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Cite this article as: Gurewich V. A New Approach to Thrombolysis. J Heart Stroke. 2017; 2(3): 1024.
For more than 25 years thrombolysis has been synonymous with the administration of tPA. This is reflected by the fact that in most clinical articles on fibrinolysis or thrombolysis over the last decade, the activator is no longer identified since it is assumed to be tPA. Moreover, the choice of activator has also become of little interest because it is believed that all activators have similar clinical effects.
This idea originated in the mega trials of the early ‘90’s in which tPA and streptokinase (SK) were compared in patients with acute myocardial infarction (AMI). Since tPA is a fibrin-specific plasminogen activator with a direct mode of action and SK is non-specific and has an inefficient, indirect mode of plasminogen activation, it was assumed that tPA would be far more effective and clinically beneficial. However, to the surprise of the investigators, it required three mega trials with a total of 95,740 patients to show a statistically significant difference between tPA and SK. In the first two trials, the AMI mortality was the same with tPA and SK [1,2]. In the last trial, which was divided into four groups, in one of them in which an accelerated infusion rate and heparin were used, statistically significant lower 30 day mortality (6.9 vs. 7.8%) with tPA was found .
These results did not satisfy a Bayesian statistical analysis, which concluded that a difference between tPA and SK had not been established . An additionally surprising finding in these trials was that the intracranial hemorrhage (ICH) rate with tPA was significantly greater than with SK, despite the fibrin specificity of tPA [1-3].
The investigators concluded from this that the “mortality differences…from different fibrinolytic regimens are unlikely to be large” . In other words, that there was little clinical difference to be expected from different plasminogen activators or different combinations of activators. This conclusion was accepted without discussion, which, not surprisingly, had a discouraging effecton both investigators and the pharmaceutical industry and little work in thrombolysis has taken place since.
Instead, tPA and its mutant forms have remained the only thrombolytics in use. Eventually, the disappointing clinical effects and ICH risk of tPA foretold by the mega trial resulted in percutaneous coronary intervention (PCI) replacing fibrinolysis as the treatment of choice in AMI. Endovascular procedures are now also being used in ischemic stroke wherever possible. In pulmonary embolism, only patients with hemodynamic instability are considered to be candidates for thrombolysis due to its bleeding hazard.
The conclusion that the mega trial results meant that little difference can be expected from different fibrinolytic regimens was based on a misunderstanding of the cause for the similar clinical effects of tPA and SK. The cause, in fact, can be attributed to the very nature of their different mechanisms of action as a result of which each activator was handicapped, but for a different reason for each. The fact that their net effects were similar was happenstance and should not have been interpreted as meaning that all fibrinolytic regimens were necessarily going to be comparable. The opposite was, in fact, potentially the case since the findings indicated that the tPA handicap needed to be understood so that it could be corrected.
SK is handicapped not only by its non-specificity but also because of its indirect mechanism of action mechanism of action. SK is not itself a plasminogen activator, but it becomes one when it forms a 1:1 complex with plasminogen (or plasmin) thereby consuming the enzyme responsible for fibrinolysis. In view of its inefficient fibrinolytic mechanism, it was especially surprising that tPA turned out to be little better than SK, indicating that it was similarly handicapped. The mechanism responsible for this is related to its high fibrin affinity, the property responsible for its fibrin-specificity and that made it such an attractive plasminogen activator. When tPA binds to fibrin, it is to a specific binding site located adjacent to the plasminogen binding site on Lysine Aα-157 on the D-domain of intact fibrin . As a result, its plasminogen activating activity is promoted about 1,000-fold . However, this promotion is limited to this one fibrin site [5, 7].
In order for tPA to activate the remaining plasminogens on fibrin, which are two in number , very high doses of tPA are needed. This is because in the absence of this D-domain fibrin promotion, tPA is a weak plasminogen activator. At the high tPA doses required, ICH complications can occur due to tPA’slysis of hemostatic fibrin since it contains the fibrin D-domain binding site. Hemostatic fibrin is located at vessel repair sites this hazard limits the amount of tPA that can be given with reasonable safety.
Therefore, tPA monotherapy is limited by its fibrin-specific mechanism of action which caused its clinical effects to be little better than that of SK. The surprising nature of these results also provided an opportunity to identify the problem with tPA monotherapy. However, since the results were essentially dismissed at the time, the occasion was lost and thrombolysis by tPA monotherapy has continued to the present time.
The general acceptance of the idea that all plasminogen activators were comparable, not surprisingly, discouraged further scientific and pharmaceutical interest in this therapeutic modality. As a result, there was little further development, and interest in fibrinolytic the rapiesfaded. Eventually, due to continued disappointing results foretold by the mega trials, tPA was replaced by endovascular procedures as the treatment of choice in AMI, and these procedures are now also being used in ischemic stroke. Since these procedures requires hospitalization in places where expertise is available, they are too time-consuming for optimal salvage of ischemic myocardial or brain tissue, for which the greatest reduction in AMI mortality and post AMI morbidity is achieved when coronary reperfusion takes place within 1-2 hours of symptom onset [9,10]. This objective for both AMI and stroke can only be achieved by thrombolysis.
The restricted mechanism of action of tPA indicates that it cannot alone be responsible for fibrinolysis, which is a remarkably efficient biological defense pathway. This is evidenced by the presence of the fibrinolytic product, D-dimer that is invariably present in blood. Its normal presence (112-250 ng/mL) indicates that fibrinolysis must be an ongoing physiological vascular repair process. Since D-dimer represents ~60% of fibrin, its normal level corresponds to a steady state of ~1 mg of fibrin lysed. In the presence of venous thromboembolism, the D-dimer level can go up to more than 5,000 ng/mL, or ~15 mg of fibrin lysed. Since most of the tPA in blood is in the form of an inactive inhibitor complex , it is evident that a second plasminogen activator must be involved.
The other fibrin-specific plasminogen activator is prourokinase (pro UK), which is a natural constituent of blood. However, since most proUK is bound to platelets [12,13] or monocytes  and only a small amount is free in plasma, it has usually been overlooked. In addition, pro UK is inactivated by thrombin so that when pro UK is experimentally included in clot formation, it can be destroyed and escape detection. Another misleading factor was the discovery of a pro UK cell receptor (UPAR) important for pericellular plasminogen activation and cell migration, a vital biological process. This finding led to the erroneous conclusion that pro UK is only an extravascular rather than an intravascular plasminogen activator . The idea has persisted and resisted change despite much evidence to the contrary .
For example, gene knockout studies showed that knocking out pro UK had a significantly greater effect on the suppression of lysis of a venous thrombus than did knocking out tPA which had little effect . This predominance of the pro UK effect is actually consistent with the fact that both pro UK, the single-chain proenzyme, and urokinase (UK), its two-chain enzymatic form, are involved in fibrinolysis. By contrast, tPA has only one effect since its single and two-chain forms have the same enzymatic and fibrinolytic activities . In fact, tPA’s single function in fibrinolysis is to initiate fibrin degradation which it does when it binds to the D-domain of intact fibrin . Therefore, using tPA alone for fibrinolysis can be seen as somewhat analogous to driving a car on its starting motor, pro UK and UK are essential for the completion of fibrin-specific fibrinolysis.
When an intravascular thrombus forms, tPA in the vessel wall at that site is released, and due to a high fibrin affinity  binds to its binding site on the intact fibrin D-domain. It initiates fibrinolysis at that site and this creates two new plasminogen bindings sites . The first of these is on the fibrin E-domain and pro UK has a high substrate affinity for plasminogen bound to this site . Since pro UK has no fibrin-affinity, it is this substrate affinity which determines its fibrin-specificity, and pro UK thereby spares intact fibrin such as that in hemostatic fibrin which is vulnerable to tPA.
Activation of plasminogen at this fibrin E-domain site is accompanied by a reciprocal activation of pro UK to UK by plasmin . UK then activates the remaining fibrin-bound plasminogen completing fibrinolysis. Therefore, tPA activates one plasminogen and pro UK/UK two. As a result, when fibrin-specific clot lysis rates by tPA and pro UK were compared, that by pro UK was invariably twice that by tPA . This observation is consistent with the number of plasminogens found bound to intact versus degraded fibrin. There is only one on intact fibrin that is activated by tPA, whereas there were two found on degraded fibrin  and these are activated by pro uK/UK.
Since tPA has a high fibrin affinity and is an enzyme, it is poorly adapted to administration by a prolonged infusion, which is the way it has been administered. By contrast, it is well suited for bolus administration. Since its only function is to initiate fibrinolysis, relatively little is also needed.
Based on these considerations, 101 patients with AMI were treated either with a 10 mg bolus of tPA (10 patients) and the remainder a 5 mg bolus (5% of the monotherapy dose) PATENT trial . This was followed by an infusion of pro UK, 40 mg/h for 90 minutes (50% of the monotherapy infusion rate). Complete coronary artery patency (TIMI-3) at 24h was seen in 82% of the patients, which compares with 45% in the best of the tPA trials, GUSTO . In accordance with this reperfusion difference, the mortality was 1% in PATENT and 6.3% in GUSTO.
