No Value: Toki Hall As The Administrator Of The Estate Of Bette Grace v. Parkview Operating Co., Llc

On March 27, 2023 a No Value was filed involving a dispute between Toki Hall As The Administrator Of The Estate Of Bette Grace, and Parkview Operating Co., Llc, for Torts - Other Negligence (Public Health Law) in the District Court of Westchester County.

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FILED: WESTCHESTER COUNTY CLERK 08/07/2023 03:06 PM INDEX NO. 58552/2023
NYSCEF DOC. NO. 7 RECEIVED NYSCEF: 08/07/2023

SUPREME COURT OF THE STATE OF NEW YORK
COUNTY OF WESTCHESTER
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TOKI HALL as the Administrator of the Estate of Index No.: 58552/2023
BETTE GRACE,
VERIFIED ANSWER
Plaintiff,

-against-

PARKVIEW OPERATING CO., LLC,

Defendant.
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C O U N S E L O R S:

Defendant, PARKVIEW OPERATING CO., LLC (hereinafter “PARKVIEW”), by its

attorneys, VIGORITO, BARKER, PATTERSON, NICHOLS & PORTER, LLP, answering the

Verified Complaint of the plaintiff, upon information and belief, respectfully shows to this Court

and alleges:

1. Denies each and every allegation in the form alleged contained within paragraph

“1” of plaintiff’s Verified Complaint.

ANSWERING THE PARTIES

2. Denies having knowledge or information sufficient to form a belief as to the truth

of each and every allegation contained within paragraph “2” of plaintiff’s Verified Complaint and

otherwise begs leave to refer all questions of law to the Court and all questions of fact to the trier

thereof.

3. Denies each and every allegation in the form alleged contained within paragraphs

“3,” “4,” “5,” “6,” “7,” “8,” “10,” “11” and “12” of plaintiff’s Verified Complaint and otherwise

begs leave to refer all questions of law to the Court and all questions of fact to the trier thereof.

4. Denies each and every allegation in the form alleged contained within paragraph

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“9” of plaintiff’s Verified Complaint, except admits the answering defendant, through certain of

its employees, agents, servants and independent contractors provided timely and appropriate care,

treatment and services to the plaintiff decedent, BETTE GRACE, in conformity with its

professional, state and federal statutory obligations and in conformity with good and accepted

standards of care on those dates and times referred to in the applicable medical records and

otherwise begs leave to refer all questions of law to the Court and all questions of fact to the trier

thereof.

ANSWERING THE FIRST CAUSE OF ACTION

5. In response to paragraph “13” of plaintiff’s Verified Complaint, defendant repeats,

reiterates and realleges each and every denial and denial of knowledge or information sufficient to

form a belief heretofore made in regard to each and every paragraph of the plaintiff’s Verified

Complaint, designated as paragraphs “1” through “12” inclusive, with the same force and effect as

though more fully set forth at length herein.

6. Denies each and every allegation in the form alleged contained within paragraph

“14” of plaintiff’s Verified Complaint, except admits the answering defendant, through certain of

its employees, agents, servants and independent contractors provided timely and appropriate care,

treatment and services to the plaintiff decedent, BETTE GRACE, in conformity with its

professional, state and federal statutory obligations and in conformity with good and accepted

standards of care on those dates and times referred to in the applicable medical records and

otherwise begs leave to refer all questions of law to the Court and all questions of fact to the trier

thereof.

7. Denies each and every allegation in the form alleged contained within paragraphs

“15,” “16,” “17,” “18” and “19” of plaintiff’s Verified Complaint.

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ANSWERING THE SECOND CAUSE OF ACTION

8. In response to paragraph “20” of plaintiff’s Verified Complaint, defendant repeats,

reiterates and realleges each and every denial and denial of knowledge or information sufficient to

form a belief heretofore made in regard to each and every paragraph of the plaintiff’s Verified

Complaint, designated as paragraphs “1” through “19” inclusive, with the same force and effect as

though more fully set forth at length herein.

