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Home My WebLink About98-00850 IlI\'l'~: fYbJduk./!l11 CASE 00. '8' ' CDJR'l'\UJol 8 ).{ 00. q ~. ~ 5:0 CIVIl. 1.8 % (}JJ()./iI 'f(. <7Atr1./"~ :::;~ ~O~~r;: 4...23' ))~~ d.~ l~iV/)r~, &.89 ~{j, 9tr)LVIi;~ bJ_ 6.1I~~ Yh"p, y. 7l1~ 7.8/S ~(j: ~ It.N,(;'J, ~-1~ (7~":Hk . 'b~ 9.8 J 7 '-;p{j;.~ ct r1ah~ 10.,,;20/' YJfClAJitu.(()~ 9Jf 11...L5 f}dl- ///. /1/, ~drhU ~ \ 12.8 ,#0 _71MJcY ~IUIJr'.-iI. - 13.8 ~I 4itjl/Jp/, ld YJfoo0- I ~ 6t '~ ~4 :::;f ~A.~tsll~~ ~~ Hi.8 i'-f l~ ';f ~.,y~~ ~ 'V 17.8 I ~~13tJ~J; 9' 18.11 17 '7Jtu.lo;L f' t./J;JJ~/lA/ 19.8 7 fJ!.!!-u./L 11. YlW.iPd 20.8 ~ 7kwJ~~, ~L 21.H 1/ >P"tucL;l{J ~_ . 7' 22.8 23.8 24.8 '79A/>>nd/ Jjy~~ 25.ft 26.8 27.8 REQUESTED POINT NO.2 Plaintiffs' Burden of Proof - Causation The mere existence of negligence on the part of Defendant and the occurrence of the accident or Injury are insufficient to Impose liability on Defendant. Plaintiffs have the burden of proving that the negligence was the proximate or legal cause of the Plaintiffs injuries. CITATION OF AUTHORITY: Ostrowski v. Crawford Door Sales Co. of Scranton, 207 Pa.Super. 424, 217 A.2d 758 (1966). G Given Refused Covered Withdrawn . <""''/ ~ REQUESTED POINT NO.5 ,<:, I Plaintiff' a Burdan of Proof. Medlcel Qolnlon on Causation The Plaintiffs have the burden to prove by expert medical testimony that the accident caused the various injuries and disabilities that the Plaintiff complains of. In order to sustain that burden of proof, the medical testimony by the Plaintiff's physicians must state specifically that he believes, to a reasonable degree of medical certainty, that the accident caused the injuries and disability complained of by the Plaintiff. If the medical expert does not state his opinion with that degree of medical certainty in his testimony, then the testimony of the medical expert is insufficient to sustain the Plaintiffs' burden of proof. CITA TION OF AUTHORITY: McCann v. Amy Joy Donut Shops, 325 Pa. Super. 340, 472 A.2d 1150 (1984) I , I , i "'-\, Y , I r " Given Covered Withdrawn Refused ~ ..~.. '~' { REQUESTED Po/NT NO.6 i I , L /: e ~~ Plaintiff's Burrlan of Proof - Nacesslty of Treatnwlt , " In order for you to compensate Plaintiff for the medical treatments that she claims to have undergone as a result of the accident, she has the burden to prove that the treatment was necessary for injuries that she has proved by expert medical opinion testimony, given to a reasonable degree of medical certainty, resulted from the accident. If sha has not provided you with such evidence of causation and the necessity of treatment, you may not compensate her for undergoing the treatment. " i ',.. I' CITATION OF AUTHORITY: Christy v. Da", 78 Pa. Cmwlth. 354, 467 A.2d 1362 (1983). ry' ~.I'- , ~~I Given Refused Covered Withdrawn ~ - REQUESTED POINT NO.8 Future Consequences of 'niuries - No Speculation You may not estimale damages based on conjecture or speculation about what might happen In the future. CITA TION OF AUTHORITY: Lorch v. Elgin, 369 Pa. 314, 85 A.2d 841 (1952) .' trlr J V-/ \,1 ~ Given Refused Covered Withdrawn ctJ REQUESTED POINT NO. 12 Charge on Damage Reoulred I am obliged by the duties of my office as a judge to charge you on the issue and manner of demages. The mere fact that I do so does not indicate nor should it be considered by you as any indication that I think damages should be awarded. I am giving you these instructions on damages simply because I am required to charge you on all phases of the case that you may have to consider. CITATION OF AUTHORITY: N/A y Given Refused Covered Withdrawn i () <D 0 C '0 --., ::-- - =:J -Of:'; -~ :;',. r:if!J r;l~n "=' ...:.:.. , ""~ ,;;:~ i . 0-),,:. 0'. :tJ -.:, .~. ell '~~l~) -0 ;~ 11 )-: >., () :~.: :~Jt~ :~;~'8 ~ Offl -..J 3 " ~ -.;, '0 -< , I J t': . l' ~. . }; . ~ '}" ::4- Iq. I i\: 'I. i \ , , PLAINTIFFS' POINT FOR CHARGE NO.2 The damages recoverable by Mrs. Sgrignoli and the items that go to make them up, each of which I will discuss separately, are as follows: a. Past Pain and Suffering; _D._.--Fu tUl"ef"i:',i fri' "aii2ts~f'f'~';;: ing; " c. Embarrassment and Humiliation; d. Loss of Enjoyment of Daily Life Activities; and e. Disfigurement. Pa. SSJI (Civ.) ~6.01 - Injuries to Adult Not Resulting in Death. PLAINTIFPS' POINT paR CHARGE NO.6 Fear for one's future emotional and physical well-being is another element of pain and suffering. This is true of the emotional reaction in the past, as well as worry, apprehension or concern over the future. Walsh v. Brodv, 220 Pa. Super. 293, 286 A.2d 666 (1971). \/9 \, \j PLAINTIFFS' POINT FOR CHARGE NO.8 The disfigurement which Mrs. Sgrignoli sustained as a result of this accident is a separate item of damages recognized by the law. Therefore, in addition to such sums as you award for pain and suffering and for embarrassment and humiliation, Mrs. Sgrignoli is entitled to be fairly and adequately compensated for the disfigurement she has suffered in the past as a result of this accident, and-wi+ieh-she-w-i-lL.continuE!-to-srrffer--dur,ing .the...fut.u:r.e.. dur~on...of-hel'~Hfe . -- Pa. SSJI (Civ) 6.01H; Frankel v. United States, 321 F. Supp. 1331 (E.D. Pa. 1970), aff'd, 466 F.2d 1226 (3d Cir. 1972); Rooers v. Moodv, 430 Pa. 121, 242 A.2d 276 (1968). J' - _./ '.., PLAINTIFFS' POINT FOR CHARGE NO. 10 The law provides that if a person goes through life with a reasonable degree of happiness and is involved in a motor vehicle accident where her pre-existing condition is aggravated and/or exacerbated, the accident victim may bring a claim for the aggravation and/or exacerbation of the pre-existing condition. r: \ \ I I ~ I, M: I , 1 , ~ , . :,' Meyers, Pennsylvania Vehicular Neolioence, ~2816 - Pre-existing Condition or susceptibility. '\ / J i \ PLAINTIFFS' POINT FOR CHARGE NO. 11 The fact that Mrs. Sgrignoli had a pre-existing condition before this accident does not mean that she is not entitled to recover if these problems were aggravated or exacerbated as a result of this accident. If you find that her condition was exacerbated by the accident, you may award her such monetary damages as you feel that she would be entitled to. The Defendant must take her victim as she finds her. Lebesco v. Seota, 251 Pa. Super. 415, 380 A.2d 848 (1977). r o PLAINTIFFS' POINT FOR CHARGE NO. 12 In other words, Mrs. Sgrignoli contends that the motor vehicle accident aggravated her cervical spine condition, necessitating the surgery. Lebesco v. Septa, 251 Pa. Super. 415, 380 A.2d 848 (1977). " lA' '~j "/ M'>- ..." .~ \-" ,. ",'" \ ' . " " t,. ttY /.r ", .. I. .,.;-. \..-. C. l~~ ,,(. " '}r" I ,,.,~ tV d .. ...-:;....... /'\.... /"V,\ \ I. .... ..:,,,~'.,.:" ) \....l". ~ \. .,..... ...' ,ft. "/'''; ~ \y~'''~'' C' '>..v.' --" . "I"}-ttv if ;1('f'O' _ ~' ./ ...;:/ 'I ,J.r/ J;:/ ..." , ',1' I ' " ., VI." .,' " , ~,~ " l:A., \ , " .f" " . .:l l,"'''''''''''''' C'" .y f'" ',,' . 1'"' ;, \ ,., ;' .!.:. '. .of" " \ \.,-\ \. l, '() \"'''~ .\ ..1, " ) IJ'" ,A , :'. \;1 ,/ ''t- v (" .J 'f ", \ \, " .' ~ .1' \" " l'i."'" . ..1., y,"i' ),1 .' '\.' , \ ., c' .,l.: \'\ " ., . t.>.;" U "N'''.. '4 ~. ,\.~..' ,.J. '\, \p"/ " '"" DEBRA E. SGRIGNOLI and TERRY SGRIGNOLI, Plaintiffs #8 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA V. CIVIL ACTION - LAW RELLA SMILEY, Defendant NO. 98-0850 CIVIL TERM PRETRIAL CONFERENCE At a pretrial conference held February 24, 1999, before Edgar B. Bayley, Judge, present for the plaintiffs was David L. Lutz, Esquire, and for the defendant, C. Roy Weidner, Jr., Esquire. This is an automobile accident, a case in which defendant admits negligence. Plaintiff, Debra E. Sgrignoli, claims general damages for cervical spine injuries, including a cervical sprain, as well as an aggravation of a pre-existing condition which she maintains resulted in her undergoing an anterior cervical discectomy and fusion at C4-5 and C5-6. Terry Sgrignoli's claim is for loss of consortium. Estimated time of trial, one to one and a half days. / ," Edgar B. I Bayley, ~)' David L. Lutz, Esquire 4503 North Front Street Harrisburg, PA 17011 For Plaintiffs C. Roy Weidner, Jr., Esquire 301 Market Street P.O. Box 109 Lemoyne, PA 17043-0109 For Defendant ----. - :prs c.... ,,., 0 C <D ...., :,.... ~ :.::J --,. -nc~ n" .' :1J U.lL:.' I:;' \1r::: ......1_.' N ,.r~ "?i, ':.~~ ...'1,C C'" '5 -<. .... ~..'lC.) i;~:CJ ~':" _...~1"t ,.'-'~c; ." ,c-:1S ..... ..Jl. 'j~ ~~~ ~ :;':rn U -I ...~\ - ~ :< ,. ~ I" .... ~ "- FER 1 8 1990-- J {)' Johnson, Duffie, Stewart & Weidner By: C. Roy Weidner, Jr. J.D. No. 19530 301 Murket Street P. O. Box 109 Lemoyne, Pennsylvuniu 17043-0109 (717) 761-4540 Allomeys for Defendunt DEBRA E. SGRIGNOLl and TERRY SGRIGNOLl IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 98-850 CIVIL Plaintiffs v. CIVIL ACTION - LAW JURY TRIAL DEMANDED RELLA SMILEY, Defendant DEFENDANT'S PRE-TRIAL STATEMENT PURSUANT TO PA. R.C.P. No. 212.1 I. STATEMENT OF THE CASE This Is an automobile liability claim arising out of an accident which occurred on June 13, 1997. Causal negligence for the accident is being admitted by the Defendant. II. TYPES AND AMOUNT OF DAMAGES CLAIMED Mrs. Sgrignoli claims cervical sprain and aggravation of preexisting condition, necessitating an anterior cervical discectomy and fusion. She claims unliquidated past and future medical expenses, loss of eamlngs and earning power and the usual non-economic losses attendant to such a personal injury claim, such as pain and suffering. Mr. Sgrignoli claims a loss of consortium. III. NAMES AND ADDRESSES OF DEFENDANT'S WITNESSES A. liability None. B. Damages None. ',' B. Summary of legal Issues . ~--~-'\:"':::-~-~::"':;:. 1. liability None. 2. Damages a. Whether Plaintiff is entitled to plead, prove and recover economic losses (medical expenses and wage loss) in light of the preclusion contained In Section 1722 of the MVFRL. C. Status of settlement negotiations 1. Plaintiffs demand - $90,000 2. Defendant's offer - $12,500 Respectfully submitted, JOHNSON, DUFFIE, STEWART & WEIDNER By: Dated: February 17,1999 :120167 'i '. tt .~ '.. . PennSta\.~ Geisinger Health System Section or Neurosurgery M.C. HIIO P.O. Box 850 Hershey, PA 17033.0850 7175318807Tel 717531 38SBFIlX Stephen K. Powers, JII.D, Seclion Hend October S, 1997 Mr. David L. Lutz Anglno & Rovner, PC 4S03 N. Front Street Hanisburg, PA 17110-170S RE: Debra Scrignoli HMC# 823941 Date of Accident: 6/13/97 Dear Mr. Lutz: I am responellng to your letter dated August 26, 1997, regarding Debra Scrignoli, who as you may know, has recently undergone surgical decompression of her cervical spine. She was hospitalized here on an outpatient basis on September 2S" and underwent anterior cervical discectomles and fusions at C4-S and CS-6, using a bone graft. She is still In the early postoperative phase, and I expect her to be in a hard cervical collar for an additional four weeks from the time of this dictation. In terms of responding to your letters sent to me regarellng this patient's neck injury and Its relationship to the recent accident, I can only state that It Is clear from the records that Ms. Scrignoli bas had problems with her neck and her hands, which I think are secondary to her neck, for well over a year and probably by her history, extenellng back to an original accident 17 years ago. It may well be that the recent accident oUune 13, 1997, pushed her over the edge and led her to seck medical attention once and for all, but It certainly did not cause the neck condition, and at best, it may have contributed to it in some degree. There is very little further that I would add to this, except to state that If questioned in the future as to the causation of her neck injury, I would certainly deny that It Vias related to the accident of June 13, 1997, and at best, her neck condition was only worsened enough to cause her to seek medical attention following that accident; whereas, in due time, she would bave probably sought medical attention without any trauma initiating her seeking surgicnltreatmenl Sincerely, w!. . StephenK. Powers, MD Professor and ChIef Section of Neurosurgery SKP:gcc ~ f:\scriI00S.97(ltrs) DEFENDANT'S EXHIBIT --............. DEBRA E. SGRIGNOLI and TERRY SGRIGNOLI, Plaintiffs IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA vs. CIVIL ACTION - NO. 18'- ~io LAW (I ~A~~L RELLA SMILEY, Defendant JURY TRIAL DEMANDED NOTICE TO DEFEND You have been sued in court. If you wish to defend against the claims set forth in the fOllowing pages, you must take action within twenty (20) days after this Complaint and Notice are served, by entering a written appearance personally or by attorney and filing in writing with the Court your defenses or objections to the claims set forth against you. You are warned that if you fail to do so the case may proceed without you and a jUdgment may be entered against you by the Court without further notice for any money claimed in the Complaint or for any other claim or relief requested by the Plaintiff. You may lose money or property or other rights important to you. YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU CAN GET LEGAL HELP. 4tH eo'I~1' IInmi'1iat-rae-er_ 'j) A r Fles];:, Cumberland County C~t.. tRiStl.5e- . rJ. err /.J15'CJCI<Uf-c"11 Carlisle, PA 17013 L L.ihedy ~. (717) ?4F1-,;....un ;2 4 Ii -j{ ~(o ORIGINAL 126864/MTG ,"' DEBRA E. SGRIGNOLI and TERRY SGRIGNOLI, Plaintiffs IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA vs. CIVIL ACTION - LAW NO o. " '", /) '.,1 - . I d' J .)..... LLl.r4-\ I t____ RELLA SMILEY, Defendant JURY TRIAL DEMANDED COMPLAINT 1. Plaintiffs Debra and Terry Sgrignoli are husband and wife, adult individuals, residing in Dillsburg, York County, Pennsylvania. 2. Defendant Rella Smiley is an adult individual and citizen of the Commonwealth of Pennsylvania who resides at 4740 Spring Road, Shermansdale, Cumberland County, Pennsylvania. 3. The facts and occurrences hereinafter related took place on or about June 13, 1997, at approximately 1:35 p.m. on South College Street, Carlisle, Cumberland County, Pennsylvania. 4. At that time and place, Mrs. Sgrignoli was operating 1990 Ford Astrovan while in the scope of her employment with Your Floral Connection. 5. Mrs. Sgrignoli was operating the Ford Astrovan while traveling in a westerly direction on West Willow Street. 6. Mrs. Sgrignoli had brought her vehicle to a complete stop at the intersection of West willow Street and South College Street. 7. After stopping at the stop sign, Mrs. Sgrignoli proceeded forward as traffic traveling south on South College 1 'j . " ,. :/ , ';: ',. " ;ie ~.Il ....- Street was at a distance that would permit Mrs. Sgrignoli to safely cross the intersection. 8. Immediately before the subject motor vehicle accident, Defendant Smiley was operating a 1985 Chevrolet Cavalier, traveling south on South College Street. 9. As Defendant Smiley approached the intersection of South College Street and West Willow Street, she observed Mrs. Sgrignoli's vehicle already crossing the intersection in front of her. 10. Defendant Smiley, in a panic, stepped on the accelerator of her vehicle and just as Mrs. Sgrignoli's vehicle was about to clear the intersection of South College Street and West willow Street, Defendant Smiley caused the front her vehicle to collide into the right rear passenger side of the van being operated by Mrs. Sgrignoli. 