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FILED: NASSAU COUNTY CLERK 08/29/2022 05:34 PM INDEX NO. 611506/2018
NYSCEF DOC. NO. 84 RECEIVED NYSCEF: 08/29/2022
SUPREME COURT OF THE STATE OF NEW YORK
COUNTY OF NASSAU
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DINO BONAVITA,
Plaintiff, ATTORNEY
AFFIRMATION
IN SUPPORT OF
-against- DEFENDANT’S
MOTION FOR
SUMMARY
JUDGMENT
SYED MUJAHID SAYEED, M.D., PRECISION
SURGERY OF NEW YORK, P.C., NORTH SHORE Index No. 611506/2018
UNIVERSITY HOSPITAL, and NORTHWELL
HEALTH,
Defendants.
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Linda M. Lin, an attorney duly admitted to practice before the Courts of the State of
New York, affirms the following to be true under the penalties of perjury:
1. I am associated with the law firm of DORF & NELSON LLP, attorneys of
record for defendants SYED MUJAHID SAYEED (hereinafter “Dr. Sayeed”) and PRECISION
SURGERY OF NEW YORK, P.C. I am fully familiar with the facts and circumstances of this
action by virtue of a review of the file maintained in your affirmant's office.
2. I make this affirmation in support of the instant motion on behalf of defendants
Dr. Sayeed and Precision Surgery, P.C. seeking an Order:
(a) Pursuant to CPLR §3212, granting summary judgment to the defendants
SYED MUJAHID SAYEED, M.D. and PRECISION SURGERY OF NEW
YORK dismissing plaintiff’s claims with prejudice;
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(b) Directing the entry of judgment in favor of the defendants SYED MUJAHID
SAYEED, M.D. and PRECISION SURGERY OF NEW YORK and,
(c) For such other and further relief as this Court may deem just and proper.
There has been no prior application for the relief requested herein.
3. The instant action sounds in medical malpractice and lack of informed consent.
The plaintiff was treated by Dr. Sayeed after sustaining a serious injury to his right hand which
had been cut by glass when he put it through a glass door at home. The plaintiff alleges that Dr.
Sayeed was negligent in failing to properly assess his wounds for the risk of presence of a
foreign (glass) body; failing to identify a presence of a foreign body upon admission to
defendant’s premises; failing to supervise and control their agents, servants and/or employees
who rendered medical care to plaintiff; deviating from the good and accepted standards of
medical practice in their care, treatment, testing and surgical services of plaintiff; failing to
timely, properly, and appropriately perform assessments, diagnostics, care treatment, testing,
and surgical services on plaintiff before, during, and after surgery on July 21, 2017; failing to
remove all foreign glass bodies from his wounds; causing and allowing plaintiff’s medical
condition to worsen causing severe and permanent injury to his right fourth finger, right fourth
finger extensor tendon; right fourth finger metacarpophalangeal joint capsule; and right hand.
4. Plaintiff alleges that the defendant’s negligence and departures from standards
of good and accepted medical practice were each an actual and proximate cause of the plaintiff’s
alleged loss of the full function of the index finger of his right hand and severe deformity and
personal injuries including mental anguish, conscious pain and suffering, loss of enjoyment of
life, economic loss, past and future earnings, and medical expense.
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5. As confirmed in the Expert Affirmation of Dr. Roy Kulick, there is no factual
basis for plaintiffs to allege any breach of the applicable standard of care by Dr. Sayeed in his
repair of the ring finger extensor tendon. There were no departures from the standard of care
governing similarly situated physicians and facilities treating patients in New York State in
2017 with respect to the care and treatment rendered to Dino Bonavita by the defendant Dr.
Sayeed. Furthermore, none of the injuries claimed by the plaintiff were caused by any
departures in the care or treatment rendered to the plaintiff by the defendant and injury to Mr.
Bonavita.
6. Dr. Sayeed exceeded the applicable standard of care for obtaining informed
consent for the extensor tendon repair. Moreover, Dr. Sayeed’s performance of the removal of
glass, extensor tendon repair, and his subsequent management of the wounds of Mr. Bonavita
were all well within the 2017 accepted standards of care. Therefore, plaintiff’s claims against
Dr. Sayeed and the derivative claims against his professional corporation must be dismissed
with prejudice.
EXHIBITS
Exhibit A: Plaintiff’s Summons and Complaint
Exhibit B: Defendant Sayeed’s Answer & Defendant Precision Surgery’s Answer
Exhibit C: Plaintiff’s Verified Bill of Particulars as to Dr. Sayeed and Precision Surgery
Exhibit D: Deposition Transcript of Plaintiff Dino Bonavita
Exhibit E: Deposition Transcript of Defendant Syed Mujahid Sayeed, M.D.
Exhibit F: Stipulation of Discontinuance as to Northwell Health
Exhibit G: Note of Issue
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Exhibit H: Syed Mujahid Sayeed, M.D. Records of treatment
Exhibit I: North Shore University Hospital Records of treatment
Exhibit J: Burt Greenberg, M.D. Records of treatment
Exhibit K: Glen Cove Hospital Records of treatment
Exhibit L: Nick Roselli Occupational Therapist Record of treatment
Exhibit M: Roslyn Rescue Hook & Ladder Record of treatment.
RELEVANT PROCEDURAL HISTORY
7. Plaintiffs commenced this action sounding in medical malpractice and lack of
informed consent by filing a Summons and Complaint on or about August 24, 2018. (Exhibit
A).
8. Issue was joined by service of the moving defendant’s Answer on September
28, 2018. (Exhibit B).
9. Plaintiffs served a Verified Bill of Particulars as to the moving defendant on or
about January 17, 2019. (Exhibit C).
10. Plaintiff Dino Bonavita appeared for his deposition on January 28, 2020.
(Exhibit D).
11. Defendant Syed Mujahid Sayeed appeared for deposition on September 23,
2020. (Exhibit E).
12. On June 22, 2022, a Stipulation of Discontinuance as to Northwell Health was
filed with this Court. (Exhibit F).
13. Plaintiffs filed the Note of Issue on August 15, 2022. Accordingly, the instant
motion is timely. (Exhibit G).
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ARGUMENT
I. Dr. Sayeed did not deviate from the standard of care in his performance of
the surgery, including the extensor tendon repair, or in the postoperative
management of Mr. Bonavita’s injury.
14. As detailed within the Expert Affirmation of Dr. Roy Kulick, Dr. Sayeed met
the standard of care in performing the surgery, including the extensor tendon repair, and the
subsequent treatment including the splinting and hand therapy were appropriate and reasonable
within the standard of care. There is no evidence that the patient sustained any injury or
damages as a consequence of the claimed omissions or acts of Dr. Sayeed. (See Dr. Kulick’s
Expert Affirmation¶3, 6-9).
