Preview
FILED: KINGS COUNTY CLERK 12/27/2022 04:12 PM INDEX NO. 504273/2017
NYSCEF DOC. NO. 136 RECEIVED NYSCEF: 12/27/2022
SUPREME COURT OF THE STATE OF NEW YORK Index No.: 504273/2017
COUNTY OF KINGS
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ROBERT ZABORSKI, EXPERT WITNESS
Plaintiff, DISCLOSURE PURSUANT
TO CPLR§ 3101(d)
-against-
MB LORIMER LLC and CORNERSTONE
BUILDERS NY LLC,
Defendants.
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CORNERSTONE BUILDERS NY LLC,
Third-Party Plaintiff,
-against-
NEW YORK BUILDER OF STAIRS, INC.
Third-Party Defendants.
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C O U N S E L:
PLEASE TAKE NOTICE, that plaintiff, ROBERT ZABORSKI, through his attorneys,
THE PLATTA LAW FIRM, PLLC, as for his expert witness disclosure pursuant to CPLR 3101(d),
state as follows:
QUALIFICATION OF THE EXPERT
1. Plaintiff hereby designates Aric Hausknecht, M.D., as an expert in the field of
Neurologist and Pain Management in this matter. The curriculum vitae of Aric Hausknecht, M.D.
is annexed hereto as “Exhibit A.”
SUBSTANCE OF FACTS AND GROUNDS OF OPINIONS
2. The substance of facts and opinions that constitute grounds for Dr. Hausknecht’s
opinions will be based on the doctor’s experience and expertise, his review of the medical records
of plaintiff’s treating physicians including, but not limited to, reports of treatment from hospitals,
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clinics, and treatment centers, and/or medical facilities of any kind, operative reports, and
radiological and other studies, and his oral and physical examinations of the plaintiff. Dr.
Hausknecht will also rely on the testimony and documents introduced into evidence at the time of
trial.
THE SUBJECT MATTER OF TESTIMONY
3. Dr. Hausknecht will opine as to the causation, severity, extent, and permanence of
plaintiff’s injuries – both from the accident itself, as well, as from the necessary treatment that
followed – as well as necessary future treatment. In addition, Dr. Hausknecht will testify
concerning the natural flowing sequel of the injuries, notes, reports, memorandum, records and
submissions, prognosis for plaintiff, and fees that may have been incurred by his in the past or in
the future regarding treatment of these injuries. Dr. Hausknecht will also offer testimony to refute
the testimony and opinions of defendants’ expert herein. Further details as to the subject matter
on which Dr. Hausknecht will testify are contained in his treating notes and reports, and his
narrative reports dated November 10, 2022 and December 21, 2022, copies of which are annexed
hereto as “Exhibit B.”
PLEASE TAKE FURTHER NOTICE that the plaintiff reserves the right to amend or
supplement this response, at any time up to and including the trial of this action.
PLEASE TAKE FURTHER NOTICE, that Plaintiff reserves the right to supplement
and amend this disclosure up to and including the time of trial.
Dated: New York, New York
December 23, 2022
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THE PLATTA LAW FIRM, PLLC
Howard Frederick
By: Howard G. Frederick
Attorneys for Plaintiff(s)
42 Broadway, Suite 1927
New York, New York 10004
212-514-5100
TO:
TRAUB LIEBERMAN STRAUS & SHREWSBERRY LLP
Attorneys for Defendant/Third-Party Plaintiff
CORNERSTONE BUILDERS NY LLC
7 Skyline Dr
Hawthorne, NY 10532
PILLINGER MILLER TARALLO, LLP
Attorneys for Third-Party Defendant
NEW YORK BUILDERS OF STAIRS, INC.
232 Madison Avenue, Suite 909
New York, NY 10016
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EXHIBIT “A”
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ARIC HAUSKNECHT, MD
EDUCATION AND TRAINING
1993 1995 Neurologi t and A i tant Neurologi t, New York Ho pital/Cornell Medical Center
and and Memorial Sloane Kettering Cancer Center, New York, NY, and Hospital for Special
Surgery, New York, NY
1992-1993 Neurology Resident, Mount Sinai Medical Center, New York, NY
1991-1992 Medical Intern, Beth Israel Medical Center, New York, NY
1987-1991 MD, Mount Sinai School of Medicine, New York, NY
1983-1987 BA, Physical Anthropology, Duke University, Durham, NC
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EMPLOYMENT
2000 Present Neurologi t and Pain Management Speciali t, Complete Care. Practice
includes providing treatment and evaluation in a community based clinic. Areas of expertise
include pain management, rehabilitation medicine, and electrodiagnostic testing. Practice
includes treatment and evaluation of orthopedic injuries and interpretation of radiological
tudie .
1995 2000 Neurologi t and Medical Director, Comprehen ive Care Of New York.
Position included the practice of neurology in a multispecialty group setting specializing in
trauma and neuromuscular disorders.
1993 Staff Physician, New York State Athletic Commission. Ringside doctor for boxing
matches.
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HOSPITAL PRIVILEGES
New York Hospital Queens, Flushing, NY
Beth Israel Medical Center, New York, NY.
BACK TO HOME PAGE
CERTIFICATION
Diplomate, American Board of Psychiatry and Neurology, certificate no. 42832, April 1996
Diplomate, American Academy of Pain Management, certificate no. 6730, November 1996
BACK TO HOME PAGE
LICENSING
Certified by the Drug Enforcement Administration, registration no. BH4452708
Qualified to practice medicine and surgery in the state of NY, license no. 190271
BACK TO HOME PAGE
RESEARCH EXPERIENCE/TEACHING POSITIONS
2001-Present Adjunct Assistant Clinical Professor, Touro University College of Osteopathic
Medicine.
1989 NIH re earch fellow hip, carpal tunnel yndrome econdary to amyloido i in patient
undergoing long-term hemodialysis.
1988 NIH research fellowship, functional evaluation and radiographic findings in hemophilic
arthropathy.
BACK TO HOME PAGE
PROFESSIONAL AFFILIATIONS
American Academy of Neurology
American Academy of Pain Management
American Clinical Neurophy iology Society
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Association for the Help of Retarded Children
National Multiple Sclerosis Society
BACK TO HOME PAGE
OTHER
Bilingual Engli h/Spani h
BACK TO HOME PAGE
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EXHIBIT “B”
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NY MED
RE: ROBERT ZABORSKI (D.O.B. September 26, 2016
SUBSEQUENT NEUROLOGIC OFFICE VISIT; Forest Hills Office
To Whom ItMay Concern:
HISTORY: Mr. Zaborski was involved in a work related injury on 7/18/16. He
complains of headaches and dizziness. He ishaving problems with his memory. He
reports difficulty sleeping.
The patient complains of pain in his neck, upper back and right shoulder. His right arm
and hand have been feeling numb and weak.
