Preview
Filing # 97652142 E-Filed 10/22/2019 10:49:53 AM
IN THE CIRCUIT COURT OF THE
15TH JUDICIAL CIRCUIT IN AND FOR
PALM BEACH COUNTY, FLORIDA
CASE NO. 50-2018-CA-15763-XXXX-MB
ELIZABETH L. BALZARANO, Individually,
and as Personal Representative of the ESTATE
OF MICHELLE L. BALZARANO,
Plaintiff(s),
vs.
LIFELINE RECOVERY, LLC d/b/a LIFELINE
RECOVERY SUPPORT SERVICES a Foreign
Corporation; JOHN BROGAN; LIFE CHANGES
ADDICTION TREATMENT CENTER OF THE
PALM BEACHES; AND CAMERON VILLA,
LLC, a Florida Corporation,
Defendant(s),
/
NOTICE OF PRODUCTION FROM NON-PARTY
TO ALL PARTIES:
YOU ARE NOTIFIED that after 10 days from the date of service of this Notice, if
service is by delivery or Electronic service, if no objection is received from any party, the
undersigned will issue or apply to the clerk of this court for issuance of the attached subpoena(s)
directed to:
1) DR. SCOTT AFTEL
2) DR. KENNETH FAISTL
who are not parties, to produce the items listed at the time and place specified in the subpoena(s),
REF. # 47360
DES2
*** FILED: PALM BEACH COUNTY, FL SHARON R BOCK, CLERK. 10/22/2019 10:49:53 AM ***CERTIFICATE OF SERVICE
I HEREBY CERTIFY that on the OB. day of October, 2019, a true and correct copy
of the foregoing has been furnished by electronic mail (email) at e-mail address: THOMAS
SCOLARO, ESQUIRE, LEESFIELD SCOLARO, 2350 $. DIXIE HIGHWAY, MIAMI, FL
331332314, (305)854-4900, Primary Email: scolaro@leesfieldcom, WILLIAM P.
MCCAUGHAN, ESQUIRE, FARRELL PATEL JOMARRON & LOPEZ, 4300 BISCAYNE
BOULEVARD SUITE 305, MIAMI, FL 33137, (305)717-7530, Primary Email:
eservice@justice360.com, Secondary e-mail: wmccaughan@justice360.com; THOMAS D.
GRAHAM, ESQUIRE, LEESFIELD SCOLARO, 2350 S. DIXIE HIGHWAY, MIAMI, FL
33133, (305)854-4900, Primary Email: graham@leesfield.com; and 1 electronically filed the
foregoing with the Clerk of PALM BEACH COUNTY by using the Florida courts eFiling Portal.
COLE, SCOTT & KISSANE, P.A.
Counsel for Defendant Life Changes Addiction
Treatment Center of The Palm Beaches
Cole, Scott & Kissane Building
9150 South Dadeland Boulevard, Suite 1400
P.O. Box 569015
Miami, Florida 33256
Telephone (305) 350-5354
Facsimile (305) 373-2294
Primary e-mail: jonathan. midwall@csklegal.com
Secondary e-mail: alyssa.tornberg@csklegal.com
By: — /s/ Jonathan M. Midwall
JONATHAN M. MIDWALL
Florida Bar No.: 182011
ALYSSA M. TORNBERG, ESQUIRE
Florida Bar No. 127409
REF. # 47360
DES3CERTIFICATE OF HIPAA SATISFACTORY ASSURANCES
(This certification must be completed fully and signed by an attorney to be valid.)
ELIZABETH L. BALZARANO, Individually, and as Personal Representative, 50-2018-CA-15763-XXX
et.al. vs. LIFELINE RECOVERY, LLC d/b/a LIFELINE RECOVERY (Docket Number)
SUPPORT SERVICES, et. al.
(Case Name)
MICHELE BALZARANO NA
(Patient Name) (Pat Med Rec/Acct No.)