15. Mr. Bonavita was transported to the emergency room at North Shore University
Hospital (hereinafter “I”). He was seen and evaluated by the emergency department physician
who sought a further consultation by Dr. Sayeed, the plastic surgeon and hand surgeon on call.
Dr. Sayeed noted in his consultation report that the patient was a 48-year-old male who had
sustained multiple lacerations to his right hand resulting in an inability to extend his fingers.
Injuries to the extremities were isolated to the right hand with multiple lacerations over the
small finger at the level of the metacarpophanangeal (MCP) joint, over the proximal
interphalangeal (PIP) joint of the ring finger, as well as at the base of the right finger on the
radial side extending onto the dorsum of the hand. There was a wound over the PIP joint of the
middle finger and a wound over the PIP joint of the index finger. The patient was unable to
extend at the MCP joint or the PIP joint of the right ring finger. (Exhibit I, p. 39).
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16. X-rays taken in the emergency department at North Shore University Hospital
on July 12, 2017, evaluating for “foreign body” glass fragments were negative. No radiopaque
foreign body was visualized. The operative report indicated that there were no foreign bodies
or fractures noted on x-rays. (Exhibit I, p.40-41).
17. Need for exploration was discussed with the patient. The pre- and
postoperative diagnosis was open wounds of the right hand with extensor tendon injury. Dr.
Sayeed explored the wounds of the right hand, repaired the extensor tendon and lateral bands
of the right ring finger metacarpal joint, repaired the metacarpophalangeal joint capsule of the
right ring finger, and repaired the extensor tendon at the proximal interphalangeal joint of the
right index finger. He also performed a debridement of skin and subcutaneous tissue of the
right hand, and simple repairs measuring 7 cm of the skin of the right dorsal hand.
18. At surgery, the wounds were thoroughly irrigated, and nonviable skin and
subcutaneous tissue were sharply debrided from the small finger at the level of the MCP joint.
A simple repair was carried out on the dorsal aspect of the middle finger and the small finger
using 4-0 nylon sutures. Attention was then focused on the ring finger and the wound was
enlarged to allow visualization of the extensor tendon mechanism. There was a transection of
extensor tendon mechanism at the level of the MCP joint with involvement of the lateral bands
as the injury was oblique. The extensor tendon mechanism was mobilized revealing injury to
the joint capsule, which was repaired using interrupted 4-0 PDS suture. (Exhibit I, p. 39-42).
19. Following this, the extensor tendon mechanism was repaired using interrupted
4-0 PDS sutures as well as 4-0 Vicryl sutures. The finger was ranged to demonstrated adequate
tension as well as absence of gapping in the repair. Similar repair was carried out at the level
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of the PIP joint on the index finger. The wounds were thoroughly irrigated and closed using
interrupted 4-0 nylon suture. Soft bulky dressing as well as a short arm volar splint were placed.
The patient tolerated the procedure without complication and post procedure wound care and
instructions were provided. (Exhibit I, p. 39-42).
20. Dr. Sayeed testified that the proximal and distal ends of the tendons were clearly
identified and repaired with sutures, then the joint was arranged to make sure the tendon repair
was intact, the skin was closed over it and the splint was placed in such a way as to immobilize
the hand and protect the tendon repair. (Exhibit E, p. 14, ll. 17-25, p. 15, ll.2).
21. It is Dr. Sayeed’s custom and practice to ask the patient if they want to see the
repair and how it’s working. Dr. Kulick’s expert affirmation supports Dr. Sayyed’s conclusion
that at the conclusion of the repair surgery performed by Dr Sayeed, the extensor tendons he
repaired were seen to be functioning properly. Next the skin was repaired and the hand was
placed in a splint and arrangements were made for the patient to be seen in the doctor’s office
as an outpatient. Dr. Sayeed did not deviate from the standard of care in the surgical repair of
the extensor tendon or post operative care rendered to the patient and there is no evidence that
the patient sustained any injury or damages as a consequence of the claimed omissions or acts
of Dr. Sayeed. (See Dr. Kulick’s Expert Affirmation ¶3, 8 and Exhibit E, p. 12, ll. 5-12).
22. Postoperatively, Dr. Sayeed’s referrals for occupational therapy and the type of
splint Mr. Bonavita was prescribed was reasonable and within the standard of care. The
postoperative care by the occupational therapist was also at all points appropriate to the
condition presented by the patient and within the applicable standard of care. (See Dr. Kulick’s
Expert Affirmation ¶9).
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II. The nature of the original injury had the potential of consequential
disability even with proper surgical and postoperative care.
23. Mr. Bonavita sustained multiple serious injuries to the delicate structures in the
back of his right hand including multiple lacerations, subcutaneous tissue injury and a tendon
injury extending down to the joint capsule, which Dr. Sayeed explained meant that he had
injured the extensor mechanisms on the back of his hand. This type of injury frequently causes
disability despite prompt and proper surgical care with appropriate occupational therapy due to
the intricacy and delicacy of the structures comprising the extensor mechanisms of the fingers.
(Exhibit I, p.39-42; Exhibit E, p. 32, ll. 17-21).
24. After the extensor tendon repair performed by Dr. Sayeed, Mr. Bonavita was
seen for follow up visits at proper intervals on July 25, 2017, August 7, 2017, August 17, 2017,
August 31, 2017, September 21, 2017, and October 12, 2017, whereupon the patient elected to
return to the care of Dr. Greenberg. The patient was apprised of the expectations of
postoperative physical/occupational therapy for this type of hand injury and he saw the
appropriate therapist on multiple occasions following surgery. The results of the hand therapy
were disappointing and suboptimal, potentially because the patient complained of persistent
pain, and his inability to participate in therapy consistently subsequent to his third procedure
for an extended duration of time. Complete occupational therapy is vital to the efforts to
maintain as much normal function of the hand as possible following the surgical repair of this
type of serious injury. Despite the proper management of the injury up until the patient left the
hospital, follow up care, and occupational therapy, Dr. Kulick opines it cannot be predicted in
a given case how the healing will progress or what the residual effects of the injury will
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ultimately be given the nature of the original injury. An intrinsic muscle imbalance with dorsal
capsule tightness of the metacarpophalangeal joint of the right ring finger, such as seen in Mr.
Bonavita’s case, are anticipated consequence of the initial injury, regardless of optimal surgical
and postoperative care. (See Dr. Kulick’s Expert Affirmation ¶8).
III. Dr. Sayeed properly explored for the presence of glass and foreign bodies
and the patient was advised there would be the possibility of retained
fragments of glass.
