Preview
Filing # 122060963 E-Filed 02/25/2021 11:48:35 AM
IN THE CIRCUIT COURT OF THE FIFTEENTH JUDICIAL CIRCUIT IN AND
FOR PALM BEACH COUNTY, FLORIDA
BERNARD SUSSMAN and DIVISION: AH
FRANCINE SUSSMAN, CASE NO.: 2020CA010576XXXXMB
Plaintiffs),
vs.
BCMB ENTERPRISES, INC d/b/a
A BETTER WAY HOME CARE,
Defendant.
/
NOTICE OF NON-PARTY PRODUCTION
Defendant, BCMB ENTERPRISES, INC d/b/a A BETTER WAY HOME CARE, by and
through undersigned counsel, hereby gives notice of the intent to serve the attached Subpoenas
Duces Tecum Without Deposition under Rule 1.351, after ten (10) days from the date of this
Notice, to the following entities:
1. Hospital Without Walls
2. Medical Specialists of the Palm Beaches, Inc. — Jose Labault-Santiago, MD
CERTIFICATE OF SERVICE
I HEREBY CERTIFY that on the 25" of February, 2021, a true and correct copy of the
foregoing has been furnished via the Florida e-filing portal: Dave K. Roy, Esq., Roy &
Associates, P.A., 1665 Palm Beach Lakes Blvd., Suite 1010, West Palm Beach, FL 33401;
info@daveroylaw.com
QUINTAIROS, PRIETO, WOOD & BOYER, P.A.
S/ Rolin N. Khaw
ROBIN N. KHANAL, ESQUIRE
Florida Bar No.: 0571032
1
'** FILED: PALM BEACH COUNTY, FL JOSEPH ABRUZZO, CLERK. 02/25/2021 11:48:35 AM ***CHRISTOPHER N. GONSALVES, ESQUIRE
Florida Bar No.: 1018014
255 S. Orange Ave., Suite 900
Orlando, Florida 32801
Tel: (407) 872-6011
Fax: (407) 872-6012
Attorneys for Defendant
Pleading designation:
RNK.Pleadings@qpwblaw.comIN THE CIRCUIT COURT OF THE FIFTEENTH JUDICIAL CIRCUIT IN AND
FOR PALM BEACH COUNTY, FLORIDA
BERNARD SUSSMAN and DIVISION: AH
FRANCINE SUSSMAN, CASE NO.: 2020CA010576XXXXMB
Plaintiff(s),
VS.
BCMB ENTERPRISES, INC d/b/a
A BETTER WAY HOME CARE,
Defendant.
SUBPOENA DUCES TECUM WITHOUT DEPOSITION
TO: Hospital Without Walls
1200 South Federal Highway, Suite 205
Boynton Beach, FL 33435
YOU ARE HEREBY COMMANDED, to appear at the Law Offices of QUINTAIROS,
PRIETO, WOOD & BOYER, P.A., 255 South Orange Ave., Suite 900, Orlando, Florida 32801,
within twenty (20) days of the date of this Subpoena and to have with you at that place and
time the following:
Note: You may comply with this subpoena by providing legible copies of the items to be
produced to the attorney whose name appears on this subpoena on or before the scheduled
date of production. This will not be a deposition. No testimony will be taken. The items
will be inspected and may be copied at the time listed above. You will not be required to
surrender the original items.
PLEASE PROVIDE ALL DOCUMENTS ON A CD IN PDF FORMAT. DO NOT SEND
PAPER COPIES.
IF THE COST OF THE RECORDS EXCEEDS $500, PLEASE INFORM US BEFORE
SENDING THE DOCUMENTS AS WE REQUIRE PREAPPROVAL FROM OUR CLIENT.
PATIENT
BERNARD SUSSMAN
D.O.B. XX/XX/XXXxX; S.S.N.: XXX-XX-XXXXTED DOCUME.
's
Each and every record, film, photo, and medical bill contained within the patient’s chart, as
specified below, whether electronically stored, printed, or handwritten, as well as a copy of
any notations on the file jacket, or otherwise in the possession of the witness, whether
prepared by you or from another source. The list below delineates our specific request.
