Preview
FILED: ONEIDA COUNTY CLERK 01/08/2024 04:59 PM INDEX NO. EFCA2023-003208
NYSCEF DOC. NO. 11 RECEIVED NYSCEF: 01/08/2024
STATE OF NEW YORK
SUPREME COURT COUNTY OF ONEIDA
YISSET SALAZAR, Individually, and as Administratrix of
the Estate of J.S.R., Deceased,
OMNIBUS DISCOVERY
Plaintiffs, DEMANDS
-vs-
Index No.: EFCA2023-003208
KWAKU AMANKWAH, M.D., FAXTON ST. LUKE’S
HOSPITAL, FAXTON ST. LUKE’S HEALTHCARE, and
SLOCUM DICKSON MEDICAL GROUP, PLLC,
Defendants.
PLEASE TAKE NOTICE, that pursuant to the appropriate sections of the Civil Practice
Law and Rules, and the authorities hereinafter referred to, we hereby demand that you provide the
undersigned, attorneys for Defendants KWAKU AMANKWAH, M.D. and SLOCUM
DICKSON MEDICAL GROUP, PLLC, in writing, within twenty (20) days after receipt of this
demand, and that all original of the items requested be preserved during the entire course of this
litigation and be made available upon request for inspection and testing, the following:
STATEMENTS
1. Pursuant to CPLR 3101(e), you are required to provide the undersigned with copies
of any and all statements of the aforesaid Defendants, its agents, servants and/or employees, oral,
recorded or written, whether signed or otherwise and whether or not obtained by investigation after
the date of the incident herein, currently in your possession concerning the occurrence and events
out of which the alleged cause of actions arose, or a written response to this demand that you have
no such statements. This should also include, but not be limited to, tapes of phone calls, messages
stored and/or saved on a telephone, cell phone or other answering and/or voice mail device; e-mail
messages sent and/or received; and any other device or technology capable of storing such data.
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WITNESSES
2. Pursuant to Rule 3101 of the Civil Practice Law and Rules and Zellman v.
Metropolitan Transportation Authority, 40 A.D.2d 248, 339 N.Y.S.2d 255, Alder v. Warren, 81
A.D2d 569, Hoffman v. Ro-san Manor, 73 A.D.2d 207, 425 N.Y.S.2d 619, Bagailuk, et al v. Heins,
82 A.D.2d 1002, and Wolf v. Davis, 108 Misc.2d 19:
(a) Names and addresses of each and every witness to the occurrence.
(b) Names and addresses of each and every witness to the injuries or damages as
alleged in the complaint.
(c) Names and addresses of witnesses to any admissions made by said
Defendant, its servants, agents, and/or employees.
(d) Names and addresses of witnesses to any acts or omissions which allegedly
caused the occurrence alleged in the complaint.
(e) If dangerous condition is alleged, names and addresses of potential witnesses
who can testify to notices and conditions about which Plaintiffs complain.
(f) If dangerous condition is alleged, names and addresses of witnesses to the
nature and duration of any alleged condition which allegedly caused the occurrence
alleged in the complaint.
(g) Names and addresses of any witnesses who will be called to testify at trial.
(h) If no such witnesses are known, so state in response to this demand.
