Preview
FILED: ONONDAGA COUNTY CLERK 08/11/2022 03:29 PM INDEX NO. 007476/2018
NYSCEF DOC. NO. 202 RECEIVED NYSCEF: 08/11/2022
EXHIBIT “G”
FILED: ONONDAGA COUNTY CLERK 08/11/2022 03:29 PM INDEX NO. 007476/2018
NYSCEF DOC. NO. 202 RECEIVED NYSCEF: 08/11/2022
STATE OF NEW YORK COUNTY OF ONONDAGA
SUPREME COURT
VALERIE AUSTIN and AMANDA DILLON, as
PLAINTIFFS'
co-administrators of the ESTATE OF LARRY C. AUSTIN,
Deceased, VERIFIED BILL OF
PARTICULARS TO
Plaintiffs, DEFENDANT PAWAN
K. RAO, M.D.
v. Index No.: 007476/2018
PAWAN K. RAO, MD, BRIAN CHANGLAI, MD, JEANNE
BISHOP, MD and OVID NEULANDER, MD,
Defendants.
The Plaintiffs, through their attorneys, Knych & Whritenour, LLC, for their Verified
Bill of Particulars in response to the demand by the Defendant, Pawan K. Rao, M.D., provides
as follows:
1. The Plaintiffs object to the Defendant's demand for the dates and times of day of
the negligent acts and/or omissions of the Defendant, Dr. Rao, to the extent that the demand
requests information solely in the possession of the Defendant and/or the James Square Nursing
and Rehabilitation Center, which have not been fully provided to the Plaintiffs to date. The
Plaintiffs will list that information which they currently possess and reserve the right to
supplement their response upon completion of discovery in this action.
The Plaintiffs allege the negligent acts and/or omissions of Dr. Pawan K. Rao as the
Plaintiffs'
Decedent's treating physician throughout the Decedent's admission at the James
Square Nursing and Rehabilitation Center from March 29, 2016 until July 27, 2016. The
Plaintiffs are not currently aware of whether the Decedent was transported to Dr. Rao's office
for care, but to the extent that he was transported to Dr. Rao's office for care during the period
.
FILED: ONONDAGA COUNTY CLERK 08/11/2022 03:29 PM INDEX NO. 007476/2018
NYSCEF DOC. NO. 202 RECEIVED NYSCEF: 08/11/2022
from Ma ch 29, 2016 to July 27, 2016, Plaintiffs allege that the Defendant was negligent at
those visits. The Plaintiffs cannot provide specific dates of care for Dr. Rao within the period
from March 29, 2016 to July 27, 2016 at this time. Plaintiffs reserve the right to supplement
this response upon completion of discovery. Upon information and belief, as the Decedent's
Plaintiffs'
treating physician, Dr. Rao regularly saw the Decedent throughout that period and in
addition reviewed the charting notes of the other physicians, nurses, physical therapists,
occupational therapists, dietary staff and other staff who attended to the Decedent throughout
that period. Upon information and belief, as the Decedent's treating physician, Dr. Rao saw,
Plaintiffs'
examined and evaluated the Decedent upon his admission to the James Square
Nursing and Rehabilitation Center on or about March 29, 2016. Upon information and belief,
Dr. Rao reevaluated the Decedent on or about June 20 and/or June 21, 2016. Upon information
and belief, Dr. Rao evaluated the Decedent or about April 22, 2016. Upon information and
belief. Dr. Rao examined and/or evaluated the Decedent on April 19, 2016. Upon information
and belief, Dr. Rao saw and/or evaluated the Decedent on July 27, 2016. Upon information and
belief, the Defendant Pawan K. Rao, M.D. reviewed the Decedent's chart, looked in on the
Decedent, examined the Decedent and/or spoke with other care providers involved in the care
of the Decedent concerning the Decedent at a number of different times and occasions during
the Decedent's admission to the James Square Nursing and Rehabilitation Center between
March 29, 2016 and July 27, 2016 which dates and times are not currently known to the
Plaintiffs, were not adequately or appropriately documented in the chart, were documented in
the chart in such a way that they are difficult to discern and/or the Plaintiffs have not been
provided with a full and complete copy of the chart, partially due to the New York State
Attorney General's Office having subpoenaed and/or confiscated some portion of those
2
FILED: ONONDAGA COUNTY CLERK 08/11/2022 03:29 PM INDEX NO. 007476/2018
NYSCEF DOC. NO. 202 RECEIVED NYSCEF: 08/11/2022
records. The Plaintiffs have provided those dates and times of treatment which they currently
have knowledge and reserve the right to supplement their response upon completion of
discovery.