A. All medical office records including Office Notes, Correspondence (to and from),
Memorandums, Medical Bills/Invoices, Ledger Cards, Home Health Records,
Hospitalization Records, Prescriptions, Log sheets, Photographs, Appointment
Schedules/Logs, Consultation reports, Telephone Call documentation, Insurance
Forms/Referrals, Laboratory Reports, EKG, EEG, ECG, Special Testing/Procedures,
Pathology Reports/Slides, Radiology Reports/Films, color photos, Narratives/Raw Data,
any records obtained from any other Healthcare provider, and all other data pertaining to
the diagnosis, treatment and care of the above patient, rendered by the witness.
B. Hospital records for the past *FIVE (5) years Please provide a list of dates of service or
for the In Patient, Outpatient, Short Stay or Emergency Room Stay records so that the
attorney may order specific dates of stay as it pertains to the legal matter in order to limit
the costs associated with obtaining the following documents: Admission Documentation
Forms (including patient information forms/questionnaires), History and Physical,
Discharge records, Emergency Department, Discharge Summaries, Consultation Reports,
Doctor's Progress Notes, Physician Orders, Operative/Procedure Reports, Legal and
Consents, Diagnostic/Laboratory, Special Testing, or Monitoring Strips, Medications
Sheets, Therapy Notes (Physical/Occupational/Speech and Respiratory Therapy),
Nutrition Notes, Nursing Notes, Graphics/Flowcharts, Code Records, Case Manger Notes,
Death Certificates, Correspondence, Memorandums, Narratives/Raw Data, Labor and
Delivery Records, Hospice notes, Wound care notes, Private Care Notes as well as any
and all other data pertaining to the diagnosis, treatment and care rendered to the above
patient.
C. All color Photos of any wounds taken during the care and treatment of the above named
patient.
D. A list of radiology Films (X-rays, MRI's, CT's other radiographic studies, and/or
diagnostic tests, and test results and/or reports) taken in the past 5 years at your facility
in order for the attorney to determine the exact films required. (DO NOT send us any films
without prior approval).
E. A list of any and all human tissue specimens, pathology slides, pathology reports
and/or other laboratory studies, and study results and/or reports, of the above patient by
the witness or by any other health-care providers that are in the possession of the witness.
(DO NOT send any slides without prior approval).F. An itemized bill for all services rendered by the witness pertaining to the diagnosis,
treatment and care of the above patient, showing dates of treatment and amounts billed for
such treatment including any record or statement, which reflects the total amount of the
bill that has been paid, payments by patient and insurance, adjustments, write off and any
remaining balances.
G. All reports and/or correspondence prepared for attorneys, insurance companies, or any
other person or entity of whatever nature by the witness, and all correspondence received
by the witness from such persons or entities.
H. Any and all prescriptions including full and complete prescriptions records showing
drugs prescribed, names of physicians, dates dispensed, refills, any computer printouts,
notes on treatment, memoranda, correspondence, bills, logs, drug information sheets of
any and all substances furnished to the above patient by the witness or by any other health-
care providers that are in the possession of the witness.
THIS SUBPOENA CONTEMPLATES ANY AND ALL RECORDS
YOU MAY HAVE IN YOUR POSSESSION.
You may condition the preparation of the copies upon the payment in advance of the
reasonable cost of preparation. You may mail or deliver the copies to the attorney whose
name appears on this subpoena and thereby eliminate your appearance at the time and place
specified above. You have the right to object to the production pursuant to this Subpoena at any
time before production by giving written notice to the attorney whose name appears on this
Subpoena.
IF YOU FAIL TO: (1) appear as specified; or (2) furnish the records in advance of the
date and time provided for above; or (3) object to this subpoena, YOU MAY BE IN
CONTEMPT OF COURT. You are subpoenaed by the attorney whose name appears on this
subpoena and unless excused from this subpoena by the attorney or the Court, you shall respond
to the subpoena as directed.HIPAA Certificate
This certifies that this subpoena has been issued in compliance with the Health Insurance
Portability and Accountability Act of 1996, (HIPAA), Public Law 104-901 and 45 CFR 164.512
(c)(1)Gi) as this subpoena has been issued pursuant to Rule 1.410 and 1.351, Fla. R. Civ. P. The
party issuing this subpoena has made a good faith attempt to provide written notice to the
Plaintiff/Patient listed above by sending his/her attorney a notice of the issuance of this
subpoena, which included sufficient information about the litigation to permit the
Plaintiff/Patient to raise an objection to the court or administrative tribunal. The time for the
Plaintiff/Patient to raise an objection pursuant to Rule 1.351, Fla. R. Civ. P. has expired and no
objections were filed.
