: IN THE SUPREME COURT OF OHIO

SOOSHYANCE GHARIBSHAHI,et al.,

Plaintiff-Appellees,

V.

SARAH ARTMAN, M.D.,

Defendant-Appellant,

and

THE OHIO STATE UNIVERSITYMEDICAL CENTER,

Defendant-Appellee.

Case No. 2014-0847

On Appeal from the Franklin CountyCourt of Appeals, Tenth AppellateDistrict

Court of Appeals Case No. 13AP-844

MEMORANDUM OPPOSING IURISDICTION OF APPELLEE THE OHIOSTATE UNIVERSITY MEDICAL CENTER

MICHAEL DEWINE (0009181)Ohio Attorney General

JEFFREY L. MALOON * (0007003)Assistant Attorney General

*Counsel of RecordCourt of Claims Defense Section150 East Gay Street18th FloorColumbus, Ohio 43215Telephone: (614) 466-7447Facsimile: (614) 644-9185j effrey.maloon@ohioattorneygeneral. govCounsel. for Appellee The Ohio StateUniversity Medical Center

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PAUL J. VOLLMAN* ( 00065680)*Counsel of Record

James P. Triona (0014272)The Triona Firm2021 Auburn AvenueCincinnati, Ohio 45219Telephone: (513) 762-5010Facsimile: (513) 762-5024pvollman a trionafirm.comCounsel for Appellant Sarah Artman, M.D.

BRENDA M. JOHNSON * (0062474)*Counsel of Record

Ellen M. McCarthy (0046757)Nurenberg, Paris, Heller &McCarthy Co., L.P.A.1370 Ontario Street, 1 St FloorCleveland, Ohio 44113Telephone: (216) 621-2300Facsimile: (216) 771-2242bjohnson@nphm.comCounsel for Appellees SooshyanceGharibshahi, et al.

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TABLE OF CONTENTS

Page

1. INTRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..1

II. STATEMENT OF THE CASE AND FACTS ...............................................2

III. THIS IS NOT A CASE OF PUBLIC OR GREAT GENERAL INTEREST ...........3

IV. ARGUMENT ..... ................................................................................6

APPELLEE'S PROPOSITION OF LAW I

A purely private-practice physician who has "privileges" to use thefacilities at a state university hospital to treat her own patients is not astate employee entitled to immunity under R.C 9.86 ................................6

APPELLEE'S PROPOSITION OF LAW II

Dr. Artman has no personal services contract with Ohio State and istherefore not an employee under R.C. 109.36(A)(1)(b) .....................9

APPELLEE'S PROPOSITION OF LAW III

Dr. Artman was permitted to conduct discovery and, since many of herdiscovery requests were made untimely, the trial court acted within itssound discretion in denying her last request for a continuance. ...........12

V. CONCLUSION ..................................................................................14

VI. CERTIFICATE OF SERVICE ..............................................................15

i

I. INTRODUCTION

This appeal stems from a medical negligence case filed against a private OB/GYN

physician who had privileges to use The Ohio State University's labor, delivery, and

surgical facilities for her private patients, and who, in exchange for those privileges,

agreed to serve as a volunteer faculty instructor at the hospital. Ohio State and the

patient, Newsha Kuhbanani, agree that Dr. Sarah Artman was not an employee of Ohio

State and is therefore not entitled to state-employee immunity under R.C. 9.86. Both

lower courts reached the same conclusion.

At issue in the underlying case is whether Dr. Artman was negligent during the

delivery of a child of one of her private-practice patients. This doctor had no

employment contract with Ohio State, received no salary from Ohio State, did not

practice through Ohio State's practice plan, and was not insured by Ohio State. Her

private practice had no affiliation with Ohio State (financial or otherwise), and she

maintained her own liability insurance coverage. Moreover, neither Ohio State nor its

billing agent invoiced Ms. Kuhbanani or her health insurance carrier for the doctor's

services; the doctor's private practice billed for such care. Ohio State never collected nor

received any portion of these private-physician fees.

Nor did Ohio State have any control over Dr. Artman's clinical practice. Unlike

the control it exercises over its employed physicians, Ohio State did not dictate Dr.

Artman's work schedule, assign patients to her, or prescribe when and how she treated

patients. Dr. Artman simply had privileges to use Ohio State's facilities if and when she

required those facilities to treat her private-practice patients. All Ohio State asked of Dr.

