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Filing # 67016235 E-Filed 01/25/2018 10:37:05 AM
IN THE CIRCUIT COURT OF THE
17 JUDICIAL CIRCUIT, IN AND FOR
BROWARD COUNTY, FLORIDA
CIVIL DIVISION
CASE NO.,; CACE-18-001878
JESUS CABRERA as Personal
Representative of the Estate of
RAMON CABRERA, Deceased,
Plaintiff,
vs.
JACK MICHEL, M.D., REHABILITATION
CENTER AT HOLLYWOOD HILLS, LLC.,
HOLLYWOOD PROPERTY INVESTMENTS, LLC.,
and LARKIN COMMUNITY HOSPITAL, INC. d/b/a
LARKIN COMMUNITY HOSPITAL,
Defendants.
/
PLAINTIFF’S NOTICE OF SERVING INTERROGATORIES TO DEFENDANT,
LARKIN COMMUNITY HOSPITAL, INC. d/b/a LARKIN COMMUNITY HOSPITAL
COMES NOW, the Plaintiff, JESUS CABRERA as Personal Representative of the Estate
of RAMON CABRERA, Deceased, by and through his undersigned counsel, and propounds to the
Defendant, LARKIN COMMUNITY HOSPITAL, INC. d/b/a LARKIN COMMUNITY HOSPITAL,
with the summons and complaint, and pursuant to F.R.C.P. §1.340, to answer, in writing and under
oath, the attached, set of Interrogatories, as prescribed by law.
DATED this 25th day of January, 2018.
FORD, DEAN & ROTUNDO, P.A.
Counsel for Plaintiffs
Turnberry Plaza, Suite 600
2875 NE 191st Street
Aventura, FL 33180
Telephone: (305) 670-2000
ile: (305) 670-1353
ddean.com
By: ™ =
WILLIAM A. DEAN, B.C.S.
Florida Bar No.: 118354
*4* FILED: BROWARD COUNTY, FL BRENDA D. FORMAN, CLERK 1/25/2018 10:37:04 AM.****PLAINTIFF’S NOTICE OF SERVING INTERROGATORIES TO DEFENDANT,
LARKIN COMMUNITY HOSPITAL, INC. d/b/a LARKIN COMMUNITY HOSPITAL
“Identify fully” means to state the full name, current or last known address, job title, social
security number, and relationship to the Plaintiff and Defendant.
Notes: The "Facility" refers to:"REHABILITATION CENTER AT HOLLYWOOD HILLS"
The "Resident" refers to: "RAMON CABRERA"
"AHCA" refers to: "Agency for Healthcare Administration"
All words used in any gender shall extend to and include all genders.
1. What is the name and address of the person answering these Interrogatories (and each person
assisting in answering interrogatories), if applicable, the person’s official position or
relationship with the party to whom the interrogatories are directed?
N
State the complete, correct legal name, (including all fictitious names and “d/b/a’s”), and
address of the owner of the Facility during the Resident's residency. If the owner is a
corporation, provide the state of incorporation and year it was incorporated; when it was
licensed to do business in the State of Florida; and, when it was licensed to operate the
nursing home under Chapter 400. If the Defendant was not licensed under Chapter 400 to
operate the nursing home while the Resident was at the Facility, please state the name and
address of the licensee.
3. For each lawsuit filed against the Facility for the past five (5) years, please state the caption
of the lawsuit, the court of jurisdiction and the court file number.
4. Does the Facility have liability insurance coverage that may cover it for the damages sought
in the Complaint? If so:
a. What is the name and address of the insurance company having coverage?
b. What is the extent of coverage provided in the policy or policies of insurance?
c. What is the policy number of each policy?
5. Is the insurance policy identified in the preceding interrogatory a "wasting policy"? If so,
state the amount of coverage left on the policy at the time the interrogatories are answered.10.
ll.
Are there any other claims being made on the policy referenced in the preceding
interrogatory. If so, state the number of competing claims, the names of the individuals
making those claims, the names, addresses and telephone numbers of the attorneys making
those claims and the status of settlement negotiations of those claims.
Describe any policy of insurance of any kind or nature not described in the preceding
interrogatories which may provide benefits to the Resident by reason of the incidents
described in the Complaint. Please include the name and address of the insurance company,
the extent of coverage provided in the policy or policies of insurance and the policy number
of each policy.
Provide the complete name and address of the first individual employed by the Facility to
assess the Resident’s overall health condition, including his/her neurologic status, upon
admission to the Facility, as well as the date of that assessment. If the Resident had multiple
admissions, provide the names and addresses of each individual that performed the
assessment, as well as the dates of the assessments.
