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HomeMy WebLinkAbout96-02005 i' "<' .~ ,~ \ . , " , " .. ~ :' ~ J J J I . ~I :t'lI, ' ".~ '~ t' ., f ,:'II'~ I~~ ~ory;!.-.t-;_{y ;(. ~F!. tD.!-.--L..2:_..__ CXlJRI'RD4' __, KJ.C}LJO[).)2" CIVII~_,._ ._..___ , 1.' I {; ~ - hid 1'+ h C ( 'rr)'.~'()N 2.' I i,~ - ;1[\(( /},I \ /) ( ,,', ( III 't . , \ ~. v()(\t_; ~ ;;l, /, , ,~ , ({ / '.JL( 'Ju I' J !,.I 4.' H:' DU'Jj lei 5 C Th'()l1,Yl'\ 5.' /,) ').' +,,{;:-;'"r;t<'-"rt~.:t-rt-- D I 6.' '-f) ,{L1:!i'iilYi r r/dCJI6{ Jp 7.' J.(, /)(/ v'c{ 7;-", II') 8.' /1) , f-t: !I'I /i) C;,Hrl c/t.. / ,) '", " 9.' !'H.' l~ 1",-, (I .. II '[JrYI'/V j 10'.'--Ht - ~t:tftT-,i J" Lb;)] ...-'- (j) '2_ }i_I 11(, ,),,,(r'/I /1 f , . J. Q__Ll 'I ,-.....o,.~'v" 'f~' "/1_' f ~ U.. / I)j" ( ! '2i,hd J) (S fCllJ'/'- t- 13.' /<-Is I,d', f j\ /Y))~'hr~llx(' . " ~ ,~~;, . , . 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LAW : JURY TRIAL DEMANDED eBQPQS~D P91NTS FOR CI:f~RGE ~NDANT.l<EVIN E, KOONS Respectfully submitted, NEALON & GOVER By: ,..V[i,tbfLI! ~n-~ Matthew R. Gover, Esquire Atty. I,D. #47593 301 Market Street -- 9th Floor P.O. Box 865 Harrisburg, PA 17108-0865 (717) 232.9900 . , 02. The Plelntlff. clelm thet they were Injured and sustelned d.m.ge .. . result of the negligent conduct of the Defendant. The Plaintiffs h.ve the burden of proving their claim. The Defendant admits that he was negligent but denies that such negligence was a substantial factor in brinlng about the Plaintiffs' Injuries, Based upon the evidence presented at this trial. the only Issues for you to decide In accordance with the law as I shall give it to you, are: First: Was the Defendant's conduct a substantial factor Is bringing about harm to the Plaintiffs? Second: If. and only if, the negligence of the Defendant was a substantial factor in bringing about harm to the Plaintiffs. then you are to decide the amount of compensation, If any. to be awarded to the Plaintiffs, Pa, SSJI (Clv.) 3,00 .1 : ,l 'I ./ , " '.,' I,i 05. The number of witnesses offered by one side or the other does not, in Itself, determine the weight of the evidence. It is a factor. but only one of many factors which you should consider, Whether the witnesses appear too biased or unbiased; whether they are interested or disinterested persons. are among the Important factors which go to the reliability of their testimony. The important thing is the quality of the testimony of each witness. In short, the test is not which side brings greater number of witnesses or presents the greater number of witnesses or presents the greater quantity of evidence; but which witness or witnesses, and which evidence. you consider most worthy of belief. Even the testimony of one witness may outweigh that of many. if you have reason to believe this testimony in preference to theirs. Obviously, however. where the testimony of witnesses appear to you to be of the same quality, the weight of numbers assumes particular significance. Pa,SSJI (Civ) 5,03 ( (J ,t) (,A ", I 07, In general. the opinion of an expert has value only when you accept the facts upon which It Is based, This Is true whether the facts are assumed hypothetically by the expert. come from his personal knowledge, from some other proper source or from some combination of these, Pa, SSJI (Civ) 5.31 /' .l(h~-J C-I , , 08, In civil cases such as this one. the Plaintiffs have the burden of proving those contentions which entitle him to relief. When a party has the burden of proof on a particular Issue. his contention on that Issue must be established by a fair preponderance of the evidence, The evidence establishes a contention by a fair preponderance of the evidence if you are persuaded that it is more probably accurate and true than not. To put it another way. if you will. of an ordinary balance scale with a pan on each side, To one side of the scale, place all the evidence favorable to the Plaintiffs; on the other place all the evidence favorable to the Defendant. If after considering the comparable weight of the evidence, you feel that the scales tip ever so slightly or to the slightest degree, in favor of the Plaintiffs, your verdict must be for the Plaintiffs. If the scales tip in favor of the Defendant or are equally balanced, your verdict must be for the Defendant. In this case, the Plaintiffs have the burden of proving the following propositions: that the Defendant was negligent. and that the negligence was a substantial factor in bringing about the accident. If, after considering all of the evidence you feel persuaded that these propositions are more probably true than not true, your verdict must be for the Plaintiff,. Otherwise, your verdict should be for the Defendant. Pa.SSJI (Civ) 5.50 HARRINGTON & CALDWELL, P.C. By: ROGER J. HARRINGTON IDENTIFICATION NUMBER: 09885 100 N. 17TH STREET 1I1TH FLOOR PHILADELPHIA. PA 19103 12151751.1135 JOHN TRAUM Ind ESTATE OF LINDA TRAUM ATTORNEY FOR PLAINTIFFS va. IN THE CUMBERLAND COUNTY COURT OF COMMON PLEAS KEVIN E. KOONS NO. 98.20011 CIVIL ACTION. LAW ~PO,tf!l FOR CttARq~ 1, Jurors, baiJed on the facts and law you are instructeu to return a verdict in favor of plaintiff John Traum and the Estate of Linda Traum ogalnst Kevin E. Koons. If. ,(. ~ " 3, Burden of Proof Members of the jury, In civil cases, such as this one, plaintiffs are only required to prove their case by the fair weight of the evidence. Unlike a criminal case, they do not have to r:onvince you beyond a reasonable doubt and to a moral certainty that what they say is correct, but are required only to prove evidence which Is more likely to be true than the evidence the defendant produces. Marrazzo vs. Scranto.Q. Nehi 80"lIno Co., 422 Pa, 51, 233 A.2d 17 (1966). " (,~ ~ ( J' J 6. There are two types of evidence from which you may properly find the truth to the facts of the case, The first type of evidence is direct, such as the testimony of any witnesses. The second type of evidence is circumstantial or Indirect evidence which points to the existence or non-existence of a (;ertaln fact. You may draw such reasonable inferences from proven fact as seem justified, (,~/A f.'( 6 ~".. \ 9 You should consider such expert opinion received In evidence. In this case, and give it such weight as you may think it deserves. If you should decide that the opinion of an expert witness is not based upon sufficient education and experience. or if you should conclude that the reasons in support of the opinions are not sound, or if you feel that it Is outweighed by other evidence, then you may disregard that expert's opinion entirely. c ,r \ (\ i/i 9 - , 10. You may also disregard an expert's opinion if It flies In the face of common sense, knowledge or experience. , Ij.J ( (/ " > " f, 1 10 _..1 12. "Credibility" means whether or not a witness Is being truthful, .!:1o{fman vs, Co.. 422 Pa. 144, 221 A.2d 315 (1966). .Q,~,j (./11'1' 12 13. Ladles and gentlemen, It is your decision to determine whether someone is being truthful and It is up to you to determine a witness' credibility, that Is whether to believe all, part or none of the testimony of any witness. Morrissev v. Com. DeDI. HIQhwavs, 424 Pa. 87, 225 A.2d 895 (1967). . p. 9 1 ( r /d ' n 15, The commission of a wrong carries with It the duty to make amends; and If the mending process Is additionally expensive because of problems encountered in ascertaining the cost of the rehabilitating agents, that process becomes part of the obligation the defendants as tortfeasors must assume. As between the innocent victim of a wrong and the person who accomplished the wrong, the law imposes on the malfeasor or wrongdoer the obligation to make the victim whole in every phase in which the victim has suffered and to the extent that rehabilitation is possible, In terms of money. Spranaler v. Helm's New York- Eittsburah Motor Exp., 396 Pa. 482, 153 A.2d 490,492 (1959). ,\ \ "-1,. j t.. " J " ' rl" ; , " J: 'I" I~ 16, The object of a trespass action Involving personal Injuries, where the defendants have admitted liability, it to compensate them for whatlhey have loss as a result of the defendant's negligence. The loss of well-being Is as much a loss as an amputation, The inability to enjoy what one has heretofore keenly appreciated Is a pain which can be equated with the infliction of a positive harm. Thus, when a tortfeasor's negligence diminishes the plaintiff's well-being, the plaintiff may recover for that loss. Corcoran v. McNeal. 400 Pa. 14, 161 A.2d 367 (1960); Lebesco v. SEPTA, Pa. Super., 380 A.2d 848 (1977). <. ( , {~I \ \ , ., , , '" 16 18. A tortfeasor must take the victim as they find him and the tortfeasor Is liable for full extent of the victim's Injuries. Thus, a tortfeasor remains responsible for the victim's Injuries, even If the victim's particular sensibility resulted in more harm than the tortfeasor could have foreseen, Tabor v. Miller, 389 A.2d 645 (3rd Clr. 1968), cert. denied, 391 U,S. 915,88 S.Ct. 1810,20 L.ED. 2d 654 (1968); Walsh v. Brodv, 220 Pa. Super. 293, 286 A.2d 666 (1971), Lebesco v, ~EPTA, Pa, Super" 380 A.2d 848 (1977). C,;<,'" 'II); I, 18 19, Ladles and gentlemen of the Jury, one way of determining the extent of plaintiff's pain and suffering is the nature and extent of the medical treatment which plaintiff required as a result of the accident. Zaaarl vs. Gralka, 264 Pa, Super, 239, 399 A.2d 755, 758 (1979). ( ( \ 1/ I (j ,~ , , 19 20. Regarding possible effects of this Injury on plaintiff in the future, a doctor Is not required to express an opinion as to plaintiff's future disability with the same definiteness required to prove causation. You may consider the possibility that plaintiff will suffer disability In the future based on plaintiff's doctor's testimony of the possible future effects of plaintiff's Injury. Boyle vs. Penn. Railroad Co., 403 Pa. 614, 170 A.2d 865, 867 (1961). Gradel v. Inouve, PA., 421 A.2d 674, 680 (1980). fJ 1"' C,' 1\ .t " ",I, I, " " , )1 '. 2() 21. Plaintiff claims that he will continue to suffer physical and emotional disability Into the future and he asks that he be compensated for this future disability claim. Plaintiff does not have to prove this with medical expert testimony that predicts with certainty the exact result expected in the future. However, in order to award future disability as an element of damages, plaintiff must present definite evidence of the degree of probability that the impairment will persist for some period of time. Baccare v. Menne~, Pa. Super" 369 A.2d B06, 807 (1976). , ~ ( " 21 23. If you find that the plaintiff's Injuries will continue beyond today, you must determine the life expectancy of the plaintiff. Plaintiff's date of birth Is July 22, 1947. According to statistic compiled by the United States Department of Health, Education and Welfare, the average life expectancy of all persons of the plaintiffs age at the time of the accident (age 46) sex and race was 30.6 years. This figure Is offered to you only as a guide, and you are not bound to accept It If you believe that the plaintiff would have lived longer or less than the average individual in his category. In reaching this decision you are to consider the plaintiffs health prior to the accident, his manner of living, his personal habits and other factors that may affect the duration of his life. Pennsylvania Suggested Standard Civil Jury Instructions, Section 6.21. } 23 .......' > . i. .J 'J' 25. Members of the Jury, there Is another element of damages in a case whenever a spouse is injured. The Estate of Linda Traum Is entitled to be paid , such sums as you believe would fairly and reasonably compensate her for her own loss. She is entitled to be compensated for her loss of the society, companionship, services, and comfort of her husband. Schutter vs. Reinhardt, 86 A.2d 438 (1952). RESPECTFULLY SUBMITTED, ROGER J. HARRINGTON Attorney for Plaintiffs ," 2~ I~ \II1~lI' AD'IIIHlI' l' "It II . IIUI"'O (Jill ~1I0" :}1II1"..HOII"'NIt!WfI......"'1."YIClNOIIIIM1'" 1I10;t1 U"'llllW III I/J II CO 0 IX z 8 .u 0 ~ 0 w " ~ ~ E . & . ~ 0 .J . .. ~ III III Z . 10 0 10 . u V) t;j ~ Kl " >- ~ x >- . W II 0 III Z z ~ III Z 0 Z III Z 9 in It t;j 0 ~ . 0 0: .. w ~ .. ~ " I!i 0 II II . . z .. I :l III . i5 '!! M II II . 1: - , ~ JOHN and LINDA TRAUM, Plalntl'" : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLSVANIA : NO. 88,2005 CIVIL Y. KEVIN E. KOONS. Defendant : CIVIL ACTION, LAW : JURY TRIAL DEMANDED VERDICT SLIP 1. Was the negligence of the Defendant, Kevin E. Koons, a substantial factor in bringing about the Plaintiffs', John and Linda Traum, harm? YES NO (If you answer question Number 1 "No", the Plaintiffs cannot recover and you should not answer any further questions and you should return to the courtroom.) 2, State the total amount of damages, if any, sustained by: John Traum $ Linda Traum $ Date: Foreperson < <,I , "I' ",::/;~.~~t .',I)"L , "'~;(1 ,'i~l I' .' / , . JOHN and LINDA TRAUM, Plaintiffs 12 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA V, KEVI N E. KOONS, Defendant NO, 96-2005 CIVIL TERM IN RE: PRETRIAL CONFERENCE A pretrial conference was held on Wednesday, August 25, 1999/ before the Honorable Edward E, Guido, J, Present for the Plaintiffs was Margaret Harrington, Esquire, appearing on behalf of Roger Harrington, Esquire, who will try this case, and present on behalf ofmthe Defendant was Matthew R, Gover, Esquire, This is a rear-end collision case, The Defendant admits negligence but contests causation, The parties indicate that this will take one and one half days to try including jury selection, Neither counsel is available on Monday of trial week, Plaintiff's counsel has no other scheduling cqnflicts, Defense counsel is attached for j, trial in another county but feels he should be available by Wednesday afternoon to begin this trial. In the event that the trial does not proceed Ii; li-! j i\ ,~, ',:,'dJ ~lrl::fO '?~'9 ij:~~.'l . .~~YI' , I,U' because of the unavailability of counsel this term, both counsel are to consider themselves attached to this court for the November term of civil trials which commences on November 8/ 1999, . . Counsel are directed to submit any motions in limine, with supporting authority, by Wednesday, September 8, 19951. Any responses with supporting authority shall be submitted by the commencement of trial, Any points for charge counsel wishes the Court to give shall be submitted by the commencement of trial, Likewise, any trial briefs that counsel wish the Court to consider shall be submitted by the commencement of trial, The parties have stipulated as to the authenticity of the Plaintiff's medical reports, However, both parties reserve the right to object on any other available grounds at trial. There is a very real possibility that the Defendant will be unable to attend the trial as a result of poor health, In said event, the parties do not object to having his mother sit at counsel table in his stead, Settlement is not likely, By Edward E, Guido, J, Roger J, Harrington, Esquire for the Plaintiffs Matthew R, Gover, Esquire For the Defendant :1fh , ...... CO ("M .,.. i: C'~ r., ,,~. ;'1 ':": :'"i ~,... , , . h.'; ,,'. ;),f''' \1., ., ,_\' ):"j . '0 '0;:. ',' ,. ~'I 'uJ , , ,)~; " , ( :-~ "fe ..... ,n " C"'l ( .' ::, <J , (.) . III III ~ III 0 II: ~ 8 cO ~ 0 III ;: l is ( 8 . ~ 0 -l 0( . 1II III Z 3 ~ III 0( III :I u f/) I;; Kl " ~ I '" ~ >- ( ~ 0 Ii! Z . III Z 0 Z z ~ iii II: ~ 0 '" . 0 ~ D. '" " ~ ,j 0 ~ III . ~ ::l Z . III ( 0 Ii! 1'1 Ii ~ 0( x . . tW.\IIIIlia. ~n "'lQ. 11"1,0-""11.11 OIt"'IIO~ ")Hl"l"I'fQII'flriillilHl.u"tsnYllll ~OIlIlMJ" 1'fflt111.1f111l" v. : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA : NO. 96.2005 CIVIL JOHN and LINDA TRAUM, Plaintiff KEVIN E. KOONS, Defendant : CIVIL ACTION. LAW : JURY TRIAL DEMANDED DEFENDANT'S PRE,TRIAL MEMORANDUM AND NOW, comes the Defendant, Kevin E. Koons, by and through his attorneys, NEALON & GOVER, P.C., and files the following Pre-Trial Memorandum: I. BRIEF NARRATIVE STATEMENT OF THE CASE On February 7, 1994, the Plaintiff was involved in a rear-end collision with Defendant, Kevin E. Koons. Both parties were operating their vehicles on Gettysburg Road in Lower Allen Township when Kevin E. Koons failed to see the Plaintiff in front of him and impacted the rear of Plaintiffs vehicle, As a result, John Traum, anticipating the Defendant's Impact, had steered to the right and his vehicle was pushed Into a snow bank. Minor damage occurred to each vehicle. The Defendant's vehicle sustained $7.00 worth of property damage. The Plaintiff did not treat for the next two weeks. Testimony will show that he was at a school in Cumberland County and completed that schooling prior to returning home to his Philadelphia area residence. Upon his return home, he sought out the treatment of Dr, Anthony G'lVlncent, a chiropractor located In the city of Philadelphia, He had been treating with Dr. Vincent for the last 18 years for various neck and back complaints. Further, he had been involved in a work related injury in the late 1980's where his lower back became problematic and he developed radicular symptoms over three years, It Is anticipated that the Plaintiff will be offering testimony as to primarily his back complaints, The Defendant will not contest negligence, however, it will be disputed that the Defendant was a substantial factor In bringing about Plaintiffs alleged harm, II. DAMAGES N/A, III. WITNESSES A, Kevin Koons, 145 Red Mill Road, Etters, PA; B, Linda Koons, 145 Red Mill Road, Etters, PA; C, Shawn Muroskl, 68 North Kinely, Etters, PA; D, Kelly Stump, 142 Meadow Brook Road, New Cumberland, PA; and E, Rlorke Rlboldn, 619 Elliot Drive, Lewlsberry. PA, These witnesses will be offered to testify as to the extent of Impact between the two vehicles and property damage associated with this accident. IV, EXHIBITS A, Medical records exchanged in discovery; and B, Photographs of the automobiles; V. EXPERT REPORTS N/A, VI, STIP~LATIONS A, The Defendant seeks a stipulation agreeing to the authenticity of any and all medical records associated with the Plaintiffs treatment. Nevertheless. any other objection other than authenticity could be properly raised at trial. 2 1,\'" ',i.:}.) I 18101111111l \ ~ lUG 1RlII~;, HARRINGTON & CALDWELL, P,C. By: Roger J. Harrington IDENTIFICATION NUMBER: 09885 100 NORTH 17TH STREET, 15TH FL. PHILADELPHIA. PA 19103 W!l7~1,1135 JOHN and LINDA TRAUM ATTORNEY FOR PLAINTIFFS va, IN THE CUMBERLAND COUNTY COURT OF COMMON PLEAS NO. 96.20015 KEVIN E. KOONS CIVIL ACTION. LAW PLAINTIFFS' PRETRIAL MEMORAt':IDUM PURSUANT TQ LOCAL RULE 212.4 1. Statement of Facts on L1aR!!!.W This action arises from a motor vehicle accident that occurred on February 7, 1994 when defendant, Kevin Koons, drove his vehicle into the rear of plaintiff John Traum's vehicle, as Mr. Traum was stopped in a line of traffic waiting for the traffic signal to change from red to green. The accident took place on Gettysburg Road (State Route 2027) at the intersection with 41st Street in Lower Allen Township, Cumberland County. 2. Stat.ment of Facts on Damaaes Plaintiff, John Traum, was born on July 22, 1947 and is currently 51 years old. At the time of the accident and until June 1, 1999 John Traum had been married to Linda for over 29 years. Together they had two (2) sons who are now adults. Linda Traum was not involved in the accident She suddenly departed this world on June 1, 1999 and her Estate has been substituted for decedent John Traum Is a white male with a life expectancy of approximately 26 years, John Trl!um's primary occupation is meat cutter at Acme Markets, He also works as a part-time public adjuster solicitor for Public Adjusters Associates under ~he supervision of Richard C. Adams, founder and owner of that company. Mr. Traum initiall~ ,ecelved treatment at the emergency room of Holy Spirit Hospital on the cay of the accident after the accident occurred. He complained of back pain, right thumb pain, right elbow pain, lightheadedness, nausea and headache. Thereafter he was treated on a conservative basis by a chiropractor until April 1994. In April 1994 John Traum came under the care of orthopedic surgeon John L. Sbarbaro, Jr., M.D. On April 25, 1994 a lumbar MRI into Mr. Traum's right leg was performed at the request of Dr. Sbarbaro due to continuing radiculopathy. Dr. Sbarbaro ordered a brace for Mr. Traum and instituted a regiment of anti-inflammatory therapy. After Dr. Sbarbaro retired from medical practice Mr. Traum returned to his chiropractor Dr. Vincent for treatment. In June 1998 Mr. Traum's condition, as a result of constant pain in his right calf, sought a second orthopeadic opinion from Randall N. Smith, M.D. 2 ..... An EMG test ordered by Dr. Smith confirmed chronic lumbar radiculopathy. Dr. Smith concluded, "it is my impression that John sustained a low back syndrome and sciatica... He Is laft with permanent radlculopathy directly from the February 7, 1994 accident." 3. I..u.. on Llabllltv and Damaae. Defendant's liability for this accident, a rear end motor vehicle accident Is established. Damages are disputed by defendant whose experts, although never having examined Mr. Traum, concluded that he should have recovered within a certain period of time following the accident and therefore he suffers no further problems. 4. Summary of Oth.r Lellall..ue. On June 1, 1999 Linda Traum, age 47, died suddenly of a heart attack, An Estate will be substituted for her as a party and her deposition testimony will be read to the jury in support of the Estate's claim for loss of consortium. In addition, plaintiffs will file a Motion in Limine in connection with certain statements made by defendant's experts and their reports which rely on unproven, unscientific data regarding injuries from automobile accidents, 5. Plaintiff.' Witne.... John Traum, Lnda Traum by way of deposition, "II ;\1 ",'1 ;'t\;f ;".\ "1' ,;1# Kevin Koons, J II. MJ.stlc'l Recorda Holy Spirit Hospital emergency room records 9 Dr. Anthony Vincent's attending physician report 10 11 12 13 14 15 16 17 John L. Sbarbaro, Jr., M,D. report 4-21-94 MRI 4-25-94 Dr. Sbarbaro report 6-28-94 Dr, Sbarbaro report 10-12-94 Dr, Sbarbaro report 12.5-94 Dr, Sbarbaro's office notes Mikhail Feylikh, M.D. EMG 6-19-98 Dr, Freylikh, M,D. report 10-26-98 Randall N, Smith, M.D. report 6-29-98 18 19 Dr. Sbarbaro C,V, 20 21 22 23 Dr. Smith C,V, Mr. Traum's bed (photo) List of Medical Treatments III. Prior Motor Vehicle Accl4ent {1-17.941 Dr. Vincent 2-4-94 paid invoice 24 'ii~ I.\~ I "\,-i~ . ~ '( I~ " 'iW \>,1' ii. , .,-" ~~ i: d Property damage estimate ($937.69) by Paul Gutherman2 25 Property damage estimate ($1,165.60) by Ted Schaum 26 2 Mr. Traum r~'ei\'~d this illlwunl from torttc3!\Or. ~ JOHN and LINDA TRAUM Plaintiffs : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNA : NO, 96-2005 v, : CIVIL ACTION. AT LAW KEVIN E. KOONS, Defendant : JURY TRIAL DEMANDED ARBITRATION EXHIBITS . A, Photographs B -Daniel R, Aerm C, Robert M, Yanchus, MD Q. -ARti'tony (" vincent, DC E. Thomas Javian, MO F, John L. Sharbaro, Jr" MD . . Respectfully submitted, NEALON & GOVER BtI~~ Matthew R. Gover, Esq, Atty, 1.0, #47593 301 Market SI. . 9th FI. PO Box 865 Harrisburg, PA 17108-0865 (717) 232-9900 JU't lb ';'1 "";,....0/"111.&.".... , ,. '112 to "..ant 'Ie' to '112 1177 to ,.., 1178 to '177 DANIEL R. AERNI MV ENGINEERING COMPANY 3888 I'AXTON ROAD CINCINNATI OH 4520B IB,31.321-88811 or , .800.221.8833 EM"OYMfNT HISTORY I',..ldent. MV Engin"'/ng CO""",y, Cincinnati, OH, Owrla,. MotDI Vllliel. lng/n,.,;ng 'vllu.rlon., BrldOlvllll. PA, Owna, ll"d lubllQu.ntly p,..ld.ntl of fore"lle .nlllnllrlnll fI,m IP.ellll1lno In motor vlhlel. Invlltlgadonl, Including uaftlc Iccld.nt rteonltl'uctlon, Vlhlcll d.ttcl Inv.ltlClltlonl, highway 1,,11y111 Ind vlhlel. flrtl, Vlc.."..ldent. P,A,C,I.. /nc.. Cincinnati. OH, Foranale Inelnllr IMaehanlcal.eIvIIl, P,A.C,E.. Int:,. Clnclnnltl, OH, Plrform.d ovtr 2200 .ngl"..rlno Invlltlgltlon. of IIr.. Ind .eeldlnt., Including v.lllcular Iceldent raconltructlonl, "portld va PIlei. daflctl, I1ructurel d.f.ctl Ind machlnlcll IQulpm.nt and mlchinlry mllfunctlonl, T,."lportatlon ltudy Dlr.etor. eHJ M",o PI.nnlng Commiuicn. St.ub.nvllle, OH, Local ".. eoordlnllor with Stltl Hlllhwly(Tranlportltlon Dlparun.ntl I" dlvelopmlnt of m.tropolltan tranlPortlllon pllns Ind progrlml, Includld saflty Itudl.. and Inlpletlon of county and townlhlp brldOII. TranlPortltlon "a,,",,, a"" Ftll. City.Ceunry PI.nning Bo"d, Grtll Falll, MT, Dlractad amaU,," urban tran,portatlon 11udy,Includlngllflty Itudl.., Ip.ellllvalUltlonl of hlohway alignmlntl Ind CBO parkino .tudi.., I , I , I \ , i I 1 ! I I "74 to R....reh Fellow. Un/v.,,/ry ofCelelldo. Bouldlr, CO, 11711 Conductld origln.1 r....rch Into mark.tlno of urb.n publiC tr.n.porutlon, 1172 to "74 11711 ,." 'elenc. and Mm Tllcher, Mllill Brorh,,, High School, 1'100 Pello. Amarlc.n Samoa, S.rv.d II . IIY vOlunt"', fPUCA TlON.. M..ter of Icllnel In ClvY Enoln..rlng. Univ.,,/ry of ColrN,do. Bouldlr, CO, Anlinld 4,0 Iverlgl In gradultl progrlm, with ,mpPl..;. on trln.pOrtltlon, , ! f laehllor of Icl.nca in Mechlnicll Entlnl.rlng. Unlv,niry of Nor" a.m., Notrl Dime, IN, Gradll.t.d r;um Ilud. in Inlllnl.rinllllrOgr.m, PROFESSIONAL AFFILIA TIONS i I : ' r oln"itu~. of Tran'llortllion Engineer, UTE) oSoclltv of Automotivl Enoln'lr. ISAEI oAmeritln Socllty of Civil Englnler. IASCEI oSAE Aeeidlnt InvI.tlgltion Prlctlc.. oAmlrican Soeilty of Mlch.nlc.1 Enoinllr' (ASME) IAIP) Commlttet oNatlon,' "'lIoeiation 01 Profll.ion.1 Aecidlnt Reeonltruction Sllleiali.ts (NAPARS) , , fliGINEERING CEf!..TI6CA TIONS Rloietlrld Professional En;in..' in Ol'lio, Kentuckv, Indilna, Penn'yl.anil, West Virglnil Ind Mieni~aM ~11 II. i I I , I ... , In~ Heallhcn ConsuItInIs.IM. '[I HC)) ',0,10. 7039. M.rlelta. CiA 30065-1039 (770) '3"'"3 P,O, Bolt 43726, CiDclDDall. OR 45343.0726 (513) ~iIj3.3m, P,O, Bolt 16959,WCIlPalm Bcacb,FL 3341~959(407)5'U049 P,O, Bolt 56159, PIloclx. AI. 85079-6159 (603) 246-6963 P,O, Bolt 41350, FI. Worth. TX 76148.0350 (117) 431-3330 MR, BRYON M. WILSON ALLSTATE INS. CO. 6345 FLANK DRIVE SUITE 1000 HARRISBURG, PA 17112 Date RE CLAIM IHe I 04/10/96 I JOHN TRAUM * I 1551562646 * I 01-0044764 Dear MR, WILSON I On Feb 09 1996, we received the above referenced consultation request for Impact Analysis. 'rhis evaluation is based on the documentation provided to us and general principles of accident reconstructio~ and physics, The medical assessment is additionally based on the general standards of care in the profession, and if the provider wishes us to consider additional information concerning the clinical status of the patient, he should submit copies of those pertinent documents to be forwarded to us for evaluation during the appeal peri.od, Attached please find the Impact Analysis performed on the above captioned patient, INTERNATIONAL HEALTHCARE CONSULTANTS, INC, 85-G \ i , , {'T - I 6-L' .- . pi &'lW- ~ f1.LVl,N(,h'1 S1"--e. e v ( ( ,l ,.~ (;.11', ,,' ,i ,:Jl,. ~~ ~..J fu)r\;Y--. I' Inla11llional Heallhcarc ConsultlnlS, Ine, [(I He] p,O.....70%9, M.rl.ll.. CA 3006$.10%9 (770) 9%6-0006% P,()o, Box 4%726. ClDciDDali. OH 45242-0726 (513) ~2-m1 P,O. DOl16959,Wesl Ptlmbach, FL3l4I6-6959(407)511-10019 P.O. DOl 56159, Pbocnlx, A2 85079-6159 (602) 241).6963 P.O. Dox 48250, Fl. Worth, TX 76148-0250 (117) 42&-3320 Interna~ional H~lthcare was requested to carry out an impact analysis concerning a low speed traffic accident which occurred at approximately 4:55 p.m. on February 7, 1994, on Gettysburg Road in Cumberland county, Pennsylvania. According to the police report, the pavement was dry and the weather was clear at the time of the accident. Mr. John Traum, driving a 1989 Mercury Topaz four-door, was reportedly stopped in traffic. Mr. Traum stated that he looked in his rearview mirror and saw a car approaching. He was reportedly struck in the rear by a 1983 Chevrolet Citation driven by Mr. Kevin Koons. According to the police report, the force of the impact pushed the Mercury onto a snowbank. Photographs of the Topaz were reviewed. None were available for the citation, Information in the file indicated, however, that the Citation had sustained no damage except for a problem in a light on a "casing", which required replacement at a cost of $7.00. The photographs of the Topaz show a cracked bumper molding and evidence on the top surface of the bumper of forward movement of the front bumper cover. According to various repair estimates, the Topaz required replacement of the bumper cover, an impact strip, both energy absorbers and a stone deflector. The repair estimates also appear to indicate some frontal repairs having been undertaken, undoubtedly from the contact with the snowbank. The total amount of repairs to the Topaz amounted to approximately $1,165,60. Also, according to materials in the file, M:..", 'fraum reportedly struck tht steering wheel in the course of the accident. Weights and other characteristics of the two vehicles (notably the rated bumper strengths) were obtained, As indicated on the attached low speed impact summary sheet, both vehicles featured bumpers rated as "weak", This rating indicates that in barrier crash tests of the bumpers, structural damage was sustained by each vehicle at impact :;;peeds as low as 2,5 MPH, Thus, in an impact causing a speed change (Delta V) of 2,5 XPH or greater, structural . 'I ',~OTO.'1 VEHICLE E','G!NEERING EVALUATIONS inlallllional HC\IIIbcare Consultants. \ne, aHC] ',O.Bo.7OJ9. Morl.ll.. GA 3006S-IOZ9 (770) 92~62 P.O, BOI 42726. CiDciDDati. OH 45242-0726 (513) .,l42.2237 P,O. BOI169l9,Weathlmlluo:b,F1.3:\416-6959(407)"....049 P,O. BOI 56159, Pboenil, A2 15079-6159 (602) 246-6963 P,O. BOI 412l0, Fl. Worth, TX 76148-0HO (117) 421.3320 damage should have been sustained by the bumper on both cars, In the absence of such damage, a collision yielding a speed change of 2.5 MPH or less can therefore be assumed. In this instance, the differen~e in the extent of damage between the two vehicles (which featured identical bumper strength ratings) is quite surprising. An attempt was made to calculate the speed changes and accelerations resulting from a 5 MPH impact of the Citation into the Topaz. Using the appropriate weights and other characteristics of the two vehicles, the speed change computed for the Citation for this coll ision amounted to approximately 3 MPH, and the speed change for the Topaz amounted to approximately 3,5 MPH, expressed within a geneFal range of 3.2 MPH to 3.8 MPH. The speed change calculated for tne Topaz thus exceeded the 2.5 MPH threshold, and the 5 MPH impact speed thus appeared reasonable. The speed change for the citation (3 MPH) was close enough to the threshold speed of 2.5 MPH so as to be within reason. The acceleration computed for the Topaz from this impact amounted to 2.44 g's, expressed within a general range of 2.8 to 2.83 g's. A 2.44 9 vehicle acceleration does not necessarily translate into a 2.44 g acceleration of the occupant. This resl',l ts from the dynamic effect of the collision on the human body and the fact that various body parts (notably the head) are unsupported. Accompanying this report is a summary page from a research report authored by O.H. West, et al. In this series of tests, a tow truck was driven into the rear of a 1979 Plymouth Horizon, Peak vehicle accelerations and peak occupant head accelerations for the staged collisions were measured, For collisions involving a vehiclA peak aCceleration in the general range of 2.4 g's, the peak occupant head acceleration amounted to approximately 4 g's, In my opinion, this represents the approximate peak acceleration experienced by the occupant of the Topaz during the impact with the citation. For comparison purposes, I have included a summary table from a report authored by Whitman McConnell, et al" illustrating the results of another series of staged collisions, In these collisions, the struck vehicle experienced sp&ed changes ranging from approrimatelY 1,89 MPH to 5,00 MPH, The speed change experienced by the Mercury in the subject collision fits reasonably within this range, In this set of tests, none of the occupants of the struck vehicle suffered any substantial or long term injuries, I have also included for comparison purposes a summary table from a study authored by Maury 1>.11en, et al, In this set of tests, individuals c,utfitted with accelerometers were subjected to a variety of dail,' activities and the peak head accelerations llllanlidona1 HeaJtbcare Consu1t1n13. Ine, [(I He] ',0.". 