The success of the PATENT trial validated the adoption of the natural fibrinolytic paradigm for therapeutic fibrinolysis. However, although this successful trial was published in a prominent journal, it received little notice and resulted in no reevaluation of standard fibrinolytic therapy. Monotherapy with tPA has continued, representing another example of resistance to a paradigm shift from a long-established practice.
Monotherapy trials with pro UK were also undertaken and these showed that at therapeutic concentrations in plasma, pro UK activated plasma plasminogen and plasmin in turn activated pro UK to UK, risking bleeding complications. This plasma instability of pro UK eventually resulted in Gruenenthal’s application to the EMEA in Europe for a marketing license to be turned down in 1999. This was the only reason given for the decision since pro UK’s clinical efficacy was comparable to that of tPA and SK and no other side effects were seen.
Therefore, there was persuasive evidence that monotherapy with either tPA or pro UK was inadequate. There was also evidence that the activators were complementary in their effects  and are, therefore, synergistic in combination . As a result, in combination significantly lower and safer doses of each can be used, as shown by the PATENT trial . However, since pro UK was the principal driver of fibrinolysis, its plasma instability, which undermined its safety and efficacy, had to be addressed.
The plasma instability of pro UK was related to its relatively high intrinsic activity which generated plasmin. Structure function studies determined that the intrinsic activity of pro UK was related to a flexible loop which contained a charged residue, Lys300, at its tip. A Histadine substitution at this site (Lys300→His) reduced the intrinsic activity 5-fold  but did not change its mechanism of action . The synergistic fibrinolytic effect of pro UK with tPA  was also retained by the His pro UK mutant .
The improved plasma stability of His pro UK was due in part to its lower intrinsic activity, but was also related to its enzymatic form, His UK, being inhibited by C1-esterase inhibitor in plasma [31,32]. This is a relatively plentiful inhibitor which is also an acute phase reactant, so that it is apt to be enhanced in patients needing fibrinolytic therapy.
By substituting His pro UK for native pro UK, the physiological fibrinolytic properties of the latter can be preserved and utilized at pharmacological doses. Since the physiological paradigm calls for the sequential administration of a bolus of tPA followed by an infusion of pro UK, this is how His pro UK should be used in therapy. Moreover, since the PATENT study  has already shown that a 5 mg bolus is sufficient to initiate fibrin degradation, this is the tPA dose that should be used. This small dose administered as a bolus is unlikely to cause any hemorrhagic side effects, since the tPA half-life is only 5-6 minutes.
Traditional thrombolysis with tPA has been plagued by inadequate efficacy and a too high risk of ICH leading to its abandonment and replacement by endovascular procedures like angioplasty whenever possible. However these hospital procedures are time consuming and too slow for salvage of ischemic myocardial tissue, which requires reperfusion within 1-2 hours of symptom onset. This can only be achieved by thrombolysis which is sufficiently simple and rapid to be administered out of hospital and in time. Thrombolysis must also be made more effective and safer, and this can be done by following the natural synergistic fibrinolytic paradigm starting with a small (5 mg) bolus of tPA to initiate the lytic process followed by an infusion of His pro UK, for additional safety, for a night minute infusion. This sequence has been shown highly effective, as judged by the PATENT results and to be safe enough to be initiated without pre-testing, since if a bleed is encountered, the His pro UK infusion should do little harm.
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Singh I, Burnand KG, Collins M, Luttun A, Collen D, Boelhouwer B, et al. Failure of thrombus to resolve in urokinase-type plasminogen activator gene-knockout mice: rescue by normal bone marrow-derived cells. Circulation. 2003;107(6):869-75.
Rijken DC, Hoylaerts M, Collen D. Fibrinolytic properties of one-chain and two-chain human extrinsic (tissue-type) plasminogen activator. J Biol Chem. 1982;257(6):2920-5.
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Harpel PC, Chang TS, Verderber E. Tissue plasminogen activator and urokinase mediate the binding of Glu-plasminogen to plasma fibrin I. Evidence for new binding sites in plasmin-degraded fibrin I. J Biol Chem. 1985;260(7):4432.
Liu JN, Gurewich V. Fragment E-2 from fibrin substantially enhances pro-urokinase-induced Glu-plasminogen activation. A kinetic study using the plasmin-resistant mutant pro-urokinase Ala-158-rpro-UK. Biochemistry. 1992;31(27):6311-7.
Petersen LC. Kinetics of reciprocal pro-urokinase/plasminogen activation--stimulation by a template formed by the urokinase receptor bound to poly(D-lysine). Eur J Biochem. 1997;245(2):316-23.
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Zarich SW, Kowalchuk GJ, Weaver WD, Loscalzo J, Sassower M, Manzo K, et al. Sequential combination thrombolytic therapy for acute myocardial infarction: results of the pro-urokinase and t-PA enhancement of thrombolysis (PATENT) trial. J Am Coll Cardio. 1995;26:374-79.
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Pannell R, Black J, Gurewich V. Complementary modes of action of tissue-type plasminogen activator and pro-urokinase by which their synergistic effect on clot lysis may be explained. J Clin Invest. 1988;81(3):853-9.
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Department of Corrections, Medical Staff, Correction Officers, and Northwest State Correctional Facility, Defendants.
Now pending before the Court is Defendants' Motion to Dismiss pursuant to Federal Rule of Civil Procedure 12(b)(6). (Doc. 5.) Young has not filed a Response to the Motion.
For the reasons that follow, I recommend that the Court GRANT Defendants' Motion to Dismiss (Doc. 5).
For purposes of deciding Defendants' Motion to Dismiss, the Court accepts as true the factual allegations contained in the Complaint, see Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009) (citing Bell Atl. Corp. v. Twombly, 550 U.S. 544, 570 (2007)), and views those facts “‘in the light most favorable'” to Young, Grullon v. City of New Haven, 720 F.3d 133, 139 (2d Cir. 2013) (quoting Chase Grp. Alliance LLC v. City of N.Y. Dep't of Fin., 620 F.3d 146, 148 (2d Cir. 2010)).
The Complaint alleges both that he did not use the prisoner grievance procedure (id. at 3), but also that he “wrote several letters exhausting [his] administrative remedies and [hasn't] received any responses at all” (id. at 4).
“To survive a [Rule 12(b)(6)] motion to dismiss, a complaint must contain sufficient factual matter, accepted as true, to state a claim to relief that is plausible on its face.” Nielsen v. Rabin, 746 F.3d 58, 62 (2d Cir. 2014) (quoting Iqbal, 556 U.S. at 678); see also Fed. R. Civ. P. 8(a)(2). Also, on a 12(b)(6) motion, “the Court may consider documents attached as an exhibit [to the complaint] or incorporated by reference, documents that are ‘integral' to plaintiff's claims, even if not explicitly incorporated by reference, and matters of which judicial notice may be taken.” Thomas v. Westchester Cty. Health Care Corp., 232 F.Supp.2d 273, 275 (S.D.N.Y. 2002) (citations omitted). “A claim has facial plausibility when the plaintiff pleads factual content that allows the court to draw the reasonable inference that the defendant is liable for the misconduct alleged.” Iqbal, 556 U.S. at 678 (citing Twombly, 550 U.S. at 556). “Although plausibility is not a ‘probability requirement, ' [p]laintiffs must allege facts that permit ‘more than a sheer possibility that a defendant has acted unlawfully.'” Turkmen v. Hasty, 789 F.3d 218, 233 (2d Cir. 2015) (quoting Iqbal, 556 U.S. at 678).
Two principles guide a plausibility determination. See Iqbal, 556 U.S. at 678. “First, the tenet that a court must accept as true all of the allegations contained in a complaint is inapplicable to legal conclusions.” Id. “[T]hreadbare recitals of the elements of a cause of action, supported by mere conclusory statements, do not suffice.” Turkmen, 789 F.3d at 233 (quoting Iqbal, 556 U.S. at 678). “Second, only a complaint that states a plausible claim for relief survives a motion to dismiss.” Iqbal, 556 U.S. at 679 (citing Twombly, 550 U.S. at 556). “Determining whether a complaint states a plausible claim for relief will . . . be a context-specific task that requires the reviewing court to draw on its judicial experience and common sense.” Id. (citing Iqbal v. Hasty, 490 F.3d 143, 157-58 (2d Cir. 2007), rev'd, 556 U.S. 662 (2009)).
