How Could You? Hall of Shame-Dr. Charles Fischer UPDATED

This will be an archive of heinous actions by those involved in child welfare, foster care and adoption. We forewarn you that these are deeply disturbing stories that may involve sex abuse, murder, kidnapping and other horrendous actions.

From Austin, Texas, Dr. Charles Fischer, 59, a long-time child and adolescent unit psychiatrist at Austin State Hospital’s Residential Treatment Center “had been involved in two separate instances of sexual abuse, said Patrick Crimmins, a spokesman” for Department of Family and Protective Services “confirmed”.

“[I]nvestigators from an independent oversight agency have opened a wider inquiry into accusations from at least eight possible victims dating back a decade ” and informed the hospital three weeks ago.

“Carrie Williams, a spokeswoman for the Department of State Health Services, which runs the Austin hospital, said Fischer, 59, was fired effective Monday.

The state hospital is a residential facility for people with mental illness. The child and adolescent unit where Fischer worked houses youths up to the age of 18. The Adult Protective Services division of the Department of Family and Protective Services is required by law to investigate allegations of abuse and neglect in state hospitals.

Crimmins said police have been notified of the agency’s findings; however, an Austin police spokeswoman said Fischer has not been charged with any crimes.

Contacted at his West Lake Hills home, Fischer declined to comment. “You’ll have to ask the hospital about that,” he said.

The Texas Medical Board, which licenses physicians, shows Fischer has an unblemished disciplinary record. Details of the case against Fischer were still unclear late Wednesday. Williams did not say when the two confirmed incidents occurred, how they were confirmed, if the youth was a boy or a girl, or whether he or she was still a hospital resident.

But, she said, Fischer, who earned $185,000 a year from the state, had been accused of sexually abusing patients in the past.

“There were previous allegations against Dr. Fischer over the years,” she said. “Each was reported and investigated outside the agency, but the allegations were never confirmed.”

Crimmins said the Department of Family and Protective Services investigated each of the abuse allegations as they became known.

“We have received several reports alleging sexual abuse by Dr. Charles Fischer dating back several years. In each instance in which sexual abuse by Dr. Fischer was alleged, law enforcement was notified at the time of the initial report, and again when a finding was made,” he wrote in an email response to questions.

“Each case was investigated thoroughly, but none were confirmed until October, when two separate allegations of sexual abuse against Dr. Fischer were confirmed, and the Department of State Health Services was notified.”

A spokeswoman for the state Health and Human Services Commission said the agency’s internal investigative arm was looking into the abuse allegations. Stephanie Goodman declined to say whether the Office of Inspector General was investigating the incidents of alleged abuse or the agency’s response to them.

And on Wednesday, Disability Rights Texas — a nonprofit organization officially designated by the federal government to protect the rights of the state’s disabled — said it had launched an inquiry into cases involving eight potential victims in incidents involving Fischer dating back to 2001. Because of its federal affiliation, the organization has access to records at state hospitals and can bring lawsuits against the state on behalf of people with disabilities.

Beth Mitchell, an attorney for the organization, said she did not yet know if the eight cases it had been notified of included the two abuse incidents confirmed by the Department of Family and Protective Services.

“We are all heartbroken over these allegations,” Williams said. “These kids come to us to heal, and the situation is very sad and extremely troubling for everyone involved.”

State records show Fischer received his medical license in 1978 from the University of Texas Health Science Center in San Antonio. He completed a residency in general psychiatry and further specialized training in child psychiatry, the records show. ”

Doctor at Austin State Hospital accused of child sex abuse
[Austin American-Statesman 11/17/11 by Andrea Ball and Eric Dexheimer]

Update: “The Texas Medical Board today suspended the license of child psychiatrist Dr. Charles Fischer, who was fired last week from Austin State Hospital after a state investigation found credible evidence that he sexually abused at least one child patient in his care.

Authorities are looking into additional allegations that he abused at least eight other children over more than a decade.

The Medical Board’s statement, issued today:

Texas Medical Board News Release November 22, 2011

TMB suspends child psychiatrist Charles Fischer, M.D.

