EXHIBIT(S) - R (Motion #2) Upstate Surgical Group records Possible SSN Administratively Redacted - Upstate Surgical Group records Possible SSN Administratively Redacted January 15, 2021 (2024)

 
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 FILED: ONONDAGA COUNTY CLERK 01/15/2021 12:23 PM INDEX NO. 2015EF3692NYSCEF DOC. NO. 63 RECEIVED NYSCEF: 01/15/2021 • UPSTATE SURGICAL GROUP, P.C . . 5100 W. TAFT ROAD, SUITE 2E LIVERPOOL, NY 13088 (315)-634-3399 Summary of Todays Visit Marlene Claps February 5, 2014 Visit with B. Sivakumar,M.D. Problem List Hernia Ventral lncisional (553.21) Stomach And Duodenum Disorder Other (537.89) Esophageal Reflux (530.81) Diarrhea (787.91) Pain Abdominal Generalized (789.07) Allergies Penicillin; Erythromycin Medications ,. Continue B. Sivakumar,M.D. Prevacid : 30 mg, 1 in evening via jtube • Ability : 2 mg, 1 in in the morning via jtube POPILEVSKAYA, YANA RPA-C Reglan : 5 mg, 1 tab by mouth every 6 hours Zupleriz : 4 mg, 1 strip every 6 hours as need Prochlorperazine Maleate : 5 mg, 1 TAB by mouth Q6HR,PRN Carafate: 1 gm/10ml, 10cc by mouth three times a day Scopolamine Transdermal : 1.5mg, 1 patch q72 hours, Dexilant : 30 mg, 1 by mouth every day Sertraline HCL : 100 mg, 2 tab oral daily Oxycodone HCL : 5 mg, 1-2 tablets orally every four hours as needed for pain Promethazine HCL : 12.5 mg, 1 by mouth every 6hr, as need Promethazine HCL: 12.5 mg, 1 tab by mouth q6hr,prn Lidocaine HCL : , apply around the tube daily, as need Valium : 5 mg, 1 by mouth night before procedure and 1 tab by mouth 1 hour prior to procedure Wheelchair : , use as directed Bactrim DS: 800-160 mg, 1 by mouth twice a day x 10 Nystatin : 100000 Unit/ML, swish and swallow 4-6 mis 4 times a day Silvadene : 1 %, apply to affected area once a day and as needed Diflucan : 200 mg, 1 by mouth x 10 days Abdominal Binder/Elastic/Medium : , use as directed Bupropion HCL : 100 mg, 1 pills oral or jtube daily Ventolin HFA : 108 (90 Base) mcg/Act, 1 puff three times a day as need Phenergan : 25 mg, 1 tab by mouth every 6 hours for nausea Zofran: 8 mg, 1 tab sl every 6hrs, as need ROBERTSON,MYA,FNP , Lortab : 5-500 mg, 1-2 by mouth every 4 hours for pain as needed • Flexeril : 5 mg, 1 by mouth tid,prn · Wellbutrin SR : 150 mg, 1 tab oral daily Unspecified PrescriberFILED: ONONDAGA COUNTY CLERK 01/15/2021 12:23 PM INDEX NO. 2015EF3692NYSCEF DOC. NO. 63 RECEIVED NYSCEF: 01/15/2021 • Abilify Sentradine : 150 mg Bupropion HCL Lamotrigine ER : 200 mg Omeprazole Crestor : 20 mg Calcium+ D Multivitamin Acidophilus Pearls Zolpidem Tartrate ER: 12.5 mg Tylenol : 325 mg Future Appointments 08/06/14 Wed 12:10p Loe: 2 Sivakumar,Balasubramaniam,MD Loe: 2 LIVERPOOL - NORTH MEDICAL CENTER UPSTATE SURGICAL GROUP · 5100 W. TAFT RD STE 2E LIVERPOOL, NY 13088-4885 Phone: (315)-634-3399 Fax: (315)-634-3481 Ins. Todays Options Aware We DO Not Par • •FILED: ONONDAGA COUNTY CLERK 01/15/2021 12:23 PM INDEX NO. 2015EF3692NYSCEF DOC. NO. 63 RECEIVED NYSCEF: 01/15/2021• HIATAL HERNIA What is a hiatal hernia? A hiatal hernia happens when part of your stomach bulges up through the diaphragm and into your chest. The diaphragm is a sheet of muscle_ that separates your belly (abdomen) from your chest. The hernia bulges through the diaphragm at a place called the hiatus. This is the opening in the diaphragm that the esophagus passes through. The esophagus is the tube that connects the throat to the stomach. There are three main types of hiatal hernia: sliding, paraesophageal and mixed. Most