the size, shape, and Class level characteristics are not then the examiner proceeds to the position of the digits and foot zones unique but demonstrate incontro- next level. If there is no affirmation, (Figure 13)? If the answer is in the vertible compatibility between similar items, i.e. bunions, hammertoes. There is no evidence considered and utilized by forensic podiatrists that has Luminol reacts by producing light, chemo-luminescence, been demonstrated to exhibit unique rather than color when applied at a crime scene to individual identification; however, the evidential weight of evidence differs detect latent blood. considerably. A condition present in 20% of the population is weaker than one that is present in 0.1% of the pop- then an inconclusive identification affirmative, then the examiner pro- ulation. The task in forensic podiatry or non-identification and exclusion ceeds to the next level. is to identify relevant features in the will result. Inclusion is based on the Level III: (Lines of Identification) questioned and known items during agreement of general features; the Is there an agreement of the identi- comparison for identification purposes. larger the number of similar size and fication lines, specifically the web The individuality of the features is de- shape features, the less likely the ridge line, the arch line and later- termined by considering the prevalence impression was made by others in al foot line, the heel line, and web in the population.”10 the general population. On the other space outline? If the answer is in the Continued on page 147

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Forensic (from page 146) that need to be taken into account. (FRE) governs the admissibil- Was the picture sharp or blurred, ity of evidence in criminal and Forensic Gait Analysis with good or poor contrast? Was the civil cases. It covers how evidence Forensic gait analysis “involves picture too bright or too dark? Was should be treated in the courts and the recognition and comparison of the lighting good or bad? Was there how the expert witness can present gait features to assist in the identifi- shadow or reflection interference? that evidence. Even though it applied cation process. Captured on closed Was the direction of the light source only to Federal courts, the majority of circuit television (CCTV), the charac- good or poor? The frame rate needs states have adopted similar rules for teristics of gait need to be examined to be evaluated; was there a contin- their courts. “The Rules of Evidence in depth and, as in other identification processes, the unknown footage of an individual of interest in relation Analysis in ACE-V is to determine if quality of evidence to a crime scene is compared against known footage that has been made is reasonable to classify and evaluate. of a known individual. Assessment of the quality of the images is imperative. CCTV images are usually of uous flow of image or were there helps to ensure that juries only con- much lower quality and resolution series of still images? From which sider admissible material and relevant than those in clinical settings. direction was the image taken, side, evidence. The rules secure fairness in CCTV images contain variables front, or back? Was the subject administration, eliminate unjustifiable viewed via only the upper body or expenses and delays, and promote lower body? Was the subject moving growth and development of the law too fast or too slow? Were ten steps of evidence so that in the end, truth or more in the shot or less than two may be ascertained and the proceed- 147 steps? Was the clothing worn good ings justly determined. Rule 702 of for gait analysis?”10 the FRE delineates the testimony of Also, the examiner must consider experts. If scientific, technical, or spe- if the gait pattern could have been cialized knowledge will assist to help amended or altered in the recordings. to understand the evidence, an expert The gait analysis performed in a clin- may testify an opinion. The testimony ical or laboratory setting is more con- must be based on sufficient facts or trolled and ideal, thus allowing gait data, and be the product of reliable Figure 16A: Expert Testimony. Personal Photo features and anomalies to be more methods and principles. The witness File readily recognized and identified must apply the principles and meth- than those observed on CCTV foot- ods to the facts of the case.”1 age. Gait analysis is class level iden- The landmark Supreme Court de- tification, Although not unique, “gait cision that involved the admissibility analysis is class level identification, of scientific evidence was Frye v Unit- demonstrating compatibility between ed States (1923). The case involved a similar items.”10 polygraph test in a murder crime. The test was considered a new science Expert Testimony that had not been accepted by the The forensic podiatrist is an “ex- relevant scientific community. The pert witness and as such is qualified evidence presented was therefore not to analyze and compare sets of facts admitted. This became the standard and then render an opinion based known as the Frye rule or test of gen- on those facts.”11 “The credible ex- eral acceptance. The United States Su- pert must be thoroughly prepared to preme Court case that changed the demonstrate a command of the sci- rules of evidence was Daubert v Mer- entific knowledge in their field of ex- rill-Dow Pharmaceuticals, Inc (1993). pertise, to understand the procedures Daubert deals with the admissibility of the court and the evidence admis- of expert witness testimony during sibility standard in their jurisdiction. legal proceedings. The testimony must They must be open in their dealings be relevant and reliable. The Daubert with attorneys and willing to discuss Factors is a non-exclusive checklist their findings and conclusions within that was created to assess the reliabili- the bounds of the trial practice for the ty of scientific expert testimony: Figure 16B: Expert Witness. Willis W, “The Ex- type of case in which they are serving 1) The theory or technique must pert Witness”, Journal of Forensic Identification, as an expert. (Figures 16a-b)”12 be refutable, testable and falsifiable; 166/43, 1993. The Federal Rules of Evidence Continued on page 148 www.podiatrym.com JANUARY 2015 | PODIATRY MANAGEMENT CME Continuing