25. Plaintiff alleges that Dr. Sayeed failed to properly appreciate the risk of the
presence of retained foreign bodies in the patient’s wounds and negligently failed to identify
the presence of a foreign body. Dr. Sayeed properly explored for the presence of foreign bodies,
balancing the risk of further injury secondary to exploration against the small risk of the retained
fragments, and the patient was advised there is generally a possibility of retained fragments of
glass.
26. Hand injuries involving broken glass and foreign bodies as such, are a fairly
common injury treated in the practice of hand surgery. It is known that fragments of glass of
various sizes may remain in the patient’s wounds after the surgical repair is performed. The
description of the repair using enlargement of the wound, direct inspection, and steel
instruments for tactile identification of glass fragments, demonstrates that Dr. Sayeed was
aware of and adhered to the standard of care for attempting to identify and remove retained
glass fragments. (Dr. Kulick’s Expert Affirmation ¶7).
27. Dr. Sayeed testified that on the initial encounter of July 21, 2017, x-rays taken
in the emergency department showed no foreign bodies and upon examination, there was
nothing that he felt or visualized within the wound. The lighting was more than adequate, the
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wound was seen to be clear and there was no need for loupe magnification. There is no standard
of care which requires the use of loupe magnification for this type of procedure unless it
involved microvascular surgery in which the surgeon would employ microscope and/or loupe
magnification. (Exhibit E, p. 15 ll. 6-21, p. 16, ll. 14-17).
28. See Dr. Kulick’s Expert Affirmation, ¶6 in which he explains that the patient did
not require microvascular repair or tendon retrieval and would not have expected to obtain any
benefit from repair in the operating room or use of an operating microscope in an operating
room, as opposed to the method of repair without magnification employed by Dr. Sayeed. The
repair in the Emergency Department without magnification was an appropriate treatment
alternative within the hand surgery standard of care at the time and place of treatment. (Dr.
Kulick’s Expert Affirmation ¶6).
29. Dr. Sayeed’s thorough exploration in which the wound was enlarged for greater
visualization and the soft tissue was dissected, using scissors and forceps demonstrates that Dr.
Sayeed was aware of the standard of care for attempting to identify and remove retained glass
fragments. (Exhibit E, p. 25, ll. 2-14).
30. The operative report reflects twice that the wounds were “thoroughly irrigated,”
which would be helpful in removing all foreign matter (Exhibit E, p. 27, ll. 7-16 and Exhibit
I, p. 42).
31. Dr. Sayeed testified that he explained to Mr. Bonavita that even if no foreign
bodies were seen or felt during the surgery, this does not ensure there is no residual retained
glass and if he continued to have pain and symptoms, there may be a need to explore the wounds
under fluoroscopy in the operating room. (Exhibit E, p. 54, ll. 14-19).
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32. Mr. Bonavita was aware of the possibility that further treatment might be
required during the postoperative course to address retained foreign bodies, and with his
consent Dr. Sayeed performed a limited exploration of the area under local anesthesia in his
office but found no foreign bodies. (Exhibit E, p. 26, ll. 11-23).
33. Following an x-ray of Mr. Bonavita’s fourth finger and Mr. Bonavita’s
continued complaints of pain, on October 12, 2017, Dr. Sayeed performed an exploratory search
under local anesthesia for foreign bodies just distal to the MCP joint. No foreign bodies were
found. Dr. Sayeed advised the patient that this did not ensure there was no glass there. (Exhibit
H, p. 16)
34. Dr. Sayeed appropriately assessed the patient for the presence of retained glass
fragments without being overly aggressive in exploring the wounds and causing unwarranted
trauma. Aggressive exploration carried the risk of increased scarring in a search for foreign
bodies which may or may not have been present or problematic. Further exploration for glass
removal was not warranted by Dr. Sayeed. Notably, the operative report for Dr. Greenberg’s
procedure performed on October 31, 2017, does not identify visible glass fragments removed
and the pathology report merely reports the finding of “microscopic refractile material
consistent with glass fragments.” There is no documentation that any glass fragments were
removed as a result of the subsequent procedure performed by Dr. Greenberg, except possible
microscopic fragments incidentally removed with scar tissue. If any fragments existed in the
pathology specimen following the October 31, 2017, they were microscopic at best and were
not documented as being seen at surgery by the subsequent surgeon Dr. Greenberg. Thus,
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plaintiff’s allegation of Dr. Sayeed’s failure to identify and remove glass fragments is blatantly
without evidentiary support. (Exhibit J, p.24-25; Exhibit K, p. 34-36, 47-48).
IV. The patient’s residual restriction of extension of the right ring finger is
most likely the result of the removal of a significant amount of scar tendon
tissue at the subsequent procedure performed by nonparty Dr. Burt
Greenberg.
35. Prior to his third procedure performed by Dr. Greenberg, Mr. Bonavita was
gradually improving. Mr. Bonavita participated in occupational therapy with Nick Roselli and
on October 23, 2017, was noted as “continuing to show good improvement in his range of
motion and joint mobility of digits including the index and ring fingers with decreased pain
intensity.” (Exhibit L, p. 136).
36. On October 31, 2017, Dr. Greenberg performed a third surgical procedure
searching for foreign bodies in which he debrided a significant amount of tendon tissue. The
patient’s residual restriction of extension of the right ring finger is in part due to the removal of
a significant amount of scar and tendon tissue. Mr. Bonavita testified that Dr. Greenberg
“shortened the tendon which then limited the full movement of his ring finger.” The tendon
had been repaired by Dr. Sayeed as the patient saw for himself during the procedure. Dr. Sayeed
further testified that the intra-operative photographs of the repair of the extensor tendon show
that all of the repairs were intact. Thus, the subsequent “repair,” performed by Dr. Greenberg
is what resulted in additional functional limitations for the patient. (Exhibit D, p. 12, ll. 5-10;
p. 34, ll. 9-16; p. 141, ll.23-25; p. 142, ll. 2-4).
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V. Mr. Bonavita did not undergo three surgical repairs under general
anesthesia and no infection occurred as a result of the procedures
performed by Dr. Sayeed.
37. Plaintiff alleges that as a result of Dr. Sayeed’s negligence, Mr. Bonavita
underwent three surgical procedures under general anesthesia to reconstruct the tendon of the
right hand and remove foreign glass material. The initial procedure performed by Dr. Sayeed
on July 21, 2017, to repair the extensor tendon due to an injury at Mr. Bonavita’s home did
not require general anesthesia. The operative report states that 1% lidocaine was administered
and Mr. Bonavita testified that he was conscious during the surgery performed by Dr. Sayeed
on July 21, 2017. On October 12, 2017, the second procedure, an exploratory search
performed by Dr. Sayeed was also performed with local anesthesia. The third procedure
performed by Dr. Greenberg was done under general anesthesia. (Exhibit I, p. 41; Exhibit
D, p. 76, ll. 8-17; Exhibit H, p. 16; Exhibit J, p. 24-25).