2. Upon information and belief, the Defendant's care and treatment of the
Decedent took place at the James Square Nursing and Rehabilitation Center in Syracuse, New
York.
3. The Plaintiffs object to the Defendant's demand for each and every act or
omission on the part of Defendant Pawan K. Rao, M.D. which is the basis of the alleged
malpractice of the Defendant as being overly broad and improper. The Plaintiffs will list all of
the acts and/or omissions of which they currently have knowledge and reserve the right to
supplement their response upon completion of discovery, and upon receipt of a complete copy
of the chart. Upon information and belief, the negligence and medical malpractice by the
Defendant Pawan K. Rao, M.D. occurred while the Decedent was an inpatient resident at the
James Square Nursing and Rehabilitation Center from March 29, 2016 until July 27, 2016. The
Plaintiffs claim that the Defendant is vicariously liable and/or directly responsible for the
negligence and malpractice of the other physicians who attended to the Decedent at that facility
as well as any malpractice of the nursing and rehabilitation staff, to the extent that Defendant
Rao was the treating physician, and had a duty and an obligation as the treating physician to
review the chart on a regular basis and to make the appropriate contacts when necessary with
other physicians, nursing staff, physical therapy/occupational therapy staff, dietary staff and/or
administration in order to ensure and bring about the proper care of the Decedent. Upon
information and belief. the Defendant failed to provide medical care and serves for a post hip
fracture patient commensurate with good and accepted nursing home/rehabilitation/medical
3
FILED: ONONDAGA COUNTY CLERK 08/11/2022 03:29 PM INDEX NO. 007476/2018
NYSCEF DOC. NO. 202 RECEIVED NYSCEF: 08/11/2022
services in the State of New York and in the Country. The Defendant deviated from accepted
nursing home/rehabilitation/medical practices in his care evaluation of the Decedent. The
Defendant failed to monitor and attend to the Decedent's basic needs for hydration, nutrition,
caloric intake, physical therapy and positional monitoring and safeguarding. The Defendant
failed to undertake and/or bring about immediate and urgent medical care for the Decedent's
numerous life threatening conditions including malnutrition, failure to thrive, weight loss,
severe decubitus ulcers, infection of decubitus ulcers, dehydration and other evident medical
problems which the Defendant was actually aware of and/or should have been aware of through
the exercise of reasonable care as the Decedent's treating physician. The Defendant failed to
monitor the Decedent's overall condition and failed to initiate care or treatment, coordination
and dialogue with other physicians who were participating in the care of the Decedent and
other care providers and nursing staff at the facility who were also participating in the care of
the Decedent in order to bring about the proper care for the Decedent. The Defendant failed to
ensure that the Decedent received proper physical therapy in order to allow the Decedent to
remain ambulatory. The Defendant deviated from accepted medical practices and failed to
monitor the Decedent's care at the facility pursuant to his responsibilities as the Decedent's
treating physician and allowed the Decedent to be isolated in a bed for extended periods of time
without proper therapy, care. monitoring and nourishment. The Defendant negligently and
carelessly represented to family members that the Decedent was receiving proper care. The
Defendant negligently and carelessly provided information to family members which would
have the effect of relaxing any efforts on their part to bring about further or emergent care for
the Decedent. The Defendant failed to issue proper orders concerning the placement and
change of the Decedent's position in order to avoid the occurrence and the worsening of
4
FILED: ONONDAGA COUNTY CLERK 08/11/2022 03:29 PM INDEX NO. 007476/2018
NYSCEF DOC. NO. 202 RECEIVED NYSCEF: 08/11/2022
decubitus ulcers. The Defendant allowed or caused the Decedent to be over-medicated and
unreasonably sedated for extended periods of time. To the extent that the Defendant issued
orders with respect to the Decedent's positioning, the Defendant failed to follow up on those
orders in order to determine whether or not they were being carried out in an appropriate
manner by the staff. The Defendant failed to monitor for the presence of decubitus ulcers as
part of a good and proper and complete physical examination of the Decedent pursuant to
