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HomeMy WebLinkAbout2020CV30363 - Stuward Cross And Katrina Richman V. City Of Fort Collins - 033B - Exhibit A - Expert DisclosuresDISTRICT COURT, LARIMER COUNTY, STATE OF COLORADO. Court Address: 201 Laporte Ave. Fort Collins, CO 80621 T: (970) 494-3500 ______________________________________________ Plaintiffs: STUWARD CROSS AND KATRINA RICHMAN v. Defendant: THE CITY OF FORT COLLINS, STATE OF COLORADO Attorneys for Plaintiffs: W. Clayton Harris, No. 46455 The Sawaya Law Firm 1600 Ogden Street Denver, CO 80218 Phone Number: (303) 839-1650 FAX Number: (303) 832-7102 E-mail: wharris@sawayalaw.com ▲COURT USE ONLY▲ Case No: 2020CV30363 Div.: Ctrm: PLAINTIFFS STUWARD CROSS AND KATRINA RICHMAN’S C.R.C.P. 26(a)(2) EXPERT DISCLOSURES Pursuant to C.R.C.P. 26(a)(2), Plaintiff Stuward Cross and Katrina Richman, submit the following Expert Disclosures: Experts Disclosed Pursuant to C.R.C.P. 26(a)(2)(B)(I) and (BII): The following physicians are expected to testify consistent with their medical records, including their care and treatment of the Plaintiff, diagnosis and prognosis, same consistent with their records and any other physicians’ records, notes, reports, and any other questions arising therefrom, including impairments and disabilities, and deposition testimony given (if any). They are expected to provide opinions at the time of trial pertaining to causation, damages, prognosis, impairment rating, permanency, past and future limitations, disabilities and consequential inabilities to work, other issues raised by the Defendants, and any other necessary for injuries arising out of the accident. They are expected to testify that their care and treatment was billed at a reasonable amount and was necessary for injuries arising out of the accident. SERVED ONLY: May 28, 2021 4:44 PM FILING ID: A600C01F7A181 CASE NUMBER: 2020CV30363 Exhibit A - Page 1 Furthermore, they will further testify regarding the reasonableness and necessity of the bills, costs, and treatment of any other treating provider as related to the subject accident. These physicians and treaters will provide opinions based upon their review of the pertinent medical records in their own treatment files that they or their colleagues created and those medical records which were created by other treaters, as well as additional records in this case that these treaters have reviewed during this case, and which these treaters may rely upon in forming their opinions and conclusions in their areas of expertise, including but not limited to the following. Stuward Cross 1. Robert Nystrom, DO Keith Meier, FNP-C Amber Payne, PA-C Bren Schmidt, MPT Lauren ProvencSio, SPT Vincent Lombardi, MD James, Esser, MD Melodie Nicholas, RMT Shimon Blau, MD Scott Parker, DC Kelly Lindauer, MD Concentra Urgent Care 0618 Fort Collins Leman 620 South Lemay Ave. Fort Collins, CO 80524 Ph: (970) 221-5811 Ms. Payne will testify that on June 13, 2017, Mr. Cross presented for an evaluation of left-sided neck pain, left-sided trapezius and shoulder pain, left-sided upper back pain between the shoulder blades and headaches following the subject motor vehicle collision on June 7, 2017. He further noted on his intake form he experienced symptoms in his left-sided neck and thoracic spine as well as left shoulder. He marked symptoms in the midline thoracic between the shoulder blades as well as in bilateral hands and left elbow. He reported he was hit on his rear passenger side by a truck. He reported he was wearing his seatbelt with no airbag deployment, and he had a passenger in the back. He further reported at the end of his shift, both of his hands were numb. He reported chronic pain in his low back from walking with a compensated gait as he was shot in his right knee with a 45 caliber, and since this accident, he has been struggling again. He reported he could not miss work as he has ten people at home to support. He reported some headaches. Following the examination, he was assessed with cervical myofascial strain, the strain of the left trapezius muscle, thoracic myofascial strain, and a motor vehicle accident injuring a restrained driver. He was ordered to obtain an X-ray of the cervical spine and thoracic spine. He was referred to physical therapy and massage therapy. He was recommended to return to full work/activity today and further recommended that he work his entire shift. He was advised to follow up in two to three days for further evaluation and treatment. Ms. Payne stated the acute musculoskeletal injury was a result of the motor vehicle wreck of June 7, 2017. Exhibit A - Page 2 Dr. Esser will testify that on June 13, 2017, Mr. Cross underwent an X-ray of the cervical spine series which noted straightening of the cervical spine as well as moderate multilevel and multifactorial degenerative cervical spondylosis. Dr. Esser will testify that on June 13, 2017, Mr. Cross underwent an X-ray of the thoracic spine with no positive findings. These providers will testify that on June 19, 2017, Mr. Cross presented for physical therapy evaluation with reports of left-sided neck pain and scapular region and mild discomfort following the subject motor vehicle collision on June 7, 2017. He also gets minor headaches. He further states he has some numbness on his left side in the ulnar nerve distribution. He rated his pain intensity at 3-7/10. He reported he was driving and getting ready to turn left in a large intersection when he got in an MVA. He reported he often gets headaches that go away. He reported numbness, pins and needles, and numbness/tingling in the ulnar nerve distribution. He reported his symptoms do occur intermittently and are present during long workdays with limited movement. He further reported his symptoms are aggravated by prolonged positions and sitting. Examination revealed mild forward head posture with rounded shoulders. He had mildly increased muscle tones bilaterally in the cervical paraspinals and scalenes. He had a mild increased tone on the left levator scapulae. He had mild guarding and tenderness bilaterally in the scalenes. He had a painful and limited range of motion of the cervical spine. He had a positive upper limb tension test. He had hypomobility and pain on the cervical anterior glide and flexion. Following the examination, he was assessed with cervical myofascial strain and strain of the left trapezius muscle. A treatment plan of physical therapy consisting of therapeutic exercises, therapeutic activities, manual therapy, soft tissue mobilization, neuromuscular re-education, home exercise program, and self-care at a frequency of three times a week for two weeks. These providers will further testify that Mr. Cross