`FILED: NEW YORK COUNTY CLERK 01m2018 12:53 PM
`NYSC 3F DOC. NO. 65
`NYSCEF DOC. NO. 65
`
`IND
`EX NO.
`162137/2014
`INDEX NO. 162137/2014
`
` VYSC
`
` 4|IV-v .D
` 3F:
`
`01/19/2018
`RECEIVED NYSCEF: 01/19/2018
`
`EXHIBIT 1D
`
`
`
`FILED: NEW YORK COUNTY CLERK 01/19/2018 12:53 PM
`NYSCEF DOC. NO. 65
`9YSCEF
`51
`DO.C. NO.
`
`INDEX NO. 162137/2014
`
`10/20/201
`RECEIVED NYSCEF: 01/19/2018
`NYSCEF:
`RECEIVED
`
`..
`
`.
`
`.
`
`WILLIAM
`Park
`580
`New York,
`
`J. KULAK,
`S.uite
`Avenue,
`New
`
`York
`
`M.D.
`1A
`
`10065
`
`(212)
`
`755-6468
`
`February
`
`5,
`
`2015
`
`Pianko
`Broad
`55
`Suite
`New
`
`York,
`
`Law
`
`Group
`Street
`
`13F
`
`NY
`
`10004
`
`Attention:
`
`Maurice
`
`Pianko,
`
`Esq.
`
`RE:
`DATE
`
`Ochs
`Yaakov
`OF ACCIDENT:
`
`July
`
`13,
`
`2014
`
`To Whom
`
`It
`
`May
`
`Concern:
`
`Yaakov
`on
`January
`vehicle
`
`Ochs
`
`was
`
`12,
`accident
`
`seen
`2015
`on
`
`at
`
`in
`July
`
`this
`regard
`
`13,
`
`office
`to
`2014.
`
`for
`injuries
`
`orthopedic
`sustained
`
`consultation
`in
`a motor
`
`patient
`The
`struck
`was
`consciousness.
`
`states
`the
`
`in
`
`that
`rear
`
`he
`
`by
`
`was
`car.
`
`a
`
`the
`
`driver
`There
`
`of
`
`the
`no
`
`vehicle,
`of
`
`loss
`
`was
`
`which
`
`He
`
`was
`
`taken
`
`car
`
`of
`
`that
`
`by
`Medical
`discharged
`to
`his
`were
`
`Center,
`with
`symptoms.
`obtained.
`
`University
`He
`was
`rpgard
`
`x-rays
`
`day
`
`to
`where
`prescription
`He
`does
`
`the
`he
`
`not
`
`a
`
`emergency
`treated
`was
`"pain
`for
`specifically
`
`room
`and
`killers"
`
`Hackensack
`discharged.
`
`remember
`
`in
`
`if
`
`continued
`He
`obtained
`spine
`
`on
`
`further
`11/3/14.
`
`treatment
`medication.
`
`with
`
`a
`
`pain
`He
`
`management
`obtained
`
`an
`
`physician
`MRI
`of
`
`the
`
`and
`cervical
`
`the
`At
`cervical
`
`time
`
`of
`
`spine
`
`the
`and
`
`accident,
`''upper"
`
`the
`
`back,
`
`patient
`indicating
`
`states
`
`the
`
`injuries
`dorsal
`
`the
`
`to
`spine.
`
`..
`
`..
`
`.....PAST-MEDICAL
`
`-HISTORY:
`
`.
`
`.--...
`
`._ _......
`
`__.....
`
`.-.
`
`.......
`
`..__
`
`Is
`negative
`indicate
`motor
`
`some
`vehicle
`
`in
`
`regardĀ·
`regard
`minor
`accident
`
`to.to
`property
`but
`
`any
`
`prior
`damage
`personal
`
`no
`
`trauma,
`to
`
`his
`injuries
`
`although
`vehicle
`
`or
`
`he
`
`a
`
`in
`need
`
`does
`prior
`for
`
`any
`
`
`
`FILED: NEW YORK COUNTY CLERK 01/19/2018 12:53 PM
`NYSCEF DOC. NO. 65
`9YSCEF
`DOC.
`NO.
`51
`
`INDEX NO. 162137/2014
`
`RECEIVED NYSCEF: 01/19/2018
`10/20/201
`RECEIVED
`NYSCEF:
`
`'
`
`;
`
`Ochs
`
`-2-
`
`5,
`
`2015
`
`treatment.