38. Plaintiff further alleges defendant ignored the signs and symptoms of infection.
There is no evidence that the patient had an infection which caused any portion of the claimed
injuries. The follow up records of Dr. Sayeed clearly denote “no sign of infection.” (See
Exhibit H).
VI. Informed consent was obtained by Dr. Sayeed for the performance of the
exploration of the patient’s wounds and repair.
39. As discussed in the Expert Affirmation of Dr. Kulick, Dr. Sayeed exceeded
the applicable standard of care for obtaining informed consent. Dr. Sayeed testified that per his
routine custom and practice, he described to the patient the injuries he had sustained to his right
hand. Mr. Bonavita then said that he knew a hand surgeon and plastic surgeon Dr. Burt
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Greenberg that operated in the same community. Dr. Sayeed advised Mr. Bonavita that he had
an extensor tendon injury and the skin could be closed and this could be managed as an
outpatient by Dr. Greenberg, if he preferred to be treated by Dr. Greenberg. Alternatively, Dr.
Sayeed advised Mr. Bonavita if he wanted to be treated in the emergency department, that was
an option if he could perform it safely here. Dr. Sayeed testified that Mr. Bonavita asked him
to call Dr. Greenberg on his cell phone, which they did from the emergency department and Dr.
Greenberg told the patient that Dr. Sayeed was fine to repair it and that Dr. Greenberg was out
of the country. (Exhibit E, p.10, ll.13-25, p. 11, 2-12).
40. Dr. Sayeed testified that it was his custom and practice to ascertain whether it was
safe to perform the procedure in the emergency department or if the procedure necessitated the
use of the operating room. If it was not safe to perform the repair in the emergency department,
he would close the skin, place a splint, and advise Mr. Bonavita he could see either Dr.
Greenberg or himself electively. (Exhibit E, p. 11, ll. 13-20).
41. After examining Mr. Bonavita’s wounds, Dr. Sayeed testified that he deemed it
safe to repair the injury in the emergency department, however, the patient was given the option
to have Dr. Greenberg repair it as an outpatient, since he was friendly with Dr. Greenberg on a
personal basis. (Exhibit E, p. 13, ll. 21-25, p.14, ll. 2-10).
42. Dr. Sayeed proceeded to discuss with the patient what the procedure would entail
and the patient agreed to proceed. Dr. Sayeed further testified that it is his custom and practice
that when a patient presents with the extensive injuries that Mr. Bonavita had, he advises the
patient in the emergency department that there remains a possibility of residual stiffness and a
need for occupational therapy. (Exhibit E, p. 11, ll. 23-25, p. 28, ll. 16-19).
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43. Dr. Sayeed discussed and explained to Mr. Bonavita the nature of his injury, the
need for exploration of his wounds and the repair, risks, benefits and alternatives. The operative
report documents that no foreign bodies or fractures were noted on x-rays and the “need for
exploration was discussed with the patient. He agreed to the procedure.”
44. Mr. Bonavita further signed a consent to admission and treatment himself on July
21, 2017. (Exhibit I, p. 36, 41 and Exhibit D, p. 74, ll. 5-25, p.75, ll. 2-11).
CONCLUSION
45. The evidence set forth in support of Dr. Sayeed’s motion for summary judgment
satisfies the criteria necessary to establish a prima facie showing that defendants Dr. Sayeed
and Precision Surgery, P.C. are entitled to summary judgment as a matter of law. The medical
records, deposition testimony, pleadings, and the Expert Affirmation of Dr. Kulick
unequivocally establish that Dr. Sayeed obtained the requisite informed consent from Mr.
Bonavita and that Dr. Sayeed did not deviate from accepted standards of care. Further, the
evidence supports the position that Dr. Sayeed’s performance of the glass removal, repair of
the extensor tendon, and the subsequent management of Mr. Bonavita were all well within the
2017 accepted standards of plastic surgery and hand surgery.
46. Plaintiff will therefore not be able to meet their burden of showing that Dr.
Sayeed deviated from good and accepted standards of medical care and practice which was a
cause of injury to the patient. Accordingly, summary judgment should be granted dismissing
all claims against the moving defendants with prejudice.
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WHEREFORE, it is respectfully requested the instant motion be granted in all respects.
Dated: Rye, New York
August 29, 2022
Linda M. Lin
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CERTIFICATION
In accordance with the Uniform Rules for the Trial Courts 22 NYCRR §202.8-b, the
undersigned certifies that the word count in this Attorney Affirmation (excluding the caption,
table of contents, table of authorities, signature block and this certification), as established using
the word processing system used to prepare it, is 4165 words.
