Preview
FILED: KINGS COUNTY CLERK 01/19/2023 03:59 PM INDEX NO. 504273/2017
NYSCEF DOC. KINGS
NO. 147 COUNTY RECEIVEDINDEXNYSCEF:
NO. 42 73 /2017
50 01/19/2023
FILED: CLERK 12 /22 /2022 11:41 AM|
NYSCEF DOC. NO. 131 RECEIVED NYSCEF: 12/22/2022
SUPREMECOURTOF THESTATEOFNEW YORK
COUNTY OF KINGS
------------------------------------------------------------------------X Index No.: 504273/2017
ROBERT ZABORSKI, SO-ORDERED
Plaintiff, SUBPOENA DUCES TECUM
-against-
MB LORIMER LLC and CORNERSTONE
BUlLDERS NY LLC,
Defendants.
............-......-................................---.............x
CORNERSTONE BUILDERS NY LLC,
Third-Party Plaintiff,
-against-
NEW YORK BUILDER OF STAIRS, INC.
Third-Party Defendants.
......................--................................................x
To: Patient: BORSKl
Kings County Hospital Center D/O/B:
451 Clarkson Avenue
Brooklyn, New York I 1203
ATTN: BfLL/NG DEPARTMENT
WE COMMAND Y OU, thatallbusiness and excuses being laidaside.you and each ofyou appear and attendbefore.T.hite
Platta Law Firm, PLLC, 42 Broadway, Suite 19271 New York, New York 10004, on January 24 2013, at9:30 a.m., and at any
recessed or adjourned date to givetestimony inthisaction on pan of the ROBERT
plaintiff, ZABORSKI and thatyou bring with
you, and produce at thetime and place aforesaid,a CERTIFIED BILLING RECORDS from July 18 2016 to present,now inyour
custody.
YOUR PERSONAL APPEARANCE IS UNNECESSARY IF YOU DELIVER THE AFOREMENTIONED RECORDS
ON OR BEFORE THE RETURN DATE HEREOF TO:
The PLATTA LAW FIRM, PLLC
42 Broadway, Suite 1927
New York, New York 10004
The aforemeqÇjoned recçrds must be accompanied by a copy ofthis subpoena and the enclosed executed
certification,
hy the custodian of recÁrÇis,another authorized witness or a qualified physician.
FAILURE to with thissubpoena is punishableas contempt of Court and shallmake you liabletothe person on whose
comply
behalf thissubpocna was issued fora penalty not toexceed fiftyand 00/100 (S50.00) dollarsand alldamages sustainedby reasons of
your failureto comply.
Dated: New York, New York
December 15, 2022 Yours, etc.
THE PLATTA LAW FlRM, PLLC
Howard Frederick,Esq.
Attorneyfor Plaintry
42 Broadway, Suite 1927
New York, NY 10004
(212) 514-5100
SO-ORDERED:
OUR OFFICE.*
COPY OF TH(S MUST ACCOMPANY ALL RF,008pS MAILED TO
'A SUBPOENA
Hon. Debra Silber J.S.C. 12/22/2022
NY 1000+PilONE: 212-514.9300
212-514-s100, FAX:
TilE PLATrA LAW FiltM,PLLC"42 nROADWAV, Sl'lTg$92&FE3F1YORK.
1 of 49
FILED: KINGS COUNTY CLERK 01/19/2023 03:59 PM INDEX NO. 504273/2017
NYSCEF DOC. NO. 147 RECEIVED NYSCEF: 01/19/2023
SUPREME COURT OF THE STATE OF NEW YORK
COUNTY OF KINGS
------------------------------------------X Index No.: 504273/2017
ROBERT ZABORSKl,
Plaintiff, SUBPOENA DUCES TECUM
-against-
MB LORIMER LLC and CORNERSTONE
BUILDERS NY LLC,
Defendants.
.---.__...---.--.._.--...._..._.--....______Ç
CORNERSTONE BUILDERS NY LLC,
Third-Party Plaintiff,
-against-
NEW YORK BUILDER OF STAIRS, INC.
Third-Party Defendants.
--....__.-------..__..---...-----.....-----..._Ç
To: Patient: ROBERT BORSKI
Kings County Hospital Center D/O/B:
451 Clarkson Avenue
Brooklyn, New York 11203
A TTN; BILLING DEPARTMENT
WE COMMAND YOU, thatallbusiness and excuses being laid aside,you and each of you appear and attendbefore _Ille
Plattp 1,pw Firm, PLLC, 42 Broadway, Suite 1927, New York, New York 10004, on January 24, 2023, at 9Q0 9,m., and Stgpy
recessed or ad journed date to give testimony in thisaction on partof the ROBERT
plaintiff, ZABORSKI and that you bring with
you, and produce at thetime and place aforesaid, a CERTIFIED BILLING REÇQRDS from July 18, 201§ 19 present, now inyour
custody.
YOUR PERSONAL APPEARANCE IS UNNECESSARY IF YOU DELIVER THE AFOREMENTIONED RECORDS
ON OR BEFORE THE RETURN DATE HEREOF TO:
The PLATTA LAW FIRM, PLLC
42 Broadway, Suite 1927
New York, New York 10004
The aforementioned records must be accompanied by a copy of thissubpoena and the enclosed certification,executed
by the custodian of records, another authorized witness or a analified physician.
FAILURE to comply with thissubpoena is punishable as contempt of Court and shall make you liableto theperson on whose
behalf thissubpoena was issuedfora penalty not toexceed fiftyand 00/100 ($50.00) dollars and all damages sustained by reasons of
your failureto comply.
Dated: New York, New York
December 15, 2022 Yours, etc.
THE PLATTA LAW FIRM, PLLC
Howard Frederick, Esq.
