EXHIBIT 4.8
CLASS ACTION
SETTLEMENT AGREEMENT
Among
SULZER ORTHOPEDICS INC.,
SULZER MEDICA AG,
XXXXXX XX,
and
CLASS COUNSEL ON BEHALF OF CLASS REPRESENTATIVES
IN RE SULZER HIP PROSTHESIS AND KNEE PROSTHESIS LIABILITY LITIGATION
MDL DOCKET NO. 01-CV-9000 (MDL NO. 1401)
dated as of
March 13, 2002
TABLE OF CONTENTS
PAGE
Article 1. DEFINITIONS....................................................................................2
Section 1.1 DEFINITIONS..........................................................................2
Article 2. SULZER SETTLEMENT TRUST AND FUNDS.............................................................12
Section 2.1 ESTABLISHMENT OF SULZER SETTLEMENT TRUST............................................12
Section 2.2 ESTABLISHMENT OF PATIENT BENEFIT FUNDS..............................................13
Section 2.3 SULZER SETTLEMENT TRUST BROKERAGE ACCOUNT...........................................13
Section 2.4 SECURITY ARRANGEMENTS...............................................................15
Section 2.5 FUNDING.............................................................................15
Section 2.6 OTHER PROVISIONS....................................................................17
Article 3. CLASS MEMBER RIGHTS AND BENEFITS..............................................................18
Section 3.1 MEDICAL RESEARCH AND MONITORING.....................................................18
Section 3.2 [RESERVED]..........................................................................19
Section 3.3 BENEFITS PAYABLE TO CLASS MEMBERS OUT OF THE UNREVISED AFFECTED PRODUCT
RECIPIENT FUND................................................................................19
Section 3.4 BENEFIT PAYMENTS TO CLASS MEMBERS OUT OF THE AFFECTED PRODUCT REVISION
SURGERY FUND..................................................................................19
Section 3.5 DERIVATIVE CLAIMANT PAYMENTS........................................................20
Section 3.6 OFFSETS.............................................................................21
Section 3.7 COMPENSATION BENEFITS PAYABLE FROM EXTRAORDINARY INJURY FUND........................21
Section 3.8 OPT-OUT RIGHTS......................................................................22
Article 4. CLAIMS ADMINISTRATION.........................................................................23
Section 4.1 UNREVISED AFFECTED PRODUCT RECIPIENT FUND...........................................23
Section 4.2 AFFECTED PRODUCT REVISION SURGERY FUND..............................................24
Section 4.3 EXTRAORDINARY INJURY FUND...........................................................25
Section 4.4 DERIVATIVE CLAIMANTS................................................................26
Section 4.5 UNINSURED AFFECTED PRODUCT RECIPIENTS...............................................26
Section 4.6 GENERAL CLAIMS ADMINISTRATION.......................................................26
Section 4.7 INDEMNIFICATION AND LIABILITY OF CLAIMS ADMINISTRATOR...............................28
Article 5. ATTORNEYS' FEES...............................................................................29
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TABLE OF CONTENTS
(CONTINUED)
PAGE
Article 6. ISSUANCE OF CCI...............................................................................30
Article 7. GENERAL TERMINATION AND RELEASE...............................................................31
Article 8. GUARANTEED PAYMENT OPTION.....................................................................32
Article 9. CONTINUING JURISDICTION.......................................................................33
Article 10. TERMINATION...................................................................................34
Article 11. [RESERVED]....................................................................................35
Article 12. [RESERVED]....................................................................................35
Article 13. SETTLEMENT IMPLEMENTATION.....................................................................35
Section 13.1 GENERAL.............................................................................35
Section 13.2 APPROVAL PROCESS PROVISIONS.........................................................35
Section 13.3 CONDITIONS..........................................................................35
Article 14. [RESERVED]....................................................................................36
Article 15. MISCELLANEOUS.................................................................................36
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CLASS ACTION SETTLEMENT AGREEMENT
WITH SULZER ORTHOPEDICS INC., et. al.
This SETTLEMENT AGREEMENT, dated as of March 13, 2002 (this "Settlement
Agreement" or "Class Action Settlement" or "Settlement"), is entered into by and
among Sulzer Orthopedics Inc., a
Delaware corporation ("SOUS"), and its
affiliated entities (including Sulzer Medica AG, a limited company organized
under the laws of Switzerland ("SML"), and each of the other SML direct or
indirect subsidiaries (such subsidiaries, together SOUS, SML and any other
direct or indirect subsidiaries of SML, are referred to collectively herein as
"Sulzer"), and Xxxxxx XX, a limited company organized under the laws of
Switzerland ("Xxxxxx XX"), each on behalf of themselves and the other Released
Parties hereunder, and the undersigned Class Counsel on behalf of the Class
Representatives (in each case, as defined herein). The Class Representatives,
together with Sulzer and Xxxxxx XX, are sometimes referred to herein as the
"Parties". This Settlement Agreement shall amend and supercede any prior
agreements of the Parties with respect to the subject matter hereof (other than
that certain Settlement Agreement, dated as of February 22, 2002, between SML
and Xxxxxx XX), including without limitation, the Settlement Agreement dated
August 15, 2001, as amended and restated as of August 23, 2001, further amended
and restated as of September 12, 2001, and further amended and restated as of
October 12, 2001, and the Memorandum of Understanding dated as of February 1,
2002.
RECITALS
WHEREAS, Sulzer, Xxxxxx XX, and the Class Representatives hereby agree
to a class action settlement (the "Class Action Settlement" or "Settlement"),
subject to the approval of the Federal District Court, with respect to Class
Members in the United States which would resolve, on the terms set forth in this
Settlement Agreement, Settled Claims against Sulzer, Xxxxxx XX and other
Released Parties arising from the Affected Products, pending in various courts,
including but not limited to claims which have been made in the actions that
have been or will be transferred for coordinated or consolidated pretrial
proceedings to the United States District Court for the Northern District of
Ohio, Eastern Division (In Re Sulzer Hip Prosthesis And Knee Prosthesis
Liability Litigation (MDL No. 1401)), and in numerous other courts.
WHEREAS, this Settlement Agreement shall not be construed as evidence
of or as an admission by Sulzer or Xxxxxx XX of any liability or wrongdoing
whatsoever or as an admission by the Class Representatives or Class Members of
any lack of merit in their claims.
NOW, THEREFORE, Sulzer, Xxxxxx XX and the Class Representatives hereby
agree, subject to Final Judicial Approval, compliance with applicable legal
requirements, and other conditions, all as set forth below, that the Unrevised
Affected Product Recipient Fund, Affected Product Revision Surgery Fund, Medical
Research and Monitoring Fund, Subrogation and Uninsured Expenses Fund and
Extraordinary Injury Fund shall be established, from which the benefits
described herein will be paid to the Class Members of the proposed Settlement
Class, and that the Settled Claims against Sulzer and other Released Parties, as
defined herein, will be settled, compromised and released, in accordance with
the following terms.
ARTICLE 1. DEFINITIONS
Section 1.1 DEFINITIONS. For purposes of this Settlement Agreement the
following terms shall have the meanings set forth in this Article 1. Terms used
in the singular shall be deemed to include the plural and vice versa.
(a) "$" shall denote United States dollars.
(b) "Additional Non-Affected Product Revision Surgery" shall
mean a surgery, not the result of trauma, performed to remove and/or replace a
product that is not an Affected Product after a Non-Affected Product Revision
Surgery and prior to the date that is three hundred and sixty-five (365) days
after the initial Affected Product Revision Surgery with respect to the same hip
or knee.
(c) "ADRs" shall mean the American Depositary Receipts of SML
(NYSE ticker symbol: SM), issued pursuant to that certain Deposit Agreement
between SML and Citibank, N.A., as Depositary thereunder, each representing one
American Depository Share (as defined in the Deposit Agreement).
(d) "Affected Products" shall mean (i) Inter-Op(TM) Acetabular
shells ("Inter-Op Shells") identified in SOUS's Safety Alert dated December 5,
2000 as identified by lot numbers on Annex I attached hereto, (ii) Natural
Knee(R) II Tibial Baseplates ("Tibial Baseplates") identified in SOUS's Special
Notification dated May 17, 2001 as identified by lot numbers on Annex I attached
hereto, (iii) Inter-Op Shells and Tibial Baseplates that are otherwise
identified by lot numbers on Annex I attached hereto and (iv) reprocessed
Inter-Op Shells ("Reprocessed Inter-Op Shells") identified by lot numbers on
Annex II attached hereto.
(e) "Affected Product Recipients" shall mean persons who are
citizens or residents of the United States, in whose bodies one or more Affected
Products have been or are now implanted in an operation or other surgical
procedure, whether or not any such Affected Product has been or may in the
future be removed.
(f) "Affected Product Related" shall mean arising out of,
based upon, relating to, or involving an Affected Product.
(g) "Affected Product Revision Surgery" or "APRS" shall mean
surgical removal and/or replacement of an Affected Product for reason other than
trauma.
(h) "Affected Product Revision Surgery Fund" shall have the
meaning set forth in Section 2.1(d).
(i) "Affected Product Revision Surgery Fund Benefits Claim
Form" shall have the meaning set forth in Section 4.2(a).
(j) "Blue Form" shall have the meaning set forth in Section
4.1(a).
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(k) "Business Day" shall mean any day other than Saturday,
Sunday or any U.S. federal holiday or any other day that the Trustee is closed.
(l) "CCI" shall have the meaning set forth in Section 6.1.
(m) "CCI Issue Date" shall have the meaning set forth in Annex
V.
(n) "CHF" shall denote Swiss francs.
(o) "Claim Form" means the Unrevised Affected Product
Recipient Fund Benefits Claim Form (or Blue Form), the Affected Products
Revision Surgery Fund Benefits Claim Form (or Orange Form), the EIF Benefits
Claim Form (or Green Form), the Derivative Benefits Claim Form (or Yellow Form)
and the Uninsured Medical Expenses Claim Form (or Red Form) and any additional
documentation required thereby.
(p) "Claims Administrator" shall mean Xxxxx XxXxxxxxx (subject
to the approval of the Court) and/or his agents, or upon the failure of the
Court to so approve his appointment, his resignation or removal, any person or
persons to be appointed by the Court and/or his or her agents, to administer
claims for benefits and to make determinations under this Settlement Agreement
and the Trust Documents and give instructions to the Trustee in connection
therewith.
(q) "Class Action Settlement" or "Settlement" shall have the
meaning set forth in the Recitals.
(r) "Class Counsel" shall mean those attorneys executing this
Settlement Agreement on behalf of the Class Representatives, or such other
attorneys as shall be approved by the Court as counsel to the Settlement Class.
(s) "Class Members" shall mean members of the Settlement
Class.
(t) "Class Representatives" shall mean, with respect to
Subclass I, Xxxxxx Yasanchak and Xxxx Xxxx Yasanchak (as Derivative Claimant),
with respect to Subclass II, Xxxxxx X. Xxxxxx, Xxxxxx X. Xxxxxx (as Derivative
Claimant) and Xxxxx X. Xxxxx, with respect to Subclass III, Xxxxxx Xxxxxxx and
Xxxxxxxxx Xxxxxxx (as Derivative Claimant), with respect to Subclass IV,
Xxxxxxxx Xxxxxxxx and Xxxxx Xxxxxxxx (as Derivative Claimant) and Xxx Xxxx
Xxxxxxxxxx, Xx., with respect to Subclass V, Xxxxxxxx Xxx Xxxxxx and Xxxx X. Xxx
Xxxxxx (as Derivative Claimant), or different persons as shall be designated by
the Court as the representatives of the Settlement Class, in the action in
Federal District Court captioned In Re Sulzer Hip Prosthesis and Knee Prosthesis
Liability Litigation (MDL Docket No. 01-CV-9000, MDL No. 1401).
(u) "Code" means the Internal Revenue Code of 1986, as
amended, or any successor statute.
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(v) "Common Benefit Attorneys" shall mean those attorneys who
contributed to the creation of the Settlement Trust through work devoted to this
"common benefit" of Class Members, including any attorney who reasonably
believes that he or she actually conferred benefits upon the Class Members as a
whole through state court litigation, subject to determination by the Court.
(w) "Court" and/or "Trial Court" and/or "Federal District
Court" means the United States District Court for the Northern District of Ohio,
Eastern Division.
(x) "Covered Revision Surgery" or "CRS" shall mean an Affected
Product Revision Surgery, Non-Affected Product Revision Surgery and Additional
Non-Affected Product Revision Surgery.
(y) "Derivative Benefits Claim Form" shall have the meaning
set forth in Section 4.4(a).
(z) "Derivative Claimant" shall mean any person asserting the
right to xxx Xxxxxx and/or Xxxxxx XX independently or derivatively, by reason of
their personal relationship with an Affected Product Recipient as a spouse or
"significant other".
(aa) "Disposition Notice" shall have the meaning set forth in
Section 2.3(c).
(bb) "EIF Benefits Claim Form" shall have the meaning set
forth in Section 4.3(a).
(cc) "Election Notice" shall have the meaning set forth in
Section 2.3(c).
(dd) "Escrow Agreement" shall have the meaning set forth in
Section 2.5(b).
(ee) "Extraordinary Injury Fund" shall have the meaning set
forth in Section 2.1(d).
(ff) "Extraordinary Injury Fund Benefits" or "EIF Benefits"
shall have the meaning set forth in Section 3.7(a).
(gg) "Fairness Hearing" means the hearing conducted by the
Court to determine the fairness, adequacy and reasonableness of this Settlement
Agreement under Fed. R. Civ. P. 23(e).
(hh) "Fairness Hearing Date" means the date on which the
Fairness Hearing takes place.
(ii) "Final Determination" shall have the meaning set forth in
Section 4.6(e).
(jj) "Final Judicial Approval" refers to the approval of the
Settlement Agreement by the Federal District Court and such approval becoming
final by the exhaustion of
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all appeals, including petitions certiorari to the United States Supreme Court.
Final Judicial Approval shall be deemed not to have been obtained in the event
that Trial Court Approval is denied, and the period for appealing such denial
has expired without any such appeal having been taken.
(kk) "Final Judicial Approval Date" shall mean the date on
which Final Judicial Approval occurs.
(ll) "Financing Amount" shall have the meaning set forth in
Section 2.5(a).
(mm) "Financing" means those certain financing arrangements
negotiated by Sulzer in order to satisfy its funding obligations under Section
2.5(a) hereof.
(nn) "Funding Date" shall have the meaning set forth in
Section 2.5(a).
(oo) "Funds" means, collectively, the Medical Research and
Monitoring Fund, Unrevised Affected Product Recipient Fund, Professional
Services Fund, Subrogation and Uninsured Expenses Sub-Fund, Plaintiffs' Counsel
Sub-Fund, Affected Product Revision Surgery Fund and Extraordinary Injury Fund.
(pp) "GPO" shall have the meaning set forth in Section 8.1.
(qq) "GPO Agreement" shall have the meaning set forth in
Section 8.3.
(rr) "Green Form" shall have the meaning set forth in Section
4.3(a).
(ss) "Hip APRS" means surgical replacement of an Inter-Op
Shell that is an Affected Product for reason other than trauma.
(tt) "Hip Beneficiaries" shall mean Affected Product
Recipients of Inter-Op Shells and Reprocessed Inter-Op Shells and Derivative
Claimants of Affected Product Recipients of Inter-Op Shells and Reprocessed
Inter-Op Shells.
(uu) "Hip Matrix" shall have the meaning set forth in Annex
IV.
(vv) "Indemnification Agreement" shall have the meaning set
forth in Section 2.5(c).
(ww) "Initial Insurance Policies" shall mean the following
insurance policies issued by Winterthur International Insurance Company and
Winterthur Swiss Insurance Company: (i) Local Policy GL 000-00-00-00 (4/1/2000
to 3/31/2001), (ii) Master Policy No. 3.307.351 (4/1/2000 to 3/31/2001); (iii)
Excess Policy No. 3.307.352 (4/1/2000 to 3/31/2001); (iv) Excess Policy No.
3.307.353 (4/1/2000 to 3/31/2001); (v) Excess Policy No. 3.167.933 (4/1/2000 to
3/31/2001); (vi) Excess Policy No. 3.167.934 (4/1/2000 to 3/31/2001); and (vii)
Excess Policy No. 3.312.133 (4/1/2000 to 3/31/2001).
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(xx) "Initial Insurance Proceeds" shall mean the insurance
proceeds payable for the benefit of SOUS, SML, or any SML subsidiary and
affiliate (up to applicable policy limits, less the aggregate amount of any
claims submitted by Sulzer that are pending as of the Insurance Proceeds
Delivery Date) pursuant to the Initial Insurance Policies.
(yy) "Insurance Proceeds" shall mean the Initial Insurance
Proceeds and the Second Year Insurance Proceeds.
(zz) "Insurance Proceeds Delivery Date" shall have the meaning
set forth in Section 2.5(c).
(aaa) "Knee APRS" means surgical replacement of a Tibial
Baseplate that is an Affected Product for reason other than trauma.
(bbb) "Knee Beneficiaries" shall mean Affected Product
Recipients of Tibial Baseplates and Derivative Claimants of Affected Product
Recipients of Tibial Baseplates.
(ccc) "Knee Matrix" shall have the meaning set forth in Annex
IV.
(ddd) "Liens" shall mean, with respect to any asset, any
mortgage, lien, pledge, charge, security interest or encumbrance of any kind in
respect of such asset.
(eee) "Matrices" or "Matrix" shall have the meaning set forth
in Section 3.7(a).
(fff) "Matrix Levels" shall have the meaning set forth in
Annex IV.
(ggg) "Medical Research and Monitoring Fund" shall have the
meaning set forth in Section 2.1(d).
(hhh) "Non-Affected Product Revision Surgery" or "NAPRS" shall
mean a surgery (not indicated as a result of trauma) that was performed to
remove and/or replace a product that is not an Affected Product within
one-hundred and eighty (180) days of an Affected Product Revision Surgery in
respect of a hip or knee that previously underwent an Affected Product Revision
Surgery.
(iii) "Notice" shall have the meaning set forth in Section
13.2(a).
(jjj) "Orange Form" shall have the meaning set forth in
Section 4.2(a).
(kkk) "Opt-Out Period" shall mean the period beginning at 5:00
p.m. Cleveland time on April 12, 2002 through 5:00 p.m. Cleveland time on May
14, 2002 or five (5) Business Days after Trial Court Approval, whichever is
later, during which Class Members may exercise the Opt-Out Right described in
Section 3.8.
(lll) "Opt-Out Right" shall have the meaning set forth in
Section 3.8(a).
(mmm) "Parties" shall have the meaning set forth in the
preamble.
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(nnn) "Plaintiffs' Counsel" shall mean any contingent-fee
attorney who represents one or more individual Class Members pursuant to a
written agreement.
(ooo) "Plaintiffs' Counsel Sub-Fund" shall have the meaning
set forth in Section 2.1.(d).
(ppp) "Preliminary Determination" shall have the meaning set
forth in Section 4.6(c).
(qqq) "Professional Services Fund" shall have the meaning set
forth in Section 2.1(d).
(rrr) "Proposed Disposition" shall have the meaning set forth
in Section 2.3(c).
(sss) "Red Form" shall have the meaning set forth in Section
4.5(a).
(ttt) "Released Parties" shall mean:
(i) SOUS and each of its affiliates, including SML
and each of SML's other past, present and future parent companies and direct or
indirect subsidiaries, together with each of their respective past, present and
future directors, officers, employees, affiliates, insurers, joint venturers and
agents, including without limitation, sales agents;
(ii) Xxxxxx XX and all of its past, present and
future parent companies and direct or indirect subsidiaries, its and their
respective past, present and future directors, officers, employees, affiliates,
insurers and agents;
(iii) Winterthur and all of its past, present and
future parent companies and direct or indirect subsidiaries, its and their
respective past, present and future directors, officers, employees, affiliates,
insurers and agents;
(iv) all surgeons who implanted an Affected Product
and affiliated physicians or physician groups; provided, that such surgeons,
physicians or physician groups shall only be Released Parties hereunder (x) to
the extent that their alleged liability arises from or relates to the
recommendation, selection or use of an Affected Product or (y) to the extent
that, but for the recommendation, selection or use of an Affected Product by the
surgeon, physician or physician group, as opposed to another product, no such
liability would exist in either case, notwithstanding the legal theory on which
such alleged liability is premised (including, but not limited to, negligence,
negligence per se, res ipsa loquitor, intentional or negligent
misrepresentation, intentional tort, fraud, deceit, civil conspiracy, violation
of state or federal statutes or codes, consumer fraud and deceptive trade
practices, failure to disclose or warn, any product liability theories, any
breach of warranty theories, agency, alter ego, joint venture, partnership,
joint enterprise, medical malpractice, or any combination thereof) and
notwithstanding the conduct alleged to give rise to such liability (including,
but not limited to, failure to disclose information about a financial
relationship with a company or business organization, failure to acquire a
patient's informed consent due to the failure to disclose
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information about the condition of or defect in an Affected Product or a
financial relationship with a company or business organization, participation in
the design, testing, promotion, marketing or post-market investigation of an
Inter-Op Shell or a Tibial Baseplate, or any other conduct that, in the absence
of the recommendation, selection or use of an Affected Product by the surgeon,
physician or physician group in the particular instance in question, would not
give rise to liability); provided, further, that the foregoing shall not
preclude claims based on such surgeons', physicians' or physician groups'
independent negligence in the performance of the surgery which is the subject of
the claim and such claim is not based on the recommendation, selection or use of
an Affected Product (Examples of such claims for "independent negligence" for
which a surgeon is not released may include, but not be limited to, the
following: (1) leaving a foreign object in the patient during surgery; (2)
failure to adequately suture the surgical wound; or (3) inadequate monitoring or
treatment in the post-operative period. Further, as it relates to an Affected
Product Recipient's ability to pursue such claims against a surgeon, physician
or physician group for independent acts of negligence not based on the
recommendation, selection or use of an affected product, this provision is not
meant to preclude such a claimant from pursuing exemplary or punitive damages
for such independent acts of negligence to the extent allowed by applicable
state law, but simply recognizes the possibility, however remote, under state
law that negligent conduct may rise to the level of recklessness, willfulness or
other indicia of intent or state of mind to support the imposition of exemplary
or punitive damages); and
(v) organized medical specialty organizations, raw
material or other suppliers of Sulzer of materials, machines or equipment used
in the manufacture of the Affected Products, distributors of the Affected
Products, and any other person or entity involved in the design, manufacture,
distribution, implant or explant of an Affected Product and all insurers of the
foregoing.
(uuu) "Representative Claimant" shall mean an estate,
administrator or other legal representative, trust or "special needs trust" of
an Affected Product Recipient or Derivative Claimant. For the purpose of
clarity, the parties acknowledge that Representative Claimants are entitled to
any and all rights and benefits under this Settlement Agreement that the
represented Affected Product Recipients and/or Derivative Claimant would have
received hereunder regardless of any state law to the contrary.
(vvv) "Second Year Insurance Policies" shall mean the
following insurance policies issued by Winterthur International America
Insurance Company and XL Winterthur International Insurance Switzerland: (i)
Local Policy No. 000-00-00-00 (4/1/01 - 3/31/02), (ii) Master Policy No.
3.307.351 (4/1/2001 - 3/31/2002), (iii) First Excess Policy No. 3.307.352
(4/1/2001 - 3/31/2002), (iv) Second Excess Policy No. 3.307.353 (4/1/2001 -
3/31/2002), (v) Third Excess Policy No. CH00001112LI01A (4/1/2001 - 5/31/2001),
and (vi) Fourth Excess Policy No. CH00001114LI01A (4/1/2001 - 5/31/2001).
(www) "Second Year Insurance Proceeds" shall mean the
insurance proceeds payable for the benefit of SOUS, SML, or any SML subsidiary
and affiliate pursuant to Second Year Insurance Policies in the amount of $40.0
million.
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(xxx) "Securities Act" shall have the meaning set forth in
Section 2.3(d).
(yyy) "Settlement Agreement" shall have the meaning set forth
in the Preamble.
(zzz) "Settled Claims" shall mean any and all claims,
including assigned claims, whether known or unknown, asserted or unasserted,
regardless of the legal theory, existing now or arising in the future by any or
all members of the Settlement Class arising out of or relating to the Affected
Products or their implantation. These "Settled Claims" include, without
limitation and by way of example, all claims for damages or remedies of whatever
kind or character, known or unknown, that are now recognized by law or that may
be created or recognized in the future by statute, regulation, judicial
decision, or in any other manner, for:
(i) personal injury and/or bodily injury, damage,
death, fear of disease or injury, mental or physical pain or suffering,
emotional or mental harm, or loss of enjoyment of life;
(ii) loss of wages, income, earnings, and earning
capacity, medical expenses, doctor, hospital, nursing, and drug bills;
(iii) loss of support, services, consortium,
companionship, society or affection, or damage to familial relations, by
spouses, parents, children, other relatives or "significant others" of Class
Members;
(iv) wrongful death and survival actions;
(v) medical screening and monitoring, injunctive and
declaratory relief;
(vi) consumer fraud, refunds, unfair business
practices, deceptive trade practices, Unfair and Deceptive Acts and Practices
("UDAP"), unjust enrichment, disgorgement and other similar claims whether
arising under statute, regulation, or judicial decision;
(vii) compensatory damages, punitive, exemplary,
statutory and other multiple damages or penalties of any kind including, without
limitation, economic or business losses or disgorgement of profits arising out
of personal injury; and
(viii) pre-judgment or post-judgment interest.
(aaaa) "Settlement Class" shall mean all Affected Product
Recipients who are citizens or residents of the United States, including their
associated Derivative Claimants and Representative Claimants. The Settlement
Class specifically includes persons who have or may have claims with respect to
injuries not yet manifested. The Settlement Class shall expressly exclude any
person or entity that entered into a settlement with Sulzer (which included a
release) related to claims arising out of the implantation of an Affected
Product.
(bbbb) "Settlement Shares" shall have the meaning set forth in
Section 2.3(a).
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(cccc) "Settlement Trust Brokerage Account" shall have the
meaning set forth in Section 2.3(a).
(dddd) "Shares" means the shares, currently CHF 30 nominal
value, of Sulzer Medica AG.
(eeee) "SML" shall have the meaning set forth in the Preamble.
(ffff) "SOUS" shall have the meaning set forth in the
Preamble.
(gggg) "Special State Counsel Committee" means the Special
State Counsel Committee established by the Court pursuant to an order dated as
of October 22, 2001.
(hhhh) "Subclass I" shall mean all Class Members who have an
unsatisfied claim with respect to an Inter-Op Shell arising out of (i) Hip APRS
performed prior to the date that is the earlier of the Final Judicial Approval
Date and (x) June 5, 2003 with respect to an Inter-Op Shell (other than a
Reprocessed Inter-Op Shell) or (y) September 8, 2004 with respect to a
Reprocessed Inter-Op Shell and/or (ii) facts that exist prior to the date that
is the earlier of the Final Judicial Approval Date and x) June 5, 2003 with
respect to an Inter-Op Shell (other than a Reprocessed Inter-Op Shell) or (y)
September 8, 2004 with respect to a Reprocessed Inter-Op Shell, that may be a
basis for such Class Member to receive benefits under the Extraordinary Injury
Fund.
(iiii) "Subclass II" shall mean all Class Members who have an
unsatisfied claim with respect to an Inter-Op Shell (other than a Reprocessed
Inter-Op Shell) arising out of (i) implantation of an Inter-Op Shell (other than
a Reprocessed Inter-Op Shell), (ii) Hip APRS performed on or after the Final
Judicial Approval Date but prior to June 5, 2003 and/or (iii) facts that exist
on or after the Final Judicial Approval Date but prior to June 5, 2003 that may
be a basis for such Class Member to receive benefits under the Extraordinary
Injury Fund.
(jjjj) "Subclass III" shall mean all Class Members who have an
unsatisfied claim with respect to a Tibial Baseplate arising out of (i) Knee
APRS performed prior to the date that is the earlier of the Final Judicial
Approval Date and November 17, 2003 and/or (ii) facts that exist prior to the
date that is the earlier of the Final Judicial Approval Date and November 17,
2003 that may be a basis for such Class Member to receive benefits under the
Extraordinary Injury Fund.
(kkkk) "Subclass IV" shall mean all Class Members who have an
unsatisfied claim with respect to a Tibial Baseplate arising out of (i)
implantation of a Tibial Baseplate, (ii) Knee APRS performed on or after the
Final Judicial Approval Date but prior to November 17, 2003 and/or (iii) facts
that exist on or after the Final Judicial Approval Date but prior to November
17, 2003 that may be a basis for such Class Member to receive benefits under the
Extraordinary Injury Fund.
(llll) "Subclass V" shall mean all Class Members who have an
unsatisfied claim with respect to a Reprocessed
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Inter-Op Shell arising out of (i) implantation of a Reprocessed Inter-Op Shell,
(ii) Hip APRS performed on or after the Final Judicial Approval Date but prior
to September 8, 2004 and/or (iii) facts that exist on or after the Final
Judicial Approval Date but prior to September 8, 2004 that may be the basis for
such Class Member to receive benefits under the Extraordinary Injury Fund.
(mmmm) "Subrogation and Uninsured Expenses Sub-Fund" shall
have the meaning set forth in Section 2.1(d).
(nnnn) "Sulzer" shall have the meaning set forth in the
Preamble.
(oooo) "Xxxxxx XX" shall have the meaning set forth in the
Preamble.
(pppp) "Sulzer Settlement Claim Number" shall have the meaning
set forth in Section 4.6(b).
(qqqq) "Sulzer Settlement Trust" shall mean a trust
established to receive funds to be paid by Sulzer, Xxxxxx XX and Winterthur as
provided in this Settlement Agreement and the Indemnification Agreement,
pursuant to the Trust Agreement.
(rrrr) "Third-Party Payor" means any insurer or other party
that makes payments on behalf of Class Members for medical expenses and would
have a subrogated claim with respect to payment of such expenses or provides
goods and services to a Class Member and who has a subrogation right or lien
with respect to the cost of such goods and services.
(ssss) "Third Party Purchaser" shall have the meaning set
forth in Section 2.3(c).
(tttt) "Trial Court Approval" shall mean the granting, by
order entered on the docket thereof, of the approval of the Settlement Agreement
by the Federal District Court.
(uuuu) "Trial Court Approval Date" shall mean the date upon
which Trial Court Approval occurs.
(vvvv) "Trust Documents" shall mean the Trust Agreement and
the Security Agreement.
(wwww) "Trustee" shall mean that person or entity approved by
the Court as Trustee of the Sulzer Settlement Trust in accordance with the Trust
Agreement, and any successor Trustee and will serve subject to the jurisdiction
and supervision of the Court.
(xxxx) "Trust Agreement" shall mean the Settlement Trust
Agreement substantially in the form to be agreed to by the Parties and the
Trustee, which shall be approved by the Court.
(yyyy) "Uninsured Affected Product Recipient" shall mean an
Affected Product Recipient who, at the time of an Affected Product Revision
Surgery, has no private, state or
11
federal or other health care insurance coverage for any medical care. For
purpose of clarity, an Affected Product Recipient who has health care insurance
coverage at the time of the Affected Product Revision Surgery but whose provider
is contesting, denying or has otherwise not paid medical expenses relating to an
Affected Product Revision Surgery is not considered an Uninsured Affected
Product Recipient for any purposes under this Agreement.
(zzzz) "Uninsured Medical Expenses Claim Form" shall have the
meaning set forth in Section 4.5(a).
(aaaaa) "Unrevised Affected Product Recipient Fund Benefits
Claim Form" shall have the meaning set forth in Section 4.1(a).
(bbbbb) "Unrevised Affected Product Recipient Fund" shall have
the meaning set forth in Section 2.1(d).
(ccccc) "Winterthur" means Winterthur Swiss Insurance Company,
a limited company organized under the laws of Switzerland, and its
successor-in-interest XL Winterthur International Insurance Switzerland, its
insurance subsidiaries, together with their respective subsidiaries and
affiliated companies.
(ddddd) "Yellow Form" shall have the meaning set forth in
Section 4.4(a).
ARTICLE 2. SULZER SETTLEMENT TRUST AND FUNDS
Section 2.1 ESTABLISHMENT OF SULZER SETTLEMENT TRUST
(a) The Sulzer Settlement Trust has been established to
receive amounts to be paid by Sulzer, Xxxxxx XX and Winterthur, as applicable,
and to receive and dispose of the CCI and the Settlement Shares for the benefit
of Class Members pursuant to the terms of this Settlement Agreement and the
Trust Agreement.
(b) On or after May 20, 2002, there shall be a single
corporate Trustee of the Sulzer Settlement Trust, which shall succeed the
interim Trustee. Such Trustee shall be a bank organized and doing business under
the laws of the United States of America, any State thereof or the District of
Columbia, authorized under such laws to exercise corporate trust powers, having
a combined capital and surplus of at least $100,000,000, subject to supervision
and examination by federal or state authority and shall be appointed by Sulzer
(with the consent of Class Counsel and the Special State Counsel Committee, such
consent not to be unreasonably withheld), subject to the approval of the Court.
The Trustee may serve as the paying agent responsible for distribution of
payments at the direction of the Claims Administrator, as specified in Article 3
herein.
(c) None of Sulzer, Xxxxxx XX or Winterthur shall have any
right to any of the funds previously deposited into or property previously
transferred to, nor to any of the funds subsequently deposited into or property
transferred to, the Sulzer Settlement Trust, on or after the date that such
applicable amount is funded in accordance with Section 2.5 hereof. Upon
12
satisfaction in full of all obligations hereunder, any remaining funds and
property shall be distributed in accordance with Section 15.6 hereunder.
(d) Subject to the conditions set forth in this Settlement
Agreement, amounts paid in accordance with Section 2.5 shall be allocated as set
forth in Section 2.2(a) (the "Medical Research and Monitoring Fund"), Section
2.2(b) (the "Unrevised Affected Product Recipient Fund"), Section 2.2(c) (the
"Affected Product Revision Surgery Fund"), Section 2.2(d) (the "Extraordinary
Injury Fund"), Section 2.2(e) (the "Professional Services Fund"), Section
2.2(e)(i) (the "Subrogation and Uninsured Expenses Sub-Fund") and Section
2.2(e)(ii) (the "Plaintiffs' Counsel Sub-Fund").
Section 2.2 ESTABLISHMENT OF PATIENT BENEFIT FUNDS
(a) Medical Research and Monitoring Fund. The Sulzer
Settlement Trust shall allocate $1.0 million to the Medical Research and
Monitoring Fund, subject to Section 2.5(c).
(b) Unrevised Affected Product Recipient Fund. The Sulzer
Settlement Trust shall initially allocate $28.0 million to the Unrevised
Affected Product Recipient Fund.
(c) Affected Product Revision Surgery Fund. The Sulzer
Settlement Trust shall initially allocate $622.5 million to the Affected Product
Revision Surgery Fund.
(d) Extraordinary Fund. The Sulzer Settlement Trust shall
allocate a minimum of $100.0 million to the Extraordinary Injury Fund.
(e) Professional Services Fund. The Sulzer Settlement Trust
shall initially allocate $244.0 million to the Professional Services Fund, (i)
$60.0 million of which shall be allocated out of the Initial Insurance Proceeds
to the Subrogation and Uninsured Expenses Sub-Fund and (ii) $184.0 million of
which shall be allocated to the Plaintiffs' Counsel Sub-Fund.
(f) Re-Allocation. The Claims Administrator, with a
recommendation from Class Counsel, together with the Special State Counsel
Committee, may re-allocate the balance left in any of the various Funds under
this Section 2.2 after payment of benefits to Class Members and/or associated
professionals, as necessary to provide benefits to Class Members, with approval
from the Court.
Section 2.3 SULZER SETTLEMENT TRUST BROKERAGE ACCOUNT
(a) Xxxxxx XX shall cause 480,349 Shares (the "Settlement
Shares") to be transferred to a brokerage account established by the Trustee on
behalf of the Sulzer Settlement Trust (the "Settlement Trust Brokerage Account")
in accordance with Section 2.5(b) below and the Escrow Agreement.
(b) Upon transfer to the Settlement Trust Brokerage Account,
each certificate evidencing Settlement Shares shall be stamped or otherwise
imprinted (or, in the event the
13
Settlement Shares shall then be uncertificated "book-entry" shares, the
appropriate "stop-transfer" instructions and legend shall be provided to the
transfer agent) with any legend that may be required under applicable United
States, state or foreign securities laws, if any, as well as the following
legend:
THE SECURITIES REPRESENTED BY THIS CERTIFICATE ARE SUBJECT TO RESTRICTIONS ON
TRANSFER SET FORTH IN THE
CLASS ACTION SETTLEMENT AGREEMENT DATED AS OF MARCH
13, 2002, A COPY OF WHICH MAY BE OBTAINED FROM THE COMPANY AT ITS PRINCIPAL
OFFICES.
Upon transfer to a Third Party Purchaser (as defined below) or in any other
permitted sale in accordance with Section 2.3(c), the legend or "stop-transfer"
instructions and legend (as applicable) set forth in Section 2.3(b)(ii) may be
removed with respect to Settlement Shares delivered to such Third Party
Purchaser or other transferee.
(c) In the event that the Trustee proposes to sell (i) more
than 10% of the aggregate amount of Settlement Shares originally transferred to
the Sulzer Settlement Trust in accordance with Section 2.5(b) and the terms of
the Escrow Agreement in open market trades during any fifteen (15) day period or
(ii) Settlement Shares in excess of 25,000 shares during any fifteen (15) day
period in block trades, in any one or more related transactions (the "Proposed
Disposition"), held in the Settlement Trust Brokerage Account (such Settlement
Shares proposed to be transferred being referred to herein as the "Disposition
Shares"), to a bona fide third party purchaser (the "Third Party Purchaser"),
not less than ten (10) Business Days prior to such Proposed Disposition, the
Trustee shall provide SML with written notice of such Proposed Disposition (the
"Disposition Notice"). Such Disposition Notice shall include (i) all material
terms and conditions of the Proposed Disposition, including the identity of the
Third Party Purchaser and (ii) an irrevocable offer to sell the Disposition
Shares to SML upon the same terms (including price) and subject to the same
conditions as those contemplated in the Proposed Disposition (except that if any
of the consideration therefor shall be other than cash, such offer shall be for
cash consideration equal to the fair market value of such non-cash
consideration). SML shall have the irrevocable right and option, within ten (10)
Business Days after receipt of the Disposition Notice, to accept the offer to
purchase any or all of the Disposition Shares on its behalf or for the benefit
of its existing shareholders by delivering written notice to the Trustee (the
"Election Notice"). In the event SML exercises its right to purchase the
Disposition Shares, the consummation of such disposition shall take place no
later than three (3) Business Days after the receipt by the Trustee of the
Election Notice. In the event that SML elects not to purchase any portion of the
Disposition Shares or fails to respond to the Disposition Notice, the Trustee
shall have ninety (90) days in which to complete the Proposed Disposition of the
remaining Disposition Shares to the Third Party Purchaser on terms and
conditions not more favorable to the Third Party Purchaser than those contained
in the Disposition Notice. If, at the end of such ninety (90) day period, the
Trustee has not completed the disposition of any such Disposition Shares, the
Trustee shall no longer be permitted to transfer such shares without again
complying with the right of first refusal contained in this Section 2.3(c) with
respect to such Disposition Shares.
14
(d) In the event that the CCI is converted in whole or in part
into ADRs or Shares pursuant to the terms thereof, the Trustee shall deliver
such ADRs or Shares to the Settlement Trust Brokerage Account for the purpose of
either (i) distribution to Class Members, Common Benefit Attorneys and/or
Plaintiffs' Counsel pursuant to Section 3.4 and Article 5 of this Settlement
Agreement or (ii) sale to third parties. The CCI, ADRs and/or Shares shall be
issued by SOUS or SML, as applicable, in the United States pursuant to an
exemption from registration under the Securities Act of 1933, as amended (the
"Securities Act") by virtue of Section 3(a)(10) of the Securities Act. Sulzer
shall take, at its sole expense, all action reasonably necessary to comply with
the rules and regulations of the Securities and Exchange Commission and
interpretations of the staff thereof to exempt the issuance of such instruments
pursuant to Section 3(a)(10) of the Securities Act. It is the intent of the
Parties that the ADRs or Shares received by third parties or Class Members,
Common Benefit Attorneys and/or Plaintiffs' Counsel in the United States shall
be freely tradable by such persons upon issuance. Notwithstanding the foregoing,
it is the intent of the Parties that Class Members shall receive the cash
equivalent of such ADRs or Shares.
(e) The Sulzer Settlement Trust shall be the holder of record
of all Settlement Shares and ADRs and/or Shares held in the Settlement Trust
Brokerage Account until released therefrom and delivered to either (i) a Class
Member, Common Benefit Attorneys or Plaintiffs' Counsel in accordance with
Section 3.4. and Article 5 hereof and/or (ii) a third party (in the case of any
Settlement Shares, in accordance with Section 2.3(c)) and shall be entitled to
all dividends or other distributions in respect of such Settlement Shares, ADRs
and/or Shares, as applicable, until so delivered, provided that the Trustee
shall vote the Settlement Shares, ADRs and/or Shares, as applicable, at the
direction of the recommendation of the board of directors of SML; provided, that
such vote is not inconsistent with the terms hereof.
Section 2.4 SECURITY ARRANGEMENTS
(a) The Parties agree that on or prior to the Fairness Hearing
Date, the Trust shall enter into such agreements and documents as reasonably
necessary to affect the release of all Liens on Sulzer's assets in connection
with the security interest previously granted to the Sulzer Settlement Trust,
including but not limited to, UCC-3s or other evidence of release of Lien or
mortgage, as applicable.
Section 2.5 FUNDING
(a) Sulzer shall deliver to the Sulzer Settlement Trust:
(i) on or prior to the date that is the later of (x)
one-hundred and eighty (180) days after the Trial Court Approval Date and (y)
sixty (60) days after the Final Judicial Approval Date (such date of delivery
being the "Funding Date"), $425.0 million in cash (less any payments made in
respect of the Notice and claims administration fees and expenses paid pursuant
to Section 2.5(f) below prior to the Funding Date) (the "Financing Amount");
provided, however, that such amount shall be increased by an amount equal to
interest calculated at a floating LIBOR rate (such rate shall equal the
one-month LIBOR as published in the Wall
15
Street Journal on the date from which interest is calculated and shall be
adjusted at the end of each three-month period during which interest is being
calculated pursuant to this clause (i)) on the Financing Amount compounded
annually and beginning one-hundred and eighty (180) days after Trial Court
Approval Date through the Funding Date (if Sulzer does not pay the Financing
Amount into the Sulzer Settlement Trust by the Funding Date and the Settlement
Agreement has not been earlier terminated pursuant to Article 10 hereof, Sulzer
shall be in default of this Settlement Agreement);
(ii) on the CCI Issue Date, the CCI, such instrument
to be payable in accordance with the terms set forth on Annex V; and
(iii) on the Insurance Proceeds Delivery Date (as
defined below), an amount in cash equal to the negative difference between the
value of the Initial Insurance Proceeds required to be delivered by Winterthur
pursuant to the Indemnification Agreement (plus any amounts paid pursuant to
Section 3.9(a) prior to the Insurance Proceeds Delivery Date) and $178.5
million.
(b) On the 60th day following the Trial Court Approval Date,
Xxxxxx XX shall deliver (i) $50.0 million in cash and (ii) the Settlement Shares
to an escrow account pursuant to the terms of the escrow agreement (the "Escrow
Agreement") attached hereto as Exhibit A. Unless this Settlement Agreement is
earlier terminated, the escrow account shall release such cash and the
Settlement Shares to the Sulzer Settlement Trust in accordance with the terms of
the Escrow Agreement.
(c) Winterthur shall fund, no later than the date that is
thirty (30) Business Days after Trial Court Approval (the "Insurance Proceeds
Delivery Date"), (i) the aggregate cash proceeds of the Initial Insurance
Proceeds to the Affected Product Revision Surgery Fund and (ii) the Second Year
Insurance Proceeds (which amount shall be $40.0 million) to an escrow account,
in accordance with the terms of the Indemnification and Release Agreement dated
as of March 13, 2002 (the "Indemnification Agreement"), by and among Sulzer,
Xxxxxx XX and Winterthur. The Second Year Insurance Proceeds shall be delivered
to the Sulzer Settlement Trust on the date that is the earlier of (x) the
Funding Date and (y) the date that Class Members representing claims for no less
than 800 Affected Product Revision Surgeries have validly elected the GPO in
accordance with Article 8 hereof and all of the Initial Insurance Proceeds have
been paid out of the Sulzer Settlement Trust. The Insurance Proceeds shall be
used for the purposes of (i) paying Class Member benefits pursuant to Section
3.4 and Section 3.5, in accordance with Article 8 or otherwise, (ii) paying
Extraordinary Injury Fund Benefits to Class Members pursuant to Section 3.7
hereof, (iii) paying attorneys' fees pursuant to Article 5 hereof with respect
to Class Member payments payable under Sections 3.4, 3.5, and 3.7 hereof and
expenses pursuant to Section 5.4 hereof and (iv) paying medical expenses to
Medicare, other Third-Party Payors and Uninsured Class Members pursuant to
Section 3.9 hereof. Winterthur shall have the right conduct an audit in respect
of any Insurance Proceeds paid out of the Sulzer Settlement Trust. In the event
that Winterthur does not deliver the Insurance Proceeds in accordance with this
Section 2.5(c) in breach of the Indemnification Agreement, Sulzer and Xxxxxx XX
agree to use commercially reasonable efforts to enforce such Indemnification
16
Agreement to the extent of Winterthur's obligation thereunder as it relates to
Winterthur's delivery of the Insurance Proceeds hereunder.
(d) In the event that there are more than 4,000 Affected
Products Recipients that have an Affected Product Revision Surgery relating to
(i) an Inter-Op Shell (other than a Reprocessed Inter-Op Product) prior to June
5, 2003 and/or (ii) a Tibial Baseplate prior to November 17, 2003 and who have
made a claim in accordance with this Settlement Agreement, the Parties agree
that any benefits owed to such Class Member pursuant to Section 3.4(a), Section
3.5(b), Section 3.7 and Section 3.9(a) shall be borne equally by Sulzer and the
Sulzer Settlement Trust such that Sulzer shall deliver to the Sulzer Settlement
Trust 50% of any such benefit at the time such benefit is paid to a Class Member
and the Sulzer Settlement Trust shall provide for the additional 50% with funds
payable pursuant to Sections 2.5(a)-(c) above.
(e) In the event that there are more than sixty-four (64)
Affected Product Recipients that have Affected Product Revision Surgery relating
to an Inter-Op Shell that is a Reprocessed Inter-Op Product prior to September
8, 2004 and who have made a claim in accordance with this Settlement Agreement,
the Parties agree that any benefits owed to such Class Member pursuant to
Section 3.4(a), Section 3.5(b), Section 3.7 and Section 3.9(a) shall be borne
100% by Sulzer and Sulzer shall deliver to the Sulzer Settlement Trust 100% of
any such benefit at the time such benefit is paid to a Class Member.
(f) Sulzer agrees periodically upon invoice to pay reasonable
fees and expenses related to the Notice (including, but not limited to fees and
expenses relating to preliminary notification) and administration of claims
incurred as of the date hereof and from and following the date hereof until the
earlier of the termination of this Agreement in accordance with Article 10 and
the Funding Date; provided, that such amount shall not exceed $4.5 million in
the aggregate, without the prior written consent of Sulzer.
(g) In the event Sulzer is able to obtain insurance to cover
the cost of additional benefits owed to Class Members pursuant to Section 2.5(d)
and (e) above, Sulzer will negotiate in good faith with the Sulzer Settlement
Trust, if requested, to include coverage of obligations of the Sulzer Settlement
Trust pursuant to Section 2.5(d) and to allocate premiums as applicable.
Section 2.6 OTHER PROVISIONS
(a) The Parties agree that the Sulzer Settlement Trust is
being established to resolve or satisfy one or more contested or uncontested
claims that have resulted or may result from an event (or related series of
events) that has occurred and has given rise to claims asserting liability
arising out of a tort. The Sulzer Settlement Trust shall be structured and
managed to qualify as a Qualified Settlement Fund under Section 468B of the Code
and related Treasury Regulations and will contain customary provisions for such
trusts including obligations of the Sulzer Settlement Trust to provide such
information to Sulzer as Sulzer shall reasonably request for financial, legal,
regulatory and tax purposes.
17
(b) The Parties agree that all of the amounts being paid to or
on behalf of Class Members or Derivative Claimants pursuant to the terms of this
Settlement Agreement are being paid as damages (other than punitive damages) on
account of alleged personal physical injuries or alleged physical sickness of
the members of the Settlement Class, including physical injuries or physical
sickness resulting from alleged emotional harm, as described in Section
104(a)(2) of the Code. The Parties further agree that the claims set forth in
the definition of Settled Claims in Article 1 have their origin in such alleged
physical personal injuries or physical sickness.
(c) Neither Sulzer nor Xxxxxx XX shall have any financial
obligations under this Settlement Agreement other than the payment obligations
explicitly set forth in this Settlement Agreement. Neither Sulzer nor Xxxxxx XX
or any of the other Released Parties shall have any responsibility for the
management of the Sulzer Settlement Trust or any liability to any Class Member
arising from the handling of claims by the Trustee and/or Claims Administrator.
(d) All cash and property transferred into the Sulzer
Settlement Trust shall be the sole property of the Sulzer Settlement Trust, and
the Trustee shall withhold and pay over such taxes as may be required and shall
fulfill all tax filing obligations, including applicable reporting obligations
with respect to all distributions and payments pursuant to the terms of this
Settlement Agreement. The Sulzer Settlement Trust shall be responsible for all
fees, taxes and other costs of administration of the Funds, including, without
limitation, taxes on any income or gain earned on such Funds.
ARTICLE 3. CLASS MEMBER RIGHTS AND BENEFITS
Section 3.1 MEDICAL RESEARCH AND MONITORING
(a) The Medical Research and Monitoring Fund shall be used to
finance medical research relating to reconstructive orthopedic implants,
specifically hip and knee implants, for the benefit of Class Members as set
forth on the proposal attached hereto as Annex III. The proposal shall provide
that the Sulzer Settlement Trust establish and maintain a "registry" of Class
Members for the purpose of collection of information and data in order to
monitor the medical condition of such Class Members.
18
Section 3.2 [RESERVED]
Section 3.3 BENEFITS PAYABLE TO CLASS MEMBERS OUT OF THE UNREVISED
AFFECTED PRODUCT RECIPIENT FUND
(a) Class Members (other than Subclass V) who have not
undergone Affected Product Revision Surgery on or before the Final Judicial
Approval Date shall be entitled to receive an aggregate cash payment of $1,000,
payable in cash by the date that is the later of the 45th day following the
Funding Date and the date the Claims Administrator makes a Final Determination
with respect to such Class Member (or if such Final Determination is appealed in
accordance with Section 4.6, the date on which all such appeals are exhausted).
(b) Cash amounts paid to Class Members pursuant to Section
3.3(a) above shall be paid out of the Unrevised Affected Product Recipient Fund.
Section 3.4 BENEFIT PAYMENTS TO CLASS MEMBERS OUT OF THE AFFECTED
PRODUCT REVISION SURGERY FUND
(a) Class Members who have undergone or who undergo Affected
Product Revision Surgery within the time periods set forth in Sections 3.4(b)
and (c) below shall be entitled to receive an aggregate payment value of
$160,000 for each such Affected Product for which such Class Member undergoes
Affected Product Revision Surgery payable in accordance with Section 3.4(b) and
(c) below. As an additional benefit to Class Members, the Sulzer Settlement
Trust will pay a portion of a Class Member's attorney fee out of the Plaintiffs'
Counsel Sub-Fund. This payment will be 23% of the product reached by multiplying
the stated benefit by 1.25. In the event that the contingent fee contract
provides for a rate that is less than 23%, the applicable attorney fee payment
under this Section 3.4(a) will be calculated using the lower rate.
(b) Payments made pursuant to Section 3.4(a) with respect to
Affected Product Revision Surgeries (i) undergone by Class Members in respect of
Inter-Op Shells (other than Reprocessed Inter-Op Shells) prior to the Final
Judicial Approval Date and prior to June 5, 2003, (ii) undergone by Class
Members in respect of Tibial Baseplates prior to Final Judicial Approval Date
and prior to November 17, 2003, and (iii) undergone by Class Members in respect
of Reprocessed Inter-Op Shells prior to the Final Judicial Approval Date and
prior to September 8, 2004, shall be made as follows: (x) at least 55% shall be
payable in cash (less any amounts paid to such Class Member pursuant to Article
8, if applicable) by the date that is the later of the 45th day following the
Funding Date and the date the Claims Administrator makes a Final Determination
with respect to such Class Member (or if such Final Determination is appealed in
accordance with Section 4.6, the date on which all such appeals are exhausted)
and (y) at least 45% shall be payable in either cash or ADRs or Shares (valued
as set forth in Article 6), or a combination of both, no later than the date
that is the later of 20 months from the CCI Issue Date and the date the Claims
Administrator makes a Final Determination with respect to such Class Member (or
if such Final Determination is appealed in accordance with Section 4.6,
19
the date on which all such appeals are exhausted). It is the intent of the
Parties that Class Members shall receive the cash equivalent of such ADRs or
Shares.
(c) Subject to Section 3.6(a), payments made pursuant to
Section 3.4(a) with respect to Affected Product Revisions Surgeries (i)
undergone by Class Members in respect of Inter-Op Shells (other than Reprocessed
Inter-Op Shells) on or after the Final Judicial Approval Date (if such date is
prior to June 5, 2003) and prior to June 5, 2003, (ii) undergone by Class
Members in respect of Tibial Baseplates on or after the Final Judicial Approval
Date (if such date is prior to November 17, 2003) and prior to November 17, 2003
and (iii) undergone by Class Members in respect of Reprocessed Inter-Op Shells
on or after the Final Judicial Approval Date (if such date is prior to September
8, 2004) and prior to September 8, 2004, shall be made as follows: (x)
approximately 55% shall be payable in cash by the date that is the later of the
45th day following the date of such Affected Product Revision Surgery and the
date the Claims Administrator makes a Final Determination with respect to such
Class Member (or if such Final Determination is appealed in accordance with
Section 4.6, the date on which all such appeals are exhausted) and (y)
approximately 45% shall be payable in either cash or ADRs or Shares (valued as
set forth in Article 6), or a combination of both, no later than the date that
is the later of 20 months from the CCI Issue Date and the date the Claims
Administrator makes a Final Determination with respect to such Class Member (or
if such Final Determination is appealed in accordance with Section 4.6, the date
on which all such appeals are exhausted). It is the intent of the Parties that
Class Members shall receive the cash equivalent of such ADRs or Shares.
(d) Cash amounts paid to Class Members pursuant to Section
3.4(b) or Section 3.4(c) above shall be paid out of the Affected Product
Revision Surgery Fund. ADRs or Shares distributed to Class Members pursuant to
Section 3.4(b) or Section 3.4(c), if applicable, shall be satisfied out of the
Settlement Trust Brokerage Account. It is the intent of the Parties that Class
Members shall receive the cash equivalent of such ADRs or Shares.
Section 3.5 DERIVATIVE CLAIMANT PAYMENTS
(a) The Derivative Claimants of a Class Member that is
entitled to payment pursuant to Section 3.3(a) shall be entitled to receive a
cash payment of $250 to be paid no later than the date the payment is made to
such Class Member pursuant to Section 3.3(a). Such payments shall be payable out
of the Unrevised Affected Product Recipient Fund.
(b) Subject to Section 3.6(b), the Derivative Claimants of a
Class Member that is entitled to payment pursuant to Section 3.4(a) shall be
entitled to receive a cash payment of $1,600 to be paid no later than the date
the payment is made to such Class Member pursuant to Section 3.4(b) or Section
3.4(c), as applicable. Such payments shall be payable out of the Affected
Product Revision Surgery Fund. As an additional benefit to Class Members, the
Sulzer Settlement Trust will pay a portion of a Class Member's attorney fee out
of the Plaintiffs' Counsel Sub-Fund. This payment will be 23% of the product
reached by multiplying the stated benefit by 1.25. In the event that the
contingent fee contract provides for a rate that is less than 23%, the
applicable attorney fee payment under this Section 3.5(b) will be calculated
using the lower rate.
20
(c) Derivative Claimants may also be eligible to receive
additional benefits pursuant to Section 3.7, as provided for in Annex IV hereof,
in an amount equal to 1% of the benefit payable to the associated Affected
Product Recipient. As an additional benefit to Class Members, the Sulzer
Settlement Trust will pay a portion of a Class Member's attorney fee out of the
Plaintiffs' Counsel Sub-Fund. This payment will be 23% of the product reached by
multiplying the stated benefit by 1.25. In the event that the contingent fee
contract provides for a rate that is less than 23%, the applicable attorney fee
payment under this Section 3.5(c) will be calculated using the lower rate.
Section 3.6 OFFSETS
(a) If a Class Member has not had an Affected Product Revision
Surgery as of the date of Final Judicial Approval and receives benefits under
Section 3.3(a) above and subsequently has an Affected Product Revision Surgery
within the time period set forth in Section 3.4(c), such Class Member shall be
entitled to the benefits payable pursuant to Section 3.4(a), less all amounts
previously paid to the Class Member pursuant to Sections 3.3(a).
(b) If a Derivative Claimant receives benefits under Section
3.5(a) and then is entitled to receive additional benefits under Section 3.5(b),
such Derivative Claimant shall be entitled to the benefits payable pursuant to
Section 3.5(b), less all amounts previously paid to the Derivative Claimant
pursuant to Section 3.5(a).
(c) If a Class Member receives benefits pursuant to Section
3.3(a) and also qualifies for benefits pursuant to 3.7, any such EIF Benefits
paid to such Class Member shall be less all amounts previously paid to the Class
Member pursuant to Section 3.3(a); provided, however, that this Section 3.6(c)
shall not apply to Class Members who qualify for benefits pursuant to Section
3.4(c).
(d) To the extent that Sulzer has made any advance or other
payments to any Class Member prior to the Insurance Proceeds Delivery Date, any
amounts owed to such Class member pursuant to Section 3.3, 3.4(a), 3.5, 3.7 and
3.9(a), as applicable, shall be reduced by the amount of such advance or other
payment; provided, however, that with respect to an Affected Product Recipient
who is eligible for benefits pursuant to Section 3.4(a), any such amounts owed
to such Class Member shall not be reduced to an amount less than $100,000
pursuant to this Section 3.6(d).