Artman was that, when she did exercise her privileges to use Ohio State's facilities, she

serve as a volunteer instructor by allowing students and resident physicians to observe.

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This is the same arrangement (including the observation by residents) that numerous

private practitioners maintain with private hospitals. And in those cases, the practitioners

are not employees of the hospitals.

Both the Court of Claims and the Tenth District thoroughly reviewed the facts of

this case and concluded: Neither Dr. Artman's privileges to use the hospital's facilities

nor her service as a volunteer instructor rendered her a state employee. The Tenth

District's decision denying immunity to Dr. Artman was correct and closely followed its

previous opinion in Phillips v. The Ohio State University Medical Center, 2013-0hio-

464, appeal not accepted, 2013-Ohio-2512, wherein a private practice OB/GYN

physician was found to be neither "a state `officer [n]or employee' for purposes of

immunity under R.C. 9.86, 109.36(A)(1)(a), and 2743.02(F)." Id., at ¶ 17.

This case is no more than a routine application of established law about whether

someone is a state employee.

II. STATEMENT OF THE CASE AND FACTS

On December 16, 2011, Newsha Kuhbanani and Shahram Gharibshahi,

individually and on behalf of their minor son, Sooshyance Gharibshahi, brought a

medical negligence action against Ms. Kuhbanani's private-practice OB/GYN, Dr. Sarah

Artman, and the doctor's private medical practice, Sarah Artman and L. Paige Turner,

MDs, Inc., in the Franklin County Court of Common Pleas. Plaintiffs alleged that Dr.

Artman was negligent during the labor and delivery of the child in May 2008.

Dr. Artman responded that she was an employee of The Ohio State University

Medical Center, and therefore both she and her private medical corporation were entitled

to civil immunity under R.C. 9.86. The trial court dismissed the action in recognition

that the Court of Claims has exclusive jurisdiction to determine an individual's immunity

2

status. See, GhaJ°ibshahi v. Sarah Artman and L. Paige Turner MDs, Inc., Franklin

County Court of Common Pleas, Case No. 11 CV 015711.

In the Court of Claims, both Ohio State and Plaintiffs opposed immunity because

Dr. Artman was not an employee of Ohio State. After an evidentiary hearing, the Court

of Claims denied immunity. That decision rested on a litany of findings showing no

employment relationship: There was no employment contract between Dr. Artman and

Ohio State; Dr. Artman was never paid by Ohio State; Ohio State did not control Dr.

Artman's practice, did not control which patients she treated, when they were scheduled,

how much they were billed, or her billing and collection methods; Dr. Artman did not

practice through the university's practice plan; and Ohio State did not require Dr. Artman

to perform didactic teaching or lectures, contribute to the medical literature, provide care

to indigent patients, participate in clinics, or provide written evaluations for the residents

she taught.

On appeal, Dr. Artman also insisted she was a hospital employee because she was

required to follow hospital bylaws, supervise residents, and document her teaching

activities. The court rejected these arguments, just as did in Phillips. Dr. Artman now

appeals to this Court.

III. THIS IS NOT A CASE OF PUBLIC OR GREAT GENERAL INTEREST

This case does not warrant review. Indeed, there is no legal issue in play. The

case simply involves the application of an established framework to a set of facts. And

the facts here point in one direction: A private-practice physician who merely has

privileges to use a state hospital's facilities to treat her own patients, and who agrees to

serve as a volunteer faculty member in exchange for such privileges, is not an employee

of the State entitled to immunity under R.C. 9.86. Nor does Dr. Artman's service-

3

provider agreement with OSU Managed Health Care Systems, Inc., change the

equation-all it means is that she accepts OSU Managed Health Care Systems, Inc.

insurance (the Health Plan is simply the health-insurance benefits plan for Ohio State

employees). Dr. Artman is no more an employee of Ohio State by virtue of taking Ohio

State insurance than she is an employee of Anthem or Aetna by taking patients who carry

insurance with those companies. Moreover, notwithstanding having "Ohio State" in its

name, OSU Health Plan, Inc. is not even a public entity; it is a private corporation that

was set up to administer health insurance benefits to University employees.

In any event, as the court of appeals rightly found, there is no meaningful

evidence in the record about the OSU Health Plan. App. Op. 1139-47. In fact, the

provider agreement that foNms the core basis, for Dr. Artman 's second proposition of law

is not even in the record. Id., ¶ 42. Those profound evidentiary defects are reason alone

to reject Dr. Artman's appeal.

