AFFIDAVIT OF JAMES JOSEPH SALZ, M. D.

        BEFORE ME, the undersigned authority, personally appeared, JAMES JOSEPH SALZ, M. D., and after being duly sworn, deposes and says:
        1.  My name is James Joseph Salz and I am licensed medical doctor, board certified in ophthalmology.  I am currently in private practice in Los Angeles, California.
        2.  My curriculum vitae is attached and accurately reflects my education, my training, my certification, my experience and my familiarity with the standards of ophthalmology, Cataract and refractive surgery, LASIK and laser surgery.
        3.  I have reviewed the records of TLC Laser Eye Center and Dr. Stanley Braverman, Bascom Palmer Eye Institute, multiple colored and black and white topographies of Mr. Ronald Pasqualino from TLC and Bascom Palmer.  The records from Bascom Palmer clearly show that Mr.Pasqualino has keratoconus in both eyes. If there were evidence of keratoconus prior to his LASIK surgery on 12/9/99, it would be a deviation from the standard of care to perform LASIK surgery on his eyes.  After careful study of the records provided, it is my opinion to a reasonable degree of medical probability that the care and treatment received from Dr. Stanley Braverman and TLC Laser Eye Center fell below the standard of care.  More specifically, including but not limited to:

1. The black and white copy of the Humphrey topography map dated 12/8/99, prior to his LASIK surgery, shows evidence of form fruste keratoconus, a contraindication for LASIK surgery. This map shows an unusual non-orthogonal type of astigmatism, which could indicate irregular astigmatism.  This map combined with the fact that the best corrected vision of 20/25 in the right eye and 20/40 in the left eye should have increased the suspicion of irregular astigmatism and possibly keratoconus;

2. There is marked difference in the black and white copies of the topography dated 12/8/99 and 12/9/99 and the color copies with Mr. Pasqualino's name and exactly the same date and time as the black and white copies.  It is clear that the color copies are not the same as the black and white copies. This is apparent from the general appearance of the maps and the distinctly different SimK values for each eye on the black and white and color copies.  The color copies are not suspicious for keratoconus and most likely represent maps from another patient.  For example, Mr. Pasqualino was found to have 3.5 D of astigmatism with the steep axis at 5 degrees on his refraction recorded on 12/9/99.  The black and white maps of 12/8/99 indicates almost 3 D of astigmatism with the steep axis at 6 degrees and the map of 12/9/99 indicates almost 3 D of astigmatism with the steep axis at 12 degrees. Both of these black and white maps would be consistent with Mr. Pasqualino's refraction for that eye.  The color maps of the same dates indicate only about 1 D of astigmatism, which is not consistent with his refraction for that eye.

3. The colored map dated 7/29/99 reflect SimK values for the right eye that are considerable different than the black and white maps of 12/8/99 and 12/9/99.  If these are truly both images of Mr. Pasqualino's right eye then he was unstable and not a candidate for surgery.  In fact, this color image cannot be of Mr. Pasqualino because the left eye color map of the same date clearly shows the typical postoperative central flattening (blue zone) typical of a postoperative patient. Of course, Mr. Pasqualino did not have surgery until 12/9/99.

4. The refractions prior to the surgery on the left eye on 6/22/00 and then on 11/4/00 were unstable and the topography showed significant inferior corneal steepening indicative of post LASIK keratoectasia and neither surgery should have been performed.

        4.  Clearly, based upon the foregoing, it seems apparent that someone tried to substitute normal color maps for the suspicious black and white maps in an attempt to show that the eyes did not demonstrate any evidence of keratoconus prior to the laser surgery.
        5.  As a result of the negligence of Dr. Braverman and TLC as stated above, including but not limited to what appears to be a deliberate attempt to manipulate the records, Mr. Pasqualino's vision has been severely compromised and has resulted in the need for bilateral corneal transplantation, which has already been performed on his left eye.
        6.  I have never had an opinion disqualified in any court of law.
Under the penalties of perjury, I declare that I have read the foregoing affidavit and the facts stated herein are true and correct to the best of my knowledge and belief.

        FURTHER AFFIANT SAYETH NAUGHT

JAMES JOSEPH SALZ, M.D.

        The foregoing instrument was acknowledged before me this.21st Day day of September, 2001, by James Joseph Salz, M. D., who is personally known to me or has produced a drives;s license or other Identification.

ROSEIIA R. DE LAND
Notary Public