Dated:
For the Court:
ROBIN N. KHANAL, ESQUIRE
Florida Bar No.: 0571032
CHRISTOPHER N. GONSALVES, ESQUIRE
Florida Bar No.: 1018014
RNK_pleadings@qpwblaw.com
255 S. Orange Ave., Suite 900
Orlando, Florida 32801
Tel: (407) 872-6011
Fax: (407) 872-6012
**Please mail records to**
QUINTAIROS, PRIETO, WOOD & BOYER, P.A.
Attn: Robin N. Khanal, Esq.
255 South Orange Ave., Suite 900
Orlando, Florida 32801
(407) 872-6011 Telephone
(407) 872-6012 Facsimile
Attorneys for DefendantIN THE CIRCUIT COURT OF THE FIFTEENTH JUDICIAL CIRCUIT IN AND
FOR PALM BEACH COUNTY, FLORIDA
BERNARD SUSSMAN and DIVISION: AH
FRANCINE SUSSMAN, CASE NO.: 2020CA010576XXXXMB
Plaintiff(s),
VS.
BCMB ENTERPRISES, INC d/b/a
A BETTER WAY HOME CARE,
Defendant.
TO:
SUBPOENA DUCES TECUM WITHOUT DEPOSITION
Medical Specialists of the Palm Beaches, Inc.
Jose Labault-Santiago, MD
140 John F Kennedy Drive
Atlantis, FL 33462
YOU ARE HEREBY COMMANDED, to appear at the Law Offices of QUINTAIROS,
PRIETO, WOOD & BOYER, P.A., 255 South Orange Ave., Suite 900, Orlando, Florida 32801,
within twenty (20) days of the date of this Subpoena and to have with you at that place and
time the following:
Note: You may comply with this subpoena by providing legible copies of the items to be
produced to the attorney whose name appears on this subpoena on or before the scheduled
date of production. This will not be a deposition. No testimony will be taken. The items
will be inspected and may be copied at the time listed above. You will not be required to
surrender the original items.
PLEASE PROVIDE ALL DOCUMENTS ON A CD IN PDF FORMAT. DO NOT SEND
PAPER COPIES.
IF THE COST OF THE RECORDS EXCEEDS $500, PLEASE INFORM US BEFORE
SENDING THE DOCUMENTS AS WE REQUIRE PREAPPROVAL FROM OUR CLIENT.
PATIENT
BERNARD SUSSMAN
D.O.B. XX/XX/XXXX; S.S.N.: XXX-XX-XXXXTED DOCUME.
's
Each and every record, film, photo, and medical bill contained within the patient’s chart, as
specified below, whether electronically stored, printed, or handwritten, as well as a copy of
any notations on the file jacket, or otherwise in the possession of the witness, whether
prepared by you or from another source. The list below delineates our specific request.
A. All medical office records including Office Notes, Correspondence (to and from),
Memorandums, Medical Bills/Invoices, Ledger Cards, Home Health Records,
Hospitalization Records, Prescriptions, Log sheets, Photographs, Appointment
Schedules/Logs, Consultation reports, Telephone Call documentation, Insurance
Forms/Referrals, Laboratory Reports, EKG, EEG, ECG, Special Testing/Procedures,
Pathology Reports/Slides, Radiology Reports/Films, color photos, Narratives/Raw Data,
any records obtained from any other Healthcare provider, and all other data pertaining to
the diagnosis, treatment and care of the above patient, rendered by the witness.