`
`He
`
`denies
`
`any
`
`injuries
`
`since
`
`the
`
`events
`
`of
`
`Yaakov
`Page
`
`February
`
`medical
`7/13/14.
`
`H
`
`is
`
`a
`
`dominant
`
`anti-anxiety
`anti-inflammatory
`of
`history
`diseases.
`restrictive
`
`right-handed
`medication
`medication
`
`for
`
`individual.
`
`pre-existing
`for
`his
`
`prior
`
`any
`He
`currently
`strappings.
`
`surgery
`utilizes
`
`or
`
`any
`no
`
`He
`
`utilizes
`
`as
`There
`
`anxiety,
`symptoms.
`other
`pre-existing
`aids
`ambulatory
`
`or
`
`well
`is
`
`low-dose
`as
`no
`systemic
`
`He
`is
`computer
`
`at
`working
`programmer.
`
`the
`
`present
`
`time
`
`at
`
`his
`
`prior
`
`occupation
`
`as
`
`a
`
`the
`
`In
`
`regard
`
`to
`
`the
`trapezial
`region
`treatment
`
`the
`symptoms
`muscles
`the
`of
`has
`
`He
`
`ongoing
`with
`as
`"tight"
`
`cervicodorsal
`were
`at
`bilaterally,
`scapula
`realized
`radiation
`any
`difficulty
`with
`with
`
`area,
`base
`
`he
`of
`
`as
`
`well
`
`states
`the
`
`and
`the
`
`that
`
`neck
`as
`to
`states
`He
`improvement
`deficit
`
`the
`
`to
`
`after
`extended
`superior
`recently
`in
`
`but
`
`his
`he
`
`does
`as
`
`He
`
`and
`has
`
`as
`
`carrying,
`difficulty
`working
`
`bilaterally.
`noticeable
`or
`with
`children.
`
`his
`
`focal
`lifting
`
`as
`
`injury
`the
`mesial
`with
`symptoms.
`state
`well
`to
`due
`the
`on
`distance
`
`a
`computer.
`or
`
`he
`denies
`residual
`interacting
`feeling
`Hp
`he
`
`time
`
`states
`must
`
`if
`
`driving,
`he
`"Motrin".
`
`use
`
`drives
`
`well
`for
`
`any
`
`with
`significant
`
`PHYSICAL
`
`EXAMINATION:
`
`Reveals
`acute
`extremities
`
`a well-nourished,
`There
`distress.
`normal
`
`and
`
`a
`
`is
`
`well-developed
`normal
`a
`station
`
`to
`
`attitude
`the
`
`43-year-old
`of
`
`the
`
`male
`upper
`
`in
`
`no
`
`head.
`
`fall
`A
`performed.
`
`and
`
`complete
`The
`
`examination
`
`to
`
`the
`
`following
`
`significant
`
`cervicodorsal
`findings
`
`are
`
`area
`noted.
`
`of
`
`Range
`degrees
`60
`degrees
`(normal
`from
`motion
`
`the
`
`of
`
`40
`left
`planes
`
`of
`
`the
`(the
`75
`
`motion
`flexion
`(normal
`degrees).
`trapezial
`negative.
`is
`
`cervical
`
`to
`All
`
`normal),
`80
`degrees)
`symptoms
`muscle
`
`area.
`
`reveals
`spine
`symptoms
`and
`
`pain
`left
`
`are
`
`with
`symptoms
`motion
`remainder
`
`at
`
`50
`rotation
`with
`left
`emanating
`of
`the
`
`with
`
`The
`
`is
`
`to
`
`55
`at
`tilt
`
`has
`He
`the
`of
`palpation
`muscle
`like
`
`pain
`left
`
`of
`the
`
`at
`symptoms
`
`frank
`
`with
`trapezius,
`distal
`the
`scapular
`with
`
`the
`
`on
`
`spasm
`as
`well
`aspect
`border.
`cross-chest
`
`palpation
`pain
`as
`of
`the
`states
`test
`
`He
`
`of
`
`the
`frank
`levator
`
`with
`left
`
`sticking
`the
`
`on
`
`left
`
`superior
`spasm
`scapular
`and
`
`border
`
`on
`
`"needle"
`
`emanating
`
`
`
`FILED: NEW YORK COUNTY CLERK 01/19/2018 12:53 PM
`NYSCEF DOC. NO. 65
`SYSCEF
`DOC..... NO.
`51
`
`INDEX NO. 162137/2014
`
`RECEIVED NYSCEF: 01/19/2018
`10/20/201
`NYSCEF:
`RECEIVED
`
`Ochs
`
`-3-
`
`Yaakov
`Page
`
`February
`
`5,
`
`2015
`
`superior
`the
`to
`on
`the
`elements
`
`mesial
`proximal
`right.
