Preview
Discovery Resource
713-223-3300
1 (Pages 1 to 4)
1 3
1 CAUSE NO. 2017-43835 1 INDEX
2 2 PAGE
SAM ALAM, ) IN THE DISTRICT COURT 3 Appearances 2
4
3 )
AJAY CHOUDHRI, M.D.
Plaintiff, ) 5
4 ) Examination By Mr. Martinez 6
vs. ) 165TH JUDICIAL DISTRICT 6
5 ) 7
Signature and Changes 104
ANDREW GOMES, M.D., )
8
6 MAHENDRA AGRAHARKAR, M.D., ) Reporter's Certificate 106
AJAY CHOUDHRI, M.D., ) 9
7 NATIONAL INTERVENTIONAL ) 10 EXHIBIT INDEX
RADIOLOGY PARTNERS, PLLC, ) 11 NO. DESCRIPTION PAGE
12 Exhibit 1 29
8 NIRP MANAGEMENT, LLC, NIRP )
E-mail correspondence
PASADENA, PLLC, NIRP SUGAR ) 13
9 LAND, PLLC, ) Exhibit 2 30
Defendants. ) HARRIS COUNTY, TEXAS 14 E-mail (Walmart)
10 15 Exhibit 3 31
11 ORAL DEPOSITION OF
Executive Summary
16
12 AJAY CHOUDHRI, M.D. Exhibit 4 33
13 AUGUST 31, 2020 17 Proposal To Provide Facility Business Plan
14 REPORTED REMOTELY 18 Exhibit 5 35
15 ORAL DEPOSITION OF AJAY CHOUDHRI, M.D., produced as E-mail (Meeting)
19
16 a witness at the instance of the Plaintiff, and duly
Exhibit 6 37
17 sworn, was taken in the above-styled and numbered cause 20 Confidentiality/Non-Circumvent/Non-
18 on August 31, 2020, from 9:00 a.m. to 11:54 a.m., before Disclosure Agreement
19 Joe Sziriski, CSR (Via Zoom), in and for the State of 21
20 Texas, reported by computerized machine shorthand, at Exhibit 7 43
21 Lawrenceville, New Jersey, pursuant to the Texas Rules of
22 Proposal To Provide Implementation Plan
23 Exhibit 8 44
22 Civil Procedure, the Twenty-Second Emergency Order Procedure List
23 Regarding the COVID-19 State of Disaster and the 24
24 provisions, if any, stated on the record or attached Exhibit 9 46
25 hereto. 25 E-mail (IR OBL Project)
2 4
1 APPEARANCES 1 Exhibit 10 48
2 E-mail (IR OBL Project)
3 FOR THE PLAINTIFF: 2
Exhibit 11 53
4 Nicholas Martinez (Via Zoom) 3 E-mail (Business model)
THE WELSCHER MARTINEZ LAW FIRM 4 Exhibit 12 55
5 1111 North Loop West E-mail (Business Model)
Suite 702 5
6 Houston, Texas 77008 Exhibit 13 58
6 E-mail (Business Model)
Telephone: 713-862-0800 7 Exhibit 14 59
7 E-mail correspondence
8 8
FOR THE DEFENDANTS: Exhibit 15 64
9 9 E-mail correspondence
Liyue Huang-Sigle (Via Zoom) 10 Exhibit 16 69
E-mail (Formal Engagement)
10 NATIONAL INTERVENTIONAL RADIOLOGY 11
PARTNERS, P.L.L.C. Exhibit 17 70
11 3703 Kirby Drive 12 E-mail (Embedded IR Lab - Summary)
Suite 1200 13 Exhibit 18 72
12 Houston, Texas 77098 E-mail correspondence
Telephone: 832-779-4779 14
Exhibit 19 75
13 15 E-mail correspondence
14 16 Exhibit 20 75
ALSO PRESENT: E-mail correspondence
15 17
Sam Alam (Via Zoom) Exhibit 21 76
16 18 E-mail (Business Model)
19 Exhibit 22 78
17 E-mail (Business Model)
18 20
19 Exhibit 23 79
20 21 E-mail (IR Centers)
21 22 Exhibit 24 81
22 E-mail (Casper Radiology)
23
23 Exhibit 25 81
24 24 E-mail (Documents)
25 25 Exhibit 26 E-mail (Legal Documents) 82
EXHIBIT
Choudhri, Ajay, M.D.
Discovery Resource 713-223-3300
C
Alam v Gomes
Discovery Resource
713-223-3300
2 (Pages 5 to 8)
5 7
1 Exhibit 27 84 1 A. I have been a expert medical witness in
E-mail (Casper Radiology) 2 multiple lawsuits, so I've had multiple depositions, and
2
3 one commercial litigation that involved NIRP.
Exhibit 28 86
3 E-mail (Elite Sugar Land) 4 Q. Okay. And what NIRP case are you referring to?
4 Exhibit 29 88 5 A. It was a lawsuit involving Medstreaming, the
E-mail (Legal Documents) 6 electronic medical record company.
5 7 Q. And is that still ongoing or is it dismissed?
Exhibit 30 92
6 E-mail (NIRP Common Development Expenses & 8 A. That's been settled or dismissed or -- or
Pro Forma) 9 ended.
7 10 Q. Okay. And how many times have you
Exhibit 31 98 11 approximately had your deposition taken as an expert?
8 E-mail correspondence
9 12 A. About eight. Seven or eight.
10 13 Q. Okay. And just real quick, in case you don't
11 14 remember, but just some ground rules for today to make
12 15 this go a little smoother. If you could just let me
13 REPORTER'S NOTE:
14 Quotation marks are used for clarity and do not
16 finish my entire question before answering. And if you
15 necessarily reflect a direct quote. 17 don't understand anything I'm asking you, please feel
16 18 free to -- to ask me to rephrase it or re-ask it. And
17 19 anytime if you need a break at all, just let me know and
18 20 we'll take a break. The only thing I'd ask is that if
19
20 21 there's a -- a pending question on the table, that we
21 22 answer that question before taking a break.
22 23 But if you could, tell me your highest
23 24 level of education.
24
25 25 A. I have an M -- an M.D. degree.
6 8
1 PROCEEDINGS 1 Q. And where was that from?
2 (Witness duly sworn.) 2 A. From Ruckers Medical School.
3 THE COURT REPORTER: Counsel, please state 3 Q. And where do you currently practice?
4 your appearances for the record and where you are 4 A. I currently practice in central New Jersey at a
5 generally located. City and state will be fine. 5 pair of hospitals called Capital Health.
6 MR. MARTINEZ: This is Nicholas Martinez 6 Q. And how long have you been practicing in that
7 for the plaintiff. I'm in Houston, Texas. 7 general area?
8 MS. HUANG-SIGLE: And this is Liyue 8 A. Since April of 2003. So about almost 18 years.
9 Huang-Sigle on behalf of the defendants. I'm located in 9 Q. And when did you get your M.D.?
10 Houston, Texas. 10 A. I graduated medical school in 1995.
11 THE COURT REPORTER: Counsel, please 11 Q. So when you graduated, what did you first do
12 proceed when you are ready. 12 after that?
13 MR. MARTINEZ: Thank you. 13 A. So you do a internship and then you do a
14 AJAY CHOUDHRI, M.D., 14 diagnostic radiology fellow -- residency.
15 having been first duly sworn, testified as follows: 15 Q. And where did you do both of those at?
16 EXAMINATION 16 A. That was at Albert Einstein in New York City.
17 BY MR. MARTINEZ: 17 My internship -- I'm sorry -- was at
18 Q. Doctor, could you please state your full name. 18 Jerseys -- Jersey Shore Medical Center.
19 A. Ajay Choudhri. 19 Q. And then you ended up practicing in the Jersey
20 Q. And could you spell that for us. 20 area after that?
21 A. The first name is spelled A-J-A-Y, the last 21 A. No. Then I did an interventional radiology
22 name is C-H-O-U-D-H-R-I. 22 fellowship in Miami. I practiced in Miami at a private
23 Q. Have you ever been deposed before? 23 practice for a year or so, and then eventually I settled
24 A. Yes, I have. 24 at this job in 2003.
25 Q. And in what context was that? 25 Q. And what type of doctor are you?
Choudhri, Ajay, M.D.
