Michigan State University President Lou Anna Simon, who presided during a massive sexual assault scandal, stepped down late Wednesday after a former employee, the disgraced physician Larry Nassar , was handed a sentence of up to 175 years imprisonment for molesting upwards of 160 young women and girls.

But more people may answer for MSUs poor handling of Nassars case, as the school faces intense criticism and questions about its response to sexual harassment and assault complaints.

The National Collegiate Athletic Association and Michigan Attorney General Bill Schuette both plan to investigate possible negligence by school officials in the Nassar case. MSU Athletic Director Mark Hollis issued a statement Wednesday saying the university will cooperate. Yet at the same time, the school is attempting to dismiss a civil suit against it filed by about 140 of the young women Nassar assaulted.

As dozens of young women stood up in court this month and blamed MSU for failing to take action against their abuser, The Detroit Free Press raised questions over what Simon knew, and what she chose to do with that information.

Past investigations have suggested a pattern of handling similar situations poorly.

Prompted by complaints, the U.S. Department of Education examined approximately 150 accusations of sexual harassment, sexual assault and sexual violence at MSU that were filed from 2011 to 2014. The departments Office for Civil Rights is responsible for enforcing Title IX, the gender equality law covering educational institutions that receive federal funds.

The DOE review found significant concerns in 30 cases. Researchers uncovered a number of problems , including a sluggish response to complaints, sloppy documentation, and some cases where the school failed to take proper action.

A DOE report said a potentially sexually hostile environment existed for numerous students and staff. In the reports most troubling example, MSU initially took no action against a counselor who allegedly sexually harassed students who sought help after experiencing sexual assault. It took multiple complaints to prompt a response, even while staff had noticed the counselors inappropriate behavior in the past, according to the report.

That was one of a few instances where MSU failed to take sufficient action against people accused of sexual misconduct who were then accused of the behavior again, the DOE said .

Following the report, MSU agreed to implement a number of changes in its handling of sexual misconduct. Those included outreach efforts to encourage staff and students to report incidents to a designated Title IX coordinator, who would also start regularly meeting with representatives from the student body and university faculty.

Shortly afterward, a Sexual Violence Advisory Committee was established and began issuing recommendations to the coordinator, Jessica Norris. The university also revised dozens of policies and more than doubled its Title IX staff after the DOE report, according to The Lansing State Journal .

Norris did not respond to HuffPosts requests for comment. Neither did an attorney for MSU or the universitys public affairs department.

Nassar, who was the subject of multiple complaints, was fired in September 2016 almost one year after the reports release when the Indianapolis Star broke the story on his behavior. Nassar was employed by MSU and USA Gymnastics as a team doctor and assaulted patients over several decades.

According to the State Journal , MSUs Title IX investigator, Kristine Moore, allowed Nassar to choose at least one of the medical experts she consulted after a patient complained about his treatment methods in 2014.

A page on MSUs website about the schools history of commitment to preventing sexual harassment and assault does not include the 2015 DOE investigation. Another commitment page boasts a two-part external review conducted by the Missouri-based law firm Husch Blackwell. While the second part has yet to be published, the first part stated the university was doing a good job to create a safe campus environment.

We acknowledge that there continues to be significant media attention around MSUs Title IX efforts that may suggest its policies and procedures are out of compliance, the report reads. We disagree with this conclusion.

The first part of the Husch Blackwell review was published in November 2017, the same month Nassar pleaded guilty to 10 counts of first-degree criminal sexual conduct.

Earlier in 2017, the university commissioned another independent report to analyze two separate incidents of sexual abuse, both involving MSU football players. Jones Day, a Cleveland-based law firm, conducted an investigation and concluded that head coach Mark Dantonio and his staff followed university procedure.

As the number of women speaking out against Nassar in court ticked well into triple digits on Monday, MSU trustee Joel Ferguson made a comment on a Michigan radio station that some took to illustrate school officials attitude toward sexual abuse at the school. Ferguson said he didnt believe Simon should resign as MSUs president because theres so many more things going on at the university then this Nassar thing.

Ferguson later apologized for the flippant remark.