The patient attends physical therapy. He isnot taking any medications. He is not
working. He is scheduled to see an orthopedist, Dr. Bursztyn later thisweek.
PHYSICAL EXAMINATION: Mental status evaluation is limited due to language
barrier. There are several beats of horizontal nystagmus on lateralgaze to both sides.
There is antalgic weakness in the right shoulder. Reflexes are symmetric. There is
hypoesthesia to light touch in the right anterior forearm. There is cervical and upper
thoracic spinal tendemess. maneuver ispositive on theright There is 20 percent
Spurling
loss of lateral flexion in the cervical spine on both sides. There is pain and crepitus in the
right shoulder joint.
PREVIOUS TESTING:
MRI of the cervical spine 9/21/16 is umemarkable.
IMPRESSION:
Cervical derangement.
Thoracic derangement
Right shoulder arthropathy.
Closed head trauma with postconcussion syndrome and mild traumatic brain injury.
P,,[AH: I have advised Mr. Zaborski to attend physical therapy and/or chiropractic
treatments. I will prescribe Naprosyn to take as needed for pain. Orthopedic evaluation
of his right shoulder is required. I will arrange for MRI of the right shoulder to assess for
rotator cuff injury.
COh@tEFE CARE COMPLETE CARE NEW YORK MED
EAsT3?" CONCoURSE.3" FLR 69-15 AUsTIN ST
19 sTREET 2488 GRAND
NY 10016 BRONX. NY 10458 .REsT HILLs,NY I1375
NEW YoRK,
(212)239-2112/ FAX 239.4224 (718) 733.1050f FAX 733-1025 (718) 263-3500/ FAX 263-3565
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PAGE 2
9/26/16
ROBERT ZABORSKI
The patient has persistent neck and right shoulder pain with associated sensorimotor signs
and symptoms. He has been symptomatic for over 2 months and has had only a partial
Workers'
response to treatment. In accordance with the New York State Compensation
Board Medical Treatment Guidelines for Neck Injury, Section C.2.a, and Shoulder Injury,
Section D.3.a.iv., I recommend NCV/EMG studies of the upper extremities to assess for
electrodiagnostic evidence of radiculopathy or brachial plexus injury. This information
will help guide further care.
The patient requires further treatment and evaluation for his head injury. I willarrange
for MRI of the brain with DTI sequences to assess forcerebral damage. The patient will
be referred to Dr. Brown at the Center for Cognition and Communication for formal
evaluation in his native language and cognitive rehabilitation as required. I willstart him
on Elavil at night for symptomatic relief.
With a reasonable degree of medical certainty, his condition is causally related to the
work accident that occurred on 7/18/16.
He has a temporary total disability and I have advised him to restricthis activities.
Prognosis is guarded. He will be followed here forcontinued care.
I,Aric Hausknecht, MD, being duly licensed to practice medicine in the State of New
York, pursuant to the applicable provisions of the CPLR, hereby affirm under the penalty
of perjury, thatthe statements contained herein are true and accurate.
Sincerely,
ARIC HAUSKNECHT, M.D.
Diplomate, American Bond of Psychiatry and Neurology
Diplomate, American Academy of Pain Management
D: 9/27/16
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NY MED
RE: ROBERT ZABORSKI (D.O.B. November 7, 2016
SUBSEOUENT NEUROLOGIC OFFICE VISIT: Forest Hills Office
Dear Dr. Bursztyn (Fax # 877-992-0798):
HISTORY: Mr. Zaborski was involved in a work related injury on 7/18/16. He
complains of headaches and dizziness. He has been feeling depressed and is having
problems sleeping at night. He reports problems with his memory. According to a
neumbchavioral screen by Dr. Brown on 10/1/16, the patient demonstrated impairment
with leaming, memory, attention, concentration, problem solving and processing speed.
He has been attending traumatic brain injury rehabilitation.
The patient complains of neck and right shoulder pain. His right arm has been feeling
weak and painful and he has difficulty lifting.He isunder the care of Dr. Ventrudo and
bit"
has been receiving physical therapy and trigger point injections. Šhis helps "a little
He isunder the orthopedic care of Dr. Bursztyn for his right shoulder and conservative
management was advised.
MEDICATIQNS: He is taking a painkiller but cannot recall the name.
PHYSICAL SKAMINATION: His affect is blunted. His mood isdepressed. Short-term
memory is impaired. He is bradyphrenic. There is pain weakness at the right shoulder.
There iscervical paravertebral tenderness. there isright trapezius muscular spasm. There
ismoderate restriction of mobility in the cervical spine. There is pain and crepitus in the
right shoulder joint.
PREVIOUS TESTING:
MRI of the cervical spine 9/21/16 is unremarkable.
MRI of the right shoulder 10/3/16 revealssupraspinatus tendon tear.
MRI of the brain 10/3/16 reveals subcortical white matter changes in the frontal lobes
indicative of traumatic white matter injury, reduced FA values in the left frontal lobe and
centrum semiovale bilaterally indicative of traumatic white matter injury.
MRI of the thoracic spine 10/3/16 reveals spondylosis.
NCV/EMG study 9/26/16 reveals bilateral median neuropathy.
IMPRESSION:
Cervical derangement.
CoMPtl!TE CARE COMPLETE CARE NEW YORK MED
37" 3" FLR 69-15 AUsTINsT
19 EAsT sTREET 2488 GRAND CONCOURSE.
NEW YORK. NY 10016 BRONX, NY 10458 MRIEST HELLs, NY I 1375
(212) 239-2112/ FAX 239.4224 018) 733-105GfFAX 733-1025 018) 263-350W FAX 263-3565
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PAGE 2
11/7/16
ROBERT ZABORSKI
Thoracic derangement.
Right shoulder arthropathy.
Closed head trauma with postconcussion syndrome and mild traumatic brain injury.
Reactive depression.
PLAN: I have advised Mr. Zaborski to continue with his current course of physical
and pain management. I have recommended that he take over the counter anti-
therapy
inflammatory agents as needed for pain. Orthopedic follow-up is required for his
shoulder injury. There is clinicaland radiographic evidence of rotator cuff tear. Surgical
repair should be considered.
The patient has significant neurocognitive and neuropsychological sequelae related to his
head trauma. His clinical presentation is suggestive of diffuse axonal injury. Further
treatment and evaluation is required. I have recommended thathe continue TBI
rehabilitation with Dr. Brown. I will also refer him for supportive psychotherapy. I will
arrange for EEG study to assess for cerebral dysfunction and BAER study to assess for
vestibular dysfunction. This information will help guide further care.
With a reasonable degree of medical certainty, his condition is causally related to the
work accident that occurred on 7/18/16.
He istotally disabled and I have advised him to restricthis activities. Prognosis is
guarded. He will be followed here for continued care.