CERTIFICATION
I hereby certify that the representations below are true and correct based upon my personal knowledge; that I have reviewed
the applicable privacy regulations of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), 45 CFR Parts 160 and
164; that | have complied with the regulations and its requirements to obtain patient health information; and that I will comply with
state and federal privacy laws as to any patient health information that I receive. { further certify the following;
1, [ have used reasonable efforts and made a good faith attempt to notify patient or personal representative in writing
by serving written notice of my intent to obtain patient’s health information to patient or personal representative at
this address: Primary Email: scolaro@leesfield.com; 2350 8, DIXIE HIGHWAY, MIAMI, FL 331332314 (or if
patient’s location is unknown, to mail a notice to the patient’s last known address listed above) by e-mail and/or
mail on . (Date)
2, This written notice provided sufficient information about this litigation or proceeding in which the patient's health
information is requested to permit the patient or personal representative to raise objections in the appropriate court
or administrative tribunal within the required time under Fla.R.Civ.P. 1.351 or other applicable rule from the date of
service of the notice of intent,
3. The deadline for the patient or personal representative to object to the notice of intent under Fla.R.Civ.P. 1.351 or
other applicable rule was set forth in the notice, which indicated that the deadline expired on
. (Date)
4, Objections (Must initial one.)
A. Patient or personal representative did not file any objections.
OR
B. Patient or personal representative filed objections with the court or administrative tribunal; the
objections have been resolved by the court or administrative tribunal; there are no further
objections pending or requiring resolution; and the disclosures of patient health information being
sought are consistent with such resolution(s).
5, Ihave attached the subpoena or other lawful process, and the notice of intent with this certification.
Signature of Atiorney Date
MUST BEAR SIGNATURE OF ATTORNEY ONLY
JONATHAN M. MIDWALL, ESQUIRE
Florida Bar No. 182011
ALYSSA M. TORNBERG, ESQUIRE,
Florida Bar No. 127409
COLE, SCOTT & KISSANE, P.A.
Attorneys For Defendant(s)
(305)350-5300
REF. # 47360
DES54IN THE CIRCUIT COURT OF THE
15TH JUDICIAL CIRCUIT IN AND FOR
PALM BEACH COUNTY, FLORIDA
CASE NO, 50-2018-CA-15763-XXXX-MB
ELIZABETH L. BALZARANO, Individually,
and as Personal Representative of the ESTATE
OF MICHELLE L. BALZARANO,
Plaintiff(s),
vs.
LIFELINE RECOVERY, LLC d/b/a LIFELINE
RECOVERY SUPPORT SERVICES a Foreign
Corporation; JOHN BROGAN; LIFE CHANGES
ADDICTION TREATMENT CENTER OF THE
PALM BEACHES; AND CAMERON VILLA,
LLC, a Florida Corporation,
Defendant(s),
/
SUBPOENA DUCES TECUM WITHOUT DEPOSITION
(RECORDS MAIL IN ONLY)
THE STATE OF FLORIDA:
To: The Records Custodian for:
DR. SCOTT AFTEL
28 EAST 32ND STREET
BAYONNE, NJ 07002
YOU ARE COMMANDED to furnish via U.S. Mail delivery to THE MCS GROUP, INC.,
7925 NW 12TH STREET, SUITE 318, MIAMI, FL 33126 on December 02, 2019 at 9:00 a.m., and to
have with you at that time and place the following:
Entire medical file, including but not limited to any and all records, including, but not
limited to, psychiatric/psychological records, drug abuse and alcohol abuse records,
rehabilitation records, therapy records, intake sheets, correspondence to and from the consulting
and treating physicians, files, memoranda, handwritten notes, history and physical reports,
medication/prescription records, intra-operative photos and video tapes, including any and all
such items as may be stored in a computer database or otherwise in electronic form, relating to
any examination, diagnosis or treatment pertaining to: MICHELE BALZARANO, DOB:
03/10/1983.
These items will be inspected and may be copied at that time. You will not be required to
surrender the original items. You may comply with this subpoena by providing legible copies of the
items to be produced to THE MCS GROUP, INC., on behalf of the attorney whose name appears on
this subpoena on or before the scheduled date of production. You may condition the preparation of the
REF. #47360
SUI4copies upon the payment in advance of the reasonable cost of preparation. You may mail or deliver
the copies to THE MCS GROUP, INC., at 7925 NW 12TH STREET, SUITE 318, MIAMI, FL 33126
and thereby eliminate your appearance at the time and place specified above. Prior approval required
for fees in excess of $100.00. You have the right to object to the production pursuant to this subpoena
at any time before production by giving written notice to THE MCS GROUP, INC. THIS WILL NOT
BE A DEPOSITION. NO TESTIMONY WILL BE TAKEN.
