Marisa Kwiatkowski, Tim Evans, and Mark Alesia

IndyStar

Editor’s note: Since this article published, IndyStar has learned that more than 30 people have come forward with allegations of sexual abuse against Dr. Larry Nassar.

In the two weeks since IndyStar reported sexual abuse allegations against former USA Gymnastics team physician Dr. Larry Nassar, 16 more women have filed criminal complaints against the doctor.

Four of the women contacted IndyStar directly, along with a fifth woman who filed a report with police in 2004. Each of them said they told police Nassar penetrated them with his finger during what were supposed to be medical treatments. Three of the five said they were underage at the time. Two said he also touched their breasts. One said Nassar was sexually aroused.

Nassar, who has not been charged with a crime, denies any wrongdoing.

In a recorded interview Sept. 12, Nassar's former attorney told IndyStar — with Nassar present — that the doctor never used a procedure involving vaginal penetration. But on Thursday, Nassar's current attorneys, Matthew Newburg and Shannon Smith, said Nassar has used a legitimate medical procedure that includes manipulation that, under Michigan law, would be considered vaginal penetration.

"Dr. Nassar is not changing his story in any way," his attorneys said in a statement. They said Nassar showed police videos that demonstrate the procedure he used. "Those videos demonstrate the exact procedures he used to treat patients and clearly show penetration according to the legal definition."

The osteopathic physician was fired from Michigan State University on Tuesday for failing to comply with "certain employment requirements," according to a university spokesman.

Nassar gained prominence through his 29-year tenure with USA Gymnastics, a position he left last September. The majority of the alleged instances of sexual abuse occurred years before USA Gymnastics said it first became aware of “athlete concerns” about Nassar and immediately took action.

A blind eye to sex abuse: How USA Gymnastics failed to report cases

The national governing body said it notified law enforcement and relieved him of his duties. Nassar's former attorney disputed that characterization, saying the doctor retired.

Police in Michigan are reviewing two earlier criminal complaints about Nassar: the one from 2004 and another from 2014. Neither the Ingham County, Mich., prosecutor nor MSU police would say how many new complaints they've received, but the university’s police crime log lists 15 new allegations of criminal sexual penetration that reportedly occurred at the MSU sports medicine clinic, where Nassar worked. One of the allegations lists Nassar's home address. The police log does not mention Nassar by name.

"I'm not aware of any other allegations or investigations into medical personnel at that clinic or any other MSU clinic," other than those involving Nassar, MSU spokesman Jason Cody said.

Collectively, the women’s allegations of sexual abuse span nearly two decades — from 1996 through 2014. Their ages ranged from 13 to 20 when the alleged abuse began. Some continued to see Nassar for treatment for years.

Standard of care

One legal expert who spoke to IndyStar said allegations such as those against Nassar can be extremely difficult to prove because of conflicting accounts of doctors and patients. Such cases can be stronger if they involve multiple victims, said Nicolas Terry, executive director of the William S. and Christine S. Hall Center for Law and Health at Indiana University Robert H. McKinney School of Law in Indianapolis.

Terry also said such suits often hinge on debates over what constitutes a legitimate medical procedure.

Nassar’s lawyers said the doctor did not use intravaginal procedures for most athletes and patients he treated, but he did use a technique that constituted penetration under Michigan law.

The legal definition, the attorneys explained, "includes the slightest penetration between the labia of the vagina."

Dr. Mark Cantieri, president of the Indiana Osteopathic Association, said he had no knowledge of the allegations against Nassar and would not comment specifically about Nassar’s case. Cantieri did, however, say there are legitimate intravaginal procedures, but they are rarely used.

When the procedures are used, he said, they should be conducted according to widely accepted standards. Among them:

What the procedure involves should be explained to the patient and, in the case of a juvenile, the parent or guardian. And prior permission should be granted.

It should be performed with another person of the same sex as the patient in the room.

Gloves should be worn, and a lubricant should be used.

The doctor should advise the patient when penetration is about to occur.

“You should have, at least, verbal permission from the patient that it’s OK to proceed,” Cantieri said. “If it’s a minor, they’re going to have a parent in the room, and their approval.”

Cantieri said he personally would not generally use such a procedure for hip or back pain.

All of the women who spoke to IndyStar said they told police that Nassar penetrated them with his finger when they were alone with him. They said his actions went far beyond slight penetration. One woman described the movement as sexual in nature. Four of the women said Nassar did not wear gloves.

One of the women said she went to Nassar for treatment when she experienced lower back pain as a young gymnast in the late 1990s in metro Detroit.

After several treatments, Katherine, then 15, said Nassar connected her back pain to her vagina.