On November 22, 2011, a disciplinary panel of the Texas Medical Board temporarily suspended, without notice, the medical license of Charles Henry Fischer, M.D., after determining that Dr. Fischer’s continuation in the practice of medicine constitutes a continuing threat to the public welfare.
The panel found that Dr. Fischer, a child psychiatrist at the Austin State Hospital in Austin, has demonstrated a pattern of sexually abusing teenage boys in his care for inpatient psychiatric treatment over a period of nearly 20 years.

The Board has received information that there are as many as nine patients who have alleged sexual abuse by Dr. Fischer since the first patient report in 1992.

Dr. Fischer, 59, was employed at Austin State Hospital from December 1990 until his termination on November 14, 2011. He has also been employed as a psychiatrist at the Waco Center for Youth, the Southwest Neuropsychiatric Institute in San Antonio, Lutheran Social Services Residential Treatment Center for Girls and Central Counties Mental Health and Mental Retardation.

The suspension remains in effect until the board takes further action.”

State medical board suspends psychiatrist’s license amid abuse inquiry
[Austin American-Statesman 11/22/11]

“In its unscheduled hearing, the medical board ordered Fischer to stop practicing medicine until further notice because he presented “a continuing threat to the public welfare.” Texas Medical Board spokeswoman Leigh Hopper described the action as similar to a temporary restraining order.

“It’s definitely an extreme measure,” she said. “You have to have a certain level of evidence.”

Although Fischer has not been charged with any crime, four law enforcement agencies are conducting a joint investigation into his case: the Texas Rangers, the attorney general’s office, the Austin Police Department and the Office of Inspector General for the Health and Human Services Commission .

His lawyer, Antonio Cobos , did not return calls Tuesday. He has said previously that Fischer “vehemently” denies all the claims against him.

Hopper said that the board takes such action about a dozen times a year, typically when a physician has a substance abuse problem or has been criminally charged.

During the hearing, a three-member panel makes “findings of fact,” which, while based on evidence presented to the panel, are not considered the same as facts in a court of law. Fischer will be given the chance to appeal the ruling.

Fischer, 59 , is accused of sexually abusing children while working at Austin State Hospital. After a five-month investigation, the state Department of Family and Protective Services told hospital officials in October that it had confirmed two cases of sexual abuse against hospital patients. The agency, which investigates claims of abuse in state facilities, terms a case “confirmed” if the preponderance of evidence indicates the allegations are true.

During the investigation, Fischer was permitted to continue working  with children. Supervisors restricted his conduct with patients, ordering him not to, among other things, touch any patients or provide counseling behind closed doors. When the protective services agency confirmed the two abuse cases in October, Fischer was immediately placed on leave and fired Nov. 14.

The two cases are the only ones that the protective services agency has confirmed to date.

The medical board’s order added new details to a case in which specifics have so far been scarce because of the sensitivity of the allegations and patient privacy laws.

According to the medical board’s order of temporary suspension, seven Austin State Hospital patients between the ages of 13 and 17 made allegations against Fischer between 2001 and 2006 . A Travis County grand jury heard accusations of sexual abuse of a child against Fischer in 2002 but did not bring charges against him.

An eighth accusation described in medical board documents came from a 16-year-old patient who said he was abused in 1992 at the Waco Center for Youth, a state-run psychiatric facility for children up to 18.

“We have no formal record of him working at Waco Center for Youth, but we think (Austin State Hospital) informally loaned him to the center on a part-time basis for a period of time in the early 1990s ,” said Carrie Williams, spokeswoman for the Department of State Health Services, which oversees the hospitals. “We are looking into it.”

A ninth patient accused Fischer of abuse when he was working at the Southwest Neuropsychiatric Institute in San Antonio, the order said. Although the order does not identify a year, Fischer worked at the center from 1982 to 1984 as a child psychiatry resident, according to licensing documents filed with the medical board.

Some patients had been sexually abused by family members, according to the suspension order. A prepared statement issued by the board said all of them were male.