If you fail to:
a) appear as specified; or
(2) furnish the records instead of appearing as provided above; or
(3) object to this subpoena,
you may be in contempt of court. You are subpoenaed to appear by the following attorney, and unless
excused from this subpoena by this attorney or the court, you shall respond to this subpoena as
directed.
DATED ON
JONATHAN M. MIDWALL, ESQUIRE
Florida Bar No. 182011
ALYSSA M,. TORNBERG, ESQUIRE
Florida Bar No. 127409
COLE, SCOTT & KISSANE, P.A.
Attorneys for Defendant(s)
c/o THE MCS GROUP, INC,
7925 NW 12TH STREET, SUITE 318
MIAMI, FL 33126
(305)374-1166
REF, # 47360
sui4IN THE CIRCUIT COURT OF THE
15TH JUDICIAL CIRCUIT IN AND FOR
PALM BEACH COUNTY, FLORIDA
CASE NO. 50-2018-CA-15763-XXXX-MB
ELIZABETH L. BALZARANO, Individually,
and as Personal Representative of the ESTATE
OF MICHELLE L. BALZARANO,
Plaintifi(s),
VS.
LIFELINE RECOVERY, LLC d/b/a LIFELINE
RECOVERY SUPPORT SERVICES a Foreign
Corporation; JOHN BROGAN; LIFE CHANGES
ADDICTION TREATMENT CENTER OF THE
PALM BEACHES; AND CAMERON VILLA,
LLC, a Florida Corporation,
Defendant(s),
/
SUBPOENA DUCES TECUM WITHOUT DEPOSITION
(RECORDS MAIL IN ONLY)
THE STATE OF FLORIDA:
To: The Records Custodian for:
DR. KENNETH FAISTL
27 §. COOKS BRIDGE ROAD
SUITE 1-4
JACKSON TOWNSHIP, NJ 08527
YOU ARE COMMANDED to furnish via U.S. Mail delivery to THE MCS GROUP, INC.,
7925 NW 12TH STREET, SUITE 318, MIAMI, FL 33126 on December 02, 2019 at 9:00 a.m., and to
have with you at that time and place the following:
Entire medical file, including but not limited to any and all records,
psychiatric/psychological records, drug abuse and alcohol abuse records, rehabilitation records,
therapy records, intake sheets, correspondence to and from the consulting and treating
physicians, files, memoranda, handwritten notes, history and physical reports,
medication/prescription records, intra-operative photos and video tapes, including any and all
such items as may be stored in a computer database or otherwise in electronic form, relating to
any examination, diagnosis or treatment pertaining to: MICHELE BALZARANO, DOB:
03/10/1983.
These items will be inspected and may be copied at that time. You will not be required to
surrender the original items. You may comply with this subpoena by providing legible copies of the
items to be produced to THE MCS GROUP, INC., on behalf of the attorney whose name appears on
REF. # 47360
SUI4this subpoena on or before the scheduled date of production. You may condition the preparation of the
copies upon the payment in advance of the reasonable cost of preparation, You may mail or deliver
the copies to THE MCS GROUP, INC., at 7925 NW 12TH STREET, SUITE 318, MIAMI, FL 33126
and thereby eliminate your appearance at the time and place specified above. Prior approval required
for fees in excess of $100.00. You have the right to object to the production pursuant to this subpoena
at any time before production by giving written notice to THE MCS GROUP, INC. THIS WILL NOT
BE A DEPOSITION. NO TESTIMONY WILL BE TAKEN.
If you fail to:
5) appear as specified; or
(2) _ furnish the records instead of appearing as provided above; or
(3) object to this subpoena,
you may be in contempt of court. You are subpoenaed to appear by the following attorney, and unless
excused from this subpoena by this attorney or the court, you shall respond to this subpoena as
directed.
DATED ON.
JONATHAN M. MIDWALL, ESQUIRE
Florida Bar No. 182011
ALYSSA M. TORNBERG, ESQUIRE
Florida Bar No. 127409
COLE, SCOTT & KISSANE, P.A.