accepted medical practices for the care and treatment of an individual of the Decedent's age
and medical background as an inpatient in a rehabilitation center. The Defendant allowed the
Decedent's decubitus ulcers to develop and become life threatening without undertaking
necessary and aggressive medical care. The Defendant failed to diagnose and treat the
Decedent for infection and failed to order the transport of the Decedent for proper wound care
of his decubitus ulcers. The Defendant failed to check, monitor and chart the Decedent's vital
signs pursuant to accepted medical practices. The Defendant failed to bring about the
Decedent's transport to a hospital for care in a timely manner and/or failed to bring about the
timely transport of the Decedent to a hospital for a higher level of care at a point well before
July of 2016, before the Decedent's medical conditions became fatal. The Defendant caused
and/or allowed the Decedent to suffer malnutrition, muscle wasting, dehydration, significant
weight loss and/or other treatable and preventable problems throughout the period that the
Defendant was the Decedent's treating physician at the James Square Nursing and
Rehabilitation Center, in deviation from good and accepted medical care standards. The
Defendant failed to monitor the Decedent's weight where he was admitted to the facility
weighing approximately 150 pounds and was discharged from the facility on an emergent basis
to the hospital weighing only 110 pounds and to the extent that the Defendant realized and was
5
FILED: ONONDAGA COUNTY CLERK 08/11/2022 03:29 PM INDEX NO. 007476/2018
NYSCEF DOC. NO. 202 RECEIVED NYSCEF: 08/11/2022
aware of the Decedent's weight loss throughout the period of admission from March 29, 2016
through July 27, 2016, the Defendant failed to undertake proper and proactive care efforts in
order to determine the cause of the weight loss and reverse the problem prior to the Decedent's
condition becoming fatal. The Defendant failed to note and respond to the Decedent's weight
documented in his care records as follows: 1/22/15 - 139 3/31/16 - 135
loss, pounds; pounds;
4/1/16 - 128.7 5/13/16 - 123.2 6/8/16 - 120.56 6/27/16 - 119.24
pounds; pounds; pounds;
pounds; and 7/20/16 111.1 pounds. The Defendant as the Decedent's treating physician failed
to conduct and/or bring about the regular and necessary medical examination and evaluation of
the Decedent and throughout his admission such that the Decedent's treatable and curable
medical conditions were allowed to advance and become fatal. The Defendant caused
conscious pain and suffering and wrongful death in a patient who should have been admitted
for a brief period of rehabilitation and then discharged home. The Defendant failed to monitor
and attend the Decedent's conditions throughout the admission including extreme pain and
allowed the Decedent to endure pain without proper treatment and/or medication on a
continuing basis. The Defendant failed to utilize reasonable care in terms of the care provided
to the Decedent and failed to properly interact with nursing staff, physical therapy/occupational
therapy staff, other physicians involved in the Decedent's care, physical therapy providers,
nurses'
aides, dietary staff, and administration as the Decedent's treating physician in order to
fulfill his responsibilities as treating physician. The Defendant negligently and carelessly
allowed the Decedent to become cachectic, failing to order, evaluate and act upon regular lab
tests including blood chemistries and urine analysis. The Defendant failed to properly diagnose
and treat the Decedent in a timely manner for sepsis, bacteremia, significant blood loss, upper
gastrointestinal bleed, septic shock, hypovolemic shock, thrombocytopenia, leukocytosis and
6
FILED: ONONDAGA COUNTY CLERK 08/11/2022 03:29 PM INDEX NO. 007476/2018
NYSCEF DOC. NO. 202 RECEIVED NYSCEF: 08/11/2022
allowed the Decedent's otherwise treatable medical conditions to progress to the point where
Plaintiffs'
they became life threatening, fatal and caused the Decedent to suffer greatly and then
die. The Defendant failed to adequately examine, diagnose and treat the Decedent for a fall on
May 13, 2016; weight loss noted on May 13, 2016; weight loss and dehydration noted on June
14, 201 6; for a fall on June 21, 2016; for over-medication resulting in lethargy, reduced
communication and eating difficulties. The Defendant negligently ordered or approved of a
plan to change the Decedent's status from a temporary rehabilitation admission to long term
care without the consent of the Decedent or his family.