Dated: Rye, New York
August 29, 2022
_________________________
Linda M. Lin
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FILED: NASSAU COUNTY CLERK 08/29/2022 05:34 PM INDEX NO. 611506/2018 NYSCEF DOC. NO. 84 RECEIVED NYSCEF: 08/29/2022 SUPREME COURT OF THE STATE OF NEW YORK COUNTY OF NASSAU -------------------------------------------------------------------------X DINO BONAVITA, Plaintiff, ATTORNEY AFFIRMATION IN SUPPORT OF -against- DEFENDANT’S MOTION FOR SUMMARY JUDGMENT SYED MUJAHID SAYEED, M.D., PRECISION SURGERY OF NEW YORK, P.C., NORTH SHORE Index No. 611506/2018 UNIVERSITY HOSPITAL, and NORTHWELL HEALTH, Defendants. ------------------------------------------------------------------------X Linda M. Lin, an attorney duly admitted to practice before the Courts of the State of New York, affirms the following to be true under the penalties of perjury: 1. I am associated with the law firm of DORF & NELSON LLP, attorneys of record for defendants SYED MUJAHID SAYEED (hereinafter “Dr. Sayeed”) and PRECISION SURGERY OF NEW YORK, P.C. I am fully familiar with the facts and circumstances of this action by virtue of a review of the file maintained in your affirmant's office. 2. I make this affirmation in support of the instant motion on behalf of defendants Dr. Sayeed and Precision Surgery, P.C. seeking an Order: (a) Pursuant to CPLR §3212, granting summary judgment to the defendants SYED MUJAHID SAYEED, M.D. and PRECISION SURGERY OF NEW YORK dismissing plaintiff’s claims with prejudice; {DN/00250342;1 } 1 of 17 FILED: NASSAU COUNTY CLERK 08/29/2022 05:34 PM INDEX NO. 611506/2018 NYSCEF DOC. NO. 84 RECEIVED NYSCEF: 08/29/2022 (b) Directing the entry of judgment in favor of the defendants SYED MUJAHID SAYEED, M.D. and PRECISION SURGERY OF NEW YORK and, (c) For such other and further relief as this Court may deem just and proper. There has been no prior application for the relief requested herein. 3. The instant action sounds in medical malpractice and lack of informed consent. The plaintiff was treated by Dr. Sayeed after sustaining a serious injury to his right hand which had been cut by glass when he put it through a glass door at home. The plaintiff alleges that Dr. Sayeed was negligent in failing to properly assess his wounds for the risk of presence of a foreign (glass) body; failing to identify a presence of a foreign body upon admission to defendant’s premises; failing to supervise and control their agents, servants and/or employees who rendered medical care to plaintiff; deviating from the good and accepted standards of medical practice in their care, treatment, testing and surgical services of plaintiff; failing to timely, properly, and appropriately perform assessments, diagnostics, care treatment, testing, and surgical services on plaintiff before, during, and after surgery on July 21, 2017; failing to remove all foreign glass bodies from his wounds; causing and allowing plaintiff’s medical condition to worsen causing severe and permanent injury to his right fourth finger, right fourth finger extensor tendon; right fourth finger metacarpophalangeal joint capsule; and right hand. 4. Plaintiff alleges that the defendant’s negligence and departures from standards of good and accepted medical practice were each an actual and proximate cause of the plaintiff’s alleged loss of the full function of the index finger of his right hand and severe deformity and personal injuries including mental anguish, conscious pain and suffering, loss of enjoyment of life, economic loss, past and future earnings, and medical expense. {DN/00250342;1 } 2 2 of 17 FILED: NASSAU COUNTY CLERK 08/29/2022 05:34 PM INDEX NO. 611506/2018 NYSCEF DOC. NO. 84 RECEIVED NYSCEF: 08/29/2022 5. As confirmed in the Expert Affirmation of Dr. Roy Kulick, there is no factual basis for plaintiffs to allege any breach of the applicable standard of care by Dr. Sayeed in his repair of the ring finger extensor tendon. There were no departures from the standard of care governing similarly situated physicians and facilities treating patients in New York State in 2017 with respect to the care and treatment rendered to Dino Bonavita by the defendant Dr. Sayeed. Furthermore, none of the injuries claimed by the plaintiff were caused by any departures in the care or treatment rendered to the plaintiff by the defendant and injury to Mr. Bonavita. 6. Dr. Sayeed exceeded the applicable standard of care for obtaining informed consent for the extensor tendon repair. Moreover, Dr. Sayeed’s performance of the removal of glass, extensor tendon repair, and his subsequent management of the wounds of Mr. Bonavita were all well within the 2017 accepted standards of care. Therefore, plaintiff’s claims against Dr. Sayeed and the derivative claims against his professional corporation must be dismissed with prejudice. EXHIBITS Exhibit A: Plaintiff’s Summons and Complaint Exhibit B: Defendant Sayeed’s Answer & Defendant Precision Surgery’s Answer Exhibit C: Plaintiff’s Verified Bill of Particulars as to Dr. Sayeed and Precision Surgery Exhibit D: Deposition Transcript of Plaintiff Dino Bonavita Exhibit E: Deposition Transcript of Defendant Syed Mujahid Sayeed, M.D. Exhibit F: Stipulation of Discontinuance as to Northwell Health Exhibit G: Note of Issue {DN/00250342;1 } 3 3 of 17 FILED: NASSAU COUNTY CLERK 08/29/2022 05:34 PM INDEX NO. 611506/2018 NYSCEF DOC. NO. 84 RECEIVED NYSCEF: 08/29/2022 Exhibit H: Syed Mujahid Sayeed, M.D. Records of treatment Exhibit I: North Shore University Hospital Records of treatment Exhibit J: Burt Greenberg, M.D. Records of treatment Exhibit K: Glen Cove Hospital Records of treatment Exhibit L: Nick Roselli Occupational Therapist Record of treatment Exhibit M: Roslyn Rescue Hook & Ladder Record of treatment. RELEVANT PROCEDURAL HISTORY 7. Plaintiffs commenced this action sounding in medical malpractice and lack of informed consent by filing a Summons and Complaint on or about August 24, 2018. (Exhibit A). 8. Issue was joined by service of the moving defendant’s Answer on September 28, 2018. (Exhibit B). 9. Plaintiffs served a Verified Bill of Particulars as to the moving defendant on or about January 17, 2019. (Exhibit C). 10. Plaintiff Dino Bonavita appeared for his deposition on January 28, 2020. (Exhibit D). 11. Defendant Syed Mujahid Sayeed appeared for deposition on September 23, 2020. (Exhibit E). 12. On June 22, 2022, a Stipulation of Discontinuance as to Northwell Health was filed with this Court. (Exhibit F). 13. Plaintiffs filed the Note of Issue on August 15, 2022. Accordingly, the instant motion is timely. (Exhibit G). {DN/00250342;1 } 4 4 of 17 FILED: NASSAU COUNTY CLERK 08/29/2022 05:34 PM INDEX NO. 611506/2018 NYSCEF DOC. NO. 84 RECEIVED NYSCEF: 08/29/2022 ARGUMENT I. Dr. Sayeed did not deviate from the standard of care in his performance of the surgery, including the extensor tendon repair, or in the postoperative management of Mr. Bonavita’s injury. 14. As detailed within the Expert Affirmation of Dr. Roy Kulick, Dr. Sayeed met the standard of care in performing the surgery, including the extensor tendon repair, and the subsequent treatment including the splinting and hand therapy were appropriate and reasonable within the standard of care. There is no evidence that the patient sustained any injury or damages as a consequence of the claimed omissions or acts of Dr. Sayeed. (See Dr. Kulick’s Expert Affirmation¶3, 6-9). 