HomeMy WebLinkAbout98-00421
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NATHAN D. MARTIN, a minor by
through his natural parents and
guardians James Martin and
Kimberly Martin,
Petitioners
v.
LITTLE STEPS DAY CARE,
Respondent
JAN 2 6 1998tIJ
: IN THE COURT OF COMMON PLEAS
: CUMBERLAND COUNTY, PENNSYLVANIA
NO. q'j-t(.;:J1 ~~ /~
CIVIL ACTION.. LAW
ORDER
AND NOW, this ~ay of J 2'1') , 199~ it is hereby Ordered that a
Hearing on the foregoing Petition for Leave to Compromise Minor's Action shall be held
on the /1tL: day of *lU~JJ 199:8: at'y :_.i;lo'cJock ,t:l..m. in Court Room No.
. 0
/ at the Cumberland County Courthouse, One Courthouse Square, Carlisle,
BY THE COURT:
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NATHAN D. MARTIN, a minor by
through his natural parents and
guardians James Martin and
Kimberly Martin,
: IN THE COURT OF COMMON PLEAS
: CUMBERLAND COUNTY, PENNSYLVANIA
'I J'. ~.) I c~.;J u.u-
Petitioners
NO.
v.
CIVIL ACTION - LAW
LITTLE STEPS DAY CARE,
Respondent
PETITION FOR LEAVE TO
COMPROMISE MINOR'S ACTION
Pursuant to Pennsylvania Rule of Civil Procedure No, 2039, James Martin
Kimberly Martin, the natural parents and guardians of minor, Nathan D, Martin, by and
through their attorney, W. Scott Henning, Esq., HANDLER & WIENER, petition this
Honorable Court to enter an Order permitting settlement and compromise of this action
and, in support, aver:
1. Petitioners, James and Kimberly Martin are the natural parents and
guardians of minor, Nathan D. Martin, currently age one (1) year old, whose date of
birth is June 27, 1996.
2. Petitioners reside with their minor child at 706 Bridge Street, New
Cumberland, Pennsylvania 17070.
3. Respondent, Little Steps Infant Care and Early Learning Center, is a
business with an address of 700 Market Street, Lemoyne, Cumberland County,
Pennsylvania 17043.
4. On or about June 3, 1997, Petitioner, Nathan D. Martin was in the care
of Little Steps Infant Care and Early Learning Center at 700 Market Street, Lemoyne,
Pennsylvania.
5. On or about June 3, 1997, Nathan D. Martin was caused to have the tip
of his left index finger severed in a doorjamb at Little Steps Infant Care and Learning
Center.
6. As a result of the injury, minor, Nathan D. Martin, suffered a fingertip/
nail amputation of the left index finger. A copy of the medical records from Polyclinic
Medical Center, Holy Spirit Hospital and Ernest R, Rubbo, M.D. pertaining to Nathan's
treatment are attached hereto as Exhibit 00 A 00.
7. As a result of the injury sustained at the Little Steps Infant Care and
Learning Center, Nathan D. Martin was taken to the Holy Spirit Hospital where his
wound was dressed and he was then transferred to Polyclinic Medical Center and
examined by Dr. Rubbo. Nathan then followed up with Dr. Rubbo at Harrisburg
Orthopaedic Associates.
8. Respondent has offered the Petitioners a settlement in the amount of
$15,000.00 as full and final settlement of the claim against the Respondent.
2
9, Petitioners propose to accept the settlement proposal from Respondent
thereby releasing Respondent from any all claims, suits, and other actions arising from
the Injuries in the present case.
10. W. Scott Henning, Esq., of HANDLER AND WIENER, has been the
attorney for the minor in this action and he requests the reasonable counsel fees of
$3,750,00 for services rendered pursuant to a Power of Attorney and Contingent Fee
Agreement signed by Petitioners, plus costs and expenses of $219.76. A copy of the
Fee Agreement and billing summary are attached hereto, made a part hereof and
marked, "Exhibit B".
1 O. Petitioners believe that this Compromise is in the best interests of minor,
Nathan D. Martin.
WHEREFORE, Petitioner requests this Honorable Court to:
a. Approve the Compromise above-stated;
b. Authorize the payment of fees in the amount of $3,750.00
and costs in the amount of $219.76 from the funds due the
minor; and
c. Direct payment of the net funds in the amount of
$11,030.24 from the lump sum payment into an interest
bearing, federally insured savings account with Petitioners,
James Martin and Kimberly Martin, named as guardians for
the benefit of Nathan D, Martin, minor. The account is to
be marked "Not to be withdrawn until minor Petitioner
reaches his majority or without the Court Order of a Court
of competent jurisdiction".
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Dear Sir or Madam: . qqq..--e&, )7C,{.,
I would appreciate at your earliest convenience, your sending me a copy of t''<~lispensary and
hospital records in this case, including admission sheets, history _ physical, physicians' consultation,
operative reports, x-ray reports and discharge summary. Also, include progress records, nurses'
notes, physicians' orders, or anything of a similar nature.