Plaintiffs'
4. The do claim that the Defendant, as the Decedent's treating physician,
is vicariously liable for the failures of other treatment providers of the Decedent at the James
Square Nursing and Rehabilitation Center to the extent that the Defendant was or should have
been in a position to ensure the proper care of the Decedent or at least to recognize treatment
issues and correct them. Those other care providers involved in the care in the Decedent for
whom Defendant Pawan K. Rao, M.D. is alleged to be vicariously liable for include the
following: Ovid Neulander, M.D., Brian Changlai, M.D., Jeanne Bishop, M.D., Brenda
Crawley, LPN, Shannon Baxter, LPN, Susan Latten, Henry Dorsey, Carol Ferrel, Marianne
Hand, Nancy Bataglia, LPN, Tyteone Perriman, Heidi Alger, Nancy Clement-Sullivant,
Colleen Knafelc, Lyudmila Melnik, James Vavra, Juditha Johnson, LPN, Christy Loomis, LPN.
Jackey Toombs, LPN, Lashawana Williams, Melissa Clark, Susan Driscoll, LPN, Irma Nichols,
LPN, Lorie Gale, Lacey Wright, Nancy Borawski, Zoe Heyward, LPN, Colleen Crader, LPN.
Erin Sotherden, Eric Rodrigues, Mary Bogart, LPN, Sandra Boateng, LPN, Linda Rooza,
Michelle Berry, LPN, Samantha Thousand, Phyllis Misius, Activities Aide, Trudy Phelps,
Social Social Robin Bridget Cummings-
Worker, Anthony Ortolano, Worker, Bowles, LPN,
7
FILED: ONONDAGA COUNTY CLERK 08/11/2022 03:29 PM INDEX NO. 007476/2018
NYSCEF DOC. NO. 202 RECEIVED NYSCEF: 08/11/2022
Martin, MDS Coordinator, Sonia Chaubal, PT, Cherrie Dunning, Dietary Tech, Jeri Tousaw,
MDS Coordinator, Cynthia McDowell, LPN, Timothy Reedy, OT, Stella Chu, Dietary Aide,
Danielle Towers, MDS Coordinator, Stephanie Magee, Susan VanGorden, Social Worker,
Timothy Wallace, RN, Mary Mann, RN, Karrie Glatt, NP, Laurie Cerio, LPN, Joshua
Zeahwon, RN, Tracy Nigro, RN, Terry Lavin, NP, Marsha Garboushin, Dietitian, Charles
Peirce, RN, Theresa Bulone, RN, Kathryn Mutter, Dietitian, David Goodwin, RN, Patrick
Harrington, Speech Therapist, Lance Osborne, RN, Bridget Benney, LPN, Nicole Beckwith,
Dietitian, Kara Cangemi, Speech Therapist, Melissa Alt, RN, Lisa Campbell, LPN, Jessica
Bramble, Dietitian, Denise Wehrle, NP, Corina Taylor, PT, Nikanya Winston, RN, Robin
Kunicki, OT, Kristin Carter, LPN, Theresa Mayo, RN, Harsh Goyal, P.T., Trudy Phelps, SW,
Charles Pierce, RN, Tracy Nigro, LPN and other employees/aides and/or physicians whose
names are not currently known to the Plaintiffs. The Plaintiffs reserve the right to supplement
this response upon completion of discovery in this action.
5. The Plaintiffs are not currently aware of any other or further acts or omissions
on the part of the Defendant other than those set forth in paragraphs 3, 6, 8 and 9 herein. The
Plaintiffs reserve the right to supplement their response upon completion of discovery in this
action.
6 Upon information and belief, good and accepted medical practices, customs and
medical standards for the care of patients at a nursing rehabilitation center for treating
ship"
physicians requires that the treating act as "captain of the in terms of initially evaluating a
patient, making the appropriate medical orders, reviewing the nursing notes, dietary notes,
physical therapy notes, occupational therapy notes, reviewing the notes of other physicians
involved in the care of an inpatient whether at the facility or upon the patient's transport outside
8
FILED: ONONDAGA COUNTY CLERK 08/11/2022 03:29 PM INDEX NO. 007476/2018
NYSCEF DOC. NO. 202 RECEIVED NYSCEF: 08/11/2022
of the facility, in order to coordinate the care, identify any treatment or care issues in a timely
manner so that they can be adjusted and/or corrected, to ensure that the patient receives proper
medical care towards the desired goal of the admission which was to rehabilitate the Decedent
for a hip fracture and then return him home for independent living with his wife and family.
