On September 11, 2018 a
Party Statement
was filed
involving a dispute between
Bradbury D.D.S., Michael G,
Bradbury, Rhonda,
Odeh, Ali,
and
Cohan, Kat,
Odeh, Ali,
Fernandez D.D.S, Lyngladen,
Fernandez Dds, Lyngladen,
Kingsley Dentistry,
Kingsly Dentistry,
Lyngadlen Fernandez Dds,
Lyngladen Fernandez D.D.S.,
Ringo Bangalan Dds,
Silagan-Fernandez D.D.S., Lyngadlen,
Suarez-Fernandez Dentistry,
Suarez Fernandez Dentistry And Ringo Bangalan, Dds,
for Medical Malpractice Unlimited
in the District Court of San Bernardino County.
Preview
CIV-050
- DO NOT FILE WITH THE COURT-
OF CIVIL PROCEDURE § 585 -
-UNLESS YOU ARE APPLYING FOR A DEFAULT JUDGMENT UNDER CODE
“TELEPHGNE NC FOR COURT USE HY
ATTORNEY OR PARTY WITHOUT ATTORNEY (Hama and Avaress, 760-751-1
Michael Bradbury, DDS;
{ Rhonda Bradbury
31525 Larga Viste
| Valley Center CA 92082
i
Y INCErvenors
FOR (ame: in pro per am count REEL NA DINO
| ATTORNE SAN BERNARDINO DI ICT
U SUPERIOR COURT OF CALIFORNIA, COUNTY OF Var ino
SIREET ADDRESS 3 West t ra St
FEB 1 0 2021
MAILING ADURESS:
Bernardino CA ¢
curv ano ze coos. SAN
BRANCH NAME a ——4 \ BY. f ahnpsse:
| PLAINTIFF: ALi Odeh eM ne aN,
Lag
L DEFENDANT: Lyngadlen Fernandez, et.al
‘CASE NUMBER:
STATEMENT OF DAMAGES CIVDS 1823772
|u. (Personal Injury or Wrongful Death)
To (name of one defendant only): > 1 Oder ( rvenee)
Plaintiff (name of one plaintiff only): G OUry, bos (fntervenor)
seeks damages in the above-entilled action, as foliow: AMOUNT
4. General damages
a. Pain, suffering, and inconvenience —_——
», [7] Emotional distress. ae
¢. [—) Loss of consortium —_—————_—-
gd.) Loss of eiey and companionship (wrongly! death actions only) ——
4 dent ice of G M el
2. (£1 otner (specify) In
yYe forgery at 900
1, [J other (spocity) B to
9. ] Continued on Attachment 1.9.
2. Special damages
—_————-
a, L__] Medical expenses (to date)
». £] Future medical expenses (present value)
c. 2! Loss of earnings (to date) ———__—__
$—_____—
Loss of future earning capacity (present value)
co Property damage
—_——-
ee
1, (J Funorat expenses (wrongful death actions only)
g. (2) Future contributions (present value) (wronglut death actions vnly) ———_—
h. (J valve of personal service, advice, or training (wronglul death actions only) —
(J other (specify)
j. C2 other (specify) ——
k, (—] Continued on Attachment
96,000.00
(1 punitive damages: Plaintiff reserves the right to f
punitive damages of
in the amount (fpeci
eS eS
when pursuing 3 judgment in the suit fled NSL yOu
Date: 2 / aos
2021 0 Boy {
G
a Michae ragoury, oD ; Chords Rhoda Broclb
TYPE OR PRINT NAME) {SIGHATURE OF PUMIRTIFFOF ATTOAKEY em
(Proof of service on reverse) Page tof?
“FR Code of Cri Procure. 5 425.11, 425.116
STATEMENT OF DAMAGES crm CuHNFO64, OY
Form aagpuedx Manca Lory isUse
CHESS Ren Sanur 07 (Personal Injury or Wrongful Death} wrw.ceb.com
CIV-050
| PLAINTIFF: ALi Odeh CASE HUMBER
OEFENDANT: Lyngadlen Fernandez, et.a CIVDS 1823772
PROOF OF SERVICE
(After having the other party served as described below, with
ari y of the documents identified in item 1, have the person who served
the documents complete this Proof of Service. Plaintiff
cannot s serve (hese papers.)
