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January 20, 2012
RITA BAYTSAYEVA, PLAINTIFF,v.MAKSIM SHAPIRO, SVETLANA ZIS, DEFENDANTS.
Plaintiff, a 50-year-old former medical assistant born in the former U.S.S.R.*fn1 and now a U.S. Citizen, alleges that defendants negligently struck her with their car while she was crossing the street on foot, causing severe and continuing physical and emotional injuries. Defendants move for summary judgment, arguing that plaintiff is barred from recovery in tort because she has not sustained a "serious injury" pursuant to New York Insurance Law § 5102(d). Because plaintiff has plainly met her burden of establishing a prima facie case of "serious injury," the defendants' motion for summary judgment is DENIED.
A. The Accident
On January 4, 2008, while crossing the street at the intersection of Bath Avenue and 23rd Street in Brooklyn, New York, plaintiff was struck by a car allegedly driven and/or owned by defendants. ECF Docket # 34 at 21-25, Complaint ("Compl.") ¶¶ 1, 4-9, 11-12. At the time of the accident, plaintiff was employed by Omega Health Services as a "home attendant" and when struck, was assisting an elderly client cross the street. ECF Docket # 32, Plaintiff's Exhibit ("Pl. Exh.") K., Affidavit of Plaintiff ("Pl. Aff.") ¶ 1; see ECF Docket # 34 at 45-50, Defense Exhibit ("Def. Exh.") D., Plaintiff's Response to Interrogatories ("Pl. Inter.") ¶ 8. The circumstances surrounding and immediately subsequent to impact are not entirely clear. According to plaintiff, "[t]he car struck my right side, I fell back on the pavement hitting my head. I was thrown back and down to the black ground. I was trying to get up, I couldn't I fell back down again. I passed out while on the ground." Pl. Aff. ¶ 2. In her deposition, plaintiff was unsure whether she lost consciousness. ECF Docket # 34 at 63-81, Deposition of Plaintiff, 3/22/10 ("Pl. Dep.") at 55 ("Q. And did you lose consciousness at any point? A. I wasn't sure. I don't know. . . . I assuming I was kind of unconscious."). In any event, plaintiff remained laying on the street until an ambulance arrived, at which point, she was placed on a stretcher, given a neck brace and ice, and transported to Lutheran Medical Center ("Lutheran"). Id. at 70-73.
Upon arrival at Lutheran, the triage physician noted that plaintiff "[p]resents with Head Trauma Occipital B . . .. The Onset is acute. The symptoms are Mild, achey [sic]. . . . [She is] fully immobilized . . . [and] also c/o [(complains of)] neck pain . . .." ECF Docket # 34 at 51-62, Def. Exh. E., Lutheran Medical Report ("Luth. Rep.") at 3. The Lutheran Report notes that plaintiff had no relevant past medical history and prior to the accident was not taking any medications. Id. at 3, 8.*fn2 A physical examination revealed full range of motion ("ROM") of plaintiff's extremities, back and neck; a CT scan of the spine revealed "[n]o evidence of acute fracture or dislocation;" and a CT scan of the head revealed "[s]light soft tissue swelling at left parietal scalp." Id. at 3, 4, 10. Plaintiff was diagnosed with "head trauma" and "occipital hematoma" and prescribed medications for inflammation, pain, and severe nausea. Id. at 4, 6.
After determining that there were "[n]o Sx(s) [(symptoms)] or objective findings that are life or limb threatening[,]" plaintiff was released from the emergency department with instructions to contact a physician for a follow up appointment within two days and "return [to the hospital] immed [(immediately)] if sxs [(symptoms)] worsen . . .." Id. at 3-4, 6. Plaintiff was later picked up by her daughter and left the hospital walking "with steady gait." Id. at 7.
B. Doctor Miller and First Year of Treatment (January 2008 -- January 2009)
Five days later, on January 9, 2008, plaintiff visited Doctor Jean D. Miller, M.D. ("Dr. Miller")*fn3 "seeking medical attention secondary to unremitting pain, which started the day, the accident [sic]" with numerous complaints, both psychological and physical. ECF Docket # 33-1, Pl Exh. M., Miller Comprehensive Medical Initial Report at 1.*fn4 After reviewing plaintiff's hospital records, observing that plaintiff had no significant past surgical or trauma history, and listening to plaintiff's complaints, Dr. Miller conducted a "thorough physical examination," including, but not limited to ROM testing of the cervical spine/neck, thoracic spine, and lumbar spine. Id. at 2-3. With regard to plaintiff's cervical spine/neck, Dr. Miller found severe loss of ROM of between 43% to 88%, central neck pain, and "significant tenderness," "severe spasm," and "[t]ender points" throughout. Id. at 2. Although there was full ROM in plaintiff's thoracic and lumbar spine, the doctor noted pain in both areas, as well as "significant tenderness," "severe spasm," and "[t]ender points" throughout. Id. at 3. Based on the foregoing, Dr. Miller made the following diagnostic impression:
Headache, post concussion syndrome, head injury, TMJ syndrome, vertigo/dizziness, anxiety, nervous tension, acute reaction to stress, insomnia, post-traumatic cervical sprain/strain, R/O cervical intervertebral disc injury, cervical & brachial radiculitis, cervical myalgia/myofascitis, R/O internal derangement of R/L shoulder, sprain/strain of R/L shoulder and upper arm, sprain and strain of thoracic spine, contusion of chest wall R/L, lumbar sprain/strain, R/O lumbosacral radiculopathy, R/O lumbosacral intervertebral disc injury, lumbar myalgia/myofascitis.
Id. at 4. The doctor prescribed Elavil for depression and Esgic for headaches, ordered an x-ray of the right and left temperomandibular joint,*fn5 and recommended supervised physical therapy multiple times per week. Id. at 4-5. The doctor further ordered that "because [of] her injuries no heavy work should be performed at this time." Id. at 4.
Plaintiff began physical therapy right away and according to detailed daily physical therapy progress notes taken by Dr. Miller-ostensibly based off of first hand reporting by plaintiff's physical therapist-plaintiff attended physical therapy sessions two and three times per week between January 10, 2008 and March 10, 2008, the first two months post-accident, and one and three times per week from March 10, 2008 through May 19, 2008. ECF Docket # 33-1, Pl. Exh. M., Miller Daily Physical Therapy Progress Notes. Physical therapy included thermotherapy, electrotherapy, and massage therapy to the lumbosacral spine, left and right shoulder, thoracic spine, and cervical spine. Id.
Nevertheless, plaintiff's symptoms did not improve. In the report from plaintiff's follow-up visit on February 13, 2008, for example, Dr. Miller indicated that plaintiff's "symptoms have gotten worse since the previous examination." Pl. Exh. M., Miller 2/13/2008 Follow-Up Visit Report at 1. Though testing revealed that the cervical spine's ROM had slightly improved (now indicating loss of ROM between 10-50% across all motion categories), Dr. Miller reported 33% loss of ROM of extension and left lateral flexion in plaintiff's lumbar spine, where no loss had previously existed. Id. at 1-2. Dr. Miller noted pain throughout plaintiff's body, that plaintiff reported experiencing headaches three times per day, and was not sleeping well. Id. Although the primary diagnoses remained the same, Dr. Miller ordered an MRI and added Neurontin to the list of plaintiff's medications. Id. at 5.
Between March 19, 2008 and July 23, 2008, Dr. Miller examined
plaintiff once a month. See Pl. Exh. M., Miller 3/19/2008, 4/21/2008,
5/7/2008, 6/11/2008, 7/23/2008 Follow-Up Visit Reports. *fn6
At each visit, plaintiff complained of daily headaches,
severe pain primarily in her neck and lower back, and sleeping issues,
as well as dizziness and anxiety. See id. According to plaintiff, the
symptoms affected her ability to carry out daily tasks.*fn7
During this period, loss of ROM in plaintiff's cervical
spine/neck ranged from a low of 0% across all motion categories
without pain to and high of 50% in left and right lateral flexion with
pain. Id. Loss of ROM in plaintiff's lumbar spine ranged from 33% in
right and left rotation to between 33% and 66% in extension, all with
pain.*fn8 Id. The MRI of plaintiff's cervical
spine-ordered by Dr. Miller in January-was performed on April 2, 2008
and revealed that "small diffuse annular bulges and/or
osteophytic ridges are seen at C5-6 [and] C6-7 without spinal cord
compression or foraminal encroachment." ECF Docket # 34-2 at 40-49,
Def. Exh. K. ("MRI Reports") at 8.
During Dr. Miller's treatment, which transpired during at least the first ten months following the accident, plaintiff did not work a single day and as described more fully, infra Part I.E., has not worked a day since. See Pl. Aff. ¶¶ 4-7. Plaintiff filed for, was awarded, and began receiving workers' compensation benefits soon after the accident, which continued up to at least January 2011. See Pl. Aff. ¶ 5; ECF Docket # 30-7, Pl. Exh. G., Kuhn Workers' Compensation Forms, 1/6/2011. Dr. Miller filed sworn workers' compensation reports, eight of which-ranging from January 10, 2008 to January 9, 2009-are included in the record, all indicating that there was no "history or evidence of pre-existing injury, disease or physical impairment;" that plaintiff is "disabled from regular duties or work;" that plaintiff's disability is "total;" and that plaintiff "can[not] . . . do any type of work." Pl. Exh. M., Miller Workers' Compensation Forms, 1/10/2008-1/9/2009 (emphasis added).*fn9
Although plaintiff did not-and could not, according to Dr. Miller-return to work, plaintiff did continue to attend morning and evening courses and completed the Spring 2008 semester at the Long Island University Hospital where plaintiff was in the middle of completing a Bachelor of Arts in nursing.*fn10 ECF Docket # 24, Defendants' Memorandum of Law in Support of their Motion for Summary Judgment ("Def. Mem.") at 2; ECF Docket # 30, Plaintiff's Memorandum of Law in Opposition to Summary Judgment ("Opp. Mem.") ¶ 7. She withdrew, however, after the semester because of her injuries,*fn11 and at least as of her March 2011 deposition, had not attended school since.*fn12
C. Dr. Neystat and Treatment (January 2009 -- November 2009)
In January 2009, plaintiff stopped seeing Dr. Miller and began to see Doctor Marina Neystat, M.D. ("Dr. Neystat"), a Diplomat of the American Board of Neurology and Psychiatry. See ECF Docket # 30-4, Pl. Exh. C., Neystat Affidavit at 1. According to plaintiff, Dr. Miller did not provide treatment for what plaintiff feared were potentially far more extensive neurological problems. See Pl. Dep. at 96-97. In addition, her pain was getting far worse and was transferring to different parts of her body: "I didn't feel this relief. It was even worse. My spine feels like electrocuting me, paralyzing me. All kind of every different type of pain." Id. at 97.
