Bradenton Healthcare Fraud - Wrongful Death Clause

BRADENTON, FLORIDA HEALTHCARE FRAUD

Massive abuse of the Elderly with no Acccountability

An Example of the Criminal Healthcare Justice System in Florida,

which await those with no economic damages

SPCP HOME ZOE BLAKE MEDICAL CENTER JUSTICE DENIED ETHICS: DOCTOR- LAWYER

Zoe died on February 13, 1999 in Bradenton, Florida after a stroke and hospital and nursing home "care" of one month.

Dr. Unaeze and IHS [now Heritage Park] were parties since 2001

See start of this Action. Also see the farce of Blake Medical Center and medical records.

CONCURRENT RECORDS IS THE ANSWER - GET A COPY OF EVERYTHING IMMEDIATELY!

Link to Defendant Filings

Fraud/Malpractice Victim Filings:

Unaeze Nursing Home

2nd AMENDED COMPLAINT

3RD AMENDED COMPLAINT Jan. 5, 2005

MOTION FOR A CASE MANAGEMENT CONFERENCE January 28, 2005

HEARING on Dr. DeGroat's Motion to Dismss February 2, 2005

HEARING on Blake Medical Center's Motion to Dismss February 9, 2005

HEARING TRANSCRIPT March 2, 2005 on Discovery Protection of Healthcare Providers [Braxtan, Sharma]

APPEAL BRIEF filed August 26, 2005

DEMAND TRIAL BY JURY

ESTATE OF ZOE E. STRONSTORFF, deceased

By CAROL STRONSTORFF, as Personal representative;

And CAROL STRONSTORFF, sui juris

/ Plaintiffs CASE NO. : 2001-CA-713

v.

INTEGRATED HEALTH SERVICES OF Lester, Inc. d/b/a

INTEGRATED HEALTH SERVICES OF BRADENTON,

And d/b/a IHS of Bradenton and d/b/a (ihs) Heritage Park, and d/b/a/

John Does;

HCA Health Services of Florida, Inc. d/b/a Blake Medical Center, d/b/a Columbia

Blake Medical Center, d/b/a; HCA L.W. BLAKE MEMORIAL HOSP; or d/b/a JOHN DOES

COLUMBIA BLAKE MEDICAL CENTER AUXILIARY, INC.., d/b/a HCA L.W. BLAKE HOSPITAL, INC.., d/b/a BLAKE MEDICAL CENTER AND/OR d/b/a COLUMBIA BLAKE MEDICAL CENTER, or d/b/a JOHN DOES,

Dr. John G. Malone

Dr. Jose Polanco

Dr. Gustavo Arrojo

Dr. Thomas N. Braxtan

Dr. Thomas S. DeGroat

Dr. Vitalis Unaeze

DR. Vishal Sharma

Bradenton Emergency Medicine Associates Defendants_________________________________________________/

RESPONSE TO BLAKE MEDICAL CENTER'S MOTION TO DISMISS

Plaintiffs understand that a motion to dismiss is the usual way for Defendants to attack a complaint. As a person, not educated in the practice of law, it is understandable that the complaint may not be in acceptable form to a professional. However, the complaint itself and the question of law found in this complaint/petition cannot be lightly dismissed as proposed by Defendants. See Ralph v. City of Daytona Beach, 471 So.2d 1, 2 (Fla.1983):

"For the purposes of a motion to dismiss . . . allegations of the complaint are assumed to be true and all reasonable inferences arising therefrom are allowed in favor of the plaintiff.".

Plaintiffs now show the Court the following:

1. Plaintiff [in response to Defendant's paragraph 1] has stated a cause of action in fraud and elder abuse, as well as medical negligence and breach of contract in their Medicare responsibilities. The action is also for spoilation of evidence, which prevented the bringing of timely and complete claims.

2. In response to Defendant's paragraph 2: It is impossible to state a short and plain statement of the ultimate facts showing the Pleader is entitled to relief. The list of fraudulent statements, false representations, neglect and abuse as well as statutory violations is too long.

3. In response to Defendant's paragraph 3:

Rules of Civil procedure require that amendment should liberally be allowed in the interest of justice. Since the first amended complaint was not served due to known defects, this honorable court would surely have no objections to the serving of the Second amended complaint, since not one party was prejudiced.

4. In response to Defendant's paragraph 4:

The issue of the statute of limitations is not clear in this case because of the issue of fraud and concealment, which based on current evidence was intentional and is still on going. Neither the "skilled" nursing home nor the hospital have disclosed how they billed Medicare and have apparently submitted fraudulent records to justify Medicare claims. Neither facility assured continuity of care. Neither facility has accurately documented, what took place on the last two days of Zoe's life nor even the "care" given to Zoe, while at their facilities. The hospital has not disclosed the admission day/night [1/11/99- 1/12/99] events involving elaborate cardiac actions, which are not documented in the medical records seen and known to plaintiff. The order for the insertion of the indwelling catheter is also not found and this is suspected by plaintiffs' medical expert to be the true cause of death, which was actively concealed by both facilities and their agents. The actual diagnoses of the patient are not clear and the cause of death was absolutely concealed by the failure to have the body examined by the medical examiner before releasing the body from the nursing home.

Plaintiff attempted to comply with the presuit requirements of Chapter 766 in bringing such an action. Defendant has failed to comply with all attempts of Plaintiff to achieve fulfillment of law and has exhibited extreme bad faith in trying to conceal the egregious actions involved in this case. See attached proof of initiation of the presuit requirements as well as case 2000-CC-4009. Blake Medical Center / HCA Health Services of Florida never took part in the presuit discovery. In fact, it never responded whatsoever. This notice was well within the statute of limitations with the 120 day extension. It never answered the request for admissions or provided all records of Zoe or a proper bill for the rebilling of Medicare.

5. In response to Defendant's paragraph 5: Count XXXX was not properly written and should pertain to the auxiliary function in suing for lack of payment and billing. Since the risk manager of the hospital is the receiving agent, it is possible that the missing volumes of records are kept here. A collection action was possibly begun from this auxiliary against law, since as a Medicare hospital, no additional charges may be made once Medicare charges have been accepted, this is a fraudulent claim. The Auxiliary would then have documents documenting this claim, which would not be accurate or fraudulent.

6. In response to Defendant's paragraph 6: In Count XXXXI, Plaintiff alleges Breach of Contract - Medical Records by B. HCA Health Services of Florida, Inc. As a Medicare patient, there are strict record keeping requirements.

7. The Medicare Conditions of Participation, section 42 CFR 482.24 (b), states that all hospitals must retain medical records in their original or legally produced form for a period of 5 years. Records were released to unauthorized individuals as shown on pages H2-H3.

8. The Request for admissions show many of the violations. The list is not complete. State laws s.395.302 and 395.3025 apply to this complaint as to record maintenance, alteration and access . These documents indicate violation of law and breach of contract as well as an attempt to alter the records to conceal the lack of appropriate care. This count can not be dismissed without manifest injustice.

9. In response to Defendant's paragraph 7 concerning Counts XXXXII and XXXXIII BREACH OF CONTRACT - LABORATORY SERVICES :

There are again requirements for Medicare and accurate reporting of results and ordering personnel are requirements. When records are suppressed, the actual condition of the patient is unknown. Knowledge of the time, place and responsible ordering party is important legal information. When the service is not provided, a breach of contract has occurred. To determine whether private cause of action should be judicially inferred, court must look to legislative intent. The intent is to preserve a legal document and give accurate results of the treatment. See H19, which indicates massive problems with the computing service contractor.

