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All Tanisha Johnson wanted was for the pain to go away.

Doctors offered little hope for his persistent migraines. But Ricardo Cruciani, who had a reputation as a brilliant pain physician at Beth Israel Medical Center in New York, was friendly and charming and prescribed strong opioids, Ms Johnson said in an interview.

“Finally, a doctor who cares,” he thought as he put his arm around her shoulder.

Over the next few months, the doctor increased the doses and added medications. As Ms. Johnson became addicted to drugs, she became more aggressive, touching him and masturbating in front of him, she said. Then he forced her to give oral sex.

When she resisted, she didn’t refill her prescriptions. “The first week of opioid withdrawal feels like death,” Ms Johnson said.

He wasn’t the only victim of Mr. Cruciani. But even as patient complaints increased, the doctor was able to move from job to job, holding positions in hospitals in three states for ten years. He was eventually charged with sexual assault in Pennsylvania, registered as a sex offender, and surrendered his medical license in a plea bargain in 2017.

He is currently facing criminal charges in New York and New Jersey. Currently, Mr. Cruciani is free on $1 million bail.

His case illustrates the failures that permeate the oversight of the medical profession, where doctors wield tremendous power in hospitals, abuses are under-reported and often covered up, and corporate employers are rarely held accountable.

At least 150 young women said they had been abused by Lawrence Nassar, doctor of the US women’s gymnastics team, for nearly two decades. like gynecologists Robert Hadden, former Columbia University doctor and George Tyndall A woman from the University of Southern California is accused of harassing women under the guise of a physical exam.

A doctor at the University of Michigan for nearly forty years, Dr. Robert Anderson sexually assaulted many patients and Dr. Frequent unnecessary rectal, breast, and pelvic exams were performed, according to a report in May, 13 years after Anderson’s death.

“One of the biggest scandals is how often a person offends, repeatedly,” said James DuBois, a bioethicist at the University of Washington in St. Louis who helped develop recommendations for improving physician education and oversight.

Dr. In most cases, “doctors manage to keep practicing,” DuBois said. “Sometimes they change states to keep their licenses. Sometimes they just move institutions.”

“I think some of the problems are peers who have doubts but don’t speak up,” he added.

Mr. Cruciani’s former patients say he used his prescription pad to manipulate women in pain, paving the way for addiction and exploiting their sex addiction.

Some of their patients took such high doses of narcotics that other pain doctors refused to see them. At one point, Ms Johnson said she was prescribed more than 1,300 pain medications per month.

Now a lawsuit filed in New Jersey on behalf of Ms. Johnson and six other former patients, along with civil lawsuits in New York and Pennsylvania, seeks to hold both the former doctor and the hospitals that employ her accountable.

The lawsuits allege that hospital administrators and staff ignored reports of Mr Cruciani sexually abusing patients until he could no longer look the other way. Plaintiffs allowed him to quietly switch jobs—never alerting other hospitals, government officials, or the police about the allegations—and allowed him to continue his predatory behavior.

Jeffrey Fritz, who represents dozens of attorneys, said: “There is a protection net in the profession and the law to detect and take action on such behavior, and we argue that they are failing in every way.” One of the former patients who sued Mr. Cruciani.

Mr. Cruciani’s lawyer, Robert E. Lytle, declined to comment. A spokesperson for the Mount Sinai Health System, which includes Beth Israel, said the hospital did not comment on the pending lawsuit.

A statement released by Drexel University said Mr Cruciani was fired in March 2017 after he launched an internal investigation that confirmed allegations of complaints from patients. The statement said the university has informed licensing authorities in Pennsylvania, New Jersey and New York and is cooperating with police investigations.

But Drexel officials pointed to other hospitals for failing to take precautions or warn them. “Drexel hired Cruciani after conducting a thorough background check that, like all potential employees, did not reveal any inappropriate or unlawful behavior,” the statement said.

The statement said Mr. Cruciani has practiced medicine in other hospitals for more than 35 years. “None of these hospitals informed Drexel about Cruciani’s behavior.”

Sexual contact between a doctor and a patient is expressly prohibited by the American Medical Association. Code of ethics requires all licensed medical professionals and nurses, as well as physicians, to report unethical behavior.

During Mr Cruciani’s tenure at Capital Health System in Beth Israel, New Jersey, and Drexel University in Pennsylvania, there were red flags, according to several civil lawsuits and interviews with six former patients who sued him.

When Mr. Cruciani saw the female patients, there was no attendant in the room and he resisted requests for a nurse or attendant. According to the claims of former patients, from time to time he takes the patient with him to the room and locks the door.