Where, as here, a complaint is filed pro se, it “must be construed liberally with ‘special solicitude' and interpreted to raise the strongest claims that it suggests.” Hogan v. Fischer, 738 F.3d 509, 515 (2d Cir. 2013) (quoting Hill v. Curcione, 657 F.3d 116, 122 (2d Cir. 2011)). “This policy of liberally construing pro se submissions is driven by the understanding that ‘[i]mplicit in the right of self-representation is an obligation on the part of the court to make reasonable allowances to protect pro se litigants from inadvertent forfeiture of important rights because of their lack of legal training.'” Triestman v. Fed. Bureau of Prisons, 470 F.3d 471, 475 (2d Cir. 2006) (per curiam) (alteration in original) (quoting Traguth v. Zuck, 710 F.2d 90, 95 (2d Cir. 1983)). Consequently, when parties seek dismissal of pro se complaints, “courts ‘apply[ ] a more flexible standard to evaluate their sufficiency than we would when reviewing a complaint submitted by counsel.'” Thompson v. Pallito, 949 F.Supp.2d 558, 571 (D. Vt. 2013) (alteration in original) (quoting Lerman v. Bd. of Elections in the City of N.Y., 232 F.3d 135, 140 (2d Cir. 2000)). Still, a complaint filed by a pro se plaintiff “must state a plausible claim for relief.” Hogan, 738 F.3d at 515.
On the first page of the Complaint, Young indicates that he is bringing suit pursuant to the Federal Tort Claims Act (FTCA). (Doc. 4 at 1.) Defendants assert that “[t]here is . . . no cause of action against a state or state employees created by the FTCA.” (Doc. 5 at 1.) I agree.

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Judge Panel: Meredith, Arthur, Sharer, J. Frederick (Retired, Specially Assigned), JJ.
Appeal from the Circuit Court for Baltimore City, W. Michel Pierson, JUDGE.
ARGUED BY: Gary L. Alexander (Gregory T. Simmons, Paula M. Carmody, People's Counsel on the brief) all of Baltimore, MD, FOR APPELLANT.
ARGUED BY: Daniel Hurson (Baltimore Gas & Electric Company on the brief) Joseph English (Public Service Commission of Maryland, John D. Corse, Exelon Business Services Co., LLC on the brief) all of Baltimore, MD, FOR APPELLEE.
Meredith, Arthur, Sharer, J. Frederick (Retired, Specially Assigned), JJ.
[226 Md.App. 487] Arthur, J.
In 2013 the General Assembly enacted legislation enabling regulated gas companies to recover the estimated costs of certain infrastructure replacement projects through a surcharge on customer bills. See Md. Code (1998, 2010 Repl. Vol., 2014 Supp.), § 4-210 of the Public Utilities Article (" PUA" ). Shortly after the statute took effect, Baltimore Gas and Electric Company (" BGE" ) sought approval of a plan to accelerate the replacement of outdated gas distribution infrastructure and to begin imposing a customer surcharge during the initial implementation of the plan. The Public Service Commission [226 Md.App. 488] approved the plan, subject to the condition that BGE could not implement the surcharge until it submitted additional information about the individual infrastructure projects that were to be undertaken in 2014.
for judicial review. On appeal, OPC contends: (1) that the Commission erred by authorizing BGE to collect estimated project costs before the completion of each project; and (2) that the Commission acted unlawfully by conditionally approving the plan before the Commission had evaluated the individual projects. We conclude that OPC has shown no basis for reversing the Commission's decisions.
This appeal involves three entities established by or regulated under the Public Utilities Article of the Maryland Code.
The Maryland Public Service Commission is an independent unit in the executive branch of State government (PUA § 2-101(b)), with jurisdiction over public service companies that operate utility businesses within the State. PUA § 2-112(a). The Commission's primary duties are to " supervise and regulate" the companies subject to its jurisdiction to " ensure their operation in the interest of the public" and to " promote adequate, economical, and efficient delivery of utility services in the State without unjust discrimination[.]" PUA § 2-113(a)(1)(i).
BGE is a public service company regulated by the Commission. In general, public service companies have a duty to " furnish equipment, services, and facilities that are safe, adequate, just, reasonable, economical, and efficient, considering the conservation of natural resources and the quality of the environment." PUA § 5-303. BGE provides gas service to approximately 655,000 customers across 800 square miles in Baltimore City and central Maryland.
[226 Md.App. 489] OPC is an agency that acts independently of the Public Service Commission. OPC has a duty to " appear before the Commission and courts on behalf of residential and noncommercial users in each matter or proceeding over which the Commission has original jurisdiction, including a proceeding on the rates, service, or practices of a public service company[.]" PUA § 2-204(a)(2).
Title 4 of the Public Utilities Article governs the Commission's rate regulation authority. The Commission has " the power to set a just and reasonable rate of a public service company[.]" PUA § 4-102(b). A public service company has a corresponding duty to " charge just and reasonable rates for the regulated services that it renders." PUA § 4-201.
In ordinary ratemaking proceedings, the Commission analyzes data from a prior " test year" to project a utility's future income and expenses: The [Public Service Commission] establishes [just and reasonable] rates by examining the utility's income and expenses during a test year, calculating the rate base (the fair value of the property used and useful in rendering service) during that year, determining the utility's cost of capital (its required rate of return), and then multiplying that rate of return against the rate base. The result is the amount of income to which the utility is entitled. To the extent that level of income significantly differs from the test year's net income, the Commission orders an adjustment in the utility's rates -- an increase or a decrease, as the case may be.
(citing Pub. Serv. Comm'n of Maryland v. Baltimore Gas & Elec. Co., 273 Md. 357, 360 n.2, 329 A.2d 691 (1974)); Maryland People's Counsel v. Heintz, 69 Md.App. 74, 84-85, 516 A.2d 599 (1986).
[226 Md.App. 490] In a conventional proceeding to set rates, the Commission will " calculate the test year's rate base, i.e., 'the fair value of the company's property used and useful' in rendering the service." Severstal Sparrows Point, LLC v. Pub. Serv. Comm'n of Maryland, 194 Md.App. 601, 620, 5 A.3d 713 (2010) (quoting PUA § 4-101(3)). A public service company ordinarily is not entitled to recover costs simply because the costs were incurred prudently; instead, the Commission normally requires the company to show that the costs relate to an asset " used and useful" in providing service. E.g. Columbia Gas of Maryland, Inc. v. Pub. Serv. Comm'n of Maryland, 224 Md.App. 575, 584-86, 121 A.3d 224 (2015) (holding that Commission did not err in denying portion of gas company's request for rate increase that sought to recover anticipated remediation costs for property not used and useful in providing gas service).
Between 2011 and 2013, the General Assembly considered a series of bills that would empower the Public Service Commission to authorize gas companies to promptly recover infrastructure replacement costs through a customer surcharge. The 2013 General Assembly enacted " An Act Concerning Gas Companies -- Rate Regulation -- Infrastructure Replacement Surcharge." The proposal was commonly referred to as the Strategic Infrastructure Development and Enhancement (STRIDE) law. The law took effect on June 1, 2013. See 2013 Md. Laws, ch. 161, § 2.
The legislation added section 4-210 to the Public Utilities Article. This new section includes an express statement of legislative intent: " It is the intent of the General Assembly that the purpose of this section is to accelerate gas infrastructure improvements in the State by establishing a mechanism for gas companies to promptly recover reasonable and prudent costs of investments in eligible infrastructure replacement projects separate from base rate proceedings." PUA § 4-210(b).

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Anderson v. Radio One, Inc.
CHERYL ANDERSON, Appellant v. RADIO ONE, INC.
This is an appeal from the District Court's grant of summary judgment in favor of Radio One, Inc. on Cheryl Anderson's claims that Radio One terminated her employment in violation of the Age Discrimination in Employment Act ("ADEA"), 29 U.S.C. § 621 et seq., and the Americans with Disabilities Act ("ADA"), 42 U.S.C. § 12101 et seq. We will affirm.
The District Court had jurisdiction under 28 U.S.C. § 1331, and we have jurisdiction under 28 U.S.C. § 1291. We exercise plenary review of the District Court's grant of summary judgment, and apply the same standard applicable in the District Court found in Fed. R. Civ. P. 56. See Doe v. C.A.R.S. Prot. Plus, Inc., 527 F.3d 358, 362 (3d Cir. 2008).
Because we write primarily for the parties, we need not discuss the facts or procedural history of this case.
With respect to the ADEA claim, Radio One did not dispute that Anderson established a prima facie case of age discrimination for purposes of the summary judgment motion and the District Court presumed that she had met this burden. See Keller v. Orix Credit Alliance, Inc., 130 F.3d 1101, 1108 (3d Cir. 1997) (en banc) (setting forth elements of a prima facie claim). The burden thus shifted to Radio One to produce evidence of a legitimate, nondiscriminatory reason for the adverse action. Id. Once Radio One produced such evidence, the burden shifted back to Anderson to provide sufficient evidence to allow a factfinder to either reject the employer's nondiscriminatory explanation, or conclude that an invidious discriminatory reason was more likely than not a motivating cause of her discharge (pretext). Id. (citing Fuentes v. Perskie, 32 F.3d 759, 763 (3d Cir. 1994)).
