” In addition, defendant stated that, prior to conducting the surgery, he consulted with plaintiff's hematologist, who recommended that Heparin be given to plaintiff to prevent any clotting that might occur as a result of the surgery. Moreover, defendant maintained that plaintiff's post-surgery anemia and blood clotting disorder were not related to the loss of the NAC, and neither was the liposuction procedure that was performed on plaintiff at the same time. This affidavit was sufficient to shift the burden to plaintiff to demonstrate that triable questions of fact exist as to whether defendant departed from accepted standards of medical practice in the manner in which the surgical procedure was performed—and in the post-surgical care provided plaintiff—and, as a result, plaintiff was injured ( see Derusha v. Sellig, 92 A.D.3d at 1193, 939 N.Y.S.2d 610;Snyder v. Simon, 49 A.D.3d 954, 956, 853 N.Y.S.2d 195 [2008];Passero v. Puleo, 17 A.D.3d 953, 954, 793 N.Y.S.2d 637 [2005];Toomey v. Adirondack Surgical Assoc., 280 A.D.2d at 755, 720 N.Y.S.2d 229). In that regard, plaintiff submitted the affirmation of Peter Neumann, a board-certified plastic surgeon, which, in effect, restated many of the allegations set forth in plaintiff's bill of particulars.

We agree with Supreme Court that there are issues of fact concerning the adequacy of the examination performed by Lorenc. Specifically, plaintiffs’ experts’ affidavits are sufficient to raise a material issue of fact as to whether a slit lamp examination was the appropriate standard of care and whether doing so would have identified an infection and prevented further harm (seeSchwenzfeier v. St. Peter's Health Partners, 213 A.D.3d at 1083–1084, 184 N.Y.S.3d 196 ; Tardi v. Casler–Bladek, 212 A.D.3d at 906, 182 N.Y.S.3d 769 ; see generallyKnish v. Meehan, 291 A.D.2d 647, 648–649, 737 N.Y.S.2d 423 [3d Dept. 2002] ; cf. Snyder v. Simon, 49 A.D.3d 954, 956, 853 N.Y.S.2d 195 [3d Dept. 2008] ). We reject the Lorenc defendants’ assertion that the ophthalmologist was not competent to offer an opinion as to their care.

The affidavit of his expert, Martin, was speculative and conclusory (seeDiaz v. New York Downtown Hosp., 99 N.Y.2d 542, 754 N.Y.S.2d 195, 784 N.E.2d 68 ; Lowe v. Japal, 170 A.D.3d 701, 703, 95 N.Y.S.3d 363 ; Garcia v. Richer, 132 A.D.3d at 810, 18 N.Y.S.3d 401 ). In particular, Martin failed to articulate the applicable standard of care (seeWebb v. Albany Med. Ctr., 151 A.D.3d 1435, 1437, 59 N.Y.S.3d 151 ; DeLaurentis v. Orange Regional Med. Ctr.-Horton Campus, 117 A.D.3d 774, 775, 985 N.Y.S.2d 709 ; Snyder v. Simon, 49 A.D.3d 954, 956, 853 N.Y.S.2d 195 ). Likewise, Rioseco established, prima facie, his entitlement to judgment as a matter of law by submitting, inter alia, an affirmation from his dental expert demonstrating that he did not depart from good and accepted practice in his treatment of the plaintiff (seeGarcia v. Richer, 132 A.D.3d at 810, 18 N.Y.S.3d 401 ).

