Preview
FILED: NASSAU COUNTY CLERK 02/23/2024 08:33 PM INDEX NO. 600444/2022
NYSCEF DOC. NO. 171 RECEIVED NYSCEF: 02/23/2024
Exhibit F
FILED: NASSAU COUNTY CLERK 02/23/2024 08:33 PM INDEX NO. 600444/2022
NYSCEF DOC. NO. 171 RECEIVED NYSCEF: 02/23/2024
Island Pulmonary Associates, P.C.
4271 Hempstead Turnpike, Bethpage, NV 11714
Phone (516) 796-3700 • Fax (516) 796-3205
Progress Note
Patient: ZOLLO, DANIELLE DOB: MRN: 960748
Provider: Jerry Ipe, DO Encounter: Friday October 26, 2012 Referring: CRAFA MD.LAWRENCE
Chief Complaint
This is a 34 year old female here today for nodule on lung
History of Present Illness
Noted to have cold like symtpoms, was having blood tinged sptum went to plainview hospital-> Ct angio , subcm nodule,
noncalcified. (see report)
8 ciggaretes a day
1 dog - no breathing at around it Only on cymbalta.
No previous nodules . No previous PPD . Pt was sick at time on CT, now symptoms have improved including hemoptysis.
Denise fevers, or chills, or SOB.
Continuing Problems
• Unknown
Medical History
• Anxiety
• Other (specify): panic attack
Surgical History
Social History
• Tobacco: current some day smoker Packs per day: 1 Years smoking: 10
• Drinks per day: social
• Illegal drugs: no
• Occupation: mom
• Exposure to hazardous material: no exposure
• Regular Exercise: no
• Weight gain past 2 years. ( 70 lbs.)
• Pregnant for 2 years weight gain two children
Family History
Wlother: livingCurrent age: 60
Father: deceasedAge of death: 58
• Cancer: lymphona
Allergies
♦ No Known Drug Allergies
Medications
• Unknown
Review of Systems
• CONSTITUTIONAL: WNL
• SKIN: WNL
• HEENT: WNL.
• RESPIRATORY: WNL.
â– CARDIOVASCULAR: WNL.
- Gl: WNL.
• GU: WNL.
• HEMATOLOGY/LYMPHATIC: WNL.
• ENDOCRINE: WNL
• MUSCULOSKELETAL: WNL.
• ALLERGY: WNL
• NEURO: WNL
FILED: NASSAU COUNTY CLERK 02/23/2024 08:33 PM INDEX NO. 600444/2022
NYSCEF DOC. NO. 171 RECEIVED NYSCEF: 02/23/2024
• PSYCH: WNL
Physical Examination
General:
The patient is a young woman whose stature is obese .
HEENT: fSleeol
NC/AT
Head/Neck:
PERRL, EOM1, and no scleral icterus present.
Eves:
Left Eye: anicteric .
Ear/Nose/Throat:
Mucous membranes are moist.
Cardiovascular:
Normal S1 S2 RRR with no murmurs and gallops or rubs.
Chest Wall:
There is symmetric expansion present.
Lunas:
Lungs are clear to auscultation bilaterally.
Abdomen:
Soft, nondistended, nontender, and normoactive bowel sounds and no organomegaly.
Musculoskeletal:
No joint deformities.
Extremities:
No clubbing cyanosis or edema present.
Neuro:
Exam revealed no focal deficits .
Psvch:
Patient presents with appropriate mood and affect.
Reviewed Data
IMPRESSION:
• Reviewed
CT Chest Date: 9/12/12- NSP Interpretation: 3mm subpleural nodule RML, 3mm nodular denisty along Right major fissure,
2mm nodular density in lingula Please see report.
Overall Impression
Subcm, noncalcified nodule incidentally found on Ct when pt was sick
Overall Plan
F/u Ct in 6 months ( pt has h/o smoking and fam history of lung cancer)
Smoking cessation encouraged
Advised pt to get general health maintenace including gyn, breast exams
Counseling Points
Smoking cessation counseling performed.
Follow Up
Follow up in 6 month(s).
Orders
• CT
° CT Chest
Progress Note: DANIELLE ZOLLO / DOB: / MRN: 960748 / Encounter: Friday October 26, 2012 >4.0
Page 2/3
FILED: NASSAU COUNTY CLERK 02/23/2024 08:33 PM INDEX NO. 600444/2022
NYSCEF DOC. NO. 171 RECEIVED NYSCEF: 02/23/2024
No Signature Configured
Jerry Ipe, DO
Signed Electronically by Jerry Ipe, DO on
10/26/2012 04:07PM
Progress Note: DANIELLE 20LL0 / DOB: / MRN: 960748 / Encounter: Friday October 26, 2012
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FILED: NASSAU COUNTY CLERK 02/23/2024 08:33 PM INDEX NO. 600444/2022
NYSCEF DOC. NO. 171 RECEIVED NYSCEF: 02/23/2024
Island Pulmonary Associates, P.C.
4271 Hempstead Turnpike, Bethpage, NY 11714
Phone (516) 796-3700 • Fax (516) 796-3205
Progress Note
Patient: ZOLLO, DANIELLE DOB: WIRN: 960748
Provider: Jerry Ipe, DO Encounter: Tuesday March 19, 2013 Referring: IPE DO, JERRY
Chief Complaint
This is a 34 year old female here today for follow to ct's
History of Present Illness
Had Ct done in 9/12 for hemoptysis showing 3 subcm nodules. Pt is a smoker, with fam hx of cancer
Had repeat ct done, here for f/u
In interim said she had pna per her doctor and was rx course of abx. currently feels well, no cough, no chest pain,
stopped smoking 3 weeks ago, but now resumed.
Continuing Problems
• Ot nonsp ab fnd lung fid
Medical History
• Anxiety
• Other (specify): panic attack
Surgical History
Social History
• Tobacco: current some day smoker Packs per day: 1 Years smoking: 10
• Drinks per day: social
• Illegal drugs: no
• Occupation: mom
• Exposure to hazardous material: no exposure
• Regular Exercise: no
• Weight gain past 2 years. ( 70 lbs.)
• Pregnant for 2 years weight gain two children
Family History
Mother : livingCurrent age: 60
Father: deceasedAge of death: 58
• Cancer: lymphona
Allergies
• No Known Drug Allergies
Medications
• Unknown
Review of Systems
• CONSTITUTIONAL: WNL.
• SKIN: WNL.
• HEENT: WNL.
• RESPIRATORY: WNL
• CARDIOVASCULAR: WNL.
- Gl: WNL.
• GU: WNL.
• HEMATOLOGY/LYMPHATIC: WNL
• ENDOCRINE: WNL
• MUSCULOSKELETAL: WNL
• ALLERGY: WNL
• NEURO: WNL.
• PSYCH: WNL.
FILED: NASSAU COUNTY CLERK 02/23/2024 08:33 PM INDEX NO. 600444/2022
NYSCEF DOC. NO. 171 RECEIVED NYSCEF: 02/23/2024
Vital Signs
- Ht: 65 inches, Wt: 250 lbs, BMI: 41.6 kg/m2, BSA: 2.28 m2, BP: 130/90, HR: 107, RR: 17, Sp02: 97 %
• Comments: spo2 on room air
Physical Examination
General:
The patient is a middle-aged woman
Head/Neck:
PERRL, EOMI, and no scleral icterus present.
Eves:
Left Eye: anicteric . Right Eye: anicteric .
Ear/Nose/Throat:
Mucous membranes are moist.
Cardiovascular:
Normal S1 S2 RRR with no murmurs and gallops or rubs.
Chest Wall:
There is symmetric expansion present.
Lunas:
Lungs are dear to auscultation bilaterally.
Abdomen:
Soft, nondistended, nontender, and normoactive bowel sounds and no organomegaly.
Musculoskeletal:
No joint deformities.
Extremities:
No clubbing cyanosis or edema present.
Neuro:
Exam revealed no focal deficits .
Psych:
Patient presents with appropriate mood and affect.
Reviewed Data
IMPRESSION:
• Reviewed
Interpretation: Ct scan from plainview 9/12-> z/p 3/13
RML 3mm-> 34 mm
R major fissure 3mm-> 5-6mm
lingula 2mm-> 6mm Please see report.
Impression and Pian
1. Ot nonsp ab fnd lung fid
Overall Impression
Subcm nodules..? pleural thickening (located in pleural, fissure)
Smoker, h/o malinancy in family
Increased size maybe variablity in reader {2 different instituions, and CT scans)
Overall Plan
F/u ct in 3 months to evaluate
smokign cessation encriraged. advised to follw up gyn and genereal helth maintenance
Counseling Points
Progress Note: DANIELLE ZOLLO/DOB: / MRN: 960748 / Encounter: Tuesday March 19, 2013 .37
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FILED: NASSAU COUNTY CLERK 02/23/2024 08:33 PM INDEX NO. 600444/2022
NYSCEF DOC. NO. 171 RECEIVED NYSCEF: 02/23/2024
Smoking cessation counseling performed.
