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Home My WebLink About00-01148 AUDREY PIERCE, Plaintiff IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA V. CIVIL ACTION - LAW NO. 00-1148 CIVIL TERM JOHN VAYANOS, Defendant PROTECTION FROM ABUSE IN RE: PETITION FOR PROTECTION FROM ABUSE ORDER OF COURT AND NOW, this 12th day of April, 2000, further hearing in this matter is continued until Wednesday, August 30th, 2000, at 3:00 p.m. Pending further hearing, the protective order entered on February 29, 2000, shall remain in full force and effect. By the Court, Ke*H~;~ :bg ~o ~,O ~,\ ~if) Joan Carey, Esquire Legal Services, Inc. For the Plaintiff Taylor P. Andrews, Esquire For the Defendant _ 'c'_',,",~, ,_~__ '<~'", _"~~'" ',', -^ l"""..,e',',r <. "--'- ,- -~~"..,'~ ", "- -+<., "-","',,'- ~ -~~,.li...:."'""-'IifIHliI!IIlIiIillil!lillfiit.'Ji!ljt'''''''''''~''''''''.'~' . ~ - iliilIm~' ~, """lIit,......Ii. .,. '~- '"',' ~"A' ,~, ill . " '"<-,~ "LE1}-Cr-:F!CE r):.',~: TI, :~_l"v~,-rl.._.1t ,r< !r'~-[I'. r;\f '- ;I\!',.) hIli .0, j" "0,:) Ii '- J H! 1'. ~ PH 2: 33 '-\1" '''-',H,_." ""._, -'\r-r"m' GU1V'JI.::c.!-U_)-",;\[j LUUi\ I PEN~<SYLv'!\NIA ~ Audrey Pierce, : IN THE COURT OF COMMON PLEAS OF Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA vs. : NO. 00-1148 CIVIL TERM John Vayanos, Defendant : PROTECTION FROM ABUSE ORDER FOR CONTINUANCE AND NOW, this -.r day of March, 2000, upon consideration of the attached Motion for Continuance, the matter scheduled for hearing on March 9, 2000, by this Court's Order of February 29,2000, is hereby rescheduled for hearing on o.?r'l\ \ d, 8-tJ::J:J , ,2000, at C'\ rom, in Courtroom No. ~ . The Temporary Protection From Abuse Order shall remain in effect for a period of one year from the date it was entered or until further Order of Court, whichever comes first. By the Court, .AL Kevin A. Hess, Judge Joan Carey LEGAL SERVICES, INC. Attorney for Plaintiff Taylor Andrews ANDREWS AND JOHNSON Attorney for Defendant ~ e_ ",,__..~ _ ' , ,r" ~ ,_, ". - . - , '. ,e.-__' """,,,- jLi " - - ~~"':. < 'Hi"I!ll~~Ull'!lml!u-,," " '" "'<""tj. ~~ f1lE[HJFFICE ,,~ ", ,.... '""^T' 'J'IO~N,RV V'l.o' [t..;;- -,.>1"'11 hi ,I" " I -"',, ,."."...." , 00 tiAR -9 PH 2: 34 CUMI3ERLfND COU1\;'1Y PENNSYLVANIA ~ ,{ 3 .J() .00 RK3 ,,' ., '" " '",' -- ~ Plaintiff : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA ; NO. 00- CIVIL TERM : PROTECTION FROM ABUSE Audrey Pierce, vs. John Vayanos, Defendant MOTION FOR CONTINUANCE The Plaintiff, Audrey Pierce, by and through her attorney, Joan Carey of Legal Services, Inc., moves the Court for an Order rescheduling the hearing in the above-captioned case on the grounds that: I. A Temporary Protection From Abuse Order was issued by this Court on February 29, 2000, scheduling a hearing for March 9, 2000, at 3: 15 p.m. 2. The Cumberland County Sheriff's Department served Defendant with a certified copy of the Temporary Protection From Abuse Order and Petition for Protection From Abuse at his residence 3. Defendant retained Taylor Andrews, Esq. to represent him in the Protection From Abuse matter. 4. The parties agree, by and through their respective counsel, that the hearing be rescheduled pending further Order in this matter. 5. The Plaintiff requests that the Temporary Protection From Abuse Order remain in effect for a period of one year from the date it was entered or until further Order of Court, whichever comes first. -~, ,,~, . < - , , "'-', ".., . ' -,- WHEREFORE, the Plaintiff requests that the Court grant this Motion and reschedule this matter for hearing, and that the Temporary Protection From Abuse Order remain in effect for a period of one year from the date it was entered or until further Order of Court, whichever comes first. Carey, Attorney for aintiff LEGAL SERVICES, INC. 8 Irvine Row Carlisle, P A 17013 (717) 243-9400 Audrey Pierce, : IN THE COURT OF COMMON PLEAS OF Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA vs. : NO. 00- I N7 CIVIL TERM John Vayanos, Defendant : PROTECTION FROM ABUSE NOTICE OF HEARING AND ORDER YOU HAVE BEEN SUED IN COURT. If you wish to defend against the claims set forth in the following papers, you must appear at the hearing scheduled herein. If you fail to do so, the case may proceed against you and a FINAL Order may be entered against you granting the relief requested in the Petition. In particular, you may be evicted from your residence and lose other important rights. , A HEARING ON THIS MATTER IS SCHEDULED ON ")17C"L{' A 9 , 2000, AT .3: /,~ f/ .M., IN COURTROOM NO. if OF THE CUMBERLAND COUNTY COURTHOUSE, CARLISLE, PENNSYL VANIA. You MUST obey the Order that is attached until it is modified or terminated by the court after notice and hearing. If you disobey this Order, the police may arrest you. Violation of this Order may subject you to a charge of indirect criminal contempt which is punishable by a fine of up to $1,000.00 and/or up to six months injail under 23 Pa.C.S. ~6114. Violation may also subject you to prosecution and criminal penalties under the Pennsylvania Crimes Code. Under federal law, 18 U.S.C. ~2265, this Order is enforceable anywhere in the United States, tribal lands, U.S. Territories and the Commonwealth of Puerto Rico. If you travel outside of the state and intentionally violate this Order, you may be subject to federal criminal proceedings under the Violence Against Women Act, 18 U.S,C, ~ 2261-2262. You should take this paper to your lawyer at once. You have the right to have a lawyer represent you at the hearing. The court will not, however, appoint a lawyer for you. If you do not have a lawyer or cannot afford one, go to or telephone the office set forth below to fmd out where you can get legal help. If you cannot fmd a lawyer, you may have to proceed without one. CUMBERLAND COUNTY BAR ASSOCIATION 2 LIBERTY AVENUE, CARLISLE, PENNSYLVANIA 17013 TELEPHONE NUMBER: (717)249-3166 AMERICANS WITH DISABILITIES ACT OF 1990 The Court of Common Pleas of Cumberland County is required by law to comply' with the Americans with Disabilities Act of 1990. For information about accessible facilities and reasonable accommodations available to disabled individuals having business before the court, please contact our office. All arrangements must be made at least 72 hours prior to any hearing or business before the court. You must attend the scheduled conference or hearing. , A,... ~_""J'-iln\iM~' JI! J J!if:,,,J!JJ ',pr i "J-~"''' ',," """,-. ~ "', ." Ii. "' "-'J.IJl:)Jj.I!iI' ~4'''., ~~rMil.( - ,. ," >, fO"" '" 1!ilI11~ l!l 0 -'~L' ., ALEl)-Qj-"'RCE Ot: TI-Ic DROTLI.QNO' TARY I . I". II, .:,'....1 IJ 00 MAR -I PM 2: 00 CUMBERU~'~D COUi\rrY PENNSYLVANIA ~. ,., -- '., ""1 '( lrJ ~ 'j.j '" ~ 'J 11 ~ " , ::'1 Audrey Pierce, : IN THE COURT OF COMMON PLEAS OF Plaintiff vs. : CUMBERLAND COUNTY, PENNSYLVANIA ; NO. 00- 11 'ff' CIVIL TERM John Vayanos, Defendant : PROTECTION FROM ABUSE TEMPORARY PROTECTION FROM ABUSE ORDER Defendant's Name: John Vayanos Defendant's Date of Birth: 717147 Defendant's Social Security Number: 192-50-9986 Names of Protected Person: Audrey Pierce AND NOW, this ~day ofFebruarv 2000, upon consideration of the attached Petition for Protection from Abuse, the court hereby enters the following Temporary Order: (8) 1. ])efendant shall not abuse, harass, stalk or threaten any ofthe above person in any pla.ce where she might be found. o 2. Defendant is evicted and excluded from the residence at _ or any other permanent or temporary residence where Plaintiff may live. Plaintiff is granted exclusive possession of the residence. Defendant shall have no right or privilege to enter or be present on the premises. (8) 3. Except for such contact with the minor child as may be