Attorney for Plaintry
42 Broadway, Suite 1927
New York, NY 10004
(212) 514-5100
SO-ORDERED:
RECORDS TO OUR OFFICE.*
*A COPY OF THIS SUBPOENA MUST ACCOMPANY ALL MAILED
THE PLATTA LAW FIRM, PLLO42 BROADWAY, SUITE 21927"NEW
of 49 YORK, NY 10004"PHONE: 212-514-5100,FAX: 212-$14-9300
FILED: KINGS COUNTY CLERK 01/19/2023 03:59 PM INDEX NO. 504273/2017
OCA Official Form No.:960
NYSCEF DOC. NO. 147
AUTHORIZATION FOR RELEASE OF
RECEIVED NYSCEF: 01/19/2023
HEALTH INFORMATION PURSUANT TO HIPPA
|Thisform has been approvedby the New York StateDepartment of llcalth]
PatientName Social Number
Security
ROBERT ZABORSKI
PatientAddress
66-21 52nd Drive.Maspeth. NY I1378
L or my authorizedrepresentative.
requestthat health
in formation
regardingmy care and treatmentbe released
as set forth
on this
form In
accordance withNew York StateIn and the Privacy
Rule of the HealthInsurance and AccountabilityActof 1996 (Il[PPA).I
Portability
understand that:
I. I hisauthorizationmay inchide disclosure of information relatingto ALCOHOI, and DRUG AllUSE, MENTAL IIEALTil
TREATMENT. except notes.and CONFIDENTAL IIIV* RELATED
psy chotherapy INFORMATION only if1 place
my initials
on the
appropriatelinein Item
9(at In the event
the health
informationdescribedbelow included these types
any of of information.
and I initial
the
lineon the hoxin Item9(a).I specifically
authorizerelease of
such informationm the person(s)indicatedinItem8.
2. If
I am authorizing
the release of
FilV-related.
alcoholor drug or mental
treatment. healthtreatmentinformation.the recipient
is prohibited
from such information
redisclosing without my authorizationunlesspermittedto do so under
federalor state
law.
I understandthatI havethe right
to requesta list
of people who may receiveoruse my I11V-relatedinformationwithout authorization.
liI
experiencediscriminationbecause ofthe releaseordisclosureof I11V-relatedinformation.
1 may contact theNew York State Divisionof
Human Rights at (212)
480-2493 or the New York CityCommission of Human Rights at (212)
306-7450. These agenciesare responsible
forprotectingmy rights.
3. I have the right
to revokethisauthorization
at anytime by w riting
to the health
eare providerlisted
below. I understand
thatI may revoke
this expect
authorization to the extent
that action
has alreadybeen takenbased on thisauthorization.
4. I understand
that signing
this authorization
is voluntary.
My treatment.
payment. enrollmentin a health
plan.or eligibility
forbenefitswill
not be conditioned
upon my authorization
of this
disclosure.
5. In formation
disclosedunder this authorization
mightbe redisclosedby the recipient
(exceptas notedabove in item2). and this redisclosure
may no longer be protected
by federa:or state
law.
6. THIS AUTHORIZATION DOES NOT AUTl1ORIZE YOU TO DISCUSS MY HEAl TH INFORMATION OR MEDICAL
CARE WITH ANYONE OTHER THAN TilE ATTORNEY OR GOVERMENTAL AGENY SPECIFIED IN ITEM 9(b).
7. Name and addressof healthprovideror entity
to release this
information:
Kings County Hospital Center, 451 Clarkson Avenue, Brooklyn, New York 11203
8. Name and addressor person(s)or category
of personto whom thiswillbe sent:
The Platta Law Firm, PLLC, 42 Broadway, Suite 1927, New York. NY 10004
9(a).Specificinfomiationto be released:
O Medical Record from (insertdate) to (insert
date)
O EntireMedicalRecord. includingpatient office
histories. notes (except notes).
psy chotherapy test results.
radiologystudies.
Glms.
consults.
referrals. billingrecords.insurance and records
records. sent to youby otherheahh care providers.
ECSen-f-
E Other: records
billine om o9//8/20/6 1lo
Include:(Indicate
by initialing)
.Z Alcohol/Drug 1reatment
Mental liealthIn formation
7 HIV-Related Information
Authorizationto DiscussIlealthinformation
(b)O By here
initialing I authorize .
Initials Name ofindividualhealthcare provider
to discuss
my healthinformationwith my attomey. or a governmentalagency. listed
here:
(Auorney/FirmName or Governmental
Agency Name)
10. Reason for in formation:
release of I 1. Date or event
on which thisauthorization
willexpire:
O At requestof indis idual
E Other: 1.ITIGATION UPON COMPl£TION OF LIGATION
12. if name of
not the patient. personsigning form: 13. Authority
to signon behalfo f patient:
All itemson thisformhave been completedand my questionsabout thisform have been answered. M1alisdacGiqmakizdisbar
In addition.
' New York
cop f tis rm Neary Pudic State of
Date: O2 2- 0½OG406539
Signat ent or'presentativ
e authorizedby law. Quelied in Queens County
Commission Expires March 30, 2024
The New York State Public Health Lau
Virus that causes AIDS
*1luman Immunodeliciency protects information someone
which reasonably could identify
as having lilV regarding a person s contacts.
symptoms or mfecuon and mfonnation
3 of 49
FILED: KINGS COUNTY CLERK 01/19/2023 03:59 PM INDEX NO. 504273/2017
NYSCEF DOC. NO. 147 RECEIVED NYSCEF: 01/19/2023
CERTIFICATION OF RECORDS
CLAIMANT'S NAME: Robert Zaborski
NAME OF OFFICE: Kings County Hospital Center /Billing Department
DATES OF SERVICE: JULY 18, 2016 TO PRESENT
Pursuant to Section 4518 of the Civil Practice Law and Rules, this is to certify that the attached is an exact
copy of the original records, which I have in my custody and control.
The records were made and kept in the regular course of business of our facility and it is in the regular
course of business of our facility to make such records at or about the time of the events described in the records.
Billing Department Date
PLATTA LAW PLLC"42 BROADWAY, sUITE 4 1927"NEW
of 49 YORK, NY 10004"PHONE: FAx:212-514-9300
212-514-5100,
THE FIRM,
FILED: KINGS COUNTY CLERK 01/19/2023 03:59 PM INDEX NO. 504273/2017
NYSCEF DOC. NO. 147 RECEIVED NYSCEF: 01/19/2023
SUPREME COURT OF THE STATE OF NEW YORK
COUNTY OF KINGS
--------------------------------------------------------------------------X Index No.: 504273/2017
ROBERT ZABORSKl,
Plaintiff, SUBPOENA DUCES TECUM
-against-
MB LORIMER LLC and CORNERSTONE
BUILDERS NY LLC,
Defendants.
