Preview
FILED: KINGS COUNTY CLERK 07/26/2022 04:25 PM INDEX NO. 521507/2017
NYSCEF DOC. NO. 78 RECEIVED NYSCEF: 07/26/2022
EXHIBIT E
FILED: KINGS COUNTY CLERK 07/26/2022 04:25 PM INDEX NO. 521507/2017
NYSCEF DOC. NO. 78 RECEIVED NYSCEF: 07/26/2022
SUPREME COURT OF THE STATE OF NEW YORK
COUNTY OF KINGS
-----------------------------------------------------X Index No.: 521507/2017
YVONNE ANDERSON,
Plaintiff,
-against- PHYSICIAN
AFFIRMATIQN
COURTNEY S. ROBINSON, HEART TO HEART
SOCIAL ADULT SERVICES LLC and
ABDOURAHAMANE DIALLO,
Defendants.
_________ _ ___ -_____________ _ ________..----Ç
STATE OF NEW YORK, COUNTY OF KINGS) S.S.:
I, Hossam Mohamed, M.D. of HEALTHEAST MEDICAL ALLIANCE, a
licensed physician in the State of New York, pursuant to CPLR 2106, do hereby affirm
to be true, under penalties of perjury, that the annexed medical reports of YVONNE
ANDERSON dated June 14, 2022 was prepared and is the work product of the
undersigned and is true to the best of my knowledge and information.
All range of motion testing were performed with a handheld goniometer, and
all normal values are in accordance with the American Association of Orthopedic
Surgeons.
Affirmed this _L3__ day of
2022
Hos amed, M.D.
FILED: KINGS COUNTY CLERK 07/26/2022 04:25 PM INDEX NO. 521507/2017
NYSCEF DOC. NO. 78 RECEIVED NYSCEF: 07/26/2022
I 4 \l I WI \ll I K \l \l I l\V I
100 Livingston Street - 2nd Floor
Brooklyn, NY 11201-5023
DOS: June 14, 2022
NARRATIVE REPORT
PATIENT NAME: Anderson, Yvonne
CASE#: Y220177060_1
DATE OF BIRTH: 07/12/1943
DATE OF ACCIDENT: 03/02/2017
HISTORY:
This patient, a 77-year-old female, was initially seen in consultation by Dr. Gideon Hydrech on
03/21/2017 regarding injuries sustained in an accident that occurred on 03/02/2017, when she
was a passenger seated on the right side of the second row seat in a minivan struck by a vehicle
while on a street. As a result of the impact, she struck her head and, injured her neck and back.
Patient was transported by ambulance to Kings County Hospital's emergency department, where
she was evaluated by the attending physician, Bernadette Colas, who ordered x-rays of the
lumbar spine, administered an APAP 325 mg tablet, and advised her to follow up with her
primary medical doctor. Subsequently, despite resting and taking over-the-counter Tylenol, her
symptoms persisted.
At the time of initial consultation with Dr. Gideon Hydrech, due to the injuries sustained in the
accident of 03/02/2017, Ms. Anderson complained of: (1) diffuse headaches and occasional
bouts of positional vertigo; (2) neck pain and limitation, with associated weakness and
numbness in both hands, right greater than left. The neck pain caused difficulty sleeping; (3)
upper back pain and limitation; and (4) lower backpain and limitation, with pain radiating to
both buttocks, right greater than left,with occasional cramping pains in both legs, right greater
than left. Sitting or standing approximately 15 minutes or walking approximately one block
caused preemptive low back pain. The low back pain caused difficulty sleeping.
Past medical history was significant for hypertension, for which she was prescribed losartan. In
approximately 2007, she underwent a cholecystectomy without sequelae. In approximately
2013, she underwent bilateral cataract surgeries without sequelae. In approximately 2016, she
sustained bilateral shoulder injuries, for which she underwent physical therapy for
approximately two months, with symptoms predominantly resolving within approximately 2-3
months without sequelae. There was no other previous significant traumatic, medical, or
surgical history.
Page 1 of 9
FILED: KINGS COUNTY CLERK 07/26/2022 04:25 PM INDEX NO. 521507/2017
NYSCEF DOC. NO. 78 RECEIVED NYSCEF: 07/26/2022
E Al f I i F ASI MI DK Al Al I b\NCF
100 Livingston Street - 2nd Floor
Brooklyn, NY 11201-5023
INITIAL EXAMINATION:
On physical examination, Patient was ambulating with her head and torso splinted.
Heel-and toe-walking were moderately to markedly limited by right lower extremity weakness.
Babinski's sign was positive on the right.