9. Denies each and every allegation in the form alleged contained within paragraph

“21” of plaintiff’s Verified Complaint, except admits the answering defendant, through certain of

its employees, agents, servants and independent contractors provided timely and appropriate care,

treatment and services to the plaintiff decedent, BETTE GRACE, in conformity with its

professional, state and federal statutory obligations and in conformity with good and accepted

standards of care on those dates and times referred to in the applicable medical records and

otherwise begs leave to refer all questions of law to the Court and all questions of fact to the trier

thereof.

10. Denies each and every allegation contained within paragraphs “22,” “23,” “24,”

“25,” “26,” “27,” “28” and “29” of plaintiff’s Verified Complaint.

ANSWERING THE THIRD CAUSE OF ACTION

11. In response to paragraph “30” of plaintiff’s Verified Complaint, defendant repeats,

reiterates and realleges each and every denial and denial of knowledge or information sufficient to

form a belief heretofore made in regard to each and every paragraph of the plaintiff’s Verified

Complaint, designated as paragraphs “1” through “29” inclusive, with the same force and effect as

though more fully set forth at length herein.

12. Denies having knowledge or information sufficient to form a belief as to the truth

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of each and every allegation contained within paragraph “31” of plaintiff’s Verified Complaint

and otherwise begs leave to refer all questions of law to the Court and all questions of fact to the

trier thereof.

13. Denies each and every allegation contained within paragraphs “32,” “33,” “34” and

“35” of plaintiff’s Verified Complaint.

ANSWERING STATEMENT REGARDING EXCEPTIONS
IN CPLR ARTICLE 1602

14. Denies each and every allegation contained within paragraph “36” of plaintiff’s

Verified Complaint.

JURY DEMAND

15. Denies each and every allegation in the form alleged contained within this

paragraph of plaintiff’s Verified Complaint and otherwise begs leave to refer all questions of law

to the Court and all questions of fact to the trier thereof.

ANY PARAGRAPH NOT ANSWERED IS DEEMED DENIED.

AS AND FOR A FIRST AFFIRMATIVE DEFENSE

16. That any injuries sustained by plaintiff at the time and place mentioned in the

Verified Complaint were caused solely and wholly by reason of the carelessness, negligence,

recklessness and acts or omissions on the part of the plaintiff and were not caused or contributed

to by reason of any carelessness, negligence, recklessness or acts or omissions on the part of the

answering defendant.

AS AND FOR A SECOND AFFIRMATIVE DEFENSE

17. Should it be held that Article 14 of the New York CPLR could apply to any claim

being made by the plaintiff herein, defendant requests that the relative culpability of each person

who is or may be liable to contribute to any liability for the damages alleged by the plaintiff in

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this action should be determined in accordance with the decisional and statutory law of the State

of New York, in such cases made and provided; and the equitable share of each person liable for

contribution should be determined and apportioned in accordance with the relative culpability of

each such person, if any, pursuant to Article 14 of the New York CPLR.

AS AND FOR A THIRD AFFIRMATIVE DEFENSE

18. That the answering defendant reserves the right to claim the limitations of liability

pursuant to Article 16 of the CPLR, for any recovery herein by the plaintiff for non-economic loss.

AS AND FOR A FOURTH AFFIRMATIVE DEFENSE

19. In the event plaintiff recovers a verdict or judgment against defendant, such verdict

or judgment must be reduced pursuant to §4545 of the CPLR by those amounts which have been,

or will, with reasonable certainty replace or indemnify plaintiff in whole or in part, for any past or

future claimed economic loss, from any collateral source.

AS AND FOR A FIFTH AFFIRMATIVE DEFENSE

20. If plaintiff is entitled to recover damages for loss of earnings or impairment of

earning ability as against defendant, PARKVIEW, by reason of the matters alleged in the Verified

Complaint, liability for which is hereby denied, then pursuant to CPLR §4546 the amount of

damages recoverable against said defendant, if any, shall be reduced by the amount of federal,

state and local income taxes which the plaintiff would have been obligated by law to pay.

AS AND FOR A SIXTH AFFIRMATIVE DEFENSE

21. The defendant asserts the defense of set-off to reduce the plaintiff’s claims under

§15-108 of the General Obligations Law.

