A Columbia doctor sexually abused patients for decades: Why didn’t anyone stop him?
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Written by Aaron Holmes

Edited by Gavrielle Jacobovitz, Julian Shen-Berro

Graphics by Isabel Wong

Photography by Rya Inman

Illustration by Liz Nichols

More than two dozen women have accused Robert Hadden of sexually abusing them while he was their physician at Columbia hospitals. Now, Columbia faces an unfolding lawsuit over whether it could have stopped Hadden sooner. As health experts point to shortcomings at Columbia and across the health care industry, how can the University ensure that abuse on such an egregious scale never happens again?

Content warning: This story contains graphic descriptions of sexual harassment and assault.

At first, the Columbia gynecologist seemed like a perfect match.

It was October 2009, and Marissa Hoechstetter and her husband were staring down a formidable task: trying to start a family in New York City. She had already visited a number of OB/GYN offices, but none seemed like the right fit. So, when a friend from college recommended that Hoechstetter see her uncle, an esteemed gynecologist working for Columbia’s hospitals, she was eager to set up her first appointment.

What Hoechstetter did not know then was this doctor, Robert Hadden, was a serial sexual abuser who had already harassed and assaulted patients for years under the guise of legitimate medical practice.

Throughout the three years she saw him, Hoechstetter says Hadden would subject her to increasingly invasive verbal and physical harassment, including questions with sexual innuendos and breast examinations that seemed unnecessarily long, both of which she says often took place under the supervision of chaperones and nurses employed by Columbia hospitals. While she felt uncomfortable with this behavior, she was unsure at the time whether it fell within the bounds of typical OB/GYN practice. She suspected something was wrong, but Hadden had medical expertise that Hoechstetter did not, and the silence of others in the office discouraged her from speaking up.

But in May 2012, during a postpartum checkup following the birth of Hoechstetter’s twins, she says his abuse became so flagrant that she was certain something was not right. As she lay on the examination table, she alleges that Hadden performed a pelvic examination despite not wearing gloves and, at one point, ducked under her gown and licked her. Hoechstetter left the appointment and resolved never to return to Hadden’s office.

“I just never went back,” Hoechstetter tells The Eye. “I did not tell anybody. I just froze and, ‘Oh God, that just happened, I’m never coming back here.’”

Just weeks later, on a Friday afternoon in June 2012, Hadden allegedly licked a different patient during an examination. The patient called the New York Police Department, who arrived at Hadden’s office that day and took him in for questioning. But the following Monday, Hadden returned to work and continued seeing patients at Columbia’s affiliated medical centers. He remained on clinical duty for about six weeks, after which Columbia removed him from seeing patients.

The NYPD questioning led to a district attorney investigation against Hadden, who was criminally indicted in June 2014 for sexually assaulting six of his patients. In 2016, Hadden took a plea deal from the DA’s office—he pled guilty to only two of the women’s charges of assault and was handed probation, losing his medical license but ultimately facing no jail time.

But in the years that followed, more and more women gradually began to come forward with accounts of the sexual abuse they faced as Hadden’s patients. To date, nearly 30 women say Hadden sexually assaulted them during their appointments with him under the guise of medical practice (an attorney for Hadden could not be reached).

Twenty-five of those women, including Hoechstetter, have joined a lawsuit that places blame not just on Hadden, but on the system that they believe enabled and protected his abuse. The plaintiffs accuse Columbia and its affiliated hospitals of neglecting to apprehend Hadden and, at various levels of its administration, of covering up his behavior in order to protect the institution’s reputation.

The lawsuit claims that following his indictment, patients were told Hadden was out on “sick leave.” Columbia is also accused of enabling Hadden to collect disability benefits under a claim that he is no longer working due to a medical condition. The court has ordered Columbia to release documents detailing Hadden’s retirement status, which the plaintiff’s attorney Anthony DiPietro says he expects will vindicate the allegation that Hadden is receiving disability payments (a Columbia spokesperson declined to comment on the details of Hadden’s termination).

Columbia has maintained that its agents were unaware of any complaints against Hadden until a report was made in 2012. In a statement to The Eye, a University spokesperson said that Columbia began investigating Hadden as soon as it was aware of the 2012 complaint, and that throughout the investigation “a nurse or other staff member was present with Dr. Hadden at all times when he was with patients.”