1, Aric Hausknecht, MD, being duly licensed to practice medicine in the State of New
York, pursuant to the applicable provisions of the CPLR, hereby affirm under the penalty
of pedury, that the statements contained herein are true and accurate.
Sincerely,
ARIC HAUSKNECHT, M.D.
Diplomate, American Doard of Psychiatry and Neurology
Diplomate, American Academy of Pain Management
D: 11/8/16
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NY MED
RE: ROBERT ZABORSKI (D.O.B. November 7, 2016
SUSSEQUENT NEUROLOGIC OFFICE VISIT: Forest Hills Office
Dear Dr. Bursztyn (Fax # 877-992-0798):
HISTORY: Mr. Zaborski was involved in a work related injury on 7/18/16. He
complains of headaches and dizziness. He has been feeling depressed and is having
problems sleeping at night. He reports problems with his memory. According to a
neurobehavioral screen by Dr. Brown on 10/1/16, the patient demonstrated impairment
with leaming, memory, attention, concentration, problem solving and processing speed.
He has been attending traumatic brain injury rehabilitation.
The patient complains of neck and right shoulder pain. His right arm has been feeling
weak and painful and he has difficulty lifting.He is under the care of Dr. Ventrudo and
bit."
has been receiving physical therapy and trigger point injections. This helps "a little
He is under the orthopedic care of Dr. Bursztyn for his right shoulder and conservative
management was advised.
MEDICATIONS: He is taking a painkiller but cannot recall the name.
PHYSICAL EXAMINATION: His affect is blunted. His mood is depressed. Short-term
memory is impaired. He is bradyphrenic. There is pain weakness at the right shoulder.
There is cervical paravertebral tenderness. There is right trapezius muscular spasm. There
ismoderate restriction of mobility in the cervical spine. There is pain and crepitus in the
right shoulder joint
PREVIOUS TESTING:
MRI of the cervical spine 9/21/16 is unremarkable.
MRI of the right shoulder 10/3/16 reveals supraspinatus tendon tear.
MRI of the brain 10/3/16 reveals subcortical white mauer changes in the frontal lobes
indicative of traumatic white matter injury, reduced FA values in the left frontal lobe and
centrum semiovale bilaterally indicative of traumatic white matter injury.
MRI of the thoracic spine 10/3/16 reveals spondylosis.
NCV/EMG study 9/26/16 reveals bilateral median neuropathy.
IMPRESSIQN:
Cervical derangement.
COMPLETE CARE COMP1EFE CARE NEW YORK MED
EAsT37" STREET 2488 GRAND CONCOURsE, 3'8 FLR
19 69-15 AUSTIN ST
NEW YORK.NY 10016 BRONX, NY 10458 FOREST HILLS. NY 11375
(212) 239-2112/ FAX 239-4224 (718) 733-t050/ FAX 733-1025 (718) 263-3500/ FAX 263"3565
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.
PAGE 2
11/7/16
ROBERT ZABORSKI
Thoracic derangement.
Right shoulder arthropathy.
Closed head trauma with postconcussion syndmme and mild traumatic brain injury.
Reactive depression.
PLAN: I have advised Mr. Zaborski to continue with his current course of physical
and pain management. I have recommended that he take over the counter anti-
therapy
inflammatory agents as needed for pain. Orthopedic follow-up is required for his
shoulder injury. There is clinicaland radiographic evidence of rotator cuff tear. Surgical
repair should be considered.
The patient has significant neurocognitive and neuropsychological sequelae related to his
head trauma. His clinical presentation is suggestive of diffuse axonal injury. Further
treatment and evaluation is required. I have recommended that he continue TBI
rehabilitation with Dr. Brown. I will also refer him for supportive psychotherapy. I will
arrange for EEG study to assess for cerebral dysfunction and BAER study to assess for
vestibular dysfunction. This information will help guide further care.
With a reasonable degree of medical certainty, his condition is causally related to the
work accident that occurred on 7/18/16.
He is totallydisabled and I have advised him to restrict his activities. Prognosis is
guarded. He will be followed here for continued care.
I,Aric Hausknecht, MD, being duly licensed to practice medicine in the State of New
York, pursuant to the applicable provisions of the CPLR, hereby affirm under the penalty
of perjury, that the statements contained herein are true and accurate.
Sincerely,
ARIC HAUSKNECHT, M.D.
Diplomate, American Bonni orPsychiatty
and Neurology
Diplomate, American Academy er Pain Management
D: 11/8/16
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1 ln/2016
ELECTRODIAGNOSTIC LABORATORY
69-15 Austin St
Forest Hills, NY 11375
Patient: Zaborski Robert
DOB:
SEX: Male
Brainstem Auditory Evoked Potential Report
Brainstem Auditory Evoked Potentials (BAEP) are a clinical tool used in the neurological evaluation of
vestibular and auditory signs and symptoms. BAEP provide data pertaining to conduction along the peripheral
and central nervous system pathways, and is useful in identifying the location and severity of abnormalities.
A stimulus to the ear elicitsa sequence of 5 waves generated by the acoustic nerve and brainstem structures.
IPL I-V represents conduction from the acoustic nerve to the upper mid brain. IPL I-IIIand M-V represents
conduction through the lower and upper brainstem, respectively.
Standard protocol was followed, and BAEP was obtained by delivering stimulus (clicks) through an ear phone.
Recording electrodes were placed on the vertex and both ears. Sweep time, sensitivity, number of sweeps,
stimulus rate,click duration and intensity, and other variables were adjusted appropriately.
RESULTS; The waveform, peak latency, amplitude, and interpeak latency results are indicated below.
BAEP Click
. . . . . . . .
1:2 L
. . . . . . .
. . . . . .
. . . . . . . . "
. . . . . . . . .
.........
.........
.. .....
......... ... . .. . ......... .--...---
......... -.--.....
1 /1;3 R
1 (ms)
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" Patient: Robett Test Date: 11/7/2016 p. 2
Zaborski,
BAEP Click
Trace I II III IV V I-HI III-V I-V
(ms) (ms) (ms) (ms) (ms) (ms) (ms) (ms)
Norm <2.0 <4.5 <6.2 <2.4 <2.3 <4.5
1:Avg R 1.39 2.38 3.23 4.30 5.02 1.84 1.78 3.63
1:1 L 1.47 2.08 3.58 4.78 6.00 2.11 2.42 4.53
L-R Norm <0.28 <0.32 <0.33
L-R 0.08 0.30 0.34 0.48 0.98 0.27 0.64 0.91
IMPRESSION: The data was analyzed and compared to the established normative values listed above.
Subject variables, including age, sex and body temperature were considered. The impression is as follows:
Normal Study.
I,Aric Hausknecht, MD, a physician licensed to practice medicine in the state of NY, hereby affirm that the
statements contained herein are true and accurate.
AricHausknecht,M.D.
e ber C1 n c
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.