MEDICAL RECORDS AND AUTHORIZATIONS
3. Pursuant to Rule 3121(a) CPLR and Myers v. Schneider, 59 A.D.2d 736, Brooks v.
Hausauer, 51 A.D.2d 660, Greuling v. Breakey, 56 A.D.2d 540, Mendelson v. Shein, 58 A.D.2d
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859, Baker v. Younts, 96 Misc. 2d 132, and Brewer v. Jamaica Hospital, 73 A.D.2d 851, you are
required to serve upon the undersigned:
(a) Copies of any and all medical records, including reports and bills, of any and
all physicians, nurses, therapists, pharmacists, health care providers, ambulance
services, or any other medical personnel who have ever treated said Decedent for
any of the medical conditions put in issue by the pleadings of this action;
(b) Copies of any and all records of any hospitalization and treatment ever
rendered to the Decedent at any hospital, health facility or clinic;
(c) Duly executed, HIPAA compliant authorizations permitting Gale Gale &
Hunt, LLC and The MCS Group, Inc. to obtain the records, reports, tissue slides,
pathology slides and re-cuts, and radiographic films of any and all physicians,
nurses, therapists, pharmacists, health care providers, medical personnel, hospitals,
health facilities or clinic who have ever treated said Decedent for any of the medical
conditions put in issue by the pleadings of this action;
(d) List of the names and addresses of all physicians, pharmacists, health care
providers, therapists, hospitals, health facilities, pharmacies or clinics who have ever
treated said Decedent.
AUTHORIZATIONS FOR DEFENDANTS TO
INTERVIEW PLAINTIFF’S HEALTH CARE PROVIDERS
4. Demand is hereby made that you provide the undersigned with duly executed
HIPAA authorizations allowing Gale Gale & Hunt, LLC to conduct an informal post-note of issue
ex-parte interview of any and all non-party treating physicians or other healthcare providers.
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TAX RECORDS
5. If lost wages are claimed, demand is hereby made that you provide the undersigned
with copies of Plaintiff’s Decedent’s federal and state tax returns and W-2 forms from five years
prior to the incident until the present.
ACCIDENT OR INCIDENT REPORTS
6. A copy of any and all written reports of the accident or incident which is the subject
of this action.
DIARIES OR LOGS
7. A copy of any and all written diaries or logs made at the time of the incident that
relate to care and treatment for any alleged injuries or medical conditions put in issue by the
pleadings of this action.
PHOTOGRAPHS, ETC.
8. Pursuant to Zimmerman v. Nassau Hospital, 76 A.D.2d 921, 429 N.Y.S.2d 262 (2nd
Dept 1980) and Brewer v. Jamaica Hospital, 73 A.D.2d 851, 423 N.Y.S.2d 188 (1st Dept. 1980),
you are required to serve upon the undersigned, for inspection, photocopying and other
examination, any and all photographs, videotapes or other image storing devices, including but not
limited to, cell phones, CD Rom or computer discs currently in your possession, custody or control
taken of or at the scene of the incident which is the subject of this action, of the personal injuries
allegedly sustained by the injured Decedent in this action, and/or of any instrumentalities involved
in the accident or incident which is the subject of this claim.
SOURCES OF COLLATERAL PAYMENTS
9. Pursuant to CPLR §3101 and CPLR §4545, Defendants demand that you provide
the undersigned:
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(a) The name, address and type of benefit for each collateral source of payment,
including, but not limited to, insurance, workers compensation benefits, employee
benefit programs, disability benefits and social security, which replace or indemnify,
in whole or in part, Plaintiff and/or Decedent’s costs whether it be past, present
and/or future, for each of the following:
i. Medical care;
ii. Dental care;
iii. Custodial care;
iv. Rehabilitation services;
v. Loss of earnings;
vi. Other economic loss.
(b) As to each collateral source, set forth the amount, if any, which Plaintiff has
received and/or will receive for each of the following:
i. Medical care;
ii. Dental care;
iii. Custodial care;
iv. Rehabilitation services;
v. Loss of earnings;
vi. Other economic loss.
(c) As to each collateral source, set forth the amount, if any, which Plaintiff has
paid in premiums during the two-year period immediately preceding the date of the
accident for the benefits and state separately the projected future cost, if any, to the
Plaintiff to maintain such benefits.
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(d) Where reimbursement was or is pursuant to a policy, set forth the name of
the policy holder, the policy number, and the name of the issuer of the policy; a list
of claims submitted pursuant to the policy, and the amount of money received
pursuant to each claim.
(e) Provide duly executed and acknowledged written authorizations permitting
Gale Gale & Hunt, LLC and The MCS Group, Inc. to obtain the records of each
identified collateral source of payment with claim numbers, file numbers and/or
social security numbers noted thereon.
