Choking allegations against doctor began at Parkland Memorial Hospital


Staff Writer

You look like the movie star Julia Roberts, the doctor told the hospital patient. She told police that he urged her to act — to pretend she “was sedated and begging him not to leave.”

Then the doctor grabbed one of her breasts and squeezed her neck “to the point that she had trouble breathing,” according to a police report. He asked “if she liked being choked.”

When Dr. Alireza Atef-Zafarmand came back to her room later that day in 2006, the woman called a nurse for help. The nurse called Parkland Memorial Hospital’s police force. Paul Nix was one of the officers who responded.

“She seemed very credible” and “very rattled,” said Nix, who recalled details of the matter as soon as The Dallas Morning News made a brief, general inquiry. “I believed her that something went wrong.”

But the police case — like many other sexual abuse allegations at Parkland reviewed by The News — went nowhere. “Eyewitnesses made statements that the accusations of choking and groping were untrue,” hospital leaders said in a written statement last month.

Police reports released by Parkland, however, do not support that claim. They refer to a single witness who was simply unable to confirm anything besides verbal contact. And Nix, who left Parkland in 2007, questioned whether there was a witness.

Parkland’s statement denied mishandling the police case, saying there was no effort “to suppress or overlook incidents of alleged assault.” However, it said Atef-Zafarmand committed verbal misconduct and that the hospital failed to discipline him for that.

“The evidence suggests he should have been promptly removed from Parkland,” the statement said. “We are confident that should a similar incident arise today, the offending physician would quickly be removed.”

Atef-Zafarmand told The News that he never touched the patient but did tell her she looked like the movie star.

“I asked her, ‘Do you have the same talent?’” the 47-year-old kidney specialist said. “A lot of people, they take it as a compliment.”

Atef-Zafarmand said he first spoke to the woman in a hallway and followed her to her ninth-floor room. She wasn’t his patient, he said, and he didn’t know her name or reason for hospitalization.

In the ensuing months, his medical superiors disciplined him for several incidents of misconduct that occurred outside the public hospital. Yet Parkland and its academic affiliate, UT Southwestern Medical Center, still let Atef-Zafarmand graduate from his training program in 2007.

The UTSW faculty member who oversaw the training program said Atef-Zafarmand was going to be expelled a few months before graduation, according to university records. But the faculty member was overruled by Dr. Greg Fitz, who has since become dean of UTSW’s medical school.

After Atef-Zafarmand graduated, some UTSW officials endorsed him to Dallas-area private hospitals. For example, the man who issued the expulsion warning, Dr. Biff Palmer, ranked him “excellent” in all categories, including ethical conduct.

Fitz and Palmer declined interview requests. In a written statement, UTSW said it never received reports from Parkland or elsewhere that Atef-Zafarmand “acted in a sexually inappropriate manner with any patient.” It added: “Based on the facts available at the time, UTSW acted appropriately.”

Since Atef-Zafarmand began working in private practice, two other women have told Dallas police that he choked and sexually assaulted them. He did not respond to questions about these allegations.

None of the cases has led to criminal charges or discipline by the Texas Medical Board, the state agency that licenses doctors.

After attending medical school in his native Iran, Atef-Zafarmand came to Dallas in 2004 for a three-year fellowship in kidney disease. He spent much of his time at Parkland, along with about 1,000 other doctors in postgraduate training. They reported to UTSW faculty members and worked under a Parkland contract that says harassment, abuse and disrespectful or unprofessional conduct “would be cause for immediate termination.”

But the consequences for Atef-Zafarmand fell far short of that mark. UTSW records show he was counseled three times in the first five months of his fellowship for “poor work ethic,” showing disrespect to a supervisor and “unprofessional conduct directed toward a patient.”

Trouble surfaced again in January 2006. Late one night, Parkland police got a call for help from the ninth floor. A patrol officer interviewed the female patient and soon notified Nix, the sergeant on duty. Nix re-interviewed the woman and said he heard none of the shifting, dreamlike tales that heavily medicated people sometimes tell. Nor did he hear any vague allegations or threats of lawsuit.

“She was very detailed, very specific,” said Nix, who is now chief deputy to the sheriff of Hardeman County, northwest of Dallas. “She never wavered from the story.”

