Defendant's Motion for Reconsideration — United States v. Aaron Ashcraft (E.D. Cal.)

Summary

Aaron David Ashcraft, writing pro se in Case No. 2:22-CR-00087-KJM-1 in the Eastern District of California, asks the court to reconsider its February 9, 2024 order denying the December 4, 2023 motion for compassionate release. Judge Kimberly Mueller had denied that motion without prejudice to renewal with supporting evidence. The filing supplies a 94 page Kaiser Permanente health report on the defendant's son, Dhameon James Ashcraft (age 21), diagnosed with multiple sclerosis on October 9, 2023, records describing the defendant's spouse, Rhonda Morton, as unable to provide care, and 4 pages of emails. The motion, dated March 12, 2024 at Sheridan, Oregon, says the prison was in lockdown without email or phone access from January 4, 2024 to February 8, 2024. It asks the court to grant release so the defendant can care for the son.

Summary drafted by a model from the document's text below and checked by script against that text before publication. It is a navigation aid, not a reading of what the document proves. Where AI is used

Record facts

Full text

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Case 2:22-cr-00087-KJM Document46- Filed 03/19/24 Page 1of 106

UNITED STATES DISTRICT COURT FOR THE, F ; L E D .

EASTERN DISTRICT OF CALIFORNIA
MAR 19 2024

Actor Wer DISTRICT COURT ~
By EBD STRICT OF CALIFORNIA

UNITED STATES OF AMERICA DEPUTY CLERK
Plaintiff,

Case No.: 2:22-CR-00087-KJM-1

AARON ASHCRAFT
Defendant,

DEFENDANT’S MOTION FOR RECONSIDERATION

Now comes the Defendant, Aaron David Ashcraft, proceeding pro se Defendant’s motion for
compassionate release pursuant to 18 U S.C. (c) (1) (A) (i), filed on December 4, 2023 and this
Honorable Court’s order filed February 9, 2024 denying the motion. The Honorable Judge
Kimberly Mueller denied the Defendant’s motion without prejudice to renewal with supporting

evidence.

BACKGROUND

This Court stipulated the lack of supporting evidence pertaining to the Defendant’s Son,
Dhameon James Ashcraft, specifically medical reports showing the diagnosis of Multiple
Sclerosis and clarification of his age. This Court also requested evidence supporting the
Defendant’s claim that the only available caretaker is mentally incapacitated and unable to
provide care for Dhameon.

EVIDENCE

A. The Defendant’s son Dhameon James Ashcraft (age 21) was diagnosed by his physician
on October 9, 2023 with Non-Progressive Relapsing Multiple Sclerosis. The supporting
evidence, a 94 page health report from Kaiser Permanente, has been included in this
motion for reconsideration and is titled “Attachment A”. Noted in the attached health
report is the diagnosis of Non-Progressive Relapsing Multiple Sclerosis and all
underlying conditions that further elaborate the extent of Dhameon’s incapacitation.
(Attachment A, Page 1, Active Problems). Also included in this report are details of 10
prior surgeries which are relates to a hereditary genetic bone disorder of which the

Page 1
Case 2:22-cr-00087-KJM Document46- Filed 03/19/24 Page 2 of 106

symptoms have been exaggerated bi-laterally by the symptoms of the Multiple Sclerosis.
(Attachment A, Page 4, Procedures).

B. The only available caretaker, the Defendant’s spouse Rhonda Morton, suffers numerous
mental disorders. The supporting evidence is noted in the attached reports titled
“Attachment B”, specifically page 3 of “Attachment B”. Paramount to the Defendant’s
claim that Rhonda Morton is mentally incapacitated is an official diagnosis from Heritage
Oaks Mental Health facility stating Rhonda suffers from Schizoaffective Bipolar, Alcohol
Use Disorder, and Methamphetamine Use Disorder. Page 1 of “Attachment B” Notice of
Certification classifies Rhonda as “Gravely Disabled” and unable to care for herself.

C. In addition to the evidence requested by this Court the Defendant has attached a
collection of email correspondence between the Defendant and Dhameon detailing some
of the struggles Dhameon has encountered without the support of his father, the
Defendant. These email correspondences, 4 pages total, are attached to this motion and
titled “Attachment C”.

CONCLUSION

The Defendant would like to express urgency and seriousness of this situation and would like to
include ancillary facts that further illustrate the depth of burden of care for Dhameon. Dhameon
has a hereditary genetic bone disorder called Osteochondroma Exostosis which is stated in
Attachment A, page 1, Active Problems. This disorder has already handicapped Dhameon with
further complications due in part by irregular bone growth and numerous surgeries as noted on
page 4, Procedures, in Attachment A. Dhameon has no driver’s license, no transportation, no
financial support, and is unemployed. The bone disorder and surgeries in conjunction with this
form of Multiple Sclerosis have further limited Dhameon’s mobility, dexterity, cognitive
function, and emotional/mental health.

The Defendant would also like to apologize to this Honorable Court for the delay in presenting
supporting evidence. The facility in which the Defendant is incarcerated has limited resources
and was in lockdown status with no access to email and phones from January 4, 2024 to
February 8, 2024, with additional prior and post intermittent weeks of limited access due to
lockdowns initiated as a result of facility wide disciplinary actions. The Defendant asks for this
Honorable Court’s mercy in granting his release to care for his son. The Defendant will be able
to procure immediate employment and will strictly abide by the ruling of this Court and the rules
set forth in release and probation guidelines. The Defendant will take his place as a law abiding,
contributing member of the community.

In conclusion the Defendant asks this Honorable Court to Grant the original Motion for
Compassionate release based on the addition of this evidence and allow the Defendant to care for
Dhameon.

Page 2
Case 2:22-cr-00087-KJM Document 46

Dated: March 12, 2024
Sheridan, Oregon

Page 3

Filed 03/19/24 Page 3 of 106

Respectfilly Submitted,

S/

Aaron Ashcraft

Reg. No.: 00025-510
FCI Sheridan Camp
P.O. Box #6000
Sheridan, OR 97378
Case 2:22-cr-00087-KJM Document46- Filed 03/19/24 Page 4 of 106

CERTIFICATE OF SERVICE

I, Aaron Ashcraft certify that I served a true copy of the attached Defendant’s Motion For
Reconsideration by placing a copy in the United States mail addressed to:

United States Attorney’s Office
501 I Street, Suite 10-100

Sacramento, CA 95814
Dated: March 12, 2024 S/
Sheridan, Oregon Adton Ashcraft
Reg. No.: 00025-510
FCI Sheridan Camp

P.O. Box #6000
Sheridan, OR 97378

Page 4
DTP (Diphtheria, Tetanus, Pertussis) (Given 1/5/2004, 3/27/2003, 1/16/2003, 11/12/2002)

| DTaP (Diphtheria, Tetanus, acellular Pertussis) (Given 2/27/2008)

HAV (Hepatitis A) (Given 8/26/2004)

HAV ped/adol 2 dose sch (Hepatitis A) (Given 2/27/2008)

| HBV (Hepatitis B) (Given 8/26/2004, 1/16/2003, 11/12/2002)

HIB HbOC (Haemophilus influenzae b) (Given 1/5/2004, 3/27/2003, 1/16/2003, 11/12/2002)

HPV4 (Human papillomavirus, quadrivalent) (Given 8/12/2014)

| HPV9 (Human Papillomavirus) 9 valent (Given 2/15/2017)

| MENcn-ACYW (Meningococcal conjugate, groups ACYW-135) (Given 8/12/2014)

MMR (Measles, Mumps, Rubella) (Given 8/11/2003)

MMR-VAR (Measles, Mumps, Rubella, Varicella) (Given 2/27/2008)

PNUcn (Pneumococcal conjugate, pneumonia) (Given 8/26/2004, 3/27/2003, 1/16/2003)

POL-IPV (Polio, Inactivated virus) (Given 2/27/2008, 3/27/2003, 1/16/2003, 11/12/2002)

Tdap (ADACEL) (Tetanus, diphtheria, acellular pertussis) (Given 8/12/2014)

VAR (Varicella, chickenpox) (Given 8/11 /2003) .

Years U :

Types Packs/Day

Tobacco Cessation: Counseling Given: Not Answered

Standard Drinks/Week
Never 0 (1 standard drink = 0.6 oz pure alcoho

/ Substance Use
| Never

Date Recorded

| Sex and Gender Information
| Sex Assigned at Birth

Last Filed Vital Signs
Vital Sign Reading
Blood Pressure (139/75

Time Taken Comments
10/30/2023 8:31 AM PDT
10/30/2023 8:31 AM PDT

_10/06/2023 6:46 PM PDT

10/06/2023 6:46 PM PDT

PM PDT

/06/2023 6:46 PM PDT

Page 2 of 94
EE! Medical Devices

Case 2:22-cr-00087-KJM Document46 Filed 03/19/24

Page 7 Of 106 \iodel / serial /

Implanted Type Area Manufacturer Device Identifier Lot

Cage Spinal 17-24mm 12mm X-Core - Orthopedic N/A: NUVASIVE 5962172 /
Log1948560 Cervical /
implanted: Qty: 1 on 01/30/2023 by JACOB Spine

| Right: Wrist ORTHOFIX

Plate Bone Eight-Plate 12mm 2. Hole Right: Tibia ORTHOFIX
Orthopedic Pediatric - Log302090

Implanted: Qty: 1 on 12/06/2012 at FOL-

OUTPATIENT SURGERY

Plate Contour 42mm Guide Growth Sys 2 Plate —S_ Left: Le Z ORTHOFIX
Hole Eight-Plate Bone Ped Grn - Lag441474 lant ce
Implanted: Qty: 1 on 07/1 5/2015 by DAVID

NEIL SCHIFEMs MD at FOL-OUTPATIEN

Screw Right: Tibia ORTHOFI
Guided Growth Plate Pediatric - Log302090 Implant
implanted: Qty: 2 on 12/06/2012 at FOL-
OUTPATIENT SURGERY
Description: eae ae on site ——

Screw Bone 4mm 5mm 54mm Lep Ss Shrt/ “@pokle = SYNTHES
Thrd Sm Bone Cannul Hex Socket Self Drill ’

Self Tap - Log552062

Implanted: Qty: 1 on 04/05/2017 by DAVID

NEIL SCHIFFMAN MD at FOL-OUTPATIENT

ical Cervical

Latex Free - Log1948560 Spine .

N/A: LIFENET
Cervical
implanted: Qty: 1 on 01/30/2008 B by JACOB Spine
HIRK FENNESSY MD at SAC-HOSPITAL
Description: Rinsed 3 times per manufacturers recommendations in NaCl lot J2N954 exp 10/2025 and Gentamicin 400mg lot

/

207654 /
/

2219123-1023 /
Performed for EXOSTOSIS, MULTIPLE HEREDITARY EXOSTOSIS _

Page 8 of 106

_ BONE SPUR EXCISION (Performed 12/23/2019)

Performed for EXOSTOSIS, MULTIPLE HEREDITARY EXOSTOSIS

ANKLE EPIPHYSIODESIS (Performed 4/5/2017)
Performed for EXOSTOSIS

KNEE EXOSTOSIS EXCISION (Performed 4/5/2017)
Performed for EXOSTOSIS

LOWER EXTREMITY HARDWARE REMOVAL (Performed 4/5/2017)
Performed for EXOSTOSIS

KNEE OR LOWER LEG HARDWARE REMOVAL (Performed 7/15/2015)

KNEE EPIPHYSIODESIS (Performed 7/15/2015) __
KNEE EPIPHYSIODESIS (Performed 12/6/2012)
Performed for HISTORY OF RETAINED HARDWARE

WRIST HARDWARE REMOVAL (Performed 12/6/2012)
Performed for HISTORY OF RETAINED HARDWARE
Resu IE ASe: BB RSGROOBTHK INS sOBK RET 46 Filed 03/19/24 Page 9 of 106
R

Analysis Performed
Component Value Range _Test Method Time At Pathologist Signature
RADIOLOGY EXAM FLUOROSCOPIC NCAL PWS
DESCRIPTION GUIDED INTERFACE

LUMBAR
PUNCTURE

Anatomical Region Laterality Modality
Radio Fluoroscopy

Anatomical Location/ Collection Method /
Specimen (Source) Laterality Volume Collection Time Received Time
11/15/2023 3:13 PM
PST

Impressions
11/15/2023 3:42 PM PST
Successful fluoroscopic guided Tumbar puncture. Samples were submitted laboratory for analysis.

Narrative

11/15/2023 3:42 PM PST
FLUOROSCOPIC GUIDED LUMBAR PUNCTURE

** HISTORY *4;
21 years old, workup for demyelinating disease. Fail

gittempt in clinic

COMPARISON: None available.

** FINDINGS **:
Risks, benefits, indications, and alternativ.
include bleeding, infection, and nerve iff
informed consent was obtained. A time- out
site,

procedure were explained to the patient. Risks
stions were answered. Both written and verbal
med to confirm the correct patient, procedure, and

Positioned prone on the fluoroscopy tale, a suitable trajectory for access to the thecal sac was
identified. The overlying skin was bgp PRs d draped in the usual aseptic fashion and then

anesthetized via local infiltraty gregpproximately 2 mL lidocaine 1% was used for local and deep
anesthesia. A 22-gauge 3-1/2) isganapeneedle was advanced into the thecal sac at the L3 level. Clear.
colorless CSF obtained on,fir . Interlaminar technique used :

The needle was remov
complications.

Radiation dose to patielg: 32.88 uGy
Fluoroscopy time. 0.4 mitt

Procedure Note
PAUL SUNG LEE MD - 11/15/2023
Procedure Note

** HISTORY **:
21 years old, workup for demyelinating disease. Failed bedside attempt in clinic

COMPARISON: None available.

** FINDINGS **: -
Risks, benefits, indications, and alternatives to the procedure were explained to the patient. Risks include bleeding, infection, i
and nerve injury. All questions were answered. Both written and verbal informed consent was obtained. A time-out was
performed to confirm the correct patient, procedure, and site. :

Positioned prone on the fluoroscopy table, a suitable trajectory for access to the thecal sac was identified. The overlying skin
was prepped and draped in the usual aseptic fashion and then anesthetized via local infiltration of approximately 2 mL
lidocaine 1% was used for local and deep anesthesia. A 22-gauge 3-1/2 inch spinal needle was advanced into the thecal sac at
the L3 level. Clear colorless CSF obtained on first attempt. Interlaminar technique used

Upon return of clear CSF, a total of 5 mL was sampled and the needle was removed.
The needle was removed. The patient tolerated the procedure well and there were no im 's

Radiation dose to patient: 32.88 uGy
Fluoroscopy time. 0.4 minutes

** IMPRESSION **:
Successful fluoroscopic guided lumbar puncture. Samples were submitted to,

rdeery for analysis. :

Authorizing Provider Result Type
MARK WAHEED DO FLUOROSCOPY

MULTIPLE SCLEROSIS PANEL (MULTIPLE SC
result (11/15/2023 2:23 PM PST)

EL (CSF OLIGOCLONAL BANDS, CSF IGG INDEX)) - Final

Analysis
Component Value Test Method Time Performed At Pathologist Signature
Albumin 4,590, TPMG
“ REGIONAL
LABORATORY,
MWS

Serum albumin performed a . Dir: E. :

Hosfield, MD
LABORATORY,
IgG TPMG
REGIONAL
LABORATORY,

Albumin TPMG
REGIONAL
LABORATORY,
MWS
. Refh

Comment:
Serum albumin performed at 914 Marina way South, Richmond, CA 94804. Dir: E.
Hosfield, MD

: REGIONAL -

Anatomical Location / | Collection Method /

Specimen (Source) Laterality Volume Collection Time Received Time
. 11/15/2023 2:23 PM 11/16/2023 2:36 AM
PST PST

Narrative

TPMG REGIONAL LABORATORY , BERKELEY - 11/17/2023 2:32 PM PST
CSF and serum required same day. Front desk: Confirm with patient if spinal
tap is done or scheduled before releasing order.

Authorizing Provider Result Type

MARK WAHEED DO LABORATORY

Performing
Organization Address City/State/ZIP Code Pho

TPMG REGIONAL 1725 Eastshore Berkeley, CA 94710
LABORATORY, Highway

BERKELEY
_TPMG REGIO AL

LABORATORY, MWS |

MULTIPLE SCLEROSIS PANEL INTERPRETATION - Final 15/2023 1:50 PM PST)
Ref . a Analysis
Component Value Range Time Performed At Pathologist Signature

Oligoclonal bands, CSF, ABNORMAL - TPMG

electrophoresis REGIONAL
LABORATORY,
BERKELEY

Comment:
Reference Range for MS Bandit

Oligoclonal Banding: _ :
Normal: ym “veal nds absent or identical bands in
Serum and CSF vo
Borderline: Hard more in CSF than in Serum
Abnormal: 2 Bagds or more in CSF than in Serum

BERKELEY

Serum: Di ffuse Gamma i peaion ae :
Reference Range for MS Bending Geum: Diffuse Gamma Region

Anatomical Location / — Collection Method /
Specimen (Source) Laterality Volume Collection Time Received Time

11/15/2023 1:50 PM 11/16/2023 2:36 AM
PST PST

Narrative

TPMG REGIONAL LABORATORY, BERKELEY - 11/17/2023 2:32 PM PST
Narrative

Authorizing Provider Result Type

MARK WAHEED DO LABORATORY

Performing

Organization Address City/State/ZIP Code Phone Number
TPMG REGIONAL 1725 Eastshore Berkeley, CA 94710

LABORATORY, Highway

BERKELEY

CEREBROSPINAL FLUID PROTEIN (PROTEIN, CSF) - Final result (11/15/2023 1:50 PM PST)

Ref Analysis
Component Value Range _Test Method Time Performed At Pathologist Signature
Protein, CSF 29 15-45 KFH
mg/dL SACRAMENTO
LABORATORY
Anatomical Location / — Collection Method / YY. a
Specimen (Source) Laterality Volume Collection Tintagy” Received Time

Narrative

M 11/15/2023 2:47 PM
PST

Authorizing Provider Result Type
MARK WAHEED DO BODY FLUIDS
Performing

Organization Address

Phone Number

KFH SACRAMENTO

2025 Morse Ave.

LABORATORY

CEREBROSPINAL FLUID GLUCOSE (GLU Gs t

Component

Glucose, CSF

geomical Location /

Final result (11/15/2023 1:50 PM PST)

_ Analysis

Test Method Time Performed At Pathologist Signature
KFH
SACRAMENTO
LABORATORY

Collection Method /

Specimen (Source} Eecality Volume Collection Time Received Time
11/15/2023 1:50 PM 11/15/2023 2:47 PM
PST PST

Narrative

Authorizing Provider Result Type

MARK WAHEED DO BODY FLUIDS

Performing

Organization Address City/State/ZIP Code Phone Number

KFH SACRAMENTO
LABORATORY

2025 Morse Ave.

Sacramento, CA 95825

CEREBROSPINAL FLUID CELL COUNT AND DIFFERENTIAL (CELL COUNT W DIFFERENTIAL, CSF) - Final result

(11/15/2023 1:50 PM PST)
Component

Case 2:22-cr-Q0087-KJ

Range

MERet Doc

Tube number, CSF

Appearance, CSF

Color, CSF

Tube #1
CLEAR.

“COLRLESS

NUCLEATED CELLS, CSE 5

TUBE A

Specimen volume, CSF

Specimen (Source)

PERFORMED

5.0

Anatomical Location /
Laterality

Collection Method /
Volume

KFH
SACRAMENTO
LABORATORY

KFH
SACRAMENTO

KFH
SACRAMENTO

KFH
SACRAMENTO

__ LABORATORY

KFH
SACRAMENTO

Received Time

Narrative

11/15/2023 2:48 PM
PST

Authorizing Provider

Result Type

MARK WAHEED DO

Performing
Organization

BODY FLUIDS

Address

KFH SACRAMENTO
LABORATORY

2025 M

| PROTHROMBIN TIME (P

Component

ity/State/ZIP Code

Phone Number

Sacramento, CA 95825

poult (11/13/2023 4:31 PM PST)

Ref
Range

Analysis

Test Method Time

Performed At Pathologist Signature

PT

Comment
Recommended Range:

11.7 -
14.9
second(s)

Ratio.

