in Re Iftikhar Ahmed, P.A. and Farhan Khan, M.D.

CourtCourt of Appeals of Texas
DecidedFebruary 25, 2020
Docket01-19-00584-CV
StatusPublished

This text of in Re Iftikhar Ahmed, P.A. and Farhan Khan, M.D. (in Re Iftikhar Ahmed, P.A. and Farhan Khan, M.D.) is published on Counsel Stack Legal Research, covering Court of Appeals of Texas primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
in Re Iftikhar Ahmed, P.A. and Farhan Khan, M.D., (Tex. Ct. App. 2020).

Opinion

Opinion issued February 25, 2020

In The

Court of Appeals For The

First District of Texas ———————————— NO. 01-19-00584-CV ——————————— IN RE IFTIKHAR AHMED, P.A. AND FARHAN KHAN, M.D., Relators

Original Proceeding on Petition for Writ of Mandamus

MEMORANDUM OPINION

Relators, Iftikhar Ahmed, P.A. and Farhan Khan, M.D., have filed a petition

for writ of mandamus challenging the trial court’s order granting a new trial on the

basis of newly discovered evidence.1 We conditionally grant the petition.

1 The underlying case is Lena Savanah, Individually, and as Estate Representative for Decedent Joseph Nicholson, and Ericka Palmer as Next Friend of Minor Child v. Houston Northwest Operating Company, LLC, d/b/a Houston Northwest Medical Center, Iftikhar Ahmed PA, Dr. Bhushan Kukkalli, Lauralyn Denton RN, Wanda Zoeller RN, and Dr. Farhan Khan, cause number 2016-76925, pending in the 113th District Court of Harris County, Texas, the Honorable Rabeea Collier presiding. Background

On November 8, 2016, Joseph Nicholson was examined at a CVS Minute

Clinic where he tested positive for strep throat and was prescribed penicillin for ten

days. Five days later, on November 13, 2016, Nicholson went to the emergency

room at Houston Northwest Medical Center and reported that he had a sore throat

for a week and intermittent fever and chills. In the emergency room, he was treated

by Iftikhar Ahmed, a licensed physician’s assistant. Ahmed conducted a physical

exam and took a medical history. The medical notes state that Nicholson did not

have a fever, but that he had enlarged tonsils with exudate and swelling, indicating

his strep infection had not been cleared by the penicillin. Ahmed diagnosed

Nicholson with tonsillitis, prescribed a new antibiotic and Ibuprofen, and discharged

him with instructions to follow up with an ear, nose, and throat specialist in two-to-

three days. The next day, Dr. Farhan Khan reviewed and signed off on the chart as

part of the hospital’s standard quality control protocol.

On November 18, 2016, five days after being seen at the emergency room,

EMS was called and found Nicholson unresponsive in his bathroom. He was

intubated and taken to the hospital where, despite multiple rounds of medications,

he could not be resuscitated. The medical examiner concluded that the primary cause

of death was acute myeloid leukemia with involvement of the skin, tonsils, lymph

2 nodes, epiglottis, spleen, lungs, heart, kidneys, liver, testes, and brain. The secondary

finding was sepsis from two strains of bacteria.

The Underlying Trial

Nicholson’s mother and daughter filed a wrongful death suit against various

health care providers and facilities, including Ahmed and Dr. Khan, alleging medical

negligence and gross negligence. Plaintiffs asserted that when Nicholson presented

to the emergency room with a sore throat, he also had evidence of hemorrhage from

facial lesions and black tarry stools. At trial, they provided testimony from

Nicholson’s mother that he had blood in his stool, as well as an EMS report from

November 18, 2016, stating that Nicholson had mentioned this complaint when seen

at the emergency room on November 13. Plaintiffs also provided testimony from

Nicholson’s mother and sister that he had lesions on his face, and the autopsy report,

which described facial scabs.

Plaintiffs’ sole expert, Dr. Arnold D. Rubin, testified that (1) based on this

evidence of bleeding, Nicholson should have had a blood test to determine the cause

of the blood loss, and (2) based on the leukemic cells that he believed would have

been identified by these tests, Nicholson would have been presumed to have acute

promyelocytic leukemia, a specific sub-type of acute myeloid leukemia that

Plaintiffs contend can be effectively treated within days. Dr. Rubin conceded that

the findings in the autopsy report for the alleged lesions on Nicholson’s face were

3 excoriations (scabs) and not petechiae (spots that appear on the skin as a result of

bleeding), and it was possible that there was no rash or splotches on his skin at the

time of the emergency room visit. Dr. Rubin further conceded that the autopsy did

not mention a massive hemorrhage or bleed.

On January 10, 2019, the jury rendered a verdict in favor of the defendants,

finding that Nicholson’s death was not caused by either negligence or gross

negligence. Accordingly, the trial court signed a final take-nothing judgment on

March 4, 2019.

Plaintiffs’ Motion for New Trial

On January 25, 2019, after the jury returned a verdict for the defense, Plaintiffs

filed a third-party subpoena to obtain autopsy photographs from the medical

examiner. On April 3, 2019, the thirtieth day after judgment was signed, Plaintiffs

filed a motion for new trial, asserting that the autopsy photographs warranted a new

trial. Relators received service of the motion without any attachments or exhibits.

The filing was returned from the e-filing system due to improper formatting and

Plaintiffs refiled the motion the next day. On April 4, 2019, Relators received service

of the motion with 40 autopsy photograph exhibits attached. Thirty-two of the

photographs were file-stamped by the trial court on April 4, 2019, but the motion

and the remaining seven photographs were not file-stamped until April 5, 2019.

4 The trial court later granted Plaintiffs’ motion to amend the petition to include

an affidavit by their counsel, Todd E. Webb, in support of the motion for new trial.

The affidavit was notarized on April 4, 2019 but was not filed until May 1, 2019.

The affidavit consists of bare assertions that the requirements for a new trial on the

ground of newly discovered evidence were met. Specifically, Webb averred the

following in his affidavit:

4. All allegations made in the attached Motion for New Trial requiring the presentation of evidence are true and correct. 5. Evidence has come to light since the time of trial therefor [sic] it was impossible to present the evidence before the trial closed. 6. It was not because of a lack of due diligence that the information did not come sooner.

7. The new evidence is not cumulative.

8. The evidence is so material that it would probably produce a different result in a new trial. The affidavit did not provide any specific details or explanation in support of these

assertions.

The trial court granted the motion for new trial on June 12, 2019. The order

states in relevant part:

Plaintiffs brought a survivor and wrongful death claim against Defendants for medical malpractice based upon the untimely death of Joseph Nicholson who died on November 11, 2014. A jury returned a verdict for defendants’ [sic] finding the defendants were not negligent. However, after trial, Plaintiffs’ [sic] discovered new evidence in the form of over forty autopsy photographs from the Harris County Institute of Forensic

5 Science. The Court finds that the new evidence has been discovered since trial; the failure to discover the evidence prior to trial was not because of lack of due diligence; the evidence is not cumulative; and the evidence is so material that it would probably produce a different verdict. For these reasons, the Court grants Plaintiffs’ Motion for New Trial.

This mandamus petition followed.

Standard of Review for Mandamus Relief

To be entitled to mandamus relief, a relator must demonstrate (1) the trial

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