AS AND FOR A SEVENTH AFFIRMATIVE DEFENSE

22. If the plaintiff was caused to sustain personal injuries and resulting damages at the

time and place set forth in the plaintiff’s Verified Complaint and in the manner alleged therein

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through any carelessness, recklessness, acts, omissions, negligence and/or breaches of duty and/or

warranty and/or contract other than of the answering defendant then the said injuries and damages

arose out of the several and joint carelessness, recklessness, acts, omissions, negligence and

breaches of duty and/or obligation and/or statute, and/or warranty, and/or contract in fact or

implied in law, upon the part of non-parties subject to in personam jurisdiction, and if answering

defendant is found negligent as to the plaintiff for the injuries and damages set forth in the

plaintiff’s Verified Complaint, then and in that event, the relative responsibilities of said pleading

defendant must be apportioned by the percentage of liability of said non-parties subject to in

personam jurisdiction.

AS AND FOR AN EIGHTH AFFIRMATIVE DEFENSE

23. The plaintiff lacks the capacity to commence and bring the within lawsuit.

AS AND FOR A NINTH AFFIRMATIVE DEFENSE

24. If the plaintiff has been injured and damaged as alleged in plaintiff’s Verified

Complaint, upon information and belief, such injuries and damages were caused, in whole or in

part, or were contributed to by reason of the carelessness, negligence or want of care on the part

of the plaintiff and not by any carelessness, negligence or want of care, on the part of the defendant,

and if any carelessness, negligence or want of care other than that of the plaintiff caused or

contributed to said alleged injuries and damages, it was the carelessness, negligence or want of

care on the part of some other party or persons, firm or corporation, his/her, its or their agents,

servants or employees over whom defendant had no control and for whose, carelessness,

negligence or want of care defendant is not and was not responsible or liable.

AS AND FOR A TENTH AFFIRMATIVE DEFENSE

25. Recovery in this action is barred in whole or in part as a result of the failure of the

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party making claim to take reasonable steps to reduce or otherwise mitigate the damages alleged.

AS AND FOR AN ELEVENTH AFFIRMATIVE DEFENSE

26. Plaintiff’s right to recover damages, if any, are barred in whole or in part pursuant

to the Patient Protection and Affordable Care Act, 26 USCS Section 5000A.

AS AND FOR A TWELFTH AFFIRMATIVE DEFENSE

27. The answering defendant did not breach any duties owed to the plaintiff neither

contractually nor by common law duty, and/or any alleged breach of duties were not the proximate

cause of plaintiff’s alleged damages.

AS AND FOR A THIRTEENTH AFFIRMATIVE DEFENSE

28. Any injuries or damages claimed were caused, in whole or in part, by the negligence

of other culpable conduct or third-parties over which this answering defendant had no control or

right to exercise such control.

AS AND FOR A FOURTEENTH AFFIRMATIVE DEFENSE

29. That the defendant acted in accordance with the appropriate provisions of Section

2805-d of the Public Health Law and relies on the defenses set out therein.

AS AND FOR A FIFTEENTH AFFIRMATIVE DEFENSE

30. At all times, defendant, PARKVIEW, complied with all applicable Federal and

State Rules, Regulations, Codes, Ordinances and Statutes.

AS AND FOR A SIXTEENTH AFFIRMATIVE DEFENSE

31. The doctor has complied with all of the rights and responsibilities as set forth in

Public Health Law §2803-C, therefore, the plaintiff’s Complaint should be dismissed.

AS AND FOR A SEVENTEENTH AFFIRMATIVE DEFENSE

32. Plaintiff’s Complaint fails to state a viable cause of action and warrants dismissal

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pursuant to CPLR §3211.

AS AND FOR AN EIGHTEENTH AFFIRMATIVE DEFENSE

33. These claims must be dismissed due to lack of jurisdiction, failure to comply with

conditions precedent and the immunities granted by the PREP Act (42 U.S.C. §247d-6d). The

Complaint against this defendant is barred by U.S.C. §247d-6d(d).

34. The PREP Act provides for the exclusive remedy for these claims, which are

subject to a “no fault” fund. This Court lacks the jurisdiction over this matter.

35. Plaintiff's claims are subject to federal immunity pursuant to 42 U.S.C. § 247d-

6d(a)(1), and therefore removable insofar as plaintiff’s claims allege a Federal Question.