Section 3.7 COMPENSATION BENEFITS PAYABLE FROM EXTRAORDINARY INJURY
FUND
(a) In addition to the benefits set forth in Sections 3.3,
3.4(a), 3.9(a) and Article 8 pursuant to this Settlement Agreement, Class
Members may be eligible to receive additional compensation under this Settlement
Agreement ("Extraordinary Injury Fund Benefits" or "EIF Benefits") pursuant to
the terms of the payment matrices (the "Matrices" or "Matrix") attached hereto
as Annex IV. As an additional benefit to Class Members, the Sulzer Settlement
Trust will pay a portion of a Class Member's attorney fee out of the Plaintiffs'
Counsel Sub-Fund. This payment will be 23% of the product reached by multiplying
the stated benefit by
21
1.25. In the event that the contingent fee contract provides for a rate that is
less than 23%, the applicable attorney fee payment under this Section 3.7(a)
will be calculated using the lower rate.
(b) EIF Benefits payable to Class Members pursuant to Annex IV
may be paid in installments, with the first payment not to be less than 50% of
the total value of the EIF Benefits due to the Class Member, at the discretion
of the Claims Administrator. The Extraordinary Injury Fund Benefits paid to
Class Members pursuant to Annex IV hereto shall be paid out of the Extraordinary
Injury Fund. To the extent a Class Member qualifies for payment under a certain
Matrix Level and then subsequently qualifies for payments under a higher Matrix
Level, any payments made pursuant to the higher Matrix Level shall be less the
amount allocated under any Matrix Level for which such Class Member previously
qualified.
Section 3.8 OPT-OUT RIGHTS
(a) All Class Members (except as provided in Section 3.8(b)
below) are eligible to opt out of the Settlement represented by this Settlement
Agreement (the "Opt-Out Right"). Each Class Member wishing to exercise an
Opt-Out Right must submit a written letter, signed by the Class Member, that
includes the following information: (i) his or her name, address and telephone
number; (ii) with respect to each Affected Product, the date of implantation;
(iii) with respect to each Affected Product, the implanting surgeon; (iv) with
respect to each Affected Product, the lot number and product number, if
available; and (v) whether such Class Member is represented by counsel and if
so, the name, address and telephone number of his or her lawyer. A copy of the
letter must be sent to a post-office box in Cleveland, Ohio established by the
Claims Administrator and set forth in the Notice and received no later than 5:00
p.m., Cleveland, Ohio time, on the last day of the Opt-Out Period (which such
period ends on the date that is the later of May 14, 2002 and five (5) Business
Days after Trial Court Approval). The Claims Administrator and/or its agent
shall promptly forward copies of any such letter to liaison Class Counsel and
Sulzer and shall file a list of all such Class Members who exercise an Opt-Out
Right with the Court.
(b) In the event that there is both an Affected Product
Recipient or a Representative Claimant and one or more Derivative Claimants, the
Affected Product Recipient's or the Representative Claimant's exercise or
failure to exercise an Opt-Out Right shall be binding on the associated
Derivative Claimant(s).
(c) If a Class Member exercises his/her Opt-Out Right pursuant
to this Section 3.8, such opt-out shall only be effective upon the termination
of the Opt-Out Period.
Section 3.9 PAYMENTS TO THIRD-PARTY PAYORS AND UNINSURED CLASS MEMBERS
(a) The Sulzer Settlement Trust shall pay to the United States
on behalf of the Centers for Medicare and Medicaid Services (formerly known as
the Health Care Finance Administration) and other Third-Party Payors in respect
of subrogation or other claims for medical expenses paid on behalf of Class
Members and shall pay reasonable and necessary expenses incurred by Uninsured
Affected Product Recipients in respect of each Affected Product
22
Revision Surgery; provided, however, that any such amount paid by the Sulzer
Settlement Trust shall not exceed (i) $15,000 in the aggregate for any and all
claims made in respect of a single Affected Product Revision Surgery (unless
approved by Sulzer as set forth below) and (ii) $60.0 million, in the aggregate.
In the event that all such payments reach $60.0 million in the aggregate, Sulzer
agrees to fund to the Sulzer Settlement Trust amounts necessary to pay
Third-Party Payors in respect of subrogation or other claims for medical
expenses paid by such Third-Party Payors on behalf of Class Members in excess of
$15,000 in the aggregate per Affected Product Revision Surgery if such
settlement with the Third-Party Payor was approved by Sulzer. In addition,
Sulzer agrees to fund to the Sulzer Settlement Trust amounts necessary to pay
the reasonable and necessary expenses incurred by Uninsured Affected Product
Recipients in respect of an Affected Product Revision Surgery that exceed
$15,000 as set forth in clause (i) above, up to a maximum of $2.0 million in the
aggregate. The Parties agree that they will negotiate and settle all claims with
respect to unpaid medical expenses paid by Third-Party Payors on behalf of Class
Members from and after the Insurance Proceeds Delivery Date, and Sulzer shall
not be obligated to fund any additional amounts to the Sulzer Settlement Trust
as provided in this Section 3.9(a) in the event the amount owed is in connection
with a settlement not authorized and directed by Sulzer. The Trustee on behalf
of the Sulzer Settlement Trust agrees to honor all agreements that have been
entered into or will be entered into after the date of this Agreement by Sulzer
with the United States on behalf of the Centers for Medicare and Medicaid
Services and/or other Third-Party Payors and to make payments in accordance with
any such agreements from and following the Insurance Proceeds Delivery Date.
Sulzer and the Sulzer Settlement Trust shall obtain a full and complete release
of Settled Claims of the Released Parties, as well as the affected individual
Class Member in the case of Third-Party Payor payments, prior to making any
payments pursuant to this Section 3.9(a).
(b) Payments made pursuant to Section 3.9(a) shall be made out
of the Subrogation and Uninsured Expenses Fund and shall be payable in
accordance with the terms of the applicable agreement entered into with respect
to such Third-Party Payor, Medicare or Uninsured Affected Product Recipient, as
applicable.
(c) The Sulzer Settlement Trust shall defend and hold Class
Members and Plaintiffs' Counsel harmless against any claims by a subrogee
directly against such Class Member or Plaintiffs' Counsel for reimbursement of
medical expenses of an Affected Product Recipient necessitated by an Affected
Product. Notwithstanding the foregoing, in no event shall this provision be
construed to require payment to the Class Member with respect to the same claim
for which Sulzer shall have already paid the subrogee.
ARTICLE 4. CLAIMS ADMINISTRATION.
Section 4.1 UNREVISED AFFECTED PRODUCT RECIPIENT FUND.
(a) Each Class Member claiming benefits under Section 3.3(a)
must submit a claim form for payment of benefits out of the Unrevised Affected
Product Recipient Fund (a "Unrevised Affected Product Recipient Fund Benefits
Claim Form" or "Blue Form"), attached
23
hereto as Exhibit B, on or before the date that is one hundred twenty (120) days
after Trial Court Approval.
(b) In addition to the Blue Form, the Class Member must
provide documentation evidencing the implantation of an Affected Product. A list
of such acceptable documentation is included on the Blue Form.
(c) If the Class Member also qualifies for compensation under
the Matrices provided for in Annex IV hereto, the Class Member may also submit a
claim for benefits payable out of the Extraordinary Injury Fund in accordance
with Section 4.3.
(d) If the Class Member subsequently undergoes an Affected
Product Revision Surgery, qualifying the Class Member for benefits under Section
3.4(a), the Class Member may submit an Affected Product Revision Surgery Fund
Benefits Claim Form in accordance with Section 4.2 and may also qualify for
additional benefits under the Extraordinary Injury Fund.
(e) Class Members claiming benefits payable out of the
Unrevised Affected Product Recipient Fund pursuant to Section 3.5(a) as
Derivative Claimants must comply with Section 4.4 of this Settlement Agreement.
Section 4.2 AFFECTED PRODUCT REVISION SURGERY FUND.
(a) Each Class Member claiming benefits under Section 3.4(a)
must submit a claim form for payment of benefits out of the Affected Product
Revision Surgery Fund (an "Affected Product Revision Surgery Fund Benefits Claim
Form" or "Orange Form"), attached hereto as Exhibit C, on or before the date
that is the later of (i) one hundred eighty (180) days after Trial Court
Approval and (ii) one hundred eighty (180) days after the applicable Affected
Product Revision Surgery. If a Class Member elects the GPO in accordance with
Article 8, the Class Member must complete the designated portion of the Orange
Form and submit it to the Claims Administrator in accordance with Section 8.2.
(b) In addition to the Orange Form, the Class Member must
provide the following documentation: (i) documentation evidencing the
implantation of an Affected Product (a list of documentation is included on the
Orange Form); (ii) documentation evidencing the removal of an Affected Product
(a list of documentation is included on the Orange Form); and (iii) a completed
"Physician Declaration," attached hereto as Exhibit D, wherein the physician
verifies that the Class Member has undergone an APRS for reasons other than
trauma or medical records evidencing the same.
(c) If the Class Member develops a condition(s) or sustains a
complication(s) compensable in accordance with the Matrices provided for on
Annex IV hereto, the Class Member may also submit a Green Form (as defined
below).
24
(d) Class Members claiming benefits payable out of the
Affected Product Revision Surgery Fund pursuant to Section 3.5(b) as Derivative
Claimants must comply with Section 4.4 of this Settlement Agreement.
(e) In connection with claims submitted pursuant to this
Section 4.2 for benefits paid in respect of an Affected Product Revision Surgery
out of the Affected Product Revision Surgery Fund, the Claims Administrator
shall identify whether the Affected Product of the Class Member submitting the
applicable Orange Form is a Reprocessed Inter-Op Product. If the Class Member's
Affected Product is a Reprocessed Inter-Op Product and such Class Member
qualifies for benefits pursuant to Section 3.4(a), Section 3.5(b), Section 3.7
and/or Section 3.9(a), the Claims Administration shall submit an invoice to
Sulzer for any such amounts in the event that Sulzer is obligated to fund such
amounts in accordance with Section 2.5(e).
Section 4.3 EXTRAORDINARY INJURY FUND.
(a) Each Class Member claiming benefits under Section 3.7 must
submit a claim form for payment of benefits out of the Extraordinary Injury Fund
(an "EIF Benefits Claim Form" or "Green Form"), attached hereto as Exhibit E, on
or before the date that is the later of (i) five hundred and forty-five (545)
days from the date of the applicable Covered Revision Surgery, (ii) one hundred
eighty (180) days of his/her treating physician's recommendation that he/she
undergo an APRS but for a medical condition(s), and (iii) one hundred and eighty
(180) days after Trial Court Approval.
(b) The Class Member must submit a Green Form with, or after
he/she has already submitted, a completed Blue Form or Orange Form, as
applicable.
(c) The Class Member must complete the portions of the Green
Form relating to the Matrix Level(s) that the Class Member believes entitle
him/her to EIF Benefits.
(d) In addition to the applicable Green Form, the Class Member
must provide the following documentation: (i) medical records evidencing the
condition(s) and/or complication(s) that form the basis of the Class Member's
claim for EIF Benefits; and (ii) a completed "Physician Declaration," attached
hereto as Exhibit D, wherein the physician verifies that the Class Member has
sustained the condition(s) and/or complication(s) for which the Class Member is
claiming EIF Benefits.
(e) A Class Member who has previously submitted a Claim Form
in accordance with this Article 4 is entitled to file a Green Form for
additional compensation if the Class Member subsequently develops a medical
condition(s) and/or complication(s) within the time period set forth in Section
4.3(a) that qualifies the Class Member for EIF Benefits at a higher Matrix Level
than the Class Member had previously been compensated. If the Class Member has
previously submitted a Green Form, in order to make a claim for subsequent EIF
Benefits, the Class Member must submit a new Green Form, indicating therein that
it is a supplemental submission. The supplemental Green Form need not be
completed in full; rather, the Class Member need only submit changes to
information previously provided. Likewise, a physician responsible for
completing the "Physician Declaration" should complete only those
25
portions of the Physician Declaration that reflect a change in condition from
the condition described in a previously filed Green Form and should sign each
such supplemental Physician Declaration. Each such supplemental Green Form
and/or Physician Declaration shall be considered a new Claim Form for purposes
of Section 4.6. If a supplemental Green Form is submitted while a prior
submission is pending but not yet paid, the Claims Administrator shall complete
all processing and payment in relation to the Green Form previously submitted
before processing any payment of any supplemental Green Form.
(f) Class Members claiming benefits payable out of the
Extraordinary Injury Fund as Derivative Claimants must comply with Section 4.4
of this Settlement Agreement.
Section 4.4 DERIVATIVE CLAIMANTS.
(a) Each Class Member claiming benefits as a Derivative
Claimant must submit a claim form for payment of benefits out of the Unrevised
Affected Product Recipient Fund, the Affected Product Revision Surgery Fund
and/or the Extraordinary Injury Fund (the "Derivative Benefits Claim Form" or
"Yellow Form"), attached hereto as Exhibit F.
(b) A completed Yellow Form must be submitted within the time
periods prescribed for the Affected Product Recipient's claim for benefits (For
example, a Class Member who is an Affected Product Recipient submitting a Blue
Form must do so on or before the date that is one hundred twenty (120) days
after Trial Court Approval. Such Class Member's Derivative Claimant must submit
a Yellow Form within the identical time period.) A Derivative Claimant is only
entitled to Settlement benefits if the Affected Product Recipient timely submits
(and is ultimately entitled to benefits pursuant to a Blue Form, Orange Form or
Green Form.
Section 4.5 UNINSURED AFFECTED PRODUCT RECIPIENTS.
(a) Each Class Member claiming benefits as an Uninsured
Affected Product Recipient must submit a claim form for payment of benefits out
of the Subrogation and Uninsured Expenses Fund (the "Uninsured Medical Expenses
Claim Form" or "Red Form"), attached hereto as Exhibit G, on or before the date
that is one hundred eighty (180) days after the date such Class Member receives
the medical care for which he or she seeks medical expense reimbursement.
(b) In addition to the Red Form, the Class Member must provide
documentation evidencing the payment of unreimbursed medical expenses made in
connection with the Affected Product Revision Surgery. A list of such acceptable
documentation is included on the Red Form.
Section 4.6 GENERAL CLAIMS ADMINISTRATION.
(a) The Claims Administrator shall make benefit determinations
based upon the information and documentation provided with a "completed" Claim
Form. Claim Forms that fail to provide required information and/or documentation
shall not be considered "completed". The Claims Administrator shall have the
discretion to set and notify Class Members of deadlines
26
in addition to those deadlines set forth in this Article 4 and shall have the
discretion to disallow any claims received after such applicable deadline. If
the Class Member submits a Claim Form within the time periods set forth in this
Article 4, such submission will be considered timely notwithstanding
deficiencies that may exist in the Claim Form. Failure on the part of the Claims
Administrator to meet any of the deadlines set forth herein or subsequently
established shall not be deemed to render a claim completed or otherwise entitle
a Class Member to benefits hereunder, unless otherwise so ordered by the Court
after notice and hearing.
(b) No later than the date that is sixty (60) days after the
Claims Administrator receives a Claim Form pursuant to this Article 4, the
Claims Administrator shall (i) assign a unique identifying number to the claim
("Sulzer Settlement Claim Number") where one has not already been assigned; and
(ii) if necessary, notify the Class Member and/or the applicable Plaintiffs'
Counsel regarding the nature of any claim form deficiency. The Class Member
and/or the applicable Plaintiffs' Counsel will have seventy-five (75) days from
the date of any such notice in which to correct any and all deficiencies with
supplemental information and/or documentation. Supplemental materials shall be
submitted along with a cover letter specifying the Sulzer Settlement Claim
Number. None of Sulzer, the Sulzer Settlement Trust or the Claims Administrator
shall be responsible for or in any way accept any liability with respect to
deficient Claim Forms.
(c) No later than ninety (90) days after the Claims
Administrator receives an acceptable Claim Form, the Claims Administrator shall
make a preliminary determination as to whether the Class Member is entitled to
any benefits, and if so, the amount to which the Class Member is entitled (the
"Preliminary Determination").
(d) Immediately upon making the determination required by
Section 4.6(c), the Claims Administrator shall notify the Class Member and the
Plaintiffs' Counsel for the Class Member, if any, of such determination. Such
Class Member and/or the Plaintiffs' Counsel shall have forty-five (45) days from
the date of the Preliminary Determination by the Claims Administrator and to
provide any additional information documentation supporting his/her position.
Any supplemental information and/or documentation shall be submitted along with
a cover letter, specifying the Class Member's Sulzer Settlement Claim Number. If
the Class Member and/or Plaintiffs' Counsel does not contest the Preliminary
Determination in accordance with this Section 4.6(d), such Preliminary
Determination shall be deemed to be a Final Determination in accordance with
Section 4.6(e) and such Class Member and/or Plaintiffs' Counsel shall have no
further right to contest such Final Determination.
(e) No later than ninety (90) days after the receipt of any
explanatory or supporting information pursuant to Section 4.6(d), the Claims
Administrator shall make a final determination as to whether the Class Member is
entitled to benefits, and if so, the amount to which the Class Member is
entitled (the "Final Determination").
(f) Within thirty (30) days after the date of the Claims
Administrator's Final Determination, the applicable Affected Product Recipient
may appeal the Final Determination by filing a notice with the Federal District
Court and serving a copy on the Claims Administrator.
27
Such notice shall be written and be no more than ten (10) pages in length. The
Claims Administrator shall have thirty (30) days to reply in writing. In the
event of such an appeal, Class Counsel together with the Special State Counsel
Committee shall appoint a special master (subject to the approval of the Court)
to make a determination with respect to such Final Determination.
(g) Any determination by the special master, if applicable,
made in accordance with Section 4.6(f) above, shall constitute a final and
binding determination. If there is no appeal of the Claims Administrator's
decision with respect to the Final Determination, the decision of the Claims
Administrator shall be final.
(h) Any and all materials submitted by a Class Member pursuant
to this Article 4 shall be deemed submitted on the date that such material is
post-marked. In the absence of a post-xxxx or if such post-xxxx is illegible,
the date of receipt shall be the date such material is deemed submitted.
(i) The Claims Administrator shall use all reasonable efforts
to make payments to Class Members as early as possible pursuant to guidelines
approved by the Court with input from Class Counsel and the State Special
Counsel Committee.
Section 4.7 INDEMNIFICATION AND LIABILITY OF CLAIMS ADMINISTRATOR.
(a) The provisions of this Section 4.7 shall apply to all
persons or entities engaged by the Claims Administrator to render services
relating to the Settlement. The Claims Administrator may provide contractual
indemnity to such persons or entities equivalent to that provided to the Claims
Administrator under this Settlement Agreement.
(b) The Claims Administrator shall not be liable to the Sulzer
Settlement Trust or to any person holding a personal injury claim or to any
other person except for said Claims Administrator's own breach of trust
committed in bad faith or for willful misconduct. The Claims Administrator shall
not be liable for any act or omission of any officer, agent, employee,
consultant, or other representative of the Claims Administrator unless the
Claims Administrator acts with bad faith or willful misconduct in the selection
or retention of such officer, agent, employee, consultant, or other
representative.
(c) The Sulzer Settlement Trust shall indemnify and defend the
Claims Administrator to the fullest extent that a corporation or trust organized
under the laws of the state in which the Sulzer Settlement Trust is domiciled is
entitled from time to time to indemnify and defend its directors, trustees,
employees, agents or advisers against any and all liabilities, expenses, claims,
damages, or losses incurred by them in the performance of his duties hereunder.
(d) The Claims Administrator who was or is a party, or is
threatened to be made a party, to any completed, pending, or threatened action,
suit or proceeding of any kind, whether civil, administrative or arbitrative, by
reason of any act or omission of such other person
28
associated with the Sulzer Settlement Trust, in any of their capacities with
respect to (a) the Settlement Agreement negotiations, (b) the liquidation or
resolution of any personal injury claims, or (c) the administration of the
Sulzer Settlement Trust or the implementation of the procedures guiding said
Sulzer Settlement Trust, shall be indemnified and defended by the Sulzer
Settlement Trust against expenses, costs, and fees (including reasonable
attorney's fees), judgments, awards, costs, amounts paid in settlement, and
liabilities of all kinds incurred by any other person.
(e) Reasonable expenses, costs, and fees (including reasonable
attorneys fees) incurred by or on behalf of the Claims Administrator in
connection with any action, suit, or proceeding, whether civil, administrative,
or arbitrative, will be paid by the Sulzer Settlement Trust in advance of the
final disposition thereof on receipt of an undertaking by or on behalf of the
Claims Administrator to repay such amount unless it shall be determined only
that such Claims Administrator is entitled to be indemnified by the Sulzer
Settlement Trust.
(f) The Claims Administrator has the sole power generally or
in specific instances to cause the Sulzer Settlement Trust to indemnify him to
the same extent with respect to any Trustee of the Sulzer Settlement Trust.
(g) The Claims Administrator may purchase and maintain
reasonable amounts and types of insurance on behalf of himself or any other
officer, employee, agent, or representative of the Claims Administrator or
against liability asserted against or incurred by such individual in that
capacity arising from his or her status as a Claims Administrator, officer,
employee, agent, or representative.
(h) The Claims Administrator may, but shall not be required
to, consult with counsel, accountants, appraisers, and other parties deemed by
the Claims Administrator to be qualified as an expert on the matters submitted
to them (regardless of whether any such party is affiliated with the Claims
Administrator in any manner except as otherwise provided in the Settlement
Agreement). The opinion of any such party submitted to the Claims Administrator
shall be full and complete authorization and protection in respect of any action
taken or not taken by the Claims Administrator hereunder in good faith and in
accordance with the opinion of such party.
ARTICLE 5. ATTORNEYS' FEES
Section 5.1 Except as noted herein, nothing in this agreement is
intended to void or to otherwise alter reasonable contingent fee contracts
entered into on or prior to February 2, 2002 for payments due to Class Members
under Sections 3.4(a), 3.5(b), 3.5(c) and 3.7. Payments made to Plaintiffs'
Counsel for attorney fees pursuant to Sections 3.4(a), 3.5(b) and 3.7 shall be
set off against the total contingent fee, and thus the obligation of any such
Class Member to his or her Plaintiffs' Counsel will be offset by such amount.
Section 5.2 The Payment of attorney fees pursuant to Sections 3.4(a),
3.5(b), 3.5(c) and 3.7(a) hereof shall be paid directly to the applicable
Plaintiffs' Counsel out of the Plaintiffs' Counsel Sub-Fund. In the event there
are any amounts remaining in the Plaintiffs' Counsel
29
Sub-Fund after all applicable amounts have been paid to Plaintiffs' Counsel,
such remaining amount shall be distributed pro rata among all Class Members who
received benefits pursuant to Sections 3.4(a), 3.5(b), 3.5(c) and 3.7.
Section 5.3 In calculating the amount of attorney fees and payments to
be made to Affected Product Recipients pursuant to Section 3.4(a), 3.5(b),
3.5(c) and 3.7, Plaintiffs' Counsel shall apply the contingent fee percentage to
the product reached by multiplying the stated benefit amount payable pursuant to
the applicable Section, by 1.25. Any amounts paid pursuant to this Section 5.3
shall be offset by those amounts, if any, paid pursuant to Section 5.2.
Section 5.4 Common Benefit Attorneys shall be entitled to reasonable
attorney fees up to a maximum of $50.0 million in the aggregate and to
reimbursement of reasonable expenses up to a maximum of $7.5 million in the
aggregate, to be paid out of the Sulzer Settlement Trust as approved by the
Court. The Common Benefit Attorney fee payment shall be made out of the CCI and
the Common Benefit Attorney expenses shall be paid out of the Initial Insurance
Proceeds. The Court shall make reasonable allowances out of such amounts for the
payment of reasonable attorney fees and expenses incurred in connection of the
administration of the Sulzer Settlement Trust.
Section 5.5 In order to receive payment pursuant to Section 5.4, any
attorney claiming benefits as a Common Benefit Attorney shall first make an
application to the Court. The Court may appoint a special master, and with the
input of a committee comprised of an equal number of members from Class Counsel
and the Special State Counsel Committee, will review all such applications and
make a determination with respect to any such attorney's eligibility to receive
payments pursuant to this Section 5.5
Section 5.6 All amounts allocated out of this Sulzer Settlement Trust
to Common Benefit Attorneys pursuant to Section 5.5 shall be paid to liaison
Class Counsel who shall distribute such amounts to Common Benefit Attorneys as
approved and allocated by the Court pursuant to Section 5.5. The Court shall
consider, among other factors, any contingent fee paid to a Common Benefit
Attorney pursuant to Section 5.1 and Section 5.2 when making an award of a fee
pursuant to Section 5.5
ARTICLE 6. ISSUANCE OF CCI
Section 6.1 In partial satisfaction of Sulzer's funding obligations
under this Settlement Agreement pursuant to Section 2.5(a), SOUS shall deliver
on the CCI Issue Date a $300,000,000 principal amount convertible callable
instrument (the "CCI") of SOUS payable to the Sulzer Settlement Trust. The CCI
shall have the terms, covenants and other provisions substantially as set forth
on Annex V to this Settlement Agreement.
Section 6.2 On or prior to the Fairness Hearing Date, the Parties shall
complete definitive documentation of the form of the CCI and shall submit such
final form to the Court for approval at the Fairness Hearing. The Parties agree
to negotiate in good faith the final terms and form of such instrument based on
the principal financial terms described on Annex V.
30
ARTICLE 7. GENERAL TERMINATION AND RELEASE
Section 7.1 The Parties agree that this Settlement Agreement is made in
good faith and in accordance with the laws of the jurisdictions in which
Affected Products Related lawsuits have been filed. If required by any court or
tribunal, Class Counsel agree to cooperate with Sulzer, Xxxxxx XX and the other
Released Parties by providing affidavits and/or testimony concerning the
circumstances of the settlement contemplated by this Settlement Agreement and
attesting to the fact that it is a good faith settlement.
Section 7.2 Unless this Settlement Agreement shall have been terminated
in accordance with Article 10 hereof after the Court approves this Settlement
Agreement as a good faith, fair, adequate and reasonable settlement, the Parties
hereby agree that every Settled Claim of each Class Member (other than a Class
Member who exercises an Opt-Out Right pursuant to Section 3.8) shall be
conclusively compromised, settled and released as to Sulzer, Xxxxxx XX, and each
other Released Party. Such releases shall remain effective regardless of changes
in the circumstances or condition of Sulzer, Xxxxxx XX, the other Released
Parties or such Class Members, discovery of new or additional facts, or changes
in applicable law. In making such releases the Settlement Class expressly
acknowledges and waives the provisions of Section 1542 of the Civil Code of the
State of California, which provides that "[a] general release does not extend to
claims which the creditor does not know or suspect exist in his favor at the
time of executing the release, which if known by him must have materially
affected his settlement with the debtor," as well as any similar provisions of
other states. Consistent with the provisions of Article 10 of this Settlement
Agreement, the releases herein shall extinguish any claims for contribution
and/or indemnification against Sulzer, Xxxxxx XX or the other Released Parties.
Section 7.3 The Parties hereby agree to request that the Court enter an
order finding this Settlement Agreement to be a good faith settlement and
barring and enjoining, to the extent permitted by applicable law, the
commencement and prosecution of any contribution and/or indemnification claim or
action by or on behalf of any Class Member (other than a Class Member who
exercises an Opt-Out Right pursuant to Section 3.8) or entity against Sulzer,
Xxxxxx XX or any other Released Party for reimbursement for payments made or to
be made to or on behalf of any such Class Member for Affected Products Related
claims, actions or injuries, or for expenses incurred in defending against any
such claims, actions or proceedings. The Parties agree that Sulzer, Xxxxxx XX
and the other Released Parties shall be entitled to dismissal with prejudice of
any claims against them by or on behalf of any Class Member (other than a Class
Member who exercises an Opt-Out Right pursuant to Section 3.8) that violate or
are inconsistent with this bar.
Section 7.4 The Parties agree that no Class Member (other than Class
Members who properly and timely exercise their Opt-Out Rights) shall recover,
directly or indirectly, any sums from Sulzer, Xxxxxx XX or any other Released
Party other than those received under this Settlement Agreement.
Section 7.5 Each Class Member (other than a Class Member who exercises
an Opt-Out Right pursuant to Section 3.8) otherwise entitled to receive benefits
under this Settlement
31
Agreement shall be required, as a further condition to receive benefits
hereunder, to execute and deliver a separate proof of claim and release with
respect to each Affected Product Related claim.
ARTICLE 8. GUARANTEED PAYMENT OPTION
Section 8.1 Class Members in Subclass I and Subclass III who are
eligible for benefits pursuant to Section 3.4(a) or 3.5(b) may elect to obtain a
portion of the settlement benefits provided for in Sections 3.4(a) or 3.5(b)
prior to the payment dates set forth in Section 3.4(b) or 3.5(b), as applicable,
through a guaranteed payment option (the "GPO") to be paid in accordance with
and subject to the conditions set forth in this Article 8 and the Orange Form.
Section 8.2 A Class Member may elect the GPO at any time from the date
of the Notice until the date that is the later of (a) one-hundred and twenty
(120) days after the Trial Court Approval Date and (b) one-hundred and twenty
(120) days after such Class Member's APRS.
Section 8.3 If a Class Member elects the GPO, such Class Member must
complete and sign the applicable section of the Orange Form (the "GPO
Agreement") and return such completed and executed GPO Agreement to the Claims
Administrator within the time period set forth in Section 8.2 above. The GPO
Agreement shall represent a binding agreement between such Class Member and
Sulzer separate and apart from this Settlement Agreement and shall provide for
such Class Member to receive the value of the payments provided for in Section
3.4(a), 3.5(b), 3,7 and 3.9(a) of this Settlement Agreement, as applicable, in
exchange for the unconditional release of the Released Parties for Settled
Claims, in each case on terms and conditions consistent with this Settlement
Agreement. Such GPO Agreement shall be effective upon execution and delivery of
the GPO Agreement to the Claims Administrator and release contained therein
shall be contingent on such Class Member receiving the balance of the benefits
provided for in Sections 3.4(a), 3.5(b), 3.7 or 3.9(a), as applicable; provided,
in the event that Sulzer defaults in obligation to pay Class Members under their
individual GPO Agreements, the release provided by such GPO Agreement shall,
nonetheless, be effective with respect to the Settled Claims as to all Released
Parties other than Sulzer.
Section 8.4 Class Members who elect the GPO and execute the GPO
Agreement shall receive a minimum of $40,000 of the payments provided in Section
3.4(a) and 3.5(b), as applicable, on the date that is the later of (a) sixty
(60) days after the Insurance Proceeds Delivery Date or (ii) forty-five (45)
days after the date the Claims Administrator receives such Class Members'
completed Orange Form. Class Members who have suffered complications that
qualify for benefits under Section 3.7 who elect the GPO in accordance with this
Article 8 may also be eligible to receive those benefits to be paid in
accordance with Annex IV pursuant to the terms of this Settlement Agreement.
Section 8.5 A Derivative Claimant may not elect the GPO if the Class
Member with whom the Derivative Claimant is associated has not elected the GPO.
Similarly, a Derivative
32
Claimant must elect the GPO if the Class Member with whom the Derivative
Claimant is associated has elected the GPO.
Section 8.6 In the event that this Settlement Agreement is terminated
in accordance with Article 10 (other than Section 10.1), Class Members electing
the GPO will retain contractual rights in accordance with the GPO Agreement to
any unpaid benefits owed pursuant to Section 3.4(a), 3.5(b), 3.7 or 3.9(a), as
applicable. If the date of such termination is after the Insurance Proceeds
Delivery Date, the Sulzer Settlement Trust shall administer payments in the
amounts provided for in Section 8.4 and additional amounts owed to such Class
Member in accordance with Section 3.4, 3.5, 3.7 or 3.9(a) shall remain the
responsibility of Sulzer. However, if Sulzer exercises its option to terminate
and withdraw from this Settlement Agreement pursuant to Section 10.1, any such
GPO elections become null and void and the GPO Agreement shall not be
enforceable.
Section 8.7 By electing the GPO and entering into a GPO Agreement, a
Class Member is knowingly and affirmatively waiving all Opt-Out Rights afforded
pursuant to Section 3.8 of this Settlement Agreement. Likewise, no person
exercising an Opt-Out Right pursuant to Section 3.8 hereof is eligible to elect
the GPO.
Section 8.8 The GPO shall be funded with the Insurance Proceeds paid in
accordance with Section 2.5(c), less amounts allocated to Common Benefit
Attorneys for expenses pursuant to Section 5.3 and less amounts allocated to the
Subrogation and Uninsured Expenses Fund pursuant to Section 2.2(e). The Sulzer
Settlement Trust shall pay to Class Members that validly elect the GPO an
initial payment of $40,000.00. In the event that there are amounts remaining
after payments have been made to all Class Members that validly elect the GPO,
any such amount shall be distributed pro rata among the Class Members that
elected the GPO up to the maximum amount of benefits such Class Member may be
eligible to receive under Section 3.4(a) and 3.5(b) hereof.
ARTICLE 9. CONTINUING JURISDICTION
Section 9.1 The Court shall retain exclusive and continuing
jurisdiction of the Complaint, the Parties, all Class Members (other than a
Class Member who exercises an Opt-Out Right pursuant to Section 3.8), Sulzer,
Xxxxxx XX and the other Released Parties, and over this Settlement Agreement
with respect to the performance of the terms and conditions of the Settlement
Agreement, to assure that all disbursements are properly made in accordance with
the terms of the Settlement Agreement, and to interpret and enforce the terms,
conditions and obligations of this Settlement Agreement. Other than provided
herein, the Court shall have the power to approve the designation, appointment
and removal of auditors, consultants and disbursing agents, the Claims
Administrator and it other agents, and the execution of contracts as necessary
and appropriate to assure the administration of this Settlement Agreement. Any
dispute that arises under this Settlement Agreement shall be submitted to the
Court. If any dispute is so submitted, each party concerned shall be entitled to
seven (7) days' written notice (or otherwise as the Court may for good cause
direct) and the opportunity to submit evidence and to be heard on oral argument
as the Court may direct. To the extent that additional or different
33
procedures for dispute resolution are provided, or standards to be applied in
connection therewith are devised, under any other provision of this Settlement
Agreement, such other provisions shall control.
ARTICLE 10. TERMINATION
Section 10.1 Sulzer shall have the option to terminate and withdraw
from this Settlement Agreement, in its sole discretion, at any time prior 5:00
p.m., Cleveland time, on the fifth (5) Business Day after the termination of the
Opt Out Period by giving written notice to the Court, Xxxxxx XX and Class
Counsel.
Section 10.2 In the event that any of the conditions set forth in
Section 13.3 have not been satisfied or waived by either Sulzer or Xxxxxx XX, as
applicable (and such conditions are no longer capable of being satisfied),
Sulzer and/or Xxxxxx XX shall have the right to terminate and withdraw from this
Settlement Agreement by written notice to the Court, Class Counsel and Sulzer or
Xxxxxx XX, as applicable.
Section 10.3 Class Representatives, on behalf of Class Members, shall
have the option to terminate and withdraw from this Settlement Agreement in the
event that, prior to the Fairness Hearing Date, Class Counsel is unable to
obtain an opinion of counsel or other evidence or advice reasonably satisfactory
to Class Counsel that the ADRs or Shares, as applicable, issued upon conversion
of the CCI in accordance with the terms thereof are freely tradable by
non-affiliates of SML upon such issuance. In the event Class Representatives
exercise their right to terminate pursuant to this Section 10.3, they shall
provide written notice to the Court, Sulzer, and Xxxxxx XX.
Section 10.4 In the event that the applicable Party terminates and
withdraws from this Settlement Agreement in accordance with Sections 10.1, 10.2
or 10.3 above, no Party shall have any further obligations hereunder.
Section 10.5 In the event that Sulzer exercises its right to terminate
this Settlement Agreement in accordance with this Section 10.1, Sulzer may not
assert any defense to claims made by Class Members who have neither exercised an
Opt-Out Right in accordance with Section 3.8 nor elected the GPO in accordance
with Article 8, based on the failure of such Class Member to timely pursue his
or her claim against Sulzer, including any statute of limitations or repose
defense, the doctrine of laches or any defense based on any release signed by
such Class Member and/or the existence of this Settlement Agreement; provided;
that such limitation on defenses that Sulzer may not assert is solely with
respect to the time period from August 29, 2001 through the date of termination
of the Settlement Agreement. Any amounts recovered by a Class Member as a result
of legal action that he or she commences upon termination of this Settlement
Agreement shall be reduced by the amount of cash benefits that such Class Member
has received hereunder (other than benefits in connection with the Section 3.3)
prior to the termination of the Settlement Agreement.
34
ARTICLE 11. [RESERVED]
ARTICLE 12. [RESERVED]
ARTICLE 13. SETTLEMENT IMPLEMENTATION
Section 13.1 GENERAL
(a) In order to become effective, this Settlement Agreement
must receive Final Judicial Approval, as well as necessary Xxxxxx XX board of
directors approval and SML board of directors approval prior to the Fairness
Hearing Date and SML shareholder approval for the transactions contemplated
hereby.
Section 13.2 APPROVAL PROCESS PROVISIONS
(a) No later than seven (7) days following the date of this
Settlement Agreement, the Parties shall file a joint motion requesting
preliminary approval of the Settlement Agreement and approval of the forms of
notice (the "Notice").
(b) Each of Sulzer and Xxxxxx XX shall retain its right to
contest class certification for any purposes other than the approval of this
Settlement Agreement.
(c) The Parties shall cooperate and assist in all of the
filings and proceedings relating to the obtaining Trial Court Approval and in
any further filings and proceedings necessary to obtain Final Judicial Approval
of the Settlement, and in any related appeals.
(d) Upon Final Judicial Approval, the Class Counsel and all
Class Members shall cooperate with Sulzer, Xxxxxx XX and any other Released
Party to cause the dismissal, with prejudice and without costs, of any action
against Sulzer, Xxxxxx XX or any Released Party asserting a Settled Claim
brought by or on behalf of any Class Member (other than a Class Member who
exercises an Opt-Out Right pursuant to Section 3.8) entitled to benefits
hereunder, including but not limited to class actions, whether or not certified
as such, which are pending in any State or federal court. Upon Trial Court
Approval, the Class Counsel and all such Class Members shall cooperate with
Sulzer, Xxxxxx XX and any other Released Party to cause further proceedings in
all such settled actions to be stayed pending Final Judicial Approval.
Section 13.3 CONDITIONS
(a) Sulzer's and Sulzer AG's obligations under this Settlement
Agreement, will be subject to the following conditions:
(i) Trial Court Approval of the Settlement, which
approval order or orders shall:
(1) Confirm the certification of the
Settlement Class, under Fed. R. Civ. P. 23(a), 23(b)(2) and 23(b)(3) for
Settlement purposes only;
35
(2) Confirm the appointment of the Class
Representatives as the representatives of the Settlement Class;
(3) Approve this Settlement Agreement in its
entirety pursuant to Fed. R. Civ. P. 23(e) as fair, reasonable, adequate, and
non-collusive;
(4) Dismiss with prejudice and without costs
all claims and actions asserting Settled Claims against Sulzer or Xxxxxx XX
pending before the Court (other than claims and actions of a Class Member who
exercises an Opt-Out Right pursuant to Section 3.8), with the condition that in
the event that Final Judicial Approval is not obtained, such claims and/or
actions may be reinstated to the status quo position, both procedurally and
substantively, of such claim and/or action at the time of its dismissal;
(5) Bar and enjoin all Class Members (other
than a Class Member who exercises an Opt-Out Right pursuant to Section 3.8)
entitled to benefits hereunder from asserting and/or continuing to prosecute
against Sulzer, Xxxxxx XX or any other Released Party any and all Settled Claims
which the Class Member (other than a Class Member who exercises an Opt-Out Right
pursuant to Section 3.8) had, has, or may have in the future in any federal or
State court;
(6) Reserve the Court's continuing and
exclusive jurisdiction over the Parties, including Sulzer, Xxxxxx XX and the
Class Members (other than a Class Member who exercises an Opt-Out Right pursuant
to Section 3.8), to administer, supervise, interpret, and enforce this
Settlement Agreement in accordance with its terms and to supervise the operation
of the Sulzer Settlement Trust; and
(7) Enter such other orders as are needed to
effectuate the terms of the Settlement Agreement;
(ii) Final Judicial Approval of this Settlement
Agreement.
ARTICLE 14. [RESERVED]
ARTICLE 15. MISCELLANEOUS
Section 15.1 Any information provided by or regarding a Class Member or
otherwise obtained pursuant to this Settlement Agreement shall be kept
confidential and shall not be disclosed except to appropriate persons to the
extent necessary to process Claims or provide benefits under this Settlement
Agreement or as otherwise expressly provided in this Settlement Agreement
(including, but not limited to, information to be released in connection with
the "registry". All Class Members shall be deemed to have consented to the
disclosure of this information for these purposes.
Section 15.2 This Settlement Agreement shall be binding on the
successors and assigns of the Parties.
36
Section 15.3 The Parties to the Settlement, including Sulzer, Xxxxxx
XX, the other Released Parties, or any Class Member, shall not seek to introduce
and/or offer the terms of the Settlement Agreement, any statement, transaction
or proceeding in connection with the negotiation, execution or implementation of
this Settlement Agreement, any statements in the Notice documents delivered in
connection with this Settlement Agreement, stipulations, agreements, or
admissions made or entered into in connection with the fairness hearing or any
finding of fact or conclusion of law made by the Trial Court, or otherwise rely
on the terms of this Settlement Agreement, in any judicial proceeding, except
insofar as it is necessary to enforce the terms of the Settlement Agreement (or
in connection with the determination of any income tax liability of a Party). If
a Class Member who is not entitled to benefits hereunder seeks to introduce
and/or offer any of the matters described herein in any proceeding, the
restrictions of this Section 15.3 shall not be applicable to Sulzer, Xxxxxx XX
and the other Released Parties with respect to that Class Member. If a Class
Member who has timely and properly exercised an Opt-Out Right seeks to introduce
and/or offer any of the matters described herein in any proceeding, the
restrictions of this Section 15.3 shall not be applicable to Sulzer, Xxxxxx XX
and the other Released Parties with respect to that Class Member.
Section 15.4 Neither this Settlement Agreement nor any Annex, Exhibit,
document or instrument delivered hereunder nor any of the statements in the
notice documents in connection herewith, nor any statement, transaction or
proceeding in connection with the negotiation, execution or implementation of
this Settlement Agreement, is intended to be or shall be construed as or deemed
to be evidence of an admission or concession by Sulzer, Xxxxxx XX or the
Released Parties of any liability or wrongdoing or of the truth of any
allegations asserted by any plaintiff against it or them, or as an admission by
the Class Representatives or members of the Settlement Class of any lack of
merit in their claims, and no such statement, transaction or proceeding shall be
admissible in evidence for any such purpose except for purposes of obtaining
approval of this Settlement Agreement in this or any other proceeding.
Section 15.5 The headings of the sections and paragraphs of this
Settlement Agreement are included for convenience only and shall not be deemed
to constitute part of this Settlement Agreement or to affect its construction.
Section 15.6 Class Counsel, together with the Special State Counsel
Committee shall make a determination, subject to the approval of the Court, with
respect to the disposition of any amounts remaining in any particular Fund upon
the satisfaction in full of all obligations to pay Class Members and Plaintiffs'
Counsel pursuant to this Settlement Agreement, which may include a pro rata
distribution to Class Members or in the event the amount is negligible, a
donation to a neutral medical research institute or university or to charity;
provided, however, that the Claims Administrator shall first use any amounts
remaining in any particular Fund after satisfaction of all obligations to Class
Members to either pay for or create a reserve for payment of all administrative
expenses that have been or will be incurred in connection with the winding-up of
the administration of the Sulzer Settlement Trust.
Section 15.7 Any notice, request, instruction or other document to be
given by any Party to another Party shall be in writing and delivered personally
or sent by Federal Express or
37
facsimile (which such facsimile notice shall be deemed effective as of the time
of receipt of confirmation by the sending party) as follows, or as otherwise
instructed by a notice delivered to the other Party pursuant to this subsection:
(i) If to Sulzer:
Sulzer Medica USA Inc.
0 Xxxx Xxxxxxxx Xxxxx, Xxxxx 0000
Xxxxxxx XX 00000-0000
Attention: Xxxxx X. Xxxx, Esq.
Facsimile: (000) 000-0000
with copies to:
The Xxxxxxx Law Firm, P.A.
Xxxx Xxxxxx Xxxxxx 0000
Xxxxxxxxxx, XX 00000-0000
Attention: Xxxxxxx X. Xxxxxxx, Esq.
Xxxxxx X. Xxxxxxxxx, Esq.
Facsimile: (000) 000-0000
and
Shook, Hardy & Bacon, LLP
One Kansas City Place
0000 Xxxx Xxxxxx
Xxxxxx Xxxx, Xxxxxxxx 00000-0000
Attention: Xxxxxx X. Xxxxxx, Esq.
Xxxxxxx X. Xxxxxxx, Esq.
Facsimile: (000) 000-0000
and
Weil, Gotshal & Xxxxxx LLP
000 Xxxxxxxx Xxxxx, Xxxxx 0000
Xxxxxx, XX 00000
Attention: Xxxxxx X. Xxxxxxx, Esq.
W. Xxxxxx Xxx, Esq.
Facsimile: (000) 000-0000
and
Bar & Xxxxxx
Xxxxxxxxxx. 00, XX - 0000
Xxxxxx, Xxxxxxxxxxx
Attention: Andreas Lanzlinger
Facsimile: x00 (0) 00 000 0000
38
(ii) If to Xxxxxx XX:
Xxxxxx XX
Xxxxxxxxxxxxxx 00, XX-0000
Xxxxxxxxxx, Xxxxxxxxxxx
Attention: Xxxxxx Xxxxxx, Esq.
Facsimile: 011-41-52-262-0022
with copies to:
Shearman & Sterling
000 Xxxxxxxxx Xxxxxx
Xxx Xxxx, XX 00000-0000
Attention: Xxxxxx X. Xxxxx, Esq.
Facsimile: (000) 000-0000
(iii) If to the Class Representatives or Class
Counsel:
Xxxxxxx, Xxxxxxxx & Xxxxxxx Co., L.P.A.
0000 Xxxxxxx Xxxxxxxx
Xxxxxxxx Xxxxxx Xxxxxx
Xxxxxxxxx, Xxxx 00000
Attention: R. Xxxx Xxxxxxx, Esq.
Facsimile: (000) 000-0000
Section 15.8 Any form or other documentation required to be submitted
under this Settlement Agreement shall be deemed timely if received on or before
the date by which it is required to be submitted under this Settlement
Agreement.
Section 15.9 No provision of this Settlement Agreement or any Exhibit
or Annex hereto is intended to create any third-party beneficiary to this
Settlement Agreement.
Section 15.10 This Settlement Agreement and that certain Settlement
Agreement, dated as of February 22, 2002, between SML and Xxxxxx XX, contains
the entire agreement between the Parties with respect to the subject matter
hereof and, except as specifically set forth herein or therein, supersedes and
cancels all previous agreements, negotiations, and commitments in writings
between the Parties hereto with respect to the subject matter hereof, including
without limitation that certain term sheet dated as of August 2, 2001, the
Settlement Agreement dated as of August 15, 2001, as amended August 23, 2001, as
further amended September 12, 2001 and as further amended October 12, 2001, and
the Memorandum of Understanding dated as of February 1, 2002. This Settlement
Agreement may not be changed or modified in any manner unless in writing and
signed by a duly authorized officer of each of Sulzer and Xxxxxx XX and by a
duly authorized representative of the Class Representatives.
Section 15.11 This Settlement Agreement shall be governed by and
construed in accordance with the laws of the State of
Delaware without regard to
conflict of laws principles thereunder.
39
Section 15.12 The Parties acknowledge and agree that in the event that
SML, SOUS and any other subsidiary of SML shall file for bankruptcy protection
under any applicable bankruptcy or insolvency laws, or a petition for an
involuntary bankruptcy or insolvency proceeding is initiated against any such
party prior to the termination of this Settlement Agreement, any plan of
reorganization or liquidating plan shall incorporate substantially the terms of
this Settlement Agreement.
Section 15.13 In the event that the Court approves a certification of
the Settlement Class other than that contemplated by this Settlement Agreement,
the parties hereby agree that they shall amend this Settlement Agreement to
reflect such certification.
Section 15.14 Xxxxxx XX agrees that it will not, nor will it permit any
of its subsidiaries, officers, directors, agents or affiliates to, submit for
payment, or charge costs against, or make any claim for reimbursement from, the
Initial Insurance Policies or the Second Year Insurance Policies in respect of
claims of Knee Beneficiaries.
Section 15.15 The Parties acknowledge that all amounts reflected in
this Settlement Agreement that are payable to Class Members pursuant to Sections
3.3, 3.4, 3.5 and 3.7 are estimates and are subject to modification based on the
actual number of Class Members submitting a claim for benefits payable in
respect of an Affected Product Revision Surgery. In the event that is it
necessary to make changes or modifications to the Settlement Agreement for any
reason, the Parties agree that Class Counsel together with the Special State
Counsel Committee, has the authority to negotiate all such changes or
modifications on behalf of the Settlement Class.
Section 15.16 This Settlement Agreement may be signed in multiple
counterparts, each of which shall be deemed to be an original and all of which
shall be deemed to be one and the same instrument.
Section 15.17 Sulzer, prior to Trial Court Approval and with the mutual
consent of the other Parties and the Court, may separate the Settlement Class
and this Settlement Agreement into two separate Settlement Classes and
Settlement Agreements, one including Subclasses I and III, and the other
including to Subclasses II, IV and V.
[The remainder of this page is intentionally left blank.]
40
IN WITNESS WHEREOF, the Parties have duly executed this amended and
restated
Class Action Settlement Agreement among SOUS, SML, Xxxxxx XX and the
Class Representatives, by their respective counsel as set forth below, as of the
______ day of March, 2002.
SULZER ORTHOPEDICS INC.
By: /s/ XXXXXXX X. XXXXXXX
--------------------------------------
SULZER MEDICA AG
By: /s/ XXXXXXX X. XXXXXXX
--------------------------------------
By:
--------------------------------------
XXXXXX XX
By: /s/ XXXXXX XXXXX
--------------------------------------
By:
--------------------------------------
CLASS COUNSEL
/s/ XXXXXXX X. XXXXXXX /s/ XXXX X. XXXXXXX
---------------------------------- ----------------------------------
Xxxxxxx X. Xxxxxxx, Esq. Xxxx X. Xxxxxxx, Esq.
Waite, Schneider, Xxxxxxx & Xxxxxxx Co., L.P.A. Climaco, Lefkowitz, Peca, Xxxxxx & Xxxxxxxx Co., L.P.A.
1513 Central Trust Tower Ninth Floor, The Halle Building
Fourth & Vine Street 0000 Xxxxxx Xxxxxx
Xxxxxxxxxx, XX 00000 Xxxxxxxxx, XX 00000
FOR SUBCLASS I
/s/ XXX XXXXXXX /s/ R. XXXX XXXXXXX
---------------------------------- ----------------------------------
Xxx Xxxxxxx, Esq. R. Xxxx Xxxxxxx, Esq.
Xxxxxxx Law Office, P.A. Xxxxxxx, Xxxxxxxx & Xxxxxxx Co., L.P.A.
000 Xxxxx Xxxxxx Xxxxx 0000 Xxxxxxx Building
Post Office Box 987 Landmark Office Towers
Lexington, Mississippi 39095 Xxxxxxxxx, Xxxx 00000
FOR SUBCLASS II
/s/ XXXXX X. XXXXXXXXXX /s/ XXXXXXX X. XXXXX
---------------------------------- ----------------------------------
Xxxxx X. Xxxxxxxxxx, Esq. Xxxxxxx X. Xxxxx, Esq.
Xxxxxxx Xxxxx Xxxxxxx Xxxxx & Xxxxxx LLP Xxxxxxx & Xxxx
Xxx Xxxxxxxxxxxx Xxxxx Xxx Xxxxxxx Xxxxxxx Xxxxxxxx
Xxx Xxxx, XX 00000-0000 000 Xxxx 0xx
Xxxxxxxxxx, XX 00000-0000
/s/ XXXXX XXXXX /s/ XXXXXX X. XXXXXX
---------------------------------- ----------------------------------
Xxxxx Xxxxx, Esq. Xxxxxx X. Xxxxxx, Xx., Esq.
Xxxxxxxx, Downing, LaBarre, Xxxxxx & Xxxx The Law Offices of Xxxxxx X. Xxxxxx, Xx.
0000 X. Xxxxxx Xxxxxx 000 Xxxx Xxxxxxx Xxxxxx
Xxxxxxxx, XX 00000 X.X. Xxxxxx X
Xxxxxxx, XX 00000
FOR SUBCLASS III FOR SUBCLASS IV
/s/ XXXXX X. XXXXXXXX /s/ XXXXXXX X. XXXXX
---------------------------------- ----------------------------------
Xxxxx X. Xxxxxxxx Xxxxxxx X. Xxxxx
Xxxxxxxxxxx, Xxxxxxx & Liber LLP Xxxxx & Xxxxxxxxxx L.L.P.
0000 Xxxx Xxxxx Xxxxxx The Huntington Building
2400 National City Center 000 Xxxxxx Xxxxxx, Xxxxx 0000
Xxxxxxxxx, XX 00000-0000 Xxxxxxxxx, XX 00000
FOR SUBCLASS V
/s/ XXXXXXX X. XXXXXXX
----------------------------------
Xxxxxxx X. Xxxxxxx
Xxxxx Cabraser Xxxxxxx & Xxxxxxxxx, LLP
Embarcadero Center West
000 Xxxxxxx Xxxxxx, Xxxxx 0000
Xxx Xxxxxxxxx, XX 00000-0000
Exhibit A
ESCROW AGREEMENT
To be prepared and agreed to by the parties.
EXHIBIT B
BLUE FORM
================================================================================
UNREVISED AFFECTED PRODUCT RECIPIENT (APR)
BENEFITS CLAIM FORM
THIS BLUE FORM IS TO BE USED ONLY BY A CLASS MEMBER REGISTERING FOR SETTLEMENT
BENEFITS WHO IS AN AFFECTED PRODUCT RECIPIENT ("APR"), WHO HAS BEEN IMPLANTED
WITH AN AFFECTED PRODUCT (OTHER THAN A REPROCESSED INTER-OP(TM) SHELL(1), AND
WHO HAS NOT UNDERGONE AN AFFECTED PRODUCT REVISION SURGERY ("APRS"). THE
COMPLETED FORM MUST BE POSTMARKED TO THE CLAIMS ADMINISTRATOR (C/O SULZER
SETTLEMENT TRUST, X.X. XXX 00000, XXXXXXXXX, XXXX 00000-0000) NO LATER THAN 120
DAYS AFTER TRIAL COURT APPROVAL FOR THE CLASS MEMBER TO QUALIFY TO RECEIVE
BENEFITS. SEE THE FINAL NOTICE OF SETTLEMENT OF NATIONWIDE HIP PROSTHESIS AND
KNEE PROSTHESIS PRODUCT LIABILITY CLASS ACTION LITIGATION ("FINAL NOTICE"), THE
CLASS MEMBER AND ATTORNEY GUIDE, OR THE SETTLEMENT AGREEMENT FOR FURTHER
INFORMATION. IF THERE IS ANY CONFLICT BETWEEN THE PROVISIONS OF THIS CLAIM FORM
AND THE TERMS OF THE SETTLEMENT AGREEMENT, THE TERMS OF THE SETTLEMENT AGREEMENT
CONTROL.
All responses must be PRINTED or TYPED. By completing this Blue Form, you(2) are
registering for benefits under the Settlement Agreement. If you have retained an
attorney regarding your Claim, you should consult with your attorney about your
options under the Settlement Agreement.
================================================================================
MEDICAL RESEARCH AND MONITORING
The Settlement Agreement creates a Medical Research and Monitoring Fund as a
benefit for all Class Members. The purposes of the Medical Research and
Monitoring Fund are to:
(1) Study the medical issues that are unique to Class Membership;
(2) Establish and maintain a registry for preserving medical information
arising from the use of Affected Products;
(3) Support medical research that may rely upon information in the registry;
(4) Establish protocols for access to the registry by third parties for medical
research.
To the greatest extent possible, the confidentiality of patient and physician
records in the registry of medical information will be protected. Refer to the
Settlement Agreement for further explanation of the Research and Monitoring
Fund.
[ ] CHECK HERE TO PERMIT INFORMATION FROM YOUR SUBMITTED CLAIM FORM(S) AND/OR
RECORDS TO BE INCLUDED IN THE REGISTRY FOR PRESERVING MEDICAL INFORMATION
ARISING FROM THE USE OF AFFECTED PRODUCTS.
================================================================================
----------
(1) Reprocessed Inter-Op(TM) Shells are identified by lot number in Annex II of
the Settlement Agreement and Exhibit II of the Final Notice of Settlement of
Nationwide Hip Prosthesis and Knee Prosthesis Product Liability Class Action
Litigation.
(2) "You" or "your" when used throughout this Claim Form refers to the APR, or
as applicable to the Representative Claimant of the APR.
BLUE FORM - 1
1. INDICATE BY CHECKING THE APPROPRIATE BOX BELOW WHETHER THE APR WAS IMPLANTED
WITH A SULZER INTER-OP(TM) SHELL OR SULZER TIBIAL BASEPLATE, WHICH HAS NOT
BEEN REMOVED. NOTE: CHECK ONLY ONE BOX. IF THE APR HAS BEEN IMPLANTED WITH
MORE THAN ONE AFFECTED PRODUCT, YOU MUST COMPLETE A CLAIM FORM FOR EACH
AFFECTED PRODUCT IMPLANTED.
[ ] APR WAS IMPLANTED WITH A SULZER INTER-OP(TM) SHELL, WHICH HAS NOT BEEN
REMOVED.
OR
[ ] APR WAS IMPLANTED WITH A SULZER TIBIAL BASEPLATE, WHICH HAS NOT BEEN
REMOVED.