Medical EducationForensic (from page 147) writing a report on your conclusions. ticipation, and collaboration with na- 1) Understanding the task re- tional and international organizations 2) The theory or technique has to quested. will afford greater opportunities and be subjected to publication and peer 2) Describing the exhibits, items, increase the need for qualified individ- review; and material examined. What exactly uals to provide these services. PM 3) There must be a known or was it that was examined? potential error rate of the theory or 3) Establishing that the exhibits, References technique; items, and material submitted were 1 Forensic Science Online Course, 4) Standards and controls of the of suitable quality to be examined. West Virginia University Forensic Science theory or technique must exist and 4) Confirming that the correct Initiative 2009. be maintained. types of examinations and proce- 2 Galvin B, “Reading the Soil”, Evi- dures were selected. dence Technology Magazine, July-August Forensic practitioners must op- 5) Confirming that the examina- 2013, pp 18-22. 3 Introduction to Forensic Sciences, erate at the highest standards. They tions and procedures were performed 2nd Edition, Eckert WG-editor, pp 37,38,4 must comply with the codes of con- competently. 0,117,148,155,180,181,248,321. duct of the professional body(ies) 6) Recording and interpreting the 4 Vernon W, McCourt, “Forensic Po- with which they are members with evidence and making a reasoned and diatry-A review and definition”, British honesty and integrity. They must be sound objective conclusion. Journal of Podiatry, vol. 2, No. 2, May 1999, pp 45-48. 5 American Society of Forensic Podia- try website, http://www.theasfp.org Daubert factors are applied to assess 6 Vernon W. Chairman Forensic Podia- the reliability of testimony except when there may be try Sub-Committee, “Forensic Podiatry: Role 148 and Scope of Practice (In the Context of Fo- an unknown error rate of the theory. rensic Human Identification)”, International Association for Identification, 2009. 7 Saferstein R, Criminalistics: An In- troduction to Forensic Science. Prentice non-discriminatory against people 7) Referring to others involved in Hall Publishers, 10th Edition, 2010. and groups. Their primary duty is the investigation and recommending 8 Houck MM, Siegel JA, Fundamentals to the court. Work must be carried other specialties, where and when of Forensic Science, Academic Press 2nd out fairly and impartially and any appropriate. Edition, 2009. conflicts of interest must be declared 8) Presenting a clear, methodical. 9 Bodziak WJ, Footwear Impression at the first opportunity. “It is the re- and logical report. Evidence, CRC Press, 2000, p 42-45, 169, 360. sponsibility of the forensic podiatrist 9) Ensuring that the report is fit 10 DiMaggio J, Vernon W, Forensic Po- to ensure professional competence. for the purpose requested. diatry—Methods and Principles, Humana This can be accomplished by con- 10) Providing evidence of con- Press, 2011, pp 19, 20, 35, 103, 169-171, 10 tinuing professional development tinuing education and expertise. 172-173. with formal educational instruction, 11 Willis WW, “The Expert Witness”, professional reading, mentorship, at- Conclusion Journal of Forensic Identification, 1993. tendance at conferences and semi- Forensic podiatry is an exciting, 166/43. nars, and the preparation of confer- evolving discipline in forensic scienc- 12 Pagliaro EM, “The Most Common ence presentation materials which es and a growing subspecialty in po- Questions Asked about Expert Witness should all be documented in a learn- diatric medicine. Membership in the Testimony”, www.forensicmag.com/articles/2013/08/. ing diary or log.”10 American Society of Forensic Podiatry There are standards of practice has also been increasing, according to that the forensic podiatrist must Dr. John DiMaggio, president of the Dr. Bryan Kagan maintain. He/she must “inform oth- ASFP. Forensic clubs have already graduated from ers where there is potential for a been established at Temple University NYCPM in 1980. miscarriage of justice. He/she must School of Podiatric Medicine and the He is an adjunct provide quality assurance and accept New York College of Podiatric Med- faculty instructor in full responsibility for all the work icine, and interest in establishing a the Department of undertaken or participated in. He/ club at the Dr. William M Scholl Col- Community Medicine she must be prepared to change their lege of Podiatric Medicine has also teaching Forensic Po- diatry and advisor to opinion in the presence of new de- being expressed. An elective foren- the Forensic Podiatry velopments, information or research sic podiatry course was introduced Club at NYCPM. He has lectured nationally and findings. It is imperative that confi- at the New York College of Podiat- published articles on forensic podiatry. He is on dentiality be maintained.”10 ric Medicine in 2013. The expanding the executive board of the American Society awareness of forensic podiatry in the of Forensic Podiatry and is on the Science and Writing a Report forensic and legal worlds through ed- Practice Subcommittee of Forensic Podiatry at There are ten essentials when ucation, research and scientific par- the International Association of Identification.