11. The foregoing accident and all of the injuries and damages set forth hereinafter sustained by Plaintiffs Debra and Terry Sgrignoli are the direct and proximate result of the negligent, careless, wanton and reckless manner in which Defendant Smiley operated her motor vehicle as follows: a. failure to keep alert and maintain a proper watch for the presence of motor vehicles that have already crossed the intersection of South College Avenue and West Willow Street; b. negligently accelerating into an intersection and striking the right rear of a vehicle that has all but cleared the intersection; c. failure to apply her brakes in sufficient time to avoid striking the right rear of Mrs. Sgrignoli's vehicle; 2 d. failure to travel at a safe speed; e. driving her vehicle upon the highway in a manner endangering persons and property and in a reckless manner with careless disregard to the rights and safety of others and in violation of the Motor Vehicle Code of the Commonwealth of Pennsylvania. CLAIM I Debra Sorionoli v. Rella Smilev 12. Paragraphs 1 through 11 of the Complaint are incorporated herein by reference. 13. Mrs. Sgrignoli sustained painful and severe injuries which include but are not limited to cervical spine injuries, including a cervical sprain, as well as aggravating a pre-existing condition that necessitated and was the direct cause of Mrs. Sgrignoli undergoing an anterior cervical discectomy and fusion at C4-5 and C5-6. 14. By reason of the aforesaid injuries sustained by Mrs. Sgrignoli, she was forced to incur liability for medical treatment, chiropractic treatment, hospitalization for her cervical spine surgery, and similar miscellaneous expenses in an effort to restore herself to health, and claim is made therefor. 15. Because of the nature of her injuries and subsequent surgery, Mrs. Sgrignoli has been advised and, therefore, avers that she may be forced to incur similar expenses in the future, and claim is made therefor. 16. As a result of the motor vehicle accident and her medical treatment to treat her motor vehicle accident injuries, 3 Mrs. Sgrignoli has incurred various accident-related medical expenses, and claim is made therefor. 17. As a result of the aforementioned injuries, Mrs. Sgrignoli has undergone and in the future may undergo physical and mental suffering, inconvenience in carrying out her daily activities, loss of life's pleasures and enjoyment, and claim is made therefor. 18. As a result of the aforesaid injuries, Mrs. Sgrignoli has been and in the future may be subject to humiliation and embarrassment, and claim is made therefor. 19. As a result of the aforementioned injuries, Mrs. Sgrignoli has sustained work loss, loss of opportunity and a permanent diminution of her earning power and capacity, and claim is made therefor. 20. As a result of the aforesaid injuries, Mrs. Sgrignoli has sustained uncompensated work loss, and claim is made therefor. 21. As a result of the aforesaid injuries, Mrs. Sgrignoli continues to be plagued by persistent pain and limitation I I 1 ~ \ \~ ., J I and, therefore, avers that her injuries may be of a permanent nature, causing residual problems for the remainder of her lifetime, and claim is made therefor. 22. As a result of the aforesaid accident, Mrs. Sgrignoli has undergone cervical spine surgery and as a result, she has a permanent surgical scar, and a claim for disfigurement is . ,. .' hereby made. " I, 4 I I I " 11.0..., I CLAIM II Terrv Sorionoli v. Rella Smilev 23. Paragraphs 1 through 22 of the Complaint are incorporated herein by reference. 24. As a result of the aforementioned injuries sustained by his wife, plaintiff Debra Sgrignoli, Plaintiff Terry Sgrignoli has been and may in the future be deprived of the care, companionship, consortium, and society of his wife, all of which will be to his great detriment, and claim is made therefor. WHEREFORE, Plaintiffs Debra and Terry Sgrignoli demand judgment against Defendant Rella Smiley in an amount in excess of Twenty-five Thousand Dollars ($25,000.00), exclusive of interest and costs and in excess of any jurisdictional amount requiring compulsory arbitration. Date: d ../ D / ~<;)' ANGINa & ROVNER, P.C. ~" J.D. #35956 4503 N. Front Street Harrisburg, PA 17110 (717) 238-6791 Counsel for Plaintiffs 5 ~90 ~,. ~. f\.. ~..J ~ ~ v ... lA., -.... - 'GJ ~ "-t:-' " ~ <':'J --. }() J ~~ ~ (") ,,0 (") f; ;"'C' -11 -T'\ ;~ -,:;i;-: \'-,-\ n'lI;! fJ' fl':T.1 ;;~: :r: r- .,.~rrl :~.i::':-: rv ~IY6 (J g:l' -u ;113 .1... .c::CJ :~.: I"" .".~ '!:: (."l " '..:? .).!. :;,...c...: Q ~ ", :4 .- ~ .... (') lO 0 ,- Ol -II -"r\::: -,.. ::;-J :1:'. rnp-, ::0 :'l:ipg :'2::., ;':'l I ""(1fT1 (./I,. , 'D ':;6 -~ !::; C~'. '1'i( .> "TI . ,:!:] ~~:~ ~~~1 ::c ~'::':") r:'i' dn - ~, :;;::: :..:> :;;! :;! ~J -< I' . - CERT/FICA TE OF SERVICE AND NO~ this 6'" day or March, 1 998, the undersigned does hereby certify that she did this date serve a copy or Ihs roregolng appearance upon the olher parties of record by causing same to be deposited In the United States Mall, first class postage prepaid, at Lemoyne, Pennsylvania, addressed as follows: David L. Lutz, Esquire Anglno & Rovner, P.C. 4503 North Front S'reet Harrisburg, PA 17110 JOHNSON, DUFFIE, STEWART & WEIDNER By: .,. -, I, t I'" t ' '/(11 r Debra E. & Terry Sgrignoll IN THE COURT OF COMMON PLEAS OF THE 41st JUDICIAL DISTRICT OF PENNSYLVANIA PERRY COUNTY BRANCH Versus Rella Smiley No. 98-850 SHERIFF'S RETURN And now February 23,1998: Served the within name Rella Smiley the defendant(s) named herin, personally at her place of residence in Carroll Twp. Perry County, PA, on February 23, 1998 at 6:20 o'clock PM by handing to Rella Smiley , an adult member of family 1 true and attested copy(ies) of the within Complaint and made known to her the contents thereof , Sworn and subscribed to before me this J~'" j , . day of r.t,."y So answers, tPJer ~ce. b'P~7 Sheriff of Perry County t /()9r .___.~.__~ tl'.'!.A ---'1 ~ ~.l'; . ":,': ~.:' IV \ I" ?,r:I.I' ,:.:, -, .:. ., :-"., r..1 ". i , CL ~~>;~>':: :,;......';, .O:I~:-""~':'~:': , . L.!~'.i v,.....:.. (",' ',' '" .-~\ : ,P II .J.-ry In Thc Court of Common Plcus of Cumbcl'lund Count\', Pcnns\'lvuniu . . .... Debra E. Sgrignoli and Terry Sgrignoli VS. Rella Smiley I' No. 98 850 Civil 19_ !'iow, February 1319~,1 SHERIFF OF CUMDEltLAND COUNTY, PA do herelJ~' depullze Ihe Sheriff of Perry Counly 10 execule this Wrll, this deputation being mode atlhe requesl ond risk oflbe Plalnllff. ~."" ,..:......'l. _ .~._...,.' ?"'~r'_ ~ -_~ ,. ... ".. ,,/, ..7............. r"~ '/-- Sberlff of Cumberland Coun!)', Po. Affidavit of Service Now, wllhln 19 ,01 o'c1ock M. ser\'ed lhe upon 01 by bonding 10 allesled copy oflhe original Ihe contenls thereof. o true and and mode known to So answers, Sheriff of Coun!)', Po. COSTS Sworn and subscribed before me this day of 19_ SERVICE MILEAGE AFFIDA VIT s s .Johnson, Duffic, Slcwllrl & Wcldncr By: C. Roy Wcidncr, Jr. J.D. No. 19530 30 I MlIrkct Strcct P. O. Box 109 LCllloync, Pcnnsylvllnill 17043-0109 (717) 761-4540 Altomcys ror Dcrcndllnt DEBRA E. SGRIGNOLl and TERRY SGRIGNOLl, IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 98-850 CIVIL TERM Plaintiffs v. CIVIL ACTION - LAW RELLA SMILEY, JURY TRIAL DEMANDED Defendant ANSWER TO PLAINTIFFS' COMPLAINT AND NOW, this ;tl!jay of March, 1 998, comes Defendant Rella Smiley, through her undersigned attorneys, and answers Plaintiffs' complaint as follows: 1. Admitted In Part. DenIed In Part. It Is admitted that Debra Sgrignoil Is an adult individual residing in Dlllsburg, York County, Pennsylvania. The remainder of this averment is denied, in that after a reasonable investigation, Defendant is without knowledge or information sufficient to form a beilef as to the truth of said averment. 2-3. Admitted. 4. Admitted in Part. Denied In Part. It is admitted that Mrs. Sgrignoil was operating a 1990 Ford Astrovan owned by Your Floral Connection. The remainder of this averment Is denied, in that after a reasonable Investigation, Defendant Is without knowledge or information sufficient to form a belief as to the truth of said averment. 5. Admitted. 6-7. Denied. After a reasonable investigation, Defendant Is without knowledge or Information sufficient to form a belief as to the truth of said averment. f' I I I t~ 8-9. Admitted. 10. Admitted In Part. Denied In Part. It is admitted that Defendant panicked and accelerated. The remainder of this averment Is denied. , I 11(a-e). Denied. Claim I Debra Sgrignoll v. Rella Smiley Claim II Terry Sgrlgnoll v. Rella Smiley 12. by reference herein. Admitted In Part. Denied In Part. Paragraphs 1 through 11 hereof are incorporated 13-22. Denied. After a reasonable Investigation, Defendant is without knowledge or information sufficient to form a belief as to the truth of said averment. 23. by reference herein. Admitted In Part. Denied in Part. Paragraphs 1 through 22 hereof are incorporated ,\ \ J 24. Denied. After a reasonable investigation, Defendant Is without knowledge or information sufficient to form a belief as to the truth of said averment. WHEREFORE, Defendant demands judgement in her favor. " C.Roy , Jr. ..~". ,-~.{ :~~T ".' r"'~ By: :107811 '"' VERIFICA TION I, Rella Smiley, verify that the statements made In the foregoing document, which are within the personal knowledge of the undersigned, are true and correct, and as to the facts based on the information of others, the undersigned, after diligent Inquiry, believes them to be true. And further, this verification is signed on the recommendation of my attorneys, who advise me that the statements and language In this document are required legally to raise Issues for resolution at trial by the Court, or by continuing Investigation and preparation for trial. I understand that some of these statements may prove Inappropriate after investigation and trial preparation are complete, and I leave determination of these matters to my attorneys on their advice. I understand that all statements herein are made subject to the penalties of 18 Pa. C.S.A. ~4904, relating to unsworn falsification to authorities. 12a.aaa, ,h~ Rella Smiley Date; 3- / rP- if ~ '..... '. (") .0 !?, s; ::0 ~- :!: -J ""0 rrt :17- ::-L~ Qir'h :;.0; 11'_ %;".1,:1 N =B~ ::-"'-:(t::' W VI.;;, U ~l:" ~-f <--' "'" ,. ~ ~C~ ::Y.: .-,.. '..0 0"" :;.-;c: ~ ' Z N ~ ~ (J'\ -:; DEBRA E. SGRIGNOLI and TERRY SGRIGNOLI, Plaintiffs IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW NO. 98-850 Civil vs. RELLA SMILEY, Defendant JURY TRIAL DEMANDED REOUEST FOR ADMISSIONS To: Rella Smiley c/o C. Roy Weidner, Jr., Esquire Johnson, DUffie, Stewart, & Weidner 301 Market Street P.O. Box 109 Lemoyne, PA 17043-0109 Please take notice that you are hereby required, pursuant to Rule 4014 of the PennsYlvania Rules of Civil Procedure, to serve upon the undersigned within thirty (30) days from service, your response to the admission(s) requested herein: 1. Do you admit that you testified under oath in a hearing on November 6, 1997? 2. Do you admit that at the hearing you were asked the fOllowing question: "Now, you made a statement to the officer that you panicked and you hit YOur accelerator; is that correct?" 3. Do you admit that you answered "Yes" to the aforementioned question? 4. Do you admit that at the hearing you were asked the fOllowing question: "Why didn't you step on the break, Mrs. Smiley?" .....' 5. Do you admit you answered that question as follows: "I thought she was going to hit me, so I was trying to get out of the road." ANGINO & ROVNER, P.C. :5iD~dl E' av~ L. Lutz, squ~re Attorney I.D. #35956 4503 North Front Street Harrisburg, PA 17110 (717) 238-6791 Date:8\~HB , ..< (") .0 r;, c: ::0 ;;: ,.,. .:1 ri'1(J:1 '- 'J~ "'Tl f:l G") 111r: -;.. -n I 'Tim iliS: .r. ~r16 (J r=:;c.-' -0 '1J iJ 0:::::" ....,. ;.,:p ::a: ~",2(') /- ) ~ "yn :PC =-' :f'" ." ~ -J ..... 0' -< PRAECIPE FOR USTt'lG CASE FOR TRIAL (~IUS'1 be rypewrilten ~nd submitted In dupllcale) TO THE PROTHONOTARY/OF Cli~IBERLAND COI.':-ITY P!east ~Sl :he (ollawinl ~:lJI: I,C~.ck one) ( x') for JCRY lrial al Ih. nUl :ttm J( :lyU ~our:. ( ) (or lrial withoUI a Jury. ---- C.-\PTION OF CASE (enll:e C2plIon must be Slmd In (u,ll) Debra' E. Sgrignoli and'Terry Sgrignoli (check one) ( Auumpsil ( ) Trespass ( X) Tr.:pus (~ICIOI V.hic!.) ( ) (plaulllfl) (olher) "'. Rella Smiley The trial list will be callec on 2-16-99 and . Trials cOlllllence on 3-'15-99 (Defendanl) Pretrials will be held on 7-74_qq (Briefs are due 5 days before pre- trials. ) (The party listing this case for trial shall provide forthwith a copy of the p'raecipe to all counsel, p~suant to local Rule 214-1.) . ys. ~a. QR-R50 ClyU 19_ Indle'le lho .ltomo)' ..'ho ..ill Il)' ~3.S0 for Ihe party "'hu :il.s this ,,,ecip.: 'DflVi rl LlIt 7. F,'''q. Indle31. trial counsel for olher parlles if known: C. Roy Weidner, Jr., Esq. This case II rndy (or lrial. ,,~.,,~ Prinl Same: David L. Lutz. Esq. AllarnO)' (or: Plaintiffs DIle: 12-8-98 cc C Roy Weidner, Jr., Esquire ORIGINAL , .......-~';,........., ,. "'..~ . , DEBRA E. SGRIGNOLI and TERRY SGRIGNOLI, Plaintiffs IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA vs. CIVIL ACTION - LAW NO. 98 - 850 Civil RELLA SMILEY, Defendant JURY TRIAL DEMANDED PLAINTIFFS' PRE-TRIAL MEMORANDUM I. Brief narrative statement of the case This case involves a motor vehicle accident. On June 13, 1997, plaintiff Debra Sgrignoli was operating a 1990 Ford Van while traveling west on West willow Street. The Defendant had been traveling south on South College Street. After the Plaintiff had all but crossed the intersection, the Defendant panicked and stepped on the accelerator and caused her vehicle to collide into the right rear of the Plaintiff's van. Attached as Exhibit A is the Carlisle Police Department accident report. II. Lists all tvoes and amounts of all damaoes claimed The Plaintiffs' Complaint alleges that Plaintiff Debra Sgrignoli sustained painful and severe injuries, which include but are not limited to cervical spine injuries, including a cervical sprain, as well as aggravating a pre-existing condition that l, ., j [ l ! necessitated and was the direct cause of Mrs. Sgrignoli undergoing an anterior cervical discectomy and fusion at C4-5 and C5-6. 14 54 72 /MTG 1 OR\G\NAL , , III. List of names and addresses as witnesses. classifvinq witnesses of all persons who mav be called them as liabilitv or damaoe Attached as Exhibit B is Plaintiffs' counsel's August 3, 1998, correspondence listing the liability witnesses, the liability exhibits, the damage witnesses, and the damage exhibits to be utilized at trial. IV. List A. B. C. D. E. of all exhibits which a partv intends to use at trial Photographs of the property damage to the van being driven by Plaintiff Debra Sgrignoli Photographs of the accident scene Diagram of the accident scene Plaintiffs' Request for Admissions Photographs of Plaintiff Debra Sgrignoli taken in Hershey Medical Center F. Cervical collar G. Dr. James Tyndall's exhibi t during Dr. 1998, deposition) medical report form (marked as an Lawrence Zimmerman's November 24, V. Copv of the written report or answer to wri t ten interrooatories consistent with Rule 4003.5 containino opinion of expert witnesses A. Dr. Lawrence Zimmerman's November 24, 1998, deposition transcript is attached as Exhibit C. B. Dr. Thomas Becker's January 5, 1999, deposition transcript is attached as Exhibit D. C. Dr. Stephen Powers's January 11, 1999, deposition transcript is attached as Exhibit E. 2 . "',of__.I;- ,.. ,/ "'_.'