Nor is there any disagreement about what all these facts amount to-the lower

courts have seen these arguments before and have repeatedly answered them the same

way. Indeed, the Phillips case involved virtually identical facts to this appeal. A private-

practice OB/GYN who had hospital privileges at Ohio State was alleged to have left a

foreign body in her patient's abdomen during a surgical procedure. The patient was a

member of Dr. Greco's private practice. Dr. Greco sought immunity and both the Court

of Claims and the Tenth District soundly rejected her pitch, finding that the mere

granting of privileges to use a public hospital's delivery and surgical facilities did not

translate to control over the physician's manner and means of practice as to render the

private doctor a public employee.

There is simply no basis for review here. Dr. Artman was not a state employee

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by a long shot. In the medical procedure at issue, the doctor was treating one of her own

patients from her own private practice. The doctor has no employment contract with

Ohio State, receives no salary from Ohio State, does not practice through the

University's physician practice plan, and is not insured by Ohio State. Her private

practice has no affiliation with Ohio State (financial or otherwise) and she maintains her

own liability insurance. All of this is worlds away from the relationship that actual

physician employees of Ohio State's medical center have with Ohio State.

Nor does Ohio State have any control over Dr. Artman's practice. Unlike the

control it exercises over its employed physicians, Ohio State does not dictate Dr.

Artman's work schedule, assign her patients, or prescribe when or how she treats them.

Indeed, unlike the many demands placed on its physician employees, Ohio State does not

actually require Dr. Artman to do anything at all for the University in a given year. This

thoroughly private doctor simply has "privileges" to use Ohio State's hospital facilities if

and when she requires the facilities to treat her private patients. And all Ohio State asks

is that, when she does exercise her privileges to use Ohio State's facilities, she serve as a

volunteer instructor by allowing residents to observe. This is the same arrangement

(including the observation by residents) that numerous private practitioners maintain

with private hospitals.

Both the Court of Claims and the Tenth District thoroughly reviewed the facts of

this case and reached the same conclusion. Neither Dr. Artman's "privileges" to use the

hospital's facilities nor her service as a volunteer instructor rendered her a state

employee. The Tenth District's decision denying immunity was therefore correct and

presents no issues meriting review.

5

IV. ARGUMENT

Appellee's Proposition of Law I:

A purely private-practice physician who has ` privileges " to usethe facilities at a State hospital to treat her own patients is nottheNeb}, a State employee entitled to immunitv under R. C'. 9.86

Dr. Artman's relationship to Ohio State is that of a purely private practitioner who

has privileges to use the hospital's facilities to treat her own patients. To best understand

this case, it is useful to understand that this arrangement is a typical one between

hospitals and private practitioners at both state and private hospitals alike. That is, while

most hospitals, like Ohio State, have numerous physicians who are hospital employees, a

number of doctors who use the hospital are merely independent physicians with

"privileges" to use the hospital's facilities to treat their own private-practice patients.

The reason for these arrangements is simple. Many doctors prefer the autonomy

and financial benefits of a purely private practice. But if they are, for instance, an

obstetrician or a surgeon, they simply could not do their jobs without access to one or

more hospitals and their labor and delivery rooms, operating suites, etc. These doctors

therefore have two choices: (1) seek emplovment with a hospital or (2) maintain a private

practice while securing "privileges" to use the facilities of one or more hospitals.

The doctor here - like thousands of OBs and surgeons throughout the United

States - chose the latter path: a purely private practice. As is undisputed, Dr. Artman has

her own private practice that has no connection (financial or otherwise) to Ohio State.

She maintains her ow-n liability insurance; she sets her own work schedule; she chooses

which patients and what insurance she accepts; and she (not Ohio State and not Ohio

State's agent) bills her patients for all of her patient care including hospital-based

procedures.

6

As both courts below correctly found, having privileges denotes no employment

relationship. Dr. Artman's relationship with Ohio State does not remotely resemble the

relationship that Ohio State's physician employees have with. the medical center. Indeed,

a comparison between such purely private practitioners and Ohio State's employee-

physicians is instructive:

• Ohio State's physician employees have employment contracts with theIJniversity. Dr. Artman does not.

• Ohio State's physician employees receive salaries from Ohio State. Dr.Artman does not.

