Motion,Ex Parte: BALZARANO, ELIZABETH V LIFELINE RECOVERY LLC DBA LIFELINE RECOVERY

• 
• 
• 
• 
• 
• 
• 
• 

						
                                
Preview
                                Filing # 141607427 E-Filed 01/07/2022 05:29:44 PM

IN THE CIRCUIT COURT FOR THE 15" JUDICIAL CIRCUIT IN AND FOR PALM BEACH
COUNTY, FLORIDA

GENERAL JURISDICTION DIVISION

CASE NO.: 50-2018-CA-015763-XXXX-MB

ELIZABETH BALZARANO, individually

and as Personal Representative of the Estate
of Michele L. Balzarano,

Plaintiff,
vs.

LIFELINE RECOVERY, LLC, et al.,

Defendants.

PLAINTIFF’S RESPONSE IN OPPOSITION TO DEFENDANT, EMILIO DUBOY
M.D.’s MOTION FOR SUMMARY JUDGMENT AND MOTION TO DISMISS FOR
FAILURE TO COMPLY WITH STATUTORY PRESUIT INVESTIGATION, OR, IN
THE ALTERNATIVE, MOTION TO DETERMINE WHETHER CLAIM RESTS ON
REASONABLE BASIS

 

Plaintiff, ELIZABETH BALZARANO, individually and as Personal Representative of
the Estate of Michele L. Balzarano, hereby responds in opposition to Defendant Emilio Duboy
M.D.’s (“Dr. Duboy”) Motion for Summary Judgment and Motion to Dismiss for Failure to
Comply With Statutory Presuit Investigation, or, In The Alternative, Motion To Determine
Whether Claim Rests on Reasonable Basis (hereinafter “Motion”):

INTRODUCTION

Dr. Duboy has moved for summary judgment contending that he lacked a duty to
Michelle Balzarano. Dr. Duboy previously moved to dismiss on this basis, but subsequently
answered. As Dr. Duboy has answered Plaintiff objects to the portion of his motion that seeks a

motion to dismiss as procedurally improper. As to the arguments on duty, the court previously

CHEN. DAIAARCACUAAIINTY Cl INGEDU ARDIIV7ZN FLEDIZ A4IN7INNGD NE-I0-A/ DNA
Pm. PAL DLA VUUINE TT, PL, JUOL IE monuecy, ULUIAN, UUriZue. Uu.2o.tt civdenied an identical motion to dismiss based on duty advanced by co-Defendants Life Changes
and Janine Beattie, ARNP. (See Order Denying Life Changes & Janine Beattie, ARNP’s,
Motion to Dismiss Plaintiff's Second Amended Complaint, dated December 16, 2019.). Dr.
Duboy’s legal arguments on duty are directly contrary to Florida Supreme Court precedent in

Chirillo v. Granicz, 199 So. 3d 246 (Fla. 2016). Plaintiff has submitted an affidavit from her

expert witness explaining that Dr. Duboy had a duty and that his breaches in the standard of care
directly and proximately caused the death of Michelle Balzarano. (See Affidavit of Amy

Harrington, M.D., attached hereto as Exhibit A.). Dr. Duboy and Nurse Beattie have both

conceded in testimony that they owed a duty of care to Michelle Balzarano, creating genuine
issues of material fact which independently preclude summary judgment:
“Q. Some things we can probably agree upon, do you agree with me that as a

licensed ARNP you have a duty and obligation to render acceptable and
appropriate care to your patients?

A. Yes.”

(Deposition of Defendant Janine M. Beattie, ARNP, Pg. 9, Lns. 16-21, (“Beattie Depo.”)
attached hereto as Exhibit B).

“Q. I was asking you part of that duty and obligation was to assist in the
medication needs of patients; is that a correct statement?

A. Correct.”
Id. at Pg. 27, Ls. 2-5.

“Q. You agree that a psychiatrist has a duty to exercise reasonable care in the

betta OMe we We ate ne tO
UCALIICI Of HS OF MeL patients, COLPCCLS
A. Yes.”

(Deposition of Defendant Life Changes Medical Director Defendant Emilio Duboy, Pg. 18, Lns.
6-11, (“Duboy Depo.”) attached hereto as Exhibit C).

“ Ctatad anathas wae wan acres urith mae unn have ta da a aamnatant inh
XS iaeG anouier Way, YOu agiee Wiui mie YOu Gave w GO a Compe jou

treating your patients?A. Yes.”

Q. Do you agree with me that part of that includes ensuring that they have
sufficient and proper medication which they are prescribed?

A. Yes.

Q. And would you agree with me that a component of that also entails having
a proper discharge plan if they are discharged from a rehabilitation
treatment center?

A. Yes.

Q. And part of that would also encompass connection with doctors that they

will need after discharge, correct’?

A. Yes.

Q. And those are all important parts of a patient maintaining their mental
health, correct?

A. Yes.
Id. at Pg. 18-19.
A duty indisputably existed to provide substance abuse care and treatment, which

includes an adequate discharge and proper supply and management of medication, in accordance

 

with the prevailing standard of care. Sweet v. Sheehan, 932 So. 2d 365, 368:
2006). Dr. Duboy’s arguments for summary judgment on duty fail.
The court should deny Dr. Duboy’s Motion.
Response to Defendant’s Undisputed Facts
1. Admitted.
2. Admitted.

3. Admitted that Plaintiff was discharged from Life Changes on April 11, 2017 to a halfway

hance anarated hy tha an_dafandant Camaran Villa Tionntad ta tha avtant naraaranh theas
mouse Gperaea oy ue CO-GeienGain, Cameron via, wispurca w ule Cah paragrapu ule’.presupposes or suggests that Michelle Balzarano was adequately discharged from the facility. At
the time of her discharge Life Changes was “pushing her out the door” because they were in the
process of ceasing operations. (Deposition of Mary Coumbe, (““Coumbe Depo.”) Pg. 67, Lns. 8-
25, attached hereto as Exhibit D.).

4. Admitted. At JFK Medical Center Emergency Department Michelle informed the
emergency room physician that Life Changes was not communicating with her, that she was out
of medication, without applicable insurance, unaware of where to go for a follow up, and that

Life Changes did not provide her with prescriptions to manage her medication needs:

 

Free Text HP! Notes
piee-Text HPL Notes
pI states she was just released fromv'rehab, “pt states the dis; i

t + pt pensed:her a ‘did 7
sat Sive her ay Seri i Sere medication. pt states her insurance i foncu a
information but they did not get back to her et ar dshe took her fast pile lay fore 8?
: a ind she
sTequesting a.refill until she can establish witha local a =~ retells todays pL -

(JFK Medical Center Record dated April 16, 2017.).

