Preview
Filing # 41618625 E-Filed 05/17/2016 02:41:56 PM
IN THE CIRCUIT COURT OF THE
FIFTEENTH JUDICIAL CIRCUIT, IN
AND FOR PALM BEACH COUNTY,
FLORIDA
Case No. CASE NO.: 2016
CA003793XXXXMB
KIM BREMER and RICHARD
BREMER, her husband,
Plaintiff,
v.
JOHNS. LEVIN, D.P.M, and
ORTHOPEDIC CENTER OF PALM
BEACH COUNTY, INC. ,
Defendant.
/
NOTICE OF PROPOUNDING
MEDICAL MALPRACTICE INTERROGATORIES
COMES NOW, the Defendant, ORTHOPEDIC CENTER OF PALM BEACH
COUNTY, INC., by and through the undersigned counsel, and hereby gives notice of
propounding Medical Malpractice Interrogatories to the Plaintiff, KIM BREMER and
RICHARD BREMER, her husband, numbered consecutively 1 through 27, to be
answered in writing within the time allotted by the Florida Rules of Civil Procedure.
I HEREBY CERTIFY that a copy of the foregoing has been furnished by e-
Seivice, UMS / q day of May, 2016, t6 thé IoOWing: Maia Speraiae, Esquizé,
Law Offices of Maria Sperando, P.A., 2682 S. E. Willoughby Boulevard , Suite 201,
Stuart, FL 34994, maria@sperandolaw.com;maryann@sperandolaw.com; Wilbert R.
Vancol, Esquire, McEwan, Martinez, Dukes, & Hall, P.A. 108 East Central Boulevard,
Orlando, FL 32801.
FILED: PALM BEACH COUNTY, FL, SHARON R. BOCK, CLERK, 05/17/2016 02:41:56 PMMedical Malpractice Interrogatories
Page 2
ADAMS | COOGLER, P.A.
1555 Palm Beach Lakes Blvd., Suite 1600
West Palm Beach, FL 33401-2329
Telephone: (561) 478-4500
Facsimile: (561) 478-7847
E-Mail Address: RKellner@adamscoogler.com and
BPhillips@adamscoogler.com
Defendant Orthopedic Center of Palm Beach
County, Inc.
Florida Bar No. : 330876Medical Malpractice Interrogatories
Page 3
MEDICALMALPRACTICE
INTERROGATORIES TO PLAINTIFF
1. What is the name and address of the person answering these interrogatories, and,
if applicable, the person's official position or relationship with the party to whom
the interrogatories are directed.
2. List the names, business addresses, dates of employment and rates of pay
regarding all employers, including self-employment, for whom you have worked
in the past ten years.Medical Malpractice Interrogatories
Page 4
List all former names and when you were known by those names. State all
addresses where you have lived for the past ten years, the dates you lived at each
address, your social security number, your date of birth, and if you are or have
ever been married, the name of your spouse or spouses and the names, ages and
present addresses of any children.
Have you ever been convicted of a crime, other than any juvenile adjudication,
which under the law under which you were convicted was punishable by death or
imprisonment in excess of one year, or that involved dishonesty or a false
ctatamant racardlace af tha nunichmant? Tf on otata ac ta nach ranvictinn the
Starcinent regarGuess Or ule Purisumene: 11 $0, Su aS i Caen COnvicucn, ule
specific crime, the date and the place of conviction.Medical Malpractice Interrogatories
Page 5
5. Were you suffering from physical infirmity, disability or sickness at the time of
the incident described in the complaint? If so, what was the nature of the
infirmity, disability, or sickness?
6. Describe in detail how the incident described in the Complaint happened,
including all actions taken by you to prevent the incident.Medical Malpractice Interrogatories
Page 6
7. Describe in detail each act or omission on the part of any party to this lawsuit that
you contend constituted negligence that was a contributing legal cause of the
incident in question. Please identify each such person.
8. List each item of expense or damage, other than loss of income or earning
capacity, that you claim to have incurred as a result of the incident described in
the Complaint, giving for each item the date incurred, the name and the business
address to whom each was paid or is owed, and the goods or services for which
each was incurred.Medical Malpractice Interrogatories
Page 7
10.
Do you contend that you have lost any income, benefits, or earning capacity in the
past or future as a result of the incident described in the Complaint? If so, state
the nature of the income, benefits, or earning capacity, and the amount and the
method that you used in computing the amount.
Has anything been paid or is anything payable from any third party for the
damages listed in your answers to these interrogatories? If so, state the amounts
paid Of payavle, ihe aie did DUSIAESS AUTESS OF thE Person OF EALIty Wao paid OF
owes said amounts, and which of those third parties have or claim a right of
subrogation.Medical Malpractice Interrogatories
Page 8
11.
