Larry Nassar kept seeing patients during 19-month police investigation

— -- Larry Nassar, the admitted serial sexual predator who worked as a physician for Michigan State and USA Gymnastics, was the subject of a 19-month investigation by the Michigan State University Police Department and was allowed to continue seeing patients at the university during the majority of that time.

That revelation comes from a MSUPD/FBI joint investigation into whether any other school employees broke the law in connection to Nassar's misconduct. Details of that investigation were released Tuesday through a university spokesman.

During the joint investigation, which was conducted in the spring of 2017, eight current or former Michigan State employees were interviewed as part of the only known independent investigation into whether anyone beyond the disgraced doctor was criminally responsible for allowing Nassar to prey on girls and young women for nearly two decades.

In the report, Dr. William Strampel, the dean of Michigan State's osteopathic school and Nassar's boss, told police he did not "see the need to follow-up to ensure" Nassar was following new guidelines they had discussed when Nassar returned to work following a 2014 accusation of sexual assault.

Police and the university's Title IX department both investigated a claim that Nassar assaulted a recent graduate in the spring of 2014. The Title IX department cleared Nassar of wrongdoing three months later, saying that when the doctor used his hand to manipulate the woman's vaginal area, it was part of a legitimate medical procedure.

Nassar returned to work in late July 2014. University police continued to investigate him until July 2015, when they asked local prosecutors to charge him with a misdemeanor sexual assault charge. The Ingham County prosecutor decided not to charge Nassar in December 2015, roughly 16 months after he returned to work.

Several young women who have come forward in the past year to accuse Nassar say he assaulted them during the time he was under police investigation.

"As soon as the MSU administration was aware of the allegation, we took immediate action and began a Title IX investigation," Michigan State University said in a statement Wednesday. "That investigation, in July 2014 and based upon the information known at that time, concluded there was no finding of a policy violation by Nassar. Thus, Nassar returned to work.

"On the criminal investigation, it is important to note that from the early stages, MSU Police detectives made multiple contacts with the Ingham County Prosecutor's office. Each time, prosecutors indicated this was not a chargeable case. Despite that, a thorough investigation was completed and the report was submitted to that office for review and consideration of charges. ... The final decision by the prosecutor's office was not to authorize criminal charges."

Strampel emailed Nassar on July 30, 2014, to say he was "happy to have you back in full practice" and glad that they had "agreed" that, moving forward, Nassar should have another person in the room whenever approaching a patient about treatment in sensitive areas. They also agreed Nassar should avoid skin-to-skin contact whenever possible, fully explain a procedure before performing it and inform new members of the Michigan State staff about these guidelines.

Strampel told police these guidelines were "health care 101," and he didn't think it was necessary to inform others in the practice that Nassar needed to follow them. Other doctors interviewed by police this past spring agreed those procedures were "common sense" but added that Strampel didn't tell anyone that he had made them mandatory for Nassar.

Dr. Doug Dietzel, Nassar's direct superior during that time, said there was no formal rule at the time about making sure a chaperone was in the room while examining private areas of a patient and that it was left up to individual doctors to use common sense in that regard.

Dietzel said he first remembers Strampel informing him of Nassar's restrictions in September 2016, when Nassar was suspended amid new allegations of abuse. Strampel told Dietzel then that Nassar had not followed the guidelines. Nassar was fired shortly thereafter.

"How do we enforce those things when we didn't even know about them?" Dietzel asked police when he was interviewed this spring.

Dietzel and others interviewed by police said no patients ever said they felt uncomfortable when being treated by Nassar. Multiple people interviewed mentioned that the only other "red flag" about Nassar was that he "incessantly" used Facebook to communicate with his patients, many of them young girls. They said his Facebook page was temporarily shut down at one point, and Nassar told them it was probably because he was friends with so many young girls.

Nassar was sentenced earlier this month to 60 years in federal prison on child pornography charges. He pleaded guilty in November to 10 counts of first-degree criminal sexual conduct, admitting that he used his position of authority to penetrate the private areas of female patients -- some younger than 13 years old -- for his own sexual gratification. He admitted that his conduct did not have any medical purpose.

Several prominent politicians from the state of Michigan have publicly asked for law enforcement to look further into the possibility that others enabled Nassar's behavior.

Michigan's attorney general's office has not said whether it intends to pursue charges or attempt an additional investigation into whether other people committed crimes by ignoring claims about Nassar's misconduct.

More than 140 women have filed civil lawsuits against Michigan State, USA Gymnastics and others, claiming that they failed to heed warning signs about Nassar. Those lawsuits allege that people in positions of authority at Michigan State knew about Nassar's abuse as early as 1997.

Michigan State's police department submitted its findings from this spring's interviews to the U.S. Attorney's office in April of this year. A spokeswoman for the U.S. Attorney's office said she could not comment on the status of any investigation or confirm whether her office was conducting an investigation.