The American psychiatrist jailed for sleeping with a teenage patient never disclosed to New Zealand medical authorities the cloud he had left the United States under, when he applied to work here.
Dr Paul Fox surrendered his medical licence in Connecticut, in the United States, in July 2012, a month after he applied for registration in New Zealand.
The Weekend Herald revealed today a patient of Fox's at the Henry Rongomau Bennett Centre at Waikato Hospital complained about Fox and alerted staff to his surrendered licence in April 2013.
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It wasn't until Fox was exposed by the Herald in January 2014 that the full extent of his background came to light and he resigned.
By then Fox, who treated a teenage Sandy Hook shooter Adam Lanza before the 20-year-old went on to kill 26 pupils and teachers at his former primary school, had been working at Waikato District Health Board for 19 months.
Medical Council of New Zealand deputy chief executive Aleyna Hall said when Fox applied for registration in New Zealand in June 2012 he made no disclosures on his application.
"Throughout that process we received information from Connecticut Department of Public Health which informed us that there was a current investigation but they were unable to provide us with more information at that time.
"His application for registration proceeded on the basis that there was insufficient information, at that time, to not grant Dr Fox registration."
The Medical Council granted registration on the provision that when more information became available it would be reconsidered, Hall said.
In 2013, when Fox applied for provisional vocational registration, the Medical Council discovered Fox had surrendered his licence in Connecticut.
"We made inquiries with Dr Fox and he advised us that the investigation had been closed and no further action had been taken.
"We checked the State of Connecticut Department of Public Health website which confirmed he no longer held a licence to practise. On that basis he was granted provisional registration."
What Fox did not tell authorities is that he had allegedly been fired from a medical centre in Connecticut in January 2011 for an ethics violation, according to US reports.
In March 2012 a university student told another doctor she had been having an affair with Fox that spanned more than a year.
Fox had been treating the 18-year-old for depression and an eating disorder and at some point began having sex with her, according to court documents.
In July that year a complaint was filed against Fox with the Connecticut Department of Public Health.
By then, Fox was in already in New Zealand and had applied for registration.
One of his patients, retired polytech lecturer Phil Brooks, told the Weekend Herald he warned Waikato DHB staff in April 2013 that Fox had surrendered his American licence, showing them an affidavit signed by a Hamilton Justice of the Peace in July 2012, referencing the voluntary surrender.
He also lodged formal complaints about Fox's provocative, aggressive and confrontational style of treatment.
"After the first consultation with Paul Fox I knew that there was something very wrong with that man and that was the catalyst for investigating him on Google," Brooks said.
"You don't provoke and attack somebody who is mentally ill. You're going to increase their levels of stress and distress and make them more desperate."
On May 13, 2013, after Brooks had been discharged, he wrote a formal complaint to Fox accusing the psychiatrist of trying to destabilise him, being culturally insensitive, and inflammatory.
It was the same day the New York State Board of Professional Misconduct made a charge of professional misconduct against Fox.
Waikato DHB hospital and community services executive director Leena Singh said the DHB investigated Brooks' complaints and responded to his requests.
"The complaints and subsequent investigations did not identify any issues or concerns with clinical competence."
She said the date an investigation into Fox began was not available, but it was eight months before Fox was publicly exposed, after which he left the DHB in February 2014.
Previously, Waikato DHB executive director of mental health and addiction services Vicki Aitken told the Herald the DHB had become aware of the specific details of the sexual assault complaint against Fox in January 2014.
"We commissioned an independent external review by a senior psychiatrist into Dr Fox's practice at the DHB. This found no issues, therefore we have no need to relook at his patients."
However, Jane Stevens, the mother of Nicky Stevens, who took his own life while in Waikato DHB care in March 2015, called for Fox's treatment of Waikato patients to be re-examined.
"Dr Fox was the person who put Nicky on the drug regime that he was on right up until he died, and that has huge concerns for me.
"There's big questions now around Adam Lanza's drug regime, and nobody's ever addressed that.
"This needs to be re-visited and there needs to be some accountability and transparency."
Timeline of events
2009/10: Began treatment of university student "Jane Doe" in Connecticut for depression and eating disorder.
2010/11: Having sex with Jane Doe, then 18, at his office and on a sail boat while she was "drugged up" on medication he prescribed.
January 2011: Allegedly fired from Connecticut medical centre for ethics violation.
March 2012: Jane Doe tells a doctor at Yale New Haven Hospital about affair with Fox.
June 2012: Fox applies for registration in New Zealand. Begins work as a locum at Waikato DHB.
July 2012: Yale New Haven makes complaint with Connecticut Department of Public Health about affair with patient. A week later Fox surrenders his license.
December 2012: Adam Lanza shoots dead his mother, 20 children and six teachers at the Sandy Hook Elementary School in Connecticut, before turning the gun on himself.
Date unknown in 2013: Fox applied for provisional vocational registration and was granted it by the Medical Council. Fox became a full-time employee of Waikato DHB's mental health and addictions service.
April 2013: Patient Phil Brooks makes complaint about Fox to Waikato DHB staff. Alerts them to Fox's surrendered licence.
May 13, 2013: New York State Board of Professional Misconduct lays a charge of professional misconduct against Fox.
May 13, 2013: Brooks lodges formal complaint with DHB about Fox's treatment style.
July 2013: Connecticut police investigating the Sandy Hook massacre interview Jane Doe as a past patient of Fox's, and discover the misconduct complaint against him.
September 2013: Brooks complains to the DHB again about Fox and asks that his complaints be investigated and that Fox's competence and fitness to practice be assessed.
Date unknown in 2013: Waikato DHB investigates Brooks' complaints and takes no action.
December 2013: Fox begins treatment of Nicky Stevens and sets up his drug regime using Olanzapine, which Nicky strongly objected to.
January 1, 2014: The Herald reports a story from the Associated Press revealing Fox was Lanza's psychiatrist who also faced allegations of misconduct in the US, was now working in Hamilton, NZ.
January 2014: Waikato DHB and the Medical Council investigate.
February 2014: Medical Council strips Fox of his registration. Fox resigns and returns to US.
December 2014: Brookfield Police inform Connecticut State Police of information about Jane Doe discovered during Sandy Hook tragedy investigation.
March 2015: Nicky Stevens takes his own life after leaving the Henry Rongomau Bennett Centre on unescorted leave, granted against the express wishes of his parents.
March 2016: Warrant issued for Fox's arrest.
April 2016: Fox arrested in Maine, US, on sexual assault charges.
June 2019: Fox pleads guilty to the charge and is jailed for 18 months. He must register as a sex offender.