Radio One claims that it terminated Anderson because she failed to satisfy the demands of the Program Assistant position, including meeting deadlines and accurately completing assignments. We agree with the District Court's conclusion that Anderson did not then produce sufficient evidence of a pretext for age discrimination. Indeed, Anderson has never meaningfully disputed the substance of Radio One's repeated concerns with her job performance. Because Anderson failed to meet her burden to show pretext, summary judgment is appropriate on her ADEA claim.
Notably, prior to termination, Radio One offered Anderson a position as a receptionist, but she rejected the offer.
Summary judgment is likewise appropriate on Anderson's ADA claim. We agree with the District Court that Anderson "is not actually disabled" within the meaning of 42 U.S.C. § 12102(2), and "she was not 'regarded as' disabled" within the meaning of 42 U.S.C. § 12102(3) by her employer. Anderson v. Radio One, Inc., No. 09-194, 2010 WL 3719088, at *9-10 (E.D. Pa. Sept. 20, 2010). Even if Anderson could establish that Radio One regarded her as disabled, as the District Court concluded, she did not meet her burden to demonstrate pretext for disability discrimination.
We have considered all of Anderson's arguments, but we find no basis for reversal. Accordingly, we will affirm the judgment of the District Court in favor of Radio One.


(a) Except as otherwise provided in this Code section, no privity is necessary to support a tort action; but, if the tort results from the violation of a duty which is itself the consequence of a contract, the right of action is confined to the parties and those in privity to that contract, except in cases where the party would have a right of action for the injury done independently of the contract and except as provided in Code Section 11-2-318.
(b) (1) The manufacturer of any personal property sold as new property directly or through a dealer or any other person shall be liable in tort, irrespective of privity, to any natural person who may use, consume, or reasonably be affected by the property and who suffers injury to his person or property because the property when sold by the manufacturer was not merchantable and reasonably suited to the use intended, and its condition when sold is the proximate cause of the injury sustained.
(2) No action shall be commenced pursuant to this subsection with respect to an injury after ten years from the date of the first sale for use or consumption of the personal property causing or otherwise bringing about the injury.
(3) A manufacturer may not exclude or limit the operation of this subsection.
(c) The limitation of paragraph (2) of subsection (b) of this Code section regarding bringing an action within ten years from the date of the first sale for use or consumption of personal property shall also apply to the commencement of an action claiming negligence of a manufacturer as the basis of liability, except an action seeking to recover from a manufacturer for injuries or damages arising out of the negligence of such manufacturer in manufacturing products which cause a disease or birth defect, or arising out of conduct which manifests a willful, reckless, or wanton disregard for life or property. Nothing contained in this subsection shall relieve a manufacturer from the duty to warn of a danger arising from use of a product once that danger becomes known to the manufacturer.
(d) Irrespective of privity, a manufacturer shall not be held liable for the manufacture of a product alleged to be defective based on theories of market share or enterprise, or other theories of industry-wide liability.
(e) Irrespective of privity, a manufacturer of a product alleged to be defective shall not be held liable for a public nuisance based on theories of market share or enterprise, or other theories of industry-wide liability.
Orig. Code 1863, § 2899; Code 1868, § 2905; Code 1873, § 2956; Code 1882, § 2956; Civil Code 1895, § 3812; Civil Code 1910, § 4408; Code 1933, § 105-106; Ga. L. 1968, p. 1166, § 1; Ga. L. 1978, p. 2202, § 1; Ga. L. 1978, p. 2218, § 1; Ga. L. 1978, p. 2267, § 1; Ga. L. 1987, p. 613, § 1; Ga. L. 2009, p. 625, § 1/SB 213.


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This coming election, Palo Alto and Livermore voters will decide whether to cap health care pricing to 115% of direct patient care and quality improvement costs. Officially known as the Accountable and Affordable Health Care Initiative, and colloquially as Measure F for Palo Alto and Measure U for Livermore, these local initiatives face opposition from opponents who assert that federal and state laws preempt and invalidate the measures. On its face, this could have spelled the end to these measures. Preemption is a tried and true way to overturn local initiatives, and health care has long been considered a realm for federal and state regulation. However, thus far, California superior court judges have rejected the argument that these local initiatives are preempted and refused to remove them from the ballot. If passed, these measures may be a novel way to accomplish rate setting, albeit on a local level.
Accountable and Affordable Health Care Initiative: What Charges Does It Cap?
Back in 2017, Service Employees International Union United Health Care Workers (SEIU-UHW) filed nearly identical ballot measures for the November 2018 election in five San Francisco Bay area municipalities: Emeryville, Livermore, Palo Alto, Pleasanton, and Redwood City. Each of the ballot measures was called the “Accountable and Affordable Health Care Initiative” (hereinafter known as “the measure”) and was heralded as lowering health care prices within these municipalities. Palo Alto and Livermore successfully put the initiative on the ballot as Measure F and Measure U, respectively, while Pleasanton, Emeryville, and Redwood City did not gather enough signatures for the November 2018 election.
These measures would limit the amount hospitals, medical clinics, and other health care providers can charge to patients, insurance companies, and other non-governmental payers. The maximum chargeable amount would be 115% of the “reasonable” costs for direct patient care and quality improvement. If the hospital, clinic, or provider exceeds this amount by more than $20, they would be required to issue, annually, a rebate or reduction in the amount billed.
The proposal to cap health care costs has been controversial from both policy and legal standpoints. Like the rate-setting bill AB 3087 from earlier this year, this measure pits labor unions, which support price control, against providers and hospitals, which oppose it. Supporters of the measure point out that Stanford Health Care charges “264% more than the statewide average to treat patients for alcohol or drug abuse, 142% more to treat patients with chest pain, and 121% more to treat patients with kidney failure,” and has about “$700 million in reserves.” They also cite to a Becker’s Hospital Review article that noted Stanford Health Care had an operating income of $74.3 million in the first quarter of fiscal year 2018, up from an operating income of $28 million in the first quarter of fiscal year 2017. Additionally, supporters argue that providers can still make a profit as patients enjoy lower healthcare costs.
Providers, on the other hand, vehemently oppose this measure. Stanford Health Care, based in Palo Alto and owner of ValleyCare Hospital in Livermore, and the Palo Alto Medical Foundation argue that the measure has “impossible administrative requirements” for providers, that the city lacks the resources for the “massive” administrative or financial demands, and that the measure does not require “out of state companies” to pass these rebates to Palo Alto patients, allowing them to instead pocket the rebates without the patients ever seeing the savings. In a letter to the Palo Alto City Attorney, Stanford’s Chief Hospital Counsel argued that the initiative would result in a 20-25% drop in revenue that would exceed Stanford’s margin. Additionally, both the mayor of Palo Alto and Livermore wrote arguments against the measure, noting high administrative costs to the city. Finally, many opponents, citing the City of Livermore’s Section 9212 Report (“Zaretsky report”), have stated that this would drive providers away from the municipalities that pass the measure, which would result in fewer providers and consequently less access to care.
Preemption 101: Are Localities Preempted from Regulating Health Care?
The doctrine of preemption asserts that a higher level of government may nullify the laws of a lower level of government. Preemption is enshrined in the Supremacy Clause of the U.S. Constitution, which states that “This Constitution, and the laws of the United States . . . shall be the supreme law of the land . . . laws of any State to the contrary notwithstanding.” The California Constitution has its own version of the supremacy clause for localities, stating that “[a] county or city may make and enforce . . . ordinances and regulations not in conflict with general laws.” This doctrine comes into play when a federal and state law or a state and local law conflicts with one another. In both instances, the law enacted by the higher level of government would prevail. For example, if a federal law required all toys to be red and a state law mandated that all yoyos be blue, the federal law would preempt the state law so that all yoyos must be red instead of blue.
However, state legislatures have become aggressive in passing legislation that preempts local ordinances. Nearly half of all states preempt any local ordinances regarding minimum wage, and about three-fourth of all states, including California, preempt local ordinances regarding ride sharing and tax and expenditure limitations. As such, preemption has been considered a threat to local innovation.
In opposition of the measures on the ground of preemption, Stanford Health Care, Emeryville’s city attorney, and the City of Livermore filed suit in Palo Alto, Emeryville, and Livermore, respectively. The three cases involve nearly identical allegations and defenses.
Defendants argue that the measures regulate providers, not health service plans under the Knox-Keene or insurers under the California Insurance Code. Thus, neither Knox-Keene nor the California Insurance Code preempts the measure. Additionally, defendants argue that the ACA only preempts the local law if it “hinder[s] or impede[s]” the application of ACA. They argue that annual cap on payments is not addressed by the ACA, therefore the local law cannot hinder or impede the application of the ACA.
Agreeing with the defendants in all three cases, the courts refused to intervene and allowed the ballot measures to move forward.