B. Hospital records for the past *FIVE (5) years Please provide a list of dates of service or
for the In Patient, Outpatient, Short Stay or Emergency Room Stay records so that the
attorney may order specific dates of stay as it pertains to the legal matter in order to limit
the costs associated with obtaining the following documents: Admission Documentation
Forms (including patient information forms/questionnaires), History and Physical,
Discharge records, Emergency Department, Discharge Summaries, Consultation Reports,
Doctor's Progress Notes, Physician Orders, Operative/Procedure Reports, Legal and
Consents, Diagnostic/Laboratory, Special Testing, or Monitoring Strips, Medications
Sheets, Therapy Notes (Physical/Occupational/Speech and Respiratory Therapy),
Nutrition Notes, Nursing Notes, Graphics/Flowcharts, Code Records, Case Manger Notes,
Death Certificates, Correspondence, Memorandums, Narratives/Raw Data, Labor and
Delivery Records, Hospice notes, Wound care notes, Private Care Notes as well as any
and all other data pertaining to the diagnosis, treatment and care rendered to the above
patient.
C. All color Photos of any wounds taken during the care and treatment of the above named
patient.
D. A list of radiology Films (X-rays, MRI's, CT's other radiographic studies, and/or
diagnostic tests, and test results and/or reports) taken in the past 5 years at your facility
in order for the attorney to determine the exact films required. (DO NOT send us any films
without prior approval).
E. A list of any and all human tissue specimens, pathology slides, pathology reports
and/or other laboratory studies, and study results and/or reports, of the above patient by
the witness or by any other health-care providers that are in the possession of the witness.
(DO NOT send any slides without prior approval).F. An itemized bill for all services rendered by the witness pertaining to the diagnosis,
treatment and care of the above patient, showing dates of treatment and amounts billed for
such treatment including any record or statement, which reflects the total amount of the
bill that has been paid, payments by patient and insurance, adjustments, write off and any
remaining balances.
G. All reports and/or correspondence prepared for attorneys, insurance companies, or any
other person or entity of whatever nature by the witness, and all correspondence received
by the witness from such persons or entities.
H. Any and all prescriptions including full and complete prescriptions records showing
drugs prescribed, names of physicians, dates dispensed, refills, any computer printouts,
notes on treatment, memoranda, correspondence, bills, logs, drug information sheets of
any and all substances furnished to the above patient by the witness or by any other health-
care providers that are in the possession of the witness.
THIS SUBPOENA CONTEMPLATES ANY AND ALL RECORDS
YOU MAY HAVE IN YOUR POSSESSION.
You may condition the preparation of the copies upon the payment in advance of the
reasonable cost of preparation. You may mail or deliver the copies to the attorney whose
name appears on this subpoena and thereby eliminate your appearance at the time and place
specified above. You have the right to object to the production pursuant to this Subpoena at any
time before production by giving written notice to the attorney whose name appears on this
Subpoena.
IF YOU FAIL TO: (1) appear as specified; or (2) furnish the records in advance of the
date and time provided for above; or (3) object to this subpoena, YOU MAY BE IN
CONTEMPT OF COURT. You are subpoenaed by the attorney whose name appears on this
subpoena and unless excused from this subpoena by the attorney or the Court, you shall respond
to the subpoena as directed.HIPAA Certificate
This certifies that this subpoena has been issued in compliance with the Health Insurance
Portability and Accountability Act of 1996, (HIPAA), Public Law 104-901 and 45 CFR 164.512
(c)(1)Gi) as this subpoena has been issued pursuant to Rule 1.410 and 1.351, Fla. R. Civ. P. The
party issuing this subpoena has made a good faith attempt to provide written notice to the
Plaintiff/Patient listed above by sending his/her attorney a notice of the issuance of this
subpoena, which included sufficient information about the litigation to permit the
Plaintiff/Patient to raise an objection to the court or administrative tribunal. The time for the
Plaintiff/Patient to raise an objection pursuant to Rule 1.351, Fla. R. Civ. P. has expired and no
objections were filed.
Dated:
For the Court:
ROBIN N. KHANAL, ESQUIRE
Florida Bar No.: 0571032
CHRISTOPHER N. GONSALVES, ESQUIRE
Florida Bar No.: 1018014
RNK_pleadings@qpwblaw.com
255 S. Orange Ave., Suite 900
Orlando, Florida 32801
Tel: (407) 872-6011
Fax: (407) 872-6012
**Please mail records to**
QUINTAIROS, PRIETO, WOOD & BOYER, P.A.