NY MED ELECTRODIAONOSTIC LABORATORY
69-15 Austin Street
Forest Hills,NY 11375
718-544-3919
Pati I,Robert
Physician: Aric Hausknecht
Date: 11R/2016
GENERAL DESCRIPTION:
This was a 19 channel awake EEG recording with Intemational 10/20 electrode placements. There was no
significant artifact or interference.
BACKGROUND ACTIVITY:
Alpha activity was poorly formed. Beta activitywas excessive. There was no significant slowing. There was no
significant sharp activity.
ACTIVATION & SLEEP:
Photic stimulation produced no changes to the background activity. No drowsiness or sleep was noted.
CLINICAL IMPRESSION:
This EEG is abnormal. There is diffuse cerebral dysfunction.
Sincerely,
I,Aric Hausknecht, MD, a physician licensed to practice medicine in the state of NY, hereby affirm that the
statements contained herein are true and accurate.
Aric Hausknecht, M.D.
Diplomate, American Board or
Psychiary & Neurology
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NY MED
RE: ROBERT ZABORSKI (D.O. August 28, 2017
SUBSEOUENT NEUROL OGIC OFFICE VISIT: Forest Hills Office
To Whom ItMay Concern:
HISTORY: Mr. Zaborski was involved in a work-related injury on 7/18/16. The patient
complains of headaches and dizziness. He had two recent episodes where he lost
consciousness. He reports that his right arm was shaking. He did not bite his tongue or
lose contml of his bowel or bladder.
The patient has completed a course of physical therapy. He has also had some injections
performed with Dr. Ventrudo. He iscunently under the orthopedic care of Dr. Kaplan,
Dr. Bursztyn and Dr. Merola. He is awaiting authorization for right shoulder surgery. He
is under the care of a pain inanagement specialist, Dr. Naciek. He attends cognitive
rehabilitation with Dr. Brown and is under the psychiatric care of Dr. Shpitalnik. He has
been unable to work.
MEDICATIONS: Ibuprofen, Naprosyn, Tramadol, Amitriptyline, Hydmxyzine.
PEYSICAL EX MiNATION:His mood is anxious. Formal mental status evaluation is
limited due to the language barrier. There are several beats of vertical nystagmus on
down gaze. There isdysmetria of the upper extremities. Tandem gait is intact.
PREVIQUS TESTING:
MRI of the cervical spine 9/21/16 is unremarkable.
MRI of the right shoulder 10/3/16 reveals supraspinatus tendon tear.
MRI of the brain 10/3/16 reveals subcortical white matter changes in the frontal lobes
indicative of traumatic white matter injury, reduced FA values in the leftfrontal lobe and
centrum semiovale bilaterally indicative of traumatic white matter injury.
MRI of the thoracic spine 10/3/16 reveals spondylosis.
NCV/EMO study 9/26/16 reveals bilateral median neuropathy.
IMPRESSION:
Cervical derangement.
Thoracic derangement.
Right shoulder arthropathy.
Closed head trauma with postconcussion syndrome and mild traumatic brain injury.
Reactive depression.
COMPLBTE cARE ·cOMPLETE CARE NBW YORK MBD
375 3S PLR d9-15 AUSTIN sT
19 HAsT $TREBT 2488 GRAND CONCOURSE,
NEW YORK, NY 10016 BRONX. NY 10458 FOREST HIU..S.NY 11375
(212) 239-2112/ PAX 239-4224 (718) 733-1050/ FAX 733-1025 (718) 263.3500/ PAX263-3565
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PAGE 2
8/28/17
ROBERT ZABORSKI
[; I have advised Mr. Zaborski to continue cognitive rehabilitation and psychiatric
care. I have recommended that he take his medications as prescribed.
His recent syncopal episodes are concerning for possible positraumatic seizures. Further
treatrnent and evaluation is required. I willarrange for EEG study to assess forseizure
activity. I will arrange for BAER study to assess for vestibular dysfunction, I will arrange
for repeat MRI of the brain with contrast. The patient will be referred to the NYU
Comprehensive Epilepsy Center and video EEG monitoring is indicated. The patient will
also be referred to an internist for cardiac workup pertaining to his syncope.
I have recommended that he take Naprosyn or ibuprofen as needed for pain and
discontinue the Tramadol. I will renew his prescription for Blavil and I have
recommended that he take Hydroxyzine as needed for sleep difficulty. I will starthim on
Lyrica for his chronic pain and empirically for seizure prophylaxis.
He will follow-up iswith his orthopedist and pursue interventional pain management
and/or surgery as required.
With a reasonable degree of medical certainty, his condition is causally related to the
work injmy that occurred on 7/18/16.
He has a temporary totaldisability and Ihave advised him torestrict his activities. He
has not yet reached maximal medical improvement. Prognosis is guarded. He will be
followed here for continued care.
I,Aric Hausknecht, MD, being duly licensed to practice medicine in the State of New
York, pursuant to the applicable provisions of the CPLR, hereby affirm under the penalty
of perjury, that the statements contained herein are true and accurate.
Sincerely,
ARIC HAUSKNECHT, M.D.
