The surgeries started that year and ended only in 2015. Each time, her handwritten medical chart reported that she had complained of pelvic and back pain, bad cramps, frequent and long periods, or something growing in her vagina.
The woman was asked whether she had ever suffered those symptoms. “I never said that,” she answered again and again. She was the latest of Perwaiz’s patients to share their experiences with a doctor prosecutors say performed unnecessary procedures over the course of a decade as part of a scam to fund his lavish lifestyle.
Perwaiz faces 61 fraud counts that cover 25 patients, most of whom he saw from 2015 to 2019. Prosecutors have not said how many others were victims. So many women came forward after his arrest in November that the FBI created a website about the case for them.
When the patient asked Perwaiz why she needed surgery, she said he replied that there was an abnormal growth in her uterus that could be cancer. “I was told this lump will keep on growing each time it was removed,” she testified. “If I do not take care of this, then it would spread very rapidly and cause cancer.”
He operated in 2006, 2007, 2010, 2012 and 2015. During the 2012 surgery, he performed a hysterectomy, removing her uterus and left ovary but leaving her right ovary intact. In 2015, according to her testimony, she voiced no complaints during her checkup, but Perwaiz told her she needed another surgery. This time, he removed her remaining ovary.
Each time he told her that surgery was necessary, she believed him. “He’s my doctor,” she told jurors. “I have to trust him.” M.C. was among the patients who testified that they trusted Perwaiz when he told them they needed invasive procedures over the years.
Like patients, health insurers also trusted him.
He billed them hundreds of thousands of dollars for phantom medical procedures, according to his indictment.
He billed for hysteroscopies, a procedure used to view inside a woman’s uterus during examinations, during times when either the scope was broken or he did not have the other materials in his office to perform the procedure, prosecutors allege. They contend he billed for colposcopies, a procedure to view the cervix, and wrote abnormal findings on patients’ charts even though he didn’t use the solution that would allow him to see those abnormalities. And they say he billed for unnecessary hysterectomies.
Prosecutors also contend that Perwaiz often induced labor for pregnant patients before they were due on Saturdays at Chesapeake Regional Medical Center, where he scheduled surgeries, so he could earn money making deliveries.
Between 2010 and 2019, Perwaiz billed insurance companies more than $2.3 million for gynecological care partially justified by diagnostic procedures he never performed, prosecutors allege in the indictment. In testimony earlier in the trial, an investigator for Anthem Blue Cross Blue Shield said that, over a decade, more than 41 percent of Perwaiz’s patients had surgical procedures compared with 7.6 percent for the other 628 obstetrician/gynecologists that billed the company.
Several malpractice suits are pending against Perwaiz, who had two offices in Chesapeake, south of Norfolk, and privileges at Bon Secours Maryview Medical Center and Chesapeake Regional Medical Center.
Perwaiz, who is jailed without bond, pleaded not guilty. He has not spoken publicly about the charges.
Defense attorneys argue that Perwaiz was a hard-working caregiver adored by the thousands of patients he tended over four decades. They say he was particularly aggressive treating the threat of cancer.
The prosecution is the first long criminal trial in U.S. District Court in Norfolk since the pandemic began. Prosecutors are expected to rest their case, which is being heard by Judge Rebecca Beach Smith, soon.
Following M.C. to the witness stand on Monday was W.H.W., a 58-year-old Portsmouth woman referred to Perwaiz after an abnormal pap smear in 2017. During that visit, she confided a fear of cancer. There was a family history, including her father, she told him.
Within days, Perwaiz claimed to have done several office procedures, including a hysteroscopy and a colposcopy. Prosecutors showed her pictures of the equipment used to perform each one. “I’ve never seen anything like that,” she answered.
The doctor did perform a dilation and curettage. There was bad news. “He said he saw lots of cancer cells,” she testified. Prosecutors entered into evidence a pathology report showing that all five samples taken during the procedure indicated the opposite — they were benign.
During an April 2018 visit, her chart indicated that she complained about pelvic and back pain and said she did not want to be examined. W.H.W. denied that she refused to be examined or suffered from pelvic pain. Perwaiz ordered an ultrasound and then told her she needed a hysterectomy.
When he said he intended to do a deeper C-section cut, she nervously asked about the effect on her sex life with her husband. “He [Perwaiz] said he will like it better,” she testified.
Perwaiz performed the surgery in July 2018. But the resulting complications, she testified, have left her incontinent. She visited a specialist hoping for a solution. “There’s nothing I can do,” the specialist told her.
He sent her back to Perwaiz.
The complications endure, including blood in her urine, she testified, sobbing softly.