The board’s order has graphic descriptions of the purported sexual abuse. Most involve fondling and oral sex.

“These allegations are, frankly, devastating to us,” Williams said.

The order also said the incidents occurred in Fischer’s office, where, according to the medical board documents, he shut and locked the door when seeing patients.

In response to the unfolding case against Fischer, state officials late last week released new rules for mental health professionals at the state hospital. Those mandates include keeping therapy doors unlocked during sessions and only providing individual treatment services in rooms with windows or other locations where professionals can be directly observed by other employees.

The department also ruled that staffers under investigation for sexual abuse must be transferred to another unit or placed on emergency leave.

Fischer also has worked for other mental health organizations, the medical board order shows: Central Counties MHMR, which, according to its website, provides mental health services to five Central Texas counties; and Lutheran Social Services, an Austin-based nonprofit group that runs residential treatment centers for troubled children.

Lutheran Social Services spokesman Scott Carroll said that Fischer was never an employee but a contractor who provided psychiatric services to youths at its Canyon Lake and Corpus Christi facilities.

Carroll said records show Fischer worked for the nonprofit before 1999; however, it doesn’t have details because those records have since been destroyed. None of the current employees at those residential treatment centers worked there at the time, he said.

“We know of no evidence in our possession that would indicate any wrongdoing of any kind by Dr. Fischer while he was at our facilities,” Carroll said.”
Psychiatrist’s license suspended; medical board cites up to 9 claims of child sex abuse
[Austin American-Statesman 11/22/11 by Andrea Ball and Eric Dexheimer]

Update 2: DFPS had only a 5-year record retention policy!

A “review of the record-keeping and reporting policies of state regulatory agencies shows a pocked network of procedures that could leave gaps in the effort to piece together a comprehensive picture of Fischer’s history, as well as make it difficult to contact potential past victims.

The Department of Family and Protective Services , which is charged with pursuing allegations of abuse and neglect at state facilities, keeps its investigation files for only five years. After that, documents — including original complaints, witness interviews and final dispositions — are destroyed, said spokesman Patrick Crimmins.

The purging even includes investigative files of confirmed cases, those in which the agency has determined that a preponderance of evidence indicates there is reason to believe the alleged abuse occurred.

In the absence of such records, Fischer case investigators must try to recreate the older files by searching for paperwork from other organizations: law enforcement, state hospitals, private employers or the Texas Medical Board. Yet those agencies, too, have differing policies on how long they keep records and do not always notify one another.

The administrative holes could prove especially problematic for authorities tracking a possible abuser such as Fischer. Though he was never formally charged with a crime, he had accumulated a number of complaints over time that investigators now say show an apparent pattern of abuse.

Although they have declined to comment in detail about the on going investigation into Fischer, who worked at the state hospital for 21 years, officials said his case has led them to review how agencies charged with caring for some of the state’s most vulnerable patients handle their records.

The Department of Family and Protective Services’ five-year records retention policy “is likely to be changed, because through this case, we have found out how important it can be for us, as investigators, to have the entire case history,” Crimmins said. “That’s a big help in situations in which you are trying to determine if patterns exist.””

Gaps and Flaws in Reporting Child Abuse by Medical Board

“Crimmins said the agency’s procedure for notifying law enforcement differs by jurisdiction. In Austin, police are notified by phone and again by email as soon as the department receives an allegation of sexual abuse. Police are contacted again when the agency concludes its investigation.

Yet, he added, such notifications amount to little more than brief emails, even when state investigators label a case confirmed. The alerts are to give police “an opportunity to request a copy of the report,” Crimmins said. Therefore, police files would not necessarily contain detailed information about the state’s abuse investigation.

Crimmins could not immediately detail how Austin’s procedure compares with those of other cities.

The Texas Medical Board also might receive reports of child abuse by a physician. But unlike the protective services agency, the board does not automatically report such allegations to law enforcement.

“The reality is, with child sexual abuse cases, (the board) is rarely the canary in the coal mine,” spokeswoman Leigh Hopper said. “Usually, it has been reported somewhere else first, to law enforcement or a child abuse hotline.”