Diplomate, Arnerican Board of Psychiatry andNeurology
DiplomsA Anwican Academy of Pain Managernent
D: 8/29/17
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NYSCEF DOC. NO. 136 RECEIVED NYSCEF: 12/27/2022
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FILED: KINGS COUNTY CLERK 12/27/2022 04:12 PM INDEX NO. 504273/2017 NYSCEF DOC. NO. 136 RECEIVED NYSCEF: 12/27/2022 SUPREME COURT OF THE STATE OF NEW YORK Index No.: 504273/2017 COUNTY OF KINGS --------------------------------------------------------------------------X ROBERT ZABORSKI, EXPERT WITNESS Plaintiff, DISCLOSURE PURSUANT TO CPLR§ 3101(d) -against- MB LORIMER LLC and CORNERSTONE BUILDERS NY LLC, Defendants. -------------------------------------------------------------------------X CORNERSTONE BUILDERS NY LLC, Third-Party Plaintiff, -against- NEW YORK BUILDER OF STAIRS, INC. Third-Party Defendants. --------------------------------------------------------------------------X C O U N S E L: PLEASE TAKE NOTICE, that plaintiff, ROBERT ZABORSKI, through his attorneys, THE PLATTA LAW FIRM, PLLC, as for his expert witness disclosure pursuant to CPLR 3101(d), state as follows: QUALIFICATION OF THE EXPERT 1. Plaintiff hereby designates Aric Hausknecht, M.D., as an expert in the field of Neurologist and Pain Management in this matter. The curriculum vitae of Aric Hausknecht, M.D. is annexed hereto as “Exhibit A.” SUBSTANCE OF FACTS AND GROUNDS OF OPINIONS 2. The substance of facts and opinions that constitute grounds for Dr. Hausknecht’s opinions will be based on the doctor’s experience and expertise, his review of the medical records of plaintiff’s treating physicians including, but not limited to, reports of treatment from hospitals, 1 of 132 FILED: KINGS COUNTY CLERK 12/27/2022 04:12 PM INDEX NO. 504273/2017 NYSCEF DOC. NO. 136 RECEIVED NYSCEF: 12/27/2022 clinics, and treatment centers, and/or medical facilities of any kind, operative reports, and radiological and other studies, and his oral and physical examinations of the plaintiff. Dr. Hausknecht will also rely on the testimony and documents introduced into evidence at the time of trial. THE SUBJECT MATTER OF TESTIMONY 3. Dr. Hausknecht will opine as to the causation, severity, extent, and permanence of plaintiff’s injuries – both from the accident itself, as well, as from the necessary treatment that followed – as well as necessary future treatment. In addition, Dr. Hausknecht will testify concerning the natural flowing sequel of the injuries, notes, reports, memorandum, records and submissions, prognosis for plaintiff, and fees that may have been incurred by his in the past or in the future regarding treatment of these injuries. Dr. Hausknecht will also offer testimony to refute the testimony and opinions of defendants’ expert herein. Further details as to the subject matter on which Dr. Hausknecht will testify are contained in his treating notes and reports, and his narrative reports dated November 10, 2022 and December 21, 2022, copies of which are annexed hereto as “Exhibit B.” PLEASE TAKE FURTHER NOTICE that the plaintiff reserves the right to amend or supplement this response, at any time up to and including the trial of this action. PLEASE TAKE FURTHER NOTICE, that Plaintiff reserves the right to supplement and amend this disclosure up to and including the time of trial. Dated: New York, New York December 23, 2022 2 of 132 FILED: KINGS COUNTY CLERK 12/27/2022 04:12 PM INDEX NO. 504273/2017 NYSCEF DOC. NO. 136 RECEIVED NYSCEF: 12/27/2022 THE PLATTA LAW FIRM, PLLC Howard Frederick By: Howard G. Frederick Attorneys for Plaintiff(s) 42 Broadway, Suite 1927 New York, New York 10004 212-514-5100 TO: TRAUB LIEBERMAN STRAUS & SHREWSBERRY LLP Attorneys for Defendant/Third-Party Plaintiff CORNERSTONE BUILDERS NY LLC 7 Skyline Dr Hawthorne, NY 10532 PILLINGER MILLER TARALLO, LLP Attorneys for Third-Party Defendant NEW YORK BUILDERS OF STAIRS, INC. 232 Madison Avenue, Suite 909 New York, NY 10016 3 of 132 FILED: KINGS COUNTY CLERK 12/27/2022 04:12 PM INDEX NO. 504273/2017 NYSCEF DOC. NO. 136 RECEIVED NYSCEF: 12/27/2022 EXHIBIT “A” 4 of 132 FILED: KINGS COUNTY CLERK 12/27/2022 04:12 PM INDEX NO. 504273/2017 NYSCEF DOC. NO. 136 RECEIVED NYSCEF: 12/27/2022 ARIC HAUSKNECHT, MD EDUCATION AND TRAINING 1993 1995 Neurologi t and A i tant Neurologi t, New York Ho pital/Cornell Medical Center and and Memorial Sloane Kettering Cancer Center, New York, NY, and Hospital for Special Surgery, New York, NY 1992-1993 Neurology Resident, Mount Sinai Medical Center, New York, NY 1991-1992 Medical Intern, Beth Israel Medical Center, New York, NY 1987-1991 MD, Mount Sinai School of Medicine, New York, NY 1983-1987 BA, Physical Anthropology, Duke University, Durham, NC BACK TO HOME PAGE EMPLOYMENT 2000 Present Neurologi t and Pain Management Speciali t, Complete Care. Practice includes providing treatment and evaluation in a community based clinic. Areas of expertise include pain management, rehabilitation medicine, and electrodiagnostic testing. Practice includes treatment and evaluation of orthopedic injuries and interpretation of radiological tudie . 1995 2000 Neurologi t and Medical Director, Comprehen ive Care Of New York. Position included the practice of neurology in a multispecialty group setting specializing in trauma and neuromuscular disorders. 1993 Staff Physician, New York State Athletic Commission. Ringside doctor for boxing matches. BACK TO HOME PAGE HOSPITAL PRIVILEGES New York Hospital Queens, Flushing, NY Beth Israel Medical Center, New York, NY. BACK TO HOME PAGE CERTIFICATION Diplomate, American Board of Psychiatry and Neurology, certificate no. 42832, April 1996 Diplomate, American Academy of Pain Management, certificate no. 6730, November 1996 BACK TO HOME PAGE LICENSING Certified by the Drug Enforcement Administration, registration no. BH4452708 Qualified to practice medicine and surgery in the state of NY, license no. 190271 BACK TO HOME PAGE RESEARCH EXPERIENCE/TEACHING POSITIONS 2001-Present Adjunct Assistant Clinical Professor, Touro University College of Osteopathic Medicine. 1989 NIH re earch fellow hip, carpal tunnel yndrome econdary to amyloido i in patient undergoing long-term hemodialysis. 