people who have a hiatal hernia have a sliding hiatal hernia. What causes a hiatal hernia? A hiatal hernia often is caused by weak muscles and tissue within and around the hiatus. In a sliding hiatal hernia, a small part of the stomach pushes through the diaphragm and into the chest. A valve between the esophagus and the stomach also moves up and away from the diaphragm. What are the symptoms? Most people who have a hiatal hernia have no symptoms. One symptom you may have is heartburn, which is an uncomfortable feeling of burning, warmth, or pain behind the breastbone. It is common to have heartburn. at night when you are trying to sleep. If you often have symptoms or they are severe, you may have Gastroesophageal Reflex Disease, or • GERO. A hiatal hernia can lead to GERO, and people often have both conditions at the same time. If you have pain behind your breastbone, it is important to make sure it is not caused by. a problem with your heart. The burning sensation caused by GERO usually occurs after you eat. Pain from the heart usually ~eels like pressure, heaviness, weight, tightness, squeezing, discomfort, or a dull ache. It occurs most often after you are active. How is a hiatal hernia diagnosed? A hiatal hernia is often diagnosed when you see your doctor or have tests for another health problem. If you have symptoms, your doctor will ask you questions about them. If your symptoms happen often and are severe, you may have Gastroesophageal Reflux Disease (GERO). If this is the case, your doctor may do more tests or give you medicine for GERO. How is it treated? If you have no symptoms, you don't need treatment. If you have mild symptoms, your doctor may suggest lifestyle changes and perhaps non-prescription medicines. Here are some things to try: - Change your eating habits. - It's best to eat several small meals instead of two or three large meals. - After you eat, wait 2 to 3 hours before you lie down. Late-night snacks aren't a good idea. - Chocolate, mint, and alcohol can make GERO worse. - Spicy foods, foods that have a lot of acid (like tomatoes and oranges) and coffee can make GERO symptoms worse in some people. If your symptoms are worse after you eat- a certain food, you may want to stop eating that food to see if your symptoms get • better . - Do not smoke or chew tobacco. - If you get heartburn at night, raise the head of your bed 6 in. (15 cm) to 8 in. (20 cm) byFILED: ONONDAGA COUNTY CLERK 01/15/2021 12:23 PM INDEX NO. 2015EF3692NYSCEF DOC. NO. 63 RECEIVED NYSCEF: 01/15/2021 • putting the frame on blocks or placing a foam wedge under the head of your mattress . (Adding extra pillows does not work.) - Do not wear tight clothing around your middle. - Lose weight if you need to. Losing just 5 to 1O pounds can help. If you often have symptoms or have severe symptoms, you may have GERO. Lifestyle changes may help, and your doctor may prescribe medicine. In severe cases, surgery can be used to pull the hernia back into the belly. · • • , '-FILED: INDEX NO. 2015EF3692 J16 / 14 ONONDAGA 04 : 57AM COUNTYIVERPOOL Gentiva-L CLERK .13154610Z96 01/15/2021131stsuesswo 12:23 PM eage a aNYSCEF DOC. NO. 63 RECEIVED NYSCEF: 01/15/2021 Patient: CI.AP5,MARLENE- 0B9529961 Clintan: foulm. MEEN i (RN) Patient Name (last, First) Client;No GLÃP$ MAREElin . a Transfer Summary Coverage Period From: 11/06/2013 To 01/04/2014 6 Ca Conference gED/C Summary SOC DATE: 07/09/2013 DC DATE. 12/31/2013 Serv ce Prwided and Classification (Check all services provided-lf