HomeMy WebLinkAbout03-0250Jfl/minors comp/lewis
SPENCER LEWIS, a minor
by and through his natural parent,
JENNIFER LEWIS, and guardian,
NILE HARVEY LEWIS,
Petitioners
JEFFREY C. CLARK,
Respondent
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
NO.o$ o ,1. 5'~ 2003 CIVIL
CIVIL ACTION - LAW
MINOR'S COMPROMISE
PETITION FOR LEAVE TO
COMPROMISE MINOR'S ACTION
Pursuant to Pennsylvania Rule of Civil Procedure Number 2039, Jennifer Lewis,
the natural parent, and Nile Harvey Lewis, the legal guardian, of minor, Spencer Lewis,
by and through their attorneys, HANDLER, HENNING & ROSENBERG, LLP, by
Matthew S. Crosby, Esq., petition this Honorable Court to enter an Order permitting
settlement and compromise of this action, and in support thereof aver:
1. Spencer Lewis was born on June 19, 2000, and is therefore two years
old and a minor. He currently resides with his mother and his grandfather at 101
Second Street, West Fairview, Cumberland County, PA 17025.
2. Jennifer Lewis, an adult individual, is the natural parent of Spencer Lewis
and currently resides with her son at 101 Second Street, West Fairview, Cumberland
County, PA 17025.
3. Nile Harvey Lewis, an adult individual, is the legal guardian and
grandfather of Spencer Lewis and currently resides with his grandson at 101 Second
Street, West Fairview, Cumberland County, PA 17025.
Exhibit A
' I'OLICE ACCIDENTILEFOHT . ,
~'REFER TO OVERLAY SHEETS REPORTABLE E~ NON-REPORTABLE ~ PENNDOT-USE ONLY
· INCIDENT 20.COUNFY CODE 21
NUMBER 01-1950
2.AGENCY 21.MUNICIPALITY WOP,~,k~YSBURG COOL 403A
NAME ' ~T SHO~ ~I~ ~LI~ DEP
3.STATION/PRECiNCT T,~ [ 4.PATROLzoNE ~' P~NCIP~ RO~WAYINFO&~ON
7. I NVES~ ~AT ION ~.ARR IVAL
DATE 06/11/200 H~E 1739 ' ]NT~BSECTINO ROAD:
27. SPEED ~ TYPE ~ ACCESS
9.ACCIDENTDATE 06/11/2001 lO.DAY OF gEEK ~ LIMIT ~5 --BIGHgAY 0 CONTROL
11.~IME OF 12.NUMBER
~A~ 1734 OF U.t~S O~ IFNOTATIN~RSEC770N:
13.~ KILLED [14.~ INJURED 15.PRIV.PROP. ~ ~ 30.CROSS S~REET OR
0 O~ ACCIDENT Y N SEGMENT MARKER
6.DID VEHICLE HAVE lO BE 17.VEHICLE DAMAGE 31.DIRECTION [32.DISTANCE
REMOVED FROM THE SCENE? O-NONE UNIT 1 ~ FROM SIIE ~ S ~ W~ FROM SITE FT. MI.
UNIT 1 UNIT 2 1-LIGHT~~ 33.DISTANCE gAS ~
2-MODERATE MEASURED EST IMAGED
3-SEVERE
UNI~
2
~ ~CONSIRUCT ION ~TRAFFIC PRINCIPAL INIERSECTING
18. HAZARDOUS 19. PENNDOT DEVI CE
,ATER,ALS Y 0 N ~ ,ROPERTY Y 0 N ~
36.LEGALLY Y N 57.REG. 138.STATE 36.LEGALLY Y N 37.REG. 38.STATE
PARKED7 ~ ~ PLATE ~-8615~ PA PARKED7 0 0 PLATE B~-6189 PA
39.PA ~IILE OR 39.PA IITLE OR
OU~-OF-S~A~E W~ 46107883902 ~-OF-STA;E V[~ 48462672003
ADDRESS ~ I ~X 314H ADDRESS 101 ~ ST.
42.CIIY,STATE 42.CITY,STATE
& ZIPCODE S~O~, PA 17870 & ZIPCODE ~ F~, PA Z7025
43.YEAR 1993 }~4..AKE ~A :4Z.~EA~ 1994 [ 44..A<E ~IT,TAC
BODY TYPE) 62G ~ N ~ UNK~ BODY TYPE) S~ D~T,T,~ ~ N 0 UNK~
~eooY ~ S~ECZA~ ~VEHZC~E ~ ~OOY ~ SPECZAL ~VEH~C~E
TYPE 04 ~USAGE O0 OWNERSHIP 02 ~TYPE O~ ~USAOE O0 OWNERSHIP O1
POINT 01 STATUS 0 SPEED Z5 POINT 1~ STATUS 0 SPEED
CONDITION
I bb.ORIVER I ,/.STALE
56.DR (VER 5~.S[A[E ~A
NUMBER 242826G3 NU;.IBER 22528177 'PA
5S.~R~VER 5S.D~VER
59.DR~VER 59.DR~VER
A~DRESS 203 ~ ST. ADDRESS 101 2~ ST.