By limiting the issues raised in their appellate brief, plaintiffs have abandoned any argument related to the dismissal of their second and fourth causes of action, as well as any arguments involving additional alleged deviations from accepted standards of medical care (see To rebut defendants' prima facie showing of entitlement to summary judgment dismissing the medical malpractice claim, plaintiffs had to come forward with proof that could establish a deviation from accepted medical practice and that such alleged deviation was the proximate cause of Yerich's injuries, so as to demonstrate the existence of a triable issue of fact (seeAlvarez v. Prospect Hosp., 68 N.Y.2d 320, 324, 508 N.Y.S.2d 923, 501 N.E.2d 572 [1986] ; Snyder v. Simon, 49 A.D.3d 954, 956, 853 N.Y.S.2d 195 [2008] ). To that end, plaintiff submitted the expert affidavit of a board-certified orthopedic surgeon, who opined, based upon his review of the relevant medical records and radiological images, including a CT scan taken shortly after the surgery, that Pedersen had improperly positioned the L4 pedicle screws into the L3–L4 facet joint and that such improper placement constituted a deviation from the standard of care that ultimately caused Yerich to develop spinal and foraminal stenosis at L3–L4.

.3d 545 ; Longtemps v. Oliva, 110 A.D.3d at 1318, 973 N.Y.S.2d 452 ).In opposition, plaintiff submitted, among other things, the affidavit of an orthopedic surgeon, Matthew J. Nofziger. Even assuming that Nofziger was qualified to provide an opinion with respect to the standard of care used in the physical therapy field for the purpose of assessing the appropriateness of transfer procedures (see generally Matott v. Ward, 48 N.Y.2d 455, 459, 423 N.Y.S.2d 645, 399 N.E.2d 532 [1979] ), we find his affidavit to be insufficient to raise a triable issue of fact. Although Nofziger criticized the assessment of Clark's physical and cognitive abilities prior to the slide board transfer, he failed to identify or define the applicable standard of care appropriate in this case, merely asserting, in a conclusory manner, that Clark required a higher level of assistance than was provided to her (see DeLaurentis v. Orange Regional Med. Ctr.–Horton Campus, 117 A.D.3d 774, 775, 985 N.Y.S.2d 709 [2014] ; Snyder v. Simon, 49 A.D.3d 954, 956, 853 N.Y.S.2d 195 [2008] ; see generally Alvarez v. Prospect Hosp., 68 N.Y.2d 320, 325, 508 N.Y.S.2d 923, 501 N.E.2d 572 [1986] ). Nor did Nofziger set forth any particular actions or procedures that could have prevented Clark from falling, thereby failing to establish the requisite nexus between the alleged malpractice and plaintiff's injury (see Yamin v. Baghel, 284 A.D.2d 778, 779–780, 728 N.Y.S.2d 520 [2001] ; Douglass v. Gibson, 218 A.D.2d 856, 857, 630 N.Y.S.2d 401 [1995] ; compare Hranek v. United Methodist Homes of Wyo. Conference, 27 A.D.3d 879, 880–881, 810 N.Y.S.2d 544 [2006] ). Therefore, even if considered, Nofziger's affidavit was patently insufficient to raise a triable issue of fact as to whether the transfer procedure used in this case deviated from the applicable standard of care (see DeLaurentis v. Orange Regional Med. Ctr.–Horton Campus, 117 A.D.3d at 775, 985 N.Y.S.2d 709 ; Martino v. Miller, 97 A.D.3d 1009, 1011–1012, 949 N.Y.S.2d 225 [2012] ; Poblocki v. Todoro, 49 A.D.3d 1239, 1

In his affidavit, defendant described his treatment of plaintiff's tooth and explained the absence of any deviations from accepted standards of care with respect to the manner in which he performed such treatment (see id.; Starr, 44 AD3d at 648). The affidavit of plaintiff's dental expert offered in opposition set forth only generalized, conclusory and speculative opinions with respect to three specific claims at issue, and thus it was insufficient to raise a triable issue of fact with respect to those claims (see Snyder v Simon, 49 AD3d 954, 956).