In Stanford Health Care v. Beth Minor, et al (Case No. 18CV330068), Stanford Health Care and Palo Alto Medical Foundation petitioned the Santa Clara County Superior Court to remove Measure F from the ballot. On August 1, Judge Mark Pierce rejected Stanford’s preemption argument, holding that “petitioners have not made a compelling showing for interfering with the initiative power.” He ruled that both the Knox-Keene and the ACA refer to the regulation of health care service plans, while Measure F regulates costs charged by providers. As such, neither Knox-Keene nor ACA preempts Palo Alto’s Measure F.
In Michael Guina v. Marilyn Smith (Case No. RG18887782), Emeryville City Attorney Michael Guina petitioned the court to stay his duty to provide a ballot title and summary of Emeryville’s measure. Since an initiative cannot circulate without such information, a stay would effectively halt the measure. In this case, the court also rejected the preemption arguments. Judge Paul D. Herbert found that the “Ballot Measure does not clearly duplicate, conflict with, or enter an area already fully occupied by [general California law] and federal law.” He further ruled that Knox-Keene, Insurance Code, Medi-Cal, Hospital Fair Policing Policies Act, ACA, Internal Revenue Code, Medicare and Medicaid, Emergency Treatment and Labor Act (EMTALA), and ERISA do not concern what the measure aims to do. While the measure ultimately failed to reach the ballot, the court’s ruling is another strike against the preemption argument.
In City of Livermore v. Tim Dupuis (Case No. RG18911516), Judge Kimberly E. Colwell rejected the City of Livermore’s attempt to remove Measure U from the ballot. Judge Colwell held that “all arguments advanced by petitioner [including preemption] can be litigated” after the election and that “if the initiative is not approved, the parties’ dispute will be moot.” As such, she did not address any of the preemption concerns.
As Palo Alto and Livermore voters consider whether to cap health care pricing to 115% of direct patient care and quality improvement costs, lawsuits in the form of preemption challenges have threatened to derail the efforts. Yet, so far, the courts are allowing the local initiatives to play out. While preemption arguments have been defeated pre-vote, courts have left the door open to litigate the measures after their passage. California superior court judges, by refusing to remove the measures from the ballot, are allowing this novel approach to move forward.
It should be noted, however, that in the midst of these local efforts, the state legislature has also attempted to regulate health care pricing via the short-lived AB 3087. If a similar rate-setting bill passes the state legislature in the future, it would most likely preempt Palo Alto’s Measure F and Livermore’s Measure U.
Regardless, if these measures pass, opponents will certainly revive the legal challenges to prevent their implementation. It will be up to the courts to determine whether health care pricing is within the exclusive realm of state authority, or whether a locality has the right to regulate health care pricing. So far, courts think localities should get a chance to.
 Angela Ruggiero, Livermore sued over city measure for healthcare costs; asks court to rule on legality, East Bay Times (Aug. 11, 2018).
 The measure would exempt children, public, or VA hospitals. See Proposed Sec. 5.40.020(d), Palo Alto Accountable and Affordable Health Care Initiative (2018); Proposed Sec. 8.21.020(d), Livermore Accountable and Affordable Health Care Initiative (2018).
 The measure would exempt chronic dialysis clinic, children hospital’s clinics or clinics exclusively for children, community or free clinics, clinics that offer reproductive health care services or family planning, a VA clinic, or a clinic licensed to “a county, a city, a city and county, the State of California, the University of California, a local health care district, a local health authority, or any other political subdivision of the state.” Proposed Sec. 5.40.020(e), Palo Alto Accountable and Affordable Health Care Initiative (2018); Proposed Sec. 8.21.020(e), Livermore Accountable and Affordable Health Care Initiative (2018).
 While the measure defines that cost of direct patient care as the “provider’s reasonable operating costs and costs to provide care to patients,” it goes on to specifically state that “reasonable cost of direct patient care” would include (a) salaries, wages, and benefits of staff excluding managerial staff; (b) staff training and development; (c) pharmaceuticals and supplies; (d) facility costs like rent, maintenance, and utilities; (e) laboratory testing; and (f) depreciation and amortization of buildings, leasehold improvements, patient supplies, equipment, and information systems. Proposed Sec. 5.40.030(b)(1), Palo Alto Accountable and Affordable Health Care Initiative (2018); Proposed Sec. 8.21.030(b)(1), Livermore Accountable and Affordable Health Care Initiative (2018).
 The quality improvement costs would include but not limited to “maintain[ing], access[ing] or exchang[ing] electronic health information; support[ing] health information technologies; train[ing] non-managerial personnel engaged in direct patient care; and provid[ing] patient-centered education and counseling.” Proposed Sec. 5.40.020(c), Palo Alto Accountable and Affordable Health Care Initiative (2018); Proposed Sec. 8.21.020(c), Livermore Accountable and Affordable Health Care Initiative (2018).
 Argument for Measure F (2018).
 Ayla Ellison, Stanford Health Care’s operation income more than doubles in Q1, Becker’s Hospital Review (Jan. 25, 2018).
 The Palo Alto City Council Staff Report (ID #9342) agreed with the critics’ second point, stating that “[a]t this time, the City does not have expertise or experience in the regulation of health care costs or health care generally” and that the “City does not currently have staff personnel who would be able to implement this program.” The staff report was also concerned over the cost and feasibility of implement given that “this type of program has not been adopted at the local level.” City of Livermore’s Section 9212 Report suggested that Measure U for Livermore would cost $1.9 million annually and an additional $750,000 to $1 million in startup costs.
 Liz Kniss, et. Al., Argument Against Measure F (2018).
 Sarah J. DiBoise, Letter to Molly Stump – Re: “Palo Alto Accountable and Affordable Health Care Initiative” at pg. 4 (June 1, 2018). See also William Cleverley, Ph.D., Impact of Livermore California Ballot Initiative on Stanford Health Care – ValleyCare Hospital (2018) (commissioned by Stanford Health Care – ValleyCare and stating that ValleyCare will have a loss of $7 milllion and be forced to cutback or close services).
 See Henry W. Zaretsky, Section 9212 Report – Livermore Accountable and Affordable Health Care Initiative (July 20, 2018) (commissioned by Livermore City Council as an independent analysis). See also Clevereley, supra note 10.
 Palo Alto City Council Staff Report (ID #9342) at 5. See Molly S. Stump, City Attorney’s Impartial Analysis of Measure F (Aug. 21, 2018) (observing that “health care regulation has largely been the province of the state and federal governments”).
 Jason Alcala, City Attorney’s Impartial Analysis of Measure U (2018).
 See National League of Cities, City Rights in an Era of Preemption: A State-by-State Analysis at 3 (2017) (hereinafter NLC); Jennifer Pomeranz & Mark Pertschuk, State Preemption: A Significant and Quiet Threat to Public Health in the United States, 107 American J. of Public Health 900, 900 (2017).
 Cal. Const. art. XI, § 7 (emphasis added).
 See Ann Taylor Schwing, Preemption, 1 Cal. Affirmative Def. § 7:19 (2d ed., April 2018 update).
 Big Creek Lumber Co. v. Cty. of Santa Cruz, 38 Cal. 4th 1139, 1149 (2006).
 NLC, supra note 16, at 3. See National Policy and Legal Analysis Network to Prevent Childhood Obesity (NPLAN), The Consequences of Preemption for Public Health Advocacy (2010) (stating “preemption on state and local governments have become almost routine in legislative and rule-making processes in recent years, particularly when health and consumer protection issues are involved”). See also Lori Riverstone-Newell, Rise of State Preemption Laws in Response to Local Policy Innovation, 47 Publius: The Journal of Federalism 403, 406 (noting the “surge of preemption legislation” by states due industry groups, conservative organizations, and Republican control of state legislature).
 NLC, supra note 16, at 3.
 Pomeranz & Pertschuk, supra note 16, at 902. See also NPLAN, supra note 22.
 Stanford Health Care v. Beth Minor, et al (Case No. 18CV330068). Beth Minor is the City Clerk of Palo Alto and the Election Official for the city.
 Michael Guina v. Marilyn Smith (Case No. RG18887782). Michael Guina is the Emeryville City Attorney. Marilyn Smith is an individual who, on behalf of SEIU, filed a Notice of Intent in Emeryville. A Notice of Intent is required before an initiative can circulate and qualify for the ballot.
 City of Livermore v. Tim Dupuis (Case No. RG18911516). Tim Dupuis is the Alameda County Registrar of Voters, and the official in charge of putting the initiative on the ballot.
 See F. Curt Kirschner Jr., Letter to Molly Stump – Re: “Palo Alto Accountable and Affordable Health Care Initiative” at pg. 1 (June 13, 2018).
 Gennady Sheyner, Opponents Gear Up for Battle Over Health Care, Palo Alto Weekly (Sept. 14, 2018).
 Brief of Amicus Curiae American Hospital Association at 11, Livermore v. Dupuis, No. RG18911516 (Cal. Super. Ct., Alameda County July 27, 2018).
