This article originally appeared on ProPublica.

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Series: Breach of Trust: Utah’s Troubled Handling of Sexual Assaults

When health care workers sexually abuse their patients in Utah, survivors confront obstacles to justice: in the law, in the courts — and in the culture as a whole.

When Carmela arrived in Utah from a village in Oaxaca, Mexico, in 1998, she was a newlywed following her husband for his job and was four months pregnant with her first child. She had never seen an OB-GYN and was hoping to find one who spoke Spanish.

The doctor she found was David Broadbent. Early on, however, she said she noticed that her visits with him left her bleeding and in pain, which felt as if she had “eaten and passed a glass bottle.”

Following her appointments, she said she took warm baths to help ease that pain.

But she kept going to Broadbent, unaware that the way the doctor was treating her was unusual. Over the next 14 years, he delivered her three children, two sons and a middle daughter. Carmela trusted him because he was American-educated and spoke her language, and because she had never been told what to expect during such visits.

“I stayed for the language,” she said of why she kept seeing Broadbent despite her pain. “I stayed there because I didn’t know what a gynecologist does.”

But through the years, Carmela had her doubts about whether the pain she felt after her doctor appointments was normal. At one point, Carmela called her older sister in Mexico to ask about her own OB visits. “What do they do to you, sister?”

Her sister described her experience; no part of it involved probing of the anus or pain. “Yes, but what else?” Carmela recalled asking, hoping to understand if her experience was common. “That’s it?”

After that conversation, Carmela reasoned that the exams in Mexico weren’t as advanced.

Ultimately, the 45-minute drive to his office became too much for their family. Five years after she stopped seeing him, her perspective continued to change when her teen daughter, Ana, asked about what to expect from her first gynecological exam. Ana listened to distressing details about her mother’s visits with Broadbent, and about how those differed from other doctors Carmela had subsequently seen. And Ana began doing her own research in 2017, including reading patient reviews of Broadbent online. (Carmela and Ana are being identified only by their first names.)

“Mom,” she said, “something’s not right.”

In 2022, it was Ana who saw on the news that other women had accused Broadbent of sexual assault. Ana, now 21, worked with attorneys to make sure that her mother would be included among the 94 women who filed a civil lawsuit against him that year.

Broadbent’s attorney, Chris Nelson, has said the women’s allegations are “without merit,” but declined further comment, saying Broadbent’s lawyers will present their case in court. In the meantime, the doctor has agreed to stop practicing while police and prosecutors investigate.

The civil case will be heard on Friday by Utah’s highest court, which will decide whether to reverse a judge’s ruling that had previously dismissed it. Because their alleged assailant is a doctor, that judge decided, the case must be governed by medical malpractice rules rather than those that apply to cases of sexual assault. If the court sides with Broadbent, many of his accusers may lose their chance to sue because, under Utah’s medical malpractice rules, too much time has passed.

The central issue the justices will weigh: Were the alleged sexual assaults part of these women’s health care?

Medical Care or Sexual Assault?

When Carmela and the 93 other women filed their civil suit, they alleged Broadbent inappropriately touched their breasts, vaginas and rectums, without warning or explanation, and hurt them. Some said he used his bare hand — instead of using a speculum or wearing gloves — during exams. One alleged that she saw he had an erection while he was touching her.

The judge who dismissed their case last September didn’t consider its merits. Judge Robert Lunnen said they should have brought their case under Utah’s medical malpractice law. Instead, they had asserted that Broadbent’s painful and traumatic treatment of them was sexual assault. They want to sue him and two of the hospitals where he delivered some of their babies for civil damages.

State laws are generally silent on whether sexual assault lawsuits involving health care workers should be covered by malpractice laws, leaving courts to grapple with that question and leading to different conclusions across the country. The Salt Lake Tribune and ProPublica identified at least seven cases outside of Utah in which state appellate judges sharply distinguished between assault and health care in such cases.

Earlier this year, Utah’s legislature stepped in and passed a law affirmatively declaring that sexual assault committed in health care settings cannot be considered health care. This mandate means that a civil lawsuit in such a case does not need to be filed as a malpractice claim, which comes with more restrictive rules, such as a lower cap on financial damages for pain and suffering and a shorter window of time in which to file a suit.

But the law was not retroactive; it wouldn’t help Carmela and the 93 other women. So they appealed to the Utah Supreme Court.

Attorneys for Broadbent and the hospitals argue his alleged misconduct “arose” out of health care and, therefore, is covered by Utah’s medical malpractice law. They further argue that his actions could have been considered medically necessary.

“For example, several plaintiffs alleged that, during a scheduled gynecological exam, Dr. Broadbent inserted his fingers or a speculum into their vaginas or rectums in an abrupt or painful way,” the lawyers wrote in filings to the Supreme Court. “Because that touching occurred during a medically indicated vaginal exam, there is a question as to whether the pain the patient experienced was typical for a non-negligent version of such an exam or whether the pain was the result of negligence.”

The women argue in their lawsuit that what there is no question in their minds that what happened to them was sexual assault — not negligence or a part of their medical treatment.

The American College of Obstetricians and Gynecologists, the lead professional organization for OB-GYNs in the U.S, advises OB-GYNs to explain physical exams and only proceed after a patient consents, and categorizes touching patients’ internal genital area without gloves as a “sexual impropriety.” Those guidelines don’t address pain and bleeding.

Adam Sorenson, an attorney for the ​94 women, argue​s that what ​they experienced was not medical care, and ​he asked the justices to revive their case.

“A sexually abusive OBGYN,” he wrote in his court filings, “should receive no special treatment, protection, or leniency.”

“We Trusted Him and He Failed Us”

Carmela and several other Spanish speakers who have accused Broadbent of abuse rely on volunteer translators or bilingual family members to relay their experiences to lawyers.

For Ana, this has meant hours steeping in the details of her mother’s case. The retelling, through her voice, provided the needed details for her mother’s lawsuit.

“At every single appointment, over the course of a number of years and pregnancies,” the lawsuit states, “Broadbent would have [Carmela] undress and would feel her breasts and look into her vagina, occasionally inserting his fingers into her vagina. Then, when Broadbent went to perform a pap smear, he inserted a speculum, took a sample, and then inserted four fingers inside her, causing discomfort and bleeding. He then inserted his middle finger in [Carmela’s] rectum with a lot of force and would insert it repeatedly for a few minutes, causing bleeding and sensitivity.”

Processing this information was difficult, she said. “It was just sad. I was shocked.”

Carmela’s family home is lined with photos of her children and their accomplishments. Tucked in a closet is an album with the photos of Broadbent at the three births. The tall white man with glasses stands shoulder to shoulder with her husband, who is glowing in each picture at the sight of their newborn.

Ana describes looking at the delivery room photos as “maddening.”

“For him to be one of the first people that ever held me,” she said, “knowing what he did to my mom, that’s so infuriating.”

Mostly, Ana wants her mother to believe she is not to blame for the doctor’s actions.

“My mom feels a lot of fault that that happened to her … or why she didn’t come forward sooner,” she said.

Carmela follows the lawsuit’s every development with much attention, but it also causes her a debilitating mix of guilt and anger. That’s why she’ll be following Friday’s court arguments from home.

“I feel rage because we trusted him and he failed us,” she said. “I want this article to reach the ears of that gynecologist, for him to remember well all that he did to me when he would hurt my rectum and say it was for my own good.”