15. Mr. Bonavita was transported to the emergency room at North Shore University Hospital (hereinafter “I”). He was seen and evaluated by the emergency department physician who sought a further consultation by Dr. Sayeed, the plastic surgeon and hand surgeon on call. Dr. Sayeed noted in his consultation report that the patient was a 48-year-old male who had sustained multiple lacerations to his right hand resulting in an inability to extend his fingers. Injuries to the extremities were isolated to the right hand with multiple lacerations over the small finger at the level of the metacarpophanangeal (MCP) joint, over the proximal interphalangeal (PIP) joint of the ring finger, as well as at the base of the right finger on the radial side extending onto the dorsum of the hand. There was a wound over the PIP joint of the middle finger and a wound over the PIP joint of the index finger. The patient was unable to extend at the MCP joint or the PIP joint of the right ring finger. (Exhibit I, p. 39). {DN/00250342;1 } 5 5 of 17 FILED: NASSAU COUNTY CLERK 08/29/2022 05:34 PM INDEX NO. 611506/2018 NYSCEF DOC. NO. 84 RECEIVED NYSCEF: 08/29/2022 16. X-rays taken in the emergency department at North Shore University Hospital on July 12, 2017, evaluating for “foreign body” glass fragments were negative. No radiopaque foreign body was visualized. The operative report indicated that there were no foreign bodies or fractures noted on x-rays. (Exhibit I, p.40-41). 17. Need for exploration was discussed with the patient. The pre- and postoperative diagnosis was open wounds of the right hand with extensor tendon injury. Dr. Sayeed explored the wounds of the right hand, repaired the extensor tendon and lateral bands of the right ring finger metacarpal joint, repaired the metacarpophalangeal joint capsule of the right ring finger, and repaired the extensor tendon at the proximal interphalangeal joint of the right index finger. He also performed a debridement of skin and subcutaneous tissue of the right hand, and simple repairs measuring 7 cm of the skin of the right dorsal hand. 18. At surgery, the wounds were thoroughly irrigated, and nonviable skin and subcutaneous tissue were sharply debrided from the small finger at the level of the MCP joint. A simple repair was carried out on the dorsal aspect of the middle finger and the small finger using 4-0 nylon sutures. Attention was then focused on the ring finger and the wound was enlarged to allow visualization of the extensor tendon mechanism. There was a transection of extensor tendon mechanism at the level of the MCP joint with involvement of the lateral bands as the injury was oblique. The extensor tendon mechanism was mobilized revealing injury to the joint capsule, which was repaired using interrupted 4-0 PDS suture. (Exhibit I, p. 39-42). 19. Following this, the extensor tendon mechanism was repaired using interrupted 4-0 PDS sutures as well as 4-0 Vicryl sutures. The finger was ranged to demonstrated adequate tension as well as absence of gapping in the repair. Similar repair was carried out at the level {DN/00250342;1 } 6 6 of 17 FILED: NASSAU COUNTY CLERK 08/29/2022 05:34 PM INDEX NO. 611506/2018 NYSCEF DOC. NO. 84 RECEIVED NYSCEF: 08/29/2022 of the PIP joint on the index finger. The wounds were thoroughly irrigated and closed using interrupted 4-0 nylon suture. Soft bulky dressing as well as a short arm volar splint were placed. The patient tolerated the procedure without complication and post procedure wound care and instructions were provided. (Exhibit I, p. 39-42). 20. Dr. Sayeed testified that the proximal and distal ends of the tendons were clearly identified and repaired with sutures, then the joint was arranged to make sure the tendon repair was intact, the skin was closed over it and the splint was placed in such a way as to immobilize the hand and protect the tendon repair. (Exhibit E, p. 14, ll. 17-25, p. 15, ll.2). 21. It is Dr. Sayeed’s custom and practice to ask the patient if they want to see the repair and how it’s working. Dr. Kulick’s expert affirmation supports Dr. Sayyed’s conclusion that at the conclusion of the repair surgery performed by Dr Sayeed, the extensor tendons he repaired were seen to be functioning properly. Next the skin was repaired and the hand was placed in a splint and arrangements were made for the patient to be seen in the doctor’s office as an outpatient. Dr. Sayeed did not deviate from the standard of care in the surgical repair of the extensor tendon or post operative care rendered to the patient and there is no evidence that the patient sustained any injury or damages as a consequence of the claimed omissions or acts of Dr. Sayeed. (See Dr. Kulick’s Expert Affirmation ¶3, 8 and Exhibit E, p. 12, ll. 5-12). 22. Postoperatively, Dr. Sayeed’s referrals for occupational therapy and the type of splint Mr. Bonavita was prescribed was reasonable and within the standard of care. The postoperative care by the occupational therapist was also at all points appropriate to the condition presented by the patient and within the applicable standard of care. (See Dr. Kulick’s Expert Affirmation ¶9). {DN/00250342;1 } 7 7 of 17 FILED: NASSAU COUNTY CLERK 08/29/2022 05:34 PM INDEX NO. 611506/2018 NYSCEF DOC. NO. 84 RECEIVED NYSCEF: 08/29/2022 II. The nature of the original injury had the potential of consequential disability even with proper surgical and postoperative care. 23. Mr. Bonavita sustained multiple serious injuries to the delicate structures in the back of his right hand including multiple lacerations, subcutaneous tissue injury and a tendon injury extending down to the joint capsule, which Dr. Sayeed explained meant that he had injured the extensor mechanisms on the back of his hand. This type of injury frequently causes disability despite prompt and proper surgical care with appropriate occupational therapy due to the intricacy and delicacy of the structures comprising the extensor mechanisms of the fingers. (Exhibit I, p.39-42; Exhibit E, p. 32, ll. 17-21). 24. After the extensor tendon repair performed by Dr. Sayeed, Mr. Bonavita was seen for follow up visits at proper intervals on July 25, 2017, August 7, 2017, August 17, 2017, August 31, 2017, September 21, 2017, and October 12, 2017, whereupon the patient elected to return to the care of Dr. Greenberg. The patient was apprised of the expectations of postoperative physical/occupational therapy for this type of hand injury and he saw the appropriate therapist on multiple occasions following surgery. The results of the hand therapy were disappointing and suboptimal, potentially because the patient complained of persistent pain, and his inability to participate in therapy consistently subsequent to his third procedure for an extended duration of time. Complete occupational therapy is vital to the efforts to maintain as much normal function of the hand as possible following the surgical repair of this type of serious injury. Despite the proper management of the injury up until the patient left the hospital, follow up care, and occupational therapy, Dr. Kulick opines it cannot be predicted in a given case how the healing will progress or what the residual effects of the injury will {DN/00250342;1 } 8 8 of 17 FILED: NASSAU COUNTY CLERK 08/29/2022 05:34 PM INDEX NO. 611506/2018 NYSCEF DOC. NO. 84 RECEIVED NYSCEF: 08/29/2022 ultimately be given the nature of the original injury. An intrinsic muscle imbalance with dorsal capsule tightness of the metacarpophalangeal joint of the right ring finger, such as seen in Mr. Bonavita’s case, are anticipated consequence of the initial injury, regardless of optimal surgical and postoperative care. (See Dr. Kulick’s Expert Affirmation ¶8). III. Dr. Sayeed properly explored for the presence of glass and foreign bodies and the patient was advised there would be the possibility of retained fragments of glass. 