5. Admitted.
6. Admitted.
7. Admitted,
8. Paragraph nine is one to which Plaintiff cannot admit or deny and is therefore not

applicable. Plaintiff disputes that Defendant is entitled to summary judgment.
9. Admitted.
Plaintiff's Statement of Additional Facts
10. Life Changes operated a partial hospitalization treatment center for substance abuse and
co-occurring psychiatric issues. (Duboy Depo. Pg. 37, 38 Lns. 24-25, 1.).
11. The patients at Life Changes were “a very vulnerable population” with substance abuse

disorders and mental health disorders. (Beattie Depo. Pg. 64, Lns. 8-11.).

412. Life Changes employed both medical and non-medical staff and personnel at its facility.
(Duboy Depo. Pg. 28, Lns. 9-12.).

13. Defendant Dr. Emilio Duboy was the Medical Director for Life Changes at the time that
Michelle Balzano was a patient in 2017. (Duboy Depo. Pg. 15, Lns. 18-21.).

14. Dr. Duboy testified that a psychiatrist has a duty to exercise reasonable care in the
treatment of patients. /d. at Pg. 18, Lns. 6-11. He testified that the duty includes ensuring that
patients have sufficient and proper medication which they are prescribed. Jd. at Lns. 15-20. The
duty also includes providing a proper discharge plan for patients. Jd. at Pg. 18-19, Lns 21-25, 1-
3. The duty also includes connecting patients with the doctors that they will need post discharge.
Id. at Pg. 19, Lns. 4-9.

15. Nurse Beattie concedes that an advanced registered nurse practitioner has a duty and
obligation to render acceptable and appropriate care to patients. (Beattie Depo. Pg. 9, Lns. 16-
20). Part of that duty includes an obligation to assist in the medication needs of patients. Id. at
Pg. 27, Lns, 1-5.

16. According to Dr. Duboy, the responsibility of making sure the patient gets medication at
Lite Changes feli upon both the nursing staff and non-medical staff. (Duboy Depo. Pg. 30, Lns.
17-21.).

17. The non-medical Clinical Director and Dr. Duboy were responsible for ensuring the
medical needs of a patient upon discharge and making discharge decisions for patients. (Beattie
Depo. Pg. 22-23.). The non-medical Clinical Director and Medical Director are involved in
transferring patients from Life Changes to an “appropriate place where they can get the care that

they need.” /d. at Pg. 40, Lns. 8-13.18. Dr. Duboy admitted that the correct dosage and administration is important for
psychotropic medications. (Duboy Depo. Pg. 35, Lns. 15-20.).

19. Dr. Duboy conceded that without the correct dosage and administration of psychotropic
medications they do not adequately treat a patients mental health conditions. /d. at Pg. 36, Lns.
1-2. He admitted that when a patient is tapering off psychotropic medications they may feel
symptoms more intensely and will lose the benefits of the medications. Jd. at Pg. 36, 37 Lns. 23-
25, 1-16.

20. Dr. Duboy testified that Nurse Beattie was responsible for doing medical assessments of
patients and addressing their needs. /d. at Pg. 27, Lns. 21-24. According to Dr. Duboy, Nurse
Beattie was “in charge” of managing patient medications. /d. at Pg. 28, Lns. 5-8.

21. Dr. Duboy developed a treatment plan for Michelle Balzarano’s psychiatric symptoms.
Id. at Pg. Pg. 46, Lns. 10-12. He implemented medications to treat her psychiatric symptoms.
Id. at Pg. 46, Lns. 10-20.

22. Dr. Duboy was aware that there was a risk that Michelle Balzarano’s psychiatric
symptoms would worsen and exacerbate if she did not receive her medication. Jd. at Pg. 47, Lns.
3-6.

23. Dr. Duboy knew that better management of Michelle Balzarano’s psychological issues
would cut down on the risk of her committing suicide. Jd. at Pg. 48-49.

24. Continuation of medication and linkage to doctors needed after discharge is an important
part of continuation of treatment. Id. at Pg. 52.

25. Dr. Duboy conceded that if Michelle Balzarano was asking Life Changes for help after

she was discharged that they should have helped her to get additional medication. /d. at Pg. 58,

Two 1.11
wihd. 1-1 a.26. Had Dr. Duboy been notified that Michelle Balzarano went to the ER to seek additional
medications he would have done something to secure her the medications she needed. /d. at Pg.
59, 60, Lns. 21-25, 1-3.

27. Michelle Balzarano did not have a personal means of transportation. (Coumbe Depo. Pg.
39, Lns. 13-14.).

28. Michelle Balzarano was provided with no instructions from Life Changes upon being
discharged. (Coumbe Depo. Pg. 69, Lns. 16-18; Pg. 70, Lns. 7-12). She was not given any
information or referral to a local psychiatrist to have her medications refilled. Jd. at Pg. 71, Lns.
10-14.

29. Michelle Balzarano called Life Changes following her discharge and asked for help in
securing her psychotropic medications. (Coumbe Depo. Pg. 67, Lns. 18-24.). Life Changes
refused to assist Michelle Balzarano despite her pleas for help. /d; Pg. 71, Lns. 2-7. Michelle
called at least three times to receive assistance from Life Changes. /d. at 81, Lns. 9-11.

30. | Without her medications Michelle Balzarano spiraled, she went from deeply depressed to
amanic state. (Coumbe Depo. Pg. 73, Lns. 19-20; Pg. 76, Lns. 16-18.).

3i. Lite Changes discharged Michelle Baizarano to a halfway house without staff to facilitate
any sort of therapy or a doctor to manage her medication needs. (Coumbe Depo. Pg. 87, Lns.
19-23.).

32. Life Changes medical and non-medical staff, Janine Beattie, and Dr. Duboy owed a duty
of care to Michelle Balzarano. (See Affidavit of Amy Harrington, M.D., at § 11, 12, 13, 15.).

33. Life Changes, through its facility, employees, and agents, including Dr. Duboy and Nurse

Beattie, breached the standard of care and negligently provided substance use disorder care andtreatment to Michelle Balzarano and failed to provide her with an adequate discharge from its
facility. Id. at ¥ 14.