discharged, fill in # of visits/96 ed by State.) g RN a PT a SLP a HHA g RT [fHe c penion G LP MN DOT a MSW PCA a NT D HousÉke er Primary Diagnosis Other Pertinent Diagnosis pysphagia constant nausea, mainutrition, G-tube, en feeding Cass Confetenc% atponded by teen Jaquint, RN Names/Titlesh acqueline yahelko, MCP Clinical Ascard Reviewed e±=y offatient's CedMpos Cne Pre¶ded, and Status éf Prchiarñs thyoughoutcourse of ceré: Pt. was originally admitted to 1 C after sus ery for a hiatal hemia. Post-operatively, pt had dysphagia, nausea, and was unable to eat enough to maintainebòdy weight. Pt. test SD Ibs., Went for a second opinion añd had a second surgery with the same result. Getube and htube were placed and pt. began enteral feedings. SN Instructed pt, oli equipment, dressing management, medicatiorils; Pt. ciontinues with enteral feedings at night due to cesent nausea which worsens when taking oral Input, Her weight it relatively 4table. she has been to Gastroenterologist and Neurosurgeon but n6 definitive diagnosis have been made. Pt, is knowledgeable about her current cate and is thdependent With it at this point. Goals let? Ves}$No , if no, e g ain Pt. has met the current goals. . COMPLETEfOR DISCHARGEfTIIA 5F£R 5 01Discharge to Home or Self O IOSent to Outpatient Rehab O 17 PatienUFamily N n- O 50 Discharge I to CH A Care O 11Transfer by Doctor Compliant D 51Discharged to Long-Term 02sentto Short-Term Request O 18Patient No Longer Care Facility Hospital O 12 Discharged for tack of Homebound O 52 Dischargedto Long-Term O 03 Sent to Skilled Nursing Progress O 19 Patient Refuses Further . Care Home Care Agency FacilitY O 13Discharged for Lack of Services O 53 Discharged to Departnent O 045entto intermediate Care Funds O 20 Expired of Social Services Facility O 14 Discharged for other O 40 Ex pired at Home O 54 Discharged to Community 05 Sent to a Different Type of Reason D 41Expired in Hospital, SNF, Agency Institution D 15 Patient Moved Out of Area ICF O 06 Sent Home with a Different O 16 Patient Has Achieved O 42 Expired, PlaceUnknown Provider Maximum Rehab Possible O 43Discharged to Federal 3 07 Left Against Medical Advice Hospital 709 Family/Friends Assume Responsibility Date of last visit/shift (Discharge/Transfer date): Last discipline out e Yes a No Specify: 5N 12/31/2013 12/11/2013 AdvanceDirective Exists:pyes tirNo . Specify: Pt. is a Full Code Referrals made to other communitf services? 0 Yes e Discharge/Transfer to: Self care No Comments/Specify1 Sutrametry 201 .44 9slf ian IVAKU ALAE1BRA Fax315È343395 DiscÌisme PlannerFILED: From ONONDAGA COUNTY CLERKThu01/15/2021 12:23 PM INDEX NO. 2015EF3692 Syracuse Gastro Feb 6 15:49:13 2014 Page 2 of 4NYSCEF DOC. NO. 63 RECEIVED NYSCEF: 01/15/2021 SyRAcusE C(A$TROENTEROLOGlCAL ASSOCIATES, RC. CNY Medical Center • 7nlrving Ave, Ste400 • Syracuse..NY 13210 • (316) 23446È/ • Fax (3î6) 2344808 • 8100 Oswego Road, Suite.140 • Liverpâol, NY 13090 • (315)'641-1966 • Fak (315) 234-6696 Clay Medical Cer ter .Corrrnunity Memorial Hospital • 150 Busad Street a Harnilton, NY 13346 (procedures only) MARKH..KASQWITZivI.D. MICHAEL.S.SIPPLE,M 1 pENNISW..REEDY,.M.D. DAylD S. KAPLAN.M.D.. |NT|KHABIQBAL..M.D. ADAMM. BERG.M.D. VINCENTLOCOcO. R.P.A:-C. NICOLED..S.INKLER..NP-C Date: 02/06/2014 03:15 PM Patient Name: MARLENE CLAPS Gender: Female Account #: 94018 DOB(age): 1952 (61) Provider: Vincent LoCoco, RPA-C Dennis W. Reedy, MD Referring Physician: MICHAEL J. BRODOWSKI 5008 BRITTONFIELD PKWY, EAST SYRACUSE, NY 