Provide the complete name and address of the last individual employed by the Facility to
assess the Resident’s overall health condition, including his/her neurologic status, prior to
discharge from the Facility, as well as the date of that assessment. If the Resident had
multiple admissions, provide the names and addresses of each individual that performed the
assessment, as well as the dates of the assessments.
Provide the complete names and addresses of all individuals that recorded that the Resident
suffered a change in her neurologic status. Provide the date that the observation was made.
State whether the Facility employed any management organization/company to assist in the
management or operation of the Facility while the Resident was at the Facility. If so, please
state: the name and address of the management organization; the type of service that it
performed; whether the nursing staff was employed by the Facility or by the management
company and the basis for the statement as to who the employer was; whether or not that
organization has a policy of insurance; and, whether or not the Facility is a “named insured”
on that policy of insurance.13.
14.
15.
16.
17.
Please identify fully each outside consultant utilized by the Facility, during the time the
Resident was at the Facility, including but not limited to dietary consultant, records
consultant, physical therapy consultant, nursing consultant, wound care specialists, laboratory
services or pharmacy consultant.
Did the Facility employ any material (whether written, by audio or video, or over the
Internet) to market, advertise or otherwise inform persons (including, but not limited to,
residents, potential residents, resident families, potential resident families, hospital
personnel, physicians or the general public) of the facility during the past five years? If so,
please identify with sufficient particularity to form the basis of a request for production, each
such brochure, advertisement or other material utilized during the time period for two years
before the admission of the Resident to the facility.
Provide the dates that the Resident was at the facility. If the Resident left the facility for more
than 24 hours, provide the date(s) he/she left, the date(s) he/she returned, the reason(s) he/she
left and the place(s) that he/she went to.
Does the Facility have in its custody or control any records of accidents or unusual incidents
referring in any way to the Resident, including but not limited to all reports of medication
errors, falls, injuries, treatment errors, skin breakdown, assaults or invasions by staff or
residents, and thefts of resident property? If the Facility has any such reports in its custody
or control, please state (1) the name of each such report, (2) the date of each such report (3)
any and all persons identified in each such report, (4) the name and job title of the individual
having custody or control report, and (5) the current location of each report.
Please list the date and substance of any investigation which the Facility knows or believes
was conducted by any governmental agency concerning the Resident, including, but not
limited to, the Agency for Health Care Administration, Long Term Care Ombudsman,
Department of Health and Rehabilitative Services, Department of Elder Affairs, Department
of Children and Family Services, or law enforcement offices, together with the name and
address of the agency that conducted the investigation.
Was the Resident ever a sampled resident or a subject of AHCA survey? Ifso, please state
the date of survey and the resident number.18.
19,
20.
21.
Did the facility utilize a computer system to maintain notes, records, communications,
billing, or any other information concerning the Resident or between the employees of the
facility during the Resident's stay at the Facility? If so, provide the complete name and
address of the corporate representative with the most knowledge concerning the computer
system.
Identify fully the following personnel employed by Facility (1) during the time the Resident
was at the Facility and (2) at the present time, and state the dates of service for each:
“Identify fully” means to state the full name, current or last known address, job title,
social security number, and relationship to the Plaintiff and Defendant. Where more
than one person fulfilled these duties during the residency, set forth the information
as to each and the applicable dates.
Administrator Assistant Administrator
Director of Nursing Assistant Director of Nursing
Personnel Director Person responsible for billing
for goods and/or services
Person responsible for purchasing
goods and/or services Medical Director
Head of the Wound Care
Department/Team
Did the Resident receive care of treatment by a home health agency or home health aide or
outside nurse while he/she was a resident at the Facility? If so, provide the complete name
and address of the individual or entity that was providing the care and the dates that care was
given.
Did the Resident suffer any signs or symptoms of a stroke while a resident at the facility. If
so, please identify each and every such incidence of a change in condition which would be
consistent with a stroke, including the date that the change in condition was noted, the name
and address of the individual that noted the change in condition, the cause of the change in
condition and how the change in condition was treated.22.
N
is)
24,
25.
26.
Provide the complete name and address of the corporate representative with the most
knowledge concerning the creation and maintenance of the Resident's chart, (i.e. the
designated records custodian).
Have the records of the Resident been altered, changed, revised or rewritten in any manner
since the original records were made, contemporaneously with the treatment given? If so,
please state who made such alterations or revisions, when they were made, which pages of
the records contain such alterations or revisions, and the purpose of making such revisions
or alterations.