Lhermitte's sign was positive on the right.
Examination of the right ear revealed decreased audition to finger rub.
Examination of the cervicothoracic spine range of motion revealed pain with limitation of
flexion at 25-30 degrees (normal is 50 degrees), of extension at 15-20 degrees (60 degrees), of
lateral flexion to the right at 10-15 degrees (45 degrees) and to the left at 15-20 degrees (45
degrees), of rotation to the right at 35 degrees (80 degrees) and to the leftat 40 degrees (80
degrees). There was moderate to marked right and moderate leftparavertebral muscle, trapezius
muscle, and suprascapular muscle spasm from C3 to T5-6.
Examination of the thoracolumbar spine range of motion revealed pain with limitation of flexion
at 35-40 degrees (normal is 80 degrees), of extension at 0-5 degrees (25 degrees), of lateral
flexion to the right at 5 degrees (35 degrees) and to the left at 5-10 degrees (35 degrees), of
rotation to the right at 10-15 degrees (45 degrees) and to the left at 10 degrees (45 degrees).
There was moderate to marked bilateral paravertebral muscle and infrascapular muscle spasm
from T6-7 to S1, with tenderness at the leftlumbosacral junction.
Straight-leg-raising test revealed a positive Lasegue's sign at 25-30 degrees on the right (normal
is negative at 90 degrees). There was a positive flip teston the right.
On neurological sensory examination, there was paresthetic/dysesthetic sensation to pinprick
over the right cervical paravertebral muscles, right trapezius muscle, and right deltoid muscle,
most densely over the C4/C5/C6/C7 dermatomes. There was decreased sensation to pinprick
over the right lateralarm and forearm, most densely over the C5/C6/C7 dermatomes. There was
dysesthetic/paresthetic sensation to pinprick over the left arm, most densely over the C5/C6
dermatomes. There was decreased sensation to pinprick over the right lower torso and right
lower extremity, most densely over the L4/S1 dermatomes. There was dysesthetic/paresthetic
sensation to pinprick over the right lower extremity, most densely over the L5 dermatome.
Evaluation of the deep tendon reflexes revealed the brachioradialis to be +2/+3 on the right and
+3/+4 on the left,the biceps to be +1 on the right and +2/+3 on the left,the triceps to be +2/+3
Page 2 of 9
FILED: KINGS COUNTY CLERK 07/26/2022 04:25 PM INDEX NO. 521507/2017
NYSCEF DOC. NO. 78 RECEIVED NYSCEF: 07/26/2022
liF \l fH F ASI MI I Al Al I I ANCF
100 Livingston Street - 2nd Floor
Brooklyn, NY 11201-5023
on the right and +3/+4 on the left,the knee-jerks to be +1/+2 on the right and +3 on the left,and
the ankle-jerks to be trace/+1 on the right and +2/+3 on the left. The motor examination
revealed 5-/5 strength at the right finger adductors, at the right wrist extensors, and at the right
shoulder abductors, 4/5 strength at the right finger abductors and at the right elbow extensors,
and 4+/5 strength at the right elbow flexors and at the left elbow extensors. There was 4+/5
strength at the right extensor hallucis longus muscle and 4/5 strength at the right ankle invertors
and at the right knee flexors and extensors.
Initialdiagnoses were:
1. Blunt head trauma with cerebral concussion.
2. Post-concussion syndrome.
3. Cervical spine derangement with traumatic myofascitis.
4. Cervical radiculopathy and/or cervical spinal cord myelopathy.
5. Thoracic spine strain/sprain, consider derangement, consider thoracic radiculopathy
and/or thoracic spinal cord myelopathy.
6. Lumbosacral spine derangement with traumatic myofascitis.
7. Lumbar radiculopathy.
X-rays and MRIs were ordered and referred her to undergo a course of physical therapy.
TREATMENT PLAN:
During her initial evaluation with Dr. Gideon Hedrych, she was prescribed Flexeril 5 mg nightly,
Tylenol 500 mg as needed for pain. Patient was also referred to Dr. Ofra Bloner ( Physical
medicine and rehabilitation) for initiation of physical therapy and Dr. Joseph Yellin
(Neurologist) for further evaluation of radicular sypmtoms and imaging wheih included X-ray
and MRI of cervical/thoracic and lumbar spine was ordered. Patient continued conservative
managment with physical therapy and a physical therapist guided home exercise program since
her initial evaluation.
FINAL EXAMINATION:
General: Well-developed, Well-nourished female, in no acute distress.
