The quiet handling of rape allegations at two Philly health institutions

How Jefferson and Rothman dealt with an alleged sexual assault involving an orthopedic surgeon and a medical resident.

It was almost midnight and Jessica Phillips, a doctor training in orthopedic surgery, was one of the few guests remaining at a pool party that surgeon John Abraham hosted each summer for Thomas Jefferson University medical residents at his nine-bedroom Main Line home.

Phillips sat in an Adirondack-style chair by a stone fire pit with Abraham, a Jefferson professor and division chief at the Rothman Orthopaedic Institute, a private practice whose physicians work at the university’s hospitals.

The band had packed up, and caterers had cleared the wine glasses and plates smeared with cocktail sauce. Abraham handed her a lit Cuban cigar. She later remembered being so drunk she dropped it on her pants.

The medical resident remembered little else afterward. In flashes, while in and out of consciousness, she recalled Abraham on top of her on the ornate rug in his library. She awoke in his bedroom naked and bruised, she later told multiple investigators.

In Abraham’s recollection, Phillips pulled him on top of her on the library floor, court records show, while his judgment was impaired by alcohol. Nonetheless, in a text message sent to his boss after the party, Abraham acknowledged it was “unethical” to have sex with a medical resident.

The events of the June 2018 party spurred three separate investigations and three lawsuits – all now rolling back the confidentiality that usually cloaks how major institutions handle sexual misconduct claims. The cases chronicle sex, power and money in the male-dominated world of orthopedic surgery.

Both Phillips and Abraham say they were victims. They blame Jefferson and Rothman for protecting their institutional interests despite federal regulations that are supposed to ensure sexual assault cases are dealt with fairly.

Instead, The Inquirer has found, Rothman’s and Jefferson’s leadership cut deals to limit their liability and avoid imposing the harshest penalties possible, including not filing a report to a national database designed to track physician wrongdoing.

The Inquirer examined thousands of pages of internal documents and court records, including confidential interviews, emails and text messages, that reveal how both institutions maneuvered to keep the matter quiet:

Jefferson used the threat of federal reporting requirements to force Abraham out of its hospitals while evading formal reports that would let other institutions know what happened.

Then Jefferson’s and Rothman’s leadership brokered a deal that avoided a sexual misconduct hearing and ultimately closed an investigation opened under the federal Title IX law prohibiting sex-based discrimination.

Rothman’s all-male board of directors decided not to fire Abraham. Instead, they restricted him from working in Jefferson’s hospitals or interacting with Jefferson residents. Eventually, they moved him to a hospital network not affiliated with Jefferson in New Jersey.

The Inquirer requested interviews with lawyers and officials at Rothman and Jefferson and separately emailed detailed questions outlining its reporting. Representatives from both institutions declined comment, citing active litigation.

“While we cannot comment on this specific case due to pending litigation, Jefferson investigates and takes seriously allegations of sexual misconduct,” Jefferson spokesperson Deana Gamble said in an email.

Both Phillips and Abraham are now looking for justice in the courts, with a trial beginning this week in Philadelphia’s Court of Common Pleas. Abraham sued Phillips for defamation and libel. She countersued for assault and battery. A police investigation did not result in criminal charges.

Neither Jefferson nor Rothman is a defendant in this case, but their actions are under scrutiny. Jefferson had fought in court for two years to keep secret its Title IX investigation, which both Abraham and Phillips sought to review. Jefferson finally shared its report after the Pennsylvania Supreme Court on April 26 denied its request for appeal.

Phillips, who returned to Philadelphia last week for the trial from her new home on the West Coast, said she was abandoned by the institutions and left to fight Abraham’s money and power alone.

“There was no one in the process who I felt like really cared about me,” she said in an Inquirer interview. “I was so terrified of what’s happening, happening.”

Abraham said he wants to publicly clear his name after Jefferson and Rothman damaged his career and reputation.

“It was quiet for everybody else and it was a nice, neat wrapped-up solution,” Abraham told The Inquirer. “For vindication and reparation of my career and my reputation, it was worth it to me to bring it to light.”