“Robert Hadden’s behavior was abhorrent, and we deeply apologize to those whom he has harmed,” the statement says.

The lawsuit comes at a pivotal moment for Columbia, which has faced a wave of lawsuits in recent years filed by female students and faculty who have alleged that the University failed to protect them from gender-based misconduct or discrimination. But the Hadden case is in many ways unprecedented—beyond the sheer scale of Hadden’s alleged abuse, this is also the largest legal action in recent memory taken against the University by patients of its hospitals, rather than by Columbia affiliates themselves.

The Hadden case also cuts to the core of a dilemma facing the health care industry, medical and legal experts argue, in light of more open conversations about sexual abuse that have emerged in the wake of the #MeToo movement: How can an industry predicated on trust in physician’s expertise and ethical judgement empower patients and lower-level hospital staff to identify and report misconduct? More broadly, how can major health care institutions like Columbia be incentivized to discipline wrongdoing without prioritizing their own reputation?

How can hospitals work to ensure a case like Hadden’s never happens again?

In interviews with The Eye, medical experts outline steps hospitals can take to better protect patients, such as empowering them to identify potential misconduct by outlining standard practices and providing avenues for patients to voice discomfort or seek a second opinion—measures that plaintiffs in the lawsuit say were not in place when they were being treated by Hadden.

“One would think that everyone in the health care system is really thinking about the patients,” says Danielle Ofri, a physician at Bellevue Hospital, professor at NYU School of Medicine, and author of the book What Patients Say, What Doctors Hear.

“A positive and negative side of medicine is that it’s a very intimate, one-on-one, closed-door affair, and so in some ways that can be a wonderful relationship,” she later adds. “And in some ways, there’s the potential for abuse.”

Everything seemed fine at first. Hoechstetter recalls that when she was just beginning to see Hadden, a few things were slightly off—she remembers abnormally long wait times for appointments and that, strangely, some pelvic exams were monitored by chaperones while others were not. But none of his early behaviors seemed like a cause for serious concern. She was further assuaged by the personal connection they shared through her college friend, Hadden’s niece. Hadden would frequently bring up this shared connection, she recalls, making small talk about seeing his niece at Thanksgiving. Looking back, Hoechstetter believes these conversations were deliberate attempts to “groom” her, to encourage her to let her guard down.

“And I remember there were times when there was nobody in the room and I thought it was strange but I thought, ‘Well, maybe it’s okay because they know that he knows me,’ or something,” she says.

Hadden’s behavior became gradually more flagrant, pushing what Hoechstetter considered the boundary between odd and inappropriate. He would allegedly barrage her with remarks about her appearance and sex life, forcing her to answer questions like how many sexual partners she had and whether her husband could “satisfy her.” Breast examinations seemed to last for unnecessary stretches of time, she says, even when chaperones were present. But up until her last appointment, Hadden’s professional esteem and the lack of intervention from chaperones (when they were present) made Hoechstetter question whether his behavior was actually inappropriate.

“I would not have kept going [to see Hadden] if I had any reason to believe that that was happening, either to me or to anybody else,” she says.

Aspects of Hoechstetter’s story resemble experiences of the other 24 women who are part of the lawsuit (Hoechstetter is the only plaintiff who is not anonymous, allowing her to speak openly about the case). Each of the women in the suit began seeing Hadden as patients and immediately noticed odd behavior that gradually transitioned into more extreme harassment and assault.

Multiple plaintiffs accuse Hadden of touching them inappropriately, licking them, performing intimate examinations without gloves, and inflicting unnecessary pain during surgical procedures. In most of the cases, Hadden allegedly told women they needed routine pap smears, sometimes as frequently as every three months (the U.S. Department of Health and Human Services recommends getting a pap smear every three to five years). One plaintiff, referred to as Jane Doe #19, alleges that Hadden ignored her pleas to administer anesthesia during labor and childbirth.

