A statue of the school mascot, the Trojan, at the University of Southern California in Los Angeles. (David McNew/Getty Images)

The University of Southern California, widely regarded as academically ascendant, faces a deepening crisis over a Los Angeles Times report that the renowned former dean of its medical school was apparently using illegal drugs even in his own office on campus.

Stunned parents, students and higher education experts are asking a simple question: If the allegations are true, why didn’t the university do something sooner?

“This is really going to damage the school,” said Arthur Caplan, head of the division of medical ethics at New York University School of Medicine, not so much because of the alleged behavior but because of the university’s apparent response. “It didn’t look like people were moving quickly to handle these reports. Even when they had them in the newspaper, they didn’t handle them quickly. That makes people wonder about leadership.”

The university’s president, C.L. Max Nikias, acknowledged Wednesday that officials “could have done better” in handling the situation with former medical dean Carmen A. Puliafito.

In a statement to the USC community, Nikias said that although officials acted in good faith, “it is clear to us now that the university currently has only loosely defined procedures and guidelines for dealing with employee behavior outside the workplace that may be improper or illegal and has the capacity to affect USC. And, presently, the university has very limited capacity to conduct investigations and follow up on leads or anonymous reports of such employee behavior.”

He said a task force would immediately begin addressing questions such as how to improve employee wellness, improve assessment and ensure that concerns are raised to higher officials.

The statement came as the 44,000-student school in Los Angeles has been rocked by revelations about Puliafito.

A USC professor acknowledged that people inside and outside the university are upset about the story, but he praised university leaders’ integrity. Jacob Soll, a professor of history and accounting who works with governments on ethics issues, said people need to keep in mind that personnel decisions are fraught and legally complex. He said Nikias, a friend, is “totally aware of the fragility of the operation … one scandal like this could ruin everything.”

Soll, a MacArthur Fellow, said he has seen Nikias choose academic integrity rather than following the money numerous times. “The guy’s squeaky clean. He has wanted to avoid the kind of scandal where the university makes the wrong decision. He’s totally conscious of this.”

Last week the Times reported that the former dean of the Keck School of Medicine, Harvard-educated eye surgeon Carmen A. Puliafito, had a secret life: Although he had raised millions of dollars in donations and grant money, and enticed academic stars to the school, he resigned as dean in March 2016 — three weeks after a 21-year-old woman who told the Times she had been working as a prostitute allegedly overdosed in his hotel room. Police found methamphetamine in the room and talked with Puliafito but made no arrests. Puliafito later picked her up from the hospital, according to the Times, took her back to the hotel and continued the party.

The Times story on July 17 described numerous videos and photos from 2015 and 2016 showing Puliafito using drugs with much younger friends at several locations — including in the dean’s office at USC:

In one video, a tuxedo-clad Puliafito displays an orange pill on his tongue and says into the camera, “Thought I’d take an ecstasy before the ball.” Then he swallows the pill.

In another, Puliafito uses a butane torch to heat a large glass pipe outfitted for methamphetamine use. He inhales and then unleashes a thick plume of white smoke. Seated next to him on a sofa, a young woman smokes heroin from a piece of heated foil.

Puliafito did not respond to messages seeking comment.

He was not arrested or charged in connection with the overdose incident, and Pasadena Police Chief Phillip L. Sanchez said this week that there was and is no evidence that he committed a crime that night. Sanchez noted that people do not usually arrest victims who are hospitalized for overdosing, or arrest people who report an overdose or who are at the hospital with an overdose victim. “The 1.16 grams of methamphetamine found inside an unoccupied hotel room were not in anyone’s physical possession,” he noted in a news release. 

The story continues to reverberate nationally, in part because it seems a particularly shocking example of the unprecedented reach of the epidemic of illegal drug use in the country, and in part because most people have so much respect and trust for doctors — especially those whose roles include furthering advanced research, educating the next generation of physicians and caring for people who need help.

USC has raised its reputation in recent years as a private research university with global aspirations. It initially responded with a brief statement that its leaders could not discuss personnel matters. The statement said that Puliafito was on leave from his roles at USC, was not seeing patients and that, if the allegations were true, the university hoped he would get the treatment he needs for a full recovery.

“I have every confidence we acted in good faith and in accordance with our core values,” Nikias wrote in his letter Wednesday. But he said that although the university has clearly defined procedures for many sorts of concerns, “it is clear to us now that the university currently has only loosely defined procedures and guidelines for dealing with employee behavior outside the workplace that may be improper or illegal and has the capacity to affect USC,” and very limited capacity to conduct investigations or follow up on leads or anonymous tips about such behavior.

Nikias detailed the directive he had given to senior leaders to question things such as the flow of information across different parts of the university, additional training for staff on mental-health challenges, opportunities for improving wellness, ensuring reports of improper actions — even if anonymous — get passed on to higher officials, and improving assessment.

He also addressed some of the many complexities facing the university, including the balance between privacy rights and the need to ensure safety, as well as possible criminal behavior and the need for compassion for employees who need treatment.