Attn: Robin N. Khanal, Esq.
255 South Orange Ave., Suite 900
Orlando, Florida 32801
(407) 872-6011 Telephone
(407) 872-6012 Facsimile
Attorneys for Defendant
Preview
Filing # 122060963 E-Filed 02/25/2021 11:48:35 AM IN THE CIRCUIT COURT OF THE FIFTEENTH JUDICIAL CIRCUIT IN AND FOR PALM BEACH COUNTY, FLORIDA BERNARD SUSSMAN and DIVISION: AH FRANCINE SUSSMAN, CASE NO.: 2020CA010576XXXXMB Plaintiffs), vs. BCMB ENTERPRISES, INC d/b/a A BETTER WAY HOME CARE, Defendant. / NOTICE OF NON-PARTY PRODUCTION Defendant, BCMB ENTERPRISES, INC d/b/a A BETTER WAY HOME CARE, by and through undersigned counsel, hereby gives notice of the intent to serve the attached Subpoenas Duces Tecum Without Deposition under Rule 1.351, after ten (10) days from the date of this Notice, to the following entities: 1. Hospital Without Walls 2. Medical Specialists of the Palm Beaches, Inc. — Jose Labault-Santiago, MD CERTIFICATE OF SERVICE I HEREBY CERTIFY that on the 25" of February, 2021, a true and correct copy of the foregoing has been furnished via the Florida e-filing portal: Dave K. Roy, Esq., Roy & Associates, P.A., 1665 Palm Beach Lakes Blvd., Suite 1010, West Palm Beach, FL 33401; info@daveroylaw.com QUINTAIROS, PRIETO, WOOD & BOYER, P.A. S/ Rolin N. Khaw ROBIN N. KHANAL, ESQUIRE Florida Bar No.: 0571032 1 '** FILED: PALM BEACH COUNTY, FL JOSEPH ABRUZZO, CLERK. 02/25/2021 11:48:35 AM ***CHRISTOPHER N. GONSALVES, ESQUIRE Florida Bar No.: 1018014 255 S. Orange Ave., Suite 900 Orlando, Florida 32801 Tel: (407) 872-6011 Fax: (407) 872-6012 Attorneys for Defendant Pleading designation: RNK.Pleadings@qpwblaw.comIN THE CIRCUIT COURT OF THE FIFTEENTH JUDICIAL CIRCUIT IN AND FOR PALM BEACH COUNTY, FLORIDA BERNARD SUSSMAN and DIVISION: AH FRANCINE SUSSMAN, CASE NO.: 2020CA010576XXXXMB Plaintiff(s), VS. BCMB ENTERPRISES, INC d/b/a A BETTER WAY HOME CARE, Defendant. SUBPOENA DUCES TECUM WITHOUT DEPOSITION TO: Hospital Without Walls 1200 South Federal Highway, Suite 205 Boynton Beach, FL 33435 YOU ARE HEREBY COMMANDED, to appear at the Law Offices of QUINTAIROS, PRIETO, WOOD & BOYER, P.A., 255 South Orange Ave., Suite 900, Orlando, Florida 32801, within twenty (20) days of the date of this Subpoena and to have with you at that place and time the following: Note: You may comply with this subpoena by providing legible copies of the items to be produced to the attorney whose name appears on this subpoena on or before the scheduled date of production. This will not be a deposition. No testimony will be taken. The items will be inspected and may be copied at the time listed above. You will not be required to surrender the original items. PLEASE PROVIDE ALL DOCUMENTS ON A CD IN PDF FORMAT. DO NOT SEND PAPER COPIES. IF THE COST OF THE RECORDS EXCEEDS $500, PLEASE INFORM US BEFORE SENDING THE DOCUMENTS AS WE REQUIRE PREAPPROVAL FROM OUR CLIENT. PATIENT BERNARD SUSSMAN D.O.B. XX/XX/XXXxX; S.S.N.: XXX-XX-XXXXTED DOCUME. 's Each and every record, film, photo, and medical bill contained within the patient’s chart, as specified below, whether electronically stored, printed, or handwritten, as well as a copy of any notations on the file jacket, or otherwise in the possession of the witness, whether prepared by you or from another source. The list below delineates our specific request. A. All medical office records including Office Notes, Correspondence (to and from), Memorandums, Medical Bills/Invoices, Ledger Cards, Home Health Records, Hospitalization Records, Prescriptions, Log sheets, Photographs, Appointment Schedules/Logs, Consultation reports, Telephone Call documentation, Insurance Forms/Referrals, Laboratory Reports, EKG, EEG, ECG, Special Testing/Procedures, Pathology Reports/Slides, Radiology Reports/Films, color photos, Narratives/Raw Data, any records obtained from any other Healthcare provider, and all other data pertaining to the diagnosis, treatment and care of the above patient, rendered by the witness. B. Hospital records for the past *FIVE (5) years Please provide a list of dates of service or for the In Patient, Outpatient, Short Stay or