At a January 19, 2009 initial neurological and physical examination with Dr. Neystat plaintiff complained of "ssevere [sic] neck pain, right leg pain 8/10 burning as well as severe low back pain . . . positional vertigo . . . memory loss, confusion, inability to sleep . . . [and] up to 5 episodes a day of confusion and disorientation." ECF Docket # 31, Pl. Exh. H., Neystat Neurology Initial, 1/19/2009 at 1.*fn13 Dr. Neystat noted that plaintiff's "[p]ast medical history is unremarkable" and that plaintiff had not had any "previous surgeries." Id. The neurological exam-though the specific test employed was unspecified-revealed an "anxious and depressed" mood, but no "abnormal or psychotic thoughts." Id. at 2. A "musculoskeletal examination" revealed "cervical and lumbar right and left paraspinal tenderness and muscle spasms." Id. at 3. A ROM test revealed that the thorasic spine and neck ROMs were within normal limits, but that the "[l]umbar sacral spine . . . shows decreased flexion, decreased extension, decreased R Tilt, decreased R Rotation." Id. Although Dr. Neystat's ROM testing included no numeric percentages, her office's physical therapist conducted ROM and "Manual Muscle" Testing, which revealed losses of ROM in plaintiff's neck across all motion categories of between 21% to 33% and losses of ROM in plaintiff's trunk across all motion categories of between 43% and 66%. ECF Docket # 31, Pl. Exh. H., 1/20/2009 Physical Therapy Evaluation at 2. Dr. Neystat concluded that plaintiff was "totally disabled," diagnosed "[p]ostconcussion syndrome [a]djustment disorder with depression [and] . . . [c]ervical and lumbar radiculopathy." Pl. Exh. H., Neystat Neurology Initial, 1/19/2009 at 3. Dr. Neystat prescribed Lexapro for depression and anxiety, recommended that plaintiff begin physical therapy with her office's physical therapist, and ordered an "EEG and EMG and nerve conduction studies lower extremeties [sic]," as well as an MRI of the brain and lumbar spine. Id.
The "EMG needle evaluation of the Right MedGastroc and the Right LatGastroc . . . reveal[ed] evidence of lumbar L5-S1 radiculopathy on the right." ECF Docket # 34-2, Def. Exh. L. at 86, Neystat Test Results. The MRI of the brain, conducted on February 12, 2009, found that "Nonspecific mild white matter signal abnormalities," MRI Reports at 1, but "no evidence of disease," Pl. Exh. H., Neystat 4/2/2009 Follow-Up Visit Report at 1, and the MRI of the lumbar spine, conducted on March 16, 2009, showed that plaintiff had a "left paracentral herniated disk with mild focal narrowing of the thecal sac" at L1/2 "with mild spinal canal stenosis."*fn14 MRI Reports at 4.
The record contains three more reports of follow-up visits with Dr. Neystat through September 10, 2009, during which the doctor conducted the same physical and neurological testing as described above and found no reason to change her diagnoses. See Pl. Exh. H., Neystat 4/2/2009, 7/9/2009, 9/10/2009 Follow-Up Visit Reports. Follow-up ROM tests conducted by Dr. Neystat's physical therapist on March 5, 2009 and September 10, 2009 demonstrated continued, significant losses of ROM.*fn15 See ECF Docket # 34-2, Def. Exh L. at 65-67, 3/5/2009 Physical Therapy Follow-Up Report; Pl. Exh. E., 9/10/2009 Physical Therapy Follow-Up Report. All of Dr. Neystat's reports reflect that plaintiff was experiencing intense pain (i.e. 6 through 9 on a scale of 10), in her neck, legs, and back, severe headaches, an inability to sleep, memory loss, confusion, and disorientation. See Pl. Exh. H., Neystat 4/2/2009, 7/9/2009, 9/10/2009 Follow-Up Visit Reports. Between January 21, 2009 and November 2, 2009, Dr. Neystat filed workers' compensation forms, all of which state that there is "no evidence of pre-existing condition;" that plaintiff is "disabled from regular duties or work;" that plaintiff's disability is "total;" that plaintiff "can[not] do any type of work;" that the "injury result[s] in permanent restriction, total or partial loss of function of a part or member, or permanent facial, head, or neck disfigurement;" and that the January 4, 2008 accident was "the competent producing cause of the injury . . . sustained." ECF Docket # 30-5 & 31, Pl. Exhs. E., H., Neystat Workers Compensation Forms 1/21/09-11/2/2009.
D. Dr. Kuhn and Treatment (June 2009 to Present)
While seeing Dr. Neystat, plaintiff also began to see Doctor Daniel Kuhn, M.D. ("Dr. Kuhn"), a New York State certified psychiatrist and Diplomat of the American Board of Neurology. ECF Docket # 30, Pl. Exh. A. at 1-4, Kuhn Affidavit. Dr. Kuhn originally saw plaintiff on June 3, 2009 for the first of three 75-minute intake examinations, which formed the basis for an "Initial Neuropsychiatric Evaluation Report," dated July 13, 2009.*fn16 See Pl. Exh. A., Kuhn Initial Neuropsychiatric at 1. During the three sessions, in addition to interviewing plaintiff and reviewing plaintiff's medical history, records, and test results, Dr. Kuhn performed a Memory Test, Digit Span Tests, Beck Depression Inventory ("BDI"), and the Conner's Continuous Performance Test II ("CPT II"). Id. at 4-5. The Memory Test revealed "impaired short term memory;" plaintiff failed the Digits Span Tests; plaintiff's score of 38 on the BDI indicated a "severe degree of depression[, which] justifies psychotherapy with medication;" and the CPT II indicated "a severe attention disorder, with a pattern similar to that seen in neurological conditions." Id. Dr. Kuhn used the Diagnostic and Statistical Manual of Mental Disorders ("DSM") "multi-axial" system to diagnose plaintiff as totally disabled.*fn17 See id. at 6. Dr. Kuhn diagnosed plaintiff with:
Axis I -- Depressive Disorder, secondary to a traumatic Brain Injury and chronic physical disability. Attention, memory and cognitive disorder, NOS [(not otherwise specified)], Post Traumatic Stress Disorder [("PTSD")].
Axis II -- Personality changes NOS [(not otherwise specified)]
Axis III -- Post Concussion Encephalopathy, Status post Traumatic Brain Injury with a loss of Consciousness, Lumbar disc herniation and lower back pain syndrome
Axis IV -- Patient has financial strssors [sic]
Axis V -- GAF [(Global Assessment of Function Scale)]=50*fn18
Id. Based on plaintiff's medical records, Dr. Kuhn's finding of a "lack of prior contributory and relevant medical history." and the "neuropsychiatric and medical symptoms that developed subsequent to the injury," the doctor "determined with a high degree of medical certainty that the patient's current disability was caused by the injuries" she suffered on January 4, 2008. Id.
The treatment plan proposed and ultimately implemented by Dr. Kuhn included "rehabilitative Psychotherapy, including neurotraining and psychotropic medications as required in order to enhance [plaintiff's] attention, memory and cognitive function, sleep, depression pain tolerance." Id. Notes from weekly appointments between August 6, 2010 and January 6, 2011 reveal that in that time period, Dr. Kuhn prescribed plaintiff a combination of Adderall, Ambien, Cymbalta, Cerafolin, Diazepam, Celexa, and Valium in varying doses. See ECF Docket # 30-7, Pl. Exh. G., Kuhn Workers' Compensation Notes, 8/6/2010-1/6/2011. The notes also reinforce in detail plaintiff's continuing condition: chronic, distracting pain over her body; nightmares, vertigo, and dizziness; diminished capacity or inability to do household chores; a preference for staying at home; difficulty traveling; and profound depression and anxiety. Id. Dr. Kuhn, like plaintiff's other doctors also filed Workers' Compensation Forms, all of which stated that plaintiff's "complaints [were] consistent with his/her history of the injury/illness;" that plaintiff's "history of the injury/illness [was] consistent with [Dr. Kuhn's] objective findings;" and that plaintiff was 100% "temporar[ily] impair[ed]." ECF Docket # 30-7, Pl. Exh. G., Kuhn Workers' Compensation Forms, 9/16/2009-1/6/2011.
E. Current Condition of Plaintiff (As of Early 2011)
Plaintiff never did return to work after the accident and has "not worked at all since that date." Pl. Aff. ¶ 4. According to plaintiff, "I can't work because since the date of the accident, to present, I have headaches while sleeping, insomnia, dizziness. My back hurts when I sit, walk or stand for over 20 minutes. I cannot concentrate mentally. I have poor memory, can't remember daily items, I can't work as a home attendant. I can't lift or push a client patient, I can't cook, vacuum clean, shop for groceries, at work with a client . . . without pain in my back and body, all movement is with great difficulty. . . . I am totally disabled at present." Pl. Aff. ¶¶ 6-7. Plaintiff attempted to return to work in 2009 through a "vocational training" program of the New York University Rusk Institute of Rehabilitation Medicine and again at Omega Health Care, but "[p]laintiff failed at both, couldn't work -- pain back, head, body, etc." Pl. Inter. ¶ 9; see also Pl. Dep. at 118-121. Home life, according to plaintiff, was no easier.
At present my back pain begins when I start walking, carrying, moving, which limits all my activities in life. . . . I can't do anything much for myself or my children. I can't play music/keyboard anymore, I can't take care of myself or my children. I need help for my physical daily activities, I hear voices in my head, I feel that my head is stuffed. . . . I am tired. I nap for hours daily. As I do not have energy. . . . I try to be well and healthy but I can't get better. I feel very old for my age. I am alone, and feel alone from my family and children, and all social activity. . . . I have lost the enjoyment of life."
Pl. Aff. ¶¶ 9-12; see also Pl. Dep. at 121.
As of January 2011, plaintiff was seeing psychiatrist Dr. Kuhn for "brain therapy to calm my nerves and brain," and a physician named Doctor Levinson,*fn19 who "prescribed pain killers for me and and [sic] exercises to stop back pain which I do twice daily." Pl. Aff. ¶ 8. On March 3, 2011, the Social Security Administration adjudged plaintiff to have "been disabled from January 4, 2008, through the date of this decision," and eligible for Social Security Insurance benefits. ECF Docket # 35, Social Security Order of Administrative Law Judge at 2.
F. Procedural History
Plaintiff initially filed her complaint on August 24, 2009 in New York Supreme Court in Kings County. The case was properly removed on the basis of diversity jurisdiction pursuant to 28 U.S.C. § 1332(a) on November 10, 2009. See ECF Docket # 1. On December 29, 2010, defendants filed a motion for summary judgment, plaintiff filed their opposition shortly thereafter, and defendants replied on February 18, 2011. ECF Docket # 34.
