On February 20, 2020 a
Request,Application
was filed
involving a dispute between
Camille Jacobsen A Minor Maeve Jacobsen A Minor Luke Jacobsen A Minor Through Their Guardian Ad Litem Stacie Jacobsen,
Jacobsen Stacie,
and
Bhandari M.D. Anil Kumar,
Cardiology Associates Medical Group Dba Los Angeles Cardiology Associates A Medical Group,
Cedars Sinai Medical Care Foundation Doe 141,
Cedars Sinai Medical Group,
Keck Medical Center Of Usc Doe 101,
Keck Medicine Of Usc Doe 104,
Khiem P.V. Nyguen M.D. Cardiology Associates Medical Group Inc A California Corporation Dba Los Angeles Cardiology Associates A Medical Group,
Usc Care Medical Group Inc. Doe 103,
Usc Care Medical Group Keck Usc Hospital Doe 102,
for Medical Malpractice - Physicians & Surgeons (General Jurisdiction)
in the District Court of Los Angeles County.
Preview
CIV-110
ATTORNEY OR PARTY 'NITHOUT ATT OR NEY (Nsm&, State Bar numb6f, and address)·
Bruce G. Fagel, Esq./Devon M . Fagel, Esq. SBN: 103674/235228 FOR COURT USE ONLY
Law Offices of Bruce G. Fagel & Associates
9200 W. Sunset Blvd., Ste. 670, West Hollywood, CA 90069
TELEPHONE NO.: (310) 281-8700 FAX NO. (Opttonal)' (310) 28 f-5656
E-MAIL ADDRESS (Optional);
ATTORNEY FOR (Name): Attornevs for Plaintiffs
SUPERIOR COURT OF CALIFORNIA, COUNTY OF Los Angeles
STREET ADDREss. 312 N. Spring Street
MAILING ADDREss, 312 N . Spring Street
cITY AND 2IP cooE: Los Angeles 90012
BRANCH NAME: Spring Street Courthouse
PLAINTIFF/PETITIONER: Stacie Jacobsen, et al.
DEFENDANT/RESPONDENT: Khiem P.V. Nguyen, M .D, et al.
REQUEST FOR DISMISSAL CASE NUMBER20STCV0722 I
A conformed copy will not be returned by the clerk unless a method of return is provided with the document.
This form may not be used for dismissal of a derivative action or a class action or of any party or cause of action in a
class action. (Cal. Rules of Court, rules 3.760 and 3.770.)
1. TO THE CLERK: Please dismiss this action as follows:
a. ( 1) IJ[] With prejudice (2) D
Without prejudice
b. (1) D Complaint (2) D
Petition
(3) D Cross-complaint filed by (name) : on (date):
(4) D Cross-complaint filed by (name) : on (date):
(5) D Entire action of all parties and all causes of action
(6) IJ[] other (specify):* Dismissal as to Defendant, Cedars Sinai Medical Group (DOE 140) ONLY
2. (Complete in all cases except family law cases.)
The court D
did [J[] did not waive court fees and costs for a party in Is case. (This information may obtained from
Electronically Received 05/12/2021 08:19 AM
the clerk. If court fees and costs were waived, the declaration on the back o · form must be complete
Date: May 6, 2021 ~ -·-···-.... __,_
(TYPE OR PRINT NAMEOF 1
.B.r:u.c~. 0, f llgel., . s.q.fevoIJ .M, fllgel., .l~s.q. . . . . . . .
X ATTORNEY D PARTY 'NITHOUT ATTORNEY)
~-----z:::;;;;~~~==:::::::::::=~r---
RE)
'II dismissal requested is of specified parties only of specified causes of action Attorney or party without attorney for:
only, or of specified cross-complaints only, so state and identify the parties,
causes of action, or cross-complaints to be dismissed. rn Plaintiff/Petitioner D Defendant/Respondent
D Cross-Complainant
3. TO THE CLERK: Consent to the above dismissal is hereby given.**
Date:
(TYPEOR PRINT NAME OF D ATTORNEY D PARTY 'NITHOUT ATTORNEY) â–º (SIGNATURE)
•• If a cross-complaint - or Response (Family Law) seeking affirmative Attorney or party without attorney for:
relief - is on file, the attorney for cross-complainant (responden1) must
sign this consent if required by Code of Civil Procedure section 581 (i} D Plaintiff/Petitioner D Defendant/Respondent
or (J) .
