Chesapeake OB-GYN admits backdating patient consent forms but denies unnecessary surgeries

Dr. Javaid Perwaiz knew that government-funded Medicaid insurance required that patients consent to sterilization surgeries at least 30 day before they were performed.

And yet he admitted during testimony Thursday in his criminal trial in U.S. District Court in Norfolk that he frequently backdated the forms to make it appear he’d complied with the rule, which prosecutors said was created decades ago to prevent low-income women from being pressured into getting sterilized.

“It was to help the patients,” Perwaiz said of his backdating practice.

Each had already expressed a desire to get sterilized more than 30 days before the procedure was done, he said, and he didn’t want to make them wait any longer. Even the ones who’d first come to him just a few days before getting procedures done had told another doctor they wanted it, he said.

Also, some were close to having their Medicaid insurance run out and he wanted to ensure they got the surgery while still covered. Perwaiz said he always informed them the procedure was permanent, but also told them it could be reversed later.

The 70-year-old doctor’s testimony came during the 11th day of his trial on 61 counts of fraud.

The trial began Oct. 14 and is expected to last several more days. Prosecutors have alleged Perwaiz performed numerous unnecessary surgeries and procedures on his patients for years in order to fund a lavish lifestyle.

The doctor first took the witness stand in his own defense Wednesday, testified all of Thursday, and is set to return Monday when the trial resumes.

During testimony Thursday, Perwaiz also conceded he never used scopes with cameras that could project what he was seeing inside the patient onto a monitor in the operating room — a common practice used by all the other OB-GYNs doing surgery at Chesapeake Regional Medical Center.

Perwaiz said the equipment wasn’t available when he was training in the 1970s, nor was it something he was comfortable using, or was required to use.

But the longtime physician strongly denied ever doing surgeries that weren’t medically necessary, or inducing pregnant patients to deliver their babies earlier than was medically safe. Prosecutors have alleged he regularly induced pregnant women early in order to make sure he was the one to deliver the baby and get paid for it.

Assistant U.S. District Attorney Elizabeth Yusi asked Perwaiz to explain why most of his pregnant patients in 2019 had their labors induced early, and almost always on Saturdays when he was at the hospital performing surgeries.

Perwaiz said that there were risks with letting a patient go beyond 39 weeks of pregnancy and he was trying to prevent that.

While prosecutors contend that the inductions were routinely scheduled at 38 weeks of pregnancy — which the American College of Obstetricians and Gynecologists says is unsafe for the mother and baby — the doctor said he always did them in the 39th week.

He also said he was proud that his rate of cesarean section

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A nurse repeatedly voiced concern about a Chesapeake doctor’s unusual surgery practices to supervisors. Nothing happened, she says

Most every Friday afternoon, Dr. Javaid Perwaiz performed outpatient surgeries at a medical center in Suffolk.

And while there were lots of other doctors who operated regularly at the Bon Secours Surgery Center at Harbour View, there were none quite like Dr. Perwaiz, operating room nurse Jean Kennedy said.

His schedule was so packed and fast-paced the surgical center’s staff had a special name for it: the Perwaiz-a-thon.

“When someone asked you what are you doing today, staff would frequently say, ‘I’ve got the Perwaiz-a-thon,’” Kennedy said during testimony Monday in U.S. District Court in Norfolk. “It was an extremely busy tempo. Very stressful. At times it was chaotic.”

Perwaiz, 70, a longtime obstetrician-gynecologist who had offices in Chesapeake for decades, is on trial for multiple counts of heath care fraud, making false statements related to health care and identity theft. The trial began Wednesday and could last more than a month.

Prosecutors allege that Perwaiz frequently performed unnecessary surgeries and procedures, regularly induced labor for pregnant patients two weeks before they were due, and changed dates on forms to make it look like he was complying with insurance rules and regulations.

Kennedy testified Perwaiz typically had more than one operating room in use on Fridays and bounced back and forth between them. The other doctors just had one, she said.