12.
List the names and business addresses of each physician who has treated or
examined you, and each medical facility where you have received any treatment
or examination for the injuries for which you seek damages in this case; and state
as to each the date of treatment or examination and the injury or condition for
which you were examined or treatment.
List the names and business addresses of all other physicians, medical facilities or
other health care providers by whom or at which you have been examined or
treated in the past fen years; a state as: lo each the dates of SL or
i f
Aah.
Weatinenht ana tie conai
4
iiiea GF treated,
tt yOu WEIE EXMedical Malpractice Interrogatories
Page 9
13. List the names and addresses of all persons who are believed or known by you,
your agents or attorneys to have any knowledge concerning any of the issues in
this lawsuit; and specify the subject matter about which the witness has
knowledge.
Have you heard or do you know about any statement or remark made by or on
behalf of any party to this lawsuit, other than yourself, concerning any issue in
this lawsuit? If so, state the name and address of each person who heard it, and
the date, time, place and substance of each statement.
=Medical Malpractice Interrogatories
Page 10
15. State the name and address of every person known to you, your agents, or
attorneys, who has knowledge about, or possession, custody or control of any
model, plat, map, drawing, motion picture, video tape, or photograph pertaining to
any fact or issue involved in this controversy; and describe as to each, what such
person has, the name and address of the person who took or prepared it, and the
date it was taken or prepared.
16. Please describe in detail the manner in which you claim that the defendant(s)
forwarding these interrogatories was negligent and departed from the accepted
standard of care in his/her care and treatment.Medical Malpractice Interrogatories
Page 11
17. Please describe in detail exactly what you allege that the defendant(s) forwarding
these interrogatories should have done in the carrying out of his/her care and
treatment in order for him/her not to have been negligent.
18. Do you intend to call any expert witnesses at the trial of this case? If so, state as
to each such witness the name and business address of the witness, the witness's
qualifications as an expert, the subject matter upon which the witness is expected
to testify, the substance of the facts and opinions to which the witness is expected
to testify, and a summary of the grounds for each opinion.Medical Malpractice Interrogatories
Page 12
19. Other than an expert, did anyone ever criticize any manner, method, action or
activity used by the defendant(s) forwarding these interrogatories? If so, please
state for each such criticism: the name, address, profession and relationship to
you, if any, of the person(s) who made the criticism, the substance of the
criticism, and the date(s) of the criticism.
20. | Have you made an agreement with anyone that would limit that party's liability to
anyone for any of the damages sued upon in this case? If so, state the terms of the
agreement and the parties to it.Medical Malpractice Interrogatories
Page 13
21. Please state if you have ever been a party, either plaintiff or defendant, in a
lawsuit other than the present matter and if so, state whether you were plaintiff or
defendant, the nature of the action, and the date and court in which such suit was
filed.
22. Do you contend that you have experienced any injury or illness as a result of any
negligence of this defendant? If so, state the date that each such injury occurred,
a description of how the injury was caused, and the exact nature of each such
injury, and as to any injuries you contend are permanent, the effects on you that
you claim are permanent.Medical Malpractice Interrogatories
Page 14
23. What condition, symptom, or illness caused you to obtain medical care and
treatment from this defendant?
24. Do you claim this defendant neglected to inform or instruct or warn you of any
tisk relating to your condition, care, or treatment? If so, state of what, in your
opinion, the defendant failed to inform, instruct, or warn you.Medical Malpractice Interrogatories
Page 15
25.
26.
If you contend that you were not properly informed by this defendant regarding
the risk of the treatment or the procedure performed, state what alternative
treatment or procedure, if any, you would have undergone had you been properly
informed.
State the date you became aware of the injuries sued on in this action, and
describe i in detail the circumstances under which you became aware of each such
nara tha An Lnnnea aeraee that tha b
injury; State ine Gate you vecaine aware tiat tie
were caused or may have been caused by medical negligence; and describe in
detail the circumstances under which you became aware of the cause of said
injuries.
a In tht ata.
cS SCG GH i US aCUdTMedical Malpractice Interrogatories
Page 16
27. State the name and address of every person or organization to whom you have
given notice of the occurrence sued on in this case because you, your agents or
attorneys believe that person or organization may be liable in whole or in part to
you.Medical Malpractice Interrogatories
Page 17
Answering Party : 7
STATE OF FLORIDA )
)ss
COUNTY OF )
SWORN TO AND SUBSCRIBED before me _ this day of
> 2016, by (name of
person), who is personally known to me or who has produced
(type of identification) as identification.