Discovery Resource 713-223-3300
Discovery Resource
713-223-3300
3 (Pages 9 to 12)
9 11
1 A. A diagnostic and interventional radiologist. 1 interventional radiology is basically its own animal.
2 Q. And could explain to us what that is? 2 Q. And you're familiar with Dr. Gomes, I presume?
3 A. Yes. So diagnostic radiology is conventionally 3 A. Yes.
4 medical imaging. So diagnostic radiologists interpret CT 4 Q. And how did you first meet him?
5 scans, MRIs, X-rays, nuclear medicine, ultrasound, MR -- 5 A. We actually worked together at my group in
6 multiple modalities. 6 probably 2008 or '9, somewhere around there early -- in
7 Interventional radiology is basically 7 the late 2000s.
8 image-guided, minimally invasive surgery. 8 Q. And you're referring to your group in New
9 Q. So as soon as you -- you began your practice, 9 Jersey?
10 were you always, you know, both, both diagnostic and 10 A. Yes.
11 interventional or only one or the other? 11 Q. And y'all hired him?
12 A. Both. 12 A. Yes. I was -- I was vice chair at the time and
13 Q. And from the time you started practicing, would 13 we needed some local docs, and he came in and filled in
14 you say that, you know, one portion, you know, whether 14 for -- when we were short-staffed.
15 it's diagnostic or interventional, has gone down and the 15 Q. And how long did he work for y'all?
16 other has gone up? 16 A. Off and on, for a couple of years. It wasn't
17 A. I'm sorry. Are you asking what proportion I 17 continuous. But when we needed help, he would come in
18 personally work? Or... 18 and help us out.
19 Q. Correct. 19 Q. And did he actually have to physically be in
20 A. So it varies from week to week. There's some 20 New Jersey or could he do it, you know, wherever he was?
21 days I'll work one or two days of diagnostic. Some weeks 21 A. So there were sometimes he could do telerad for
22 I'll work five days of interventional radiology. So it 22 us, but mostly it was physical, a physical location.
23 depends on the schedule. But I do both. 23 Yeah.
24 Q. But the overall your proportion hasn't changed 24 Q. And did y'all hire him under his individual
25 much, I guess, since you started practicing? 25 name or through his company?
10 12
1 A. I -- I would -- yeah, I -- I think it's -- it 1 A. I don't remember to be honest.
2 just -- it varies from week to week, but it's about the 2 Q. Are you familiar with a company called Casper
3 same over the last 20 years. Yeah. 3 Radiology?
4 Q. And do you have to get any specialized training 4 A. Yeah. I know that's his company, but I don't
5 in interventional radiology or a specialization for that 5 know who the checks were being cut to.
6 field? 6 Q. And what was your impression of him when he
7 A. I did a fellowship in interventional 7 worked for you?
8 radiologist -- interventional radiology for one year. 8 A. You know, I think we had very similar
9 Q. And where was this at? 9 entrepreneurial spirit, and I just liked the -- the way
10 A. At Miami Cardiac & Vascular Institute. 10 of his thinking. I don't believe that the status quo is
11 Q. Do you consider interventional radiology to be 11 necessarily the right way to do things, and so we both
12 something more of the future whereas diagnostic is more 12 believe in the arc of innovation and we both believe in
13 of the past? 13 driving down cost and removing complexity.
14 A. I don't know. That's a pretty broad -- a 14 So a lot of those things were common
15 pretty broad question. Do you -- do you consider cars 15 between us, and he understood the language of business
16 something of the future? 16 and so did I. So that's how we would -- you know, we had
17 I mean, IR and diagnostic radiology have 17 a very common vein of interest.
18 been around since 1990 -- 1980. So I'm not sure how to 18 Q. So you mentioned, you know, innovation
19 answer that question. 19 entrepreneurism, you know, business sense.
20 Q. I was curious if you have an opinion which way 20 How have you been involved in those things
21 it's going, you know, if one is going to be, you know, be 21 in the past?
22 stronger than the other in the future. 22 A. You mean my personal involvement?
23 A. I'm not sure which will be stronger because 23 Q. Right. You know, how have you been
24 diagnostic radiology has its place. You can't do 24 entrepreneur or a businessman, you know, aside from just
25 anything these days without imaging, and then 25 being, you know, a practicing physician?
Choudhri, Ajay, M.D.
Discovery Resource 713-223-3300
Discovery Resource
713-223-3300
4 (Pages 13 to 16)
13 15
1 A. So I'll start with, I am the chairman and 1 Andrew Gomes get it off the ground.
2 managing partner of a 16-man radiology group that does a 2 Q. So we'll back up a little bit and talk about
3 fair amount of revenue that requires me to administer 3 what NIRP is. Could you tell us what -- what is NIRP to
4 over the business operations, expand the business, make 4 you? What does that mean?
5 sound business decisions. Those are all things that I've 5 A. NIRP operates a number of facilities that
6 been experienced with. I also advise a number of medical 6 performs outpatient-based, image-guided surgery.
7 start-ups through an incubator locally in Princeton. I'm 7 Q. And what do you mean by "outpatient-based,
8 also an angel investor in a number of -- in a number of 8 image-guided surgery"? What is that?
9 start-ups also. 9 A. So in contrast to hospitals where you may go to
10 I also serve as advisory board on small 10 the hospital and be admitted after your procedure, or
11 device companies and invest my own money. So, and that 11 it's done in a large hospital, outpatient-based labs work
12 would probably be the best representation of my business 12 out of small, lean offices that provide a faster service
13 acumen. 13 and less bureaucracy and -- and are usually smaller in
14 Q. So you said you have a 16-man radiology group. 14 scale.
15 What is the name of the -- that group? 15 Q. And before NIRP have you been involved in any
16 A. Capital Health Advanced Imaging. 16 of those type of, you know, outpatient-based facilities?
17 Q. And do y'all just do business up in the New 17 A. I -- yes, I have. I had previously moonlighted
18 Jersey area? 18 in a number of outpatient labs.
19 A. That is correct. 19 Q. But you were never an owner?
20 Q. And how long has that group been around? 20 A. Never an owner.
21 A. Founded probably in about 2005, but we were 21 Q. So NIRP was your first foray into ownership in
22 together in 2003 as a cohort, and then we incorporated. 22 this type of business?
23 Or I don't know what the legal term is, but formed a PC. 23 A. I'm sorry. I didn't hear that last part.
24 Q. And you said, I think you do -- I'm not -- I'm 24 My "first foray"?
25 not sure if I heard that right. 25 Q. Into this type of outpatient-based business?
14 16
1 But was it consulting with -- with 1 A. As an investor, yes. As an owner, yes.
2 Princeton? Or what was it? 2 Q. So when was this idea first brought to you, the
3 A. Advise. Advisory. 3 idea of the NIRP itself, that idea?
4 Q. For like students? 4 A. So the name, not necessarily, but the idea we
5 A. For their -- it's earlier staged incubator 5 had been discussing. Me and Dr. Gomes had been
6 start-up companies. 6 discussing this when he was running a group in an Indian
7 Q. And this is only for medical companies, I 7 reservation town in Arizona. I don't remember the name
8 guess? 8 of the city.
9 A. Yeah. Digital health. Yeah. 9 But he was thinking about opening an IR on
10 Q. And how long have you been doing that for? 10 the facility. I don't know the exact dates, but we had
11 A. Since 2006 about. No. 2010. I'm sorry. 11 been talking for quite some time about it, and I advised
12 2010. 12 him that it's way more profitable than diagnostic
13 Q. And that's still going on? 13 imaging.
14 A. Yeah. 14 Q. And where did it go from there? I mean, that
15 Q. And you also said you're an angel investor. 15 -- that sounds like, you know, early discussions about a
16 Could you explain that? 16 potential idea.
17 A. Yeah. So I've invested in a number of 17 But when did y'all actually talk about,
18 companies in their pre-capital market stages. 18 "Okay. Let's -- let's form something and get something
19 Q. And so you sort of invest in them before they 19 going"?
20 get started up? 20 A. So I would say probably, it had been brewing
21 A. Yeah. 21 for 24 months before opening. So maybe 2000 -- I am
22 Q. And is that what you did with NIRP here or is 22 going to guess on dates, but something like 2013, 2014,
23 that different? 23 something like that.
