MSU hid full conclusions of 2014 Nassar report from victim

EAST LANSING – A 2014 sexual assault investigation of Larry Nassar by MSU’s Title IX office concluded that his conduct could open the university to lawsuits and expose patients to “unnecessary trauma based on the possibility of perceived inappropriate sexual misconduct.”

Those key findings were never shared with Amanda Thomashow, the patient who said Nassar had assaulted her. Instead, those conclusions were part of a second report that went to Michigan State University’s Office of General Counsel, Nassar and his then-boss at the College of Osteopathic Medicine, William Strampel.

The final Title IX report Thomashow received from MSU, which she shared with the Lansing State Journal in 2016, had a “Conclusions and Recommendations” section of just 41 words. The complete “Conclusions and Recommendations” section in Nassar’s copy, which the State Journal has obtained, is 246 words and cited problems with both Nassar’s conduct and MSU’s procedures.

Here is the conclusion Thomashow received:

"We cannot find that the conduct was of a sexual nature. Thus, it did not violate the Sexual Harassment Policy. However, we find the claim helpful in that it allows us to examine certain practices at the MSU Sports Medicine Clinic."

And Nassar's copy:

"We cannot find that the conduct was of a sexual nature. Thus, it did not violate the Sexual Harassment Policy. However, we find the claim helpful in that it brought to light some significant problems that the practice will want to address.

"We find that whether medically sound or not, the failure to adequately explain procedures such as these invasive, sensitive procedures, is opening the practice up to liability and is exposing patients to unnecessary trauma based on the possibility of perceived inappropriate sexual misconduct. In addition, we find that the failure to obtain consent from patients prior to the procedure is likewise exposing the practice to liability. If procedures can be performed skin-on-skin or over clothes in the breast or pelvic floor area, it would seem patients should have the choice between the two. Having a resident, nurse or someone in the room during a sensitive procedure protects doctors and provides patients with peace of mind. If 'touching is what DO’s do' and that is not commonly known, perhaps the practice will want to consider a disclaimer or information sheet with that information provided to the patient up front.

Finally, we believe the practice should consider whether its procedure for intake of complaints about physicians’ behavior is adequate. Ms. Thomashow claims she tried to file a complaint with the front desk receptionist, telling her that she was cancelling her appointment because she felt 'violated.' Whether this triggers a reporting protocol should be examined by the practice."

It is this second report, with the longer conclusion section, that Strampel and Nassar had in hand when they met to establish the protocols required for Nassar as he returned to clinical duties, the same protocols Strampel later told police he didn’t intend to follow up on to ensure Nassar’s compliance.

More: Nassar recommended expert who helped clear him in 2014

More: MSU let Larry Nassar see patients for 16 months during criminal sex assault investigation

Nassar, who worked for MSU and with USA Gymnastics for 20 years, was sentenced to 40 to 175 years in prison Wednesday on seven charges of sexual assault, six of which occurred at MSU. His seven-day sentencing hearing included emotional statements from 156 women and girls who described the abuse they suffered.

Amanda Thomashow gave her statement on the second day.

"MSU tried to silence my client in July 2014, by giving her a Title IX report stating she had not been sexually assaulted," Jim Graves, Thomashow's attorney, said in a statement to the State Journal.

"At the same time, MSU had the audacity to keep a second version of the same report undisclosed to my client and the public until now. The second version reveals MSU’s additional undisclosed findings that Nassar’s 'sensitive procedures, is opening up the practice (MSU Sports Medicine Clinic) to liability and is exposing patients to unnecessary trauma...' MSU’s disgraceful actions enabled Nassar’s egregious and destructive abuse of girls to continue after my client so bravely reported him to MSU."

In a statement to the State Journal, MSU spokesman Jason Cody said, "as was standard practice at the time, in cases in which our Title IX office at the time determined there had been no violations of MSU’s sexual harassment policy, but had otherwise identified areas for improvement in protocol or procedures, the investigator would convey those recommendations to the appropriate MSU personnel in an internal version of the report. The investigator followed that standard practice in this case.

"The final results of the sexual harassment investigation itself were included in the version delivered to the claimant. Although the claimant did not receive the internal recommendations, she was advised that the investigation had resulted in recommended changes to policy at the Sports Medicine clinic."

More: 2014 police report sheds light on how Nassar avoided criminal charges

The State Journal first reported the existence of two versions of the 2014 Title IX report in April 2017, after using public records laws to obtain university emails. One of those emails was from the Title IX investigator to Strampel, in which she sent him the final report. That email referenced “substantive text in the conclusion” that wasn’t provided to the female patient, but did not describe the details. The email included attachments, which MSU did not release to the State Journal.