 Real Party in Interest’s Opposition to the Petition for Writ of Mandate at 13-14, 16, Livermore v. Dupuis, No. RG18911516 (Cal. Super. Ct., Alameda County Aug. 2, 2018).
 Gennady Sheyner, Judge Allows Health-care Initiative to Proceed, Palo Alto Weekly (Aug. 6, 2018).
 Order Denying Motion for Stay of Litigation at 5-6, Guina v. Smith, No. RG18-887782 (Cal. Super. Ct., Alameda County Jun. 25, 2018).
 Order Denying Petition for Writ of Mandate, Livermore v. Dupuis, No. RG18911516 (Cal. Super. Ct., Alameda County Aug. 17, 2018).
 See note 38; Order Denying Motion for Stay of Litigation at 11, Guina v. Smith, No. RG18-887782 (Cal. Super. Ct., Alameda County Jun. 25, 2018) (limiting the scope of judgment by holding that this judgment pertains to whether “the asserted invalidity of the Ballot Measure is clear beyond a doubt” and not “whether the Ballot Measure is constitutional on its face, or whether the Ballot Measure is constitutional as applied”).
 See Amended Opening Brief in Support of Plaintiff and Petitioner City of Livermore’s Petition for Writ of Mandate at 17, Livermore v. Dupuis, No. RG18911516 (Cal. Super. Ct., Alameda County July 20, 2018) (the “fair return” argument was made in all three cases).
 See Debra Zumait, Letter to Molly Stump – Re: “Palo Alto Accountable and Affordable Health Care Initiative” at pg. 5 (June 6, 2018). See also Amended Opening Brief in Support of Plaintiff and Petitioner City of Livermore’s Petition for Writ of Mandate at 17, Livermore v. Dupuis, No. RG18911516 (Cal. Super. Ct., Alameda County July 20, 2018) (the “fair return” argument was made in all three cases).
 Gillian Brassil, Legality Questions Surround Palo Alto’s Measure F, Which Would Regulate Health Costs, Peninsula Press (Oct. 24, 2018). See also Stump, supra note 12 (writing the “court determined that the legal questions about Measure F could be decided after the election if the measure is approved”).
 Sheyner, supra note 29. Judge Herbert, in Guina v. Smith, also echoed this sentiment, holding that the “court will not presume a conclusion before the measure is even presented to the voters.” Order Denying Motion for Stay of Litigation at 8, Guina v. Smith, No. RG18-887782 (Cal. Super. Ct., Alameda County Jun. 25, 2018).

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§ 102-1 Legislative findings and purpose.
§ 102-3 Waste, debris and motor vehicles; liability; inspection and notice; penalties for offenses.
§ 102-4 Brush, grass and weeds; nuisance determination; notice of violation; penalties for offenses.
§ 102-6 Injunctive relief; remedies cumulative.
Fire prevention and building code — See Ch. 71.
Recycling — See Ch. 107, Art. I.
Editor's Note: This local law also repealed former Chapter 102, Property Maintenance, adopted 5-6-2002 by L.L. No. 1-2002.
The Town Board of the Town of Wilson hereby finds that the outdoor storage, accumulation, deposit and placement of abandoned, junked, discarded, wholly or partially dismantled or unlicensed or unregistered motor vehicles, rubbish, debris, or solid waste upon private property threatens the health, safety and welfare of the Town residents. Outdoor storage, accumulation, deposit or placement of such items creates a significant fire hazard, endangers the environment and groundwater, leads to infestation by insects, vermin or rodents, depreciates property values and has a deteriorating and blighting effect upon the neighborhood and community.
The Town Board hereby determines that the outdoor storage, accumulation, deposit or placement of abandoned, junked, discarded, wholly or partially dismantled or unlicensed or unregistered motor vehicles, rubbish, debris or solid waste upon private property constitutes a public nuisance.
Low woods, undergrowth, seasonal growth and chopped-off tree branches, except trees or shrubbery intended and actually used for landscaping, fencing, shade or decoration, and tree branches piled near the structure intended for use as firewood.
Includes all materials resulting from the construction, excavation, renovation, equipping, remodeling, repair or demolition of structures, property or roads as well as materials consisting of vegetation resulting from land clearing and grubbing, utility line maintenance and seasonal and storm-related cleanup. Such materials include, but are not limited to, bricks, concrete and other masonry materials, soil, rock, wood, wall coverings, plaster, drywall, plumbing fixtures, insulation, roofing shingles, asphaltic pavement, glass, window frames, electrical wiring and components, plastics, carpeting, foam padding, linoleum, metals or any combination thereof which are incidental to construction, excavation, renovation, equipping, remodeling, repair or demolition.
Includes all putrescible animal and vegetable waste resulting from processing, marketing and preparation of food items, including the container in which packaged.
Includes all vehicles as defined by New York State Vehicle and Traffic Law § 125. The term "motor vehicle" as used in this chapter shall also include all-terrain vehicles as defined by New York State Vehicle and Traffic Law § 2281 and snowmobiles as defined by New York State Vehicle and Traffic Law § 2221, and shall further include any vehicle intended for operation on land by means other than muscle power. This term "motor vehicle" shall also include campers and trailers generally found in use over the highway.
Includes anything not housed in a fully enclosed building.
The owner as identified on the current assessment roll.
Includes all nonputrescible solid wastes consisting of both combustible and noncombustible wastes, including but not limited to paper and paper products, rags, wrappings, cigarettes, cardboard, tin cans, yard clippings, wood, glass, metals, plastics, tires, bedding, cloth, crockery, furniture, appliances and similar items.
Includes all putrescible and nonputrescible materials and substances having served their original intended use or being spent, useless, worthless or in excess to the owner, including but not limited to household and commercial garbage, industrial waste, rubbish, debris, garbage, litter and ashes.
Vegetation that grows in profusion in an uncultivated state and which is allowed to exceed 12 inches in height. For the purposes of this chapter, the term "weeds" shall not include vegetation such as growing crops, trees, bushes or shrubs used for landscaping purposes around or near a structure.
No person, as owner, occupant, lessee or agent or in any capacity, shall store, deposit, place, maintain or cause or permit to be stored, deposited, placed or maintained or grown outdoors any abandoned, junked, discarded, wholly or partially dismantled, unlicensed or unregistered motor vehicle or any solid waste, rubbish, or debris upon any private property within the Town.
Any solid waste, rubbish or debris temporarily stored or placed in containers for collection or disposal.
The maintenance of a mulch pile used for on-premises gardening or landscaping confined to an area to the rear of a residence and not exceeding 50 square feet.
The temporary storage on a premises of a single motor vehicle meeting New York State inspection requirements, which is unlicensed or unregistered but which is not dismantled, abandoned, junked or discarded. This exception shall only apply where the vehicle is stored on a stone or paved surface not closer to the street than the front facade of the building.
The maintenance of any motor vehicle on a duly licensed automobile repair or sales business lot, properly zoned, while said vehicle is being repaired or sold, provided that this exception shall not permit storage of vehicles which will not pass a New York State vehicle inspection on any premises for a period in excess of 30 days.
The maintenance or storage of farm equipment or materials used in a farming or agricultural operation on a premises in actual use for agricultural purposes.
The maintenance or storage of operable farm equipment, business equipment or construction equipment for sale or in connection with a legally operating business.
For purposes of this chapter, every owner and occupant shall be strictly liable and fully responsible and shall be deemed to have permitted any condition on the premises he or she owns or occupies.
Inspection and notice. Whenever it shall appear that the provisions of this chapter are violated, the Code Enforcement Officer or his designated representative is authorized to make an inspection of the property involved, at any reasonable hour. The right of entry shall not be limited in any way by the existence or lack of existence of a request, authorization, license, or other consent or approval of entry, inspection or removal and disposal. When the Code Enforcement Officer or his designated representative deems it necessary, he shall notify by regular mail and by conspicuously posting a legal notice on a structure or at the front of said property, any such persons that they are in violation of this section. This notice shall direct the person so served, regardless of ownership, that the motor vehicle, solid waste, rubbish or debris determined to be in violation of this chapter be removed from the property on or before 10 days after the service or mailing of such notice.
Issuance of appearance ticket; penalties for offenses.
In the event of noncompliance with the provisions of this chapter, after 10 days have elapsed from the service of notice as provided by § 102-3D, the Code Enforcement Officer may issue an appearance ticket returnable in the Town of Wilson Justice Court on a date and time as specified on the appearance ticket. The appearance ticket shall specify the alleged local law violation and date and time involved, a copy of which shall be forwarded to the Town Justice with information detailing the violation amid the attempts made by the Code Enforcement Officer to achieve compliance.
A violation of § 102-3A of this chapter is a violation punishable by a fine of up to $250 and/or imprisonment for up to 15 days. Each additional week of continuous violation of the terms of this chapter constitutes a separate violation.
Any tract or parcel of land containing 1 1/2 acres or less shall be cut in its entirety to a length of 12 inches or less.