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See answer sheet on page 151.

1) Examples of civil cases in- 7) Cyanoacrylate fuming can 12) The foot zone percentag- clude: further enhance visualization of es that help to determine the A) landlord and tenant dis- foot prints with all of the follow- height of the “unknown” indi- putes ing except: vidual: B) divorce proceedings A) Gentian violet A) Forefoot 40% C) property disputes B) Ninhydrin B) Forefoot 30% D) all of the above. C) Rhodamine 6G C) Rearfoot 40% D) Ardrox 970-P10 D) Midfoot 40% 2) An example of trace evidence is: 8) When do foot/toe prints first 13) Which are different types of A) serology appear? evidence in forensic sciences? B) DNA A) at two years of age A) Real C) glass B) at embryological 8th B) Physical D) blood stain week C) Demonstrative C) at embryological 20th D) All of the above 3) Lines of identification are week agreed upon in which Level of D) at one year of age 14) What is the methodology 149 Certainty? (ACE-V) to evaluate evidence? A) III 9) To address the confusion in A) Assessment-Compari- B) II terminology such as possible, son-Examination-Verification C) I probable, etc., which methodol- B) Analysis-Comparison-Ex- D) IV ogy was devised? amination-Veracity A) Standards of Practice C) Analysis-Compari- 4) Foot zones are agreed upon B) Federal Rules of Evidence son-Evaluation-Verification in which Level of Certainty? C) Levels of Certainty D) Assessment-Con- A) III D) ACE-V trast-Evaluation-Verification B) II C) I 10) What is NOT in the Stan- 15) Analysis in ACE-V is: D) IV dards of Practice? A) to determine similarities A) Primary duty is to the of evidence with known 5) 3-Dimensional impressions court B) to determine dissimilari- are NOT found in: B) Maintain confidentiality ties of evidence with known A) sand C) Must provide quality as- C) to analyze random sam- B) dust surance of your work. pling C) snow D) Must not change your D) to determine if quality D) soil opinion in the presence of of evidence is reasonable to new information. classify and evaluate. 6) Which chemical reagent causes a light change instead of 11) Foot print impressions can 16) Forensic podiatry falls a color change? be: under the main category of A) DFO A) latent A) Biology B) Ninhydrin B) plastic B) Trace evidence C) Cyanoacrylate C) visible C) Physical evidence D) Luminol D) all of the above D) Demonstrative evidence

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Medical Education CME Program 17) Level of class characteristics is based on the forensic podiatrist’s clinical knowl- Welcome to the innovative Continuing Education edge and experience of: Program brought to you by Podiatry Management A) Morphology Magazine. Our journal has been approved as a B) Biomechanics sponsor of Continuing Medical Education by the C) Pathology Council on Podiatric Medical Education. D) All of the above Now it’s even easier and more convenient to 18) Forensic podiatry enroll in PM’s CE program! A) Shows linkage of an individual to a You can now enroll at any time during the year crime and submit eligible exams at any time during your B) Answers legal questions concerning enrollment period. foot function PM enrollees are entitled to submit ten exams C) Identifies victims of mass disasters published during their consecutive, twelve–month D) All of the above enrollment period. Your enrollment period begins with the month payment is received. For example, 19) Daubert Factors are applied to assess if your payment is received on November 1, 2014, 150 the reliability of testimony. Which is in- your enrollment is valid through October 31, 2015. correct? If you’re not enrolled, you may also submit any A) The theory must be testable. exam(s) published in PM magazine within the past B) The theory has to be peer reviewed twelve months. CME articles and examination and published. questions from past issues of Podiatry Manage- C) There may be an unknown error ment can be found on the Internet at http:// rate of the theory. www.podiatrym.com/cme. Each lesson is ap- D) There must exist standards and con- proved for 1.5 hours continuing education contact trols. hours. Please read the testing, grading and payment instructions to decide which method of participa- 20) In forensic gait analysis what is to be tion is best for you. taken into account from visualization of Please call (631) 563-1604 if you have any ques- CCTV footage? tions. A personal operator will be happy to assist you. A) The lighting Each of the 10 lessons will count as 1.5 credits; B) The clothing of the individual thus a maximum of 15 CME credits may be earned C) The image flow during any 12-month period. You may select any 10 D) All of the above in a 24-month period.

The Podiatry Management Magazine CME program is approved by the Council on Podiatric Education in all states where credits in instructional media are accepted. This article is approved for 1.5 Continuing Education Contact Hours (or 0.15 CEU’s) for each examination successfully completed.

