Loading...
HomeMy WebLinkAbout97-04817 '. , , :"'/'" , , . II, , . .' '" . " I" " - ,II - -. ~ c1 " , " " t,' " , '" ). " , , " , , !, Ii i'l ""1 ~ " " " ", " '/, I; II " " '- " ~ - - \,,; ! 'I " i' '.', ", I: '~~ ih ifi 'ii' ;, .. " . , , " " ". "1 , 'j , ii! ',' ':;,1 I' , "~ , " "ll:" . I, ',1',' ,"jf', i\l, " " II I , , , " ,I \ I', ,I 'I' ',I " ".1 , ,. / " ,,' " , , 1:: 'I, " ' ',', " " 'i " I,J , , , I"; )1 , , , ~ , , , \ " "I " ,'I .i, I, " , , " , "I q, " '. , " " :,'-il' , "', " ..... o. .':) .. ,', r- I,' " , ..... If) ..... C!; u: I~~ ." t.-.. (.'; ., -' ll.Jr) :! ~. (); ',' ; f'" L. j , . .., (r)( '1 m fd;. I ..- fi! II -', , iC,:j ~: : I.:L , " 00 :j 1;.) (J' U . " '" ... '" ;,~ 'olJ Ii ,) Christopher J. Gill, deceased. 3, Christopher J, Gill died as a result of injuries sustained in an automobile accident which occurred on or about December 1, 1996, and as a result of the alleged failure of the Defendants in the above-captioned action to properly treat Mr. Gill for these injuries, 4. At the time of the above-referenced accident, Christopher J. Gi.ll was legally intoxicated with a B,A.C, of .21 percent. 5. The above-referenced accident was proximately caused by the negligence of Christopher J. Gill. 6, The above-referenced accident was a two-car accident involving automobiles driven by Christopher J. Gill and the Petitioner Fred, C. Lescallcet, II, 7. As a result of said accident, your Petitioner, Fred C, Lescalleet, II, suffered numerous injuries. 8. Your Petitioner, Fred C. Lescalleet, II, has filed a personal injury action against the Estate of Christopher J. Gill in the Court of Common Pleas of Cumberland County, Pennsylvania at Docket Number 98-2937 seeking damages to compensate him for his injuries. 9, The lawsuit filed by the Petitioner has not yet gone to trial or reached a sottlement, 2 10, Due to the death of Christopher J, Gill, Petitioner must look to Christopher J. Gill's Estate to compensate Petitioner for his injuries. 11. petitioner has learned through the news media and by contacting the Cumberland County Courthouse that the parties in the above-captioned litigation have reached a settlement in this case, and that the Plaintiffs filed with your Honorable Court on or about October 15, 1998, a petition for Approval of Distribution of Proceeds of Settlement for the allocation of the settlement proceeds between the wrongful death and survival actions in this matter. 12, The terms of the above-referenced petition are unknown to petitioner as the pleadings in the above-captioned matter have been placed under seal, PETITION TO INTERVENE 13. Paragraphs 1 through 12 are incorporated herein as if set forth at length. 14. Petitioner, as a party seeking compensation for injuries sustained due to the fault of Christopher J, Gill, deceased, is a creditor of the Estate of Christopher J, Gill, lS, Your Petitioner filed suit against the Estate of Christopher J. Gillon May 27, 1998. 3 16. The Plaintiffs in the above-captioned action received notice of Petitioner's claim against th~ Estate of Christopher J. Gillon May 29, 1998. 17. The Plaintiffs in the above-captioned case have failed and refused, despite requests of Petitioner, to provide any information or assurance that sufficient funds will be allocated to the Estate to cover the claims of creditors, including the Petitioner, 18. Petitioner may have a legally enforceable claim against the Estate which will be frustrated if a sufficient portion of the settlement, in the above-captioned case is not distributed to the Estate, 19. Petitioner, as a creditor of the Estate of Christopher J. Gill has an interest in assuring that assets are not diverted from the Estate for the purpose of frustrating the claims of creditors. 20. If permitted to intervene, the petitioner requests that the terms of the Petition to approve the distribution of the proceeds of the settlement in the above-captioned matter be made available for the Petitioner's review. 21, Petitioner has not delayed unduly in filing against Petitioner for intervention inasmuch as Petitioner did not learn of the settlement until October 14, 199~, no Petition for 4 Distribution as well as all other pleadings in this case have been placed under seal, thus restricting Petitioner's ability to review these documents, and Petitioner has required time to research and draft this pleading, 22, Petitioner's interest in this action is not adequately represented, in as much as the interest of all of the Plaintiffs in this matter is to allocate as much of the settlement in the above-captioned aceion to the wrongful death claim so as to minimize or avoid estate taxes and claims of creditors against the Estate. WHEREFORE, petitioner respectfully requests that your Honorable Court grant Petitioner leave to intervene in thiu action pursuant t~ P,A,R.C.P. 2327(4), 2329. PETITION FOR DISCLOSURE 23, Paragraphs 1 through 22 are incorporated herein as if set forth at length. 24. Petitioner has requested counsel for Plaintiffs and counsel for the Estate of Christopher J, Gill, deceased, to provide information to petitioner regarding the distribution of the proceeds of the settlement in the above-captioned case. This request has been summarily refused. 5 25, The rights of the creditors of the Eatate of Christopher J. Gill were not adequately represented when Plaintiffs presented their Petition to approve the distribution of the proceeds of the settlement of the above-captioned lawsuit. 26. The Petitioner has been anable to gain access to this information as these documents have been placed under seal by the Court. 27. The creditors of the Estate of Christopher J. Gill have an equitable interest in determining whether the proceeds of the settlement of the above-captioned case have been made fairly or have been structured in a manner designed to avoid estate taxes and frustrate the claims of creditors. 28, If the terms of the Petition for Approval of Distribution of the Proceeds of the settlement of the above- captioned case are made available for review by the Petitioner, Petitioner will agree to keep the terms of the settlement of the above-captioned case confidential. WHEREFORE, the Petitioner respectfully requests your Honorable Court enter an Order directing counsel for the part i.. to provide Petitioner with a copy of the Petition for Distribution of Proceeds and Order approving said distribution 6 " ).. >- t'1 ~ n' c: ..~ ,- '" .. to) ~<( ~ 8~ , -, )I" ';,i: tl~. T 1.1... ()'::l (+)1..... .'19 1 I,; '0 f.j N ~\! 'j -. ft-l'J I- WIfe II - , U UI F-' (;;) ;r~ u. <Q a 0 (Ii " . KDM/PLOO/4Q04)6,1/10JQ~8 5. Denied as a legal conclusion. 6, Admitted on information and belief. 7-9, Answering Defendants are without sufficient information or knowledge to form a belief as to the truth of the matter and therefore it is denied, 10. Denied as a legal conclusion. 11. Admitt~d in part and denied in part. It is admitted that on or about October 15, 1998, a Petition concerning the distribution and allocation of settlement proceeds was filed in the above-referenced matter. The remainder of the allegation is denied. After reasonable inve~tigation, Answering Defendants are without sufficient information or knowledge to form a belief as to the truth of. the allegation and therefore the same is denied. 12. It is admitted that the pleadings in the above- captioned matter have been placed under seal. ANSWER TO PETITION TO INTERVENE 13, Answering Defendants' answers to paragraphs 1 through 12 of this petition are incorporated herein by reference, 14-22, If Petitioner is permitted to intervene. and is provided with the terms of the settlement, Answering Defendant requests that Petitioner and any other parties to the law suit docketed at No, 98.~937, sign a confidentiality agreement and agree not to disolose the terms of the settlement or 2 KrM/PLOO/4004l8.1/10J098 diatribution, Insofar as a further response to these allegations is necessary, they are denied either as conclusions of law or they are denied because, after reasonable investigation, Answering Defendants are without sufficient information or knowlddge BO as to form a belief as to the truth of the allegations, WHEREFORE, if the Court grants Petitioner's Petition, Answering Defendants request that the Court direct counsel and all parties in both the instant action and the civil action docketed at No, 98-2937 to sign a confidentiality agreement prior to the disclosure of any information in the above-captioned action. ANSWER TO PETITION FOR DISCLOSURE 23, Answering Defendants' answers to paragraphs 1 through 22 of this petition are incorporated herein by reference, 24-25. After reasonable investigation, Answering Defendants are without sufficient information or knowledge so as to form a belief as to the truth of the allegation and therefore the same is denied. 26. It is admitted that documents in the above-captioned action nave been appropriately placed under seal by the Court, 27. Denied as a conclusion of law. 3 KbM/PLOO/4Il04IN. 1/10jO~N 28. Answering Defendants agree that the terms and distribution of the settlement proceeds in the above-captioned case should be kept confidential, Answering Defendant asks that the parties sign a confidentiality agreement, WHEREFORE, if the Court grants Petitioner's Petition, Answering Defendants request that the Court direct counsel and all parties in both the instant action mnd the civil action docketed at No. 98-2937 to sign a confidentiality agreement prior to the disclosure of any information in the above-captioned action. ANSWER TO MOTION TO SET ASIDE PETITION FOR APPROVAL FOR DISTRIBUTION OF PROCEEDS 29-34. Answering Defendants take no position on this Motion. It is believed that the Court's distribution of proceeds and the sealing of the record were entirely proper, warranted and negotiated by the parties in the above-referenced matter, WHEREFORE, if the Court grants Petitioner's Petition, Answering Defendants request that the Court direct counsel and all parties in both the instant action and the civil action docketed at No. 98-2937 to sign a confidentiality agreement prior to the disclosure of any information in thtl above-captioned action, 4 ,I tc; (1) t ." l.r~ , ' .. . )~ u,c: N , , v:' :-:: ) :;-,~ I", . -\ ,. , u_ .! ~:j (:')1 . ~ ~. '\)/) " tJ') "I: I "1 .~ ";' , -. i .JLU , ,~'. "J... ~..J ,~,~.'L . ;.1', co. er) ;..) 0 ." U 4-7, After reasonable investigation, Plaintiffs lack sufficient information to justify a belief in these allegations and they are therefore denied, 8, Plaint.iffs admit. that their son's Estate has been sued by Mr, Lesca lleet. To the extent that the a llegations suggest anything other than this, said allegations are denied. 9. Plaintiffs do not believe that the law suit against their son's Estate has gone to trial or has reached sett lement and therefore said ailegations are admitted, To the extent that the allegations suggest anything other than this, said allegations are denied. 10, The a llegations constitute conclusions of law to which no response is required. To the extent that any response is required, said allegations are denied as, after reasonable investigation, Plaintiffs lack sufficient information to respond otherwise. Specifically, Plaintiffs are not at all certain whether Mr. Lescalleet has filed suit against all appropriate parties. 11. After reasonable investigation, Plaintiffs lack sufficient information to justify a belief as to what Mr. Lescalleet learned about this case, and therefore said allegations are denieu. All other matters make reference to the sealed record in this case, and therefore require no response. 12. Plaintiffs admit that the Court ordered this record sealed, 13, The allegations require no response. To the extent that any response is required, said allegations are denied, 2 14. Denied. Mr. Lescalleet is not a creditor of the Estate of Christopher J. Gill. No judgment has been entered in his favor and no settlement has been reached, to Plaintiffs' knowledge, that exceeds all available insurance policies for Mr, Lescalleet. Furthermore, it is not at all clear whether Mr, Lescalleet has pursued cla ims against all appropr iate part ies for whatever damages he alleges to have sustained as a rp.sult of any automobile accident, Furthermore, Mr, Lescalleet has come forth with nothing to suggest the nature and extent of his injuries, the amount of all insurance coverages available, and whether he has pursued claims against all appropriate parties, However, Mr. Lescalleet is a creditor to no one until he obtains a judgment or seeks to pursue a valid settlement agreement. Accordingly, Mr. Lescalleet's allegations are denied, 15. After reasonable investigation, the Plaintiffs lack sufficient information to justify a belief in these allegations, and they are therefore denied. Plaintiffs do not have first hand knowledge as to when suit was filed. 16, Plaintiffs lack sufficient information to justify a bel~ef therein, and therefore said allegations are denied. Plaintiffs do not know what exactly Mr, Lescalleet is referring to in these allegations, 17. Denied. To the contrary, Mr, Lescalleet has withheld any and all information concerning any injuries he may have allegedly sustained in any automobile accident and has further withheld any information concerning all applicable policies of insurance 3 available to him, and has further failed to provide any information concerning all of the appropriate claims he may have against all appropr iate part iea. Furthermore, as Mr, Lesca lleet' s attorneys well know, he is not lawfully entitled to any such information from the Plaintiffs. Mr. Lescalleet, through his attorneys, knows that he is not a creditor of anyone, Accordingly, said allegations are denied, 18, Denied. Mr. Lescalleet, through his attorneys, recognize in these allegations that he has no legally enforceable claim as a creditor against the Estate as of this time. However, to the extent that the allegations suggest anything otherwise, specifically, that Mr. Lescalleet may eventually some day have a potentially enforceable claim against the Estate, said allegations are denied, Furthermore, the allegations are denied to the extent that they might suggest that Plaintiffs had anything to do with the apportionment of anything in this case. Mr, Lescalleet's allegations suggest a fundamental misunderstanding of what occurs in such cases. As counsel for Mr, Lesca11eet no doubt understands, any such apportionment is condu.cted by the Pennsylvania Department of Revenue, The Court is then ca lled upon to approve the Department's apportionment, 19, Denied. Mr. Lescalleet is not a creditor of the Estate of Christopher J. Gill for rea",""s set forth above, He has no interellt in attempting to influenCE! the Department of Revenue's decision, nor this Court's decision. He has no standing to file such a petition or intervene in anything. 