2.0-3.0 for most medical and surgica
2.5-3.5 for artificial heart valves and rec

Specimen (Source)

Anatomical Location /
Laterality

Volume

Collection Method /

Collection Time

TPMG
REGIONAL
LABORATORY,
MWS.

TPMG
REGIONAL

Received Time

11/13/2023 4:31 PM
Narrative 2:2.9-6r-00087-KIM Decument 46 Filed 02/19/24 Page-14 of 106

Authorizing Provider Result Type
MARK WAHEED DO BLOOD

Performing
Organization Address City/State/ZIP Code Phone Number

TPMG REGIONAL 914 Marina Way South Richmond, CA 94804
LABORATORY, MWS

QUANTIFERON TB TESTING (GAMMA INTERFERON (TB), CD4 AND CD8 T-CELL RESPONSE) - Final result (10/18/2023
9:58 AM PDT)

Ref Analysis
Component Value Range Test Method Time Performed At Pathologist Signature
QFT TB GOLD PLUS Negative Negative ARUP
INTERPRETATION LABORATORIES

Comment:
Interpretive Data: Quantiferon TB Gold Plus

Interferon gamma release is measured for specimens from each of
the four collection tubes. A qualitative result (Negative,
Positive, or Indeterminate) is based on interpretation of the fou
values, NIL, MITOGEN minus NIL (MITOGEN-NIL), TB1 minus NIL y
C(TB1-NIL), and TB2 minus NIL (1B2-NIL). The NIL value represene
nonspecific reactivity produced by the patient specimen. The
MITOGEN-NIL value serves as the positive control for the ga’
specimen, demonstrating successful lymphocyte activity. i
TB1- NIL tube specifically detects CD4+ jaymphoeyte reg

TB2 antigens. An overall Negative result does he :
out TB infection.

A false-positive result in the absence o
of TB infection is not uncommon. Refer
Using Interferon Gamma Release Assays
tuberculosis Infection --- United g
Chttp: //www. cdc. gov/mmwr/preview/
information concerning test iT
populations and use in 0c
TB ANTIGEN _ 0.00 4 : . : =
STIMULATED GAMMA « 34 1U/ _ LABORATORIES
IFN BY CD4 CELLS } mL

nical evidence
ped Guidelines for

ARUP
STIMULATED GAMMA 0.34 IU/ LABORATORIES
IFN BY CD4+CD8 CELLS mL
TUBERCULIN 0.11 IU/mL ARUP

STIMULATED IFN LABORATORIES
GAMMA RELEASE, NEG

CONTROL

Comment:

Performed By: ARUP Laboratories

500 Chipeta way

Salt Lake City, UT 84108

Laboratory Director: Jonathan R. Genzen, MD, PhD

CLIA Number: 4600523979
Narrative

Authorizing Provider Result Type

MARK WAHEED DO MICRO - KPHC ONLY

Performing

Organization Address City/State/ZIP Code

Phone Number

ARUP LABORATORIES 500 Chipeta Way

Salt Lake City, UT 84108

@ HEPATITIS C ANTIBODY (HEPATITIS C VIRUS ANTIBODY (HCVAB), PLASMA) - Final result (10/18/2023 9:58 AM PDT)

Ref

Component Value Range Test Method

Analysis
Time

Hep C AB NEGATIVE

Comment:

Samples should not be taken from patients receiving therapy with

doses (>5 mg/day) until at least 8 hours following the last
administration. (Falsely low results are possible.)

Anatomical Location/ Collection Metho

Specimen (Source) Laterality

Narrative

Performed At Pathologist Signature

biotin

ollection Time Received Time

10/18/2023 9:58 AM
PDT

10/18/2023 2:02 PM
PDT

Authorizing Provider Result Type

MARK WAHEED DO MICRO - KPHC

Performing

Organization Addr@ City/State/ZIP Code

Phone Number

TPMG REGIONAL
LABORATORY,
BERKELEY

Berkeley, CA 94710

JC VIRUS ANTIBODY INHIBIT
Ref

Component Value Range __Test Method

fON ASSAY - Final result (10/18/2023 9:58 AM PDT)

Analysis

Time Performed At Pathologist Signature

JC VIRUS AB
INHIBITION

FINAL RSLT:
NEGATIVE

QUEST
. Ref : j :

Comment:

REFERENCE RANGE: NEGATIVE

INTERPRETATION:

Positive: Antibodies to Jc virus (JcVv) detected
indicating the patient has been exposed
to JcV at an undetermined time

Negative: Antibodies to JcV not detected

Test Performed at:

Quest Diagnostics Nichols Institute

33608 ortega Highway

San Juan Capistrano, CA 92675-2042 Director: I Maramica MD, PhD

Anatomical Location/ Coilection Method /
Specimen (Source) Laterality Volume Collection Time Received Time
10/18/2023 9:59 AM
PDT

Narrative

Authorizing Provider Result Type

NON-CPM LAB MICROBIOLOGY
PROVIDER

Performing ‘
Organization Address i hone Number

QUEST DIAGNOSTICS 33608 Ortega Highway

| JC VIRUS ANTIBODY GC VIRUS ANTIBODY W TOMIHIBITION ASSAY) - Final result (10/18/2023 9:58 AM PDT)
Ref gv Analysis
Component Value Time Performed At Pathologist Signature

JC VIRUS AB INDETERM tp : QUEST
DIAGNOSTICS
. Ref ; lys)

Comment:
See Inhibition Assay result below for the final
antibody result.

Index interpretive criteria:
<0.20 negative
0.20-0.40 indeterminate
>0.40 positive

INTERPRETATION
Negative: Antibodies to JCv not detected.

Indeterminate: Low level reactivity detected, see
Inhibition Assay result below for the final
antibody result.

Positive: Antibodies to JC virus (JcVv) detected
indicating
the patient has been exposed to JcVv at an
undetermined time.

The STRATIFY JCV Antibody Test is an enzyme-linked
immunosorbent assay (ELISA) designed to detect JCV
antibodies to help identify individuals who have
been exposed to the virus. Samples with low level
reactivity in the detection assay are retested in
a confirmation (inhibition) assay to confirm
presence or absence of JCV-specific antibodies.

Retrospective analyses of post marketing data fro
various sources, including observational studie
and spontaneous reports obtained worldwide,
suggest that the risk of developing PML °

; Director: I Maramica MD , PhD . _.
DIAGNOSTICS

Collection Method /
Specimen (Source) ali Volume Collection Time Received Time
10/18/2023 9:58 AM 10/18/2023 9:59 AM
PDT PDT

Narrative

Authorizing Provider Result Type
MARK WAHEED DO MICROBIOLOGY

Performing
Organization Address City/State/ZIP Code Phone Number
QUEST DIAGNOSTICS = 33608 Ortega Highway San Juan Capistrano, CA

92690

LYMPHOCYTE PANEL (LYMPHOCYTE PANEL (CD3, CD19, CD16, CD56, CD4, CD8 ABSOLUTE COUNT AND %), FLOW,
CYTOMETRY) - Final result (10/18/2023 9:58 AM PDT) : Page 13 of 94 ©
CD3/100 cells, qn 80 53 - 83 TPMG
% REGIONAL
LABORATORY,

REGIONAL
LABORATORY,

€D8/100 cells, qn

Comment:

This test was developed and its performance characteristics deter

Regional Laboratory. It has not been cleared or approved by the,£D/ The
laboratory is regulated under CLIA as qualified to perform hig

testing. This test is used for clinical purposes. It shoul garded
as investigational or for research. é

“LABORATORY,
This test was developed and j aMyctewistics determined by TPMG
Regional Laboratory. for 2p proved ee, the FDA. The

laboratory is regulated under CLIA as.
This test ais used for clini

CD19/100 cells, qn ‘ 3 TPMG
LABORATORY,
MWS

Comment:

This test was develop d its performance characteristics determined by TPMG
Regional Laboratory. »has not been cleared or approved by the FDA. The
laboratory is regulated Yader CLIA as qualified to perform high-complexity
testing. This test is used for clinical purposes. It should not be regarded
as investigational or for research.

REGIONAL J
_ LABORATO RY,

Regional Laboratory. it has not been cleared-or approved by the FDA. The
aif ed to perform high- comnts exity.

qn REGIONAL

We Page 14 of 94
Specimen (Source)

562 ful

Anatomical Location / Collection Method /
Laterality Volume

Analysis

se ogist Signature

REGIONAL

Collection Time Received Time

Narrative

10/18/2023 9:58 AM —_—_ 10/18/2023 4:40 PM
PDT PDT

Authorizing Provider

Result Type

MARK WAHEED DO

Performing
Organization

BLOOD

Address City/State/ZIP Code

Phone Number

TPMG REGIONAL
LABORATORY, MWS

HEPATITIS B VIRUS CORE TOTAL ANTIBODY (HEPATITIS B VIRUS CORE AN

914 Marina Way South

Richmond, CA 94804

© (10/18/2023 9:58 AM PDT)

Component

Ref

Value Range Test Method

DY (HB@AB), TOTAL) - Final result

Performed At Pathologist Signature

HEP B VIRUS CORE AB

Specimen (Source)

NEGATIVE

Anatomical Location /
Laterality

TPMG
REGIONAL
LABORATORY,
BERKELEY

Collection Time Received Time

Narrative

10/18/2023 9:58 AM 10/18/2023 1:58 PM
PDT PDT

Authorizing Provider

MARK WAHEED DO

Performing
Organization

City/State/ZIP Code

Phone Number

TPMG REGIONAL
LABORATORY,
BERKELEY

Berkeley, CA 94710

ALANINE AMINOTRANSFERASE (ALT) (ALT) - Final result (10/18/2023 9:58 AM PDT)

Component

Ref

Value Range __ Test Method

Analysis
Time

Performed At_ Pathologist Signature

ALT

18 0-47 U/
L

TPMG
REGIONAL
LABORATORY,
MWS

Anatomical Location /

Specimen (Source) Laterality

Collection Method /

Volume Collection Time

Received Time

Narrative

10/18/2023 9:58 AM
PDT

10/18/2023 2:08 PM
PDT

Page 15.0f 94
Performing
Organization Address City/State/ZIP Code Phone Number
TPMG REGIONAL 914 Marina Way South Richmond, CA 94804
LABORATORY, MWS

ASPARTATE AMINOTRANSFERASE (AST) (AST) - Final result (10/18/2023 9:58 AM PDT)
Ref Analysis
Component Value Range __ Test Method Time Performed At_ Pathologist Signature
AST 13 10 - 40 TPMG
U/L REGIONAL
LABORATORY,
MWS

Anatomical Location / Collection Method /
Specimen (Source) Laterality Volume . i Received Time
pe 10/18/2023 2:08 PM
PDT

Narrative

Authorizing Provider Result Type
MARK WAHEED DO BLOOD

Performing

Organization Address i >a? hone Number
TPMG REGIONAL 914 Marina Way South :

LABORATORY, MWS

42023 9:58 AM PDT)
Analysis
Component Performed At Pathologist Signature
VITAMIN D, 25- y TPMG
HYDROXY fost, REGIONAL
LABORATORY,
MWS

Comment:

; “vale) ‘guidelines represent clinical decision
points for healthy ad &} Refinitive data is lacking for the pediatric age
group. sufficient rang& Ower limit changed from 25 to 20 ng/mL on 06/04/2012.

Interpretation of 25-OH Atamin D Levels (ng/mL) :

Deficient <12
Insufficient 12-19
Sufficient 20-79
High 80-150
Toxic >150

This test was developed and its performance characteristics determined by TPMG
Regional Laboratory. It has not been cleared or approved by the FDA. The
laboratory is regulated under CLIA as qualified to perform high-complexity
testing. This test is used for clinical purposes. It should not be regarded
as investigational or for research.

Anatomical Location/ Collection Method / .
Specimen (Source) Laterality Volume Collection Time Received Time

10/18/2023 9:58AM 10 341
Authorizing Provider Result Type

MARK WAHEED DO BLOOD

Performing
Organization Address City/State/ZIP Code Phone Number

TPMG REGIONAL 914 Marina Way South — Richmond, CA 94804
LABORATORY, MWS

HEPATITIS B VIRUS SURFACE ANTIGEN (HEPATITIS B VIRUS SURFACE ANTIGEN (HBSAG)) - Final result (10/18/2023
9:58 AM PDT)

Ref Analysis
Camponent Value Range _Test Method Time Performed At_ Pathologist Signature

Hep B surface AG NEGATIVE TPMG
REGIONAL

Comment:
Used to determine acute, recent, or chronic hepatitis B infection status.

Samples should not be taken from patients receiving therapy wit
doses (>5 mg/day) until at least 8 hours following the last
administration. (Falsely low results are possible.)

Anatomical Location / Veet!
Specimen (Source) Laterality Collection Time Received Time

10/18/2023 9:58 AM —- 10/18/2023 1:58 PM
PDT PDT

Narrative

Authorizing Provider Result Type

MARK WAHEED DO

Performing a" rd
Organization oe » City/State/ZIP Code Phone Number

TPMG REGIONAL ve] ae Berkeley, CA 94710
BERKELEY

| VARICELLA ZOSTER VIRUS ANTIBODY - Final result (10/18/2023 9:58 AM PDT)
Ref Analysis
Component Value Range _ Test Method Time Performed At_ Pathologist Signature

VARICELLA ZOSTER POSITIVE TPMG
VIRUS IGG, EIA REGIONAL
LABORATORY,
BERKELEY
Comment:
Positive indicates evidence of immunity or of infection at some time.
Negative indicates no evidence of immunity or previous infection.

Anatomical Location/ —_ Collection Method /
Specimen (Source) Laterality Volume Collection Time Received Time

10/18/2023 9:58 AM 10/18/2023 2:00 PM

PDT
“Page 17 of 94
Narrative

Case 2:22-cr-00087-KJM Document46- Filed 03/19/24 Page 22 of 106

Authorizing Provider Result Type

MARK WAHEED DO MICRO - KPHC ONLY

Perfarming
Organization Address City/State/ZIP Code Phone Number

TPMG REGIONAL 1725 Eastshore Berkeley, CA 94710
LABORATORY, Highway
BERKELEY

HEPATITIS B VIRUS SURFACE ANTIBODY (HEPATITIS B VIRUS SURFACE ANTIBODY (HBSAB)) - Final result (10/18/2023

9:58 AM PDT)
Ref Analysis
Component Value Range _ Test Method Time Performed At_ Pathologist Signature

HEP B VIRUS SURFACE POSITIVE >/= TPMG

ANTIBODY 10 mlU/mL REGIONAL
ABORATORY,

Comment: +

When the Hepatitis B surface antibody result is POSITIVE, this indicates a%|

Hepatitis B surface antibody level of >=10 mIU/mL. i.

Samples that are POSITIVE are considered protective for Hepatitg 2
in accordance with CDC guidelines.

Anatomical Location/ Collection Me

Specimen (Source) Laterality Volume Sm, “gh ollection Time Received Time
. 10/18/2023 9:58 AM 10/18/2023 1:58 PM
PDT PDT

Narrative

Authorizing Provider Result Type

MARK WAHEED DO MICRO - KPHC oN

Performing > *
Organization GS 4 @ _City/State/ZIP Code Phone Number

TPMG REGIONAL hore Berkeley, CA 94710
BERKELEY

MMUNOGLOBULINS G, A AND M (IGG, IGA, IGM) - Final result (10/18/2023 9:58 AM PDT)

Ref Analysis
Component Value Range _ Test Method Time Performed At Pathologist Signature

IgG 830 600 - TPMG
1,600 REGIONAL
mg/dL LABORATORY,
BERKELEY
REGIONAL
_ LABORATORY,
_ BERKELEY.
TPMG
REGIONAL
LABORATORY,
BERKELEY
Ref.

-Immature Granulocytes 2.
%, Automated Count _

Specimen (Source)

Anatomical Location / Collection Method /
Laterality Volume

Collection Time

REGIONAL
LABORATORY,

Received Time

Narrative

10/18/2023 9:58 AM

PDT

10/18/2023 3:03 PM
PDT

Authorizing Provider

Result Type

MARK WAHEED DO

Performing
Organization

LABORATORY

Address City/State/ZIP Code

TPMG REGIONAL
LABORATORY, MWS

914 Marina Way South — Richmond, CA 94804

Phone Number

Component

Ref

Range _ Test Method

023 9:58 AM PDT)

Performed At Pathologist Signature

WBC COUNT

3.7 -
11.1 K/

ood cells count

Platelets count

Specimen (Source)

400 K/uL

100WC

Collection Method /
Volume

Anatomical Location /
Laterality

REGIONAL
LABORATORY,
MWws

Collection Time

LABORATORY,

TPMG
REGIONAL
LABORATORY,

TPMG

_ LABORATORY, -

REGIONAL
LABORATORY,

TPMG
REGIONAL
LABORATORY,

REGIONAL
LABORATORY,

Received Time

10/18/2023 9:58 AM

PDT

10/18/2023 3:03 PM
PDT
Narrative

Case 2:22-cr-00087-KJM Document46_ Filed 03/19/24 Page 25 of 106
Authorizing Provider Result Type

MARK WAHEED DO BLOOD

Performing
Organization Address City/State/ZIP Code Phone Number
TPMG REGIONAL 914 Marina Way South — Richmond, CA 94804

_LABORATORY, MWS

EKG 12 OR MORE LEADS W INT & RPT - Final result (10/06/2023 7:04 PM PDT)

Ref Analysis Performed

Component Value Range Test Method Time At Pathologist Signature
EKG Impression Sinus NCAL EKG

bradycardia GE MUSE

with sinus INTERFACE

arrhythmia 12 LEAD

confirmed

by Kim MD,

Peter

(6104) on

10/10/2023

10:18:04 AM

PR interval ,-_~_™”. NCAL EKG
'@ GE MUSE

INTERFACE

NCAL EKG
GE MUSE
INTERFACE

NCAL EKG
GE MUSE
INTERFACE

NCAL EKG
GE MUSE
INTERFACE
12 LEAD

Anatomical Location / Collection Method /
Specimen (Source) Laterality Volume Collection Time Received Time

10/06/2023 7:04 PM 10/10/2023 10:18 AM
PDT

Narrative
THOMAS MD

Performing

Organization Address City/State/ZIP Code Phone Number

NCAL EKG GE MUSE
INTERFACE 12 LEAD

MRI BRAIN WO/W CONTRAST. (09/16/2023 4:44 PM PDT)
Ref Analysis
Component Value Range Test Method Time

Performed
At

Pathologist Signature

Study recommendation, #d14

radiology

RADIOLOGY EXAM

DESCRIPTION WITHOUT
AND WITH

Anatomical Region Laterality Modality

NCAL PWS
NCAL PWS
INTERFACE

Magnetic Resonance

Anatomical Location / Collection Method f
Specimen (Source) Laterality Volume

Impressions

Received Time

09/16/2023 9:21 PM PDT

Few areas of T2 signal abnormality supra and inf 4
disease, presumably MS 4

Enhancement along left brachium pontis af® @eral peduncle compatible with active/inflammatory

component to disease

+

Action required. +

Narrative

09/16/2023 9:21 PM PD
Narrative

MRT BROTNSG 222-CEOUUS ERIM? Document 46 Filed 03/19/24 Page 27 of 106

* HISTORY **:
21 years old, associated diagnoses: PARESTHESIA; FUSION OF CERVICAL SPINE; MULTIPLE HEREDITARY
EXOSTOSIS.

** TECHNIQUE **:
MR images of the brain acquired without and with 14 mL Clariscan intravenous contrast.

COMPARISON: MRS 9/12/2023, 1/31/2023, 12/20/2022

** FINDINGS **;:

BRAIN PARENCHYMA:

Focal areas of T2 prolongation in the supra and infratentorial brain. Regions involved left brachium
pontis, left cerebral peduncle and medial geniculate region, and 2 periventricular lesions near atria.