For each employee or agency staff having any contact with the resident, provide the
following:
a. The person's name, last known address, telephone number, social security number,
license number and position (¢.g. R.N., L.P.N., C.N.A.);
b. Whether the employee is currently employed by the Facility and if not, the date of
termination or departure;
c. If the person was agency staff, the name and address of the agency; and,
d. If the person made an entry in the Resident's chart, the dates of the last three entries
and the location within the chart of the entry.
If the Facility intends on calling any nurses, CNAs or other care providers who will testify
that they provided care in a fashion different than indicated in the records, please set forth
for each:
a. Name, address and job title of each person;
b. Summary of anticipated testimony;
c Page number from the medical records reflecting care that deviates from that they
claim that they provided.
Provide the complete name and address of the corporate representative with the most
knowledge concerning any and all laboratory testing that was performed on the Resident,
while at the facility.27.
28.
29.
30.
Provide the complete names and addresses of all individuals that assessed whether or not the
Resident had suffered a change in condition during her residency.
List the names, addresses, phone numbers and social security numbers of all persons believed
or known by you, your agents or attorney's to have any knowledge concerning any of the
issues raised by the pleadings and specify the subject matter about which the witness has
knowledge.
Do you contend that any individual or entity not named as a party to this action, including
any Fabre person or entity, was at fault in causing the injuries or damages about which the
Plaintiff complains and which are set forth in the Complaint? If so, please state the
following:
a. The name(s) and address(es) of such individuals or entities.
b. All facts upon which you rely to support your contention that those named in a.
above, were at fault.
c. The names and addresses of all witnesses with knowledge or opinion, or both, to
support your contention that those named in a., above, were at fault in causing the
Plaintiff's injuries and damages.
d. The percentage of fault you attribute to those named in a., above, and the factual
basis for such apportionment.
Identify the complete name and address of the individual or entity that owns the property
upon which the facility is located.
Does the facility have a surveillance system in the facility? If so, identify the corporate
representative with the most knowledge concerning the operation of that system.STATE OF FLORIDA )
)ss
COUNTY OF )
BEFORE ME, the undersigned authority, personally appeared . who, after being
first duly sworn, and from his/her/their own personal knowledge, deposes and says that the answers
to Interrogatories attached hereto are true and correct to the best of his/her/their knowledge,
information and belief.
The foregoing, was acknowledged before me this day of > 2018, by
() who is personally known to me, or
() who has produced as identification, and who () did() did
not take an oath.
NOTARY PUBLIC
My Commission Expires:
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Filing # 67016235 E-Filed 01/25/2018 10:37:05 AM IN THE CIRCUIT COURT OF THE 17 JUDICIAL CIRCUIT, IN AND FOR BROWARD COUNTY, FLORIDA CIVIL DIVISION CASE NO.,; CACE-18-001878 JESUS CABRERA as Personal Representative of the Estate of RAMON CABRERA, Deceased, Plaintiff, vs. JACK MICHEL, M.D., REHABILITATION CENTER AT HOLLYWOOD HILLS, LLC., HOLLYWOOD PROPERTY INVESTMENTS, LLC., and LARKIN COMMUNITY HOSPITAL, INC. d/b/a LARKIN COMMUNITY HOSPITAL, Defendants. / PLAINTIFF’S NOTICE OF SERVING INTERROGATORIES TO DEFENDANT, LARKIN COMMUNITY HOSPITAL, INC. d/b/a LARKIN COMMUNITY HOSPITAL COMES NOW, the Plaintiff, JESUS CABRERA as Personal Representative of the Estate of RAMON CABRERA, Deceased, by and through his undersigned counsel, and propounds to the Defendant, LARKIN COMMUNITY HOSPITAL, INC. d/b/a LARKIN COMMUNITY HOSPITAL, with the summons and complaint, and pursuant to F.R.C.P. §1.340, to answer, in writing and under oath, the attached, set of Interrogatories, as prescribed by law. DATED this 25th day of January, 2018. FORD, DEAN & ROTUNDO, P.A. Counsel for Plaintiffs Turnberry Plaza, Suite 600 2875 NE 191st Street Aventura, FL 33180 Telephone: (305) 670-2000 ile: (305) 670-1353 ddean.com By: ™ = WILLIAM A. DEAN, B.C.S. Florida Bar No.: 118354 *4* FILED: BROWARD COUNTY, FL BRENDA D. FORMAN, CLERK 1/25/2018 10:37:04 AM.****PLAINTIFF’S NOTICE OF SERVING INTERROGATORIES TO DEFENDANT, LARKIN COMMUNITY HOSPITAL, INC. d/b/a LARKIN COMMUNITY HOSPITAL “Identify fully” means to state the full name, current or last known address, job title, social security number, and relationship to the Plaintiff and Defendant. Notes: The "Facility" refers to:"REHABILITATION CENTER AT HOLLYWOOD HILLS" The "Resident" refers to: "RAMON CABRERA" "AHCA" refers to: "Agency for Healthcare Administration" All words used in any gender shall extend to and include all genders. 1. What is the name and address of the person answering these Interrogatories (and each person assisting in answering interrogatories), if applicable, the person’s official position or relationship with the party to whom the interrogatories are directed? N State the complete, correct legal name, (including all fictitious names and “d/b/a’s”), and address of the owner of the Facility during the Resident's residency. If the owner is a corporation, provide the state of incorporation and year it was incorporated; when it was licensed to do business in the State of Florida; and, when it was licensed to operate the nursing home under Chapter 400. If the Defendant was not licensed under Chapter 400 to operate the nursing home while the Resident was at the Facility, please state the name and address of the licensee. 