13057 (315) 449-3800 (phone) (315) 449-0558 (fax) BALASUBRAMANIAM SIVAKUMAR 5100 W TAFT RD STE 2E, LIVERPOOL, NY 13088 (315) 634-3399 (phone) (315) 634-3481 (fax) Chief Complaint: difficulty swallowing History of Present Illness: patient with history of swallowiñg. She is a pleasant female status post paraesophageal hernia repair also history of • fundoplication. swallowing. She has had extensive She does have a J-tube surgical intervention and has been stuck with weight in place she takes Jevity and has increased loss and difficulty her tube feedings and her weight is up from lasting seen. Due to her history of difficulty swa!!owing repeat upper éñd090py revealing biliary fluid in her fundus. Her fundoplication was intact. She did have a mild essphageal stricture.patient did have empiric dilation with persistent symptoms. She also has difficulty sw± with liquids. Her local surgeon is sending her to Strong Memorial Hospital for second opinion next week. She has had prêvicus gastric intake study that was normal. she is unable to take Reglan because she takes Abilify. She also has an allergy to erythicrñycin. Past Medical History Medical Conditions: Acid Reflux Anemia Depression Fibrocystic breast disease HIatal hernia Hyperllpidemia Low Back Pain (chronic) Migraines Surgical Procedures: Ventral Hernia Repair, 6/25/2013 Bowel obstruction, 2013 Gallbladder removed, 1973 C-Section, 1978,1982 child birth, 1978,1982 J tube, 06-2013 esophageal digitation, 03-2013 Hiatal Hernia Repair, 01-17-2013 Torn Retina ACL Graft Dx Studies: Barium swallow, 2-26-13 Colonoscopy, 06-20127 Faxed on 2/6/2014 MARLENE CLAPS,94018FILED: ONONDAGA COUNTY CLERK 01/15/2021 12:23 PM INDEX NO. 2015EF3692 From Syracuse Gastro Thu Feb 6 15:49:13 2014 Page 3 of 4NYSCEF DOC. NO. 63 RECEIVED NYSCEF: 01/15/2021 CT Abdomen, Chest, 3-28-13 CT Scan, 2012,2013 • EGD, 01/28/2014, Stenosls In the gastroesophageal junction. (Dilation), Fluid in the fundus and Previous. Surgery in the cardla EGD, 04/16/2013, Food In the lncisura of the stomach and Hlatal Hernia Fecal Hemoccult Slides, 2012 Flexible Sigmoidoscopy, 10/12 Panendoscopy, 3-5-13 Sonogram, 03-2013 Upper GI Serles, 06-2012,03-2013 Medications: Abilify 2 mg Take 1 tablet by mouth once a day bupropion HCI 300 mg Take 1 tablet by mouth every morning Carafate 100 mg/ml l0ML PO Four times daily lamotrigine 200 mg Take 1 tablet by mouth once a day melatonin 5 mg 1/2 TAB PO AS NEEDED multivitamin with minerals 1 TAB PO DAILY omeprazole 40 mg 1 tab bid oxycodone 5 mg AS NEEDED sertraline 100 mg Take 2 tablet by mouth once a day Allergies: Erythromycln - MIid - hives Penlcllllns - MIid - hives Social History Alcohol: None Tobacco: Never smoker Drug: None Exercise: None Caffeine: None Marital Status: Married Occupation: Disability • Family History No history of Colitis, Colon Polyps, Gastrointestinal Cancer First Cousin: Diagnosed with COLON CA; First Cousin: Diagnosed with COLON CA; Paternal Grandfather: Diagnosed with Abdominal Cancer; Mother: Deceased; at age 50; Diagnosed with LUNG CANCER; Uncle: Deceased; Diagnosed with COLON CA; Maternal Grandmother: Deceased; Diagnosed with COLON CA; Other: Deceased; Diagnosed with Abdominal Cancer, COLON CA; Father: Deceased; at age 73; Diagnosed with STROKE (CVA); Review Of Systems: Allergic/Immunologic: Denies HIV exposure, persistent infections, strong allergic reactions or urticaria. Cardiovascular: Denies chest pain, dyspnea with exercise, irregular heart beat, orthopnea, palpitations, peripheral