A penalty decision of the tribunal, released today, said after Khodaverdian was notified her claims would be audited she altered or created and supplied inaccurate or false records intended to mislead the Ministry of Health.
She did this by retrospectively creating or altering entries in the Expect Maternity programme by noting details of antenatal and postnatal visits that never occurred.
Khodaverdian then tried to circumvent the Ministry’s oversight of manual claims she was asked to produce by inventing 12 claims for payment for services she hadn’t provided.
According to the charges, she also submitted claims to the Ministry for 10 antenatal visits she knew had not happened or had occurred over the phone rather than in-person as required.
She also failed to obtain the informed consent of her clients to their registration with her or failed to record confirmation of their informed consent.
On top of that Khodaverdian provided inadequate midwifery services at the risk of the health and safety of expectant mums and their babies, the tribunal noted. This included failing to:
- Provide adequate first, second, and third-trimester antenatal care by conducting infrequent and irregular visits;
- Consult with a number of her clients during their third trimester;
- Arrange a backup midwife on 90 occasions, and in the case of 37 was not present at the birth;
- And remain with her clients for the minimum two hours post-birth.
Charges relating to her claiming for services via another midwife and not protecting her clients’ privacy were not established.
Khodaverdian did not defend the charges and was found guilty of professional misconduct following a hearing in May last year.
During submissions on penalty counsel for the Professional Conduct Committee (PCC) that brought the charges, Jo Hughson, said this was not a case where there had been an isolated lapse on Khodaverdian’s part.
“When the conduct is considered cumulatively the picture one has of the extent of Ms Khodaverdian’s professional conduct is very bleak and extremely serious.”
The PCC submitted there had been a continuum of offending over a period of seven years in circumstances where the midwife ought to have been well aware of the potentially serious consequences of her lapses for the health of the women in her care or her professional integrity, and the reputation of the midwifery profession.
Hughson submitted Khodaverdian’s conduct amounted to such serious malpractice and negligence as to portray indifference and was an abuse of the privileges of a midwife.
“At every level on which the totality of Ms Khodaverdian’s departures from accepted practice is viewed, her conduct was disgraceful.”
The tribunal noted Khodaverdian’s excessive workload as an aggravating factor because it compromised the quality of care for her clients.
It said the overclaiming, which involved 863 audited claims for 144 pregnancies, was unethical.
There were an extra 366 claims for Additional Post-Natal Visits (APNVs). In relation to the latter payments, while the national average for midwives claiming APNVs between 2018 and 2020 was 16-17 per cent of a midwife’s caseload, Khodaverdian’s average over this period was around 98 per cent.
The tribunal said the maternity claiming system relied on integrity and Khodaverdian’s overclaiming escalated over time.
A mitigating factor was that Khodaverdian agreed to a repayment plan in March 2022, a month after leaving midwifery, and had already paid back $147,207.
She stopped engaging with the PCC in December 2022 due to ill-health in her own, high-risk pregnancy, saying the disciplinary process was causing her “severe harm” and she had “suffered great financial loss”.
The tribunal considered whether it could avoid cancellation of her registration but said Khodaverdian’s extensive overpayments under the Maternity Notice coupled with failings across the scope of her midwifery practice reflected the need to cancel her registration as a mark of the seriousness of the professional misconduct.
It also censured her and ordered her to pay $210,000 toward the costs of the tribunal hearing and PCC investigation, and declined her bid for permanent name suppression.
Natalie Akoorie is a senior reporter based in Waikato and covering crime and justice nationally. Natalie first joined the Herald in 2011 and has been a journalist in New Zealand and overseas for 28 years, more recently covering health, social issues, local government, and the regions.