If the board eventually takes disciplinary action against a doctor, it publicly announces its findings and notifies law enforcement or the physician’s employer. If it doesn’t act, police are not notified.

That would appear to conflict with Texas Family Code, which requires anyone who suspects a child may be the victim of abuse to report it to the protective services agency or law enforcement. Dayna Blazey , a prosecutor with the Travis County district attorney’s office who specializes in child abuse cases, said she did not know of any exceptions for the Texas Medical Board.

“It is important that anyone with knowledge of child abuse report what they know,” Crimmins said. “It does not matter if you do not have first hand information. That happens often in child abuse cases. In order to protect a child, we need to know that child may have been hurt so that we can investigate to find out what may have happened. Not reporting possible child abuse is unacceptable.”

But Hopper said the medical board is not ruled by Texas Family Code, but by Texas Occupations Code, which states that complaints may not be shared unless disciplinary action is taken or law enforcement specifically asks for them.

“I disagree with their interpretation,” Hopper said. “If that were required of us, we’d already be doing it.”

Hospital Records NOT Kept Indefinitely as Required in this Case

“After the protective services agency completes an investigation, a copy of the report is also sent to the facility in which the incident was alleged to have occurred.

Carrie Williams , spokeswoman for the Department of State Health Services, which oversees the state hospital system, said hospitals are supposed to keep the records “indefinitely, and we believe we have the vast majority of the records.”

Some of the files are on microfilm; others are stacked in boxes. But a review of policies since the Fischer case revealed “that some older files in two of our hospitals (Rusk and Terrell) may have been discarded in previous years,” she said. “So, we probably don’t have 100 percent of the records going back through time.”

After learning of the gap, she said, “we have made it very clear that all of our hospitals need to maintain the records indefinitely.”

A month after the protective services agency confirmed the two abuse cases against Fischer, the Texas Medical Board met and revoked Fischer’s medical license. The board said he had engaged in “a disturbing pattern” of conduct allegedly involving the sexual abuse of nine children. Transcripts of the hearing reveal that at least two of the allegations dated back 20 years.

But compiling details of those cases, as well as identifying other possible victims from that time, may be difficult.

Employment records released by the state show Fischer worked for two non profit s after his medical residency graduation. The first, according to his self-completed employment history, was Southwest Neuropsychiatric Institute in San Antonio from 1984 to 1990 .

Today, the small hospital and outpatient mental health treatment center for children is known as Clarity Child Guidance Center . CEO Frederick Hines said it has no records of Fischer’s employment there, other than a four-month rotation he completed while at the University of Texas Health Science Center at San Antonio.

Will Sansom , spokesman for the health science center, said its records show Fischer graduated in 1978 and worked part time for the center from 1988 to 1990 in a teaching position “with no patient care responsibility.”

But any files from Fischer’s time there are gone now; the hospital destroys documents after six years, Sansom said.

State employment files also show that, from 1993 to 1996 , Fischer worked part time at Lutheran Social Services of the South’s New Life Children’s Center, a residential treatment facility in Canyon Lake for troubled girls. A spokesman said the nonprofit destroys records after seven years and could not say definitively if anyone there had accused Fischer of abuse.

“None of our current employees in those facilities were working there during that time, so there is no way for us to tap into the memory of an employee who remembers anything,” spokesman Scott Carroll said.”

Doctor’s case reveals flaws in state’s ability to investigate older allegations
[Austin American-Statesman 12/22/11 by Andrea Ball and Eric Dexheimer]

Update 3: Dr. Fischer “has filed an official grievance protesting his Nov. 14 firing from the Austin State Hospital. He has also sent notice to the Texas Medical Board indicating that he intends to fight for the return of his medical license. The agency has temporarily suspended Fischer’s physician privileges, citing nine instances in which the psychiatrist had been accused of abusing young patients.