34. The breaches of the duties owed to Michelle Balzarano by Life Changes, Janine Beattie,
and Dr. Emilio Duboy directly and proximately led to a decline in her mental health, an
exacerbation of her mental health symptoms, and ultimately her death by suicide. Jd. at §16, 17,
18. Life Changes, Janine Beattie, and Dr. Emilio Duboy directly and proximately caused the
suffering and death of Michelle Balzarano. Id.

ARGUMENT

L Summary Judgment Standard

“In negligence cases, especially those dependent on expert testimony, summary
judgment should be restricted to extraordinary circumstances.” Slaats v. Sandy Lane Residential,
LLC, 59 So. 3d 320, 321 (Fla. 3d DCA 2011).

Florida Rule of Civil Procedure 1.510 adopted the federal summary judgment standard
articulated in Celotex Corp. v. Catrett,477 U.S. 317 (1986); Anderson v. Liberty Lobby,
Inc., 477 U.S. 242 (1986); and Matsushita Elec. Indus. Co. v. Zenith Radio Corp., 475 U.S. 574
(i986). A moving party is entitied to summary judgment “if the pleadings, depositions, answers
to interrogatories, and admissions on file, together with the affidavits, if any, show that there is
no genuine dispute as to any material fact and that the moving party is entitled to judgment as a
matter of law.” Fed. R. Civ. P. 56(c)(2). A dispute of material fact is genuine “if the evidence is
such that a reasonable jury could return a verdict for the nonmoving party.” See Anderson 477
US. at 248.

Where an affidavit raises an issue of material fact, summary judgment is precluded.

Casthaun Attunations Tan x Curr OF Gn IA 190 (Bla 10654). Ctamatinns wv Mauthanot Ajulinas
wounern Auracuons, wi. V. Grau, 75 50. 20 1cu Wid. 1750s, SIGMGUNOS V. IVOTineast Airunes,Inc., 258 So. 2d 52 (Fla. 3d DCA 1972). If the existence of such issues or the possibility of their
existence is reflected in the record summary judgment must be denied. Furlong v. First National
Bank of Hialeah, 329 So.2d 406 (Fla. 3d DCA 1976); Williams v. Florida Realty & Management
Co., 272 So.2d 176 (Fla.3d DCA 1973).

I. Dr. Duboy Had And Breached A Duty Of Care Owed To Michelle Balzarano

Dr. Duboy’s arguments on duty are legally incorrect and based on a misinterpretation of
the concept of duty as it applies in this case. Chirillo v. Granicz, 199 So. 3d 246, 249 (Fla. 2016)
(“Petitioners attempt to classify the duty in the instant case as a duty to prevent suicide is
incorrect and inappropriate.”). Dr. Duboy was “unquestionably” obligated to provide substance
abuse care and treatment, which includes an adequate discharge and proper management of
Michelle Balzarano’s psychotropic medication, in accordance with the prevailing standard of
care. Sweet v. Sheehan, 932 So. 2d 365, 368-369 (Fla. 2d DCA 2006). The decisional law cited
by Dr. Duboy in his section on duty is without application to the facts of this case. He avoids the
controlling and applicable case law explaining Defendant’s duty to conform to the standard of
care. Id.; Chirillo v. Granicz, 199 So. 3d 246, 249 (Fla. 2016); Surloffv. Regions Bank, 179 So.
3d 472, 475 (Fia. 4th DCA 2015) (“[Pjrofessionais, such as psychiatrists, have a duty to treat
patients in accordance with professional standards.”); Perez v. U.S., 883 F. Supp. 2d 1257, 1284
(S.D. Fla. 2012) (“A health care provider is obligated to conform its conduct to the prevailing
standard of care or else that provider will be held liable for damages proximately caused by its
failure to do so.”); Estate of Rotell ex rel. Rotell v. Kuehnle, 38 So. 3d 783, 789 (Fla. 2d DCA
2010) citing Moransais v. Heathman, 744 So. 2d 973, 975-76 (Fla. 1999) (“Where the negligent

party is a professional, the law imposes a duty to perform the requested services in accordancewith the standard of care used by similar professionals in the community under similar
circumstances.”).

Florida law recognizes that a legal duty will arise whenever a human endeavor creates a
generalized and foreseeable risk of harm. McCain v. Florida Power Corp., 593 So. 2d 500, 503
(Fla. 1992). The duty can also arise from other sources, such as a defendant’s status (i.e.
substance abuse treatment provider, psychiatrist, ARNP), legislative enactments or
administration regulations, under operation of law and judicial interpretations, and arising from
the general facts of the case. Jd. at fn. 2. In the instant case a duty arises by way of Dr. Duboy’s
status as a psychiatrist and the Medical Director of Life Changes, requiring him to perform his
services in accordance with the standard of care. A duty also arose in this matter by legislative
enactment under Chapter 397 Florida Statutes as well as Florida’s administrative code:

e Florida Statute § 397.419 (1) on substance abuse services which requires that substance

abuse treatment providers “ensure that services are rendered consistent with prevailing
professional standards.”

« Florida Statute Fla. Stat. Ann. § 397.501 (3)(a) on substance abuse treatment services
which requires that “[e]ach individual must be delivered services suited to his or her

needs, administered skillfully, safely, humanely, with full respect for his or her dignity
and personal integrity, and in accordance with all statutory and regulatory requirements.”

¢ Florida Administrative Code 65D-30.004 on substance abuse treatment centers which
requires that “[a]dministrative and clinical services must align with current best
practices.”
These statutes created a duty of care that Defendants, including Dr. Duboy, owed to
Michelle Baizarano.
Dr. Duboy relies upon three cases, discussed in turn, to incorrectly suggest that he did not
owe a duty of care. He first points to Azizi v. Regency Properties of Boca Raton, Inc., d/b/a Boca

House, 2015 WL 1735538 (Fla. 15th Jud. Cir. March 17, 2015). Azizi has no application here as

it dealt with a “sober house” which did not provide substance abuse treatment services,

10psychiatric treatment services, discharge of patients, the maintenance and procurement of
medications to its residents, or continuity of care. The defendant in Azizi merely operated an
apartment where individuals in recovery could live. /d. When a previous tenant committed
suicide the court correctly determined that the sober house, which had rendered no services other
than renting a room, had no duty to prevent him from injuring himself. The facts are
incomparable.

