The University of Vermont Medical Center fired a licensed nursing assistant last year after it found out he had sexually harassed a former patient, according to a recent order from the Vt. Board of Nursing.

The hospital network fired Marc Fleming in May 2018, days after a female patient formerly under his care at the Fanny Allen rehabilitation unit reported him for sending an unsolicited nude photo of himself, public records show. The woman had been staying at the Colchester campus to recover from a double leg amputation, and often had Fleming assigned to her room.

Before leaving Fanny Allen, the female patient shared her cell phone number with several staff members, including Fleming. A month later, he sent the woman a nude photo of himself, board documents show. “[D]on’t be shocked we’re all naked,” he wrote in a text message. He then added, “[I]t was just a nod to you we all have legs.”

The patient was reportedly upset and alerted a staff member at the assisted-living facility where she was staying. Fanny Allen fired Fleming five days later.

Fleming wasn’t finished. In the month after his firing, he sent his nude photo to two more women without their consent: the daughter-in-law of an elderly patient and his former coworker who still worked at Fanny Allen, board documents show.

LNAs perform medical tasks and assist patients on a variety of personal needs, a level of access that gives them an “extremely important” role in making a patient’s hospital stay “as comfortable as possible,” reads the UVMMC website.

Because LNAs are licensed by the nursing board, the regulatory body can investigate complaints and can suspend or revoke a licensee’s right to practice medicine if it deems their behavior puts the public at risk or damages the integrity of the profession.

The board opened an inquiry into Fleming’s conduct in June and sent an investigator to his home for an interview, during which he admitted to sending the pictures to the patient, according to the board’s order. He tried to justify the behavior by saying that he was an alcoholic and was intoxicated at the time.

The board took emergency action against his license in August 2018. A year later, it issued an indefinite suspension, finding he had engaged in actions “repugnant” of the profession.

The incident was not Fleming’s first offense: In 2015, he sent an unsolicited nude photo to a coworker.

When the hospital network learned of the incident and determined that Fleming had committed sexual harassment, it disciplined him with a “final written warning” but allowed him to keep his job, according to the nursing board order.

It’s unclear whether the hospital ever reported Fleming to the nursing board after the 2015 incident. The Office of Public Regulation has no record of charges against him prior to 2018, and the board cannot confirm or deny whether a particular licensee has been the subject of a complaint that does not result in charges, according to Gabriel Gilman, the OPR’s general counsel.

Whether the hospital would have even been required to report Gilman is equally unclear. State law requires hospitals to only report licensees when they condition or limit the employee’s privilege to practice medicine, Gilman said.

“It’s sort of a funny trigger,” Gilman said. “If you know about something appalling and you do nothing,” then there’s no obligation to report the conduct to the board.

Spokeswoman Annie Mackin said the UVMMC legal team decided the hospital network can’t comment on Fleming’s case because it’s a personnel matter, so there’s no telling whether the disciplinary action went beyond the formal slap on the wrist. Nor would the hospital say if it transferred Fleming or the harassment victim following the complaint.

In a general written statement, Mackin said the health center investigates any allegations of harassment so that it can “come to a full understanding” of every situation before determining the next steps.

“We consider many factors, including but not limited to the behavior itself, whether there is a pattern, the employee’s willingness to correct the issue, whether there is any impact to patient care, and other potential factors,” Mackin wrote in the statement. “Based on the outcome of each investigation, an employee may be terminated or may receive formal action and the opportunity to correct their behavior, if everyone involved feels they are able to move forward in a comfortable work environment.”

Fleming, through his attorney, Jessica Burke, declined an interview for this story. Burke also declined to comment.

If Fleming wishes to return to work as an LNA, he will need to seek reinstatement. But first, he must undergo a psychological evaluation that shows he’s not a risk to patients, according to the board’s order. He must also undergo a drug and alcohol assessment and submit to at least three random urine analyses. The board can then decide whether to reinstate his license with conditions.