Case 3:12-cv FAB Document 1 Filed 05/31/12 Page 1 of 20 IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF PUERTO RICO COMPLAINT

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1 Case 3:12-cv FAB Document 1 Filed 05/31/12 Page 1 of 20 IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF PUERTO RICO GERARDO FELICIANO VAZQUEZ, GRIZZLY LORNA DE JESUS FELICIANO, GRISOYDA LIZ DE JESUS VAZQUEZ, Plaintiff, CIVIL NO. vs. DR. JOSE E. MARIN LOPEZ, his CONJUGAL PARTNERSHIP MARIN-DOE, DR. ALLAN SAUNDERS MALAVE, and his CONJUGAL PARTNERSHIP SAUNDERS-ROE, DR. OSVALDO JIMENEZ MERCADO, and his CONJUGAL PARTNERSHIP JIMENEZ ROE, DR. JUDITH PALMER, and her CONJUGAL PARTNERSHIP PALMER-ROE, SINDICATO DE ASEGURADORES PARA LA SUSCRIPCION CONJUNTA DE SEGURO DE RESPONSABILIDAD PROFESIONAL MEDICO- HOSPITALARIA ( SIMED ), and JOHN AND JIM DOE, unknown joint tortfeasors, TORT ACTION FOR MEDICAL MALPRACTICE TRIAL BY JURY DEMANDED Defendants. TO THE HONORABLE COURT: APPEAR NOW the Plaintiffs in this action, GERARDO FELICIANO VAZQUEZ, GRIZZLY LORNA DE JESUS FELICIANO, GRISOYDA LIZ DE JESUS VAZQUEZ and through the undersigned attorneys, and respectfully state, allege and pray as follows:

2 Case 3:12-cv FAB Document 1 Filed 05/31/12 Page 2 of 20 PAGE 2 JURISDICTIONAL BASIS 1. Plaintiffs GERARDO FELICIANO VAZQUEZ, GRIZZLY LORNA DE JESUS FELICIANO, GRISOYDA LIZ DE JESUS VAZQUEZ, are domiciliaries and residents of the state of Florida. 2. All co-defendants are domiciled, incorporated or with principle place of business in Puerto Rico or in another state other than Florida. 3. The matter in controversy exceeds the sum of Seventy Five Thousand Dollars ($75,000), exclusive of interest and costs, vesting jurisdiction on this Honorable Court pursuant to 28 U.S.C THE PARTIES 4. GERARDO FELICIANO VAZQUEZ is the son whereas GRIZZLY LORNA DE JESUS FELICIANO and GRISOYDA LIZ DE JESUS VAZQUEZ, are granddaughters of Joaquina Vázquez. 5. Defendant Dr. JOSE EDGARDO MARIN LOPEZ (hereinafter Marin or Dr. Marin ) is a surgeon authorized to practice medicine in Puerto Rico. 6. Defendant Dr. ALLAN SAUNDERS MALAVE (hereinafter Saunders or Dr. Saunders ) is a radiologist authorized to practice medicine in Puerto Rico. 7. Defendant Dr. OSVALDO JIMENEZ MERCADO ( hereinafter Jimenez or Dr. Jimenez ) is an internist specializing in cardiology who is authorized to practice medicine in Puerto Rico. 8. Defendant Dr. JUDITH T. PALMER BENGOA (hereinafter Palmer or Dr. Palmer )