Upon information and belief, Defendant Pawan K. Rao, M.D. deviated from the above accepted
medical practices, customs and medical standards by or through the failures listed in paragraph
3 above. Furthermore, good and accepted medical practices, customs and medical standards
required that the Defendant, as a treating physician, track, monitor, examine and record the
patient's vital signs, weight, weight loss, la
Preview
FILED: ONONDAGA COUNTY CLERK 08/11/2022 03:29 PM INDEX NO. 007476/2018 NYSCEF DOC. NO. 202 RECEIVED NYSCEF: 08/11/2022 EXHIBIT “G” FILED: ONONDAGA COUNTY CLERK 08/11/2022 03:29 PM INDEX NO. 007476/2018 NYSCEF DOC. NO. 202 RECEIVED NYSCEF: 08/11/2022 STATE OF NEW YORK COUNTY OF ONONDAGA SUPREME COURT VALERIE AUSTIN and AMANDA DILLON, as PLAINTIFFS' co-administrators of the ESTATE OF LARRY C. AUSTIN, Deceased, VERIFIED BILL OF PARTICULARS TO Plaintiffs, DEFENDANT PAWAN K. RAO, M.D. v. Index No.: 007476/2018 PAWAN K. RAO, MD, BRIAN CHANGLAI, MD, JEANNE BISHOP, MD and OVID NEULANDER, MD, Defendants. The Plaintiffs, through their attorneys, Knych & Whritenour, LLC, for their Verified Bill of Particulars in response to the demand by the Defendant, Pawan K. Rao, M.D., provides as follows: 1. The Plaintiffs object to the Defendant's demand for the dates and times of day of the negligent acts and/or omissions of the Defendant, Dr. Rao, to the extent that the demand requests information solely in the possession of the Defendant and/or the James Square Nursing and Rehabilitation Center, which have not been fully provided to the Plaintiffs to date. The Plaintiffs will list that information which they currently possess and reserve the right to supplement their response upon completion of discovery in this action. The Plaintiffs allege the negligent acts and/or omissions of Dr. Pawan K. Rao as the Plaintiffs' Decedent's treating physician throughout the Decedent's admission at the James Square Nursing and Rehabilitation Center from March 29, 2016 until July 27, 2016. The Plaintiffs are not currently aware of whether the Decedent was transported to Dr. Rao's office for care, but to the extent that he was transported to Dr. Rao's office for care during the period . FILED: ONONDAGA COUNTY CLERK 08/11/2022 03:29 PM INDEX NO. 007476/2018 NYSCEF DOC. NO. 202 RECEIVED NYSCEF: 08/11/2022 from Ma ch 29, 2016 to July 27, 2016, Plaintiffs allege that the Defendant was negligent at those visits. The Plaintiffs cannot provide specific dates of care for Dr. Rao within the period from March 29, 2016 to July 27, 2016 at this time. Plaintiffs reserve the right to supplement this response upon completion of discovery. Upon information and belief, as the Decedent's Plaintiffs' treating physician, Dr. Rao regularly saw the Decedent throughout that period and in addition reviewed the charting notes of the other physicians, nurses, physical therapists, occupational therapists, dietary staff and other staff who attended to the Decedent throughout that period. Upon information and belief, as the Decedent's treating physician, Dr. Rao saw, Plaintiffs' examined and evaluated the Decedent upon his admission to the James Square Nursing and Rehabilitation Center on or about March 29, 2016. Upon information and belief, Dr. Rao reevaluated the Decedent on or about June 20 and/or June 21, 2016. Upon information and belief, Dr. Rao evaluated the Decedent or about April 22, 2016. Upon information and belief. Dr. Rao examined and/or evaluated the Decedent on April 19, 2016. Upon information and belief, Dr. Rao saw and/or evaluated the Decedent on July 27, 2016. Upon information and belief, the Defendant Pawan K. Rao, M.D. reviewed the Decedent's chart, looked in on the Decedent, examined the Decedent and/or spoke with other care providers involved in the care of the Decedent concerning the Decedent at a number of different times and occasions during the Decedent's admission to the James Square Nursing and Rehabilitation Center between March 29, 2016 and July 27, 2016 which dates and times are not currently known to the Plaintiffs, were not adequately or appropriately documented in the chart, were documented in the chart in such a way that they are difficult to discern and/or the Plaintiffs have not been provided with a full and complete copy of the chart, partially due to the New York State Attorney General's Office having subpoenaed and/or confiscated some portion of those 2 FILED: ONONDAGA COUNTY CLERK 08/11/2022 03:29 PM INDEX NO. 007476/2018 NYSCEF DOC. NO. 202 RECEIVED NYSCEF: 08/11/2022 records. The Plaintiffs have provided those dates and times of treatment which they currently have knowledge and reserve the right to supplement their response upon completion of discovery. 