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Did witnesses fail USC women in care of ‘predator’ gynecologist?

USC and a former gynecologist there are facing a number of lawsuits.

As lawsuits mount against the University of Southern California and a former gynecologist who worked at the school, so do the outrage and demand for answers.

Mixed into the conversation is this: If nurses or medical assistants serving as chaperones witnessed Dr. George Tyndall inappropriately touching and treating students, as some have claimed, what’s the point of chaperones?

A recent investigation by the Los Angeles Times revealed decades of allegations of inappropriate behavior by Tyndall. A 2016 USC investigation led to a suspension with pay, the Times reported, but he did not leave the university until June 2017, after he signed separation papers and agreed to retire.

The more than 20 former and current USC employees interviewed, and numerous complaint documents reviewed, included accounts from chaperones who were in the exam rooms, the paper reported.

One lawsuit filed Monday on behalf of four former students calls Tyndall a “serial sexual predator” and backs the contention that chaperones were aware of what was happening.

A chaperone was there and “deliberately looked away” when Tyndall penetrated Jane Doe 1’s vagina “with his entire hand, up to his wrist … without a glove,” the complaint reads.

A chaperone was there and “took no action to prevent or report Tyndall’s sexual abuse” when Jane Doe 2 was told to strip naked, was groped and asked “whether or not she had ever swallowed semen before,” the documents say.

They also say that because a chaperone was there, Jane Doe 3 “trusted that Tyndall had provided her with legitimate medical treatment” when he repeatedly penetrated her with his ungloved fingers and refused to do the Pap smear that prompted her appointment in the first place.

And while the USC-sanctioned doctor groped Jane Doe 4, “spread her naked buttocks cheeks” and asked about her “willingness to engage in oral and anal sex,” the complaint says that the mere presence of the chaperone had helped her ignore that she was “sexually assaulted” — until stories about Tyndall’s alleged actions gained national publicity.

‘The ethical obligation’

Students and staff members, including chaperones, reportedly filed complaints about the doctor over the course of many years. Why those alarms didn’t amount to meaningful action will be a subject for courtroom arguments.

But what about those nurses and medical assistants who reportedly served as chaperones and their responsibility? What does the Tyndall story mean when it comes to them?

Nurses have an obligation “to promote, advocate for and protect the rights, health and safety of the patient,” said Liz Stokes, director of the American Nurses Association‘s Center for Ethics and Human Rights. And that obligation “transcends into chaperoning, as well.”

Though not familiar with the details of the Tyndall case and unable to know how many of the chaperones working with Tyndall were in fact nurses, Stokes said the association’s code of ethics requires that nurses “take appropriate actions” when the interests of patients are in jeopardy. “With the ethical obligation to do no harm,” nurses must report wrongdoing, including unsafe practices.

Speaking up can be difficult and uncomfortable, she said, but that’s where seeking advice from other staff members and supervisors comes in. And, she added, nurses — like any health care provider — have the authority to file complaints with licensing boards.

USC filed a complaint about Tyndall with the Medical Board of California in March, after he wrote a letter requesting his reinstatement at the university.

‘No foolproof methods’

The use of chaperones during gynecological exams is not law, but it is recommended by the American College of Obstetricians and Gynecologists, the leading professional membership organization.

“A chaperone should, at the very least, be offered,” said Dr. Sigal Klipstein, a former chairwoman of the organization’s ethics committee. And if a chaperone isn’t offered, she said, patients need to feel empowered to ask for one.

The practice started at a time when most gynecologists were men, she said, and chaperones stepped in “to make women feel comfortable and protected.”

Now, irrespective of a gynecologist’s gender, she said, the practice is still recommended.

Teenage girls often want their mothers in the room, but even then, Klipstein said, it’s best to also have “an unbiased observer.”

Chaperones exist not just for the patients, she explained; they are also there to protect physicians who might be slapped with false accusations. It is in the interest of both parties — the patient and the doctor — to have a bystander and witness present.

If that bystander in the corner sees something inappropriate, she has a responsibility to speak up, Klipstein said.

“We would expect that that would happen,” she said before reflecting on news reports about Tyndall, which seemed to be “a breakdown in the system.”

Though there are “no foolproof methods,” the system in place usually works, Klipstein said. Ob/gyns explain what they’re doing to put patients at ease, while chaperones stand by to help patients feel safe and protected.

Gynecological exams are crucial in preventing disease, diagnosing cervical cancer and protecting reproductive health. For that reason, the allegations against Tyndall — and the reported inaction of chaperones in his exam room — leave her concerned.

“I would hate for this situation to make women uncomfortable to go to the gynecologist,” she said. “It’s so important.”