MEDICARE INFORMATION AND NOTICE TO PRODUCE
10. Set forth a statement as to whether the Decedent had received benefits from
Medicare at any time prior to the date of this demand. This demand is not limited to the claimed
injuries at issue in the subject action.
11. If the answer to paragraph 10 is in the affirmative, set forth the following:
(a) Decedent’s date of birth;
(b) Decedent’s social security number (or other tax identification number);
(c) Medicare and/or Health Insurance Company (HICN) file number;
(d) Date when Decedent became a beneficiary;
(e) Whether Medicare claims a lien or right of subrogation and the amount of
said lien or right of subrogation;
(f) Whether any Medicare secondary payer (MSP) claims exist.
12. If the answer to paragraph 10 is in the negative, state whether or not Plaintiff intends
to apply for Medicare benefits.
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13. In the event Decedent was a Medicare beneficiary or Plaintiff intends to apply for
Medicare benefits, set forth the following:
(a) Date of the event giving rise to the injury for which Medicare benefits have
been or will be sought;
(b) The injury for which Medicare benefits have been received or will be sought;
(c) The event Plaintiff claims caused the injury for which Medicare benefits
have been received or will be sought.
14. If Medicare payments have been made relating to the injury(ies) claimed in this
actions, set forth the date(s) and amount(s) of such payments and a description of the materials or
services for which payment was made.
15. Demand is hereby made that the Plaintiff produce:
(a) Copies of all documents and records in Plaintiff’s possession pertaining to
Plaintiff or Decedent’s receipt of Medicare benefits;
(b) If there are Medicare secondary payer (MSP) claims, produce a copy of the
claims summary from Medicare regarding those claims;
(c) Duly executed and acknowledged written authorizations permitting Gale
Gale & Hunt, LLC and The MCS Group, Inc. to obtain and make copies of all
Medicare records, Part A and B, specifying the correct address of said Medicare
office along with the Plaintiff’s Social Security number and the file number.
(d) Duly executed and acknowledged written authorizations permitting Gale
Gale & Hunt, LLC and The MCS Group, Inc. to contact Medicare.
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MEDICAID INFORMATION AND NOTICE TO PRODUCE
16. Set forth a statement as to whether Decedent had received benefits from Medicaid at
any time prior to the date of this demand. This demand is not limited to the claimed injuries at issue
in the subject action.
17. If the answer to paragraph 16 is in the affirmative, set forth the following:
(a) Decedent’s date of birth;
(b) Decedent’s social security number (or other tax identification number);
(c) Medicaid file number;
(d) Whether Medicaid claims a lien and the amount of said lien;
(e) Whether any Medicaid secondary payer (MSP) claims exist.
(f) Name, address and county in which Decedent made a claim for Medicaid;
(g) Date that a claim for Medicaid was made;
(h) Date when Decedent became a beneficiary.
18. If the answer to paragraph 16 is in the negative, state whether or not Plaintiff intends
to apply for Medicaid benefits.
19. In the event Decedent was a Medicaid beneficiary or Plaintiff intends to apply for
Medicaid benefits, set forth the following:
(a) Date of the event giving rise to the injury for which Medicaid benefits have
been or will be sought;
(b) The injury for which Medicaid benefits have been received or will be sought;
(c) The event Plaintiff claims caused the injury for which Medicaid benefits
have been received or will be sought.
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20. If Medicaid payments have been made relating to the injury(ies) claimed in this
action, set forth the date(s) and amount(s) of such payments and a description of the materials or
services for which payment was made.
21. Demand is hereby made that the Plaintiff produce:
(a) Copies of all documents and records in Plaintiff’s possession pertaining to
Plaintiff or Decedent’s receipt of Medicaid benefits;
(b) If there are Medicaid secondary payer (MSP) claims, produce a copy of the
claims summary from Medicaid regarding those claims;
(c) Duly executed and acknowledged written authorizations permitting Gale
Gale & Hunt, LLC and The MCS Group, Inc. to obtain and make copies of all
Medicaid records, specifying the correct address of said Medicaid office along with
the Plaintiff’s Social Security number and the file number.