attended more than 13 physical therapy visits from June 21, 2017, through August 23, 2017. These providers will testify that on June 21, 2017, Mr. Cross presented for a follow-up evaluation of his neck pain, shoulder pain, and back pain secondary to the motor vehicle wreck of June 7, 2017. He reported constant pain in the left posterior neck, right anterior neck, left lateral neck, left trapezius, and left shoulder. He rated his pain intensity at 3/10 and described it as dull and aching with moderate severity. He reported that his pain radiates to the left trapezius and left shoulder as well as down the left arm. He further noted he was having pain in the right front of his neck. He reported his associated symptoms do include headache, neck muscle spasm, neck stiffness, neck tenderness, upper extremity paresthesias, and numbness in the left posterior upper arm. He further reported his symptoms are exacerbated with neck movement. Examination revealed tenderness in the left C5-C7 cervical spine, level C5-C7 left paraspinal, level C5-C7 right paraspinal, and left trapezius muscles with left-sided cervical muscle spasms on palpation. He had tenderness in the C5-T3 thoracic spine, level C5-T3 left paraspinal, and tenderness in the left rhomboid muscle with left-sided thoracic muscle spasms on palpation. He had a painful range of motion of the cervical spine. He was prescribed Cyclobenzaprine Hydrochloride, Ibuprofen, and Muscle Rub External Cream. He was recommended to continue physical therapy and advised to follow up in three to five days for further evaluation and treatment. Exhibit A - Page 3 These providers will testify that Mr. Cross presented on July 19, 2017 for follow-up evaluation. Mr. Cross complained of continuing neck pain in the posterior bilaterally, lateral bilaterally, trapezius bilaterally and shoulder bilaterally. He rated the pain a 4/10 and noted the pain radiates to his bilateral shoulders. He further noted headaches and decreased range of motion. Exam revealed painful range of motion in the cervical spine as well as tenderness in the C4-7 region, bilateral paraspinal and trapezius muscles. Cervical bilateral muscle spasms were noted. The thoracic region was revealed to be tender in the T2-6 region with painful but full range of motion. Tenderness to the thoracic bilateral paraspinal and rhomboid muscles was noted. Thoracic bilateral muscle spasms were noted. Mr. Cross was released to work an entire shift, referred for chiropractic treatment, told to continue PT. He was prescribed flexeril and ibuprofen. Scott Parker, DC will testify consistent with all his records and that on July 25, 2017 he evaluated Mr. Cross for chiropractic care upon referral from Keith Meier, FNP-C. Mr. Cross noted he was in a Ford Crown Victoria cab when a dump truck contacted the passenger rear bumper and scraped it up around the corner. Mr. Cross began to experience left-sided cervico-thoracic pain the next day and a minor tension headache. Mr. Cross currently complained ofleft-sided cervicothoracic pain and pinching in a pain scale of 5.5/10. He gets occasional headaches when his neck tightens. He denied previous neck injuries. Dr. Parker noted upon exam slight restriction in cervical range of motion with some pain. Mild muscle spasm was palpated. Tenderness noted at T7 as well the left first rib. Trigger points were noted within the trapezius and rhomboid muscles. Chiropractic treatment was prescribed and carried out for from the date of service 7/25/2017 until 12/17/2017 for a total of 12 treatments. Dr. Nystrom re-evaluated Mr. Cross on August 2, 2017. Dr. Nystrom noted that Mr. Cross was attending PT and chiropractic therapies. He noted Mr. Cross complained of neck pain, upper back, shoulder pain and numbness and tingling. He noted he still had tightness in his neck. Upon exam, Dr. Nystrom noted left upper back tenderness and increased muscle tightness around T4. Dr. Nystrom recommended continuing chiropractic care, holding off on additional PT and a follow up in 3-4 weeks. Mr. Cross appeared for a follow-up evaluation with these providers on August 23, 2017. Mr. Cross noted he was improving but still having a lot of tightness in the left upper part of his neck and back. Notes the pain radiates to left trapezius region and left shoulder. He noted his hands get tingly after about 30-40 minutes of driving. Examination revealed cervical tenderness at C5-7 regions with left sided trapezius and paraspinal muscle tenderness as well as left-sided muscle spasms. Mr. Cross was referred for 6 more sessions of chiropractic care, 8 sessions of massage and a possible MRI of his cervical spine was noted as well. Mr. Cross appeared for a follow-up evaluation with these providers on August 30, 2017. Mr. Cross noted to Dr. Nystrom that he still had a sore back as well as soreness in his collarbone. He further noted left trapezius pain which increases in the car. He also noted numbness and tingling. Mr. Cross was told to continue conservative care and was referred over to Dr. Shimon Blau for a physiatry evaluation. Ms. Nicholas will testify that on September 13, 2017, Mr. Cross presented for massage therapy evaluation with reports of left-sided neck pain following the subject motor vehicle collision. He Exhibit A - Page 4 reported numbness and tingling in the left extremity, primarily starting with the left fourth and fifth digits, moving across, and in the right arm. He reported pain looking down. He reported that long cab drives exacerbate his symptoms. Following the examination, he was assessed with the strain of muscle/fascia/tendon at shoulder/upper arm, left arm, and strain of muscle and tendon of unspecified wall of the thorax. A treatment plan of massage therapy at a frequency of one to two times a week for eight weeks was recommended. Ms. Nicholas will further testify that Mr. Cross attended more than five (5) massage therapy sessions from September 13, 2017, through October 25, 2017. Dr. Blau will testify that on October 10, 2017 he saw Mr. Cross on referral from Dr. Nystrom for a physiatry evaluation. Dr. Blau noted the complaints stemmed from a motor vehicle wreck on June 7, 2017. Mr. Cross complained of 6-9/10 pain after undergoing conservative care which included PT, chiropractic and massage therapy. He noted he was currently working without restrictions. Upon exam, Dr. Blau noted cervical tenderness along bilateral paraspinal muscles and slight pain with facet loading on the right. He further tenderness along the bilateral medial and inferior scapular borders and upper thoracic region. He diagnosed Mr. Cross with cervicalgia and thoracic pain. He referred Mr. Cross for MRIs of his cervical and thoracic spines. He told Mr. Cross to continue conservative treatment and noted he would consider trigger point injections. On October 18, 2017, Mr. Cross followed up with Keith Meier, NP. Mr Cross noted neck pain in the left posterior, left trapezius, and left shoulder region which radiated to the left trap and shoulder areas. He further noted neck tightness, stiffness, tenderness and decreased ROM. Upon exam, cervical tenderness in the C4-7 region was noted in the left paraspinal and trapezius muscles. On November 4, 2017, Mr. Cross presented to Dr. Lindauer to undergo two sets of imaging. Mr. Cross underwent MRI of his thoracic and cervical spine. The following findings were noted in cervical spine:  Scoliosis, mild congenital narrowing of the bony cervical canal from C3 to C6.  