Follow Up
Follow up in 3 month(s).
Orders
• CT
0 CT Chest
No Signature Configured.
Jerry Ipe, DO
Signed Electronically by Jerry Ipe, DO on
03/19/2013 03:32PM
Progress Note: DANIELLE ZOLLO/ DOB: / MRN: 960748 / Encounter: Tuesday March 19, 2013 .,.j
Page 3/3
FILED: NASSAU COUNTY CLERK 02/23/2024 08:33 PM INDEX NO. 600444/2022
NYSCEF DOC. NO. 171 RECEIVED NYSCEF: 02/23/2024
Island Pulmonary Associates, P.C.
4271 Hempstead Turnpike • Bethpage, New York 11714 • (516) 796-3700 • Fax (516) 796-3205
173 Mineola Boulevard • Suite 305 • Mineola, New York 11501 • (516) 663-1100
Progress Note
Patient: ZOLLO, DANIELLE DOB: MRN: 960748
Provider: Jerry Ipe, DO Encounter: Thursday June 27, 2013 Referring: IPE DO, JERRY
Chief Complaint
This is a 35 year old female here today for abnormal cT/nodules
History of Present Illness
Had Ct done in 9/12 for hemoptysis showing 3 suborn nodules. Pt is a smoker, with fam hx of cancer
Had repeat ct done in marhc with ? increase ( but it was from 2 different institutions), here for f/u after another repeat CT 3
months later
No SOB, no hemptysis. no fevers, no chills. 1/2 PPD
no other complaints.
Continuing Problems
• Ot nonsp ab fnd lung fid
Medical History
• Anxiety
• Other (specify): panic attack
Surgical History
Social History
• Tobacco: current some day smoker Packs per day: 1 Years smoking: 10
• Drinks per day: social
• Illegal drugs: no
• Occupation: mom
• Exposure to hazardous material: no exposure
• Regular Exercise: no
• Weight gain past 2 years. ( 70 lbs.)
• Pregnant for 2 years weight gain two children
Family History
Mother: livingCurrent age: 60
Father: deceasedAge of death: 58
• Cancer: lymphona
Allergies
• No Known Drug Allergies
Medications
• Unknown
Review of Systems
• CONSTITUTIONAL: WNL.
• SKIN: WNL
• HEENT: WNL.
• RESPIRATORY: WNL.
• CARDIOVASCULAR: WNL.
• Gl: WNL.
• GU: WNL.
• HEMATOLOGY/LYMPHATIC: WNL.
• ENDOCRINE: WNL
• MUSCULOSKELETAL: WNL.
â– ALLERGY: WNL
• NEURO: WNL.
• PSYCH: WNL.
FILED: NASSAU COUNTY CLERK 02/23/2024 08:33 PM INDEX NO. 600444/2022
NYSCEF DOC. NO. 171 RECEIVED NYSCEF: 02/23/2024
Vital Signs
• Ht: 65 inches, Wt: 240 lbs, BM1: 39.94 kg/m2, BSA: 2.23 m2, BP: 112/70, HR: 94, Sp02: 98 %;
• Comments: SP02 taken on RA
Physical Examination
General:
The patient is a well-appearing and young woman whose stature is obese .
HEENT: fSleeot
NC/AT
Head/Neck:
PERRL, EOIVII, and no scleral icterus present.
Eves:
Left Eye: anicteric . Right Eye: anicteric .
Ear/Nose/Throat:
Mucous membranes are moist.
Cardiovascular:
Normal S1 S2 RRR with no murmurs and gallops or rubs.
Chest Wall:
There is symmetric expansion present.
Lungs:
Lungs are clear to auscultation bilaterally.
Abdomen:
Soft, nondistended, nontender, and normoactive bowel sounds and no organomegaly.
Musculoskeletal:
No joint deformities.
Extremities:
No clubbing cyanosis or edema present.
Neuro:
Exam revealed no focal deficits .
Psvch:
Patient presents with appropriate mood and affect.
Epworth Sleepiness Scale
Situation:
• Sitting and reading: 0
• Watching TV: 1
• Sitting, inactive in a public place (e.g. a theater or a meeting): 0
• As a passenger in a car for an hour without a break: 0
• Lying down to rest in the afternoon when circumstances permit: 3
• Sitting and talking to someone: 0
• Sitting quietly after a lunch without alcohol: 0
• In a car, while stopped for a few minutes in traffic: 0
TOTAL: 4
Reviewed Data
IMPRESSION:
• Reviewed
Impression and Plan
1. Ot nonsp ab fnd lung fid
- End of Document: ZoIIo, Danielle, DOB: MRN: 960748, Encounter: Thursday June 27, 2013 -
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FILED: NASSAU COUNTY CLERK 02/23/2024 08:33 PM INDEX NO. 600444/2022
NYSCEF DOC. NO. 171 RECEIVED NYSCEF: 02/23/2024
Overall Impression
Subcm nodules- stable after 3 month CT scan I supect one of them is just pleural thickening
New subsgemtal atelectasis on lingula, no endobronchial lesions ? poor inspiration
High risk pt, smoker with fami history of malingnacy
Overall Plan
At this point doubt singicance of these nodules, however in light of smoking hisotry will continue to monitor. Will repeat
Ct in 6 months to eval progression of nodules and lingular subsegmetal atlectasis.
smoking cessation encouraged
General Helath care maintenance advised.
PFt's also on next visit.
Follow Up
Follow up in 6 month(s).
Patient Educational Materials
• Behavior modification for a healthy lifestyle guide
Orders
• CT
» CT Chest
No Signature Configured
Jerry Ipe, DO
Signed Electronically by Jerry Ipe, DO on
06/27/2013 09:50AM
- End of Document: Zollo, Danielle, DOB: MRN: 960748, Encounter Thursday June 27, 2013 -
Page 3/3
FILED: NASSAU COUNTY CLERK 02/23/2024 08:33 PM INDEX NO. 600444/2022
NYSCEF DOC. NO. 171 RECEIVED NYSCEF: 02/23/2024
Island Pulmonary Associates, P.C.
173 Mineola Boulevard, Suite 305, Mineola, NY 11501 • Phone (516) 663-1100 • Fax (516) 663-1105
4271 Hempstead Turnpike, Bethpage, NY 11714 • Phone (516) 796-3700 • Fax (516) 796-3205
Progress Note
Patient: ZOLLO, DANIELLE DOB: WIRN: 960748
Encounter: Thursday December 26
Provider: Jerry Ipe, DO Referring: IPE DO, JERRY
2013
Chief Complaint
This is a 35 year old female here today for 6 month folllow up.Follow up to ct chest.
History of Present Illness
Had Ct done in 9/12 for hemoptysis showing 3 subcm nodules. Pt is a smoker, with fam hx of cancer
Had repeat ct done in march with ? increase (but it was from 2 different institutions), then another 3 months later which
showed stabilty and ? atlectasis lingula
No SOB, no hemptysis. no fevers, no chills. 1/2 PPD
no other complaints. Switched to e ciagrettes
Continuing Problems
• Ot nonsp ab fnd lung fid
Medical History
• Anxiety
• Other (specify): panic attack,
Surgical History
Social History
• Tobacco: current some day smoker Packs per day: 1 Years smoking: 10
• Drinks per day: social
• Illegal drugs: no
• Occupation: mom
• Exposure to hazardous material: no exposure
• Regular Exercise: no
• Weight gain past 2 years. ( 70 lbs.)
• Pregnant for 2 years weight gain two children
Family History
Mother: livingCurrent age: 60
Father: deceasedAge of death: 58
• Cancer: lymphona
Allergies
• No Known Drug Allergies
Medications
• Unknown
Review of Systems
• CONSTITUTIONAL: WNL
• SKIN: WNL.
â– HEENT: WNL.
• RESPIRATORY: WNL
• CARDIOVASCULAR: WNL.
• Gl: WNL.
• GU: WNL.
• HEMATOLOGY/LYMPHATIC: WNL.
• ENDOCRINE: WNL
FILED: NASSAU COUNTY CLERK 02/23/2024 08:33 PM INDEX NO. 600444/2022
NYSCEF DOC. NO. 171 RECEIVED NYSCEF: 02/23/2024
• MUSCULOSKELETAL: WNL
• ALLERGY: WNL.
• NEURO: WNL.
• PSYCH: WNL.
