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Home My WebLink About01-06185 t:'='h~' ___c___, '1;-' I', . ~ , KATHY DELGRANDE, Plaintiff IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA v. CIVIL ACTION - LAW NO, 01-6185 VALLEY QUARRIES, INC., Defendant JURY TRIAL DEMANDED v, JUDITH L. JUMP, Additional Defendant PLAINTIFF'S ARBITRATION MEMORANDUM I. Statement of Facts This case arises out of a motor vehicle accident which occurred on Monday, November 1, 1999 at approximately 11:50 p.m. on Interstate 81 southbound in Penn Township, Cumberland County, Pennsylvania. At the time of the accident, Plaintiff Kathy Delgrande was a right front seat passenger in a car driven by her aunt, Judy Jump, which was travelling southbound in the left lane of Interstate 81. The right southbound lane of Interstate 81 was closed for construction activities being undertaken by the Defendant Valley Quarries. The right southbound lane was closed by plastic construction barrels and signs restricting traffic to the left lane. Some time before the actual accident, an employee of the Defendant Valley Quarries was in the process of moving traffic control signs which were moved as the construction activities progressed along the highway. The construction project involved a 7.2 mile section of Interstate 81. At the time of the accident, the construction company was in the process of working on the milling of the shoulders of the highway. Randy L. Smith, an employee of Valley Quarries, was responsible for maintaining the traffic control plan on the construction site. On the day of the accident, he was maintaining the traffic control plan for work being undertaken by a subcontractor, Mr. Smith was moving 11 construction signs on a trailer so that they were closer to the actual construction activity. 267627.1\MEKIMMM ... 1'i.-i,,,'-'~"~ ~,- .- ,. M_ 'I;' I The construction signs were of a portable type utilizing a portable base known as a Windmaster. These were a portable-type of construction sign where the base would unfold with four legs and a post was placed into the base that would hold the construction sign. The signs were on spring- loaded posts to prevent the signs from being blown over by winds or passing traffic. See photograph ofWindmaster sign from the manufacturer, TAPCO's web page, attached as Exhibit A. Mr, Smith is expected to testify consistent with his deposition where he described loading the Windmasters in a folded up manner at which time they were approximately 8 to 10 inches square and, four feet long, onto the base of the trailer. Mr, Smith is expected to explain that he laid three or four of the Windmasters on the trailer and then piled the others three high on top, Mr. Smith did not secure the Windmasters in any way, although he did secure the signs themselves. As he was proceeding through the construction area, a Windmaster fell off the side of the trailer into the highway across the southbound lane. A short time later, Additional Defendant Judy Jump was proceeding south in the left lane and did not observe the metal Windmaster in her lane until it was too late, Additional Defendant Judy Jump struck the Windmaster causing an abrupt impact. Judy Jump slammed on her brakes and pulled her car to the left side of the road as quickly as possible. See, Pennsylvania State Police Report concerning the incident attached hereto as Exhibit B. Plaintiff Kathy Delgrande sued Valley Quarries because of the negligence of Randy Smith in failing to secure the Windmaster in the trailer while it was being transported, The trailer had open sides which would permit the Windmaster to fallout of the sides of the trailer which occurred on this occasion, Valley Quarries joined Judy Jump as an Additional Defendant. Plaintiff Kathy Delgrande maintains that she was a right front seat passenger in the car and had no control over the motor vehicle and therefor cannot be found to be comparatively negligent for this accident. 267627.11MEKIMMM ;,;:;r.."^ II. Liability of V allev Quarries. Inc. Defendant Valley Quarries is liable for the negligence of their employee, Randy L. Smith, on a theory of Respondeat Superior. Based upon Mr. Smith's anticipated testimony, Plaintiff Kathy Delgrande maintains that it will be established that a Windmaster from a trailer which he loaded came off the trailer through the side opening of the trailer and that the Windmaster had never been secured on the trailer. The mere fact that part of the load came off the trailer, in itself, can establish the negligence of the Defendant. It should be beyond dispute that a properly and safely loaded trailer being used under normal operating conditions would not lose either part or all of its load in the absence of negligence. Negligence may be inferred where a trailer loses a part of its load onto the highway creating an obstruction in the highway. In Hammerstone v. Rose, 317 Pa, Super. 569,464 A.2d 468 (1983), the Pennsylvania Superior Court held that the Restatement (Second) of Torts S328(D), adopted by the Pennsylvania Supreme Court in Gilbert v. Korvette's Inc., 457 Pa. 602, 327 A.2d 94 (1974), was applicable under a similar scenario, The Restatement provides an evidentiary rule which permits a logical and realistic approach to circumstantial proof of negligence where the event is the kind which does not occur in the absence of negligence and other possible causes for the event are sufficiently eliminated and the negligence is within the scope of the Defendant's duty to the Plaintiff, In the Hammerstone case, a trailer broke loose and fell from the Defendant's truck when traversing a dip in the highway causing damage to a parked car. The Superior Court found that this was the type of circumstance where the inference of negligence rule would apply. Plaintiff maintains that a similar circumstances exist in this case. Clearly, no party, even a construction vehicle, is permitted to operate on the highway and lose its load creating a hazard for other 267627.1\MEK\MMM ~'~ . ,'g/ motorists. Plaintiff further maintains that improper loading or failure to secure the load is within the scope of the Defendant's duty. The only possible cause for the Windmaster coming off the trailer was the improper loading or securing ofthe load by Mr. Srnith and, therefore, Valley Quarries may be held to be liable for the circumstances which occurred, Pennsylvania also has a statute requiring the securing of loads in vehicles, 75 Pa.C.S,A. g4903 provides: (a) General Rule. - No vehicle shall be driven or moved on any highway unless the vehicle is so constructed or loaded to prevent any of its load from dropping, sifting, leaking or otherwise escaping. (b) Fastening load. - Every load on a vehicle shall be fastened so as to prevent the load or covering from becoming loose, detached or in any manner a hazard to other users of the highway. Plaintiff maintains that clearly this statute was violated in that the Windmaster was improperly loaded and allowed to fall onto the highway and no fastening device was used. Plaintiff maintains that this violation of the statute is negligence per se and Valley Quarries should be held liable for the accident. 111. Damages Plaintiff Kathy Delgrande was shaken up as a result of impacting the Windmaster which had been across the left southbound lane. She was thrown forward and she struck the windshield with her head and the dashboard with her upper body. Immediately after the accident, she did not believe that she needed to be taken to a hospital since her daughter, who was asleep in the rear seat, and Judy Jump were not able to get home until approximately 3:00 a.m. in the morning, and she immediately went to bed, The next day, she was extremely sore, and she eventually went to the Chambersburg Hospital two days after the accident. At the hospital, she was diagnosed as having sustained head trauma and post-traumatic headaches, cervical strain/sprain and lumbar strain/sprain, 267627.1IMEK\MMM --~ ;;r" ~ .,~~ A CT scan was taken at the hospital, as well x-rays, which showed only a loss of lordosis in the cervical spine which is an indication of muscle spasms, Within the week she began treatment with Dr. Frankeny of Orthopedic Institute who again confirmed that she suffered a musculoskeletal injury to her neck and back and referred her to the Keystone Spine Center for therapy, She attended Keystone Spine and was treated with the McKenzie program, However, because of the distance that she lived away and child care responsibilities, it was difficult to attend on a regular basis. Kathy treated at Keystone Spine and Dr. Frankeny through April, 2000. Dr. Frankeny's notes provide a good summary of Kathy Delgrande's condition. Dr. Frankney continued to disable Kathy through his last visit when he continued her disability indefinitely. In June, 2000, and she eventually sought treatment at Maderia Chiropractic in Chambersburg. She received treatment there and fmally progressed to the point that she was released close to the one-year anniversary of the accident. Treatment at Maderia Chiropractic initially started out three times a week then tapered off to two times a week by July and then she was essentially down to maintenance treatments by the end of August through the end of her treatment, Dr, Jahn's report summarizing Kathy's treatment at Maderia Chiropractic is attached hereto as Exhibit C. Attached as Exhibit D is a medical treatment summary which further summarizes her course of treatment, and the medical records are being supplied in a separate arbitration appendix, At the time of the accident, Kathy Delgrande had applied for and was expecting to start work as a clinical care representative at Manor Health Care on November 8, 1999. Because of injuries she suffered in the accident, Kathy was unable to start work. Disability slips provided by her doctors are tabbed in the medical records appendix. Kathy was prevented from returning to 267627JIMEK\MMM ;~~,M" EI <,"-'. "'-":r'.".;;"..~.: ;1.,;<."'''._ -" 'e" . ~-~~;f''''- '"-0 _~-: I:"" .' --y , "," ' ,-' . '0 ""_"'0'''.' ' ~ k' ~ ;1' work for an extended period of time. Plaintiff has shown the calculations of her lost earnings in a work loss summary which is attached hereto as Exhibit E along with copies of employment information obtained from Manor Care by her first-party carrier. Plaintiff has deducted the first- party payments that she received from her insurance company from the calculations, and only the first five days in uncompensated wage loss benefits are being sought in this action. Plaintiff Kathy Delgrande maintains that she is entitled to receive compensation for pain and suffering and loss of enjoyment of life for the injuries she sustained in the accident. Plaintiff had varying degrees of pain and disability which extended for up to a year following the accident, however, the most severe problems were within the fust six months following the accident. Plaintiff also seeks to recover for her lost earnings occasioned as a result of her injuries and disability and as reflected in the wage loss summary. P,C. lchae1 E. Kosik J.D. No. 36513 4503 N, Front Street Harrisburg, P A 1711 0 (717) 238-6791 Attorney for Plaintiff 267627.1\MEKIMMM ", di \i~ "'-", ',;,ii' r:~-- <Iii' -----. ....- jV/f'. \!) C00136 -t:? ~ COMMONWEAL TN OF PENNSYL VANIA POLICE ACCIDENT REPORT f{l f'OfHAlJ(,E ,X~ NON REPORTABlE; I' '_111" !"'I,l 11;,\( ',HI' I'; POLICE INFORMATION H2-1097062 , ItlU/)lNT tl~;Mfl[H .' AI:I uC.Y rlAMt. J sr/HIOr'V. '4 PATROl I'Rf:CIt.lCT Carl~sle/2120 lONE. :> INV[$llGAfOR ,...,,....... (JA[)CF. Tpr. Michael J. MITCHELL NUM"'R 6650 o'~)Vrou.t.. ......... BADGE lC!'WI_Oo ~~. ~. ~____ NUMBEH -...;JU"eC) r ItNt llGATlOt~ 11/01/99 6 ARRIVAl 2352 lJo\/f' flME ACCIDENT INFORMATION 10 DAY Of WEEK 11/01/99 Man 2350 . 12. NUMOCR Of UNITS 1'5- PH!'! !>f~OP ACCIDENT PA State Police 9 ACCIOI-:NT DAn "l1Tlut:m- 'lAY 1. :;KI\:p_D 14ilJt>jjU~ED Y N x' 16 nlo VHIICI.f-. tlAVt- TO BE III Movt [) I nOM IHr 5l~rNf'1 UNH 1 I)N"? l' VEUlClE DAMAGE fl tlour UtltT 1 J IK;JlI '} - MOOfRATE ) . SE'lERE utllT 2 y X t, Y " -18 HAlARDOUS MATERIAlS Y 19. PENNOOT N.~~.____~~_ yX~ N: UNIT # 1 - V--t,-'j, Hf.G Pl.A" 233MOA JHMCA5649KC063311 Tll:GAi,';- PARKED 7 39. PA TITLE OR Ollr-Of.srAfE VlN . 41) OWNER Judy Jump 41 OWNI::R ADDRESS 504 Brenton St- . 4'1 CITY. STATE Shippensburg Pa & llPCOOE ' . , . 43 YFAR 69 :"~ MO()f.l.iNOl BODY TYPE) . '4f BODY TYPE . 'YJ',lNnIAt IMPACT 14 l'OINt ;l:(vniIC:I[ 1 Glu.olUH '",DRIVER 105916442 NUMBER . sa.DRIVEFf ~ME Judity L. Jump ! 59. DRIVER 504 B t St AOOAESS ren on .. ; 60. CrTY. STATE . .... . , & ZIPCOOE Sh~ppensburg, Pa_ '".SEt ""OATEOF 06/20/50 , BIRTH ~ vEH. 65.0fl;(vER V N Xl CLASS D . 6r. CARRIER J8 S~!f 17257 (44. MAKE Honda 04 Accord {4i SPECL6.l USAGE f){,VEHlClf : STATUS !""54-0RIVER I PIU,5H'CI '46 IN~ ;X: Ni i UNKI (49:-VEHM:lE . OWNERSHIP t si, TRAVEL' SPEED r'5,ORIVER , CONDITION ;515ffl.\E o o ~'-' , 6IS CARRIER AUUU[SS : 69 CITY. SlATE "/11'(;0/:>> . If) US[}OJ It '1l;1: It :n-b."'RGO BODVTVPE "U'; HAl AROOU5 MArFRIAI <; PIle It "2'VEH COt-OFIG . 15 NO OF M.lIS AA.45Ir.'jB) 14. GWJJf n REL~'SE OF HAlMAT YDt>lD~N~p 3 ? ( :; ? .".; ~ d. PEHNDOJ USE OM. V LOCATION l ACCIDENT 20. COUNTY Cumber land 71 C~'l" 2i~,,!,\\'ff"ilUp. ' u~jEu .. -...,,-----_..~.,.- PRINCIPAL ROADWAY INFORMA TlON 22. ROUTE He'-. OR STREET NAME 23. SPEED' 50 LIMIT SR 0081 r- u - ,.. ...., ~r~'-'- '-.----.-~ 24.iT'tPE 1 25.)ACCESS 2 - HIGHWAY.. .____, -:~~.~~~~_____._ INTERSECTING ROAD: 26.' RWE NO. OR STREET NAME . if SPEED' liMIT ..- '28.,rtPE ~-.- un ---'l~ACCESS- 'u HIGHWAY .J CONTROl . L, ~_..._ '... ., ..,..~___ ~__ IF NOT AT INTERSECTION: :to CROSS STREET OR' '~R" o'i)). SEGMENT MARKER - 31.OIRECTION-' 132. DISTANce: 3J~:~EEwqpS-,~- w_ -' ~ROr-~ISf!!, __ _~1_*_. MEASURED ""MATEO *j!:J '34,CONSTROCTION )"L~l----'1 t35.)TRAFFK:. PRINCIPAl -ZONE ~ ~~ Loj --~. 1NTERSECTtNG r~J UNIT # 2 36 lEGALLY Y N J7. REG. ~~KE,D!.r. II. ,il PlATE 39. I'A TITlE OR OUT-oF-STATE V/N 40. OWNER' 38. STATE 41. OWNER ADORESS 42'- ciiY."sfAte ~, un_,__ & IIPCOOE .43.YEMC-..-.--.- 1 50 1 45> MODEi.'. lOOT' ...---~~~) !41.iBODY . . TYPE so:.'iNifW.IMPAcT , . POINT ;"5i"'rVEHlCtE . .. GRADIENT 56.11RI\IER NU_R 58.15RIVEIt----.-----------.-- NAME 59. M-~-' AOORESS SO. CITY. STATE & ZIPCOOE si" SEX ., ...- Ri.-DATE OF BIRTH i 64. COMM. VEH'ISS. DRIVER .Y,lNr1 ClASS 67. C.\RRlER . . .. '6[CARRiER- _. ADDRESS 69. c1l'Y,'STATE &ZIPCODE 1Q.\15OO1'--- - ~,~ FT- ~~ 'I'P\JC" "0--, ~ f~~~, mm_ _~_ :~~::_ __ ~ fr,151HAZARDOU, S 77 RELEASEOF'HAZidA.r _ .n.r- MATER~S. .~ y Ll N I J UNl<[J PACE: 1 "'''.--. ,-.-.---- (h)~EH. - CONFIG. is.oo'-oF" AXl,ES ~'''''"':-"~V ,U,""'" -r' .f'C' "<c-'i"-"',";:';,~?'- , '--17' ~~. '"": I~ ", ,,'., - ,," -' "" , " '.~' .-" '" ,'. ". ';'~ :"" '.",. "'.. .,,,,-,,<,,,,,, i<>h;C;)";;:,.- F"-~r," " ;'1/1"0 C00137 .'11 HI ',,'1 )rnJlt~; I M~:; AI;I UCY None None INCIDENT #: H2~i(j91062 ACCIDENT DATE: "'1/01/99-' -- --., j I'J lAt ll"'''l fA(_llll~' llltl PI:OPlE IN' OHMATlON .\tlC()[~GUA"'1 AOORt-ss II I J K l M ! 0 f~ ! 0 N 0 10 0 0 N 0 10 -----! 0 0 N 0 0 f 49 3 1 0 Oper # 1 3 f 34 3 1 0 Kathy Delgrande same address as oper # 1 4 f 6 2 1 0 Rebecca Delgrande same. address..,,,~_S'l',,,.r_.jL,l '86 D~M'-.-"'--- : M PENN..">YlVANIA SCHOOL DISTRICT !If APPLICABlE) NA : 1i5:-6[scR-iPi'iONOfDAMACE-O PROPERfy. -.---- ~~- 81 Ilt.UMIUAUQN 3 82, WEATUER' 0' . 83 ROAD SURF ACE: 1 ! ~ '0' ,."... !;^,,6IS~ None OWNER "..EI>/I'<)'/ . ADDRESS 81. NARRATIVE. IDENTIFY PRECIPITATING EVENTS, CAUSATKlN FACTORS. SEQUENCE Of EVENTS, ~~~JlS:.l~~..I~~I;__~~~!.~ ~_~~~. Of ~ \IEHICLES. F KNOWN. . JlfiW'IIt.~ 8/J'-O'l"'" S, AND PROVIDE IONM. ~ I" H )tll s.. Unit # 1 was traveling South on.S~,Qq~l. This accident occured as unit r:~--l .str-;'ck a metal construction sign,hoder with it's undercarriage. This was the initial point of impact. It, .should be noted that at the time of the [_~~ident the right hand lane of the above location was shut down due to con- [struction zone maned by workers. 1- ___pAmag~ to unit II- 1 consisted- o.f moderate radiator damage. Nil P.",A'E TDCtfJN~r. I Oper # 1 was interviewed by th~s officer at the scene on 11/01/99 at 2355 lhrso_and related that she was traveling South on SR 0081 in the construction I...~~_e whe~~he hit a metal object left on the roadway by the construction crew t.~~~nit # 1 was towed from the scene by Johns towing_ ~P7-0015 furnished to oper # 1, news release submitted. i INSURANCE COMPANY INSURANCE COMPANY : l~fORMATlON ~ _ Uo?~. ._,__ n,..._ .__.__._ INFORtM.TION ~ UNliT i PO~~Y 003291530U7103 UNIT POlICY N~ M I 88. None 'WITNESSES NAME -.;, Ci ,~~ -"AOoRESS-- PHONE ,",' - -~~ : Ii '".~' i -,"'1 I 89. VIOLATIONS INDICATED ,'.INIT 1 None : 90. SECTION NUMBERS (ONlY IF CHARGED) ! u, ,_,.., , ,....., ._.. m._______, nn f.lLJ vrmz UNIT I 91 PROBABlE USE o .92 , TYPE TEST o I 9~. RESULTS '.XiNO TEST o ' ; REFUSE O.__Yo: 1 UNK 3302910 91. PROBABlE .-' USE : 92.) TYPE (93.)RESULTS ONO TEST '-' TEST '- 0 REFUSE O'__%[~I UNK 94.INVESTtGATION COMPlETE 7 YES [19 NO P Pl.':;nWl.Ut-iSIE T AA-~S 17'QSl -..-.. --"-.;AGE~_- '" "f"I,,," ,_ -, '..~ '<-""- '''-'1' . ~'I' . -'- ',!"?,?:-, .'" .e_^ ,= ~_" ',- __-----'____L~~_ ;1'- "t""~' ,-" ,-"~ ~ SP7-0015 (7.s7) PENNSYLVANIA STATE POLICE NOTICE OF ACCIDENT INVESTIGATION AND APPLICATION TO OBTAIN COpy OF ACCIDENT REPORT The accident in which you were involved has been reported to the Pennsylvania State Police and will be investigated in accordance with Section 3746 (c) of the Vehicle Code. ACCIDENT INVESTIGATION - A complete accident investigation, reported on the Commonwealth of Pennsylvania police Accident Report. Form AA-45, is conducted by the Pennsylvania State Police for vehicle accidents which involve: 1. Injury or death of any person.. , 2. Damage to any vehicle involved to the extent that it cannot be driven under its own power in its customary manner without further damage or hazard to the vehicle, other traffic elements, or the roadway, and therefore requires towing, 3. Hit and run. 4. Driving under the influence, 5. Commonwealth vehicles. 6, State Police vehicles. 7. Hazardous substances when a: (a) Commodity is damaged. (b) Commodity container is damaged and leakage occurs, e.g" damaged vials, boxes, barrels, the tank itself, etc. (c) Commodity must be transferred. 8, Local police department vehicles. when the local police department requests an investigation. IT IS RECOMMENDED THAT YOU OBTAIN, AT LEAST, THE FOLLOWING INFORMATION FROM THE OTHER INVOLVED PERSONlS) BEFORE LEAVING THE SCENE OF THE ACCIDENT, THIS INFORMATION CAN BE OBTAINEO FROM THE DRIVER UCENSE, VEHICLE REGISTRATION CARD AND ANY PROOF OF FINANCIAL RESPONSIBIUTY. } DRIVER (S)lPEDESTRIAN (S)IP~OPERTY OWNER (S) INFORMATION: OWNER (S) INFORMATION: NAME NAME ADDRESS ADDRESS TELEPHONE,NO. ( ) TELEPHOI\IE NO. ( ) DRIVER IS) L1CENSr: INFORMATION: VEHICLE (S) INFORMATION: LICENSE NO. YEAR MAKE REGISTRATION NO. VEHICLE IS} INSURANCE INFORMATION: COMPANY NAME POLICY NO. REMARKS: aMi: \lEt-,ll C(E I'(C/~A'Al7" ./110 1=A U f .,- or- A..? I I/"'A os. 'T",.-. ABoViC. ('ON .tT'/lV c "(, ",AJ C:ON << /RN", /JOT' E @u,-"'Nl r. o1r r' eN /? /, A /) Lv A 'f ,J '-J I 1 , ~ "1 o J j J CERTIFIED COPIES OF THE COMMONWEALTH OF PENNSYLVANIA POLICE ACCIDENT REPORT (EXCLUDING DOCUMENTS ANO APPENOED PHOTOGRAPHS) FOR ACCIDENTS REPORTED TO THE PENNsYLVANIA STATE POLlCE ARE AVAIlABLE TO QUALIFIED INDIVIDUALS UPON REQUEST AND RECEIPT OF A CHECK OR MONEY ORDER IN THE AMoUNT OF S8.00. PAYABLE TO THE COMMONWEALTH OF PENNSYLVANIA. GOVERNMENTAL AGENCIES ARE EXEMPT FROM PAYMENT OF THE $8.00 FEE, SEE REVERSE SIDE FOR INSTRUCTIONS TO OBTAIN A COPY OF ACCIDENT REPORT, - AS A SERVICE TO THE PUBLIC, AN ACCIDENT REPORT MAY BE VIEWED OR PHOTOGRAPHED (WITH PERSONAL EQUIPMENT) FREE OF CHARGE BY ANY PERSON INVOLVED, THElrt AnORNEY OR INSURER, AND CERTAIN GOVERNMENT OFFICIALS ONLY AT THE STATE POLICE STATION LISTED BELOW. I 1. Dale and Time of Accident 3. Location s /l !;' I 5 B p - (lldll'll( ;)3S'() 2. Incident No. 1.-1;> - i 0 q ( 0 (" ;) 4. County (' u M 13;.- /? 1 A"" ,0 it b SeJ ;:) "",. s. e:;;C €r.IT It 5. Officer "'lr./'A. ~...~J ;:l A.o....~ .......TURE BADGE NO. -, ~~- 6. Name of Station .cAnl'Sl~ -, I 7 - ~ 'I 'i - ~ I ~ I '--Wf'!Ol,-,"""""",." ~. _ "" .'_ _ . " ,"'~- " ~r, I' " " I~' " " ,~- -"~ " ,,' ," . MADEIRA CHIROPRACTIC, P.C. DR. ALFRED L. MADEIRA, D.C. DR. DAREN E. ESHBAUGH. D.C. DR. BRADLEY A JAHN. D.C. 1124 Kennebec Drive Chambersburg. Pennsylvania 17201 Telephone: (717) 263.8919 October 10, 2003 Angina & Rovner P.C. 4503 North Front Street Harrisburg, Pa 17110-1708 ~'ii. RE: Kathy DelGrande ~~"-': :::1' DOB: 1/17/1965 To Whom It May Concern: Ms. Kathy DelGrande was first seen in our office on June 12, 2000 for injuries sustained in an automobile accident on January 11, 1999, Ms. DelGrande initially presented with the following complaints: Low back pain, mid back pain, neck pain and stiffness, leg pain and numbness. Ms. DelGrande was diagnosed with: 756.1 Lumbosacral Anomaly, 724.4 Lumbar Neuritis, 722.10 IVD Syndrome Lumbar Spine, 728.85 Thoracic Myospasm, and 729.1 Cervical Myofascitis, .,~';.'.,; R~rr-: ~,,-., ", We provided the following treatment: Electromuscuiar therapy, myofasciai release, traction and spinal joint mobilization. The patient was treated approximately 26 times, initially three days per week for six weeks. We last saw the patient Ms. DelGrande on November 1, 2002. During that time, we made mild to moderate improvement in her condition. Due to Ms. DelGrande's mother's illness, a new job in Harrisburg, and a divorce, she found it difficult to make appointments and con1'inue her rehabilitation exercise program. She was released to full work activities at that point with additional instructions for at home exercises and if possible to continue a supervised rehabilitation program in our office. It is important to note that her condition was not "'~_1'1'_" - "',-'" --"'~'''"" ,,"-.1 " -J~--'"_>'':\''"C-_'''';'~J--''' ..;0,,, _'-~-"'1-"_ v". ''''-.i''. ,; _"_'."~, _, _ _ ",., d" _ ~ . ~ ~ _ _ :~"0!. resolved at that time. Ms. DelGrande has not been back to our office for a follow-up appointment since that last visit on November 1, 2002. At this point, r can only assume that either she was dealing with her discomfort with medications, or she had sought care elsewhere that was more convenient with her hectic schedule and stressful situation. At any rate, because of the length of time since I have Seen Ms. DelGrande, it could only be considered as unreasonable for me to adequately predict the cost of future treatment. This is often dependent on job stress, activities of daily living, and recreational activities/hobbies. I can confirm with a reasonable degree of chiropractic certainty that }JIS. DelGrande's injuries were the result of the auto accident on J anuarl 11, 1999 and that the treatment provided by our office was for those injuries suffered in the January 11, 1999 auto accident. In regards to the necessity of future treatment, due to Ms. DelGrande's lumbosacral anomaly, which is a complicating factor, meaning that the lumbosacral anomaly didn't cause her condition, the January 11, 1999 auto accident caused the injuries as previously stated, Due to the lumbosacral anomaly, these injuries didn't heal within the expected amount of time. Furthermore, because of this structural weakness, frequent exacerbations continued to occur. Continued exacerbations and injuries such as this is often the caUSe of fibrotic tissue replacement within the musculature which often can lead to a chronic condition such as myofascial pain syndrome. Therefore, it can be argued that Ms. DelGrande may need continued ongoing supportive care based upon her symptomatology and functioning. It is also reasonable that Ms. DelGrande may have to restrict certain activities, both work and recreational, to avoid further damage, function ioss, or exacerbations in her symptomatology in the future. Please contact our office if we can be of any further assistance in regards to this patient. Sincerely, Bradley A. Jahn, D,C. ~ "j",~, '''~\'.,-,-p',,,~'''.'',:." ',,....":':,,c',.-,,'-'f'~~".',';,_;,. "'''-'') ,''"''-', , . , " ~,,"-~," ,.' ''''i. ",- ,', . .~. -, ';l-"'''^J ,,~ ,.., -, ~~ - 'i :--'! i': ""':i'l'Ij\~ _ , - ~" I ~I <( :2 :2w =>0 (f)Z 1-[21- i:iie>Z :2..JUJ I-WO <(O() UJ>-() O:::J:<( 1-1-- ..../<c0 <(ll:::UJ () ~ o 0 UJ :2 C .~ Q. "' C -~ - "' rn " .~ '" " .~ Ol rn rn .e Q. 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" tIl ~ ;;:, " t- " lD N ~."," ".,~ ."- ji WAGE LOSS SUMMARY KATHY DELGRANDE DATE of ACCIDENT 11/01/99 EMPLOYER: ManorCare Health Services 11/08/99 - 12/01/99 3.3 $ 12/02/99 -08/29/00 38.1 $ Sub-Total: $ LESS PIP Payment: $ TOTAL WAGE LOSS: $ 354.86 7,704.86 8,059.71 5,000.00 3,059.71 DATES I 11/8/99-1/18/00 1/18/00-4/18/00 4/25/00-indefinite I TREATING PHYSICIAN I STATUS I alP - Dr. John Frankeny totally disabled alP - Dr. John Frankeny totally disabled alP - Dr. John Frankeny totally disabled 254749_1.xls, updated 10/30/2003 ^--J)""""""""~ " "-'--:,-'lCi!;'7'~1'~:_<"~_- .~-~'-C'_4'" - "-;,,,'1""" -~"'l ""-.,,,_<^ ,'_''', -,,'- -.--" " _'f';~ "1"" , "-~ i~ -<,--., , " ~ II . CERTIFICATE OF SERVICE AND NOW, thisJDttaay of October, 2003, I, Michelle M. Milojevich, an employee of Angino & Rovner, P.C., do hereby certify that I have served a true and correct copy of the PLAINTIFF'S ARBITRATION MEMORANDUM in the United States mail, postage prepaid at Harrisburg, Pennsylvania, addressed as follows: Harry D. McMunigal, Esquire Bingaman, Hess, Coblentz & Bell Treeview Corporate Center 2 Meridian Blvd., Ste. 100 Wyomissing, PA 19610 Attorney for Defendant Jeffrey T. McGuire, Esquire CALDWELL & KEARNS 3631 North Front Street Harrisburg, PA 17110-1533 Attorney for Additional Defendant Barbara Sumple-Sullivan, Esquire 549 Bridge Street New Cumberland, P A 17070 Allen C. Welch, Esquire 50 E. High Street Carlisle, P A 17013 Richard W. Stewart, Esquire PO Box 109 Lemoyne, P A 17043-0109 %J1JJ;71llhjJ~ Michelle M. Milojevich 267627.1IMEKIMMM , .:",.,..,. .. "'-"" - ., MADEIRA CHIROPRACTIC~ P.C. DR AlFRED L. MADEIRA. D.C. DR DAREN E. ESHBAUGH. D.C. DR BRADLEY A JAHN. D.C. 1124 Kennebec Dlive Chambersburg. Pennsylvania 17201 Telephone: (717) 263-8919 June 10, 2002 RE: Kathy Delgrande To Whom It May Concern: The following are records in their entirety for the above listed patient. Ms. Delgrande discontinued her treatment on November 1,2000. We have not treated her since. If you have any questions, please can our office. Thank you, Madeira Chiropractic, P.C. !"