2. AFFECTED PRODUCT RECIPIENT INFORMATION
------------------------------ --- ----------------------------
(First Name) (Middle Initial) (Last Name)
----------------------------------------------------------------------------
(List all other names that the APR uses or has used during the last ten years)
----------------------------------------------------------------------------
(Street Address)
-
-------------------------------------- ------ --------------------
(City) (State) (Zip Code)
( ) - ( ) -
----------------------------------- ----------------------------------
(Daytime Area Code & Phone Number) (Evening Area Code & Phone Number)
----------------------------------------------------------------------------
(Email Address, if any)
/ / - -
--------------------------------- ------------------------------
(Birth Date MM/DD/YYYY) (Social Security Number)
--------------------------------
(Sulzer Settlement Claim Number, if known)
Gender: Female [ ] Male [ ]
3. REPRESENTATIVE CLAIMANT INFORMATION
IF YOU ARE THE REPRESENTATIVE CLAIMANT OF A LIVING PERSON OR THE ESTATE OF A
DECEASED PERSON WHO IS OR WAS AN APR AND WHO EITHER HAS OR HAD A CONDITION
THAT YOU BELIEVE QUALIFIES THE APR OR THE ESTATE OF THE APR FOR
COMPENSATION, YOU MUST PROVIDE THE INFORMATION REQUESTED BELOW.
------------------------------ --- ----------------------------
(First Name) (Middle Initial) (Last Name)
----------------------------------------------------------------------------
(List all other names that you have used during the last ten years)
BLUE FORM - 2
----------------------------------------------------------------------------
(Street Address)
-
-------------------------------------- ------ --------------------
(City) (State) (Zip Code)
( ) - ( ) -
----------------------------------- ----------------------------------
(Daytime Area Code & Phone Number) (Evening Area Code & Phone Number)
----------------------------------------------------------------------------
(Email Address, if any)
/ / - -
--------------------------------- ------------------------------
(Birth Date MM/DD/YYYY) (Social Security Number)
--------------------------------
(Sulzer Settlement Claim Number, if available)
----------------------------------------------------------------------------
(Legal Relationship to APR, i.e. Trustee, Power of Attorney, etc.)
IF YOU ARE A REPRESENTATIVE CLAIMANT, YOU MUST ATTACH A COPY OF YOUR COURT
APPROVAL OR OTHER AUTHORIZATION TO REPRESENT THE APR IN THIS SETTLEMENT.
XXXX THE APPROPRIATE BOX BELOW TO INDICATE YOUR PREVIOUS OR CURRENT
SUBMISSION OF A COURT APPROVAL OR AUTHORIZATION:
[ ] I have provided the requested documentation previously on another
form and there is no change.
[ ] A copy of my court approval or other authorization to represent
the APR is attached.
4. ATTORNEY INFORMATION
Are you represented by an attorney in connection with this claim?
Yes [ ] No [ ]
If "Yes," you must provide the following information.
---------------------------------------------------------------------------
(Law Firm Name)
---------------------------------------------------------------------------
(Attorney's Name)
---------------------------------------------------------------------------
(Street Address)
-
------------------------------------- ------ --------------------
(City) (State) (Zip Code)
- -
---------------------------------- ---------------------------------
(Daytime Area Code & Phone Number) (Evening Area Code & Phone Number)
-------------------------------- ----------------------------------------
(Email Address, if any) (Attorney Tax Identification Number)
BLUE FORM - 3
State the date on which your attorney-client fee agreement was signed:
------------
(MM/DD/YYYY)
NOTE: A copy of such attorney-client agreement must be attached to your
Claim Form.
State the total amount of litigation expenses that were incurred in relation
to your claim(s): $____________
NOTE: An itemization of all litigation expenses must be attached.
5. PENDING LAWSUIT
Do you currently have a lawsuit pending in any Federal or State Court?
Yes [ ] No [ ]
If "Yes," you must provide the following information. You must also attach a
copy of your complaint.
Federal Court [ ] State Court [ ]
Jurisdiction in which case is pending:
-------------------------------------
Case Number:
---------------------------------------------------------------
Date original complaint was filed:
-----------------------------------------
6. IMPLANTATION OF AFFECTED PRODUCT
Date of implantation of Affected Product:
---------------------------------
(MM/DD/YYYY)
Hospital where implantation of Affected Product was performed:
----------------------------------------------------------------------------
(Hospital Name)
----------------------------------------------------------------------------
(Street Address)
-
-------------------------------------- ------ --------------------
(City) (State) (Zip Code)
( ) - ( ) -
----------------------------------- ----------------------------------
(Area Code & Phone Number) (Fax Area Code & Number)
BLUE FORM - 4
Implanting surgeon of Affected Product:
------------------------------ --- ----------------------------
(Surgeon's First Name) (Middle Initial) (Last Name)
----------------------------------------------------------------------------
(Street Address)
-
-------------------------------------- ------ --------------------
(City) (State) (Zip Code)
( ) - ( ) -
----------------------------------- ----------------------------------
(Area Code & Phone Number) (Fax Area Code & Number)
7. IDENTIFICATION OF AFFECTED PRODUCT
To prove that you were implanted with an Affected Product, you must attach
one of the following:
[ ] a. The hospital and/or medical records evidencing the implantation of
an Affected Product that specifies the lot number of the implanted
device and identifies Sulzer as its manufacturer. These records must
include, without limitation, the operative report;
NOTE: If the page containing the product identification fails to
indicate that it is part of the APR's hospital or medical record, a
certified copy of the record must be provided and a supplemental
statement from the records custodian may be required.
OR
[ ] b. An affirmative statement from the implanting physician (or a records
administrator at the facility where the implantation occurred)
attesting that the APR was implanted with an Affected Product and
identifying its lot number, and articulating the basis for this
conclusion;
NOTE: This type of proof is acceptable only if the records outlined in
Question 7.a are not available and must include a description of the
efforts that were made to secure the requested documentation.
OR
[ ] c. Such other proof that is adequate as determined by the Claims
Administrator.
NOTE: This type of proof is acceptable only if the proof outlined in
Questions 7.a and 7.b is not available and must include a description
of the efforts that were made to secure the requested proof.
8. DERIVATIVE CLAIMS
If there are Derivative Claimants who will be filing a claim for benefits,
they must complete a Yellow Form.
BLUE FORM - 5
9. DOCUMENT SUBMISSION
All documents submitted in support of a claim must be page numbered and
clearly labeled with the APR's full name and Sulzer Settlement Claim Number,
if known, and attached to this Claim Form.
10. EXTRAORDINARY INJURY FUND ("EIF")
If you believe that you are entitled to benefits pursuant to the EIF, you
must also complete a Green Form in order to be considered for those
benefits.
11. CHANGES TO APR OR REPRESENTATIVE CLAIMANT CONTACT INFORMATION
Class Members must provide the Claims Administrator updated name, address,
and telephone number information in order to ensure processing of their
Claim. Failure to provide updates may result in termination of a Claim or
disallowance of benefits. Class Members must include their Sulzer Settlement
Claim Number on all correspondence to the Claims Administrator.
12. WAIVER OF OPT-OUT RIGHTS
By submitting this form and agreeing to accept benefits pursuant to the
Settlement Agreement, the undersigned knowingly waive(s) all Opt-Out Rights
provided by the Settlement Agreement, as described in the Final Notice, and
agree(s) not to object to the Settlement Agreement or to appeal any Court's
approval of the Settlement Agreement.
13. RELEASE AND COVENANT NOT TO XXX
x. In consideration of the obligations of Sulzer as set forth in the
Settlement Agreement, I, the undersigned Class Member, individually and
for my heirs, beneficiaries, agents, estate, executors, administrators,
personal representatives, successors and assignees, and/or, if my claim
is that of a representative of a person who was implanted with an
Affected Product or of the person who has a Derivative Claim arising
out of the implantation of the Affected Product, in that capacity,
whether as heir, beneficiary, agent, estate, executor, administrator,
personal representative, successor, assignee, guardian, or otherwise,
hereby expressly RELEASE AND FOREVER DISCHARGE AND AGREE NOT TO XXX
Xxxxxx and all other Released Parties as to all Settled Claims. I
understand that certain principles of law provide that a release may
not extend to claims that I do not know or suspect to exist. I am aware
that I may discover claims presently unknown or unsuspected or facts in
addition to or different from those which I now believe to be true with
respect to the matters released herein which may be applicable to this
Settlement. Despite such principles of law, I HEREBY KNOWINGLY AND
VOLUNTARILY RELINQUISH THE PROTECTIONS OF ALL SUCH FEDERAL OR STATE
LAWS, RIGHTS, RULES OR LEGAL PRINCIPLES THAT MAY BE APPLICABLE AS
FOLLOWS: I FULLY, FINALLY, AND FOREVER SETTLE AND RELEASE ANY AND ALL
SETTLED CLAIMS, including assigned claims, whether known or unknown,
asserted or unasserted, regardless of the legal theory, existing now or
arising in the future out of or relating to the purchase, use,
manufacture, sale, distribution, promotion, marketing, clinical
investigation, administration, regulatory approval, and labeling of an
Affected Product THAT I MAY HAVE AGAINST ANY RELEASED PARTY.
BLUE FORM - 6
b. For purposes of the Release and Covenant Not to Xxx, the terms "Settled
Claims" and "Released Parties" are defined as set forth in the
Settlement Agreement, which is incorporated by reference.
c. I agree that acceptance of benefits pursuant to the Settlement
Agreement settles any lawsuit previously initiated by me, if any,
asserting any Settled Claim against Sulzer or any other Released Party,
and I stipulate and agree to the dismissal of all such claims, suits
and proceedings, with prejudice and without costs and agree to
cooperate as reasonably requested in order to effectuate such a
dismissal.
14. CONFIDENTIALITY
The person(s) signing below hereby consent(s) to the disclosure of the
information contained herein to the extent necessary to process claims for
benefits pursuant to the Settlement Agreement.
15. DECLARATION UNDER PENALTY OF PERJURY
Each person signing below acknowledges and understands that this form is an
official document sanctioned by the Court that presides over the legal
action entitled In Re Sulzer Hip Prosthesis and Knee Prosthesis Product
Liability Litigation. Submitting this Claim Form to the Claims Administrator
is equivalent to filing it with the Court. After reviewing the information
that has been provided on this form, including information, if applicable,
that was supplied by a Board-Certified physician and/or an attorney, each
person signing this form declares under penalty of perjury that the
information provided in this form is true and correct to the best of that
person's knowledge and belief.
/ /
-------------------------------------------------- --------------------
(Signature of APR) (Date MM/DD/YYYY)
OR
/ /
-------------------------------------------------- --------------------
(Signature of Each Representative Claimant, if any) (Date MM/DD/YYYY)
Mail this Claim Form and all attachments to:
Claims Administrator
Sulzer Settlement Trust
X.X. Xxx 00000
Xxxxxxxxx, Xxxx 00000-0000
BLUE FORM - 7
AUTHORIZATION FOR RELEASE OF MEDICAL RECORDS
AND OTHER HEALTH INFORMATION
I hereby authorize the use or disclosure of my individually identifiable health
information and medical records as described below. I understand that this
authorization is voluntary. I understand that because the organization
authorized to receive the information is not a health plan or health care
provider, the released information may no longer be protected by federal privacy
regulations, but it will be subject to the confidentiality provisions of the
Settlement Agreement.
INFORMATION AUTHORIZED FOR RELEASE: I authorize the release of the following
records/recordings to the Sulzer Settlement Trust: any medical records that
pertain or relate to the diagnosis, care or treatment of any disease, condition
or procedure related to or arising from any implantation in the Patient/Affected
Product Recipient of a hip or knee prosthesis(es) including information about
the undersigned Affected Product Recipient or Patient, his/her hip or knee
prosthesis(es), the hospital(s) where and surgeon(s) who made, provided, gave or
performed any diagnosis, care treatment, or procedure, the manufacturer, product
and lot numbers of any hip or knee prostheses, any surgery(ies) associated with
the hip or knee prosthesis(es), the date(s) and nature of any medical treatment
associated with the implant(s) of the hip or knee prosthesis(es), hospital
reports including pre-admission and admission histories, treating and implanting
surgeons' records, physical examinations, hospital discharge summaries,
operative reports and nursing notes, anesthesia records, pathology reports,
results/reports of all objective quantitative studies performed, progress notes,
prescription records, medical records of cardiothoracic surgeons and/or
cardiologists or neurologist, death summaries, certificate of death or autopsy
report, and any billing records and/or payment records.
PATIENT/AFFECTED PRODUCT RECIPIENT IDENTIFICATION:
------------------------------ --- ------------------------------
(First Name) (Middle Initial) (Last Name)
------------------------------------------------------------------------------
(List all other names that the APR uses or has used during the last ten years)
- -
--------------------------------- --------------------------------
(Birth Date MM/DD/YYYY) (Social Security Number)
PERSONS/ORGANIZATIONS PROVIDING THE INFORMATION: Any organization maintaining
records described above that are necessary to adjudicate the relevant claim
filed under the Settlement Agreement.
FORWARD THE ABOVE RECORDS TO:
Sulzer Settlement Trust
X.X. Xxx 00000
Xxxxxxxxx, XX 00000-0000
================================================================================
I understand that this authorization will expire three (3) years from the date I
sign this document as indicated below. In addition, I understand that I may
revoke this authorization at any time by notifying the providing organization in
writing, but if I do revoke this authorization it will not have any effect on
any actions any providing organization took before it received the revocation.
Also, this authorization does not authorize the disclosure of any information
other than the items referenced above.
-------------------------------------------------------------------------------- -----------------
Signature of Patient/Affected Product Recipient or Authorized Representative Date (MM/DD/YYYY)
---------------------------------------------------------------------------------------------------------
Printed Name of Authorized Representative (if applicable)
---------------------------------------------------------------------------------------------------------
Relationship of Representative to Patient/Affected Product Recipient (if applicable)
BLUE FORM - 8
EXHIBIT C
ORANGE FORM
================================================================================
AFFECTED PRODUCT REVISION SURGERY (APRS)
BENEFITS CLAIM FORM FOR AFFECTED PRODUCT RECIPIENT
(APR) ONLY
THIS ORANGE FORM IS TO BE USED BY ANY CLASS MEMBER REGISTERING FOR SETTLEMENT
BENEFITS WHO IS AN AFFECTED PRODUCT RECIPIENT ("APR"), WHO HAS BEEN IMPLANTED
WITH AN AFFECTED PRODUCT, AND WHO HAS UNDERGONE AN AFFECTED PRODUCT REVISION
SURGERY ("APRS").
TO QUALIFY TO RECEIVE BENEFITS, CLASS MEMBERS WHO SUBMIT THIS ORANGE FORM AND DO
NOT CHOOSE THE GUARANTEED PAYMENT OPTION, MUST SUBMIT THIS COMPLETED FORM,
POSTMARKED TO THE CLAIMS ADMINISTRATOR (C/O SULZER SETTLEMENT TRUST, X.X. XXX
00000, XXXXXXXXX, XXXX 00000-0000), NO LATER THAN (i) 180 DAYS AFTER TRIAL COURT
APPROVAL OR (ii) 180 DAYS AFTER AN APRS.
TO QUALIFY TO RECEIVE BENEFITS, CLASS MEMBERS WHO SUBMIT THIS ORANGE FORM AND DO
CHOOSE THE GUARANTEED PAYMENT OPTION (GPO), MUST SUBMIT THIS COMPLETED FORM,
POSTMARKED TO THE CLAIMS ADMINISTRATOR (C/O SULZER SETTLEMENT TRUST, X.X. XXX
00000, XXXXXXXXX, XXXX 00000-0000), NO LATER THAN (i) 120 DAYS AFTER TRIAL COURT
APPROVAL OR (ii) 120 DAYS AFTER AN APRS.
SEE THE FINAL NOTICE OF SETTLEMENT OF NATIONWIDE HIP PROSTHESIS AND KNEE
PROSTHESIS PRODUCT LIABILITY CLASS ACTION LITIGATION ("FINAL NOTICE"), THE CLASS
MEMBER AND ATTORNEY GUIDE, OR THE SETTLEMENT AGREEMENT FOR FURTHER INFORMATION.
IF THERE IS ANY CONFLICT BETWEEN THE PROVISIONS OF THIS CLAIM FORM AND THE TERMS
OF THE SETTLEMENT AGREEMENT, THE TERMS OF THE SETTLEMENT AGREEMENT CONTROL.
YOU(1) MUST REVIEW THE CLASS MEMBER AND ATTORNEY GUIDE, WHICH OUTLINES
COMPENSATION AVAILABLE FROM THE EXTRAORDINARY INJURY FUND (EIF). TO RECEIVE
COMPENSATION FROM THE EIF, A GREEN FORM MUST ALSO BE COMPLETED IN ADDITION TO
THIS ORANGE FORM.
All responses must be PRINTED or TYPED. By completing this Orange Form, you are
registering for benefits under the Settlement Agreement. If you have retained an
attorney regarding your claim, you should consult with your attorney about your
options under the Settlement Agreement.
----------
(1) "You" or "your" when used throughout this Claim Form refers to the
APR or, as applicable, to the Representative Claimant of the APR.
ORANGE FORM - 1
================================================================================
GUARANTEED PAYMENT OPTION (GPO)
BY SELECTING THE GUARANTEED PAYMENT OPTION, YOU ARE ELIGIBLE TO RECEIVE QUICKLY
AN INITIAL PAYMENT OF $40,000 (APPROXIMATELY 20% OF THE MINIMUM TOTAL BENEFITS
YOU MAY BE ELIGIBLE TO RECEIVE PAYABLE FROM THE AFFECTED PRODUCT REVISION
SURGERY FUND), EVEN IF THE SETTLEMENT IS NEVER APPROVED BY THE COURT. IN
ADDITION TO THE $40,000 MINIMUM PAYMENT, YOU WILL BE ENTITLED TO THE BALANCE OF
ALL BENEFITS YOU MAY RECEIVE UNDER THE SETTLEMENT AGREEMENT, IN EXCHANGE FOR
YOUR UNCONDITIONAL RELEASE AS PROVIDED IN SECTION 17 OF THIS ORANGE FORM. IF YOU
CHOOSE THIS OPTION, YOU WILL LOSE YOUR RIGHT TO BE EXCLUDED FROM THE SETTLEMENT
BY EXERCISING YOUR OPT-OUT RIGHT PURSUANT TO THE SETTLEMENT AGREEMENT AND YOU
WILL LOSE YOUR RIGHT TO OBJECT TO THE SETTLEMENT AGREEMENT.
BY SIGNING THE "ACKNOWLEDGMENT" BELOW, YOU ARE ENTERING INTO A GPO AGREEMENT
THAT SHALL BE EFFECTIVE UPON EXECUTION AND DELIVERY TO THE CLAIMS ADMINISTRATOR.
THIS GPO AGREEMENT REPRESENTS A BINDING AGREEMENT BETWEEN YOU AND SULZER
SEPARATE AND APART FROM THE SETTLEMENT AGREEMENT. YOUR RELEASE OF SULZER IS
CONTINGENT ON YOUR RECEIVING THE BALANCE OF YOUR BENEFITS FROM SULZER; HOWEVER,
YOUR RELEASE OF THE OTHER RELEASED PARTIES SHALL BE EFFECTIVE WHEN THE
ACKNOWLEDGMENT IS SIGNED AND DELIVERED TO THE CLAIMS ADMINISTRATOR. IF THE
SETTLEMENT IS NOT APPROVED BY THE COURT, THIS GPO AGREEMENT REPRESENTS AN
INDIVIDUAL SETTLEMENT WITH SULZER THAT ENTITLES YOU ONLY TO THE BENEFITS THAT
YOU WOULD HAVE OTHERWISE RECEIVED IN THE SETTLEMENT. REFER TO THE SETTLEMENT
AGREEMENT AND FINAL NOTICE FOR FURTHER EXPLANATION OF THIS GPO.
NOTE: IN ORDER TO ELECT THE GPO, YOU MUST BE AN AFFECTED PRODUCT RECIPIENT (APR)
WHO HAS UNDERGONE AN AFFECTED PRODUCT REVISION SURGERY, YOU MUST COMPLETE THIS
ORANGE FORM AND YOU MUST SIGN THE "ACKNOWLEDGMENT" BELOW.
ACKNOWLEDGMENT
BY SIGNING BELOW, I HEREBY ACKNOWLEDGE THAT I UNDERSTAND THE GPO TERMS AND
CONDITIONS SET FORTH HEREIN AND IN THE SETTLEMENT AGREEMENT AND I HEREBY ELECT
THE GPO OPTION AND ENTER INTO THIS GPO AGREEMENT.
--------------------------------------------------------------------------------
(SIGNATURE OF APR OR REPRESENTATIVE CLAIMANT ELECTING GPO) (DATE)
================================================================================
ORANGE FORM - 2
================================================================================
MEDICAL RESEARCH AND MONITORING
The Settlement Agreement creates a Medical Research and Monitoring Fund as a
benefit for all Class Members. The purposes of the Medical Research and
Monitoring Fund are to:
(1) Study the medical issues that are unique to Class Membership;
(2) Establish and maintain a registry for preserving medical information
arising from the use of Affected Products;
(3) Support medical research that may rely upon information in the
registry;
(4) Establish protocols for access to the registry by third parties for
medical research.
To the greatest extent possible, the confidentiality of patient and physician
records in the registry of medical information will be protected. Refer to the
Settlement Agreement for further explanation of the Research and Monitoring
Fund.
CHECK HERE TO PERMIT INFORMATION FROM YOUR SUBMITTED CLAIM FORM(S) AND/OR
RECORDS TO BE INCLUDED IN THE REGISTRY FOR PRESERVING MEDICAL INFORMATION
ARISING FROM THE USE OF AFFECTED PRODUCTS.
================================================================================
1. INDICATE BY CHECKING THE APPROPRIATE BOX BELOW WHETHER THE APR WAS IMPLANTED
WITH A SULZER INTER-OP(TM) SHELL, REPROCESSED INTER-OP(TM) SHELL OR SULZER
TIBIAL BASEPLATE, WHICH WAS THE SUBJECT OF AN APRS. NOTE: CHECK ONLY ONE
BOX. IF THE APR HAS BEEN IMPLANTED WITH MORE THAN ONE AFFECTED PRODUCT, YOU
MUST COMPLETE A CLAIM FORM FOR EACH AFFECTED PRODUCT IMPLANTED.
APR WAS IMPLANTED WITH A SULZER INTER-OP(TM) SHELL.
OR
APR WAS IMPLANTED WITH A REPROCESSED INTER-OP(TM) SHELL.
OR
APR WAS IMPLANTED WITH A SULZER TIBIAL BASEPLATE.
ORANGE FORM - 3
2. AFFECTED PRODUCT RECIPIENT INFORMATION
---------------------------------- ------ --------------------
(First Name) (Middle Initial) (Last Name)
----------------------------------------------------------------------------
(List all other names that the APR uses or has used during the last ten years)
----------------------------------------------------------------------------
(Street Address)
-
------------------------------ -------- --------------------
(City) (State) (Zip Code)
( ) - ( ) -
------------------------------------ ----------------------------------
(Daytime Area Code & Phone Number) (Evening Area Code & Phone Number)
----------------------------------------------------------------------------
(Email Address, if any)
/ / - -
------------------------- -------------------------------
(Birth Date - MM/DD/YYYY) (Social Security Number)
--------------------------------
(Sulzer Settlement Claim Number, if known)
Gender: Female [ ] Male [ ]
3. REPRESENTATIVE CLAIMANT INFORMATION
IF YOU ARE THE REPRESENTATIVE CLAIMANT OF A LIVING PERSON OR THE ESTATE OF A
DECEASED PERSON WHO IS OR WAS AN APR AND WHO EITHER HAS OR HAD A CONDITION
THAT YOU BELIEVE QUALIFIES THE APR OR THE ESTATE OF THE APR FOR
COMPENSATION, YOU MUST PROVIDE THE INFORMATION REQUESTED BELOW.
---------------------------------- ------ --------------------
(First Name) (Middle Initial) (Last Name)
----------------------------------------------------------------------------
(List all other names that you use or have used during the last ten years)
----------------------------------------------------------------------------
(Street Address)
-
------------------------------ -------- --------------------
(City) (State) (Zip Code)
( ) - ( ) -
------------------------------------ ----------------------------------
(Daytime Area Code & Phone Number) (Evening Area Code & Phone Number)
----------------------------------------------------------------------------
(Email Address, if any)
/ / - -
------------------------- -------------------------------
(Birth Date - MM/DD/YYYY) (Social Security Number)
----------------------------------------------------------------------------
(Legal Relationship to APR, i.e. Trustee, Power of Attorney, etc.)
ORANGE FORM - 4
NOTE: If you are a Representative Claimant, you must attach a copy of your
court approval or other authorization to represent the APR in this
Settlement. Xxxx the appropriate box below to indicate your previous or
current submission of a court approval or authorization:
I have provided the requested documentation previously on
another form and there is no change.
A copy of my court approval or other authorization to
represent the APR is attached.
4. ATTORNEY INFORMATION
Are you represented by an attorney in connection with this claim?
Yes No
If "Yes," you must provide the following information.
----------------------------------------------------------------------------
(Law Firm Name)
----------------------------------------------------------------------------
(Attorney's Name)
----------------------------------------------------------------------------
(Street Address)
-
------------------------------ -------- --------------------
(City) (State) (Zip Code)
( ) - ( ) -
------------------------------------ ----------------------------------
(Daytime Area Code & Phone Number) (Evening Area Code & Phone Number)
--------------------------------- -------------------------------------
(Email Address, if any) (Attorney Tax Identification Number)
State the date on which your attorney-client fee agreement was signed: / /
--------------
(MM/DD/YYYY)
NOTE: A copy of such attorney-client agreement must be attached to
your Claim Form.
State the total amount of litigation expenses that were incurred in
relation to your claim(s): $____________
NOTE: An itemization of all litigation expenses must be attached to
your Claim Form.
ORANGE FORM - 5
5. PENDING LAWSUIT
Do you currently have a lawsuit pending in any Federal or State Court?
Yes No
If "Yes," you must provide the following information. You must attach a copy
of your complaint.
Federal Court State Court
Jurisdiction in which case is pending:
-------------------------------------
Case Number:
---------------------------------------------------------------
Date original complaint was filed: / /
------------
(MM/DD/YYYY)
6. IMPLANTATION OF AFFECTED PRODUCT
Date of implantation of Affected Product: / /
------------
(MM/DD/YYYY)
Hospital where implantation of Affected Product was performed:
----------------------------------------------------------------------------
(Hospital Name)
----------------------------------------------------------------------------
(Street Address)
-
-------------------------------- -------- ---------------------------
(City) (State) (Zip Code)
( ) - ( ) -
------------------------------------ ----------------------------------
(Area Code & Phone Number) (Fax Area Code & Number)
Implanting surgeon of Affected Product:
----------------------------------------------------------------------------
(Surgeon's Name)
----------------------------------------------------------------------------
(Street Address)
-
------------------------------ -------- --------------------
(City) (State) (Zip Code)
( ) - ( ) -
------------------------------------ ----------------------------------
(Area Code & Phone Number) (Fax Area Code & Number)
ORANGE FORM - 6
7. IDENTIFICATION OF AFFECTED PRODUCT
To complete your application for benefits under the Affected Product
Revision Surgery Fund, you must attach one of the following:
a. The hospital and/or medical records evidencing the
implantation of an Affected Product that specifies the lot
number of the implanted device and identifies Sulzer as its
manufacturer. These records must include, without limitation,
the operative report;
NOTE: If the page containing the product identification fails
to indicate that it is part of the APR's hospital or medical
record, a certified copy of the record must be provided and a
supplemental statement from the records custodian may be
required.
OR
b. An affirmative statement from the implanting physician (or
a records administrator at the facility where the implantation
occurred) attesting that the APR was implanted with an
Affected Product and identifying its lot number, and
articulating the basis for this conclusion;
NOTE: This type of proof is acceptable only if the records
outlined in Question 7.a are not available and must include a
description of the efforts that were made to secure the
requested documentation.
OR
c. Such other proof that is adequate as determined by the
Claims Administrator.
NOTE: THIS TYPE OF PROOF IS ACCEPTABLE ONLY IF THE PROOF
OUTLINED IN QUESTIONS 7.a AND 7.b IS NOT AVAILABLE AND MUST
INCLUDE A DESCRIPTION OF THE EFFORTS THAT WERE MADE TO SECURE
THE REQUESTED PROOF.
8. AFFECTED PRODUCT REVISION SURGERY (APRS)
Date of removal of Affected Product: / /
----------------
(MM/DD/YYYY)
Hospital where removal of Affected Product was performed:
---------------------------------------------------------------------------
(Hospital Name)
---------------------------------------------------------------------------
(Street Address)
-
------------------------------ -------- --------------------
(City) (State) (Zip Code)
( ) - ( ) -
------------------------------------ ----------------------------------
(Area Code & Phone Number) (Fax Area Code & Number)
ORANGE FORM - 7
Surgeon who removed Affected Product:
----------------------------------------------------------------------------
(Surgeon's Name)
---------------------------------------------------------------------------
(Street Address)
-
------------------------------ -------- -------------------
(City) (State) (Zip Code)
( ) - ( ) -
------------------------------------ ----------------------------------
(Area Code & Phone Number) (Fax Area Code & Number)
9. PROOF OF AFFECTED PRODUCT REVISION SURGERY (APRS)
In order to prove that you underwent an APRS, you must attach one of the
following:
a. The hospital records evidencing the removal of an Affected
Product that should include, without limitation, a
preadmission/admission history and physical examination, an
operative report, progress notes and a discharge summary; or
b. The medical records of the surgeon evidencing removal of an
Affect Product; or
c. An affirmative statement from the surgeon who performed the
revision wherein the surgeon attests that the APR was revised,
indicates the date of the revision and identifies the
particular hip or knee that was revised; or
d. Such other proof that is adequate as determined by the
Claims Administrator.
NOTE: The type of proof in Question 9.d is acceptable only if
the proof outlined in Questions 9.a, 9.b, or 9.c is not
available and must include a description of the efforts that
were made to secure the requested proof.
10. PROOF THAT REMOVAL OF THE AFFECTED PRODUCT WAS NOT INDICATED AS A RESULT OF
TRAUMA
In order to prove that the Affected Product Revision Surgery was not
indicated as a result of trauma, you must provide one of the following:
a. An affirmative statement from the revising surgeon
attesting that the APRS was not indicated as a result of
trauma; or
b. The hospital/physician records which specifically indicate
that the APRS was not indicated as a result of trauma; or
c. Such other proof that is adequate as determined by the
Claims Administrator.
NOTE: The type of proof in Question 10.c is acceptable only if
the proof outlined in Questions 10.a and 10.b is not available
and must include a description of what steps were taken to
secure the requested documentation.
ORANGE FORM - 8
11. ADDITIONAL APRS
Have you had more than one Affected Product Removed?
Yes No
IF "YES," YOU MUST COMPLETE AN ADDITIONAL ORANGE FORM.
12. DERIVATIVE CLAIMS
If there are Derivative Claimants who will be filing a claim for benefits,
they must complete a Yellow Form.
13. DOCUMENT SUBMISSION
All documents submitted in support of a claim must be page numbered and
clearly labeled with the APR's full name and Sulzer Settlement Claim Number,
if known, and attached to this Claim Form.
14. EXTRAORDINARY INJURY FUND ("EIF")
If you believe that you are entitled to benefits pursuant to the EIF, you
must also complete a Green Form in order to be considered for those
benefits.
15. CHANGES TO APR OR REPRESENTATIVE CLAIMANT CONTACT INFORMATION
Class Members must provide the Claims Administrator updated name, address,
and telephone number information in order to ensure processing of their
claim. Failure to provide updates may result in termination of a claim or
disallowance of benefits. Class Members must include their Sulzer Settlement
Claim Number on all correspondence to the Claims Administrator.
16. WAIVER OF OPT-OUT RIGHTS
By submitting this form and agreeing to accept benefits pursuant to the
Settlement Agreement, the undersigned knowingly waive(s) all Opt-Out Rights
provided by the Settlement Agreement, as described in the Final Notice, and
agree(s) not to object to the Settlement Agreement or to any Court's
approval of the Settlement Agreement.
17. RELEASE AND COVENANT NOT TO XXX
x. In consideration of the obligations of Sulzer as set forth in the
Settlement Agreement, I, the undersigned Class Member, individually and
for my heirs, beneficiaries, agents, estate, executors, administrators,
personal representatives, successors and assignees, and/or, if my claim
is that of a representative of a person who was implanted with an
Affected Product or of the person who has a Derivative Claim arising
out of the implantation of the Affected Product, in that capacity,
whether as heir, beneficiary, agent, estate, executor, administrator,
personal representative, successor, assignee, guardian, or otherwise,
hereby expressly RELEASE AND FOREVER DISCHARGE AND AGREE NOT TO XXX
Xxxxxx and all other Released Parties as to all Settled Claims. I
understand that certain principles of law provide that a release may
not extend to claims that I do not know or suspect to exist. I am aware
that I may discover claims presently unknown or unsuspected or facts in
addition to or different from those which I now believe to be
ORANGE FORM - 9
true with respect to the matters released herein which may be
applicable to this Settlement. Despite such principles of law, I HEREBY
KNOWINGLY AND VOLUNTARILY RELINQUISH THE PROTECTIONS OF ALL SUCH
FEDERAL OR STATE LAWS, RIGHTS, RULES OR LEGAL PRINCIPLES THAT MAY BE
APPLICABLE AS FOLLOWS: I FULLY, FINALLY, AND FOREVER SETTLE AND RELEASE
ANY AND ALL SETTLED CLAIMS, including assigned claims, whether known or
unknown, asserted or unasserted, regardless of the legal theory,
existing now or arising in the future out of or relating to the
purchase, use, manufacture, sale, distribution, promotion, marketing,
clinical investigation, administration, regulatory approval, and
labeling of an Affected Product THAT I MAY HAVE AGAINST ANY RELEASED
PARTY.
b. For purposes of the Release and Covenant Not to Xxx, the terms "Settled
Claims" and "Released Parties" are defined as set forth in the
Settlement Agreement, which is incorporated by reference.
c. I agree that acceptance of benefits pursuant to the Settlement
Agreement settles any lawsuit previously initiated by me, if any,
asserting any Settled Claim against Sulzer or any other Released Party,
and I stipulate and agree to the dismissal of all such claims, suits
and proceedings, with prejudice and without costs and agree to
cooperate as reasonably requested in order to effectuate such a
dismissal.
18. CONFIDENTIALITY
The person(s) signing below hereby consent(s) to the disclosure of the
information contained herein to the extent necessary to process claims for
benefits pursuant to the Settlement Agreement.
19. DECLARATION UNDER PENALTY OF PERJURY
Each person signing below acknowledges and understands that this form is an
official document sanctioned by the Court that presides over the legal
action entitled In Re Sulzer Hip Prosthesis and Knee Prosthesis Product
Liability Litigation. Submitting this Claim Form to the Claims Administrator
is equivalent to filing it with the Court. After reviewing the information
that has been provided on this form, including information, if applicable,
that was supplied by a Board-Certified physician and/or an attorney, each
person signing this form declares under penalty of perjury that all of the
information provided in this form is true and correct to the best of that
person's knowledge and belief.
/ /
--------------------------------------------------- -------------------
(Signature of APR) (Date - MM/DD/YYYY)
OR
/ /
--------------------------------------------------- -------------------
(Signature of Each Representative Claimant, if any) (Date - MM/DD/YYYY)
Mail this Claim Form and all attachments to:
Claims Administrator
Sulzer Settlement Trust
X.X. Xxx 00000
Xxxxxxxxx, Xxxx 00000-0000
ORANGE FORM - 10
AUTHORIZATION FOR RELEASE OF MEDICAL RECORDS
AND OTHER HEALTH INFORMATION
I hereby authorize the use or disclosure of my individually identifiable health
information and medical records as described below. I understand that this
authorization is voluntary. I understand that because the organization
authorized to receive the information is not a health plan or health care
provider, the released information may no longer be protected by federal privacy
regulations, but it will be subject to the confidentiality provisions of the
Settlement Agreement.
INFORMATION AUTHORIZED FOR RELEASE: I authorize the release of the following
records/recordings to the Sulzer Settlement Trust: any medical records that
pertain or relate to the diagnosis, care or treatment of any disease, condition
or procedure related to or arising from any implantation in the Patient/Affected
Product Recipient of a hip or knee prosthesis(es) including information about
the undersigned Affected Product Recipient or Patient, his/her hip or knee
prosthesis(es), the hospital(s) where and surgeon(s) who made, provided, gave or
performed any diagnosis, care treatment, or procedure, the manufacturer, product
and lot numbers of any hip or knee prostheses, any surgery(ies) associated with
the hip or knee prosthesis(es), the date(s) and nature of any medical treatment
associated with the implant(s) of the hip or knee prosthesis(es), hospital
reports including pre-admission and admission histories, treating and implanting
surgeons' records, physical examinations, hospital discharge summaries,
operative reports and nursing notes, anesthesia records, pathology reports,
results/reports of all objective quantitative studies performed, progress notes,
prescription records, medical records of cardiothoracic surgeons and/or
cardiologists or neurologist, death summaries, certificate of death or autopsy
report, and any billing records and/or payment records.
PATIENT/AFFECTED PRODUCT RECIPIENT IDENTIFICATION:
----------------------------- ---------------- -------------------------
(First Name) (Middle Initial) (Last Name)
/ / - -
------------------------- -------------------------------
(Birth Date MM/DD/YYYY) (Social Security Number)
--------------------------------------------------------------------------------
(List all other names that the APR uses or has used during the last ten years)
PERSONS/ORGANIZATIONS PROVIDING THE INFORMATION: Any organization maintaining
records described above that are necessary to adjudicate the relevant claim
filed under the Settlement Agreement.
FORWARD THE ABOVE RECORDS TO:
Claims Administrator
Sulzer Settlement Trust
X.X. Xxx 00000
Xxxxxxxxx, XX 00000-0000
================================================================================
I understand that this authorization will expire three (3) years from the date I
sign this document as indicated below. In addition, I understand that I may
revoke this authorization at any time by notifying the providing organization in
writing, but if I do revoke this authorization it will not have any effect on
any actions any providing organization took before it received the revocation.
Also, this authorization does not authorize the disclosure of any information
other than the items referenced above.
/ /
---------------------------------------------------------------------------- -----------------
Signature of Patient/Affected Product Recipient or Authorized Representative Date (MM/DD/YYYY)
------------------------------------------------------------------------------------------------------
Printed Name of Authorized Representative (if applicable)
-------------------------------------------------------------------------------------------------------
Relationship of Representative to Patient/Affected Product Recipient (if applicable)
ORANGE FORM - 11
EXHIBIT D
================================================================================
PHYSICIAN DECLARATION FORM
Sulzer Orthopedics Inc., Sulzer Medica AG (collectively "Sulzer") and
Xxxxxx XX have agreed to settle certain legal claims that are pending or that
may be brought against them relating to two implantable medical devices that
Sulzer marketed, the Inter-Op(TM) Acetabular Shell and the Natural Knee II(R)
Tibial Baseplate ("Affected Products"). Affected Product Recipients ("APRs") are
those persons who have been implanted with one or more Affected Products.
To register for benefits under the Sulzer
Class Action Settlement
Agreement, APRs must submit Claim Forms. To qualify for certain benefits, APRs
also must submit this "Physician Declaration," wherein a treating physician(1)
is required to certify that an APR has/had a particular medical condition. These
conditions are set forth in the various Claim Forms, and include surgical
removal and/or replacement of an Affected Product for a reason other than trauma
("Affected Product Revision Surgery" or "APRS").
In completing this "Physician Declaration," you may consider the APR's
medical records, charts, reports, diagnostic films, medical history or other
sources of information that physicians regularly and routinely rely upon in
their practice. By signing this Form, you certify that all opinions set forth in
this "Physician Declaration" are offered to a reasonable degree of medical
certainty.
If this "Physician Declaration" is being used to supplement a prior
Physician Declaration form, you only need to provide information which relates
to a medical condition that has changed since the date on which any prior EIF
Benefits Claim Form was completed.
1. PHYSICIAN'S MEDICAL BACKGROUND
--------------------------- -------- ---------------------------
(First Name) (Middle Initial) (Last Name)
------------------------------------------------------------------------
(Office Address)
-
---------------------------- -------- -------------------------------
(City) (State) (Zip Code)
( ) - ( ) -
------------------------------ -------------------------------
(Area Code & Telephone Number) (Fax Area Code & Number)
Check whether you are:
[ ] A Board-Certified Orthopedic surgeon; or
[ ] A Board-Certified Cardiologist; or
[ ] A Board-Certified Cardiothoracic surgeon; or
[ ] A Board-Certified Neurologist; or
[ ] A Board-Certified Neurosurgeon; or
[ ] Other
---------------------------------
YOU MUST ATTACH A COPY OF YOUR CURRENT BOARD CERTIFICATION TO THIS
DECLARATION.
----------
(1) The Claims Administrator MAY accept a "Physician Declaration" supplied by a
Board-Certified orthopedic surgeon, neurologist, neurosurgeon, cardiologist
and/or cardiothoracic surgeon ONLY where the treating physician is unavailable
to certify these responses.
PHYSICIAN DECLARATION - 1
2. PATIENT INFORMATION
A. State the name, birth date and social security number of the Affected
Product Recipient ("APR") for whom you are providing the information
contained in this Declaration.
---------------------------------------- ----- ----------------------
(Affected Product Recipient's First Name) (Middle Initial) (Last Name)
/ / - -
--------------------- -------------------------------
(Birth Date MM/DD/YYYY) (Social Security Number)
B. Are you one of the APR's treating physicians?
[ ] Yes [ ] No
C. If "Yes," state your role in the APR's medical care and treatment
relative to his/her Sulzer Implant:
------------------------------------------------------------------------
------------------------------------------------------------------------
3. AFFECTED PRODUCT REVISION SURGERY NOT PERFORMED DUE TO TRAUMA
An Affected Product Revision Surgery ("APRS") is a surgical removal and/or
replacement of an Affected Product for a reason other than trauma. Were any
of the APR's Affected Product Revision Surgeries indicated as a result of
trauma?
[ ] Yes [ ] No
FOR QUESTIONS 4-12, COMPLETE ONLY THOSE QUESTIONS THAT APPLY TO THE MEDICAL
CONDITION(s) OF THE APR.
4. MATRIX LEVEL I (RECOMMENDED REVISION SURGERY)
This question relates to MATRIX LEVEL I and must be completed ONLY if you
are attesting that an Affected Product Revision Surgery for the APR is
medically contraindicated.
A. Is an Affected Product Revision Surgery for the APR medically
contraindicated?
[ ] Yes [ ] No
B. If "Yes," is there a medical condition that prevents the APR from
undergoing the Affected Product Revision Surgery?
[ ] Yes [ ] No
C. If "Yes," describe the medical condition(s) that prevent(s) replacement
of the Affected Product:
-----------------------------------------------------------------------
-----------------------------------------------------------------------
-----------------------------------------------------------------------
PHYSICIAN DECLARATION - 2
D. Did the APR have the medical condition(s) that prevents the APR from
an APRS before the APR was implanted with an Affected
Product?
Yes [ ] No [ ]
E. Provide the date on which it was determined that an Affected Product
Revision Surgery for the APR was medically contraindicated. / /
------------
(MM/DD/YYYY)
5. MATRIX LEVEL II (NON-REMOVAL SURGERY)
This question relates only to MATRIX LEVEL II and should be completed ONLY
if you are attesting that the APR underwent a non-removal surgery, wherein
you have or another treating physician has attempted to secure an Affected
Product using screws, cement, or some other means, as a result of
non-traumatic loosening.
A. Did you perform one or more non-removal surgeries on the APR?
Yes [ ] No [ ]
B. If "No," state the name, address and telephone number of the treating
surgeon:
--------------------------- -------- ---------------------------
(First Name) (Middle Initial) (Last Name)
------------------------------------------------------------------------
(Office Address)
-
---------------------------- -------- -------------------------------
(City) (State) (Zip Code)
( ) - ( ) -
------------------------------ -------------------------------
(Area Code & Telephone Number) (Fax Area Code & Number)
C. Provide the date(s) on which the APR underwent a non-removal surgery:
/ / / / / /
------------ ------------ ------------
(MM/DD/YYYY) (MM/DD/YYYY) (MM/DD/YYYY)
D. Were any of the non-removal surgeries indicated as a result of trauma?
Yes [ ] No [ ]
6. MATRIX LEVEL III (NON-AFFECTED PRODUCT REVISION SURGERY AND ADDITIONAL
NON-AFFECTED PRODUCT REVISION SURGERIES)
This question relates only to MATRIX LEVEL III and should be completed ONLY
if you are attesting that an APR has undergone one or more Non-Affected
Product Revision Surgeries ("NAPRS"), none of which was indicated as a
result of trauma. A NAPRS is a surgery (not indicated as a result of trauma)
that was performed to remove and/or replace a product that is not an
Affected Product within 180 days of an Affected Product Revision Surgery. An
Additional NAPRS is a surgery, not the result of trauma, that was performed
to remove and/or replace a product that is not an Affected Product after a
NAPRS and prior to the date that is 365 days after the initial Affected
Product Revision Surgery with respect to the same hip or knee.
PHYSICIAN DECLARATION - 3
A. Did you perform a NAPRS or an Additional NAPRS on the APR?
Yes [ ] No [ ]
B. If "No," state the name, address and telephone number of the treating
surgeon(s):
--------------------------- -------- ---------------------------
(First Name) (Middle Initial) (Last Name)
------------------------------------------------------------------------
(Office Address)
-
---------------------------- -------- -------------------------------
(City) (State) (Zip Code)
( ) - ( ) -
------------------------------ -------------------------------
(Area Code & Telephone Number) (Fax Area Code & Number)
C. Provide the date(s) on which the APR underwent a NAPRS:
/ / / / / /
------------ ------------ ------------
(MM/DD/YYYY) (MM/DD/YYYY) (MM/DD/YYYY)
D. Was each of the NAPRS(s) performed on the same hip/knee that was
implanted with an Affected Product?
Yes [ ] No [ ]
E. Were any of the NAPRS(s) indicated as a result of trauma?
Yes [ ] No [ ]
7. MATRIX LEVEL IV (MAJOR SURGICAL COMPLICATIONS)
This question relates only to MATRIX LEVEL IV and should be completed only
if you are attesting that an APR has suffered one or more Major Surgical
Complications as a result of a Covered Revision Surgery ("CRS"). A CRS is an
Affected Product Revision Surgery ("APRS"), a Non-Affected Product Revision
Surgery ("NAPRS"), or an Additional Non-Affected Product Revision Surgery
("Additional NAPRS"). An APRS is a surgical removal and/or replacement of an
Affected Product for a reason other than trauma. A NAPRS is a surgery (not
indicated as a result of trauma) that was performed to remove and/or replace
a product that is not an Affected Product within 180 days of an Affected
Product Revision Surgery. An Additional NAPRS is a surgery, not the result
of trauma, that was performed to remove and/or replace a product that is not
an Affected Product after a NAPRS and prior to the date that is 365 days
after the initial Affected Product Revision Surgery with respect to the same
hip or knee.
A. What Major Surgical Complication(s) do you believe was caused by a CRS?
[ ] Direct injury to the genito-urinary system during revision;
[ ] Wound infection occurring within 180 days from the date of a CRS
and requiring surgical debridement with prosthesis retention,
resection arthroplasty, hip arthrodesis or reimplantation;
PHYSICIAN DECLARATION - 4
[ ] (HIP ONLY) One or more dislocation(s)/subluxation(s) of the
prosthetic femoral head occurring within ninety (90) days from the
date of a CRS and requiring closed reduction under intravenous
sedation or general anesthesia;
[ ] Pulmonary embolism requiring hospitalization and/or placement of
an inferior xxxx xxxx filter;
[ ] Grade IV heterotopic ossification (as demonstrated on x-ray)
and/or heterotopic ossification requiring surgical repair, each
occurring within 180 days from the date of a CRS;
[ ] (HIP ONLY) Non-union of a trochanteric osteotomy occurring within
180 days from the date of a CRS and requiring surgical repair;
[ ] (KNEE ONLY) Non-union of either a tibial tubercle osteotomy
occurring within 180 days from the date of a CRS and requiring
surgical repair;
[ ] Periprosthetic fracture experienced within ninety (90) days from
the date of a CRS and requiring either open or closed reduction;
[ ] (HIP ONLY) Abductor mechanism disruption occurring within 180 days
from the date of a CRS and requiring surgical repair;
[ ] (KNEE ONLY) Extensor mechanism disruption occurring within 180
days from the date of a CRS and requiring surgical repair; or
[ ] Other: Explain:
--------------------------------------------------
B. Date on which the Major Surgical Complication(s) was recognized:
------------
(MM/DD/YYYY)
C. Did you diagnose the Major Surgical Complication(s) listed above?
Yes [ ] No [ ]
D. If "No," state the name, address and telephone number of the physician
who diagnosed and treated the complication(s):
--------------------------- -------- ---------------------------
(First Name) (Middle Initial) (Last Name)
------------------------------------------------------------------------
(Office Address)
-
---------------------------- -------- -------------------------------
(City) (State) (Zip Code)
( ) - ( ) -
------------------------------ -------------------------------
(Area Code & Telephone Number) (Fax Area Code & Number)
8. MATRIX LEVEL V (PERMANENT INJURY)
This question relates only to MATRIX LEVEL V and should be completed
ONLY if you are attesting that an APR has suffered one or more
Permanent Injuries that were caused by a Covered Revision Surgery
("CRS").
PHYSICIAN DECLARATION - 5
A CRS is an Affected Product Revision Surgery ("APRS"), a Non-Affected
Product Revision Surgery ("NAPRS"), or an Additional Non-Affected
Product Revision Surgery ("Additional NAPRS"). An APRS is a surgical
removal and/or replacement of an Affected Product for a reason other
than trauma. A NAPRS is a surgery (not indicated as a result of trauma)
that was performed to remove and/or replace a product that is not an
Affected Product within 180 days of an Affected Product Revision
Surgery. An Additional NAPRS is a surgery, not the result of trauma,
that was performed to remove and/or replace a product that is not an
Affected Product after a NAPRS and prior to the date that is 365 days
after the initial Affected Product Revision Surgery with respect to the
same hip or knee.
A. What Permanent Injury do you believe the APR suffered as a result
of a CRS?
[ ] Permanent nerve injury, as demonstrated by both objective
physical examination and quantitative measures (e.g., EMG
and/or nerve conduction studies) 365 days after the CRS;
[ ] Permanent vascular injury as demonstrated by both objective
physical examination and quantitative measures (e.g.,
angiogram) 365 days after the CRS;
[ ] Permanent injury due to an infection (qualifying as a major
complication under Matrix IV), as demonstrated by objective
physical examination and quantitative measures 365 days
after the CRS; or
[ ] Other: Explain:
-------------------------------------------
B. Date on which the APR underwent the CRS that you believe resulted
in the Permanent Injury:
/ /
------------
(MM/DD/YYYY)
X. Xxxx on which the Permanent Injury was diagnosed: / /
------------
(MM/DD/YYYY)
D. Did you diagnose the Permanent Injury listed above?
Yes [ ] No [ ]
E. If "No," state the name, address and telephone number of the
physician who diagnosed and treated the Permanent Injury:
--------------------------- -------- --------------------
(First Name) (Middle Initial) (Last Name)
-----------------------------------------------------------------
(Office Address)
-
---------------------------- -------- ------------------------
(City) (State) (Zip Code)
( ) - ( ) -
------------------------------ -------------------------
(Area Code & Telephone Number) (Fax Area Code & Number)
F. What is the nature of the Permanent Injury that you believe
resulted from a CRS?
[ ] MODERATE: Pain, sensory loss or gait alteration requiring
narcotics and/or use of a cane or xxxxxx;
PHYSICIAN DECLARATION - 6
[ ] SEVERE: Pain, sensory loss or gait alteration requiring a
wheelchair and/or amputation;
[ ] Other: Explain:
-------------------------------------------
----------------------------------------------------------
G. If you checked MODERATE in Question 7.F, describe the medical
treatment that the APR has required as a result of the moderate
Permanent Injury:
-----------------------------------------------------------------
-----------------------------------------------------------------
Did the APR require the above medical treatment prior to the CRS?
Yes [ ] No [ ]
H. If you checked SEVERE in Question 8.F, describe the medical
treatment that the APR has required as a result of the severe
Permanent Injury:
-----------------------------------------------------------------
-----------------------------------------------------------------
Did the APR require the above medical treatment prior to the CRS?
Yes [ ] No [ ]
9. MATRIX LEVEL VI (MYOCARDIAL INFARCTION)
This question relates only to MATRIX LEVEL VI and should be completed
ONLY if you believe that an APR has suffered a myocardial infarction
during a Covered Revision Surgery ("CRS") or during the hospitalization
associated with a CRS. A CRS is an Affected Product Revision Surgery
("APRS"), a Non-Affected Product Revision Surgery ("NAPRS"), or an
Additional Non-Affected Product Revision Surgery ("Additional NAPRS").
An APRS is a surgical removal and/or replacement of an Affected Product
for a reason other than trauma. A NAPRS is a surgery (not indicated as
a result of trauma) that was performed to remove and/or replace a
product that is not an Affected Product within 180 days of an Affected
Product Revision Surgery. An Additional NAPRS is a surgery, not the
result of trauma, that was performed to remove and/or replace a product
that is not an Affected Product after a NAPRS and prior to the date
that is 365 days after the initial Affected Product Revision Surgery
with respect to the same hip or knee.
A. Did the APR suffer a myocardial infarction as a result of a CRS?
Yes [ ] No [ ]
B. Date on which the APR underwent the CRS that you believe resulted
in that myocardial infarction:
------------
(MM/DD/YYYY)
PHYSICIAN DECLARATION - 7
X. Xxxx on which the myocardial infarction occurred:
------------
(MM/DD/YYYY)
D. Did you diagnose the myocardial infarction?
Yes [ ] No [ ]
E. If "No," state the name, address and telephone number of the
physician who diagnosed and treated the myocardial infarction:
--------------------------- -------- --------------------
(First Name) (Middle Initial) (Last Name)
-----------------------------------------------------------------
(Office Address)
-
---------------------------- -------- ------------------------
(City) (State) (Zip Code)
( ) - ( ) -
------------------------------ -------------------------
(Area Code & Telephone Number) (Fax Area Code & Number)
F. Check the appropriate box below for the New York Heart Association
Functional Class(2) symptoms the APR had before the his/her
myocardial infarction:
[ ] Class I;
[ ] Class II;
[ ] Class III; or
[ ] Class IV
G. Check the appropriate box below for the New York Heart Association
Functional Class(3) symptoms the APR had after his/her myocardial
infarction:
[ ] Class I;
[ ] Class II;
[ ] Class III; or
[ ] Class IV
10. MATRIX LEVEL VII (STROKE)
This question relates only to MATRIX LEVEL VII and should be completed
ONLY if you believe that an APR has suffered a stroke during a Covered
Revision Surgery ("CRS") or during the hospitalization associated with
a CRS. A CRS is an Affected Product Revision Surgery ("APRS"), a
Non-Affected Product Revision Surgery ("NAPRS"), or an Additional
Non-Affected Product Revision Surgery ("Additional NAPRS"). An
----------
(2) See X. Xxxxxxxx, X. Xxxxxxx, X. Xxxxxxxxx, X. Xxxx, X. Xxxxx, Xx., Xxxxx
Essentials of Medicine, at 12 (3d ed. 1993).
(3) See id.
PHYSICIAN DECLARATION - 8
APRS is a surgical removal and/or replacement of an Affected Product
for a reason other than trauma. A NAPRS is a surgery (not indicated as
a result of trauma) that was performed to remove and/or replace a
product that is not an Affected Product within 180 days of an Affected
Product Revision Surgery. An Additional NAPRS is a surgery, not the
result of trauma, that was performed to remove and/or replace a product
that is not an Affected Product after a NAPRS and prior to the date
that is 365 days after the initial Affected Product Revision Surgery
with respect to the same hip or knee.
A. Did the APR suffer a stroke as a result of a CRS?
Yes [ ] No [ ]
B. Date on which the APR underwent the CRS that you believe caused
the stroke:
/ /
------------
(MM/DD/YYYY)
X. Xxxx on which the stroke occurred: / /
-----------------
(MM/DD/YYYY)
D. Did you diagnose the stroke?
Yes [ ] No [ ]
E. If "No," state the name, address and telephone number of the
physician who diagnosed and treated the stroke:
--------------------------- -------- --------------------
(First Name) (Middle Initial) (Last Name)
-----------------------------------------------------------------
(Office Address)
-
---------------------------- -------- ------------------------
(City) (State) (Zip Code)
( ) - ( ) -
------------------------------ -------------------------
(Area Code & Telephone Number) (Fax Area Code & Number)
F. What is the APR's Functional Stroke Outcome Classification (as
defined by the American Heart Association(4)?
[ ] Level I;
[ ] Level II;
[ ] Level III; or
[ ] Level IV
----------
(4) See The American Heart Association Stroke Outcome Classification, 29 Stroke
at 1274-75 (1998).
PHYSICIAN DECLARATION - 9
11. MATRIX LEVEL VIII (DEATH)
This question relates only to MATRIX LEVEL VIII and should ONLY be
completed if you believe that an APR has died during a Covered Revision
Surgery ("CRS") or during the hospitalization associated with a CRS. A
CRS is an Affected Product Revision Surgery ("APRS"), a Non-Affected
Product Revision Surgery ("NAPRS"), or an Additional Non-Affected
Product Revision Surgery ("Additional NAPRS"). An APRS is a surgical
removal and/or replacement of an Affected Product for a reason other
than trauma. A NAPRS is a surgery (not indicated as a result of trauma)
that was performed to remove and/or replace a product that is not an
Affected Product within 180 days of an Affected Product Revision
Surgery. An Additional NAPRS is a surgery, not the result of trauma,
that was performed to remove and/or replace a product that is not an
Affected Product after a NAPRS and prior to the date that is 365 days
after the initial Affected Product Revision Surgery with respect to the
same hip or knee.
A. Date on which the death occurred: / /
-------------
(MM/DD/YYYY)
B. Date on which the CRS occurred: / /
------------
(MM/DD/YYYY)
C. Did you perform the CRS that caused the APR's death?
Yes [ ] No [ ]
D. If "No," state the name, address and telephone number of the
physician who did perform the CRS leading to the APR's death:
--------------------------- -------- --------------------
(First Name) (Middle Initial) (Last Name)
-----------------------------------------------------------------
(Office Address)
-
---------------------------- -------- ------------------------
(City) (State) (Zip Code)
( ) - ( ) -
------------------------------ -------------------------
(Area Code & Telephone Number) (Fax Area Code & Number)
12. MATRIX LEVEL IX (MISCELLANEOUS COMPLICATION)
This question relates only to MATRIX LEVEL IX and should ONLY be
completed if you believe that an APR suffered injuries and/or damages
not specifically addressed in Matrix Levels I-VIII.
