`INDEX V0.
`59468/2015
`INDEX NO. 59468/2015
`FILED: WESTCHESTER COUNTY CLERK 02/17/2017 12:16 PM
`FILED: WESTCHESTER COUNTY CLERK 02m2017 12:16 PM
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`NYSC 3F DOC. NO. 40
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`EXHIBIT “D”
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`INDEX NO. 59468/2015
`FILED: WESTCHESTER COUNTY CLERK 02/17/2017 12:16 PM
`INDEX “0' 59468/2015
`FILED: WESTCHESTER COUNTY CLERK 02m2017 12:16 PM
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`NYSCEF DOC. NO. 40
`RnCnIVnD NYSCEF: 02/17/2017
`NYSCEF DOC. NO. 40
`RECEIVED NYSCEF: 02/17/2017
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`Uurzorcuca rm. Luci:
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` Orthopaedics
`
`Wi [50“
`
`Assistant Clinical Professor of Orthopedic Surgery
`Albert Einstein College of Medicine
`Attending Physician NYU Hospital [or
`Joint Diseases
`Attending Physician Montefiore Medical Center
`
`onmpaflsugm
`Reconstr we urgerv
`Sports Medicine
`
`Arnold B. Wilson, MD FAAOS
`Board Certified Orthopaedic Surgeon
`
`Law Firm ofHaIiock & Malerba
`334 Deer Park Avenue
`
`Babylon Village, New York 11702
`
`Dear Sirs:
`
`June 23, 2013
`
`Re: Geoffrey MacKenzie
`
`As per your request, I am providing you the following summary on my patient, Geoffrey MacKcnzie.
`
`Mr. MacKenzie is a 51-year-old gentleman who first came under my care in July, 2012.
`
`At the time of his initial evaluation, he was seen for evaluation of multiple injuries he sustained as a
`result of a motor vehicle accident on February 14, 2009. The accident occurred when he was driving
`his car and was struck by an oncoming vehicle. During this accident, his knees struck the dashboard
`and he also injured his neck and lower back.
`
`Following the accident, he received a comprehensive evaluation in the emergency room.
`
`I—iaig
`Subsequently, he Was seen and evaluated by Dr. Scott Haig, an ortlmpeedic surgeon. Dr.
`evaluated him for injuries he sustained to his right knee, neck, and lower back. He received anti-
`
`inflammatories and a comprehensive course of physical therapy,
`
`During my initial evaluation he complained ofpain in his right knee and neck. l-Iis lower back pain had
`show: significant subsidence.
`
`Fax 713-798~5522
`713-798-1000
`75 East Gunhlll Road Bronx New York 10467
`530 First Avenue New York New York 10016
`212-564-5828
`All mall correspondence to the Bronx address
`www.wilsonorthopaerlics.com
`
`
`
`
`59468/2015
`INDEX NO. 59468/2015
`FILED: WESTCHESTER COUNTY CLERK 02/17/2017 12:16 PM
`INDEX “0-
`FILED: WESTCHESTER COUNTY CLERK 02m2017 12:16 PM
`
`
`
`
`NYSCI
`EF DOC. NO.
`RnC fiIVfiD NYSCEF:
`40
`02/17/2017
`NYSCEF DOC. NO. 40
`RECEIVED NYSCEF: 02/17/2017
`urn/aura”; mu warn:
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`Geoffrey MacKenzie
`June 23, 2013
`
`Page 2
`
`During my initial evaluation, his right knee exhibited diffuse tenderness about the medial and laterai
`
`aspects of the joint line. He exhibited a stable range of motion and was able to range from full
`extension with flexion to 120 degrees. I examined his neck and noted he had tenderness to palpation in
`the cervical region with restrictions in range of motion. He exhibited normal motor strength.
`
`X-rays/MRI: X-rays were taken on July 23, 2012. An x-ray of the right knee showed no bony
`abnormalities and showed normal alignment. X-rays of the neck showed no focal abnormalities.
`
`An MR1 ol’the right knee was performed on March 4, 2009. This MRI was significant for showing
`tears of the medial and lateral menisci as well as showing evidence of choodronralacia patella. An MRI
`of the LS spine was performed on January 25, 2010, significant for showing a broad-base disk
`herniation at L4—L5. A disk herniation was also present at L5~Sl.
`
`Following my initial evaluation, 1 recommended undergo arthroscopic surgery to his right knee.
`
`This surgery was performed on October 15, 2012 at Westchester Square Medical Center. During
`surgery, he was found to have tears of the medialand lateral menisci. He had an inflamed synovium
`and had evidence of chondromaiacia patella.
`
`Surgery consisted of a medial and lateral menisectomies and resection of synovial tissue.
`
`Following surgery, he was closely followed in my office. A comprehensive course of physical therapy
`was prescribed. i-ie was given analgesic pain and anti-inflammatory medication.
`
`Following surgery, he had an uneventful recovery and experienced significant pain relief.
`
`He was last seen and evaluated in my office on June 13, 2013. At this time, he was having intermittent
`complaints of pain in his right knee. He was having difficulty with exercise and getting up from a
`seated position. He had been unable to return back to any sports participation including jogging. In
`addition. he continued to complain of pain in his neck and iowcr' back.