And while the other doctors had their patients check in at staggered times, all of Perwaiz’s patients were told to report at the same time. Many of them didn’t seem to understand why they were having surgery, she said. And many had been there before.

“It was a first-come, first-serve basis,” she said. “There was no set schedule. It was just whoever was prepped and ready.”

The practice made Kennedy nervous because she feared it could lead to confusion and mistakes, she said.

Kennedy also said she occasionally saw the doctor write down post-surgery notes, in which he lists what he saw and did during the procedure, before the operation had even begun.

And unlike the other doctors, Perwaiz never used a scope with a camera on the end that could project images from inside the patient’s body onto a monitor for everyone in the operating room to see, she said.

Kennedy, who had once been a patient of Perwaiz and had worked in his office for a couple of years, said she and other hospital employees told supervisors of their concerns about Perwaiz’s unusual and concerning practices.

“They were fully aware,” she testified.

“And what happened?” prosecutor John Butler asked. “Nothing,” she said. “Things continued as they always had.”

In other testimony Monday, a 51-year-old former patient told jurors how she went to see Perwaiz after learning she had an abnormal pap smear. The woman had already survived breast cancer and feared getting cancer again.

The woman said Perwaiz performed one procedure, told her it didn’t work and that she’d need to get a hysterectomy. She said she was adamant about having it done vaginally because

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A nurse saw a Chesapeake doctor do questionable things for years. She also got gifts totaling hundreds of thousands of dollars.

Margo Stone did a little bit of everything over the nearly three decades that she worked for Dr. Javaid Perwaiz.

Her job titles included nurse, office administrator, and bookkeeper. She assisted Perwaiz in the examining rooms, checked patient’s blood pressure and weight, ordered supplies, paid bills, recorded deposits, and handled the payroll and payroll taxes.

She also had a romantic relationship with the longtime obstetrician-gynecologist now on trial for more than 60 criminal charges in U.S. District Court in Norfolk.

Prosecutors allege that Perwaiz, 70, performed unneeded work on patients for years in order to fund a lavish lifestyle. He’s charged with multiple counts of health care fraud, making false statements related to health care matters and identity theft. His jury trial began Wednesday and could last more than a month.

Stone told jurors she first started working part-time as a nurse for Perwaiz in the early 1990s and later became a full-time employee. Over the years, her responsibilities grew. So, too, did her relationship with the doctor.

He spent lots of time with Stone, her husband and two sons, Stone testified. He became a kind of grandfather figure for the boys, now in their 20s. He paid for the boys’ high school and college tuitions and bought the oldest son a car. The boys eventually started calling him Papa.

Perwaiz hung the boys’ framed portraits on the walls of his office and put their initials on the license plate of one of his cars.

Stone also got lots of gifts from the doctor. She estimated that he gave her about 10 watches, each valued at $2,000. She also got purses, sunglasses, and jewelry. She even shared an American Express card with him that she used to buy things for herself and her sons.

When asked by Assistant U.S. Attorney John Butler to estimate the total value of the gifts that Perwaiz gave her over the years, her response: “Several hundred thousand dollars.”

And while Stone testified that she would have stopped working for the doctor immediately if she ever thought he did anything that would put a patient’s safety in jeopardy, she said she saw him do some things that were questionable.

One day when she was filling in at the main office, she said she saw him examining a patient with an instrument that was broken. She immediately ordered a new part for it.

When staff complained that he wasn’t sterilizing a piece of equipment for the recommended amount of time, she said she confronted him and he agreed to wait in the future. And when she heard patients complain about having to undergo too many surgeries, she confronted him about that, too.

“Sometimes he seemed to listen, sometimes he did not,” she said.

Stone also said she knew that he wasn’t using some instruments properly and occasionally saw him alter information on patients records.

In other testimony Friday, two of Perwaiz’s former patients told jurors how the doctor recommended they get a hysterectomy after they

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