Vital Signs
â– Ht: 65 inches, Wt: 256 lbs, BMI: 42.6 kg/m2, BSA: 2.31 m2, BP: 120/80 , HR: 83, Sp02: 97 %
• Comments: spo2 on room air
Physical Examination
General:
The patient is a young woman
HEENT: (Sleep)
NC/AT
Head/Neck:
PERRL, EOMI, no scleral icterus present.
Eyes:
Left Eye: anicteric. Right Eye: anicteric.
Ear/Nose/Throat:
Mucous membranes are moist.
Cardiovascular:
Normal S1 S2 RRR with no murmurs, gallops or rubs.
Chest Wall:
Lungs:
Lungs are clear to auscultation bilaterally.
Abdomen:
Soft, nondistended, nontender, normoactive bowel sounds and no organomegaly.
Musculoskeletal:
No joint deformities.
Extremities:
No clubbing cyanosis or edema present.
Neuro:
Exam revealed no focal deficits.
Psych:
Patient presents with appropriate mood and affect.
Epworth Sleepiness Scale
* Test performed on June 27, 2013
Situation:
• Sitting and reading: 0
• Watching TV: 1
• Sitting, inactive in a public place (e.g. a theater or a meeting): 0
• As a passenger in a car for an hour without a break: 0
• Lying down to rest in the afternoon when circumstances permit: 3
• Sitting and talking to someone: 0
• Sitting quietly after a lunch without alcohol: 0
• In a car, while stopped for a few minutes in traffic: 0
TOTAL: 4
Reviewed Data
IMPRESSION:
• Reviewed
- End of Document: Zollo, Danielle. DOB: MRN: 960748, Encounter: Thursday December 26, 2013 -
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FILED: NASSAU COUNTY CLERK 02/23/2024 08:33 PM INDEX NO. 600444/2022
NYSCEF DOC. NO. 171 RECEIVED NYSCEF: 02/23/2024
Interpretation: 12/13: Stable nodules
R major fissure: 7 mm
RML 6 mm
LUL 6 mm
? 6mm GG nodular denisty-> lingula ? consfluence of linear markings (reported on last Ct as well) Please see report.
Interpretation: 12/26/13:normal spriomtry, volumes and dlco Please see report.
Impression and Plan
1. Ot nonsp ab fnd lung fid
Overall Impression
Suborn nodules- stable after 6 months
New subsgemtal atelectasis on lingula, no endobronchial lesions ? poor inspiration ? confluence of linear markings
High risk pt, smoker with family history of malingnacy
Overall Plan
At this point doubt singicance of these nodules, however in light of smoking hisotry will continue to monitor. Will repeat
Ct in months to eval progression of nodules and lingular subsegmetal atlectasis.
smoking cessation encouraged
General Helath care maintenance advised.
Pt considering bariatric surgery down the line
Follow Up
Follow up in 9 month(s).
Orders
• CT
<* CT Chest
No Signature Configured
Jerry Ipe, DO
Signed Electronically by Jerry Ipe, DO on
12/26/2013 12:02PM
- End of Document: Zollo, Danielle, DOB: MRN: 960748, Encounter: Thursday December 26, 2013 -
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FILED: NASSAU COUNTY CLERK 02/23/2024 08:33 PM INDEX NO. 600444/2022
NYSCEF DOC. NO. 171 RECEIVED NYSCEF: 02/23/2024
ZOLLO, DANIELLE PV CTA CHEST WITH CONTRAST 9/12/2012 CT
: Report
. Patient ID: PV799652 Patient Name: ZOLLO, DANIELLE
! Birth Date: Sex: F
:i EXAM: CTA CHEST WITH CONTRAST
> PROCEDURE DATE: 09/12/2012
!
1 CLINICAL STATEMENT: Evaluate for pulmonary embolus.
I INTERPRETATION:
TECHNIQUE: CTA of the chest was performed with IV contrast.
COMPARISON: None.
i FINDINGS:
: There is no filling defect within the main, right interlobar, left
t descending and visualized proximal segmental pulmonary arteries.
There is no thoracic aortic aneurysm or dissection.
Small nodule noted in the left lobe of the thyroid gland.
!
There is no axillary, mediastinal or hilar lymphadenopathy by size criteria.
There is no pericardial effusion. There is no pleural effusion.
S 3 mm subpleural nodule noted in the right middle lobe, image 54. 3 mm
| nodular density along the right major fissure on image 64. 2 mm nodule
i lingula, image 54.
No evidence of pulmonary embolus as described above.
:t
IMPRESSION:
• Subcentimeter pulmonary nodules as described above. Follow-up recommended.
SAMUEL KIM M.D., ATTENDING RADIOLOGIST
This examination was interpreted on: Sep 12 2012 5:24P. This document has
been electronically signed. Sep 12 2012 5:38P.
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10/25/2012
FILED: NASSAU COUNTY CLERK 02/23/2024 08:33 PM INDEX NO. 600444/2022
NYSCEF DOC. NO. 171 RECEIVED NYSCEF: 02/23/2024
J
Report ZOLLO, DANIELLE PV CHEST PA AND LAT *fl2/2Q12 CR
: Patient ID: PV799652 Patient Name: ZOLLO, DANIELLE
! Birth Date: Sex: F
’ EXAM: CHEST PA \T\ LAT
| PROCEDURE DATE: 09/12/2012
INTERPRETATION: Heart and mediastinum normal. Lungs clear. Costophrenic
: angles sharp bilaterally. Skeletal structures intact.
i IMPRESSION: Normal chest
*r
X
DOMINIC ALTIERI M.D., ATTENDING RADIOLOGIST
This examination was interpreted on: Sep 12 2012 5:06P. This document has
been electronically signed. Sep 12 2012 5:07P.
:
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10/25/2012
FILED: NASSAU COUNTY CLERK 02/23/2024 08:33 PM INDEX NO. 600444/2022
NYSCEF DOC. NO. 171 RECEIVED NYSCEF: 02/23/2024
. Report ZOLLO, DANIELLE PV VENOUS DUPLEX LOWER EXT
BILAT 9/12/2012 US
Patient ID: PV7996S2 Patient Name: ZOLLO, DANIELLE
• Birth Date: Sex: F
EXAM: VENOUS DUPLEX LOWER EXT BILAT
PROCEDURE DATE: 09/12/2012
INTERPRETATION: CUNICAL STATEMENT: Evaluate for DVT. l
TECHNIQUE: Ultrasound of bilateral lower extremity deep venous system. >
*
. COMPARISON: None.
FINDINGS:
There is flow, compression and augmentation of the common femoral,
; superficial femoral and popliteal veins. i
’ There is flow in the posterior tibial vein.
IMPRESSION: No evidence of DVT.
j SAMUEL KIM M.D., ATTENDING RADIOLOGIST
• This examination was interpreted on: Sep 12 2012 S:39P. This document has
been electronically signed. Sep 12 2012 5:39P.
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10/25/2012
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3/11/2013 7:37 PM ESKER -> Page 1 Of 2
NYSCEF DOC. NO. 171 RECEIVED NYSCEF: 02/23/2024
Massapeaua
126 Hicksville Road
Zwaimcser-Pesiri Massapequa, NY 11758
Phone: 516-798-4242
Fax: 516-797-3509
To; Jerry Ipe, DO Name: DANIELLE ZOLLO
4271 Hempstead Turnpike MRN ff; 745350 Exam tf: 7081736
Bethpage, NY 11714 Phone: 516-303-6556
DOB: Gender: Female
Exam Date: 3/11/13
Referring Rhys.: Jerry Ipe, DO
Exam: CT-CHEST W/O CONTRAST
Clinical Indication!
Pulmonary nodules.
Contiguous axial CT scan imaging of the thorax was obtained on the multislice volume
acquisition CT scanner without the introduction of intravenous contrast material. Coronal
and sagittal images were reconstructed. This study was performed using automatic
exposure control (radiation dose reduction software) to obtain a diagnostic image quality
scan with patient dose as low as reasonably achievable. The administered radiation dose
was 5.54 mSv.
Outside institution CT angiogram of the chest dated 09/12/2012 is provided for review and
states 3 mm subpleural nodule noted in the right middle lobe and a 3 mm nodular density
along the right major fissure, 2 mm nodular density in the lingula. Prior images are not
available for comparison.
Associated with the right major fissure is a faint slightly lobulated nodular density measuring
approximately 5-6 mm (image 53 series 3). Indistinct ovoid approximately 6 mm nodule
abuts the inferoanterior margin of the left hilum in the left lingular segment (image 50 series
3). There is a faint pleural-based nodular density in the right middle lobe measuring
approximately 3-4 mm (Image 64 series 3). It is uncertain if these correspond to the
nodules as discussed in the outside institution report and such study should be provided for
review to compare to the current study. If not available, short interval 3-4 month follow-up
advised. The lungs are otherwise unremarkable and there are no pleural effusions. The
tracheobronchial tree appears unremarkable.