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JUL 2 5 1997
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June 12, 1997
Holy Spirit Hospital
503 N. 21st Street
Camp Hill, PA 17011
ATTENTION: Medical Records
Re: Our ClientIYollr Patient
Date of Birth
Date of Incident
: Nathan 0, Martin
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MEDICAL RECORD DEPARTMENT: This is a case where litigation is pending or contemplated,
Please retain the hard copies of the entire record, including nurses' bedside notes until such time as
needed or until notified by me to the contrary.
X-RAY DEPARTMENT: Please tag all x-ray films of this patient to be retained for possible future
Court presentation. In no event should these films be discarded before notifying my office.
Enclosed is a properly executed medical authorization permitting you to release these records.
If there are any questions as to what portions should be included, please call my office.
cc: James and Kimberly Martin
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CONSqNT ~O ~tIlDlCAL TIUlAIMlltIT
I hereby consenlnnd aulllOrl7.e Iluly Splrllllu'Jlllnl, lIS .gelll', Ill1ti clIIJllllyee" IlIlhe ,enticrlng "r IIIc,lIc.1 Cllle. which IIIny IlIdllde rlllllllle dlagllll,lIe
procedures and sueh medlcallreallllenl as lilY nllelllll1l8 IIr cll,"ll1lg Ilhy,lcllIlI c"",lde,, III he lIec..my. I nl,o o.dcrsllllld III, ell"omary, .h,elll
emergency ol"cll;traonlinnry clrcunutanccs, thnt nn luhlllnrlllRI prncetlurc!i will he l'crfur1l1cd upun me 1I111c!I!I or mull I hRve hntl nn oppurtunlty 10
dllCUII them wllh a phyalclnn or olher health care profc!lJlunnlln lilY 1I11t1l1fncII1l1l. Ir I Rill R l'lIl1lpclcnt ndull, J have the rlghl III COlI!lcnl or rerUi'll:
10 consent to any proposed procedure or Ihcrnpcullc trealment. I wllll1ul he IllvlIlvcllln nllY reseArch or c~pcrllllcnlnlllm"'cdllrc wilhnlllmy full knowledge
and eonsenl, I undersland Ihal Ihe prncllee "r lIIedlellle n.d 'urgery I, ""1 1111 e'"cl ,ciellee .lId Ih.1 dlllgll",I, nlld IreaUlIenl IIlRY Involve rl,ks IIr
Injury or even death and acknowledge Ihnt no gllRrlllllcc hnll heen Illude 10 me 118 In Ihe rC!iIlII!l or IlOY examination or Ircnlll1cnt In Ihlll IImpilnl.
r understand mony of Ihe physician! on lhe ~Inrr lIf IJuly S\,lrllllm1lillllllle lUll CllIllluyccs lit IlI~l'IIlS elf Ihe Iltl'il'llnl. hUI rnlllcr Arc Indc(lelulcnt CI1I\lrncltlrs
who have heen granled the privilege u( u!ln~ Ihcse rllcllllc~ rur Ihe l'IllC IIIltlUClllll1l!ll1 Cll' Ilclr I'llliellls, PUrlhcr, I rcnlllc Ihls IInsJlllnll!~ n teaching
Hospllol nnd at lhe Hospilal ore health care pcuunllclln Irnlnll1ll Whll, unles!II e.'(llrcslil>' rCtIIlC!ilCI 1I1herwilic, nmy IJIlrllclplllc or II1AY he present during
my corc as pari of Ihelr education. Stili nr lIlullon plclures IIl1d c1mcdocltl.lIi1lclcvl'iltlll IIlClllllurllll! uf 1'1I11cIlllollrC lIlay AI!io he lI!icd Ihr educDliullol
purposes, unless I exprc~sly rcque!it nil rwlse
Dale Slgnalure
RELEASE OF MEDICAL INFORMATION
I aulhori7.c Holy Spirit Hospital to releDse 10 requesting health insurance lOnrricr(5), Iheir rcprcscllllllives ami alldilors, and IIny referring health core providers,
such diagnostic Dnd Iherapeutic informallun flncluding any lllfnnnaliclll relllllng In lrclIllIlcrn rur o[gQlli!Lnnd subslance abuse and/or Ircollllenl of DSVChlDlriJ;
disorders. and/or confidential HIV related infonnalion), 05 may he neccssllry fur Ihcll1lo determine bencfit cntitlement; 10 process payment claims for
heallh eare servlees provided during Ihls hospllall7..lIun/lre.llllelll epl,nde, and rnr cnlllinllillg c.re/lreaunelll. A phUlosl.lle or earbun copy or Ihls
authorlzallon shall be considered as errecllve and vnlld.s Ihe urigln.l. The IInderslglled nl,o .lIlh"ri7.e, Medicare, when npplicable. lu release~o anolher
insurance carrier, upon their request, medical information necdcd In make payment upon thnt claim,
I undermnd and eonsent thallhe manuraelurer or any Implanlablo deviee In,erted by my physlci.1I dllring Ihe euurse or my surgery/procedure may be
provided wilh my Idenlificallon inronnallon. I.eludlng suelal se urity number. a, ma.daled by Federal Low.
