FILED: QUEENS COUNTY CLERK 12/15/ :11 PM INDEX NO /2015 NYSCEF DOC. NO. 54 RECEIVED NYSCEF: 12/15/2017
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2 etq SUPREME COURT OF THE STATE OF NEW YORK COUNTY OF QUEENS X â X MOHAMMED H. ULLAH Index No.: /15 Plaintiff, -agarnst- -against - PHYSICIAN'S AFFIRMATION MOHAMMED QASIM SALEEM and CAPITAL CAR & LIMOUSINE SERVICE, TNC, , c-----x Defendant(s). â â X DAVID R. PAYNE, MD, a physician duly licensed to practice medicine in the State of New York, hereby affirms and attests to the truth and accuracy of the following: 1. That I am a Radiologist duly licensed to practice medicine in the State of New York. 2. That on April 20,2015 I performed a reading the Magnetic Resonance Irnages (MRI) of the Right Shoulder of MOHAMMED H. ULLAH, above-named, at All County. LLC Diagnostic Radiology located at Horace Harding Exp., Flushing, NY , That the following information is photographically inscribed onto said films, and that said inscription is done so in the practice of ordinary course of business of All County, LLC Diagnostic Radiology: (a) the name of the patient. MOHAMMED H. ULLAH.; (b) the date of birth of the patient, 07/01/1977; (c) the part of the body scanned, right shoulder; (d) the date the MRI was taken, 4/20/ That said MRI film is the MRI referred to herein. That the MRI referred to herein represent a fair and accurate depiction of the physical condition of MOHAMMED H. UI.I,AH on 4/20i'2015.
3 S. After per~onalh' personally c andaing said MRI filrn(s), I set forth my C findings in a written report, dated April 20, Annexed hereto, and incorpo1sted by reference herein, is a true and accurate copy of said report. 6. If called as a witness to testify in the above-captioned matter, I would estify in confonnity with said report, and the facts set forth herein. 1, DAVID R. PAYNE, ME., bring a physician (radiologist) duly licensed to practice medicine in the state vtnew York, hereby affits under the penalties of penury that the. statements contained herein are true and accumte pursuant to CPLR 2106, Dated: Qccens, New York December 15,-2017 tm DAVID Rk. PA~NB, PAYNE, M.D 1 1i I t ti
4 001/00 2 All County, LLC Diagnostic Radiology Article 28 Diagnostic & Treatment Center Cert. No R Jason R. Baynes, MD 54 South Dean Street Englewood, NJ Fax #:(201) /20/15 Re: Mohammad H Ullah DOB: 07/01/1977 Pt Tel#(917) Patient#: Dear Dr. Baynes: MRI OF THE RIGHT SHOULDER TECHNIQUE: Oblique coronal proton density weighted spin-echo, R weighted fast spin-echo, and inversion recovery images were obtained. Oblique sagittal T2 weighted fast spin-echo images were obtained. Axial T1 weighted spin-echo images were obtained. FINDENGS: The glenohumeral joint is intact. The acromioclavicular joint is preserved. There is a laterally down-curving acromion. There is inferior enthesophyte formation extending from its lateral undersurface to impinge upon the distal supraspinatus. Evaluation of rotator cuff musculature reveals tendinosis of posterior fibers of supraspinatus and anterior fibers of the infraspinatus. Teres minor and subscapularis muscles are preserved. There is a capsular effusion. There is decompression into the biceps long head tendon sheath. The biceps long head tendon is anatomic in position and is intrinsically intact. The biceps anchor is preserved. There is a tear of the anterior labrum at the equator. IMPRESSION: 1. TENDINOSIS OF POSTERIOR FIBERS OF SUPRASPINATUS AND ANTERIOR FIBERS OF INFRASPINATUS. 2. TEAROF THE ANTERIOR LABRUM AT WE EQUATOR HoraceHanjing Exp., Flushing, NY Tel Fax Rushing@ancountyradidogysorn wwwalsountyredttlogy.corri
5 ....- a o... u r as / 0 o 2 All County, LLC Diagnostic Radiology Article 28 Dieptostle & Treatmetit Cetiter Cert Na R Page 2 Re: Mohammad H Ullah DOB: 07/01/1977 Pt Tel#(917) Patient#: /20/15 3, NO ACUR BONY PATHOLOGY. Thank you for the courtesy of this referral. Sincerely, David R. Payne, M.D. Diplomate, American Board of Radiology, with Added Qualifications in Neuroradiology DRP/ds Sectronically approved by: David Ross Payne, MD Date: 04/27/15 09: Horace Harding Exp,, Rushing, NY Tel Fax Flushing@allcountyradology.com wow.a}tcorjnt7radiology.corn
FILED: QUEENS COUNTY CLERK 12/15/ :11 PM INDEX NO /2015 NYSCEF DOC. NO. 51 RECEIVED NYSCEF: 12/15/2017
SUPREME COURT OF THE STATE OF NEW YORK COUNTY OF QUEENS ------------------------------------------------------------------X MOHAMMED H. ULLAH Index No.: 711861/15 Plaintiff -against- AFFIDAVIT of MOHAMMED
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