A. Legal Standard
Summary judgment under Rule 56(c) of the Federal Rules of Civil Procedure "is warranted when, after construing the evidence in the light most favorable to the nonmoving party and drawing all reasonable inferences in its favor, there is no genuine issue as to any material fact." Sledge v. Kooi, 564 F.3d 105, 108 (2d Cir. 2009) (citing Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 247-50, 255 (1986)). The party opposing summary judgment must set forth evidence demonstrating a genuine issue for trial, and may not rely only on allegations in its pleadings. Salahuddin v. Goord, 467 F.3d 263, 273 (2d Cir. 2006) ("[T]he non-movant cannot rest on allegations in the pleadings and must point to specific evidence in the record to carry its burden on summary judgment."). "[C]onclusory statements, conjecture, or speculation by the party resisting the motion will not defeat summary judgment." Kulak v. City of New York, 88 F.3d 63, 71 (2d Cir. 1996).
B. New York No-Fault Insurance Law
1. General Principles
State law governs diversity actions and there is no dispute that New York law governs this case. Erie R. Co. v. Tompkins, 304 U.S. 64 (1938). Defendants do not move for summary judgment on the issue of liability, and rightfully so given the highly factual nature of the accident and disagreements over what actually occurred. See, e.g., Mangual v. Pleas, No. 02 Civ. 8311(CBM), 2004 WL 736817, at *3 (S.D.N.Y. Apr. 6, 2004) (Motley, J.) ("Sharp conflicts of evidence . . . regarding the circumstances of a vehicle collision present questions of fact and credibility that properly belong to the jury.") (citing Campbell v. Driscoll, 593 N.Y.S.2d 549, 549 (N.Y. App. Div. 1993)). Instead, defendants argue that summary judgment should be granted because plaintiff did not sustain a "serious injury," as defined under New York's No Fault Insurance Law, N.Y. Ins. Law § 5102(d) (McKinney 2006).
Under New York's No Fault Insurance Law, there is no right to recovery in tort for non-economic loss resulting from an automobile accident unless a covered person sustained a "serious injury." N.Y. Ins. Law § 5104(a) (McKinney 2009).*fn20 Whether the claimed injury is "serious" is a threshold matter of law for the court to decide. Licari v. Elliott, 441 N.E.2d 1088, 1091 (N.Y. 1982) ("It is incumbent upon the court to decide in the first instance whether plaintiff has a cause of action to assert within the meaning of the statute.").
There are nine distinct categories of "serious injury" under New York law, only three of which are claimed by plaintiff here and thus relevant to the instant action. A personal injury is considered "serious" under New York law when it "results in . . . [(1)] permanent loss of use of a body organ, member, function or system [(hereinafter "permanent loss claim")]; . . . [(2)] significant limitation of use of a body function or system [(hereinafter "significant limitation claim")]; or [(3)] a medically determined injury or impairment of a non-permanent nature which prevents the injured person from performing substantially all of the material acts which constitute such person's usual and customary daily activities for not less than ninety days during the one hundred and eighty days immediately following the occurrence of the injury or impairment [(hereinafter "90/180 claim")]." N.Y. Ins. Law § 5102(d). "Serious injure[ies]" are not limited to physical injuries alone: "[A] causally-related emotional injury, alone or in combination with a physical injury, can constitute a serious injury . . .." Taranto v. McCaffrey, 835 N.Y.S.2d 365, 366 (N.Y. App. Div. 2007) (emphasis added) (internal quotations and citations omitted).
Where, as here, the defendant moves for summary judgment for lack of "serious injury," the Court must engage in the familiar "burden-shifting scheme," recently endorsed by the Second Circuit:
[A] defendant must establish a prima facie case that plaintiff did not sustain a "serious injury" within the meaning of Insurance Law § 5102(d). In support of its argument that there is no such serious injury, defendant may rely on the unsworn reports by plaintiff's physicians, but must provide evidence from its own physicians in the form of sworn affidavits. Once a defendant's burden is met, the plaintiff is then required to establish a prima facie case that he sustained a serious injury. For plaintiff to defeat a summary judgment motion, admissible evidence must be presented in the form of sworn affidavits by physicians.
Yong Qin Luo v. Mikel, 625 F.3d 772, 777 (2d Cir. 2010) (quoting Barth v. Harris, No. 00 Civ. 1658(CM), 2001 WL 736802, at *2 (S.D.N.Y. June 25, 2001) (McMahon, J.)). Once a defendant has discharged his prima facie burden, no matter the underlying category of claimed "serious injury," a "Plaintiff must present objective proof of injury, as subjective complaints of pain will not, standing alone, support a claim for serious injury." Id. at 777. Nevertheless, plaintiff's subjective evidence and complaints are not irrelevant and may be considered alongside objective evidence to determine whether plaintiff raises a genuine issue of material fact as to "serious injury." Id. at 778.
2. Evidence Presented
In support of their motion for summary judgment, defendants proffer, in pertinent part, plaintiff's deposition, plaintiff's Lutheran records, various unsworn medical records of plaintiff, and sworn reports of two of its own physicians: Radiologist, David A. Fisher, M.D. ("Dr. Fisher"), ECF Docket # 34-2 at 27-28, Def. Exh. H. ("Fisher Report"), and Board Certified Neurologist, Jerome M. Block, M.D. ("Dr. Block"), ECF Docket # 34-2 at 12-25, Def. Exh. G. ("Block Report").*fn21
Dr. Fisher reviewed the MRI of plaintiff's cervical spine taken on April 2, 2008 and the MRI of plaintiff's lumbar spine taken on March 16, 2009. See Fisher Report. Dr. Fisher did not conduct any physical examination of plaintiff and the record does not indicate that he reviewed any other medical records. See id. Regarding the cervical spine, Dr. Fisher concluded:
There is clear evidence of degenerative changes throughout . . . most pronounced at the C5/6 and C6/7 levels. These changes are unlikely to have developed in the short interval between the accident and the study and in my opinion represent a pre-existing condition. . . . The disc bulges noted are compatible with the amount of degenerative change present.
Id. at 1 (emphasis added). Regarding the lumbar spine, Dr. Fisher concluded:
The disc herniation noted at L1/2 is compatible with the amount of degenerative change present. This is non-specific and could be traumatic or degenerative in nature.
Id. at 2 (emphasis added).
Dr. Block conducted a full physical and neurological examination of plaintiff in May 2010 and reviewed plaintiff's medical records and doctor's reports described at length, supra Part
I. Dr. Block conducted ROM testing on plaintiff's cervical and lumbar spine, as well as her legs and concluded:
With bilateral straight leg raising at 90 degrees she reports some mild ache in the popliteal space of either leg. Her spinal curvatures are well preserved. She showed full and painless cervical and lumbar ranges of motion except for report of discomfort with full lumbar extension. I find no evidence of paravertebral muscle spasm, trigger points, elicitable Tinel's sign over the superficial nerves, pain over sciatic nerves, notches or brachial plexii. Function of the autonomic nervous system is entirely normal . . ..
Block Report at 8. He further noted that during the examination, plaintiff . . .
. . . showed no signs of pain or discomfort. Her movements were easy in sitting, rising, turning and looking about the room. There was no pain on palpation of multiple muscle groups. . . . She showed supple and full ranges of motion through the spinal column.
Id. at 8. Dr. Block found "no evidence of fibromyalgia," no evidence of any nervous system dysfunction, "no objective evidence of neurological dysfunction," "no sign of traumatic brain injury," and "no continuing neurological abnormality." Id. Dr. Block did not rule out post-concussion syndrome, noting that "[a]ny concussive injury would have been mild. If present at all, symptoms would long since have resolved." Id. As to plaintiff's depression, Dr. Block conceded that "[t]here may be some posttraumatic depression," but then opined that the depression "may well have" been due to plaintiff's divorce and having to yell at her children occasionally. Id.
In opposition to defendants' motion for summary judgment, plaintiff submits her own sworn affidavit, as well as the sworn affidavits of Drs. Miller, Neystat, and Kuhn, incorporating the findings and conclusions of all of their medical records and workers' compensation forms described at length, supra Part I.
C. "Serious Injury" Claims 1. Permanent Loss
Plaintiff asserts that her cervical and lumbar spine injuries, head injuries, emotional injuries, and her ongoing pain and various other symptoms constitute a "permanent loss of use of a body organ, member, function or system." N.Y. Ins. Law § 5102(d); Opp. Mem. ¶ 2; Compl. ¶ 19-20. Dr. Block's report, based on his thorough review of plaintiff's medical record, as well as his physical examination, is sufficient to show prima facie that plaintiff's alleged physical injuries were not permanent in nature. The physical examination revealed full ROM in the lumbar and cervical spine with minimal pain, no evidence of any "traumatic brain injury," and at least no "continuing" neurological problems. Block Report at 8.However, defendants failed to show prima facie that plaintiff's depression and other emotional injuries are not permanent. Dr. Block acknowledged, based upon an examination he conducted more than two years after the accident, "[t]here may be some posttraumatic depression" and gave no indication when or if plaintiff's depression would ever subside.*fn22 Id. Even so, plaintiff submitted sufficient admissible, objective, and recent proof to show prima facie that all of her alleged injuries, including depression, may be permanent in nature so as to defeat summary judgment.
To prove permanence, "it is not necessary to prove a total loss of the affected function or system, but it is still necessary to submit proof that it operates in some limited way, or operates only with pain." Booker v. Miller, 685 N.Y.S.2d 837, 837 (N.Y. App. Div. 1999) (internal quotations omitted); see also Paolini v. Sienkiewicz, 691 N.Y.S.2d 836, 837 (N.Y. App. Div. 1999) ("When permanence is shown, the significance of the resulting curtailment is not material . . . as long as it involves some actual limitation of use.") (internal quotations omitted). "[P]ermanent pain, even of an intermittent character, may form the basis of a 'serious injury . . ..'" Dwyer v. Tracey, 480 N.Y.S.2d 781, 781 (N.Y. App. Div. 1984). Nevertheless, in order to show prima face permanent loss of use under an intermittent pain theory, a "plaintiff's pain [must be] more than minor or involve[] at least some restriction of motion." Barth, 2001 WL 736802 at *11 (citing, among other cases, Cole v. United States, No. 85 Civ. 5295 (BN)(KTD), 1986 WL 5805, at *8 (S.D.N.Y. May 16, 1986) (Newman, J.) (finding prima facie showing by plaintiff where there was mild impairment and restriction of movement in addition to pain). Moreover, to prove permanence, plaintiff must not rely solely on past evaluations as "a recent medical examination substantiates, or, at the very least, purports to substantiate, that portion of a plaintiff's serious injury claim which alleges some sort of permanent or significant injury-that is, an injury which has an extended duration element." Troutovski v. Sitnir, 687 N.Y.S.2d 534, 535 (N.Y. Civ. Ct. 1999) (emphasis in original). "Conversely, the absence of proof of a recent medical examination leaves an important evidentiary vacuum in a plaintiff's opposition to a motion for summary judgment, where the plaintiff is claiming some form of permanent or significant injury." Id.
