Prosecutors said Dr. Strampel failed to take steps to protect patients from Dr. Nassar when allegations of abuse emerged. He neglected, the prosecutors said, to follow a set of protocols that would, for instance, have required Dr. Nassar to conduct exams only with other staff members present. “Despite his representation of his (and the college’s) intended response to the allegations against Nassar, Strampel did not actually enforce or monitor these protocols, nor did he alert other employees in the Sports Medicine Clinic about the existence of the protocols,” the charging documents said.

The police detective’s affidavit outlining the charges also described a series of disturbing interactions between Dr. Strampel and four female medical students, none of whom were named publicly. In several of the cases, the women said they had gone to meet with Dr. Strampel to discuss their academic work but that he had turned the conversation to other topics.

One woman who said she had been summoned to Dr. Strampel’s office after falling asleep in class said that he told her to “turn around in a circle twice so that he could observe her body,” and that he said that she was “never going to make it in the profession if she did not dress sexier.” When she was later called to a dinner honoring scholarship recipients at a club on Michigan State’s golf course, she said Dr. Strampel reached around and gripped her buttock as they posed for photos, according to the affidavit.

Another student who had failed a medical school test said she was required to meet with Dr. Strampel, who asked her what her “Plan B” was since “she could not cut it in medical school.” The student said Dr. Strampel told her he would do her a favor by letting her take the exam again, but that she would then be required to do anything for him. “Given the context,” the affidavit said, the woman “understood that she was being asked to do anything he wanted sexually in exchange for the favor.”

In an interview, Dr. Nicole Eastman, who graduated from the school in 2010 and who said that she was interviewed by investigators in the case, said that Dr. Strampel made inappropriate sexual remarks, beginning soon after she started school in 2006.