36. To the extent plaintiff alleges willful misconduct, plaintiff's claims are barred, as

this Court lacks subject matter jurisdiction to hear substantive claims related to willful misconduct

which proximately caused death or injury, as such claims must be brought in the United States

District Court for the District of Columbia pursuant to 42 USC § 247d-6d(e)(1).

AS AND FOR A NINETEENTH AFFIRMATIVE DEFENSE

37. Defendant acted at all times within the proper standards of care generally, as well

as the standards of care in place in the locality in question at the time of the COVID-19 emergency.

AS AND FOR A TWENTIETH AFFIRMATIVE DEFENSE

38. These claims are barred in whole or in part by the error in judgment doctrine and/

or the unprecedented and extenuating circumstances of COVID-19, which render the defendant’s

judgment proper and within the standards of care concerning accepted medical practice generally

and/ or in place at the locality where the alleged acts or omissions occurred during the COVID-19

emergency.

AS AND FOR A TWENTY-FIRST AFFIRMATIVE DEFENSE

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39. The defendant followed Executive Orders, Federal mandates, as well as the

guidance issued by the NY DOH, the CDC, the W.H.O., the federal COVID-19 task force and

other state and federal agencies.

40. The care and treatment provided by defendant met standards set forth in federal and

state statutes and regulations, as well as the standards of care prevailing among similar facilities

in this community.

AS AND FOR A TWENTY-SECOND AFFIRMATIVE DEFENSE

41. That plaintiff’s claims regarding COVID-19 are not subject to any community

standard, due to the novel, evolving nature of COVID-19 at all relevant times, and the defendant

was all times practicing in conformity with all recommendations, guidelines and protocols.

AS AND FOR A TWENTY-THIRD AFFIRMATIVE DEFENSE

42. The defendant is afforded all defenses pursuant to the Good Samaritan doctrine.

AS AND FOR A TWENTY-FOURTH AFFIRMATIVE DEFENSE

43. Defendant avails themselves of the doctrine of danger invites rescue. Defendant put

themselves at risk for patient care despite sometimes unavailable PPE and other dangerous risks

to their personal health.

AS AND FOR A TWENTY-FIFTH AFFIRMATIVE DEFENSE

44. If plaintiff sustained the injuries and damages alleged in the Complaint, said injuries
are the result of some independent intervening cause over which defendant had no control.
45. The injuries alleged in the Complaint were caused by conditions outside the scope

and control of the defendant and, therefore, plaintiff cannot recover against this defendant.

AS AND FOR A TWENTY-SIXTH AFFIRMATIVE DEFENSE

46. Plaintiff’s claims are barred because any alleged conduct on the part of the

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defendant was made in good faith and as part of defendant’s efforts to comply with its obligations,

if any, under the law in preventing the spread of COVID-19.

AS AND FOR A TWENTY-SEVENTH AFFIRMATIVE DEFENSE

47. The plaintiff has already recovered, in whole or in part, the quantum meruit value

of any services performed and, accordingly, plaintiff’s claim for quantum meruit relief is barred

by operation of the doctrine of collateral estoppel.

AS AND FOR A TWENTY-EIGHTH AFFIRMATIVE DEFENSE

48. That there exists no proximate causation between any of the alleged acts or breach

of duty by defendant claimed by plaintiff and plaintiff’s alleged injuries and/or damages.

AS AND FOR A TWENTY-NINTH AFFIRMATIVE DEFENSE

49. These claims must be dismissed on the basis of the absolute and qualified

immunities granted by Governor Cuomo’s March 7, 2020 and subsequent Executive Orders

(“EO”), Article 30-D, §3082(2) of the Public Health Law [now known as the Emergency or

Disaster Treatment Protection Act (“EDTPA”)] and Good Samaritan doctrine and laws.

50. These claims must be dismissed in whole or in part pursuant to the EDTPA, which

affords absolute and/or qualified immunity from the allegations in the claims, including any claims

that allegedly pre-date March 7, 2020, as such claims are covered under the EDTPA and amount

to allegations of staffing or resource shortage which is subject to an absolute immunity.