3 Case 3:12-cv FAB Document 1 Filed 05/31/12 Page 3 of 20 PAGE 3 is an emergency room doctor who is authorized to practice medicine in Puerto Rico. 9. Defendant SINDICATO DE ASEGURADORES PARA LA SUSCRIPCION CONJUNTA DE SEGURO DE RESPONSABILIDAD PROFESIONAL MEDICO- HOSPITALARIA (hereinafter, SIMED ) is an insurance company organized, existing, and with its principal place of business in Puerto Rico or a state or territory other than Florida, which insures co-defendants Dr. Marin, Dr. Saunders, Dr. Jimenez, and/or other unknown joint tortfeasors. 10. The MARIN-DOE CONJUGAL PARTNERSHIP, comprised by co-defendant Dr. Marin and his wife, referred to as Mrs. Marin-Doe for lack of information as to her real name, is liable for the damages caused by the other spouse while engaging in those activities which benefit the conjugal partnership. 11. The SAUNDERS-ROE CONJUGAL PARTNERSHIP, comprised by co-defendant Dr. Saunders and his wife, referred to as Mrs. Saunders-Roe for lack of information as to her real name, is liable for the damages caused by the other spouse while engaging in those activities which benefit the conjugal partnership. 12. The JIMENEZ-ROE CONJUGAL PARTNERSHIP, comprised by co-defendant Dr. Jimenez and his wife, referred to as Mrs. Jimenez-Roe for lack of information as to her real name, is liable for the damages caused by the other spouse while engaging in those activities which benefit the conjugal partnership. 13. The PALMER-ROE CONJUGAL PARTNERSHIP, comprised by Dr. Palmer and her husband, referred to as Mr. John Roe for lack of information as to his real name, is liable

4 Case 3:12-cv FAB Document 1 Filed 05/31/12 Page 4 of 20 PAGE 4 for the damages caused by the other spouse while engaging in those activities which benefit the conjugal partnership. 14. JOHN AND JIM DOE are unknown joint tortfeasors who are therefore liable to Plaintiffs, in whole or in part, for the actions herein described and the damages suffered by Plaintiffs. GENERAL ALLEGATIONS 15. Ms. Joaquina Vázquez was at the time of her death, a 77 year-old patient attended at Doctors Center Hospital, Puerto Rico. 16. Doctors Center Hospital assigned Dr. Esteban Ramos as Joaquina Vázquez s internal medicine doctor. 17. On August 10, 2009, Dr. Esteban Ramos admitted his patient, Joaquina Vázquez with a preliminary diagnosis of dehydration induced diarrhea and recto-vaginal fistula. 18. On August 14, 2009 surgeon Garcia Troncoso was consulted regarding her medical condition. 19. Dr. Garcia Troncoso decided to operate on Joaquina Vázquez and on August 20, 2009 between 8:55 am and 10:05 am, performed a colostomy on his patient. 20. Patient Vázquez had exhibited fever during her hospitalization at Doctors Center Hospital as recently as midnight on August 20, The following day, on August 21, 2009 at approximately 1:10 pm, hospital records reflect that Joaquina Vázquez was discharged home from the hospital. 22. Patient Vázquez was taken home by family members and shortly after eating that

5 Case 3:12-cv FAB Document 1 Filed 05/31/12 Page 5 of 20 PAGE 5 Saturday evening, felt ill and began vomiting dark and foul-smelling matter. 23. An ambulance was called and the patient was taken immediately back to hospital at approximately 1 am on Sunday, August 23, Patient Vázquez lay unattended for hours at the emergency department corridors of the hospital and had to resort to vomiting in a trash can while awaiting treatment. 25. Hours passed without the emergency room doctor or nursing personnel attending to patient, despite patient s daughter s repeated pleas to emergency department doctor Judith Palmer to treat her mother. 26. Dr. Judith Palmer, who was in charge of the emergency room that night, did not treat Joaquina Vázquez, who evinced an emergency medical condition, in a timely manner. 27. Emergency department records initial entries begin at approximately 4:00 am. 28. Joaquina Vázquez s condition progressively turned for the worse, with continued vomiting, abdominal pain and dehydration. 29. Joaquina Vázquez s medical condition was not being closely monitored and/or was not being attended to in a timely or adequate fashion. 30. Despite the signs of sepsis, which required the administration of antibiotics, many hours passed before they were ordered and then administered. 1 On August 6, 2010, a Complaint was filed against the Doctors Center Hospital and Doctors Esteban Ramos and Jose F. Garcia Troncoso as joint tortfeasors of the defendants now named in this Complaint, whose acts and identities were discovered subsequently. See, Gerardo Feliciano et al, v. Doctors Center Hospital, San Juan, Inc., et al, Civil No (CCC). Individual claim letters were delivered to these co-defendants on September 26, Thus, the instant action is being filed in a timely fashion.