_~''''''' '. p. e.'e. ~o m. REFER TO OVERLAY S COMMONWeALTH OF PENNSY. ,NIA POLICE ACCIDENT REPORT REPORTABLE QCX! Notl.REPORTABlED ACCIDENT I' 1. I/ICIOENT NUMBER , 2, AGENCY IIAME .S A lOW I PRECINCT " INVESTIGATOR I g. ACCIOENT I DATE ':.TIMEOF L OAY 13, . KlllEO \9 ORMATION 97-08560 CARLISLE RLISLE M. POLICE DEPT. 4, PATROL ZONE 3 BADOE NUMBER 24 BADOE NUMBEFL.:? . 8, ARRIVAL TIME 1340 ACCIDENT INFORMATION 1'0, DAY DF WEEK FRIDAY 1'2. NUMBER OF UNITS 2 I".PRIV.PROP. 0 N r::1 ACCIOENT Y U(J 'I 17. VEHICLE OAAlAGE O.NONE UNIT 1 ,.LIGHT I 2.MDDERATE j 3. SEVERE UNIT 2 l,g. PENNOOT Y 0 PROPERTY , 18.010 VEHICLE HAVE TO BE , REMOVEO FROM THE SCENE? UNIT 1 UNIT 2 y\QdND : 18, HAZAROOUS MATERIAlS Y:""" NIii( N~ UNIT # 1 CJ GJ N@: Y 36, LEGALLY Y N 137. REG. PARJ<EO ? 0 . PLATE , 39. PA TITLE OR OllT .oF.STATE VIN , 40. OWNER ; 41, OWNER AOORESS 42. CITY. STATE & ZIPCOOE :43. YEAR , - 1T1":LVEH. . . ,. CONF1G, .." NO. OF ,_""L.ES M-IS (11/95) PENPioorUSE CNt.Y LOCATION 20. COUNTY CODE CUMBERLAND 21 21. MU'lICIPALITY COOE CARLISLE 402 PRINCIPAL ROADWAY INFORMA TION 22. ROllTE NO, OR STREET NAME 23, SPEEO LIMIT 25 S COLLEGE STREET 24,)TYPE ~}ACCESS - HIGHWAY 0 - CONTROL 1 INTERSECTING ROAD: 28. ROUTE NO. OR STREET NAME 27. SPEEO LIMIT 1-1. WILLOW STREET 28jTYPE 129.jACCESS 1 2S - HIGHWAY 0 '-' CONTROL IF NOT A T INTERSECTION: 30. CROSS STREET OR SEGMENT MARKER 31.0IRECTlON FROM SITE N SEW 33, DISTANCE WAS 32.0ISTANCE FROM SITE FT. MI. (J.l)CONSTRUCTION - ZONE MEASURED 0 (35,) TRAFFIC ~ CONTROL OEVICE ESTIMATEO PRINCIPAL W o INTERSECTING GJ GJ UNIT # 2 38. STATE 36. LEGALLY Y N I 37. REG. PARKEO? XX PLATE 39, PA TITLE OR OUT.oF.STATEV1N 40. OWNER /3a.STATE PA '. . 44, MAKE 2 .Ice 11 PUC' ,73.CARGO !lOOY TYPE 70. HAl AROOUS --' MA TERLALS 1 4'. OWNER AOORESS 42, CITY. STATE & ZIPCOOE 43, YEAR ." MODEL. (NOT BOOYTYPE) 47)BOOY - TYPE 'OJ INITIAl IMPACT - POINT ~3.jVEHICLE GRAOIENT 56. ORIVER NUMBER sa. ORIVER NAME 59, ORIVER AOORESS 60, CITY. STATE & ZIPCOOE a,.sEX F 162.0ATEOF BIRTH 64. COMM. VEH, 65, ORIVER Y Cl N ~ CLASS 67, CARRIER UNKD 46.\SPECIAL -' USAGE S1.)VEHICLE . STATUS 54)ORIVER r--; PRESENCE I' I 66, CARRIER AOORESS 69, CITY . STATE & ZIPCODE 70, USOOT. Ice 11 74, GVWR 72,)VEH, '- CONFIG. 77. RELEASE OF HAZMAT 7', NO. OF yO NO UNKO ~LES 74. GVWR 77. RELEASE OF HAZ.....T YONOUNKO INVESTIGATING AGENC ... .;"-., . .," "10.,./ .--- ~. ICIDENT #: 97-08560 lB. RE.....Otm,:~o EMS AOENCY NON 1-=-' IACCIDENT DATE: n< /_ , In~ 1!J, MEDICAL FACILITY . ~.....,..... 80-fEOPLE INFORMATION 0 NAME AOORESS H I J K L M ....aCOEF t t E- e. . t 0 ~LLAJL--S.MILEL4.7..!&.SnIlliLRD_SUE.RlIA..'{J)ALE p ^ 170g ~ ~ OR R n n , , " I,' , . n ~~nllA ~r.ll T minI T 10<;7 vnRK RD.JlTlI !'lRllR'" D" 1 ~nl a I, . 1 b n n I I (!I' ILLUMINATION GJ @l WEATHER W 88, OIAGRA~ ~ ~". fl/,,~ " ... I1flDA '1'0/1., N (e3/ ROAD SURFACE W 11' - 1 ~ A /U(/I/A~ * --.... .. --i.., --.- ..._m.._...~ .....~..-~., ... ,-, ............. -.-., .., .......".... ,. ......~..~... ...- _.,_._...........~.. .... "..--.. ,-, 84. PENNSYLVANIA SCHOOL OISTRICT , (IF APPLICABLE) likti ~" @ /.AI!Mt.u:GI ~~.! , 85. OESCRIPTION OF OAMAGEO PROPERTY ,...';I/<:Z-" ....,'.. ,I M...."........."'.,. .... ..e'" ..._....~... .....~._,.,___._..N..._..'... ~. -.. '. :--.... .,-'-t-: - ,- . . , -t-- : : , OWNER , , , : I AOORESS ! ! I ......,..........,-,.........,...,. i -.. ....-.-...-........- ~ M1"-;1.; ~A<.e I PHONE ' ($): STDt s,.,,, 87. NARRATIVE -IO.NTIFY PRECIPITATING EVENTS. CAUSATION FACTORS. SEQUENCE OF EVENTS. WITNESS STATEMEIlTS. ANO PROVIOE ADDITIONAL OETAILS. LIKE INSURANCE INFORMATION ANO LOCATION OF TOWED VEHICLES. IF KNOWN. OPERAtOR III WAS tRAVELING SOUtHBOUND ON S. COLLEGE STREEt AND UPON APPROACHING tHE INtER- S ECtION WItH Ii. WILLOW StREEt, OBSERVED VEHICLE 112 CROSSING THE INTERSECtION IN FRO/IT OF HER. .~ .--- ... - :-... .- -. ---. ".-- -- - ., .., . HER VEHICLE MID SPED tOWARDS VEHICLE 112, CAUSING AN IMPACT. OPERAtOR 02 StAtED tHAt SHE APPROACHED tHE INtERSECtION OF S. COLLEGE st. ~mILE tRAVELING ON W. IIILLOW StREET AND, UPON . _.n n..._ ...,- -, - ..~ , - . tHAt SHE. NEVER OBSERVED VEHICLE III AND CLEARED tHE INTERSECtION PRIOR to ENtERING. tHE ONLY WItNESS WHO liAS IDENTIFED liAS DAVID HOPCRAFt (SEE BELOW). ~m. HOPCRAFt stAtED tHAt HE .-. . . . tHE tllO APPROACH THE INtERSECtION, DID NOt tHINK AJ.'<Y COLLISION WOULD OCCUR: UNtIL. FOR REASON UNKNOWtl to HIli, VEHICLE III SPED UP It SPEED OF tRAVEL AJ.'ID COLLIDED l-lItH VEHICLE 02, CAUSING . . ... - ..~ -..--- .. . . . - . . SUStAINED A BRUISE TO HER RIGHt HAlID. BUt DEtlIED AllY MEDICAL BEING SUMMONED. OPERAtOR 02 SUStAINED A BLOODY NOSE, BUt ALSO DENIED ANY ~lEDICAL BEING SutlHOtlED to SCENE. VEHICLE III I,AS --". -.. . . .. - , . . FLUIDS (tRAI1SHISSION!OIL?) ImICH \fAS tREAtED l-lItH HY-DRY BY CmWERLAND-GOODllILL CO 1140. INSURANCE COMPANY 1 INSURANCE ICOMPANY INFORMATION PE~~llJU~D INSURANCE INFORMATION ERIE UNIT POL,IZY "AF.R4444 I UN~T I PO~~Y n I <n..7 1 N NAME p~n "nv'lF. ADDRESS '~~:?I.,_eaQe 88. -.----." PA 1701'>. WITNESSES NAME AODRESS PHONE . 89. VIOlA liONS INOICAIEO '190. SeCTION NUMBERS (ONLY IF CHARGED) TC NTC' I UNIT 1 "AP'" ".. I '>.71[. ..GO . I DO ,91. ;PROBABLE " ~TYPE ,~,)RESULTS DNOTEsf~!:)PRoaABLE 1~TYPE ~~RESULTS ONOTEST 94.1NVESTIGATION - USE ! TEST '.EST I UNITl 0 i o REFUSE USE , 0 REFUSE COMPLETE 1 L 0'__'/'0 UNK UNIT2 0 I O'__Y'O UNK YES I8l NO 0 AA.-S, (11195) PAGE: .1l2..- ~ - .. - 7 -.. ",,' ,; '.~ '.J I.J. _. '.: ...J t..l ..J IllVES'IIGA'IING AGEllCY @ I. I I!~ ~,i . "'I '... \. ';~; - ~ ::z: iii =l lD " IOSEPII M, MELIllO TERRY 5, II~IA.~ DAVID 1.. LlnZ ~DClIAEL E. KOSIK PAMELA 0, SilliMAN RlClIARD A. SADLOCK Angino fI Rovner NlIOLE C. OLSON MIClIAEL I. NAVITSKY 10SEPII M, DORIA DUANE 5, DARRICK lAMES D,CI/(fl- DAVID S, WISNEsKI ,\ , , ~ \ , \" , ) ,r I :t , \, " i i l' r ~I .:: L1S11l0 IN TIlE BEST LAWYERS -IN- AMERICA RICllARD C. ANDINO NElL I, ROVNER August 3, 1998 C. Roy Weidner, Jr., Esquire Johnson, DUffie, Stewart & Weidner P.O. Box 109 301 Market Street Lemoyne, PA 17043-0190 RE: Sgrignoli v. Smiley No. 98-850 Civil Term , Dear Roy: The liability witnesses I plan to call at trial are as follows: 1. 2. Plaintiff Debra Sgrignoli; Carlisle Police Officer Dzezinski; David Hopcraft - eye witness; and Defendant Smiley on cross-examination. Michael 3. 4. The liability exhibits I plan to use at trial are as follows: 1. Photographs of the property damage to the van being operated by Plaintiff, Debra Sgrignoli; 2. Photographs of the accident scene; 3. Diagram of the accident scene; 4. Plaintiff's Requests for Admissions; and Defendant's Response to the Plaintiff's Request for Admissions. 5. t;1h,'hlfb 4503 NORTH FRONT STREET, HARRISBURG. PA 17110.1708 (717) 238-6791 FAX (717) 239-5810 Page Two Auoust 3. 1998 The damage witnesses I plan to call at trial are as follows: 1, Plaintiff Terry Sgrignoli; 2. Plaintiff Debra Sgrignoli; 3. Dr. Thomas E. Becker, II, D.C.; 4. Dr. Larry Zimmerman; 5. Dr. Stephen Powers; ,and 6. Jen Horn - friend. , The damage. ~xhibits I plan to utilize at trial are as follows: 1. Photographs of Mrs. Sgrignoli taken in the Hershey Medical Center; 2. Medical bill summary; 3. Cervical collar; 4. Diagnostic studies taken of Mrs. Sgrignoli before the June 13, 1997 accident; and 5. Diagnostic studies taken of Mrs. Sgrignoli taken after the June 13, 1997 accident. Should you require further information and/or documentation in order to prepare for trial, please contact me. DLL/ks _ t:~~;r? David L. Lut~ h J." ~ . " ' , , ' ,. , i> ; . @ r"~; ;";;': ~ . " I~ ~\ 1 \:' ~, ( , " , \ \, '. " .~~{: ".~ " f I f' h. i ... v.' .. ~.; ~~'.1 " I'~r:' '\' , , ,p I " J. i 'lJ I, ,', .J, " ,~... I ~~~\,' ~ f'! 'i': J .3- " ...~ j , -~- !J H \:, r;!i'h'~i\\; '1" ,.'.'. ".' !J^',', . t I,; ~lj'_e '/, 4-' .' I' " H " I I " ! , ..,: " : (I , I t.,,~ ,,0 j _." '. - .-. t', ,,!ii.L; )"''i "'.; . \ ,,,-:," ,,:,;. ..:..-.-1'::l\~' (C(Q)[PY RELLA SMILEY, DEFENDANT JURY TRIAL DEMANDED (: .\ " i : II, . Ii .~ I ) I, l DEBRA E. SGRIGNOLI AND TERRY SGRIGNOLI, PLAINTIFFS IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA V CIVIL ACTION - LAW NO. 98-850 CIVIL DEPOSITION OF: LAWRENCE B. ZIMMERMAN, M.D. ;, TAKEN BY: ,PLAINTIFFS '" BEFORE: TAMMY J. BAKER, REPORTER NOTARY PUBLIC , DATE: NOVEMBER 24, 1998, 4:23 P.M. PLACE: 108 LOWTHER STREET LEMOYNE, PENNSYLVANIA ) APPEARANCES: ') ,\ , I ANGINa & ROVNER, P.C. BY: DAVID L. LUTZ, ESQUIRE i ( FOR - Pk~INTIFFS JOHNSON, DUFFIE, STEWART & WEIDNER BY: C. ROY WEIDNER, JR., ESQUIRE FOR - DEFENDANT " i ! , ~ . 2000 Linglesrown Road. Suite 302 · Harrisburg, PA 17110 717.540.0220 · Fax 717.540.0221 · Lancaster 717.393.5p}h1 hi 1- Q I 2 3 4 5 6 7 8 9 EXII1BITS 10 ZIMMERMAN EXIIIDIT NO, II 1. MEDICAL REPORT fORM 12 13 14 15 16 17 18 19 20 21 22 23 24 25 WllNESS NAME DIRECT CROSS REDIRECT RECROSS LAWRENCE B, ZIMMERMAN, M,D. BY: MR. LUTZ J 22 BY: MR. WEIDNER .. IJ PRODUCED AND MARKED 2J Page 3 I STIPULATION 2 It is hereby stipulaled by and between counsel 3 for the respective parties that reading, signing, sealing, 4 certification and filing are hereby waived. 5 6 LAWRENCE B. ZIMMERMAN. called as a witness, being 7 duly sworn, testified as follows: 8 DIRECT EXAMINATION 9 BY Mil. LUTZ: 10 Q Will you please state your full name? II A Lawrence B Zinuncnnan. 12 Q Your profession? 13 A Physician. 14 Q What type of doctor? 15 A Internist. 16 Q How long have you been a doctor? 17 A Since I graduated in 1978, completed my residency 18 in '82, so I've been in pmctice since 1982. 19 Q Where are your offices located, Doctor? 20 A In Lemoyne. 21 Q Could you tell the jury what you do on a daily 22 basis? 23 A I see primarily adults in geneml internal 24 medicine, which is the pmctice of adult medicine, it's .. 25 We see patients in the clinic as well as hospital patients. HUGHES, ALBRIGHT, FOLTZ & NATALE 717-540-0220\717-393-5101 Multi-Page ", LA WRENCE D. ZIMMERMAN, M.D. NOVEMBER 24, 1998 Page 4 Page 2 I Q f lake it you have partners in your medical 2 group" 3 A 11lal's correcl. 4 Q Is one of those doctors Dr. James Tyndall? 5 A 11lal's correct. 6 Q Doctor, will you please summarize for the jury 7 your educational background and tmining? 8 A 1 wcnt to medical school at Penn State 9 University, graduated in 1978, did an internship and medical 10 residency at Harrisburg Hospital from 1978 through 1981 and II then did a fellowship from '81 to '82 in geriatric medicine. 12 Q Can you explain to the jury what a fellowship is 13 as compared to a residency or internship? 14 A A fellowship is just extended training. In my 15 case it was one year and it was specifically for geriatric 16 medicine. 17 Q Do you have any certifications in your field? 18 A Yes, I'm certified in general internal medicine 19 as well as added qualifications in geriatric medicine. 20 Q Do you have any privileges at any of the local 21 hospitals? 22 A Yes, at both Harrisburg Hospital and Holy Spirit 23 Hospital. 24 Q Doctor, over the years have you had the occasion 25 to treat people that are involved in motor vehicle accident Page 5 1 trauma7 2 A 1 have on occasion seen patients. 3 Q On occasions do you refer those people to 4 specialists if you believe it W8rranl<:d7 5 A Yes. 6 Mil. LlTIZ: At this pointl'm going to move to 7 have Dr. Zlmmcnnan admitted as an expert in internal 8 medicine and ask if there questions on qualifications. 9 Mil. WEIDNl!R: No questions. 10 BY Mil. W12: II Q Doctor, you have your records in front of you and 12 in order to answer any of my questions or Attorney Weidner's 13 questions you may certainly look at your medical records? 14 Can you lell us when you fIrSt saw Debra 15 Sgrigooli? 16 A Yes,l fIrSt saw her on 3/29/96. 17 Q Do you know bow it Was that sbe came to be seen 18 by you? 19 A At that time her major complaint wns cbest 20 discomfort wblch sa:med to be reJal<:d to exertion, both when 21 sbe would be on the exercise bike and also sbe did some 22 dancing and sbe would have some of these symptoms while sbe 23 wns doing that. 24 Q Did you perfOrtl1 an examination? 25 A Yes, 1 did a physical examination on her. Page 2 - Page 5 LA WRENCB B. ZIMMERMAN, M.D. NOVEMBER 24, 1998 Mulli-Puge'" Page 8 I which was resolving. I didn't have any spccifie reason for 2 it, I did note that she had takcn .. shc had taken some 3 Scldanc and I think some .. an hcrbal remcdy or hcrbal 4 stimulalor several hours prior to the onset of this thing. 5 I didn't think that that probably had anything to 6 do with this, but I did order a CAT scan of the brain on the 7 chance that she could have had a subarachnoid hemorrhage. 8 That turned out to be nonnal. 9 Q Doctor, docs that pretty much summarize your 10 October 29,1996, note? II A That was the .. yes, 12 Q Doctor, was any history of trauma to her neck 13 given? 14 A No. As she told me, she was just driving and IS this just came on her, there was no history of trouma that 16 - she related to me. 17 Q Did you ask her to come back and see you after 18 this visit of October 29th of '96? 19 A Yes, I did. 20 Q Okay. 21 A And I saw her again on the 8th of November, '96. 22 1lUs kind of related to some of her previous complaints of 23 throat tightness and these would wake her up at night. 24 She" I had noted here she had been exposed to 25 certain house cleaning ehemicn1s and she seemed to relate Page 7 Page 9 1 rapid heart bent, some tightness in her throat and some 1 that sometimes that's when she gets short of breath and it 2 chest tightness and then she also had some nausea. 2 also occurred with cigarette smoking. 3 This whole thing occurred over a 20 to 30 minute 3 I don't really note any problems with her neck at 4 period and she continued to drive until her pain was so 4 that time and that was the extent of the visit. 5 severe that she started to see spots, 5 Q When was she next seen in your office? 6 She pulled off the side of the road and her 6 A That would have been 6/18/97. 7 girlfriend who was troveliog with her contacted the State 7 Q Doctor, between November 8, 1996, and 8 Police. 8 approximately seven months later, Jnne 18, 1997, she wasn't 9 The State Police came, they took her to an 9 seen? 10 emergency room and they wanted to admit her overnight, but 10 A She wasn't seen in our office, no. II she decided to proceed on home. Appnrenlly her blood work 11 Q Now, who saw heron June 18,19977 12 in the emergency room was unremarkable. 12 A Dr. Tyndall. 13 The nausea persisted for several hours and she 13 Q Have you reviewed his note before today? 14 did not go to work the next day and when I saw herin the 14 A Yes, I have. IS office she was feeling better, but wasn't quite back to IS Q Could you tell us about the visit with Dr. 16 norrnn1. 16 Tyndall on June 18, 19977 17 Her exam at that time documented that her pupils 17 A What he writes is that she was in a motor vehicle 18 were equal and reactive to light. Her neck was supple. 18 accident, allegedly hit by another car. She was hit in the 19 There was no tenderness to flexion/extension and rotation of 19 passenger's side. 20 the neck. 20 It says hit in the passenger's side rear quarter 21 I don't know that there was any radiation of the 21 spinning her car around. She slammed her fnee into the 22 pain. Her chest was clear. She had no focal neurologic 22 steering wheel and was dazed. She also had severe nose 23 deficits; that is, she didn't have any weakness of any of 23 bleed, passing blood clots for about 24 hours. 24 her extremities. 24 She was seen by a chiropractor the following day, 25 Again, I .. she had had this severe neck pain 25 had x.rays which were described as quote, unquote, severe Page 6 _ Page 9 HUGHBS, ALBRIGHT, FOLTZ & NATALE 717-540-0220\717-393-5101 Page 6 Q Old you fOllnulnte on Inltlallmp"".lon? 2 A My Initial hnp"".lon wa. I wa. unclcor a. 10 . 