Here, plaintiff, through the sworn affidavits of three doctors, proffers MRIs showing disk herniation and bulging, the existence of which was confirmed by defendants' own medical expert, Dr. Fisher. See Fisher Report at 1-2.*fn23 Although the existence of herniated and/or bulging disks confirmed by MRIs alone are insufficient "without additional objective medical evidence establishing that the accident resulted" in a permanent injury, Pommells v. Perez, 4 N.Y.3d 566, 574 (N.Y. 2005), plaintiff has also submitted relatively recent (September 2009) ROM testing by Dr. Neystat's office which showed continued significant limitations nearly two years after the accident. Pl. Exh. E., 9/10/2009 Physical Therapy Follow-Up Report at 2. Dr. Neystat's workers' compensation records, as recent as November 2009, indicated that plaintiff's injuries were "permanent." Pl. Exh. E., Neystat Workers' Compensation Forms, 11/2/2009. Based on recent objective physical and psychiatric testing, Dr. Kuhn diagnosed plaintiff with-among other injuries-"depressive disorder, secondary to traumatic brain injury and chronic physical disability," as well as "post-concussion encephalopathy, status post traumatic brain injury with a loss of consciousness. Pl. Exh. A., Kuhn Initial Neuropsychiatric at 6. Although defendants note that Dr. Kuhn's initial psychological evaluation indicates that at least as of July 13, 2009, the duration of plaintiff' disability was "[u]ndetermined," Id., Dr. Kuhn's weekly treatment notes reflect that plaintiff was still experiencing near-constant and severe pain throughout her body and ongoing depression and anxiety at least through January 2011. See Pl. Exh. G., Kuhn Workers' Compensation Notes, 8/6/10-1/6/2011. Dr. Kuhn never ruled out permanency. See id. The foregoing objective evidence in combination with plaintiff's subjective complaints of ongoing, permanent, and severe physical and emotional injuries is sufficient to show prima facie that plaintiff has suffered "serious injure[ies]" to survive summary judgment on her Permanent Loss Claim.
2. Significant Limitation Claim
Plaintiff additionally asserts that her alleged injuries constitute a "significant limitation of use of a body function or system." N.Y. Ins. Law § 5102(d); Opp. Mem. ¶ 2; Compl. ¶ 20. For substantially the same reasons just discussed, supra Part II.C.1, Dr. Block's report is both sufficient to show prima facie that plaintiff's alleged physical injuries did not result in a "significant limitation," yet insufficient to show prima facie that plaintiff's alleged depression and other emotional injuries did not result in a "significant limitation." In any event, plaintiff has again submitted admissible and objective proof to show prima facie that all of her alleged injuries has resulted in "significant limitation," sufficient to defeat summary judgment.
In order to show prima facie "significant limitation" a plaintiff must prove "significant limitation in both degree and duration." Gualtieri v. Farina, 283 F.Supp.2d 917, 925 (S.D.N.Y. 2003) (Conner, J.) (granting summary judgment where plaintiff proved degree, but not duration of the significant limitation) (citing Petrone v. Thornton, 561 N.Y.S.2d 49, 50 (N.Y. App. Div. 1990)); see also Jones v. United States, 408 F.Supp.2d 107, 120 (E.D.N.Y. 2006) (Azrack, J.) (granting summary judgment where "plaintiff's neck and back functions were both slight and short-term.") (emphasis added). "[T]he word 'significant' . . . should be construed to mean something more than a minor limitation of use. . . [A] minor, mild or slight limitation of use should be classified as insignificant within the meaning of the statute." Licari, 441 N.E.2d at 1091.
Soft tissue injury claims-i.e. herniated and bulging lumbar and cervical disks- "commonly fall" under the "significant limitation" category. Pommells, 4 N.Y.3d at 571. "In order to prove the extent or degree of physical limitation, an expert's designation of a numeric percentage of a plaintiff's loss of range of motion can be used to substantiate a claim of serious injury." Toure v. Avis Rent A Car Sys., Inc., 774 N.E.2d 1197, 1200 (N.Y. 2002). "While there is no set percentage for determining whether a limitation in range of motion is sufficient to establish 'serious injury,' the cases have generally found that a limitation of twenty percent or more is significant for summary judgment purposes." Hodder v. United States, 328 F.Supp.2d 335, 356 (E.D.N.Y. 2004) (Pollak, J.) (citing cases).
Here, plaintiff tenders admissible evidence to show both the degree and duration of her soft tissue injuries. Plaintiff's MRI and EMG findings, in combination with detailed ROM testing executed over the course of nearly two years by two different doctors, evidencing losses in ROM of consistently greater than 20%, are more than sufficient to discharge plaintiff's prima facie rebuttal burden. See, e.g., Tenzen v. Hirschfeld, No. 10-cv-50, 2011 WL 6034462, at *7 (E.D.N.Y. Dec. 5, 2011) (Glasser, J.) ("[S]pecific, numeric measurements of [plaintiff's] loss of range of motion as a result of the accident . . . [t]aken together with evidence of a herniated disk recorded by the MRI . . . raise[d] genuine issues of material fact."); Persaud v. URS Midwest, Inc., No. 06 CV 3119(JG)(JMA), 2007 WL 4556908, at *7 (E.D.N.Y. Dec. 21, 2007) (Gleeson, J.) (finding sufficient to survive summary judgment MRI evidence of herniated disc in combination with sworn "test results showing that over time [plaintiff's] range of motion of the cervical and lumbar spine diminished to a significant degree"). That plaintiff's doctors' objective ROM findings shifted and varied over time and were also inconsistent with Dr. Block's findings, only further "supports the conclusion that summary judgment would be inappropriate at this time." Ahmed v. H E Transp., Inc., No. 06 CV 2938(CLP), 2008 WL 520244, at *10 (E.D.N.Y. Feb. 26, 2008) (Pollak, J.). These objective findings, in combination with plaintiff's subjective complaints of pain and inability to work, study, or perform household chores, show that plaintiff has raised a triable issue of fact as to "significant limitation."
Plaintiff has also proven a degree and duration of emotional injury sufficient to defeat defendants' summary judgment motion. Plaintiff was diagnosed by Dr. Miller as early as January 2008 and by Dr. Neystat in January 2009 with depression and anxiety as a result of the accident. Although these diagnoses are arguably insufficient as they were not based on any explicit objective testing, Dr. Kuhn's more recent, detailed diagnoses of severe emotional trauma in mid-2009, which confirmed Dr. Miller's and Neystat's observations, as well as plaintiff's complaints, were based upon wide-ranging objective testing taking place over the course of three 75-minute examination periods. Cf. Villeda v. Cassas, 871 N.Y.S.2d 167, 168 (N.Y. App. Div. 2008) (finding plaintiff failed to raise triable issue of fact as to emotional harm where diagnosis was "based only upon the plaintiff's subjective complaints, as all admissible objective test results were normal or inconclusive."). According to Dr. Kuhn's records, Plaintiff's emotional injuries not only lasted to at least January 2011, but were still very severe at that point. See Pl. Exh. G., Kuhn Workers' Compensation Notes, 1/6/2011. For the foregoing reasons, plaintiff has carried her burden to show prima facie that she has suffered serious emotional injuries to survive summary judgment under her Significant Limitation claim.
3. 90/180 Claim
Lastly, plaintiff asserts that her injuries "prevent[ed] [her] . . . from performing substantially all of the material acts which constitute such person's usual and customary daily activities for not less than ninety days during the one hundred and eighty days immediately following the occurrence of the injury or impairment." N.Y. Ins. Law § 5102(d); Opp. Mem. ¶ 2; Compl. ¶ 20. Defendants have failed to discharge their prima facie burden to disprove this claim. Dr. Block's report only speaks to the condition of plaintiff in May 2010, two and one-half years after the subject accident, "not plaintiff's condition during the six months immediately after the accident." Quinones v. Ksieniewicz, 915 N.Y.S.2d 70, 71 (N.Y. App. Div. 2011) ("[D]efendants failed to establish prima facie that plaintiff did not sustain [90/180 injury]" where "[t]he reports of defendants' medical experts were based on examinations of plaintiff conducted nearly two years after the subject accident.").
Nevertheless, defendants argue that plaintiff's 90/180 claim should be dismissed because plaintiff "was enrolled as a full-time student for 74 of the first 90 days immediately following the accident," and "[s]ince the accident . . . completed a day-long orientation seminar . . . and a vocational training program . . .." Def. Reply. at 4-5. First, under New York Insurance Law, plaintiff need not show that she was prevented from "performing substantially all" customary material activities for the first ninety days immediately subsequent to the accident; rather, she only need show that such circumstances existed for "not less than ninety days during the one hundred and eighty days immediately following the occurrence." N.Y. Ins. Law § 5102(d) (emphasis added). Even if plaintiff's school attendance were sufficient in itself to disprove her 90/180 claim, there is no dispute that she withdrew from school following the semester and thus for at least ninety days during the first one hundred and eighty days following the accident did not attend school. Second, plaintiff's attempts to return to the work force as evidenced by the Omega Health Care orientation and vocational training through the Rusk Institute, both occurred in 2009, long after "one hundred and eighty days immediately following the occurrence." N.Y. Ins. Law § 5102(d). These failed attempts to return to work are thus irrelevant to this claim.
Lastly, defendants attempt to characterize plaintiff's alleged inability to work during the first one-hundred-and-eighty days as an inability only "to continue the job she previously held [because] [t]he woman she had been assisting had moved into a nursing home, rendering plaintiff's previous job unavailable." Def. Reply at 5. However, plaintiff's sworn workers' compensation records from three different doctors all confirm that plaintiff's disability was "total" and that she was unable to do "any type of work." Yet even if defendants had discharged their prima facie burden, plaintiff has again submitted sufficient admissible and objective proof to show prima facie that defendants' motion for summary judgment should be denied on this claim.
In adjudicating a 90/180 claim, "the words 'substantially all' should be construed to mean that the person has been curtailed from performing his usual activities to a great extent rather than some slight curtailment." Licari, 441 N.E.2d at 1091. A plaintiff's inability to work, whether or not she can perform other "usual activities" is sufficient alone to make out a prima facie 90/180 claim. See Mercado v. Lee, No. 04 Civ. 7166(PGG), 2008 WL 4963985, at *5 (S.D.N.Y. Nov. 21, 2008) (Gardephe, J.) ("[A]n inability to work is a limit on 'substantially all' of a plaintiff's customary activities . . .."). Nevertheless, plaintiff's claimed inability to work must be substantiated by objective medical evidence. Jackson v. New York City Trans. Auth., 708 N.Y.S.2d 469, 470 (N.Y. App. Div. 2000) ("[P]laintiff's self-serving affidavit stating that she was unable to return to work . . . without a physician's affidavit substantiating the existence of a medically determined injury which caused the alleged limitation of her activities [i]s insufficient" to make out a 90/180 claim); see also Tenzen, 2011 WL 6034462 at *8 (no 90/180 showing where "[p]laintiff did not submit any medical evidence that she [wa]s unable to conduct ordinary activities or must restrict her physical activities in any way.").