10. In response to Defendant's paragraph 8 concerning COUNT XXXXIV of The Defendant, HCA Health Services of Florida, Inc. d/b/a Blake Medical Center and d/b/a [HCA] L W Blake Memorial Hospital and d/b/a Blake Hospital and d/b/a Columbia Blake Medical Center. Negligence in medical treatment and negligence per se resulting in actual elder abuse is pleaded. The same treatment by a nonmedical person would result in criminal charges. Fraud and concealment interrupts both the statutes of repose and statute of limitations.

11. In response to Defendant's paragraph 8 concerning Counts XXXVIII and XXXIX : The nursing staff problem and the Borelli report were not discovered during the time for making the complaint. It appears the staffing requirements as were reported to the Agency for Health Care Administration were falsified for the case of the patient, since AHCA did not find staff violations, or for some reason did not report them.

12. Due to the Florida Wrongful Death clause pertaining to medical malpractice, access to a competent attorney was denied the plaintiff. The purpose of this statute is surely not only to cut down malpractice suits, when human lives are endangered by corporate policies, which breach compliance agreements and necessary staffing requirements. Patient safety and proper care must have priority over age of the patient's survivors.

13. In response to Defendant's paragraph 9: COUNT XXXXV states FRAUD AND CONSPIRACY BY THE DEFENDANT, HCA HEALTH SERVICES OF FLORIDA, INC. and facts are given to indicate just this . Eighteen points are mentioned to document the fraud and conspiracy issue. [The list is not complete]. Some of the documents were attached to the complaint. Others are found in the records of the lower case 2000-CC-4009. At the scheduled hearing each point can be illustrated. The facts are there, although many are actively being concealed by the defendant parties involved. No reasonable person can believe that these are simple administrative errors. Plaintiff alleges these are actions calculated to increase profits at the expense of all rights of the patient and her family. This has the effect of ruining quality care and increasing healthcare costs, which is certainly not the goal of the legislature.

14. Please see the excerpts from a recent letter to the Attorney General's Tampa Office as to the records used in an "investigation" as to abuse of the elderly:

5. You are missing the identification of the hospital emergency room doctor. AHCA has reported a different entry to the hospital, than is true [ false - 2/11/99 -night - highly critical]. The diagnoses found under the name SILPA are unknown to me and not found in my copy of the medical records [Volume II]. LISKIEWICZ was the doctor and his diagnoses are almost correct.

Considerable undocumented heart action is taken under Silpa's name and the ICU heparin records are missing. Admission was on the 11th of January, 1999, yet no cardiologist is documented as having seen the patient until the 20th. This is nine days later and this doctor,

DeGroat, does not identify the attending physician. ["Roho" is used - Arrojo is the name and his code is ARGU]?

Is this not abuse/ and/or fraud [hospital and doctors]? If she needs care does she get it? And is her daughter and health surrogate not supposed to be informed?

The discharge lacks continuity of care - false diagnoses. The supposed attending physician Arrojo does not write a discharge summary until 3 months after discharge and has her discharged one day earlier than the truth. All legal and acceptable in Florida?

Are these "reliable, trustworthy caregivers who treat [patients] with the utmost care and respect?"

6. Page 36 [n60] shows the patient crying out all night on 2/11/99 and nothing done - nothing done -- pain triggers a RAP and some action. {contrast this page w/ page 21 [n42]- fraud - unknown nurse Medi wrote time of 750 yet page 60 shows a later time and a different nurse, which negates Unaeze's story about starting Darvocet on 2/12/99, since it was started more than 12 hours earlier and not working. Page 45[n171] is a worthless test - also please note date in records - Feb. 1, 2000 - missing in the original SNF records by required completion of all records - death 2/13/99 - discharge 2/12/99 ????

Are these "reliable, trustworthy caregivers who treat [patients] with the utmost care and respect?"

7. You have zero laboratory reports in the nursing home records, which show a questionable laboratory "PL Physicians' Laboratory", which is billed under St. Josephs Hospital [ in the name of STRONSTOTFF - Tampa- Is it real? Was it legal?] -- tests on 2/8/99 only under diagnoses for Diabetes [25000] and Noninf gastroenterit nec [5589] Dr. Sharma, who ordered the tests does not use the latter code in billing the insurance with an unpaid claim for only 2 days - 2/7/99 and 2/8/99.

In the meantime, I have discovered that Physician Laboratories is "phlebotomy draw station" in Ocala. Zoe was in Bradenton. Also that Integrated Health Services of Bradenton had a license to do waived procedures, which most of Zoe's tests were.

Just why do you think tests are then done through an Ocala draw station for a Bradenton SNF resident in a false name, which by the way loses results or restarts them 4 or 5 days after notification that it was submitted with the wrong colored cap? Just why do you think Dr. Sharma only submits a claim for Feb. 7th and 8th. Did he abandon her?

What the hell do you think is going on? Are these "reliable, trustworthy caregivers who treat [patients] with the utmost care and respect?"

8. You do not have the pharmacy records showing strange drugs - all under the name of Sharma, who is required to bill for patients under state law in the next billing cycle. Are they not important in your investigation of ABUSE? But where did the "attending physician Hernandez" on page 20 [n41] - also see page top with Hoban's date altered - come from?

We have a new unknown attending physician and AHCA could not find him? Are these reliable, trustworthy caregivers who treat [patients] with the utmost care and respect?"

9. You have no release of the body and the death certificate is fraudulent. See expert opinion. Are these "reliable, trustworthy caregivers who treat [patients] with the utmost care and respect?"

10. See page 223 , when Zoe's daughter is not allowed [forbidden] to see the patient's chart and has virtually no doctor - no one - to inform her of the patient's condition and options. Zoe was blind; could not talk clearly enough to order her way home; could not walk out; and the person, who she had legally designated to make informed decisions for her was denied information and help to do so. Have her rights not been massively abused?

[from site http://justicedenied.homestead.com/MediCareMurderofZoe.html and http://justicedenied.homestead.com/files/fax_Iglesias041018.htm].

15. In response to Defendant's paragraph 10: COUNT XXXXVI VIOLATION OF § 415.1111 relates to abuse of the disabled and elderly.

16. Zoe, a diabetic was denied any nourishment other than normal saline [salt water - 18 grams per day] for three days. She then was denied proper testing of her swallowing ability. [Fraudulent audit sheet [H5] showing Speech on 1/11/99. This event is not found in the only medical records made available to Plaintiff and is not known to Carol, who was with the patient]. Zoe was harassed to have an unwanted operation. Instead of allowing the patient to eat and drink, the patient was coerced into a nasal tube. The records appear to be fraudulently adjusted to try to justify such an action.

17. The 2nd insertion of the nasal tube was achieved by circumventing the patient's wishes and withholding Zoe's written notes from her legally designated health surrogate, her daughter. At this time, Carol had been forbidden access to her mother's record, yet had no attending physician to consult.

18. The documented overdose of Mannitol appears too extreme to be common negligence and medical malpractice. This was started after the refusal of the patient to have a stomach tube operation. Normally, a reason for an overdose amount is documented. No reason is given. Pharmaceutical instructions are for close evaluation of input/output and electrolytes. This is not shown anywhere in the medical records.

19. The insertion of a urinary catheter is against the Florida stroke guidelines. This is not allowed for staffing convenience. There must be a necessity. It is a known detriment for the patient in introducing dangerous infections. Zoe died almost a month later with this device still in place. She did not want it and it was forced upon her in the emergency room on 1/11/99. It has been excused, because of the ability to accurately measure urine. However, there are no accurate I/O measures shown in the medical records as having been done.

20. Worst of all is the abuse with the swallowing procedures. Not doing the appropriate swallow testing in presence of family and explaining all the options of swallowing techniques.