edema, syncope. · Constitutional: Denies fatigue, fever,. loss of appetite, malaise, sweats, weight gain, weight loss. ENMT: Complains of difficulty swallowing, sore throat. Denies dizziness, double vision, ear pain, loss of vision, nasal obstruction, nose bleeds, photophobia. Endocrine: Denies excessive thirst, hair loss, heat intolerance, thyroid disease. Gastrointestinal: Denies abdominal pain, abdominal swelling, change in bowel habits, constipation, diarrhea, gas, heartburn, jaundice, nausea, rectal bleeding, stomach cramps, vomiting. Genitourinary: Denies dark urine, decrease In urine flow, dysurla, frequent urinary Infections, frequent urination, hematurla, nocturia, urethral discharge or Incontinence. Hematologic/Lymphatic: Denies bleeding gums or palpable lymph nodes, easy bruising, prolonged bleeding. Integumentary: Denies allergies, dryness, hives, i_tching, jaundice, lesions, rashes. Musculoskeletal: Denies arthritis, back pain, gout, joint deformity, joint pain, muscle weakness, stiffness. Neurological: Denies dizziness, fainting, frequent headaches, migraine, numbness or tingling, seizures, tremors, vertigo. Psychiatric: Denies anxiety, depression, difficulty sleeping, hallucinations, nervousness, panic attacks, • paranoia . Faxed on 2/6/2014 MARLENE CLAPS, 94018, 11952FILED: From ONONDAGA COUNTY CLERK 01/15/2021 12:23 PM INDEX NO. 2015EF3692 Syracuse Gastro Thu Feb 6 15:49:13 2014 Page 4 of 4NYSCEF DOC. NO. 63 RECEIVED NYSCEF: 01/15/2021 Respiratory: Denies asthma, cough, dyspnea, excessive sputum, hemoptisis, shortness of breath with exercise, wheezing. • Vital Signs: BP Pulse Weight (lbs/oz) Height (ft/in) BMI (mmHg) (ppm) 108/64 68 131 / 5/2 23.96 Physical Exam: Constitutional: Appearance: well developed, well nourished, normal habitus, in no acute distress. Skin: Inspection: no rashes, ulcers, icterus or other lesions, no clubbing or telangiectasias. Head/face: Inspection: Normal. ENMT: . .. ··-··- -··-·--·- - -··-· - - - - - - - - - - - - External: normal external inspection of ears and nose. Lips/teeth/gums: normal. Neck: Examination: normal motion, central trachea. Jugular veins: normal. ,Extremities: Digits/Nails: no cyanosis, no clubbing. Inspection: no edema. Psychiatric: Judgment/insight: within normal limits. Memory: within normal limits for recent and remote events. Mood and affect: no evidence of depression, anxiety or agitation. Impression: DYSPHAGIA UNSP patient with difficulty swallowing even liquids at this point. She may benefit from a motility study of the esophagus. We'll await tardiothoracic surgeon in Rochester's opinion patient unable to take Reglan or erythromycin. empirically trial of Levsin as needed for possibly spasm Esophageal stricture ABO DIST/BLOAT Plan: Levsin 0.125 mg 1 po q4hrs as needed Follow-up with Dr. Reedy in 5 weeks Risk & Medical Necessity: The patient.requires Low to Moderate Severity care for this visit.Diagnosis and management options are Limited.The amount of data reviewed and/or ordered is Limited.The level of risk is Low. Vincent Lococo, RPA-C Dennis W. Reedy, MD Electronically signed on 2/612014 3:47:31 PM by Vincent LoCoco, RPA-C Please Note: This document was electronically signed and dictated utilizing Dragon naturally speaking software. A reasonable attempt at proofreading has been made to minimize errors. Please call with any questions or corrections . • Faxed on 2/6/2014 MARLENE CLAPS, 94018, 1952FILED: ONONDAGA COUNTY CLERK 01/15/2021 12:23 PM INDEX NO. 2015EF3692NYSCEF DOC. NO. 63 