(d) Duly executed and acknowledged written authorizations permitting Gale
Gale & Hunt, LLC and The MCS Group, Inc. to contact Medicaid.
LIENS OR SUBROGATION RIGHTS
22. Pursuant to CPLR §3101(a), provide Defendants with a list of any and all entities
who have provided you with notice, in any form, of a claim in the nature of a lien and/or right of
subrogation against the proceeds of any settlement or judgment in this pending case and provide
copies of all documents reflecting such a claim and provide said Defendants with duly executed and
acknowledged written authorizations permitting Gale Gale & Hunt, LLC and The MCS Group,
Inc. to obtain and make copies of all records, specifying the correct address of said office along
with claimant’s Social Security number and the file number.
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NARRATIVE MEDICAL REPORTS
23. Pursuant to 22 NYCRR 202.17(h), provide a narrative report and all medical records
of any physician and/or health care provider whom Plaintiff will call to testify at the time of trial of
this matter regarding his/her examination of Plaintiff or Decedent for trial; said reports must include
a detailed recital of the injuries, conditions and opinions as to which testimony will be offered at
trial, and also refer to and identify those x-rays and technicians’ reports which will be offered at
trial.
APPEARANCES PURSUANT TO CPLR §2103(e)
24. Provide the undersigned with a list of the parties who have appeared in this action,
together with the names and addresses of their attorneys.
25. Defendants KWAKU AMANKWAH, M.D. and SLOCUM DICKSON
MEDICAL GROUP, PLLC hereby requests that each paper served in this action be served on the
undersigned.
OTHER
26. Identify the Index Number and the name of the I.A.S. Justice assigned to this case.
27. Provide a copy of any documentation evidencing bankruptcy filings made on behalf
of the Plaintiff or Decedent including but not limited to the petition and attached schedules within
the past five years.
28. Provide a copy of any pleadings filed in companion actions or actions filed in other
courts that arise in relation to the injuries claimed in the pleadings of this action.
29. Provide complete, clear and legible copies of all affidavits of service.
30. Provide complete, clear and legible copies of Decedent’s death certificate and
autopsy report.
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31. Provide a true copy of letters of administration.
32. Provide a date-stamped copy of the original Summons and Complaint filed in this
action.
PLEASE BE ADVISED, that these demands are continuing demands during the pendency
of this action, including any trial herein.
PLEASE BE FURTHER ADVISED, that in the event of your refusal or failure to comply
herein, the undersigned will move for an order precluding the use at trial of any and all of the
information requested but not furnished, the testimony of any witness whose identity has not been
disclosed, or the contents of any statement not furnished.
Dated: January 8, 2024
Kirsten Lerch Kroft, Esq.
GALE GALE & HUNT, LLC
Attorneys for Defendants Kwaku Amankwah, M.D. and
Slocum Dickson Medical Group, PLLC
P. O. Box 97
Fayetteville, New York 13066
(315) 637-3663
TO: Anna Badalian, Esq.