The party

The afternoon of June 23, 2018, clouds gave way to sun as caterers set up a poolside bar and high-top tables in the backyard of Abraham’s Gladwyne home.

Before guests arrived, Abraham asked the hired bartender to dilute his cocktails, he said in court depositions. He didn’t want to get drunk.

The orthopedic surgeon, then 43 and going through a divorce, specialized in surgically removing cancerous bones and tissues. At the time, Abraham said, he performed 400 to 500 surgeries a year at Jefferson’s flagship hospital in Center City. Court records show the Harvard- and Yale-educated doctor earned about $2 million in annual income.

Just before 2 p.m., Abraham texted a last-minute invite to his boss, Alexander Vaccaro, Rothman’s president and Jefferson’s chair of orthopedic surgery.

“Hey Alex my residents graduation party/OR [operating room] thank you party is tonight! Starting at 6pm...stop by for a few minutes if you have time!”

“John what a bummer. I’m [in] Aruba,” Vaccaro replied.

“Sounds terrible! Haha okay next time…Enjoy!”

By 7 p.m., several dozen guests mingled near the poolside bar. A few swam. As the evening wore on, some jumped in the pool with their clothes on.

Jessica Phillips walked up the long driveway in wedge-heeled sandals. The 30-year-old was at the end of the second year of her five-year residency at Jefferson. She spent her limited time outside of work with her husband of nearly five years. They were trying to conceive their first child.

She had received the party invitation in an email sent by the chief medical resident to all Jefferson residents in orthopedics. She had been to Abraham’s house once previously for a medical journal club, mandatory for residents.

On the party night, Phillips ordered a glass of red wine. Then a second, according to her court deposition.

As the party progressed, she recalled guests bringing her more drinks: A Jefferson nurse gave her a fruity mixed drink in a red cup. Abraham had two college friends from out of town at the party. One handed her a vodka tonic, then another. His other friend poured her some amber-colored alcohol from the surgeon’s liquor collection, she later told investigators.

Throughout the evening, Abraham drank two gin and tonics and a margarita.

Phillips remembers realizing she was too drunk to drive. She decided to sleep it off on Abraham’s couch.

As party-goers cleared out, one of Abraham’s friends said he saw Abraham and Phillips walking through the yard with their arms draped around one another, police and court records show.

They ended up together by his fire pit.

Abraham said Phillips brought him a glass of Irish whiskey. She insisted he drink it. When he took the glass to sniff its contents, she tipped it up to his mouth, forcing him to gulp it. He pushed the glass away, causing it to shatter, according to his account in court records.

Just before 11 p.m., one of Abraham’s friends, a fellow Harvard grad from New York, texted Abraham, “don’t do it.”

“Getting cock blocked anyway,” Abraham replied. “One of my residents so I really can’t anyway.”

He would later say that Phillips told him she wanted to have sex, according to his court depositions, and pulled him onto the floor on top of her in the library. He didn’t think it was a good idea, but his “judgment was clouded” by alcohol.

The next morning, Phillips woke up in Abraham’s bed, naked and disoriented, with him beside her.

She went to the bathroom and saw bruises all over her body, she later told investigators. She had been at the end of a menstrual cycle and panicked when she had to reach far within to find the tampon she was using.

“I knew that something very, very, very wrong had happened,” she said in a court deposition.

When Abraham went downstairs to retrieve her bra from the library, she crawled into bed and covered herself with a sheet.

He returned and climbed back in bed, she said in the deposition. He kissed and touched her, then entered her. “I was frozen,” she said.

According to Abraham, Phillips demanded sex, but he was unable to perform.

Both agreed that the interaction stopped when Abraham got a phone call.

Phillips said she quickly got dressed, ran downstairs, scooped up her sandals, caked in dirt and mud, and grabbed her purse from atop a piano. She drove home and “took the longest, hottest shower.”