1988 NIH research fellowship, functional evaluation and radiographic findings in hemophilic arthropathy. BACK TO HOME PAGE PROFESSIONAL AFFILIATIONS American Academy of Neurology American Academy of Pain Management American Clinical Neurophy iology Society 5 of 132 FILED: KINGS COUNTY CLERK 12/27/2022 04:12 PM INDEX NO. 504273/2017 NYSCEF DOC. NO. 136 RECEIVED NYSCEF: 12/27/2022 Association for the Help of Retarded Children National Multiple Sclerosis Society BACK TO HOME PAGE OTHER Bilingual Engli h/Spani h BACK TO HOME PAGE 6 of 132 FILED: KINGS COUNTY CLERK 12/27/2022 04:12 PM INDEX NO. 504273/2017 NYSCEF DOC. NO. 136 RECEIVED NYSCEF: 12/27/2022 EXHIBIT “B” 7 of 132 FILED: KINGS COUNTY CLERK 12/27/2022 04:12 PM INDEX NO. 504273/2017 NYSCEF DOC. NO. 136 RECEIVED NYSCEF: 12/27/2022 NY MED RE: ROBERT ZABORSKI (D.O.B. September 26, 2016 SUBSEQUENT NEUROLOGIC OFFICE VISIT; Forest Hills Office To Whom ItMay Concern: HISTORY: Mr. Zaborski was involved in a work related injury on 7/18/16. He complains of headaches and dizziness. He ishaving problems with his memory. He reports difficulty sleeping. The patient complains of pain in his neck, upper back and right shoulder. His right arm and hand have been feeling numb and weak. The patient attends physical therapy. He isnot taking any medications. He is not working. He is scheduled to see an orthopedist, Dr. Bursztyn later thisweek. PHYSICAL EXAMINATION: Mental status evaluation is limited due to language barrier. There are several beats of horizontal nystagmus on lateralgaze to both sides. There is antalgic weakness in the right shoulder. Reflexes are symmetric. There is hypoesthesia to light touch in the right anterior forearm. There is cervical and upper thoracic spinal tendemess. maneuver ispositive on theright There is 20 percent Spurling loss of lateral flexion in the cervical spine on both sides. There is pain and crepitus in the right shoulder joint. PREVIOUS TESTING: MRI of the cervical spine 9/21/16 is umemarkable. IMPRESSION: Cervical derangement. Thoracic derangement Right shoulder arthropathy. Closed head trauma with postconcussion syndrome and mild traumatic brain injury. P,,[AH: I have advised Mr. Zaborski to attend physical therapy and/or chiropractic treatments. I will prescribe Naprosyn to take as needed for pain. Orthopedic evaluation of his right shoulder is required. I will arrange for MRI of the right shoulder to assess for rotator cuff injury. COh@tEFE CARE COMPLETE CARE NEW YORK MED EAsT3?" CONCoURSE.3" FLR 69-15 AUsTIN ST 19 sTREET 2488 GRAND NY 10016 BRONX. NY 10458 .REsT HILLs,NY I1375 NEW YoRK, (212)239-2112/ FAX 239.4224 (718) 733.1050f FAX 733-1025 (718) 263-3500/ FAX 263-3565 8 of 132 FILED: KINGS COUNTY CLERK 12/27/2022 04:12 PM INDEX NO. 504273/2017 NYSCEF DOC. NO. 136 RECEIVED NYSCEF: 12/27/2022 PAGE 2 9/26/16 ROBERT ZABORSKI The patient has persistent neck and right shoulder pain with associated sensorimotor signs and symptoms. He has been symptomatic for over 2 months and has had only a partial Workers' response to treatment. In accordance with the New York State Compensation Board Medical Treatment Guidelines for Neck Injury, Section C.2.a, and Shoulder Injury, Section D.3.a.iv., I recommend NCV/EMG studies of the upper extremities to assess for electrodiagnostic evidence of radiculopathy or brachial plexus injury. This information will help guide further care. The patient requires further treatment and evaluation for his head injury. I willarrange for MRI of the brain with DTI sequences to assess forcerebral damage. The patient will be referred to Dr. Brown at the Center for Cognition and Communication for formal evaluation in his native language and cognitive rehabilitation as required. I willstart him on Elavil at night for symptomatic relief. With a reasonable degree of medical certainty, his condition is causally related to the work accident that occurred on 7/18/16. He has a temporary total disability and I have advised him to restricthis activities. Prognosis is guarded. He will be followed here forcontinued care. I,Aric Hausknecht, MD, being duly licensed to practice medicine in the State of New York, pursuant to the applicable provisions of the CPLR, hereby affirm under the penalty of perjury, thatthe statements contained herein are true and accurate. Sincerely, ARIC HAUSKNECHT, M.D. Diplomate, American Bond of Psychiatry and Neurology Diplomate, American Academy of Pain Management D: 9/27/16 9 of 132 FILED: KINGS COUNTY CLERK 12/27/2022 04:12 PM INDEX NO. 504273/2017 NYSCEF DOC. NO. 136 RECEIVED NYSCEF: 12/27/2022 NY MED RE: ROBERT ZABORSKI (D.O.B. November 7, 2016 SUBSEOUENT NEUROLOGIC OFFICE VISIT: Forest Hills Office Dear Dr. Bursztyn (Fax # 877-992-0798): HISTORY: Mr. Zaborski was involved in a work related injury on 7/18/16. He complains of headaches and dizziness. He has been feeling depressed and is having problems sleeping at night. He reports problems with his memory. According to a neumbchavioral screen by Dr. Brown on 10/1/16, the patient demonstrated impairment with leaming, memory, attention, concentration, problem solving and processing speed. He has been attending traumatic brain injury rehabilitation. The patient complains of neck and right shoulder pain. His right arm has been feeling weak and painful and he has difficulty lifting.He isunder the care of Dr. Ventrudo and bit" has been receiving physical therapy and trigger point injections. Šhis helps "a little He isunder the orthopedic care of Dr. Bursztyn for his right shoulder and conservative management was advised. MEDICATIQNS: He is taking a painkiller but cannot recall the name. PHYSICAL SKAMINATION: His affect is blunted. His mood isdepressed. Short-term memory is impaired. He is bradyphrenic. There is pain weakness at the right shoulder. There iscervical paravertebral tenderness. there isright trapezius muscular spasm. There ismoderate restriction of mobility in the cervical spine. There is pain and crepitus in the right shoulder joint. PREVIOUS TESTING: MRI of the cervical spine 9/21/16 is unremarkable. MRI of the right shoulder 10/3/16 revealssupraspinatus tendon tear. MRI of the brain 10/3/16 reveals subcortical white matter changes in the frontal lobes indicative of traumatic white matter injury, reduced FA values in the left frontal lobe and centrum semiovale bilaterally indicative of traumatic white matter injury. MRI of the thoracic spine 10/3/16 reveals spondylosis. NCV/EMG study 9/26/16 reveals bilateral median neuropathy. IMPRESSION: Cervical derangement. CoMPtl!TE CARE COMPLETE CARE NEW YORK MED 37" 3" FLR 69-15 AUsTINsT 19 EAsT sTREET 2488 GRAND CONCOURSE. NEW YORK. NY 10016 BRONX, NY 10458 MRIEST HELLs, NY I 1375 (212) 239-2112/ FAX 239.4224 018) 733-105GfFAX 733-1025 018) 263-350W FAX 263-3565 10 of 132 FILED: KINGS COUNTY CLERK 12/27/2022 04:12 PM INDEX NO. 504273/2017 NYSCEF DOC. NO. 136 RECEIVED NYSCEF: 12/27/2022 PAGE 2 11/7/16 ROBERT ZABORSKI Thoracic derangement. Right shoulder arthropathy. Closed head trauma with postconcussion syndrome and mild traumatic brain injury. Reactive depression. PLAN: I have advised Mr. Zaborski to continue with his current