Straightening of cervical spine  C2/3 to C3/4 o Mild disc desiccation and minimal loss of disc height. o Small osteophyte complexes. Mild facet joint OA. o Minimal central spinal canal stenosis predominantly on congenital basis.  C4/5 o Mild-to-moderate disc desiccation and loss of disc height. o Circumferential disc osteophyte complex. o Mild facet joint OA. o Minimal central spinal canal stenosis predominantly on congenital basis. o Moderate left and severe right foraminal stenosis.  C5/6 o Mild-to-moderate disc desiccation and loss of disc height. o Circumferential disc osteophyte complex with superimposed left paracentral to posterolateral disc protrusion Exhibit A - Page 5 o Mild cranial and caudal migration of the extrusion which measures 10 mm transverse, 4 mm anterior to posterior and 10 mm cranial to caudal. o Moderately indents the left anterolateral thecal sac contributing to central spinal canal stenosis and left foraminal stenosis. o Mild facet joint OA. Mild-to-moderate central spinal canal stenosis. Thecal sac measures 7 mm anterior to posterior. o Severe bilateral foraminal stenosis.  C6/7 o Moderate disc desiccation and loss of disc height. o Mild modic type 1 endplate change. o Irregular Circumferential disc osteophyte complex mildly asymmetric to the right. o Mild facet joint OA. o Mild-to-moderate central spinal canal stenosis. Thecal sac measures 8mm anterior to posterior o Moderate-to-severe bilateral foraminal stenosis.  C7-T1 o Mild disc desiccation and minimal loss of disc height. Small disc osteophyte complexes. o Severe right facet joint OA at T3/4 with mild associated facet joint bone edema. o There is moderate facet joint OA elsewhere at these levels. No stenosis. The following findings were noted by Dr. Lindauer for Mr. Cross’ thoracic spine:  Mild scoliosis  C7-T4/5  Mild disc desiccation and minimal loss of disc height. Small disc osteophyte complexes.  Severe right facet joint OA at T3/4 with mild associated facet joint bone edema.  There is moderate facet joint OA elsewhere at these levels. No stenosis.  T5/6  Moderate disc desiccation and mild loss of disc height.  Circumferential disc osteophyte complex with superimposed broad-based 5 mm left paracentral to posterolateral disc protrusion o Protrusion focally indents the left anterolateral thecal sac and contacts the thoracic spinal cord.  Facet joints are normal. No stenosis  T6/7  Mild-to-moderate disc desiccation and mild loss of disc height. There is an anterior disc osteophyte complex.  There is also a broad based 2mm central disc protrusion which minimally indents the thecal sac. Exhibit A - Page 6  Facet joints are normal. No stenosis  T7/8  Mild disc desiccation and mild loss of disc height.  Small Circumferential disc osteophyte complex with superimposed left paracentral to posterolateral disc extrusion o Mild cranial and caudal migration of the extrusion which measures 4 mm transverse, 4 mm anterior to posterior and 11 mm cranial to caudal. o Focally indents the left anterolateral thecal sac and contacts the anterolateral aspects of the thoracic spinal cord.  Minimal facet joint OA. No stenosis  T8/9  Mild disc desiccation and mild loss of disc height.  Small Circumferential disc osteophyte complex with superimposed broad based 4mm central disc extrusion o Moderately indents the thecal sac and mildly indents the anterior aspects of the thoracic spinal cord.  Mild facet joint OA. Mild central spinal canal stenosis. o Thecal sac measures 9mm anterior to posterior.  T9-L1 o Mild disc desiccation and disc height loss. There are Schmori’s nodes. o Small anterior disc osteophyte complexes. o Mild joint OA. No stenosis. On February 8, 2017, after 4 massage and chiropractic treatments in November and December, Mr. Cross presented to Mr. Meier for a follow-up evaluation. Mr. Cross noted he was stable and had seen Dr. Da Silva for a second opinion where he prescribed lyrica. He noted this helped with his arm pain but his feet began to swell a lot. They tried gabapentin and had the same result. Mr. Cross noted he was working but the pain was occasionally difficult to deal with. Mr. Cross noted continued neck pain the same as last time. Mr. Meier noted the pain complaints were secondary to the motor vehicle wreck of June 7, 2017. Mr. Meier noted that roughly 50% of anticipated healing has taken place. On February 19, 2018, Mr. Cross presented for a follow up evaluation with Dr. Blau. Dr. Blau noted that Mr. Cross had completed chiropractic, massage and physical therapies since he last saw Mr. Cross on October 10, 2017. Dr. Blau noted that Mr. Cross was doing significantly better but continued to have tightness from the left neck down his left arm along the medial elbow and into his left fifth digit. He additionally had constantly burning neck pain and upper back pain in a pain range of 4-7/10. Dr. Blau reviewed the MRIs of Mr. Cross’s thoracic and cervical spine. Upon examination he noted slight cervical pain with facet loading bilaterally. Dr. Blau noted Mr. Cross was likely nearing MMI but he would recommend the following future treatment: 8-12 chiropractic maintenance sessions as needed, injections for severe pain flare-ups and a gym pass for 6 months. Exhibit A - Page 7 On February 26, 2018, Mr. Cross presented to Dr. Nystrom for a follow-up evaluation and discharge appointment. Dr. Nystrom did not perform an exam at this appointment. He stated he agreed with Dr. Blau and that Mr. Cross was at maximum medical improvement with no permanent impairment and restrictions. Future treatment would consist of visits and injections as needed with Dr. Blau over the next year and up to 10 chiropractic visits over the next year as well as gym membership 2. Arnaldo Da Silva, MD Colorado Clinic 3810 North Grant Avenue Loveland, CO 80538 Ph: 970-221-9451 Dr. Silva will testify that on December 12, 2017, Mr. Cross presented for evaluation of headaches following the subject motor vehicle collision. He reported