A. What injury or damage do you believe the APR suffered?
------------
------------------------------------------------------------------
------------------------------------------------------------------
B. Date on which the APR was implanted with an Affected Product: / /
------------
(MM/DD/YYYY)
PHYSICIAN DECLARATION - 10
X. Xxxx on which the injury/damage was recognized: / /
-------------
(MM/DD/YYYY)
D. Did you perform the Covered Revision Surgery ("CRS") that caused
the APR's injury/damage?
Yes [ ] No [ ]
E. If "No," state the name, address and telephone number of the
physician who did perform the CRS leading to the APR's
injury/damage:
--------------------------- -------- --------------------
(First Name) (Middle Initial) (Last Name)
-----------------------------------------------------------------
(Office Address)
-
---------------------------- -------- ------------------------
(City) (State) (Zip Code)
( ) - ( ) -
------------------------------ -------------------------
(Area Code & Telephone Number) (Fax Area Code & Number)
F. Name and address of the treating physician(s) (if other than you)
who diagnosed and treated the injury/damage that you believe
resulted from a CRS:
--------------------------- -------- --------------------
(First Name) (Middle Initial) (Last Name)
-----------------------------------------------------------------
(Office Address)
-
---------------------------- -------- ------------------------
(City) (State) (Zip Code)
( ) - ( ) -
------------------------------ -------------------------
(Area Code & Telephone Number) (Fax Area Code & Number)
13. DECLARATION UNDER PENALTY OF PERJURY
This form is an official document sanctioned by the Court that presides
over the legal action entitled In Re Sulzer Hip Prosthesis and Knee
Prosthesis Liability Litigation. Submitting the Physician Declaration
to the Claims Administrator is equivalent to filing it with the Court.
I declare under penalty of perjury that the information provided in
this form is true and correct to the best of my knowledge, information
and belief.
/ /
----------------------------- ------------------------
(Signature of Physician) (Date - MM/DD/YYYY)
PHYSICIAN DECLARATION - 11
EXHIBIT E
GREEN FORM
================================================================================
EXTRAORDINARY INJURY FUND (EIF)
BENEFITS CLAIM FORM
AFFECTED PRODUCT RECIPIENT ONLY
THIS GREEN FORM IS TO BE USED BY ANY CLASS MEMBER REGISTERING FOR SETTLEMENT
BENEFITS FROM THE EXTRAORDINARY INJURY FUND ("EIF"). A TIMELY BLUE OR ORANGE
FORM (WHICHEVER APPROPRIATE) MUST HAVE BEEN COMPLETED IN ADDITION TO THIS EIF
BENEFITS FORM (GREEN FORM). THIS COMPLETED FORM MUST BE POSTMARKED TO THE CLAIMS
ADMINISTRATOR (C/O SULZER SETTLEMENT TRUST, P.O. BOX 94558, CLEVELAND, OHIO
44101-4558) ON OR BEFORE THE DATE THAT IS THE LATER OF:
o 545 DAYS AFTER THE DATE OF THE APPLICABLE COVERED REVISION SURGERY
("CRS")(1); OR
o 180 DAYS AFTER A NON-REMOVAL SURGERY; OR
o 180 DAYS AFTER THE APR'S TREATING PHYSICIAN'S DETERMINATION THAT AN
APRS WOULD BE INDICATED BUT FOR A MEDICAL CONDITION(s); OR
o 180 DAYS AFTER TRIAL COURT APPROVAL.
SEE THE FINAL NOTICE OF SETTLEMENT OF NATIONWIDE HIP PROSTHESIS AND KNEE
PROSTHESIS PRODUCT LIABILITY CLASS ACTION LITIGATION ("FINAL NOTICE"), THE CLASS
MEMBER AND ATTORNEY GUIDE, OR THE SETTLEMENT AGREEMENT FOR FURTHER INFORMATION.
IF THERE IS ANY CONFLICT BETWEEN THE PROVISIONS OF THIS CLAIM FORM AND THE TERMS
OF THE SETTLEMENT AGREEMENT, THE TERMS OF THE SETTLEMENT AGREEMENT CONTROL.
All responses must be PRINTED or TYPED. By completing this Green Form, you(2)
are registering for benefits under the Settlement Agreement. If you have
retained an attorney regarding your claim, you should consult with your attorney
about your options under the Settlement Agreement.
1. INDICATE BY CHECKING THE APPROPRIATE BOX BELOW WHETHER THE APR WAS IMPLANTED
WITH A SULZER INTER-OP(TM) SHELL, A REPROCESSED INTER-OP(TM) SHELL OR A
SULZER TIBIAL BASEPLATE. NOTE: CHECK ONLY ONE BOX. IF THE APR HAS BEEN
IMPLANTED WITH MORE THAN ONE AFFECTED PRODUCT, YOU MUST COMPLETE A CLAIM
FORM FOR EACH AFFECTED PRODUCT IMPLANTED.
[ ] APR WAS IMPLANTED WITH A SULZER INTER-OP(TM) SHELL.
OR
[ ] APR WAS IMPLANTED WITH A REPROCESSED INTER-OP(TM) SHELL.
OR
[ ] APR WAS IMPLANTED WITH A SULZER TIBIAL BASEPLATE.
----------
(1) A CRS is an Affected Product Revision Surgery ("APRS"), a
Non-Affected Product Revision Surgery ("NAPRS"), or an Additional Non-Affected
Product Revision Surgery ("Additional NAPRS"). An APRS is a surgical removal
and/or replacement of an Affected Product for a reason other than trauma. A
NAPRS is a surgery (not indicated as a result of trauma) that was performed to
remove and/or replace a product that is not an Affected Product within 180 days
of an Affected Product Revision Surgery in respect of a hip or knee that
previously underwent an APRS. An Additional NAPRS is a surgery, not the result
of trauma, that was performed to remove and/or replace a product that is not an
Affected Product after a NAPRS and prior to the date that is 365 days after the
initial Affected Product Revision Surgery with respect to the same hip or knee.
(2) "You" or "your" when used throughout this Claim Form refers to the
APR or to the Representative Claimant of the APR.
GREEN FORM - 1
2. AFFECTED PRODUCT RECIPIENT INFORMATION
--------------------------- -------- --------------------------------
(First Name) (Middle Initial) (Last Name)
------------------------------------------------------------------------------
(List all other names that the APR uses or has used during the last ten years)
-----------------------------------------------------------------------------
(Street Address)
-
------------------------------- -------- -------------------------------
(City) (State) (Zip Code)
( ) - ( ) -
---------------------------------- ------------------------------------
(Daytime Area Code & Phone Number) (Evening Area Code & Phone Number)
-----------------------------------------------------------------------------
(Email Address, if any)
/ / - -
----------------------- -------------------------------
(Birth Date MM/DD/YYYY) (Social Security Nunber)
--------------------------------
(Sulzer Settlement Claim Number)
3. REPRESENTATIVE CLAIMANT INFORMATION
IF YOU ARE THE REPRESENTATIVE CLAIMANT OF A LIVING PERSON OR THE ESTATE OF A
DECEASED PERSON WHO IS OR WAS AN APR AND WHO EITHER HAS OR HAD A CONDITION
THAT YOU BELIEVE QUALIFIES THE APR OR THE ESTATE OF THE APR FOR COMPENSATION
UNDER THE EIF, YOU MUST PROVIDE THE INFORMATION REQUESTED BELOW.
--------------------------- -------- ------------------------------
(First Name) (Middle Initial) (Last Name)
---------------------------------------------------------------------------
(List all other names that you use or have used during the last ten years)
---------------------------------------------------------------------------
(Street Address)
-
------------------------------- -------- -----------------------------
(City) (State) (Zip Code)
( ) - ( ) -
---------------------------------- ----------------------------------
(Daytime Area Code & Phone Number) (Evening Area Code & Phone Number)
---------------------------------------------------------------------------
(Email Address, if any)
/ / - -
----------------------- ----------------------------------
(Birth Date MM/DD/YYYY) (Social Security Nunber)
--------------------------------
(Sulzer Settlement Claim Number, if known)
---------------------------------------------------------------------------
(Legal Relationship to APR, i.e., Trustee, Power of Attorney, etc.)
GREEN FORM - 2
IF YOU ARE A REPRESENTATIVE CLAIMANT, YOU MUST ATTACH A COPY OF YOUR COURT
APPROVAL OR OTHER AUTHORIZATION TO REPRESENT THE APR IN THIS SETTLEMENT.
XXXX THE APPROPRIATE BOX BELOW TO INDICATE YOUR PREVIOUS OR CURRENT
SUBMISSION OF A COURT APPROVAL OR AUTHORIZATION:
[ ] I have provided the requested documentation previously on another
form and there is no change.
[ ] A copy of my court approval or other authorization to represent
the APR is attached.
4. ATTORNEY INFORMATION
Are you represented by an attorney in connection with this claim?
Yes [ ] No [ ]
IF "YES," YOU MUST PROVIDE THE FOLLOWING INFORMATION. NOTE: IF INFORMATION
PREVIOUSLY PROVIDED REMAINS CURRENT, YOU MAY PROCEED TO QUESTION 5.
---------------------------------------------------------------------------
(Law Firm Name)
---------------------------------------------------------------------------
(Attorney's Name)
---------------------------------------------------------------------------
(Street Address)
-
------------------------------- -------- -------------------------------
(City) (State) (Zip Code)
( ) - ( ) -
---------------------------------- -----------------------------------
(Daytime Area Code & Phone Number) (Evening Area Code & Phone Number)
--------------------------------- -----------------------------------
(Email Address, if any) (Attorney Tax Identification Number)
State the date on which your attorney-client agreement
was signed:
------------
(MM/DD/YYYY)
NOTE: A copy of such attorney-client agreement must be attached
if you did not previously provide it with your Blue or Orange
Form.
State the total amount of litigation expenses that were incurred in relation
to your claim(s): $
------------------
NOTE: An itemization of all litigation expenses must be
attached.
5. CHANGE IN CONDITION
If you have qualified for settlement benefits (but not benefits from the
EIF) and you subsequently develop a medical condition that qualifies you for
EIF benefits, then you have a right to receive additional compensation. You
must file a Green Form to receive EIF benefits.
If you have previously submitted a Green Form and your medical condition
worsens and your change places you on a higher Matrix Level, then you have a
right to receive incremental payments. To seek additional payment based on a
worsened medical condition, you must complete another Green Form.
GREEN FORM - 3
NOTE: If this Green Form is used to supplement a prior claim, the entire
Claim Form does not have to be completed again in full. You need only submit
changes to information previously provided. The Physician responsible for
completing the "Physician Declaration" should complete only those portions
of the form that reflect a change in condition from the condition described
in the prior Claim Form(s).
Check the appropriate box below:
[ ] This is an original Green Form. [ ] This is a Green Form seeking
additional compensation for a
worsened medical condition.
6. REQUESTED SUPPLEMENTATION
If you have submitted a Green Form and receive a Tentative Determination
Letter or other communication from the Claims Administrator requesting
supplemental documentation to support your claim for EIF benefits, you have
the right to provide any additional, new documentation or evidence that
further supports your claim. All such new documentation must be submitted
via cover letter specifying the Sulzer Settlement Claim Number, outlining
the new or additional information, and attaching all supporting
documentation or evidence.
NOTE: Individuals submitting such additional documentation need not submit a
new Claim Form for this --- purpose. A cover letter as indicated above will
suffice.
7. MATRIX LEVELS
Check each Matrix Level under which you believe you are entitled to
compensation from the EIF and then for Questions 8-16, only complete those
question(s) that apply to the Matrix Level(s) you check below. For Questions
8-16, do not complete any question(s) for which you do not believe you are
entitled to compensation.
[ ] Matrix Level I (Revision Surgery Indicated But For A Medical Condition)
[ ] Matrix Level II (Non-Removal Surgery)
[ ] Matrix Level III (Non-Affected Product Revision Surgery and Additional
Non-Affected Product Revision Surgeries)
[ ] Matrix Level IV (Revision Surgery: Major Complication)
[ ] Matrix Level V (Revision Surgery: Permanent Injury)
[ ] Matrix Level VI (Revision Surgery: Myocardial Infarction)
[ ] Matrix Level VII (Revision Surgery: Stroke)
[ ] Matrix Level VIII (Revision Surgery: Death)
[ ] Matrix Level IX (Miscellaneous Complication or Other Harm)
NOTE: For all Matrix Levels, you must complete the Medical Authorization
Form on the last page of this Green Form. For certain Matrix Levels, it is
mandatory that you provide a "Physician Declaration" to support your claims.
A Physician Declaration Form is included in the Final Notice Packet.
GREEN FORM - 4
8. MATRIX LEVEL I (Revision Surgery Indicated But For a Medical Condition)
This question relates to MATRIX LEVEL I and should be completed only if an
Affected Product Revision Surgery (APRS) would be medically contraindicated.
If you believe that you qualify for benefits pursuant to MATRIX LEVEL I, you
must provide the following information:
A. DATE THE AFFECTED PRODUCT WAS IMPLANTED: / /
----------------
(MM/DD/YYYY)
B. NAME AND ADDRESS OF HOSPITAL OF IMPLANTATION:
---------------------------------------------------------------------------
(Hospital Name)
---------------------------------------------------------------------------
(Street Address)
-
---------------------------- -------- -------------------------------
(City) (State) (Zip Code)
( ) - ( ) -
------------------------------ -------------------------------
(Area Code & Telephone Number) (Fax Area Code & Number)
C. IMPLANTING SURGEON OF AFFECTED PRODUCT:
----------------------------- ------ --------------------------
(Surgeon's First Name) (Middle Initial) (Last Name)
---------------------------------------------------------------------------
(Street Address)
-
---------------------------- -------- -------------------------------
(City) (State) (Zip Code)
( ) - ( ) -
------------------------------ -------------------------------
(Area Code & Telephone Number) (Fax Area Code & Number)
D. TREATING SURGEON (IF DIFFERENT THAN ABOVE) WHO BELIEVES THAT AN APRS
WOULD BE MEDICALLY CONTRAINDICATED:
----------------------------- ------ --------------------------
(Surgeon's First Name) (Middle Initial) (Last Name)
---------------------------------------------------------------------------
(Street Address)
-
---------------------------- -------- -------------------------------
(City) (State) (Zip Code)
( ) - ( ) -
------------------------------ -------------------------------
(Area Code & Telephone Number) (Fax Area Code & Number)
GREEN FORM - 5
E. TREATING PHYSICIAN (IF DIFFERENT THAN ABOVE) WHO BELIEVES THAT YOUR
MEDICAL CONDITION PREVENTS YOU FROM HAVING AN APRS:
---------------------------------- ------ ----------------------
(Treating Physician's First Name) (Middle Initial) (Last Name)
---------------------------------------------------------------------------
(Street Address)
-
---------------------------- -------- -------------------------------
(City) (State) (Zip Code)
( ) - ( ) -
------------------------------ -------------------------------
(Area Code & Telephone Number) (Fax Area Code & Number)
F. DATE ON WHICH YOU WERE ADVISED BY YOUR TREATING PHYSICIAN THAT AN APRS
WAS INDICATED:
/ /
------------
(MM/DD/YYYY)
G. TO THE BEST OF YOUR KNOWLEDGE, STATE THE MEDICAL CONDITION(s) THAT
PREVENTED YOU FROM UNDERGOING AN APRS:
-------------------------------------------------------------------------
-------------------------------------------------------------------------
H. TO THE BEST OF YOUR KNOWLEDGE, DID YOU HAVE THE MEDICAL CONDITION(s) THAT
PREVENTED YOU FROM UNDERGOING AN APRS BEFORE YOU WERE IMPLANTED WITH AN
AFFECTED PRODUCT?
Yes [ ] No [ ] Don't Know [ ]
I. TO COMPLETE YOUR APPLICATION FOR EIF BENEFITS UNDER MATRIX LEVEL I, YOU
MUST ATTACH THE FOLLOWING INFORMATION:
[ ] The hospital records evidencing the implantation of an Affected
Product that should include, without limitation, a
preadmission/admission history and physical examination, an
operative report, progress notes and a discharge summary; AND
[ ] The medical records of the surgeon who implanted the Affected
Product; AND
[ ] The medical records of the treating surgeon (if different than
above) who believes that an APRS is medically contraindicated; AND
[ ] A completed "Physician Declaration" from your treating surgeon
wherein the surgeon: (i) attests that an APRS would be medically
contraindicated; and (ii) describes the change(s) in your physical
condition (between the time of implantation and the time the
physician determined the need for APRS) that makes an APRS
contraindicated;(3) AND
----------
(3) The Claims Administrator may accept a Declaration that is prepared
by a non-treating, Board-Certified physician if submitted in combination with
your affidavit setting forth your attempts to secure a Declaration from a
treating physician.
GREEN FORM - 6
[ ] A medical authorization, enabling the Claims Administrator to
obtain additional medical records, if the Claims Administrator
chooses to do so, in order to evaluate your claim.
NOTE: Medical authorization forms will only be used by the Claims
Administrator to verify certain information provided by you. An
execution of a medical authorization form does not relieve you of
your obligation to provide all of the medical documentation
requested herein.
9. MATRIX LEVEL II (Non-Removal Surgery)
This question relates only to Matrix Level II and should be completed only
if you have undergone a Non-Removal Surgery, wherein your treating surgeon
has attempted to secure an Affected Product (for example, by using screws or
cement) as a result of non-traumatic loosening. If you believe that you
qualify for benefits pursuant to Matrix Level II, you must provide the
following information:
A. HOW MANY NON-REMOVAL SURGERIES HAVE YOU UNDERGONE?
[ ] 1 [ ] 2 [ ] 3 [ ] Other
B. FOR EACH NON-REMOVAL SURGERY, YOU MUST PROVIDE THE FOLLOWING:
Date of Non-Removal Surgery: / /
------------
(MM/DD/YYYY)
C. NAME AND ADDRESS OF HOSPITAL WHERE NON-REMOVAL SURGERY OCCURRED:
---------------------------------------------------------------------------
(Hospital Name)
---------------------------------------------------------------------------
(Street Address)
-
---------------------------- -------- -------------------------------
(City) (State) (Zip Code)
( ) - ( ) -
------------------------------ -------------------------------
(Area Code & Telephone Number) (Fax Area Code & Number)
D. NAME AND ADDRESS OF SURGEON WHO PERFORMED THE NON-REMOVAL SURGERY:
----------------------------- ------ --------------------------
(Surgeon's First Name) (Middle Initial) (Last Name)
---------------------------------------------------------------------------
(Street Address)
-
---------------------------- -------- -------------------------------
(City) (State) (Zip Code)
( ) - ( ) -
------------------------------ -------------------------------
(Area Code & Telephone Number) (Fax Area Code & Number)
---------------------------------------------------------------------------
(Reason/Indication for Non-Removal surgery)
IF YOU REQUIRED MORE THAN ONE (1) NON-REMOVAL SURGERY, CHECK HERE [ ] AND
MAKE A COPY OF THIS PAGE TO PROVIDE THE ADDITIONAL INFORMATION AND ATTACH IT
TO THIS CLAIM FORM.
GREEN FORM - 7
E. TO COMPLETE YOUR APPLICATION FOR EIF BENEFITS UNDER MATRIX LEVEL II, YOU
MUST ATTACH THE FOLLOWING INFORMATION:
[ ] The medical records of the treating surgeon who performed each
Non-Removal Surgery; AND
[ ] The hospital records evidencing each Non-Removal Surgery that must
include, without limitation, a preadmission/admission history and
physical examination, an operative report, operative nursing
notes, anesthesia records and a discharge summary; AND
[ ] A completed "Physician Declaration" from your treating surgeon
wherein the physician attests that each Non-Removal Surgery (for
which compensation is sought pursuant to MATRIX LEVEL II) was not
indicated as a result of trauma;(4)
NOTE: A completed "Physician Declaration" is only required if the APR's
hospital/medical records fail to specifically indicate that each
Non-Removal Surgery was not indicated as a result of trauma.
AND
[ ] A medical authorization, enabling the Claims Administrator to
obtain additional medical records, if the Claims Administrator
chooses to do so, in order to evaluate your claim.
NOTE: Medical authorization forms will only be used by the Claims
Administrator to verify certain information provided by you. An
execution of a medical authorization form does not relieve you of your
obligation to provide all of the medical documentation requested herein.
10. MATRIX LEVEL III (Non-Affected Product Revision Surgery and Additional
Non-Affected Product Revision Surgeries)
This question relates only to MATRIX LEVEL III and should be completed only
if you have undergone one or more Non-Affected Product Revision Surgery
("NAPRS")(5). If you believe that you qualify for benefits pursuant to
MATRIX LEVEL III, you must provide the following information:
A. HOW MANY NON-AFFECTED PRODUCTS HAVE YOU HAD REMOVED/REVISED?
[ ] 1 [ ] 2 [ ] 3 [ ] Other
B. For each NAPRS, you must provide the following:
Date of NAPRS: / /
------------
(MM/DD/YYYY)
----------
(4) The Claims Administrator may accept a Declaration that is prepared
by a non-treating, Board-Certified orthopedic surgeon if submitted in
combination with your affidavit setting forth your attempts to secure a
Declaration from a treating orthopedic surgeon.
(5) A NAPRS is a surgery (not indicated as a result of trauma) that was
performed to remove and/or replace a product that is not an Affected Product
within 180 days of an Affected Product Revision Surgery in respect of a hip or
knee that previously underwent an APRS. An Additional NAPRS is a surgery, not
the result of trauma, that was performed to remove and/or replace a product that
is not an Affected Product after a NAPRS and prior to the date that is 365 days
after the initial Affected Product Revision Surgery with respect to the same hip
or knee.
GREEN FORM - 8
C. HOSPITAL WHERE NAPRS OCCURRED:
---------------------------------------------------------------------------
(Hospital Name)
---------------------------------------------------------------------------
(Street Address)
-
---------------------------- -------- -------------------------------
(City) (State) (Zip Code)
( ) - ( ) -
------------------------------ -------------------------------
(Area Code & Telephone Number) (Fax Area Code & Number)
D. NAME OF SURGEON WHO PERFORMED NAPRS:
----------------------------- ------ --------------------------
(Surgeon's First Name) (Middle Initial) (Last Name)
---------------------------------------------------------------------------
(Street Address)
-
---------------------------- -------- -------------------------------
(City) (State) (Zip Code)
( ) - ( ) -
------------------------------ -------------------------------
(Area Code & Telephone Number) (Fax Area Code & Number)
---------------------------------------------------------------------------
(Reason/Indication for Non-Removal surgery)
IF YOU REQUIRED MORE THAN ONE (1) NAPRS, CHECK HERE [ ] AND MAKE A COPY OF THIS
PAGE TO PROVIDE THE ADDITIONAL INFORMATION AND ATTACH IT TO THIS CLAIM FORM.
E. TO COMPLETE YOUR APPLICATION FOR EIF BENEFITS UNDER MATRIX LEVEL III, YOU
MUST ATTACH THE FOLLOWING INFORMATION:
[ ] The medical records of the treating surgeon who performed each NAPRS;
AND
[ ] The hospital records evidencing each NAPRS that must include, without
limitation, a preadmission/admission history and physical examination,
an operative report, operative nursing notes, anesthesia records and a
discharge summary; AND
[ ] A completed "Physician Declaration" from your treating surgeon wherein
the physician attests that each NAPRS (for which compensation is sought
pursuant to MATRIX LEVEL III) was not indicated as a result of
trauma;(6)
NOTE: A completed "Physician Declaration" is only required if the APR's
hospital/medical records fail to specifically indicate that the NAPRS
and any Additional NAPRS were not indicated as a result of trauma.
AND
[ ] A medical authorization, enabling the Claims Administrator to obtain
additional medical records, if the Claims Administrator chooses to do
so, in order to evaluate your claim.
----------
(6) The Claims Administrator may accept a Declaration that is prepared
by a non-treating, Board-Certified orthopedic surgeon if submitted in
combination with your affidavit setting forth your attempts to secure a
Declaration from a treating orthopedic surgeon.
GREEN FORM - 9
NOTE: Medical authorization forms will only be used by the Claims
Administrator to verify certain information provided by you. An
execution of a medical authorization form does not relieve you of your
obligation to provide all of the medical documentation requested
herein.
11. MATRIX LEVEL IV (Revision Surgery: Major Complication)
This question relates only to MATRIX LEVEL IV and should be completed only
if you have suffered a Major Surgical Complication as a result of a Covered
Revision Surgery ("CRS"). A CRS is an Affected Product Revision Surgery
("APRS"), a Non-Affected Product Revision Surgery ("NAPRS"), or an
Additional Non-Affected Product Revision Surgery ("Additional NAPRS"). An
APRS is a surgical removal and/or replacement of an Affected Product for a
reason other than trauma. A NAPRS is a surgery (not indicated as a result of
trauma) that was performed to remove and/or replace a product that is not an
Affected Product within 180 days of an Affected Product Revision Surgery in
respect of a hip or knee that previously underwent an APRS. An Additional
NAPRS is a surgery, not the result of trauma, that was performed to remove
and/or replace a product that is not an Affected Product after a NAPRS and
prior to the date that is 365 days after the initial Affected Product
Revision Surgery with respect to the same hip or knee. If you believe that
you qualify for benefits pursuant to MATRIX LEVEL IV, you must provide the
following information:
A. WHAT MAJOR SURGICAL COMPLICATION(s) DO YOU BELIEVE HAVE RESULTED FROM A
CRS?
[ ] Direct injury to the genito-urinary system during revision;
[ ] Wound infection occurring within 180 days from the date of a CRS
and requiring surgical debridement with prosthesis retention,
resection arthroplasty, hip arthrodesis or reimplantation;
[ ] (HIP ONLY) One or more dislocation(s)/subluxation(s) of the
prosthetic femoral head occurring within ninety (90) days from
the date of a CRS and requiring closed reduction under
intravenous sedation or general anesthesia;
[ ] Pulmonary embolism requiring hospitalization and/or placement of
an inferior xxxx xxxx filter;
[ ] Grade IV heterotopic ossification (as demonstrated on x-ray)
and/or heterotopic ossification requiring surgical repair, each
occurring on or before 180 days from the date of a CRS;
[ ] (HIP ONLY) Non-union of a trochanteric osteotomy occurring within
180 days from the date of a CRS and requiring surgical repair;
[ ] (KNEE ONLY) Non-union of a tibial tubercle osteotomy occurring
within 180 days from the date of a CRS and requiring surgical
repair;
[ ] Periprosthetic fracture experienced within thirty (30) days from
the date of a CRS and requiring either open or closed reduction;
[ ] (HIP ONLY) Abductor mechanism disruption occurring within 180
days from the date of a CRS and requiring surgical repair;
[ ] (KNEE ONLY) Extensor mechanism disruption occurring within 180
days from the date of a CRS and requiring surgical repair; or
[ ] Other: Explain:
------------------------------------------------
----------------------------------------------------------------
GREEN FORM - 10
B. DATE ON WHICH THE MAJOR SURGICAL COMPLICATION WAS RECOGNIZED: / /
-------------
(MM/DD/YYYY)
X. XXXX ON WHICH THE CRS THAT YOU BELIEVE RESULTED IN THE MAJOR SURGICAL
COMPLICATION WAS PERFORMED: / /
-------------
(MM/DD/YYYY)
D. HOSPITAL WHERE THE CRS THAT YOU BELIEVE RESULTED IN THE MAJOR SURGICAL
COMPLICATION OCCURRED:
---------------------------------------------------------------------------
(Hospital Name)
---------------------------------------------------------------------------
(Street Address)
-
---------------------------- -------- -------------------------------
(City) (State) (Zip Code)
( ) - ( ) -
------------------------------ -------------------------------
(Area Code & Telephone Number) (Fax Area Code & Number)
E. NAME AND ADDRESS OF THE TREATING PHYSICIAN(s) WHO DIAGNOSED AND TREATED
THE MAJOR SURGICAL COMPLICATIONS THAT YOU BELIEVE RESULTED FROM A CRS:
---------------------------------- ------ ----------------------
(Treating Physician's First Name) (Middle Initial) (Last Name)
---------------------------------------------------------------------------
(Street Address)
-
---------------------------- -------- -------------------------------
(City) (State) (Zip Code)
( ) - ( ) -
------------------------------ -------------------------------
(Area Code & Telephone Number) (Fax Area Code & Number)
F. HOSPITAL WHERE THE MAJOR SURGICAL COMPLICATION THAT YOU BELIEVE
RESULTED FROM A CRS WAS TREATED:
---------------------------------------------------------------------------
(Hospital Name)
---------------------------------------------------------------------------
(Street Address)
-
---------------------------- -------- -------------------------------
(City) (State) (Zip Code)
( ) - ( ) -
------------------------------ -------------------------------
(Area Code & Telephone Number) (Fax Area Code & Number)
G. TO COMPLETE YOUR APPLICATION FOR EIF BENEFITS UNDER MATRIX LEVEL IV,
YOU MUST ATTACH THE FOLLOWING INFORMATION:
[ ] The hospital records evidencing each CRS that you believe
resulted in a Major Surgical Complication that must include,
without limitation, a preadmission/admission history and physical
examination, an operative report, operative nursing notes,
anesthesia records and a discharge summary; AND
[ ] The medical records of each treating surgeon who performed a CRS
that you believe resulted in a Major Surgical Complication; AND
GREEN FORM - 11
[ ] The hospital records evidencing treatment of each Major Surgical
Complication (for which compensation is sought) that should
include, but not be limited to (where applicable), a
preadmission/admission history and physical examination, an
operative report, operative nursing notes, anesthesia records and
a discharge summary; AND
[ ] The medical records of the treating surgeon(s) (if different than
above) who treated the Major Surgical Complication (for which
compensation is sought); AND
[ ] A completed "Physician Declaration" from your treating surgeon
wherein he/she causally relates a Major Surgical Complication to
a CRS(7); AND
[ ] A medical authorization, enabling the Claims Administrator to
obtain additional medical records, if the Claims Administrator
chooses to do so, in order to evaluate your claim.
NOTE: Medical authorization forms will only be used by the Claims
Administrator to verify certain information provided by you.
Execution of a medical authorization form does not relieve you of
your obligation to provide all of the medical documentation
requested herein.
12. MATRIX LEVEL V (Permanent Injury)
This section relates only to MATRIX LEVEL V and should be completed only if
you have suffered a Permanent Injury as a result of a CRS (see definition of
CRS in Question 11). If you believe that you qualify for benefits pursuant
to MATRIX LEVEL V, you must provide the following information:
A. WHAT PERMANENT INJURY DO YOU BELIEVE THAT YOU HAVE SUFFERED AS A
SURGICAL COMPLICATION OF A CRS?
[ ] Permanent nerve injury, either moderate or severe, as
demonstrated by objective physical examination and quantitative
measures (e.g., EMG and/or nerve conduction studies) 365 days
after a CRS; or
[ ] Permanent vascular injury, either moderate or severe, as
demonstrated by objective physical examination and quantitative
measures (e.g., angiogram) 365 days after a CRS; or
[ ] Permanent injury due to an infection (qualifying as a major
complication under MATRIX IV), either moderate or severe, as
demonstrated by objective physical examination and quantitative
measures 365 days after a CRS; or
[ ] Other: Explain:
------------------------------------------------
----------------------------------------------------------------
B. DATE ON WHICH THE CRS THAT YOU BELIEVE RESULTED IN THE PERMANENT INJURY
WAS PERFORMED: / /
-----------
(MM/DD/YYYY)
----------
(7) The Claims Administrator may accept a Declaration that is prepared
by a non-treating, Board-Certified orthopedic surgeon if submitted in
combination with your affidavit setting forth your attempts to secure a
Declaration from a treating orthopedic surgeon.
GREEN FORM - 12
C. HOSPITAL WHERE THE CRS THAT YOU BELIEVE RESULTED IN THE PERMANENT
INJURY OCCURRED:
---------------------------------------------------------------------------
(Hospital Name)
---------------------------------------------------------------------------
(Street Address)
-
---------------------------- -------- -------------------------------
(City) (State) (Zip Code)
( ) - ( ) -
------------------------------ -------------------------------
(Area Code & Telephone Number) (Fax Area Code & Number)
D. NAME AND ADDRESS OF THE TREATING SURGEON WHO PERFORMED THE CRS THAT YOU
BELIEVE RESULTED IN THE PERMANENT INJURY:
---------------------------------- ------ ----------------------
(Treating Surgeon's First Name) (Middle Initial) (Last Name)
---------------------------------------------------------------------------
(Street Address)
-
---------------------------- -------- -------------------------------
(City) (State) (Zip Code)
( ) - ( ) -
------------------------------ -------------------------------
(Area Code & Telephone Number) (Fax Area Code & Number)
E. DATE ON WHICH THE PERMANENT INJURY THAT YOU BELIEVE RESULTED FROM A CRS
WAS DIAGNOSED:
/ /
------------
(MM/DD/YYYY)
F. TREATING PHYSICIAN(S) WHO DIAGNOSED THE PERMANENT INJURY YOU BELIEVE
RESULTED FROM A CRS:
---------------------------------- ------ ----------------------
(Treating Physician's First Name) (Middle Initial) (Last Name)
---------------------------------------------------------------------------
(Street Address)
-
---------------------------- -------- -------------------------------
(City) (State) (Zip Code)
( ) - ( ) -
------------------------------ -------------------------------
(Area Code & Telephone Number) (Fax Area Code & Number)
G. HOSPITAL/FACILITY WHERE THE PERMANENT INJURY THAT YOU BELIEVE RESULTED
FROM A CRS WAS CONFIRMED BY QUANTITATIVE MEASURES (E.G., EMG, NERVE
CONDUCTION STUDY, ANGIOGRAM): -
---------------------------------------------------------------------------
(Hospital Name)
---------------------------------------------------------------------------
(Street Address)
-
---------------------------- -------- -------------------------------
(City) (State) (Zip Code)
( ) - ( ) -
------------------------------ -------------------------------
(Area Code & Telephone Number) (Fax Area Code & Number)
GREEN FORM - 13
H. WHAT IS THE NATURE OF THE PERMANENT INJURY THAT YOU BELIEVE RESULTED
FROM A CRS?
[ ] MODERATE: Pain, sensory loss or gait alteration requiring
narcotics and/or use of a cane or xxxxxx;
[ ] SEVERE: Pain, sensory loss or gait alteration requiring a
wheelchair and/or amputation;
[ ] Other Explain:
--------------------------------------------------
----------------------------------------------------------------
I. NAME AND ADDRESS OF ALL PHYSICIAN(s) WHO HAVE TREATED YOU FOR THE
PERMANENT INJURY THAT YOU BELIEVE RESULTED FROM A CRS. MAKE A COPY OF
THIS PAGE IF YOU REQUIRE ADDITIONAL SPACE AND ATTACH IT TO THIS CLAIM
FORM:
---------------------------------- ------ ----------------------
(Treating Physician's First Name) (Middle Initial) (Last Name)
---------------------------------------------------------------------------
(Street Address)
-
---------------------------- -------- -------------------------------
(City) (State) (Zip Code)
( ) - ( ) -
------------------------------ -------------------------------
(Area Code & Telephone Number) (Fax Area Code & Number)
J. TO COMPLETE YOUR APPLICATION FOR EIF BENEFITS UNDER MATRIX LEVEL V, YOU
MUST ATTACH THE FOLLOWING INFORMATION:
[ ] The hospital records evidencing each CRS that you believe
resulted in a Permanent Injury that must include, without
limitation, a preadmission/admission history and physical
examination, an operative report, operative nursing notes,
anesthesia records and a discharge summary; AND
[ ] The medical records of each treating surgeon who performed a CRS
that you believe resulted in a Permanent Injury; AND
[ ] The medical records of the treating surgeon(s) (if different than
above) who diagnosed the Permanent Injury that you believe
resulted from a CRS; AND
[ ] The hospital records confirming the diagnosis of a Permanent
Injury that you believe resulted from a CRS that should include
but not be limited to (where applicable) a preadmission/admission
history and physical examination, results/reports of all
objective quantitative studies performed (EMG, nerve conduction
study, angiogram), an operative report, operative nursing notes,
anesthesia records and a discharge summary; AND
[ ] Hospital records (if different than above) evidencing treatment
of the Permanent Injury that you believe resulted from a CRS that
should include but not be limited to (where applicable) a
preadmission/admission history and physical examination,
operative report, operative nursing notes anesthesia records, and
a discharge summary; AND
[ ] The medical records of the treating surgeon(s) (if different than
above) who treated the Permanent Injury that you believe resulted
from a CRS; AND
GREEN FORM - 14
[ ] A completed "Physician Declaration" from your treating surgeon
wherein your physician 1) documents a Permanent Injury (as
confirmed by both objective physical signs and quantitative
measures 365 days or more after a CRS); 2) describes the nature
of the Permanent Injury (i.e. whether it is one requiring
narcotics, use of a cane, walker, wheelchair or amputation); and
3) causally relates that Permanent Injury to a CRS(8); AND
[ ] A medical authorization, enabling the Claims Administrator to
obtain additional medical records, if the Claims Administrator
chooses to do so, in order to evaluate your claim.
NOTE: Medical authorization forms will only be used by the Claims
Administrator to verify certain information provided by you.
Execution of a medical authorization form does not relieve you of
your obligation to provide all of the medical documentation
requested herein.
13. MATRIX LEVEL VI (Revision Surgery: Myocardial Infarction)
This question relates only to MATRIX LEVEL VI and should be completed only
if you have suffered a myocardial infarction during a CRS or during the
hospitalization associated with a CRS(9) (see definition of CRS in Question
11). If you believe that you qualify for benefits pursuant to MATRIX LEVEL
VI, you must provide the following information:
A. DATE ON WHICH THE MYOCARDIAL INFARCTION THAT YOU BELIEVE WAS
PRECIPITATED BY A CRS OCCURRED:
/ /
------------
(MM/DD/YYYY)
B. DATE ON WHICH THE CRS THAT YOU BELIEVE PRECIPITATED THE MYOCARDIAL
INFARCTION WAS PERFORMED:
/ /
------------
(MM/DD/YYYY)
X. XXXX ON WHICH YOU WERE DISCHARGED FROM THE HOSPITAL WHERE THE CRS THAT
YOU BELIEVE PRECIPITATED YOUR MYOCARDIAL INFARCTION WAS PERFORMED:
/ /
------------
(MM/DD/YYYY)
----------
(8) The Claims Administrator may accept a Declaration that is prepared
by a non-treating, Board-Certified orthopedic surgeon if submitted in
combination with your affidavit setting forth your attempts to secure a
Declaration from a treating orthopedic surgeon.
(9) The Claims Administrator may compensate individuals whose treating
cardiothoracic surgeon or treating cardiologist causally relates to the CRS a
myocardial infarction that did not occur during a CRS or during the
hospitalization associated with a CRS.
GREEN FORM - 15
D. NAME AND ADDRESS OF THE HOSPITAL WHERE THE CRS THAT YOU BELIEVE
PRECIPITATED YOUR MYOCARDIAL INFARCTION WAS PERFORMED: -
---------------------------------------------------------------------------
(Hospital Name)
---------------------------------------------------------------------------
(Street Address)
-
---------------------------- -------- -------------------------------
(City) (State) (Zip Code)
( ) - ( ) -
------------------------------ -------------------------------
(Area Code & Telephone Number) (Fax Area Code & Number)
E. SURGEON WHO PERFORMED THE CRS THAT YOU BELIEVE PRECIPITATED YOUR
MYOCARDIAL INFARCTION:
----------------------------- ------ --------------------------
(Surgeon's First Name) (Middle Initial) (Last Name)
---------------------------------------------------------------------------
(Street Address)
-
---------------------------- -------- -------------------------------
(City) (State) (Zip Code)
( ) - ( ) -
------------------------------ -------------------------------
(Area Code & Telephone Number) (Fax Area Code & Number)
F. NAME AND ADDRESS OF THE CARDIOTHORACIC SURGEON(s) AND/OR
CARDIOLOGIST(s) WHO DIAGNOSED AND TREATED THE MYOCARDIAL INFARCTION
THAT YOU BELIEVE WAS PRECIPITATED BY A CRS:
---------------------------------------------------------------------------
(Cardiothoracic Surgeon's and/or Cardiologist's Name)
---------------------------------------------------------------------------
(Street Address)
-
---------------------------- -------- -------------------------------
(City) (State) (Zip Code)
( ) - ( ) -
------------------------------ -------------------------------
(Area Code & Telephone Number) (Fax Area Code & Number)
G. NAME AND ADDRESS OF THE HOSPITAL WHERE THE MYOCARDIAL INFARCTION THAT
YOU BELIEVE WAS PRECIPITATED BY A CRS WAS DIAGNOSED AND TREATED:
---------------------------------------------------------------------------
(Hospital Name)
---------------------------------------------------------------------------
(Street Address)
-
---------------------------- -------- -------------------------------
(City) (State) (Zip Code)
( ) - ( ) -
------------------------------ -------------------------------
(Area Code & Telephone Number) (Fax Area Code & Number)
GREEN FORM - 16
H. CHECK THE APPROPRIATE BOX BELOW FOR THE NEW YORK HEART ASSOCIATION
FUNCTIONAL CLASS(10) SYMPTOMS YOU HAD BEFORE THE MYOCARDIAL INFARCTION
THAT YOU BELIEVE WAS PRECIPITATED BY A CRS:
[ ] Class I;
[ ] Class II;
[ ] Class III; or
[ ] Class IV
I. CHECK THE APPROPRIATE BOX BELOW FOR THE NEW YORK HEART ASSOCIATION
FUNCTIONAL CLASS(11) SYMPTOMS YOU HAD AFTER THE MYOCARDIAL INFARCTION
THAT YOU BELIEVE WAS PRECIPITATED BY A CRS:
[ ] Class I;
[ ] Class II;
[ ] Class III; or
[ ] Class IV
J. TO COMPLETE YOUR APPLICATION FOR EIF BENEFITS UNDER MATRIX LEVEL VI,
YOU MUST ATTACH THE FOLLOWING INFORMATION:
[ ] The hospital records evidencing the CRS that you believe
precipitated your myocardial infarction that should include, but
not be limited to, a preadmission/admission history and physical
examination, an operative report, operative nursing notes,
anesthesia records and a discharge summary; AND
[ ] The medical records of each treating surgeon who performed the
CRS that you believe precipitated your myocardial infarction;
AND
[ ] The hospital records (if different than above) evidencing
treatment of your myocardial infarction that you believe was
precipitated by a CRS, that should include, but not be limited
to (where applicable), preadmission/admission history and
physical examination, operative report, operative nursing notes,
anesthesia records and a discharge summary; AND
[ ] The medical records of the cardiothoracic surgeon(s) and/or
cardiologist(s) who diagnosed and treated your myocardial
infarction that you believe was precipitated by a CRS; AND
----------
(10) See X. Xxxxxxxx, X. Xxxxxxx, X. Xxxxxxxxx, X. Xxxx, X. Xxxxx, Xx.,
Xxxxx Essentials of Medicine, at 12 (3d ed. 1993).
(11) See id.
GREEN FORM - 17
[ ] A completed "Physician Declaration" from a treating
cardiothoracic surgeon and/or treating cardiologist wherein the
physician documents a 1, 2 or 3 class change in Functional
Classification (as defined by the New York Heart
Association(12))(13); AND
[ ] A medical authorization, enabling the Claims Administrator to
obtain additional medical records, if the Claims Administrator
chooses to do so, in order to evaluate your claim.
NOTE: Medical authorization forms will only be used by the
Claims Administrator to verify certain information provided by
you. Execution of a medical authorization form does not relieve
you of your obligation to provide all of the medical
documentation requested herein.
14. MATRIX LEVEL VII (Stroke)
This question relates only to MATRIX LEVEL VII and should be completed
only if you have suffered a stroke during a CRS or during the
hospitalization associated with a CRS(14) (see definition of CRS in
Question 11). If you believe that you qualify for benefits pursuant to
MATRIX LEVEL VII, you must provide the following information:
A. DATE ON WHICH THE STROKE THAT YOU BELIEVE WAS PRECIPITATED BY A CRS
OCCURRED:
/ /
------------
(MM/DD/YYYY)
B. DATE ON WHICH THE CRS THAT YOU BELIEVE PRECIPITATED THE STROKE WAS
PERFORMED:
/ /
------------
(MM/DD/YYYY)
X. XXXX ON WHICH YOU WERE DISCHARGED FROM THE HOSPITAL WHERE THE CRS THAT
YOU BELIEVE PRECIPITATED YOUR STROKE WAS PERFORMED: / /
-----------
(MM/DD/YYYY)
D. NAME AND ADDRESS OF THE HOSPITAL WHERE THE CRS THAT YOU BELIEVE
PRECIPITATED YOUR STROKE WAS PERFORMED:
---------------------------------------------------------------------------
(Hospital Name)
---------------------------------------------------------------------------
(Street Address)
-
---------------------------- -------- -------------------------------
(City) (State) (Zip Code)
( ) - ( ) -
------------------------------ -------------------------------
(Area Code & Telephone Number) (Fax Area Code & Number)
----------
(12) See id.
(13) The Claims Administrator may accept a Declaration that is prepared
by a non-treating, Board-Certified cardiothoracic surgeon or Board-Certified
cardiologist if submitted in combination with your affidavit setting forth your
attempts to secure a Declaration from a treating cardiothoracic surgeon and/or a
treating cardiologist.
(14) The Claims Administrator may compensate individuals whose treating
neurosurgeon or treating neurologist causally relates to the CRS a stroke that
did not occur during a CRS or during the hospitalization associated with a CRS.
GREEN FORM - 18
E. SURGEON WHO PERFORMED THE CRS THAT YOU BELIEVE PRECIPITATED YOUR STROKE:
----------------------------- ------ --------------------------
(Surgeon's First Name) (Middle Initial) (Last Name)
---------------------------------------------------------------------------
(Street Address)
-
---------------------------- -------- -------------------------------
(City) (State) (Zip Code)
( ) - ( ) -
------------------------------ -------------------------------
(Area Code & Telephone Number) (Fax Area Code & Number)
F. NAME AND ADDRESS OF THE NEUROSURGEON(s) AND/OR NEUROLOGIST(s) WHO
DIAGNOSED AND TREATED THE STROKE THAT YOU BELIEVE WAS PRECIPITATED BY A
CRS:
----------------------------------------- ------ ---------------
(Neurosurgeon and/or Neurologist's Name) (Middle Initial) (Last Name)
---------------------------------------------------------------------------
(Street Address)
-
---------------------------- -------- -------------------------------
(City) (State) (Zip Code)
( ) - ( ) -
------------------------------ -------------------------------
(Area Code & Telephone Number) (Fax Area Code & Number)
G. NAME AND ADDRESS OF THE HOSPITAL WHERE THE STROKE THAT YOU BELIEVE WAS
PRECIPITATED BY A CRS WAS DIAGNOSED AND TREATED:
---------------------------------------------------------------------------
(Hospital Name)
---------------------------------------------------------------------------
(Street Address)
-
---------------------------- -------- -------------------------------
(City) (State) (Zip Code)
( ) - ( ) -
------------------------------ -------------------------------
(Area Code & Telephone Number) (Fax Area Code & Number)
H. WHAT IS YOUR FUNCTIONAL STROKE OUTCOME CLASSIFICATION (AS DEFINED BY THE
AMERICAN HEART ASSOCIATION(15)):
[ ] Level I;
[ ] Level II;
[ ] Level III; or
[ ] Level IV
----------
(15) See The American Heart Association Stroke Outcome Classification
29 Stroke at 1274-75 (1998).
GREEN FORM - 19
I. TO COMPLETE YOUR APPLICATION FOR EIF BENEFITS UNDER MATRIX
LEVEL VII, YOU MUST ATTACH THE FOLLOWING INFORMATION:
[ ] The hospital records evidencing the CRS that you believe
precipitated your stroke that must include, without
limitation, a preadmission/admission history and
physical examination, an operative report, operative
nursing notes, anesthesia records and a discharge
summary; AND
[ ] The medical records of each treating surgeon who
performed the CRS that you believe precipitated your
stroke; AND
[ ] The hospital records (if different than above)
evidencing treatment of your stroke that you believe was
precipitated by a CRS, that should include but not be
limited to (where applicable), a preadmission/admission
history and physical examination, operative report,
operative nursing notes, anesthesia records and a
discharge summary; AND
[ ] The medical records of the neurosurgeon(s) and/or
neurologist(s) who diagnosed and treated your stroke
(that you believe was precipitated by a CRS); AND
[ ] A completed "Physician Declaration" from a treating
neurosurgeon and/or treating neurologist wherein he/she
documents a Functional Stroke Outcome Level of I, II,
III or IV (as defined by the American Heart Association
Stroke Outcome Classification(16))(17); AND
[ ] A medical authorization, enabling the Claims
Administrator to obtain additional medical records, if
he/she chooses to do so, in order to evaluate your
claim.
NOTE: Medical authorization forms will only be used by
the Claims Administrator to verify certain information
provided by you. Execution of a medical authorization
form does not relieve you of your obligation to provide
all of the medical documentation requested herein.
15. MATRIX LEVEL VIII (Death)
This question relates only to MATRIX LEVEL VIII and should only be
completed by a Representative Claimant who is submitting this EIF
Benefits Claim Form on behalf of an APR who has died during a CRS or
whose death was a result of a CRS(18) (see definition of CRS in
Question 11). If you believe that you qualify for benefits pursuant to
MATRIX LEVEL VIII, you must provide the following information:
A. DATE ON WHICH THE DEATH THAT YOU BELIEVE WAS CAUSED BY A CRS
OCCURRED:
/ /
------------
(MM/DD/YYYY)
----------
(16) See id.
(17) The Claims Administrator may accept a Declaration that is prepared
by a non-treating, Board-Certified cardiothoracic surgeon or Board-Certified
cardiologist if submitted in combination with your affidavit setting forth your
attempts to secure a Declaration from a treating cardiothoracic surgeon or a
treating cardiologist.
(18) The Claims Administrator may compensate individuals whose treating
physician causally relates the death to the CRS that did not occur during a CRS
or during the hospitalization associated with a CRS.
GREEN FORM - 20
B. DATE ON WHICH THE CRS THAT YOU BELIEVE RESULTED IN THE DEATH OCCURRED:
/ /
------------
(MM/DD/YYYY)
C. HOSPITAL WHERE THE CRS THAT YOU BELIEVE RESULTED IN DEATH TOOK PLACE:
---------------------------------------------------------------------------
(Hospital Name)
---------------------------------------------------------------------------
(Street Address)
-
---------------------------- -------- -------------------------------
(City) (State) (Zip Code)
( ) - ( ) -
------------------------------ -------------------------------
(Area Code & Telephone Number) (Fax Area Code & Number)
D. NAME AND ADDRESS OF THE SURGEON WHO PERFORMED THE CRS THAT YOU BELIEVE
RESULTED IN DEATH:
----------------------------- ------ --------------------------
(Surgeon's First Name) (Middle Initial) (Last Name)
---------------------------------------------------------------------------
(Street Address)
-
---------------------------- -------- -------------------------------
(City) (State) (Zip Code)
( ) - ( ) -
------------------------------ -------------------------------
(Area Code & Telephone Number) (Fax Area Code & Number)
E. HOSPITAL (IF DIFFERENT THAN ABOVE) WHERE THE APR DIED:
---------------------------------------------------------------------------
(Hospital Name)
---------------------------------------------------------------------------
(Street Address)
-
---------------------------- -------- -------------------------------
(City) (State) (Zip Code)
( ) - ( ) -
------------------------------ -------------------------------
(Area Code & Telephone Number) (Fax Area Code & Number)
F. CAUSE OF DEATH:
--------------------------------------------------------
---------------------------------------------------------------------------
G. MARITAL STATUS AT THE TIME OF DEATH:
Married [ ] Divorced [ ] Separated [ ] Widowed [ ]
If "Divorced" or "Separated" from the APR, state the date of separation
and/or divorce.
Date: / /
------------
(MM/DD/YYYY)
GREEN FORM - 21
If "Married," you must provide the following information:
--------------------------- -------- --------------------------------
(Spouse's First Name) (Middle Initial) (Last Name)
-----------------------------------------------------------------------------
(Street Address)
-
------------------------------- -------- -------------------------------
(City) (State) (Zip Code)
( ) - ( ) -
---------------------------------- ------------------------------------
(Daytime Area Code & Phone Number) (Evening Area Code & Phone Number)
-----------------------------------------------------------------------------
(Email Address, if any)
/ / - -
----------------------- -------------------------------
(Birth Date MM/DD/YYYY) (Social Security Number)
H. NUMBER OF MINOR CHILDREN, ADULT CHILDREN AND PARENTS AT THE TIME OF
DEATH:
---------
For each minor child, adult child or parent, provide the following:
--------------------------- -------- --------------------------------
(First Name) (Middle Initial) (Last Name)
-----------------------------------------------------------------------------
(Street Address)
-
------------------------------- -------- -------------------------------
(City) (State) (Zip Code)
( ) - ( ) -
---------------------------------- ------------------------------------
(Daytime Area Code & Phone Number) (Evening Area Code & Phone Number)
( ) -
---------------------------------- ------------------------------------
(Email Address, if any) (Fax Area Code & Number, if any)
/ / - -
----------------------- -------------------------------
(Birth Date MM/DD/YYYY) (Social Security Number)
IF THERE ARE ADDITIONAL MINOR CHILDREN, ADULT CHILDREN OR PARENTS, CHECK
HERE [ ] AND MAKE A COPY OF THIS PAGE FOR EACH ADDITIONAL SUCH PERSON AND
ATTACH IT TO THIS CLAIM FORM.
I. IF THE APR WAS EMPLOYED AT THE TIME OF DEATH, PROVIDE THE NAME AND
ADDRESS OF THE APR'S PLACE(S) OF EMPLOYMENT AT THE TIME OF DEATH.
-----------------------------------------------------------------------------
(Employer's Name)
-----------------------------------------------------------------------------
(Street Address)
-----------------------------------------------------------------------------
(Street Address)
-
---------------------------- -------- -------------------------------
(City) (State) (Zip Code)
( ) - ( ) -
------------------------------ -------------------------------
(Area Code & Telephone Number) (Fax Area Code & Number)
GREEN FORM - 22
J. TO COMPLETE YOUR APPLICATION FOR EIF BENEFITS UNDER MATRIX
LEVEL VIII, YOU MUST ATTACH THE FOLLOWING INFORMATION:
[ ] The hospital records evidencing the CRS (that you
believe caused the Death of the APR) that must include,
without limitation (where applicable), a
preadmission/admission history and physical examination,
operative report, operative nursing notes, anesthesia
records, discharge/death summary, Certificate of Death,
and Autopsy Report; AND
[ ] The medical records of the treating surgeon who
performed the CRS that you believe caused the death; AND
[ ] The hospital records (if different than above) for the
admission leading up to the APR's death that should
include, but not be limited to (where applicable),
preadmission/admission history and physical examination,
operative report, operative nursing notes, anesthesia
records, discharge/death summary, Certificate of Death,
and Autopsy Report (if applicable); AND
[ ] Records of the Coroner including Certificate of Death
and autopsy findings (if applicable); AND
[ ] A completed "Physician Declaration" from a treating
physician wherein he/she causally relates an APR's death
to a CRS(19); AND
[ ] A medical authorization, enabling the Claims
Administrator to obtain additional medical records, if
he/she chooses to do so, in order to evaluate your
claim;
NOTE: Medical authorization forms will only be used by
the Claims Administrator to verify certain information
provided by you. Execution of a medical authorization
form does not relieve you of your obligation to provide
all of the medical documentation requested herein.
AND
[ ] Documentation confirming a minor or adult child's date
of birth which may include a photocopy of his/her birth
certificate, Social Security card, or driver's license;
AND
[ ] Documenation certifying a parental relationship to the
APR; AND
[ ] Documentation (in the form of federal income tax-returns
or W-2 statements) that evidence an APR's wages,
salaries, or income from self-employment for the 3 years
before his/her death.
16. MATRIX LEVEL IX (Miscellaneous Complications or Other Harm)
This question relates only to MATRIX LEVEL IX and should only be
completed if you believe that you are entitled to receive compensation
for complication(s) and/or other harm not anticipated and/or
specifically provided for in Questions 8-15. If you believe that you
qualify for compensation pursuant to MATRIX LEVEL IX, you must provide
the following information:
----------
(19) In his/her discretion, the Claims Administrator may accept a
Declaration that is prepared by a non-treating, Board-Certified physician if
submitted in combination with your affidavit setting forth your attempts to
secure a Declaration from a treating physician.