Police records show that Nix consulted one of the patient’s physicians, who also found her to be credible. She “was not on any medications that would normally cause one to hallucinate,” the physician was quoted as saying.

Nix recalled alerting a lieutenant at home around midnight. A higher-level supervisor also was notified, “and I want to say they called Dr. [Ron] Anderson,” Parkland’s chief executive at the time. “It was a big brouhaha.”

Smith Lawrence, then Parkland’s police chief, said he didn’t remember the case but did recall investigating other sexual abuse allegations around the same time. “You’d catch hell for that,” he said, referring to investigations of doctors.

Lawrence retired in 2008, when he was in his early 70s, and declined to be interviewed in detail. “When I left Parkland, I made it my last mission to leave all that stuff behind,” he said.

He suggested that The News contact CaSandra Williams, who was his top aide and now heads the police department at Texas Health Presbyterian Hospital Dallas. She did not respond to interview requests. Parkland has retained responsibility for her officer’s license, state records show. It would not say why.

Atef-Zafarmand said police questioned him the day after the patient complained. “That’s impossible,” he recalled telling them. “There must be a mistake.”

An officer took him to the patient’s room, and she identified him as her attacker. He said she told him, “When you talked to me, I felt that something is getting to my brain, and I knew that you were doing it.”

The woman seemed “scared to death,” Atef-Zafarmand said. “It was a very disturbing situation.”

He said police never asked him to take a lie-detector test.

“That would have been an option,” Nix said, because Parkland frequently dealt with a contracted polygraph operator, primarily when evaluating job candidates. He said he was not involved in the case after the first night and knew no details of the investigation.

Not seeking a polygraph sounds odd, said Fred Price, who was a Parkland police detective until the year before the incident and is now a Dallas County courtroom bailiff. “They used the snot out of that polygraph when I worked there,” he said.

Atef-Zafarmand said Parkland officials told him that the patient had previously been hospitalized for psychiatric problems. Legal experts say that releasing such information could violate her privacy rights under HIPAA, the Health Information Portability and Accountability Act.

A senior hospital executive, Atef-Zafarmand said, apologized for the necessity of the police investigation and told him officials believed he was innocent. The executive also warned him not to make unnecessary remarks.

“That is one of my personal problems,” Atef-Zafarmand said. “I do a lot of unnecessary things.”

Atef-Zafarmand insisted that witnesses would have seen him if he had touched the patient. There was a second patient in the room, he said, and she had a relative visiting.

Statements from Parkland officials and hospital records contradict each other on this point. For more than a year, the hospital had refused to release police records on the case. After it finally did so on Jan. 18, officials said they were sharing copies of all police reports.

Those reports made no mention of eyewitnesses. But a Parkland statement to The News, four days later, said police had dropped the case after eyewitnesses said the assault allegation was “untrue.”

After The News asked Parkland whether it had released all records, the hospital produced a one-page document that it said had been accidentally withheld. It was labeled the “final page” of the police file and referred to a single, unnamed witness. Nothing else in the file references a witness.

This witness, described as the patient’s roommate, heard Atef-Zafarmand’s “Julia Roberts” remark and role-playing request, according to the one-page document. But “roommate could not provide any additional information to confirm the complainant’s allegation of physical contact.” There is no reference to anyone calling the allegation “untrue.”

There are other discrepancies. The “reporting officer” box on the form was left blank, meaning no one took responsibility for writing the final page. Nix said he could not remember ever seeing such an omission on a Parkland police report.

“That’s very stinky,” said Nix, who reviewed the police file released to The News.

Equally strange, he said, is the final page’s reference to a roommate. He said the patient didn’t have one when Atef-Zafarmand first visited her. She got one later that day. “[She] now has a roommate and that also makes her feel better,” says Nix’s contemporaneous police report.

That corresponds to the other records Parkland initially released. The group of reports begins with an overview, written by the first responder that makes no mention of anyone having information except the patient and the nurse she’d asked for help.

The final page said it “appears the conduct was not appropriate, but not illegal in any manner.” The criminal case was closed on Jan. 29, 2006, one day after Nix’s report.

Police records don’t show that an investigator was ever assigned to the case, although they do name one officer who began interviewing Atef-Zafarmand. That officer was Kenneth Cheatle, then a lieutenant and now Parkland’s police chief. There are no reports in the file from him.

