Johns Hopkins Hospital has agreed to pay $190 million to settle claims from thousands of women who may have been surreptitiously recorded during pelvic exams by gynecologist Dr. Nikita A. Levy.
The amount of the settlement is one of the largest on record involving sexual misconduct by a physician. Levy, a doctor in the Johns Hopkins Community Medicine system for 25 years, took his life in February 2013 during an investigation that revealed he was using tiny cameras concealed in pens and key fobs to record patients.
Investigators found more than 1,300 videos and images during searches of Levy's home and office. Plaintiffs' attorneys estimate more than 8,000 patients could have a claim.
Because the women could not be identified from the images, all former patients could be considered victims. Anyone treated by Levy has been affected by a feeling of "betrayal" and an invasion of doctor-patient confidentiality, said Jonathan Schochor, the lead attorney for the patients.
"Many of our clients still feel a betrayal and lack of trust and have fallen out of the medical system," Schochor said. "They stopped seeing their doctors, they stopped taking their children to doctors. They refused to see male OB-GYNs, or any OB-GYN.
"Their lives, needless to say, have been severely and negatively impacted," he said.
In a statement, Hopkins said the settlement would be paid through its insurance policy and "will not in any way compromise the ability of the health system to serve its patients, staff and community."
"It is our hope that this settlement, and the findings by law enforcement that the images were not shared, helps those affected achieve a measure of closure," the hospital statement read.
Donald L. Devries Jr., an attorney for Hopkins, acknowledged that Levy had committed a "colossal breach of trust" but emphasized that the doctor was a "rogue employee" whose actions could not have been flagged by the institution.
"There was no inkling of it," Devries said. "It's one of those situations where no matter what rules or regulations or whatever you put in place, if somebody wants to violate it secretly as this physician did, there's not a thing that institution is going to be able to do to know that."
Howard Janet, another plaintiffs' attorney, disputed that, saying Levy's actions occurred within the scope of his employment as a physician working for Hopkins.
"Our position is that if it's something they didn't know, it's something they should have known," Janet said.
While industry experts said Hopkins, a multibillion-dollar operation, would be able to absorb any financial hit, hospital system officials might be more cautious in hiring decisions, especially in affiliated settings that carry the Hopkins banner — and benefit from its credibility and resources.
"That's what the hospital brand name means to the consumer," said Mark Pauly, a professor of health care management, business economics and public policy at the Wharton School of the University of Pennsylvania.
Hopkins might have settled to avoid more liability, said Tom Baker, a professor of law and health sciences at the University of Pennsylvania Law School. "You don't pay $200 million unless you thought you had a risk of losing quite a bit more than that," he said.
Levy, who was 54 at the time of his death, practiced in East Baltimore under the arm of the Johns Hopkins Community Physicians, where he served largely low-income residents of the area. A Jamaican-born New Yorker, he was married and had three children, and had a reputation among some patients as willing to go above and beyond to provide care, such as driving through a snowstorm to deliver a patient's child.
In court, plaintiffs' attorneys alleged that Levy "engaged in doctor-patient boundary violations during the course of his patients' treatment," including "an excessive number of unnecessary pelvic exams and engaging in inappropriate physical contact." Some patients said Levy practiced without medical professionals on hand as observers. Observers are used routinely in hospitals for the safety of patients and doctors.
Kim Hoppe, a spokeswoman for Hopkins Medicine, said hospital officials had "redoubled our efforts to uphold the highest standards of patient privacy."
"We have implemented numerous steps to educate, inform and empower our staff to identify and alert us if they have any concerns," she said in an email. "We also conducted a comprehensive initial inspection of our facilities and continue to conduct random inspections."
Schochor said settlement negotiations had been continuing for months until Friday, and attorneys received word Monday that Circuit Judge Sylvester B. Cox had granted preliminary approval of the agreement.
Attorneys from both sides plan to work with outside experts over the next few months to determine how to calculate individual patient payouts. Schochor said each plaintiff will be evaluated by a "team of professionals," including a psychiatrist. The plaintiffs will then be placed into one of four categories, based on the degree to which they were affected; attorneys declined to provide more details.
Neither side sought to determine which patients were pictured in the images found in Levy's possession, to avoid further privacy violations. The images were of sex organs and did not show faces.
"Because we don't know and never will know who was actually videotaped or photographed, no one's in a position to put at ease the minds of Dr. Levy's patients that they were not" recorded, Janet said.
The next hearing in the case is scheduled for September. Additional patients who believe they have a claim to the settlement will be allowed to come forward until November, Schochor said.
It was not clear how much of the settlement the attorneys will receive; Schochor said that would be decided by the judge.
In a class-action lawsuit involving a Delaware pediatrician convicted of recording assaults on hundreds of children that led to a $123 million settlement in 2012, attorneys received 22.5 percent of the total payout.
Levy was terminated by Hopkins on Feb. 8, 2013, after allegations of secret surveillance were brought to the attention of hospital officials by a female colleague who had become suspicious of the pen he wore around his neck. Within days, his Towson-area home was searched by police.
He was found dead Feb. 18. He left a letter of apology to his wife before wrapping a plastic bag around his head and pumping it with helium.
Among the items seized from Levy's home and office were six cameras concealed in pens and two cameras concealed in fobs, which can be attached to key chains. Police also seized four computers and several external hard drives.
After Levy's death, authorities continued investigating his activities in an attempt to learn the scope of the criminal activity and determine whether images were shared with others. A spokesman for the Baltimore state's attorney's office said earlier this year that authorities had concluded Levy was acting on his own.
Mark Cheshire, the spokesman, also said at that time that investigators determined Levy had not recorded underage patients. But Janet, the plaintiffs' attorney, said Monday that 62 underage victims were identified. Police did not respond to questions about the discrepancy.
Plaintiffs' attorneys also expressed skepticism that Levy acted alone; Schochor and Janet said the plaintiffs hired a "profiler" who said that those who engage in this type of conduct are "prone to disseminate" their images. They acknowledged, however, that no such evidence was uncovered by investigators.
Baltimore Sun reporters Scott Dance, Colin Campbell and Nayana Davis contributed to this article.Copyright © 2014, The Baltimore Sun