RECEIVED NYSCEF: 01/15/2021 • Patient: Marlene Claps DOB: 1952 Date: 2/5/14 History: Patient comes in for followup. She continues to gain weight. Her J tube is in place without any problem. She underwent a re-endoscopy that shows recurrence of a·small hiatal hernia . • Assessment: I discussed at length with the patient her course. I do not feel she qualifies for any surgical intervention at this time, as she had many issues with the previous attempted hiatal hernia repair. She still has cervical dysphagia. She will continue to nee_d dilatation. In my opinion she has done well enough not to attempt any further surgical procedure unless it becomes absolutely necessary. Plan: The patient will followup in six months. B. Sivakumar, M.D. cc: Michael Brodowski MD cc. Mark Kasowitz MD •FILED: ONONDAGA COUNTY CLERK 01/15/2021 12:23 PM INDEX NO. 2015EF3692NYSCEF DOC. NO. 63 2/28/2014 1:56 PM FROM: Fax TO: 9634-3481 PAGE: 001 OF 001 RECEIVED NYSCEF: 01/15/2021 301 Prospect Ave Syracuse, NY 13203 St. Josephs Hospital Health Center Medical Record Number: 1071388 - Account #: 3004014115 Deliver To: Patient: MARLENE M CLAPS THOMAS WATSON Patient Type: Outpatient a 601 ELMWOOD AVE BOX SURG ROCHESTER, NY, 14642 Gender: Female Date of Birth: 1952 Accession #: 2218564 Referred by: THOMAS JACK WATSON ______________________________________________________ CC:MICHAEL J BRODOWSKI CC:B SlVAKUMAR Study Information: 00099 - NM GASTRIC EMPTYlNG (SOLID) Accession # 2218564 Study Date: 02/28/2014 10:08 Comparison: None Indication: dysphagia Intra-procedural medications: The patient received Technetium-99m Colloid - Oral - 1 - mCi - - vm By Mouth -1000 Technique: planar imaging. Findin;;:: The time activity curve was plotted after oral ingestian of a solid meal containing radionuclide. The T1 half for solid gastric emptying is 130 minutes. This is delayed compared to the normal range of 83+/-25 minutes. It is however significantly improved compared to the March 21, 2013 examination, T1 half = 274 minutes. IMPRESSION: Abñ0rmai delayêd T1 half for solid gastric emptying of 130 minutes. This is still uiyñiiioant improved compared the March 2013 examination. Dictating Radiologist: John Teixeira Fri Feb 28 13:55:08 EST 2014 Transcribed by: John Teixeira Fri Feb 28 13:55:08 EST 2014 Approved by: John Teixeira Fri Feb 28 13:55:08 EST 2014 • St. Joseph's is sponsored by the Sisters of St. Francis MARLENE M CLAPS 2218564FILED: ONONDAGA COUNTY CLERK 01/15/2021 12:23 PM INDEX NO. 2015EF3692NYSCEF DOC. NO. 63 RECEIVED NYSCEF: 01/15/2021 UPSTATE SURGICAL GROUP, P.C. 5100 W. TAFT ROAD, SUITE 2E LIVERPOOL, NY 13088 (315)-634-3399 Summary of Todays Visit Marlene Claps March 5, 2014 Visit with POPILEVSKAYA, YANA RPA-C Problem List Hernia Ventral lncisional (553.21) Stomach And Duodenum Disorder Other (537.89) Esophageal Reflux (530.81) Diarrhea (787.91) Pain Abdominal Generalized (789.07) · Allergies Penicillin; Erythromycin Medications Continue POPILEVSKAYA, YANA RPA-C Nexium : 40 mg, 1 by mouth every day • Reglan : 5 mg, 1 tab by mouth every 6 hours Zuplenz : 4 mg, 1 strip every 6 hours as need Prochlorperazine Maleate: 5 mg, 1 TAB by mouth Q6HR,PRN Carafate : 1 gm/10ml, 10cc by mouth three times a day Scopolamine Transdermal : 1.5mg, 1 patch q72 hours, Dexilant : 30 mg, 1 by mouth every day Sertraline HCL : 100 mg, 2 tab oral daily · Oxycodone HCL : 5 mg, 1-2 tablets orally every four hours as needed for pain Promethazine HCL : 12.5 mg, 1 by mouth every 6hr, as need Promethazine HCL : 12.5 mg, 1 