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1054763\311789382.v1 

JS 44 (Rev. 9/19) CIVIL COVER SHEET

The JS 44 civil cover sheet and the information contained herein neither replace nor supplement the filing and service of pleadings or other papers as required by law, except 

as provided by local rules of court. This form, approved by the Judicial Conference of the United States in September 1974, is required for the use of the Clerk of Court for the 

purpose of initiating the civil docket sheet. (SEE INSTRUCTIONS ON NEXT PAGE OF THIS FORM.)

I. (a) PLAINTIFFS 

PALMETTO EKG & ECHO READERS PROFESSIONAL ASSOCIATION, 

DEFENDANTS

CIGNA HEALTHCARE OF FLORIDA, INC.

(b) County of Residence of First Listed Plaintiff Broward County, Florida County of Residence of First Listed Defendant Hillsborough County FL 

(EXCEPT IN U.S. PLAINTIFF CASES) (IN U.S. PLAINTIFF CASES ONLY)

NOTE: INLAND CONDEMNATION CASES, USE THE LOCATION OF 

THE TRACT OF LAND INVOLVED.

(c) Attorneys (Firm Name, Address, and Telephone Number) 

Patrick Sullivan, Mark Rosen, George Dahdal, Lubell Rosen, 200 S. Andrews 

Ave, # 900, Ft. Lauderdale, FL 33301, prs@lubellrosen.com

mlr@lubellrosen.com , ged@lubellrosen.com. 

Attorneys (If Known) 

Ruel W. Smith, Esq. and Steven Lehner, Hinshaw & Culbertson, LLP, 

100 South Ashley Drive, Ste 500, Tampa FL rsmith@hinshawlaw.com

and slehner@hinshawlaw.com

II. BASIS OF JURISDICTION (Place an “X” in One Box Only) III. CITIZENSHIP OF PRINCIPAL 

PARTIES

(For Diversity Cases Only)

(Place an “X” in One Box for 

Plaintiff and One Box for Defendant)

 1 U.S. Government

Plaintiff

2 U.S. Government

Defendant

3 Federal Question

(U.S. Government Not a Party)

4 Diversity

(Indicate Citizenship of Parties in Item III)

Citizen of This State

Citizen of Another State

Citizen or Subject of a 

Foreign Country

PTF DEF

1 1 

2 2 

3 3

Incorporated or Principal Place 

of Business In This State

Incorporated and Principal Place 

of Business In Another State

Foreign Nation

PTF DEF

4 4 

5 5

6 6

IV. NATURE OF SUIT (Place an “X” in One Box Only) Click here for: Nature of Suit Code Descriptions

CONTRACT TORTS FORFEITURE/PENALTY BANKRUPTCY OTHER STATUTES

 110 Insurance 

 120 Marine 

 130 Miller Act 

 140 Negotiable Instrument 

 150 Recovery of 

Overpayment 

& Enforcement of 

Judgment 

 151 Medicare Act 

 152 Recovery of Defaulted 

 Student Loans (Excludes 

Veterans) 

 153 Recovery of 

Overpayment 

 of Veteran’s Benefits 

 160 Stockholders’ Suits 

 190 Other Contract 

 195 Contract Product 

Liability 

 196 Franchise 

PERSONAL INJURY

 310 Airplane 

 315 Airplane Product 

Liability 

 320 Assault, Libel & 

Slander 

 330 Federal Employers’ 

Liability 

 340 Marine 

 345 Marine Product 

Liability 

 350 Motor Vehicle 

 355 Motor Vehicle 

Product Liability 

 360 Other Personal 

Injury 

 362 Personal Injury - 

Med. Malpractice 

PERSONAL INJURY

 365 Personal Injury - 

Product Liability 

 367 HealthCare / 

 Pharmaceutical 

 Personal Injury 

 Product Liability 

 368 Asbestos Personal 

Injury Product 

 Liability 

PERSONAL PROPERTY

 370 Other Fraud 

 371 Truth in Lending 

 380 Other Personal 

Property Damage 

 385 Property Damage 

Product Liability 

 625 Drug Related Seizure 

 of Property 21 USC 881 

 690 Other 

 422 Appeal 28 USC 158 

 423 Withdrawal 

 28 USC 157 

 375 False Claims Act 

 376 Qui Tam (31 USC 

3729(a)) 