permitted by the parties Custody Order, Defendant is prohibited from having ANY CONTACT with Plaintiff at any location including, but not limited, to any contact at Plaintiffs residence or place of employment. Defendant is specifically ordered to stay away from the following locations for the duration of this Order: Plaintiff's residence and place of employment located at 353 Farmington Manor, Farmington Drive, Shippensburg, Pennsylvania. (8) 4. Except for such conta.ct with the minor child as may be permitted by the parties Custody Order, Defendant shall not contact Plaintiff by telephone or by any other means, including through third persons. ;~ - -,^ , o 5. Pending the outcome of the final hearing in this matter. Plaintiff is awarded temporary custody of the following minor child/ren: Until the final hearing, all contact between Defendant and the child/ren shall be limited to the following: The local law enforcement agency in the jurisdiction where the child/ren are located shall ensure that the childlren are placed in the care and control of Plaintiff in accordance with the terms of this Order. o 6. Defendant shall immediately relinquish the following weapons to the Sheriffs Office or a designated local law enforcement agency for the delivery to the Sheriffs Office: Utirlrt is prohibited from possessing, transferring or acquiring any other weapons for the duration of this Order. [B) 7. The following additional relief is granted: The Cumberland County Sheriff's Department shall attempt to make service at Plaintiff's request and without pre-payment of fees, but service may be accomplished under any applicable Rule of Civil Procedure. This Order shall be docketed in the office of the Prothonotary and forwarded to the Sheriff for service. The Prothonotary shall not send a copy of this Order to Defendant by mail. This Order shall remain in effect until modified or terminated by the Court and can be extended beyond its original expiration date if the Court fmds that Defendant has committed an act of abuse or has engaged in a pattern or practice that indicates risk of harm to Plaintiff. Defendant is enjoined from damaging or destroying any property owned jointly by the parties or owned solely by Plaintiff. Defendant is to refrain from harassing Plaintiff's relatives. [B) 8. A certified copy of this Order shall be provided to the police department where Plaintiff resides and any other agency specified hereafter: Mid-Cumberland Valley Regional Police Department. o 9. THIS ORDER SUPERSEDES o ANY PRIOR PF A ORDER and o ANY PRIOR ORDER RELATING TO CHILD CUSTODY THIS ORDER APPLIES IMMEDIATEL YTO DEFENDANT AND SHALL REMAIN IN EFFECT UNTIL MODIFIED OR TERMINATED BY THIS COURT AFTER NOTICE AND HEARING. NOTICE TO DEFENDANT Defendant is hereby notified that violation of this Order may result in arrest for indirect criminal contempt, which is punishable by a fine of up to $1,000.00 and/or up to six months in jail. 23 P a. C. S. ~6114. Consent of the Plaintiff to Defendant's return to the residence shall not invalidate this Order, which can only be changed or modified through the filing of appropriate court papers for that purpose. 23 Pa.C.S. ~6113. Defendant is further notified that violation ofthis Order may subject himlher to state charges and penalties under the Pennsylvania Crimes Code and to federal charges and penalties under the Violence Against Women Act, 18 D.S.C. ~~ 2261-2262. Any protection order granted by a court may be considered in any subsequent proceedings, including child custody proceedings, under title 23 (Domestic Relations) of the Pennsylvania Consolidated Statutes. NOTICE TO LAW ENFORCEMENT OFFICIALS This Order shall be enforced by the police who have jurisdiction over the plaintiff's residence OR any locations where a violation of this order occurs OR where the defendant may be located. If defendant violates Paragraphs 1 through 6 of this Order, defendant may be arrested on the charge ofIndirect Criminal Contempt. An arrest for violation of this Order may be made without warrant, based solely on probable cause, whether or not the violation is committed in the presence of law enforcement. Subsequent to an arrest, the law enforcement officer shall seize all weapons used or threatened to be used during the violation of this Order OR during prior incidents of abuse. Weapons must forthwith be delivered to the Sheriff's office of the county which issued this Order, which office shall maintain possession of the weapons until further Order of this Court, unless the weapon/s are evidence of a crime, in which case, they shall remain with the law enforcement agency whose officer made the arrest. BY THE COURT, 4iL. Judge Audrey Pierce, : IN THE COURT OF COMMON PLEAS OF Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA vs. :NO.OO- 1/<;1' CIVIL TERM John Vayanos, Defendant : PROTECTION FROM ABUSE PETITION FOR PROTECTION FROM ABUSE 1. The Plaintiff is Audrey Pierce. 2. The name ofthe person who seeks protection from abuse is Audrey Pierce. 3. Plaintiff's address is 353 Farmington Drive, Shippensburg, Pennsylvania. 4. Defendant is believed to live at 219 Senior Drive, Shippensburg, Pennsylvania. Defendant's Social Security Number is 192-50-9986. Defendant's date of birth is 7/7/47. Defendant's place of employment is located at The Cottages, Shippensburg, Pennsylvania. 5. Defendant is Plaintiff's former intimate partner. 6. Plaintiff and Defendant have been involved in the following court actions custody: Case name Vayanos v. Pierce Custody Case No. 99-6195 Date fIled October 13, 1999 Court Cumberland Co.-Common Pleas 7. Defendant has been involved in the following criminal court action: Defendant has been arrested for DUI and Mail Fraud. 8. The facts of the most recent incident of abuse are as follows: On or about February 24, 2000, Defendant went to Plaintiffs work after Plaintiff had advised him that he was not to come to her place of employment. Defendant argued with Plaintiff's supervisor who sent the Defendant a Defiant Trespass letter this same date stating he was no longer allowed on the property or he could be arrested. r'. .. 9. Defendant has committed the following prior acts of abuse against Plaintiff: a) On or about February 20, 2000, Defendant left a message on the Plaintiffs answering machine stating he knew his son was home and in his bedroom causing Plaintiff to fear Defendant had been watching her residence and stalking her. Defendant had told Plaintiffs son he had someone following Plaintiff. b) In or about the middle of February 2000, Defendant told Plaintiffs son that he knew when they came and went from Plaintiff's residence and what his mother was doing causing her to fear. c) In or about January 2000, Defendant asked his son to draw him a diagram of the inside of his mother's residence causing Plaintiff to fear for her safety. d) In or about Fall of 1999, Defendant who worked at a housing project adjacent to Plaintiffs home was seen by an employee of the housing project where Defendant worked watching Plaintiff's residence/employment place from the property where he was staying spied on Plaintiff by using binoculars exacerbating her fear. e) In or about August 1999, Defendant forced himself on Plaintiff sexually. When Plaintiff asked Defendant to stop, he would not. On one occasion, Defendant became angry, grabbed Plaintiff by the arms, and threatened her preventing her from leaving the residence. t) In or about Spring 1999, Defendant grabbed Plaintiff by her cheeks, and her hair, grabbed her by her throat, and pushed her against the wall. Defendant kicked her, ripped her clothes, and demanded that she have sexual intercourse with him. Defendant forcefully grabbed Plaintiff by the arms causing bruises. g) Since 1991, Defendant has abused Plaintiffin ways including the following: kicked, grabbed, and restrained Plaintiff, and threatened to kill her. On one occasion, Defendant punched Plaintiff in the chest causing her to have difficulty breathing and to suffer bruising. Several times, Defendant has pushed Plaintiff's head against a wall or sidewalk causing her to suffer a concussion on at least one occasion.. 