-".d""'.Fc<;':""",.o "'__':',~~ ,e. _." __ ""''1 r, . . . , ... -~. ." 1 .~~ KATHY DEL GRANDE Plaintiff IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA V. 01-6185 CIVIL VALLEY QUARlES, INC. Defendant V. JUDITH L. JUMP Additional Defendant: IN RE: ARBITRATION ORDER OF caURT ,AND NOW, October 29, 2003, the appointment of Lauralee B. Baker, Esquire to the above-captioned arbitration panel is vacated, and Shaun J. Mumford, Esquire is appointed in her stead. By the Court, Georg~ P.J. Jeffrey T. McGuire, Esquire H7" D. McMunigal, Esquire ~chard Stewart, Esquire, Chairman Allen Welch, Esquire Shaun J. Mumford, Esquire Court Administrator ^'1"!'~ "."",--~, "'. " " I .~_. , "-" ~ ~ KATHY DELGRANDE Plaintiff IN THE COURT OF CO}n10N PL;AS OF CUNBERLAND COUNTY. PENNSYLVANIA v. NO'01-6185 CIVIL 19 VALLEY QUARRIES, INC. Defendant v. JUDITH L. JUMP, Additional Defendant RULE 1312~1. The Petition for Appointment of Arbitrators shall be substant~ally in the following form; PETITION FOR APPOINTMENT OF ARBITRATORS TO THE HONORABLE, THE JUDGES OF SAID COURT: Michael E. Kosik, Esquire , counsel for the plaintif f / ~~, ..........0{ in the above 1- 2. action (or actions). respectfully represents that: The above-captioned action (or actions) is (are) at issue. The claim of the plaintiff in the action is $ The counterclaim of the defendant in the action is The following attorneys are ~nterested in the case(s) as counselor are other- wise disqualified to sit as arbitrators: Jeffrey T. McGuire, 363lN. Front St., Hbg., PA 17110-1533 and Harry D. McMunigal, 2 Meridian Blvd., Ste. lOa, Treeview Corp- orate Center, Wyornissing, PA 19610 WHEREFORE, your petit~oner prays your Honorable Court to appoint three (3) arbitrators to whom the case shall be submitted. ORDER OF COURT "" lID', 4".1.;1/ , ,,;'.3, foregoing petidon 10.('1 #d ~tI./ii:: Esq., and /1/b~ 'b~LJ in consideration of the ESq.,&AkAA)~-.JJ~ .Esq., are appointed arbitrators in.the above-captioned action (or actions) as prayed for. P. J. cc: Jeffrey T. McGuire, Esquire Harry D. McMunigal, Esquire :jt~.~:~ 11,;[.1. '"'--" ,,'" -OLi.""""'",,' _ '_R'.',"! _,''<-. ,w__~" ,",,~I,',' . 'Pf.- . " "c' ',"" ,~, ~~ . ,~ -.. 'c ~~~t~~WMN,!d~$f@!i!ol~1ib~~-m!("';i~'_JJiM\l~Jlli~~~~'iidii' -''''''~._Ui' ,_.-i'~1tiiQ\JjU 'i:'::~~' >- ~ ;IIG 2~~ i~~ ~~ C'IC, LLl :.,', --"~ LL o .. ~ >- l.- Z -=> )<( ~<Z :_.J~ ~.-:-3 ::::i 7>- of(/) :'Z ..Z :J](iJ i TJ -D- '5 5 CJ l.f: N .,J_ LL.. r~~ c.:: ~ C"') o 0;:: 1 'Jl {X=F'\(~E - '~,." ..~ ,,-., "-iT/,P. Y , '.' ,'1'\, I,', 1 ~~IG ! t Pt'": 4: I 0 __, " -- ,>,rV1\\rr\!' CU\\;i8t:.r\Li..\'~0 vvUl ~ I i PENNSYLVANIA f~ -dt'~ rr:- ~ () o V> ~ <? "1 V) V ~ d - -:# c:!.. ,'"' lillir" ~'~ '"' - ~~ ~ I' tE RLECOPY KATHY DELGRANDE, Plaintiffs IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA " v. CIVIL ACTION - LAW VALLEY QUARRIES, INC., Defendant NO. 01-6185 ARBITRATION v. JUDITH L. JUMP, Additional Defendant NOTICE OF ARBITRATION HEARING NOTICE is hereby given that the Arbitrators appointed by the Court to hear and decide the above matter will hold a hearing for the purpose of their appointment on Friday, November 7,2003, at 10:00 A.M., in the offices of Johnson, Duffie, Stewart & Weidner, 301 Market Street, Lemoyne, Pennsylvania. September 23, 2003 -zfY? /;It/ ~ Richard W. Stewart, Chairman TO: Michael E. Kosik, Esquire 4503 North Front Street Harrisburg, PA 17110 Attorney for Plaintiff Barbara Sumple-Sullivan, Esquire 549 Bridge Street New Cumberland, PA 17070 Arbitrator Harry D. McMunigal, Esquire 2 Meridian Blvd., Suite 100 Treeview Corporate Center Wyomissing, PA 19610 Attorney for Defendant Alien C. Welch, Esquire 50 E. High Street Carlisle, PA 17013 Arbitrator Jeffrey T. McGuire, Esquire 3631 North Front Street Harrisburg, PA 17110-1533 Attorney for Additional Defendant Prothonotary, Curnberland County Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013 :218671 ',;s~~'%.~"'l'.<, ~', '. ," H_ ~ ~". ~ Lr KATHY DELGRANDE, \ IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PA Plaintiff, CIVIL ACTION - LAW v. V ALLEY QUARRIES, INC., NO. 01-6185 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 HA VB A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU CAN GET LEGAL HELP. CUMBERLAND CaUNTY LAWYER'S REFERRAL SERVICE 2 Liberty Avenue Carlisle, Pennsylvania 17013 (717)249-3166 NOTICIA Le han demandado a usted en la corte. Si usted quiere defenderse de estas demandas expuestas en las paginas sugnuientes, usted tiene ',deute (20) dias de plazo ai partir .de la fecha de la demanda y la notificacion. Usted debs presentar unaapariencia escrita 0 en persona 0 por abogado y archivar en la corte en forma escrita sus defensas 0 sus objeciones a las demandas en contra de su persona. Sea avisado que si usted no se defiende, la corte tomara medidas y puede entrar una orden contra usted sin previo aviso 0 notificacion y por cualquier queja 0 alivio que es pedido en la peticion de demanda. Usted puede perder dinero 0 sus propiedades 0 otros derechos importantes para usted. LLEVE ESTA DEMANDA A UN ABOGADO IMMEDIATEMENTE. SI NO TIENE ABOGADO 0 SI NO TlENE EL DlNERO SUFIClENTE DE PAGAR TAL SERVICIO, VAYA EN PERSONA 0 LI"AME POR TELEFONO A LA OFIClNA CUY A DlRECCION SE ENCUENTRA ESCRITA ABAJO PARA A VERIGUAR DONDE SE PUEDE CONSEGUlR ASISTENClA LEGAL. CUMBERLAND COUNTY LAWYER'S REFERRAL SERVICE 2 Liberty Avenue Carlisle, Pennsylvania 17013 (717) 249-3166 236997.1\\MMM\LC2 .-,;;:~"" , ~~~ '-"-T_'>,....' ~" II KATHY DELGRANDE, IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PA Plaintiff, CIVIL ACTION - LAW v. VALLEY QUARRIES, INC., NO. 01-6185 Defendant. JURY TRIAL DEMANDED COMPLAINT 1. Plaintiff Kathy Delgrande is an adult individual and citizen of the Commonwealth of Pennsylvania, who resides at 504 Brenton Street, Shippensburg, Pennsylvania. 2. Defendant Valley Quarries, Inc. (Valley Quarries), is a Pennsylvania Corporation licensed to do business in the Commonwealth of Pennsylvania, and has a mailing address of Box J, Chambersburg, Pennsylvania. 3. The facts and occurrences hereinafter related took place on November I, 1999, at approximately 11:50 p.m. on Route 81, southbound, in Penn Township, Cumberland County, Pennsylvania. 4. Interstate 81 in the area of the accident is a four-lane interstate highway with two northbOlUld and two southbound lanes of travel. 5. At the time of the accident, the right southbound lane ofIterstate 81 was closed due to construction activities being performed by Defendant Valley Quarries. 6. Prior to the subject accident, a metal object was dropped in the left southbound lane of Iterstate 81 from the bed of a motor vehicle owned, operated by an employee of Defendant Valley Quarries, Inc. and registered to Defendant Valley Quarries. 236997.1 \\MMMlLC2 "'1Ji''''~~" .,~~~~, 7. Defendant Valley Quarries either knew or should have known that the metal object was deposited onto the roadway from its motor vehicle. 8. The aforementioned metal object obstructcd the lefthand southbound lane ofIterstate 81 and was not readily visible due to the lighting conditions which existed. 9. Defendant Valley Quarries did not remove the metal object from the roadway. 10. At the time of the accident, Plaintiff Kathy Delgrande was a passenger of a 1989 Honda Accord operated by Judy Jump, traveling southbound in the left southbound lane of Interstate 81. II. The vehicle in which Kathy Delgrande was a passenger collided with the aforementioned metal object. 12. As a direct result of the subject accident, Plaintiff Kathy Delgrande suffered severe and painful injuries, including, but not limited to cervical and lumbar spine strain/sprain, with resulting headaches and back and neck pain. 13. The aforementioned accident and resulting injuries and damage sustained by Plaintiff Kathy Delgrande are the direct and proximate result of the negligent, careless, and reckless manner in which Defendant Valley Quarries and its employees loaded and secured the load in its motor vehicle and operated the motor vehicle including but not limited to the following: (a) Failing to conduct a proper and safe inspection of the load before moving on to a public highway; (b) Failing to properly load the motor vehicle so as to prevent its load from dropping onto the roadway in violation on the Pennsylvania Motor Vehicle Code; and 236997.11MEKILC2 (c) Failing to properly secure the load in the motor vehicle so as to prevent the load from dropping onto the highway in violation of the Pennsylvania Motor Vehicle Code; (d) Failing to close the tailgate or otherwise placing a barrier to prevent the load from falling off the back of the vehicle into the highway in violation of the pennsylvania Motor Vehicle Code; (e) Depositing from the motor vehicle, a metal object upon the roadway, thereby creating a hazardous obstruction and endangering others on the roadway in violation of the Pennsylvania Motor Vehicle Code; (f) Failing to stop the motor vehicle when Defendant's employee knew or should have known that the object fell onto the highway creating a significant hazard for motorists operating on the highway; (g) Creating an obstruction in the highway in violation of the Pennsylvania Motor Vehicle Code; (h) Failing to warn other motorists of the hazard which was created in the highway; (i) Failing to take steps to protect other motorists or to alleviate the hazard which was created in the highway; G) Failing to immediately remove the metal object deposited from Defendant's motor vehicle in violation of the Pennsylvania Motor Vehicle Code; and (k) Otherwise driving the vehicle with an unsecured load in a manner endangering persons and property and in a reckless manner with careless disregard for the rights and safety of others and in violation of the Motor Vehicle Code. 14. By reason of the aforesaid injuries, Plaintiff Kathy Delgrande has been forced to mcur liability for medical treatment, medication, hospitalizations and other similar and miscellaneous expenses in an effort to restore herself to health, and a claim is made therefor. 15. Because of the nature of these injuries, Plaintiff Kathy Delgrande has been advised and therefore avers that she may be forced to incur similar medical expenses in the future and a claim is made therefor. 236997.IIMEK\LC2 '3~~~ !'~ 16. As a result of the aforesaid injuries, Plaintiff Kathy Delgrande has undergone and in the future will continue to undergo great physical and mental suffering, great inconvenience in carrying out her daily activities, loss of life's life's pleasures and enjoyment, and claim is made therefor. 17. As a result of the aforementioned injuries and resulting pain, Kathy Delgrande has sustained work loss, loss of opportunity and a permanent diminution of her earning power and capacity, and claim is made therefor. 18. Plaintiff Kathy Delgrande continues to be plagued by persistent pain and limitation and has been advised, 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. WHEREFORE, Plaintiff Kathy Delgrande demands judgment against Defendant Valley Quarries, Inc., in an amount in excess of Twenty-five Thousand Dollars ($25,000), exclusive of interest and costs and in excess of any jurisdictional amount ulsory arbitration. , P.c. . c ael E. Kosik, Esquire I.D. No. 36513 4503 North Front Street Harrisburg, PA 17110 (717) 238-6791 Counsel for Plaintiff Date: 12/17/01 236997.11MEKILC2 ~<!Ji'&~.t "', ,,':",1,; ',--f ,-~,,",t,~r,"'f,""~' ""~" -, ,'~';',..."""j"'", ,;" ,,-. _' ,70k, ' '1'1{" .~~ - II VERIFICATION I, KATHY DELGRANDE, do hereby swear and affIrm that the facts set forth in the foregoing Complaint are true and correct to the best of my knowledge, information and belief. I understand that this verification is made subject to the penalties of the Rules of Civil Procedure relating to unsworn falsification to authorities. Dated:--l~ ?/ 01 /r;~ :J Hi! 'I KATHY RANDE "0,11, ~ "" -f""" ~ .-'--\',,-,'<-';.'~'-:J'!.---"":__y.," ~,,__ ,-,S'" ,'" --I. ,,"~,,__. "~I''''"",_ ;,_~_ ,;_ '-"~,' ' '., 'c","'''' '"', ,---, --~ " ". CERTIFICATE OF SERVICE AND NOW, this 17th day of December, 2001, Michelle M. Milojevich, an employee of Angino & Rovner, P.C., do hereby certify that I have served a true and correct copy of the COMPLAINT in the United States mail, postage prepaid at Harrisburg, Pennsylvania, addressed as follows: Harry D. McMunigal, Esquire Bingaman, Hess, Coblentz & Bell Treeview Corporate Center 2 Meridian Blvd., Ste. 100 Wyomissing, PA 19610 Attorney for Defendants , ",. ~ 177 (hl11!ctL Michelle M. Miloje lch 236997.1 IMEK\LC2 '~-~~ >'''i"'~, ___"' _ ",,',0,,<:", ;"'""'.' ' _ ,,'~ - ._..I.,,~,~,'L.,' , 1~_~~,", ,'c" , )~--~, -', eo, "">,!'1' -,~, ",," .- - ',.'- -''<''''' ", , > () - W:- Q P ;:,; _I tl1 .,...... -, ("'1 r' /_,' ~ - D~ f\ CO L:< ~ 4-)> ::> _.::? n St... - \J) G' ,-,--' Irr!ill' -'-i ,'-) C''::' --I,' ",51 G~~ r:;s' BI! ._p.,''''P',,_,'-l..~I$l,J~,~'!,!~"~~~,l~~)W''''~~~l!ift~~1ljW~~,*E~r_r;! J~,- BINGAMAN, HESS, COBLENTZ & BELL, P.C. BY: HARRY D. McMUNIGAL, ESQUIRE IDENTIFICATION NO. 38386 TREEVIEW CORPORATE CENTER 2 MERIDIAN BL YD., SUITE 100 WYOMlSSING, PA 19610 (610) 374-8377 (610) 376-3105 (Fax) ATTORNEY FOR DEFENDANT VALLEY QUARRIES, INC. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA KATHY DELGRANDE Plaintiff CIVIL ACTION - LAW NO. 01-6185 v, VALLEY QUARRIES, INC. Defendant JURY TRIAL DEMANDED PROOF OF SERVICE COUNTY OF BERKS ss. COMMONWEALTH OF PENNA. I, Malissa N. Young, hereby certify that a true and correct copy of the foregoing Defendant's, Valley Quarries, Inc., Objections to Plaintiffs Interrogatories 18, 19,29,30 and 31 and Defendant's, Valley Quarries, Inc., Objections to Plaintiffs Requests 7 and 13, were served via United States first class mail, on January J::L., 2002 postage prepaid upon the following party(ies): Michael E. Kosik, Esquire ANGINO & ROVNER, P.C. 4503 North Front Street Harrisburg, P A 1711 0-1708 ~N~~g Sworn to and subscribed before me this ~ ~ay of ~j ,2002. 6cVJ~ -mA<~ tp ff'-- otary Public Notarial Seal Ctulllla-Maria Pagan, Notaty Publlo WlIOIIllsaing Boro, BerIcs Counll' My Oommissfon Expi....luJy 7, 2005 Mlllnbe"","..,1vanla.6esocl_ofNolllri8e ~':~r<!j,,~_~,. -, ,,_,,- ~,>7'~' ,c<<,,^;<.;? '--"',~~. ",.'''~''',. '/''1' ,'; '~_,__I t', r- ~ I.. '--~-' (") CJ ~~ C t'-J- $:" r,.,. g5ss :;:-.:a ,- ~- z ,.- I ~:i~: ',D ~C' :::<" ~t~ . , -"'-C.:~ .-:.,;; ~ <:"" _ml .....,-:: en ~.._'''''''~~ 'W"~'<<~~~ =~ E5 Bi .~, .'_', ,,"', ~_ _cp"_"",,"',', _"'~O ~,z,,", _.." "."'f'"._o ,v.;:r.~~~,~im;~'f"~~~~~~~";",""!?",,,~!BltlIrrl!,~,,, J~~;;UJ;.~~; '" BINGAMAN, HESS, COBLENTZ & BELL, P.C. BY: HARRY D. McMUNIGAL, ESQUIRE IDENTIFICATION NO. 38386 TREEVIEW CORPORATE CENTER 2 MERIDIAN BL YD., SUITE 100 WYOMISSING, PA 19610 (610) 374-8377 (610) 376-3105 (Fax) ATTORNEY FOR DEFENDANT V ALLEY QUARRIES, INC. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYL VANIA KATHY DELGRANDE Plaintiff CIVIL ACTION - LAW NO. 01-6185 v, VALLEY QUARRIES, INC. Defendant JURY TRIAL DEMANDED PROOF OF SERVICE COUNTY OF BERKS ss. COMMONWEALTH OF PENNA. I, Malissa N. Young, hereby certify that a true and correct copy of the foregoing Defendant's, Valley Quarries, Inc., Responses to Request for Production of Documents, were served via United States first class mail, on January -9-, 2002 postage prepaid upon the following party(ies): Michael E. Kosik, Esquire ANGINO & ROVNER, P.C. 4503 North Front Street Harrisburg, P A 1711 0-1708 , ~ ~L.J)~4 11 Malissa N. Y un~ Sworn to and subscribed before me this-'1..~.dayof -~""\)Qr'l ,2002. ('.,,~'%V -lrnQM-~X(l ~JV'. otary Public Notarial Seal I Cruzjla-td~a Pagan, Nolaly Public WyomlSsmg Bora, Berks County My Commission Expl....luly 7, 2005 Member, Pennsylvan/aAs8oclatlonolNotarlel f;o,ml,J",. , , , ,.,,~ ',<?? .,~-,,,>:,,,',. ,~,,'~'-'fY'; ',".~ ,'.' .:',;-.~L,' ,;,',..:;-_:~-i: __r:'''-,,,:-''':=<'~:'/',;'~, >'~',' ,'<-'.~ . ,,>.-,',:,":",t."',' " '". ,-"_,,~,,,?,"jt," '_. , ",0'.,- ,_.. H'H'. .1 ~ o~~ "".,,!lIl1tt '^'__"~,~;,,lC' ,'~' '7"""""-'-,'- ""'. '" """', .,"< ~. .~ ~, ~~.' '""~"" ~., . '~~ ~~~,~'~',-,.. -~>.~""''''"' ~""'-~ o r;: 0C;- nlfT ~1 ;2 2~ =< "--,,.- -1" C'1 f....;:; t.::.; '""'b r:"..) -:.~) I"'s '\3t/ ..,.~ ~,j"""'_'__~'"' _~~,~rmr~~~'~~~W~~&l,~'lO~!lm~~~I!\..~_~" -:: -'<:7;'::;~r~~f-,::~ ?,,;, , BINGAMAN, HESS, COBLENTZ & BELL, P.C. BY: HARRY D. McMUNIGAL, ESQUIRE IDENTIFICATION NO. 38386 TREEVIEW CORPORATE CENTER 2 MERIDIAN BLVD., SUITE 100 WYOMISSING, PA 19610 (610) 374-8377 (610) 376-3105 (Fax) ATTORNEY FOR DEFENDANT VALLEY QUARRIES, INC. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYL V ANlA KATHY DELGRANDE Plaintiff CIVIL ACTION - LAW NO. 01-6185 v, VALLEY QUARRIES, INC. Defendant JURY TRIAL DEMANDED NOTICE 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 Answer and New Matter 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 with only such further notice to you as may be required by law, for any money claimed in the Answer and New Matter or for any other claim or relief requested by the defendant. You may lose money or property or other rights important to you. YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE, OR 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. Court Administrator 4th Floor Cumberland County Courthouse 1 Courthouse Square Carlisle, P A 17013 Telephone: 717-240-6200 )',,,,,",,,,,,,,, '/ ",,"0', ~1"'~','-/~,'~'J;"',,-~,, ,-" '0'" 'C_, ' ;,<", ,..+":::.-"",,"e, '. 'I' _~ " "--'__'':~ ,,-,_ "~", ' "',~,',", --, ~". ~__"",-, ,,,,; "--",'~~~'" ,,_?'t' ,y _" fd BINGAMAN, HESS, COBLENTZ & BELL, P.C. BY: HARRY D. McMUNIGAL, ESQUIRE IDENTIFICATION NO. 38386 TREEVIEW CORPORATE CENTER 2 MERIDIAN BLVD., SUITE 100 WYOMISSING, PA 19610 (610) 374-8377 (610) 376-3105 (Fax) ATTORNEY FOR DEFENDANT VALLEY QUARRIES, INC. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA KATHY DELGRANDE Plaintiff CIVIL ACTION - LAW NO. 01-6185 v, VALLEY QUARRIES, INC. Defendant JURY TRIAL DEMANDED DEFENDANT'S ANSWER WITH NEW MATTER TO PLAINTIFF'S COMPLAINT I. Denied. After reasonable investigation, answering Defendant is without information sufficient to form a belief as to the truth or accuracy of the averments of paragraph 1 of Plaintiffs Complaint and the same are accordingly denied. Specific proof thereof, if relevant, is demanded at trial. 2. Admitted. 3. Denied. After reasonable investigation, answenng Defendant is without information sufficient to form a belief as to the truth or accuracy of the averments of paragraph 3 of Plaintiffs Complaint and the same are accordingly denied. Specific proof thereof, if relevant, is demanded at trial. 4. Admitted. 5. The allegations of paragraph 5 are deemed denied pursuant to Pa.R.C.P. 1029. "..L,k,,, " ,,' .~(, "'h'< ';>,- ;'"":'^',"'b-:.-;-",,,~,',"'''' ",e~~Y '-.',.'" ~'I:~:,:'f' ", ---_~ ,',-1-"',;,',"" J.-,.,.",.- ',~, ,""' -- . <, ,.,.. ,,_,e "".+,~,",. .,__,,-,'.', ",~". "";' _'M,' I"". :~ - 6. Admitted in part; denied in part. It is admitted that answering Defendant owned the motor vehicle referenced in paragraph 6 of this Complaint. It is further admitted that this vehicle was being operated by an employee of answering Defendant. It is further admitted that this vehicle was registered to answering Defendant. The allegations of paragraph 6 are deemed denied pursuant to Pa.R.C.P. 1029. 7. Admitted in part; denied in part. It is admitted that answering Defendant owned the referenced motor vehicle. The allegations of paragraph 7 are deemed denied pursuant to Pa.R.C.P. 1029. 8. Denied. It is specifically denied that the referenced metal object obstructed any of the traveling lanes of Interstate 81. It is further denied that this metal object was not readily visible due to any lighting conditions that existed at the time. On the contrary, this metal object was of a sufficiently large size that its condition was open and obvious to any individual exercising reasonable care for his or her own safety. 9. The allegations of paragraph 9 are deemed denied pursuant to Pa.R.C.P. 1029. 10-11. Denied. After reasonable investigation, answering Defendant is without information sufficient to form a belief as to the truth or accuracy of the averments of paragraphs 10 and 11 of Plaintiffs Complaint and the same are accordingly denied. Specific proof thereof, ifrelevant, is demanded at trial. 12. Denied. The allegations of paragraph 12 constitute conclusions of law to which no response is required. To the extent that responsive pleading is required, after reasonable investigation, answering Defendant is without information sufficient to form a belief as to the truth or accuracy of these allegations, and the same are accordingly denied. Specific proof thereof, if relevant, is demanded at trial. ';rr~~,-- ,,,,.l'i , "-~ ,'. "'!':~"\~,':':~t::~~7,.^;:~; ,;. t'< A. .';~,"',> ,:::;", ,k'~ : L":::,.,) ~,'IA<"'.",o,;:" ';""':"'7 __~ ,",' -'Tee','''' , -'"" ,... 13. The allegations of paragraph 13 are deemed denied pursuant to Pa.R.C.P. 1029. 14. Denied. The allegations of paragraph 14 constitute conclusions oflaw to which no response is required. To the extent that responsive pleading is required, after reasonable investigation, answering Defendant is without information sufficient to form a belief as to the truth or accuracy of these allegations, and the same are accordingly denied. Specific proof thereof, if relevant, is demanded at trial. 15. Denied. After reasonable investigation, answenng Defendant is without information sufficient to form a belief as to the truth or accuracy of the averments of paragraph 15 of Plaintiff s Complaint and the same are accordingly denied. Specific proof thereof, if relevant, is demanded at trial. 16-18. Denied. The allegations of paragraphs 16 through 18 constitute conclusions of law to which no response is required. To the extent that responsive pleading is required, after reasonable investigation, answering Defendant is without information sufficient to form a belief as to the truth or accuracy of these allegations, and the same are accordingly denied. Specific proof thereof, if relevant, is demanded at trial. WHEREFORE, Defendant respectfully requests that Plaintiffs Complaint be dismissed with prejudice and costs. NEW MATTER 19. Plaintiffs Complaint fails to state a claim upon which relief may be granted. 20. Plaintiff s claims, if any, may be barred by the applicable statute of limitations. 21. Plaintiffs claims, if any, may be barred and/or substantially reduced by the doctrines of assumption of the risk, contributory negligence and/or comparative negligence. ':0"1" .: ,1":;;"il,lI!" '. '<J."'?1:__~'''' ~ -',"'; ''''~,'''' '.-' '-';"T--"';"",; . "1'-"--'-' "",7'" ,~~","" , ": ',\",'""""-,<':',,~,,~~"""'" -"')'~'.,'~..,,< "0_,0 __'~r' w__, ',1 ~],,' ~~M 22. To the extent that Plaintiff did sustain injuries as alleged, which allegations are specifically denied, then said injuries were caused by individuals other than answering Defendant and over whom answering Defendant had no control and/or by circumstances beyond answering Defendant's control. WHEREFORE, Defendant respectfully requests that Plaintiffs Complaint be dismissed with prejudice and costs. BINGAMAN, HESS, COBLENTZ & BELL, P.C. H~"lUire Attorney for Defendant :~ ) : "<,,-,,,~:~,_ '!'",,-,"',]'~~cr~"_~'r:,',;,~-~,;,,, 'C\ ',~, "'~""~:,;';-'I'_' "__ "IJ'--~ ",;--, , ' , '.' .,.." , ,,0, <".' ",',c,', '"',I, , c, -' -. .= i~ 10176-828 VERIFICATION I, -J:~.gpl<l ;!;WIHtf/eNjIfL/ state that I am a representative of the Defendant, Valley Quarries, Inc., in the within action and that the facts set forth in the foregoing Defendant's Answer with New Matter to Plaintiff's Complaint are true and correct to the best of my knowledge, information and belief. I understand that false statements herein made are subject to the penalties of 18 Pa. C.S.A. Section 4904, relating to unsworn falsification to authorities. Dated: \ \ \'--\ \ O~ :i1:,rJ" . ,,,,c,JUi,$.,.l,,,..,, RU!. .'l'.' "[ .". J --:""~ '-' - " ~ :,.1 ~ "'C ",--,--. " ~" 1- ',' ,~ r BINGAMAN, HESS, COBLENTZ & BELL, P.C. BY: HARRY D. McMUNIGAL, ESQUIRE IDENTIFICATION NO. 38386 TREEVIEW CORPORATE CENTER 2 MERIDIAN BLVD., SUITE 100 WYOMISSING, PA 19610 (610) 374-8377 (610) 376-3105 (Fax) ATTORNEY FOR DEFENDANT VALLEY QUARRIES, INC. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA KATHY DELGRANDE Plaintiff CIVIL ACTION - LAW NO. 01-6185 v, V ALLEY QUARRIES, INC. Defendant JURY TRIAL DEMANDED CERTIFICATE OF SERVICE I, Harry D. McMunigal, Esquire, hereby certify that a true and correct copy of the foregoing Defendant's Answer with New Matter to Plaintiff's Complaint was mailed by United States first class mail, postage prepaid upon the following party(ies): Michael E. Kosik, Esquire ANGINO & ROVNER, P.C. 4503 North Front Street Harrisburg, P A 1711 0-1708 Ifurry~_re DATE:/-li{--o L-- ,,'( ; --:' ;,' :~,':':~; ~': ~ '~',~-:,::~ '; j' ;" ",---'^ ~,""",,..-,,,',, 'I',:""::' -, , '," r:"--; " " ,,':'{ ,~ , 1 ~ ~" "'__-''~')7.,.,':", ,,/," ,,"~'" /'1'''-:'' _," ., ",;'; ,,~- C,''," " ." ',-'; """~', ":'=?""~ ,~~ -~ ~'V'~'~ ' o ~~ gjt~~ ..< ,- (/) '. ;:.:..~ ,- ;:=,;,- ,.~~~ -"-~' >:(:~..' :-:; -' -, _'"'_'_~_M"'.""'" TCt! c-o" t" :'1 i= ..5 BfJ '''''':~"~":o>P''F ,",,~~.[ :~t~~!\f:),:mt~~~~~~,IJ1lil:~WIIlT ,- L-, ' '.-- ~it:. ,,:-'. ii ,,0. i\' ~i !' t... ;J ~~~;~.: I' ...~',., ~. , ~,i fi !,,' ',J P ~j I') ;-,-,,4-.