Cervicothoracic spine: Range of motion (degrees): Pain with limitation of flexion at 25-30
degrees (normal 90 degrees), extension at 15 degrees (normal 70 degrees), lateral flexion to the
right at 15 degrees (normal 45 degrees) and lateral to the left at 15 degrees (normal 45 degrees),
rotation to the right at 45 degrees (normal 90 degrees) and rotation to the leftat 35-40 degrees
(normal 90 degrees). Mild-to-moderate bilateral paravertebral and trapezius muscle tenderness.
Negative Spurling's bilaterally. Decreased sensation over the right trapezius, right deltoid and
Page 3 of 9
FILED: KINGS COUNTY CLERK 07/26/2022 04:25 PM INDEX NO. 521507/2017
NYSCEF DOC. NO. 78 RECEIVED NYSCEF: 07/26/2022
I il \l II I \SI MI I)K \l Al I I W( I
100 Livingston Street - 2nd Floor
Brooklyn, NY 11201-5023
right upper extremity primarily over the C5, C6, and C7 dermatomes. Reflexes are 1+ at the
brachioradialis and biceps on the right and 3+ on the left, triceps 2+ bilaterally. Negative
Hoffmann's bilaterally. Manual muscle testing is 5-/5 in bilateral upper extremities.
Thoracolumbar spine: Range of motion (degrees): Pain with limitation of flexion at 25-30
degrees (normal 90 degrees), extension at 5-10 degrees (normal 40 degrees), lateral flexion to the
right at 15-20 degrees (normal 45 degrees) and lateral flexion to the left at 15-20 degrees (normal
45 degrees), rotation to the right at 20 degrees (normal 35 degrees) and rotation to the left at 20
degrees (normal 35 degrees). Mild-to-moderate bilateral paravertebral muscle tenderness.
Positive SLR bilaterally. Sensation is decreased over the right L4, L5 and S1 dermatomes. Deep
tendon reflexes at the knee is 2+ bilaterally. Manual muscle testing is 5-/5. Negative clonus
bilaterally. negative FABER and Negative FADIR.
RECORDS REVIEWED:
Initial Evaluation/Consultation report by Dr. Gideon Hedrych from 03/21/2017.
Follow-up Evaluation by Dr. Gideon Hedrych from 07/14/2021.
Initial Evaluation by Dr. Ofra Blonder on 03/27/2017
RADIOLOGY:
I personally reviewed the following diagnostic imaging studies:
X-rays performed on 03/30/2017 were read by the radiologist: Cervical spine as: "C2-3 through
formation."
C5-6 anterior bridging osteophyte Thoracic spine as: "Multilevel anterior and
formation."
marginal osteophyte Lumbosacral spine as: "(1) Anterior and marginal hypertrophic
quadrant."
changes at Ll-2 through L5/Sl; and (2) Post-surgical changes in the right upper
An MRI of the cervical spine performed on 04/04/2017 was read by the radiologist as: "C3-4,
C5-6, and C6-7 disc herniations deforming the thecal sac with C3-4 and C5-6 cord abutment,
C3-4 left neural foraminal extension and C6-7 right neural foraminal extension abutting the
exiting nerve roots, C3-4 bilateral neural foraminal narrowing, C6-7 right neural foraminal
narrowing, and C3-4 and C5-6 mild central spinal stenosis in conjunction with hypertrophic
narrowing."
changes. C2-3 and C4-5 disc bulges with C4-5 right neural foraminal
An MRI of the thoracic spine performed on 04/04/2017 was read by the radiologist as: "T2-3
Dextroscoliosis."
right paracentral disc bulge.
An MRI of the lumbar spine performed on 04/04/2017 was read by the radiologist as: "L5/S1,
L4-5, and L3-4 disc herniations deforming the thecal sac with bilateral neural foraminal
Page 4 of 9
FILED: KINGS COUNTY CLERK 07/26/2022 04:25 PM INDEX NO. 521507/2017
NYSCEF DOC. NO. 78 RECEIVED NYSCEF: 07/26/2022
MF Al FM FASI MF DK \I Al I I CF
100 Livingston Street - 2nd Floor
Brooklyn, NY 11201-5023
extension (leftgreater than right at both L4-5 and L3-4), with L5/S1 abutment of the proximal Sl
nerve roots bilaterally. L2-3 disc bulge deforming the thecal sac with bilateral neural foraminal
levoscoliosis."
extension. Mild
Somatosensory Evoked Potential (SSEP) studies of the upper and lower extremities performed
on 04/26/2018 were read by the neurologist as: "This is a normal bilateral median nerve SEP
study."
study. This is a normal bilateral tibial nerve SEP
EMG/NCV (Electromyogram/Nerve Conduction Velocity) studies of the upper and lower
extremities performed on 05/08/2018 were read by the neurologist as: "The above
electrodiagnostic study reveals evidence of a bilateral median nerve neuropathy at the wrist, right
more so than left. This is consistent with the clinical diagnosis of carpal tunnel syndrome.
only."
