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I began to see Dr. Elaine A. Brown in West Lebanon, N. H. as a general dentist. In April, 1999 I broke a section off tooth #13 in the upper left jaw (opposite side as the sinus fistula)and she recommended that the tooth be crowned. Shortly after the crown on April 26, 1999 was placed the the tooth the area began to become sensitive and kept getting worse until it affected the surrounding gum and the adjacent gum and tooth. On June 24, 1999 she inspected it and indicated she did not know what was causing the problem and nothing was done. In July it got worse spreading along the gum to the next tooth #14 and the gums were pulling away from the teeth and bleeding between both teeth. On August 9, 1999 she again inspected the area and indicated in her records the the gum tissue was purple and raw between the teeth as well. She now said it could be an allergic reaction to the metal in the crown. As this was very similar to what had happened in all the prior mistakes/accidents I documented by letters to her. On August 12, 1999, I wrote to her that when I flossed tooth #13, there was a very sharp surface under the gum that would cut off the floss like a razor. This went on without any treatment to clear up the problem nor antibiotics being prescribed until it had spread far beyond tooth #13. It had spread to the next two teeth and surrounding gums with the gums bleeding and with irritation in my left sinus. (Bro1)

My letter of August 13, 1999 went into detail on what was happening to the tooth and the surrounding area. (Bro2)

Her suggestion that it was an allergic reaction was was not logical. For more than twenty years, I have had (still do) a permanent bridge in the upper front with crowns on teeth #10 and 8 with the same composition of metals as the new crown and have never had any reaction to it. (Bro3 and Bro4A, Bro4B)

As this was proceeding exactly as occurred on the upper right side with continuing infection without proper treatment and the whole upper left area was involved, it was next recommended that I seek treatment for the gums etc. to stop the loss of the teeth at Tufts University School of Medicine Faculty Practice.


Upon contacting Tufts I was assigned to Dr. Mohammed Hassan to evaluate and treat the condition of my gums. I sent a letter to Dr. Brown with a copy to Dr. Hassan transferring my dental records to Dr. Hassan for the evaluation appointment. On July 16, 1999 he evaluated my gums and teeth and took an x-ray. He said he would be calling me later in the week on a course of action to save my remaining teeth and gums. (Ha1)

Not hearing from him I faxed and mailed a letter of July 29, 1999 asking if he had any recommendations. He called back later that day indicating he was going to call me the week of August 2, 1999 with recommended procedures. (Ha2)

On August 6, 1999 at about 2:00 P.M. he left a message on my telephone message machine just indicating he had called my office. At about 3:00 P.M. when I got back to the office I tried to call him and the secretary told me he had left on a three week trip to Egypt and the only message was that the x-rays from Dr. Brown were insufficient and new ones would be needed. He did not make any arrangements for the x-rays he needed or follow-up with another dentist from Tufts. It really did appear that he was not interested in treating me. Again I was being pushed out the door with a worsening condition. (Ha3)

The condition was getting worse and so far no matter what I did I was not going to get any treatment. This was the time preparing to go after Gerald A. Berube and I was not going to not be able to last long enough to get that case to court. I had teeth #13 and #14 extracted again without any antibiotics being administered and tooth #15 was removed on April 7, 2000.


So now I had recurring sinusitis on the right side because of the sinus fistula and a continuing infection of the upper left side in the area of the extractions. When it did not resolve on its own and knowing that it was very unlikely that I would get proper treatment through normal referrals and appointments, I randomly went to the Northeastern Vermont Regional Hospital Emergency Room on July 2, 2000. The attending doctor Stephen Buzzell diagnosed that it was a dental abscess which had an area of pus and prescribed amoxicillin & clavulanate, 875mg taken twice a day for 10 days and to see a dentist within 24 hours.

We were trying to prepare for the upcoming lawsuit against Gerald A. Berube and the damages and lack of treatment were increasing as though it was going to prevent me from going to court.

My attorney indicated for the case we needed an evaluation and closing of the open sinus fistula, but I also really needed the infection on the left side also taken care of.

I was given the name of Dr. Louis Clarizio.


