The patient from Mount Prospect was at a low point when she turned to Allan Aven, her longtime family physician, for help.
Chronic vertigo and vomiting had left less than 90 pounds on her 5-foot-3 frame. Surgery to address those problems was unsuccessful, and left her deaf in one ear. Her litany of ailments, like her list of prescription drugs, was long. And her poor health was making sexual problems in her marriage even worse.
Aven's prescription? Have intercourse with him to stimulate her libido.
The woman was swept into secret encounters at the doctor's Arlington Heights office, convinced that he was the only one who cared for her, even though he said he did not intend to leave his wife and had engaged in sex with other patients, she alleged in court records.
His hold over her was so strong that when her husband discovered the sexual relationship months later, prompting Aven to cut it off, the woman was admitted to the psychiatric ward of Northwest Community Hospital.
"She was crying," therapist Christine Saindon said in a deposition, describing the call that prompted the hospitalization. "She told me she was considering an overdose."
A psychiatric breakdown is one of the consequences that can arise when doctors target vulnerable patients for sex. Since her release, the woman has suffered post-traumatic stress syndrome and lasting damage to her marriage.
State regulators allowed Aven to continue practicing.
A Tribune investigation has found wayward doctors have little to fear from the regulators. Illinois officials have waited years to act on well-founded allegations. They have failed to monitor disciplined doctors. And even convicted sex offenders keep practicing.
The Mount Prospect woman wasn't the first patient to turn suicidal following an alleged affair with Aven, according to court records. In 2001, Damaris Algarin-Bonnier, a 31-year-old woman dealing with mental health problems, excess weight and marital strife, was found lying outside his office after overdosing on drugs he had prescribed. She died later that day.
Her therapist later testified in a wrongful death case that the day before Algarin-Bonnier died Aven had ended a sexual relationship with her. Algarin-Bonnier tearfully told him that Aven had forced her on a scale, berated her for being fat and told her he was in love with his medical assistant, the therapist alleged in a deposition.
Aven, a short man with white hair and glasses, denied having a sexual relationship with Bonnier. His insurance company paid a financial settlement to her husband.
He admitted to having sex with the patient from Mount Prospect, but disputed the details, and said he did not realize it was harmful.
"My mind went totally blank when this woman came on to me. ... It was an unfortunate emotional takeover," said Aven, 68, who shuttered his Arlington Heights practice in June and moved to Arizona, where he works for the Quality of Life Medical and Research Center in Tucson.
When a Tribune reporter asked whether having sex with the patient was wrong, he said: "We were both in unpleasant marriages. Does that give you a right to have sex? People do it all the time. Clinton did it. Kennedy did it. I guess I'm in good company."
Medical guidelines dating back to the Hippocratic oath prohibit sexual contact between doctors and patients. The American Medical Association calls it "sexual misconduct," pointing out it can exploit a patient's vulnerability, obscure the physician's judgment and be detrimental to the patient's well-being.
Some experts say it's impossible for patients to consent to sex with someone who has so much control over their body and mind.
"Unless the doctor sits the patient down and says, 'What I'm doing is a violation of long-standing ethics and is likely to damage you,' there is no consent," said Gary Schoener, a Minneapolis psychologist who has consulted in more than 4,000 cases of professional misconduct nationwide. "These doctors are predators who abuse the power and safety of their office and the fact that they can call the person crazy or drive her to suicide if anyone finds out."
In many of those cases, experts say, doctors prey on needy patients who don't realize they are being manipulated until it's too late. When the reality comes crashing down, the pain can ripple through the patient's family.
The woman from Mount Prospect had known Aven since she was a teenager. He treated most members of her family, and even came to their home to care for her dying mother. After she wed, Aven took her husband on as a patient.
When her health declined, forcing her to quit her longtime job, and her marriage became further strained, Aven provided not only basic medical care but also counseling and prescriptions for depression, court records show.
