A Dayton law firm now represents 79 plaintiffs in a lawsuit against former Cincinnati Children's Hospital physician Howard Saal, a geneticist and dysmorphologist who spent 30 years at the hospital before federal agents charged him with possessing child pornography. The former patients allege Saal sexually abused them during medical appointments and that the hospital failed to protect them, while a separate federal criminal case against Saal proceeds over material found on his electronic devices.
According to WKRC, the latest lawsuit claims Saal photographed patients in stages of undress and asked parents to leave the exam room during appointments, according to the lawsuit's claims. Many of the patients involved had genetic conditions, and the 79 plaintiffs include former patients treated by Saal over his decades-long career at the hospital. The lawsuit is part of multiple ongoing legal actions involving Saal, and it also claims Cincinnati Children's Hospital failed to protect patients, according to the lawsuit.
The criminal case against Saal traces back to a cyber tip that a Hamilton County Sheriff's Office detective, working on the FBI's child exploitation task force, followed up on regarding a local IP address linked to child pornography searches. As reported by KRDO, that tip in February 2025 led investigators to trace the IP address to Saal, and detectives executed a search warrant on his home in June 2025, seizing 29 electronic devices.
What Investigators Found on Saal's Devices
A review of those devices revealed more than 153,000 images and 470 videos of child pornography, according to investigators. Per a statement from U.S. Attorney Dominick Gerace, the material involved victims as young as newborns. At the time federal charges were announced, investigators said forensic reviews found no evidence that any of the recovered images or videos depicted hospital patients or children connected to Cincinnati Children's Hospital, the same account notes.
That distinction sits at the center of the case's two separate legal tracks. The federal criminal charges concern digital files recovered from Saal's seized hardware, while the civil lawsuits allege physical misconduct inside clinical exam rooms — two different sets of allegations resting on two different bodies of evidence. Dysmorphology, the subspecialty Saal practiced, standardly involves detailed physical exams and diagnostic clinical photography used to diagnose rare genetic conditions, according to research published on ResearchGate. That clinical context is central to the dispute now playing out in court over what was legitimate medical documentation and what plaintiffs allege was unauthorized conduct.
Hospital Departure and Regulatory Fallout
Saal officially left his position at Cincinnati Children's Hospital Medical Center in July 2025, after which the hospital mailed letters notifying patient families of his departure without disclosing the underlying investigation or reason for his exit, per KRDO. The following month, the State Medical Board of Ohio voted to accept the permanent surrender of Saal's medical license, permanently revoking his authority to practice medicine in the state without the right of appeal, the outlet reported.
Civil litigation filed against Saal and the hospital includes specific legal counts alleging fraud and spoliation of evidence tied to missing or altered patient photographs and medical records, according to Helping Survivors. The case also arrives amid broader statewide reform: Ohio enacted legislation in late 2024 expanding the State Medical Board's oversight authority and mandatory reporting protocols for physician misconduct following other high-profile medical abuse cases in the state, the same organization notes.
Court Proceedings and Community Standing
At his initial federal court appearance, prosecutors did not seek pre-trial detention for Saal, and the court ordered him released on an own-recognizance bond with specific release conditions, according to a report from WLWT. Under federal law, a conviction for transporting child pornography carries a statutory sentence of 5 to 20 years in prison, while possession carries a potential maximum penalty of 20 years.
Before his arrest, Saal served as president of Congregation Etz Chaim in Cincinnati from 2021 through June 2024. After the federal charges became public, the synagogue's executive committee voted to condemn child exploitation, according to KVIA. Hoodline previously reported on earlier civil claims against Saal, and the newly reported 79-plaintiff lawsuit adds to that expanding litigation as both the criminal and civil cases remain active.
