Dr. Javaid Perwaiz knew exactly how to scare and manipulate his patients—by telling them they had cancer or were at serious risk for it. The scary news, combined with his authority as a doctor, meant the women in his care were the perfect victims for his crimes.

The Virginia obstetrician/gynecologist convinced women their health was in imminent danger.

He then pressured them into having immediate, invasive surgeries that they didn’t need, including hysterectomies and dilation and curettage (D&C) surgeries, a procedure typically used for clearing uterine lining after a miscarriage or as a treatment for heavy bleeding. In some cases, he falsified pregnant patients’ due dates so he could induce labor early on his own schedule.

Perwaiz’s motivation was simple greed. The more surgeries he did, no matter how unnecessary, the more money he collected from Medicaid, Medicare, Tricare, and private insurance. Perwaiz lived a lavish lifestyle at the expense of his patients’ physical and mental health. He shopped at high-end stores and owned five luxury cars.

More than $20 million was billed over 10 years in fraudulent claims, but the human toll is incalculable. Perwaiz’s actions left many patients traumatized. Some experienced serious harm like incontinence or the inability to have sex.

Following the news of Perwaiz’s arrest, more than 500 former patients contacted the FBI tip line.

“Many women who were subjected to this did not know what surgeries they had or why,” said Special Agent Desiree Maxwell, who investigated this case out of the FBI’s Norfolk Field Office. “The patients were afraid, and he manipulated them.”

There were warning signs over Perwaiz’s decades in medical practice. Investigators found at least eight malpractice suits. His medical license had been censured in the 1980s. Perwaiz’s license was briefly suspended in the 1990s after he was convicted of federal tax fraud.

But no one put together the pieces of Perwaiz’s longstanding, abusive treatment of women until a tipster told the FBI that women were coming into the hospital for surgery unaware of why they were there.

That’s when investigators started looking into him and found alarming signs. For one, 40% of his Medicaid patients wound up having surgery. Of those, 42% had multiple surgeries—a very high number.

A search warrant and cooperation from inside the practice showed more evidence. But investigators needed proof Perwaiz was willfully lying to his patients.

They found it when a young woman in her early 20s went to Perwaiz for care in 2019. He told her she had uterine fibroids that needed to be removed immediately. But the staff in Perwaiz’s practice knew the woman’s ultrasound was normal.

So, investigators from the FBI and Defense Criminal Investigative Service approached the patient. Would she be willing to record her next phone call with Perwaiz?

While secretly being taped, Perwaiz boldly lied to his patient, telling her she had “big” tumors that needed to come out through abdominal surgery.

“He was great at exploiting patients,” Maxwell said. “He used fear of cancer, or, in other cases, fear of infertility to convince them to go through with surgery.”

Maxwell noted that Perwaiz often exploited the same woman multiple times, telling her something was concerning in her first surgery, and he needed to do more surgeries.

One helpful aspect of a health care fraud investigation is that insurance providers require paperwork to reimburse medical providers. To get reimbursed, Perwaiz created duplicate records. One was a patient’s actual medical record, and the other was a false one claiming the need for surgery—essentially, a detailed paper trail of the crime. In one case, Perwaiz forgot to shred the real medical record, another strong piece of evidence.

A jury found Perwaiz guilty on 52 counts of health care fraud in November 2020. In May 2021, he was sentenced to 59 years in prison. Prosecutors proved his crimes happened at least between 2010 and 2019, but women came forward from decades ago claiming victimization by Perwaiz. Numerous victims testified at trial to the harm Perwaiz had caused them.

The case was a rewarding one for the investigative team, knowing that Perwaiz did physical and emotional harm to dozens of women.

“It’s impossible not to get emotional when you hear these women’s stories. It’s horrible what he did to them,” Maxwell said. “It’s a shame he got away with this for so long, but knowing he will never touch another woman is a huge sense of accomplishment.”