Enhancement along left brachium pontis and left cerebral peduncle compatible with active/inflammatory
component to disease

No acute hemorrhage or infarct. No significant mass effect or midline shift.
VENTRICLES/EXTRA-AXIAL SPACES: No hydrocephalus or extra-axial fluid collections.
FLOW VOIDS: Intact.

EXTRACRANIAL STRUCTURES: No significant abnormality

MRI BRAIN WITHOUT AND WITH CONTRAST }

Procedure Note /
ANOOP CRUMSAN NUNDKUMAR MD - 09/16/2023 a
Formatting of this note might be different from the original. “S :

** HISTORY **: 4
21 years old, associated diagnoses: PARESTHESIA; FUSION OF cach Og MULTIPLE HEREDITARY EXOSTOSIS.

** TECHNIQUE **:

MR images of the brain acquired without and with 14 mL untravenous contrast.

COMPARISON: MRs 9/12/2023, 1/31/2023, 12/20

** FINDINGS **:

BRAIN PARENCHYMA:

Focal areas of T2 prolongation in the supra an
peduncle and medial geniculate region, afer

rategtorial brain. Regions involved left brachium pontis, left cerebral

Enhancement along left brachium
disease

No acute hemorrhage o (Ye ct. icant mass effect or midline shift.

VENTRICLES/EXTRA-AXIAL (CES: No hydrocephalus or extra-axial fluid collections.
FLOW VOIDS: Intact.
EXTRACRANIAL STRUCTURES: No significant abnormality

** IMPRESSION **:
Few areas of T2 signal abnormality supra and infratentorial brain compatible with demyelinating disease, presumably MS

Enhancement along left brachium pontis and left cerebral peduncle compatible with active/inflammatory component to
disease

#d14

+

Action required. +

Page 23 of 94 —
UKESH

Co
RADHIKA M

KADAKIA MD
MRI CERVICAL SPINE NO CONTRAST. (09/12/2023 5:59 PM PDT) :
Ref Analysis Performed 7
Component Value Range Test Method Time At Pathologist Signature
RADIOLOGY EXAM MRI NCAL PWS :
DESCRIPTION CERVICAL INTERFACE
SPINE
WITHOUT
CONTRAST
Anatomical Region Laterality Modality
Magnetic Resonance
Anatomical Location / Collection Method /
Specimen (Source) Laterality Volume Collection Time Received Time

09/13/2023 11:16 AM PDT

Postoperative changes at C4-C5 with right osteochondroma. Ques ss effect on the transiting
right nerve roots and deviation of the spinal cord to the le

+

Narrative

09/13/2023 11:16 AM PDT
MRI CERVICAL SPINE WITHOUT CONTRAST

** HISTORY **:
Male, age 21 years: Cervical tumor removal, fr,

** TECHNIQUE **:
MR images of the cervical spine acquire

1t intravenous contrast.

** FINDINGS **:
SPINAL CORD: Unremarkable.

DISCS: Question disc desig

BONES: Vertebral bodyhei ght “@ad a’ iignment are not significantly changed. Anterior fusion from C4 to

SOFT TISSUES: Unremarkag@e.

c2-c3: No significant cé@tral canal or foraminal stenosis.

c3-c4: No significant central canal or foraminal stenosis.

c4-C5: Postoperative changes with redemonstration of right osteochondroma, questionable mass effect on
the transiting right nerve roots. Deviation of the spinal cord to the left.

c5-c6: No significant central canal or foraminal stenosis.

C6-C7: Uncovertebral hypertrophy with mild left foraminal narrowing

C7-T1: Uncovertebral hypertrophy with mild right foraminal narrowing

OTHER: Visualized posterior fossa is unremarkable.

Procedure Note

Page 24 of 94
Procedure Note

Formattinggel thionoteg hog dktgrant freyyeqeshe46 Filed 03/19/24 Page 29 of 106
MRI CERVICAL SPINE WITHOUT CONTRAST

** HISTORY **:
Male, age 21 years: Cervical tumor removal, returning numbness

** TECHNIQUE *?:
MR images of the cervical spine acquired without intravenous contrast.

COMPARISON: CTs 9/11/2023, 12/27/2022, MRs 1/31/2023, 12/20/2022

** FINDINGS **:
SPINAL CORD: Unremarkable.

DISCS: Question disc desiccation at C6/C7
BONES: Vertebral body height and alignment are not significantly changed. Anterior fusion from C4 to C6
SOFT TISSUES: Unremarkable.

C2-C3: No significant central canal or foraminal stenosis.

C3-C4: No significant central canal or foraminal stenosis.

C4-C5: Postoperative changes with redemonstration of right osteochondroma, quggtionable )

ass effect on the transiting right :
nerve roots. Deviation of the spinal cord to the left.

C5-C6: No significant central canal or foraminal stenosis.

C6-C7: Uncovertebral hypertrophy with mild left foraminal narrowing ¢ ‘

C7-T1: Uncovertebral hypertrophy with mild right foraminal narg fi ig

OTHER: Visualized posterior fossa is unremarkable.

** IMPRESSION **:
Postoperative changes at C4-C5 with right osteochom
deviation of the spinal cord to the left. .
+

> uestionable mass effect on the transiting right nerve roots and

Authorizing Provider Result. T a
JACOB HIRK FENNESSY MRI |

CT CERVICAL SPINE NO CG@AITRAST. (09/11/2023 2:48 PM PDT)

Ref Analysis Performed
Component Value Range __ Test Method Time At Pathologist Signature
RADIOLOGY EXAM CT CERVICAL NCAL PWS
DESCRIPTION SPINE INTERFACE

WITHOUT
CONTRAST

Anatomical Region Laterality Modality
Computed Tomography

Anatomical Location/ Collection Method /
Specimen (Source) Laterality Volume Collection Time Received Time
09/11/2023 5:02 PM
PDT

Impressions
09/11/2023 5:13 PM PDT
Impressions

Narrative

09/11/2023 5:13 PM PDT
CT CERVICAL SPINE WITHOUT CONTRAST

** HISTORY **:
21 years old, cervical spine tumor removal

* TECHNIQUE **:
cT images of the cervical spine acquired without intravenous contrast.

CTDI: 31.39 mGy
DLP: 741.32 mGy~cm

COMPARISON: MR 1/31/2023, CTs 1/31/2023, 12/27/2022

** FINDINGS **;
BONES: Postoperative features are seen at C4-C6 with C5 corpectomy and interbody cage. There is :
anterior plate fusion C4-C6. Hardware projects in satisfactory position. No further osseous .
destruction. The dens is intact, the lateral masses of Cl are normally aligned, and the atlantodental |

interval is normal.

DISCS: The other disc heights are within normal limits.
SPINAL CANAL: NO osseous narrowing of the spinal canal. ~~ ™
SOFT TISSUES: No prevertebral soft tissue swelling. Visualized neck soft ti g@ue
OTHER: Visualized lung apices are clear.

Procedure Note

JAMES HOWARD SMITH MD - 09/11/2023
Formatting of this note might be different from the original.
CT CERVICAL SPINE WITHOUT CONTRAST

** HISTORY **:
21 years old, cervical spine tumor removal

** TECHNIQUE **:
CT images of the cervical spine acquired without intrav,

s trast.

CTDI: 31.39 mGy
DLP: 741.32 mGy-cm

COMPARISON: MR 1/31/2023, CTs 1/31/2

** FINDINGS **: '
BONES: Postoperative features ; with C5 corpectomy and interbody cage. There is anterior plate fusion C4-C6.
further osseous destruction.. The dens is intact, the lateral masses of C1 are

erval is normal.

nagrowtmg of the spinal canal.
SOFT TISSUES: No preverte&l soft tissue swelling. Visualized neck soft tissues are normal.

OTHER: Visualized lung apice' Pere clear.

** IMPRESSION **:
1. C5 corpectomy with C4-C6 anterior fusion in satisfactory position. No hardware failure or fracture.

Authorizing Provider Result Type

JACOB HIRK FENNESSY = CT
MD

XR CERVICAL SPINE. (09/08/2023 4:28 PM PDT)

Ref Analysis Performed
Component Value Range __ Test Method Time At Pathologist Signature
RADIOLOGY EXAM XRAY NCAL PWS
DESCRIPTION CERVICAL INTERFACE

SPINE Page 26 of 94 |
Anatomical Region Laterality Modality
Case 2:22-cr-00087-KJM Document 46 ©CoPHeedRHigyaahy Page 31 of 106

Anatomical Location / Collection Method /

Specimen (Source) Laterality Volume Collection Time Received Time
09/08/2023 8:08 PM
PDT

Impressions

09/08/2023 8:09 PM PDT
Intact anterior fusion hardware extending from C4 to C6.

Narrative

09/08/2023 8:09 PM PDT
XRAY CERVICAL SPINE

** HISTORY **:
21 years old, POST OP EVALUATION (SPECIFY IN COMMENTS)

** TECHNIQUE **:
2 view(s) of the cervical spine acquired, including AP and lateral.

COMPARISON: Radiograph 5/3/2023

** FINDINGS **:

Normal vertebral body height. No acute fracture. Anterior fusion
appears intact. Normal alignment. Multilevel disc space narrowing.,.
normal. ;

Procedure Note

DEREK SON VIEN MD - 09/08/2023
Formatting of this note might be different from the original.
XRAY CERVICAL SPINE

** HISTORY **:
21 years old, POST OP EVALUATION (SPECIFY IN COM

** TECHNIQUE **:
2 view(s) of the cervical spine acquired, includin

COMPARISON: Radiograph 5/3/2023
** FINDINGS **:

Normal vertebral body height.
alignment. Multilevel disc space™

. v4 Anterior fusion hardware extending from C4 to C6 appears intact. Normal
a frevertebral soft tissues are normal.

** IMPRESSION **: .
Intact anterior fusion hard@aregextem@aing from C4 to C6.

Authorizing Provider Result Type
MATTHEW JOSEPH GENERAL RADIOLOGY
NEDRESKY PA-C

( M PDT

)

EKG 12 OR MORE LEADS W INT & RPT - Final result (07/27/2023 4:34 P

Page 27 of 94
Ref : j r

Componen Range ethod

RADIOLOGY EXAM XRAY NCAL PWS

DESCRIPTION CERVICAL INTERFACE .

Anatomical Region Laterality Modality .

Computed Radiography

Anatomical Location / Collection Method /
Specimen (Source) Laterality Volume Collection Time Received Time
05/03/2023 7:29 PM
PDT

impressions

05/03/2023 7:31 PM PDT
c4-c6 anterior fusion without evidence of hardware failure.

Narrative iL
05/03/2023 7:31 PM PDT y :
XRAY CERVICAL SPINE

* HISTORY **;
20 years old, POST OP EVALUATION (SPECIFY IN COMMENTS)

** TECHNIQUE **:
2 view(s) of the cervical spine acquired, including AP and lat

COMPARISON: Radiograph 1/31/2023

*

FINDINGS **:
Anterior fusion hardware at C4-c6. No evidence of hardwafe gai

Normal vertebral body height. No acute fracture. No hent. Disc spaces are normal. Prevertebral _

soft tissues are normal.

Procedure Note

NEIL JENSEN MD - 05/03/2023 7
Formatting of this note might be different from
XRAY CERVICAL SPINE

** HISTORY **:
20 years old, POST OP EVALUATIO

** TECHNIQUE alah

** FINDINGS **:

Anterior fusion hardware at C4-C6. No evidence of hardware failure.

Normal vertebral body height. No acute fracture. Normal alignment. Disc spaces are normal. Prevertebral soft tissues are
normal.

** IMPRESSION **:
C4-C6 anterior fusion without evidence of hardware failure.

Authorizing Provider Result Type

MATTHEW JOSEPH GENERAL RADIOLOGY
NEDRESKY PA-C

7 MRI CERVICAL SPINE - WO/W | CONTRAST. (01/31/2023 2:42 PM PST)
Case 2:22-cr-00087-KIM"! Document.46, Filed ognyyon pdgess of 196

96 nist Signature

Component Range ethod
RADIOLOGY EXAM MRI NCAL PWS 7
DESCRIPTION CERVICAL INTERFACE .

WITHOUT

Anatomical Region Laterality Modality .
Magnetic Resonance /

Anatomical Location / Collection Method / :

Specimen (Source) Laterality Volume Collection Time Received Time .
01/31/2023 2:44 PM :

impressions

01/31/2023 3:00 PM PST

steochondroma, improved

Status post C5 corpectomy with C4-cC6 anterior fusion and debulking of CS
he,.cervical cord at this

caliber of the cervical spinal canal and decreased flattening/myomalacia’ 9
level.

Narrative

01/31/2023 3:00 PM PST
MRI CERVICAL SPINE WITHOUT AND WITH CONTRAST

** HISTORY **: ox
20 years old, post op eval following C5 corpectomy and tg

** TECHNIQUE **: tin y
MR images of the cervical spine acquired without and@wreh “a@’Gadavist intravenous contrast.

COMPARISON: CTs 1/31/2023, 12/27/2022, Radiographf
12/20/2022 %

** FINDINGS **;
SPINAL CORD: Posterior fossa contents are
at the cS level following partial corpe Yeand debulking of the right sided osteoma. There is
persistent T2 prolongation and leftwar
level. Postcontrast enhanced images ar
fusion construct. Within the limi tage

d secondary to metallic artifact from the corpectomy and
am, no discrete abnormal cord enhancement demonstrated.

DISCS: No significant disc space}

following C4-c6 anterior fusion and C5 corpectomy. Debulking

BONES: Postsurgical chang@
ing from the right C5 pedicle with improved caliber of the

of the exophytic osseous 1
cervical canal. ;

SOFT TISSUES: Mild pré@ soft tissue swelling, expected postoperatively.

C2-C3: No canal or forasgnal stenosis.
c3-c4: No canal or foraminal stenosis.

c4-c5: Status post debulking of the exophytic lesion arising from the right C5 pedicle with improved
caliber of the canal. Persistent narrowing/effacement of the right foramen. Left neuroforamen remains
patent.

c5-C6: Postsurgical changes with improved caliber of the cervical canal. No significant foramina]
narrowing

C6-C7: No significant canal or foraminal stenosis.

C7-T1: No significant canal or foraminal stenosis.

OTHER: Visualized posterior fossa is normal.

Procedure Note

BRIAN CHRISTOPHER DAHLIN MD - 01/31/2023
Procedure Note

Formatting o& tbierote rniahbberdieren romdbepriaiit'4é — Filed 03/19/24 Page 35 of 106

** HISTORY **:
20 years old, post op eval following C5 corpectomy and tumor ressection

** TECHNIQUE **:
MR images of the cervical spine acquired without and with 7 mL Gadavist intravenous contrast.

COMPARISON: CTs 1/31/2023, 12/27/2022, Radiographs 1/31/2023, 1/30/2023, 12/13/2022, 8/12/2013, MR 12/20/2022

** FINDINGS **:

SPINAL CORD: Posterior fossa contents are unremarkable. Improved caliber of the cervical spinal canal at the C5 level following
partial corpectomy and debulking of the right sided osteoma. There is persistent T2 prolongation and leftward displacement of
the spinal cord within the canal at the C5 level. Postcontrast enhanced images are limited secondary to metallic artifact from
the corpectomy and fusion construct. Within the limitations of exam, no discrete abnormal cord enhancement demonstrated.

DISCS: No significant disc space height loss.

BONES: Postsurgical changes are present following C4-C6 anterior fusion and C5 corpectgmy. Debulking of the exophytic
osseous lesion, arising from the right C5 pedicle with improved caliber of the cervical cart@

SOFT TISSUES: Mild prevertebral soft tissue swelling, expected postoperatively.

C2-C3: No canal or foraminal stenosis.

C3-C4: No canal or foraminal stenosis.

C4-C5: Status post debulking of the exophytic lesion arising from the riggg icle with improved caliber of the canal.
Persistent narrowing/effacement of the right foramen. Left neuroforarg ¥. " gins*patent.

Significant foraminal narrowing

C5-C6: Postsurgical changes with improved caliber of the cervic
C6-C7: No significant canal or foraminal stenosis.
C7-T1: No significant canal or foraminal stenosis. :
OTHER: Visualized posterior fossa is normal.

** IMPRESSION **:

Status post C5 corpectomy with C4-C6 ag a. af
spinal canal and decreased flatteni dé

and debulking of C5 osteochondroma, improved caliber of the cervical
of the cervical cord at this level.

Authorizing Provider

JACOB HIRK FENNESSY
MD

CT CERVICAL SPINE NO CONTRAST. (01/31/2023 9:39 AM PST)

Ref Analysis Performed
Component Value Range _ Test Method Time At Pathologist Signature
RADIOLOGY EXAM CT CERVICAL NCAL PWS
DESCRIPTION SPINE INTERFACE
CONTRAST
Anatomical Region Laterality Modality i

Computed Tomography

Anatomical Location / Collection Method /

Specimen (Source) Laterality Volume Collection Time Received Time
01/31/2023 9:55 AM

PST
Impressions

01/31/2023 40509 MP5D087-KJIM Document46 Filed 03/19/24 Page 36 of 106

THE FOLLOWING DETAILS REPRESENT PERTINENT SUMMARY ONLY AND DOES NOT CONSTITUTE THE ENTIRETY OF THE
REPORT
PLEASE SEE BODY/FINDINGS OF REPORT FOR ALL RELEVANT DETAILS

Status post partial surgical resection of C5 osteochondroma mass with improvement of the regional bony
spinal canal size.

Anterior surgical fusion and hardwares of C4-6. Please see procedure report for relevant details.

Clinical follow up according to care plan.

Narrative

01/31/2023 10:09 AM PST
CT CERVICAL SPINE WITHOUT CONTRAST

** HISTORY **:
20 years old, post op eval s/p tumor ressection

** TECHNIQUE **:
cT images of the cervical spine acquired without intravenous contrast.

CTDI: 13.3 mGy
DLP: 295.15 mGy-cm

COMPARISON: CT 12/27/2022

** FINDINGS **:
BONES: Status post anterior surgical fusion procedure at C4-6 wit
vertebral body and surgical vertebral strut device placement a
bony osteochondroma mass medially at C5 with improvement of t
height and alignment are unchanged. The dens is intact, the
and the atlantodental interval is normal. No acute fractu
DISCS: Disc space heights are unchanged. F
SPINAL CANAL: CT is suboptimal modality for evaluation of tcluded intraspinal structures.
Assessment of the intraspinal region is limited by s ware beam hardening artifacts.

SOFT TISSUES: Postsurgical soft tissue changes of t -erior neck soft tissues. Postsurgical
changes and fluid within the upper-mid prevertebr, sues,

tial resection of the central C5
ptnal canal size. Vertebral body

Individual axial levels as follows:
C2-3: Bony spinal canal and foramen are

C3-4: Bony spinal canal and foramen are un

c4-5: Partial resection of the include c5 chondroma mass with improvement of the bony spinal

canal size. Bony foramen are unchanged

c5-6: Bony spinal canal and fora n nchanged.

C6-7: Bony spinal canal ag unchanged.
C7-T1: Bony spinal canal ai are unchanged.

OTHER: Visualized lu clear.

Procedure Note

sses of Cl are normally aligned,
Procedure Note

Formattingcaé thi iene BT ICsIeE" franuearishe46 Filed 03/19/24 Page 37 of 106
CT CERVICAL Sine WITHOUT CONTRAST

** HISTORY **:
20 years old, post op eval s/p tumor ressection

** TECHNIQUE **:
CT images of the cervical spine acquired without intravenous contrast.

CTDI: 13.3 mGy
DLP: 295.15 mGy-cm

COMPARISON: CT 12/27/2022

** FINDINGS **:
BONES: Status post anterior surgical fusion procedure at C4-6 with partial resection of the central C5 vertebral body and
surgical vertebral strut device placement at C5. Partial resection of the exophytic bony osteochondroma mass medially at C5
with improvement of the bony spinal canal size. Vertebral body height and alignment are unchanged. The dens is intact, the
lateral masses of C1 are normally aligned, and the atlantodental interval is normal. No acute fracture or subluxation.