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Dale Slgnalure Tu Pallenl ~
INSURANCE ASSIGNMENT ( -
lauthorl7.e paymenl dlreelly 10 Holy Spirit Hospllal .nd ror physlei.ns or.1I hellefil, pay.ble under lilY in,ur.nee policies. I undersland I am responsible
10 the Hospital for all charges nol co,,:::! by ~hlS a..lgnmenl and/o pholucopy or Ihi, ."igllmell!.
. Relalloll,hip, K. /I " ,f --
Dale Signature ' To Patienl tr-"\.-I'~
STATEMENT TO PERMIT PAYMENT OF MEDICARE BENEFITS
TO PROVIDERS, PHYSICIANS AND PATIENT
I..quest paymenl of Authorized Medicare benefilS 10 me ur un lilY behalf for any services furnished lIIe by ur illlloly Spirit Hospital ineluding physielan
~CVlces, [authorize any holder of medical and other informAtion nboulmc, 10 rcleascd to Medicare and its agencies any inronnation needed to dctermine
these benefils for relaled servlees. .
DATE: SIGNATURl!:
HOSPITAL BENEFITS/PART AlEFF. DATE:
MEDICAL BENEFITS/PART B/EFF. DATE:
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Ilelalllln,hlp
To Palient
MEDICAL ASSISTANCE RECIPIENT
My signalure certifies that I received a serviee or Ilems frolll Holy Spirit 1I0'pil.1 a.d Dr. on Ihe dale listed below,
I undcrstand tbal payment for lhis service or item will be from Fcderal and State funds, and that nny (olsc claims, statemenlS, or documenlS, or concealment
of malerin! may be proseeuled under applleable Federal and Slale Lows.
I have read and agree with the above statements:
DATE:
RECIPIENT/AGENT SIGNATURE:
RELEASE AGAINST MEDICAL ADVICE
This Is 10 certilY thaI I, . . palienl .t Holy Spirit Hospital. wn leaving the hospital
against the advice of Dr, and the administration. I hove been informed o( the risk involved and hereby
rele.se Ihe physician and the hospilal frum all responsibilily .lId leg.1 liabllily.
SIGNATURE: WITNESS: i'
RELATION TO PATIENT: TIME: DATE:
FORM WITNESSED BY
Dale
Slgnalure
CONSENT FOR TREATMENT/RELEASE OF INFORMA71ON
INSURANCE ASSIGNMENT
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HOLY SPIRIT HOSPITAL
CAMP HILL, PA
ECU.PHYSICIAN ASSESSMENT
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CHART COPY
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Initial Lub 3< X-Ray Ordera:
LlIb. / Urine SpecImen.
I I Acalamlnophan I I ESA
I I Alechol I I Gluea.a
I J Amyl..nlUpa.. I I HCGS
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I J C.rv. Spine Aeulfno
I J Ch.'1 Aln. I Po" I TPA
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I I Fool
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J Abdomen
J Duplex Doppler
J Gallbladder
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Culturell
I I Bela Slrap AG I Cultura
I JCervlcal
I I Chlamydia
I J GC Culture
J CT Scan 01
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Holy Spirit Hospital
Camp Hili, PA
Emergency Care Unit
PhysIcian Order Sheet
2OS.ECU REV. 8I9B JD.DA.MQ
CHART COpy
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J TOil Seroon
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IToa A L
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Medications I IV's I Additional Orders
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:1 Age: --1..L.chos Log-In Time:
,
n Trlnga Tlma:
Time 10 Exem Room:
Modlcnl Conllnnnd AmbulAnco Mnrnhor?
INITIAL OBSERVATIONS:
De8t1netlon:. [ ] ECU [ ] EDF TRIAGEDTO X-RAY:
Oelormlty
Extremity Evaluation: Skin Colorrremp
Distal Pulses
Inlervenl/on:
X-ray 01:
Cnpillery Refill
Pain (1-10)
Paresthosla
R,N, Signature:
Temp:
Last Tetanus:
Resp: 2.A 8IP:
LMP:
Oxygen Sat.
Welght:_ scale/estlmste (II pertinent)
.'~~:7:1:.~
SubJective:
ObJective:
Vllull Acuity: 0.0.
Allergies I Reaction:
Medlcatlon/Dose/Fre uenc
L
O.S.
O.U. With or W1lhout Lenses
Last Dose Medlcatlon/Dose/Fre uenc
Last Dose
10
Past Medical/Surgical History:
"
,
Has pal/ent been exposed 10 measlas, chickenpox or luberculosls In Ihelasl30 days? _ Ves _ No
NURSING DIAGIiQSIa El\P.ECTEQ..OUTCOMES
_Cardiac Output, alteration In _Improvement In cardiac oulput demonstrated by Improved v_so Bnd diagnostic tests.
