Awaad put Martinez on the anti-seizure medication Lamictal. Several months later, her headaches had gotten even worse, and Awaad increased her dose, court documents say. Over the next four years, Martinez underwent 10 more EEGs under the care of Awaad. He told her that most of them were abnormal. Eventually, Martinez was taking a high dose of 400 milligrams of Lamictal daily. The medication made her tired and withdrawn, to the point where she didn’t feel like herself. But she continued taking it, thinking it was good for her health.

Four years after she first saw Awaad, Martinez went to see another doctor, Brian Woodruff, because Awaad had left his practice. Woodruff performed his own EEG, and the result was so surprising, Martinez’s mother didn’t believe it at first. It was completely normal. “I have come to the determination she never had seizures,” Woodruff would later testify in court. What’s more, he said, “You don’t get headaches like this with absence epilepsy.” In fact, Lamictal can cause headaches.

More than a decade later, Martinez is one of hundreds of patients who have accused Awaad of intentionally misreading their EEGs and misdiagnosing them with epilepsy in childhood, all to increase his pay. In June, Martinez’s case became the first to go to trial in Michigan. The case shines a light on the grim world of health-care fraud—specifically, the growing number of doctors who are accused of performing unnecessary procedures, sometimes for their own personal gain.

At Awaad’s trial, Martinez’s lawyers painted a portrait of a man on a quest to conduct as many EEGs as possible, and of a hospital that looked the other way as red flags flew up around him. The lawyers accused Awaad of being hired by Oakwood Healthcare on a contract that compensated him for each EEG he performed. In his time at the hospital, from 1999 to 2007, his salary rose from $185,000 to $300,000, and he qualified for bonuses up to $220,000 if he met certain billing targets. Brian McKeen, Martinez’s lawyer, told jurors that Awaad had “turned that EEG machine into an ATM.”

In court, Awaad denied Martinez’s accusations. He claimed that there were “many reasons” to do an EEG, such as to confirm a diagnosis or to see if a medication was working. Awaad was born in Egypt, and after stints at New York University and the Children’s Hospital of Michigan, he told the court, he went to Oakwood to serve the area’s many Arabic-speaking patients. (Awaad and his lawyer did not return requests for comment.)

Soon after his arrival, however, there were signs that many of his supposedly epileptic patients did not actually have the disease. In 2001, two years before Martinez saw Awaad, a patient’s mother wrote Awaad a letter claiming that he had misdiagnosed her son with epilepsy and mis-medicated him. She wrote that when she asked to view her son’s EEG, the office claimed it could not provide it, because it didn’t own a printer. She requested that Awaad’s office withdraw her $523.60 bill. Instead, McKeen told jurors, Awaad turned the bill over to a collection agency.