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The top doctor at Hawaii’s only comprehensive medical rehabilitation hospital was fired this year after allegations of sexual misconduct, including sexual assault on hospital premises.

Dr. Jason Chang was the chief medical officer at the in Honolulu. He was fired from the top job in June after two women filed complaints against him for inappropriate conduct and sexual harassment. He quickly sued the hospital. After a judge ruled against him, Chang resigned his physician privileges.

Chang’s alleged sexual misconduct set off a chain reaction that affected hundreds of patients and continues to hamper the hospital’s ability to serve patients.

An entire hospital division dealing with medical equipment shut down in mid-April when both complainants went on leave. The hospital’s chief executive officer says at least 200 patients were affected by the staff exodus when their cases were left in temporary limbo. The hospital has stopped doing intake for some services, so the actual number of affected patients could be even higher.

“What happened continues to limit our ability to provide certain services in the outpatient clinic,” says Timothy Roe, the hospital’s CEO. “Those services haven’t been re-established yet. We’re still scrambling. We’ve made some adaptations which allows us to cover some of the activities of that area but not all.”

“It was a big loss for the hospital, a big loss for the victim and a big loss for our patients. There’s just no question about it.”

(Civil Beat is not naming the specific hospital division affected due to privacy concerns for the alleged victim, who is not named in a lawsuit between Chang and the hospital.)

Chang admitted to having an inappropriate sexual relationship with a subordinate on hospital grounds but maintains that it was consensual. An independent investigator hired by the hospital concluded the relationship was more than likely non-consensual.

Although Chang was fired from his job as chief medical officer, he resigned his role as a physician at the hospital. He continues to practice medicine at , another health center with an office less than a mile away from his previous employer, according to Ashley Bass from the human resources office at the medical facility.

The woman who alleged sexual harassment is still on a leave of absence, Roe said.

Eric Seitz, an attorney for Chang, said he would pass on Civil Beat’s request for comment but said that the doctor was unlikely to comment. An attorney for the alleged sexual misconduct victim declined to comment.

What Happened

The Rehabilitation Hospital of the Pacific is the only hospital in the state to provide comprehensive specialized care to patients whose medical conditions have stabilized but are still in recovery. Patients may be recovering from strokes, accidents, surgeries or other major injuries or illnesses. Teams of medical professionals work to help patients regain their independence through physical therapy, occupational therapy, speech therapy and recreation therapy.

Roe says he first learned about the allegations against Chang on March 13 when two employees filed complaints with the hospital’s human resources department.

One employee alleged inappropriate behavior and the second alleged sexual harassment. The hospital hired Honolulu attorney Susan Ichinose to investigate the claims.

In her report, Ichinose wrote the employees “alleged that for the past 2-3 years they have been subject to intimidating, invasive and inappropriate conduct by Chang. He is alleged to have frequented their offices dozens of times, disrupting their work, regaling them with boasts of his power and authority, lingering for up to an hour at a time with no business purpose.”

According to the report, Chang acknowledged interrupting their work on dozens of occasions for hours at a time three to five days per week.

Ichinose concluded Chang failed to observe that his interruptions were not welcome and that due to his authority he has the power to “potentially affect the jobs and careers of subordinates.”

Ichinose wrote it’s more likely than not that Chang hurt the women’s work performance and caused job stress.

The second woman alleged Chang sexually harassed and assaulted her at work. Chang contended it was a consensual affair with a subordinate and acknowledged he engaged in sexual activity on hospital grounds. Chang acknowledged the relationship as inappropriate but said it wasn’t harassment.

He said that the affair began at a Kakaako bar and that his colleague “was often, if not usually, the one to initiate sexual activity,” according to a letter sent to hospital officials by Chang’s attorneys William Ota and Leighton Hara.

But Ichinose concluded “it is more likely than not that the sexual activity was unwelcome and imposed … without her actual consent,” and “it is more likely than not that (the complainant) experienced distress, anxiety and humiliation as a result of Dr. Chang’s sexual conduct.”

Ichinose wrote that the unwelcome sexual activity included intercourse.

Delays In Care

The alleged sexual misconduct had major ripple effects. Three months after the affected department closed, more than 100 patients were waiting for services and medical equipment, according to a June 10 letter by Roe detailing the fallout.

The division’s closure also affected 79 physicians and health care clinics who work closely with the hospital, Roe wrote.

“REHAB currently receives one to four calls a day from patients and their caregivers asking for our assistance with the medical equipment vendors and insurance payers because of their concerns resulting from a lack of responsiveness or transparency with the status of the purchase of the much-needed medical equipment,” Roe wrote. “There are limited other resources in Hawaii which further complicates the process.”

Last week, Roe told Civil Beat that the affected hospital division is still closed. He now estimates about 200 patients have been impacted. The number may be higher given that the hospital has stopped doing intake for certain services.

“We had to really scramble to cover our patients’ needs,” he said.

Roe didn’t want to specify the exact services that aren’t being provided due to concerns about the complainants’ privacy.

But he said, “For patients with certain types of disability we may be the only provider in the state providing these services. It has a ripple effect all the way down the line.”

Some patients faced delays in care for up to two months.

“You can lose one or two providers and all of a sudden those services are no longer provided in the state,” Roe said.

Chang’s departure was also tough for the hospital, given Hawaii’s statewide physician shortage.

The hospital hired another physician to serve as chief medical officer, but Roe says other medical providers had to pitch in to make up for the work Chang used to do regarding inpatient care.

The Fallout

After getting fired from his role as chief medical officer and suspended as a physician, Chang unsuccessfully sued the hospital to prevent them from reporting him to a national oversight organization.

A federal judge ruled against Chang. His attorney, Seitz, told Civil Beat that Chang dropped the lawsuit after he and the hospital agreed to specific wording for the hospital’s report to the National Practitioners Data Bank.

The hospital also reported Chang to the state Regulated Industries Complaints Office. Esther Brown, the state complaints and enforcement officer, said Monday that the complaint against Chang is still under review.

She doesn’t know when the investigation will be complete, although she said RICO tries to prioritize complaints related to sexual harassment. She couldn’t say how long those types of investigations generally take — RICO doesn’t have any required deadlines for finishing its reviews and the agency still relies on an outdated software system for managing its complaints.

Roe said the hospital followed the law by reporting Chang to both the state and federal licensing organizations but has not said anything to Chang’s newest employer.

Roe said the hospital takes what happened very seriously and has zero tolerance for sexual harassment.

“I’m very conscious of how important it is that everyone in the hospital work together as a team. Obviously an environment in which this kind of behavior is occurring is not an environment where people can work together as a team,” he said.

He noted that as a federal contractor, the hospital is required to follow certain regulations regarding both due process for Chang and working conditions for his accusers.

Both Chang and the employees who complained had gone through anti-sexual harassment training while working at the hospital. While the hospital didn’t update its training in response to what happened, Roe said the hospital was already planning to expand its training when the complaints came to light. The hospital now requires in-person training for all employees.

“When this happened we felt that the plans we had put together were still appropriate in terms of trying to respond to this,” he said. “We were able to roll out these enhancements in a timely manner.”

Roe said it’s frustrating it took so long for the complaints to come to light. He pointed to a recent survey saying most Hawaii workers don’t report sexual harassment.

“We try to meet or exceed the industry standard in regard to how we handle these types of situations. It’s very frustrating to find ourselves in these circumstances,” Roe said, adding: “We know that we can always do better.”