On Friday, Nikias issued another public statement, telling the campus community that “we are outraged and disgusted by this individual’s behavior.” He said that the school had hired a partner in a law firm, a former federal prosecutor, for an inquiry into Puliafito’s conduct, the university’s response, and its policies and procedures.

The university’s provost, Michael Quick, also wrote a letter to the faculty Friday saying that he was aware many people “wanted us to act on allegations and hearsay, but we needed actual facts.” He said they had that day for the first time seen information firsthand of egregious behavior. “It is extremely troubling and we need to take serious action.”

Officials had begun the process of firing Puliafito and stripping him of his faculty tenure, Quick wrote. Puliafito is suspended, banned from campus and all university events.

But many asked why the university had not acted sooner.

“You can be fired for cause if you engage in behavior that is morally abhorrent,” said Raymond D. Cotton, a lawyer specializing in leadership and governance in higher education.

“Boards need to keep their radar up — that’s part of their fiduciary duty. The president of the university has to keep his radar up, too. He’s the last person who should be in denial about serious allegations,” Cotton said. “This person is dean of a medical school — setting moral standards for his students. If allegations are made, they need to be looked into. They may turn out to be false, but at least look into them.”

The Medical Board of California is looking into the allegations based upon the information provided in the Times article, according to Cassandra Hockenson, a spokeswoman for the board, but she said the board does not discuss ongoing investigations or complaints.

Paul S. Rosenbloom, president of USC’s Academic Senate, said in an email: “I am appalled by what has been alleged concerning the behavior of the former medical school dean, and concerned about anyone who may have been hurt by his actions. Furthermore, all faculty have a stake in knowing that this particular situation has been, and will be, handled appropriately by the university; and that we are confident that the appropriate policies and procedures are in place for the future.” He said he was looking forward to the results of the investigations.

“The entire academic community has been shaken up by this,” said John Prescott, an emergency medicine doctor and former dean who is chief academic officer for the Association of American Medical Colleges. He said that in working with hundreds of medical school deans over years he had never seen anything remotely like the behavior the Times described. “There are 100,000-plus faculty members currently in the United States. For any individual faculty member, this would be an outlier,” he said.

“When it’s a dean — because of the position, the trust the university and the school places on that individual” and the scrutiny and vetting they face before they are hired, he said, the situation is far more serious.

“It’s as important an issue as any that a school or university could face; it’s a senior leader of an academic institution.” Deans are juggling the demands of shifting national health-care policy, fundraising, threats to research funding,” he said. “And lives are literally at stake.”

Soll pointed out that the situation was complicated because police had not arrested Puliafito or charged him with anything. With a huge research university, he said, countless calls and complaints come in.

An audio recording suggests that the police officer who spoke with Puliafito about the overdose seemed unconvinced of what the dean told him, the Times reported. According to the newspaper, that recording captures a social worker asking the officer: “You buy it?” “No,” the officer responds.

The officer can be heard on the audio asking Puliafito how he knows the woman. Puliafito responds that he is a friend of her father. The officer also asks if the two were involved in a romantic relationship, which Puliafito denies.

USC Board of Trustees Chairman John Mork said in a statement that he had “utmost confidence and trust” in Nikias and Quick’s ability “to lead USC through this challenging time.”

Frederick J. Ryan Jr., publisher and chief executive of The Washington Post, also is a member of the USC board.

Charles Sipkins, speaking for USC, confirmed that, as the Times initially reported, an anonymous call was placed to the president’s office in March 2016. That information was never relayed to senior administrators, he said.

Puliafito resigned as dean that month.

He was honored by the university in June 2016 for his contributions.

This January, the Times reported, a reporter went to Nikias’s home and left a letter asking the president to talk about the circumstances surrounding Puliafito’s resignation — a letter that was returned the next day, unopened, via courier. In March of this year, the Times reported, the newspaper asked to interview Nikias, with a list of questions and information the reporters had learned, including that methamphetamine had been found in the hotel room where the woman overdosed the year before, and that the room was registered to Puliafito. The newspaper attached the recording of the 911 call made to report the apparent overdose which included audio of Puliafito identifying himself as a doctor and saying the woman was sleeping after having several drinks.

Nikias did not respond to that March 2 email, according to the Times, and reporters who went to his office were turned away.

Robert E. Tranquada, a former dean of Keck, said he had not heard concerns about illegal drug use or anything remotely like that from faculty members.  “I felt, and I think others did, that he was very self-absorbed — and yet he was extremely successful in a variety of things, including, obviously, fundraising, and recruiting absolutely first-rate faculty, getting new programs, and other things. That’s where I think most of the faculty attention went.” 

After the investigation, he said, “I think that will all be dealt with appropriately, but not until the facts are really known. And, I suspect, not in the public.”

“This is a disaster right now,” Soll said. “It needs to be cleared up — and people have to understand what the university’s constraints are.”

Letter to USC campus community

Carmen A. Puliafito, former dean of the University of Southern California medical school. (Tonya Wise/Invision/AP)