25. Plaintiff alleges that Dr. Sayeed failed to properly appreciate the risk of the presence of retained foreign bodies in the patient’s wounds and negligently failed to identify the presence of a foreign body. Dr. Sayeed properly explored for the presence of foreign bodies, balancing the risk of further injury secondary to exploration against the small risk of the retained fragments, and the patient was advised there is generally a possibility of retained fragments of glass. 26. Hand injuries involving broken glass and foreign bodies as such, are a fairly common injury treated in the practice of hand surgery. It is known that fragments of glass of various sizes may remain in the patient’s wounds after the surgical repair is performed. The description of the repair using enlargement of the wound, direct inspection, and steel instruments for tactile identification of glass fragments, demonstrates that Dr. Sayeed was aware of and adhered to the standard of care for attempting to identify and remove retained glass fragments. (Dr. Kulick’s Expert Affirmation ¶7). 27. Dr. Sayeed testified that on the initial encounter of July 21, 2017, x-rays taken in the emergency department showed no foreign bodies and upon examination, there was nothing that he felt or visualized within the wound. The lighting was more than adequate, the {DN/00250342;1 } 9 9 of 17 FILED: NASSAU COUNTY CLERK 08/29/2022 05:34 PM INDEX NO. 611506/2018 NYSCEF DOC. NO. 84 RECEIVED NYSCEF: 08/29/2022 wound was seen to be clear and there was no need for loupe magnification. There is no standard of care which requires the use of loupe magnification for this type of procedure unless it involved microvascular surgery in which the surgeon would employ microscope and/or loupe magnification. (Exhibit E, p. 15 ll. 6-21, p. 16, ll. 14-17). 28. See Dr. Kulick’s Expert Affirmation, ¶6 in which he explains that the patient did not require microvascular repair or tendon retrieval and would not have expected to obtain any benefit from repair in the operating room or use of an operating microscope in an operating room, as opposed to the method of repair without magnification employed by Dr. Sayeed. The repair in the Emergency Department without magnification was an appropriate treatment alternative within the hand surgery standard of care at the time and place of treatment. (Dr. Kulick’s Expert Affirmation ¶6). 29. Dr. Sayeed’s thorough exploration in which the wound was enlarged for greater visualization and the soft tissue was dissected, using scissors and forceps demonstrates that Dr. Sayeed was aware of the standard of care for attempting to identify and remove retained glass fragments. (Exhibit E, p. 25, ll. 2-14). 30. The operative report reflects twice that the wounds were “thoroughly irrigated,” which would be helpful in removing all foreign matter (Exhibit E, p. 27, ll. 7-16 and Exhibit I, p. 42). 31. Dr. Sayeed testified that he explained to Mr. Bonavita that even if no foreign bodies were seen or felt during the surgery, this does not ensure there is no residual retained glass and if he continued to have pain and symptoms, there may be a need to explore the wounds under fluoroscopy in the operating room. (Exhibit E, p. 54, ll. 14-19). {DN/00250342;1 } 10 10 of 17 FILED: NASSAU COUNTY CLERK 08/29/2022 05:34 PM INDEX NO. 611506/2018 NYSCEF DOC. NO. 84 RECEIVED NYSCEF: 08/29/2022 32. Mr. Bonavita was aware of the possibility that further treatment might be required during the postoperative course to address retained foreign bodies, and with his consent Dr. Sayeed performed a limited exploration of the area under local anesthesia in his office but found no foreign bodies. (Exhibit E, p. 26, ll. 11-23). 33. Following an x-ray of Mr. Bonavita’s fourth finger and Mr. Bonavita’s continued complaints of pain, on October 12, 2017, Dr. Sayeed performed an exploratory search under local anesthesia for foreign bodies just distal to the MCP joint. No foreign bodies were found. Dr. Sayeed advised the patient that this did not ensure there was no glass there. (Exhibit H, p. 16) 34. Dr. Sayeed appropriately assessed the patient for the presence of retained glass fragments without being overly aggressive in exploring the wounds and causing unwarranted trauma. Aggressive exploration carried the risk of increased scarring in a search for foreign bodies which may or may not have been present or problematic. Further exploration for glass removal was not warranted by Dr. Sayeed. Notably, the operative report for Dr. Greenberg’s procedure performed on October 31, 2017, does not identify visible glass fragments removed and the pathology report merely reports the finding of “microscopic refractile material consistent with glass fragments.” There is no documentation that any glass fragments were removed as a result of the subsequent procedure performed by Dr. Greenberg, except possible microscopic fragments incidentally removed with scar tissue. If any fragments existed in the pathology specimen following the October 31, 2017, they were microscopic at best and were not documented as being seen at surgery by the subsequent surgeon Dr. Greenberg. Thus, {DN/00250342;1 } 11 11 of 17 FILED: NASSAU COUNTY CLERK 08/29/2022 05:34 PM INDEX NO. 611506/2018 NYSCEF DOC. NO. 84 RECEIVED NYSCEF: 08/29/2022 plaintiff’s allegation of Dr. Sayeed’s failure to identify and remove glass fragments is blatantly without evidentiary support. (Exhibit J, p.24-25; Exhibit K, p. 34-36, 47-48). IV. The patient’s residual restriction of extension of the right ring finger is most likely the result of the removal of a significant amount of scar tendon tissue at the subsequent procedure performed by nonparty Dr. Burt Greenberg. 35. Prior to his third procedure performed by Dr. Greenberg, Mr. Bonavita was gradually improving. Mr. Bonavita participated in occupational therapy with Nick Roselli and on October 23, 2017, was noted as “continuing to show good improvement in his range of motion and joint mobility of digits including the index and ring fingers with decreased pain intensity.” (Exhibit L, p. 136). 