Here, Dr. Miller's affidavit and supporting documentation incorporated by reference is more than sufficient to support a prima facie 90/180 claim. Dr. Miller saw plaintiff five days after the accident, ordered plaintiff to attend physical therapy, ordered plaintiff to refrain from "heavy work," and soon after affirmed that she was unable to do any work. Dr. Kuhn saw plaintiff regularly over the course of the first one hundred and eighty days post-accident and continued to reinforce his diagnoses and treatment plan. Furthermore, plaintiff testified (through her deposition and affidavit) that she did not and could not return to work and was severely limited in her daily activities for ninety of the first "one hundred and eighty days immediately following the occurrence" to the present. Compare Yong Qin Luo, 625 F.3d at 778 (denying summary judgment where plaintiff provided proof that doctor "limited plaintiff's return to work to light duty[,] . . . [p]laintiff attended physical therapy for at least three months following the surgery[,] . . . and plaintiff testified that "she was unable for a number of months following the accident to, inter alia, return to work, leave her home, attend continuing education and English classes, and engage in other normal activities . . ..") (emphasis added); with Licari, 441 N.E.2d at 1092 (grating summary judgment where "it is undisputed . . . that plaintiff returned to work 24 days after the accident and that upon his return he immediately resumed his usual schedule . . . was able to maintain his daily routine for most of each day after returning to work . . . [and] offered no proof that his ['occasional, transitory'] headaches in any way incapacitated him or interfered with his ability to work or engage in activities at home."); Tenzen, 2011 WL 6034462 at *8 ("[Plainitff's] usual activities were impeded slightly . . . [she] returned to work the day after the accident, was not absent any days during the first 180 days following the accident, and continues to maintain her position as a retail administrator."); Pierre v. Nanton, 719 N.Y.S.2d 706, 706 (N.Y. App. Div. 2001) ("Although the plaintiff claimed that he did not work for almost four months after the accident [as a result of disc herniation], he was not ordered by a doctor to stay home.") (emphasis added).
For the foregoing reasons, plaintiff has carried her burden to show prima facie that she has suffered "serious injure[ies]" under a 90/180 claim.
4. Causation
Defendants argue that even if plaintiff proffered sufficient evidence to show prima facie "serious injury" plaintiff's injuries are not the result of the accident. "Even where there is objective medical proof, when additional contributory factors interrupt the chain of causation between the accident and claimed injury-such as . . . a pre-existing condition-summary dismissal of the complaint may be appropriate." Pommells, 4 N.Y.3d at 572.
Defendants proffer Dr. Fisher's MRI findings to show that plaintiff's conditions were degenerative in nature and not caused by the accident. However, the New York Court of Appeals has already held that a defendant's allegations of a pre-existing condition based solely upon the defendant's radiologist's "conclusory notation" of a degenerative condition following review of an MRI and nothing more is "itself insufficient to establish that plaintiff's pain might be chronic and unrelated to the accident." Id. at 577-79, 580 (comparing another joined case, in which defendants proffered "persuasive" evidence of "pre-existing degenerative disc condition" where defendants' expert had "physically examin[ed] plaintiff and review[ed] prior medical records, including MRI's and x-rays" and plaintiff's own treating physician found degenerative conditions) (emphasis added); see also Gay v. Cevallos, No. 10 Civ. 949(LMM), 2011 WL 2015528, at *5 (S.D.N.Y. May 17, 2011) (McKenna, J.) (finding pre-existing condition where defense experts, based upon review of both MRI and physical examination, found degenerative condition, and both of plaintiff's experts conceded the existence of degenerative condition).
Moreover, Dr. Fisher's findings are themselves inconclusive on the issue of causation and thus have the opposite affect intended by defendants: they actually raise a material issue of fact for trial. Dr. Fisher opined only that it is "unlikely" that the changes in the cervical spine had "developed in the short interval between the accident and the study," and that the lumbar disc herniation "is non-specific and could be traumatic or degenerative in nature." Fisher Report at 1-2 (emphasis added). Similarly, Dr. Block did not rule out the possibility that plaintiff's depression was caused by the accident. See Block Report at 8 ("There may be some posttraumatic depression.") (emphasis added). Where, as here, the defendants have not proffered persuasive and/or conclusive evidence of pre-existing condition, the plaintiff is "not obliged" to specifically rebut defendants' contention. Cf. Valentin v. Pomilla, 873 N.Y.S.2d 537, 538 (N.Y. App. Div. 2009) (finding prima facie lack of causation where MRI revealed "no evidence of post-traumatic injury to the disc structures" and both of plaintiff's experts found "pre-existing degenerative changes"); Gay, 2011 WL 2015528 at *3 (prima facie lack of causation where MRI and physical examinations "showed nothing more than pre-existing pathology[,]" "could not be attributed to a single accident[,]" "were considerably more long-standing than three to four weeks in duration," and revealed "no evidence of trauma-related derangement").
Defendants, however, claim that plaintiff's experts' opinions as to causation are merely "conclusory" and solely based on plaintiff's subjective complaints. See Def. Reply at 9-15. "Absent an explanation of the basis for concluding that the injury was caused by the accident, as opposed to other possibilities evidenced in the record, an expert's conclusion that plaintiff's condition is causally related to the subject accident is mere speculation, insufficient to support a finding that such a causal link exists." Valentin, 873 NY.S.2d at 539. However, plaintiff's experts' opinions on causation were based on thorough, objective, and repeated physical and neurological examinations, review of MRIs, and other diagnostic tests and medical records. These examinations and reviews confirmed, rather than relied solely upon, plaintiff's statements that she had no relevant past medical history, surgeries, or pre-existing conditions, which already comported with the findings of Lutheran upon intake and the fact that the plaintiff had not previously taken any medications. See supra note 2 and accompanying discussion.
The fact that plaintiff did not see Dr. Kuhn "until a year and a half after the accident," does not mean that Dr. Kuhn "may not give an opinion as to the causation of the alleged lumbar herniated disc or alleged psychological injury," Def. Reply at 9, as defendants urge. To the contrary, the time-lapse between an accident and a doctor's conclusions of the seriousness and/or causation of injuries does not diminish the force of the doctor's findings where they are "based not only on . . . physical examinations, but on review of the medical records made in connection with his alleged injuries." Barth, 2001 WL 736802 at *3 (two year time lapse). Such is the case here.
For the foregoing reasons, defendants' motion for summary judgment is DENIED.
RAYMOND J. DEARIE United States District Judge
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Soon even more new shops will open at Stockholm Arlanda Airport, with fashion, home furnishings, exclusive perfumes and the latest in technology on offer.
In mid-December, the variety of shopping options at Stockholm Arlanda will be further enhanced, when a large new shopping area opens in Terminal 5. You can shop here for home furnishings and fashion from the New England-inspired brand Lexington. At Samsung, you'll find smartphones, tablets, cameras, computers and mobile accessories. There will also be space for wellness products and a wine shop.
If you like luxury scents, you can find your favourites in the perfume section. An assortment of unusual niche scents from exclusive brands such as Xerjoff, L'Artisan Parfumeur, Penhaligon's, Rallet, Tiziana Terenzi, Bond N°9 and The Different Company will be on offer.
The new shopping area has about 650 square metres of space and is located in the area for Gates 1-10 in Terminal 5.

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Yes! Thank you to all who supported me in this cause. Can't wait to meet you at the screening.
True journalism and political bias do not go together, as the latter tries to fit the facts to a narrative rather than letting the facts tell their own story.
Unfortunately, with the exception of some dining and entertainment stories this might be the only un-biased article I have read in the Independent over the last year. Your editorial staff might think that provides a balance to the other news sources in town, but frankly it just drags you down to their level.
They should have been protesting the lack of good candidates.
I, too, believe the prediction to be accurate, but the GOP has set themselves up for the perfect designated survivor situation to occur, and with our luck, the MORON Ben Carson would be the only one left to run the government. To leave you with a bit of bittersweet humor that I saw on FB, Now that Trump has been elected as President, we are all waiting for Aston Kutcher to pop out and say we all just got punked.
Prediction professor who called Trumps big win also made another forecast: Trump will be impeached
I'm going to make another prediction, he said. This one is not based on a system, it's just my gut. They don't want Trump as president, because they can't control him. He's unpredictable. They'd love to have Pence an absolutely down the line, conservative, controllable Republican. And I'm quite certain Trump will give someone grounds for impeachment, either by doing something that endangers national security or because it helps his pocketbook.
So the same generation that loved "The Hunger Games" books and movies now wants to get rid of the electoral college? Talk about a lack of critical thinking skills. And this is the real problem with participation trophies, you have to learn how to lose when you are a child. Great job public school system, you have created an entire generation of entitled people that now have to learn how to lose much later in life.
Calling the majority of people who use the incline "hikers" strains credibility. Actual hikers in Colorado will yield to others who are hiking uphill, respect rules regarding dogs, wear appropriate footwear for hiking, and not travel in large groups carrying on loud conversations that can be heard hundreds of feet down the trail as if they were at the mall. Since so many incline users aren't able to comply with the signs at the Barr Trail lot and park elsewhere, the city should continue to raise the fee for this lot and give the rebate to those who go to Barr Camp. This is, after all, the Barr Trail parking lot, not the incline, Ute Pass, Cameron's Cone, Pike National Forest parking lot.
TAKE BACK THE VOTE: Electoral College: Make Hillary Clinton President on December 19
Love you Jene!
Agree they proved how "smart" they are. They proved too why the preservation of our way of life depends on charter schools and vouchers to provide valid education to the next generation about how precious our form of republican govt is to the preservation of personal liberty and freedom. A lack of being taught about WHY America's founding fathers - rebels, every one of them - broke away from England, and a lack of knowledge about our Constitution and republican form of govt results in the production of educated dimwits. The People are fed up with the political status quo. The People are fed up with surrendering our sovereignty. The People are fed up with socialist policies. And that's why Trump, regardless of his politically incorrect comments, was elected President.
Good for them. They proved how smart they are, so maybe not all is lost. Let them go forth and be our future! Unlike the porrly educated who voted for bluster and empty promises over substance.
As always, thank you Pam Zubeck and the Independent. You have our gratitude for your commitment to the story of Strawberry Fields. It's not over yet!
So glad the scab is off the wound! Trump is the quintessential American. These guys are all over Paris London Moscow. ..I tend to put public figures on a pedestal. But trump is a lot like me it turns out...hmmm...I've grabbed girls with impunity I've been racist in jest which is no better. Finally, we men can say YES! I AM A MAN, I AM OFTEN INAPROPRIATE, I AM SAVAGE! I AM A HUNTER OF THINGS AND PRAISE!