GREEN FORM - 23
A. WHAT INJURY(IES) OR DAMAGE(s) DO YOU BELIEVE RESULTED FROM A CRS?
---------------------------------------------------------------------------
---------------------------------------------------------------------------
---------------------------------------------------------------------------
---------------------------------------------------------------------------
B. DATE ON WHICH THE INJURY/DAMAGE WAS RECOGNIZED: / /
---------------------
(MM/DD/YYYY)
X. XXXX ON WHICH THE CRS THAT YOU BELIEVE RESULTED IN THE INJURY/DAMAGE WAS
PERFORMED:
/ /
---------------------
(MM/DD/YYYY)
D. NAME AND ADDRESS OF THE TREATING PHYSICIAN WHO PERFORMED THE CRS THAT YOU
BELIEVE RESULTED IN INJURY/DAMAGE:
---------------------------------- ------ ----------------------
(Treating Physician's First Name) (Middle Initial) (Last Name)
---------------------------------------------------------------------------
(Street Address)
-
---------------------------- -------- -------------------------------
(City) (State) (Zip Code)
( ) - ( ) -
------------------------------ -------------------------------
(Area Code & Telephone Number) (Fax Area Code & Number)
E. HOSPITAL WHERE THE CRS THAT YOU BELIEVE RESULTED IN THE INJURY/DAMAGE TOOK
PLACE:
---------------------------------------------------------------------------
(Hospital Name)
---------------------------------------------------------------------------
(Street Address)
-
---------------------------- -------- -------------------------------
(City) (State) (Zip Code)
( ) - ( ) -
------------------------------ -------------------------------
(Area Code & Telephone Number) (Fax Area Code & Number)
F. NAME AND ADDRESS OF THE TREATING PHYSICIAN(S) (IF DIFFERENT THAN ABOVE) WHO
DIAGNOSED AND TREATED THE INJURY/DAMAGE THAT YOU BELIEVE RESULTED FROM A
CRS:
---------------------------------- ------ ----------------------
(Treating Physician's First Name) (Middle Initial) (Last Name)
---------------------------------------------------------------------------
(Street Address)
-
---------------------------- -------- -------------------------------
(City) (State) (Zip Code)
( ) - ( ) -
------------------------------ -------------------------------
(Area Code & Telephone Number) (Fax Area Code & Number)
GREEN FORM - 24
G. HOSPITAL (IF DIFFERENT FROM ABOVE) WHERE THE INJURY/DAMAGE THAT YOU BELIEVE
RESULTED FROM A CRS WAS TREATED:
---------------------------------------------------------------------------
(Hospital Name)
---------------------------------------------------------------------------
(Street Address)
-
---------------------------- -------- -------------------------------
(City) (State) (Zip Code)
( ) - ( ) -
------------------------------ -------------------------------
(Area Code & Telephone Number) (Fax Area Code & Number)
H. TO COMPLETE YOUR APPLICATION FOR EIF BENEFITS UNDER MATRIX LEVEL IX, YOU
MUST ATTACH THE FOLLOWING INFORMATION:
[ ] The hospital records evidencing each CRS that you believe
resulted in injury/damage that should include, but not be
limited to, preadmission/admission history and physical
examination, operative report, operative nursing notes,
anesthesia records and a discharge summary; AND
[ ] The medical records of each treating surgeon who performed a CRS
that you believe resulted in injury/damage; AND
[ ] The hospital records evidencing treatment of the injury (for
which compensation under MATRIX LEVEL IX is sought) that should
include, but not be limited to (where applicable),
preadmission/admission history and physical examination,
operative report, operative nursing notes, anesthesia records
and a discharge summary; AND
[ ] The medical records of the treating physician (if different than
above) who treated the injury (for which compensation under
MATRIX LEVEL IX is sought); AND
[ ] A completed "Physician Declaration" from your treating surgeon
wherein he/she causally relates the injury/damage (for which
compensation under MATRIX LEVEL IX is sought) to a CRS(20); AND
[ ] A medical authorization, enabling the Claims Administrator to
obtain additional medical records, if the Claims Administrator
chooses to do so, in order to evaluate your claim.
NOTE: Medical authorization forms will only be used by the
Claims Administrator to verify certain information provided by
you. Execution of a medical authorization form does not relieve
you of your obligation to provide all of the medical
documentation requested herein.
17. DOCUMENT SUBMISSION
All documents submitted in support of a claim must be page numbered and
clearly labeled with the APR's full name and Sulzer Settlement Claim
Number, if known, and attached to this Claim Form.
----------
(20) In his/her discretion, the Claims Administrator may accept a
Declaration that is prepared by a non-treating, Board-Certified orthopedic
surgeon if submitted in combination with your affidavit setting forth your
attempts to secure a Declaration from a treating orthopedic surgeon.
GREEN FORM - 25
18. CHANGES TO APR OR REPRESENTATIVE CLAIMANT CONTACT INFORMATION
Class Members must provide the Claims Administrator updated name,
address, and telephone number information in order to ensure processing
of their claim. Failure to provide updates may result in termination of
a claim or disallowance of benefits. Class Members must include their
Sulzer Settlement Claim Number on all correspondence to the Claims
Administrator.
19. WAIVER OF OPT-OUT RIGHTS
By submitting this form and agreeing to accept benefits pursuant to the
Settlement Agreement, the undersigned knowingly waive(s) all Opt-Out
Rights provided by the Settlement Agreement, as described in the Final
Notice, and agree(s) not to object to the Settlement Agreement or to
appeal any Court's approval of the Settlement Agreement.
20. RELEASE AND COVENANT NOT TO XXX
x. In consideration of the obligations of Sulzer as set forth in
the Settlement Agreement, I, the undersigned Class Member,
individually and for my heirs, beneficiaries, agents, estate,
executors, administrators, personal representatives,
successors and assignees, and/or, if my claim is that of a
representative of a person who was implanted with an Affected
Product or of the person who has a Derivative Claim arising
out of the implantation of the Affected Product, in that
capacity, whether as heir, beneficiary, agent, estate,
executor, administrator, personal representative, successor,
assignee, guardian, or otherwise, hereby expressly RELEASE AND
FOREVER DISCHARGE AND AGREE NOT TO XXX, Sulzer and all other
Released Parties as to all Settled Claims. I understand that
certain principles of law provide that a release may not
extend to claims that I do not know or suspect to exist. I am
aware that I may discover claims presently unknown or
unsuspected or facts in addition to or different from those
which I now believe to be true with respect to the matters
released herein which may be applicable to this Settlement.
Despite such principles of law, I HEREBY KNOWINGLY AND
VOLUNTARILY RELINQUISH THE PROTECTIONS OF ALL SUCH FEDERAL OR
STATE LAWS, RIGHTS, RULES OR LEGAL PRINCIPLES THAT MAY BE
APPLICABLE AS FOLLOWS: I FULLY, FINALLY, AND FOREVER SETTLE
AND RELEASE ANY AND ALL SETTLED CLAIMS, including assigned
claims, whether known or unknown, asserted or unasserted,
regardless of the legal theory, existing now or arising in the
future out of or relating to the purchase, use, manufacture,
sale, distribution, promotion, marketing, clinical
investigation, administration, regulatory approval, and
labeling of an Affected Product THAT I MAY HAVE AGAINST ANY
RELEASED PARTY.
b. For purposes of the Release and Covenant Not to Xxx, the terms
"Settled Claims" and "Released Parties" are defined as set
forth in the Settlement Agreement, which is incorporated by
reference.
c. I agree that acceptance of benefits pursuant to the Settlement
Agreement settles any lawsuit previously initiated by me, if
any, asserting any Settled Claim against Sulzer or any other
Released Party, and I stipulate and agree to the dismissal of
all such claims, suits and proceedings, with prejudice and
without costs and agree to cooperate as reasonably requested
in order to effectuate such a dismissal.
GREEN FORM - 26
21. CONFIDENTIALITY
The person(s) signing below hereby consent(s) to the disclosure of the
information contained herein to the extent necessary to process claims
for benefits pursuant to the Settlement Agreement.
22. DECLARATION UNDER PENALTY OF PERJURY
Each person signing below acknowledges and understands that this form
is an official document sanctioned by the Court that presides over the
legal action entitled In Re Sulzer Hip Prosthesis and Knee Prosthesis
Product Liability Litigation. Submitting this Claim Form to the Claims
Administrator is equivalent to filing it with the Court. After
reviewing the information that has been provided on this form,
including information, if applicable, that was supplied by a
Board-Certified physician and/or an attorney, each person signing this
form declares under penalty of perjury that the information provided in
this form is true and correct to the best of that person's knowledge
and belief.
------------------------------------------------------ ----------------
(Signature of APR, if living) (Date MM/DD/YYYY)
------------------------------------------------------ ----------------
(Signature(s) of each Representative Claimant, if any) (Date MM/DD/YYYY)
------------------------------------------------------ ----------------
(Signature(s) of Derivative Claimant, if any) (Date MM/DD/YYYY)
Mail this Claim Form and all attachments to:
Claims Administrator
Sulzer Settlement Trust
P. O. Xxx 00000
Xxxxxxxxx, Xxxx 00000-0000
GREEN FORM - 27
AUTHORIZATION FOR RELEASE OF MEDICAL RECORDS
AND OTHER HEALTH INFORMATION
I hereby authorize the use or disclosure of my individually identifiable health
information and medical records as described below. I understand that this
authorization is voluntary. I understand that because the organization
authorized to receive the information is not a health plan or health care
provider, the released information may no longer be protected by federal privacy
regulations, but it will be subject to the confidentiality provisions of the
Settlement Agreement.
INFORMATION AUTHORIZED FOR RELEASE: I authorize the release of the following
records/recordings to the Sulzer Settlement Trust: any medical records that
pertain or relate to the diagnosis, care or treatment of any disease, condition
or procedure related to or arising from any implantation in the Patient/Affected
Product Recipient of a hip or knee prosthesis(es) including information about
the undersigned Affected Product Recipient or Patient, his/her hip or knee
prosthesis(es), the hospital(s) where and surgeon(s) who made, provided, gave or
performed any diagnosis, care treatment, or procedure, the manufacturer, product
and lot numbers of any hip or knee prostheses, any surgery(ies) associated with
the hip or knee prosthesis(es), the date(s) and nature of any medical treatment
associated with the implant(s) of the hip or knee prosthesis(es), hospital
reports including pre-admission and admission histories, treating and implanting
surgeons' records, physical examinations, hospital discharge summaries,
operative reports and nursing notes, anesthesia records, pathology reports,
results/reports of all objective quantitative studies performed, progress notes,
prescription records, medical records of cardiothoracic surgeons and/or
cardiologists or neurologist, death summaries, certificate of death or autopsy
report, and any billing records and/or payment records.
PATIENT/AFFECTED PRODUCT RECIPIENT IDENTIFICATION:
--------------------------- -------- ----------------------------------
(First Name) (Middle Initial) (Last Name)
/ / - -
----------------------- -------------------------------
(Birth Date MM/DD/YYYY) (Social Security Nunber)
------------------------------------------------------------------------------
(List all other names that the APR uses or has used during the last ten years)
PERSONS/ORGANIZATIONS PROVIDING THE INFORMATION: Any organization maintaining
records described above that are necessary to adjudicate the relevant claim
filed under the Settlement Agreement.
FORWARD THE ABOVE RECORDS TO:
Claims Administrator
Sulzer Settlement Trust
X.X. Xxx 00000
Xxxxxxxxx, XX 00000-0000
============================================================================
I understand that this authorization will expire three (3) years from the date I
sign this document as indicated below. In addition, I understand that I may
revoke this authorization at any time by notifying the providing organization in
writing, but if I do revoke this authorization it will not have any effect on
any actions any providing organization took before it received the revocation.
Also, this authorization does not authorize the disclosure of any information
other than the items referenced above.
---------------------------------------------------------------------------- -----------------
Signature of Patient/Affected Product Recipient or Authorized Representative (Date MM/DD/YYYY)
---------------------------------------------------------------------------------------------
Printed Name of Authorized Representative (if applicable)
---------------------------------------------------------------------------------------------
Relationship of Representative to Patient/Affected Product Recipient (if applicable)
GREEN FORM - 28
EXHIBIT F
YELLOW FORM
================================================================================
DERIVATIVE CLAIMANT
BENEFITS CLAIM FORM
THIS YELLOW FORM IS TO BE USED ONLY BY A CLASS MEMBER WHO IS REGISTERING FOR
SETTLEMENT BENEFITS AS A DERIVATIVE CLAIMANT OF THE AFFECTED PRODUCT RECIPIENT
("APR"). THE COMPLETED FORM MUST BE POSTMARKED TO THE CLAIMS ADMINISTRATOR (C/O
SULZER SETTLEMENT TRUST, X.X. XXX 00000, XXXXXXXXX, XXXX 00000-0000) WITHIN THE
TIME PERIODS PRESCRIBED FOR THE APR'S CLAIM FOR BENEFITS. SEE THE FINAL NOTICE
OF SETTLEMENT OF NATIONWIDE HIP PROSTHESIS AND KNEE PROSTHESIS PRODUCT LIABILITY
CLASS ACTION LITIGATION ("FINAL NOTICE"), THE CLASS MEMBER AND ATTORNEY GUIDE,
OR THE SETTLEMENT AGREEMENT FOR FURTHER INFORMATION. IF THERE IS ANY CONFLICT
BETWEEN THE PROVISIONS OF THIS CLAIM FORM AND THE TERMS OF THE SETTLEMENT
AGREEMENT, THE TERMS OF THE SETTLEMENT AGREEMENT CONTROL.
All responses must be PRINTED or TYPED. By completing this Yellow Form, you(1)
are registering for benefits under the Settlement Agreement. If you have
retained an attorney regarding your claim, you should consult with your attorney
about your options under the Settlement Agreement.
1. INDICATE BY CHECKING THE APPROPRIATE BOX BELOW WHETHER THE APR WAS IMPLANTED
WITH A SULZER INTER-OP(TM) SHELL, REPROCESSED INTER-OP(TM) SHELL OR SULZER
TIBIAL BASEPLATE, WHICH HAS NOT BEEN REMOVED. NOTE: CHECK ONLY ONE BOX. IF
THE APR HAS BEEN IMPLANTED WITH MORE THAN ONE AFFECTED PRODUCT, YOU MUST
COMPLETE A CLAIM FORM FOR EACH AFFECTED PRODUCT IMPLANTED.
[ ] APR WAS IMPLANTED WITH A SULZER INTER-OP(TM) SHELL.
OR
[ ] APR WAS IMPLANTED WITH A REPROCESSED INTER-OP(TM) SHELL.
OR
[ ] APR WAS IMPLANTED WITH A SULZER TIBIAL BASEPLATE.
2. AFFECTED PRODUCT RECIPIENT IDENTIFICATION (APR INFORMATION ONLY)
-------------------------------------- ------- -------------------
(First Name) (Middle Initial) (Last Name)
------------------------------------------------------------------------------
(List all other names that the APR uses or has used during the last ten years)
------------------------------------------------------------------------------
(Street Address)
----------
(1) "You" or "your" when used throughout this Claim Form refers to the
Derivative Claimant or to the Representative Claimant of the Derivative
Claimant.
YELLOW FORM - 1
------------------------------- -------- -----------------------------
(City) (State) (Zip Code)
( ) - ( ) -
---------------------------------- ---------------------------------
(Daytime Area Code & Phone Number) (Evening Area Code & Phone Number)
---------------------------------------------------------------------------
(Email Address, if any)
/ / - -
----------------------- -------------------------------
(Birth Date MM/DD/YYYY) (Social Security Nunber)
------------------------------------------
(Sulzer Settlement Claim Number, if known)
Gender: Female [ ] Male [ ]
3. RELATIONSHIP TO APR
WHAT IS THE RELATIONSHIP OF THE DERIVATIVE CLAIMANT TO THE APR?
Spouse [ ]
Significant Other [ ]
IF "SPOUSE," WHAT IS THE CURRENT STATUS OF YOUR RELATIONSHIP TO THE APR?
Married [ ] Divorced [ ] Separated [ ] Widowed [ ]
IF "DIVORCED" OR "SEPARATED" FROM THE APR, YOU MUST STATE THE DATE OF
SEPARATION AND/OR DIVORCE.
Date: / /
-------------
(MM/DD/YYYY)
IF "SIGNIFICANT OTHER," EXPLAIN YOUR RELATIONSHIP. IF YOU REQUIRE ADDITIONAL
SPACE, CHECK HERE " AND ATTACH A SEPARATE SHEET.
---------------------------------------------------------------------------
---------------------------------------------------------------------------
---------------------------------------------------------------------------
4. DERIVATIVE CLAIMANT INFORMATION
--------------------------- -------- ------------------------------
(First Name) (Middle Initial) (Last Name)
---------------------------------------------------------------------------
(List all other names that you use or have used during the last ten years)
---------------------------------------------------------------------------
(Street Address)
YELLOW FORM - 2
-
------------------------------ -------- ------------------------------
(City) (State) (Zip Code)
( ) - ( ) -
---------------------------------- ----------------------------------
(Daytime Area Code & Phone Number) (Evening Area Code & Phone Number)
---------------------------------------------------------------------------
(Email Address, if any)
/ / - -
----------------------- -------------------------------
(Birth Date MM/DD/YYYY) (Social Security Nunber)
5. DOCUMENT SUBMISSION
All documents submitted in support of a claim must be page numbered and
clearly labeled with the APR's full name and Sulzer Settlement Claim
Number, if known, and attached to this Claim Form.
6. CHANGES TO APR OR REPRESENTATIVE CLAIMANT CONTACT INFORMATION
Class Members must provide to the Claims Administrator updated name,
address, and telephone number information in order to ensure processing
of their claim. Failure to provide updates may result in termination of
a claim or disallowance of benefits. Class Members must include their
Sulzer Settlement Claim Number on all correspondence to the Claims
Administrator.
7. WAIVER OF OPT-OUT RIGHTS
By submitting this form and agreeing to accept benefits pursuant to the
Settlement Agreement, the undersigned knowingly waives all Opt-Out
Rights provided by the Settlement Agreement, as described in the Final
Notice, and agrees not to object to the Settlement Agreement or to
appeal any Court's approval of the Settlement Agreement.
8. RELEASE AND COVENANT NOT TO XXX
x. In consideration of the obligations of Sulzer as set forth in
the Settlement Agreement, I, the undersigned Class Member,
individually and for my heirs, beneficiaries, agents, estate,
executors, administrators, personal representatives,
successors and assignees, and/or, if my claim is that of a
representative of a person who was implanted with an Affected
Product or of the person who has a Derivative Claim arising
out of the implantation of the Affected Product, in that
capacity, whether as heir, beneficiary, agent, estate,
executor, administrator, personal representative, successor,
assignee, guardian, or otherwise, hereby expressly RELEASE AND
FOREVER DISCHARGE AND AGREE NOT TO XXX Xxxxxx and all other
Released Parties as to all Settled Claims. I understand that
certain principles of law provide that a release may not
extend to claims that I do not know or suspect to exist. I am
aware that I may discover claims presently unknown or
unsuspected or facts in addition to or different from those
which I now believe to be true with respect to the matters
released herein which may be applicable to this Settlement.
Despite such principles of law, I HEREBY KNOWINGLY AND
VOLUNTARILY RELINQUISH THE PROTECTIONS OF ALL SUCH FEDERAL OR
STATE LAWS, RIGHTS, RULES OR LEGAL PRINCIPLES THAT MAY BE
APPLICABLE AS FOLLOWS: I FULLY, FINALLY, AND FOREVER SETTLE
AND RELEASE ANY AND ALL SETTLED CLAIMS, including assigned
claims, whether known or unknown, asserted or unasserted,
regardless of the legal theory, existing now or arising in the
future out of or relating to the purchase, use, manufacture,
sale, distribution, promotion, marketing, clinical
investigation, administration, regulatory approval, and
labeling of an Affected Product THAT I MAY HAVE AGAINST ANY
RELEASED PARTY.
YELLOW FORM - 3
b. For purposes of the Release and Covenant Not to Xxx, the terms
"Settled Claims" and "Released Parties" are defined as set
forth in the Settlement Agreement, which is incorporated by
reference.
c. I agree that acceptance of benefits pursuant to the Settlement
Agreement settles any lawsuit previously initiated by me, if
any, asserting any Settled Claim against Sulzer or any other
Released Party, and I stipulate and agree to the dismissal of
all such claims, suits and proceedings, with prejudice and
without costs and agree to cooperate as reasonably requested
in order to effectuate such a dismissal.
9. CONFIDENTIALITY
The person signing below hereby consents to the disclosure of the
information contained herein to the extent necessary to process claims
for benefits pursuant to the Settlement Agreement.
10. DECLARATION UNDER PENALTY OF PERJURY
Each person signing below acknowledges and understands that this form
is an official document sanctioned by the Court that presides over the
legal action entitled In Re Sulzer Hip Prosthesis and Knee Prosthesis
Product Liability Litigation. Submitting this Claim Form to the Claims
Administrator is equivalent to filing it with the Court. After
reviewing the information that has been provided on this form,
including information, if applicable, that was supplied by a
Board-Certified physician and/or an attorney, each person signing this
form declares under penalty of perjury that the information provided in
this form is true and correct to the best of that person's knowledge
and belief.
-------------------------------------------- -----------------
(Signature of Derivative Claimant) (Date MM/DD/YYYY)
Mail this Claim Form and all attachments to:
Claims Administrator
Sulzer Settlement Trust
X.X. Xxx 00000
Xxxxxxxxx, Xxxx 00000-0000
YELLOW FORM - 4
EXHIBIT G
RED FORM
================================================================================
UNINSURED AFFECTED PRODUCT RECIPIENT
BENEFITS CLAIM FORM
THIS RED FORM IS TO BE USED ONLY BY A CLASS MEMBER REGISTERING FOR SETTLEMENT
BENEFITS AS AN UNINSURED AFFECTED PRODUCT RECIPIENT ("UNINSURED APR") WHO HAS
UNDERGONE AN AFFECTED PRODUCT REVISION SURGERY ("APRS"). THE COMPLETED FORM MUST
BE POSTMARKED TO THE CLAIMS ADMINISTRATOR (C/O SULZER SETTLEMENT TRUST, X.X. XXX
00000, XXXXXXXXX, XXXX 00000-0000) NO LATER THAN (i) 180 DAYS AFTER TRIAL COURT
APPROVAL OR (II) 180 DAYS AFTER AN APRS. AN ORANGE FORM MUST HAVE BEEN
PREVIOUSLY SUBMITTED OR BE SIMULTANEOUSLY SUBMITTED FOR THE CLASS MEMBER TO
QUALIFY TO RECEIVE BENEFITS. SEE THE FINAL NOTICE OF SETTLEMENT OF NATIONWIDE
HIP PROSTHESIS AND KNEE PROSTHESIS PRODUCT LIABILITY CLASS ACTION LITIGATION
("FINAL NOTICE"), THE CLASS MEMBER AND ATTORNEY GUIDE, OR THE SETTLEMENT
AGREEMENT FOR FURTHER INFORMATION. IF THERE IS ANY CONFLICT BETWEEN THE
PROVISIONS OF THIS CLAIM FORM AND THE TERMS OF THE SETTLEMENT AGREEMENT, THE
TERMS OF THE SETTLEMENT AGREEMENT CONTROL.
All responses must be PRINTED or TYPED. By completing this Red Form, you(1) are
registering for benefits under the Settlement Agreement. If you have retained an
attorney regarding your claim, consult with your attorney about your options
under the Settlement Agreement.
1. INDICATE BY CHECKING THE APPROPRIATE BOX BELOW WHETHER THE UNINSURED APR WAS
IMPLANTED WITH A SULZER INTER-OP(TM) SHELL, REPROCESSED INTER-OP(TM) SHELL
OR SULZER TIBIAL BASEPLATE, WHICH WAS THE SUBJECT OF AN APRS. NOTE: CHECK
ONLY ONE BOX. IF THE APR HAS BEEN IMPLANTED WITH MORE THAN ONE AFFECTED
PRODUCT, YOU MUST COMPLETE A CLAIM FORM FOR EACH AFFECTED PRODUCT IMPLANTED.
[ ] UNINSURED APR WAS IMPLANTED WITH A SULZER INTER-OP(TM) SHELL.
OR
[ ] UNINSURED APR WAS IMPLANTED WITH A REPROCESSED INTER-OP(TM) SHELL.
OR
[ ] UNINSURED APR WAS IMPLANTED WITH A SULZER TIBIAL BASEPLATE.
----------
(1) "You" or "your" when used throughout this Claim Form refers to the Uninsured
APR, or, as applicable, to the Representative Claimant of the Uninsured APR.
RED FORM - 1
2. ORANGE FORM SUBMISSION
IN ORDER FOR THIS RED FORM TO BE VALID, ELIGIBLE CLASS MEMBERS MUST HAVE
PREVIOUSLY SUBMITTED OR SIMULTANEOUSLY SUBMIT AN ORANGE FORM. XXXX THE
APPROPRIATE BOX BELOW.
[ ] I have previously submitted an Orange Form.
OR
[ ] I am simultaneously submitting an Orange Form with this Red Form.
3. UNINSURED AFFECTED PRODUCT RECIPIENT INFORMATION
--------------------------- -------- ------------------------------
(First Name) (Middle Initial) (Last Name)
-----------------------------------------------------------------------------
(List all other names that the APR uses or has used during the last ten years)
----------------------------------------------------------------------------
(Street Address)
-
------------------------------- -------- ------------------------------
(City) (State) (Zip Code)
( ) - ( ) -
---------------------------------- -----------------------------------
(Daytime Area Code & Phone Number) (Evening Area Code & Phone Number)
----------------------------------------------------------------------------
(Email Address, if any)
/ / - -
----------------------- -----------------------------------
(Birth Date MM/DD/YYYY) (Social Security Nunber)
--------------------------------
(Sulzer Settlement Claim Number, if known)
Gender: Female [ ] Male [ ]
RED FORM - 2
4. REPRESENTATIVE CLAIMANT INFORMATION
IF YOU ARE THE REPRESENTATIVE CLAIMANT OF A LIVING PERSON OR THE ESTATE OF A
DECEASED PERSON WHO IS OR WAS AN UNINSURED APR AND WHO EITHER HAS OR HAD A
CONDITION THAT YOU BELIEVE QUALIFIES THE UNINSURED APR OR THE ESTATE OF THE
UNINSURED APR FOR COMPENSATION, YOU MUST PROVIDE THE INFORMATION REQUESTED
BELOW.
--------------------------- -------- ------------------------------
(First Name) (Middle Initial) (Last Name)
---------------------------------------------------------------------------
(List all other names that you use or have used during the last ten years)
---------------------------------------------------------------------------
(Street Address)
-
------------------------------- -------- -----------------------------
(City) (State) (Zip Code)
( ) - ( ) -
---------------------------------- ----------------------------------
(Daytime Area Code & Phone Number) (Evening Area Code & Phone Number)
---------------------------------------------------------------------------
(Email Address, if any)
/ / - -
----------------------- ----------------------------------
(Birth Date MM/DD/YYYY) (Social Security Nunber)
---------------------------------------------------------------------------
(Legal Relationship to Uninsured APR, i.e. Trustee, Power of Attorney, etc.)
IF YOU ARE A REPRESENTATIVE CLAIMANT, YOU MUST ATTACH A COPY OF YOUR COURT
APPROVAL OR OTHER AUTHORIZATION TO REPRESENT THE UNINSURED APR IN THIS
SETTLEMENT. XXXX THE APPROPRIATE BOX BELOW TO INDICATE YOUR PREVIOUS OR
CURRENT SUBMISSION OF A COURT APPROVAL OR AUTHORIZATION:
[ ] I have provided the requested documentation previously on another
form and there is no change.
[ ] A copy of my court approval or other authorization to represent the
Uninsured APR is attached.
RED FORM - 3
5. ATTORNEY INFORMATION
Are you represented by an attorney in connection with this claim?
Yes [ ] No [ ]
If "Yes," you must provide the following information.
---------------------------------------------------------------------------
(Law Firm Name)
---------------------------------------------------------------------------
(Attorney's Name)
---------------------------------------------------------------------------
(Street Address)
-
------------------------------- -------- -------------------------------
(City) (State) (Zip Code)
( ) - ( ) -
---------------------------------- -----------------------------------
(Daytime Area Code & Phone Number) (Evening Area Code & Phone Number)
--------------------------------- -----------------------------------
(Email Address, if any) (Attorney Tax Identification Number)
State the date on which your attorney-client fee agreement was signed:
-----------
(MM/DD/YYYY)
NOTE: A copy of such attorney-client agreement must be attached if you
did not previously provide it with your Orange Form.
State the total amount of litigation expenses that were incurred in relation
to your claim(s): $____________
NOTE: An itemization of all litigation expenses must be attached.
6. IMPLANTATION OF AFFECTED PRODUCT
Date of implantation of Affected Product:
--------------
(MM/DD/YYYY)
Hospital where implantation of Affected Product was performed:
---------------------------------------------------------------------------
(Hospital Name)
---------------------------------------------------------------------------
(Street Address)
-
---------------------------- -------- -------------------------------
(City) (State) (Zip Code)
( ) - ( ) -
------------------------------ -------------------------------
(Area Code & Telephone Number) (Fax Area Code & Number)
RED FORM - 4
Implanting surgeon of Affected Product:
----------------------------- ------ --------------------------
(Surgeon's First Name) (Middle Initial) (Last Name)
---------------------------------------------------------------------------
(Street Address)
-
---------------------------- -------- -------------------------------
(City) (State) (Zip Code)
( ) - ( ) -
------------------------------ -------------------------------
(Area Code & Telephone Number) (Fax Area Code & Number)
7. UNINSURED REMOVAL OF AFFECTED PRODUCT
Date of uninsured removal of Affected Product: / /
-------------
(MM/DD/YYYY)
Hospital where uninsured removal of Affected Product was performed:
---------------------------------------------------------------------------
(Hospital Name)
---------------------------------------------------------------------------
(Street Address)
-
---------------------------- -------- -------------------------------
(City) (State) (Zip Code)
( ) - ( ) -
------------------------------ -------------------------------
(Area Code & Telephone Number) (Fax Area Code & Number)
Surgeon for uninsured removal of Affected Product:
----------------------------- ------ --------------------------
(Surgeon's First Name) (Middle Initial) (Last Name)
---------------------------------------------------------------------------
(Street Address)
-
---------------------------- -------- -------------------------------
(City) (State) (Zip Code)
( ) - ( ) -
------------------------------ -------------------------------
(Area Code & Telephone Number) (Fax Area Code & Number)
RED FORM - 5
8. UNINSURED MEDICAL EXPENSES INCURRED AS A RESULT OF APRS
Amount of medical expenses PAID BY CLASS MEMBER as a result of the APRS
(expenses for each provider must be listed separately).
Provider Total Amount of Xxxx Amount Paid
-------- -------------------- -----------
-------- -------------------- -----------
-------- -------------------- -----------
-------- -------------------- -----------
-------- -------------------- -----------
For each expense listed above, the following documentation must be
submitted:
a. Proof of payment of the medical expenses incurred as a result of the
APRS. The following is acceptable proof: (1) A canceled check
evidencing payment of the uninsured medical expenses; or (2) a
cashier's check stub evidencing the payment of the uninsured medical
expenses; OR
b. A Declaration from the billing department(s) of the provider(s) for
each expense listed above indicating the amount of uninsured medical
expenses incurred that were paid by the Uninsured APR.
Amount of medical expenses that remains DUE AND OWING as a result of the
APRS (expenses for each provider must be listed separately).
Provider Total Amount of Xxxx Amount Paid
-------- -------------------- -----------
-------- -------------------- -----------
-------- -------------------- -----------
-------- -------------------- -----------
-------- -------------------- -----------
NOTE: A statement from the provider(s) must be submitted for each expense
listed above indicating the amount of the total xxxx and any amount that is
due and owing. If you require additional space, check here " and attach a
separate sheet.
RED FORM - 6
9. DOCUMENT SUBMISSION
All documents submitted in support of a claim must be page numbered and
clearly labeled with the Uninsured APR's full name and Sulzer
Settlement Claim Number, if known, and attached to this Claim Form.
10. CHANGES TO APR OR REPRESENTATIVE CLAIMANT CONTACT INFORMATION
Class Members must provide to the Claims Administrator updated name,
address, and telephone number information in order to ensure processing
of their claim. Failure to provide updates may result in termination of
a claim or disallowance of benefits. Class Members must include their
Sulzer Settlement Claim Number on all correspondence to the Claims
Administrator.
11. WAIVER OF OPT-OUT RIGHTS
By submitting this form and agreeing to accept benefits pursuant to the
Settlement Agreement, the undersigned knowingly waive(s) all Opt-Out
Rights provided by the Settlement Agreement, as described in the Final
Notice and agree(s) not to object to the Settlement Agreement or to
appeal any Court's approval of the Settlement Agreement.
12. RELEASE AND COVENANT NOT TO XXX
x. In consideration of the obligations of Sulzer as set forth in
the Settlement Agreement, I, the undersigned Class Member,
individually and for my heirs, beneficiaries, agents, estate,
executors, administrators, personal representatives,
successors and assignees, and/or if my claim is that of a
representative of a person who was implanted with an Affected
Product or of the person who has a Derivative Claim arising
out of the implantation of the Affected Product, in that
capacity, whether as heir, beneficiary, agent, estate,
executor, administrator, personal representative, successor,
assignee, guardian, or otherwise, hereby expressly RELEASE AND
FOREVER DISCHARGE, AND AGREE NOT TO XXX Xxxxxx and all other
Released Parties as to all Settled Claims. I understand that
certain principles of law provide that a release may not
extend to claims which I do not know or suspect to exist. I am
aware that I may discover claims presently unknown or
unsuspected or facts in addition to or different from those
which I now believe to be true with respect to the matters
released herein which may be applicable to this Settlement.
Despite such principles of law, I HEREBY KNOWINGLY AND
VOLUNTARILY RELINQUISH THE PROTECTIONS OF ALL SUCH FEDERAL OR
STATE LAWS, RIGHTS, RULES OR LEGAL PRINCIPLES THAT MAY BE
APPLICABLE AS FOLLOWS: I FULLY, FINALLY, AND FOREVER SETTLE
AND RELEASE ANY AND ALL SETTLED CLAIMS, including assigned
claims, whether known or unknown, asserted or unasserted,
regardless of the legal theory, existing now or arising in the
future out of or relating to the purchase, use, manufacture,
sale, distribution, promotion, marketing, clinical
investigation, administration, regulatory approval, and
labeling of an Affected Product THAT I MAY HAVE AGAINST ANY
RELEASED PARTY.
b. For purposes of the Release and Covenant Not to Xxx, the terms
"Settled Claims" and "Released Parties" are defined as set
forth in the Settlement Agreement, which is incorporated by
reference.
c. I agree that acceptance of benefits pursuant to the Settlement
Agreement settles any lawsuit previously initiated by me, if
any, asserting any Settled Claim against Sulzer or any other
Released Party, and I stipulate and agree to the dismissal of
all such claims, suits and proceedings, with
RED FORM - 7
prejudice and without costs and agree to cooperate as
reasonably requested in order to effectuate such a dismissal.
13. CONFIDENTIALITY
The person(s) signing below hereby consent(s) to the disclosure of the
information contained herein to the extent necessary to process claims
for benefits pursuant to the Settlement Agreement.
14. DECLARATION UNDER PENALTY OF PERJURY
Each person signing below acknowledges and understands that this form
is an official document sanctioned by the Court that presides over the
legal action entitled In Re Sulzer Hip Prosthesis and Knee Prosthesis
Product Liability Litigation. Submitting this Claim Form to the Claims
Administrator is equivalent to filing it with the Court. After
reviewing the information that has been provided on this form,
including information, if applicable, that was supplied by a
Board-Certified physician and/or an attorney, each person signing this
form declares under penalty of perjury that all of the information
provided in this form is true and correct to the best of his or her
knowledge, information and belief. Further, each person signing below
declares under penalty of perjury that the information provided in this
form is true and correct to the best of that person's knowledge and
belief, and further declares that at the time of the APRS, the APR had
no private, state, federal or other health care insurance for any
medical care.
------------------------------------------------------------------- -----------------
(Signature of Uninsured APR, if living) (Date MM/DD/YYYY)
OR
------------------------------------------------------------------ ----------------
(Signature of Each Representative Claimant of Uninsured APR, if any) (Date MM/DD/YYYY)
Mail this Claim Form and all attachments to:
Claims Administrator
Sulzer Settlement Trust
X.X. Xxx 00000
Xxxxxxxxx, Xxxx 00000-0000
RED FORM - 8
Annex I
AFFECTED PRODUCTS
(OTHER THAN REPROCESSED INTER-OP SHELLS)
LOT NUMBERS
I. INTER-OP SHELL LOT NUMBERS
1285448-B 1308057 1309240
1295134 1308058 1309240-A
1295155 1308059 1309241
1295156 1308060 1309241-A
1295159 1308061 1309242
1295163 1308062 1309242-A
1295164 1308063 1309243
1295165 1308064 1309243-A
1304742 1308065 1309946
1304751 1308066 1309947
1304752 1308067 1309948
1304752-A 1308068 1309949
1305391 1308416 1310552
1305393 1308417 1310553
1305398 1308418 1310731
1306149 1308419 1310732
1306149-A 1308420 1310756
1306149-B 1308719 1310757
1306998 1308719-A 1310758
1307650 1308720 1310759
1307652 1308720-A 1310760
1307653 1308721 1310890
1307654 1308721-A 1310891
1307655 1308722 1310892
1307656 1308722-A 1310893
1307659 1308723 1310894
1307661 1308724 1310895
1307845 1308725 1310896
1307846 1308726 1310897
1307848 1308727 1310898
1307849 1308728 1310899
1307850 1308729 1310900
1308054 1308730 1310901
1308054-A 1308731 1310902
1308055 1308732 1310903
1308055-A 1308733 1310904
1308056 1309239 1311021
1308056-A 1309239-A 1311022
ANNEX I-1
1311023 1312806 1315720
1311024 1313479 1315721
1311024-A 1313480 1315722
1311025 1313481 1315723
1311615 1313482 1315724
1311615-A 1313483 1315725
1311616 1313484 1315726
1311839 1313485 1315727
1311840 1313486 1315728
1311841 1313487 1315729
1311842 1313488 1315730
1311843 1313489 1315731
1311844 1313490 1315732
1311845 1313491 1315832
1311846 1313492 1315833
1311847 1313493 1315834
1311848 1314438 1315834-A
1311849 1314439 1315835
1311850 1314440 1315835-A
1311851 1314441 1315836
1311852 1314442 1315836-A
1311853 1314443 1315837
1312377 1314444 1315837-A
1312378 1314445 1316605
1312379 1314446 1316606
1312380 1314447 1316607
1312381 1314448 1316608
1312382 1314449 1316609
1312383 1314450 1316610
1312384 1314451 1316611
1312385 1314452 1316612
1312386 1314535 1316613
1312387 1314535-A 1316614
1312388 1315174 1316615
1312794 1315175 1316616
1312795 1315176 1316617
1312796 1315177 1317187
1312797 1315178 1317188
1312798 1315179 1317189
1312799 1315180 1317190
1312800 1315181 1317191
1312801 1315182 1317192
1312802 1315183 1317193
1312803 1315184 1317194
1312804 1315185 1317195
1312805 1315186 1317196
ANNEX I-2
1317197 1319352 1321187
1317198 1319353 1321718
1317199 1319354 1321718-A
1318017 1319355 1321719
1318018 1319884 1321720
1318019 1320035 1321721
1318020 1320036 1321722
1318021 1320037 1321723
1318022 1320037-A 1321724
1318023 1320038 1321725
1318024 1320039 1321726
1318025 1320040 1321726-A
1318026 1320040-A 1322348
1318027 1320041 1322349
1318028 1320042 1322350
1318029 1320043 1322351
1318030 1320044 1322352
1318031 1320045 1322353
1318393 1320046 1322513
1318393-A 1320047 1322514
1318619 1320048 1322515
1318620 1320049 1322516
1318621 1320547 1322517
1318622 1320548 1322518
1318623 1320549 1322519
1318624 1320550 1322520
1318625 1320605 1322521
1318626 1320606 1322522
1318627 1320750 1322523
1318628 1320751 1322524
1318629 1320752 1322525
1318630 1320753 1322526
1318631 1320754 1322527
1318632 1320755 1323095
1318633 1320756 1323096
1319341 1320757 1323097
1319342 1320757-A 1323098
1319343 1320758 1323099
1319344 1321179 1323100
1319345 1321180 1323101
1319346 1321181 1323102
1319347 1321182 1323103
1319348 1321183 1323104
1319349 1321184 1323105
1319350 1321185 1323106
1319351 1321186 1323592
ANNEX I-3
1323593 1325150 1327467
1323594 1325151 1327468
1323595 1325152 1327469
1323596 1325153 1327470
1323597 1325154 1327471
1323598 1325155 1327472
1323599 1325156 1327473
1323600 1325824 1327474
1323601 1325825 1328485
1323602 1325826 1328486
1323603 1325827 1328487
1323604 1325828 1328488
1323605 1325829 1328489
1323606 1325830 1328490
1323863 1325831 1328491
1323864 1325832 1328492
1323865 1325833 1328493
1323865-A 1325834 1328494
1323968 1325835 1328495
1323968-A 1325836 1328496
1323969 1325836-A 1328497
1323970 1325836-B 1328498
1323970-A 1325837 1328499
1324306 1325838 1329481
1324307 1326812 1329482
1324308 1326813 1329483
1324309 1326814 1329484
1324310 1326815 1329485
1324311 1326816 1329486
1324312 1326817 1329487
1324313 1326818 1329488
1324314 1326819 1329489
1324564 1326820 1329490
1324565 1326821 1329491
1324566 1326822 1329492
1324567 1326823 1329493
1324568 1326824 1329494
1324569 1326825 1329495
1325142 1326826 1329521
1325143 1327460 1330175
1325144 1327461 1330176
1325145 1327462 1330177
1325146 1327463 1330297
1325147 1327464 1330298
1325148 1327465 1330299
1325149 1327466 1330300
ANNEX I-4
1330301 1332209 1334103
1330302 1332210 1334104
1330303 1332211 1334105
1330304 1332212 1334967
1330305 1332213 1334968
1330306 1332214 1335883
1330307 1332215 1335884
1330308 1332216 1335885
1330309 1332217 1335886
1330310 1332218 1335887
1330311 1332219 1335888
1330312 1332220 1335889
1330313 1332221 1335890
1330314 1332222 1335891
1330315 1332223 1335892
1330316 1332224 1335893
1330818 1332225 1335894
1330819 1332837 1335895
1331256 1332838 1335896
1331257 1332839 1335897
1331258 1332840 1336834
1331259 1332841 1336835
1331260 1332842 1336836
1331261 1332843 1336837
1331262 1332844 1336838
1331263 1332845 1336839
1331264 1332846 1336840
1331265 1332847 1336841
1331266 1332848 1336842
1331267 1332849 1336843
1331268 1332850 1336844
1331269 1332851 1336845
1331270 1334089 1336846
1331271 1334090 1336847
1331272 1334091 1336848
1331695 1334092 1337711
1331696 1334093 1337712
1331697 1334094 1337713
1331698 1334095 1337714
1331698-A 1334096 1337715
1331699 1334097 1337716
1331700 1334098 1337717
1331701 1334099 1337718
1331702 1334100 1337719
1331703 1334101 1337720
1331704 1334102 1337721
ANNEX I-5
1337722 1341102 1343986
1337723 1341103 1345339
1337724 1341104 1345340
1337725 1342081 1345341
1338806 1342082 1345342
1338848 1342083 1345343
1338849 1342084 1345344
1338850 1342085 1345345
1338851 1342086 1345346
1338852 1342087 1345347
1338853 1342088 1345348
1338854 1342089 1345349
1338855 1342090 1345350
1338856 1342091 1345351
1338857 1342092 1345352
1338858 1342985 1345353
1338859 1342986 1346313
1338860 1342987 1346314
1338861 1342988 1346315
1340094 1342989 1346316
1340095 1342990 1346317
1340096 1342991 1346318
1340097 1342992 1346319
1340098 1342993 1346320
1340099 1342994 1346321
1340100 1342995 1346322
1340101 1342996 1346323
1340102 1342997 1346324
1340103 1342998 1346325
1340104 1342999 1346326
1340105 1343971 1346327
1340106 1343972 1347376
1340107 1343973 1347377
1340108 1343974 1347378
1341090 1343975 1347379
1341091 1343976 1347380
1341092 1343977 1347381
1341093 1343978 1347382
1341094 1343979 1347383
1341095 1343980 1347384
1341096 1343981 1347385
1341097 1343982 1347386
1341098 1343983 1347387
1341099 1343984 1348286
1341100 1343985 1348287
1341101 1343985-B 1348288
ANNEX I-6
1348289 1354268 1357292
1348290 1354269 1357293
1348291 1354270 1357294
1348292 1354271 1357295
1348293 1354272 1357296
1348294 1354273 1357297
1348295 1354274 1357298
1348296 1354275 1357299
1348297 1354276 1357300
1348298 1354277 1357301
1348299 1354278 1358279
1348300 1354279 1358280
1348474 1354280 1358281
1348475 1354281 1358282
1348936 1354282 1358283
1348937 1354283 1358284
1348938 1354284 1358285
1348939 1356234 1358286
1348940 1356235 1358287
1348941 1356236 1358288
1348942 1356237 1358289
1348943 1356238 1358290
1348944 1356239 1358291
1348945 1356240 1358292
1348946 1356241 1358293
1348947 1356242 1359105
1348948 1356637 1359106
1353455 1356638 1359107
1353456 1356639 1359108
1353457 1356640 1359109
1353458 1356641 1359110
1353459 1356642 1359111
1353460 1356643 1359112
1353461 1356644 1359113
1353462 1356645 1359114
1353463 1356646 1359115
1353464 1356647 1359116
1353465 1356648 1359117
1353466 1356649 1359118
1353467 1356650 1359119
1353468 1356651 1360020
1353469 1357287 1360021
1354264 1357288 1360022
1354265 1357289 1360023
1354266 1357290 1360024
1354267 1357291 1360025
ANNEX I-7
1360026 1361654 1364635
1360027 1361655 1364636
1360028 1361656 1364637
1360029 1361656-A 1364638
1360030 1361657 1364639
1360031 1361658 1364640
1360756 1361658-A 1364641
1360757 1362518 1364642
1360758 1362518-A 1364642-A
1360759 1362519 1364643
1360760 1362520 1364644
1360761 1362521 1364645
1360762 1362522 1364646
1360763 1362523 1365496
1360764 1362524 1365497
1360765 1362525 1365498
1360770 1362526 1365499
1360771 1362527 1365500
1360772 1362528 1365501
1360773 1362529 1365502
1360774 1362530 1365503
1360775 1362531 1365504
1360776 1362532 1365505
1360777 1363171 1365506
1360778 1363172 1365507
1360779 1363441 1365508
1360780 1363442 1365509
1360781 1363443 1365510
1360782 1363444 1366383
1360783 1363445 1366384
1360784 1363446 1366385
1361387 1363447 1366386
1361388 1363448 1366387
1361389 1363449 1366388
1361390 1363450 1366389
1361391 1363451 1366390
1361644 1363452 1366391
1361645 1363453 1366392
1361646 1363454 1366393
1361647 1363455 1366394
1361648 1364629 1366395
1361649 1364630 1366396
1361650 1364631 1366397
1361651 1364632 1367345
1361652 1364633 1367346
1361653 1364634 1367347
ANNEX I-8
1367348 1370521 1372835
1367349 1370522 1372836
1367350 1370523 1372837
1367351 1370524 1372838
1367352 1370525 1372839
1367353 1370526 1372840
1367354 1370527 1372841
1367355 1370528 1372842
1367355-A 1370946 1372843
1367356 1370947 1372844
1367357 1370948 1372845
1367358 1370949 1372846
1367359 1370950 1372847
1368235 1370951 1372848
1368236 1370952 1373690
1368237 1370952-A 1373691
1368238 1370953 1373692
1368239 1370954 1373693
1368240 1370955 1373694
1368241 1370956 1373695
1368242 1370957 1373696