The relationship took a turn in September 2004 after she mentioned her husband's sexual dysfunction during a discussion of her libido's response to antidepressants. The woman, who was taking classes at Harper College, said in her deposition that Aven's response confused her.
"He seemed concerned, like that was a problem, and his next phrase was, 'Well, you could bang one of those 17- or 18-year-olds at school or have sex with a kind, gentle 60-year-old ... ,'" she said.
When she sought clarification, she said, Aven solicited their first secret meeting.
Aven denied that exchange and said the sexual relationship began when the woman showed up unexpectedly at his office early one morning.
Almost all of the encounters took place at his private practice, where the doctor insisted a medical sheet be placed on his green couch to avoid stains, she said.
He asked her to avoid scented soaps or perfumes that could be detected by his wife but encouraged her to leave her husband so it would be easier for them to get together, she alleged in court records.
The sex was physically painful, the woman said, but she valued the attention. At Aven's instructions, she was taking more prescription drugs, which made her feel like a walking zombie, according to court records.
"My life was really hard at that time," said the woman, 49, who wore a pink breast cancer button and a bracelet that said "faith" during a recent interview. "There were problems between me and my husband. My father wasn't present. He filled that role."
Her husband turned to Aven in November for help with his sexual dysfunction. He hoped that Viagra or another treatment would help save his marriage. Much to his confusion, Aven advised him to stay away from his wife for six months, the husband said in court records.
The advice, which Aven denied giving, made sense weeks later when he overheard his wife arranging a secret meeting with the doctor on the phone, the husband said.
"It's all of that realization rushing in on me thinking, my God, I sat there talking to this guy, and he's looking me in the eye and pretending he's a doctor, and he's molesting my wife," he recalled in his deposition. "I didn't even know how to function at that time."
He confronted his wife and she insisted Aven was the best thing that ever happened to her.
But after the doctor, made aware of the revelation, shunned her, and her husband threatened to report him to the police, she became hysterical and turned her attention toward the table on which her bottles of medication sat.
"I remember looking over at it and thinking about taking all the pills," she said in her deposition.
When she was admitted to Northwest Community Hospital that day, she was disoriented, paranoid and emotionally disturbed, He Yuan, the psychiatrist who treated her, said in his deposition. Yuan began weaning the woman off drugs prescribed by Aven, he said.
The woman did not reveal the relationship to Yuan or her therapist until her husband was hospitalized shortly after her release from the psych ward with something similar to an anxiety attack.
"I could hear the paramedic that was on the radio, I could hear him say, I have a 47-year-old male, and I don't have a pulse," the husband recalled in his deposition. "I remember thinking to myself, just you know, you've got to fight through this."
That scare shattered Aven's spell over the woman, she said, and made her realize how much she loved her husband.
But recovery proved difficult. The husband became overwhelmed with feelings of betrayal. The marriage survived, but in his deposition in 2007 he questioned whether he would ever again be in love with his wife.
"A piece of me died that day she left to see him, and I don't think that can ever be repaired," he said.
His wife had a hard time repairing herself. She suffered from flashbacks, nightmares, anxiety and other symptoms of post-traumatic stress syndrome, according to records. She couldn't trust doctors -- a problem, because her health problems demanded them.
"If you want exactly how much this relationship, sexual relationship contributed to the PTSD ... what I saw from [the woman], this was a major issue," Yuan, the psychiatrist, explained in his deposition.
Making matters worse for husband and wife was that Aven continued to practice. They saw it as a gross injustice, and feared for other patients.
Aven denied having extramarital sex with anyone aside from the Mount Prospect woman and a medical assistant, who also was once a patient. But the medical assistant said in a deposition that Aven told her that he had sex with other patients.
The couple filed a complaint with the Illinois Department of Financial and Professional Regulation.
Kevin Bonnier, the husband of the patient who committed suicide in 2001, said he also spoke with the department'sinvestigator.