SIGNATURE OF NOTARY
PRINTED NAME OF NOTARY
NOTARY PUBLIC, STATE OF FLORIDA
NOTARY COMMISSION NUMBER
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Filing # 41618625 E-Filed 05/17/2016 02:41:56 PM IN THE CIRCUIT COURT OF THE FIFTEENTH JUDICIAL CIRCUIT, IN AND FOR PALM BEACH COUNTY, FLORIDA Case No. CASE NO.: 2016 CA003793XXXXMB KIM BREMER and RICHARD BREMER, her husband, Plaintiff, v. JOHNS. LEVIN, D.P.M, and ORTHOPEDIC CENTER OF PALM BEACH COUNTY, INC. , Defendant. / NOTICE OF PROPOUNDING MEDICAL MALPRACTICE INTERROGATORIES COMES NOW, the Defendant, ORTHOPEDIC CENTER OF PALM BEACH COUNTY, INC., by and through the undersigned counsel, and hereby gives notice of propounding Medical Malpractice Interrogatories to the Plaintiff, KIM BREMER and RICHARD BREMER, her husband, numbered consecutively 1 through 27, to be answered in writing within the time allotted by the Florida Rules of Civil Procedure. I HEREBY CERTIFY that a copy of the foregoing has been furnished by e- Seivice, UMS / q day of May, 2016, t6 thé IoOWing: Maia Speraiae, Esquizé, Law Offices of Maria Sperando, P.A., 2682 S. E. Willoughby Boulevard , Suite 201, Stuart, FL 34994, maria@sperandolaw.com;maryann@sperandolaw.com; Wilbert R. Vancol, Esquire, McEwan, Martinez, Dukes, & Hall, P.A. 108 East Central Boulevard, Orlando, FL 32801. FILED: PALM BEACH COUNTY, FL, SHARON R. BOCK, CLERK, 05/17/2016 02:41:56 PMMedical Malpractice Interrogatories Page 2 ADAMS | COOGLER, P.A. 1555 Palm Beach Lakes Blvd., Suite 1600 West Palm Beach, FL 33401-2329 Telephone: (561) 478-4500 Facsimile: (561) 478-7847 E-Mail Address: RKellner@adamscoogler.com and BPhillips@adamscoogler.com Defendant Orthopedic Center of Palm Beach County, Inc. Florida Bar No. : 330876Medical Malpractice Interrogatories Page 3 MEDICALMALPRACTICE INTERROGATORIES TO PLAINTIFF 1. What is the name and address of the person answering these interrogatories, and, if applicable, the person's official position or relationship with the party to whom the interrogatories are directed. 2. List the names, business addresses, dates of employment and rates of pay regarding all employers, including self-employment, for whom you have worked in the past ten years.Medical Malpractice Interrogatories Page 4 List all former names and when you were known by those names. State all addresses where you have lived for the past ten years, the dates you lived at each address, your social security number, your date of birth, and if you are or have ever been married, the name of your spouse or spouses and the names, ages and present addresses of any children. Have you ever been convicted of a crime, other than any juvenile adjudication, which under the law under which you were convicted was punishable by death or imprisonment in excess of one year, or that involved dishonesty or a false ctatamant racardlace af tha nunichmant? Tf on otata ac ta nach ranvictinn the Starcinent regarGuess Or ule Purisumene: 11 $0, Su aS i Caen COnvicucn, ule specific crime, the date and the place of conviction.Medical Malpractice Interrogatories Page 5 5. Were you suffering from physical infirmity, disability or sickness at the time of the incident described in the complaint? If so, what was the nature of the infirmity, disability, or sickness? 6. Describe in detail how the incident described in the Complaint happened, including all actions taken by you to prevent the incident.Medical Malpractice Interrogatories Page 6 7. Describe in detail each act or omission on the part of any party to this lawsuit that you contend constituted negligence that was a contributing legal cause of the incident in question. Please identify each such person. 8. List each item of expense or damage, other than loss of income or earning capacity, that you claim to have incurred as a result of the incident described in the Complaint, giving for each item the date incurred, the name and the business address to whom each was paid or is owed, and the goods or services for which each was incurred.Medical Malpractice Interrogatories Page 7 10. Do you contend that you have lost any income, benefits, or earning capacity in the past or future as a result of the incident described in the Complaint? If so, state the nature of the income, benefits, or earning capacity, and the amount and the method that you used in computing the amount. Has anything been paid or is anything payable from any third party for the damages listed in your answers to these interrogatories? If so, state the amounts paid Of payavle, ihe aie did DUSIAESS AUTESS OF thE Person OF EALIty Wao paid OF owes said amounts, and which of those third parties have or claim a right of subrogation.Medical Malpractice Interrogatories Page 8 11. 