4 20, Denied. Mr. Lescalleet has no lawful basis to intervene in this closed case. It is respectfully pointed out to Mr. Lescalleet that this case is no longer pending. The case has been closed and sealed. Therefore, Mr. Lescalleet's attempt to intervene must be denied pursuant to the plain language of Pennsylvania Rule of civil Procedure 2327, Furthermore, Petitioner offers no lawful reason to be permitted access to this sealed record, Accordingly, said allegations are denied. 21. Denied. If Mr. Lescalleet honestly believed he had some legal basis to intervene in this case, he could have attempted such unlawful maneuvers at any time during the pendency of the case. While Mr, Lescalleet or his counsel knew or should have known about this case, he failed to take any steps toward this unlawful attempt. Therefore, Mr, Lescalleet's efforts at this point are not only unlawful, but tardy and in violation of Pennsylvania Rule of civil Procedure 2327. The remainder of any allegations in this paragraph are denied based on Plaintiffs' lack of informat.ion sufficient to justify a belief therein. 22. Denied. Mr. Lescalleet has no interest in this closed, sealed, case, He had no lega 1 interest in this case dllr ing its pendency. He is not a cr'edi tor of the decedent's Estate. He merely has a personal injury claim which he may pot.entially win or lose or settle for whatever amount. is eventually deemed appropriate, if any, Mr, Lescalleet lacks standing to come before the Court in this closed and sealed case, To the extent that Mr. Lescalleet's allegations suggest that the Plaintiffs have a right 5 or interest to apportion anything, said allegations are denied. Mr. Lescalleet's allegations reflect a fundamental misunderstanding as to how apportionment issues are resolved. As the Court well knows, such apportionment issues are decided exclusively by the Pennsylvania Department of Revenue and reviewed by the Court in every such case, Therefore, to the extent that the allegations reflect such a fundamental misunderstanding, they are denied, 23. The allegations require no response. To the extent that any response is required, said allegations are denied, 24. It is admitted that Mr. Lescalleet's attorney have attempted to violate this Honorable Court's Order in connection with this case, Such attempts have been summarily refused by undersigned counsel, To the extent that the allegations suggest anything otherwise, they are denied. 25. Denied. The, allegations once again reflect the fundamental misunderstanding of Mr. Lescalleet as to how apportionment issues are decided in such cases. Furthermore, Mr. Lescalleet is not a creditor of the Estate of Christopher J. Gill. He has no standing before this Court in this closed, sealed case. To the extent that the allegations suggest that the Plaintiffs or their counsel had any decision making process with respect to any apportionment issue, said allegations are denied. 26, The allegations are hopefully true, otherwise, Mr. Lescalleet or his counsel would be subject to the sanctions of this Court. 6 6, Please admit that vital signs are, in fact, an important factor when performing serial examinations on patients to determine whether there is any evolving evidence of internal injury. 7. Please admit that Dr. Kurlantzick did not utilize the vital signs recorded by Nurse Gorden at ~:20 a.m. when dictating his note at 6:5Y a,m. 8. Please admit that Dr. Kurlantzick should have considered the vital signs recorded by Nurse Gorden at 6:20 a.m, in the patient's chart before dictating his note at 6:59 a,m. 9. Please admit that Nurse Gorden should have told Dr. Kurlantzick of the patient's vital signs that she recorded at 6:20 a.m, 10, Please admit that the nursing staff should have notified the emergency department physician of the patient's vital signs as recorded at 6:20 a,m. 11. Please admit that the nursing staff should have advised the emergency room department physician that the patient could not dress himself. .". '~ t? '...." f.- ~. c~i , , t;' ~., . ~ 7" ,- '- , J: ~ , " i" t.... ~.-~ , " -ii, EL.:-' ro_'.' Itij ., ::..1 Id.. /. "" , t.. c_"] '~:5 0 .. , U GERALD W, GILL alld DIANE GILL,: Individually and as Administrators of the Estate of CHRISTOPHER J. GILL, Deceased, IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNA NO, 97-4817 CIVIL Plaintiffs CIVIL ACTION - LA~RIGINAL VS. CARLISLE HOSPITAL and ROBERT L, KURLANTZICK, M,D" Defendants JURY TRIAL DEMANDED PLAINTIFFS' RESPONSE TO NEW MATTER OF DEFENDANTS 55, The allegations constitute conclusions of law to which no response is required. To the extent that any response is required, said allegations are denied. Plaintiffs have stated a claim upon which relief can be granted. 56, The allegations constitute conclusions of law to which no response is required, To the extent that any response is required, said ~llegations are denied. Plaintiffs' claim was timely filed, 57, The allegations constitute conclusions of law to which no response is required, To the extent that any response is required, said allegations are denied. The decedent was not negligent, Any negligence on his part, which is denJ.ed, did not exceed the negligence of the Defendants. Plaintiffs' recovery is not barred by operation of the Pennsylvania Comparative Negligence Act, 58, The allegations constitute conclusions of law to which no response is required, To the extent that any response is required, said allegations are denied. Decedent was not negligent, 121765/J~W Plaintiffs' claims are not limited by pennsylvania Comparative Negligence Act. negligent, 59, The allegations constitute conclusions of law to which no response is required, To the extent that any response is required, said allegations are denied, The decedent did not voluntarily assume a known risk. Plaintiffs recovery is therefore not barred by the operation of the doctrine of assumption of risk, 60. The allegations constitute conclusions of law to which no rasponse is required. To the extent tLat any response is required, said allegations are denied. Decedent's injuries were sustained not as a result of natural or unknown causes, but were the result of Defendants' negligence in failing to diagnose and treat his condition, Decedent would not have died but for Defendants' neg ligence. 61. Denied. Defendants fa i led to r:>rovide full, complete, proper, reasonable and adequate medical care and treatment in accordance with the applicable standard of care to the decedent. To the contrary, Defendants were negligent and this negl igence directly and proximately caused decedent's death. 62, Denied, Defendants' negligence was a substantial factor in causing or contributing to decedent's harm; namely, his death. 63. Denied. Decedent would not have died but for Defendants' neg ligence, 64, Denied. This is not an "informed consent" case in that no surgical procedure was provided to decedent, To the contrary, the opera~ion of the Defendants were solely 2 surgery was what the decedent needed whlle under the Defendants' care, but this was not offered or provided to him because the Defendants failed to diagnose and treat decedent's medical conditions. Accordingly, Plaintiffs' claim is not barred by any informed consent doctrine. Further~ore, no Plaintiff voluntarily consents to a medical Defendants' negligence, 65, The allegations constitute conclusions of law to which no response is :o:equired. To the extent that any response is required, said allegations are denied. Dr, Kurlantzick and the medical staff at Carlisle Hospital were either agents, ostensible agents, servants, or employees of Carlisle Hospital. Dr. Kurlantzick may or may not have been employed by RWC, as alleged by the Defendants, but this does not alter his ostensible agency with Carlisle Hospital. Furthermore, Plaintiffs believe, and therefore Jlver, that the nurses and other medical personnel at Carlisle Hospital who attended to decedent, were employees, agents, and most certainly, ostensible agents, and/or servants of Carlisle Hospital, 66. The allegations constitute conclusions of law to which no response is required. To the extent that any response is required, said allegations are denied, The defense of "two schools of thought" does not apply to this case, It is not acceptable for any doctor, nurse, licensed practical nurse, or any individual with any medical training whatsoever / especially an emergency room at a community hospital, such as Carlisle Hospital, to not as much as x-ray obvious hip and abdominal injuries. The medical care that was not provided to the decedent while a patient in the emergency ) , I " " '., ,.... .. i.I.' ~"I i' ., '" ('I ( , " , , ,- )..-.' y! , ,(":) I , " , i;: I. /-- '" , ".-- "', e.: 1.1. ,.~ ,I 0 ~~\ U ',.,' " ~ RAE/PLDG/381087,l/061698 required to file a pre-trial statement on or before May 7, 1998, 6. The case was improperly listed for trial in contravention of Local Rule 213-2, All pretrial action has not been taken, and the case is not ready for trial in all respects, 7. Plaintiffs are still in the process of serving expert reports, Nearly one month after certifying this matter for trial, ~ the Call of the Civil Trial List, Plaintiffs served their first expert report. 8. Plaintiffs' first liability expert report was served upon Defendants on June 9. 1998. Plaintiff's second liability expert report was served upon Defendants on June 12, 1998. 9. Thirty days is insufficient time in which to obtain rebuttal reports. 10. Defendant Carlisle Hospital retain experts, obtain their reports and must serve expert reports upon Plaintiffs. The Hospital is in the process of retaining experts and obtaining their reports. This process will not be complete by July 7, 1998, 11, Plaintiffs have not yet responded completely to expert Interrogatories, Plaintiffs' counsel has not served a curriculum vitae for either of the experts Plaintiffs identified in their Answers to Defendant Carlisle Hospital's Interrogatories, Without an understanding of thID qualifications of all of the experts to be utili2ed by Plaintiffs, Defendant Carlisle Hospital 2 " , " ~ C/ ~ '..:I ~ .. ~;) ..'1'! ~~J - :3 ~~:; I- \~ ~ ~" 0_ ~"'i (', ;;... r'. '.J:/ ,;,,) " 1 ~~ ffLli -~ : r' .r'~' ~...; ;.'IUJ' j;" ., IJlP"'" ,. ~ ro d, " IT' 1,j , , , , '" 2. Admitted in part and denied in part. It is admitted that Christopher J. Gill died on December 2. 1996. The remaining averments of this paragraph are denied. After reasonable investigation. Answering Defendants are without knowledge or information sufficient to form a belief as to the truth or falsity of the remaining averments contained in this paragraph and therefore. deny same and demand strict proof thereof at time of trial. 3. Denied. The averments colltained in this paragraph are generally denied in accordance with Pa.R.C.P. 1029(e). Strict proof thereof is demanded at the time of the trial If deemed material. 4. Admitted. 5. Admitted in part and denied in part. It is admitted that Robert L. Kurlantzick, M.D. was at all matelial times a physician licensed to practice and practicing within the Commonwealth of Pennsylvania. The remaiuing averments of this paragraph are denied. After reasolUlble investigation, Answering Defendants are without knowledge or information sufficient to form a belief as to the truth or falsity of the remaining averments contained in this paragraph and therefore. deny same and demand strict proof thereof at time of trial. 6. Denied as stated. Based upon information and belief, it is specifically and unequivocally denied that Defendant Robert L. Kurlantzick, M.D. is an employee, agent, apparent agent, and/or servant of Carlisle Hospital. and "trict proof thereof is demanded at time of trial if deemed material. To the contrary, at all times material hereto, Defendant Robert L. Kurlantzick, M.D. was an employee of RWC. 7. Denied. It is specifically and unequivocally denied that all nurses and medical personnel who examined, evaluated and/or treated Christopher J. Gill at Carlisle Hospital were employees. agents. apparent agents, and/or servants of Carlisle Hospital, and strict prool thereof is demanded at time of trial if deemed material. By way of further answer, Plaintiffs' Complaint fails to provide the identity of nurses and medical personnel and as such, Answering Defendant 15 unable to ascertain the identities of these alleged agents, apparent agents, servants and/or employees of Defendant Carlisle Hospital. Strict proof thereof is demanded at time of trial, if relevant. 8. Denied as a conclusion of law 85 opposed to statements of fact. No response is required. In the event that a response is deemed required the averments of this paragraph are denied in accordance with Pennsylvania Rule of Civil Procedure No. 1029 (e). 9. Denied as a conclusion of law as opposed to statements of fact. No response is required. In the event that a response is deemed required the averments of this paragraph are denied in accordance with Pennsylvania Rule of Civil Procedure No. 1029 (e). 10. Denied. The averments contained in this paragraph are generally denied in accordance with Pa.R.C.P. 1029(e). Strict proof thereof is demanded at the time of the trial if deemed material. 11. Denied. TIle averments contained in this paragraph are generally denied in accordance with Pa.R.C.P. 1029(e). Strict proof thereof is demanded at the time of the trial if deemed material. 12. Denied. The averments contained in this paragraph are generally denied in accordance with Pa.R.C.P. 1029(e). Strict proof thereof is demanded at the time of the trial if deemed material. 13. Denied. The averments contained in this paragraph are generally denied in accordance with Pa.R.C.P. 1029(e). Strict proof thereof is delt.anded at the time of the tria1 if deemed material. 14. Denied. The averments contained in this paragmph are generally denied in accordance with Pa.R.C.P. 1029(e). Strict proof thereof is demanded at the time of the trial if deemed material. 15. Denied. The averments contained in this paragraph are generally denied in accordance with Pa.R.C.P. 1029(e). Strict proof thereof is demanded at the time of the trial if deemed material. 16. Denied. The averments contained in this paragraph are generally denied in accordance with Pa.R.C.P. 1029(e). Strict proof thereof is demanded at the time of the tria1 if deemed material. 17. Denied. The averments contained in this paragraph are generally denied in accordance with Pa.R.C.P. 1029(e). Strict proof thereof is demanded at the time of the trial if deemed material. 