Katherine, whose last name IndyStar agreed to withhold, said she recently told police that Nassar repeatedly penetrated her with his fingers during seven to 10 treatments over a two-year period. Most of the time, Katherine said, she was alone with Nassar.

Another woman, a dance student who had lower back pain, said she told police that Nassar penetrated her vagina with his finger on about 30 visits over six years. She said one of those treatments was in the basement of Nassar’s home.

She said she saw Nassar sexually aroused. And once, when she was 17, he discussed "fingering" his ex-girlfriend as he penetrated the dance student. She said he once reached inside her sports bra and touched her breast while working on her ribs.

'He was like this hero'

All five women interviewed by IndyStar said they wondered about the treatment they received from Nassar, but they initially deferred to his reputation and expertise in the field of sports medicine.

"He was like this hero in ... sports medicine, especially for gymnastics, because the injuries and type of stress you’re putting on your body are so different than any other sport," Katherine said. "A trainer and doctor for the U.S. Olympic team accessible in Michigan; it was like, everyone thought it was amazing.”

Former USA Gymnastics doctor accused of abuse

USA Gymnastics President Steve Penny in 2014 praised Nassar as being “instrumental to the success of USA Gymnastics at many levels, both on and off the field of play.” Nassar also is president of the Gymnastics Doctor Autism Foundation, which helps gymnastics clubs establish programs for special needs children.

The dance student said Nassar told her that he was going to use an Australian technique that just two people in Michigan were certified to perform. It turned out that the technique included vaginal penetration, but the woman said she trusted him because he was an elite doctor.

“When I was 13, I didn’t know what ‘fingering’ was,” she said, adding, "I presumed his sexual behavior was clinical."

That woman said she didn't report it at the time but recently spoke to MSU police about Nassar. She also is a co-complainant in a Title IX case against the doctor.

She and the others contacted police after IndyStar's Sept. 12 article about sexual abuse allegations made against Nassar by two former gymnasts, one of whom is an Olympic medalist. One filed a complaint with MSU police Aug. 29. The other is suing Nassar and USA Gymnastics in California.

In separate interviews, those former gymnasts also said Nassar penetrated them with his finger and fondled their breasts during what was supposed to be treatment. They didn't report it until years later.

Marci Hamilton, founder and CEO of CHILD USA, an interdisciplinary think tank focused on issues of child abuse and neglect, said there are many reasons children don't report allegations of sexual abuse. Many don't know what sex is. Others are overwhelmed or ashamed of what happened to them.

"They don't know how to process it, and so their youthfulness gets in the way of them being able to come forward and report in the first place," Hamilton said. "And that's true, all the way from incest to the large institutional problems."

'I think I was just in shock'

One of the five women who spoke to IndyStar said she immediately reported her concerns about Nassar to police in 2004, but no charges were filed.

Then 16, the former high school athlete said she had been seeing Nassar for treatment of back pain. Her mother accompanied her on the first visit but could not attend the next one. It was during that second visit that the Seattle woman, who asked that her name be withheld, said she became uncomfortable.

She said Nassar had her strip down to minimal clothing so he could work on her back. He began massaging her back, pressing so hard that she flinched from the pain.

"Let me do something to release that pain," she said Nassar told her.

She said he went inside her underwear and put his fingers in the entrance of her vagina, then pressed his other hand on her breast. She said she was on her period and wearing a tampon at the time.

“I think I was just in shock," she recalled, "and I just froze."

Afterward, she said she went back to school and described the experience to her friends. She asked whether they thought it sounded normal. They said it didn't and encouraged her to talk to someone.

She told her mom, who took her to the police station to report those allegations. She said police sent her to the hospital to have a sexual assault kit done.

Soon after, police reached out to her parents and asked them to meet with police and Nassar. The Seattle woman said Nassar told her parents that the type of treatment he used was well-known for the release of back pain and that because she wasn't a gymnast, she may not have been as comfortable with her body.

Meridian Township police confirmed the existence of the report she filed on Nassar but have not yet released it. The woman said police told her last week that they're reviewing the investigation.

“I think that what affected me the most is that I came forward and I felt like I did everything I was supposed to do, but there was no action on it," she said. "I felt very alone in that fact because I felt like I had kind of spilled everything and there was no one there to protect me."

Call IndyStar reporter Marisa Kwiatkowski at (317) 444-6135. Follow her on Twitter: @IndyMarisaK.

Call IndyStar reporter Tim Evans at (317) 444-6204. Follow him on Twitter: @starwatchtim.

Call IndyStar reporter Mark Alesia at (317) 444-6311. Follow him on Twitter: @markalesia.

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Share your experiences

IndyStar will continue to investigate this topic. If you have information you would like to share, please email investigations@indystar.com or call (317) 444-6262.