.......--------....----......___-------.._____....---_____.--____-._______Ç
CORNERSTONE BUILDERS NY LLC,
Third-Party Plaintiff,
-against-
NEW YORK BUILDER OF STAIRS, INC.
Third-Party Defendants.
______.-------
_____.--------____--------._____.--__________--....______...Ç
SUBPOENADUCESTECUM
I II
THE PLATTA LAW FIRM, PLLC
Attorneys for: Plaintiff(s)
42 Broadway, Suite 1927
New York, New York 10004
(212) 514-5100
The undersigned attorney hereby certifies,pursuant to22 NYCRR 130-1.1-a that he/she has read the within papers and that same are
not frivolous as thatterm is definedin 22 NYCRR 130-1.1(c).
Howard Frederick, Esq.
Service of a copy of thewithin is hereby admitted.
Dated,
Attorney(s) for
PLEASE TAKE NOTICE:
O NOTICE OF ENTRY
thatthe within true
is a (certified) copy of an duly entered in
the officeof theclerk of thewithin named court on 200__.
O NOTICE OF SETTLEMENT
thatan order of which the within is a true
copy willbe presented forsettlement to theHON.
one of the judges of thewithin named Court, at on
200 at O'clock .M.
Dated: December 15, 2022 Yours, etc.
THE PLATTA LAW FIRM, PLLC
THE PLATTA LAW FIRM, PLLC"42 BROADWAY, SUITE 51927"NEW
of 49 YORK, NY 10004-PHONE: 212-514-5100,FAX: 212-514-9300
FILED: KINGS COUNTY CLERK 01/19/2023 03:59 PM INDEX NO. 504273/2017
NYSCEF DOC. NO. 147 RECEIVED NYSCEF: 01/19/2023
.
SUPREME COURT OF THE STATE OF NEW YORK
COUNTY OF KINGS
-----------------------------------------------------------------------X Index No.: 504273/2017
ROBERT ZABORSKl,
Plaintiff, SUBPOENA DUCES TECUM
-against-
MB LORIMER LLC and CORNERSTONE
BUlLDERS NY LLC,
Defendants.
___---------------------.........._____________________Ç
CORNERSTONE BUILDERS NY LLC,
Third-Party Plaintiff,
-against-
NEW YORK BUILDER OF STAIRS, INC.
Third-Party Defendants.
----------------.._____.....____.__......._......__,---Ç
DATE OF SERVICE: f
NAME OF FACILITY: Kings County Hospital Center /Billing Department
SERVED ON (NAME):
MANNER OF SERVICE: ERSONAL _MAIL
DECLARATION OF SERVER
I declareunder penalty of perjuryunder the laws ofthe United Statesof America thatthe foregoing information contained inthe Proof
of Service is true
and correct.
EXECUTED ON (DATE):
SIGNATURE OF SERVE
SERVER NAME:
ADDRESS OF SERVER: 42 BROADWAY, SUITE 1927, NEW YORK, NY 10004
TIfE PLATIA 1.AW FIRM, PL[.042
61927-NEW
StjITE
of 49 NY 10004"PIloNE:
BROADWAY, YORK, 2t2-514-5100,
FAX: 212-514-9300
FILED: KINGS COUNTY CLERK 01/19/2023 03:59 PM INDEX NO. 504273/2017
FILED: DOC. KINGS COUNTY CLERK 12/22 /2022 INDEXNYSCEF:
NO. 504273/2017
NYSCEF NO. 147 11: 41 AM| RECEIVED 01/19/2023
NYSCEF DOC. NO. 131 RECEIVED NYSCEF: 12/22/2022
SUPREME COURTOF THE STATEOF NEW YORK
COUNTY OF KINGS
-------------------------------------------------------------------------X ·
Index No 504273/2017
ROBERT ZABORSKl, SO-ORDERED
Plaintiff, SUBPOENA DUCES TECUM
-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
To: Patient: ROBERT ZABORSKl
Kings County Hospital Center D!OiB:
45I Clarkson Avenue
Brooklyn, New York 11203
A TTN: RA DIOLOGY DEPARTMENT
WE COMMAND YOU, thatall business and excuses being laid aside,you and each of you appear and attend beforeTILe
Platta Law Firm, PLLC, 42 Broadway, Suite 1927, New York, New York 10004, on January 24, 2023, at 9:30 a.m.,and atany
recessed or ad journed date togive lestimony in thisaction on partof the ROBERT
plaintiff, ZABORSKI and thatyou bring with
you, and produce at the time and place aforesaid, a CERTIFIED copy of RADIOLOGICAL & DIAGNOSTIC STUDIES
RECORDS & FILMS from July 18, 2016 to present, now inyour custody.
YOUR PERSONAL APPEARANCE IS UNNECESSARY IF YOU DELIVER THE AFOREMENTIONED RECORDS
ON OR BEFORE THE RETURN DATE HEREOF TO:
The PLATTA LAW FIRM, PLLC
42 Broadway, Suite 1927
New York, New York 10004
The aforementioned records must be accompanied by a copy ofthis subpoena and the enclosed certifiçation,executed
by the custodian of records, another quthorized witness or a qualified physician.
FAILURE to with thissubpoena is punishabicas contempt of Court and shallmake you liableto theperson on whose
comply
behalf thissubpoena was issued fora penalty not toexceed and
fifty 00/100 (S50.00) dollarsand all damages sustainedby reasonsof
your failuretocomply.
Dated: New York, New York
December 15, 2022 Yours, etc.
THE PLATTA LAW FIRM, PLLC
Howard Frederick,Esq.