24 A. No. In a lot of those situations, it's very, 24 Q. And during those primary preliminary
25 very early. At NIRP I had a active part in helping 25 discussions did y'all talk about, you know, specific, you
Choudhri, Ajay, M.D.
Discovery Resource 713-223-3300
Discovery Resource
713-223-3300
5 (Pages 17 to 20)
17 19
1 know, business models, forecasts, projections, anything 1 other week. Every -- every two weeks, and then it became
2 like that? 2 less and less often.
3 A. I mean, you know, when you decide to jump in, 3 Q. And what did y'all typically discuss in those
4 you do a lot of modeling. You do -- you look at 4 meetings?
5 reimbursement, equipment costs, rents, personnel costs. 5 A. Generally expansion, direction, policy,
6 So we did a lot of that. 6 operations, things that need to be looked at. Basically
7 Q. And how did y'all get that information? 7 everyday -- everyday operations.
8 A. A lot of it, it's common knowledge. A lot of 8 Q. So how comfortable did you feel investing in,
9 it, it is based on my knowledge, and some -- and a lot of 9 you know, a business that's based in the Texas area when
10 it is based on Dr. Gomes' knowledge. 10 you're up in, you know, New Jersey?
11 Q. Did y'all have to hire anyone to figure that 11 A. So there are some business impediments in New
12 out? 12 Jersey regulatory-wise for me to do something like this.
13 A. I -- I'm -- I am pretty sure that Dr. Gomes had 13 It's much harder to do it in a very heavy -- heavily
14 people doing research for him. He had a number of staff 14 regulated -- heavy -- heavily regulated healthcare market
15 that were already working. 15 like New Jersey, and I felt that Texas offered a much
16 Q. But you, yourself, didn't -- 16 better climate for this sort of thing, and I trusted
17 A. I personally did not, no. 17 Dr. Gomes because we have a very common way of thinking.
18 Q. So when did y'all finally decide, "Okay. This 18 So, and -- and Houston is an ideal healthcare market for
19 is a viable, you know, business model. Let's move 19 this sort of thing, so I was comfortable with it.
20 forward"? 20 Q. Why did you say that, you know, "Houston is an
21 A. I don't know the exact date, but I could give 21 ideal healthcare market" for it?
22 you a rough estimation of when we started to build on it. 22 A. Very population dense. It wasn't that
23 So somewhere in that time between '15 and '16 I'm -- I'm 23 penetrated with this sort of business, and it's in Texas,
24 going to guess. 24 and Dr. Gomes is in Houston.
25 Q. Are you and Gomes -- I'm sorry. 25 Q. You mentioned, you know, some regulations that
18 20
1 Are you and Dr. Gomes, you know, 50-50? Or 1 New Jersey, I guess, made it tough on you to do this type
2 what's your business -- 2 of business, but what, you know, generally were those
3 A. No. No. I'm a minority investor in two of the 3 that would prohibit you from doing this in New Jersey?
4 facilities. 4 A. So in New Jersey there was a law passed that
5 Q. And which facilities were those? 5 any outside patient facility that performs surgery has to
6 A. The first two, NIRP Sugar Land and NIRP 6 be majority-owned by a hospital.
7 Pasadena. 7 And once you get a hospital involved, it's
8 Q. And are you involved at all in the day-to-day 8 very really not worth doing business. So...
9 operations of the businesses? 9 Q. Okay. Understood. So when you were
10 A. Not anymore. Perhaps in the first few months I 10 formulating this business with Dr. Gomes, did you ever
11 was there just to help oversee things, but I -- I wasn't 11 travel to Houston, you now, personally to talk with him
12 there physically and I'm not there physically now, so I 12 about it?
13 don't participate in day-to-day operations. 13 A. To talk to --
14 Q. Do you participate at all in the business or 14 Q. Dr. Gomes.
15 are you just, you know -- 15 A. -- Dr. Gomes? So I've been to Houston multiple
16 A. Yes. 16 times before and after.
17 Q. -- investor? 17 Q. So before the business was actually formed and
18 A. When I get called to meetings, board meetings, 18 launched, did you meet with anyone else besides Dr. Gomes
19 that sort of stuff, management -- 19 about the business?
20 Q. About -- 20 A. Please repeat the question.
21 A. -- meetings. Sorry. Not board meetings, but 21 Q. So before NIRP was actually formed and you
22 management meetings. 22 traveled down here to Houston to meet with Dr. Gomes, did
23 Q. And how often do y'all have those meetings? 23 you meet with anyone else along with, you know,
24 A. It's become less often because the business is 24 Dr. Gomes?
25 maturing. Initially it was fairly often. I'd say every 25 A. So in either 2014 or '15, I had flown to
Choudhri, Ajay, M.D.
Discovery Resource 713-223-3300
Discovery Resource
713-223-3300
6 (Pages 21 to 24)
21 23
1 Houston for a couple of non-related IR, for -- for 1 neuroscience program at the Bay Area Regional Medical
2 projects not related to interventional radiology at 2 Center.
3 Dr. Gomes' request. 3 The hospital itself is very close to a
4 Q. And who else, you know, met with y'all? 4 another competitive hospital. So then you need a
5 A. So I had met Dr. Agraharkar once and I had met 5 differentiator, and I thought that that would be a pretty
6 Sam Alam, which is the purpose of this deposition, a 6 good idea to do it there, but you would need a fairly
7 couple -- I think a couple of times. 7 strong clinical management team to get it off the ground.
8 Q. So before you came down here and met, you know, 8 Q. And you said Dr. Gomes was involved in this
9 NIRP, and you met with Sam, had you known Sam previously? 9 neuroscience program pitch as well?
10 A. I had not. 10 A. He was there, yes.
11 Q. And do you recall the first time you either met 11 Q. Do you know how he was involved in coming up
12 with Sam personally or talked with Sam? 12 with that whole pitch or idea?
13 A. So I don't remember the exact sequence of 13 A. No. I just know that it was the three of us.
14 events, but I had come down at least once to pitch a 14 Q. And do you know if it was Sam's idea or
15 neuroscience project at Bay Area Regional Medical Center, 15 Dr. Gomes' idea?
16 which we had met with the CEO, and I think, maybe a vice 16 A. That, I'm not sure of. It wasn't my idea, I'll
17 president and made a day-long pitch of some program that 17 tell you that.
18 Sam and Andrew were interested in doing at that medical 18 Q. And you were just there to help out if they
19 center. 19 need some help?
20 So since I had experience as a hospital 20 A. Yes.
21 chairman, I had a very successful neuroscience program, I 21 Q. And do you know what happened with that pitch,
22 went there to pitch this unrelated neuroscience idea to 22 you know, if they accepted it or denied it? Or what did
23 the CEO. 23 the hospital do?
24 And the owner of, whose name I forget, it 24 A. I think the hospital decided that they weren't
25 was a, I think a Persian name, Mansoor or somebody, we 25 ready for something like that.
22 24
1 had met with him at his house. 1 Q. So I think you said -- we were talking about
2 Q. And do you recall when this was? 2 Sam and how you first, you know, got to know Sam.
3 A. I couldn't tell you the date. I probably could 3 And is it correct that that was sort of
4 look my through -- travel, you know, logs and stuff and 4 your first exposure to Sam?