DISCS: Disc space heights are unchanged. ,
SPINAL CANAL: CT is suboptimal modality for evaluation of the included intraspinal stru@ ire
region is limited by surgical hardware beam hardening artifacts. 4
SOFT TISSUES: Postsurgical soft tissue changes of the left anterior neck soft tissues. PostsurG@é
upper-mid prevertebral soft tissues. ‘

Assessment of the intraspinal

! changes and fluid within the

Individual axial levels as follows:
C2-3: Bony spinal canal and foramen are unchanged.

C3-4: Bony spinal canal and foramen are unchanged.

C4-5: Partial resection of the included C5 osteochondroma mass with | in
are unchanged.

gent of the bony spinal canal size. Bony foramen -

C5-6: Bony spinal canal and foramen are unchanged.

C6-7: Bony spinal canal and foramen are unchang@g g~

C7-T1: Bony spinal canal and foramen are unch

OTHER: Visualized lung apices are clear.

** IMPRESSION **:
THE FOLLOWING DETAILS REPRES
REPORT
PLEASE SEE BODY/FINDINGS O

ER SUMMARY ONLY AND DOES NOT CONSTITUTE THE ENTIRETY OF THE

R ALL RELEVANT DETAILS

Status post partial surgicaliee C5 osteochondroma mass with improvement of the regional bony spinal canal size.

Anterior surgical fusion and Fardwares of C4-6. Please see procedure report for relevant details.

Clinical follow up according to care plan.

Authorizing Provider Result Type

JACOB HIRK FENNESSY = CT
MD

® XR CERVICAL SPINE. (01/31/2023 9:34 AM PST)

Ref Analysis Performed
Component Value Range _Test Method Time At Pathologist Signature
RADIOLOGY EXAM XRAY NCAL PWS
DESCRIPTION CERVICAL INTERFACE

SPINE
Anatomical Region Laterality Modality
Case 2:22-cr-00087-KJM Document 46 CoPWMEDRHdiggmehY Page 38 of 106

Anatomical Location/ Collection Method /
Specimen (Source) Laterality Volume Collection Time Received Time
01/31/2023 11:24 AM
PST

Impressions

01/31/2023 11:26 AM PST
Status post recent C4-c6 fusion. No acute radiographic complications.

Narrative

01/31/2023 11:26 AM PST
XRAY CERVICAL SPINE

*# HISTORY **:
20 years old, s/p fusion

** TECHNIQUE **:
2 view(s) of the cervical spine acquired, including AP and lateral.

COMPARISON: Radiograph 1/30/2023
** FINDINGS **:

Anterior and interbody fusion C4-C6. Disc spaces are normal. Mod expectgd prevertebral soft tissue
swelling. Airways patent. Surgical drain in place. ,

Procedure Note

BRADEN WARNER BOICE MD - 01/31/2023
Formatting of this note might be different from the original.
XRAY CERVICAL SPINE

** HISTORY **:
20 years old, s/p fusion

** TECHNIQUE **:
2 view(s) of the cervical spine acquired, including AP"

COMPARISON: Radiograph 1/30/2023

** FINDINGS **:
Anterior and interbody fusion C4-
patent. Surgical drain in place.

** IMPRESSION **:

Status post recent C4-C64 e radiographic complications.

Authorizing Provider Re

JENNIFER TUYET GENERAL RADIOLOGY
NGUYEN PA-C

| CBC (COMPLETE BLOOD COUNT) WITH DIFFERENTIAL (CBC W AUTOMATED DIFFERENTIAL) - Final result
01/31/2023 6:48 AM PST)

Ref Analysis
Component Value Range _Test Method Time Performed At Pathologist Signature
WBC COUNT 12.2 3.7 - KFH
11.1 K/ SACRAMENTO
Red blood cells count 4.59 4.10 - : . —sOKFH :
: 5.7/0 M/ SACRAMENTO
Hgb 14.1 13.0 - KFH
17.0 g/ SACRAMENTO
ee ____\aoratory Page 34 of 94
MCV KFH
SACRAMENTO
LABORATORY

SACRAMENTO

_ LABORATORY _

400 K/uL SACRAMENTO

SACRAMENTO
Anatomical Location/ Collection Method /
Specimen (Source) Laterality Volume Collection Time Received Time
01/31/202 01/31/2023 7:02 AM
PST PST

Narrative

Authorizing Provider Result Type
JAMES ARELLANO PA-C LABORATORY

Performing

Organization Address

KFH SACRAMENTO 2025 Morse Ave.
LABORATORY

R)) - Final result (01/31/2023 6:48 AM PST)
4 Analysis
Component ' Time Performed At Pathologist Signature
Sodium Sh, KFH
45g SACRAMENTO
: ¢ ed ae LABORATORY
Chloride 3 << KFH
f SACRAMENTO
KFH
SACRAMENTO
GLUCOSE, RANDOM KFH
SACRAMENTO
LABORATORY

Comment:
Borderline range of 160 - 199 mg/dL suggests follow-up. Results greater than
or equal to 200 mg/dL is suggestive of diabetes in the setting of classical
symptoms.
Anatomical Location/ Collection Method /

61 731 72023 6:48 AM 01/31/2023 7:02 AM
PST PST i.

Narrative

Authorizing Provider Result Type
JAMES ARELLANO PA-C LABORATORY

Performing

Organization Address City/State/ZIP Code Phone Number
KFH SACRAMENTO 2025 Morse Ave. Sacramento, CA 95825

LABORATORY

XR CERVICAL SPINE. (01/30/2023 1:17 PM PST)

Ref Analysis Performed
Component Vaiue Range _ Test Method Time t Pathologist Signature
RADIOLOGY EXAM XRAY
DESCRIPTION CERVICAL
SPINE
Anatomical Region Laterality Modality

Anatomical Location/ — Collection Method /ggggs
Specimen (Source) Laterality Volume ‘ ,olR@ction Time Received Time -

"a /30/2023 1:21 PM

impressions

01/30/2023 1:22 PM PST ;
Postsurgical changes with anatomic align

Narrative

01/30/2023 1:22 PM PST
XRAY CERVICAL SPINE

** HISTORY **:
20 years old, intra-op

** TECHNIQUE **:
2 view(s) of the ce

COMPARISON: CT 12/27/

*% FINDINGS **:
Normal vertebral body he ght and alignment. Patient is status post C5 corpectomy with C4-c6 anterior
fusion. Surgical hardware is intact.

Procedure Note
AMIT ASHOK RAHEJA MD - 01/30/2023
Procedure Note “

Formagiagel tip pots ater Rane" TeREEACARAG Filed 03/19/24 Page 42 of 106

** HISTORY **:
20 years old, intra-op

** TECHNIQUE **:
2 view(s) of the cervical spine acquired, including AP and lateral.

COMPARISON: CT 12/27/2022, MR 12/20/2022
** FINDINGS **:

Normal vertebral body height and alignment. Patient is status post C5 corpectomy with C4-C6 anterior fusion. Surgical
hardware is intact.

** IMPRESSION #*:
Postsurgical changes with anatomic alignment.

Authorizing Provider Result Type

SURGICAL PATHOLOGY - Final result (01/30/2023 11:16 AM PST)

Component

Ref
Value Range

Test Method

PATHOLOGY REPORT

Provider: JACOB
HIRK FENNESSY M.D.
Collected:

Pathologist
Performed At Signature
KFH

SACRAMENTO
LABORATORY

1/30/2023
Case #:
SACS23-2534

Surgical Pathology
Report

FINAL PATHOLOGge
DIAGNOSIS, . & g

GORY SCOTT
MOES M.D.

** Report
Electronically
Signed by GSM **
Comment
This specimen was
diagnosed and
signed out at:
Kaiser Oakland
Medical Center
CLIA License #
05D0602613
3600 Broadway
Oakland, CA 94611
(510) 752-6813

Page 38 of 94

IPR:YZ
Case 2:22-cr-00087-KJM Document46 Filed 03/19/24 Page 43 of 106

Page 39 of G4
Microscopic
Description

A microscopic
examination has
been performed. The
microscopic
findings support
the diagnosis.

Clinical History
BENIGN NEOPLASM,
VERTEBRAL COLUMN
MULTIPLE HEREDITARY
EXOSTOSIS

Gross Description
Received in
formalin labeled
with the patient's
name

(Ashcraft, Dhameon) ,
medical record
number (13095514),
designated as

"c5 tumor" and
consists of 2.3 x
2.3 x 0.3 cm
aggregate of
multiple

tan-white firm

tissue, entirely ™~
submitted in 1

following j
decalcification. C)
rgh/2/1/2023

Specimen ,

ASHCRAFT, DHAMEON
J

Med. Rec #:
13095514 DOB/

Age: 8/9/2002
(Age: 20) sex: M
Facility:
Sacramento Med Ctr
Location:

INPATIENT NURSING

Sacramento
Pathology

2025 Morse Ave.
Sacramento, CA

95825

Priya Brink, M.D.
Laboratory

Director

Page 40 of 94 ;
Anatomica! Location/ Collection Method /

BONE RESECTION : 5473672023 114 AM
(BONE RESECTION) PST

Narrative

Authorizing Provider Result Type

JACOB HIRK FENNESSY PATHOLOGY/CYTOLOGY
MD

Performing
Organization Address City/State/ZIP Code Phone Number

KFH SACRAMENTO 2025 Morse Ave. Sacramento, CA 95825
LABORATORY

| PROTHROMBIN TIME (PT) - Final result (01/30/2023 7:33 AM PST)
Ref Analysis
Component Range __Test Method Time t Pathologist Signature

PT . 11.7 -
14.9
second(s)

PTINR a Ratio

, LABORATORY

Comment
Recommended Range:

2.0-3.0 for most medical:and surgical thromboembolic sta
a 5-3.5 for artificial heart valves and recurrent

Anatomical Location/ —Collecti
Specimen (Source) Laterality : Collection Time Received Time

01/30/2023 7:33 AM 01/30/2023 7:51 AM
PST PST

Narrative

KFH SACRAMENTO LABORATORY - 01/399
For pre-op. q

Authorizing Provider Result

JACOB HIRK FENNESSY
MD

Organization Cpe City/State/ZIP Code Phone Number

KFH SACRAMENTO 2025 Morse Ave. Sacramento, CA 95825
LABORATORY

ARS-COV-2 (COVID-19), MOLECULAR ASSAY, NAA/PCR (SARS-COV-2, NAA (COVID-19), SURVEILLANCE, PRE-OP) -
Final result (01/27/2023 4:00 PM PST) :

Ref Analysis Performed
Component Range _Test Method Time At Pathologist Signature

Specimen source TPMG
REGIONAL
LAB,
__BERKELEY

SARS-COV-2 COVID NOT : TPMG
(COVID-19) PANEL, NAA DETECTED 2 REGIONAL
BERKELEY

Commen Nasopharynx/Oropharynx source

Page 41 of 94
e 2:22-cr- PRIN Docigglertraere raed 03/19/24 ,, Page 46 £1064 time

Specimen ASE Sey Laterali
01/27/2023 4:00 PM 01/27/2023 10:57 PM
PST PST

Narrative

TPMG REGIONAL LAB, BERKELEY - 01/28/2023 2:28 PM PST
Asymptomatic patient being tested pre-procedure or pre-op

Authorizing Provider Result Type

JACOB HIRK FENNESSY MICRO - KPHC ONLY
MD

Performing

Organization Address City/State/ZIP Code Phone Number
TPMG REGIONAL LAB, 1795 Second Street Berkeley, CA 94710

BERKELEY

Ref Analysis
Component Value Range _Test Method Time |

ABO+Rh group type O POS

. Pathologist Signature

Anatomical Location/ Collection Method o
Specimen (Source) Laterality Volume ' action Time Received Time
issiace 4:35 PM 01/23/2023 4:40 PM

PST

Narrative
KFH SACRAMENTO LABORATORY - 01/23/2023 5:14 PM
No previous ABORH historical record is ayail

confirmation test ordered by the Transfu

Authorizing Provider Result Type

MATTHEW JOSEPH BLOOD
NEDRESKY PA-C

Performing
Organization

KFH SACRAMENTO
LABORATORY

City/State/ZIP Code Phone Number
Sacramento, CA 95825

| NON-FASTING LIPID PANEL PID PANEL, NON-FASTING (CHOL, DHDL, TRIG, CALC LDL W REFLEX TO DLDL)) - Final
result (01/23/2023 4:31 PM PST)

Ref Analysis
Component Value Range _ Test Method Time Performed At Pathologist Signature
Cholesterol 163 <=239 TPMG

mg/dL REGIONAL

LABORATORY,
MWS

Comment:
Reference Ranges for Cholesterol: (mg/dL)

Age Range Optimal Normal Risk High Risk

0-18 yrs <170 170-199 >199
18-150 yrs <200 200-239 >239

Page 42 of 94
TRIGLYCERIDE, TPMG
NONFASTING REGIONAL
MWS

Comment:

Nonfasting triglycerides vary depending on : sition of last
meal. If nonfasting triglyceride level 440 mg/dL, consider ordering
fasting triglycerides to better asses :
TPMG
REGIONAL
LABORATORY,
MWS
Comment:

Reference Range for HDL Cholesterol: (mg/dL)

Age Range Low Normal Optimal

Male: 0-18 yrs <40 40-45 >45
Male: 18-150 yrs <40 40-59 >59
Female: 0-18 yrs <40 40-45 >45
Female: 18-150 yrs <50 50-59 >59

: LDL CALCULATED, 90 <=159 , E
|| NONFASTING mg/dL “>, REGIONAL .
LABORATORY,
MWS
Comment: oe
Reference Range for LDt Calculated: (mg/dL)

“Age. ange Optimal _— Low Normal Very High

Risk Risk i PRISk

0-18 yrs <110
18-150 yrs <100 100-129

Anatomical Locatj
Specimen (Source) Laterality Collection Time Received Time
01/23/2023 4:31 PM 01/24/2023 7:25 AM
PST PST

Narrative

Authorizing Provider

DONNA LEE MARIANO
MD

Performing

Organization Address City/State/ZIP Code Phone Number
TPMG REGIONAL 914 Marina Way South — Richmond, CA 94804

LABORATORY, MWS

CREATININE AND CALCULATED GLOMERULAR FILTRATION RATE (CREATININE W GFR, CALCULATED) - Final result

(01/23/2023 4:31 PM PST)

Ref Analysis
Component Value Range __ Test Method Time Performed At Pathologist Signature
Creatinine 1.04 <=1.34 TPMG

mg/dL REGIONAL

LABORATORY,
. Ref . j
>=60
1.73 m2

Estimated Glomerular >60

Filtration Rate

Comment:
Estimated GFR (eGFR) helps us know how the kidneys ar
on the creatinine blood test result, age, sex,
over time helps us understand changes in kidney

Actual kidney function may be better or
blood creatinine levels are affected by bo
genetics, and more.

Multiple eGFR values are used to dete
stages, defined by the following rang:

eGFR 45 - 59 =
eGFR 30 - 44 = Stage 3b
eGFR 15 - 29. = Stage 4
eGFR under 15 = Stage 5

Stage 3a

Values for eGFR before 05/25/2022 will appear in Tab results unde
results’.

isease (CKD)

peraded’ 8 of 101 ogist Signature

TPMG
REGIONAL
LABORATORY,
MWS

‘$ize. Monitoring eGFR

the estimated GFR because
up, diet, hydration,

REGIONAL
LABORATORY,

Anatomical Location /

Specimen (Source) Laterality

Collection Time

TPMG

MWS

Received Time

01/23/2023 4:31 PM

PST

Narrative

01/24/2023 7:25 AM
PST

Authorizing Provider

DONNA LEE MARIANO
MD

Performing

Organization Addess City/State/ZIP Code

Phone Number

TPMG REGIONAL
LABORATORY, MWS

914 Marina Way South — Richmond, CA 94804

RED BLOOD CELL ANTIBODY SCREEN (MEDICAL CENTER) (RBC ANTIBODY SCREEN (MEDICAL CENTER)) - Final result :
| (01/23/2023 4:31 PM PST)

Ref
Range

Analysis

Component Value Test Method Time

Performed At Pathologist Signature

AB screen, blood Negative

Anatomica! Location /

Collection Method /

KFH
SACRAMENTO
LABORATORY

Specimen (Source) Laterality Volume Coilection Time

Received Time

01/23/2023 4:31 PM

01/23/2023 4:33 PM
PS Page 44 of 9
Narrative

KFH SA . fA 202 - i

Location of Surgery->SAC - Sacramento

Informed consent obtained: The advantages, risks, and complications of

transfusion therapy, as well as the alternatives (including no transfusion),

have been explained to the patient and/or family.->No

Authorizing Provider Result Type

MATTHEW JOSEPH LABORATORY
NEDRESKY PA-C

Performing

Organization Address City/State/ZIP Code Phone Number
KFH SACRAMENTO 2025 Morse Ave. Sacramento, CA 95825

LABORATORY

ABO-RH TYPING (ABO-RH TYPING (MEDICAL CENTER)) - Final result (01/23/2023 4:31 PM PST)
Ref Analysis
Component Value Range _ Test Method Time arformed At Pathologist Signature

ABO+Rh group type O POS

Anatomical Location/ Collection Method /

Specimen (Source) Laterality Volume Received Time
01/23/2023 4:33 PM
PST

Narrative

KFH SACRAMENTO LABORATORY - 01/23/2023 5:39 PM PST
Date of Surgery->1/30/2023

Location of Surgery->SAC - Sacramento

Informed consent obtained: The advantages, risk
transfusion therapy, as well as the alternati
have been explained to the patient and/

plications of
clu&ing no transfusion),

Authorizing Provider Result Type

MATTHEW JOSEPH BLOOD
NEDRESKY PA-C

Performing

Organization Addrggs .@ City/State/ZIP Code Phone Number
KFH SACRAMENTO 2025 NG Sacramento, CA 95825

LABORATORY es.