Parkland would not give The News written statements from the patient, roommate or suspect, even though the newspaper agreed to have all patient-identifying information blacked out.

“The whole investigation,” Nix said, “is completely missing.”

A few months after the choking report, Atef-Zafarmand faced trouble again. These accusations came from another hospital where UTSW doctors work, the Dallas VA Medical Center. He was moonlighting in its urgent care center, earning extra money while doing kidney research.

This time Atef-Zafarmand was accused of harassing female co-workers — other doctors in residency training and at least one hospital employee. VA officials terminated him and notified UTSW, according to medical center records that the Texas attorney general ordered released to The News. (UTSW tried to withhold the records, saying they belonged to a medical committee that needed secrecy to promote frank evaluation of trainees.)

“Dr. Atef made sexually suggestive remarks,” said a June 2006 letter from the VA to the physician’s lawyer, “and, in every instance, attempted to or did in fact make inappropriate physical contact with the residents under the guise of a ‘study’ that he was doing.”

When top UTSW lawyer Leah Hurley released the VA correspondence, she said she had produced all public records related to sexual misconduct allegations against Atef-Zafarmand. The News twice responded that records appeared to be missing, leading Hurley each time to disclose more documents.

These documents included material showing that UTSW had placed the doctor on probation because of the VA matter. In doing so, his fellowship supervisor warned that “any other allegations of this nature or similar in nature would not be tolerated and would be grounds for dismissal.”

Atef-Zafarmand said UTSW helped replace the VA income by giving him moonlighting work at Parkland and the university’s own St. Paul hospital.

In late 2006, he submitted a required annual report to the Texas Medical Board. On it, according to records released by Parkland, he said he had not been disciplined by any health-care entity. He signed his name next to a warning that it’s a crime “to submit a false or misleading statement to a governmental agency.”

Atef-Zafarmand did not respond to recent News questions about the submission. But earlier, he did tell the newspaper he understood that adverse actions must be reported to the medical board.

More trouble surfaced in early 2007. Records say Atef-Zafarmand approached a young radiology technician in the gift shop of UTSW’s other hospital, Zale Lipshy. He asked if she was interested in psychiatry and invited her to participate in a study. She agreed and went with him to his nearby office.
“You asked her a series of questions such as ‘Can you act like someone else?’” says a reprimand letter that UTSW gave Atef-Zafarmand. “You asked her to take deep breaths and to picture herself in a place that made her feel completely relaxed. You moved her arms and legs to make sure that she was completely relaxed.

“She reports that she ultimately fell to the floor.”

According to the letter, Atef-Zafarmand never obtained UTSW’s permission to conduct such research or the young woman’s written consent to participate. Federal law generally requires researchers to meet both conditions.

The letter notes similarities between the incident and the VA findings. It also mentions a prior complaint at Parkland, without details.

And it raises the possibility of other incidents: “Although we have not been able to verify this information, we have received reports from at least one woman unaffiliated with UT Southwestern that you approached her at a local bar and made similar statements” to those made to the radiology technician.

Atef-Zafarmand’s conduct at Parkland, the VA and in his office was “unprofessional and will not be tolerated,” the letter says. He was warned not to contact the technician, not to invite anyone to his office for research participation, and “not to engage in the activity of hypnotizing anyone while on the UT Southwestern campus.”

The letter says Atef-Zafarmand denied asking the woman to take part in a study. “You indicated that you had a personal interest” in her and “had been very straightforward with her regarding your intentions.”

That’s absurd, the woman told The News. Roxann Neal said the doctor approached her again, in her work area, to ask that she leave with him. He said he wanted to “buy a gift for me to tell me thank you for helping” with the study.

Neal recalled realizing early in their first encounter “that something was wrong,” leading her “to play along and get out of there.” She said the state medical board should strip Atef-Zafarmand of his license. “I don’t think he has the morals that a physician needs to have.”

Texas law generally prevents the medical board from revealing whether it has received complaints about a doctor.

Atef-Zafarmand did not appeal the reprimand at the time but later sought to minimize it and, in 2010, tried unsuccessfully to have it rescinded, other UTSW records say. An email from Atef-Zafarmand said the woman “had no concern about issues such as sexual harassment” and mistakenly suspected he was conducting research not related to kidneys.