The timeline presented in the lawsuit indicates that Hadden’s abuse went on without intervention for decades. The earliest plaintiff saw Hadden beginning in 1993, and two others saw him in 1998. Most plaintiffs were unaffiliated with Columbia, though one was a Columbia alumna and another was a Columbia student while she was Hadden’s patient. Two of the plaintiffs were just 15 years old when Hadden first abused them, including one whom he delivered as an infant 15 years earlier.

Periods during which the plaintiffs were Robert Hadden's patients

1988

1990

1992

1994

1996

1998

2000

2002

2004

2006

2008

2010

2012

2014

2016

Jane Doe #3

August 2012

Hadden is removed

from patient care.

Jane Doe #4

Jane Doe #5

Reported Hadden's behavior

to a Columbia administrator

after last appointment.

Jane Doe #6

Marissa Hoechstetter

Jane Doe #8

Jane Doe #9

Jane Doe #10

Jane Doe #11

Jane Doe #12

Jane Doe #13

Jane Doe #14

Jane Doe #15

Patient is born; Hadden delivers

Jane Doe #16

Jane Doe #17

Jane Doe #18

Jane Doe #19

Jane Doe #21

Jane Doe #22

Jane Doe #23

Jane Doe #26

Jane Doe #27

Jane Doe #28

Reported Hadden's behavior

to a nurse; nurse said there

was nothing to worry about.

Jane Doe #29

Jane Doe #30

Note: No time frame was provided for Jane Doe #23.

March 2016: Hadden is sentenced; he loses medical license, registers as sex offender, but does not face jail time.

Periods during which the plaintiffs were Robert Hadden's patients

1988

1992

1996

2000

2004

2008

2012

2016

Jane Doe #3

August 2012

Hadden is

removed from

patient care.

Jane Doe #4

Jane Doe #5

Reported Hadden's behavior

to a Columbia administrator

after last appointment.

Jane Doe #6

Marissa Hoechstetter

Jane Doe #8

Jane Doe #9

Jane Doe #10

Jane Doe #11

Jane Doe #12

Jane Doe #13

Jane Doe #14

Patient is born; Hadden delivers

Jane Doe #15

Jane Doe #16

Jane Doe #17

Jane Doe #18

Jane Doe #19

Jane Doe #21

Jane Doe #22

Jane Doe #23

Jane Doe #26

Jane Doe #27

Jane Doe #28

Reported Hadden's behavior

to a nurse; nurse said there

was nothing to worry about.

Jane Doe #29

Jane Doe #30

Note: No time frame was provided for Jane Doe #23.

March 2016: Hadden is sentenced; he loses medical license, registers as sex offender, but does not face jail time.

Periods during which the plaintiffs were Robert Hadden's patients

August 2012

Hadden is removed

from patient care.

1988

1996

2012

2004

Jane Doe #3

Jane Doe #4

Jane Doe #5

Reported Hadden's

behavior to a Columbia

administrator after last

appointment.

Jane Doe #6

Marissa Hoechstetter

Jane Doe #8

Jane Doe #9

Jane Doe #10

Jane Doe #11

Jane Doe #12

Jane Doe #13

Jane Doe #14

Patient is born; Hadden delivers

Jane Doe #15

Jane Doe #16

Jane Doe #17

Jane Doe #18

Jane Doe #19

Jane Doe #21

Jane Doe #22

Jane Doe #23

Reported Hadden's behavior to a nurse; nurse said there was nothing to worry about.

Jane Doe #26

Jane Doe #27

Jane Doe #28

Jane Doe #29

Jane Doe #30

March 2016: Hadden is sentenced; he loses medical license, registers as sex offender, but does not face jail time.

Note: No time frame was provided for Jane Doe #23.

Periods during which the plaintiffs were Robert Hadden's patients

August 2012

Hadden is removed

from patient care.

1988

1996

2012

2004

Jane Doe #3

Jane Doe #4

Jane Doe #5

Reported Hadden's behavior to a Columbia administrator after last appointment.

Jane Doe #6

Marissa Hoechstetter

Jane Doe #8

Jane Doe #9

Jane Doe #10

Jane Doe #11

Jane Doe #12

Jane Doe #13

Jane Doe #14

Patient is

born; Hadden

delivers

Jane Doe #15

Jane Doe #16

Jane Doe #17

Jane Doe #18

Jane Doe #19

Jane Doe #21

Jane Doe #22

Jane Doe #23

Reported Hadden's behavior to a nurse; nurse said there was nothing to worry about.

