A former Johns Hopkins gynecologist, Dr. Nikita Levy, might have surreptitiously photographed or recorded the examinations of at least 9,000 patients, lawyers representing his alleged victims said Friday.
More detailed allegations emerged as attorneys in a class-action lawsuit announced that a judge had approved negotiations for a group settlement with Johns Hopkins Hospital and its medical systems. Levy, who died in an apparent suicide in February as investigators closed in, had worked at the Baltimore hospital and health system since 1988.
Potential victims included Hopkins employees who were Levy's patients, said Jonathan Schochor, one of the lead litigators among eight law firms in the class-action suit.
"They are all women who feel betrayed, women who feel violated," said Howard A. Janet, another lead attorney for the plaintiffs.
The case has shocked Levy's colleagues and many patients who recalled a caring and conscientious doctor who had delivered their children. It started when a female colleague noticed what looked like a pen camera hanging from the doctor's neck and alerted Hopkins officials.
Levy handed over several recording devices, including a similar pen camera, to investigators. They also found that Levy had stored images of women in clinical settings on 10 file servers he owned, Schochor said Friday.
Schochor and Janet say that thousands more former patients could have been victims in addition to the 3,800 who are plaintiffs — in part because of his voluminous computer storage capacity and 25-year tenure at Hopkins.
Schochor said investigative interviews in recent weeks have revealed a pattern of "sexual boundary violations" by Levy. Schochor said patients reported that the doctor had used inappropriate language during exams and that he might have made crude observations or inappropriate anatomical remarks to patients.
Patients also told lawyers that visits included inappropriate touching and unnecessary physical exams, Schochor said. Some said Levy practiced without medical professionals on hand as observers, a routine hospital practice for the safety of patients and doctors.
Levy's family did not return a phone message seeking comment Friday.
On Wednesday, a Baltimore court approved the class action, which would enable Hopkins to avoid litigation if the sides can reach a settlement. The class action will include all patients who have a claim against Levy's estate or Hopkins related to the secret recordings, according to the court order.
The court order requires plaintiffs and Hopkins officials to report back to the court on settlement negotiations in six months. If no settlement is reached, the class-action certification will be thrown out and patients would be free to pursue claims individually, according to the order.
The legal strategy was crafted with the help of Hopkins' attorneys, though the institution has not admitted wrongdoing. In a class action, one or more plaintiffs serve as representatives for a larger group that shares common facts and questions of law.
"Because of the sensitive nature of the allegations, Johns Hopkins believes that attempting to resolve the claims without protracted litigation is in the best interests of those potentially affected by Dr. Levy's conduct and will help to preserve the privacy of our patients," Hopkins officials said in a statement.
An attorney representing the hospital declined to comment.
Both sides have agreed to postpone court hearings and to mediate a settlement.
Levy patients who may be included in the class action must be identified through Hopkins billing records, the court order said.
Some former patients, such as Nichelle Wilson, are waiting for attorneys to contact them to let them know whether they will be included in the suit.
Wilson, who was suffering from a thyroid condition, said Levy first gave her a gynecological examination in October 2011. Upon learning that she had a heart condition, she said, the doctor told her that he needed to get clearance from her heart doctors before he could order a needed surgery.
In September 2012, she said, Levy gave her a second Pap smear in preparation for the operation but then ordered another one in November, saying he had to make sure Wilson "didn't have any diseases" that would conflict with the operation.
Immediately after the exam, Wilson said, Levy told her that he couldn't order the surgery because of her heart problems.
"I told him my heart failure didn't change in an hour," she said. "Everything he was saying wasn't adding up." Wilson recalled a strange pen hanging around Levy's neck during her procedures.
Hopkins officials did not respond to an email inquiring about allegations that Levy scheduled unnecessary exams.
Baltimore police and the FBI continue to review electronic images seized from Levy's home, both agencies said Friday. Plaintiffs' attorneys in the class action said they have not been given access to the evidence. Baltimore police and Schochor have said the explicit images could include patients who were minors.
Janet said many victims have expressed concern that the images might have been uploaded to pornography websites, but he said attorneys have turned up no evidence of that.
"That's one of the things they're worried about," he said.
Pursuing a settlement through a class action could help Hopkins avoid lengthy court battles that could hurt its reputation and cost it more money, said Gregory Dolin, co-director of the Center for Medicine and Law at the University of Baltimore School of Law. For the patients, it could help speed the legal process and reduce uncertainty over damages.
"When you have that sort of case, you never know what the jury's going to do," Dolin said.
Wilson, who has seen a counselor but not another gynecologist since Levy, said she preferred the quickest route to a resolution.
"Anything just to get everything over with and to get everything in the past," she said.
A settlement also would be in the interest of Baltimore's court system, which would be clogged with thousands of individual lawsuits if talks break down, Schochor said.
"It would serve the hospital by ending this disaster, certainly," he said. "It would serve the community, and it would serve the court system."
Plaintiffs listed in the class action include an anonymous patient named in court records as "Jane Doe No. 1," who first filed suit in February. Three other plaintiffs are also listed in the lawsuit as Jane Roe No. 1, No. 2 and No. 3, who all want to remain anonymous "because this is a sensitive, highly personal matter," Janet said.
A website and toll-free number will soon be set up for the thousands of patients in the class action — as well as any more of Levy's patients who believe they were victimized, Janet said.
Baltimore Sun reporter Nayana Davis contributed to this article.