`
`Fax 718—798-5522
`718-798—1000
`75 East Gunhill Road Bronx New York 1046?
`530 First Avenue New York New York 10015
`212~564--6828
`Ali mail correspondence to the Bronx address
`www.wilsono rthopaedicsxom
`
`
`
`
`59468/2015
`INDEX NO. 59468/2015
`FILED: WESTCHESTER COUNTY CLERK 02/17/2017 12:16 PM
`
`INDEX \10-
`FILED: WESTCHESTER COUNTY CLERK 02m2017 12:16 PM
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`
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`NYSCI3F DOC. NO.
`40
`RnCfiIVnD NYSCEF:
`02/17/2017
`NYSCEF DOC. NO. 40
`RECEIVED NYSCEF: 02/17/2017
`wuuvl uvu
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`Geoffrey MacKenzle
`
`June 23, 2013
`
`Page 3
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`Physical Examination: Physical examination performed on June 13, 20l3. Right knee, well—healed
`surgical sites, minimal joint line tenderness, some patellol’emoral tendemess, some quad atrophy and
`quad weakness. Range of motion, full extension with flexion to 125. Examination of lower back
`showed tenderness to palpation about the lumbosacra] junction and geod ability to straight leg raise.
`Examination of neck showed mild tenderness about the lower cervical region, some restrictions in
`range of motion with flexion to 20. extension to 25, good side-to~side motion, normal strength
`throughout both upper extremities.
`
`AssessmentlSummary: This is a 51-year—old gentleman who sustained multiple injuries as a result of
`a motor vehicle accident. Following the accident, he received a comprehensive course of physical
`therapy and anti-inflammatory medication. An MRI of the LS spine showed disk hemiations at L4vL5
`and LS-Sl . A11 MR1 of the right knee showed tearing of the medial and lateral menisci and evidence of
`
`chondromalacia patella. In light of his persistent pain, he required arthroscopic surgery. Surgery
`consisted of a partial medial and lateral meniscectomy as well as resection of synovial
`tissue.
`Following surgery, he continues to have intermittent complaints of pain in his right knee. He has had
`difficulty returning back to activities of daily living and is unable to participate in sports. In addition,
`he continues to have complaints of pain in his neck and lower back.
`
`His prognosis for further recovery is guarded.
`
`All of the injuries he sustained to his right knee, neck, and lower back are causally related to the
`accident of February _l 4, 2009.
`
`In the future, he will
`therapy.
`
`likely require intermittent anti-inflammatory medication along with physical
`
`As a result of this accident, he is at risk for positraumatic arthritis of his right knee. Arthroscopic
`surgery showed some loss of articular. cartilage about
`the patcllofemoral
`joint. Should this
`posttraumatic arthritis worsen, he may eventually require repeat arthroscopic surgery and may
`ultimately require joint replacement surgery at an unusually young ago.
`
`Should he require iiirther surgery, it is anticipated he will require further physical therapy and anti—
`inflaunuatory medication.
`
`Fax 718-798—5522
`718—798-1090
`2’5 East Gunhlll Road Bronx New York 10116?
`530 First Avenue New York New Vork 3.00M 212-564~6828
`All mail correSpondanCe to the Bronx address
`www.wllsonorthopaedlc5.com
`
`
`
`
`INDEX NO. 59468/2015
`FILED: WESTCHESTER COUNTY CLERK 02/17/2017 12:16 PM
`INDEX VO- 59468/2015
`FILED: WESTCHESTER COUNTY CLERK 02m2017 12:16 PM
`
`
`
`
`
`NYSCI3F DOC. NO.
`40
`RnCnIVnD NYSCEF: 02/17/2017
`NYSCEF DOC. NO. 40
`RECEIVED NYSCEF: 02/17/2017
`UUIeor‘uma ran.
`muuuuun
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`I'M
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`Geoffrey MacKenzie
`
`June 23, 2013
`
`Page 4
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`in addition, the pievious MRI showed disk herniations at L4-L5 and L5~Sl. If the pain about his lower
`
`back persists, he may require further treatment. Specifically, he may benefit from pain management
`and epidural steroid injections.
`
`Ultimately, if the pain is not controlled, he may require surgical intervention to his back.
`
`Commonly, Spinal surgery results in a prolonged period of disahility. He will require further physical
`then-aw, analgesic pain medication, and anti-inflammatories.
`
`As a result of this accident, he has sustained permanent injuries to his right knee, neck, and lower back.
`
`Please do not hesitate to contact me should you have any questions regarding my care andz'or
`evaluation of Mr. MacKenzie.
`
`All of the aforementioned statements are true to the best of my knowledge. They are based on an
`intewiew with the patient and acornprehensive review of medical records.
`
`I further certify that I am a board certified orthopaedic surgeon licensed to practice medicine in the
`State oi-‘New York.
`
`Sincerely,
`
`Arnold B. Wilson, MI).
`
`fax 718-798-5522
`718-798-1000
`75 East Gunhtli Road Bronx New York 10457
`530 First Avenue New York New York 10016
`2125646828
`All mall correspondence to the Bronx address
`wwwmilsonorthopaedicecem
`
`