1368243 1370958 1373697
1368244 1370959 1373698
1368245 1370960 1373699
1368246 1371669 1373700
1368247 1371670 1373701
1368248 1371671 1373827
1368249 1371672 1373828
1369483 1371673 1373829
1369484 1371674 1373830
1369484-A 1371675 1373831
1369485 1371676 1373832
1369486 1371677 1373833
1369487 1371678 1373834
1369488 1371679 1373835
1369489 1371680 1373836
1369490 1371681 1373837
1369491 1371682 1373838
1369491-A 1371683 1373839
1369492 1371684 1373840
1369493 1371685 1373840-A
1369494 1371686 1373841
1369495 1372831 1373842
1369496 1372832 1375157
1369497 1372833 1375158
1370520 1372834 1375159
ANNEX I-9
1375160 1377075 1379110
1375161 1377076 1379111
1375162 1377077 1379112
1375163 1377078 1379113
1375164 1377079 1379114
1375164-A 1377080 1379115
1375165 1377891 1379116
1375166 1377892 1379117
1375167 1377893 1379118
1375168 1377894 1379119
1375169 1377895 1379119-A
1375170 1378105 1379120
1375171 1378106 1379121
1375172 1378107 1379122
1375173 1378108 1379123
1375174 1378108-A 1379124
1375175 1378725 1379125
1375176 1378726 1379126
1376139 1378727 1379127
1376140 1378728 1379128
1376140-A 1378762 1379129
1376141 1378763 1379567
1376142 1378764 1379568
1376143 1378765 1379569
1376144 1378974 1379570
1376145 1378976 1379571
1376146 1378977 1379572
1376147 1378979 1379573
1376148 1378982 1379574
1376149 1378983 1379575
1376150 1378984 1379576
1377061 1378985 1379577
1377061-A 1379096 1379578
1377062 1379097 1379579
1377063 1379098 1379580
1377064 1379099 1379581
1377065 1379100 1379582
1377066 1379101 1379583
1377067 1379102 1379584
1377068 1379103 1379585
1377069 1379104 1379586
1377070 1379105 1380593
1377071 1379106 1380594
1377072 1379107 1380595
1377073 1379108 1380596
1377074 1379109 1380597
ANNEX I-10
1380598 1382536 1384831
1380599 1382537 1384832
1380600 1382538 1384833
1380601 1382539 1384833-A
1380602 1382540 1386285
1380603 1382541 1386286
1380604 1382542 1386287
1380605 1382543 1386288
1380606 1382544 1386288-A
1380607 1382545 1386289
1380608 1382546 1386290
1380609 1382547 1386291
1380609-A 1382548 1386292
1380610 1382549 1386293
1380611 1382550 1386294
1380612 1382551 1386295
1381222 1382552 1386296
1381223 1382553 1386297
1381224 1382554 1386298
1381225 1382555 1386299
1381226 1382556 1386300
1381227 1382557 1386301
1381228 1382558 1386302
1381229 1382559 1386303
1381230 1382560 1386304
1381231 1382561 1386305
1381232 1384097 1386306
1381233 1384098 1386307
1381234 1384519 1386308
1381235 1384814 1386309
1381236 1384815 1386310
1381237 1384816 1386311
1381238 1384817 1386312
1381239 1384818 1386313
1381240 1384819 1386314
1381241 1384820 1386315
1382526 1384821 1386316
1382527 1384822 1386317
1382528 1384823 1386318
1382529 1384824 1386319
1382530 1384825 1386320
1382531 1384826 1386321
1382532 1384827 1386322
1382533 1384828 1386323
1382534 1384829 1386324
1382535 1384830 1388309
ANNEX I-11
1388310 1390418-A 1393101
1388311 1391304 1393102
1388312 1391305 1393103
1388313 1391306 1393104
1388314 1391307 1393105
1388315 1391308 1393106
1388316 1391309 1393107
1388317 1391310 1393107-A
1388318 1391310-A 1393108
1388319 1391311 1393109
1388320 1391312 1393110
1388321 1391313 1393111
1388322 1391314 1393112
1388323 1391315 1393113
1388324 1391316 1393114
1388325 1391317 1393115
1388326 1391318 1393116
1388327 1391319 1394057
1388328 1391320 1394058
1389344 1391321 1394059
1389345 1391322 1394060
1389346 1391323 1394061
1389347 1392115 1394062
1389348 1392116 1394063
1389925 1392117 1394064
1389926 1392118 1394065
1390399 1392119 1394066
1390400 1392120 1394067
1390401 1392121 1394068
1390402 1392122 1394069
1390403 1392123 1394070
1390404 1392124 1394071
1390405 1392125 1394072
1390406 1392126 1394073
1390407 1392127 1394074
1390408 1392128 1394075
1390409 1392129 1394076
1390410 1392130 1395032
1390411 1392131 1397531
1390412 1392132 1398229
1390413 1392133 1398229-A
1390414 1392134 1398230
1390415 1393097 1398230-A
1390416 1393098 1398231
1390417 1393099 1398232
1390418 1393100 1398233
ANNEX I-12
1398234 1399515 1400675
1398235 1399516 1400676
1398236 1399517 1400677
1398237 1400062 1400678
1398237-A 1400063 1400679
1398238 1400064 1400680
1398611 1400065 1400681
1398964 1400066 1400682
1398965 1400067 1400683
1398966 1400068 1400684
1398968 1400069 1400685
1398968-A 1400070 1400686
1398969 1400071 1400687
1398970 1400072 1400688
1398971 1400073 1400689
1398972 1400074 1400690
1398973 1400075 1400691
1398974 1400076 1400692
1399487 1400077 1400693
1399488 1400078 1400694
1399488-A 1400079 1400695
1399488-B 1400080 1400696
1399489 1400081 1400697
1399490 1400082 1400698
1399490-A 1400083 1400699
1399494 1400084 1400700
1399495 1400085 1400701
1399496 1400086 1400702
1399497 1400087 1400703
1399498 1400088 1401003
1399499 1400089 1401011
1399500 1400090 1401014
1399501 1400091 1401036
1399502 1400092 1401046
1399503 1400093 1401062
1399504 1400094 1401063
1399505 1400095 1401147
1399506 1400095-A 1401157
1399507 1400096 1401166
1399508 1400096-A 1401178
1399509 1400668 1401189
1399510 1400669 1401190
1399511 1400670 1401190-A
1399512 1400671 1401283
1399513 1400672 1401291
1399514 1400674 1401298
ANNEX I-13
1401311 1402098 1402745
1401317 1402099 1402746
1401317-A 1402100 1402747
1401352 1402101 1402748
1401450 1402102 1402749
1401451 1402103 1402750
1401452 1402104 1402751
1401453 1402105 1402751-A
1401453-A 1402106 1402752
1401453-B 1402107 1402753
1401454 1402108 1402754
1401458 1402109 1402755
1401459 1402110 1402756
1401467 1402134 1402757
1401476 1402145 1402758
1401483 1402148 1402784
1401491 1402155 1402806
1401578 1402173 1402807
1401584 1402271 1402810
1401591 1402289 1402822
1401597 1402294 1402839
1401601 1402312 1402849
1401611 1402358 1402858
1401647 1402367 1402892
1401729 1402450 1402946
1401747 1402467 1402955
1401752 1402471 1402971
1401789 1402476 1402987
1401797 1402500 1402989
1401843 1402511 1403002
1401852 1402576 1403031
1401862 1402587 1403041
1401867 1402635 1403092
1401873 1402651 1403102
1401980 1402674 1403112
1401992 1402678 1403152
1401999 1402703 1403183
1402026 1402735 1403188
1402036 1402739 1403216
1402091 1402739-A 1403229
1402092 1402739-B 1403232
1402093 1402740 1403243
1402094 1402741 1403274
1402095 1402742 1403281
1402096 1402743 1403376
1402097 1402744 1403390
ANNEX I-14
1403398 1403887 1404518
1403416 1403959 1404520
1403419 1403971 1404531
1403438 1403981 1404536
1403507 1403989 1404548
1403522 1404072 1404638
1403527 1404085 1404648
1403537 1404096 1404659
1403559 1404101 1404665
1403564 1404105 1404670
1403566 1404116 1404708
1403567 1404209 1404721
1403568 1404210 1404747
1403569 1404211 1404764
1403570 1404212 1404766
1403571 1404213 1404770
1403572 1404214 1404821
1403573 1404215 1404854
1403574 1404216 1404876
1403575 1404217 1404890
1403576 1404218 1404897
1403577 1404245 1404907
1403578 1404247 1405040
1403578-A 1404252 1405041
1403579 1404264 1405059
1403580 1404269 1405062
1403580-A 1404292 1405072
1403581 1404303 1405112
1403582 1404304 1405172
1403583 1404304-A 1405179
1403584 1404305 1405185
1403585 1404306 1405197
1403586 1404307 1405202
1403587 1404308 1405255
1403598 1404309 1405256
1403691 1404309-A 1405257
1403706 1404310 1405258
1403708 1404311 1405259
1403724 1404312 1405260
1403756 1404380 1405261
1403770 1404381 1405262
1403804 1404384 1405263
1403814 1404386 1405264
1403823 1404396 1405345
1403831 1404407 1405355
1403860 1404509 1405371
ANNEX I-15
1405381 1406177 1406835
1405392 1406178 1406836
1405464 1406179 1406836-A
1405484 1406180 1406836-B
1405493 1406181 1406836-C
1405503 1406182 1406837
1405518 1406182-A 1406838
1405571 1406182-B 1406839
1405572 1406182-C 1406840
1405573 1406183 1406841
1405574 1406183-A 1406842
1405575 1406184 1406843
1405576 1406185 1406844
1405577 1406185-A 1406844-A
1405578 1406186 1406845
1405599 1406187 1406846
1405612 1406188 1406847
1405618 1406189 1406847-A
1405625 1406190 1406848
1405630 1406236 1406848-A
1405638 1406246 1406849
1405700 1406250 1406849-A
1405708 1406257 1406849-B
1405715 1406271 1406894
1405721 1406282 1406899
1405808 1406370 1406904
1405817 1406388 1406919
1405833 1406407 1406924
1405841 1406419 1407003
1405850 1406426 1407004
1405976 1406433 1407005
1405993 1406456 1407014
1406000 1406519 1407019
1406015 1406528 1407030
1406018 1406542 1407041
1406116 1406548 1407098
1406131 1406554 1407102
1406137 1406704 1407133
1406137-A 1406704-A 1407152
1406142 1406714 1407160
1406156 1406728 1407174
1406172 1406737 1407247
1406173 1406741 1407262
1406174 1406832 1407271
1406175 1406833 1407284
1406176 1406834 1407289
ANNEX I-16
1407291 1408109 1408708
1407376 1408119 1408798
1407389 1408127 1408809
1407392 1408151 1408814
1407399 1408196 1408822
1407408 1408197 1408834
1407427 1408198 1408937
1407510 1408199 1408938
1407514 1408200 1408939
1407523 1408201 1408940
1407611 1408212 1408941
1407612 1408212-A 1408942
1407613 1408213 1408943
1407614 1408213-A 1408944
1407615 1408214 1408945
1407616 1408214-A 1408946
1407617 1408215 1409001
1407618 1408217 1409015
1407619 1408218 1409023
1407620 1408219 1409032
1407621 1408220 1409039
1407622 1408221 1409049
1407623 1408222 1409110
1407624 1408223 1409111
1407625 1408224 1409120
1407626 1408225 1409134
1407627 1408226 1409140
1407628 1408239 1409150
1407629 1408249 1409160
1407694 1408257 1409176
1407695 1408266 1409244
1407708 1408361 1409264
1407714 1408367 1409270
1407732 1408383 1409285
1407829 1408398 1409289
1407840 1408436 1409295
1407850 1408534 1409360
1407858 1408547 1409375
1407870 1408560 1409389
1407921 1408569 1409400
1407957 1408573 1409411
1407968 1408582 1409416
1407977 1408662 1409491
1407992 1408684 1409509
1408024 1408688 1409531
1408086 1408701 1409536
ANNEX I-17
1409543 1410295 1410400
1409630 1410301 1410401
1409637 1410327 1410402
1409648 1410359 1410403
1409654 1410360 1410404
1409726 1410361 1410405
1409727 1410362 1410406
1409728 1410363 1410407
1409729 1410364 1410407-A
1409730 1410365 1410408
1409731 1410366 1410488
1409732 1410367 1410489
1409733 1410368 1410503
1409734 1410369 1410504
1409735 1410370 1410520
1409736 1410371 1410522
1409737 1410372 1410526
1409738 1410373 1410530
1409739 1410374 1410538
1409739-A 1410375 1410608
1409740 1410376 1410642
1409741 1410377 1410649
1409797 1410378 1410655
1409798 1410379 1410739
1409816 1410380 1410751
1409819 1410381 1410759
1409824 1410381-A 1410767
1409837 1410382 1410773
1409956 1410382-A 1410852
1409969 1410383 1410863
1409978 1410384 1410873
1409985 1410385 1410882
1409990 1410386 1410888
1410041 1410387 1410943
1410054 1410388 1410958
1410062 1410389 1410965
1410070 1410390 1410985
1410084 1410391 1411059
1410149 1410392 1411069
1410159 1410393 1411077
1410173 1410394 1411082
1410184 1410395 1411180
1410191 1410396 1411196
1410261 1410397 1411202
1410276 1410398 1411208
1410287 1410399 1411211
ANNEX I-18
1411293 1411651 1412289
1411308 1411652 1412321
1411317 1411653 1412327
1411323 1411654 1412334
1411334 1411655 1412365
1411401 1411656 1412401
1411420 1411657 1412401-A
1411427 1411658 1412402
1411434 1411659 1412403
1411437 1411660 1412404
1411517 1411661 1412404-A
1411539 1411662 1412405
1411545 1411663 1412406
1411550 1411664 1412407
1411556 1411665 1412407-A
1411621 1411666 1412408
1411622 1411667 1412409
1411623 1411668 1412410
1411624 1411669 1412411
1411625 1411670 1412412
1411626 1411671 1412413
1411627 1411718 1412414
1411628 1411731 1412415
1411629 1411745 1412416
1411630 1411752 1412417
1411631 1411758 1412498
1411632 1411842 1412539
1411633 1411866 1412551
1411634 1411874 1412558
1411635 1411881 1412562
1411636 1411886 1412654
1411637 1411973 1412668
1411638 1411988 1412679
1411639 1411995 1412699
1411640 1412005 1412708
1411640-A 1412010 1413049
1411641 1412055 1413050
1411642 1412077 1413051
1411643 1412085 1413052
1411644 1412096 1413053
1411645 1412108 1413054
1411646 1412181 1413055
1411647 1412200 1413056
1411648 1412216 1413057
1411649 1412221 1413058
1411650 1412228 1413059
ANNEX I-19
1413060 1413926 1414767
1413061 1413948 1414779
1413062 1413959 1414780
1413063 1413991 1414781
1413063-A 1413992 1414781-A
1413064 1413993 1414782
1413065 1413994 1414783
1413066 1413995 1414784
1413067 1413996 1414785
1413068 1413997 1414786
1413069 1413998 1414787
1413070 1413999 1414788
1413086 1414000 1414789
1413087 1414002 1414790
1413417 1414003 1414791
1413455 1414004 1414792
1413461 1414005 1414793
1413462 1414006 1414808
1413463 1414007 1414817
1413464 1414107 1414848
1413465 1414111 1414853
1413466 1414117 1414859
1413467 1414127 1414865
1413468 1414155 1414942
1413469 1414250 1415055
1413473 1414257 1415061
1413474 1414267 1415083
1413475 1414273 1415090
1413476 1414320 1415102
1413477 1414345 1415123
1413478 1414364 1415123-A
1413511 1414372 1415227
1413531 1414384 1415249
1413551 1414395 1415260
1413557 1414401 1415270
1413566 1414471 1415331
1413638 1414481 1415351
1413668 1414496 1415361
1413675 1414505 1415361-A
1413680 1414511 1415378
1413702 1414525 1415393
1413764 1414650 1415402
1413795 1414691 1415411
1413799 1414695 1415461
1413809 1414700 1415474
1413911 1414726 1415501
ANNEX I-20
1415521 1416348 1417136
1415531 1416370 1417142
1415558 1416395 1417150
1415567 1416405 1417159
1415568 1416419 1417187
1415624 1416446 1417197
1415658 1416447 1417227
1415664 1416457 1417228
1415671 1416490 1417244
1415703 1416511 1417264
1415732 1416536 1417280
1415733 1416543 1417289
1415734 1416550 1417321
1415735 1416600 1417328
1415736 1416657 1417356
1415737 1416666 1417364
1415738 1416671 1417480
1415739 1416676 1417517
1415740 1416685 1417519
1415741 1416686 1417535
1415742 1416689 1417549
1415743 1416693 1417594
1415744 1416696 1417626
1415766 1416762 1417627
1415815 1416789 1417799
1415824 1416790 1417818
1415838 1416800 1417819
1415857 1416802 1417820
1415861 1416803 1417821
1415961 1416804 1417822
1416057 1416870 1417823
1416058 1416876 1417837
1416059 1416888 1417856
1416060 1416961 1417865
1416061 1416973 1417888
1416193 1416977 1417897
1416194 1416987 1417912
1416195 1416997 1417934
1416196 1417004 1417958
1416197 1417010 1418012
1416198 1417019 1418022
1416199 1417066 1418032
1416200 1417080 1418035
1416201 1417080-A 1418035-A
1416202 1417098 1418045
1416203 1417113 1418050
ANNEX I-21
1418068 1418761 1419485
1418079 1418770 1419495
1418102 1418781 1419498
1418174 1418790 1419505
1418174-A 1418870 1419513
1418177 1418879 1419536
1418185 1418892 1419539
1418192 1418894 1419585
1418206 1418902 1419644
1418222 1418916 1419646
1418291 1418923 1419674
1418314 1418949 1419696
1418318 1419018 1419699
1418330 1419027 1419703
1418343 1419028 1419706
1418408 1419033 1419712
1418432 1419039 1419721
1418434 1419051 1419756
1418441 1419067 1419763
1418445 1419117 1419772
1418446 1419125 1419821
1418460 1419135 1419853
1418485 1419141 1419859
1418545 1419146 1419864
1418559 1419153 1419866
1418572 1419170 1419876
1418576 1419181 1419910
1418580 1419220 1419913
1418592 1419233 1420017
1418607 1419234 1420060
1418617 1419235 1420067
1418655 1419236 1420070
1418656 1419237 1420094
1418657 1419238 1420120
1418658 1419239 1420153
1418659 1419240 1420220
1418660 1419244 1420225
1418661 1419245 1420236
1418662 1419273 1420238
1418663 1419303 1420254
1418664 1419308 1420261
1418707 1419327 1420265
1418740 1419357 1420277
1418740-A 1419358 1420307
1418744 1419385 1420353
1418750 1419472 1420412
ANNEX I-22
1420413 1421037 1421815
1420413-A 1421047 1421826
1420414 1421059 1421827
1420415 1421073 1421861
1420416 1421073-A 1421892
1420417 1421111 1421893
1420418 1421112 1421894
1420433 1421113 1421895
1420435 1421115 1421896
1420450 1421120 1421897
1420457 1421227 1421996
1420464 1421228 1421997
1420475 1421249 1422001
1420478 1421281 1422006
1420547 1421287 1422025
1420548 1421299 1422137
1420622 1421328 1422146
1420625 1421332 1422154
1420630 1421334 1422199
1420632 1421334-A 1422209
1420640 1421335 1422210
1420663 1421439 1422210-A
1420664 1421444 1422296
1420666 1421450 1422344
1420695 1421476 1422347
1420784 1421496 1422354
1420785 1421498 1422373
1420786 1421504 1422386
1420792 1421516 1422389
1420797 1421600 1422390
1420812 1421603 1422404
1420850 1421610 1422406
1420861 1421618 1422406-A
1420864 1421641 1422407
1420876 1421645 1422505
1420877 1421650 1422506
1420878 1421677 1422507
1420879 1421682 1422524
1420890 1421748 1422525
1420899 1421771 1422526
1420901 1421777 1422563
1420995 1421782 1422566
1420997 1421800 1422576
1421001 1421805 1422593
1421009 1421808 1422622
1421036 1421809 1422627
ANNEX I-23
1422628 1423724 1424847
1422629 1423725 1424848
1422631 1423733 1424850
1422642 1423734 1424851
1422726 1423817 1424852
1422734 1423832 1424853
1422743 1423833 1424854
1422766 1423834 1424916
1422772 1423925 1424917
1422773 1423970 1424942
1422786 1423971 1424947
1422885 1424020 1424954
1422886 1424102 1424971
1422909 1424108 1425006
1422915 1424110 1425007
1422963 1424115 1425010
1422967 1424140 1425011
1423063 1424148 1425012
1423064 1424150 1425013
1423160 1424153 1425015
1423166 1424317 1425017
1423172 1424318 1425019
1423184 1424323 1425020
1423215 1424341 1425021
1423216 1424355 1425095
1423224 1424356 1425112
1423226 1424357 1425117
1423226-A 1424357-A 1425129
1423315 1424463 1425177
1423316 1424469 1425178
1423332 1424483 1425211
1423335 1424503 1425212
1423351 1424525 1425213
1423376 1424527 1425214
1423377 1424530 1425215
1423488 1424607 1425216
1423500 1424644 1425217
1423509 1424657 1425218
1423663 1424670 1425219
1423680 1424685 1425220
1423688 1424780 1425221
1423693 1424781 1425222
1423698 1424789 1425223
1423721 1424792 1425224
1423722 1424795 1425311
1423723 1424846 1425328
ANNEX I-24
1425330 1426627 1427685
1425338 1426628 1427710
1425355 1426636 1427752
1425429 1426638 1427796
1425430 1426641 1427797
1425529 1426702 1427798
1425556 1426703 1427799
1425557 1426704 1427829
1425651 1426705 1427887
1425652 1426706 1427901
1425671 1426707 1427901-A
1425677 1426708 1427910
1425724 1426709 1427916
1425725 1426804 1428128
1425726 1426836 1428136
1425727 1426849 1428140
1425728 1426854 1428161
1425729 1426859 1428173
1425730 1426879 1428228
1425731 1426929 1428381
1425732 1426997 1428387
1425737 1427008 1428405
1425738 1427065 1428414
1425739 1427088 1428445
1425826 1427169 1428452
1425836 1427175 1428453
1425870 1427177 1428454
1425889 1427238 1428455
1425922 1427238-A 1428547
1425997 1427247 1428574
1426015 1427366 1428579
1426020 1427392 1428585
1426031 1427404 1428589
1426049 1427413 1428735
1426220 1427509 1428747
1426241 1427518 1428752
1426244 1427533 1428774
1426256 1427533-A 1428854
1426260 1427546 1428855
1426272 1427557 1428856
1426324 1427586 1428857
1426390 1427587 1428863
1426401 1427588 1428989
1426409 1427589 1429002
1426455 1427673 1429016
1426523 1427681 1429030
ANNEX I-25
1429050 1430239 1431055
1429056 1430240 1431152
1429058 1430241 1431172
1429059 1430243 1431186
1429061 1430256 1431231
1429263 1430362 1431232
1429273 1430383 1431233
1429278 1430393 1431234
1429292 1430397 1431265
1429343 1430427 1431302
1429344 1430443 1431311
1429347 1430445 1431390
1429360 1430446 1431398
1429364 1430447 1431404
1429492 1430484 1431426
1429500 1430485 1431435
1429509 1430580 1431436
1429536 1430590 1431437
1429562 1430590-A 1431438
1429563 1430594 1431466
1429564 1430628 1431521
1429565 1430791 1431522
1429703 1430803 1431523
1429704 1430808 1431524
1429819 1430827 1431525
1429829 1430842 1431526
1429833 1430847 1431527
1429849 1430891 1431528
1429865 1430891-A 1431589
1429876 1430892 1431600
1429877 1430902 1431605
1429878 1430902-A 1431632
1429879 1430927 1431633
1429996 1430936 1431634
1430007 1430946 1431635
1430012 1430946-A 1431636
1430035 1430950 1431786
1430070 1431000 1431794
1430071 1431002 1431799
1430072 1431048 1431827
1430073 1431049 1431840
1430075 1431050 1431841
1430198 1431051 1431843
1430208 1431052 1431844
1430213 1431053 1431845
1430237 1431054 1431846
ANNEX I-26
1431977 1433004 1434222
1431991 1433024 1434233
1431994 1433024-A 1434260
1432013 1433048 1434264
1432049 1433165 1434266
1432050 1433178 1434404
1432056 1433183 1434412
1432058 1433225 1434412-A
1432059 1433236 1434421
1432060 1433237 1434455
1432179 1433238 1434472
1432187 1433264 1434540
1432192 1433330 1434540-A
1432208 1433330-A 1434541
1432240 1433340 1434569
1432253 1433366 1434580
1432333 1433395 1434590
1432356 1433449 1434652
1432356-A 1433516 1434653
1432366 1433516-A 1434654
1432373 1433543 1434681
1432401 1433560 1434685
1432422 1433573 1434743
1432428 1433610 1434744
1432429 1433646 1434769
1432430 1433659 1434775
1432481 1433753 1434781
1432513 1433755 1434797
1432538 1433755-A 1434822
1432542 1433759 1434823
1432578 1433782 1434827
1432578-A 1433796 1434891
1432613 1433838 1434892
1432624 1433839 1434931
1432625 1433912 1434932
1432630 1433932 1434954
1432704 1433949 1434961
1432723 1433955 1434965
1432743 1433963 1434973
1432747 1433984 1435004
1432749 1434015 1435006
1432750 1434019 1435225
1432751 1434053 1435234
1432752 1434117 1435241
1432838 1434209 1435262
1432839 1434214 1435282
ANNEX I-27
1435287 1436562 1437498-A
1435400 1436563 1437503
1435407 1436580 1437504
1435414 1436586 1437506
1435423 1436591 1437529
1435455 1436608 1437545
1435456 1436654 1437556
1435457 1436710 1437559
1435586 1436724 1437589
1435600 1436732 1437592
1435609 1436757 1437593
1435618 1436761 1437599
1435626 1436769 1437632
1435659 1436777 1437679
1435660 1436814 1437766
1435661 1436814-A 1437773
1435731 1436831 1437787
1435745 1436847 1437794
1435750 1436866 1437802
1435750-A 1436896 1437827
1435764 1436903 1437849
1435803 1436919 1437859
1435909 1436922 1437901
1435925 1436962 1437905
1435938 1436973 1437908
1435948 1436997 1437909
1435980 1437046 1437933
1435996 1437060 1437957
1436026 1437074 1437992
1436066 1437079 1438009
1436139 1437080 1438015
1436152 1437082 1438024
1436157 1437086 1438049
1436185 1437100 1438068
1436280 1437119 1438136
1436316 1437171 1438153
1436348 1437237 1438213
1436360 1437258 1438215
1436377 1437273 1438226
1436387 1437287 1438240
1436400 1437296 1438248
1436425 1437313 1438274
1436452 1437342 1438319
1436517 1437427 1438331
1436520 1437490 1438360
1436525 1437498 1438383
ANNEX I-28
1438392 1439386 1440225
1438405 1439401 1440236
1438413 1439437 1440265
1438420 1439455 1440274
1438443 1439464 1440365
1438467 1439465 1440437
1438519 1439474 1440438
1438537 1439515 1440439
1438545 1439522 1440440
1438581 1439533 1440441
1438584 1439535 1440442
1438599 1439551 1440464
1438610 1439555 1440536
1438627 1439568 1440561
1438679 1439573 1440647
1438686 1439611 1440656
1438737 1439640 1440758
1438750 1439666 1440777
1438759 1439667 1440831
1438763 1439678 1440846
1438797 1439689 1440856
1438840 1439705 1440886
1438866 1439711 1440918
1438911 1439728 1440929
1438931 1439755 1440986
1438938 1439791 1441063
1438946 1439804 1441104
1438979 1439857 1441108
1438991 1439860 1441135
1439015 1439871 1441139
1439040 1439875 1441147
1439095 1439886 1441220
1439103 1439911 1441221
1439116 1439921 1441246
1439122 1439938 1441279
1439124 1439993 1441288
1439156 1440001 1441322
1439179 1440018 1441349
1439234 1440031 1441409
1439258 1440037 1441451
1439259 1440077 1441458
1439292 1440089 1441488
1439303 1440104 1441502
1439318 1440139 1441520
1439340 1440198 1441523
1439385 1440205 1441524
ANNEX I-29
1441525 1442787 1443913
1441526 1442795 1443917
1441527 1442801 1443934
1441563 1442855 1443968
1441616 1442869 1444006
1441648 1442891 1444018
1441673 1442905 1444027
1441680 1442917 1444040
1441696 1442923 1444060
1441702 1443007 1444070
1441736 1443075 1444102
1441795 1443108 1444159
1441874 1443144 1444266
1441888 1443165 1444280
1441911 1443179 1444288
1441918 1443303 1444309
1441928 1443332 1444315
1441934 1443333 1444344
1441978 1443334 1444364
1441992 1443335 1444383
1442038 1443336 1444435
1442051 1443337 1444483
1442066 1443338 1444509
1442073 1443369 1444532
1442078 1443458 1444541
1442148 1443468 1444545
1442161 1443507 1444583
1442204 1443514 1444604
1442211 1443522 1444625
1442318 1443540 1444683
1442440 1443559 1444694
1442454 1443615 1444717
1442465 1443693 1444721
1442481 1443712 1444755
1442481-A 1443720 1444783
1442492 1443739 1444798
1442507 1443743 1444892
1442543 1443752 1444915
1442584 1443782 1444925
1442608 1443804 1444951
1442629 1443848 1444958
1442633 1443864 1444962
1442649 1443880 1444987
1442671 1443883 1445056
1442687 1443896 1445113
1442777 1443908 1445154
ANNEX I-30
1445179 1446287 1447300
1445180 1446291 1447310
1445202 1446305 1447313
1445206 1446346 1447328
1445240 1446363 1447336
1445265 1446417 1447341
1445276 1446454 1447362
1445278 1446489 1447420
1445281 1446493 1447537
1445283 1446502 1447602
1445284 1446545 1447620
1445350 1446579 1447631
1445394 1446580 1447634
1445412 1446581 1447645
1445422 1446582 1447660
1445430 1446583 1447673
1445475 1446584 1447700
1445539 1446602 1447758
1445616 1446620 1447803
1445623 1446633 1447812
1445627 1446648 1447814
1445631 1446761 1447874
1445657 1446763 1447885
1445660 1446766 1447892
1445665 1446800 1447919
1445689 1446822 1447950
1445723 1446882 1447968
1445733 1446937 1448031
1445825 1446943 1448054
1445839 1446959 1448060
1445844 1446965 1448086
1445866 1446970 1448094
1445871 1446994 1448101
1445878 1447012 1448134
1445913 1447042 1448197
1445920 1447056 1448212
1445954 1447119 1448234
1446000 1447123 1448249
1446032 1447145 1448253
1446071 1447149 1448277
1446077 1447152 1448286
1446100 1447156 1448341
1446125 1447158 1448371
1446184 1447173 1448397
1446232 1447218 1448425
1446256 1447260 1448436
ANNEX I-31
1448465 1449465 1450439
1448479 1449466 1450456
1448494 1449467 1450467
1448542 1449468 1450479
1448619 1449469 1450497
1448696 1449470 1450520
1448738 1449471 1450521
1448753 1449472 1450522
1448767 1449473 1450523
1448778 1449490 1450524
1448786 1449560 1450525
1448804 1449581 1450526
1448805 1449599 1450539
1448824 1449615 1450609
1448856 1449618 1450667
1448881 1449630 1450707
1448882 1449653 1450729
1448882-A 1449707 1450740
1448909 1449735 1450756
1448956 1449787 1450762
1448983 1449799 1450803
1448996 1449827 1450803-A
1448996-A 1449827-A 1450824
1448997 1449827-B 1450858
1449015 1449832 1450880
1449036 1449855 1450891
1449055 1449862 1450895
1449109 1449918 1450900
1449124 1449963 1450918
1449136 1449975 1450987
1449163 1449979 1450992
1449178 1450007 1451005
1449183 1450010 1451034
1449201 1450021 1451063
1449216 1450045 1451088
1449235 1450085 1451188
1449276 1450182 1451202
1449357 1450221 1451229
1449372 1450230 1451237
1449383 1450251 1451247
1449393 1450251-A 1451261
1449407 1450263 1451329
1449431 1450292 1451356
1449453 1450318 1451445
1449463 1450385 1451450
1449464 1450421 1451459
ANNEX I-32
1451475 1452628 1453625
1451478 1452635 1453643
1451492 1452643 1453660
1451520 1452663 1453693
1451545 1452700 1453701
1451584 1452722 1453754
1451635 1452848 1453760
1451641 1452848-A 1453796
1451664 1452870 1453803
1451674 1452875 1453817
1451693 1452901 1453845
1451722 1452913 1453855
1451748 1452937 1453880
1451832 1452955 1453963
1451840 1453056 1454052
1451844 1453109 1454061
1451853 1453136 1454061-A
1451874 1453143 1454100
1451890 1453158 1454108
1451914 1453177 1454123
1451961 1453186 1454149
1452022 1453221 1454176
1452070 1453244 1454240
1452075 1453276 1454363
1452080 1453325 1454374
1452081 1453338 1454398
1452092 1453352 1454407
1452120 1453354 1454420
1452123 1453356 1454449
1452136 1453357 1454474
1452140 1453375 1454521
1452172 1453386 1454550
1452237 1453394 1454556
1452289 1453407 1454566
1452354 1453429 1454572
1452364 1453472 1454615
1452395 1453513 1454622
1452395-A 1453531 1454629
1452399 1453534 1454654
1452406 1453535 1454704
1452419 1453537 1454732
1452443 1453538 1454747
1452513 1453540 1454748
1452563 1453568 1454749
1452602 1453584 1454750
1452608 1453620 1454751
ANNEX I-33
1454793 1456026 1457240
1454801 1456040 1457257
1454832 1456057 1457276
1454840 1456080 1457303
1454842 1456106 1457311
1454881 1456132 1457328
1454915 1456201 1457353
1454936 1456228 1457375
1454972 1456236 1457393
1455031 1456241 1457442
1455038 1456268 1457495
1455067 1456276 1457525
1455081 1456289 1457547
1455110 1456334 1457563
1455141 1456353 1457594
1455182 1456372 1457607
1455253 1456449 1457629
1455277 1456455 1457673
1455363 1456475 1457695
1455375 1456480 1457695-A
1455402 1456489 1457718
1455407 1456517 1457765
1455424 1456581 1457778
1455447 1456618 1457813
1455477 1456661 1457828
1455540 1456671 1457843
1455561 1456671-A 1457894
1455568 1456672 1457907
1455581 1456695 1458003
1455593 1456706 1458017
1455624 1456767 1458022
1455648 1456794 1458022-A
1455680 1456820 1458031
1455728 1456836 1458035
1455736 1456842 1458048
1455741 1456851 1458050
1455746 1456854 1458073
1455749 1456857 1458080
1455817 1456912 1458092
1455825 1456936 1458104
1455838 1457001 1458165
1455876 1457085 1458184
1455905 1457115 1458300
1455905-A 1457129 1458311
1455960 1457138 1458334
1456012 1457188 1458348
ANNEX I-34
1458365 1459429 1460496
1458387 1459526 1460548
1458398 1459532 1460563
1458424 1459559 1460564
1458483 1459575 1460599
1458495 1459581 1460605
1458496 1459605 1460617
1458516 1459616 1460646
1458516-A 1459645 1460713
1458525 1459708 1460740
1458551 1459722 1460809
1458569 1459738 1460823
1458579 1459765 1460839
1458604 1459776 1460852
1458679 1459794 1460868
1458706 1459816 1460886
1458715 1459836 1460905
1458736 1459880 1460916
1458736-A 1459884 1460979
1458748 1459892 1461021
1458767 1459922 1461034
1458782 1459927 1461054
1458874 1459936 1461061
1458912 1459962 1461070
1458962 1459988 1461089
1458962-A 1460030 1461178
1458972 1460071 1461201
1459061 1460123 1461270
1459061-A 1460132 1461319
1459076 1460148 1461322
1459084 1460168 1461347
1459095 1460174 1461358
1459115 1460195 1461375
1459115-A 1460210 1461400
1459193 1460211 1461420
1459219 1460221 1461433
1459223 1460238 1461497
1459224 1460286 1461541
1459228 1460301 1461542
1459252 1460315 1461607
1459260 1460364 1461610
1459297 1460372 1461621
1459308 1460376 1461660
1459324 1460401 1461678
1459345 1460433 1461692
1459405 1460460 1461777
ANNEX I-35
1461783 1462810 1463773
1461793 1462833 1463801
1461802 1462837 1463817
1461817 1462860 1463892
1461825 1462879 1463951
1461840 1462899 1464086
1461889 1462901 1464125
1461901 1462922 1464190
1461910 1462978 1464198
1461979 1463001 1464202
1461992 1463006 1464244
1462000 1463021 1464245
1462015 1463028 1464252
1462025 1463039 1464274
1462041 1463075 1464281
1462074 1463107 1464404
1462101 1463119 1464435
1462120 1463151 1464508
1462182 1463167 1464522
1462194 1463197 1464533
1462211 1463200 1464536
1462228 1463205 1464545
1462233 1463240 1464581
1462240 1463263 1464591
1462288 1463297 1464624
1462319 1463348 1464628
1462343 1463349 1464666
1462359 1463350 1464695
1462373 1463351 1464761
1462390 1463352 1464809
1462400 1463353 1464816
1462420 1463377 1464826
1462432 1463425 1464859
1462456 1463432 1464877
1462502 1463443 1464916
1462538 1463459 1464953
1462550 1463470 1465048
1462560 1463474 1465056
1462657 1463505 1465060
1462661 1463536 1465072
1462665 1463587 1465096
1462692 1463657 1465118
1462713 1463719 1465150
1462752 1463720 1465173
1462780 1463753 1465238
1462794 1463763 1465242
ANNEX I-36
1465247 1465289 1465372
1465256 1465313
1465277 1465346
II. TIBIAL BASEPLATE LOT NUMBERS
1443185 1444790 1446179
1443186 1444791 1446180
1443188 1444792 1446181
1443194 1444988 1446181-A
1443481 1444990 1446182
1443482 1444992 1446370
1443483 1444993 1446371
1443484 1444994 1446373
1443484-A 1445242 1446373-A
1443701 1445244 1446374
1443702 1445245 1446375
1443703 1445246 1446377
1443704 1445247 1446378
1443798 1445248 1446561
1443799 1445249 1446562
1443800 1445526 1446563
1443801 1445527 1446564
1443961 1445528 1446565
1443962 1445529 1446565-A
1443963 1445530 1446828
1443964 1445531 1446829
1444113 1445532 1446831
1444114 1445702 1446832
1444115 1445703 1446833
1444116 1445704 1446834
1444350 1445705 1446834-A
1444351 1445706 1446835
1444352 1445707 1447019
1444353 1445708 1447020
1444354 1445928 1447021
1444386 1445929 1447022
1444389 1445930 1447023
1444390 1445931 1447024
1444608 1445932 1447025
1444609 1445933 1447184
1444610 1445934 1447184-A
1444611 1445934-A 1447185
1444612 1446176 1447186
1444788 1446177 1447186-A
1444789 1446178 1447187
ANNEX I-37
1447188 1448540 1450092
1447188-A 1448541 1450093
1447189 1448806 1450094
1447189-A 1448807 1450095
1447190 1448808 1450096
1447499 1448809 1450399
1447500 1448810 1450400
1447501 1448810-A 1450401
1447503 1448811 1450403
1447505 1448812 1450404
1447506 1449001 1450405
1447507 1449002 1450406
1447679 1449003 1450481
1447680 1449004 1450482
1447681 1449005 1450483
1447682 1449006 1450484
1447683 1449007 1450485
1447684 1449225 1450486
1447685 1449227 1450487
1447907 1449228 1450795
1447908 1449229 1450796
1447909 1449230 1450799
1447910 1449231 1450802
1447911 1449232 1451038
1447914 1449422 1451039
1447915 1449424 1451040
1448111 1449426 1451041
1448112 1449427 1451042
1448113 1449428 1451043
1448114 1449429 1451044
1448115 1449430 1451330
1448116 1449699 1451331
1448117 1449700 1451332
1448358 1449701 1451333
1448359 1449702 1451334
1448360 1449703 1451335
1448361 1449704 1451337
1448362 1449872 1451511
1448363 1449873 1451512
1448363-A 1449874 1451513
1448364 1449874-A 1451514
1448535 1449875 1451515
1448536 1449876 1451516
1448537 1449877 1451517
1448538 1450089 1451517-A
1448539 1450090 1451698
ANNEX I-38
1451699 1453236 1454718
1451700 1453237 1454719
1451702 1453238 1454919
1451705 1453412 1454920
1451708 1453415 1454921
1451710 1453417 1454922
1451931 1453418 1454923
1451932 1453419 1454924
1451933 1453424 1454925
1451934 1453425 1455102
1451936 1453653 1455103
1451937 1453654 1455104
1451938 1453655 1455105
1452145 1453656 1455106
1452146 1453657 1455107
1452147 1453657-A 1455411
1452148 1453658 1455412
1452149 1453658-A 1455415
1452150 1453659 1455417
1452151 1453878 1455419
1452436 1453879 1455422
1452437 1453881 1455716
1452438 1453882 1455717
1452439 1453884 1455718
1452440 1453885 1455719
1452441 1453887 1455721
1452442 1454212 1455722
1452678 1454213 1455867
1452679 1454215 1455868
1452681 1454216 1455870
1452682 1454217 1455871
1452685 1454219 1455873
1452688 1454267 1455874
1452689 1454439 1456083
1453070 1454440 1456085
1453070-A 1454441 1456086
1453071 1454442 1456087
1453072 1454443 1456088
1453073 1454444 1456089
1453074 1454445 1456588
1453075 1454713 1456589
1453076 1454714 1456590
1453232 1454714-A 1456591
1453233 1454715 1456592
1453234 1454716 1456593
1453235 1454717 1456602
ANNEX I-39
1456603 1458157 1459974
1456604 1458158 1459975
1456605 1458475 1459976
1456606 1458477 1459977
1456607 1458479 1459978
1456708 1458479-A 1459979
1456709 1458480 1460630
1456710 1458481 1460631
1456711 1458481-A 1460632
1456712 1458482 1460633
1456713 1458583 1460634
1457166 1458584 1460635
1457167 1458585 1461006
1457169 1458586 1461008
1457170 1458588 1461010
1457171 1458589 1461012
1457172 1458857 1461013
1457336 1458858 1461014
1457337 1458859 1461186
1457338 1458860 1461187
1457339 1458861 1461188
1457340 1458862 1461189
1457537 1459200 1461190
1457538 1459201 1461191
1457539 1459202 1461409
1457540 1459203 1461410
1457542 1459204 1461411
1457544 1459205 1461412
1457545 1459389 1461413
1457770 1459390 1461414
1457771 1459391 1461664
1457772 1459392 1461665
1457773 1459393 1461666
1457774 1459394 1461667
1457775 1459622 1461668
1457776 1459623 1461669
1458009 1459624 1461846
1458010 1459625 1461848
1458011 1459626 1461849
1458012 1459627 1461851
1458013 1459801 1461853
1458014 1459803 1461855
1458153 1459804 1462055
1458154 1459805 1462056
1458155 1459806 1462057
1458156 1459810 1462058
ANNEX I-40
1462059 1463788 1465799
1462060 1463789 1465800
1462274 1463790 1465801
1462275 1464085 1465802
1462276 1464088 1465803
1462277 1464089 1465804
1462278 1464090 1465985
1462279 1464091 1465986
1462436 1464092 1465987
1462437 1464275 1465988
1462438 1464276 1466393
1462439 1464277 1466394
1462440 1464278 1466395
1462441 1464279 1466396
1462701 1464280 1466397
1462702 1464755 1466398
1462703 1464755-A 1466427
1462704 1464756 1466428
1462705 1464757 1466429
1462706 1464758 1466430
1462864 1464759 1466431
1462865 1464760 1466837
1462866 1464906 1466838
1462867 1464908 1466839
1462868 1464909 1466840
1462870 1464910 1466840-A
1463074 1464911 1466841
1463077 1464912 1467022
1463078 1465174 1467023
1463079 1465175 1467024
1463080 1465176 1467025
1463082 1465177 1467027
1463300 1465178 1467233
1463301 1465179 1467238
1463302 1465328 1467240
1463303 1465329 1467242
1463304 1465330 1467243
1463513 1465331 1467474
1463515 1465332 1467475
1463517 1465335 1467475-A
1463519 1465551 1467476
1463520 1465552 1467477
1463523 1465553 1467478
1463785 1465554 1467479
1463786 1465555 1467720
1463787 1465556 1467721
ANNEX I-41
1467722
1467723
1467724
1467725
ANNEX X-00
Xxxxx XX
XXXXXXXXXXX XXXXX-XX XXXXXX
XXX XXXXXXX
0000000-XX 0000000-XX 1332850-CA
1291961-CA 1320752-CA 1333898-CA
1308054-CA 1320756-CA 1334103-CA
1308055-CA 1320757-CA 1334105-CA
1308056-CA 1321185-CA 1336838-CA
1308067-CA 1321186-CA 1336848-CA
1308068-CA 1321187-CA 1337719-CA
1308416-CA 1321718-CA 1338851-CA
1308417-CA 1321723-CA 1338855-CA
1308719-CA 1321725-CA 1340094-CA
1308720-CA 1321726-CA 1341100-CA
1308721-CA 1321795-CA 1341103-CA
1308722-CA 1321803-CA 1341104-CA
1308731-CA 1322519-CA 1342088-CA
1309239-CA 1322523-CA 1342089-CA
1309240-CA 1323864-CA 1342090-CA
1309241-CA 1323865-CA 1342091-CA
1309242-CA 1323968-CA 1342092-CA
1310756-CA 1325153-CA 1342112-CA
1310904-CA 1326407-CA 1342113-CA
1311023-CA 1328499-CA 1342996-CA
1311024-CA 1329482-CA 1342999-CA
1311615-CA 1329495-CA 1346316-CA
1311616-CA 1329521-CA 1346324-CA
1311841-CA 1330313-CA 1346325-CA
1312377-CA 1330314-CA 1346326-CA
1312801-CA 1330315-CA 1346327-CA
1314535-CA 1330316-CA 1347375-CA
1315720-CA 1331698-CA 1347377-CA
1315732-CA 1331700-CA 1347385-CA
1315834-CA 1331702-CA 1347387-CA
1315835-CA 1331703-CA 1348286-CA
1315836-CA 1331704-CA 1348287-CA
1315837-CA 1332221-CA 1348289-CA
1316614-CA 1332222-CA 1348299-CA
1318017-CA 1332224-CA 1348300-CA
1318028-CA 1332225-CA 1348474-CA
1318393-CA 1332837-CA 1348475-CA
1319355-CA 1332840-CA 1348936-CA
1320036-CA 1332846-CA 1348938-CA
1320037-CA 1332848-CA 1348943-CA
1320548-CA 1332849-CA 1348947-CA
ANNEX II-1
1348948-CA 1363447-CA 1371682-CA
1353463-CA 1363452-CA 1371683-CA
1354266-CA 1363454-CA 1372839-CA
1354281-CA 1364026-CA 1372843-CA
1354283-CA 1364027-CA 1373840-CA
1354284-CA 1364028-CA 1374002-CA
1354430-CA 1364050-CA 1374021-CA
1354646-CA 1364053-CA 1375168-CA
1354654-CA 1364367-CA 1375175-CA
1354664-CA 1364630-CA 1375176-CA
1354665-CA 1364634-CA 1375335-CA
1354666-CA 1364637-CA 1376142-CA
1354672-CA 1364638-CA 1376146-CA
1354675-CA 1364643-CA 1376149-CA
1354677-CA 1364644-CA 1377067-CA
1354680-CA 1364646-CA 1377072-CA
1356234-CA 1365498-CA 1377076-CA
1356235-CA 1365502-CA 1377077-CA
1356639-CA 1365508-CA 1377895-CA
1356640-CA 1366383-CA 1378106-CA
1356643-CA 1366386-CA 1378728-CA
1356648-CA 1366394-CA 1378762-CA
1356651-CA 1366651-CA 1378764-CA
1358290-CA 1367345-CA 1378765-CA
1359113-CA 1367346-CA 1378972-CA
1360021-CA 1367347-CA 1378974-CA
1360024-CA 1367349-CA 1378976-CA
1360026-CA 1367350-CA 1379096-CA
1360029-CA 1367352-CA 1379100-CA
1360030-CA 1367353-CA 1379103-CA
1360757-CA 1367355-CA 1379107-CA
1360758-CA 1367356-CA 1379109-CA
1360759-CA 1367357-CA 1379112-CA
1360760-CA 1367358-CA 1379115-CA
1360761-CA 1367359-CA 1379117-CA
1360762-CA 1368238-CA 1379118-CA
1360765-CA 1368245-CA 1379121-CA
1361389-CA 1368249-CA 1379122-CA
1361390-CA 1369486-CA 1379123-CA
1361391-CA 1369492-CA 1379124-CA
1361654-CA 1369497-CA 1379125-CA
1362520-CA 1370951-CA 1379129-CA
1362526-CA 1370953-CA 1379571-CA
1362529-CA 1370960-CA 1379573-CA
1362530-CA 1371675-CA 1379574-CA
1363172-CA 1371676-CA 1379578-CA
ANNEX II-2
1380596-CA 1391586-CA 1399488-CA
1380608-CA 1391588-CA 1399489-CA
1380609-CA 1391590-CA 1399490-CA
1380610-CA 1391595-CA 1399494-CA
1381231-CA 1391596-CA 1399499-CA
1382541-CA 1392115-CA 1399500-CA
1382546-CA 1392118-CA 1399501-CA
1382549-CA 1392119-CA 1399506-CA
1383258-CA 1392122-CA 1399511-CA
1383259-CA 1392126-CA 1400062-CA
1383261-CA 1392127-CA 1400068-CA
1384801-CA 1392130-CA 1400074-CA
1384810-CA 1392131-CA 1400076-CA
1384817-CA 1393097-CA 1400079-CA
1384820-CA 1393098-CA 1400092-CA
1384821-CA 1393101-CA 1400093-CA
1384824-CA 1393104-CA 1400095-CA
1384825-CA 1393105-CA 1400096-CA
1384828-CA 1393109-CA 1400668-CA
1384829-CA 1393111-CA 1400669-CA
1384830-CA 1393116-CA 1400671-CA
1386265-CA 1393121-CA 1400672-CA
1386288-CA 1394053-CA 1401063-CA
1386292-CA 1394055-CA 1401298-CA
1386300-CA 1394060-CA 1401311-CA
1386308-CA 1394072-CA 1401352-CA
1386309-CA 1394076-CA 1401450-CA
1386312-CA 1394866-CA 1401451-CA
1386317-CA 1394868-CA 1401452-CA
1388238-CA 1394869-CA 1401453-CA
1388312-CA 1395015-CA 1401454-CA
1388315-CA 1395032-CA 1401584-CA
1388316-CA 1395558-CA 1401601-CA
1388321-CA 1396837-CA 1401729-CA
1388324-CA 1397530-CA 1401797-CA
1388328-CA 1397531-CA 1401843-CA
1389925-CA 1398234-CA 1401852-CA
1390407-CA 1398235-CA 1401980-CA
1390408-CA 1398236-CA 1402036-CA
1390414-CA 1398237-CA 1402091-CA
1391309-CA 1398238-CA 1402092-CA
1391312-CA 1398966-CA 1402093-CA
1391314-CA 1398968-CA 1402095-CA
1391320-CA 1398969-CA 1402096-CA
1391322-CA 1398974-CA 1402097-CA
1391323-CA 1399487-CA 1402098-CA
ANNEX II-3
1402099-CA 1403419-CA 1404381-CA
1402100-CA 1403522-CA 1404407-CA
1402101-CA 1403564-CA 1404518-CA
1402102-CA 1403566-CA 1404531-CA
1402103-CA 1403568-CA 1404548-CA
1402104-CA 1403571-CA 1404665-CA
1402105-CA 1403572-CA 1404708-CA
1402140-CA 1403573-CA 1404721-CA
1402145-CA 1403574-CA 1404770-CA
1402148-CA 1403576-CA 1404854-CA
1402173-CA 1403577-CA 1404897-CA
1402271-CA 1403578-CA 1404907-CA
1402476-CA 1403579-CA 1405040-CA
1402500-CA 1403580-CA 1405072-CA
1402511-CA 1403581-CA 1405112-CA
1402576-CA 1403582-CA 1405179-CA
1402587-CA 1403583-CA 1405197-CA
1402651-CA 1403584-CA 1405255-CA
1402703-CA 1403585-CA 1405256-CA
1402739-CA 1403586-CA 1405257-CA
1402740-CA 1403587-CA 1405258-CA
1402741-CA 1403756-CA 1405259-CA
1402742-CA 1403804-CA 1405260-CA
1402744-CA 1403814-CA 1405261-CA
1402745-CA 1403831-CA 1405262-CA
1402747-CA 1403959-CA 1405263-CA
1402748-CA 1403981-CA 1405264-CA
1402749-CA 1404096-CA 1405355-CA
1402750-CA 1404209-CA 1405381-CA
1402751-CA 1404211-CA 1405392-CA
1402752-CA 1404215-CA 1405493-CA
1402753-CA 1404217-CA 1405503-CA
1402754-CA 1404245-CA 1405518-CA
1402755-CA 1404247-CA 1405571-CA
1402756-CA 1404252-CA 1405572-CA
1402757-CA 1404303-CA 1405573-CA
1402758-CA 1404304-CA 1405575-CA
1402849-CA 1404305-CA 1405576-CA
1402892-CA 1404306-CA 1405577-CA
1402971-CA 1404307-CA 1405578-CA
1403031-CA 1404308-CA 1405618-CA
1403112-CA 1404309-CA 1405630-CA
1403243-CA 1404310-CA 1405721-CA
1403281-CA 1404311-CA 1405841-CA
1403376-CA 1404312-CA 1406015-CA
1403398-CA 1404380-CA 1406018-CA
ANNEX II-4
1406142-CA 1406849-CA 1408199-CA
1406167-CA 1406894-CA 1408200-CA
1406172-CA 1406899-CA 1408201-CA
1406174-CA 1406904-CA 1408212-CA
1406175-CA 1407003-CA 1408213-CA
1406176-CA 1407005-CA 1408214-CA
1406177-CA 1407014-CA 1408215-CA
1406178-CA 1407133-CA 1408217-CA
1406179-CA 1407174-CA 1408218-CA
1406180-CA 1407262-CA 1408219-CA
1406181-CA 1407392-CA 1408220-CA
1406182-CA 1407399-CA 1408221-CA
1406183-CA 1407510-CA 1408222-CA
1406184-CA 1407514-CA 1408223-CA
1406185-CA 1407611-ca 1408225-CA
1406186-CA 1407613-CA 1408226-CA
1406187-CA 1407615-CA 1408239-CA
1406188-CA 1407616-CA 1408257-CA
1406189-CA 1407617-CA 1408266-CA
1406190-CA 1407618-CA 1408361-CA
1406246-CA 1407619-CA 1408436-CA
1406250-CA 1407620-CA 1408569-CA
1406271-CA 1407621-CA 1408573-CA
1406282-CA 1407622-CA 1408582-CA
1406370-CA 1407623-CA 1408688-CA
1406419-CA 1407624-CA 1408809-CA
1406426-CA 1407625-CA 1408937-CA
1406456-CA 1407626-CA 1408938-CA
1406528-CA 1407627-CA 1408940-CA
1406704-CA 1407628-CA 1408941-CA
1406714-CA 1407695-CA 1408942-CA
1406728-CA 1407708-CA 1408944-CA
1406737-CA 1407714-CA 1408945-CA
1406832-CA 1407732-CA 1408946-CA
1406834-CA 1407829-CA 1409049-CA
1406836-CA 1407921-CA 1409244-CA
1406837-CA 1407957-CA 1409264-CA
1406838-CA 1407968-CA 1409285-CA
1406839-CA 1407977-CA 1409416-CA
1406842-CA 1408024-CA 1409491-CA
1406843-CA 1408086-CA 1409509-CA
1406844-CA 1408127-CA 1409536-CA
1406845-CA 1408151-CA 1409543-CA
1406846-CA 1408196-CA 1409648-CA
1406847-CA 1408197-CA 1409654-CA
1406848-CA 1408198-CA 1409726-CA
ANNEX II-5
1409727-CA 1410383-CA 1411293-CA
1409728-CA 1410384-CA 1411308-CA
1409730-CA 1410385-CA 1411401-CA
1409731-CA 1410386-CA 1411420-CA
1409732-CA 1410387-CA 1411434-CA
1409733-CA 1410388-CA 1411517-CA
1409734-CA 1410389-CA 1411539-CA
1409735-CA 1410390-CA 1411545-CA
1409736-CA 1410391-CA 1411563-CA
1409737-CA 1410392-CA 1411621-CA
1409738-CA 1410394-CA 1411622-CA
1409739-CA 1410395-CA 1411624-CA
1409740-CA 1410396-CA 1411626-CA
1409741-CA 1410397-CA 1411627-CA
1409797-CA 1410398-CA 1411628-CA
1409819-CA 1410399-CA 1411629-CA
1409824-CA 1410400-CA 1411630-CA
1409969-CA 1410401-CA 1411631-CA
1409978-CA 1410402-CA 1411632-CA
1409990-CA 1410403-CA 1411633-CA
1410041-CA 1410404-CA 1411634-CA
1410191-CA 1410405-CA 1411635-CA
1410276-CA 1410406-CA 1411636-CA
1410295-CA 1410407-CA 1411637-CA
1410301-CA 1410408-CA 1411638-CA
1410359-CA 1410488-CA 1411639-CA
1410360-CA 1410489-CA 1411640-CA
1410361-CA 1410522-CA 1411643-CA
1410364-CA 1410526-CA 1411644-CA
1410365-CA 1410608-CA 1411645-CA
1410366-CA 1410642-CA 1411646-CA
1410368-CA 1410649-CA 1411647-CA
1410369-CA 1410751-CA 1411648-CA
1410370-CA 1410767-CA 1411649-CA
1410371-CA 1410852-CA 1411650-CA
1410372-CA 1410873-CA 1411651-CA
1410373-CA 1410943-CA 1411652-CA
1410374-CA 1410958-CA 1411653-CA
1410375-CA 1410965-CA 1411654-CA
1410376-CA 1410985-CA 1411655-CA
1410377-CA 1411069-CA 1411656-CA
1410378-CA 1411082-CA 1411657-CA
1410379-CA 1411180-CA 1411658-CA
1410380-CA 1411202-CA 1411659-CA
1410381-CA 1411208-CA 1411660-CA
1410382-CA 1411211-CA 1411661-CA
ANNEX II-6
1411662-CA 1412654-CA 1413638-CA
1411663-CA 1412679-CA 1413668-CA
1411664-CA 1412699-CA 1413680-CA
1411665-CA 1413049-CA 1413799-CA
1411666-CA 1413050-CA 1413911-CA
1411667-CA 1413051-CA 1413948-CA
1411668-CA 1413052-CA 1413959-CA
1411669-CA 1413053-CA 1413991-CA
1411670-CA 1413054-CA 1413992-CA
1411671-CA 1413055-CA 1413993-CA
1411718-CA 1413056-CA 1413994-CA
1411745-CA 1413057-CA 1413995-CA
1411758-CA 1413058-CA 1413996-CA
1411842-CA 1413059-CA 1413997-CA
1411874-CA 1413060-CA 1413998-CA
1411881-CA 1413061-CA 1413999-CA
1411886-CA 1413062-CA 1414000-CA
1412055-CA 1413063-CA 1414002-CA
1412085-CA 1413064-CA 1414003-CA
1412108-CA 1413065-CA 1414004-CA
1412181-CA 1413067-CA 1414005-CA
1412221-CA 1413068-CA 1414006-CA
1412228-CA 1413069-CA 1414007-CA
1412334-CA 1413070-CA 1414107-CA
1412365-CA 1413086-CA 1414111-CA
1412401-CA 1413087-CA 1414117-CA
1412402-CA 1413417-CA 1414155-CA
1412403-CA 1413455-CA 1414250-CA
1412404-CA 1413461-CA 1414267-CA
1412405-CA 1413462-CA 1414273-CA
1412406-CA 1413463-CA 1414345-CA
1412407-CA 1413464-CA 1414372-CA
1412408-CA 1413465-CA 1414395-CA
1412409-CA 1413466-CA 1414401-CA
1412410-CA 1413467-CA 1414471-CA
1412411-CA 1413468-CA 1414525-CA
1412412-CA 1413469-CA 1414695-CA
1412413-CA 1413473-CA 1414700-CA
1412414-CA 1413474-CA 1414726-CA
1412415-CA 1413475-CA 1414767-CA
1412416-CA 1413476-CA 1414779-CA
1412417-CA 1413477-CA 1414780-CA
1412498-CA 1413478-CA 1414781-CA
1412539-CA 1413551-CA 1414782-CA
1412558-CA 1413557-CA 1414783-CA
1412562-CA 1413566-CA 1414784-CA
ANNEX II-7
1414785-CA 1415857-CA 1417136-CA
1414786-CA 1415861-CA 1417142-CA
1414787-CA 1415961-CA 1417159-CA
1414788-CA 1416057-CA 1417187-CA
1414789-CA 1416058-CA 1417197-CA
1414790-CA 1416061-CA 1417244-CA
1414791-CA 1416193-CA 1417264-CA
1414792-CA 1416194-CA 1417280-CA
1414793-CA 1416195-CA 1417289-CA
1414853-CA 1416196-CA 1417328-CA
1414859-CA 1416197-CA 1417356-CA
1414942-CA 1416198-CA 1417364-CA
1415055-CA 1416199-CA 1417480-CA
1415083-CA 1416200-CA 1417535-CA
1415102-CA 1416201-CA 1417549-CA