the headaches are located on the left side of the head and in the left occipital area and typically last for approximately one day. He characterized his pain as aching, a sensation of pressure, and sharp with moderately severe in intensity. He reported his associated symptoms do include blurred vision, numbness, and weakness. He further reported a worse headache with neck movement and muscle spasms. He reported fatigue, eye pain, nausea, dizziness, difficulty concentrating, and memory loss. Examination revealed tenderness over the greater occipital nerve and trapezius. Following the examination, he was assessed with cervicogenic headache and cervical sprain/strain. He was prescribed Cyclobenzaprine and Lyrica. He was ordered to obtain an EMG of the upper extremities. He was advised to follow up on an as-needed basis for further evaluation and treatment. Dr. Silva will further testify that on January 9, 2017, Mr. Cross presented for a follow-up evaluation of his headaches. He reported his symptoms are unchanged since the last visit. He was prescribed Gralise and referred to Dr. Eric Hoffman. He was instructed to stop Lyrica as it caused ankle swelling and advised to follow up on an as-needed basis for further evaluation and treatment. 3. Bradley J. Martin, PA-C Arden M. Mahaffey, DO Isaac Jones, MD Andrew Mills, MD Becky K. Benz, MD UC Health Neurology Clinic-Loveland 2695 Rocky Mountain Avenue, Suite 200 Loveland, CO 80538 Ph: (970) 667-7664 Mr. Martin will testify that on May 28, 2019, Mr. Cross presented for evaluation of memory issues and neck pain following the subject motor vehicle collision. He reported pain makes him angry. He reported trouble with memory and trouble with remembering dates. He reported super intense pain in random joints. He reported bad neck tension and further reported the pain radiates from his neck down to his left hand. Examination revealed pain moving the neck and bending over. Exhibit A - Page 8 Following the examination, he was assessed with chronic pain status post motor vehicle accident, headaches, memory change, and joint pain. He was prescribed Amitriptyline and ordered Medrol Dosepak. He was ordered to obtain an MRI of the brain and cervical spine. He was recommended occupational therapy and advised to follow up on an as-needed basis for further evaluation and treatment. Mr. Martin assessed Mr. Cross had chronic pain secondary to the motor vehicle wreck of June 7, 2017. Dr. Jones will testify that on June 8, 2019, Mr. Cross underwent an MRI of the brain. The study showed a small T2 hyper-intense focus in the right frontal subcortical white matter. Dr. Benz will testify that on June 9, 2019, Mr. Cross underwent an MRI of the cervical spine. The study showed:  Motion on the axial images limits evaluation. Degenerative changes result in the mild narrowing of the spinal canal at C5-C6 and C6-C7.  There are moderate bilateral foraminal stenosis at C5-C6. There is at least mild bilateral foraminal stenosis at C4‐C5, and there is mild bilateral foraminal stenosis at C6‐C7 and on the left at C3‐C4. Dr. Mahaffey will testify that on September 10, 2019, Mr. Cross presented for evaluation of pain following the subject motor vehicle collision. He reported burning in his bones and pain everywhere. He further reported significant neck pain that radiates into the left upper limb. He reported numbness and weakness in both of his hands. He reported left shoulder pain and weakness in the left shoulder. Examination revealed a restricted range of motion of the left shoulder. He had a positive impingement sign. He underwent nerve conduction studies of the bilateral upper limbs and needle EMG of the left upper limb and left cervical paraspinals. The study showed electrodiagnostic evidence of bilateral median neuropathy at the wrist, carpal tunnel syndrome, and very mild severity bilaterally. He was recommended physical therapy, moderate exertional exercise, and anti-inflammatories. He was provided a referral to a pain specialist and might benefit from trigger point injections. He was instructed to limit overhead lifting. He was advised to follow up with neurology for further evaluation and treatment. Dr. Mahaffey diagnosed Mr. Cross with chronic neck pain with intermittent radiation into the left upper extremity. He reasoned the MRI revealed degenerative changes and suspected the etiology of his neck pain is mechanical and muscular in nature with additional psycho-emotional contribution. All of these issues came since sustaining injuries in a motor vehicle wreck of June 7, 2017. Mr. Martin will testify that on September 13, 2019, Mr. Cross presented for a follow-up evaluation of his ongoing symptoms and a review of MRI results. Mr. Martin assessed that Mr. Cross had chronic pain secondary to the motor vehicle wreck of June 7, 2017. He reported several spikes are worse at night. He reported worse joint pain. The MRI of the brain and cervical spine and EMG/NCS results were reviewed. He was prescribed Cymbalta and instructed to stop Amitriptyline. He was recommended physical therapy and advised to follow up in one to three months for further evaluation and treatment. Mr. Martin will testify that on December 6, 2019, Mr. Cross presented for a follow-up evaluation of his chronic neck pain and shoulder pain. He reported weakness/numbness in the arm. He reported headaches and trouble with his left shoulder. After informed consent, Mr. Cross was Exhibit A - Page 9 administered a Toradol injection. He was recommended a trial of Effexor. He was ordered pain management with NOCO for possible epidural steroid injection and advised to follow up on an as- needed basis for further evaluation and treatment. 4. John C. Mann, PA-C Salud Family Health Centers 1635 Blue Spruce Drive Fort Collins, CO 80524 Ph: (970) 494-4040 Mr. Mann will testify that on February 20, 2019, Mr. Cross presented to establish care with reports of back pain. He reported pinching, shooting pain and could not extend his legs, and has been walking with a walking stick. He reported shooting pains on his left leg that wrap from his hip to the top of his calf for the past week and a half. He noted he was in a motor vehicle wreck on June 7, 2017. He noted his pain seems to have gotten worse in the last six (6) months. He feels like his left arm has rotator cuff issues, and the pain has been getting worse for the past six months. He reported shooting explosive pains that last 15-30 seconds. He reported severe sciatic pain, thoracic pain, sternal pain, and his back cracks often, and he has been experiencing memory issues which he did not have prior to the wreck. He reported trouble with episodic memory, remembering dates, errands, and bad headaches. Examination