I had copies of my records from Northeastern Vermont Regional Hospital sent to Dr. Clarizio prior to my appointment on July 11, 2000 for evaluation of the right sinus fistula and infection in my upper left jaw. At the appointment he acted like a man betwixt and between. He was very nervous and it was clear he did not want to get involved in any way. He indicated he had been called prior to my appointment by Dartmouth Hitchcock Medical Center offering him a position in the oral maxillofacial surgical department to replace Dr. Paul C. Kuo. Although the records sent to him indicated an abscess in the upper left side, he avoided discussing it and indicated he did not think there was anything there. As to the sinus fistula, he indicated he did not want to get involved. Although it is not in the records he suggested I use a mouth-guard to cover the sinus fistula which might eventually help to close it. In his treatment plan records he indicates sinusitis and prescribed Cleocin. I requested copies of his records which included the material from Northeastern Vermont Regional Hospital. You will note that the Northeastern x-rays indicated sinusitis in the right sinus (sinus fistula) but all the rest of the sinuses were clear. (CL1A, CL1B,CL1C, CL1D)

The form sent to Healthsource by Northeastern Vermont Regional Hospital dated July 7, 2000 lists diagnosis code in #21 block 522.4 AC APICAL PERIODO which under the Hospital & Payor ICD.9.CM Medicode Book describes, "Acute apical periodontitis of pulpal origin. Severe inflammation of periodontal ligament resulting from pulpal inflammation or necrosis (dead pulpal). (CL2)

My primary care physician in reliance of the work at Northeastern made a referral to Dr. Clarizio with the clinical information/reason for referral Diagnosis Code: "jaw abscess." (CL3)

Clarizio only indicates sinusitis on the left side. (CL1B)

The infection had spread into the surrounding gum and tooth #15. I went to a dentist in Canada who extracted tooth #15. and finally gave me an antibiotic which finally stopped the infection on the upper left side. He was amazed at the loss of teeth and damage to my upper right jaw which did not match the the condition of my teeth in the lower jaw. He said it was almost as though the upper jaw was that of an old person and definitely not the same person with the lower jaw. Now I had lost teeth #13, 14 and 15 on the upper left side. And as indicated in the section on Salah Salman, tooth #12 was cracked completely around and loose after his surgery which led to loss of that tooth.


About the end of August, 1995, I had surgery performed by Dr. Stephen N. Rous at Dartmouth Hitchcock Medical Center to remove a hydrocele in the right testicle area. I have included a copy of the Charge Determination sheet listing the procedure as hydrocelectomy. (Ro1 and Ro2)

I also enclose a copy of the ultrasound dated August 14, 1995 taken prior to that surgery which lists on the right very large epididymal cysts with a small hydrocele only slightly larger than normal. In the surgery he removed the cysts on the right and the tissue on the right which could lead to the development of a hydrocele even though there was no large hydrocele. He did not operate on the left as the cysts were still small and may not have increased in size. (Ro3)

The cysts on the left however gradually got larger over time and I had it included in the list of matters to be examined at my annual physical in February 28, 1997 and I was again referred to Dr. Rous. There was a new ultrasound done on April 10, 1998 which indicated multiple left epididymal cysts on the left side similar to the results of the 1995 test on the right side. (Ro4)

In my appointments with Dr. Rous, we discussed the procedures of the surgery in 1995 as it involved the same problems except now on the left side. I indicated my concerns as this was a second surgery and that I would like to eliminate possible future surgery. He indicated he would perform the same kind of surgery as in 1995 removing tissue that might lead to further complications especially any hydroceles.

On May 20, 1998, based on my understanding of what was to happen in the operation, I signed a consent form which indicated the procedure as "Hydrocoelectomy(Left)." On the day of the operation, I signed the consent to administration of anesthesia for anesthesia during a procedure, "SCROTAL EXPLORATION LT/EXCISION CYST*/HYDROCELECTOMY*" (Ro5)

After the operation, my condition was much, much worse than before the operation. The scrotum was swollen, extremely sore, bleeding around the sutures, etc. and was almost the size and feel of a baseball with the swelling going up into my groin and lower abdomen. This was entirely different from the hydrocelectomy done in 1995. Dr. Rous by letter of May 28, 1998 informed me that he only removed the epididymal cyst and not any other membranes that might cause complications. There were more than one cyst on the left side.