Surloff v. Regions Bank, 179 So. 3d 472 (Fla. 4th DCA 2015) is inapposite. Surloff dealt
with a mentally ill individual who took his own life after being informed by a loan officer that he
had been denied a bank loan. Jd. at 474. The court in Surloff arrived at the logical conclusion
that there was no nexus between the duties owed by a bank to a client and the decedent’s suicide.
Id. The decision in Surloff distinguishes the holding of Rafferman v. Carnival Cruise Lines, Inc.,
659 So, 2d 1271 (Fla. 3d DCA 1995), a case where the court ruled that one can be held liable for
another’s suicide so long as the suicide is foreseeable. Id. at 476. In analyzing Rafferman the
court in Surloff noted the following distinguishing factors: “Obviously, banks and their clients do
not share the same, close relationship as ship owners and their seamen. A bank neither
supervises its clients’ day-to-day activities, nor exerts any type of supervisory controi over
them.” Jd. at 476-77. In the instant case Michelle Balzarano’s relationship with Dr. Duboy was
beyond intimate. She relied upon him to provide her with medication she needed, and to support
her in the lowest point in life. Dr. Duboy had a duty to exercise reasonable care that he owed to
Michelle Balzarano which cannot exist in the banking context. Additionally, Dr. Duboy was
responsible for making sure Michelle Balzarano had the medication she needed, had follow up

appointments to ensure continuity of care, and was otherwise able to stand on her own two feet

llwhile recovering from addiction and battling mental illness. Sur/off has zero application to the
facts of this case.

The ruling on a motion to dismiss in Herrera v. Q Health Services, Inc., et. al., 2021 WL
3929943 (Fla. 15th Jud. Cir. March 30, 2021) is also inapplicable. The court in Herrera was not
presented with the controlling rationale of Chirillo v. Granicz, 199 So. 3d 246 (Fla. 2016) and
Sweet v. Sheehan, 932 So. 2d 365 (Fla. 2d DCA 2006). In Herrera the decedent overdosed on
drugs the very same day he was ejected from the facility, there was no argument that any failure
on behalf of QO Health caused or contributed to his overdose. Herrera, 2021 WL at *2. In the
instant case the facts establish that Michelle Balzarano was discharged with insufficient amounts
of medications that she needed to control and manage a medical condition. The lack of
medication and exacerbation of her psychiatric symptoms caused her to suffer and die.
Furthermore, Michelle Balzarno made numerous attempts following her negligent discharge to
seek assistance from Life Changes. Dr. Duboy admitted that he would have helped Michelle
Balzarano had he known she was making requests. (Duboy Depo. Pg. 59, 60, Lns. 21-25, 1-3.).
No such allegations existed in Herrera, and the holding is without factual or legal application
here.

In sharp contrast to the inapplicable decisions relied upon by Dr. Duboy, the instant case
is identical to the controlling decision of Chirillo v. Granicz, 199 So. 3d 246 (Fla. 2016) and
Sweet v. Sheehan, 932 So. 2d 365 (Fla. 2d DCA 2006), and the same result should be reached.
In Chirillo the trial court granted summary judgment because it found that Dr. Chirillo did not
have a duty to prevent the unforeseeable suicide of the outpatient decedent. Id. at 249. The

Second District reversed the trial court, agreeing that the trial court had improperly characterized

tha Ante awed ta tha danadant ac ane ta “avauant tha unfaracaaahla oniaida af an antnationt
uie Gury GWG WO ule GCOS aS Gne Ww preveie ule UnorescCadie SuICiGe G1 an Curpaucie.

12Granicz v. Chirillo, 147 So. 3d 544, 547 (Fla. 2d DCA 2014). The Second District framed the
duty as a duty “to use the ordinary skills, means and methods that are recognized as necessary
and which are customarily followed in the particular type of case according to the standard of
those who are qualified by training and experience to perform similar services.” Id. at 548
(quoting Sweet v. Sheehan, 932 So. 2d 365, 368 (Fla. 2d DCA 2006)). The Florida Supreme
Court agreed with the analysis finding that there was a statutory duty to treat the patient within
the standard of care. Chirillo v. Granicz, 199 So. 3d 246, 251 (Fla. 2016). In the instant case the
facts of the case give rise to a duty on the part of Life Changes and Janine Beattie to exercise the
skill and knowledge normally used by substance abuse treatment providers and ARNPs under
similar circumstances. Additionally, while not the only source of duty, a duty arises under
Florida Statute § 397.419 (1), which requires that substance abuse service providers must
“ensure that services are rendered consistent with prevailing professional standards.” The
rationale of Chirillo v. Granicz, 199 So. 3d 246, 251 (Fla. 2016), is controlling and commands
denial of Dr. Duboy’s Motion.

The relevant inquiry here is not whether Dr. Duboy had a duty, which he indisputably did
as arising from various sources set forth herein including status, facts of the case, professional
standards, and legislative enactments including Florida Statue 766.102, but whether Defendant
breached said duty by failing to adequately treat and provide Michelle Balzarano with proper
substance abuse and mental health treatment services, including minimally: providing sufficient
medication upon discharge to manage her substance abuse and mental health issues; linkage to
qualified professionals in the community to ensure continuity of care; confirmed and set

appointments prior to discharge; an investigation or inquiry that the facility she would be

teanefarrad ta wre adarmata and abla ta neawide fae hae naados adanmate fallaur un
Uanowinea 1 Was aacquare ana aoe iw provige 10r er Teas; aaequare 1udw up

13communication and meaningful response when Michelle Balzarano was asking Life Changes
and Dr. Duboy for help; and general competence in rendering professional services to Michelle
Balzarano. This relevant inquiry presents issues of fact that can only be resolved by the jury.

Til. Dr. Duboy’s Motion to Dismiss Fails

As a threshold matter, Dr. Duboy’s motion to dismiss within his motion for summary
judgment is procedurally improper. Dr. Duboy has already answered the operative Complaint
and waived his opportunity to seek a motion to dismiss by answering. The court should deny the
motion to dismiss as procedurally improper.

Dr. Duboy seeks dismissal from this wrongful death lawsuit by pointing to Florida’s
medical malpractice presuit requirements and claiming that Dr. Harrington did not possess a
valid expert witness certificate. Dr. Duboy’s attempt to argue a meaningless technicality is
emblematic of the “disturbing trend” of Defendants misusing statutory requirements as a sword
against plaintiffs. Michael v. Med. Staffing Network, Inc., 947 So. 2d 614, 619 (Fla. 34 DCA
2007). Florida’s medical malpractice presuit requirements are designed to “alleviate the high
cost of medical negligence claims through early determination and prompt resolution of
claims.” Weinstock v.  Groth,629  So.2d 835, 838  (Fia.i993). Nonetheless,
“the medical malpractice statutory scheme must be interpreted liberally so as not to unduly
restrict a Florida citizen's constitutionally guaranteed access to the courts.” Kukral v.
Mekras, 679 So.2d 278, 284 (Fla.1996); see also Weinstock, 629 So.2d at 838 (“[T]he purpose of
the chapter 766 presuit requirements is ... not to deny access to the courts to plaintiffs....”). The
statutory requirements are not to be used by prospective defendants as preemptive sword against

a plaintiff as Dr. Duboy does here. Holden v. Bober, 39 So. 3d 396, 400 (Fla. 2d DCA 2010).

