Guilty plea in doctor’s case sheds light on reporting delays

The guilty plea of a local doctor accused of touching the breasts of two teenage girls is the latest turn in a case that raises questions about why Dayton Children’s Hospital administrators did not immediately report the allegations to law enforcement.

Police videos obtained by the Dayton Daily News using Ohio public records law and never made public before show that Dayton detectives in May 2015 repeatedly questioned Dayton Children's administrators about why they did not report the allegations against Dr. Arun Aggarwal, a pediatric gastroenterologist who practiced at Children's under a contract with Wright State University.

Aggarwal pleaded guilty Thursday to four counts of felony gross sexual imposition and will be sentenced Dec. 28. His attorney says a plea deal will recommend 10 months of incarceration — including four already served in jail — and for Aggarwal to return to his native India. He is currently in the country on a work visa.

In their interviews with Dayton Police Detective Elizabeth Alley in May 2015, several Children’s administrators said they did not feel the allegations needed to be to reported, saying the attorney for the hospital, Chris Bennington, assured them that the hospital’s internal measures to discipline Aggarwal were adequate.

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Aggarwal was indicted in August 2017 — more than three-and-a-half years after the mother of a 15-year-old patient in January 2014 reported that Aggarwal touched her daughter’s breasts after asking the mother to leave the room.

Another mother complained in November 2014 that Aggarwal touched her daughter’s breasts on more than one visit starting when she was 17, according to police records.

Police only became aware of the allegations in January 2015, when a hospital supervisor reported the incidents to the hospital’s social work office after becoming frustrated over the hospital’s response. Following a nearly year-long police investigation, the Montgomery County Prosecutor’s office declined to move the case forward, citing a lack of evidence. However, the office reopened the case earlier this year based on some of the testimony presented at Aggarwal’s licensing hearing before the State Medical Board of Ohio.

Aggarwal vigorously defended his actions before the board, saying everything he did was for medical purposes. The board disagreed, and in May of this year it permanently revoked Aggarwal’s license and criticized hospital staff for “dragging their feet” in investigating and disciplining him.

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After his indictment, Aggarwal was arrested at Dulles International Airport attempting to flee the country, according to prosecutors.

‘We would do things differently’

Hospital officials declined to make any employees available for an interview because of the ongoing criminal case.

Bennington, who works for the Ohio-based law firm Bricker and Eckler, said he can’t comment due to attorney-client privilege.

But in a statement released last week, Dayton Children’s CEO Deb Feldman acknowledged mistakes were made in the handling of the allegations against Aggarwal.

“We are now viewing the situation with the benefit of hindsight, which makes matters much clearer now than they were at the time,” the statement says.

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“As I said previously, knowing what we know now, we would do things differently and in fact, we since have done things differently, changing and strengthening policies. We continue to seek ways to improve and better serve children and their families.

“Most importantly, safety is our top priority,” Feldman’s statement says. “We do not — and will not — tolerate any actions that could impact the quality of care the hospital provides or that would undermine the trust placed in us by patients, parents and the community. We believe passionately in our mission and protect children above all else.”

Video-taped interviews

In her interviews with Dayton Children’s administrators, Detective Alley sought clarification from each on why the incidents were not reported.

“It absolutely should have been reported because it is inappropriate touching,” she said to Dr. James Rick, Aggarwal’s supervisor. “And even if in doubt, it doesn’t hurt to report it just in case so you don’t have to carry that burden.”

Rick said it didn’t cross his mind that Aggarwal’s actions were possibly a reportable sexual abuse allegation.

“It seemed plausible that (Aggarwal) felt the need to do a breast exam on these patients,” Rick said.

The hospital’s Chief Operating Officer, Matt Graybill, told Alley he trusted the advice of the hospital’s attorney — Bennington — and Chief Medical Officer Adam Mezoff, both of whom didn’t feel the allegations needed to be reported to police.

“I asked (Bennington) if he was aware of the allegations. He told me he was. I asked him if he thought we were handling it appropriately (and) it did not need to be reported. He said that was the case,” Graybill said.

Mezoff told Alley that after the first accusation, he met in person with Feldman and administrators at Wright State.

“The sense was there was a misunderstanding,” Mezoff told the detective. “(Aggarwal) had been a physician in good standing and that it was very plausible that if you push somebody’s mid-chest that that could certainly have been the way that was perceived,” he said.

