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Michigan State University for the first time has said Dr. Larry Nassar allegedly sexually assaulted a patient he was treating, according to documents released Tuesday.

The final investigative report by MSU’s Office of Institutional Equity was issued in response to a complaint filed in September by Rachael Denhollander, the first woman to come forward and speak out against Nassar.

Nassar, 53, was a highly regarded physician at MSU and USA Gymnastics until September, when allegations emerged that he treated injured athletes with a procedure that involved him digitally penetrating female patients without a glove, lubricant or consent.

Since Denhollander filed a police report, lawsuit and complaint with MSU’s Title IX office, civil filings against the osteopathic doctor have grown to include about 80 females, and about dozen more suits pending, according to Okemos-based attorney Mick Grewal who is representing about 20 women suing. MSU police also are investigating more than 90 complaints.

Nassar has denied wrongdoing.

“I am deeply grateful to see the truth about Larry Nassar finally be recognized, but I am grieved that it took twenty years of reports from young girls and women before it was,” Denhollander said in a Facebook message on Tuesday night.

“As early as 1997, women were expressing concern to various employees and officials at MSU about Larry Nassar’s conduct, including at least three women telling gymnastics coach Kathy Klages that Nassar was digitally penetrating them. Others came forward in the 90s to various officials in the athletic department, alleging the same treatment. Each time, these young girls and women were dismissed. Now, a full 20 years later, justice is beginning to be done.”

MSU spokesman Jason Cody said: “I can confirm we have had six official OIE investigations regarding Nassar, one of which has been completed and resulted in a finding of a policy violation,” he said. “The other five are still open.”

Denhollander made the allegation that she was sexually assaulted by Nassar on five occasions for medical treatment for back pain in sessions that began in 2000 at his office on campus at MSU, according to the report.

She was 15 years old and a gymnast then. Denhollander said she practiced primarily at the Kalamazoo Gymnastics Club.

The report said Denhollander had five osteopathic massage appointments with Nassar in 2000 for pain in her back and wrists. She said her mother was in the room with her for all of the appointments. Denhollander said Nassar “conducted a full evaluation of her back and wrists” and told her “certain muscles weren’t firing properly, she had some vertebrae issues, her hips were out of alignment, and there were several other issues.”

Nassar then told her “I need to rotate your hips” and asked her to stand up. He did not ask permission of her or her mom, the report said, to start osteopathic massage and “did not explain what he was about to do.” She was wearing loose athletic shorts and underwear when “Nassar knelt to her left side as she was standing and put his left hand on her leg and with his right hand, through the inside part of (her) shorts, with his palm on her back side, inserted two fingers into her vagina and rotated her hips.”

This action continued during subsequent visits, the report said. During one of them, he got an erection and massaged her breasts, the report said.

Denhollander said it “felt wrong, but also thought he could not have reached his level of prominence by doing something that was inappropriate,” the report said.

She started to do research on what happened to her in 2001 and 2002, the report said. But she decided to come forward and speak to authorities last year after seeing a report by an Indiana newspaper about USA Gymnastics “burying the files of sexual complaints against coaches,” Denhollander said.

“That made me hopeful that they could either find something on Nassar, or that with the culture of abuse at USAG being uncovered, there would be enough public pressure to drive the truth about Nassar forward,” she said.

According to the report, when MSU officials interviewed Nassar in September, he said he did not remember Denhollander and he did not remember treating her. He said he has been practicing myofascial release in the pelvic floor area for back pain since the 1990s. Many patients he has treated have given him positive feedback, the report said.

Nassar said he did not penetrate the vagina or anus and did not use gloves because he did not penetrate a patient’s vaginal or anal areas.

It also said that Nassar said he did not massage a patient’s breast or have an erection while treating a patient.

“(Nassar) said that would be totally unprofessional,” the report said. “The Respondent said there was no ulterior motive or sexual gratification ... .”

Denhollander reported her allegations to MSU’s Office of Institutional Equity in September and a final report was released Friday.

“Under Michigan law in 2000, a person under the age of 16 years old is unable to consent to a physical act of a sexual nature where the actor is five or more years older than the child,” the report concluded.

“When Claimant Denhollander was treated by the Respondent in 2000 when she was 15 years old, the Respondent was more than five years older than her. Therefore, it is found by a preponderance of the evidence that Claimant Denhollander did not consent to the physical acts of a sexual nature of vaginal penetration, anal penetration, massaging of her genitals, and massaging of her breasts committed by the Respondent.

“Having found that the Respondent engaged in a physical act of a sexual nature without the consent of Claimant Denhollander, it is further found by a preponderance of the evidence that the Respondent sexually assaulted Claimant Denhollander in 2000 on campus while an employee of the University, and, therefore, violated the University’s Sexual Harassment policy effective in 2000,” the report said.

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