7~Z9, Marl,"., GA 3006$.IOZ9 (770) 9Z,,"6Z P.O. BOI 42726, CLacillllaU. OH 45242-0726 (513) ~2.m7, P.O, BOI16959.W"'P.lmBcacb,FL3341~6959(407)5""049 P,O. BOI 56159, PbOCll!x. AZ 15079-6159 (602) 24~6963 P.O. BOI 41250. Fl. Wol1h. TX 761~-0250 (117) 421-3320 resulting from these activities were measured. As the attached table indicates, peak vector accelerations during these tests ranged from approximately 0.6 to 10.1 g's, with a mean value of 3.5 g'8. For accelerations in the general range of 4 g's, the corresponding activities involved being jostled in a crowd, being slapped on the back and being seated in an office chair which was kicked in the back. 'I One final note needs to be made. The subsequent collision of the Topaz with the snowbank could well have generated additional accelerations andlor rotations which may have affected the occupant. The report of the driver striking the steering wheel is more consistent with a second impact of this nature. The presence ~f a se~ondary impact (in this case, with a snowbank) could lead not only to additional or supplementary loads, but also to an interaction ~tween the loads resulting from the separate collisions. This certainly can affect the potential for personal injury, particularly if constructive feedback occurs during the occupant motion. \" , Overall, it is my opinion that the collision which is the subject of this report generated peak accelerations to the occupant of the Topaz of approximately 4 g' s. This opinion is expressed to a reasonable degree of engineering certainty. I appreciate the opportunity to have been of service to you. .D,~~( ({ !Ls I . Daniel R. Aerni, P.E. .In/iemallonal Hcallhc:are ConsuItants.lne, [(I He] P,O, 101 702'. M.rlttt.. CA 300~102' (170) '2'-40,42 P,O,.Bo142726. CilKiDDIlI. OR 45242.0726 (513) ,.2.2237 , P.O, 80116959, Weal hIIlI &e.c;b, FL 3304 I 6-6959(407)1I1-8G49 P,O, BOI 56159. PIlocllil, A2 85079-6159 (602) 246-6963 P,O. B0148250. Fl. Wonh. TX 76148-0250 (817) 428-3320 LOW SPEED IMPACT SUMMARY VER. NO. 1 (REAR) VER. NO, 2 (FRONTl VEHICLE TYPE 1983 Chevrolet citation 1989 Mercury Topaz 4-door WEIGHT 3079 lbs. 2657 lbs. DAMAGE SUMMARY --Light on casing replaced --Photo shows bumper molding evidence of movement of cover --Bumper cover, impact strip, both absorbers, stone deflector replaced cracked and forward bumper . BUMPER STRENGTH Weak EST; IMPACT SPEED 5 MPH ACCEL. (g's) DELTA-V (MPH) 3.0 OTHER I COMMENTS --$7.00 cost to repair Weak o MPH 2.44 (2.0a to 2.83) 3.5 (3.2 to 3.8) --Car pushed onto snowbank --Oriver reportedly hit steering wheel --$1,165.60 repair estimate / Poor Good Low Good 25 Low o 30.8 2321 97,3 ;,j ..' Front '.'i Good High , , 20 Low Fair 36.1 2456 I 104.9 I < 3.000 ' 89' I..... ':'; .: . .... ':~1 ~r ~:".., .' Front Good Poor Poor 20 20 W""k 1 0 38.1 38.6 3147 106 Mercury Topai'~1984-92 :,::i:.~::,~.~'rj:;'}. :::';.".' Compact Front Good 27 ';r~''''''~; . .iL..u~_~ ',' ..t'f:......~. ~Av~rage "'"\~'~''''' ; ~egu13r. ..^I'.';t.......,~.... ~ "'-25 ~'r~' .~; -.1 )";~ I.~ /..' ...",1 .. .. . ;,il,lAw..,i1 ~'-J:' to~J'." ~...,\f~~.r~;-f , ,'i:flrr*'; I'.....'..., '. " !.;~.,38.5 ;.o.:! __..:..~:-_.::2 I' 23'73:1 Weak o 36,5 25 21 '" .~II} '~.,.~1t''''~1l~ 'ff'J, 9~';~j ...."'.. .1'. ~ .... ."'.' i' W~illht (I~'.l~ "".... l":"',:~ f WhIb'l,e (in.i.' ~i~~ $:,1; :~~ ' Low ~trorg 4 Low Fair 33.5 21"3 - ~-----.-...--. (J""I_..L_...~~_:'.! . ~ :'__(".'/.:_l~~t~:~," . elf le,le,J '..(f 'I ,',1\(1 aort,Jr .. Oat. r" ," r , ,'r, I~." '.1:1 126 . ....' .' ,.:;.l"'r t.' ~ REFERENCES 1. Allen, H.E./ Weir-Jones, "Acceleration Perturbations 'Whiplash'"; Soine; Volume Lippincatt company (1994). I. / Motiuk, of Daily Living: 19, No. 11/ pp. O.R., et a1.; A Comparison to 1285-1290; J.B. 2. McConnell, W.E., Howard R.P., Guzman, H.M., et al.; "Analysis of Human Test Subject Kinematic Responses to Low Velocity Rear-End Impacts" ; Vehicle and OccuDants Kinematics: simulation and Modeling; Society of Automotive Engineers, Inc., (1993). 3. West/ D.H., Gough, J.P./ Har.per, G.T.; "Low Spep{\ Collision Testing Using Human Subjects"; Reconstruction Journal (MaY/June 1993). Rear-End Accident . . IlI1D T.c SltIlCk T.c Strik.r DIY No, Subj V wele "'V Subj V chiele "'V 1\0, No, Typo (1cpb) (^,") No, Typo (1cpb) ~,.) I 2 V... 3,48 ~.'1. I CoDver1 -4.81 ~,11 1 2 1 V... 6.4$ i,oo 4 PieJ.-up -6.04 1,1(' 2 3 I Pickup 3,04 1.1'1 4 V... -3,3$ 7...,S 2 4 4 Pickup 6,65 4,11 1 V... -6,74 ".''1 2 5 3 CoDV.rt IIA 2 Coupe IIA < 10 6 3 CODV.rt 8,06 tf.~o 2 Coupe -7,82 'I." 10 7 2 Coupe 7,83 4,11 3 CoDV.rt -9,24 .."14 10 8 2 V... 6.61 4,Q 4 Pickup -8,21 s: ,. 10 9 2 Coupe 3.93 ~ .44- 4 Pickup .3,28 t.Q4 \l 10 4 Pickup 7.03 4~1 2 Van .7.48 4.1.(' \l , , .;..i iul!j..I'. ref.ral.. polall (bitcblock. mulOid prOCCU. IIlaIlIder &Del bip) wllb rupoclto lime. IS w.1l IC lb. vehlclo I&Ilt bIlCk,roUDd m._" ,poillll UllD' a proci.ioo optical di,illziD, p_, Cervical ulclllioo IIld n..ioo aDalca w.re cM&crm\Ded Ulin, di,iliz.od bi,b tpcod film ditpllUlDCOI claLl, lba Q-tilllO aDd di.pllUlDCDHilllC clata WIS lbco comllted &Del Iba resulll valiclated by I dcLliled ccmparilOO or lb. calculltod claLl wilb lbo rrame by rrame vidoo rocordin,. or lha IlIlI*l r.llled lc51 .ubjoc:l kia.malic rupolllCl, TEST IlELATEO CUNlCAL FINDINGS - Eacb lCIl I\lbjoc:l bad frtlm 3 lD 7 vehicl. lD vchiclo leIl collilioD upo_, divided bclwOCD lb. .trikiD, IIld .tl'llCk rolea durin, lb. 10 \eSl colli.ioD ..rica, (See T.blo 1.) Thcao leIl NAI were coDductod durin, 1\10I0 wooltcod leIl pcriodl ICpanled by III eiabl clay bilrus, No....1 .ubjocI reported bevin, diocomIort.ymploms durin, or immediltely Ifter lilY ot tho leIl collisiolll, Tcs/ ",bjOC:I Dumber 4 DOted DO .ymplDlDI II 011 ,..l.otod lD hi. 6 tul ..po"',..., llc,iDDin, low &Del mid.ooc:k diocomfort over lbe area of hi. C6. C7 IlD4 Tl vor1CbrllaDd WlICQmIortu. biSlnpcziUl mu.scull/W'l CD !be monWI' rollowiol bi. lbroc ....1 NAI 00 clay 10, 'Poll polo. WIC 'ODe lbo DOli clay. bUI be coDti.aued lD beve mild wocomIort 00 Cllre- Dock CllcllsioD ...d lateral n..ioa Wltil II ,raduolly raolved dUMlthe oUllhroo clay., No lJUI!JICG1 or lb.rllpy was Deeded aDd DCIDe of lbe leIl par1icipaoLl bad aDY (urlber .ymplOms thai relatod lD lb.ir ....1 OIpoauro1 for ,ruter \hall .i,blOCD mootha followio,lbe WIlD" PHOTOGRAPHIC ANALYSIS OF AN EXAMPLE KINEMATIC RESPONSE - Tho rollowin, il a dcacriptioD or ooc tullUbjOC:I'. kinematic rc.cpoDlClto a typicallCll (RIID 7). as be ..pcriCllc:al I rorward ",V of 7 ,83 kpb (U7 mpb), (Soo Fiaurc 1.) Ph...., 1 . 10ili.1 Re5I)(lose (0 to 100 mill;....nodsl - Durin, lbe first 50 milli$ClCOoda .fter bumper impacl. Ibo ",bjoc:l'. eotire body .ppcarcd motioal... with rerereo.. lD lbe teal.i... boI:k,round. whil.the vehicle IIld driver'l.... moved rorward oboul S to 8 ...,limdlCn (2 lD 3 iDcbel), Al obout 60 milliooc:ooda .ft.r cooLICI. lbe lower put or lbo _ba<:k cuahioa bad boc<lme compreaaed ..,ou,b 10 bellD moviD& tho .1 , ~ .'; Table 1. Tesl Subject Driven Low Velocily Collision Test Series " lboul 4' to 60 minu.... Ifte~ re.st 2, lesl subjecl Dumber 1 reported . .l\IoIiD~.. of dj"""mfort .. the poslerior blo.soo or IUs Deck whicb I...tod .boullWO bou". The discoouort WL' gooe by lb. lime or hi. pMliCipolioo in te.t number 3 and did 001 recut later. Test subjo:t Dumher 2 nOIc:d the on<;et of -a.:b.inesaw in the pJ.r~pirl41 Gl~':"':U:J,;'..Ht: Ilt th~ ha..c,.e (If hj~ Deck tho moro.in~ of IJ:..St dJy t~, aft~r pMti.:iratinb in I total or 6 &e4i1 ~ during the precewJl."1a r....~, J..iIy Ie....' ~<n'~,J, ffi~ 'YlDfltoa::.l luted about 4..5 hdunl &!1J rc.~...)I\ieJ '""lthOl.lt recu.rre.ou. Tc&t ''J.bjo.:t C'.~~t~: 3 rO:j)l.):--tc...J t..hc: OC'.sd of mild tal subject's IUps and low bock rorward IIld upward (s.. Fiiuro 2). Al lbe """" lime, the upper part o( t.h. _boI:k was flexing re<lJ'W.rd with r..,peel 10 lb. vehicle and lb. sulbock cushioo WL' being compr..-J 00 t.he tal oubjocl'. .,ill ourly 5ulior.uy upper torso. fh;.<e 1 ' PPn.j~ Forward Acc<lenil,oU (100 10200 (llilli,",ond'l - Al .buUI 100 nulllsc<ooJ." the ....tbAo:k bid De.aLtly racb(.-d ILi tn.lUlmum ruJ......"IlId nex~ positioD of about 10 c.kw:r~ ~st iL'i n0rn~ position, U1J the leBC lubject'. upper lrunk hJlJ be~un """eo"",1 (orw&nl and upward. Tbo 23 11 .ACC/OfNT RfCONSTFlUCIJON JOURNAL LOW SPEED REAR-END COLLISION TESTING USING nUMAN SUBJECTS By D. H. West, P.E,; J, P. Gough, P,E,; G. T. K, Harper, P.E. ABSl'IlACT Hurun yolunlter IllbJrcu were l!:Ipoted 10 the (orca of low.peed rur ImpaClI, n. ,ubJeCI.were Ic:lled In paUC"Jrr ~rhiclc:l .nd were opoK\110 Impacts up (o,.nd ac.cclJlnl. IhecurTcnl Cln.din bumpcra1and.N of./\ 8 kmIh (5 mph) blnier Impacl, Th. lesl dlla Indfolded Ihe ",chicle velocities .nd .calerallonl, occupanc leal.nllon.. vehicle dam'lf .uaamenl, .nd .,;l.leo recordin. ot vehicle .tld oc.cup.nl raponac 10 thc c.olll.lon Corca. The tall re"o'rJltd th.l hum.n lubject. can be used 10 .uesa occupant dynamla In ,,,,,,.peed Impa". wilhoul ri.k or InJul)"o .he 'Ub),,", The I""el. 01 hud ICCCICrlllon Ind neck atcnlion wert round to be well below published thresh- old.where c.crvlallO(lUuUC Injut')' ....ould be expected (Qr hullhy individual.. ItEYWORDS, Whlpl..h. rear-cnd ImpacLI, ccrvialllraln INTRODUCTIOS Low lpeed reu ImplCLs which re"ullln Ii~( 0( no dama,c 10 Ihe Ilruck \/Chicle comprise Ililninc.anl perccntil&c oC the lolal number o(motorvchicle accldenls, p.nlcul.uly in urban areal. While the damJlc raullinl from Inee impaclIls mlnilllll or non-aislcnl, claima or neck or back injury oflen mull. In Ihe pAIl le'Ycn )'e.1n. B.ker EneinecrinC Lid, hll Investl'3tcd Uloua.andl or colli.lon. ollhi. type. In order 10 qunnlity Ihe (orca Ind displ.cemcnls apcricnccd by Ihe ~upanls oC the struck vchlere. a num~r or IIJ&td coll151on lall han been pcrfonncd. The low speeds lnvol\lcd in Ihc:!c implicts cn.bled UI 10 use humanvoluntccMllo USOIlhc oecupanl dyo.mica wilhout rilk or Injury, thereby "",crcomlnl the dn...baclu or ulioa anlhropomclric dummies or c:.aday- CrI. Thll piper lummarizes Ihe rcsulu o(a.omc oC Ihe lestswe h''14: conducted. BACKCROUND tn Canada, MotOr Vehicle Sa relY Regul3tion 21~1 requires that vehicles be equipped with. bumpers capable oC absorbina the Corces occ:umn& In an 8 IunJlt (5 mph) filed barrier impact without sustaining dJmaac 10 the liahlina. (uel or exh.ust system. and als.o that the hood, tNnk, and dool'1 ope:ral~ properly followinllhesc lestS. The energy .bosorption capabilities or such bumpen ilrc commonly achieved through Ihe use oC either nard bumper beams which are '(llched 10 Ihe vehicle structure vIa hydraulic isol~ton, or, rigidly mounted bumpers which are ovcrlaid will\ energy absorbing roam cushions, II is these Incrl)' Ibtorbinl bumpcrsY'lemswhich enablc:vehides 10 undergo a su~tanlill Impact without suslalnina any residual dc:Corm'lion. The current medical literature concerning Ihe '.......hiplash" phenomenon de- acribes that this type or injury occurs as a result or the hyper-C:Xlcnsion or Ihe c<<rvic.al ponion o( the spine. Merlz and Palrick2 have reported Ihal .:crvial a1enslon should be: limited to 60 degrees in order 10 prevent such injllry. HowC'Ycr, (or le";cls o( cervical C:Xlcn~ion approlldinllhc physiotoaical tinlil, ccrvic.allorquc m.,y be a betler mc.uure of injury-causin, polential. TIlc non. Injury levet for a 50th pcrccnti:le male has been r~por1cd 10 occur al a torque, m~surcdaboullhcoecipit.3t cJndytes.of 47 N.m (3~ fl.lb)while Ihe lorque Il.'\'el It which Iil~menlous injury occurred W:lS 57 N.m (4~ fl.lb). One of the earlj~1 l/lvc-,tig,llions u( Ihe v.hip1.l.'lh phcnlm:cll'_Jn wa~ n:p<'lrtcd~!)' SC'o'ery el a14. Tho:y cOnuIJ<:.It:J l'~;lr im ~,I"':ILI.::JIS III '...l1i~h IIJ :~;;J~ ',ullJn: t:-<,:r; ....c~c scared in the sl [1; :~; '.ehi~k Th~ \":~li:k: i..... ,,1,-:.1 were nn! cfjuirr,<,d ....flll ~ncrgy IIbsorbinll blJr;".~r.:-', ;lnJ nn 11'~:L'~ r(-,:r:II~~I' \l. ,:,rc ,1\',111.1 r-k Li [llc nll1cr rllhli.~hcd research hal ber:n cltnJuclcJ In ....hl.:11 II~c r~rt1n:;e or hum~n"" r;llher than dummio or C,"~,lven\. h,H h<'cn d. .~\jrr,'::',lt...: 'lllC ..I".('n.:e (,r ene~hY Jtx.nrDlllg bumpcrs or se.l' ~,ldl', (I( <Idc'llJ,lle bc,~II' Ie rr,'\'IJc he;,": SlJrf'nrL lImJls lhe Ippllc.abill!Y (I( Lho: St.",cr') rt::tdl~ L' 11-".~k; \>:',~I~le, ,,; \~,,:-r':nl ":l': I~n There.lrin~r,,;I~tu-:,'~~"':I,'i ,v' '''j'.' . lo~imul.1!espe;irl': ~t:~I: ....,.fl,; 11~~i;l~:' ';1,': ~'.': de$(rir.c~ ir I~,~ f '-..' '.:.J -, '.:: ).;!...: ~o(':.'r J,.,,:, li:n'~.1 .!:" ~ '~'~,,:::.' 0: I~H-:C IC".I',.He TfST Mf.lIlOD Th.I.., mulll rrpor1rd In Ihl. publiCA' Ion ..e,. o'l.nlzrd 10 dupllalr .po_ln_ IccldenllCt'nlriOl. The ltehlcla were &elecled 10 dupllcale the aanuiOl undcr con.iderlIIOn, .nd u .uch. Ihcrr WI' no intenalo.ueu In)' plnlcul.r venlcle pcrfonnlnec or rel.lilte per1'onn.nc.c. The humin tcst lub!eclI wen III Dllla .nd nnl~ In 'Ie rrom 2j )'ean t043 )'ean. The .ubjccllwereor nanDlI ph)'llc.al ClOndltlon ror their 111':1 Ind none hid .n)' prc-ajJtinalplnll denclencla. Eo_h.ubj.., ""',.. helme, ..hl_h.... nnnly allaehrd 10 Iheh..d Onlhehelme', Ihrtc acx.clcromclcn were Ittached 10 fCc.ord .culcnllona In Ihe X. VI .nd Z dlrectlon. AcccleroID4tcr cap.billties were + 2.0,00 I with uelUllivtry of O,O! I, A Iln,le Irl....I.I.cccleromelcrwll D10Unled onto Ihc lell vehicle. The .blllry to Idequ'ldy ICCUrc thlJ .ccclerom'lcr 10 Ihe vehicle provtd 10 be . IllnlnClnl ClOnaldcrlllon 10 .vold vlbratlonlllnlerfcrcnoc. The Implcl.peed orlhe vehicle wu reco"Jed u.aln,. pneum.tlc lruLJle .ptcm. 0.11 from Ihe .ca:leromeler wu .cqulred II j:OO IIlDples pcr ICCOnd by · Hewlett Paclurd OJmpuler, Ihe I(,cclerallon CUNei weR dl.pl.)'ed Ihrouah.n HP Colour Jel printtr, Ind the Icaleratlon maximum. were tlbullted Ihf'Qu,h Ihe JOflwlre. 51,nll conditloninllnd rillerinl were accomplilhed In .ccordance with 5AE ,uldelino'. The acquisition pllckale 15 propriel'ry .nd was prepared by Weir,Jones Enaincerin, Consullant. lid. Video recorda were mlde or the occupant .nd vehicle dynamics (or laler 'ludy. TEST RESULTS S.,inA Our urliesttcsl WII intended 10 limul~te a simple rc.ar-cnd collision in which lhe Itruck vehkle WIS llation.ary, The Icst vehicle wu IU\lck in the rur by I lOW lruck. Sldkinl ltchic1e Struck vehicle SIMklnl Yehlcle Speed P",k Acccteration (km/h)~(g) 1.8 09 2,9 I,J 0.9 3.2 to 1.0 4.7 ,A 1.5 5.5 1.4 15 6.1 1.1 1.7 7.1 ~. 1 9 7Z .d.t. OZ.4 80 ro 30 87 r4 28 98 'J 29 IUi'" 3.1 . Tow lruck wllh steel push bumper . 1919 PI~mouth Horizon. oS door . Bumper desi,n .oolator ,..,oke Icna.h 1>1 mm (25In,.hcs) . HC.1d IUppclr1 .Inlelral .81 em (32Inehcs) hlah . Occupanl slalure .183 em (72 Inches) Oecupllnl Peak Yehlcle Head Displacement Accclenlion x' '~- -2." (a) (g) (g) (em) 13 13 14 96 31 46 l.5 1.1 0.5 12 17 0.5 23 1.8 0.5 19 10 10 2.3 13 18 45 Z,O 18 J.8 109 1.9 48 30 l.8 iJ JJ ~,9 70 3' 28 83 3.4 28 1~4 l()ol l~Z no! rl',c;I~'Jrc,l .. oncnl.l:10n ~lQn;ILlJJln.lt. y.:.llc!r.:. z-'.t:nic.11 Isolator Compres!lon tAft RighI (mm) (mm) 13 13 22 29 22 29 48 44 48 44 48 44 rull full filII full full Cull full full full rull rull rull j",'\n:.r ,. F'I".."',,,';" r:,' J" !(.J' U'Ij',I,'t Iu;.r vII'l)II'ln},' a 10" l1"tJ.;k and a f/\.'1..UV. lilll';:OI'l. .,' I EWO penonl 'R "on.-Irom th. .1 p.rNrbarion I. , cause inlury, In on. .re INly th. " likely 10 be 10, rid In rbl. .Ndy, in, down InIO a : not chi lime for "Iorm .lmUarly, perNlb.the body cf unorm"" cKo l. Thl. 'Ndy u..d a way to complre :ved In .imp!e ev. altl feaf.end mo" \CS. luch as .win,- <led. lookin, over ;J, crClud acuter. e b.cklltoW1d of 1 UI to occur under 10,1 G ~. 8,5G ,untldon 01 m, vlclOr a' ""tOQ In chli," .vtnt. :h U\I lorclS ~oyl4 bl ml/'l,"{urriUltldllltir h,I'IUdi"l/'lis se~.m.tIC "an ..pr'Hlon or thl . 0...1, Pcmublrion. VcnuI ''I':'~pl&ahl , 111' rabl. 2, H..d ..,. forc. P.""r1ledona 01 O.lIy Llvln; II.., O",,"d ",ce,I",oon 10.1 'i,rtlul CI/lcltd Acullllqon tllIl Vlelll "'ultf,un VICI"MIII .,- -,- -,- .,. -,- "," ",-t" "l-t" hllll Low HI~h ~OIn lAw ti19" Mu" '..11 V.lllI D."... . lOIlIr.'''' 0.1 0.' OJ 01 01 0,' O' lU , Sul1'1 OJ ~1 0,5 OJ O' 0,4 0,1 ...5 . Sl'louldlf""CIr. OJ 1.1 0.1 0.1 0,_ OJ 1.1 III . Slln,vll 0,_ I.! 01 0,' IJ 01 1.1 110 , Hud lIab .., 1.1 1,- 0.1 1.1 04 11 IU . $itclo....n 0,5 I,' 1.1 0,4 10 10 U IlJ . S/l..n 0.1 I.! 10 0.5 U II U IIJ . CouV" 0,5 3,0 1.1 OJ 1.1 0.1 3J lO.! , C,owd 10111. 0.' U I.- 0.1 30 1.1 1.I IlJ , SlIP on Uck 05 U 11 ... 1.1 I' -,I ILl , Klckclllir 10 3.1 1,1 0.1 U IJ _J 3U . Hall 0" flIP IJ U ~7 11 U U ',1 ILl . '100 In cll.ir 1.1 $.I IJ ~O ',5 U 10.1 IOJ Mun. 0,1 U I.- 01 U 1.1 lJ 41J "''9'', ~. tI"4 ""'"1 01 .~hl I\,jOllet. m..."'" lor a<<:II,"llCln 8 rorc.. '.~"IWi '" ltle ,..' dw-ICWJl'III &.11.I1. .,.,.s ~IU IItr\lul tI ,,"I . 13 "'"'" ....rm 0' rI"1'I IMrtIjI. Sill, to .lde y Ul'''''" WI' \4,.,...."11..,1 tt1d....u not ~l)\olelld, \'h. 1C.uI.tl~ ....era, .".,.,... 01, ,o~.. IIwtl"Ic\jIl'.o I~ lII4lN.1irnum ....luU ct I '1'1'1 r 'or ..r-. ....tH. Th, ."VII or ~ 'D~U /lOfIMIII' U'Ie dil'K\lotl 01 LII, ~.IO' in c1~"" Ircwn t'MJr'IrOfl\ll. A . kVWI, me.".... or.,. pIIN'l4MI mo--.,.,....l'It. JI .. ~u.I\'., m..,,.,-t ,n U"y'OI.tl"Oll.cl or 1'1111"" motIOn CI"IIV lINt peDP'l'~'.tvucl .,....'.I\"IM.I,II.,ne1l1a we/' co.lld on one 'lflll"'- QnJy GrlI 11.IC11K1 ...... '1.1(.'" 'rom beNI"d 1ft 11I1 d'\ail, It ,nc,."~ '"'WI,rUIIY!) 10 In. rn&lIlfT1lOrn Gm.' tOlerated by u... Illc_.,. such cirC'!mstances, then it can be considered to occur spontaneously. Other simple daily even~, such as Inl:ezing. cough- ing, or being jostled as if in a crowd, were shown to Q'C.1tc ma..ximum accelerations to the hud (and corre- .ponding lorquclevcl,.. the neck) of 2.9 g ro 3.6" Thi, leyel of per:Nlbarion was recognizable by the subjecu, but ...Iso was cor:si-d-<<ed trivial. Th~ upper level of jos. ding experienced by the .ubiecu was for hopping off · step and plopping down into a chair, with respective vector a"elc",ion, 01 8.1 g .nd 10,1 " neither of which caused any adverse notice by the subjects. Is this an uppellimit of normal ~olelance? Exploring the tower limics ot routine eventS is sa(e, bu~ exposing subjectS co forces ~hat could be considered injurious would be eth. ically trC3cherous. Without the application o( some external force, mere can be no modon. Ultimately, it is the appliation of some excern:11 (oree that uuses bodily modon th:at should be responsible for all that (allows, particularly if ph.ysical bodily injury is to be considered. With the advent of 50phistkared accelerometers and high-speed computer.based acquisition systems, colleering acceler. ation data for various bodily perrurbacions is fC:1~iblc. The purpose of this srudy was to express an extension. nexion modon that could be related ~o the sO-CJ,llec "whip\J.sh" rnonon of MYA scenarios. The extension r.tngc wu not me.tsllred, only the 2"elecacior1s or "g" for,e,. We found chat in one event of daily Jctlviry, the vector ;lcceler~don of to.4 g was experienced unevcnc. fupy. The,e 'Ialucs m3Y be comparable in (occe anJ direcdon fO low vclociry no.d.1mage re:H.end MVA,. When ornp3ring: J"clt:r:uion HceHe, berwe~n d:lily ..;. t;',IInc:~ .lnd \tV..~'j, ie i, import,lnt only w c...rT~p,: [he: ,,~. ;;\',~i,::cr J"::~. For .:'':Jrr.r1e:, \;t,.'eH'S ,\{'.'r. b',Ht,p .rudy" u"d only the horllon..1 "x" ax;', Th.refore, when this rypc of d... I. compared 10 the .",.Iendon pemub.rion. of daily living, only the .ame axil obould be referenc.d. NOle that thi, sNdy wa, limiled In the number 01 volumel:r5. The fuli spectrum of the population, with · prcsumed wide variance in phy.lcal and psycholoalc pro61cs. was noc ~es~l:d. In thi, ,rudy, the aceeleradon. uperienced by rho head in activities 01 daily Uvlng wore "..." th.n would be inruirivcly expected. Also. the .mleraaon. appeared to be greater chan those letn in the sam. pua 01 the body durin, some no-damage malar vehicle rcar-cnd imp.acu. When alsosing the claims of and porrndaJ (or injury from an aceidenr, many medical. p.yeholoalc, and po.uible nomogenic faw.! 01 the cue need 10 lie cor-,ldered, One factor \, the ..dm... 01 the lor... rhal wore applied 10 the pmon and the ranle 01 po..lbl. tinue damage <1>.. could be ..used by applyin, .uch (orees. With no-damage accidents, one can real.WI III "cidenr victim who h.d o.herwise been &i&hlCncd by rumors of horror and the mystery thac somrtimcs fol- lows the MVA .......hip!.tsh.' scenuio. Ret.r.nces 1. Bogduk N. The anatomy and l'afhophyliololY o( .hl,. la1h, Cliniu.l Biom~d'la;,la 1986;1:92-101. 2. Cats-Baril WI., Frymoyer JW. Idenrifyinl padenmll Nil of beeomin. diubled be~U1e (1f low bade pain. The V_"" Renabiliuoon Enpnetring Center Predictive Model. (!II"", Orthopaedic: Auot:iadon Award for Spin..1 Racalchl. SplM 1991;16,605-7. J, McConnell WE, HOVfard POP, BUlman H.\t, c, OIl. AAalytii Qf nlJman teH ,ubltc:t kiMmario:: mpor'Uu to low velocity tI" end impH'u. Sodtry ()f AuromGti...c Enginecrins. "'1. flel\. nlot pJper 1'11). 9J.).:;S'l. ]UN 16 'S7 ~S:48AM I H C P,2 InternllllolfDl H..ltbure Coftlullllnl:', Ine, (I H C) p,O, 101 702', M.ri.IllI, 0430065,102' P.O. 1101 41126, CI..lnn.d, OH 45242,0726 P.O B.I 312, Mlddl'IO"'., P....170S7 P,O, B.I 48250, FI. Worlh, TX 76141-02S0 (770) no.oon (513) 9'H~7 (717) "".1667 (117) 421.3320 ROB~RT M. YANCHUS, M,O, Summary of Qualifications EDUCATION Univer.ity of Pittsburghr Pittsburgh, PA, B.S., 1945-46 University of Pittsburgh, Pittsburgh, PA, M.D., 1946-50 University of Pittsburgh, Pittsburqh, PA, Internship, 1950-51 Children" Hoepital, Pittsburgh, PA, Residency-Pediatric Orthopedics, 1951-55 Veterans Administration, PittSburgh, PA, Residency- Adult Orthopedics, 1951-55 Pre.byterian Ho.pital, Pittsburgh, PA, Residency-Adult Orthopedic., 1951-55 POSITIONS Orthopedic Surgery, N.w Kensington, PA, Private Practice, 7/55 to 12/86 Citizens General Hospital, New Kensington, PA, President, Medical StaH, 1990-81 Citizen. General Hospital, New Kensington, PA, Head, Dept. of Surgery, 1991-93 Citizen. General Hospital, New Kensington, PA, Head of Infection, Utilization, Admission and Long Stay Committees 1960-80 LICENSUJU: Pennsylvania, North Carolina, nnd South Carolina PROfESS;ONAL ASSOCIATIONS Pennsylvania Medical Society American Academy of Orthopeaic Surgeons Tri-County Medical SOcietr Interstate Orthopedic Soo ety Alpha Omega Alpha Honor Medical Fraternity . I' ( Rev. 4/9 7 ) ',O.80170ZII, M"rItl'". GA 30065-IOZ' (770) 'Z60406Z P.O, Box .Z726. Ci.Dc:lIlIlIli, OH .52A2.0726 (513) ~2.2237 P,O. Box 16959. WearP.1m Bcacb, F1. 3304 1 6-6959(407) 5BU049 P,O. Box 56159, PbOCllix, AZ "079-6159 (602) 246-6963 P,O, Box .8250, 1'\. Worth, TX 76148-0250 (817) .28-3320 MR. BRYON M. WILSON ALLSTATE INS. CO, 6345 FLANK DRIVE SUITE 1000 HARRISBURG, PA 17112 04/10/96 JOHN TRAUM 1551562646 01-0044764 Date RE CLAIM II IHC II Dear MR, WILSON On Feb 09 1996, we received the above referenced consultation request for Impact Analysis, This evaluation is based on the documentation provided to us and general principles of accident reconstruction and physics, The medical assessment is additionally based on the general standards of care in the profession, and if the" provider wishes us to consider additional information concerning the clinical status of the patient, he should submit copies of those pertinent documents to be forwarded to us for evaluation during the appeal period, The following documents were reviewed to support the necessity, appropriateness, and relatedness of all treatment to the above-noted claimant for injuries alleged in the motor vehicle accident of February 7, 1994: Commonwealth of Pennsylvania Police Accident Report dated February 7, 1994; Impact Analysis report from an engineering company; bill from Becker's Towing in Camp Hill, Pennsylvania, for $35; bill for repairs from Auto Body by Schaum'S, Bensalem, Pennsylvania, for $1165,60; claim photograph records of the rear end of the claimant's 1989 Mercury Topaz Sedan; Police Department Lower Allen Township Report, Camp Hill, Pennsylvania, February 7, 1994; Application for Benefits/ Personal Injury Protection submitted by this patient, February 26, 1994; report of a CT scan of the lumbar spine performed at St, Mary Hospital, Langhorne, Pennsylvania, March 5, 1987; office notes from Thomas Javian, M. D" from April 27, 1987, through June 18, 1991; x-ray report of the lumbosacral spine, June 14, 1988, taken at St, Mary Hospital; office notes from Anthony G. Vincent, a chiropractor of Philadelphia, Pennsylvania, from February 26, 1993, through February 4, 1994; a second group of office notes from Dr, Vincent, February 18, 1994, t.hrough March 30, 1994, for a motor vehicle accident of February 7, 1994, and treatment thereof; note of ~arch 18, 1994, to Ms, Olson from John Traum, with information regarding first automobile accident of January 17, 1994, and second automobile accident of February 7, 1994; Holy Spirit Hospital Emergency Room record from February 7, 1994, including x-ray reports of the chest and cervical/thoracic/lumbar spine; office notes from John Sbarharo, Jr., M,D" orthopedic surgeon, from April 21, 1994, through and including a discharge summary of December 5, 1994; itemized l,st of medical expenses for motor vehicle accident of February 7, 1994, from Holy Spirit Hospital, A.Z. Ritzman Associates of ~echanjcsburg, Pennsylvania (for x-rays), Dr. A.G, Vincent and Dr, Sharbo"c,; E.n:l a EC-l"ir,s of 1"tu3rs fHlm O'Brien & O'Brien Associates, , . . Inllrnlljonal HeaIlhc:are ConsuIIIIIIs, Inc, ((I' He] P,O....7019, M.rlell.. GA 3006S-1019 mil) 916-0061 P.O, &1 42716. CiDciDDali. OH 4S2A2.0716 (SI3) 942.2237 P,O. D01169S9. WcstPIIm Bc.:b,FL330416-69S9(407)SIU049 P.O, DOl S61S9. PbOCDix, AZ .S079-6IS9 (602) 246-6961 P,O, DOl 482S0. Fl. Worth, TX 76141-02S0 (117) 428-3320 Date RE CLAIM * IHC * t 04/10/96 JOHN TRAUM 1551562646 01-0044764 Philadelphia, Fennsylvania, Pennsylvania, This 48-year-old meat cutter was headed west on Gettysburg Road and was stopped for traffic at the intersection with 41st Street, when his vehicle was rear-ended by a 1983 Chevrolet Citation, This patient's vehicle was pushed into a snowbank, requirin~ Becker's Towin~ for removal, He was treated at Holy Spirit Hospltal, after arrivlng at 6:09 p,m, Complaints at this time were back and right thumb pain, 1 ightheadedness, nausea, and headache, X-rays were takeh of the chest and cervical/thoracic/lumbar spine, Slight narrowing was noted at the C5-6 disc space. No significant neural foraminal encroachment was noted, The thoracic and lumbar spine x-rays were negative except for small spurring at L4 and facetal arthritis at L5-Sl, This patient was discharged at 8:45 p.m. with a dia~nosis of MVA with back sprain. He was given a prescription for Motrln 400 mg, and Skelaxin, He was advised to follow up with the emergency room as needed and to return if any problems. to Allstate Insurance, Harrisburg, This patient had been rear-ended earlier in the year, on January 17, 1994, by a 1988 Plymouth Horizon. He also reported that he injured himself at work in 1987, when he fell while carryi~g a tray of meat. A CT of the lumbar spine of March 5, 1987, at St. Mary Hospital suggested a lateral herniation of the L5 disc on the right, He was subsequently treated by Dr, Thomas Javian from April 27, 1987, until June 18, 1991. He later began treating on February 26,. 1993, with Dr, Anthony Vincent, a chiropractor in Philadelphia, who diagnosed him with cervical/lumbar strain, He continued treating at monthly intervals with Dr, Vincent in 1993, and on February 2, 1994, five days before the second accident, he had undergone a "cervical/thoracic adjustmeit" , Subsequent to the February 7, 1994, treating again with Dr, Vincent on approximately every two weeks, with March 30, 1994, again for cervical/thoracic/lumbar strain, motor vehicle accident, he began February 18, 1994, returning the last visit being recorded as a diagnosis listed as On April 21, 1~~4, nearly t.hree months post-accident, this patient was referred to Dr, John Sbarbaro, Jr" orthopedic surgeon, He stated the c~iropractic treatment was of limited value,. His physical examination at this t ;n,,,, ~h:,..'",d that the, neck/lumbar spine had 90% mobility, with 2 Inllmlllpnal Hea1thcIre CansuJIInlS.Inc, ((IHC] '.0.... 7029, Marlot1.. GA 30065-1029 (770) 92~062 P,O, Dol 42726. CiDcillllatl. OH 452A2.0726 (513) 942.2237 P,O. BOI16959. Will Palm Beacb,FL 3341 6-6959(407)5""049 P.O. BoI 56159. PbOCDlx, III 15079-6159 (602) 2A6-6963 P.O, BOI 41250. Fl. Wol1b, TX 76141-0250 (117) 421-3320 Date RE CLAIM IHC I 04110/96 I JOHN 'l'RAUM * I 1551562646 * I 01-0044764 pain at extremes of motion. This was diagnosed as acute cervical/lumbar strain with radiculopathy secondary to the MVA of February 7, 1994, HNP was to be ruled out, Lumbar MRI was scheduled and was done on April 25, 1994, and was negative for lumbar disc herniation, canal, or foraminal stenosis, He was fitted with a lumbosacral brace, He was also given a prescription for Day-Pro. He was seen in follow-up on June 28, 1994, noticing some improvement but also with ri9ht leg and lower back pain, Neck symptoms had cleared, Beginning May 19, .June 16, and..._July 14, he noticed improvement. A letter of October 12, 1994, to Attorney Roger Harrington notes that at this time the lumbar spine had normal mobility and the neurological examination was negative. He saw him on November 30, 1994, indicating the patient had gotten his weight down to 180 ~ounds and felt better. Physical examination was negative, and prognosis was guarded, The discharge summary was submitted by Dr. Sbarbaro on December 5, 1994, again noting physical examination was essentially nega~ive, although he had pain at the extremes of motion. Prognosis was described as guarded. He was to use a back brace for strenuous activities, I am asked to review this file for necessity and .ppropriateness of treatment, As noted in the report by the engineering company, the damage to the claimant.s car was $1165,60, However, it should be pointed out that the damage to the vehicle striking his car was all of $7 to replace a light bulb, The engineer determined the vehicle transmitted the force of impact to, the claimant's vehicle of approximately 4 g's, This force is described as being the equivalent of "being jostled in a crowd, being slapped on the back, or being seated in an office chair which was kicked in the back", ' The treat~ent of injuries from rear-end collisions such as this are commonly known as whiplash, A low-impact collision could be handled with no treatment and be expected to be better in a month or two, at the very most, This fact is dor.umented by the engineer's report, in which he also references articles from ~E~~~: Volume 19, Lippincott Company, 1994/ an article from Society of Automotive Engineers, 1993, by McConnell, W,E" at ai, and an engineering study from the Accident Recons~ruS_t..