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6. As a result of his injury, the minor was admitted to the
Carlisle Hospital on August 13, 1993. The fraoture was reduoed
by manipulation by Thomas J, Green, M.D. and a spioa oast was
applied. He was discharged August 19, 1993 to the oare of
Dr. Green.
7. Portions of the hospital reoords and offioe notes of
Thomas J. Green, M.D. are attaohed. The minor was last seen on
February 1, 1994 at which time Dr. Green determined that he was
making a good recovery.
8. There is no medioal payments insuran~e ooverage
available. The outstanding medioal expense is as follows:
Carlisle Hospital -
Thomas J. Green, M.D. -
Blue Mountain Anesthesia -
Carlisle Imagining Assoc. -
RWC Physicians - \
Total -
$4,566.96
1,032.00
495.00
139.00
66.00
$6,298.96
9. The Chestnuts' liability insurance carrier has offered
to pay its $15,000 policy limit. A copy of declarations page is
attaohed.
10. Your petitioners, with the advice of counsel, William A.
Addams, are willing to settle and compromise this claim for the
offer set forth above.
11. Said liability carrier, in addition to its policy limit,
will pay counsel fees and expenses attendant with this petition.
3.2. Your pet,i tioners believe it would be advantageous for
the minor to accept the offer and that this settlement is in the
best inter\.lst of the minor.
......'
MVERS'JR., ROBERT
RM* 304 A
HIYIlICI\L mHINM'I~
II. In this examination the follCMirg IlUSt be
OOI/ered: Vital Signs, General ~,
skin, ~ Glards, Hood, Neck, Chest, Heart,
Blood Vessels, 1Ibdanen, Genitourinaty organs,
Bones aM Joints, Neurat1Jsall.ar, am Illpression.
MR. 376480
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,vi" 0'00 HYERS. ROBERT JR
O~/I 31q3 PO BOX I ~'j
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IOO'REMlTIES :
,
Well deVelqled, wll noorished boy who is in nonnal l\lTOOIlt
of distresa.
TelTperature normal, pllse 108, respirations 24.
'lbere is ro evidence of head or neck traUll'A. PupilS are
equal. uwer aixway is clear.
Expansion is symnetrical ard clear. No crepitus.
Negative.
Elctremity exam is negative except for the tender swollen
an;] crepitant left leg.
GEm:RAL:
VITAL SIGNS:
HEm!'1
CHES'l'1
lIBlX:tIm :
DlPRES8I~1
lis above.
PLl\NI Traction foll~ by spica cast awlication. I explained everyt:hirg to
the parents tonight.
WG/I'M 01 08/13/93 @ 21,32
Tl 08/13/93
'J.~,M.O.
OARLISLB HOSPITAL
PHYSICAL BXAMINATION
MVERS, JR., ROBERT 1376480 ois
Dl\'Rl CJI OPDlA'l'IOOI 08"18-93
~I ~. T. ~~
JlSSIB1'1IN1' /ltJRG!X',N1 None
JlSSIST1INl'S I DJnlap
***..**
PREXlPERATIVE D~ISI Lorq spiral fracture shaft of the left flllTl1r
l'OS'roPmM'IVE DI.l\lH:eIBI Lorq spiral fracture shaft of the left fenur
OPmM'IOOI Manip.tlative reduction arrl Spica cast awlication '7705""
l'ROC!1XlREl with the patient in the supine position, an anesthetio was admin-
istered in the patient's bed. '1he traction was rE!Il'OVeCI while tOO surgeon
ll'aintained traction ard alignment arrl the patient was placed in the spica
table ard all of the adjusbnents were ll'ade to the table while the surgeon
maintained the traction arrl alignment. '!he traction arrl alignment was further
maintained tllen by transferrirq the right leg over to an assistant am the
surgeon positioned the hip an::1 knee ard ankle for that leg. In a similar
fashion, the surgeon positioned another assistant with traction balrq awlied
to the proximal tibia through the hip joint an::1 then the rotation an::1 valgus
varos an::1 flexion extension alignment were established. 'Ihis allowed the
surgeon's hand free to awly a well-padded cast starting with felt around the
superior edge at the xiFhoid level. Groin an::1 ankle ones were awlied ard
taped in place. Regular Webril was then awlied over top of that aOO also a
sacral pad was installed. When the paddirq was felt to be opt:in'PJln, three
rolls of foor inch plaster were used, one for eacl1 leg and one for the pelvio
to establish the basic cast. '!hen this was lTOlded ard held by the surgeon in
the corrected position being certain to avoid any extension or varus in the
C'ast as this oould be an unacaJptable carplication. X-rays were taken ard it
shcMed Sliljht valgus rot a nice straight line to the lateral border of the
fllllllr ard an anatanio anterior bcM with apposition on both views in the 80t
ran:Je am the overlaw1rv:J of only about 2 or 3 mn. '!his was felt to be idqal
ard was the goal of the manip.tlation an::1 the castirq. A broanstick was then
awlied between the knees after ext:errlirq the cast d~ bel~1 the knee to the
ankle. '1lle ankles were well-padded prior to doing that, then the bloanstic:k
was aWlied with fiberglass to reinforce the entire cast. '!he C<lSt was then
trimned all alnIt its edges to make sure that they were all srrooth. '!his
concluded the operation. 1he patient tolerated it well. He left the t-
1rv:J roan in satisfactory corxlition.