D Cross-Complainant
(To be completed by clerk)
4. D Dismissal entered as requested on (date) :
5 D Dismissal entered on (date) : as to only (name):
6. D Dismissal not entered as requested for the following reasons (specify):
7. a. D Attorney or party without attorney notified on (date) :
b. D Attorney or party without attorney not notified. Filing party failed to provide
D a copy to be conformed D
means to return conformed copy
Clerk, by _ _ _ _ _ __ __ _ _ _ _ __ __ _ _ , Deputy
Date:
Pago 1 of 2
Form Adopted for Mandatory Use Code of Civil Procedure, § 581 et seq ,
Judicial Council of California REQUEST FOR DISMISSAL Gov Code, § 68637(c)· Cal. Rules ot Court, rule 3 1390
CIV-110 IRev. Jan. 1, 2013) Westlaw~&Fonnlltilder 1vivw.courts ca gov
Document Filed Date
May 12, 2021
Case Filing Date
February 20, 2020
Category
Medical Malpractice - Physicians & Surgeons (General Jurisdiction)
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CIV-110 ATTORNEY OR PARTY 'NITHOUT ATT OR NEY (Nsm&, State Bar numb6f, and address)· Bruce G. Fagel, Esq./Devon M . Fagel, Esq. SBN: 103674/235228 FOR COURT USE ONLY Law Offices of Bruce G. Fagel & Associates 9200 W. Sunset Blvd., Ste. 670, West Hollywood, CA 90069 TELEPHONE NO.: (310) 281-8700 FAX NO. (Opttonal)' (310) 28 f-5656 E-MAIL ADDRESS (Optional); ATTORNEY FOR (Name): Attornevs for Plaintiffs SUPERIOR COURT OF CALIFORNIA, COUNTY OF Los Angeles STREET ADDREss. 312 N. Spring Street MAILING ADDREss, 312 N . Spring Street cITY AND 2IP cooE: Los Angeles 90012 BRANCH NAME: Spring Street Courthouse PLAINTIFF/PETITIONER: Stacie Jacobsen, et al. DEFENDANT/RESPONDENT: Khiem P.V. Nguyen, M .D, et al. REQUEST FOR DISMISSAL CASE NUMBER20STCV0722 I A conformed copy will not be returned by the clerk unless a method of return is provided with the document. This form may not be used for dismissal of a derivative action or a class action or of any party or cause of action in a class action. (Cal. Rules of Court, rules 3.760 and 3.770.) 1. TO THE CLERK: Please dismiss this action as follows: a. ( 1) IJ[] With prejudice (2) D Without prejudice b. (1) D Complaint (2) D Petition (3) D Cross-complaint filed by (name) : on (date): (4) D Cross-complaint filed by (name) : on (date): (5) D Entire action of all parties and all causes of action (6) IJ[] other (specify):* Dismissal as to Defendant, Cedars Sinai Medical Group (DOE 140) ONLY 2. (Complete in all cases except family law cases.) The court D did [J[] did not waive court fees and costs for a party in Is case. (This information may obtained from Electronically Received 05/12/2021 08:19 AM the clerk. If court fees and costs were waived, the declaration on the back o · form must be complete Date: May 6, 2021 ~ -·-···-.... __,_ (TYPE OR PRINT NAMEOF 1 .B.r:u.c~. 0, f llgel., . s.q.fevoIJ .M, fllgel., .l~s.q. . . . . . . . X ATTORNEY D PARTY 'NITHOUT ATTORNEY) ~-----z:::;;;;~~~==:::::::::::=~r--- RE) 'II dismissal requested is of specified parties only of specified causes of action Attorney or party without attorney for: only, or of specified cross-complaints only, so state and identify the parties, causes of action, or cross-complaints to be dismissed. rn Plaintiff/Petitioner D Defendant/Respondent D Cross-Complainant 3. TO THE CLERK: Consent to the above dismissal is hereby given.** Date: (TYPEOR PRINT NAME OF D ATTORNEY D PARTY 'NITHOUT ATTORNEY) ► (SIGNATURE) •• If a cross-complaint - or Response (Family Law) seeking affirmative Attorney or party without attorney for: relief - is on file, the attorney for cross-complainant (responden1) must sign this consent if required by Code of Civil Procedure section 581 (i} D Plaintiff/Petitioner D Defendant/Respondent or (J) . D Cross-Complainant (To be completed by clerk) 4. D Dismissal entered as requested on (date) : 5 D Dismissal entered on (date) : as to only (name): 6. D Dismissal not entered as requested for the following reasons (specify): 7. a. D Attorney or party without attorney notified on (date) : b. D Attorney or party without attorney not notified. Filing party failed to provide D a copy to be conformed D means to return conformed copy Clerk, by _ _ _ _ _ __ __ _ _ _ _ __ __ _ _ , Deputy Date: Pago 1 of 2 Form Adopted for Mandatory Use Code of Civil Procedure, § 581 et seq , Judicial Council of California REQUEST FOR DISMISSAL Gov Code, § 68637(c)· Cal. Rules ot Court, rule 3 1390 CIV-110 IRev. Jan. 1, 2013) Westlaw~&Fonnlltilder 1vivw.courts ca gov