Attorney forPlaintif
42 Broadway, Suite 1927
New York. NY 10004
(212) 514-5100
SO-ORDERED:
OFFICE,*
COPY OF TlIIS SUBPOENA MyST ACCOMPANY ALL RECORDS MAILED TO OUR
*
Hon. Debra Silber J.S.C. 12/22/2022
TilE PLATTA 1AW Final,PLLC·42 BROADWAY, SUIT§492 FEy1YORK, NY 10004·PlIONE: 211-514-9300
212-514.5100, FAX:
7 of 49
FILED: KINGS COUNTY CLERK 01/19/2023 03:59 PM INDEX NO. 504273/2017
NYSCEF DOC. NO. 147 RECEIVED NYSCEF: 01/19/2023
SUPREME COURT OF THE STATE OF NEW YORK
COUNTY OF KINGS
--------------------------------------------------X Index No.: 504273/20i7
ROBERT ZABORSKI,
Plaintiff, SUBPOENA DUCES TECUM
-against-
MB LORIMER LLC and CORNERSTONE
BUILDERS NY LLC,
Defendants.
-...--.....--..--......-...--...-.---..._.-------Ç
CORNERSTONE BUILDERS NY LLC,
Third-Party Plaintiff,
-against-
NEW YORK BUILDER OF STAIRS, INC.
Third-Party Defendants.
_.-------.__-..-------.........___.._...-----.x
To: Patient: ROBERT ZABORSKI
Kings County Hospital Center D/O/B:
451 Clarkson Avenue
Brooklyn, New York I 12O3
ATTN: RADIOLOGV DEPARTMENT
WE COMMAND YOU, that allbusiness and excuses being laid aside,you and each of you appear and attend before T!le
Platta Law Firm. PLLC. 42 Broadway. Suite 1927. New York. New York 10004. on January 24. 2023. at 9:30 a.m.. and at any
recessed or adiourned date to give testimony inthis actionon partof the ROBERT
plaintiff, ZABORSKI and that you bring with
you, and produce at the time and place aforesaid, a CERTIFIED copy of RADIOLOGICAL & DIAGNOSTIC STUDIES
RECORDS & FILMS from Juiv 18. 2016 to oresent. now inyour custody.
YOUR PERSONAL APPEARANCE ISUNNECESSARY IF YOU DELIVER THE AFOREMENTIONED RECORDS
ON OR BEFORE THE RETURN DATE HEREOF TO:
The PLATTA LAW FIRM, PLLC
42 Broadway, Suite 1927
New York, New York 10004
The aforementioned records must be accompanied by a copy of thissubooena and the enclosed certification. executed
by the custodian of records. another authorized witness or a analified physician.
FAILURE to comply with thissubpoena is punishable as contempt ofCourt and shall make you liableto theperson on whose
behalf thissubpoena was issued fora penalty not to exceed fiftyand 00/100 ($50.00) dollars and alldamages sustained by reasons of
your failureto comply.
Dated: New York, New York
December 15, 2022 Yours, etc.
THE PLATTA LAW FIRM, PLLC
Howard Frederick, Esq.
Attorneyfor Plaintif
42 Broadway, Suite 1927
New York, NY 10004
(212) 514-5100
SO-ORDERED:
MAILED TO OUR OFFICE.*
*A COPY OF THIS SUBPOENA MUST ACCOMPANY ALL RECORDS
THE PLATTA LAW FIRM, PLLC"42 BROADWAY, SUITE 81927"NEW
of 49 YORK, NY 10004"PHONE: 2t2-514-5100,FAX: 212-514-9300
FILED: KINGS COUNTY CLERK 01/19/2023 03:59 PM INDEX NO. 504273/2017
OCA Official Form No.:960
NYSCEF DOC. NO. 147 RECEIVED NYSCEF: 01/19/2023
AUTHORIZATION FOR RELEASE OF HEALTH INFORMATION PURSUANT TO IIIPPA
[Thisform has been approvedby the New York StateDepartment of Ilealth]
PatientName SocialSecurityNumber
ROBERT 7ABORSKI
PatientAddress
66-21 52nd Drive.Maspeth. NY I1378
1. or my authorized
representative.
requestthat
health informationregardingmy eare and treatmentbe released
as set forth
on this
form: in
accordance nithNew York StateLaw and the Privacy
Rule of the Ilealth
Insurance and Accountability
Portability Actof 1996 (HIPPA), I
understandthat:
1. This authorizationmay includedisclosure of information relatingto ALCOllOL and DRUG ABUSE, MENTAL HEALTH
TREATMENT. except notes.and CONFIDENTAL HIV* RELATED
psychotherapy INFORMATION only if1place my initials
on the
appropriatelinein Item9(a).In the event
the health
informationdescribed belon includedany ofthese ty pes of
inlhrmation.and I initial
the
lineon the boxm Item 9(a).I specifically
authorizereleaseofsuch informationto the person(s)
indicatedinItem 8.
2. If
I am authorizingthe release of
IIlV-related.
alcoholor drugtreatment.
or mental healthtreatmentinformation.
the recipient
is prohibited
from such
redisclosing informationwithout my authorizationunlesspermittedto do so underfederal
or state
law.
1 understandthatI havethe right
to requesta list
ofpeople who may receiveor use myIIIV-relatedinformationwithout authorization.
IfI
experience discrimination
because of thereleaseor disclosure
of lilV-relatedinformation,1 may contactthe New York StateDivisionof
f lumanRights at (212)480-2493 or the New York CityCommission of Human Rights at (212)306-7450. These agenciesare responsible
forpmtecting my rights.
3. I have the right
to revokethisauthorizationat any time
by writingto the health
care provider
listed
below. I understand
thatI may revoke
thisauthorization
expect to the extent
that action
has alreadybeen takenbased on thisauthorization.
4. I understand
that signing
this authorization
is voluntary.
My treatment.
payment. enrollmentin a health
plan.or eligibility
forbenefitswill
not be conditioned
upon my of
authorization this
disclosure.
5. Information
disclosedunder this authorization
might be redisclosed
by the recipient
(exceptas notedabove in Item2). and this redisclosure
may no longerbe protected
by federalor state law
6. THIS AUTHORI7,ATION DOES NOT AUTHOR1ZE YOU TO DISCUSS MY HEALTil INFORMATION OR MEDICAL
CARE WITH ANYONE OTHER THAN TilE ATTORNEY OR GOVERMENTAL AGENY SPECIFIED IN ITEM 9(b).