DeFrancisco & Falgiatano, LLP
Attorneys for Plaintiffs
6739 Myers Road
East Syracuse, New York 13057
(315) 479-9000
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FILED: ONEIDA COUNTY CLERK 01/08/2024 04:59 PM INDEX NO. EFCA2023-003208 NYSCEF DOC. NO. 11 RECEIVED NYSCEF: 01/08/2024 STATE OF NEW YORK SUPREME COURT COUNTY OF ONEIDA YISSET SALAZAR, Individually, and as Administratrix of the Estate of J.S.R., Deceased, OMNIBUS DISCOVERY Plaintiffs, DEMANDS -vs- Index No.: EFCA2023-003208 KWAKU AMANKWAH, M.D., FAXTON ST. LUKE’S HOSPITAL, FAXTON ST. LUKE’S HEALTHCARE, and SLOCUM DICKSON MEDICAL GROUP, PLLC, Defendants. PLEASE TAKE NOTICE, that pursuant to the appropriate sections of the Civil Practice Law and Rules, and the authorities hereinafter referred to, we hereby demand that you provide the undersigned, attorneys for Defendants KWAKU AMANKWAH, M.D. and SLOCUM DICKSON MEDICAL GROUP, PLLC, in writing, within twenty (20) days after receipt of this demand, and that all original of the items requested be preserved during the entire course of this litigation and be made available upon request for inspection and testing, the following: STATEMENTS 1. Pursuant to CPLR 3101(e), you are required to provide the undersigned with copies of any and all statements of the aforesaid Defendants, its agents, servants and/or employees, oral, recorded or written, whether signed or otherwise and whether or not obtained by investigation after the date of the incident herein, currently in your possession concerning the occurrence and events out of which the alleged cause of actions arose, or a written response to this demand that you have no such statements. This should also include, but not be limited to, tapes of phone calls, messages stored and/or saved on a telephone, cell phone or other answering and/or voice mail device; e-mail messages sent and/or received; and any other device or technology capable of storing such data. 1 of 11 FILED: ONEIDA COUNTY CLERK 01/08/2024 04:59 PM INDEX NO. EFCA2023-003208 NYSCEF DOC. NO. 11 RECEIVED NYSCEF: 01/08/2024 WITNESSES 2. Pursuant to Rule 3101 of the Civil Practice Law and Rules and Zellman v. Metropolitan Transportation Authority, 40 A.D.2d 248, 339 N.Y.S.2d 255, Alder v. Warren, 81 A.D2d 569, Hoffman v. Ro-san Manor, 73 A.D.2d 207, 425 N.Y.S.2d 619, Bagailuk, et al v. Heins, 82 A.D.2d 1002, and Wolf v. Davis, 108 Misc.2d 19: (a) Names and addresses of each and every witness to the occurrence. (b) Names and addresses of each and every witness to the injuries or damages as alleged in the complaint. (c) Names and addresses of witnesses to any admissions made by said Defendant, its servants, agents, and/or employees. (d) Names and addresses of witnesses to any acts or omissions which allegedly caused the occurrence alleged in the complaint. (e) If dangerous condition is alleged, names and addresses of potential witnesses who can testify to notices and conditions about which Plaintiffs complain. (f) If dangerous condition is alleged, names and addresses of witnesses to the nature and duration of any alleged condition which allegedly caused the occurrence alleged in the complaint. (g) Names and addresses of any witnesses who will be called to testify at trial. (h) If no such witnesses are known, so state in response to this demand. MEDICAL RECORDS AND AUTHORIZATIONS 3. Pursuant to Rule 3121(a) CPLR and Myers v. Schneider, 59 A.D.2d 736, Brooks v. Hausauer, 51 A.D.2d 660, Greuling v. Breakey, 56 A.D.2d 540, Mendelson v. Shein, 58 A.D.2d 2 of 11 FILED: ONEIDA COUNTY CLERK 01/08/2024 04:59 PM INDEX NO. EFCA2023-003208 NYSCEF DOC. NO. 11 RECEIVED NYSCEF: 01/08/2024 859, Baker v. Younts, 96 Misc. 2d 132, and Brewer v. Jamaica Hospital, 73 A.D.2d 851, you are required to serve upon the undersigned: (a) Copies of any and all medical records, including reports and bills, of any and all physicians, nurses, therapists, pharmacists, health care providers, ambulance services, or any other medical personnel who have ever treated said Decedent for any of the medical conditions put in issue by the pleadings of this action; (b) Copies of any and all records of any hospitalization and treatment ever rendered to the Decedent at any hospital, health facility or clinic; (c) Duly