3. For each lawsuit filed against the Facility for the past five (5) years, please state the caption of the lawsuit, the court of jurisdiction and the court file number. 4. Does the Facility have liability insurance coverage that may cover it for the damages sought in the Complaint? If so: a. What is the name and address of the insurance company having coverage? b. What is the extent of coverage provided in the policy or policies of insurance? c. What is the policy number of each policy? 5. Is the insurance policy identified in the preceding interrogatory a "wasting policy"? If so, state the amount of coverage left on the policy at the time the interrogatories are answered.10. ll. Are there any other claims being made on the policy referenced in the preceding interrogatory. If so, state the number of competing claims, the names of the individuals making those claims, the names, addresses and telephone numbers of the attorneys making those claims and the status of settlement negotiations of those claims. Describe any policy of insurance of any kind or nature not described in the preceding interrogatories which may provide benefits to the Resident by reason of the incidents described in the Complaint. Please include the name and address of the insurance company, the extent of coverage provided in the policy or policies of insurance and the policy number of each policy. Provide the complete name and address of the first individual employed by the Facility to assess the Resident’s overall health condition, including his/her neurologic status, upon admission to the Facility, as well as the date of that assessment. If the Resident had multiple admissions, provide the names and addresses of each individual that performed the assessment, as well as the dates of the assessments. Provide the complete name and address of the last individual employed by the Facility to assess the Resident’s overall health condition, including his/her neurologic status, prior to discharge from the Facility, as well as the date of that assessment. If the Resident had multiple admissions, provide the names and addresses of each individual that performed the assessment, as well as the dates of the assessments. Provide the complete names and addresses of all individuals that recorded that the Resident suffered a change in her neurologic status. Provide the date that the observation was made. State whether the Facility employed any management organization/company to assist in the management or operation of the Facility while the Resident was at the Facility. If so, please state: the name and address of the management organization; the type of service that it performed; whether the nursing staff was employed by the Facility or by the management company and the basis for the statement as to who the employer was; whether or not that organization has a policy of insurance; and, whether or not the Facility is a “named insured” on that policy of insurance.13. 14. 15. 16. 17. Please identify fully each outside consultant utilized by the Facility, during the time the Resident was at the Facility, including but not limited to dietary consultant, records consultant, physical therapy consultant, nursing consultant, wound care specialists, laboratory services or pharmacy consultant. Did the Facility employ any material (whether written, by audio or video, or over the Internet) to market, advertise or otherwise inform persons (including, but not limited to, residents, potential residents, resident families, potential resident families, hospital personnel, physicians or the general public) of the facility during the past five years? If so, please identify with sufficient particularity to form the basis of a request for production, each such brochure, advertisement or other material utilized during the time period for two years before the admission of the Resident to the facility. Provide the dates that the Resident was at the facility. If the Resident left the facility for more than 24 hours, provide the date(s) he/she left, the date(s) he/she returned, the reason(s) he/she left and the place(s) that he/she went to. Does the Facility have in its custody or control any records of accidents or unusual incidents referring in any way to the Resident, including but not limited to all reports of medication errors, falls, injuries, treatment errors, skin breakdown, assaults or invasions by staff or residents, and thefts of resident property? If the Facility has any such reports in its custody or control, please state (1) the name of each such report, (2) the date of each such report (3) any and all persons identified in each such report, (4) the name and job title of the individual having custody or control report, and (5) the current location of each report. Please list the date and substance of any investigation which the Facility knows or believes was conducted by any governmental agency concerning the Resident, including, but not limited to, the Agency for Health Care Administration, Long Term Care Ombudsman, Department of Health and Rehabilitative Services, Department of Elder Affairs, Department of Children and Family Services, or law enforcement offices, together with the name and address of the agency that conducted the investigation. Was the Resident ever a sampled resident or a subject of AHCA survey? Ifso, please state the date of survey and the resident number.18. 