Patient was seen for diagnostic testing
Assessments causally related to the MVA on 03/02/2017.
1. Cervical spine derangement
2. Thoracic spine strain/sprain
3. Lumbosacral spine derangement
Given the medical records, history, examinations, consultations, electrodiagnostic studies, and
imaging studies performed to date, I can state with medical certainty that Ms. Anderson was
significantly injured in the accident of 03/02/2017. Her injuries have altered her ability to
function as she did prior to the accident and will result in chronic and exacerbative symptoms,
with limitations upon her activities of daily living.
Ms. Anderson has objective MRI-proven evidence in her cervical spine of C2-3 and C4-5 disc
bulges, a C3-4 disc herniation abutting the spinal cord with left neural foraminal extension
abutting the leftC4 nerve root, a C5-6 disc herniation abutting the spinal cord, and a C6-7 disc
herniation With right neural foraminal extension abutting the right C7 nerve root, which are
producing objective clinical evidence of a cervical radiculopathy, an injury to the nerve roots in
the cervical spine, and of a cervical spinal cord myelopathy, an injury to the spinal cord at the
cervical spine level, the objective evidence for which includes the herniated disc at C3-4 abutting
the left C4 nerve root, the herniated disc at C5-6 abutting the spinal cord, and the herniated disc
at C6-7 abutting the right C7 nerve root, diffuse diminished and altered sensation in the right
upper extremity, diffuse altered sensation in the left upper extremity, and diffuse diminished and
altered sensation in the right lower extremity, diffuse motor deficits in both upper extremities
Page 5 of 9
FILED: KINGS COUNTY CLERK 07/26/2022 04:25 PM INDEX NO. 521507/2017
NYSCEF DOC. NO. 78 RECEIVED NYSCEF: 07/26/2022
I I \I f l F ASI \ll l )K Al Al I IANCF
100 Livingston Street - 2nd Floor
Brooklyn, NY 11201-5023
and in the right lower extremity, and hyperreflexia in both upper extremities and in both lower
extremities. This is a permanent condition directly attributable to the trauma of 03/02/2017.
Ms. Anderson also has objective MRI-proven evidence in her lumbosacral spine of an L5/S1 disc
herniation abutting the S1 nerve roots, an L4-5 disc herniation with bilateral neural foraminal
extension, an L3-4 disc herniation with bilateral neural foraminal extension, and an L2-3 disc
bulge with bilateral neural foraminal extension, which are producing objective clinical evidence
of a lumbar radiculopathy. This is also directly attributable to the trauma of 03/02/2017.
Itis my opinion, to a reasonable degree of medical certainty, that Ms. Anderson's injuries and
residual symptoms, as described above; are causally related to the accident of 03/02/2017.
Within reasonable medical probability, the multiple injuries sustained by the patient arose from
the mechanism of injury from the MVA that occurred on 03/02/2017. Within reasonable degree
of medical probability, the patient has the above diagnoses due to the motor vehicle accident
which are chronic and permanent in nature.
Sincerely,
Hossam Eldin Mohamed, M.D.
Electronically signed by Hossam Mohamed on 6/20/2022 9:24:54 AM.
Job#: 637908949339404970 & 637908975832084890
Skycliff
Date of Dictation: 06/15/2022
Date of Transcription: 06/16/2022
Page 6 of 9
FILED: KINGS COUNTY CLERK 07/26/2022 04:25 PM INDEX NO. 521507/2017
NYSCEF DOC. NO. 78 RECEIVED NYSCEF: 07/26/2022
Index No.: 521507/2017
SUPREME COURT OF THE STATE OF NEW YORK
COUNTY OF KINGS
-------------------------------------------------------------------------
YVONNE ANDERSON,
Plaintiff,
-against-
COURTNEY S. ROBINSON, HEART TO HEART SOCIAL ADULT SERVICES LLC
and ABDOURAHAMANE DIALLO,
Defendants.
---....--------------------------------------------------------------------------------
AFFIRMATION IN OPPOSITION
EXHIBITS
--------------__-----__ _-------.------------------------------------------------
ROSS AND HILL, ESQS.