60.c~ ~v, S~ATE 60.C~ TY, S~A~E
~ Z~PCODE ~IS~, PA 17013 & Z~PCODE ~T F~R~, PA 17025
M 8~RTH 717-243-4623 H BIRTH 717-732-6026
64.COMM.VEH 6b.DRIVER [ 64.COMM.VEH. 65.DR,VER
Y ~ N ~ CLASS Y ~ N ~ CLASS
67. CARR I ER 67. CARR I ER
68.CARRIER 68.CARRIER
ADDRESS ADDRESS
69.CITY,STATE 69.CITY,STATE
& ZIPCODE & ZIPCODE
70.USDOT ~~[ICC ~ PUC ~ 70.USDOT ~ ~1 ICC fl PUC ~
~VEH. ~CARGO r4.GWR ~VE,. ~CARGO rA.GV~R
CONFIG. BODY TYPE CONFIG. BODY TYPE
75.N0. OF ~HAZARDOUS 77.RELEASE OF HAZ MAT 75.N0. OF ~HAZARDOUS 77.RELEASE OF HAZ MAT
AXtES MATERIALS Y~ N~ UNK~ AXLES MATERIALS Y~ N~ UNK~
PAGE: I EXHIBIT A SAFETY
~LPEOPLE INFORMAl ION
J ~ B C O E F G NAME ADDRESS
ti :01-1950
DATE: q6/11/2001
NIJKLMi
(~).ROAD SURFACE F~'1
84.PENNSYLVANIA SCHOOL DISTRICT
(IF APPLICABLE)
85.DESCRIPTION OF DAMAGED PROPERTY
OtJNER
ADDRESS
· st. No-->
6L
PHONE
87.NARRATIVE-IDENTIFY PRECIPITATING EVENTS CAUSATION FACTORS, SEQUENCES OF EVENTS, WITNESS STATEMENTS, ANO PROVIDE ADDITIONAL
DETAILS, LIKE INSURANCE INFORMATION AND LOCATION OF TOWED VEHICLES, IF KNOWN.
IRE OPEPATOR OF t~TIT ~!, JEFFREI' CT_APl<, %~S TF~F/~'~ N~]P___TNZOL%TD CH' FF.C%~ ST.
APPROACHING THE ~ECTION WITH ET M ST. CT ARK MOVED OJE% N'rfO 1-HE MIDDLE TUP~N L~I~E
MAKE A T,RET TURN ONTO ET M ST. PROM N. FRONT ST. HE TUP~,N-~D HIS VEHIFT,E DIRECTLY IN FRONT
OF IJNIT ~2 ~F6ICH WAS TRAVELING SOUTH AND DID NOT HAVE ~O~ TI~ TO GET CUV OF THE
BEFORE UNIT ~2 STRUCK TH~ FRONT OF HIS VEHICT,E. C]_AR~ TOT=D P~ THAT HE NEVER SAil UNIT ~2
COMING FROM THE OPPOSITE DIRECTION.
NILE L~zlIS, THE OPEPJtTOR OF UNIT ~2, ~S TPJiVELI~13 SCbqiH CNN. FRO}Ir ST. ~Z~r~_' ,l U~IIT t~!
A'~ TO MAKE A LEFF TURN IN FRONT OF HIM. TH]EPS ~S blOT EN~Dk~ TIME NOR LE%qIS TO
STOP AND HE STRUCK UNIT #1 WITH THE FRONT OF HIS VEHICI,R.
EO'i~ VEHICT,F.S WERE REMOVED FROM THiE SCENE BY MAGARO'S TOWIng.
THE THI~,EE PASSENGERS IN LEWIS' VEHICI,E WERE TREATED BY ~'iS AND TPJtNSPORTED TO HOLY SP!R~T
HOSPITAL, ~__J-ARK RE~73SED ~ 'i:REA~' Al' ~ SCENE.
INSURANCE COMPANY INSURANCE CCMPANY
JINFORMATION
INFORMATION ERIE INSUPJ~NCE EXCHANGE STATE FARM
~NIT~M~IPOLICY NO JS U~IT POLICY NO
88. j ADORE: PHONE
WITNESSESJ~
ADDRESS
UNIT 1/
UNIT 2/
:i.:iiib!.J~..~3).PROBABLE ~.~.TYPE ~). RESULTS
~ USE
PHONE
L 90. SECIJON NUMBERS (ONLY IF CttARGED) IC NIC
DD
,J J 9L?_J/PROABLE 9~,.T[~PS~ ,~).RESOL TS NO J94. ,NVE$[ ,G~A[ ION
J---J NO TES J~f:":] ~ ~ TESTJ COMPLETE.