_Comfort. alteration In _Decrease or relief 01 discomfort
-Fluid volume, al~eraUon In _Improvement I" fluid vol. demonslrated by decrease In symptoms of fluid vol. imbalance
mpalred gas exchange _Improved gas exchange demonstrated by Improved oxygenallon and vital signs
PolenllaVActuallnfecllon ~Decrease In symploms Indicallng Inlecllon or polenllallor Inlecllo
-1nerrecl/ve coplng/Knowledge del. _Improved coping mochanl.m Data Obtelned by:
Admission Callad: Assessment Completed
Reperl Called: [ ] Observallon [ I OA al Dlschargad: t..L ~ I 'JI7
Old Records 10 Floor ~ 3.II.laclory I ] Improved harge Inslrucllons /"CI
AdmlUed 10 at Hrs. DISCHARGE R.N. TIME _-:2.. .32>
Holy Spirit Hospital
Camp Hili, PA
"
.'
2QI.ECU (1/97)
AllY. ',lg7JO,MOo nn
CHART COpy
1 (] b '.\ b 1 ). q "R 110 H E
1l1'l1P, .Hr!U'
7'1& ~ll!!;[ Sf rCd -;,
I: l ,/ C)'\ 'H 'H. A " (l I' l I 707 0 ,~
0..'2111 '1'1', 170-0'150 i:1i
'1'11.';'1,'21"" EO GROIlP . ..!jU. ..
C ~.~ I S H'C . K 80. 8 II SZO"~5~~~..:;j: ~';~~t,6;>;;~;R;;;.
o<>/OH'l1 . ..l' ~,.;-~,,1t"\~-:-;i::;:;:;j~~~~'..hll~"'i,
ECU Nursing Assessment
.~.
Date: .
.
.
.
"
.
A.....m.nt: Time:
,
Vllr,l Sign.
Monllor
Phy.lclon A.....monl
02 SOlurollon
Lung Aooo..mont
VI.uol Acuity
Ollgnoltlcl:
EKG
Lob.
PCXA/Port, C.Splno
Sontlo Rodlology
AOlUrnod from Aodlology
Proeldurll:.
Aooplrolory Troolmenl
lee
FOley Inoerllon
NG I"perllon
Wound Cere
SollnUOCUSllno/Crulcheo
MllelUlnloul:
Poln Scole (0.10)
Lovel of Coneclousness
Slderells
Inleke & Oulput
PeUenl EduceUon Inlo
Olhor:
Time: Inlllals:
,...,'-(< . .....~. -- ."..,~ ~~ -:- - -......",.....,-
"'~- \. 7'7._;" ..,./.,~ ...\{\.... ~9.. "".::-_h _~_
I. _ ~"KV . _.. _:..:. .~.,., ~~. ""'-
~ f.r\ ,^- - . '- 'rJ. ~A A ~~.O.. . :...C:' _...T- .n.. - ~ )
I .....;.+- . /r II' n <..l ~ ...-....
0 ~
IV Therapy
Oil. Tim.
Aile
Control
Amounl Solution Cllh.te,
Slle Alt.
Condlllon Allem II Inlll"'"
Inlllal: ~ Signature:
Inlllal: ..'.'. Signature:
Inlllal: Signature:
Inlllal: Slgnatura:
Condition Cod..: RII.
a-No Inll.m.lIon 3-P.ln Conlrol:
l,Edem. 4-H.rdn.ss 1.AVI
2A,Erylhom. 5-W.rmlh 2.SlalMBsler
2B.Ecchymosls
Holy Spirit Hospital
Camp Hili, PA
Emergency Patient Documentation
J71776. [
1 fl \') '1 ':l 1 \. q 'j '\
II ~ f 1 1'1 ,'i \ 1 II ^" [ell
7'):, ~.\ ~\ ~ (~, L ~ ~l r ~ l I 7070
td I C J 710-0'l'i0
0'./27/1 yiP, to (jROUP '8
q'l'l_O~-21'l~ 004 8b'i20bb4S4~
C Ii 'II S i\ l" . ~
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I,.
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CHART COPY
\71'1) 76JOZJ1.' .r1.17)76J,24.. .' . . . ;w.;........ .:,' .. "':.";11"\ 'I-~... ..;". "i"~'i.""
'>'H" ~",'l.... ".'''~', "';. '. 1", 1..\~.";"I'''~ '\.""'i\"'~ l
'lM,umlnlll~i~I~" , . ~velt(~I\"dlnthe " . , Unl;'(na;)~.\':'~nrl . . ~mr;.e~ib~I.,on~ "hvtl':,ndedl...llhU '~ndrlll'llIrlU\'hle
C.OfUr'flt mtdl~1 Cale, I , 'to' e op new problfml ~comP. c.d~ canllel ,our rhYltcla.a,O!., . '. :.; " ~Cut.~!!~~~.1'fm INSrnUc:nON5 CIII!CKl!D lIur.ow. .
SPEClrolC INSTRU~IONS: Follow U'eaclo,!t,n!cUona.1f Utey.dllle: IrOl~ Ul~ paUenllnlorma4i!l' ~heet.".. ,... 0'.
WOUNDCARE' .,.' I. ".',.'.._..... --;. .iJH.' ,;'t".'OIlOWUP iD.."'"'/..I.... '.
-------- ~. " ." . '.'f"':'('-' . t",-\.,., "...,. ~--_._~----~--lJ.D,I,if,. "",1~'4o' .....
