CHESAPEAKE, Va. (WAVY) — Where should you turn if you’ve been harmed by a doctor? What should you do if reporting that harm leads to a dead end?

A dead end is where women found themselves after filing complaints against Dr. Javaid Perwaiz —women like Susan Anderson, who began seeing the obstetrician-gynecologist in the late 1980s.

Perwaiz diagnosed Anderson with precancerous cells in her uterus because she was bleeding between menstrual cycles. The OB-GYN performed six procedures on her to treat the precancerous cells before giving her a partial hysterectomy in 1988. When Anderson’s symptoms continued after the surgery, she sought a second opinion. Her new OB-GYN confirmed the worst: The partial hysterectomy was unnecessary, and the other surgeries she’d endured left the lining of her uterus “paper thin.”

In 1991, Perwaiz sent Anderson a medical bill for $1,140. When she didn’t pay, Perwaiz sued her in Chesapeake Circuit Court and won. As part of the lawsuit, Anderson wrote a letter to the circuit court judge. The letter was a cry for help — a plea for someone to step in and take a closer look at Perwaiz.

“I do not feel that I owe Dr. Perwaiz the $1,140.00 he states I owe him because the surgeries performed by Dr. Perwaiz on myself were not only unnecessary, but irreversible,” Anderson wrote to the judge.

“I hope that the courts will look at all of the evidence presented and come to the same conclusion that I have. Dr. Perwaiz is a disgrace to his profession and has taken advantage of trusting women for too long,” Anderson continued. “Between the monies paid him by myself and the insurance companies, I feel he has been paid very well indeed for ruining my life.”

Anderson wrote a similar letter to the Virginia Board of Medicine on June 4, 1991. She asked the agency to investigate Perwaiz but said she never got a response.

“Didn’t get a response. Nothing was done. That’s the sad part, and all these other people have suffered beause of it,” Anderson said.

Twenty-eight years would pass between Anderson’s letters to the Chesapeake Circuit Court judge and the Virginia Board of Medicine before authorities would step in to remove the scalpel from Perwaiz’ hands. The OB-GYN was arrested in November 2019 after a nurse raised the same types of concerns Anderson had to the FBI. A year later, a federal jury convicted Perwaiz of performing unnecessary surgeries on procedures on unsuspecting women to profit off of a health insurance fraud scheme.

Anderson wasn’t the first, or the last, person to raise questions about Perwaiz’ medical judgment. 10 On Your Side investigators discovered that in the decades before his arrest, patients and a local hospital reported Perwaiz to the Virginia Board of Medicine, women filed lawsuits against him in Portsmouth and Chesapeake, nurses raised concerns about him to their supervisors at Chesapeake Regional Medical Center and Bon Secours Health Center at Harbour View, and an insurance company audit labeled him an extreme outlier compared to his peers.

Despite a long list of red flags, Perwaiz continued to practice and profit for nearly 40 years, with only one minor blip — a brief suspension of his license in 1996 after he pleaded guilty to federal tax evasion.

The long list of complaints our investigators discovered left us with a question: Could healthcare authorities have stopped Perwaiz before the FBI stepped in?

“This is a failure of action, and many patients had to pay the price,” said Azza AbuDagga, who earned a doctorate degree in health policy and administration from Pennsylvania State University.

AbuDagga has been a health services researcher for the nonprofit consumer advocacy organization, Public Citizen, since 2013. Public Citizen has published 38 reports on healthcare provider discipline and oversight since 1997.

10 On Your Side investigators spoke with AbuDagga and her colleague, Public Citizen’s Health Research Group Co-founder Dr. Sidney Wolfe, about the warning signs that permeated Perwaiz’ career. The experts agreed that the issues that allowed Perwaiz to flourish are systemic problems in regulating the healthcare system.

“Although this is sad and disheartening, unfortunately, it is not uncommon. We’ve seen from the work that we’ve been doing that some physicians can keep practicing, and they can sort of go through the cracks in the healthcare system, and that’s due to failures we have in terms of the way the medical profession self-regulates itself,” AbuDagga said.