On June 3, 1998 I went for my annual physical evaluation with my Physician Assistant Kristin L. Carney who was associated with Dr. Richard D. Whiting. She wrote into my records, Genitourinary: Cannot insert finger into inguinal canal due to scrotal swelling. The patient has enlarged left testicle, difficult to discern the testicle amongst the swelling, which is anterior and lateral." Under Assessment/Plan: "1. Status post hydrocelectomy had epididymal cyst resection, left testicle, with increased swelling since operation, warmth. Have called Dr. Lars Ellison in Neurology who will see the patient today to assess whether he might require any antibiotic therapy until his follow-up visit, June 8, 1998. I did not get any antibiotics and had to continue to struggle with just getting around. The pain and swelling went high up into the groin as well as into the lower abdomen area. Even now, from time to time, there is some swelling and pain that still can go up into the lower abdomen area. (Ro6)

As a result of the swelling, another ultra sound was performed on June 12, 1998 which now indicated that there was a very large left hydrocele. The left testis was hyperemic (containing excessive blood) and the reedy testis dilated. (Ro8)

By letter of June 25, 1998, Dr. Rous informed me that I now had a hydrocele. He recommended an additional surgical procedure (hydrocelectomy) which we had discussed prior to this surgery and was to include removing the surrounding tissue that could lead to a hydrocele. In his letter he sets out what we discussed about the dangers of forming a hydrocele. At the time of the surgery he had changed the procedure and only removed the cysts. (Ro9)

The clinical review services Diagnosis and Procedure Data Collection form prepared by Rous sets out the surgical procedures that were supposed to be done and which were sent to Healthsource. For the surgery of May 22, 1998 the CPT Codes: were 55040 (excision of hydrocele) and 54830 (excision of local lesion of epididymus. Under the Procedures (with dates): he listed 5/22 L. Hydrocelectomy ICD.9.CM-CODE 61.2 and Epididymus cyst exc. ICD.9.CM-CODE 63.3. In the (Final Diagnosis) Principal(Condition which after study caused admission):lists L. Hydrocele ICD.9.CM-CODE 603.9 and Other existing conditions/complications/post operative episodes: Epididymal cyst 608.89.

Under the Medicode Book that is used to define these types of surgeries, etc these are defined as follows:

61.2 Excision of hydrocele (of tunica vaginalis) The tunica vaginalis is the remnant of the pathway taken by the testicle as it descends into the scrotum, ordinarily in utero (while in the mother). In normal development it is isolated as a sac in the scrotum. In some instances the abdominal end remains open, however, and peritoneal fluid passes through the passageway creating a hydrocele of the tunica vaginalis. Fluid in this passageway is called a hydrocele.

63.3 Excision of other lesion of spermatic cord and epididymis. Excision of appendix epididymis.

Under the general section 603 Hydrocele includes hydrocele of spermatic cord, testis, or tunica vaginalis.

603.9 Hydrocele unspecified.
608.89 Other .... Cyst. (Ro10)

The same day Program Physician Record by Rous indicates: Prior surgery hydrocele R. Problem List: L. Hydrocele and under Rectal/Genital Ls epididymal cyst and L. Hydrocele. (Ro11)

Although there is listed hydrocele which we discussed prior to surgery, he left the tissue that could cause an hydrocele. The swelling did not go down to any noticeable extent for quite some time. It was very painful in all positions except standing with my feet spread apart with support or laying flat on my back. It would also increase in size depending on my activity and also generally enlarging as the day progressed, the longer on my feet, the larger it grew. Because of my occupation, I had to sit a lot which was extremely uncomfortable. It was extremely uncomfortable when driving. My goal was to avoid further complications and the pain, etc. and the expense of another operation. If I had known he was only going to remove the cyst and expose me to a second operation, I would not have consented to the operation at DHMC.

As the swelling did not go down, was extremely uncomfortable and restricted my activities, I tried to get a second opinion from Dr. Zafiropoulos the results of which has been set out in a prior section.