course of physical and pain management. I have recommended that he take over the counter anti- therapy inflammatory agents as needed for pain. Orthopedic follow-up is required for his shoulder injury. There is clinicaland radiographic evidence of rotator cuff tear. Surgical repair should be considered. The patient has significant neurocognitive and neuropsychological sequelae related to his head trauma. His clinical presentation is suggestive of diffuse axonal injury. Further treatment and evaluation is required. I have recommended thathe continue TBI rehabilitation with Dr. Brown. I will also refer him for supportive psychotherapy. I will arrange for EEG study to assess for cerebral dysfunction and BAER study to assess for vestibular dysfunction. This information will help guide further care. With a reasonable degree of medical certainty, his condition is causally related to the work accident that occurred on 7/18/16. He istotally disabled and I have advised him to restricthis activities. Prognosis is guarded. He will be followed here for continued care. 1, Aric Hausknecht, MD, being duly licensed to practice medicine in the State of New York, pursuant to the applicable provisions of the CPLR, hereby affirm under the penalty of pedury, that the statements contained herein are true and accurate. Sincerely, ARIC HAUSKNECHT, M.D. Diplomate, American Doard of Psychiatry and Neurology Diplomate, American Academy of Pain Management D: 11/8/16 11 of 132 FILED: KINGS COUNTY CLERK 12/27/2022 04:12 PM INDEX NO. 504273/2017 NYSCEF DOC. NO. 136 RECEIVED NYSCEF: 12/27/2022 NY MED RE: ROBERT ZABORSKI (D.O.B. November 7, 2016 SUSSEQUENT NEUROLOGIC OFFICE VISIT: Forest Hills Office Dear Dr. Bursztyn (Fax # 877-992-0798): HISTORY: Mr. Zaborski was involved in a work related injury on 7/18/16. He complains of headaches and dizziness. He has been feeling depressed and is having problems sleeping at night. He reports problems with his memory. According to a neurobehavioral screen by Dr. Brown on 10/1/16, the patient demonstrated impairment with leaming, memory, attention, concentration, problem solving and processing speed. He has been attending traumatic brain injury rehabilitation. The patient complains of neck and right shoulder pain. His right arm has been feeling weak and painful and he has difficulty lifting.He is under the care of Dr. Ventrudo and bit." has been receiving physical therapy and trigger point injections. This helps "a little He is under the orthopedic care of Dr. Bursztyn for his right shoulder and conservative management was advised. MEDICATIONS: He is taking a painkiller but cannot recall the name. PHYSICAL EXAMINATION: His affect is blunted. His mood is depressed. Short-term memory is impaired. He is bradyphrenic. There is pain weakness at the right shoulder. There is cervical paravertebral tenderness. There is right trapezius muscular spasm. There ismoderate restriction of mobility in the cervical spine. There is pain and crepitus in the right shoulder joint PREVIOUS TESTING: MRI of the cervical spine 9/21/16 is unremarkable. MRI of the right shoulder 10/3/16 reveals supraspinatus tendon tear. MRI of the brain 10/3/16 reveals subcortical white mauer changes in the frontal lobes indicative of traumatic white matter injury, reduced FA values in the left frontal lobe and centrum semiovale bilaterally indicative of traumatic white matter injury. MRI of the thoracic spine 10/3/16 reveals spondylosis. NCV/EMG study 9/26/16 reveals bilateral median neuropathy. IMPRESSIQN: Cervical derangement. COMPLETE CARE COMP1EFE CARE NEW YORK MED EAsT37" STREET 2488 GRAND CONCOURsE, 3'8 FLR 19 69-15 AUSTIN ST NEW YORK.NY 10016 BRONX, NY 10458 FOREST HILLS. NY 11375 (212) 239-2112/ FAX 239-4224 (718) 733-t050/ FAX 733-1025 (718) 263-3500/ FAX 263"3565 12 of 132 FILED: KINGS COUNTY CLERK 12/27/2022 04:12 PM INDEX NO. 504273/2017 NYSCEF DOC. . NO. 136 RECEIVED NYSCEF: 12/27/2022 . PAGE 2 11/7/16 ROBERT ZABORSKI Thoracic derangement. Right shoulder arthropathy. Closed head trauma with postconcussion syndmme and mild traumatic brain injury. Reactive depression. PLAN: I have advised Mr. Zaborski to continue with his current course of physical and pain management. I have recommended that he take over the counter anti- therapy inflammatory agents as needed for pain. Orthopedic follow-up is required for his shoulder injury. There is clinicaland radiographic evidence of rotator cuff tear. Surgical repair should be considered. The patient has significant neurocognitive and neuropsychological sequelae related to his head trauma. His clinical presentation is suggestive of diffuse axonal injury. Further treatment and evaluation is required. I have recommended that he continue TBI rehabilitation with Dr. Brown. I will also refer him for supportive psychotherapy. I will arrange for EEG study to assess for cerebral dysfunction and BAER study to assess for vestibular dysfunction. This information will help guide further care. With a reasonable degree of medical certainty, his condition is causally related to the work accident that occurred on 7/18/16. He is totallydisabled and I have advised him to restrict his activities. Prognosis is guarded. He will be followed here for continued care. I,Aric Hausknecht, MD, being duly licensed to practice medicine in the State of New York, pursuant to the applicable provisions of the CPLR, hereby affirm under the penalty of perjury, that the statements contained herein are true and accurate. Sincerely, ARIC HAUSKNECHT, M.D. Diplomate, American Bonni orPsychiatty and Neurology Diplomate, American Academy er Pain Management D: 11/8/16 13 of 132 FILED: KINGS COUNTY CLERK 12/27/2022 04:12 PM INDEX NO. 504273/2017 NYSCEF DOC. NO. 136 RECEIVED NYSCEF: 12/27/2022 1 ln/2016 ELECTRODIAGNOSTIC LABORATORY 69-15 Austin St Forest Hills, NY 11375 Patient: Zaborski Robert DOB: SEX: Male Brainstem Auditory Evoked Potential Report Brainstem Auditory Evoked Potentials (BAEP) are a clinical tool used in the neurological evaluation of vestibular and auditory signs and symptoms. BAEP provide data pertaining to conduction along the peripheral and central nervous system pathways, and is useful in identifying the location and severity of abnormalities. A stimulus to the ear elicitsa sequence of 5 waves generated by the acoustic nerve and brainstem structures. IPL I-V represents conduction from the acoustic nerve to the upper mid brain. IPL I-IIIand M-V represents conduction through the lower and upper brainstem, respectively. Standard protocol was followed, and BAEP was obtained by delivering stimulus (clicks) through an ear phone. Recording electrodes were placed on the vertex and both ears. Sweep time, sensitivity, number of sweeps, stimulus rate,click duration and intensity, and other variables were adjusted appropriately. RESULTS; The waveform, peak latency, amplitude, and interpeak latency results are indicated below. BAEP Click . . . . . . . . 