6 Case 3:12-cv FAB Document 1 Filed 05/31/12 Page 6 of 20 PAGE Despite Joaquina Vázquez worsening condition, hospital personnel and Dr. Palmer failed to timely contact Dr. Ramos or another attending internist with the urgency that patient s emergency condition required. 32. Dr. Palmer, knowing that Joaquina Vázquez had recently had surgery, did not consult the surgeon Dr. Garcia Troncoso or any other surgeon. 33. Dr. Palmer allowed Joaquina Vázquez to continue deteriorating and did not take the adequate measures to treat her emergency condition. 34. In spite of the repeated requests by patient s family, it was not until approximately 7 am that Dr. Palmer requested a consultation with Dr. Ramos. 35. Dr. Palmer failed to treat Joaquina Vázquez adequately to the point where she became septic, febrile and cyanotic. 36. Dr. Ramos informed patient and family that he was worried because patient was septic, febrile and cyanotic. 37. Dr. José E. Marín López was the head of surgery and also the on call surgeon for that day. 38. Dr. Ramos contacted Dr. Marín because it was a surgical emergency and he had been unable to contact Dr. García Troncoso, but was merely told by Dr. Marín to keep trying to reach Dr. García. 39. Dr. José E. Marín López did not examine or treat Ms. Vázquez. 40. Dr. Ramos ordered an abdominal CT while patient was still in the emergency ward. 41. Dr. Allan Saunders Malavé was the radiologist on duty that day and in charge when the abdominal CT scan was performed.

7 Case 3:12-cv FAB Document 1 Filed 05/31/12 Page 7 of 20 PAGE The abdominal CT was performed in the early afternoon, and a radiological technician informed patient s daughter that it appeared that she had a serious intestinal obstruction and that as soon as Dr. Saunders confirmed the findings the emergency results would be notified to Dr. Ramos and the surgery department for immediate intervention. 43. Dr. Osvaldo Jiménez Mercado was the cardiologist assigned to the patient by Doctors Center Hospital. 44. Dr. Ramos consulted Dr. Jiménez, who saw patient Vázquez in the hospital ward and found her very ill. 45. Despite suspecting an MI, Dr. Jiménez merely recommended that the patient be transferred to intensive care treatment. 46. Dr. Jiménez did not follow up on patient s condition nor did he timely alert Dr. Ramos of his findings. 47. Dr. Jiménez only commented to the patient s daughter that he hoped Joaquina s son, Plaintiff Gerardo Feliciano, would be able to arrive in time to ensure adequate treatment. 48. The aforementioned medical practitioners were negligent in their care of Joaquina Vázquez. 49. The aforementioned medical personnel belatedly and ineffectively administered medical assistance to counteract the patient s condition and prevent her death. Neither did they transfer Joaquina Vázquez to the ICU in order to receive the appropriate treatment. 50. Joaquina Vázquez died as a result of the lack of timely and effective medical treatment administered by the medical personnel assigned to her treatment.

8 Case 3:12-cv FAB Document 1 Filed 05/31/12 Page 8 of 20 PAGE 8 FIRST CAUSE OF ACTION FOR NEGLIGENCE UNDER ARTICLE 1802 OF THE PUERTO RICO CIVIL CODE AGAINST DR. JOSE E. MARIN LOPEZ 51. The allegations contained above are incorporated by reference as if again fully set forth herein. 52. Defendant Dr. José E. Marín López s treatment of Joaquina Vázquez was below the medical standard that satisfies the exigencies generally recognized by the medical profession in light of the modern means of communication and teaching, and as such directly caused and/or contributed to causing Plaintiffs the untimely death of their beloved mother, Joaquina Vázquez, and the injuries as described herein. 53. At the time of the incidents giving rise to this Amended Complaint, Defendant Dr. José E. Marín López was the head of surgery for Doctors Center Hospital and was the surgeon on call for the day Joaquina Vázquez was admitted to the emergency room (August 23, 2009). 54. Defendant Dr. José E. Marín López negligently and carelessly failed to intervene, examine, treat, monitor, and operate on Joaquina Vázquez s medical condition. 55. Defendant Dr. José E. Marín López negligently and carelessly failed to provide Joaquina Vázquez with prompt attention and medical care despite the fact that Dr. Esteban Ramos contacted him and told him it was a surgical emergency. 56. Defendant Dr. José E. Marín López negligently and carelessly failed to examine Joaquina