executed, HIPAA compliant authorizations permitting Gale Gale & Hunt, LLC and The MCS Group, Inc. to obtain the records, reports, tissue slides, pathology slides and re-cuts, and radiographic films of any and all physicians, nurses, therapists, pharmacists, health care providers, medical personnel, hospitals, health facilities or clinic who have ever treated said Decedent for any of the medical conditions put in issue by the pleadings of this action; (d) List of the names and addresses of all physicians, pharmacists, health care providers, therapists, hospitals, health facilities, pharmacies or clinics who have ever treated said Decedent. AUTHORIZATIONS FOR DEFENDANTS TO INTERVIEW PLAINTIFF’S HEALTH CARE PROVIDERS 4. Demand is hereby made that you provide the undersigned with duly executed HIPAA authorizations allowing Gale Gale & Hunt, LLC to conduct an informal post-note of issue ex-parte interview of any and all non-party treating physicians or other healthcare providers. 3 of 11 FILED: ONEIDA COUNTY CLERK 01/08/2024 04:59 PM INDEX NO. EFCA2023-003208 NYSCEF DOC. NO. 11 RECEIVED NYSCEF: 01/08/2024 TAX RECORDS 5. If lost wages are claimed, demand is hereby made that you provide the undersigned with copies of Plaintiff’s Decedent’s federal and state tax returns and W-2 forms from five years prior to the incident until the present. ACCIDENT OR INCIDENT REPORTS 6. A copy of any and all written reports of the accident or incident which is the subject of this action. DIARIES OR LOGS 7. A copy of any and all written diaries or logs made at the time of the incident that relate to care and treatment for any alleged injuries or medical conditions put in issue by the pleadings of this action. PHOTOGRAPHS, ETC. 8. Pursuant to Zimmerman v. Nassau Hospital, 76 A.D.2d 921, 429 N.Y.S.2d 262 (2nd Dept 1980) and Brewer v. Jamaica Hospital, 73 A.D.2d 851, 423 N.Y.S.2d 188 (1st Dept. 1980), you are required to serve upon the undersigned, for inspection, photocopying and other examination, any and all photographs, videotapes or other image storing devices, including but not limited to, cell phones, CD Rom or computer discs currently in your possession, custody or control taken of or at the scene of the incident which is the subject of this action, of the personal injuries allegedly sustained by the injured Decedent in this action, and/or of any instrumentalities involved in the accident or incident which is the subject of this claim. SOURCES OF COLLATERAL PAYMENTS 9. Pursuant to CPLR §3101 and CPLR §4545, Defendants demand that you provide the undersigned: 4 of 11 FILED: ONEIDA COUNTY CLERK 01/08/2024 04:59 PM INDEX NO. EFCA2023-003208 NYSCEF DOC. NO. 11 RECEIVED NYSCEF: 01/08/2024 (a) The name, address and type of benefit for each collateral source of payment, including, but not limited to, insurance, workers compensation benefits, employee benefit programs, disability benefits and social security, which replace or indemnify, in whole or in part, Plaintiff and/or Decedent’s costs whether it be past, present and/or future, for each of the following: i. Medical care; ii. Dental care; iii. Custodial care; iv. Rehabilitation services; v. Loss of earnings; vi. Other economic loss. (b) As to each collateral source, set forth the amount, if any, which Plaintiff has received and/or will receive for each of the following: i. Medical care; ii. Dental care; iii. Custodial care; iv. Rehabilitation services; v. Loss of earnings; vi. Other economic loss. (c) As to each collateral source, set forth the amount, if any, which Plaintiff has paid in premiums during the two-year period immediately preceding the date of the accident for the benefits and state separately the projected future cost, if any, to the Plaintiff to maintain such benefits. 5 of 11 FILED: ONEIDA COUNTY CLERK 01/08/2024 04:59 PM INDEX NO. EFCA2023-003208 NYSCEF DOC. NO. 11 RECEIVED NYSCEF: 01/08/2024 (d) Where reimbursement was or is pursuant to a policy, set forth the name of the policy holder, the policy number, and the name of the issuer of the policy; a list of claims submitted pursuant to the policy, and the amount of money received pursuant to each claim. (e) Provide duly executed and acknowledged written authorizations permitting Gale Gale & Hunt, LLC and The MCS Group, Inc. to obtain the records of each identified collateral source of payment with claim numbers, file numbers and/or social security numbers noted thereon. MEDICARE INFORMATION AND NOTICE TO PRODUCE 10. Set forth a statement as to whether the Decedent had received benefits from Medicare at any time prior to the date of this demand. This demand is not limited to the claimed injuries at issue in the subject action. 