18. Denied. The averments contained in this paragraph are genllrally denied in accordance with Pa.R.C.P. 1029(e). Strict proof thereof is demanded at the time of the trial if deemed material. 19. Denied. The averments contained in this paragraph are genellllly denied in accordance with Pa.R.C.P. 1029(e). Strict proof thereof is demanded at the time of the trial if deemed mater!al. 20. Denied. The averments contained in this paragraph are generally denied in accordance with Pa.R.C.P. 1029(e). Strict proof thereof is demanded at the time of the tria1 if deemed material. 21. Denied. The averments contained in this paragraph are generally denied in accordance with Pa.R.C.P. 1029(e). Strict proof thereof is demanded at the time of the trial if deemed material. 22. Denied. The averments contained in this paragraph are generally denied in accordance with Pa.R.C.P. 1029(e). Strict proof thereof is demanded at the time of the trial if deemed material. 23. Denied. The averments contained in this paragraph are generally denied in accordance with Pa.R.C.P. 1029(e). Strict proof thereof is demanded at the time of the trial if deemed material. 24. Denied. The averments contained in this paragraph are generally denied in accordance with Pa.R.C.P. 1029(e). Strict proof thereof is demanded at the time of the trial if deemed material. 25. Denied. The averments contained in this paragraph are generally denied in accordance with Pa.R.C.P. 1029(e). Strict proof thereof is demanded at the time of the trial if deemed material. 26. Denied. The averments contained in this paragraph are generally denied in accordance with Pa.R.C.P. 1029(e). Strict proof thereof is demanded at the time of the tria1 if deemed material. 27. Denied. The averments contained in this paragraph are generally denied in accordance with Pa.R.C.P. 1029(e). Strict proof thereof is demanded at the time of the tria1 if deemed material. 28. Denied. The a"l'rments contained in thi& paragraph are generally denied in accordance with Pa.R.C.P. 1029(e). Strict proof thereof i& demanded at the time of the trial if deemed material. 29. Denied. The averments contained in this paragraph are generally denied in accordance with Pa.R.C.P. 1029(e). Strict proof thereof is demanded at the time of the trial if deemed material. 30. Denied. The averments contained in this paragraph are generally denied in . accordance with Pa.R.C.P. 1029(e). Strict proof thereof is demanded at the time of the trial if deemed material. 31. Denied. The averments contained in this paragraph are generally denied in accordance with Pa.R.C.P. 1029(e). Strict proof thereof is demanded at the time of the trial if deemed material. 32. Denied. The averments contained in this paragraph are generally denied in accordance with Pa.R.C.P. 1029(e). Strict proof thereof is demanded at the time of the trial if deemed material. 33. Denied. The averments contained in this paragraph are generally de,nied in accordance with Pa.R.C.P. 1029(e). Strict proof thereof is demanded at the time of the trial if deemed material. 34. Denied. The averments contained in this paragraph are generally denied in accordance with Pa.R.C.P. 1029(e). Strict proof thereof is demanded at the time of the trial if deemed material. 35. Denied. The averments colltained in this paragraph are generally denied in accordance with Pa.R.C.P. 1029(e). Strict proof thereof is demanded at the time of the trial if deemed material. 36. Denied. The averments contained in this paragraph are generally denied in accordance with Pa.R.C.P. 1029(e). Strict proof thereof is demanded at the time of the trial if deemed material. 37. Denied. The averments contained in this paragraph are generally denied in accordance with Pa.R.C.P. 1029(e). Strict proof thereof is demanded at the time of the trial if deemed material. 38. Admitted in part and denied in part. It is admitted that Mr. and Mrs. Gill bring this 3ction individually, and as Administrators of the Estate of Christopher J. Gill, deceased. The remaining averments contained in this paragraph are generally denied in accordance with Pa.R.C.P. 1029(e). Strict proof thereof is demanded at the time of the trial if deemed material. 39. Admitted in part and denied in part. It is admitted that Mr. and Mrs. Gill bring this action individually, and as Administrators of the Estate of Christopher J. Gill. deceased. The remaining averments contained in this paragraph are generally denied in accordance with Pa.R.C.P. 1029(e). Strict proof thereof is demanded at the time of the trial if deemed material. 40. Denied. The averments contained in this paragraph are generally denied in accordance with Pa.R.C.P. 1029(e). Strict proof thereof is demanded at the time of the trial if deemed material. 41. Admined in pan and denied in part. It is admitted that Mr. and Mrs. Gill bring this action individually. and as Administrators of the Estate of Christopher J. Gill, deceased. The (a) failing to obtain an adequate medical history: (b) failing to record an adequate medical history; (c) failing to share an adequate medical history with other medical health care providers at Carlisle Hospital: (d) failing to recognize the significance and severity of the patien~s history of being involved in a serious motor vehicle accident and being trapped in the vehicle: (e) failing to consider this history or u.,ing it to formulate an assessment, treating and treatment plan; (0 failing to recognize the potential for life-threatening injury to the patient based on the patien~s history, exam, physical complaint.' and findings; (g) failing to recognize and reaClto the patien~s abnormal and deleriorating vital signs during his hospitalization; (h) failing to alert or inform emergency room physicians, such as Dr. Kurlanuick, that the vital signs were abnormal and deteriorating: (i) failing to investigate the cause of the patien~s ahnormaland deteriorating vital signs; (j) failing to order and/or perform x-rays of the cervical spine, chest, and pelvis; (k) failing to order and/or perform blood tests and urinalysis in an effort to determine the cause of the patient's abnormal and deteriorating vital signs; (I) failing to order and administer intravenou~ fluids to stabilize the patien~s abnormal and deteriorating vital signs: (m) failing to recognize the severity of Plaintiffs i'liuries: (n) failing to call in a surgeon or other physician or medical specialist to admit the patient to the hospital for further evaluation, testing and treatment; (0) failing to provide the patient and his mother with appropriate and adequate discharge instructions; (p) failing to instruct and warn the patient and his mother about blunt trauma and provide them with a description of the signs and symptoms of occult internal injuries, and to instruct them to seek medical attention immediately if and of them develop; (q) failing to instruct the patient and his mother to see a specific physician within 24 hours for reevaluation; (r) failing to diagnose and treat the patient's internal injuries and fractures that caused his death; (s) failing to recognize the significance of the patient's inability to dress himself secondary to pain; (t) failing to recognize the significance of the patient's inability to ambulate independently secondary to pain, so much so that the patient needed to be taken to his mothers vehicle in a wheelchair; (u) failing to recognize or even consider the aforesaid evidence of pain and immobility as signs and symptoms of internal injuries and fractures; (v) failing to formulate a differential diagnosis which should have included potentially life-threatening internal injuries and fractures and to then rule in or out these potentially life-threatening conditions with appropriate examination and testing, which should have included x. rays, blood work, urinalysis, and IV therapy; and (w) failing to promulgate and implement policies, procedures and protocol for the Emergency deparlmentto insure accurate and adequate history taking, examination, treatment, monitoilng and diagnostic testing of blunt trauma patients and to insure the proper and adequate discharge instructions be given to each such patient and their family, Any allegations of agency appearing in this paragraph or its subparts are specifically denied with strict proof thereof is demanded at time of trial if deemed material. By was of further response, at all times material hereto, Answering Defendants provided full, complete, proper, reasonable and adequate medical care and treatment in accordance with the applicable standard of care. 47. Denied as a conclusion of law as opposed to statements of fact. No response is required. In the event that a response is deemed required the averments of this paragraph are denied in accordance with Pennsylvania Rule of Civil Procedure No. 1029 (e). 48. Denied as a conclusion of law as opposed to statements of fact. No response is required. In the event that a response is deemed required the averments of this paragraph are denied in accordance with Pennsylvania Rule of Civil Procedure No. 1029 (e). WHEREFORE, Answering Defendants deny that Plaintiffs are entitled to the relief claimed or any relief whatsoever and demand that judgment be entered in their favor and against the Plaintiffs and that they be awarded appropriate costs and fees. (e) failing to consider this history or using it to formulate an assessment, treating and treatment plan; (I) failing to recognize the potential for life-threatening injury to the patient based on the patient's history, exam, physical complaints and findings; (g) failing to recognize and react to the patient's abnormal and deteriorating vital sigru during his hospitalization; (h) faiiing to investigate the cause of the patient's abnormal and deteriorating vital signs; (i) failing to order and/or perform x-rays of the cervical spine, chest, and pelvis; (j) failing to order and/or perform blood tests and urinalysis in an effort to determine the cause of the patient's abnormal and deteriorating vital signs; (k) failing to order and administer intravenous fluids to stabilize the patient's abnormal and deteriorating vital signs; (I) failing to recognize the severity of Plaintiffs injuries; (m) failing to call in a surgeon or other physician or medical specialist to admit the patient to the hospital for further evaluation, testing and treatment; (n) failing to provide the patient and his mother with appropriate and adequate discharge instructions; (0) failing to instruct and warn the patient and his mother about blunt trauma and provide them with a description of the signs and symptoms of occult internal injuri", and to instruct them to seek mtdical attention immediately if and of them develop; (p) failing to instruct the patienland his mother to see a specific physician within 24 hours for reevaluation; (q) falling to diagnose and treat the patient's internal injuries and fractures that caused his death: (r) falling to recognize the significance of the patient's inability to dress himself secondary to pain: (5) failing to recognize the significance of the patient's inability to ambulate independently secondary to pain, so much 50 that the patient needed to be taken to his mother's vehicle in a wheelchair: (t) failing to recognize or even consider the aforesaid evidence of pain and immobility as SigllS and symptoms of internal injuries and fractures: and (u) failing to formulate a differential diagnosis which should have included potentially life-threatening internal injuries and fractures and to then rule in or out these potentially life-threatening conditions with appropriate examination and testing, which should have included x- rays, blood work, urinalysis, and IV therapy. By was of further response, at all times material hereto, Answering Defendants provided full, complete, proper, reasonable and adequate medical care and treatment in accordance with the applicable standard of care. 53. Denied as a conclusion of law as opposed to statements of fact. No response is required. In the event that a response is deemed required the averments of this paragraph are denied in accordance with Pennsylvania Rule of Civil Procedure No. 1029 (e). 54. Denied as a conclusion of law as opposed to statements of fact. No response is required. In the event that a response is deemed required the averments of this paragraph are denied in accordance with Pennsylvania Rule of Civil Procedure No. 1029 (e). WHEREFORE, Answering Defendants deny that Plaintiffs are entitled to the relief claimed or any relief whatsoever and demand that judgment be entered in their favor and against the Plaintiffs and that they be ItWBrded appropriate costs and fees. NEW MATrER 55. Plaintiffs have failed to state (\ claim upon which relief can be gmnted. 56. Plaintiffs' claim is barred and/or limited by the applicable Statute of Umitations. 57. It is believed, and therefore averred, that the discovery will show that the Decedent was negligent and that his negligence exceeded the negligence, if any, of the Answering Defendants, thereby barring Plaintiffs' recovery by operation of the Pennsylvania Comparative Negligence Act. 58. It is believed, and therefore averred. that discover)' will show that the Decedent was negligent and that by virtue of his negligence, Plaintiffs' claims may be limited by the operation of the Pennsylvania Comparative Negligence Act. 59. It is believed, and therefore averred, that discovery will show thatlhe Decedent voluntarily assumed a known risk thereby barring recovery by the operation of the Doctrine of Assumption of Risk. 60. Deceden~s injuries, if any, were sustained as a result of natural or unknown causes and not as thl! result of any action or inaction on behalf of the Answering Defendants. 61. At all times material hereto, Answering Defendants provided full, complete, proper, reasonable and adequat~ medical care and treatment in accordance with the applicable standard of care. 62. No conduct on the part of the Answering Defendants was a substantial factor in causing or contributing to any harm which the Decedent may have suffered. 63. If Decedent suffered any damage, the damages were caused by the conduct of others over whom the Answering Defendants had no control or right to control. 64. All claims and causes of action pleaded against the Answering Defendants are barred by Deceden~s knowing and voluntary informed consent to the care in question. 65. All physicians rendering medical care or treatment to the Decedent were independent contractors in relationship to the Answering Defendants and were not the agents, ostensible agents, servants or employees of the Answering Defendants. 