9 Case 3:12-cv FAB Document 1 Filed 05/31/12 Page 9 of 20 PAGE 9 Vázquez, and instead told Dr. Esteban Ramos to continue trying to reach Dr. García Troncoso, who did not arrive until the next day. 57. Defendant Dr. José E. Marín López negligently and carelessly failed to ensure that another surgeon intervene with patient Joaquina Vázquez, which was his duty as both the surgeon on call and the head of surgery for Doctors Center Hospital. 58. Defendant Dr. José E. Marín López negligently and carelessly failed to provide proper care of patient Joaquina Vázquez, by failing to intervene immediately with her emergency medical condition. 59. Defendant Dr. José E. Marín López failed to exercise reasonable care and skill commensurate with the standard of care practiced in the medical profession at that time and under like and similar circumstances when he failed to appropriately intervene, examine, treat or operate on Ms. Joaquina Vázquez when Dr. García Troncoso was unreachable. 60. In so doing, Defendant Dr. José E. Marín López committed professional negligence, including lack of expertise, fault and malpractice, which directly and proximately caused the injuries and damages suffered by Plaintiffs, particularly for the loss of Ms. Joaquina Vázquez, as detailed herein. 61. As a direct and proximate cause of co-defendant Dr. José E. Marín López s negligence in failing to properly treat Ms. Joaquina Vázquez, Plaintiffs sustained severe injuries and other damages, as described below.

10 Case 3:12-cv FAB Document 1 Filed 05/31/12 Page 10 of 20 PAGE 10 SECOND CAUSE OF ACTION AGAINST DR. JOSE E. MARIN LOPEZ S CONJUGAL PARTNERSHIP 62. The allegations contained above are incorporated by reference as if again fully set forth herein. 63. At the time of the events described in this complaint, Co-defendant Dr. José E. Marín López was married and had a Conjugal Partnership with his wife. 64. The activities by which Co-defendant Dr. Marin Lopez caused Plaintiffs damages were activities which benefitted co-defendant Conjugal Partnership comprised by Dr. Marin Lopez and his wife, Jane Doe, referred to herein as such here for lack of information as to her real name. 65. As such, this Conjugal Partnership is jointly and severally liable to all Plaintiffs for the damages caused by Dr. Marin Lopez. THIRD CAUSE OF ACTION AGAINST SIMED 66. The allegations contained above are incorporated herein by reference as if again fully set forth. 67. Co-defendant SIMED was, at all times herein pertinent, an insurance company authorized to do business as such in the Commonwealth of Puerto Rico which issued a public liability and/or malpractice insurance policy on behalf of co-defendants Dr. Marin Lopez, Dr. Saunders Malavé, Dr. Jiménez Mercado, and/or other unknown joint tortfeasors.

11 Case 3:12-cv FAB Document 1 Filed 05/31/12 Page 11 of 20 PAGE Pursuant to 26 P.R. Laws Ann. 2001, an insurance company is liable for the negligence or fault of its insured. 69. Pursuant to 26 P.R. Laws Ann. 2003, an action against an insurer may be brought separately or may be joined together with an action against its insured. 70. Therefore, co-defendant SIMED is jointly and severally liable to all Plaintiffs for the damages caused to them by co-defendants Dr. Marin Lopez, Dr. Saunders Malavé, Dr. Jiménez Mercado, and/or other unknown co-defendants, respectively. FOURTH CAUSE OF ACTION FOR NEGLIGENCE UNDER ARTICLE 1802 OF THE PUERTO RICO CIVIL CODE AGAINST DR. ALLAN SAUNDERS MALAVÉ 71. The allegations contained above are incorporated by reference as if again fully set forth herein. 72. At the time of the incidents giving rise to this Amended Complaint, Co-defendant Dr. Allan Saunders was the radiologist in charge for Doctors Center Hospital. 73. When Joaquina Vázquez returned to Doctors Center Hospital emergency ward on August 23, 2009, with a suspected intestinal obstruction and sepsis, Co-defendant Dr. Allan Saunders was the radiologist on call. 74. That same day, the attending, Dr. Ramos, ordered an abdominal CT while the patient was still in the emergency ward, which was performed in the early afternoon. Co-defendant Dr. Saunders confirmed the findings of this CT, which revealed a serious abdominal