There is no adenopathy. Grossly the thyroid appears unremarkable. The heart and great
vessels appear grossly unremarkable.
The visualized intraabdominal contents appear grossly unremarkable.
The bony and soft tissue structures are unremarkable.
Impression:
Right and left lung nodules as described. It is uncertain if these definitively correspond to
the densities as enumerated on the outside institution report and such study should be
2wanger-Pesiri Radiology Page 1 of 2
FILED: NASSAU
ot ±xt ttvxo / . u / rn COUNTY CLERK 02/23/2024 08:33 PM
INDEX NO. 600444/2022
4
NYSCEF DOC. NO. 171 RECEIVED NYSCEF: 02/23/2024
20LL0, DANIELLE (Exam 7081736) Jerry Ipe, DO MRN «: 745350
provided for review lo compare to the current study at this institution. If no priors are
available for comparison three month follow-up advised.
Interpreting Radiologist
4~.- •x
- -•:7
Ronald 3. Sticco, MD 516-798-4242
Electronically Signed: 03/11/2013
Zwanger-Pesiri Radiology Page 2 of 2
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Page 02/23/2024
i
ZWANGER-PESIRI Massaoeaua
126 Hicksville Road
Massapequa, NY 11750
Phone; 5167984242
RADIOLOGY Fax: 5167973509
:: Jerry Ipe, DO Patient: Danielle Zollo
:: 4271 Hempstead Turnpike MRN: 745350
Bethpage, NY 11741 DOB:
Gender: Female
Exam Date: 06/19/2013 05:20 PM
Exam: CT-CHEST W/O CON | 71250
CT-CHEST W/O CON
History: Followup lung nodules
CT scan of the chest was performed with volume acquisition obtained from the pulmonary apices to
the costophrenic sulci. Intravenous contrast was not utilized. Axial, sagittal and coronal images were
reconstructed. The study was performed on the Multislice Volume Aquisition CT scanner. This study
was performed using automatic exposure control (radiation dose reduction software) to obtain a
diagnostic image quality scan with patient dose as low as reasonably achievable. The administered
radiation dose was 5.48 mSv.
A smoking history is provided.
Comparison is made to selected images from, and report of prior noncontrast CT scan of the chest
3/11/2013.
The nodular densities there are stable. The these are located along the right major fissure image 52,
in the right middle lobe (image 63, and in the perihilar portion of the lingula on image 50. In the
periphery of the lingula there is groundglass nodule-linear density on image 76 that is new. It
probably represents focal subsegmental atelectasis. No suspicious nodule has developed. There is no
endobronchial lesion. '
No axillary, mediastinal or hilar adenopathy has developed. There are mediastinal nodes in the
precarinal and aortopulmonic window that appear persistent and unchanged (Image 37. A right
hilum no image 52 also appears stable. No pleural or pericardial effusion has developed.
The spleen appears prominent measuring approximately 14 cm anterior posterior. It appears
unchanged. The visualized adrenal glands appear unremarkable. No suspicious bony lesions have
developed.
Impression:
Stable nodular densities in each lung. No new nodules have developed.
Stable upper limit of normal mediastinal and right hilar nodes. No new nodes have developed.
Visualized portion of the spleen suggested at the upper limit of normal versus mildly prominent.
Clinical correlation is requested.
http://synris/Reports/printReportCustom.aspx?acc=12196195 6/25/2013
FILED: NASSAU COUNTY CLERK 02/23/2024 08:33 PM INDEX NO. 600444/2022
NYSCEF DOC. NO. 171
Page 2 of 2
RECEIVED NYSCEF: 02/23/2024
Robin Scarlata M.D.
06/20/2013
http://synris/Reports/printReportCustom.aspx?acc=12196195 6/25/2013
FILED: NASSAU COUNTY CLERK 02/23/2024 08:33 PM INDEX NO. 600444/2022
From: GFI FaxMaker To: Jerry Ipe Page: 1/2 Date: 12/21/2013 5:42:25 AM
NYSCEF DOC. NO. 171 RECEIVED NYSCEF:
O-
02/23/2024
Zwanger-Pesipi Elmont
1390 Hempstead Turnpike
Elmont, NY 11003
RADIOLOGY Phone: (516)797-7796
Fax: (516)798-8354
:: Jerry Ipe, DO Patient: Danielle Zollo
:: 4271 Hempstead Turnpike MRN: 745350
Bethpage, NY 11741 DOB:
Home Phone: (516)303-6556
Exam Date: 12/20/2013
Exam: CT-CHEST W/O CON | 71250
CT-CHEST W/O CON
History: Followup lung nodules
Contiguous axial CT scan imaging of the thorax was obtained without the introduction of intravenous
contrast material. Coronal and sagittal images were reconstructed. This study was performed using
automatic exposure control (radiation dose reduction software) to obtain a diagnostic image quality
scan with patient dose as low as reasonably achievable. The administered radiation dose was 5.11
mSv.
The study is compared to the prior chest CT 6/19/2013 as well as 3/11/2013
Again evident associated right major fissure near the level of the hilum is a 7 mm nodular focus
(image 54 series 6). Anterior pleural periphery right middle lobe is an approximately 6 mm nodule
(image 64 series 6). There is a 6 mm nodule left upper lobe cyst and branching bronchial segments
(Image 44 series 6). All these nodules remain stable. Linear type density in the lingula segment
stable however the suggestion for the presence currently of a 6 mm groundglass nodular density in
the medial segment (image 75 series 6) which was not present previously. The lung parenchyma is
otherwise unremarkable. There are no pleural effusions. The visualized tracheobronchial tree
appears unremarkable.
There is no definitive evidence of adenopathy. The heart and great vessels appear grossly
unremarkable.
The visualized thyroid is normal and symmetrical.
The visualized intraabdomina! contents again suggests slightly prominent spleen.
The bony and soft tissue structures appear unremarkable.
The remainder of the study is unremarkable.
IMPRESSION:
Stable pulmonary nodules as described, however one in the inferior lingula segment may developed
in the interval. This may represent confluence of linear markings in the area however would advise a
continued 6 to eight-month followup to assure its stability. No other interval changes
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FILED: NASSAU COUNTY INDEX NO. 600444/2022
Korn: OKI CLERK
KaxMaker 02/23/2024
To: Jerry Ipe Page:08:33
2/2 Date:PM
12/21/2013 5:42:26 AM
O•
NYSCEF DOC. NO. 171 RECEIVED NYSCEF: 02/23/2024
•c
Ronald Sticco M.D., Ext, 4055
12/20/2013
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FILED: NASSAU COUNTY CLERK 02/23/2024 08:33 PM INDEX NO. 600444/2022
NYSCEF DOC. NO. 171 RECEIVED NYSCEF: 02/23/2024
Date of Test: 10/26/2012
Island Pulmonary Associates, P.C.