14Notwithstanding the meaningless nature of the argument, Dr. Harrington holds a valid
certificate through the Florida Department of Health. (See Expert Witness Certificate of Amy
Harrington, attached hereto as Exhibit E.). Dr. Duboy has not advanced a valid legal decision to
support his argument or explained how he has suffered any sort of prejudice to support dismissal.

The court should reject his motion to dismiss as a baseless gripe.

CONCLUSION
Dr. Duboy has failed to set forth a viable basis for summary judgment based on duty. He

himself admitted that he did owe her a duty, and controlling Florida Supreme Court precedent

indisputably applies. Dr. Duboy’s incorporated Motion to Dismiss is simply illegitimate, is
procedurally improper, and advances no legal or factual basis for dismissal. The court should
deny Dr. Duboy’s Motion in its entirety.

CERTIFICATE OF SERVICE

I HEREBY CERTIFY that a true and correct copy of the foregoing was filed with the
Florida Court’s E-Filing Portal on this 7 day of January, 2022, which will send an automatic e-
mail message to the following parties registered with the e-Filing Portal system: Jonathan M.
Midwall, Esquire, jonathan.midwall@csklegal.com and Alyssa Tornberg, Esquire,
ALYSSA LOTOELA@CSKIERAL.COi aid Gia garca@esKiegar.com, Core, Scott & Kissaiie, P.A.,
9150 South Dadeland Boulevard, Suite 1400, P.O. Box 569015, Miami, FL 33256, Counsel for
Defendant Life Changes Addiction Treatment Center of The Palm Beaches; Jeanine Beattie,
ARNP; Noelle Sheehan, Esquire Noelle.Sheehan@wilsonelser.com;
alyssa.heitman@wilsonelser.com; Denise.lendway@wilsonelser.com, Wilson Elser Moskowitz
Edelman & Dicker LLP, 111 North Orange Avenue, Suite 1200, Orlando, FL 32801, Counsel for
Defendant Emilio Duboy, MD; and via U.S. Mail and Email to: John Brogan
jbrogan@lifelinerss.com, Lifeline Recovery, LLC, 136 Newark Avenue, Lavallette, NJ 08735.

Respectfully submitted,

15LEESFIELD SCOLARO, P.A.
Attorneys for Plaintiff
2350 South Dixie Highway
Miami, Florida 33133
Telephone: 305-854-4900
Facsimile: 305-854-8266
Email: scolaro@leesfield.com
graham@leesfield.com
arguello@leesfield.com

By: _/s/Thomas Graham
Thomas Scolaro, Esq.
Fla. Bar No. 178276
Thomas D. Graham, Esq.
Fla. Bar No. 89043

16EXHIBIT A

AFFIDAVIT OF AMY HARRINGTON, M.D,

 

1. My name is Amy Harrington. I am more than 18 years of age and of sound mind,
and I render and affirm the statement below of my own free will.

2. The portions of my education, training, experience, and scholarly works pertinent
to the opinions I express below appear in the attached Curriculum Vitae, the entirety of which 1
incorporate herein by reference.

3. The opinions expressed in this affidavit are based upon my personal knowledge.

Including my knowledge of the substance use disorder care and treatment rendered to Michelle

4

 

Dalenenen ne fe avelndnn aL thn abn Anal AL mnun Dan the bunaten ct aL mbinte nn ee Bond oon
DAIZALAII, Gait SHOWISUE O1 US Sranuaiu O1 Cale 10F UIE Learnt Gr SUOSAICE USE GASOTUEIS:

 

and my clinical experience working in this field for over a decade,

4, Iam a medical doctor and hold board certification in General Psychiatry and
Addiction Psychiatry. I am an Assistant Professor of Psychiatry at the University of
Massachusetts Medical School, and I am the Associate Director of the Addiction Psychiatry
Fellowship Program. I am also the Medical Director for Ambulatory Psychiatry at UMass
Memorial Healthcare. Prior this position, 1 was the Medical Director for Addiction Services at
Community Healthlink, a UMass Memorial affiliated community mental health center. I am
currently authorized and licensed to actively practice medicine in the State of Massachusetts. I
hold a valid certificate to serve as an expert witness in Florida.

5. This affidavit is made following my review of pleadings in this matter, including
Defendant Life Changes Addiction Treatment Center of the Palm Beaches and Janine Beattie
ARNP’s Motion for Summary Judgment; Defendant Emilio Duboy, M.D.’s Motion for Summary
Judgment; Michelle Balzarano’s chart from Life Changes Addiction Treatment Center (“Life

Changes”), the deposition transcripts of Emilio Duboy and Janine Beattie, the depositiontranscript of Mary Coumbe; as well as my background, training, and extensive clinical
experience in the day to day practice of substance use disorder treatment and relapse prevention
for individuals suffering from addiction. These documents, records, and sources of information
are incorporated hereto by reference,

6. At the time she was a client/resident at Life Changes, Michelle Balzarano was a
suffering from drug use disorder and mental health issues and her ability to provide for her own
care and protection was impaired, Michelle Balzarano was offered the opportunity to attend Life

Changes following an arrest. She left her home state of New Jersey to attend Life Changes in

Tlavida Cha wine alana in Dlacida etthant ftnnda nu famstler
Vidliaa, oe Was a10le-ii Luiida Wiuivut Wisius OF lairuLy.

7. At the time of her admittance to life changes Michelle Balzarano was suffering
from Bipolar disorder.

8. To manage her mental health conditions Michelle Balzarano was taking
psychotropic medications, including at the time of discharge from Life Changes: topiramate,
quetiapine and olanzapine.

9. Michelle Balzarano needed these medications to manage her mental health
condition and to function normally.

10. Life Changes through its facility, employees, and agents, including Dr. Emilio
Duboy and Nurse Janine Beattie was entrusted and assumed the responsibility for providing care
and services to Michelle Balzarano.