5 tell you when it was exactly. 5 A. Either that or one visit before. I don't
6 Q. But that was before y'all formed NIRP. Right? 6 remember. But, yes.
7 A. That is correct. 7 Q. And you said Sam was, I think you said, "in
8 Q. Was it before y'all started meeting about NIRP? 8 over his head with the neuroscience program pitch."
9 A. So I don't think the NIRP formally -- formal 9 Why would you believe that?
10 discussions by NIRP happened before that. But I had been 10 A. So I've been doing this a while, probably like
11 talking to Dr. Gomes at length about IR for a long time 11 you have, and first impressions are important, especially
12 by phone, by conversation. 12 in business and especially in the science and business of
13 Q. So this neuroscience program y'all were 13 medicine, and you can tell when somebody knows a lot
14 pitching to the Bay Area Hospital in Houston, I mean, did 14 about the field and when somebody is out of their depth,
15 it have a name? Or what exactly what was it? 15 and I certainly -- while Sam was a very affable and nice
16 A. I -- I don't think it had a name at the time. 16 guy, I didn't think he had the depth of knowledge --
17 I thought it was a slightly harebrained scheme, but, you 17 Q. Was it --
18 know, I -- I helped him out with my expertise. 18 A. -- and I --
19 Q. So why did you think it was a harebrained 19 Q. Go ahead.
20 scheme? 20 A. Sorry. And I spend a lot of time judging
21 A. I -- I felt like we didn't -- I -- I felt like 21 start-ups and allocating money to small companies, so the
22 Sam was in over his head. I -- I don't think he had a 22 management team to me is very, very important, so I was
23 grip of -- on the idea of what it entailed. 23 not initially impressed.
24 But, you know, I gave it my best sell to 24 Q. So that was sort of the initial, I guess, time
25 see if we could guide and pilot a comprehensive 25 you met Sam.
Choudhri, Ajay, M.D.
Discovery Resource 713-223-3300
Discovery Resource
713-223-3300
7 (Pages 25 to 28)
25 27
1 But after that, you know, after this 1 So you never would have used your Capital
2 neuroscience pitch, did you still continue to meet with 2 Health e-mail to, you know, correspond with Dr. Gomes or
3 Sam about the NIRP idea? 3 Sam or anyone in NIRP?
4 A. I never did. Or if I -- I do not recall I did. 4 A. So, not my Capital Health e-mail. I have
5 It's quite some time ago, but I have a lot going, and I 5 another gmail account that I use for group. I keep -- I
6 don't ever remember discussing anything about IR with 6 try to keep my personal e-mail and my group, you know,
7 Sam. 7 medical CHAI, or Capital Health Advanced Imaging,
8 Q. So for the NIRP project -- I mean, whether or 8 business straight because it gets to be too confusing.
9 not it was called NIRP, the idea was basically an 9 That e-mail is chsrad@gmail.com.
10 interventional radiology program with office-based labs. 10 So I had looked through the records to tell
11 Right? 11 you if I communicated via e-mail with Sam through that,
12 A. That's what it is, yes. 12 but I don't remember. I'm pretty sure I would have used
13 Q. So that idea, you know, the -- the NIRP idea is 13 my personal e-mail.
14 what I'm calling it. 14 Q. So when working with Dr. Gomes about forming
15 So you're saying that you never met with 15 this, you know, NIRP idea, did you ever go talk with any
16 Sam about that NIRP idea? 16 of Dr. Gomes', you know, associates such as, you know,
17 A. I don't recall even talking to him about IR. 17 Donna, or anyone else he had -- he had hired?
18 If did I, then it's beyond my memory. But 18 A. Generally when I spoke to them, it's usually in
19 I didn't -- I personally don't think he does -- knew what 19 a conference call with Dr. Gomes. I generally don't
20 IR was and, you know, maybe he had discussions with 20 directly speak to his direct reports. It's via a
21 Dr. Gomes and -- in that, but I never spoke directly 21 conference call. So...
22 about him or any knowledge concerning IR. 22 Q. Do you have any idea who Jessica Nantz is?
23 Q. Uh-huh. Did you say you worked at Capital 23 A. No.
24 Health in New Jersey? Was that correct? 24 Q. So earlier you mentioned Dr. Agraharkar.
25 A. That is the hospital that we are contracted to. 25 Who is that?
26 28
1 Correct. 1 A. Dr. Agraharkar is a well-respected,
2 Q. And I presume they gave you an e-mail address? 2 well-established nephrologist in the Houston area who
3 A. The hospital does. I do not use it. 3 invested in healthcare businesses, and I had met him
4 Q. So since 2013, do you know which e-mail 4 through Dr. Gomes, and eventually he became the landlord
5 addresses you've used? 5 of one of the NIRP facilities Pasadena, and I think a
6 A. Since 2013? 6 minority investor.
7 Q. Yes. 7 Q. And how involved were you with Dr. Agraharkar
8 A. My personal e-mail address, which is a gmail 8 as far as discussing the NIRP idea before you actually
9 account that I use for my personal e-mails, and I have an 9 started the company?
10 e-mail address with NIRP. 10 A. So one of my visits to Houston I had met him
11 Q. And what's your personal one? What's that? 11 and he had shown us the properties and where we intended
12 A. It's my first name, period, last name, 12 to build, that sort of thing, and, you know, he was
13 @gmail.com. 13 excited; we were excited.
14 Q. And I guess you didn't start using the NIRP one 14 Q. But nothing else really besides that?
15 until the company actually got formed? 15 A. Not direct communication, no.
16 A. That is correct. 16 Q. And since the companies formed, have y'all done
17 Q. Do you have any idea, you know, how Sam and 17 anything like that, discussions about specifics with
18 Dr. Gomes even met or how they started their business 18 NIRP?
19 relationship? 19 A. Between me and Dr. Agraharkar?
20 A. Vaguely. I know that they're both 20 Q. Correct.
21 Houston-based and they're both healthcare -- involved in 21 A. No.
22 healthcare. I imagine there was an introduction, or they 22 Q. And do you remember when it was that you came
23 met through a common party. I'm not sure. 23 down and he showed you the facilities, Dr. Agraharkar?
24 But I do not know that person. 24 A. Probably somewhere 2014, '15. The dates escape
25 Q. (Speakerphone interruption.) Sorry about that. 25 me right now.
Choudhri, Ajay, M.D.
Discovery Resource 713-223-3300
Discovery Resource
713-223-3300
8 (Pages 29 to 32)
29 31
1 Q. And earlier I mentioned the "office-based lab." 1 Q. (BY MR. MARTINEZ) And here it looks like
2 But could you explain to us, what that is? 2 another e-mail from Dr. Gomes to Sam where Dr. Gomes
3 A. Yes. So in contrast to a surgical center or a 3 called Sam an "expert and industry, you know, "veteran."
4 hospital, it is basically a small, lean office-space 4 But I'm curious, you know, did -- did
5 operation where they perform procedures, usually 5 Dr. Gomes, you know, relay the same thing -- the same
6 minimally invasive and can administer sedation and that 6 thing to you about Sam?
7 sort of stuff as opposed to like a plain old doctor's 7 Did Dr. Gomes say, "Oh, yeah, Sam is great.
8 office. 8 He is a veteran. He knows what he is doing"?
9 Q. All right. Let's look at an exhibit here. 9 Do you recall, you know, Dr. Gomes saying
10 (Exhibit No. 1 marked.) 10 anything like that about Sam?
11 Q. (BY MR. MARTINEZ) All right. Can you see 11 A. I -- I'll be honest, Mr. Martinez, I don't
12 this? 12 listen to stuff like that, but I do not recall him
13 A. I can. 13 speaking ill or positive about Sam. He had -- he said
14 Q. All right. This is Bates 211. So I'm just 14 that Sam was a Houston-based healthcare entrepreneur and
15 trying to establish, you know, a timeline so that way we 15 I just took it as -- as that.
16 can, you know, sort of figure this out together maybe. 16 Q. And you said you don't, you know, listen to
17 But this an e-mail between Dr. Gomes and 17 things like that, I guess, hyperbole and exaggeration or
18 Sam. He's got Donna copied on it from February of 2015 18 compliments because, I guess, you take a more critical
19 and he talked about how they met and -- 19 eye to things?