• Ohio State's physician employees are required to practice tlirough theUniversity's practice plan. Dr. Artman is not, and she maintains her ownprivate practice via her own professional corporation.

• The patient fees for Ohio State's employed physicians are collected byOhio State (and its practice plan), and are used to fund employee salariesand the medical center. Not so for Dr. Artman. Ohio State neithercollects nor receives any portion of her fees for patient care including forthose procedures that she performs at the hospital.

• Ohio State controls the clinical practices of its employed physicians:Among other things, Ohio State prescribes their work and on-callschedules; it assigns patients to them; it sets their salaries; and it prescribestreatment and billing protocols. Ohio State has no such control over Dr.Artman and other purely private practitioners who merely have privilegesto use the hospital's facilities for their own patients.

It is also critical to note that Ohio State's employed physicians are all insured by

Ohio State (which maintains a self-insurance fund for medical negligence claims). Dr.

Artman is not. Rather, she maintains her own professional liability insurance. Indeed,

like most hospitals, Ohio State will not even extend hospital privileges to a private

practitioner without proof qf his own liability insurance. That Ohio State does not insure

these purely private doctors confirms that Ohio State does tiot regard them as employees

just because it extends hospital privileges to them. It also demonstrates why considering

them state employees would be senseless, and devastating to both public and private

7

hospitals. That is, like Ohio State, most hospitals fund the insurance coverage for their

employed physicians from patient fees collected for the care those physicians provide.

But as noted, Ohio State does not collect or receive any portion of Dr. Artman's patient

fees (including for services she performs at the hospital). Thus, if physicians like Dr.

Artman were deemed employees merely for having privileges, state and private hospitals

alike would be forced to make payouts on behalf of purely private practitioners who

never even make pay ins to the hospitals.

The fact is that Ohio State does not actually require Dr. Artman to do anything for

Ohio State in any given year. She simply has privileges to use the hospital's facilities if

and when slae needs them to treat her private patients. In other words, Ohio State does

not require her to perform any procedures, or to deliver any babies, or to teach anyone at

Ohio State. She was not required to cover the outpatient resident clinic, to treat Ohio

State's patients, or to perform on-call duties for labor and delivery, and she did not

participate in scheduled didactic responsibilities. All Ohio State asks is that, if she does

use her hospital privileges for her private practice needs-meaning, if she operates or

delivers a baby at the hospital for one of her patients-she serve as a volunteer instructor

and allows residents to learn from the procedure.

And this Court has already been around the block as to whether volunteer

instructors are state employees-the answer is "no." In Engel v. University of Toledo

College of Nfedicine, 130 Ohio St. 3d 263, 2011-Ohio-3375, the Court held that a

volunteer instructor for a state medical college is not a state "employee" entitled to

iinmunity: "[W]e conclude that there was no contract of employment between the

College of Medicine and Dr. Skoskiewicz, that the College of Medicine did not exercise

control over Dr. Skoskiewicz's medical practice, and that the College of Medicine did not

8

pay Dr. Skoskiewicz. Based on these conclusions, we conclude that Dr. Skoskiewicz was

not an employee of the College of Medicine," Id., at ¶ 16.

These are the same factual conclusions reached by the Court of Claims and the

Tenth District here, and so the result is the same. Dr. Artman is not a state employee. As

explained above, if Dr. Artman never performed any procedures at Ohio State, and never

taught any students or residents, there is no consequence to tliat. How strange it would be

to grant her immunity by virtue of her privileges (and the volunteer teaching she performs

in exchange for them), when Ohio State does not even require her to exercise those

privileges or to teach at all. Dr. Artman's teaching was merely as a volunteer instructor.

Under well-settled law, neither that nor her privileges to use Ohio State's facilities for her

own patients rendered her an Ohio State employee.

Finally, not only do the facts of this case and this Court's own precedents show

that Dr. Artman is not entitled to immunity, but additionally, numerous courts have

analyzed whether facilities privileges create an employment relationship with an

otherwise independent physician, and the resounding conclusion is "no." See, e.g.,

Wojewski v. Rapid City Reg'l Hosp., Inc., 450 F.3d 338, 342-45 (8th Cir. 2006); Shah v.

Deaconess Hosp., 355 F.3d 496, 499-500 (6th Cir. 2004); Swanson v. Univ. of

Cincinnati, 268 F.3d 307, 318-19 (6th Cir. 2001); Cilecek v. Inova Health Sys. Servs.,

115 F.3d 256, 261-63 (4th Cir. 1997).

In sum, there is no basis to review the iinmunity appeal of this private doctor.