11. Life Changes had a duty to exercise reasonable care in the provision of its medical
and non-medical substance use disorder treatment and services rendered to Michelle Balzarano.

12. Dr. Duboy is a licensed medical doctor practicing in the area of psychiatry. He

was employed by Life Changes as its medical director. He provided psychiatric care andtreatment for Michelle Balzarano, developed a treatment plan for Michelle Balzarano, and at all

times had a physician patient relationship with Michelle Balzarano. During his course and
treatment of Michelle Balzarano he made changes to her psychotropic medication regimen, and
he was fully aware of her prescription medication needs. Dr. Duboy had a duty to exercise
reasonable care in his care and treatment of Michelle Balzarano. This includes a duty to provide
her with sufficient amounts of psychotropic medications upon discharge to manage her mental
health conditions for a reasonable amount of time until an out-patient provider could be

established. It also includes a duty to provide her with referrals to qualified medical

wn,

net. When

  

nunfasaianala ta tha a».
PLOWSsKONGID I US Ot

  

   

hier ieita Tealin Heeas We
discharging a patient from substance use disorder treatment to a half-way house and the
expectation is that the. half-way house will arrange for out-patient psychiatric follow-up, the
standard of care is to discharge the patient with 30 days and 1 refill of all psychiatric medications
as this is a reasonable amount of time for a patient to establish out-patient psychiatric treatment.
The role of an emergericy department is to assess for appropriate level of care, and if a patient
requires in-patient psychiatric hospitalization to arrange for that level of care. It is not the
standard of care for an emergency department to arrange for outpatient psychiatric care for
patients appropriate for outpatient level of care, therefore an evaluation in an emergency
department setting would not negate the obligation of Life Changes to ensure a patient had a
reasonable supply of medication to last until outpatient services could be established.

13. Nurse Janine Beattie is a licensed ARNP. She was emploved by Life Chanpes as
a nurse. She had a nurse practitioner-patient relationship with Michelle Balzarano. Nurse

Beattie was aware of Michelle Balzarano’s medication needs, and ordered medications for

Michelle Balzarano while she was her patient. Nurse Beattie had a duty to exercise reasonablecare in her care and treatment of Michelle Balzarano. This includes a duty as a primary care
provider who has received consultation from an expert in treating mental health disorders to
provide her with sufficient amounts of psychotropic medications upon discharge to manage her’
mental health conditions based on the treatment plan set forth by the expert consultant. It also
includes a duty to link her with qualified medical professionals in the community to make sure
her mental health needs were met. Nurse Beattie had an obligation and duty to communicate on
behalf of Michelle Balzarano if an escalation in her care and treatment was needed, if additional

medications were needed, and if Michelle Balzarano had a medical condition that required care

hevand the scone of her nractice as a nrimary care APRN that an annronsiataly cualifiad
Sey oe py Va awe panvuey Go W puluy Ge OMAN, UAL Gah Gppaupalalely QuauiTd

specialist was consulted to ensure all medical needs were being appropriately addressed.

14. Life Changes through its facility, employees, and agents, including Dr, Duboy
and Nurse Beattie, negligently provided substance use disorder care and treatment to Michelle
Balzarano and failed to provide her with an adequate discharge from its facility. Michelle
Balzarano was discharged from Life Changes with an inadequate supply of psychotropic
medications to manage her mental health needs, and she was not linked with a qualified
psychiatrist or specialist in the community to manage her needs.

15, The non-medical staff of Life Changes also had a duty to communicate on behalf
of Michelle Balzarano, and to ensure her prescriptions were filled and she had access to her
medication upon discharge. Additionally, the non-medical staff of Life Changes had a duty to
investigate and determine that the facility Michelle Balzarano would be transferred to was
equipped with a medical director and medical care and treatment necessary to manage Michelle
Balzarano’s mental health disorders. The non-medical staff, including Life Changes Clinical

Director, had a duty to ensure that the halfway house Michelle Balzarano was sent to wasequipped to handle her care, or otherwise ascertain that her medical, mental health, and
substance use disorder needs could be adequately managed at the facility.

16. The failure to properly discharge Michelle Balzarano and ensure that her medical
needs were met directly and proximately led to a decline in her mental health, an exacerbation of
her mental health symptoms, and ultimately her death by suicide.

17. Medical literature and studies clearly indicate that the depression increases an
individual's risk of attempting and completing suicide. (Ribeiro et al. 2018. Depression and

hopelessness as risk factors for suicide ideation, attempts, and death: a meta-analysis of

   

ry 212(5):279-286,) In addition, a mixed
depressive-hypomanic episode in a patient with Bipolar Disorder increases the risk of attempted
and completed suicide. (Miller and Black. 2020. Bipolar Disorder and Suicide: a Review.
Current Psychiatry Reports 22(2):6) Abruptly discontinuing mood stabilizing medication will
increase the likelihood that a patient with Bipolar disorder will experience a depressive or mixed
episode. Per the testimony of Michelle Columbe, Michelle Balzarano most likely experienced a
depressive episode soon after discharge from Life Changes, followed by mixed depressive-
hypomanic episode in the time-period preceding her death.

18. Within a reasonable degree of medical probability, had Michelle Balzarano been
adequately discharged and provided with sufficient amounts of medication to manage her
conditions, she would still be alive today. The breaches of the duties of care owed to Michelle

Balzarano by Life Changes, Janine Beattie, and Dr. Emilio Duboy, directly and proximately

caused Michelle Balzarano to suffer and die.FURTHER AFFIANT SAYETH NAUGHT.

 

STATE OF Elotides
COUNTY OF Midi i = Dede

Swor to and gnbscrihed before me via remote on this / igh day of TOWNIN uU. 2092.
Tne SOuF Wd

Oo OID

10

11

12

13
14

15
16

17

18
19

20
21
22
23
24

25

EXHIBIT B

 

Page 1

IN THE CIRCUIT COURT OF THE 15th
JUDICIAL CIRCUIT IN AND FOR PALM
BEACH COUNTY, FLORIDA
GENERAL JURISDICTION DIVISION

CASE NO.: 50-2018-CA-015763

BTTvADUME DAT TVADANN In At
Won DAUGARANU, LiCl

  

and as Personal Representative of the
Estate of Michele L. Balzarano,
Plaintiff,
vs.
LIFELINE RECOVERY, LLC, d/b/a
LIFELINE RECOVERY, SUPPORT
SERVICES, a Foreign Corporation; JOHN
BROGAN; LIFE CHANGES ADDICTION
TREATMENT CENTER OF THE PALM
BEACHES; WARBIRD PROPERTIES, LLC,
d/b/a CAMERON VILLA, LLC, a Florida
Corporation; EMILIO DUBOY, M.D.; and
JANINE BEATTIE, ARNP,
Defendants.