The longer conclusion section provides more insight into MSU’s Title IX investigation of Nassar, which ultimately determined the now disgraced former doctor’s actions were not of a sexual nature and therefore did not violate university policy. And it provides context for what university officials knew when MSU allowed Nassar to resume seeing patients in July 2014, some 16 months before the criminal investigation of Thomashow’s complaint ended without charges.

More a dozen women and girls say they were abused by Nassar after Thomashow’s Title IX investigation closed.

More:

- Woman who reported Nassar in 2014: 'It destroyed me but I lived'

- Larry Nassar and a career filled with ‘silenced’ voices

- At MSU: Assault, harassment and secrecy

‘Significant problems’

In its final correspondence with Thomashow in July 2014, MSU thanked her for bringing her concerns forward.

During a medical appointment at Nassar’s MSU office four months earlier, he cupped her buttocks and then, about an hour into the session, he sent the only other person present, a female resident, out of the examination room, she told them. Then he massaged her breast and vaginal area.

She told him to stop, but he didn't. He only stopped when she physically removed his hands from her. Thomashow's report didn't include vaginal penetration, which many other women and girls have reported to police.

More: 'Just signed your death warrant': Larry Nassar sentenced to 40 to 175 years

Kristine Moore, the Title IX investigator, determined that Thomashow likely misinterpreted a medical procedure as sexual assault because she didn’t understand the “nuanced difference.”

The conclusion section read: “We cannot find that the conduct was of a sexual nature. Thus, it did not violate the Sexual Harassment Policy. However, we find the claim helpful in that it allows us to examine certain practices at the MSU Sports Medicine Clinic.”

The conclusion sent to Nassar and his former boss was far more pointed.

“We cannot find that the conduct was of a sexual nature. Thus, it did not violate the Sexual Harassment Policy. However, we find the claim helpful in that it brought to light some significant problems that the practice will want to address,” Moore wrote the longer conclusion section that was withheld from Thomashow.

“We find that whether medically sound or not, the failure to adequately explain procedures such as these invasive, sensitive procedures, is opening the practice up to liability and is exposing patients to unnecessary trauma based on the possibility of perceived inappropriate sexual misconduct. In addition, we find that the failure to obtain consent from patients prior to the procedure is likewise exposing the practice to liability.”

The day after Thomashow saw Nassar, she called the clinic to cancel an appointment that had been scheduled in the future, according to her report, and she told the receptionist it was because she felt violated. The receptionist "simply said 'O.K.' and that was it," Moore wrote in the report Thomashow received.

It's a detail addressed in the conclusion section Nassar was given, but wasn't included in what Thomashow was given.

"Finally, we believe the practice should consider whether its procedure for intake of complaints about physicians’ behavior is adequate," Moore wrote in the full conclusion section. "Ms. Thomashow claims she tried to file a complaint with the front desk receptionist, telling her that she was cancelling her appointment because she felt 'violated.' Whether this triggers a reporting protocol should be examined by the practice."

The 2014 Title IX investigation has been the focus of much of the criticism directed at MSU over the university's handling of Nassar.

Moore, an attorney with background in employment law who later took a promotion to MSU’s Office of General Counsel, cleared Nassar of policy violations, in part, based on the opinions of four medical experts who all worked for the university and had close ties to Nassar.

In 2017, a Title IX expert told the State Journal that MSU could have violated the federal Title IX law, which prohibits gender discrimination on campus, by giving Thomashow a final report with less information than the one Nassar and the university received. The Title IX law, the expert said, requires equal notification.

Strampel apparently responded to the guidance in Moore’s report by creating protocols for Nassar’s return to seeing patients. They included a requirement to wear gloves when performing procedures in intimate areas, to have another person present during such treatments and to explain the procedure and obtain consent before treating patients.

When MSU terminated Nassar in September 2016, one of the reasons was his failure to follow those protocols, although Strampel himself later acknowledged that he had not tried to enforce them after the Title IX review concluded there was no violation of university policy.

The 2014 Title IX investigation of Nassar occurred while MSU was under investigation by the U.S. Department of Education for its handling of sexual assault and harassment complaints. That investigation concluded in November 2015. Federal investigators reviewed 150 cases and found “significant concerns” in 30, saying that case files lacked key documentation and MSU officials had ignored reports of sexual assault and relationship violence, resulting in additional reports. Federal investigators determined that MSU failed to respond to complaints in a timely manner and may have contributed to a “sexually hostile environment” on campus.

On Thursday ESPN reported that MSU had asked the DOE to stop monitoring its Title IX efforts late last year, a request that was denied because MSU had not disclosed the investigation of Nassar in 2014 and because MSU still has not provided federal officials with all the documents related to the Nassar allegations.

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