66. Insofar as any agent, servant or employee of the Answering Defendants or any person for whom it is or may be vicariously liable, elected a treatment modality which is recognized as proper but may differ from another appropriate treatment modality, then said Answering Defendants raises the "two schools of thought'. defense. 67. To the extent it was required to do 50, the Answering Defendants took all reasonable and necessary steps to make a proper and appropriate diagnosis and to the extent it may be det<lrmined that that diagnosis was in error, the Answering Defendants assert that the error in diagnosis was a reasonable and legally justifiable error. 68. Answering Defendants acted reasonably, prudently, and properly at all times material hereto. .... ,.... '- f,., (....' ( "; ., """ (.~ ) ,..,. ~' f ~- .1 " ':':.' .... , C " t.... I I",.,.i;, (" .' I . ~ " " G_ L I~ , "~ , I <,' 1'._ f" ) c) C" V , , I ~ ,. -," d ~"l\:,,_\-.l~'\:_:i::-:; ,-L, i,; ,(. ,'.i.,''', '1-\' " d ., I" ,i' I" it;: _ -,;: l ".".:, ,',:- ~ I ":~'I~:'~I'; ,''I! I '.1 ;-(,/,.-'J)j-' 'I ,',: 'j,! \~~ I ,I ""1'"....11..0. 'A ~7.UO - , I " I \, " , ' ;1, ':1:1'1 . . , ,-- .,. '-'"'.' r:: ~-;; " ," (1 , o' r'" \I , " ) !..'" , '" Ii: " , , , ,,' i (l J' .::J " l (.,", CO'" " " LJ.'I ...- " . Ij L-" ~ .' ltl.. ;;" ~ l! (1 ~ :.J " <J " <.' , , , ":,' ~:;:,:i ;t:~!,i;,,:ihM!;'~ ;(j',~ .~\~ ,; 'ii,u';;; '/~)\:' :~~ \',', ','! ';:- ; ,"', ,:,;':'::: ';('; i 'i,:" "I :~i~~{tll ;7~ ,,\{fY.l'1~ ,-' :':'1/~,{{,I':('I.~W,tl; ,;!;~,/t ---~r_i>~:ri:~_ -,__,I_~" i1,:?,--, L ' :,'1 _ , J ~'" h"':I'},';;;'1 ,',I ~j~~>4n;\ 'l": t;::~:i1:W:~~:~~!~~!t~~t:l,t):I!!Y~;i'W/;:'{;',::n/,",~I,: '., " . L\W. o.tlO..' , '.', ' \..':: ",:,f,;~\j:;~ ,~i, '",' r J, ';fl\";<'fl,I.i!}I;:,I'it.,,:,:",!':r:~';<4:.'.:':;:ti~1IUY. SnDBS. SB~" & COHM,'i'''(il'i .' ,::;~!.11~}:t~:ii:i ' \iJt;\\:~,:%/;V:,'" ~ixO ..a'7. ~.7.~ Pbm~~I~ I"'~~'~/ :,;:,/~;) , '):r\~.t.:\:1i...,1q;-j'__,_-,_;{ttl'L~\HI~,.1_~~;"H,I;FF,'" , ',.1':_ ,'~ltt,;_,_:l'~. 1\....,.:. ",,(\.,"':'fl';';lf,ltt; !~i~lj:'1)',-H ;h'V,,~-..-jc ,Jj: < -, . FJ("\U"i ;:{,,~',\'t.,i':ll;' ,,:"'.-'" """'";;.:1' t't"', ''!J".';V';'''''.)''''\'.o'.; 'T,I'.. ;, ,r . .'-1 lJ~~i:.i,~:.,:;.'::;,' ',' l"'i~"""" ,_j" i._._~, ,., 1" ,; ,I-,',LI;),', :'~\;1i J! ~""\'I_' ,~!-.-,....I_"",.( .~t'" ,'1 ',~ j J",'!t-'~",,- 'r:(::,'~~:11V::: ::: '\i,\'ir":-~;~}I;,,.ill...},\ 'jil'.;,I" '- .\,~, . .,' rN~'):r;','.' \O!' J;;~l:};:,,',:i" ., '\' . ,~.v;-..' . . I " , .~- '.' "I (". \(, \,.(. .1 \ ',', c". \ ~,\ , , " , L/1 :,.1 , .- , c, i' II. l ,J.. (.., ..,':j " r- i) u t;,;:'" d, , , , " " , " I' ..... ~I (; ~.J.~ , " 61 , " r 1.I 1- , ( , -, l:~ . (I.. _I ....,1 ~: t".::) '"I " l:t t.'\J L: " ,] i ."1.. I'. (':;': " (.) ., ," V " '" 5. On or about December 10, 1997, Barley, Snyder, Senft & Cohen and Kendra D. McGuire, Esquire, entered an appearance on behalf of the Carlisle Hospital and Marshall, Smith & Haddick, P.c. and Francis E. Marshall, Jr.. Esquire, wilhdrew its appearance on behalf of the Carlisle Hospital. 6. A:l a result of the substitution of counsel for Defendant Carlisle Hospital, the depositions which were scheduled to take place on December 4, 1997, were postponed. 7. The depositions of the Plaintiffs were scheduled and accomplished on April 21, 1998. 8. Prior to the accomplishment of the depositions of the Defendanu or any fact witness other than the Plaintiffs, counsel for the Plaintiffs filed a Praecipe for Listing the Case for Trial. 9. The Plaintiffs' filing of n Praecipe to List this case for trial is premature. Discovery in this case is Car from complete. 10. The depositions of Nurse Gordon, Nurse Rush, and Nurse Swisher were accomplished on May 27, 1998. Counsel has yet to be provided with transcripts of the testimony set forth at those depositions. 11. The deposition of Defendant Kurlantzick hiSS yet to be accomplished. 12. Aher the accomplishment of Dr. Kurlantzick's deposition and all remaining (act witnesses, the parties will need to engage in an exchange of expert reports. 13. This case, as characterized by the Plaintiffs in their Praecipe to List this Case for Trial, c:oncerns allegations of medil:al negligence. ~ _1'. >- lJ': ,.. ....: iw, ~.: t ~;! ~':).,. C~C! ,:: '.2'~ ( )t;" ~L u.. ,0_; ') :,"., N .'j ..,: ttl~.: ::,~rn I i{:3:; fro I'" ~ 'r:: i;i~ L'. en a 0 t'J\ " " , " I " '> ~l" i~ ,~ .:1 t :-r. u.1 ~ I: ~ " , ~< "i (..~ (~, " ~_.1 C\ c"'l ',\ ~,: ('oj __,J l 1-- ':'1 le- c_., cLo I"~ C l' 1'" 1- ,:l C~ 07 u , , " ~ C") ?;; ~ - Q M g::s m4 :r..: C.11 . ~ ( )~;. c.. .,..:') ~' . ,.0 ';~(;j ':1,. ;>.~ " .'M~ 0- ,!.I 0_'1 ~ to 1- ~ " CO () 0:.>' ("l 'I 5. Defendant, Robert L. I<urlantzick, M,D., was at ;all material times a physician licensed to practice and practicing within the Commonwealth of Pennsylvania, specifically, in the Emergency Department of Carlisle Hospital, 6, At all material times, Robert L. I<urlantzick, M.D, acted as an employee, agent, apparent agent and/or servant of Carlisle Hospital. 7, At all material times, all nurses and medical personnel who examined, evaluated and/or treated Christopher J. Gill at Carlisle Hospital were employees, agents, apparent agents and/or servants of Carlisle Hospital. 8. At all material times, the Defendant's owed Christopher a duty to provide him with the appropriate standard of emergency room medical care which, had they done so, would have prevented his death. 9, The Plaintiffs contend that Defendants failed to provide their son with the appropriate standard of medical care, and were therefore negligent, and that this negligence directly and proximately caused their son's death, tor reasons specified herein. 10, Mr. and Mrs. Gill represent to this Honorable Court that on December 1, 1996 at approximately 2:30 a.m., their son, Christopher, was driving a friend's vehicle and was involved in a head on collision with another vehicle in Carlisle, Cumberland County, Pennsylvania. 11, The impact was on the left front and driver's door of the vehicle being driven by Christopher, 2 12, The damage to the vehicle was such that Christopher's left leg was entrapped and the door had to be "popped" to remove him from the vehicle. 13, tolr, Gill was initially unconscious. 14, Paramedics arrived at the scene at approximately 2:39 a.m. 15, The paramedics found Christopher to be awake, alert, and oriented. 16. The paramedics recorded that Christopher had no complaints, and had normal vital signs as follows: P88, R16, BP110/74. He was transported by ambulance to the Carlisle Hospital Emergency Department. 17. Christopher was admitted to the Emergency Department of Carlisle Hospital, and evaluated by a nurse at approximately 3:30 a,m. 18. The emergency room nurse, whose name appears on the chart to be w. Swisher, R,N., noted that Christopher was a driver in a motor vehicle accident who was entrapped in the vehicle and who complained of cuts on both hands. He had abnormal vital signs at this time of P104, R20, BP 118/90. He had an abrasion and a contusion of the left chest and left hip. 19. Christopher was then evaluated by Defendant Robert Kurlantzick, M.D. in the Emergency Department of Carlisle Hospital, who noted that Christopher was an unbelted driver in "head to head" motor vehicle accident, 3 20, Dr. l<urlantzick examined Christopher and documented continued abnormal vital signs of P104, R20, BP1l8/90 and noted that Christopher was alert, and would answer his questions. 21. Dr, l<urlantzick recorded a normal physical exam and specifically noted that Christopher's chest was clear, the abdomen was soft and non-tender and the pelvis was stable. 22. Dr. l<urlantz ick recorded that Christopher was observed on serial exams and that, according to Dr. l<urlantzick "there were no evolving evidence of internal injury," 23, At no time were any lab tests or x-rays performed while Christopher was admitted as a patient to the Emergency Department of Carlisle Hospital on December 1, 1996. 24, Christopher was observed for approximately five hours in the emergency department of Carlisle Hospital. 25. Defer,dant's chart reveals that a 6:20 a,m" a nurse, whose signature might possibly identify this individual as being M.E, Gorden, R.N" noted abnormal vital signs of P100, R32, BPllO/80. 26. At 7:00 a.nl., according to the Defendant's chart, another nurse, who might possibly be identified by the signature of W. Swisher, R,N., noted that Christopher had a steady gate. 27. At 8: 20 a. m., another nurse, whose signature proves impossible to decipher, noted that Christopher was dressed with the assistance of his mother and discharged home in a wheelchair at approximately 8:35 a.m. 4 28, Dr. Kurlantzick discharged Christopher to his home with the instruction to take Tylenol for aches and to return to the Emergency Department if needed. 29. Christopher J. Gill was discharged from the emergency department of Carlisle Hospital by Dr, Kurlantzick with the medical diagnosis of no significant injury found. 30. Mrs. Gill drove Christopher home, Just as when being discharged from Carlisle Hospital, he could not ambulate on his own due to left hip pain. He needed the assistance of his mother to dress while in the Emergency Department and needed a wheelchair to be discharged from Carlisle Hospital because of extreme pain with ambulation. In addition, he needed assistance from the car to his bed at home, 31. Christopher remained in his bed at home throughout the remainder of December 1, 1996 and December 2, 1996. 32. He was found to be unconscious by his mother on December 2, 1996, at approximately ,,: 00 p. m. An ambulance was called and arrived at approximately 4:20 p.m. where paramedics found Christopher to be unconscious, unresponsive, pulseless, and apneic, in a cardio-respiratory arrest. Just as the day before in the Emergency Department of Car lisle HospJ. ta I, Chr istopher was noted to have a bruised left flank, 33. Advanced life support was performed while in route to Carlisle Hospital, The ambulance arrived at Carlisle Hospital at approximately 4:40 p.m. At Carlisle Hospital, resuscitation 5 efforts continued unsuccessfully and Christopher was pronounced dead at 5:31 p.m, on December 2, 1996. 34, An autopsy performed on December 4, 1996, revealed that Christopher J, Gill died from severe internal injuries suffered in the automobile accident, including a ruptured left hemidiaphragm with herniation of stomach and omentum into the left chest, a perfo~ation of the stomach, lacerations of the spleen, severe left pelvic fractures, and a laceration of the urinary bladder. 35. Christopher's death was attributed to blunt force trauma to the torso caused in the automobile accident. The rupture of his left hemidiaphragm lead to herniation of his stomach into his left chest with eventual perforation of the stomach, consequent spillage of gastric contents into the left chest and hemorrhage. The fractures of the left pelvis resulted in a laceration of the urinary bladder, which also contributed to significant blood loss, 36. While these severe internal injuries and pelvic fractures lead to Christopher's death, none of them were diagnosed or in any way treated whi le he was a patient of Dr. Kurlantz icl< and Carlisle Hospital. 37. Mr. and Mrs. Gill believe, and therefore aver, that had Christopher's internal injuries and fractures been diagnosed and treated by Dr. Kurlantzicl< and Carlisle Hospital on December 1, 1996, their son would not have died. 38. Hr. and Mrs, Gill bring this action individually, and as Administrators of the Estate of their deceased son, Christopher J, Gill, for damages suffered by the Estate as a result of 6 Christopher's deAth, tor the p~in and suffering he endured prior to his death, tor the 10s8 of earnings and earning power tor Christopher's life eKpectnncy, and tor all other damages allowed by law and sustalned by reason of Christopher's death, as is recognized by Pennsylvanln's survival Action. )9, Mr. and Mrs, Gill further bring this claim individually, and ns the Admlnistrators of the Estate of Christopher J, Gill for his wrongtul death, on behalf of themselves individually, and all persons entltled to recover damages under and by virtue of Pennsylvania's Wrongful Death Act. In this regard, they contend that they hava suffered a pecuniary loss, and in the future will be deprived of thelr son's companionship, support, guidance, comfort, and services, as well as for all damages recoverable under and by virtue of Pennsylvanla's Wrongful Death Act. 40. As a result of Christopher'S death, Mr. and Mrs. Gill have lncurred medlcal, funeral, burial, and related expenses, and claim l. mad8 therefor, 41, Accordlngly, Plaintiffs, Gerald W. Gill and Diane Gill, lndlvldually, ~nd as Administrators of the Estate of Christopher J. Olll, br.ing this suit against Defendants, Carlisle Hospital and Robert I,. Kurlantzick, M.D., under Pennsylvania'S Wrongful Death and Survival Act, for all damages cognizable under each claim, and clalm is made therefor, 7 COUNT I Gerald W. Gill and Diane Gill. Individual1v and as Administrators of the Estate of Christopher J, Gill. Deceased vs. Carlisle Hospital 42. Paragraphs one through forty-one of this Complaint are incorporated herein by reference as if set forth at length. 