11. If the answer to paragraph 10 is in the affirmative, set forth the following: (a) Decedent’s date of birth; (b) Decedent’s social security number (or other tax identification number); (c) Medicare and/or Health Insurance Company (HICN) file number; (d) Date when Decedent became a beneficiary; (e) Whether Medicare claims a lien or right of subrogation and the amount of said lien or right of subrogation; (f) Whether any Medicare secondary payer (MSP) claims exist. 12. If the answer to paragraph 10 is in the negative, state whether or not Plaintiff intends to apply for Medicare benefits. 6 of 11 FILED: ONEIDA COUNTY CLERK 01/08/2024 04:59 PM INDEX NO. EFCA2023-003208 NYSCEF DOC. NO. 11 RECEIVED NYSCEF: 01/08/2024 13. In the event Decedent was a Medicare beneficiary or Plaintiff intends to apply for Medicare benefits, set forth the following: (a) Date of the event giving rise to the injury for which Medicare benefits have been or will be sought; (b) The injury for which Medicare benefits have been received or will be sought; (c) The event Plaintiff claims caused the injury for which Medicare benefits have been received or will be sought. 14. If Medicare payments have been made relating to the injury(ies) claimed in this actions, set forth the date(s) and amount(s) of such payments and a description of the materials or services for which payment was made. 15. Demand is hereby made that the Plaintiff produce: (a) Copies of all documents and records in Plaintiff’s possession pertaining to Plaintiff or Decedent’s receipt of Medicare benefits; (b) If there are Medicare secondary payer (MSP) claims, produce a copy of the claims summary from Medicare regarding those claims; (c) Duly executed and acknowledged written authorizations permitting Gale Gale & Hunt, LLC and The MCS Group, Inc. to obtain and make copies of all Medicare records, Part A and B, specifying the correct address of said Medicare office along with the Plaintiff’s Social Security number and the file number. (d) Duly executed and acknowledged written authorizations permitting Gale Gale & Hunt, LLC and The MCS Group, Inc. to contact Medicare. 7 of 11 FILED: ONEIDA COUNTY CLERK 01/08/2024 04:59 PM INDEX NO. EFCA2023-003208 NYSCEF DOC. NO. 11 RECEIVED NYSCEF: 01/08/2024 MEDICAID INFORMATION AND NOTICE TO PRODUCE 16. Set forth a statement as to whether Decedent had received benefits from Medicaid at any time prior to the date of this demand. This demand is not limited to the claimed injuries at issue in the subject action. 17. If the answer to paragraph 16 is in the affirmative, set forth the following: (a) Decedent’s date of birth; (b) Decedent’s social security number (or other tax identification number); (c) Medicaid file number; (d) Whether Medicaid claims a lien and the amount of said lien; (e) Whether any Medicaid secondary payer (MSP) claims exist. (f) Name, address and county in which Decedent made a claim for Medicaid; (g) Date that a claim for Medicaid was made; (h) Date when Decedent became a beneficiary. 18. If the answer to paragraph 16 is in the negative, state whether or not Plaintiff intends to apply for Medicaid benefits. 19. In the event Decedent was a Medicaid beneficiary or Plaintiff intends to apply for Medicaid benefits, set forth the following: (a) Date of the event giving rise to the injury for which Medicaid benefits have been or will be sought; (b) The injury for which Medicaid benefits have been received or will be sought; (c) The event Plaintiff claims caused the injury for which Medicaid benefits have been received or will be sought. 