Jane Doe #26

Jane Doe #27

Jane Doe #28

Jane Doe #29

Jane Doe #30

March 2016: Hadden is sentenced; he loses medical license, registers as sex offender, but does not face jail time.

Note: No time frame was provided for Jane Doe #23.

Five of the plaintiffs were Hadden’s patients up until he was finally removed from patient duty in August 2012. According to DiPietro, several of these women were sexually abused by Hadden during the weeks that he remained employed after the day NYPD were called to his office.

A series of studies by medical professionals points to potential answers to the difficult questions posed by cases like Hadden’s. An academic study published in the Journal of Medical Regulation in December and a publication by Public Citizen this month both outline the need for clear policies for reporting forms of physician sexual abuse and for tracking wrongdoing and disciplinary action taken against physicians in a database that potential employers at other health care providers could access.

The Columbia Code of Conduct outlines policies and procedures for faculty and staff to report misconduct: Staff are instructed to report troubling activities to their supervisor or, if their supervisor is involved, to the next supervisory level to prohibit retaliation against those who report. But it does not clarify procedures by which patients, who are not University employees, could internally report troubling conduct.

“In the system itself, the cards are all stacked against the victim, against the patient. The physician has clout, has status, and for anything to happen it typically will take dozens of accusations,” Azza AbuDagga, one of the authors of the Public Citizen publication, says. “We need these safeguards for patients, and they should be at multiple levels, including educating patients, training for providers including bystander reporting, and ways to encourage reporting.”

All 25 of the plaintiffs in the lawsuit expressed uncertainty about the role chaperones were meant to play in the OB/GYN practice. The presence of chaperones wavers throughout the women’s testimony—in some instances, chaperones were present and seemed indifferent to Hadden’s inappropriate behavior; other cases describe Hadden “outmaneuvering” chaperones or delaying appointments until chaperones were unavailable; some plaintiffs allege that entire examinations were conducted with no chaperones present at all.

“The nurses were never consistently there. There was no definitely no signage or commitment to what the office should be like,” Hoechstetter says.

She adds that she doesn’t remember receiving any written or spoken information about her right to have a chaperone in the room during the examination, her rights as a patient, or any other information about standards for OB/GYN practice. A statement provided to The Eye by a CUMC spokesperson says that all patients are informed of the New York State Patients’ Bill of Rights when they are first admitted—Hoechstetter says that, if this was among the paperwork she was handed as a new patient, it wasn’t emphasized or made clear enough for her to remember it.

According to a Columbia spokesperson, it is the OB/GYN department’s policy that chaperones be present in the room during all examinations. But none of the women involved in the lawsuit were explicitly made aware of this policy, according to DiPietro. Referencing Columbia’s public statement that Hadden was always accompanied by chaperones during the six weeks he was under investigation in 2012, DiPietro questioned the effectiveness of the policy.

“Guess what? Some of these women were sexually assaulted after the police came to apprehend him,” DiPietro says. “So where were these chaperones?”

And merely having chaperones present isn’t sufficient to ensure an effective chaperone system, according to experts.

“As a general preventive measure, chaperones can offer patients some protection. But chaperones must be trained—trained to observe carefully, to know when an intimate exam is needed, and how it should be conducted,” James DuBois, a professor of medicine at Washington University in St. Louis and co-author of the Journal of Medical Regulation study, says. “Otherwise, sexual abuse can occur in front of chaperones—something that many people find surprising.”

The alleged failure of Columbia’s chaperone policy isn’t the only shortcoming that survivors of Hadden’s abuse outline. In every case, Hadden is described as a master of manipulating patients’ understanding of medical procedures and taking advantage of their lack of expertise to pretend his assaults were legitimate health care practices.

Specific policy recommendations offered by experts highlight gaps in current practices at Columbia’s affiliated hospitals. Patients should be clearly informed about standard procedures and their patients’ rights, according to experts—two resources that Hadden’s former patients say they never received from Columbia.

“Oftentimes in my research reviewing OB/GYN cases, many of them thought that this was part of a normal procedure,” AbuDagga says, noting that, for instance, there should be standard guidelines for examinations that are made explicit to patients.