o
REFUSE J ~
g REFUSE ~ n J O. % ~
U,K I I ~ UNK J YES ~ NO
PAGE: o9 CENTER FOR HIGHWAY SAFETY
Jfl/minors comp/lewis
SPENCER LEWIS, a minor
by and through his natural parent,
JENNIFER LEWIS, and guardian,
NILE HARVEY LEWIS,
Petitioners
JEFFREY C. CLARK,
Respondent
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
NO.O$ o ,Z 5'~ 2003 CIVIL
CIVIL ACTION - LAW
MINOR'S COMPROMISE
PETITION FOR LEAVE TO
COMPROMISE MINOR'S ACTION
Pursuant to Pennsylvania Rule of Civil Procedure Number 2039, Jennifer Lewis,
the natural parent, and Nile Harvey Lewis, the legal guardian, of minor, Spencer Lewis,
by and through their attorneys, HANDLER, HENNING & ROSENBERG, LLP, by
Matthew S. Crosby, Esq., petition this Honorable Court to enter an Order permitting
settlement and compromise of this action, and in support thereof aver:
1. Spencer Lewis was born on June 19, 2000, and is therefore two years
old and a minor. He currently resides with his mother and his grandfather at 101
Second Street, West Fairview, Cumberland County, PA 17025.
2. Jennifer Lewis, an adult individual, is the natural parent of Spencer Lewis
and currently resides with her son at 101 Second Street, West Fairview, Cumberland
County, PA 17025.
3. Nile Harvey Lewis, an adult individual, is the legal guardian and
grandfather of Spencer Lewis and currently resides with his grandson at 101 Second
Street, West Fairview, Cumberland County, PA 17025.
4. On or about June 11, 2001, the minor, Spencer Lewis, was
a backseat passenger in a 1994 Cadillac Sedan Deville (hereinafter "Petitioner's
vehicle"), driven by his grandfather, Nile Lewis.
5. At all times material hereto, the Petitioner's vehicle was traveling
southbound on North Front Street in Wormleysburg, Cumberland County,
Pennsylvania.
6. On or about June 11, 2001, Respondent, Jeffery C. Clark, was traveling
northbound on Front Street in Wormleysburg, Cumberland County, Pennsylvania,
approaching the Petitioner's vehicle.
7. Respondent Clark moved into the middle turning lane to make a left turn
onto Elm St. and, then, turned his vehicle directly into the path of Petitioner's vehicle.
The Police Accident Report is attached hereto, made a part hereof, and marked,
"Exhibit A."
8. As a direct and proximate result of the negligence of the Respondent, the
minor, Spencer Lewis, suffered cuts behind his ear, abrasions to both sides of his neck,
and bruises from the child seat belts.
9. Spencer was seen in the Holy Spirit Emergency Room on June 11, 2001,
and was treated and released. No follow-up care was sought and he has made a full
and ample recovery with no residual problems whatsoever. A copy of the Holy Spirit
Hospital Emergency Room report is attached hereto, made a part hereof, and marked
as "Exhibit B."
10. Respondent's vehicle was insured under a policy of motor vehicle
insurance issued by Erie Insurance Company that was in effect at the time of the
collision.
11. At the time of this collision, the minor, Spencer Lewis, was insured under
Petitioner's automobile insurance policy with State Farm Insurance Company. To date,
all of said minor's collision-related medical bills have been paid by State Farm
Insurance Company.
12. After negotiations, Erie Insurance Company has offered to settle the
minor's claim against the Respondent, Jeffrey C. Clark, for seven hundred fifty dollars
($750.00). Attached hereto, made a part hereof, and marked, "Exhibit C," is a copy of
the proposed release.
13. Petitioners, Jennifer Lewis and Nile Lewis, believe said settlement is in
the best interests of the minor, Spencer Lewis, and propose to accept said settlement
offer of $750.00 from Erie Insurance Company, thereby releasing the Respondent from
any and all claims, suits, and/or actions in the future.
14. Matthew S. Crosby, Esquire, of HANDLER, H£NNING & ROSENBERG,
LLP, has been the attorney for the minor in this action and he requests counsel fees of
one hundred eighty seven dollars and 50/100 ($187.50) for services rendered,
pursuant to a Contingent Fee Agreement signed by Petitioner, plus costs and expenses
of ninety dollars and 70/100 ($90.70). Although the original Contingent Fee
Agreement, had indicated a fee of 33 1/3%, or $250.00, counsel has elected to reduce
this fee to 25%, or $187.50. Thus, the total amount requested for attorney's fees and
costs is two hundred seventy-eight dollars and 20/100 ($278.20). A copy of said
Contingent Fee Agreement and billing summary are attached hereto, made a part
hereof and marked, "Exhibit D."
15. Petitioner requests this Honorable Court order payment of four hundred
and seventy-one dollars and 80/100 ($471.80) to be placed in an account investing only
in securities guaranteed by the United States Government or by a Federal Government
agency managed by responsible financial institutions, bearing the name of the minor,
Spencer Lewis, that is marked, "Not to be withdrawn until minor reaches the age of 18
or without the Order of a Court of competent jurisdiction."
