More than 500 women sued a Virginia health system and its senior executives on Monday for negligence, claiming that for nearly a decade one doctor performed medically unjustified operations, including unnecessary C-sections and sterilizations without consent.
The 510 plaintiffs are seeking $10 million each from the Chesapeake Regional Medical Center, which employed the doctor. The claims are notable both for the number of women who say they were victimized and for the fact that their lawsuit names individual executives whom the patients blame for not preventing the abuse.
The former gynecologist, Javaid Perwaiz, already is serving a 59-year prison sentence for Medicaid fraud stemming from the unnecessary operations. His medical license expired in 2020.
The plaintiffs, most of whom are Black, were covered by Medicaid, the government health plan for the poor. Many were in their childbearing years when Mr. Perwaiz removed their reproductive organs under duress or without their knowledge, and performed other unnecessary procedures, according to federal investigators.
Efforts to reach Mr. Perwaiz in prison were unsuccessful. He does not appear to have legal representation.
The lawsuit named the medical center and three senior hospital executives: James Reese Jackson, the current president and chief executive, and two of his predecessors, Peter Francis Bastone and Wynn Lawton Dixon Jr.
The lawsuit, which covers a period from 2010 to 2019, said the three repeatedly renewed Mr. Perwaiz’s hospital privileges despite red flags and explicit reports of abuse by medical staff.
Asked for comment, Mr. Dixon and Mr. Bastone said they were unaware of any misconduct by Mr. Perwaiz and never heard complaints about his work when they worked at the hospital.
“We had hundreds of physicians,” Mr. Bastone said. “I have no recollection of what you’re talking about.”
Evidence in the Medicaid fraud case showed that Mr. Perwaiz had falsified records in order to induce early labor at times convenient for him, always on Saturdays.
Mr. Dixon said that he knew Mr. Perwaiz always delivered babies and did other surgeries on Saturdays, but “that was kind of laughed at. I’m not aware of any complaints from anyone.”
He added that it was the responsibility of the medical executive staff to appoint physicians, and that the chief executive had no responsibility for oversight of the medical staff. “I wasn’t responsible for credentialing,” Mr. Dixon said.
A woman who answered Mr. Jackson’s phone said he was not available for comment. Hospital officials did not respond to a request for comment.
Chesapeake Regional Medical Center is also facing criminal charges of health care fraud, an indictment that is very rare. A conviction could shut down the hospital down by rendering it ineligible for future participation in government health plans.
The hospital has said that the indictment was “an unjust and meritless overreach by the federal government.”
Federal investigators in the Medicaid fraud case found that Mr. Perwaiz had falsely told patients they had cancer or were at risk for cancer and required surgeries.
Investigators also found that Mr. Pewaiz had backdated patient consent forms, violating a Medicaid rule requiring a 30-day waiting period for elective sterilizations.
Many of his patients had babies who were admitted to the neonatal intensive care unit in disproportionate numbers.
Dracena Holloway, a 42-year-old mother of seven in Portsmouth, Va., and a plaintiff in the lawsuit, started seeing Mr. Perwaiz as a patient in 2002.
Over the next several years, she said in an interview, he induced labor four times. All four of her newborns spent time in intensive care, and all four experienced developmental delays.
When Ms. Holloway went into labor with twins in 2011, she said the doctor performed a C-section and a tubal ligation that sterilized her without her consent or knowledge.
Over the course of a six-year period starting in 2014, Mr. Perwaiz operated on Ms. Holloway repeatedly, she said, falsely telling her she had fibroids and cancer. He removed her uterus and did abdominal surgery, falsely telling her she had stomach cancer.
The frequent operations left her with a large scar across her belly and chronic pain that restricts her mobility, Ms. Holloway said. She has since learned that she never had cancer.
“He made me feel very comfortable, like I was in good hands,’’ Ms. Holloway said. “When he told you that you had to have surgery, he said, ‘Here, Dr. P will take care of you.’ He was very convincing.”
According to the lawsuit, hospital staff complained to the senior executives numerous times about the abuses over the years. But the chief executives kept renewing the doctor’s credentials.
When the Virginia Board of Medicine briefly revoked Mr. Perwaiz’s license to practice medicine in 1996, after he pleaded guilty to tax fraud, Donald S. Buckley, then the hospital’s chief executive, pressed the board to reinstate the license.
His letter “indicated Perwaiz’s surgeries resulted in substantial profit to Chesapeake Regional Medical Center,” the lawsuit noted. From 2010 to 2019, Mr. Perwaiz’s Medicaid billings amounted to more than $18 million, federal investigators found.
“There were not only red flags, they were sirens being alarmed, and the hospital completely turned a blind eye to what he was doing, solely for monetary profit and with complete disregard for patient safety,” said Victoria Wickman, an attorney representing the women, along with Anthony T. DiPietro.
“And it seems to be that the majority of women who were targeted were African American women, all of them poor and on Medicaid, who believed everything he said,” she said of Mr. Perwaiz.
As far back as the 1990s, a local obstetrician had warned the state medical board that Mr. Perwaiz was performing unnecessary procedures and operating on healthy young women. According to federal prosecutors, hospital officials reprimanded the doctor who had complained.
Around 2008, the Chesapeake Regional Medical Center’s own neonatology group raised concerns about Mr. Perwaiz’s routine delivery of babies early through elective induction or C-section for no medical reason.
“The need for intensive neonatal care for the babies Mr. Perwaiz delivered early was so common that CRMC neonatologists referred to it as the ‘Perwaiz special,’” the lawsuit said.
Nurses complained to hospital officials that consent forms were being altered for Mr. Perwaiz’s patients after they were under anesthesia so that he could perform more invasive surgeries, and that patients often “lacked knowledge about their planned surgeries,” according to the lawsuit.
The plaintiffs also allege Mr. Perwaiz also routinely misclassified inpatient surgeries as outpatient procedures to evade the heightened scrutiny of inpatient procedures.
Although there were a series about the doctor’s abuses in 2014 and 2015, according to the suit, the medical center’s internal metrics identified him as a “top ten” performer, a single surgeon who did more procedures each year than some group practices did.
Roni Caryn Rabin is a Times health reporter focused on maternal and child health, racial and economic disparities in health care, and the influence of money on medicine.
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