The one radiologist report [H460] of 1/25/99 indicates that Zoe could tolerate solids, yet solids were denied her through her stays up to her death. Ice is solid. Liquids were denied her through her stays up to her death -- no water or fluid drink for one whole month until her death.

Plaintiff viewed the video swallow test on 1/25/99 and was told by the hospital Speech Language Pathologist that there was no aspiration. She was told that there was only danger of it because liquids stayed around the larynx too long. The nursing home would not accept the patient, while there was aspiration, Plaintiff was told. However, the report states that there was aspiration with thin liquids. The video tape was destroyed, although required to be maintained for five years.

In the nursing home, we have all kinds of precautions for swallowing based on some report, which appears to be different from the one made on 1/25/99. Furthermore, we have the nursing home speech therapist [SLP] not allowing Zoe to rinse her mouth between bites. At the same time, we have a medical doctor, Dr. Sharma, prescribing a salt water gargle on 2/7/99. Anyone knows that gargling is not that easy, yet here we have special therapy and great precautions supposedly being necessary, yet obviously not necessary according to the attending physician.

21. Zoe was unnecessarily denied food and drink. She was forced to have a catheter, which is not documented as having been necessary. It was unwanted by the patient. She was coerced into a nasal tube and harassed for an operation. She was virtually forced into a nursing home, although she wanted to go home and had her family available to care for her. Medicare only covers necessary services and procedures provided at the appropriate care level.

22. Zoe had her health harmed by the "treatment" at the hospital and nursing home. Having had a stroke and being rejected as poor material for hospital rehabilitation, the only patient friendly [non-abusive] treatment would have been discharge home with prescription of home therapy.

23. However, it appears the patient was held against her will and without informing the patient family of true options for the purpose of increasing hospital and physician profits.

In light of the concealment of the adverse heparin incident on admission night [highly critical over thinned blood values for two days, which were later suppressed] and related unknown cardiac 'care", it appears that possibly Zoe was supposed to die to prevent any possible lawsuit for cardiac damage - Florida's Wrongful Death Clause, the "free kill.". Cardiac damage could not be hidden once the patient was released alive from the hospital and could be evaluated by independent physicians. The EKG taken at IHS on 2/9/99 is again miraculously missing. No other heart test is found although Zoe was supposed to be at the SNF for the diagnosis of atrial fibrillation [AFIB], a heart condition, which can lead to a stroke and death. No medication was given to prevent a blood clot as is normally done. It appears, she was supposed to die as quickly as possible and without an autopsy.

Had death happened in a stomach tube operation with a signed consent form, all would have been over. However, the Stronstorffs did not believe in such operations. This makes it appear that other tactics were taken - under nourishment, overdose Mannitol, overdose antibiotics without proper testing for the causing microorganism - lack of diagnoses , lack of blood-thinner, lack of proper transfers and finally refusal of treatment for two days prior to death and then concealment of all actions on admission and the last two days of Zoe's life.

24. Zoe was virtually thrown out of the hospital on 2/2/99 without a legal admission contract to the skilled nursing home located at 2302 59th St. W, Bradenton [a/k/a IHS of Bradenton - today Heritage Park]. There was no true continuity of care. The ambulance transportation was not properly billed and there were different/unknown diagnoses given.

Zoe wanted to go home. Home Health services could have been made available. According to Blake's own subacute, this would have been the appropriate move [long-term program], yet the only way to get her out of the hospital was through a nursing home. Zoe was not weak at this time, but reports make it appear as if she may have been declared on hospice. Also, it appears there is an effort to imply "dementia," which was never present. The billing and interaction of the two [possibly more] facilities seem to indicate fraud to cover up the extreme abuse of the patient. The records at both facilities appear to have been altered to justify their claim. By creating an untrue legal document, the healthcare providers have committed fraud. A fraudulent record appears to have been necessary to hide the extreme neglect and abuse of the elderly disabled patient.

25. The toothless Florida Patient's Bill of Rights and Responsibilities in Florida Statutes of Section 381.026 was totally violated. There were willful violations, yet due to the provider friendly atmosphere in Florida, fraudulent records are tolerated and crimes continue unpunished. H175 clearly shows the major violation of Zoe's rights with the written denial on 1/15/99 of Zoe's health surrogate to read her records.

The abuse of the patient is to be evaluated by a jury and not dismissed on defendant's wish to conceal the "normal course of business", which awaits the elderly patient in Florida at certain healthcare facilities like these two in Bradenton.

26. In Paragraph 11, Defendant accurately states that the "case arises out of medical treatment rendered to the decedent, Zoe Stronstorff, the early part of 1999. Ms. Zoe E. Stronstorff was 88 years old at the time the treatment was rendered." Zoe's mother lived to be 105. "Zoe died on February 13, 1999 and the factual allegations of this Second Amended Complaint pertain to the conduct which occurred more than 5 years ago." On the face of the complaint without the element of fraud, the complaint would be outside of the statute of limitations. Fraud and concealment are alleged and this extends the statutes. Furthermore, the exceptional issue of the Wrongful Death Clause, with the effect of violation of Constitutional due process and equal protection rights, adds another element to this particular case.

27. The Paragraph 12 is factually correct. However, it is presented to portray that the elements of the issues were adjudicated, which was not the case. Case 2000-CC-4009 was started to obtain the entire patient records and a bill. This was done by the daughter of Zoe pro se, because she was barred entry to a law firm on the basis of the "Wrongful Death Clause" baring children over 25 in a medical malpractice suit. Since the treatment was so egregious, she attempted to get the complete medical record for review. The complaint was filed in County Court. The entire facts were given, yet the entire case was treated as an Injunction. On the basis of a false certificate of compliance by attorney Evangelista, the case was dismissed with much unfair delay in a very questionable manner.

28. The record of the case indicates clearly that the court lost jurisdiction with the injunction order, yet defendant and judge allowed the court to drag on without any jurisdiction. The April 9th, 2001 order was never complied with despite statements to the contrary. The February 8th filings were never heard or acted upon. The court orders as to viewing of the records were not complied with - appointments made, but not all records given.

29. The August 23,2001 and Oct. 10, 2001 requested hearings on contempt and an itemized bill were set for ten minutes each for Oct. 17th, 2001. An unknown judge "heard" the motions and dismissed the entire case. The recorded hearing and background is at http://www.spcpi.homestead.com/justicedenied.html.

30. Please note the big farce with the April 29th Opinion "(Hearing held on March 18, 2002)" THERE WAS NO HEARING ON THE MERITS. This hearing was on the motion to strike the supplemented missing order proposals of Blake Medical Center's indicating Lawyer Evangelista- Judge Defuria ex parte communications. The transcript of this hearing is in the 2000-CC-4009 file. It appears Judge Williams did not wish to have another hearing with a court reporter. His actions were everything but fair. The dismissal of the "rehearing " request was dismissed although, Stronstorff had requested a stay in the proceedings, while she was in Europe.

31. The appeal to Lakeland was declared untimely, so it too was never heard.

32. The January 6th, 2004 motion to transfer was dismissed since the County Court had no jurisdiction to transfer the case. It would not have been filed except for the case disposition, which is still "reopen"

33. The County Court never adjudicated any of the claims made by Plaintiff. Judge DeFuria made it clear, that he at no time would review the medical records for completeness. As a county court judge, at the first hearing, he knew nothing about the Wrongful Death Clause, which barred Stronstorff from an attorney. He relied solely on information and the false compliance statements of Mr. Evangelista. One only need to look at the records on file in that case and one can see that there are no medical records for Zoe in the file after February 2, 1999.