20 MS. HUANG-SIGLE: Objection. This has 20 A. As I imagine you as an attorney do also, yes.
21 nothing to do with the witness. 21 Q. So we're looking at -- Doctor, it's on Line
22 MR. MARTINEZ: Okay. 22 2174. That's the Bates number.
23 MS. HUANG-SIGLE: You're -- you're asking 23 (Exhibit No. 3 marked.)
24 the witness about a document that's not -- he is not a 24 Q. (BY MR. MARTINEZ) So this is an executive
25 party to. 25 summary. It's got Casper Radiology's, you know,
30
Preview
Discovery Resource 713-223-3300 1 (Pages 1 to 4) 1 3 1 CAUSE NO. 2017-43835 1 INDEX 2 2 PAGE SAM ALAM, ) IN THE DISTRICT COURT 3 Appearances 2 4 3 ) AJAY CHOUDHRI, M.D. Plaintiff, ) 5 4 ) Examination By Mr. Martinez 6 vs. ) 165TH JUDICIAL DISTRICT 6 5 ) 7 Signature and Changes 104 ANDREW GOMES, M.D., ) 8 6 MAHENDRA AGRAHARKAR, M.D., ) Reporter's Certificate 106 AJAY CHOUDHRI, M.D., ) 9 7 NATIONAL INTERVENTIONAL ) 10 EXHIBIT INDEX RADIOLOGY PARTNERS, PLLC, ) 11 NO. DESCRIPTION PAGE 12 Exhibit 1 29 8 NIRP MANAGEMENT, LLC, NIRP ) E-mail correspondence PASADENA, PLLC, NIRP SUGAR ) 13 9 LAND, PLLC, ) Exhibit 2 30 Defendants. ) HARRIS COUNTY, TEXAS 14 E-mail (Walmart) 10 15 Exhibit 3 31 11 ORAL DEPOSITION OF Executive Summary 16 12 AJAY CHOUDHRI, M.D. Exhibit 4 33 13 AUGUST 31, 2020 17 Proposal To Provide Facility Business Plan 14 REPORTED REMOTELY 18 Exhibit 5 35 15 ORAL DEPOSITION OF AJAY CHOUDHRI, M.D., produced as E-mail (Meeting) 19 16 a witness at the instance of the Plaintiff, and duly Exhibit 6 37 17 sworn, was taken in the above-styled and numbered cause 20 Confidentiality/Non-Circumvent/Non- 18 on August 31, 2020, from 9:00 a.m. to 11:54 a.m., before Disclosure Agreement 19 Joe Sziriski, CSR (Via Zoom), in and for the State of 21 20 Texas, reported by computerized machine shorthand, at Exhibit 7 43 21 Lawrenceville, New Jersey, pursuant to the Texas Rules of 22 Proposal To Provide Implementation Plan 23 Exhibit 8 44 22 Civil Procedure, the Twenty-Second Emergency Order Procedure List 23 Regarding the COVID-19 State of Disaster and the 24 24 provisions, if any, stated on the record or attached Exhibit 9 46 25 hereto. 25 E-mail (IR OBL Project) 2 4 1 APPEARANCES 1 Exhibit 10 48 2 E-mail (IR OBL Project) 3 FOR THE PLAINTIFF: 2 Exhibit 11 53 4 Nicholas Martinez (Via Zoom) 3 E-mail (Business model) THE WELSCHER MARTINEZ LAW FIRM 4 Exhibit 12 55 5 1111 North Loop West E-mail (Business Model) Suite 702 5 6 Houston, Texas 77008 Exhibit 13 58 6 E-mail (Business Model) Telephone: 713-862-0800 7 Exhibit 14 59 7 E-mail correspondence 8 8 FOR THE DEFENDANTS: Exhibit 15 64 9 9 E-mail correspondence Liyue Huang-Sigle (Via Zoom) 10 Exhibit 16 69 E-mail (Formal Engagement) 10 NATIONAL INTERVENTIONAL RADIOLOGY 11 PARTNERS, P.L.L.C. Exhibit 17 70 11 3703 Kirby Drive 12 E-mail (Embedded IR Lab - Summary) Suite 1200 13 Exhibit 18 72 12 Houston, Texas 77098 E-mail correspondence Telephone: 832-779-4779 14 Exhibit 19 75 13 15 E-mail correspondence 14 16 Exhibit 20 75 ALSO PRESENT: E-mail correspondence 15 17 Sam Alam (Via Zoom) Exhibit 21 76 16 18 E-mail (Business Model) 19 Exhibit 22 78 17 E-mail (Business Model) 18 20 19 Exhibit 23 79 20 21 E-mail (IR Centers) 21 22 Exhibit 24 81 22 E-mail (Casper Radiology) 23 23 Exhibit 25 81 24 24 E-mail (Documents) 25 25 Exhibit 26 E-mail (Legal Documents) 82 EXHIBIT Choudhri, Ajay, M.D. Discovery Resource 713-223-3300 C Alam v Gomes Discovery Resource 713-223-3300 2 (Pages 5 to 8) 5 7 1 Exhibit 27 84 1 A. I have been a expert medical witness in E-mail (Casper Radiology) 2 multiple lawsuits, so I've had multiple depositions, and 2 3 one commercial litigation that involved NIRP. Exhibit 28 86 3 E-mail (Elite Sugar Land) 4 Q. Okay. And what NIRP case are you referring to? 4 Exhibit 29 88 5 A. It was a lawsuit involving Medstreaming, the E-mail (Legal Documents) 6 electronic medical record company. 5 7 Q. And is that still ongoing or is it dismissed? Exhibit 30 92 6 E-mail (NIRP Common Development Expenses & 8 A. That's been settled or dismissed or -- or Pro Forma) 9 ended. 7 10 Q. Okay. And how many times have you Exhibit 31 98 11 approximately had your deposition taken as an expert? 8 E-mail correspondence 9 12 A. About eight. Seven or eight. 10 13 Q. Okay. And just real quick, in case you don't 11 14 remember, but just some ground rules for today to make 12 15 this go a little smoother. If you could just let me 13 REPORTER'S NOTE: 14 Quotation marks are used for clarity and do not 16 finish my entire question before answering. And if you 15 necessarily reflect a direct quote. 17 don't understand anything I'm asking you, please feel 16 18 free to -- to ask me to rephrase it or re-ask it. And 17 19 anytime if you need a break at all, just let me know and 18 20 we'll take a break. The only thing I'd ask is that if 19 20 21 there's a -- a pending question on the table, that we 21 22 answer that question before taking a break. 22 23 But if you could, tell me your highest 23 24 level of education. 24 25 25 A. I have an M -- an M.D. degree. 6 8 1 PROCEEDINGS 1 Q. And where was that from? 2 (Witness duly sworn.) 2 A. From Ruckers Medical School. 3 THE COURT REPORTER: Counsel, please state 3 Q. And where do you currently practice? 4 your appearances for the record and where you are 4 A. I currently practice in central New Jersey at a 5 generally located. City and state will be fine. 5 pair of hospitals called Capital Health. 6 MR. MARTINEZ: This is Nicholas Martinez 6 Q. And how long have you been practicing in that 7 for the plaintiff. I'm in Houston, Texas. 7 general area? 8 MS. HUANG-SIGLE: And this is Liyue 8 A. Since April of 2003. So about almost 18 years. 9 Huang-Sigle on behalf of the defendants. I'm located in 9 Q. And when did you get your M.D.? 10 Houston, Texas. 10 A. I graduated medical school in 1995. 11 THE COURT REPORTER: Counsel, please 11 Q. So when you graduated, what did you first do 12 proceed when you are ready. 12 after that? 13 MR. MARTINEZ: Thank you. 13 A. So you do a internship and then you do a 14 AJAY CHOUDHRI, M.D., 14 diagnostic radiology fellow -- residency. 15 having been first duly sworn, testified as follows: 15 Q. And where did you do both of those at? 16 EXAMINATION 16 A. That was at Albert Einstein in New York City. 17 BY MR. MARTINEZ: 17 My internship -- I'm sorry -- was at 18 Q. Doctor, could you please state your full name. 18 Jerseys -- Jersey Shore Medical Center. 19 A. Ajay Choudhri. 19 Q. And then you ended up practicing in the Jersey 20 Q. And could you spell that for us. 20 area after that? 21 A. The first name is spelled A-J-A-Y, the last 21 A. No. Then I did an interventional radiology 22 name is C-H-O-U-D-H-R-I. 22 fellowship in Miami. I practiced in Miami at a private 23 Q. Have you ever been deposed before? 23 practice for a year or so, and then eventually I settled 24 A. Yes, I have. 24 at this job in 2003. 25 Q. And in what context was that? 25 Q. And what type of doctor are you? Choudhri, Ajay, M.D. Discovery Resource 713-223-3300 Discovery Resource 713-223-3300 3 (Pages 9 to 12) 9 11 1 A. A diagnostic and interventional radiologist. 1 interventional radiology is basically its own animal. 2 Q. And could explain to us what that is? 2 Q. And you're familiar with Dr. Gomes, I presume? 3 A. Yes. So diagnostic radiology is conventionally 3 A. Yes. 4 medical imaging. So diagnostic radiologists interpret CT 4 Q. And how did you first meet him? 5 scans, MRIs, X-rays, nuclear medicine, ultrasound, MR -- 5 A. We actually worked together at my group in 6 multiple modalities. 6 probably 2008 or '9, somewhere around there early -- in 7 Interventional radiology is basically 7 the late 2000s. 8 image-guided, minimally invasive surgery. 8 Q. And you're referring to your group in New 9 Q. So as soon as you -- you began your practice, 9 Jersey? 10 were you always, you know, both, both diagnostic and 10 A. Yes. 11 interventional or only one or the other? 