10. The following police department or law enforcement agency in the area in which Plaintifflives should be provided with a copy of the Protection Order: Mid-Cumberland Valley Police Department. II. There is an immediate and present danger of further abuse from Defendant. -,,-" - WHEREFORE, PLAINTIFF REQUESTS THAT THE COURT ENTER A TEMPORARY ORDER, AND AFTER HEARING, A FINAL ORDER THAT WOULD DO THE FOLLOWING: A. Restrain Defendant from abusing, threatening, harassing, or stalking Plaintiffin any place where Plaintiff may be found. B. Prohibit Defendant from having any contact with Plaintiff either in person, by telephone, or in writing, personally or through third persons, including, but not limited to, any contact at Plaintiff's residence or place of employment, except as the Court may find necessary with respect to partial custody and/or visitation with the minor child. C. Prohibit Defendant from having any contact with Plaintiff's relatives. D. Order Defendant to pay the costs of this action, including filing and service fees. E. Order Defendant to reimburse Cumberland County, a Legal Services funding source, $250.00 for the value of the legal services provided to Plaintiff for the cost of litigating this case if the case goes to hearing. F. Order the following additional relief, not listed above: The Defendant is enjoined from damaging or destroying any property owned jointly by the parties or owned solely by Plaintiff. The Defendant is to refrain from harassing Plaintiffs relatives. G. Grant such other relief as the court deems appropriate. H. Order the police or other law enforcement agency to serve Defendant with a copy of this Petition, any Order issued, and the Order for Hearing. The Petitioner will inform the designated authority of any addresses, other than Defendant's residence, where Defendant can be served. Plaintiff prays for such other relief as may be just and proper. ;;'/<29/0--0 J ! Respectfully submitted, (] Date: Oan Carey, Attorney LEGAL SERVICES, 8 Irvine Row Carlisle, PA 17013 (717) 243-9400 "~';':~I '-_: ~ , , . - o o VERIFICATION I verify that I am the Petitioner as designated in the present action and that the facts and statements contained in the above Petition are true and correct to the best of my knowledge. I understand that any false statements are made subject to the penalties of 18 Pa.C.S. ~4904, relating to unsworn falsification to authorities. Dated: ~k)Jl) / :, I i'., I , " ,'~ , , ~,~ ...,. '" ,.,...' - '''- ~, ", .~, ~. o L. ~.LJ~ u_ '.- ", . ~ ,la~~ -. I ~..& 1'".,.,~n_1Ln .,' '"' ,- ~. , . ~.::-" :-..') en ~~ '-'" . <v Gc; .l'll _lll""""" ,__ SHERIFF'S RETURN - REGULAR CASE NO: 2000-01148 P COMMONWEALTH OF PENNSYLVANIA: COUNTY OF CUMBERLAND PIERCE AUDREY VS VAYANOS JOHN DAWN KELL , Sheriff or Deputy Sheriff of Cumberland County, Pensylvania, who being duly sworn according to law, says, the within PROTECTION FROM ABUSE was served upon VAYANOS JOHN the DEFENDANT , at 0017:50 HOURS, on the 1st day of March 2000 at 219 SENIOR DRIVE SHIPPENSBURG, PA 17257 by handing to JOHN VAYANOS a true and attested copy of PROTECTION FROM ABUSE together with NOTICE OF HEARING & ORDER, TEMPORARY PROTECTION FROM ABUSE ORDER, PETITION and at the same time directing His attention to the contents thereof. Sheriff's Costs: Docketing Service Affidavit Surcharge 18.00 13.02 .00 10.00 .00 41.02 So Answers: r~~( R. Thomas Kline 03/02/2000 Sworn and Subscribed to before me this .tv''CO day of By: ~.J1Y\ J ~ eputy Sheriff ~.2<nrO A.D. ~ (tIYvPO,) ~7 Prothonotary -'OJ , "'" 2-25-20<) 2,59AM FRON p, I -- 353 FARMINGTON DRIVE SHIPPENSBURG, PA 172S7 DATE: ~-?;{,ll ' [TO: CI . (fJ . 'f:-J.dL . 'ft./( ct..;) <J71 C NY: I FROM: Audrey J. i;kroc---" Property M~ager CQMP ANY: Fannington Manor PHONE; {7l7) 532-3444 fAX: 717 53:2-7552 PACJES: F- I , '--'~. ' '-=l ,-'~1 i- ~r:. (i~/{Ad'-~ ,_ : - .1 ~ ~ . .. ~-t'j~~,.d;,MFI _~_ ~ =_'-C --- -- ! --=1 .,.__J I '-- , , I i ~' , '''vt________._,,_ If you have any questions or problems with this transmission, please cal~-- (717) 532-3444. DEFENDANii'S EXHI8!1 s_ AUDREY PIERCE, Plaintiff : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA vs. : NO: 00-1148 CIVIL TERM JOHN VA Y ANOS, Defendant : PROTECTION FROM ABUSE PRAECIPE To the Prothonotary: Please enter my appearance on behalf oftbe defendant, John Vayanos, in the above captioned action. Respectfully submitted, ANDREWS & JOHNSON Tayl P. Andrews, Esquire 78 st Pomfret Street Carlisle, PA 17013 (717) 243-0123 cc: Joan Carey, Esquire Attorney for Plainitff ~ '- . , ~, . '- ,,' , , -- ~ , "-~ I r ._~.~ -- ."".",., ,- _'~lIl!ffllfl'tm'IMM ">,., ~'"-".' .. "~" ~ ~"4 ,~.=, 0 C,.:l 0 c-= C:, ~Tl -:,C.,.. v CD ;"7' :::::1 rj-l ,,~--. 'CO ,":';1 -rl " F~ /:-: ;5\ I "f) rn , :,j 0 UJ --.. ,.0 C) , _.<,- (') s::: ,.'. -,"1 '-1- -I", !: ::r: ~~~ ~Tl \._'-' 0 ~D t-l C5 c5 rn (::: --,j ......:... r:- );'; -I ~ -, (,,) ._ _~.l!iIIIII! -!IIQQQ'" ,I ~1JfN""_ ...'...., ..... ~'-'-"" _, ~'.' ,'-.J."J , ..._1',' '." ,.,... ~~ _l 1"".1 L, , , :l..............e 7,!jlAM FR~ FARMINGTON MANOR 353 Farmington Drive Shippensburg, PA 17257 Phone (717) ~32-3444 FAX (717) 532-7552 hbMll')' 24, 2000 John S. VayllllOll lbe CoUqfll of Smppen.bur& 219 Sm;aQr Drive SI1iJ:.lpfilJburg, PA 11257 ae; Notice Defiant Tr".pas. Mr. JOM S. V'YIIl'IO'. You 31'e hel'eb)' no1ified that if you IUe found on the prl.lpert)' lulOWll lIS 'arminl1on Manor, in Cvm~r1aod CoWllY. in 1119 ..it)' orShippentburg. stale of i'ennaylvlll1ia. you wiU be a",stod for Deli",t Tntlpen. The reasoOlJ for this notice, _the clhitu~c:es that you lIave caused to tile sudf and l'tsiden&s Qn Ilie property known... Fal'lllillglOD Manor, You will not rOlleive funher notitk:atlon concerning \hill maltel'. Cc; Me.V.pollce Depl. Atlomey Doily Attorn.)' M",Sride Lepl Services The Cotllq&es of Sbil'l"'nlburg DEfENDANT'S EXHIBn' :",,' c( P, I I I " Ii I I 1 , I I I I I Q r~ g oJ)!, (){f) !:':otr:: 0 ~ ~ ~ '-]rrJ ~s~ >-37, Ql3::z '", CgUl "-H id", tJ:j 00 ~"c trJ "U ~::o (J) hi :,.. tJ 0 ({J ',. .... ........... I I o ,'~ ,n. ~ ---~---- L.__":_.___'" -c ._--:::: - .'0 ofl w lID. _ ._~ ~ I'L I- ffi I . . I .. c:.. I ,I Ii , II Ii- 'I Ii I I! I, !i - ..,.,-- .:..=-==~ :..::..-. ~_. TOTAL p.e2 -, -","',-," - ., ,'."-,' " ,~,_";,,{>'.,,,,~,,~;^",,_ '_, "',,~"d" ,!,-:.,~,-, "'0' '_,'"C,,?"'_ - '~, ~ _ _,c'__ -."-,,-.',' 'I C Dat&{rnL~ lal~t:c() CHAMBERSBURG HOSPITAL An affiliate of Summit Health I, Shirley Culbertson, ART, Clerical Supervisor in the Health Information Management Department at T~bersburg Hospital, do hereby certify that the attached records on C\.U:::'tJl()l~ LL are true, accurate, and complete copies from the time period 1~ll ~qd, to \~l,lq~ . I further certify that the originals (or the microfilm of the originals) are on file at The Chambersburg Hospital and that the said records were prepared and maintained by the ordinary and usual course of hospital business. This certification is given pursuant to 42 Pa.C.S. Ch.61 Subch. E (relating to medical records) by the cnstodian of the records in lieu of personal appearance. Sincerely, _J~,JHC~ fl~ Shi~;~y~ulbertson, ART Clerical Supervisor, Health Information Management The Chambersburg Hospital Subscribed and sworn to before me this (d-~ day of ~,~9) ~~ Notary Public # of pages atttached~ Notarial Seal Barbara L, Beam Notary P bile Chambersburg Bore F ,u I My Commission Expire~aB~~ f.