1:2 L . . . . . . . . . . . . . . . . . . . . . " . . . . . . . . . ......... ......... .. ..... ......... ... . .. . ......... .--...--- ......... -.--..... 1 /1;3 R 1 (ms) 14 of 132 FILED: KINGS COUNTY CLERK 12/27/2022 04:12 PM INDEX NO. 504273/2017 NYSCEF DOC. . NO. 136 RECEIVED NYSCEF: 12/27/2022 " Patient: Robett Test Date: 11/7/2016 p. 2 Zaborski, BAEP Click Trace I II III IV V I-HI III-V I-V (ms) (ms) (ms) (ms) (ms) (ms) (ms) (ms) Norm <2.0 <4.5 <6.2 <2.4 <2.3 <4.5 1:Avg R 1.39 2.38 3.23 4.30 5.02 1.84 1.78 3.63 1:1 L 1.47 2.08 3.58 4.78 6.00 2.11 2.42 4.53 L-R Norm <0.28 <0.32 <0.33 L-R 0.08 0.30 0.34 0.48 0.98 0.27 0.64 0.91 IMPRESSION: The data was analyzed and compared to the established normative values listed above. Subject variables, including age, sex and body temperature were considered. The impression is as follows: Normal Study. I,Aric Hausknecht, MD, a physician licensed to practice medicine in the state of NY, hereby affirm that the statements contained herein are true and accurate. AricHausknecht,M.D. e ber C1 n c 15 of 132 FILED: KINGS COUNTY CLERK 12/27/2022 04:12 PM INDEX NO. 504273/2017 NYSCEF DOC. . NO. 136 RECEIVED NYSCEF: 12/27/2022 . NY MED ELECTRODIAONOSTIC LABORATORY 69-15 Austin Street Forest Hills,NY 11375 718-544-3919 Pati I,Robert Physician: Aric Hausknecht Date: 11R/2016 GENERAL DESCRIPTION: This was a 19 channel awake EEG recording with Intemational 10/20 electrode placements. There was no significant artifact or interference. BACKGROUND ACTIVITY: Alpha activity was poorly formed. Beta activitywas excessive. There was no significant slowing. There was no significant sharp activity. ACTIVATION & SLEEP: Photic stimulation produced no changes to the background activity. No drowsiness or sleep was noted. CLINICAL IMPRESSION: This EEG is abnormal. There is diffuse cerebral dysfunction. Sincerely, I,Aric Hausknecht, MD, a physician licensed to practice medicine in the state of NY, hereby affirm that the statements contained herein are true and accurate. Aric Hausknecht, M.D. Diplomate, American Board or Psychiary & Neurology 16 of 132 FILED: KINGS COUNTY CLERK 12/27/2022 04:12 PM INDEX NO. 504273/2017 NYSCEF DOC. NO. 136 RECEIVED NYSCEF: 12/27/2022 NY MED RE: ROBERT ZABORSKI (D.O. August 28, 2017 SUBSEOUENT NEUROL OGIC OFFICE VISIT: Forest Hills Office To Whom ItMay Concern: HISTORY: Mr. Zaborski was involved in a work-related injury on 7/18/16. The patient complains of headaches and dizziness. He had two recent episodes where he lost consciousness. He reports that his right arm was shaking. He did not bite his tongue or lose contml of his bowel or bladder. The patient has completed a course of physical therapy. He has also had some injections performed with Dr. Ventrudo. He iscunently under the orthopedic care of Dr. Kaplan, Dr. Bursztyn and Dr. Merola. He is awaiting authorization for right shoulder surgery. He is under the care of a pain inanagement specialist, Dr. Naciek. He attends cognitive rehabilitation with Dr. Brown and is under the psychiatric care of Dr. Shpitalnik. He has been unable to work. MEDICATIONS: Ibuprofen, Naprosyn, Tramadol, Amitriptyline, Hydmxyzine. PEYSICAL EX MiNATION:His mood is anxious. Formal mental status evaluation is limited due to the language barrier. There are several beats of vertical nystagmus on down gaze. There isdysmetria of the upper extremities. Tandem gait is intact. PREVIQUS TESTING: MRI of the cervical spine 9/21/16 is unremarkable. MRI of the right shoulder 10/3/16 reveals supraspinatus tendon tear. MRI of the brain 10/3/16 reveals subcortical white matter changes in the frontal lobes indicative of traumatic white matter injury, reduced FA values in the leftfrontal lobe and centrum semiovale bilaterally indicative of traumatic white matter injury. MRI of the thoracic spine 10/3/16 reveals spondylosis. NCV/EMO study 9/26/16 reveals bilateral median neuropathy. IMPRESSION: Cervical derangement. Thoracic derangement. Right shoulder arthropathy. Closed head trauma with postconcussion syndrome and mild traumatic brain injury. Reactive depression. COMPLBTE cARE ·cOMPLETE CARE NBW YORK MBD 375 3S PLR d9-15 AUSTIN sT 19 HAsT $TREBT 2488 GRAND CONCOURSE, NEW YORK, NY 10016 BRONX. NY 10458 FOREST HIU..S.NY 11375 (212) 239-2112/ PAX 239-4224 (718) 733-1050/ FAX 733-1025 (718) 263.3500/ PAX263-3565 17 of 132 FILED: KINGS COUNTY CLERK 12/27/2022 04:12 PM INDEX NO. 504273/2017 NYSCEF DOC. NO. 136 RECEIVED NYSCEF: 12/27/2022 PAGE 2 8/28/17 ROBERT ZABORSKI [; I have advised Mr. Zaborski to continue cognitive rehabilitation and psychiatric care. I have recommended that he take his medications as prescribed. His recent syncopal episodes are concerning for possible positraumatic seizures. Further treatrnent and evaluation is required. I willarrange for EEG study to assess forseizure activity. I will arrange for BAER study to assess for vestibular dysfunction, I will arrange for repeat MRI of the brain with contrast. The patient will be referred to the NYU Comprehensive Epilepsy Center and video EEG monitoring is indicated. The patient will also be referred to an internist for cardiac workup pertaining to his syncope. I have recommended that he take Naprosyn or ibuprofen as needed for pain and discontinue the Tramadol. I will renew his prescription for Blavil and I have recommended that he take Hydroxyzine as needed for sleep difficulty. I will starthim on Lyrica for his chronic pain and empirically for seizure prophylaxis. He will follow-up iswith his orthopedist and pursue interventional pain management and/or surgery as required. With a reasonable degree of medical certainty, his condition is causally related to the work injmy that occurred on 7/18/16. He has a temporary totaldisability and Ihave advised him torestrict his activities. He has not yet reached maximal medical improvement. Prognosis is guarded. He will be followed here for continued care. I,Aric Hausknecht, MD, being duly licensed to practice medicine in the State of New York, pursuant to the applicable provisions of the CPLR, hereby affirm under the penalty of perjury, that the statements contained herein are true and accurate. Sincerely, ARIC HAUSKNECHT, M.D. Diplomate, Arnerican Board of Psychiatry andNeurology DiplomsA Anwican Academy of Pain Managernent D: 8/29/17 18 of 132 FILED: KINGS COUNTY CLERK 12/27/2022 04:12 PM INDEX NO. 504273/2017 NYSCEF DOC. NO. 136 RECEIVED NYSCEF: 12/27/2022