7. Name and addressof healthprovideror entity
to release
thisinformation:
Kings County Hospital Center, 451 Clarkson Avenue, New York 11203
Brooklyn,
8. Name and address or person(s)
or category
of personto whom thiswillbe sent:
The Platta Law Firm. PLLC, 42 Suite 1927. New NY 10004
Broadway, York,
9(a).Specificinformationto be released:
O Medical Record from (insert
date) to (insert
date)
O Entire MedicalRecord. includingpatienthistories.
of ee notes(except notes).test results.
psychotherapy radiologystudies.films.
referrals.
consults.
billingrecords.
insurancerecords,and recordssent to youby otherhealthcareproviders.
[El Other: ra,diological
Preview
FILED: KINGS COUNTY CLERK 01/19/2023 03:59 PM INDEX NO. 504273/2017 NYSCEF DOC. KINGS NO. 147 COUNTY RECEIVEDINDEXNYSCEF: NO. 42 73 /2017 50 01/19/2023 FILED: CLERK 12 /22 /2022 11:41 AM| NYSCEF DOC. NO. 131 RECEIVED NYSCEF: 12/22/2022 SUPREMECOURTOF THESTATEOFNEW YORK COUNTY OF KINGS ------------------------------------------------------------------------X Index No.: 504273/2017 ROBERT ZABORSKI, SO-ORDERED Plaintiff, SUBPOENA DUCES TECUM -against- MB LORIMER LLC and CORNERSTONE BUlLDERS NY LLC, Defendants. ............-......-................................---.............x CORNERSTONE BUILDERS NY LLC, Third-Party Plaintiff, -against- NEW YORK BUILDER OF STAIRS, INC. Third-Party Defendants. ......................--................................................x To: Patient: BORSKl Kings County Hospital Center D/O/B: 451 Clarkson Avenue Brooklyn, New York I 1203 ATTN: BfLL/NG DEPARTMENT WE COMMAND Y OU, thatallbusiness and excuses being laidaside.you and each ofyou appear and attendbefore.T.hite Platta Law Firm, PLLC, 42 Broadway, Suite 19271 New York, New York 10004, on January 24 2013, at9:30 a.m., and at any recessed or adjourned date to givetestimony inthisaction on pan of the ROBERT plaintiff, ZABORSKI and thatyou bring with you, and produce at thetime and place aforesaid,a CERTIFIED BILLING RECORDS from July 18 2016 to present,now inyour custody. YOUR PERSONAL APPEARANCE IS UNNECESSARY IF YOU DELIVER THE AFOREMENTIONED RECORDS ON OR BEFORE THE RETURN DATE HEREOF TO: The PLATTA LAW FIRM, PLLC 42 Broadway, Suite 1927 New York, New York 10004 The aforemeqÇjoned recçrds must be accompanied by a copy ofthis subpoena and the enclosed executed certification, hy the custodian of recÁrÇis,another authorized witness or a qualified physician. FAILURE to with thissubpoena is punishableas contempt of Court and shallmake you liabletothe person on whose comply behalf thissubpocna was issued fora penalty not toexceed fiftyand 00/100 (S50.00) dollarsand alldamages sustainedby reasons of your failureto comply. Dated: New York, New York December 15, 2022 Yours, etc. THE PLATTA LAW FlRM, PLLC Howard Frederick,Esq. Attorneyfor Plaintry 42 Broadway, Suite 1927 New York, NY 10004 (212) 514-5100 SO-ORDERED: OUR OFFICE.* COPY OF TH(S MUST ACCOMPANY ALL RF,008pS MAILED TO 'A SUBPOENA Hon. Debra Silber J.S.C. 12/22/2022 NY 1000+PilONE: 212-514.9300 212-514-s100, FAX: TilE PLATrA LAW FiltM,PLLC"42 nROADWAV, Sl'lTg$92&FE3F1YORK. 1 of 49 FILED: KINGS COUNTY CLERK 01/19/2023 03:59 PM INDEX NO. 504273/2017 NYSCEF DOC. NO. 147 RECEIVED NYSCEF: 01/19/2023 SUPREME COURT OF THE STATE OF NEW YORK COUNTY OF KINGS ------------------------------------------X Index No.: 504273/2017 ROBERT ZABORSKl, Plaintiff, SUBPOENA DUCES TECUM -against- MB LORIMER LLC and CORNERSTONE BUILDERS NY LLC, Defendants. .---.__...---.--.._.--...._..._.--....______Ç CORNERSTONE BUILDERS NY LLC, Third-Party Plaintiff, -against- NEW YORK BUILDER OF STAIRS, INC. Third-Party Defendants. --....__.-------..__..---...-----.....-----..._Ç To: Patient: ROBERT BORSKI Kings County Hospital Center D/O/B: 451 Clarkson Avenue Brooklyn, New York 11203 A TTN; BILLING DEPARTMENT WE COMMAND YOU, thatallbusiness and excuses being laid aside,you and each of you appear and attendbefore _Ille Plattp 1,pw Firm, PLLC, 42 Broadway, Suite 1927, New York, New York 10004, on January 24, 2023, at 9Q0 9,m., and Stgpy recessed or ad journed date to give testimony in thisaction on partof the ROBERT plaintiff, ZABORSKI and that you bring with you, and produce at thetime and place aforesaid, a CERTIFIED BILLING REÇQRDS from July 18, 201§ 19 present, now inyour custody. YOUR PERSONAL APPEARANCE IS UNNECESSARY IF YOU DELIVER THE AFOREMENTIONED RECORDS ON OR BEFORE THE RETURN DATE HEREOF TO: The PLATTA LAW FIRM, PLLC 42 Broadway, Suite 1927 New York, New York 10004 The aforementioned records must be accompanied by a copy of thissubpoena and the enclosed certification,executed by the custodian of records, another authorized witness or a analified physician. FAILURE to comply with thissubpoena is punishable as contempt of Court and shall make you liableto theperson on whose behalf thissubpoena was issuedfora penalty not toexceed fiftyand 00/100 ($50.00) dollars and all damages sustained by reasons of your failureto comply. Dated: New York, New York December 15, 2022 Yours, etc. THE PLATTA LAW FIRM, PLLC Howard Frederick, Esq. Attorney for Plaintry 42 Broadway, Suite 1927 New York, NY 10004 (212) 514-5100 SO-ORDERED: RECORDS TO OUR OFFICE.* *A COPY OF THIS SUBPOENA MUST ACCOMPANY ALL MAILED THE PLATTA LAW FIRM, PLLO42 BROADWAY, SUITE 21927"NEW of 49 YORK, NY 10004"PHONE: 212-514-5100,FAX: 212-$14-9300 FILED: KINGS COUNTY CLERK 01/19/2023 03:59 PM INDEX NO. 504273/2017 OCA Official Form No.:960 NYSCEF DOC. NO. 147 AUTHORIZATION FOR RELEASE OF RECEIVED NYSCEF: 01/19/2023 HEALTH INFORMATION PURSUANT TO HIPPA |Thisform has been approvedby the New York StateDepartment of llcalth] PatientName Social Number Security ROBERT ZABORSKI PatientAddress 66-21 52nd Drive.Maspeth. NY I1378 L or my authorizedrepresentative. requestthat health in formation regardingmy care and treatmentbe released as set forth on this form In accordance withNew York StateIn and the Privacy Rule of the HealthInsurance and AccountabilityActof 1996 (Il[PPA).I Portability understand that: I. I hisauthorizationmay inchide disclosure of information relatingto ALCOHOI, and DRUG AllUSE, MENTAL IIEALTil TREATMENT. except notes.and CONFIDENTAL IIIV* RELATED psy chotherapy INFORMATION only if1 place my initials on the appropriatelinein Item 9(at In the event the health informationdescribedbelow included these types any of of information. and I initial the lineon the hoxin Item9(a).I specifically authorizerelease of such informationm the person(s)indicatedinItem8. 2. If I am authorizing the release of FilV-related. alcoholor drug or mental treatment. healthtreatmentinformation.the recipient is prohibited from such information redisclosing without my authorizationunlesspermittedto do so under federalor state law. I understandthatI havethe right to requesta list of people who may receiveoruse my I11V-relatedinformationwithout authorization. liI experiencediscriminationbecause ofthe releaseordisclosureof I11V-relatedinformation. 1 may contact theNew York State Divisionof Human Rights at (212) 480-2493 or the New York CityCommission of Human Rights at (212) 306-7450. These agenciesare responsible forprotectingmy rights. 3. I have the right to revokethisauthorization at anytime by w riting to the health eare providerlisted below. I understand thatI may revoke this expect authorization to the extent that action has alreadybeen takenbased on thisauthorization. 4. I understand that signing this authorization is voluntary. My treatment. payment. enrollmentin a health plan.or eligibility forbenefitswill not be conditioned upon my authorization of this disclosure. 5. In formation disclosedunder this authorization mightbe redisclosedby the recipient (exceptas notedabove in item2). and this redisclosure may no longer be protected by federa:or state law. 6. THIS AUTHORIZATION DOES NOT AUTl1ORIZE YOU TO DISCUSS MY HEAl TH INFORMATION OR MEDICAL CARE WITH ANYONE OTHER THAN TilE ATTORNEY OR GOVERMENTAL AGENY SPECIFIED IN ITEM 9(b). 7. Name and addressof healthprovideror entity to release this information: Kings County Hospital Center, 451 Clarkson Avenue, Brooklyn, New York 11203 8. Name and addressor person(s)or category of personto whom thiswillbe sent: The Platta Law Firm, PLLC, 42 Broadway, Suite 1927, New York. NY 10004 9(a).Specificinfomiationto be released: O Medical Record from (insertdate) to (insert date) O EntireMedicalRecord. includingpatient office histories. notes (except notes). psy chotherapy test results. radiologystudies. Glms. consults. referrals. billingrecords.insurance and records records. sent to youby otherheahh care providers. ECSen-f- E Other: records billine om o9//8/20/6 1lo Include:(Indicate by initialing) .Z Alcohol/Drug 1reatment Mental liealthIn formation 7 HIV-Related Information Authorizationto DiscussIlealthinformation (b)O By here initialing I authorize . Initials Name ofindividualhealthcare provider to discuss my healthinformationwith my attomey. or a governmentalagency. listed here: (Auorney/FirmName or Governmental Agency Name) 10. Reason for in formation: release of I 1. Date or event on which thisauthorization willexpire: O At requestof indis idual E Other: 1.ITIGATION UPON COMPl£TION OF LIGATION 12. if name of not the patient. personsigning form: 13. Authority to signon behalfo f patient: All itemson thisformhave been completedand my questionsabout thisform have been answered. M1alisdacGiqmakizdisbar In addition. ' New York cop f tis rm Neary Pudic State of Date: O2 2- 0½OG406539 Signat ent or'presentativ e authorizedby law. Quelied in Queens County Commission Expires March 30, 2024 The New York State Public Health Lau Virus that causes AIDS *1luman Immunodeliciency protects information someone which reasonably could identify as having lilV regarding a person s contacts. symptoms or mfecuon and mfonnation 3 of 49 FILED: KINGS COUNTY CLERK 01/19/2023 03:59 PM INDEX NO. 504273/2017 NYSCEF DOC. NO. 147 RECEIVED NYSCEF: 01/19/2023 CERTIFICATION OF RECORDS CLAIMANT'S NAME: Robert Zaborski NAME OF OFFICE: Kings County Hospital Center /Billing Department DATES OF SERVICE: JULY 18, 2016 TO PRESENT Pursuant to Section 4518 of the Civil Practice Law and Rules, this is to certify that the attached is an exact copy of the original records, which I have in my custody and control. The records were made and kept in the regular course of business of our facility and it is in the regular course of business of our facility to make such records at or about the time of the events described in the records. Billing Department Date PLATTA LAW PLLC"42 BROADWAY, sUITE 4 1927"NEW of 49 YORK, NY 10004"PHONE: FAx:212-514-9300 212-514-5100, THE FIRM, FILED: KINGS COUNTY CLERK 01/19/2023 03:59 PM INDEX NO. 504273/2017 NYSCEF DOC. NO. 147 RECEIVED NYSCEF: 01/19/2023 SUPREME COURT OF THE STATE OF NEW YORK COUNTY OF KINGS --------------------------------------------------------------------------X Index No.: 504273/2017 ROBERT ZABORSKl, Plaintiff, SUBPOENA DUCES TECUM -against- MB LORIMER LLC and CORNERSTONE BUILDERS NY LLC, Defendants. .......