Delayed forensic medical evaluation in prison-referred alleged assault cases: A comparative clinical forensic study

Alleged assault in prison represents a sensitive area of clinical forensic medicine because persons deprived of liberty require timely, independent, and standardized medico-legal evaluation. This retrospective comparative study evaluated adult assault cases examined between January 1, 2025, and March 31, 2026, at the forensic medicine outpatient clinic of a tertiary training and research hospital. Cases referred from correctional facilities and recorded as alleged assault in prison were compared with general assault cases evaluated in the same outpatient setting. Demographic characteristics, timing of forensic medical evaluation, injury localization, life-threatening injury, bone fracture, and medico-legal injury severity were analyzed. A total of 837 adult assault cases were included, comprising 87 prison-referred alleged assault cases and 750 general assault cases. Prison-referred cases were younger than general assault cases (median age: 30 vs. 35 years; p < 0.001) and were predominantly male (98.9% vs. 55.2%; p < 0.001). Objective medico-legal severity indicators, including life-threatening injury, bone fracture, and injury not minor enough to be managed by simple medical intervention, did not differ significantly between the groups. The most prominent difference concerned the timing of forensic medical evaluation: evaluation after the first week was markedly more frequent among prison-referred cases than among general assault cases (95.4% vs. 42.4%; p < 0.001). These findings suggest that prison-referred alleged assault cases differ primarily in referral timing rather than injury severity. Delayed forensic evaluation may reduce the visibility of resolving superficial injuries and limit the evidentiary value of medico-legal documentation, supporting the need for timely, independent, and standardized assessment in custodial assault allegations.