EAST LANSING - MSU allowed Larry Nassar to see patients for 16 months while he was under criminal investigation by its own police department after a 2014 allegation of sexual assault by a female patient.

The university has the ability to suspend any employee under criminal investigation, Michigan State University spokesperson Jason Cody said. Nassar was allowed to return to work after the university cleared him in a separate Title IX investigation involving the woman’s accusations.

At least a dozen women and girls have reported to police that Nassar sexually assaulted them after MSU allowed the former doctor to return to work after a three-month Title IX investigation, records show.

(For full coverage on Larry Nassar, go here.)

And the Ingham County Prosecutor’s Office ultimately cleared Nassar of any criminal wrongdoing involving the patient despite a request from MSU police that Nassar be charged with sexual assault. Roughly nine months later more than 140 women, nearly all of them his patients, began coming forward to publicly accuse him of sexual assault.

The newly released records, which State Journal obtained from MSU through a public records request, provide greater clarity to the time frame during which the Nassar allegations and investigations unfolded. They also run counter to what Patrick Fitzgerald, a former federal prosecutor MSU hired as outside counsel, told Michigan Attorney General Bill Schuette earlier this month, when he said, "We believe the evidence will show that no MSU official believed Nassar committed sexual abuse prior to newspaper reports in late summer 2016."

Sexual assault charge denied

The woman who told police and the Title IX investigator in 2014 that Nassar assaulted her was a recent MSU graduate at the time. She had gone to see him for treatment for hip pain. She told her story to the State Journal last year and is among the women and girls who have filed lawsuits against MSU.

MSU's Title IX investigation — which determined the woman didn’t understand the "nuanced difference" between sexual assault and an appropriate medical procedure — began in April 2014 and concluded three months later.

However, the Michigan State University Police Department’s criminal investigation, which also began in early 2014, wasn't sent to prosecutors for review for more than a year, on July 1, 2015, prosecutors said on Tuesday. Five more months passed before Ingham County Assistant Prosecutor Steve Kwasnik told police on Dec. 15 that he would not charge Nassar.

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Nassar last month pleaded guilty to sexually assaulting eight women and girls during medical appointments in a deal with Attorney General Bill Schuette, who charged Nassar last year. He admitted to digitally penetrating women and girls, nearly all during medical appointments, and he admitted that he did so for his pleasure, not for any medical purpose.

The woman said Nassar cupped her buttocks and massaged her breast and vaginal area. She added that Nassar became sexually aroused and that the appointment didn’t end until she physically removed his hands from her.

The Title IX investigator relied on the opinions of four medical experts who all worked for MSU and had close ties to Nassar in reaching the conclusion that the woman received a medical procedure and wasn't sexually assaulted. The woman has asked MSU to reopen her Title IX investigation; the university declined because she is suing.

Cody said the Title IX investigator reached the proper conclusion in 2014, based on the information the university had at the time. Cody said he couldn't speak to why that inquiry wrapped up before the police investigation.

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Days after the Title IX investigation concluded in July 2014, Nassar met with William Strampel, who at the time was Nassar's boss, and they "agreed" on three protocols for Nassar's return to clinical work. Those protocols included having another person in the room during procedures of "anything close to a sensitive area" and modifying procedures to have "little to no" skin-to-skin contact.

Strampel, who stepped down as dean of the College of Osteopathic medicine this month for medical reasons, only told one other person about the protocols.

"Strampel said because Dr. Nassar was 'cleared of all charges' and 'exonerated,' he did not see the need to follow-up to ensure that he was complying with the guidelines that were common sense for all physicians," according to an MSU police report the State Journal obtained through a public records request.

Ingham County prosecutors declined to charge Nassar, but did address his actions.

The office told an MSU detective "that she should make contact with Dr. Nassar and explain that he should have a witness in the room when performing the medical technique and he should do a better job explaining his technique when he sees patients," according an MSU police report from earlier this year.

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Ingham County Prosecuting Attorney Carol Siemon wasn't the county's prosecutor at the time. She's serving her first term as the county's top law enforcement officer.

Her term began in January. Nearly all of the assistant prosecutors working in the office before she started, including Kwasnik and the two highest ranking assistant prosecutors, are still in the office.

"The office and reviewing attorneys did not have knowledge of the trove of child pornography and numerous victims of sexual assault that later came to inform the charging process," Siemon said in an email response to several questions. "The Ingham County Prosecutor’s Office was never presented with the full range of evidence against Nassar. This evidence was submitted to the Michigan Attorney General’s Office, which has also has jurisdiction over criminal charges under state law."

Kwasnik told the State Journal on Tuesday that MSU police had sent a warrant request for a fourth-degree criminal sexual conduct charge, which is a misdemeanor.

He added the five-and-a-half months it took to review the case wasn't a delay, but reflective of the amount of material he needed to review and his other responsibilities to review and prosecute sexual assault cases.

Kwasnik defended his decision, saying with the information he had at the time it was the right decision.

"Knowing what I know now," he said, "I would have looked at it differently."

Kwasnik said he didn't recall anything in the materials he reviewed that included an allegation that Nassar massaged the woman's vaginal area, which the MSU Title IX investigation included, or that Nassar was sexually aroused. He said the materials included videos showing what Nassar described as medical techniques and letters from doctors who wrote that Nassar was at the top of his field and performed legitimate procedures.

In the end, Kwasnik said he felt at the time that Nassar had performed a legitimate medical procedure but needed to do a better job of explaining it.

MSU fired Nassar in September 2016, as new sexual assault allegations were being reported to police, because the university said it learned Nassarhad not followed the protocols he and Strampel agreed to and that there was a 2004 police investigation he didn't disclose during the 2014 investigation. That 2004 investigation, conducted by the Meridian Township Police Department, was never sent to prosecutors.

Nassar, 54, pleaded guilty last month to 10 sexual assault charges split between Ingham and Eaton counties.

Schuette's office prosecuted Nassar after a wave of new sexual assault reports following an Indianapolis Star story in September 2016. A federal judge sentenced Nassar last month to 60 years in prison on three child pornography charges.

As Nassar began to plead guilty to state charges, calls for independent investigations of MSU officials were renewed. Schuette then sent a letter to MSU requesting a copy of its internal investigative report of the entire Nassar matter, which Fitzgerald said doesn't exist.

Contact Matt Mencarini at (517) 267-1347 or mmencarini@lsj.com. Follow him on Twitter @MattMencarini.