Wolfe said that one way the healthcare industry regulates doctors is through the National Practitioner Data Bank, which was established by U.S. Congress in 1986. The database contains three types of information about doctors: payouts from medical malpractice lawsuits, board of medicine actions, and hospital disciplinary actions that last 30 days or longer.

The problem? The public doesn’t have access to the National Practitioner Data Bank. Only insurance companies and hospitals can access the data.

“It’s a good question why it is not made public,” Wolfe said. “If it were, these kinds of problems would not drag on for 10 or 20 or 30 or 40 years, because people would not knowingly go to a doctor who has been found to do these kinds of things.”

Wolfe said that Congress has the power to make the National Practitioner Data Bank public, but the American Medical Association is determined not to let that happen.

The agencies with the most power to hold doctors accountable are state medical boards, AbuDagga and Wolfe said. But even those agencies have limitations. Both experts said that state boards of medicine are generally comprised of physicians, creating a conflict of interest because doctors are expected to regulate each other.

“The medical board is comprised mostly of physicians who are members of the state medical associations,” AbuDagga said. “The culture that prevails is that they’re willing to gently slap the physician on their hands for wrongdoing.”

The Virginia Board of Medicine is the agency charged with licensing and regulating doctors in the commonwealth. The Virginia Board of Medicine is made up of 18 governor-appointed Virginians. Most of them are doctors who have different specialties and come from different parts of the state.

10 On Your Side investigators attempted to go directly to the Virginia Board of Medicine for answers about Perwaiz.

Our investigators began contacting the Virginia Board of Medicine about Perwaiz in early December 2019, just weeks after the OB-GYN was arrested. In several emails, we requested information about the board’s process when complaints are filed, copies of transcripts from hearings that the Virginia Board of Medicine held in connection to hearings about Perwaiz, and an on-camera interview with the agency.

Virginia Department of Health Professions spokesperson Diane Powers provided 10 On Your Side investigators with documents that were already publicly available on the Virginia Board of Medicine’s website and declined WAVY’s request for an on-camera interview.

In February 2020, 10 On Your Side investigators Jason Marks and Kevin Romm drove to Richmond to attend one of the Virginia Board of Medicine’s quarterly meetings. Their goal was to speak with the Board president about why WAVY’s interview was declined, but the journalists were stonewalled.

“I answered you yesterday,” Powers told Marks in a confrontation captured on camera. “I told you that we respectfully decline the invitation.”

“Right, so I’m here to talk with the board to ask the president of the Board why we were declined an opportunity to talk to someone from the board, which is a public entity,” Marks told Powers.

Powers declined several more interview requests from WAVY journalists. She said that the Virginia Board of Medicine is prohibited by law from expanding on any Order of the Board. 10 On Your Side investigators also asked Powers about requesting copies of complaints about Perwaiz that were made by the Virginia Board of Medicine. She said that complaints against physicians are kept confidential.

There are only two public complaints against Perwaiz on the Virginia Board of Medicine’s website. These are two incidents in which the Virginia Board of Medicine took adverse action against the OB-GYN.

One public record was filed in 1996 when the Virginia Board of Medicine suspended Perwaiz’ medical license for less than six months after he pleaded guilty to federal tax evasion. He claimed that luxury cars were actually expenses for his medical practice.

The other public record was filed in 1984 after Maryview Hospital accused Perwaiz of performing unnecessary hysterectomies on more than a dozen women and having sex with one of his patients. Perwaiz received a slap on the wrist: The Virginia Board of Medicine censored him for bad recordkeeping and “lack of judgment” in his sexual relationship with his patient. On the latter issue, the Virginia Board of Medicine advised him to “use more discretion in the future.”

Virginia Del. Steve Heretick, who is not a physician, served on the Virginia Board of Medicine from 2003 until 2014. He became the president of the Virginia Board of Medicine in 2007, and was the first non-physician in that role. Heretick is also the state representative for the parts of Portsmouth and Chesapeake where Perwaiz practiced.

Heretick spoke with 10 On Your Side after several chapters of “The Patients v. Perwaiz” were released on WAVY.com. He is the only former member of the Virginia Board of Medicine who granted our investigators an interview.

