On June 02, 2020 a
Judgment
was filed
involving a dispute between
Sandberg, Erica,
and
Dignity Community Care Dba Saint Francis Memorial,
Dignity Health, Inc.,
Does 1 To 50 Inclusive,
Prieto Md, Victor,
St. Francis Memorial Hospital,
St. Francis Memorial Hospital Center For Sports,
St. Francis Orthopedic Institute,
The Estate Of Stephen Van Pelt,
The Estate Of Stephen Van Pelt, M.D.,
Van Pelt Md, Stephen,
for MALPRACTICE - MEDICAL/DENTAL
in the District Court of San Francisco County.
Preview
CIV-110
ATTORNEY OR PARTY W ITHOUT ATTORNEY (Name. State Bar number. and a(j(jress): FOR COURT USE ONLY
Cyrus A. Tabari 13 3842
Sh e uerma n Mart i ni Tabar i Zenere & Garvin
1 033 Wi l low Street
San Jose , CA 9 512 5 ELECTRONICALLY
( 4 08)
TELEPHONE NO.: 2 8 8- 9700 ( 4 0 8 ) 3 5 0 - 14 3 2
FAX NO. (Opuonal}:
E-MAIL ADDAEss10p1iona11: c tabar i@s mt law.com
F I L E D
Superior Court of California,
ATTORNEY FOR (Name):Defendants DIGNITY HEALTH, INC. , ET AL County of San Francisco
SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN FRANCISCO
STREET ADDRESS: 400 Mc Al l is t er St r eet 12/08/2021
Clerk of the Court
MAILING ADDRESS: BY: MADONNA CARANTO
CITY AND ZIP CODE:San Francisco CA 941 02 Deputy Clerk
BRANCH NAME:
PLAINTIFF/PETITIONER: ERICA SANDBERG
DEFENDANT/RESPONDENT: DIGNITY HEALTH, INC. I ET AL
CASE NUMBER:
REQUEST FOR DISMISSAL
CGC- 20 - 584 686
A conformed copy will not be returned by the clerk unless a method of return is provided with the document.
This form may not be used for dismissal of a derivative action or a class action or of any party or cau se of action in a
class action. (Cal. Rules of Court, rules 3.760 and 3.770.)
1. TO THE CLERK: Please dismiss this action as follows:
a. !XI
(1 ) W ith prejudice (2) D Without prejudice
b. (1)!XI Complaint (2) D Petition
(3)D Cross-complaint filed by (name): on (date):
(4)D Cross-complaint f iled by (name): on (date):
(5)D Entire action of a ll parties and all causes of action
(6)IXJ Other (specify):• As to defenda n t DI GNITY COMMUNI TY CARE dba SAI NT FRANCIS
2. (Complete in all cases except family law cases.;MEMORI AL HOS PITAL. Each p ar ty to bear its own costs .
The court 0did [X)did not waive court fees and costs for a party in this case. (This information may be obtained from
the clerk.
If court fees
and costs were waived, the declaration on the back of this form must ompl
Date: /Z- ff'-,,20_2.(
Mark. ..J ......Zanobini ...SB.#.1.211.84....................... .
!XI ATTORNEY
(TYPE OR PAINT NAME OF â–¡ PARTY W ITHOUT ATTORNEY) (SIGNATURE)
• ERICA
Attorney or party without attorney for:
If dismissal requested is of specified parties only. of specified causes of action SANDBERG
only, or of specified cross-complaints only, so slate and identify the parties,
causes of action, or cross•complaints to be dismissed.
!XI Plaintiff/ Petitioner D DefendanVRespondent
D Cross-Complainant
3. TO THE CLERK: Consent to the above dismissal is hereby given...
Date:
â–º -----------
(TYPE OR PAINT NAME OFâ–¡ ATTORNEYâ–¡ PARTY WITHOUT ATTORNEY) (SIGNATURE)
•• If a cross-complaint - or Response (Family Law) seeking affirmative Attorney or party without attorney for:
relief - is o n file, the attorney for the cross-complainant \respondent) must
D
sign this consent if required by Code of Civil Procedure seclion 581(i)
or 0).