Aggarwal maintained in medical board testimony that he pressed on the first teenage patient’s sternum because she complained of chest pain. The second patient, he has said, had a surgical scar on her breast he was examining for infection; on another instance, he testified, he went under her shirt with a stethoscope to hear her breathing.

“When you got the second complaint, did you ever think, hey maybe there is something going on inappropriate?”Alley asked Mezoff. “Like maybe he’s not doing what he should be doing. Maybe we should be re-evaluating this. Was there ever anything like that?”

Mezoff said he consulted with Bennington and Dr. Lori Vavul-Roediger, a child abuse expert at the hospital. He said his impression was that Aggarwal was well-meaning but socially awkward.

Vavul-Roediger gave a statement to police saying Mezoff told her about one incident of an unnamed doctor performing a breast exam on a female patient.

"It was this physician's understanding that neither the patient nor the parent had complained about the exam, and the patient's family had not filed a report of maltreatment regarding the incident," she wrote in the memo, which was obtained by the Dayton Daily News.

Alley said in a hearing held by the state medical board that her understanding from talking to Vavul-Roediger was that Mezoff “didn’t provide all the information about what the allegation was.”

COO unaware of hospital reporting policy

Police became aware of the allegations involving Aggarwal after Karen Braun, the hospital’s then-director of ambulatory services, reported them to the hospital’s social work division, the body that typically considers whether to report to law enforcement.

Asked last week why she took that action, Braun said, “I reported because I had a legal and ethical obligation to do so.”

Graybill, in his interview with Alley, acknowledged that Braun did not agree with how top administrators handled the allegations against Aggarwal.

“I think she (Braun) continues to believe that it should’ve been reported and continues to be uncomfortable that we did not, that the hospital did not report it,” Graybill said.

“Are you aware that the policy actually says that mandated reporters have to report to social work?” Alley then asked. “Are you aware of that?”

“No, I’m not,” answered Graybill, the hospital’s second-in-command.

“It actually says mandated reporters are to report directly to social work when they learn of an alleged sex abuse or physical abuse, that that’s the children’s hospital policy,” Alley said. “You’re not aware of that?”

“No,” Graybill responded.

The hospital’s current policy, established after the Aggarwal allegations, refers all such incidents to child abuse experts to report to authorities, and includes what they call one of the most extensive chaperoning policies in the country. The newspaper was unable to obtain a copy of the previous policy to determine if Alley was portraying it accurately.

‘If we were concerned, he wouldn’t be working here’

When the Dayton police detective interviewed Children’s administrators, Aggarwal was still working in the hospital. Graybill said if police have evidence that Aggarwal did anything wrong, they should let hospital officials know, so they can respond.

“If we thought that this doctor was a risk to our patients, he wouldn’t be working there,” Graybill said.

“I understand that, but you get one allegation and then you get another one that is fairly similar,” Alley responded. “These two kids don’t know anything about each other. They’re not siblings. They don’t know each other. They are seen on different days.”

“Certainly I think it rises to the level of lots of concern,” she said.

“If we were concerned, he wouldn’t be working there,” Graybill said, “and if you guys know something from parents, the kids or anything else that we should know about, then I think you have an obligation to let us know so that we can do what we need to do.”

Aggarwal was placed on administrative leave in June 2015, roughly a month after the interviews. He was fired from Wright State three months later after his admitting privileges at Children’s lapsed. He sued Wright State and an arbitrator last month awarded him $91,799, ruling that WSU did not give the physician due process, according to court records. The university can appeal the decision.

‘That’s how you find the bad guys’

In announcing the charges against Aggarwal last August, Montgomery County Prosecutor Mat Heck said the law requires hospital staff to report such incidents, though he stopped short of saying they will be charged with failing to report.

“The decision on whether to pursue charges will be made after the criminal case on Aggarwal is completed,” prosecutor’s office spokesman Greg Flannagan said this month.

An attorney for the hospital said Friday they’ve been assured throughout the case that no one will be charged.