~()n_.1..o."!n'!!, Kay/June 1993/ by [J,H, West/ et al. It is worthwhile noting that this claimant had undergone treatment in the Fa~t [-,'1' a rliagnclsis of injuries to his LS disc, which had 3 InIanIIlor* HIIlIIthcIre ConsuItants,lne, ((I He)) P~O.BOI 70J'. Mulot'.. GA 3006S-IOZt (770) 'Julin P,O, Box 4J726. CiDc:iDDaU. OH 45242-0726 (513) 942.2237 P.O, Box 1695'. Well Palm S-b, FL 33416-6959(407)5....049 P,O. Box 56159. Pboeolx, AZ 1507~6159 (602) 246-6963 P,O. Box 41250. Fl. Worth, TX 76141.0250 (117) 421-3320 Date RE CLAIM t IHC t I 04/10/96 JOHN TRAUM 1551562646 01-0044764 recovered, He was actually being treated at the time of the second motor vehicle accident on February 7, 1994, for another rear-end collision on January 17, 1994, by Dr. Vincent, a chiropractor, He had been "adjusted" on February 2 and 4, 1994, for cervical/thoracic strain, out of the forces, in a crowd or The engineering study submitted takes some of the mystery rear-end collision, which brings it down to basic physical this case, 4g's, described as no more than being jostled in sitting in a chair._and having it kicked on the back, This brings back to mind addressing the impressions of the MRI and its reasonableness, and I would point out that an MRI at this point with 90% cervicdl range of motion and a negative neurological examination, in my opinion, was not indicated, With reference to the chiropractic treatment by Dr, Vincent from February 18, 1994, through March 30, 1994, it is my opinion that this type of treatment was unnecessary. Frankly, if one used a "whiplash" as a hyperextens ion/ flexion strain/sprain of the neck ligaments, so-called "adjustments" would have nothing but a deleterious influence on the stability of the spinal column, . Addressing the treatment by Dr, Sbarbaro, it is my opinion that the initial visit of April 21, 1994, was reasonable, The fitting of a back brace also was reasonable, although the cost of $210 is excessive, It is noted the claimant has a 90% normal range of motion, and I am sure he would have done guite well with a generic canvas lumbosacral support with Velcro fasteners in the front, It would simply be more cost-efficient, Addr.essing the treatment from Dr.. Sbarbaro, as reflected in the billing of eight office visits from April 21, 1994, through October 5, 1994, I ~would question any further visits after July 14, 1994, Revi8win~ the doctor's office notes on July 14, this patient is described as "doing good" and is noted to have a full range of motion of his back, with negative tension signs noted with an SLR of 90 degrees, Regarding the degenerative changes noted in the cervical/thoracic/lumbar spine, these would, of course, be consistent with the claimant's age of 48 years. It is my opinion, based on review of the documentatIon in this file, that this patient sustained a low-impact whiplash injury (hyperextension/flexion) with reference 4 . Inllnllllonel H...... ConIuItInII, Inc, [I He]) ..0,...10%9, Marlolt.. GA 300"-1029 mi) t2uO'2 P,O, 801 42726. CIDc:...u. OH 45242.0726 (5U) 942.2137 P,O, Bolt 16"9. Will Palm BoKb,fl. 3341 ~9"(407)51U049 P,O, 801 56159, PbOClllx, AZ 15079-6159 (602) 24606963 P,O.801 41250, F\, WOllh, TX 76141-0250 (1\7) 42a.mO Date RE CLAIM IHC I 04/10/96 I JOHN TRAUM It I 1551562646 It I 01-0044764 to his cervical and lumbar spine. This injury has a good prognosis for healing, with or without treatment. Robert Yanchus, M.D. Orthopedic Surgeon Signed copy available upon request. 12-G . 5 "\ \1 1 I" , o' Intemialon.J ~faI1hcIrI ConIuItanIs,lnc. tI He]) '.0.". 70n, Marlotl.. GA )OO~102' (770) '2'-"'2 P,O, Box 42726, ClDclmlall. OR 45242.0726 (513) 1'42.2237 P.O. Boa 16959. W... Pa1m 1lcKb, Ft3:141 ~959(407) 5....049 P.O. Boa 56159. PbOQix, AZ 15079-6159 (602) 246-6963 P,O. Box 41250. Fl. Wonb, TX 7614-0250 (117) 421-3320 Datel 04/18/96 Patient I TRAUM, JOHN T. Pagel 1 Provider SBARBARO, JOHN L., JR., M.D. ORTHO. ARTHRITIC AND HAND SURG GSB BUILDING/SUITE 620 BALA-CYNWYD, PA 19004- ( ) File No. 01-0044764 Provider Charges/Reviewer Allowance Date Code Service Charge Allowance -------- ----- ------------------------------ ------------ ------------ 04/21/94 OOOOa--INITIAL CONSULT-COMPL EX 04/21/94 00000 LUMBAR PROSTHESIS 05/05/94 00000 O.V.-COMPREHENSIVE 05/19/94 00000 O.V.-COMPREHENSIVE 06/02/94 00000 OBUS FORME/UPRIGHT SUPP. 06/16/94 00000 Q.V.-COMPREHENSIVE 07/14/94 00000 O.V.-COMPREHENSIVE 08/31/94 00000 O.V.-COMPREHENSIVE 10/05/94 00000 O.Y.-COMPREHENSIVE $250.00 $210.00 $90.00 $90.00 $92.00 $90.00 $90.00 $90.00 $90.00 $250.00 $210.00 $90.00 $90.00 $92.00 $90.00 $90.00 $.00 $.00 ------------ $912.00 $1,092.00 ........=.*. ~........... . The narrative contains the rationale .for denials listed i~ the recommended allowance column. Allowances are the actual billed charge and are not the prevailing rates for that geographic area. Prevailing rates are available upon request for most therapies. IntemllionaJ HCIIIIbc:arc ConsuItanIS,lnc. ((I HC]) P.O,Bo.7019, Martolla, GA 3006501029 (770) 916-0062 P.O, Box 42726, ClDciDDIll, OR 45242.0726 (513) 1'42.2237 P,O, Box 16959, WeslPtIm Bcac:b.Fl.H416-6959(407)5II-I049 P.O. Box 56159, PbOClllx, AZ 85079-6159 (602) 246-696) P,O, Box 48250. FI, Wortb, TX 76148.0250 (117) 42..3320 MR. BRYON M. WILSON ALLSTATE INS. CO. 6345 FLANK DRIVE SUITE 1000 HARRISBURG, PA 17112 Date RE CLAIM IHC I 04/10/96 JOHN TRAUM N 1551562646 N I 01-0044764 Dear MR. WILSON On Feb 09 1996, we received the above referenced consultation request for Impact Analysis. This evaluation is based on the documentation provided to us and general principles of accident reconstruction and physics. Tho medical assessment is additionally based on the general standards of care in the profession, and if the' provider wishes us to consider additional information concerning the clinical status of the patient, he should submit copies of those pertinent documents to be forwarded to us for evaluation during the appeal period, The following documents were reviewed to support the necessity, appropriateness, and relatedness of all treatment to the above-noted claimant for injuries alleged in the motor vehicle accident of February 7, 1994: Commonwealth of pennsylvania Police Accident Report dated February 7, 1994; Impact Anal~sis report from an engineering company; bill from Becker's Towing 1n Camp Hill, Pennsylvania, for $35; bill for repairs from Auto Body by Schaum's, Bensalem, Pennsylvania, for $1165.60; claim photograph records of the rear end of the claimant's 1989 Mercur~ Topaz Sedan; Polic~ Department Lower Allen Township Report, Camp H11l, Pennsylvania, February 7, 1994, Application for Benefits/ Personal Injury Protection submitted by this patient, February 26, 1994; report of a CT scan of the lumbar spine performed at St. Mary Hospital, Langhorne, Pennsylvanial March 5, 1987; office notes from Thomas Javian, M.D., from April 27, 1987, through June 18, 1991; x-ray re~ort of the lumbosacral spine, June 14, 1988, taken at St. Mary Hospltal; office notes from Anthony G. Vincent, a chiropractor of Philadelphia, pennsylvania, from February 26, 1993, through February 4, 1994; a second group of office note. from Dr. Vincent, February 18, 1994, through March 30, 1994, for a motor vehicle accident of February 7, 1994, and treatment thereof, note of 1M arch 18, 1994, to Ms. Olson from John Traum, with information regarding first automobile accident of January 17, 1994, and second automobile accident of February 7, 1994; Holy Spirit Hospital Emergency Room record from February 7, 1994, including x-ray report. of the chest and cervical/thoracic/lumbar spine; office notes from John Sbarbaro, Jr., M.D., orthopedic surgeon, from April 21, 1994, through and including a ciischarge summary of December 5, 1994, itemized list of medical expenses for motor vehicle accident of February 7, 1994, from Holy Spirit Hospital, A.Z, Ritzman Associates of Mechanicsburg, Pennsylvania (for x-rays), Dr. A,G. Yincent and Dr. Sbarbaro; and a series of letters from O'Brien & O'Brien Associates, 1 Inlr:mlliollll Hca11hcaie ConsulIanlS,lnc. '[lHe] P.O, Be. '029, Marlol'", GA 30065-1029 (770) 916-0062 P,O, Box 42n6, Cillclmlall. 01145242-0726 (513) 942.2237 P,O, Box 169'9, Weal PallD Belcb,FLB41 6-6959(407)5B8-8049 P,O, Box 56159, PbOClllx. AZ "079-61~? (60:) 24G-6961 P,0,80x 48250. FI. Wortb. TX 76141-0250 (117) 42..3320 Date RE CLAIM N IHC N 04/10/96 JOHN TRAUM 1551562646 01-0044764 to Allstate Harrisburg, Insurance, Philadelphia, Pennsylvania, pennsylvania. This 48-year-old meat cutter was headed west on Gettysburg Road and was stopped for traffic at the intersection with 41st Street, when his vehicle was rear-ended by a 1983 Chevrolet Citation. This patient's vehicle was pushed into a snowbank, requiring Becker's Towing for removal. He was treated at Holy Spirit Hospital, after arriving at 6:09 p.m. Complaints at this time were back and right thumb pain, lightheadedness, nausea, and headache. X-rays were taken of the chest and cervical/thoracic/lumbar spine. Slight narrowing was noted at the C5-6 disc space. No significant neural foramina I encroachment was noted. The thoracic and lumbar spine x-rays were negative except for small spurring at L4 and facetal arthritis at L5-S1. This patient was discharged at 8:45 p.m. with a dia~nosis of MYA with back sprain, He was given a prescription for Motrln 400 mg. and Skelaxin, He was advised to follow up with the emergency room as needed and to return if any problems. This patient had been rear-ended earlier in the year, on Januarr 17, 1994, by a 1988 Plymouth Horizon. He also reported that he injured himself at work in 1987, when he fell while carrying a tray of meat. A CT of the lumbar spine of March 5, 1987, at S~. Mary nospital suggested a lateral herniation of the L5 disc on the right, He Wll.. subsequently treated by Dr, Thomas Javian from April 27, 1987, until June 18, 1991. He later began treating on February 26,.1993, with Dr. Anthony Yincent, a chiropractor in philadelphia, who diagnosed him with cervical/lumbar strain. He continued treating at monthly interval. with Dr. Yincent in 1993, and on February 2, 1994, five days before the second accident, he had undergone a "cervicaI7thor.ci~ adjustment" . Subsequeht to the February 7, 1994, treating again with Dr. Yincent on approximately every two weeks, with March 30, 1994, again for cervical/thoracic/lumbar strain. r<" " ":i~i! ,JJi.\~' '1 ",\'l! '. j,~{ll 'l!\" _'kt ",~'l :1'; motor vehic Ie acc ident, he began. February 18, 1994, returnift9 the last visit being recorded .. a diagnosis listed .. On Apri 1 21, 1994, nearly three months post-accident, this patient w.. referred to Dr. John Sbarbaro, Jr., orthopedic surgeon. He stated tho chiro~ractic treatment was of limited value. His physical examination at thls time showed that the neck/lumbar spine had 90~ mobility, with 2 Intemllional Heallhcarc ConsuJtants,lnc. '[iHC]J P.O.Bo.7019, Marlol.., GA 3006$-1019 (770) 92'-4061 P.O. Box 42726. CiDclllllall, OH 45242.0726 (513) 1'42.2257 P.O. Box 16959,West Palm Bcac:b,FL H41 6-6959(407)"1-1049 P,O. Box 56159, Pbocnl.. AZ 15079-6159 (602) 246-6963 P.O, Box 48250. F\. Wonb. TX 76141-0250 (117) 421-mO Date RE CLAIM N IHC It 04/10/96 JOHN TRAUM 1551562646 01-0044764 pain at extremes of motion. This was diagnosed as acute cervical/lumbar strain with radiculopathy secondary to the MVA of February 7, 1994. HNP was to be ruled out. Lumbar MRI was scheduled and was done on April 25, 1994, and was negative for lumbar disc herniation, canal, or foramina 1 stenosis. He was fitted with a lumbosacral brace. He was also given a prescription for Day-Pro, He was seen in follow-up on June 28, 1994, noticing some improvement but also with right leg and lower back pain. Neck symptoms had cleared. Beginning May 19, June 16, and July 14, he noticed improvement. A letter of October 12, 1994, to At~orney Roger Harrington notes that at this time the lumbar spine had normal mobility and the neurological examination was negative. He saw him on November 30, 1994, indicating the patient had gotten his weight down to 180 ~ounds and felt better. physical examination was negative, and prognosls was guarded. The discharge summary was submitted by Dr. Sbarbaro on December 5, 1994, again noting physical examination was essentially negative, although he had pain at the extremes of motion. Prognosis was described as guarded. He was to use a back brace for strenuous activities. . I am asked to review this file for necessity and ap~ropriateness of treatment. As noted in the report by the engineerlng company, the damage to the claimant's car was $1165.60. However, it should be pointed out that the damage to the vehicle striking his car was all of $7 to replace a light bulb. The engineer determined the vehicl~ transmitted the force of impact to the claimant's vehicle of approximately 4 g's. This force is described as being the equivalent of "being jostled in a crowd, being slapped on the back, or being seated in an office chair which was kicked in the back". The tre~tment of injuries from rear-end collisions such as this are commonly known as whiplash. A low-impact collision could be handled with no treatment and be expected to be better in a month or two, at the very most. This fact is documented by the engineer's report, in which he also references articles from Spine: Yolume 19, Lippincott Company, 1994, an article from Society of Automotive Engineers, 1993, by McConnell, W.E., et ai, and an engineering study from the Accident Reconstruction Journal, May/June 1993, by D.H. West, et al. - It is worthwhile noting that this claimant had undergone treatment in the past for a diagnosis of injuries to his L5 disc, which had 3 -- InllmllionaJ Heahbc:aIe ConsuItlnlS,InC. ((I 'He]) P.O,Bo.7019, Marlol'.. GA 300~1029 (770) 926-0062 p,<>, Box 42726, ClDciDDIll. OR 45242.0726 (513) 1'42.2237 P,O, Box 16959, Weal PalmDe.cb.FL33416-6959(407)"I-I049 P.O, Box 561'9, PbOClllx, AZ 8507~6159 (602) 246-6963 P,O. Box 48250, FI. Wortb. TX 76148-0250 (117) 42..3320 Date RE CLAIM IHC I 04/10/96 JOHN TRAUM ~ : 1551562646 ~ 01-0044764 recovered. He was actuaily being treated at the time of the second motor vehicle accident on February 7, 1994, for another rear-end collisio~ on January 17, 1994, by Dr. Vincent, a chiropractor, He had been "adjusted" on February 2 and 4, 1994, for cervical/thoracic strain. The engineering study submitted takes some of the mystery out of the rear-end collision, which brings it down to basic physical forces, in this case, 4g's, described as no more than being jostled in a crowd or sitting in a chair and having it kicked on the back. This brings back to mind addressing the impressions of the MRI and its reasonableness, and I would point out that an MRI at this point with 90% cervical range of motion and a negative neurological examination, in my opinion, was not indicated. With reference to the chiropractic treatment by Dr. Vincent from February 18, 1994, through March 30, 1994, it is my opinion that this type of treatment was unnecessary. Frankly, if one used a "whiplash" as a hyperextension/flexion strain/sprain. of the Reck ligaments, so-called "adjustments" would have nothing but a deleterious influence on the stability of the spinal column. Addressing the treatment by Dr. Sbarbaro, it is my opinion that the initial visit of April 21, 1994, was reasonable. The fitting of a back brace also was reasonable, although the cost of $210 is excessive. It is noted the claimant has a 90% normal range of motion, and I am sure he would have done quite well with a generic canvas lumbosacral support with Yelcro fasteners in the front, It would simply be more cost-efficient. Addressing the treatment from Dr. Sbarbaro, as reflected in the billing of eight office visits from April 21, 1994, through October 5, 1994, I j,would question an:( further visits after July 14, 1994. Reviewin~ the doctor's office notes on July 14, this patient is described as "doing good" and is noted to have a full range of motion of his back, with negative tension signs noted with an SLR of 90 degrees. Regarding the degenerative changes noted in the cervical/thoracic/lumbar spine, these would, of course, be consistent with the claimant's age of 48 years. It is my opinion, based on review of the documentation in this file, that this patient sustained a low-impact whiplash injury (hyperextension/flexion) with reference 4 Inllmlliollll HeaIIhcare ConIultInlI, Inc. ((I 'HC]l '.Q,80. 7029, Marloll.. GA 300~1029 (770) '26-0062 P,O. Box 42726, ClDciDDIll, OR 45242.0726 (513) 941.22:17 P,O, Boa 16959.W...Ptlmo-b,FLJJ416-6959(407)~1U049 P.O, Boa 56159, PbOClllx, AZ 1507\1.6159 (602) 246-696j ".0. Box 41250, F\, Wortb, TX 7614-0250 (117) 42..3320 Date RE CLAIM * IHC , 04/10/96 JOHN TRAUM 1551562646 01-0044764 to his cervical and lumbar spine, This injury has a good prognosis for healing, with or without treatment. Robert Yanchus, M,O, Orthopedic Surgeon Signed copy available upon request:. 12-G . ' ,,,, ",'.1. , , ' 5 Intemllional HCIIIIbc:arc ConsuItanIS, Inc. ((lHe)) ~.O,Bo. 7019, Mulol'.. GA 30065-1019 (770) 916-0062 P,O. Box 42726, Cloclalllli, OH 45242.0'/26 (513) 1'42.2237 P,O. 90xl6959, W... Palm o...:b. FL 3}o116-6959(407)"....049 P,O. Box 56159, Pbotlllx. AZ 8$079-61'9 (602) 246-6963 P,O. Box 41250. Fl. Wor1h, TX 7614-0250 (117) 421-3320 Datel 04/18/96 Patient I TRAUM, JOHN T. Page I 1 Provider SBARBARO, JOHN L., JR., M,D. ORTHO, ARTHRITIC AND HAND SURG GSB BUILDING/SUITE 620 BALA-CYNWYD, PA 19004- ( ) File No. 01-0044764 Provider Charges/Reviewer Allowance Date Code Service -------- ----- ------------------------------ 04/21/94 00000 INITIAL CONSULT-COMPL EX 04/21/94 IJOOOO LUMBAR PROSTHESIS 05/05/94 00000 O.V,-COMPREHENSIYE 05/19/94 00000 O,V,-COMPREHENSIVE 06/02/94 00000 OBUS FORME/UPRIGHT SUPP. 06/16/94 00000 O,Y.-COMPREHENSIYE 07/14/94 00000 O.V.-COMPREHENSIYE 08/31/94 00000 O,V.-COMPREHENSIVE 10/05/94 00000 O.Y.-COMPREHENSIYE Charge Allowance ------------ ------------ $250,00 $210,00 $90.00 $90.00 $92,00 $90,00 $90,00 $90.00 $90.00 $250,00 $210.00 $90.00 $90.00 $92.00 $90.00 $90.00 $,00 $,00 ------------ $912.00 ------------ $1,092,00 =.::a::&:Jl======= =====:=:&:1:==2:1 . The narrative contains the rationale tor denials listed. in the recommended allowance column. Allowances are the actual billed charge and are not the prevailing rates for that geographic area. Prevailing rates are available upon request for most therapies, , , ' ~ I l: .'A'....NY 111....0 DR. ANTHONY G. \.NCENT CHIIIO""ACTo" aaoe .L..fGH ..,_.It k~'-"" "r;Jr, ~ < (J . '" w.....--,,<_, 9'~ .. "-- Mi."" ....... ~J@ ~~ T:(4! !--. ~~ ~' r-, ~ ~~ , ~!rA,[t~ " , ,< .TA'......T 11.....0 DR. ANTHONY G. VINCENT CHlltO,"ltACTO" ..0' eLllClH .'.IIT .H'........H'... .~ ICf ,.Z3 ~ ~~.~. d0~~~. IJIr If 'tL~ .'A'....NT ~~.....o DR. ANTHONY G. VINCENT CHt"O"""CTO" ..0. .t.ltO" 1'.11' (lJJ ~~_.... .~ - ..3 () ..9'.3 '111' 1'""'''-' c-/ (})~ ~M_~ V~:2-~ ~ ~~~~ . ~;frrJ~ " , I: .. "A'.W.HT nl.lltO DR, ANTHONY G. VINCENT C:HII'IO~""'C:TO" "01 ....110" .,.. 'M'''.D.'''M'. - " .... ,'1 . :;2J ..V ,...y~:s.q ~, ~ 'j:). '" -&-:--:. ~ j/q'A- V ~.'-~ '... ' 'i/ II,L, , '.;1 . ,l , , ..,..,....N., ua....o DR. ANTHONY G. VINCENT CHI"O""ACTO" c3u,~ I. 'I I ~ V-~c~~...2-<F~ ~~ o:::y . ~ ftJtJ~ ,. .TAT........, UI....O ,I DR. ANTHONY G. VINCENT CHIROI'''ACTOI1 a.o. ...IIGH 8TIIIIIT ...'....D.L"MI.. ...~.. (-r Q~ f,../....:) ~ ~ 0~u (/ 01J... '-''''TJ~~ ~ . -/h~f/~ " ,-,,', '." /~~~ &~ /?~ ~ ~59/fJ;J.6dY' ..'ATINa"", ~~2,U&O DR, ANTHONY G. VINCENT CHIROPRACTOR .tso. .LIIO" .'.In '"'L'O"""'. ..~~., tf r c.. c..~.) I._~/ ik-~1JJli, Q> ~~U:J ~'D ~, . PfAtl~ .. '. . ! r'. , I r From thl) nfflClll)f 'I hl'l11n~ .111,..1111, H f' REI 'I1A'"I, IIJIIII.lR. "'I^lrT 11 fI 8540 6/22/:1/ - Pntlent secn t",lny. Ilo'r,!, to I", .., ""'" , 1." I'''", worl, Injury. No i m" r" v c m c" t. S tiff n" ,." low c r b a c k, R f r, I, r. 1 /l"" I ".", r" m I t Y a till has b"r"tng "cnsatlon, ~w~lllng ,,, right "1'1"'1' '''.''...'''lty haa sub s i" c ,I , I' n tie n t do f n g ex c r c f "e s "t h 0 111 (' II" ,,, n I r" c t ed, Exsml"ntlon fs Rame aR nt prevfou.. eV'1JlIntfo", P"t'~nt advlRed to conti""" cxcl'clRCS at homc; tllk" Vitamin nr" ~() "g., rx given; r e com I" C " " 0 h " A f () r m b r II c P, P re! ~ (' rIp t Ion >( tv,! n , J. " ,t,1 y. n I urn b 0 9 a era 1 apine ""pporr wns appl I cd to lo,"cr back ,1J:1!a. I'H (p,nt ahould con t I "",' w 0 r 1'.1" g . Pre f." 0." I" r c"' 11 I " s g" a r de d . I: e t>l T." her e in 8 wee ka, T,' If",' diet.. lIot ,"('ne! 8/24/MI - Patient re-evaluated today. injury, Working. Pain In lower back. Patient Is doing exercises as adviaed, Discus.ed diet and told to walk. Keep 50 mg., b.1.d.. rx given. Return in 4 He iR r, montha post work Some daya wors~ than others. Did not get Obusform brace. working. Continue Vitamin 86 months, TJ/fmv diet,. oot read . l'" I.. 11111/11.., rntlent R~en todny for re-evaluation. II~ ia II month, po.t leci,!c,' ~ C"".pLnlns of lowcr back patn with ~1.l:h~ len r~ln nnd. numbner..' In right foot nnd toes, Also hl\~ right" rt,. 1'0 In. rJo t hell'Ap\ or m.. ,II c" t fans. \oJor ~ In!!. J.umboAlI c Ie,' I ",1" .'.0' "r e~ Io'nll eXaminr,!. Cont [l1l1e worktnp,. Prognosis remllll1rJ fP' ,,,In,l. Return here in 3 mnl1tlo.. TJ/fmv d t ct.. 'I<, t r e 11" cc: Krtnppr (~rollp Patientl Traum, .John ':lintl. n ^ 8540 . 6-13-88 - The patient wnR aeen for a follow up ~vnluntlon on 6-13-88. This patient relates a situation that developed at work, He waa apparently working, throwing 8 ment trsy Into a grln~er and In the performnnce of this ~ctlon, developed severe pain In his bnck, He was rendered almoRt Immovable secondary to pain. He waR unnble to contlnne working lifter te Incident, He was seen nt Snint Hnry emergency room, He h.d X-RAya nnd wns referr.d here. X-R.!.l.!: Were rrvl ""ed. 1'h..y wero done nn r,. A.. ilII. The fllmR offlclnlly wC're rend l1A Il('lRntiv,'. I,PIJf\'pr. [ ''''nH con c" r n e d n h 0 1I t the r Cl R S t h t 1 i t Y 0 f nAp 0 'I cl Y I C' t v f' l~; II r J, -. 5 . .l'hyslcol Examlno.!.Lon: EXAnlinntio" toclny r"vl'nl'l tend..rnesR to palpation of his Illmhar spIll". Tl,e I,,,,,,.,lve rang" of motion of his Jomhnr spIne is pnlnfu!. n,,, n"tive rang" of motion is decrraRed, lie 19 onJy ahle to flex 30 degreea I extend 10 degrees, rotate to the right nnd !"ft 10 degrees and bend laterally to the rIght and left 10 "efree.. 'rhl're was rigidity of ti,e lumhro9ncral Rpfne in mtlA'~1I1nttlrft. 01111 III wfrl' '"n. D I_!3.E_~~j.tl ~~! : I. 2. 3, CnnllnlJe rpo::;l:tIlP:lt J'f'''I':'. ret.urn ,." \.rnr!( n'l (,-III :~(', K ('I (" I' r (' r." , :! r n r II r) I "t It! f' 't ~ . fJhrnlll new fllms lo I'h,.,-I, rill t.1,e pOSBIblllty of III",'"" " po n d y 101 y B I R . r t. '.R ,. II "..'" nfter fJ 1m iB done "11" r..' ',:" phnne call from thIs office nftor r review th~ films. I;. TAJ/m. diet" not read. 6-16-R8. ADDENDUM: T"!.. I.. an1ddell.llIm tD IIl)tea wlllell )"", h;ve received of 6-13-18. Hr. Trnum wn~ _een In "or offLce for n ,,"mp1alnt which orlRI'lat",1 on ()-8-88. Pd. mo"" recent Ineldent "3t1Qed an. Acerbation of h!oJ exlstlnfl condlllon. Nr. Traum Inform~d ""r "ffice that h. re-Injore.1 "''''II'Jf nt ",,,Ie on (,.I1..IIR nod tl',H hc r"r.nrted the Injury n two d< nil d \1'1 <t t a Jr. e 11 I:'.l ~l.' i ntH II r y II n r~( t ., I., ""..1 ~ t r t" n t e d and r e 1 e a 8 e d and r,'fcrre" t,) ollr off lee. Plense note this informntlon In re.arda to pa'lent' s c 1nim. TAJ/ms I diet.. not read. 'l't ,,~ i FIll'", II,,, "Jfice 01 ., l1"rn(l~ ,}n'.',:!" 1.1 " Pat lent: .John 'rraum Cl1l\rt # ^ 8540 3/] 1/89 - John TraUm wan rc-e'lilluated in the "fUr-I? on 3/13/89. Thh pdti~nt is :! }'<:>nrs 1 month p(1r,t: worl: related injury. Pat I.ent in current I Y wr)rld,nq. He cont.! 11 II Nl t.o experience low bac-I.: paln, right <:Il:m p'lln ;In,1 numbne~s nnd r.i ght leg pain and pal,. I'lCrOFfI ,'ll.l five tr)es of the rl.ght I'oot. I'iltient relates th.. ~ h... IIn s been Sl''':!! n'} fl ch l t:'npract.ot' ;'\IV.I Iwltw I rnprovement with t.hli' t-r"n':l'l')I\t:!;. F:~:il,"lnatloll of thE' <:l~rvlcnl ",nd lumbosacral I'ph'!Cl n'VE'flJs tend",tnl'!W3 to r;,Jpation. lie wan limited range of mot Ion. I'rll1noflis 'JlIilrded. ('(ltItlnu"l ',{ot'I:hHJ. Return to this of( lee In 'j 1~"nU1s "'I: rp-e'~:III1;.tl"n. TJ/)g dicL, not read 8/1'/89 - ,John Traum WilS seen in the offiCii! for a ,follow up visit on "/14/89. He is approximately one ynilr nJ:( ~lOnths post work rel"ted injury. Pat lent is currently w"rldncr. 1\1- torlay's 'lisit, the patient continues to have 1.ct{ t"Ie-I:. p~i", " ,. ;,..,1 FpllH! pilin and left ilnd right l"'g pain. Ex,'mll1.1t:h" I,.. lPl,h'''~nr:I'nl spill'" reveals tenderness to p.,lpatiol). J1p 1'.1' I ,jl",1 l.:r"Jo of motion. There is tenderness t.o pa.1r"t'!o:" :~r t.,. "",":.inll. npine. Patient is encouraged to contitlllp. ,y-,:I.lnl'ip., ,,,,- pX'3l:cise. Pro'Jnosis gunrded. Continue working. Ruttan to thi.n office in 5 monl.hs. TJ/.Is dicI'., not read . Fwr" Iti, ollie., (Ir 1110mB!! Jovian. M.D. Pal i'mt: .John Traml '"hart * A 8540 12,'11/89 - John Traum was seen in the office tor re-evaluation on 12/11/89. This patient is approximately 1 year 6 months post inlury. Patient is currently working. At today'. visit, the pai ient continues to have lumbosacral spinel pain and burn in.;, sel'RAtion down his right lower extrem.1ty. EX"lmination of the lu~bosacral spine reveals tenderness to palpntion. Patient does nol receive physical therapy treatmentn. II'? dons not tal:e any me,1f cat ions. Prognosis guarded. Cont I. nlln '"nrl, i 119. Return to thJs office in 6 months. T,Jj in di('~., not read . TJ/Js diet., not read 10/29/90 -John Traum was seen in the office on 10/29/90. He is apl'roximately 2 years 4 months post work related injury. Patient is currently working. lie continues t,o complain of low back pain willI the pain going down his right leg, lie does not receive php;ica 1 therapy but does exercises at a gym wh Ich he has joined. Expmination of the lumbosacral spine revenln tenderness to pa 1 pat ion. lie has flex ion of 40 degrees, extp.JJ'3f (Ill of 20 degrees, rol., t ion to the right and left of 10 del/roN'!' ,me! I fll"lI',n 1. pending to ~he right and left of 10 dE'grees. Pa t h"lt tn 1<1 to continue exrrcising and to use a step machine. Pro'!I":!: I." J:!?m<lillS guarded. COld: inue w()J:"Jdng. Return to this office in Ii ,"""ths. It', ~: , , i! '. From 'he office o' Thomas Javhlll. M,D, Pal ient: John Traum Chl'trt # h 8540 6/J8/91 - John Traum was seen in the office on 6/18/91. He 1s apl'roximately 3 years post injury. Patient IEl wl')rk1ng. He co,'tinues to compla 1n of constant pain j n hi r; 111mhosflcral sp.lne Ilrn, , lie has been doing exercises Sllch as lJr: I n', ~ :<lbO'p machine and ~"'lIdnq. Examinat.!on today of his LlJrnb~I"'T"1 !'p.il1'1 rr,venls tep,l",rnNJR to palpntlon. Passive rang€' ,)( 'I"t h." j" painful in thr r>xtn>ml?FJ. hctlvl? rangn of motion I..; c1"CI:I"ltl.?d. He has flr ~fon of 40 dcgrlJcs, 'O'xtension of 20 d,'grf?f'n, )"ot,.t1on t.o the r!'Jilt. ilnd l<?ft of 10 d<:>grees and lateral b<;\Il,II.rl'I to I'lln right and let t of 10 degrees, Patient encollraq<!!,l 1(, ('ontinue with exrrcising utilizing the step machine, mdm 1'11<1 walk. His pr€'1nos is should be considered as gunrded. continue working. Thr patient will be seen back in this offira in 6 months. TJ/ jl1 dil't:" f1(lt "(';'lei ,. ; I.;., I , i\' . JOHN ';, SBARBARO, ,JR., :\'.1), f16~..'C)~C) .........,1' ,;'"\ '\. '-=,...."_" ,["':illllll" "-'it!! f:IIl' ~~. .8'/1/11'1/1 ,:?,.,IIII<" Suite ~20 .81r/,"l...'"IIIIII,I, F'"II.III/' I"".' 1~'Ql"..J i\ P r:. _ .~. 1, :! I) '. Roger Harrington, Esq, 1260 One Penn Center 1617 JFK BouleVard Philadelphia, PA 19103 Re. John Traum Dear Mr. Harrington. This 46 year-old man states that he was involved in an accident on 2/7/94 when his car got rear-ended by another car. The i~pact wa. of such magnitude that he broke the steering wheel and the ear was rammed into a snow bank. He was seen in an Emergency. Room because of pain in his low hack wit.h riaht le'l radiation, He <1130 had some brulsing J.oout the rlght :orcdrm dll'J r.110 In the neck as well as multiple aches through his body He was disorientad for a period of time, X-rays were obtained and he was detained for a number of hours, primarily, for observation. He then consulted his chiropract.or and had some treatment which was of limited value. The past medical history raveals that he ,nJured his lower back about 4 years J.qo when he was carrying ~ tray of meat. Ye W~5 treated with chiropractic adjustments and this appears to clear up most of the symptoms I however, he did have occasional aching in his back but no radicular components and the symptoms were manageable. He continued to work as a meat cutter. Three weeks before this current accident, he was. involved in a motor vehicle accident I however. he was not injured. The examination today demonstrates that the neck has 90\ mobility with pain at the extremes 'If motion. The lumbar spine has 90\ mobility with pain at the extremes of motion. The rlght sciatic notch is tender, the right straight leg raising sign is positive at 80' and the neurologic profile is otherwise unremarkable. He does have an 5-l distributlon through his right leg and this lS an ominous sign. This man has an acute cervical strain and an acute lumbar strain with Iradiculopathy incident to the accident of 2/7/94. I believe that a herniated disc has to be ruled out and, accordingly, I have scheduled a lumbar MRI. I have fitted him with a back brace and I have given him a prescription for Day-Pro. I would like him to return in 2 weeks. ~fI.liy s.l..r!..cer~l:!' " I /l/ / j. - 7"" '/ ,.--, (, -.....AL /1 - (~L\~ ,()J1.6.-' /J 0 hilL. S bar bar 0, J r., :-1, D , JLS/sh Dictated, not read. a .tAU....n ~~.....o DR. ANTHONY G, VINCENT C:HtltlO,.RACTOItI ..:1$' '0. ....... A ..... ")) cdc dj ~ g-.J @ .. ~ ~I 6-t& , Oft,Ft-V~ C?. ~\ . I1AUM'NT 3111....0 DR. ANTHONY G. VINCENT <::HI"O"".<::TO" ..-1:Y ~-~ ~c...f-ro j:)~ ~ , DRA'V~ a ITA""'NT UI....O DR. ANTHONY G, VINCENT CHI"O"""CTO" .Ioe .~'I." ITIt'IT ~MIL.D'''PMI'''. ""'!' II I.?b I ~ ~~c)~~~i':Y)}. I ~.