Emergency Room Stay records so that the attorney may order specific dates of stay as it pertains to the legal matter in order to limit the costs associated with obtaining the following documents: Admission Documentation Forms (including patient information forms/questionnaires), History and Physical, Discharge records, Emergency Department, Discharge Summaries, Consultation Reports, Doctor's Progress Notes, Physician Orders, Operative/Procedure Reports, Legal and Consents, Diagnostic/Laboratory, Special Testing, or Monitoring Strips, Medications Sheets, Therapy Notes (Physical/Occupational/Speech and Respiratory Therapy), Nutrition Notes, Nursing Notes, Graphics/Flowcharts, Code Records, Case Manger Notes, Death Certificates, Correspondence, Memorandums, Narratives/Raw Data, Labor and Delivery Records, Hospice notes, Wound care notes, Private Care Notes as well as any and all other data pertaining to the diagnosis, treatment and care rendered to the above patient. C. All color Photos of any wounds taken during the care and treatment of the above named patient. D. A list of radiology Films (X-rays, MRI's, CT's other radiographic studies, and/or diagnostic tests, and test results and/or reports) taken in the past 5 years at your facility in order for the attorney to determine the exact films required. (DO NOT send us any films without prior approval). E. A list of any and all human tissue specimens, pathology slides, pathology reports and/or other laboratory studies, and study results and/or reports, of the above patient by the witness or by any other health-care providers that are in the possession of the witness. (DO NOT send any slides without prior approval).F. An itemized bill for all services rendered by the witness pertaining to the diagnosis, treatment and care of the above patient, showing dates of treatment and amounts billed for such treatment including any record or statement, which reflects the total amount of the bill that has been paid, payments by patient and insurance, adjustments, write off and any remaining balances. G. All reports and/or correspondence prepared for attorneys, insurance companies, or any other person or entity of whatever nature by the witness, and all correspondence received by the witness from such persons or entities. H. Any and all prescriptions including full and complete prescriptions records showing drugs prescribed, names of physicians, dates dispensed, refills, any computer printouts, notes on treatment, memoranda, correspondence, bills, logs, drug information sheets of any and all substances furnished to the above patient by the witness or by any other health- care providers that are in the possession of the witness. THIS SUBPOENA CONTEMPLATES ANY AND ALL RECORDS YOU MAY HAVE IN YOUR POSSESSION. You may condition the preparation of the copies upon the payment in advance of the reasonable cost of preparation. You may mail or deliver the copies to the attorney whose name appears on this subpoena and thereby eliminate your appearance at the time and place specified above. You have the right to object to the production pursuant to this Subpoena at any time before production by giving written notice to the attorney whose name appears on this Subpoena. IF YOU FAIL TO: (1) appear as specified; or (2) furnish the records in advance of the date and time provided for above; or (3) object to this subpoena, YOU MAY BE IN CONTEMPT OF COURT. You are subpoenaed by the attorney whose name appears on this subpoena and unless excused from this subpoena by the attorney or the Court, you shall respond to the subpoena as directed.HIPAA Certificate This certifies that this subpoena has been issued in compliance with the Health Insurance Portability and Accountability Act of 1996, (HIPAA), Public Law 104-901 and 45 CFR 164.512 (c)(1)Gi) as this subpoena has been issued pursuant to Rule 1.410 and 1.351, Fla. R. Civ. P. The party issuing this subpoena has made a good faith attempt to provide written notice to the Plaintiff/Patient listed above by sending his/her attorney a notice of the