tab by mouth q6hr,prn lidocaine HCL : , apply around the tube daily, as need Valium : 5 mg, 1 by mouth night before procedure and 1 tab by mouth 1 hour prior to procedure Wheelchair : , use as directed Bactrim DS : 800-160 mg, 1 by mouth twice a day x 10 Nystatin : 100000 UniUML, swish and swallow 4-6 mis 4 times a day Silvadene : 1 %, apply to affected area once a day and as needed Diflucan : 200 mg, 1 by mouth x 10 days Abdominal Binder/Elastic/Medium : , use as directed Bupropion HCL : 100 mg, 1 pills oral or jtube daily Ventolin HFA: 108 (90 Base) mcg/Act, 1 puff three times a day as need Phenergan : 25 mg, 1 tab by mouth every 6 hours for nausea Zofran : 8 mg, 1 tab sl every 6hrs, as need ROBERTSON,MYA,FNP Lortab : 5-500 mg, 1-2 by mouth every 4 hours for pain as needed Flexeril : 5 mg, 1 by mouth tid,prn Wellbutrin SR : 150 mg, 1 tab oral daily • B. Sivakumar,M.D. Prevacid : 30 mg, 1 in evening via jtube Abilify : 2 mg, 1 in in the morning via jtubeFILED: ONONDAGA COUNTY CLERK 01/15/2021 12:23 PM INDEX NO. 2015EF3692NYSCEF DOC. NO. 63 RECEIVED NYSCEF: 01/15/2021 • Unspecified Prescriber Abilify Sentradine : 150 mg Bupropion HCL Lamotrigine ER : 200 mg Omeprazole Crestor : 20 mg Calcium+ D Multivitamin Acidophilus Pearls Zolpidem Tartrate ER: 12.5 mg Tylenol: 325 mg Future Appointments 08/06/14 Wed 12:10p Loe: 2 Sivakumar,Balasubramaniam,MD Loe: 2 . LIVERPOOL - NORTH MEDICAL CENTER UPSTATE SURGICAL GROUP 5100 W. TAFT RD STE 2E LIVERPOOL, NY 13088-4885 Phone: (315)-634-3399 Fax: (315)-634-3481 Ins. Todays Options • Aware We DO Not Par •FILED: ONONDAGA COUNTY CLERK 01/15/2021 12:23 PM INDEX NO. 2015EF3692NYSCEF DOC. NO. 63 RECEIVED NYSCEF: 01/15/2021 • Patient: Marlene Claps DOB: 1952 Date: 3/5/14 History: Patient presents for evaluation of a feeding tube for dysphagia and nausea. She will be seen by Dr. Watson in Rochester next week for further evaluation, but she is feeling some discomfort at the superior aspect of the J tube. She is tolerating tube feedings . • Physical Examination: The J tube is in place. There is mild erythema superior to the J tube but I am wondering how it is positioned and whether the fold of her skin is what is irritating that area. I deflated the balloon and reinflated it with 1.5 cc. of fluid and it flushed very well, no extravasation is noted. Patient tolerated this well. Plan: Will try to obtain a 5.0 length of a tube to see if that would help. I am not sure whether the discomfort she is feeling is of the tube being pulled it, whether the balloon pops out into the abdominal wall. I see no abscess or collection at this time. •·FILED: ONONDAGA COUNTY CLERK 01/15/2021 12:23 PM INDEX NO. 2015EF3692NYSCEF DOC. NO. 63 RECEIVED NYSCEF: 01/15/2021 Marlene Claps DOB 1952 Page #2 • Patient will be seen by Dr. Watson in Rochester. She will call with any questions or concerns. Yana Popilevskaya RPAC cc.Dr.Brodowski • •FILED: ONONDAGA COUNTY CLERK 01/15/2021 12:23 PM INDEX NO. 2015EF3692NYSCEF DOC. NO. 63 RECEIVED NYSCEF: 01/15/2021 • 5/12/2014 RE: Marlene Claps DOB: /1952 MRN: 2428025_ Dear Dr. Brodowski: l·~e!fqrrne_q]'_fapar9_tomy·wtth·totarga~tre!3tomy'::left.thoracot~my.wittiTrrtrathora~c~~Roax;en"Y7 [€soP-h~goj~jfjhostomy,-andrepl'3~!TI~Q.t'~a feedingJ~JIInc,,sl9my.tubeJoclay_oh·y~rpatienl,"CMarlene·Claps, C~t' Strqng:Mefu:o·ri_aLHospitaL The operation proceeded smoothly and she is currently on the-wayfo-the-- recovery room. ShouldaU'go well, I anticipate discharge home in approximately 10 days. I truly appreciate this opportunity to participate in her care. We will send a hospital summary upon discharge. Please feel free to contact _me should you need any additional information . • Sincerely, Thomas J. Watson, MD, FACS Chief, Division of Thoracic and Foregut Surgery University of Rochester School of Medicine and Dentistry Phone: 585-275-1509 FAX: 585-273-1011 Pager. 