The requested records involving February 12 and 13, the two last days in the life of Zoe were refused and they involved a request for emergency care for Zoe on the 12th and a communication with Dr. Silpa of the emergency room and EMS at the nursing home at the time of Zoe's death.

Similarly, there is no bill identifying the corporate entity for billing of Medicare and there are no laboratory results identifying the ordering physician, the location of the patient and her diagnosis - reason for testing.

34. If the court were to grant Defendant's request and dismiss this complaint, a grave injustice would be done to all potential patients. Sanctioning Stronstorff for attempting to seek accountability from entities, which break laws without a second thought, would be outrageous. Fraud and concealment would be rewarded. This cannot be allowed in the area of healthcare. Health is the most important issue of our lives.

FRAUD AND CONCEALMENT TOLL STATUTES

35. There can be no doubt that Blake Medical Center is fully aware that breach of contract, ethics and abuse of the elderly have occurred. This is documented in the medical records made available in court case 2000-CC-4009 and the actions of both Blake Medical Center and their counsel in the lower court action.

36. It is hoped that the honorable Court will follow the logic of the Supreme Court of Florida in their Opinion filed November 27, 2002 (No. SC00-105) in FLORIDA DEPT.; HLTH. AND REHAB. v. S.A.P., 835 So.2d 1091 (Fla. 2002) and rely "upon the principle that our courts will not protect defendants who are directly responsible for delays of filing because of their own willful acts."

37. "Concealment" required to extend the statute of repose in medical malpractice matters to seven years requires fraud, intent to conceal or some other active element. Nardone v. Reynolds, 333 So.2d 25 (Fla. 1976). See also Almengor v. Dade County, 359 So.2d 892 (Fla. 3d DCA 1978). Concealment also requires knowledge (by the tortfeasor) about plaintiff's condition which is not conveyed to plaintiff. Nardone, 333 So.2d at 37.

38. Florida statute 95.031 (2)(a), An action for fraud under s. 95.11(3) "must be begun under s. 95.11(3), Must be begun within 12 years after the date of the commission of the alleged fraud, regardless of the date the fraud was or should have been discovered.

39. Section 95.11(4)(b), Florida Statutes, extends the normal four-year statute of repose in a medical malpractice action may be extended to seven years in cases of "fraud, concealment, or intentional misrepresentation of fact."

40. "Concealment" is defined in Black's Law Dictionary 282 (7th ed. 1999) as (1)

the act of refraining from disclosure; esp. an act by which one prevents or hinders the discovery of something; and (2) the act of removing from sight or notice; hiding. Under these definitions, concealment connotes knowledge.

41. There can be no doubt that there was knowledge of wrong doings at the hospital and nursing facility and that an effort was made to conceal them. The entire cardiac care/harm on or about admission is still not revealed to Plaintiff. The heparin administration has not been fully disclosed. The laboratory reports, which would show results of "care," have been denied Plaintiff. These would show the ordering physicians and help expose the fraudulent and abusive care of the patient and her designated health surrogate.

42. The attempt to hide different doctors from the regular care is still partially successful. The forbidding of access to the patient's records by the daughter of the blind handicapped patient is the epitome of abuse of her rights against all law.

43. The unknown discharge conditions along with the various reports to control authorities {FMQAI and AHCA} indicate scienter of wrong doing and fraud. These are actionable under the false claims act since both facilities appear to be reporting falsely and using a false record to justify the claim and secure payment.

44. The death of the patient at the SNF facility, yet on paper discharged to unknown destinations a day and one half earlier indicate known violations and an attempt to hide these by both facilities acting with doctors Unaeze and Sharma and John Doe.

45. There can be no reason for IHS to deny Plaintiff the Medicare UB-92 billing unless it is to conceal their crimes and their partner[s] in crime. Similarly Blake Medical Center conceals it's interaction with the Plaintiffs on the 12th and 13th of February 1999. [See case 2000-CA-4009]. Blake Medical Center literally threw the patient into the SNF, without any arrangements to assure continuity of care and an orderly transfer. The number of discrepancies cannot be explained away with "administrative" and "documentation" errors, but scienter. IHS has also not given the statutory required agreement for emergency transfer with the hospital.

46. "Intentional misrepresentation of fact" is the intentional (done with the aim of carrying out the act) act of making a false or misleading statement about something.

47. Applying the doctrine of noscitur a sociis, because both "fraud" and "intentional misrepresentation of fact" involve a level of knowledge or intent, we conclude that

the legislative intent was to extend the repose period when intentional acts prevent

discovery of the injury. NEHME v. SMITHKLINE BEECHAM CLINICAL LAB., 863 So.2d 201 (Fla. 2003) did not rule out concealment in extending the statute of repose beyond four years.

"Concealment" required to extend the statute of repose in medical malpractice matters to seven years requires fraud, intent to conceal or some other active element. Nardone v. Reynolds, 333 So. 2d 25 (Fla.1976). See also Almengor v. Dade County, 359 So. 2d 892 (Fla. 3d DCA 1978).

Concealment also requires knowledge (by the tortfeasor) about plaintiff's condition which is not conveyed to plaintiff. Nardone, 333 So. 2d at 37. In such instances, the plaintiff is being actively misled about his or her true condition by the tortfeasor.

48. "Conceptually, this intentional withholding of information acts to delay plaintiff's ability to discover the tortfeasor's wrongdoing or the nature of the injury itself." NEHME v. SMITHKLINE BEECHAM CLINICAL LAB..

49. Also see DOE v. HILLSBOROUGH CTY. HOSP., 816 So.2d 262 (Fla.App. 2 Dist. 2002) and Glus v. Brooklyn Eastern District Terminal, 359 U.S. 231 (1959) and MAJOR LEAGUE BASEBALL v. MORSANI, SC96004 - 07/12/01).

BACKGROUND INFORMATION NECESSARY TO UNDERSTAND THE ISSUES

50. Florida has had known cases of "murdering" their elderly, yet covering it up. In 1998, 19 homicides were reported by Volusia County medical examiner Dr. Ronald Reeves. They involved the community Halifax Medical Center and it's hospice facility: Volusia Hospice. One of the more prominent cases involved 78-year-old Mary Comford, who went into the hospital for kidney stones. While there the doctors reported, however, that she was terminal with brain cancer and had her admitted to Volusia Hospice for treatment, where she died quickly. Yet the autopsy indicated zero cancer and a deadly morphine overdose. The coroner found 18 more such homicides. The state attorney, however, squashed all further homicide investigations.

51. The protective state medical panel ran their own protective investigation and changed all death certificates from homicide to "undetermined." This protective arrangement of doctors protecting doctors and healthcare facilities does not promote responsible ethical healthcare, but fraud, waste and abuse and yes, even murder.

52. Doctors receive favored treatment in Florida, as they do elsewhere. The October 12th, 2004 announcement by Florida Attorney General as to their different handling of Medicaid fraud is indicative of the violation of due process and equal protection under the law in this state.

The Hudson doctor was allowed to buy his way off criminal Medicaid fraud. The OB, Dr. Armbruster, stole nearly $200,000 by reporting self-performed difficult birthing, which he never did. [One sees the great necessity of gynecologists in this example]. His mid-wife employees, however, delivered for him. It appears the two hospitals went along with the scam.

53. On the other hand, the lowly physical therapist, who stole less than $2000 from Medicaid [by reporting work, she did not perform] went to jail and will be prosecuted as a 3rd degree felon.

54. These policies [protective of healthcare providers] allow for ever worsening of healthcare, when physicians and healthcare providers are not held accountable for obvious crimes. Zoe is only one case out of many, which allow medical malpractice to occur as agenda -shortening the lives of our elderly at the personal profit of irresponsible physicians. Since about 50% of revenue comes from Medicare patients - potentially those affected by the Wrongful Death Clause. This statute allows for unaccountable malpractice, which assures profits of healthcare providers and insurance companies, yet not proper and humane medical care.

