Lexington doctor loses SC license after regulators find sexual contact with patients and staff

A Lexington doctor accused of sexually assaulting two patients can no longer practice medicine in South Carolina after he admitted to misconduct more extensive than previously reported.

The S.C. Board of Medical Examiners permanently revoked the state license of Dr. Fernando Xavier Castro in an Aug. 11 order, saying he was “a danger to the public.” 

The regulatory body found that Castro, who’d been affiliated with Lexington Rheumatology, built relationships with patients based on trust and confidence, which he then “exploited for his own sexual gratification or attempted sexual gratification.”

The board said Castro admitted to multiple instances of professional misconduct — with patients, a co-worker and office staff — incidents that have not been previously reported. They included sex with a patient, sexual activity with a nurse in the office and accessing confidential medical records to check if patients were married.

Castro, who specialized in internal medicine and pulmonology, submitted a written statement where he took responsibility for his “inappropriate behavior,” according to the board. 

“I recognize that my conduct represented a serious breach of medical ethics and professional standards and, more importantly, may have caused emotional and psychological harm to my patients,” Castro said in the statement.

It’s unclear whether Castro intends to appeal the administrative decision. Castro’s attorney, Tracey Perlman, did not immediately respond to the Chronicle’s messages on the afternoon of Aug. 13.

The Lexington Health network, which runs Lexington Rheumatology, earlier said Castro was removed from the clinic in March 2024. It declined to comment on the medical board’s findings and revocation order.

Castro still has active medical licenses in North Carolina and Florida. Though the N.C. medical board temporarily suspended his license last year, just as its S.C. counterpart did upon receiving a sexual assault complaint from one of Castro’s patients. 

‘Not a momentary lapse in judgment’

The S.C. medical board said Castro’s conduct was “abominable,” citing violations of multiple state administrative laws on the conduct of health care professionals. The board’s biggest concern was that Castro’s conduct, both inside and outside the office, showed a “pattern of disregard for his obligations as a physician.” 

“This was not a limited or even momentary lapse in judgment,” the regulatory body said in the publicly posted order. It added that Castro’s misconduct was “more pervasive than initially believed.”

The board said Castro admitted to the following professional offenses:

• Offering and performing massages for “many patients” that he hoped would become sexual
• A few of these massages occurred in the office
• Sexual contact with two patients, including an instance of intercourse
• Sexual contact with a nurse in the office and other sexual behaviors unrelated to patients
• A massage given to office cleaning staff while they were in the office
• Use of medical records to verify what he knew about a patient’s marital status
• Arranging to meet a patient at a hotel or residence for massages 

The board said Castro used his patients’ protected health records — in violation of the federal HIPAA law — to identify patients “as possible victims for his sexual encounters.”

Boundary violations between a doctor and patient, such as sexual contact, were among the most serious breaches of professional ethics and trust, the board said. Violations of sexual boundaries, it said, can have harmful psychological effects on patients, including anxiety, depression and post-traumatic stress. 

Two patients report sexual assault

The S.C. board’s findings and order came almost exactly two years after it received a complaint from one of Castro’s female patients. 

The woman said Castro sexually assaulted her in January 2022, under the guise of conducting a therapeutic massage at her home in Richland County. She said Castro also touched her inappropriately during a 2023 appointment at his West Columbia clinic.

Another patient reported similar allegations to the Lexington County Sheriff’s Department. She said Castro sexually assaulted her during a massage therapy session at a motel across from the Lexington Medical Center. 

The sheriff’s department could not find probable cause to charge Castro with a crime and closed the case.

The two complainants, who did not know each other, said these encounters left them feeling violated and traumatized. These accounts were previously published by The Post and Courier.

The woman who filed the board complaint has sued Castro and Lexington Health in state court on allegations that include gross negligence and breach of contract resulting in injury. The defendants deny the accusations. The cases are ongoing. 

The Chronicle does not identify victims of alleged sexual assault without their consent. The woman asked not to be named in this story.

Her lead attorney, Liz Dalzell, said the S.C. medical board’s findings affirm their team’s belief that Castro’s behavior was part of a pattern of violations that his supervisors should have caught.

“This was happening, and nobody was paying attention to it,” Dalzell told the Chronicle. “It becomes more of a systemic problem when you see the extent of what went on.”

It’s not clear what compelled Castro to disclose other professional violations, on top of what his two patients had reported to the board and the sheriff’s department. 

Holly Beeson, legal counsel to the S.C. medical board, said she could not provide additional details beyond what was in the order.