Date:
WHEREFORE, Petitioner requests this Honorable Court to:
a. Approve the Compromise stated above;
b. Authorize the payment of fees stated above
from funds due to the minor; and
c. Direct payment of the net funds due, in
accordance with the Compromise stated above.
Respectfully submitted,
HAN~NG ~RG, LLP
By~ ~" ~
Matthew S., Crosby, Esq.
I.D. # 69367
1300 Linglestown Road
Harrisburg, PA 17110
(717) 238-2000
Attorneys for Petitioners
VERIFICATION
THE UNDERSIGNED hereby verify that the statements in the foregoing
document are based on information that Was gathered by counsel in preparation of this
lawsuit. The language of the above-named document is of counsel and not our own. We
have read the said document and, to the extent that it is based on information that we gave
to counsel, it is true and correct to the best of our knowledge, information and belief. To
the extent that the contents of the said document is that of counsel, we have relied upon
our counsel in preparing this Verification.
THE UNDERSIGNED also understand that the statements therein are made
subject to the penalties of 18 Pa.R.C.P. 2252(d) C.S. Section 4904, relating to unsworn
falsification to authorities.
DATE:
Jl~N~iF~R I~E'~VIS, natural parent of
SP~'NCER I~.EWIS A/?
NII~E HARVEY LE~, legal guardian of
SPENCER LEWIS
Exhibit A
?. POLICE ACCIDENT REPORT
O'REFER 10 OVERLAY SNEETS REPORTABLE J'~ NON-REPORTABLE ~ PENNDOT U~E ONLY
1. INCIDENT 20.COUNTY CODE 21
NUMBER 01-1950 CL~v~
2.AGENCY 21.MUNICIPALITY WO~SBURG CODE 403A
NAME ' WEST SHORE PJ~GICNAL POLICE DEP
3.STAHON/ I 4.PATROL.
PRECINCT T'F'JvIOYNE ZONE '~ PRINCIPAL ROADWAYINFOI~'V[ATION
5.~N%~'~st'~i^TO% .~ ,---------,~^DGE 2Z.ROUTE NO.OR N. FR(N",TI' ST.
[ ~'1"[~. ~TG~SE[qE-I~_ EP, S( m~MBER 3210 STREET NAME _
7. INVES~r gATION 06/ll/200~.~.ARRIVAL
DATE TIME 1739 ' INTERSECTING ROAD:
: 27. SPEED ~ TYPE ~.~).ACCE$S
9.ACCIDENTDATE 06/1]./2001 10.DAY OF ~JEEK ~Y LIMIT 25 HIGHWAY 0 CONTROL 0
~I.~IME OF 12.NUMBER
DAY ].734 OF UNITS 02 IFNOTATINTERSEC'ITON:
1].# KILLED JLA.# IN,URED 15.PR'V.PROP. [] [] m. CROSS STREET OR
0 03 ACCIDENT Y N SEGMENT MARKER
l~.DID VEHICLE RAVE TO BE mVEBICLE DAMAGE ~I.DIRECTION [ ]Z.DISYANCE
REMOVED FROM THE SCENE? O-NONE UNIT 1 ~ FROM SITE N S Z ["$I FROM SITE FT. MI.
UNII 1 UNIT 2 1-LIGHT~ 33.DISTANCE t/AS
2-MODERATE~ MEASURED [] ESTIMATED []
3-SEVERE
UNIT
2
~ FA CONSTRUCTION ~. TRAFFIC PRINCIPAL INTERSECTING
Y []. I--I, rtl. [] CONTROL
36.LEGALLY Y N 37.REG. 38.STATE 36.LEGALLY Y N 37.REG.
PARKED? O0 PLATE ~-8615 PA PARKED? OO PLATE B~-6189{ PA
39.PA TITLE OR ]9.PA TITLE OR
OUT-OF-STATE WN 46107883902 ~T-OF-STATE WN 48462672003
AOOEESS ~ 1 ~X 314H ADOEESS 10t ~ ST.
42.C1TY,STA[E 42.CiTY,STATE
~ ZiPCOOE S~,~O~, PA 17870 & ZlPcooE ~ F~R~, PA 17025
{ ~5.MODEL- (NOT
45.MODEL-(NOT 46.1~S~ N~ UNK~ ~ODY IYPE)
BODY TYPE) 626
TY~ 04 USA~ 00 ~O~NERS,~P 02 T~p~ 04 USAOE 0O 0~ERS~iP 01
01 ~STA~US 0 ~SPE~ 15 POINT 12 STATUS 0 SPEE~ 35
(~VEMICLE g DRIVER ~ DRIVER ~VEHICLE
56.0RIVER S/.STA[E PA
NUMBER 24282683 NU;.mER 22528177 'PA
58.~IVER
59.DRIVER 59.0RIVER
ADDRESS 203 ~ ST. ADDRESS 101 2~ ST.
