Indian Health Service Declines to Release Report on Sexual Abuse

One of Stanley Patrick Weber's victims testified about his abuse at both of the pediatrician's criminal trials.

One of Stanley Patrick Weber's victims testified about his abuse at both of the pediatrician's criminal trials.

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February 20, 2020

The U.S. Indian Health Service says it can’t disclose a report that identifies the officials responsible for mishandling a government pediatrician who abused Native American boys for decades, citing a law meant to protect medical reviews.

That stance has angered relatives of the pediatrician’s victims, tribal members and former agency employees who hoped the report would provide a public reckoning and greater accountability for those who didn’t do enough to protect Native American children.

“I don’t think they want change, or are capable of it,” said Chris Boy, the stepfather of a Montana man who testified that the doctor had sexually abused him. “They’re just going to learn how to hide stuff better.”

The IHS, which provides health care to 2.6 million Native Americans, commissioned Integritas Creative Solutions LLC to do the review soon after an investigation by The Wall Street Journal and FRONTLINE showed agency officials had missed warning signs, punished whistleblowers and — despite their suspicions — transferred the pedophile, Stanley Patrick Weber, from one reservation to another before he retired in May 2016.

Weber was sentenced to five lifetime prison terms last week, following convictions for sexually abusing six boys on two reservations. Days later, court records revealed another IHS doctor had been indicted on charges of sexually abusing adult women at a different South Dakota government hospital, ratcheting up pressure on the agency to publicly address abuse at its facilities.

Lawyers for the doctors declined to comment or didn’t respond to inquiries.

The Integritas investigators gathered a detailed account of how specific IHS officials ignored explicit warnings — including in one case, a state medical board investigation of Weber — allowing him to continue practicing, and how concerns about the doctor spread more widely across the agency earlier than previously known, according to people familiar with the matter.

Last month, the IHS said it is committed to transparency, but that records such as the report “are protected from public disclosure.” In a statement Thursday, the IHS cited a broad interpretation of the law it says requires it to withhold the report.

Integritas won its contract in May and finished the work in January, according to contracting records and people familiar with the matter.

The IHS claim that the records can’t be disclosed hinges on a 2010 law that makes records of IHS “medical quality assurance programs” and “medical treatment review committees” confidential and privileged. It is an interpretation some legal experts question.

Most states have secrecy laws for such records, but they usually apply only to clinical reviews of the sort conducted by peer groups, such as other doctors, said William Maruca, a Pittsburgh-based health care attorney at the firm Fox Rothschild LLP. “This protection was created to encourage candor in physician self-policing,” he said.

The IHS said Thursday that a court had found the statute protecting its quality assurance records is far broader, encompassing “any activity…to assess the quality of medical care.”

However, in the court ruling the IHS cited, the judge specifically ordered the government to disclose certain records of “audits, evaluations and investigations” of particular medical providers, even though the agency claimed the confidentiality law protects them. IHS didn’t immediately respond to a request for comment about that portion of the ruling.

The Bozeman, Mont.-based Integritas team includes former law enforcement officers, among them retired U.S. Marshals, who don’t appear to have any medical or health care quality assurance experience.

Carl Caulk, Integritas’s leader, didn’t respond to inquiries.

The IHS has used the confidentiality law to withhold records before. Agency officials said in a 2018 call with a Journal reporter that a list of doctors permitted to practice at a particular hospital was confidential under the law.

The IHS told a U.S. Senate staffer earlier this month that Integritas would produce an “executive summary” of the report containing “broad findings and recommendations,” an email shows.

An IHS spokeswoman said the agency “is in discussions about publicly releasing a summary of the report and will…announce its plans soon.”

Still, the kinds of details in the full report that don’t make the summary could be valuable to the public, at a time when communities are grappling with the role former IHS officials — some of whom are still in positions in which they are entrusted with the safety of children — played in the scandal.

The Journal made a Freedom of Information Act Request seeking the full report in January. A response by the agency is due on Feb. 27.

“We deserve to know which of our people failed to protect those boys,” said Pauletta Red Willow, a social worker on the Pine Ridge reservation.

Meanwhile, several federal bodies, including a White House task force, are reviewing the agency’s patient-safety practices.

Mary Ellen LaFromboise, who was the CEO of a Browning, Mont., IHS hospital when Weber worked there in the mid 1990s, said she told Integritas’s investigators last year that the agency’s regional office, not her, had ultimate authority over personnel decisions about the doctor.

In an earlier Journal interview, she said she had reported mounting concerns about Weber’s behavior with children to regional officials, who subsequently ordered Weber’s boss, Randy Rottenbiller, then the hospital’s clinical director, to fire him.

Weber stayed at the agency, however. He was transferred from the Blackfeet reservation to a hospital at the Pine Ridge reservation in South Dakota.

Now retired from IHS, Dr. Rottenbiller said Wednesday that the investigators from Integritas had Weber’s personnel records in hand when they interviewed him. They asked about how the pediatrician was able to get hired at Pine Ridge after being removed from Browning.

Dr. Rottenbiller said he told them no one from Pine Ridge ever called him about Weber. If they had, he said, he would have told them Weber had been forced out at Browning over suspicions that he was a pedophile.

IHS provided little training on how to report misconduct and had weak controls on vetting doctors, Dr. Rottenbiller said he told Integritas investigators.

At Pine Ridge, Weber repeatedly came under scrutiny, including in 2009. Around that time, Jan Colton, then the Pine Ridge acting clinical director, said she commissioned an investigation of Weber by the IHS’s local medical staff. The medical staff report found Weber’s behavior to be “highly suspicious” but was inconclusive, a former IHS official who was involved said Tuesday.

Dr. Colton, a dentist who has retired from the agency, said she was told by an Integritas investigator to “keep quiet about” the inquiry, and that she didn’t know the answers to his questions.

Mark Butterbrodt, a former IHS doctor, said Mr. Caulk and another Integritas investigator showed him internal documents revealing that, around that same time, Weber self-reported to another IHS medical staff committee that he was separately under investigation by the South Dakota board of medicine.

One day later, according to another document Dr. Butterbrodt described, the Pine Ridge hospital’s CEO notified Weber that his credentials to treat IHS patients had been renewed.

This story has been updated.

Christopher Weaver, The Wall Street Journal

Dan Frosch, The Wall Street Journal

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