Abraham said he nursed a hangover and went out to breakfast with his friends, then go-karting.

Sexual misconduct in medicine

Three days after the party, Abraham sent another text to his boss, Rothman’s Vaccaro: “I have an issue.”

“Made a big mistake,” he wrote in a text string. “Don’t think it’s illegal, just unethical .. ugh.”

When they spoke later by phone, Vaccaro recalled, Abraham said he had consensual sex with a medical resident.

In a subsequent conversation, Vaccaro told Abraham that he “very likely would be fired,” and Abraham told his boss that he would sue if they fired him, according to a document from the Rothman investigation obtained by The Inquirer.

There are rules against sex in relationships involving unequal power dynamics in medicine at every level: Jefferson, Rothman and the professional societies that set the standards for the profession.

In 2014, the American Medical Association declared relationships between medical supervisors and their trainees unacceptable, even when consensual, “because of inherent inequalities in the status and power that medical supervisors wield in relation to medical trainees.”

The professional society update to its code of medical ethics noted: “It may adversely affect patient care.”

Rothman’s partnership agreement with Abraham also stated that he could be fired for “sexual harassment or sexual misconduct.” In a copy reviewed by The Inquirer, the terms are not defined.

Jefferson’s policies at the time made clear that excessive drinking by either individual would make it impossible to consent to sex.

Jefferson’s sexual misconduct policy also prohibited “quid pro quo” sexual harassment, which includes physical contact, whether subtle or overt. It did not expressly prohibit sex between a supervising physician and a medical resident, but its ethics guidelines stated that supervisors must behave ethically or face termination.

At the time of the party, Jefferson’s faculty handbook stated that supervising physicians are expected to provide a learning environment free from mistreatment, including “exploitation of the power differential in the faculty-student relationship.”

The university’s shared code of conduct said “faculty should not use their professional position to engage in romantic or sexual relationships with students,” according to an Inquirer review of Jefferson’s archived websites.

Power and gender disparities are particularly potent in the specialized field of orthopedic surgery.

Nationwide, 7% of practicing orthopedic surgeons are women. And medical residents, Phillips said, are “at the bottom” of the hierarchy.

That’s why she initially planned to keep quiet about what happened with Abraham, who ran a hospital unit where she would have to do an eight-week rotation to achieve her years-long dream of becoming an orthopedic surgeon.

Phillips told The Inquirer that she also didn’t want to believe that she could be a victim of sexual assault.

“Surviving as a woman in this field is really hard,” she said. “It’s career suicide for us to come out and discuss these things.”

On the Sunday night after the party, while working at Bryn Mawr Hospital, a Jefferson teaching affiliate, Phillips called her husband and told him about the drinking, memory lapses, sex, bruises and the tampon.

He asked whether it was consensual. “Yes, I don’t know,” she answered, recounting the conversation in a deposition.

She told Lower Merion detectives that she “was afraid and felt that I would have to report to and work with this person moving forward,” according to her police statement.

Early Tuesday, two days after the party, Phillips said, she called Abraham to let him know that her husband, who thought she had been assaulted, wanted to talk to him. Abraham asked her to state in writing that the sex was consensual, according to both Abraham and Phillips.

Abraham suspected that the couple was trying to extort him, but the couple never explicitly asked for money, he said later in court depositions, adding that he was too drunk to consent to sex that night.

Later Tuesday, Phillips tearfully recounted her recollection of the party to James Purtill, the physician overseeing the residency program for Jefferson and Rothman.

A lawyer hired by Rothman to investigate subsequently asked Purtill whether he thought the sex was consensual. Purtill’s answer was an unequivocal “no.”

Only 0.2% of physicians – 1,354 doctors nationally – were reported for sexual misconduct in the 15 years after federal tracking of the offense began in 2003, according to a report by Public Citizen, a nonprofit consumer-rights advocacy group.

Study authors say the problem likely is much greater, because even when complainants do come forward, doctors are rarely disciplined by medical disciplinary committees made up of peer doctors, or hospital supervisors work out private agreements with doctors, according to Azza AbuDagga, a health researcher who authored the Public Citizen report.