Heretick said that the Virginia Board of Medicine licenses about 75,000 healthcare workers and receives about 2,000 complaints about physicians each year. Some of them are simple — patients who are upset because they had to wait too long for their doctors. Others are more complicated, like patients who make malpractice allegations against physicians. All complaints are looked at by an investigative team that reports to the Virginia Board of Medicine, Heretick said.

Heretick was not on the Virginia Board of Medicine on the dates that 10 On Your Side discovered some patients and a local hospital filed formal complaints against Perwaiz.

10 On Your Side questioned Heretick about the Virginia Board of Medicine’s decision to simply reprimand Perwaiz in 1984. He called the decision “appalling” and said that founded allegations as serious as the ones made by Maryview Hospital would be met with harsher punishment by the current Virginia Board of Medicine.

“The types of problems that are listed here, and there are many, including many, many patients, including allegations that the doctor was engaged in sexual contact with a patient — any one of these violations today would be grounds for revocation of the doctor’s license,” Heretick said.

Heretick said the current Virginia Board of Medicine is governed by different rules and leadership than the one that reprimanded Perwaiz nearly 40 years ago, but he is concerned that the Board did not pay more attention to the OB-GYN given the red flags in his history.

“It is a huge disappointment to me, both as a former member of the Board of Medicine and as a legislator in the Commonwealth of Virginia today, that we have anyone like this practicing,” Heretick said.

Heretick provided clarity on why the Virginia Board of Medicine could not issue an emergency suspension of Perwaiz’ medical license in 2019 when approached about it by federal prosecutors who were investigating the OB-GYN. He said that the Virginia Board of Medicine is required to see evidence against a physician before suspending a doctor’s license, but prosecutors were not willing to share it with the agency.

“If the Board of Medicine had simply acted unilaterally on the say-so or the request of the United States attorney, Dr. Perwaiz would have certainly, would have been well within his rights to appeal any decision by the board to a circuit court, which almost surely have reinstated his license, because again there was no evidence given to the board which supported these allegations,” Heretick said.

10 On Your Side asked the U.S. Department of Justice why it declined to share evidence with the Virginia Board of Medicine, but have not received a response to that question. In a January interview, federal prosecutor Elizabeth Yusi said that the Virginia Board of Medicine’s decision not to issue an emergency suspension of Perwaiz’ medical license in 2019 forced her office’s hand.

Federal authorities decided to arrest Perwaiz to ensure he would not be able to perform surgeries on women while they completed their investigation into the OB-GYN.

In the first eight chapters of “The Patients v. Perwaiz,” 10 On Your Side investigators laid out the red flags that permeated Perwaiz’ career, including several complaints to the Virginia Board of Medicine, a written warning to Chesapeake Regional Medical Center by Maryview Hospital after the facility took away his privileges in the wake of the unnecessary hysterectomies in the 1980s, several nurses who said they reported Perwaiz to their superiors at local hospitals, and an Optima Healthcare audit that labeled the OB-GYN an outlier compared to his peers.

Over his nearly 40-year career, officials never took serious action against Perwaiz despite resurfacing red flags. Those few disciplinary actions issued by the Virginia Board of Medicine did not stop the OB-GYN from practicing medicine for any substantial period of time.

“Clearly there were red flags all over. This physician shouldn’t have been able to maintain his practice for so long,” AbuDagga said.

Ultimately, Perwaiz was stopped by the federal government in 2019 and convicted for the health insurance fraud scheme by a jury a year later. The government’s case against him spanned 10 years due to limitations in their ability to obtain medical records, but in an unusual move, prosecutors put out a call for victim impact statements from any patient or colleague who believes they were impacted by Perwaiz’ crimes.

“I would say that he hurt a lot of people, a lot of innocent people, that put their trust in him, and believed in him, because that’s what we are supposed to do. He hurt so many people. He really needs to ask for their forgiveness, and he needs to spend a lot of time alone with God,” Anderson said.

On Friday, April 2, our team of investigators answered viewer questions about this Chapter of The Patients v. Perwaiz. Watch the full discussion.