Oltclom.lorautu"!."lIlovalln '. 'da~..." ~~:' '.' ,-\.;:.;..~.!.; 'ORcturnlo'JJ/:ilJ'l.PHCpn' ,.. ...., lurBlecheck.
o Change dre..lng '. r'-. -., " 0 See youq\hyalc:lan orapeclollallf nol hener In_dny..
and apply' tllIle. a day until Iteturn IIII!CU II unoblo 10 do all.
o Telanui/dlplllherla booster:glven. I, 0 See Ininlly I compony phyalclon I rllc on _lor
"'~ [] ttccllcck II Suture rell1uvnl
SPKAIf'/SlDRUISES . 0 Pick up your x.rnya lrollllhe Rodlology Oepl. IIn Ihe 20d noor
o llIevote Injured port obove heort for _doy.. helure going 10 doctor'. uffice. (Call 763.2696 belllle ocrlvol.)
DAce 0 Sling 0 Spllnl 0 Cnuche. lor_dny. 0 Vour blood pre"lIre wn. . I'leo,e gel It rechecked
o Apply: 0 Ice 0 lIe.1 0 Altem.lelce and heol lor hy your Inmlly doctor.
. _mlnule._limea a day untllaymploll1 Iree.
o Wear cervical collar-for _daya.
ADVlTlONAL INSTRUCTION
o orr work I .chool: rrom
[) Return to work un
o Llmltotlon:
o No gym or .port lur _dny,.
o See Workmen's Campen sheet.
,If.
10
. 0 Llghl 0 Regulnr duty.
MEDICATION INSTRUCTIONS
o Take__BSpirlno Tylenol or Advllevery_huu15.
o Take Ute lollowlng ( O.T.C, ) medicine.
I.
2,
3.
4. Yllur regular medleinea excepl
o Do nol drive or operate any' machinery while taking
\ /1.' -,-'
(JfHERGt>'4~'~ ~~~d~
. PATlENT INFORMATION: PllU.entlnfonn.tlon sheets contalnimpUrt:n1 h;formntlon to review BlId keep.
'..., \
o Abdomlnol poln ''-.. 0 Comeolab""lonlforelgn body 0 lIypenenslon {( 0 PIDIVD
o Alcohol abuse 0 CrouplbrunchJtis 0 ImmunlzationsJlcu\nus 0 Rash
o Atlergic reaction \ 0 Crutch walking a KIdney stones Q Seizure
o Anlmol bile 0 Diarrhea and Vomiting IJ Lnceratlon 0 Sore throat
. ,_0 Asthma . ..... 0 DrupAlcohol abuse/addiction U I"ck stroln 0 Sprains and strain.
, 0 Dick'paln 0 Fcbri1e convul5ion 0 NO!i~bleed 0 Threatened miscarriage
o Bites.HumanJAnlmaUlnscct 0 Fever 0 Otitis media 0 Toothache
o Bwn 0 Flu 0 Pedlotric levcr 0 URI and colds
o Chest' pain 0 Fracture 0 Pediatric head injury 0 UTI and pyeloncphrilis
o Conjunctivi~s 0 Headache a Pediatric URl 0 Other
o COpO......... . 0 Heod Injury ~pedi tric vomiting
,~"n;r;-terprt:lIdonorYOUrllof'lYls.prell~zepoi1. The films wUl be rcvlcwtd by a radioJoglu and PATIENTVERDALlZES UNO. ERSTANDlNG .
....)'OU.~ yourdoctor wlY,be Informed If lhere Is. change In diagnosis. I hereby acknowledge receipt of
tbesc tnftluctions and equipment and undtntand !hem. I undmtand that I have had emergency tn:atmcn 7L~' ~~
onJyand thal I may bc released bdorc aJl of my mcdlcaJ~blemsareknownortreaLed.1 wUlurangc SIGNATURE: I <J<71 Vl/~'/n4/'/ ..,....,
forfollowupcltCulhavcbecnlnstrucLed. . . lor'1rn~' 7
.-... ...,. ,...., ... ' '" ..
Signatures:
M.D,
R.N.
-
~
HOLY SPIRIT HOSPITAL EMERGENCY CAKE UNIT
503 NORTH 21ST STREET CAMP HILL. PA 17011.2288 (717) 763.2316
( ) Vanllho Abraham. M.D. 03BB40L ( ) Rohen Ilynick. D.O. OS lXJ4.IOO-L
( ) Thorn.. Aldous, M.D. 017075E ( ) Richard Luley, M.D. 029960-1!
( ) SoIvatore Alfano, M.D. 025502 ( ) Phillip Maguke, M.D. 015063-1!
(~b-Aro{a, M.D. 0167271! ( ) Lnwrence Poul. M.D. 039524-
( O"n Da~gllt/y, OSl1067761! Frank Procopio. 3643.
()10nDu ...0.0.05 () . Sh 65-
DATE
G
( ) Dnvld Spurrier, M.D. 023502-1!
( ) Alan Teplis, M.D. 0300IB-1!