The people elected their ilk.
Then they all killed each other...
Liberal school with a bunch of spoiled liberal babies that can't except the fact that they lost! It's a life lesson morons, you can't get everything you want!
the hillbilly goobers did rise up... now they will all want tictac's and will want to grab...things. they will soon see that gump will do nothing for them, except the rough talk they enjoy. the riots have already started... this is not going to be a positive time in American history. the rich gump supporters will also soon see that he will do nothing for them either... this is going to be interesting to see the repubs reaction to what they created...
Most people coming south from Canada aren't coming here looking for handouts and freebies. Big Diff. #TooEasy
[url="http://thanksgivingwallpapers.org/"]Happy Thanksgiving Pictures 2016[/url]
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Incredible article Nat Stein!!! Thank you for reporting on this.


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Circa 1940's Triari petalette bird pin with pink glass wings. The pin measures 1 3/8" x 1". This piece is not signed but it is from the petalette series by Alfred Philippe for Trifari. There is wear to the gold plating, otherwise condition is good.
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Thank you for sharing this article. I have been using Arnica 30c for wrinkle prevention and it has worked very well so far, I also believe that it helps with many other health issues even for Rosacea and stomach ulceration (but maybe effects vary from person to person?) Kind regards from Austria
Unfortunately, I don't think that arnica works on scar tissue. You could try Bio-Oil - read Stephanie's post here
Hi Claire,
Do you know if this, or any other product works on scars or insect bites that leave a discoloration or slightly darker pigment in the skin? Like those small brownish dots or marks on the ankles or wrists or legs due to things like fading scars, bites, bruises, scratching, or recovering popped blisters? Thank you. They're nothing too major, but small things add up, and it's annoying to have little spots and dots everywhere. Looks like fading eczema or something.


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1pm: Lancashire are all out at Old Trafford, but not before picking up a four batting points, writes Richard Rae. Resuming on 261-5, they quickly lost Luke Sutton, edging a catch behind off a Chris Tremlett delivery that bounced a bit, and Glenn Chapple pushing forward at David Balcombe and giving second slip catching practice. Francois Du Plessis became the fourth Lancashire batsman to get a half-century when he tucked Tremlett off his legs to the square leg boundary (142 balls) but was then leg before well forward to James Tomlinson. It swung back in enough to just about justify the decision. At that stage Lancs were 294-8 and in danger of missing out, but Dominic Cork took 14 off a Tahir over, and Gary Keedy gave him good support in taking the total to 341 before Cork's flat-footed flail at Tomlinson gave Nic Pothas another catch behind. Keedy and Saj Mahmood took them past the 350 before Keedy's slog sweep at Tahir was caught by David Balcombe on the midwicket boundary.
It's cloudy and muggy here, and you'd have to back the Lancs bowlers to get more movement than their Hampshire counterparts. A good crowd is anticipating as much anyway. Question: is there a crowd anywhere in the country with a greater proportion of those intensely irritating individuals who respond to every appeal with an entirely unfunny shouted 'witticism'?
1.05pm: Torture by swing continued at Trent Bridge this morning, writes Mike Averis Or rather, it did while Charlie Shreck was bowling. The lanky Cornishman cut down his pace to not much more than military medium to take three more wickets today for his second 'five for' of the season.
Yorkshire's nightwatchman, Matthew Hoggard was the first to suffer. His first two balls swung away late before the third dipped in, catching him on the foot before Andre Adams put an end to the suffering. Hoggard fended, got a thick edge and had his bat under his arm almost before Mark Ealham had the ball in his hands at third slip.
However the Schreck formula was good enough to get rid of Adil Rashid, Gerard Brophy - both lbw - and Rana Naved. Rashid had just hit Shreck through extra cover for his second boundary when the leg-stump yorker caught him trapped on the crease. Brophy got half forward to a length ball, but the yorker was back in action to halt an assault by Naved, rearranging his leg stump.
Schreck's 11 overs had cost 33 - ten coming in one over when Naved hit him into the extra cover stand - and Yorkshire had been reduced to 115 for nine. Tim Bresnan then made best use of the bowling change to shield No 11 Deon Kruis from the attack while reducing Nottinghamshire's lead to 52 at lunch. He's 32 not out off 88 balls. Nottinghamshire 213, Yorkshire 161-9 at lunch
3.45pm Charlie Shreck's morning master class in bowling at Trent Bridge was followed by something less substantial when Yorkshire got their hands on the ball for the second time, writes Mike Averis.
The Yorkshire innings lasted only two balls after lunch - Tim Bresnan the final lbw victim of five - before Nottinghamshire's batsmen got their heads down and applied themselves to extending the first innings lead of 52.
Matthew Wood, top scorer in the first innings and still the only man to have got passed fifty in the match, and Bilal Shafayat made heavy work of it and had taken 11 overs to get to 22 when Matthew Hoggard trapped Wood on the crease. Umpire Jeff Evans, who had turned down two earlier appeals, looked long and hard before giving the former Somerset opener out.
And that was that until tea, when the Nottinghamshire lead was 124. Tim Bresnan had four overs, Rana Naved had five and Deon Kruis seven without causing much of a ripple. Shafayat grew in confidence and Mark Wagh found the boundary five times as they began to push the score along to 72 for one.


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Route Stats
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Via Rhôna - Variante Saint-Vallier > Tain l'Hermitage
La Roche-de-Glun, Auvergne-Rhône-Alpes, France
8km unknown unknown
Via Rhôna - Variante Donzère > Bourg-Saint-Andéol
Bourg-Saint-Andéol, Auvergne-Rhône-Alpes, France
15km unknown unknown
Via Rhôna - Avignon > Tarascon
Beaucaire, Languedoc-Roussillon-Midi-Pyrénées, France
28km unknown unknown
Via Rhôna - Arles > Mas Thibert
Arles, Provence-Alpes-Côte d'Azur Region, France
35km unknown unknown
Via Rhôna - Valence > Avignon
Bourg-Saint-Andéol, Auvergne-Rhône-Alpes, France
161km unknown unknown
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|By Marketwired .
Article Rating:
|July 24, 2014 08:30 AM EDT
MONTREAL, QUEBEC -- (Marketwired) -- 07/24/14 -- Orbite Aluminae Inc. (TSX: ORT)(OTCQX: EORBF) ("Orbite" or the "Corporation") today announced that it will hold a conference call to discuss its fiscal 2014 second quarter results on Wednesday, July 30, 2014 at 10.00 a.m. (ET). Participants will be able to dial in or listen to the call via webcast. The call will be hosted by Glenn Kelly, President & CEO, and Jacques Bedard, CFO. The Company expects to report its financial results for the second quarter that same day prior to markets open.
The call will be held in English. The Q&A session will be in English and French.
CONFERENCE CALL DETAILS: Date: July 30, 2014 Time: 10.00 a.m. (ET) Dial in number: +1 (888) 231-8191 +1 (647) 427-7450 Webcast: http://bit.ly/1sQKJkY Taped replay: +1.855.859.2056 +1 514.807.9274 +1 416.849.0833 Encore password: 78983471 Available until: 12.00 midnight (ET), Wednesday, August 13, 2014
About Orbite
Orbite Aluminae Inc. is a Canadian cleantech company whose innovative and proprietary processes are expected to produce alumina and other high-value by-products, such as rare earth and rare metal oxides, at one of the lowest costs in the industry, and in a sustainable fashion, using feedstocks that include aluminous clay, kaolin, nepheline, bauxite, red mud and fly ash. Orbite is currently finalizing its first commercial high-purity alumina (HPA) production plant in Cap-Chat, Quebec and has completed the basic engineering for a proposed smelter-grade alumina (SGA) production plant, which would use clay mined from its Grande-Vallee deposit. The Corporation's intellectual property portfolio contains 16 intellectual property families, and the Corporation owns the intellectual property rights to 11 patents and 72 pending patent applications in 10 different countries. The first intellectual property family is patented in Canada, USA, Australia, China, and Russia. The Corporation also operates a state of the art technology development center in Laval, Quebec, where its technologies are developed and validated.
Mark Lakmaaker
External Investor Relations Consultant
1-800-385-5451 ext. 248
[email protected]
For Media Inquiries:
Crystal Quast
External Media Relations Consultant
1-800-385-5451, ext. 266
[email protected]
IoT is rapidly changing the way enterprises are using data to improve business decision-making. In order to derive business value, organizations must unlock insights from the data gathered and then act on these. In their session at @ThingsExpo, Eric Hoffman, Vice President at EastBanc Technologies, and Peter Shashkin, Head of Development Department at EastBanc Technologies, discussed how one organization leveraged IoT, cloud technology and data analysis to improve customer experiences and effici...
Dec. 9, 2016 06:45 PM EST Reads: 5,130
Everyone knows that truly innovative companies learn as they go along, pushing boundaries in response to market changes and demands. What's more of a mystery is how to balance innovation on a fresh platform built from scratch with the legacy tech stack, product suite and customers that continue to serve as the business' foundation. In his General Session at 19th Cloud Expo, Michael Chambliss, Head of Engineering at ReadyTalk, discussed why and how ReadyTalk diverted from healthy revenue and mor...
Dec. 9, 2016 06:15 PM EST Reads: 1,759
The 20th International Cloud Expo has announced that its Call for Papers is open. Cloud Expo, to be held June 6-8, 2017, at the Javits Center in New York City, brings together Cloud Computing, Big Data, Internet of Things, DevOps, Containers, Microservices and WebRTC to one location. With cloud computing driving a higher percentage of enterprise IT budgets every year, it becomes increasingly important to plant your flag in this fast-expanding business opportunity. Submit your speaking proposal ...
Dec. 9, 2016 05:30 PM EST Reads: 2,362
In this strange new world where more and more power is drawn from business technology, companies are effectively straddling two paths on the road to innovation and transformation into digital enterprises. The first path is the heritage trail – with "legacy" technology forming the background. Here, extant technologies are transformed by core IT teams to provide more API-driven approaches. Legacy systems can restrict companies that are transitioning into digital enterprises. To truly become a lead...
Dec. 9, 2016 05:30 PM EST Reads: 444
You have great SaaS business app ideas. You want to turn your idea quickly into a functional and engaging proof of concept. You need to be able to modify it to meet customers' needs, and you need to deliver a complete and secure SaaS application. How could you achieve all the above and yet avoid unforeseen IT requirements that add unnecessary cost and complexity? You also want your app to be responsive in any device at any time. In his session at 19th Cloud Expo, Mark Allen, General Manager of...
Dec. 9, 2016 05:15 PM EST Reads: 1,883
The Internet of Things (IoT) promises to simplify and streamline our lives by automating routine tasks that distract us from our goals. This promise is based on the ubiquitous deployment of smart, connected devices that link everything from industrial control systems to automobiles to refrigerators. Unfortunately, comparatively few of the devices currently deployed have been developed with an eye toward security, and as the DDoS attacks of late October 2016 have demonstrated, this oversight can ...