TJG/~
J. GREEN, M.D.
01 . 1,08"18-931 o.lL1~ 'mO ~Q18K!0;~ 1\.
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CARLISLE HOSPITAL
OPERATIVE REPORT
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~lS~~2S 31bY80
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. NNlBI Myers, Robert
HAIl 376480
DM'I!lI 08/13/93
DG!2mKlY IlOCJl RBDlD
am:r CXJal1oUN1'I Pain, left thigh.
lIIImEYI '!his two year old male child was, awarently, riclirq a I1'G'ped with
his teenage ooosin. Acoording to the t"'lJOlt fran the rother, the child, ap-
parently, let go of the harillebars (he was riding in front) . '!he teenager
then lost ClClI'ltrol of the I1'ClpEd arx:1 they fell off the bike. '!his aooident
ocx:mTed aR,lroldmately orle hoor prior to his arrival.
PN1r MEDICAL ~YI No medical problems.
1ILLE1lGIES1 No knc:Mn drug allergies. Both the parents are allergio to Peni-
oillin.
HEDICA!l'IctlSl vitamins.
UlS'l' Tm'Mm SII:1l'I Less then five yeat'S.
P\JYBICAL EX7IMI1lM'I~1 Tenperature 37.1' C, lXllse 108/ respiratory rate 24.
'1he patient is in no acute distress.
No trauma.
Nontender, no bruising.
SOft, nonterder.
No bruis1.n1 or temerness.
Nontender to palpation.
'!here is a swelling arx:1 ternerness over the mid thigh.
'lhere is a good dorsalis pedis Jclse ard posterior tibial
p,1lse. capillaty refill is less than two 1leOOI"ds. '1here is
no tenderness aboot the knee, legs, ankle or foot. '1here is
a superfioial 3 DIn abrasion over the medial knee.
D~C TESTS: X-ray left fenur-'lhere is a displaced, overriding fracture
of the left fenur.
GENmAL:
HEENl':
OIESl':
J\BIXtolEN :
BAa<:
PELVIS:
EXmEM1TIES:
aLDlICAL IK\'RESBICfiI Fracture left fenur.
mElM'Hm1' PLNfI Dr. 'Ibaras Green has been consulted am has assumed this
patient's care.
MDB/mrf - D - 08/13/93 - 2116
T - 08/14/93
0......4( -110" /,-t~/..t.....~ I .11))..~ JJ .
MARK D. BJ'ORKWND, M. D.
CARLISLE HOSPITAL
EMERGENCY ROOM RECORD
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Page 1. .
OFFICE RECORD
THOMAS J, GREEN, M,O,
220 Wilson Street . Suite 104
Carlisle, PA 17013
(717) 243.1414
Name MYERS. Robert Jr. 2vrs. (l /20/Q I)
P .0. Box 185
70 E. Main St.
Plainfield, Pa. 17081
(717)249-1908
Parents: Robsrt & Stephanie
Ins: None-Self Pay
13 Aug. 93 HOSPITAL DISPENSARY & ADMISSION:
17 Aug 93 NOTATION: His blood count is a little low but I am going to do the operation
on him which is bssically just putting him in a cast.