19, 20. 21. Did the facility utilize a computer system to maintain notes, records, communications, billing, or any other information concerning the Resident or between the employees of the facility during the Resident's stay at the Facility? If so, provide the complete name and address of the corporate representative with the most knowledge concerning the computer system. Identify fully the following personnel employed by Facility (1) during the time the Resident was at the Facility and (2) at the present time, and state the dates of service for each: “Identify fully” means to state the full name, current or last known address, job title, social security number, and relationship to the Plaintiff and Defendant. Where more than one person fulfilled these duties during the residency, set forth the information as to each and the applicable dates. Administrator Assistant Administrator Director of Nursing Assistant Director of Nursing Personnel Director Person responsible for billing for goods and/or services Person responsible for purchasing goods and/or services Medical Director Head of the Wound Care Department/Team Did the Resident receive care of treatment by a home health agency or home health aide or outside nurse while he/she was a resident at the Facility? If so, provide the complete name and address of the individual or entity that was providing the care and the dates that care was given. Did the Resident suffer any signs or symptoms of a stroke while a resident at the facility. If so, please identify each and every such incidence of a change in condition which would be consistent with a stroke, including the date that the change in condition was noted, the name and address of the individual that noted the change in condition, the cause of the change in condition and how the change in condition was treated.22. N is) 24, 25. 26. Provide the complete name and address of the corporate representative with the most knowledge concerning the creation and maintenance of the Resident's chart, (i.e. the designated records custodian). Have the records of the Resident been altered, changed, revised or rewritten in any manner since the original records were made, contemporaneously with the treatment given? If so, please state who made such alterations or revisions, when they were made, which pages of the records contain such alterations or revisions, and the purpose of making such revisions or alterations. For each employee or agency staff having any contact with the resident, provide the following: a. The person's name, last known address, telephone number, social security number, license number and position (¢.g. R.N., L.P.N., C.N.A.); b. Whether the employee is currently employed by the Facility and if not, the date of termination or departure; c. If the person was agency staff, the name and address of the agency; and, d. If the person made an entry in the Resident's chart, the dates of the last three entries and the location within the chart of the entry. If the Facility intends on calling any nurses, CNAs or other care providers who will testify that they provided care in a fashion different than indicated in the records, please set forth for each: a. Name, address and job title of each person; b. Summary of anticipated testimony; c Page number from the medical records reflecting care that deviates from that they claim that they provided. Provide the complete name and address of the corporate representative with the most knowledge concerning any and all laboratory testing that was performed on the Resident, while at the facility.27. 28. 29. 30. Provide the complete names and addresses of all individuals that assessed whether or not the Resident had suffered a change in condition during her residency. List the names, addresses, phone numbers and social security numbers of all persons believed or known by you, your agents or attorney's to have any knowledge concerning any of the issues raised by the pleadings and specify the subject matter about which the witness has knowledge. Do you contend that any individual or entity not named as a party to this action, including any Fabre person or entity, was at fault in causing the injuries or damages about which the Plaintiff complains and which are set forth in the Complaint? If so, please state the following: a. The name(s) and address(es) of such individuals or entities. b. All facts upon which you rely to support your contention that those named in a. above, were at fault. c. The names and addresses of all witnesses with knowledge or opinion, or both, to support your contention that those named in a., above, were at fault in causing the Plaintiff's injuries and damages. d. The percentage of fault you attribute to those named in a., above, and the factual basis for such apportionment. Identify the complete name and address of the individual or entity that owns the property upon which the facility is located. Does the facility have a surveillance system in the facility? If so, identify the corporate representative with the most knowledge concerning the operation of that system.STATE OF FLORIDA ) )ss COUNTY OF ) BEFORE ME, the undersigned authority, personally appeared . who, after being first duly sworn, and from his/her/their own personal knowledge, deposes and says that the answers to Interrogatories attached hereto are true and correct to the best of his/her/their knowledge, information and belief. The foregoing, was acknowledged before me this day of > 2018, by () who is personally known to me, or () who has produced as identification, and who () did() did not take an oath. NOTARY PUBLIC My Commission Expires: