Sent: Thur, Aug 20, 2009

To: Adams, David

Subject: Mitral Valve Repair - October 2008

Ten months have passed since you and your team performed my mitral valve repair. I wanted to thank you and your staff for squeezing me into your schedule so that I could have six months of recovery time with the hope that I would be able to test for my Black Belt exam at Barley’s Karate. In April 2009, I was able to test and “pass” my Black Belt exam with my wife Kerri. Our children Meagan and Michael are already Black Belts. Without you and your team’s expertise, dedication and caring this goal would not have been possible. Thanks again.

Sincerely,

David A.