Explicitly telling patients that a chaperone should be present and that physicians should always wear gloves, for instance, might have prevented Hadden from taking advantage of patients’ lack of knowledge of standard practices.

Experts also recommend a patients’ advocate position who can serve as an ombudsman for patients who think something went wrong with their treatment—this position exists in other NYC-area hospitals, but not at Columbia Presbyterian. At Bellevue Hospital, the Patient Advocacy Office serves as a resource for patients or their families to express complaints when they’re unsatisfied with responses from the doctors and nurses treating them.

According to a CUMC spokesperson, the medical center doesn’t have a specific phone number or avenue for patients to express concerns or seek a second opinion, but patients are able to voice concerns using the general information number listed on the medical center’s website.

“The medical center has a written policy that ensures complaints regarding patient care are promptly investigated and responded to,” a statement from the CUMC spokesperson to The Eye reads, without providing further specifics.

Ofri believes it can be inherently difficult for patients to delineate between acceptable and unacceptable behavior on the part of a physician given their lack of expertise, but providing patients with more avenues to voice discontent could help empower them to identify and report unethical behavior by physicians.

“It’s a very subtle thing to educate people about, so I don’t have an exact answer, other than providing people with, if something feels wrong, here’s an avenue to explore that and find out,” Ofri says.

Take a taxi down FDR Drive on the east side of Manhattan and you’ll see why doctors jokingly refer to the area as “Bedpan Alley”—dozens of hospitals, clinics, doctor’s offices, and boutique practices scatter the neighborhood. From 90th to 30th Street, the view from the highway is a mosaic of brutalist high-rises and sans serif medical advertisements vying for the attention and trust of health insurance policy-holding New Yorkers.

Columbia physicians see patients at several locations on the Upper East Side alone, including offices on 68th, 60th, and 53rd Streets. More than 1,800 Columbia-affiliated physicians see patients regularly through the University’s affiliation with NewYork-Presbyterian Hospital, ranked by U.S. News as the number one hospital in New York, and the prestige of both organizations is touted as a selling point to potential patients.

The sense of competition between major health care institutions in New York is palpable, according to experts, and incentivizes hospitals to distinguish themselves as trustworthy and prestigious: “It’s a medical arms race all along Bedpan Alley,” Ofri says.

NewYork-Presbyterian/Weill Cornell Medical Center on East 68th Street

Accordingly, hospitals tend to be as quick to promote their successes as they are to de-emphasize their failures. In the wake of Hadden’s criminal conviction, Columbia has done little to retroactively inform Hadden’s patients that he was an abuser. Of the 25 women involved in the lawsuit, none of them say they received any communication from Columbia regarding Hadden’s dismissal—no information about his removal itself, let alone the reasons for it.

Hoechstetter first learned of Hadden’s dismissal months after the appointment that convinced her never to return to Columbia. She recalls making a phone call to his office to request a refill on her birth control and being informed over the phone that Hadden was no longer employed there. Shortly after, she recalls learning from her friend, his niece, that somebody accused him of assault. Suddenly, Hoechstetter began to realize that Hadden was a sexual abuser: “It put everything together for me,” she says.

Despite Columbia’s apology to survivors of Hadden’s abuse in its statements to the press, Hoechstetter expressed frustration she was never directly contacted with any form of apology or statement of regret from the University.

“I think they could be much more upfront,” she says. “You don’t want to expect that something like this happens, but what are they going to do to make sure it doesn’t happen?”

In many cases, health care institutions are reluctant to broadcast wrongdoing out of legal caution.

“A lot of times these institutions fear litigation if they reveal the reason a physician has left,” AbuDagga says. “It can be a black box.”

According to experts, a failure to be open and forthcoming about details of Hadden’s abuse may seem like a safe option but could ultimately damage Columbia’s reputation.

“I feel that if a hospital were to say, you know, one of our thousands of staff was a bad apple, it might actually engender more trust in these institutions. But it’s hard to convince a PR team of that,” Ofri says. “Why would they want to go public and say, ‘Hey, one of our doctors was really awful?’ So I’m not surprised. I’m disgusted, but not surprised.”