60.Cl}Y,STA/E 60.C11Y,STATE
~ Z[PCODE ~IS~, PA 17013 & Z[PCODE ~T F~R~, PA 17025
61 .SEX I62.DATE OF J63.PHONE 61.SEX 62.DATE OF 08/05/1949 J63.PHONE
~ ~ BIRTH 0~/~/~77 217-243-4623 ~ BIRTH 2t7-232-E026
6~. CAER I ER 6Y. CARE I ER
68.CARRIER 68.CARRI ER
ADDRESS ADDRESS
69.CITY,S~A~E 69.CI TY, STATE
& ZIPCODE & ZIPCODE
~ VE H. ~ CARGO 74. GVUR ~ VEH. ~ CARGO 14. GVUR
75.N0. OF OHAZARDOUS 77.RELEASE OF HAZ MAT 75.NO. OF ~HAZARDOUS 77.RELEASE OF HAZ MAT
AXLES MATERIALS Y~ N ~ UNK~ AXLES MATERIALS Y~ N ~ UNK~
PAGE: I EXHIBIT A SAFEW
,'~-RLSPUNL'ING L~S A~E~C¥ WEST SHORE & C' ~ HILL
79.MEDICAL FACILITY HOLY SPI,RIT HC"' ' ITAL
~PEOPLE INFORMA[ION
A B C D E F G NAME
o21 1MIO1141118I
~ROAD SURFACE J'--~J
84.PENNSYLVANIA SCHOOL DISTRICT (IF APPLICABLE)
85.DESCRIPTION CF DAMAGED PROPERTY
OWNER
ADDRESS
[ LNr~"~DENT il :01-1950
-'CID~ DATE: 06/11./2001
ADDRESS I J K L M ,
0 00 00 B 0 0i
0 O0 O0 B 0 O!
4 09 98 B 0 li
4 09 98 B 0 11
o Ioolool ID I1.
:
JEFFREY C. (JAP, K, 203 GRAHAM ST., CARLISLE, PA 17013
NILE HARVEY LRTWIS, 101 2ND ST., WEST FA/RVIEW, PA 170J
MARYI_OU LEWIS, 101 2ND ST., WEST FA/RVIEW, PA 17025
JENNIFER LEWIS, 101 2ND ST., WEST FAIRVIEW, PA 17025
SPENC"~R T,RTWIS, 101 2ND ST., WEST FA!RVIEW, PA 17025
BT.NARRATIVE-IDENTIFY PRECJPITATIHG EVENTS CAUSATION FACTORS, SEaUENCES OF EVENTS, ~ITNESS STATEMENTS, AND PROVIDE ADDITIONAL
DETAILS, LIKE INSURANCE INFORMATION AND LOCATION OF TO~ED VEfllCLES, IF KNO~R.
THE OPEPATOR OF L~FiT ~1, JEFFREY C!AP~<, 9DS ~A3~.~ NQR~%~.~ CN ~.~ ST.
~PROA~ ~ ~~I~ ~ ~ ST. ~
~ A ~ ~ ~ ~ ST. ~ N. ~ ST.
OF ~T ~2 ~I~ ~ ~,I~ SO~ ~ DID ~
BEFO~ ~T ~2 S~ ~ ~ OF HIS ~I~,E. ~ ~;~ P~ ~T ~ N~ ~P; ~T ~2
~I~ ~ ~ OP~SI~ DI~I~.
NILE L5%~IS, THE OPPATOR OF UNIT ~.2, ~D_S TPJ~VELING SC'TJqi~I ON bi. FROIxTf ST. ~Sg L%~T t~!
ATFSMPISD TO MAKE A LEFT TURN IN FRONT OF HIM. IHERE ~S NOT E~DUGH TIME FOR L~HIS TO
SlOP A~FO hie STRUCK UNIT ~1 WITH THE FRONT OF HIS VEHICI,E.
£CrfH VEHICT,FS WEP~E Pd~OVED F~C~ TH~ SCENE BY M~GARO'S TOWIb~.
THE It{NEE PASSENGERS IN LEWIS' VEHICI,R WERE TREATED BY ~k~ AND TPJ%NSPORTED TO HOLY SP!R~T
HOSPITAL. ~=ud< REFUSED 5Uk~ 'iTSElf' Al' THE SCENE.