~ ~~.2~ f}~~ c:r? .:;2/3 U.Jn) ~~ .' IT...nlllt,.., :u....o DR, ANTHONY G, VINCENT CHUIO,.'ucrOll nOI ILoilO" "...., ,,",......O.L...HI.. '10, I.I~ ,S'..:a ~o. ~_.allo~' . ICIa : ~( _ -/-, ~ tns- ' . ~~ ~~/ - . . / ' D~~ c; ~~ 6- .A'd.-~ crr;z.13 j)ff A-(j ~~ I. I I 1 I ~. a "ATI"'NT n.....o DR, ANTHONY G, VINCENT c:HI"O"....c:TO" Iloe 1&'110'" IT."T ('i=':~~..:d (? .51QD VD'.,/! ~ ~ ~ CfJ!, . '~~ ~cf~ A-"~ a CJ () 1 r:2l3 ()fI" It Vu~-\- . .,..,......y n...." DR, ANTHONY G, VINCENT CHlltO"''''CTOlt la. .....,." .'.'1' , ""...D.....".., .... ..~. l+-''55' ..~ I .oR -A- tJ~ . nATI".N" ~u....o DR, ANTHONY G, VINCENT CHIIIO,""..CTO" 11011 ."lIle.. .1'... ~''''D''''''A' ~A. I.'~ _ V I ~!L~ I 'i- <f?~0 ~ It, ~ r.s-v-u j~ft,ti . , I ", ,. . lun".N' ~u....o DR. ANTHONY G. VINCENT CHINO"""CTO" Ilot ILIIO'" .'.IIIT 'M...OI.,MI.,'. '....y_ 1.5 a~ / ~-~ ~~.s:'1'cd-J#O~1k /' ~~~ IT ~ (JcJO 'fer A ~ t'f/.!tV~1 . I '. a . .'.n....HT ,u....o DR. ANTHONY G. VINCENT CHU'O,.....CTOl't 1101 '~'IOM "..1' ....IL...DIL.~"IA,~. I.'. ,'J~- ;;V-:f~ I CJf.9..- t -r-~ Ar~c-&-o 1 r ;2.I3 pAvL,u~ " , a .Uy.....NT UI....O DR. ANTHONY G. VINCENT C;HI.O",UC;TO" 110. l'-IIIlIM ".'IT ."...oa,,",.. .. "~. ( ( I.[g . I a .'4"...1"'" 3U.95S0 OR. ANTHONY G V cHI"oPRAc;o"INCENT oliO. ."'_11)101 IITlIt.I' ..1ot1"'.D_"~HI4...... ,....u ~ c-(.'\\~. 1(, ..YJ V' _h~ I ,.J ," I I <f- \ " t r ~~1f~~-#- JffJ~' , t . ~ . :~ .. -. A"~~ i?d7f3 prr H'V~ -. . . - . . . . . _.,....~. . . , .' '1 ~ . ~ _ ,', ';'. it i I 1 ......,.":.! ',',:.: , . . "'.;.~ ~ . -. ,":-:: "'~'~~" : \ \ ...~ SAE TECHNICAL PAPER SERIES 930889 Analysis of Human Test Subject Kinematic Responses to Low Velocity Rear End Impacts Whitman E. McConnell, Richard P. Howard. Herbert M. Guzman, John B. Bomar, James H. Raddin, James V, Benedict, Harry L. Smith, and Charles P. Hatsell Biodynamic Research Corp. ~ 3) > Reprinted from: Vehicle and Occupant Kinematics: Simulation and Modeling (SP-975) ') ':e; "\ ~. ~ ~~~" ,;.1:\,\... _, ; "1 ~..." l. " _ . ~:. .~,. ; ; ~ ~ ~" .,~ Ie _,~, . . '. . .. ~ " ' I .AII!! The Engineering Society ~ For Advenclng Mobility ~ Lend See Air end Spec" ~ INTERNATIONAL International Congre.. and Exposition Detroit. Michigan March 1-5, 1993 400 Commonwealth Drive, Warrendale, PA 15096-0001 U.S.A. Tel: (412)776-4841 Fax:(412)n6-5780 930889 Analysis of Human Test Subject Kinematic Responses to Low Velocity Rear End Impacts Whitman E. McConnell, Richard P. Howard. Herbert M, Guzman. John B. Bomar, Jam.. H. Raddln. Jamal V. Benedlcl. Harry L. Smith. and Charle. P. Hata.1I BiodynamiC Au.arch Carp. ABSTRACT The b"'ld. nec:k IOd trunk kinemallc r....ponses of fOUl volunteer tC61 lubjec:ts. rocorded during a ...ri.... of e.perimcntallow velocity motor vwcle collilionl. have '-n measured and aoalyzcd. Usinll da1a obtalDed from multiple lugh speed film. video and elec:tronl" o<:ccleromclcr lIlC&IuremcDlSof lbe teat lubjec15. it w.. found that the actual kiDematic rcapoosea Df lbe bUDWl b"'ld. neck and trunk that occur dunnlllow velocity reareDd collilionsl1e more comple. than previously lbougbt. Our fU1dings indicate that the lime. honored deacriplioD of the cervical .wluplash" r"1"'n... is both incomplele and inaccurate. A1thougb the classic .wluplash" neck re"ponse 10 ,earend collisions IOd lbe Widely ."""Pled hyperexlenslOnl hyperllexion cervical injury mC'Chanlsm bave ~n e..enSlvely wnUen and speculated aboul. there have '-n l'lIle human e.peomcDtal data available. c:.1JCClally for low velocity <ollisions. Low velocity collisioDs .re defined in this report as molor velucle collisions ID which the ImpacI relaled chan~e of lbe rOlltended velucle's velocity (AV) is about 12,9 kpb (8 mph) or less. Througbout n...r1y 4 dec.ld.. of expenmeoud <rash testIDg. low velocily D1Isbaps (as defined above) have booen felt to have a minor IDJury causallOn polential and have remained. relalively unsllldicd .r.... The absence of good experimental data. ,,"uralely defining ,...1 occupant klnemallC respoDse during thi. co~n type of tr.mc .celdenr h;os spawned a plethora of I divergent concept". Id...., and speculahon .bout possible injUry mechanIsm,. ID February 1991. a ""oos of vehicle coll'.<Ion tesl< using fully .DStOlDlCDled volunlcer human te.,t SUbJ":I/dnvers and a Hybod III malukID p...senger w... conducted, ullllL1ng looal te.tlng f",ilito... ThIs project WlL' underuken 10 heller define human, dummy and veh,de '..pon,",. dunng low velocity collisioM. METHODS VEHICLES - Four \cal velucl... a 1986 Dodge 600 convertible. a 1984 Bllick Regal Limited coupe. a 1984 Font Club WagoD VIO and a 1984 GMC 1500 pickup InlCk we... prepared for the \cat protocol. Eacb vehicle was witboUI evideDce of colliSion ItrucNraI damage IOd wu in loadw,,-rt.by condltioD with fllCtory sl&nclard equipment IOd parl.s, The convertible IOd coupe bad fllClory ltandard eoerllY aboorber bumper systems. and the lrUc:k IOd VIO bumper 'yllems we... ngidly mounled to the vehicle frame,INeIll"'. A1thougb eacb vehicle rcmained in slo<:k condilion 10 the lIIUimum e.leal possible. the t..ting protocol required a number of modificalions. The teal subjec:ts !wi 10 be pbotograpluca.'.ly accessible. so the upper portion of the Ford VIO', left B.pillar and th. fronl doors of eacb veiUcls were removed. 1bc rear window of the pickup lruck w.. rcplllCed with a .maIl lelia panel. and headr..ts in the convertible IOd the coupe we... kepI 10 the r.,sed P05l110D. Several mounllng points for lugb speed cameras we.. IDstalled on each vehicle, Eacb vebicle's ongUUlI. f"'tory standard 3.point re&lraint system was used throughout the 1..1S. Vehicles were checked prior 10 ~.ating and any bumper ....mbly damage found .... repaired with new parts. TEST SUBJECrS - The propooed teal prolocol was evaluated by the Univer.llty of T.... Health Scicoce Cente, Inslltutional ReView Board IOd IRB Protocol 19010099006 of lbe University of Texas Health Science Center. IL1dcr DHHS Resulahon 46.110(3). approved the use of iour bUmID leal subJ""ts selected from the staff of Bllxlynamic R-..:b Corporal ion in tho tosl seo... Four bealthy volunteer male 1..1 "ubJccts. nonging in age from 45 to 56, complCled Prll- 1..llOg phYSIcal evalual1on. lOeludlng radio,rapbic ima,in, stud,e. of the cervical. tho"",ic and lumbar regioDS of lbeir SplO". T..t .ubjec:1 marking for photo,raphic analy.i. ,nduded a sllff "U" sbapcd yellow roo altached to an IOdlV.dually filled bileblo<:k and accelerometer ....mbly UId onsnted rearward on both .ides parallcllo Ihe aluminum ..rip l;onnechng the acceleromelen, and the dos.d 21 man.Jlbl.II1llUIU.. Th.,. ....., II,):," II ph"hlW'"phl<llU, 'lS,ble mark pl..,.,.,j bo:low an.J .Ii~blly bo:bm.J lb. left <>1."",1 auditory ..:anal over the: m&5h>ld rronun.enc~ 6L'i an IIpproxlmallon of Ih. IlIt.,aI proJ""",,n "f lb. oppe' .n.J of lb. cervacal liplne. Reference: marks \Iol!re appliC41 hl the !:.klO 0'''' lb. leot .0bJ""r. I.ft n""k. ,.mul'"n~ Ih. IlIt.ral P,oJ",,"on of lb. c.rvi~ spin., Tug.ts ....r. pl""al approxima..ly 0'.' lb. I.ft gl.nn-home,al JUlnl an.J lal.",1 left .Ibow on . lighl fillin~ ~.'m.nl ..om ov., lb. 1""0 an.J arm:;, A Hybri.J 111 anthropomorphic 1....1 .Jommy ...... tillal ...,Ib a blleblo.;k IYpe e.:cel.,omet.r L....,mbly an.J ha.J ..mllar n~bl .i.Je ....toaucal ...f....n'" p,"nl markln~. .ppli..!. ...ith the .Ic.phon of the Ilommy'. a1ro:a<ly exposc<l n""k u",", INSTRUMENTATION - Eacb v.hicl..twh Inallal LSCB.IO ace.l.rome..r array mounlOO on lb. v.h,d. frame h, m....or. 01 Uorwarll/,earwa,Il), Gy (nwhl an.J lefl'al.ral). anll Gz (op...ull/Ilown....rll) mollolU an.J a bi..i.1 ace.l.rome.., array (GI anll Gz) on lb. .1m.,'. ,..1. """tback. Conlaet ....,.cb operalal nash units ...r. inslall...J In vi..bl. po.illOn.s In .110... pbolnwraphlc hm. marking of iilll,.1 bomper 10 bumper contacl anll . sunilar cnntac. ....'Ich coal Ihe d""lrolUc <lata 1C<j0lSilion .ystem. Allllllinnal in.trumenta.,on 10 "",,mpllsb olber t..t obj""t".. "'L' .Iso m.tallal on the v.blcles. Tut subjeclan.trumentalion inclu.J...J . Iightw.lghl lriaxi.l .""I.romel<r ....mbly of En.Jevcn '7290.30 anll End.vco ,729Q..10 accel.romel.", moonl...J on . .hon a10minum s.rip fixal 10 an andividually f.bn""lal moulh pi"". (bit.block) ...hi<b. wb.n held ...11b normal j.... <10'0'. pressure, allowed DO Ipprcc:iablc: relative motion hetv.-een (he: acc.l.rom...r ....mbly anll Ih. I..t .ubJ.cI" maxilla/mandibl.. An Id.nlic.1 acc.l.rom.ter .rray mounlal OD an. aluminum strip was affixed in an equivalenl posllion on th. Hybnd III maRlkan's h""d. A biaxial 1I"".I.,omel.' asscembly u.si.ng similar ~n50f$ was affaxecJ 10 a c()rset.lik~ ga~nl and was worn by on~ test subject during two of th~ tr;st runs 10 masure Gx and Gz direction accel~ratlOn. EI~tronlc c1&ta Iransftr dunng test runs was aCl.:omplisht:.J by . .IIding loop umbilical bundl. cOMecle<J to a PAC.58lx) high ,olom. wta IIcqul5illon .y.l.m housOO n..rby. PHOTOGRAPHIC EQUIPMENT -- Pholographlc documentatIOn of I~'t runs was accomplished hy ~v~ral Rallak. LoC.m Modd #51 high .peed 16 mOl camera.. operated II 500 fro.... per ,"",onll (nominal) and "'lOlppcJ wilh an LED liaunW IIghl ope'allng at 100 h.nz. These cameras w~re mounted at various loalions on the vehicle."i and from sev.ral filal poSlllon. .bout th. I.st .il.. On. high .peed VIdeo unll anll 5<,.,.1 lripod RlOunlOO ,un<la,1l Video ~mceras also r~ordtd th, ev~nt.'i. TEST SITE - The test .". ....... ..,(abll.hOO on a 1.,e1 ."",Uon of a slan<larll. .sphalt p.vOO ro.d....y IIn.J ha.J t:1~lronlc s~ trip Inslrum~nt.UlOn IUlJ high sptx.J VIJ~J lrackln~ WILli near realtimt: \idoclty ma.'iUr~mc:nl capablhty, Impact speed reproducibility WtL'I ..It.:hle\i~ hy th~ U~ of .. 'ipa:I.lIly conilNctefJ ramp permlltmg gra'o'lty 1I.(l.:c:Icrarlon of lh" 5tnk.lni vehu.:le. The Sinking vehiclc's st.utang pOSitIOn on th. ramp WilS c.ahbratoo hdor~ Ut.;h l~sl run 10 (nsur~ thai th~ rc:~ultlng velocity ill Ihe: Imra~t pOint WoL'i In Ihe Jl!Mrcd ran~e:. The lii.:tWlJ dO."lur( ~pt.ws anJ ~ull1nll d'1&lIg~ In 't~hlClt:,. of huth the .lnklD~ an.J the struck v.hld.. .Jo"n~ the teot runs ...... """urolely .Jol.munal by hl~h .peed film, high sp<>al Vld"u an.J the .1""lronlc .p<>al trap WIth ..llsl""lu,y .g,,,,,menl. f1,~h sf'<""'! came.... un lb. v.h.d"" anL! AI thal !\Ite pt.)/Iillwn!t wtr~ Ill.:luahou by . I.;altraJ eh,~.,.:Il'\)nl": conlrol and lb. >1.100 <ame..., ...... "onlrullal by IOLilvidual operator> re'lponuin~ Co IUUllory and VISuaJ cua. TEST PROCEDURES - Teol runs ...... conducted &i:4.:Ofuing to . pn)(ocol which le5toJ . variety of combi.n&tioD.l of v.hicl. to v.hid. coUi.ioM and expoaed leat .UbjClCII 10 hulb .Inkin, and .truck ...1... .Jurtn, teall plannod for . forw.rd .Iruck v.hicl. t. V uf 4 kph (2.5 mph) anll 8 kpb (5.0 mph). Th. .Inking vehlcl. ..... back..! op the ramp by lb. tesl .ubjecHlnv.r 10 . ~culated poallion and ..Ieaaod ...ith the transnli..ion 1II n.ulral an.J lb. enlin. running. It lbm rollal down the ramp and through lb. impa<t poant spo..J !rap wb... the v.locity ..... n:co,dod. rbi. proc.cdW'll wu r.pea.OO unul the d...."al impa.cl or-! ..... reproducibly ..:hi.vod, Th. ,.hicl< 10 bo: struck ..... Iben placod into i15 ..(all<lnary po..llon at tho Impact pollll. The stnkinl v.hicl. Iben rollal down th. ramp and ov.r lb. l.v.1 pav.ment to the 'mpact polOl. N" v.hicl. rontrol inputs ....... nlade durinlteal tuns, e~cept (or minunaJ steering lnputs to ensure cc:atcrlinc conliel bo:tw""n vehicl.., and 1.1. brakin~ .ft., the teal impact perturbations were OV(r. In !WlmiifC&5e5. to prevent an over or unll.rTId. .itual,on. th. h.'lbl of one of the two ve.b.icl.. ..... oI.v'l..! by the os. of wood.n p1ankinl ...hicb formed an oI.val<<l ruadbed. Aft.r each tut collision. the driver'. phYSical cond,"on "'L' check...J. poaHeal pholOlr.pbic .......'sm.nl of ,.h,c," wma~. was rompl.ted, anll .Ieclronic te.'\t re..,ult c.1olt.a stnraHe: WIL~ &C4.:ompllshlOd. Da.ta from leo mannoo ve:hll..:l~ to v(hlde t~'il colh'ilons were recorded. HEAD, NECK AND TRUNK KINEMATIC RESPONSE ANALYSIS - Th. purpo'" of this article i. to r.pon our fmdings aft.r a d.lallal analysis of buman bead. n..:k and lrunk kin.mall< '....pon...' lXCumng durin I and IInmal,alely aft., 10... velocily ......nd impa<15. R.I.vanl<lata mclud...J the recor.J...J G.lIme mformation from lb. buman and v.hlcl. mountal """.I.rome..",. displacemenl.lime llaIa taken from lb. hlgb .peed film "",ord anll lb. .10... molion video reco,d of each t..,1 .0bJ""'" mollon durin, the collision sequ.nces. Th. .Ieelronlc G mea,'u...menl<lata..... proceuod into. u....bl. form w,lb .moothin~ 10 .liminal. noi... artifac15 and '.ry .hon I.rm lran".nL.. Biteblock O.time vClClor resultanL. ....r. ~culal...t f,om O~. Gy and Gz <lata recorded for ..ch colli.ion sequ.nc.. In o,d.r 10 oblaln lrue (earth onho~olUl) G 'eclor ,..ultanl<lata, malb.malle&l coordinate Iransformalion WL'i done to ,"(Junt for the curviHneuly .JlSplll<...J path of tho b,l.blo<:k ,ef.,.nc. frame from its inJllal earth ortho~onal orie:ntallun IUIl.l r~ulr~ ullliZlllon of lime~ angl. <lata oblalO...J hy m<a..u,.menl from lb. blllh spo..J film .<<oru. An adJlhonal ~f1~ of malhe-mAllc.a1 maDJpwataons gnc an earth ref(r('n~~ hoL~ G-tune h.!\lory for I point near the Jun<lIon of lb. ho:a<l 1lil.J upper C.rvl~ .pin.. This IOfornw.tlOn \Iw...... \,,'orrdclh...tJ IJIollh pHnl diiplacemenl information (lht.unl!J fnlm the: high spt't:el film by ploUlnM' each ::2 1",,1 .ubj""I'. ,efe,ence poinll (blleblock. ",,"IO'.! p""''''', .boul.!e, an.! hip) \IIllh ....peelIO h""" .. ,...11 &I lbe ,ehacle an&! """kl'oun&! ,efe,ence poUtIl \lIln~ a p""''''''" opllcal &!'~lIlZlnl P'OI:"", CervIcal "Ien..on an.! ne."," an~I.., ,,"cr. &!elemunN Wiin~ &!1~iliz..J hilh ~ film &!I.pl""emcnlll.ot<o. TIle G-lIme an.! &!"place"",nl.tlmc dall \11&5 then currdalc.! an&! lbe ,..uILl ,aladalN by a &!ellilc&! cOlllJlllnsun of Ihc <alcullllld data WIlb lbe frame by fralDl' ,i&!"" m:or&!.n~' 01 lbe impACI ,clalc&! leol aubjocllunemalic '..pon_, RESULTS TEST RELATED CLINICAL FINDINGS - Eacb leal .ubjecl bad f,om 3 10 7 vebicle 10 vehicle le41 colla.iun ..poau,ca. dividc&! belwDCll lbe .lrWnl IIld .Iruck ",I.. &!Urlnl the 10 leal colli.ion ..rica, (See Tat,.. I.) These 1..1 I'\lIIJ \IIere cooducled du""S IWO woeltCll&! leal penods separaled by III eisbl day billlls. No leal subjecl ,eportod havins &!ilCOmfort .ymplOIDl dUrlnS 0' i~ately aft&r any of the leal colli.ions, T..I .ubJecl number 4 nOlod no .ymploms al all ..lalod 10 bis 6 leal ..paso...... BegilUl1n~ 10\11 an&! nu&!.n""k &!Iscomf,)rt over the asu of bia C6. C7 Ill&! Tl 'ertebra ..n&! &!15COmfort ID h.. l"'peZlWi muocularure on the rnomlng follu\lllDg hi. th,,,,,, 1",,1 run. on day 10, Th. p&III \11&1 gone lbe ne'l day. hul he conllnood 10 have mil&! &!lIlcomfo,1 on e.I,eme n""k cAlen..on an&!laleral n..ion unlil IlSnItJually ,..olved &!unnl the ne.. th"", day.. No IreallIIClIl 0' lberapy \II'" needed an&! none of the 1uI paruciplllll bad any turthe, .ymptoms thai ",lated 10 th.ir 1uI upoaureo for I,eale, than ellbleeD DIllOW followioslbe ","linS. PHOTOORAPHIC ANALYSIS OF AN EXAMPLE KINEMATIC RESPONSE - Th. followS i. a deacriptioo of ooe tcalsubjecl'a kinemahe ~ to a typical tcaI (Run 7). &I b. uperiCllccd a forward tJ,V of 7.83 kpb (4.87 mpb). (See FiJllre I.) Ph.lU'! I .. Initial Resnonse (0 10 100 milliUlt'nndsl - DUrlnS the fint ~O millilleCOoda aft&r bwnper impact. the .ubjecl'. entire body appeared moliooJ_ with ref....ce to the leal.ite backSrouod, wbile the vehiel. and driver'.... moved forward about ~ 10 8 CCIltimelera (2 to 3 incb..). At about 60 millaooc.onw after c"nlaCI. the 10\ller pari of the scatback cuwon bad be"",,,,, compressal ...ougb 10 berio movins the Run Teal Slruck T..I Slriker Day No. Subj Vehicle tJ,V Subj Vehicle ::'V No. No, Type (kpb) No, Type (kpb) I 2 Von 3.48 I Convert -4,81 I 2 1 Van 6.45 4 Pickup ~,04 2 3 1 P.ckup 3,04 4 VIII .3,35 2 4 4 Pickup 6.65 I Van ~,74 2 5 3 Convert na 2 Coupe na 10 . 6 3 Convert 8.06 2 Coupe .7,82 10 7 2 Coupe 7,83 3 Coravert .9.24 10 8 2 VIII 6.61 4 Pickup -8,21 10 9 2 Coupe 3.Y3 4 Pickup -3,28 11 10 4 Pickup 7,03 2 VIII -7.48 11 Table 1. Test Subje.t nriv~n Lo\ll Vdo.ity Collision T~t S~ri~ abour 45 10 60 nunul.. r.. ft.r T..I 2. lesl SUbJecl num"", I r~port~ I "rwinae" of d KOmfort at the po~ten()r blL~ 01" hI" n<<k ",b,cb I.."od anoullWo bou,s. Tho &!'!lComfort wa.< gone by Ihe II~ of his partic:ipi&1I0n 10 I~.'it num~r J and JIJ not rl:(ur Iilter. Test suhJt.Ct nu,n~r 2 notw the onStlt of "il.chmcss" m the rarasplnal mu~ulature at th~ has4e of hiS n<<k the morning of leAl d.ly 1 '1. ah~r partl'lpatJn8 In a InW) of 6 IOSI run. &!unng Ibe p,ecC<J.ng Iwo day losl penIx!, H.. ~ymptoms laKl<<J ahoul 4-'s hours and resolv(J Ylo Ithout recunrnce. Test :'\uhJa:1 number 3 reportnJ the on~1 of nulJ leal .ubJecl's hIps an&! low h.&ck forward Ill&! upward (See Fisu,e 2), Al the same lime. the upper pari of the aealback \11&5 n..inS r""rwar&! Wllh ',,"p<cl 10 the vebicle IIld !be _Iback c\llhioll w... belnll comp'.....-J 00 lbe leal subject'. ,1111 nea,ly stallonary upper Ill....'. Ph... 2 - Prindoal Fllrwar&! Acceleralion (IOO 10 200 ITlllIlsccon&!,) - AI aboul 100 nulhlClCOow. !be _Iback bad .,,,,,,Iy rucbod lis maximum r""rwar&! flexed poailioo of aboUI \0 lieS'''' pasl il< no"""l pos.tlon. and lbe leIl subject's uppe' lrunk luoJ begun movemenl forward and upwanl. Tba 23 ~r~ ~\ ~ l~ ~ .-,i ~....., ..ItI'".""" '''~.~'- .jtC. - CIl E o ll:l CIl E o C": </'. E o .' .,\ /'.... )....'~..1 , .l"j / 'I' E /,,/.' . 0 r .. N CIl E o ... N 4 ,,\ "1 ~ CIl E o CO ... r- '" >- ~ .c n; a. .. C\l '0 :; o .c '" ",,"g -Ol ilia. ~o .:.~ uC\l "c ~o -C\l '-0 :~ a:- OC\l _E CL) ';' Ill'" c~ 00 CIl o..c E .,,,, C\lC\l o ex:-; C") ,!!t3 (') 0..- e;: "," '" "' w...J ~ai a...~ ..- ='.c .E't u.:ll C\l .. "' '" C\l ~ "Q (5 oi ~ CIl E o r-- N t 03G Om. 60 m. lOOms a'l (\ 2JG --- '---...!/JG -.....--. 2 J <J ____.43 G 120m. 160m. ~OG !17G O.IG\ . 200 m. 250 m. 300 ms f1"ure 2, 350 rn. 400 m. Head, Ne.;k and Trunk Ro:sponses to Low Veloo;ity Rear End Impao;t S1lbjec", bead and neck were .till almosl slJlt'onary wllh ...peello the earth Wllilaboul 120 mill,"""onds when, ..s the subjecl'a IUp. .....d lrunk rOle upw..d on a path parallel 10 the rearward nexed oealback, his neck appeared 10 he ...ally compr..sed and .Irailblencd as lhe lop of the cervical 'plDe belan DIllyinl upward ..d rearward wllb r..peel 10 the forward IIIOYinl yehlcle, Subsequenlly, the subJecl" head belan a biteblock upward and rearward "''''"nl moyemenl with respecl to the .ubJecl's .houlde". By 160 rrulhseconds lb. forward and upw..d m1,yemenl of the sunJec"s L'lUndlnl upper lono had bolun 10 pull the hlL.... of his neck forward lnlO .pparwnl ccnsiml anJ ~LarttnlC Ihe: furwlntJ mohon of th~ rubject's head. eVen .., hi!l cx:c!pul continued II) lip uownward lowllds lb. acal headr"l. Ph.... 3 . I WIlL Ove""""Mrorso R<enyery 1200 In 300 miIIiMlConc.1~) - AI 200 mllll!ieCOnds the! upward moClon of the aubJec:I'S lrunk and should,.. hlll.l c....<ed after ahoul 9 ccnlimete" (J.~ inche.,) of n~ and th~ ~llen~uon .\lI10 10...110081 anll"lation of IU. had had .lopped aboul45 del...... rearward from yertlcal. The subjecl'slOp oflbe """,ieal ",ine mark., point had "...n aboul 1. 25 cenliDllOlen (0.5 iDcIIes) ahoye '" lOilial yertical posilion and lbe aubjec:I'. bead wu starting 10 reye"" it. molion, with respec:11O the ywel., inlD a forward arcong moyemenl. By 250 millileCOlUl< the forward rebounding bead hlll.l nol yet reacbed vertical, bUlthe IlIbjec:I'S trunk, oe.:k and head were already deaceodinl &lODI a paIb parallel 10 the ,,,,.hack, Ilia lrunk wu nearl! balfway loward.. iLS .urllng poSllion WIth reapecl 10 the sa! botlom. By this lime, the oealback bad rerurned 10 ils pre-illlpllCl no"",,1 angl. and Ihe .uhJect's 10,"" WM reboundin, forward and away from lb. ...thack's surface. AI Ibis poinlthe ... suh,,,,,.'. upper ~.>dy w..s probably I>oinlacllyely ...lard<<I by the I.ghtened r....'ralnl 'yslem, The ....I..inl sylltm bad h<<ome more than normally ligbleoed wbeG lb. ",rill, powered ...thelt r.lraclo, reeled in aboul 5 10 8 C8ll1i_n (2 to J inch..,) of ...tl>ollano .houlder ham... alack thal ~ 25 Deco produ~ hy the inlllll 'ompre:1.'ilun and udallvdy rearward flcliuD of t.he fonurlo! movmM ~lhal.:k l.:u,'1hlOn hy lbe Itlhonlry tul lubj&!lCl's lunu.) , Thill .ut()lIklhl(nln~ phenomenon wu nota! conlllltenlly an tteveral \o't:hu:lcl'i dunn.r our lcat lenea. Ph... 4 . Head D<<:d'l'IIlionrro"", R." ()OO In 400 milli!ICCond,) - Alte, 300 nulh"""onds '.rum li"t humper CODlIet, th. dClCCDI of th. 1.., .uhject's lrunk h..J '-n completed IIld bia trunk wu movina al ....nllally the urne velocity u Lbe vebicle. The rebound forward mollnn of hi. bud, DOW poailioDcd Dea, ver1ie,ol, conlinued bUI wu Leina ",lively decelel'llled by the len.ioo in hia Deck, AI abouI 400 milhaecoDdI bi. bead bad ruched ill mo'l forward p,,"uion with reapecl 10 lbe vebiele, The bileblock 10 mulol<l referenc:e liD. WU Dearly level with lbe bOriZOD and the head wu .10willi10 . Dearly level, forw.rd and lowered posllioD with reapecl 10 the IlIbjecl" >boulders. The .ubJocl's head lben beaan a return movemenl relalively rearward and upward lowards a DOrmal upriahl po.ilioD OVtl, bis shoulders. Ph.... 5 . Reslitulion Ph..... (400 '0 600 mllli. seconds) - Afte, .boUI 450 nullioecond.s aft.r lirsl bumper CODlaCl, all lesl IUbjecl body parIS w.re tl'llveling al approxiDIII.ly the vehicle's velocily and his immc:dlll. impacl r.I.,ed molioDS were Dearly compl.'ed. During this penoo th. lcal .ubjocI's bead and bileblock returned 10 appro.imaldy Ibeir pr..leal posilioDI wilb "'pecllo lb. vehld.. However, the lesl subjocI's &bould.rs and hips ....Ied in a po,ilion abouI 3,8 eenhmel.rs (1.5 inebes) biah.r Ihan befor.. TlME.DISPLACEMENT AND ACCELER,\TlON ANALYSIS - Analy.is of th.lime-displaccmenl record of the body reference tara.1I and the G'lime record of the blleblock seoaors, re(erenced by e,oleulalion 10 a poinl approSlmaldy al the lop o( the cervical spin., delined the . dirOCIlOD "",,Ieralion prolile for each 10.<1. Analysis also conlirmed the u"'eDce of signJlicanl upw.rd and downward "",d.raled mol ion of Ibe lrunk, Deck and head along Ih. z a.i,. V.hicl. and 1..1 subJecl mollons along the y ....,. were nol (ound 10 be signiflcanl In this t.:.al series. Teal .ubjecl cervie,ol ntenaion and 11..iOD angl.. observed duriDa this lesl seriu were always found 10 fall within Lbe subject'. voluntary pbyslOlog,"" limilS. Hyper.xlell5loo or byperfluioD did Dol occur during any of lb. leal runs. Th. muimum cervical eSl.nSlOD (nose up) observed (or all slruck vehiel. lcal NIlS appeared 10 be ..If limiled 10 a DlU,mum of .boul 40 10 45 d.areca, ev.n (or ICSI run. u.sina Lbe van, wbicb bad DO headrulS. R.bound cervIcal flexion was mirumal for .very leal w,'h head angulatIOn (nose down) from tho normal upn~hl posture averaging Ihree 10 rive d.ar.... 0' leas. L' the typical leal .ubJect's h..d (ollowed a mild, head l.v.I, 'onlrollC<! (orward and downward decel-=rah'fC morion. followw by a Mtlnllc rtelurn 10 .it nunnal Up<lahl posture. Throuahoul the" ImpaCl r.laled kln.mal.c rcapon..., each lul suhJ""t's hca.J and t<",,, g.n.~1I y rCmAlnt:d WIUlID I J to 18 cenllmelcn (5 to 7 an~hc.:;). or les~. of Ih." pr..imp.cI polllions wllh rUpe<1 10 the v.h,cl.. FifUre 3 show!I Test Run 7 re."iUILilnl lI..:celc:rJ(Jons lll:lInll at the lop of the l;t""ll.:al ~plnt: for ~1(4;I~J IHT1C~. ~l.l1nmnll ()() Imlhso.;ond... .t'II:r humper ,'tJnl&4.:1 (l1~ 0), Figure ~ Itlso ~huws lh(,K G \'o.:lur rtAullanLA, 3 ~ - 'I' Z[g} 0 ., .2 .3 n. .. I I I I \ . 3 2 0 ., .2 .3 X(g} F1~ure 3, Resultalll Acceleralion (Os) of the Neck Top at Selected Times after Impact (milliseconds). Test 7 PhL'Ie I . Ini,ial R."""nse (010 100 millioecoD!b1 The milia! lOp of the cervical spme resullaDl """'I.....ion ., aboul60 milliseconds aft.r conllel is upward .1 aboul 0.3 G and SOOD rise., 10 1.8 G upward and forward by 100 1Ol11i"",onds. PhL'Ie 2 . PnnciDal Forward Accel.l'lllIon (100 10 200 lIIIlIi"",ond<) - AI .boul 120 milli~DdI """,1.l'IIlioD forward and upward climbs 10 an ov.raIl peak of aboul 4.3 G" As forw.rd G. """,1.l'IIlion CODlinuea, lb. lop of th. cervical spin. Gz ac.c:e1.ralloD rev..- from . + 1.2 G~ pooillve (upward) peak 01 150 millisecoods 10. peak Deaaliv. (downward) .3.5 Gs .1 .boul 220 millisecooda. Al 190 millisecoDds rcaullaDl """,1.l'IIlioD .. lb. lop of lb. cervical spm. 15 Dearly 4 G. in . downward and forward eli_lion. Phase 3 . Head Over.mecdrrono Recovetv (200 10 300 IOJllisecond5) AI 200 Ollllisecolllh, Ill. IUbjecl'. bead begins 10 arc forw.rd with rapecl 10 bis lorso and ove, the out 30 milliseconds lb. lOp of !be cervic:a1 aplne is bein, "",,leralLd forward and downward .1 2 10 3.5 G. Simultancously, the 101'10 bealDllo r.turn forward and dowD Ihe """Ihack slope. By 220 1Ollliseconds mosl of lb. forward ""elenll,on o( Ih. lOp of the cervic:a1 spme baa '- accomph,hed and Ih. aClual upward mollOD of lbe 101'10 and head h.., nearly ,........J. Also by Ibis lime. the """I.....ioo allered sealhack anal. h.u Dearly returned 10 i15 IIOfIIIaI p""lIon and Ih. ...., spong. have become a1moat unJOIded. By 250 rnllh_on!b, the forw.rd moviDa 101'10 is hein, relarded hy Ihe ,..<Iralnl <y"em and the Gz acceleralloo of Ill. 26 lOp of the: ccrvacal spln~ is r~ytenlng It.S th~ .runk IS n~)W aoout hallWay down t!le _Iback and movID~ loward, ," ""~II\al polllion, The .ubject'. h...J has now a"..! f""""d Wllh r"!"",1 to Ihe lor"", decrca.sin~ lis r...rward an~le tll .bout half the maximum 1UI~le achlev..! anJ the lOp of the c<rv,,,,,1 'pine i, beln~ """"Ieral".) r..uward and sllghlly 'Jpwud 01 about 2.3 G. Over the neXI 50 null."",onJs. as the """I cUAbion i. compr......! by the ,ubject'. downward m"vlll~ body, the upward Ozaculerallon expenenc..! II the lOp of the cemcal ""ine incre&SellIO .boUI 1.5 G, Phase 4 - Head Decel.rullonrror.;o Re't (100 hl 40Q milli5econd.1 - Around 300 nulliseconds the downwa,d molion of the lrunlt reversea and the ,ubjece's head ha., retum".) 10 aboul ils pno.impacl posItion over bis 10"". At this poinl, the reaullalllaccel.ralion al the lOp of th. cemcal ""in. dec...... 10 .boul 1 G direcled upward and rearward. DurinK the nul 50 10 100 milliseconds, the lrunk and lorso be,in to .....'un. . ....1 po.ilion. AI the same lime, the more rapidly forward mavin, bead conllnu.. forwud and downward wbile mainLainin, . nearly level poSllion with rOSJl<'CI to the horiwn. Durin, this lIlll~.uver the lower neck become., mildly flex".) wbile the lOp of the cervical 'pIDe nuldly e..ends r..ullln' in . Iund of "I.vel head bob". At around 400 millil5OCOnds the .ubject'. head beK.n. a controll..! relum upward and rearward wbile .till nlma1Din~ nearly level. Th. n:sullalll upward llId rearw.rd a=lerallon at the lOp of Ih. cervical ""in. .1 this poinl is 1.7 G. Ph.... 5 - R"litution Ph.... (400 10 600 milla- :;ec;ondsl After 400 milliseconds Ihe Ic:.sl subjece's tx.ly po.llIon returns 10 .boUI its pre.impact po'"lon With the e.ceplion of bip llId .boulder poSitions about 3.8 centur.cle" (1.5 incb..) bisb.r Ihan al the stan of the tc:.st. This may h;ove r..ult"') from shiftinK of lrunk and hip., on Ihe ""'t', surf"., r..idWlI 'p,na1 curv.lure slraiKhteDln~, or perhaps duc to lack of lime for the ....I cushions 10 fully conform 10 the" recenlly reacqull".) 10lld. Bdw..n abouI 400 and 600 mdlaseconds .fter inlli.1 contacl, mild Gx and Gz o""illations appe<lr 10 h"eny <onlinue bUI are rapidly dampe.d and ''>In hlend IOto a low l<veI "jiUle", probably a.'iSOClalo:J With the ,.hlel.'s movement ovter the pavement. GENERALIZED FINDINGS The kinemalic responsc:s of th~ strul;:k ...(hlde It:st subjects illr ucb leSl run were quaht.allVely slITulor '0 Ihe above description. Th.r. were some subtle but conSistently observed differences in the kinematic rc~sponses of Ce.'il subjecls due 10 u., di..tmilar dc:.sign belw..n thc coupe/conven,hlc seats and the more uprishlillld somewhal sllff.. 'e'"s of Ih. pICkup tnlck and van. The'lesl suhJ""1 S luncmatIC responses for thc 4 kph (2.~ mph) A V Ic:.sl runs "'ere Slmll.r 10 Ihe 8 kpb (5.0 mpb) A V ..Ie,olle., bul vlS,hly ,cl1"",OO Ihe lour,f"IJ decrea.~ in collision relaled energy. Lower yt:I<)t;lty I~ljt runs, ID Mener..l. w.:re asliOCllled wllh con~mh:r"bly It:s~noo ovc-rall kiDemallc IClivity and much nuh,h:r ce:fVH:al c:xlt:nslt.m~. From a chnic.al slalldpolnl, the nO!TUnal 8 kph (5 mph) A V lesl runs appeared In he on the: threshold fin mild l.:t:I'\"I~JI stram Inlury fnr ,Jur rC~III1"dy ("'rx)nc..1I(..~1 sUbJc:-.:L'i. Thte Doaun&14 kph (~.5 mph) jV It:bt runs wt:re l..:'IDsujeRJll 1'lA:r hy the: partl~lpi&tln~ physlI.:iWl Ic~C suhlc:..:l'i 10 hJl,vt: heen M) very mild thai a Single .'po,ure ",uulJ havc heen unhkdy to havc rCtlult..:J In Ill1Y S) mpIOm.ilh,!,)gy. DISCUSSION In revlt:wlng lh~ voluminous literature 00 this subjecl, <Sl""'lally the many .nlelc:.s on clinica.1 analysis, experimental I"""ng and compuler based mode1inl effona, ooe moal be careful abouIII'.akinK the ...umplion IhalIbe CODCloaiona aboul buman bead and neck kinem.llet reacbed in Ibeae 1IlIdi.. neceasarily apply 10 low and very low veloclry rearend cullisio... involvinS "real people". The majorily of th... .lUdi"" bave been primanly based on bisb.r speed, 24 10 SO kpb (I~ 10 50 mph) or more, rearend colliaions ulilizin, dummies, cadav..., animals, compuler models and very few Iiye YOluoteeR. The puzz.ling, and sometimes stubb<>rnJy penist=1 d,ni<:o1J symplom picluno frequently associ&led with .wbiplash" inJury, especially in the absence of objective pby.ica.1 fiodinss, leads by defa.lllo the a...umpllon thallOmedUnS unknown is happeninS durinK low velocity re&rclId collisiona wbicb i. damaging cervical slructurc(S) without cauains objectively d'SC<lrnable acule changes. Since exaueraled neck motion fu beyond lole,.ble bullWl limits bad been freqllClllly obicrved in dummies and cadave.. durinS bi,b speed lC&Iin" it baa been commonly lS5\Imed thai cervical byperellension and hypernelion would also occur durinS low and very low velocily collisions. It bas been coojectured by IDlDY thaI the forced movemenl of the neck beyood pbysiolo,ic IimilS was thc injury mechanism causinK th. "wbiplash" s)'Ddrome, es!"",lally in thin necked, unprepared peopl.. n. Ic:.sl subjecls in this ..riea were robUSlly healthy nuddle-aged men wbo we", w.1I .w.... of 1O&1Io, procalwa. To the maximum ulenl po..ible, lell subjects were kepi unaware of the s!"",tfic time of the impending lest iDIpIICland all conllClOusly auempt".) 