11 Q. And y'all hired him? 12 A. Both. 12 A. Yes. I was -- I was vice chair at the time and 13 Q. And from the time you started practicing, would 13 we needed some local docs, and he came in and filled in 14 you say that, you know, one portion, you know, whether 14 for -- when we were short-staffed. 15 it's diagnostic or interventional, has gone down and the 15 Q. And how long did he work for y'all? 16 other has gone up? 16 A. Off and on, for a couple of years. It wasn't 17 A. I'm sorry. Are you asking what proportion I 17 continuous. But when we needed help, he would come in 18 personally work? Or... 18 and help us out. 19 Q. Correct. 19 Q. And did he actually have to physically be in 20 A. So it varies from week to week. There's some 20 New Jersey or could he do it, you know, wherever he was? 21 days I'll work one or two days of diagnostic. Some weeks 21 A. So there were sometimes he could do telerad for 22 I'll work five days of interventional radiology. So it 22 us, but mostly it was physical, a physical location. 23 depends on the schedule. But I do both. 23 Yeah. 24 Q. But the overall your proportion hasn't changed 24 Q. And did y'all hire him under his individual 25 much, I guess, since you started practicing? 25 name or through his company? 10 12 1 A. I -- I would -- yeah, I -- I think it's -- it 1 A. I don't remember to be honest. 2 just -- it varies from week to week, but it's about the 2 Q. Are you familiar with a company called Casper 3 same over the last 20 years. Yeah. 3 Radiology? 4 Q. And do you have to get any specialized training 4 A. Yeah. I know that's his company, but I don't 5 in interventional radiology or a specialization for that 5 know who the checks were being cut to. 6 field? 6 Q. And what was your impression of him when he 7 A. I did a fellowship in interventional 7 worked for you? 8 radiologist -- interventional radiology for one year. 8 A. You know, I think we had very similar 9 Q. And where was this at? 9 entrepreneurial spirit, and I just liked the -- the way 10 A. At Miami Cardiac & Vascular Institute. 10 of his thinking. I don't believe that the status quo is 11 Q. Do you consider interventional radiology to be 11 necessarily the right way to do things, and so we both 12 something more of the future whereas diagnostic is more 12 believe in the arc of innovation and we both believe in 13 of the past? 13 driving down cost and removing complexity. 14 A. I don't know. That's a pretty broad -- a 14 So a lot of those things were common 15 pretty broad question. Do you -- do you consider cars 15 between us, and he understood the language of business 16 something of the future? 16 and so did I. So that's how we would -- you know, we had 17 I mean, IR and diagnostic radiology have 17 a very common vein of interest. 18 been around since 1990 -- 1980. So I'm not sure how to 18 Q. So you mentioned, you know, innovation 19 answer that question. 19 entrepreneurism, you know, business sense. 20 Q. I was curious if you have an opinion which way 20 How have you been involved in those things 21 it's going, you know, if one is going to be, you know, be 21 in the past? 22 stronger than the other in the future. 22 A. You mean my personal involvement? 23 A. I'm not sure which will be stronger because 23 Q. Right. You know, how have you been 24 diagnostic radiology has its place. You can't do 24 entrepreneur or a businessman, you know, aside from just 25 anything these days without imaging, and then 25 being, you know, a practicing physician? Choudhri, Ajay, M.D. Discovery Resource 713-223-3300 Discovery Resource 713-223-3300 4 (Pages 13 to 16) 13 15 1 A. So I'll start with, I am the chairman and 1 Andrew Gomes get it off the ground. 2 managing partner of a 16-man radiology group that does a 2 Q. So we'll back up a little bit and talk about 3 fair amount of revenue that requires me to administer 3 what NIRP is. Could you tell us what -- what is NIRP to 4 over the business operations, expand the business, make 4 you? What does that mean? 5 sound business decisions. Those are all things that I've 5 A. NIRP operates a number of facilities that 6 been experienced with. I also advise a number of medical 6 performs outpatient-based, image-guided surgery. 7 start-ups through an incubator locally in Princeton. I'm 7 Q. And what do you mean by "outpatient-based, 8 also an angel investor in a number of -- in a number of 8 image-guided surgery"? What is that? 9 start-ups also. 9 A. So in contrast to hospitals where you may go to 10 I also serve as advisory board on small 10 the hospital and be admitted after your procedure, or 11 device companies and invest my own money. So, and that 11 it's done in a large hospital, outpatient-based labs work 12 would probably be the best representation of my business 12 out of small, lean offices that provide a faster service 13 acumen. 13 and less bureaucracy and -- and are usually smaller in 14 Q. So you said you have a 16-man radiology group. 14 scale. 15 What is the name of the -- that group? 15 Q. And before NIRP have you been involved in any 16 A. Capital Health Advanced Imaging. 16 of those type of, you know, outpatient-based facilities? 17 Q. And do y'all just do business up in the New 17 A. I -- yes, I have. I had previously moonlighted 18 Jersey area? 18 in a number of outpatient labs. 19 A. That is correct. 19 Q. But you were never an owner? 20 Q. And how long has that group been around? 20 A. Never an owner. 21 A. Founded probably in about 2005, but we were 21 Q. So NIRP was your first foray into ownership in 22 together in 2003 as a cohort, and then we incorporated. 22 this type of business? 23 Or I don't know what the legal term is, but formed a PC. 23 A. I'm sorry. I didn't hear that last part. 24 Q. And you said, I think you do -- I'm not -- I'm 24 My "first foray"? 25 not sure if I heard that right. 25 Q. Into this type of outpatient-based business? 14 16 1 But was it consulting with -- with 1 A. As an investor, yes. As an owner, yes. 2 Princeton? Or what was it? 2 Q. So when was this idea first brought to you, the 3 A. Advise. Advisory. 3 idea of the NIRP itself, that idea? 4 Q. For like students? 4 A. So the name, not necessarily, but the idea we 5 A. For their -- it's earlier staged incubator 5 had been discussing. Me and Dr. Gomes had been 6 start-up companies. 6 discussing this when he was running a group in an Indian 7 Q. And this is only for medical companies, I 7 reservation town in Arizona. I don't remember the name 8 guess? 8 of the city. 9 A. Yeah. Digital health. Yeah. 9 But he was thinking about opening an IR on 10 Q. And how long have you been doing that for? 10 the facility. I don't know the exact dates, but we had 11 A. Since 2006 about. No. 2010. I'm sorry. 11 been talking for quite some time about it, and I advised 12 2010. 12 him that it's way more profitable than diagnostic 13 Q. And that's still going on? 13 imaging. 14 A. Yeah. 14 Q. And where did it go from there? I mean, that 15 Q. And you also said you're an angel investor. 15 -- that sounds like, you know, early discussions about a 16 Could you explain that? 16 potential idea. 17 A. Yeah. So I've invested in a number of 17 But when did y'all actually talk about, 18 companies in their pre-capital market stages. 18 "Okay. Let's -- let's form something and get something 19 Q. And so you sort of invest in them before they 19 going"? 20 get started up? 20 A. So I would say probably, it had been brewing 21 A. Yeah. 21 for 24 months before opening. So maybe 2000 -- I am 22 Q. And is that what you did with NIRP here or is 22 going to guess on dates, but something like 2013, 2014, 23 that different? 