400 State Reapportionment 

 410 Antitrust 

 430 Banks and Banking 

 450 Commerce 

 460 Deportation 

 470 Racketeer Influenced 

and 

 Corrupt Organizations 

 480 Consumer Credit 

 490 Cable/Sat TV 

 850 

Securities/Commodities/ 

 Exchange 

 890 Other Statutory Actions 

 891 Agricultural Acts 

 893 Environmental Matters 

 895 Freedom of Information 

 Act 

 896 Arbitration 

 899 Administrative 

Procedure 

Act/Review or Appeal of 

Agency Decision 

 950 Constitutionality of 

 State Statutes 

PROPERTY RIGHTS

 820 Copyrights 

 830 Patent 

 830 Patent – Abbreviated 

 New Drug Application 

 840 Trademark

LABOR SOCIAL SECURITY

 710 Fair Labor Standards 

 Act 

 720 Labor/Mgmt. Relations 

 740 Railway Labor Act 

 751 Family and Medical 

 Leave Act 

 790 Other Labor Litigation 

 791 Empl. Ret. Inc. 

 Security Act 

 861 HIA (1395ff) 

 862 Black Lung (923) 

 863 DIWC/DIWW (405(g)) 

 864 SSID Title XVI 

 865 RSI (405(g)) 

REAL PROPERTY CIVIL RIGHTS PRISONER PETITIONS FEDERAL TAX SUITS

 210 Land Condemnation 

 220 Foreclosure 

 230 Rent Lease & Ejectment 

 240 Torts to Land 

 245 Tort Product Liability 

 290 All Other Real Property 

 440 Other Civil Rights 

 441 Voting 

 442 Employment 

 443 Housing/ 

Accommodations 

 445 Amer. w/DisabilitiesEmployment 

 446 Amer.w/DisabilitiesOther 

 448 Education 

Habeas Corpus:

 463 Alien Detainee 

 510 Motions to Vacate 

Sentence 

Other: 

 530 General 

 535 Death Penalty 

 540 Mandamus & Other 

 550 Civil Rights 

 555 Prison Condition 

 870 Taxes (U.S. Plaintiff 

 or Defendant) 

 871 IRS-Third Party 26 USC 

7609 

IMMIGRATION

 462 Naturalization Application 

 465 Other Immigration 

Actions 

V. ORIGIN (Place an “X” in One Box Only)

 1 Original 

Proceeding 

2 

Removed 

from State 

 Court 

3 Re-filed (see VI 

below)

4 

Reinstated or 

Reopened 

 5 Transferred from 

Another District 

(Specify) 

6 Multidistrict 

Litigation 

Transfer 

7 Appeal to 

District Judge from 

Magistrate 

Judgment 

8 Multidistrict 

Litigation 

Transfer 

9 Remanded from 

Appellate Court 

VI. RELATED/REFILED CASE(S)

(See instructions): a) Re-filed Case Yes No b) Related Cases Yes No 

 Docket Number: 

VII. CAUSE OF 

ACTION 

Cite the U.S. Civil Statute under which you are filing and Write a Brief Statement of Cause (Do no cite jurisdictional statutes unless diversity): 

28 U.S.C. § 1331, 28 U.S.C. § 1441 and 28 U.S.C. § 1446 

LENGTH OF TRIAL via 4 days estimated (for both sides to try entire case) 

VII. REQUESTED IN 

COMPLAINT:

CHECK IF THIS IS A CLASS ACTION UNDER 

RULE 23, F.R.Cv.P.

DEMAND $ 

 

CHECK YES only if demanded in complaint: 

JURY DEMAND: Yes No

ABOVE INFORMATION IS TRUE & CORRECT TO THE BEST OF MY KNOWLEDGE 

DATE 10/14/22 SIGNATURE OF ATTORNEY OF RECORD /s/ Ruel W. Smith 

FOR OFFICE USE ONLY

RECEIPT# Amount IFP JUDGE MAG JUDGE 

Case 1:22-cv-23355-JEM Document 1-3 Entered on FLSD Docket 10/14/2022 Page 1 of 2
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1054763\311789382.v1 

JS 44 Reverse (Rev. 09/19) 

INSTRUCTIONS FOR ATTORNEYS COMPLETING CIVIL COVER SHEET FORM JS 44

Authority For Civil Cover Sheet

The JS 44 civil cover sheet and the information contained herein neither replaces nor supplements the filings and service of pleading or other papers as required 

by law, except as provided by local rules of court. This form, approved by the Judicial Conference of the United States in September 1974, is required for the 

use of the Clerk of Court for the purpose of initiating the civil docket sheet. Consequently, a civil cover sheet is submitted to the Clerk of Court for each civil 

complaint filed. The attorney filing a case should complete the form as follows: 

I.(a) Plaintiffs-Defendants. Enter names (last, first, middle initial) of plaintiff and defendant. If the plaintiff or defendant is a government agency, use only the 

full name or standard abbreviations. If the plaintiff or defendant is an official within a government agency, identify first the agency and then the official, 

giving both name and title. 