INSURANCE ICOMPANY
INFORMATIONI E]ID,.TI~, IN~I_]P, ANC]~' EX~
UNIT I POLICY NO
UITNESSES ~
JINSURANCE
INFORMATION
UNIT
2
ADORE S
CCMPANY
ST_A17~ ~APJM
POLICY NO
6945893 -A03 -38D
PHONE
ADDRESS PHONE
UNIT
UNIT
UNIT '
~9. VIOLANONS INDICATED
.~/iPROBABLEUSEo L~.TYDETjsT ~ . RESULTS
E~ NO TEST
[~ REFUSE
~ UNK
90. SECTION NUMBERS (ONLY IF OIARGED) TC RFC
UP~ J94. ,NVESTiGA I ION
~. EOABLE 9~i. IYPE L9._jJ).RESULTS ~
TEST NO TESTJ COMPLETE~
0 O. % ~ REFUSE m ' ~
J I
PAGE:
CENTER FOR HIGHgAY SAFETY
ADM. DATE: 06/11/2001
CHIEF COMPLAINT: Motor vehicle ac=dent
HISTORY OF PRESENT ILLNESS; This 11 ~ month old male presents to the UrgiCenter
from home by car w~th his mother The pabent was revolved ~n a motor vehicle acc;dent ~n
which he was a back seat passenger ~n a ch~Id seat The mother states that she was also ~n the
back seat They apparently ware traveling northbound when a car crossed their path and they
struck the car on their driver's s~e The child remmned In the car seat, but the mother was not
restrained end ro[ied over onto h~m She noticed he had some abrasions on h~s neck,.
presumably from the straps from the child seat She was c~ncemed that he may have other
Jnjunes and brought h~m m for evaluation She said he did cry ~mtJaliy for about a m~nute, then
he seemed to settle dova~ and was able to eat and dnnk normally w~thout any vom~trng He had
no bleeding, no cuts or bruises noted, the mother sa,d Othermse, he seems healthy and
normal, but she did want h~m to be evaluated
PAST MEDICAL HISTORY: No sJgnn'~cant history
MEDICATIONS: None
ALLERGIES:
No known drug atlerg,es
PHYSICAL EXAMINATION:
GENERAL:
EYES:
ENT:
NECK:
LUNGS:
CARDIAC:
Th~s rs a heall~y appearing 11% month old male who ~s ~n no acute d~stress
V~tal s~gns per nurse's notes
Normocaphallc, atraumatlc The anterior fontanel ~s barely palpable w~th no
depression or elevation noted
Pupils equal, round, and reactive to I~ght and accommodation. Patient ~s able to
follow objects w~thout d~flculty No discharge from the eyes
Ea~s TM's w~thout perforation, ~nject~on or bulging External canals clear w~thout
exudate Nose. Atmumaflc, no injection, exudate or septal hematoma. Throat.
Pharynx w~thout mjecf~on, exudata or tons[liar hypertrophy A~rway patent
Supple, nontender, no lymphadenopathy. There are small abrasions noted to
each s~de of the neck which are linear, seem to follow the line of the restraints
There seems to be no tenderness w~th range of motion of the neck No evidence
of pain over the thorac;c or lumbar spine
Clear to auscultation
Regular rate and rhythm
Page 1 of 2
HOLY SPIRIT HOSPITAL
Camp Hill, PA NAME: Levis, Spencer H
17011 MR# 442543
ROOM~ ER3
EMERGENCY ROOM REPORT
ORJGINAL
NAME: Lewis, Spencer H
MRS: 442543
ABDOMEN:
SKIN:
Soft and nontender There are pos~ve bowel sounds No evidence of
any bleeding in the a~domen
Warm and dry There are the two abrasions noted to the neck above
Otherwfse, no evidence of ~njury
NEURO/PSYCH: The patmnt ~s awake and alert He Is able to follow objects He does say
"mamma" He does seem to be holding onto obJeCtS appropnately
Othenvise, he's difficult to assess ~eurolog;cally
PLAN: The patient apparently has · normal exam with the exception of the abrasions to his
neck I did recommend to the mother that he be followed up with his pediatnc4an th~s week.
Should he develop any other symptoms incJudlng vomiting, ~mtabdlty, fever, etc, he w~ll followup
sootier
iMPRESSION: Neck abres;on, status-post motor vehicle accident
NGIck
DOC # 152416
D 06/11/2001
T 06/19/2001 2 09 P
030731
Signed
NATALIE GILLIS, CRNP 06/20/2001 12 57
NATALIE GILLIS, CRNP
HOLY SPIRIT HOSPITAL
Camp Hill, PA
17011
Page_ 2 of 2
NAME Lewis, Spencer H
MR#' 442543
EMERGENCY ROOM REPORT
ORIGINAL
Exhibit C
For the consideration of
GENERAL RELEASE
dollars ($ ?~"'~) -
receipt of which is hereby acknowledged, I/we release and discharge, and for myself/ourselves my/our heirs,
representatives, executors, administrator.s, successors and assigns, do hereby remise, release and forever discharge
hereinafter referred to as the releasee(s), his/her/their/its
heirs, executors, administrators, insurers, successors and assigns, and any and all other persons, firms, corporations,
associations, of and from any and all causes of action, suits, judgments, claims and demands of whatsoever
kind, in law or in equity, known and unknown, which. I/we now "have or may hereaftbt have, and/or which the minol'
now has or may hereafter have, especially the claimed legal liability of releasee(s) which liability releasee(s)
expressly deny(les), arising from or by reason of any and all bodily or personal injury and/or property damage known
and unknown, foreseen and unforeseen which heretofore has/have been or which hereafter may be sustained by
me/us or the minor aforementioned arising out of the accident on or about "'~-'L] f[,~' ] ) , '~(_~ / ,
at or near [,i,~'~' f',~.~¢~-u~ , in the County of ~--~~ (Year) ,
in the State of ?J~ , in which the minor aforementioned sustained personal
injuries and/or property damage.