--------....----......___-------.._____....---_____.--____-._______Ç CORNERSTONE BUILDERS NY LLC, Third-Party Plaintiff, -against- NEW YORK BUILDER OF STAIRS, INC. Third-Party Defendants. ______.------- _____.--------____--------._____.--__________--....______...Ç SUBPOENADUCESTECUM I II THE PLATTA LAW FIRM, PLLC Attorneys for: Plaintiff(s) 42 Broadway, Suite 1927 New York, New York 10004 (212) 514-5100 The undersigned attorney hereby certifies,pursuant to22 NYCRR 130-1.1-a that he/she has read the within papers and that same are not frivolous as thatterm is definedin 22 NYCRR 130-1.1(c). Howard Frederick, Esq. Service of a copy of thewithin is hereby admitted. Dated, Attorney(s) for PLEASE TAKE NOTICE: O NOTICE OF ENTRY thatthe within true is a (certified) copy of an duly entered in the officeof theclerk of thewithin named court on 200__. O NOTICE OF SETTLEMENT thatan order of which the within is a true copy willbe presented forsettlement to theHON. one of the judges of thewithin named Court, at on 200 at O'clock .M. Dated: December 15, 2022 Yours, etc. THE PLATTA LAW FIRM, PLLC THE PLATTA LAW FIRM, PLLC"42 BROADWAY, SUITE 51927"NEW of 49 YORK, NY 10004-PHONE: 212-514-5100,FAX: 212-514-9300 FILED: KINGS COUNTY CLERK 01/19/2023 03:59 PM INDEX NO. 504273/2017 NYSCEF DOC. NO. 147 RECEIVED NYSCEF: 01/19/2023 . SUPREME COURT OF THE STATE OF NEW YORK COUNTY OF KINGS -----------------------------------------------------------------------X Index No.: 504273/2017 ROBERT ZABORSKl, Plaintiff, SUBPOENA DUCES TECUM -against- MB LORIMER LLC and CORNERSTONE BUlLDERS NY LLC, Defendants. ___---------------------.........._____________________Ç CORNERSTONE BUILDERS NY LLC, Third-Party Plaintiff, -against- NEW YORK BUILDER OF STAIRS, INC. Third-Party Defendants. ----------------.._____.....____.__......._......__,---Ç DATE OF SERVICE: f NAME OF FACILITY: Kings County Hospital Center /Billing Department SERVED ON (NAME): MANNER OF SERVICE: ERSONAL _MAIL DECLARATION OF SERVER I declareunder penalty of perjuryunder the laws ofthe United Statesof America thatthe foregoing information contained inthe Proof of Service is true and correct. EXECUTED ON (DATE): SIGNATURE OF SERVE SERVER NAME: ADDRESS OF SERVER: 42 BROADWAY, SUITE 1927, NEW YORK, NY 10004 TIfE PLATIA 1.AW FIRM, PL[.042 61927-NEW StjITE of 49 NY 10004"PIloNE: BROADWAY, YORK, 2t2-514-5100, FAX: 212-514-9300 FILED: KINGS COUNTY CLERK 01/19/2023 03:59 PM INDEX NO. 504273/2017 FILED: DOC. KINGS COUNTY CLERK 12/22 /2022 INDEXNYSCEF: NO. 504273/2017 NYSCEF NO. 147 11: 41 AM| RECEIVED 01/19/2023 NYSCEF DOC. NO. 131 RECEIVED NYSCEF: 12/22/2022 SUPREME COURTOF THE STATEOF NEW YORK COUNTY OF KINGS -------------------------------------------------------------------------X · Index No 504273/2017 ROBERT ZABORSKl, SO-ORDERED Plaintiff, SUBPOENA DUCES TECUM -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 To: Patient: ROBERT ZABORSKl Kings County Hospital Center D!OiB: 45I Clarkson Avenue Brooklyn, New York 11203 A TTN: RA DIOLOGY DEPARTMENT WE COMMAND YOU, thatall business and excuses being laid aside,you and each of you appear and attend beforeTILe Platta Law Firm, PLLC, 42 Broadway, Suite 1927, New York, New York 10004, on January 24, 2023, at 9:30 a.m.,and atany recessed or ad journed date togive lestimony in thisaction on partof the ROBERT plaintiff, ZABORSKI and thatyou bring with you, and produce at the time and place aforesaid, a CERTIFIED copy of RADIOLOGICAL & DIAGNOSTIC STUDIES RECORDS & FILMS from July 18, 2016 to present, now inyour custody. YOUR PERSONAL APPEARANCE IS UNNECESSARY IF YOU DELIVER THE AFOREMENTIONED RECORDS ON OR BEFORE THE RETURN DATE HEREOF TO: The PLATTA LAW FIRM, PLLC 42 Broadway, Suite 1927 New York, New York 10004 The aforementioned records must be accompanied by a copy ofthis subpoena and the enclosed certifiçation,executed by the custodian of records, another quthorized witness or a qualified physician. FAILURE to with thissubpoena is punishabicas contempt of Court and shallmake you liableto theperson on whose comply behalf thissubpoena was issued fora penalty not toexceed and fifty 00/100 (S50.00) dollarsand all damages sustainedby reasonsof your failuretocomply. Dated: New York, New York December 15, 2022 Yours, etc. THE PLATTA LAW FIRM, PLLC Howard Frederick,Esq. Attorney forPlaintif 42 Broadway, Suite 1927 New York. NY 10004 (212) 514-5100 SO-ORDERED: OFFICE,* COPY OF TlIIS SUBPOENA MyST ACCOMPANY ALL RECORDS MAILED TO OUR * Hon. Debra Silber J.S.C. 12/22/2022 TilE PLATTA 1AW Final,PLLC·42 BROADWAY, SUIT§492 FEy1YORK, NY 10004·PlIONE: 211-514-9300 212-514.5100, FAX: 7 of 49 FILED: KINGS COUNTY CLERK 01/19/2023 03:59 PM INDEX NO. 504273/2017 NYSCEF DOC. NO. 147 RECEIVED NYSCEF: 01/19/2023 SUPREME COURT OF THE STATE OF NEW YORK COUNTY OF KINGS --------------------------------------------------X Index No.: 504273/20i7 ROBERT ZABORSKI, Plaintiff, SUBPOENA DUCES TECUM -against- MB LORIMER LLC and CORNERSTONE BUILDERS NY LLC, Defendants. -...