585-220-0039 E-mail: thomas_watson@urmc.rochester.edu CC: Recipients MiCHAEL BRODOWSKI Vanessa R Gibson Balasubramar,iam SivakumarFILED: ONONDAGA COUNTY CLERK 01/15/2021 12:23 PM INDEX NO. 2015EF3692NYSCEF DOC. NO. 63 RECEIVED NYSCEF: 01/15/2021 • UR MEDICINE MEDJClNE of THE, H1CH£ST On0ER STRONG MEMORIAL HOSPITAL (V) 601 Elmwood Avenue Rochester NY 14642 Marlene Claps's Discharge Plan/ After Visit Summary Age: 62 y.o. MRN: 2428025 Admitted on: 5/12/2014 Discharged on: Visit Number 369664016 PLEASE TAKE THIS FORM TO YOUR FOLLOW-UP APPOINTMENT WITH YOUR DOCTOR. This discharge pl~n has been designed to give you information that you will need to care for yourself after you leave the hospitai. • An up-to-date medication list is very important to your safe care. Bring your list to all healthcare appointments. Carry it with you at all times in case of emergency. Update your list whenever you start a new medication, change the dose of a current medication, or stop a prior medication. Remember to include over- the-counter medications and supplements such as vitamins and herbs. About your hospitalization The unit you fast received care on: PACU Unit phone nun·1ber: 585-275-2926 Why you were hospitallzed Your prirna,y diagnosis was: Not on File Your diasn1lses also included; SIP Gastrectomy Oischarg~ Instructions None You aro allergic to the following Alle1Jjen Reactions Morphine Other (See Comments) Does noi work Scopolarnine Other {See Comments) hallucinations Erythromycin Hives Pen (Penicillins) Hives The following eersonal items were collected during your a~mission and were returnod to you: · · · · .~ost Recent Value · Patient 8eton91!1Q!~------...;_-----~-------~-'.":--------- • Den·tures · · ·-------- --.......,___-._ None [porclien veneers tof) and bottom front) . __H_!~g A~_Q.ochle.!!r.Jm,P:.,.:la:.:.n::.t_ _ _. ,_N~o,. n:.:::e_ _ _ _ _ _ _ _ _ _ __ . ---- • Jewelry_______ ~lothin9, --''-----N;.;;;co_ne"--_ ____________ Fa_m_il¥,_ _•··········-·•······-··••··········-··· _ _ _ _ ___ -·_-·· __ -----· ___ ___ _ _ _ _ _ _ _ _ _ Other Valuables NoneFILED: ONONDAGA COUNTY CLERK 01/15/2021 12:23 PM INDEX NO. 2015EF3692NYSCEF DOC. NO. 63 RECEIVED NYSCEF: 01/15/2021 Ciaps, Marlene (MR# 2428025 I Visit# 369664016) Printed Page 2 of4 [7217] at 5/12/14 9:54 PM • The following personal items wore coUected during your admission and were returned to ~ou: (continued) · · · ·· ·. : Most Recent Value . .. · · •...;.....Prosthesis/Assistlve Devices . None · ·-------·-~--···•---··-~-- Valuables Given To - .!:!!n!!Y --- Responsl~on(s) in the waiting· -· [oeU 315-882-104/315-682-4389 vincent/david bro 3157516288) room? ___________ • Cashie(sOffice- No ----- - - - - - - - - - - - - - - - - - - -- ~· • ·•FILED: ONONDAGA COUNTY CLERK 01/15/2021 12:23 PM INDEX NO. 2015EF3692NYSCEF DOC. NO. 63 RECEIVED NYSCEF: 01/15/2021 Claps, Marlene {MR# 2428025 / Visit# 389664016) Printed Page 3 of 4 [7217] at 5/12/14 9:54 PM • Take only the medications listed below: Check with your doctor if you think this list is not complete or correct Medication List ASK your doctor about these medications . 

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