revealed mild tenderness to palpation on the superior sternum. He feels like his left arm is heavy and tingly. He has pale fingers bilaterally and pain on external rotation against resistance. He had a reduced range of motion in the left shoulder. He had tenderness to palpation diffusely in the back. He had a positive empty can test. Following the examination, he was assessed with pain in the left shoulder, post-concussive syndrome, chronic pain after traumatic injury, and low back pain at multiple sites. He was prescribed Cyclobenzaprine Hydrochloride. He was provided a referral to Sports Medicine, neurology, and physical therapy. He was advised to follow up on an as-needed basis for further evaluation and treatment. Mr. Mann will testify that on October 30, 2019, Mr. Cross presented for a follow-up evaluation of his ongoing symptoms. He reported that he could barely lift his left arm above the shoulder level, cannot put his hand on his back, and has significant weakness now in his left arm. He was prescribed Baclofen and ordered to obtain an X-ray of the left shoulder. Mr. Mann informed Mr. Cross that he doubted he has rotator cuff tear as he would have had symptoms immediately following the accident, consider the possibility of rotator cuff tendinitis, frozen shoulder, or muscle atrophy. He was advised to follow up on an as-needed basis for further evaluation and treatment. Mr. Mann will testify that on April 27, 2020, Mr. Cross presented for a follow-up evaluation via telehealth. He reported low back pain and reported disc issues in his neck to bother occasionally. He was provided a referral to physical therapy and advised to follow up on an as-needed basis for further evaluation and treatment. 5. Jordan Allison, PT, DPT Colorado in Motion 115 East Harmony Road, Suite 160 Fort Collins, CO 80525 Ph: (970) 221-1201 Exhibit A - Page 10 Dr. Allison will testify that on June 3, 2020, Mr. Cross presented for physical therapy evaluation with reports of chronic cervicothoracic pain, right shoulder pain, and low back pain following the subject motor vehicle collision. He rated the pain intensity at 7-9/10. He reported constant pain in the thoracic spine, sternum, and upper extremities. He reported a lot of comorbidities and has had some serious depression since the onset of Covid 19. He reported limited in all head and neck movements in addition to right upper extremity movements. Examination revealed an extremely limited range of motion of the cervical spine, a very restricted range of motion of the lumbar spine, and a limited range of motion of the right shoulder. Following the examination, he was assessed with chronic cervicothoracic pain, right shoulder pain, and low back pain. A treatment plan of physical therapy consisting of joint mobilization, therapeutic exercise, neuromuscular re- education, therapeutic activities, modalities, and trigger point dry needling at a frequency of twice a week for twelve weeks. Dr. Allison will further testify that Mr. Cross attended more than twelve (12) physical therapy sessions from June 3, 2020, through July 17, 2020. Katrina Richman 6. Jordan Allison, PT, DPT Jason Dooley, PTA Meggan B. Jorgensen, DPT Derick W. Page, PTA Sarah Baily, DPT Sierra Evers-Hellmich, PTA Rebecca Paratore, PTA Anna Siliciano, DPT Rocky Mountain Physical Therapy 1307 East Prospect Road, Suite 120 Fort Collins, CO 80525 Phone: (970) 568-8461 These providers will testify that on June 9, 2017, Ms. Richman presented for physical therapy evaluation with reports of increased soreness in the neck and left hip following the subject motor vehicle collision. She reported she was involved in a motor vehicle collision while riding in a taxi on the way home from her last physical therapy visit. She stated she could not perform her home exercise program very consistently and wanted to hold off on traction due to the subject motor vehicle collision. Examination revealed soft tissue restrictions and cervical facet hypomobility noted at C2-C6, needed consistent verbal and occasional tactile cues to correct posture and perform therapeutic exercise program. She had a neck disability index score of 36 with impairment of 72. Following the examination, she was assessed with cervicalgia and cervical disc degeneration. A treatment plan of physical therapy consisting of manual therapy with soft tissue mobilization, joint mobilization, manual traction, retractions, stretching exercises, therapeutic activities, and postural awareness activities was recommended. These providers will further testify that Ms. Richman attended more than twelve (12) physical therapy sessions from June 9, 2017, through July 26, 2017. Exhibit A - Page 11 These providers will testify that on January 22, 2018, Ms. Richman presented for physical therapy evaluation with reports of exacerbated neck pain and stiffness following the subject motor vehicle collision. She described the pain as burning and tingling, originating in the cervical spine and extending into both shoulders. She rated the pain level up to 9/10. She reported experiencing two to three migraines per month. She reported limitations with functional activities of dressing, sitting, standing, bending, driving, sleep, recreational exercise, reaching, lying, household chores, and bathroom hygiene. Examination revealed increased kyphosis, protracted scapulae, forward head, capital extension; decreased cervical spine range of motion; decreased cervical spine muscle strength bilaterally; positive Spurling’s test and distraction test; firm end feel with mid and lower cervical spine joint mobility; decreased myotome strength in the neck; hypersensitive right C3 and C4 dermatomes; decreased right C7 triceps reflex. She had tenderness to palpation with increased tissue tension in bilateral cervical musculatures. She had a neck disability index score of 78 with impairment of 79. Following the examination, she was assessed with cervicalgia and cervical disk degeneration. A treatment plan of physical therapy consisting of flexibility with active and passive stretching, neuromuscular reeducation, range of motion exercises, therapeutic exercises, cryotherapy, heat, electrical stimulation, ultrasound, manual stretching, soft tissue mobilization, dry needling, and mechanical traction was recommended at a frequency of twice per week for eight weeks. These providers will further testify that Ms. Richman attended more than eight (8) physical therapy sessions from January 22, 2018, through February 23, 2018. Dr. Siliciano will testify that on October 16, 2018, Ms. Richman presented for physical therapy evaluation with reports of low back pain. She reported constant pain, which was an aching/burning type of pain