Pi^monary Function Laboratoty Temp: 23°C
4271 Hempstead Turnpike Pressure: 760mmHg
Bethpage, NY 11714 Phone: (516) 796-3700 Fax: (516) 796-3205 BTPS: 1.050
MRN: 960748 Sex: F DOB: Age: 34 Race: W
Name: Zollo, Danielle
Height: 65 in Weight 256 lb BMI: 42.7 Diagnosis: 1:
Technician: Peter Puch Physician: Referring:
Predicted Range Pre Bronchodilator Post Bronchodilator Percent
Spirometry (BTPS) Mean 95% Actual % Pred Actual % Pred Change
L 3.55 2.74 4.23 119 4.42 125 4
FVC
FEVi L 3.01 2.37 3.38 112 3.62 120 7
FEVi / FVC % 85 76 80 94 82 96 2
L/S 3.41 2.02 3.17 93 3.70 109 17
FEF25-75
L/$ 6.50 3.65 7.63 117 5.77 89 -24
PEFR
L/s 6.11 3.39 7.06 116 5.67 93 -20
FEF25
L/s 2.84 1.24 4.02 142 4.50 158 12
FEFso
U$ 1.82 0.75 1.45 80 2.07 114 43
FEF75
sec 7.01 4.31 -39
FET
MW L/m 108.3 107.3
Flow Volume
Predicted Range Pre Bronchodilator
Lung Volumes (He) Actual % Pred
Pre Rx
Mean 95% «-i
Post Rx
VC L 3.55 2.74 4.38 123 7-
«- Predicted
FRC L 2.86 1.80 4.89 171
5-
IC L 2.20 1.14 0.45 20 fevi -aae
<-
ERV L 1.35 0.29 3.93 291
3-
RV L 1.51 0.74 0.96 64 FEV3=4.(D
3-
TIC
RV/TLC
L
%
5.06
28
4.00
17
5.34
18
106
64
I3. V
5 1 2 3 S 6 7 ]
Predicted Range Pre Bronchodilator O’
Diffusion u. â– 3
Mean 95% Actual % Pred
-j-
DLCO [Hb] mUmin/mmHg 27.03 17.55 22.84 84
DLCO mL/min/mmhg 27.03 17.55 22.84 84
•5-
VA [BTPS
Preview
FILED: NASSAU COUNTY CLERK 02/23/2024 08:33 PM INDEX NO. 600444/2022 NYSCEF DOC. NO. 171 RECEIVED NYSCEF: 02/23/2024 Exhibit F FILED: NASSAU COUNTY CLERK 02/23/2024 08:33 PM INDEX NO. 600444/2022 NYSCEF DOC. NO. 171 RECEIVED NYSCEF: 02/23/2024 Island Pulmonary Associates, P.C. 4271 Hempstead Turnpike, Bethpage, NV 11714 Phone (516) 796-3700 • Fax (516) 796-3205 Progress Note Patient: ZOLLO, DANIELLE DOB: MRN: 960748 Provider: Jerry Ipe, DO Encounter: Friday October 26, 2012 Referring: CRAFA MD.LAWRENCE Chief Complaint This is a 34 year old female here today for nodule on lung History of Present Illness Noted to have cold like symtpoms, was having blood tinged sptum went to plainview hospital-> Ct angio , subcm nodule, noncalcified. (see report) 8 ciggaretes a day 1 dog - no breathing at around it Only on cymbalta. No previous nodules . No previous PPD . Pt was sick at time on CT, now symptoms have improved including hemoptysis. Denise fevers, or chills, or SOB. Continuing Problems • Unknown Medical History • Anxiety • Other (specify): panic attack Surgical History Social History • Tobacco: current some day smoker Packs per day: 1 Years smoking: 10 • Drinks per day: social • Illegal drugs: no • Occupation: mom • Exposure to hazardous material: no exposure • Regular Exercise: no • Weight gain past 2 years. ( 70 lbs.) • Pregnant for 2 years weight gain two children Family History Wlother: livingCurrent age: 60 Father: deceasedAge of death: 58 • Cancer: lymphona Allergies ♦ No Known Drug Allergies Medications • Unknown Review of Systems • CONSTITUTIONAL: WNL • SKIN: WNL • HEENT: WNL. • RESPIRATORY: WNL. ■CARDIOVASCULAR: WNL. - Gl: WNL. • GU: WNL. • HEMATOLOGY/LYMPHATIC: WNL. • ENDOCRINE: WNL • MUSCULOSKELETAL: WNL. • ALLERGY: WNL • NEURO: WNL FILED: NASSAU COUNTY CLERK 02/23/2024 08:33 PM INDEX NO. 600444/2022 NYSCEF DOC. NO. 171 RECEIVED NYSCEF: 02/23/2024 • PSYCH: WNL Physical Examination General: The patient is a young woman whose stature is obese . HEENT: fSleeol NC/AT Head/Neck: PERRL, EOM1, and no scleral icterus present. Eves: Left Eye: anicteric . Ear/Nose/Throat: Mucous membranes are moist. Cardiovascular: Normal S1 S2 RRR with no murmurs and gallops or rubs. Chest Wall: There is symmetric expansion present. Lunas: Lungs are clear to auscultation bilaterally. Abdomen: Soft, nondistended, nontender, and normoactive bowel sounds and no organomegaly. Musculoskeletal: No joint deformities. Extremities: No clubbing cyanosis or edema present. Neuro: Exam revealed no focal deficits . Psvch: Patient presents with appropriate mood and affect. Reviewed Data IMPRESSION: • Reviewed CT Chest Date: 9/12/12- NSP Interpretation: 3mm subpleural nodule RML, 3mm nodular denisty along Right major fissure, 2mm nodular density in lingula Please see report. Overall Impression Subcm, noncalcified nodule incidentally found on Ct when pt was sick Overall Plan F/u Ct in 6 months ( pt has h/o smoking and fam history of lung cancer) Smoking cessation encouraged Advised pt to get general health maintenace including gyn, breast exams Counseling Points Smoking cessation counseling performed. Follow Up Follow up in 6 month(s). Orders • CT ° CT Chest Progress Note: DANIELLE ZOLLO / DOB: / MRN: 960748 / Encounter: Friday October 26, 2012 >4.0 Page 2/3 FILED: NASSAU COUNTY CLERK 02/23/2024 08:33 PM INDEX NO. 600444/2022 NYSCEF DOC. NO. 171 RECEIVED NYSCEF: 02/23/2024 No Signature Configured Jerry Ipe, DO Signed Electronically by Jerry Ipe, DO on 10/26/2012 04:07PM Progress Note: DANIELLE 20LL0 / DOB: / MRN: 960748 / Encounter: Friday October 26, 2012 Page 3/3 FILED: NASSAU COUNTY CLERK 02/23/2024 08:33 PM INDEX NO. 600444/2022 NYSCEF DOC. NO. 171 RECEIVED NYSCEF: 02/23/2024 Island Pulmonary Associates, P.C. 4271 Hempstead Turnpike, Bethpage, NY 11714 Phone (516) 796-3700 • Fax (516) 796-3205 Progress Note Patient: ZOLLO, DANIELLE DOB: WIRN: 960748 Provider: Jerry Ipe, DO Encounter: Tuesday March 19, 2013 Referring: IPE DO, JERRY Chief Complaint This is a 34 year old female here today for follow to ct's History of Present Illness Had Ct done in 9/12 for hemoptysis showing 3 subcm nodules. Pt is a smoker, with fam hx of cancer Had repeat ct done, here for f/u In interim said she had pna per her doctor and was rx course of abx. currently feels well, no cough, no chest pain, stopped smoking 3 weeks ago, but now resumed. Continuing Problems • Ot nonsp ab fnd lung fid Medical History • Anxiety • Other (specify): panic attack Surgical History Social History • Tobacco: current some day smoker Packs per day: 1 Years smoking: 10 • Drinks per day: social • Illegal drugs: no • Occupation: mom • Exposure to hazardous material: no exposure • Regular Exercise: no • Weight gain past 2 years. ( 70 lbs.) • Pregnant for 2 years weight gain two children Family History Mother : livingCurrent age: 60 Father: deceasedAge of death: 58 • Cancer: lymphona Allergies • No Known Drug Allergies Medications • Unknown Review of Systems • CONSTITUTIONAL: WNL. • SKIN: WNL. • HEENT: WNL. • RESPIRATORY: WNL • CARDIOVASCULAR: WNL. - Gl: WNL. • GU: WNL. • HEMATOLOGY/LYMPHATIC: WNL • ENDOCRINE: WNL • MUSCULOSKELETAL: WNL • ALLERGY: WNL • NEURO: WNL. • PSYCH: WNL. FILED: NASSAU COUNTY CLERK 02/23/2024 08:33 PM INDEX NO. 600444/2022 NYSCEF DOC. NO. 171 RECEIVED NYSCEF: 02/23/2024 Vital Signs - Ht: 65 inches, Wt: 250 lbs, BMI: 41.6 kg/m2, BSA: 2.28 m2, BP: 130/90, HR: 107, RR: 17, Sp02: 97 % • Comments: spo2 on room air Physical Examination General: The patient is a middle-aged woman Head/Neck: PERRL, EOMI, and no scleral icterus present. Eves: Left Eye: anicteric . Right Eye: anicteric . Ear/Nose/Throat: Mucous membranes are moist. Cardiovascular: Normal S1 S2 RRR with no murmurs and gallops or rubs. Chest Wall: There is symmetric expansion present. Lunas: Lungs are dear to auscultation bilaterally. Abdomen: Soft, nondistended, nontender, and normoactive bowel sounds and no organomegaly. Musculoskeletal: No joint deformities. Extremities: No clubbing cyanosis or edema present. Neuro: Exam revealed no focal deficits . Psych: Patient presents with appropriate mood and affect. Reviewed Data IMPRESSION: • Reviewed Interpretation: Ct scan from plainview 9/12-> z/p 3/13 RML 