12 Case 3:12-cv FAB Document 1 Filed 05/31/12 Page 12 of 20 PAGE 12 obstruction and potential perforation. 75. The patient s daughter, Leonarda Feliciano, was told by a radiological technician that once the CT finding was confirmed by Co-defendant Dr. Saunders the emergency results would be notified to the attending Dr. Ramos and the surgery department for immediate intervention. 76. Co-defendant Dr. Allan Saunders negligently and carelessly did not inform referring physician Dr. Ramos of the emergency results, which required immediate attention. 77. In addition, Co-defendant Dr. Allan Saunders failed to notify the treating physician or the surgery department for immediate intervention, thereby contributing to Joaquina Vázquez s deteriorating condition and eventual death. 78. Co-Defendant Dr. Saunders delay in diagnosing Joaquina Vázquez was below the medical standard that satisfies the exigencies generally recognized by the medical profession in light of the modern means of communication and teaching, and as such directly caused and/or contributed to causing Plaintiffs the untimely death of their beloved mother, Joaquina Vázquez, and the injuries as described herein. 79. Co-Defendant Dr. Saunders negligently and carelessly failed to timely manage Joaquina Vázquez medical condition by not alerting the attending or the surgery department to her serious intestinal obstruction. 80. In so doing, co-defendant Dr. Saunders committed professional negligence, including lack of expertise, fault and malpractice, which directly and proximately caused the injuries and damages suffered by Plaintiffs, particularly for the loss of Joaquina Vázquez,

13 Case 3:12-cv FAB Document 1 Filed 05/31/12 Page 13 of 20 PAGE 13 as detailed herein. 81. As a direct and proximate cause of co-defendant Dr. Allan Saunders negligence in failing to properly treat Ms. Joaquina Vázquez, Plaintiffs sustained severe injuries and other damages, as described below. FIFTH CAUSE OF ACTION AGAINST DR. ALLAN SAUNDERS CONJUGAL PARTNERSHIP 82. The allegations contained above are incorporated by reference as if again fully set forth herein. 83. At the time of the events described in this complaint, Co-defendant Dr. Allan Saunders was married and had a Conjugal Partnership with his wife. 84. The activities by which Co-defendant Saunders caused Plaintiffs damages were activities which benefitted Co-defendant s Conjugal Partnership comprised by Dr. Allan Saunders and his spouse, Sally Roe, referred to herein as such for lack of information as to her real name. 85. Therefore, this Conjugal Partnership is jointly and severally liable to all Plaintiffs for the damages caused by Dr. Allan Saunders. SIXTH CAUSE OF ACTION FOR NEGLIGENCE UNDER ARTICLE 1802 OF THE PUERTO RICO CIVIL CODE AGAINST DR. OSVALDO JIMÉNEZ MERCADO 86. The allegations contained above are incorporated by reference as if again fully set forth herein.

14 Case 3:12-cv FAB Document 1 Filed 05/31/12 Page 14 of 20 PAGE At all times relevant to the incidents giving rise to this Amended Complaint, Dr. Osvaldo Jiménez Mercado was the cardiologist on call for Doctors Center Hospital. 88. Co-defendant Dr. Osvaldo Jiménez Mercado was the cardiologist assigned to Joaquina Vázquez by Doctors Center Hospital s protocol or procedure. 89. Co-defendant Dr. Osvaldo Jiménez Mercado was consulted by the attending Dr. Ramos. 90. Despite having seen Joaquina Vázquez and suspecting she had an MI and was very ill, Co-defendant Dr. Osvaldo Jiménez Mercado only recommended that the patient be transferred to intensive care treatment. 91. Co-defendant Dr. Osvaldo Jiménez Mercado negligently and carelessly failed to timely manage Joaquina Vázquez medical condition by denying her proper and life-saving care. 92. Co-defendant Dr. Osvaldo Jiménez Mercado failed to exercise reasonable care and skill commensurate with the standard of care practiced in the medical profession at that time and under like and similar circumstances when he failed to appropriately treat Ms. Joaquina Vázquez by not following up on the patient s condition or ordering her transfer to intensive care. 93. Moreover, Co-defendant Dr. Osvaldo Jiménez Mercado negligently and carelessly failed to discuss his emergency findings with the treating physician Dr. Esteban Ramos, thereby failing in his duty to adequately treat Joaquina Vázquez. 94. In so doing, co-defendant Dr. Osvaldo Jiménez Mercado committed professional negligence, including lack of expertise, fault and malpractice, which directly and proximately caused the injuries and damages suffered by Plaintiffs, particularly for the loss