10 maintain. aormal relaxed 10_1. looe wllile awailinK the impacl. While no ....1 IIlbjecl c.ceeded bis normal volunl.ary rang. of cervica.1 DIOIiOll dWI the lesl OlDS, thRe of the four did subaequeolly develop lransieol, mild cervical slrain symploma wbich indicaled IllII Ibere was III Injury mechaniSID IllII wu nOl depeadenl upoo cxceedinS the physiologic limits of cervical moIioa. nere bas been an ocaaiooal refereoce in die rcyicwed literature to yer1aw movement of the reueoded vduelc te.'1 subJecl (usually . dummy) under specific 1"1 CIrCUmstanCes, or as a po..ibilily in concepruaJ mode1inS. However, Since forward accele"lion becomes 10 domiDanl in thc often slud,,,,) hi~her s~ re&rclId collia;on. analysis of 1e.,1 suhJocI venlcal molton bas been Keaerally ipored. We wcre cooceplllally awar. before the 10&1 ..ri.. of die p<,,,,,,hilIlY of Impact-relal".) accele,.l1on in the Gz direction and mad. provo"ons 10 nleaSure il. However, the IDlpilllde and app.renl <:.IU,",' of the vcnlcal movemenll&lllCialed wilb our human I"'" SUhJoel' and tho correspond inS Ir.k of . ~) 1 samill&r \'er1llUll ex,unaon oh~r\o'e.d in the HyhnJ lit Jummy had nol ~n prwlcl~ (rom our r~\'lew ot Ih~ !l.uhJe~t Iilerature. Ob..rvallon of the high sJ'C<"l tilm ,e.:",1I 0' Ihe slruck "hicl. 1..'1 runs dlsdo...J lhal Ihe 1..,1 sub,""I', carly upwaru n~k move~nt an..! Ifillial (nrwllru haJ motion v.~re due 10 ..v.ral prob.ble IIl<<hllfllsms, Flrsl. th.re w.., Ilfl upward lo"ina acllon caw;ed by Ihe n"",,,,1 v.h,cl. ...uback anale, wbich w.. il5elf increaocd by aceelerallen rolal.,.) deOeclion of the _Iback, Second, there Ippeaml 10 be an acceleralioo rellled Ilraiablenina of the normal thorac.c, cervical and, perhaps, lumbar 5Jlwl cUrvlturea .gain'l the forward movina 1lCI1back surface, r.,.ultina in an app.renl axial I.nathenina of the spine. Third, rea.slance 10 neck slructure bendiDa leDeraled by the DOrmal postural muscle laD. of lb. upriahl ne.:k may conlribule 10 the inilial forward bead accel.ratioD .. recorded .1 lb. lop of the ccrvlCJlI .pone. Th. upward movemenl of the 1....I.ubjecl'.lrunk anll Deck ba&o caw;ed I more complex than ..peeled motion of the neck and bead. 'This inilial upwlrll motion w.. irnrne.dlal<ly followed by I sudd.n and surprisinaly v.goro..., d"",enl of the lrunk, wbicb may have resulled from a "rubbe,band" eff""l of the kinemalically straiablened and slrelched lrunklspirud Slructures as the upwlrdly moving pelvis bccom.... restricI.,.) by the lapbelt. Sbortly If.er the subject's lrunk reach.... Ih. Iimil of upwlrd compliance permilled by the lapbelt, the 5Jline .ppeared 10 forcefully return 10 ils original un.cr.lched and curved Slal.. According to our me&.'iurements o( the struck vehicl~ leslsubj""L' durinalbe 6 10 S kpb (4 10 5 mph) t>.V 1....1 runs, lb.r. was an inilial axial comprossion. m.asured al the lop of the cervical5Jline, wbicb aceeleraled the head at about I 101.5 Gs upward, followed, as the base of Ihe n""k wa.' pull"" forwa,d and downward, by . brief peal< axlallenSlon through Ihe r...""ard "I.nded cervical spine of .bout 2 10 4.5 Gs. Th. I... .nersetic J 10 4 kph (I. 9 10 2.4 mph) ::. V I.." runs rl!4ulted io .....ntially the same lype of head and n""k mOllon wilh much d<<reased accelerations and kinr:malic rr:sponse..'i. Al lb. low and very low velocuy rearend collisions evalualed dunng our lesl senes, the mosllik.ly IOJUry to have occu"',.! w.. I mild cervi",,1 and upper shoul~.r muscular slrain. In ou, e.perience, this relalively OlJld injUry would bave been e.peeled to be, and wa." self-limlled. It appears from our present results thaI the principal mechani""l 5Ir""s on the cerviC.lliI 5pine roelaled to rearcnd vet'licle ,olhsions in the low 10 very low velocity range is a rapid compre.'ision4Censlon cycle d""cled axially through Ih. cervICal 'pin. and neck musculature a.'i the ne.:lic;1 sequentially compresses. extends. accelerates the head 10. lens Ion and th.:n tl~xe.'i, all occumng wi.hin thr: normal physiologic range of motion limits of th~ ne.ck. A :\ugg~sted prohahle injury causation m~chanism consistent With the.'ie ob~rvi&hons \\Iould he a locahuJ cervlc.d/upp:r thoracic muscular stram cau.<:,e(j hy rapid. short e,,"curslon. (orced muscular complIance ta suJden unantlclpateJ hmslon. occurring II an onset rate heyond the phYSIOlogiC tolerance of the .freeled muscles' intract'lIular nucro- str\lccur~:i. Fklah:d, o\lcracllvt> or out of 'i~n(hronllJ!lon n:tlt:x musculiu len!iHlnlnl!J It) cuntrul had motion may I.:nnlnhut~ to Ihe muscubr !'llnAin proc~. ..llhoulih our t~l suhJL":ts mu..~:ulllr corr~h\'e Oll:\:hani~m.s appeamJ t.o ~ .pprnpnale1y c.."dulJlled and eHoc~lve hy .boul 200 to 150 nulh"""on.u .ft.r Im"""l. An aJdiliolw, I... likely, bu. posslhle injury medwlIsm may "" simple comprcaaion-rellled ";UI. nucflH:onluslllnal injun.. to the cervica.1 and upper lbo"",,,, 5Jlin. cOMoclI'. lI..ue and joinc slruclURa. Similar compr....ion.l.n.,on injury coLlSllion mecbanisma may accounl for the nuld low b..:k dIscomfort symplomsthal are sotllOlimea reported by individuals invol,cd ill low ,.lociIY rumld c"lIisions. Pbolographic observllioD of the bead, Deck and upper torso relalionships thaI occumd during eacb leal subjecl's peak cervical e'lettsion su....led the pclIIibiliey of an inhereDl, analomically based, neck extensioD limilllioo mechanism, A IrianMUlar shaped support slructure for the top of the cervical 5Jline is ro~ by the auPportilll ItruclURa of the upper 10rso, the partially ..Lellded (.Irailblelled) cervical spine and lb. musdos of the ant.rior Deck tbal Dormally malntaiD the b""! erecl. lnilial cervica.1 muscl. bracina would involve p......,.isting DOrmal neck muscl. tOD., followed durinl the middle and end of the inilial kin.mallc respo..... period by ,ene. and voluncary muscular bead rigblina activily. 'This progressl.ely more lelive bracing mechanism, ill c:onjunclioo wilb the downward and forward movellieiJI of lb. should.,. and base of the nock, (wblcb occumd ill our leal aeri.. ",ell before the subject's head and neck IIlld reacbed full..t....ion), may help self.limil (.11....1 in the low v.locilY .ilUllioD) neck ell.nsion 10 withiD pbysiologically lolerabl. limits, The ab",nce of t1us active bracina mechanism in both anlbropomorphic dummi.., and cadaver le.<l subjects may lecount for the observation of unchecked rearward bead molion and n""k hyperell.nsion reported in experiments ulllizing th.... .mperfocl human analoas .. I.... subjecca. CONCLUSIONS The dala from our low velocily rearend collision Le61 sene.' uSing volunt<<r losl subjects supports lbe preliminary conclus.on lMlsubstantlal Gz d"""lIon a<;ee1.ralioD occun and IS associaled WIth both compressive and tensile forces sequ.nllally d"oct"" a.tially IMough the cervica.1 spine. These push-pull fore.,. probably repl'elOlll an iIIjury causal ion mecbanism indepeDd.DI of lb. C<lmmonly dac:ribed cervical "whiplash" hypere'lensioDlhyperlle.ion mechanilm. For "",rend collisions withiD the ,.Ineity rani. included ill our tosl series. the classic "wbiplash" injury mechanism, _IDS unlikely since no hyper"lension or hyperlluion wy nbaerved 10 any of nur tesl subjects. Desp'l. bavinl e.perioaced DO n""k excurSIons beyond the" volunlary range limits, IMoe of ou, four 1",1 SUbJecl' I"",si.ntly IIlld very mild, bul clinically clasSIC neck dIscomfort symploms. During the lower .ne'IY level 4 kpb (2.' mpb) AV 1.'1 runs, the losl suh,oc!'s relallvely rearward bead molloo w.., sllnilar bUI much OlJlder and. In eacb ....., tha back of lba ''''I suhjec!', head did nol r...ch Ihe headrelll. The injury 28 ""llUl,on polenllal durin, th... leA" WL' luhl""'''e1y )udW..J hy the phYOlclan lell luhiect' III have ~n nununal or nlln. Oli.lenl. The rcport~ rcaults uf this Il)w V~IUl;IIY tC'~l scn~!ri IUIsal . cUmpreli5lon.leDllwD injury C/I,U5Alwn Dl<<hanJim wbicb probably C&ll C&uae ..If.limil..J minor cervical, tho"",c and lumbar mWlCle .Irain. and, po"lbly, COM"""ve II..Uc and/or verteb..t JOlnl micr<Konlwllon.1 inJuneo an'" thai =y ,,"Dual for the d,,,,,,,meon .ymplom' commonly reponcd .ft., low velooily rurend colli.ion.. The very !WI'" "',,,,,omion .ymplollll Olpcnoaced by our three lco' .ubjecla, after mullipl. leal ..""'u...., indic&led lllelthe 6 10 8 kpb (4 10 5 mpb) .INck vebicle (; V ,co. condllion., we,.. pmhebly ", or neer, Iypical bUIIIID Ib,....I\l)ld for very mil"', 510ale evcnl mlllCulo.bletaJ cervical .'rain injury. The Ial reeulla from our .maIl number of leo' run. and rel'lively bomo,eoeoUSlesl panel shoul'" be .upplemenlcd by (Urlber leaIiD,. Thi. leaILOa, whicb should indu"'c. wider variely of leal .ubjecla UTaOacd in differeo' """lina "".lIions, various ridin, po.lU.... and ....Imnl .yslem uoaae, would beUer derLOe lbe complcle ranao of c.pecl<d k'Demal" responS4O& by lb. vehiclo ridina aonoral puhlic 10 low and vory low ve'ooilY ruread collisions. BIBLIOGRAPHY AmN. AMu,. Cavic&l Whipluh: COMide..tio... in lI1e RdlAbililation ofCervic:al Myofucllllnjury. Con. Fam. PIIySlC..", Vol. n. 1811.1876 (Scplanbc, 1986). 1IalJa, JOM I The ULc Whipluh Syndrome. AU5l. NZ. J. Surg. Vol. 50. No. 6, 61~14 (Do;:cmber 1980). Be""n, R.i. 'Mtipluh: T_ of II1c: Influcnll.ll V.nabl.. s."""'yor AuIOmolIve Ent;inccn, 68OOBO. 1.10 (January 19611 Bollig, /I"",ey E., Jt. M.D.. F.I S.C. Thc M",haru..m or Il.lupluh In)unc:s. lnlCt1WJonaJ RcoonJ of MedlCU1e. 1<>9, 3.7 (l9S61 Bollduk, NUr.olaJ, PII.D.. Dip. Anal. The anaLomy ar.J pathophYlloloRY of whiplash. CIWaJ BlOmcch, I. No 2,92.101 (1986) CarlslOn, GcnJ. Nilsson. SLcfan, Nduon.EhIc. 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Joo01lI 01 N...rology, N...ro.u'l"')', and "'ychia!ry, 52. 1329,1331 (1989). ~no, R. The IIlIlOmy 01 Ihe ....i<al n:lli<>n wiIh partl<ular n:1crcna: ID lhc .ymplDmllDlolD' ollhe 'whipluh' ....... J. Bone JoW Swa. (\956); 31A; 438. Pirar, FA. Sancca, A. Yopnandan, N. Rcinaru, J, Maiman, OJ. Suh JK, Unl"'. G, Cualck IF, Unon, S/: Biodynamics oflhc ToIal Human Cadaveric Cavic:aJ Spine. Proc' JoIIh Sl.app Car Cruh Coni. Soc:icIy of A_v. Eneinecn, WI1TCIldaIc, PA. pp ~~.7:!, (\990). Pruad. P.. ct. al. 'Dynamic RcaponIC 01 the SpUlC DUNlg -GX Aoo:clcntion" ""'-Jing. of lhc 19th Sl.app Confcrcna:, pp 869-897. S.\E Poper No. 7~ 11 n. Raney, A.A., Raney, R.B.. IIlll HunlCr, C.R. Chroruc polllnumauc headache and the syndrome of ccNk.al di.\c ksion foUoWU1g head lrauma, J. N...ro.urg, 6: 4~~. (\949). s..-, Jr., ct. al. 'E>pc1'U'lla1l.iJ Stud... 01 Bram and 1'1... inJury' ""'-Jingo oflhe ~th Sl.app Conlc","c", 1'1'. 149.194, SA!! ""per No 811032 (1981). s..-.lr.. el. al. "_physiology ofC.crY;.",) InJunca' l'roo;cQjU1g. orlhc 260h Sl.app Conlm:ncc, pp. 4),70, SA!! Popcr No 8211~3, (1982) _ry. D.M.. MIIhcwaon, J.H.. and 8c<hIDl, C.O., M.D. ConlrolJal A_iJc Rear.End Colliaiol\l,lIllnvcatigalion 01 R.iaJ.cd Engine<ring and Mcdi<al PIIcnomcna. Conadian XIV''''''' Mall...,,1 Journal. VII, "r..7. ~9 (\955) Snydc" RG. "Human ImpadTol""",...,," 1970 Inlcn1lllonal AUIDl"ohilc Sefdy Cllnftrcncc Compendium, pp. 712.782. SAE, WUTcndalc, PIper No. 700398, (1970) S~, ID, K"m, MW, MU<f1IOII. J B 'TI.. Em""",, of Whlplluh Injuria" Proc:ccdinis of the 1301 Ctl"f~I'l:""C: of the Amenan A1lOCiation (or AutDmouve MaJil:U1e. pp. 83-108, AAAM, Arlintrto" H.,ghU. II11n00a, to<...... 19691 Slalca, 10., el. aJ. 'lnlury F""lUCI"'y.".J Hu.! Rauau1i ErrCl:tl'..- U1 R.....En.! Impa" Ao.....oIcn.." Procuo.lu,... 01 lhc Il>lh Sl.app <At Cruh Conf.........., 1'1' ~~7, SA!!, W.I'TCtl>olaIc, I'lpor No. 1Z.fN67, tNovanhrr 19"r..). Thibaull,L., Go:nnarclli, TA. Biomcc_ of DifTuac Brain Injuria. ""'-JU1g1 01 lhc Illh InIm1otionaJ T..hnIcal Conr........ on E>pcrima1lal Sorely Vchk..., Odord, England, July 1-4, 1915. Wulunl"'n, DC., u.S. ~ or TIMIpOIIAIlon. NaIlonaI Hi&/1way Tram.: SorclJl AdminiIlnIion. DOT.H~""I, Mud11919. Thicmcycr, lohn 5., lI., M.D" OI.rl<M, Goo... A., M,D.. HolIinI, Goo... G., Jr., M.D. Whij>Laah Injuria of lhc Ccrvioal Spine. Vlrainia Medial MOf1lhly, Vol, 15, 171-4 (Apnl19"), WdIb, Michael 1'1.. TcmI\, Allan GJ. WhipIuh: Mcchaniama and PIIlcma of rllluc InjUl)'. lownal 01 lhc AUIInlian ChiropradD,'. AIIlocialion, Vol. 1~, No. 2, ro69 (J1UlC 1915), Weinberg, Simon, DDS, FRC[)(C) and LaFl>iru, Havy, DDS. Cavical E>lauionlFlWon Injury (WlUpIu/1) and lnlcmaJ Dcran~ or Ihe Temporomandibular loW. J Oral MullIol'oc. SUIll, 4', 6,S~ (Augual 1987). While, A. A.. 10 Ii. Plnjabi. M. M. "Clinical BiomccIIIni<e 01 Ihe Spine". Lippinooll, PlWatJcIplUa (1971). WLlliams, J F., McKenzie, I.A. Techni<al NOI.CI. The Elfrd or C.ollialOn s.",erily on Ihe Motion 01 lhc Head and 1'1... During 'Whiplash'. J. Biomcchania, Vol. 8, :1'7.2$9 (1975). Wllmana, l., Oorachol, H, Wolbing, IU: OnW-DircclionaI Human Head-Neck Response. Proc. 30h Slapp Cor Cruh Coni. Soc:idy or A""'motivc Engineers. Wanendale, PA, pp 313,325, (1986). 30 srudyU used only r},e horizontil "x" axis. Therefore, wh.n this type of dlta is comp"red '0 <h. .((.I....lIon p.mublrion. of dlily living, only the lame axla &bould be rer.rene.d. No.. thl. this 'Ndy WI' Iimi..d In the number of volunteers. The full spectrum of the population, with I p...um.d wide varilnce in physical and p.yobotopc profiles, W:IJ not tested. In this 'Ndy, the .ccel.radon. .xperi.nced by the h..d in activities of daily living wer.Ill'....r thsn would be inrultlvcly expected. Also, the acceleradons appeared to be snater than those seen in the same pans 01 th. body durin. some no~damale moeor vebicle rea..~nd impacu. When assusinl che claims of and poeendal for injury from an Iceid.n., many m.dlcal, p.ycholopc; and possible nomogenic facets of the c:a.sc need co be considered. One (aaor is the estimate of the lor~ that were appli.d <0 the person and the ran8' of po"ibl. rissu. damage that could be caused by Ipplyin, .uob (orces. With no-damJgc accidenu, one can rc&SSU,U an :lcc:idenc victim who had oehet"YJise been fri&hu:ncd by rumors of h(lrTor and the mYStery that sometimes (01.. tows the MY A "whiplash" scenuio. R.f.rlncts 1. Bogduk N. The anatomy and parhophysiololY of whl,. 1;l1h. Cliniol Biomcchanics 198&;1:92-101- 2. C.us.Banl WL. Frymoycr ]VI. Idc:ntifyil'll padena at ritk oi becominlJ disabled beuuse of low bade pain. The VU1ZIonc Renabiliurion Engjncennl Centu Predictive ModeL l!a.ll,m Or1kopaedic A.s.s.oci,uion Award for Spinal Rcsurch). S,iM 1911, \6,605-7. J. ;o..(..;C"nndl WE, Howud RP, BuamJn H.,\t. noli. AAaly11a I,l nurtUI1 (UC fuble~ '.cinematic usponses to loW' .,.Iocicy tear en,! In'pJ~U, Society IJl AutomotiVe Enlil'lcerinl, U91. .ech. r'Il':.ll t1Jper (\1), ')JIH-i'J. 0.\111' Pcmub,rion. VcrtU, 'W\ipl&th' 111' T.bl. 2. Hud ";- fo,c. P.""rlI.tJon, 01 O.i1y Li.in~ ".., 01,.C114 Acell.lIlllln IGII V.,'tlc,l 0111(114 Acc,I"'lIlIn IG.I Vlcllll 'CUIII,a," '1mG' Aller, .,. .,. .,. .,' .,. ',' ""1" ....1.. hllll Low Hloa" Mun Low HI,,, Mun ,..11 Vllu. a.',... A ~oolll.,. 0.1 U OJ 0.1 OJ 0.1 U 1SI..J , $I,rllt OJ ~I 01 OJ 01 0.' 0.1 <0.5 A Shollldlrc"l:k OJ 1.1 OJ 0.1 0.' OJ 1.1 ILl A 5"J1d 'JO 0.' IS 01 01 Il 0.1 1.1 .0 , Mud !lob 01 1.1 II 01 II 0.' U 21.1 A 51140""'" O. 1.1 1.1 0.' 10 10 I.l iU A SnIU' 0.1 1.5 10 01 I.l II U .... A Cou," 0.1 l.O 1.1 0.1 LI ~I l.1 lII.5 , C,ow410,tI. 0.1 1.1 U OJ lO " U fJ.J , srlll on !lIck 0.1 U 11 0.1 l.1 " '.1 <a..J , K1ckcPlli, 10 ~1 1.1 OJ I.J IJ OJ n. A 104000" If' II Ll " II IS 1.1 II 1.1 IU A P!110 in c"llr " U lJ 1.0 II U I~I SOU Mlln' 0.1 I.J II ., 11 U l.1 61.0 Hiq1l, 'ow, IfI4 m..,.. 0' .'9f'IIIIICIKI' tY\,.'Ultod rOl .CUllllllOI'l "IIIICI' ..O'...ed ,n tile '''' alrllCnotl II WlI. II'ld OOwnwMt ~ II &lltl /0113 ..."... .....n.. 014"'" 1Ml'It. SicI. to Ild_. "'I' cStl' Wit ..,n....lHfl.i! aI'ld wit nOI ~Ia'lld, ",I KCel."t.o" ....en" "'.,...,.. 01" 'otell ""'II ~lc\IlIleo'rom \lit ~ ....h... c,. '1'11' '0' 'M:" .....,,1, n-_ .,....01 the rore". IIQf".1'I11 ~IiIIC\l(Jll 01 \t'I. ~Klot ," dlqrMI 'rom Joo'IlOI'ItM. ,,-.""'.. me~irog .OI.......~ movl"",'.I'II, It . ""I'f'. rr'l1"'''' an IolrY:OI.rlVll.., Q' I'IIP"'. mollon. C,,1y 'our P'I)Cl4,.,r.JVUO ."..I'I'l"M'UIItnII"U wet. C'QIIecttod on 0f'4 ,..CltICt. Only ~ ,1oltl.lICl 'IOU 'lie." 110m tNI"'nd .n lI'I. ~'. 1I'l'lCr"'1119 ;nl.....U.. 110 14 111. "'.,,"'u"' il",'IICl4"I~ l7y IN lICht, 1:1 ["NO ~non' are ""on.-r,O", the 01 pC""lbl.lon '0 o Clwe injury. In Ion. are INly lI1e ,o.lik.ly .0 bc 10, ",d in ,hi. 'Ndy, .In, down in.o . ., no' 111. I.me for crform .imllarly. pe""rb. the body fer '"norm.1ln ec.. ,d, 'Thl. 'Ndy used I Wlr to compare 11..d In .imple ev. ult, rlar.end mo" nCI, luch as swinl. nI.d, looklnl over IP, ctelled .cccler. " b.ckaround of 1 IlItI to occur under luch circumSl:ances, Ihen it can be considered to occur Iponl:aneously. Other simple daily evenu, such :as sncezin" cough.. ing. or beins jostled as if in :a crowd, were shown to crute maximum acceleradons to the head (and carre. spondinl lorque ',vcls a. Ihe ncck) of 2,9 g.o 3,6 g. Thi. level of perturbanon was recognizable by the subjectS, bur also was considered trivial. The upper level of jos. Iling .xperi.nc.d by rhe lubj.... was for hopping off a step and plopping down into a chair, with--tespcctive veCtor accelerations of 8.1 , and 10.1 I. neither of which caused any adverse notice by the subjeCt'S. Is this an upper limit of norm~l tolcrance? E.xploring the lower limits of routine events is ufe, but exposing subjcCt's to forces chac could be considered injurious would be: eth. ically crucherous. Without the applicacion of some external force, there can be no lnotion. Ultimately, it is the applic.:uion of some extern31 force that causes bodily motion that should be responsible for all cha~ follows, particularly if physical bodily injury is co be considered. With the advent of sophisticated acceleromc:un and high-~pecd compuce(.bascd ac:quisition syuems, collecting .1cccier. acion d.at.a for vuious bodily pertUrbations is feaSIble. The purpose of this study was co express ;In extension. t1e.'cion modon that ,auld be (elated to the so-calle.:! "whiplash" monon ot MVA scenarios. The extension rlnge W3.S not measured, only the accelerations or "g" for.::cs. We found that in one event of dally Jaivicy, the vector Jcceler:uion of 10.4 g was experienced unevent. ful'y. These values m1Y be comparable in force and dic~ction to low velocity no-damage re;J;C.(nd MV As. When 'ampJrin~ 1.:cclefJtlon Hresses between J.1dy 3C' rlVlOC1 .1nJ ;...('I,\s, it is imponJnt (Jnl,. co comp:ue' the C'1'jl'/11~nr .1.'<js_ For c'tJrr.ple, W-:u', ;"'1'/,\ bump 8.5G ,u,nlitlon 0' tJ'!l ~"tor 01 "plOIl in chai," IVtne. cl'l tit. lorcu 'Nould Il. I'US t"."f I./nltJ Ind tI't,i' It'l. I'\lId in this sc!'l,m'IIC IS an ,..pt"'lon 0' t'" ~--I 1\ 37 ........) HARRINGTON & CALDWELL, P.C, By: ROGER J. HARRINGTON ATTORNEY FOR PLAINTIFFS IDENTIFICATION NUMBER: 09885 100 NORTH 17TH STREET, 15TH FLOOR PHILADELPHIA, PA 19103 . 12151751-1135 JOHN AND LINDA TRAUM v, IN THE CUMBERLAND COUNTY COURT OF COMMON PLEAS KEVIN E. KOONS NO, 92.2005 CIVIL ACTION. LAW PLAINTIFFS' ARBITRATION EXHIBIT PACKAGE I, Llali>lIitv Exhibits Tab Police report 1 Admission of defendant's negligence (Koon's deposition, 2-23-98, NT 23) 2 Prudential policy det;laratlons showing Full tort 3 Property damage estimate ($874 84) by Mike Fleming t 4 Property damage estimate ($1,44024) by Ted Schaum 5 Towlrlg bill 6 ~hotographs of plaintiffs' motor vehicle after 2-7.94 accident 7 Mr Traum's fax transmittal of Schaums two damage estimates and towing bill to Mr Fleming 8 , To/tfeasor paid property damages In this amount a II. Mtijlc.' Record, Holy Spint Hospital emergency room records 9 Or. Anthony Vincent's attending physIcian report 10 John L Sbarbaro, Jr M 0 report 4-21-94 11 MRI 4.25-94 12 Or. Sbarbaro report 6-28-94 13 Or. Sbarbaro report 10-12-94 14 Or Sbarbaro report 12-5.94 15 Dr. Sbarbaro's office notes 16 Mikhail Feylikh, MD. EMG 6-19-98 17 Or. Freylikh, MD report 10-26-98 18 Randall N. Smith, M.D. report 6-29-98 19 Dr Sbarbaro C. V 20 Dr. Smith CV 21 Mr. Traum's bed (photo) 22 list of Medical Treatments 23 III, Prior Motor Vehicle Accident 11-17 '@41 Dr. Vincent 2-4-94 paid Invoice 24 Property damage estimate ($937 69) by Paul Gutherman" 25 Property damage estimate ($1.165.60) by ~ed Schaum 26 -----_._.-...._.~_._.....-_.-_._.- 1 Mr. Traum received this amount from lortf88sor 2 . IV prior M.e~lcals Dr. Anthony Vincent's (chiropractor) paid InVOices for visits In 1993 27 Dr. Vincent's response to defendant's subpoena for records 28 Dr. Javlan's file for treatment from 1987 to 1991, inclusive 29 V Post Medlcals Emergency room record and x.ray report following motor vehicle accident on 1-20.95 30 . , 3 . . ' .,~ [1".'~ E!IS AGENCY "'INCIDENT 1/: YI.J- J 'I" ,.;: 17UtiDtCAI. FACLITY IfICCIDEI'fTDATE: ..:J. ?_ Cj'l/ rlO:f'lot>L.a. IIWORlIA TlON H I 1'-1.'. C 0 E F Q N.UE ADORESS J K L M } / 11 ,e,] / 0 I(,.,...!;'"",.!; /1/\';6.11-4,11 (l~ {--;r..,,,,. fL 0 a (") tJ (j 'J J J 1'1 '" J , 0 C... ,~JI.. fl',', ,0/ /J. /1../. t:"" -+,,{l (!) (J I (j I JV (J (j / L( ,. ( :J , () 1('1/" S"fu..dJ /'1.,'-'>>1 '" J~"'/(, 7..._ ~ L /', .LI.. 0 t1 u IN' (J 0 / , (-fIJI, oJ'2 .'...",?,t'h.d/I/N("UJuFu... )6~,_J.U"'L ,t ItJI111n IAII/, b ...711 IHL/c. J I ol"Tl..-r.. rh "'-J,,,,,,,-H?~~I; Il.IloAIVDI./J.. tll41 l/ l:ir In ~ ~U~TION r;-J ~..lltER rOJ -, DWII M :"It:- <>- i@RCW)SU"'ACll~ 'V'-- l.:::.J : ~ 1:1 L..LJ : ~ ;-3 ... ..-vI.V_ ICHOCL Ol5TRICf (F AI'l'LICAIlf) . . ......... ,...,...... ............:........,.............;.................. r, i ~ 1 ~ . Ill. D1E15CIV11JN OF ON.AAGEo PROPERTY .......,.......;.........,............ .. C-J'./-IC}('j,+"f ~ - . . , . . . , . . . . . . . . . .~. . .. .. . . . . . . . .. . . . : . .... . . . . . , . . .. ...) : : : '7. NARRATIYE .IDiNTIFY PRECIPITAnNG IYEIlTS, CAUSATION FACTORS, UOUEHCE OF EVUHS, wrrnESli STAILlI"-HTS, AND PROYlOI ADOIlIONAL onAILS.UKIINSURANCI INFO....""" AND :.DCATlON OI'TOWlri WHIlClS "KNnWN (I~ l,,; 2 s:~,,/, /.:~ '~17'<..- <" 1.h14C' 1,1,,, .Z;;./ /<-;.. Ovo../ !<J..o k ../ I" j,,) Ii!~~.( ',1..'..... . , / ;' I I 1 -r-" .-. .' ,'J/"I/,1C'.~<I ,,~.I .,,~ 0 C""" ,'"",f-"c-v ... ,~~ .; I., ,,- I; " '-/1., A f d M F/ ~.', ~"I a. I " 'l.dt f _",.> ,,,,';;' '" 4..' IlN On ..-Jl.. 1 1/ i, ,; I::. ;,1 "I'..... 11.", k, ( LA (.-rL, .<,. C. f.. <'~ I/.;"L 'f- ,u. ~./ 7;; .11.... ",.....~d~, J . ./ /A .1-;./ i....;.. <h-./ 11. ,....IoL.f 17-j~,-o L ~... I! / ,1. f -. VJ' ~ . (', I. '~, ,4 ....""'" ,~.. I I~/.. J, -" ...---"'t'M .,I.,.J_A, .,..v.'",-I..... ../;L/1Jfl.. t7.-.....,1. 'I:J.A ,. " G.A h,h-J/...I "1,,./ l I V/"6'/ *, ('I, it. ji~ .jA'/.L ,~'/~ 1~L-.o...~/1)... ..i ). ~6J!/.,u, .'.~, j d-' 11 ,. "Z..l" I, ..,,:....+ "" JL'.J~ C'" -I- dIN L -f:; J. ' , "/';1 INSlJRANCl; I'lFORMA flJN <NT I ~. rii:T c..j.",f, -::r::, ~ ~,U S::;Q';;(.02 >lAME , ~ I Hit,,} If)""" j /7. ~' 11~ICY "'1:1~At. 7j:.1'1(/( AOOM~ ~ AOORESS """"" 11-,'1..4 ... WlHTUsa, _ i~ It. YKllAlIQ,..SINIJ";AIED." ~ , ~...:-'. UNIT' e'f/re' 'J:f"I,~~- ... UNU J ~'. BAI'E 192.J'T'" ~SULTS DNDTUT~'. 01lA1lU USI r---- TEST 0 IVUSl USE UNII'I 0.__% 0 LfII( UNIT 2 ... SIOCIIlJNNU.-RSIONLYFCHAAOEDl TC NIC 02.1TYPf '-"'lEST 00 00 ~ DNDTlST ... tMEsnr,^TION 0- C~.m, 0.__% 0 IN( YES ][J IIJ 0 ...-._5 (IIW) 4R47hO P'Gli~ INVISTIGATING AGENCY KEVIN E. KOONS FEBRUARY 23,1998 Multi-Page '" Page 22 I problems wilh that vehicle that you can rem(J1lber' 2 A No 3 Q Do you know what the mileaae was on the car 4 around lhe date of the accident? ~ A Over 80,000 miles, I believe. 6 Q Do you know al whal pOInt on the road lhat the 7 unpacl occum:d? Do you remember any" 8 A Whal do you mean by that? 9 Q Do you remember any" 10 A Anything that sticks out in my mind' II Q Ves, anything that sticks out, a sign, a school, 12 a building, anytlung. a rOlld. InterllCClion' 13 A As far 15 I don't think there was anything.. if 14 we wenl there right now I believe I could show you where it 15 was, but I don't.. J think it wasjusl basically, you 16 know, a line of houliCs and SlUff 11lere wasn't any 17 outstanding buildings or anything 18 Q Do you remember whelher there was a school wne 19 during thai stretch of road? 20 A No, nol .. 21 Q Vou don't remember .. 22 A Not the pan .. 23 Q" or, no, there wasn'l? 24 A On the pan that I had already traveled, like .. 25 MR. GOVER. I objeclto the form. At what poant And that cracked? Ves, it did Whal part of your car Impacted wllh Mr. Traum's I Q 2 ^ 3 Q 4 car? 5 ^ l' m nol sun: I would assume the bumper. . Q Al the pOInt of Impact, what was your SpCI<d 7 limit. what spCI<d were you driving? 8 ,\ I can'l say for sure. I can 'I give you a 9 definite number. III Q After the car turned left in front of you, you II said you had put on the brakes, possibly decreased five 12 miles an hour and put your foot back on the gas. How 13 long .. how many seconds pllSSed before the impact 14 occurred" 15 A One, maybe one or two. 16 Q So it would be fair to say that the unpacl 17 occurred while you were going approxunalely 30 miles per 18 hour'! Iq ^ No, I wouldn't say the Impacl occurred. I would 20 say prior to impact, prior to me hilling the brllkes befon: 21 impacl occurred. 22 Q When did you hit the brakes' 23 A As !lOOn as my vision was .. I gu<ss it was 24 approximately one 10 IWO seconds after my vision was 25 restored. Page1t ~ r .. 5 A ~ Q ~ ^ ~ Q r ac.:iden A r Q ~ is A ~ 9 people I o no byst ~ Q ( ~ A .J Q .. A' .5 Q I 16 A' '7 anyone Shadlo, 9 If they !O hospi to 11 Q J i2 A I 13 Q' t ~ i ~ Page 23 Page 2 I in the: road are you referring 10 the: school zone? 1 Q Whal happened althe scene of the accident? 2 MS. HARRINGTON: It's kind of hard. He doesn'l 2 A What, as far 15" 3 remember the name of the: road. 3 Q What did you do" After the impacl occurred, what 4 MR. GOVER: I have also indicated for the: record 4 did you do? 5 we will admil negligence. 5 A I got out of the car. lie got out of his car, 6 BY MS. HARRlNGTON. 6 came back I said would you like to exchange insurance? 7 Q Sure. From the: mall and to the: point of impact 7 lie said. no, I'm not from around tJus area. We need to S do you remember ever passing the: school zone? 8 call the police and walked to the closesl house and went .. 9 A No. 9 he said he had 10 use the phone, there had been an 10 Q Were any of your passengers injured in tJus 10 acc.dent, went in and called the police, J beh.ve, or II accident? 1 J maybe somebody" J tJuok somebody from inside the house 12 A No. 12 called. I don'l remember actually who Inade lhe call. 13 Q Were you injured in this accident? 13 Q Where was Mr Traum's vehicle after the impacl? t4 A No. 14 A Off the SIde of the road. like an .. well. lhere 15 Q Was your car <lamaged in Uus accidenl' 1\ wa.. mow there, so I would assume there', grass then: when 16 A Ves. I 16 the,'C's not mow 17 Q Whal wa.. wrong with your car? 17 Q llis car was pushed mto the snow bank' 18 A II had a cracked turn signal lens. 18 A Veah. 19 Q Whal else? 19 Q Okay. 20 A That was it. 20 AVes 21 Q Okay. Describe for me the: cracked turn signal. 21 Q Did you ever ask Mr. Traum if he was hurt after 22 Whal actually happened to your car? 22 lhe accident' 23 A Well.the:re IS a plaslic lens thai is colored 23 A No, he didn't seem to be injW'Cd No, I did not. 24 yellow so that when the: bulb comes on II looks like your 24 Q The question was did you ever ask Mr Traum if he 25 lurn signal. l5 was injured' Page 22 - Page 25 HUGHES. ALBRIOIIT, FOLTZ Ie NAT 717-S40-0220\717-39)-S I AI Z the:y n , p Q. 4 happe' 15 A' 6 the:y Cl '7 Q 18 A' '9 Q' 10 accide. II A I 12 parked 3 Q I .. A; 5 Q. 6 arrive, 7 A, 8 same I 9 the: 5pt. o accidc: I drivab 2 contae 3 hour. 4 Q I , traveli ThellNdnll8 r.:U~.ntlal "....Iy ..... ell.ally ....'M' Com"rty 11111111111I111111111111 /to ''''''1'111' If Thl "....nU.1 h..wlflu C..,..,., If A"'lft" Car Polley Amended Declerellon. Pollay Numb.r: 28 ZA6387~ 1 AlIenay Dill: 55706At 2 IIEDA 016 " O. loa 1127 JICuo""lIIa, F\. .uu CU.nt ....vl... '_'00-4'7-11" CI,'m. '-'00-417-'515 Nili'll" lnaurld ..~ ',0, A~~"" ~ .I IIi I \1 "'....../' ~ Thl E"lctlvl Dltl 0' Tr.llm Jahn Jr .nd Lind. 1705 Slnnltt Pl.cl Holland PA 18966-26At7 thll Pal Icy Chlngl II OAt/15/9At Thl. polley perlad coverl 6 month., 'ram 01/07/9At to 07/07l9At, 12.01 A.II. It placl 0' glraglng, Llltad bllow Ira name. and birth dltal 0' Ilclnlld drlvlr. relld.nt In your hOUlahold. I Traum John Jr 07/22/At7 2 Trlum Llndl 03/27/At9 Lilted below Irl th. clr. covlrad by your polley. CAR YUR IIAKE II0D~L 800Y TYP[ VEHICL[ 10 NUIIBER TERRITORY SYIIIOL CLASS coot 1 2 1988 PIYllouth 1990 llercury Horlzan A Hchbk 50 Topa. as Sedan ltO IP38KI8D6JY139160 211EPK36X71P6399lt5 031 031 7 At 811120 811At20 Lilted balow arl your polley covlrlgel, llmltl Ind premluml. I' e premium charge dOli nat Ippelr, th.t cavlrlge II not provldld. COVERAOH LIIIITS PREIIIUIIS Clr , Cn 2 $ 1~~ $ 185 $ 59 $ 77 $ 25 $ 25 $ 71 $ 79 lodll Y InJury IIch Parlon $ 100,000 Each Accldlnt $ 300,000 Proplrty Dlllllgl lach Accident S 100,000 Ex III.lcII 8enl'I\1 Elch Plrlon $1,000,000 U~'nlurld lIo\orlltl , 8cidlly Injury _Each Parlon $ 50,000 lech AccIdent $ 100,000 Undlrlnlurld lIo\orl&tl locllly Injury Each 'Irion $ 50,000 Elch Accldlnt $ 100,000 Flrlt Plrty l,n"llt. CollI.lon Dlductlbll - $1000 Deductlbll - $ 500 COIIprlhlnllvl Deductlbll - $1000 Deductlbll - $ 500 Towing. $50 Elch Oll.blamlnt ~Int.' C.r Coverlge $ 10 $ 13 PAC 681 [D. 1/90 $ 132 $ 1119 $ 35 $ 18 $ , $ 23 $ 2 $ 2 $ 5 $ 5 .......... -----.. $ .92 $ 6At6 PAGE I U27-002." TOTAL P~III'UII PI~ CAR PRIMIUM DI"ERENCE 'OR REMAINDER OF TERM $ 13 Poll cy NUlllber 28 ZA63871t I TOTAL POLICY PREMIUM $1.1'8 Your policy I. lIlede up of your .ppllc.tlon, your 1Il0.t rec.nt Decl.r.tlon., .nd the forlll. .nd .ndor.em.nt. II.ted b.low, Forlll. .nd endor..m.nt. b.lng m.d. p.rt of your polfcy with thl. tr.n..ctlon .r. proyld.d In ..p.r.t. bookl.ts or .r. Ind.x.d .nd r.produc.d on P'lI" which follow. FORM NUMIER EDITION DAn POLICY FORMS AND MANDATORY ENDORSEMENTS PAC 186 4/86 C.r Policy, P.rt. 1, 2, end 3 Appllc.bl. policy p.rt. .r. tho.. for which. premium ch.rll' I. .hown In the D.cl.retlon., P.nn.yly.nl. Sp.cl.l St.t. Proyl.lon. C.r Policy, P.rt. It, 5, 6 .nd 7 Appllc.bl. policy p.rt. .r. tho.. for Which' premium ch.rge I. .hown In the D.cl.r.tlon.. PAC 226 PA PAC 190/PA 8/92 7/90 . OPTIONAL ENDORSEMENTS 'I)) PAC 359"/PA 12/89 lxtr.ordln.ry ".dlc.1 I.n.flt. Coy.r.g. OTHER CHARGES' CREDITS Th. Deluxe P.ck.g. DI.count eppll.. to your policy. The Multl-C.r DI.count .ppll.. to your polley, A S,'ety O.ylc. DI.count .pplle. to C.r(.) 2. The Comp.nlon for LI'e Df.count .ppll.., LI.ted below .re llllport.nt "....g.. .bout your polfcy. flret Perty I.n.flt. Includ... "edlc.' lap.n.e. $100,000 I ncOlll. LOll $ 1,000 p" 1Il0nth up tCJ " tot., of $ 5,000 Funel'81 bpen... $ 1 ,500 D..th .eneff t $ 25.000 IP nas POLICY '''OVlDES COLLISION COVIRAGE 'OR ANY VEHICLE, THAT COLLISION COVERAGE ALSO IXTlNDS TO VEHICLES RINTII), UP TO A MAXIMUM 0' 30 DAYS. Your policy I. 're. 0' .ny .ccldent, conylctlon or Inexperl.nced drlyer .urch.rg.. Full Tort eppll.. to ell car. ll.ted on the Policy, I ",ORTANTI Your polley premium lIl'y h.y. ch.nged due to r.tlng by m.ke .nd mod.l 0' ~our c.r. Pi.... check the y.hlcl. de.crlptlon 'hown. The n.cklng re'erred to In PAC "/PA Unln.ured IIotorl.u .ppll.. to ." c.r. lined on the poll cy, Th. .t.cklng r.f.rr.d to In PAC 5/PA Und.rln.ur.d IIotorl.t. .ppll.. to .11 c.r. lined on the poll cy. Rente' Cer CO\I...ge. r.ferr.d to uncl.r "Our Obligation. to You (P.rt 3)" 0' your policy, IIPpll.. 'or C.. (.) 1, 2, Ther. h.. b..n . '\jb. t I tut. for Cer 21 89 MERCURY TOPAZ LTS 1"IP",8S6KK619391t h.. b..n remov.d from the policy. Th.re he. b..n . chenge In Colll.lon cov.r.g. for C.r(.) 2. Ther. h.. b..n . change In COIIIpreh.n.ly. cov.r.g. 'or C.r(.) 2, PAC 681 10. 1/90 PAGE ~ 9"0" 1 5911050S ",,' ,., . , , I -to ~ " , ... ...... '. . .... . .' - ',.l... DI \' ~ . .'-'AL'. . ~ATE..INSURANCE C:OM~.~~'" ." HARRISBURG Mca . ..... .~...._. . '(l~!tI!.ANIC DRIVE. . .'