~," _~.o.,,"'" - MADEIRA CIDROPRACTIC, P.C. DR. ALFRED L. MADEIRA. D.C. DR. DAREN E. ESHBAUGH, D,C, DR BRADLEY A JAHN, D.C, 1124 Kennebec DliV'e Chambersburg, Pennsylvania 17201 Telephone: (717) 263-8919 October 10, 2003 Angino & Rovner P.C. 4503 North Front Street Harrisburg, Pa 17110-1708 RE: Kathy DelGrande DOB: 1/17/1965 To Whom It May Concern: Ms. Kathy DelGrande was first Seen in our office on June 12, 2000 for injuries sustained in an automobile accident on January 11, 1999. Ms. DelGrande initially presented with the following complaints: Low back pain, mid back pain, neck pain and stiffness, leg pain and numbness. Ms. DelGrande was diagnosed with: 756.1 Lumbosacral Anomaly, 724.4 Lumbar Neuritis, 722.10 IVD Syndrome Lumbar Spine, 728.85 Thoracic Myospasm, and 729.1 Cervical Myofascitis. We provided the following treatment: Electromuscuiar therapy, myofasciai release, traction and spinal joint mobilization. The patient was treated approximately 26 times, initially three days per week for six weeks. We last saw the patient Ms. DelGrande on November 1, 2002. During that time, we made mild to moderate improvement in her condition. Due to Ms. DelGrande's mother's illness, a new job in Harrisburg, and a divorce, she found it difficult to make appointments and continue her rehabilitation exercise program. She was released to full work activities at that point with additional instructions for at home exercises and if possible to continue a supervised rehabilitation program in our office. It is important to note that her condition was not '4 . - ~ "-c "'~'" ""'_c~""" "'-"!I,v,'''.';.' "~~--,r"'c,'>,__':"'",~"",~",,<,~ ~,' '," , ".., resolved at that time. Ms. DelGrande has not been back to our office for a follow-up appointment since that last visit on November 1, 2002. At this point, I can only assume that either she was dealing with her discomfort with medications, or she had sought care elsewhere that was more convenient with her hectic schedule and stressful situation. At any rate, because of the length of time since I have seen Ms. DelGrande, it could only be considered as unreasonable for me to adequately predict the cost of future treatment. This is often dependent on job stress, activities of daily living, and recreational activities/hobbies. I can confirm with a reasonable degree of chiropractic certainty that Ms. DelGrande's injuries were the result of the auto accident on January 11, 1999 and that the treatment provided by our office was for those injuries suffered in the January 11, 1999 auto accident. In regards to the necessity of future treatment, due to Ms. DelGrande's lumbosacral anomaly, which is a complicating factor, meaning that the lumbosacral anomaly didn't cause her condition, the January 11, 1999 auto accident caused the injuries as previously stated. Due to the lumbosacral anomaly, these injuries didn't heal within the expected amount of time. Furthermore, because of this structural weakness, frequent exacerbations continued to occur. Continued exacerbations and injuries such as this is often the cause of fibrotic tissue replacement within the musculature which often Can lead to a chronic condition such as myofascial pain syndrome. Therefore, it can be argued that Ms. DelGrande may need continued ongoing supportive Care based upon her symptomatology and functioning. It is also reasonable that Ms. DelGrande may have to restrict certain activities, both work and recreational, to avoid further damage, function ioss, or exacerbations if< har S'fmptomatology in the future. Please contact our office if we can be of any further assistance in regards to this patient. Sincerely, Bradley A. John, D.C. ':''''"'',71, ,l.~..", "'~"; ',' ~--, "'OJ '0,1, ':'':'';':f<'-;';';-~'-1: ,,:,,'!" _,:"",",~l,;1 ;,' ""''''1 '^ '~': ,00"- "";-',":>>. _ ,', ~" , - "'. ;..-,"" ,,-'" -, ^~" , [ r ,. ii , ~ : ~:i ," , , ! ,~ '/' ,. t: ~:, ?; f ~i f,: , F;i 'i''''r~t''''l~Jli ------ ;Vlh @ C00136 -0 ~ COMMONWEAL TN OF PENNSYLVANIA POLICE ACCIDENT REPORT HIPO~IABl.f .X~ NON-REPORTABlE! I_ "1111'1"".IIlI,\(',\nll'; POLICE INFORMATION H2-1097062 1 ttl(.lI1[NT Nta..tafH .. AI;t UC.Y N~\Mi-. 3 sTAnoru . / . 4 .>AIItOI. PR:[Clt./CT Carl1.s1e 2120 lONE. 5 lNV[ST!GArOR "",,-.. liAOGt: Tpr. Michael J. MITCHELL "UM&R 6650 "~NrDn:L.. ~ BADGE ~_~ _2~~ ~____ NuW{n ~ 1 ::',fr lICATK)tj 11/01/99 8 :::JVAL 2352 ACCIDENT INFORMATION ra DAY Of WEEK 11/01/99 Mon 2350 "2,NUMOCR Of'UNtrS 1'J. ~!'I !>nop ACCIDENT PA state police 9 ACCIDENT OAR '1\ tll\.lEtu JJA.V 1. ~KlttlO i4i1tt-IJl.JBED , " x. 16 Illll VfHlC.t f-. HA'vi-, TORE In MOVI () I. HOM 111'- Sl.:rNf? UWl' UNII 'J, 11 VEttIClE OAMAGE II UONf'. U~IIT 1 1 (Killf '}.MOOl-RATE ) . SEVERE UNIT 2 Y x U " y 18, HA[AROOUS MA TERlALS : 19, PENNOOJ ~.~~_____~OPERTY Y x~ N i Y. UNIT # 1 J,c;-,icAij';~"y~-tJ-11 m,G 233MDA PARKED'? ptATE ~~~~~~~~i:VlN JHMCAS649KC063311 . ",0 OWNER Judy Jump '"'1 OWNER 504 Brenton st. ADDRESS - 42 CITY. STATE Shippensburg Pa 17257 , &. ZIPCOOE ' .. ! 43 YE'AR ! 44. MAKE 89 i Honda 43 MOUH . (NOT Accord aoov TYPE) . '4'- eODY (4i $f'ECIA( TYPE 04 USAGE "~li,lNnIAlIUPAC1' 14 r~1~,VEHIClF '>OINT : STATUS ~)3:VFHICIE 1 "'54~DRIVER CRAUJUH j I'H~ SUIt;f. ,.ORIVER 105916442 NUMBER . 58. ORNER NAME Judi ty L. Jump i 59. ORIVER 504 B t st ADDRESS ren on .. : 60. ~~.PcS~E Shippen~b~rg, Pa. '61."'t 62. DATE OF 06/20/50 . BIRTH ~ VEt', 65. ORIVER y N Xl CLASS 0 . 5T,CARRIER Jt\S~1f o o -r" '46 INS., '; Y Xj N1 , lINK! 149:.\t'EHtCLE OWNERSHIP t 5;1, TRAVEL SPEEO 155,ORIVER , CO~lDlTION :5r~E 1 50 1 . ~ CARRIER AUOHESS ; fi9 C1TY,SlATE ,\ /II'COIll" If) USUOT II 'K:!; II I'IICII 'T2'VEH Cor~FIG. "5 NO OF MilS AA,,15 r7.'jB) ~T3'CARGO E/(JDY TYPE '.7f;~ HAl ARDQUS MAfr-RrAI <; 17. RE'lEASE OF HAlMAT yO~OUN~P , 74,GWIR 3~)()') .~~S4 PENNDOf lJSE ONly 1 ---j 71 ACCIDENT LOCATION 20, COUNTY Cumber land c~'f ._.______,_.u__ 2'....UNICIl'AUTY CO"" t"enn TWp. .i':,j' .__~,_ u_+.________._._'_ PRINCIPAL ROADWAY INFORMATION 22, ROUTE No: 'Ok ' SIREET NAME 23. ~~D' 50 SR 0081 f24:;1WE - 1 -r:25iIiCCESS--2--- I' fUGHWAY _ __ :_~N!R9l_~_~_ INTERSECTING ROAD: is: ROUTE NO. OR STREET NAt.E 2i'SPeED . --- .- .--- 12i./1YPE-"-' - ----.I(STACCESS lIMIT .... f~._-. ~~A_~. _..___ _ ~!J CONTROL IF NOT AT INTERSECTION: JO CROS.C;STREEToR'''~-R""O.i33 SEGMENT MARKER ~ :~~~~~~~_:~~-,~_. L~:~~r'~~]~~------ _JH ~I. MEASURED .. ESTIMATED +,~J (35.) TRAFFtc PRINCIPAl INTERSECTING -=.- LOj r~J 34 CONSTRUCTION '. ZONE [iJ UNIT. 2 36 lEGAllY '( N 37. REG. PARKED" L Ii i ptATf!: 39. PA'tn-LE.6R ' . OtlT..oF-STATE VI,., 4O,OWNER-' -- "". OWNER AOOftESS :t2. t1tY:SfATE' -- -,...-.- . ~u .~,~_~~~.. 43. YEAR .-. 4S MOOtC (00'''- BODY IVPl) (4'7:',BotW. - - . ..;:...~_._-- - : SO:INITIAL IMPACT - _ POINT ,1iiNE:HICLE . .. GRADIENT 56. DRIVER NUMBER 58. ORNER ...... 59, D~IVER AOOftESS 6o-:C1TY, STA~ & llPCODE i>f"se)( --,-, lii:O-AiEoF BIRTH 164, COMM~ VE. H.I65. OR.IVER V,'iNn ClASS 61. C.\RRlER '.. 38. STATE '6i.CARRiER-- ---.---- n____________. AOOftESS 59,CITY,STATE & ZIPCOOE 10,'U&)(:IT'ii:--' - - --]"iCC'- ----- -- - -P\.iC"j.-----u t72:VEH. [73.;CARGO 1.. GVWR ,-, COOONFIGF.., .....TJJ:!!!Y..~. _______ ___ ,. . ~_~S' _ ,. .n.r~~~:;>~.S. PAGE: 1 71.'REIEASEOF"H6.zMi;'f y f,!!'YLtJI<l(Q ~ P"-"!~"!"":""~"""" , '-,'~ " -~ ,':,,:~'r'l ,. ,. f' '_' - ,~, . ~.~,., " ':) "0< 'j'H__'_~~' ~~ r , I' ~I " i ii 'I !:,i [_,'I 1.1 f! fi t ,. , , i l~ b I' V f: reo: R ~ ,: k F ,. j,' i' " ;:1 Ii &~ r'i ,.1 f'! \-1 1:: Ii 'I ',' [~ .1 \:'1 " 1, R" " r: t, I i I, , ~--"'~J\O;w;!!'''! I IV /1'< C00137 ~r1 HI ',f'lifllllt,K; 1M'; _\(;1 t,j(:V None None INCIDENT iI: H2~ili9'i06i-u,-, CCIDENT DATE: 1"1/01/99-.. "J MIIlK'AI IAdlli" 111<\ f'I:.OPtl INIOIUAATlON .\ 1\ \: [) [ ,. G UA.... AUOfU'SS " I J K l .. TH I... N 0 1 : 0 0 N 0 0 N 0 0 f 49 3 1 0 Oper # 1 3 f3431 4 f 6 2 1 o Kathy Delgrande same address as oper # 1 o Rebecca Delgrande sam~. a~~~~;;~...~,~_9pe_~_.1___' 1'86 OLAGRAM ~tI 81 Ill.UMINAUON 3 82. WEATHER' 0' . 83 ROADSURFACf.! 1 : : M PENNSYlVANLA SCHOOt rnsTRICT (Ir APPLICABlE) NA : iiS--6[sfR"ipjlONcifl5AMAGi-o PROPE1fTY--.---- ~ 20' ~ :~;<<'SIS~ None OWNER ""PIA'" . ADDRESS . l' ! l'Hntll ItlEWVlu.G IJ~~() .,..... 87. NARRATIVE .IOENTIFY PRECIPITATING EVENTS, CAUSATMJN FACTDRS.SEQlJENCEOF EVENTs, W1TNE818 ATEMENJa.ANO PROVIDE IOHAL ~"":~":~....l_~_,I~E ,1!'!'.~!.~_~_L~~~O'ft!D VEHIClES. FICNOWN. Unit # 1 was traveling South on.SR.~Q.B1. This accident occured as unit # 1 struck a metal construction Sign. ~o der with it's undercarriage. This ---------- was the .initial point of impact. It should be noted that at the time of the accident the right hand lane of the above location was shut down due to con- struction zone maned by workers~ I ,___DAmage to unit 1# 1 consisted' of moderate radiator damage. Nit "I"'Af-ETD 'tIN_r. ( Oper # 1 was interviewed by this officer at the scene on 11{01{99 at 2355 Phrs. and related that she was traveling South on SR 0081 in the construction zone when she hit a metal object left on the roadway by the construction crew f'. --unit ~i was towed from the scene by Johns towing. SP7-0015 furnished to oper # 1, news release submitted. i INSURANCE COMPANY INSURANCE COMPANV : INFORMATION [ USM .. .___ . ____,_ INFOAMA.TION ; .. UN:T r PO~ICY' o03i91530U71 03 UN;T NAME [88. None ~ WITNESSES NAME POlICY NO -ADoREs.s------------..---.. PHONE 89_ VIOLATIONS INDICATE : 90. SECTION NUMBERS (ONlY IF CHARGED) I --. _n_. . u ..._... __ _. .'.~_____ ,!/NlTl None nn L1[] 'lJtllf'l UNIT 1 91 PROBABlE USf o -'-'-';;G~?_- ',92. TYPE TEST o i g~. RESUlTS '.XiNOTEST ; REFUSE O__%~ UNK 91. PROBABLE : 92.jTYPE .-' USE -' TEST '.~:JRESULTS ONOTEST o REfUSE O.--%L-::-J UNK 94.INVESTIGATION COMPlETE 1 ~[jg NO c::] P'~nl\WI . W-iS[E A!>,.-l(; I7'QB) 3302910 , ,~, --'--""..~' ", p '~I " ,--;[ "~'. ~'i, ,,4, ^, --,., , ',-<c^."__' .....-..1 J ;., ::~: ";!:~.~, ij I -'.1 NT \1 ~l ., 'I , ! , r '" . 24. "28. TYPE HI(]HWA Y o . NOT PHYSICALLY DIYDED 1 . DIVIDED HIGHWAY. MEDIAN STRIP WffiiOUfTRAFFIC BARRIER 2 - DIVIDED HIGHWAY. MEDIAN STRIP WITH TRAFFIC BARRER N -ONE WAY TRAFFIC NOATH S -ONE WAYTAAFFICSOUTH E. ONE WAY TRAFFIC EAsT W -ONE WAYTAAFFICWEST 25. "21. ACCESS CONTROL 1 . NO CONTROlS (UNLIMITED ACCESS) 2 - FUl L CONTROl. (ONlY RAMP E!>IrA" ANO EXIT) 8-0THER 9 - UNKNOWN 34. CONSTRUCTION ZONE 0- Ncrr APPLICABlE I - CONSTRUCTION ZONE 2 - WtlNTENANCE ZONE 3 - UTILITY COMPANY WORK 9 . UNKNOWN 35. TRAFFIC CONTROL DEVICE o . NO CONTROlS 1 - FLASHING SIGNALS 2. TRAFFIC SIGNAL 3 - STOP SIGN 4 - YIElD SIGN 5 - RR CROSSING . - POLICE OFFICER OR FLAGMAN 7 - FLASHING SCHOOL ZONE 8.0THER 9. UNKNOWN 47. BODY TYPE AUTOMOBILES 01 - CONVERTiBlE 02-2000R 03 - 3 DOOR (HATCH BACK. 2 DR) 04-4000R OS - 5 DOOR (HATCH BACK, 4 DR) .OO-STATIONWAGON 07 - HATCH BACK tAlMIIER OOORS U~WN '~'71'!!1__ f" J POLICE ACCIDENT REPORT 47. BODY TYPE (CONTINUED) . AttrOMOBILES COIITINUED 08 - arlER AUTOWBILE 09 - UNKNOWN AUTOMOBILE 10 - AUTOMOBILE BASED PICK-UP 11 . AUTOMOBILE BASED PANEL 12 - SHORT UTILITY 13 - LARGE LIMOUSINE 14 -THREE WlEEL AUTO OR DERIVATIVE MOTORCYCLES .', 20 - MOTORCYCLE 21 - MOPED Zl- THREE WHEEL MOTORCYCLE OR MOPED 28 - MINIBIKE. MOTORSCOOTER 29 - U'lKNOWN MOTORCYCLE BUSES 30 - SCl100lBUS 31 - CROSS COUNTRYIINTERCITY 32 - TRANSIT BUS 38 - OTHER BUS 39 - UNKNOWN BUS TYPE VANS 4Q.VAN 41 -VAN COMMERCIAL CUTAWAY 42 - VAN BASED MOTORHOME 48 - OTIER VAN TYPE 49 - UNI<NOWN VAN TYPE LIGHT TRUCKS IGVWR . 10,0001) 50 - PICK. UP 51 - PICKUP WITH SLIDE IN CAMPER 52 - PICKUP BASED MOTORHOt.'€ 53 - CAB CHASSIS BASED 54 . TRUCK BASED PANEL 55 - TRUCK BASED STATION WAGON 56 - TRUCK BASED UTILITY 58-0TlER LIGHrTAUCK 511- \Jl1\NOWN LIGHrTRUCK TYPE 87. STATIONWAGON - BASE BOOY TYPE UNKNOWN 68. UTIlITY - BASE BOllY TYPE UNKNOWN 6Il.lJNKIK7NN LIGHr TRUCK MEDIUIllllEAVYTRUCKS 71)- SINGLE UNIT STAAIGHr TRUCK 73 - MED~IMlEAVY TRUCK BASED MOTORHOME 74. TRUCK TRACTOR (CABI 75 - UNKNOWN IF SINGLE UNIT OR COMBINATION TRUCK 'n "CAMPER OR MOTORHOME UtI<NQWN TRUCK TYPE 19 - UNKNOWN Tfl\JCK TYPE " J^ '"__C':,"~_' ,_ f"r"'q'Vi,--,,,'t'-,., ,., "'-\,3'" ';'-"'~7'8" '-(-',""'"7'[" ,~ . _" ,~'~_ ,'^ __ '~,'__~, Overlay Sheet - 1 47.BODYTYPE (CONTINUED) OTHER MOTORIZED VEHICLE 80- SNOWMOBILE 81 - FARM EOUIPM:;NT 82-ATV 83 - CONSTRUCTION EQUIPMENT 88 - arHER UNSPECFED VEHICLE 89 - UNKNOWN OTHER MOTORIZED VEHICLES NON-MOTORIZED UNITS 90 - UNICYCLE, BICYCLE, TRICYCLE 91 - OTIER PEDALCYCLE IBIG WHEEL) 92 - UNKNOWN PEDALCYCLE 93 - HORSE AND BUGGY 94 - HOII5E AND RllER TRACK VEHICLES 95 - TRAIN 95 - TROlLEY IF NOTHING ELSE 98 - OTHER BOOY TYPE 99 - UNKNOWN BOOY TYPE 48_ SPECIAL USAGE 0- Ncrr APPLICABlE I - PUPL TRANSPORT 2 - FIRE VEHJCl.E 3 - AMBUlANCE 4-OTHEREMERGENCYVEH~LE 5 - POL~E VEHICLE 8 - TRACTOR TRAILER 7 . lWlN TRALER fl. COMMERCIAL PASSENGER 12 - TOWING PASSENGER VEH~LE 13 - TOW TRUCK 14 - TOWING UTLITY TRALER 15 - TOWING MOBl.E OR t.OlU\.AR Ha.lE 16 - TOWING CAMPER 20 - MooIFIED VEHICLE 48. vEHICLE OWNERSIIIP 1 - PRIVAlE VEHIClE OWNED BY DRIVER 2- PRIVAlE VEHICLE OWNED BY ANOTHER 3. RENlEO VEHICLE 4 - STAlE POLICE VEH~LE 5 - PENNDOr VEHICLE 6 - arlER COMMONWEAlTH VEH. 7 - WN~IPAL POl~E vEHIClE 8 - OfHER WNICIPALGOVT VEH 9 - FEDERAL GOVERNt.'€NT VEH. '0 - CO/JIoERCIAL VEHICLE 11 - PUPL TRANSPORT CARRER 98 - OfHER 99. UNKNOWN '-", ,~,,~ SO. INITIAL IMPACT POINT 0- NO "'PACT OR CONTACT 1 - 12 CLOCK POINTS 13-TOP 14-UNDERCARRIAGE 15 - TOWED UNIT 99 . UNKNOWN 12 9 3 . 61. YEHICLE STATUS 0- Ncrr APPLICABlE .1 . LEGAU Y PAffiED 2 -IUEGAll Y PARKED. ON ROAD 3 -IUEGALL Y PARKED - OFF RCIAO 4. HIT AND RUNó5 . DISABLED FROM PREVIOUS ACCDENT 52. TRAVEL SPEED 00 - STOPPED OR PARKED 01 - 97 ACTUAL OR ESTlMAlED SPEED 98 - 98 MPH OR GREAlER 99 - UNKNOWN !l3. VEHICLE GRADIENT 1- LEVEL ROAOWAY 2-UPHIU 3 - DOWN HlU. 4-SAG lBOTTOMOFHU) 5 - CREST (rOP OF 1tIU.) IF DRIVER PRESENCE" 2 WEN DD NOHNTEI1 DAT M on Tllf DF[llA1011 , ' 54. DRIVER PRESENCE I.DRIVEROPERATEOVEH~LE 2 . DRIVERlESS VEHICLE 3 - DRIVER LEFT SCENE (AFTER ACCDEPO) 55. DRIVER COHIlITIOIl 1 - APPEARED NORMAl 2. HAD BEEN DRINKING S - UEGAL DRUG USE 4-S~K 5-PATIGUE 8 - ASlEEP 7 - MEDICATION 9 - UNKNOWN .. ~ '. . , POLICE ACCIDENT REPORT . Overlay Sheet - 2 '- 72 VEIlICLE CONFIGURATION 80. UNIT NUMBERS - BLOCK A 80. TYPE OF INJURY. BLOCK I (CONTINUED FROM BELOW) l-BUS cooe UNIT NUMBERS AS o - NO ltUJRY . BLOCK M 2 - SINGLE UNIT .(2 AXLES, 6 TIRES) RECOflQED ON PAGE 1. 1 - AMPUTATION 2 - HELICOPTER a . SINGlE UNIT (3 + AXLES) 2 - BLEEDING WOUND a - FIRE RESCUE VEHICLE .. TRUCK TRACTOR (BOBTAIL) 80. SEAT POSITION. BLOCK B a - BROKEN BONES 4 - PRIVATE VEHICLE 5 - TRUCK TRALER 1 . DRIVER . - DISTORTEO MEMBER 5 - POlICE VEHICLE 6- TRACTOMEMl-TRALER 2. MIDDLE FRONT 5 - BRUISES/ABRASIONS 6-OT1-1ER 7.TRACTOR(XJUBLES a - RIGf{f FRONr 6-BURNS g. UNKNOWN 6. TRACTOI\ITRIPlES . . LEFT REAR 7 . SWElliNG g. UNKNOWN HEAVY TRUCK 5. MlDOLE REAR 8 . LIMPING 6 . RIGf{f REAR . . COMPlAli'If OF PAIN 61. ILLUMINATION 73. CARGO BODY TYPE 7. PEDESTRIAN .', 97- OTHER INCAPACTrATlNG INJURY 1.DAWN 1.BUS 6 - OTfER SEAT POsITION 98 - OTHER NON-tlCAPACITATlNG 2 . DA YUGf{f 2. VAN / ENCL05EO BOX 9 - UNKNOWN 99 - UNKNOWN 3 - DARI< . STREET LIG/{[S a . CARGO TANK . - DARK - NO STREET LIGf{fS .. FLATBED 80. SEX. BLOCK C 80. AREA OF APPARENT INJURY 5. DUSK 5. DUMP M.MALE F -FEW\tE . BLOCK J 6. CONCRETE MIXER U -UNKNOWN o. NO ItUJRY 82. WEATHER 7. AUTO TRANSPORT I-FACE o. NO ADVERSE CONllfTIONS . 6.GARBAGE/REFUSE 80. AGE" BLOCK II 2. HEAD 1 . RAINING 9-orHERfUNKNOWN COOE ACTUAl AGE, EXCEPT FOR a . NECK 2. SlEET. flAil. FREEZING RAIN 1 - FOR INFANTS UP TO AGE 2 '-BACK a-SNOWING 711. HAZARDOUS MATERIALS 98. AGE 98 OR GREATER 5 - ARM(S) . . FOG. SMOKE 99 . UNKNOWN 6. LEGIS) 5 - RAIN AND FOG COOE THE . DIGIT HAZARDOUS 7. CHEST/STOMACH MATERJAI. cooe ON THE PlACARD BO. ACTIVE RESTRAINT TYPE 6 - tlTERNAl ".ROAOSURFACECONOrrKmS OR . BLOCK E 9 - ENTIRE BOOY l-DRY 0- NONE OR PEDESTRIAN 96. OT1-1ER AREAS 2-WET SELECT ONE OF THE FOllOWING 1 . SHOOLDER HARNESS ONLY 99. UNKNOI'm 3. MJOOY CODES 10 REPRESENT TI-E PlACARD. 2. SEAT BELT ONlY .. SNOW COVERED 00. NOT APPlICABlE 3 - COMBINATION 80. INJURY INFORIIAl'ON SOURCE 5 - ICE COVERED 01 . NON-FlAMMABLE GAS (HARNESS & BelT) " BLOCK K 6. PlOWED SNOW 02" COMflUSTIlLE . - CHLD RESTRAINT DEVICE N - NOT APPlICABlE 7 . SAlTED & CIKlERED 03 . ORGANIC PEROXIDE 7 - HELMET A. OBSERVATION OF OFFICER 8 -ICE PA TCfES 04 . CORROSIVE . 8. OTHER B - STATEtoENT FROM INllIVlOUAL 05. EXPlOSIVES "A" 9. UNKNOWN C. toEdicAuPAfW.aJfCAl. 06. OXYGEN PERSONNEL .,. PROBABLE USE 07 - POISON 80. ACTIVE RESTRAINT ~SAGE (ALCOHOL OR ORUGSJ 08 - EXPlOSIVES "ll" 80. EJECTIONIEXTRICA TION o . NONE 09 - CHLORINE . BLOCK F " BLOCKL 1 - AlCOHOL 10- OXIDIZER o. fKJT APPlICABlE O.NOT APPUCABlE 2. CONTRCllEO SUBSTANCES 11 . POISONOUS GAS 1.INUSE 1. TOTALlY EJECTED a. OT1-1ER DRUGS 12" FUEL OIl 2 - NOT IN USE 2. PARTIAllY EJECTED . - BOTH AlCOHOl Mil DRUGS 13-DANGEROUS . 9. UNKNOWN 3. PARTIALlY EJECTEO REQUIRING 9.UNKNOI'm it ", RADIOACTIVE 80. PASSIVI; RESTRAINT TYPE EXTRICATION 15. FlAMMABlE SOlD "W' .. EXTRICATlON BY PERSONS 02. TYPE TEST ; 16 - FLAMMABlE . BLOCK G UNl<NOI'm o. Nor" APPuc.fu 17 . FlAMMABLE GAS o. NONE OR PEDESTRIAN 5 - EXTRICATION. TWO OR MORE /NO TEST GIVEN 18. FlAMMABLE SOlID 1 - AIRBAG (DEPlOYED) 1 - BlOOD . TYPES .. 19 . GASOLINE 2 - AIR BAG (NOT DEPlOYED) 6. EXTRICATION BY AMBUlANCE 2-BREATH . 20 - BLASTlNG AGENT a - AUTOMATIC SEAT BELT OR RESCUE PE_EL 3. URINE 98. OTHERiNOT SIGNED 6. OTHER 7. EXTIJlCATKlN BY POlICE 4. TEST REFUSED 99. UNKNOWN 9 - UNKNOI'm 8 . EXTRICATlON BY SElF 6 . OTHER 9 . UNKNOWN EJECTION 9 - UNKNOWN OR 80. INJURY SEVERITY - BLOCK fI DR EXTRICATION o. NO ItUJRY 113 SESUL TS (ALCOHOL lEST) cooe TfE 1 DIGTr HAZARDOUS 1 - DEATH 80. INJURYTRANSPORTATlON MATERIAl CODE ON mE PlACARO 2 - M'IXlfl fUJRY .BLOCK II CODE ACTlJAL TEST RESUlT 3-MODERATE ItUJRY 0- NOT APPlICABlE E.G 197GRAMS.0.2O'X. (MOVE 4 -/dWOR I/'UJRY 9-UNKNOWN 1 - AMllULANCE (COHr'O ADOVEI 3 OECfML PlACES AND ROUND I :~~~~"lI!1J'."',__^" _. '~"'", "-''"-''-'' -, --',~_"--::"I:'f<','__~'T '''~'':l'' ,,~ ,":'Co:'.;!': ,.' ~ii;;",::,;, ' ~,::~.< . ~~r,~ . .'.;., i: ,;! \: .~ >i ,", .' I" ~i~' ~.:j - ',.,..' ",~~~'\\IJIl'>, , . MADEIRA CHIROPRACTIC, P.C. DR. ALFRED L. MADEIRA. D.C. DR DAREN E. ESHBAUGH, D.C. DR. BRADLEY A JAHN, D.C. 1124 Kennebec Dlive Chambersburg, Pennsylvania 17201 Telephone: (717) 263-8919 October 10, 2003 Angino & Rovner P.C. 4503 North Front Street Harrisburg, Pa 17110-1708 RE: Kathy DelGrande DOB: 1/17/1965 To Whom It May Concern: Ms. Kathy DelGrande was first seen in our office on June 12, 2000 for injuries sustained in an automobile accident on January 11, 1999. Ms. DelGrande initially presented with the following complaints: Low back pain, mid back pain, neck pain and stiffness, leg pain and numbness. Ms. DelGrande was diagnosed with: 756.1 Lumbosacral Anomaly, 724.4 Lumbar Neuritis, 722.10 IVD Syndrome Lumbar Spine, 728.85 Thoracic Myospasm, and 729.1 Cervical Myofascitis. We provided the following treatment: Electromuscuiar therapy, myofasciai release, traction and spinal joint mobilization. The patient was treated approximately 26 times, initially three days per week for six weeks. We last saw the patient Ms. DelGrande on November 1, 2002. During that time, we made mild to moderate improvement in her condition. Due to Ms. DelGrande's mother's illness, a new job in Harrisburg, and a divorce, she found it difficult to make appointments and continue her rehabilitation exercise program. She was released to full work activities at that point with additional instructions for at home exercises and if possible to continue a supervised rehabilitation program in our office. It is important to note that her condition waS not c., 'c;" >, ,.:-;~",,.,o. """." 'Ci'_,!:,,'-'" '-;';'("-,1_"" \" >'~~'I',"~ .', -, " "'""-'.", " " ;'~"" . - ---,,-'" '~-",~ ~',,-,,~' -,"... ' ,. ,''''' ." -' ... . ~ resolved at that time. Ms. DelGrande has not been back to our office for a follow-up appointment since that last visit on November 1, 2002. At this point, I can only assume that either she was dealing with her discomfort with medications, or she had sought care elsewhere that was more convenient with her hectic schedule and stressful situation. At any rate, because of the length of time since I have seen Ms. DelGrande, it could only be considered as unreasonable for me to adequately predict the cost of future treatment. This is often dependent on job stress, activities of daily living, and recreational activities/hobbies. I can confirm with a reasonable degree of chiropt'octic certainty that Ms. DelGrande's injuries were the result of the auto accident on January 11, 1999 and that the treatment provided by our office was for those injuries suffered in the January 11, 1999 auto accident. In regards to the necessity of future treatment, due to Ms. DelGrande's lumbosacral anomaly, which is a complicating factor, meaning that the lumbosacral anomaly didn't cause her condition, the January 11, 1999 auto accident caused the injuries as previously stated. Due to the lumbosacral anomaly, these injuries didn't heal within the expected amount of time. Furthermore, because of this structural weakness, freq"uent exacerbations continued to occur. Continued exacerbations and injuries such as this is often the cause of fibrotic tissue replacement within the musculature which often can lead to a chronic condition such as myofascial pain syndrome. Therefore, it can be argued that Ms. DelGrande may need continued ongoing supportive Care based upon her symptomatology and functioning. It is also reasonable that Ms. DelGrande may have to restrict certain activities, both work and recreational, to avoid further damage, function loss, or exacerbations 1" liar symptomatc!ogy in the future. Please contact our office if we can be of any further assistance in regards to this patient. Sincerely, Bradley A. Jahn, D.C. w.: , ~ ""-"; ,- -.,', '"~'-"-";',-"".."",: ",. '.', ,'"'''-'''''''''--'I.'''"';-"''''h''r'','r'':''' -~~ "', ","'~, -, ",-,,' -"-'"""".~"-,,,--~~.~. =, .... ~I fJ}f\ i ~ , ~. f:: fi !! I' ! l~ I:: I " [" ".. "-I II" 1"f,,1 PlAt ',Ht I "j @ 000136 -0 ;::J, COMMONWEAL TH OF PENNSYL VANIA POLICE ACCIDENT REPORT HIPOHIAJ)IE .x~ NON. REpoRTABlE! POLICE INFORMATION H2-1097062 P/\ State Police ~ f: 9 Al:CIDI-:N\' DAn. "11 Tlur.:m' flAY ,. ~KI'd.f..O i~"ItIJ\WEO f;' V' I: t:1 I" ," If) 1)10 VfHlCtf, ttAVf, TO BE HI MOV11J I HUM 1111' SCrNr? UN" 1 lINJ12 j" [,: 1-: I ': ! I.,' [ ~i ~ v " 18 HAZARDOUS , 19, PENNOOT ).tA, TERIAlS '( . .. t~, ~~L_ _~OPERTY y x~ N ; y x u j/ I. f.. l: ;;' ;~ ... ~ ,,1 :. . 68 CARRIER ,A,ut)U[SS : 69 CfTY. STATE A.IlI'CO!ll' lfJ u~{)or II "K:C II :73'~ARGO BODY TYPE . "7f;"Hfo.l AROOUS MATr-RIA!<) "72-YEH CONflG. . IS tlO OF /'IXI! S AA,,j5IJ,'J8/ ,.->-;;".;j1.~,,, ~,' '. 'I'>' <;""-- '1"~ "'~ t'i ~l',' ?nllP ACCIDENT Y N x: " VEUlClE DAMAGE Cl tlotU' Utili 1 I lK;UJ J. MODfRAtE ) . SEvtRE UNIT 2 ,.S~~ o o -reo ",Ui INS . Y ;Xl N1 i UNKI (49.'VEHlClE 1 . OWNERSHIP r5i. TRAVEL -50 SPEED r5',ORIVER 1 . CO~IDlTION ;5-, 5ffl.\E 1'1 Ie , , 7.t.GWlR 77. RE'LEASE OF HAlMAT yD~D~N~p ~~ ? ! '; '; .-.: S 4 f>ENNOOT USE ONl V ..'..-------ACCIDENT LOCATION CQIlE -l :20. COUNTY Cumber land to I -l 2;~rt'ft~UP.___::::_~cpyn ~~-j PRINCIPAL ROADWAY INFORMATION 71 22. ROUTE Nci'.-bR STREET NAME il. SPEED' -'.. LIMIT 50 SR 00S1 . r~\~HW~Y- :~. ._._1~~~~__~_=.= INTERSECTING ROAO: :i6'-ROUTe NO. OR - ...-----.-.-.---------,----------- ..-. STREET NAME 27" SPEED .---.. n~l28.liYPE-.._-.---..--.l@ACCEss llMfT .... L~, ~~y., _. _.____ _ ~ CONTROL IF NOT AT INTERSECTION: 30 cnos-c; STREET oi:t.. ~-R'-O"2-j3 SEGMENT MARKER - :n.OIRECTION-' '- In. DISTANCE - - 33~:~EEw~~_E-W- --~~OMr.-J5f!!u _ n_~Jl.. MI. MEASURED ESTIMATED fj,J (35) tRAFfIC PRINCIPAL 1NTERSECTING ~:c LOI [~] .~ ;~,tRUCTION [iJ UNIT' 2 38_ STATE 36 lEGALLY 'i N 31. REG. PARKED 1 :. Ii i PlATE" 39, PA trrLE'OR . , . OUT-oF.STATE "IN 40, OWNER;' . n . 41. OWNER AOORESS 42: trtY.SfAtif -. ..--.-' & llPCOOE 'ii iEAR...-..-..----- .50 MOOtC: 'NO'''- BOD'tlVPf;) .~1:i9oOY'" .. . - m'E SO::'iNfffACIMPAcr _ POINT ;'"s:i)itiUCU;: . .. GRADIENT :>6.ORfllER - 5i1iRIVER-------------.-- """E 59. o;r~- ADORESS 6Qcrrv. STATE & ZIPCODE i(SEx' ..--. 62:0ATE-OF BIRTH I...... COUM. VE. H.j65. OO.IVER : Vi'; N n ClASS 61. C.\RRIER .. '68.CARRiER'- ---.---- ADORESS 69,dtv:STATE &ZlPCODE 7o,'uSbtif,--" rfl);'EH. -, CONFIG. 7S,N<YO( ~ AXlES - -'-~IlCCi- - ---.- - -- - -PoC.; ~--_. - t~c;~- _._ .__. _,. G~ 11?6~HA.ZARDOU5 77RElEASE-OF-W'ii."U ....._..L - MATER~S_. _ ~ _ _ Y U l"J U~Q PAGE: 1 ,,,,"' '0 "---,', .~ ,h, . , I'" , 0 " ,,~ -. "'" , !tfCIOt:tH NtiMHl::H. .',\(;It,l(:" riAl.... ] ST,\rIOW . 1 '" "MHOI. l'~tC1UCT Car11s1e 2120 lONE :> INVr.STlGAfQR ,....,,.,... UAOGF. Tpr. Michael J. MITCHELL "~R 6650 'Af~JVf'DIlx.. ~ ~~R s3c.s- -~.~ ~--- , ::~I\ TlCAfK)t~ 11/01/99 . 8 ~=IVAl 2352 ACCIDENT INFORMATION / 1 10 DAY OF Vw"EEK 11 01 99 Mon 2350 '12.NUU8[~ OF UNtTS UNIT # 1 )i;,l~j.i'..Y--N)iHJ.c 233MDA ~ARKED? PLATE )9,~A.TITLEOR JHMCA5649KC063311 OUf-OF.STATE vtN . 40 OWNER Judy Jump 4' OWNER 504 Brenton St ADDRESS . '.$2 CITY. STArE Shippensburg Pa 17251 , & ZIPCOOE ' .. j 43 YEAR ~ 44. MAKE 89 i Honda : 4~ MOOH . (NOT BODY NPE) Accord "4fsooy f4isPECIAl TYPE 04 USAGE: '~,I'J',INITIAlIMPACr 14 (S1-.VEHtCtF f>QINT i STATUS ~i:\: vrUlC1 E tsi DRIVER GRAUlun ! I'Rt, SFtlc;t 560RIVER 105916442 NUMBER . 58. DRIVER- ~ME Judity L. Jump r 59. ORIVER 504 B t St AOORESS ren on . tW.CITY.STATE . . '0'. . &ZIPCODE Sh1ppensburg,Paa '''SEt '2. DATE OF 06/20/50 ; BIRTH 64 COMf.\ VOl. 65. DRIVER Y.NX\ ClASS 0 . 6-1, CARRIER )--" '::\ ~,', ;'"','1"1"0' ,",,", -" , .rJ " L I,,' l, ~ i f:~ !" ;c, f-i -., f:i [~ (, I'! ,,' i; ~ : C ;:': ~', ( , r , f,: .;:J\;[~ ,..,~ ~T - iV/I-'< C00137 :ri HI ',I~ ItltHU(j. I M~i M~I uey None None INCIDENT it: H2~fli9'j06i-u.- .-. uJ ACCIDENT DATE: f1/01{9ff-. /'J MlllM"AI 'A,.~lIl1 ,- 11\11 f>t:Of'lE INH)fU.tATlON .\n\:nt:I-G~L\Ml AIJORf- 55 " I J K l M for I.. N 0 10 ,0 o 0 0 N 0 ,0 --,-,+ 0 0 0 N 0 0 f 49 3 1 0 Oper # 1 3 f3431 4 f 6 2 1 o Kathy Delgrande Same address as oper # 1 o Rebecca Delgrande sam~, a~~~~~~..,~.l!._ ~.E~_~_.1.__, 1'860~"'.'-'''-''.' ~/I 81 ILLUMINATION 3 82, WEATHER' 0' . 83 ROAD SURF ACE: 1 1 : M PENN..<;:YlVAN~ SCHOOl DlSTRICT (If APPLICABlE) NA : 85'-OiscR"lPrK>NcifI:iAMAGE-O PROPE.Rly.-.---- - :i20' r;-t.:.. S t't'5"IS ~....!___r'- None OWNER f"~I>IP,# """'ESS :",--EW"'C.~ 8#0 If""" 81. NARRATIVE -IDENTIFY PREClPlrATINO EVENfS. CAUSATNJN FACTORS. SEQUENCE OF EVENTS. WITNE88 STATEMENTS, AND PROYIJE ~~<<:~:.~_~"~E,,I!:tf.~!.~~~tlOC~~_=_~~ VEHIClES, IFJCHOWN. ___ Unit_ # 1 was traveling South on 'SR., QQ.81. This accident occured as unit # 1 struck a metal construction sign. 1>0 der with it's undercarriage. This was the initial point of impact. It. should be noted that at the time of the r~ccident the right hand lane of the above location was shut down due to con- ~:ruction zone maned by workers. I ___DAmag_e to unit fI- 1, .consisted' of modera'te radiator damage. Nil I4fi'A'-E TDCDItU1:. 