CHESAPEAKE, Va. — The last time Brittni DuPuy-German saw her trusted gynecologist, she once again explained that the stabbing, mystery pain in her abdomen had not gone away.
It first appeared two years earlier, after she said her doctor, Javaid Perwaiz, surgically tied her tubes. To fix it, he had proposed more surgery — three additional procedures in nine months that she said included a hysterectomy when she was 29. But the pain persisted.
So on Nov. 8, 2019, at his private-practice office, Perwaiz and DuPuy-German discussed the possibility of yet another surgery, she said. He scheduled an ultrasound for just days later, a sign of the efficiency that DuPuy-German had come to expect from her family’s longtime gynecologist. He was her mother’s doctor, her sister-in-law’s doctor, her best friend’s doctor. Perwaiz had delivered DuPuy-German and delivered her children.
Which is why, when her phone buzzed the day after her appointment, she was shocked by the headline she was reading: “Chesapeake doctor tied women’s tubes, performed hysterectomies without their consent, feds say.”
She absorbed the details of the FBI investigation. Her doctor, the news report said, was accused of lying to patients and persuading them to have life-altering surgeries they didn’t need. DuPuy-German began doubting everything Perwaiz had told her about her own body.
“That’s when all of the things that I didn’t question before started popping up,” she said.
As Perwaiz faces trial this week, a year after his arrest, DuPuy-German has received few answers to those questions — even as the FBI’s investigation expanded and the list of alleged victims grew. There are 29 patients specified in court documents and hundreds of others who contacted authorities after the doctor’s arrest.
DuPuy-German, now 32, is not cited in the criminal case but has filed a lawsuit against Perwaiz.
The U.S. attorney’s office for the Eastern District of Virginia would not say how many women in total were allegedly mistreated by Perwaiz, but in a recent trial memorandum prosecutors wrote that “the identified patients are only ‘examples’ of the scheme to defraud.”
The case, which authorities said was launched in 2018 after a hospital employee’s tip, first hinged on one charge each of health-care fraud and false statements. Federal prosecutors now allege that Perwaiz executed an “extensive scheme” spanning nearly a decade that endangered women’s pregnancies, robbed their ability to conceive and pressured them into unnecessary procedures based on unfounded cancer diagnoses and exams using broken equipment.
The more procedures Perwaiz performed, authorities said, the more money he made off insurance companies. He used the profits, according to prosecutors’ trial memorandum, “to support his lavish lifestyle.”
Perwaiz, who is jailed without bond, pleaded not guilty. He has not spoken publicly about the allegations but defense attorneys said in a court document he is “prepared to defend himself at trial.” His lawyers in the criminal case have not responded to multiple requests for comment, but have argued unsuccessfully in numerous motions to dismiss that, among other things, some charges were duplicative. The attorney representing Perwaiz against DuPuy’s civil suit declined to comment.
Among the more than two dozen former patients who shared their experiences with The Washington Post, many said they feel betrayed by Perwaiz, ashamed for trusting the doctor and angered to learn that in his past he had been convicted of tax fraud and fired for surgical misconduct. Others are exasperated because they say they raised red flags about Perwaiz for years.
Perwaiz’s trial in federal court in Norfolk could give some of these women a chance to see the doctor confronted about the pain prosecutors say his patients endured. For others, it will mean reliving surgical trauma and mourning the possibility of a child they were never able to have. And for some, no trial will be able to answer lingering questions about the surgeries Perwaiz performed — and whether they were necessary.
‘He was a family friend’
To many patients, Perwaiz seemed the composite of an ideal doctor: kind, soft-spoken, affirming and endorsed by women they trusted.
Over a nearly 40-year career in the Hampton Roads area, he treated women at his two private-practice offices and at least three hospitals. His website touted his surgical skills as “unparalleled.” Perwaiz offered same-day appointments and accepted most insurance providers, including Medicaid. He cared for multiple generations in families.
“I would see him in the grocery store and he would give me a hug and ask, ‘How are the babies?’ ” said Jo Anne Lindsay, 74, a patient for nearly 20 years. “He was a family friend.”
Perwaiz delivered Lindsay’s grandchildren and was a frequent customer at the Mercedes-Benz dealership where her husband worked. She has stood by Perwaiz and described him as a professional, caring physician.
Perwaiz’s lawyer, Lawrence Woodward Jr., told the Associated Press last fall that he received “a multitude” of emails from Perwaiz’s patients praising him.