1415123-CA 1416202-CA 1417594-CA
1415227-CA 1416203-CA 1417626-CA
1415260-CA 1416348-CA 1417799-CA
1415331-CA 1416370-CA 1417818-CA
1415351-CA 1416405-CA 1417819-CA
1415361-CA 1416419-CA 1417820-CA
1415378-CA 1416457-CA 1417821-CA
1415393-CA 1416490-CA 1417822-CA
1415402-CA 1416511-CA 1417823-CA
1415501-CA 1416543-CA 1417837-CA
1415521-CA 1416550-CA 1417865-CA
1415531-CA 1416600-CA 1417897-CA
1415567-CA 1416657-CA 1417912-CA
1415568-CA 1416666-CA 1417934-CA
1415664-CA 1416671-CA 1417958-CA
1415703-CA 1416686-CA 1418012-CA
1415732-CA 1416693-CA 1418032-CA
1415733-CA 1416696-CA 1418035-CA
1415734-CA 1416789-CA 1418050-CA
1415735-CA 1416790-CA 1418068-CA
1415736-CA 1416800-CA 1418079-CA
1415737-CA 1416804-CA 1418102-CA
1415738-CA 1416876-CA 1418174-CA
1415739-CA 1416888-CA 1418177-CA
1415740-CA 1416961-CA 1418192-CA
1415741-CA 1416973-CA 1418206-CA
1415742-CA 1416977-CA 1418291-CA
1415743-CA 1416987-CA 1418318-CA
1415744-CA 1417004-CA 1418343-CA
1415766-CA 1417066-CA 1418408-CA
1415838-CA 1417080-CA 1418460-CA
ANNEX II-8
1418545-CA 1419505-CA 1420622-CA
1418559-CA 1419513-CA 1420625-CA
1418572-CA 1419585-CA 1420630-CA
1418576-CA 1419674-CA 1420632-CA
1418607-CA 1419699-CA 1420640-CA
1418655-CA 1419703-CA 1420663-CA
1418656-CA 1419706-CA 1420664-CA
1418657-CA 1419712-CA 1420666-CA
1418658-CA 1419721-CA 1420695-CA
1418659-CA 1419756-CA 1420785-CA
1418660-CA 1419763-CA 1420786-CA
1418661-CA 1419821-CA 1420797-CA
1418662-CA 1419853-CA 1420812-CA
1418663-CA 1419864-CA 1420850-CA
1418664-CA 1419866-CA 1420864-CA
1418707-CA 1419876-CA 1420876-CA
1418740-CA 1419913-CA 1420877-CA
1418744-CA 1420017-CA 1420878-CA
1418761-CA 1420060-CA 1420890-CA
1418770-CA 1420067-CA 1420901-CA
1418781-CA 1420070-CA 1420995-CA
1418870-CA 1420094-CA 1420997-CA
1418879-CA 1420120-CA 1421001-CA
1418916-CA 1420153-CA 1421009-CA
1418923-CA 1420220-CA 1421037-CA
1418949-CA 1420225-CA 1421059-CA
1419018-CA 1420236-CA 1421073-CA
1419028-CA 1420238-CA 1421112-CA
1419039-CA 1420261-CA 1421113-CA
1419051-CA 1420265-CA 1421115-CA
1419067-CA 1420277-CA 1421227-CA
1419117-CA 1420353-CA 1421228-CA
1419125-CA 1420412-CA 1421249-CA
1419141-CA 1420413-CA 1421281-CA
1419153-CA 1420414-CA 1421287-CA
1419181-CA 1420415-CA 1421328-CA
1419244-CA 1420416-CA 1421332-CA
1419245-CA 1420417-CA 1421334-CA
1419273-CA 1420418-CA 1421439-CA
1419303-CA 1420433-CA 1421444-CA
1419308-CA 1420435-CA 1421450-CA
1419385-CA 1420450-CA 1421472-CA
1419472-CA 1420457-CA 1421476-CA
1419485-CA 1420478-CA 1421496-CA
1419495-CA 1420547-CA 1421516-CA
1419498-CA 1420548-CA 1421600-CA
ANNEX II-9
1421603-CA 1422627-CA 1423834-CA
1421610-CA 1422628-CA 1423970-CA
1421641-CA 1422629-CA 1423971-CA
1421645-CA 1422631-CA 1424020-CA
1421650-CA 1422642-CA 1424102-CA
1421677-CA 1422726-CA 1424110-CA
1421771-CA 1422743-CA 1424115-CA
1421777-CA 1422766-CA 1424148-CA
1421805-CA 1422773-CA 1424150-CA
1421815-CA 1422786-CA 1424153-CA
1421826-CA 1422885-CA 1424317-CA
1421827-CA 1422886-CA 1424318-CA
1421861-CA 1422909-CA 1424323-CA
1421892-CA 1422915-CA 1424341-CA
1421893-CA 1422963-CA 1424355-CA
1421894-CA 1422967-CA 1424356-CA
1421896-CA 1423063-CA 1424463-CA
1421996-CA 1423064-CA 1424483-CA
1422001-CA 1423172-CA 1424503-CA
1422006-CA 1423184-CA 1424525-CA
1422146-CA 1423215-CA 1424527-CA
1422154-CA 1423216-CA 1424607-CA
1422199-CA 1423224-CA 1424644-CA
1422209-CA 1423226-CA 1424657-CA
1422210-CA 1423316-CA 1424670-CA
1422296-CA 1423332-CA 1424780-CA
1422344-CA 1423335-CA 1424781-CA
1422347-CA 1423351-CA 1424789-CA
1422354-CA 1423376-CA 1424792-CA
1422386-CA 1423377-CA 1424795-CA
1422389-CA 1423488-CA 1424846-CA
1422404-CA 1423500-CA 1424847-CA
1422406-CA 1423509-CA 1424848-CA
1422407-CA 1423663-CA 1424850-CA
1422473-CA 1423680-CA 1424851-CA
1422505-CA 1423688-CA 1424852-CA
1422506-CA 1423693-CA 1424853-CA
1422507-CA 1423721-CA 1424854-CA
1422524-CA 1423722-CA 1424916-CA
1422525-CA 1423723-CA 1424917-CA
1422526-CA 1423724-CA 1424947-CA
1422563-CA 1423725-CA 1424951-CA
1422566-CA 1423733-CA 1424954-CA
1422576-CA 1423817-CA 1424971-CA
1422593-CA 1423832-CA 1425006-CA
1422622-CA 1423833-CA 1425007-CA
ANNEX II-10
1425010-CA 1425826-CA 1427404-CA
1425011-CA 1425836-CA 1427413-CA
1425012-CA 1425870-CA 1427509-CA
1425013-CA 1425889-CA 1427546-CA
1425015-CA 1425922-CA 1427586-CA
1425017-CA 1425997-CA 1427587-CA
1425019-CA 1426015-CA 1427588-CA
1425020-CA 1426020-CA 1427589-CA
1425021-CA 1426049-CA 1427673-CA
1425177-CA 1426220-CA 1427681-CA
1425178-CA 1426244-CA 1427685-CA
1425211-CA 1426256-CA 1427752-CA
1425212-CA 1426260-CA 1427796-CA
1425213-CA 1426272-CA 1427797-CA
1425214-CA 1426324-CA 1427798-CA
1425215-CA 1426390-CA 1427829-CA
1425216-CA 1426401-CA 1427887-CA
1425217-CA 1426409-CA 1427901-CA
1425218-CA 1426523-CA 1427910-CA
1425219-CA 1426627-CA 1427916-CA
1425220-CA 1426628-CA 1428128-CA
1425221-CA 1426636-CA 1428136-CA
1425222-CA 1426638-CA 1428161-CA
1425223-CA 1426703-CA 1428173-CA
1425224-CA 1426704-CA 1428228-CA
1425311-CA 1426705-CA 1428381-CA
1425330-CA 1426706-CA 1428387-CA
1425429-CA 1426707-CA 1428405-CA
1425529-CA 1426708-CA 1428414-CA
1425556-CA 1426709-CA 1428445-CA
1425557-CA 1426804-CA 1428452-CA
1425651-CA 1426836-CA 1428453-CA
1425652-CA 1426854-CA 1428454-CA
1425671-CA 1426859-CA 1428455-CA
1425724-CA 1426879-CA 1428547-CA
1425725-CA 1426929-CA 1428574-CA
1425726-CA 1426997-CA 1428579-CA
1425727-CA 1427008-CA 1428585-CA
1425728-CA 1427065-CA 1428589-CA
1425729-CA 1427088-CA 1428735-CA
1425730-CA 1427169-CA 1428747-CA
1425731-CA 1427175-CA 1428752-CA
1425732-CA 1427177-CA 1428774-CA
1425737-CA 1427247-CA 1428854-CA
1425738-CA 1427366-CA 1428855-CA
1425739-CA 1427392-CA 1428856-CA
ANNEX II-11
1428857-CA 1430240-CA 1431437-CA
1428989-CA 1430241-CA 1431438-CA
1429002-CA 1430243-CA 1431466-CA
1429016-CA 1430256-CA 1431521-CA
1429030-CA 1430362-CA 1431522-CA
1429050-CA 1430383-CA 1431523-CA
1429056-CA 1430393-CA 1431524-CA
1429058-CA 1430397-CA 1431525-CA
1429059-CA 1430443-CA 1431526-CA
1429061-CA 1430445-CA 1431527-CA
1429263-CA 1430447-CA 1431528-CA
1429273-CA 1430484-CA 1431589-CA
1429278-CA 1430485-CA 1431600-CA
1429292-CA 1430580-CA 1431605-CA
1429343-CA 1430590-CA 1431632-CA
1429360-CA 1430594-CA 1431633-CA
1429364-CA 1430628-CA 1431634-CA
1429492-CA 1430791-CA 1431635-CA
1429500-CA 1430808-CA 1431786-CA
1429509-CA 1430827-CA 1431799-CA
1429562-CA 1430847-CA 1431827-CA
1429563-CA 1430891-CA 1431840-CA
1429564-CA 1430902-CA 1431841-CA
1429565-CA 1430936-CA 1431843-CA
1429818-CA 1430946-CA 1431844-CA
1429819-CA 1430950-CA 1431845-CA
1429829-CA 1431000-CA 1431846-CA
1429833-CA 1431002-CA 1431977-CA
1429849-CA 1431048-CA 1431991-CA
1429876-CA 1431049-CA 1431997-CA
1429877-CA 1431050-CA 1432013-CA
1429878-CA 1431051-CA 1432050-CA
1429879-CA 1431052-CA 1432056-CA
1430007-CA 1431053-CA 1432058-CA
1430012-CA 1431054-CA 1432059-CA
1430035-CA 1431055-CA 1432060-CA
1430070-CA 1431152-CA 1432179-CA
1430071-CA 1431172-CA 1432187-CA
1430072-CA 1431231-CA 1432208-CA
1430073-CA 1431234-CA 1432240-CA
1430075-CA 1431265-CA 1432253-CA
1430198-CA 1431302-CA 1432333-CA
1430208-CA 1431311-CA 1432356-CA
1430213-CA 1431390-CA 1432366-CA
1430237-CA 1431435-CA 1432373-CA
1430239-CA 1431436-CA 1432401-CA
ANNEX II-12
1432422-CA 1433782-CA 1434961-CA
1432428-CA 1433796-CA 1434965-CA
1432429-CA 1433838-CA 1434973-CA
1432481-CA 1433839-CA 1435006-CA
1432513-CA 1433912-CA 1435225-CA
1432538-CA 1433932-CA 1435234-CA
1432542-CA 1433949-CA 1435241-CA
1432578-CA 1433955-CA 1435262-CA
1432613-CA 1433963-CA 1435282-CA
1432624-CA 1433984-CA 1435287-CA
1432625-CA 1434015-CA 1435400-CA
1432630-CA 1434019-CA 1435407-CA
1432704-CA 1434053-CA 1435414-CA
1432723-CA 1434117-CA 1435423-CA
1432743-CA 1434214-CA 1435455-CA
1432749-CA 1434222-CA 1435456-CA
1432750-CA 1434233-CA 1435457-CA
1432751-CA 1434260-CA 1435586-CA
1432752-CA 1434264-CA 1435609-CA
1432838-CA 1434266-CA 1435618-CA
1433024-CA 1434404-CA 1435626-CA
1433048-CA 1434412-CA 1435659-CA
1433165-CA 1434421-CA 1435660-CA
1433178-CA 1434455-CA 1435661-CA
1433183-CA 1434472-CA 1435731-CA
1433225-CA 1434540-CA 1435745-CA
1433236-CA 1434541-CA 1435750-CA
1433237-CA 1434569-CA 1435764-CA
1433238-CA 1434580-CA 1435803-CA
1433264-CA 1434590-CA 1435909-CA
1433330-CA 1434652-CA 1435925-CA
1433340-CA 1434653-CA 1435938-CA
1433366-CA 1434654-CA 1435948-CA
1433395-CA 1434681-CA 1435980-CA
1433449-CA 1434685-CA 1435996-CA
1433516-CA 1434743-CA 1436026-CA
1433543-CA 1434744-CA 1436066-CA
1433560-CA 1434769-CA 1436139-CA
1433573-CA 1434775-CA 1436152-CA
1433593-CA 1434781-CA 1436185-CA
1433610-CA 1434797-CA 1436280-CA
1433646-CA 1434822-CA 1436316-CA
1433659-CA 1434823-CA 1436348-CA
1433753-CA 1434827-CA 1436360-CA
1433755-CA 1434932-CA 1436377-CA
1433759-CA 1434954-CA 1436387-CA
ANNEX II-13
1436400-CA 1437498-CA 1438420-CA
1436425-CA 1437504-CA 1438443-CA
1436452-CA 1437506-CA 1438467-CA
1436517-CA 1437529-CA 1438519-CA
1436525-CA 1437545-CA 1438537-CA
1436562-CA 1437556-CA 1438545-CA
1436580-CA 1437559-CA 1438581-CA
1436586-CA 1437589-CA 1438584-CA
1436591-CA 1437599-CA 1438599-CA
1436608-CA 1437632-CA 1438610-CA
1436654-CA 1437679-CA 1438627-CA
1436710-CA 1437766-CA 1438679-CA
1436724-CA 1437773-CA 1438686-CA
1436732-CA 1437787-CA 1438737-CA
1436757-CA 1437794-CA 1438750-CA
1436761-CA 1437802-CA 1438759-CA
1436769-CA 1437827-CA 1438763-CA
1436777-CA 1437849-CA 1438797-CA
1436814-CA 1437859-CA 1438840-CA
1436831-CA 1437901-CA 1438866-CA
1436847-CA 1437905-CA 1438911-CA
1436866-CA 1437908-CA 1438931-CA
1436896-CA 1437909-CA 1438938-CA
1436903-CA 1437933-CA 1438946-CA
1436919-CA 1437957-CA 1438979-CA
1436922-CA 1437992-CA 1438991-CA
1436962-CA 1438009-CA 1439015-CA
1436973-CA 1438015-CA 1439040-CA
1436997-CA 1438024-CA 1439095-CA
1437046-CA 1438049-CA 1439103-CA
1437060-CA 1438068-CA 1439116-CA
1437080-CA 1438136-CA 1439122-CA
1437082-CA 1438153-CA 1439124-CA
1437086-CA 1438213-CA 1439156-CA
1437100-CA 1438215-CA 1439179-CA
1437119-CA 1438226-CA 1439234-CA
1437171-CA 1438240-CA 1439258-CA
1437237-CA 1438248-CA 1439259-CA
1437258-CA 1438274-CA 1439292-CA
1437273-CA 1438319-CA 1439303-CA
1437287-CA 1438331-CA 1439318-CA
1437296-CA 1438360-CA 1439340-CA
1437313-CA 1438383-CA 1439386-CA
1437342-CA 1438392-CA 1439401-CA
1437427-CA 1438405-CA 1439437-CA
1437490-CA 1438413-CA 1439455-CA
ANNEX II-14
1439464-CA 1440439-CA 1441702-CA
1439465-CA 1440440-CA 1441736-CA
1439474-CA 1440441-CA 1441795-CA
1439515-CA 1440442-CA 1441874-CA
1439522-CA 1440464-CA 1441888-CA
1439533-CA 1440536-CA 1441911-CA
1439535-CA 1440561-CA 1441918-CA
1439551-CA 1440647-CA 1441928-CA
1439555-CA 1440656-CA 1441934-CA
1439568-CA 1440758-CA 1441978-CA
1439571-CA 1440777-CA 1441992-CA
1439611-CA 1440831-CA 1442038-CA
1439666-CA 1440846-CA 1442051-CA
1439667-CA 1440856-CA 1442066-CA
1439678-CA 1440886-CA 1442073-CA
1439689-CA 1440918-CA 1442078-CA
1439705-CA 1440929-CA 1442148-CA
1439711-CA 1440986-CA 1442161-CA
1439728-CA 1441063-CA 1442204-CA
1439755-CA 1441104-CA 1442211-CA
1439791-CA 1441108-CA 1442318-CA
1439804-CA 1441135-CA 1442440-CA
1439857-CA 1441139-CA 1442454-CA
1439860-CA 1441147-CA 1442465-CA
1439871-CA 1441221-CA 1442481-CA
1439875-CA 1441246-CA 1442492-CA
1439886-CA 1441279-CA 1442507-CA
1439921-CA 1441288-CA 1442543-CA
1439938-CA 1441297-CA 1442584-CA
1439993-CA 1441322-CA 1442608-CA
1440001-CA 1441349-CA 1442629-CA
1440018-CA 1441409-CA 1442633-CA
1440031-CA 1441451-CA 1442649-CA
1440037-CA 1441458-CA 1442671-CA
1440077-CA 1441488-CA 1442687-CA
1440089-CA 1441502-CA 1442777-CA
1440104-CA 1441520-CA 1442795-CA
1440139-CA 1441523-CA 1442855-CA
1440198-CA 1441524-CA 1442869-CA
1440205-CA 1441525-CA 1442891-CA
1440225-CA 1441563-CA 1442905-CA
1440236-CA 1441616-CA 1442917-CA
1440265-CA 1441648-CA 1443075-CA
1440365-CA 1441673-CA 1443108-CA
1440437-CA 1441680-CA 1443144-CA
1440438-CA 1441696-CA 1443165-CA
ANNEX II-15
1443179-CA 1444344-CA 1445657-CA
1443303-CA 1444364-CA 1445660-CA
1443332-CA 1444435-CA 1445665-CA
1443333-CA 1444483-CA 1445689-CA
1443334-CA 1444509-CA 1445723-CA
1443335-CA 1444532-CA 1445733-CA
1443336-CA 1444541-CA 1445825-CA
1443337-CA 1444545-CA 1445839-CA
1443338-CA 1444583-CA 1445844-CA
1443369-CA 1444604-CA 1445866-CA
1443458-CA 1444625-CA 1445871-CA
1443468-CA 1444683-CA 1445878-CA
1443507-CA 1444694-CA 1445913-CA
1443522-CA 1444717-CA 1445920-CA
1443540-CA 1444721-CA 1445954-CA
1443559-CA 1444755-CA 1446000-CA
1443615-CA 1444783-CA 1446032-CA
1443693-CA 1444798-CA 1446070-CA
1443712-CA 1444892-CA 1446071-CA
1443720-CA 1444915-CA 1446077-CA
1443739-CA 1444925-CA 1446100-CA
1443743-CA 1444951-CA 1446125-CA
1443752-CA 1444958-CA 1446184-CA
1443782-CA 1444962-CA 1446232-CA
1443804-CA 1444987-CA 1446256-CA
1443848-CA 1445056-CA 1446287-CA
1443864-CA 1445113-CA 1446291-CA
1443883-CA 1445154-CA 1446305-CA
1443896-CA 1445179-CA 1446346-CA
1443908-CA 1445180-CA 1446363-CA
1443913-CA 1445202-CA 1446417-CA
1443917-CA 1445206-CA 1446454-CA
1443968-CA 1445240-CA 1446493-CA
1444006-CA 1445265-CA 1446502-CA
1444018-CA 1445276-CA 1446545-CA
1444027-CA 1445278-CA 1446579-CA
1444040-CA 1445281-CA 1446580-CA
1444060-CA 1445283-CA 1446581-CA
1444070-CA 1445284-CA 1446582-CA
1444102-CA 1445394-CA 1446583-CA
1444159-CA 1445412-CA 1446584-CA
1444266-CA 1445422-CA 1446602-CA
1444280-CA 1445430-CA 1446633-CA
1444288-CA 1445475-CA 1446648-CA
1444309-CA 1445539-CA 1446761-CA
1444315-CA 1445616-CA 1446763-CA
ANNEX II-16
1446766-CA 1448134-CA 1449407-CA
1446800-CA 1448234-CA 1449431-CA
1446822-CA 1448249-CA 1449453-CA
1446882-CA 1448253-CA 1449463-CA
1446937-CA 1448271-CA 1449464-CA
1446943-CA 1448277-CA 1449465-CA
1446959-CA 1448286-CA 1449466-CA
1446965-CA 1448341-CA 1449467-CA
1446970-CA 1448371-CA 1449468-CA
1446994-CA 1448397-CA 1449469-CA
1447012-CA 1448436-CA 1449470-CA
1447056-CA 1448479-CA 1449471-CA
1447119-CA 1448494-CA 1449472-CA
1447123-CA 1448542-CA 1449473-CA
1447145-CA 1448619-CA 1449490-CA
1447152-CA 1448696-CA 1449560-CA
1447156-CA 1448753-CA 1449581-CA
1447158-CA 1448778-CA 1449599-CA
1447173-CA 1448786-CA 1449615-CA
1447300-CA 1448804-CA 1449618-CA
1447310-CA 1448824-CA 1449630-CA
1447313-CA 1448856-CA 1449653-CA
1447328-CA 1448881-CA 1449707-CA
1447341-CA 1448882-CA 1449735-CA
1447420-CA 1448909-CA 1449787-CA
1447537-CA 1448956-CA 1449799-CA
1447602-CA 1448983-CA 1449827-CA
1447620-CA 1448996-CA 1449832-CA
1447631-CA 1448997-CA 1449855-CA
1447645-CA 1449015-CA 1449862-CA
1447673-CA 1449036-CA 1449918-CA
1447700-CA 1449055-CA 1449963-CA
1447758-CA 1449109-CA 1449975-CA
1447803-CA 1449124-CA 1449979-CA
1447812-CA 1449136-CA 1450007-CA
1447814-CA 1449163-CA 1450010-CA
1447885-CA 1449178-CA 1450021-CA
1447892-CA 1449183-CA 1450045-CA
1447950-CA 1449201-CA 1450085-CA
1447968-CA 1449216-CA 1450182-CA
1448031-CA 1449235-CA 1450221-CA
1448054-CA 1449276-CA 1450230-CA
1448060-CA 1449357-CA 1450251-CA
1448086-CA 1449372-CA 1450263-CA
1448094-CA 1449383-CA 1450292-CA
1448101-CA 1449393-CA 1450318-CA
ANNEX II-17
1450385-CA 1451450-CA 1452608-CA
1450421-CA 1451459-CA 1452628-CA
1450439-CA 1451475-CA 1452635-CA
1450456-CA 1451478-CA 1452643-CA
1450461-CA 1451492-CA 1452663-CA
1450467-CA 1451520-CA 1452700-CA
1450479-CA 1451545-CA 1452722-CA
1450497-CA 1451584-CA 1452848-CA
1450520-CA 1451635-CA 1452870-CA
1450521-CA 1451641-CA 1452875-CA
1450522-CA 1451664-CA 1452901-CA
1450523-CA 1451674-CA 1452913-CA
1450524-CA 1451693-CA 1452937-CA
1450525-CA 1451722-CA 1452955-CA
1450526-CA 1451748-CA 1453056-CA
1450539-CA 1451832-CA 1453109-CA
1450609-CA 1451840-CA 1453136-CA
1450667-CA 1451844-CA 1453143-CA
1450707-CA 1451853-CA 1453158-CA
1450729-CA 1451874-CA 1453177-CA
1450740-CA 1451890-CA 1453186-CA
1450756-CA 1451914-CA 1453221-CA
1450762-CA 1451961-CA 1453244-CA
1450803-CA 1452022-CA 1453276-CA
1450824-CA 1452070-CA 1453325-CA
1450858-CA 1452075-CA 1453338-CA
1450880-CA 1452080-CA 1453352-CA
1450891-CA 1452081-CA 1453354-CA
1450895-CA 1452092-CA 1453357-CA
1450900-CA 1452123-CA 1453375-CA
1450918-CA 1452136-CA 1453386-CA
1450987-CA 1452140-CA 1453394-CA
1450992-CA 1452172-CA 1453407-CA
1451005-CA 1452237-CA 1453429-CA
1451034-CA 1452289-CA 1453472-CA
1451063-CA 1452298-CA 1453513-CA
1451088-CA 1452354-CA 1453531-CA
1451188-CA 1452364-CA 1453534-CA
1451202-CA 1452395-CA 1453535-CA
1451229-CA 1452399-CA 1453537-CA
1451237-CA 1452406-CA 1453538-CA
1451247-CA 1452419-CA 1453540-CA
1451261-CA 1452443-CA 1453568-CA
1451329-CA 1452513-CA 1453584-CA
1451356-CA 1452563-CA 1453620-CA
1451445-CA 1452602-CA 1453625-CA
ANNEX II-18
1453643-CA 1454832-CA 1456106-CA
1453660-CA 1454840-CA 1456132-CA
1453693-CA 1454842-CA 1456201-CA
1453701-CA 1454881-CA 1456228-CA
1453754-CA 1454915-CA 1456236-CA
1453760-CA 1454936-CA 1456241-CA
1453796-CA 1454972-CA 1456268-CA
1453803-CA 1455031-CA 1456276-CA
1453817-CA 1455038-CA 1456289-CA
1453845-CA 1455067-CA 1456334-CA
1453855-CA 1455081-CA 1456353-CA
1453880-CA 1455110-CA 1456372-CA
1453963-CA 1455141-CA 1456449-CA
1454052-CA 1455182-CA 1456455-CA
1454061-CA 1455253-CA 1456475-CA
1454100-CA 1455277-CA 1456480-CA
1454108-CA 1455363-CA 1456489-CA
1454123-CA 1455375-CA 1456517-CA
1454149-CA 1455402-CA 1456581-CA
1454176-CA 1455407-CA 1456618-CA
1454240-CA 1455424-CA 1456661-CA
1454363-CA 1455447-CA 1456671-CA
1454374-CA 1455477-CA 1456672-CA
1454398-CA 1455540-CA 1456695-CA
1454407-CA 1455561-CA 1456706-CA
1454420-CA 1455568-CA 1456767-CA
1454449-CA 1455581-CA 1456794-CA
1454474-CA 1455593-CA 1456820-CA
1454521-CA 1455624-CA 1456836-CA
1454550-CA 1455648-CA 1456842-CA
1454556-CA 1455680-CA 1456851-CA
1454566-CA 1455728-CA 1456854-CA
1454572-CA 1455736-CA 1456857-CA
1454615-CA 1455741-CA 1456912-CA
1454622-CA 1455746-CA 1456936-CA
1454629-CA 1455817-CA 1457001-CA
1454654-CA 1455825-CA 1457085-CA
1454704-CA 1455838-CA 1457115-CA
1454732-CA 1455876-CA 1457129-CA
1454747-CA 1455905-CA 1457138-CA
1454748-CA 1455960-CA 1457188-CA
1454749-CA 1456012-CA 1457240-CA
1454750-CA 1456026-CA 1457257-CA
1454751-CA 1456040-CA 1457276-CA
1454793-CA 1456057-CA 1457303-CA
1454801-CA 1456080-CA 1457311-CA
ANNEX II-19
1457328-CA 1458525-CA 1459776-CA
1457353-CA 1458551-CA 1459794-CA
1457375-CA 1458569-CA 1459816-CA
1457393-CA 1458579-CA 1459836-CA
1457442-CA 1458604-CA 1459880-CA
1457495-CA 1458679-CA 1459884-CA
1457525-CA 1458706-CA 1459892-CA
1457547-CA 1458715-CA 1459922-CA
1457563-CA 1458736-CA 1459927-CA
1457594-CA 1458748-CA 1459936-CA
1457607-CA 1458767-CA 1459962-CA
1457629-CA 1458782-CA 1459988-CA
1457673-CA 1458874-CA 1460030-CA
1457695-CA 1458912-CA 1460071-CA
1457718-CA 1458962-CA 1460123-CA
1457765-CA 1458972-CA 1460132-CA
1457778-CA 1459061-CA 1460148-CA
1457813-CA 1459076-CA 1460168-CA
1457828-CA 1459084-CA 1460174-CA
1457843-CA 1459095-CA 1460195-CA
1457894-CA 1459115-CA 1460211-CA
1457907-CA 1459193-CA 1460221-CA
1458003-CA 1459219-CA 1460238-CA
1458017-CA 1459223-CA 1460286-CA
1458022-CA 1459224-CA 1460301-CA
1458031-CA 1459228-CA 1460315-CA
1458035-CA 1459252-CA 1460364-CA
1458048-CA 1459260-CA 1460372-CA
1458050-CA 1459297-CA 1460376-CA
1458073-CA 1459308-CA 1460401-CA
1458080-CA 1459324-CA 1460433-CA
1458092-CA 1459345-CA 1460460-CA
1458104-CA 1459405-CA 1460496-CA
1458165-CA 1459429-CA 1460548-CA
1458184-CA 1459526-CA 1460563-CA
1458300-CA 1459532-CA 1460564-CA
1458311-CA 1459559-CA 1460599-CA
1458334-CA 1459575-CA 1460605-CA
1458348-CA 1459581-CA 1460617-CA
1458365-CA 1459605-CA 1460646-CA
1458387-CA 1459616-CA 1460713-CA
1458398-CA 1459645-CA 1460740-CA
1458424-CA 1459708-CA 1460809-CA
1458483-CA 1459722-CA 1460823-CA
1458496-CA 1459738-CA 1460839-CA
1458516-CA 1459765-CA 1460852-CA
ANNEX II-20
1460868-CA 1462101-CA 1463167-CA
1460886-CA 1462120-CA 1463197-CA
1460905-CA 1462182-CA 1463200-CA
1460916-CA 1462194-CA 1463205-CA
1460979-CA 1462211-CA 1463240-CA
1461021-CA 1462228-CA 1463297-CA
1461034-CA 1462233-CA 1463348-CA
1461054-CA 1462240-CA 1463349-CA
1461061-CA 1462288-CA 1463350-CA
1461070-CA 1462319-CA 1463351-CA
1461089-CA 1462343-CA 1463352-CA
1461178-CA 1462359-CA 1463353-CA
1461201-CA 1462373-CA 1463425-CA
1461270-CA 1462390-CA 1463432-CA
1461319-CA 1462400-CA 1463443-CA
1461322-CA 1462420-CA 1463459-CA
1461347-CA 1462432-CA 1463470-CA
1461358-CA 1462456-CA 1463474-CA
1461375-CA 1462502-CA 1463505-CA
1461400-CA 1462538-CA 1463536-CA
1461420-CA 1462550-CA 1463587-CA
1461433-CA 1462560-CA 1463657-CA
1461541-CA 1462657-CA 1463720-CA
1461542-CA 1462661-CA 1463733-CA
1461607-CA 1462665-CA 1463753-CA
1461610-CA 1462692-CA 1463773-CA
1461621-CA 1462752-CA 1463801-CA
1461660-CA 1462780-CA 1463817-CA
1461678-CA 1462794-CA 1463951-CA
1461692-CA 1462810-CA 1464190-CA
1461777-CA 1462833-CA 1464244-CA
1461783-CA 1462860-CA 1464245-CA
1461793-CA 1462879-CA 1464404-CA
1461802-CA 1462899-CA 1464508-CA
1461817-CA 1462901-CA 1464522-CA
1461825-CA 1462922-CA 1464533-CA
1461840-CA 1462978-CA 1464545-CA
1461889-CA 1463001-CA 1464581-CA
1461901-CA 1463006-CA 1464591-CA
1461910-CA 1463021-CA 1464628-CA
1461979-CA 1463028-CA 1464695-CA
1462000-CA 1463039-CA 1464826-CA
1462015-CA 1463075-CA 1464859-CA
1462025-CA 1463107-CA 1464877-CA
1462041-CA 1463119-CA 1464916-CA
1462074-CA 1463151-CA 1464953-CA
ANNEX II-21
1465060-CA 1467567-CA 1347385-CB
1465096-CA 1467613-CA 1348300-CB
1465118-CA 1467628-CA 1348475-CB
1465150-CA 1467648-CA 1348947-CB
1465173-CA 1467665-CA 1348948-CB
1465238-CA 1467691-CA 1354283-CB
1465247-CA 1467744-CA 1356234-CB
1465256-CA 1467768-CA 1356643-CB
1465277-CA 1467788-CA 1356648-CB
1465289-CA 1467806-CA 1356651-CB
1465313-CA 1467817-CA 1360021-CB
1465346-CA 1467834-CA 1360024-CB
1465372-CA 1467892-CA 1360757-CB
1465426-CA 1467926-CA 1360759-CB
1465437-CA 1467955-CA 1360760-CB
1465484-CA 1467963-CA 1360761-CB
1465592-CA 1467972-CA 1360762-CB
1465749-CA 1467980-CA 1361390-CB
1465787-CA 1308054-CB 1362530-CB
1465817-CA 1308055-CB 1364364-CB
1465897-CA 1308056-CB 1364634-CB
1465915-CA 1308720-CB 1367345-CB
1465977-CA 1308721-CB 1367347-CB
1466108-CA 1308722-CB 1367350-CB
1466233-CA 1310756-CB 1367357-CB
1466256-CA 1311615-CB 1367358-CB
1466351-CA 1315834-CB 1367359-CB
1466357-CA 1315835-CB 1369497-CB
1466386-CA 1315837-CB 1370951-CB
1466513-CA 1318393-CB 1376146-CB
1466537-CA 1321185-CB 1377067-CB
1466628-CA 1321718-CB 1377895-CB
1466641-CA 1321726-CB 1378762-CB
1466806-CA 1323865-CB 1378764-CB
1466815-CA 1323968-CB 1379117-CB
1466836-CA 1325153-CB 1379118-CB
1466919-CA 1329521-CB 1379122-CB
1466960-CA 1332849-CB 1379125-CB
1466978-CA 1332850-CB 1379129-CB
1467165-CA 1334105-CB 1379574-CB
1467166-CA 1336848-CB 1380596-CB
1467364-CA 1341104-CB 1380608-CB
1467367-CA 1342091-CB 1380609-CB
1467410-CA 1342996-CB 1383261-CB
1467414-CA 1342999-CB 1384825-CB
1467506-CA 1346327-CB 1384828-CB
ANNEX II-22
1384829-CB 1402099-CB 1404548-CB
1386300-CB 1402100-CB 1404708-CB
1386312-CB 1402101-CB 1405072-CB
1389925-CB 1402104-CB 1405197-CB
1392118-CB 1402105-CB 1405256-CB
1392126-CB 1402500-CB 1405257-CB
1392130-CB 1402744-CB 1405259-CB
1393097-CB 1402745-CB 1405260-CB
1393098-CB 1402749-CB 1405261-CB
1393101-CB 1402750-CB 1405262-CB
1393105-CB 1402751-CB 1405263-CB
1393109-CB 1402753-CB 1405392-CB
1395032-CB 1402754-CB 1405572-CB
1397530-CB 1402755-CB 1405577-CB
1397531-CB 1402756-CB 1406142-CB
1398234-CB 1402757-CB 1406174-CB
1398237-CB 1403031-CB 1406177-CB
1398238-CB 1403398-CB 1406180-CB
1398968-CB 1403522-CB 1406182-CB
1398969-CB 1403566-CB 1406183-CB
1399487-CB 1403568-CB 1406184-CB
1399488-CB 1403570-CB 1406185-CB
1399489-CB 1403576-CB 1406186-CB
1399490-CB 1403577-CB 1406187-CB
1399494-CB 1403578-CB 1406188-CB
1399499-CB 1403579-CB 1406189-CB
1400092-CB 1403580-CB 1406246-CB
1400093-CB 1403583-CB 1406250-CB
1400095-CB 1403584-CB 1406271-CB
1400096-CB 1403585-CB 1406456-CB
1400668-CB 1403814-CB 1406714-CB
1400669-CB 1403831-CB 1406737-CB
1400671-CB 1403959-CB 1406832-CB
1400672-CB 1403981-CB 1406842-CB
1401298-CB 1404211-CB 1406844-CB
1401450-CB 1404303-CB 1406845-CB
1401451-CB 1404304-CB 1406847-CB
1401452-CB 1404305-CB 1406848-CB
1401453-CB 1404307-CB 1406849-CB
1401454-CB 1404308-CB 1406894-CB
1401797-CB 1404309-CB 1407133-CB
1402093-CB 1404310-CB 1407392-CB
1402095-CB 1404312-CB 1407514-CB
1402096-CB 1404380-CB 1407616-CB
1402097-CB 1404381-CB 1407617-CB
1402098-CB 1404531-CB 1407618-CB
ANNEX II-23
1407619-CB 1410368-CB 1411647-CB
1407620-CB 1410369-CB 1411649-CB
1407622-CB 1410370-CB 1411655-CB
1407623-CB 1410374-CB 1411656-CB
1407624-CB 1410375-CB 1411657-CB
1407625-CB 1410376-CB 1411658-CB
1407626-CB 1410379-CB 1411660-CB
1407695-CB 1410380-CB 1411662-CB
1408086-CB 1410381-CB 1411667-CB
1408199-CB 1410382-CB 1411670-CB
1408200-CB 1410384-CB 1411745-CB
1408201-CB 1410386-CB 1411758-CB
1408212-CB 1410389-CB 1412055-CB
1408213-CB 1410390-CB 1412085-CB
1408214-CB 1410391-CB 1412108-CB
1408215-CB 1410392-CB 1412365-CB
1408218-CB 1410394-CB 1412401-CB
1408257-CB 1410395-CB 1412403-CB
1408361-CB 1410396-CB 1412404-CB
1408688-CB 1410397-CB 1412408-CB
1408940-CB 1410398-CB 1412409-CB
1408942-CB 1410400-CB 1412410-CB
1408946-CB 1410401-CB 1412415-CB
1409285-CB 1410403-CB 1412416-CB
1409509-CB 1410404-CB 1412417-CB
1409536-CB 1410405-CB 1413052-CB
1409648-CB 1410406-CB 1413063-CB
1409727-CB 1410407-CB 1413065-CB
1409730-CB 1410408-CB 1413068-CB
1409733-CB 1410488-CB 1413086-CB
1409735-CB 1410642-CB 1413087-CB
1409736-CB 1410873-CB 1413417-CB
1409737-CB 1410985-CB 1413461-CB
1409738-CB 1411082-CB 1413464-CB
1409739-CB 1411211-CB 1413467-CB
1409740-CB 1411545-CB 1413473-CB
1409741-CB 1411624-CB 1413551-CB
1409797-CB 1411632-CB 1413668-CB
1409824-CB 1411633-CB 1414117-CB
1409990-CB 1411634-CB 1414273-CB
1410295-CB 1411635-CB 1414345-CB
1410301-CB 1411637-CB 1414372-CB
1410359-CB 1411640-CB 1414395-CB
1410361-CB 1411643-CB 1414401-CB
1410364-CB 1411644-CB 1414471-CB
1410365-CB 1411646-CB 1414525-CB
ANNEX II-24
1414695-CB 1417821-CB 1420622-CB
1414726-CB 1417822-CB 1420664-CB
1414779-CB 1417823-CB 1420666-CB
1414780-CB 1417934-CB 1420785-CB
1414782-CB 1418032-CB 1420797-CB
1414783-CB 1418035-CB 1420864-CB
1414789-CB 1418068-CB 1420995-CB
1414942-CB 1418079-CB 1421001-CB
1415055-CB 1418318-CB 1421009-CB
1415123-CB 1418343-CB 1421037-CB
1415331-CB 1418408-CB 1421073-CB
1415351-CB 1418545-CB 1421115-CB
1415501-CB 1418607-CB 1421332-CB
1415531-CB 1418655-CB 1421334-CB
1415568-CB 1418656-CB 1421496-CB
1415736-CB 1418659-CB 1421516-CB
1415740-CB 1418660-CB 1421603-CB
1415743-CB 1418661-CB 1421610-CB
1415766-CB 1418744-CB 1421645-CB
1415838-CB 1418781-CB 1421826-CB
1415961-CB 1418923-CB 1421892-CB
1416057-CB 1419018-CB 1421893-CB
1416195-CB 1419028-CB 1421894-CB
1416348-CB 1419125-CB 1421896-CB
1416370-CB 1419141-CB 1422199-CB
1416405-CB 1419181-CB 1422210-CB
1416511-CB 1419385-CB 1422296-CB
1416550-CB 1419498-CB 1422354-CB
1416600-CB 1419505-CB 1422406-CB
1416671-CB 1419674-CB 1422563-CB
1416696-CB 1419699-CB 1422593-CB
1416888-CB 1419712-CB 1422628-CB
1416987-CB 1419756-CB 1422629-CB
1417004-CB 1419763-CB 1422631-CB
1417080-CB 1419853-CB 1422642-CB
1417136-CB 1419876-CB 1422743-CB
1417159-CB 1420067-CB 1422786-CB
1417187-CB 1420153-CB 1422886-CB
1417264-CB 1420220-CB 1422963-CB
1417280-CB 1420265-CB 1423063-CB
1417328-CB 1420277-CB 1423226-CB
1417480-CB 1420412-CB 1423316-CB
1417535-CB 1420413-CB 1423376-CB
1417594-CB 1420414-CB 1423488-CB
1417626-CB 1420478-CB 1423500-CB
1417819-CB 1420547-CB 1423509-CB
ANNEX II-25
1423722-CB 1427177-CB 1430241-CB
1423724-CB 1427247-CB 1430362-CB
1423725-CB 1427413-CB 1430383-CB
1423733-CB 1427586-CB 1430397-CB
1423817-CB 1427588-CB 1430445-CB
1423970-CB 1427589-CB 1430580-CB
1423971-CB 1427685-CB 1430628-CB
1424020-CB 1427796-CB 1430808-CB
1424115-CB 1427829-CB 1430891-CB
1424153-CB 1427910-CB 1430946-CB
1424317-CB 1428128-CB 1430950-CB
1424323-CB 1428161-CB 1431000-CB
1424483-CB 1428173-CB 1431152-CB
1424503-CB 1428381-CB 1431172-CB
1424525-CB 1428414-CB 1431234-CB
1424607-CB 1428452-CB 1431265-CB
1424644-CB 1428453-CB 1431436-CB
1424670-CB 1428455-CB 1431605-CB
1424781-CB 1428579-CB 1431632-CB
1424954-CB 1428585-CB 1431634-CB
1425007-CB 1428747-CB 1431635-CB
1425013-CB 1428854-CB 1431844-CB
1425020-CB 1428855-CB 1431846-CB
1425177-CB 1428857-CB 1431991-CB
1425224-CB 1429002-CB 1432050-CB
1425330-CB 1429016-CB 1432056-CB
1425429-CB 1429050-CB 1432058-CB
1425529-CB 1429056-CB 1432059-CB
1425556-CB 1429058-CB 1432187-CB
1425557-CB 1429263-CB 1432208-CB
1425671-CB 1429273-CB 1432240-CB
1425889-CB 1429278-CB 1432253-CB
1426015-CB 1429292-CB 1432333-CB
1426020-CB 1429344-CB 1432366-CB
1426220-CB 1429562-CB 1432373-CB
1426244-CB 1429563-CB 1432401-CB
1426256-CB 1429564-CB 1432613-CB
1426260-CB 1429819-CB 1432630-CB
1426390-CB 1429849-CB 1432704-CB
1426627-CB 1429877-CB 1432723-CB
1426854-CB 1429878-CB 1432743-CB
1426859-CB 1429879-CB 1432750-CB
1426879-CB 1430070-CB 1432751-CB
1426929-CB 1430071-CB 1432838-CB
1427088-CB 1430198-CB 1433024-CB
1427169-CB 1430240-CB 1433048-CB
ANNEX II-26
1433165-CB 1435455-CB 1437273-CB
1433183-CB 1435456-CB 1437296-CB
1433225-CB 1435457-CB 1437342-CB
1433237-CB 1435586-CB 1437427-CB
1433264-CB 1435618-CB 1437498-CB
1433330-CB 1435626-CB 1437529-CB
1433340-CB 1435659-CB 1437545-CB
1433395-CB 1435731-CB 1437589-CB
1433449-CB 1435750-CB 1437599-CB
1433516-CB 1435803-CB 1437632-CB
1433560-CB 1435909-CB 1437787-CB
1433573-CB 1435938-CB 1437794-CB
1433755-CB 1435948-CB 1437827-CB
1433759-CB 1435980-CB 1437859-CB
1433782-CB 1435996-CB 1437909-CB
1433796-CB 1436139-CB 1437933-CB
1433838-CB 1436152-CB 1437957-CB
1433912-CB 1436185-CB 1438015-CB
1433949-CB 1436280-CB 1438024-CB
1434015-CB 1436316-CB 1438049-CB
1434019-CB 1436360-CB 1438153-CB
1434053-CB 1436377-CB 1438213-CB
1434233-CB 1436387-CB 1438215-CB
1434260-CB 1436400-CB 1438248-CB
1434266-CB 1436425-CB 1438319-CB
1434404-CB 1436452-CB 1438360-CB
1434412-CB 1436517-CB 1438383-CB
1434540-CB 1436608-CB 1438392-CB
1434580-CB 1436710-CB 1438413-CB
1434590-CB 1436724-CB 1438467-CB
1434652-CB 1436732-CB 1438519-CB
1434653-CB 1436757-CB 1438537-CB
1434743-CB 1436761-CB 1438545-CB
1434744-CB 1436777-CB 1438584-CB
1434769-CB 1436814-CB 1438610-CB
1434827-CB 1436831-CB 1438679-CB
1434932-CB 1436903-CB 1438750-CB
1434954-CB 1436919-CB 1438759-CB
1434961-CB 1436922-CB 1438797-CB
1434973-CB 1436973-CB 1438866-CB
1435234-CB 1436997-CB 1438911-CB
1435262-CB 1437046-CB 1438931-CB
1435400-CB 1437080-CB 1438946-CB
1435407-CB 1437100-CB 1438979-CB
1435414-CB 1437237-CB 1439015-CB
1435423-CB 1437258-CB 1439040-CB
ANNEX II-27
1439095-CB 1440831-CB 1442917-CB
1439103-CB 1440846-CB 1443075-CB
1439116-CB 1440856-CB 1443144-CB
1439122-CB 1440918-CB 1443179-CB
1439156-CB 1440929-CB 1443303-CB
1439179-CB 1441063-CB 1443458-CB
1439258-CB 1441104-CB 1443468-CB
1439259-CB 1441108-CB 1443507-CB
1439303-CB 1441135-CB 1443522-CB
1439340-CB 1441139-CB 1443540-CB
1439437-CB 1441147-CB 1443559-CB
1439455-CB 1441221-CB 1443615-CB
1439464-CB 1441246-CB 1443743-CB
1439474-CB 1441279-CB 1443848-CB
1439551-CB 1441322-CB 1443913-CB
1439555-CB 1441349-CB 1443917-CB
1439568-CB 1441409-CB 1443968-CB
1439611-CB 1441447-CB 1444006-CB
1439666-CB 1441451-CB 1444018-CB
1439667-CB 1441488-CB 1444027-CB
1439678-CB 1441502-CB 1444070-CB
1439705-CB 1441520-CB 1444159-CB
1439755-CB 1441616-CB 1444266-CB
1439791-CB 1441648-CB 1444288-CB
1439804-CB 1441736-CB 1444344-CB
1439857-CB 1441795-CB 1444364-CB
1439875-CB 1441874-CB 1444532-CB
1439886-CB 1441888-CB 1444541-CB
1439921-CB 1441918-CB 1444545-CB
1439938-CB 1441934-CB 1444583-CB
1439993-CB 1441978-CB 1444717-CB
1440001-CB 1441992-CB 1444721-CB
1440018-CB 1442073-CB 1444755-CB
1440031-CB 1442148-CB 1444783-CB
1440037-CB 1442318-CB 1444798-CB
1440089-CB 1442454-CB 1444951-CB
1440198-CB 1442481-CB 1444958-CB
1440225-CB 1442492-CB 1444987-CB
1440236-CB 1442507-CB 1445056-CB
1440365-CB 1442629-CB 1445113-CB
1440464-CB 1442633-CB 1445202-CB
1440536-CB 1442649-CB 1445206-CB
1440647-CB 1442687-CB 1445240-CB
1440656-CB 1442795-CB 1445265-CB
1440758-CB 1442855-CB 1445284-CB
1440777-CB 1442905-CB 1445394-CB
ANNEX II-28
1445430-CB 1448996-CB 1455905-CB
1445475-CB 1449383-CB 1456080-CB
1445539-CB 1449453-CB 1456201-CB
1445616-CB 1449473-CB 1456618-CB
1445657-CB 1449490-CB 1456671-CB
1445665-CB 1449618-CB 1457188-CB
1445689-CB 1449735-CB 1457311-CB
1445871-CB 1449799-CB 1457695-CB
1445878-CB 1449827-CB 1457907-CB
1445913-CB 1449832-CB 1458022-CB
1445920-CB 1450007-CB 1458516-CB
1445954-CB 1450045-CB 1458736-CB
1446071-CB 1450251-CB 1458962-CB
1446100-CB 1450263-CB 1459061-CB
1446125-CB 1450467-CB 1459084-CB
1446287-CB 1450522-CB 1459115-CB
1446291-CB 1450802-CB 1459297-CB
1446305-CB 1450803-CB 1459526-CB
1446346-CB 1450824-CB 1460372-CB
1446493-CB 1450858-CB 1461610-CB
1446545-CB 1451005-CB 1462550-CB
1446580-CB 1451034-CB 1462922-CB
1446761-CB 1451063-CB 1463151-CB
1446763-CB 1451356-CB 1463425-CB
1446766-CB 1451584-CB 1466836-CB
1446800-CB 1451748-CB 1467410-CB
1446822-CB 1452395-CB 1308054-CC
1446882-CB 1452399-CB 1308055-CC
1446937-CB 1452848-CB 1308721-CC
1446959-CB 1452913-CB 1308722-CC
1446965-CB 1453109-CB 1311615-CC
1446994-CB 1453394-CB 1315834-CC
1447012-CB 1453513-CB 1315835-CC
1447056-CB 1453584-CB 1315837-CC
1447156-CB 1453660-CB 1318393-CC
1447173-CB 1453693-CB 1321718-CC
1447631-CB 1453845-CB 1323968-CC
1447673-CB 1454061-CB 1334105-CC
1447950-CB 1454108-CB 1348300-CC
1447968-CB 1454556-CB 1348475-CC
1448101-CB 1454832-CB 1348948-CC
1448479-CB 1455067-CB 1356234-CC
1448542-CB 1455363-CB 1360021-CC
1448824-CB 1455424-CB 1360757-CC
1448856-CB 1455447-CB 1361390-CC
1448882-CB 1455838-CB 1364634-CC
ANNEX II-29
1367357-CC 1404304-CC 1410400-CC
1367359-CC 1404309-CC 1410403-CC
1377895-CC 1404380-CC 1410405-CC
1383261-CC 1404708-CC 1410406-CC
1384828-CC 1405257-CC 1410642-CC
1386312-CC 1405259-CC 1410985-CC
1392130-CC 1405261-CC 1411082-CC
1393097-CC 1405577-CC 1411632-CC
1393101-CC 1406174-CC 1411634-CC
1393105-CC 1406177-CC 1411635-CC
1395032-CC 1406182-CC 1411647-CC
1398234-CC 1406183-CC 1411655-CC
1398237-CC 1406185-CC 1411656-CC
1398238-CC 1406187-CC 1411657-CC
1398968-CC 1406189-CC 1411658-CC
1398969-CC 1406842-CC 1411660-CC
1399487-CC 1406847-CC 1412401-CC
1399488-CC 1406848-CC 1412415-CC
1399489-CC 1406849-CC 1413461-CC
1400092-CC 1406894-CC 1413464-CC
1400093-CC 1407392-CC 1413473-CC
1400095-CC 1407619-CC 1414273-CC
1400671-CC 1407620-CC 1414525-CC
1400672-CC 1407624-CC 1414726-CC
1401450-CC 1407625-CC 1414783-CC
1401452-CC 1407626-CC 1415123-CC
1401453-CC 1408200-CC 1415501-CC
1401454-CC 1408201-CC 1415568-CC
1401797-CC 1408212-CC 1415736-CC
1402096-CC 1408213-CC 1415740-CC
1402098-CC 1408214-CC 1415838-CC
1402104-CC 1409727-CC 1415961-CC
1402105-CC 1409736-CC 1416195-CC
1402745-CC 1409737-CC 1416348-CC
1402749-CC 1409739-CC 1416370-CC
1402750-CC 1409990-CC 1416511-CC
1402751-CC 1410365-CC 1416671-CC
1402754-CC 1410370-CC 1416888-CC
1402755-CC 1410382-CC 1416987-CC
1402756-CC 1410384-CC 1417080-CC
1403576-CC 1410386-CC 1417328-CC
1403577-CC 1410389-CC 1417480-CC
1403578-CC 1410390-CC 1417535-CC
1403580-CC 1410391-CC 1417819-CC
1403583-CC 1410394-CC 1417821-CC
1404303-CC 1410396-CC 1417934-CC
ANNEX II-30
1418032-CC 1429050-CC 1436710-CC
1418035-CC 1429056-CC 1436724-CC
1418343-CC 1429278-CC 1436732-CC
1418408-CC 1429562-CC 1436761-CC
1418607-CC 1429563-CC 1436777-CC
1418659-CC 1430070-CC 1436814-CC
1418781-CC 1430241-CC 1436831-CC
1419028-CC 1430362-CC 1436903-CC
1419385-CC 1430445-CC 1436997-CC
1420067-CC 1430580-CC 1437046-CC
1420220-CC 1430808-CC 1437100-CC
1420547-CC 1430946-CC 1437237-CC
1420622-CC 1431172-CC 1437342-CC
1421073-CC 1431436-CC 1437498-CC
1421332-CC 1431844-CC 1437529-CC
1421334-CC 1432056-CC 1437545-CC
1421610-CC 1432058-CC 1437589-CC
1421892-CC 1432208-CC 1438015-CC
1421893-CC 1432704-CC 1438024-CC
1421894-CC 1432743-CC 1438153-CC
1421896-CC 1433075-CC 1438319-CC
1422210-CC 1433264-CC 1438519-CC
1422406-CC 1433330-CC 1438545-CC
1422743-CC 1433395-CC 1438584-CC
1422886-CC 1433449-CC 1438610-CC
1422963-CC 1433516-CC 1438679-CC
1423063-CC 1433573-CC 1438931-CC
1423226-CC 1433755-CC 1438946-CC
1423316-CC 1433912-CC 1439122-CC
1423500-CC 1433949-CC 1439259-CC
1423725-CC 1434233-CC 1439303-CC
1423733-CC 1434260-CC 1439455-CC
1423817-CC 1434652-CC 1439551-CC
1424670-CC 1434653-CC 1439568-CC
1425429-CC 1434973-CC 1439666-CC
1425889-CC 1435234-CC 1439667-CC
1426020-CC 1435407-CC 1439678-CC
1426220-CC 1435455-CC 1439705-CC
1427088-CC 1435586-CC 1439755-CC
1427177-CC 1435659-CC 1440031-CC
1427247-CC 1435750-CC 1440089-CC
1427685-CC 1435803-CC 1440856-CC
1428414-CC 1435980-CC 1440929-CC
1428453-CC 1436400-CC 1441063-CC
1428579-CC 1436425-CC 1441104-CC
1428857-CC 1436608-CC 1441139-CC
ANNEX II-31
1441147-CC 1446125-CC 1402098-CD
1441246-CC 1446287-CC 1402751-CD
1441279-CC 1446493-CC 1403576-CD
1441322-CC 1446761-CC 1403578-CD
1441409-CC 1446766-CC 1404303-CD
1441451-CC 1446800-CC 1405259-CD
1441648-CC 1446822-CC 1405261-CD
1441918-CC 1446882-CC 1405577-CD
1442318-CC 1447012-CC 1406182-CD
1442454-CC 1447173-CC 1406185-CD
1442492-CC 1447631-CC 1406847-CD
1442649-CC 1448479-CC 1406849-CD
1442687-CC 1449383-CC 1407392-CD
1442795-CC 1449453-CC 1407619-CD
1442917-CC 1449618-CC 1409739-CD
1443075-CC 1449832-CC 1410389-CD
1443144-CC 1450045-CC 1410391-CD
1443179-CC 1450467-CC 1410400-CD
1443468-CC 1450824-CC 1410406-CD
1443540-CC 1451005-CC 1411647-CD
1443743-CC 1451034-CC 1411656-CD
1443848-CC 1451356-CC 1411658-CD
1443913-CC 1451584-CC 1411660-CD
1444006-CC 1453109-CC 1412401-CD
1444018-CC 1453584-CC 1413473-CD
1444027-CC 1455067-CC 1414783-CD
1444070-CC 1455838-CC 1415568-CD
1444344-CC 1456201-CC 1416348-CD
1444532-CC 1456618-CC 1417328-CD
1444545-CC 1457188-CC 1417934-CD
1444583-CC 1315834-CD 1418659-CD
1444717-CC 1348475-CD 1420220-CD
1444755-CC 1360021-CD 1421894-CD
1444951-CC 1360757-CD 1422886-CD
1444987-CC 1386312-CD 1423063-CD
1445056-CC 1393097-CD 1423226-CD
1445202-CC 1393105-CD 1423733-CD
1445265-CC 1395032-CD 1423817-CD
1445394-CC 1398237-CD 1425429-CD
1445689-CC 1399488-CD 1425889-CD
1445871-CC 1400092-CD 1428453-CD
1445878-CC 1400095-CD 1428579-CD
1445920-CC 1401452-CD 1429056-CD
1445954-CC 1401453-CD 1429278-CD
1446071-CC 1401797-CD 1429562-CD
1446100-CC 1402096-CD 1430808-CD
ANNEX II-32
1431172-CD 1443179-CD 1405261-CE
1432058-CD 1443468-CD 1406182-CE
1432704-CD 1443743-CD 1409739-CE
1433449-CD 1443913-CD 1417328-CE
1435659-CD 1444755-CD 1425889-CE
1435980-CD 1445265-CD 1429056-CE
1436710-CD 1446287-CD 1429562-CE
1436732-CD 1446761-CD 1435659-CE
1436761-CD 1446822-CD 1436732-CE
1436831-CD 1448479-CD 1437100-CE
1437100-CD 1449832-CD 1439259-CE
1437589-CD 1450467-CD 1446287-CE
1438153-CD 1450824-CD 1448479-CE
1438519-CD 1451034-CD 1449832-CE
1439259-CD 1451356-CD 1455067-CE
1439455-CD 1455067-CD 1403576-CF
1439678-CD 1456618-CD 1406182-CF
1439705-CD 1315834-CE 1409739-CF
1440089-CD 1393105-CE 1436732-CF
1441147-CD 1399488-CE 1439259-CF
1441648-CD 1400092-CE 1455067-CF
1442649-CD 1400095-CE 1406182-CG
1442917-CD 1401453-CE 1436732-CG
1443075-CD 1403576-CE 1406182-CH
ANNEX II-33
Annex III
MEDICAL RESEARCH AND MONITORING PROPOSAL
Disposition of the Medical Research and Monitoring Fund will be the
responsibility of the Court. An advisory board will be established for the
purpose of providing recommendations and advice to the Court to assist in the
stewardship of the Medical Research and Monitoring Fund. The advisory board will
be comprised of the following 6 members: (1) the Claims Administrator; (2) a
representative appointed by Sulzer; (3) a representative appointed by Class
Counsel; (4) two representatives appointed by the governing body of the American
Academy of Orthopedic Surgeons; and (5) a representative appointed by the
Special State Counsel Committee. Members of the advisory board will not receive
compensation specific to their service as board members.
The intended purpose and uses of the Medical Research and Monitoring
Fund include: (1) study of Class Members for the purpose of recognition and
identification of medical issues unique to the experience of class membership;
(2) the establishment and maintenance of a registry for the preservation of
medical information arising from the use of the Affected Products; (3) the
support of medical research and scholarship that may rely upon information
preserved by the registry; and (4) the establishment of protocols for access by
third parties to information contained in the registry for the purpose of
medical research and scholarship.
To the greatest extent possible, and to the degree consistent with the
purposes of the Medical Research and Monitoring Fund, the Court will preserve
the privacy and confidentiality of the patients and physicians whose information
may be contained in the registry. In addition to documents and medical records,
the registry is also authorized to take constructive possession of radiographic
films, explants, pathology samples, or other similar residue that may have
medical value in support of the purposes and uses of the Medical Research and
Monitoring Fund. Members of the advisory board may be reimbursed for reasonable
expenses incurred as a result of their service on the advisory board. The Trust
Agreement may provide for successor governance of the Medical Research and
Monitoring Fund to the extent the fund exists beyond the term of the Trust.
ANNEX III-1
Annex IV
COMPENSATION BENEFITS PAYABLE FROM
THE EXTRAORDINARY INJURY FUND
For purposes of providing Extraordinary Injury Fund Benefits to those
Class Members eligible to receive such payments, the following two Matrices are
established, one relating to Hip Beneficiaries (the "Hip Matrix") and the other
relating to Knee Beneficiaries (the "Knee Matrix").
Each Matrix is divided into levels (the "Matrix Levels") that describe
the amount that an eligible Class Member is entitled to recover based on (1) the
complication that he/she has experienced; in most instances, (2) the severity of
that complication; and, in some instances, and (3) the Class Member's age at the
time that the complication was recognized.
For purposes of determining the amount of EIF Benefits with respect to
a given Matrix Level, the terms listed below shall have the following meanings:
1. "adjusted current annual income" means 78.5% (which percentage
is calculated to reflect fringe benefits as well as personal
maintenance expenditures) of the Affected Product Recipient's
average actual income from wages, salaries, personal services,
personal business activities or other form of income from
self-employment, as reported on his/her federal income tax
return over the period of 3 years prior to the year of death.
2. "moderate" means the Class Member experienced pain, sensory
loss or gait alteration that required narcotics and/or use of
a cane or walker.
3. "severe" means the Class Member required the use of a
wheelchair or underwent an amputation.
If a Class Member is eligible for EIF Benefits, such Class Member shall
receive the applicable amount set forth in the applicable Matrix less the
applicable Plaintiffs' Counsel fees or allocable in accordance with Article 5.
HIP MATRIX
The Hip Matrix is separated into levels that are based upon the varying
complications which entitle Class Members to EIF Benefits. These levels are as
follows:
I. MATRIX LEVEL I (REVISION SURGERY INDICATED BUT FOR A MEDICAL CONDITION)
ELIGIBILITY. Class Members for whom Affected Product Revision Surgery
would be indicated but for a medical condition(s).
BENEFITS. Under Matrix Level I, a Class Member will receive up to
$120,000.
ANNEX IV-1
II. MATRIX LEVEL II (NON-REMOVAL SURGERY)
ELIGIBILITY. Class Members who have not undergone an APRS, but who have
undergone a surgery wherein their treating surgeons have attempted to secure an
Affected Product using screws, cement, or some other means, as a result of
non-traumatic loosening.
BENEFITS. Under Matrix Level II, a Class Member receives up to $36,000
for each such procedure that he/she undergoes, not to exceed $90,000.
III. MATRIX LEVEL III (NON-AFFECTED PRODUCT REVISION SURGERY AND ADDITIONAL
NON-AFFECTED PRODUCT REVISION SURGERIES)
ELIGIBILITY. Class Members who have undergone a Non-Affected Product
Revision Surgery on or before the date that is one-hundred and eighty (180)
days(1) after the date of an APRS; this Matrix Level III additionally relates to
those Class Members who have required one or more Additional Non-Affected
Product Revision Surgeries (after the First NAPRS) on or before the date that is
three hundred and sixty-five (365) days(2) after the date of their APRS.
BENEFITS. Under Matrix Level III, a Class Member receives up to $80,000
for a NAPRS and receives up to $40,000 for each Additional Non-Affected Product
Revision Surgeries performed on or before the date that is three hundred and
sixty-five (365) days after the date of his/her APRS, not to exceed $200,000 in
the aggregate.
IV. MATRIX LEVEL IV (MAJOR COMPLICATIONS)
ELIGIBILITY. Class Members who have suffered any of the following as a
major surgical complication of a CRS:
(1) direct injury to the genito-urinary system during revision;
(2) wound infection occurring within one-hundred and eighty (180) days
from the date of a CRS and requiring surgical debridement with prosthesis
retention, resection arthroplasty, hip arthrodesis or reimplantation;
(3) one or more dislocation(s)/subluxation(s) of the prosthetic femoral
head occurring within ninety (90) days from the date of the CRS and requiring
closed reduction under intravenous sedation or general anesthesia;
(4) pulmonary embolism requiring hospitalization and/or placement of an
inferior vena cava filter;
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(1) The Claims Administrator may, at his/her discretion, extend this compensable
time period by 180 days where a Class Member's treating orthopedic surgeon
causally relates (to a medical probability) the NAPRS to the APRS and/or to the
original implantation of the Affected Product.
(2) The Claims Administrator may, at his/her discretion, extend this compensable
time period by 180 days where a Class Member's treating orthopedic surgeon
causally relates (to a medical probability) the Additional Non-Affected Product
Revision to a NAPRS or to his/her APRS.
ANNEX IV-2
(5) grade IV heterotopic ossification (as demonstrated on x-ray) and/or
heterotopic ossification requiring surgical repair, each occurring within
one-hundred eighty (180) days from the date of a CRS;
(6) non-union of a trochanteric osteotomy occurring within one-hundred
and eighty (180) days from the date of a CRS and requiring surgical repair;
(7) periprosthetic fracture experienced within thirty (30) days from
the date of a CRS and requiring either open or closed reduction; or
(8) abductor mechanism disruption occurring within ninety (90) days
from the date of a CRS and requiring surgical repair.
The Claims Administrator, at his/her discretion, may qualify a Class Member who
has suffered a major surgical complication not listed above for benefits under
this Matrix Level IV.
BENEFITS. Under Matrix Level IV, a Class Member receives up to $36,000
for each major complication that he/she experiences not to exceed $90,000.
V. MATRIX LEVEL V (PERMANENT INJURY)
ELIGIBILITY. Class Members who have suffered any of the following
permanent injuries as a surgical complication of a CRS:
(1) permanent nerve injury, either moderate or severe, as demonstrated
by objective physical examination and quantitative measures (e.g. EMG and/or
nerve conduction studies) on or after the date that is three hundred and
sixty-five (365) days after a CRS;
(2) permanent vascular injury, either moderate or severe, as
demonstrated by objective physical examination and quantitative measures (e.g.
angiogram) on or after the date that is three hundred and sixty-five (365) days
after a CRS; or
(3) permanent injury due to an infection (qualifying as a major
complication under Matrix Level IV), either moderate or severe, as demonstrated
by objective physical examination and quantitative measures on or after the date
that is three hundred and sixty-five (365) days after a CRS.