15 Case 3:12-cv FAB Document 1 Filed 05/31/12 Page 15 of 20 PAGE 15 of Joaquina Vázquez, as detailed herein. 95. As a direct and proximate cause of Co-defendant Dr. Osvaldo Jiménez Mercado s negligence in failing to properly treat Ms. Joaquina Vázquez, Plaintiffs sustained severe injuries and other damages, as described below. SEVENTH CAUSE OF ACTION AGAINST DR. OSVALDO JIMÉNEZ MERCADO S CONJUGAL PARTNERSHIP 96. The allegations contained above are incorporated by reference as if again fully set forth herein. 97. At the time of the events described in this complaint, Co-defendant Dr. Osvaldo Jiménez Mercado was married and had a Conjugal Partnership with his wife. 98. The activities by which Co-defendant Jiménez caused Plaintiffs damages were activities which benefitted Co-defendant s Conjugal Partnership comprised by Dr. Osvaldo Jiménez Mercado and his spouse, Sally Roe, referred to herein as such for lack of information as to her real name. 99. Therefore, this Conjugal Partnership is jointly and severally liable to all Plaintiffs for the damages caused by Dr. Osvaldo Jiménez Mercado. EIGHTH CAUSE OF ACTION FOR NEGLIGENCE UNDER ARTICLE 1802 OF THE PUERTO RICO CIVIL CODE AGAINST DR. JUDITH PALMER BENGOA 100. The allegations contained above are incorporated by reference as if again fully set forth herein.

16 Case 3:12-cv FAB Document 1 Filed 05/31/12 Page 16 of 20 PAGE Co-defendant Dr. Judith Palmer s treatment of Joaquina Vázquez was below the medical standard that satisfies the exigencies generally recognized by the medical profession in light of the modern means of communication and teaching, and as such directly caused and/or contributed to causing Plaintiffs the untimely death of their beloved mother, Joaquina Vázquez, and the injuries as described herein Co-defendant Dr. Palmer, who was in charge of the emergency room at the time relevant herein, negligently and carelessly refused prompt and adequate treatment, thereby failing in her duty to monitor, examine, and reevaluate, and did not issue the necessary medical orders or timely consult specialists to provide Joaquina Vázquez with the appropriate medical treatment she needed Co-Defendant Dr. Palmer negligently and carelessly failed to timely treat Joaquina Vázquez s medical condition, thereby causing or contributing to the sepsis, dehydration and deterioration that eventually led to respiratory failure and death Co-defendant Dr. Palmer negligently and carelessly failed to attend, examine, and adequately treat the patient while she was under her care in the emergency room Co-defendant Dr. Palmer failed to exercise reasonable care and the necessary skill required by the standard of care upheld by the medical profession at that time and under similar circumstances when she stopped treating the patient Joaquina Vázquez while she was under her care in the emergency room In so doing, co-defendant Dr. Palmer committed professional negligence, including lack of expertise, fault and malpractice, which directly and proximately caused the injuries and

17 Case 3:12-cv FAB Document 1 Filed 05/31/12 Page 17 of 20 PAGE 17 damages suffered by Plaintiffs, particularly for the loss of Joaquina Vázquez, as detailed herein As a direct result of co-defendant Dr. Palmer s negligent actions and omissions, Joaquina Vázquez did not receive appropriate medical treatment or care In so doing, co-defendant Dr. Palmer committed professional negligence, including lack of expertise, fault and malpractice, which directly and proximately caused the injuries and damages suffered by Plaintiffs, particularly for the loss of Joaquina Vázquez, as detailed herein As a direct and proximate result of co-defendant Dr. Palmer s negligence in not providing Joaquina Vázquez with adequate treatment while she was in the emergency room of Doctors Center Hospital, Plaintiffs sustained severe damages, which will be described herein. NINTH CAUSE OF ACTION AGAINST DR. JUDITH PALMER S CONJUGAL PARTNERSHIP 110. The allegations contained above are incorporated by reference as if again fully set forth herein At the time of the events described in this complaint, Co-defendant Dr. Judith Palmer was married and had a Conjugal Partnership with her husband The activities by which co-defendant Dr. Palmer caused Plaintiffs damages were activities which benefitted co-defendant Conjugal Partnership comprised by Dr. Judith Palmer and her spouse, John Roe, referred to herein as such for lack of information as to