BLOOD UREA NITROGEN (WMJN) (BUN) - Final result (01/23/2023 4:31 PM PST)

P Ref Analysis
Component Value Range _ Test Method Time Performed At _ Pathologist Signature
BUN 8 7-27 TPMG
mg/dL REGIONAL

LABORATORY,
MWS
Anatomical Location / — Collection Method /
Specimen (Source) Laterality Volume Collection Time Received Time
01/23/2023 4:31 PM 01/24/2023 7:29 AM
PST PST

Narrative

Authorizing Provider Result Type

JACOB HIRK FENNESSY BLOOD
MD
_ Ref
Com Case 2:22-CI- mel KJM Ra ne aS
ESTIMATED AVERAGE. 85-126

Anatomical Location / Collection Method /

TPMG
REGIONAL

Specimen (Source) Laterality Volume Collection Time

Received Time

01/23/2023 4:31 PM

PST

Narrative

01/24/2023 2:15 AM
PST

Authorizing Provider Result Type

DONNA LEE MARIANO BLOOD
MD

Performing
Organization Address City/State/ZIP Code

TPMG REGIONAL 914 Marina Way South = Richmond, CA 94804
LABORATORY, MWS

| CBC (COMPLETE BLOOD COUNT) (CBC NO DIFFERENTIAL) - Final result
Ref
Component Value Range __ Test Method

WBC COUNT 5.7

RDW, RBC

400 K/uL

100WC

Anatomical Location/ Collection Method /

Performed At

Pathologist Signature

TPMG
REGIONAL
LABORATORY,
MWS

REGIONAL |

LABORATORY,

TPMG
REGIONAL
LABORATORY,

REGIONAL
LABORATORY,
MWS

TPMG

Mws

TPMG
REGIONAL

LABORATORY,
MWS

REGIONAL

~ LABORATORY,

MWS

Specimen (Source) Laterality Collection Time

Received Time

01/23/2023 4:31 PM

01/24/2023 2:01 AM
Document 46... Filed 03/19/24. Page 54 of 106

Authorizing Provider Result Type

DONNA LEE MARIANO BLOOD

MD

Performing

Organization Address City/State/ZIP Code Phone Number

TPMG REGIONAL
LABORATORY, MWS

914 Marina Way South

Richmond, CA 94804

| SODIUM - Final result (01/23/2023 4:31 PM PST)

Anatomical Location / Collection Method /

Ref Analysis
Component Value Range _Test Method Time Performed At Pathologist Signature
Sodium 150 135 - TPMG

145 REGIONAL

mEq/L LABORATORY,

Specimen (Source) Laterality Volume Co jon Tim Received Time
01/ 23 4:31 PM 01/24/2023 7:25 AM
PST
Narrative
Authorizing Provider Result Type
DONNA LEE MARIANO BLOOD
MD
Performing
Organization Address Phone Number

TPMG REGIONAL
LABORATORY, MWS

914 Marina Way Sout

MAGNESIUM - Final result (01/2 PST)
Component Test Method
MAGNESIUM 1.7 - 2.3

mg/dL

Anatomical Location / Collection Method /

Analysis
Time Performed At Pathologist Signature
TPMG
REGIONAL
LABORATORY,
MWS

LABORATORY, MWS

Specimen (Source) Laterality Volume Collection Time Received Time
01/23/2023 4:31 PM 01/24/2023 7:25 AM
PST PST

Narrative

Authorizing Provider Result Type

DONNA LEE MARIANO BLOOD

MD

Performing

Organization Address City/State/ZIP Code Phone Number

TPMG REGIONAL 914 Marina Way South — Richmond, CA 94804
Case 2:22-cr-00087-KJM Document 46 Filed 03/19/24 Page 55 of 106
| GLUCOSE - Final result (01/23/2023 4:31 PM PST)

Ref Analysis
Component Value Range __Test Method Time Performed At_ Pathologist Signature
GLUCOSE, RANDOM 92 60 - 159 TPMG
mg/dL REGIONAL
LABORATORY,
MWS
Comment:
Borderline range of 160 - 199 mg/dL suggests follow-up. Results greater than /
or equal to 200 mg/dL is suggestive of diabetes in the setting of classical |

Anatomical Location/ Collection Method /

Specimen (Source) Laterality Volume Collection Time Received Time
01/23/2023 4:31 PM 01/24/2023 7:25 AM
PST PST

Narrative

Authorizing Provider Result Type

DONNA LEE MARIANO =BLOOD
MD

Performing —_
Organization Address City/State/ZIP Codg"i Pi@ge Number
TPMG REGIONAL 914 Marina Way South

LABORATORY, MWS

CT CERVICAL SPINE NO CONTRAST. (12/27/2022 2:01

Ref Analysis Performed
Component Value Range Time At Pathologist Signature
RADIOLOGY EXAM CT CERVICAL NCAL PWS
DESCRIPTION SPINE INTERFACE
WITHOUT

CONTRAST

Modality
Computed Tomography

Anatomical Region

Collection Method /

Volume Collection Time Received Time
12/27/2022 4:44 PM
PST

Specimen (Source)

Impressions
12/27/2022 5:02 PM PST

Exophytic bony tumor arising from the cortex of the right C5 pedicle and right posterior vertebral body |
compatible with osteochondroma causing cord compression at C4-5 with myelopathy and myelomalacia and
displacing the cervical cord leftward. Bulk of the exophytic tumor component measures 1.3 x 1.8 x 1.4
cm AP, transverse, craniocaudal

Images interpreted in conjunction with the cervical spine MRI from one week prior.

Narrative
12/27/2022 5:02
Narrative

CT CERYEGR SBIN5 TRIOS PARI =Document 46 Filed 03/19/24 Page 56 of 106

* HISTORY **:
20 years old, preoperative planning. C4-5 bony tumor cord compression.

** TECHNIQUE **:
CT images of the cervical spine acquired without intravenous contrast.

CTDI: 10.62 mGy
DLP: 208.48 mGy-cm

COMPARISON: MR 12/20/2022

** FINDINGS **:
Images interpreted in conjunction with the cervical spine MRI from one week prior.

Exophytic bony tumor arising from the cortex of the right cS pedicle and right posterior vertebral body

compatible with osteochondroma causing cord compression at C4-5 with myelopathy and myelomalacia and
displacing the cervical cord leftward. Bulk of the exophytic tumor component measures 1.3 x 1.8 x 1.4
cm AP, transverse, craniocaudal

SOFT TISSUES: No prevertebral soft tissue swelling. Visualized neck soft tissues are normal.

C2-c3: No canal or foraminal stenosis.

C3-C4: Mild spinal canal narrowing with effacement of the dorsal thecal s eserved ventrally. Mild
right, moderate left foraminal narrowing

c4-c5: Large osteochondroma causing severe spinal canal stenosis lacing the cord leftward causing
cord compression with myelopathy and myelomalacia.
No significant foraminal stenosis. Mild right foraminal narrow}

c5-C6: Moderate spinal canal narrowing with ventral and dorsa sac effacement. Cervical cord

displaced leftward. Mild foraminal narrowing bilateral.
C6-C7: No spinal canal stenosis. Mild foraminal narrowin
C7-T1: No spinal canal stenosis. Mild foraminal narrwi

OTHER: Visualized lung apices are clear.

Procedure Note

PAUL SUNG LEE MD - 12/27/2022
Procedure Note

CT CERVICAL SPINE WITHOUT CONTRAST

** HISTORY **:
20 years old, preoperative planning. C4-5 bony tumor cord compression.

** TECHNIQUE **:
CT images of the cervical spine acquired without intravenous contrast.

CTDI: 10.62 mGy
DLP: 208.48 mGy-cm

COMPARISON: MR 12/20/2022

** FINDINGS **:
Images interpreted in conjunction with the cervical spine MRI from one week prior.

Exophytic bony tumor arising from the cortex of the right C5 pedicle and right posterior vertebral body compatible with
osteochondroma causing cord compression at C4-5 with myelopathy and myelomalacia and displacing the cervical cord
leftward. Bulk of the exophytic tumor component measures 1.3 x 1.8 x 1.4 cm AP transverse, craniocaudal

SOFT TISSUES: No prevertebral soft tissue swelling. Visualized neck soft tissues are normal.

C2-C3: No canal or foraminal stenosis.

rally. Mild right, moderate left

C3-C4: Mild spinal canal narrowing with effacement of the dorsal thecal sac
foraminal narrowing

C4-C5: Large osteochondroma causing severe spinal canal stenosis dig
myelopathy and myelomalacia.
No significant foramina! stenosis. Mild right foraminal narrowin

C5-C6: Moderate spinal canal narrowing with ventral and sal tical sac effacement. Cervical cord displaced leftward. Mild
foraminal narrowing bilateral.

C6-C7: No spinal canal stenosis. Mild foraminal nar

C7-T1: No spinal canal stenosis. Mild foraminal@jarrow¢ g ;

OTHER: Visualized lung apices are clear.

** IMPRESSION **:

Exophytic bony tumor arising f
osteochondroma causing,cord c
leftward. Bulk of the exo# ‘> nor

Images interpreted in conjug@¢ fon with the cervical spine MRI from one week prior.

tex’of the right C5 pedicle and right posterior vertebral body compatible with
at C4-5 with myelopathy and myelomalacia and displacing the cervical cord
ponent measures 1.3 x 1.8 x 1.4 cm AP, transverse, craniocaudal

Authorizing Provider Result Type

JACOB HIRK FENNESSY = CT
MD

MRI THORACIC SPINE NO CONTRAST. (12/20/2022 5:30 PM PST)

Ref Analysis Performed
Component Value Range __Test Method Time At Pathologist Signature
RADIOLOGY EXAM MRI NCAL PWS
DESCRIPTION THORACIC INTERFACE

SPINE
WITHOUT
CONTRAST

Anatomical Region Laterality Modality
Magnetic Resonance Page 53 of 94
Collection Method q/

Anatomical Location /

13/21/2020 11:4
PST

AM

Impressions
12/21/2022 12:29 PM PST

Unremarkable MRI thoracic spine.

Narrative

12/21/2022 12:29 PM PST
MRI THORACIC SPINE WITHOUT CONTRAST

* HISTORY **:
20 years old,

** TECHNIQUE **:
MR images of the thoracic spine acquired without intravenous contrast.

COMPARISON: None available.

** FINDINGS **:
SPINAL CORD: Unremarkable.

DISCS: Grossly maintained.

BONES: Vertebral body height and alignment are grossly maintained. rrow signal is normal.
SOFT TISSUES: Normal.

SPINAL CANAL: NO significant canal or foraminal stenosis.

OTHER: None.

Procedure Note

LILLIAN XIONG MD - 12/21/2022
Formatting of this note might be different from the origg
MRI THORACIC SPINE WITHOUT CONTRAST

** HISTORY **:
20 years old,

** TECHNIQUE **:

MR images of the thoracic spine a ntravenous contrast.

COMPARISON: None available.

** FINDINGS **:
SPINAL CORD: Unremarkal :

DISCS: Grossly maintained.

BONES: Vertebral body height and alignment are grossly maintained. Marrow signal is normal.

SOFT TISSUES: Normal.

SPINAL CANAL: No significant canal or foraminal stenosis.

OTHER: None.

** IMPRESSION **:
Unremarkable MRI thoracic spine.

Authorizing Provider Result Type

Page 54 of 94
Case 2:22-cr- 00087- KIM Document 46

RADIOLOGY EXAM va NCAL PWS
DESCRIPTION CERVICAL INTERFACE :
WITHOUT
Anatomical Region Laterality Modality

Magnetic Resonance

Collection Method /
Volume

Anatomical Location /

Specimen (Source) Laterality Collection Time Received Time

12/21/2022 11:35 AM
PST

Impressions

12/21/2022 12:28 PM PST

Severe central canal narrowing with lateral displacement of the spinal cord at C4-C5 secondary to

osseous lesion, likely representing an osteochondroma. T2 signal within gbe cord from mass effect of
the osseous lesion. é
Recommend noncontrast CT of the C-spine for surgical planning.

Action required. +

Narrative

12/21/2022 12:28 PM PST
MRI CERVICAL SPINE WITHOUT CONTRAST

** HISTORY **:
Male, age 20 years: Myelopathy

**% TECHNIQUE **: _
MR images of the cervical spine acquired withou® anous contrast.

COMPARISON: None available.

** FINDINGS **:

SPINAL CORD: T2 hyperintense signal wi

Rsord at the level of the osseous lesion posterior to C4-

DISCS: Grossly maintained

BONES: Vertebral body height Bined. Straightening of the normal cervical lordosis. Marrow
signal is unremarkable. "

SOFT TISSUES: Unremagkable.

C2-C3: No significant] anal or foraminal stenosis

c3-c4: Mild left foram7@al narrowing

c4-c5: Severe central cafial narrowing with lateral displacement of the spinal cord. Osseous structure
that appears to demonstrate marrow signal extending into the central canal measuring 15 x 9 mm with a
mushroom configuration and likely medullary continuity with the adjacent C5 superior endplate. Causing
severe right foraminal narrowing

c5-C6: No significant central canal or foraminal stenosis.
C6-C7: No significant central canal or foraminal stenosis.

C7-T1: No significant central canal or foraminal stenosis.

OTHER: Visualized posterior fossa is normal.

Procedure Note
Procedure Note

MRI CERVICAL SPINE WITHOUT CONTRAST

** HISTORY **:
Male, age 20 years: Myelopathy

** TECHNIQUE **:
MR images of the cervical spine acquired without intravenous contrast.

COMPARISON: None available.

** FINDINGS **:

DISCS: Grossly maintained

SOFT TISSUES: Unremarkable.

C2-C3: No significant central canal or foraminal stenosis.

C3-C4: Mild left foraminal narrowing

C4-C5: Severe central canal narrowing with lateral displacement of the spinal cor

demonstrate marrow signal extending into the central canal measuring 15 x 9 |
medullary continuity with the adjacent C5 superior endplate. Causing severe

C5-C6: No significant central canal or foraminal stenosis.
C6-C7: No significant central canal or foraminal stenosis.
C7-T1: No significant central canal or foraminal stenosis.
OTHER: Visualized posterior fossa is normal.

** IMPRESSION **;

Severe central canal narrowing with lateral displ

representing an osteochondroma. T2 signal wi
Recommend noncontrast CT of the C-spine for

n the
ic

f the spinal cord at C4-C5 s

lanning.
Action required. +

Authorizing Provider Rave t Type

Filed 03/19/24

SPINAL CORD: T2 hyperintense signal within the cord at the level of the osseous lesion posterior to C4-C5

a

from mass effect of the osseous lesion.

Page 60 of 106

BONES: Vertebral body heights are maintained. Straightening of the normal cervical lordosis. Marrow signal is unremarkable.

seous stMicture that appears to
a mushroom configuration and likely
fal narrowing

econdary to osseous lesion, likely

FRANKLIN TL LUM MD MRi

XR SCOLIOSIS INIT STUDY. (12/13/2022 1:31 PM PST)

Ref Analysis Performed
Component Value Range _Test Method Time At Pathologist Signature
RADIOLOGY EXAM XRAY NCAL PWS \
DESCRIPTION SCOLIOSIS INTERFACE .
SPINE .
Anatomical Region Laterality Modality

Collection Method /
Volume

Anatomical Location /

Specimen (Source) Laterality

Computed Radiography

Collection Time

Received Time

12/13/2!

022 1:54 PM
Impressions

12/13 157 j
113/287 6: 572A FSD0087-KIM Document 46 Filed 03/19/24 Page 61 of 106

No sig

Narrative

12/13/2022 1:57 PM PST
XRAY SCOLIOSIS SPINE

*

HISTORY **:
20 years old, SCOLIOSIS, FOLLOW UP RADIOGRAPH

** TECHNIQUE **:
2 views of the thoracic and lumbar spine acquired. _

COMPARISON: Radiograph 8/12/2013

** FINDINGS **:
Stable vertebral body height and alignment. Disc spaces are normal. No significant scoliosis.

Procedure Note

ROBERT PAUL OCHI MD - 12/13/2022
Formatting of this note might be different from the original.
XRAY SCOLIOSIS SPINE

** HISTORY **:
20 years old, SCOLIOSIS, FOLLOW UP RADIOGRAPH

** TECHNIQUE **:
2 views of the thoracic and lumbar spine acquired.

COMPARISON: Radiograph 8/12/2013

** FINDINGS **:

Stable vertebral body height and alignment. Disc spaces are nor; icant scoliosis.

** IMPRESSION **:
No significant scoliosis.

Authorizing Provider Result Type

_ DAVID NEIL SCHIFFMAN GENERAL RADI
MD

Analysis Performed

Component Test Method Time At Pathologist Signature
RADIOLOGY EXAM NCAL PWS
DESCRIPTION INTERFACE
Anatomical Region Laterality Modality
Computed Radiography
Anatomical Location/ Collection Method / =
Specimen (Source) Laterality Volume Collection Time Received Time .
11/09/2022 12:40 PM .
impressions

11/09/2022 12:44 PM PST
No acute osseous abnormality.

2nd and 3rd proximal phalangeal exostoses.

Partially visualized ulnar chronic deformity.
Narrative

11/09/2072 AY MMCPSIOO87-KIM Document 46 Filed 03/19/24 Page 62 of 106

XRAY RI

** HISTORY **:
20 years old, PAIN WITHOUT TRAUMA

** TECHNIQUE **:
3 view(s) of the right hand acquired.

COMPARISON: Radiographs 9/17/2019, 1/26/2018

** FINDINGS **:

No acute fracture or dislocation. Partially visualized chronic deformity of the right ulna.
chronic appearing corticated deformities of the 2nd and 3rd proximal phalanges with exostoses measuring _
No significant degenerative changes.

Procedure Note

RANJIT SINGH SANDHU MD - 11/09/2022

Formatting of this note might be different from the original.
XRAY RIGHT HAND

** HISTORY **:
20 years old, PAIN WITHOUT TRAUMA

** TECHNIQUE **:
3 view(s) of the right hand acquired.

COMPARISON: Radiographs 9/17/2019, 1/26/2018

** FINDINGS **:
No acute fracture or dislocation. Partially visualized chronic deformity ht ulna.

Chronic appearing corticated deformities of the 2nd and 3rd proygtiae es with exostoses measuring 3 mm.
No significant degenerative changes. =

** IMPRESSION #*:
No acute osseous abnormality.

2nd and 3rd proximal phalangeal exostoses.

Partially visualized ulnar chronic deformity.

Authorizing Provider__ Result TV
NATHAN LEWIS TAYLOR GEN Pe
MD

XR LEFT FEMUR. (1 1/03/28 4 11:03 AM PDT)

Ref Analysis Performed
Component Value Range _Test Method Time At Pathologist Signature
RADIOLOGY EXAM XRAY LEFT NCAL PWS Fe
DESCRIPTION FEMUR INTERFACE .
Anatomical Region Laterality Modality

Computed Radiography

Anatomical Location / Collection Method /

Specimen (Source) Laterality Volume Collection Time Received Time
11/03/2022 12:24 PM
PDT

Impressions

11/03/2022 12:33 PM PDT
Stable multiple bony exostoses.
Narrative

11/03/20%2s62733 PMPROO87-KIM Document 46 Filed 03/19/24 Page 63 of 106

XRAY LEFT FEMUR

** HISTORY **:
20 years old, PAIN WITHOUT TRAUMA

** TECHNIQUE **:
2 view(s) of the left femur acquired.

COMPARISON: Radiographs 11/3/2022, 9/17/2019, 12/6/2012, CTs 11/4/2016, 7/1/2015, 3/2/2015, 8/18/2014,
8/12/2013, 9/28/2012

** FINDINGS **:
No acute fracture or dislocation.

Multiple bony exostoses are again noted, the largest involving the posterolateral femur.

Procedure Note

ROBERT PAUL OCHI MD - 11/03/2022

Formatting of this note might be different from the original.
XRAY LEFT FEMUR

** HISTORY **:
20 years old, PAIN WITHOUT TRAUMA

** TECHNIQUE *?:
2 view(s) of the left femur acquired.

COMPARISON: Radiographs 11/3/2022, 9/17/2019, 12/6/2012, CTs 11/4/2044) 7/1 5, 3/2/2015, 8/18/2014, 8/12/2013,
9/28/2012

** FINDINGS #**:
No acute fracture or dislocation.

Multiple bony exostoses are again noted, the largest involving? tM posterolateral femur.
** IMPRESSION **:

Stable multiple bony exostoses.

Authorizing Provider Result Type Ss
DONNA LEE MARIANO GENERAL RADI@#Ga

Analysis Performed

Component Test Method Time At Pathologist Signature
RADIOLOGY EXAM NCAL PWS
DESCRIPTION INTERFACE
Anatomical Region Laterality Modality
Computed Radiography
Anatomical Location/ Collection Method / .
Specimen (Source) Laterality Volume Collection Time Received Time
11/03/2022 11:01 AM
PDT
impressions

11/03/2022 11:05 AM PDT
Stable appearance of multiple exostoses arising from the distal femur, proximal tibia, and proximal
fibula.

Narrative
11/03/2022 11:05 AM PDT
Narrative
XRAY RIGHT SEFYUB2-cr-00087-KJM Document46 Filed 03/19/24 Page 64 of 106

** HISTORY **:
20 years old, PAIN WITHOUT TRAUMA

** TECHNIQUE **:
2 view(s) of the right femur acquired.

COMPARISON: Radiograph 9/17/2019

** FINDINGS **:

Multiple exostoses of the distal femur, proximal tibia, and proximal fibula are unchanged in
appearance. The largest arises from the posterolateral aspect of the distal femur measuring 3.8 cm. No
evidence of acute fracture.

Procedure Note

ALVIN JOHN YAMAMOTO MD - 11/03/2022

Formatting of this note might be different from the original.
XRAY RIGHT FEMUR

** HISTORY **:

20 years old, PAIN WITHOUT TRAUMA

** TECHNIQUE **: .
2 view(s) of the right femur acquired. /
COMPARISON: Radiograph 9/17/2019

** FINDINGS **: —
Multiple exostoses of the distal femur, proximal tibia, and proximal fibulgg : anged in appearance. The largest arises from

the posterolateral aspect of the distal femur measuring 3.8 cm. No evigeénc
** IMPRESSION **:

Stable appearance of multiple exostoses arising from the distalés Ir . oximal tibia, and proximal fibula.