~~'b% '\~~Vn!''''I' I}p"'no 1 '. ,,'''" '''.N "."',ocialloo nHIM.ri.. 112 North Seventh Street P.O. Box 6005 Chambersburg, PA 17201-6005 717-267-3000 '" "" ,- .,--. ",,," " .-' -, . ~'--'''' -'-""-- --'~'"~'.' -" "'-"''-"---',~' , -, ",._~,,~' '- '''~ ^,' -- ~ ~i!',~ ~--'" ,," -"'.""r .' , DEe 06-SgrJl; JOHNS. VAYANOS, Plaintiff v IN TIIE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW NO. 99-6195 CIVIL IN CUSTODY, AUDREY J. PIERCE, Defendant COURT-ORDER "AA'D NOW, this ,J 0 .J:L day of December, 1999, upon consideration of t.'Ie attached Custody Coriciliatioll Report, it is ordered and directed as follows: . 1. The Father, John S. Vayanos, and the Mother, Audrey J. Pierce, shall enjoy shared legal and shared physical custody of JOM S. Pierce, born May 2, 1985. 2. Physical custody of the minor child shall be handled with the Father having the . following periods of physical custody: A. On alternating w~kends from Friday after school until Sunday at 7:00 p.m. ,In the event'Father schedules an activity with the minor child for Sunday evening; Father shalt upOn reasonable notice to the Mother, have the opportunity to continue his altemating weekend time through Monday morning; ", B. On two evenings per weeJc which shall be overnight. The time frame shall be from after school until when tile child is taken to school the next day. These shall be- Tuesday and ThUrsday unless agreed otherwise by the parties. ' 3. On a weekly basis, Mother shall have physical custody of the minor child at all other times except when Father has custooy as set forth in Paragraph 2 above, 4. During the summer months, both parties sliall enjoy at least two (2) weeks vacation with the minor child as long as reasonable notice has been given to the other party. 5. In the event a trip is planed by the Father to, take the minor child to Greece and reasonable notice is given to the Mother, the child shall be allowed to go to Greece for family activities with this time frame not counting against either parent for their smnmer vacation. ' 6. Mother shall always have American Easter weekend and Father shall always have Greek Easter weekend, the time frame being Friday through Sunday evening. ' PLAINTIFF'S EXHIBIT , I RLC~'< .',-'.:-',,,\ i-:,,:';;:j -'"""'l'" ,..,....., -, - . ."'""<~..,,--- I Christmas shall be divided between two segments with the fIrst segment being the few days before Christmas until noon on Christmas Day and the second segment being from noon on Christmas Day until a few days after Christmas. For 1999, Mother shall have the child from the Thursday before Christmas until 3:00 p.m. on Christmas Day_ Fathe~sha1I have time from 3:00 p.m. on Christmas Day until December 29. The parties shall communicate with each other in advance of Christmas in future years to arrange the alternating schedule. 7. 8. Thanksgiving holiday shall also be alternated, with one parent having Wednesday after sehooliinn'FIiililyeveiili:lgat7:00 p.m. and the other-parenfliliving Friday evening at 7:00 p.rn. until Monday at 7:00 p.m. In the year 2000, Father shall have the first time frame: ,.---- , , 9. ' Mother shall always havetl1e child on Mother's Day and Father shall always have 'the .child on Father's Day_ Thctime frame shall at a minimwn be 9:00am. until 7:00 p.m. 10, This order is entered pursuant to anagieement reached by the parties at aCustody Conciliation Conference. In the event either party desires to modify this order, that party may petition the court to have the case again scheduled with a Custody Conciliator for a Conference. , BY THE COURT, J:l/ll{,IJ~ &~ ~ . J. ." ('~ ~ J:J../13/Q1. -1). . ..,&:6> . cc: JohrmaJ. Deily, Esquire .~ Lynn y. MacBride, Esquire ~, .~,:'-" ..~~- .-.,,",.,,',i. :":;'r,<~~U:: ;.(,-.:,:. ::.:::; -f':';l hBnd TR~',:, -.~, ~ \r. T€~t \~- .. .- o~d ;'h'2 :' ,,; .,,' , '. '" ,:::': i <,' C-n:;;:", '"0'19..9.,9- ." : J 3,t;L 02" 01....10,2&....." ,[\IS "..~.. .....(!."...:.,~~y.__.. "".............. .......Jf'ii . Prothonctilrj I I - ;/ , , JOHN S. VA Y ANOS, Plaintiff IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW NO, 99.{)195 CIVIL IN CUSTODY v AUDREY J. PIERCE, Defendant Prior Judge: CONCILIATION CONFERENCE SUMMARY REPORT IN ACCORDANCE wrrn THE CUMBERLAND COUNTY CIVIL RULE OF PROCEDURE 1915.3-8(b), the undersigned Custody Conci1i~t.or subJr.its tIle follcwi.ll!fteport: 1. The pertinent information pertaining to the child who is the subject of tJUs litigation is as follows: . , John S. Pierce, born May 2,1985. 2. A Conciliation Conference was held on December 2, 1999, with the following individuals in attendance: The Father, John S. Vayanos, with his counsel, Lynn Y. MacBride, Esquire; and the Mother, AudreyJ. Pierce, with her counsel, Johnna J. Deily, Esquire. 3. The parties agree to the centry of an order in the form as attached. 1:<.[3(Q7 DAlE ' Hubert X. Gil , Esquire Custody Co, iliator , In ~ (J)!, ("){J) :EoE5 0 ~ W "'(j .....1[1J ",> "'(j ''') ~5M '-1~ Ql~ Z ;J>H ~~ ~ 00 o ~, . ;0',-. M 11 ~::u (fJ 1-11 ,. tl () ,.v '" .0 ',...~.. I I I / I ( , , ~ {} ~ . " G. --'-~ .._.~ ...._ !.:--rt..r..,';':_,l-:-:............:.,....=:~ ' . _.. ...-..,-..::..::-==:::..::.... .,.p.:..:;..-. TOTAL P.132 ";'~1 r T "1, - ~ ~. =_~"" ~~~__~~_P"_ DSUTURE REMOVAl. DGI..L1COSCAN , , J,...,..";,,, cwlkJ OORESSING, " DdT 0.5 cc ' DACE, OMETAt. SPLINT DUNtvERSAl.' SPLINT ~,~ OOCL }7.Jf,.-' U " OSLlNG 7f'::> ~ DNEW M.O, LIST " " '1~~.~~~'."'i-' '~';"~:"':Ol,)'~~""'r ,.'_ ~ '".~ .~. ':~,~~- It '. f;J:.'~' ~,'h". ~'''''''I' , . r.., ' 1.~! i y~:~.. <1 .: ,... '".-.,\ '!~, -~ The Chamber.burq, .,pital ~I ,;II,:~ CH,t,MI"RS8URO. P~NNSyW,.VANI~. 17201 'c , , -9lJ , AUTHORIZATIONS ON REVERSE sIDe MUST BE SIGNED BY PATIENT OR AUTHORIZED PERSON PA.TIENT NAME .j ',I PTERCE. AUDREY J :,',: I' , DATE OF BIRTH AGE , 04/09/ 0 3~! F ',.1,- P <ONE . i (7:l /) 532-8499 WOUNO o CLEANSED PATIENT NUMBER 12/07/92 682044-3 MF~* 317266 EMERGENCY CARE UNIT DOCTOA CVEA, FAMtL Y oBeroR UNI(IQ 1m. . ..7~=j TIME NOTIFIED , VICTHI PRESENT MEO$ AND DOSAGE fl c..P : '......', QRTHOSTATtCS VITAL SIGNS TIME BP PULse TIME TEMP ~ULSE RESP. 2.0 BG room cee ERUM PREGNANCY CH M8 HEM 5 ACP MYLASE PT PTT PORT CX.R P LAT CXA !.AT CXR AAS PORT PELVIS PELVIS PORT C SPINE C.SPINE tAT FIRST C-SPINE T SPINE LS SPINE UA URINEC&S DC CHLAMYOIA C&S-WOUNO QUICK STREP STREP SCREEN FACIAL BONES IVP CT HEAD CT ABOOMEN SEAU R.Tox.~. FOOT ANKLE TI8 FIB KNEE FEMUA HIP HAND ATTN. WRIST ELBOW SHOULOER Old Records: 0 ECU EKG: INTERP. o Inpatient TO X.RAY FROM X.RAY X-RAYS: o WET nEAD LAB O~~ LAB REPORT 'i','_,:'"..; 'WIN C;D;,..I..!' ~'3lO' --oe...J...o ("e> I./' 1: 'du..,v,4-h <- CONDITION ()N DISCHARGE tlSATtS: 0 OISPOS1TI0~ OF CASE OOISCHAJ\GE TO ACCOMPANIED MODE: OAMBULATORY 0 WHEELCHAIR OSTRETCHEFl: ,~~L NgTlFIED TIME NOTIFIED ~.J-_ I: RELATIVE 1'1 COAONER I OLICE : ~ ()U~; flO'{lM NO -r"'"A5 MENTAL STATUS BY: i 0 AOMl r 1I00II.t NO ~ 0 ALERT & ORIENTED OCARAIED I OIHflNSFE.fl [J OTHER (describe) # j~ 0 rnAN:-ifJ~,f,!AJ!.!....S: 1 r COPIED SFNT AUDIT lNFORMATION o POlS REVIEWED, GIVEN/VERBALIZES UNDEASTANDING _ _ _ _~~~'"71w---,--~ (AN) INITIALS [J EMERGENT o Ax GIVEN ~<t ~ ~ fl ~ 0 NON.SMERGENT '(PHYSIC~~~^R~ G hu<--.D REFERRED TO: ,', ", ,,:, '. " "'{fo :'} ,.~ <j" :~ .:,;;.: ,~iii ;~ I "I ,:~ BIP ~ ,~'~:. ",., ,c' ~ ~t " ; " .\ , .,'\1. ",~ ,.i~ " :~ "\' '." ( ,\ " ""T1ENTNO O"TE , ','d".,"",.".." ,y'e,~;,A';,~_~ " 1'-~,1i I"""'.~ ".."..j I M_,,;\"!'ln:-:_'A' 'f't"}Il'1t-\M l/:",'hR~S~l rf~~~. "-;..'....,. " EMERGENCY ROOM REGISTRA 10N;u:,.:" , 'f-'lt: '-:,:j " ~ " .....:.i ',"4 i ':.':i! METt<QOQF.f.RRIY"L PlJ8USH AOMITIV ;:;.