ALBANY — A physician who branded multiple women with the initials of Keith Raniere and television actress Allison Mack is the target of an investigation in which state officials have quietly waged a court battle to compel eight people associated with NXIVM to testify.

The Health Department's efforts are outlined in a state Supreme Court case filed last year against eight "Jane Does" who allegedly were involved in — or had knowledge of — the secret branding ceremonies.

The court case confirms that Dr. Danielle D. Roberts, 37, an osteopath and former Clifton Park resident who had been associated with NXIVM, is being investigated for "allegations of professional medical misconduct."

The state Health Department's Office of Professional Medical Conduct served subpoenas on the women in January 2018, setting off a 10-month legal battle. Attorneys for the NXIVM associates, including Lauren Salzman, who is the daughter of NXIVM President Nancy Salzman, tried unsuccessfully to convince a judge to revoke the subpoenas.

Lauren and Nancy Salzman, along with Mack, each pleaded guilty to federal criminal charges over the past month in a racketeering prosecution that remains ongoing against Raniere and two other NXIVM associates: Clare Bronfman, an heiress of the Seagram Co. business empire, and Kathy Russell, a longtime bookkeeper for NIXVM.

Mack and Lauren Salzman both admitted to helping enroll NXIVM followers into what was purported to be an all-female "slave-master" club, where many of the women were coerced into being branded. Some of them also were allegedly manipulated to have sex with Raniere.

The federal criminal case has laid bare Raniere's secretive efforts to recruit and control women in his cloistered organization, but questions have lingered about Roberts' role in using a cauterizing pen to brand nearly two dozen women during ritualistic ceremonies. Many of the female participants said they wore blindfolds and had been held down by others to help them complete the excruciating procedure.

"The complaint alleged that the subject physician participated in an initiation ceremony for a secret society, which involved the branding of female initiates with a cautery pen without anesthesia and under duress," states a court order issued last September that authorized the Health Department's investigation to go forward.

The charges against Roberts that are being considered by the Health Department include allegations that she practiced medicine with negligence on more than one occasion; practiced on one occasion with gross negligence; is morally unfit to practice medicine; and failed to use scientifically accepted precautions and infection-control practices during the branding procedures.

The investigation of Roberts has been slowed by the federal criminal prosecution of NXIVM's leaders, including charges related to the secret club that conducted the branding ceremonies, sources said.

Hector J. Diaz, an Arizona attorney, is representing Lauren Salzman in her federal criminal case and also is listed as an attorney for one of the "Jane Doe" witnesses in the Health Department's investigation of Roberts. Michael S. Kelton, a New York City attorney who specializes in medical malpractice, represented the remaining seven "Jane Doe" witnesses in the case, according to court records.

The attorneys argued in court filings that "body scarification" is not a form of practicing medicine and therefore the Health Department had no authority to compel the women — who are private citizens and not physicians — to respond to the subpoenas.

Acting state Supreme Court Justice Kimberly A. O'Connor ruled last September that state Education Law gives the Health Department "wide latitude" in determining whether a procedure like branding is within the scope of practicing medicine.

"Additionally, courts have recognized that physicians performing certain procedures that can also be performed by a layperson are held to the standards applicable to a physician," O'Connor wrote.

The once-secret branding ceremonies, which took place in a Halfmoon neighborhood, were initially brushed off by the Health Department after it received a formal complaint in 2017 from a Canadian woman who had been branded. But the agency's probe was revived after published reports drew attention to the branding.

The 2017 complaint filed by Sarah Edmondson of Vancouver, a longtime NXIVM associate, said that at least 20 women associated with the Colonie-based organization were lured into the club and allegedly coerced into being branded in their pubic area.

Members of the club, called Dominus Obsequious Sororium (which means "Master Over the Slave Women"), were required to provide some sort of damaging "collateral," such as a nude photo or a dark revelation from their past, as part of their initiation, Edmonson said.

Edmondson and another woman involved with NXIVM told the Times Union in 2017 that they were brought into the club and subsequently branded by Roberts, who then gave them special bandages and advice on helping the wounds heal.

Edmondson had said she was told it would be a "tattoo" and that she only learned weeks later that the brand, which she was told was a Latin symbol for "the elements," was actually the initials of Raniere and Mack, whom Edmondson's complaint identified as having "started" the secret women's group with Raniere.

After the branding ceremonies were publicized, state Health Department officials said they were researching what regulations might govern human branding. In July 2017, though, they initially dismissed Edmondson's complaint, saying the allegations "did not occur with the doctor-patient relationship and should be reported to law enforcement ...."

Edmondson was associated with NXIVM for 12 years, but left the organization in June 2017 after she learned the brand that she received was really the initials of Mack and Raniere.

Roberts had worked at St. Peter's Hospital from 2012 to 2015 through an employment agency. It's unclear whether she continues to practice medicine, but is often featured at seminars promoting health and wellness programs.

In a related case, the Health Department has filed disciplinary charges against Dr. Brandon B. Porter, a physician for NXIVM who conducted human brain-activity experiments on people associated with the organization.

The state attorney general's office last year suspended its investigation of a nonprofit foundation associated with NXIVM that had sponsored the brain-activity and other human behavioral studies without any apparent oversight, according to court records.

The nonprofit Ethical Science Foundation was formed in 2007 by Bronfman, who has described herself as the operations director of NXIVM.

The Times Union reported in October 2017 that NXIVM's leaders had recruited participants who took part in unsanctioned brain activity studies and other human experiment studies conducted by Porter.

The Health Department's disciplinary case against Porter remains pending.

Kelton, the attorney for both Porter and Roberts, on Thursday said he had "no comment to make with respect to either physician." Diaz, the attorney for Lauren Salzman, did not respond to a request for comment.

Porter abruptly resigned from his job at St. Peter's Hospital in Albany in 2017 after his role in the human brain studies became public.

NXIVM had acknowledged it conducted human research studies, including for treatment of Tourette syndrome, although the studies were apparently never published or peer-reviewed.

The state Health Department initially brushed off a complaint filed in August 2017 by another Vancouver woman who was associated with NXIVM. Jennifer Kobelt, then 28, said she was traumatized by a bizarre experiment in which Porter showed her videos depicting graphic violence in August 2016.

The experiment she was subjected to took place in a small commercial building in Halfmoon that had been used for years by NXIVM for training and seminars. Kobelt said she was recruited for the study by an assistant of Nancy Salzman, and that she knew of at least four other women who took part. Kobelt said she was not told what the study was for or what would take place, and that she was not asked to sign any documents indicating she had been informed what the study was about and consented to take part.

Porter drove Kobelt to the building that day, she said, hooked her up to an EEG machine that monitors brain activity and showed her terrifying images and videos of murder, rape and mutilation.