1, | served the
a. L_ ] Statemen
of Damages
t CJ other (specity):
b. on (name):
¢. by serving CT ge‘endant Cc other (name and litle or relationship to person served).
d. Choy delivery [Jat home [Jat business
(1) date:
(2) time:
(3) address:
e. [7] by mailing
(1) date:
(2) place:
2. Manner of service (check proper box):
a Personal service. By personally delivering copies. (CCP § 415.10)
» CI Substituted service on corporation, unincorporated association {includin
g partnership), or public entity. By
leaving, during usual office hours, copies in the office of the person served wilh the person who apparentlywas in
charge and thereafter mailing (by si-class inail, postage prepaid) copies to the person served at the place where the
Copies were left. (CCP § 415,20(a))
« (J Substituted service on natural person, minor, conservatee,
or candidate. By leaving copies at the dwelling house,
usual place of abode, or usual place of business of ine person
served in the presence of a competent member of the
household or a person apparenily in charg @ of the office or place
of business, at least 18 years of age, who was
informed of the general nature of the pape: rs, and (hereafter mailing
(by first-class mail, postage prepaid) copies to the
person served al the place where the copi ies wal r@ lell. (CCP
§ 415.20(b)) (Attach separate declaration or affidavit
stating acts relied on to establish reasonabl @ diligence In first attemptin
g personal service.)
4] Mall and acknowledgment service. By mailing (by t- class mail or airmail, postage prepaid) copies to the person
served, together with two copies of ihe forin of notice al Ind acknowled
gment and a return envelope, postage prepaid,
addressed lo the sender. (CCP § 415.30} (Atach completed
acknowlodgment of receipt.)
. CJ Certified or registered mail service. By mailing to an address outside Cali
fornia (by first-class mail, postage prepaid,
requiring a return receipt) copies to the pers on served. (CCP § 415.40) (Attach signed return recelpt or other
evidence of actual delivery to the person served.)
{. [2 other (specify code section):
additional page is atiachod.
3. At the time of service | was al least 18 yex '$ of age and not a party to this action.
4. Fee for service: $
5. Person serving:
a. California sheriff, marshal, or constable
{, Name, address and telephor
H
b, Registered California process server
umber and, if applicable,
©, Employee or independent contractor of a registered
county of registration and number:
California process server
af) Nat a registered California process server
e. Exempt from registration under Bus. & Prot. Code
§ 22350(b)
| declare under penalty of perjury under the laws of ihe (For California sheriff, marshal, or constable use only)
State of California that the foragoing is true and correct.
| certify that the foregoing is rue and correct.
Date: ate:
y (SIGNATURE)
b (SIGNATURE)
- —
C1v.-080 fRew. January 1, 2097]
PROOF OF SERVICE CEB
werw.ceb.com
Page Zot?
Cose of Civ Proceowe §§ 425.11, 425.115
(Statement of Damages)
Preview
CIV-050 - DO NOT FILE WITH THE COURT- OF CIVIL PROCEDURE § 585 - -UNLESS YOU ARE APPLYING FOR A DEFAULT JUDGMENT UNDER CODE “TELEPHGNE NC FOR COURT USE HY ATTORNEY OR PARTY WITHOUT ATTORNEY (Hama and Avaress, 760-751-1 Michael Bradbury, DDS; { Rhonda Bradbury 31525 Larga Viste | Valley Center CA 92082 i Y INCErvenors FOR (ame: in pro per am count REEL NA DINO | ATTORNE SAN BERNARDINO DI ICT U SUPERIOR COURT OF CALIFORNIA, COUNTY OF Var ino SIREET ADDRESS 3 West t ra St FEB 1 0 2021 MAILING ADURESS: Bernardino CA ¢ curv ano ze coos. SAN BRANCH NAME a ——4 \ BY. f ahnpsse: | PLAINTIFF: ALi Odeh eM ne aN, Lag L DEFENDANT: Lyngadlen Fernandez, et.al ‘CASE NUMBER: STATEMENT OF DAMAGES CIVDS 1823772 |u. (Personal Injury or Wrongful Death) To (name of one defendant only): > 1 Oder ( rvenee) Plaintiff (name of one plaintiff only): G OUry, bos (fntervenor) seeks damages in the above-entilled action, as foliow: AMOUNT 4. General damages a. Pain, suffering, and inconvenience —_—— », [7] Emotional distress. ae ¢. [—) Loss of consortium —_—————_—- gd.) Loss of eiey and companionship (wrongly! death actions only) —— 4 dent ice of G M el 2. (£1 otner (specify) In yYe forgery at 900 1, [J other (spocity) B to 9. ] Continued on Attachment 1.9. 