43. At all material times, Mr, and Mrs. Gill and Christopher J, Gill reasonably relied upon the apparent expertise, apparent competence, diagnosis, conclusions, and authority of those nurses and doctors, agents, apparent agents / servants, and/ or employees of Defendant Carlisle hospital, 44, At all material times, the nurses, doctors, and medical personnel in the Emergency Department of Carlisle Hospital acted as Carlisle Haspi tal's employees / agents, apparent agents, and/or servants and owed a duty to their patients to provide adequate, appropriate medical care. 45, At all material times, Carlisle Hospital had the right and duty to exercise control, authority, and supervision over its agents, apparent agents, servants and/or employees and owed a duty to its patients to provide adequate, appropriate medical care. 46, Defendant, Carlisle Hospital, acting through its agents, apparent agents, servants, and/or employees, including those doctors, nurses, and medical personnel that examined and assessed Christopher J. Gill, provided inadequate medical care, medical care that fell below the appropriate standard of medical care, and were therefore negligent with respect to the care provided to Christopher J. Gillon December 1, 1996 for the following reasons: 8 (a) tailing to obtain an adequate medical history; (b) failing to record an adequate medical history; (e) failing to share an adequate medical history with other medical health care providers at Carlisle Hospital; (d) fail ing to recogn ize the sign i f icance and severity of the patient's history of being involved in a serious motor vehicle accident and being trapped in the vehicle; (e) failing to consider this history or using it to formulate an assessment, testing, and treatment plan; (f) failing to recognize the potential for lite-threatening injury to the patient based on the patient's history, exam, physical complaints and findings; (g) failing to recognize and react to the patient's abnormal and deteriorating vital signs during his hospitalization; (h) failing to alert or inform emergency room physicians, such as Dr. Kurlantzick, that the vital signs were abnormal and deteriorating; (i) failing to investigate the cause of the patient's abnormal and deteriorating vita 1 signs; (j) failing to perform x-rays of the cervical spine, chest, and pelvis; (k) failing to order and perform blood tests and urinalysis in an effort to determine the cause of the patient's abnormal and deteriorating vital signs; 9 (1) failing to order and administer intravenous fluids to stabilize the patient's abnormal and deteriorating vital signs; (m) failing to recognize the severity of Plaintiff's injuries; (n) failing to call in a surgeon or other physician or medical specialist to admit the patient to the hospital for fur.ther evaluation, testing and treatment; (0) failing to provide the patient and his mother with appropriate and adequate discharge instructions; (p) failing to instruct and warn the patient and his mother about blunt trauma and provide them with a description of the signs and symptoms of occult internal injuries, and to instruct them to seek medical attention immediately if any of them develop; (q) failing to instruct the patient and his mother to see a specific physician within 24 hours for reevaluation; (r) failing to diagnose and treat the patient's internal injuries and fractures that caused his death; (s) failing to recognize the significance of the patient's inability to dress himself secondary to pain; (t) failing to recognize the significance of the patient's inabili,ty to ambulate independently secondary to pain, so much so that the patient needed to be taken to his mother's vehicle in a wheelchair; 10 (u) failing to recognize or even consider the aforesaid evidence of pain and immobil i ty as signs and symptoms of internal injuries and fractures; (v) failing to formulate a differential diagnosis which should have included potentially life-threatening internal injuries and fractures and to then rule in or out these potentially life-threatening conditions with appropriate examination and testing, which should have included x-rays, blood work, urinalysis, and I.V. therapy. (w) failing to promul~ate and implement policies, procedures and protocol for the Emergency Department to insure accurate and adequate history taking, examination, treatment, monitoring and diagnostic testing of blunt trauma patients and to insure the proper and adequate d~scharge instructions be given to each such patient and their family. 47, As a direct and proximate result of Defendant's negligence, through its agents, apparent agents, servants, and/or employees, as alleged herein and incorporated herein by reference as if set forth at length, Christopher J. Gill died. His death could have been prevented and would not have occurred but for Defendant's negligence, 48, As a direct and proximate result of Defendant's negligence, Plaintiffs have sustained injuries and damages as set forth above and as is recognized under Pennsylvania's Wron9ful Death and Survival Acts, which are incorporated herein by reterence as if set forth at length, 11 WHEREFORE, Plaintiffs, Gerald W. Gill and Diane Gill, individually and as Administrators of the Estate of Christopher J. Gill, deceased, demands judgment against Defendant Carlisle Hospi tal, for compensatory damages in an amount in excess of Twenty-five Thousand ($25,000) Dollars, exclusive of interests and costs and in excess of any jurisdictional amount requiring compulsory arbitration. COUNT II Gerald W. Gill and Diane Gill. Individuallv and as Administrators Qf the Estate of ChristoDher J, Gill. Deceased vs, Robert L, Kurlantzick. M,D, 49. Paragraphs one through forty-eight and Count I of this Complaint are incorporated herein by reference as if set forth at length, 50. At all material times, Mr, and Mrs. Gill and Christopher J. Gi 11 reasonably relied upon the apparent expertise, apparent competence, diagnosis, conclusions, and authority of Dr. KurJ.antzick, 51. At all material times, Dr, Kurlantzick owed a duty to his patient, Chr istopher J. Gi 11 , to provide adequate, appropr iate medical care. 52, Defend3nt, Robert L. Kurlantzick, M.D., is liable to Plaintiffs for injuries and damages alleged herein which were directly and proximately caused by the breach of his duty to provide Christopher J, Gill the appropriate standard of medical care (negligence) for the fOllowing reasons: 12 (a) failing to obtain an adequate medical history; (b) failing to record an adequate medical history; (c) failing to share an adequate medical history with other medical health care providers at Carlisle Hospital; (d) failing to recognize the significance and severity of the patient's history of being involved in a serious motor vehicle accident and being trapped in the vehicle; (e) failing to consider this history or using it to formulate an assessment, testing, and treatment plan; (f) failing to recognize the potential for life-threatening injury to the patient based on the patient's history, exam, physical complaints and findings; (g) failing to recognize and react to the patient's abnormal and deteriorating vital signs during his hospitalization; (h) failing to investigate the cause of the patient's abnormal and deteriorating vital signs; (i) failing to order and/or perform x-rays of the cervical spine, chest, and pelvis; (j) failing to order and/or perform blood tests and urinalysis in an effort to determine the cause of the patient's abnormal and deteriorating vital signs; (k) failing to order and administer intravenous fluids to stabilize the patient's abnormal and deteriorating vital signs; 13 (1) failing to recognize the severity of Plaintiff's injuries; (m) failing to call in a surgeon or other physician or medical specialist to admit the patient to the hospital for further evaluation, testing and treatment; (n) failing to provide the patient and his mother with appropriate and adequate discharge instructions; (0) failing to instruct and warn the patient and his mother about blunt trauma and provide them with a description of the signs and symptoms of occult internal injuries, and to instruct them to seek medical attention immedlately if any of them develop; (p) failing to instruct the patient and his mother to see a specific physician within 24 hours for reevaluation; (q) failing to diagnose and treat the patient's internal injuries and fractures that caused his death; (r) failing to recognize the significance of the patient's inability to dress himself secondary to pain; (s) failing to recognize the significance of the patient's inability to ambulate independently secondary to pain, so much so that the patient needed to be taken to his mother's vehicle in a wheelchair; (t) failing to recognize or even consider the aforesaid evidence of pain and immobility as signs and symptoms of internal injuries and fractures; and 14 (u) failing to formulate a differential diagnosis which should have included potentially life-threatening internal injuries and fractures and to then rule in or out these potentially life-threatening conditions with appropriate examination and testing, which should have included x-rays, blood work, urinalysis, and I,V, therapy. 53. As a direct and proximate result of Defendant's negligence, as alleged herein, Christopher J. Gill died. His death could have been prevented and would not have occurred but for Defendant's negligence. 54, As a direct and proximate result of Defendant's negligence, Plaintiffs have sustained injuries and damages as set forth above and as is recognized under Pennsylvania's Wrongful Death and Survival Acts, which are incorporated herein by reference as if set forth at length. WHEREFORE, Plaintiffs, Gerald W. Gill and Diane Gill, individually and as Administrators of the Estate of Christopher J, Gill, deceased, demand judgment against Defendant Robert L, Kurlantzick, M.D" for compensatory damages in an amount in excess 15 I I v)~ I' V ~':: r'::) t: ;. c II Ie, (,; , " , I l~ , I , , ." ( '..0 r' c' '.n L " 1 ; .-' 1:1.._ . (;, ll.1 ' 'j !oJ' ; :)~ I, c) r- .J ~l' '.J ~ .~- ... .~ ~ ~e~ N ~~(1 J:0 ~ ~ -...s ~ ""i ... " " , -, 'i/ ".; .:' GERALD W. GILL AND DIANE GILL, INDIVIDUALLY AND AS ADMINISTRATORS OF CHRISTOPHER J. GILL, DECEASED, Plaintiffs 7 IN THE COURT OF CQMMON PLEAS 0' CUMBERLAND COUNTY, PENNSYLVANIA V, CARLISLE HOSPITAL AND ROBERT L, KURLANTZICK, M.D.,: CIVIL ACTION - LAW Defendants NO. 97-4817 CIVIL TERM IN RE: PRETRIAL CONFERENCE A pretrial conference was held Wednesday, August 26, 1998, before the Honorable Edward E. Guido, Judge. Present for the Plaintiffs was MiGhael J, Navitsky, Esquire; present for Defendant Robert L, Kurlantzick, M,D., was Sarah Arosell, Esquire; and present for Defendant Carlisle Hospital was Kendra 0, McGuire, Esquire, Although settlement is close, it may very well proceed to trial. This is a medical malpractice case that will take all week to try, Because of my prior familiarity with the Plaintiffs, I do not feel comfortable trying this case; therefore, it should be assigned to another judge. All motions in limine shall be filed by Tuesday, September 8th, 1998, and responses thereto by Friday, September 11, 1998, Any pretrial briefs the parties wish to submit shall be filed by Friday, September 11, 1998. All proposed points for charge shall be filed at the commencement of trial, Plaintiff indicates that he has a motion in limine to " '. r:J (' ...~, , , I :~, "r , " ~" , t./_ " I. j'.... , (-: I , (' ,'I] " I,L .. , , I ,:). I "'-I.. I , ,-,',' .') 1...J (,;' (,j , , , , " '! GERALD W, GILL AND DIANE GILL, INDIVIDUALLY AND AS ADMINISTRATORS OF CHRISTOPHER J. GILL, DECEASED, Plaintiffs 21 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA V, CARLISLE HOSPITAL AND ROBERT L, KURLANTZICK, M,O., Defendants NO, 97-4817 CIVIL TERM IN RE: PRETRIAL CONFERENCE A pretrial conference was held Wednesday, June 17, 1998, before the Honorable Edward E, Guido, Judge, Present for the Plaintiffs was Michael J. Navitsky, Esquire, present for Defendant Rob9rt L, Kurlantzick, M.D. was Franois E. Marshall, Jr., Esquire, and present for Defendant Carlisle Hospital was Kendra 0, McGuire, Esquire. It appears that discovery has not yet been completed, Therefore, this case is continued to the September term of court, There is no need for counsel to relist this case for the September term, The Court Administrator is directed to do so. All discovery depositions and any other discovery except for the exchange of expert reports shall be completed by July 27, 1998. All expert reports shall be supplied to opposing counsel by August 18, 1998. Any supplemental reports in response to expert reports supplied by opposing counsel shall be produced and supplied by August 26th, 1998. Although I have pretried this case, because of my long time familiarity with Trooper and Mrs. Gill, I do not feel comfortable trying the case. Therefore, it should be assigned to another judge. /' , , .,.. I'~ (of. tJ: ~" ~-:; .:~ L1J~~ (., ", -'.,~ I ti:: I'''' " " ':j , ' <ji ~. ,.j f'!;.l , , L...J' - l~,. Lu I , ~...I t, g,"l !r.\ u. . , (, '" 'd. .' p, tr: "::.j U '" U , , I, !\ I , I " .... C) ~ {r, e-- r. HI i <, i' -., t f..,: , ('.j " ~ - I I ~, J U:I; I ~- .., lJ.. t' I '-J <- ,-) 'I 1" c! ':'>-':~i' "i -", '':1 .j,~, ,\. ~ 'I'. , " . , , ,',r. ' "';i ~,~,\,,:p.I~"I';I' \'11\1.1,,,, 'l'I" , /1, _"~;.;' j~'w(,I~~'i! "j.i ;~,j." ,j " I . (! ,,';:f, ":' ", "", , ,~,l'r~1-~'ml\;'1 \~" ~t~ !' ;\:, I ,';<: 1 ,I ( "":wO,;",l~ '/, i,")_', t , '''Jf~l.j'' l,.,<lf< !,". -t ~"" ".. "".., ,:1_1_ ,",;' , 1,,0j:~,!,I~~~~iY. S:~~J)..; S.N~ &COHBN. ~l;:P, 1r;..i~fA,"" '..'&nI9t....~.ftlll. ......~Ta.V~Jt"'I?..... ""', ,,".".' ' '-'" I"~, :'-'\11,1 q'., , . ') ,",,";" ,,(',:'1'(, "" ,,' n' i <,' {f ~ '1 ,/'U"',', .',' '~,f\i~'f:,",:u:r; 1.':1 l!/ ,,!!u.1i'l '''P'~'I'II''li -"~'t'o "'f'.,d ", r " J'r~fJ;, :1/W:h':l\l:),\:';)\'{;\~::'X\;':",:-t'\~,t~~! \1,,; II L'_ :(~t".J ,;:~,(~'j;i: ;;""'l~"~'\-\!;!': i", ;'-;-'rj -f'tH':;' ','"i:r'il:Y iT1,"-';,'.t1ii:!,':'" ;""{':i::\:~':\i.(I!\',;~i'.;;V I,' ":~' .-cJIf.:::, ;~~:S!;;;-I,}.r;'t~:)~ 'j .'-"...." 'ur\l\ "_"<""'-,)r'~~'J ,"'ij';,~,,:, . ';"-'1 b" 1~j.'J"',I-'-'i,."ql'~ 'I ... ",I' ,..-:I':-'-'j-"",.'I_il'I""'!I',1"\ "':""i_L, ." ~'(:}~;'I~i:~Xl~~~ii'i~~:(i~: :<;{: ; ~~'~:j,'[.~:#~~'Hl'';-\'NPi;:ff':;j;:l:1.~ r';(i' }, ',>' f") . . , , 1, , ...,..'- ,.. ;' RAE!PLDG!381087.1/061698 required to file a pre-trial statement on or before May 7, 1998. 6. The case was improperly listed for trial in contravention of Local Rule 213-2. All pretrial action has not been taken, and the case is not ready for trial in all respects. 7. Plaintiffs are still in the process of serving expert reports. Nearly one month at~ certifying this matter for trial, ~ the Call of the Civil Trial List, Plaintiffs served their first expert report. 8. Plaintiffs' first liability expert report was served upon Defendants on June 9, 1998. Plaintiff's second liability expert report was served upon Defendants on June 12, 1998. 9. Thirty days is insufficient time in which to obtain rebuttal reports. 10. Defendant Carlisle Hospital retain experts, obtain their reports and must serve expert reports upon Plaintiffs. The Hospital is in the process of retaining experts and obtaining their reports. This process will not be complete by July 7, 1998. 11. Plaintiffs have not yet responded completely to expert Interrogatories. Plaintiffs' counsel has not served a curriculum vitae for either of the experts Plaintiffs identified in their Answers to Defendant Carlisle Hospital's Interrogatories. Without an understanding of the qualifications of all of the experts to be utilized by Plaintiffs, Defendant Carlisle Hospital 2 RAE/PLDG/381087.1/061698 is unable to determine exactly which experts it should retain in order to rebut the opinions of Plaintiffs' experts. 12. Defendant Carlisle Hospital has not yet had an opportunity to explore discovery and to take all depositions necessary to prepare this matter for trial. 13. Defendant Carlisle Hospital is prejudiced by Plaintiffs' actions. 