The Boulder police department contacted several pathologists and pediatric experts. These were: -Dr. James Monteleone, Professor of Pediatrics at St Louis University School of Medicine; -Dr. David Jones, from University of Colorado Health Sciences Center; -Dr. Ronald Wright, medical examiner Cook County Illinois; -Dr. Virginia Rau, medical examiner, Dade County, Florida; -and Dr. John McCann, Clinical Professor of Medicine at University of California at Davis.
This last is, or at least was at the time, considered the foremost authority on child sexual abuse in the United States. He was instrumental in establishing proper methods and findings for determining sexual abuse. In August of 1997, Dr. McCann examined the autopsy report, autopsy photos and microscopic slides of JonBenet's vaginal tissue. His findings were as follows: "According to McCann, examination findings that indicate chronic sexual abuse include the thickness of the rim of the hymen, irregularity of the edge of the hymen, the width or narrowness of the wall of the hymen, and exposure of structures of the vagina normally covered by the hymen. His report stated that there was evidence of prior hymeneal trauma as all of these criteria were seen in the post mortem examination of JonBenet. There was a three dimensional thickening from inside to outside on the inferior hymeneal rim with a bruise apparent on the external surface of the hymen and a narrowing of the hymeneal rim from the edge of the hymen to where it attaches to the muscular portion of the vaginal openings. At the narrowing area, there appeared to be very little if any hymen present. There was also exposure of the vaginal rugae, a structure of the vagina which is normally covered by an intact hymen. The hymeneal orifice measured one centimeter which is abnormal or unusual for this particular age group and is further evidence of prior sexual abuse with a more recent injury as shown by the bruised area on the inferior hymeneal rim. A generalized increase in redness of the tissues of the vestibule was apparent, and small red flecks of blood were visible around the perineum and the external surface of the genitalia.
Dr. McCann explained the term "chronic abuse" meant only that it was "repeated", but that the number of incidents could not be determined. In the case of JonBenet, the doctor could only say that there was evidence of “prior abuse". The examination results were evidence that there was at least one prior penetration of the vagina through the hymeneal membrane. The change in the hymeneal structure is due to healing from a prior penetration. However, it was not possible to determine the number of incidents nor over what period of time. Because the prior injury had healed, any other incidents of abuse probably were more than 10 days prior." Upon examination of the materials mentioned, the other experts came to similar conclusions, as outlined by case detective Steve Thomas: "In mid-September, a panel of pediatric experts from around the country reached one of the major conclusions of the investigation - that JonBenet had suffered vaginal trauma prior to the day she was killed. There were no dissenting opinions among them on the issue, and they firmly rejected any possibility that the trauma to the hymen and chronic vaginal inflammation were caused by urination issues or masturbation. We gathered affidavits stating in clear language that there were injuries 'consistent with prior trauma and sexual abuse' 'There was chronic abuse'. . .'Past violation of the vagina'. . .'Evidence of both acute and injury and chronic sexual abuse.' In other words, the doctors were saying it had happened before." Dr. Richard Krugman, Dean of the University of Colorado Medical School, an expert first contacted for assistance in the Ramsey case by the D.A.’s office, was the most adamant supporter of the finding of chronic sexual abuse. These findings were presented to the Boulder DA's office in June 1998, along with a side-by-side photo comparison between a normal six-year-old's vagina and that of JonBenet. The difference was described as startling.