Plaintiff/ Petitioner D DefendanVRespondent
D Cross-Complainant
(To be completed by clerk)
4. D Dismissal entered as requested on (date): DISMISSAL ENTERED
5. D Dismissal entered on (date): as to only (name): 12/08/2021
6. D Dismissal not entered as requested for the following reasons (specify): By: MADONNA CARANTO
Deputy Clerk
7. a. D Attorney or party without attorney notified on (date):
b. D Attorney or party without attorney not notified.
Filing party failed to provide
D a copy to be conformed D means to return conformed copy
Date: Clerk, by - - - - -- - - - - - - - - - - - - - - - - - , , Deputy
Pago 1 o f 2
Cffi' IEssential
Form Adopled for Mandatory Use Code of Civil Procedure. § 581 et seq.;
Judicial Council of California REQUEST FOR DISMISSAL Gov. Code. § 68637(c); Cal. Rules of Court. rule 3. 1390
CIV- 110 [Aev. Jan. 1.2013]
mForms-
c:eb.com
Sandberg,
www.cour1s.ca.gov
Erica
CIV-110
PLAINTIFF/PETITIONER: ERICA SANDBERG CASE NUMBER:
CGC-20-584686
DEFENDANT/RESPONDENT: DIGNITY HEALTH, INC., ET AL
COURT'S RECOVERY OF WAIVED COURT FEES AND COSTS
If a party whose court fees and costs were initially waived has recovered or will recover $10,000 or
more in value by way of settlement, compromise, arbitration award, mediation settlement, or other
means, the court has a statutory lien on that recovery. The court may refuse to dismiss the case until
the lien is satisfied. (Gov. Code,§ 68637.)
Declaration Concerning Waived Court Fees
1. The court waived fees and costs in this action for (name):
2. The person in item 1 is (check one below):
a. D not recovering anything of value by this action.
b. D recovering less than $10,000 in value by this action.
c. 0 recovering $10,000 or more in value by this action. (If item 2c is checked, item 3 must be completed.)
3. D 0
All court fees and costs that were waived in this action have been paid to the court (check one): Yes O No
I declare under penalty of perjury under the laws of the State of California that the information above is true and correct.
Date: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
â–º-----------
â–¡
(TYPE OR PRINT NAME OF ATTORNEY â–¡ PARTY MAKING DECLARATION) (SIGNATURE)
CIV-110 (Rev. January 1, 2013) Page2of2
REQUEST FOR DISMISSAL
~Irr:= Sandberg, Erica
Document Filed Date
December 08, 2021
Case Filing Date
June 02, 2020
Category
MALPRACTICE - MEDICAL/DENTAL
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CIV-110 ATTORNEY OR PARTY W ITHOUT ATTORNEY (Name. State Bar number. and a(j(jress): FOR COURT USE ONLY Cyrus A. Tabari 13 3842 Sh e uerma n Mart i ni Tabar i Zenere & Garvin 1 033 Wi l low Street San Jose , CA 9 512 5 ELECTRONICALLY ( 4 08) TELEPHONE NO.: 2 8 8- 9700 ( 4 0 8 ) 3 5 0 - 14 3 2 FAX NO. (Opuonal}: E-MAIL ADDAEss10p1iona11: c tabar i@s mt law.com F I L E D Superior Court of California, ATTORNEY FOR (Name):Defendants DIGNITY HEALTH, INC. , ET AL County of San Francisco SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN FRANCISCO STREET ADDRESS: 400 Mc Al l is t er St r eet 12/08/2021 Clerk of the Court MAILING ADDRESS: BY: MADONNA CARANTO CITY AND ZIP CODE:San Francisco CA 941 02 Deputy Clerk BRANCH NAME: PLAINTIFF/PETITIONER: ERICA SANDBERG DEFENDANT/RESPONDENT: DIGNITY HEALTH, INC. I ET AL CASE NUMBER: REQUEST FOR DISMISSAL CGC- 20 - 584 686 A conformed copy will not be returned by the clerk unless a method of return is provided with the document. This form may not be used for dismissal of a derivative action or a class action or of any party or cau se of action in a class action. (Cal. Rules of Court, rules 3.760 and 3.770.) 