(b) County of Residence. For each civil case filed, except U.S. plaintiff cases, enter the name of the county where the first listed plaintiff resides at the time 

of filing. In U.S. plaintiff cases, enter the name of the county in which the first listed defendant resides at the time of filing. (NOTE: In land condemnation 

cases, the county of residence of the "defendant" is the location of the tract of land involved.) 

(c) Attorneys. Enter the firm name, address, telephone number, and attorney of record. If there are several attorneys, list them on an attachment, noting in this 

section "(see attachment)". 

II. Jurisdiction. The basis of jurisdiction is set forth under Rule 8(a), F.R.Cv.P., which requires that jurisdictions be shown in pleadings. Place an "X" in one 

of the boxes. If there is more than one basis of jurisdiction, precedence is given in the order shown below. 

United States plaintiff. (1) Jurisdiction based on 28 U.S.C. 1345 and 1348. Suits by agencies and officers of the United States are included here. 

United States defendant. (2) When the plaintiff is suing the United States, its officers or agencies, place an "X" in this box.

Federal question. (3) This refers to suits under 28 U.S.C. 1331, where jurisdiction arises under the Constitution of the United States, an amendment to the 

Constitution, an act of Congress or a treaty of the United States. In cases where the U.S. is a party, the U.S. plaintiff or defendant code takes precedence, 

and box 1 or 2 should be marked. 

Diversity of citizenship. (4) This refers to suits under 28 U.S.C. 1332, where parties are citizens of different states. When Box 4 is checked, the 

citizenship of the different parties must be checked. (See Section III below; NOTE: federal question actions take precedence over diversity cases.) 

III. Residence (citizenship) of Principal Parties. This section of the JS 44 is to be completed if diversity of citizenship was indicated above. Mark this 

section for each principal party. 

IV. Nature of Suit. Place an "X" in the appropriate box. If there are multiple nature of suit codes associated with the case, pick the nature of suit code that is 

most applicable. Click here for: Nature of Suit Code Descriptions. 

V. Origin. Place an "X" in one of the seven boxes. 

Original Proceedings. (1) Cases which originate in the United States district courts. 

Removed from State Court. (2) Proceedings initiated in state courts may be removed to the district courts under Title 28 U.S.C., Section 1441. 

Remanded from Appellate Court. (3) Check this box for cases remanded to the district court for further action. Use the date of remand as the filing date. 

Reinstated or Reopened. (4) Check this box for cases reinstated or reopened in the district court. Use the reopening date as the filing date. Transferred 

from Another District. (5) For cases transferred under Title 28 U.S.C. Section 1404(a). Do not use this for within district transfers or multidistrict 

litigation transfers. 

Multidistrict Litigation – Transfer. (6) Check this box when a multidistrict case is transferred into the district under authority of Title 28 U.S.C. Section 

1407. 

Multidistrict Litigation – Direct File. (8) Check this box when a multidistrict case is filed in the same district as the Master MDL docket. PLEASE 

NOTE THAT THERE IS NOT AN ORIGIN CODE 7. Origin Code 7 was used for historical records and is no longer relevant due to changes in 

statue. 

VI. Cause of Action. Report the civil statute directly related to the cause of action and give a brief description of the cause. Do not cite jurisdictional 

statutes unless diversity. Example: U.S. Civil Statute: 47 USC 553 Brief Description: Unauthorized reception of cable service 

VII. Requested in Complaint. Class Action. Place an "X" in this box if you are filing a class action under Rule 23, F.R.Cv.P. Demand. In 

this space enter the actual dollar amount being demanded or indicate other demand, such as a preliminary injunction. Jury Demand. 

Check the appropriate box to indicate whether or not a jury is being demanded. 

VIII. Related Cases. This section of the JS 44 is used to reference related pending cases, if any. If there are related pending cases, insert the docket 

numbers and the corresponding judge names for such cases. 

Date and Attorney Signature. Date and sign the civil cover sheet. 

Case 1:22-cv-23355-JEM Document 1-3 Entered on FLSD Docket 10/14/2022 Page 2 of 2