Doctor accused of unnecessary surgeries, altering medical records defends himself as an ‘advocate for my patients’

NORFOLK —Javaid Perwaiz, the obstetrician-gynecologist accused of performing unnecessary sterilizations, billing for phantom medical procedures and inducing healthy pregnant women to deliver for his convenience, testified this week that he altered consent forms and changed due dates to benefit his patients, not line his pockets.

Perwaiz, who is charged with dozens of counts of health fraud, told jurors in U.S. District Court that he ignored congressionally mandated regulations requiring patients to wait 30 days after signing a sterilization consent form by having them sign an undated form. Instead, he backdated the forms, sometimes performing sterilizations within days of seeing a patient.

“Yes, I knew the 30-day requirement. I just couldn’t say no,” he said from the witness stand Thursday. “I’m an advocate for my patients.”

He said he performed the sterilizations in contradiction to the requirement to benefit his patients. Often, they had discussed sterilization with doctors who referred them. They told him, he testified, that their insurance would run out if he waited or that they could not get a ride or a babysitter on other dates. Asked during cross examination if he could name which of the patients in the indictments told him that their insurance was running out, Perwaiz could not.

Backdating forms is part of three broad categories of charges against Perwaiz. Prosecutors say he altered medical records to justify unnecessary surgery, often scaring women by mentioning the threat of cancer. They allege he changed due dates so he could induce women into labor on the Saturdays he was operating on other patients at Chesapeake Regional Medical Center. And they contend he billed insurers for office medical procedures done with broken equipment.

He is also charged with falsifying his application to health-care providers by omitting a felony conviction for tax fraud in 1996, which resulted in a brief suspension of his license, and failing to admit his loss of privileges at Maryview Hospital in 1983. Perwaiz, 70, has been jailed since his November arrest.

[doctor is accused of years of unnecessary hysterectomies. The women who trusted him want answers.]

In a full day of testimony, Perwaiz, led by defense lawyer Emily Munn, defended the care he gave to the two dozen patients named in the 61 counts against him. In case after case, she broadcast his medical charts and the form he filed with Chesapeake Regional Medical Center before surgery. The charts were identified by the initials of the women prosecutors charge he operated on unnecessarily — D.B., D.P., A.G., T.D.C., A.F., A.N. S.N., D.B.D — and by their age and the complaints they wrote down, which several women who testified previously said were false.

In case after case, Perwaiz explained that the complaints by the women — often pelvic pain, bleeding and cramping — justified his procedures. Often, he said, women asked him to be sterilized. In none of the cases of women named in the indictments, Perwaiz said, did he refer them to other doctors after finding evidence of cancer.

During cross examination

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Arizona governor defends school rule as virus ‘storm’ looms

PHOENIX (AP) — Arizona Gov. Doug Ducey on Thursday warned that a “storm is ahead” as coronavirus cases climb in the state, but defended new guidelines for in-person school instruction that will let students remain in class far beyond what earlier guidance would have recommended.

The Republican governor insisted that his administration consulted with public education and health officials before making the decision to ease guidance for when schools should consider ending in-person instruction and returning to online classes.

But Superintendent of Public Instruction Kathy Hoffman, a Democrat, said in a tweet that her department did not request or recommend any changes to the state health department’s guidance.


And two major school administrator groups objected to the decision, saying it goes against months of planning done following the previous guidance. The Arizona School Administrators and the Arizona School Boards Association released a statement s aying the change was made without communicating its reason or an understanding of its impact on schools.

Ritchie Taylor, Hoffman’s spokesman, said the Health Services Department presented the change as a done deal at a regular weekly meeting earlier this month of a group of county health officials and Education Department officials. The group has been meeting since the summer to collaborate on school virus issues.

“It was not put up for a collaborative debate or input,” Taylor said. “It was put up as a policy decision.”

The Health Services Department in August issued guidance outlining how and when schools can consider reopening and when they should close again if virus cases surge. Those rules suggested a return to remote learning if at least one of a county’s three benchmarks based on COVID-19 cases, testing positivity and prevalence of COVID-19-like illness moved from moderate to substantial spread.

The new recommendations were quietly posted on the health services department website last Thursday, and went unnoticed until KNXV-TV reported on them earlier this week. They call for districts to move to remote learning when all three benchmarks move to substantial spread for two weeks.

Ducey on Wednesday dodged questions about why there was no announcement of the change and did not specifically say who requested them. The guidance covers 1.1 million public school students in district and charter schools statewide. It doesn’t cover private or parochial schools.

“These guidelines were adjusted at the request of public education leaders in coordination with public health officials,” Ducey said. “And that’s how we’ll continue to do that and we will be completely transparent.”