Fischer’s lawyer, Antonio Cobos, declined to make him available for an interview. But in an email and conversation, Cobos revealed glimpses of Fischer’s plans to defend himself, which include questioning the credibility of several of the doctor’s alleged victims.

One boy who had accused Fischer, for example, later recanted his accusations against the psychiatrist, Cobos said. And “at least one of the patients has a documented history of hallucinations and delusions.” Another has “a significant criminal history,” he said. None of the accusers has been identified in public documents.

“We strongly maintain Dr. Fischer’s innocence, and we will continue to vigorously defend this matter,” Cobos said.

Carrie Williams, spokeswoman for the Department of State Health Services, which oversees the state hospital system, said the agency stands by its decision to fire Fischer. Yet experts said Fischer’s assertive defense illustrates the challenges ahead for state officials who will be asked to justify their actions against the psychiatrist, as well as for law enforcement agencies considering whether there is sufficient evidence to bring a criminal case against the doctor. The Austin Police Department, the Travis County district attorney’s office and the Texas Rangers are all investigating the claims against Fischer.

“These cases are hard — damn hard,” said David Gonzalez, an attorney whose Austin firm often represents clients with mental illness.

One hurdle is the time that has passed since the alleged incidents of abuse. The nine cases identified by the medical board date back to the early 1990s. The state Department of Family and Protective Services, which investigates claims of abuse in state facilities for the mentally ill, concluded there was sufficient evidence to substantiate two incidents of sexual abuse against Fischer: one in 2003, the other in 2006.

With physical evidence of abuse in such old cases unlikely, “it turns into a swearing contest,” said Carlos Garcia, who prosecuted child abuse cases for Travis County before joining the Texas Defender Service, a nonprofit organization that helps defend death penalty cases. “The child swears it happened, and the defendant swears it didn’t.”

Complicating matters further is the mental capacities of Fischer’s accusers. “What I find troubling is any sort of misperception that a person who has a mental illness is not credible simply because they have a mental illness,” said Kathryn Lewis, a lawyer with Disability Rights Texas, a federally funded group that investigates abuse cases in state hospitals. “That is not true.”

Experts said successful prosecution of a case against the psychiatrist could hinge on the former patients’ ability to accurately and consistently recount the instances of abuse, a potential challenge for those with severe mental disabilities. As patients at a state hospital, Fischer’s accusers had serious psychiatric problems.

Another unanswered question is how heavily the accumulation of accusations against Fischer will weigh in his legal cases. New state laws and policies have meant that state investigators must now look for trends in abuse claims, even if they are unable to substantiate the allegations. How such information can or should be used is not always clear.

Garcia said a consistency of details among the accusers’ allegations could help prosecutors. “Child abuse leaves ‘fingerprints,'” he said — common behaviors and responses among victims.

“In the process of investigating the new complaint, if the pattern demonstrates enough consistencies in the stories, it could be helpful,” said Leigh Hopper, a spokeswoman for the medical board. But, she added, a pattern of accusations alone generally cannot make a case: “There really needs to be at least one credible victim and hopefully a contemporaneous outcry and some corroboration.”

When it suspended Fischer’s license, the board cited a “disturbing pattern of abuse.” Cobos, however, said Fischer should not be punished based on any unproven accusations. “The medical board relied solely upon (Family and Protective Services Department) reports, including reports long since dismissed as unsubstantiated,” Cobos said.

Cobos also signaled that he might try to use the state’s years of inaction against Fischer as a defense. Personnel records show that Fischer received consistently glowing evaluations from his work supervisors.

“The Austin State Hospital supervisors supported Dr. Fischer throughout his tenure, including previous review by the Texas Medical Board, no doubt because they too concluded the allegations were, and always have been, wholly without merit and outlandish.””

Fired state psychiatrist fighting back against abuse accusations
[Austin American-Statesman 1/4/11 by Andrea Ball and Eric Dexheimer]

REFORM Puzzle Pieces

This is a case where accountability is at the forefront. Like the lawyer for Disability Rights Texas said, we are concerned that the mentally ill patients from this RTC may not be deemed credible due to their mental illness that makes them vulnerable to begin with.