Any tract or parcel of land, regardless of lot size, containing a residential or business structure shall, within 100 feet of said structure, be cut to a length of 12 inches or less.
Poisonous plants. It shall be unlawful for any such person or persons to cause, suffer or allow poison ivy, ragweed or other poisonous plant or plants detrimental to health to grow on the part of any such lot or land required to be cut in accordance with § 102-4A(1) and (2) of this chapter, or to allow the seed, pollen or other particles or emanations therefrom to be carried throughout the air into any public place.
Present any other danger to health, safety, morals, or general welfare.
Please take notice that you are hereby required to cut and remove all grass, weeds, and other rank, poisonous, and harmful vegetation on the property owned or occupied by you and to comply with the local law of the Town of Wilson relative to the removal of brush, grass and weeds. In the event of your failure to remove such brush, grass and weeds, the Code Enforcement Officer or his designated representative may cause such brush, grass and weeds to be cut and removed, and the cost thereof shall thereupon become and be a charge and lien upon your property and shall be collected the same as other taxes upon your property.
Failure to comply with notice.
If the provisions of the foregoing Subsections A through D are not complied with within 10 days of the date of the mailing and posting of the notice hereinbefore provided for, the Code Enforcement Officer may cause brush, grass and weeds on such lot or land to be cut and removed. The actual cost of such cutting and removing, plus $200 for inspection and other additional costs in connection therewith, shall be billed to the property owner. Thirty days after the billing date, all unpaid charges will become a lien upon the property upon which said brush, grass, and weeds were located and shall bear interest at the same rate as taxes and shall be collected and enforced by the same officer and in the same manner as taxes levied and assessed against such property, or the same may be collected by suit against the owner or owners in the name of the Town.
Any person who shall fail, neglect or refuse to comply with the provisions of any notice herein provided for, or who shall resist or obstruct the Code Enforcement Officer, his designated representative or any employee of the Town of Wilson in, the cutting and removing of brush, grass and weeds shall, upon conviction thereof, be subject to a penalty as hereinafter provided.
Upon noncompliance with notice from the Code Enforcement Officer as identified in § 102-4E(2) of this chapter, said Code Enforcement Officer may issue an appearance ticket returnable in the Town of Wilson Justice Court on a date and time as specified on the appearance ticket. The appearance ticket shall specify the alleged local law violation and date and time involved, a copy of which shall be forwarded to the Town Justice with information detailing the violation amid the attempts made by the Code Enforcement Officer to achieve compliance.
The penalties for violation of any provision of this section shall be as follows: a fine of not less than $100 nor more than $250 or imprisonment for not more than 15 days, or both. Said penalties shall be in addition to those charges levied under § 102-4E(1) of this chapter for the actual cost of such cutting and removing, plus $200 for inspection and other additional costs in connection therewith.
The continuation of any violation for each successive week shall constitute a separate offense, and the person allowing or permitting the continuation of a violation may be punished as above provided for each separate offense.
Nothing in this chapter shall prohibit the Town from entering onto private property to remove any solid waste, motor vehicle, appliance, rubbish, debris or any other hazard whenever there exists an imminent threat to the life or safety of persons. Municipal authority pursuant to this section may only be exercised where there is a direct necessity to protect life and safety. Any municipal action taken pursuant to this section must be reasonably calculated to alleviate or prevent the crisis condition and must be limited to those actions necessary to eliminate the emergency situation.
A property owner shall be given notice and an opportunity to be heard prior to any costs and expenses incurred by the Town in removal pursuant to § 102-5A being placed on the property's tax bill.
The Town may seek injunctive relief in a court of competent jurisdiction and shall be entitled to a judgment for any expenses incurred, including reasonable attorney fees.
All remedies set forth in this chapter are alternative and cumulative, and the Town may enforce this chapter utilizing any remedy or combination thereof.


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As a former Surface Warfare Officer in the United States Navy, John "Jay" Jurata is no stranger to keeping his cool in face of pivotal conflicts. This has served him well in his career as an antitrust trial attorney that has spanned nearly two decades. He has represented some of the biggest names in the technology industry, including Microsoft, Sharp, LG, Panasonic and Fujifilm.
He currently co-leads Microsoft’s defense of an antitrust class action overcharge litigation in Canada seeking more than four billion dollars in damages (the first “abuse of dominance” case brought under Canadian antitrust law) in addition to representing Microsoft on merger control, antitrust investigations and private litigation arising from patent enforcement. For example, he helped to resolve the Korea Fair Trade Commission’s challenge to Microsoft Corporation’s acquisition of the Nokia devices and services business, with no changes to Microsoft’s pre-acquisition patent licensing practices.
Other recent successes include representing Sharp Corporation in a standards-essential patent licensing arbitration against InterDigital Corporation that sought $390 million in damages, a dismissal of a suit regarding a standards-essential patent dispute against iBiquity and later that year a trial victory for the client on the same issue.
Jay is a recognized authority in the field of antitrust and its overlap with intellectual property, and he speaks and publishes regularly on topics such as standards-essential patents, FRAND, and patent trolls.
Below are some examples of the types of engagements that Jay has handled.
Korea FTC vs. Microsoft (2014-2015): Served as Microsoft's lead U.S. outside counsel in resolving the Korea FTC's opposition to Microsoft's $7.2B purchase of Nokia's devices and services business. In that matter, Jay was responsible for the overall strategy in responding to the investigation, including preparing Microsoft's written submission to the KFTC, participating in oral arguments before the agency, and developing the consent decree strategy that ultimately resolved the dispute.
FTC Internet Search Advertising Investigation (2012-2013): Represented emerging start-up companies in advocating the U.S. Federal Trade Commission to stop Google from allegedly manipulating its search ranking results to block potential competition to its search advertising monopoly.
EU Patent Enforcement Investigation (2011-2013): Assisting Microsoft in responding to allegations by Google that Nokia's 2011 sale of patents to a non-practicing entity violates EU competition law.
Yammer, Inc. (2012): Secured unconditional clearance through U.S. Department of Justice Antitrust Division of Microsoft Corporation's $1.2 billion acquisition of Yammer, Inc., which adds Yammer's popular social networking tool for businesses to Microsoft's popular line of productivity software.
DOJ and State AG Mainframe Investigations (2009-2011): Represented the Computer and Communications Industry Association (CCIA) in persuading the U.S. Department of Justice Antitrust Division and Florida AG office to open a two-year antitrust investigation into IBM's business practices involving mainframe computing.
EU Mainframe Investigation (2010-2011): Represented TurboHercules SAS in convincing the EU Directorate General for Competition to initiate a formal abuse of dominance investigation into IBM's conduct in mainframe computing.
DOJ/FTC Wooden Bedroom Furniture Investigations (2011): Represented a U.S. importer seeking that the U.S. Department of Justice Antitrust Division and U.S. Federal Trade Commission stop the alleged manipulation of Department of Commerce antidumping procedures by certain companies to disadvantage competitors.
EU Browser and Interoperability Investigations (2008-2009): Assisted Microsoft in responding to claims that including browsing functionality as part of Windows and productivity software product design choices violated EU competition law.
GPX v. United States (2008): Represented GPX Int'l Tire Corp. in seeking a preliminary injunction from the U.S. Court of International Trade to stay a ruling by the U.S. International Trade Commission ordering antidumping counter duties for certain imported products.
FTC v. Western Refining, Inc. (2007): Member of trial team that defeated the U.S. Federal Trade Commission's request for a preliminary injunction to block Western's $1.3 billion acquisition of Giant Industries (D.N.M. May 29, 2007), as well as the FTC's emergency requests for an injunction pending appeal from the district court (D.N.M. May 30, 2007) and the Court of Appeals for the Tenth Circuit (10th Cir. May 31, 2007).
KFTC Media Player Investigation (2005): Assisted Microsoft in responding to claims that including media player functionality as part of Windows violated Korean competition law.
JFTC Licensing Investigation (2004): Assisted Microsoft in responding to claims that including media player functionality as part of Windows violated Japanese competition law.
Confidential SEP licensing arbitration: Represent a telecommunications device manufacturer in a confidential arbitration against a major wireless technology provider seeking more than $100 million in damages for violations involving SEPs and FRAND.
iBiquity Digital Corp. v. Continental Automotive Sys. (2014-2015): First-chaired a multi-million dollar trial victory for iBiquity in a "bet the company" licensing dispute involving SEPs and FRAND. Successfully dismissed a parallel lawsuit brought against iBiquity in federal court.
Microsoft Corp. v. Samsung Corp. (2014-2015): Represented Microsoft in a multi-billion lawsuit against Samsung concerning the Nokia acquisition's effect of the companies' patent cross-license agreement.
Oasis Research LLC v. Adrive LLC et al.: Represented EMC Corporation in successfully dismissing patent litigation brought by an Intellectual Ventures "shell" organization in the Eastern District of Texas.