THE WRONGFUL DEATH CLAUSE [§768.21(8)] IS UNCONSTITUTIONAL

55. Plaintiff would again like to raise the question of the legality section 768.21(8), Florida statutes in light of the Supreme Court of Florida ruling in an opinion filed in April 20, 2000 in MIZRAHI v. NORTH MIAMI MEDICAL CENTER, LTD., 761 So.2d 1040 (Fla. 2000)Nos. SC93649, SC93650. Section 768.21(8) is unconstitutional as a violation of equal protection. It bears no rational relationship to a legitimate state interest. Sky rocketing medical malpractice insurance premiums are not being curtailed by these interventions. Caps do not work. Malpractice suit restrictions do not benefit the public, but only insurance companies and perpetrators of malpractice and negligence.

56. As proof of this, Plaintiff offers the recent statements made by the nation's largest medical malpractice insurer, GE Medical Protective on justifying it's 19% increase on physicians' premiums just one year after Texas lawmakers passed a $250,000 cap on non-economic damage compensation to victims of medical malpractice caps. [fn1]

57. This footnoted article documents the vaudeville show and lies, which are made to achieve profit-oriented objectives, against the public and moral interests. Plaintiff calls again attention to the Florida specific facts of July 15, 2003 - already mentioned in the 2nd amended Complaint under Conclusion on page 86 ff. [fn2]

58. This does not improve affordable quality healthcare in Florida. This law actually encourages crime. Due process violations aside from age discrimination and crime is the result. Despite numerous violations of law, ethics and quality care problems, the door to a law office and legal help was barred to plaintiff and all other adult children in similar circumstances by section 768.21(8).

59. On the basis of these newly exposed and stated truths, Plaintiff moves the court to have the constitutionality of this law again reviewed, since it allows rampant crime among certain unethical healthcare providers and insurance companies, who seek profits before the real concerns of the citizens and patients of Florida.

[fn1]

SANTA MONICA, Calif., Oct. 26 /U.S. Newswire/ -- The nation's largest medical malpractice insurer, GE Medical Protective, has admitted that medical malpractice caps on damage awards and other limitations on recoveries for injured patients will not lower physicians' premiums.

The insurer's revelation was made to the Texas Department of Insurance (TDI) in a regulatory filing obtained by the Foundation for Taxpayer and Consumer Rights (FTCR). The revelation was contained in a document submitted by GE Medical Protective to explain why the insurer planned to raise physicians' premiums 19 percent a mere six months after Texas enacted caps on medical malpractice awards. In 2003, Texas lawmakers passed a $250,000 cap on non-economic damage compensation to victims of medical malpractice caps after Medical Protective and other insurers lobbied for the change.

According to the Medical Protective filing: "Non-economic damages are a small percentage of total losses paid. Capping non-economic damages will show loss savings of 1.0 percent." The company also notes that a provision in the Texas law allowing for periodic payments of awards would provide a savings of only 1.1 percent. The insurer did not even provide its doctors that relief and eventually imposed a rate hike on its physician policyholders.

The Medical Protective document can be downloaded from: http://www.consumerwatchdog.org/insurance/rp/rp004689.pdf

"When the largest malpractice insurer in the nation tells a regulator that caps on damages don't work, every legislator, regulator and voter in the nation should listen," said FTCR's Executive Director Douglas Heller. "Medical Protective's rate increase and this smoking gun document prove that the insurance industry cannot be trusted on the issue of malpractice caps."

Medical Protective and other supporters of medical malpractice caps have repeatedly argued that damage awards are the primary reason for skyrocketing medical malpractice premiums. For example, in a March 2004 report. GE Medical Protective stated that capping non-economic damages is a "critical element (of reform) because in recent years we have seen non-economic damages spiraling out of control." (from Health Care Crisis: Causes and Solutions)

[fn2]

The Florida Senate held a hearing on July 15, 2003 on the new insurance crisis. Under oath. this hearing laid bare that the court's argumentation is a myth. This myth is fed by corporate interests in limiting their liability for profit. It is not beneficial for the majority of the population - and certainly not for the elderly. Insurance companies and bad practitioners win, not the public.

This is what the hearing under oath showed:

1) Florida is the most profitable state for FPIC Insurance Group, First Professional's parent company in the country

2) There are more doctors coming to Florida than leaving the state.[ 2,658 new doctors' licenses and 2,471 new licenses were granted in each of the last two years.

3) There is no avalanche of frivolous lawsuits against doctors. Witness after witness denied a crush of frivolous lawsuits has crippled the state's medical malpractice tort system.

4) There has been no sharp rise in medical malpractice settlements made by insurance companies.

5) Florida Medical Association officials received $4.5 million in insurance company endorsements. The equivalent of 10 % of the association's annual budget. In other words, the crisis is a fraud. This vaudeville show is marching from state to state and with hype and propaganda restricting patient's rights to just compensation.

So the majority opinion in Mizarah fell for the hype and it has produced what one sees here in the case of Zoe: tremendous medical negligence and poor quality service and possibly total lack of ethics in a protected profession group. It is generally known to healthcare professionals that the elderly without a spouse or child are free game. If the medical malpractice victim dies, all is forgotten. Only the public is unaware of this until one of their loved ones falls victim here in Florida - often through egregious negligence and malpractice and cover-up.

This does not improve affordable quality healthcare in Florida. This law actually encourages crime.

Due process violations aside from age discrimination is the result. Despite numerous violations of law, ethics and quality care problems, the door to a law office and legal help was barred by section 768.21(8).

On the basis of this newly discovered truth, Plaintiff moves the court to have the constitutionality of this law again reviewed, since it allows rampant crime among certain healthcare providers, who seek profits before the real concerns of their patient population.

Respctfully submitted,

____________________________________________________________________________

RESPONSE TO DR. UNAEZE'S MOTION TO DISMISS

Plaintiffs understand that a motion to dismiss is the usual way for Defendants to attack a complaint. As a person not educated in the practice of law, it is understandable that the complaint may not be in an acceptable form to a professional. However, the complaint itself and the question of law found in this complaint/petition cannot be lightly dismissed as proposed by Defendants. See Ralph v. City of Daytona Beach, 471 So.2d 1, 2 (Fla.1983):

"For the purposes of a motion to dismiss . . . allegations of the complaint are assumed to be true and all reasonable inferences arising therefrom are allowed in favor of the plaintiff.".

Plaintiffs now show the Court the following:

1. Plaintiff [in response to Defendant's paragraph 2] has stated a cause of action in fraud and elder abuse, as well as medical negligence and breach of contract in their Medicare responsibilities. The action is also for spoilation of evidence, which prevented the bringing of timely and complete claims.

2. In response to Defendant's paragraph 2:

First, the issue of the statute of limitations and the statute of repose is not clear in this case because of the issue of fraud and concealment, which is based on current evidence, was intentional and is still on going.

3. Second., Plaintiff attempted to comply with the presuit requirements of Chapter 766 in bringing such an action. Defendant has failed to comply with all attempts of Plaintiff to achieve fulfillment of law and has exhibited extreme bad faith in trying to conceal the egregious actions of Dr. Unaeze in this case. Defendant Counsels have made false statements to the court as to Plaintiff not participating. See attached proof of initiation and negotiation according to the presuit requirements.