Dec. 9, 2016 05:15 PM EST Reads: 1,460
"MathFreeOn.com is a line coding platform for engineers and scientists. When they want to solve an engineering problem and they have to use software - they have to pay a lot of money for licenses - but with MathFreeOn you don't have to pay a lot of money. Just go to our site and write the code and you can check the result right away," explained Simon Lee, CMO of MathFreeOn, in this SYS-CON.tv interview at 19th Cloud Expo, held November 1-3, 2016, at the Santa Clara Convention Center in Santa Cla...
Dec. 9, 2016 05:15 PM EST Reads: 378
In his session at 19th Cloud Expo, Claude Remillard, Principal Program Manager in Developer Division at Microsoft, contrasted how his team used config as code and immutable patterns for continuous delivery of microservices and apps to the cloud. He showed how the immutable patterns helps developers do away with most of the complexity of config as code-enabling scenarios such as rollback, zero downtime upgrades with far greater simplicity. He also demoed building immutable pipelines in the cloud ...
Dec. 9, 2016 05:00 PM EST Reads: 2,057
As data explodes in quantity, importance and from new sources, the need for managing and protecting data residing across physical, virtual, and cloud environments grow with it. Managing data includes protecting it, indexing and classifying it for true, long-term management, compliance and E-Discovery. Commvault can ensure this with a single pane of glass solution – whether in a private cloud, a Service Provider delivered public cloud or a hybrid cloud environment – across the heterogeneous enter...
Dec. 9, 2016 04:45 PM EST Reads: 1,861
Bert Loomis was a visionary. This general session will highlight how Bert Loomis and people like him inspire us to build great things with small inventions. In their general session at 19th Cloud Expo, Harold Hannon, Architect at IBM Bluemix, and Michael O'Neill, Strategic Business Development at Nvidia, discussed the accelerating pace of AI development and how IBM Cloud and NVIDIA are partnering to bring AI capabilities to "every day," on-demand. They also reviewed two "free infrastructure" pr...
Dec. 9, 2016 04:45 PM EST Reads: 1,290
In his session at Cloud Expo, Robert Cohen, an economist and senior fellow at the Economic Strategy Institute, provideed economic scenarios that describe how the rapid adoption of software-defined everything including cloud services, SDDC and open networking will change GDP, industry growth, productivity and jobs. This session also included a drill down for several industries such as finance, social media, cloud service providers and pharmaceuticals.
Dec. 9, 2016 03:45 PM EST Reads: 586
"Dice has been around for the last 20 years. We have been helping tech professionals find new jobs and career opportunities," explained Manish Dixit, VP of Product and Engineering at Dice, in this SYS-CON.tv interview at 19th Cloud Expo, held November 1-3, 2016, at the Santa Clara Convention Center in Santa Clara, CA.
Dec. 9, 2016 03:30 PM EST Reads: 1,233
"ReadyTalk is an audio and web video conferencing provider. We've really come to embrace WebRTC as the platform for our future of technology," explained Dan Cunningham, CTO of ReadyTalk, in this SYS-CON.tv interview at WebRTC Summit at 19th Cloud Expo, held November 1-3, 2016, at the Santa Clara Convention Center in Santa Clara, CA.
Dec. 9, 2016 03:15 PM EST Reads: 864
Extracting business value from Internet of Things (IoT) data doesn't happen overnight. There are several requirements that must be satisfied, including IoT device enablement, data analysis, real-time detection of complex events and automated orchestration of actions. Unfortunately, too many companies fall short in achieving their business goals by implementing incomplete solutions or not focusing on tangible use cases. In his general session at @ThingsExpo, Dave McCarthy, Director of Products...
Dec. 9, 2016 03:15 PM EST Reads: 980
Infrastructure is widely available, but who's managing inbound/outbound traffic? Data is created, stored, and managed online – who is protecting it and how? In his session at 19th Cloud Expo, Jaeson Yoo, SVP of Business Development at Penta Security Systems Inc., discussed how to keep any and all infrastructure clean, safe, and efficient by monitoring and filtering all malicious HTTP/HTTPS traffic at the OSI Layer 7. Stop attacks and web intruders before they can enter your network.
Dec. 9, 2016 03:00 PM EST Reads: 391


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Potato Salad A La Greco
|2 Pound (Red Bliss Or New)
|Finely chopped onion
|2 Tablespoon
|Finely chopped celery
|2 Tablespoon
|Finely diced green pepper/Red / yellow
|2 Tablespoon
|Kosher dill pickle
|1 , finely chopped
|Hardboiled egg
|1 Teaspoon
|Black pepper
|To Taste
|1⁄4 Cup (4 tbs)
|Granulated sugar
|1⁄4 Teaspoon
|Dry mustard/Dijon
|1⁄2 Pinch
|Cider vinegar
|1 Tablespoon (Or To Taste)
|Pickle juice
|1 1⁄2 Teaspoon
|Sliced black olives/Green olives
|2 Tablespoon
1. Peel potatoes and cook in a large pot of water until tender but firm. Cool potatoes and cut into chunks. In a large bowl, combine potatoes with onion, celery, peppers, chopped pickle, egg, salt, and pepper.
2. In small bowl, make the dressing by whisking together the mayonnaise, sugar, mustard, vinegar, and pickle juice. Add the dressing to the potato mixture. Toss lightly. Garnish with olives, if desired. Chill thoroughly before serving.
Rate It
Nutrition Rank
Nutrition Facts
Serving size: Complete recipe
Calories 1268 Calories from Fat 491
% Daily Value*
Total Fat 55 g84.8%
Saturated Fat 6.1 g30.4%
Trans Fat 0 g
Cholesterol 281 mg93.7%
Sodium 2816.4 mg117.3%
Total Carbohydrates 178 g59.4%
Dietary Fiber 21.9 g87.5%
Sugars 11.9 g
Protein 27 g53.6%
Vitamin A 11.5% Vitamin C 310.9%
Calcium 18.2% Iron 46.2%
*Based on a 2000 Calorie diet


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There are millions of Internet-Servers daily hacked from the same hand full of Hackers.
Every Webmaster has the same problems with Hackers, Intruders, Attackers and Spammers, but nobody is fighting against these Terrorists.
Should that then go on forever?
No, we are fighting against Hackers, Intruders, Attackers, Spammers, Cyber Terrorists and 126.96.36.199!
Sat, 03 Dec 2016 11:33:37 GMT - Actual more as 21.000.000 Hackers in our Database. (The newest 100 are displayed on the Globe and Map)
Detail informations for IP
WebServer Output: http://18.104.22.168
☎ Whois 188.8.131.52
HTML Markup Validation 126.96.36.199
The Web Site Header: 220.127.116.11
Black Listed: 184.108.40.206
Ping to 184.108.40.206
Open Ports on 188.8.131.52
Geo-Location Information 220.127.116.11
Tor lookup for IP 188.8.131.52
Reputation of 22.214.171.124
IP Geo Information: 220.127.116.11
Trace a Route to 18.104.22.168
DNS Records 188.8.131.52
Bad Neighbor IPs of 184.108.40.206
169 bad neighbor IPs are known!


text:
The most essential miles on your horse are the 1st handful of hundred. If you mishandle or abuse your bike throughout these early stages, you'll regret it later. Every bike comes with its own set of procedures for engine breaking. Some may possibly be as ambiguous as "Take it straightforward," whilst other people may be more particular with complicated directions that involve RPM limits and the like. Nevertheless, chill out and let the wind do the speaking.
The major feasible reason you are taking your motorbike to a repair shop is to address some issues with your bike. It is most likely that you don't know how to decide the precise motorcycle difficulties you are obtaining, so you will rely on the experience of the mechanics in a motorcycle service center. A great mechanic, in certain, need to not take too much time trying to figure out what aspect of your bike requirements repair. The a lot more quickly they spot the problem, the a lot more reputable they are as this just means that they have the encounter in dealing with such circumstances.
As you take your motorbike to the repair shop, 1 of your greatest concerns is actually the time it would take for your machine to be completely serviced. You should ask the mechanic when specifically you could get your bike back. Given that a very good repair shop ought to accurately diagnose your motorcycle difficulties, they would also have an notion of how long it would take to remedy all these difficulties.
If a bike sits unused with fuel in the tank, that fuel can grow to be contaminated and stop the machine from starting. The gas goes stale and clogs the fuel program. If you strategy to retire your automobile for the winter, buy a fuel additive remedy that can avert the gas from expiring and clogging the engine. When this doesn't perform, bring the bike to a motorcycle repair center to clear away fuel contamination and get the motor operating once again.
As a motorcycle owner, one of your responsibilities is to take your bike to a motorcycle repair shop on a standard basis. Bear in mind that your motorbike doesn't have to get broken before you take into account possessing motorcycle repairs. If you want your motorbike to stay in best and safe situation, make positive that you frequently keep it in verify so that all essential repairs or modifications could be performed. In selecting the proper motorcycle service center, there are certain items you need to contemplate or qualities and features to look for. Needless to say, you want only the authorities to take care of all the repairs required by your bike.
The very best way to avoid difficulties before they happen is to be your here personal mechanic, at least in spirit. Realizing and understanding the mechanics of your automobile will enable you to sustain it and preserve it performing at its highest level. But when it comes time to make a motorcycle repair, skilled mechanics have the tools and know-how required to disassemble and reassemble read more your car, make clean fixes, and get you back on the road.
New bikes tend to come with pretty low-grade tires. Even though these tires are functional, they put on out relatively speedily and are more susceptible to blowouts. When you buy a new hog, plan to upgrade your tires in order to avoid difficulty out on the road. Aside from that, have a mechanic replace your tires each couple years, or according to the schedule advised by your service manual. When you do encounter blowouts or tire punctures, trust a professional to replace the damaged tire rather than undertaking it your self. He or she will know how to fit the tire on the wheel to ensure the highest possible performance and prevent additional problems.
Buy Carport - An Overview
What's this? Are you also a victim of the identical business or unique? Want Justice? File a Rip-off Report, help other buyers to be educated and don't let them get away with it!
Obviously, since you're dealing with the actual fabricator and not just a broker, we will customize dimensions to suit your Specific instances!
Storage opportunities are only the beginning, as boats, hunting, fishing, tenting and mountaineering gear may be saved within the metal buildings easily, letting lots of place to spare for fish and sport cleansing alternatives.
And you'll need some protected region to shop things far too, Will not you? Well, these carport plans include a storage closet which includes double doorways and actions over ten toes vast. The storage closet has a total of 55 sq. feet of place for safekeeping of your valuables.
What on earth is your car or truck really worth? Regardless of whether you do not know the precise price you know one thing - your vehicle is worth safeguarding. When you buy a 20x20 carport , you are preserving that expenditure. It does not matter the greenback volume. To obtain the required permits for 20x20 carport, You will probably need to have to generate Evidence of property ownership, Permit application worksheets, furnished by the town, and Construction drawings.