In cases like Hadden’s, however, an institution’s reflex to protect its reputation is not the only factor that could inhibit action to stop an abusive doctor. Given the intimate nature of medical practice, those who are most likely to witness ethical violations are those in lower-level positions like nurses, assistants, and residents who may find themselves unable to speak up due to the hierarchical nature of the field.

“The hierarchy is so entrenched, and it often feels futile. Do you want to rock the whole boat, especially if it's somewhat vague?” Ofri says. “That puts the onus on someone who’s often low-paid, at the lower end of things, to make this decision all by themselves.”

Experts point to a need for sweeping changes in workplace culture across hospitals, where top brass are typically reluctant to admit wrongdoing or openly discuss uncomfortable issues like sexual assault. According to Emily Anderson, a professor at Loyola University Chicago who specializes in health care ethics and co-authored the JMR study published in December, these difficult conversations need to be initiated from the top down in order to effect change.

“It’s obviously difficult for individuals who have been affected by sexual misconduct to report it. But I also think because of discomfort around sex, it’s difficult for organizations to talk about it and therefore make effective policies and adequately investigate cases,” Anderson says. “It’s easier and more comfortable—in the short term—for those in leadership to just ignore the problem or pretend it isn’t happening.”

Hospitals across the country have been slow to implement meaningful changes to address sexual misconduct. (“I have not seen any evidence that hospitals are doing more to prevent sexual misconduct by physicians,” DuBois says.)

Hadden’s alleged abuse is a clear outlier, on both a local and national scale. But as the sheer scale of his abuse illustrates, one “bad apple” can result in harm to dozens of patients if abuse is allowed to continue unchecked.

As demonstrated by experts and survivors alike, Hadden’s abuse cannot be separated from its context. He allegedly made use of loopholes and operational shortcomings whenever possible to continue his abuse without retribution for decades. Without being equipped with the resources or knowledge to identify his breaches of medical standards, survivors continued to return to him for years without speaking out, and despite the near-constant presence of chaperones and other hospital staff, Hadden never faced a formal investigation by Columbia until police opened a criminal investigation against him.

As the ongoing lawsuit unfolds, more details will surface that will shine light on the extent to which Columbia’s agents were aware (or unaware) of Hadden’s abuse before his termination. But even with these facts aside, experts researching the prevalence of sexual abuse in hospitals have a clear message for Columbia and peer institutions nationwide: Without radical changes from the top down, institutions will be unable to ensure that a case like Hadden’s never happens again.

ColumbiaDoctors East Side Associates

Until recently, Hoechstetter couldn’t look at her twins’ birth certificates without seeing his name. Day-to-day acts of parenting like enrolling them in pre-K or signing them up for summer camp were tinged by the printed reminder of Hadden’s abuse, his name listed below her children’s on their birth certificates as the obstetrician who delivered them.

For years, Hoechstetter tried to have his name stricken from these records, but city health codes prevented her from pursuing official changes on the birth certificates without evidence of a factual error. Through her attorney, she asked Columbia if there was anything they could do to petition the city to change the certificates, but she says she didn’t hear anything back.

So, Hoechstetter took matters into her own hands—she met with city council member Mark Levine, who drafted a bill to amend the city’s codes to allow for changes in cases like Hoechstetter’s.

On a warm morning in late March, Hoechstetter sat in the sun-streaked chamber of City Hall, beside her husband and seven-year-old twins, and watched as the council ratified the bill that resulted from her story. For Hoechstetter, the passage didn’t just signify a new legal pathway to change her children’s birth certificates; it was also the first sweeping institutional acknowledgment of the magnitude of abuse experienced by Hadden’s patients. Since then, a similar bill has been introduced in the New York State Assembly.

“It’s an acknowledgment of what happened to me and other women, something that I think the city and institutions that employed and enabled Hadden have so far failed to do,” she remarked in the City Hall lobby later that day.

“At points it felt like a crazy ask, but I just kept thinking there has to be some way to do this,” she added. “I didn’t want to give up.”

Survivors of sexual assault can contact the RAINN hotline for confidential support and resources to assist with next steps. New York State encourages anyone with information about a physician’s misconduct to file a report with the Department of Health.

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