4. "Further, the Plaintiffs have made allegations which either do not apply to VITALIS UNAEZE, M.D., as a physician, and/or are not cognizable causes of action. It is true that Dr. Unaeze did not act as a proper physician in his dealings with Zoe during the last two days of her life. As a board certified internist, his non-action and fraud with Zoe's daughter indicate elder abuse of egregious nature.

5. There should be recoverable damages since they have accrued and Florida is also one state under God and has laws as well as the Constitution with it's equal protection clause.

A. PROCEDURAL BACKGROUND

7. Plaintiffs filed the original complaint on February 13, 2001 not chancing that the 120 day extension for review would not be recognized. Stronstorff achieved one lawyer visit [seventy-five dollars payable in advance] to be told that although, one had a cause of action for medical malpractice, that cause of action died with the patient under Florida's Wrongful Death Statute. Had she lived, it would have been valid, but not after her death. Almost all other medical malpractice attorneys work on contingency. These, stated that by law, they are unable to take on a case, where there is no spouse or dependent under age 25 [sic]. The law does not state this, in that it allows recovery of medical expenses and funeral expenses. Yet, Plaintiff understands that patients with no children under the age of 25 have no economic value. In view of the jury tendency to favor healthcare providers and the huge litigation expense, this law is a welcome excuse for lawyers to ignore the aggrieved children of medical malpractice victims. Their practice is not about law, it is about money.

8. This case is a result of defective laws, which allow medical malpractice to flourish. It is also a result of the non-enforcement of laws, which could mitigate malpractice. However, Florida appears to be fraud friendly in the area of healthcare to the detriment of the majority of it's citizens. Defendant, based on his dealings with Zoe, is an example of the type of physician, who is responsible for medical malpractice suits.

9. Please take note of statements 6 and 7 of Dr. Unaeze's Motion to Dismiss. Plaintiff knows nothing of Lou LaCava. Ms. Adamski was the only attorney known and she worked and wrote letters under the letterhead "Law Offices of SLK." Attached are the responses from Stronstorff, which were "never" made. Luckily, these documents were certified and I have the receipts. Knowing the high respect this Court has for the legal profession, please take note how lawyers have not been truthful, or is this just a little "administrative error" which the new counsel knows nothing about? Counsel Ulano, representing IHS, also spread this myth about my never responding.

B FRAUD TOLLS THE statute of Limitations and statute of repose

10. It would be difficult to deny that Plaintiff was not aware that Zoe died and that Dr. Unaeze was involved in the last two days of her death. However, Stronstorff was told by AHCA based on their investigations that nothing was wrong. When false reports or records were used to hide the medical malpractice and prevent the plaintiff from bringing a suit, spoilation has occurred. Facts were intentionally concealed by the various parties.

11. Repose was already broken with the beginning of the lawsuit and notice of intent. Dr. Unaeze through his SLK counsel did not respond to Stronstorff's requests for information. - statutory required agreement for emergency transfer with the hospital. "Intentional misrepresentation of fact" is the intentional (done with the aim of carrying out the act) act of making a false or misleading statement about something.

12. Applying the doctrine of noscitur a sociis, because both "fraud" and "intentional misrepresentation of fact" involve a level of knowledge or intent, we conclude that the legislative intent was to extend the repose period when intentional acts prevent discovery of the injury. NEHME v. SMITHKLINE BEECHAM CLINICAL LAB., 863 So.2d 201 (Fla. 2003) did not rule out concealment in extending the statute of repose beyond four years.

13. "Concealment" required to extend the statute of repose in medical malpractice matters to seven years requires fraud, intent to conceal or some other active element. Nardone v. Reynolds, 333 So. 2d 25 (Fla.1976). See also Almengor v. Dade County, 359 So. 2d 892 (Fla. 3d DCA 1978). Concealment also requires knowledge (by the tortfeasor) about plaintiff's condition which is not conveyed to plaintiff. Nardone, 333 So. 2d at 37. In such instances, the plaintiff is being actively misled about his or her true condition by the tortfeasor. "Conceptually, this intentional withholding of information acts to delay plaintiff's ability to discover the tortfeasor's wrongdoing or the nature of the injury itself." NEHME v. SMITHKLINE BEECHAM CLINICAL LAB..

14. Also see DOE v. HILLSBOROUGH CTY. HOSP., 816 So.2d 262 (Fla.App. 2 Dist. 2002) and Glus v. Brooklyn Eastern District Terminal, 359 U.S. 231 (1959) and MAJOR LEAGUE BASEBALL v. MORSANI, SC96004 - 07/12/01).

15. Stronstorff felt that her claims against Dr. Unaeze were valid, yet based on false records in which the defendant was personally involved. She was led to believe, she could not make Dr. Unaeze responsible for her mother's death. Yet, fraud concealed his actions with the help of Blake Medical Center and Integrated Health Services of Bradenton.

II. Failure to Comply with Chapter 766

16. With no records concerning Dr. Unaeze from either the hospital or the nursing home and the questionable advice given by attorneys regarding the Wrongful Death Clause, it was difficult to fulfill the presuit process. Plaintiff was hindered in bringing suit by the lack of an attorney,and the abominable condition of records available to her.

17. The attached documents indicate that Stronstorff made every effort to comply, yet defendant through his attorneys denied Stronstorff the simplest explanations to his actions and omissions.

18. In paragraphs 21 and 22 Defendant cites § 766.206(2). The statement in paragraph 23 is an outright lie. Stronstorff responded to every writing. She did not file a notice of filing with the case number 2001CM000003, because as a non-lawyer, she was not aware of the customs. Since the documents were certified, the only way Defendant can make this statement is to purposely discard the responses of Plaintiff, As counsel to Dr. Unaeze, the attorneys must have known of the issue of fraud as well as the statutory violations, yet took advantage of the lack of knowledge of Plaintiff and the hopelessness of her situation based on Florida's unconstitutional laws.

19. Defendant's statement :

"24. As such, the Plaintiffs' failure to conduct a good faith investigation, including but not limited to the failure to provide a corroborating written medical expert opinion and respond to the presuit discovery requests made by Defendant, VITALIS UNAEZE, M.D., is a violation of Chapter 766 and the Plaintiffs' Complaint must be Dismissed."

is untrue. Defendant never answered Stronstorff's questions and took full advantage of her inexperience.

20. § 766.206(3) states:

If the court finds that the response mailed by a defendant rejecting the claim is not in compliance with the reasonable investigation requirements, the court shall strike the defendant's response, and the person who mailed such response, whether the defendant, the defendant's insurer, or the defendant's attorney, shall be personally liable for all attorney's fees and costs incurred during the investigation and evaluation of the claim, including the reasonable attorney's fees and costs of the claimant.

21. Regrettably, thanks to the unconstitutional due process and equal protection violations of Florida's Wrongful Death Clause, Stronstorff had no attorney to ask for fees for defendant's bad faith dealings during presuit "negotiations." Plaintiff pleads the attached documents concerning presuit to indicate bad faith on the part of Dr. Unaeze's attorney/insurer?.

22. Paragraph 25, which requests an award of "sanctions against the Plaintiffs and seeks attorney's fees and costs incurred during the investigation and evaluation of the claim." Should be carefully reviewed by the court and denied.

23. § 766.206(4) states:

If the court finds... that an attorney for a defendant mailed a response rejecting the claim without reasonable investigation, the court shall submit its finding in the matter to The Florida Bar for disciplinary review of the attorney. Any attorney so reported three or more times within a 5-year period shall be reported to a circuit grievance committee acting under the jurisdiction of the Supreme Court. If such committee finds probable cause to believe that an attorney has violated this section, such committee shall forward to the Supreme Court a copy of its finding.