~ l"C',(~V'\-rl", ~":: ,1'1' ',:" ,,,,''It.!:I'', <;"1' 6820443 12/07/92 11MB N I<TtC REASOJ\IFOFlV!SJ1 ;iiP.IE:RCE,' IIUIiREY J l213 N PRINCE ST " (717)532-8499 IISS , ", , OCClJPATION liP .JOHN S ,.SHIPPENSBURG, I'll 17257 .['lNI""_""L'''' ,,<,.,,,,,,'I"_'N 1<<c'(,'ON ,", r ,".~ ! 1 ;;j ,5' , " , I " 1 i i MEDICARE SECONDARV PAVOR INFORMATION 1.N2.N3.N4.N5.N6,N SliME l'tAU' AND II"', (). AC{;IDHH N u .,.~: '-'--1 ..~., :' .; '.-......" ,:r-' .iJ, ~':"1:"~;' :.f;; !ii< OCCllPA110N. oo,lPLOYCA IHEf'tiQN[ NlJ"FlEA ,,:--.1 J (717)532-8499 ST PII 17257 l<\.A/l< CODE P()L'l.-YI"-'lU~11 Rll ".. ~ULI(.Y,'.HlJl~'(.M~ NO COMP COOf GROUP NUMIlER INS, CO "OORESS i , " I 'I "1 :1 ,1,' , , ~NONE G!VEN ~:. \ IN5 CO_AOORESS PRECERl INF(): i I .',:i. ~/, ;,. ,""'.. , ", I j '" 'JOr'11 6J~~~~)Q, ,~w.!~" ~, ' :z,~ " -"1"".\'1"'''''1'' ~ 1- ""d' . ." .,. '. \,~., 1\... I '~ \..) \.:... i '. V -I" .' 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'" '''Ii' ",iI", i, "".J ""'''"1\,, 1 "11"",,,,111.\ IIIAI li~"M~\\\ IIii'd, ' !JM1~(f!t:.fllyh ,-.t !hi,,: ;:lf1;/(, -lid, ""t1 Il/i//I f"n,fnlt,1 ~Hld r~ht" 'lId.!': fltl,l t!I'd nl\\ tdl~l~ t:ln\l\\"\, 't\;ih~I,\\"'l\H~, ',~t' 'l:tntrll'\~I~i~\ 'Or 6&f,ol#,IMpr,1 r" dlnrn;il1/ll-1,{rt I/tn',/ ',to I".,'-r.. ,II,,,! !1'l'l,'f 'q!rdt..~d,t.1 t ,,,In,,,1 :"nl ~1~\I'r1 1_1\v"1 ~- ;!lftrIiHN" tflf"! (':1r.""iIiI'jr'''"'l'I'r/ jl""rd't!f /I~ ,r::'.~;" / ",.'" J ( l;(A~~)~:~~""',\ , "'1"..11",., 11'''''I,,,,,,,ld,, ,.. ,',d,,,,,, .F.' il ~. ",~. :'r-~~:r'~:~ [ . ~ , "'- ~1'i,' :~~1~ ~ >r";;t{~~i"ftrt.f7:.., d_' "--.-!-:{.,~'i';J~r;-, "'.~"'~" ,]~~~Itl ,,:,",,_t.::\('':''''''~ .' J".' .,;ji'f~': -""."'" ."tj1:,'jry,"",'(...., -.:-,::~ ~,,\..,:. t.,...."~ ,Ii;. -' ';. ",~,,!H4:Z;,q"T'::"~tY::, ",~,~'j ._.-,~-",..,~"':" I'; ,'" __A___._.___'........,... ',_ ,,,,,- PIERCE, AUDREY J MR# 3:7266 PAT# 682044 AGE: 32Y SEX: F o~)o~~~.-o ::. L..AE:UF((.~ITORY C~/EA ~ -_____ ___ __ __.____ __ - __ _____ __ ..., ..._.,...._.._ m. ....__._ _ _..._._ .... _""m .... ..___ ... ..., __, ......__ _ HH'___' __ _ _, __ ......_ .., __.._____________ _.___ ._____ ORDERED FOR 12/07 23;20 UJ"\.~'~::!I'.. .!.! (;\ U:,:~ AI_CDHOL I~THYI.... ALCOHOl_ ETHYI_ ">1- J,I."'I '7 (:' t"1G/DL STAT ii $.1'" :g( \' " . _:~j;~~;:;'~:, ;~~~;~,~~. ~:;; ',1,':'\,lA .f, !>~~':\~':f~)~\\,'~'-\;.~.r~~ " ',,'-r.;J~~ ~i: "Ye!!",;, ,;", \~~l.:;;':.. t,'iiffi ';.':' " . , ~, . -: ,- '.;" : ~l.: <'_ ~~:~~'~ :j7:r-" d~;'. ;:'8' '2'O':fLf 3 12/07/92 HR3!7266 t' '~~,--, F 213 1 PRINCE ST AL-U ,SHIPPfNSBURG. Pi 17257 04/09/&0 32Y 717 532-8499 ~ cvEA. " ;-'#- -f"..... THE CHAMBERSBURG HOSPITAL EMERGENCY CARE UNIT PATIENT INSTRUCT/ON SHEET (717) 267.7146 'tlIIIt-.. _.JJ$"--~1'l~ .~,~,:.~......-n..'Ji#'" x The treatment you have received has been rendered on an emergency .b,asis ~nly. It .is imRortant that you follow discharg~ instructions and receive follow-up care, Follow the instructions below that are checked and any addlllonallnstructJOns given. WOUND CARE o Keep dressing cle,ll1 ;Jill! nrv Ivr !lex! _.. day(s). o Following this time period, remove d,~ssin9, wasl, wound with sonD and w;mn waler, dry Ilwrp.ught.,:. and cover with appropriate 1.J3Ild;1Ue. Repeat daily until lhewound has healed. o Return here tor wound check in __~u..______ day(s).Oale: o Have sutures removed in __.~,__._ day(s), Date: o .time(sl a day, wash burns thoroughly with soap and water, then reappry Silvadene cream and redress. Keep dressing cfean and dry. o Your wound has been closed with steri.strips, They musl be kepi clean and dry. Leave sted-strips in place until lhey fall oflspontaneously in about five ,losevendays, o Rcturn Immedltllely 10 the Emergency Oeptlrl. ment or your lamlly doctor ir signs olinlection develop-increasing redness.-swelJing, pus, foul odor, red streaks, lever. ORTHOPEDIC & BACK INJURIES o Apply Ice intermillenlly to the allcctcd area lor the, next 48 hours and keep it elevaled 10 reduce swelling. o Restaffecled area_day(s) or until pain-free. o Use crutches, do not'bear weight until ablelo stand wlthoulpain, lhen slowly return to usual activities. o You may remove elastic bandage and/or splint every_ day(sl. If allected area Is stiJI painful. reapply and continue use.until pain-free. o Bed rest lor the next day(s), ,0 Nollftlngover10Ibs,forthenext_day{s), o Apply warm compresses or soaks to affected area 10r,30 minutes at least four limes a day, o Wear elastic bandageand/orspllnluntU rechecked in day{s}. o II the extremity below any bandage becomes increas- ingry painful. numil, blue, or swollen, remove or loosen It immediately and contactlhe Emergency Department. OTAE(9 ~\<..e~ ~ C1> ~() ,J ()t ~ 0.. " 0, . ~.addlhOnallnstructlons: ~ead Inlury (over) 0 Ammal bile r 0 Tetanu, rmmuOIzaHon serres (over) ~ti2u.A 1}1"t..QOA' ~ ~ 0 1 ~ :3 "",,, V ). MEDICATION INSTRUCTIONS C Gel prescripllDIl JJJlerJ, Jake OJ' apply merJicine as directed on I<loel. Dlsconlinue medica lion if allcrgicre<lctionoccurs(rash.houblebreillhing 01' olher sudden, un(!~llr.l;ted symptoms} illld conl<JcIElllc!ljencyDc[J<Jrlmenfimmedi<ltely. o Continue current medica lions ilsdirected. o Take two <Ispirin or Tylenol every lour hours as nccdeil [or paillorfcvcrljrealcrlhan 101" SCt!'addlllOnnl mcdicatiolllfl!ormillion: (over) o AntibllJllcs o Muscle relaxants o Anti-inflammatories 0 Decongestantsl o Narcotics/sedatlves Antihistamines GENERAL INSTRUCTIONS Olncreasefluidinlake. ~;lkeOnIYCICarIiqUid5bYI1l0Ulhinsma.llqUanlitics at frequent intervals until nausea. vomiting or diarrhea stopS,.lhen slowly relurn to usual dlel. Avoid dairy producls until syrnptoms have cleared, DUsevaporizerorcoolmislhumidifier. o For pain or temperature over 101", give aspirin- free medication (Tylenol. Tempra. Acetamino- pl1en,etc,) by rollowing schedule, CHILDREN'S ACETAMINOPHEN DOSAGE RECOMMENDATIDNS '" 4.1\ 1:l-23 ,,' .'S " >I, " 12.IJ G~O\JP .os ,os '"' '"' 'AS '"' 'AS >OS Wel9nt 9Sind Ilbl) 12.17 "" 24.3536-41 '*5961).11 7f.9S .. OOSEOF . .. .. '" '" '" ,. '" ACETI~I~e~ I'nmli ., ., 'S ., ., ., ., ., DROPS {6QmgiO.8ml) 10 drpl_lull ELIXE~ 116Om'}Smll 10 ,. ~Iull CHEWAOLE TABlErs '" l6Qm9e1C11I JCJ(:f~ TAAE1 '" 11!1Omgeach) Repeat dose every 4 hours as needed 00 nol bundle child in blankets. .Ill.! { FOllOW.UP CARE INSTRUCTIONS o Relurn 10 the Emergency Dcparlment in _ day(s). Date: Time: o Return 10 the Emergency Department or see your lilmilydoclorin_day(s)lfyoursymptoms havenolirnproved. o Call Dr. [clephonelt lor follow.up appoinlment in day(s). II you arc unable lo_conlaclyour physician, call or ~eturn to the Emergency Department. Return to the Emergency Department or call your family doctor immediately if you develop new symptoms or if any aspect of your condition should suddenly worsen. EYE INSTRUCTIONS OWeareyapalchunlllrechcckcdfn_hours. o Wear eye patch lor nexl_hours,lhen remove it. o Return to Emergency Department or call your eye doctor immediately if increasing pain. redness. dis- charge, or blurred vision develops. AaOmONAllNSTRUCTlONS o Your x-rays have received a preliminary interpre- tation by the Emergency physician and will be reviewed by the radiologist within 24 hours. Please call the Emergency Department in 24 hours for final interpretation. o You have received a booster Injection of D.T. to maintain protection against tetanus (lock jaw) and diplheria. o While in the Emergency Department, your blood pressure was found to be elevated. This may be due to the stress of an Emergency Department visit. We recommend your blood pressure be rechecked by your family physician within one week. o A cullure specimen has been obtained 10 test for bacteria. Please call the Emergency Department in 3 days for the results. l:lin of th! above instructions, including the additional instruction sheets. Dale: 0 ";':\-- Physiclan'sSignalure JD~CW~ ~,i ,,' CHART COPY , ,.;, -: ,. 