1 Oper # 1 was. interviewed by th~s officer at the scene on 11/01/99 at 2355 r.- . Lhrs._and related that she was traveling South on SR 0081 in the construction I,_~~e whe~~he hit a metal object left on the roadway by the construction crew t-~-~~nit fI- 1 was towed from the scene by Johns towing. ~P7-0015 furnished to oper # 1, news release submitted. i INSURANCE COMPANY INSURANCE COMPANY . INFORMATION! USAA INFORMATtoN i .. UNlIT r PO~~Y' oo'j29153oii71 0.).-----'- UN~T NAM SS ! 88. None i WITNESSES NAME ~ l'lIOt. IlINAl POlICY NO '--AfioRESS------.-~----'----.. PHONE 89. VIOLATIONS INDICATED i 90. SECTION NUMBERS (ONt Y IF CHARGE ) ! m...m.,.. ...m.. __ .. ______ nn I] LI ,UNIT1 None 'IJtlIT2 UNIT 1 91 PROBABlE USE o t 9~. RESULTS '.XiNO TEST : REFUSE O'__%~] UNK '-"-- --'-';A~;-~- ,92. TYPE TEST o 91. PR08ABlE ; 92.ITYPE .-' USE -. TEST '.~)RESUlTS DNOTEST o REFUSE o.__%c] UNK 94.INVESTtGATK>N COMPlETE 7 YES [1g NO [] Pt'l1I,WI.8I-i!;IE AA.-l~ (7'Q8j 3302916 . . -",".,' "-,~,.,,,< 'I. '" , 'I -" ,< '--',"'"" ".'> . ,. '," '~" , -' , ,."',, ..^,-;"., ,", ..'{ '~~ff~! ";~ . .~~: ~~:1 '~~l :.:':;"! ..,,';.j ..1 .::i NT 11 ,:.'! "i i ; f ." .. 24. & 28. TYPE HIGHWAY' O. NOT PHYS1CAlL Y DIVDED 1 - DIVIDED HIGHWAY. MEDIAN STRIP WrTHOUT TRAFFIC BARRIER 2-DIV~DHIGHWAY.MEDIAN STRIP WrTH TRAFFIC BARRIER N - ONE WAY TRAFFIC IloRTH S - ONE WAY TRAFFIC SOUTH E - ONE WAY TRAFFIC EAsT W -ONE WAY TRAFFIC WEST 25. & 2'. ACCESS CONTROL 1 -NO CONTROLS (UNLIMITED ACCESS) 2 - Fut L COIImo!. (ON. Y RAMP ENTRY ANO EXfT) 8 - OTHER 9 - UNKNOWN 34. CONSTRUCTION ZONE 0- NOT APPlICABLE 1 - CONSTRLlCTION ZONE 2 - MAINTE/lo\NCE ZONE 3 - UTlLIrY COMPANY WORK 9 ~ UNKNO'NN 35. TRAFFIC CONTROL DEVICE o . NO CONTROLS 1 - FLASHING SIGNALS 2 - TRAFFIC SIGNAL 3 - STOP SIGN 4 - YIELD SIGN 5. RR CROSSING B. POLICE OFFICER OR FLAGMAN 7 - FLASHNG SCHOa. ZONE B-OTHER 9-UNKNOWN 47. BOOYTYPE AUTOMOBILES 01 - CONVERTIBlE 02. 2 DOOR 03.3 DOOR (HATCH BACK. 2 DR) 04 - 4 DOOR 05. 5 DOOR (HATCH BACK. 4 DR) 'OO-STATIONWAGON 07. NATCH BACK M!MIl€R DOORS lJNI(N()WN ~,"l'1~. ~ "",,~ "'~..' '" . 0, l('l,e.<:", ,-,-0_. I, _ _ .,e.-. , _ ._:."_ " "-j- POLICE ACCIDENT REPORT 47. BODY TYPE (CONTINUED! . AUTOMOBILES CONTINUED . 06 - OTHER AUTOMOBILE 09 - UNKNOWN AUTOMOBILE 10 - AUTOMOBILE BASED PICK-UP 11 - AUTOMOBlE BASED PANEL 12 - SHORT UTIlIrY 13 - LAFlGE UMQUSINE 14 - THREE WfEEL AUTO OR DERIVATIVE MOTORCYCLES ", 20 . MOTORCYCLE 21 - MOPED ' Z7. THREE WHEEL MOTORCYCLE OR MOPED 28 - MINIBIKE. MOTOflSCOOTER 29 .lJoIKNOWN MOTORCYCLE BUSES 30 - SCl100L BUS 31 . CROSS COlJNTRY~NTERCllY 32 - TRANSIT BUS 36 - OTHER BUS 39. UNKNOWN BUS TYPE VANS 40 - VAN 41-VANCOMMERClAlCUTAWAY 42 - VAN BASED MOTORHOME 43 - OTHER VAN TYPE 49-lJ/>l(NOWN VAN TYPE lIGNT TRUCKS (GYWR . 10,0001) 50 - PICK - UP 51 - PICKUP WITH SliDE IN CAMPER 52 - PICKUP BASED MOTORHOME 53 - CAll CHASSIS BASED 54 . TRUCK BASED PANEL 55 - TRUCK BASED STATION WAGON 56 . TRUCK BASED UTILIrY 56. OTfER lIGHT TRLlCK 69 .lJoIKNOWN LIGHTTRLlCK TYPE 87. STATIONWAGON. BASE BODY TYPE UNKNOWN 68.lITflIrY. BASE BODY TYPE UNKNOWN 69. UNKNOWN lIGHT TRUCK MEDlUMlHEAVY TRUCKS 7IJ. SNGlE!.tIIT STRAIGHT TRUCK 73. MEDIJMtlEAVY TRUCK BASED MOTOflHOME 74 - TRUCK TRACTOR (CAB) 75 - UNKNOWN IF SNGlE UNIT OR CO/.ilI/lo\TION TRUCK -n . CAMPER OR MOTORHOME UN<NOWN TRUCK TYPE 70 -l.tIKNOWN TRUCK TYPE Overlay Sheet - 1 47. BOOYTYPE (CONTINUED) OTHER MOTORIZED VEHICLE 60 - SN0WM081LE 81- FARM EQUIPMENT 82 -ATV 63 - CONSTRLlCTION EOUIPMENT 68 .OTfER lJoISPECFIED VEHICLE B9. UNKNOWN OTHER MOTORIZED VEHICLES NON-MOTORIZED UNITS 90 - UNICYClE. BICYClE. TRICYCLE 91 - OTHER PEDAlCYCLE (BIG WHEEL) 92 - l.tIKNOWN PEOAlCYCLE 93 - HORSE AND BUGGY !l4 - HORSE AND RIlER TRACK VEHICLES 95- TRAIN 96 - TROLLEY IF NOTHING ELSE 96 - OTHER BODY TYPE !l9 - UNKNOWN llOOY TYPE 48. SPECIAL USAGE O. NOT APPlICABLE 1 - PUPL TRANSPORT 2- FIRE VEHIClE 3 - AMBULANCE 4 . OTHER EMERGENCY VEHICLE 5- POLICE VEHIClE 6 - TRACTOR TRAILER 7 - TWIN TRALER 11- COMMERCIAl PASSENGER 12 - TOWING PASSENGER VEHICLE 13 - TOW TRUCK 14- TOWING UTLfTY TRALER 15- TOWING MOBlE OR MOOULAR I-ioME lB. TOWING CAMPER 20. MODIFIED VEHICLE 4.. VEHICLE OWNERSIlIP 1 - PRIVA'IE VEHICLE OI/NED BY DRIVER 2. PRIVA'IE VEHICLE OWNED BY ANOTHER 3 .IiENTEO VEHICLE 4 - STA'IE POLICE VEHICLE 5 - PENtVOT VEHICLE 6- OTHER COMMONWEAl TIl VEH. 7 - MUNICIPAl POLICE VEHICLE 8 - OTHER MUNICIPAl GCNT VEH 9 - FEDERAl GOVERNMENT VEH. 10 - COIMERCIAl VEHIClE 11 - PUPL TRANSPORT CARRER 96-0THER !l9-!.tIKNOWN SO. INITIAL IMPACT POlNT 0- NO NPACT OR CONTACT 1 - 12 CLOCK POINTS 13-TOP 14' UNDERCARRIAGE 15- TOWED UNIT !l9 - l.tIKNOWN 12 9 3 6 ". VEHICLE STATUS 0- NOT APPUCABLE .1-LEGAllY PARKED 2 .1llEGAU. Y PARKED. ON ROllO 3 -ILlEGAlLY PARKED. OFF ROAD 4-HITANDRUN 5 - DISABLED FROM PREVIOUS ACCDENT 52. TRAVEL SPEED 00 - STOPPED OR PARKED 01- 97 ACTUAl OR ESTI/do\'lED SPEED 96 - 98 MPH OR GREA'lER 99 . UNKNOWN 53. VEHICLE GRADIENT 1- LEVEL ROAOWAY 2- UP HilL 3-00WNHIU.. 4 - SAG (BOTTOM OF Hll) 5 -,CREST (TOP OF hill) IF DRIVER PRESENCE" 2 TIIEN DO NOTEN1El1DATM0l1rilr OrEI1ATOl1 54. DRIVER PRaSeHCi 1 - DRIVER Ol'ERA'lEO VEHICLE 2. OflIVERlESS VEHICLE 3 - DRIVER LEFT SCENE (AFlER IICCIlENl] 55. DRIVER COHOITlOH 1 - APPEARED NORMAl 2 - HAD BEEN 0fI1NK1NG 3 - UEGAl OfIUG USE 4-SICK 5 - FATIGUe 6- ASlEEP 7 - MEDICATION 9 - UNKNOWN - . " POLICE ACCIDENT REPORT - Overlay Sheet - 2 " .~ 72 VEHICLE CONFIGURATION 80. UNIT NUMBERS. BLOCK A 60. TYPE Of INJURY. BLOCK I (CONTINUED FROM BELOW) 1.BUS A CODE UNIT NUMBERS AS O. NO l/U)RY .BLOCK M 2 - SINGLE UNIT. (2 AXLES, 6 TIRES) RECORDED ON PAGE 1, 1 - AMPUTATION 2 - HELICOPTER 3 - SINGLE UNIT (3 + AXLES) 2 - BlEEDING WOUND 3 - FIRE RESCUE VEHICLE . - mUCK TRACTOR (BOBTAIL) 60. SEAT POSfTtON . BLOCK B 3. BROKEN BONES 4 . PRIVATE VEHICLE 5. TRUCK TRAl.E!l 1 . DRIVER 4-DSTORTEDMEMBER 5 - POLICE VEHICLE 6.TRACT~~TRALER 2 . MIDDLE FRONT 5 - BRUISES/ABRASIONS 8-0THER 7 - TRACTOMlOLlBLES 3 . RIGHT FRONT .-BURNS 9 - UNKNOWN . - TRACTOfVTRIPLES 4. LEFT REAR 7. SWEllING 9 - UNKNOWN HEAVY TRLlCK 5 - MIDOlE !lEAR 8 . LIMPING . . RlGHT REAR 9. COMPLAINT OF PAIN 81, ILLUMINATION 73. CARGO BOOY TYPE 7 - PEDESTRIAN'; 97- OffER INCAPACITATINGII'UJRY l-DAWN l-BUS . - OTHER SEAT PQSmON 98 - OTHER NON-tlCAPACITATING 2 - llA YLIGHT 2 - VAN / ENCLOSED BOX 9 - UNKNOWN 99 - UNKNOWN 3 - DARK - STREET lIGHTS 3 - CA!lGO TANK 4 - llARK - NO STREET LIGHTS . - FLATBED 60. SEX. BLOCK C 60. AREA OF APPARENT INJURY 5-DUSK 5. DUMP M - MAlE F - FEMALE . BLOCK J 6 - CONCRETE MIXER U. UNKNOWN o - NO IN.JJRY 62, WEATHER 7 - AUTO TFlANSPORT '-FACE 0- NO MNERSE CONDITIONS 8-GARBAGE/REFUSE 80, AGE, BLOCK [I 2-HEAD 1 . RAINING 9-OTHER/UNKNOWN CODE ACTUAl AGE. EXCEPT FOR 3. NECK 2 - SLEET, HAIL. FREEZING RAIN 1 - FOR INFANTS UP TO AGE 2 4 - BACK 3. SNOWING 16. HAZARDOUS MATERIALS 98 - AGE!l6 OR GREATER 5 - ARM(S) 4 . FOG, Sl.4OKE 99 - UNKNOWN 6 -LEG(S) 5 - RAIN AND FOG CODE TfE 4 DIGIT HAZAROOUS 7. CHEST/STOMACH MATERIAL CODE ON THE PLACARD 60. ACTIVE RESTRAINT TYPE . - tlTERNAL 83. ROAD SURFACE CONDTTIONS OR . BLOCK E 9 - ENTIRE BODY 1.DRY 0- NONE OR PEDESTRIAN 98 - OTHER AREAS 2. WET SELECT ONE OF THE FOllOWING 1- SHOULDER HARNESS ONLY 99 - !.tIKNOWN 3.MjllllY <XXlES TO REPRESENT THE PLACARD. 2-SEATBElTONLY 80. INJURY INFORMA~OI/ SOURCE 4. SNOW COVERED 00 - NOT APPLiCABLE 3. COMBINATION 5 . ICE COVERED 01 . NON-fLAMMABLE GAS (HARNESS & BEL 1] , BLOCK K 8 . PLOWED SNOW 02. COMIIUSTIlLE 4 . CHLD RESTRAINT DEVICE N. NOT APPLICAlllE 7 - SAt TED & CIIDERED 03. OFIGANIC PEROX~ 7-HELMET A - OBSERVATION OF OFFICER 8 -ICE PA TCfES 04. CORROSIVE . - OTHER B - STATEMENT FROM INDIVIDUAL 05. EXPLOSIVES 'N 9 - UNKNOWN C - MEDlCAUPARAMEDICAl 06. OXYGEN PERSONNEL iI. PROBABLE USE 07. POISON 80. ACTIVE RESTRAINT \!SAGE (ALCOHOL OR DRUGS) 09. EXPLOSIVES "II' M. EJECTION/EXTRICATION O. NONE 09. CHLORINE .BLOCKF . BLOCK L l-AlCOHOL 10.0XIOlZER 0- t'lOT APPLICABLE 0- NOT APPLICABLE 2. CONTRCUED SUBSTANCES 11 - POISONOUS GAS l-INUSE 1 . TOTAlLY E.ECTED 3 - OTHER DRUGS 12. FUEL OIL 2-NOTINUSE 2 - PARTIALLY EJECTED 4 - BOTH AlCOHOL AND DRUGS 13-DANGERQUS ' 9 - UNKNOWN 3 - PARTIAllY EJECTED REOUIRING 9- UNKNOWN .. 14 - RADIOACTIVE 80. PASSIVE RESTRAINT TYPE EXTRICATION 112. TYPE TEST ; 1.- FLAMlMBLE SOlD 'W" .. EXTRICATION BY RERSONS 18.FLAMlMBLE . BLOCK G UNKNOWN 0- NOT APP~ 17 - FlAMMABLE GAS 0- NONE OR PEDESTRIAN 5 - EXTRICATION. TWO OR MORE /NO TEST GIVEN 18-FLAMMABlE SOliD I - AI!lBAG (DEPLOYED! TYPES 1 - BLDOO . ~. 18 - GASOlINE 2 - AIR BAG (NOT DEPLOYED! 6 - EXTRICATION OY AMBUlANCE 2 .1I/lEA TH . 20 - BLAST1NG AGENT 3 - AUTOMATIC SEAT BELT OR REscue PERSONNEL 3 - URINE 98 . OTHEIVNOT SIGNED ..OTHER 7 - EXTRICATION OY POlICE 4. TEST IlEFUSED 99 - UNKNOWN 9. UNKNOWN 8 - EXTRICA'nON OY SELF .-OTHER 9 - UNKNOWN EJECTION 9 - lJN/(NOWN OR 80. INJURY SEVERITY. BLOCK H OR EXTRICATION o . NO IN.JJRY 83 RESULTS (ALCOHOL TEST) CODE THE 1 DIGIT HAZARlJOUS 1.D€ATH 80, IIlJURY TRANSPORTATION MATERIAl CODE ON THE PLACARD 2. MAJOR IlUJRY ,BLOCK II CODE ACTUAl. TEST RESULT 3. MODERATE Il'UJRY O. NOT APPLICABLE E,G 197 GRAMS _ 0.20% (MOVE 4 - MINOR II'UJRY 9 - UN<NOWN 1 - AIABULANCE (CONT'D ABOVE) 3 DECIMAl PLACES AND ROUND) ~M,~~, fJ ,<,_,"'''__';_',-__. "- " ,-," d-"""_~_,,,'_q -u"~"'_' -"_''',~,__''''<__,__......,,'''__''''','''<_ _,~.__~_~_ ',_ . 'l. _ ,-,--,- (.;oi~r>i1tc'I{'('Al "j ,-,'- - -" ~ ' OCT 20 2003 14:01 FR TRAVElERS \:lil'3(l<ld sse\: UI. l>U 610 736 2575 TO 9216103763105 P.04/12 oc:tt ~0~ e~ PO ~ " . - ClaIm I: ~<<z nO 70.) Dispatch Cover Sheet Field, T~I Loss, Supplement:, ",. . ' LR$ID-~ Cov: Dat,'Asslgned: mOlt;} J FleldTe.:h 2ItI.A (ClIo'" Aden, a-[J T_O In'" s.mc:. QIg , ID fI TItMfI,IDWINII'1 yOND n:-D~-~D -.,... .""- yOND - ~: s1,'1.(CA 'TrwI'" AAtJ, snop 10: ~'DalI &o.EGllImIIeAmvlml .1 " ~/ro.l~ I' /? 7'0. f:? S ' on; ...... Call PlIoM "0111 DIlle 'I 0.7r ,,(tJ- I -"'IoTA.~ VClN 1'otal LoSs Service ~ep , IlllIIaI S...... ColI 10 I TI1IIlII...IOTII.T..,,7 Y01,/OI AaI/grlIl1llllIl"'~ Dr N....VI/IdoIIo~ " ' . ~~~' =-__,~IDn~&:acfe'I .."_~Vddll~_~..!=.~ _._ . ' LIl;YNUOlSEIl i'l. - /'U 7 6SN/TIN Ag_ ACV i:IIIe s,*,"etIl_ Cd __Dolo ~-----"7'- __ __I, " '" ... ... '"' '" "",I, ..,\ oj"; " (~j , I "1 . : '" ,11 111_\ '. . ":",". "f..-h/ .... ... , i-~ ~L)/'- !-, ?~'I G-..k W" ~(;.,.9,. (......, ~I rf-"'''f/jJ~ nul tf#iJI - -yld /lelt> ---. -------.-- -' . - -r~-; I I. I Refund Reconclllallon ID AmulIDlIe .,,""', -- Kor: "'ofaro, DcDI/Mg, A-Ant< ~~"""''''''''a1~fo) "S\lPlII. Tnle: ,:oJnoo\taIt Plloo :z..o._1cocI DIIN9t 3"HIdd1n ~ \ ; . . .'~ . ;: . : "--'. '.,-' . . : ~; I:~: DTL.14 -,- E 'd om 'ON ~ H9~n9S11Id/~li'Sll~ w~6H ml 'Ol 'DO ;-'\'''''-f,''~!l''"l'# . ~ jrw. .")' ,--" " , .W1" ~;;-<'~~;"'J''(j~~: 't'~f1 ""Li.J -" - OCT 20 2003 14:02 FR TRAVELERS VI2I"::I!J~c:I S90C 2U v~lo 610 736 2575 TO 9216103763105 P.05/12 ~:n ~ e~ 1:>0 ALLSTATE INS~Ci COMPANY HAUISBUltG MCO 6345 F~ l)RIVE HARRISBURG. PA 17112 ' (711) 540-7500 ------SUPPLEMENTS: Sl!<<>P CALL 1-800-726-&890 xaoao------ CO LOG NO 1010 -0 05-12-00 9:14 AM ESTIMATE REAR WIPER AI~ CONDITIONING MILEAGE 134.925 VIN JHMED8350LS0024S2 CO])E H111 VEil INSP /I CLAIM INFORMATION CLAIM # 6652130703801 COMPANY ALLSTATE INSURANCE COMPANY INSURED DEL GRANDE. WILLIAM 0 CLAIMANT INSPECTION TYPE FIELD APPRAISER NAME STEPHEN W JONSS LICENSE , 143441 WORK PHONE (800) 726-8890 AD])USS 6345 PLANK Dk STE 1.000 CITY STATE HARRISBURG PA ZIP 17112- OWNI!R DEL GRANDE. WILLIAM D POBOX 63 TIDIOUTE PA 16351-0083 REPAIR VEHICLE 1990 HONDA CIVIC CRX STD 2 DR COUPE 4CYL GASOLINE 1. 5 OPTIONS TWO-STAG! - EXTBRIOR SVRFACES TILT STEERING WHEEL BODY COLOR CON1>,IT1!ON LlC!NSl!J /I LICENSE STATE WHItE PAIR BLY6415 PA PO~ICY R 008254727 eLM HEP I AGNT LOSS DATE 05-07-00 LOSS TYPE COMPREHENSIVE PAX ' INSP DATE 06-10;00 LOCATION RESIDENCE CITY STATE WORKIt HOME,ca14) 484-2245 , ~: ~OR sufP~S CALL SUPPL~ HOTLINE, .1-800-726-8890 X ao,o ~LL SlilP~s MUST BE CALLED IN PRIOR TO REPAIRING INVOICES ARE Rl!QUIRED. .QONOT c~u. 'tHE ADJUSTER FOR SUPPLEMENTS ' GiVE TlUS BSTlHATI! TO REPAIR SHOP PERFORMING REPAIRS. 11I0TE: O~ DAMAGE TO LEFT DOOR NO SUPPLEMENTS PAID WITHOUT PRIOR APPROVAL OR REINSPBCTION OJ? coolS: · "USIijt-.ENrERED VALUE iC . COMPEtITIVE PART TE = PARTL lUiPL PRICE E . REPLACE OEM EU = RECYCLED PART ET " PARTL REPL LABOR NG " REPLACE NAGS EP . CoHP2tITIVE PART IT " PARTIAL REPAIR -1- I' 'd mB 'ON -'>T' ,-""","~'=~~ !lI'l!I!i,.=.~ -"!l 1- "-, r ~ - --, I ~ H9Hn8S11Id/~liISI\V WV6E: 6 EOOt 'ot "DO ~ ~~~. , ~~'"""""~~ :""'lnl':-lJ'-lf""--- OCT 20 2003 14:02 FR TRAVELERS 5;0' 3!ll:ld S90!O: 2,u. 1721. 610 736 2575 TO 9216103763105 P,06/12 1aL;j,j, et:l""'- ~ .J...JU RIoI ASSBMBl.y UPAIR REFINISH SURFACE TWO-STAGE TWO-STAG!!: SB'I'lJP N 0973 HEADLAMPS AIM ADDITIONAL LABOR I 0083 PANEL.HOOD REPAIR L 0083 PANEL.HOOD BUlNISH >>REPINISH LABOR TO SPOT COLOR . CLBAR COAT ENTIRE PANEL. EP 0103 FENDBR.FBON'l' LT COMPETITIVE PART 141.00 L 0103 FENDER.FRONT LT REFINISH SURFACE EDGE TWO-STAGB MLDG.FENOSR SIDE LIB 7s321$H2013 MLDG.PENT>1m LOWER L/R 71860SH2JOO SHAPT . AXLE DRIVE LIF COMPETITIVE pART MLDG.FllOI\T DOOR LOWER LT REPAIR MLDG.PRONT DOOR LOWER LT Ral ASSEMBLY PINSTRIPES COMPETITIVE PART FRONT BND ALIGNMENT SUBLET ALIGN FllT SHEET MiTAL REPAIR 1990, HONDA CIVIC CRX STD 2 DR COUPE CtAtM H 6652730703HOl LOG 1010 -0 I = REPAIlI. N = ADDItIONAL LABOR AA . APP!AR ALLOWANCE OP CDli: MC DBSClUPTION L "REFINISH RI = RIo I ASSEMBLY RP " RELATED PRIOR l'lFR.PART NO. -- --. -- ----------- RI 0005 I 0006 L 0006 I:lUMPER. nONT COVER. FRONT BVMP!ll. COVER. FRONT BUMPER E 0138 E 0134 EP 0682 I 0~43 RI 0243 Ee S9 I 16 ITEMS PINAl. CALCULATIONS &: ENTRIES PARTS GROSS PARTS OTHER PARTS PAINT MATERIAL !\DJUS'IMENTS DISCOUNT MARKUP PARTS TOTAL TAX ON PARTS . MATERIAL @ 6.000" $ $ $ UllOR RATE REPLACE HRS REPAIR HRS ;-,.: 1-$H!ET METAL S 34.00 4.8 6.5 S i 2-MJl:CJi/ELEC $ 34.00 2.2 S 3-JlftAMP; $ 3S.00 4-llBFINISH S 34.00 8.1 $ 5-l'AII'lT S 16.00 LABOII. TOTAL TAlC ON uao~ t 6.000" TAX ON SUBLET @! 6.000% StlllLE1' REPAIRS TOWING -2- ; 'd om 'ON H9~neSllld/;ltl~11V I '",""'C''<",,,""~, ._" ~~ ., "."'?~ - , . ~~ '~r> - " 05-12-00 9:14 AM SB - SUBLEt P = CHECK UP = UNRELATED PRIOR PRIOE AJ% HOURS R _____ ___ _____ 4 2.0 1 2.0"'1 3.2 4 2.2 0.4 0.6 0.5 1 2.0*1 2.2.4 8.37 19,67 119.53 1.8 1 2.7 4 1.8 0.5 0.4 0,2 1 0.2 1 2.2.2 1. 0* 1 0.3 1 0.3* 1" 1 1.0"'1"' 25.00. 39.95* 28.04 285.53 129.60 $ $ 443.17 26.59 384.20 74.80 275.40 S 734.40 $ 44.06 $ 2.40 $ '39.96 WV6E:6 tOO~ 'O~ 'l~O , ~~~ e_, . :"!~~..." "-,'," ' "r"~ ._ - _~., ~ , OCT 213 2003 14: 132 FR TRAVELERS 90 '3DtI.. S900: ZU t>c.!. 6113 736 2575 TO 9216103763105 P,07/12 0O::n ~00Z 0<: ~ 1990 HONDA CIVIC CRX STD 2 DR COUPE CLAIM # 6aS2130703HOl LOG 1010 -0 STOHAG! 05-12-00 9:14 AM CROSS TO'1'AL LESS: D!DVCTI8LE NET TOTAL {)flf1rr11~ S 1,290.57 $ 100.00- <...0190.57 ~ 11201 PRANKLIN COOOY PXN Y/02/02/00/00/00 CUM 02/02/00/00/00 Geoeode: SPPL Yes Geoeode: ADP P~RO W0338 BS LOC 1010 -0 05-12-00 09:20:21 Kit 3.38 CD 04/00 COPYRIGHT. AUTOMATIC DATA PROCESSING. INC. 1999 1.4 HOURS WERE ADDED TO THIS ESTIMATE BASED ON 1.91" 5 TWQ-STAGI! REFINISH FORMULA: 20% OF RlFINISH HOURS. APTER 0VEIlLAP. PLUS sE'l'Ul' TIME POR THE FlRST MAJOR PANEL. WHERE NOTED. ALLSTATE WILL NOT BE RESPONSIBLE FOR ANY RBl.ATED TOWING SERVICES OR STORAGE CHARGES. KNOWN AT THE TIMB OF APPRAISAL. APTER . AFTER WHICH THE CHARGES WILL BE THE RiSPONSI:aXLITY OF THE CONSUMER. THIS ESTIMATE ~ BEEN PB.EPUiII BASI!D ON THE USE OF AJlTERMARKETCIlASH PARTS. IF TIm USE OF AN AFTERIolAlU(E1' CRASH PART VOIDS THB ~ISTING WARRANTY ON THE PAillTBIUNG REPLACED OR ANY OTHER PART. THE j\FT~ CRI\.SH', PART SHALL HAVE A W~ EQUAL TO OR BJ!o.lu'K 1'HAN TKi REMAINDER OP 1'HE' EXISTING WAlUlANTY. W~IES APPLICABLi TO AFTERHAllDT C1tASH PARTS AlIB ;pROVIDED BY THE M/UIltW~ OR THE DISTl'\IBuTOll OF THESE PARTS NOT THE ORIGINAL MANlJ'PACTURER OP YOUR VEHICLE. ANY PERSON WHO l(NOWINGLY AND WITH, INTiNT TO INJURE OR D81J\AUD ANY INSUBEll Fn:.ES AN APPLI~TION OR CLAIM CONTAINING FALSE, :rNCOM~LErE OR MISLEAJ)ING INFORMATION SHALL. UPON CONVIPTION. BE SUBJECT TO IMPRISONMENt POR 1JP TO SEVBt<! YEARS AND PAYMENt OF A FINE OP UP TO $15.000. IT IS TQ OUR MUTUAL INSTEREST THAT YOU UCIEVE PROMPT, AND cOl.JRTEqus SERVICE ALONG WUH QUAL,~TY REPAIR WOIUC ATA PAIR PRICE. IFYPU HAVE APB!EPERENCE FOR A PARTICULAR smp. YOUR ADJUST~ WILL WRITIi Oil ApP~ AJ'l, ESTIMAtE OF UPAIRS WI~ THAT SHOP J3ASED ON COMPETITVB PRICES IN THE AREA'. INFoRMATION REGARDING REP:'AIR JlA-CILITIES. WHICH MAY BE ABLE TO REPAIR THE'VEiatCLI! POR THE APPRAISED AMOONT. IS AVAILABLE FRQM YOUR AnJustn Ort INSl!RBR. HOWEVER. THERE IS NO REQUIRIHEI'lT TO vsa ANY SPECIFIED SHOP. COSTS AllOVE THE APPRAISED AMOUNT MAY BE THE RESPONSIBILITY OF 'IH.l! vallCLE OWNER. ALL SUPl'I.EMEN'I"S MUST BE APPROVED PRIOR TO REPAIR. AFTERMAlUCET CRASH PARTS ARE IDENTIPIBD IN THIS ESTIMATE WITHTHES'YMBOL "Be". 'U" (COMl':ETITI"VE PART) AND "XU" (RECYCLED PART), ,AN "APTERHARl(:ET CRASH Pt\BT' IS A NON-ORIGINAL MANUFACTURER (NON-O$H) REPLACEMENTPAkT. IUTHER NEW 01 US4n. FOR ANY OF THE NON-MECHANICAL PARTS THAT GEN!RALt.Y CONSTITUTE THE EXTERIOR OP THE MOTCl.ll VElJlCLE. INCLUDING INNER AND OUTER PANELS. NEW. ORIGINAL EQUIPMENT MANlIl"AC'IVREa, REPLACEMENT PAM'S A!tE ,IDENTIFIIJ) BV TH1l LEtTER "E" ANI) CAN' BE LOCA.ttD AT ANY ORIGINAl. EQUIPMENT MANUFACTURER PARTS DEALER. -3- 9'd om 'ON H9HnaSll1d/311lSllV wvW 6 EOOi 'OZ '100 , .-,,'i'""""';.'l"'''''*r .j~" ~ - TI n~"~'"''lj '<q{(,_W; ~_-T: '1)" ~~. - ~'fi[l ",0'3~cI $905: 21.1. ~cl. 610 736 2S75 TO 9216103763105 P.08/12 0U" ~00Z 02 .L::lO OCT 20 2003 14: 02 FR TRA\JELERS 1990,HONDA CIVIC CRX STD 2 DR COUPE CLAIM " 6652730703HOl LOG 1010 -0 05-1Z.00 9:14 AM ADJVSTER ~lCENSE: II DATE ______~"~________________________~__..______~____~M_~~-___.._____________~______ TO ALL REPAIR FACILITIES: B8FOftE USING AN AFTmlMARKET SHEETMETAL PART. BB SURE TO LOOK FOR THE CAPA SEAL. mIS IS NOT AN AurHORIZATION FOR ilil'AIlt, SUPPLEMEN'I'S MUST 8E APP1lOVEP PRIOR TO REPAIR. IF YOUR CAR IS OF UNITIZED CONSTRUCTION, IN 50MB CASES THI 1t!PAIll SHOP HAY NiEJ) SJ'l!CIAL EQUIPMENT TO PROPERLY RBPAIR THE CAll. yOU SHOULD DETEBMINE IP THE SHOP yotI SELECT TO COMPLETE THE REPAIRS IS PROPERLY EQUIPPED. -4- L 'd om 'ON H9ijnaSllld/1lilSllV WVO,:6 (OO~ 'ot '100 ;""''-''\'''''Lr.'''~',~ ~'_"'_' ~J_ , I , ' -," ~""'"""" , ~ ,,~1" T'H~ "" -~ OCT 213 2003 14:132 FR TRAVELERS 813 '301;k1 S90C Ui.. t>U 6113 736 2575 TO 92161037631135 P.09/12 0E:t> ~c: ire .1.:)0 CD LOG NO 1010 -0 ,DATE 05-12-00 VEHICLE 1990 HONDA CIVIC CRX STD 2 OR COUPE 4CYL GASOLINE 1.5 Ol'tIOlllS TWO-STAGE - EXTmlIO!l. SURFACES TILT STEERING WHEEL SUPPLIER PART PART I)ESCRIPTION NtlMBD FRONT BODY AND WINDSHIELD Fend~r,Front LT H01240106 29-08-31-5 FRONT SUSPENSION Shaft,AXle Drive L/F 1028L NUJ-6300 REAR WlPEa AIR CONDITIONING SUBSTITUTED POR OEM PART NUMBER SUPPLIER CLS SB.C CODE S0261SH2AOOZZ 60261SH2AOOZZ 002 >003 C C 1 1 44011SH3A02 440USli3A02 >001 004 1 1 > .. 2STIMA.TE TOTAL IS BASBD ON PRICE QUOTED BY 'l.'HIS SUPPLIER KEY TO CLASSIFICATION/SOURCE CODES CLS .. CLASSIFICAtION CODE: C - CAPA CERTIFIED PART QUOTED BY LISTED SUPPLIER R - RACQNDITIONED PARt SRe .. SOtlltCE CODE; 1 - NON ORIGINAL EQUIPHENf MANUFACTURER PART 3 - OlUGINAL EQlJIPHEN'l' MANUFACTURER (OEM) PART D~Aluro DISTRIBUT<m LIST 001 - PXN1757 STEERING SYSTMS*RMFD 620 ROUTE 168 ~VILLB. NJ 08012 (856) 227-4080 (800) 553-4080 AUTO BODY SUP. .emu. 2215 ADAMS PLACB N.!. WASHINGTON. DC 20018 (202) 636-8700 (800) 432-2726 SMEAL'S ENT .CERT 5500 PAXTON STREET HARRISBURG. PA 17111 (800) 441.93~7 (717) 565-1920 NAPA PARTS CALL YOUR LOCAL NAPA STOYl! -1- 002 - PXN3060 003 - PXN3795 004 - PXN6106 g 'd am 'ON H9MnaSl1Jd/ililSIIV W~O;:6 Eoot 'Ot '100 "r_"'vcr'_.'_""~"",,,,_~'I!!'~ I' .., -~ < , ,~ F - ., ,'"","""'~" - , '",,'00''' ,', OCT 20 2003 14: 02 FR TRAVElERS 60'~~d S9BE ~~~ ~~ 610 736 2575 TO 9216103763105 P.10/12 Ill.' \ \ lolltl~ lOG J..N 1-800-LET-NAPA. GA 30339 (800) 538-6272 (0001 000-0000 ADP PENPRO W0338 85 LOG 1010 -0 05-12-00 09:20:23~~ 3.38 CD 04/00 GBOCODE: 11201 SA: PRANKtJN COUNTY COPYRIGHT, AUTOMATIC DATA PllOC!SSING. INC; 1999 -2- 6'd om 'ON H9~naSllld/ll'ISII~ ~VOH E OO~ 'O~ 'l~O ,0""'_'-'.',''''1''1'''.<<'<<'' ~ 00, r ,_ ~ ~ ~ I ., ., ~~,~p ~~,,~ - ~, , - ,~ "1frT."::"11l'IT-T .c - ~ ,~-- OC 20 2003 14:03 FR TRAVELERS er '381;1.1 S90~ G.!." "GL 610736 2575 TO 9216103763105 P.11/12 ~~..~ 4~~~ U~ .~ DESK: 81llS INITIAL CASUAL TV WOI\1<SHEET 665 273079 S DOL: 65/07/2BBS INSURED: DEL GRANDE. WILLIAM 0 10; 92 DEL GRANDE, KATHY HASKELL D.O.B.: 01 - 17 - 1955 AGE: 38 SSN: SPOUSE FIRST NAI4E: WILLIAI'I SPOUSE LAST NAME: eeL GAANOE IN.JURY DESCRIPTION: CHIPPED 18/28/83 SEX: F BODY PART AFFECTED: TOP TEETH WAS TREATMENT RENDERED IN A HOSPITAL OR EMERGENCY FACILITY (~/N)? N CASUAL TV COMMIiI'l'tS: PF:3=SAVE&EXIT 01 'd om 'ON H9HOSSIUd/ll! 1lllV wvot:6 EOO~ 'Ot 'DO ~-."",-~""",,,,,..~~ ." !l!!!lW~ ~~,~" , f ~ ,Uf> ' OCT 20 2003 14:03 FR TRAVaERS n '3!l1:fd S90~ e:U. ~(!l. 610 736 2575 TO 9216103763105 P.12/12 t~:tt ~ ae: .L::lO DESK: BfJ3 665, 2731670 3 DOL.: 1Il5 - ID: 92 KATHY HASKELL DRIVER HOME PHON!: (717)$30-9566 INVOLVED PERSON STATEMENT 167 . 2fl'''' INSD: W;JLLIAH 0 DEL GRANDE PAGE: 1 OF OEL GRANDE , BlIS PHONE: ( ) STlrr EHPL NAME: DATE: 05 . 1l/J - 2Il1Dl!l STATEMENT TYPE: EFFeCi ON INSD I.IAB AND/OR CL.MT DAl'lA.GES: NOTIFY, ANALYSIS, SPOKE WITH INSO SHE STATED THAT SHE HIT A DEER THEN A GAURD RAIL NO DAMAGE TO THe QAUROAAIL. NO POLIce WERI! CALLED. INSD CHIPPED HER TEI!"1!H IN THE A.CCIDENT , SH!!! HASH I T ElEEN TO THE DENTIST /IS OF YET. HAD MECHANIO LOOK AT VEHICLE SHE STATED THAT THe CV BOOT ANDSOHETHING ELSE IS OAHAGlI;D AND WAS ADVIseD NOT TO DRIVEA THe V1!,HICl.E. MAKING A FIELD ASSIGNMENT. EXPLAINED PF\OOESS AND OOVERAG es. ADVISED OF NO UU ON POLICY GAVE NAM!:$ OF RENTAL co JlNSO ql!CLINED WI!.:L GET ALTERNATIi VEHICLE FOR USE. GAVE INSO MY NAME, NUMBER, CL NUMBER. AND BUSINESS HOURS NO FURTHER QUESTIONS OR CONCERNS. e5/18/2_ SHARON INTERVIEW (S=NONE 1 =FA.V 2s UNFAV) HFlS: KERSHNER PF5-~o FlU PF7-BACKWD PF8-FRWD PPS.PRINT PF11-PREV Sf~ PF12-NEXT STMT ... ONLY EMPLOYEE JGBl CAN UPDATE THE STATEMENT YOU HAVE SELECTED ... II 'd om 'ON H9~n9S11Id/~lilill~ WVOv:6 EOO~ 'O~ '100 ** TOTAL PAGE. 12 ** ". ';;<'f"'-"'~<'~;';O,:r:"""!","~, ,~~=.=~ _ __ ""' '_1 1!'l_. '"_I ,. ~- "~ " . ~ ~. " ~. . 4-; "'"I . I c'AA/'/\~lWs ~,Tf\t.. . "-"~-,~' -, r "--'~"":~-'"''' - " , . ;1 ,] ;':i ;i ~.:'1 ,"~ ,:,~ '0 ,"t '" "'i -,.,~- , -f ;::;<;-~;J~",#_. . ~ _ r' THE CHAMBERSBURC ,.OSPITAL 112 N. Seventh St. Chambersburg, P A 17201 , Page 1 ~' EMERGENCY CARE UNIT (717p67-7146 DEL GRANDE, KATHY L Patient #: 2666600 Treatment Date: 11/04/99 K. E . Senecal, M,D. Medical Record #: 523057 Patient Type: 2 D,O.B: 01/17/65 CHIEF COMPLAINT: MY A. HISTORY OF PRESENT ILLNESS: This 34-year-old was the restrained passenger in the front seat of a vehicle involved in a front-end collision three days ago. She hit the windshield with her head. There was swelling but no loss of consciousness. No paralysis Dr paresthesia. She continues to have problems with headache which started in the area of trauma but has become more global and constant and, also, increasing pain in the back of the neck as well as in the low back, No paralysis or paresthesia, No vomiting, No abdominal or chest pain. No injury to the extremities. No previous concussion, PAST MEDICAL HISTORY: She has had infertility treatments, none now, No present medications other than using Aleve for this pain. No allergies to medicines. PHYSICAL EXAM: Temperature 99,2, pulse 95, respirations 20, blood pressure 145/91. The patient is alert, conversant. PERRL, EOMI, Normal symmetry of facial expression and sensation to light touch. Normal gag and tongue thrust. TMs clear. No nasal drainage or . ' bleeding. Scalp and skull presently appear atraumatic, There is no apparent residual from the forehead contact. No bony or scalp tenderness at this point. Neck is slow in movement, particularly anteriorly, She has tenderness in the paraspinous muscles much more than spinous processes themselves in the cervical distribution, There is no thoracic spinous process or paraspinous tenderness, There is again tenderness in the lumbar distribution. This is all rather widespread rather than well localized. There is no visible lesion. No sacroili-actenderness. Lungs clear. Heart regular, Abdomen soft and nontender, Moves extremities symmetrically, Normal light touch in all extremities, Normal pulses throughout. No evidence of trauma in the extremities. DIAGNOSTIC STUDIES: Cranial CT scan without contrast, cervical spine x-rays and -- lumbosacral spine x-rays show no acute bony abnormality, DIAGNOSIS: 1. Head trauma. 2. Posttraumatic cephalgia. 3, Cervical strain/sprain. 4. Lumbar strain/sprain. 5. Assessment post-m9,tpr V~hicl!;,l\fcident. :.-;.- .~- -,..; -",. ",-,'".' +-F';'"o "''''',I - ",,,,, __~i"""__ ^_" .~~c '___'0"' ~. > ~ . - --,.,-~ -... ,- ~~ - -- -~- - <. '-,^": ,T , . .. THE CiiAMBERSBUR~110SPIT~ 112 N. Seventh St. Chambersburg, P A 17201 ( Page 2 } EMERGENCY CARE UNIT (717) 267-7146 DEL GRANDE, KATHY L Patient #: 2666600 Treatment Date: 11/04/99 K. E . Senecal, M.D, Medical Record #: 523057 Patient Type: 2 D.O,B: 01/17/65 PLAN: Discussed with patient there appears to be no surgical lesion, Discussed with patient OTC nonsteroidal agents, FlexerillO mg p,o, t.i.d. (one received now, prescription for #15), heat and/or ice to sore area as helpful. She will followup with her family physician on Monday. Recheck sooner if any problem or question, Note for offwork now through 11/7, She has moved to this area but gets her medical care in Harrisburg, Family physician list dispensed in case she wants to convert to local practice, KES/dad D: 11/05/99 T: 11/05/99 cc: Dr, Hontowitz, Harrisburg K. E . Senecal, M.D. > ~;~~':~-1~~;~~..:.~~'~' ~ ~~, '_"T'"'' ~, ,,_ .= I,'"~~_~.M .,.." ,~.,..