24. The sudden disappearance of the SLK attorneys indicate that this may very well be the case.

25. Stronstorff's presuit letter to SLK attorney Adamski on July 24, 2001 shows that Unaeze had rejected the claim without providing any medical expert opinion. Please read that letter carefully and you will see it is impossible to say that Stronstorff was acting in bad faith and frivolous.

26. Only at this time did Adamski provide an opinion and by an IHS director on August 3, 2001. See the August 8th response questioning the validity of the opinion and just which medical records were used for the review --THE ISSUE OF FRAUDULENT MEDICAL RECORDS AGAIN.

27. It appears that this court could find "that the corroborating written medical expert opinion attached to any notice of claim or intent or to any response rejecting a claim lacked reasonable investigation [and that] the court [should] report the medical expert issuing such corroborating opinion to the Division of Medical Quality Assurance..." According to § 766.206(5)(a).

28. It must be stated again that fraudulent records rule out that insurance will settle a liability. It appears that this was known at the time that SLK and Ms. Adamski took on the case. Fraud tolls both the statue of limitations and repose in medical malpractice. Plaintiff's had been told that fraud actions have a limitation of seven years. The exceptional problem of the Wrongful Death Clause barring legal aid for adult children must be reviewed in addition to the fraud and concealment in this case.

29. Defendant is correct [26 and 31] that Dr. Charles Phillips executed an affidavit, which was not presented during the initial presuit period.

30. Statement 27 and 28 are untrue: statements 4 and 5 of the affidavit indicate that he has appeared as a qualified witness in several states and still appears as of last week.

31. Statement 29 relating to Dr. Phillips having been placed on "five years of probation by the Medical Board of California for various reasons, including but not limited to, incompetence and failure to keep accurate records." May or may not be true. I have not yet received a reply from Dr. Phillips, yet if true it would make him very qualified to rule on the lack of "accurate records" in this case. It appears that in Florida, accurate records are never a requirement --only records that justify treatment, even if fraudulent.

32. Dr. Phillips is very qualified to execute an affidavit in this matter.

III.FAILURE TO COMPLY WITH FLORIDA RULES OF CIVIL PROCEDURE 1.110(B)

33. In paragraph 32 through 63, Defendant attacks the pleading ability of Plaintiff. Stronstorff had seen statements as to not using [60] "realleged and averred statements, yet in the many cases reviewed, she found real attorneys doing it. Consequently, for ease, she utilized this system.

34. It is believed that the counts are clear and the circumstances which involve all these professionals is clear. A complaint this large should not have to be in the hands of one individual and may appear convoluted because of the very complexity of the case.

IV. IMPROPER ALLEGATIONS

35. Plaintiffs has included in their cause of action several allegations under statutes which are not applicable to Defendant, VITALIS UNAEZE, M.D [64]. They may not be recognized as causes of action in Florida, yet under common law, they surely are.

36. In 65- 69 Dr. VITALIS UNAEZE claims that Florida Statute § 395.1041 does not apply to Defendant, VITALIS UNAEZE. It is true, that basically it § 395.1041 applies to hospitals. Dr. Unaeze was supposed to have provided "care and treatment to Zoe Stronstorff at an assisted living facility and it was not under and "emergent" basis. As such, his care and treatment does not fall under Florida Statute Chapter 395. [68 - italics added]. He is on the hospital staff.

37. Plaintiffs reallege that Defendant, VITALIS UNAEZE, M.D., deprived Zoe Stronstorff of access to emergency medical services and that it was on "emergent" basis, although this was cover-up by massive fraud in medical records and billing.

38. The use of the term "assisted living facility" [ALF] is indicative of just how convoluted the documentation is. Zoe was officially transferred to IHS - officially a skilled nursing facility for therapy.

39. Attorney Ulano convinced the Court that the complaint was wrong with the ALF paragraphs and had the complaint dismissed. Yet, here we are with an attorney for the doctor, who supervised Zoe's dying and he says that the services were in an ALF.

40. Fact is that due to the missing medical and billing records, one cannot know where Zoe was in WHICH RECORDS. In the last request for production, IHS again refused to provide how Medicare was billed for Zoe's "services." Medicare has reported, it was done in the name of "Heritage Park," which was not a licensed SNF between 2/2/99 and 2/13/99.

41. That more facts are not alleged, has to do with the continued withholding of medical records. Furthermore, massive records were added and it appears that there are multiple records to justify the horrendous care given to Zoe.

42. It is known that § 458.331 is an administrative remedy for doctor's negligence. The question is just why they were not applied in this very case based on the facts. Falsifying facts and involvement and location should not allow perpetrators of abuse to escape common law responsibility and justice.

43. All of Plaintiff's allegations made in Defendant's paragraphs 70-71 are true. Such abuse cannot be excused by no remedy by Florida Statute. The issue of the false report of Dr. Unaeze - the only available one in the medical record may be totally fraudulent in that Dr. Unaeze's signature on a recent official record filed in Manatee County appears different than the one on this report.

44. Fact is that Dr. Unaeze let Zoe suffer to death for almost two days without a decent painkiller.

There is no excuse for allowing a woman die in this manner. Dr. Unaeze lied about this patient's fall in presence of those symptoms and canceled his own ordered emergency sonogram to rule out DVT - an emergency condition. After he ordered an x-ray for a 4-day old fall, which showed strong bones and no tissue damage, he ordered a CT_scan, which is considered an unnecessary test - especially in the light of the results of the completed x-ray. He hid his identification in the entire transaction.

45. [72-73] True is that Plaintiff has cited §415.113 incorrectly. The two paragraphs under this citation come from § 825.102, which is in the Crimes section and is only available to the state prosecutor and not to civil actions.

46. It concerns aggravated abuse and the intentional withholding of emergency care and especially a painkiller is certainly such an act.

47. It appears another file number was submitted for the investigation of Dr. Unaeze. Further records have been found indicating fraudulent hospice services on patients at this SNF. Further discovery is necessary, since the records and billing information is being withheld. Fraud and abuse is a common law action.

48. [75] lying to the patient's family about the patient's condition - pretending it is just a fall and then stating, she was known terminal, yet not filing out the death certificate as the attending physician. One is not terminal just because one is 88 years old or because one has "poor prognosis" written in the record.

49. One must ask: Does one have a poor prognosis from the physical condition or from the substandard and abusive care?

50. [76] Plaintiff knows of no one, who finds that depriving an elderly woman of needed care - especially an adequate painkiller and lying to their family as not being egregious. Falsifying medical records and reports is furthermore unforgivable and illegal.

51. [77-80] Medicare requires that physicians in their program, in which Dr. Unaeze takes part, requires that all care and diagnoses be reported. [Under Federal law he is required to bill Medicare. Doctors who provide medical services to Part B beneficiaries must submit claim forms identifying the services provided. See 42 U.S.C. 1395w-4(g)(4)(A)(i).] There is sound reasoning in this to keep track of patients and eventual fraudulent activities. As part of a conspiracy to defraud Medicare by using a false record to justify payments, Dr. Unaeze can be sued.

52. One must inquire for what reason, Dr. Unaeze is not billing for his "care"? Doctors are not known for "un"coding - upcoding id standard.

53. [81-83] Proof, Plaintiff does not have of Unaeze's negligent inducement, yet his suspect actions appear to have occurred after the emergency sonogram was ordered from assumedly Blake Medical Center. Unaeze refused to answer where he was at the time of the cancellation in the presuit investigation.

54. Fact is that many questionable things happened at the hospital and with the transfer to Integrated Health Services of Bradenton. Fact is that with the patient's death, the probability of starting legal action was reduced to almost zero through the Wrongful Death Clause.