“His life has been his work,” Woodward told the AP.
But prosecutors say the man known to many as a committed town doctor had been misleading women about their health.
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. They say he falsified medical charts of “unsuspecting patients” to justify high volumes of unnecessary surgeries — including hysterectomies, dilation and curettages, and the removal of ovaries and fallopian tubes.
Perwaiz “frequently” rushed women into permanent sterilization procedures by inaccurately saying they could be “easily reversed,” according to the indictment. Prosecutors say the doctor backdated sterilization consent forms to make it appear as if his patients had signed them 30 days before their procedures — a Medicaid requirement — when they had not.
He also is accused in the indictment of repeatedly inducing preterm pregnancies without medical reason to align with his hospital shift. Witnesses described a frenzied environment in which hospital staff struggled to keep pace with Perwaiz as he rushed from procedure to procedure, according to his arrest affidavit.
Given that he had faced allegations of surgical misconduct decades earlier, some patients wondered why that volume of surgeries didn’t draw scrutiny sooner.
“I don’t understand why, if he was doing all these surgeries on people … it could have gone on for so long,” said Karen Lane, a longtime patient. “How could they have not known?”
Perwaiz first became an OB/GYN and established his private practice in 1982. Surgeries he performed that same year were soon called into question.
While on staff at Maryview Hospital, Perwaiz allegedly performed 11 hysterectomies on women in their 20s, 30s and early 40s without medical reason, according to state records. The hospital fired Perwaiz citing “poor clinical judgment, unnecessary surgery, lack of documentation and discrepancies in recordkeeping,” the records show.
The Virginia Board of Medicine, which also took up the allegations, had the power to revoke or suspend Perwaiz’s license. Instead, it chose to censure him — chastising his bad note-taking and condemning his “lack of judgment” for engaging in a sexual relationship with a patient.
In a 1984 letter describing its decision, the board did not address the claim that Perwaiz had performed unnecessary surgeries, nor did it place limitations on his license. The documents do not say whether Perwaiz refuted the allegations.
Over the next decade, the doctor grew his private practice and saw patients at two other hospitals, including Chesapeake General Hospital, where in 1995 he was president-elect of the obstetric staff, according to news reports at the time.
That same year, Perwaiz was charged with federal tax fraud for allegedly making $158,300 in personal purchases — including Oriental rugs, lingerie and porcelain fixtures — then deducting them as business expenses on his taxes, according to news reports. Perwaiz also allegedly bought a Mercedes-Benz and a red Ferrari, claiming them as “business malpractice insurance” and an ultrasound machine.
He pleaded guilty to two of six counts, a conviction that again brought him before the Board of Medicine in 1996. His medical license had been automatically revoked after his guilty plea, but the board reinstated it — this time with stipulations and supervision.
While under the board’s watch, Perwaiz’s admitting privileges were briefly suspended then reinstated at Chesapeake General, now known as Chesapeake Regional Medical Center. Perwaiz also returned as a staff member at Maryview Hospital, which monitored his surgical cases. The hospital would later change its name to Bon Secours Maryview Medical Center and name Perwaiz its chair of obstetrics and gynecology, according to news reports.
At the time of his arrest last fall, authorities said Perwaiz was affiliated with both hospitals.
A spokesperson for Maryview declined to answer questions about Perwaiz’s surgical cases, whether patients or staff had filed complaints about his conduct or if his cases had previously been reviewed. The spokesperson said the hospital is conducting an internal investigation.
Along with Perwaiz, Chesapeake Regional Medical Center is a target of DuPuy-German’s lawsuit, which alleges the hospital did not properly monitor the doctor’s surgical cases. A lawyer representing Chesapeake Regional denied those claims in a statement, citing privacy concerns that prevented the hospital from further discussing DuPuy-German’s care or Perwaiz’s performance.
The attorney, Jason R. Davis, said the hospital has an “established and thorough system” for evaluating doctors with admitting privileges.
DuPuy-German contends that system failed, alleging in the suit that hospitals have the responsibility to be “the best, and possibly only, check on incompetent surgeons in the medical community.”
The Board of Medicine also holds those powers — but records show that Perwaiz did not tangle with them again after 1999, when his license was fully reinstated.
“The Board wishes you well in your future endeavors,” it said in a letter at the time.