Sear /

Witness Location

1455 Villa Juno Drive North
Juno Beach, Florida 33458
Friday - November 19, 2021
10:07 - 11:47 a.m.

TWMpAMADEN NeNAetTMTAM An TATA Mo oAmammTn ana
VAUDULArDY URFUDLILUN UD UANIING M. DEALLIO, ANNE

- VIA ZOOM

Taken before Zuleika Berger, a Court Reporter
and Notary Public for the State of Florida at Large,
pursuant to Notice of Taking Videotaped Deposition

filed in the above cause.

 

 

 

Veritext Legal Solutions

800-726-7007 305-376-8800Page 2
1 APPEARANCES VIA ZOOM
2 Onbelulf ofthe Plaintiff
Tacefald Sonlarn DA

3 23508. Dixie Highway
‘Miami, Florida 33133
4

 

Graham@leesfieldcom
BY: THOMAS D. GRAHAM, ESQ.

5
‘Onbelulf of the Defendant - Life! Addiction

‘Changes.
6 ‘Treatment Center ofthe Palm Beaches and Janine
Beattie, ARNP.
7 Cole, Scott & Kissane, PA
10 SE. 6th Street, Suite 2700
8 Fort Lauderdale, Florida 33301

 

10 ESQ.
11 Onbelualf ofthe Defendant - Emilio Dubey, MD.:

‘Wilson Elser Moskowitz Edelman & Dicket, LLP
12 111 N Orange Avenue, Suite 1200

Orlando, Flosida 32801
13 Molly.darso@wilsonelser.com
BY: MOLLY J. DURSO, ESQ.
4

On behalf of the Defendant - Warbird Properties, LLC:
15 Nicole Sauvola, PA.

‘555 E. ComettRoad

16 East Tawas, Michigan 48730
Cotelaw36(

17 BY: NICOLE SAUVOLA-LAMAY, ESQ.
18

19 ALSOPRESENT:

20 Shanma Decker - Videographer.

a

Page 4
THE VIDEOGRAPHER: In the case styled

1
3 Recovery, LLC, etal. This is the video

4 deposition of Janine Beattie, ARNP, on November
5

6

7

8

  

19th 2021, the time is now 10:07 a.m.
‘Would counsel please state their
appearances for the record.
MR. GRAHAM: Thomas Graham on behalf of the
9 Plaintiff.
MS, TORNDERG, Alyssa Tomuueig Ou Leal OL

Life Changes Addiction Treatment Center of the

 

12 Palm Beaches and Janine Beattie, ARNP.

13 MS. DURSO: Molly Durso on behalf of Emilio

14 Duboy, MD.

15 MS. SAUVOLA-LAMAY: Nicole Sauvola-LaMay on
16 _ behalf of Warbird Enterprises.

JANINE BEATTIE, ARNP.
1S Was Caucd aS a Wimess by Wie Deenuais anu, having
19 been first duly swom and responding, "I do," was

20 examined and testified as follows:

21 DIRECT EXAMINATION

22 BY MR. GRAHAM:

 

2 23  Q Good moming, Ms. Beattie. How are you?
7 24 A. Good moming. I'm okay.
25 25  Q Good. Good. Did I say your name
Page 3 Page 5

I INDEX 1 correctly?

2 Examination Page 2 A. Yes.

3 Direct By Mr. Graham 04 3 Q. Allright. My name is Thomas Grabam, I

4 4 represent the family in this matter. Today is my

5 5 chance to take your deposition.

6 CERTIFIED QUESTION 6 Have you ever had a deposition taken

7 Page 74, Line 19: 7 before?

8 Qa Did you ever -- Were you ever dating or | 8 A. No, never.

9 romantically involved? 9  Q Okay. I'm gonna go over a few ground rules
10 10 with you to make this go as smooth as possible. As yo
IL 11 probably have realized there is a court reporter with
12 PROTECTIVE ORDER QUESTION | 12 us today typing down every word that is said and this

13 Page 76, Line 18:

14 Q > Whatis your current relationship with
15 either Mobarak?

16

 

13 is also being videoed, for that reason I need you to

14 make all of your answers out loud, oral responses, so
15 that it translates down into -- into written words that

16 can be typed; okay?

17 A. Okay.

18 Q. There are a lot of people on this

19 deposition so I'd ask that give a second in-between

20 each of my questions before responding that way we're
21 not talking over each other and if anyone wants to make
22 an objection they can; okay?

23 A. Sure.

24 = Q. This probably isn't gonna be a marathon but
25 if at point you wanna take a break I'm happy to

 

 

 

2 (Pages 2 - 5)

Veritext Legal Solutions

800-726-7007

305-376-8800Page 6
1 accommodate you; okay?
2 AD Thank von,
3 Q. Ifany of my questions seem unclear you can
4 let me know and I'll try to rephrase; okay?
5 A. Sure.
6 Q. Allright. And I just saw the screen
7 moving so I just wanna make sure you're all settled in.
8 A. Tmtrying to establish where my camera is.
9 It's my daughter's iPad that I'm using so...

19 Q, No—nonrohlem, These thinos hannen, so

LL just —~ It looks like 1 now you -- we cannot see a so
12 maybe you wanna press the video button.

13 A. Yeah. Give me one second, I pushed

14 something. Okay.

 

 

15 MS. TORNBERG: If you put it back the way
16 that it was it was perfect.

17 THE WITNESS: Well, this way I have to look
18 ta the side and Tean't lnk straioht ahead co T

19 think this is this better; is that okay for --

20 MS. TORNBERG: Okay.

21 THE WITNESS: Okay. Sorry.

22 BY MR. GRAHAM:

Page 8
I mean, we're — we're generally

Jevel nractitionere in — in the

eve, PIACHMORers 2

1 A. No,I--

      

3 profession.
4 Q And would you give me the benefit of your
5 background and training to become an ARNP, including
6 the education that you possess?
7 A. Sure. I-- I went to school for my
8 bachelor's in the science of nursing initially, and
9 then I worked as a registered nurse. You have to have
10 at least two vear's recictored nurse exnerience hefore
11 you can apply for NP school, but I worked I believe
12 about seven years before I went to NP school. And they
13 that was another two to three years of master’s level
14 preparation, involving about 800 clinical hours working)
15 with doctors and nurse practitioners, as well as
16 classroom requirements, and so it's about seven years

17 total of schooling and 800 hours of clinical training
MDs or — ar NPs to qualify —-

Q And—
20 A. --to qualify — to qualify to graduate.