“When you have physicians trying to police their own, it turns into a club mentality,” AbuDagga said. “Doctors should be able to control their impulses. Their power, their money, their grants are not worth the damage that they cause.”

A quiet exit

Amid investigations by the university and Rothman, Abraham said, a Jefferson top doctor offered him a deal in a private conversation: Take a voluntary leave, and we won’t report the alleged sexual misconduct.

Congress generally expects health institutions employing doctors accused of wrongdoing to file a report into the National Practitioner Data Bank (NPDB), a federal tracking system.

Hospitals must query the data bank before credentialing a newly hired doctor to ensure that the person hasn’t gotten into trouble elsewhere. Data bank reports also go to state licensing boards.

In court depositions, Abraham recalled getting a phone call from Edmund Pribitkin, chief physician and executive vice president of Jefferson Health, telling him that he had to take an immediate leave of absence from Jefferson.

If he didn’t do as told, Pribitkin said, the sexual assault allegations would go before the hospital’s medical executive committee and they’d likely have to report him to the NPDB, according to Abraham.

“It was a gun to my head,” Abraham said.

Abraham complied in an email sent to Pribitkin and the doctor who headed the committee overseeing disciplinary matters at the time. His July 2018 email requested a leave “for personal reasons.”

“I think in [Pribitkin’s] mind, he thought he was doing me a favor, but the real favor would be to say, ‘Look, we’re going to listen to what you have to say and we’re going to sort this out before we make any decisions on anything,’” Abraham told The Inquirer.

Jefferson declined to comment when The Inquirer asked about Abraham’s statements. In a legal filing, Jefferson disputed Abraham’s claims, noting he took a voluntary leave.

Under the law, if a doctor takes a leave of absence – or resigns – in exchange for a hospital not pursuing the matter, the hospital has to file a report, said Robert Oshel, who was in charge of the NPDB unit that reviewed disputed cases before retiring and remains a well-regarded expert on the federal regulations.

“Hospitals can’t offer not to report if a physician resigns or takes a leave, at least not legally,” Oshel said.

The regulations are riddled with complex caveats, from the nature of the misconduct and the impact on patient care, to whether a hospital advances the suspension to a peer review.

It is not clear whether Rothman, which employed Abraham, faced the same reporting requirements as Jefferson’s traditional hospitals because Rothman is a private physician group.

Rothman suspended Abraham with pay, which at the time was a base salary of $575,000, according to the orthopedic surgeon’s court filings. Rothman also revoked his access to patient records and barred him from hospitals where its doctors practiced, including Jefferson hospitals. Abraham’s suspension and loss of hospital privileges lasted from late June 2018 to January 2019.

Abraham’s suspension meant he couldn’t interact with any Jefferson residents. He also couldn’t see his patients.

Hospitals are supposed to report physician misconduct cases that could disrupt the workplace and impact patient care if an action is taken that affects a physician’s clinical privileges for more than 30 days, Oshel said.

“That includes suspensions that last more than 30 days,” he said.

Abraham said the suspension caused chaos for his patients, some of whom were scheduled for surgery weeks in advance.

Phillips’ colleagues could tell she was troubled. Her husband had also tried to confront Abraham at a hospital where the orthopedic surgeon was seeing patients, and security was called to escort him out.

But neither Jefferson nor Rothman reported Abraham, which their lawyers later said wasn’t required, documents obtained by The Inquirer show. The records do not explain their reasoning.

“Rothman Orthopaedics has no comment as it is in active litigation with Dr. Abraham,” spokesperson Alexandria Hammond said in an email.

Title IX case closed

Over three months in late 2018, leaders at both institutions quietly brokered Abraham’s departure from Jefferson. The terms: Abraham could get back to work at Rothman if he gave up his hospital privileges and academic appointment at Jefferson, according to emails obtained by The Inquirer.