Attorneys for Defendant(s)
c/o THE MCS GROUP, INC.
7925 NW 12TH STREET, SUITE 318
MIAMI, FL 33126
(305)374-1166
REF. # 47360
SUI4
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Filing # 97652142 E-Filed 10/22/2019 10:49:53 AM IN THE CIRCUIT COURT OF THE 15TH JUDICIAL CIRCUIT IN AND FOR PALM BEACH COUNTY, FLORIDA CASE NO. 50-2018-CA-15763-XXXX-MB ELIZABETH L. BALZARANO, Individually, and as Personal Representative of the ESTATE OF MICHELLE L. BALZARANO, Plaintiff(s), vs. LIFELINE RECOVERY, LLC d/b/a LIFELINE RECOVERY SUPPORT SERVICES a Foreign Corporation; JOHN BROGAN; LIFE CHANGES ADDICTION TREATMENT CENTER OF THE PALM BEACHES; AND CAMERON VILLA, LLC, a Florida Corporation, Defendant(s), / NOTICE OF PRODUCTION FROM NON-PARTY TO ALL PARTIES: YOU ARE NOTIFIED that after 10 days from the date of service of this Notice, if service is by delivery or Electronic service, if no objection is received from any party, the undersigned will issue or apply to the clerk of this court for issuance of the attached subpoena(s) directed to: 1) DR. SCOTT AFTEL 2) DR. KENNETH FAISTL who are not parties, to produce the items listed at the time and place specified in the subpoena(s), REF. # 47360 DES2 *** FILED: PALM BEACH COUNTY, FL SHARON R BOCK, CLERK. 10/22/2019 10:49:53 AM ***CERTIFICATE OF SERVICE I HEREBY CERTIFY that on the OB. day of October, 2019, a true and correct copy of the foregoing has been furnished by electronic mail (email) at e-mail address: THOMAS SCOLARO, ESQUIRE, LEESFIELD SCOLARO, 2350 $. DIXIE HIGHWAY, MIAMI, FL 331332314, (305)854-4900, Primary Email: scolaro@leesfieldcom, WILLIAM P. MCCAUGHAN, ESQUIRE, FARRELL PATEL JOMARRON & LOPEZ, 4300 BISCAYNE BOULEVARD SUITE 305, MIAMI, FL 33137, (305)717-7530, Primary Email: eservice@justice360.com, Secondary e-mail: wmccaughan@justice360.com; THOMAS D. GRAHAM, ESQUIRE, LEESFIELD SCOLARO, 2350 S. DIXIE HIGHWAY, MIAMI, FL 33133, (305)854-4900, Primary Email: graham@leesfield.com; and 1 electronically filed the foregoing with the Clerk of PALM BEACH COUNTY by using the Florida courts eFiling Portal. COLE, SCOTT & KISSANE, P.A. Counsel for Defendant Life Changes Addiction Treatment Center of The Palm Beaches Cole, Scott & Kissane Building 9150 South Dadeland Boulevard, Suite 1400 P.O. Box 569015 Miami, Florida 33256 Telephone (305) 350-5354 Facsimile (305) 373-2294 Primary e-mail: jonathan. midwall@csklegal.com Secondary e-mail: alyssa.tornberg@csklegal.com By: — /s/ Jonathan M. Midwall JONATHAN M. MIDWALL Florida Bar No.: 182011 ALYSSA M. TORNBERG, ESQUIRE Florida Bar No. 127409 REF. # 47360 DES3CERTIFICATE OF HIPAA SATISFACTORY ASSURANCES (This certification must be completed fully and signed by an attorney to be valid.) ELIZABETH L. BALZARANO, Individually, and as Personal Representative, 50-2018-CA-15763-XXX et.al. vs. LIFELINE RECOVERY, LLC d/b/a LIFELINE RECOVERY (Docket Number) SUPPORT SERVICES, et. al. (Case Name) MICHELE BALZARANO NA (Patient Name) (Pat Med Rec/Acct No.) CERTIFICATION I hereby certify that the representations below are true and correct based upon my personal knowledge; that I have reviewed the applicable privacy regulations of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), 45 CFR Parts 160 and 164; that | have complied with the regulations and its requirements to obtain patient health information; and that I will comply with state and federal privacy laws as to any patient health information that I receive. { further certify the following; 1, [ have used reasonable efforts and made a good faith attempt to notify patient or personal representative in writing by serving written notice of my intent to obtain patient’s health information to patient or personal representative at this address: Primary Email: scolaro@leesfield.com; 2350 8, DIXIE HIGHWAY, MIAMI, FL 331332314 (or if