Update 4: “Travis County District Attorney Rosemary Lehmberg indicted Charles Fischer, 59, in five felony cases” including two child sexual assault cases.
“His license suspended since late November, the psychiatrist is indicted on charges of two sexual assaults of a child, two cases of indecency with a child by contact and one sexual assault.

The alleged crimes happened from 2001 through 2005.

Austin police started investigating after one of Fischer’s former patients told the Texas Department of Family and Protective Services about the alleged sexual abuse from Fischer while at Austin State Hospital.

Austin police detectives spearheaded the investigation, with help from the Office of Attorney General, the Office of Inspector General, the Texas Rangers, the Texas Department of Family and Protective Services and the Austin State Hospital.

Meanwhile, State Hospital officials let Fischer go on Nov. 14[2011].”
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“DFPS spokesman Patrick Crimmins said the agency has received several reports alleging sexual abuse by Fischer dating back several years. Crimmins said police were notified at the time of the initial report in each instance and also when a finding was made.

“Each case was investigated thoroughly, but none were confirmed until October, when two separate allegations of sexual abuse against Dr. Fischer were confirmed, and the Department of State Health Services was notified,” said Crimmins.

The Adult Protective Services division of DFPS is required by law to investigate allegations of abuse or neglect in state hospitals. After reviewing evidence, APS makes investigation findings and determines whether the abuse likely did or did not happen.”

Psychiatrist indicted in child sex case

[KXAN 6/14/12 by Jackie Vega]

Update 5:“A former state hospital psychiatrist charged with sexually abusing five boys at Austin State Hospital was jailed on Friday, three days after Austin police arrested him and said he was having sex in a public park.

Dr. Charles Fischer, 60, had been out on $1.25 million in bonds since June, when a Travis County grand jury indicted him on multiple counts of sexual assault and indecency with a child after he was accused of abusing patients at the state psychiatric hospital.

But on Tuesday, after being accused of having sex with another man in a wooded area off Rollingwood Drive near MoPac Boulevard (Loop 1), Fischer was charged with public lewdness. He was released that day on $5,000 bail.

The lewdness charge — a Class A misdemeanor for which Fischer faces up to a year in jail — spurred the Travis County district attorney’s office to ask state District Judge Karen Sage to revoke Fischer’s bail in his sexual abuse case. In her motion to the court, prosecutor Monica Flores wrote that Fischer was “likely to commit other sexual offenses against children and other persons” if his bail were not revoked.

On Friday morning, Sage revoked Fischer’s bail and ordered him into custody by the end of the day. Fischer turned himself in to authorities and is now in jail, said Chris Gunter, his attorney.

Prosecutors with the Travis County district attorney’s office declined to comment on the case, citing office policy that prohibits them from discussing pending cases.

The bail revocation is the latest chapter in the ongoing saga surrounding Fischer, a once-respected psychiatrist who worked with youths at Austin State Hospital for 20 years. Despite being accused of abusing multiple children during that time, Fischer continued to enjoy glowing performance reviews, raises and promotions.

In October 2011, the Department of Family and Protective Services confirmed that Fischer had been involved in two cases of sexual abuse. The agency terms an incident “confirmed” if its investigation shows the allegation is supported by a preponderance of the evidence. The state hospital quickly fired Fischer.

In November 2011, the Texas Medical Board suspended Fischer’s license to practice medicine indefinitely, saying that his “continuation in the practice of medicine constitutes a continuing threat to the public welfare.”

In June 2012, Fischer was indicted on two counts of sexual assault, nine counts of sexual assault of a child, seven counts of indecency with a child by contact and five counts of indecency with a child by exposure.

Since then, Fischer’s lawyers have vehemently denied the charges against him. On Friday, Gunter made no such denial of the lewdness charge but stressed that it was an act between consenting adults.

“He’s just really disappointed in himself,” Gunter said.””

Psychiatrist back in jail after bail revoked[Austin Statesmen 1/25/13 by Andrea Ball and Eric Dexheimer]