`
`from
`
`level.
`
`Neurologically
`
`from
`
`the
`
`.
`
`.
`
`extending
`pegative
`posterior
`distal
`sensation.
`
`the
`of
`mesial
`symptoms
`
`border
`upper
`has
`through
`he
`
`He
`C7
`
`T3
`
`to
`
`is
`
`intact
`
`scapular
`trapezius.
`palpation
`on
`greater
`a
`for
`
`motor
`
`level
`
`It
`
`and
`is
`
`the
`
`of
`degree
`and
`
`at
`
`the
`
`The
`of
`
`pathology
`findings
`his
`
`and
`
`in
`
`precautions
`relationship
`
`were
`to
`
`given.
`the
`
`Anatomic
`was
`
`explanation
`provided.
`
`trauma
`
`His
`needed
`exercises
`trapezial
`
`anti-inflammatory
`and
`on
`were
`and
`
`medication
`
`a
`
`prophylactic
`shown
`in
`levator
`
`regard
`scapular
`
`basis.
`to
`levels.
`
`was
`
`continue
`to
`addition
`In
`rehabilitation
`
`used
`
`as
`
`be
`to
`specific
`at
`the
`
`REVIEW
`
`OF MEDICAL
`
`RECORDS:
`
`Narrative
`reviewed.
`was
`ended
`and
`symptoms
`
`report
`
`of
`
`It
`he
`
`10/28/14
`indicates
`was
`a
`pain
`
`from
`that
`restrained
`tightness
`and
`shoulders"
`
`the
`the
`
`pain
`patient's
`driver.
`
`the
`
`management
`vehicle
`complained
`He
`cervical
`with
`
`his
`
`physician
`was
`
`rear-
`
`of
`
`area
`current
`
`It
`
`that
`regarding
`"bilateral
`to
`regard
`from
`has
`
`in
`
`and
`
`to
`
`the
`condition
`the
`persisted
`
`radiating
`findings
`"This
`accident
`
`pain
`
`in
`consistent
`and
`been
`
`scapula.
`ongoing
`without
`
`trapezius
`has
`
`every
`
`day
`
`indicates,
`the
`
`since
`remission".
`
`examination
`to
`
`On
`regard
`sensation
`Reflexes
`bilaterally.
`,through
`C3
`through
`muscles
`decreased
`planes.
`deemed
`
`C7
`
`and
`
`partially
`
`abduction
`upper
`the
`to
`diminished
`were
`had
`He
`with
`positive
`a
`of.
`motion
`of
`diagnosis
`The
`disabled,
`
`the
`
`test
`spine
`
`Spurling
`cervical
`cervical
`was
`although
`
`he
`
`had
`
`weakness
`the
`
`to
`shoulder
`
`at
`
`extremities,
`for
`
`and
`C5
`tenderness
`tender
`
`frank
`multiple
`
`both
`
`upper
`
`extremities
`had
`He
`in
`
`in
`
`diminished
`the
`report.
`
`level.
`nonspecific
`distributions
`C6
`the
`in
`
`to
`
`cervical
`the
`
`paraspinal
`There
`in
`
`he
`
`point
`and
`
`spine
`
`at
`
`was
`multiple
`was
`
`that
`
`working.
`
`points
`bilaterally.
`at
`radiculitis
`he
`was
`
`MRI
`a
`left
`T3
`a
`consistent
`
`...
`
`radiology
`paracervical
`vertebral
`
`with
`
`report
`
`of
`disc
`
`endplate
`fracture
`a
`
`cervical
`the
`herniation
`deformity.
`of
`
`the
`
`spine
`C4-5.
`findings
`
`at
`The
`endplate.
`
`of
`
`11/3/14
`There
`
`at
`
`indicates
`also
`T3
`
`are
`
`at
`
`was
`
`the
`
`DIAGNOSIS:
`
`MRI
`
`findings
`
`of
`
`C4-C5
`
`disc
`
`herniation,
`
`left.
`
`
`
`FILED: NEW YORK COUNTY CLERK 01/19/2018 12:53 PM
`NYSCEF DOC. NO. 65
`9YSCEF-DOC.
`NO.
`51
`
`INDEX NO. 162137/2014
`
`RECEIVED NYSCEF: 01/19/2018
`10/20/201
`NYSCEF:
`RECEIVED
`
`Yaakov
`Page
`
`February
`
`"
`
`Ochs
`
`-4-
`
`S,
`
`2015
`
`findings
`MRI
`consistent
`
`of
`
`with
`
`endplate
`fracture.