--.....--..--......-...--...-.---..._.-------Ç CORNERSTONE BUILDERS NY LLC, Third-Party Plaintiff, -against- NEW YORK BUILDER OF STAIRS, INC. Third-Party Defendants. _.-------.__-..-------.........___.._...-----.x To: Patient: ROBERT ZABORSKI Kings County Hospital Center D/O/B: 451 Clarkson Avenue Brooklyn, New York I 12O3 ATTN: RADIOLOGV DEPARTMENT WE COMMAND YOU, that allbusiness and excuses being laid aside,you and each of you appear and attend before T!le Platta Law Firm. PLLC. 42 Broadway. Suite 1927. New York. New York 10004. on January 24. 2023. at 9:30 a.m.. and at any recessed or adiourned date to give testimony inthis actionon partof the ROBERT plaintiff, ZABORSKI and that you bring with you, and produce at the time and place aforesaid, a CERTIFIED copy of RADIOLOGICAL & DIAGNOSTIC STUDIES RECORDS & FILMS from Juiv 18. 2016 to oresent. now inyour custody. YOUR PERSONAL APPEARANCE ISUNNECESSARY IF YOU DELIVER THE AFOREMENTIONED RECORDS ON OR BEFORE THE RETURN DATE HEREOF TO: The PLATTA LAW FIRM, PLLC 42 Broadway, Suite 1927 New York, New York 10004 The aforementioned records must be accompanied by a copy of thissubooena and the enclosed certification. executed by the custodian of records. another authorized witness or a analified physician. FAILURE to comply with thissubpoena is punishable as contempt ofCourt and shall make you liableto theperson on whose behalf thissubpoena was issued fora penalty not to exceed fiftyand 00/100 ($50.00) dollars and alldamages sustained by reasons of your failureto comply. Dated: New York, New York December 15, 2022 Yours, etc. THE PLATTA LAW FIRM, PLLC Howard Frederick, Esq. Attorneyfor Plaintif 42 Broadway, Suite 1927 New York, NY 10004 (212) 514-5100 SO-ORDERED: MAILED TO OUR OFFICE.* *A COPY OF THIS SUBPOENA MUST ACCOMPANY ALL RECORDS THE PLATTA LAW FIRM, PLLC"42 BROADWAY, SUITE 81927"NEW of 49 YORK, NY 10004"PHONE: 2t2-514-5100,FAX: 212-514-9300 FILED: KINGS COUNTY CLERK 01/19/2023 03:59 PM INDEX NO. 504273/2017 OCA Official Form No.:960 NYSCEF DOC. NO. 147 RECEIVED NYSCEF: 01/19/2023 AUTHORIZATION FOR RELEASE OF HEALTH INFORMATION PURSUANT TO IIIPPA [Thisform has been approvedby the New York StateDepartment of Ilealth] PatientName SocialSecurityNumber ROBERT 7ABORSKI PatientAddress 66-21 52nd Drive.Maspeth. NY I1378 1. or my authorized representative. requestthat health informationregardingmy eare and treatmentbe released as set forth on this form: in accordance nithNew York StateLaw and the Privacy Rule of the Ilealth Insurance and Accountability Portability Actof 1996 (HIPPA), I understandthat: 1. This authorizationmay includedisclosure of information relatingto ALCOllOL and DRUG ABUSE, MENTAL HEALTH TREATMENT. except notes.and CONFIDENTAL HIV* RELATED psychotherapy INFORMATION only if1place my initials on the appropriatelinein Item9(a).In the event the health informationdescribed belon includedany ofthese ty pes of inlhrmation.and I initial the lineon the boxm Item 9(a).I specifically authorizereleaseofsuch informationto the person(s) indicatedinItem 8. 2. If I am authorizingthe release of IIlV-related. alcoholor drugtreatment. or mental healthtreatmentinformation. the recipient is prohibited from such redisclosing informationwithout my authorizationunlesspermittedto do so underfederal or state law. 1 understandthatI havethe right to requesta list ofpeople who may receiveor use myIIIV-relatedinformationwithout authorization. IfI experience discrimination because of thereleaseor disclosure of lilV-relatedinformation,1 may contactthe New York StateDivisionof f lumanRights at (212)480-2493 or the New York CityCommission of Human Rights at (212)306-7450. These agenciesare responsible forpmtecting my rights. 3. I have the right to revokethisauthorizationat any time by writingto the health care provider listed below. I understand thatI may revoke thisauthorization expect to the extent that action has alreadybeen takenbased on thisauthorization. 4. I understand that signing this authorization is voluntary. My treatment. payment. enrollmentin a health plan.or eligibility forbenefitswill not be conditioned upon my of authorization this disclosure. 5. Information disclosedunder this authorization might be redisclosed by the recipient (exceptas notedabove in Item2). and this redisclosure may no longerbe protected by federalor state law 6. THIS AUTHORI7,ATION DOES NOT AUTHOR1ZE YOU TO DISCUSS MY HEALTil INFORMATION OR MEDICAL CARE WITH ANYONE OTHER THAN TilE ATTORNEY OR GOVERMENTAL AGENY SPECIFIED IN ITEM 9(b). 7. Name and addressof healthprovideror entity to release thisinformation: Kings County Hospital Center, 451 Clarkson Avenue, New York 11203 Brooklyn, 8. Name and address or person(s) or category of personto whom thiswillbe sent: The Platta Law Firm. PLLC, 42 Suite 1927. New NY 10004 Broadway, York, 9(a).Specificinformationto be released: O Medical Record from (insert date) to (insert date) O Entire MedicalRecord. includingpatienthistories. of ee notes(except notes).test results. psychotherapy radiologystudies.films. referrals. consults. billingrecords. insurancerecords,and recordssent to youby otherhealthcareproviders. [El Other: ra,diological