3 wbot wa. cau.lng the chest pain; buIlt wo. exercise relnted 4 and.o I .ent her off fer a .In:S. IcSland an S eebocardlogrnm. 6 Q When I. the nexl time yeu .aW her, Doclor? 7 A '\lult was 4/26/96 and Ihnt was for basically 8 follow.up of her 'lUdles thot we hod done. 9 Both the 'lUdies were ba.lcally normal, so I felt 10 Ihnt I bod excluded any significant beart problems and noled 11 Ihnt.be mlght .. some of thls may be sort of an astlunatlc 12 type of condition; .0 I gave her a trial of an Inholer to t3 try. 14 Q When did you next see her, Doctor? IS ' A The next time I saw her wa. 10/29/96. 16 Q What I'd like for you to do Is go over thl. nole 17 relatively In detail. Would you plcose lell us whot she 18 told you when'b: come to see you on October 29th, 1996, and 19 B? from there? ' 20 A Okay. BaslcaUy she hod been trovellng In Obio 21 and sbe hod a sudden onset wbcrc.be become very sweaty and 22 developed seven: neck pain. 23 This progressed to the point wbcrc she was 24 hyperventilating; Ihnt's br<athlng rapidly. She developed 2S sensation of palpitalions; Ihnt's kind of a sensation of a Page 10 I whiplash. She was taking some Skelaxin, which is 0 musclc 2 relaxant and for the muscle spasm and it says through the 3 episode she has not had full x-rays of hcr hend and ncek in 4 Ule emcrgency room. 5 She was tnking some Ibuprofen and Valium. She 6 dcseribed pain In hcr hend to the top, pain behind her 7 eyes, TIlcre was no further nose bleeding. On exam, the 8 most pertinent thing was she had tenderncss to palpation of 9 the poslerior occiput, just over the muselcs, as well as 10 pnmcervical muscles. 11 Q Let me interrupt you for 0 second, Doctor. Whcre 12 is the posterior occiput? 13 A That's the back of the hcad. 14 Q And the pnmcervicol muscles? 15 A They are around the neck. 16 Q And you mentioned the tenn spasm. What is a 17 muscle spasm? 18 A That's a _. the muscle con actually become tight 19 and taut and can be painful. 20 Q What was the diagnosis on June 18, 19971 21 A The diagnosis was cervical musculoligamentous 22 injury secondary to hyperextension/flexion injury secondary 23 to the motor vehicle accident. 24 Q Now, can you put Ulat in layman's tenns? 25 A It's basically a strain of the cervicol muscles, Page 11 1 The hyperextension and flexion is .. hyperextension is when 2 the neck would be fully'. would go back. Flexion is when 3 the neck would go forward. 4 Q What was the treatment plan, Doctor? 5 A Treatment was to stop the Ibuprofen and went to 6 Voltaren and then they gave her some F1exeril which is a 7 muscle relaxant and heat to the back of the neck. 8 Q What type of medication is Voltaren? 9 A It's a non.steriadal anti'inflammatory agent, 10 it's commonly used for these kinds of circwnstances, for 11 pain. 12 Q When was she next seen in your office? 13 A The next time would have been 7/22/97. 14 Q Was this again Dr. Tyndall? 15 A Dr. Tyndall saw her again, yes. 16 Q Will you please tell us about that visit? 17 A He states she's still not feeling well. He notes 18 that she has 0 history of problems with neck and ann pain 19 which predates her motor vehicle accident. 20 The previous pain was described as being a mild 21 diseomfort in the lower cervical area down into the left 22 shoulder. 23 Q Did he record that she had an accident a long 24 time ago? 25 A Yes, she did mention an MVA long ago. HUGHES, ALBRIGHT, FOLTZ & NATALE 717-540-0220\717-393-5101 Multi-Page'>! LA WRENCE D. ZIMMERMAN, M.D. NOVEMBER 24,1998 Page 12 I Q MVA mcans motor vehicle accident? 2 A Yes, 3 Q I'm sorry, Doclor, I inlerruptcd you, Go ahcad? 4 ^ She stales thaI occasionally the pain went from 5 Ihe left shouldcr down inlo the Icft ann llSSociatcd with 0 6 toothache and discomfort, the left side being greater than 7 the right side. 8 Sincc the accident on 6113, she had 0 marked 9 increase in her pain, The pain also moved up into the base to of the skull. TIle pain is equal bilateral and it stays at a 11 higher level of intensity bilaterally. 12 She's continued to have the discomfort in the 13 anns. At night she described 0 weird sensation in her head 14 as 0 tingling. 15 She has gone back to work. She has restrictions 16 of no lifting or bending. She's been on thc F1exeril which 17 has helped somewhat, but it .. what he describes is space4 18 her out. It kind of made her feel funny and she wasn't able 19 to take it during the day. 20 She continued on the Voltaren without any 21 problems. Shc was seeing 0 chiropractor on a regular 22 basis. 23 On his exam she had tenderness to thc posterior 24 occiput, that's thc back of the head, and into the shoulder 25 and there was decreased range of motion which was limited by Page 13 1 discomfort. 2 Q Did the diagnosis changc at all, Doctor? 3 A No, the diagnosis was the same. She was to 4 continue on the Voltaren and F1exeril and then the 5 possibility.. he notes here possibility of cervical disc 6 disease was raised. 7 Q Doctor, based on the history of the motor vehicle 8 accident of June 13, 1997, your physicol examinations and 9 your treatment before the accident and your review of Dr. to Tyndall's records after the accident, do you have an opinion 11 with a reasonable degree of medical certain that Debra 12 Sgrignoli sustained a cervical musculoligamentous injury 13 secondary to a hyperextension injury as a result of the June 14 13, accident? 15 A Yes. 16 MR. LUTZ: Thank you, Doctor, Mr. Weidner will 17 probably have some questions. 18 CROSS EXAMINATION 19 BY MR. WEIDNER: 20 Q Doctor, 1 looked at your office notes and it 21 appears to me she was in here to see you or Dr. Tyndall 22 starting back on 3/29/96, is that eoneet? 23 A That's eoneet. 24 Q And it appears from the office notes that the 25 fl/'St she ever mentioned this motor vehicle accident a long Page 10 - Page 13 LAWRENCE B. ZIMMERMAN, M.D. NOVEMBER 24, 1998 Multi-PageT>' Puge 14 I time ago that she menlloned to Dr. Tyndall 011 7/22/97 was, 2 in fact, on thai dale; Is thai correct? 3 A That's the first that she specifically mentions 4 about the motor vehicle accident a long time ago, 5 Q Okay. This episode when you were seeing her on 6 10/29/96 when she was !mvellng In Ohio, do you have any 7 Independent recollection of that visit or enn you only 8 testify from your notes today? 9 A I remember the visit. I menn I remember her 10 being in the office and describing this to me, but. . . II Q Were you awnre then she had been In this aula 12 accident a number of years ago? 13 A I don't think that I was awnre of that, no. 14 Q So she didn't bring it to your attention? 15 A I don't document it in my office nole that she 16 was In that accident, no. 17 Q Certainly something you would have documented if 18 she had brought it to your attention In light of the fact 19 she was complliining of severe neck pain, is that correct? 20 A That's true. I mean if she had mentioned that 21 she had been in a motor vehicle accident, I think I would 22 have documented that, yes. 23 Q And the visit on 10/29/96 you record that her 24 pain was so severe that she started seeing spots, is that 25 correct? Page IS I A That's correct, yes, 2 Q Would that be what one would consider 3 excruciating neck pain, if you're seeing spots? 4 A Yes. 5 Q Did you ever detennine what the cause of that 6 excruciating neck pain was that you saw her for on 10/29/96? 7 A No, that was never established. It -- by the 8 time I had seen her in the office, it was much --It was 9 better and seemed to be something that was Improving. 10 Q This neck pain this excruciating neck pain you II saw her for on 10/29/96, you have it as all of a sudden, 12 this neck pain; is that correct? 13 A That's how it was described, yes. 14 Q Something that just came out of the blue, so to 15 speak, correct? 16 A That's how it's described, yes. 17 Q Okay. You saw her again on 1118/96, is that 18 correct? 19 A That's correct. 20 Q And she saw you then for throat tightness, is 21 that correct? 22 A Yeah. It was kind of a follow'up visit from the 23 cr scan of the head that I had perfonned, but what she 14 talked about mainly was the throat tightness. 25 Q And she also complained of neck tightness, is Page 14 - Page 17 Puge 16 I thai correct? 2 A Yes, she did. 3 Q And she lold you that by theo she had slarted 4 sccing a chiropractor for thaI, is thai correct'/ 5 A That's correct, yes. 6 Q And had two visits with him? 7 A Yes, that's correct, two visits, 8 Q These episodes apparently woke her up at night, 9 is that correct? 10 A Certainly Ihe throat tightness was wakiog her up II at nighl, yes. 12 Q Okay. And could you.. did you find any reason 13 for thatthront tighlness? 14 A At that point I was thinking perhaps this was 15 some sort of astlunutic attack; but I certainly wasn't 16 certain of that. 17 Q Well, you have in your noles you were .. 18 difficult to make out-- strike that. 19 Difficult what to make of these episodes that 20 wake her up at night, comma, whether thesc could be somatic 21 in nature or whether this is a fonn of asthmatic attack, 22 correct? 23 A That's what I wrote, yes. 24 Q So one alternative consideration was an asthmatic 25 attack, correct? Page 17 I A That's correct. 2 Q And the either was a somatic problem? 3 A Right. 4 Q What is a somatic problem? 5 A A somatic problem is where a person can have like 6 an underlying anxiety problem and it sometimes will manifest 7 itself as a physical sign such as pain or abdominal pain, 8 nausea, shortness of breath. 9 Q So this -- you were then considering the 10 possibility the neck tightness and thronttightness were II some kind of anxiety reaction, is that correct? 12 A That was a consideration. 13 Q Okay. Did you ever link the throat pain or 14 thronttighlness and neck pain to asthma? 15 A I can't say that I did. 16 Q Okay. 17 A No, I never specifically linked it to that. 18 Q Then I believe Dr. Tyndall saw Mrs. Sgrignoll on 19 6/18/97, is that correct? 20 A That's correct. 21 Q That's the visit immediately after the aeeident'/ 22 A That's correct, yes. 23 Q And it says she has F-R-O'M. That means full 24 range of motion? 25 A Yes. HUGHES, ALBRIGHT, FOLTZ & NATALE 717-540-0220\717-393-5101 .r .,___If Multi-Page'" LA WRENCE n. ZIMMERMAN, M.D. NOVllMBER 24, 1998 Page 18 Page 20 I Q Would that mean that her neck was able to be 1 indieale" of neck und unn pain predating her most recent 2 moved about fully without any problems? TImt was Dr, 2 auto accidc"llt, is that correcl? 3 Tyndall's note? 3 A TIIDI's correct. 4 A Aclually whatlhat stales is she hllq full mnge 4 Q And they date back .- these neck and ann 5 of motion of her extraocular muscles, TImt's her eyes. 5 complaints date back to what he described as a motor vehicle 6 That's full mnge of motion of hcr eye movements from right 6 aceidenllong ago, is that eorreel'} 7 to len and up and down. 7 A TIlal' s eorreel, uh-huh. 8 Q She had a nonnal gait? 8 Q And she also complains of a weird sensalion at 9 A She had nonnal gail, nonnal walking. 9 the hcad described as a tingling 01 night, is that correct? 10 Q No problem with Ihe lower extremities? 10 A Thai's correct. J1 A No, J1 Q And she's still seeing a chiropmelor on a 12 Q No. mcaning no problcm? 12 regular basis? 13 A One would assumc lhat hcr lowcr cxtremities were 13 A Yes, 14 nonnal if her gait was nonnal, yes, 14 Q An lhen he notes again tenderness in thc 15 Q It reflccts tenderness to palpation over the 15 poslerior occipital area and the shoulder, is that correct? 16 posterior occiput just OVcr the muscles as well as over the 16 A That's correct. 17 pnracervical muscles, is that correct? 17 Q But no spasm is nOled? 18 A That's correct. 18 A He docs not nolc any spasm. 19 Q That means Dr. Tyndall was pressing on them and 19 Q Then he does note a decrease in her range of 20 she would complain of pain? 20 motion limited by discomfort, is that correct? 21 A Of tenderness. yes. 21 A Yes. 22 Q There was no spasm in the neck or post.:rior 22 Q That would be her neck? 23 occiput muscles as noted by Dr. Tyndall? 23 A That would be her neck, yes. 24 A He doesn't mention any actunl muscle spasm, just 24 Q What that reflects is she's telling him it hurts 25 the tenderness. 25 to turn it a certain way, is that correct? Page 19 , Page 21 I Q And typically when you feel spasm; I.e., the I A That's correc~ yes. 2 muscles tightening up, you note that, don't you? 2 Q While he notes that somebody aIn:ady has imposod 3 A Typically you do note that, yes. 3 limilations and restrictions on her, he docs not impose any 4 Q Okay. That's an abnonnalfinding? 4 according to his notes, is that correct? 5 A That would be an abnonnalfinding. 5 A He has not specifically sold that, yes. 6 Q And you arc basically tmincd to note abnonnal 6 Q And he docs not schedule any follow-up visits to 7 findings? 7 s= her, docs he? 8 A That's correct. 8 A He docsn'lschcdule any. The only thing he has 9 Q And no such finding was noted? 9 in his nole is that he would refer her back to me and he wns 10 A He does not note that, correct. to lalking about a dIet pill. J1 Q Okay. It does not appear to me from reading his J1 Q She was, in fac~ using a dIet pill at that time 12 noles that he has imposed any limitations or restrictions on 12 because of the concern that she has - over weight gain, is 13 her activities as a result of that visit? 13 that correct? 14 A He doesn't document any here, no. 14 A Yes. 15 Q Would you typically nole that if you told a 15 Q Okay. Now, Dr. Tyndall's records do not indIcale 16 patient to limit their activities? 16 anything in the way of lower cxtremity problems at any time 17 A You would, yes. 17 after the accident occurring In June of 1996, is that 18 Q Then she had an appointment for 6/27/97, is that 18 correct? 19 correct? 19 A I'm sony. Could you repeat that. 20 A That's correct. 20 Q Dr. Tyndall's notes and the records do not 21 Q And she canceled that? 21 indicale anything in the way of lower cxtremity prohlems 22 A That's what was documented hcre, that she 22 after the accident OCcurring in June of 1996? 23 canceled that, yes. 23 A No, his notes don'l. 24 Q Then we get to 7/22/97, July of '97 and this is 24 Q And would you think that If she had told him 25 where she fU'St tells Dr. Tyndnll .. as far as your records 25 anything about pain and numbness and tingling going from her { ( ~i I, Ii I' HUGHES, ALBRIGHT, FOLTZ & NATALE 717-540-0220\717-393-5101 Page .8 - Page 21 I I.' I, I' ;~ LA WRENCE B. ZIMMERMAN, M.D. NOVEMBER 24,1998 Page 22 I neck down her back Into hcr lower cxtremitics, legs and 2 feet, he would have noted that? 3 A [would think hc would have nolcd thaI. 4 Q Would you think that If shc had told him anything 5 about pain down into tllC back area ancr thc June 1997 6 accident hc would havc noted thai as well? 7 A [would think so. 8 Q And basically atthc tlmc that he saw hcr In Junc 9 and July of 1997, hc was seeing her chleny for orthopedic 10 complnlnts,Is that correct? 11 A That's correct. 12 Q And that was complaints attributed by her to the 13 motor vehicle accident in June, is that correct? 14 A That's correct. 15 Q So when he was examining her, he would be looking 16 for injuries to the muscles, spine, back, neck and other 17 areas, correct? 18 A Yes. 19 MR. WEIDNER: That's alii have. 20 REDIRECT EXAMINA nON 21 BY MR. LlTlZ: 22 Q Doctor, I'll be very brief. You were ~ed about 23 Dr. Tyndall's June 18th, 1997, office visit. I'm going to 24 show you a fonn. Can you tell me if that form is a fonn 25 signed by Dr. Tyndall? Page 23 1 MR. WEIDNER: Let's go off the record. 