Notice of medical, dental or podiatric malpractice action.
(1) Within 60 days after joinder
of issue by all defendants named in the complaint in an action for medical,
dental or podiatric malpractice, or after the time for a defaulting party to
appear, answer or move with respect to a pleading has expired, the plaintiff
shall obtain an index number and file a notice of such medical, dental or
podiatric malpractice action with the appropriate clerk of the county of venue,
together with:
(i) proof of
service of the notice upon all other parties to the action;
(ii) proof that, if demanded,
authorizations to obtain medical, dental and hospital records have been served
upon the defendants in the action;
(iii) copies of the summons, notice of
appearance and all pleadings, including the certificate of merit if required by
CPLR 3012-a;
(iv) a
copy of the bill of particulars, if one has been served;
(v) a copy of any arbitration
demand, election of arbitration or concession of liability served pursuant to
CPLR 3045; and
(vi) if
requested and available, all information required by CPLR 3101(d)(1)(i).
The notice shall be served simultaneously
upon all such parties. If the bill of particulars, papers served pursuant to
CPLR 3045, and information required by CPLR 3101(d)(1)(i) are not available,
but later become available, they shall be filed with the court simultaneously
when served on other parties. The notice shall be in substantially the
following form:
Notice of Medical, Dental or Podiatric
Malpractice Action
Malpractice
Calendar No.
______________
Reserved for Clerk's use
Index No. ____________
Name of Assigned Judge ____________
SUPREME COURT
____________ County
____________
______________
Plaintiff(s)
vs.
______________
Defendant(s)
____________
Please take notice that the above action for
medical, dental or podiatric malpractice was commenced by service of summons on
________, that issue was joined therein on ________, and that the action has
not been dismissed, settled or otherwise terminated.
1. State full name, address and
age of each plaintiff.
2. State full name and address of each
defendant.
3. State
alleged medical specialty of each individual defendant, if known.
4. Indicate whether claim is
for
________ medical malpractice
________ dental malpractice
________ podiatric malpractice
5. State date and
place claim arose.
6.
State substance of claim.
7. (Following items must be checked)
(a) Proof is attached that
authorizations to obtain medical, dental, podiatric and hospital records have
been served upon the defendants in the action ________
or demand has not been made for such
authorizations. ________
(b) Copies of the summons, notice of
appearance, all pleadings, certificate of merit, if required, and the bill of
particulars if one has been served,
are attached. ________
(c) A copy of any demand for
arbitration,
election of arbitration or concession of
liability is attached ________
or demand has not been made for arbitration.
________
(d)
All information required by CPLR
3101(d)(1)(i) is attached ________
or a request for such information has not
been made ________
or such information is not available.
________
8. State name, addresses and telephone
numbers of counsel for all parties.
____________
(PRINT NAME)
Attorney for Plaintiff
Address
Telephone number
Dated:
Instructions:
1. Attach additional 8 1/2 x 11 rider
sheets if necessary.
2. Attach proof of service of this
notice upon all other parties to the action.
(2) The filing of the
notice of medical, dental or podiatric malpractice action in an action to which
a judge has not been assigned shall be accompanied by a request for judicial
intervention, pursuant to section
202.6 of this Part, and shall
cause the assignment of the action to a judge.
