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Pi022-Plaintiffs Forms
1. STATE OF NEW YORK
SUPREME COURT COUNTY OF [Insert County]
__________________________________________
[INSERT PLAINTIFF]
Plaintiff
Index No: [INSERT]
vs. RJI No: [INESRT]
Hon. [INSERT]
[INSERT DEFENDANT]
Defendant
__________________________________________
PLAINTIFFS’ PARTIAL EXHIBIT LIST AS OF [INSERT DATE]
Plaintiffs’
Exhibits
Exhibit Description
In
Evidence
Date
entered
1 Labor and Delivery Records
2 Fetal Heart Monitoring Strips
3 Birth Records
4 Infant x-rays
5
Certified Neonatal Medical Center Hospital Chart for
the infant
6
Infant x-rays of the infant at the Neonatal Medical
Center from [Insert Date] to [Insert Date]
7
CT Scans of the infant at the Neonatal Medical Center
dated [Insert Date]
8
CT Scans of the infant at Neonatal Medical Center dated
[Insert Date]
9
MRIs of the infant taken on [Insert Date] in the state of
[Insert Name of State] ([Insert #] films)
2. 10 Certified Certificate of Live Birth of the Infant
11
Certified Bills of Neonatal Medical Center for the infant
[Insert Date] to [Insert Date]
12 (a)
Defendant hospital protocol -- Use of gel prior to
induction
12(b) Additional protocol -- Care of the intrapartum patient
12(c)
Additional protocol --Induction and Augmentation of
Labor with Oxytocin
12(d) Additional protocol -- Determination of Fetal Heart Rate
12(e)
Additional protocol -- Continuous Fetal Heart Rate
Monitoring
12(f)
Additional protocol -- Immediate Care of the Newborn
in Labor and Delivery
12(g)
Additional protocol -- Admission of the newborn to the
Nursery
12(h)
Additional protocol -- Maternal Fetal, Neonatal
Transfers to a Regional Center
13 Hospital Labor and Delivery Log
14 Demonstrative Art
15 Demonstrative Art
16 Exemplar infant in utero
17 Demonstrative Art
18
Scanned copies of hospital exhibits admitted for
demonstrative purposes
Dated: [INSERT DATE]
______________________________
[Name of Attorney]
[Name of Law Firm]
Attorneys for Plaintiffs