2 (Discussion held off the record.) 3 TIlE WJTIolESS: Yes, it is. 4 BY MR. LIIIZ: 5 Q And docs the fonn relate a history, Doctor? 6 A Yes. It relates on 6/13 patient involved In 7 motor vehicle accident. Her van was hit on passenger's side 8 rear ql1lll1cr and spun around: She slwnrned her face into the 9 steering wheel. She had immediate problems with being dazed 10 and nose bleed, increased neck pain and arm pain. 1 J Q And docs the fonn ask Dr. Tyndall the question of 12 whether he is releasing her to return to work without 13 restrictions at that time? 14 A It says here there's a question as to can patient 15 return to his or her pre-injury job without restrictions and 16 it's checked no under the cireumstances. 17 MR. LIIIZ: I'll have that mark as Dr. Zimmerman 18 Ilcpositlon Exhibit 1 and thank you, Doctor, those are all my 19 questions. 20 (Medical Report Form produced and marked 21 Zimmerman Exhibit No.1.) 22 MR. WEIDNER: I have no questions, 23 (Whereupon, the deposition was concluded at 4:55 24 p.m.) 25 Page 22 - Page 24 Multi-Page'" I COWIY or DAUPIIIN : 2 : 5S 3 COMMONWEALTII or PENNSYLVANIA: 4 I, Twnrny J. !lakcr, a Notary Public, aUlhori7.ed 10 5 administer oalhs within and for the Commonwealth of 6 Pennsylvania, do hereby certify that the foregoing is the 7 testimony of L\WRENCE 8, ZIMMERMAN, M,D. 8 I further certify that before the taking of said 9 deposition, the witness was duly sworn; that the questions 10 and answers were taken down stenographically by the snid 11 Reporter-Notary Public, and anerwards reduced to 12 typewriling under the direction of the snld Reporter. 13 I further certify that the said deposition was taken 14 at the time and place specified in the caplion sheet hereof. 15 I further certify that [am not a relative or employe.: 16 or attorney or counsel to any of the parties, or a relative 17 or employe.: of such attorney or counsel, or financially 18 interested directly or indirectly in this action. 19 I further certify that the snid deposition 20 constitules a true record of the lcstimony given by the said 21 witness. 22 IN WJTIolESS WHEREOr, I have hereunto set my hand 23 this 4th day of Dcccrnber, 1998. 24 lo.mmy I. U3kcr,Rcpot1ef 25 Notary Public HUGHES, ALBRIGHT, FOLTZ & NATALE 717-540-0220\717-393-5101 Page 24 ! II... 'I .'i < , . (C(g~V DEBRA E. SCRIGNOLI AND TERRY SCRIGNOLI, PLAINTIFFS IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA V CIVIL ACTION - LAW NO. 98-850 RELLA SMILEY, DEFENDANT DEPOSITION OF: DR. THOMAS E. BECKER TAKEN BY: PLAINTIFFS BEFORE: CHRISTINE F. HAAG, RPR NOTARY PUBLIC DATE: JANUARY 5, 1999, 1:45 P.M. PLACE: BECKER CHIROPRACTIC 501 MARKET STREET LEMOYNE, PENNSYLVANIA APPEARANCES: ANGINO & ROVNER, P.C. BY: DAVID L. LUTZ, ESQUIRE FOR - PLAINTIFFS JOHNSON, DUFFIE, STEWART & WEIDNER BY: C. ROY WEIDNER, JR., ESQUIRE FOR - DEFENDANT 2000 Linglestown Road · Suite 302 · Harrisburg, PA 17110 ~ 717.540.0120 · F" 717.540.0'" · I..,~", 7I7 J93f!th I 'h, ~ -LJ 1)lt TIIOMAS E. UECKER JANUARY 5, 1999 Pugc 2 . Pugc 4 1 cxphllnln 5UIIlcwlmt dcrull your CtIUclltlullnl hnckl:lrnlllltllllul CIlOSS IU:DIHECT IUlCflOSS 2 \mll1ll1g 101":<l1Il1e 11 chlmpmcf"r. 3 ^ Sure. I hnvc nil l15'iochllc'!I from "^cc,lIl1rri!lhurg 4 A'''I Commlllllty ColI<,!!e, 'will 011111 Shlppcl1,hllrg Ulllvenlty 10 18 S nnl,h lip my P=ll1hltes nlld \hell n:<elvulmy doclornle nl 6 I'almer ColI<,!!e of Chlmproellc nl Dovenport, lown, 7 Q Ilow long I, Ihe eOllrsc of sillily 01 Dnvenport, 8 lawn? 9 A II wn, n fOllr')""r progmm, 10 Q Could you e.pluln 10 Ihe Indlcs and genllemen of II Ihe Jllry whnl cOllrses you look while In chlroprnellc 12 college? 13 A Lc:nmlng II.. bnsle anolomy, physiology courses, os 14 well os lI,e Sludles of d.. dlscose, chlroprnclie, rndlology, 1 S nnd dlngnosls nnd procedure. 16 Q Do you hnppen 10 oxnll how mnny hours of sludy? 17 A T\\~nly.nve hundred I think sOllnds righl. 18 Q When you I!l'lIduatcd from ehlroprnclic college did 19 you lhen n:turn 10 Pennsylvanln? 20 A Yes, I did. 21 Q And did YOII become licensed 10 prnClice in lhc 22 stoic of Pennsylvania? 23 A Yes, I did. 24 Q When did you receive Ihallicense? 2S A January of 1990. I WITNESSES 2 NAME DIHEcr 3 D11.11I0MAS E, OECKIJII 4 BY, Mil. ltIl'l 3 S BY, Mil. WIJIDNI!II 6 7 8 9 10 II 12 13 14 IS 16 17 18 19 20 21 22 23 24 2S Page 3 1 S11PULA 110N 2 It is hereby stipulated by and between counsel for 3 the respective parties that reading, signing, sealing, 4 certification and filing are hereby waived; and that all S objections except as to thc form of thc qucstion are reservcd 6 10 the time of trial. 7 g DR. nlOMAS E. BECKER. called as a witness, being 9 duly sworn, lestified as follows: 10 DIRECT EXAMlNA nON II BY MR, LUTZ: 12 Q Please stnte your full name. 13 A Thomas Edward Decker 11, 14 Q Your profession? 1 S A Doctor of chiropractic. 16 Q Dr. Decker, my name is David Lutz. I am the 17 aUorney thaI represents Debra Scrignoli. I am going to ask 18 you questions concerning your care and treatment of 19 Mrs. Scrignoli, but before I do I want to ask you a few 20 questions about your background. How long have you been a 21 chiropractor? 22 A This is my ninth year in practice. 23 Q Whcre are your offices located? 24 A I have one office at 501 Markct Street, Lemoyne. 2S Q For the purposes of thc jury, would you please HUGHES, ALBRIGHT, FOLTZ & NATALE 717-540-0220\717-393-5101 Multi-I>oge'" Page 5 Q Would you please explain the philosophical 2 difference between a doclor of chiropractic and a medical 3 doctor? 4 A A doctor of chiropractic, our basic philosophy is S that the nervous system controls the body and any 6 interference to that nervous system. In particular the 7 central nervous system can have a result and affect upon 8 other aspects of the body, be it cells, muscles, tissues, or 9 other systems. 10 So our job is to properly diagnose the II misalig;tment within the spine in terms of vertebral 12 subluxation and correct those, allowing the body to heal 13 itself naturally. 14 Q What are some of the modalities that you use to IS correct that problem? 16 A To correct that procedure would be specific I? chiropractic adjustments. In addition to that there is 18 resultant paraspinal muscle spasms, inflammation that we will 19 lreatthrough low volt Galvanic, moist heat, ice, 20 intersegmental traction, stretching and exereise. 21 Q Can you explain to the jury in layman's tenns what 22 exactly you do for a chiropractic adjustment? 23 A Yes. I palpate the spine two different ways: 24 Initially I do what is called a static palpation where I will 25 run my fingers down their spine, And generally around an Page 2 - Page 5 .. ,I , J I , I ; ,~ " J i I : II ! " ,'""1. DR. THOMAS E. BECKER JANUARY 5, 1999 . Mulli-I'agc'" Puge 6 I oreo of nerve irrilution or misalignmenl there willi.: whal 2 is lenned pining edema, 3 And I would liken Ihal to a soft SpOI on an apple 4 where yoo can aelually feci like a Ilnte pit. So thot is S almosl always prescnl at or neor an irritated nerve. 111en 6 beyond thai, once Ihalis found, I wlll ask the patient if 7 there is tenderness there ond generally there is, S Oecnsionally, if through vision yoo can S<.'C whal 9 ore coiled spider nervi or spider veins which Indieoles that 10 the innammalion is oetually offecting Ihe little tiny blood 11 vesscls neor the skin, eousing some of thosc to slightly 12 enlarge or ruplurcjust 0 little bil. 13 Through motion we derennine what is tenned 14 /ixotion. Fixation Is improper movement of one vertebra in IS relation to the one obove or below. 16 Q Doctor, medical doctors prescribe medicotion 17 obviously. Do you prescribe medieotion? IS A As 0 profession we hove chosen to not get Involved 19 In prescribing medicine. 20 Q Over the yeors hove you treated people that have 21 been involved in motor vehicle occident trauma? 22 A Yes, I hove. 23 Q Attimcs do you refer the people to other medieol 24 doctors? 2S A Yes, I do, Poge 7 I MR. LUTZ: At this time I will move to hove 2 Dr. Beeker odmilted os on expert in chiropractic ond Dsk 3 Attorney Weidner if he hos ony questions on quolificotions. 4 MR. WEto","" No questions. S BYMR.LUTZ: 6 Q Okoy. Doctor, we're now soing to swilch gears ond 7 ask you questions concerning your core ond trcntrncnt or S Mrs. Scrisnoli. When did yoa firsl see her Dfler on occidenl 9 on Iune 13th, 19971 10 A I sow her on Iunc 14th, 1997. 11 Q Thc very next doy? 12 A Yes. 13 Q When you sow Mrs. Scrisnoli did yoa obcoin 0 14 history of whot hod hoppcned ond how she wos fcolins? IS A Yes. I did. 16 Q Could yoa tell the lodies ond sentlemen of the 17 jury what yoa recorded. Doctor? IS A Sure. I tronscribcd off the potienl's cose 19 history ronn, consultntion ond examination that she was 20 involved in n motor vehicle occident. As D result, she 21 experienced neek sposms ond numbness in the hands. She had 0 22 history of ollCTl!ies. 23 There was on increase in her hcndochcs os well os 24 sinus problems. There wos 0 slight ",ferral of pOlO into the 2S bock 0""'. She is 0 light-olcohol drinkL", non-corr.", Page 6 - Page 9 Page 8 I drinker, nonsmoker. 111e consuilaliun revealed thol she was 2 presently experiencing neck poin, headaches in the back of 3 her head with referral into the areo behind the eye, 4 Her neck poin also referred down into the mid bock S orea belween Ihe shoulder bladcs, She sloles Ihal she wos 6 expericncing numbness in her honds Ihat begon shortly after 7 the accident, the doy prior. S Q Now, Doctor, you mentioned the tenn sposms, Whot 9 is 0 sposm? 10 A A spasm Is 0 body's way of responding to a II troumo, 11 is almost like 0 notural costing of an orea to 12 proleel it from Injury. 13 Q Did you examine Mrs. Serignoli thai doy? 14 A Yes, I did. IS Q Wilhout going into every detail of your 16 examination eould you tell us the highlights of that 17 examinotion? IS A Yes, There wos a reduction in her oetive cervical 19 ronge of motion, bending her hend sideways In a lateral 20 motion like 20 degrees which elicited a pulling in her lower 21 neck arcn, 111ere wos also reduction In her rotation 22 eliciting lower neck pain, 23 There was pain in all placements of the actual 24 cervical range of motion in the lower cervical spine. And 2S then upon compressing her hend down, and this is tenned a Page 9 I SOlo-Holl Test. thc:rc wos 0 lower neek poin elicited ond then 2 olso 0 Foramlnal Compression which once ogain is 0 placement 3 of the head in vorious positions, In compressing dawn there 4 was on clicitntion of cervical spine poin. S Q Based on the history and physical exominotion did 6 you n:nch a diognosis? 7 A Yes. I did. g Q And whot wos thol, Doctor? 9 A Cervicol nexion extension injury, what we coli 10 eervicolgio; cervical subluxotion 2-3 os well os 6'7; 11 brachiol radiculitis; headoehes: ond then cervicol spinol 12 sposms. 13 Q You mentioned spoms ond I think thot everyone 14 knows whot headoches ore. Could you put the other tcr.ns in IS loyman's =? 16 A Sure. The subluxotion os I mentioned carlier is 0 17 misalignment of onc vertebra relotive to the other, e"",dnll 18 on aberrant mOlion or improper motion which would elicit some 19 innollunotion ond irricotion of the disk, ultimotely ofreeting 20 UIC nerve. 21 The nexion extension injury is when the neek is 22 coken often violently in directions thot it nonnolly goes bUI 23 beyond the nonn.loclive range of malion eousing stroin in 24 the IigomcnlS ond sprain of soft tissues. 2S Q Doclor. what wos your trentment pion os of Iune HUGHES, ALBRIGHT, FOLTZ & NATALE 717-540-0220\717-393-5101 ...-.,' Multi-I'age '" Pnge 10 I 14th, 1997" 2 ^ Well, due to the neute nllture or her InJurie~ I 3 SIIW her on a rellltively Inten~lve hll~i~ ror the lirst live 4 vl~lts, at which time on the liOh vl~lI, which Wll~ Jnne 5 23rd, I altempted to deerellsc the frequency to 0 wl,<:k IInd 6 follow thllt up aallln with a week, which was followed up 7 shortly over a month, just 10 detenulne the ~tahllity that 8 was preseot In her spine. 9 Q Let me ask a more sJll'Cllie quesllon, What 10 treatment did you render on June 14th, 1997? II ^ Spccllie chiropractic adjustment tn the Sl'Cond and 12 seventh cervical vertebrnc, the fourth and eighth throughout 13 this urea, lIS well as therupeutlc modalitic~ for the soft 14 tissue injury, 15 Q What are therapeutic modalilles? 16 A Low volt Galvanic and moist heat. 17 Q Now, Doctor; had you seen Mrs. Scrignoli before 18 this accident? 19 A Yes, I did. 20 Q And do you know from looking at your records when 21 you first met Mrs. Scrignoli and she WIIS seen by you in your 22 office? 23 ^ Mrs. Scrignoli originally entered my omce 24 December 28 of 1992. 25 Q And have you sc<'n her through the yeurs before the Page II 1 accident? 2 A Yes, I have. 3 Q Can you tell us, Doctor, in summary fllShion the 4 reasons you wen: seeing Mrs, Scrignoli over the five.year 5 time period befon: this accident? 6 ^ Well, I treated various areas in her spine us I 7 look over my treatment record. I treated her cervical spine, 8 her thoracic spine, her lumbar spine, us well lIS some 9 extremities, her shoulder in particular and even the pelvic to urea us well. 11 Q When was the lust time you snw her befon: her June 12 13th, 1997, motor vehicle accident? 13 A May 7th, 1997. 14 Q What WIIS that for, Doctor? 15 A Her primary complaint for the three visits 16 including sn previous was a lower lumbar condition. 17Q Okay. Now what dates did you see her in 1997 18 befon: her motor vehicle accident? 19 A sn, 5/5 and 4/29. 20 Q And all of those visits .. 21 A 4/28" I'm sorry. 22 Q 4/28. And all of those visits wen: for low back 23 problems? 24 A Primary condition of low back. 25 Q How about before that for the four years before HUGHES, ALBRIGHT, FOLTZ & NATALE 717-540-0220\717-393-5101 DR. THOMAS E. UECKER JANUARY 5,1999 Poge 12 1997, what wa~ the primllry prohlenllf you elln tell us" 2 ^ Well, due to the nllture of her spine It WII~ IIn 3 evcr.ehanaina thlna, 11lere was ocenslons when it Wu.s 4 cervienl, there WIIS occasions when It was thoracic, and there 5 were oceadons when II wa~ lumhar. 6 Q So, Doclor, when you saw her aOer this accident 7 you had already known her as a patient for approximatcly five 8 years? 9 ^ 11mt's correcl. to Q Now you indicatcd that you saw her the day aOer 11 the nccident. Could you tell us the dates you saw her aOer 12 that, how she WIIS doing and what you did for her? 13 ^ Sure, I saw her 6/14, that WIIS followed up by 14 6/16. Shc states that.. and we reviewed her X rays and 15 reviewed her examination, and she stated that she is in a lot 16 of pain In her neck us well as mid back. When she moves her 17 head around she hears a lot of cracking and she hus an uneasy 18 fcolina. ' 19 Q Doctor, did the X rays show any fractures? 20 A No. 21 Q Were the X rays completely nonnal? 22 A There was a reverse in the cervical curve. 23 Q Tell us in layman's tenns what that means? 24 ^ A curve in the spine is kind of like a shock 25 absorber on a cur, and when the curve is reversed the body Page 13 I loses its ability to absorb gravity body weight, which is 2 actually weight bearing, which is just the nonnal down 3 pressure to gelting up, silting down, walking and so on. 4 So those curves ure very important. When they are 5 lost the secondary curves have to do all of the work. The 6 secondary shock absorbers ure the disks between the 7 vertebrae, 8 Q I take it that you did provide her with 9 chiropractic manipulation that day? to A Yes, I did. 11 Q Did you give her any other modality of treatment? 