In re Certain Handheld Electronic Computing Devices, Related Software, and Components Thereof (2011-2012): Represented Microsoft in successfully dismissing, on summary determination, a defense raised in the U.S. International Trade Commission alleging that Microsoft's patent licensing program for distributers of Android-based devices constituted patent misuse.
Digitechnic v. Microsoft (2008-2009): Assisted Microsoft in responding to claims brought against it in French court that Microsoft's pricing for its popular productivity software violated French competition law.
Daisy Mountain v. Microsoft (2007-2009): Represented Microsoft in defending against an antitrust class action lawsuit on behalf of government entities in Arizona that Microsoft overcharged consumers for its popular operating systems and productivity software.
Microsoft indirect purchaser antitrust litigation (2001-2008): Represented Microsoft in defending against antitrust class action lawsuits on behalf of indirect purchasers in California, Mississippi and other states alleging that Microsoft overcharged consumers for its popular operating systems and productivity software.
Comes v. Microsoft (2006-2007): Member of trial team that defended Microsoft in a four month antitrust trial in Iowa state court alleging that Microsoft overcharged consumers for its popular operating systems and productivity software.
Globespan v. Texas Instruments (2005-2006): Member of trial team that achieved a $112 million patent damages verdict on behalf of Texas Instruments and Stanford after a four-week jury trial in the District Court of New Jersey; also obtained dismissal of Globespan's antitrust claims alleging that Texas Instrument's patent licensing practices violated U.S. antitrust law.
Real Networks v. Microsoft (2004-2005): Represented Microsoft in defending against claims that including media player functionality as part of Windows violated U.S. antitrust law.
Burst v. Microsoft (2004-2005): Represented Microsoft in defending against claims that including media player functionality as part of Windows violated U.S. antitrust law.
Gordon v. Microsoft (2003-2004): Member of trial team that defended Microsoft in a two month antitrust trial in Minnesota state court alleging that Microsoft overcharged consumers for its popular operating systems and productivity software.
3M Antitrust Litigation (2002-2003): Represented 3M Company in various antitrust class action lawsuits in federal/state court alleging that 3M overcharged consumers for its popular adhesive tape products.
TeleSpectrum v. SER (2003): Represented TeleSpectrum in an emergency filing in federal district court seeking a temporary restraining order to deactivate a "time bomb" which was secretly planted in the company's mission-critical software.
Standards-Essential Patent Licensing Issues: Currently advise numerous large technology companies on potential antitrust issues under U.S., EU and Asia competition laws pertaining to the licensing of standards-essential patents.
Product Distribution Issues (2008-2011): Currently advise a large technology company on potential antitrust issues under U.S. and other competition laws regarding product distribution policies.
Google "Spy Fi" Wireless Data Collection (2010): Advised a large technology company on the legal implications of Google's collection of unsecure wireless data as part of its Street View mapping efforts.
Supply Parts Joint Venture Counseling (2009): Advised a large computer manufacturer on how to structure a complex joint venture for obtaining supply parts in order to obtain worldwide antitrust clearance, while minimizing the impact on the company's combined business operations.
Board of Directors Internal Investigation (2009): Advised the Board of Directors of a large technology company on the merits of competition claims asserted by government competition authorities.
Merger Counseling (2009): Advised a product retailer on options under U.S. law to respond to the proposed sale of retail mall assets in bankruptcy proceedings.
Software Interoperability Issues (2008-2009): Advised a large technology company under EU competition law on options to obtain critical product interoperability information being withheld by a dominant competitor.
Consent Decree Compliance Issues (2008): Assisted a large technology company to prepare to address anticipated compliance issues under a government antitrust consent decree.
Pre-Litigation Antitrust Settlements (2004-2007): Assisted a large technology company in reaching out-of-court antitrust settlements with some of its largest customers without resorting to formal litigation.
Panelist, "Huawei-ZTE: The Quintessential European Essential Patents Decision?," ABA Section of Antitrust Law Teleconference (July 26, 2015).

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Facebook: To Post Or Not To Post?
Litigants need to be aware that no material posted on Facebook is truly private. If you are involved in a lawsuit one needs to be sure not to post anything on Facebook, or any other web site, which could have an adverse effect on one's pending litigation. The law on this issue is still developing and judges will decide these issues on a case by case basis.
General rule of thumb: If you have to think about whether a Facebook or other posting will possibly hurt or affect your claim. Don't Post It.
Facebook, MySpace, Twitter, LinkedIn. Who are you following? Did you see what he tweeted? How many "friends" do you have? Did you see that photo album that she posted? How entertaining was that link I posted on your wall? These types of questions seem common place around the standard workplace water cooler conversation. However, persons who bring lawsuits, plaintiffs, need to take heed about what they post not only regarding information about their pending litigation but also information that may represent their personal character. Privacy settings may not be as private as Plaintiffs would hope or believe. Issues involving information exchanged on social networks have begun to arise in a variety of different litigation matters. Plaintiffs need to be careful about what information they share, with whom they share it, and that it indeed is not adverse to their pending lawsuit.
Let us take a closer look at the most popular online social networking website, Facebook. Facebook is an internet-based social networking site that allows users to connect and exchange information both privately and publicly. At present, Facebook boasts over 500 Million users, who can all upload an unlimited number of photos, share links and videos and learn more about the people they wish to include in their group.
Facebook allows users to create a personal profile page to permit only selected users to share with their "friends" personal and educational background information, pictures, videos, blogs, etc. Facebook allows each user to post comments and exchange information on a virtual bulletin board, or "wall," which becomes a forum for anyone given access to the wall. Facebook also provides various means for one user to communicate privately with another.
New York Law requires parties to disclose all matters that are material and necessary in the prosecution or defense of an action. If the matter is in Federal Court, The Federal Rules of Civil Procedure also limit discoverable information to non-privileged material that is relevant to a party's claim or defense. Rule 34(a) provides that "electronically stored information" is included within the breadth of Rule 26.
In a recent New York state court decision in a personal injury action, Romano v. Steelcase, the plaintiff had claimed that she had permanent injuries and was largely confined to her house and bed. However, her publicly accessible Facebook page showed her "smiling happily in a photograph outside the confines of her home" after the date of the accident. Given these facts, the motion court applied New York's liberal disclosure standard and allowed discovery of the plaintiff's private postings, finding them relevant on the issue of the extent of plaintiff's injuries.
However, parties in litigation are not entitled to complete, full access to a user's account without establishing relevancy of a search. In a New York case, McCann v. Harleysville Ins. Co. of N.Y., the Appellate Division held that the defendant was not entitled to access the plaintiff's private Facebook posting, since the defendant "failed to establish a factual predicate with respect to the relevancy of the evidence" The defendant "essentially sought permission to conduct "a fishing expedition" into plaintiff's Facebook account based on the mere hope of finding relevant evidence.
In addition, a plaintiff who posts material privately undoubtedly has a reasonable expectation of privacy in that data. So ruled the court in Crispin v. Christian Audigier Inc., which recognized a stronger privacy interest in private webmail and messaging, than a more public "wall" posting. Id.
A Nevada court, in Mackelprang v. Fidelity Nat'l Title Agency of Nevada Inc., limited discovery of a plaintiff's private messages which had been exchanged with third parties regarding her sexual harassment or emotional distress allegations. The court declined to recognize a sufficiently relevant connection between a plaintiff's non-work related sexual messaging activity on a MySpace page and the allegation that she was subjected to unwelcome and offensive sexual advancements in the workplace since the account was setup outside the relevant time period of her employment.
In its Formal Opinion 2010-2, entitled "Obtaining Evidence From Social Networking Websites," the New York City Bar's Committee on Professional Ethics opined that a lawyer may not by herself or through a third-party, including a client, attempt to gain access to a social networking site under false pretenses. The lawyer should pursue formal discovery procedure. The committee classified such lawyer's conduct as deceptive and contrary to New York Rules of Professional Conduct, 4.1 and 8.4 (c).
A subsequent committee went further in September 2010, stating in Opinion 843 that a lawyer can look at public pages on a social media site, but cannot make use of pages that are available only to "friends," as opposed to the general public without obtaining the court's consent.
 NY Civ. Pr. R. ∫ 3101.
 Romano v. Steelcase, 30 Misc.3d 426, 907 N.Y.S.2d 650 (S. Ct. Suffolk County, Sept. 21, 2010).
McCann v. Harleysville Ins. Co. of N.Y., 78 A.D.3d 1524, 910 N.Y.S.2d 614 (4th Dep't 2010).
 citing Crazytown Furniture v Brooklyn Union Gas Co,150 A.D.2d 420,421 (1989).
 Crispin v. Christian Audigier Inc., 2010 U.S. Dist. LEXIS 52832(C.D. Cal. May 26, 2010).
 Mackelprang v. Fidelity Nat'l Title Agency of Nevada Inc., Not Reported in F.Supp.2d, 2007 WL 119149 (D. Nev. 2007).

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