2. Upon information and belief, the Defendant's care and treatment of the Decedent took place at the James Square Nursing and Rehabilitation Center in Syracuse, New York. 3. The Plaintiffs object to the Defendant's demand for each and every act or omission on the part of Defendant Pawan K. Rao, M.D. which is the basis of the alleged malpractice of the Defendant as being overly broad and improper. The Plaintiffs will list all of the acts and/or omissions of which they currently have knowledge and reserve the right to supplement their response upon completion of discovery, and upon receipt of a complete copy of the chart. Upon information and belief, the negligence and medical malpractice by the Defendant Pawan K. Rao, M.D. occurred while the Decedent was an inpatient resident at the James Square Nursing and Rehabilitation Center from March 29, 2016 until July 27, 2016. The Plaintiffs claim that the Defendant is vicariously liable and/or directly responsible for the negligence and malpractice of the other physicians who attended to the Decedent at that facility as well as any malpractice of the nursing and rehabilitation staff, to the extent that Defendant Rao was the treating physician, and had a duty and an obligation as the treating physician to review the chart on a regular basis and to make the appropriate contacts when necessary with other physicians, nursing staff, physical therapy/occupational therapy staff, dietary staff and/or administration in order to ensure and bring about the proper care of the Decedent. Upon information and belief. the Defendant failed to provide medical care and serves for a post hip fracture patient commensurate with good and accepted nursing home/rehabilitation/medical 3 FILED: ONONDAGA COUNTY CLERK 08/11/2022 03:29 PM INDEX NO. 007476/2018 NYSCEF DOC. NO. 202 RECEIVED NYSCEF: 08/11/2022 services in the State of New York and in the Country. The Defendant deviated from accepted nursing home/rehabilitation/medical practices in his care evaluation of the Decedent. The Defendant failed to monitor and attend to the Decedent's basic needs for hydration, nutrition, caloric intake, physical therapy and positional monitoring and safeguarding. The Defendant failed to undertake and/or bring about immediate and urgent medical care for the Decedent's numerous life threatening conditions including malnutrition, failure to thrive, weight loss, severe decubitus ulcers, infection of decubitus ulcers, dehydration and other evident medical problems which the Defendant was actually aware of and/or should have been aware of through the exercise of reasonable care as the Decedent's treating physician. The Defendant failed to monitor the Decedent's overall condition and failed to initiate care or treatment, coordination and dialogue with other physicians who were participating in the care of the Decedent and other care providers and nursing staff at the facility who were also participating in the care of the Decedent in order to bring about the proper care for the Decedent. The Defendant failed to ensure that the Decedent received proper physical therapy in order to allow the Decedent to remain ambulatory. The Defendant deviated from accepted medical practices and failed to monitor the Decedent's care at the facility pursuant to his responsibilities as the Decedent's treating physician and allowed the Decedent to be isolated in a bed for extended periods of time without proper therapy, care. monitoring and nourishment. The Defendant negligently and carelessly represented to family members that the Decedent was receiving proper care. The Defendant negligently and carelessly provided information to family members which would have the effect of relaxing any efforts on their part to bring about further or emergent care for the Decedent. The Defendant failed to issue proper orders concerning the placement and change of the Decedent's position in order to avoid the occurrence and the worsening of 4 FILED: ONONDAGA COUNTY CLERK 08/11/2022 03:29 PM INDEX NO. 007476/2018 NYSCEF DOC. NO. 202 RECEIVED NYSCEF: 08/11/2022 decubitus ulcers. The Defendant allowed or caused the Decedent to be over-medicated and unreasonably sedated for extended periods of time. To the extent that the Defendant issued orders with respect to the Decedent's positioning, the Defendant failed to follow up on those orders in order to determine whether or not