) Elaine Thallner, M,D. 0
an, .D.l105636.1!
-.....
SIGNATURE
OI!AN
REFILL
TIMES
RODj1.crro BB DISPENSED, TilE
,
''':~,
OLABEL
D SUBsmvnON PERMISSWU!
. .,.
;/
"
"............. ... ....
,. . ,.. ........... ........... ...... .. . .
HARRISBURG ORTHOPAEDIC ASSOCIATES, p,C" Harrisburg, PA
MARTIN, NATHAN D
ACCT' 52765
CHART' 971635
6-5-97 (Rubbo)
- 2 -
Continued
The
own.
visit,
other option is that it may turn black and granulate on its
We will see him back early next week for a follow-up
(transcribed 6-9-97 gb)
TK Faxed to Dr, Coldren 6-9-97 gb
6/5/97 XRAY REVIEW (Left Index Finger and Hand, 2 views): Xrays
show the soft tissue amputation from the index finger with no
sign of bony involvement at this point. Otherwise, no abnor-
malities are seen, (Dictated by Frank Horner, PAC _ transcribed
6/19/97 Irah)
6-9-97 (Dr. Rubbo) Nathan is fOllow-up for an avulsion injury
to his left index finger, His Wound appears to be healing nicely
and his fingertip does appear to be black and the skin graft is
not going to take, However, at this time I will allow it to stay
there and as a scab, There is no evidence of any infection, The
patient is not crying and appears to be very happy and content,
At this time I have told the parents that I would leave things
as is and continue with his dressing changes and it is okay for
him to soak his finger in a bathtub, We will see him back in one
weeks time for a follow-up visit, (transcribed 6-11-97 gb)
TK Faxed to Dr, Coldren 6-11-97 gb
6-12-97 (Dr. Eshbach)
DIAGNOSIS: Partial fingertip amputation left index finger
6-3-97,
Nine days following injury being followed by Dr, Rubbo who is
not here today, The mother was concerned about some Possible
drainage or other problems with the fingertip,
Examination today, however, shows the blackened tip which is not
shrinking down much and with very healthy margins appearing just
proximal to it, I could not express any pus or note any cavitary
type defects beneath the re-sutured tip, I have a feeling that
this is going to do very well and certainly I saw no evidence
for any problems at this time. The finger was re-dressed, and
the patient should return in about one week for ongoing
fOllOW-Up, (transcribed 6-13-97 gb)
',:
t!
I,
'/
I .
I
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( ~
l~,
HARRISBURG ORTHOPAEDIC ASSOCIA'l'ES, p, C, , Harr isburg, PA
MARTIN, NATHAN D
ACCTIt 52765
CHARTIt 971635
TK Faxed to Dr, Coldren 6-13-97 gb
6/16/97 OFFICE EXAMINATION (DR, RUBBO)
Nathan returns today, He has had the recent fingertip injury,
left index fingertip appears to be black and eschar looks like
it is going to falloff shortly, There is some slight redness
but no sign of infection at this point. He will see myself or
Dr. Rubbo one week here in the office; sooner, if the finger-
tip begins to falloff,
(Dictated by Frank Horner, PAC transcribed 6/17/97 /rah)
TKFAX sent to Dr, Coldren
6/5/97 XRAY REVIEW (Left Index Finger and Hand, 2 views): Xrays
show the soft tissue amputation from the index finger with no
sign of bony involvement at this point, Otherwise, no abnor-
malities are seen, (Dictated by Frank Horner, PAC - transcribed
6/19/97 /rah)
HARRISBURG ORTHOPAEDIC ASSOCIATES, P,C" Harrisburg, PA
M;.RTIN, NATHAN D
ACCT# 52765
CHART# 971635
TK Faxed to Dr. Coldren 6-13-97 gb
Page 3
6/16/97 OFFICE EXAMINATION (DR. RUBBO)
99211
Nathan returns today. He has had the recent fingertip injury,
left index fingertip appears to be black and eschar looks like
it is going to falloff shortly. There is some slight redness
but no sign of infection at this point. He will see myself or
Dr. RUbbo one week here in the office; sooner, if the finger-
tip begins to falloff.
(Dictated by Frank Horner, PAC transcribed 6/17/97 /rah)
TKFAX sent to Dr. Coldren
6/5/97 XRAY REVIEW (Left Index Finger and Hand, 2 views): Xrays
show the soft tissue amputation from the index finger with no
sign of bony involvement at this point. Otherwise, no abnor-
malities are seen. (Dictated by Frank Horner, PAC - transcribed
6/19/97 /rah)
6/23/97 OFFICE EXAMINATION (Rubbo, Ernest R. MD)
99211
Nathan returns today. His left index finger the soft tissue
amputation that is necrotic is now beginning to falloff, The
area looks clean and dry underneath it, They continue to clean
it with peroxide daily and it looks like it is coming along very
well. I expect the necrotic tip to falloff. I have given
instructions to the mother and she will follow-up with myself
and Dr. Rubbo in a week or less, as scheduled,
(Dictated by Frank Horner, PAC transcribed 6/25/97 /rah)
TKFAX sent to Dr. Coldren
f
,
7-1-97 (Dr. Rubbo) Nathan is follow-up for an amputation to
his index finger of his left hand, This appears to be healing
very nicely by secondary intention, The open area measures
approximately 4-5 mm in circumference, He is using his hand and
has no dysfunction. His nailbed appears to be growing in nicely.