This allowed Jefferson to close its Title IX investigation, which had found enough evidence of likely sexual misconduct by Abraham to determine that “a no-charge decision is not possible in this case,” Zoe Gingold, the university’s Title IX coordinator, said in an October 2018 letter to Abraham.

Gingold wrote that Jefferson would move forward, and the matter would advance to a hearing. She offered an alternative, saying the university thought it would be in the “best interests” of both parties to explore working out an agreement, known as a “non-hearing resolution.”

Subsequent updates to federal regulations no longer allow such negotiations in cases involving an alleged sexual assault between a professor and a student, said Samantha Harris, a Philadelphia-area lawyer who represents complainants and respondents in Title IX cases.

“Universities will act in their own interests,” Harris said. “If their interest is more in throwing a respondent under the bus without a fair process, they’ll do that. If their interest is sweeping a victim’s allegations under the rug, they’ll do that.”

At the time, talks between lawyers for Abraham and Phillips didn’t get far. In an interview, Abraham said Phillips wanted monetary damages, and he wasn’t going to pay her for “something that I didn’t do.”

Stewart Ryan, Phillips’ lawyer, said he had no recollection of any financial requests.

Phillips said it was outrageous that Jefferson expected her to work out an agreement with Abraham. "It's crazy," she said, "I'm supposed to work out some kind of understanding with the person who assaulted me?"

Emails and letters chronicle extensive discussions between Abraham and leaders at both institutions.

Rothman had assigned oversight of Abraham’s suspension to its president, Vaccaro, who is also in leadership at Jefferson. As part of this oversight, Vaccaro obtained Abraham’s “voluntary resignation of his faculty appointment and clinical privileges and effectively severed his relationship with Jefferson,” according to a February 2019 letter from Rothman’s lawyer.

This closed the Jefferson Title IX investigation, the letter notes, and preserved Abraham’s ability to practice medicine.

Phillips said she was in an operating room in January 2019 when she learned from a colleague that Jefferson had closed its Title IX investigation. She was upset that the case would not go to a hearing and accused the university of cutting her out of the process.

Jefferson’s lawyer said the university never negotiated its own separate agreement with Abraham, in a February 2019 letter to Phillips’ attorney.

Abraham’s departure was “the most severe outcome that could have resulted from the Title IX proceedings,” Jefferson’s letter noted, adding that the university felt “there was no purpose in proceeding to a hearing.”

Abraham’s communications with Rothman and Jefferson made clear that his voluntary departure could not be reported in a way that became a red flag to future employers.

“We were trying to do it in a way that we all agreed wouldn’t have any impact on my credentialing at other hospitals,” Abraham said in an interview.

Days after the Title IX investigation was closed, with no misconduct ever flagged to the national data bank, Rothman lifted Abraham’s suspension and moved him to Capital Health, a hospital network in New Jersey not affiliated with Jefferson.

Rothman’s board weighs in

On Aug. 20, 2018, Rothman’s board of directors met to take up “the conduct of Dr. Abraham.” Board members gathered in a conference room at Jefferson’s Sheridan building to determine whether Abraham should be terminated.

The all-male board included team doctors for Philadelphia’s professional sports teams, including the Phillies, Eagles, Flyers and 76ers. Abraham was not on the board, but had regularly attended their proceedings as chief of Rothman’s orthopedic oncology department.

Abraham was invited to speak; Phillips said she was not. He opened by reading from a one-paragraph statement.

“You all know me well and you know exactly who I am,” he said. “You know there is no way these charges could possibly be true.”

Details from the party night were presented to Rothman’s board by a private investigator hired by Abraham.

The investigator, Diane Cowan, had interviewed 29 party guests. She noted that a male friend of Abraham’s had spent the night and never heard a “no” or “sounds of anyone in distress.”

“It was evident that the female whose voice he heard was enjoying herself,” Cowan, president of Confidential Investigative Services, told the board.

Several witnesses described Phillips as “touchy-feely” and “aggressively” flirtatious with other men at the party, Cowan told board members.