Since the defendants failed to establish their prima facie entitlement to judgment as a matter of law, that branch of their motion which was for summary judgment dismissing the cause of action alleging lack of informed consent should have been denied, regardless of the sufficiency of the plaintiff's opposition papers (see Winegrad v. New York Univ. Med. Ctr., 64 N.Y.2d 851, 853, 487 N.Y.S.2d 316, 476 N.E.2d 642 ; Schussheim v. Barazani, 136 A.D.3d 787, 790, 24 N.Y.S.3d 756 ; see also Snyder v. Simon, 49 A.D.3d 954, 956–957, 853 N.Y.S.2d 195 ). In light of our conclusion that Supreme Court should have denied that branch of the defendants' motion which was for summary judgment dismissing the cause of action alleging lack of informed consent

In any event, even if defendants had met their burden on either of these issues, plaintiff raised material issues of fact as to each. Contrary to defendants' contention, CPLR 4401–a, regarding plaintiff's burden of providing expert testimony at trial to support his cause of action, does not govern our review here; inasmuch as defendants' submissions conceded that a warning was necessary regarding the potential injuries to nerve cells that controlled the intimate function of the penis and asserted that such a warning was given to plaintiff, plaintiff's contradictory testimony that no such warning was ever given to him was sufficient to demonstrate a triable question of fact on that issue ( see Snyder v. Simon, 49 A.D.3d 954, 956–957, 853 N.Y.S.2d 195 [2008] ). Further, plaintiff's testimony that he would not have chosen to have the surgery had he been properly informed of the risk of sexual dysfunction is sufficient to raise a triable issue of fact as to whether a fully informed reasonable person would have elected for the surgery ( see Schilling v. Ellis Hosp., 75 A.D.3d 1044, 1046, 906 N.Y.S.2d 187 [2010];Santilli v. CHP, Inc., 274 A.D.2d 905, 907–908, 711 N.Y.S.2d 249 [2000] ).

In opposition, the plaintiff submitted an expert affirmation that was speculative and conclusory. The plaintiff's expert failed to identify or define the applicable standard of care, and to set forth the manner in which the conduct of ORMC's nursing staff deviated from that standard of care ( see Poblocki v. Todoro, 49 A.D.3d 1239, 856 N.Y.S.2d 327;Snyder v. Simon, 49 A.D.3d 954, 853 N.Y.S.2d 195). The assertions of the plaintiff's expert were unsupported by competent evidence tending to establish the essential elements of medical malpractice against ORMC, and, thus, were insufficient to defeat its motion for summary judgment ( see Alvarez v. Prospect Hosp., 68 N.Y.2d 320, 325, 508 N.Y.S.2d 923, 501 N.E.2d 572;Bendel v. Rajpal, 101 A.D.3d 662, 955 N.Y.S.2d 187;Arkin v. Resnick, 68 A.D.3d 692, 890 N.Y.S.2d 95;Myers v. Ferrara, 56 A.D.3d 78, 864 N.Y.S.2d 517;Rea v. Gallagher, 31 A.D.3d 731, 818 N.Y.S.2d 490). The court providently exercised its discretion in denying the plaintiff's cross motion for leave to amend her bill of particulars, as she offered no reasonable excuse for the delay in making the cross motion once she was aware of the facts upon which the cross motion was predicated, and ORMC, Stambaugh, and CRHC would have been prejudiced if leave to amend had been granted ( see Schreiber–Cross v. State of New York, 57 A.D.3d 881, 870 N.Y.S.2d 438;Navarette v. Alexiades,

In that regard, plaintiff does not dispute that Vicinanzo made a prima facie showing of entitlement to summary judgment. Therefore, in order to rebut Vicinanzo's showing, plaintiff was required to "establish[] a departure from accepted medical practice, as well as a nexus between the alleged malpractice and [her] injury" ( Rossi v Arnot Ogden Med. Ctr., 268 AD2d 916, 917, lv denied 95 NY2d 751; accord Snyder v Simon, 49 AD3d 954, 956). In opposition to the motion, plaintiff submitted the affidavit of her expert, a licensed chiropractor, whose name was redacted.