8 of 11 FILED: ONEIDA COUNTY CLERK 01/08/2024 04:59 PM INDEX NO. EFCA2023-003208 NYSCEF DOC. NO. 11 RECEIVED NYSCEF: 01/08/2024 20. If Medicaid payments have been made relating to the injury(ies) claimed in this action, set forth the date(s) and amount(s) of such payments and a description of the materials or services for which payment was made. 21. Demand is hereby made that the Plaintiff produce: (a) Copies of all documents and records in Plaintiff’s possession pertaining to Plaintiff or Decedent’s receipt of Medicaid benefits; (b) If there are Medicaid secondary payer (MSP) claims, produce a copy of the claims summary from Medicaid regarding those claims; (c) Duly executed and acknowledged written authorizations permitting Gale Gale & Hunt, LLC and The MCS Group, Inc. to obtain and make copies of all Medicaid records, specifying the correct address of said Medicaid office along with the Plaintiff’s Social Security number and the file number. (d) Duly executed and acknowledged written authorizations permitting Gale Gale & Hunt, LLC and The MCS Group, Inc. to contact Medicaid. LIENS OR SUBROGATION RIGHTS 22. Pursuant to CPLR §3101(a), provide Defendants with a list of any and all entities who have provided you with notice, in any form, of a claim in the nature of a lien and/or right of subrogation against the proceeds of any settlement or judgment in this pending case and provide copies of all documents reflecting such a claim and provide said Defendants with duly executed and acknowledged written authorizations permitting Gale Gale & Hunt, LLC and The MCS Group, Inc. to obtain and make copies of all records, specifying the correct address of said office along with claimant’s Social Security number and the file number. 9 of 11 FILED: ONEIDA COUNTY CLERK 01/08/2024 04:59 PM INDEX NO. EFCA2023-003208 NYSCEF DOC. NO. 11 RECEIVED NYSCEF: 01/08/2024 NARRATIVE MEDICAL REPORTS 23. Pursuant to 22 NYCRR 202.17(h), provide a narrative report and all medical records of any physician and/or health care provider whom Plaintiff will call to testify at the time of trial of this matter regarding his/her examination of Plaintiff or Decedent for trial; said reports must include a detailed recital of the injuries, conditions and opinions as to which testimony will be offered at trial, and also refer to and identify those x-rays and technicians’ reports which will be offered at trial. APPEARANCES PURSUANT TO CPLR §2103(e) 24. Provide the undersigned with a list of the parties who have appeared in this action, together with the names and addresses of their attorneys. 25. Defendants KWAKU AMANKWAH, M.D. and SLOCUM DICKSON MEDICAL GROUP, PLLC hereby requests that each paper served in this action be served on the undersigned. OTHER 26. Identify the Index Number and the name of the I.A.S. Justice assigned to this case. 27. Provide a copy of any documentation evidencing bankruptcy filings made on behalf of the Plaintiff or Decedent including but not limited to the petition and attached schedules within the past five years. 28. Provide a copy of any pleadings filed in companion actions or actions filed in other courts that arise in relation to the injuries claimed in the pleadings of this action. 29. Provide complete, clear and legible copies of all affidavits of service. 30. Provide complete, clear and legible copies of Decedent’s death certificate and autopsy report. 10 of 11 FILED: ONEIDA COUNTY CLERK 01/08/2024 04:59 PM INDEX NO. EFCA2023-003208 NYSCEF DOC. NO. 11 RECEIVED NYSCEF: 01/08/2024 31. Provide a true copy of letters of administration. 32. Provide a date-stamped copy of the original Summons and Complaint filed in this action. PLEASE BE ADVISED, that these demands are continuing demands during the pendency of this action, including any trial herein. PLEASE BE FURTHER ADVISED, that in the event of your refusal or failure to comply herein, the undersigned will move for an order precluding the use at trial of any and all of the information requested but not furnished, the testimony of any witness whose identity has not been disclosed, or the contents of any statement not furnished. Dated: January 8, 2024 Kirsten Lerch Kroft, Esq. GALE GALE & HUNT, LLC Attorneys for Defendants Kwaku Amankwah, M.D. and Slocum Dickson Medical Group, PLLC P. O. Box 97 Fayetteville, New York 13066 (315) 637-3663 TO: Anna Badalian, Esq. DeFrancisco & Falgiatano, LLP Attorneys for Plaintiffs 6739 Myers Road East Syracuse, New York 13057 (315) 479-9000 11 of 11