Authorizing Provider Result Type

DONNA LEE MARIANO = GENERAL RADIOLOGY
MD

SURGICAL PATHOLOGY - Final result @2/25ag019 11:39 AM PST) :
pe” © Re Analysis
range _ Test Method Time Performed At Pathologist Signature
KFH
SACRAMENTO
LABORATORY

Component
PATHOLOGY REPORT

Case #: :

SACS19-31513

Pathology Report

FINAL PATHOLOGIC
DIAGNOSIS

BONE, RIGHT
ULNA, RESECTION:
OSTEOCHONDROMA , :
PLEASE SEE .
COMMENT

MALATHY Page 60 of 94

KAPALI M.D. :
Case 2:22- “cr 90087- KJM Bcument 46 Filed ogregfe4 Page 65 of 106

Component Range _Test Method Time Performed At Pathologist Signature _

a*

Report
Electronically
Signed by MK **
Comment

Grossly the
lesion is
received as an
aggregate of
bone fragments

and is
adequately
sampled. On

microscopic
examination the
lesion

shows thickened
hyaline
cartilaginous
cap which
matures into
bony

trabeculae. XK
There is no ,

evidence of )
atypia within .

the cartilage. 14;

Hemorrhage is
noted within the
intertrabecular
space. The
morphology of
the lesion is
consistent with
. osteochondroma.

Microscopic
Descriptgo

Clin¥cal History
Forearm excision
soft tissue mass
deep

Gross
Description

The specimen is
received in
formalin filled
container,
labeled with
the patient's :
name (Ashcraft, :
Dhameon),

medical record

(13095514), and Page 61 of 94 ©

"exostosis right
ist Signature |

consists
of a 8.0 x 7.5 x
4.2 cm aggregate
of bone
fragments. The
articular
cartilage shows
eburnation. The
medullary bone
is tan, friable
and hemorrhagic.
The
resection margin
of the larger
portions are
inked BLACK and
BLUE.

It is serially
sectioned and
representative
sections are
submitted

in cassette Al-
A7 following
decalcification:

Al-2 largest
portion; decal
A3-4 second
larger portion;
decal

A5-7

additional

sections of
bone; random;
decal

em] /12/24/2019
Specimen(s)
Received

DHAME

Med. Rec #:
13095514
DOB/Age:
8/9/2002 (Age:
17) sex: M
Facility:
Sacramento Med
ctr

Location:
INPATIENT

NURSING

Sacramento
Pathology
2025 Morse Ave.
Sacramento, CA

95825 Page 62 of 94
Ref Analysis

Fax:

916-973-7283
Priya Brink,
M.D. Laboratory
Director

Anatomical Location / Collection Method /
Specimen (Source) Laterality Volume Collection Time Received Time
BONE RESECTION 12/23/2019 11:39 AM
(BONE RESECTION) PST

Narrative

Authorizing Provider Result Type

NATHAN LEWIS TAYLOR PATHOLOGY/CYTOLOGY
MD

Performing 7
Organization Address City/State/ZIP Code Phane Number
KFH SACRAMENTO 2025 Morse Ave. SACRAMENTO, CA ’
LABORATORY 95825

XR RIGHT FOREARM. (09/1 7/2019 3:56 PM PDT)
Anatomical Region Laterality

Anatomical Location / Collectight vi
Collection Time Received Time

Specimen (Source) Laterality Volume

09/17/2019 3:56 PM
PDT

impressions

09/18/2019 12:58 PM PDT Mies. .
1. very large exostosis is noted gris m the distal ulna, significantly increased in size from the |
prior examination. There is 4 q go of the ulna deformity of the distal radius and ulna. :

2. Additional exostoses aj : ing from the distal radius.

3. Marked dislocation,7 "fhe radial head with associated deformity

Narrative

09/18/2019 12:58 pM PDT’
RIGHT WRIST AND RIGHT FOREARM

** HISTORY **:
Fol lowup

** FINDINGS **:
Comparison: 01/26/2018

Technique: 3 radiographs of the right wrist were obtained. She radiographs of the right forearm are
obtained.

Very large exostosis is noted arising from the distal ulna, significantly increased in size from the
prior examination. There is foreshortening of the ulna deformity of the distal radius and ulna.

Additional exostoses are noted arising from the distal radius.

Marked dislocation is noted of the radial head with associated deformity.

Procedure Note

ARVIND SONIK MD - 09/18/201 Page 63 of 94
Procedure Note

Formatting sé thisrpte mano br7ditanent framdeemieniel46 Filed 03/19/24 Page 68 of 106

RIGHT WRIST AND RIGHT FOREARM

** HISTORY **:
Followup

** FINDINGS **:
Comparison: 01/26/2018

Technique: 3 radiographs of the right wrist were obtained. She radiographs of the right forearm are obtained.

Very large exostosis is noted arising from the distal ulna, significantly increased in size from the prior examination. There is

foreshortening of the ulna deformity of the distal radius and ulna.
Additional exostoses are noted arising from the distal radius.
Marked dislocation is noted of the radial head with associated deformity.

** IMPRESSION **:

1. Very large exostosis is noted arising from the distal ulna, significantly increased in size from 1 the prior examination. There is

foreshortening of the ulna deformity of the distal radius and ulna.
2. Additional exostoses are noted arising from the distal radius.

3. Marked dislocation is noted of the radial head with associated deformity

Authorizing Provider Result Type

DAVID NEIL SCHIFFMAN GENERAL RADIOLOGY
MD

XR LEG LENGTH. (09/17/2019 3:55 PM PDT)
Anatomical Region Laterality

Leg, Lower extremity, Extremity N/A omputed Radiography

Anatomical Location /

gtion Method /
Specimen (Source) Laterality re

Collection Time

Received Time

09/17/2019 3:55 PM
PDT

Impressions

09/18/2019 2:29 PM PDT
1. Leg lengths as desggeri

2. Multiple exostoses'g i giated deformities.

Narrative

8/2019 2

Page 640 94
Narrative

XRAY LESS 'DD-cr-00087-KJM Document46 Filed 03/19/24 Page 69 of 106

HISTORY **:
17 year old boy, exostoses

+

* TECHNIQUE **:
AP views of both lower extremities were acquired with a ruler placed centrally.

* FINDINGS **:
The right femur measures approximately 49 cm.

The left femur measures approximately 49 cm.
The right tibia measures approximately 36.5 cm.
The left tibia measures approximately 38 cm.

The right lower extremity measures approximately 85.5 cm. The left lower extremity measures
approximately 87 cm.

Multiple exostoses are noted involving the femurs, tibias, and fibulas. Associated deformities are
noted, Orthopedic screws are noted across both medial malleoli.

Procedure Note S

ARVIND SONIK MD - 09/18/2019
Formatting of this note might be different from the original.
XRAY LEG LENGTH

** HISTORY **:
17 year old boy, exostoses

** TECHNIQUE **:
AP views of both lower extremities were acquired with a ruler platec

** FINDINGS **:
The right femur measures approximately 49 cm.

The left femur measures approximately 49 cm.
The right tibia measures approximately 36.5 c
The left tibia measures approximately 38

The right lower extremity measwre i ly 85.5 cm. The left lower extremity measures approximately 87 cm.

Multiple exostoses are ngged involv
noted across both mediak qiar@es

** IMPRESSION **:
1. Leg lengths as described.

2. Multiple exostoses and associated deformities.

Authorizing Provider Result Type

the femurs, tibias, and fibulas. Associated deformities are noted. Orthopedic screws are

DAVID NEIL SCHIFFMAN GENERAL RADIOLOGY
MD

| XR RIGHT FEMUR. (08/17/2019 2:58 PM PDT)
Anatomical Region Laterality Modality

Computed Radiography

Anatomical Location / = Collection Method /
Specimen (Source) Laterality Volume Collection Time Received Time

09/17/2019 2:58 PM
PDT
09/18/2019 12:53 PM PDT ~ ‘
Multiple exostoses, as described. The large pedunculated exostoses of the distal right femur increased

in size.

Narrative

09/18/2019 12:53 PM PDT
RIGHT FEMUR

** HISTORY **:
Followup

* FINDINGS **:
Comparison: 3/31/17

Technique: 4 radiographs of the right femur were obtained.

Large pedunculated exostoses are noted arising from the distal right femur, increased in size from the
prior examination.

Broadening is noted in the neck of the proximal right femur, likely representing a sessile exostoses,
similar to the prior examination.

Exostoses are properly visualized arising from the proximal tibia and Fite

Procedure Note
ARVIND SONIK MD - 09/18/2019

Formatting of this note might be different from the original. ww
RIGHT FEMUR

Followup

** FINDINGS **:
Comparison: 3/31/17

Technique: 4 radiographs of the right femur were

distal right femur, increased in size from the prior examination.

Large pedunculated exostoses are noted arising

Broadening is noted in the neck of the proximaFgight femur, likely representing a sessile exostoses, similar to the prior
examination. :

proximal tibia and fibula.

Exostoses are properly visualized a

** IMPRESSION **:

Multiple exostoses, as d e pedunculated exostoses of the distal right femur increased in size.

Authorizing Provider

DAVID NEIL SCHIFFMAN GENERAL RADIOLOGY
MD

| XR RIGHT WRIST. (09/17/2019 2:55 PM PDT)
Anatomical Region Laterality Modality
Computed Radiography

Anatomical Location/ Collection Method /
Specimen (Source) Laterality Volume Collection Time Received Time
09/17/2019 2:55 PM
PDT

Impressions

12:5

PM PDT
2. Additional exostoses are noted arising from the distal radius.

3. Marked dislocation is noted of the radial head with associated deformity

Narrative

09/18/2019 12:58 PM PDT
RIGHT WRIST AND RIGHT FOREARM

* HISTORY **:
Fol lowup

** FINDINGS **:
Comparison: 01/26/2018

Technique: 3 radiographs of the right wrist were obtained. She radiographs of the right forearm are
obtained.

very large exostosis is noted arising from the distal ulna, significantly increased in size from the
prior examination. There is foreshortening of the ulna deformity of the distal radius and ulna.

Additional exostoses are noted arising from the distal radius.

Marked dislocation is noted of the radial head with associated deformity.

Procedure Note

ARVIND SONIK MD - 09/18/2019

Formatting of this note might be different from the original.
RIGHT WRIST AND RIGHT FOREARM

** HISTORY **:
Followup

** FINDINGS **:
Comparison: 01/26/2018

Very large exostosis is noted arising from the
foreshortening of the ulna deformity of thgyghict

and ulna.

foreshortening of the ulna d fermity of the distal radius and ulna.

2. Additional exostoses are no ed arising from the distal radius.

3. Marked dislocation is noted of the radial head with associated deformity

Authorizing Provider Result Type

DAVID NEIL SCHIFFMAN GENERAL RADIOLOGY
MD

| X-RAY FOREARM (XR FOREARM AP AND LAT) - Final result (01/26/2018 4:19 PM PST)
Anatomical Region Laterality Modality
Computed Radiography
Anatomical Location / Collection Method /

01/26/2018 4:19 BM

PST

impressions

01/26/2018 4:31 PM PST
1. Large sessile osteochondroma is noted of the distal ulna. The ulna is short, with marked ulnar minus
variance. Marked associated deformity is noted of the distal radius and ulna.

2. Irregularity is noted of the volar aspect of the metaphysis of the distal radius, which may be
secondary to the deformity is present a small sessile osteochondroma.

3. Dislocation is noted of the radial head.

Action required.

Narrative

01/26/2018 4:31 PM PST
LEFT FOREARM

** HISTORY **;:
After care

** FINDINGS **:
Technique: Two views of the right forearm were obtained.

Large sessile osteochondroma is noted of the distal ulna. The uln short,* with marked ulnar minus
variance. Marked associated deformity is noted of the distal radjys Ina.

Irregularity is noted of the volar aspect of the metaphysis tal radius, which may be

secondary to the deformity is present a small sessile osteochom@

Dislocation is noted of the radial head.

Procedure Note

ARVIND SONIK MD - 01/26/2018
Formatting of this note might be different from the origi
LEFT FOREARM _

** HISTORY **:
After care

** FINDINGS **:
Technique: Two views of the right

Dislocation is noted of the radial head.

IMPRESSION
1. Large sessile osteochondroma is noted of the distal ulna. The ulna is short, with marked ulnar minus variance. Marked

associated deformity is noted of the distal radius and ulna.

2. irregularity is noted of the volar aspect of the metaphysis of the distal radius, which may be secondary to the deformity is
present a small sessile osteochondroma.

3. Dislocation is noted of the radial head.

Action required.

Authorizing Provider Result Type

DAVID NEIL SCHIFFMAN GENERAL RADIOLOGY
MD
Case 2:22-cr-00087-KJM_ Document 46 __ Filed 03/19/24 Page 73 of 106
| X-RAY FOREARM (XR FOREARM AP AND LAT) - Final result (01/26/2018 4:19 PM PST)

Anatomical Region Laterality Modality
Computed Radiography

Anatomical Location / Collection Method /
Specimen (Source) Laterality Volume Collection Time Received Time
01/26/2018 4:19 PM
PST

impressions

01/26/2018 4:33 PM PST
1. Small sessile osteochondroma is noted arising from the distal ulna. There is associated marked ulnar
minus variance and mild associated deformity of the distal radius.

2. Mild prominence is noted of the metaphysis of the distal radius which may be secondary to sessile .
osteochondroma or may be secondary to the deformity at the DRUJ.

Narrative

01/26/2018 4:33 PM PST
RIGHT FOREARM

** HISTORY **:
After care

** FINDINGS **:
Technique: Two views of the left forearm were obtained.

small sessile osteochondroma is noted arising from the distal ere is associated marked ulnar

minus variance and mild associated deformity of the dist
Mild prominence is noted of the metaphysis of the distal hich may be secondary to sessile
osteochondroma or may be secondary to the deformity g

Procedure Note
ARVIND SONIK MD - 01/26/2018
Formatting of this note might be different from t the "Gigi
RIGHT FOREARM

** HISTORY **:
After care

** FINDINGS **:
Technique: Two views of the le

Small sessile osteochond ising from the distal ulna. There is associated marked ulnar minus variance and mild

associated deformity of th Rig

3e metaphysis of the distal radius which may be secondary to sessile osteochondroma or may be ©
e DRUJ. :

Mild prominence is noted of§
secondary to the deformity at®

IMPRESSION
1. Small sessile osteochondroma is noted arising from the distal ulna. There is associated marked ulnar minus variance and mild |
associated deformity of the distal radius. :

2. Mild prominence is noted of the metaphysis of the distal radius which may be secondary to sessile osteochondroma or may
be secondary to the deformity at the DRUJ.

Authorizing Provider Result Type
DAVID NEIL SCHIFFMAN GENERAL RADIOLOGY

SURGICAL PATHOLOGY - Edited Result - FINAL (04/05/2017 9:54 AM PDT)
PATHOLOGY REPORT Provider: DAVID KFH

NEIL SCHIFFMAN ROSEVILLE

M.D. LABORATORY

collected:

4/5/2017

Case #:

ROSS17-9966

Surgical
Pathology Report

* Amended *

AMENDMENT FOR CASE
Amended:

4/30/2017 by
BEVERLY JANE
MYERS~BUDGE M.D.

Reason: Change
Final Diagnosis
Amended to

add diagnosis from
Mayo Clinic
Previous Signout
Date: 4/19/2017

FINAL PATHOLOGIC
DIAGNOSIS
AMENDED REPORT

—

LEFT DISTAL FEMUR
CEXOSTOSIS
REMOVAL) :
OSTEOCHONDROMA;
PLEASE SEE DR.
INWARD'S
CONSULTATION F
MAYO

CLINIC

MAYO CLINIC;
RESULTS OF
CONSULTATION SEE
BE ISSUED IN AN
AMENDED REPORT

10 DECALCIFIED
SLIDES

BEVERLY JANE
MYERS-BUDGE M.D.

** Report

Electronically
Ref Analysis

Comment

The consultation
report was faxed
to Dr. Schiffman
on April 27,
2017.

Microscopic
Description

A microscopic
examination has
been performed.
Microscopic
findings

support the above
diagnosis.

Clinical History
SURGICAL :
PROCEDURE: Left
knee hardware ;

removal and
exostosis

removal; bilateral
ankle screw
replacement.
CLINICAL DATA:
Multiple
hereditary
exostoses.
SPECIMEN: Bone,
left distal femur.

4/5/17 9:54 a.m. : : :

Gross Descripti
The container
labeled wi

formalin are two,
5.9 x 3.1 x 2.2 cm

and

2.8 x 1.7 x 0.8
cm, irregular
fragments of tan-
pink to pink-white
tissue. Sectioning 4
reveals white-pink

to

pink-tan

osteocarti laginous

cut surfaces :
displaying a L

cap ranging up to Page 74 of O4
53.

Represent
sections are
submitted in
five cassettes
after
decalcification.

Cassette key:

Al cross
section, smaller
fragment

A2-3 cross
section, larger
fragment, bisected :
A4-5 cross :
section, larger :
fragment, bisected .

dab/4/7/2017

Specimen(s)
Received

A:BONE EXOSTOSIS
- BONE/LEFT

DISTAL FEMUR

Patient Name:
ASHCRAFT, DHAMEON
J

Med. Rec #:
13095514 DOB/
Age: 8/9/2002
(Age: 14) Sex:
M

Facility: Folsom
Location:
OUTPATIENT
SURGERY

Roseville

. Jacobs,
Laboratory

Anatomical Location/ — Collection Method / :
Specimen (Source) Laterality Volume Collection Time Received Time
BONE EXOSTOSIS 04/05/2017 9:54 AM 04/06/2017 8:16 AM
(BONE EXOSTOSIS) PDT PDT

Narrative

Authorizing Provider Result Type

DAVID NEIL SCHIFFMAN PATHOLOGY/CYTOLOGY :
MD

Performing
Organization Address City/State/ZIP Code Phone Number D
p

NCAL PATH INTERFACE
Performing

LABORATORY

| X-RAY ANKLE (XR ANKLE AP AND LAT) - Final result (04/05/2017 9:17 AM PDT)

Anatomical Region Laterality Modality
Other 7
Specimen (Source) Laterality Volume Collection Time Received Time :
04/05/2017 9:17 AM
PDT

Narrative

04/06/2017 9:07 AM PDT
Report Transcribed Manually

Procedure Note

N K PHYSICIAN - 04/06/2017
Formatting of this note might be different from the original.
Report Transcribed Manually

Authorizing Provider Result Type

DAVID NEIL SCHIFFMAN GENERAL RADIOLOGY
MD

X-RAY ANKLE (XR ANKLE AP AND LAT) - Final result (04/05/ce

Anatomical Region Laterality .
Anatomical Location / =
Specimen (Source) Laterality Collection Time Received Time
04/05/2017 9:17 AM
PDT
Narrative
04/06/2017 9:07 AM PDT
Report Transcribed Manually
Procedure Note :
N K PHYSICIAN - 04/067@gz
Formatting of this note m YY ae erent from the original.
Report Transcribed Manualigg
Authorizing Provider Resifit Type
DAVID NEIL SCHIFFMAN GENERAL RADIOLOGY
MD — ona :
X-RAY BONE AGE STUDY (XR BONE AGE STUDY) - Final result (03/31/2017 3:12 PM PDT) :
Anatomical Region Laterality Modality L

Computed Radiography

Anatomical Location / Collection Method /
Specimen (Source) Laterality Volume Collection Time Received Time

03/31/2017 3:12 PM
PDT
Impressions
03/31/2017 5:27 PM PDT

- to. : age 73 of 9:
impressions

Normal b8Q%& 29 _cr-00087-KJM Document 46 Filed 03/19/24 Page 78 of 106

Multiple exostoses as above.

Narrative

03/31/2017 5:27 PM PDT
BONE AGE.

* HISTORY **:
History of hereditary exostosis.

Technique: Single view of the left hand and wrist was obtained. The hand radiograph was compared to the |
standardized images in the Greulich and Pyle atlas.

Comparison: None available.

* FINDINGS **:

Chronologic age: 14 years 8 months.
Bone age: 14 years.

Standard Deviation: 12.0 months.