>___" ^"~,~ _ .. _". _,~ "."'H '." '.... '"~"- '''rrl'''!!!lI , . fCW r EMERGEN.... ( CARE UNIT Registration Data Sheet CHART COpy CHAMBERSBURG HOSPITAL TELEPHONE NO, y] .;oj q '"; ;:J ,Cf,I.':" :;:'::,::. ;',0:':: '-'w_:',_':: ]t";:: 'J~,)\ :::ifI:: ~- An affiliate (If Summit Health MEOICAL RECORDS NO. WALKED 523057 DEL GRANDE, KATHY L 504 BRENTON STREET (7171530-9566 UNEMPLOYED EMPCODE: SHIPPENSBURG, PA 'SN 209-60-4571 PRECERT INFO: NO INFO 17257 11/04/99 NEXT OF KIN/PERSON TO N TIFY (INFO) DWAYNE HSBD 7175305966 1, N 2. N 3. N 4, N 5, N 6. N ' u.r:\'::, .;;.1',::-.:: Ii 1:1:,'::::::;:: DEL G RANDE, KATHY l 504 BRENTON mNO (7171530-9566 S5N 209-60-4571 SHIPPENSBURG, PA 17257 TEL NO INSURANCE COMPANY PLAN CODE POlley HOLDER Aa. POLlCY/CERTIFICATE NO. GROUP NO. ":}j:-J\ 2" ;2\ ::O,~'::" 0',/ f;?t'. ALLSTATE INSURANCE 4014 DEl GRANDE. KAT 01 1553597367 ;.' ~:;::'::: '.c[":':/ a:-,'"", ::>:Vi'--: U)-.f.IlI'_" ~li! _}.....o:-: Jr:C:..: :~:!:-:: &r"," a...';:' U';:::."'.. 'Z:;::::::.:; :fI II ;0.:.;:.-:.< :~II{ AllSTATE INSURANCE CO 6345 FLANK DR #1000 HARRISBURG, PA 17112 14 REASON FOR VISIT/CIAGNP IS ATTENDING DOCTOR MVA CVEA, H FAMILY DOCTOR HARRISBURG AREA, DOCTORS NOTES: Registration Receptionist ~JJ!... . /(, ~" {l"~,~~~~;'.~,:;:~f.-jr, " !. [:,':;::;1';.,31._/(1[ ., -."'! ",~, _ _N. .c.~,' _".~~".". .<",.~ , ,~ ,I. ,,' , . ,;, ,_." ,_' . ^" ""1"".",, . .'~. -- ". , " ~.< '."fI' . _ '_..' 7,~.." _ ", ~'I- ! #(fI CHAMBERSBURG HOSPITAL An affiliare afSummit Health -~ PATIENT NAME DEL GRANDE, KATHY L AGE SEX DATE OF BIRTH MEORECI 34Y F 01/17/65 523057 CHIEF COMPLAINT If), ,/ ~ ECU DOCTOR \._ /1 ~ATED STAT 0 MEDIC CALL TIME SEEN 'Z/<,'!t. ~+ATED 0 ORDERS VITAL SIGNS: { T CjCjcr P t; d R , EKG CARDIAC PACK TRAUMA PACK PSYCH PACK TRAMA.XRY PELVIC PACK PED PROFILE DIGOXIN LEVEL THEOPHYLLINE LEV. DILANTIN LEVEL ETOH TIME ABG room CBC SERUM PREGNANCY BMP CPMP AMYLASE PT PTT SERUM/UR, TOX. SCR. STREP SCREEN --..... .-/ o IV NS KVa. MONITOR, 02 I o PULSE Ox % - MED PREPACKS TYLENOL #3 po q 4 hr with food pm pain TYLENOL #3 ELIXIR cc TG, tsp q 4 hr pm pain <\: PERCOCET . 4TO - 1 po Q 4 hr with food pm pain .-( DARVOCET - 1 po q 4 hr with food pm pain DIAGNOSTIC IMPRESSION , 'i d() KNEE FEMUR HIP HAND ATTN. WRIST FOREARM ELBOW SHOULDER CLAVICLE RIB SERIES " EMERGENCY CARE UNIT REC.ORD . CHAMBERSBVRG,PA POO090 10:6/97) / EC7JW4 J.~Aji'i-'n.D7~~0J.C ) 'AMY DOCTOR, , ' . I.. N\h-\....~IA', .,J I/H)' 5, Ii, I ~"" 0" ,\.-- v),.; \< REFERRED TO DOCTOR 11/04/99 PATIENT NUMBEfl 266660-0 TIME 12:46 'jJ Or-."" v J \*7 V TREATMENT N PLAN Is Patient Workers Comp? Y fN J IIf Yes, Place a green dot on chart,'i"'-"'" o ADDENDUM o ATTEND NOTE BP iVS-/q/ / PORT CXR PA/LA T CXR LA T CXR AAS PORT PELVIS PELVIS PORT C SPINE C.SPINE.J..ur FIRS I)C "-SPlt>II'J. T SPINE ~ ~ LS SPIN.ur. (. _I k~ ~~~ ALLERGIES:\'" . 1, 2. OLD RECORDS: D ECU EKG: INTERP. X.RA YS OWET READ AMOXll 250mg . 1 po tid AMOXIl 125mg/5cc tsp po tid AMOXll 250mg/5ec tsp po tid ERYTHRO 250mg tab. 4TG - 1 po qid with food BACTRIM OS . 2TG . 1 po bid .I 1 _-ki' .1,0,;., I..;:, /'7) rev-llf.,,} ,;,,,,,,, ' (r:) w.b)~~r /.I'lL}- 4 - ~,l.. 0<1:.1 ~ ';~"<_-",,)"l\ /",) k....~ L ~\d ~\~ 1'-1\ r I. , \../ U/A URINE C& S UACS GC CHLAMYDIA FACIAL BONES IVP !lI:T HEAD -J FOOT \ NKLE TIB/FIB -,-- ""- /- -.............----" \ h / ~,:... ,~~ fu -.r,..J '-W:J ~ :'2: f> a ,'\ ~__ ~ ~ ~ v (<<.t.-4'1S'1 .. ',- 0/ /1' ./ (l- lj..,,~ CONDITION ON DISCHARGE ~~TIS/EMERGENT 0 SADSINON-EMERGENT o OTHER/EMERGENT ..e'OTHER/J'lON.EMERGENT (. I '\e'1( ,! (PHYSICIANSYIGNA TURE) -;O"'.\'.",,~"-__ ""''":'''"1lI1!'''ll / REFERRED TO: <<,b v....<L 1 01(if/ u (('q{) I 'f~LfO 84-10 qUid-..... \nl\.V ,..,~ I '1 \ - ~);~ENT J )DRY (REFERRAL PHYSICIAN SIGNATUREI CHART COpy . " I, ~ '~"'? "r-,v ,._u, _ "'C ,""---'" D INPATIENT TO,5RA,Y, /1- I ~ 1O//:::.tJ<- , FROM X-RfY '"'l? '1''' l{5c 0) LAB DRAWN " LAB REPORT Td O.5ee VIS GIVEN PRIOR TO Td ACE AIRCAST CHES SUTURE REMOVAL STERI STRIPS DRESSING FOAM METAL SPLINT UNIVERSAL SPLINT OCL SLING KNEE IMMOBILIZER NEW PHYSICIAN LIST ORTHOSTATIC TlMI'I1 VITAL SIGNS 'I p LYING SITTING STANDING KEFLEX 250mg . 1 po qid ROBITUSSIN AC cc TG. BlEPH 10 gtts 00/0$ qid GENTICIDIN DROPS gtt, DO/OS Qid FlEXERll 1 po tid pm spasm RN (lNITIALSI 1)1 I~-'/ 'DISCHARGE TII\1IE -,_., ~~, , tsppoq4hr ~ISCHARGE o 23 OBS ROOM NO. o ADMIT ROOM NO, ~TRANSFER ' ,I(X) I , + TlT!r()S IN~S I-//LA~~ {/ - !'\ mnu Jl /,,~ ..:v-l- -+- I ! ~ ,-, ,. '\ ~~ / )" . ZO'l y ) ') (of) ECU PATIENT ASSI7~SMENT <{57' Name '(N AU 4;U/1A7tU ~ Date .I 1- i- 9 f Time /.: t/u Triage Category 3, Mode of Arrival: ~mbulatOry 0 Wheelchair.p Stretcher ~rried VS: T 11'i) P q(" R Z<J BP.-j l.() (tf( . ') ~ , , iADEl GRANDE, KATHY l i cct: 266660-0 I MR#: 523057 , Date: 11/04/99 D0!3/Age:01/17/65 34YSex' F , Patient PhDne: (717)530-9566 CHIEF gOMPLAINT/BRIEF HISTORY/PATIENT ASSESSMENT: MEDICATION I ' ~ mVJ4 ht. 711~ '<-I c C ~dLu..L1; ,J1~ v--. I ' o L. DC . ~ f1I~ ~!14/ 4 ~/'L?/~V .,..~, Mental Status: ~/Alert .Jil Other :. RN Signa;yr~~~~ ....l__L- PHM: ~...wdH'1~ Allergies: ,{)j(~ Date of Last Telanus/Diphthe,ia (rd) Weight Height Head Circumference Instructions given prior to Td 0 Peds: shots up to date? 0 Yes D No If no, immunization material provided 0 Do you have any religious or cultural preferences that will affect your care?..8~ 0 Yes Evidence of suspected physical/psychosocial abuse identified? ~ 0 Yes If yes, note findings and refer to social services. Date Time Evidence of growth/d~velopmental/nutritional problems: ~ k Yes Referral to Do you have any other concerns that you want to tell me about? /E LAST DOSE ~:j , ',,- if!, ~~-I :~'1 o Pregnant o Lactating Ti Date Time In~4~- d- SAFETY ID armband Consent for Tx signed Side rails x with patienVsignificant other consent Clothing/belongings separated from patient Initials INTERVENTIONS o See Nurse's Notes ,)< ""' ri\ PROGRESS NOTES TimeTPR MEDICATION Wound site cleaned Wound site dressed Immobilization - Appliance Spinal immobilization removed per MD order Ice to Crutches fitted/instructions given with return demonstration UPON ARRIVAL 0 C-COLLAR 0 SPINE BOARD o CERVICAL IMMOBILIZATION DEVICE ~-- "".;;'S' ;......::.~._:_~'J. . I ~iiiilllf'.;'c" Family notified Oil ,(J~ Police notified Report to ECF , It --/(-r f/ ~ ~ DISCHARGE ""","o'De ~ Mode of exit M AJ 1;' Accompanied by Men~.Status on DC ~Iert Cl Other AnajJiliarra[SWIlrtlirH<'Dllh P00084E 3/98 ;'""',,-- ""-',"1""_ '1,' . ?I"-'~ -,. ,,~ '~~'T'- ,".\1''',,'".'>; -.'-_",.' c.," ... 1.~ '_"'c~.,,,. ,,"--. . <H THE {~AMBERSBURG ~~uSPITAL DIAGNOSTIC IMAGING CONSULTATION REPORT RADIOLOGIST: (CHAMBERSBURG IMAGING ASSOCIATES, P,C.) ROBERT S. PYATT, M.D., DIRECTOR PHILIP J. SABRI. M.D. NITEEN SUKERKAfl. M.D. HENRY CHING. M.D. T. TOE THANE, M.D. PETER J.W. FANG, M.D. A.E. LEWANDOWSKI, M.D. FRANK D'AMELla. M.D. CHRISTOPHER DEAN LADO. M.D. HOSPITAL 1i'171 267-3000 RADIOLOGY 267-7149 OR 26".714~ NUCLEAR MEtlICINE 267.7171 CAT SCAN 2.67.7707 ULTRASOUND 267.7126 . BONE DENSITOMETRY 267.7145 , . PAUL R. WILLIAMS. R.T., ADMIN. PIR. RADIOLOGISTS REPORT " FINAL Name: DEL GRANDE, KATHY L MR#: Date Done: 11-04-1999 Read: 11-04-1999 TPD Ordering Dr: C.V,E.A, C. V. EMERGENCY ASSOC, Nurs Stat: O/P Faculty Dr: M.D., BARRY L. LEVIN Room no.: Admitting Diag: M V A Rsn for Exm: NA 523057 ReqSeq: 815095 Date: 11-05-1999 Time: 0822 Transcriptionist: DMS Pat Class: 2 Date of Birth: 01-17-1965 Patient phone: 7175309566 ACCOUNT NO: 266660 ** FINAL ** ***F/C: 14 *** ,:1 NDICATION: MVA 1-4-9 :T HEAD: CT OF THE HEAD WITHOUT CONTRAST ENHANCEMENT SHOWS NO ;VIDENCE OF VENTRICULAR ENLARGEMENT. THERE IS NO MIDLINE SHIFT OR ~SS EFFECT. THERE IS NO FOCAL DEFECT. THERE IS NO SUBDURAL HEMATOMA )R SUBARACHNOID HEMORRHAGE. THE BONE WINDOWS FAIL TO DEMONSTRATE ~VIDENCE OF FRACTURE. ,MPRESSION: NO ABNORMALITY SEEN IN THE CT OF THE HEAD WITHOUT :ONTRAST ENHANCEMENT. 'J ,\~ :i~ '<~ lX 0.00 0450 :X 959 ~rI~ Signed by DR. BARRY L. LEVIN M.D. s' ~,"~::~~~~'~~:~~J.~~,~'~- . ~ 'c.;";, - 'OI<'-.-_o~." ,,~<. , ~,'" ",I- . 'u' 1_ r~"_"~",,,,,,,,,,,,~ _ "rF, <'.' ~,,_.., ',""'.-~,"- ~ """-'- ,~j ~~~w . (B r . \,,: THE Ct-lAMBERSBURG HOSPITAL DIAGNDSTIC IMAGING CONSULTATION REPORT RADIOLOGIST: (CHAMBERSBURG IMAGING ASSOCIATES. P.C.) ROBERT S. PYATT, M.D., OIRECTOR PHILIP J. SABRI, M.D. NITEEN SUKERKAR. M.D. HENRY CHING. M.D. T. TOE THANE. M.D. PETERJ.W. FANG, M.D. A.E. LEWANDOWSKI, M.D. FRANK D'AMELlO, M.D. CHRISTOPHER OEAN LADD, M.D. HOSPlTAL{717J267-3000 RADIOLOGY 267.'149 OR267.71~ NUCLEAR MEDIt:INE 267.7171 CAT SCAN 267.7707 . . UtTflASOUNQ 267.7126 '~ BONE DENSITOMETRY 267.7145 . PAUL R. WILLIAMS. R.T.. ADMIN. DIR. RADIOLOGISTS REPORT FINAL Name: DEL GRANDE, KATHY L MR#: Date Done: 11-04-1999 Read: 11-04-1999 TPD Ordering Dr: C.V.E.A, C. V. EMERGENCY ASSOC. Nurs Stat: olp Faculty Dr: M.D., DAVID M. ROGOVITZ Room no. : Admitting Diag: M V A Rsn for Exm: 523057 ReqSeq: 815016 Date: 11-05-1999 Time: 0925 Transcriptionist: DMS Pat Class: 2 Date of Birth: 01-17-1965 Patient phone: 7175309566 ACCOUNT NO: 266660 ** FINAL ** **-* F/c: 14 *** ~ISTORY: MVA, PAIN IN THE LEFT SIDE OF THE NECK AND LOWER BACK , ',C, :l'j -.~ ;, ;;j :" ,:.:1 11 J " 11-4-99 :ERVICAL SPINE: THERE IS LOSS OF THE USUAL CERVICAL LORDOSIS WHICH ~YBE SECONDARY TO POSITIONING OR MUSCLE SPASM. VERTEBRAL BODY ~LIGNMENT IS MAINTAINED. THERE IS NO LOSS OF VERTEBRAL BODY HEIGHT JF INTERVERTEBRAL DISC SPACE DISTANCE. THE NEURAL FORAMINA AND THE ?OSTERIOR ELEMENTS ARE INTACT. SMALL CERVICAL RIBS ARE PRESENT AT :7. THE DENS IS UNREMARKABLE. THE PREVERTEBRAL SOFT TISSUES SHOW NO WNORMALITY. IMPRESSION: THERE IS NO INTRINSIC OSSEOUS ABNORMALITY DEMONSTRATED IN THE CERVICAL SPINE. SMALL CERVICAL RIBS ARE PRESENT. LOSS OF USUAL CERVICAL LORDOSIS. "~ :S'f >{- !~]i ,fr '?;. ~UMBAR SPINE: THERE IS LOSS OF USUAL LUMBAR LORDOSIS. THE JERTEBRAL BODY ALIGNMENT IS MAINTAINED. THERE IS NO LOSS OF JERTEBRAL BODY HEIGHT OR INTERVERTEBRAL DISC SPACE DISTANCE. THE ?EDICLES AND, THE POSTERIOR ELEMENTS ARE INTACT. THE SACRUM AND SI JOINTS ARE UNREMARKABLE. IMPRESSION: NO INTRINSIC OSSEOUS ABNORMALITY DEMONSTRATED IN THE ~UMBAR SPINE. ':j' )X 000.0 62060 723.4 LOSS OF USUAL LUMBAR LORDOSIS. 000.0 62110 724,5 {X ~.~~,.~:~~~ .;':~~;~{~-' M~ ( ~\"A " Signed by DR. DAVID M. ROGOVITZ ~ -, , ~ ;'-.'.'(!l>-"f'J'k""""",,", " ""-"""'<,,~,,_'t'_- . cu".",,>, "'N''I-, - -'I,",,,-,"-,o,,,-'!"3,,, c", . "do__, -',,~'"- ,_c_'_ ~-- - , , -,,_,_, ,_" '''~ "",..,,v. - '-"';?" , 1~-r-- "' r-- II " , , 'r' '[ ,- \F~ or +OttZ..EST ~'LlS ~"'""".-,""" ~~ "ilrJl(" - >'. ", ".~. ~ -" . , , _"_i: ';'::1 ";,,,v~_,~~ GE: DISPOSITION: RECEIVED BY: Form 9323-41A (1'2198) ~ PHYSICIAN: PHYSICIAN , < ~" ",~ - ~ .,., ._".k,,,,,~_,,, .~~ ~>.~.__~~" ^,_'_",>;'~,,'_' 'S_,^,'-"~, __,,~__, """__,N ",,--,~-~"'''', 7"'" _ " ,__1 __ ._-~_ "" " < '. t):IENT IDENTIFICATION Ir~ 07 ) NARRATIVE PROGRESS NOTES PAGE FILE NO. I DATE () I COMMENTS 12/27/01 DELGRANDE, KATHY DOB: 01/17/1965 ,'t: S: Problem: Indigestion, This is a patient from the former office. She said that she has had indigestion now for the past several months and feels nausea quite a bit. Noted that she had an acid taste in her mouth and just feels miserable with it, She has not thrown up. She has not had any diarrhea. , V,I }~ ~; , 0: Weight 207; afebrile; /78. epigastrium on real deep palpation. upper quadrant. Obese abdomen, but tender in the She is not tender in the right A: Reflux disease. P: 1. X-ray. 2. Put her on Aciphex daily. 3. Have her call after the results are in. Michael D. Howanitz, M.D,/jaz D.D. 12/27/01 D.T. 01/07/02 L 4 lfD! /q (!LI.. r ~ [.,,,, ". '-', )lI!If ",-"-",-,--'.""" , -,'~ '.,I.',.,t---- n"f;"-' -,,'" "., > t 1_1U-UZ;1U:~oAM;HAWIULUGY ~ULY , FAMILY MEDICINE CENTERS DIAGNOSTIC IMAGING REPORT DELGRANDE, KATHY S8#: 209-60-4571 DOB: 01/17/1965 ORDeRING PHYSICIAN: ,MICHAEL HOWANITZ, M.D. DATE OF STUDY: 07/08/2002 FAMILY MEDICINE CENTER: FOREST HILLS STUDY: LUMBAR SPINE SERIES ;\- INDICATION FOR STUDY: Back and leg pain. ;/~ZZ~l::!>1 #' 1/ l::!> DISCUSSION: The alignment of the lumbar vertebrae is within normal limits. There is no evidence of loss of vertebral body height, disc space narrowing, or other significant abnormality. ~, ~; -, '-"~ ~~ -~1 .j1 IMPRESSION: Radiographs of the lumbar spine are within noimallimits. ,~f7,.1.- RICHARD p, MOSER, JR., M.D. RPM/wsw DT: 0711 0/2002 10:28 A D#: 1030962 -_-~ -'~'!I' f "~,{,,,., "--~,,"".. ,,-,,:;-",.,.-~., ',"~' _I"_~ . _ <.I~''''''_~_<-_,,~_''- c/""__~.... -~-,_ . -- - "-;""'-<'-"--~,-" -, ~ ;. ,-" -, ",.^' " ,,<"",,",--- >.' 1.' . . k~~E SPINE 'I I~ '1rrr-ij~Tll , . RUSSELLF.POOu:. PT,er.dMDT PATIENT PROGRESS REPORT GREGORY J SILVA,PT, DipMDT Name: ~\fit'(W~, \J'(\-\~I\\ Mechanical Dx Visit#: ?, Vi5it#: 9 Date: ,,3~O~) 1f Date: 3~ CD PT_ ~-S<:x) Treatment region: LS TS CS RUE LUE RLE LLE , , , % Improvement " , ,/ , , , , Most distal SX(see diapm) , , 1 ~ Intensity xflO(moot distal Sx) f-I- Frequency (moot distal Sx) . , L ~ . R RECOVERYSCALE/GOALS , c Poor Maintain reduction n J &' Fair Good I? I Restore function ill ProphyIexis IV Reduce/abolish I :~ Poor Fair Good ;-1 -,j ':1 Sitting posture Exercise technique Exercise frequency MOVEMENT LOSS (%): Flexion Extension Retraction fUNCTIONAL LIMITATIONS: Bendinl: Wa!kinJ1; 'Stairs Turning bead ADDmONAL NOlES: Dynamic posture Propbylaxis Compliance -~i ;'1; Side bending (R) Rotation (R) Protrusion Side bending (L) Rotation (L) ;i:; :? SittinJ1; StandinJ1; Lying/sleeping :"", -:Fti -':tj te- ~J- ,~. ; j;~\~ -~ '11;J ~j ~~i "'-'1 j] ,':;' -~ ~ QJ-. rW-~~,J-~~~ ~ ,", '" -~~ , ^,: ': ,._",:<~~._'--,_- -, _ - _ -~'" _ "., ~". 'c _ ,,1.- ", :ro,,_'. -".1""-,';' - -, ",~ ,---' -- ,'c, _~ .~"~"\' . . ,,' ,^. , ., . ~i~_" _1" >~'T':>rrl:r' r i RUSSEll.. F. POOLE. PT, CredMDT PATIENT PROGRESSREPO RT GREOORY J. SILVA. PT, [);pMDT Sitting posture Exercise technique Exercise frequency MOVEMENT LOSS (%): FlexiDn Extension Retraction FlJNCTIONAL LIMITATIONS: Bendine Sitting Standing Walkin2 Lying/sleeping Swrn Uftm2 Turning head @ -).-,-,' tu::er:,a;q . ADDmON NOTES: I~ 1 -z_~ ~ ~ - ~ ~ wd-f pw-;f- ~ th IS ~/L. ~ ' ' foe f., 1<6? ~ ~ cfX- /. ~' /.,t--% ~ y{!U cA ~ .4~ 11f9~ f~,LUJ,~ dl/~O-y~ ;;;ri/!/" ~ z ~ 1 ~ e<rI:.. ~ ~~~~/s- Name: 1~./~/.t:1/.T)rh: /~J Mechanical Ox Visit#: ;; Date: ,-9-bl-a) PT 7Jt: Visit#: if Date: 2. .li1~ cO RUE LUE RLE LLE Treatment region: LS CS TS " , % Improvement <::0 , , , Most distal SX(see diagram} i Intensity x110(mool dibl Sx} 5 Frequency (most diul SX)---!. , , 1 ~ . , ~ . R RECOVERY SCALE I GOALS L , , ;, Reduce/abolish I Maintain reduction II Prophylaxis IV Restore function ill <I ,,' Poor Good Fair Fair Poor Dynamic posture ;:;; ProphyIaxili }.-. ,;, j :',j Compliance Side bending (R) Rotation (R) Prottusion Side bending (L) Rotation (L) ~'!i -~ ~i: ", ;'e'! i.-i" .~: ,,~ ;)! \1' "0 q '~f -~~ ,;t! t~ :' 2~: tf' "'0' ,,;: ~,~ 'l' ,;); y~ ~* },. ,,:, ':);1 ;:;,r: -;,<:i '1-, '~j ~ ,'-<' -'-,,: Ui ,(~j " I.: r~;; _'i ", C"..,"'''''__!<<'''''X_!!'- , ~ - - ~ '-I -,. ,~.,CI ,'-~ <, ., - '-"',', .". , "- .,. ~, ~ " Good ~'~"'7', -,,,",,, -'.t _~",.~, ,-,., , . ~ _'_d . RUSSELLF, POOtE.IT,o.dMDT ?ATIENT PROGRESS REPORT GREGO} SILVA, IT, DipMDT Name~(I\(lS"(\f, V \' '(\--li'I; , '\ c:. Visit #: '--~ 11~ -" c::::1(l Date:~PT~ . Mechanical Ox Vi5it#: Date: PT_ Treatment region: LS TS CS RUE LUE RLE LLE \ " , " ,/ 2 2 , l l l % Improvement , , , Most distal SX(see diagram) , , 1 ~ Intensity x/IO(rnosl distal Sx) Frequency (moot di....1 Sx) . , L +'R RECOVERY SCALE I GOALS 'c.- Reduce/abolish I Maintain reduction n Restore function ill ProphylBXis IV Poor Fair Good Poor Fair Good Sitting posture Exercise technique Exercise frequency MOVEMENT LOSS (%): Flexion Extension RetractiDn FI1NCTIONAL LIMITATIONS: Bending WaIkin~ 'Stairs Turning head ADD ONAL NOTES: -r. Dynamic posture Prophylaxis Compliance Side bending (R) RotatiDn (R) Protrosion Side bending (L) Rotation (L) Sitting Standing LyinglsIeepin~ .;." , - .~-' 'I ~,::i ;,':1 -J (LdI ~ a.U~ '~'r", _,. "',>!"<","" .cr" _ ',' -','_ '. '-',"1""" <~ 't-., ._f.- ~" "",;,0.-' __""",' -,'. L '. ,~ ",'~',_' .-, ".'- .' 1--"'", __L:"fili . '( '" i~ ,:1 :,' ~j I ~,: i " ,f:'~! hi <I >.1 ~-::i :~;,i ";',i ;-'."""""" .. REPEATED MOVEMENT TESTING (if required): Pain status: Standing;sitting 1. FIS 2. EIS 3. SGIS L 4. SGIS R 5. FIL 6, ElL' 7. FISit, 8. EISit Lying 9. RotlSit 10. Pro 11_ Ret 12. Ret Ex! 13. Flex 14. Lat flex L 15. Lat fle?< R 16. Rot Does pain change location? Yes Sustained positions Number of reps to abolish No OTHER TESTS (if required): 1. Strength 2. Sensation 3.DTR 4. SLR 5. FNS 6. Elvey 7. 8-1 8. Hip 9. Shoulder 10. TMJ REASSESSMENT CONCLUSIONS: (preceed comments with visit number) 1. Mechanical Dx confirmed? 2. New mechanical conclusionltreatment principle: 3. Progression to therapist technique: 4. Initiate recovery of function: 5. Prophylactic instructions/discharge _/._, O>._O"'o'~' ,~" ~'," ,_c~~ . 1,\- "'J" oj,__, - ~_,~" '7<~___" . ,__", ,- - , "., ~ - , " ,. ."-,,. ".1 -iifUl " .; RUSSELLF. POOLE. PT, CredMDT PATIENT PROGRESS REPORT GREGORY 1. SILVA. PT, DipMDT Name:\"r\C'":1ro~i t'i:rl~ Visit #: ,J Visit #: .5 I'}(~" !~ Date:~PT Date: 12,3] -qq -, Mechanical Dx , , LS TS CS RUE LUE RLE LLE . % Improvement cf6 6D , , , , Most distal SX(scc diagram) , l l Intensity x110(moot distal Sx) Frequency (moot distal Sx) L ---+--'-'R RECOVERY SCALE I GOALS Treatment region: " , ;- /, -- . , " j ::\ ~M Reduce/abolish I Maintain reductioii nl ~ Fair Good Restore function ill Prophylaxis IV ;'~ Poor Poor Fair Good "'j " ~ -'1 Sitting posture Exercise technique Exercise frequency MOVEMENT LOSS (%): Flexion Side bending (R) Extension ~ -"':> "-0 Rotation (R) Retraction Protrusion FUNCTIONAL LIMITATIONS: Dynamic posture Prophylaxis Compliance 11 :',,~ ,:, .+~ si Side bending (1..) Rotation (1..) j 'iii ;,. Sitting Standing Lying/sleeping Lifting Other: '.,1 ,,_':C) ~~)-"-O) <::"''''''-~~~'''''_1''9l!ll_, ,,_~.,_. . ' 'f''-' '4 i. --" -, .. -,' ._.,.,._~ , ., ~ ., _~ -~ ' ~ , - L_ C'_I ~""-"'-._O~:"/ir-~'". -, ~ '~' ," ' .~~- - , " REPEATED MOVEMENT TESTlh" (if required): I . ~ )" I/MJ Lying 9. RotlSit 10. Pro 11. Ret 12. Ret Ex! 13. Flex 14. Lat ftex L 15. Lat ftex R 16. Rot Pain status: Standing/sitting 1. FIS 2. E~ J. - I:, 3. SGIS L :~I$R~ 6. ElL '-.. II C- 7. FISit 8. EISit Does pain change location? flJ.. ~ ~o Sustained positions V/~, .r ~'6€ - ~, 5W~ ~ ~ - ~.JO - ~0- REASSESSMENT CONCLUSIONS: (preceed comments with visit number) Number of reps to abolish f.P OTHER TESTS (if required): 1, Strength 2. Sensation 3. DTR 4. SLR 5. FNS 6, Elvey 7. 8-1 8. Hip 9. Shoulder 10. TMJ 1. Mechanical Dx confirmed? 2, New mechanical conclusionttreatment principle: ;--i 3, Progression to therapist technique: 4. Initiate recovery of function: 5. Prophylactic instructions/discharge , ,i, J ':l "',."~rr, . ~,,~ , ' . .,-,"--" ','- ,--,' .,., ."" ":1'''' I' ,--~=., " Name: 7'~{y""r,d~. JQ/AtJ ( , ) Mechanical Ox RUSSELL F, POOLE. PT. C.-ed.\lDT PATIENT PROGRESS REPORT GREGORY J SILVA, PT. Dip\lDT V;"" ~ D", /(,fl'-",1 Visit #:~ Date: i;:i!f9'-f PT ,; , , LS TS CS RUE LUE RLE LLE Q % Improvement '";) 30 . , d Most distal SX(see di.gr.m) , , , l ~ Intensity x1IO(mostd",-,' s.) Frequency (most diSl.\1 s.) 0 . RECOVERY SCALE I GOALS L R Treatment region: " , . . '!1 :~! , , ;;-1 fl I , z- S Fair Restore function ill Prophylaxis N Reduce/abolish I Maintain reduction Poor .... Good Poor Fair Good :1:J "I Sitting posture Exercise technique Exercise frequency MOVEMENT LOSS (%): ( I z- I, v ( Dynamic posture Prophylaxis Compliance t., ~> Side bending (L) Rotation (L) Side bending (R) Rotation (R) ProtIUsion Flexion Extension RetractiDn FUNCTIONAL LIMITATIONS: Sitting Standing Lying/sleeping ',:, ,-1\ -'. vr , ~Ls~ ~A.h. ~4 tn<.f2-.. , "-'~'--""-"!-'"' -0-,-;-:",'-,. ~ .- ~,. A - -,"~ -., -_--,~_, ,~ _,_._~~ __"""."","" _ v_ , _~ - !Ill --. n " REPEATED MOVEMENT TESTING (if required): · (i) pain status: Standing/silting 1. FIS ~ 2. Efs--J 3. SGIS L 4, SGIS R 5.~ ---..., 1.\_ ,ElL 7. FISit 8. EISit Lying 9, RollSit 10. Pro 11. Ret 12. Ret Ex! 13. Flex 14. Lat fiex L 15. Lat fiex R 16. Rot Does pain cha~~?~ti~? 'fps_ TJ--=- ~~ ~ Number of reps to abolish Sustained posi I ~+ rOC-w j, ~ ~ ~~P ~ Jj' ~- ~ ~ 4:J-1/ OTHER TESTS Of required): 1. Strength 2. Sensation 3.DTR 4. SLR 5. FNS 6, Elvey 7. 8-1 8. Hip 9, Shoulder 10, TMJ - ~i .-'..... t- [A.... ~ q :o:i (! ;.' ;-! REASSESSMENT CONCLUSIONS: (preceed comments with visit number) ;.-, ,;! 1, Mechanical Ox confirmed? ie ~ . 2. New mechanical conclusionllreatment principle: 3. Progression to therapist technique: ~ ~ ~ ~ rt..--L ~ IS 4. Initiate recovery of function: : ,-~' ! 5. Prophylactic instructions/discharge !):_-~"-~. ~-, - '. -". ',' 'I __ .'.e e__, "" ~_ ,. ,_c_~,_ ,_" __ '_<', ". '. ."">-. .^--"'f'? ,'-r.'_?,_ .' ',-__' ,e__,,,~,,_ SYMPTOMS Symptoms thisi'pisQde to be marked on body diagram Describe relevant symptoms .".4:~~."".../~...~.d~,.,t,#A~...~.)..,..,.".,~...,'........:.,....,....,.."....,....,..,.....",..,...,..' Present since .......... / ",.,....".. / ...,..:::,...}...":::..t..~...,,,...,...,......,....,...,,..........,.............,.,,..,...........,.., lmprovin!tlinchallginu worsellillg Commenced a~ a result qf: ......!fr1.yl.t.................................................,...............................,..................................... or no apparent reason Symptoms at onsecg:; thigh / leg ......................,..........,........................,....,."..,...........,.....,.,...,.."....."........."..,........,..................,..............,...,.... Constant Symptoms: back / thigH / leg , 'Intermittent symPtom~k / thigh / leu Worse: ~na/ltg ::> (:jittil'ifj rting stalldillg walking lying ".!!!.! as day progresses / pm ~n the move otl1er.....,.".........,.,.............................."....,.............................................",.,.,.....""...,..................................,...................,........................,.... bellding sitting C stanam~ Goalki;V <::Ji!!ij) m'.!! as day progresses / pm when still ~he mo;V other...............................""......"......"...".................................,.....,................................-...............,.....................'..,.."..........,..............,..."." Disturbed sleep? Yes (jji) Sleeping postures: prone / sup / side (R / L) Surface: firm / soft / sag / w, bed Coul';h / sneeze / 5train:ct!!l:f -ve Bladde~bllormal Ga~n~ / abllormal ,............""...,...,.."" Previous Episodes: 0 1-5 6-10 11+ Year offirst episode: 19....",......"............ P;.evioushistory:,~.................,...,.................,..........................................'............................................,....".........,..........,......,..,..........,..........................,.. if iU .' "[ The MCh.e!lzie Institute Lumbar Spine Assessment . Date,II.../.'::..~....../i.L. ~:;r:~~",~"........~, Date of ~irt/J;~:1..~..c:::~~=j',~ex: MCZP ~:::::'~n~~;:~~:~.~..?:~'~..~:f~..~.,..... Telephone ".,,,,,,,,,,,.,,,,.,,,,,,.,,,,,,.........,,,,.,,,,.....,,,,,,...,,,,,,,,,,,,,,,, "..."""."".,... ...,...,...",,,,,.,,,,,,,,,,,,,,, Referral: G~ Self/Other ..."""...'"'''~':'''''''''''......'''''''''...,...''''''''' Off work because of current episode? Ye~/lce ....."../......./......., ., 0 Better: .'1 ...........................................,.................................................................................................................................................................................................................... Previous treatments: .:::~..,..............................".,.....".,..,....".,.....".,,,.,...,......,.........."".........,,,............,.........................,..,.,,,,,......,.............,.....,...... ..'....'......'......."......."..Q.....".................:.....'.............................................................................,......................,.....".................................................. X-Ray~...,,,..,,..,,...0.:,~:.,~...,',.....,.,............,,....."....,..,.......,...,...,...... ,...., ,....,...............,......,......,.. ,.....,....,...,,,'................,,,....,.......,. Gen, Healt~air / Poor .....,..,..,.....",,,,,,,,..,,,...,...,,,,,..,,,......,.,.....,.,,....,....,........,.,....,......,,,.,,....,,..,...............,..,,..,...,,.,.......,,.............,..,.....,......"" MedicatiO~AlD / Allalg / Steroids / Allticoag / Olher ...............,.."...'"""......................".'.......................,,...................'................... Recent or major surgery: Y es !JJj:2,,,,,,.....,,....,..,,,,,,,,,,.....,,,,,,,,,,..,.,,.,,,,.,..,,,......,,.,...,.",.....,,,,,,,,,..,,...,,.,:...,..............,.,.......,,,,...,,....,.....,...,.,..,.,.""..... Acciden~No.....,.............."''''".."''''''''''"....,,...,.........,........,.......,,.....",.........'."..."...",.....,.,..,,,,.. Unexplained weight loss: Y e~ BY PERMISSION OF THE McKENZIE INSTITUTE INTERNATIONAL ORTHOPEDIC PHYSICAL THERAPY PRODUCTS. PO BOX 47009, MINNEAPOLIS, MN 55447 (612) 553-0452 [)1993.0PTI'.lnc. 'I i j ;1,,\;,1 , - '" I ,~~ ,_-"'-,:I':'-"~~-",. ~~_",_^",~". .~;^-",-,," , "-'-=---'. -00'-" r---.-- -1 -- q y;~, """"f'if""~' -"~r-'''-' ~,,~--- , . , "'~<~i" ,,' EXAMINATION POSTURE ~ Sitting: Good I Fa~ Standing: Good I Fair I Poor Lordosis:~ Acc I Normal Lateral Shift: Right I Le~ Other Observa tions: .......... ................................................. .................................. ........................................................................................................... .- MOVEMENT LOSS maj mod min nil kJ( Deviation in Flexion: ~eft I Nil Deviation in Extension: Righ~ Nil , ~ Flexion .........,..,...,......,...... ,..............' .............'.... ....,......,...' Extension ....................,.... ............,... ,................ .......,......... ................ Side Gliding (R) .........' ..,........,..., .......,~.. '..............., ................. Side Gliding (L) ,......... ................ ................. ..~,....... ......,.......... , TEST MOVEMENTS: Describe effects on present pain - produces,abDlishes, increases, decreases, PDM ERP o..cr:'b7,::ti~~~:E~~'~~3~~~~~:::-: ::::: ::::: :: ::~i~,-;ji~~~~=~:=:::::::=:===::=::::=::: :::: ::: ;:~t-~r;,~:~~g;~:~~~~:::--::::::~::-:-~:~::::::::::::::::- 1\ _ ElL--71[j:,--fiiil'fP,"ra:;~--c-~----f;:-- ----- RePEIL......J...,........:~{}'.......................................,.!':.~.............-l..~~..... ...... ................ .................. lfreqUir~ep E:~ ~~i::~..,~...:.......~::......:.......:..:..:.:....::::..:,..::......:~~::....l~~:=:~..:~~:....::: .:~:..;.~::......, ....:...~::.:..::..:..~~..:' =:~=~ii:::::::::::::--::,::.::::~~j;jjj;it: SLta.nding Slo~chedt .....':........;];:;...~.....;;.:...;t......... SLtand~tgt.eTect ..................,...........,~................................... ymg prone m ex enSlOn .:::;.'';R.if;i.~........,;,.....~.........::.. ong Sl mg .........,...........................................................,................ NEUROLOGICAL I,P r ~ ~ MSeotor DDeficfi~t::t..........,.........~............-:::........... ...."..~..8.. DReuflreaxl eSI~gns: ......:......................._'....'.....',..',.....,.......,.,...,...,........'...........'....,.,..',..'.'.'.......'....:...........~.....k...."................,'...',..._... nsory e Cl :..............."..............,.....,...,........,...,.,.....,........................., 1/'"":': OTHER :i~::,~~-::::::::::::::::::::::-E'~=.t:C::: CONCLUSION V~' Posture Dysfunction Derangement No. .s- Trauma Otl1er".,....",...........,.........,..,........,......,..,.,...,....................................................."......................................,......................,.....,.,............,..,........,..,.....,.............,.. :~ ", ;~: :11 ~1 ,;:; :;:'! ~J ''f ';-;: ~- ,i PRINCIPLE OFrREAT?~ P::::~o~..,.......?l.i.~~~::::..::::.::::::~:~~::~::,:::::::::::::::::::.:::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: . ,,-r;? (.. La~:~:~'::'::."':::':',"?!.?~:':.'...:'::.':.,~":::':,~":::..:'.':.::..:..:....,'..,...:..:.:.,:..:.....,.:,.,.........,:...,:'........:.................:,.,',~..:.........:....:............,...,.,...:.:..,......:...,.::....:..,.::,':.'::..:.:.,:.:.:......:,.,....:...:,..,.::,..',':,.:,:.:....:.,':..::..:..:...':,',':.:,':"., Other.................................................,..,..,..,...........,...,..................'......................................'...........................,...,......,...,................,..........,.....,.......................'.... BY PERMISSION OF THE McKENZIE INSTITUTE INTERNATIONAL ORTHOPEDIC PHYSICAL THERAPY PRODUCTS, PO BOX 47009, MtNNEAPOLIS, MN 55447 (612) 553-0452 @1993,OPTP, Inc, ,- '"y - ,:-~-'-", ',1- -, ,~-'':''r=--'" .-"0 ." ,,""-' .~,,,,?,,,-, . -~ __.'_'o~' __J -, ,.,- TT"-r"n> """-~ ' ,.. '" .' ~~\'>} h:t\-~ .. - Vro\l~ t\\ate6- c'L~'C\.~ 0 \'l() 'O\-iJwl N.) t~\-, ~ OW ,,"-~ J'L+qq ~_. )-8- '1 ??t C4-oI - ~,;d cPJoL r 7.ddd.--4oA ~-vd- /;;1)0 , ' o'/l.~.. ,do!., /Yk.)t _ace.J.Ld.u.Le. .. dfJ ~ :;;-/0- 99 j::;t- C4d -odd ddo-L c; .-oi:e..r I-S-eD /t /{)3 if Ie. 12 ' .. \3-(:0 V-\- CQ\~o -\0 ~ - \ III ~ 2,: CO -7 rrili1X ~\n III (hnrrhrtht, ~ 'eN-CO 'f::oi ~d. ...>> .. 'r }-f\ _, - ciA::.. /?..ux:d ,dhy. ~ l!.j'LU I \i'..;I\\ ~ c.Y\l'<:J \-0 \0 ,\ CfIJ.\J\ ~')\ " ' z.;,CD \)\ m e:h::OJj ro ~\.\\\ " ,~\j)~f~Y; - \ecJ~ci QW .3!-Z..-;y $-OC /t "'<<_ dJe/. ~ ~ d_j ,"i ".1 "..' ';'~,,-,1'f7-."_ 0_' ~" , .., ,_,o~" _ ',.'_". ",_, , "" -, "I -' "'_",,",'=__,0__,7,". "_7,<<, C, - ,-,-+.>,> "_ 0' '. '_'^.'_ "."~' ~, , "-'---'j ,; , ~.- .. i "" i ;! :"1_~~,i'1i~ \>., \ "'~"~~"_ '1-" TELEPHONE: 761-5530 ORTHOPEDIC INSTITUTE OF PENNSYLVANIA 875 POPLAR CHURCH ROAD, CAMP HILL. PA 17011 WI6TRINDLEROAD. CAMPI-lILL. PA 17011 . 890 POPLAR CHURCH ROAD. STE. 108. CAMP HILL. PA 17011 450 PQWERSAVE., HARRISBURG. PA 17109 . COCOA & CHOCOLATE AVE., HERSHEY, PA 17033 DAVID M. JOYNER, M.D., FAC.S. M0020092E JAMES R. HAMSHER, M.D., FAC.S RICHAADJ. BOAL M.D. MD01S216E GREGORY A. HANKS, M.D. ROBCRT A. DAHMUS, M.D. MD025631E ALEXANDEA KALENAK, M.D. STEPHEN W. DAILEV. M.D. M0068036L ROBERT R. KANEOA, D.O. WILLIAM W. OEMUTH, M.D., F.A.C.S. MD027980E RONALD W. LIPPE, M.D.. FAC.S. JOHN R. FRANKENY II, M.D., F.A.C.S. MD040026E JASON J. UTTQN, M.D. MARK R. GRUBB, M.D. MDOS7099L STEVEN B. WOLF. M.D. RICHARD H. HALLOCK. M.D. MD022465E THOMAS J. YUCHA, M.D. KQ:~ D~ PATIENT'S NAME DATE M0006219E MD037915E MD0066B1E OSOO33B2L MOO33837E MD011448E MD034685E MD012730E 1//9/7'7' , ADDRESS IN ORDER FOR A BRAND NAME PRODUCT TO BE DISPENSED, THE PRESCRIBER MUST HANDWRITE, BRAND NECESSARY OR BRAND MEDICALLY NECESSARY IN THE SPACE BELOW, & fY) e t(~ V<LA. v ~ r>, . _ 0 ... n, , ~~~,Q'''' $jp m vA REFILL: YES b NO 0 ,M,D. 0,0. SUBSTITUTION PERMISSIBLE BF 1096759 ~ , " I ,,,~ -,'" -'ii- -" ,""" ;M,__ .' .- MI\1J1Et-A Ctl-fJ20PILM f1 C- I " d " ,'~ 'J \j -!'iflF~~" " .' 717-263 2655 MADEIRA CHIROPRATIC 467 P03/05 MAY 15 '01 12:11 DAILY NOnS Kathy Del~rande (1D# 000006482) November 1, 2000 Examined by: Bradley A. Jahn, D.C, I SUBJECTIVE At today's visit, the following symptoms were identified by Ms, Delgrande: - Bilateral neck pain, stiffness, numbness, and weakness. The neck discomfort is moderate, Kathy experiences the symptoms on a frequent basis. The pain is represented as a throbbing sensation and a sharp or jabbing sensation. According to Kathy, her symptoms have not changed since the last treatment, - Bilateral lower back pain, stiffness, numbness, and weakness. The intensity of the discomfort is moderate. 'The symptoms have been appearing with function. The pain is represented as a throbbing sensation and a sharp Or jabbing sensation. According to Kathy, the last treatment had little effect on her lower back pain, stiffness, numbness, and weakness. Pt continues to have difficulty making appointments due to her mother's illness and new job in Harrisburg. She is also currently going through a divorce whiCh is vary s~ressful. She continues to have pain in her neck and low back, but has made some improvement since starting at home exercises. ( OBJECTIVE) A muscle spasm of mild intensity was revealed in the bilateral upper lumbar regions. The bilateral upper cervical, bilateral lower cervical, and bilateral lower lumbar regions were in a state of moderate muscle spasm. Durinq palpation, the bilateral upper cervical, bilateral lower cervical, left upper thoraCic, and bilateral lower lumbar regions revealed muscular trigger points. The bilateral upper cervical, bilateral lower cervical, bilateral upper lumbar, and bilateral lower lumbar regions were notably tender during examination today. Straight Leg Raise evaluation: The right side SLR reproduced lower back pain. The right SLR was limited at 60 degrees, The left side SLR reproduced lower back pain. The left SLR was limited to 60 degrees. A mild decrease of the cervical flexion. extension, right ro~ation, left rota~ion, right lateral flexion, and left lateral flexion was observed, During the cervical left lateral flexion, Kathy indicated she telt pain. The lumbar flexion and left lateral flexion revealed a mild decrease. Ms. Delgrande indicated she felt pain while undergoing the lumbar right lateral flexion and left lateral flexion. During palpation, abnormal position and/or motion of the oSseous structures was noted in the lumbar spine. The following osseous structures were in an abnormal position and/or moved in an aberrant fashion: right sacroiliac. Ely's test was positive bilaterally, Cer~ical compression test was positive bilaterally. Kemp's test was positive bilaterally. Minor's sign was negative. Sitting Becterew's was positi~e bilaterally, Soto-Hall test was posi,ive bilaterally. ( ASseSSMENT) It is recommended that Kathy return to her work activities without res~rictions. Kathy'S condition is improving. ( PLAN) After review Of the recommended home exercises, Kathy has been instructed to perform them On a regular basis. Treat with active care rehab for 3-4 weeks, I TREATMENT ) Today's treatment consisted of the following: ,'-"",._'o,,,t -''"':--'~-'':''+'' 0 -, '-?'h'''-,''',,-~_, ,.c" '1 .. ~, '.' ,:j " \;,1 ::! "'1 , '-,1 :J -"1 ".;! '-i ,-:' " ','!i 'J '--'j ::; 'iiJ1f'i'l 717-263-2655 M~DEIR~ CHIRORRATIC 467 R04/05 MAY 15 '01 12:11 .' Moist heat was directed at the bilateral upper cervical, bilateral lower cervical, bila~eral lumbar, and bilateral sacroiliac/hip regions. Therapeutic exercises were provided for the bilateral upper cervical, bilateral lower cervical, bilateral lumbar, and bilateral sacroiliac/hip regions. Therapeutic activities and Neuromu$cul~r Re-edueation were performed with increased units of therapeutic activities to return normal ROM, strength and functional stability to the joint. Approximate treatment time is 4 weeks. CX ROM: Active and Passive 3 sets - lS Reps PNF Resistant/Stretching ExtenSion/Flexion 5 Reps, 5 Sec holds R/L Rotation 5 Reps, 5 Sec holds R/L Lateral Flexion 5 Reps, 5 Sec holds Cx Machine Weight Training: 4-Way Cx ~ sets, 15 Reps - Each ROM Flexion ExtenSion R Rotation L Rotation R Lateral Flexion L Lateral Flexion Lx ROM: Active and Passive 3 sets - 15 Reps PNF Resistant/Stretching ExtenSion/Flexion 5 Reps, 5 Sec holds R/L Rotation 5 Reps, 5 Sec holds R/L Lateral Flexion 5 Reps, 5 Sec holds LOW BACK WEIGHT TRAINING 1. Abdominal - 3 Sets/ 10-15 Reps Muscles trained: Rectus Abdominis and Iliopsoas. 2, BaOk Extension - 3 Sets/ 10-15 Reps Muscles trained: EreCcor Spinal group 3. Rotary Torso - 3 Sets/ 10-15 Reps Muscles trained: External Obliques, Internal Obliques, Erector spinal group and Deep posterior spinal group, 4, Side Flexion - 3 Sets/ 10-15 Reps Muscles trained: Obliques. SWISS BALL EXERCISE - PELVIC CIRCLE - 2-3 minutes FIGURE 8 - 2 minutes SIDE BEND - 10-15 reps (Arms up and Stretch) GROIN STRETCH - 5 each leg (Leg Out and Stretch) ABS STRETCH - 5 reps - 3 second hold (Extend body back on ball) ROTAT~ UPPER TORSO - 15-20 reps (Extend arms and straight in front and roll torso) ROTATE LOWER TORSO - 15-20 reps (Legs on ball rotate side to side) SQUAT - PUSH - PRESS - 10-15 reps (Pick ball up from floor and push towards the sky keeping good posture) STAND AND ROTATE UPPER TORSO - 10-15 reps " -c ~~ _ -;,r: , '- 1- _e -' ..--,. ",,'" .'" c-,~-.,- ,. o___,-,_~~ "'." ',-__", ,'_-__,.",~,,.c. T'" - " '-'. '''1. _~_:? r- .,,,~",,~1.-_'" ""~"'" .- ,-1; " '; ,\' J;'f~ . ~ " ,-" "'~~- .,.. ,-'- , 467 P05/05 MAY 15 '~1 1':::; J.':::: 717-263 2655 MADEIRA CHIROPRATIC .' (Stand and hold baIlout in front, rotate, change ball position) EXERCISES: 3 SETS PELVIC TILT- 5-10 reps wi 10 second hold Rest 10-20 seconds/repeat. Push back on floor. SUPINE 2-LEGGED BRIDGE- 10-15 reps wi 3 second holds. Calves on ball, lift buns in air, squeeze glutes, SUPINE LEG EXTENSION - 10-15 reps, Calves On ball, lift buns in air, roll ball towards glutes. BENT LEG HIP EXTENSION - 10 reps each leg, Ball under chestlstomach, lift leg up, point toes, squeeze glutes, keep good pos't.ure. SEATED POSITION TRAINER - 10 reps each leg wi 3 second ho~ds. Pick up leg wi knee bent, hold, keep chest high, keep good posture. SUPINE HIP EXTENSION - 10 reps, Neck and upper back on ball, drop pelvis straight down and up again. OBLIQUE CRUNCH - 1 to max. Arms straight down, shoulders and neck On ball, lift torso 'co left and right, squeezing abs. ABDOMINAL CRUNCH - 1 to rnax. Arms straight down, shoulders and neck On ball, lift toward ceiling, squeezing abs. )__.,~, C-,"".." " ~, ~ _'_/_ ,,~ ,i..-<'" , _r , 1- -. -""""!I,-_" _ ,. ._,<''''-,0. ~'7 .' ,.-,. .-r_' --'. . .- /-j >'-~~-~~-, ~- ""^" 717 263 2655 MADEIRR CHIROPRRTIC w' DAILY NOTES Kathy Oelgrande (10* 000D064B2) 467 P02/05MRY 15 '01 12:11 October 24. 2000 ( SUBJECTIvE 1 At today'S visit, the following sympto~S were identified by Ns. Delgrande: neck pain and stiffness. The neck discomfort is moderate. KathY experiences the symptoms intermittentlY. The pain is represented as a dull achy feeling and a throbbing senSation. Ms. Delgrande indicates that her neck problems have worsened. ( OBJECTIVE) The bilateral lower cervical regions were in a state of moderate muscle spasm, During palpation, the bilateral lower cervical regions revealed muscular trigger points. The bilateral lower cervical regions were notably tender during e~amination today. During palpation, abnormal position and/or motion of the osseous structures was noted in the cervical spine. ( ASSESSMENT ) Ms. Delgrande reported that an exacerbation has occurred, Increased neCk pain. not sure what happened or why she's feeling worse, ( PLAN ) Kathy will continue to appear on' a pRN basis. :"'-' -~~ '" .,.' ." "'9- -"~I'_ """-~I__ ," ,- ~.. - /,\ .,. . -,~,- - ,'" - r- '-,- ,.. . . DAILY NOTES Kathy Delgrande (10# 000006482) September 21, 2000 Examined by: **NAME NOT AVAILABLE** ( SUBJECTIVE The following symptoms were identified by Ms, Delgrande today: _ Bilateral neck pain and stiffness which is mild to moderate in intensity and is occurring on an intermittent basis. Kathy describes her discomfort as a throbbing sensation. _ Bilateral upper back pain and stiffness occurring intermittently. Kathy describes her upper back discomfort as mild to moderate in intensity. A dull ache and throbbing sensation best describes Kathy's discomfort. which is mild to moderate in intensity. She describes the irritation as a dull ache and a throbbing sensation. _ Bilateral lower back pain, stiffness, numbness, and weakness which is moderate to severe in intensity. . The symptoms occur as long as the area is being stressed. Kathy describes her discomfort as a throbbing sensation, a sharp or jabbing sensation, and a tingly or prickly sensation. which is occurring with movement and is moderate to severe in intensity. A throbbing sensation, sharp or jabbing sensation, and tingly or prickly sensation is how Kathy describes her discomfort. pt continues to experience LBP with pain down legs. pt has missed last several weeks of treatment due to her mother's illness of cancer. ( OBJECTIVE) During palpation, a mild muscle spasm in the bilateral upper lumbar regions was apparent. The bilateral lower lumbar regions revealed a moderate muscle spasm, Muscular trigger points were found in the bilateral lower lumbar regions. The bilateral upper lumbar and bilateral lower lumbar regions were tender with palpation today. Straight Leg Raise results: SLR on the right reproduced lower back and radiating lower leg pain. The right SLR was stopped at 45 degrees. SLR on the left reproduced lower back pain. The left SLR was stopped at 45 degrees, Cervical range of motion for extension, right rotation, left rotation, right lateral flexion, and left lateral flexion was considered within normal limits. A moderate decrease during right rotation, right lateral flexion, and left lateral flexion was found during lumbar range of motion. A significantly decreased lumbar range of motion was apparent during extension. The lumbar spine osseous structures were found to be in abnormal position and/or motion during palpation. ElyJs test was positive bilaterally. Kemp's test was positive bilaterally. Sitting Becterew's was positive bilaterally. ASSESSMENT Kathy's condition remains essentially unchanged. ( PLAN) A new visit schedule will require Kathy to be seen 3 times per week for a period of 4 weeks. Kathy has been advised to rest at home. ( TREATMENT) The following treatment was provided to Ms, Delgrande today: Moist heat was applied to the left lumbar region, To strengthen and stretch the injured areas, therapeutic exercises were performed on the bilateral lumbar and bilateral sacroiliac/hip regions. Ms. Delgra~de's right sacroiliac/hip area was fit with an orthopedic support to temporarily assist in stabilization during healing. To the areas containing trigger points noted in the objective section above, myofascial release was applied. Therapeutic activities and Neuromuscular Re-education were performed by patient as listed. Treatment goal is to return "~~_1{ '_,_,""_-'-_""'''":_,,,., ". ~___;_ - '''':'''''''71 aO, ''"-:,I~' -"'~_'<:"'_J_ '-"r"'_ _~_ - "..-', ~~ ~ ~ .' DAIL Y NOTES Kathy Delgrande (ID# 000006482) August 29, 2000 Examined by: Bradley A, Jahn, D,C. ( SUBJECTIVE At today's visit, the following symptoms were identified by Ms, Delgrande: _ Bilateral neck pain and stiffness. The neck discomfort is mild to moderate. Kathy experiences the symptoms intermittently. The pain is represented as a dull achy feeling. According to Kathy, her symptoms have been reduced since the last treatment. _ Bilateral upper back pain, stiffness, and weakness. The intensity of the symptoms is mild to moderate. The symptoms are experienced on an intermittent basis. The discolnfort is identified as a dull ache, Since the last treatment, Kathy indicated that the symptoms have been reduced. - Bilateral lower back pain, stiffness, numbness, and weakness. The intensity of the discomfort, is moderate, The symptoms have been appearing with function, The pain is represented as a dull ache and a throbbing sensation. According to Kathy, the last treatment had little effect on her lower back pain, stiffness, numbness, and weakness. ( OBJECTIVE) A muscle spasm of mild intensity was revealed in the bilateral upper cervical and right upper thoracic regions. The bilateral lower cervical, bilateral upper lumbar, and bilateral lower lumbar regions were in a state of moderate muscle spasm. During palpation, the bilateral lower cervical, bilateral upper lumbar, and bilateral lower lumbar regions revealed muscular trigger points. The bilateral upper cervical, bilateral lower cervical, right upper thoracic, bilateral upper lumbar, and bilateral lower lumbar regions were notably tender during examination today. During palpation, abnormal position and/or motion of the osseous structures was noted in the cervical and lumbar spine, The following osseous structures were in an abnormal position and/or moved in an aberrant fashion: right sacroiliac. Ely's test was positive bilaterally. Cervical compression test was positive bilaterally. Kemp's test was positive bilaterally. Lindner's test was positive with Cx pain. Lindner's test was positive with Tx pain. Sitting Becterew's was positive bilaterally. ASSESSMENT ) Kathy's condition is improving. ( PLAN) Her new schedule for office visits will be 3 times per week for a period of 4 weeks. ( TREATMENT) Today's treatment consisted of the following: Moist heat was directed at the left lumbar region. Therapeutic exercises were provided for the bilateral upper cervical, bilateral lower cervical, bilateral lumbar, and bilateral sacroiliac/hip regions. Myofascial release was administered to the trigger point regions noted above. Therapeutic activities and Neuromuscular Re-education were performed by patient as listed, Treatment goal is to return 75% of normal ROM and pain-free status. Approximate treatment time is 2 weeks. ex ROM: Active and Passive 3 sets - 15 Reps PNF Resistant/Stretching Extension/Flexion 5 Reps, 5 Sec holds R/L Rotation 5 Reps, 5 Sec holds V";'" ""<' ",,_ 'I' ~" c_ c_,_ -1-- ~.,. '-'1"-" - ,", - ." '0'-'''-''_, . iJ ;1 " :1 }i i Ii j1 :1 "I "' ',j " 1"1 ':;~~'~l~ .._.." DAILY NOTES Kathy Delgrande (ID# 000006482) August 17, 2000 Examined by: Bradley A. Jahn, D.C. ( SUBJECTIVE During this visit, Ms, Delgrande described the following symptoms she has been experiencing: neck pain and stiffness. Kathy says the intensity of the neck symptoms is mild to moderate. _ Bilateral upper back pain and stiffness which is mild to moderate in intensity. The upper back symptoms are best described as a dull ache and a throbbing sensation, Kathy indicated the last treatment reduced the upper back discomfort. - Bilateral lower back pain, stiffness, numbness, and weakness which is occurring on a frequent basis and is moderate to severe in intensity. A throbbing sensation, sharp or jabbing sensation, and tingly or prickly sensation is how Kathy best described her discomfort. Since her last treatment, Kathy says her lower back problems have been temporarily reduced. ( OBJECTIVE) A moderate muscle spasm in the left upper cervical, left lower cervical, left upper thoracic, and bilateral upper lumbar regions was detected. The bilateral lower lumbar regions revealed a severe muscle spasm. Palpation indicated the left lower lumbar region are edematous. Muscular trigger points were found in the bilateral upper cervical, bilateral lower cervical, bilateral upper thoracic, bilateral upper lumbar, and bilateral lower lumbar regions. During palpation, the bilateral upper cervical, left upper thoracic, bilateral upper lumbar, and bilateral lower lumbar regions revealed tenderness. Palpation on the cervical and lumbar spine indicated abnormal position and/or motion of the structures. ASSESSMENT ) Kathy's condition is improving. PLAN ) Kathy has been advised that she should be resting at home. ( TREATMENT) The following treatment was given to Kathy today: Manual mobilization to the cervical and lumbar spine was provided to improve joint function and restore normal joint position. Moist heat was used on the bilateral upper cervical, bilateral lower cervical, left upper thoracic, bilateral lumbar, and bilateral sacroiliac/hip regions. Electrical myostimulation therapy was used to treat the bilateral upper cervical, bilateral lower cervical, bilateral upper thoracic, bilateral lumbar, bilateral sacroiliac/hip, and left shoulder regions. ..,.o(,..~_", .,...~'"n_ _. _~, ., R/L Lateral Flexion 5 Reps, 5 See holds Lx ROM: Active and Passive 3 sets - 15 Reps PNF Resistant/Stretching Extension/Flexion 5 Reps, 5 See holds R/L Rotation 5 Reps, 5 See holds R/L Lateral Flexion 5 Reps, 5 See holds Appropriate preparatory physiotherapy was provided as listed above enabling the patient to achieve maximum benefit from Exercise Rehabilitation. SWISS BALL EXERCISE - PELVIC CIRCLE - 2-3 minutes FIGURE 8 - 2 minutes SIDE BEND - 10-15 reps (Arms Up and Stretch) GROIN STRETCH - 5 each leg (Leg Out and Stretch) ABS STRETCH - 5 reps - 3 second hold (Extend body back on ball) ROTATE UPPER TORSO - 15-20 reps (Extend arms and straight in front and roll torso) ROTATE LOWER TORSO - 15-20 reps (Legs on ball rotate side to side) SQUAT - PUSH - PRESS - 10-15 reps (Pick ball up from floor and push towards the sky keeping good posture) STAND AND ROTATE UPPER TORSO - 10-15 reps (Stand and hold baIlout in front, rotate, change ball position) EXERCISES: 3 SETS PELVIC TILT- 5-10 reps w/ 10 second hold Rest 10-20 seconds/repeat, Push back on floor. SUPINE 2-LEGGED BRIDGE- 10-15 reps w/ 3 second holds, Calves on ball, lift buns in air, squeeze glutes. SUPINE LEG EXTENSION - 10-15 reps, Calves on ball, lift buns in air, roll ball towards glutes, BENT LEG HIP EXTENSION - 10 reps each leg. Ball under chest/stomach, lift leg up, point toes, squeeze glutes, keep good posture, SEATED POSITION TRAINER - 10 reps each leg w/ 3 second holds. Pick up leg w/ knee bent, hold, keep chest high, keep good posture, SUPINE HIP EXTENSION - 10 reps, Neck and upper back on ball, drop pelvis straight down and up again. OBLIQUE CRUNCH - 1 to max. Arms straight down, shoulders and neck on ball, lift torso to left and right, squeezing abs. ABDOMINAL CRUNCH - 1 to max. Arms straight down, shoulders and neck on ball, lift toward ceiling, squeezing abs. ~'1!11i)~\!!~~>ry" _~~ . . - <"'~."_,,,,;',,; : _',"'_0,' , , I -'.." ,-;,~~ -,-:< ,-~ ,"__0," ,..,,~,- i -I ", :'-j 'I '-I .'{ I I , (! , J:'!1I ,or ~ T _" " DAILY NOTES Kathy Delgrande (ID# 000006482) August 16, 2000 Examined by: Bradley A. Jahn, D.C. ( SUBJECTIVE) During this visit Ms. Delgrande indicated she has had the following symptoms: - Bilateral neck pain and stiffness. The symptoms occur on a frequent basis. The intensity of the neck symptoms is moderate. The pain is described as a throbbing sensation. Since the last treatment, Kathy indicates her neck pain and stiffness has remained the same. - Bilateral upper back pain and stiffness, The symptoms occur on a frequent basis, Kathy describes her upper back discomfort as moderate in intensity, The pain is best described as a dull ache and a throbbing sensation. Kathy states that the last treatment had little effect on the upper back pain and stiffness. - Bilateral lower back pain, stiffness, numbness, and weakness. The symptoms occur constantly. The lower back discomfort is severe in intensity. The pain is described as a throbbing sensation, a sharp or jabbing sensation, and a tingly or prickly sensation radiating into the lower extremity. Kathy indicates that her lower back problems have worsened. During her last visit, Kathy rated her primary pain as a 6. ( OBJECTIVE) During palpation, a mild muscle spasm was apparent in the right upper cervical region, A moderate muscle spasm was detected in the left upper cervical, bilateral lower cervical, and right upper thoracic regions. The right upper lumbar and bilateral lower lumbar regions were in a state of a severe muscle spasm. During palpation, the bilateral upper lumbar and bilateral lower lumbar regions were determined to be edematous. Muscular trigger points were found in the right lower cervical, bilateral upper lumbar, and bilateral lower lumbar regions. The patient expressed tenderness during palpation of the bilateral lower cervical and left lower lumbar regions. Straight Leg Raise evaluation: SLR on the right reproduced lower back and radiating lower leg pain. The right SLR was stopped at 30 degrees, SLR on the left reproduced lower back pain, The left SLR was stopped at 45 degrees. A significantly decreased lumbar range of motion was evident during the flexion, extension, right rotation, right lateral flexion, and left lateral flexion. Ms. Delgrande indicated she experienced pain during the lumbar left rotation, right lateral flexion, and left lateral flexion, Palpation indicated abnormal position and/or motion of the osseous structures in the cervical and lumbar spine. Palpation indicated that the following osseous structures were in an abnormal position and/or moved in an aberrant fashion: right sacroiliac. Cervical compression test was positive bilaterally. Ely's test was positive bilaterally. Kemp's test was positive bilaterally. Lindner's test was positive with LBP. Minor's sign was positive bilaterally. Sitting Becterew's was positive bilaterally. Soto-Hall test was positive bilaterally. Shoulder Depression Test was positive bilaterally. ( ASSESSMENT ) has worsened. Ms. Delgrande has suffered an exacerbation, Kathy's condition pt had death in the family and had been in the car for a long ride which caused an exacerbation in her condition. ( PLAN ) Ms. Delgrande has been instructed to rest at home. ";'. - ~ ,.,.,," ",' ," '.: ,1-- '[-'_1'-', "." ,-- -,~. < <, . ( TREATMENT) The following treatment was provided to Ms. Delgrande today: Moist heat was applied to the right lumbar and bilateral sacroiliac/hip regions. Electrical myostimulation therapy was administered to the bilateral lumbar and bilateral sacroiliac/hip regions,. Myofascial release was applied to the areas containing trigger points noted in the objective section above. Supplements were provided to the patient. The cervical and lumbar spine were mobilized by manual means to improve joint function and restore normal joint position. ;r :'~~1TL.;"_.,,,. "'"",_"_'_':;:;' _:_'~_' - "'~: _,; ,~__' ,1-,.