The governor spoke at a media briefing where he discussed current virus conditions, which he said were rising. Health Services Director Dr. Cara Christ said she expects a further spike in cases after Thanksgiving, when college students return home and families gather for the holidays.

“I hope that I am wrong, but what I would anticipate is to see a spike about 10 to 14 days after Thanksgiving and then potentially continue to increase over the next four to six weeks,” Christ said.

That would strain hospitals, who

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Pritzker Defends Coronavirus Data Used To Ban Indoor Dining

CHICAGO — Gov. J.B. Pritzker defended the metrics used to guide his regional COVID-19 resurgence mitigation plan, which have triggered restrictions on indoor service at restaurants and bars across most of the state.

Coronavirus positivity rates in all but one region of Illinois are above the 8 percent fail-safe threshold that leads to increased restrictions under the governor’s Restore Illinois plan and executive orders.

“Let’s be clear,” Pritzker said. “Well-meaning and reasonable people can have fair disagreements about how and where to draw lines and connect dots, but when every single metric in every single corner of our state is trending poorly, we have to take meaningful action to keep our people safe”

In addition to a positivity rate that has risen by 3.4 percentage points since Oct. 1, the number of hospitalized patients with COVID-19 rose by 73 percent, while the number of coronavirus patients in the state’s intensive care units is up by 61 percent this month, according to Illinois Department of Public Health data Pritzker shared at a briefing Thursday in Chicago.

Of the two regions where restrictions have yet to be imposed: Region 6, the Champaign EMS region, is on track to see restrictions announced Friday, having already averaged two days above the 8 percent mark. And Region 2, the Peoria EMS region, saw its positivity rate rise to 7.9 percent on the most recent day for which data was available.

The restrictions can also be triggered by a period of seven out of 10 days with both increasing positivity rates and an increasing rounded rolling average number of new daily hospitalizations of people with coronavirus symptoms. That led to the first tier of mitigations in suburban Cook County and Chicago before the regions also triggered restrictions by spending three days above the 8-percent mark.

“Bars and restaurants are spreading locations,” Pritzker said. “We need to clamp down because we need to bring the numbers down. They’re headed in the wrong direction, and unfortunately bars and restaurants are the location — no fault of the people who own them or operate them or even people who visit them — but it is true that those are places where there is a higher transmission likelihood than other locations.”

Tiered mitigations restricting indoor dining and limiting the size of gatherings have been imposed on nine of the state’s 11 regions. Region 3, the Springfield emergency medical services region, Thursday became the latest to trigger the additional measures. One region — Region 1 in Northwest Illinois — has advanced to the second tier of mitigations. “Tier 2” includes a 10-person gathering size limit and a six-person limit at outdoor tables.

Pritzker was asked whether the first two tiers of limitations that be enough to curb the spread.

“I don’t know. I really would like to know the answer to that. This virus is unknowable, seemingly,” he said. “We didn’t know when we put the stay-at-home order back in March, we didn’t know if that was enough. We

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GoodLife Fitness defends email asking for re-opening support

A chain of gyms in Ontario is facing a flood of feedback after asking its members to “stand up for fitness” by contacting their MPPs about the current strict limitations to indoor fitness as a result of COVID-19.

GoodLife Fitness sent an email to about 200,000 of its employees and members in the province, encouraging them to contact their local MPPs to push to reopen gyms. 

“Between mandated shutdowns, capacity restrictions, and ongoing questions about the safety of fitness facilities, our industry is facing the most difficult time in its history,” the email reads.

The email, which was sent on Monday, included links to a downloadable template for the letter, as well as a website that helps identify your local MPP.

Some people took to social media to criticize — and defend — the email campaign.

Currently gyms located in hotspots across Ontario, like Toronto and Peel, are not allowed to operate under Stage 2 restrictions. As of October 10, fitness centres like indoor gyms and yoga studios were ordered to close for 28 days. 

Jason Sheridan, senior vice-president of operations with GoodLife Fitness, says the idea of the email blast originally came as an initiative from the Fitness Industry Council of Canada. He says that the email was sent out after hearing from staff and members who wanted to know what they could do to make a difference.

“They wanted to know how to advocate on the behalf of the work they do, or the need that people have to have that space to exercise,” he tells Yahoo Canada. “When the Fitness Industry Council of Canada suggested it, we thought this was a great place to go. We want to provide this service of physical and mental health for people who want to get back to the gym.”

When GoodLife Fitness reopened locations in July, lineups of patrons eager to get back in the gym could be seen stretching down the street. (Rene Johnston/Toronto Star via Getty Images)

Two-thirds of GoodLife club members had returned to the gym prior to the

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