Attorneys for Plaintif
Off ice and Post OBice Address
16 Court 35th FlOOr
Street,
Brooldyn, New York 11241
Tel (718) 855-2324
Fax (718) 855-4617
_ _ ___----- __-.__..-------------------------------------------------------------------
To: Service of a copy of the within
is hereby admitted.
Dated:
Attorney(s)for
--------------------------------------------------..----------------------
Preview
FILED: KINGS COUNTY CLERK 07/26/2022 04:25 PM INDEX NO. 521507/2017 NYSCEF DOC. NO. 78 RECEIVED NYSCEF: 07/26/2022 EXHIBIT E FILED: KINGS COUNTY CLERK 07/26/2022 04:25 PM INDEX NO. 521507/2017 NYSCEF DOC. NO. 78 RECEIVED NYSCEF: 07/26/2022 SUPREME COURT OF THE STATE OF NEW YORK COUNTY OF KINGS -----------------------------------------------------X Index No.: 521507/2017 YVONNE ANDERSON, Plaintiff, -against- PHYSICIAN AFFIRMATIQN COURTNEY S. ROBINSON, HEART TO HEART SOCIAL ADULT SERVICES LLC and ABDOURAHAMANE DIALLO, Defendants. _________ _ ___ -_____________ _ ________..----Ç STATE OF NEW YORK, COUNTY OF KINGS) S.S.: I, Hossam Mohamed, M.D. of HEALTHEAST MEDICAL ALLIANCE, a licensed physician in the State of New York, pursuant to CPLR 2106, do hereby affirm to be true, under penalties of perjury, that the annexed medical reports of YVONNE ANDERSON dated June 14, 2022 was prepared and is the work product of the undersigned and is true to the best of my knowledge and information. All range of motion testing were performed with a handheld goniometer, and all normal values are in accordance with the American Association of Orthopedic Surgeons. Affirmed this _L3__ day of 2022 Hos amed, M.D. FILED: KINGS COUNTY CLERK 07/26/2022 04:25 PM INDEX NO. 521507/2017 NYSCEF DOC. NO. 78 RECEIVED NYSCEF: 07/26/2022 I 4 \l I WI \ll I K \l \l I l\V I 100 Livingston Street - 2nd Floor Brooklyn, NY 11201-5023 DOS: June 14, 2022 NARRATIVE REPORT PATIENT NAME: Anderson, Yvonne CASE#: Y220177060_1 DATE OF BIRTH: 07/12/1943 DATE OF ACCIDENT: 03/02/2017 HISTORY: This patient, a 77-year-old female, was initially seen in consultation by Dr. Gideon Hydrech on 03/21/2017 regarding injuries sustained in an accident that occurred on 03/02/2017, when she was a passenger seated on the right side of the second row seat in a minivan struck by a vehicle while on a street. As a result of the impact, she struck her head and, injured her neck and back. Patient was transported by ambulance to Kings County Hospital's emergency department, where she was evaluated by the attending physician, Bernadette Colas, who ordered x-rays of the lumbar spine, administered an APAP 325 mg tablet, and advised her to follow up with her primary medical doctor. Subsequently, despite resting and taking over-the-counter Tylenol, her symptoms persisted. At the time of initial consultation with Dr. Gideon Hydrech, due to the injuries sustained in the accident of 03/02/2017, Ms. Anderson complained of: (1) diffuse headaches and occasional bouts of positional vertigo; (2) neck pain and limitation, with associated weakness and numbness in both hands, right greater than left. The neck pain caused difficulty sleeping; (3) upper back pain and limitation; and (4) lower backpain and limitation, with pain radiating to both buttocks, right greater than left,with occasional cramping pains in both legs, right greater than left. Sitting or standing approximately 15 minutes or walking approximately one block caused preemptive low back pain. The low back pain caused difficulty sleeping. Past medical history was significant for hypertension, for which she was prescribed losartan. In approximately 2007, she underwent a cholecystectomy without sequelae. In approximately 2013, she underwent bilateral cataract surgeries without sequelae. In approximately 2016, she sustained bilateral shoulder injuries, for which she underwent physical therapy for approximately two months, with symptoms predominantly resolving within approximately 2-3 months without sequelae. There was no other previous significant traumatic, medical, or surgical history. Page 1 of 9 FILED: KINGS COUNTY CLERK 07/26/2022 04:25 PM INDEX NO. 521507/2017 NYSCEF DOC. NO. 78 RECEIVED NYSCEF: 07/26/2022 E Al f I i F ASI MI DK Al Al I b\NCF 100 Livingston Street - 2nd Floor Brooklyn, NY 11201-5023 INITIAL EXAMINATION: On physical examination, Patient was ambulating with her head and torso splinted. Heel-and toe-walking were