I/We agree that the consideration set forth is specifically applicable to and paid to me/us with respect to any
and all damage to any property, either real or personal, of mine/ours or the minor aforementioned, and with
· respect to any and all personal or bodily injury of mine/ours or the minor aforementioned, whether presently known
or unknown, foreseen or unforeseen or which may subsequently develop and the consequences thereof, all as
arising from the aforementioned accident.
I/We further agree that the consideration set forth above is specifically applicable to and paid to me/us with respect
to any right of contribution that I/we or the minor aforementioned may have against the releasee(s), his/her/their/its
heirs, executors, administrators, insurers, successors and assigns relative to claims of others that may be brought
against me/us or the minor aforementioned by reason of said accident.
I/We further agree that the consideration set forth above is specifically applicable to my/our agreement that I/we
or the minor aforementioned will not join nor attempt to join the releasee(s), his/her/their/its heirs, executors,
administrators, insurers, successors and assigns in any capacity, in any action that may be brought against me/us or
the minor aforementioned arising out of said accident.
In consideration of the aforesaid payment, I/we for myself/ourselves and my/our heirs, representatives, executors,
administrators, successors, and assigns do hereby:
(1) agree to indemnify and hold forever harmless the releasee(s) and his/her/its/their/representatives,
administrators, or assigns, against loss from any and all further claims, demands or actions that may
hereafter be made at any time or brought against the releasee(s) by me/us or the minor aforementioned,
or by anyone in our behalf for the purpose of enforcing a further claim, for which this release is given;
(2) warrant that I/we have received no money or other valuable consideration from any other person or
persons by reason of any causes of action, suits, covenants, agreements, judgments, claims and
demands of whatsoever kind, which I/we now have or may hereafter have, for injuries to person or
property arising out of the aforementioned accident or for the other matters for which this release is given.
Intending to be legally bound thereby, WITNESS my/our hand(s) and seal(s) this day of
(Year)
WITNESSES: (Seal)
Father---Guardian
Mother
Minor
(Seal)
(Seal)
NOTICE: Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance or
statement of claim containing any materially false information or conceals for the purpose of misleading, information concerning any fact
material thereto commits a fraudulent insurance act, which is a crime and subjects the person to criminal and civil penalties.
C-41M-PA 12/99 EXHIBIT C
Exhibit
CONTINGENT FEE AGREEMENT
KNOWALLMEN BYTHESE PRESENTSIthatl, Nile Lewis, guardianofSPENCER
LEWIS, a minor, do hereby retain HANDLER, HENNING & ROSENBERG, of Harrisburg,
Pennsylvania, as my attorneys in this matter to represent me and to process, negotiate,
arbitrate a settlement or to institute for me in my name, any legal proceedings or actions
that, in their judgment are necessary, against JEFF CLARK or against anyone else as a
result of injuries or damages said minor sustained in an incident that occurred on June 11,
2001.
I agree not to settle, negotiate or adjust the above claim or any proceedings based
thereon without the written consent of my said attorneys.
NOW, THERE. FORE, in consideration of the services so to be rendered by Handler,
Henning & Rosenberg, I hereby covenant, promise and agree to pay them for their
professional services rendered, THIRTY-THREE AND ONE-THIRD PERCENT (33 1/3%)
of whatever sum is recovered as a result of settlement without suit; or FORTY PERCENT
(40%) of whatever sum is recovered after suit is filed or in the event of arbitration or
mediation. I will reimburse Handler, Henning & Rosenberg for any necessary expenses
and costs advanced on my behalf in pursuing Spencer Lewis's claim. I also authorize
counsel to destroy said minor's file three (3) years afte, ~;~e cast ~s closed.
Counsel reserves the right to withdraw if they desire to do so, for any reason(s) they
deem proper.
I ACKNOWLEDGE that I have read, approved and understood the above
Contingent Fee Agreement and I acknowledge having received a copy of the same. The
terms set forth are accepted.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~' day of
d Ut--¢ ,2001.