j
At this
there is
him back
gb)
,..;
time
not
if
I have told the mother that
that much more that needs to
he has any further problems.
he is doing well and
be done, We will soe
(transcribed 7-14-97
,'I
TK Faxed to Dr. Coldren 7-14-97 gb
HARRISBURG ORTHOPAEDIC ASSOCIATES, P,C" Harrisburg, PA
MARTIN, NATHAN D
706 BRIDGE ST
NEW CUMBERLAND, PA 17070
ACCOUNT# 52765
CHART# 971635
6/3/97 SEEN AT PH-PH (DR, RUBBO)
This is an ll-month-old white male who was at the daycare center
in Lemoyne and had his left index finger pinned in a door. He
unfortunately avulsed the fingertip and was seen in the ER at
Holy Spirit Hosp, He was subsequently transferred to Polyclinic
for further evaluation and treatment,
His past medical history is significant for otitis media, which
he just recently started Amoxicillin,
His physical examination shows avulsion of the nail as well as
the fingertip just the tip of the proximal phalanx, Under
sterile conditions, a metacarpal block was carried out to his
left index finger and then the fingertip was repaired to the
finger. The fingertip skin did appear to be white, dysvascular
but we will use this as a skin graft and hopefully this will
heal,
IMPRESSION: Avulsion of the fingertip with nail avulsion, left
index finger,
PLAN: The patient today under sterile conditions had a repair
of his left index fingertip, The fingertip was repaired with
6-0 Monocryl type suture after undergoing thorough irrigation.
The plan is to see him back in two days' time in the office for
removal of his dressing. He is to continue with his oral anti-
bio~ics as well as type Tylenol elixir for pain, (transcribed
6/4/97 rah)
TKFAX sent to Dr. Coldren
6-5-97 (Dr, Rubbo) Nathan is an ll-month-old white male who
was at a daycare center and unfortunately got his right index
finger caught in a doorway, He avulsed the fingertip as well as
the nail and had this repaired in the cast room, He is now 2
days post injury for a dressing change, His wound appears to be
healing nicely and the tip of his finger actually has some color
to it and does not appear to be black,
At this time, I have redressed his hand and have asked him to
return early next week for re-evaluation, I explained to the
mother that the fingertip may take and heal as a skin graft,
,~
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HANDLER AND'WIENI:R
LESUE D. HANDLER
lAIC J. WIENER'
w. aeon IlCNNINQ
O....VID II ROSENBERG"
ATTORNEYS AND COUNSELORS AT LAW
319 MARKET STREET
P.O. bOX 1177
HARRISBURG. M. 17108
C....ROL VN M. ANNER
MA TlMIW S. CROSbY
SAMU~I. IIANnlIII11171./111
'ALSO AOMIII[I) CONNICIICUT
.-AUIIf Ao~mtr"(V'''ln'
\ ~ I ,
1\ .r,' ~ 1/." '
- ~'.", J~'t.
.. '.(l.I"
r
FAX TRANSMITTAL MEM7/~':::>'\--....
\. (Ii' '\
------.- ...~
17171 :!:31.R021
lAX NO.17171134,1a02
DATE:
July 17, HI97
II.")
--'.
TO: Karef,l - He~lth Information - Polyclinic Modical Contor ,,~;~:.-
COMMENTS: Nathan D. Martin
We spoke on the phone today about our office rcquostlng modlcal bills
regarding Nathan D. Martin for an incident that occured on 6/4/97, I
have been advised by Nathan's father that they were soen in tho CDBt
room. Please forward any and all medical records regarding Nathan's
treatmellt for an Incident tha t uccurt:t.1 011 6/4/97, -,- r'\
} , KL-'
'll{ .Jj
1./) - LV
<I (",
. .
NUMBER OF PAGES FAXED (INCLUDING COVER SHEET): 3
FROM:
Becky King
Handler and Wiener
P.O. Box 1177
Harrisburg. PA 17108
717-238-2000
I=ax: 717-234 1802
*'00::>(
7...'J.I. C'(' 7 .
/ / I/.XJ;J
. .
IF THERE IS ANY PROBLEM. PLEASE FEEL FREE Tn C':ALL us.
IF THIS COMMUNICATION HAS 1lt:I:N ItI:CEIVED IN EIUIOR. PLeAse NOllPV us IMMEOIATELV.
THE INFORMATION CONTAINED INTHEFAX MESSAGE IS TRANSMlrTED BY AN AnORNEY, OR HIS/HER
AGENT. FOR THE SOLE USE OF THE INDIVIDUAL(S) OR ENTITYIIESI TO WHICH IT IS ADDRESSED, AND
MAY CO NT AIN IN~UHMATION THATl5 PRIVILEGED, CONfiDENTIAL ANI) El<EMM' rnOM DIGCLOGURE
UNDER APPLICABLE LAw. IF THE READER OF THIS MESSAGE IS tm! TIlE INTENDED RECIPIENT.