1 : ~I;; ~ (< \ ':' l' \ \ ' EMERGENCY CARE UNIT PATIENT INSTiWCTIO~t-~ "-~ o HEAD INJURY - " . ' ~,l At Ihe t "me the rlatient's condition is satisfactory and hospitalization is not consIdered necessary, However, you should contact.,the) presenl ~ " . .' .')~'I Ernp.f!:!encv Department or return for re-evaluatJo~ If any of the followIng symptoms occur. 1";:- ! I.. Mental confusion, change in usual personality. , . -; " . ~ 2, Vomiting, especially more than once. ' 3, Severe Of worsening headache. 4. Convulsions (seizures), . . 5. Increased sleepiness or difficulty in awak.ening - over and above normal bedtIme tiredness, 6. Difficulty in walking or dizziness. 7. Blurred or double vision. S, Blood or clear liquid draining from nose or ears. 9. Difficulty speaking. Follow these directions: 1. If nausea is present, give only clear liquids by mouth for first 12 hours following injury. 2. Sleep is permitted, however, patients should be checked every 2-3 hours during sleep periods for next 24 hours to see that they can be awakened normally, 3, Give nothing stronger than Aspirin or Tylenol for pain relief, unless prescribed by physician. 4. Apply ice to swollen areas, intermittently for next 24 hours. IMMUNIZATION INSTRUCTIONS o DIPTHERIA, TETANUS - DT You have received a booster injection of DT for tho purpose of maintaining your protection against Tetanus (lockjaw) and Diptherla, rJ TETANUS TOXOID - IT You have received a booster .injeCtion of Tetanus Toxoid for the purpose of maintaining your protection against Tetanus infection (lockjaw). This injection will provide protection for 10 years. It is important, therefore, to note the date of this injection and contact your family doctor at the end of 10 years for your next booster injection, In the event you "cut" yourself it will be necessary to have a booster after 5 years have elapsed. o DIPTHERIA, PERTUSIS AND TETANUS - OPT You have received a booster injection of DPT forthe purpose of maintaining your protection against Diptheria, Pertusis (whooping cough), and retanus (lockjaw). o TETANUS TOXOID -1s1 DOSE You have received the first dose of Tetanus Toxoid for the purpose of providing long-term protection against Tetanus infection (lockjaw). To complete the immunization process, contact your family doctor in 4-6weeks in order to receive the second injection. The3rd and final injection must be received 6-12 months after the second injection. When this initial immunization process is completed, booster injection will be required only every 10 years or at the time of injury. It is important, therefore, that an accurate record be kept of the dates of these injections. iJ ANTIBIOTICS You have been prescribed an antibiotic, a chemical substance which kills or prevents the growth of bacteria, Antibiotics are used to treat bacterial Infections (strep throat, ear infection, sinusitis, urinary infections, etc.), Antiobiotics are not effective against viral infections (colds). Take all the medicine prescribed according to the instructions even though you may be feeling better. Some commonly used antibiotics: (brand names will vary) Ampicillin, Erythromycin, Amoxicillin, Bactrim, Septra, Augmentin, Keflex, Duricef, Cee/or, Pediazole. Tetracycline. o ANTI.INFLAMMATORY We have recommended the use of an antl~jnflammatory for the treatment of your pain. These medications reHeve pain by decreasing the inflam'mation present. They are best taken after meals or with food. If you experience nausea, vomiting, or abdominal pain, stop the medication and consult your doctor. Do not take this medication if you have had an ulcer or bleeding from your stomach or bowels, This medication interferes with some other medicines: Consult your doctor if you are taking any of the following: (1) blood thinners\like Coumadin or Warfarin; (2) diabetic medications like Grinase, Tolinase, Dymelor and - Diabinese. Do not take more than one anti- inflammatory medication at once. Examples of other antj-inflamm~ies are: Aspirin, and any other over the counter medicines containing Aspirin; Nuprin, Advil, lndoc!n, Feldene, Anaprox, Clinirol, Butazolidin, Dolobid, Meclomen, etc. You may use Tylenol along with anti-inflammatories, o MUSCLE RELAXANTS > The medicine you have been prescribtf<l may decrease your muscle coordination and reflexes. Until you have been able to experience what your response will be: DO NOT drive a.carorpilot an aircraft; DO NOT work around dangerous machinery; DO NOTclimb ladders or work in high, unprotected places; NEVER DRINK alcohol while taking this medicine. ( '. o SEDATIVES AND NARCOTICS _ .I r" You have received a sedative as part of your treatment in the Emergency Care Unit. DO NOT: drive, drink alcoholic beverages, or,\York f.o~ 4.12 hours. Many more additional hours may be needed for complete effects to disappear. You may need assistan);e walking'an8' should go to bed or rest when you gel home. If you have a prescription for additional medication, you will need to follow these instructions each lime you take the drug, o DECONGESTANTS AND ANTIHISTAMINES "..' ",,\ """" AntihIstamines a,nd decongestants arc usod to rellevo or provont tho symptoms of your modlcal problem;'Take them only as directed, These medications may add to the effects of alcohol, sleeping pills or tranquilizers, Check with your doctor before taking anY',addltJonal , medications with this new prescription. Side effects may include drowsiness; restlessness, especially in children; U'nusu8l:tlredness; \ unusual bleeding or bruising; sore throat and fever. Any side effect should be reported to your physician immediately. Q.d"riofdrive or operate dangerous machinery while taking this medication, . -'-.__",~........ MEDICATION INFORMATION SHEET ':!. l,A'. . I -,'1 ,," ,;,...---,- C 503-1 _~L'~-:'""~~'~' ..-.:--'~ 'to .......-oJ".... ,-..,:"'/- ~ Ib820lflf 3 12107/92 MR3J72fCO ,,' PI EReE, AuDREY J ~L-U 213 ~ PRINCE ST SHIPPENSBVRC, PA 17257 ; 04/09/60 32Y 717 532-B499 I - . Dale: "",_",-~,J ;:i!/";:- '1!l',T~t \ I I , o o ,93 t/) Discharge Home ) Blue Sheet Signed ) Discharge to ( ) E.C.F. ( ) Another Hospital ( )AMA ( ) Psych ( ) Rehab ( ) Other (specify) /0 3 S 6J)jp,M. ~. ' THE CHAMBERS BURG HOSPITAL CHAMBERSBURG, PENNSYLVANIA PATIENT DISCHARGE SUMMARY I. MENt"fL STATUS: (check one) If-.- Alert and Oriented Other (specify) II. PHYSICAL STATUS: (?ssess acc~ to diagno. sis) ~ _ d I . j ~~ ~l' 1.t.iU<<--A-/.-.'{(h~, ~ ---~' ~ ~ /W .., d.'i 'Z r.,^.JSJ_ ,4t~ IV. MODE OF DISCHARGE: (check one) t>C ^ mbulatory Wheelchair V. PATIENT ACCOMPANIED BY: (check where applicable) Family .>I ~olunteer Nursing Staff III. ACTIVITY STATUS: (check one) t((.;.mbUlatOry Ad Lib Ambulatory with help Other (specify) Stretcher I,( . ther (specify) I SiGNATURE:, VI. EXPECTED OUTCOME REVIEW: (To be completed by the R.N.) EXPECTED OUTCOMES/NOT ACHIEVED' ~ fI 'INDICATE "NONE" IF ALL ACHIEVED pO'355 R,N. SIGNATURE: ACTION TAKEN '. .,( '-'/ ,//,':" :..( .-' " o ,.-, ('., o ('., ~;- "DATE TIME, PROBLEM NOTES W '7 ,,- ~ <-2, - .....- 503-1 THE CHAMBERS BURG HOSPITAL PATIENT PROGRESS NOTES I b820LfLf 3 12/07/92 MR317266 ' PIERCE, IUDREY J F' 213 ~ PRI~CE ST H-U: SHIPPENSBURC, PI 17257 · 04/09/60 32Y 717 532-8499 . P 4265 REVISION 9/90 ORIGINAL 10/86 ".-0--' ".."---'. ..,-, ^'_"C">~" -' ",;,-" ,-",>,.<- ~""".."'