with occasional sharp and shooting pain down her legs, right more than left. She stated she wanted to avoid back surgery. She reported limitations with functional activities and the inability to perform recreational exercises. Examination revealed slouched posture, forward head, rounded shoulders; poor core activation with transitions; decreased lumbar lordosis; decreased lumbar spine range of motion; decreased lumbar spine muscle strength; positive lumbar Slump test; increased firmness with gross lumbar joint mobility; significant tenderness to palpation of bilateral lumbar musculature. She had an Oswestry score of 66 with impairment of 66. Following the examination, she was assessed with intervertebral disc degeneration of the lumbar region, sciatica, and contracture of muscle. A treatment plan of physical therapy consisting of body mechanic training, core stabilization, flexibility with active and passive stretching, neuromuscular reeducation, range of motion exercises, therapeutic exercises, cryotherapy, heat, electrical stimulation, ultrasound, manual stretching, soft tissue mobilization, and spine mobilization was recommended at a frequency of twice per week for eight weeks. Dr. Siliciano will further testify that Ms. Richman attended just one (1) physical therapy session on October 16, 2018. 7. Erik Hermstad, MD Amy Hayes, MD Kevin Limbaugh, MD James Campain, MD Katie M. Weatherhogg, MD UCHealth Harmony Campus 2127 East Harmony Road., Suite 140 Fort Collins, CO 80528 Phone: (970) 297-6250 Exhibit A - Page 12 Dr. Hermstad will testify that on June 20, 2017, Ms. Richman presented to the emergency department with reports of headache and abdominal pain. She reported having some nausea and vomiting intermittently for a week with constipation. She stated she had a coughing episode and developed a severe headache. She rated her pain level at 5/10. She reported neck pain. During the emergency department course, she was administered intravenous Fentanyl, Zofran, and normal saline; had labs drawn; and underwent CT of the brain and X-ray of the abdomen. Following the examination and review of diagnostic studies, she was assessed with tension headache, neck strain, abdominal discomfort, and drug-induced constipation. She was prescribed Lidocaine patches and Flexeril. She was discharged home in stable condition with routine discharge instructions. She was advised to follow up with her primary care physician for further evaluation and treatment. Dr. Hayes will testify that on June 20, 2017, Ms. Richman underwent an X-ray of the abdomen- chest. The study showed nonspecific bowel gas pattern and bibasilar scarring. Dr. Limbaugh will testify that on June 20, 2017, Ms. Richman underwent a CT scan of the head, which showed no positive findings. Dr. Campain will testify that on September 27, 2017, Ms. Richman presented to the emergency department with report of back pain. She reported having a history of chronic back pain, taking medications as prescribed but not getting much relief. She stated she used a wheeled walker to navigate in her apartment but could not leave the apartment and was unable to refill her pain medications from the pharmacy. During the emergency department course, she was administered Dilaudid and was given oral Lorazepam. Following the examination, she was assessed with chronic bilateral low back pain. She had her MS Contin filled by the pharmacy. She was advised to follow up in the clinic for further concerns and to follow up with Front Range Pain Management in a week for further evaluation and treatment. She was discharged home with routine discharge instructions. Dr. Weatherhogg will testify that on June 5, 2018, Ms. Richman presented for evaluation of neck pain, back pain, bilateral hand numbness, right leg weakness, and numbness. Examination revealed tenderness to palpation and spasms in bilateral trapezius and cervical paraspinals, decreased lumbar flexion, and tenderness to palpation and spasms right more than left in lumbar musculature, decreased sensation in the right L5 dermatome. She underwent an electrodiagnostic study with nerve conduction and needle EMG on selected muscles of bilateral lower extremities, which showed no positive findings. Following the examination and review of electrodiagnostic studies and prior radiologic studies, she was assessed with chronic cervical and lumbar pain secondary to myofascial pain syndrome, lumbar paraspinal spasms, and underlying degenerative disc disease. She was advised to begin a trial of Baclofen for chronic muscle spasms. She was recommended warm water aquatic therapy/physical therapy and massage therapy. She was advised to follow up on an as-needed basis for further evaluation and treatment. 8. Kristin Andreen, MD Bernard Birnbaum, MD Diana M. Jackson, FNP David R. Marchant, MD Exhibit A - Page 13 Heather Schnorr, FNP Katie L. Rutledge, MD UC Health Family Medicine Center 1025 Pennock Place Fort Collins, CO 80524 Phone: (970) 495-8800 Dr. Andreen will testify that on June 21, 2017, Ms. Richman presented for reports of headaches. She reported the symptoms started seven days prior and occurred constantly. This pain was different than her prior headaches She stated the pain was located in the bilateral and frontal regions. She reported that the pain radiating to the neck. She described the pain as sharp and pulsating and rated the pain level at 10/10. She reported associated symptoms of blurred vision, nausea, photophobia, and vomiting. She stated the pain aggravated with bright light. Examination revealed tenderness to palpation with tightness along the traps and bilateral cervical paraspinous muscles. Following the examination, she was assessed with episodic tension-type headache, cervicalgia, and environmental allergies. She was prescribed Flexeril. She was advised to restart Flonase and antihistamine and to trial Imitrex. She was recommended physical therapy for further evaluation and treatment. Dr. Birnbaum will testify that on June 29, 2017, Ms. Richman presented for a follow-up evaluation of chronic pain. She reported headaches and opiate-induced constipation. She stated she was taking prune-based medication and MiraLAX to treat constipation. She reported neck pain, back pain, and fatigue. She reported that the subject motor vehicle collision exacerbated her pain, and she felt her symptoms were related to it as she had been having more pain since then. She was tearful. Following the examination, she was assessed with chronic pain syndrome, cervicalgia, which was worse since motor vehicle collision, cervical dysplasia, and constipation due to opioid therapy. She was refilled MS Contin, MSIR, and MiraLAX. She was advised to follow up with Ms. Diana Jackson