PLEASE BE ADVISED THAT ANY DISSEMINATION, DISTRIBUTION OR COPY OF THIS COMMUNICATION
IS STRICTt.V PROHIBITED,
m'd 8869c8.'.
O.l
hlml:J eS;:r.l 1.66l-.'.l-T1r
.. I,. ". ,.
.....
,
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,
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POWER OF ATTORNEY
AND
CONTINGENT FEE AGREEMENT
KNOW ALL MEN BY THESE PRESENTS, that we, JAMES AND KIMBERLY
MARTIN, parents and legal guardians of NATHAN D. MARTIN, do hereby retain
HANDLER AND WIENER, 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 judgement are necessary,
against LITTLE STEPS DA YCARE, or against anyone else as a result of injuries or
damages sustained by NATHAN D. MARTIN, in an incident that occurred on June 4,
1997.
We agree not to settle, negotiate or adjust the above claim or any proceedings
based thereon without the written consent of our said attorneys.
NOW, THEREFORE, in consideration of the services so to be rendered by
Handler & Wiener, we hereby covenant, promise and agree to pay them for their
professional services rendered, TWENTY-FIVE (25%) of whatever sum is recovered
as a result of settlement without suit; or THIRTY-THREE and ONE-THIRD (331/3%)
in the event of arbitration, mediation or if suit is filed, We will reimburse Handler &
Wiener for any necessary expenses and costs advanced on our behalf in pursuing our
claim.
Counsel reserves the right to withdraw if, after complete investigation, they
determine that there is no merit to the claim.
WE ACKNOWLEDGE that We have read, approved and understood the above
Contingent Fee Agreement and Power of Attorney and We acknowledge having
received a copy of the same. The terms set forth are Dgreeable.
IN WITt\jESS WHEREOF, We have hereunto set my hands and seals this ~~-tl
day of '-- 1. GL/l...-L- , 1997.
J{n,lf 'II!. il/
, , I
,
(SEAL)
JA 'S M RTI , parent and legal
) ardian of NATHAN D. MARTIN
/' i ;',' .../
. (1 / '/ /, (~I !Jh ///.'/ (SEAL)
KIMBERLY MARTIN, parent and legal
guardian' of NATHAN D. MARTIN
...E~BIT;',
.....':(' .'. .:,;.;:....j-:
-
-,
,\
\
lI....lIl1"r Itllll Nl..nr'f
. hllllllll tlllu.k"",,"I' W. Rc:utl 1If1lllllm,
lint." .., IAnt 11111
. Ilntll .., I lUll IfOmltlll"1'
, I"nt 11111 t hll)II~lh tlnt41
. hl1) tVII" COlin R-'
nellllll 1.0 II" tnh""
II 111.1 hi t I
1 .. "I.. ....mind"..
:I ..ltl"O,,"" 0111 V hi t J
.
.
""m'MI'V oll1V
full IInt"ll
f1umm"ty w!,u11Iltfllll,n
Doc~mbnr 12, 1991
CIHH'lIt
]0 tlnyn
." 11,1)'n
'0 IIIlY"
120 d..y"
,DO
,DO
,DO
,DO
,DO
Dl1 hI! through 12/12/91
0111 numbor
202397.00000-001 WSII
NATHAN D HARTIN
1006 BRIOOB ST
NBN CUMBBRLAND PA 17070
DISBURSEMENTS
0&/JO/97
07/01/97
08/06/97
10/0./.,
IO/Hi/97
12/04/91
12/12/97
12112/'7
12/12/91
12/12/fJ7
12/12/97
12/12/97
12/12/97
DILLING SUMMARY
hll1lnq Crr.qul!nc:y A-12
lnnt rnymmlt
bl111n9 tonlJlntioll
o .
correspondence Management
lIarrhburg Orthopaedic Association
Polyclinic Medical Center
Correspondence Monogement
lIorrisburg OrthopAedic A88ociation
Photography COBts
Proth of Cumberland County
Proth of Cumberland County
Miscellaneous
Document Reproduction
Document Reproduction
Postage Coats
Postage Costs
miltter 00000
30.99 5051 06/30/91 30,99
15.00 5146 0'1/01/97 15.00
16.01 5270 08/06/97 16,07
18.61 5057 10/09/91 18.61
5.00 51'1G 10/16/97 5.00
l. 00 PilOT 12/04/91 3,00
45.50 ./ 1CUM 12/12/97 45.50
5.00"" leUH 12/12/91 5.00
50.00/ MISC 12/12/97 50.00
2.40 COPY summary 2.40
21. GO ISI 8umm., ry 21.60
!L12 PUS 8ummary 5.12
1.47 POST summ.'1. ry 1,41
._--......
$ 219.16 219.76
Totol disbursements for this matter
leUM 50.50
5057 49,60
5146 20.00
5270 16.07
COPY 2,40
ISI 21.60
MISC 50,00
PilOT 3,00
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