21 And then you have to sit for your Florida State License
22 Boards and then your National Certification Boards.

 

 

2 A. Full name is Janine Beattie, Janine Marie

3 Beattie.

4 QQ. And what is your address?

5 A. My current address 1455 Villa Juno Drive

6 North, Juno Beach, Florida 33458.

7  Q  Itsmy understanding that you are an ARNP?

8. A. Comect.

9 Q. What does that mean?
10 A. Advanced Re — Registered Nurse
11 Practitioner, that means Iam a master's levelled
12 prepared registered nurse that functions more in the
13 capacity of a -- ofa doctor than a nurse, where you
14 can prescribe and diagnose and treat, whereas a nurse
15 you have to follow the doctor's orders. As an NP you
16 can create your own orders and a doctor oversees it.
17 Q Are ARNPs sometimes called like physician
18 extenders?
19 A. They're called mid-level practitioners,
20 usually PAs, physician assistants, are referred to in
21 that matter, but across the board nurse practitioners
22 and PAs are called mid-level practitioners. You're
23 sort of above a nurse and below a doctor, that's how --
24 QQ. Okay. Makes sense. I didn't mean to cut
25 you off there. Please go ahead and finish.

 

23 Q. Noneed to apologize. Are you ready? 23 Q. And that was gonna be my next question:
24 A. Yes. 24 What -- what licenses and certifications do you hold?
25 Q. Okay. Would you please state your full 25 +A. Iholda Florida State Registered Nurse
Page 7 Page 9
1 name? 1 license and an ARNP license and a national

 

2 certification as a nurse practitioner.

3 Q. The ARNP license, that's also issued by the

4 ~ the State of Florida?

5 A. Correct. They make you maintain your

6 registered nurse license as well as your advanced

7 registered nurse practitioner license.

8 Q. And did you hold both of those licenses in

9 2017?
10 A. Yes, Idid.
11 Q._ The case we're here about today occured
12 in-between essentially February and June of 2017, so my
13 questions today are gonna basically be relating to that
14 time period unless I specify otherwise; okay?
15 A. Okay.
16 Q. Some things we can probably agree upon, do
17 you agree with me that as a licensed ARNP you have a
18 duty and obligation to render acceptable and
19 appropriate care to your play -- to your patients?
20 A. Yes.
2 Q. [went through your answers to
22 interrogatories that we received yesterday which detail
23 your -- your work history and before we begin I
24 wonder -- I want to know if you have any sort of a
25 special emphasis or focus in substance abuse issues?

 

 

3 (Pages 6 - 9)

Veritext Legal Solutions

800-726-7007

305-376-8800Page 10

1 A. No,Ido not.
oO. How did vou -- how did you obt

3 position with Life ¢ Changes Treatment Center?

4 A. Iwas friends with a family member of the

5 owner who asked me to do a favor and help out. They

6 were a little - they had Dr. Duboy I believe but

7 didn't have a nurse practitioner to help, and so I was

8 volunteering actually at that time on an as-needed

9 basis when I could, I was working somewhere else as
10 well, so it was more of a -- a favor at that time

ll Q I kind of wanna unpack that a little bit.

12 So you were friends with a family member of the owner
13 who is the owner -- who is the owner?

your

 

 

Page 12
1 could really do at that time because I had another, you
2. know, igh at that tim: w me
3 was available to help out I would come in, so it was
4 like a PRN basis, I would say about once a week.

 

5 Q. What does PRN mean?
6 A. Asneeded.
7 Q. Where was your other job that you held

8 during this same time period?

9 A. Iworked at Gardens Medical Group, it was
10 an intemal medicine practice in Palm Reach Gardens,
11 Florida.

12 Q. I'm assuming that that position was a --
13 was a paid position?

 

 

 

 

 

14 A. Yusef Mobarak. 14 A. Correct.
15 Q. Lhate to do this, but can you spell that 15 Q. How many days a week would you work with
16 forme? 16 Gardens Medical?
W A. First or last or both? 17 A. Five days a week.
18 Q. Can von do both nlease? 18 Q. Monday throngh Friday?
19 A. Yusefis Y-U-S-E-F. Mobarak, "M" as in 19 A. Yes.
20 Mary, O-B as in Bob, A-R-A-K as in kite. 20 Q. Would you work 40 hours a week or would it
21 Q. And you were friends with one of Yusef's 21 vary?
22 family members? 22 A. It would vary.
23 A. Correct. His... 23 Q. Sometimes more?
24 Q. Whois that? 24 A. No, never more.
25 A. His father. 25 Q. Did you ever work weekends for Gardens?
Page 11 Page 13
1 Q And what is his father's name? 1 A. No,I did not.
2 A. Martin, M-A-R-T-I-N, same last name. 2 When you were asked to -- to begin working
3  Q. During your time with Life Changes were you 3 at Lift Changes by Mr. Mobarak did it seem to you that]
4 ever paid, were you ever given any type of compensation 4 they were understaffed?
5 of was it completely a volunteer basis? 5 MS. TORNBERG: Objection to form.
6 A. I volunteered for some time. I can't 6 Go ahead and answer if you can.
7 recall how long that was. At some point I did 7 ‘THE WITNESS: That was muffled, I didn't
8 transition into a - a paid employee. 8 hear the iast part.
9 —Q Do~do you know one way or the other if 9 MS. TORNBERG: Sorry, I just objected to

10 you were paid prior to the discharge of Michele

11 Balzarano, which occurred on April 11th of 20177
12 A. No, Iwasnot being paid at that time.
13 Q_ When did you begin receiving a paycheck

14 from Life Changes?

15 A. I don't recall the specific date.
16 Q When did you~ Strike that.
17 According to your resumé, which I can put

18 up on the screen if that helps you. It looks like you
19 began with Life Changes in January of 2017; does that

 

 

10 the form of the question. I'm gonna do that from
3 time to time, but unless I tell you not to answer
12 the question you can go ahead and answer it if
13 you can.

14 THE WITNESS: Okay. So could you repeat
15 the question then again, sorry?

16 BY MR. GRAHAM:

17 Q Sure. When you were asked by Mr. Mobarak
18 to come