The nurse who handled the bulk of Clark County sexual assault exams has died. What now?

When an adult was sexually assaulted in Clark County and needed an exam to preserve evidence, Jeri Dermanelian was the nurse most likely to conduct it.

Dermanelian, who worked out of University Medical Center, died April 20 at age 64, according to an online obituary. Now, community stakeholders are adjusting to her absence and trying to move forward.

Another local health care organization says it has picked up the patient load Dermanelian would have shouldered and prosecutors said they have a plan for pending cases in which she conducted the exams.

Metropolitan Police Department sex crimes Sgt. Andrew O’Grady thinks Dermanelian’s loss will still be felt.

“Jeri was our expert for so long with doing these exams and kits that it’s going to be a huge gap,” he said in a recent interview.

At least one advocate is critical of the situation and the dependency she thinks authorities had on Dermanelian, who, according to O’Grady, conducted most adult sexual assault exams and all strangulation exams in Clark County.

“Obviously, as we’re all grieving from the loss of Jeri, we’re seeing there is no redundancy,” said Liz Ortenburger, CEO of domestic violence organization SafeNest. “This is a one point of failure system for all of our sexual assault victims.”

Debra Fox, UMC’s chief nursing officer, said, “There are other entities, other hospitals who have the capacity and should have the interest in helping us all come together to create a community safety net for victims of violence.”

‘Public service oriented’

Dale Carrison, the former director of UMC’s emergency department, met Dermanelian in 1991 when he came to work at the hospital.

Back then, she was a nurse supervisor working nights and was not yet conducting sexual assault exams.

Carrison said practices for examining rape victims were haphazard.

Physicians didn’t want to conduct the exams because they knew doing so meant having to go to court, he said. Medical staff would announce the presence of a sexual assault victim over the hospital loud speaker. And every hospital in Las Vegas conducted sexual assault exams differently, making things difficult for Metro.

Carrison, who worked as a deputy sheriff and FBI agent before he became a doctor, said he taught a group of three nurses how to do the exams and preserve evidence.

Two of the examiners got sick and stopped doing the exams. One retired. Dermanelian, who was not one of the original sexual assault nurses, became in charge of doing the exams, he said.

“She was very public service oriented with regard to the sexual assaults and the victims of sexual assaults,” Carrison said.

Forensic nurse exams demand a lot of expertise.

Rachell Ekroos, clinical and executive director of Nevada HealthRight, the organization now seeing patients Dermanelian would have examined, said forensic sexual assault nurses have to take into account a patient’s medical needs and how those needs intersect with the legal system.

The nurses meet and talk to the patient, review their health history and the history of the violence they’ve experienced, discuss sexually transmitted infections and emergency contraception and address other needs, like housing or advocacy support, Ekroos said.

They also document injuries with photos, write a medical report and package sexual assault kit items, she said, and may be responsible for sexual assault kits if a patient has not agreed to release them to law enforcement.

Eventually, Dermanelian worked exclusively on sexual assault and strangulation exams, said Fox. She was often physically present at UMC, which provided her with exam space and supplies.

After hours, Fox said, and on weekends, Dermanelian was on call and would come to the hospital to provide an exam.

‘Hardest working person’

“Jeri, I would say, was the hardest working person I’ve ever met in my entire life,” said O’Grady, the Metro sergeant, of Dermanelian.

He added: “We could have a sexual assault at 10 p.m. at night and Jeri would be there and at 2 a.m. we’re getting called out for another one, Jeri would still be there and then 8 a.m. the next morning, day shift would have another one and Jeri would still be there doing sex assault kits or strangulation exams on victims.”

Chief Deputy District Attorney Peter Thunell said “nobody cared more than Jeri” about victims of sexual assault and strangulation.

“I think she knew how much these people depended on her,” he said. “She knew how important what she was doing was and she never took that lightly.”

Dermanelian was constantly trying to improve her work, said O’Grady, reading medical journals and keeping up with research. Police officers and prosecutors trusted her.

So did victims.

“Victims felt at peace and ease with her,” O’Grady said, adding, “Jeri saw every walk of life from the county. Very high profile cases to homeless people to prostitutes. Every walk of life walked in that door and Jeri saw them and she treated them all the same. Jeri loved all people.”

Kimberly Small, CEO of Signs of HOPE, which helps survivors of sexual assault and trafficking and worked with Dermanelian, said, “It’s not easy what she did. It isn’t for the faint of heart.”

Dermanelian wanted to share her knowledge and tried to train other nurses to do sexual assault exams, Small said, but “it just didn’t pan out for everyone.”

What’s next?

After Dermanelian’s death, the primary challenge has been fielding calls from stakeholders trying to figure out how to move forward and adapt, said Ekroos. She’s spent time meeting with Metro, the district attorney’s office and UMC.

Dermanelian conducted exams at UMC, but sexual assault victims are now coming to the Nevada HealthRight clinic, Ekroos said. She is open to doing exams at the hospital and plans to continue expanding her team, which includes two nurse practitioners and multiple forensic nurses, she said.

“It’s not like her passing means, ‘Oh no, nobody’s out there,’” said Thunell, who thinks there are enough sexual assault nurse examiners in Clark County.

Small thinks the community needs more sexual assault nurse examiners and said Dermanelian’s death leaves a void.

“It’s a hard, hard field, but we need to do more to encourage others to get into this field because we need more help,” she said.

Ortenburger questioned what will happen with pending cases in which Dermanelian would have been the expert witness.

Thunell said the district attorney’s office has a plan and does not anticipate her death will disrupt those cases. Other experts could use the work she did, including notes and pictures, he said.

Ekroos said she is open to testifying in pending cases in which Dermanelian did the exams. She has done so in the past when nurses have died or programs have closed, she said.

She expects that her organization will be handling the bulk of sexual assault exams for the foreseeable future in Clark County and has thought about a succession plan for Nevada HealthRight. “This organization can’t be dependent on me,” she said.

“The team’s really stepped up and the community stepped up,” said University Medical Center CEO Mason Van Houweling. “So I’m really impressed and have not had a single incident, issue.”

Ortenburger hopes services will expand. She said in some cases, there have been wait times so significant that women have traveled out of state to get exams. Van Houweling said society should do more to address violence, but denies that victims have faced significant wait times.

“My hope is that at some point here we’re going to take sexual assault and domestic violence seriously and put into place a forensic program that matches the size of our victimized population but also the size of our county,” said Ortenburger. “We continue to act like we’re 200,000 people and this is a perfect example of that.”

Contact Noble Brigham at nbrigham@reviewjournal.com. Follow @BrighamNoble on X.