AS AND FOR A THIRTIETH AFFIRMATIVE DEFENSE

51. Defendant is informed and believe, and on that basis allege, that the Complaint is

barred, in whole or in part, because to the extent plaintiff has suffered any losses, damages or

detriments, in any sum or amount whatever, such harm was caused by the intentional or negligent

acts, omissions or misconduct of others, including plaintiff and plaintiff’s agents.

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AS AND FOR A THIRTY-FIRST AFFIRMATIVE DEFENSE

52. Plaintiff’s Complaint, to the extent that it seeks exemplary or punitive damages,

violates defendant constitutional right to procedural due process under the Fourteenth Amendment

of the United States Constitution, and the Constitution of the State of New York, and therefore,

fails to state a cause of action upon which either punitive or exemplary damages can be awarded.

AS AND FOR A THIRTY-SECOND AFFIRMATIVE DEFENSE

53. Plaintiff’s Complaint, to the extent that it seeks exemplary or punitive damages,

violates defendant constitutional right to protection from "excessive fines" as provided in the

Eighth Amendment of the United States Constitution, and Article 1, § 5 of the Constitution of the

State of New York, and violates defendant’s constitutional right to substantive due process duly

provided in the Fifth and Fourteenth Amendments of the United States Constitution and the

Constitution of the State of New York and, therefore, fails to state a cause of action supporting the

punitive or exemplary damages claimed.

AS AND FOR A THIRTY-THIRD AFFIRMATIVE DEFENSE

54. Defendant reserves the right to allege additional affirmative defenses as they

become known during discovery, and to amend their Answer accordingly.

WHEREFORE, the defendant, PARKVIEW OPERATING CO., LLC, demands judgment

dismissing the plaintiff’s Verified Complaint together with the costs and disbursements of this

action.

Dated: Garden City, New York
August 7, 2023 Yours, etc.,

VIGORITO, BARKER, PATTERSON,
NICHOLS & PORTER, LLP

By: Michael Milchan
Michael Milchan

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Attorneys for Defendant
PARKVIEW OPERATING CO., LLC
300 Garden City Plaza, Suite 100
Garden City, New York 11530
(516) 282-3355
m.milchan@vbpnplaw.com
VBPNP File No.: 0329-004

To: DALLI & MARINO, LLP
Attorneys for Plaintiff
231 Mineola Boulevard
Mineola, New York 11501
(516) 292-4700
arockensies@dallimarino.com

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ATTORNEY'S VERIFICATION

DYLAN C. BRAVERMAN, an attorney duly admitted and licensed to practice in the

courts of this State affirms the following pursuant to CPLR §2106:

I am the attorney for defendant, PARKVIEW OPERATING CO., LLC herein; and I have

read the foregoing answer and know the contents thereof; that the same is true to my own

knowledge except as to the matters therein stated to be alleged upon information and belief, and

that as to those matters, I believe them to be true.

That the reason this verification is made by your affirmant and not by the defendant

personally is, that the defendant is not located within the county where your affirmant has an office.

That the sources of your affirmant's information and the grounds of his/her belief as to the

matters so alleged herein are investigations had by the defendant, its agents, servants and

representatives into the subject matter hereof and correspondence relating thereto, reports of which

investigations and copies of which correspondence are in the possession of your affirmant.

Dated: Valhalla, New York
August 7, 2023

Dylan Braverman
DYLAN BRAVERMAN

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-against-

PARKVIEW OPERATING CO., LLC,

Defendant.
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C O U N S E L O R S:

PLEASE TAKE NOTICE that, within twenty (20) days from the date hereof, you are

required to serve the undersigned with duly executed authorizations, which include the address of

the party to whom the authorizations apply, permitting VIGORITO, BARKER, PATTERSON,

NICHOLS & PORTER, LLP, or their authorized representatives, to obtain copies of the records

of:

1. Medical Examiner’s Office, including autopsy, photographs, pathology,
toxicology etc.;
2. Wound care providers;
3. Ambulance records;
4. All collateral sources;
5. Employment records;
6. Pharmacy records;
7. Physical therapy records;
8. All radiological studies, including but not limited to x-rays, CT scans,
MRIs, etc., and their corresponding reports.
9. All prior and subsequent treating physicians and facilities;
10. Internal Revenue Service Form 4506, 1099’s, W-2’s for the past 5 years
with two forms of identification;
11. Medicare/Medicaid/SSI/SSDI;
12. Workers’ Compensation;
13. All health care insurers;
14. Primary care physician;
15. Mental healthcare providers with whom the plaintiff treated.