--~ ""'" .,,,- ,~ -~ : .:';, ': () /'""'\ ;-"'1 r-. i""""\ ',; rHE CHAMBERS):n;itG HOSPITAL CHAMBERS BURG, PENNSYLVANIA - ',! NEUROLOGICAL & NEUROSURGICAL ASSESSMENT SHEET , (GUIDELINES FOR COMPLETION - SEE REVERSE SIDE) '. OBSERVATION RECORD FOR DATE ilItl Ion 10/1" BRAIN DISEASE & TRAUMA TIME N1,': 0-.,0 EYES OPEN Spontaneous Iv .. n, <I.l- ,11/ Closed by To Speech 1 , To Pain I I I S"ellin2 = C None I I Oriented ., ~, lJY ,v 1 VERBAL Confused COMA Inappropriate Words MSPONSE IncCltlnrehensive Sounds None Obey Command ", 1\, ,; Vr:... , MOTOR Localizes Pain - Flexion to Pain MSPONSE (Decorticate) - - Extension to Pain (Decerebrate) - - None ARMS Normal Power "" '" n, ~(.. LUrn Record L&R Mild Weakness - ~ separately Severe Weakness - - M:MMENr / No Response --- --- MUSCLE if differ Grin Stren2th '" I, S 1<, TONE LEGS Normal Power . n, ,~. I", v"- Record L&R Mild Weakness , - . separately Severe Weakness - - '..1 if differ No Response -\ FACE Facial Droop ~ , ''1 -- ,. PUPILS Reaction - Rillht ~ 'I 'f ;, ,;i ;~ EYE ('I)-React Size - Rillht " ~ .;, ) '.'\oj :~1 (N)-No Reac tion - Left ~ 'I v v . ' 'j,;; (NA)-Not Size - Left " u ~ <~ CHECK .;; i .)~ Applicable Photophobia '.'.'\'\t I I Z I & I 0 l' NvstYl!1IluS . ..> . . ..... . Eye :Vf" Deviation I ; ,'~7--, I VISION Clear/Double / Blurred III 'I I'L el ~...-:-~. . ,,-.....' -,--;" I *INDICATES TO -SEE DATE :'l''''' , NURSES' NOTES TIME ,,.. " i ,;'.'~ i Record Intracranial Pressure .'.-1; ;~::'~ Appropriate CSF Drainage , ..J-.' VALUES Numbers Urine OUtDut ;, ,-,~.;,'t .'t, in Blocks Specific Gravitv .'\>i " Pitress:ln Given -.;',1., Neck Measurement ',j' . ,,~;~ , . . . . -- :~r:;~_f~k~" 1208'12 INITIAL SIGNATUM , >~~.. , " n, I,l~ fJ:>A 1-> -~;~f. 503-1 , d' ;'#~~v1: " '~S;J b820ltlt 3 12/07/92 MR31726& :l):;;' .' PIERCE, AUDREY J F ":.,-, 213 N P R I :IC E ST AL-U ,:",'.,:';:;. SHIPPEHSBURG, PA \ 7257 P.3625 ,>::;,'(';, 04/0Q/&0 32Y 717 532-8499 R.OSI'S " , R,':,06ZS8 , _,1_- . 'I"''''',,' .-C=, II " o the(fI' ~ ("j ("j n o DISCHARGE INSTRUCTIONS ALLERGIES: OII!K_MED NIlWICHANOIl CARD OIVEN MEDICATION MEDICATIONS DOSE FREQUENCY ADDITIONAL INSTRUCTIONS APPOINTMENTS Primary Doctor's Appointment: Dr. phone: Consultation Appointment: ,- Dr. phone: Diet: Activity: o No Restrictions o Printed Instructions Given I CALL IN EMERGENCY: f read and understand these instructions: 1208Q2 503-1 b820Lflf 3 12107/92 PIeRCE. lUDRtl J 21~ II PRI~CE ST SHIPPEMSBURG. PA 04/0q/~O 3ZY 717 CYEA. MR317Hb F At-U 17257 53Z-S4qq Palient Signature Instructions Given By fre~..r.4"t~'T"'.f,"'l'i."''-'''i'''--,I'''~':''; ;'~t.if"""- 0 , the CM ~lIg ,-, o o o DISCHARGE/ATIESTATION OF DIAGNOSIS DIAGNOSIS (reason for admission after study) lisr one: OTIiER diagnosis and/or complications (all conditions that co-exist at the time of admission, that develop subse- quently, or that affect the treatment received and/or the length of stay): OPERATIONS Summary dictated: DYes D No DISCHARGE ORDER D Home D AMA D Expired D Transfer t~ D ECF D Hospital o Other I certify that the narrative descriptions of the principal and secondary diagnoses and Ihe major procedures perfonned are accurate and completed 10 the best of my knowledge. Discharge Date! Attestalion Date Physician's SignatureIDate 503-1 b820l.Pt 3 12/07/92 PIERCE, AUDREY J 213 H PR1HCE ST SHIPPEHSBURC, PA 17257 04/Q9/bO 12Y 7\7 532-8499 ~ 'J EA. wnlte. CMrt ye low. phYSician HR3172H F AL-U THE CHAMBERSBURG HOSPITAL DEPARTMENT OF PATHOLOGY PIERCE, AUDREY J ACCOUNT#: 682044 AGE: 32Y SEX: F MR#: 317266" ROOM: 0503-01 ADMI7TED: 12071992, DIAG: ASSUALT ,'!CTIM PHYSICIAN: CVBll ***************~******************* QUALITATIVE TOXICOLOGY t**ttttttt************************** ALCOHOL MG/DL -------------,~-~------------------------------------------------------------------------------- 114.9 . ~w ~, j~~~~:, ~!~:, ,f' IY I,'.' I'! I - PAGE. 1 AUDREY J PIERCE INPATIENT REPORT , 12/08/92 07:33 END OF REPORT ACCOUNT#. 682044 MR #. 317266 LOC: 5NS' RM #. 0503-0L, ~ - '>-,<1l-,'j{.'..._i'>r,Ao-',._r,,,.,,___. ,,,,,,,,:~,:_.;,,l:..,,-- ..c,,^o ~~ ,,'~ ,m"~. ~~5:;. 1'"'\ 0 !'1';~:h3) i';;. i"""I i"""I 1'"'\ .:,. -,:; ""'''' , , I I I I I I I I , , , , , :,_:1'-,!, , , jld~ I ,~II ~1)L(I/J-l/0 In I n,1191.:~obdd.;J ~ :-f~ 1 I I DATE ;1 II IlJ :>~~ I I I II 1)1 I I I ' I I I I I I -,~,~ I MEDICATION i I ! j i I ! I '<.1 .. " i i i i I j i i , (';)(Jrn q, Po. al!*i--J.;;;-) I I I I I I I I ';.iJ I ''-.:1 ~'-I/ ~ /7C/ I. V ~ '--, , ",t; < , '.: I ,-" ! I. < , , , " , , I " , :.': :) ". " ,~< I . - ~! i .... j '''''~ . _u -'.;.~ ,.1"' '... , .,'); '.",i .!~ . "' .(~ ,'",;,;]j 0' "r't {..::~ ..;;;~ '~ __i'_._",. 1208'l2 '00 P4084 Revised 1/92 ", ':~:;~~", , , """1 503-1 ";-;),/, CHAMBERS BURG HOSPITAL ' 1<' THE ';'~ ,:,,-,',T- I MEDICATION PROFILE i,~~' b820lfLf 3 12/07/92 MR317266 PI ERCE. AUDREY J F = Medication given as ordered 21 3 ~I PRINCE ST AL-U 0 = Medication omitted for some ,," ,''''' SHIPPEHSBURG. PA 17257 reason ~~ 04/09/60 32Y 717 532-8499 0 = No doses of a PRN medication I. CVEA, given 1 H. .. ,c'- 'I., ~ n (', ('*', ~ ..., = '" ..., L, '" Co 0 ~ ..., Co ...f\ ..r:: C) '" = 0 ..., '" '" ~ '" e ): ... >- ): ): ): - 0 0 0 0 = = = = "0 -'" -'" -'" -'" = '" ..., ..., ..., ..., 0 0 0 0 = = = = " 0 0 0 0 0 ..., Cl Cl Cl Cl '" = 0 ~ cv ~~ c:: ~ ~ .... < :z: '" z: '" z: >- 0 , '" .... = '" ..., ... '" '" '" '" '" '" '" '" .... '" V'l '" '" '" '" '" '" '" 0'> '" Cl ~ >- >- >- >- >- >- >- 5J= 29 :::> 0' . 0 '" ;::l ... '" ell z: > e ~-@ l.l.l '" ..., :z: .... u ... w '" ~ < ... 0 '" c.. .... ..., ... ell Cl c:: ~'5. V'l '- = '" w w -'" l.l.l u u > ... :> = 0 , CO Vl .... ..r:: '" 0'> ~ :0: ... ..., > '<::- ~-C~ u ~ "0 = '" c:: 0 ell ,j-IU l.l.l w '" .c a: ~~ ..r:: = ... e .... .... 0 w '" 0 ~c;,~ ... = Co :0: ~ 0 0 l.l.l "- u ..., =.' ..., ..., u , U >, .... '" w '" '-, .~ z: 'n w "0 = , ..., ~ " < ~~ = ... 0 ..r:: = :> ... '" "0 '" 0 0' 11 0 u U n ," "d- O ~~ ..., '" = Co' N ") < ..., '- ::J '" ~ ,- '" 0 '" Co '" ,'. , " '" V) ..., -N ~~- :ii "- 0 , N ~, .~~ 0 "0 ..., ..r:: Co '" .." , U '" "- ~ ... w = = ~ ,... .... w "'~ '" ~ r- lli;J ~.... ):.... "'.... 0'> 0" --- ~..., 0"" "'..., ... .... "- ....... ..... c... ,~ \r~ ,- ... Co... ... 0 , 0 N>-<n ): '" '" ..., '" ..r:: L..J ......_ ~ji ..r:: W..r:: ,..r:: = '" l- - cr: UJ <';:""1 M g'U ~ U = U w Ou r.::: *' :;: .c '" .c (1"1=:1' :;- .~ ~ .- = '" = 0'>= "0 0'> e 0- r;'; > 0 ... 0 '- 0 w " ::J - - '0 ::J 0 ..., u.J = C::VlC> f;Q):;;J ~ >, "0 >, >, '" ::t- '0.. :.-~ ~'" - Co Co = Co '" = '" '" 0 '" 0 .. 0 ... = :;t-w w.,.. U U U W 0 OU::>"C'_(f' W W W ..., = ..r:: 0: n_ (--, ...c II > > > = 0 Co ruW~ - ~" '" '" '" '" '" '" '" w ClJ- - :t: ~l.:-- ':rtH ..r:: ell ..r:: ell ..r:: w ..., ~ ~"'~ >, >, >, <5 .. ell n.NVJOU ::J ::J ::J E ..., ..D ~~-:'l 0"- 0"- 0"- >, ... , ell ~ >,- >,- >,- }; .' 0 '" ... .,;; '" "- e ::J 0 0 0 ... " '" ..., .... ~ Cl Cl Cl c:: - = '" - m = - 0'> "" - '" - N "" .... .... V) c.. i .il ,1 ,'.l". ": DATE /.;J- --; - '1.:2.._ :? '} /CI Ii /:J.- /3 A.M, P,M. A,M. P.M, A.M, P,M, A.M, P.M, A.M. P.M, A.M, P,M. A,M, P,M. HOUR 4 812 4 8 12 4 8 12 4 8 12 4 8 12 4 812 4 8 12 418112 4 8 12 418112 4 8 12 418112 418112 41812 10e f-f- , - , , 104 , -+-+- , , , 103 , , , , , , 102 , , , , , , w , , , 0: , ~ 101 , , , , , , , -t+- , 0: , , , , w , , , , , 11. , ::; 100 , , , , , , w , , .... , , , , 99 , , , , : , Norma! , , , , , , 98 , , , , , , , -t+- f-++ 97 , , , , , , , , , , , , , ~ 98 , , , , , , , PULSE 4 / \/ 1), 8 V i\ ~O 12 / \ / 1ft' J RESP. 4 \/ V :Ml 8 /\ 1/ \ OlD 12 1/ I <i. B.P, 4 \ } \/ lJ'ihD 8 Y /\ t/oliD l' 1/ c IS7/t STOOLS WEIGHT ,10- A8C GIRTH o 1'1 .