Years later, Virginia began requiring all board-certified doctors to report felony convictions to their profile page on the Board of Medicine website, where their appearances before the board also are listed.
But DuPuy-German never knew to look.
“Had I ever heard anywhere that he was punished,” she said, “I definitely would have gotten other opinions before rushing into surgery. But I didn’t know.”
‘I just blindly trusted him’
In the weeks after Perwaiz’s arrest, DuPuy-German checked in with women in her life who were also his patients. Her mother told her she had undergone dozens of procedures over decades. And her sister-in-law said she believes Perwaiz may have removed an ovary and fallopian tube without her knowledge.
At the same time, DuPuy-German began revisiting her own experiences. Like the women described in news reports, DuPuy-German was on Medicaid. Like them, she said, she had never seen her ultrasound images or been offered medication as an alternative to surgery. Her appointments, she said, always followed the same swift routine: checkup one week, ultrasound the next, surgery just days later.
“Makes me wonder…” she texted her friend.
So DuPuy-German, like hundreds of others, requested her medical records.
Still confused by her mystery pain, she found a new doctor and was stunned by what she learned. DuPuy-German said her new physician told her that, according to her charts, Perwaiz had diagnosed her with endometriosis — a painful disorder in which tissue that normally lines the uterus grows outside of it. DuPuy-German said she had no idea.
Questioning their care
Angela Lee, 61
Patient in 2002
Perwaiz suggested performing a hysterectomy on Angela Lee, then 42, in order to treat the heavy periods she was experiencing, she said. After he warned her the issue could turn into cancer, she said she agreed. Days after the procedure, she started bleeding intensely, and was rushed in an ambulance to a different hospital, she said. There, a doctor performed emergency surgery, she said, and she was placed in an induced coma for three days. A doctor later told Lee her bowel had been punctured during the hysterectomy, she recalled. She still does not know whether the hysterectomy was necessary.
Shamai Watkins, 45
Patient from 1998 to 2013
Shamai Watkins first started seeing Perwaiz for her annual exams, she said, when he told her a pap smear revealed cancerous cells. The diagnosis kicked off a string of surgeries that left her feeling a stabbing, twisting pain, she recalled. Perwaiz blamed the pain on fibroids, and said a hysterectomy would be the only solution, Watkins remembers. She agreed, but said she later learned he had persuaded her with misleading information about her reproductive organs. The surgery took away her ability to have another child, she said, but did not eliminate the pain.
Donna Manson, 51
Patient from 1997 to 2007
In the decade that Donna Manson saw Perwaiz, he performed six surgeries on her — none of which helped stop the intense bleeding she was experiencing, she said. The procedures only made her periods worse, she recalled, and caused a sharp, cramping pain that lasted for years. He never suggested medication as an alternative to surgery, Manson said. After he tried urging her to undergo a hysterectomy, she left his office. She said a new gynecologist offered her medication and hormone treatments instead, and told her many of her surgeries may have been unnecessary.
But the new doctor also told her that she might not have endometriosis at all, she said, and told her the pain may have been due to nerve damage from her surgeries.
“[Perwaiz] didn’t give me a plan of what he was going to do,” DuPuy-German said. “I just blindly trusted him.”
Other former patients also told The Post they have reevaluated their care, including a woman who said Perwaiz tried to convince her to get a hysterectomy she did not want when she was 24 years old; a woman who wanted more children but agreed to have her ovaries and uterus removed because the doctor said it was the only way to address the cysts he said she had; and a mother of three who asked Perwaiz to tie her tubes only to learn about a year later she was pregnant.
Karen Lane was 33 when Perwaiz told her in 2000 that she needed emergency surgery to remove her uterus, she said.
She had been experiencing heavy bleeding after a minor procedure weeks earlier, and her blood count was running low. Lane had hoped to have more children. But Perwaiz said her life was at risk, Lane remembers, and she believed him.
Just a year later she returned to Perwaiz’s operating room so the doctor could remove cysts he told her he found on her ovaries, she said. When she awoke, Lane recalls him telling her he had to remove both her ovaries, because the cysts were wrapped around them. She was thrown into early menopause and suffered terrible night sweats.
Until last year, she believed it all was necessary. Then she learned of Perwaiz’s arrest. “I thought, that can’t be me,” Lane said. “It couldn’t be me.”