The email attributed these statements to Vernon Mullen, who headed UTSW’s office of equal opportunity and minority affairs. He “told me that the issue was a misunderstanding and there was nothing to worry about,” Atef-Zafarmand wrote.

Mullen retired in 2011, UTSW said. He did not respond to an interview request.

Atef-Zafarmand told The News he never harassed or engaged in sexual misconduct with anyone and never touched fellow trainees. He said he did invite some of them to try breathing exercises that promote relaxation but did not bother those who declined.

He also said he had tried for several months, without success, to obtain all of UTSW’s records about him.

“I am talking to you right now as a victim, not as the person who did the offense,” Atef-Zafarmand said in an interview late last year. “I think that the way they have it structured over there, when you get on the spot on something, they ruin your brain.”

That, he said, is why he decided to speak with the newspaper. “That’s why when you called me about abuse, I said, ‘Yeah, there is abuse, but not what you think.’ I was the abused one.”

He said his experiences at Parkland and UTSW “changed my personality,” leading him to fear being open with hospital co-workers and unwilling to date them.

Atef-Zafarmand finished his training in June 2007, receiving a Parkland certificate saying he “discharged the duties with honor.” The document was signed by Palmer, his UTSW training program director; Anderson, the hospital’s CEO; and Dr. Lauren McDonald, then chair of Parkland’s governing board.

Later that year, Atef-Zafarmand went to work for McDonald’s employer — Dallas Nephrology Associates, a prominent group of kidney specialists. McDonald said she played no role in hiring him and was unaware of any misconduct allegations. The group’s chief executive issued a statement saying he, too, knew nothing about them.

Dallas Nephrology helped Atef-Zafarmand get permission to treat patients at several Dallas-area hospitals, he told UTSW. But in applying for these privileges, he failed to disclose the reprimand to at least some of them. The reprimand letter had cautioned that it would be part of his permanent UTSW file and “subject to disclosure to requesters such as medical boards, potential employers etc.”

Atef-Zafarmand acknowledged this failure in a 2008 email that asked Palmer for help. “In two places, Baylor and Presby Dallas, I did not get a chance to fix the applications ahead of time before they brought it up to me,” he wrote. He attached an email he previously sent to Presbyterian that said he didn’t know he was ever on probation and added: “I did not try to hide any fact from you.”

Palmer responded that he couldn’t help with the disclosure failure, but “I can attest that you have successfully completed the program.”

Later, when another faculty member took over as training program director, she asked Palmer how he responded when hospitals and prospective employers asked about Atef-Zafarmand’s history. “I have generally put he is qualified in all categories,” Palmer responded. “When asked whether he was ever in trouble during fellowship such as probation, I report he received a letter of reprimand.”

“Letter of reprimand for unprofessional behavior, correct?” the new director asked.

“I never specify, but yes,” Palmer wrote back.

Baylor Health Care System ultimately awarded Atef-Zafarmand privileges at its Garland hospital. When The News asked why, the system gave a written answer: “All of this physician’s professional references recommended him.”

There is no indication in medical board records that he was ever allowed to treat patients at Presbyterian. Its officials declined to comment.

The two most recent abuse allegations against Atef-Zafarmand arose from encounters outside hospitals. Both were reported to Dallas police within 24 hours.

In July 2010, a 21-year-old woman said he attacked her after they had lunch at his condo near downtown. He “started rubbing her shoulders,” according to a police report, “and then started choking her from behind.”

The woman said he forced her to the floor, pulled her pants off and raped her. He “pressed both his thumbs on the veins in her neck,” she told police, causing her “to come in and out of consciousness about three times.”

In July 2011, an 18-year-old woman said he reached into her shorts at a Dallas nightclub and penetrated her with a finger. She had agreed to spend the evening with him for $400 but had not been paid and had not consented to sexual contact, a police report says.

“She told the susp[ect] to stop,” according to the report, then vomited and was ejected from the club. Atef-Zafarmand walked her to his car, where he allegedly put out a cigarette on her chest and choked her. “She does not remember what took place after that and woke up” at his condo, the report says. A detective later photographed injuries to her neck, arms and one breast.

Records released by Dallas police show no sign that the doctor was questioned in either case. Both accusers ultimately decided not to pursue prosecution, the records say.

In 2011, Atef-Zafarmand left Dallas Nephrology. He has since worked a series of temporary jobs, both in the Dallas area and in North Dakota.