23 something like that. 24 A. No. In a lot of those situations, it's very, 24 Q. And during those primary preliminary 25 very early. At NIRP I had a active part in helping 25 discussions did y'all talk about, you know, specific, you Choudhri, Ajay, M.D. Discovery Resource 713-223-3300 Discovery Resource 713-223-3300 5 (Pages 17 to 20) 17 19 1 know, business models, forecasts, projections, anything 1 other week. Every -- every two weeks, and then it became 2 like that? 2 less and less often. 3 A. I mean, you know, when you decide to jump in, 3 Q. And what did y'all typically discuss in those 4 you do a lot of modeling. You do -- you look at 4 meetings? 5 reimbursement, equipment costs, rents, personnel costs. 5 A. Generally expansion, direction, policy, 6 So we did a lot of that. 6 operations, things that need to be looked at. Basically 7 Q. And how did y'all get that information? 7 everyday -- everyday operations. 8 A. A lot of it, it's common knowledge. A lot of 8 Q. So how comfortable did you feel investing in, 9 it, it is based on my knowledge, and some -- and a lot of 9 you know, a business that's based in the Texas area when 10 it is based on Dr. Gomes' knowledge. 10 you're up in, you know, New Jersey? 11 Q. Did y'all have to hire anyone to figure that 11 A. So there are some business impediments in New 12 out? 12 Jersey regulatory-wise for me to do something like this. 13 A. I -- I'm -- I am pretty sure that Dr. Gomes had 13 It's much harder to do it in a very heavy -- heavily 14 people doing research for him. He had a number of staff 14 regulated -- heavy -- heavily regulated healthcare market 15 that were already working. 15 like New Jersey, and I felt that Texas offered a much 16 Q. But you, yourself, didn't -- 16 better climate for this sort of thing, and I trusted 17 A. I personally did not, no. 17 Dr. Gomes because we have a very common way of thinking. 18 Q. So when did y'all finally decide, "Okay. This 18 So, and -- and Houston is an ideal healthcare market for 19 is a viable, you know, business model. Let's move 19 this sort of thing, so I was comfortable with it. 20 forward"? 20 Q. Why did you say that, you know, "Houston is an 21 A. I don't know the exact date, but I could give 21 ideal healthcare market" for it? 22 you a rough estimation of when we started to build on it. 22 A. Very population dense. It wasn't that 23 So somewhere in that time between '15 and '16 I'm -- I'm 23 penetrated with this sort of business, and it's in Texas, 24 going to guess. 24 and Dr. Gomes is in Houston. 25 Q. Are you and Gomes -- I'm sorry. 25 Q. You mentioned, you know, some regulations that 18 20 1 Are you and Dr. Gomes, you know, 50-50? Or 1 New Jersey, I guess, made it tough on you to do this type 2 what's your business -- 2 of business, but what, you know, generally were those 3 A. No. No. I'm a minority investor in two of the 3 that would prohibit you from doing this in New Jersey? 4 facilities. 4 A. So in New Jersey there was a law passed that 5 Q. And which facilities were those? 5 any outside patient facility that performs surgery has to 6 A. The first two, NIRP Sugar Land and NIRP 6 be majority-owned by a hospital. 7 Pasadena. 7 And once you get a hospital involved, it's 8 Q. And are you involved at all in the day-to-day 8 very really not worth doing business. So... 9 operations of the businesses? 9 Q. Okay. Understood. So when you were 10 A. Not anymore. Perhaps in the first few months I 10 formulating this business with Dr. Gomes, did you ever 11 was there just to help oversee things, but I -- I wasn't 11 travel to Houston, you now, personally to talk with him 12 there physically and I'm not there physically now, so I 12 about it? 13 don't participate in day-to-day operations. 13 A. To talk to -- 14 Q. Do you participate at all in the business or 14 Q. Dr. Gomes. 15 are you just, you know -- 15 A. -- Dr. Gomes? So I've been to Houston multiple 16 A. Yes. 16 times before and after. 17 Q. -- investor? 17 Q. So before the business was actually formed and 18 A. When I get called to meetings, board meetings, 18 launched, did you meet with anyone else besides Dr. Gomes 19 that sort of stuff, management -- 19 about the business? 20 Q. About -- 20 A. Please repeat the question. 21 A. -- meetings. Sorry. Not board meetings, but 21 Q. So before NIRP was actually formed and you 22 management meetings. 22 traveled down here to Houston to meet with Dr. Gomes, did 23 Q. And how often do y'all have those meetings? 23 you meet with anyone else along with, you know, 24 A. It's become less often because the business is 24 Dr. Gomes? 25 maturing. Initially it was fairly often. I'd say every 25 A. So in either 2014 or '15, I had flown to Choudhri, Ajay, M.D. Discovery Resource 713-223-3300 Discovery Resource 713-223-3300 6 (Pages 21 to 24) 21 23 1 Houston for a couple of non-related IR, for -- for 1 neuroscience program at the Bay Area Regional Medical 2 projects not related to interventional radiology at 2 Center. 3 Dr. Gomes' request. 3 The hospital itself is very close to a 4 Q. And who else, you know, met with y'all? 4 another competitive hospital. So then you need a 5 A. So I had met Dr. Agraharkar once and I had met 5 differentiator, and I thought that that would be a pretty 6 Sam Alam, which is the purpose of this deposition, a 6 good idea to do it there, but you would need a fairly 7 couple -- I think a couple of times. 7 strong clinical management team to get it off the ground. 8 Q. So before you came down here and met, you know, 8 Q. And you said Dr. Gomes was involved in this 9 NIRP, and you met with Sam, had you known Sam previously? 9 neuroscience program pitch as well? 10 A. I had not. 10 A. He was there, yes. 11 Q. And do you recall the first time you either met 11 Q. Do you know how he was involved in coming up 12 with Sam personally or talked with Sam? 12 with that whole pitch or idea? 13 A. So I don't remember the exact sequence of 13 A. No. I just know that it was the three of us. 14 events, but I had come down at least once to pitch a 14 Q. And do you know if it was Sam's idea or 15 neuroscience project at Bay Area Regional Medical Center, 15 Dr. Gomes' idea? 16 which we had met with the CEO, and I think, maybe a vice 16 A. That, I'm not sure of. It wasn't my idea, I'll 17 president and made a day-long pitch of some program that 17 tell you that. 18 Sam and Andrew were interested in doing at that medical 18 Q. And you were just there to help out if they 19 center. 19 need some help? 20 So since I had experience as a hospital 20 A. Yes. 21 chairman, I had a very successful neuroscience program, I 21 Q. And do you know what happened with that pitch, 22 went there to pitch this unrelated neuroscience idea to 22 you know, if they accepted it or denied it? Or what did 23 the CEO. 23 the hospital do? 24 And the owner of, whose name I forget, it 24 A. I think the hospital decided that they weren't 25 was a, I think a Persian name, Mansoor or somebody, we 25 ready for something like that. 22 24 1 had met with him at his house. 1 Q. So I think you said -- we were talking about 2 Q. And do you recall when this was? 2 Sam and how you first, you know, got to know Sam. 3 A. I couldn't tell you the date. I probably could 3 And is it correct that that was sort of 4 look my through -- travel, you know, logs and stuff and 4 your first exposure to Sam? 5 tell you when it was exactly. 5 A. Either that or one visit before. I don't 6 Q. But that was before y'all formed NIRP. Right? 6 remember. But, yes. 7 A. That is correct. 7 Q. And you said Sam was, I think you said, "in 8 Q. Was it before y'all started meeting about NIRP? 8 over his head with the neuroscience program pitch." 9 A. So I don't think the NIRP formally -- formal 9 Why would you believe that? 10 discussions by NIRP happened before that. But I had been 10 A. So I've been doing this a while, probably like 11 talking to Dr. Gomes at length about IR for a long time 11 you have, and first impressions are important, especially 12 by phone, by conversation. 