patient’s location is unknown, to mail a notice to the patient’s last known address listed above) by e-mail and/or mail on . (Date) 2, This written notice provided sufficient information about this litigation or proceeding in which the patient's health information is requested to permit the patient or personal representative to raise objections in the appropriate court or administrative tribunal within the required time under Fla.R.Civ.P. 1.351 or other applicable rule from the date of service of the notice of intent, 3. The deadline for the patient or personal representative to object to the notice of intent under Fla.R.Civ.P. 1.351 or other applicable rule was set forth in the notice, which indicated that the deadline expired on . (Date) 4, Objections (Must initial one.) A. Patient or personal representative did not file any objections. OR B. Patient or personal representative filed objections with the court or administrative tribunal; the objections have been resolved by the court or administrative tribunal; there are no further objections pending or requiring resolution; and the disclosures of patient health information being sought are consistent with such resolution(s). 5, Ihave attached the subpoena or other lawful process, and the notice of intent with this certification. Signature of Atiorney Date MUST BEAR SIGNATURE OF ATTORNEY ONLY JONATHAN M. MIDWALL, ESQUIRE Florida Bar No. 182011 ALYSSA M. TORNBERG, ESQUIRE, Florida Bar No. 127409 COLE, SCOTT & KISSANE, P.A. Attorneys For Defendant(s) (305)350-5300 REF. # 47360 DES54IN THE CIRCUIT COURT OF THE 15TH JUDICIAL CIRCUIT IN AND FOR PALM BEACH COUNTY, FLORIDA CASE NO, 50-2018-CA-15763-XXXX-MB ELIZABETH L. BALZARANO, Individually, and as Personal Representative of the ESTATE OF MICHELLE L. BALZARANO, Plaintiff(s), vs. LIFELINE RECOVERY, LLC d/b/a LIFELINE RECOVERY SUPPORT SERVICES a Foreign Corporation; JOHN BROGAN; LIFE CHANGES ADDICTION TREATMENT CENTER OF THE PALM BEACHES; AND CAMERON VILLA, LLC, a Florida Corporation, Defendant(s), / SUBPOENA DUCES TECUM WITHOUT DEPOSITION (RECORDS MAIL IN ONLY) THE STATE OF FLORIDA: To: The Records Custodian for: DR. SCOTT AFTEL 28 EAST 32ND STREET BAYONNE, NJ 07002 YOU ARE COMMANDED to furnish via U.S. Mail delivery to THE MCS GROUP, INC., 7925 NW 12TH STREET, SUITE 318, MIAMI, FL 33126 on December 02, 2019 at 9:00 a.m., and to have with you at that time and place the following: Entire medical file, including but not limited to any and all records, including, but not limited to, psychiatric/psychological records, drug abuse and alcohol abuse records, rehabilitation records, therapy records, intake sheets, correspondence to and from the consulting and treating physicians, files, memoranda, handwritten notes, history and physical reports, medication/prescription records, intra-operative photos and video tapes, including any and all such items as may be stored in a computer database or otherwise in electronic form, relating to any examination, diagnosis or treatment pertaining to: MICHELE BALZARANO, DOB: 03/10/1983. These items will be inspected and may be copied at that time. You will not be required to surrender the original items. You may comply with this subpoena by providing legible copies of the items to be produced to THE MCS GROUP, INC., on behalf of the attorney whose name appears on this subpoena on or before the scheduled date of production. You may condition the preparation of the REF. #47360 SUI4copies upon the payment in advance of the reasonable cost of preparation. You may mail or deliver the copies to THE MCS GROUP, INC., at 7925 NW 12TH STREET, SUITE 318, MIAMI, FL 33126 and thereby eliminate your appearance at the time and place specified above. Prior approval required for fees in excess of $100.00. You have the right to object to the production