“During the course of the investigation by the Dayton Police Department and the Montgomery County Prosecutors Office, the hospital and its employees fully cooperated with the investigation involving Arun Aggarwal,” attorney John F. McCaffrey said in an email. “This included producing documents and making hospital employees available for interviews and/or testimony before a Montgomery County Grand Jury. During the investigative process and leading up to preparation for the trial in State of Ohio v. Arun Aggarwal, I received repeated assurances from a senior member of the Montgomery County Prosecutor’s Office that no employee from Dayton Children’s Hospital would be criminally charged.”

Cara Sweet of the prosecutor’s office said Friday the office stands by Flannagan’s statement that the decision on charges will be made after the Aggarwal case is concluded.

Prosecutions for not reporting allegations of sexual abuse are rare in Ohio.

The State Medical Board of Ohio has disciplined a couple doctors in recent years for failing to report allegations, including a Lancaster doctor whose license was suspended 180 days after he was convicted on misdemeanor charges. The doctor failed to report the rape of a minor who came to his office with complaints stemming from sexual abuse, according to the medical board.

In another case, a Summit County doctor had his license revoked in March 2016 for not reporting repeated allegations that his business partner improperly touched sedated patients, board records show.

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Dan Frondorf, Cincinnati leader of the group SNAP, which was created in the wake of the Catholic priest sex abuse scandal but now advocates for other types of sex abuse victims, said there should be consequences for mandated reporters who refuse to report.

“I’d be disappointed if somebody clearly should have reported and they didn’t (and) they weren’t prosecuted,” Frondorf said. “It undermines the whole point of why the law is there. That’s how you find out about the bad guys.”

Aggarwal timeline

September 2013: Dr. Arun Aggarwal is hired as a pediatric gastroenterologist by the Wright State University Boonshoft School of Medicine, practicing at Dayton Children’s Hospital.

December 2013: Aggarwal examines a 15-year-old female patient with Crohn’s disease. After her mother leaves the room, she claims he touched her breasts. He claims he was performing a sternum examination.

January 2014: The first patient’s mother reports the incident while asking for a different doctor for a follow-up visit. Allegation escalates to hospital chief medical officer, who says he notified top administrators and told Aggarwal to not conduct such examinations without a chaperone present. Karen Braun, director of ambulatory services, argues for more action to be taken.

August 2014: Aggarwal examines a 17-year-old female patient with acid reflux and while examining a scar on her chest allegedly squeezes her nipple.

November 2014: The second patient sees Aggarwal for a follow-up, at which she claims he had her remove her shirt and bra to hear her breathing and touched her breasts. The patient’s mother complained to the hospital. Hospital and WSU officials give Aggarwal warning letters and direct him to have a female health care professional present for an examination of any pubescent female.

December 2014: Braun raises concerns that Aggarwal is not using chaperones, as required.

January 2015: After arguing that the incidents should be reported, Braun reports them herself to Montgomery County Children Services. Dayton police launch an investigation.

May 2015: Dayton police issue search warrants at Dayton Children’s Hospital’

June 2015: Aggarwal is placed on administrative leave.

September 2015: WSU terminates Aggarwal after his admitting privileges lapsed at Dayton Children’s.

October 2015: Aggarwal sues WSU, alleging he was fired without due process.

December 2015: Prosecutors decline to pursue charges against Aggarwal.

May 2016: The State Medical Board of Ohio issues a citation against Aggarwal based on allegations that doctor engaged in sexual misconduct with two patients.

March 2017: After a hearing in February, a state medical board examiner recommends revocation of Aggarwal’s license alleging he “engaged in sexual misconduct” with two patients.

May 10, 2017: The State Medical Board of Ohio permanently revokes Aggarwal’s license.

May 15, 2017: Dayton Children’s Hospital CEO Deb Feldman outlines changes made in hospital policy and practice in response to the Aggarwal incident.

August 2017: Aggarwal is indicted by a Montgomery County grand jury on four counts of felony gross sexual imposition. He is arrested at Dulles International Airport allegedly attempting to flee the country. Aggarwal enters a not guilty plea through his attorney.

Nov. 27, 2017: A filing in Aggarwal’s federal lawsuit against Wright State shows an arbitrator ruled the university has to pay Aggarwal $91,799 because the school didn’t follow proper steps to fire him.

Dec. 21, 2017: Aggarwal pleads guilty to four counts of felony gross sexual imposition.

Dec. 28, 2017: Aggarwal’s sentencing hearing is scheduled.

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