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PLEASE TAKE FURTHER NOTICE that, with respect to all authorizations for

medical/hospital/healthcare records, the authorizations must comply with Federal HIPAA

regulations.

Dated: Garden City, New York
August 7, 2023
Yours, etc.,

VIGORITO, BARKER, PATTERSON,
NICHOLS & PORTER, LLP

By: Michael Milchan
Michael Milchan
Attorneys for Defendant
PARKVIEW OPERATING CO., LLC
300 Garden City Plaza, Suite 100
Garden City, New York 11530
(516) 282-3355
m.milchan@vbpnplaw.com
VBPNP File No.: 0329-004

To: DALLI & MARINO, LLP
Attorneys for Plaintiff
231 Mineola Boulevard
Mineola, New York 11501
(516) 292-4700
arockensies@dallimarino.com

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-against-

PARKVIEW OPERATING CO., LLC,

Defendant.
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C O U N S E L O R S:

PLEASE TAKE NOTICE that, the below named attorney demands that the plaintiff

furnishes the below named defendant with the following, at the time the Note of Issue is filed:

HIPAA COMPLIANT AUTHORIZATIONS FOR ALL PROVIDERS IDENTIFIED

DURING DISCOVERY ENABLING THE DEFENDANT TO SERVE SUBPOENAS FOR THE

TRIAL OF THIS MATTER.

Said authorizations are to contain full and proper names and addresses, together with any

necessary identifying information, such as Social Security Number, and are to be HIPAA

compliant to obtain the requisite records, films and billing records.

PLEASE TAKE FURTHER NOTICE that, failure to comply with the above demand will

be the basis of a motion seeking appropriate relief, including, but not limited to dismissal of the

complaint.

Dated: Garden City, New York
August 7, 2023 Yours, etc.,

VIGORITO, BARKER, PATTERSON,
NICHOLS & PORTER, LLP

By: Michael Milchan
Michael Milchan

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Attorneys for Defendant
PARKVIEW OPERATING CO., LLC
300 Garden City Plaza, Suite 100
Garden City, New York 11530
(516) 282-3355
m.milchan@vbpnplaw.com
VBPNP File No.: 0329-004

To: DALLI & MARINO, LLP
Attorneys for Plaintiff
231 Mineola Boulevard
Mineola, New York 11501
(516) 292-4700
arockensies@dallimarino.com

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-against-

PARKVIEW OPERATING CO., LLC,

Defendant.
------------------------------------------------------------------------X
C O U N S E L O R S:

PLEASE TAKE NOTICE that, pursuant to Rule 3042(a) of the Civil Practice Law and

Rules, you are hereby required to serve upon the undersigned attorneys for defendant,

PARKVIEW, within thirty (30) days after the service of a copy of this demand, a Verified Bill of

Particulars setting forth in detail the following:

1. (a) Set forth each and every act of commission of the answering defendant

which plaintiff claims is the basis of the alleged negligence, malpractice or other wrongdoing on

the part of this defendant.

(b) State the date or dates when such acts by this defendant allegedly took place.

2. (a) Set forth each and every act of omission of the answering defendant which

plaintiff claims is the basis of the alleged negligence, malpractice or other wrongdoing on the part

of this defendant.

(b) State the date or dates when such acts by this defendant allegedly took place.

3. Did the answering defendant’s malpractice occur in the course of an emergency

treatment, procedure or surgery?

4. If it will be claimed that any of the acts or omissions particularized in Items 1 and

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2 above were performed by another for whose acts or omissions the answering defendant has legal

responsibility, state as to each such act or omission the name of the person who performed it, and

that person's legal relationship to this defendant.

5. Referring to the Complaint, set forth, with particularity, the manner and respect in

which it is claimed that answering defendant was negligent.

6. If loss of earnings will be claimed to have resulted from the alleged negligence, set

forth the following:

(a) The loss of earnings that will be claimed.