In an Inquirer interview, her lawyer, Ryan, said the way that investigators questioned her behavior at the party reflected the sexist “idea that if a woman acts a certain way, she’s asking for it.”

For Phillips’ account of the evening, board members were given an investigative report prepared by a Rothman-hired lawyer. It included her answers to 22 questions about what happened.

The board reconvened Nov. 19, 2018 – roughly a week after Lower Merion police and Montgomery County prosecutors closed their investigation with no charges. At the meeting, the board voted not to fire Abraham or terminate his partnership, according to a letter sent to Phillips’ lawyer. In a deposition, Abraham recalled an 8-6 vote in his favor, which The Inquirer was unable to confirm.

Phillips said she tried to learn the names of board members and who voted to keep Abraham, but no one would tell her.

The fallout continues

Five years after his pool party, Abraham is suing all parties involved, providing a rare public view into how two prominent medical institutions dealt with a doctor accused of misconduct.

“If I just went away and quietly tucked my head under a rock, then it’s business as usual at all those places,” Abraham told The Inquirer, insisting that he has done nothing wrong.

A chief contention was Jefferson’s efforts to keep private its Title IX investigation.

In Abraham’s lawsuit against Phillips and in her countersuit, both parties asked Jefferson to turn over its Title IX investigative report. Jefferson claimed it was confidential under attorney-client privilege, because the university had hired an outside law firm to produce it.

Two lower courts ordered Jefferson to turn over at least a redacted report to Abraham and Phillips. Jefferson then petitioned the state Supreme Court to block their access. In late April, the Supreme Court denied Jefferson’s appeal petition. Last week, Jefferson gave copies to Abraham and Phillips.

Abraham also has an arbitration claim against Rothman, which fired him last year for allegedly failing to bring in $1.3 million in annual revenue, a requirement for partners, court documents show.

He told The Inquirer that Rothman used financial tactics to force him out of his ownership stake in the practice, and that he disputes their numbers. Saying his former patients are suffering without access to his expertise, he is seeking to terminate a non-compete agreement and has opened his own practice.

His complaint states that Rothman’s leadership “engaged in a campaign to starve” him of work as retaliation after he separately sued Jefferson in federal court in June 2020.

In response to Abraham’s complaint against Rothman, the institution’s lawyer denied that there was any plan to squeeze him out of the practice.

In his federal case, Abraham says Jefferson violated his civil rights with an unfair, gender-biased investigation. He says Jefferson did not investigate at all his allegation that Phillips got him drunk, so he could not consent to sex. He faults the university for forcing him to take a leave of absence while not seeking the same consequences for her.

Jefferson tried to get the lawsuit dismissed, saying the fact that Abraham was a man was not a factor, but rather that the case involved a professor and an attending physician accused of raping a student. A federal judge is allowing the case to proceed.

In a Philadelphia Court of Common Pleas trial this week, with opening arguments set for Monday, Abraham sued Phillips and her husband for harming his career and life. Her countersuit claims that he is trying to shame her and make her life “a living hell.”

She received the notice that she was being sued one week after the birth of her first child. She recalls how her happiness over having a daughter evaporated in that moment.

For Phillips, it seemed bad enough that no wrongdoing was reported, and that Abraham was able to move to another hospital. Even after she moved to the West Coast to get as far away as possible, each legal action is forcing her to relive painful details.

“I still can’t heal from this five years later,” Phillips said, now a practicing orthopedic surgeon, adding that she understands why victims don’t come forward. “My whole life has been ripped apart.”

Were it not for Abraham’s lawsuits, no one would ever know how Jefferson and Rothman handled the matter.

Phillips’ lawyer asked what would happen if Abraham applied for a job somewhere and the university was asked why he left Jefferson.

The university’s lawyer explained in a February 2019 letter that it might confirm “a Title IX-related complaint of alleged sexual assault and that Dr. Abraham relinquished his faculty appointment.”

But only, the letter noted, if Abraham signed a release authorizing the disclosure.