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When a patient of gymnastics doctor Larry Nassar complained in 2014 that she had been molested during an exam, Michigan State University conducted an investigation and decided his actions were not sexual in nature.
Three years later — with Nassar accused of molesting dozens of women and jailed on state and federal charges — the school has come to a very different conclusion after investigating a similar complaint.
A Title IX report found that Nassar "engaged in sexual harassment" by penetrating gymnast Rachael Denhollander, then 15, with his fingers during treatments in 2000.
"[Nassar] committed these acts in a sexual manner regardless of whether it was done for sexual purposes," the report said, finding that Denhollander's claim that Nassar was aroused during the treatments was credible.
When Denhollander first filed her complaint in September, the university interviewed Nassar, who said he had performed pelvic manipulations on the teenager but denied penetrating her or being aroused.
Nassar has since been fired from MSU and charged with molesting 10 girls and possessing more than 37,000 images of child pornography. He has pleaded not guilty and maintains his exams and treatments were medically legitimate.
The Denhollander complaint was not the first time MSU had investigated Nassar, who enjoyed a high profile thanks to his ties to USA Gymnastics and the U,S. Olympic teams.
In 2014, an MSU graduate reported him, sparking a Title IX probe. That investigation ended very differently, however, with MSU finding Nassar had not sexually harassed the woman — relying heavily on the analysis of thee doctors, all MSU employees with ties to Nassar.
One of those doctors, Brooke Lemmen, has since left MSU under threat of termination after the school rebuked her to removing medical files at Nassar's request after the scandal broke and for failing to inform MSU that Nassar was investigated for sexual abuse by USA Gymnastics in 2015.
Lemmen's lawyer told NBC News this week that MSU was "trying to scapegoat" his client and that the more important questions are why MSU did not tell Nassar's colleagues that it imposed restrictions on him after the 2014 complaint, requiring him to use chaperones and limit skin-to-skin contact.
MSU used those rules to fire Nassar after the latest allegations came to light in September, saying he had failed to follow them. The university, the nation's ninth largest, is in the midst of an internal review into its handling of the Nassar allegations but so far has resisted calls to turn over the probe to an outside entity.