Home Study CME credits now See answer sheet on page 151. accepted in PennsylvaniaContinued on page 150

JANUARY 2015 | PODIATRY MANAGEMENT $ MedicalContinuing Education Enrollment/Testing Information and Answer Sheet Note: If you are mailing your answer sheet, you must complete all rolled in the annual exam CME program, and we receive this exam info. on the front and back of this page and mail with your credit card during your current enrollment period. If you are not enrolled, please information to: Podiatry Management, P.O. Box 490, East Islip, send $25.00 per exam, or $195 to cover all 10 exams (thus saving $55 NY 11730. over the cost of 10 individual exam fees). Testing, Grading and Payment Instructions Facsimile Grading (1) Each participant achieving a passing grade of 70% or higher To receive your CME certificate, complete all information and fax on any examination will receive an official computer form stating the 24 hours a day to 1-631-563-1907. Your CME certificate will be dated number of CE credits earned. This form should be safeguarded and and mailed within 48 hours. This service is available for $2.50 per exam may be used as documentation of credits earned. if you are currently enrolled in the annual 10-exam CME program (and (2) Participants receiving a failing grade on any exam will be noti- this exam falls within your enrollment period), and can be charged to fied and permitted to take one re-examination at no extra cost. your Visa, MasterCard, or American Express. (3) All answers should be recorded on the answer form below. If you are not enrolled in the annual 10-exam CME program, the For each question, decide which choice is the best answer, and circle fee is $25 per exam. the letter representing your choice. Phone-In Grading (4) Complete all other information on the front and back of this page. You may also complete your exam by using the toll-free service. (5) Choose one out of the 3 options for testgrading: mail-in, fax, Call 1-800-232-4422 from 10 a.m. to 5 p.m. EST, Monday through or phone. To select the type of service that best suits your needs, Friday. Your CME certificate will be dated the same day you call and please read the following section, “Test Grading Options”. mailed within 48 hours. There is a $2.50 charge for this service if you are Test Grading Options currently enrolled in the annual 10-exam CME program (and this exam 151 Mail-In Grading falls within your enrollment period), and this fee can be charged to your To receive your CME certificate, complete all information and Visa, Mastercard, American Express, or Discover. If you are not current- mail with your credit card information to: ly enrolled, the fee is $25 per exam. When you call, please have ready: 1. Program number (Month and Year) Podiatry Management 2. The answers to the test P.O. Box 490, East Islip, NY 11730 3. Your social security number PLEASE DO NOT SEND WITH SIGNATURE REQUIRED, AS 4. Credit card information THESE WILL NOT BE ACCEPTED. In the event you require additional CME information, please There is no charge for the mail-in service if you have already en- contact PMS, Inc., at 1-631-563-1604.

Enrollment Form & Answer Sheet Please print clearly...Certificate will be issued from information below.

Name ______Soc. Sec. #______Please Print: First MI Last Address______City______State______Zip______Charge to: _____Visa _____ MasterCard _____ American Express Card #______Exp. Date______Note: Credit card is the only method of payment. Checks are no longer accepted. Signature______Soc. Sec.#______Daytime Phone______State License(s)______Is this a new address? Yes______No______

Check one: ______I am currently enrolled. (If faxing or phoning in your answer form please note that $2.50 will be charged to your credit card.) ______I am not enrolled. Enclosed is my credit card information. Please charge my credit card $25.00 for each exam submitted. (plus $2.50 for each exam if submitting by fax or phone). ______I am not enrolled and I wish to enroll for 10 courses at $195.00 (thus saving me $55 over the cost of 10 individual exam fees). I understand there will be an additional fee of $2.50 for any exam I wish to submit via fax or phone.

www.podiatrym.com Over, please JANUARY 2015 | PODIATRY MANAGEMENT Enrollment Form & Answer Sheet (continued) Continuing

Medical Education

EXAM #1/15 Forensic Podiatry (Kagan)

Circle: 1. A B C D 11. a B C D 2. A B C D 12. a B C D 3. A B C D 13. a B C D 4. A B C D 14. a B C D 5. A B C D 15. a B C D 6. A B C D 16. a B C D 7. A B C D 17. a B C D 8. A B C D 18. a B C D 9. A B C D 19. a B C D 152 10. a B C D 20. a B C D

Medical Education Lesson Evaluation

Strongly Strongly agree Agree Neutral Disagree disagree [5] [4] [3] [2] [1]

1) This CME lesson was helpful to my practice ____

2) The educational objectives were accomplished ____

3) I will apply the knowledge I learned from this lesson ____

4) I will makes changes in my practice behavior based on this lesson ____

5) This lesson presented quality information with adequate current references ____ 6) What overall grade would you assign this lesson? ABCD How long did it take you to complete this lesson? ______hour ______minutes

What topics would you like to see in future CME lessons ? Please list : ______

JANUARY 2015 | PODIATRY MANAGEMENT www.podiatrym.com