36. On October 31, 2017, Dr. Greenberg performed a third surgical procedure searching for foreign bodies in which he debrided a significant amount of tendon tissue. The patient’s residual restriction of extension of the right ring finger is in part due to the removal of a significant amount of scar and tendon tissue. Mr. Bonavita testified that Dr. Greenberg “shortened the tendon which then limited the full movement of his ring finger.” The tendon had been repaired by Dr. Sayeed as the patient saw for himself during the procedure. Dr. Sayeed further testified that the intra-operative photographs of the repair of the extensor tendon show that all of the repairs were intact. Thus, the subsequent “repair,” performed by Dr. Greenberg is what resulted in additional functional limitations for the patient. (Exhibit D, p. 12, ll. 5-10; p. 34, ll. 9-16; p. 141, ll.23-25; p. 142, ll. 2-4). {DN/00250342;1 } 12 12 of 17 FILED: NASSAU COUNTY CLERK 08/29/2022 05:34 PM INDEX NO. 611506/2018 NYSCEF DOC. NO. 84 RECEIVED NYSCEF: 08/29/2022 V. Mr. Bonavita did not undergo three surgical repairs under general anesthesia and no infection occurred as a result of the procedures performed by Dr. Sayeed. 37. Plaintiff alleges that as a result of Dr. Sayeed’s negligence, Mr. Bonavita underwent three surgical procedures under general anesthesia to reconstruct the tendon of the right hand and remove foreign glass material. The initial procedure performed by Dr. Sayeed on July 21, 2017, to repair the extensor tendon due to an injury at Mr. Bonavita’s home did not require general anesthesia. The operative report states that 1% lidocaine was administered and Mr. Bonavita testified that he was conscious during the surgery performed by Dr. Sayeed on July 21, 2017. On October 12, 2017, the second procedure, an exploratory search performed by Dr. Sayeed was also performed with local anesthesia. The third procedure performed by Dr. Greenberg was done under general anesthesia. (Exhibit I, p. 41; Exhibit D, p. 76, ll. 8-17; Exhibit H, p. 16; Exhibit J, p. 24-25). 38. Plaintiff further alleges defendant ignored the signs and symptoms of infection. There is no evidence that the patient had an infection which caused any portion of the claimed injuries. The follow up records of Dr. Sayeed clearly denote “no sign of infection.” (See Exhibit H). VI. Informed consent was obtained by Dr. Sayeed for the performance of the exploration of the patient’s wounds and repair. 39. As discussed in the Expert Affirmation of Dr. Kulick, Dr. Sayeed exceeded the applicable standard of care for obtaining informed consent. Dr. Sayeed testified that per his routine custom and practice, he described to the patient the injuries he had sustained to his right hand. Mr. Bonavita then said that he knew a hand surgeon and plastic surgeon Dr. Burt {DN/00250342;1 } 13 13 of 17 FILED: NASSAU COUNTY CLERK 08/29/2022 05:34 PM INDEX NO. 611506/2018 NYSCEF DOC. NO. 84 RECEIVED NYSCEF: 08/29/2022 Greenberg that operated in the same community. Dr. Sayeed advised Mr. Bonavita that he had an extensor tendon injury and the skin could be closed and this could be managed as an outpatient by Dr. Greenberg, if he preferred to be treated by Dr. Greenberg. Alternatively, Dr. Sayeed advised Mr. Bonavita if he wanted to be treated in the emergency department, that was an option if he could perform it safely here. Dr. Sayeed testified that Mr. Bonavita asked him to call Dr. Greenberg on his cell phone, which they did from the emergency department and Dr. Greenberg told the patient that Dr. Sayeed was fine to repair it and that Dr. Greenberg was out of the country. (Exhibit E, p.10, ll.13-25, p. 11, 2-12). 40. Dr. Sayeed testified that it was his custom and practice to ascertain whether it was safe to perform the procedure in the emergency department or if the procedure necessitated the use of the operating room. If it was not safe to perform the repair in the emergency department, he would close the skin, place a splint, and advise Mr. Bonavita he could see either Dr. Greenberg or himself electively. (Exhibit E, p. 11, ll. 13-20). 41. After examining Mr. Bonavita’s wounds, Dr. Sayeed testified that he deemed it safe to repair the injury in the emergency department, however, the patient was given the option to have Dr. Greenberg repair it as an outpatient, since he was friendly with Dr. Greenberg on a personal basis. (Exhibit E, p. 13, ll. 21-25, p.14, ll. 2-10). 42. Dr. Sayeed proceeded to discuss with the patient what the procedure would entail and the patient agreed to proceed. Dr. Sayeed further testified that it is his custom and practice that when a patient presents with the extensive injuries that Mr. Bonavita had, he advises the patient in the emergency department that there remains a possibility of residual stiffness and a need for occupational therapy. (Exhibit E, p. 11, ll. 23-25, p. 28, ll. 16-19). {DN/00250342;1 } 14 14 of 17 FILED: NASSAU COUNTY CLERK 08/29/2022 05:34 PM INDEX NO. 611506/2018 NYSCEF DOC. NO. 84 RECEIVED NYSCEF: 08/29/2022 43. Dr. Sayeed discussed and explained to Mr. Bonavita the nature of his injury, the need for exploration of his wounds and the repair, risks, benefits and alternatives. The operative report documents that no foreign bodies or fractures were noted on x-rays and the “need for exploration was discussed with the patient. He agreed to the procedure.” 44. Mr. Bonavita further signed a consent to admission and treatment himself on July 21, 2017. (Exhibit I, p. 36, 41 and Exhibit D, p. 74, ll. 5-25, p.75, ll. 2-11). CONCLUSION 45. The evidence set forth in support of Dr. Sayeed’s motion for summary judgment satisfies the criteria necessary to establish a prima facie showing that defendants Dr. Sayeed and Precision Surgery, P.C. are entitled to summary judgment as a matter of law. The medical records, deposition testimony, pleadings, and the Expert Affirmation of Dr. Kulick unequivocally establish that Dr. Sayeed obtained the requisite informed consent from Mr. Bonavita and that Dr. Sayeed did not deviate from accepted standards of care. Further, the evidence supports the position that Dr. Sayeed’s performance of the glass removal, repair of the extensor tendon, and the subsequent management of Mr. Bonavita were all well within the 2017 accepted standards of plastic surgery and hand surgery. 46. Plaintiff will therefore not be able to meet their burden of showing that Dr. Sayeed deviated from good and accepted standards of medical care and practice which was a cause of injury to the patient. Accordingly, summary judgment should be granted dismissing all claims against the moving defendants with prejudice. {DN/00250342;1 } 15 15 of 17 FILED: NASSAU COUNTY CLERK 08/29/2022 05:34 PM INDEX NO. 611506/2018 NYSCEF DOC. NO. 84 RECEIVED NYSCEF: 08/29/2022 WHEREFORE, it is respectfully requested the instant motion be granted in all respects. Dated: Rye, New York August 29, 2022 Linda M. Lin {DN/00250342;1 } 16 16 of 17 FILED: NASSAU COUNTY CLERK 08/29/2022 05:34 PM INDEX NO. 611506/2018 NYSCEF DOC. NO. 84 RECEIVED NYSCEF: 08/29/2022 CERTIFICATION In accordance with the Uniform Rules for the Trial Courts 22 NYCRR §202.8-b, the undersigned certifies that the word count in this Attorney Affirmation (excluding the caption, table of contents, table of authorities, signature block and this certification), as established using the word processing system used to prepare it, is 4165 words. Dated: Rye, New York August 29, 2022 _________________________ Linda M. Lin {DN/00250342;1 } 17 17 of 17