pursuant to this subpoena at any time before production by giving written notice to THE MCS GROUP, INC. THIS WILL NOT BE A DEPOSITION. NO TESTIMONY WILL BE TAKEN. If you fail to: a) appear as specified; or (2) furnish the records instead of appearing as provided above; or (3) object to this subpoena, you may be in contempt of court. You are subpoenaed to appear by the following attorney, and unless excused from this subpoena by this attorney or the court, you shall respond to this subpoena as directed. DATED ON JONATHAN M. MIDWALL, ESQUIRE Florida Bar No. 182011 ALYSSA M,. TORNBERG, ESQUIRE Florida Bar No. 127409 COLE, SCOTT & KISSANE, P.A. Attorneys for Defendant(s) c/o THE MCS GROUP, INC, 7925 NW 12TH STREET, SUITE 318 MIAMI, FL 33126 (305)374-1166 REF, # 47360 sui4IN THE CIRCUIT COURT OF THE 15TH JUDICIAL CIRCUIT IN AND FOR PALM BEACH COUNTY, FLORIDA CASE NO. 50-2018-CA-15763-XXXX-MB ELIZABETH L. BALZARANO, Individually, and as Personal Representative of the ESTATE OF MICHELLE L. BALZARANO, Plaintifi(s), VS. LIFELINE RECOVERY, LLC d/b/a LIFELINE RECOVERY SUPPORT SERVICES a Foreign Corporation; JOHN BROGAN; LIFE CHANGES ADDICTION TREATMENT CENTER OF THE PALM BEACHES; AND CAMERON VILLA, LLC, a Florida Corporation, Defendant(s), / SUBPOENA DUCES TECUM WITHOUT DEPOSITION (RECORDS MAIL IN ONLY) THE STATE OF FLORIDA: To: The Records Custodian for: DR. KENNETH FAISTL 27 §. COOKS BRIDGE ROAD SUITE 1-4 JACKSON TOWNSHIP, NJ 08527 YOU ARE COMMANDED to furnish via U.S. Mail delivery to THE MCS GROUP, INC., 7925 NW 12TH STREET, SUITE 318, MIAMI, FL 33126 on December 02, 2019 at 9:00 a.m., and to have with you at that time and place the following: Entire medical file, including but not limited to any and all records, psychiatric/psychological records, drug abuse and alcohol abuse records, rehabilitation records, therapy records, intake sheets, correspondence to and from the consulting and treating physicians, files, memoranda, handwritten notes, history and physical reports, medication/prescription records, intra-operative photos and video tapes, including any and all such items as may be stored in a computer database or otherwise in electronic form, relating to any examination, diagnosis or treatment pertaining to: MICHELE BALZARANO, DOB: 03/10/1983. These items will be inspected and may be copied at that time. You will not be required to surrender the original items. You may comply with this subpoena by providing legible copies of the items to be produced to THE MCS GROUP, INC., on behalf of the attorney whose name appears on REF. # 47360 SUI4this subpoena on or before the scheduled date of production. You may condition the preparation of the copies upon the payment in advance of the reasonable cost of preparation, You may mail or deliver the copies to THE MCS GROUP, INC., at 7925 NW 12TH STREET, SUITE 318, MIAMI, FL 33126 and thereby eliminate your appearance at the time and place specified above. Prior approval required for fees in excess of $100.00. You have the right to object to the production pursuant to this subpoena at any time before production by giving written notice to THE MCS GROUP, INC. THIS WILL NOT BE A DEPOSITION. NO TESTIMONY WILL BE TAKEN. If you fail to: 5) appear as specified; or (2) _ furnish the records instead of appearing as provided above; or (3) object to this subpoena, you may be in contempt of court. You are subpoenaed to appear by the following attorney, and unless excused from this subpoena by this attorney or the court, you shall respond to this subpoena as directed. DATED ON. JONATHAN M. MIDWALL, ESQUIRE Florida Bar No. 182011 ALYSSA M. TORNBERG, ESQUIRE Florida Bar No. 127409 COLE, SCOTT & KISSANE, P.A. Attorneys for Defendant(s) c/o THE MCS GROUP, INC. 7925 NW 12TH STREET, SUITE 318 MIAMI, FL 33126 (305)374-1166 REF. # 47360 SUI4