Appellee's Proposition of Law II:

Dr. Artinan has no personal services contract with Ohio State andis therefore not an employee undeN R. C. 109. 36(A) (1) (b).

The doctor's argument that she had a "personal services contract" with Ohio State

likewise goes nowhere.

9

First and foremost, as the Tenth District rightly found "[t]here is no evidence Dr.

Artman had a written contract with OSUMC [the medical center]." App. Op. ¶ 13. In other

words, the courts below found no contract at all, let alone a personal services contract under

R.C. 109.36(A)(1)(b). This Court's analysis can end there.

Not only that, but the court of appeals correctly theorized that "[e]ven if her

arrangement with OSU was contractual, she was not obligated to render medical services

pursuant to that contract." App. Op. ¶ 38. Meaning, as explained above, Ohio State never

required anything of Dr. Artman. She sought out and asked for privileges to use the hospital

facilities for her private patients; and she was granted privileges. Whether she used them or

not was entirely up to her. There was no personal services contract by which she agreed to

provide medical care for Ohio State. Indeed, even when she did exercise her privileges and

used the facilities, she was not providing medical care for Ohio State; she was providing

care _ for her own private patients. Ohio State did not assign her the patients, pay her for

treating the patients, or bill the patients for the treatment she provided-Dr. Altinan or her

private practice corporation did all of that.

Even if the Court were to unpack Dr. Artman's arguments-and she says that there

were two ways in which she had a "personal services contract" with Ohio State-they are

still meritless.

She first claims that the prerequisites for privileges-i.e. private doctors must be

"credentialed" by the hospital and must comply with hospital bylaws, including guidelines

for working with residents-amounted to a personal services contract. Not so. Like all

hospitals, as a simple matter of patient safety, Ohio State has a duty to use care in selecting

who it awards privileges to. Accordingly, being credentialed, and complying with hospital

bylaws, are simply conditions for being granted hospital privileges; they do nothing to create

10

a contract or employinent status. And again, the courts below specifically found there was

never any contract here-not in this regard, or any regard.

Next, Dr. Artman says that her service-provider agreement with OSU Managed

Health Care Systems, Inc., constituted a personal services contract under R.C.

1 Q9.36(A)(1)(b). This argument fails for several reasons and borders on the absurd.

The service-provider agreement simply means that Dr. Altman takes the health

insurance plan for Ohio State employees (called "OSU Managed Health Care Systems,

Inc." insurance). Dr. Artman is no more an employee of Ohio State by virtue of taking

Ohio State insurance than she is an employee of Anthem or Aetna by taking patients who

carry insurance with those companies.

Moreover, as the court of appeals rightly found, there is no evidence in the record

about the OSU Managed Health Care Systems, Inc., App. Op. ¶¶ 39-47. In fact, the

provider agreement that foNms the core basis for Dr. ANtrnan's second proposition of law

is not even in the record. Id., ¶ 42. Those record defects alone warrant denying Dr.

Artman's appeal. There is no basis for this Court to hear a contracts claim where the

alleged underlying contract is not even in the record.

Finally, notwithstanding having "Ohio State" in its naine, OSU Managed Health

Care Systems, Inc. is not even a state entity; it is a private corporation set up to

administer health insurance benefits to University employees and is independent of Ohio

State. Accordingly, that agreement is simply not a contract "with a department, agency,

or institution of the state." R.C. 109.36(A)(1)(b). Dr. Altman says that the

"[c]orporation [is] organized exclusively to serve the needs of a state medical school,"

but Ohio State has no idea what that means, and in any case, there is no evidence in the

record supporting that assertion. This entity is simply the private health insurance

11

provider for Ohio State entities, and private doctors do not become employees of Ohio

State by virtue of accepting patients who carry this insurance.

Appellee's Proposition of Law III:

Dr. ANtnzan was permitted to conduct discovery and, since n2any of herdiscovery requests were untimel}; the trial court acted within its sounddiscretion in denying her last request for a continuance.

Dr. Artman's final claini grouses about trial court discovery rulings. Probably

knowing that these types of claims are unsuitable for this Court's review, Dr. Artman

seeks to dress them up as a constitutional question. This argument should be rejected.