The Claims Administrator, at his/her discretion, may qualify a Class Member who
has suffered a permanent injury as a surgical complication not listed above for
benefits under this Matrix Level V.
BENEFITS. A Class Member's compensation under this Matrix Level V will
be based upon (1) the severity of the permanent injury and (2) the Class
Member's age on the date the permanent injury was recognized, as follows:
ANNEX IV-3
Age on Date Permanent Injury was Recognized
Severity Level < or = to 40 41-49 50-59 60-69 > or = to 70
-------------- ------------ ----- ----- ----- ------------
Moderate $160,000 $126,316 $ 92,631 $ 63,158 $37,894
Severe $320,000 $252,631 $185,263 $126,316 $75,790
VII. MATRIX LEVEL VI (MYOCARDIAL INFARCTION)
ELIGIBILITY. Class Members who have suffered a myocardial infarction
during a CRS or during the hospitalization associated with a CRS. In addition,
the Claims Administrator, at his/her discretion, may qualify a Class Member
whose treating cardiothoracic surgeon or treating cardiologist causally relates
a myocardial infarction (neither occurring during a CRS nor CRS hospitalization)
to the Covered Revision Surgery.
BENEFITS. A Class Member's compensation under Matrix Level VI will be
based upon (1) the pre and post myocardial infarction change in Functional
Classification (as defined by the New York Heart Association(3)) and (2) the
Class Member's age on the date of the myocardial infarction as follows:
Age on Date of Myocardial Infarction
Complication
Level < or = to 40 41-49 50-59 60-69 > or = to 70
------------ ------------ ----- ----- ----- ------------
1 class change $280,000 $221,053 $162,106 $110,526 $66,316
2 class change $320,000 $252,631 $185,263 $126,316 $75,790
3 class change $360,000 $284,420 $208,421 $142,106 $85,263
VII. MATRIX LEVEL VII (STROKE)
ELIGIBILITY. Class Members who have suffered a stroke (or other event
resulting in central nervous system sequelae) during a CRS or during the
hospitalization associated with a CRS. In addition, the Claims Administrator, at
his/her discretion, may also qualify a Class Member whose treating neurosurgeon
or treating neurologist causally relates a stroke (neither occurring during a
CRS nor CRS hospitalization) to a Covered Revision Surgery.
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(3) See X. Xxxxxxxx, X. Xxxxxxx, X. Xxxxxxxxx, F. Plum, X. Xxxxx, Jr., Xxxxx
Essentials of Medicine, at 12 (3d ed. 1993).
ANNEX IV-4
BENEFITS. A Class Member's compensation under Matrix Level VII will be
based upon (1) the Class Member's Functional Stroke Outcome Classification (as
defined by the American Heart Association(4))and (2) his/her age on the date of
the stroke (or other event resulting in central nervous system sequelae) as
follows:
Age on Date of Stroke
Stroke
Outcome
Classification < or = to 40 41-49 50-59 60-69 > or = to 70
-------------- ------------ ----- ----- ----- ------------
Level I $280,000 $221,053 $162,106 $110,526 $66,316
Level II $320,000 $252,631 $185,263 $126,316 $75,790
Level III $360,000 $284,210 $208,421 $142,106 $85,263
Level IV $400,000 $315,790 $231,580 $157,894 $94,737
VIII. MATRIX LEVEL VIII (DEATH)
ELIGIBILITY. Class Members whose claims are brought on behalf of
Affected Product Recipients who have died during a CRS or during the
hospitalization associated with a CRS. In addition, the Claims Administrator, at
his/her discretion, may also qualify a Class Member whose treating surgeon or
treating physician causally relates a death (neither occurring during a CRS nor
CRS hospitalization) to a Covered Revision Surgery.
BENEFITS. A Representative Claimant's compensation under Matrix Level
VIII will be as follows:
(1) he/she will receive a minimum payment of up to $40,000;
(2) he/she will receive up to $160,000 if the Affected Product
Recipient was married on the date of death;
(3) he/she will receive up to $80,000 multiplied by the number of minor
children (under the age of 18), if any, on the date of the Affected Product
Recipient's death;
----------
(4) See The American Heart Association Stroke Outcome Classification 29 Stroke
at 1274-75 (1998).
ANNEX IV-5
(4) he/she will receive up to $20,000 multiplied by the number of adult
children (age 18 or older), if any, on the date of the Affected Product
Recipient's death;
(5) he/she will receive up to $40,000 multiplied by the number of
parents, if any, on the date of the Affected Product Recipient's death and whose
claims are recognized pursuant to applicable state law; and
(6) where applicable, he/she will receive the Affected Product
Recipient's lost income, calculated as the sum of the following: (x) the
percentage of the "adjusted current annual income" equal to the number of days
from the date of death to the end of the year divided by 365; and (y) the
present value of the future "adjusted current annual income," beginning the year
following the death, ending the year of the Affected Product Recipient's 62nd
birthday, and discounted to the date of Final Judicial Approval at a net
interest rate of 1.5% (which percentage is calculated as the difference between
5.5% growth and a 7.0% discount rate). If the Affected Product Recipient has no
such income or is age 62 at the time of death, then there is no payment under
this section.
LIMITATION. Under no circumstances should the total benefits
recoverable under this Matrix Level VIII exceed $800,000.
IX. MATRIX LEVEL IX (DISCRETIONARY)
ELIGIBILITY. Class Members who feel that they are entitled to EIF
Benefits as a result of a complication that was neither anticipated, nor
provided for under Matrix Levels I-VIII
BENEFITS. The Claims Administrator, at his/her discretion, may award
EIF Benefits to a Class Member under this Matrix Level IX. In doing so, the
Claims Administrator shall consider evidence of any catastrophic loss of income
and/or extraordinary medical expenses related to the Affected Product.
KNEE MATRIX
The Knee Matrix is separated into levels that are based upon the
varying complications which entitle Class Members to EIF Benefits. These levels
are as follows:
I. MATRIX LEVEL I (REVISION SURGERY INDICATED BUT FOR A MEDICAL CONDITION)
ELIGIBILITY. Class Members for whom Affected Product Revision Surgery
would be indicated but for a medical condition(s).
BENEFITS. Under Matrix Level I, a Class Member receives up to $120,000.
II. MATRIX LEVEL II (NON-REMOVAL SURGERY)
ELIGIBILITY. Class Members who have not undergone an APRS, but who have
undergone a surgery wherein their treating surgeons have attempted to secure an
Affected Product using screws, cement, or some other means, as a result of
non-traumatic loosening.
ANNEX IV-6
BENEFITS. Under Matrix Level II, a Class Member receives up to $36,000
for each such procedure that he/she undergoes not to exceed $90,000.
III. MATRIX LEVEL III (NON-AFFECTED PRODUCT REVISION SURGERY AND ADDITIONAL
NON-AFFECTED PRODUCT REVISIONS).
ELIGIBILITY. Class Members who have undergone a Non-Affected Product
Revision Surgery on or before the date that is one-hundred and eighty (180)
days(5) after the date of an APRS; this Matrix Level III additionally relates to
those Class Members who have required one or more Additional Non-Affected
Product Revision Surgeries (after the First NAPRS) on or before the date that is
three hundred and sixty-five (365) days(6) after the date of their APRS.
BENEFITS. Under Matrix Level III, a Class Member receives up to $80,000
for a NAPRS and receives up to $40,000 for one or more Additional Non-Affected
Product Revision Surgeries performed on or before the date that is three hundred
and sixty-five (365) days from the date of his/her APRS, not to exceed $200,000
in the aggregate.
IV. MATRIX LEVEL IV (MAJOR COMPLICATIONS)
ELIGIBILITY. Class Members who have suffered any of the following as a
major surgical complication of a CRS:
(1) wound infection occurring within 180 days from the date of CRS and
requiring surgical debridement, resection arthroplasty, knee arthrodesis, or
reimplantation;
(2) pulmonary embolism requiring hospitalization and/or placement of an
inferior vena cava filter;
(3) grade IV heterotopic ossification (as demonstrated on x-ray) and/or
heterotopic ossification requiring surgical repair, each occurring within
one-hundred and eighty (180) days from the date of a CRS;
(4) non-union of a tibial tubercle osteotomy occurring within
one-hundred and eighty (180) days of the date of a CRS and requiring surgical
repair;
(5) periprosthetic fracture experienced within thirty (30) days of the
date of a CRS and requiring either open or closed reduction; or
(6) extensor mechanism disruption occurring within one-hundred and
eighty (180) days of the date of a CRS and requiring surgical repair.
----------
(5) The Claims Administrator may, at his/her discretion, extend this compensable
time period by 180 days where a Class Member's treating orthopedic surgeon
causally relates (to a medical probability) the NAPRS to the APRS and/or to the
original implantation of the Affected Product.
(6) The Claims Administrator may, at his/her discretion, extend this compensable
time period by 180 days where a Class Member's treating orthopedic surgeon
causally relates (to a medical probability) the Additional Non-Affected Product
Revision to a NAPRS or to his/her APRS.
ANNEX IV-7
The Claims Administrator, at his/her discretion, may qualify a Class Member who
has suffered a Major Surgical Complication not listed above for benefits under
this Matrix Level IV.
BENEFITS. Under Matrix Level IV, a Class Member receives up to $36,000
for each major complication that he/she experiences - not to exceed $90,000.
V. MATRIX LEVEL V (PERMANENT INJURY)
ELIGIBILITY. Class Members who have suffered any of the following
permanent injuries as a surgical complication of a CRS:
(1) permanent nerve injury, either moderate or severe, as demonstrated
by objective physical examination and quantitative measures (e.g. EMG and/or
nerve conduction studies) on or after the date that is three hundred and
sixty-five (365) days after a CRS;
(2) permanent vascular injury, either moderate or severe, as
demonstrated by objective physical examination and quantitative measures (e.g.
angiogram) on or after the date that is three hundred and sixty-five (365) days
after a CRS; or
(3) permanent injury due to an infection(qualifying as a major
complication under Matrix Level IV), either moderate or severe, on of after the
date that is three hundred and sixty-five (365) days after a CRS.
The Claims Administrator, at his/her discretion, may qualify a Class Member who
has suffered a permanent injury as a surgical complication not listed above for
benefits under this Matrix Level V.
BENEFITS. A Class Member's compensation under this Matrix Level V will
be based upon (1) the severity of the permanent injury and (2) the Class
Member's age on the date the permanent injury was recognized, as follows:
Age on Date Permanent Injury was Recognized
Severity Level < or = to 40 41-49 50-59 60-69 > or = to 70
-------------- ------------ ----- ----- ----- ------------
Moderate $160,000 $126,316 $ 92,631 $ 63,158 $37,894
Severe $320,000 $252,631 $185,263 $126,316 $75,790
VII. MATRIX LEVEL VI (MYOCARDIAL INFARCTION)
ELIGIBILITY. Class Members who have suffered a myocardial infarction
during a CRS or during the hospitalization associated with a CRS. In addition,
the Claims Administrator, at his/her discretion, may qualify a Class Member
whose treating cardiothoracic surgeon or treating cardiologist causally relates
a myocardial infarction (neither occurring during a CRS nor CRS hospitalization)
to the Covered Revision Surgery.
ANNEX IV-8
BENEFITS. A Class Member's compensation under Matrix Level VI will be
based upon (1) the pre and post myocardial infarction change in Functional
Classification (as defined by the New York Heart Association(7)) and (2) his/her
age on the date of the myocardial infarction as follows:
Age on Date of Myocardial Infarction
Complication
Level < or = to 40 41-49 50-59 60-69 > or = to 70
------------ ------------ ----- ----- ----- ------------
1 class change $280,000 $221,053 $162,106 $110,526 $66,316
2 class change $320,000 $252,631 $185,263 $126,316 $75,790
3 class change $360,000 $284,210 $208,421 $142,106 $85,263
VII. MATRIX LEVEL VII (STROKE)
ELIGIBILITY. Class Members who have suffered a stroke (or other event
resulting in central nervous system sequelae) during a CRS or during the
hospitalization associated with a CRS. In addition, the Claims Administrator, at
his/her discretion, may also qualify a Class Member whose treating neurosurgeon
or treating neurologist causally relates a stroke (neither occurring during a
CRS nor CRS hospitalization) to a Covered Revision Surgery.
BENEFITS. A Class Member's compensation under Matrix Level VII will be
based upon (1) the Class Member's Functional Stroke Outcome Classification (as
defined by the American Heart Association(8)) and (2) his/her age on the date of
the stroke (or other event resulting in central nervous system sequelae) as
follows:
Age on Date of Stroke
Stroke
Outcome
Classification < or = to 40 41-49 50-59 60-69 > or = to 70
-------------- ------------ ----- ----- ----- ------------
Level I $280,000 $221,053 $162,106 $110,526 $66,316
Level II $320,000 $252,631 $185,263 $126,316 $75,790
Level III $360,000 $284,210 $208,421 $142,106 $85,263
Level IV $400,000 $315,790 $231,580 $157,894 $94,737
----------
(7) See X. Xxxxxxxx, X. Xxxxxxx, X. Xxxxxxxxx, F. Plum, X. Xxxxx, Jr., Xxxxx
Essentials of Medicine, at 12 (3d ed. 1993).
(8) See The American Heart Association Stroke Outcome Classification 29 Stroke
at 1274-75 (1998).
ANNEX IV-9
Level II $320,000 $252,631 $185,263 $126,316 $75,790
Level III $360,000 $284,210 $208,421 $142,106 $85,263
Level IV $400,000 $315,790 $231,580 $157,894 $94,737
VIII. MATRIX LEVEL VIII (DEATH)
ELIGIBILITY. Class Members whose claims are brought on behalf of
Affected Product Recipients who have died during a CRS or during the
hospitalization associated with a CRS. In addition, the Claims Administrator, at
his/her discretion, may also qualify a Class Member whose treating surgeon or
treating physician causally relates a death (neither occurring during a CRS nor
CRS hospitalization) to a Covered Revision Surgery.
BENEFITS. A Representative Claimant's compensation under Matrix Level
VIII will be as follows:
(1) he/she will receive a minimum payment of up to $40,000;
(2) he/she will receive up to $160,000 if the Affected Product
Recipient was married on the date of death;
(3) he/she will receive up to $80,000 multiplied by the number of minor
children (under the age of 18), if any, on the date of the Affected Product
Recipient's death;
(4) he/she will receive up to $20,000 multiplied by the number of adult
children (age 18 or older), if any, on the date of the Affected Product
Recipient's death;
(5) he/she will receive up to $40,000 multiplied by the number of
parents, if any, on the date of the Affected Product Recipient's death and whose
claims are recognized pursuant to applicable state law; and
(6) where applicable, he/she will receive the Affected Product
Recipient's lost income, calculated as the sum of the following: (x) the
percentage of the "adjusted current annual income" equal to the number of days
from the date of death to the end of the year divided by 365; and (y) the
present value of the future "adjusted current annual income," beginning the year
following the death, ending the year of the Affected Product Recipient's 62nd
birthday, and discounted to the date of Final Judicial Approval at a net
interest rate of 1.5% (which percentage is calculated as the difference between
5.5% growth and a 7.0% discount rate). If the Affected Product Recipient has no
such income or is age 62 at the time of death, then there is no payment under
this section.
ANNEX IV-10
LIMITATION. Under no circumstances should the total benefits
recoverable under this Matrix Level VIII exceed $800,000.
IX. MATRIX LEVEL IX (DISCRETIONARY)
ELIGIBILITY. Class Members who feel that they are entitled to EIF
Benefits as a result of a complication that was neither anticipated, nor
provided for under Matrix Levels I-VIII.
BENEFITS. The Claims Administrator, at his/her discretion, may award
benefits to a Class Member under this Matrix Level IX. In doing so, the Claims
Administrator shall consider evidence of any catastrophic loss of income and/or
extraordinary medical expenses related to the Affected Product.
ANNEX IV-11
Annex V
SUMMARY TERMS OF CONVERTIBLE CALLABLE INSTRUMENT ("CCI")
Issuer Sulzer Orthopedics Inc., a
Delaware corporation
Guarantor Sulzer Medica AG, a Switzerland
limited company, will guarantee
SOUS's obligations under the
CCI, with standard waiver of
any SML subrogation,
contribution and
indemnification rights against
SOUS
Principal Amount $300,000,000
Stated Maturity The CCI shall be issued as of
the later of (i) the 180th day
following the Trial Court
Approval Date and (ii) the 60th
day following the Final
Judicial Approval Date (the
"CCI Issue Date"). Unless
earlier redeemed, the entire
face amount plus accrued but
unpaid interest of the CCI will
be paid in cash by SOUS on the
date that is 18 months from the
CCI Issue Date (the "Maturity
Date"); provided, however, that
to the extent shareholders have
not exercised the Subscription
Options (as hereinafter
defined) as of the Maturity
Date, a proportionate amount of
the unredeemed face amount plus
accrued and unpaid interest
thereon may, at the option of
SOUS, be converted into ADRs or
shares of SML ("Shares") based
on the Conversion Price
(defined below) in effect on
the Maturity Date.
"Conversion Price" means, for
the 30 consecutive trading days
ending 10 Business Days before
the date of determination, the
weighted (by volume of shares
traded) average closing sales
price of the ADRs or Shares as
reported by the principal
securities market on which the
ADRs or Shares trade in the
United States or Switzerland,
as applicable, all as
calculated and certified by
ANNEX V-1
the Chief Financial Officer of
SML in an instrument delivered
to the Sulzer Settlement Trust
prior to the date as of which
the Conversion Price is being
determined.
The Conversion Price will be
subject to adjustment for stock
splits, dividends,
reclassifications and
recapitalizations; provided,
that no adjustment shall be
made to the Conversion Price
with respect to the
distribution of options to
purchase Shares to the current
shareholders of SML for the
purpose of granting rights to
such shareholders to subscribe
to Shares for the purpose of
retiring the CCI prior to the
Maturity Date.
Ranking The payment obligations under
the CCI will be unsecured and
subordinated to the Financing.
Interest Interest on the CCI shall
accrue (beginning on the CCI
Issue Date) at a rate equal to
7.5% compounded annually. No
interest shall be payable prior
to the Maturity Date, except
with respect to and only to the
extent of a prior redemption,
in which case the corresponding
accrued but unpaid interest
shall be payable upon such
redemption. In the case of a
conversion into ADRs or Shares,
accrued but unpaid interest
will be paid in ADRs or Shares
based on the Conversion Price
in effect at the Maturity Date.
Optional Call SOUS may at any time and from
time to time, upon 10 days
prior written notice to the
Sulzer Settlement Trust, redeem
for cash all or any portion of
the face amount of the CCI at a
cash price equal to 100% of the
face amount to be redeemed plus
accrued but unpaid interest
through the date of such
redemption; provided, however,
that each partial redemption
shall be in a minimum face
amount of $10 million.
ANNEX V-2
Mandatory Call 1. Upon the occurrence of any
of the events described below,
concurrently with or as soon as
practicable after the
consummation of such event,
SOUS shall redeem for cash the
entire outstanding face amount
of the CCI at a cash price
equal to 100% of such
outstanding face amount plus
accrued but unpaid interest
through the date of such
redemption:
(i) a Change of Control of
SML (as defined below);
(ii) a default under the
Financing or any other funded
indebtedness of SOUS or its
affiliates that permits
acceleration of $10 million or
more of outstanding
indebtedness and that is not
waived by lender or cured by
SOUS or such affiliate within
30 days of notice thereof;
(iii) a default by SOUS or
SML of (x) any payment,
redemption or conversion
provision of the CCI or (y) any
other provision thereof that
continues for 10 Business Days
after notice thereof is given
to SOUS by the Sulzer
Settlement Trust or other
holder thereof; or
(iv) a sale of all or
substantially all of the assets
of SML and its subsidiaries
taken as a whole.
"Change of Control" means (i)
the acquisition by any "person"
or "group" (as such terms are
used in Section 13(d)(3) of the
U.S. Securities Exchange Act of
1934) of ADRs and/or Shares
such that such person becomes
the ultimate "beneficial
owner," as defined in Rule
13d-3 under the Exchange Act,
of more than 50% of the total
voting power of the Shares on a
fully-diluted basis or (ii) any
merger, consolidation,
amalgamation or other similar
transaction involving SML
whereby the beneficial holders
of Shares immediately prior to
such
ANNEX V-3
transaction hold less than a
majority of the outstanding
voting power with respect to
SML (or, if SML shall not be
the surviving entity following
such transaction, such
successor entity) immediately
following such transaction.
2. SML expects to distribute
options (the "Subscription
Options") to its existing
holders of Shares for the
purpose of permitting existing
shareholders to subscribe for
new Shares at an exercise price
which, in the aggregate, shall
equal the principal amount of
the CCI. Upon the exercise of
any such Subscription Option,
SOUS or SML shall set aside the
cash proceeds of such exercise
in a sinking or other fund for
the purposes of redeeming a
portion of the CCI at a cash
price equal to 100% of the face
amount thereof, together with
accrued and unpaid interest to
the date of redemption, which
redemptions shall take place in
increments of $10 million of
face amount of the CCI each
time such fund reaches at least
that amount.
Covenants 1. So long as any face amount
of the CCI is outstanding, SML
and its affiliates will not
incur indebtedness, except as
follows:
(i) the Financing in a
maximum principal amount equal
initially to $425 million and
thereafter decreasing in
accordance with the required
amortization schedule of such
Financing, if any;
(ii) refinancing of the
Financing in an aggregate
principal amount not greater
than the amount permitted to be
outstanding under clause (i)
above;
(iii) other indebtedness
permitted to be incurred
pursuant to the terms of the
Financing or any permitted
refinancing thereof; and
ANNEX V-4
(iv) the incurrence of any
other indebtedness the net
proceeds of which are used to
pay down all or part (in
increments of at least $10
million principal face amount)
of the outstanding obligations
due under the CCI.
2. SML will not issue shares of
capital stock that rank senior
in dividend rights or
liquidation preference to the
Shares or the ADRs unless the
net proceeds of such issuance
are used to pay down all or
part (in increments of at least
$10 million principal face
amount) of the outstanding
obligations under the CCI.
3. Subject to any required
shareholder approval, SML shall
take all action reasonably
necessary, at its sole expense,
to properly reserve for
issuance the number of Shares
(and, if applicable, the
corresponding number of ADRs)
into which the CCI may be
converted at the Maturity Date.
4. SML and SOUS shall not enter
into or engage in transactions
with affiliates on terms other
than arm's length (conclusively
as determined in good faith by
the board of directors of SML),
other than any such affiliates
are at least direct or indirect
majority owned-subsidiaries of
SML.
5. Except for (x) options to
purchase Shares issued to the
existing shareholders of SML
with respect to which the
proceeds from any exercise will
be used to retire the CCI on or
prior to the Maturity Date and
(y) dividends of shares of
capital stock of SML for which
appropriate adjustment of the
Conversion Price is made
pursuant to the terms of the
CCI, SML will not declare or
pay cash dividends in respect
of its Shares, declare or pay
any other dividends in respect
to the Shares or make any
distributions of assets or
rights to the holders of
Shares; provided, however, that
the foregoing shall
ANNEX V-5
not prevent any declaration
payment or distribution that is
made or effective only after
the prior redemption or
conversion in whole of the
entire outstanding face amount
of the CCI.
Subordination All cash payments in respect of
the CCI will be subordinated on
standard terms and conditions
to the prior payment in full of
all amounts owing in respect to
the Financing or the
refinancing thereof as
permitted by the terms of the
CCI, together with all other
senior indebtedness of SOUS and
SML. Such subordination will
not prevent the Sulzer
Settlement Trust from
exercising any right it might
properly have to file
appropriate proofs of claims
with respect to the CCI in the
event of any bankruptcy or
other insolvency proceeding of
SML or any of its subsidiaries.
Transfer Restrictions The CCI will not be
transferable by the Sulzer
Settlement Trust in whole or in
part without the prior written
consent of SOUS and subject to
applicable United States and
foreign securities laws.
Transferability of ADRs or Shares The ADRs or Shares issued upon
conversion of the CCI will be
issued in the United States
pursuant to an exemption from
registration under the
Securities Act of 1933, as
amended, by virtue of Section
3(a)(10) of the Securities Act.
SML shall (at its own expense)
take all action reasonably
necessary to comply with the
rules and regulations of the
United States Securities and
Exchange Commission and
interpretations of the staff
thereof to exempt the issuance
of the CCI, ADRs and/or Shares
pursuant to Section 3(a)(10) of
the Securities Act. It is the
intent of the Parties that the
ADRs or Shares received by
non-affiliated third parties or
Class Members in the United
States shall be freely tradable
by such persons upon issuance.
SML will (at its own expense)
also use its commercially
ANNEX V-6
reasonable efforts to comply
with the applicable securities
laws of any foreign
jurisdiction on which the
Shares are then traded to
ensure that any Shares received
by non-affiliated third parties
or Class Members shall be
freely tradable by such persons
upon issuance.
ANNEX V-7
UNITED STATES DISTRICT COURT
NORTHERN DISTRICT OF OHIO
EASTERN DIVISION
IN RE: : Case No. 01-CV-9000
:
SULZER HIP PROSTHESIS AND : MDL Docket No.: 1401
KNEE PROSTHESIS PRODUCT :
LIABILITY LITIGATION : Judge Xxxxxxxx M. O'Xxxxxx
:
This Document Relates to All Cases :
--------------------------------------------------------------------------------
FIRST AMENDMENT TO
CLASS ACTION SETTLEMENT AGREEMENT
--------------------------------------------------------------------------------
It is hereby stipulated and agreed between the parties to the
Class
Action Settlement Agreement dated March 13, 2002 ("Settlement Agreement") and
the Claims Administrator that the Settlement Agreement shall be amended as
follows:
1. Section 1.1 (zzz) is amended to add the following provision at
the end of the first sentence:
"; provided, however, that "Settled Claims" shall not include
claims held by Third-Party Payors in respect of subrogation or
other claims for medical expenses paid on behalf of Class
Members. Further, the term 'assigned claims' in the release to
be signed by Affected Product Recipients shall have the same
meaning as 'Settled Claims'."
2. Article 5 is amended to add the following Section 5.7:
"Section 5.7 Notwithstanding the foregoing, in the event that
a class Member is paid benefits pursuant to Section 8.4
hereof, no attorneys' fees or expenses shall be deducted from
such amount at the time payment is made to such Class Member,
rather any such applicable attorneys' fees or expenses owed in
respect of such payment shall be deducted from the amount of
any additional benefits paid to such Class Member."
3. Section 3.7(b) is amended to delete the last sentence in its
entirety and replaced with the following:
"To the extent a Class Member qualifies for payment under
Matrix Level IV and then subsequently qualifies for payment
under Matrix Level V because the Major Surgical Complication
has resulted in a permanent impairment, any payment made
pursuant to Matrix Level V shall be less the amount allocated
under Matrix Level IV. By way of example, where a Class Member
qualifies for benefits under Matrix Level IV due to an
infection and subsequently suffers from a permanent impairment
as a result of that infection, the Class Member shall receive
benefits under Matrix Level V for the permanent impairment,
less any benefits previously received by the Class Member
under Matrix Level IV as a result of the infection."
4. Section 2.2(d) is amended to replace the heading
"Extraordinary Fund" with the heading "Extraordinary Injury
Fund".
5. Section 3.9(b) is amended to replace the reference to
"Subrogation and Uninsured Expenses Fund" with "Subrogation
and Uninsured Expenses Sub-Fund."
6. Section 5.1 is amended to add the following after the last
sentence:
"In no event shall attorneys' fees or expenses be deducted
from the amount of any benefits received by a Class Member
pursuant to Section 3.3 and 3.5(a)."
7. Annex IV is amended to replace "VII. MATRIX LEVEL VI
(Myocardial Infarction)" with "VI. MATRIX LEVEL VI (Myocardial
Infarction)" in both the Hip and Knee Matrices.
8. Annex IV, Hip Matrix Level IV (8) is amended to replace
"ninety (90) days" with "one hundred eighty (180) days."
9. Annex IV, Matrix Level IX in both the Hip and Knee Matrices is
amended to add the following sentence after the first sentence
under "Benefits":
"A Class Member's eligibility to receive benefits pursuant to
Matrix Levels I-VIII in no way precludes such Class Member
from receiving benefits pursuant to this Matrix Level IX."
10. The first sentence of Section 8.4 is deleted in its entirety
and replaced with the following:
"Class Members who elect the GPO and execute the GPO Agreement
shall receive a minimum of $40,000 of the payments provided in
Section 3.4(a) and a minimum of $400 of the payments provided
in Section 3.5(b), as applicable on the date that is the later
of (a) sixty (60) days after the Insurance Proceeds Delivery
Date or (b) forty-five (45) days after the Claims
Administrator reviews such Class Members' completed Orange
Form."
11. The first sentence of Section 3.5(b) is deleted in its
entirety and replaced with the following:
"Subject to Section 3.6(b), Derivative Claimants of Class
Members who are entitled to payment under Section 3.4(a) are
entitled to receive a cash payment of $1,600 (less any amounts
paid to such Derivative Claimants pursuant to Article 8, if
applicable), to be paid no later than the date on which
payments are made to Class Members pursuant to Sections 3.4(b)
or 3.4(c) as applicable."
12. Section 3.6(d) is amended to add the following after the last
sentence:
"Notwithstanding the foregoing, (i) any benefits payable to a
Class Member pursuant to Section 3.3 will not be offset from
the amount of any payment received by such Class Member prior
to the Insurance Proceeds Delivery Date; and (ii) to the
extent a Class Member receives any payment of benefits prior
to the Insurance Proceeds Delivery Date, such amounts shall be
deducted from amount of benefits that such Class Member is
entitled to pursuant to Sections 3.4(b), 3.4(c) and 3.7;
provided, that, any such amounts, if possible, shall be
deducted from the final payment made to such Class Member
hereunder."
13. The last sentence of Section 5.2 is deleted in its entirety
and replaced with the following:
"In the event there are any amounts remaining in the
Plaintiffs' Counsel Sub-Fund after all applicable amounts have
been paid to Plaintiffs' Counsel, such remaining amount shall
be distributed pro rata among all Class Members who received
benefits pursuant to Sections 3.4(a), 3.5(b), 3.5(c) and
3.7(a)."
14. The first sentence of Section 3.9(a) is deleted in its
entirety and replaced by the following:
"The Sulzer Settlement Trust or, if prior to the Insurance
Proceeds Delivery Date,
Sulzer shall pay to the United States on behalf of the Centers
for Medicare and Medicaid Services (formerly known as the
Health Care Finance Administration) and other Third-Party
Payors in respect of subrogation or other claims for medical
expenses paid on or behalf of Class Members and shall pay
reasonable and necessary expenses incurred by Uninsured
Affected Product Recipients in respect of each Affected
Product Revision Surgery; provided, however, that any such
amount paid by the Sulzer or the Sulzer Settlement Trust shall
not exceed (i) $15,000 in the aggregate for any and all claims
made in respect of a single Affected Product Revisions Surgery
(unless approved by Sulzer as set forth below) and (ii) $60.0
million, in the aggregate,"
15. Section 3.3(a) is deleted in its entirety and replaced with
the following:
"(a) Class Members (other than Subclass V) who have not
undergone Affected Product Revision Surgery on or before the
Final Judicial Approval Date shall be entitled to receive an
aggregate cash payment of $1,000, payable in cash by the date
that is the later of the 45th day following the Funding Date
and the 45th day following the date the Claims Administrator
makes a Final Determination with respect to such Class Member
(or if such Final Determination is appealed in accordance with
Section 4.6, the date on which all such appeals are
exhausted)."
16. Section 3.4(b)(x) is deleted in its entirety and replaced with
the following:
"(x) at least 55% shall be payable in cash (less any amounts
paid to such Class member pursuant to Article 8, if
applicable) by the date that is the later of the 45th day
following the Funding Date and the 45th day following the date
the Claims Administrator makes a Final Determination with
respect to such Class Member (or if such Final Determination
is appealed in accordance with Section 4.6, the date on which
all such appeals are exhausted) and"
17. Section 3.4(b)(y) is deleted in its entirety and replaced with
the following:
"(y) at least 45% shall be payable in either cash or ADRs or
Shares (valued as set forth in Article 6), or a combination of
both, no later than the date that is the later of 20 months
from the CCI Issue Date and the 45th day following the date
the Claims Administrator makes a Final Determination with
respect to such Class member (or if such Final Determination
is appealed in accordance with Section 4.6, the date on which
all such appeals are exhausted)"
18. Section 3.4(c)(x) is deleted in its entirety and replaced with
the following:
"(x) approximately 55% shall be payable in cash by the date
that is the later of the 45th day following the date of such
Affected Product Revision Surgery and the 45th day following
the date the Claims Administrator makes a Final Determination
with respect
to such Class Member (or if such Final Determination is
appealed in accordance with Section 4.6, the date on which all
such appeals are exhausted) and"
19. Section 3.4(c)(y) is deleted in its entirety and replaced with
the following:
"(y) approximately 45% shall be payable in either cash or ADRs
or Shares (valued as set forth in Article 6), or a combination
of both, no later than the date that is the later of 20 months
from the CCI Issue Date and the 45th day following the date
the Claims Administrator makes a Final Determination with
respect to such Class Member (or if such Final Determination
is appealed in accordance with Section 4.6, the date on which
all such appeals are exhausted)"
20. Section 4.3(a) is amended to add the following:
(iv) "one hundred eighty (180) days after a Non-Removal
Surgery."
21. Section 4.5(a) is deleted in its entirety and replaced with
the following:
"(a) Each Class Member claiming benefits as an Uninsured
Affected Product Recipient must submit a claim form for
payment of benefits out of the Subrogation and Uninsured
Expenses Fund (the "Uninsured Medical Expenses Claim Form" or
"Red Form"), attached hereto as Exhibit G, on or before the
date that is the later of (i) one hundred eighty (180) days
after the date such Class Member receives the medical care for
which he or she seeks medical expense reimbursement and (ii)
one hundred eighty (180) days after Trial Court Approval."
22. The second sentence of Section 5.1 deleted in its entirety and
replaced with the following:
"Payments made to Plaintiffs 'Counsel for attorney fees
pursuant to Sections 3.4(a), 3.5(b), 3.5(c) and 3.7 shall be
set off against the total contingent fee, and thus the
obligation of any such Class Member to his or her Plaintiffs'
Counsel will be offset by such amount."
23. Section 3.5(c) is deleted in its entirety and replaced with
the following:
"(c) Derivative Claimants may also be eligible to receive
additional benefits pursuant to Section 3.7, as provided for
in Annex IV hereof, in an amount equal to 1% of the benefit
payable to the associated Affected product Recipient. In the
event that the contingent fee contract provides for a rate
that is less than 23%, the applicable attorney fee payment
under this Section 3.5(c) will be calculated using the lower
rate."
24. The third sentence of Section 2.5(c) is deleted in its
entirety and replaced with the following:
"The Insurance Proceeds shall not be used for any purposes
other than (i) paying Class Member benefits pursuant to
Section 3.4, Section 3.5(b), and Section 3.5(c), in accordance
with Article 8 or otherwise, (ii) paying Extraordinary Injury
Fund Benefits to Class Members pursuant to Section 3.7 hereof,
(iii) paying attorneys' fees pursuant to Article 5 hereof with
respect to Class Member payments payable under Sections 3.4,
3.5, and 3.7 hereof and expenses pursuant to Section 5.4
hereof and (iv) paying medical expenses to Medicare, other
Third-Party Payors and Uninsured Class Members pursuant to
Section 3.9 hereof."
The Settlement Agreement shall remain the same in all other respects.
IN WITNESS WHEREOF, the Parties, through their counsel, have duly
executed this First Amendment to
Class Action Settlement Agreement dated as of
March 13, 2002 on this ______ day of May, 2002.
/s/ Xxxxxxx X. Xxxxxxx
---------------------------------------
XXXXXXX X. XXXXXXX, ESQ. (0000852)
XXXXX, SCHNEIDER, XXXXXXX &
XXXXXXX CO., L.P.A.
0000 XXX Xxxxx
Xxxxxx & Xxxx Xxxxxx
Xxxxxxxxxx, XX 00000
TEL: 000-000-0000
FAX: 000-000-0000
Email: xxxxxxx@xxx.xxx
Class Co-Counsel
/s/ Xxxx X. Xxxxxxx
---------------------------------------
XXXX X. XXXXXXX, ESQ. (0011456)
CLIMACO XXXXXXXXX, XXXX, XXXXXX
& GAROFOLI CO., L.P.A.
Ninth Floor, The Halle Building
0000 Xxxxxx Xxxxxx
Xxxxxxxxx, XX 00000
TEL: 000-000-0000
FAX: 000-000-0000
Email: xxxxxx@xxxxxxxxxx.xxx
Class Co-Counsel
/s/ R. Xxxx Xxxxxxx
---------------------------------------
R. XXXX XXXXXXX, ESQ. (0006174)
XXXXXXX XXXXXXXX & XXXXXXX
CO., L.P.A.
0000 Xxxxxxx Xxxxxxxx
Xxxxxxxx Xxxxxx Xxxxxx
Xxxxxxxxx, Xxxx 00000
TEL: 000-000-0000
FAX: 000-000-0000
Email: xxxxxx@xxxxxxxxxx.xxx
Liaison Counsel/Counsel for SubClass I
/s/ Xxx Xxxxxxx
---------------------------------------
XXX XXXXXXX, ESQ.
XXXXXXX XXX OFFICE, P.A.
000 Xxxxx Xxxxxx Xxxxx
Post Xxxxxx Xxx 000
Xxxxxxxxx, Xxxxxxxxxxx 00000
TEL: 000-000-0000
FAX: 000-000-0000
Email: xxxxxxxx@xxxxxxxxxxxxxxxx.xxx
Class Co-Counsel
/s/ Xxxxx X. Xxxxxxxxxx
---------------------------------------
XXXXX X. XXXXXXXXXX, ESQ.
XXXXXXX XXXXX XXXXXXX
XXXXX & LERACH, LLP
Xxx Xxxxxxxxxxxx Xxxxx
Xxx Xxxx, Xxx Xxxx 00000-0000
TEL: 000-000-0000
FAX: 000-000-0000
Email: xx@xxxxxxx.xxx
Class Co-Counsel
/s/ Xxxxxx Xxxxxx
---------------------------------------
XXXXXX XXXXXX, ESQ.
LAW OFFICES OF XXXXXX XXXXXX
000 Xxxx Xxxxxxx Xxxxxx
X.X. Xxxxxx X
Xxxxxxx, XX 00000
TEL: 000-000-0000
FAX: 000-000-0000
Email: xxxxxxx@xxxxxxxxx.xxxxx.xxx
Class Co-Counsel
/s/ Xxxxx Xxxxx, II
---------------------------------------
XXXXX XXXXX, II, ESQ.
XXXXXXXX, XXXXXXX, XXXXXXX,
XXXXXX & DEAN
0000 X. Xxxxxx Xxxxxx
Xxxxxxxx, XX 00000
TEL: 000-000-0000
FAX: 000-000-0000
Email: xxx@xxxxxxxx-xxxxxxx.xxx
Class Co-Counsel
Xxxxxxx X. Xxxxx
---------------------------------------
XXXXXXX X. XXXXX, ESQ. (0022390)
STRAUSS & TROY
THE FEDERAL RESERVE BUILDING
000 Xxxx Xxxxxx Xxxxxx
Xxxxxxxxxx, Xxxx 00000-0000
TEL: 000-000-0000
FAX: 000-000-0000
Email: xxxxxxx@xxxxxxx-xxxx.xxx
Counsel for SubClass II
/s/ Xxxxx J. Brodhead
---------------------------------------
XXXXX J. BRODHEAD, ESQ. (0006733)
XXXXXXXXXXX XXXXXXX & LIBER LLP
0000 Xxxx Xxxxx Xxxxxx, Xxxxx 0000
Xxxxxxxxx, Xxxx 00000
TEL: 000-000-0000
FAX: 000-000-0000
Email: xxx@xxxxxxxx.xxx
Counsel for Subclass III
/s/ Xxxxxxx X. Xxxxx
---------------------------------------
XXXXXXX X. XXXXX, ESQ. (0066134)
CIANO & GOLDWASSER, LLP
Tri-Pointe Building
00000 Xxxxxxxx Xxxx Xxxxx
Xxxxxxxxx, Xxxx 00000
TEL: 000-000-0000
FAX: 000-000-0000
Email: xxxxxx@xxxxxxxxxxxxxxx.xxx
Counsel for Subclass IV
/s/ Xxxxxxx X. Xxxxxxx
---------------------------------------
XXXXXXX X. XXXXXXX, ESQ.
LIEFF, CABRASER, XXXXXXX &
BERNSTEIN, LLP
30TH Floor, 000 Xxxxxxx Xxxxxx
Xxxxxxxxxxx Xxxxxx
Xxx Xxxxxxxxx, XX 00000
TEL: 000-000-0000
FAX: 000-000-0000
Email: xxxxxxxx@xxxx.xxx
Counsel for Subclass V
/s/ Xxxxxxx X. Xxxxxxx
---------------------------------------
XXXXXXX X. XXXXXXX
XXXXXX X. XXXXXXXXX
THE XXXXXXX XXX FIRM
000 Xxxxxx Xxxxxx
X.X. Xxxxxx 0000
Xxxxxxxxxx, Xxxxxxxxxxx 00000-0000
TEL: 000-000-0000
FAX: 000-000-0000
Email: xxxxxxxxxxx@xxx.xxx
Attorney for Defendants, Sulzer Medica
AG and Sulzer Orthopedics Inc.
/s/ Xxxxxx X. Xxxxx
---------------------------------------
XXXXXX X. XXXXX
XXXXXXXX & STERLING
000 Xxxxxxxxx Xxxxxx, #000
Xxx Xxxx, XX 00000
TEL: 000-000-0000
FAX: 000-000-0000
Email: xxxxxx@xxxxxxxx.xxx
Attorney for Defendant Sulzer AG
UNITED STATES DISTRICT COURT
NORTHERN DISTRICT OF OHIO
EASTERN DIVISION
IN RE: : Case No. 01-CV-9000
:
SULZER HIP PROSTHESIS AND : MDL Docket No.: 1401
KNEE PROSTHESIS PRODUCT :
LIABILITY LITIGATION : Judge Xxxxxxxx M. O'Xxxxxx
:
This Document Relates to All Cases :
--------------------------------------------------------------------------------
SECOND AMENDMENT TO
CLASS ACTION SETTLEMENT AGREEMENT
--------------------------------------------------------------------------------
It is hereby stipulated and agreed between the parties to the
Class
Action Settlement Agreement dated March 13, 2002 ("Settlement Agreement") and
the Claims Administrator that the Settlement Agreement shall be amended as
follows:
1. Section 3.7 is amended to add the following:
"(c) In the event of funding shortfall in the EIF, the Claims
Administrator, with approval of the Court and after conferring
with Class Counsel and the Special State Counsel Committee,
shall reduce the benefits payable pursuant to Matrix Levels
III through VIII to meet the shortfall before making any
reduction in benefits payable to Class Members who qualify for
payment pursuant to Matrix Levels I and II."
2. Annex IV, Matrix Level I, in both the Hip and Knee Matrices,
is amended to provide that Class Members who are eligible to
receive benefits pursuant to Matrix Level I, but who do not
suffer a diminished life expectancy as a result of the medical
condition(s) that are preventing those Class Members from
undergoing a revision surgery, may be eligible to receive
additional benefits pursuant to Matrix Level IX.
The Settlement Agreement and First Amendment to Class Action Settlement
Agreement shall remain the same in all other respects.
IN WITNESS WHEREOF, the Parties, through their counsel, have duly
executed this Second Amendment to Class Action Settlement Agreement dated as of
March 13, 2002 on this 3rd day of May, 2002.
/s/ Xxxxxxx X. Xxxxxxx
-----------------------------------------
XXXXXXX X. XXXXXXX, ESQ. (0000852)
XXXXX, SCHNEIDER, XXXXXXX &
XXXXXXX CO., L.P.A.
0000 XXX Xxxxx
Xxxxxx & Xxxx Xxxxxx
Xxxxxxxxxx, XX 00000
TEL: 000-000-0000
FAX: 000-000-0000
Email: xxxxxxx@xxx.xxx
Class Co-Counsel
/s/ Xxxx X. Xxxxxxx
-----------------------------------------
XXXX X. XXXXXXX, ESQ. (0011456)
CLIMACO XXXXXXXXX, XXXX, XXXXXX
& GAROFOLI CO., L.P.A.
Ninth Floor, The Halle Building
0000 Xxxxxx Xxxxxx
Xxxxxxxxx, XX 00000
TEL: 000-000-0000
FAX: 000-000-0000
Email: xxxxxx@xxxxxxxxxx.xxx
Class Co-Counsel
/s/ R. Xxxx Xxxxxxx
-----------------------------------------
R. XXXX XXXXXXX, ESQ. (0006174)
XXXXXXX XXXXXXXX & XXXXXXX
CO., L.P.A.
0000 Xxxxxxx Xxxxxxxx
Xxxxxxxx Xxxxxx Xxxxxx
Xxxxxxxxx, Xxxx 00000
TEL: 000-000-0000
FAX: 000-000-0000
Email: xxxxxx@xxxxxxxxxx.xxx
Liaison Counsel/Counsel for SubClass I
/s/ Xxx Xxxxxxx
-----------------------------------------
XXX XXXXXXX, ESQ.
XXXXXXX XXX OFFICE, P.A.
000 Xxxxx Xxxxxx Xxxxx
Post Xxxxxx Xxx 000
Xxxxxxxxx, Xxxxxxxxxxx 00000
TEL: 000-000-0000
FAX: 000-000-0000
Email: xxxxxxxx@xxxxxxxxxxxxxxxx.xxx
Class Co-Counsel
/s/ Xxxxx X. Xxxxxxxxxx
-----------------------------------------
XXXXX X. XXXXXXXXXX, ESQ.
XXXXXXX XXXXX XXXXXXX
XXXXX & LERACH, LLP
Xxx Xxxxxxxxxxxx Xxxxx
Xxx Xxxx, Xxx Xxxx 00000-0000
TEL: 000-000-0000
FAX: 000-000-0000
Email: xx@xxxxxxx.xxx
Class Co-Counsel
/s/ Xxxxxx Xxxxxx
-----------------------------------------
XXXXXX XXXXXX, ESQ.
LAW OFFICES OF XXXXXX XXXXXX
000 Xxxx Xxxxxxx Xxxxxx
X.X. Xxxxxx X
Xxxxxxx, XX 00000
TEL: 000-000-0000
FAX: 000-000-0000
Email: xxxxxxx@xxxxxxxxx.xxxxx.xxx
Class Co-Counsel
/s/ Xxxxx Xxxxx, II
-----------------------------------------
XXXXX XXXXX, II, ESQ.
XXXXXXXX, XXXXXXX, XXXXXXX, XXXXXX & DEAN
0000 X. Xxxxxx Xxxxxx
Xxxxxxxx, XX 00000
TEL: 000-000-0000
FAX: 000-000-0000
Email: xxx@xxxxxxxx-xxxxxxx.xxx
Class Co-Counsel
Xxxxxxx X. Xxxxx
-----------------------------------------
XXXXXXX X. XXXXX, ESQ. (0022390)
STRAUSS & TROY
THE FEDERAL RESERVE BUILDING
000 Xxxx Xxxxxx Xxxxxx
Xxxxxxxxxx, Xxxx 00000-0000
TEL: 000-000-0000
FAX: 000-000-0000
Email: xxxxxxx@xxxxxxx-xxxx.xxx
Counsel for SubClass II
/s/ Xxxxx J. Brodhead
---------------------------------------
XXXXX J. BRODHEAD, ESQ. (0006733)
XXXXXXXXXXX XXXXXXX & LIBER LLP
0000 Xxxx Xxxxx Xxxxxx, Xxxxx 0000
Xxxxxxxxx, Xxxx 00000
TEL: 000-000-0000
FAX: 000-000-0000
Email: xxx@xxxxxxxx.xxx
Counsel for Subclass III
/s/ Xxxxxxx X. Xxxxx
-----------------------------------------
XXXXXXX X. XXXXX, ESQ. (0066134)
CIANO & GOLDWASSER, LLP
Tri-Pointe Building
00000 Xxxxxxxx Xxxx Xxxxx
Xxxxxxxxx, Xxxx 00000
TEL: 000-000-0000
FAX: 000-000-0000
Email: xxxxxx@xxxxxxxxxxxxxxx.xxx
Counsel for Subclass IV
/s/ Xxxxxxx X. Xxxxxxx
-----------------------------------------
XXXXXXX X. XXXXXXX, ESQ.
LIEFF, CABRASER, XXXXXXX &
BERNSTEIN, LLP
30TH Floor, 000 Xxxxxxx Xxxxxx
Xxxxxxxxxxx Xxxxxx
Xxx Xxxxxxxxx, XX 00000
TEL: 000-000-0000
FAX: 000-000-0000
Email: xxxxxxxx@xxxx.xxx
Counsel for Subclass V
/s/ Xxxxxxx X. Xxxxxxx
-----------------------------------------
XXXXXXX X. XXXXXXX
XXXXXX X. XXXXXXXXX
THE XXXXXXX XXX FIRM
000 Xxxxxx Xxxxxx
X.X. Xxxxxx 0000
Xxxxxxxxxx, Xxxxxxxxxxx 00000-0000
TEL: 000-000-0000
FAX: 000-000-0000
Email: xxxxxxxxxxx@xxx.xxx
Attorney for Defendants, Sulzer Medica AG
and Sulzer Orthopedics Inc.
/s/ Xxxxxx X. Xxxxx
-----------------------------------------
XXXXXX X. XXXXX
XXXXXXXX & STERLING
000 Xxxxxxxxx Xxxxxx, #000
Xxx Xxxx, XX 00000
TEL: 000-000-0000
FAX: 000-000-0000
Email: xxxxxx@xxxxxxxx.xxx
Attorney for Defendant Sulzer AG
UNITED STATES DISTRICT COURT
NORTHERN DISTRICT OF OHIO
EASTERN DIVISION
IN RE: : Case No. 01-CV-9000
:
SULZER HIP PROSTHESIS AND : MDL Docket No.: 1401
KNEE PROSTHESIS PRODUCT :
LIABILITY LITIGATION : Judge Xxxxxxxx M. O'Xxxxxx
:
This Document Relates to All Cases :
--------------------------------------------------------------------------------
THIRD AMENDMENT TO CLASS ACTION SETTLEMENT AGREEMENT
--------------------------------------------------------------------------------
It is hereby stipulated and agreed between the parties to the Class
Action Settlement Agreement dated March 13, 2002 ("Settlement Agreement") and
the Claims Administrator that Section 6.2 of the Settlement Agreement shall be
amended to replace the first sentence in its entirety with the following
sentence:
On or before the date that is twenty (20) days after the final date of
the Fairness Hearing, the Parties shall complete definitive
documentation of the form of the CCI and shall submit such final form
to the Court for approval.
The Settlement Agreement, First Amendment to Class Action Settlement
Agreement, and Second Amendment to Class Action Settlement Agreement shall
remain the same in all other respects.
IN WITNESS WHEREOF, the Parties, through their counsel, have duly
executed this Third Amendment to Class Action Settlement Agreement dated as of
March 13, 2002 on this 5th day of May, 2002.
/s/ Xxxxxxx X. Xxxxxxx
-----------------------------------------
XXXXXXX X. XXXXXXX, ESQ. (0000852)
XXXXX, SCHNEIDER, XXXXXXX &
XXXXXXX CO., L.P.A.
0000 XXX Xxxxx
Xxxxxx & Xxxx Xxxxxx
Xxxxxxxxxx, XX 00000
TEL: 000-000-0000
FAX: 000-000-0000
Email: xxxxxxx@xxx.xxx
Class Co-Counsel
/s/ Xxxx X. Xxxxxxx
-----------------------------------------
XXXX X. XXXXXXX, ESQ. (0011456)
CLIMACO XXXXXXXXX, XXXX, XXXXXX
& GAROFOLI CO., L.P.A.
Ninth Floor, The Halle Building
0000 Xxxxxx Xxxxxx
Xxxxxxxxx, XX 00000
TEL: 000-000-0000
FAX: 000-000-0000
Email: xxxxxx@xxxxxxxxxx.xxx
Class Co-Counsel
/s/ R. Xxxx Xxxxxxx
-----------------------------------------
R. XXXX XXXXXXX, ESQ. (0006174)
XXXXXXX XXXXXXXX & XXXXXXX
CO., L.P.A.
0000 Xxxxxxx Xxxxxxxx
Xxxxxxxx Xxxxxx Xxxxxx
Xxxxxxxxx, Xxxx 00000
TEL: 000-000-0000
FAX: 000-000-0000
Email: xxxxxx@xxxxxxxxxx.xxx
Liaison Counsel/Counsel for SubClass I
/s/ Xxx Xxxxxxx
-----------------------------------------
XXX XXXXXXX, ESQ.
XXXXXXX XXX OFFICE, P.A.
000 Xxxxx Xxxxxx Xxxxx
Post Xxxxxx Xxx 000
Xxxxxxxxx, Xxxxxxxxxxx 00000
TEL: 000-000-0000
FAX: 000-000-0000
Email: xxxxxxxx@xxxxxxxxxxxxxxxx.xxx
Class Co-Counsel
/s/ Xxxxx X. Xxxxxxxxxx
-----------------------------------------
XXXXX X. XXXXXXXXXX, ESQ.
XXXXXXX XXXXX XXXXXXX
XXXXX & LERACH, LLP
Xxx Xxxxxxxxxxxx Xxxxx
Xxx Xxxx, Xxx Xxxx 00000-0000
TEL: 000-000-0000
FAX: 000-000-0000
Email: xx@xxxxxxx.xxx
Class Co-Counsel
/s/ Xxxxxx Xxxxxx
-----------------------------------------
XXXXXX XXXXXX, ESQ.
LAW OFFICES OF XXXXXX XXXXXX
000 Xxxx Xxxxxxx Xxxxxx
X.X. Xxxxxx X
Xxxxxxx, XX 00000
TEL: 000-000-0000
FAX: 000-000-0000
Email: xxxxxxx@xxxxxxxxx.xxxxx.xxx
Class Co-Counsel
/s/ Xxxxx Xxxxx, II
-----------------------------------------
XXXXX XXXXX, II, ESQ.
XXXXXXXX, XXXXXXX, XXXXXXX, XXXXXX & DEAN
0000 X. Xxxxxx Xxxxxx
Xxxxxxxx, XX 00000
TEL: 000-000-0000
FAX: 000-000-0000
Email: xxx@xxxxxxxx-xxxxxxx.xxx
Class Co-Counsel
Xxxxxxx X. Xxxxx
-----------------------------------------
XXXXXXX X. XXXXX, ESQ. (0022390)
STRAUSS & TROY
THE FEDERAL RESERVE BUILDING
000 Xxxx Xxxxxx Xxxxxx
Xxxxxxxxxx, Xxxx 00000-0000
TEL: 000-000-0000
FAX: 000-000-0000
Email: xxxxxxx@xxxxxxx-xxxx.xxx
Counsel for SubClass II
/s/ Xxxxx J. Brodhead
-----------------------------------------
XXXXX J. BRODHEAD, ESQ. (0006733)
XXXXXXXXXXX XXXXXXX & LIBER LLP
0000 Xxxx Xxxxx Xxxxxx, Xxxxx 0000
Xxxxxxxxx, Xxxx 00000
TEL: 000-000-0000
FAX: 000-000-0000
Email: xxx@xxxxxxxx.xxx
Counsel for Subclass III
/s/ Xxxxxxx X. Xxxxx
-----------------------------------------
XXXXXXX X. XXXXX, ESQ. (0066134)
CIANO & GOLDWASSER, LLP
Tri-Pointe Building
00000 Xxxxxxxx Xxxx Xxxxx
Xxxxxxxxx, Xxxx 00000
TEL: 000-000-0000
FAX: 000-000-0000
Email: xxxxxx@xxxxxxxxxxxxxxx.xxx
Counsel for Subclass IV
/s/ Xxxxxxx X. Xxxxxxx
---------------------------------------
XXXXXXX X. XXXXXXX, ESQ.
LIEFF, CABRASER, XXXXXXX &
BERNSTEIN, LLP
30TH Floor, 000 Xxxxxxx Xxxxxx
Xxxxxxxxxxx Xxxxxx
Xxx Xxxxxxxxx, XX 00000
TEL: 000-000-0000
FAX: 000-000-0000
Email: xxxxxxxx@xxxx.xxx
Counsel for Subclass V
/s/ Xxxxxxx X. Xxxxxxx
-----------------------------------------
XXXXXXX X. XXXXXXX
XXXXXX X. XXXXXXXXX
THE XXXXXXX XXX FIRM
000 Xxxxxx Xxxxxx
X.X. Xxxxxx 0000
Xxxxxxxxxx, Xxxxxxxxxxx 00000-0000
TEL: 000-000-0000
FAX: 000-000-0000
Email: xxxxxxxxxxx@xxx.xxx
Attorney for Defendants, Sulzer Medica AG
and Sulzer Orthopedics Inc.
/s/ Xxxxxx X. Xxxxx
-----------------------------------------
XXXXXX X. XXXXX
XXXXXXXX & STERLING
000 Xxxxxxxxx Xxxxxx, #000
Xxx Xxxx, XX 00000
TEL: 000-000-0000
FAX: 000-000-0000
Email: xxxxxx@xxxxxxxx.xxx
Attorney for Defendant Sulzer AG
CERTIFICATE OF SERVICE
A copy of the foregoing has been filed electronically with the
U.S. District Court and has been sent electronically via email on this 6th day
of May, 2002, to all Class Counsel; Plaintiffs' Steering Committee and Special
Counsel Members; Special State Counsel Committee Members; all Defense Counsel;
and all Federal Case List Members, identified and attached to "Plaintiffs'
Second Amended and Consolidated Class Action Complaint."
/s/ R. Xxxx Xxxxxxx
-----------------------------------------
R. XXXX XXXXXXX, ESQ. (0006174)
XXXXXXX XXXXXXXX & XXXXXXX
CO., L.P.A.