.. .,.,.~.. HARRIS'BuAt, "Pill' "4711:! ." - (717)' 540-7500 fi':! '..r '. ..'....' ...- PACE ;,... 'f" '~a . . ~ ,.w.. ..~.,"..~.,,~..... . .. , - - -. . .. CL~!M' '5~'=~~~46RrM . \ .. ~ ':' ':'" ... , . ".. .... , ' .. "',IIf""'~1 . ....."'---- r. ,.... ". ~.,... ~~e~9:!c':': C~~:~~NT T~AUM. JOH~ TYPE CF LCS~ ~IAP/F .......~w ~,;7E:- ~'.:. 07/94 , IN~;:' DATE 02/1 ;;/94 ~'..,..; ~(~CI~ICjN ADJUST:::R MIKE FLEHING -3..L..-- . CO/'IPANY -ft... -<~:-'...~.... 7' -,/ .~, I>~Q .-/r/ ..':1.:'" -..., . , 'L. .1 ...... ,,'J '..__"".a"lll>>)" ,..,lto\:..,.,..lolJ'IV AUT~ BODriy"-sc'~~;.Ji'.,:'.', '~I~Tf~r~\)~ 531 HAUNTED LANE F'HONE BENSALEM. PA 19020 REF NO. , ..'..... 1.;,1 ,+., ,.....-.:,. .~ .~, ..~ ., .~, II. c.~ " It . ,\,,,,,,,..~.':,,,~,J;.~^,>>,,r ...iri..... .... ,*'~;.... SHOP ADDRESS CIT':' STATE .t. ~;ME JO~N T~AU~ '':Ir--.:';~' '705 P::~I'iE-- "1..,,::: C:7.' ~?~?E HOLLAND ~~ z:o' 18966 HOH~ ?SO~;.~ ~l:._~~~;_~~j~ Wr.?~ ?~CNE 2':-NC;-WC:~ '_!S~ :<~J '43 <::NG/2Cl.Cfi REI) ,.... ,-- ",,' ..,In :. -,-i V:N M::LEAG2: ~~E~~J3;~KK6!9394 00~000 i:-:OMPEr!;IV! PART E..NEill ;:~;:,~ I=R~~~:~/ALIGN/SUBLET TE=PAR-/PARTIAL REPLACE qA=APPEARANCE ALLOWANCE ~~CS~R cNTE~ED VALUE E D=COMPET!;!VE PA~? El.!=SALVAGE PART L=REFINISH ET=LABOR/PARTIAL REPl.ACE RP=RELATED ?~::~ ~~MAGE F'=CHECY. N=ADDNL l.ABOR OPERAT:ON IT-LABOR/PARTIAL REPAIR UP=UNRELAT~D PRIOR DAHAGE ~~::~-::, ~KO ,:';~~,:,"S ..';: ST~~~:"':.'~E-~-:0'~-242-14(: . '~;;~ "::.:';'L:":f\'" i,Ji=AZ !... ~s J :'::.:,~. S'~DAN ,::,' :~:::' 't ::T~S ':-./':';C':UN.;';:~ ....... ..... - jIl' .. ..J" , .. "J' J ~ ~:JTJ~ATIC rR~'..; ~c~-~J fACK G~~~'; F'aWE~ WINDOW; ~~~: ~E~CTE ::~J"';CL ~:~RJR= ~:~. ::::-'/D :T:ClNli\':; 7:L. 37cERING w"Ec~ ~:~~~ ~JaR LOCK: 7:N?::: ~'-6!:S ""'-::' ;i):: ...- :::=:~:~TION MF":;. P,F:- NJ. p-'" ,.,- ~..:% \.I':;~~S . .. t\:_...~ I 50'" F'ANEL, REAR BOD'~ REFAIR/Pl..:GII J.O-' L 509 FW!E,-, REAR BOD~ REFUHS.1 1.2 " EU 510 TANK ,FUEL SAL IJAGE FART 81 ,;!5;t .8 . Elt 534 TA!LLAMF' ASSEMB'_ Y Rl ::AL VA:;E PART 93.75_ .3 , L "(T"' . CLEAR COAT "E:-:~I!S;'; .7"'" .. N ~O4 UNDERCOATINCi ADDTL LABOR 10.00" . ii3~ SEj-UF' FOr.: F:EAL.IGNMENT ':EPf\ to, ,,,,,,_,~ ';'1 2.0,' I M35 lJNIDODY REALIGN/'IENT-":T , ""E~'~~:,.. :! .0.' ,., N CL,EAN-LI<Q-T~NI< ADDTL LAI<Or~ .5~ N R l. I GASS IN TANK I\!lDTL LAPOe; ..51' N R ~ I TRIM c'ANEL ADDTL LAEiOr, 3" II :;E':- t~l::'" -, ~i...[l~j, --...:- 11LD7i.. i-N"I,.d\ 1:>.0011 .. ~~::' "',:: -, --:TC:.r; ~.:~; - - , I.. > :."'\EF';': r\/'(I:_:': '; 1 ,", , ., ...' _, I. ~. ,j .l-.Jr :.r:.~ Al.~::.~ ADD:t. Lt~r:c,~ , .7.. " r~i:''' :,..', -, :.'"\ T -l-:JM,"E."'\ -:1 ,:~ . ,)Dil: .. L.~b,~.:, 1 , . . L'" ~-~'4 ':" '="!~/.j_ ~:~~CULHT~:'j'~S ~, ;:~~TRIES GFWSS F'ARTS OTH=:R PARTS F'AINT IIATERIAL F'ARTS TOTAl.. 7AX eN PARTS ~ MATEP!AL '-Al'l'JR ~ -SHEE',' i'1=:TAL 2-HECH/EL:::C ;!-FRAME .;-",::,=-INISH :;-r' '-!NT "'!,';::;;.rAL, ..~E':;r\ ~'~.T":.. -~x eN [lIZ-OR :'JB!_::'~ ::::.F'tl!'=~S "'ow::.!,"; (, STORAGE :~.;~ .~.':; -. J"..~I., \'....... .'t:. RATE 3::.00 35.00 33.00 32.00 44.':<1 200.00 . 26.60 226.60 (I ~ . ooo:~ 13.60 ,. REPLACE HRS REF'AIr, HRS 1.1 8.1 294.40 ,'. 45.50 . .", :: . () ~6~;.00 < .9 60. r~o 5 6 '5~7) ~? ' 6..000:'; 33. "4 35.00 874.8'\ 874.8,; ~D' A~DATS% ~~ U PT LO~ 640~,32 DATE 02/::a/~q 19.'0:00 046 F :<;~. "~/(''':)/00/'''0/00 Ct!f'!' 00/00/00/0i) NSU v:::~r~::'...::.: '_:~'D~::: ':ODE NO. ~! ~ 7.r. ...,.' . . 'I' ...:: ,':.~.,:;:EPrUR FACIL:TIES' PEE';-'::: I.!SING AN AFT;::Ri~~,,'f<E- ','HEETMETAL F'ART, B~ su~;:: ~J ~CJ~ FOR THE C~i~ ;~~~. T~IS IS NOT AN ~urHORI~ATION FOR REPAIR. ;U?F~EMEN~~ Mwsr BE APPRCVEO p;~c~ TO REPA!R. :~ ~CUR CAR IS OF UNIT::ED ::C:'~:'-::" .:-.'::::i'I ':>. :'~,..!~: "":~,.':::,' ""..1:: h':::I~I:' .>~:.~' M~\. ~;~~:~':'l:::~:-..;'.. ::(?..I~:....::. - -.:) ::'l;;L~;:::.~,.... " ,:;,EF,..\':,; -~2 r:j~R. ...,~I.: ~"";C:L;L!: .:~~~t.:RM!N::': _. ..'..:: ~;HCF' ,./OU :;F'...::>:Y" "r1 :J~~'_:.'~' --i~ ~s~';:~: ::: :'::J~~~~:' ~G~,[Ft~D. ----...--------------------------..----..------------------------------------------. ,.', . ::",~".;,::,'.I ...,. "j .,":~~J7.I~~... 7.'~_~':' ...," ,.,:::..::,:,I::~Jr~ ,:;;;, : :'-":~,':\7"::::~ S:"'r~ .P':tJ :"=-"i~~> "~':::;,R.;' ArJr. :: 'l'~'f'o::>(''" .- .~"~.'.)..r ':'':,''?\'El\:-:'.":':', .. ':'::I,):,::'v'.."/,:"I"~: ~ :_.l,~R~l~\!~r '.'.: :.;.J:Tr~ ,-::-fT::>~T '.,: .::.',., .,,~,: .:::; r'Er~HU:1 t:.,'.. .: '.~_ -=":,:,, :_,.,::1 CON 7',~ J.N:::NI:; ":"-1_';'~: ::.,!C'::..,::-..I_:.T5: C,:::,' "'i!:: ..:::':l:':'l:~ -- .'~'i::"'::'J PE :;~::-,...::I::'- -,. ~;'~;::;.:~~CNi'1C::". ::I:R L: ~'. -' ;" '.:': ~.~ _ - U'=' "'8 '3.5. < 'j',', , . - -,. .,..- .'-:r .. ~.:;.... '. " .. . . ')-/..Ic-I ~.-r AUTO BODY BV SCHAUM-S ~e 531 Haunted ~ane Bensalem. Pennsylvania 19020 (215) 638-2272 We Have Over Thirty Vear~ In Business visib~e Damage Quotation "181 on 02-21-94 .:JOHN TRAUM 1705 8ENNET PLACE Style 4/0R. Lie. Plate: Paint Code: Prod. Date: Profile STANDARD Deductible: 0.00 Insurer Adj us ter : Appraiser: Claimant Insured Policy' Claim. HOLLAND, PA 18966 Phone: 89 HERCURY TOPAZ VIN: Hileage: 0 Options: l..ililpEl ASSY . hAGNl l/fNJG. lRACKEl ....". ...-,; 3 . AU" R.~Hm .{~.; ~".;_: .""~t:l~ :C~::~~ 5'. RI;( Ll:SYS1EIi'.TANK 6 R if ',"', AS'IN TANK . 7 AEPAIR " REAR 10DY PANEL . All .'TAlHmlL 9 REPA:R UHlBODY STAUCTUAE 10 AEPLACE R CmlKATlON Lm ASSEmy II ADL OPER UHOERCOATm 12 AOL om FRAKE/RACK SET UP to AOL ,U,j umlL/CLEA~UP 1 lvdg...nt Itl' , . Price lIbor hint lIbor C'OVl 'rle. CroVI 0.00 D.' 0.0 10DY 0.00 1.01 0.0 100Y 1 EXlSTlK; . -H 0,00 I.~ 0.0 HECKA.NICAL ~.~~ 2.~' ",,, @~~y 1 EXISm; 1 -H 151.17 I.~ 0.0 HECHANICAL HU 0.00 0.5' 0.0 100Y 1 mSlm . 0.001 4.01 1.0 100Y m5m; . 0.00 0.31. o.d 100Y EWIlKO a 0.00 ..0' 0.0 FAAHE EXlSm; 1 .177.05 0,4 0.0 800Y HEW 0.00 10.01 0.0 800Y 0.00 2.5' 0,0 rRm 15.001 0.0 0.0 Summary 100Y 19.08 ~4.00. 646.001 REflHISH I.ot 34.00 ~4.00r 'IlAHE 6,Sf ~5,OO 227.501 KECNAKICAL 2,68 35.00 91.00T Tued Labor .' . 991,50 .h 6.000' 59.91 PAINT MATERIALS 14.00T KEI 321.22T DETAIl/DELIVERY 15,OOT NAZARDOUS lAST[ . 3.001 lmd Costs ~2,OO hXld Parts 321.22 " 6.000' 1.92 h 6.000' 19.69 LJbor ( 29.1 hrs) 998.50 Add'l Costs/Ha terla Is 32.00 Parts 328.22 Tax 81.52 'Gara'''.",J Tot_ '1. ;1.44(",,) _ 2"'''11 ':':'~" .. I, , ~'ldl'lr_ 0' Hitchlll Intlrnational CotyrllU 1"1, 1994 All AilftU AlstrV.4 f ~I f'''' ~..' ')\ . 1, ('. ,\\. \: BEC!,(ER~S .,TOWING~~J\ 3150 Gelt)sbura Ro.d .-....-' '- :"'t.~F r;;....., '[,., ::-.:.:: Phon. 761.5731 I.' AM 11I10""1 PM ......... AOCNtIIl -Jv/';v __flyl;;;!1 IIILlAGE II" VICE TillE "WSH r1rllSH START S,^ IT .' TOTAL TOTAL _. 1,,"0,.,. ...1"., . ." .nRA 'ERSON nNI~H START TOTAL " " 1/1 I u tilaING./HOIS T T,OW o WHUL L.n I 0 'LAT BED/RAMP :: :~J.;-:i o LOCK OUT IPECIAL IOU"MENT SINGLE LIN~ WINCHING OUAL LtNf WtNCloilNG 5"rlATCH Sl.OCKS SCOTCH BI.OCI':S DOLLY .1 I I I 18 18 o o ; 0 FloAT T}RE i. 0 OUT 0' GAS o WRECK V"'... WID 0 ~ E K '" d //1/ ;-A ":;-/A'('."I/ ,J'(I~"I {IV v __I/v,.W I" ' : /?,/J?V? I#/P (/'5/-/ " MILUGE CHARGI I TOWING CIWIGI :j'lj c_ LAlOR CHARGI I .-.-----.-- _......:\_ --l_._ STORAGI CIWIGI I --"-t-.. I "' I TOTAL ,," I O"llIIATOflI 11C,"'''''ultl AU'",OlllIZlc!iIa,,,,.1UIII' road serv"i'ce "'1>>,.("'11'14" ... G<_ ......In !.('lo"'''"<JJC!~".u,..nw. 82/28/1994 18:83 STAPLES ilEl'Ef' "oM PAGE 81 21!l63p."468 '. ...... ..w Fav TrAnsmittal Memo - ;t1,/(o( r/<'",,'" ~ e........ I! It' . :;-:; '7'''' ',. @......,.. ..".. lilIa,'DMa r.... e_' ...... ClaIII"'.... .... , Oa__ OCalltor_ '-QlW.';; "1' "'m' 7~6 ~.t9" d'j~ /;" ~ ~ """6 'n' ~n\IIIlf'I" 4/, c.- C.apMlIOIt. 00,_ t! aiM --- -;). ,41 ('i ~u.;-"'!:':;:;- AU ... a I3CJ()V u:~v 1 ElJ ~3 c::: I-.'U'" ',.J,.1 .. ~:;;: S~! Haunted lane n"n~~lem. P'nn~ylvanl~ 19020 (.L5 j 63'3-n72 w. H~VG Over ThIrty Ye.rs In Bu.in~.~ V!Slible Oamage Quotation ..181 on 02-21-'. .JOHN TRAUM .i..7C~ =;,,,,,;T ~I.ACE Style 4/CR. Insur.r Lie. PlItI : iIld; us tlr HCI.I.~NO. PA 18'6~ Paint Cod.: iIlpprlh.r: Pilon.: PrOd. Oatt: Cldunt 89 /lERCURY TOPAZ Profile STANOARD Insur.d "IN: Oeduct ibl.: 0.00 Policy' /ll1UlIl: 0 Clal" . Option,: I llM' a. ~tlcri.li.. '~iCl LIMP ,alnl Ldar 'roul ,,11:1 .,.. 1 I . l FII IWlPII ISST 0.00 o I 0,0 lOOT 7 11I11I I/S 'lOll I/C .1'. IIICIII 0.00 1.0' 0.0 lOOT . UlIllI' 1 'LIS. 'OUI 'KlIL o. 0,00 I.J 0,0 IIC"AIlm I 11/11I SlIUlI; COLUII 0,00 2.0' 0.0 100Y a mSllNQ . I IIlLICI FulL STSII. TlU 01 151.11 1.3 0.0 "leNIIICIL III , I . I "S I" rm 0.00 O.S' 0,0 lOOT . IXlSTIII . 1 IIPIll IIU 1m mIL o.ooa 4.0' i.O lOOT mSIJN5 , I III !UN HilL 0,00 Q.3' 0,0 lOOT . UUTl.. , . 11I':1 UIIIOO' ,I.UCIU'I 0.00 4,oa 0.0 """1 ....... ..1. . 10 "'L4CI l CeNlllt'IO. LII' ISSI"ILT 11U5 0,4 0.0 lOOT IU 11 AQ. em UIDIlCOlllli 0.00 10.0' ~.~ .uv, 17 IDL om "III/IaCI SIT U' UO U' 0.0 'NIII IJ ADL CDS r orrm/CLUMU' Il.;U' u u · I~""'n\ 1111 SUIII"'.....V --..-....... ..---- ----... lOOT 19.01 J4.00 "'.00' pml '"lUlLS 14.001 III m.m Im.11I l.ot J4.oo J4,00l OITAIL/mUUI 15,001 'IMI '.It Jue m.lel IIAIIIOOllS 1111I J.OOI ,IC,....IC.aL. 1 il 1! ~1 ,~ 10r --:-::dr::- I AlG ~TI: 01/07/94 11:41 40LY PIRIT HOSPITAL . "T': .19..19 CA LL, PlNNIYLVANIA 17011 HR .: 111167 IMIRGINCY '~H ~. I "AT liNT IN'~HATION lAHI: TRAUH .IOHN T II .: 191-'.-9549 lDONn: 170. .NNITT PLACE: IHOL.LANO IPA/II964 PH .: II '-"1-31540 "RTHOATI: 07111/1947 AGE: 46 IIX: , M8~ H RACE: I 1310: ~HPLOVIR: ACHE HARlCITI OCCU"ATlON: HEAT CUTTIR w:lOAIn: I I I PH .: :HURCH : CATHOLIC AHB: IA": lOClMII: IHlRGINCY CONTACT INFORHATION TRAUM ,LINDA AIL TO "T: W WORK PH .: 100-71'-4011 170. IINNITT PLACE IHOL.LANO I"A/II'" PH .: 115-"1-1'40 IA": iDDRIn: RlL TO PT: I I WQRlC PH .: PH .: I 10HIT OR: ITTNO OR: II'ER OR: 10HIT OX: :OHPLA I NT: ,HB BAT IN CAllE 111110 OUBIN.lON A 0.0. 111110 DUBIN .ION A D.O. IN'ORMATION RIG IOURCU 10 "AT liNT TVIDI: I HO" IIRV: ICU FINANCIAL a.1: T VIIIT CLINIC COCC: ICU ROUT ICD-. OX: lACK ANO NI CIe PA I N BV: eRT IN BV: AHBULANCE 'ATI/TI HI: '1ICRI"TlON: ACCIDlNT INF~HATIDN ACC IND: .101 RILATED: . LOCATION: Ai'll: DONn: HPLOYER: DOREn: GUARANTOR INFORHATION PT RIL TO GUAR: S IHOL.LAND IPA/II'" CONTACT NAHE: I I I ',o;/- <;- ;89. ~ 7~.t!- 7~'() ~ ?1$i) ,;~1, , )... .IOHN TRAUH 170. BENNETT PLACE: ACHE HARleETS sa .: 1'1-3'-9'49 PH .: 11'-"1-2'40 PH .: PLAN INIURANCE INFORHATION COB POL.ICV . AIL PC V'Y HA CONTRACT I 282A631741 I V GROUP . NUHIER INSURANCE CO eUillCR lIE.. I HII AUTO INSURANCE: 1/0 TRAU" ,.I0HN T a 3 4 EDICAAI IECONDARv QUIITIONI: EOICAAI IIGNATURE ON 'ILl: )""INTI: INITIAL': ....ClAT I: .... ClAT I: 'TIENT NA"I: TRAU" ,JOHN T IGI'TlRED BY: TAZUI "TI: '1'3'19 HA': .111.7 1..0 (II' OOCU"NT Aa/A'I.. ,~ LII..'....". .\IEDIC.UE _ -- . NON.MEDICARE - I t ".rltt)' .'\'UI1onu Or. "". lijCn Inalm.nL u u n""'&ry. . 'ER~IlSSION fOR ~EA nf~1IT I:'iSt:RMICE RELEASE ~G "'"0mlYlr nlllh, m:ay dllll"&11 U hl./h.r oIIIUI.anU to rlnlS.r aU procl4uru I HERU Y .\t.:THOIUZE PA ~E."1' ~lrlCUy to Holy SplnL HOIOu~ oJt It,. no,pu",1 _n'IUMCI ben.nll 01"....._'.. pay'Dle to m. but 1101 to UCll4 tt'll ba.Ullce aut ot Iftl provIde,.. rc;ulu cnar;e.s (or lnU ponOd o( hosplI.aJitanon. t unOluland t am tin&llcllJly fI'pon'lbll 10 "\I "o'pUIJ (or :n.vl" nN ,;ovlrc.d by It'lU ..u.U\onul.lon. I HEJ\EB.Y A7~ ~n_~ .:'"FOR.'dAnO:'l <0 ",auntl" comp,"," Cor Ill. ,0mPI:;on 'ho. SIO:'iAT\;RE. __ WlT:'iaSS. IU~AnO:'l TO PAnE:\T; ::lATE; a? ? el.wm,. O"T6; S;O:'lAT\;RE; ST.\TE:'olEST TO PER.\lIT P"YME~T or .MEDICARE DE~UITS TO PROVIDERS. PHYSICIA:'IS AND PATIE.~T MEDCCARE NtJMBU; [ 'Iql,ll" paymlnl o( Aulilon:tt4 Midi",' bt:n."" to ml ar an ."y behalf (or any IIN',., (umullea ml by or in Holy Spln& Halpu&.I. 11141u41nl PhYIU:l1lI IIrv".,. [&l.u"anu. Illy hOldlr o( mldlW and oll'ler intormluon 11:I01.11 mi. to rlllul \0 M'dicare and II. ..,nu any Intormll.lon nlldl4 \0 aIL,"",nl U,... bcnarlu (ar nll"d """ICII. Hosprr...L BE.'1EmSIPART .".Fl'. D"TE; MEDICAL BE:;iFITSIP.~RT DI!Fl' D"TE; MEOIC.\L ASSISTANCE RECIPIENT ~y IIlnl"u, Clnln., It'l~ [ rlCltvIG a .lrvlQ or i14ms (ram Haly Splnt Ho,l-'ua.I and Or, on the 4&1.. hllld INlow. I ~nalrlt~4 t.."~ ~~ymlnl (or l'\IJ .,rvICI or 111m IIt\U bl rrom Ft"cra1 .1lId SI~1 (undl. and tJ'\&I. .1lIy (,..u cl&1.ms, .1~lmlnll. or documlnLI. or conCla.lmlnt oJ" ml41naJ may ~e prollelula unGer "9pl1c..o11 Floera.l .1l1d Stili L.IWI. [ navl ,..4 ana .alru wun :'''1 1GO~' HUlmlnt,: O"TE; REC:P!e;:..T:"GEST SIr.:'I...n;~E: RELE.\SE AGAI:-lSTMEDICAL ADVICE nUl 11 to "nl(Y tnu t. , I pluln, ~ Haly SPll1l Ho,plt&l. &In ("'~Inl Ln, I'lo'p,w alunn lJ\. IdvICI ot Or. and tn. admll'UJln110n. I l'Ia~1 :)un lI\(armld at til. rill In'f'ohld &I'ld I'llnby AIIUI tl\l daClar Md It'll nOJpll,,", (rom ",,11 ruparulDlluy. SIO:'lATt:RE. WITNESS; lU.....nON TO p"nE.'T. m.tE; D"TE: HOLY SPIRIT HOSPITAL. CAMP HILL. PA CONSE", 'OR TREATMENTIRE!.EIISE INFORMA.TION MEDICME ASSICNM!", RELEASE MjAJNST .\fEDIC,\L ADVICE FHC107 113 ~. I ()/ ~) ) . HOLY SPIRIT Jl)SpITAL . DD'AR'ftlDft' t:E ~Ior.oc;r AND DIAGII08TIC IIIAGING CMP tdu.; PIHlIYLVlINIA 17011 (717) 763-2600 PATIDft'1 'ftWII, JCHl T IIh 311867 IOC IlECI 192~36-9549 otlO DR. I PARW8, 1 .D., DIRK PI' TYPEI E ADft DATE 02/07/1994 06148Pft LOCATION ECU DICTATION DA1E1 02/08/1994 TRANSatIPrION DA1E 02/08/1994 11107M ARRIVAL DA1E1 IIll8P IiI1WICEI ECU ElAllIIlATIONI CHEST (2v), CERVICAL SPINE (7v), THClRACIC SPINE (3v). LUIlIlAR SPINE (6v) cotUIENTSl ExaalrlllUon 01 the che.t reveal. a poor lneplratory ellort wlth 'OM r..ultant blbullar hypovenUlatory C:Mnge. !hen 1. no .upedllp)..d acute ln1Utrste. Glven the devree 01 In.plraUon, heart .1ze b lelt to be top norlMl. There 1. no c:on;..tlon CId no pleural eflu.lon. E:xaalnation 01 the c:ervlcal ,plne dellon.trat.. norllal allvawent without uidlllc:e 01 fracture. !hare 11 .119ht narrowlng of the C5-6 ~c: .pace. Ilnll111l .purrlng 1. pre.ent at the unc:overtebral jolnt level at C5-6 CId C6-7. Thll 1. not re.ulting ln any .1ll"1flc:ant neural lor..lnal lIIc:roacllllent. No anterior .purrlng c:an be outlined. 'nte Cl-C:2 relation.hlp. are nonal a. an the prec:ervlcal .oft tb.ue.. ElIMlnation of the thorac:lc: .plne reveal. no fracture. 11nl111ll deveneraUve change 1. .een. 'nten ere .0lNI Sc:IWIorl'. nod.. In the lower thorac:lc: and upper lUlber revlon. 'nte lu.tlE .plne 1. norllally all~ed. Agaln there b no Iracture. Only aUd deveneratlvt .purrlng 1. ...n. 'ntl. 11 prlnc:lpally ln tha lora 01 .lIIlll anterior o.teophytu at L4 and ln the fora of .lld de9eneraUve c:hanQe at the facet joint. at L5-Sl. 'nIe 51 joint. ere norMJ,. CXlNQ.USIOth "lld buller hypovenUlatory change wlth no actlve db.... ln the ch..t. cervlcal .plnfl 1. n'98tlve lor fl1lcture. Early dbc .pac. ~lng 11 pr..ent at C5-6. 'ntere 1. .lld devllleratlve c:hange at the unc:overtebral jolnt level at C4-5 CId C5-6. No .vldlllc:e for thorac:lc .plne fractur.. Ilnlllal .purrlng I. pnaent. No evldenc:e for lUlber .plne fracture. "lld dev_ratlv. c:I'IIInge described. (Irrt1 DlC'I'AftD IY. I.K. Kunkel, ..D./d; DAft: 01' aM. OV07ll994 , oJ>.._........~.,....... ~,(. \C\I.\' :J\o, , ,. . II1C1101101.00y I II S.""AG I II S"",CUI"". I I AerobcCultur. I 18100dCullurf I I C"am,.,. NUCUAllIIIDIC'NI I I GC Culture I I Lung sean I I Tltroot Cu""'. I I Soot SctIl ~I ~ :I~~u~,,! In :: vonog,am ~ l~c/. ~DINT I I SUIIOIIIY SU'~II I I Ad!. CrIlle'" "1 13* I IOCU'" I I PId, Cruletlll PIT 23112 I I OCL'" L I I OCL4" I I I Mod. o_ng Mil '410564 I I OCLI" , I ISuourlSet IIOCLl"1 I CAllDlAC I I Man... I IIKG I IIleMI II~ I I IllUtIlATOIIY I 102 lJM I IHe 11M... I Ilnlllbauon I I AnpA. I I AOG I I 02 Sol I I ~lUmGlS I I IV IlATE 10SW_ INSS _ ILA _. I O!ll 4&NS SIZ1 IO!ll9NI 1l.00D lANK I I T1\lI & 50'"" IIC_I"'_ I I Trani"''' I IUM_ I I Unit. ~ LMOMr. I I CIC I I CK I I "AO (lDCP) I I GLUC I I AN'AlAEN' I I UA _ooY I AbdIObII_ Il'IlIpiIlorU9!'O"' ~tMI ATIj ISe<nlI!'JCoccyJ \ Cnlll RTN \ C'", ,_ I Albl L J Pyelogram IV' RTN J Ank'. 01 L , I FOOl L I Hip L : ~..~l7S L)~ I Toe L I E.bOw L IFinQll' 1. IF"","" L I Hond L I Wn.. L I ShOuldlt L I Facial Bon" I Skull I Spin, CffVflaI only Spine Ctr1/RTN ICIC RTN ULTAA SOUND II- I I OOppIlII I IGaiI~ I I't/VIC I I III1C1UANIOUI I IIIEDlCAL III_CY IIKG I E..bam I_onl II &0 A ....................... I ACETAMIN'HN I AlCO I AMMONIA I AMYL JAPTT IIUN I CA I CAEA I CAPI 10lFF I DIG 101l.ANTlN I ESA I GL YCOSYLA TED HGI I HeGS I LI,A I UV' I LYTE I MONOSPOT I PTP I OUINIOINE J SACE I SAUeYI.ATEI I A,A I THEA I THYR I TIH I URIC ACID I DOIAQI !&.-Ra. 'C.l.. \ ~f"'~ HAl A A R R A R R A R R R R ~ HAS _HAS HAS HAS HAS --~ MO/OO /~ AN AN IILUNO CUSSlP1CATION I I L.... I I IL~lI 1~....1II I Levll V I bt SOl''' W I bt. ileN L IV I Ext. $eN. LV I I Cue I I IIIIDICALN_CY PIlOCIDU,," I I~'"ll.oc. ISuturlL.lCntlon Longtll LDcIuon Longtll LDcI"'" ~li~ HOLY SPIRIT HOSPITAL CAMP HILL, PA EMERGENCY DEPARTMENT PHYSICIAN ORDER FORM CHART CO,y ~ , . .'-. .. EMERGENCY SERVICE: .. ~. - INS"'RU~1:IQt.lS. TO THE PATIENT . HOLY SPIRIT HOSPITAL , (717) 713.231. .' ..: ,;. ~.' .... . CAMP HILL. PA 17011 TM ..amlnallOn and I..almonl Y"'" ha.. vac,11~tIli'Eal!rnOY~lI1ma~1 (E. D.) ha.. bHn rondarad on In amaroanoy bul. only, and ara nOllnlondad 10 be a IUbllllula lor, ~ an aHorlIO provlda 'l!R~alilll'lllblcll car.. II Y"'" devalop n.. ptobl.m. or compUcallon. ..nllct vour ph\'flclan or Ihl. Emft9lllCV tlapartmonl (E. D.). ~.... . ~OLLOW THE INSTAUCTIONS CIRC,LED OR CHECKED IlELOW. ... LACIIIIA TIONI. A'''AIIONI 0" 'URN' t, Wlllt Gilly ..." IOeO & w..... or ,*01llM, a. ~.,..clM't,d"'INCOWweCl/uncovertcIlUllII 3. en.,.. 4tMllno !)It I~ ~ lI""'ICllYrot__. .. '.1'.,.. bIclOIMiI rtId, 1WCll1tn, hol or drllII\IrIlt OClow", eM! '"""'1' dOCtor. or ,etl,ll'n ..... b.1I1MfeOlng 0ClN'I or .....lntI InotMIII, '1IUm 10 I D I. TelII'lUl/OlpntMn. TOIIOld """, "RAIN' AND IRUIIII IIIYIlt.,. t. KMO "" In,.". PM ~... Pot 7 Ic.PKQror I. AcIlQ11lor IUOOOl1Iof' dey. ~IHIY II It II IOOH OIll IIlfI'MlftY IMlow lhI bMOegI b.,oM" jMlntUl. ~Iu.. /11.1mb Of 1WOIl,". t. UMlDllntlor 10. u. ~CI\IlIIOt' cMyt. No -om DMIlng lOt . 11 "- on "'lid IMltrMt lor dI~'I. ~,wItl'I comorll..1 10 lIffftlfd 11M lor 71J d_tv Il.unt " .- J. ! 1. r unlM IV'"IMOm ".. 13, W,.,CllMClllOOIlItlor d,.,., ,.. No'*'WV~lIfUngtor d..,. 15. 0.0 rn.tM I oouon.,..-y PMllA I'. U........ .,., NotIfy '.0. If ll'ICNMecI ~ coot~ or IWIIIiIlf 00CUtL HEAD INJURY INlTRUCTlONI .",. Ifll/l, 1/-1.. .- 17 tfartyOl""fl:lIlMIInIOClOUI',CIII ,.."..,10 I,D, '-- C*'Ml"" WOfIMtIno ,- conMUIII .....,.. tot .... INn .. .... tIIOOdarflwld""" naM &101.. ~oIlllf'l1f''''tII,,",orDoln 'I. A........., hOUl'1lQr ...-.- YnlQUI!pupI" ~",ar~dneU .......-.. urovr- . .... """'.' ; IYIINITRUCTIONI I'. tmoIft........."...,.,., 1Qn1Or I'lour.. 20. ~"'Il\IWl'''' ~. ~ 10 I,D. arcall.,ow..,.doclOl'. 1'......"".~,arlMUn'ldvlliOlt/JllllllOPl. :11. A\IOIdIlr9'l'IQlltl. Tv, '~rwdlnglGr"~, MIDICAL INITRUCTIONI - 0 Sit QUALITY CONTAOI. ~AM '21, Olf 'lIIllnIKnOOI: '1OIl'l .. 21 No WftIIpcwt fW dly.. JO IlIllurn It ... on Cl.,.ntdllfYtor__CIlI,,-""'Y 'I Tu. IIDlM or T~ ...,., I\W, (jj)ru. lilt tolloMnO 1fIIidlcl"" .. Your IIQUIar IMdIclnII tIOICIt : {VI 0 J.u.;, - it or) I'tC f - rfz</ ~ I : L{ ~... cJCM {(- (.coJ. ) €Oo""_"_""~__ .'ih,I"A"':' _ .. ~ DIIT I... Tille only ctNt lIQuaII ~ /fIOlIlfI (I.g. 1111 MIda. ... I", 11110. ~ar..~tuntMbMt." TlIItl....,retlMntonotl'l'llldllt Ib,IAYOMI 31 OMit p/IfIly 0I11q~. :II. If G/'llld lW ,.,., ""'* IttM lC>>1 , ... In NO 01 luII..trm .... end ....... lOt :10 INn\IltI. ...... . ~, 00 not '* lei pMkI 01 -- .A c.. cncr\llOft ....".1nIWlIt. ... by <..;!). .......... (:VI I(.Lf duI o IlIItUf'ftIOIO. on )A:)-IMIIfyDr,OI~Dr,oro.. ,~ HMlrft....... e:.a-... c .... """'*_ CJ You hM In IIIC\GlIttrNtnl """ YWl' doCtOlOll CJ CIII ~ _ in daylll:r II' 4,,_~1. ~1l\lm..I,D..f C-~"", A~"I-.... I . o......~"..._. Ie. OIC1l1IJ IM\IOtIIOC>>O---, .. YtNll:lIacIdOlWIl 40 OTHI" INmucnoNl I 11'IclIl,lp ~.~ 110m Ihe X~ -. an 2nd IIoor Deftn QCIIIIIIO 00Ct0r'1 ~. (call 70_ """ MNII) ) TIll rtOOr'IIl.O r'IClOt'd IJ*l to petlItIl. ) Vou ..... tlI ~ If 'fOUl' lIItl &"OW ."., cNn9I In .,...... { )W'''Moon., cuft'UrtI ~IINT VIR.ALlZlS UNDIRlTANOING 'I. .. .. --.... "'-_lI~Oy,owIM\llyOOCtOr, - ,. of -:'/, ~ EAR, NOli, MOUTH INITRUCTIONI a:a.Cool~tollfect.o.... 23,OoMtDlowyovtnoN. ~... It blfldlng CHIC"", U'!rOUIII'! no,.,"",1 1II11ltlng 0' 1ft ""0'1. 'llUf" to 10 21. ~n.. "IOl,lIft Ifllft .." 01 moull'! "'" 11"*'_ancI""lMIIIIlnCI~ildlllftl. ai, OIrtItWllft drn.."'y Z7. U"~OI'OOlltrnlllltumldl....tlIdIIdt. tlSI~NATUAIS' iJM1N ~ YD '. THIINTIR'RITATION 0' YOUR X.RAY IS ONL~INARY RE~ORT, THE RADIOLOOIST WILL REV1EW THE ~ILI\IS. I~ THERE IS A CHANGE IN THE DIAGNOSIS WE WILL IN~ORM YOU OR YOUR FAMILY DOC'fClR. ~ HIRIIY ACKNOWLIDGI RECII'T O~ THISIINSTRUCTIONS ANO EOUI"MENT AND UNDIRSTAND THIM. I UNDIRSTAND THAT I HAVI HAD IMIRGINCY TREATMINT ONLY AND THAT I MAY IE RELIASID BEFORE ALL OF MY MEDICAL ""OILIMI ARI KNOWN R TREATED. I WILL AIlIlANG 1'01'1 ~ OW U, CA I HAVI lIEN INSTRUCTED .~:~li. "'1,1 ..:- :;.!.lW,...,. , . JOHN L. SBARBARO. JR.. M.I). 664.3040 gSB Bui/Jing Cily Cint $- '&/monl il~tnuts Suilt 620 '&/~-Cym~qJ. 'Pennsy/~~ni~ /9004 April 21, 1994 Roger Harrington, ~sq. 1260 One Penn Center 1617 JFK Boulevard Philadelphia, PA 19103 Re, John Traum Dear Mr. Harrington, This 46 year-old man states that he was involved in an accident on 2/7/94 when his car got rear-ended by another car. The im,pact was nf such magnitude that he broke the steering wheel and the car was rammed into a snow bank. He was seen in an Emergency Room because of pain in his low back with right leg radiation. He also had some bruising about the right forearm and pain in the neck as well as multiple aches through his body. He was disoriented for a period of time, X-rays were obtained and he was detained for a number of hours, primarily, for obeervation. He then consulted his chiropractor and had some treatment which was of limited value. The past medical history reveals that he injured his lower back about 4 years ago when he was carrying a tray of meat. He WdS treated with chiropractic adjustments and this appears to clear up most of the symptoms, however, he did have occasional aching in his back but no radicular components and the symptoms were manageable. He continued to work as a meat cutter. Three weeks before this motor vehicle accident, accident, he was involved he was not injured. in a current however, The examination today demonstrates that the neck has 90\ mobility with pain at the extremes of motion. 1'he lumbar spine has 90\ mobility with pain at the extremes of motion. The right sciatic notch is tender, the right straight leg r.ising sign is positive at 80' and the neurologic profile is otherwise unremark.ble. He does have an 5-1 distribution through his right leg and this is an ominous sign. This man has an acute cervicdl strain an:! an acute lumbdr strain , with raficulopathy incident to the accident of 2/7/94. I believ~ that a herniated disc has to be ruled out and, accordingly, I have scheduled a lumbar MRI. I have fitted him with a back brace and I have given him a prescription for Day-Pro. I would like him to return in 2 weeks. V<t.ljy s.incer~lY./. . ) . '/ ~/,l /.J C'L-.,~L' .f.}J1.,(J I l . IJohn L. 5barbaro, Jr.. M,,t>. d ""/'p'"{; 1\ 'ii "~~i I F ,\.,\,'\~ ; r "~~~ JL5/sh Dictated, not re,.ld. C --101'- JOHN L SBAKBAKO, JR., M.D. 664.3040 gS13 13uilJill!J City Dllt' 01;'" 13d"'~lIt 7l~ellu(s Suitt' 620 13ala,CYllwyJ. 'PflllIJyl~allia 19004 June 28, 1994 Roger Harrington, Esq. 1260 One Penn Center 1617 JFK Boulevard Philadelphia, PA 19103 Re, John Traum Dear Mr. Harrington. Subsequent to the report of 4/21/94, this man has been seen on 5/5, 5/19 and 6/16/94. Over this interval of time, there has been gradual progress, however, he has had aome recurring pain through his right leg and lower back. The symptoms in his neck have cleared. The lumbar spine has 90\ mobility, the right straight leg raising sign is equivocally positive at 90.. I have recommended that he continu<J on with his brace and Daypro medication. I would like him to return in 4 weeks. JLS/sh sincerely, . ~ /6/;1' . Sba~bar~~;.w~ Dictated, not read. ;! " JOHN I.. SBARBARO. JR.. M.I). 664.3040 (}S'B 'BuilJin9 City .cint ~ 'Btlmont 7l1'l'nul's Suitt 620 'Bala.CynwyJ, Pe"'IS.~/l'ania 19004 October 12, 1994 Roger Harrington, Esq. 1260 One Penn Center 1617 JFK Boulevard Philadelphia, PA 19103 , ~ ,,1(1) Re, John Traum Dear Mr. Harrington, Subsequent to the report of 6/2B/94, this patient was seen on 7/14, B/31 and 10/5/94. Over this interval of time, there has been continued progress. As of his more recent visit. he was coming along very well. He continues to require medication and a lumbar sup~ort and he is now actually sleeping better. The examination demonstrates that his lumbar spine has normal mobility and the neurologic profile in the lower extremities is normal. I have suggested that he lose some weight but continue on with his medication and spinal supports for at least another two months. I would like to check him at that time. 'j.f!9Y .,sinc~relY:J- ( " / /, . / /: _/~A?.. (~ ..; ~_<-< ~-?- L, '-<>/',J/ .- . ( /John L. Sbarbaro, Jr.,,/M.D. JLS/sh Dictated, not read. 0__-.__-.-- --. /-- ..... - 2/ ~7tj. -7J''''. -J!;f'~1" ...., .-..-.. ~.. ...- ....--------- 11~ ~ v. -.--....--... , /5/f/1 CF&-n 1-' ' /;v/N ~-"~ CP\}' -~~ 0-::(iY ~ .-- ~.~ ) :.;,~ ._ q 0 " " ( d ',~ "," ".J ) I , ~.-<.~. '-1'-<...J _) I i/~ /?4 1/N/91 . . , )1'tlA; L -k .' ~ ~ ~\L. ,..'U,..4",...,V' .~'. ~t;j ,-r,L)/ R v- ~~~ /f1/?/o ...- /' /...b _~....."..\ I;' ,.,?t~ ;- ./f'~~ ~~t.,. oG.' ~::i.,& ~ -:t~_/~' '7'."-'-U~s;r -/-L Riuj (J' .'~ . '. .' l;.,-J ~4 r A ~. '- " _.s:. L. !?G - ~ V /D -r / ~~ ).--> ~....A v~ ---7 ,,'-e' P SL..i? r .,G . ... -/.-4 ___ t ./. d-t~.. <I. "" ~ ~ r;g -c." ~ V .' I '~J::- - -J:"K'dl7t '.! ~)~ I 9~ ~~G? . , IJ _/~ fif:j (f ~'r>-' A I ." ~w~>' ,~:-- (j 1.1(/~t/ ~..;..~ t -k'~c;[:r;r--~ r ~ e47 ~ ...d! i: -I.'_U ..,&:.<;-, 6..h -../2" );>,I/M , ~ I.'r ~1 i2 ~qve;- '7" !) ... '1 Itf)v ?::~- ~r:-. ~~ - ..-4-" M-..:71tC:.. ~~J' '~~Kt1~ /II',v . ~ If' 0>>>- ~.s; ;11l7~' -z:.,...~ .~ ;;:r- ,is ,{ J~)N- ~ 't Aj~ ft- ~ r-/..lt::::: /?E. - "J~ -. '..r/ I " Patienl: Heighl: I.D.N: Ref.Dr.: HislOl:y/CummenlL M. PREYLlKH MD PELLOW. AMERICAN BOARD Oil PHYSICAL MEDICINE AND REHABILITATION TRAUM, JOHN 67 in.hes 192-36-9549 DR. SMITH Phone: Test Dale: 9611.2540 06/19/911 THIS ~O Y.n.M PRI'SENTED Wlnl C/O I'AINS IN THE lOWER BACK ON THE R SID!'., RADIATING DOWN IllS R L.EG. BECOMING BURNING IN THE R CAl.F, MORE AT THE NIGHT TIME. H/O MVA WITH TRAUMA TO HIS SPINE SEVERAl. YEARS AGO. ON EXAM: Sl.R AND l.ASEGUE' - NEGATIVE ON THE l.EFT SIDE. AND ARE f /. ON THE R SIDE. l.EANING FORWARD PROVOKES PAINS IN THE l.UMBAR SPINE WITH RADIATION DOWN THE Rl.F. SENSORY - WNL. REFL - I lOVER THE LOWER EXTREMITIES. Molor Nerve Sludy Peroneal Nerve Rec site: EDB STIM SITE Ankle Fib,Bead Pop,Fos, Tibial Nerve Rec Site: All STIM SITE Ankle POp.F05. Lat 1151 Alp IIV) C.V, (1/5) L R L R L R 4.8 4,7 5,7 5.7 11,7 11.5 5.7 5,7 46,8 16,8 14,0 1l,2 5,7 5,7 45,0 57.0 Lat liS) L R ].5 4.2 12.2 1l.8 Alp (IV) C,V, II/s) L R L R 11.7 10,) 10.8 9.2 49.0 52,8 SensoQ' Nerve Slully Sural Nerve Rec Sib: Ankle STIM SITE lid calf tat lu) L R ),5 ).1 Alp (uV) C,V, II/s) L R L R 20,) )).) page 2 Pallent: I D.N: TRAUM. JOHN 192.36.9.549 Test Dale: 06/19/98 f:,Wavc Study Peroneal Hme Rec site: [DB Stil site: Ankle Latency 15 L 5.3) 16,)) NQnal Latency H wave F wave R 5,)) 47.00 Tibial Hem Rec site: All stll site: Ankle Latency IS L 5.)) 47,)) Horul Latency H wave F wave R 5,)) 49.67 H Reflu Slucly Tibial Herve Rec Site: SoleWl sth site: POp,F05, _ 8 wave Latency IS L R 29.)) 29,00 I!MG Study Hue Ins Act Fibs PSW Faadcs Polyph HU Alp HU OUr Conflg Pattern Int Pat Recruit R. paraapinala Nonal norl none none none none norl norl non norl full norl L. Pausplnals Horlal norl none none none none norl non non norl full norl R, Gastroc,Hed.8, Inc+ )+ none inc. inc inc poly norl reduc dec R. Tibialis Ant. Inc none none none Inc. norl inc poly norl reduc dec R, Bleeps S,8, inc none none none hc non non non norl Ml dec Patient: I.D.#: TRAUM. JOHN 192.36.9549 Test Date: 06/19/98 L. I'cnmcal !'.wave R. Pcroncal ".wavc page 2 '!OJ Rf!.CIRr, 111"'1 L. Tihial ('.wavc 11)"'1 ."" II) "'I ~...... '41_ RHORD _/\ J\ j\ ,,-,,-' _J\ ........ " ) \ ,'~- -1\;--- t..,.,-..-- \;--- "'----....---~._~. ...-_.~-- ~,- - \'- . \ r.A'......... I. r.Jo...'\.",,^' , I..". \.,. ,---"1 '-... _ _ 'Ii.. 1\ ~r~-':'~-,~-:-" .....". \.......,.....".-..,-,,.....'V... " ,,' 1- _d' . -.... _.. ". ~ - -.... .. '0 \r"-"--~- --~'. '~4.,-".~ "..,........- __~ ,~. r\..,_.__--.....~_ "."..-~ _,/'-___..__._ '4lo,II(I.(l"O .^ " ~ ,.0. . J',('I, 1 ,\ "'Ii \. ,.1 V.'...-- J,J'_""_,.,, "__ ~.. A,~,..,. "__,,_.___.. - -\vc- '-",'-''''',--,-.. \/\,,'''''' ---- ".~,--- ~1!'lI'JlI Ill1 I' 116/1'l198 l1UQl 1"'I'},18 "lll.11l " -.r:tJw RHOAD """N R. Tibial F.wave L. Tihial H.rellex R. Tibial H.rdlex 1m, 'm. tOm! 'j(I},N J1 J\V'" \(~------ , .I\~.-..-.................--......... - Jv \'I.~^--;----;-----~ 1'.\--,-",--,,- ,,,1-1'16 11 ',,'1) , 1..il'1/'J1 nOI" I. I; ~ ..I "I ') ~ih " ~iYJI) It U \ c-.... . \ V ~./\I 1\ \ ; ( .' ~ 'l ,J. ,\,-/tJ "1,1'.' 1,-.' \ I .'. \ \.../,. ," \.\.,~ \1 I , T'r". l.' ',II,t, '."\"" ,I , < ". ," '\. t. ~ \',1 ,\ ,/V"V \,1 2OOJ./ Oml 200J./ Om. 200'J.i 10m. E ......................... mu j,moopuV : mu dut OCnll ;II,itilii"dOmi' .,......... . ph+... 0: m u .111 .............. mu jrnpOpuV mu dul OClms ilsei~.Odmi...' . pIl+... 0: m u .112 .'