Incidentally noted are multiple exostoses involving the base of the left third proximal phalanx, the
neck of the left fifth metacarpal and the distal left radius and ulna. oted is a short ulna with
a sloping distal radial epiphysis.

Procedure Note

MICHAEL J SILBERSTEIN MD - 03/31/2017

Formatting of this note might be different from the original.
BONE AGE.

** HISTORY **:
History of hereditary exostosis.

Technique: Single view of the left hand and wrist was obtaine radiograph was compared to the standardized images

in the Greulich and Pyle atlas.

Comparison: None available.

** FINDINGS **:

Chronologic age: 14 years 8 months.
Bone age: 14 years.

Standard Deviation: 12.0 months.

Ag the base of the left third proximal phalanx, the neck of the left fifth
Klso noted is a short ulna with a sloping distal radial epiphysis.

Incidentally noted are multiple ¢ exo of
metacarpal and the distal left ra

IMPRESSION
Normal bone age.

Multiple exostoses as above™,

Authorizing Provider Result Type

ROBYN R CHATMAN- GENERAL RADIOLOGY
BOLDS NP

X-RAY BONE LENGTH STUDY (XR BONE LENGTH STUDY) - Final result (03/31/2017 3:12 PM PDT)
Anatomical Region Laterality Modality
Computed Radiography

Anatomical Location / Collection Method /
Specimen (Source) Laterality Volume Collection Time Received Time
03/31/2017 3:12 PM
PDT

Impressions D
03/31/2017 6:48 PM POT :
Impressions

Narrative

03/31/2017 6:48 PM PDT
LEG LENGTH.

** HISTORY **:
Leg length discrepancy. Multiple hereditary exostoses.

** FINDINGS **:
Technique: Multiple views of lower extremities were obtained using a measuring ruler.

Right femoral length: 44.1 cm.
Right tibial length: 33.0 cm.
Right leg length: 77.1 cm.
Left femoral length: 44.5 cm.
Left tibial length: 35.0 cm.
Left leg length: 79.5 cm.

Incidentally noted are multiple osteochondromas involving both distal femurs and both proximal and |
distal tibias and fibulas. Some of the cartilage caps have calcified. There is an epiphysiodesis of the
medial proximal left tibia.

Procedure Note

MICHAEL J SILBERSTEIN MD - 03/31/2017

Formatting of this note might be different from the original.
LEG LENGTH.

** HISTORY **:
Leg length discrepancy. Multiple hereditary exostoses.

** FINDINGS **:
Technique: Multiple views of lower extremities were obtained usi@q" g ruler.

Right femoral length: 44.1 cm.
Right tibial length: 33.0 cm.
Right leg length: 77.1 cm.

Left femoral length: 44.5 cm.
Left tibial length: 35.0 cm.
Left leg length: 79.5 cm.

Incidentally noted are multiple osteochogé me Ving both distal femurs and both proximal and distal tibias and fibulas.
Some of the cartilage caps have cajcified§ThgteSagan epiphysiodesis of the medial proximal left tibia.

IMPRESSION
Leg length discrepancy of, 2.4 c

Type
a BRAL RADIOLOGY

Authorizing Provider

DAVID NEIL SCHIFFMAN GE
MD

X-RAY BONE LENGTH STUDY (XR BONE LENGTH STUDY) - Final result (11/04/2016 1:43 PM PDT)

Anatomical Region Laterality Modality :
Computed Radiography
Anatomical Location / Collection Method /
Specimen (Source) Laterality Volume Collection Time Received Time
11/04/2016 1:43 PM
PDT
Narrative

Transcriptions
JAMES HOWARD SMITH MD - 11/04/2016 12: Rage 75 OF 94
Transcriptions

Formattieasie!®: DAEcrOOOS PCAVE frombecigit 46 Filed 03/19/24 Page 80 of 106

** HISTORY **:
Hereditary exostosis

** FINDINGS **:
Spot images were obtained of the hips, knees, and ankles
bilaterally with a ruler placed centrally.

The right femur measures 43 cm from the top of the femoral head to
the medial condyle.

The left femur measures 43 cm from the top of the femoral head to
the medial condyle.

The right tibia measures 32 cm from the medial tibial plateau to
the distal tibial articular surface.

The left tibia measures 34 cm from the medial tibial plateau to
the distal tibial articular surface.

There are multiple osteochondromas or exostosis projecting from
the distal right and left femoral metaphysis and distal right

tibial metaphysis. There are also osteochondromas of the proximal
right tibia and fibula and distal left fibula. They're unchanged

in size since the prior exam.

** IMPRESSION **:
Lower extremity leg lengths as described above. Calibrated marker
is seen in the midline.

JH SMITH M.D.

DD: DT: 11/04/2016

Authorizing Provider Result Type

| DAVID NEIL SCHIFFMAN GENERAL RADIQB@¢

X-RAY TOE (XR TOES 2 OR MOR@ VY e- Final result (03/08/2016 3:23 PM PST) ,
Anatomical Region en Modality .
Computed Radiography

Collection Method /

Volume Collection Time Received Time
03/08/2016 3:23 PM :
PST

Specimen (Source)

Narrative

Transcriptions
ARVIND
Transcriptions

RIGHT T

** HISTORY **: i
Trauma :

** FINDINGS **:
Technique: Three views of the right toes were obtained.

Exam is somewhat suboptimal as the digits overlap the lateral view.

Small ossification is noted adjacent to the tuft of the third
distal phalanx on the oblique view. This could represent subtle
fracture.

Irregularity is also noted at the base of the fourth proximal
phalanx, which may represent a subtle fracture.

Soft tissues are unremarkable.

** IMPRESSION **:

Question fractures of the third distal phalanx and base of the
fourth proximal phalanx, as above. Correlate for tenderness at
these sites.

Action required.

A SONIK M.D.

DD: DT: 03/08/2016

Authorizing Provider Result Type

ROBYN R CHATMAN- GENERAL RADIOLOGY % #
BOLDS NP

FLUOROSCOPY (FLUOROSCOPY > 1HRgt
PDT)
Anatomical Region

RADIOLOGIC PHYSICIAN) - Final result (07/15/2015 10:49 AM

Other

Collection Method /

Volume Collection Time Received Time
07/15/2015 10:49 AM
PDT

Specimen (Source)

Narrative

Transcriptions

DAVID NEIL SCHIFFMAN MD - 07/16/2015 7:42 AM PDT
Formatting of this note might be different from the original.
Report Transcribed Manually

Authorizing Provider Result Type

DAVID NEIL SCHIFFMAN FLUOROSCOPY
MD

X-RAY KNEE (XR KNEE, AP AND LATERAL) - Final result (07/15/2015 10:49 AM PDT)

Anatomical Region Laterality Modality oo eas
Other Fdage ff OT94
. i ti i th
Specim Fase, 2:22-cr- HOSE TRIRG DocifrsAtnd”*retéd 03/19/24 _ Page 82 of 106

ection Time Received Time

07/15/2015 10:49 AM
PDT

Narrative

Transcriptions

DAVID NEIL SCHIFFMAN MD - 07/16/2015 7:42 AM PDT
Formatting of this note might be different from the original.
Report Transcribed Manually

Authorizing Provider Result Type

DAVID NEIL SCHIFFMAN GENERAL RADIOLOGY
MD

X-RAY BONE LENGTH STUDY (XR BONE LENGTH STUDY) - Final result (07/01/201
Anatomical Region Laterality Modality
Computed Radiography

11:18 AM PDT)

Anatomical Location/ Callection Method /
Specimen (Source) Laterality Volume

Received Time

Narrative

Transcriptions
ARVIND SON
Transcriptions

** HISTORY **:
Multiple multiple revisionary exostosis

** FINDINGS **:

Radiographs were obtained of both lower extremities with a ruler
placed centrally.

RIGHT femur measures 41 cm in length.

LEFT femur measures approximately 41 cm in length.

RIGHT tibia measures approximately 30.5 cm in length.

LEFT tibia measures approximately 32 cm in length.

RIGHT lower extremity length measures approximately 71.5 cm. LEFT
lower extremity length measures approximately 72 cm.

Multiple exostoses are noted involving the distal femurs, and
proximal and distal tibias, consistent with multiple recurrent
exostosis.

Exostosis of the distal diaphysis of the LEFT fibula results in
mild deformity of the distal LEFT tibia.

Prominent sulci versus of the distal RIGHT tibia results in >
deformity of the distal RIGHT fibula.

Epiphysiodesis is noted of the medial proximal RIGHT tibia. Ther,
is no evidence of hardware failure or loosening.

/ ** IMPRESSION **:
1. Lower extremity lengths, as above
2. Multiple exostoses with associated deformities, as@aove
3. Post surgical changes, as above

A SONIK M.D.

DD: DT: 07/01/2015

Authorizing Provider

DAVID NEIL SCHIFFMAN
MD

X-RAY BONE LENGTH STUDY (XR BONE LENGTH STUDY) - Final result (03/02/2015 11:07 AM PST)
Anatomical Region Laterality Modality
Computed Radiography

Anatomical Location/ Collection Method /

Specimen (Source) Laterality Volume Collection Time Received Time
03/02/2015 11:07 AM
PST

Narrative

Transcriptions
MICHAEL J SILBERSTEIN MD - 03/02/2015 12:00 AM PST

Page 79 of 94
Transcriptions

Formatti is pate mi if fro igi .

** HISTORY **:
Leg length discrepancy. Patient with multiple hereditary exostosis.

** FINDINGS **:
Technique: Mulitple views were obtained of lower extremities using
a measuring ruler.

Right femoral length: 40.3 cm.
Right tibial length: 31.0 cm.
Right leg length: 71.3 cm.
Left femoral length: 41.0 cm. :
Left tibial length: 31.5 cm. |
Left leg length: 72.5 cm.

Incidentally noted is a proximal medial left tibial
epiphysiodesis. Also noted are multiple osteochondromas involving
both distal femurs and both proximal and distal tibias and fibulas.

** IMPRESSION **:
Leg length discrepancy of 1.2 cm, left leg longer.

Multiple osteochondromas as above.

M J SILBERSTEIN M.D.

DD: DT: 03/02/2015

Authorizing Provider Result Type

DAVID NEIL SCHIFFMAN GENERAL RADIOLOGY
MD

BY) - Final result (08/18/2014 1:06 PM PDT)
Modality
Computed Radiography

X-RAY BONE LENGTH STUDY (XR BONE LEN@"
Anatomical Region Laterality

Collection Method /

Volume Collection Time Received Time
08/18/2014 1:06 PM

PDT

Specimen (Source)

Narrative

DAVID NEIL SCHIFFMAN MD - 08/18/2014 2:14 PM PDT :
Formatting of this note might be different from the original.
Report Transcribed Manually

Authorizing Provider Result Type

DAVID NEIL SCHIFFMAN GENERAL RADIOLOGY
MD

X-RAY THORACOLUMBAR SPINE (XR THORACOLUMBAR SPINE, STANDING) - Final result (08/12/2013 9:19 AM PDT)
Anatomical Region Laterality Modality
Computed Radiography
PDT

Narrative :
Transcriptions
SOON CHURL DAVID KOH MD - 08/12/2013 12:00 AM PDT U
Formatting of this note might be different from the original. :
SCOLIOSIS SPINE .

** HISTORY *?:
Evaluate scoliosis

** FINDINGS **:

Frontal and Lateral views of the thoracic and lumbar spine were
obtained. There are no relevant prior comparison studies available
in Kaiser radiology archive.

Curvature measure from superior endplate of T8 to the inferior
endplate of L4 , apex to the right , estimated angle of 7 degrees
as projected.

Twelve pairs of ribs are present. No gross anomalous vertebral
body noted as projected. No segmentation anomaly identified.

** IMPRESSION **:
Mild thoracolumbar curve as described

SD KOH M.D.

DD: DT: 08/12/2013

Authorizing Provider Result Type

DAVID NEIL SCHIFFMAN GENERAL RADIOLOG
MD

Modality
Computed Radiography

Collection Method / .
Volume Collection Time Received Time
08/12/2013 8:12 AM
PDT

Specimen (Source)

Narrative

Transcriptions
SOO
Transcriptions

LEG LENGTH STUDY

** HISTORY **:
Followup

** FINDINGS **: .
AP views were obtained over the hips, knees and ankles. Comparison
is made with prior study of 09/28/2012.

No radiopaque was utilized on current exam and leg length is
estimated using Stentor electronic ruler. There may be minor
caliber placement indication due to manual nature of this process.
Please review images directly for any necessary management
decision.

Femur length is estimated by measuring from top of femoral head to
the medial femoral condyle. The left femoral head projects
slightly higher than the right side.

Right Femur: 37.7 cm
Left Femur: 37.5 cm

Tibial length is estimated by measuring from top of the medial

tibial plateau to the top of the talar dome. Slight valgus

orientation at the knees and ankles present, medial motion of the

tibial plateau and medial motion of the talar dome were used for
measurement. There has been interval surgery with fixation

hardware along the proximal medial tibia on the right. y

Right Tibia: 29.1 cm
Left Tibia: 30.2 cm

** IMPRESSION **:
1. Leg length measured as above

SD KOH M.D.

DD: DT: 08/12/2013

Authorizing Provider

DAVID NEIL SCHIFFMAN “@@e
MD

X-RAY WRIST (XR WRIST PA AND LATERAL VIEWS) - Final result (08/12/2013 8:12 AM PDT)
Anatomical Region Laterality Modality
Computed Radiography

Anatomical Location/ Collection Method /

Specimen (Source) Laterality Volume Collection Time Received Time
08/12/2013 8:12 AM
PDT

Narrative
** HISTORY **:
Follow up surgery

** FINDINGS **:
Technique: AP and lateral views of the right wrist were obtained.
Comparison is made with prior exams of 09/28/2012 and 08/10/2011.

Chronic contour deformity of the distal radius and are again noted
associated with multiple rotatory exostoses. There has been
interval removal of surgical hardware from the distal radius since
September 2012. Overall appearance and alignment are otherwise
stable. Exostoses at the base of the proximal phalanges are also
stable.

** IMPRESSION **:
Status post interval removal of surgical hardware from distal
radius, stable alignment and appearance of multiple exostoses

S D KOH MLD.

DD: DT: 08/12/2013

Authorizing Provider Result Type

DAVID NEIL SCHIFFMAN GENERAL RADIOLOGY
MD

X-RAY FLUOROSCOPY (XR FLUOROSCOPY, UP TO ONE} ‘ale B PHYSICIAN TIME) - Final result (12/06/2012 1:49 PM
PST) _ >
Anatomical Region Laterality odality

Other

Cof ection Method /

Anatomical Location #,
» ~sVebime Collection Time Received Time

Specimen (Source) Laterality

12/06/2012 1:49 PM /
Narrative
DAVID NEIL SCHIFFMAN - 12/07/2012 12:15 PM PST
Formatting of this note might®e different from the original. .
Report Transcribed Manually a

Authorizing Provider Result Type

DAVID NEIL SCHIFFMAN FLUOROSCOPY
MD

X-RAY KNEE (XR KNEE, AP AND LATERAL) - Final result (12/06/2012 1:49 PM PST)
Anatomical Region Laterality Modality

Other

Anatomical Location/ Collection Method /
Laterality

Collection Time Received Time

12/06/2012 1:49 PM
PST

Specimen (Source)
Narrative

Case 2:22-cr-00087-KJM Document 46 Filed 03/19/24 Page 88 of 106

DAVID NEIL SCHIFFMAN MD - 12/07/2012 12:15 PM PST C
Formatting of this note might be different from the original.
Report Transcribed Manually

Authorizing Provider Result Type

DAVID NEIL SCHIFFMAN GENERAL RADIOLOGY
MD

X-RAY BONE LENGTH STUDY (XR BONE LENGTH STUDY) - Final result (09/28/2012 12:45 PM PDT)
Anatomical Region Laterality Modality
Computed Radiography .

Anatomical Location / — Cojlection Method / :
Specimen (Source) Laterality Volume Collection Time Received Time :

PDT

Narrative

Transcriptions

MICHAEL J SILBERSTEIN MD - 10/01/2012 12:00 AM PDT
Formatting of this note might be different from the original.
LEG LENGTH

** HISTORY **:
Leg length discrepancy.

** FINDINGS **:
Technique: Mulitple views were obtained of lower@xtr
measuring ruler. _

Right femoral length: 37.5 cm.
Right tibial length: 29.4 cm.
Right leg length: 66.9 cm.

Left femoral length: 37.4 cm.
Left tibial length: 31.0 cm.
Left leg length: 68.4 cm.

** IMPRESSION **:

Delayed discrepancy of 1: cm. longer than right leg.

MIKE SILBERSTEIN MD

DD: 10/01/2012 DT: 10/01/2012 MJS

Authorizing Provider Result Type

DAVID NEIL SCHIFFMAN GENERAL RADIOLOGY
MD

| X-RAY ANKLE (RADIOLOGIC EXAM, ANKLE, COMPLETE, 3+ VIEW) - Final result (09/28/2012 12:44 PM PDT)
Anatomical Region Laterality Modality
Computed Radiography

<

Anatomical Location/ Collection Method /

Specimen (Source) Laterality Volume Collection Time Recelved Time
09/28/2012 12:44 PM Paae 84 of 94 |
PD
Narrativ@ ase 2:22-cr-00087-K.JM Document.46. Filed.03/19/24 Page 89 of 106

Transcriptions

MICHAEL J SILBERSTEIN MD - 10/01/2012 12:00 AM PDT
Formatting of this note might be different from the original.
LEFT ANKLE.

** HISTORY **:
Multiple hereditary exostosis.

** FINDINGS **: :
Technique: Three views of the left ankle were obtained. /

Comparison: None available .

Findings: There is a large sessile osteochondroma arising from the
lateral and posterior aspect of the distal tibia and a sessile .
osteochondroma arising from the medial aspect of the distal
fibula. There are associated modeling deformities. The superior
articular margin of the talus is sloped from lateral to medial.
The talus is central within the ankle mortise. There is no ankle
joint effusion.

** IMPRESSION **:
Changes in distal tibia and fibula consistent with history of

multiple hereditary exostosis. Sloping of the superior aspect of
distal talus.

MIKE SILBERSTEIN MD

DD: 10/01/2012 DT: 10/01/2012 MJS

Authorizing Provider Result Type

DAVID NEIL SCHIFFMAN GENERAL RADIOLOGY ,
MD

| X-RAY ANKLE (RADIOLOGIC EXA,

"0 MPLETE, 3+ VIEW.) - Final result (09/28/2012 12:44 PM PDT) L
Anatomica! Region z

Modality
Computed Radiography

Collection Method /
Volume Collection Time Received Time

09/28/2012 12:44 PM
PDT

Specimen (Source)

Narrative

Transcriptions
MICHAEL J SILBERSTEIN MD - 10/01/2012 12:00 AM PDT
Transcriptions

Formate ASE DLP MOUOET EIT" fraydbenighel46 Filed 03/19/24 Page 90 of 106

** HISTORY **:
Multiple hereditary exostosis.

** FINDINGS **:
Technique: Three views of the left ankle were obtained.

Comparison: None available .

Findings: There is an osteochondroma arising from the medial
aspect of the distal fibula into the interosseous membrane. There
is a modeling deformity of the distal tibia. The ankle joint is
intact and the talus is central within the ankle mortise. There is
no ankle joint effusion.

** IMPRESSION **:
Changes in distal tibia and fibula consistent with history of
multiple hereditary exostosis. ,

MIKE SILBERSTEIN MD

DD: 10/01/2012 DT: 10/01/2012 MJS

Authorizing Provider Result Type
DAVID NEIL SCHIFFMAN GENERAL RADIOLOGY
MD

X-RAY ELBOW (XR ELBOW, AP AND LATERAL) - Final re 28/2012 12:44 PM PDT)

Anatomical Region Laterality

Anatomical Location /¢
Specimen (Source) Laterality

Collection Time Received Time

09/28/2012 12:44 PM
PDT

Narrative

Transcriptions
CHAE
Transcriptions

FormattPageti2s rate mQO08 MK ait froMdeum@eml46 Filed 03/19/24 Page 91 of 106
RIGHT ELBOW.