12. List the names and business addresses of each physician who has treated or examined you, and each medical facility where you have received any treatment or examination for the injuries for which you seek damages in this case; and state as to each the date of treatment or examination and the injury or condition for which you were examined or treatment. List the names and business addresses of all other physicians, medical facilities or other health care providers by whom or at which you have been examined or treated in the past fen years; a state as: lo each the dates of SL or i f Aah. Weatinenht ana tie conai 4 iiiea GF treated, tt yOu WEIE EXMedical Malpractice Interrogatories Page 9 13. List the names and addresses of all persons who are believed or known by you, your agents or attorneys to have any knowledge concerning any of the issues in this lawsuit; and specify the subject matter about which the witness has knowledge. Have you heard or do you know about any statement or remark made by or on behalf of any party to this lawsuit, other than yourself, concerning any issue in this lawsuit? If so, state the name and address of each person who heard it, and the date, time, place and substance of each statement. =Medical Malpractice Interrogatories Page 10 15. State the name and address of every person known to you, your agents, or attorneys, who has knowledge about, or possession, custody or control of any model, plat, map, drawing, motion picture, video tape, or photograph pertaining to any fact or issue involved in this controversy; and describe as to each, what such person has, the name and address of the person who took or prepared it, and the date it was taken or prepared. 16. Please describe in detail the manner in which you claim that the defendant(s) forwarding these interrogatories was negligent and departed from the accepted standard of care in his/her care and treatment.Medical Malpractice Interrogatories Page 11 17. Please describe in detail exactly what you allege that the defendant(s) forwarding these interrogatories should have done in the carrying out of his/her care and treatment in order for him/her not to have been negligent. 18. Do you intend to call any expert witnesses at the trial of this case? If so, state as to each such witness the name and business address of the witness, the witness's qualifications as an expert, the subject matter upon which the witness is expected to testify, the substance of the facts and opinions to which the witness is expected to testify, and a summary of the grounds for each opinion.Medical Malpractice Interrogatories Page 12 19. Other than an expert, did anyone ever criticize any manner, method, action or activity used by the defendant(s) forwarding these interrogatories? If so, please state for each such criticism: the name, address, profession and relationship to you, if any, of the person(s) who made the criticism, the substance of the criticism, and the date(s) of the criticism. 20. | Have you made an agreement with anyone that would limit that party's liability to anyone for any of the damages sued upon in this case? If so, state the terms of the agreement and the parties to it.Medical Malpractice Interrogatories Page 13 21. Please state if you have ever been a party, either plaintiff or defendant, in a lawsuit other than the present matter and if so, state whether you were plaintiff or defendant, the nature of the action, and the date and court in which such suit was filed. 22. Do you contend that you have experienced any injury or illness as a result of any negligence of this defendant? If so, state the date that each such injury occurred, a description of how the injury was caused, and the exact nature of each such injury, and as to any injuries you contend are permanent, the effects on you that you claim are permanent.Medical Malpractice Interrogatories Page 14 23. What condition, symptom, or illness caused you to obtain medical care and treatment from this defendant? 24. Do you claim this defendant neglected to inform or instruct or warn you of any tisk relating to your condition, care, or treatment? If so, state of what, in your opinion, the defendant failed to inform, instruct, or warn you.Medical Malpractice Interrogatories Page 15 25. 26. If you contend that you were not properly informed by this defendant regarding the risk of the treatment or the procedure performed, state what alternative treatment or procedure, if any, you would have undergone had you been properly informed. State the date you became aware of the injuries sued on in this action, and describe i in detail the circumstances under which you became aware of each such nara tha An Lnnnea aeraee that tha b injury; State ine Gate you vecaine aware tiat tie were caused or may have been caused by medical negligence; and describe in detail the circumstances under which you became aware of the cause of said injuries. a In tht ata. cS SCG GH i US aCUdTMedical Malpractice Interrogatories Page 16 27. State the name and address of every person or organization to whom you have given notice of the occurrence sued on in this case because you, your agents or attorneys believe that person or organization may be liable in whole or in part to you.Medical Malpractice Interrogatories Page 17 Answering Party : 7 STATE OF FLORIDA ) )ss COUNTY OF ) SWORN TO AND SUBSCRIBED before me _ this day of > 2016, by (name of person), who is personally known to me or who has produced (type of identification) as identification. SIGNATURE OF NOTARY PRINTED NAME OF NOTARY NOTARY PUBLIC, STATE OF FLORIDA NOTARY COMMISSION NUMBER