-..,/ ;;,~;;,;~.ciPuv my (jut OOms ;1,',i.;n;'dOmi' . pIl+le. 0: mu.3 Jastloe e Ins Act Inc.. Fib. PSW 3. Festles none Po~pIl ,"c' MU Amp. lne MU OUl .ne Conlog poly P altltln nafro In' Pel I.duc AecrulI dee TRAUM, JOHN 192.36.9549 06119/98 Use lelt/ught ~rOW$ to select dIltelent maIO( unis Pie.. CURSORS 10 monpulelelhe cun"n on l~e ..Iecled molOl UI>' PIe,s NOTES 10 changelhe noles Press REPOAT 10 pllnt thi. sc"en. Pre" ERASE 10 erase the selected motOf unit Pie.. SELECT to eM~ MIKHAIL FREYLlKH, MD fn-I.OW, AMf:Rl( 'AN HOARD OF PHYSI( 'AI. MF/J/( 'INfo: & REHAHllJli1110N MlN REHAB INC, FEASTERVlllE. PA (215) 942-2292 October 26, 1998 Roger Harrin~ton, Esquire 100 Nonh 17 Street ISlh floor Philadelphia, PA 19103 Re Traum, John Dear Mr. Harrington Included, please, tind the original bill, faxed by me to the Prudential Ins Company, lellers from that company and UFCW local 56 H&W Fund, denying reimbursement and copy of the EMG/NCS repon for your client and my patient Mr John Traum Mr Traum was referred to me for a consultation and diagnostic testing by Dr R Smith and I saw the patient on June 19, 1998 John presented, complaining of pain in the right lower back, radiating down his right lower extremity, becoming burning in the right calf, more at nighttime Mr. Traum admits to having the above pains since 02.07 94, when he was injured at the moment of the motor vehicle accident The patient was diagnosed with the "whip-lash" neck injury and lower back sprain and strain, was treated for that with not much of a success and continued to suiTer. On clinical examination John showed doubtful SlR and lasegue' tests on the right side, but the lower back pains, radiating down the right leg to the calf were provoked by leaning forward Tests to rule out malingering were negative Results of the subsequent NCSfEMG were as follows "Presence of spontaneous potentials in the right gastrocnemius muscle, clinical findings and patient's complaints suggest S 1 level radiculopathy on the right side and would warrant funher investigation, incl radiological (MRI, ete)". Spontaneous potentials (positive sharp waves) you can see printed on the last pall' of the repon. PALMACCIO~SMITH ASSOCIATES (it'tI.mll OrtbfJPdt'dl(S, VJt.Jrt.'i ,\(,..'cil,:",c.', NL'c;omU'lftll't' 'h",eJ tit", r")fll "''''1<('''1 ANTHONY J I'AI.MACCIO. .111, MD. IlANI>Al.I. N SMITH. Mil June 29, 1998 Selly J. Caldwell, Esquire Harrington and Caldwell, P.C. Robert Morris Building, 15th Floor 100 North 17th Street Philadelphia, PA 19103 RE: JOHN TRAUM 1158011 Dear Ms. Celdwell: This is a note on John who I eKamined an June 29, 1998. ~s you know, his problem dates back to February 7, 1994, when he was involved in an automohile accident. He wall a driver who was rear ended, injuring his lower back. Ever aince then, he has been waiting for this pain to resolve, but it has only persisted and even increased with the pain in the lower back and going down the right leg. Standing and walking particular.ly bring this on. It is constant and it is there all the time, but it is worse with certain activities. Medications have not been well tolerated. He tries to do some walking exercises and has continued with his busy schedule,-but he is quite inconvenienced by this pain in the back and going down the right leg, Review of systems is otherwise unremarkable. Physical Examination: This reveals tightness on straight leg raising on the right with positive Lasegue and negative Wadell's testing. There is no evidence of any neurologic asymmetry or hip pathology. The tendernesll is in the right sacroiliac and sciatic notch with paraspinal tightness. Studies were reviewed, including a recent EMG, showing an 5- 1 radiculopathy. ~n old MRI was positive, but it has been a while since any other testing was done. I reviewed the previous records involving treatment and studies. It is my impression that John has sustained a low back syndrome and sciatica from a probable herniated disc. Options were discussed with John, These include the present progra~ of medications, moist heat, exercises, modification of activity, and living with it vs. more aggressive treatment such as an updated MRI or CT discogram, followed by Cortisone injections which could be epidural, facet, or intradiscal, depe"ding on the results of the studies. Finally, the possilbility of a surgical decompression can be considered. I am I~(~~l L1u,'II~lon Aw ' Sllll~ ~(X, . I'halolddphlol, I'A l<Jll(, . 121;) 677.2076. folx Ill;) (,77.17;6 1 !lJla I'lala 11..2\ . Baja Cynwyd. I'A I'X~H . fr.llI) (,fJ.i-WXl . fax ((,1Il1 (/,1-<;116 JOIIM TRAUM, PAGJI: TWO JUIfI 29, 1998 peeeimi~tic that this will ever resolve. 1 am convinced that he ie either going to have to learn to live with it or update the studies and get more aggressive treatment. He seema to undsrstand the problem. He will let us know if he wants us to go ahead further. Once again, he is left with a permanent residual directly from the February 7, 1994 accident, If I can be of any further assietance, please teel tree to contact me. Thank you. I remain Slncerely yours, ~k///~::.~ Rsndell N. Smith, M.D. . RNS: 111I1 Dictated but not read " ctmmctlIL~'1 VITAE I . Sti~b.1rCl. John L., Jr. eem: ~/22/27 Educ:aticn: St. Joseph's C?llege, Sept., 1947 - June, 1949 University of Pennsylvania, Sept., 1949 - June, 1951 -- a.A. Hahnemann Medicsl College, Sept., 1951 - June, 1955 -- M.D. Internsrup - fl..ar.r:emann :-!edic:al College & HOSPltal, , 955 - 1956 Resic~c! Ge..o:e.r31 Surge=-l - Ha..hr.err3rJ"'. :.~edica!. C.:Jllege !a :!cspltJ.l, 19:0: - . ',::.. Resicer.c! Or::.'1cpaedic Surger'/ - Hcsp:::al for Sp:-::i.:ll Sc:r;er'!, Cor.lell ~ledic:i.l Center, , 957 - 196") !loar.d Ce..'"ufied, Amer1can Ac..'\demy of Ortr.opaedic Surge::,!, 1962 Board Ce::ifi.ed, Amerlc:Ln Academy of O~..hcpaed:..c & Neur:loglc .sl.;r~e:-"..', ~ :"'~r"A~ . 1'=,. AcOOlr.~e..'1t:S : InstrL:C':cr in Or-..::cpaedic Surgery Scl-..ool c: :-te::iic:.ne, Uru.ve::s~"::: c: :,<:",,:~~.,'.,,:u"."I, , 960 - 1 963 Associate in Ort.":cpaedic Surge::'/ -- School of MediC1ne. l:n1':ers:.t./ at p.,"..~, '. 1963 - 1965 Assistant I?rofessor in Orthopaedic SurgeJ:y -- School of :led1c::1e, Universlt., of ?'lr.ns':l':~r,l,' 1965 - Juiy, 1973 . I?rofesscr of Orthcpaedic Surgery -- School of Medicir.e, Medical College of ?:i.. 1973 - 1983 Attero.ding Ort.'1opaedic Surgeon -- HoSp1tal of t.'1e Un1vers1t'! of l?eMs,'I.','~~:'J, 1960 - 1973 Ccnsultant to Ort.'1cpa.~ic Sel;"/lce -- Veterans ;..dnun1st:-~t:on Hos';ll::al, I?hiladelphia, I?A 1960 to presen:: Ccnsult3.r.: C=:..;:pled C".i2.d.ren Ccmniss:..c~, St.at.~ of ~:e'tI :arsey, '......-......a.... ....... --...-- , Me:iic:al Boar:! - Clildren' s Seashore P.cuse, A t"am:ic Ci ':" CIa'" J erse:' , 1964 to present Board of Governor~, 'The Arthritis E'our.dation CaTmittee on Arthritis, American Academy of OJ:""...hopaedic Surgeons, Jan., . :,~:. Rheumatism Sociecy of Philddel~hia, I?resident, 1971 - ;972 - 2 - . I Apcointments: (cant'd) Naticnal Advisory Board for Bic:mftchanical Research, Clemson Uni'/I!rslt" ~ n2 - .. Americ.J.l'l Rheurratisn Associatlon, Vice-Jilreslcent, 1972-74. Ccnsul:ant - Lecturer for Qrthopaedic Surgary, United States Na'/al Hosp I. r.,,: , 1973 - 1983 ~~ltis Fc~~tlon, Eastern Pennsylvania Chapter, Presldent, July, 1974 - June, 1976 t:;DVR.'!P Ar':.":=i tis Ccr.::=cl Pro<;ranl Ccur.cil, 1974 - 1980 C::rmu.ttee on EduC3tlon, Amenca.'1 Academy of Orthopaedic Surgeons, : 971 _ : 00. >'resldent Ele<;:t, Philadelphia OrthopaediC Society, 1979 !loard of Governors, Eastern Orthopaedic A.!ssoci;!.tion, 1978 - 1981 ~eslcent, Phil;!.delphla O~~opaedic Society, 1980 - 1981 Treasurer, CST Soclet"/, 1975 - 1980 Jilresicent, OST Societ"/, 1980 - 1981 Soard of Governors, Eastern O~~opaedic A.!ssociation, 1977 - 1980 Olau:nan, OrthopaediC Department, U.S. Naval Hospital, July 1980 - 1983 >'resident, OST Soclety, 1982 - 1983 ~ of Governors, Philadelphia Orthopaedic Society, 1981 - 1984 CRG.\NI:A'I'ICNS: Philadelphia Ccunty ~edical SOClety Pennsylvanla State Medlcal Soclety Amerlcan Medical Asscclatlon Di9lc:mate of National Boards Arnerlcan Geriatrics Society ~e ~~::::s ara Rr.e~clsm Fcur~ticn Amerlc.J.l'l Rheurratlsm Associatlon The Philadelphia O~~opaedic Society The Pennsylvania Or-:..~opaedic Society Amerlcan Board of Or'"_~cpaedic Surgerl Trauma Organization - Amerean Col ;.~"" -' AmeriC3ll Academy of Orthopaedic Surgeons Fellow, Amerlqn College of Surgeons Philadelphia RHeumatism Society Eastern Orthcpaedic Soclety The rnteznational Soclety of Orthopaedic Surgerl and Traumatology - 3 - .CRGANIZATICtlS (ccnt'd) "an-~erican Medical Associaticn CST Society Assoc~ticn of Orthopaedic d-.airmen .wuican Academy of Orthcpaedic & Neuroloqic SlU"qery American Academy of ThflJ:'lllOlogy AWARDS: Distinguished Service Award - Eastern Pennsylvania Chapter ~~ltlS foundation, June, 1966 Distlngulshed Serllce Awarti - Natlor.al Art.hrltls foundatlor" ':.:t~t..r Distinguished Ser/lCQ Award . Eas"ern Pennsylvanla C~pter Ar"hrltl; June 1970 :-:..:;.~,:.. Distinguished Ser/lce Award - Eas"e.~ pennsylvanla d-.apter ~=~.Iitls June 1979 -:-"I'~":.,... ...... ~ .-..,.,.. PAPERS : 1. Sbarbaro, Jchn L.. Jr.. Seitc!uk, Mur.:ay W" and Martln, \'ll~~l3l1\ ::.: Improved and slIllplified tidal drainage. AMA Archlves of Surge:",', 73: ~:;o - -.-,' 2. Sbarbaro, John L.. Jr., Francis, Kenneth C.: EoslnophHic GranulCl1\'l cf ?,..ro. Bulletin of Hospltal for Special Surgery, Vol. 2, No.2, 28-33, 19;'. 3. Sbarbaro, John L.. Jr., Straub, Lee Ramsey. Olondrosarccrna of tr,~ ?:,~lar;~. Am. J. Surg., Vol. 100, No.5, 751-752, 1960. 4. Sbarbaro, John L., Jr., Francis, Kenneth C.: Eosinophilic Granul~a ~f. ?-r~. J. of .'.'lA, Vol. 178, 706-710, 1961. 5. Straub, Lee Ralnsey, Calnpbell, Rolla, Sbarbaro, John L., Jr.: Sur-:;el:'c'''F. ".~" Arthri tic Hand. 6. Sl::ari:a.ro, John L., Jt'.: Surgery of t.~e Ar"_"'.::.':ic Har.ci. Pr'X'3i!t:hrr:e ,..... ~'...= Pennsylvania Cepartment of Heal.t.'l, June, 196~. 7. Sbarbaro, John ~., Jr.: Cefo:rntityof the Rheumatoid Hand. f..mer:.=7<...., ,"'-".:;',~ ~ of Sl.l.t?ery, 110:3. ~30-434, 1965. 8. Ralston, Edgar L.. Schmidt, ErNin R., J.., Sbarl:aro, Jchn f_" Jr,: :.e.ry'..... Necrosis of t.'le Femoral Head Followlng Systemlc Use of ~cr;!nal ':"r~:~~ ;....... AMA, June, 1966. - 4 - ,PaDers (cant'd) 9. Sbarbaro, John L., Jr., et. al.: Early Synovectony in the Ju':enllp. Rhl'!'J......r.l"wj t\rthritie. Journal of Arthr~tis and Rheumat:.sm. ':01. 10, No. J. 10. Sbarbaro, John L., Jr.,: Vol. 4, No.4. Surger/ of Artl.r:.t:.s. .. Arthrltis Journal, 11. Sbarbaro, Jehn., Jr.: Surger/ of the Rheumatold Hand. Arthnt~s .To"rr",l, vol. 4, No.4. 12. Sbarbaro, Jchn ~. Jr.,: Reccr.:s~.:ct:.ve Surgery 0: the A:t.....:.:.,':::- :.':~~Q. Read A.O..\., Jur.e, 1967. 13. Sbarbaro, John L., J.,: ~~e.nce ',o/ith Reccnstr":CO::"le Sur-;e:-;, ,::e ':~~ ,"~.".'...::. 10.. :" Knee. Read HOSP1Ul fer SP'!C~al Surge!;'"/ Alumn:., ~lov., 1967. , 4. Sbarbaro, John L., Jr.: Csteoar"....~:.t:s of t..'":.e Spine. Read P~r.."'l::'.'1.'Ii\n:'3 S.....~..l". Medical Soc:.ety, Ccteber 1966. 15. Sbarbaro, Jchn L., Jr.: SLJrge:j of ~'-'.r:.':.:..s. ?ead ~rat:.cr.al ~!L;.:'S'"1S ':.~nv'?ro"::",". Cctober, 1967. 16. Sbarbaro, John L., Jr.: Early Synovectcmy of the Arthr:.t:.c Patlent, Read I.R.S.A., Amsterdam, April 1967. 17. Sbarbaro, John L., Jr.: Osteoarthritis of the Kneil. Read P.A.11.A. Annual ~seting, Euenos Aires, Argent:.na, Nov., 1967. 16. Sbarbaro, John L., Jr.: The Arthritis Journal. Surger/ of the Arthritic El.OOw and Shoulder. '101.5, No.1, Feb., 1968. 19. Sbarbaro, John L., Jr.: The Arthritis Journal. Foref~t Reccns~~c~:.cn of ~~e Rhe'~tcld Foet. Vol. '1, No.3, p. 508, June, 1968. 20. Sbarbara, John L., Jr., 'Ianace, ?eter: Early 3ynovec':ctny in JU'.'enlle P,r.e,.~.,.""t":"; Art."1rltiS. Journal of the Medical Scclety of ~lew Jersey, '/01. ~:, ::", ~, September, 1968. 21. Sbarbaro. John L., Jr.: Surge...'l' of t.',e RheUll'atoid Knee. Read Per.ns'.'i'.'~"i" Or".hopae:iic Society, I?ittsbu..'"gn, I?er.nsylvanla, Cc'.:c:i::er 29, 19~8. 22. Kit=:.dou, Rodanthi, Schumac~er, H. Ral~h, Sbar=aro, Jchn L., Jr. ~~~ Hollander, Joseph: Recurrent Hemart.hrosls After I?rost.heuc Yn,",", ,. ~",r,r~r 1., ,-. Identification of :-!etal I?art.:.cles ln the Syno'llal Flud. ".r':."rlt.:~ .,,~d RheUll'atism, Vol. 12, No.5, p. 520, Octooer 1969. 23. 'I\J.mer,IRObert, Brown. Ernest ~., Sbarbaro, John L., Jr.: Reconst:-Jct.:.,'", Surgery of Rheumato:.d i<'.nee, Rev:.ew of Fif':.y-tl':e cases. Acee<;J:......l :-:. Publication ArthntJ.s and Rheumatlsm. " " " - 5 - 24. Hughes, Edward C., Jr., Schumacher, H. Ralph, Sbarbaro, John L., Jr.: 8ll~tnr^1 Avascular Necrosls of the Hip Following Leriche Syr.drcrne. The Jcurnill "f Bone ani Joint Surger/. Vol 53-A, No.2, pp. 280-382, ;''arch 1971. 25. Sbarbaro, ';chn L., Jr.: f1.ar.d Injuries, ~ergency t-!ediClne, August, :?", Vol 3, No.8, l'g. 63. j 26. Sbarbllro, Jchn L., Jr.: Reccnstr..:cti'/e StJr;et"'/ of t.'le Arthritic Kne~, Medical Trial Technique QJarterly, Cec., 1971, '/01. :\'III!, No. 2. ~, ::4-1,;. .. 27. Sbar!:lar.l, JchnL. Jr.: "Syncvectcrny in?.r,eumatold Art..".rltls", C....,3pt~~ ~', Art.'l:l':lS ar.d ;J.lied Ccr.citlcns. 28. Sbarbaro, Jcr.n L., Jr.: "Trccr.anteric Reconstr..:ctlcn land Trcchant~!'~c Arthroplasty", Surger/ of t.'le Hip Joint, 1973. 29. Sbarbaro, Jcr."l L., Jr.: "Surglcal Approaches to Hip". JoL"lt, 1973. Surger/ cf the Hl;, 30. Sbar'"..aro, Jchn L., Jr.: Hemi-Tibial Plateau Prostl".esls Ten Years E::<p!!~l'i!no:''''''; in 500 Knee Art......rcplasties, Ac1:a Ort..'lcp. belg., 1973, 39,91-101, 31. Sbarbaro, John L., Jr.: Femoral Condylar t-'.old Art..'l:cplasty in 150 Rheumatoid Knees, Ac1:a Orthop. belg., 1973, 39, 138-147. 32. Sbarbaro, John L., Jr;: "The Rheumatoid Shoulder", orthopaedic Clinlcs of North ~Jnerica, Apnl 1975. 33. Sbarbaro, John L., Jr.: "The Feet and Ankles in the Diagnosis of Rhe~t:c Disease, Rheumatic Disease, Olapter 'N, 1977. 34. Sbarbaro, John L., Jr.: "Arthritis": "Surger/ of t.'1e Rhe\JIM.toid <'Y.lt". MUsculoskeletal System, Section 9, W. 9:191, 1963, Evarts. Pacers Read M'i!etinos 1. "Quadriceps Plasti of the "nee" i'.mer:can "-.dademy of Orthcpaedic Surgeons, Jan., 1959. 2. "Metacarpal Phalangeal Arthroplasty of the Hand" i'.mer:can Academy of Ortl'.opaedic Surgeons, Jan., 1960. 3. "Eos:..r:cpnelic Granulana of Sone" i'.merlcan Academy of Orthopaedic Surgeons, Jan.. 1961. 4. "Reccnseruct:ve SurgerJ of the Arthntic: Patient" i'.mencanl Rheumatlsm ,1,ssociation, June, 1965. 5. "Early Synovectany in Rheumatoid Art..'1ritis" Inter:-.aticnal Sym;x::sium, ISRA, "prll, 1 968, i'.msterdarn. . - 6 - '~rs Read I>!"tinas (ccnt'd) 6. "Recorllltruction of the Arthritic Knoae" American Orthopaedic Association, June 1968. 7. "Reccr.st..'"\:ctive Sl.lrger! of the Arthritic 1'1lee" Pan-AmeriC3ll National Assoclation, NovEmber 1968, Buenos-';ires. 8. ">'ress-Fit Tor.al Hip Arthroplasty" Pall-AmerlC3ll ~eCic:ll Association, Octc:~, 1971. 9. "Theoretical Basis for Early Synovectcmy", Surgery in RheUlT'atold Art.'".:ltis, AmerlC31l Acaderoy of Orthopaecllc Surgecns, June 1970, SrJ.ll f:'3f\ClSCO. 10. "Ar'"..hrcplasty of the Rheumatoid Hip and Its Ifollow-up", The Hip, September 1970, Philadelphia. 11. "Reccnst..""\lC'::.cn of the Arthritic Knee", Reconst..."1Jcti'le Surgery of the Art:\ritic Patient, American Academy of OrthCpaedlC Surgecns, P..Oo;laln Chalr.nan, May 1971, Philadelphia. 12. "Mold and Prcst.hetic Arthroplasty of the Rheumatoid Knee" Eastern Ortl1cpaedic Society, Oc:'=ober, 1970, i\bseccn, ~lew Jersey. 13. "Reconstruction of the Til:lial Plateau by Metal Implant" Brussels O~~opaedic Society, April 1972, Brussels. 14. "The Syncvium in Health and Disease", Amencan Academy of Orthopaedic SurgeoM, August, 1972, Fort Wayne, Indiana. 15. "Synovectany in Rheumatoid i\rthritis", American Academy of Orthopaer:hc Sur?'Y.lns, Octcber 1972, Atlanta, Georgla. 1 6. "Knee Reconstr .:cticn", Eastern OrthopaediC Soclel:Y. Octcber, 1972. 17. "l?ress-Fit Total Hip Arthroplasty", Amencan Academy of Orthopaedic Surg'Y.ln5, November 1 972, Boston, I'.ass. 18. "l?ress-Fit Implant Arthroplasty of Hip ar.d Knee", Clemson IJni'l8rSlt\', Naticnal AdvlSCr! Board, ';prll, 1973. 19. "Total Hip procedure" ~etal to Metal: Mechanical Reccnstructl'/e Surgery in Rhe'Jmatoic ,\rthrl~l~, Tusccn, Arizcna, ';prll, 1973. 20. "Surgery in Arthntis", GDVRMP, Arthritis Seminar for Allied Healt), l?rOfeSStCnals, ~.arch, 1974. 21. "Surgery of t.~e Rheumatoid Hand", OST Society, June 1978. IIandal1 N, IIIIH.. ~.O. Pe'le 2 S~ollO'la ana Brs~lnq ~Li~ ~ P~ESENTATIONS N.A.R.e, Orthotlcl Journal Oaranqullentl ~f tha Knee WOVT Radl0 Guelt N,A,R.e. OrthOtlCB Journal 19117 - ArchrltU 198B . 8.~K Peln Chllf RIIldlnt Prasant.tlon C.rpal tunnll' Anslrll. of Inpatlant OVer 5 Valrl Knaa Inltsbllltles Chl.f RIIldent prelent.tlon Varloue ToPlcl Lecturer N. ~. Chiropractic School 'ranKford HOlpltal ~ Lo~al Servl~1 ClUb. GUilt Spe.ker ADDITIONAL r.OlJRSES NI~K Injuries In Sport I IIana TrClIllllll Orthotl~1 of the upper ana Lower latre.ltlll 'nIa Spina Thl Hip Clevaland Cllnlc Jeffereon Unlverlltr New York University Unlvurllty Of Mla..l H.hn....nn Mealc.l Aalrl~an Ac.asay cf Orthopadlc SurQlon. Orthopedl~ Specialty Revllw Couree Amarlcan Academy cf orthopadl~ Surqeonl Nerva 6ympoelW1l Nutrition Symposllm Hip Recon.tructlor AclVancad Arthrolccpr Couree Total Kna. 8)'111l'OIluDl I,O.A, Unlv.rslty of Panna. Unlvarlltr of Pann., Unlver81tr of Penna. Unlvarslty DC P.nna. Temple University IIlcant Advan~1I 111 Iladloloqy Plycholout IC AIP.lct I of Ac~ldant , vlol..nca Cornall Unlvarllty T.m~le Unlverelty OctOber 1974 April 1915 May 1976 March 1977 Mar 19711 Fabruary un AU9\llt 1979 '.bruary 1981 AprU 19111 AprU 1982 May 1912 July 1982 AU9\llt 1982 Oct olllr 1912 'ab~ry 191) Novalllllr UI3 IlanoaU tl. Smlth, 11,0, P..... 3 aDDITIONAL COURses (Contlnuodl update In lleurophy'ltOI09Y Arthroscopy update eMI Updat II Implant ArthrOlcoPf orthopedlc Trau.a Ind Infectlon' ln Ch11dr.n , practur. ear. wlth lat.rn.l Plx,tlon Aa.rlcan Academy of Orthopedic Sur....ona HI.tln; Hod.rn CIII.ctIOn TocnnlquBa of Ion., Blom.tall. Blocer~lcS end Blopl..tlcS Crucial 0,c1810nl ln Total Hlp lIepleclDl.nt Totel Hlp Arthropl..ty Total Hlp Conc.pts Th. ShOUlder ARkl. Spr.lne and Heel Peln Th. Should.r MR1 Ankl. and Pool Kill CerVical Splnll II10fe.d&)eck and BIIG IndolcoplC Carpal T\lnn.l R.I.... and CUZIIIlaUv. ~~r8uma Current Tr.na. ln Hlp and Kn.e ArthroplliltY Work lI.alth occupllt 10nal S.mlnar Shrln.rl-SlCl 1nJuI'leS, CTS II Coll.s Fractur. l!I.t.rnel SUDlulet,on and Flxat Ion , Ion. " Jhnt 01.."s. rnd.. R.Vl.W 80n. " Joint OUellet Ino.. Revl.w thomal J.fferlon Unlveralty UniverSity of P.nna. Templ. Unlv.rllty H.rsh.y M.dlcal C.nter ~rlc.n Acad.my of Orthop.dlC Sur....ona S.U.N,Y. G.orga Walhlnqton Unlv.ralty Medical cllnt.r Unlveralty ot P.nna. Hont.flore M.olcal C.nter Hersh.y Medical Cent.r Shrlnerl HOIPltal Shrln.ra HOlpltal Unlverllty of P.nna. J.tferson HOlpltel J.ff.rlon Hospital Pr.lbyt.rIBn HOSPital University of P.nn.. H.yo Clinic prankford Hoapltal Temple Unlverllty III M.dlcll systems July 1984 October 1994 January 19a~ April 1986 MeY 1986 Aprll 1917 hbruary 1988 M.rcn 30- 31. Apr 11 1, 1989 Apr 11 1989 Oct ob.r 199. April 19111 Hey 1991 May 1992 June 1992 January 1993 Pebruary 19113 February 1993 Marcil 19113 April 1913 October 19113 May 1994 June 1994 J.nua ry 19115 'ebru.ry 1995 i.1 Randall N, Smith. ~,O. pao;e " ACDI.rON~L CQ~SSS tContlnuedl Phy.lclln , Sports M.dlcln. Shrln.r. Confer.nce . ~dult lack Pain Ph7alGl.n , lport., MediCine pnyalclan , Sport. M.dlclne lone' Joint DI..... Inde. ~avl'W Manaq.m.nt Of Low.r .ack Pain unlv.rllty Of P.nna. T'1I\5l11l HOIpltal OVT Tr.atment MaeBachusettl General Upper Extremltl'l - ~oot ,Ankl. Phl1a. Crthopedlc Meetlnq M.dlcal Leval Coul'n I'a. M.dlcal SOCiety NBIIID Induced 131 /. R.nal ToXIC I ty Medical Bducatlon R..ourcee Itlr'lnerl-Total JO:.nt R.plac.m.nt TalllPlI HOlpltal Ant ltllot lC Treatlll"nt Unlvere Ity of Netlralka l\IIIerlcan \:ol1eqe :iports Medlcln. lIaerlCan Col18ge IlporU Medicine Shrln.rl- Upper lIl:ttnlDlty 'racture. .. Nero,e InJuria. Minimal Intlrvent ~on In Spinal Surqlry Pain Manaqement Orthoped:c tll1Plan': I Tibial , remor.l 'racturel .ncl Multiple %'r.IWIllI PatlentB COlI\PlIte poot CaN Ivlnq ~nalYlll Tell\Ple HOlpltal All.qheny Unlv.r.lty Q,P.P.S. John. Hopkins Shrlnerl HOlpltal Orthopedic 'oat , Ankle SOCllty Healthlouth ~prll 1995 Apnl 1995 May 1915 JUne 199' ,1uly 19" Septlllltler 1995 Novembar 1995 Novelll:ler 1995 March 1996 ~prll 1996 May 1996 June 1996 'ebruary 1997 March 1997 May 1997 Novellll:llf 1997 ~prll 1998 May U9I May 1998 June 1998 July 19'1 ~al"cIal1' N, Smlttl, 1'4,0, ?aCJe 5 II!lJJ'ITAL Ilrru,t"'TION6 rran~ford HOlpltal . Tor~eldale Dlvlslon . Red Lion' KnlQtltl ~d.. Phlla, Pa 19114 I'rallkford DIvISion . I'rankforc:1 Ilvenue , WekeUnQ Street Philadelphia, PA 19124 AlleQhony Unlverllty H08)ltala - Ea8t railS DlV. - 33" Henry Avenue rhlledelphla, P~ 19128 _ 4151 city Line Avanu. Philad.lphla, p~ 19131 TtI. Spin. Center - 1'11 IIrc:h Il1:r..t - Phlladelphla. p~ 19113 cay Avenu. 6THLE:TICS C.rtlfled Football, Beek.tball , Goc:cer Rofere. Captain. Te~le Medical RUQbY ream Community Coach, Aefere., OffiCial and PhYIlclen - soccer, uaakltbal1 and Baleball ~ctIVI Ballyl Health Spa me~er alnCI 1987 CIlRTlrICATtONS National Board' National BoardB surqery Board cortlfl~.tlon 1911 1913 1919 19" 1984 1911 1911 - 1996 1997 Pert I Part II M1trlc:an loard of Orthol'edlc reUow A.~,O.B, OrthoP.cUc Selt ~.......'nt CerUucatlon OrthopediC hlt ".......nt Cert 1f Icatlon ApproVed OrthopediC Tra\.. BurGeon Orthop.dlC: Self A.ee"..nt Certlflcatlun ( Bplne) COMMl~'mIS / OIRBCTOASHIPS I MY SCILLANIlOUS Orthopedic committee Bylawe committee Quallty Aelurance Committee Dlr.ctOr PhYllclan 1I1111tant M.ntor Volunte.r Work Be.ver CoUtQe p, A. Prol,r... Medical Student EKtern Profellor rrankford HOlpltal tMonthly M , "I rrankford nOlpltal J.fferaon park Ho.pltal Som.rton Indu~trlal Center Frankford'e Orthopedic CLiniC Cal. Re.erve, PCOH. MCP !lONORS Strathmore'. Who'. Who Who', Who ..n the World Who', Who ln Medlcln. alld H.althcare NIIRD Pharmac18t FUllly (If the '{ear Chief Rel1de~ Orthoped:,ce Prnldent I'll 11 01 Hedlca:, P'raternlt y Dorm Che.. Champion Dorm Athletic Chalrman Re.ldent counl.lor Phy.lelans Ilec:oqnlt lon IIwerd 1998 lSlSle 1997 1981 1976 1912 19.. 1966 a61 18 73 69 - 67 - 69 Nndall II, SllIlth. II,C. Paq. 6 g,'ICE AccnESSmS P.l,,~C10-S.lth AI.oclate. So..rCOn Mldlea1 B~lldln; 12... IUlcleCon Avenue Pftllldelphl.. pennlylvenl. 19116 Phone. 216-177-2'71 Palmllcclo.SmlCh Associate. a Balli P18Za SU1U U.-21 Sal11 Cynwyd. Penneylvllnla 19". Pftonel ~\'.61.-21" Ii " " I ' .....\' " .j OiI,f.",:.,......_f;r::u<.w.:!.', . \,.' 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TOPAZ L5 4 DOOR S~OAN .~ GOE Me DESC~!PT!ON ~A !3:3 E F'~7:: L.. ~7":: E ~..;,~, T~I~~~~? ~';~!~~~y e'JMPER A';';E!"!.1L Y , REAR COVE~.R~AR 9UMPE8 40 A~~.REA~ ENE~GY ~,) A~S.~~A~ 2~!~'~'( ~t..t<1, REA::: e'.lMF'E~ C'::\JEF: 40 FILL~R.R~AR ~UMP~R ~:~~S~ ~~~~ BVM~~R "Lc::i-"lR ,4.,"_ .. _I~' '.. ..'I'" !="_iE'.' prl~':"!\J':: Clr~!~ =:~ :~LII:~~Y I:'AF: 1:: I:t \/I!::: - ~~,7 E F'~7~ E ~19 ~~, '? '- ,.,.,) ~ ~':- " -::.... .' : -':""; ~I: .M=~':~I:;~ " :,.:'1 i..~,'r~,~.::,::I" 0: ':'C':.. 1:'1-0:- , _, _, 4_ :-':_,:::~I:'':/,=':':,::-:;~.:.. '::~:='r":-: r:'A~!t~,~~~ .':-,,-:',,',.',::,;::".~,-:-~:' ~'P! :',':, : ~~r11::::: R17:3C IS CPTN9 AI ""IFr:';. PART I'll'. PF!!C~ A,s;.: l-',':ilJRS F: 4." " .~ " '~..1r IE . . -: .' ,.,l. , -. . " 74 . 'llJ . J : ~ , .' ~ . . . . . :.:! . "':' ! 7~ . .:-~ '$ 1 . 7 4 . 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" ~",' ,"- ,\~.."\..,,..tf, ,..':....~~..:."(2 ~' '221 . ) "t ,.,.., -' -l'i~, _ .~'.," -:"~,'t:"'~',,..,;~ '" ":.1' ,.... ~~'t '6',:.,..UIj:'lr'!, _ -~, 1.~3~- ,,~, :::-," ""'.';IJ."~"" ",'~.'" '.. :, \ -I', ....~~;)...'.~.'.r.F ~'~,l: '1'; A, 'V' e ,d"" - '.' "'.: ,1,-. ",' ,: I~""\!'. ""'7'?-"'1&.:.., \,''', , ,f:..~." ",,,'~' '\.;'.t ',";' ",\40" , ,. ~ '. . ' . . ~Wta~..., "'\"'" f:!'is.../;!!IVe qvC!r Thjrty Years, In Business 'i>.~'~<""':t~\ii~~... .,', ,,'~'.i~~.',;w:, '.7~~~," ~~'~"~,'II:'..,fttY~!,, ,~. '." "~~""~"~~'~'!t"J"W;f(,~""in\:~:' Visible Damage Quotation tf.182 on 02-21-94 .:JOHN TRAUM., 1705 BENNET PLACE .. '~~"~1~' , . '\.~~""...... ' >'t."~ :", ' Insurer Adjuster Apprd ser I::, Claimant Insured Policy. Claim' : ~'<'i"';' . .~."' "",' 'j ,. "" "'. ~:f!:; '. .. - ~. . . .:~~!. ~~ ':'"" Style'- : " L~Plate.: · Pd.ntCode: Prod. Date: Profile Deductible: \'l\"il~~f*~to' ',. " : I" "~:; . ,"~~~:"~~"~;~ ,;/;;. :-~' 'I " 4/DR. HDLLA~D, PA 18966 Phone: 89 HERCURY TOPAZ VIH: Hlleage: 0 Options: , . . .,'1. S I ANOARO 0.00 P nt 0.0 0.0 2,6 0,0 0.0 U. 1.0 0.0 0,0 ~ ~mmar'", SOOY 2.9' 3l,OO 98.601 REFIHISH 3.6' 3l.00 122.l01 '':,~Jtc.;'' '.. "":~" PAIHI HA TERIAlS DETAil/DELIVERY ;ii,-'( . HAIAIUIOUS WASIl SpeL PA lHT mE T.u:~rl ~~'~1 , ' Ix 6.000' 50..01 15.001 3.001 14.001 !1 l~ ..,4 HEW 796.231 liX.d labor 221.00 T. 6.000' 13.26 f nl~ Pn Is I. 6.000' 1'~.23 47,77 Labor ( 6.5 hr~) Add'l Costs/Hate,dal$ '" ~!~~: ' Tax 221.00 82.40 796.23 65.97 'Grand Tot.a.~ ~.1.6&;. oI!!'.O '. . ..' ,~ , I~ti".l. C. Is . Ir.d...rk ;, Hit~h.11 Int.rnational copyrltU 1991. 1"4. 'm Althts A.mw.d '1' " , .1'A'......' ........ , . DR. ANTHONY G. VINCENT CHIIIOP'IIACTOII .... .".'OM ..,.In '"'~D..'"'A, '11~ ' ' (k'cr~ .. ,- " '0. '.O".IIION..L . ~ ~Jw ~,J ~<= _<.JJl<:~j2k , PTA-~~ " .'A'......' 1";"'0 DR. ANTHONY G. VINCENT CHI"O,"""CTOlt "oe 11.110" .,.~;t1-J...... (] .HIUD...HIA, 'A~ ~)( ?,.z ~.~ ~~1;:( ~cA ~~~ ~/ ftrilJ ~ , , , ;., , r I I',' " i-(,'. ~. :'1 ~' ( I:;. ,. '1- ITA""I"' "....10 DR. ANTHONY G. VINCENT CHI"O~""CTO" II" ."'.'.H ".IIT ~'~.:~~ 1I:t3 I , ~ , I ."vleu ~ * . ~~ ~ 1,' I, ffiJ 1/ l<~ , i I ! , .,.u......., u.....o DR. ANn/ONY G. VINCENT C:HU'O~""C:TO" '.0' ....110... 8'''IIT ""'''A 0 I"'''''' I.... "'..., ,. .at :' ::2S"..!l-::. I v ~-~ V<L-~43~ o:v~ [)~ (5~ ~~~~. j)f(~Jr [J ~~~~~I , " . , . ~,' i ., l"AYlWIN" ".....0 Dft. ANTHONY G. VINCENT CH'''O''''''CTO'' '101 eLlI.'" .'.11' ...,..........,.., .... 'e; - 3 c ~ =(h~ ~3 1.- . ;;:;;:::-~ ~~:;L'!rJL ~ ~c,u~~, fl'I/f.r)~ ;, ' , I .'AflM'''' .11....0 DR. ANTHONY G. VINCENT CHIIlO"IlACTOIl ..oe .~II." ..,..., ...'LAD,,'"'A, 'A. ""i' (- :;2-.3 I.~ .'A'......' II.....D .' \ DR. ANTHONY G. VINCENT CHI"O""ACTO" ..0. ....,." .'"IIT PM.........."... P"''f1.~ _~ ..13 / " " J;fJt.1J ~ I\. ATI'ORNEYS AT LAW 3<Jl MARKET STREET' 9'" FLOOR PO. BOX 86~ HARRISBURG, PENNSYlVANIA 1710ij 7l'7..B!-9900 7l7.W,6J~j FA.'( 7l7.J.\6-9119 April 25, 1997 Dr. Anthony G. Vincent 3506 Sleigh Street Philadelphia, PA 19136 RE: John Traum Dear Dr, Vincent: I recently received the enclosed note from your office In response to a Subpoena for your file on John Traum. Is the note enclosed the only record that you have? Would you kindly advise the undersigned whether any additional records are available? Very truly yours, 'tit /-:iIZll!/~ Matthew R. Gover NEALON & GOVER MRG/shk tf....d). 9. ~ 9 7 Enclosure..-:::>rn - ~ lL ........ L ~ -;t"'~ ~J J)I?A'V~ JAMES G. NEALON m . M"lTHEW R. GOVER. BRIAN W. PERRY " PRO,as.'IOf"AL CORPORATIQN From Iho o"lo.F! ", rhOfl1AS Jovian. M.D, ,\ P r" 27, I 'I R 7 Noll ~. StlhH, ~,. fl. :~ to ~II1' Y ~'o" I 0" I II I .1" . t:ll f t p :10:' 1,ltflJt'lnrn~,"^ 11111',7 I>Ft TRAil". .'OIlN .JR. "Oil r 1\ r. S I , h. n . t 1"1 h 11 r I'" ... II III f r. w n ~ R ~ I' II I" h. off Ie. 00 h/!7/H7. T hi" r 11 t f .. 11 t t" n I q y"." ,,' ,I mill 0 who I nlll r : d hIm R e If w h I 1. n' 1" II r k . ff p W i1 A ,':1 r t' V f It ~ it t n1 \' "r m p tt n 11 d f I! I J . r 11 I tin I I~'. he f e t t: "'Irl', t' "~I ': 1"\lI"< I l!.:Pt' .f,.., '.,1 'I""! '. '1P.r.t p:tin .1ntl ',!j ~ "dmtttf',t for '\ t/1 r. "ny". Pntlont ,lid hnvo 11 "^T "ono hilt It wnR not rlr'ld,e~ n" mnrhlnl' hrnke ,J.llHL ffe Wrl~ tnld hl' hnd C'ompreilu:jecf dt~c in lower hl1rk, rnrt.nt ,11,1 Reok ,v,',I",,, 1"0 "t lIolvo,"lty of ronoRylv"oln ~rnrtR Clinic, thnv wer(1 IlrlRlIrn of ht!CJ problem. He diet hove n CAT "0110 whloh conl,1 ont exrlll,lo pn."thlllty of dine hernlntlon. rntloot "t" 1 ,'xrerlpocc" stlffoeRs In lower "nck nnd hllrnln~ RenAntfon tn rf~"t Inwpr (':'(trrmlt"v. Pntlent: Rought my eVAltl.1tlon on iliA nwn nR worl'IIlPI1' ~ (,Clmp('n~.,t Inn would not pny (or the visit. lie hn~ "(1(>" \...nrkinp, slllC'ro ,..IIt'" Inc1dent. ~:!,n.)I.: I ell eI r 0 v I .' w n C ,IT "r" 0 do 0 c n t S t. ~I n r y 11 o. pit" Inn 11'/RI. ~.~l!!.~~lI! ~':tllllr~:!!.!on: rovr,'" teod.rneR" to pnlpntlon of hlR IlImhnR;1C'rnl ~q";li~ :lreA. 'Pnq~lv"" r:1n~(t of motion [~ painful 1n the extrrmeR. ^ctfvro r:lnge of mntff1rl Is decrenAed, secondary to pntn. Thp.rr iR wenknr''l't p.vtdent of tltl' gilRtrocnemius muscle on the rt~ht when comp"red t/1 the left Riel.. !"!F.!~~,~!~n : lIernlnted 1""h"r disc 1.~/Sl 00 rl~ht. D!!!F."s,it!on: I) Continue "nrkln~ In p"lu t/1 hest of "ltuntlon, 2) Ohtnln nhUR for", hr"o. f"r lower bnek, rx ~iven. 1) PrnRnoRfR should he rOil" 'dered ,," ~""rded. 4) Roturn hero for re-ev."",ltlon 10 h week. [ w.'n t pntlent. I to th"nk you for tho opportunity of evnluAtlng your ~ I tI (' (l reI y , 'Tit. J, n. " , ., "f _, :' ",'J~' ,1.::,:.,;1,1 f"Lt,.,l,-!, ',' hY' . .',,;I'll ":',\( (. -- T.I/ r",v tl f .' ~ .. nn I' r (l ,'loft '"'~"" ,1""" .,.,;n.,"" " ,-\) ".."ett '1. Rnt hn", P~. l~ 4~,.q, np "". ft. t'tllt,..,. sv.,\) ~'\ SAINT MARY HOSPI rAl LANGHORNE. PENNSYLVANIA '90<41 IV;~ll DEPARTMENT OF RADIOLOGY '~~R.~ ," -ns-sc 0.1. , 3-'-1'- .-- -. ----_.._~=~,.::....-=". --= -. --- REGION TO BE EXAMINED C'" Ilr> t."~ CLINICAL INFORMATION lIth" Whp..1 Chair 8toli'lId<' _,__,_._..__.,__ M 0 '~IIl~:lt ..."",..~l \"'1.\1, : I 'II~' I"". :~iA'&1-ioSTlc IMAGING REPORT: 'HI)""":" ,. ,'t: t' ,.,un',. I I' 'lilt., "'''' \I" :,,1 liT' ftll1'.\TI"". ""~""I' :111 "..",. "~"", I 'fI"'1. "P/I' 1Il"lI11\T"/" ,\T ,.~."I ',RI'P'. ,," , ,. I ,,1/1'\. ~ "", ,.,.,., ,.""" \f'U n'WONMII\' Tt) ''A'r1I!NT ".'II.,"T. "'",,"'''''T: ",.1 t 1 r ,,, ',,"r"" " r f.\,....... I \" ,"nn. f,..t . "'t ,..nrl""I' .,. ,." .r'.,.,cr,.....~ or '",r..r lu.b<l"""ral "plnr ,.1 >t.t..,d. .,.,tl d' fir ...'th~r 'n'r"th"~l'\1 .....r Int".""nnu,, .\t t h.. I." /, t "",' '.1 .."'nnr......'. t '..p' ",fn " nUl"""'" .,llllu1'"..'.... '01 t,. ".\",.1" 0" '''{"''dr''''",n' n~'fll"n'll1 ,.,. ,..". .l...."... ,', '. '~1~"'" ,t.,,,, I,. '''''r-- ,... n"t (1\"",.nf"'f!l nr h.,,.nl"',~d ,,,,,,,,,,.,,,. or..l"" 'IIt"nf'l~..,I~co \t th.' ,\, 'II ,,. "1. 'I. 1"''1' ", I, '.. ,'h~t ,."t"t",' ...'"n. "y__h',\, ..,...1""'1",, ."'fI,'HI' n.~.." ,- """1.' In"r..",,,..,1 ~,,'t 1.1"".,.. ""nlllty "Uh'" _hill "'1""1"" ,.,,""., ,i't. .,.,hl "'It, ",I . ".n"""'" "" ,,,... tit) 1~"f"Il t)n th., rlllht. 1''''... rtl)"lr.1 I I'rn"",' I,. >" II'","~ t,.. r."t'....,. PH""(.h ~\lt, " ,."j- ,,,,,.,..,, II.',' ......'11.'; " '...n".... ,,,., ,.d.." "',." .."..n,..t.. "oprt.fllnt,. ., th.....mtt""t hili" .'~'Iq t '1"",d,,~,'" th q,\" ."~",,,. .,.,'Jfl,lItr"rh)' -"T hf! """",11 '.,r rllr''''''''' ..'\'.llll'tt...." ". ,\'h,..,' ,..il/I..,i '.nt ..hnnr.",ltt'..." "rill' not",,". r~fTt MUMMO.".D. , 1111 '/"':~~ij ,tht ~ '" ' , I I Ilo. RAOIO\OG'Sf 1111'111"'" 'lIP.... fU'l I II,. ~ "I From IIlll ollleo ", fh/lmos Jovian, MD PATIENT: TIl^lJM, JOliN CII^RT * A 8540 8/15/88 - Pntient re-evnlunted today. lie is approximately 1 year 6 month~ poat work relntnd injury. Working. complaints are the same as in previous vlnlt, stiffness lower back pain across ri9ht toes. ~xnmined lumbonncral spine. Discussed with patient doin9 half ~it-ups. Physicnl therapy treatments bothers patient. lie takes no m<!dicat ions. continue working. Return here in 3 months. T^J/js d ict., not rend 11-21-RA: Patient Wnn rn-evaluated in the office today. lie is one year And 9 months post work related injury. lie is workin9. Patient states thnt his symptoms are getting worse. lie has numbnesn In the right tons. He complains of stiffness in his back and dOlm his right leg. lie has good and bad days and has problems getting up from a sitting position. Patient is seeing a chiropractor. Return to the office in 4 months. continue working. TJ/ms d ict., not rOM!. ,. " From tile ollie" 'If I llamas Javlao. M 0 Patient: John Traum Chart . A 8540 3/13/89 - John Traum was r('-....valuated in the office on 3/13/89. This patient is 2 YC'ilrs 1 month post work related injury. Patient is currently worldl1'1. lie continues to oxperience low back pain, right arm pain "l1d numbness and right leg pain and pain across .,11 five toes of the right foot. Patient relates that he has h""n seeing a chiropractor and notes improvement with the treatmC'ntr,. Examinilt ien of the cervical and lumbosacral spines revenlr, tenderness to palpation. lie was limited range of motion. prmJllOS is guarded. continue working. Return to this office in 5 months for re-ev"luation. TJ / j 5 diet., not rend 8/14/89 - John Traum was s(>('" in the office for a follow up visit on 8/14/89. lie is approxim.,tely one year six months post work related injury. Patient is c'lrrently working. At today's visit, the patient continues to hilV,," low back pain, cervical spine pain and left aml right leg pilin. Examination of the lumbosacral spine reveals tenderness to palpation. He has limited range of motion. There is tenderness to palpation of the cervical spine. Patient is encouraged to continue swimming for exercise. Prognosis gtlo,r(led. continue working. Return to this off ice in 5 months. '1'J/js diet., not n~ild From Ihe o"I~.. n,rhomas Javlan, M.D. P3tl.ntl John Traum chart * A 8540 12/11/99 - .Inhn Traum WElfJ ""nn in the office for re-evaluation on 12/11/99. Thin patl"nt I" npproximately 1 year 6 months post Injury. I'ntl"nt. Is curr"ntly working. At today's visit, the pElt lent cont I nllOB to hnvl' 1 umbosacral spine pa in and burning "",IBElt lotI ""'./11 his right ln~ler extremity. Examination of the lumbonnr'rEll "I'I no revl'lll n t"nderness to palpation. Patient does not rocolvn I'hynlcnl thl'rnpy treatments. He does not take any mlldlc'ltlonn, I'rognosla glln"led. continue working. Return to thl~ offlc" In ft monthfJ. T,I/ js cllct., not tn;.,' 10/29/90 ~I"hn Traum was """n in the office on 10/29/90. He is Ilpproximatrly 2 years 4 month" post work related injury. Patient Is currently working. He continues to complain of low back pain with the p.lIn going down hi.. right leg, He does not receive physlclll thnrnpy but dons pxnrcises at a gym which he has joined. ~xElml""tlon or the lumbonncral spine reveals tenderness to pEllpatlon. IIn h.