She, too, requested her medical records, and wept in a hospital parking lot as she read what Perwaiz had written in her chart — that Lane “had very strongly expressed that if there is any problem of disease on either ovary, she wants both of them removed regardless of her age and the need for subsequent hormone therapy.”
Lane said she never consented to that.
“I’ve never been raped,” she said, “but I feel like I’ve been raped.”
Other women have questioned Perwaiz’s care for years, including in at least eight lawsuits. All but one were eventually dismissed or stalled after years of inactivity.
One was filed by Juanita Bryant, a mother of four who agreed to have both her ovaries removed in March 2003 after Perwaiz said he found a mass on one of them, according to her lawsuit. But after a car accident years later, she said she learned both ovaries and a mass were still in her body. She underwent another surgery to remove them.
Perwaiz countersued, and after years of litigation both sides agreed to a dismissal. Bryant said could no longer afford to fight in court.
Bryant still suffers from pain she blames on the times she was “gutted out,” she said. She cried as she explained how the surgeries and legal fight left her depressed and put a strain on her marriage.
“To this day,” she said, “I don’t feel like a woman.”
‘My life was supposed to be within my control’
Of the hundreds of women who reached out to law enforcement or to malpractice lawyers, only a few will be part of the doctor’s criminal trial. Donna Ingram-Allen said she expects to be one of them.
She hopes to tell a jury what she told prosecutors, and what she has been trying to tell medical malpractice lawyers for years: That Perwaiz gave her a surgery she did not ask for. That she — a Medicaid patient and a Black woman — felt she was taken advantage of by a doctor she trusted.
“I was nothing but a means to an end for him,” she said.
When Ingram-Allen first started seeing Perwaiz in 2012, she was in remission for Stage 3 breast cancer. Perwaiz told her an exam had revealed precancerous cells and that she needed a hysterectomy, according to Allen and the indictment. But the mother of two thought that was too extreme, so she said she agreed to an outpatient surgery to remove only her ovaries.
She awoke afterward in “horrendous pain,” she said, and was shocked to learn that Perwaiz had performed a complete abdominal hysterectomy. Three days later, she was rushed back to the hospital with blue skin. She was septic, she said, and her kidneys were shutting down. Ingram-Allen’s bladder had been perforated several times during her hysterectomy, she said her new doctor told her.
“[Perwaiz] lied about what I needed and what was done to me,” Ingram-Allen said. “My life was supposed to be within my control.”
After her recovery, numerous malpractice lawyers declined to take her case. So Ingram-Allen enrolled in paralegal classes at a community college and filed a lawsuit on her own. It was ultimately dismissed because she improperly filed the paperwork. But years later, it caught the attention of federal agents.
She is among the women identified in an indictment charging Perwaiz with more than 60 counts of health-care fraud, making false statements related to health-care matters, aggravated identity theft and forfeiture.
Ingram-Allen said she sees her case through the lens of the historic mistreatment of women of color by doctors. Her experiences, she said, have reminded her of the forced sterilizations of Black, Latina and Native American women in the 20th century, generations of abuse that continues to cause distrust of the medical field.
“It’s continued,” Ingram-Allen said, “in so many different domains.”
For Lane, the trial could bring some of the validation she has yearned for. She said malpractice attorneys would not take up her case, telling her the surgeries had happened too long ago. The FBI never called her back, she said.
But part of her also dreads reliving those experiences, she said, wondering about the child she might have had, the pain she might have avoided.
Just last month, Lane, now 53, learned she is on the verge of osteoporosis. She thinks it could have been caused by the many years her body lacked its natural hormones due to her early menopause, she said. Medical studies show that estrogen deficiency is a pivotal cause of bone loss.
“I feel like my body is 20 years older than it should be,” Lane said. “If he had left me alone … what would have happened?”
The outcome of Perwaiz’s trial also won’t change the fact that DuPuy-German still has pain in her abdomen.
Weeks of medication made no difference, and her new doctor told her the cramping could be the result of nerve damage from the surgeries performed by Perwaiz. Physical therapy has helped some, but the pain may be permanent.
“I don’t know what was really wrong with me,” DuPuy-German said. “Nobody knows what he really did.”
Photography by Matt McClain/The Washington Post and Julia Rendleman for The Washington Post. Some subjects also provided family photos. Design by Tara McCarty, CeCe Pascual and Junne Alcantara. Jennifer Jenkins also contributed to this report.