55. A jury should be presented with the facts as to why Dr. Unaeze canceled the sonogram, which meets the standard of care and why he denied treating the patient on the record and released her body from the nursing home without an autopsy if the cause of death were unknown. Dr. Unaeze has never answered these presuit questions.

56. Enough facts are known that he did not wish to be identified in the medical records and that he gives a false diagnosis for the CT-scan, which was intentionally concealed by Blake Medical Center [See case 2000-CC-4009].

V. IMPROPER DAMAGES OR IMPROPER LAWS

57. Defendant Unaeze's attorney now presents [86-89] all the unconstitutional and unjust provisions of the Wrongful Death Statute, specifically Florida Statute § 768.21 (8). Economic damages will hardly be recoverable for any Medicare patient, since most are retired. Furthermore, many, like Zoe, are widowed and have adult children. Consequently, when they enter a healthcare facility in Florida, they are recognized as helpless before any medical malpractice, negligence and abuse.

58. Faking the records is the easiest way of eliminating any further problem like an administrative complaint.

59. This law leads to substandard care and abuse and possibly unaccountable "murder" of the elderly and even unmarried and childless younger people over age 25.

60. The problem is widespread and appears to be actively encouraged in the state of Florida to the benefit of insurance companies and unethical and negligent healthcare providers.

VI. Defendant's Conclusion

61. [90-93] The statute of repose has not run due to the active fraud of Dr. Unaeze, who denied proper testing of the "free-kill" patient to determine the true cause of death, because it would in all probability be incriminating.

62, [94] Not Plaintiffs, but defendant , Dr. Unaeze is guilty of not conducting a good faith investigation.

63. [95] Dr. Phillips is qualified to give a medical opinion.

64. [96-97] If the pro se pleading is truly so severe to warrant dismissal, then Plaintiffs pray for the right to amend.

65. [98] All allegations concerning Dr. Unaeze are true and if not supported by Florida law are supported in common law remedies against the egregious behavior of Dr. Unaeze against Zoe and her family for the last two days of her life as well as the cover-up of the entire "care" of Zoe by his partner and the nursing home facility and the hospital.

66. [99] Plaintiff seek damages not only through the Wrongful Death Clause, but also for simple Elder abuse and fraud. Without damages, crimes against the elderly, which make up over 50% of hospital profits, become "free-kill." Poor medical care and unethical behavior with no accountability become the rule.

67. Plaintiff does not seek damages for herself, but for accountability in healthcare. Dr. Unaeze exemplifies the physician, who is allowed to perform substandard healthcare repeatedly due to defective laws. Only when sufficient penalties are assessed will such behavior stop.

68. Speaking for all adult children of medical malpractice victims, these penalties need not be paid out to the families, but into a special fund to help prevent just such practices as witnessed here.

Vii. The Wrongful Death Clause [§768.21(8)] IS unconstitutional

69. Plaintiff would again like to raise the question of the legality section 768.21(8), Florida statutes in light of the Supreme Court of Florida ruling in an opinion filed in April 20, 2000 in MIZRAHI v. NORTH MIAMI MEDICAL CENTER, LTD., 761 So.2d 1040 (Fla. 2000)Nos. SC93649, SC93650. Section 768.21(8) is unconstitutional as a violation of equal protection. It bears no rational relationship to a legitimate state interest. Sky rocketing medical malpractice insurance premiums are not being curtailed by these interventions. Caps do not work. Malpractice suit restrictions do not benefit the public, but only insurance companies and perpetrators of malpractice and negligence.

70. As proof of this, Plaintiff offers the recent statements made by the nation's largest medical malpractice insurer, GE Medical Protective on justifying it's 19% increase on physicians' premiums just one year after Texas lawmakers passed a $250,000 cap on non-economic damage compensation to victims of medical malpractice caps. [ found in fn1 of the Plaintiff's response to Blake Medical Center's Motion to Dismiss - p. 19 ff]

71. This footnoted article documents the "vaudeville show" and lies, which are made to achieve profit-oriented objectives, against the public and moral interests. Plaintiff calls again attention to the Florida specific facts of July 15, 2003 - already mentioned in the 2nd amended Complaint under Conclusion on page 86 ff.

72. This does not improve affordable quality healthcare in Florida. This law actually encourages crime. Due process violations aside from age discrimination and crime is the result. Despite numerous violations of law, ethics and quality care problems, the door to a law office and legal help was barred to plaintiff and all other adult children in similar circumstances by section 768.21(8). Despite numerous violations of law, ethics and quality care problems, the door to a law office and legal help was barred by section 768.21(8).

73. On the basis of these newly exposed and stated truths, Plaintiff moves the court to have the constitutionality of this law again reviewed, since it allows rampant crime among certain unethical healthcare providers and insurance companies, who seek profits before the real concerns of the citizens and patients of Florida.

WHEREFORE, Plaintiffs respectfully request to deny Defendant's request for dismissal, as well as his attorneys' outrageous request for sanctions and attorney fees in light of the false presentation of the presuit investigation as shown in the attachment. Good faith behavior of defendants as to their legal requirements to medical records and billing, would have done much to alleviate the problems, we see listed here before you at this moment.

Respectfully submitted,

Carol Stronstorff, sui juris

Nov.18, 2004

RESPONSE TO Integrated Health Service's MOTION TO DISMISS

Plaintiff is not educated in the practice of law. It is understandable that the complaint may not be in an acceptable form to a professional. However, the complaint itself and the question of law found in this complaint/petition cannot be lightly dismissed as proposed by Defendants. Evidence for punitive damages has been given and will be more fully shown below.

See Ralph v. City of Daytona Beach, 471 So.2d 1, 2 (Fla.1983):

"For the purposes of a motion to dismiss . . . allegations of the complaint are assumed to be true and all reasonable inferences arising therefrom are allowed in favor of the plaintiff.".

Plaintiff believes her complaint shows

"the existence of a legal right in the plaintiff, with a corresponding duty in the defendant, coupled with a violation of that duty which results in injury or damages to the plaintiff." See Heard v. Mathis, 344 So.2d 651, 655 (Fla. 1st DCA 1977).

Plaintiffs now show the Court the following:

NOTE: References using N followed by a number [leading zeros are truncated] refer to the bate stamped nursing home medical records as received from IHS' attorney on August 17, 2001 and referenced in exhibit 2 to the 2nd amended complaint. Those references using H followed by a number [leading zeros are truncated] refer to the bate stamped medical chart found in case 2000-CC-4009.

1. Plaintiffs understand that a motion to dismiss is the usual way for defendants to attack a complaint. However, for the record, it is impossible to write a "short and plain statement," since the list of fraudulent statements, false representations, neglect and abuse as well as statutory violations is too long. Plaintiff , however, has stated a cause of action in fraud and elder abuse, as well as medical negligence and breach of contract in their Medicare responsibilities. §400.23, Fla. Stats. Entitles her to relief as well§ 415.1111.

2. Furthermore, Defendant INTEGRATED HEALTH SERVICES OF BRADENTON was supposed to be a skilled nursing home. As such pursuant § 400.0237, Fla. Stat. punitive damages may be sought for conduct which is willful, wanton, gross or flagrant, reckless, or consciously indifferent to the rights of the resident, which is ongoing with the refusal of providing their billing information. Chapter 400 expressly provides that such damages are available.

3. Florida Statutes § 768.72 should be fulfilled and allowed by the information already proffered in the complaint and attached medical documents to her 2nd Amended Complaint. These facts indicate :

4. The painful death of the patient on 2/13/99, which was not officially reported by the facility. A fraudulent paper discharge on 2/12/99 - one and one half days prior to Zoe's death - was reported. [No signed body release is found in the medical records - no death certificate. No cause of dea