issuance of this subpoena, which included sufficient information about the litigation to permit the Plaintiff/Patient to raise an objection to the court or administrative tribunal. The time for the Plaintiff/Patient to raise an objection pursuant to Rule 1.351, Fla. R. Civ. P. has expired and no objections were filed. Dated: For the Court: ROBIN N. KHANAL, ESQUIRE Florida Bar No.: 0571032 CHRISTOPHER N. GONSALVES, ESQUIRE Florida Bar No.: 1018014 RNK_pleadings@qpwblaw.com 255 S. Orange Ave., Suite 900 Orlando, Florida 32801 Tel: (407) 872-6011 Fax: (407) 872-6012 **Please mail records to** QUINTAIROS, PRIETO, WOOD & BOYER, P.A. Attn: Robin N. Khanal, Esq. 255 South Orange Ave., Suite 900 Orlando, Florida 32801 (407) 872-6011 Telephone (407) 872-6012 Facsimile Attorneys for DefendantIN THE CIRCUIT COURT OF THE FIFTEENTH JUDICIAL CIRCUIT IN AND FOR PALM BEACH COUNTY, FLORIDA BERNARD SUSSMAN and DIVISION: AH FRANCINE SUSSMAN, CASE NO.: 2020CA010576XXXXMB Plaintiff(s), VS. BCMB ENTERPRISES, INC d/b/a A BETTER WAY HOME CARE, Defendant. TO: SUBPOENA DUCES TECUM WITHOUT DEPOSITION Medical Specialists of the Palm Beaches, Inc. Jose Labault-Santiago, MD 140 John F Kennedy Drive Atlantis, FL 33462 YOU ARE HEREBY COMMANDED, to appear at the Law Offices of QUINTAIROS, PRIETO, WOOD & BOYER, P.A., 255 South Orange Ave., Suite 900, Orlando, Florida 32801, within twenty (20) days of the date of this Subpoena and to have with you at that place and time the following: Note: You may comply with this subpoena by providing legible copies of the items to be produced to the attorney whose name appears on this subpoena on or before the scheduled date of production. This will not be a deposition. No testimony will be taken. The items will be inspected and may be copied at the time listed above. You will not be required to surrender the original items. PLEASE PROVIDE ALL DOCUMENTS ON A CD IN PDF FORMAT. DO NOT SEND PAPER COPIES. IF THE COST OF THE RECORDS EXCEEDS $500, PLEASE INFORM US BEFORE SENDING THE DOCUMENTS AS WE REQUIRE PREAPPROVAL FROM OUR CLIENT. PATIENT BERNARD SUSSMAN D.O.B. XX/XX/XXXX; S.S.N.: XXX-XX-XXXXTED DOCUME. 's Each and every record, film, photo, and medical bill contained within the patient’s chart, as specified below, whether electronically stored, printed, or handwritten, as well as a copy of any notations on the file jacket, or otherwise in the possession of the witness, whether prepared by you or from another source. The list below delineates our specific request. A. All medical office records including Office Notes, Correspondence (to and from), Memorandums, Medical Bills/Invoices, Ledger Cards, Home Health Records, Hospitalization Records, Prescriptions, Log sheets, Photographs, Appointment Schedules/Logs, Consultation reports, Telephone Call documentation, Insurance Forms/Referrals, Laboratory Reports, EKG, EEG, ECG, Special Testing/Procedures, Pathology Reports/Slides, Radiology Reports/Films, color photos, Narratives/Raw Data, any records obtained from any other Healthcare provider, and all other data pertaining to the diagnosis, treatment and care of the above patient, rendered by the witness. B. Hospital records for the past *FIVE (5) years Please provide a list of dates of service or for the In Patient, Outpatient, Short Stay or Emergency Room Stay records so that the attorney may order specific dates of stay as it pertains to the legal matter in order to limit the costs associated with obtaining the following documents: Admission Documentation Forms (including patient information forms/questionnaires), History and Physical, Discharge records, Emergency Department, Discharge Summaries, Consultation Reports, Doctor's Progress Notes, Physician Orders, Operative/Procedure Reports, Legal and Consents, Diagnostic/Laboratory, Special Testing, or Monitoring Strips, Medications Sheets, Therapy Notes (Physical/Occupational/Speech and Respiratory Therapy), Nutrition Notes, Nursing Notes, Graphics/Flowcharts, Code Records, Case Manger Notes, Death Certificates, Correspondence, Memorandums, Narratives/Raw Data, Labor