18 Case 3:12-cv FAB Document 1 Filed 05/31/12 Page 18 of 20 PAGE 18 his real name Therefore, this Conjugal Partnership is jointly and severally liable to all Plaintiffs for the damages caused by Dr. Judith Palmer. DAMAGES 114. The allegations contained above are incorporated by reference as if again fully set forth herein As a result of the professional negligence, lack of expertise, fault, and malpractice of all Defendants, Plaintiffs unnecessarily lost their mother and grandmother, Joaquina Vázquez, a 77 year-old vivacious, beloved, warm, caring and industrious person Joaquina Vázquez and Plaintiffs had a very close and special relationship Joaquina Vázquez and Plaintiffs visited, spoke regularly or otherwise were in contact In losing Joaquina Vázquez, Plaintiff not only lost their mother/grandmother, but also a friend and confidant Plaintiffs have suffered dearly the loss of Joaquina Vázquez As a direct and proximate result of the negligence of all Defendants, Plaintiff will no longer have the joy of having his mother/grandmother, Joaquina Vázquez with them, or otherwise enjoy the irreplaceable pleasures and value of Ms. Joaquina Vázquez company and advice As a direct and proximate result of the negligence of all Defendants, Plaintiffs will continue to suffer the irreparable loss of their mother/grandmother Joaquina Vázquez As a direct and proximate result of the negligence of all Defendants, Ms. Joaquina

19 Case 3:12-cv FAB Document 1 Filed 05/31/12 Page 19 of 20 PAGE 19 Vázquez suffered many hours in agony and eventually a painful death, a cause of action which Plaintiff Gerardo Feliciano inherits as Ms. Joaquina Vázquez heir under Puerto Rico law Joaquina Vázquez s pain and suffering has a reasonable value of no less than One Million Dollars ($1,000,000) Mr. Gerardo Feliciano s emotional damages as a result of the needless and premature death of his beloved mother has a reasonable value of no less than One Million Seven Hundred and Fifty Thousand Dollars ($1,750,000) Ms. Grizzly L. De Jesus Feliciano and Grisoyda L. De Jesus Vazquez s emotional damages as a result of the unnecessary, painful and premature death of their beloved grandmother has a reasonable value of no less than Five Hundred Thousand Dollars ($500,000) each The damages suffered by Plaintiffs have a reasonable value in excess of THREE MILLION SEVEN HUNDRED AND FIFTY THOUSAND DOLLARS ($3,750,000.00), including, but not limited to their own, past and future mental and emotional pain and suffering, as well as the inherited pain and suffering as described above Plaintiffs hereby demand trial by jury.

20 Case 3:12-cv FAB Document 1 Filed 05/31/12 Page 20 of 20 PAGE 20 WHEREFORE, Plaintiffs demand judgment against Defendants jointly and severally, in the amount of no less than THREE MILLION SEVEN HUNDRED AND FIFTY THOUSAND DOLLARS ($3,750,000.00), plus costs incurred, reasonable attorneys' fees, and such other and further relief as to this Honorable Court may seem just and proper under the law. RESPECTFULLY SUBMITTED. st In San Juan, Puerto Rico this 31 day of May, INDIANO & WILLIAMS, P.S.C. 207 del Parque Street, Third Floor San Juan, P.R Tel: (787) ; Fax: (787) jeffrey.williams@indianowilliams.com vanesa.vicens@indianowilliams.com s/ Jeffrey M. Williams JEFFREY M. WILLIAMS U.S.D.C. P. R. Bar No s/ Vanesa Vicéns Sánchez VANESA VICENS SANCHEZ USDC PR Bar No