On July 14, 1998, I went to Dr. Kevin Killeen, a local urologist for a separate opinion and surgery for removal of the hydrocele if it did not resolve itself. He strongly recommended that an operation within six months of the May 22, 1998 operation was out of the question as it was almost certain to result in more serious complications, almost guarantee loss of the testicle. He also indicated that an operation after the six month period would involve a high risk of serious complications and likely loss of the testicle. He indicated that the first operation had now created a higher risk of serious complications for a second operation. At this time the hydrocele completely surrounded the left testicle. As it was not getting better on August 21, 1998, I wrote to him about having the operation performed rather than waiting for 3 months. (Ki1)

He called and told me that one of the complications would be the loss of the left testicle. He indicated he would require me to sign a consent with that understanding. I wrote to him on August 25, 1998 confirming his opinion as I wanted to be sure I had misunderstood his opinion and he never contacted me to modify the contents of my letter. (Ki2)

There evidently was communication between Dr. Killeen and my primary care physician, Dr. Connolly and I enclose a copy Dr. Connolly's letter confirming Killeen's warning of loss of the testicle. You will also note his reference to the oral surgeries issues which were also ongoing as well. (Ki3)

Becoming quite concerned that I would have to live with the hydrocele which was severely restricting my activities, using a payphone I called two urology offices in southern New Hampshire. I indicated that I had an epididymal cyst removed and now had an hydrocele which completely surrounded and put pressure on the testicle. I wanted to get it removed. I indicated that a friend had told me that there was a high risk of losing the testicle because of the first operation to remove an epididymal cyst. At the first place, the chief nurse indicated that if the hydrocele was completely around the testicle and putting pressure on the testicle, it was more likely to cause damage to the testicle than a second operation. She indicated that for that type of operation, the first operation did not cause a high risk of loss of the testicle. At the second place, I had the same discussion with one of the urologists, who laughed at the idea of loss of the testicle if I was operated on for the hydrocele. Even my primary care physician since has indicated that Killeen over exaggerated the risks. It would appear that his advice if the hydrocele continued to completely surround the testicle, and increase pressure on the testicle, was more likely to cause damage to the testicle.

I obtained copies of my records from Dr. Killeen. Although his notes of July 14, 1998 indicate I was allergic to Tetracycline, he prescribed Doxycycline, as did Zafiropoulos. Again the pharmacy indicated it was contraindicated. Although I obtained the antibiotic, I did not take it. I have included a record prepared by my pharmacist indicating the prescription was written. (Ki4 and Ki5)

He wrote to my primary care physician on August 22, 1998 indicating that I was not treated with antibiotics as I was allergic to Tetracycline. (Ki6)

My left testicle is somewhere inside a hard ball of tissue which is twice the size of my original testicle. The ball is hard enough that it is impossible to physically find the testicle. Since the operation in 1998 I have been unable to do the usual physical exam for growths or tumors.


I had my annual physicals performed at Dartmouth Hitchcock Medical Center for a number years and enclose copies of annual reports February 13, 1991, April 6, 1995 and March 25, 1997 which were sent to me with the annual results which are representative of the reports I have received up to but not in my annual physical in 1998. (An1, An2 and An3)

On June 3, 1998 I had my appointment with Kristin Carney my Physician's Assistant. At the examination, my blood pressure was taken by the nurse, the physician's assistant checked my chest with the stethoscope, did the manual check for prostate and colon polyps. There was a discussion of my present life style and I was given a hemocult kit to complete and return to the hospital. The Physician's assistant also examined the hydrocele resulting from the operation and recommended having another set of ultrasounds. As the physical appeared to be somewhat cursory compared to prior years, I asked if she would be able to get the rest of the results from the prior urine and blood tests, etc.(I had a series of tests just before the May 22, 1998 operation /hydrocelectomy) and she indicated those results could be used. I sent in the hemocult test the week of June 15, 1998.