in one month and work on getting into the pain clinic. She was advised to follow up with physical therapy for further evaluation and treatment. Ms. Jackson will testify that on July 21, 2017, Ms. Richman presented for a follow-up evaluation of her ongoing pain symptoms and pain medication. She reported neck and back pain. Following the examination, she was assessed with chronic pain syndrome with chronic low back pain and multiple arthralgias. She was refilled with Morphine ER. She was advised to follow up in one month for further evaluation and treatment. Dr. Birnbaum will testify that on August 24, 2017, Ms. Richman presented for a follow-up evaluation of her ongoing pain symptoms. She reported she was still struggling with ramifications from the subject motor vehicle collision. She stated she was working on getting into a pain clinic. She reported continued neck and back pain and was nervous/anxious. She was refilled with pain medications for one month. She was advised to follow up on an as-needed basis for further evaluation and treatment. Dr. Birnbaum will testify that on October 18, 2017, Ms. Richman presented for a follow-up evaluation of her ongoing pain symptoms and exacerbation. She stated she was scheduled for a back injection. She was tearful when discussing her pain. Following the examination, she was Exhibit A - Page 14 assessed with chronic pain syndrome and chronic bilateral low back pain. She was refilled with MSIR and MS Contin. She was referred for home health evaluation and home health PT/OT as the pain was making it very difficult for her to leave the house. She was advised to follow up in two months for further evaluation and treatment. Dr. Birnbaum will testify that on December 18, 2017, Ms. Richman presented for a follow-up evaluation of her ongoing pain symptoms. She reported she struggled with neck and back pain and stated she woke up from sleep due to pain. She stated everything she did hurt. Following the examination, she was assessed with cervicalgia and chronic pain syndrome. She was refilled with MSIR and MS Contin. She was referred to physical therapy. She was advised to follow up in two months for further evaluation and treatment. Dr. Birnbaum will testify that on February 2, 2018, Ms. Richman presented for a follow-up evaluation of her ongoing pain symptoms. She reported she was frustrated that she still hurt all over. She was advised to follow up with the pain clinic and to pick up medications as previously prescribed. Dr. Marchant will testify that on February 5, 2018, Ms. Richman presented for evaluation of pain management and to establish care with the pain clinic. She rated the pain level at 7/10 and described the pain as aching and continuous. Following the examination, she was assessed with chronic pain syndrome. She was counseled on responsible use of pain medication. She was advised to follow up on an as-needed basis for further evaluation and treatment. Dr. Marchant will testify that on February 14, 2018, Ms. Richman presented for a follow-up evaluation of her chronic pain syndrome and pain management. She reported migraines, right shoulder pain, neck pain, and back pain. She stated three days out of the week, she would wake up from sleep, and her back pain hurt her so much that she could not bend to wipe herself. She was recommended EMG/NCS for further evaluation. She was advised to work on muscle balancing. She was advised to follow up on an as-needed basis for further evaluation and treatment. Dr. Marchant will testify that on March 14, 2018, Ms. Richman presented for a follow-up evaluation of her ongoing pain symptoms and pain management. Following the examination, she was assessed with bilateral neck pain, chronic pain syndrome, and chronic bilateral low back pain with bilateral sciatica. She was advised to use pain medications as prescribed (MS Contin and MSIR). She was recommended to follow up in one month for further evaluation and treatment. Ms. Schnorr will testify that on April 20, 2018, Ms. Richman presented for a follow-up evaluation of her ongoing pain symptoms and pain management. She was advised to use pain medications as prescribed. She was recommended to use heat therapy for pain. She was advised to follow up in one month for further evaluation and treatment. Ms. Schnorr will testify that on May 18, 2018, Ms. Richman presented for a follow-up evaluation of her ongoing pain symptoms and pain management. She was advised to use pain medications as prescribed. She was advised to follow up in one month for further evaluation and treatment. Exhibit A - Page 15 Ms. Schnorr will testify that on June 19, 2018, Ms. Richman presented for a follow-up evaluation of her ongoing pain symptoms and pain management. She was advised to use pain medications as prescribed. She was counseled about vitamin D. She was advised to follow up in one month for further evaluation and treatment. Dr. Birnbaum will testify that on June 22, 2018, Ms. Richman presented for a follow-up evaluation of her ongoing pain symptoms. She was prescribed Alprazolam and Ibuprofen. She was advised to follow up on an as-needed basis for further evaluation and treatment. Ms. Schnorr will testify that on July 20, 2018, Ms. Richman presented for a follow-up evaluation of her ongoing pain symptoms. The PDMP was reviewed with her. She was advised to follow up next month for further evaluation and treatment. Dr. Andreen will testify that on September 10, 2018, Ms. Richman presented for a follow-up evaluation of her ongoing pain symptoms. She reported moderate-severe pain in the right shoulder, neck, and back. She described her pain as sharp, stabbing, burning, shooting, and some achy. She was prescribed MS Contin and MSIR. She was advised to follow up on an as-needed basis for further evaluation and treatment. Dr. Andreen will testify that on December 26, 2017, Ms. Richman presented for a follow-up evaluation of her ongoing pain symptoms. She was prescribed MSIR and advised to follow up on an as-needed basis for further evaluation and treatment. Ms. Schnorr will testify that on February 5, 2019, Ms. Richman presented for a follow-up evaluation of her ongoing pain symptoms. She attended a group pain clinic and participated in yoga. The PDMP was reviewed and recommended to continue her medications. She was advised to follow up on an as-needed basis for further evaluation and treatment. Ms. Jackson will testify that on March 5, 2019, Ms. Richman presented for a follow-up evaluation of her ongoing pain symptoms. She attended group pain class and participated in a game. The PDMP was reviewed and recommended to continue her medications. She was advised to follow up on an as-needed basis for further evaluation and