12 in business and especially in the science and business of 13 Q. So this neuroscience program y'all were 13 medicine, and you can tell when somebody knows a lot 14 pitching to the Bay Area Hospital in Houston, I mean, did 14 about the field and when somebody is out of their depth, 15 it have a name? Or what exactly what was it? 15 and I certainly -- while Sam was a very affable and nice 16 A. I -- I don't think it had a name at the time. 16 guy, I didn't think he had the depth of knowledge -- 17 I thought it was a slightly harebrained scheme, but, you 17 Q. Was it -- 18 know, I -- I helped him out with my expertise. 18 A. -- and I -- 19 Q. So why did you think it was a harebrained 19 Q. Go ahead. 20 scheme? 20 A. Sorry. And I spend a lot of time judging 21 A. I -- I felt like we didn't -- I -- I felt like 21 start-ups and allocating money to small companies, so the 22 Sam was in over his head. I -- I don't think he had a 22 management team to me is very, very important, so I was 23 grip of -- on the idea of what it entailed. 23 not initially impressed. 24 But, you know, I gave it my best sell to 24 Q. So that was sort of the initial, I guess, time 25 see if we could guide and pilot a comprehensive 25 you met Sam. Choudhri, Ajay, M.D. Discovery Resource 713-223-3300 Discovery Resource 713-223-3300 7 (Pages 25 to 28) 25 27 1 But after that, you know, after this 1 So you never would have used your Capital 2 neuroscience pitch, did you still continue to meet with 2 Health e-mail to, you know, correspond with Dr. Gomes or 3 Sam about the NIRP idea? 3 Sam or anyone in NIRP? 4 A. I never did. Or if I -- I do not recall I did. 4 A. So, not my Capital Health e-mail. I have 5 It's quite some time ago, but I have a lot going, and I 5 another gmail account that I use for group. I keep -- I 6 don't ever remember discussing anything about IR with 6 try to keep my personal e-mail and my group, you know, 7 Sam. 7 medical CHAI, or Capital Health Advanced Imaging, 8 Q. So for the NIRP project -- I mean, whether or 8 business straight because it gets to be too confusing. 9 not it was called NIRP, the idea was basically an 9 That e-mail is chsrad@gmail.com. 10 interventional radiology program with office-based labs. 10 So I had looked through the records to tell 11 Right? 11 you if I communicated via e-mail with Sam through that, 12 A. That's what it is, yes. 12 but I don't remember. I'm pretty sure I would have used 13 Q. So that idea, you know, the -- the NIRP idea is 13 my personal e-mail. 14 what I'm calling it. 14 Q. So when working with Dr. Gomes about forming 15 So you're saying that you never met with 15 this, you know, NIRP idea, did you ever go talk with any 16 Sam about that NIRP idea? 16 of Dr. Gomes', you know, associates such as, you know, 17 A. I don't recall even talking to him about IR. 17 Donna, or anyone else he had -- he had hired? 18 If did I, then it's beyond my memory. But 18 A. Generally when I spoke to them, it's usually in 19 I didn't -- I personally don't think he does -- knew what 19 a conference call with Dr. Gomes. I generally don't 20 IR was and, you know, maybe he had discussions with 20 directly speak to his direct reports. It's via a 21 Dr. Gomes and -- in that, but I never spoke directly 21 conference call. So... 22 about him or any knowledge concerning IR. 22 Q. Do you have any idea who Jessica Nantz is? 23 Q. Uh-huh. Did you say you worked at Capital 23 A. No. 24 Health in New Jersey? Was that correct? 24 Q. So earlier you mentioned Dr. Agraharkar. 25 A. That is the hospital that we are contracted to. 25 Who is that? 26 28 1 Correct. 1 A. Dr. Agraharkar is a well-respected, 2 Q. And I presume they gave you an e-mail address? 2 well-established nephrologist in the Houston area who 3 A. The hospital does. I do not use it. 3 invested in healthcare businesses, and I had met him 4 Q. So since 2013, do you know which e-mail 4 through Dr. Gomes, and eventually he became the landlord 5 addresses you've used? 5 of one of the NIRP facilities Pasadena, and I think a 6 A. Since 2013? 6 minority investor. 7 Q. Yes. 7 Q. And how involved were you with Dr. Agraharkar 8 A. My personal e-mail address, which is a gmail 8 as far as discussing the NIRP idea before you actually 9 account that I use for my personal e-mails, and I have an 9 started the company? 10 e-mail address with NIRP. 10 A. So one of my visits to Houston I had met him 11 Q. And what's your personal one? What's that? 11 and he had shown us the properties and where we intended 12 A. It's my first name, period, last name, 12 to build, that sort of thing, and, you know, he was 13 @gmail.com. 13 excited; we were excited. 14 Q. And I guess you didn't start using the NIRP one 14 Q. But nothing else really besides that? 15 until the company actually got formed? 15 A. Not direct communication, no. 16 A. That is correct. 16 Q. And since the companies formed, have y'all done 17 Q. Do you have any idea, you know, how Sam and 17 anything like that, discussions about specifics with 18 Dr. Gomes even met or how they started their business 18 NIRP? 19 relationship? 19 A. Between me and Dr. Agraharkar? 20 A. Vaguely. I know that they're both 20 Q. Correct. 21 Houston-based and they're both healthcare -- involved in 21 A. No. 22 healthcare. I imagine there was an introduction, or they 22 Q. And do you remember when it was that you came 23 met through a common party. I'm not sure. 23 down and he showed you the facilities, Dr. Agraharkar? 24 But I do not know that person. 24 A. Probably somewhere 2014, '15. The dates escape 25 Q. (Speakerphone interruption.) Sorry about that. 25 me right now. Choudhri, Ajay, M.D. Discovery Resource 713-223-3300 Discovery Resource 713-223-3300 8 (Pages 29 to 32) 29 31 1 Q. And earlier I mentioned the "office-based lab." 1 Q. (BY MR. MARTINEZ) And here it looks like 2 But could you explain to us, what that is? 2 another e-mail from Dr. Gomes to Sam where Dr. Gomes 3 A. Yes. So in contrast to a surgical center or a 3 called Sam an "expert and industry, you know, "veteran." 4 hospital, it is basically a small, lean office-space 4 But I'm curious, you know, did -- did 5 operation where they perform procedures, usually 5 Dr. Gomes, you know, relay the same thing -- the same 6 minimally invasive and can administer sedation and that 6 thing to you about Sam? 7 sort of stuff as opposed to like a plain old doctor's 7 Did Dr. Gomes say, "Oh, yeah, Sam is great. 8 office. 8 He is a veteran. He knows what he is doing"? 9 Q. All right. Let's look at an exhibit here. 9 Do you recall, you know, Dr. Gomes saying 10 (Exhibit No. 1 marked.) 10 anything like that about Sam? 11 Q. (BY MR. MARTINEZ) All right. Can you see 11 A. I -- I'll be honest, Mr. Martinez, I don't 12 this? 12 listen to stuff like that, but I do not recall him 13 A. I can. 13 speaking ill or positive about Sam. He had -- he said 14 Q. All right. This is Bates 211. So I'm just 14 that Sam was a Houston-based healthcare entrepreneur and 15 trying to establish, you know, a timeline so that way we 15 I just took it as -- as that. 16 can, you know, sort of figure this out together maybe. 16 Q. And you said you don't, you know, listen to 17 But this an e-mail between Dr. Gomes and 17 things like that, I guess, hyperbole and exaggeration or 18 Sam. He's got Donna copied on it from February of 2015 18 compliments because, I guess, you take a more critical 19 and he talked about how they met and -- 19 eye to things? 20 MS. HUANG-SIGLE: Objection. This has 20 A. As I imagine you as an attorney do also, yes. 21 nothing to do with the witness. 21 Q. So we're looking at -- Doctor, it's on Line 22 MR. MARTINEZ: Okay. 22 2174. That's the Bates number. 23 MS. HUANG-SIGLE: You're -- you're asking 23 (Exhibit No. 3 marked.) 24 the witness about a document that's not -- he is not a 24 Q. (BY MR. MARTINEZ) So this is an executive 25 party to. 25 summary. It's got Casper Radiology's, you know, 30