they were being carried out in an appropriate manner by the staff. The Defendant failed to monitor for the presence of decubitus ulcers as part of a good and proper and complete physical examination of the Decedent pursuant to accepted medical practices for the care and treatment of an individual of the Decedent's age and medical background as an inpatient in a rehabilitation center. The Defendant allowed the Decedent's decubitus ulcers to develop and become life threatening without undertaking necessary and aggressive medical care. The Defendant failed to diagnose and treat the Decedent for infection and failed to order the transport of the Decedent for proper wound care of his decubitus ulcers. The Defendant failed to check, monitor and chart the Decedent's vital signs pursuant to accepted medical practices. The Defendant failed to bring about the Decedent's transport to a hospital for care in a timely manner and/or failed to bring about the timely transport of the Decedent to a hospital for a higher level of care at a point well before July of 2016, before the Decedent's medical conditions became fatal. The Defendant caused and/or allowed the Decedent to suffer malnutrition, muscle wasting, dehydration, significant weight loss and/or other treatable and preventable problems throughout the period that the Defendant was the Decedent's treating physician at the James Square Nursing and Rehabilitation Center, in deviation from good and accepted medical care standards. The Defendant failed to monitor the Decedent's weight where he was admitted to the facility weighing approximately 150 pounds and was discharged from the facility on an emergent basis to the hospital weighing only 110 pounds and to the extent that the Defendant realized and was 5 FILED: ONONDAGA COUNTY CLERK 08/11/2022 03:29 PM INDEX NO. 007476/2018 NYSCEF DOC. NO. 202 RECEIVED NYSCEF: 08/11/2022 aware of the Decedent's weight loss throughout the period of admission from March 29, 2016 through July 27, 2016, the Defendant failed to undertake proper and proactive care efforts in order to determine the cause of the weight loss and reverse the problem prior to the Decedent's condition becoming fatal. The Defendant failed to note and respond to the Decedent's weight documented in his care records as follows: 1/22/15 - 139 3/31/16 - 135 loss, pounds; pounds; 4/1/16 - 128.7 5/13/16 - 123.2 6/8/16 - 120.56 6/27/16 - 119.24 pounds; pounds; pounds; pounds; and 7/20/16 111.1 pounds. The Defendant as the Decedent's treating physician failed to conduct and/or bring about the regular and necessary medical examination and evaluation of the Decedent and throughout his admission such that the Decedent's treatable and curable medical conditions were allowed to advance and become fatal. The Defendant caused conscious pain and suffering and wrongful death in a patient who should have been admitted for a brief period of rehabilitation and then discharged home. The Defendant failed to monitor and attend the Decedent's conditions throughout the admission including extreme pain and allowed the Decedent to endure pain without proper treatment and/or medication on a continuing basis. The Defendant failed to utilize reasonable care in terms of the care provided to the Decedent and failed to properly interact with nursing staff, physical therapy/occupational therapy staff, other physicians involved in the Decedent's care, physical therapy providers, nurses' aides, dietary staff, and administration as the Decedent's treating physician in order to fulfill his responsibilities as treating physician. The Defendant negligently and carelessly allowed the Decedent to become cachectic, failing to order, evaluate and act upon regular lab tests including blood chemistries and urine analysis. The Defendant failed to properly diagnose and treat the Decedent in a timely manner for sepsis, bacteremia, significant blood loss, upper gastrointestinal bleed, septic shock, hypovolemic shock, thrombocytopenia, leukocytosis and 6 FILED: ONONDAGA COUNTY CLERK 08/11/2022 03:29 PM INDEX NO. 007476/2018 NYSCEF DOC. NO. 202 RECEIVED NYSCEF: 08/11/2022 allowed the Decedent's otherwise treatable medical conditions to progress to the point where Plaintiffs' they became life threatening, fatal and caused the Decedent to suffer greatly and then die. The Defendant failed to adequately examine, diagnose and treat the Decedent for a fall on May 13, 2016; weight loss noted on May 13, 2016; weight loss and dehydration noted on June 14, 201 6; for a fall on June 21, 2016; for over-medication