~!l flexion of 40 degrees, extension of 20 degrees, rotat Ion t.o thn right and lo:-rt of 10 degrees and lateral bendifl-r:j to the right nnd lelt of 10 degrees. Patient told to continue .'xllrc I A Ing "I'" to uBe a BtE'p machine. Prognosis remains guarded. cont,lnlle work I nq. Return to this office in 6 months. T,II j. diet. I not r""Ht I I.' .1 "f , l,1 ,,~t &\int Mary Hospital ,r 'I' EMERGENCY ROOM . RECORD , '_, , 0 '..na"" NAWI L.alT,'~ITMl ....... r' , '''HF 1111""/41 4'!V ~'f'SlCIAN \JA~:'~~~AI I I,ll lit, I ;HI"O ......,.'" , ,," T" L' ,,"'" PH'W'~H..IAN :.'~l-~ I, i','" nlHlll1 <CIrJ~I', NO'IJIID t~~O,~~ H ~I I ~l'''' I MI.I.,'t.:.l.ANl,' AVE Y:If I" I: 'I) 19!'-'. 1 J ")U If.rwa"' '-.~ I F ~"" AMHIII A 11IkVp~I' .,,'" I IIAI,II'1, "rmRt" flU..A PiANI t , \,I...., I'll?''',''''': 1"1 ....:'I,.,AI. E "'ODAln "'DOIlIl5S ';';;T - 1 I k-'( ers.z ""'Nt ~~;C" rRAI.Ii"'!, I I, ^JIIA l~O"IR AI :M~ ,.w 1 ~~; ADONIS , 7()"i kF NNI- I' ...,1 hi 'r AOOAISS errv"TATll11' HI; If I A"lJ I .JA ,I :,-:':'('-.(" AII.ATIOH CiSit =--:~ " ...i-q/,,;,:I....:1-i41,1:, l"n~J- /:~n-".l")l) ''::I')I''.I~ PHONI ~IMt-:-~.II"A'" ':"'1141 IIIN,"~Y '-;"1'..' ,I ~i-r..: lP 1"f)/'~Ir. ':<:1 I f.lAI, 111, . :'.....'\1 .~~34/,,!1I/, t -:( 110.. l~,' tJ\!I" . "I ,.'j ~:I '" IY CIT't"'A'ltll' ~ "1~''''''I.;.r,-,''',.II' w H. I' ! ~~ r.'1I h'~~ ,'.:-,'. 1','" '- "( -'.I'lll.'i AIIM ",'<":-,,", I..uJVlIll 1-\1'1"11:- ~,~. 1 :- ....... CITY"'''''IilI' HI..N~.;:A'.F'" ~ '.~l~,-"-'/'J.-::lf)(II" OCcu' HI II I ~rlfl I-'A 1:=t';',.1.. IIlI':L.UlOH ':j:', .. 'I "';_"'/,;"!_ ,--,Ill' 5!" ,. 1,'_' tl-,... .,r:,d.'."' HI:- N~~AI.~ 1"\ ',~'. ~I--il-..A-~':C:)()I) HH I,II:-I:W I I~" :'11 III\I! (n-I .'" "" Nt-I 1 ..,: "~:U',':'';-,4'~' Gill' "" MAN N~I,:'. ~'['" ~IRP"M, \J~ H I YF~~ ~lHAI.IM. V..'R, VI"'" \ . ......'" , :', illiG . \or ,lflHN 1t1::;fIl .I"-"H~I 1Il181=1... cp .::. OIl' Pf/I,IP"N 1 'AI, .... """'" :&' 'l"f,!A/..:",:.,14' :is' F' "'" .... It& '~.:cn ~ ~COOID :If I-fMlI F-i"'f-R I if-' ~t)tAQN()6I. I r.I~;'; ~ I- MfJ-AI ;f"1~ Mt<l ';"-; MVA, " _ .IIH"",",R.. ~ .1":/1:1 I:H~'=:I n.":~:&:fl"'"'.(;f-.:I ~,. ... COT "" ~l"'" TI , , (I ~ I) ~~ , "" .,~ -, \ Ir~J~~.,-".."'1" I \T&f, Vf-;.:, TRAIIM. VHH Nro M~', f'" , !NPA ...t;;PI'III~;; Sl-' HMO:, l-'A'.I ~ ~Nl' " '1;/5 00' I ,.' I r":.'i - ,,"000 PAUSUfII, ""SI , ~ "" "n'IfIIATION rtMP , , ." H' VO'PA SIN' '-'" '..., ""' .,~...... I ~VSICALI""'" ,./ . "ST I fIllSUl.fI .- ~ /L~n- -... .J f ~,-....-.......... ,- " , I.J.,... r::r- . , IA:;-' t / I' ~ ,<, ,'~ "'" I CIIC ....z........, ~ ,!']... ,,/(,- .. .~-- jo~'"'' " ~ , ;:,4'~ r~' (" p"f ~,< "'" I.. '1 C'.,~ ,"'" \7' , L-... r7'M ,,-e,rF '~'//"'...J. 71" - ,.... 77(' t.~ /_h <.,( II .. N"V , .-..- /-' \If.-.~..l . ..,....... tff ~l"" '- 0- )J~J.I ~ ,-.,; 1--1.'~ ( ~/'-- .l.........__ ~, '10'(. .1'1/., i.::"" ,"T/ " , r: .... "., V' .1 \......._ .., I, r- '." r ,.,. ,.... 1".Jr. , .. (-J.. f7t.(,,~ i/., c,-'" .J (I ..,.,,/' ,( to. ",. /1/ / ( A~/J, ~~~, ) /1"".1' I~ '. (. 0',.;~..,J .r. L..... ..~..1'-1./~ . , . ~. .....r A A ~>"I ,~ ' ,.,.,.- r ~ (fit ~'_,- I;". r ( II'Y 1 ' I' .,. ... ,,;1.,1 .; ~)(""'" /' / ~/ /,.. ~,...J,t,W\" ,/-i ." .. ,/ ~.., v~. u , ,...., "1011:"" HISTQAV ..~)" , ...f-. Y ,;.. ....... G.,. .A -!..&.!. I..... .:.. . -- '.....YHISlOII',. '\ _. SOCIAL HISlOfll't' / " , __WClfriITOIll ,-., ~1tCIAN 5 01'0,"1 I ""'~'" :).... J<.' . '''f,- I- e -.J ,r,,,, .! I I I '-<. , A ('"\',, -"'.~" . ....... - /1.-1..( ,f "7.x,c' .,,-1- I, ()f ,,~) (~.';-;" , (J /1 ~ ,(I f I/O .f;'. '''- ' " ... -- V OlK.HARGIII'fSTII'UCTIONS I - OlAGN06Hl () L.H. d t~~i -. "La I( 1 . _GAlfII'OI""IIIIITIS _UIlIliLM't'TII'ACl' '<, )............ _"II'AI"" PHVKlANS CALl.IOiAI'IAI\AL5<ADMlrTINU PH't'SICIAN ..- _ 'QIAklfIl COU) _ HI AD IN,JUIIl't' _'IVI"CHILI.S _ CASfeAfllI _ WOUNO CAIlII , ..., . UR' -,Llvn _ &leK. NICK NOH,CAlIIDIAC ""IN lOse (. -- .-- <' .-.-.... "'lJo_91"I!IV_' . .. .. ; I.' I. '.M~ " ,. - P I L: , I.,. , '.1 . - , , , .,. ~ r . - ~ .-{ h , - ~~ ~("~ \ t .7:::) -C -: r0 :t:L - -::i- ('C""' ~ ~'\)..,. ~ ~ ~ ~(~' - \..~ .....,1 "1I1:/ '-' ,,1\, . . " '. , " STIPULATION TO TRANSFER VENUE 1. On January 18, 1996, Plaintiffs, John and Linda Traum, commenced this action by filing a Complaint. 2. This civil action arises out of a motor vehicle accident that occurred on Febr.uary 7, 1994, on Gettysburg Road, Lower Allen Township, Cumberland County, pennsylvania. 3. At all relevant times, Defendant, Kevin E. Koons, was a resident of 145 Red Mill Road, Etters, York County, pennsylvania 17319. 4. Venue is not proper in Bucks County. 5. The parties stipulate to transfer the action to Cumberland County. WHEREFORE, the parties, by and through their respective counsel, hereby stipulate that the matter is to be transferred to r" Fr' ,. ':1..1 .,. . ':,., 1"','1 , It \, , I ~" ,,) I IH j ~ : j 7 . ..... '.r" ", '.'1' ..'.' "I ~~., <j ,I) ."; I .,'J .. .....: ".Io"'~ ''r'lll "..,'I .,., . , Q Ul t: z . .. :! ~ '" It . ~ '" Z ~ c C ~ C . .. 0 ..J " > x . "" ..J . .. >. 0 c z l/I 1(1 u UI 0 Z . )- ~ Z c " oJ . ... ... oJ 0 Z < II. .. .., . II: ~ 15 ~ . 0 0 u a: 0 . "" z :;) 0 "" ;; oJ . <( III <C . .. l/I U C I'l ii a: <( J: . . --- ,-... lJIJ .'1 !1IJ:; "UO I ~6 JOHN AND LINDA TRAtJII, I IN TBB BUCKS COtJNTY COURT 01' I COJIMON PLBAS Plaintiff. I I NO. 96000377-13-2 v. I I CIVIL ACTION . LAW ltBVIN B. KOONS, I Defendant I JtJRY TRIAL DIilMANDBD ENTRY OP APPBARANCIIl TO THE PROTHONOTARY: ... .~ Please enter~ appearance on behalf of Defendant, Kevin E. Koona, only, in the above captioned matter. Respectfully submitted, CALDWELL & KEARNS {l~ G. NUd\'Y\. es G. Nealon, III, Esquire torney's ID #46457 3631 North Front Street Harrisburg, PA 17110 Attorneys for Defendant, Kevin E. Koons By: Dated: February 14, 1996 66559-1 I. it :0/1/,/ " .{ !:.. ~. I, . . , 02" VJJ0. CJ(J : ~. ';, , " ... ---I' /I' I' .., 'I J ".liJ,~" iJU I (t'! CERTIFICATE OF SERVICE AND NOW, this 14th of February, 1996, I hereby certify that I have served a copy of the within Entry of Appearance on the following by depositing a true and correct ccpy of the same in the U.S. Mail at Harrisburg, Pennsylvania, postage prepaid, addressed to: Roger J. Harrington, Esquire O'Brien and O'Brien Associates 1260 Suburban Station Bldg. Philadelphia, PA 19103 6"'V--i? G, NL.Q.t vV s G. Nealon, III, Esq. 66559-1 I-.J~ I ... (I; -.LoI~ SHERIFF'S RETURN _ Bucks -t'093) Cepullze ~Z-l County _11Cl0) Cerlllled MOil Po R.CP #__ _ll103IPo~.Pa RCP #.----- ....,.J-/ CIS' # --J.L:.t-L1i-J.-_.. Filed -0 L4/.4 ACllon __.._j::J~_....__. Plllnllff JOHN THl\!.tL& L!NDA..THALM vs Celendant KEylJ;1..J:J~g;;>,NS 145 RED MILL RIL",_________ "Rl'I'F.RS PA..-llllll._...,__,____. , , . I . I J , 'I I Served under Po R.C.P. #402 --r;-i'OO3) Bucks A:-nOI4) Cepullzed County ...p..JAIII) Ce'endanl parson.lly served . _jAI12) III Femlly Member ' \ --JAI 12111) Adullln Charge 01 Residence . _-lA) (21111) Mensger/Clerk 01 Celts.~odjIlhg ~ --JAI12) 1111) Person In Charge of llusines, --Jcl or Idl Other See list --Jl0941 By Posling ._11011) Ce,tifled Mill _...Jl006) Address Served II Different' Sy Hlndlng to I~ I 1),1 f " ,l" 11 I( Ii; i) 1';.1 ' , I,i. NOI Served _11016) Bucks _(1015) Deputized County -(1012) Certified Me" _ 30 Ceys Ren Out _ Delendent Not Home _ Cellndent Moved _.. Address Vlclnt . _Cel. Unknown _Dep. Needs Belt_Add. - Checked POSI Office _, No Forwlrdlng _ Forwlrdlng Address .. \ , ," --J' 125) Othar \ i ~r t w I. '~;'r I ,. J lt~ , " if.' . ~ ,:1 ., ':' Twp.lBoro ~ '... ;. , , ., , '. ..vt\ " 1,' , '.I I' .." (' By Clputy Witness , AI .I 1....:..2.._ o'clock<[~~ PM) on ..1.J.:i.Y J4; The above documenl WIS ..rved/no. sorved on Ihl d,'endlntl' per information hsted abovI in the County 01 Common So .nlw ...~ . I 1<. " , I . .. 'r I .~ . "t I :' \ ; , . . . I ~,.' . . \ . ~f "to ~,"..., ; . . r I ' ( , ' ". " I. .j ,~ " " ., " I i ~ \ .~ . I I "I , \ I , r t nsylvanla, ~ , .,.t"",/"..I, '" ~,.,.t~ Shlrlff 0' .. {..-" I. .:.:: Cou y Affirmed end subSCribed belore me on Ihis dlY -/ -../ - --_.,----~---- .-------- Prolhonollry Affirmed end 5ubsctlbed before me on Ihls day _/ ,..,/-- ---_._._-------~_._------_._.~--_._._--- NotifY Public My Com bp .-------- --.----~.. _..-. -- .-----------.---- ~ , i , ,-, ] el.." '1r.: -(':'~:': / I i _ ,~,.L/189k.., I hereby d.pull.. thl Sheri" 01 1L./-! .-:T ! . . y"r'f Counly to """ th. within ( I I, I .r.'" . , . I, 1, (~, Enclol.d lor ..,vice. Pt.... UII thll ce,d f ou, .tu,n Think you. .nc. R. Mlchllls, Sheri" 01 Buckl Counly . . L 'lIe I' "") / . ;/" I AlIO''1' y I;. ;' ./. 'd' I '. (if ,-/,' I I I ". I ( J (l\. f I,' ',I , --/1013) Involc. m.lled on -.1-.1_. Speclellnltrucllonl I, r'l''\ "..FU:;.TE RECEIPT \0',) ":J.W'> * 13~t l.()~;';:.:.~ :'1; :.r <';,liO I Ot I * 1.:11 ~,~. '.'~.~ j, .: FOR E P.OGER ! HI~FF; Iii. . "I ["",;, 'jl ~7 . PC '~00C;'31'.\5 :~ ~X -'~' .. to ..Q .JIj U ,r1L. _.l-~. -r ,',' c~ ("It' Y'lHI. '. U:" ,i ,in , . .,"r' '.,.- :HH\ll.jl~. Tl',~I~ "[Ill In!"',;' I.. :~ t 11 ' .,J> , ,. i I , , :I i , " , : , .. 'J' . .' ,."",.. ~ " , . , .11.' i I' I d ,~' f . ' '1. , j. I '. , I I Ii, I I' :rerm* 96-377 '-',,1"'111,'..11111"':' . 'J ,I ~ .._~!l1.U..f\.f.~!~!)..!=:~P..~::.~!lt ...........,.........................,.......... .......,. .. . . ...................... Served the within .....................................................................................................................................................n.................. upon ....I5.'f.y.kn..f....:.lSQQnli......................__................................................................................................ ................................~..............._......._..........................-...................................................................................... the within named defendanll by handing to and leaving with ...~!}y.L~...~9:?D.~.......................... ............................................................'......_..........._.....__...___._._...n........................................................ .., ................. ..... .... ....... ......uu.~.n.uu_.u~._..... .._...u...._.__..~......_un..~.............. ..... ...n.............................. .......... a true and attested copy of the same at ..XQrJs..~9.v.IJ.~Y.,!;'9.IJX.t:J1Q.\\~.r:.....~.e..~.....I:t~r.K~~..~~.../........ York ('ounty, PA ..............................................u...._._....._......___._..............................~......................................................... at ...H!.Q1........... O'clock ....t\,.M., ...J.mLMry....lQ~...l.~.~.ti......................................................................... and informed .......tl.~[1)................................................................................... of the conten!s thereof, Sheriff'. Cosll $ 20.00 Paid 2-15-96 So Answers, Sworn of this ..).?~~............. day of ....r.~PX.':l.<;1.!':I'......:.................... 19.?L... /////~rh-'l $heriff of YORE COUNTY ................................................................ ......;(1k~~..,/~~... ~notary Notarial Seal Mell... J. Oros.. Notary Publlo York. York Counly t'.1y COl1lml~:",,")- ,pi",', AJ,Hil20. 199B r'\ ......, r I, ',II ili,' 1.1' No. 'It, . J 77 T.rm, 19 . 1M"'" 0III'ICa YOIIK COUNTY COURT HOUI. YORK, PA 17401 . eliI'I .~LI.111). I'JJ'.11I1 V.. .~v ill I:. 1\(1I.'1l1'-, Type Action Date Altom.)' I'.',)' I'.' r ,). 1.I.I.n ..Il: II:..m A'~vanc. Colt Paid ,:.U.,',,\< lIl.rIff COI" Refund ',.'lJ,lilJ Dateol8ervlce,;.: '" ..1" K:.WL/\ K'.K.. 'r"H I'. I' "lilt,,' ,)1<1 'ii' l!l.j,,', )ll E. i'I;- ;1., (oJt'\, I'" , ,~~.J!J...,I;j,I.l Balanc. Due.. /, Cheek No. I I" ; ..... ... ".uk'l Date 01 Refund 1/(( SHEIRIFF'S DEPARTMENT York CAlunay Court Hou.. York, PtnnlVlvlnll 17401 ~~) (:9 II .~. 1\(( , ,\~~b'lI . ~ (~ U,fl {( 'ff Ie.-' .:,)-' ~{\I\.U ..,1 l.,> If (~)\..., DATE NO Jj 1. 8 -( i! ;i!, 111 (/ll' , ~l!)(. ('~(, \~, NIOMr PAlO . .. ,bl'(,' COUJoRB o CA8H 121 CHICK ~ rJ>~, ffianb CYOU! ~ JI ~ o f-o ~ C <.l <ol ~ " ~ :\ -- ~' ti ~ ~ ~i I ! P ! ~l i h! 1i! ffi ~ ...; EO ~ - ~ 0 !( <ol <.:l ~ :>' ~ ~Q.I'" ~U'" f-o ~ '" ~I <Xl <"'- 52" ,...,,< ~"'" ~ '" <: . <: "'" ~ ~ c:: '" ZI.f"II"""l ::co- 0....0 ..,-::c ~ o <.l "'''' "'- OM Vl"''''' Z - 0_ 0_ ~,~ < . X t).. '" '" . " Ul Z~\.l ,... " :--"'" <ol""'" ~~f.IJ E~ ;:>~ "'''' Ul ;. ~i ZO ,...U .' '. . . .' '1'" ~"'lJ' H)'"I''' II'IUI,~, lII",II'f O.......H r;>1"!i,m' l,,'Hl IlWj'1 '" . . .( ~ "- ~ Iii a t , , ,i';' --- nt,'/, 11~\1Utl O'BRIEN Hnd O'BRU:N, ASSOClAn:s By: ROGER J IIARRINGTON IDf:NT....ICATION NlIMllt:a: O'lKK5 1260 SlIllllRBAN STATION ULUG, PIIIl.ADELPIIIA. PA 1910J {11~) ~67.7J81 ; ATTORNEY FOR PLAINTIFFS , JOliN AND/LlNDA TRAlJM 170!! Bennett PIHce lIollHnd. PA 18966 IN TilE DUCKS COUNTY COURT OF COMMON PU:AS Jlllty TRIAL DEMANDED v, NO, ." ,fit 1/ /: 1';"7 - .).. / KEVIN E, KOONS 14~ Red Mill ROHd Etters. PA 17319 COMPLAINT IN CIVIL ACTION COllNT ONt:: ,JOliN TltAlIM V, Kt:VIN E. KOONS I. Plaintitl's are adult married individuals who reside at the above-captioned address. 2. Defendam, Kevin E Koons, is an adult individual and resident of this Commonwealth residing at the above,captioned addre:is :I On or about February 7, 1<)<)4, Plaintitl: John Traum, was lawfully operating his I <)8<) Mercury Topaz when Dctcndant, Kevin E Koons, suddenly and violentiy rear-ended Plaintil}' on Gettysburg Road in l.ower Allen Township, Pennsylvania. ~. As a result of the al()resaid a~~ident plaintitl: John Traum, was ~aused to sutler severe and serious personal injuries, ~ome of whi~h may be permanent, to his head, neck, arms, shoulders, ba~k, body trunk, extremities, nerves and nervous system; as well a~ pain and sutlering, emotional and menial distress, loss of life's pleasures, some of which ~ . ,,..... I'" III :;" I' .1',11, () injuries have continued to the present time and, further as a result of said injuries, plaintiff has been prevented from attending to his usual duties, vocations and activities and may be further prevented from attending to them in the future, all to his severe emotional, mental, psychological and economic detriment S. Also, as a result of the accident, plaintitl'has incurred medical bills for which plaintitf seeks reimbursement herein. 6. Plaintitfs personal injuries, economic and non-economic losses set forth in the above paragraphs incorporated herein by reference, were caused by the negligence of Defendant, Kevin E. Koons, which consists of the following (a) Operating his motor vehicle in violation of and in disregard for state and local traffic rules, regulations, ordinances, and statutes; (b) Failing to have his motor vehicle under propeLand adequate control; (c) Failing to be on the look out for other motor vehicles on the roadway; (d) Operating his vehicle without due regard for the rights and safety of others in and about Gettysburg Road, (e) Failing to stop his motor vehicle in the assured clear distance ahead; (t) Operating his motor vehicle in a grossly careless and reckless manner; (g) Operating his vehicle at an excessive rate of speed; (h) Driving too fast for the conditions of the roadway andlor exceeding the posted speed limit; (i) Negligence at law, (j) Negligence per se; and (k) Whatever additional negligence that may appear during the course 2 -- "...... , i ,: Ii 'I ',llIUih, of investigation and di~overy in this mailer. WHEREFORE, plaintiff, John Traum, demands judgment against defendant, Kevin E. Koons, for a sum not in excess of Fifty Thousand (550,000) Dollars plus interest, costs and allorney fees. COUNT TWO: LINDA TRAUM V. KEVIN E. KOONS 7. Plaintiff, Linda Traum, incorporates paragraphs one (I) through six (6) as if set forth herein at length. 8. Plaintiff, Linda Traum. is the wife of John Traum, and as a result of the negligence of Defendant. Kevin E. Koons, Plaintiff, Linda Traum, has been deprived of her husband's companionship and consortium, for which Plaintiff, Linda Traum, seeks compensation WHEREFORE, Plaintiff, Linda Traum, prays for judgment against Defendant, Kevin E. Koons, for a sum not to exceed 550,000, plus interest, costs and allorneys' fees. ( "- " RESPECTFULL Y SUBMITTED, -~ _.J . ROGER J. ARRINGTON Attorney fo' Plaintiffs j~l' .'jl: , :\' ,~\: J II I --- ,,"""" " .1\ it,!I" 1.1 I ! ~ '. " ~ . VERIFICATION The undersigned hereby states that he is duly authorized to take this verification and avers that the facts as set forth in the foregoing document are true and correct to the best of his knowledge. These statements are made to the penalties of 18 Pa. C.S.A. Section 4904 relating to unsworn falsifications to authorities. ~~L~~ )O!;lNl'RAUM . -~ , ... v'" ~ J~(L A~,~ L A TRAUM ( Date: j-~ 1. 11' ' Q-I07M . ',oJ' , C" j, I Il -. - , ). r" , 'I" , , " , (', ; .,) i ". 1,"'1 r' .. ,I"J . , I .', I.' \.i) ) , l'..-' ,) tn ~ I iii ' ~:- >:~ " O~ ~,,; t:)~~ ~~! lIJ~~1 ~~~ z 0 z ". ~ Oiiill 01[ ..J ~ e ~ a: . ~~~ !5 ~ z. i OJ C ,II ~ ~ ~ r ,. . .' . JOHN and LINDA TRAUM, Plaintiff v, : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLSVANIA : NO, 96.2005 CIVIL KEVIN E, KOONS, Defendant : CIVIL ACTION. L-"W : JURY TRIAL DEMANDED ANSWER 1 . 8 Paragraph 2 is admitted; it is further admitted that on February 7, 1994, Dsfendant, Kevin E. Koons, was operating a motor vehicle which struck the rear of a 1989 Mercury Topaz being operated by the Plaintiff, John Traun; the remaining averments contained in Plaintiffs Complaint are denied pursuant Pa. R.C.P, 1029(e). Respectfully submitted, NEALON & GOVER <::...----, By: c=t - James G. Nealon, III, Esquire Atty. 1.0. #46457 301 Market Street u 9th Floor P,O. Box 865 Harrisburg, PA 17108-0865 (717) 232-9900 .. VERIFICATION I, KevIn E. Koons, verify that the statements made in the foregoing Answer to Complaint are tl'Ue and correct. I understand that false statements herein are made subject to the penalties of 18 Pa, C.S.A, 4904 relating to unsworn falsification to authorities. ~ /~ Kevin E, Koons Dated: ~ . JC> -"1 ~ . CERTIFICATE OF SERVICE AND NOW, this 25th day of June, 1996, I hereby csrtlfy that I have served the foregoing ANSWER on the following by depositing a true and correct copy of same in the United Statss mails, postage prepaid, addressed to: Roger Harrington, Esquire O'Brien and O'Brien, Associates 1260 Suburban Station Bldg. Philadelphia, PA 19103 ~ James G. Nealon, III, Esquire Dated: June 25, 1996 , l~1 .'1 , . ~ ,I i I; 't ! '-I , ,,' '.. I:: ~ " , , I;; , "'" , , '-l:' ; I;!' - .: f':" .:J; .1 , , " .:, , " 1 U C''.j I , I.::. ~ . " . '1;'; I .... -,! ~j- '.:.J r..,:, -j '-" (J - - Ul <D ~ 10 8 9 ffi z 10 0 ~ 0 i' ~ ~ E > c I . g 0 ..J .. ~ . ~ m Ul z . <D 0 .. U .. 10 =J Kl " UI I \oJ X >- >- \oJ c ... ~ 0 Ul Z . ~ <D Z 0 Z z 0 iii 0: .. ci '" oJ . 0 ~ ~ u \oJ ~ " ~ . <!i 0 ~ a: . < :l Z . I 10 c i5 Ul ~ a: a: .. I - '. COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND JOHN TRAUM and LINDA TRAUM v, : FILE NO, 96-2005 CIVIL KEVIN E. KOONS SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009,22 TO: EMPIRE ADJUSTMENT & APPRAISAL SERVICES Within twenty (20) days after service of this Subpoena you are ordered by the Court to produce the following documents or things SEE ATTACHED at the offices 01 Nealon & Gover, 301 Market Street, 9th Floor, Harrisburg, PA 17101 You may deliver or mail legible caples 01 the documents or produce t~;ngs requested by this Subpoena. together With the Certificate of Compliance, to the party making this ,..quest at the address listed above You have the right to seek in advance the reasonable cost of preparing the copies or producing the things sought. If you fail to produce the documents or things required by this Subpoena within twenty (20) days alter its service, the party serving this Subpoena may seek a Court Order compelling you to comply with It. This Subpoena was issued at the request 01 the lollowing person Sharon Mlnnaugh, Paralegal for Matthew R. Gover, Esquire 301 Market Street, 9'" Floor Harrisburg, PA 17101 717.232-9900 Attorney for Defendant BY THE COURT I 7. . .1' at DATED: CJ _ I, , ~. . } ~ ( u..t C U../ .A '-/:l....,~. . PROTH01TjY . . )'J l 1',.J<;:(1; ~. ~ Seal 01 the Court AND NOW, this 24th day of March, 1998, I hereby certify that I have served the foregoing Certlflcats Prerequisite to Service of a Subpoena on the following by depositing a true and correct copy of same In the United States malls, postage prepaid, addressed to: Rogert J, Harrington, Esquire HARRINGTON & CALDWELL, P.C, 100 North 17th Street, 15th Floor Philadelphia, PA 19103 '/.' '/, ,f I/./ //!< :-',r, '('i.?") ")i;~:~/) Matthew R. Gover, Esquire j . ,I .j ._~ , (W"'Il'F (W I'I~()'('/I(),"()T,\I~\ 'I 1'11111"1,,1.111111 "Ulli\ ( "11I~k J .,\ I Jill . , 11,1, (] a.--i.....- Thi-- I' IUII'llll\ ,\\\11 rll,tl C/~oJ Id.c..r-...---.. 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I' I~ ( II II t f '...4 i I \ I,' \ \ ' . , ~ 1 'I I.i, ~: . ~,. - l\ill J I .. ~ ,.., -~.- --" ~- -. " I' I I I", -. IN THE COURT OF COMMON PLEAS Of CUMBERLAND COUNTY, PENNSYLVANIA John and Linda Traum NO, 2005 CIVIL 1996 VS, Kevin E, Koons RULE 1312.1, The Petition for Appointment of Arbitrators shall be substantially in the following fonn: PETlTlON .'OR APPOINTMENT 010' ARBITRATORS TO THE HONORABLE, THE JUDGES OF SAID COURT: Rngpr.1 lI"rri ngt-nn, I'~'''J" i rp, counsel for the plaintiff/defendant in the above action (or aClions), respectfully represents that: I. The above.captionedaction (or aClions) is (are) II issue. 2. The claim oflhe plaintiff in Ihe aClion is $ unliquid,ted l.pain and suffering frOll\ The counterclaim of Ihe defcndnm in Ihe action is N A Motor Ven1.c~e Ace The following anomeys are inlerested in the case(s) as counselor are olherwise disqunlilied to sit as arbiur.:ors: Except foJ;' counsel representinq parties or counsel who represent Allstate Ins. Co" Plaintiffs' counsel is unaware of any other counsel who should be WHEREfORE, your petition~oiW~JJr~~'\ig..a~d~rhNt>p~fiR^r~~tJIj~liitttators to whom the case shall be submitted. ~:t)IY su rnitte~, ~er ~ I a rlngton, Esquire ORDER OF COllRT ANDNOW,~ Lf foregoing petition, luP/~-tII.) ~ Esq., and !tUU.....LJ, ~/V'l.I actions) as prayed for, , 19~, in consideration of the . bq., ~ ~t;U~:u . Esq., are appointed arbitrators in the atiove caplioned Klion (or P,J, III " , , , I. (f' .' , ,; Ii ;.~ j o \..,' '..' I . 111 III ~ III 0 ffi . 8 a, 0 Ii 0 ;: ~ i3 c > " ~ 0 ..J C g . !( 01 111 Z " III 0 III ~ u UI ~ ~ I<'l " )- .. . ~ c loJ ~ 0 111 Z . III Z 0 Z 111 Z 0 ;; II: ~ 0 W oJ . 0 ~ .. " ~ " ~ ~ l!i 0 ~ ~ " ~ ~ Z . III ( 0 111 1'1 it 0: C . . JOHN TRAUM and LINDA TRAUM PLAINTIFF : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNA v. : NO. 96.2005 : CIVIL ACTION. AT LAW KEVIN E. KOONS DEFENDANT : JURY TRIAL DEMANDED t!!OTICE OF INTENT TO SERVE A SUBPOENA TO PRODUCE DOCUMENTS AND THINGS FOR jllSCOVERY PURSUANT TO RULE 4009,21 -Defendant, Kevin Koons, intends to serve a Subpoena[s] identical-to the one[s] that is attached to this Notice. You have twenty (20) days from the date listed below in which to file of record and serve upon the undersigned an objection to the Subpoena[s]. If no objection Is made the Subpoena[s] may be served, Date:4/21/98 Matthew R. Gover Esquire Attorney for the Defendant AND NOW, this 12TH day of May, 1998, I hereby certify that I have served the foregoing Certificate Prerequisite to Service of a Subpoena on the following by depositing a true and correct copy of same in the United States mails, postage prepaid, addressed to: Robert J, Harrington, Esquire 100 North 1711I Street, 1511I Floor Philadelphia, PA 19103 ,''':., '-'~I / /,/'. ,r / ", . I, , . ;' ,'.' . , Matthew R, Gover, Esquire ...' ..:.r c. (.; i L;'.j , " , , ': " '.J.. ;"/1 II'} , ' ", , I' " I , " i. " I',. I ~ . l Co, , ) <, .I '-' nllQ OIi"'ljO~ -I1Y Q. I' (~HQ' I'" Ml"'1Yl)'1111'tL1 \IMIIIIO"~~I~::"'JlI11"" .oIiOIOIl JNI'IWt<<lIIY"Il.' ) ..l; ''Y) (j Q ~ r~ C) o '~~ :+-...~ J~T<~ ~ .~ , ~ - . . r-- ~ i ~~ III $ ~ 0 8 ~ · ~ 0 ffi ~ ~ ~ ~ > ~..J CI III Z g~~ ~$~ U Ul I '" )( >- k5~~ ~g~ Z ~ Z III ci ~ 0;; II: ~"'.. ..n 0 ~ i!i ~~~ ~ ~ z ~ g ~ ~ ~ I CERTIFICATE OF SERVICE NO NOW, this 14'" day of April, 1999, I hereby certify that I have servsd the foregoing Notice of Appeal From Award of Board of Arbitrators on the following by dsposltlng a true and correct copy of same in the United States malls, postage prepaid, addressed to: Roger J. Harrington, Esquire HARRINGTON & CALDWELL, P.C, 100 North 17th Street. 15th Floor Philadelphia, PA 19103 Respectfully submlttsd, NEAL ~ GOVER (/ / - ~ ( By: ~d(, l~) atth w R. Gover Attorney 1.0, #47593 301 Market Street -- 9th Floor P.O. Box 865 Harrisburg, PA 17108-0865 (717) 232-9900 , , ! ",I >. ., ',... 0:; - l" r'~ ".: '.- r N "I' ( . 1'.\ .- J'f ll.-. j (11 " L.; ~) C. 1 lJ.I' .. .' il~l ~ ;. ;I.J "- .'! ~ ~~ I .J; I.' m "j u (jl (..l . \ , I, I tn The Court of Common Pl~as of I IC/ I /, ) ) l ) ) ) ) Cumberland County. ?enns~lvania I", I 'I' ;to. 19 / I" OATH We do solemnly swear (or affirm) the ConaCicution of che United States wealth and Chat we will discharge the that we will support; obey and derend and the Constitl,lcioa oc..-t:tris'Colll,Clon- duties of our oCf.icjl '.ith!:l.deliey. /, );, I ~~.~J ~&9 c~ ; I (or ..... (") rr; Lfi j-:- LLt.~~' (~) ()< 1-( :c I:, u.. '1'.' f.) r. : till I...:..'.. M .1;:; l~.1 ~ ,.'j(il " X JJO... '~ t~ uAdersigned arbitrators, having ~een dull appointed and sworn af!irm~d),t~ke che following award: (Note: If damage. for d.la~ are awarded, they shall be separacely stated,) t :"j"lr" , ).1 i"J;"": -. ,:4, -]:1 AWARD 1 I ' ( I (I , ! , , ,I t, . , " i 1'1-' ~ I ' , , appl.tCiITe:; .--- \ Arbitrator, dis.enrs. f1:n~~!'t' :"3;. if ) ( .. . ( I ... ('" ./ i ( \J),y ~)' ffr;. , .' 1 ,'.1," .t._____.... , '" . , Oa te of aearing: / ! Oace of Award: ~OTIC::: OF EN't'R';" OF AWARD ~ow, thel.3/ day of 1I( Il. \ " t \ avard was entered upon the dockee and OIartie. or t~ei: attornev., ) . l'J2.L. at _, .L.:l" :lotiee thereof gi-,en ;,~ mail cha above to the Arbitrators' companaation paid upon appeal: Jell h $'\ I U . ( . ) j' I("I,L. X 'Jff: ~. r~ onotary 3~ : tl 'l ( II '\ (l . O.."uc-, , to be / PRAECIPE FOR [,I STING CASE f'OR TRIAL (Must be typewritten and Hut:rnittc)d in duplicate) ro THE PrunlO1'VI'ARY Of' CUMBERLAND COUNrY Please list the following case. (Check one) ()( for JURY trial at the next term of civil court, for trial without a jury. ----------------------------------------- CAPTION OF CASE (entire caption must be stated in full) (check one) ( ) Civil Action - Law (.)(') Appeal from Arbitration John and !.indo Tr. urn (other) (Plaintiff ) VB, Kevin E, Koona The trial list will be called on 8-17-99 and Trials commence on 9-13-99 (Defendant) Pretrials will be held on 8-25-99 (Briefs are due 5 days before pretrials,) VB. (The party listing this case for trial shall provide forthwith a copy of the praecipe to all counsel, pursuant to local Rule 214.1. ) No, 2005 Civil 1996 r\...ti9A Indicate the attorney who will try case for the party who files this praecipel Roger J. Harrington, Esquire LO,f09885 Harrington & <';,lldwoll, P.C, 100 N. 17th st., 15th Pi. PHiladnlphla. PA 19103 215-751-1135 Indicate trial counsel for other parties if known. Matthew R. Gove" Esquire, Nealon' Gover, 301 Market Street, ~~ll rl. rlattl~but~, 'g 17188 1.0,.47593, TolrPhono No.: 717-232,9900 This case is ready for trial. Signe~~'l' )l~-- Print Narre. Roger J. Harrington Attorney for: Plaintiffs Dete. ,June 14, 1999 i!; C) r .;:J f.. ~..; .:~ ~i ..( u , .' ,. ; . , , , ~,J_ ,':j , ,. ;/1 'il? , " l' r.~:;; . ;rfj , lu... o. l ,. . (";" 'j " LY' e.> ...... ....... j.,: I. .. r ,. .. -~ ~'r: " , '.1,:; , . .' .- .~,-, .I....; .j'-':"J -", : ~1.. '''T\ ~J , CJ HARRINGTON & CALDWELL, p.e. Sy: ROGER J, HARRINGTON IDENTIFICATION NUMBER: 09885 100 NORTH 17TH STREET, 15TH FL. PHILADELPHIA, PA 19103 121517151.-.:1 135 JOHN and LINDA TRAUM A TTORNEV FOR PLAINTIFflS va, IN THE CUMBERLAND COUNTY COURT OF COMMON PLEAS NO.: 96.20015 KEVIN E. KOONS SUGGESTION OF DEATH At!D Sl!BSTITUTI,ON OF PARTY TO THE PROTHONOTARY: On June 1,1999 Linda M. Traum departed this world, It is requested that John T. Traum, Jr., executor of the Estate of Linda M. Traum be substituted for Linda M. Traum. Attached is a Short Certificate. Thank you. RESPECTFULLY SUBMITTED, ~~; Attorney for Plaintiffs ", ., ~ .4 ~ C"l ,- & 8~ (') ~'~;,': :c: R" ) r:I' 0... ~I t,., ~~~ ...0 ~,(. LJ.~ ( , r1t .1 L,) ::;) i.~ CC u ~ '3 c5 -,I>. D.. l\tgi.trr of 81m. of .urls. ~ount,-" tbnn.plbanta 6bud (:rrtlfh:att ~ommonbJeaUb of t)tnn.plbania ~ountp of .uek. f .. \ I, .arbara., I1tillp ,H,~"l" ,,' 11',1" ,n .nll for lh. Counly of .uek.. In lh. Commonweallh of Plnn.ylvanll, IX) IIERloBY CEHTIFY ,h., nn II" ,I, " LETIEHS On Ih. Estale of " . . fl r ::.: ~ ' i',' /. I', ')-.!' ~I 1. :,.' ',1- II" Ii I , ,II : : l'. 'j' I; i\ ! j t'l ~ ) i.: . . havIOg f",t b..n quahfied.w.1l and lOuly 10 administer lhe 'am'. And, I further certify Ihal no revocation of said L.ll... appear. of record In my office, (.,yon under my hand and .eal of office Ihi. ~.. nf Dealh ,!J , . ~~/~ Social SecufllY No. '- ,'. fill.' No i" ~ I, : .1 L' - I R,'R;,"~' of Will! NOT V AUD WITHOUT SIGNA TUn ANIIIMPRESSEII SEAL f. \'~ I <j~':< ~"" !' , , i I " .'" , ' 'I " ,', ' ,"/,~ ." I (,I .... 't,.;,' , ~"';'.;" , ~I ~ , F'l.tr}-.CHICI; OF ':.1; rlr;I'Jr-'I"lTAt'N \, ,I" ,I,' 1"' tV'll ','l , 99 ~IJG \6 P~\ 12: 3~ . CUMi3lJ,i.NIU .couN1Y PENNS\1.VANIA I I t . ! , . ~I r 'I I' I' , 1-. ~ . .1,,1, I I ! i ~ 1 ~ i I I , " , '1>1 I ,,', I~', }, 1'1 \i :11 I (, , i,,', ;'! d I~, i," r.') " ..'::~ (.1"'(, ", 1'.:\ I," 1.'( I " :.., ~, 'I~~r' I': '.' I . I' ;' I" I. ' I . I' \1. I, ! I , l :). t'i ~ ' '~";:~:'l j' ,I, I I , I