-., ("'\ o 503-1 THE CHAMBERSBURG HOSPITAL GRAPHIC SHEET , I t b 8? OLfL~ ~.3J FzV9119!nii R31 72 (, (, PIERCE,AUDREY'j"" F 213 'I PRINCE ST AL-U Sfll PPE:,SBURG. PA 17257 24/09/60 32Y 717 532-8499 "VE A, P.04060 ~ THE CHAMBERS!lURG HOSPITAL Chambers,burg, PA 17201 t-, t""\ (""I, o EMERGENCY CARE UNIT (717) 267-7146 PIERCE, AUDREY #682044 Date: 12/07/92 G. E. Willwerth, M.D. * CHIEF COMPLAINT: Assault. HISTORY OF PRESENT ILLNESS: 32-year-old patient was living with a friend for the past eleven years and has had some problems. Presently seeing a counselor. The patient was having a few drinks tonight with some friends at dinner. Apparently, met her male friend. There was an altercation that took place and she was pushed partially to the ground. She was allegedly grabbed around the neck and thrown to the ground, hitting her head. She is unsure whether she had loss of consciousness; however, she was immediately up and running. She presents now with discomfort to her neck. Denies midline neck pain. No paresthesias, muscle weakness. Denies epistaxis. Denies chest, back, abdominal discomfort. No paresthesia, muscle weakness. PAST MEDICAL HISTORY: Significant for skull fracture remotely, herniorrhaphy. Allergies to Penicillin. Medications include birth control pills. PHYSICAL EXAM: Finds patient seated upright. Temperature 97.9, pulse 84, respirations 20, blood pressure 140/88. There is no midline spinal column tenderness. There is mild paraspinous muscle discomfort at the base of the skull. There is a 6 em. contusion over the right occiput region. Pupils equal, round and reactive to light. Extraocular muscles intact. TMs, nares, pharynx, no blood. No step off or crepitus. No other signs of head trauma. Lungs are clear. Heart regular rate and rhythm without murmurs, gallops or rubs. Abdomen positive bowel sounds, soft, nontender, nondistended. No masses, megaly, rebound or guarding. No signs or extremity trauma. Equal hand grips.,_ On questioning, the patient states she does not have a safe place to stay tonight. She anticipates calling family members from Potter County tomorrow to take her there for several days. She has agreed to see Women In Need in the morning. Feel frequent neuro checks and determination of blood alcohol is appropriate, as well as keeping a safe environment for patient to stay this evening. She was given Toradol for pain. Orders were written. Transferred to the floor in stable condition. IMPRESSION: Acute head contusion. I," ",' , , iii!l~"""""'(" ..' IwIl :~~;:~,~lf)': ". .. .. ~Jr~<;,'\:;j~'~'(i.':", .. ~ W"';;:......"", ~).T1U:{CHAMBERSBURG ~~Cha,mbersbUrg, PA :~~~/'.: -", .',! ~ ~ ,.", o ~ HOSPITAL 17201 '."j.:,;::, .':-"' ,,', . EMERGENCY CARE UNIT (717) 267-7146 PIERCE, AUDREY #682044 Date: 12/07/92 G. E. Willwerth, M.D. * Ethanol ingestion. ~..~ GEW/gme D: 12/07/92 T: 12/07/92 G. E. Willwerth, M'D~ ee: Dr. Breneman 2 ;:'~-''''. (-1 (\ o CONSOLIOATEO aUSINESS FORMS CO., ALTOONA, PA CHAMBERSBURG HOSPITAL CHAMBERSBURO, PENNSYLVANIA 17201- PHYSICIAN'S ORDERS . PHYSICIAN'S ORDERS """;, ,-.~-,,: .:"':'I";l',)'~'i;~,~.~;~~~7ft!\~ c. V e.,4 2. " G ~p O->"V-~;~'- ~~, I ::4. ~,.- C t<JJl,-~-"O ./ ;: .,,4J.\-I).j..4~ /IV ( Cc.-- ,,~"'" <c"-4(' E: CC-'- ~ 0 'f'" 1" -h., L1" WO,,",,_N ,N N..d h:l ".~ 503-1 MedIcation or Food with Advorse ONglFood Reaction :b8201flJ- 3 12/07ln U3:7ZH ,. ~~~~~j~~;TtJ .'.", .., Ar~ll sltJ1J,Wi1Si8\l~J1. [J'iA 'm57 O.JO~/bO 321 11i 532-$4~~ CHA. "- ...... ORIGINAL COpy P-,J-l (', C""'l '"""1': r-. -;i< ~t IlR3172&6 F AL-U 17257 532-8499 PHYSICIAN PROGRESS NOTES b820LfLf 3 12/07/92 , PI [RCE. AUDREY J 213 ~ PRlrtCE ST SHIPP[~SBURC. pA 04/~9/60 32Y 717 C'lEA. " H Dale '~i. , ~~ ~~ .'c' ~ ~ - ""'-' ....-.d. <...tJ .l.n~/J#'I...l-~~ I c- ,~,-nJ.- ~ ~ (,) \. ~,^---f..- ,'", "....... ",". .. .. ... "....-f'"' NAME: PIERCE, AUDREY J DIAG: (UNKNOWN DIAGNOSIS) ACCOUNT#: 682044 AGE: 32Y SEX: F MRI: 317266 ROOM: 0503-01 ADMITTED: 12071992, DISCHARGED: 12071992 ,<;~~~ rUi1 . ,~'i; ~". .~'1 THE CHAMBERSBURG HOSPITAL , DEPARTMENT OF PATHOLOGY PHYSICIAN: CVE!1 ",i', ~~(.- 'it' :,' TEST: "tl" :';~~, UNI':'S: ~c ' :"c' 12/07/92 + 2320 *************~********************* QUALITATIVE TOXICOLOGY ************************************ ALCOHOL MG/DL --------------,---------------------------------------------------------------------------~----- 114,9 . : ", ,- " 2,' '.(:' '",' ,1;/ .\ 1; ,.,', .;;;,:," ~i1;.'. ~~,,:.'~,;; . ~',.' ,.. 'If ,i:' '~,;' ,~;\ ;~~ j' ~~~ . :-: ,,~ ~;'i: END OF REPORT ;-" PAGE: 1 AUDREY J PIERCE INPATIENT MEDICAL RECORDS COPY 12/08/92 22:25 ACCOUNTI I 682044" MR I: 317266" LOC: 5NS ' ,,;, RM I: 0503~01' " ~, ,:' I:~ .. Indlcatas purpose of ~ , medication has been ~ . axplalnftd 10 patient. . r'"'\ tf-- I) ,r-, MEDICATION ADMINISTRATION RECORD -'14 DAY nEnterHere D . _ IN PENCIL . ~ Number 01 Forma In Use . Sd1eduled Medications OAT;:S GIVEN CR."''' EtifCATE MEOICATION.OOSAGE.FREQUENCY.RT. OF ADM, . HA. / 1/ 1/ i/ 7 7 / / /' / / / 1/ / INITIALS TIME , '. " ,,-,' __"f . ",. ,"" - Single Olllers + Pnt-Operallves OR, DATe INITIALS N"NPO R " REfUSED NIV .. NAUSEAlVOUrTlNO TO BE alvEN NURSE; OR DATE OATI:: llUE INlllAL INITIA.LS MEDlCATION-DOSAOE.RT, OF ADM, MEDICATION-DOSAGe.AT, Of ADM. "",. TIM! 503-1 INJECTION SITE CODES \. OMS RUO - AT, UPPER OUADRANT RVO - RT. VENTROOlUTfAL RD - RT, DELTOID RVl. - AT. VASTUS LATEAAUS sos RLA - RT. LATERAL ARM RAB - FtT. ASOOMfN RALT - RT. ANTERIOR LATERAL THIGH b820'-l1f 3 12/07/<;2 ~R317Z66 PI ERCE. AUDREY J F 213 H PRIMCE ST AL-U SHI PPENS8URG. Pi 17257 04/0Q/60 32Y 717 532-S4QQ CVEA. ALLERGIES: ~,,/ ,i, OIAGNOSES,&<?d ('dr7rt/<' J <In NAME: Plr)ZcJ Ilvu/Z.Er/ ' , I . ".'. If'rNl?nd/ 1115 l:'3T/tIn ,; RM S(')-;") , , '. , - ,~ " ;-<'''' 'i., .." ...- "'" "'" -,- -- -'- -- -- , ; , , / 1:., I ( J<U.( ~~.^j(.. / '" C. IrY"I(a ./lIl..' reJ II". \,iL ,h 'j 'NlTlAlJI -V NAAfl!""''flTU INITIALS ......""'T1T1..E ""TO r-. MASON'01t OMIUfOH ....,.(<WI) I ,I PAM MldlcoUonl PAN'll Ihould lIIIo be recorded In nUlM'I noteI ., ; , "".... DP.t>>.T! _1CA~ DCIOISGM!N ; TlME AT. OF ACN. ,., ; Tu/"""'/ I. '-0,.,...,4 ""TO lH [ " Id-'6': , i:o I "i-, A <.I~ PiUl v TlME 0""" -} mf SITE !t'" ...,'% I' 1(:)f),rJ (.. ~,~ lHIT. i ""TE Tllll sm! ",:., ..., ""TO "... ,'.. ~ "- , SITE ."i -, :P"_>:. ""TE 'i "I "... 1""; , ,,' SITE -'r,:' INIT ,,;......c ""TO ::, "... SITt ',,' :"i}.it! ,~ INfT. ~,~i"- ""TO I' ,. ..,,.;,t.!"-I1', "... ",'."-,;,;' SITt <,'- ,'.":~ ... '",-_'""4; ""TE -.. - TWIE ',,-. ,.,~" - "'E 1 ", ;, "'" ., ....,. '-.J V '0 '-......,) @r-' '" ," ~, -,,--~. ..........,.-- .,11"----,,-'=' ,- , AUDREY PIERCE, Plaintiff IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA V. CIVIL ACTION - LAW 00-1148 CIVIL TERM JOHN VAYANQS, Defendant PROTECTION FROM ABUSE IN RE: PROTECTIVE ORDER VACATED ORDER OF COURT AND NOW, this 30th day of August, 2000, on agreement of the parties, the protective order entered in this case is vacated. By the Court, Joan Carey, Esquire For the Plaintiff ./}IL Taylor P. Andrews, For the Defendant Esquire > ~ ~ q._/vH! -r- . :mae :j~ ~ /l.t..~ psP .~,,.,, , , ~ OF ._j:--"-' ("('I 'Hjr 1 i ,Jl..., h., " ,.r ~ r::D~{)fF~ICE , , ..iC>X)l;\RY I,." I: en , ~ ~: I .... CLRV'12t:H~f\ .D COUNT)! PENNSYLVi\~JIA h-- '. ,,""""""'" ,.,,,C", :-'~ " ,-- .-, , p - ~ ,~ V) V1 ~ ""b ..". ,:\) ~ ~ , "_~,~I\IIliF<_ ,~_"",!,,,",_~II'!."" !J~,__ V,l!" """"" '--'" . CUMB CO PROTHONOTARY 141001 09/~1/00 'FRI 14:13 FAX 717 240 6573 TRANSMISSION OK TX/RX NO CONNECTION TEL CONNECTION ID ST. TIME USAGE T PGS. RESULT ****$$*************** ... TX REPORT ... ********************* 2136 92490779 09/01 14:12 00'52 2 OK Is fl 1;~ . 09{01/~0. FRI 14:08 FAX 717 240 6573 CUMB CO PROTHONOTARY 141001 $$$$$$$$$$$$$$$$$$$$$ $$$ TX REPORT $$$ ********************* TRANSMISSION OK TXlRX NO CONNECTION TEL CONNECTION ID ST, TIME USAGE T PGS. RESULT 2134 92405331 09/01 14:07 00'53 2 OK ~.f e - ~ 9-I-o-r.) '"I> ~ " -".~ . 091,01/DO. FRI 14: 06 FAX 717 240 6573 CliMB CO PROTHONOTARY 141001 TRANSMISSION OK TX/RX NO CONNECTION TEL CONNECTION ID ST, TIME USAGE T PGS, RESULT ********************* *** TX REPORT *** ********************* 2133 92438026 09/01 14: 05 00'55 2 OK I4<--^- t --,~ j,5', ", '