and Delivery Records, Hospice notes, Wound care notes, Private Care Notes as well as any and all other data pertaining to the diagnosis, treatment and care rendered to the above patient. C. All color Photos of any wounds taken during the care and treatment of the above named patient. D. A list of radiology Films (X-rays, MRI's, CT's other radiographic studies, and/or diagnostic tests, and test results and/or reports) taken in the past 5 years at your facility in order for the attorney to determine the exact films required. (DO NOT send us any films without prior approval). E. A list of any and all human tissue specimens, pathology slides, pathology reports and/or other laboratory studies, and study results and/or reports, of the above patient by the witness or by any other health-care providers that are in the possession of the witness. (DO NOT send any slides without prior approval).F. An itemized bill for all services rendered by the witness pertaining to the diagnosis, treatment and care of the above patient, showing dates of treatment and amounts billed for such treatment including any record or statement, which reflects the total amount of the bill that has been paid, payments by patient and insurance, adjustments, write off and any remaining balances. G. All reports and/or correspondence prepared for attorneys, insurance companies, or any other person or entity of whatever nature by the witness, and all correspondence received by the witness from such persons or entities. H. Any and all prescriptions including full and complete prescriptions records showing drugs prescribed, names of physicians, dates dispensed, refills, any computer printouts, notes on treatment, memoranda, correspondence, bills, logs, drug information sheets of any and all substances furnished to the above patient by the witness or by any other health- care providers that are in the possession of the witness. THIS SUBPOENA CONTEMPLATES ANY AND ALL RECORDS YOU MAY HAVE IN YOUR POSSESSION. You may condition the preparation of the copies upon the payment in advance of the reasonable cost of preparation. You may mail or deliver the copies to the attorney whose name appears on this subpoena and thereby eliminate your appearance at the time and place specified above. You have the right to object to the production pursuant to this Subpoena at any time before production by giving written notice to the attorney whose name appears on this Subpoena. IF YOU FAIL TO: (1) appear as specified; or (2) furnish the records in advance of the date and time provided for above; or (3) object to this subpoena, YOU MAY BE IN CONTEMPT OF COURT. You are subpoenaed by the attorney whose name appears on this subpoena and unless excused from this subpoena by the attorney or the Court, you shall respond to the subpoena as directed.HIPAA Certificate This certifies that this subpoena has been issued in compliance with the Health Insurance Portability and Accountability Act of 1996, (HIPAA), Public Law 104-901 and 45 CFR 164.512 (c)(1)Gi) as this subpoena has been issued pursuant to Rule 1.410 and 1.351, Fla. R. Civ. P. The party issuing this subpoena has made a good faith attempt to provide written notice to the Plaintiff/Patient listed above by sending his/her attorney a notice of the issuance of this subpoena, which included sufficient information about the litigation to permit the Plaintiff/Patient to raise an objection to the court or administrative tribunal. The time for the Plaintiff/Patient to raise an objection pursuant to Rule 1.351, Fla. R. Civ. P. has expired and no objections were filed. Dated: For the Court: ROBIN N. KHANAL, ESQUIRE Florida Bar No.: 0571032 CHRISTOPHER N. GONSALVES, ESQUIRE Florida Bar No.: 1018014 RNK_pleadings@qpwblaw.com 255 S. Orange Ave., Suite 900 Orlando, Florida 32801 Tel: (407) 872-6011 Fax: (407) 872-6012 **Please mail records to** QUINTAIROS, PRIETO, WOOD & BOYER, P.A. Attn: Robin N. Khanal, Esq. 255 South Orange Ave., Suite 900 Orlando, Florida 32801 (407) 872-6011 Telephone (407) 872-6012 Facsimile Attorneys for Defendant