`a
`
`deformity
`
`at
`
`the
`
`T3
`
`vertebral
`
`endplate,
`
`Residual
`. planes.
`
`decreased
`
`range
`
`of
`
`motion,
`
`cervical
`
`spine
`
`in
`
`multiple
`
`Symptomatic
`
`spasm,
`
`left
`
`frank
`levator
`
`spasm,
`scapular
`
`left
`
`trapezius
`muscle.
`
`and
`
`symptomatic
`
`frank
`
`Findings
`level.
`
`of
`
`myoligamentous
`
`inflammation,
`
`C7
`
`through
`
`T3
`
`vertebral
`
`PROGNOSIS
`
`AND
`
`DISCUSSION:
`
`The
`after
`findings
`his
`
`patient
`the
`
`level
`
`clinical
`The
`undetermined
`will
`
`examined
`
`is
`accident.
`noted
`are
`symptoms.
`of
`
`at
`Residual
`consistent
`
`a
`
`point
`objective
`with
`
`.approximately
`subjective
`and
`mechanism
`
`the
`
`five
`
`months
`physical
`
`of
`
`injury
`
`and
`
`findings
`amount
`permanent
`of
`that
`
`be
`use
`to
`
`of
`
`are
`time.
`at
`left
`
`expected
`There
`in
`
`least
`upper
`is
`
`to
`
`that
`
`with
`
`they
`repetitive
`activities
`movement
`
`basis
`lateral
`
`the
`
`at
`
`of
`least
`tilting.
`
`the
`area.
`cervical
`the
`
`to
`
`It
`spine
`and
`
`left
`
`continue
`a
`is
`strong
`intermittent
`extremity
`however
`felt
`limited
`will
`be
`also
`
`possibly
`
`and/or
`that
`
`in
`
`an
`for
`potential
`recurrences
`stressful
`the
`on
`a
`regard
`
`rotational
`permanent
`to
`
`For
`three
`
`a more
`to
`
`concrete
`months
`
`four
`
`prognosis,
`would
`
`be
`
`reevaluation
`indicated.
`
`in
`
`approximately
`
`Atathe
`restricted
`of
`the
`medical
`related
`
`present
`
`time
`
`function
`shoulder
`reviewed
`traumatic
`
`left
`records
`to
`the
`
`is
`
`the
`
`there
`for
`girdle
`
`an
`cervical
`region,
`the
`
`ongoing
`
`spine
`which
`history
`7/13/14.
`
`of
`
`and
`events
`
`disability
`and
`
`and
`
`secondarily
`based
`is
`on
`obtained,
`
`use
`
`the
`
`causally
`
`an
`
`is
`There
`self-exercises
`remissions
`and
`
`and
`periods
`
`during
`conservative
`
`need
`
`use
`
`of
`
`for
`the
`ongoing
`-
`provided.
`Intermittent
`are
`expected
`continue
`to
`supervised
`possibly
`therapy
`exacerbations
`of
`do
`treatment.
`
`that
`
`medication
`of
`
`the
`episodes
`occur
`to
`would
`respond
`
`not
`
`and
`
`be
`
`and
`exacerbations
`medical
`required
`rapidly
`
`the
`
`to
`
`Dr.
`the
`
`William
`State
`
`Kulak
`New
`
`of.
`
`being
`York
`
`physician
`a
`pursuant
`
`to
`
`duly
`CPLR
`
`licensed
`Section
`
`to
`
`practice
`under
`
`2106
`
`the
`
`in
`
`
`
`FILED: NEW YORK COUNTY CLERK 01/19/2018 12:53 PM
`NYSCEF DOC. NO. 65
`YSCEF
`DOC... NO.
`51
`
`INDEX NO. 162137/2014
`
`RECEIVED NYSCEF: 01/19/2018
`10/20/201
`NYSCEF:
`RECEIVED
`
`Yaakov
`Page
`
`February
`
`penalties
`foregoing.
`
`Ochs
`
`-5-
`
`5,
`
`2015
`
`of
`
`perjury,
`
`do
`
`hereby
`
`affirm
`
`the
`
`contents
`
`of
`
`the
`
`hank
`
`you.
`
`WJK/dl
`
`Si
`
`y
`
`u
`
`,
`
`-
`
`il
`
`i
`
`.
`
`Kulak,
`
`M.D.
`
`