1. TO THE CLERK: Please dismiss this action as follows: a. !XI (1 ) W ith prejudice (2) D Without prejudice b. (1)!XI Complaint (2) D Petition (3)D Cross-complaint filed by (name): on (date): (4)D Cross-complaint f iled by (name): on (date): (5)D Entire action of a ll parties and all causes of action (6)IXJ Other (specify):• As to defenda n t DI GNITY COMMUNI TY CARE dba SAI NT FRANCIS 2. (Complete in all cases except family law cases.;MEMORI AL HOS PITAL. Each p ar ty to bear its own costs . The court 0did [X)did not waive court fees and costs for a party in this case. (This information may be obtained from the clerk. If court fees and costs were waived, the declaration on the back of this form must ompl Date: /Z- ff'-,,20_2.( Mark. ..J ......Zanobini ...SB.#.1.211.84....................... . !XI ATTORNEY (TYPE OR PAINT NAME OF □ PARTY W ITHOUT ATTORNEY) (SIGNATURE) • ERICA Attorney or party without attorney for: If dismissal requested is of specified parties only. of specified causes of action SANDBERG only, or of specified cross-complaints only, so slate and identify the parties, causes of action, or cross•complaints to be dismissed. !XI Plaintiff/ Petitioner D DefendanVRespondent D Cross-Complainant 3. TO THE CLERK: Consent to the above dismissal is hereby given... Date: ► ----------- (TYPE OR PAINT NAME OF□ ATTORNEY□ PARTY WITHOUT ATTORNEY) (SIGNATURE) •• If a cross-complaint - or Response (Family Law) seeking affirmative Attorney or party without attorney for: relief - is o n file, the attorney for the cross-complainant \respondent) must D sign this consent if required by Code of Civil Procedure seclion 581(i) or 0). Plaintiff/ Petitioner D DefendanVRespondent D Cross-Complainant (To be completed by clerk) 4. D Dismissal entered as requested on (date): DISMISSAL ENTERED 5. D Dismissal entered on (date): as to only (name): 12/08/2021 6. D Dismissal not entered as requested for the following reasons (specify): By: MADONNA CARANTO Deputy Clerk 7. a. D Attorney or party without attorney notified on (date): b. D Attorney or party without attorney not notified. Filing party failed to provide D a copy to be conformed D means to return conformed copy Date: Clerk, by - - - - -- - - - - - - - - - - - - - - - - - , , Deputy Pago 1 o f 2 Cffi' IEssential Form Adopled for Mandatory Use Code of Civil Procedure. § 581 et seq.; Judicial Council of California REQUEST FOR DISMISSAL Gov. Code. § 68637(c); Cal. Rules of Court. rule 3. 1390 CIV- 110 [Aev. Jan. 1.2013] mForms- c:eb.com Sandberg, www.cour1s.ca.gov Erica CIV-110 PLAINTIFF/PETITIONER: ERICA SANDBERG CASE NUMBER: CGC-20-584686 DEFENDANT/RESPONDENT: DIGNITY HEALTH, INC., ET AL COURT'S RECOVERY OF WAIVED COURT FEES AND COSTS If a party whose court fees and costs were initially waived has recovered or will recover $10,000 or more in value by way of settlement, compromise, arbitration award, mediation settlement, or other means, the court has a statutory lien on that recovery. The court may refuse to dismiss the case until the lien is satisfied. (Gov. Code,§ 68637.) Declaration Concerning Waived Court Fees 1. The court waived fees and costs in this action for (name): 2. The person in item 1 is (check one below): a. D not recovering anything of value by this action. b. D recovering less than $10,000 in value by this action. c. 0 recovering $10,000 or more in value by this action. (If item 2c is checked, item 3 must be completed.) 3. D 0 All court fees and costs that were waived in this action have been paid to the court (check one): Yes O No I declare under penalty of perjury under the laws of the State of California that the information above is true and correct. Date: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ ►----------- □ (TYPE OR PRINT NAME OF ATTORNEY □ PARTY MAKING DECLARATION) (SIGNATURE) CIV-110 (Rev. January 1, 2013) Page2of2 REQUEST FOR DISMISSAL ~Irr:= Sandberg, Erica