But much to their dismay, the response from the department, and its medical disciplinary board, was to suspend Aven's license for just four months and place him on professional probation for two years. The regulators cited only the 2004 sexual relationship for sanction and struck a settlement that allowed the doctor to avoid a formal hearing.
The Tribune investigation found that the agency's probation works like an honor system. Aven was required to submit quarterly reports attesting to his good behavior. He said he met with a probation agent once.
Brent Adams, secretary of the Department of Financial and Professional Regulation, Donald Seasock, director of its division of regulation, and Edward Rose, chair of its medical disciplinary board, declined to comment.
Sue Hofer, the department spokeswoman, said she could not address whether the sanction imposed on Aven was appropriate because four years had passed.
"Therefore, commenting on a case, in hindsight and without a full understanding of the facts and issues as they existed at a certain point in time, would be inappropriate," Hofer said in an e-mail.
The department has refused to provide the number of patient complaints filed against Aven, even though the office of Attorney General Lisa Madigan has determined, in response to a Tribune appeal, that such information is public.
A state law allows Madigan to file injunctions and temporary restraining orders against doctors who have sexual contact with patients to whom they offer mental or emotional care.
But Madigan has never taken action against a doctor under the law, said Cara Smith, her deputy chief of staff.
Meanwhile, because medical insurance companies refuse to cover damages caused by sexual misconduct, it is difficult for victims to bring malpractice lawsuits.
In March 2009, the Mount Prospect couple settled for $199,500.
Kevin Bonnier settled for $300,000.
The night Bonnier's wife went missing, he drove around in search of her car. He received a phone call from Aven's office the next morning, informing him that she had been found.
At Northwest Community Hospital, he saw her writhing in pain, he said in his deposition. Her eyes were closed, and she was mumbling and scrunching up her body.
Later that morning, he listened outside a curtain as her life passed away.
"I don't know how to describe what you feel," he said in an interview, the eyes in his weathered face filling with tears. "It's like the earth is pulled out from underneath you, and you're in a free fall."
The pain intensified when her therapist, Harvey Wolf, told him that his wife had been having a sexual relationship with Aven, he said.
Wolf said in his deposition that he encouraged Damaris Algarin-Bonnier to report the relationship to the state, but she refused, and threatened to sue him if he did.
Aven's medical assistant said in her deposition that Algarin-Bonnier told her about having sex with the doctor.
Aven said Algarin-Bonnier fabricated their affair, and that she was in fact having sex with the therapist Wolf and the medical assistant.
Bonnier, who also was a patient of Aven, remains consumed with grief.
He said he awakes every morning in an empty bed, questioning why he should get up, and how it is that Aven still practices.
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Tribune investigations of dangerous doctors
This is the latest in a series of Tribune reports about patients who allege that the system -- law enforcement and state regulators -- failed to protect them from dangerous doctors. Read all of these investigations at chicagotribune.com/doctors
'Honor system' for guilty doctors
A Tribune investigation found that state regulators place many doctors found guilty of sexual misconduct in a program that does little to prevent them from reoffending.
Illinois once provided the public with detailed histories of the state's doctors. No longer.
Lack of communication
A Tribune investigation found that it took at least four patients coming forward with complaints of sexual assault and abuse before Ricardo Arze was charged in criminal court and had his license suspended. By that time, the family physician had allegedly assaulted at least 21 women and girls.
Doctors with sex convictions
A Tribune investigation found that 16 individuals on the Illinois registry of sex offenders have held a state medical license within the past 15 years, and not one had his license permanently revoked following his conviction.
Multiple rape allegations
A Tribune investigation found Bruce Smith, a Chicago gynecologist, was allowed to continue practicing for years despite multiple allegations of rape and sexual abuse. Following the story, the state's attorney's office charged Smith with sexual assault in one of the cases.
If you have a complaint about a doctor, contact the police department nearest the doctor's office and the Illinois Department of Financial and Professional Regulation at www.idfpr.com/dpr/FILING/
Complaint.asp or 312-814-6910.
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