What is this? Will you be an owner, worker or ex-worker with either negative or beneficial information about the organization or personal, or could you supply "insider information and facts" on this enterprise?
This carport canopy is big more than enough to cover two entire measurement vans. This is a 24 x 26 x nine standard fashion carport canopy with two gable ends and a three foot extensive panel down both sides. This design is our most inexpensive carport. The carport is installed on gravel.
This metal carport encompasses a 2-car or truck facet entry. Not just can we build metal carports with end entry, we might also location entries around the side with the device.
You can start employing your lower-routine maintenance steel buildings when They can be erected, so Exactly what are you looking forward to? Connect with Coastline two Coast right now Carport Designs And Plans to pick which selections of steel buildings or automobile ports are best for your needs!
Facebook: Web site: I am building a brand new storage shed for my garden mower and gardening equipment. I have found that the majority of sheds tend to rot from The underside up and are sometimes property to floor hogs and skunks.
Carports While using the a-frame design are prefect for placement beside your home Because the roof type is a great deal more eye-catching than our frequent carports. This homeowner went With all the 24 x 21 x 8 with two gable finishes plus a panel on either side to sheild agains blowing rain.
This vehicle shelter was mounted in just below an hour or so by our installation contractors. This double motor vehicle shelter is anchor's to The shopper's concret slab with enlargement anchors and it create a awesome addition to the homeowners residence. This device is an eighteen x 21 x 6 regular carport.
When you have only one particular vehicle and prefer to have more Area to open doors, do upkeep, or have excess coverage for whichever purpose, this may additionally be click here the design to suit your needs.
) head more than to our Carport Builder driven by BuildID. You can customize Nearly any aspect of your carport to your specs. If you'd only prefer to speak to an individual about the right sized carport for your requires, give us a toll-totally free call at (855) Automobile-PORT and a person is going to be website delighted to assist you with pricing.
Chiropractic Care: Is It Right For You?
Back problems could happen to anybody at any time under any situation. There are plenty of muscles from the lower and upper back plus they are all very sensitive. These article offers many chiropractic care tips.
To further improve your back issues, consider the method by which you lie on your back. Place a pillow below your head and shoulders. Then, you can find rolled up towels put under your neck and knees so you're capable to stabilize your body's three major curves. Make certain that your mattress is comfortable.
Monitor how you're sleeping on your back to maintain back discomfort from increasing. Place a pillow beneath your head and shoulders. Then, use rolled up towels beneath the knees and neck, which helps stabilize three of the major curves for the body. You have to also buy yourself a comfortable, supportive mattress.
Speak to your chiropractor and learn of should they offer reductions for patients who return for multiple treatments. Chiropractic care often requires multiple visits for treatment. It could be several times every week for a lot of months. It may become quite costly. The doctor's office might have some sort of discount for multiple visits to create treatment far more affordable.
Check their references even before you make a scheduled visit if you opt to work with a chiropractor. There are several bad eggs inside the bunch, although nearly all professional chiropractors are experts with their field who actually value your health. Use online reviews and trusted references from physicians provided you can.
Have you got high blood pressure levels? Research shows that vertebrae manipulation is much more effective than blood pressure level medications. The manipulation lets the blood supply flow freely.
Refrain form chiropractors that attempt to sell you dietary supplements and also other products. Are are probably charlatans if they are selling these kinds of products within their office. nutritionists and Physicians would be the most reliable sources for this sort of advice.
Chiropractic care is more than necks and backs, it will also boost immunity, too. It may cause difficulties with your nervous system should your spinal column is misaligned. cell, organ and tissue function, any decline in its performance could affect your wellbeing, since your neurological system controls tissue. Correcting any underlying problems really helps to restore the immune system to its optimal condition.
Ensure that you carefully look into the references of more info any practitioner prior to a scheduled visit if you opt to seek chiropractic care. The vast majority of chiropractors are genuinely concerned with your wellbeing. Some, however, may try to get more money out from you than you ought to be paying. Search for information from customer reviews and find out how many other doctors need to say.
How you will sleep may affect your back. An incredible course of action is defined a rolled towel under the neck when sleeping. These will let your mind lay even instead of being pushed up by a pillow.
Do you have elevated blood pressure? Research shows that vertebrae manipulation is far more effective than blood pressure medications. The manipulation lets the blood supply flow freely.
Many individuals suffer from back problems, not merely laborers. Tight hamstrings certainly are a huge cause of pain inside the lower back. sitting and Standing frequently causes stress around the hamstrings. Stretching helps to fight this.
They can actually experience more, though you might think office workers couldn't experience all the pain as laborers. One reason lower back pain occurs is because of tightness in the hamstring muscles. Whenever you operate the hamstring will yank in your pelvis, which can certainly make your spine hurt. By stretching regularly, you may avoid this.
People wait until it's past too far to tend to their back. This information has provided useful several suggestions about handling your back. When you are careful to follow these tips, you may never have to experience a read more painful, damaged spine. Be sure the guidelines here can assist you live a more comfortable and healthy pain free life.
How You Can Save Lots Of Money With Coupons
Coupons are probably the few things available which provide two benefits as well. Good coupons enables you to realize big savings on things that you desire. You can use the amount of money you save to deliver yourself an added vacation or something else you haven't been able to pay for to buy. To start out saving using couponing, continue reading.
When you go to make use of a coupon, make sure that the deal you're getting is as great as you believe it is. Sometimes, it will save you more should you buy the shop brand or generic version, instead. Because you have a coupon doesn't mean you are getting the best bargain.
Put coupons to work with whenever a store includes a buy one, get one at no cost deal. Besides getting the additional item cost-free, you'll frequently get a significant decrease in the expense of the first item in question. You could wind up paying lower than a good quarter of its initial price.
When working with coupons, it may be beneficial to not always immediately rely on them. To obtain more savings, await a sale on the item, then make use of coupon along with the sale. Like that, you can save twice as much and quite often it will be even free.
Search the internet to discover online coupons or promotional reductions for websites you shop from frequently. Frequently, you will discover promo codes to work with that could help you save money on your web purchases from big companies.
Use competing supermarkets. Many stores have a policy of honoring their competitors' coupons. If you take advantage of these deals, it helps you to save time and expense from needing to travel around to many different stores. You could lose your savings when you have to buy gas.
You can play grocery chain tactics and competition in your own benefit. For example, your coupons for just one store may be honored in the competitor down the street. By watching for this, you may avoid running around to varied stores to save cash. You save along with your coupons, and also you save gas money at the same time.
When you have no specific intends to make use of them, it's smart to have your coupons easily accessible if you shop, even. You don't know if you have an in-store sale, and you may want to run out and provide the coupons in.
Consider utilizing a coupon service where you can get a bunch of the same coupons if there is an item you would like and it will surely be for sale. A coupon website would probably be your best option here. As an alternative to buying a bunch of newspapers, you can just use the website to get duplicates.
"Like" companies on Facebook for additional valuable coupons or offers. If you appreciate this brand or company, you will have a greater potential for obtaining certain coupons and sales discounts, which could save you plenty of cash. Becoming a loyal customer is rewarding, so don't neglect to produce a Facebook account and to like those different brands out there.
Become a fan of your preferred brands and companies on Facebook. You are able to definitely save by keeping informed using the best details about coupons and upcoming sales, by liking the organization. Companies typically give prizes for the fans which are probably the most loyal. Make sure that you are part of this loyal group.
Create your listing of groceries you're going to get first then shop around on the Internet for many different coupons. You are able to adjust your list in order to use coupons that are available when you can't find each of the coupons you want.
Almost every online purchase, besides those at big name retailers, could be supplemented by coupons. A lot of companies offer coupon and promo codes will get special deals. Make use of favorite internet search engine to consider them. Use search strings including the current year and month to help you find more current deals and coupon codes. Enter in the name of your retailer together with the year and month to discover these coupons.
Coupons can be troublesome and learning to utilize them will take time. why not try these out As soon as you enter into the habit of smoking of utilizing coupons it will feel natural, and you'll feel good about conserving money along the way. Use coupons today to check it out see just how much you save!
Rumored Buzz on banner exchange
An increasing ad is often a loaded media body ad that alterations dimensions upon a predefined ailment, such as a preset period of time a customer spends on the webpage, the person's click the advert, or maybe the consumer's mouse motion around the advertisement.[30] Growing advertisements let advertisers to fit more details right into a limited advertisement Room.
Arm your workforce Together with the promoting details and insights they should make knowledgeable decisions. Get hold of Us
Body ads were the first kind of World-wide-web banners.[seventeen] The colloquial use of "banner advertisements" usually refers to common frame advertisements.
Advertisers could also produce ads determined by a user's suspected geography via geotargeting. A consumer's IP handle communicates some geographic information (at bare minimum, the person's place or common location). The geographic details from an IP could be supplemented and refined with other proxies or facts to slender the choice of doable areas.
Search engine optimisation, or Search engine marketing, makes an attempt to improve a website's natural and organic search rankings in SERPs by growing the website material's relevance to look conditions.
CPC (Price For every Click on) or PPC (Spend for every simply click) usually means advertisers shell out every time a consumer clicks to the ad. CPC advertising functions perfectly when advertisers want visitors to their sites, but it is a a lot less accurate measurement for advertisers looking to build brand awareness.
Many people have reservations about by on line behavioral focusing on. By web site traffic tracking users' on the web functions, advertisers are equipped to comprehend buyers rather perfectly. Advertisers normally use technologies, including Net bugs and respawning cookies, to maximizing their skills to trace individuals.[55]:sixty[89][90] According to a 2011 survey carried out by Harris Interactive, above fifty percent of Internet customers experienced a damaging impact of on the internet behavioral advertising, and forty percent feared that their personally-identifiable info were shared with advertisers with out their consent.
Price tag for each mille, typically abbreviated to CPM, ensures that advertisers shell out For each and every thousand shows in their message to potential prospects (mille will be the Latin phrase for thousand). In the web context, advert shows are generally named "impressions.
Mobile advertising is growing quickly for a number of factors. You'll find more cellular units in the sector, connectivity speeds have improved (which, amid other items, allows for richer media advertisements for being served swiftly), display resolutions have Superior, cellular publishers have become more refined about incorporating advertisements, and shoppers are making use of cellular units more extensively.[1]:14 The Interactive Advertising Bureau predicts continued progress in cellular advertising Together with the adoption of spot-based mostly focusing on and also other technological characteristics not readily available or applicable on own computer systems.
The Internet's affordable of disseminating advertising contributes to spam, In particular by massive-scale spammers. Quite a few attempts have been carried out to overcome spam, ranging from blacklists to regulatorily-essential labeling to material filters, but the majority of All those initiatives have adverse collateral consequences, for example mistaken filtering.[6]