moderately to markedly limited by right lower extremity weakness. Babinski's sign was positive on the right. Lhermitte's sign was positive on the right. Examination of the right ear revealed decreased audition to finger rub. Examination of the cervicothoracic spine range of motion revealed pain with limitation of flexion at 25-30 degrees (normal is 50 degrees), of extension at 15-20 degrees (60 degrees), of lateral flexion to the right at 10-15 degrees (45 degrees) and to the left at 15-20 degrees (45 degrees), of rotation to the right at 35 degrees (80 degrees) and to the leftat 40 degrees (80 degrees). There was moderate to marked right and moderate leftparavertebral muscle, trapezius muscle, and suprascapular muscle spasm from C3 to T5-6. Examination of the thoracolumbar spine range of motion revealed pain with limitation of flexion at 35-40 degrees (normal is 80 degrees), of extension at 0-5 degrees (25 degrees), of lateral flexion to the right at 5 degrees (35 degrees) and to the left at 5-10 degrees (35 degrees), of rotation to the right at 10-15 degrees (45 degrees) and to the left at 10 degrees (45 degrees). There was moderate to marked bilateral paravertebral muscle and infrascapular muscle spasm from T6-7 to S1, with tenderness at the leftlumbosacral junction. Straight-leg-raising test revealed a positive Lasegue's sign at 25-30 degrees on the right (normal is negative at 90 degrees). There was a positive flip teston the right. On neurological sensory examination, there was paresthetic/dysesthetic sensation to pinprick over the right cervical paravertebral muscles, right trapezius muscle, and right deltoid muscle, most densely over the C4/C5/C6/C7 dermatomes. There was decreased sensation to pinprick over the right lateralarm and forearm, most densely over the C5/C6/C7 dermatomes. There was dysesthetic/paresthetic sensation to pinprick over the left arm, most densely over the C5/C6 dermatomes. There was decreased sensation to pinprick over the right lower torso and right lower extremity, most densely over the L4/S1 dermatomes. There was dysesthetic/paresthetic sensation to pinprick over the right lower extremity, most densely over the L5 dermatome. Evaluation of the deep tendon reflexes revealed the brachioradialis to be +2/+3 on the right and +3/+4 on the left,the biceps to be +1 on the right and +2/+3 on the left,the triceps to be +2/+3 Page 2 of 9 FILED: KINGS COUNTY CLERK 07/26/2022 04:25 PM INDEX NO. 521507/2017 NYSCEF DOC. NO. 78 RECEIVED NYSCEF: 07/26/2022 liF \l fH F ASI MI I Al Al I I ANCF 100 Livingston Street - 2nd Floor Brooklyn, NY 11201-5023 on the right and +3/+4 on the left,the knee-jerks to be +1/+2 on the right and +3 on the left,and the ankle-jerks to be trace/+1 on the right and +2/+3 on the left. The motor examination revealed 5-/5 strength at the right finger adductors, at the right wrist extensors, and at the right shoulder abductors, 4/5 strength at the right finger abductors and at the right elbow extensors, and 4+/5 strength at the right elbow flexors and at the left elbow extensors. There was 4+/5 strength at the right extensor hallucis longus muscle and 4/5 strength at the right ankle invertors and at the right knee flexors and extensors. Initialdiagnoses were: 1. Blunt head trauma with cerebral concussion. 2. Post-concussion syndrome. 3. Cervical spine derangement with traumatic myofascitis. 4. Cervical radiculopathy and/or cervical spinal cord myelopathy. 5. Thoracic spine strain/sprain, consider derangement, consider thoracic radiculopathy and/or thoracic spinal cord myelopathy. 6. Lumbosacral spine derangement with traumatic myofascitis. 7. Lumbar radiculopathy. X-rays and MRIs were ordered and referred her to undergo a course of physical therapy. TREATMENT PLAN: During her initial evaluation with Dr. Gideon Hedrych, she was prescribed Flexeril 5 mg nightly, Tylenol 500 mg as needed for pain. Patient was also referred to Dr. Ofra Bloner ( Physical medicine and rehabilitation) for initiation of physical therapy and Dr. Joseph Yellin (Neurologist) for further evaluation of radicular sypmtoms and imaging wheih included X-ray and MRI of cervical/thoracic and lumbar spine was ordered. Patient continued conservative managment with physical therapy and a physical therapist guided home exercise program since her initial evaluation. FINAL EXAMINATION: General: Well-developed, Well-nourished female, in no acute distress. Cervicothoracic spine: Range of motion (degrees): Pain with limitation of flexion at 25-30 degrees (normal 90 degrees), extension at 15 degrees (normal 70 degrees), lateral flexion to the right at 15 degrees (normal 45 degrees) and lateral to the left at 15 degrees (normal 45 degrees), rotation to the right at 45 degrees (normal 90 degrees) and rotation to the leftat 35-40 degrees (normal 90 degrees). Mild-to-moderate bilateral paravertebral and trapezius muscle tenderness. Negative Spurling's bilaterally. Decreased sensation over the right trapezius, right deltoid and Page 3 of 9 FILED: KINGS COUNTY CLERK 07/26/2022 04:25 PM INDEX NO. 521507/2017 NYSCEF DOC. NO. 78 RECEIVED NYSCEF: 07/26/2022 I il \l II I \SI MI I)K \l Al I I W( I 100 Livingston Street - 2nd Floor Brooklyn, NY 11201-5023 right upper extremity primarily over the C5, C6, and C7 dermatomes. Reflexes are 1+ at the brachioradialis and biceps on the right and 3+ on the left, triceps 2+ bilaterally. Negative Hoffmann's bilaterally. Manual muscle testing is 5-/5 in bilateral upper extremities. Thoracolumbar spine: Range of motion (degrees): Pain with limitation of flexion at 25-30 degrees (normal 90 degrees), extension at 5-10 degrees (normal 40 degrees), lateral flexion to the right at 15-20 degrees (normal 45 degrees) and lateral flexion to the left at 15-20 degrees (normal 45 degrees), rotation to the right at 20 degrees (normal 35 degrees) and rotation to the left at 20 degrees (normal 35 degrees). Mild-to-moderate bilateral paravertebral muscle tenderness. Positive SLR bilaterally. Sensation is decreased over the right L4, L5 and S1 dermatomes. Deep tendon reflexes at the knee is 2+ bilaterally. Manual muscle testing is 5-/5. Negative clonus bilaterally. negative FABER and Negative FADIR. RECORDS REVIEWED: Initial Evaluation/Consultation report by Dr. Gideon Hedrych from 03/21/2017. Follow-up Evaluation by Dr. Gideon Hedrych from 07/14/2021. Initial Evaluation by Dr. Ofra Blonder on 03/27/2017 RADIOLOGY: I personally reviewed the following diagnostic imaging studies: X-rays performed on 03/30/2017 were read by the radiologist: Cervical spine as: "C2-3 through formation." C5-6 anterior bridging osteophyte Thoracic spine as: "Multilevel anterior and formation." marginal osteophyte Lumbosacral spine as: "(1) Anterior and marginal hypertrophic quadrant." changes at Ll-2 through L5/Sl; and (2) Post-surgical changes in the right upper An MRI of the cervical spine performed on 04/04/2017 was read by the radiologist as: "C3-4, C5-6, and C6-7 disc herniations deforming the thecal sac with C3-4 and C5-6 cord abutment, C3-4 left neural foraminal extension and C6-7 right neural foraminal extension abutting the exiting nerve roots, C3-4 bilateral neural foraminal narrowing, C6-7 right neural foraminal narrowing, and C3-4 and C5-6 mild central spinal stenosis in conjunction with hypertrophic narrowing." changes. C2-3 and C4-5 disc bulges with C4-5 right neural foraminal An MRI of the thoracic spine performed on 04/04/2017 was read by the radiologist as: "T2-3 Dextroscoliosis." right paracentral disc bulge. An MRI of the lumbar spine performed on 04/04/2017 was read by the radiologist as: "L5/S1, L4-5, and L3-4 disc herniations deforming the thecal sac with bilateral neural foraminal Page 4 of 9 FILED: KINGS COUNTY CLERK 07/26/2022 04:25 PM INDEX NO. 521507/2017 NYSCEF DOC. NO. 78 RECEIVED NYSCEF: 07/26/2022 MF Al FM FASI MF DK \I Al I I CF 100 Livingston Street - 2nd Floor Brooklyn, NY 11201-5023 extension (leftgreater than right at both L4-5 and L3-4), with L5/S1 abutment of the proximal Sl nerve roots bilaterally. L2-3 disc bulge deforming the thecal sac with bilateral neural foraminal levoscoliosis." extension. Mild Somatosensory Evoked Potential (SSEP) studies of the upper and lower extremities performed on 04/26/2018 were read by the neurologist as: "This is a normal bilateral median nerve SEP study." study. This is a normal bilateral tibial nerve SEP EMG/NCV (Electromyogram/Nerve Conduction Velocity) studies of the upper and lower extremities performed on 05/08/2018 were read by the neurologist as: "The above electrodiagnostic study reveals evidence of a bilateral median nerve neuropathy at the wrist, right more so than left. This is consistent with the clinical diagnosis of carpal tunnel syndrome. only." Patient was seen for diagnostic testing Assessments causally related to the MVA on 03/02/2017. 