'~NIi'E LEWIS, g~a'~dian of
SPENCER LEWIS, minor
EXHIBIT D
January 7, 2003
Handler, Henning & Rosenberg
SPENCER LEWIS
C/O MR NILE LEWIS
101 SECOND STREET
WEST FAIRVIEW, PA 17025
invoice# 4553 MSC
Our file# 205919 00000
Billing through 01/31/2003
EXPENSES
CASE 01/06/2003 55 50 {
01/06/2003 Vendor PROTH OF CUMBERLAND CO; General Case Expense
17343 01/31/2003 26 30
01/31/2003 ELECTRONIC HEALTH INFORMATION
[COPY 01/31/2003 2 00
01/31/2003 Document Reproduction
[ISI 01/31/2003 4 40
01/31/2003 Document Reproduction
[POS 01/31/2003 1 V0
01/31/2003 Postage Costs
[POST 01/31/2003 0 80
01/31/2003 Postage Costs
55.50
26.30
2.00
4.40
1.70
0.80
$90.70
Billing Summary
Total expenses incurred
Total of new charges for this invoice
$90.70
$90.70
Total balance now due $90.70
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SPENCER LEWIS, a Minor
by and through his natural parent,
JENNIFER LEWIS, and guardian,
NILE HARVEY LEWIS,
Petitioners
JEFFREY C. CLARK,
Respondent
: IN THE COURT OF COMMON PLEAS
: CUMBERLAND COUNTY, PENNSYLVANIA
.
:
: NO. ~ CIVIL
:
: CIVIL ACTION - LAW
:
: MINOR'S COMPROMISE
AND NOW,
Petition,
DER,
2003, upon consideration of the within
IT IS HEREBY ORDERED that the disbursement of funds, including counsel fees
and expenses, is approved as set forth in said Petition and the funds shall be disbursed
in accordance with the terms and conditions of the settlement agreement as follows:
A. Direct payment of two hundred seventy-eight dollars and 20/100 ($278.20)
to Matthew S. Crosby, Esq., representing reasonable attorney's fees and expenses;
B. Direct the remaining four hundred seventy-one dollars and 80/100 ($471.80)
to be placed in an account investing only in securities guaranteed by the United States
Government or a Federal Government agency managed by responsible financial
institutions, bearing the name of the minor, Spencer Lewis, that is marked "Not to be
withdrawn until the minor reaches the age of 18 or without the Order of a Court of
competent jurisdiction."
C. Proof of deposit is to be filed with the Court.
¥1NYA1/LSNN~Id
9~ :5 ~lY h~ N'~,,CF ,60
SPENCER LEWIS, a minor
by and through his natural parent,
JENNIFER LEWIS, and guardian,
NILE HARVEY LEWIS,
Petitioner
JEFFREY C. CLARK,
Respondent
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
NO. 03-250 CIVIL
CIVIL ACTION - LAW
MINOR'S COMPROMISE
PROOF OF DEPOSIT
AND NOW, comes the Petitioner, Spencer Lewis, a minor, by and through his
natural parent, Jennifer Lewis, and guardian, Nile Harvey Lewis, and by and through
his attorneys, HANDLER, HENNING & ROSENBERG, LI_P, and avers that a restricted
account was opened for the said minor, in a Federally-insured savings account, in
accordance with the January 23, 2003, Order of Court, signed by The Honorable
George E. Hoffer, President Judge. Attached hereto, made a part hereof, and marked,
"Exhibit A," is documentation evidencing the opening of the said restricted account for
the said minor.
DATE:
HAND~N~RG, LLP
BY: ~ ~'J
Matthew S. Crosby, Esq.
1300 Linglestown Rd.
Harrisburg, PA 17110
Tel. No.: 717-238-2000
Supreme Court ID No.69367
Attorneys for Petitioner
Exhibit A
nning
osenberg
ATTORNEYS AT LA~(/
Leslie B. Handler, Retired
V,/. Scott Henning
David H Rosenberg [PA, 'FLJ
Caro/yn M. Anner (PA, NY, RNJ
Matthew S. Crosby (PA, NJ)
Gregory M. Feather (PA, NJ)
Stephen G. Held
Jason C. Imler
Robin Strauser
Fulton Bank
Third and Locust Streets
Harrisburg PA 17101
February 20, 2003
HARRISBURG OFFICE
1,300 Linglestown Road
Harrisburg, PA 171 I0
717-238-200O
!-800-422-2224
717-233-3029 Ifa,x)
LANCASTER OFFICE
140A E King Street
Lancaster, PA ! 7602
717-431-4000
DIRECT MAIL TO:
P.O. Box 60337
Harrisburg, PA 17106
www. HHRLaw. com
LorieS@HHRLaw. com
Dear Robin:
Enclosed you will find a completed Retail Account Agreement to open a new account in the name
of:
Spencer Lewis
Tax Identification # 209-78-1408
This deposit in the amount of $471.80 shall be placed in a College Savings Plan Account marked
not to be withdrawn without a court order until Paris reaches the age of 18. His date of birth is
June 19, 2000which means these funds may not be released until June 19, 2018. Thank you for
your immediate attention to this matter.
BANK CERTIFICATIOI~:
Type of Account Opened
Account # I ~//~
Amount of Deposit _
Account Opened By _~~
Sincerely,
Lorie A. Snyder
Assistant Administrator
Term of
_Interest Rate
Withdrawal Restrictions
Court Order Received
Date
EXHIBIT
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