07 Sept. 93 OFFICE VISIT: The boy looks a Utte better. The x-rays show increase in
the shortening from about 5 to 8mm. now (" there may be a little valgus built
into this which was planned when we put the cast on. I think that he'll
mold out into a more rounded varus positj,on. The flexion appearance is
not excessive & the coaptation should be satisfactory. We'll check h~m
again with an x-ray in 2 weeks. (TJGI dmg)
21 Sept 93 on'ICE VISIT: No further increase in shortening or any angulation in fact
I think it looks straighter en the AP view and certainly no worse in its bowing
of the lateral view. I find this to be quite satisfactory and now there is
bony callous. We'll take him the full time as planned and on the next visit
remove the cast and get x-rays out of the cast, AP (" lateral projections from
hip to knee. gss
cc: Dr. Krebs
12 Oct 93 OFFICE VISIT: Cast was removed today and x-rays look fine and I explained
to the mother how to manage his rehabilitation at home and check him again in a couple
of weeks.
9 Nov 93 OFFICE VISIT: He has done very well, he no longer looks pale. I think
he has already restored his blood count, we don't need to get a blood
count today. He's running around, he walks without a limp but he's about
3/8 of an inch short on the affected side, I think this is going to grow
,closer together. On the next visit we' 11 taks his pants and shoes and
socks off and check the leg lengths more accurately than we did today
with his clothes on, At that time we can look at some complaints that
he had about his toes and knees. The exam of the knee today is certainly
neg~tive. gss
HI
. 70 - _ ~)ij. ..!Q.O__ ~,' u !L~L02L'L _______L DUlE.tU J hl!.
[MAIUNGINST, 42[1i' _ ____' ___
C V LM CSTI' ,\MOUNT C-V-LM'CS-(P--AMlllJNTcv"l.'''\CS-r-p--- AMOUNT" CV--LM-'CS TP AMOUNT 69
12 04 _ -,SIlO ,
'O'~ ""'PREM1JjPRE~:II PR~tft:M J;~iP~E~Ffr[~~~Jll"PRET E
This declarations pago Wiltl "POLICY PROVISIONS" complotos this po' y. .900
, JP6-L1CYPERlOD--- ----'.--E AMENDED -
POLICY ,2:01 A.M, STANDARD TI AT THE CODE AMENDED PROCESSING
NUMBER 328-64-91 ADDRESS OF THE NAM INSURED SEE REVERSE DATE DATE
CLAIM 2703h8 59~ COMPo _fROM"-Q.8/Q~:!}T<2-08/0r,2(,!,!_ 08/13/9 08/25/93
7 PHO c ~ -442-6832
NAMED CHESTNUT, ,~E:LVIN P AGENT R & K INS ASSOCIATES
INSURED 107 3 GRAHAI~S WOODS RD 37-o'lil
(O~~6R) NEWVILLE PA 17241 20'1 [lOX 79'1 1100 LIGONIER
ADDRESS S LATROBE / '
~ PA 15650 ~ /
LOSS PAYEE. SEE LOSS PAYABLE CLAUSE THIS POLICY COVERS ONLY THE U (S) DESCRIBED BELOY
ON REVERSE SIDE YEARiMAKEISIZE/SERIAL NUMBE V
1972 HONDA 90CC CT9014o2485
THIS IS A LIMITED POLICY - READ CAREFULLY
WE WILL INSURE YOU FOR THE COVERAGES AND LIMITS OF LIABILITY FOR WHICH PREMIUM IS SHOWN,
SUBJECT TO THE TERMS AND CONDITIONS OF THIS POLICY,
ENDORSEMENTS: 8317 3857 3825 8221 8246
COVERAGES (ACV MEANS ACTUAL 61~JLSv~L~~~~~~~ MEANS DEDUCTIBLE)
A. LIABILITY COVERAGE L' -- -" -.-"'::\
- ~~g~~~~;~~~AGE _~~~~~RSO~ ,~.__1S, ~~_~ l ~~g~ ~gg:g~~~ ~ i ~: ~~~
PHYSICAL DAMAGE
COMPREHENSIVE
COLLISION
MEDICAL PAYMENTS EACH PERSON $
UNINSURED MOTORISTS
BODILY INJLIRY EACH PERSON $ 15,000
PROPERTY DAMAGE
PEDESTRIAN BASIC FIRST PARTY BEN. LIMIT
UNDERINSURED MOT8RlST
BODIL Y INJURY EACH PERS. $
-,
PREMIUM
ACV LESS OED, OF $
ACV LESS OED, OF $
LESS OED, OF $
EACH ACCIDENT $
EACH ACCIDENT $
5,000
15,000
EACH ACCIO. S
30,000
IF CANCELLED BY INSURED, MINIMUM RETAINED PREMIUM .50 APPLIES
1981-1 (1I81I1R12J621 HOME OFFICE FI LE coPy
Counterslgnod by Authorized Represenlatlve ---I