1. Cervical spine derangement 2. Thoracic spine strain/sprain 3. Lumbosacral spine derangement Given the medical records, history, examinations, consultations, electrodiagnostic studies, and imaging studies performed to date, I can state with medical certainty that Ms. Anderson was significantly injured in the accident of 03/02/2017. Her injuries have altered her ability to function as she did prior to the accident and will result in chronic and exacerbative symptoms, with limitations upon her activities of daily living. Ms. Anderson has objective MRI-proven evidence in her cervical spine of C2-3 and C4-5 disc bulges, a C3-4 disc herniation abutting the spinal cord with left neural foraminal extension abutting the leftC4 nerve root, a C5-6 disc herniation abutting the spinal cord, and a C6-7 disc herniation With right neural foraminal extension abutting the right C7 nerve root, which are producing objective clinical evidence of a cervical radiculopathy, an injury to the nerve roots in the cervical spine, and of a cervical spinal cord myelopathy, an injury to the spinal cord at the cervical spine level, the objective evidence for which includes the herniated disc at C3-4 abutting the left C4 nerve root, the herniated disc at C5-6 abutting the spinal cord, and the herniated disc at C6-7 abutting the right C7 nerve root, diffuse diminished and altered sensation in the right upper extremity, diffuse altered sensation in the left upper extremity, and diffuse diminished and altered sensation in the right lower extremity, diffuse motor deficits in both upper extremities Page 5 of 9 FILED: KINGS COUNTY CLERK 07/26/2022 04:25 PM INDEX NO. 521507/2017 NYSCEF DOC. NO. 78 RECEIVED NYSCEF: 07/26/2022 I I \I f l F ASI \ll l )K Al Al I IANCF 100 Livingston Street - 2nd Floor Brooklyn, NY 11201-5023 and in the right lower extremity, and hyperreflexia in both upper extremities and in both lower extremities. This is a permanent condition directly attributable to the trauma of 03/02/2017. Ms. Anderson also has objective MRI-proven evidence in her lumbosacral spine of an L5/S1 disc herniation abutting the S1 nerve roots, an L4-5 disc herniation with bilateral neural foraminal extension, an L3-4 disc herniation with bilateral neural foraminal extension, and an L2-3 disc bulge with bilateral neural foraminal extension, which are producing objective clinical evidence of a lumbar radiculopathy. This is also directly attributable to the trauma of 03/02/2017. Itis my opinion, to a reasonable degree of medical certainty, that Ms. Anderson's injuries and residual symptoms, as described above; are causally related to the accident of 03/02/2017. Within reasonable medical probability, the multiple injuries sustained by the patient arose from the mechanism of injury from the MVA that occurred on 03/02/2017. Within reasonable degree of medical probability, the patient has the above diagnoses due to the motor vehicle accident which are chronic and permanent in nature. Sincerely, Hossam Eldin Mohamed, M.D. Electronically signed by Hossam Mohamed on 6/20/2022 9:24:54 AM. Job#: 637908949339404970 & 637908975832084890 Skycliff Date of Dictation: 06/15/2022 Date of Transcription: 06/16/2022 Page 6 of 9 FILED: KINGS COUNTY CLERK 07/26/2022 04:25 PM INDEX NO. 521507/2017 NYSCEF DOC. NO. 78 RECEIVED NYSCEF: 07/26/2022 Index No.: 521507/2017 SUPREME COURT OF THE STATE OF NEW YORK COUNTY OF KINGS ------------------------------------------------------------------------- YVONNE ANDERSON, Plaintiff, -against- COURTNEY S. ROBINSON, HEART TO HEART SOCIAL ADULT SERVICES LLC and ABDOURAHAMANE DIALLO, Defendants. ---....-------------------------------------------------------------------------------- AFFIRMATION IN OPPOSITION EXHIBITS --------------__-----__ _-------.------------------------------------------------ ROSS AND HILL, ESQS. Attorneys for Plaintif Off ice and Post OBice Address 16 Court 35th FlOOr Street, Brooldyn, New York 11241 Tel (718) 855-2324 Fax (718) 855-4617 _ _ ___----- __-.__..------------------------------------------------------------------- To: Service of a copy of the within is hereby admitted. Dated: Attorney(s)for --------------------------------------------------..----------------------