treatment. Dr. Birnbaum will testify that on April 24, 2018, Ms. Richman presented for a follow-up evaluation of her ongoing pain symptoms. She was prescribed Alprazolam and Clotrimazole cream. She was provided a referral to physical therapy. She was advised to follow up on an as-needed basis for further evaluation and treatment. Ms. Schnorr will testify that on July 15, 2019, Ms. Richman presented for a follow-up evaluation of her ongoing pain symptoms. She reported she is scheduled for epidural injections. She was prescribed MSIR and advised to follow up on an as-needed basis for further evaluation and treatment. Dr. Rutledge will testify that on July 31, 2019, Ms. Richman presented for a pain management evaluation. She reported pain in the neck just below her shoulders up and mid back to low back pain. She reported sciatic nerve pain, and numbness and tingling in the left leg bother her. She Exhibit A - Page 16 reported pain in the hands, numbness and tingling in the right arm, and burning pain in the right arm. She reported her pain feels poorly controlled. Following the examination, she was assessed with cervicalgia, chronic bilateral low back pain with sciatica, and chronic pain syndrome. She was prescribed MSIR. She was ordered to obtain the X-rays of the cervical spine, thoracic spine, and lumbar spine. She was advised to follow up on an as-needed basis for further evaluation and treatment. Ms. Schnorr will testify that on August 26, 2019, Ms. Richman presented for a follow-up evaluation of her ongoing pain symptoms. She reported she is scheduled for two epidural injections. She was prescribed MSIR and advised to follow up on an as-needed basis for further evaluation and treatment. 9. Elizabeth Baggett, EMT Poudre Valley EMS 1024 South Lemay Avenue Fort Collins, CO 80524 Phone: (970) 495-5019 Ms. Baggett will testify that on September 27, 2017, Ms. Richman was responded to a report of back pain. She reported that she had chronic neck and back pain, and the back pain was too much for her to handle. She stated that she had unbearable pain and that she could not walk. Following the examination, she was assessed with pain. She was placed in a Semi-Fowlers position and transported to the emergency department for further evaluation and treatment. 10. Colin M. Carpenter, MD Front Range Pain Medicine/Harmony Surgery Center 3744 South Timberline Road, Suite 102 Fort Collins, CO 80525 Phone: (970) 495-0506 Dr. Carpenter will testify that on October 19, 2017, Ms. Richman underwent right L5-S1 transforaminal epidural steroid injection (L5 nerve root) and left L5-S1 transforaminal epidural steroid injection (L5 nerve root) under fluoroscopic guidance with Midazolam and Sublimaze. Her preoperative and postoperative diagnosis included lumbar degenerative disc disease. Dr. Carpenter will testify that on August 21, 2018, Ms. Richman presented for evaluation of neck pain, mid back pain, and low back pain. She reported right-sided neck pain with neuropathic pain down her right arm and mid-back pain and stated that the symptoms stemmed from the subject motor vehicle collision and that the symptoms had changed somewhat since then. She reported the back pain had slowly started to return, and it was across the low back and radiating into bilateral legs, right greater than left in the same direction. Following the examination, she was assessed with right greater than left neck and radiating arm pain consistent with cervical radiculopathy and lumbar degenerative disc disease with bilateral L5 radicular component. She was recommended a repeat bilateral L5 translaminar epidural steroid injection. She was advised to continue physical therapy for neck and upper back issues. She was recommended a cervical MRI for interventional planning if neck pain continued a few weeks following the lumbar epidural steroid injections. Exhibit A - Page 17 Dr. Carpenter will testify that on August 30, 2018, Ms. Richman underwent right L5-S1 transforaminal epidural steroid injection (L5 nerve root) and left L5-S1 transforaminal epidural steroid injection (L5 nerve root) under fluoroscopic guidance with Midazolam and Sublimaze. Her preoperative and postoperative diagnosis included lumbar degenerative disc disease. Dr. Carpenter will testify that on August 14, 2019, Ms. Richman presented for a follow-up evaluation of neck pain and back pain. She reported a significant increase in her neck pain, left greater than right, radiating down the left arm, and numbness and tingling in her fingers. She stated that her neck was worse than her back. She was diagnosed with left greater than right neck and radiating arm pain consistent with cervical radiculopathy and lumbar degenerative disc disease with recurrent bilateral L5 radicular component. She was recommended cervical epidural steroid injection (C7-T1). She was advised to follow up two weeks following the cervical epidural injection. 11. Officer Rebakah Finkle, Badge Number FCC177 Fort Collins Police Department 2221 South Timberline Road Fort Collins, CO 80525 Ph: (970) 221-6540 Officer Finkle was the responding officer to the incident on June 7, 2017, and will testify consistent with the police report previously produced in this case. He will testify as to the degree of damage he saw on Plaintiff and Defendant’s vehicles at the scene, and he will testify as to how the incident occurred. Specifically, he will testify that Defendant Antonio Lopez hit Mr. Cross vehicle. Officer Finkle will further testify regarding the general rules of careless driving and that Mr. Cross did not cause or contribute to the collision. 12. Any expert endorsed by any other party in this case. 13. Any expert testimony necessary for rebuttal or impeachment. This disclosure of expert testimony is based on the information reasonably available to Plaintiff at this time. Plaintiff hereby reserves the right to amend and/or supplement this disclosure of expert testimony pursuant to C.R.C.P. 26(e) in the event that additional information pertinent to these experts’ opinion is obtained in the future. Respectfully submitted dated May 25, 2021. s/ W. Clayton Harris, Esq. This pleading was filed electronically pursuant to Rule 121 § 1-26 Original signed pleading is on file in counsel’s office Exhibit A - Page 18 CERTIFICATE OF SERVICE I certify that on May 28, 2021, the foregoing PLAINTIFF STUWARD CROSS AND KATRINA RICHMAN EXPERT C.R.C.P. 26(a)(2) DISCLOSURES was served via ICESS and copy addressed to the following: Andrew W. Callahan, Esq. Wick & Trautwein, LLC P.O. Box 2166 Fort Collins, CO 80522 Attorney for Defendant /s / Jessica Johnson _______________ Original Signature on File in Attorney’s Office Jessica Johnson, Litigation Paralegal Exhibit A - Page 19