12 A Yes. On the first day us I stated earlier we did 13 low volt Galvanic. On the second visit we did intersegmental 14 traction with moist heat. . IS Q What is the truction? Explain that to us, 16 please. 17 A What traction will do is it will actually" try 18 to put in simple tenns .. it will traction each vertebra 19 individually allowing motion to come back into that joint in 20 a fashion excluding a sponge forcing the right fluid out and 21 allowing fresh new fluid in. That's the purpose of the 22 traction, 23 Q And aOer the June 16th, 1997, visit did she ever 24 come back to see you? 25 A Yes, June 18th, Page 10 - Page 13 , ,I ! \. I 1 '\,..,' I,', t' . ~ I, 'I' !,.'. I'" 'I' \ ! , , I l.i', " I,: \ "I!.' , '. ~. !:-" J \1 .'+.1 ',.F !\ DR. 'mOMAS E. DECKER JANUARY 5,1999 ' 1 Q Wnllho IIII~rovlng with 1111I0, Doolor'/ 2 A Do..,1 on tho 181h, IlIhJ""lIve cOIII~lolnll, Ihere J wos 110 Impro\'CmcIU. 4 Q Okoy. AI ony 1111I0 Iho' ,ho wnl seeing YOII Uo yon 5 know If she wnl ,eelng onollK.T Uoolor7 6 A Not to lilY knowlc<lgo, 7 Q In your June 181h, 1997, office notOl, Uo YOII hovo 8 on InUlcollon whot your I""'bncnl ~Ion wo,7 9 A Ycuh. AClUolly, In II.. olSClSlnent bosc<l on II.. 10 18111 vlllt or II.. June 18111 visit ot Ihol point we UlsculSc<l II her going 10 lee Dr. ZllIIlIIcnnon. So It WOI ot this ~olnl IIlDI 12 ,he wo, going 10 ,eck him for on evoluollon. 13 Q AflCt the lune 18th, 1997, visit when did you next 14 'ee hcr7 15 A The 20th, 16 Q Okay. Tell US about thai visit, plcuse. 17 A She stoted this portlculor doy 1I10t upon doing her 18 ncok exercises thot we hod lCConuncodc<l she ncurly pOISed oul 19 and ,he wo' not qU!le.surc why. She hod n Jot of pain In ber 20 ncok, upper ncok Inlo the hond. lower ncok into her 21 sboulder. She also hos low bock discomfort. 22 Q Whal trcouncot did you provide for her thot doy7 23 A On the 20th specific chiroprocllc odJusuncnts 24 ogoln to the some four segmcnts: CI.2, C7.Tl 0' well os 2S L4.S. And we went bock to the low vall Golvonlc wilb moist Page 15 1 heat. 2 Q Doctor, when was Ihe next time you saw 3 Mrs. Serignoli? 4 A On 6123. S Q Was she doing better? 6 A Deb is still having trouble with her lower neck, 7 upper neck into her head and mid back betwc<,n her shoulders, 8 wrapping around her ribs. 9 Q Had the spasms resolved by then, Doctor? 10 A No. II Q Okay. Next office visit? 12 A 6/30. 13 Q And could you tell us about that visit, please? 14 A Very much the same as the previous visit. She was IS eontinuing to hove quite a bit of discomfort. There was 16 referral into the right arm, severe numbness, continued 17 paruspinol spasms, pain edema, inflammation, fixation and 18 adjustments to the samc places basically. 19 Q Did you see her in July of 19977 20 A Ves,I did, 21 Q When was the last time that you sow her? 22 A The last visit was August 15th. 23 Q Vou did see her in July I take it? 24 AVes, 1 did. July 7th, 25 Q One time? Page 14 - Page 17 Mulli-l'lIgc ", I'uge 14 Puge 16 I ^ Olle time in July, 2 Q Wen: Ihose visits in July nud August any diffcrent 3 Ihan the olher prior visits'l 4 A No. 5 Q lIow mnny times did you sc.'C her after the accidenl, 6 Doctor? 7 A Eight times totnl. 8 Q Whot was your dingnosis oS of the last visit? 9 A II was the some as the first. 10 Q Okay. If that was your last visit, Doctor, do you 11 know whcther she went to see her medical doetor? 12 A Yes, she did. She was released to Dr. Zinuncnnan. 13 Q Doctor, based on the history of the motor vehiele 14 occident, the fact that you hod seen her for a couple of 15 years before this accidcnt, your physical exams and the 16'X rays, do you hove an opinion within a reasonablc degree of 17 chiropractic certainty that Mrs. Scrignoli's cervical flexion 18 cxtension injury, the cervical subluxation that you described 19 is causally related to the June 13th, 1997, motor vehicle 20 occident? 21 A As I stated previously, 1 did treat hcr for these 22 same oreas before. Shc always responded well and was 23 released from core. In this particular case following this 24 occident, which was very severe in its nature, a side impact 2S injury is always more serious than a rcar-end or a front-end Page 17 I collision just because of the lock of mobility side to side, 2 and whcn you odd to that maybe a turning of the head or a 3 positioning of the hands on the stcering whcel and so on it 4 further compromises thc neck. S So as a result of this injury after eight visits, 6 which is very atypical, you know she was released from care 7 and continued on with her family doctor. 8 Q I don't mean to" strike that. Is your answer, 9 yes, there is a causal relationship, Doctor? 10 MR, WEIDNER, I'm going to object to that. Vou're 11 leading him. 12 BY MR. LtJIZ: 13 Q Let me restate that long, convoluted legal 14 question again, Doctor. Based on the history of the motor 15 vehicle accident, the fact that you saw her before this 16 occident, your physical exwns, your review of the X rays, do 17 you have on opinion within a reasonable degree of 18 chiropractic certainty whether Mrs. Scrignoli's cervical 19 flexion extension injury and cervical subluxation injury is 20 causally related to the June 13th, 1997, motor vehicle 21 occident? 22 A Based on my result of the chiropractic treatments 23 and her lack of recovery, I would say, yes, it is directly 24 related, 25 MR. LtJIZ: Thank you, Doctor. Mr. Weidner will HUGHES, ALBRIGHT, FOLTZ & NATALE 717-540-0220\717-393-5101 , " , \ , I j ~ " 'i: " y; " 'T,i Pnge IS I have SOIllC questions, 2 CItOSS'I!XAMINA'f\ON 3 DY Mil. WUlONI!It: 4 Q Doctor, whcn did you firsl Sloe Mrs, Serignoli , preceding the accidcnt" 6 A I'receding Ihe accident, I first snw Mrs, Scrignoli 7 12/28 or 1992, 8 Q And what was thai ror? 9 A My initial diagnosis was lumbar mdlculitis with 10 lumbar subluxation at L5.6. II Q And that was 12/28 or '92" 12 A Yes, that's correct. 13 Q There is a pre-consultation note in your chart ror 14 that date ir you'll look at it. 15 A Sure, 16 Q And it says at the lop what is your major 17 complaiat, docs it not? 18 A Yes. 19 Q What is the complaint? 20 A It says neck and shoulders. 21 Q So she came in here on 12/28/92 complaining or 22 neck and shoulder discomrort; is tbat comct? 23 A That's correct. 24 Q And you said you diagnosed her as having a lumbar 25 problem? Mulli-I'uge 'M DR. THOMAS E. DECKER JANUARY 5,1999 I'nge 20 I A Ycs, Four.nllll.a-halr Illllliths, 2 Q Okay, She saw you 4/28/97, correct'l 3 A l1mt's correct. 4 Q 5/5/97, correct" , A 111at'scorrect, 6 Q 5/7/97: is that correct? 7 A l1mt's correct. 8 Q She was 10 see you 011 5/12/07, but she rorgot her 9 appointlllenl; is that correct? lOA 111at is correct, 11 Q An appointment was rescheduled ror her ror 12 6/10/97; is that correct? 13 A No, that's not correct. 14 Q Wbat docs the 6/1 0/97 mean? 15 A The 6/10/97 is when a reschedule card was sent out 16 to her rrom the office, 17 Q But you were expecting to see her as late lIS 18 6/10/97; is that correct? 19 A Yes, that's correct. 20 Q Okay. So there were still some ongoing problems 21 Ihat occasioned your office to want to see her lIS or 6/10/97; 22 is that correct? 23 A Yes, that's correct. 24 Q And that relatcd bock to her initial presentation 25 on 4/2 8/977 Page] 9 Page 21 I A Well, at the bollom or that same rorm it says low A Most likely, yes. 2 bock pain into right leg. 2 Q Well, Is that the case7 la other words, you 3 Q Okay. But she also at the time complaiaed or neck 3 wonted to see her on 6/10/97. Allenst you sent a cord oul 4 and shoulder problems lIS her major complaint, is that right, 4 to see her In rollow-up for her complaints on 4/28/!l7. 5 on 12/28/92? 5 A Well, If you undcrsmnd the nature of 6 A Well, bnscd on her cnsc histol)' fonn she actually 6 chiropractic, there Is this whole pmcollltivc maintenance 7 indicates both. 7 philosophy thnt we have. It's very possible that by 6/10 if 8 Q But her major complaint.. and thcre is a specific 8 she's not been in her acute cxacerbalioa has broushl her In 9 question on your form that says what is your major complaint: 9 004/28, may not be a concern anymore, bUI just 0 preexisting 10 is that correct? 10 condition would warrant Its ongoing malntenonce core. II A That is correct. II Q It appeared thnl at least from your n:cords there 12 Q And she puts down neck and shoulder; is that 12 was some concern on your port of ongoing symptomatology rrom 13 correct? 13 4128/97 down through 6/10/97: would thot be correct? 14 A Yes, that is correct. 14 A Well. through 5/12" 6/10. Actually. it's the ' 15 Q And she first noticed this 17 years previous 10 15 same office procedure. If someone hasn't been In for over a 16 that? 16 month they will scod a card OUl, 17 A That's correct. 17 Q Bul sbe went to see you. Atlenst for ccrlllin you 18 Q So that would be some 17 years prior to 1992? 18 would expect to sce her on 5/12/971 19 A Thai's correct. 19 A Thot's correct. 20 Q And then you saw her some -- looks like 35 times 20 Q Now her complaint.. her major comploint on 21 up through May 7, 1997; is that correct? 21 4/28/97 was severe low bock pain with refcnul into the legs: 22 A Let mc Just.. yes, thai's correct. 22 is thol correct? 23 Q In fact, there is a series, It appears on 4/28/97 23 A Yes. 24 shc came bock to you arter a bricf hiatus or no treatment; is 24 Q But you also nole on objoclive findings on 4/28/97 25 that correct? 25 thot she hod mUI, tender ropy fihers, hypamobility with HUGHES, ALBRIGHT, FOLTZ & NATALE 717-540-0220\717-393-5101 Page 18 -Page 21 r, DR. THOMAS E. nnCKllIt JANUARY 5, 1999 ' Multi-I'Dge I" I'nge 22 I fixollon 0\ the following scglllenl~: CI.2, C(,.7 nllll 1'3..\, I" 2 tlIBI cllrn:cl? 3 A Yc~, thut's correct 4 Q 11lBlllleunslhat she hud nllcn~lllhjcctlve 5 findings in the cervical ond thllrncle lIn:n? 6 A 111B1 's correct, yes, 7 Q And Ihat would be Ihe neck and upper pori of lhe 8 shoulders; is that camel? 9 A Yes, that's comet. 10 Q So il would be rair to soy thai on 4/28/97 she did II present to you with objcetive fiodings of ccrtoln condillons 12 in those arcos, tile oeck ond shoulders? 13 A That's correcl. 14 Q Now these lout, tender ropy fibers what would lhey 15 be In laymon's tenns? 16 A Musele spasms. 17 Q Okay. So she had .. 18 A Let me Just clarify thai. Muscle spasms at the 19 spinnllevel. Not the big bock muscles but the small spinol 20 muscles, 21 Q Her neck muscles were spasming, Is that It In 22 layman's teons? 23 A The small neck muscles, yes, 24 Q Okay, And what is the hypomobility with fixotion? 25 A That would be another leon for vertebral Pnge 24 I Q Okll)', Dll )'011 know whlll ctlun....llhut'l 2 A No, I don'1. IlIlelln II" pmhnhllily I. II wonhl 3 he relul"llo Ihele e,~vlcnl sllhlnxnllon.lnn nol dellullely, 4 Q Andlh",e emlcnl ,uhh"ullon. pn,lol"llhe 5 6/131'J7 nceldenllhol we're h,,", oholnlodny; i, Ihnt 6 com:c17 7 AYe.. Ihol" com:cl. 8 Q Now when ,he come In here 00 6114/97 whol were her 9 complolnts7 10 A On Ihe case hl.lory fonn ,he '1l11es that ,he hnd II neck Spn!llns, numbness in the Imnd. TIlen the consultlltlon she t 2 '1l11ed she hod n<<k pain; hendoches nllhe bnek of Ihe hend 13 referring hila Ihe Orcll behind lite eyes, also referring Inlo 14 bolh ,houlders; tbcrc Is numbness in \he hnnd.. 15 Q Sbe indienled on 0 pnlicnl history fonn thaI she 16 had had lite .)mplam. previously, did sbe nOl7 Specifically, 17 whal appcnl'110 be item 1-10, prior .ymptolllS. 18 A Yes. ThaI"\he accldenl report. Yes, she did 19 slalC thai, 20 Q So.he bnd these symploms thol sbe came In for on 21 6/14 priorto 6/14: Istlull com:c17 22 A Thnl i. com:cl. 23 Q And.be anribuled those to 0 prior aulo accldenl: 24 is thol com:c17 25 A Yes. sbe did, Page 23 Page 25 I subluxation, 0 lock of motion due to a misolignment of the I Q On 6/16 )'OU sow her: is dlUt com:c17 2 vertebra, 2 A Thot's eom:cl. yes. 3 Q So, in other words, hcr ncek could not move right 3 Q And sbe again hod these lender, ropy fibers: 4 completely on 4/28/977 4 muscle spnsm: and fixalion with hypomobllity at C2.7 and T4; 5 A Thnt's correct. 5 is thot cO=17 6 Q So although she presenled that day for complaints 6 A Yes. Ihnl'. com:cl, 7 that she stated to you in the low bock you found tltese 7 Q Now you also hove this piuing edemn noted on your 8 objective problems of muscle spasm and lack of motion In the 8 ehnrt for thnl dnle, Whnt is thol7 9 neck and upper shoulder areas, eorreel? 9 A As I de.cribed e,ulier, when you mn your fingers 10 A That's correct. 10 down it's like finding 0 soft spOI on on apple. It'sjusI nn 11 Q And you were 10 see her for all of these II inflommation renclion. 12 complaints at least up through I believe it wos 5/7 of '97? 12 Q Okay. Where is the pining 1lIldng plnce7 13 A Yes, thnt's correct. 13 A Gcncrnlly, il isju.t 10 the side of what', lcrmed 14 Q She in fact presented to you back on 11/6/96 with 14 \he .pinou. process or \he bock of the vatcbru. 15 taut, tender cervical pnrasplnal muscle spasms; is thai 15 Q And then )'OU have cap.uIili, noted on thot dnle; 16 correct? 16 isthal com:c17 17 A Thnt's correct. 17 A Yes. 18 Q Do you know whether specifically that date would 18 Q And nfter that sbe pretty much eonlinued to have 19 hove been 11/6 of '96; is thnt correct? 19 \he some symplom.; i. thot co=17 20 A Yes, 20 A Yes, thnl's com:cl. 21 Q Did she tell you anything al that time about an 21 Q When sbe complained to you or at any time during 22 episode when she was traveling in Ohio where she experienccd 22 your trcntmenl aflC\' this accidenl about episodes in \he 23 excruciating neck pain? 23 lower c:xtmnilic. wl.:re sbe would .. and this nccldent I'm 24 A You know I didn't document this in my record, but 24 referring to 6/13/97 .. did sbe complnin abOUI epi.odes wbcrc 25 I actually remember that conversation. And, yes, she did, 2S pnin would go dOlm across her low bnck Into both c:xtn:milies Page 22 - Page 25 HUGHES, ALBRIGHT, FOLTZ & NATALE 717-540-0220\717-393-5101 , :~; Pnge 26 I ond she would lose sen,;otiol1" 2 ^ On 6120 she sllltes she hlllllow hllek diselllnl'or\. 3 Agllln, 011 6/30 she hos mid bllek ond low hock Pllln hut nollls 4 severe os her IIl'Ck. 5 Q Did you S<.'C her ul ull on July of 1997" 6 ^ Yes, I SIIW her on July 71h, 7 Q How oboul oner Ihlll? 8 ^ She wos SCCII ollce in August 011 Augusl 151h, 9 Q Okoy. And oner Ihol? 10 ^ No. 11 Q At ony time during the July visit or the August 12 visil did she tolk about pain going down from the lower bock 13 Into the legs and feet on both sides? 14 ^ I don't hove any records oflhot, no. 15 Q That would be somethlnglhot you would expect to 16 record if she told you; is Ihol correct? 17 A Probably, yes. 18 Q Did she talk about any morning numbness In the 19 lower extremities? 20 A I don't hove it recorded. Now I do hove 0 case 21 history fonn on her inltiol visit thot she hod tingling or 22 numbness Into her feet os well os In her arms and hands, 23 Q Thot was whotlnitiol visit? 24 A Thot wos 6/14. 25 Q But ofier thot she didn't comploin to you about Page 27 1 that or describe that sensation at 011 to you? 2 A If she did, I didn't record it. 3 Q Wouldn't that be 0 significant thing to record in 4 your practice? 5 A Yes, it would. 