** HISTORY **:
Multiple aerated greater exostosis.

Technique: 2 views of the right elbow were obtained.
Comparison: 6/9/2010.

** FINDINGS **:

Since 6/9/2010 the multiple exostoses involving the distal left
ulna are again noted with shortening of the ulna. There is marked
shortening of the ulna. There is posterior and lateral dislocation

of the hypoplastic radial head. The distal humerus appears intact.

** IMPRESSION **:
Distal ulnar exostoses with shortening.

Posterior and lateral dislocation of hypoplastic radial head.

MIKE SILBERSTEIN MD

DD: 10/01/2012 DT: 10/01/2012 MJS

Authorizing Provider Result Type

DAVID NEIL SCHIFFMAN GENERAL RADIOLOGY
MD

MQW.) “Final result (09/28/2012 11:15 AM PDT)
omputed Radiography

Anatomical Region Laterality

Anatomical Location /g@@eolf@jrion Method /
Specimen (Source) Laterality rie Collection Time Received Time
09/28/2012 11:15 AM
PDT

Narrative

DAVID NEIL SCHIFFMAN Yap 09 28/2012 12:41 PM PDT

Formatting of this note migh® be different from the original.
Report Transcribed Manually

Authorizing Provider Result Type

DAVID NEIL SCHIFFMAN GENERAL RADIOLOGY
MD

RAY WRIST (XR WRIST PA AND LATERAL VIEWS) - Final result (08/10/2011 11:17 AM PDT)
Anatomical Region Laterality Modality
Computed Radiography

Anatomical Location / — Collection Method /

Specimen (Source) Laterality Volume Collection Time Received Time
08/10/2011 11:17 AM

PDT

Narrative
RIGHT WRIST

** HISTORY **:
Exostosis

** FINDINGS **:
Technique: Two views of the right wrist were obtained. Comparison
is made with a prior examination from 6/9/2010.

Again noted is a large exostosis of the distal which results in a
varus deformity of the forearm. There has been interval placement
of a plate and screws across the physis of the distal radius.

There is no evidence of heart failure or loosening.

** IMPRESSION **:

#1, Large exostosis of the distal ulna with varus deformity the
forearm.

#2. Status post placement of plate and screws across the distal
radius physis.

ARVIND SONIK MD

DD: 08/10/2011 DT: 08/10/2011 AS

Authorizing Provider Result Type

DAVID NEIL SCHIFFMAN GENERAL RADIOLOGY
MD

| X-RAY FOREARM (XR FOREARM, AP AND LATERA
Anatomical Region Laterality : odality
Computed Radiography

Anatomical Locat :
Specimen (Source) Laterality Collection Time Received Time
06/09/2010 1:08 PM
PDT

Narrative

Transcriptions
Transcriptions

RIGHT ECRQS6 AND IQREANOS7-KJIM Document 46 Filed 03/19/24 Page 93 of 106

** HISTORY **:
Multiple hereditary exostosis.

Technique: Two views of the left elbow and two views of the left
forearm were obtained. (Examination includes accession numbers
42102073 and 42102074).

Comparison: None available.

** FINDINGS **:

There are multiple small exostoses involving the distal left ulna
and resulting in slight shortening of this bone. There is mild
ulnar deviation of the left radius with lateral to medial sloping
of the radial articular surface. The radiocarpal alignment carpal
and visualized metacarpal bones, proximal radius and ulna,
radiocapitellar alignment, elbow joint and distal humerus are
intact. There is no elbow joint effusion.

** IMPRESSION **:
Multiple small distal ulnar exostoses with slight shortening.
Mild ulnar deviation of radius.

Unremarkable left elbow joint.

MIKE SILBERSTEIN MD —

DD: 06/10/2010 DT: 06/10/2010 MJS

“MICHAEL J SILBERSTEIN MD - 06/10/2010 12:00 AM PD
DDENDUM **: ADDED ON 06/10/2010 BY SACIMS **

port: The above report is for the

“MIKE SILBERSTEIN MD

DD: DT: 06/1 0/2010 MJS

Authorizing Provider

DAVID NEIL SCHIFFMA
MD

/ X-RAY FOREARM (XR FOREARM, AP AND LATERAL) - Final result (06/09/2010 1:08 PM PDT)
Anatomical Region Laterality Modality
Computed Radiography

Anatomical Location / Collection Method /
Specimen (Source) Laterality Volume Collection Time Received Time
06/09/2010 1:08 PM
PDT

Narrative

Transcriptions
MICHAEL J SILBERSTEIN MD - 06/10/2010 12:00 AM PDT
RIGHT ECBQUGAND POREARDO87-KJIM Document 46 Filed 03/19/24 Page 94 of 106

** HISTORY **:
Multiple hereditary exostosis.

Technique: Two views of the right elbow and two views of the right
forearm were obtained. (Examination includes accession numbers
42102072 and 42102071).

Comparison: None available.

** FINDINGS **:

There is a large exostosis involving the distal ulna and resulting

in prominent shortening of this bone and posterior curving of the
ulnar shaft. There is broadening of the proximal ulna. The

radius is curved laterally (ulnar deviation) and there is

prominent lateral to medial sloping of the radial articular

surface. The carpal and metacarpal bones appear intact. There is
a small exostosis arising from the medial aspect of the distal
radius.

There is posterior and lateral subluxation of the radial head with
disruption of the radiocapitellar alignment. The proximal ulna is
broad and the olecranon process is truncated. The distal humerus
is unremarkable.

** IMPRESSION **:
Short ulna with large distal exostosis, ulnar deviation of radius
with sloping distal radial articular surface. Posterolateral
subluxation of radial head.

MIKE SILBERSTEIN MD

DD; 06/10/2010 DT: 06/10/2010 MJS

Authorizing Provider Result Type

DAVID NEIL SCHIFFMAN GENERAL RADI
MD

X-RAY ELBOW (XR ELBOW, AP@ 4 AL) - Final result (06/09/2010 1:08 PM PDT)
Computed Radiography

Collection Method /
Volume Collection Time Received Time

06/09/2010 1:08 PM
PDT

Narrative

Transcriptions
MICHAEL J SILBERSTEIN MD - 06/10/2010 12:00 AM PDT
Transcriptions

RIGHT ECRQYE ANDZFQREAWO87-KIM Document 46 Filed 03/19/24 Page 95 of 106

** HISTORY **:
Multiple hereditary exostosis.

Technique: Two views of the left elbow and two views of the left
forearm were obtained. (Examination includes accession numbers
42102073 and 42102074).

| Comparison: None available.

) ** FINDINGS **:

| There are multiple small exostoses involving the distal left ulna

i and resulting in slight shortening of this bone. There is mild
ulnar deviation of the left radius with lateral to medial sloping
of the radial articular surface. The radiocarpal alignment carpal
and visualized metacarpal bones, proximal radius and ulna,
radiocapitellar alignment, elbow joint and distal humerus are
intact. There is no elbow joint effusion.

** IMPRESSION **:
Multiple smail distal ulnar exostoses with slight shortening.
Mild ulnar deviation of radius.

Unremarkable left elbow joint.

MIKE SILBERSTEIN MD

DD: 06/10/2010 DT: 06/10/2010 MJS

MICHAEL J SILBERSTEIN MD - 06/10/2010 12:00 AM PDTg
a ADDENDUM **: ADDED ON 06/10/2010 BY SACIMS * qt

@ above report is for the 4

MIKE SILBERSTEIN MD
DD: DT: 06/1 0/2010

Authorizing Provider

DAVID NEIL SCHIFFMANg@EN

X-RAY ELBOW (XR ELBOW, AND LATERAL) - Final result (06/09/2010 1:08 PM PDT)
Anatomical Region Laterality Modality
Computed Radiography

Anatomical Location / Collection Method /
Specimen (Source) Laterality Volume Collection Time Received Time
06/09/2010 1:08 PM
PDT

Narrative

Transcriptions
MICHAEL J SILBERSTEIN MD - 06/10/2010 12:00 AM PDT
Transcriptions

RIGHT ECB BNDPFOREABYS7-KJIM Document 46 Filed 03/19/24 Page 96 of 106

** HISTORY **: e
Multiple hereditary exostosis.

Technique: Two views of the right elbow and two views of the right
forearm were obtained. (Examination includes accession numbers
42102072 and 42102071).

Comparison: None available.

** FINDINGS **:

There is a large exostosis involving the distal ulna and resulting

in prominent shortening of this bone and posterior curving of the
ulnar shaft. There is broadening of the proximal ulna. The

radius is curved laterally (ulnar deviation) and there is

prominent lateral to medial sloping of the radial articular

surface. The carpal and metacarpal bones appear intact. There is
a small exostosis arising from the medial aspect of the distal
radius.

There is posterior and lateral subluxation of the radial head with
disruption of the radiocapitellar alignment. The proximal ulna is
broad and the olecranon process is truncated. The distal humerus
is unremarkable.

** IMPRESSION #?:
Short ulna with large distal exostosis, ulnar deviation of radius :
with sloping distal radial articular surface. Posterolateral :
subluxation of radial head.

MIKE SILBERSTEIN MD

DD: 06/10/2010 DT: 06/10/2010 MJS

Authorizing Provider Result Type

DAVID NEIL SCHIFFMAN GENERAL RADIQJ@K
Care | .

Team Member

End Date

DONNA LEE MARIANO MD _sPCP - General 9/30/20
NPI: 1497106967

2025 MORSE AVENUE

SACRAMENTO, CA

95825-2115

916-480-643 1-x6431 (Work)

916-614-6424 (Fax)

DAISY MURILLO MSW. é nary | nu 3/22/19
2025 MORSE AVENUE
SACRAMENTO, CA

STACEY ANDREA SILVA CM - Medicaid Support RN GENERAL, OTHER 11/10/19
TUALLA RN

2025 MORSE AVENUE

SACRAMENTO, CA

NING WU MD _Neurolo st
NPI: 1902149321 :
1600 EUREKA ROAD

ROSEVILLE, CA 95661-3027
916-474-6398-x6398 (Work)
SHARLENE D JONES icai 1/6/24
3555 WHIPPLE RD. ,

_ UNION CITY, CA 94587- 1336

Contact Address 4 rn - Relationship to Patient

5910 DULWICH WAY 443 (Mobile) Father, Guardian
SACRAMENTO, CA 95835 . 67-4443 (Home)
Document Information

DONNA LEE MARIANO
MD (Sep. 30, 2020 -
Present)

NPI: 1497106967
916-480-6431-x6431 (Work)
916-614-6424 (Fax)

2025 MORSE AVENUE
SACRAMENTO, CA
95825-2115

Family Practice

Kaiser Permanente
Northern California

4460 Hacienda Dr, Bldg. A
Pleasanton, CA 94588

Custodian Organization

DAISY MURILLO MSW (CM - Medicaid Primary MSW) Aug. 09, 2002 - Feb. 10, 2024
2025 MORSE AVENUE

SACRAMENTO, CA 95825-2115

GENERAL, OTHER

Kaiser Permanente Northern California

4460 Hacienda Dr, Bldg. A

Pleasanton, CA 94588

STACEY ANDREA SILVA TUALLA RN (CM - Medicaid Support
RN)

2025 MORSE AVENUE

SACRAMENTO, CA 95825-2115

GENERAL, OTHER

Kaiser Permanente Northern California

4460 Hacienda Dr, Bldg. A

Pleasanton, CA 94588

NING WU MD (Neurologist)

NPI: 1902149321

916-474-6398-x6398 (Work)
916-474-6401-x6401 (Fax)

1600 EUREKA ROAD

ROSEVILLE, CA 95661-3027

Neurology

Kaiser Permanente Northern California
4460 Hacienda Dr, Bldg. A

Pleasanton, CA 94588

SHARLENE D JONES (CM - Medicaid M
510-618-5800-x5800 (Work)
3555 WHIPPLE RD.

UNION CITY, CA 94587-1336
ADMIN WITH ACCESS TO KPHG?
Kaiser Permanente Norther a
4460 Hacienda Dr, Bia. 4%
Pleasanton, CA 94588

4460 Hacienda Dr, Bldg. A
Pleasanton, CA 94588

Kaiser Permanente Northern California Si
Case 2:22-cr-00087-KJM Document46_ Filed 03/19/24 Page 103 of 106

TRULINCS 00025510 - ASHCRAFT, AARON - Unit: SHE-E-A

FROM: 00025510

TO: Ashcraft, Ohameon
SUBJECT: Hi Buddy

DATE: 02/09/2024 12:49:54 PM

Hi Buddy,

How are you doing? | couldn't get through to you through the phone is everything ok? | am really worrled about you, my letter

Imailed you was recently retumed too. Please respond back to me a6 soon as You Can. | am going to emall your friend Jason a6
well and see if he can tell me whats going on.

ilove you and hope you are doing ok.

Page 1 of 4
Case 2:22-cr-00087-KJM Document 46 Filed 03/19/24 Page 104 of 106

TRULINCS 00025510 - ASHCRAFT, AARON - Unit: SHE-E-A

FROM: Ashcraft, Dhameon

TO: 00025510

SUBJECT: RE: Hi Buddy
DATE: 02/09/2024 07:36:06 PM

| really miss you when are you getting out? I’m sorry | didn't email you back my computer was broke and my phone was broken
and | couldn't pay the bill. My friend Jason just fixed it for me last week and today he got the rest of the money you gave me
from the atm for me and brought back some groceries. | don't know why the letter didn't come to

happened to yoh.

friends aren't stopping by like they used to. I'm really depressed this isn't fair | hate this do anything anymore | will never
be ale to gat a license or drive your car like you said | could. Can't the prison let yo: e | thought u said you were
going to talk to them. | sent them the paper from the doctor about my condition. ‘

wouldn't let you out to help me. How is Roxy | haven't seen her fo awhile, | feel |

di too.

Any way I'm not doing very weil | have no TV and my computer wa
my other arm for the mouse and play some of the games but it's sti
| can send you messages from the voice text thing.. The other up and | fell on the floor | couldn't feel my leg and
then you know that bump on my bone [hit in on the dresser a g and made a mess. | was scared and was
yelling and the neighbor called 911. The firemen came by and age on it and they said it didn't need stitches they
were really nice.

getting me money | am all out and the food card doesnt work
anymore.

| love you dad. Please write me back.

Hi Buddy,

How are you doing?.I ¢ : 0 you through the phone is everything ok? | am really worried about you, my letter
: lease respond back to me as soon as you can. | am going to email your friend Jason as
well and see if he can

| love you and hope-you

Page 2 of 4
Case 2:22-cr-00087-KJM Document 46 Filed 03/19/24 Page 105 of 106

TRULINCS 00025510 - ASHCRAFT, AARON - Unit: SHE-E-A

FROM: 00025510

SUBJECT: RE: RE: Hi Buddy
DATE: 02/10/2024 06:35:08 AM

Hi Deedies,

[miss you tremendously, | have been so worried about you. | was afraid something had happened when the letter | sent you
was retumed. | don't have any way to call you unless you can give me Jason's phone number and let me know when he will be
over there next. | gave you all the money | had left, | don't know what to do, lam very sory buddy. | will try to think of
something, maybe Jason can sell something from the storage unit. Please let me know his email an contact him about it

1 am so sorry about all of this son. | love you. | can't believe you are going through this, it really
there with you to help you through this. How long have you been doing the IV's now?

Did you know that my moms dad had Multiple Sclerosis too? | helped my Grandmother, your Great
him, | don't even remember your Great Grandfather ever walking, he would just yell at
meeting your Great Grandmother? She was just a little Itallan woman but she could ha
ease. She was an amazing woman.

To answer your question about being released | am still trying to deal with th
they denied it but she was talking about the Bureau of Prisons. | had to requ
before the court. | filed the motion in late November and | don't know wha
recommended the court deny my release, citing | didn't have evidenc
in the family can take care of you. | just sent a memorandum to the
included some paperwork showing Roxy had been declared grav
mentally, when | surrendered she went completely down hill and c
in the mental hospital. | never got the paperwork | asked :
supposed to mail it to the court you were supposed ¢ E
more than anything, it proves that you were diagnose
me his email | will contact him and let him know

| condition and no evidence that anyone
opefully suffice, | wrote them a letter and
| wish she could help but she is really sick |
erself to the point of major health issues and ended up
id m@ about your medical condition and you weren't
at attorneys email | had given you. | need that paperwork

iil have one of Roxy's kids contact him and if you can give

like that. | really need to talk to him though because i need to get the |

Jason is a good friend to you, | am glad you hav
y release.

paperwork to the court before they make

and its hurt more than me, its hurt you, Roxy has spiraled down, everything |
itis harder than anything. We were on lockdown for almost 2 months with no
bie to contact you or anyone to help me with getting the paperwork | need for the
and can't seem to stop messing it up for the people that are trying to do their time

lam very sorry about all of this,

Again, please get me J email, itis super important... When is he supposed to stop by next? If you know his email or
phone number please email it back to me ASAP.

if | don't get this release | am very very worried about what will happen to you, especially now that | will be here longer... The
court reduced my sentence from 41 months to 33 months but the RDAP program | came to this prison for to help reduce my
sentence further was suspended. If they bring it back and with my goad time credits and FSA | could be out of here by August of
this year but if nat | will be here until February of 2026... If my calculations are correct, its super confusing.

| miss you and love you so much deedles. I'm sorry you are going through this and | promise when | gat out | will do everything
in my power to allow you to live as normal a life as possible. | can't contact your doctor and nobody will help and it is so
aggravating and depressing, You are a tough young man, please hold on buddy. | am trying my best. | haven't done any devas
and | am back to myself and have really made some important changes in myself. | don't want to use too much of my email

credits so | will email you later.

| love you buddy!!! :
You are a dork :) JK | love you... Dork
Ashcraft, Dhameon on 2/9/2024 7:36 PM wrote:

Page 3 of 4
Case 2:22-cr-00087-KJM Document46 — Filed 03/19/24 Page 106 of 106

TRULINCS 00025510 - ASHCRAFT, AARON - Unit: SHE-E-A

Hi Dad

| really miss you when are you getting out? I'm sorry | didn't email you back my computer was broke and my phone was broken
and | couldn't pay the bil. My friend Jason just fixed it for me last week and today he got the rest of the money you gave me
from the atm for me and brought back some groceries. | don't know why the letter didn’t come to me. | was worried

happened to yon.

| haven't been feeling well latefy | just had my tv thing at the hospital and it makes me feel super sick. Oh and Jason is typing
this for me because it’s hard to type. Sometimes it's OK but it keeps getting harder | don't think the me ines is working | don't
know what I'm going to do dad !'m really worried about not being able to pay rent next month. have any money you can
send me? When are you going to behome | really miss you and | really need your help | can ba get to the bathroom and my
friends aren't stopping by like they used to. I'm really depressed this isn't fair | hate this | can’t yihing more | will never
be ale to get a license or drive your car like you said | could. Can't the prison let you out to help med thoug: u Said YOU were
going to talk to them. | sent them the paper from the doctor about my condition. Roxy ta e awhil at the prison

wouldn't let you out to help me. How is Roxy I haven't seen her fo awhile, | feel like everys @ forgot about me | was worried you

on fixed It, thankiully i can use
ging to have Jason fix the microphone so

on the floor | couldn't feel my beg and
made a mess. | was scared and was
id they said it didn’t need stitches they

Any way I'm not doing very well | have no TV and my computer was broken for 2 “i
my other arm for the mouse and play some of the games but It's still hard to
i can send you messages from the voice text thing.. The other morning |
then you know that bump on my bone { hit in on the dresser and it was bl
yelling and the neighbor called 911. The firemen came by and put a

Now that my computer is fixed { will be able to talk to you. It's
really need some help and please see what you can do about

I love you dad. Please write me back.

AARON ASHCRAFT on 2/9/2024 4:09:25 PM
Hi Buddy, .

How are you doing? | couldn't
imaiied you was recently retume
well and see if he can tell me |

re at night this really sucks. | hope you come home soon
pmoney | am all out and the food card doesn't work

the phone is everything ok? | am really worried about you, my letter
nd back to me as soon as you can. | am going to email your frend Jason as

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