14. Proceeding to trial in July, 1998, under the facts and circumstances provided herein, results in irreparable harm and prejudice to Defendant Carlisle Hospital. WHEREFORE, Defendant Carlisle Hospital respectfully requests that the Court strike this matter from the Civil Trial List and direct that the case shall not be listed for trial until discovery is complete. Date, ;.It-i'';.fl I f BARLEY'~N~DER: l'~ &. ~OHEN' LLC BY::;;;Wj-1~i~ .. - Kendra D. McGuire, Esquire Rebert A. Evarts, Esquire Attorneys for Defendant CarliFle Hospital 126 East King Street Lancaster, PA 17602.~&93 (717) 299-5201 Court I.D. No. 50919 Court I.D. No. 75767 3 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY GILL Vs. CARLISLE HOSP NO. 974817 CERTIFICATE PREREQUISITE TO SERVICE OF A SUBPOENA PURSUANT TO RULE 4009.22 As a prerequisite to service of a subpoena(s) for documents and things pursuant to Rule 4009.22 FRANCIS S MARSHALL, ESQUIRE certifies that: 1. A Notice of Intent to Serve the Subpoena (s) with a copy of the subpoena (s) attached thereto was mailed or del:lvered to each party at least twenty days prior to the date on which the subpoena(s) is sought to be served, 2. A copy of t.he Notice of Intent, including the proposed subpoena(s) is attached to this certificate, 3. No objection to the subpoena(s) has been received, and 4. The subpoena(s) which will be served is identical to the subpoena(s) which is attached to the Notice of Intent to Serve the Subpoena(s). Date: 10/23/97 File .: M233111-01 FRANCIS E MARSHALL, ESQUIRE 20 S 36TH ST CAMP HILL, PA 17011 717-731-4800 ATTORNEY FOR DEFENDANT INQUIRIIS SHOULD SI ADORBSSIO TOI MEDICAL LEGAL REPRODUCTIONS, INC. 4940 DISSTON STREET PHILADELPHIA PA 19135 (215) 335-3590 By: Heide Collin. i, ,>. ,t) -- "1, ~" ,.. -.-.. I .. ~i jj , : IJI. . .- ~l . >.: ),:'~ ('1 I 1'-1 ~,: " J I" l('1 '" C:'I., '" .'1:') L;jt; I,.. t&.!1 :~ ' 'J r, 0 "j~ :.-:.: ". ", ,... i] U 01 .. have been further investigated. These vital signs, which wer.e the only other vital signs taken during the hospital stay, clearly revealed evidence of evolving internal injuries. The nurse did not tell the doctor and the doctor did not review the chart before dictating his discharge note at 6:59 a.m. Christopher could not dress himself nor walk, so he was wheeled out of the Emergency Department in a wheelchair to his mother's vehicle. He died the next day, according to the autopsy report, from severe internal injuries sustained in the automobile acci.dent. He had a crushed pelvis, a ruptured diaphragm, lacerated spleen and bladder, and various internal injuries that all conspired to lead to his death. Unfortunately, none of these severe internal injuries were diagnosed while in the Emergency Department at Carlisle Hospital. Up until August 21, 1998, neither Defendant offered any excuse or explanation for their failure to appropriately take vital signs, record them, report them, and act upon them during the five hour Emergency Department admission. On August 21, 1998, Carlisle Hospital submitted a nursing report by Nurse Sam Miranda. On August 24, 1998, an expert report was submitted on behalf of Dr. Kurlantzick. Both reports are attached to this Motion in Limine. The Plaintiffs respectfully remind the Court that the issue of medical malpractice in this case centers solely on the Defendants' failure to diagnose and treat Christopher's internal injuries suffered in the automobile accident. Neither the report of Nurse Miranda nor Dr. Rudnick address these issues. Rather, both reports 2 serve only to raise irrelevant, undlJly prejudicial, and inadmissible issues which have not existed in this case until now. Plaintiffs respectfully submit that the defense expert reports serve the sole purpose of raising three improper issues: (1) The relevance of alcohol; (2) Speculation as to the cause of decedent's injuries; and (3) Contributory negligence of Mr. and Mrs. Gill. Plaintiffs object to any evidence or even inference of any of these issues at trial. (1) Alcohol consumption is irrelevant. The decedent admitted to drinking alcohol prior to the automc.bi le ace ident. However, a 11 three Emergency Department nunes testif ied that he was quiet, cooperative, and understood them. Dr. Kurlantzick testified that the decedent was not clinically intoxicated. Dr. Kurlantzick testified that the decedent's consumption of alcohol in no way impaired his ability to diagnose and treat him. There is no evidence -- none -- that Christopher Gill was an alcoholic. Defendants' sole purpose in submitting the reports of Nurse Miranda and Dr. Rudnick is to unduly and cruelly prejudice Mr. and Mrs. Gill by attempting to tell the jury that the decedent was a drunk driver. This fact, true or not, is irrelevant and inadmissible in a medical malpractice case. Richardson v. LaBUz, 474 A.2d 1181, 1183 (Pa. Cmwlth. 1984). The Ri9.lli\rdson case clearly holds that any antecedent negligence on behalf of the decedent is irrelevant in a medical malpractice case. Therefore, any evidence of the decedent's consumption of alcohol in this case 3 would be inappropriate and unduly prejudicial, as it did not affect the medical health care providers' ability to diagnose or treat him. He was in fact, not clinically intoxicated. Dr. Rudnick speculates that the decedent was an alcoholic. There is absolutely no evidence whatsoever to substantiate this bizarre and bold accusation. It is especially inappropriate in this case, where the Defendant doctor and all three nurses confirmed that the decedent's alcohol consumption in no way affected their inability to diagnose and treat his condition. In Pennsylvania, when a medical expert testifies, he must do so on the basis of admissible evidence. The expert must specify that his opinions are based upon personal observation, study, or knowledge or, in the alternative, counsel must delineate the exact factual predicate from which the experts' opinions are to be derived. ~ak v. Struth, 515 Pa. 554, 531 A.2d 420 (1987). For this expert to speculate about alcoholism would mandate a mistrial, as the defense knows there is no evidence, none whatsoever, to support such a claim. Accordingly, Plaintiffs ther.efore respectfully request the Court to instruct Defendants to make no inference or suggestion of alcohol consumption in this case. (2) Speculation as to the cause of dec.dent's injuries. Christopher Gill died of severe internal injuries caused in an automobile accident which went undiagnosed during the five hour admission to the Carlisle Hospital Emergency Department. This is confirmed in the autopsy report and in the report of the coroner. 4 The defense expert, Dr. Rudnick, questions in his report whether the decedent may have fallen down the steps at his home. There is absolutely no evidence whatsoever to support this wild speculation. The defense knows this and Plaintiffs request that the Court instruct the Defendants not to allow either expert to engage in such speculation without any factual support whatsoever. Kozak v. Struth, 515 Pa. 554, 531 A.2d 420 (1987) and Daubert v. l'Ierrell llilli, 509 U.S. 579, 125 L.Ed.2d 469, 113 S. ct. 2786 (1993). (3) contributory n.gligence. There has been no claim that either Mr. or Mrs. Gill were negligent in some fashion in causing or contributing to the cause o( their son's death. Nevertheless, both defense experts opine that Mrs. Gill was negligent in failing to diagnose the evolving evidence of internal injuries suffered by her son, Mrs. Gill is a real estate appraiser. She has no medical training. More than that, this claim of contributory negligence, which had not been raised by the Defendants, but only most recently by their experts, is legally improper and inadmissible. Ini tially, a mother's negligence cannot be imputed to her child and a mother cannot be contributorily negligent absent a "defendant status." Shafer v. Soencer Hosoital, 10 D. & C. 4th 276 (1991). Furthermore. in a wrongful death case, neither the child nor parents can be held contributorily negligent even it the parents fail to call the physician if the child's condition becomes worse. Clark v. Hoerner, 525 A.2d 337 (pa. Super. 1987). Finally, when a patient is discharged from a hospital, as occurred in this case, the 5 Gerald W, Gill and Diane Gill, AdDllalJtnllon of the E.tate of Chri.topher J. GIU vs. Carlille Hospital CHnit":t1 ~umm.3ry Mr. Christopher Gill at time of said event was a twenty year old college student who was admitted to the Emergency Departmenl of Carlisle HospitAl in Carlisle, Pennsylvania on December I, 1996 at 03:50 hours (3:50 A,M,). A PoIiu Accid,,,t Rtport lists thattbe accident occurred at approximately 02:28 hours (2-28 AM,) of thaI dale. He was driving the car unrestrained and was involved in a head on collision with another vehicle, One witness Illlhe scene provided the police wilh a stalementthat both kids in the white car (Gill) were unconscious, The par.medic who responded 10 Ihe scene advised the police that bolh Iuds were oul of it, however the male accompanying Christopher, (Justin) appropriately gave his narne, lhe medical record includes a P.nn\)'lvnni~ F.MS R.pqrt created by the paramedics who inilially assessed Chri$lopher Gill at the scene Christopher advised the paramedic lhat he was an unbelted driver and was struck on the driver's side front wheel He denied being entrapped. It is lisled Ihatthe sleering wheel and dash were intac!. Christopher was without complaints however admitted to drinking alcohol that evenin!! He delued any loss of consciousness, chest pain, shortness of breath, nausea, vomiting, dizzmess, abdominal pain or headache An assessment was completed which revealed him to be awake, alert and oriented X4 (in all spheroes). His skin was pink, warm and dry. There was no evidence ofoextemal trauma aboullhe palient. There wu no pain on chest palpation. His abdomen was soft, non-tender with no masses, His extremities were wilh good color. mOlion, sensation, pulses and temperature. He had minor cuts to both hands with no bleeding, He was released to a Basic Life Support Ambulance CBLS) and was trlllsponed to Carlisle Hospital with an eSlimated time of arrival of ten minutes, The history recorded by the BUlc Life Support Unit (BlS) members of the Carlisle Community Ambulance noted that while .nroute to Ihe hospital, they were advised by the Fire Department Ihlt entrapmenl occurred, There is a variation in the documentation relativ. 10 the circumstances surrounding the mode of pllienl removal from the automobile The BLS crew also dotumented the presente of alcohol and that his skin wu warm, pink and dry, It is also documenled Ihat his abdomen was soft and non-tender, hislunllS were clear bilaterally and hi, pupils were equal, No deformities were noted and he was transported without event to Carlisle Hospital The mcclita! record reflecu I registrltion lime of 03: 30 hours (3 30 A. M) on December I. 1996. A nursinl assessment was initiated on arrival, The patient was further assessed by the Emerpncy Department Physician, Robert L Kurlanuick, M D Or. Kurlantzick in his history noted Ihal Mr, 0111 was In unbelted driver in a mOlor vehicle accident, It was a head to head injury The history reflecu thai he wu Ihrown about in Ih. OillVl, Carlisle Hospital Page 2 vehicle bUI was nOI ejected, He offered nn 'p...,lfir r"mplnh'h and although alert wu evasive about his history. II was the physicil.n's assessmmtthat Mr Gill denied beins in I car accident seemingly to avoid blame. Mr, Gill did not reveal his degree of alcohol consumption, The physical exwnation performed by Dr, Kurlanrzick confirmed the findings of the Emergency TCl:hnician Staff of the Basic Life SuppOrt Unit as weU as the Paramedic Slalfofthe Advanced Life Support Unit Mr, Gill was alert and had a clear chest His abdomen was 50ft and non-tender, He had good mOlion to all of his elCtremities. Mary Gorden, RN nores in her narralive that Mr, Gill denied beins the driver, She noted that he moved conlinuaUy about the backboard and wu moving his neck about She encouraged him 10 remain immobile however he failed 10 cooperale. He continued to move his extremilies well, Tracy Rush, R.N. wl1med the care ofMr, Gill at 07:00 hours (7:00 A,M.), She nOled a steady gait which confirmed his ability 10 ambulate He remained under observalion until approximately 08:20 hours (8:20 AM.) at which time his mother accompanied him upon discharge, The medical record reflect5 thaI Wrillen Instructions were given, Christopher denied having any questions and was discharged in lhe care ofhis mother. Approximalely 32 hours later on December 2, 1996, Mr, Gill was found unconscious by his mother. Mrs Gill advised Ihe Puamedic staff thaI she saw hcr son thirty minutes prior to th. event and describes Christopher as being awake but somewhal slow 10 respond to her al that time, She summoned the ambulance and initiated CPR efrorts after CPR instruclions were given to her by lelephone Mr, Gill wa~ relumed to Carlisle Hospital where he was pronounced dead at 17:4] hours (5'41 PM.) by Dr, Gerald Fronko An autopsy was ordered and compleled on 12/4/96 which revealed the cause of dealh to be Blunt Force Trauma to Torso, Discult~ion In reviewinlllhe conSliluen15 of lhe medical record of Christopher J Gill and related doc;uments including the plaintifl's phYSician and nursing expert repom. it is evidenllhat Ihe prinwy concern discussed center around Ihe appropnateness of Ihe care which was delivered It Carlisle Hospi"l. I will address lhose issues listed in the complaint as it relates to the nursing care and wID UIU those elemenu as Ihe conceptual rrlmework 10 evaluale those issues (a) railinllo obtain an adequate medical history (b) ramnlto record an adequate medicol hislory (c) 'allinlto ,har, lIn adequate medical hiSlory witb olller IDtelleal "ealtb ..... pro~lden al Carlisle Hospitlll Gill vs, Carlisle Hospital Plse 3 A review of multiple records including hospital and police records clearly reveal that Mr, Gill wu not truthful in delivering the account of the accident He would not admit to the investigating officer that he was in an accident. He then Stated he was not hurt however submined to I blood alcohol level, During his second Interview by the same officer, ~. Gill said that he did not know who wu driving and he did not know what kind of car he was in, His blood alcohol wu detennined 10 be 0,21 %. Mr, Gill advised Jeff Horgan, EMT -P that he wu an unbelted dlivCf and was struck on the driver's side, front wheel, He offered no complaints however admitted to drinking alcohol, He denied loss of consciousness and had no e)(temaJ traurna other than minor cuts to both hands. The narrative C1'~ated by the BLS staff notes that Mr, Gill advised them that he was not in a