resulting in lethargy, reduced communication and eating difficulties. The Defendant negligently ordered or approved of a plan to change the Decedent's status from a temporary rehabilitation admission to long term care without the consent of the Decedent or his family. Plaintiffs' 4. The do claim that the Defendant, as the Decedent's treating physician, is vicariously liable for the failures of other treatment providers of the Decedent at the James Square Nursing and Rehabilitation Center to the extent that the Defendant was or should have been in a position to ensure the proper care of the Decedent or at least to recognize treatment issues and correct them. Those other care providers involved in the care in the Decedent for whom Defendant Pawan K. Rao, M.D. is alleged to be vicariously liable for include the following: Ovid Neulander, M.D., Brian Changlai, M.D., Jeanne Bishop, M.D., Brenda Crawley, LPN, Shannon Baxter, LPN, Susan Latten, Henry Dorsey, Carol Ferrel, Marianne Hand, Nancy Bataglia, LPN, Tyteone Perriman, Heidi Alger, Nancy Clement-Sullivant, Colleen Knafelc, Lyudmila Melnik, James Vavra, Juditha Johnson, LPN, Christy Loomis, LPN. Jackey Toombs, LPN, Lashawana Williams, Melissa Clark, Susan Driscoll, LPN, Irma Nichols, LPN, Lorie Gale, Lacey Wright, Nancy Borawski, Zoe Heyward, LPN, Colleen Crader, LPN. Erin Sotherden, Eric Rodrigues, Mary Bogart, LPN, Sandra Boateng, LPN, Linda Rooza, Michelle Berry, LPN, Samantha Thousand, Phyllis Misius, Activities Aide, Trudy Phelps, Social Social Robin Bridget Cummings- Worker, Anthony Ortolano, Worker, Bowles, LPN, 7 FILED: ONONDAGA COUNTY CLERK 08/11/2022 03:29 PM INDEX NO. 007476/2018 NYSCEF DOC. NO. 202 RECEIVED NYSCEF: 08/11/2022 Martin, MDS Coordinator, Sonia Chaubal, PT, Cherrie Dunning, Dietary Tech, Jeri Tousaw, MDS Coordinator, Cynthia McDowell, LPN, Timothy Reedy, OT, Stella Chu, Dietary Aide, Danielle Towers, MDS Coordinator, Stephanie Magee, Susan VanGorden, Social Worker, Timothy Wallace, RN, Mary Mann, RN, Karrie Glatt, NP, Laurie Cerio, LPN, Joshua Zeahwon, RN, Tracy Nigro, RN, Terry Lavin, NP, Marsha Garboushin, Dietitian, Charles Peirce, RN, Theresa Bulone, RN, Kathryn Mutter, Dietitian, David Goodwin, RN, Patrick Harrington, Speech Therapist, Lance Osborne, RN, Bridget Benney, LPN, Nicole Beckwith, Dietitian, Kara Cangemi, Speech Therapist, Melissa Alt, RN, Lisa Campbell, LPN, Jessica Bramble, Dietitian, Denise Wehrle, NP, Corina Taylor, PT, Nikanya Winston, RN, Robin Kunicki, OT, Kristin Carter, LPN, Theresa Mayo, RN, Harsh Goyal, P.T., Trudy Phelps, SW, Charles Pierce, RN, Tracy Nigro, LPN and other employees/aides and/or physicians whose names are not currently known to the Plaintiffs. The Plaintiffs reserve the right to supplement this response upon completion of discovery in this action. 5. The Plaintiffs are not currently aware of any other or further acts or omissions on the part of the Defendant other than those set forth in paragraphs 3, 6, 8 and 9 herein. The Plaintiffs reserve the right to supplement their response upon completion of discovery in this action. 6 Upon information and belief, good and accepted medical practices, customs and medical standards for the care of patients at a nursing rehabilitation center for treating ship" physicians requires that the treating act as "captain of the in terms of initially evaluating a patient, making the appropriate medical orders, reviewing the nursing notes, dietary notes, physical therapy notes, occupational therapy notes, reviewing the notes of other physicians involved in the care of an inpatient whether at the facility or upon the patient's transport outside 8 FILED: ONONDAGA COUNTY CLERK 08/11/2022 03:29 PM INDEX NO. 007476/2018 NYSCEF DOC. NO. 202 RECEIVED NYSCEF: 08/11/2022 of the facility, in order to coordinate the care, identify any treatment or care issues in a timely manner so that they can be adjusted and/or corrected, to ensure that the patient receives proper medical care towards the desired goal of the admission which was to rehabilitate the Decedent for a hip fracture and then return him home for independent living with his wife and family. Upon information and belief, Defendant Pawan K. Rao, M.D. deviated from the above accepted medical practices, customs and medical standards by or through the failures listed in paragraph 3 above. Furthermore, good and accepted medical practices, customs and medical standards required that the Defendant, as a treating physician, track, monitor, examine and record the patient's vital signs, weight, weight loss, la