When I did not receive any results at all, I wrote on June 28, 1998 requesting results of the annual physical. (An4)

Ms. Carney left a message on my telephone message recorder for me to call her on taking a colonoscopy and I responded with a letter on July 27, 1998 again requesting the usual written results. (An5)

On July 30, 1998, I sent out a letter again requesting written results. I received a telephone call from the Physician's assistant after this letter was mailed in which she only gave me the results of the hemocult test and recommended a colonoscopy examination. (An6)

Because of various telephone conversations with the secretary who indicated they had already mailed a second hemocult kit, I sent another letter on July 31, 1998 acknowledging their sending of the second kit and advising them that I had a new primary care physician. (An7)

Upon request for my records I received a copy of the July 30, 1998 checklist with only the Stool Hidden Blood results of the hemocult kit listed. (An8)



For a number of years I was an approved attorney for First American Title Insurance Company and over the years sent a substantial number of requests for title insurance on First American through a local attorney, Karl Bruckner, who was the agent for First American. Sometime prior to 1993, Karl sold his title insurance company, North Country Title Services to the law firm in which one of the four Bar Examiners for the Bar Examination in 1972, Willard G. Martin, Jr. Esq. is the senior partner.

In December, 1994, I received a letter from First American Title Insurance Company in which they indicated First American records did not indicate that I had used their services for quite some time. I sent a letter back making them aware that my applications were on a regular basis but were going through North Country Title. At the time of my letter I had pending six title insurance applications on First American. I requested they contact North Country to get an accurate record of my applications. They were satisfied with the number of my applications. (Fi1)

I continued to place title policies through North Country Title Services on a regular basis.

I received a letter of June 18, 1996 from Richard A. Dickson, Vice President and State Manager of First American Title Insurance Company that they were cancelling my approved attorney status. There was no question about the amount of policies I was requesting from them. I was cancelled without cause. At the time I had four active policy applications needed for closings for a two banks. (Fi2)

I called First American and North Country to indicate I was obtaining policies on a regular basis from First American through North Country and had four pending policies that I needed for clients. Mr. Dickson faxed and mailed a letter authorizing me to continue until my existing title insurance orders were finished and then I was cancelled. (Fi3)

There did not appear to be any logical explanation for terminating an approved attorney who was obtaining title insurance policies on a regular basis and at the time of cancellation had four active applications. There had never been a claim made against any policy I had written on First American nor any other insurance company. An approved attorney does not issue policies nor receive any part of the premium. To be accepted as an approved attorney, you have to show that you are an attorney in good standing, have not had any recent or major title defect claims made, and that you have sufficient malpractice insurance all of which I was in compliance. First American was not incurring any expense because I was an approved attorney but were receiving premiums on the policies I was placing with North Country.

Quite some time later a person who worked in that law office told me they were sorry about what had been done to me with First American. The person indicated the cancellation resulted from information sent by personnel at the law firm.

At the time of cancellation all the banks that I certified title to required title insurance. If I had not also been an agent with another Title Insurance Company, it would have made it more difficult for me to offer the same service especially for new re-write mortgages which were previously insured under First American.


On September 23, 1996, I had a call on my telephone message machine from a law firm in Concord, N.H. The message indicated that someone had done a title search on property that I had certified title to several years prior and they had found a title error. That it was property in Monroe, NH owned by Michael McFazden, a Trooper with the N.H. State Police. That the sale was about to fall through which would result in a large claim for damages unless I or the Bank holding the mortgage came up with $3,900.00 within 48 hours.

I made repeated calls to the law office and talked to the secretary but could not get any information about the defect, only that it was serious and $3,900.00 was required to clear it up to close. I spent most of the day trying to get information from them. As I assumed it was legitimate, I called another attorney to represent me and was about to report it to my insurance carrier when in response to still another call late in the day from me, a fax of a letter was sent to me at 4:10 P.M.. The letter of demand was prepared and sent out not only to the attorneys involved in the incident, but also mailed to my bank without informing me of the claimed error or giving me an opportunity to review my file. (Ma1 and Ma2A, Ma2B)

If they had given information on the claimed defect, I could have faxed them a copy of the recorded partial release of the attachment. You will note that the letter itself does not indicate the name of the party on the attachment. I went to the Registry of Deeds and reviewed all my title work again to be sure there was not another attachment. When they finally indicated the specific claimed defect, I was able to refer them to the release but the damage was done. The Bank President was very upset with receiving a letter demanding money without any information on the claim.