(b) The name and address of the employer at the time of the alleged negligence.

(d) The decedent's gross earnings for the last calendar year prior to the alleged
negligence.

(e) The decedent's gross earning for any calendar year(s) during which it will
be claimed that the claimant was incapacitated from work.

(f) If the decedent was employed by another immediately prior to the alleged
incapacitation, state:

(1) The name and address of the employer.

(2) The decedent's weekly gross salary at that time.

(g) If the decedent was in whole or in part self-employed, state the decedent's
earnings from such self-employment for each of the three (3) years prior to
the alleged incapacitation.

(h) The last date the decedent worked prior to the alleged incapacitation.

(i) The dates the decedent worked prior to the alleged incapacitation.

(j) The amount and source of any reimbursement to the decedent or others for
the alleged loss of earnings.

7. Please identify the employees or agents of the answering defendant who were

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allegedly careless and negligent in rendering care to the decedent.

8. Concerning the claim of physical injury to the decedent, state the following:

(a) The nature, location and extent of each injury it will be claimed was caused
by the negligence of the answering defendant.

(b) If any injuries are claimed to be permanent, so state.

9. If it will be claimed that the injuries to the decedent necessitated treatment by any

physicians, psychologists or other therapists, set forth:

(a) The name of each such person.

(b) The dates of treatment.

10. If it will be claimed that the aforesaid injuries necessitated any hospitalizations, set

forth the name of each hospital with the date of confinement or outpatient treatment.

11. If it will be claimed that the aforesaid injuries necessitated treatment at any other

institutions, set forth the name of each institution with dates of confinement or treatment.

12. Decedent's residence or the residence of the decedent's estate's representative at the

time of the commencement of this action.

13. State the Social Security number of the decedent.

14. Detail sums reimbursed to plaintiff or decedent for medical and/or hospital

expenses by medical insurance or other sources, identifying the reimbursor.

15. If it is claimed that answering defendant caused decedent's death, set forth the

following:

(a) The date of death.

(b) The place of death.

(d) Was an autopsy performed? If so, set forth the date and place where autopsy

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was performed.

(e) The name and address of the last treating physician.

(f) The name and address of the physician who signed the death certificate.

(g) The decedent's address at the time of death.

(h) The decedent's date of birth.

16. Set forth:

(a) The name,

(b) address,

(d) the affinity to decedent of each person who it is claimed was dependent
upon decedent for support at the time of death.

17. State the names, ages and addresses of all of the decedent's distributes and how they

are related to the decedent.

(a) State the occupation of each of the Decedent's distributes.

(b) State the names of the distributees who will claim to have suffered
pecuniary injury as a result of the decedent's death.

(d) State separately the amount of funeral and cemetery and monument
expenses paid by the decedent's estate.

(e) The date of death of the deceased and his age at death.

(f) The cause of death as listed on the death certificate.

18. State:

(a) The date and place of decedent's birth, and

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19. If any loss of support is claimed, set forth the following:

(a) If the decedent was employed immediately prior to death:

(1) the decedent's annual salary;

(2) the name, and

(3) address of the employer.

(b) The decedent's occupation.

(d) The amount contributed by decedent to the support of each of the above-
named dependents in the last full year prior to death.

(e) The yearly earnings which, if will be claimed, have been lose as a result of
decedent's death.

(f) The last date decedent worked prior to death.

(g) If the decedent was self-employed in whole or in part:

(1) The nature of such self-employment, and

(2) The earnings of such self-employment for the last year worked prior
to death.

20. If a derivative claim for loss of service is asserted by plaintiff’s spouse, provide the

following particulars:

(a) the date of the marriage;

(b) state whether plaintiff and plaintiff’s spouse were living together as
husband and wife as of the date of the accident;

(c) the usual business or occupation of the plaintiff’s spouse, including the
name and address of each employer, if employed outside the home;

(d) the basis for the claim of loss of service, separately specifying each
Component thereof;

(e) an itemized statement of all monetary sums claimed as part of the loss of
ser

Case Info

Judge

Nancy Quinn Koba Track Judge’s New Case

Case No.

(Subscribe to View)

Document Filed Date

August 07, 2023

Case Filing Date

March 27, 2023

County

Parties

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