Nearly two decades ago, Pennsylvania regulators were confronted with evidence that a well-regarded pediatrician had fondled the genitals of two small children during office visits. Instead of holding him accountable, regulators let the doctor keep his medical license. He went on to molest at least a dozen more young patients, victimizing children right up until the time of his arrest in January, prosecutors say.
Now, as Dr. Johnnie "Jack" Barto sits in jail awaiting trial on sexual assault charges involving more than 30 children, his 1990s-era patients and their parents say the state Board of Medicine failed to stop him when it had the chance and bears responsibility for what investigators are calling a "pervasive and prolonged pattern of abuse." Police, prosecutors and Barto's own colleagues also deserve blame for looking the other way, they say.
"It could've stopped with me," Lee Ann Berkebile, 28, of Johnstown, said in an interview with The Associated Press. "Instead they chose to cover for him and stick up for him, and now look what happened. All you did was let a sicko touch other girls."
Barto, 71, was arrested in January and charged with groping a 12-year-old girl during an office visit several weeks earlier. Suspecting she might not be alone, the Pennsylvania attorney general's office put out a call for other accusers to come forward -- and they did, by the dozen, with claims going back to the late 1980s.
Barto has pleaded not guilty. If the charges hold up, the case will represent another black mark against a profession that's long had trouble policing itself over sexual misconduct.
There have been more than 1,000 cases across the nation in which doctors were sanctioned for sexual misconduct but held onto their medical licenses, according to a 2016 investigation by The Atlanta Journal-Constitution. A study by the consumer group Public Citizen that same year found state regulators often failed to punish abusive doctors at all. More than two-thirds of doctors with sexual misconduct reports in the National Practitioner Data Bank, a federal government database, faced no discipline from their states' medical boards, the study found.
"Without consequences, we cannot really solve the problem. You don't have enough deterrence out there," Public Citizen health researcher Azza AbuDagga said. Referring to Barto, she added, "This physician was let loose and was able to hurt other people. The interest of the physician superseded the interest of the public and that's not acceptable."
The Pennsylvania Department of State, which provides legal and administrative support to the board and prosecutes administrative cases of doctor misconduct, said in a statement that "the Board of Medicine takes allegations of sexual misconduct by professional licensees very seriously." But the board does not keep statistics on how often it punishes doctors accused of sexual misconduct, so it's difficult to judge how seriously it has treated sexual abuse -- either then or now.
Current board members were not in office when Barto's case was considered.
Lee Ann Berkebile was just 4 years old when her mother took her to see the pediatrician in 1994 for a runny nose and cough. At the end of the appointment, Barto offered to walk Lee Ann down the hall to a medicine closet. It was then, Berkebile said, that Barto shoved his hand down her pants and inserted his finger in her vagina.
The little girl immediately told her mother, who went to the county child welfare agency. The case was referred to Johnstown police. A sergeant interviewed Lee Ann and her parents but did not file charges, citing her age, according to documents obtained by the AP from state archives.
Lee Ann's father, Sam McAdams, believes it was Barto's prominence, the strong support he had in Johnstown and the family's own poverty that helped him avoid criminal prosecution.
"We got treated like we were garbage for even saying something or suggesting something," McAdams said.
Four years after Berkebile says she was molested, another patient, 3-year-old Kelsey Bowman, had an appointment with Barto. At the end of it, Barto sat Kelsey -- who wore a T-shirt, socks and nothing else -- on his lap.
Her mother, Kelli Bowman, who was also in the exam room, said Kelsey gave a sudden jerk, and she saw Barto's hand on her daughter's vagina for at least a minute. Bowman grabbed her daughter and left. Afterward, she said, Kelsey cried and said the "mean doctor touched me on my monkey."
Johnstown police and the Cambria County district attorney's office investigated. This time, authorities took action. Barto faced administrative charges -- not only for touching Kelsey, but for the earlier incident involving Berkebile.
Testifying at the equivalent of a trial, young Lee Ann described what she says Barto did to her, and Bowman told a hearing examiner how Barto fondled her daughter. Barto denied the allegations, but hearing examiner Suzanne Rauer found the accusers to be credible and consistent -- calling Lee Ann's testimony "heart-stopping." Rauer concluded that Barto "sexually assaulted two of his very young patients" and committed a "grave abuse of his position," according to her March 2000 ruling that stripped him of his medical license.
Facing the imminent loss of his career, the pediatrician appealed to the Board of Medicine, an independent body that's comprised primarily of doctors and is in charge of licensing and discipline. The board dismissed the accusers' accounts on a 7-2 vote and said Barto could resume his career. The allegations, it said, were "incongruous to his reputation."
Vivian Lowenstein, one of the two votes to strip Barto of his license, blasted the physician members of the board for letting him off the hook. "I'm sick about it," she told the AP recently.
Lowenstein, a nurse practitioner, said the case serves as an example of how Pennsylvania's physician-regulators typically looked out for their own. "It was my perception that there was a pattern that physicians were protective of other physicians, and didn't always make the best decisions," she said.
Kishor Mehta, who served on the board with Lowenstein, disputed that physician members were biased.
"They never favored doctors. They were very objective," said Mehta, who is not a doctor. He said he had no memory of the Barto case but added that accused doctors are entitled to due process like anyone else: "Unless there is good evidence, you don't want to take the livelihood of somebody."
The 1990s accusers and their parents, meanwhile, remain bitter that regulators took his word over theirs.
"I was livid. I was appalled they gave him back his license," Kelli Bowman said. Of the later accusers, she added. "I feel sorry for those kids. It's all the medical board's fault."
The two practices for which Barto worked also might have missed the warning signs -- or been willfully ignorant. Parents complained to office staff and other physicians over the years about Barto's sexual misconduct toward their children, and, at one point, Barto promised he would no longer examine teenage girls, according to court documents. But he continued seeing and abusing patients, prosecutors say.
Court documents do not indicate whether Barto's medical practices ever took any steps to protect patients, but one doctor tried to explain away his behavior by telling an upset parent that Barto had an "odd bedside manner," according to an affidavit. The doctor also speculated Barto might have Asperger's syndrome, a milder form of autism.
Neither practice offered any comment when contacted by the AP.
Berkebile said the assault affected her in profound ways. She became self-destructive. She doesn't trust people, especially men, and remains in therapy.
"He ruined my life," Berkebile said. She said she feels for the other girls whom prosecutors say Barto assaulted, "because I know what it's going to do their lives and how it's going to affect them."
Cambria County District Attorney Kelly Callihan, who referred the ongoing criminal prosecution to the Pennsylvania attorney general's office because staffers in her office had Barto as their children's pediatrician, said the older accusers are right to be angry.
"It looks like a missed opportunity here to file charges, get a conviction and stop this happening to the many other victims who have now come forward," said Callihan, who joined the DA's office in 1996 but said she wasn't involved in Barto's case. "The system failed them, whether it was the criminal system or the administrative process they went through."