One-on-one visits can take an hour or more. Patients said their appointments are usually scheduled at the end of the day, when there are very few people in the office.

A few patients said they repeatedly asked nurses or other staff members to stay in the room during consultations, but the requests were often turned down.

“If a nurse knocked on the door, she would open the door and look around,” a former patient said in an interview. “I felt like they should have known.”

According to the lawsuits, some patients informed other staff members at the hospitals where Mr. Cruciani worked, about their sexual assaults. Several patients said they left their complaint letters in hospital comment boxes to alert managers.

The husband of a patient identified in the cases as Jane Doe 8 said in an interview that he called the office of the patient attorney at Capital Health and told him about the attacks, but never got a response.

Capital Health representatives denied that many of their staff had been warned of the abuse and said the hospital had not received any complaints from patients during Mr Cruciani’s time there.

“We were shocked and saddened when these allegations emerged,” Capital Health’s press office said in a statement.

One of the first reports was made in 2005 by long-term patient Hillary Tullin, who was then treated by Mr. Cruciani for three years.

Like many women treated by Mr. Cruciani at Beth Israel Medical Center (now Mount Sinai Beth Israel), Ms. Tullin experienced severe, chronic pain, and her condition surprised other doctors.

“I went to 15 or 18 different doctors who had no idea about my problem and dismissed me as crazy,” Tullin said in an interview. Mr. Cruciani diagnosed him with full-body complex regional pain syndrome, which is not fully understood.

The doctor prescribed opioids, but Ms. Tullin did not respond to them and tried other treatments.

He also started calling her from his house almost daily, telling her about his personal and family life, that she was beautiful, and that he thought of her. She said that short hugs during office visits turned into long hugs and eventually attacks.

Ms Tullin told a Beth Israeli psychologist that Mr Cruciani had forcibly kissed her, according to the latest case. The psychologist asked Ms. Tullin if she wanted the doctor to kiss her, and then asked what she wanted her to do about it.

“I said ‘I want you to report this,'” Ms Tullin recalled. The psychologist did not.

“It was a culture of silence,” said Ms. Tullin. “I didn’t talk about it again.”

Like Mr. Cruciani’s other patients, Ms. Tullin could not find another doctor to treat her and continued to see Mr. Cruciani for medical care. Although he tried to stop the attacks, it intensified.

On January 8, 2013, a patient named Nella Vince told New York City police officers that Mr. Cruciani had been sexually assaulted several times over the years and presented evidence: a shirt with semen on it.

The police report, reviewed by The New York Times, said Ms. Vince was taking multiple medications, including methadone, and was discussing with police officers the possibility of attaching a wire to her next doctor’s appointment.

It is unclear what happened after that. The police report said that Ms. Vince stopped responding to her calls and that officers closed the case in June, saying “the complainant was uncooperative”.

Ms. Vince said in an interview that the police did not take her seriously because the doctor had no criminal record.

In late 2013, Mr. Cruciani abruptly resigned from the hospital and joined the Capital Institute for Neurosciences in Hopewell Township, NJ. They couldn’t find other doctors to take care of them, many of Mr. Cruciani’s patients followed him to the Capital, where they said he was getting more and more aggressive.

Several patients said they told nurses at Capital about the abuse. At least once, Ms Johnson said she begged a nurse to stay in the room with her, but the nurse refused.

In November 2015, Mr. Cruciani announced his resignation from his position as head of neurology at Drexel University in Philadelphia.

Mr. Cruciani began working for Drexel in February 2016, and plaintiffs in a civil case allege that he continued to prescribe high-dose narcotics and sexually abuse patients.

Little action was taken after the first complaints were made in August 2016. But by February 1, 2017, at least five patients and at least three staff had come forward, and Drexel had launched an investigation into the doctor’s behavior, according to the lawsuits. Filed in Philadelphia.

A month later, Mr. Cruciani left Drexel. Warning about the investigation, other former patients reported their attacks to police in Pennsylvania.

In September 2017, Mr. Cruciani was arrested on multiple charges of indecent assault and a single indecent exposure. However, he did come to a plea agreement that allowed him not to face jail time as long as he dropped his medical license and registered as a low-level sex offender.

The coronavirus pandemic has delayed other criminal and civil cases. A trial on charges including predatory sexual assault was scheduled for next month in Manhattan, but was delayed due to the pandemic.

Consumer advocates say Mr Cruciani’s ability to continue seeing patients despite longstanding abuse and complaints is not unusual.

“We are calling for healthcare providers to have zero tolerance for sexual abuse of patients,” said Azza AbuDagga, researcher at Public Citizen’s Health Research Group. “If this standard is not adopted, we will not be close to solving the problem.”