In essence. Dr. Artman claims she was not permitted to conduct discovery, That

is not the case. Dr. Artman was permitted to conduct discovery, but she was tardy in

propounding certain requests and, in light of her tardiness, the trial court would not

continue the hearing (again) in order to permit the additional discovery. Review of this

matter is not warranted because, as the Tenth District carefully reviewed and found, the

trial court acted within its sound discretion in denying the continuance.

The following brief overview of the discovery path followed in this immunity

case should satisfy the Court that there is no legal issue here for review, that Dr. Altman

was given all the opportunities she was due, and that the trial court's exclusions were

reasonable.

The initial immunity hearing before the Court of Claims was scheduled to take

place on November 5, 2012. Dr. Artman did not seek any fact development during the

six months following her assertion of immunity, from May 2012 through November

2012. In the meantime, Ohio State moved for a continuance of the hearing, since counsel

was scheduled to be in trial on November 5. The immunity hearing was then rescheduled

to February 4, 2013.

Dr. Artman did not serve any discovery requests until November 28, 2012, just

12

nine weeks before the new hearing date. The requests included nutnerous interrogatories

and requests for production of documents. Ohio State served its responses on December

31, 2012.

Ohio State objected to certain of Dr. Artman's requests as being ambiguous,

overly broad, burdensome, and not reasonably calculated to lead to relevant evidence,

and Ohio State asked Dr. Artman to narrow her requests. Dr. Artman refused to do so

and, at the same time, made an additional request to depose five current or former

medical center staff members, some of whom had been deposed in previous immunity

cases. Ohio State thereafter filed a motion for a protective order, since Dr. Artman's

requests were seeking information far outside what could possibly be relevant or likely to

lead to relevant evidence and her subsequent refusal to narrow the requests. Dr. Artman

filed a counter motion to compel, which was denied.

Dr. Artman also moved to continue the February 4 immunity hearing. The

motion was granted, and the new hearing date of Apri130 was selected and agreed upon

by all parties. It was during this time frame (from January through March 2013) that the

court addressed many discovery issues usually via conference calls with the parties.

On April 9, 201.3, Dr. Artman fiJ.ed a motion to continue the April 30 immunity

hearing. She said Ohio State had not responded appropriately to her then-pending

discovery requests. Ohio State filed a response to Dr. Artman's motion within seven

days and the court conducted a status conference on April 19, just ten days after the

motion was filed. After a lengthy conversation on Friday, April 19, the cour-t held

another conference on Monday, April 22, to discuss the status of discovery and Dr.

Artman's motion to continue the hearing. As a result of those conferences and Ohio

State's agreement to produce additional documents, the court denied Dr. Artman's

13

_motion and the mat6er;,pEoceeded to an immunity hearing on April 30.

In sum, this Court does not referee discovery disputes and Dr. Artman's discovery

arguments do not merit review. This Court has provided trial courts with authority to

enforce rules in order to control their dockets and, in the absence of an abuse of that

authority-and there was patently none here-appellate review is not warranted.

V. CONCLUSION

Based upon the foregoing, the Court should deny review of this matter.

Respectfully submitted,

MICHAEL DEWINE (0009181)ttorney Gener

Jeffre^ . a (0007003)Assis n ey GeneralCourt of Claims Defense Section150 East Gay Street, 18th FloorColumbus, Ohio 43215Telephone: (614) 466-7447Facsimile: (614) 644-9185j effrey. rnalo on@ohi oattorneygeneral. gov

Counsel for Defendant-Appellee The OhioState University Medical Center

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CERTIFICATE OF SERVICE

The undersigned hereby certifies that a true and accurate copy of the foregoing

memorandum was served via electronic transmission and regular U.S. Mail, postage

prepaid, this 1^^^ day of June 2014, upon the following counsel of record:

Paul J. Vollman, EsquireThe Triona Firm2021 Auburn AvenueCincinnati, Ohio 45219pvollman@trionafinn.com

Cou.nsel for Defendant-Appellant Sarah Artman, M.D.

Brenda M. Johnson, EsquireNurenberg, Paris, Heller & McCarthy Co., L.P.A.1370 Ontario Street1 " FloorCleveland, Ohio 44113bjohnson@phm.com

Counsel for Plaintiffs-Appellees SooshyanceGharibshahi, et al.

Jeffi

ec: Paula L. Paoletti, EsquireMark L. Schumacher, EsquireJulia A. Turner, Esquire

General(0007003)

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