6 Q So it would be fair to soy that she didn't tell 7 you or you would hove recorded it? 8 A Yes. 9 MR. WEIDNER: That's 011 I hove. 10 MR. LUfZ: Nothing. Done. 11 (Deposition concluded at 2:19 p.m.) 12 13 14 15 16 17 18 19 20 21 22 23 24 25 HUGHES, ALBRIGHT, FOLTZ & NATALE 717-540-0220\717-393-5101 Mulli-l'llgC ,,, DR. TlIOMAS ll.BECKl!R JANUARY 5, 1999 I'nge 28 I COUNTY Oil CUMIIHHlANIJ : 2 : ss 3 COMMONWllAL11I all rnNNSYt.VANIA: 4 I. Chrisline F. Hong. n Notory Poblle. aOlhorilCtI to 5 odmlnlsler oalhs within and for Ihe Conllllonwelllth or 6 Pennsylvania, do hen:by ec:r\lfy Umllhc: foregolag is Ihe 7 le'timony of Dr. 1110mo' 11. Ilecker. S I forther el'rllfy UlOt before Ihe toklng of ,old 9 d''Posltlon. Ihe witness wa. duly .wom; IllOt UIO quesllons 10 ond nn.wer. were token down stenogmphleally by tllO ,nld 11 Reporter-Notary Public. and aflcrWard. reduced 10 t)'JlCWlitlng 12 under Ihe direct Inn of tllO sold Reporter. 13 I further certify tlmt tllO sold depo.itlon wos Illkcn 01 14 UIO time and place specified In lbe eapllon .heel hereof. 15 I fUrther certify thot I om nolo relative or employo: 16 or ohomey or coonsel to any of UIO portles, or 0 relalive 17 or employee of soch ottorney or counsel, or finonclolly 18 Interested directly or Indirectly In this action. 19 I further certify thaI the sold deposition 20 , constitutes 0 true record of Ihc: lcStlmony given by the sold 21 wilness. 22 IN WlTNfSS WHEREOf. I hovc hcn:unto set my hand 23 II1ls 12111 doy oflonuory. 1999. 24 l.llnsnnc r. II~I RlR 2S Notary Public Page 26 - Page 28 <!) , I I I~ ~\ , I l, ~, i ,. ~ ~ . 'f !. 1<':, 'i"," , I Ii "/.', !'nge 2 WI"INI!SS 2 NAME IlXAMINA110N 3 STEPIIES K, POWElIS. M,D, 4 5 6 7 S 9 10 11 12 13 DEFENDA~"'S EXIlIDIT NO, 14 1. LETTER DATEO 10/8/97 15 16 17 IS 19 20 21 22 23 24 25 3 BY: MR. LlflZ BY: MR. WEIDNER 16 PRODUCED AND MARKED 23 Page 3 1 STIrULA TION 2 It is hereby slipulaled by and between counsel 3 for the respective parties that reading, signing, scaling, 4 certification and filing arc hereby waived, 5 6 STEPHEN K. POWERS. M.D,. called as a witness, 7 being duly sworn, lestified as follows: 8 EXAMINATION 9 BY Mil. LlITZ: 10 Q Would you please stale your full name? 11 A Stephen Kent Powers, 12 Q Your profession? 13 A I'm a neurosurgeon. 14 Q Where are you a neurosurgeon? 15 A Hershey Medical Center. 16 Q Could you explain to the ladies and gentlemen of 17 the jury your duties as a doctor here at the Hershey Medical 18 Center? 19 A Well, my title is professor and head of the 20 section of neurosurgery. I do three things, one of which is 21 to spend 80 percent of my time in clinical praclice, 22 perfonning brain and spinal operations. 23 The olher 20 percent is spent teaching and also 24 in administrative duties. 2S Q Would you please summarize your educational HUGHES, ALBRIGHT, FOLTZ & NATALE 717-540-0220\717-393-5101 Mulli-!'lIgc"'! STEVEN K. I'OWERS, M.D. JANUARY II, 1999 !'nge 4 I huekgruund nnd Iruinlng'l 2 ^ I gmduutcd medienl sehnnlln 1977 from Ohio 3 Slule University, Columhus, Ohln, In 1978 finished a year 4 of inlernship, University nf Mlnnesoln, Minneupolls und thut 5 wus In surgery, 6 Spent five yeurs in neurosurgery at the 7 University of Culll'ornlu, Sun Frunsclseo, und then went to 8 my first uppointment in 1983 on the fueulty at the 9 Universlly of North Curolinu in Chapel Hill. I wus there 10 until 1992 and I became the professor and ehuinnan of the II section of neurosurgery here. 12 Q Dr. Powers, over the years have you had occasions 13 to treut people Ihat have been involved in motor vehicle 14 accident tmuma? 15 A Yes. 16 Q And would that also include surgery? 17 A Yes. 18 Q Doclor, we're now going to swileh gcars and ask 19 you questions concerning your care and treatment concerning 20 Mr. Sgrignoli. 21 When did you first meet Debra Sgrignoli? 22 A My first encounter with her was on August 8th, 23 1997. 24 Q And at thut time, Doctor, did you take a 2S relutively detailed history? A I did, 2 Q And could you summarize for the jury the history 3 that you recorded? 4 A Basically, in summary, the history that I S obtained WllS that this was a 46'year.old woman who had been 6 seen by Dr. William Graham who was a plastic sl1tgtOn that 7 had recently joined our group hen: from in to\m. 8 Dr. Graham had been treatins this patient over 9 the years for various cosmetic nbnonnnlitics and at this 10 time Dr. Graham was intcrcslcd in having the patient seen 11 for a history of neck pain and bilateral hand numbness. 12 The patient gave me the history that she 13 apparently was involved in a motor vehicle accident 17 years 14 prior 10 seeing me; so In 1980, but more recently. . IS approximntcly two months prior, sometime in Junc or May, she 16 had another accident and sbe felt that this accident had 17 resulted in an aggravation or an increase in her symptoms of 18 neck pain and hand diseomfon. 19 For that reason, after being seen by Dr. Graham's 20 group, be fell that sbe nceded 10 be evaluated by a 21 ncurosl1tgtOn. 22 Q When you met her, did you do a hands-on physical 23 cxamination? 24 A That I did, 25 Q And could you sununarize that for us. please, Page 2 - Page 5 Page 5 ~. STEVEN K. POWERS, M.D. JANUARY II, 1999 . Mulli-I'llgc '" J>ngc 6 J>ngc H I Doctor? I And Ihe nthcr condililln wns thnt of n chronic 2 A In summary, I didn't find many objcctlve findings 2 ncck condililln which had S<.'Cl1lcd In be aggravatcd In tcnns of 3 In tenns of 11l0tor or sensory wCllkncss, being the l1lotor 3 thc IImount of palnllnd radillting pllln down tn thc right 4 exam. I didn't find any weakness In her cxtremlties, 4 shnulder sincc the accidcntlhat she had a couple months 5 Her sensory exam was fairly nonl1allhroughout, 5 prior to seeing me. 6 but I did find that she had pain Inereu.o;cd wilh neck motion, 6 Q Doctor, did you discuss with Mr. and Mrs, 7 particularly whcn I threw the neck into hypcrnexion, and 7 Sgrignoli her treatmcnt options" 8 that there was somc radiation of numbncss ovcr the right 8 A Yes, I gavc hcr two options, onc was to consider 9 shoulder area down into tbe right upper arm area. 9 a lemporary relief of using cervical halter traction and 10 Q Could you show us on your own body what 10 outlined a program for her to use a home Iraction kil. 11 hypernexion is? II On the othcr hand, I fclt that thc ehanges that I 12 A II's tucking Ihc chin In towards thc chcst. 12 sow on the MIU sean, which ore quite ehronie, probably were 13 Q And, Doctor, arter doing this eXlllUination did you 13 going to necessitate some fonn of surgery In the future and 14 review any diagn03tle studies? 14 I offered her the option of undergoing that surgery. 15 A She brought with her an MRI scan done ovcr on Ihc 15 Q Did shc eventually dceide 10 undergo Ihe surgcry, 16 west shore ond I had a ehonce to look at that. I didn't note 16 Doctor? 17 the date of the test, but I would asswne it was probably 17 A She did. 18 within a month or so of Ihe timc I sow hcr. 18 Q Can you tell us Ihc date of the surgcry? 19 The study basically showcd Ihat shc had pretty 19 A The date of the surgery was.. this is the first 20 signifieont spondylotlc diseuse or spurs on the spine, 20 surgery that I perfonned on her.. was September 25th, 1997. 21 related to underiylng dise disease and this was most notable 21 Q Could you tell us in laymon's tenns perhaps using 22 on the mid cervical areas at C5.6 and C4-5, but also at thc 22 the model what you did during the surgical procedure? 23 C6-7level. 23 A Well, basically what I did was to make an 24. Q Now, Doctor, would this.. thcse changcs or these 24 Incision in thc front of the neck about the level of the. 25 things that show up on the MRf. would thcy have existed 25 collar from the midline up to the border of what's known as . Pagc 7 Page 9 1 before the June 13th, 1997, accident? 1 thc sternocleidomastoid muscle. This muscle that turns our 2 A Yes, 2 head. 3 Q And you mentioned thc tenn C5'C6. Could you use 3 And then going between tissuc planes approached 4 the model and show the jury what we're talking about? 4 the front of the spine and removed the central portion of 5 A Well, there ore seven cervical vertebrnc ond C5 5 the C4-5 ond the C5.6 disc using a microseope to visualize 6 refers to the fifth cervical vcrtebrnc coming down from the 6 this urea, going through the disc to the back of the disc I 7 bottom of the skull, so C5 would be this vcrtebrnc here. 7 was then able to, under the mlcroseope, drill off spurs that 8 C4, C5, C6, C7. C4-5 disc space is the disc 8 were pushing from the back edge of the vertebral bodies and 9 space between the two vertebral bodies of C4 and C5; and 9 the disc spaces Into the front of the spinal canal. 10 C5-6 intervertebral disc is located here ond 6.7 down here. 10 This was then accomplished, the space was then 11 The C7-TI disc is the lowest disc in the cervical 11 filled in by taking a piece of cadever bonc, in this case 12 area and once we get into the thoracic area we ore now with 12 fibula, CUlling it and sizing it to fit specifically into 13 ribs on the vertebrae. 13 cach of these spaces and wcdging those pieces of bonc in 14 Q What is the purpose of the discs betwcen these 14 place to act as a fusion. IS vertebrnc? 15 We then closed the wound in layers with 16 A Well, It's felt they act as a cushion between the 16 absorbable sutures on the inside. 17 vertebral bodies. 17 Q Doctor, eon you tell us generally speaking how 18 Q Arter doing your examination and looking at the 18 long the surgical procedure takes? 19 diagnostic studies, did you fonnulate an initial impression 19 A II's variable, onywhere between two and a hnlf to 20 or diagnosis? 20 four hours. 21 A Yes, I felt the patient actually bad two types of 21 Q Any particular complications during the surgery? 22 symptoms, those related to a chronic history of hand 22 A We had, during removnl of the spur at the 4-5 23 nwnbness with some prior infonnation indicating that she had 23 level a tear in the durn whieh is the sac that contains the 24 carpal tunnel syndrome which I did not feel was really 24 spinal cord and nerve roots, which is also filled with 25 severe at the time that I sow her on August the 8th, 25 spinal nuid; ond to prevent that from leaking, a suture was Page 6 - Page 9 HUGHES, ALBRIGHT, FOLTZ & NATALE 717-540-0220\717-393-5101 rj. r.., ~ ~' I'nge 10 I plnccdlnto lhc sac, 2 Q What type of Inslruments dll you lIse 10 nelUully 3 remove Ihe disc malerial? 4 A There's 0 buoeh of dlfferenl types, Spccifienlly ~ Ihe drill Is used 10 drill away lhe hard bony areus andlhen 6 to fraelure away spurs we use instrumenls coiled eurels, 7 111CSC ore smail spoon shaped Instruments: and also whal arc 8 known os pituitary rongeurs or CUi biting forceps Ihal ore 9 able 10 bite into ligaments and bone and remove that in 0 10 piecemcal fashion. 11 Q I toke it, Doctor, Ihat after the surgery that 12 she was hospilalized? 13 A She was, I believe, on outpatient. She wos 14 watched overnight and discharged Ihe foilowing morning, 1~ Q Did you give her instructions to relurn 10 see 16 you after discharge? 17 A I did. 18 Q And can you teil us the dates you sow her, how 19 she wos doing and whal you did for her? 20 A Her firsl follow'up visit.. surgery was on 21 September 25th. Her firsl follow'up visit wns about one 22 Week later on October the 3rd and at that time I feltlhat 23 she wos doing quite weil, that she was wilhin the realm of 24 what I would expeclto see for a patient at that point 2~ following this kind of surgery. Page 11 1 We also oblnined on x.ray at that time to check 2 the position of the grofts and it seemed to be Ihat 3 everything was okay. 4 Q When did you next see her, Doctor? ~ A She returned then to see me on November the 12th 6 and at that time she wos again evaluated with an x-ray and 7 based on the x'ray I believe I asked her to .. yes. 8 Usually I would at that lime ask the patient 10 9 come out of the hard collar, but because we had used 10 allographs; in other words, a cadnver bone rather than her 11 own bone, Ihe healing process is somewhat delayed. 12 I osked her to stay in the hard collar for some 13 additional period of time. So she wns discharged from the 14 clinic a day to relurn to see me again with another IS foilow-up x-ray in about Ihree to four weeks time. 16 Q Did you have any discussion with her about the 17 surgery and the aggravation? 18 A Can you rephrase Ihat? 19 Q Sure. I'm looking at your report of November 12, 20 1997, and I was wondering if you had discussed with Mrs. 21 Sgrignoli the aggravation of her neck condition? 22 A I mentioned in my letter bock to Dr. Zlmmeooan, 23 who had served os her referring physician, that I felt that 24 there.. I can just read what I soid, that I fclt that the 25 accident of June the 13th, 1997, when she wos driving 0 HUGHES, ALBRIGHT, FOLTZ & NATALE 717-540-0220\717-393-5101 ". Mulli-Puge '" STEVEN K. POWIlRS, M.D. JANUARY 11, 1999 Pnge 12 I ellmpuny vchiclc, hud Icnd llllhe lIllllruvation of her neck 2 condition, which we knew thul she hud hud repllrtedly for at 3 leusl a yeur or Sll befllre I sow hcr, 4 Q And, Dllctor, when did you next S<.'C her? ~ A On December Ihe 10th, '97. 6 Q Was shc improving with lime, Doctor'l 7 ^ She stili had some complain Is of inteooittenl 8 neck pain, intcooiltenl unn numbness, but I did fcellhat 9 she Wl!S getting beller and allhat time I felt Ihat the bone 10 plugs on lhe x.ray were improved In leoos of the fusion and, 11 therefore, decided 10 put her in 0 soft collar. 12 Q Wos Ihere any discussion about work? 13 ^ I had menlioned 10 her thaI I felt that il would 14 be probably another couple months before she could go bock 1 ~ 10 work. 16 Q Okay. Doctor, did you see her in 1998? 17 A I did. 18 Q And can you tell us the dates you saw her and ho~ 19 she wos doing? 20 ^ I sow her on January 21st and at that time I felt 21 that she wns doing very well, that she was, as I note here, 22 cured of her pain and weakness that she had in her legs 23 previous to surgery; but she still had occosional numbness 24 and burning, dysesthesios in Ihe hands, which I felt at that 2~ time wns just more of her earpaltunnel syndrome than it wns Page I3 1 the original cervical problem; but thaI the ovcrn11 neck 2 condition wns much improved. 3 Q You were pretty plcnscd at that point, Doclor? 4 A Pretty plcnscd at that point. We had an office ~ call from her on the 30th of March. When she came out of 6 the collar altogether and started working again she felt 7 that she was having some headaches and some neck pain upon 8 movement. 9 I then brought her back on April 22nd to see her 10 and just to check things out again and at that time felt 11 that primarily that she had pretty good range of motion of 12 her hcad and neck; that she seemed to be improved with 13 respect to the cervical condition, but she wos still 14 complaining of some dysesthesias over the palms of her hands 1~ and particularly on the left we found that there wos a 16 lillle bil of atrophy more on the thenar eminence, this 17 portion of the hand than on the other side and that's 18 suspicious for 0 chronic problem with median nerve 19 compression or earpal tunnel syndrome; so at that time I 20 talked to her a little bit about undergoing 0 carpal tunnel 21 relcnsc on the left hand which she decided to do the 22 following month. 23 Q The earpaltunnel wasn't related to this accident 24 wos It, Doctor? 2~ A Not that I con pUllogether, no. Page 10 - Page 13 STEVEN K. POWERS, M.D. JANUARY 11, 1999 ' Multi-l'lIgc '" Pllgc 14 1 Q Doctor, when did you next S<.'C her with regllrd to 2 the neck Pllln? 3 A Well, actually [ believe that [ did not S<.'C her 4 ogain for the neck pain. The nexttil11e I sow her we 5 performed hand surgery on her and lhen followed her up for 6 the hand surgery on May the 15th and she was basically nol .7 really eOl11plaining of any neck pain after the April visit. 