-- ':-<'-~L"" 0 /~,~ _',"'_ ~. ~" . .. DAILY NOTES Kathy Delgrande (ID# 000006482) August 8, 2000 Examined by: Bradley A. Jahn, D.C. :',: f r- ( SUBJECTIVE) During this visit Ms. Delgrande indicated she has had the following sYThptoms: - Bilateral neck pain and stiffness. The symptoms occur on a frequent basis. The intensity of the neck symptoms is moderate. The pain is described as a dull ache and a throbbing sensation. Since the last treatment, Kathy indicates her neck pain and stiffness has been reduced. - Bilateral upper back pain and stiffness. The symptoms occur on a frequent basis. Kathy describes her upper back discomfort as moderate in intensity. The pain is best described as a dull ache and a throbbing sensation. - Bilateral lower back pain, stiffness, numbness, and weakness. The symptoms occur on a frequent basis. The lower back discomfort is moderate in intensity. The pain is described as a throbbing sensation, a sharp or jabbing sensation, and a tingly or prickly sensation radiating into the lower extremity. Since the last treatment, Kathy indicates her lower back pain, stiffness, numbness, and weakness has remained the same. - Bilateral. The symptoms occur on a frequent basis. The pain is best described as a tingly or prickly sensation. [ Ii, Ii: pt just got back from vacation. She continues to complain about LBP with leg numbness and neck pain. Pain worsens with sitting, lifting, bending, and twisting. On a scale from 1 to 10, with 1 being no pain and 10 being the most severe, Ms. Delgrande rated her overall primary pain to be a 6. ( OBJECTIVE) During palpation, a mild muscle spasm was apparent in the right upper cervical region. A moderate muscle spasm was detected in the left upper cervical, bilateral lower cervical, and bilateral upper lumbar regions, The bilateral lower lumbar regions were in a state of a severe muscle spasm. During palpation, the left lower lumbar region was determined to be edematous. Muscular trigger points were found in the left upper cervical, bilateral lower cervical, bilateral upper lumbar, and bilateral lower lumbar regions. The patient expressed tenderness during palpation of the bilateral upper cervical, bilateral lower cervical, bilateral upper lumbar, and bilateral lower lumbar regions. Straight Leg Raise evaluation: SLR on the right reproduced lower back and radiating lower leg pain. The right SLR was stopped at 45 degrees. SLR on the left reproduced lower back pain, The left SLR was stopped at 45 degrees, Palpation indicated abnormal position and/or motion of the osseous structures in the lumbar spine. Cervical compression test was positive bilaterally. Kemp's test was positive bilaterally. Ely's test was positive right. Lindner's test was positive with Cx pain. Minor's sign was negative. Lindner's test was positive with LBP. Sitting Becterew's test was positive right. Sato-Rall test was negative. ASSESSMENT ) Kathy's condition remains essentially unchanged. PLAN ) Ms. Delgrande has been instructed to rest at home. pt states that she feels better resting. Start rehab next week to strengthen and stabalize her condition. ;~'H,_, ~-. . -!-- ~-,]-- - "~ -~ .^::~ -I"" ","1--' ""'1'" ( TREATMENT) The following treatment was provided to Ms. Delgrande today: Moist heat was applied to the bilateral upper cervical, bilateral lower cervical, bilateral lumbar, and bilateral sacroiliac/hip regions. Myofascial release was applied to the areas containing trigger points noted in the objective section above. Supplements were provided to the patient, Manual traction was applied to the lumbar region. ","'...,~"~ ,-~ '~"_~'~_":IJJ_,-, 'f .~- ,,'-'. ----.","',' ",~ -, -"(,~, " " DAILY NOTES Kathy Delgrande (ID# 000006482) July 26, 2000 Examined by: Bradley A. Jahn, D.C. ( SUBJECTIVE) During this visit Ms. Delgrande indicated she has had the following symptoms: - Bilateral neck pain, stiffness, numbness, and weakness. The symptoms occur on a frequent basis. The intensity of the neck symptoms is moderate to severe. The pain is described as a throbbing sensation, a sharp or jabbing sensation, and a tingly or prickly sensation. - Bilateral upper back pain and stiffness. The symptoms occur intermittently. Kathy describes her upper back discomfort as mild to moderate in intensity. The pain is best described as a dull ache and a throbbing sensation. - Bilateral middle back stiffness, The intensity is described as mild to moderate. The irritation is characterized as a dull ache and a throbbing sensation. - Bilateral lower back pain, stiffness! numbness, and weakness. The symptoms occur on a frequent basis. The pain is described as a throbbing sensation, a sharp or jabbing sensation, and a tingly or prickly sensation radiating into the lower extremity. ( OBJECTIVE) During palpation, a mild muscle spasm was apparent in the bilateral upper thoracic and bilateral lower thoracic regions. A moderate muscle spasm was detected in the bilateral upper cervical, bilateral lower cervical, and bilateral upper lumbar regions. The bilateral lower lumbar regions were in a state of a severe muscle spasm. During palpation, the bilateral lower lumbar regions were determined to be edematous. Muscular trigger points were found in the left upper cervical, bilateral lower cervical, bilateral upper lumbar, and bilateral lower lumbar regions. The patient expressed tenderness during palpation of the left upper cervical, left lower cervical, left upper thoracic, bilateral lower thoracic, bilateral upper lu~ar, and bilateral lower lumbar regions. Palpation indicated abnormal position and/or motion of the osseous structures in the cervical, thoracic, and lumbar spine. ASSESSMENT Kathy's condition remains essentially unchanged. (PLAN ) Ms. Delgrande has been instructed to rest at home. ( TREATMENT) The following treatment was provided to Ms. Delgrande today: Moist heat was applied to the bilateral upper cervical, bilateral lower cervical, bilateral upper thoracic, bilateral lumbar, and bilateral sacroiliac/hip regions. Cryotherapy was administered to the right upper thoracic region. Electrical myostimulation therapy was administered to the bilateral upper cervical, bilateral lower cervical, bilateral upper thoracic, bilateral lumbar, and bilateral sacroiliac/hip regions. Myofascial release was applied to the areas containing trigger points noted in the objective section above. Mechanical traction was applied to the cervical region, the thoracic region, and the lumbar region. The cervical, thoracic, and lumbar spine were mobilized by manual means to improve joint function and restore normal joint position. . ,-, co ,'"_'''''~'__;'' _, ,__ .' I II I II ! l I, l~ Ii 1',1 , r i' i" I r r~ 1:0 i\ [ I ii. i: I, I, !;! 'I i:: 1--; I,' I' I !.- i-"~!1i",",,, . . DAILY NOTES Kathy Delgrande (10# 000006482) July 21, 2000 Examined by: Bradley A. Jahn, D.C. ( SUBJECTIVE During this visit, Ms. Delgrande described the following symptoms she has been experiencing: - Bilateral neck pain, stiffness, numbness, and weakness. Kathy says the intensity of the neck symptoms is moderate. Generally, Kathy's discomfort feels like a throbbing sensation and a sharp or jabbing sensation. _ Bilateral upper back pain and stiffness which is moderate in intensity and is occurring on a frequent basis. The upper back symptoms are best described as a throbbing sensation and a sharp or jabbing sensation. Kathy indicated the last treatment temporarily reduced the upper back discomfort. - Bilateral middle back pain and stiffness which is moderate in intensity. Kathy characterized the discomfort as a throbbing sensation. After the last treatment, her middle back discomfort was temporarily reduced. - Bilateral lower back pain, stiffness, numbness, and weakness which is occurring as long as the area is being stressed and is moderate in intensity. A throbbing sensation and sharp or jabbing sensation is how Kathy best described her discomfort. Since her last treatment, Kathy says her lower back problems have been temporarily reduced. ( OBJECTIVE) The left lower thoracic region experienced a mild muscle spasm during palpation. A moderate muscle spasm in the bilateral upper cervical, bilateral lower cervical, bilateral upper thoracic, and bilateral upper lumbar regions was detected~ The bilateral lower lumbar and right trapezius regions revealed a severe muscle spasm. Palpation indicated the bilateral lower lumbar regions are edematous. Muscular trigger points were found in the bilateral upper cervical, bilateral lower cervical, bilateral upper thoracic, bilateral upper lumbar, and bilateral lower lumbar regions. During palpation, the left upper cervical, bilateral lower cervical, bilateral upper thoracic, bilateral lower thoracic, bilateral upper lumbar, and bilateral lower lumbar regions revealed tenderness. Palpation on the cervical, thoracic, and lumbar spine indicated abnormal position and/or motion of the structures. ASSESSMENT ) Kathy's condition remains essentially unchanged. PLAN ) Kathy has been advised that she should be resting at home, Reviewed MRI with pt. 1 -<~I", _~- .,," . DAILY NOTES Kathy Delgrande (ID# 000006482) July 20, 2000 Examined by: Bradley A. Jahn, D.C. ( SUBJECTIVE At today's visit, the following symptoms were identified by Ms. Delgrande: - Bilateral ~eck pain, stiffness, and numbness. The neck discomfort is moderate. K~thy experiences the symptoms on a frequent basis. The pain is represented as a throbbing sensation and a sharp or jabbing sensation. According to Kathy, her symptoms have not changed since the last treatment. - Bilateral upper back pain and stiffness. The intensity of the symptoms is moderate. The symptoms are experienced frequently. The discomfort is identified as a dull ache and a sharp or jabbing sensation. Since the last treatment, Kathy indicated that the symptoms have remained about the same. - Bilateral middle back pain and stiffness. The intensity is moderate. The symptoms appear on a frequent basis. The pain is described as a dull aching feeling, Kathy indicated that the last treatment had little effect on the symptoms. - Bilateral lower back pain, stiffness, numbness, and weakness. The intensity of the discomfort is moderate to severe. The symptoms have been appearing on a constant basis. The pain is represented as a throbbing sensation, a sharp or jabbing sensation, and a tingly or prickly sensation. According to Kathy, the last treatment had little effect on her lower back pain, stiffness, numbness, and weakness. The hip discomfort is rated as moderate to severe in intensity. ( OBJECTIVE) A muscle spasm of mild intensity was revealed in the bilateral lower thoracic and right upper lumbar regions. The bilateral upper cervical, bilateral lower cervical, bilateral upper thoracic, and left upper lumbar regions were in a state of moderate muscle spasm. A severe muscle spasm was detected in the bilateral lower lumbar regions. Edema was noted in the bilateral lower lumbar regions. During palpation, the bilateral upper cervical, bilateral lower cervical, bilateral upper thoracic, left upper lumbar, and bilateral lower lumbar regions revealed muscular trigger points, The bilateral lower cervical, left upper thoracic, bilateral lower thoracic, bilateral upper lumbar, and bilateral lower lumbar regions were notably tender during examination today. During palpation, abnormal position and/or motion of the osseous structures was noted in the cervical, thoracic, and lumbar spine. ASSESSMENT ) Kathy's condition remains about the same. PLAN ) Kathy has been instructed to rest at home. ( TREATMENT) Today's treatment consisted of the following: Moist heat Was directed at the bilateral upper cervical, bilateral lower cervical, left upper thoracic, bilateral lumbar, and bilateral sacroiliac/hip regions. Electrical myostimulation therapy was applied to the bilateral upper cervical, bilateral lower cervical, bilateral upper thoracic, bilateral lumbar, and bilateral sacroiliac/hip regions. The bilateral lumbar and bilateral sacroiliac/hip regions received a soft tissue massage. ,''''_Wr;l. . "-"c>C~ ,.,. _;"^,,,<c' . ~. '~I . "1-';,-. ~-'- . , '''-<" '. ~-- " DAILY NOTES Kathy Delgrande (ID# 000006482) July 19, 2000 I SUBJECTIVE) The following symptoms were identified by Ms. Delgrande today: _ Bilateral neck stiffness', numbness, and weakness which is moderate to severe in intensity and is occurring on a frequent basis. Kathy describes her discomfort as a throbbing sensation and a sharp or jabbing sensation. Since Kathyrs last treatment, she indicates her neck problem has been temporarily reduced. - Bilateral upper back stiffness and weakness occurring intermittently. Kathy describes her upper back discomfort as moderate to severe in intensity. A dull ache and throbbing sensation best describes Kathy's discomfort, Kathy felt that her last treatment temporarily reduced the upper back discomfort. - Bilateral middle back pain and stiffness which is mild to moderate in intensity. Kathy states that she has felt the symptoms on an intermittent basis. She describes the, irritation as a dull ache and a throbbing sensation. The last treatment reduced Kathy's discomfort. - Bilateral lower back pain, stiffness, numbness, and weakness which is ~oderate to severe in intensity. The symptoms occur constantly. Kathy describes her discomfort as a throbbing sensation, a sharp or jabbing sensation, and a tingly or prickly sensation radiating into the lower extremity. Since the last treatment, Kathy indicates her lower back problem has remained the same. Kathy indicates these symptoms radiate into the lower extremity. Since the last treatment, the hip symptoms have remained about the same. Pt has neck and low back pain and stiffness. She continues to experience frequent exacerbations of her symptons. (OBJECTIVE) During palpation, a mild muscle spasm in the left upper thoracic and bilateral lower thoracic regions was apparent, The bilateral upper cervical, bilateral lower cervical, right upper thoracic, and bilateral upper lumbar regions revealed a moderate muscle spasm. A severe state of muscle spasm was found in the bilateral lower lumbar regions. Palpation revealed edema in the bilateral lower lumbar regions. Muscular trigger points were found in the bilateral upper cervical, bilateral lower cervical, right upper lumbar, and bilateral lower lumbar regions. The right upper cervical, right lower cervical, bilateral upper thoracic, bilateral lower thoracic, bilateral upper lumbar, and bilateral lower lumbar regions were tender with palpation today. Straight Leg Raise results: SLR on the right reproduced lower back and radiating lower leg pain, The right SLR was stopped at 60 degrees, SLR on the left reproduced lower back pain. The left SLR was stopped at 60 degrees. A moderate decrease in the cervical range of motion for flexion, extension, right lateral flexion, and left lateral flexion was evident. During cervical range of motion for flexion, extension, right rotation, left rotation, right lateral flexion, and left lateral flexion Ms. Delgrande indicated that she experienced pain. A moderate decrease during flexion, extension, right rotation, left rotation, right lateral flexion, and left lateral flexion was found during lumbar range of motion. Lumbar left rotation, right lateral flexion, and left lateral flexion caused Kathy to experience pain. The cervical and lumbar spine osseous structures were found to be in abnormal position and/or motion during palpation. Palpation revealed that the following osseous structures moved in an aberrant fashion and/or were in an abnormal position: right sacroiliac. Ely's test was positive right. Cervical compression test was positive bilaterally, Kemp's test was positive bilaterally. Lindner's test was positive with ex. Minor's sign was positive bilaterally. Sitting Becterew's was positive n~". 'I' - ".'. - -",,-. _0'" --~. .' bilaterally. Soto-Hall test was positive bilaterally. Due to slow progress patient is scheduled fDr ex and Ix MRI on Friday July 21,00. ( PLAN ) Kathy has been advised to rest at home. We discussed patients activities of daily living and went over proper lifting and sleeping habits as well as stretching and at home exercises. I will determine future care based upon patients MRI results on Friday. ( TREATMENT) The follDwing treatment was provided to Ms. Delgrande today: Moist heat was applied to the bilateral upper cervicalt bilateral lower cervical, right lumbar, and bilateral sacroiliac/hip regions. Electrical myostimulation therapy was applied to the bilateral upper cervical, bilateral lower cervical, bilateral lumbar, and bilateral sacroiliac/hip regions. To the areas containing trigger points noted in the objective section above, myofascial release was applied, The patient was given supplements and instructed on dosage. Mechanical traction was applied to the cervical region, the thoracic region, the lumbar region, and the full spine. The cervical and lumbar spine were mobilized by manual means. Went over activites of daily living. '>'~~!>l'lll " ,. DAILY NOTES Kathy Delgrande (ID# 000006482) July 18, 2000 Examined by: Bradley A. Jahn, D.C. ( SUBJECTIVE) During this visit Ms. Delgrande indicated she has had the following symptoms: - Bilateral neck numbness and weakness. The symptoms occur with movement. The intensity of the neck symptoms is moderate to severe. The pain is described as a throbbing sensation, a sharp or jabbing sensation, and a tingly or prickly sensation. Since the last treatment, Kathy indicates her neck numbness and weakness has remained the same. - Bilateral upper back stiffness. The symptoms occur on a frequent basis. Kathy describes her upper back discomfort as moderate in intensity. The pain is best described as a throbbing sensation and a sharp or jabbing sensation. Kathy states that the last treatment temporarily reduced the upper back stiffness, - Bilateral middle back pain and stiffness. The symptoms occur on a frequent basis. The intensity is described as moderate. The irritation is characterized as a throbbing sensation and a sharp or jabbing sensation. Kathy states that the last treatment temporarily reduced the middle back pain and stiffness. - Bilateral lower back pain, stiffness, numbness, and weakness. The symptoms occur as long as the area is being stressed. The lower back discomfort is moderate to severe in intensity. The pain is described as a throbbing sensation, a sharp or jabbing sensation, and a tingly or prickly sensation. Since the last treatment, Kathy indicates her lower back pain, stiffness, numbness, and weakness has remained the same. ( OBJECTIVE) During palpation, a mild muscle spasm was apparent in the left upper thoracic, right lower thoracic, and right upper lumbar regions. A moderate muscle spasm was detected in the bilateral upper cervical, left lower cervical, right upper thoracic, left lower thoracic, and left upper lumbar regions. The bilateral lower lumbar regions were in a state of a severe muscle spasm. During palpation, the left lower lumbar region was determined to be edematous. Muscular trigger points were found in the left lower cervical, right upper thoracic, left lower thoracic, left upper lumbar, and bilateral lower lumbar regions. The patient expressed tenderness during palpation of the right lower cervical, right upper thoracic, bilateral lower thoracic, bilateral upper lumbar, and bilateral lower lumbar regions. Palpation indicated abnormal position and/or motion of the osseo~s structures in the cervical and lumbar spine. ASSESSMENT Kathy's condition remains essentially unchanged. PLAN ) Ms. Delgrande has been instructed to rest at home. ( TREATMENT) The following treatment was provided to Ms. Delgrande today: Moist heat was applied to the bi12teral upper cervical, bilateral lower cervical, bilateral upper thoracic, bilateral lower thoracic, bilateral lumbar, and bilateral sacroiliac/hip regions. Mechanical traction was applied to the cervical region, the thoracic region, the lumbar region, and the full spine. The cervical and lumbar spine were mobilized by manual means to improve joint function and restore normal joint position. >'~~;;1 .,...-:- ,,,,. _"-".<._, . -I, ,.-" -'.I'"~' I'.... .' DAILY NOTES Kathy Delgrande (ID# 000006482) July 14, 2000 Examined by: Bradley A. Jahn, D.C. ( SUBJECTIVE The following symptoms were identified by Ms. Delgrande today: neck pain and numbness. Kathy describes her discomfort as a throbbing sensation. Since Kathy's last treatment, she indicates her neck problem has remained the same. upper back numbness occurring on a frequent basis. Kathy describes her upper back discomfort as moderate in intensity. Kathy felt that her last treatment had little effect on the upper back discomfort. -'Bilateral middle back pain, stiffness, and numbness which is moderate in intensity. Kathy states that she has felt the symptoms as long as the area is being stressed. She describes the irritation as a throbbing sensation. The last treatment had little effect on Kathy's discomfort, lower back pain, stiffness, and numbness which is moderate to severe in intensity. The symptoms occur constantly. Kathy describes her discomfort as a throbbing sensation, a sharp or jabbing sensation, and a tingly or prickly sensation radiating into the lower extremity, Since the last treatment, Kathy indicates her lower back problem has remained the same. ( OBJECTIVE) The bilateral upper cervical, left lower cervical, and left ~pper thoracic regions revealed a moderate muscle spasm. A severe state of muscle spasm was found in the right upper thoracic, left upper lumbar, and bilateral lower lumbar regions. Palpation revealed edema in the bilateral upper lumbar and bilateral lower lumbar regions. Muscular trigger points were found in the bilateral lower cervical, bilateral upper thoracic, bilateral upper lumbar, and bilateral lower lumbar regions. The left lower cervical, bilateral upper thoracic, and bilateral lower lumbar regions were tender with palpation today. The cervical, thoracic, and lumbar spine osseous structures were found to be in abnormal position and/or motion during palpation. ASSESSMENT ) Kathy's condition remains essentially unchanged. ( PLAN) The current plan for this patient has not changed, Kathy has been advised to rest at home. ( TREATMENT) The following treatment was provided to Ms. Delgrande today: Moist heat was applied to the bilateral upper cervical, bilateral lower cervical, bilateral upper thoracic, bilateral lower thoracic, bilateral lumbar, bilateral sacroiliac/hip, and right shoulder regions. Electrical myostimulation therapy was applied to the bilateral upper cervical, bilateral lower cervical, bilateral upper thoracic, bilateral lower thoracic, bilateral lumbar, and bilateral sacroiliac/hip regions, Mechanical traction was applied to the cervical region, the thoracic region, the lumbar region, and the full spine. The cervical, thoracic, and lumbar spine were mobilized by manual means. '~,- - - 'C. " ~~' r_,_ >~~"':::-"" ,T_," 'l' "._'"". ,'~~' ---"~'I .,-, ., '>- r ,-;;' ',' ,. DAILY NOTES Kathy Delgrande (ID# 000006482) July 13, 2000 Examined by: Bradley A. Jahn, D.C. ( SUBJECTIVE) During this visit, Ms. Delgrande described the following symptoms she has been experiencing: - Bilateral neck pain and stiffness occurring on a frequent basis. Kathy says the intensity of the neck symptoms is moderate. Generally, Kathy's discomfort feels like a throbbing sensation. - Bilateral upper back pain, stiffness, and numbness which is moderate in intensity and is occurring on a frequent basis. The upper back symptoms are best described as a throbbing sensation. - Bilateral middle back pain, stiffness, and numbness which is moderate in intensity. The symptoms occur as long as the area is being stressed. Kathy characterized the discomfort as a throbbing sensation and a sharp or jabbing sensation. After the last treatment, her middle back discomfort was not improved. - Bil~teral lower back pain, stiffness, numbness, and weakness which is occur~ing constantly and is moderate to severe in intensity. A throbbing sensation, sharp or jabbing sensation, and tingly or prickly sensation is how Kathy best described her discomfort. The symptoms radiate into the lower extremity. Since her last treatment, Kathy says her lower back problems have remained the same. The intensity of Kathy's hip symptoms is moderate to severe. ( OBJECTIVE) A moderate muscle spasm in the bilateral upper cervical, left lower cervical, left upper thoracic, and left upper lumbar regions was detected. The right lower cervical, right upper thoracic, right upper lumbar, and bilateral lower lumbar regions revealed a severe muscle spasm. Palpation indicated the right upper lumbar and bilateral lower lumbar regions are edematous. Muscular trigger points were found in the right upper cervical, bilateral lower cervical, bilateral upper thoracic, bilateral upper lumbar, bilateral lower lumbar, and left trapezius regions. During palpation, the bilateral upper cervical, bilateral lower cervical, bilateral upper thoracic, bilateral upper lumbar, and bilateral lower lumbar regions revealed tenderness. Palpation on the cervical, thoracic, and lumbar spine indicated abnormal position and/or motion of the structures. ASSESSMENT ) Kathy's condition remains essentially unchanged. PLAN ) Kathy has been advised that she should be resting at home, ( TREATMENT) The following treatment was given to Kathy today: Manual mobilization to the thoracic and lumbar spine was provided to improve joint function and restore normal joint position. Moist heat was used on the left upper cervical, bilateral lower cervical, bilateral upper thoracic, bilateral lower thoracic, bilateral lumbar, and bilateral sacroiliac/hip regions. Electrical myostimulation therapy was used to treat the left upper cervical, bilateral lower cervical, bilateral upper thoracic, bilateral lower thoracic, bilateral lumbar, and bilateral sacroiliac/hip regions. Mechanical traction was used on the cervical region, the thoracic region, the lumbar region, and the full spine. ~r" .. '~-, ,-. "', , .' DAILY NOTES Kathy Delgrande (ID# 000006482) July 12, 2000 Examined by: Bradley A. Jahn, D.C. ( SUBJECTIVE At today's visit, the following symptoms were identified by Ms, DelglCande: - Bilateral neck pain, stiffness! and numbness. The neck discomfort is mode~ate. Kathy experiences the symptoms on a frequent basis. The pain is repr~sented as a throbbing sensation. - Bilateral upper back pain, stiffness, and numbness. The intensity of the symptoms is moderate. The symptoms are experienced frequently. The discomfort is identified as a throbbing sensation. - Bilateral middle back pain, stiffness, and numbness. The intensity is mode~ate. The symptoms appear with function. The pain is described as a throbbing sensation and a sharp or jabbing sensation, Kathy indicated that the last treatment had little effect on the symptoms. - Bilateral lower back pain, stiffness, numbness, and weakness. The intensity of the discomfort is moderate to severe. The symptoms have been appearing on a q::mstant basis. The pain "is represented as a throbbing sensation, a sharp or jabbing sensation, and a tingly or prickly sensation radiating into the lower extremity. According to Kathy, the last treatment had little effect on her lower back pain, stiffness, numbness, and weakness. The hip discomfort is rated as moderate to severe in intensity. ( OBJECTIVE) The bilateral upper cervical, left lower cervical, left upper thoracic, and left upper lumbar regions were in a state of moderate muscle spasm. A severe muscle spasm was detected in the right lower cervical, right upper thoracic, right upper lumbar, and bilateral lower lumbar regions. Edema was noted in the right upper lumbar and bilateral lower lumbar regions. During palpation, the right upper cervical, bilateral lower cervical, bilateral upper thoracic, bilateral upper lumbar, bilateral lower lumbar, and left trapezius regions revealed muscular trigger points. The bilateral upper cervical, bilateral lower cervical, bilateral upper thoracic, bilateral upper lumbar, and bilateral lower lumbar regions were notably tender during examination today. During palpation, abnormal position and/or motion of the osseous structures was noted in the cervical, thoracic, and lumbar spine. ASSESSMENT Kathy's condition remains about the same. PLAN ) Kathy has been instructed to rest at home. ( TREATMENT) Today's treatment consisted of the following: The thoracic and lumbar spine were mobilized by manual means. Moist heat was directed at the left upper cervical, bilateral lower cervical, bilateral upper thoracic, bilateral lower thoracic, bilateral lumbar, and bilateral sacroiliac/hip regions. Electrical myostimulation therapy was applied to the left upper cervical, bilateral lower cervical, bilateral upper thoracic, bilateral lower thoracic, bilateral lumbar, and bilateral sacroiliac/hip regions. The cervical region, thoracic region, lumbar region, and full spine received mechanical traction during today's visit. ,:!.