MV A (motor vehicle accident) The BLS staff advised him of tile event prior to transport, Mr, Gill denied any diiCOmfort to that staff howl\ver provided a varied version to that of the paramedic crew. The history given to the Emergency Department physician is recorded as Mr. Gill subjectively offered no specific complaints He denied bemg in a car accident. He did not present with any complaints to the physician, He advised the nursing staff within his limned conversation that he was neither the dr passenger Consistency is noted in that Christopher was aim and oriented however was defensi One cannot obtain, record, and share information when clear, concise information is the caregivers, One cannot be critical of the healthcate providers obtaining an a.ssea infonnation is not accurately relayed (d) raillnl to recognize the sigllificance and severity of the patleDt's beine involved In a serious motor vehicle accident and beine tnn vehicle (e) famne to consider Ihe histolr}' ~'r usill\: illo forrnulate In a.ue.ument, tarlal and trutment plan There is a conflict in the pre-hospital records relative to entrapment The paramedic unit (ALS), educated to perfoml at a higher level of assessment and functionmg than a Buic Life Support Unit (BLS) notes no emrapment The BLS ufllt documented history of entrapment as provided by Ihe Fire Department Mr Gill dId nor relate to the Emergency Department staff thai he was entrapped He told the physiCian lhat he wa.s thrown about but not ejected There was no failure on the pan ofth~ nursin\! staff to recognize the significance and ,everily haled on the information which the patient prOVIded to the healthcare prOVIders Furthermore. it il n'JI within the scope of nursing licensure In the Commonweahh of Pc:nnsyl'Mlia to formulate a testlOg/treatment plan amvs, Carlisle Hospital Pase 4 (I) railinl to l'Koloize tbe potential ror Ure-threateninlllojury to the patient based 00 tbe patient's history, flam, physical complalnts aDd findiols One CAnnot recognize the pOlential for life threatening injuric::; when the patient offered no complaints to any of the health care providcrs from hi$ pre-hospital clle to his in-hOIPltil care, His history was consinently vague and he offered no complaints He did not participate as a cooperative individual within his care as he refused to remam on the backboud, He limited the delivery of infonnation during the attempt of lhe statT to gather a detailed history. (g) flailing to recognize and react to the p~titnt5 abnormal nnd delanoratinl vital siens during his hospitalization (h) failine to alert or inform emergency room physicians, such as Dr. Kurlantzick that the "ltal signs were abnormal and detarioratine (i) failing to in"utillale the cause of the patient's abnormal and deteriorating vital signs There is no evidence of deteriorating vital signs within Mr Gill's stay al the hospital, His blood pressure remained stable and his heart rate remained in a low leveltachycardic rale. An increase of respirations OCCUlTed however it was not accompanied by respiratory dinreu, Several factors are associated with vital sign changes however a blood pressure of 110/80, pulse rate of 100, and a respiratory rale of 32 are nOI indicatIve of a "deteriorating" viral sign. (j) failing 10 perform loreys or the cervical spine. chest and pelvis (k) ralline to order and perform blood tuts and urinalysis in an effort lu determine tbe cause of the patienl's abnormal and deteriorating "Ital,illn, II is not within the Scope of Nursing PraCllce for a staff nurse in lhe Commonwealth of Penn~'lvania to order x-rays or laboratory studies (I) r,mnl to order and administer intravenous fluids to stabilize tbe patient', abnormal alld deteriorating vitalsilRJ It is not within the Scope of Nursing Practice for a staff nurse in the Commonwealth of PeMsyl.ania 10 order intr..cnous fluids The admil\lllrallOn ofintravenou, fluids is pennitt.d under the direction of an appropriately licensed physician who by law is permitted 10 order plITenteraltherapy Mr GiU did.JuU demonstrate any components of a nursing asseS$ment wllere Ruid resuscitative mC8Sures were nece.uary as It relates 10 his vital si8Jl.'l Fluid replacemenl is indicated in hypotemion and continu..! progressi.e tachycardias which were not appli~ble in his situation Oillva, Carlisle Hospital Palle S (m) failing to RCo&nlze tbe severity of Plaintiff's injuries The first step of the nursing process which is the scientific basis for planning patient cue is the assessment component This component rehes pnmarily on the patient's subjective statements followed by the caregiver's observations. Mr. Gill conSIStently advised his caregiver5that h(l had no complainu The onsessment components made pre-hospiul rermined unchanged during his hospitalization up to imd including the time of discharge (n) falling to call in a surgeon or other physician or mediul specialist to admit the plltient to the hospital for further eV:lluadon. tuting and treatment It is not within the Scope of Nursing Practice within the Corrunonwulth of Pennsylvania to call in a surgeon or other physician once care is assigned to a physician (0) falling to provide the patient and his mother with appropriate and adequate discharge instructions (p) failing to instruct and warn tbe patient and his mother about blunt trauma and provide them with a description of the signs and symptoms of occult internal injuries. and to instruct them to seek medical attention immediately if any of tbem develop (q) failinc to Instruct Ibe pa.ient and his mol her to see a specific physician within 24 hoon for reevaluation Mr Gill was provided WIth written instmctions on discharge, The Evaluation and Discharge Enlry reveals that he denied any questioll5 He was provided with the hospital's G,",raJ Instructions upon discharae. Mrs Gill validates in her deposition of April:.!], 1998 on pago 32 thai Discharge Instructions were gIven She recalls a nurse educating them to call if his stomach hurt, She also recalls receiving oS "pink slip" that said gIVe Tylenol She further notes in her deposition that his only complaint on her visits was sore hips I11d thighs She left for Bloomsburg upon returning home from the hospilal and did not return until apprmomately 400 P,M Christopher was left alone during this time period as his father won working She noted on her relum that she did nOI see urine in the buckel she brollght to his bedside, Her deposition (pagl! 43) reflects thaI she did nol have any recollecllon on checking on him on a regular basis on the day of his discharge Mrs, Gill cannot recall ~heckin8 on her son the following mommg (Monday, December 2, 1996). She laler stated that she worked from eight 10 four however did go home at lunc:h, She does rec:all (palle 45) that she earned him a tea cooler She does nOl recall if any urine wu in the bucket, She recalled that his "pallid" was a little "strange" and Ihat he was bll.Ck and blue Gill vs, Carlisle Hospital Page 6 Her deposition (page 47) reveaJsthat she yelled up the steps and she felt that he answered her howeYa' when she was at lile lOp of the stairs, she noticed I:e was not breaehing, The history siven on December 2, 1996 per the Pennsylvania EMS Report nOles that Mrs Gill advised them thaI 30 minutes previous to her finding him unconscious on the floor, he was awake but slow to respond to her, Mrs, Gill did nOI call1he Emergency Departmenl atlhal time when she noted the change, (5) failing to recognize the significance of the paticnt's inability to dress himself secondary to pain (t) failing to recognize the sipificance of the patient's inability to ambulate independentJy secondary to pain, so much so that the patient needed to be taken to his mOlher', vehicle in a wheelclllir It is not an unusual circumslanr.e in an Emergency Department thaI individuals of any age may require assistance ge:ting dre~sed al the time of their discharge from the hospital, Patients and their families in facl are instructed on many occasions that the pain may be worse lhe neJet 24 hours. Furthermore, a wheelchair discharge was appropriale as Mr Gill was under influence of alcohol, (u) failine to recagnae or even consider the aforesaid evidence of palD and immObility as sillns and symptoms of intern III injuries and fnctures (v) failing to formulate a differential diallnosis which should have included potenlially Iife'lhreatening lnterual injuries and fractured and to then rul. in or out these potentially life-lhrutenins condition, with appropriate examination and lesting, which should have lncludtd J-rays, blood work, urin"l)'sis, and t.V. Therapy The above mentioned allegallon' ale not '..;thin Ihe realm of the Scope of Practice for a RegiStered Nur,e in the Commonwealth of Pennsylvania (w) failing to promulgate and implement policies, procedures IInd protocol for Ihe Emergency Department to huure ICcurate and adequate history taklD,. examination, treatment, monitoring and dlagnoJllc t"ling or blunt trauma patients and to insure the proper and adequllte dischal'Je instruction. be linn 10 uch such patient and their 'amily. CarlisM Hospilal is an inSlltUlion which is accrediled by lhe JOlnl Cornmi5.1ion on Ihe Aecreditation of He.llhcare Organizalions (JCAHO) A component ofthll accreditation i. the aVlilabililY of policle, and procedures relative 10 Emergency Care Delivery Systems. GiU vs, C.rliale Hospital Pase 7 r.rp. Ana1YJil. and Nurtinr Opininn A critical revi.w of the palienfs medical record and related documenlS was completed wilh regard to the standards of nursins care associated with Ihe care administered to Chrialopher GUI while a patienl at Carlisle Hospital in Carlisle, Pennsylvania, Special emphasis was given 10 Ihe nursing carc as it relates 10 Ihe care of an individual who was a viclim in motor vehicular accident (MY A) who presenled 10 Ihe Emergency Department for an evaJuatic. This analysis consisted of reviewinglhe medical records and relaled documents, followed by the subsequent analysis of the aClivities implemented by the nursing staff dunngthe assessment, planning, inteNention and evaluation components oflhe nursing process as were existent in December, 1996, The componenlS are idenlified as Ihe scientific melhod relaled to nurlin!! practice and their applicability to the care delivery given to Mr. Gill, It is with a reasonable degree of nursing cenainly thaI I conclude that Ihe nursing care rendered to Mr, Gill was in compliance with the slandards of nursing care and practice as existent during December, 1996 It is my conclusion Ihat the admiruslrative activilies implemented by Ihe hospital were in concen with the medical plan of care, Mr, Gill was a poor historian who was afraid of disclosing the complete elements regarding the accident of which he was a participant This is clearly evident in his discussion with Emer;:lency Medical Persnnnel as well as the hospital staff' The depositions of his parents reflect a situalion whereby little 10 no discussion en.sued relative to the events leading up to and including Ihe accident It is further reflected in the parent's depositions that obscNalion on the part of either parent was inconsistent Mrs Gill returned her daughter to school in Bloomsburg and left her son unattended and unobseNed She too felt Ihat his injuries were minimal or would not have pursued a trip leaving him unattended. AS one r<<:ognizes that the loss of a you"8 person is a tragedy, one cannot blame a healthcare organization inclusive of its nursing staff for not completing a proper assessment. A substantial change in Christopher Gill's condition occurred approximately 32 hours after discharlle from the hospital, It is unfonunale that intervention was nOI instituted at the time of recOiflition that Christopher's color started to change, if indeed her deposition more accurately reflects Ihe events more 50 than the ambulance record. One cannot be insensitiv.! 10 the grief and loss feh through the death of Christopher Gill, Christopher presented limited infonnation 10 the pre-hospital and hosl'ital bued persoMel. The lack of sup.msion in the twenty four hour period foUowin. dischar.. from lhe hospital wu a major defiCiency, especially with the knowledge that a color chanse occurred and thaI Christopher had no urinary OulPUI for many hours poSI discharae from the hospilal. It is unfair to place blame on a healthcare instilulion and its providers wh.n family members had the opportunity to r.port the chanps they observed - r , Currently, a scoring system called the Trauma Score or .CRAMS. which lakes into account the assessment of circulatory function, respiration, abdominaJ lendemess, movement and speech. He has a normal Trawna Score. The Trauma Score has been used as an indiclor as to which persons have major trauma and which do nol. The Emergency Health Services Federation is the agency responsible for care administered by ambulance personnel in this region, By their prolOcol, Christopher would have qualified as a "Class 3" patient who did nOI demonstrate any serious injuries, [n addition 10 the Paramedic docurnenting no complaints and a chest and abdomen which were wuemarkable, the Emergency Medical Technician dOCwllents suml31' findings in their separate report, They write, "abdomen was soft and nOlltender" and "IWlgs were clear bilaterally", II would be unusual for .omeo"e to have such major injuries to have no complaints of pain aDd DO objective silins ofinju1'Y Altboullh Christopher stated he had been drinking alcoholic beverages, he was not dinicaUy intoxicated. We know from the bk'Od alcohol taken requested by the police that Christopher had a blood alcohol in the range of 2 I Omg, %, One would expect Christopher to exhibit extreme signs and symptoms of alcohol intoxication at this level, The major reason that one would not exhibit signs and symptoms of alcohol intoxication at this level is because of a phenomena called "to[erance", By this I mean thai Christopher must have had a history of considerable alcohol use so that his body became accustomed to a high alcohol and he exhibited less signs and symptoms then one would expect, We know from the assessment of the pre hospital team that Christopher did not appear to exhibit signs or S)lIlptoms of intoxication. In the deposition by Mrs. Gill, there is mention that Chris may have had problems with alcohol at his Uni..rsiry and. that resulted in SQme sort of disciplinary action, The patient arrived at Carlisle Hospital Emergency Department and was assessed aI 0330, Nurse Gordon docurnents Christopher to be "defensive, vague/disconnected, speech normal, memory impaired", From her deposition, it i. clear that what Nurse Gordon MEANT by the terms "vague, disconnected, memory impaired" was Christopher's evasiveness about being the driver \lfthe vehicle, She stated that she had no other meanings attached to those phrases, Therefore, there is nothing in Nurse's Gordon's evaluation that contradicts the Paramedic's assessment that the patient was alert 3lld oriented. Vital sign. were recorded as a pulse of 100, Respiratory Rate of 20 and a Blood Pressure of II g/90. It was also noted that his "gait was steady", Or, Kurlantzick promptly evaluated Christopher at 0330, He nOlc. the patient's vital signs, His history includes the fact that the patient had no specific complaints, and was evasive about being in the car nor would he be specific about how much or when he drank alcoholic beverllllcs, He notes Christopher's speech was well formed, he had an odor of alcohol on his breath, the neck was non tender, the chest and heart was nonnal, the abdomen was soft and non tender and the pelvis stable, His neurological examination was normal, So, Or, Kurlantzick is faced with a patient involved in a motor vehicle accident, the patient has no cQmplaints and the physical examination i. wuemarkable, Although Christopher has been drinking alcoholic beverage, he is not clinically intoxicated, The heart rate of 104 is nonspecific, The patient has recenlly arrived from !he scene of an accident, is moved from the stretcher to the bed in the Emergency Department and is being poked and prodded, Dr, KurlanlZickls examination did not indicate any majC'f injuries to the chest, abdomen or pelvis, The rule of thumb is that a patient may not be cleared on the basis of a clinical examination if the person is inloJlicated, However, Christopher was not clinically Intolicated. Dr, KurlanlZick determined that he did nol have any cervical spine injUry by palpating over ktlL I. that area. This is perfectly acceplllble in a patienl that is nol clinically inloxicated, Chrislopher meets this description. The decision 10 draw blood for laboratory investigation or 10 oblalD x-rays depends on your assessmenl of the nature and degJ'ee of injuries present In the case where the person has no complaints and no significanl se:rious physical rlDdings. il is nOI indicated 10 oblllin exlensive blood and laboralory leslS. To do otherwise would expose: MANY people 10 unneccsSlll)' leSlS, Once allaln. with Ihe view orhindsillhl, Chrislopher's lack or complaints and pbysical findlnlls Is very unusual. Dr, KurlanlZick elected to kt:ql the patienl in the Emergency Depa/1ll1enl for se:rial examinations, He could have discharged Chrislopher bUI chose: 10 keep in the the Emergency Department until 0700(although the patienl was lIClIllIlly discharged al 0820), Why would he do this ifhe did nol inlend 10 do serial examinations, II would have been much easier and less work for himself and the nursing slllff 10 discharge the patienl after he bad seen him al 0330, In my view, Ihls aclion demonstrales a clear inlention 10 do serial examinations. There is increasina dernand on the parr of busy ernergcor.y physicians 10 provide derailed documentation. This is very time conswning and, the caring physician i~ often faced with the decision of spending their time at a desk writing or. spending that rime caring for patients, The W1iversities have been buffered from this because of the abundance of trainees who the staff physician can delegate these lasks, In fact, many physicians do nOl docwnenl each and every time they go in 10 do a serial examination, ThaI is the deracto standard. I again reiterale. Dr, KurlanlZick demonstraled a clear inlenllo do serial exwninations. wby would he then nol do them, The docwnentation in his nOle thai "The patienl was observed with serial exams and there were no evolving evidence of inlernal injury" is adeqU/lle documentation, Ccnainly abnonnal vilal signs warranl further investigation. The nalUre of this investigation and the scope is often a mailer of judgment.. In this case, the change in vital signs was nOI broughllo Dr. KurlanlZick's arrention prior 10 discharge, II is nol Wlusual for a person in a molor vehicle accident 10 have aches and pains and 10 be discharged from an emergency departmenl using a wheel chair, II has no specific meaning, Another issue thaI came up during the depositions is the issue of Christopher nOI passing IIline, I should point oul that most males in this age group do nOI wake up in the middle of the nigh I 10 urinale, Chrislopher was in the Emergency Depa/1ll1enl in the middle of the night Why should anyone think it unusual for him not 10 urinale, Again. I would nol make anything of the issue of as 10 whether he did or did nOI urinale, In reviewing the deposition of Nurse Tracy Rush she slales She look Mrs, Gill 10 the room and. "Chrll wu l)'inll on his stomach with his head down", Again.. I find this unusual. an individual with such a degree of major abdominal injuries lying on his abdomen and nOI complaining of any pain.. This had 10 be close 10 when Chrislopher was discharged since Mrs, Gill was presenl, The discharlle instructions were adequale for an adull patienl who bad DO spfelllc complaints or pbyslca' IIndlnlls. It is nOI possible to advise patients of every possible symplom Ihal might develop, One would assume that an adult with average inlelligence knows that if they bave severe pain \\'l1l0 blCk 10 se.. their physician, 1 r'tll In reviewing Mrs, Gill's deposition she sllltes thai Christopher did not complain of pain in this chest or abdomen, According to her deposition Chris was able to gel out of the car without help and walk to the house without help, Docs this sound like a person with a fractured pelvis and multiple serious internal abdominal and chest injuries? Illnd this hilhly unusual. He appeared to be well enough at home and clear enough menlally to want 10 call his employer to lell him he could not go to work, When asked if there was any poinl on Sunday when !\Irs, Gill would have considered returning him to the hospital she said no, On 12/2/96 Mrs, Gill left home for some time, Upon arriving home, she found Christopher in bed in cardiorespiratory lIITest. C.P,R, was instituted with insuuction by telephone and at 16:12 Emergency Medical Services were dispatched, Extensive resuscitative efTorts were undertaken both in the field and at the Carlisle Hospilal, The fact is, there was almost no chance of Christopher surviving once he developed cardiorespiratory lIITest. Statistics show that persons who develop cardiorespiratory lIITestllS a result of trawna almost all die, I keep questioning in my mind whether Christopher could have sulTered additional trauma in the time his Mother was out of the house? Could he have fallen down stairs or sustained further injuries trying to move around the house? The Coroner's Report swnmarizes the injuries that Christopher sustained: Ruptured hemidiapbragm Herniation of stomach and Omentum into the chest Perforation of the stomach with blood and gastric fluid in the chest Approximately 150 gms ofbloodlgastric fluid in the abdomen Multiple pelvic fractures Superficial lacerations of the spleen I think it is important to review the major injuries in some detail. Only about four percent of trawna victims have ruptured diaphragms, So, the injury is relatively rare and most emergency physicians do nol see many patients with this injwy, Ruptured diaphralms are difficult to diacnose and sludies !how that It is not diacnosed in approximately 69% or the cases. It is usually diacnostd coincidenlallyas a result or tnatInc olber injuries. II can hardly be said that a physician wbo does not make Ibis dialnosis is neeli&ent wben 69"1. or the patients ~ludied bad the diacnosis missed, In a sense. not diagnosing Ihis condition IS the standard, The hole in the diaphragm otI10w intestine and stomach to enter the chest and as a complication, the slomach perforaled, Splenic injuries usually presenl with pain, It has clearly been established that Christopher was nol complaining of any abdominal pain, was non tender on palpanon of his abdomen by multiple health professionals and was seen to be lying on his abdomen, Even after going home he did nOI complain of abdominal pain or chest pain, He never complained of shortness of breath, ACain, tbis is very unusual ror someone wllb Ibis deeree or Injuries Finally, the Paramedic described Chris's pelvis as stable, What does this mean, It usually means thai the examiner pushes on both sides of the pelvis to asc:crtain if there is pain or abnonnal movement. Dr, KurlanlZik examined Chris's pelvis and did not elicit pain or instability, Chris was able get out of the cat on his own and walk to the house without complaining of pain' I think this h1lbly unusual, ~ 4 " ~ -. .1; M .. ~.. ~p. M ~... t. <;"" r:o y..: t',.jfJ ..... :..~ q.. "j"" ':. ;j' ...~~ (:, \.0 0',,(/) ~,t 'J.-r' {(';. ~;, ft. I'" , 'jLe lit !.; . J~ v> "'j ~ ~, " en CJ ~ Individually and as Administrators of the Estate of CHRISTOPHER J. GILL, Ilcccascd, CUMBERLAND COUNTY, PENNA NO, '>7-41\ 17 CIVIl. Plaintiffs CIVII.ACTION.I.AW ORIGINAL VS, CARLISLE HOSPITAL and ROBERT L. KURLANTZICK, M.D., Defendants JURY TRIAL DEMANDED ORDER ..... L1 AND NOW. this 17 _ day of~. 2000, upon presentation of the Petition for Approval of Distribution of the Proceeds, and due consideration thereof, it is hereby Ordered and decreed as follows: I, The settlement is approved, The proceeds are to be allocated in accordance with the agreement between Petitioners and the Pennsylvania Department of Revenue; , 2, The record in this case is sealed at Defendants' request so that this document or any other document in the record n.',garding the facts of the settlement, its amount, or its tenns and conditions, will be disclosed to no one at 110 time. The Prothonotary is hereby Ordered to seal the record, .. -----~~ k (\ .j .\1.00 l)Jr ~ ,)~ 1-'"" 1199041JKW 1 GERALD W, GILL and DIANE GILL, InJiviJually anJ as Administrators of the Estate llfCHRISTOPIIER J, GILL, Dcccuscd. IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNA Plaintiffs NO. 97.4817 CIVIL CIVIL ACTION, LAW ORIGINAL VS. C ARLlSLE HOSPITAL and ROBERT L KURLANTZICK, M,D" Defendants JURY TRIAL DEMANDED ORDER ~ A....:R AND NOW. this 11 _ day of LT""~' 2000, upon presentation of the Petition for Approval of Distribution of the Proceeds. and due consideration thereof, it is hereby Ordered and decreed as follows: I, The settlement is approved, The proceeds are to be allocated in accordance with the agreement betwccn Petitioners and the Pennsylvania Dcpartmcnt of Revenue; 2, The record in this case is sealed at Defendants' request so that this document or any other document in the record regarding the facts of the settlement. its amount, or its terms and conditions, will be disclosed to no one at no time, The Prothonotary is hereby Ordered to seal the record, ~- J, , 1\ ~ .\'1>>,00 \)Jf ~ 1-'t-.~ 11'J<)t)~JKW GERALD W. GILL and DIANE GILL. : Individually and as : Administrators of the Estate of CHRISTOPHER J. GILL, Deceased, IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNA ,- plaintiffs NO. 97-4817 CIVIL.. -=-' -, CIVIL ACTION - LAW :':1 .,j JURY TRIAL DEMANDEO " ",'l - , VS. CARLISLE HOSPITAL and ROBERT L. KURLANTZICK, M.D., Defendants PET:TION FOR APPROVAL OF DISTRIBUTION OF THE PROCEEDS 1. plaintiffs, Mr. and Mrs. Gill, are co-administrators of the Estate of the deceased son, Christopher Gill, by virtue of Letters of Administration granted to them by the Register of Wills of cumberland County. 2. Your Petitioners brought suit against the Defendants on the basis of alleged negligent medical care causing or contributing to the cause of their son's death. 3. The case was pre-tried twice and scheduled to go to trial during the September, 1998 trial term. 4, The case settled prior to trial and the Defendants have requested that this Court seal the records so that the amount, terms, and conditions of the settlement do not become public knowledge. 5. It is in the Court's sole discretion to seal a record in a case if it considers the facts or nature of the case such that the record of the case should be sealed from public knowledge. 6. The case settled for a total of $1,000,000. 7. This Court is called upon to approve the settlement to ensure that a portion of the funds are attributed to the surviva,', claim and therefore SUbject to Pennsylvania Inheritance Tax. .' 8. Petitioners attach a copy of the October 5, 1998 correspondence from Laura A. Kulick, assistant counsel for the commonwealth of Pennsylvania, Department of Revenue as Exhibit A. As the Court will observe, the Department of Revenue has agreed to an allocation of $120,000 toward the survival claim. This allocation was decided by the Department of Revenue based on a carefully considered analysis of the case. 9. petitioners have reviewed this petition and Order and attach their Verification approving of same as Exhibit B. WHEREFORE, Petitioners pray that this Honorable Court enter an Order approving said compromised settlement, sealing the record to preserve its confidentiality as requested by the Oefendants. and directing the distribution of the proceeds thereof in accordance with the averments in this Petition. Plaintiffs have already executed and delivered to the Defendants an appropriate Release, discharging them from any and all claims and demands, rights or causes of actions arising from or asserted in this suit concerning the death of their son. Respectfully Submitted, & V, ESQUIRE Dated: ~ (~vJM I~ l~B ^ttorneys for Plaintiffs I .. t n:RTIFICAn: Ot. SERVIC;t; AND NOW, this ..~ I~: day of (';.)' ..~'. .2000, I. Jessie K. Walsh, an employee of Angino & Rovner, p,c., do hereby certify that I have served a true and correct copy ortlle ORDt:RlI'I,AINT.......S' PETITION ...OI{ APPROVAL 0... DISTRIBUTION m'TlIE PROCEEDS, in the United States mail. postage prepaid at Harrisburg, Pennsylvania, addressed as ti.}lIows: Ethan W, Smith, Esquire Henry, Coreelius, Gates. Gill, & ady 200 Penn Street p,a, Box JSJ Huntingdon, PA 16652 Attorney for Fred C. Lescalleet Richard H, Wix. Esquire Wix. Wenger & Weidner, PC 50S North Second Street Harrisburg. P A 17101 Attorney for the Estate of Christopher], Gill Kendra 0, McGuire. Esquire B,lrley. Snyder, Senft & Cohen. LLP 126 East King Street Lancaster, P A 17602-2893 Counsel for Carlisle Hospital Sarah W. Arosell, Esquire Thomas, Thomas. & Hafer, LLP J05 North Front Street p,a, Box 999 Harrisburg, PAl 710S Counsellor Robert 1.. Kurlantzick, M.D, J.: IS ) ;}.1 ~ ".~"..JI'. {l.-t?~ Jessie K. Walsh ..... ~ ,., N ~ " :'~icf. 1,-' - r:, II; ~;: '.1 ~':: -J: L' '1~.~ I..... ":: i./; I I';; , r" "J'''\ " , 1.1.;' L" :,;,j., " tl C) .. , ., c;~ -" " ' * , , , , ,