When I called Dave Shepatin's office about the partial release information that should be in his file, his secretary indicated that my correspondence about the release and payment were in the file. Later in the day I talked to Shepatin and asked him why he made the claim for the $3,900.00 and he said he forgot it. I called Attorney Puckhaber to obtain the time frame for this matter. She indicated she had been contacted about the attachment first on September 11, 1996 with ten or more follow up calls.

When I reviewed the file in conjunction with the activities over the claimed defect, the whole matter did not make any sense. The documents were recorded sequentially with the partial release of the attachment recorded in Book 1881 Page 454, this being the page before the discharge of the prior mortgage which was on page 455. The Registry Book 1881 opens so that page 454 is at the top and page 455 is at the bottom so that the reader will see both documents when looking at the open book. If one was aware of a lien one would look in the few pages before and after the deed to see if the discharges and releases were recorded together. (Ma3, Ma4)

A copy of the final update report dated October 13, 1990 listing the recording information of the partial release of the attachment was sent to Mr. McFazden. (Ma5)

The alleged attachment lien was first discussed on September 11, 1996 but no one contacted the attorney who did the prior search and wrote the owner's title insurance policy.

All title policies specifically indicate that as soon as a defect is found, the company must be notified to make a claim and I as the agent should have been notified of the defect to allow the Company to take steps to remove the defect. Title standards indicate the prior attorney should be contacted to allow a response which is a customary courtesy that is extended before sending letters especially to a client of the attorney, in this instance the Bank. None of these procedures were followed. The seller had an owner's title insurance policy and the claim should have been made under the terms of the policy.


The Town of Haverhill (Woodsville is a village precinct in Haverhill) had been going through a reappraisal for some time and we did not know for sure when it would be completed. While I was out of the area, the Haverhill Town Booklets listing the new tax appraisals were mailed first class mail to all Haverhill Taxpayers at their last known tax mailing address.

We did not receive our tax booklet at our last known address of 1095 Woodsville Road, Monroe, NH and being out of the area was not aware they had been mailed out. On a chance conversation with an acquaintance at the Registry of Deeds, she asked me what I thought of my new appraisal on the Woodsville property. I obtained a spare copy and found that the Woodsville Propert was now assessed at $91,500.00. (Wo1 and Wo2)

I had recently had an appraisal by a licensed appraiser and it was appraised at $35,000.00 as it was in need of considerable repair. (Wo3)

I called the Haverhill Town Office to find out why we had not received the tax assessment booklet and was informed that it was sent to our old residence in North Haverhill, N. H., that it had returned and they were re-mailing it. We never received from the Town of Haverhill by mail a tax booklet or this tax booklet which would have shown the mailing and re-mailing. The Town administrative assistant indicated that the Town had sent to the appraisers, Nyberg, Purvis & Associates a list of taxpayers as their addesses appeared in the Towns computer. I sent a letter of October 13, 2000 to the Town and the appraisers setting out my concerns about not receiving the tax assessment booklet and requesting a copy of the page with my address of the town printout of addresses from the appraiser and enclose a portion of it. (Wo4A, Wo4B)

By letter of October 23, 2000, I requested from the Town a copy of the page of the computer print-out as sent to the appraisers listing my address. The town sent a copy of the page which showed the address 1095 Woodsville Road, Monroe, NH 03771. (Wo5)

By letter of October 24, 2000, the appraiser sent a copy of the page with my address as they received from the Town. They also adjusted the appraisal from $91,500 down to $42,000.00. (Wo6)

The Town sent a letter of October 30, 2000 enclosing a copy of the page with my address the town sent to the appraiser. (Wo7)

The page both in the town computer and as sent to the appraiser were the same, 1095 Woodsville Road, Monroe, NH 03771. (Wo8)

We moved from our old address in North Haverhill to Monroe in 1986 and all tax forms and notices have been sent to our Monroe address except for the tax booklet. The old address we had in North Haverhill no longer existed in the town records as it had been replaced by the 911 addresses and was under the new owners. Every indication is that the tax booklet was never mailed to me at any address.