8 Q So your prognosis with regard to her neck would 9 be what, Doctor? 10 A I think that her neck condition atlenst at this II time is stable, she's free of pain and she docs not appear 12 to be sYlllptomatie from it. 13 Q Now, Doctor, you had described thc changes that 14 you sow on MRI and you indicated that those changes existed 15 ,before the occident, correct? . 16 A Yes. 17 Q Would she hove needed this surgery even if there 18 had not been a motor vehicle accident? 19 A It's hypothetical. I can't answer that. It's 20 possible that she may have needed the occident (sic). 21 The faetIs that the spurs that hod formed in the 22 neck, the bony changes toke a long time to occur. Those 23 didn't happen just due to the accident. 24 Whether or not those spurs would have caused her 25 to develop enough neck pain that resulted in her seeking Page 15 I medical attention for surgery is anybody's guess. I can't 2 say that she would or would not have. 3 It's my guess, based on her age that.. she's 46 4 years old and she's a very active person ..that she 5 probably would require surgery at some point in the future 6 because she's going to be the type of person that will 7 repeatedly traumatize her neck and at some point probably 8 lead to 0 condition that would Ir.ad her to seek medical 9 attention. 10 Q Doctor, do you hove an opinion with a reasonable 11 degree of medical certainty whether the June 13, 1997, motor 12 vehicle accident aggravated her preexisting condition 13 necessitating the medical treatment, thereby accelerating 14 the need for the surgery? 15 A Well, I think I can say with 0 pretty high degree 16 of medical certainty that if the occident had not occurred 17 when it did that she probably would not have sought medical 18 attention and would not have pursued surgery. 19 This is a woman who had a fairly chronic history 20 of some neck pain which she got around with and really 21 didn't bother her much and the only reason she wonted to see 22 a neurosurgeon at this point was because it was 23 incapacitating. She couldn't do her usual job. She 24 couldn't do her floral work and hcr jewelry work. 25 MR. LlITZ: Thank you, Doctor. I'm sure Mr. Page 14 - Page 17 Page 16 I Weidller hilS sOl11e questions, 2 UY MIl. WElDNElI: 3 Q Doctor, illY nume's Roy Weidner und I do hove some 4 questiolls, I represent Mrs. Smiley. S Ilad you seen Mrs. Sgrignoli prior to August S, 6 1997'/ 7 ^ No, I hadn't. 11lcre was on error somehow in the 8 letter or comments mode by Dr. Bill Graham before. I think 9 looking at the medical record there was another Debra 10 Sgrignoli, exactly the some spelling. II In fact, when tltis patient was first seen by me, 12 I thought it was this patient. This was a woman who had a 13 pituitary tumor and the records here hod demonstrated due to 14 0 mixing of the files that there had been several visits. 15 No, I had never seen her before. 16, Q Are you aware that on October 29,1996, she 17 presented to Dr. Zimmerman, an internist in Lemoyne, and his 18 records state she was traveling in Ohio on Sunday when all 19 of 0 sudden she became diaphoretic and developed severe neck 20 pain. Shc continued to drive, but the pain b<:came so severe 21 shc started seeing spots? 22 A I wasn't aware of that, but if you would like a 23 comment about that I'd be happy to moke it. 24 Q Well, is it consistent with 0 person that has 2S cervical spondylosis? Page 17 I A No, it's morc consistent with a cardiac problem. 2 Q Do you know that she was ruled out as having a 3 cardiac problem? 4 A No, I don't, but that would be the first thing I 5 would think of if a patient presented like that to me, I 6 wouldn't even think of cervical disc problem, I'd think more 7 about doing a cardiac evaluation. 8 Q And, in fact, that's what Dr. Zimmerman did and 9 ruled out thc cardiac problem. 10 A Okay. That would, in my mind, be inconsistent II with a cervical disc problem. 12 Q She does -- she did, in fact, when she initially 13 presented to you, have cervical spondylosis, is that 14 correct? 15 A That is true, yes. 16 Q And that is basically a degenerative condition, 17 is that correct? 18 A That's probably the best way to categorize it. 19 It may be a traumatic condition, too, if you look at it in 20 the sense that this is repeated trauma involving joints and 21 the discs. 22 Q Doctor, I'm going to give you what I'm going to 23 have the stenographer mark as Exhibit I and ask if you wrote 24 that letter? 25 A Yes, I did, October the Sth, '97 to Mr. Lutz. HUGHES, ALBRIGHT, FOLTZ & NATALE 717-540-0220\717-393-5101 Puge IX I Q TuMr, l.ul1.'I 2 ^ LUI1., 3 Q 11le cuucludlug purugruph ,Iules Ihelllls \'Cry 4 IIIt1e furl her IIUlI I wuuld mid lu Ihls exeelll lu Hhlle Ihul , If que,lioued iu Ihe fUIUllluS lu Ihe euusulluu uf her neck 6 Injury, I wuuld eerluiuly deny Ihulll \\'US Illlule,llnlhe 7 oecldenl uf Juue 131h, 1997, IIl1llulllCSI her ueek euudllluu 8 wos only wur..:ned enuugh lu cuu,,: her Iu s,."ck medleul 9 ollenllun fullnwlng Ihe uecldenl, ..:mlculun, whelllns, In due 10 IIl1le she would hllve prnhllhly ,oughlmedlcnlullcullon 11 Wilhoul ony Iroulllulnlllullug her HCCklng HUl1licul 12 Ireolmenl,lHlhnl correcl" IJ ^ Yes, 14 Q Wos Ihlll your oplnlun" I' ^ II sllll I" 16 Q Su ho,lclllly whnl you're 8IIylug here I, Ihol over 17 the COUnI<l of IIl1le her eondlllon would hove coused her 10 18 sc.:k lIledleol ollenllun ollll hod Ihe sUl1lery wllhoullhe 19 Imulllu of Ihe Juno 1997 occident" 20 ^ Well, I didn't 80Y II like Ihnt, f soid 21 prohohlo. I u..:d Iho word prnhohly, It's 0 hypolhetic.l 22 point on my side, 23 Q ^8 18 your opinion Ihollhe HUl1lery you perfonned 24 Is eoullOlly relolcd 10 Ihe occident, I, Ihol com:ct? 2' ^ Well, nol .. woll0 mlnule. You're toking it out Poge 19 1 of eOlllexl. WI,ollhl, ,0Y' II I'm ,"yl"g Ihllllh. occidelll 2 did 001 coule Ihe n",k h\lury; lu olher wordl, did nol couse 3 d.. .poudylolll, 111011 hove .Inled nlraldy. 4 DUll fclllhlllll worselled II.. condition Ihol , exl.ted which I. .Ioled hcre Ulld I olIO poilll oul dial In my 6 opinion, 81ven IholIhllII a very oetlve potlcnl. Ihis Is a 7 Woman who rides .nowmobllel and her olld her husband do all 8 klndl of dllnSl, Iholll'. probably likely 10 her Iifclime 9 dial .1.. would hove nceded 10 IlOve lomcllllng done anyway. 10 becou.e of d.. pOlllblllty of rq1CQled trnumolo Ibl. II underlying dcaencrnlive n",k. 12 Q 11CJlC'1led Inllllno I. a rl.k foclor for cervical IJ .pondylo.I... 14 ^ COrn:cI, I' Q.. I. dlnl corn:cl? 16 ^ 11'011. corn:cl. 17 Q So IIUlI whllll uudenllllld you'", .oylns" ond 1 18 dOIl'1 wonllo mllquote you ..I. wllh her oclive 19 IIf""yle, II., IIkelll.xxll. oluellllhl. molar vehicle 20 occldelll. .1.. wOllld hllve "-")lIln:<I II.. ,ursery olld medical 21 In:lllmenl for I.:r lI",k? 22 ^ !'ulllhly, !'robohly. ImCllu II .. you don'l 23 kllllW, I dnll'l kllow. SI.. 1.111 rilk, It'. jUSllike If you 24 Inke II plllielll whn ho, IIn ullderlylng high cholc<lcrollcvel 2' nnd Yllulelllhellllo S1np .moklllg and Ihey don'l SlOp IIlJOIJJ1S, ALBRIGHT, FOLTZ & NATALE 717-540-0220\717-393-5101 \ Mulll-I'UllC'\i STEVEN K. POWERS, M.D. JANUARY 11, 1999 Puge 20 1 Hnlllklng, Ihey hu\'~ II higher risk of de\'eloping heurt 2 dlsclISC, II doeslI'tmelln thlltlhey will, butlhey huve u 3 higher Incldellls nf myocllrdllll Infuretlon. 4 Q Ok'JY, Whlll (ullderslund the sltulltinn to he with , her Is Ihllllhere \\'C1ll osteophyles impinging on the spinul 6 cord, IH Ihllt correct" 7 ^ Onlhe cunul. 111e spinul cord, itself, I don't 8 Ihlnk WII' Illlllly compreHsed yct. 9 Q Okuy. ^nd thnse were the poslerior oSlcophytes, 10 Is that correct" II ^ Poslerior.. off the posterior margin of the 12 vertcbml bodics, not posterior in Icnns of eunallocutlon. 13 In other words, they were off the disc, they weren't off the 14 fucet joints, l' Q Okuy. And they preexisted this uccident? 16 A Correct. 17 Q ^nd busicully whutthey do is they impinge on the 18 splnul cunal, is Ihut correct? ' 19 A Correct. 20 Q And then thot cuuses Ihe pain, nUll1bness and 21 tingling, is thot correct? 22 A If it comes into conlact with poin sensitive 23 structures like the nerve root or the duml sac, yes. 24 Q And would thot have been the cause of her puin 2' und discomfort? Page 21 I A That wus my belief. And also the fact that she 2 had known angulution of the spine which is putting excessive 3 traction on posterior ligamentous structures of the spine. 4 Q Okuy. And whut yoo did is busically relieve S those osteophytes from impinging on the spinal cunol, is 6 that correct? 7 A Thotund also fuse the spine at those levels to 8 tuke off any movement, uny movement thot would cause 9 tmction und reluted poin on the ligaments ut the back of 10 the spine or on the muscle tissue to the buck of the spine. I) Q Her surgery was .. except for thut problem I 12 believe somebody nicked .. 13 A Well, I would put it with the drill -- during the 14 drilling process where we're shaving off the osteophytes, U the drill hus u diamond burr on the end of it and what we 16 genemlly do is to drill down to the .. what is culled 17 poslerior longitudinolligament. 18 In the case where you have a large spur that 19 ligament may be so Ihinned out, the next structure that you 20 come in contoct with is the dum. 21 And in this case ofter going through the hone, 22 the dura wus the next structure and it was very thin und 23 happened to be .. if you wont to use the word nick, I would 24 use the word shuved atthut edge, so it wus thinned out, 2S requiring that we put a suture in there to prevent it from Page 18 - Page 21 STEVEN K. POWERS, M.D. JANUARY 11, 1999 . PlIge 22 1 leaking. 2 Q Olher than that, the surgery WllS uncompliclIled? 3 A Right. 4 Q And her recovery WllS uncomplicatcd? 5 A It WllS a little longer than mosl, bUllthink 6 that it WllS uncomplicated, yes. '7 Q And she recovered well? 8 A Yes. 9 Q This" her condition was cervical spondylosis, 10 is that correct? 11 A Correct. 12 Q And that is a degenerative change or process? 13 A Again, it's primarily considered degenerative. 14 Q And it's usually seen in people 40 to 50 years 15 old, is that correct? 16 A Or older. Very common, much older than that. It 17 doesn't slart usually until you your 30s and worsens with 18 age. 19 Q And bllSically one of the risk factors for this is 20 an active life-style? 21 A Yes. 22 Q As far as it becoming symptomatic? 23 A Yes. 24 MR. WEIDNER: That's all I have, thank you. 25 MR. LUTZ: Thank you, Doctor. Page 23 1 (Whereupon, the deposition was concluded at 10:54 2 a,m.) 3 (Letter dated October 8,1997, produced and 4 marked Defendant's Exhibit No. 1.) 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 Page 22 - Page 24 Multi-Page 1>, Page 24 I COUNTY OF DAUI'IIIN 2 : 55 3 COMMONWEALTII 01' l'ENN5YLVANIA: 4 I, Tammy J. Daker, a Notary Public, authorized to 5 administer oalhs within and for the Commonwealth of 6 Pennsylvania, do hereby certify that the foregoing is the 7 testimony of STEPHEN K. POWERS. M,D. 8 I further certify that before the taking of said 9 deposition, the witness was duly sworn; that the questions 10 and answers were taken down stenographically by the said 11 Reporter-Notary Public, and afterwards reduced to 12 typewriting under the direction of the said Reporter. 13 I further certify that the said deposition was taken 14 at the time and place specified in the caption sheet hereof. 15 I further certify that I am not a relative or employee 16, or attorney or counsel to any of the parties, or a relative 17 or employee of such attorney or counsel, or financially 18 inlerested directly or indirectly in this action. 19 I further certify that the said deposition 20 constitutes a lnle record of the testimony given by the said 21 witness. 22 IN WJTI/ESS WHEREOF,l have hereunto set my hand 23 this 13th day ofJanunry, 1999. 24 j:unm)' J. uucr,Keponer 25 Notary Public i I ! HUGHES, ALBRIGHT, FOLTZ & NATALE 717-540-0220\717-393-5101 @ ~,,~ , {1g fl r (1 \, ,1')( l$. f'd I ~, , ~. l,i ;. I ".I ~~ , l,., .~ . ~) I.. II' . .J" '". ,,);; I.,'J~ t't<) ~}, ~ % iii =i ,. 1; jl 1:') \,; i>. I",. t~,./ ,:~.:' "<'. t.{,:i );..~ 10SEPH M, MELILLO 1CRRY S, HYMAN DAVID L. turz MICHAEL Eo KOSIK PAMELA 0, SHUMAN RICHARD A. SADLOCK Angino URovner DAVIDS. \\1SNF..'lKI NUOLE C, OLSON MICHAEL I, NAvrrSKY IOSEPH M, DORIA DUANE S, DARRICK lAMES OlCINTI L1S1<1lIN , TIlE BEST LAWYERS -IN_ AMERICA RICHARD C. ANOINO NEIL I. ROVNER February 10, 1999 Rick Pierce, Court Administrator Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013 Re: Sgrignoli v. Smiley Dear Rick: The above-captioned case is listed as NO.8 of the trial list. However, the Plaintiff, Debra Sgrignoli, is scheduled to travel to Fort Worth, Texas, on March 17, 1999. Enclosed is a copy of her itinerary. Accordingly, I would respectfully request that this trial, which I believe will take 1M days, be scheduled for the first day of the trial term, March 15, 1999. Should you have any questions, please contact me. DLL:mtg ~~lY yours, ~ ~y Lutz Enclosures cc C. Roy Weidner, Esquire (w/enc.) -. . 145260/MTG 4S03 NORTH FRONT STREET, HARRISBURG, PA 17110.1708 -Bfh ,'b/f F (717) 238-8791 FAX (717) 238.5810 @ i.' _... I I ~ I i,; , ('.. I .' i"(" . , ,. I I IOSCPII M, MI!1.IU,O 11'JlRY S, IIYMAN DAVID L. urn MICIIACL II. KO.!IK rAMI!1.A 0, SilliMAN RlCIIARD A, SADLOCK Angino DRovner NllOl.fi c. OL.mN MICIIAru.1. NAVrrSKY IOSfiPII M. DORIA DUANa 5, MRRICK IAMP.s llIC11rr1 DAVID S, WISNESKI L1SmD IN TIlE BEST LAWYERS -IN- AMERICA RICIIARD C. ANOINO NFIL I, ROVNER January 26, 1998 Ms. Tyeddie Desmarais Harleysville Insurance Company 2700 Commerce Drive Harrisburg, PA 17111 Re: Claimant: Debra Sgrignoli Insured: George Smiley, Jr. Claim No.: 44211005 Date of Loss: 6-13-97 Dear Ms. Desmarais: I plan litigation. filed. to settle this case in the next 30 days or initiate Enclosed is a copy of the Complaint that will be My records indicate that on December 5, 1997, we spoke and you informed me that your insured's policy limits were $100,000. Given the clear liability, Mrs. Sgrignoli's surgery, and the worker's compensation lien, I would counsel my client to accept a settlement offer of $90,000 if said offer is made within 30 days of the date of this letter. In such a fashion, Harleysville would be able to realize a savings from its policy limits, as long as the underinsured motorist carrier consents to the settlement, waives SUbrogation, and agrees to a "credit." See, Bovle v. Erie Insurance Co., 656 A.2d 941 (1985). I , I Enclosed is a copy of my December 5, 1997, correspondence addressed to the Hershey Medical Center. Please note that I did not limit my request, but simply askeg for all of the records. Enclosed are all of the records we recelved in response. Should you require further information and/or documentation, please contact my office. However, and as previously indicated, if , .:. B-;Ai'Dr+6 4503 NORTH FRONT STREET, HARRISaURG, PA 17110.1708 . (717) 238,8791 . FAX (717) 238-5810 CERTIFICATE OF SERVICE I, Mary T. Geraets, an employee of the law firm of Angino & Rovner, P.C., do hereby certify that I am this day serving a true and correct copy of PLAINTIFFS' PRE-TRIAL MEMORANDUM upon all counsel of record via postage prepaid first class United States mail addressed as follows: C. Roy Weidner, Jr., Esquire 301 Market Street P.O. Box 109 Lemoyne, PA 17043-0109 Attorney for Defendants ~\~\ .~ \~ M Y . 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