But many remain frustrated and confused about why the prominent rheumatologist, Dr. Derrick Todd, hasn’t faced more criminal repercussions more quickly given the vast number of accusations that surfaced more than a year ago.
The indictment last week of a former Brigham and Women’s Hospital doctor for allegedly raping two patients brought some solace for the more than 200 patients who have accused him of sexual assault.
Police in Boston and Framingham, where Todd practiced, have interviewed dozens of former patients since the summer of 2023, when Todd was forced to resign from the Brigham following an internal investigation. Former patients have filed a total of 228 civil lawsuits against him so far, alleging he assaulted them while conducting breast and pelvic exams over the past decade.
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While a Middlesex County grand jury on Thursday indicted Todd on two rape charges involving two patients at Charles River Medical Associates in Framingham, prosecutors in Suffolk County, where Todd practiced at the Brigham and Brigham and Women’s Faulkner Hospital, have yet to file charges.
A number of women have repeatedly contacted police detectives and district attorneys offices seeking information and encouraging them to criminally charge Todd.
James Borghesani, spokesman for Suffolk District Attorney Kevin Hayden, described his office’s investigation into Todd as “active,” but would not provide further details.
The cases raise complex issues that can be specific to alleged sexual assaults during medical care, which can include exams that are by their nature hands-on and invasive, and where the patient has placed their utmost trust in the doctor. Prosecutors in some cases must show the exams or how they were conducted were unnecessary for diagnosis or treatment, often by finding the right medical experts to testify the provider’s actions were unquestionably improper.
Todd, 51, pleaded not guilty to the rape charges and was released on $10,000 cash bail. Todd, who has also maintained his innocence in the civil lawsuits, signed an agreement in September 2023, with the Board of Registration in Medicine to stop practicing medicine.
He was primarily a rheumatologist, treating diseases of the bones and joints, including complex conditions such as rheumatoid arthritis that other doctors have trouble managing or even recognizing. He also saw patients as a primary care physician.
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Some key differences exist between some of the other allegations and the two cases in Middlesex County, where prosecutors brought rape charges.
During Todd’s arraignment Friday, prosecutors said both women went in for medical appointments and received pelvic exams and pap smear tests that they explicitly refused. With one patient, Todd performed pelvic floor therapy, a type of physical therapy that he admitted he was not qualified to do and to which the patient did not consent, according to court documents.
The woman said he put a finger into her vagina and would not stop when she told him to, the documents described. After a previous “demo” of the procedure, he told her “it was normal to orgasm” during the therapy, according to the prosecution’s summary of the case.
In dozens of other lawsuits filed against Todd, women said they had consented to the pelvic and breast exams, but under false pretenses because they were not necessary to their care, even though Todd insisted they were. In these circumstances, prosecutors likely want an expert rheumatologist to testify the exams were well outside the normal course of care; moreover, the expert must be someone who does not know Todd or his wife, who also practices rheumatology in Massachusetts. Prosecutors are now searching outside the state, according to an attorney familiar with the lawsuits but who was not authorized to speak about the process.
The attorney said prosecutors in Suffolk County have sought advice from their counterparts in Michigan who won a conviction against Dr. Larry Nassar. He was sentenced to decades in prison for sexually assaulting college and Olympic athletes under the guise of medical care while employed at Michigan State University. Nassar, who also claimed his patients needed pelvic floor therapy, told the young athletes the assaults were part of his treatment to ease their muscle and joint ailments.
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Lisa Esser-Weidenfeller, an attorney who represented victims in civil lawsuits against Nassar, said prosecutors often want an expert who is “black and white” and believe the doctor’s actions were “clearly far afield,” and not a “gray area.”
After one Nassar victim went to police in 2004, law enforcement officials consulted an expert who said “it’s possible” that what he was doing was legitimate, she said. Police called in Nassar, who brought along a PowerPoint describing “his unique technique,” she said. He was not charged until 2016.
“The perfect storm has to form,” said Esser-Weidenfeller. “This is a doctor who everyone is supposed to trust and often has a very good reputation before allegations come out. People don’t want to believe they would do something like that. It usually takes a lot of people coming forward.”
That is something prosecutors clearly have going for them in the Todd case, she said. “What you do have is over 200 women telling you ‘I was assaulted.’ How do you ignore that?‘’
A number of Todd’s patients applauded the Middlesex County charges but said they do not understand why prosecutors are not moving more aggressively. One woman who has brought a civil lawsuit against Todd said he forced a breast exam on her during an appointment at the Brigham, even after she told him she did not want one and that her gynecologist had done an exam several months prior. It did not feel like a routine clinical exam, she said, questioning why prosecutors in Suffolk County have not filed charges in her case.
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“There is no doubt in my mind that a crime occurred,‘’ she said. ”It’s just so maddening.”
Karli Nee, 34, another patient who has sued Todd, said Friday she also had mixed feelings about the indictments.
“I felt a sense of relief that clearly something is being done. Then I burst into tears,’’ said Nee, who saw Todd at the Framingham medical office and Faulkner hospital. “I was so happy for those two women getting some justice. But two out of so many and counting … just thinking about what he has stolen from me personally. I am infuriated.”
The last she heard from a Boston police detective in December was that the district attorney’s office was still “sifting through records and reviewing material.”
Like many of Todd’s accusers, Nee was desperate for solutions to the unrelenting pain and numbness in her arms and hands when she began seeing him in 2022.
She said Todd performed frequent and prolonged breast and pelvic exams during her visits that were unnecessary but which he insisted were part of her medical care. She felt something was not quite right, and after her visits, she would often Google him in her car to double-check his credentials, which were impressive.
“I thought if I told anyone what he was doing to me, I would go to jail,” she said in her civil lawsuit against Todd. “It would be my word against his and I would be accused of slander.”
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Nee originally filed her lawsuit under a pseudonym, but recently decided to step forward with her name because of her frustration over the lack of criminal charges and information from investigators, whom she has regularly contacted.
Tyler Fox, an attorney in Cambridge who represents one of the women who has sued Todd, was critical of the pace of indictments, especially in Suffolk County. “Even given the number of victims, complexity of the case, and possible need for experts, indictments should have happened by now,‘’ he said. “If justice is not swift and certain and complete, doctors will feel free to continue to perpetrate these crimes.“
Fox called on Governor Maura Healey’s office and Attorney General Andrea Campbell’s office to step in and assist prosecutors. In the Nassar case, the Michigan attorney general’s office became deeply involved, Esser-Weidenfeller said. “The AG has more resources, more money, more attorneys, more investigators,” she said.
Another patient who has sued Todd, identified in court documents as Jane Roe #1, said in an email shared by her attorney that she was “overwhelmed with relief and sadness” after the indictments on Thursday. “This has been a long journey, almost a year and a half of waiting and hoping for justice.‘’
Beyond criminal charges, the woman also called for a “complete evaluation regarding how a leading doctor at one of the top hospitals in the world was able to carry out the despicable practice of sexual abuse of this size and scope and go unchecked for over 10 years.” She declined to be identified in order to protect her privacy.
“I am left with many questions and frustration,” she said.
Liz Kowalczyk can be reached at lizbeth.kowalczyk@globe.com.
Dr. Derrick Todd accusers angered by pace of rape charges against him
