When police in western France searched the home of surgeon Joel Le Squarnek in 2017 after he raped his six-year-old neighbor, they found a cache of child pornography.
They also discovered electronic diaries that appeared to detail nearly three decades of rape and sexual assaults on hundreds of his young patients in hospitals across the region.
Le Skuarnek was sentenced to 2020 years in prison in 15 for raping and sexually assaulting his neighbor, as well as two relatives and a four-year-old patient.
However, the investigation continued into the alleged victims listed in his records. Prosecutors eventually charged him with aggravated rape and sexual assault of 299 people, many of whom were children, some of whom were under anesthesia at the time the alleged abuse occurred.
Le Skuarnek, 74, will face trial on the charges in the Breton city of Vannes on February 24, in the largest child sexual abuse case in French history.
The prosecution says the defendant has admitted to investigators many of the charges against him. His lawyers declined to comment on the case before trial.
The trial comes as France is being scrutinized over sex crimes after Dominique Pellico was found guilty of convicted in December of drugging his wife and inviting dozens of men to their home to rape her. In that shocking case, 50 other men were convicted of rape.
Le Skuarnek's case raises serious questions about France's publicly funded healthcare system, victims and rights groups say. Despite a 2005 conviction for child pornography, Le Skuarnek continued to work in public hospitals until his arrest in 2017.
Francois, one of the plaintiffs in the case who was 12 years old when Le Squarnek allegedly abused him, said he hopes this process will provide answers to the question of how the system failed him.
"I understand that this surgeon should not have operated on me," Francois, who did not want his last name to be published, told Reuters. "I feel that the authorities have failed me... Why didn't anyone stop this surgeon from working with children?"
After the discovery of Le Skuarnek's diaries in 2017, investigators began identifying potential victims by comparing descriptions from the diaries with hospital records. Although many of the patients who were under anesthesia had no memory of the alleged abuse, psychiatrists documented symptoms of post-traumatic stress disorder in the victims, according to court documents.
Mathis Vine was 10 years old in 2007 when his father and grandfather took him to a hospital in Kimperle with stomach pains. The grandfather, Roland Vine, 78, remembers meeting Le Scuarnec and did not suspect anything when the surgeon ordered Mathis to spend the night alone in the hospital, he told Reuters.
In his diary, Le Skuarnek wrote that he sexually abused the boy that day and the next.
After his hospital stay, Mathis never recovered, Vine said. He later became addicted to alcohol and drugs. He died of an overdose in 2021 at the age of 24, three years after he learned from police that he had been abused.
Vine and his wife, who are also prosecutors in the case, believe that Mathis took his own life and blame Le Squarnek for his death.
Le Skuarnek was sentenced to a suspended four-month prison sentence in 2005 for possession of child pornography. The very next year, he got a job as a surgeon at the public hospital in Kimperle.
According to a court document, a psychiatrist at the hospital alerted management to Le Scuarnec's concerning behavior in 2006, but the surgeon continued to work with children.
The Lorient prosecutor's office, led by Stephane Kellenberger, which led the investigation into Le Squarnec's alleged crimes, has launched a special preliminary investigation to determine whether there is criminal liability on the part of institutions or individuals who could have prevented the abuse.
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