2. Special damages —_————- a, L__] Medical expenses (to date) ». £] Future medical expenses (present value) c. 2! Loss of earnings (to date) ———__—__ $—_____— Loss of future earning capacity (present value) co Property damage —_——- ee 1, (J Funorat expenses (wrongful death actions only) g. (2) Future contributions (present value) (wronglut death actions vnly) ———_— h. (J valve of personal service, advice, or training (wronglul death actions only) — (J other (specify) j. C2 other (specify) —— k, (—] Continued on Attachment 96,000.00 (1 punitive damages: Plaintiff reserves the right to f punitive damages of in the amount (fpeci eS eS when pursuing 3 judgment in the suit fled NSL yOu Date: 2 / aos 2021 0 Boy { G a Michae ragoury, oD ; Chords Rhoda Broclb TYPE OR PRINT NAME) {SIGHATURE OF PUMIRTIFFOF ATTOAKEY em (Proof of service on reverse) Page tof? “FR Code of Cri Procure. 5 425.11, 425.116 STATEMENT OF DAMAGES crm CuHNFO64, OY Form aagpuedx Manca Lory isUse CHESS Ren Sanur 07 (Personal Injury or Wrongful Death} wrw.ceb.com CIV-050 | PLAINTIFF: ALi Odeh CASE HUMBER OEFENDANT: Lyngadlen Fernandez, et.a CIVDS 1823772 PROOF OF SERVICE (After having the other party served as described below, with ari y of the documents identified in item 1, have the person who served the documents complete this Proof of Service. Plaintiff cannot s serve (hese papers.) 1, | served the a. L_ ] Statemen of Damages t CJ other (specity): b. on (name): ¢. by serving CT ge‘endant Cc other (name and litle or relationship to person served). d. Choy delivery [Jat home [Jat business (1) date: (2) time: (3) address: e. [7] by mailing (1) date: (2) place: 2. Manner of service (check proper box): a Personal service. By personally delivering copies. (CCP § 415.10) » CI Substituted service on corporation, unincorporated association {includin g partnership), or public entity. By leaving, during usual office hours, copies in the office of the person served wilh the person who apparentlywas in charge and thereafter mailing (by si-class inail, postage prepaid) copies to the person served at the place where the Copies were left. (CCP § 415,20(a)) « (J Substituted service on natural person, minor, conservatee, or candidate. By leaving copies at the dwelling house, usual place of abode, or usual place of business of ine person served in the presence of a competent member of the household or a person apparenily in charg @ of the office or place of business, at least 18 years of age, who was informed of the general nature of the pape: rs, and (hereafter mailing (by first-class mail, postage prepaid) copies to the person served al the place where the copi ies wal r@ lell. (CCP § 415.20(b)) (Attach separate declaration or affidavit stating acts relied on to establish reasonabl @ diligence In first attemptin g personal service.) 4] Mall and acknowledgment service. By mailing (by t- class mail or airmail, postage prepaid) copies to the person served, together with two copies of ihe forin of notice al Ind acknowled gment and a return envelope, postage prepaid, addressed lo the sender. (CCP § 415.30} (Atach completed acknowlodgment of receipt.) . CJ Certified or registered mail service. By mailing to an address outside Cali fornia (by first-class mail, postage prepaid, requiring a return receipt) copies to the pers on served. (CCP § 415.40) (Attach signed return recelpt or other evidence of actual delivery to the person served.) {. [2 other (specify code section): additional page is atiachod. 3. At the time of service | was al least 18 yex '$ of age and not a party to this action. 4. Fee for service: $ 5. Person serving: a. California sheriff, marshal, or constable {, Name, address and telephor H b, Registered California process server umber and, if applicable, ©, Employee or independent contractor of a registered county of registration and number: California process server af) Nat a registered California process server e. Exempt from registration under Bus. & Prot. Code § 22350(b) | declare under penalty of perjury under the laws of ihe (For California sheriff, marshal, or constable use only) State of California that the foragoing is true and correct. | certify that the foregoing is rue and correct. Date: ate: y (SIGNATURE) b (SIGNATURE) - — C1v.-080 fRew. January 1, 2097] PROOF OF SERVICE CEB werw.ceb.com Page Zot? Cose of Civ Proceowe §§ 425.11, 425.115 (Statement of Damages)