3mm-> 34 mm R major fissure 3mm-> 5-6mm lingula 2mm-> 6mm Please see report. Impression and Pian 1. Ot nonsp ab fnd lung fid Overall Impression Subcm nodules..? pleural thickening (located in pleural, fissure) Smoker, h/o malinancy in family Increased size maybe variablity in reader {2 different instituions, and CT scans) Overall Plan F/u ct in 3 months to evaluate smokign cessation encriraged. advised to follw up gyn and genereal helth maintenance Counseling Points Progress Note: DANIELLE ZOLLO/DOB: / MRN: 960748 / Encounter: Tuesday March 19, 2013 .37 Page 2/3 FILED: NASSAU COUNTY CLERK 02/23/2024 08:33 PM INDEX NO. 600444/2022 NYSCEF DOC. NO. 171 RECEIVED NYSCEF: 02/23/2024 Smoking cessation counseling performed. Follow Up Follow up in 3 month(s). Orders • CT 0 CT Chest No Signature Configured. Jerry Ipe, DO Signed Electronically by Jerry Ipe, DO on 03/19/2013 03:32PM Progress Note: DANIELLE ZOLLO/ DOB: / MRN: 960748 / Encounter: Tuesday March 19, 2013 .,.j Page 3/3 FILED: NASSAU COUNTY CLERK 02/23/2024 08:33 PM INDEX NO. 600444/2022 NYSCEF DOC. NO. 171 RECEIVED NYSCEF: 02/23/2024 Island Pulmonary Associates, P.C. 4271 Hempstead Turnpike • Bethpage, New York 11714 • (516) 796-3700 • Fax (516) 796-3205 173 Mineola Boulevard • Suite 305 • Mineola, New York 11501 • (516) 663-1100 Progress Note Patient: ZOLLO, DANIELLE DOB: MRN: 960748 Provider: Jerry Ipe, DO Encounter: Thursday June 27, 2013 Referring: IPE DO, JERRY Chief Complaint This is a 35 year old female here today for abnormal cT/nodules History of Present Illness Had Ct done in 9/12 for hemoptysis showing 3 suborn nodules. Pt is a smoker, with fam hx of cancer Had repeat ct done in marhc with ? increase ( but it was from 2 different institutions), here for f/u after another repeat CT 3 months later No SOB, no hemptysis. no fevers, no chills. 1/2 PPD no other complaints. Continuing Problems • Ot nonsp ab fnd lung fid Medical History • Anxiety • Other (specify): panic attack Surgical History Social History • Tobacco: current some day smoker Packs per day: 1 Years smoking: 10 • Drinks per day: social • Illegal drugs: no • Occupation: mom • Exposure to hazardous material: no exposure • Regular Exercise: no • Weight gain past 2 years. ( 70 lbs.) • Pregnant for 2 years weight gain two children Family History Mother: livingCurrent age: 60 Father: deceasedAge of death: 58 • Cancer: lymphona Allergies • No Known Drug Allergies Medications • Unknown Review of Systems • CONSTITUTIONAL: WNL. • SKIN: WNL • HEENT: WNL. • RESPIRATORY: WNL. • CARDIOVASCULAR: WNL. • Gl: WNL. • GU: WNL. • HEMATOLOGY/LYMPHATIC: WNL. • ENDOCRINE: WNL • MUSCULOSKELETAL: WNL. ■ALLERGY: WNL • NEURO: WNL. • PSYCH: WNL. FILED: NASSAU COUNTY CLERK 02/23/2024 08:33 PM INDEX NO. 600444/2022 NYSCEF DOC. NO. 171 RECEIVED NYSCEF: 02/23/2024 Vital Signs • Ht: 65 inches, Wt: 240 lbs, BM1: 39.94 kg/m2, BSA: 2.23 m2, BP: 112/70, HR: 94, Sp02: 98 %; • Comments: SP02 taken on RA Physical Examination General: The patient is a well-appearing and young woman whose stature is obese . HEENT: fSleeot NC/AT Head/Neck: PERRL, EOIVII, and no scleral icterus present. Eves: Left Eye: anicteric . Right Eye: anicteric . Ear/Nose/Throat: Mucous membranes are moist. Cardiovascular: Normal S1 S2 RRR with no murmurs and gallops or rubs. Chest Wall: There is symmetric expansion present. Lungs: Lungs are clear to auscultation bilaterally. Abdomen: Soft, nondistended, nontender, and normoactive bowel sounds and no organomegaly. Musculoskeletal: No joint deformities. Extremities: No clubbing cyanosis or edema present. Neuro: Exam revealed no focal deficits . Psvch: Patient presents with appropriate mood and affect. Epworth Sleepiness Scale Situation: • Sitting and reading: 0 • Watching TV: 1 • Sitting, inactive in a public place (e.g. a theater or a meeting): 0 • As a passenger in a car for an hour without a break: 0 • Lying down to rest in the afternoon when circumstances permit: 3 • Sitting and talking to someone: 0 • Sitting quietly after a lunch without alcohol: 0 • In a car, while stopped for a few minutes in traffic: 0 TOTAL: 4 Reviewed Data IMPRESSION: • Reviewed Impression and Plan 1. Ot nonsp ab fnd lung fid - End of Document: ZoIIo, Danielle, DOB: MRN: 960748, Encounter: Thursday June 27, 2013 - Page 2/3 FILED: NASSAU COUNTY CLERK 02/23/2024 08:33 PM INDEX NO. 600444/2022 NYSCEF DOC. NO. 171 RECEIVED NYSCEF: 02/23/2024 Overall Impression Subcm nodules- stable after 3 month CT scan I supect one of them is just pleural thickening New subsgemtal atelectasis on lingula, no endobronchial lesions ? poor inspiration High risk pt, smoker with fami history of malingnacy Overall Plan At this point doubt singicance of these nodules, however in light of smoking hisotry will continue to monitor. Will repeat Ct in 6 months to eval progression of nodules and lingular subsegmetal atlectasis. smoking cessation encouraged General Helath care maintenance advised. PFt's also on next visit. Follow Up Follow up in 6 month(s). Patient Educational Materials • Behavior modification for a healthy lifestyle guide Orders • CT » CT Chest No Signature Configured Jerry Ipe, DO Signed Electronically by Jerry Ipe, DO on 06/27/2013 09:50AM - End of Document: Zollo, Danielle, DOB: MRN: 960748, Encounter Thursday June 27, 2013 - Page 3/3 FILED: NASSAU COUNTY CLERK 02/23/2024 08:33 PM INDEX NO. 600444/2022 NYSCEF DOC. NO. 171 RECEIVED NYSCEF: 02/23/2024 Island Pulmonary Associates, P.C. 173 Mineola Boulevard, Suite 305, Mineola, NY 11501 • Phone (516) 663-1100 • Fax (516) 663-1105 4271 Hempstead Turnpike, Bethpage, NY 11714 • Phone (516) 796-3700 • Fax (516) 796-3205 Progress Note Patient: ZOLLO, DANIELLE DOB: WIRN: 960748 Encounter: Thursday December 26 Provider: Jerry Ipe, DO Referring: IPE DO, JERRY 2013 Chief Complaint This is a 35 year old female here today for 6 month folllow up.Follow up to ct chest. History of Present Illness Had Ct done in 9/12 for hemoptysis showing 3 subcm nodules. Pt is a smoker, with fam hx of cancer Had repeat ct done in march with ? increase (but it was from 2 different institutions), then another 3 months later which showed stabilty and ? atlectasis lingula No SOB, no hemptysis. no fevers, no chills. 1/2 PPD no other complaints. Switched to e ciagrettes Continuing Problems • Ot nonsp ab fnd lung fid Medical History • Anxiety • Other (specify): panic attack, Surgical History Social History • Tobacco: current some day smoker Packs per day: 1 Years smoking: 10 • Drinks per day: social • Illegal drugs: no • Occupation: mom • Exposure to hazardous material: no exposure • Regular Exercise: no • Weight gain past 2 years. ( 70 lbs.) • Pregnant for 2 years weight gain two children Family History Mother: livingCurrent age: 60 Father: deceasedAge of death: 58 • Cancer: lymphona Allergies • No Known Drug Allergies Medications • Unknown Review of Systems • CONSTITUTIONAL: WNL • SKIN: WNL. ■HEENT: WNL. • RESPIRATORY: WNL • CARDIOVASCULAR: WNL. • Gl: WNL. • GU: WNL. • HEMATOLOGY/LYMPHATIC: WNL. • ENDOCRINE: WNL FILED: NASSAU COUNTY CLERK 02/23/2024 08:33 PM INDEX NO. 600444/2022 NYSCEF DOC. NO. 171 RECEIVED NYSCEF: 02/23/2024 • MUSCULOSKELETAL: WNL • ALLERGY: WNL. • NEURO: WNL. • PSYCH: WNL. Vital Signs ■Ht: 65 inches, Wt: 256 lbs, BMI: 42.6 kg/m2, BSA: 2.31 m2, BP: 120/80 , HR: 83, Sp02: 97 % • Comments: spo2 on room air Physical Examination General: The patient is a young woman HEENT: (Sleep) NC/AT Head/Neck: PERRL, EOMI, no scleral icterus present. Eyes: Left Eye: anicteric. Right Eye: anicteric. Ear/Nose/Throat: Mucous membranes are moist. Cardiovascular: Normal S1 S2 RRR with no murmurs, gallops or rubs. Chest Wall: Lungs: Lungs are clear to auscultation bilaterally. Abdomen: Soft, nondistended, nontender, normoactive bowel sounds and no organomegaly. Musculoskeletal: No joint deformities. Extremities: No clubbing cyanosis or edema present. Neuro: Exam revealed no focal deficits. Psych: Patient presents with appropriate mood and affect. Epworth Sleepiness Scale * Test performed on June 27, 2013 Situation: • Sitting and reading: 0 • Watching TV: 1 • Sitting, inactive in a public place (e.g. a theater or a meeting): 0 • As a passenger in a car for an hour without a break: 0 • Lying down to rest in the afternoon when circumstances permit: 3 • Sitting and talking to someone: 0 • Sitting quietly after a lunch without alcohol: 0 • In a car, while stopped for a few minutes in traffic: 0 TOTAL: 4 Reviewed Data IMPRESSION: • Reviewed - End of Document: Zollo, Danielle. DOB: MRN: 960748, Encounter: Thursday December 26, 2013 - Page 2/3 FILED: NASSAU COUNTY CLERK 02/23/2024 08:33 PM INDEX NO. 600444/2022 NYSCEF DOC. NO. 171 RECEIVED NYSCEF: 02/23/2024 Interpretation: 12/13: Stable nodules R major fissure: 7 mm RML 6 mm LUL 6 mm ? 6mm GG nodular denisty-> lingula ? consfluence of linear markings (reported on last Ct as well) Please see report. Interpretation: 12/26/13:normal spriomtry, volumes and dlco Please see report. Impression and Plan 1. Ot nonsp ab fnd lung fid Overall Impression Suborn nodules- stable after 6 months New subsgemtal atelectasis on lingula, no endobronchial lesions ? poor inspiration ? confluence of linear markings High risk pt, smoker with family history of malingnacy Overall Plan At this point doubt singicance of these nodules, however in light of smoking hisotry will continue to monitor. Will repeat Ct in months to eval progression of nodules and lingular subsegmetal atlectasis. smoking cessation encouraged General Helath care maintenance advised. Pt considering bariatric surgery down the line Follow Up Follow up in 9 month(s). Orders • CT <* CT Chest No Signature Configured Jerry Ipe, DO Signed Electronically by Jerry Ipe, DO on 12/26/2013 12:02PM - End of Document: Zollo, Danielle, DOB: MRN: 960748, Encounter: Thursday December 26, 2013 - Page 3/3 FILED: NASSAU COUNTY CLERK 02/23/2024 08:33 PM INDEX NO. 600444/2022 NYSCEF DOC. NO. 171 RECEIVED NYSCEF: 02/23/2024 ZOLLO, DANIELLE PV CTA CHEST WITH CONTRAST 9/12/2012 CT : Report . Patient ID: PV799652 Patient Name: ZOLLO, DANIELLE ! Birth Date: Sex: F :i EXAM: CTA CHEST WITH CONTRAST > PROCEDURE DATE: 09/12/2012 ! 1 CLINICAL STATEMENT: Evaluate for pulmonary embolus. I INTERPRETATION: TECHNIQUE: CTA of the chest was performed with IV contrast. COMPARISON: None. i FINDINGS: : There is no filling defect within the main, right interlobar, left t descending and visualized proximal segmental pulmonary arteries. There is no thoracic aortic aneurysm or dissection. Small nodule noted in the left lobe of the thyroid gland. ! There is no axillary, mediastinal or hilar lymphadenopathy by size criteria. There is no pericardial effusion. There is no pleural effusion. S 3 mm subpleural nodule noted in the right middle lobe, image 54. 3 mm | nodular density along the right major fissure on image 64. 2 mm nodule i lingula, image 54. No evidence of pulmonary embolus as described above. :t IMPRESSION: • Subcentimeter pulmonary nodules as described above. Follow-up recommended. SAMUEL KIM M.D., ATTENDING RADIOLOGIST This examination was interpreted on: Sep 12 2012 5:24P. This document has been electronically signed. Sep 12 2012 5:38P. i r : : < i 10/25/2012 FILED: NASSAU COUNTY CLERK 02/23/2024 08:33 PM INDEX NO. 600444/2022 NYSCEF DOC. NO. 171 RECEIVED NYSCEF: 02/23/2024 J Report ZOLLO, DANIELLE PV CHEST PA AND LAT *fl2/2Q12 CR : Patient ID: PV799652 Patient Name: ZOLLO, DANIELLE ! Birth Date: Sex: F ’ EXAM: CHEST PA \T\ LAT | PROCEDURE DATE: 09/12/2012 INTERPRETATION: Heart and mediastinum normal. Lungs clear. Costophrenic : angles sharp bilaterally. Skeletal structures intact. i IMPRESSION: Normal chest *r X DOMINIC ALTIERI M.D., ATTENDING RADIOLOGIST This examination was interpreted on: Sep 12 2012 5:06P. This document has been electronically signed. Sep 12 2012 5:07P. : \ I i r > i • ! i ■i 10/25/2012 FILED: NASSAU COUNTY CLERK 02/23/2024 08:33 PM INDEX NO. 600444/2022 NYSCEF DOC. NO. 171 RECEIVED NYSCEF: 02/23/2024 . Report ZOLLO, DANIELLE PV VENOUS DUPLEX LOWER EXT BILAT 9/12/2012 US Patient ID: PV7996S2 Patient Name: ZOLLO, DANIELLE • Birth Date: Sex: F EXAM: VENOUS DUPLEX LOWER EXT BILAT PROCEDURE DATE: 09/12/2012 INTERPRETATION: CUNICAL STATEMENT: Evaluate for DVT. l TECHNIQUE: Ultrasound of bilateral lower extremity deep venous system. > * . COMPARISON: None. FINDINGS: There is flow, compression and augmentation of the common femoral, ; superficial femoral and popliteal veins. i ’ There is flow in the posterior tibial vein. IMPRESSION: No evidence of DVT. j SAMUEL KIM M.D., ATTENDING RADIOLOGIST • This examination was interpreted on: Sep 12 2012 S:39P. This document has been electronically signed. Sep 12 2012 5:39P. 5i i i s i t i ! i 10/25/2012 FILED: NASSAU COUNTY CLERK 02/23/2024 08:33 PM INDEX NO. 600444/2022 3/11/2013 7:37 PM ESKER -> Page 1 Of 2 NYSCEF DOC. NO. 171 RECEIVED NYSCEF: 02/23/2024 Massapeaua 126 Hicksville Road Zwaimcser-Pesiri Massapequa, NY 11758 Phone: 516-798-4242 Fax: 516-797-3509 To; Jerry Ipe, DO Name: DANIELLE ZOLLO 4271 Hempstead Turnpike MRN ff; 745350 Exam tf: 7081736 Bethpage, NY 11714 Phone: 516-303-6556 DOB: Gender: Female Exam Date: 3/11/13 Referring Rhys.: Jerry Ipe, DO Exam: CT-CHEST W/O CONTRAST Clinical Indication! Pulmonary nodules. Contiguous axial CT scan imaging of the thorax was obtained on the multislice volume acquisition CT scanner without the introduction of intravenous contrast material. Coronal and sagittal images were reconstructed. This study was performed using automatic exposure control (radiation dose reduction software) to obtain a diagnostic image quality scan with patient dose as low as reasonably achievable. The administered radiation dose was 5.54 mSv. Outside institution CT angiogram of the chest dated 09/12/2012 is provided for review and states 3 mm subpleural nodule noted in the right middle lobe and a 3 mm nodular density along the right major fissure, 2 mm nodular density in the lingula. Prior images are not available for comparison. Associated with the right major fissure is a faint slightly lobulated nodular density measuring approximately 5-6 mm (image 53 series 3). Indistinct ovoid approximately 6 mm nodule abuts the inferoanterior margin of the left hilum in the left lingular segment (image 50 series 3). There is a faint pleural-based nodular density in the right middle lobe measuring approximately 3-4 mm (Image 64 series 3). It is uncertain if these correspond to the nodules as discussed in the outside institution report and such study should be provided for review to compare to the current study. If not available, short interval 3-4 month follow-up advised. The lungs are otherwise unremarkable and there are no pleural effusions. The tracheobronchial tree appears unremarkable. There is no adenopathy. Grossly the thyroid appears unremarkable. The heart and great vessels appear grossly unremarkable. The visualized intraabdominal contents appear grossly unremarkable. The bony and soft tissue structures are unremarkable. Impression: Right and left lung nodules as described. It is uncertain if these definitively correspond to the densities as enumerated on the outside institution report and such study should be 2wanger-Pesiri Radiology Page 1 of 2 FILED: NASSAU ot ±xt ttvxo / . u / rn COUNTY CLERK 02/23/2024 08:33 PM INDEX NO. 600444/2022 4 NYSCEF DOC. NO. 171 RECEIVED NYSCEF: 02/23/2024 20LL0, DANIELLE (Exam 7081736) Jerry Ipe, DO MRN «: 745350 provided for review lo compare to the current study at this institution. If no priors are available for comparison three month follow-up advised. Interpreting Radiologist 4~.- •x - -•:7 Ronald 3. Sticco, MD 516-798-4242 Electronically Signed: 03/11/2013 Zwanger-Pesiri Radiology Page 2 of 2 FILED: NASSAU COUNTY CLERK 02/23/2024 08:33 PM INDEX NO. 600444/2022 NYSCEF DOC. NO. 171 RECEIVED NYSCEF: 1 of 2 Page 02/23/2024 i ZWANGER-PESIRI Massaoeaua 126 Hicksville Road Massapequa, NY 11750 Phone; 5167984242 RADIOLOGY Fax: 5167973509 :: Jerry Ipe, DO Patient: Danielle Zollo :: 4271 Hempstead Turnpike MRN: 745350 Bethpage, NY 11741 DOB: Gender: Female Exam Date: 06/19/2013 05:20 PM Exam: CT-CHEST W/O CON | 71250 CT-CHEST W/O CON History: Followup lung nodules CT scan of the chest was performed with volume acquisition obtained from the pulmonary apices to the costophrenic sulci. Intravenous contrast was not utilized. Axial, sagittal and coronal images were reconstructed. The study was performed on the Multislice Volume Aquisition CT scanner. This study was performed using automatic exposure control (radiation dose reduction software) to obtain a diagnostic image quality scan with patient dose as low as reasonably achievable. The administered radiation dose was 5.48 mSv. A smoking history is provided. Comparison is made to selected images from, and report of prior noncontrast CT scan of the chest 3/11/2013. The nodular densities there are stable. The these are located along the right major fissure image 52, in the right middle lobe (image 63, and in the perihilar portion of the lingula on image 50. In the periphery of the lingula there is groundglass nodule-linear density on image 76 that is new. It probably represents focal subsegmental atelectasis. No suspicious nodule has developed. There is no endobronchial lesion. ' No axillary, mediastinal or hilar adenopathy has developed. There are mediastinal nodes in the precarinal and aortopulmonic window that appear persistent and unchanged (Image 37. A right hilum no image 52 also appears stable. No pleural or pericardial effusion has developed. The spleen appears prominent measuring approximately 14 cm anterior posterior. It appears unchanged. The visualized adrenal glands appear unremarkable. No suspicious bony lesions have developed. Impression: Stable nodular densities in each lung. No new nodules have developed. Stable upper limit of normal mediastinal and right hilar nodes. No new nodes have developed. Visualized portion of the spleen suggested at the upper limit of normal versus mildly prominent. Clinical correlation is requested. http://synris/Reports/printReportCustom.aspx?acc=12196195 6/25/2013 FILED: NASSAU COUNTY CLERK 02/23/2024 08:33 PM INDEX NO. 600444/2022 NYSCEF DOC. NO. 171 Page 2 of 2 RECEIVED NYSCEF: 02/23/2024 Robin Scarlata M.D. 06/20/2013 http://synris/Reports/printReportCustom.aspx?acc=12196195 6/25/2013 FILED: NASSAU COUNTY CLERK 02/23/2024 08:33 PM INDEX NO. 600444/2022 From: GFI FaxMaker To: Jerry Ipe Page: 1/2 Date: 12/21/2013 5:42:25 AM NYSCEF DOC. NO. 171 RECEIVED NYSCEF: O- 02/23/2024 Zwanger-Pesipi Elmont 1390 Hempstead Turnpike Elmont, NY 11003 RADIOLOGY Phone: (516)797-7796 Fax: (516)798-8354 :: Jerry Ipe, DO Patient: Danielle Zollo :: 4271 Hempstead Turnpike MRN: 745350 Bethpage, NY 11741 DOB: Home Phone: (516)303-6556 Exam Date: 12/20/2013 Exam: CT-CHEST W/O CON | 71250 CT-CHEST W/O CON History: Followup lung nodules Contiguous axial CT scan imaging of the thorax was obtained without the introduction of intravenous contrast material. Coronal and sagittal images were reconstructed. This study was performed using automatic exposure control (radiation dose reduction software) to obtain a diagnostic image quality scan with patient dose as low as reasonably achievable. The administered radiation dose was 5.11 mSv. The study is compared to the prior chest CT 6/19/2013 as well as 3/11/2013 Again evident associated right major fissure near the level of the hilum is a 7 mm nodular focus (image 54 series 6). Anterior pleural periphery right middle lobe is an approximately 6 mm nodule (image 64 series 6). There is a 6 mm nodule left upper lobe cyst and branching bronchial segments (Image 44 series 6). All these nodules remain stable. Linear type density in the lingula segment stable however the suggestion for the presence currently of a 6 mm groundglass nodular density in the medial segment (image 75 series 6) which was not present previously. The lung parenchyma is otherwise unremarkable. There are no pleural effusions. The visualized tracheobronchial tree appears unremarkable. There is no definitive evidence of adenopathy. The heart and great vessels appear grossly unremarkable. The visualized thyroid is normal and symmetrical. The visualized intraabdomina! contents again suggests slightly prominent spleen. The bony and soft tissue structures appear unremarkable. The remainder of the study is unremarkable. IMPRESSION: Stable pulmonary nodules as described, however one in the inferior lingula segment may developed in the interval. This may represent confluence of linear markings in the area however would advise a continued 6 to eight-month followup to assure its stability. No other interval changes This fax was sent with GFI FaxMaker fax server. For more information, visit http://www.gfi.com FILED: NASSAU COUNTY INDEX NO. 600444/2022 Korn: OKI CLERK KaxMaker 02/23/2024 To: Jerry Ipe Page:08:33 2/2 Date:PM 12/21/2013 5:42:26 AM O• NYSCEF DOC. NO. 171 RECEIVED NYSCEF: 02/23/2024 •c Ronald Sticco M.D., Ext, 4055 12/20/2013 This fax was sent with GFi FaxMaker fax server. For more information, visit: http://www.gfi.com FILED: NASSAU COUNTY CLERK 02/23/2024 08:33 PM INDEX NO. 600444/2022 NYSCEF DOC. NO. 171 RECEIVED NYSCEF: 02/23/2024 Date of Test: 10/26/2012 Island Pulmonary Associates, P.C. Pi^monary Function Laboratoty Temp: 23°C 4271 Hempstead Turnpike Pressure: 760mmHg Bethpage, NY 11714 Phone: (516) 796-3700 Fax: (516) 796-3205 BTPS: 1.050 MRN: 960748 Sex: F DOB: Age: 34 Race: W Name: Zollo, Danielle Height: 65 in Weight 256 lb BMI: 42.7 Diagnosis: 1: Technician: Peter Puch Physician: Referring: Predicted Range Pre Bronchodilator Post Bronchodilator Percent Spirometry (BTPS) Mean 95% Actual % Pred Actual % Pred Change L 3.55 2.74 4.23 119 4.42 125 4 FVC FEVi L 3.01 2.37 3.38 112 3.62 120 7 FEVi / FVC % 85 76 80 94 82 96 2 L/S 3.41 2.02 3.17 93 3.70 109 17 FEF25-75 L/$ 6.50 3.65 7.63 117 5.77 89 -24 PEFR L/s 6.11 3.39 7.06 116 5.67 93 -20 FEF25 L/s 2.84 1.24 4.02 142 4.50 158 12 FEFso U$ 1.82 0.75 1.45 80 2.07 114 43 FEF75 sec 7.01 4.31 -39 FET MW L/m 108.3 107.3 Flow Volume Predicted Range Pre Bronchodilator Lung Volumes (He) Actual % Pred Pre Rx Mean 95% «-i Post Rx VC L 3.55 2.74 4.38 123 7- «- Predicted FRC L 2.86 1.80 4.89 171 5- IC L 2.20 1.14 0.45 20 fevi -aae <- ERV L 1.35 0.29 3.93 291 3- RV L 1.51 0.74 0.96 64 FEV3=4.(D 3- TIC RV/TLC L % 5.06 28 4.00 17 5.34 18 106 64 I3. V 5 1 2 3 S 6 7 ] Predicted Range Pre Bronchodilator O’ Diffusion u. ■3 Mean 95% Actual % Pred -j- DLCO [Hb] mUmin/mmHg 27.03 17.55 22.84 84 DLCO mL/min/mmhg 27.03 17.55 22.84 84 •5- VA [BTPS