~ '."<-- -'-'''"1-' "-,,'-i %, '~ - " . ' " DAILY NOTES Kathy Delgrande (ID# 000006482) July 6, 2000 Examined by: Bradley A. Jahn, D.C. ( SUBJECTIVE The following symptoms were identified by Ms. Delgrande today: _ Bilateral neck pain and stiffness which is moderate in intensity and is occurring on a frequent basis. Kathy describes her discomfort as a throbbing sensation. Since Kathy's last treatment, she indicates her neck problem has remained the same. - Bilateral upper back pain and stiffness occurring on a frequent basis. Kathy describes her upper back discomfort as moderate in intensity. A throbbing sensation and sharp or jabbing sensation best describes Kathy's discomfort. - Bilateral middle back pain, stiffness, numbness, and weakness which is moderate to severe in intensity, Kathy states that she has felt the symptoms constantly. She describes the irritation as a throbbing sensation, a sharp or jabbing sensation, and a tingly or prickly sensation. The last treatment had little effect on Kathy's discomfort. - Bilateral 'lower back pain, stiffness, numbness, and weakness which is severe in intensity. The symptoms occur constantly. Kathy describes her discomfort as a throbbing sensation, a sharp or jabbing sensation, and a tingly or prickly sensation radiating into the lower extremity. Since the last treatment, Kathy indicates her lower back problem has remained the same. which is occurring constantly. OBJECTIVE) The bilateral upper cervical, left lower cervical, left upper thoracic, bilateral lower thoracic, and bilateral upper lumbar regions revealed a moderate muscle spasm. A severe state of muscle spasm was found in the bilateral lower lumbar regions. Palpation revealed edema in the bilateral lower lumbar regions. Muscular trigger points were found in the left upper cervical, bilateral lower cervical, bilateral upper thoracic, left lower thoracic, bilateral upper lumbar, and bilateral lower lumbar regions. The bilateral upper cervical, bilateral lower cervical, bilateral upper thoracic, bilateral lower thoracic, bilateral upper lumbar, and bilateral lower lumbar regions were tender with palpation today. The cervical, thoracic, and lumbar spine osseous structures were found to be in abnormal position and/or motion during palpation. ASSESSMENT ) Kathy1s condition remains essentially unchanged. PLAN ) Kathy has been advised to rest at home. TREATMENT) The following treatment was provided to Ms, Delgrande today: Moist heat was applied to the bilateral upper cervical, bilateral lower cervical, bilateral upper thoracic, bilateral lower thoracic, bilateral lumbar, and bilateral sacroiliac/hip regions. Electrical myostimulation therapy was applied to the bilateral upper cervical, bilateral lower cervical, bilateral upper thoracic, bilateral lower thoracic, bilateral lumbar, and bilateral sacroiliac/hip regions. To the areas containing trigger points noted in the objective section above, myofascial release was applied. Mechanical traction was applied to the cervical region, the thoracic region, the lumbar region, and the full spine. The cervical, thoracic, and lumbar spine were mobilized by manual means. ~""'" ,~- -,-"-', - '" "-~ '-~-~l - .. ,>~_-'" 1-\"-,.;",='-- - '-" -'~-~ - .-., -~ .' ,. DAIL Y NOTES Kathy Delgrande (ID# 000006482) July 5, 2000 Examined by: Bradley A. Jahn, D.C. ( SUBJECTIVE) During this visit, Ms. Delgrande described the following symptoms she has been experienc~ng: - Bilateral neck pain and stiffness occurring on a frequent basis. Kathy says the intensity of the neck symptoms is moderate. Generally, Kathy's discomfort feels like a throbbing sensation and a sharp or jabbing sensation. Since the last treatment, Kathy said that her neck symptoms have remained the same. - Bilateral which is moderate in intensity and is occurring on a frequent basis. The upper back symptoms are best described as a throbbing sensation and a sharp or jabbing sensation, Kathy indicated the last treatment had little effect on the upper back discomfort. - Bilateral middle back numbness and weakness which is moderate in intensity. The symptoms occur as long as the area is being stressed. Kathy characterized the discomfort as a throbbing sensation and a sharp or jabbing sensation. After the last treatment, her middle back discomfort was not improved. - Bilateral lower back pain, numbness, and weakness which is occurring constantly and is moderate to severe in intensity. A throbbing sensation, sharp or jabbing sensation, and tingly or prickly sensation is how Kathy best described her discomfort. The symptoms radiate into the lower extremity. Since her last treatment, Kathy says her lower back problems have remained the same, ( OBJECTIVE) A moderate muscle spasm in the bilateral upper cervical, left lower cervical, and left upper thoracic regions was detected. The right lower cervicalr right upper thoracic, right upper lumbar, and bilateral lower lumbar regions revealed a severe muscle spasm. Palpation indicated the bilateral upper lumbar and bilateral lower lumbar regions are edematous. Muscular trigger points were found in the bilateral lower cervical, bilateral upper thoracicr right lower thoracic, bilateral upper lumbar, and bilateral lower lumbar regions. During palpation, the right lower cervical, right upper thoracic, and left lower lumbar regions revealed tenderness. Palpation on the cervical, thoracic, and lumbar spine indicated abnormal position and/or motion of the structures. ASSESSMENT Kathy's condition remains essentially unchanged. ( PLAN) The treatment plan for this patient remains the same. Kathy has been advised that she should be resting at home. ( TREATMENT) The following treatment was given to Kathy today: Manual mobilization to the cervical, thoracic, and lumbar spine was provided to improve joint function and restore normal joint position. Moist heat was used on the bilateral upper cervical, bilateral lower cervical, bilateral upper thoracic, bilateral lower thoracic, bilateral lumbar, bilateral sacroiliac/hip, and right shoulder regions. Electrical myostimulation therapy was used to treat the bilateral upper cervical, bilateral lower cervical, bilateral upper thoracic, bilateral lower thoracic, bilateral lumbar, and bilateral sacroiliac/hip regions, Galvanic therapy was applied to the right sacroiliac/hip region. Mechanical traction was used on the cervical region, the thoracic region, the lumbar region, and the full spine. '~_o_'~.,. --ry. "'1" . .' -""'I c." ~_.,-r"" " " ",. ~ .,"'",-, ,'- "' +' .. DAILY NOTES Kathy Delgrande (ID# 000006482) June 29, 2000 Examined by: Bradley A. Jahn, D.C. ( SUBJECTIVE) During this visit Ms. Delgrande indicated she has had the following symptoms: neck pain and stiffness. The intensity of the neck symptoms is moderate. The pain is described as a throbbing sensation and a sharp or jabbing sensation. Since the last treatment, Kathy indicates her neck pain and stiffness has remained the same. - Bilateral upper back pain and stiffness. The symptoms occur on a frequent basis. Kathy describes her upper back discomfort as moderate in intensity. The pain is best described as a throbbing sensation and a sharp or jabbing sensation. Kathy states that the last treatment had little effect on the upper back pain and stiffness. - Bilateral middle back pain, stiffness, numbness, and weakness. The symptoms occur as long as the area is being stressed. The intensity is described as ffi9cterate. The irritation is characterized as a throbbing sensation and a sharp o~ jabbing sensation. Kathy states that the last treatment had little effect on the middle back pain, stiffness, numbness, and weakness. - Bilateral lower back pain, stiffness, numbness, and weakness. The symptoms oCcur constantly. The lower back discomfort is moderate to severe in intensity. The pain is described as a throbbing sensation, a sharp or jabbing sensation, and a tingly or prickly sensation radiating into the lower extremity. Since the last treatment, Kathy indicates her lower back pain, stiffness, numbness, and w~akness has remained the same. r: ( OBJECTIVE) During palpation, a mild muscle spasm was apparent in the left lower thoracic region. A moderate muscle spasm was detected in the bilateral upper cervical, left lower cervical, left upper thoracic, right lower thoracic, and left upper lumbar regions. The right lower cervical, right upper thoracic, right upper lumbar, and bilateral lower lumbar regions were in a state of a s~vere muscle spasm. During palpation, the right upper lumbar and bilateral lower lumbar regions were determined to be edematous. Muscular trigger points were found in the left lower cervical, bilateral upper thoracic, bilateral upper lumbar, and bilateral lower lumbar regions. The patient expressed tenderness during palpation of the right upper cervical, bilateral lower cervical, bilateral upper thoracic, bilateral lower thoracic, bilateral upper lumbar, and bilateral lower lumbar regions. Palpation indicated abnormal position and/or motion of the osseous structures in the cervical, thoracic, and lumbar spine. I:; ,I ('ASSESSMENT) Kathy's condition remains essentially unchanged. ( PLAN) The current plan will remain the same for this patient. Ms. Delgrande has been instructed to rest at home. ( TREATMENT) The following treatment was provided to Ms, Delgrande today: Moist heat was applied to the bilateral upper cervical, bilateral lower cervical, bilateral upper thoracic, bilateral lower thoracic, bilateral lumbar, and bilateral sacroiliac/hip regions, Electrical myostimulation therapy was administered to the bilateral upper cervical, bilateral lower cervical, bilateral upper thoracic, bilateral lower thoracic, bilateral lumbar, and bilateral sacroiliac/hip regions. Mechanical traction was applied to the cervical region, the thoracic region, the lumbar region, and the full spine. The cervical, thoracic, and lumbar spine were mobilized by manual means to improve joint function and restore normal joint position. \i_ DAILY NOTES Kathy Delgrande (ID# 000006482) June 28, 2000 Examined by: Bradley A. Jahn, D.C. ( SUBJECTIVE The following symptoms were identified by Ms. Delgrande today: - Bilateral neck pain and stiffness which is mild to moderate in intensity and is occurring on a frequent basis. Kathy describes her discomfort as a dull ache and a throbbing sensation. Since Kathy's last treatment, she indicates her neck problem has been reduced. -. Bilateral upper back pain and stiffness occurring on a frequent basis. Kathy describes her upper back discomfort as mild to moderate in intensity. A dull ache and throbbing sensation best describes Kathy's discomfort, Kathy felt that her last treatment reduced the upper back discomfort. - Bilateral middle back pain, stiffness, and numbness which is moderate to severe in intensity. Kathy states that she has felt the symptoms as long as the area is being stressed. She describes the irritation as a throbbing sensation and a sharp or jabbing sensation. The last treatment temporarily reduced Kathy's discomfort. - Bilateral lower back pain, stiffness, numbness, and weakness which is moderate to severe in intensity. The symptoms occur constantly. Kathy describes her discomfort as a throbbing sensation, a sharp or jabbing sensation, and a tingly or prickly sensation radiating into the lower extremity. Since the last treatment, Kathy indicates her lower back problem has remained the same. which is occurring constantly. ( OBJECTIVE ) During palpation, a mild muscle spasm in the bilateral upper cervical, left upper thoracic, and bilateral lower thoracic regions was apparent. The bilateral lower cervical, right upper thoracic, and bilateral upper lumbar regions revealed a moderate muscle spasm. A severe state of muscle spasm was found in the bilateral lower lumbar regions. Palpation revealed edema in the bilateral lower lumbar regions. Muscular trigger points were found in the bilateral lower cervical, right upper thoracic, right lower thoracic, bilateral upper lumbar, and bilateral lower lumbar regions. The bilateral upper cervical, bilateral lower cervical, bilateral upper thoracic, bilateral lower thoracic, bilateral upper lumbar, and bilateral lower lumbar regions were tender with palpation today. The cervical and lumbar spine osseous structures were found to be in abnormal position and/or motion during palpation. ASSESSMENT ) Kathy's condition remains essentially unchanged. PLAN) Kathy has been advised to rest at home. ( TREATMENT) The following treatment was provided to Ms, Delgrande today: Moist heat was applied to the bilateral upper cervical, bilateral lower cervical, bilateral lumbar, and bilateral sacroiliac/hip regions. Electrical myostimulation therapy was applied to the bilateral upper cervical, bilateral lower cervical, bilateral lumbar, and bilateral sacroiliac/hip regions. Mechanical traction was applied to the cervical region, the thoracic region, the lumbar region, and the full spine, The cervical and lumbar spine were mobilized by manual means. " i:i f-.'~ , .',_.-e,.uC-5-",'_I"T"'"'. -'I - >1"" ,,--.~,,,, - -'>- " w".. ..-t ',~ . ' DAILY NOTES Kathy Delgrande (10# 000006482) June 27, 2000 Examined by: Bradley A. Jahn, D.C. ( SUBJECTIVE) During this visit, Ms. Delgrande described the following symptoms she has been experiencing: - Bilateral neck pain and stiffness occurring on a frequent basis. the intensity of the neck symptoms is mild to moderate, Generally, discomfort feels like a dull ache and a throbbing sensation, Since treatment, Kathy said that her neck symptoms have been reduced. - Bilateral upper back pain and stiffness which is mild to moderate in intensity and is occurring on a frequent basis. The upper back symptoms are best described as a dull ache and a throbbing sensation. Kathy indicated the last treatment reduced the upper back discomfort, - Bilateral middle back pain, stiffness, numbness, and weakness which is moderate in intensity. The symptoms occur as long as the area is being stressed. Kathy characterized the discomfort as a throbbing sensation and a sharp or jabbing sensation. After the last treatment, her middle back discomfort was temporarily reduced. - Bilateral lower back pain, stiffness, numbness, and weakness which is occurring constantly and is moderate to severe in intensity. A throbbing sensation, sharp or jabbing sensation, and tingly or prickly sensation is how Kathy best described her discomfort. The symptoms radiate into the lower extremity. Since her last treatment, Kathy says her lower back problems have remained the same. hip pain, stiffness, and weakness. Kathy says Kathy's the last ( OBJECTIVE) The bilateral upper cervical, right lower cervical, left upper thoracic, and left lower thoracic regions experienced a mild muscle spasm during palpation. A moderate muscle spasm in the left lower cervical, right upper thoracic, right lower thoracic, and bilateral upper lumbar regions was detected. The bilateral lower lumbar regions revealed a severe muscle spasm. Palpation indicated the right lower lumbar region are edematous. Muscular trigger points were found in the left lower cervical, right upper thoracic, right lower thoracic, bilateral upper lumbar, and bilateral lower lumbar regions. During palpation, the bilateral upper cervical, bilateral lower cervical, bilateral upper thoracic, bilateral upper lumbar, and bilateral lower lumbar regions revealed tenderness. Palpation on the lumbar spine indicated abnormal position and/or motion of the structures. PLAN Kathy has been advised that she should be resting at home. ( TREATMENT) The following treatment was given to Kathy today: Moist heat was used on the bilateral lumbar, bilateral sacroiliac/hip, and left shoulder regions. Electrical myostimulation therapy was used to treat the bilateral lumbar, bilateral sacroiliac/hip, and right shoulder regions. Galvanic therapy was applied to the right lumbar regions. '0"" )\,;;: ',"~:MilJ~_.,~ DAILY NOTES Kathy Delgrande (ID# 000006482) June 23, 2000 Examined by: Bradley A. Jahn, D.C. ( SUBJECTIVE At today's visit, the following symptoms were identified by Ms. Delgrande: - Bilateral neck stiffness. The neck discomfort is moderate. Kathy experiences the symptoms with movement. The pain is represented as a dull achy feeling and a. throbbing sensation. According to Kathy, her symptoms have been temporarily reduced since the last treatment. - Bilateral upper back stiffness. The intensity of the symptoms is moderate. The symptoms are experienced as long as the area is being stressed. The discomfort is identified as a dull ache and a throbbing sensation. Since the last treatment, Kathy indicated that the symptoms have been temporarily reduced. - Bilateral middle back pain, stiffness, numbness, and weakness. The intensity is moderate. The symptoms appear with function. The pain is described as a throbbing sensation, a sharp or jabbing sensation, and a tingly or prickly sensation. Kathy indicated that the last treatment had little effect on the symptoms. - Bilateral lower back pain, stiffness, numbness, and weakness. The intensity of the discomfort is severe. The symptoms have been appearing on a constant basis. The pain is represented as a throbbing sensation, a sharp or jabbing sensation, and a tingly or prickly sensation radiating into the lower extremity. Since the last treatment, Kathy indicates that her lower back problems have worsened. ( OBJECTIVE A muscle spasm of mild intensity was revealed in the bilateral upper cervical, left lower cervical, bilateral upper thoracic, and bilateral lower thoracic regions. The right lower cervical and bilateral upper lumbar regions were. in a state of moderate muscle spasm. A severe muscle spasm was detected in the bilateral lower lumbar regions. Edema was noted in the bilateral lower lumbar regions. During palpation, the right lower cervical, left upper thoracic, left lower thoracic, bilateral upper lumbar, and bilateral lower lumbar regions revealed muscular trigger points, The bilateral upper cervical I bilateral lower cervical, bilateral upper thoracic, bilateral lower thoracic, bilateral upper lumbar, and bilateral lower lumbar regions were notably tender during examination today. During palpation, abnormal position and/or motion of the osseous structures was noted in the cervical, thoracic, and lumbar spine. ASSESSMENT ) Kathy's condition remains about the same. ( PLAN) Kathy will continue on her current plan. Kathy has been instructed to rest at home. ( TREATMENT) Today's treatment consisted of the following: The cervical, thoracic, and lumbar spine were mobilized by manual means. Moist heat was directed at the bilateral upper cervical, bilateral lower cervical, bilateral lumbar, bilateral sacroiliac/hip, and left shoulder regions. Electrical myostimulation therapy was applied to the bilateral upper cervical, bilateral lower cervical, bilateral lumbar, and bilateral sacroiliac/hip regions. The right sacroiliac/hip region received galvanic therapy. To provide stabilization during healing, Ms. Delgrande was fit with an orthopedic support for the bilateral upper cervical, bilateral lower cervical, bilateral lumbar, and bilateral sacroiliac/~ip areas. The cervical region, thoracic region, "'-f.""" '- . "~ "1 '_""~'I -" ,,,"~ -hV, . -"~~' . ~" "'-o/~'.':4_""'__ .' lumbar region, and full spine received mechanical traction during today's visit. Myofascial release was administered to the trigger point regions noted above. __.__0", _", " - """".I.-'"-'f'--,.t, . - I ", ,Y _ .~ i '.'' ", , . ' DAILY NOTES Kathy Delgrande (ID# 000006482) June 21, 2000 Examined by: Bradley A. Jahn, D.C. ( SUEJECTIVE) During this visit Ms. Delgrande indicated she has had the following symptoms: - Bilateral neck stiffness. The intensity of the neck symptoms is moderate. The pain is described as a dull ache. Since the last treatment, Kathy indicates her neck stiffness has remained the same. upp~r back stiffness. The symptoms occur intermittently. Kathy describes her uppe~ back discomfort as moderate in intensity. The pain is best described as a dull ache and a throbbing sensation. - Bilateral middle back pain, stiffness, and numbness. frequent basis. The intensity is described as moderate irritation is characterized as a throbbing sensation, a sens~tion, and a tingly or prickly sensation. - Bilateral lower back pain, stiffness, numbness, and weakness. The occu~ constantly. The lower back discomfort is severe in intensity. is described as a throbbing sensation, a sharp or jabbing sensation, tingly or prickly sensation radiating into the lower extremity. The symptoms occur to severe. The sharp or jabbing on a symptoms The pain and a (OBJECTIVE) During palpation, a mild muscle spasm was apparent in the bilateral upper cervical, left lower cervical, bilateral upper thoracic, and left lower thoracic regions. A moderate muscle spasm was detected in the right lower cervical, right lower thoracic, and bilateral upper lumbar regions. The bilateral lower lumbar regions were in a state of a severe muscle spasm. During palpation, the right upper lumbar and bilateral lower lumbar regions were determined to be edematous. Muscular trigger points were found in the right lower cervical, left upper thoracic, bilateral lower thoracic, bilateral upper lumbar, and bilateral lo~er lumbar regions. The patient expressed tenderness during palpation of the bilateral upper cervical, bilateral lower cervical, bilateral upper thoracic, bilateral lower thoracic, bilateral upper lumbar, and bilateral lower lumbar regions. Palpation indicated abnormal position and/or motion of the osseous structures in the cervical, thoracic, and lumbar spine. Palpation indicated that the following osseous structures were in an abnormal position and/or moved in an aberrant fashion: T8, TIO, and L5. ASSESSMENT ) Kathy's condition remains essentially unchanged. ( PLAN) The current plan will remain the same for this patient. Ms. Delgrande has been instructed to rest at home. ( TREATMENT) The following treatment was provided to Ms. Delgrande today: Moist heat was applied to the bilateral upper cervical, bilateral lower cervical, bilateral upper thoracic, bilateral lower thoracic, bilateral lumbar, and bilateral sacroiliac/hip regions. Interferential therapy was administered to the bilateral upper cervical, bilateral lower cervical, bilateral upper thoracic, bilateral lower thoracic, bilateral lumbar, and left sacroiliac/hip regions. Mechanical traction was applied to the cervical region, the thoracic region, the lumbar region, and the full spine. The cervical, thoracic, and lumbar spine were mobilized by manual means to improve joint function and restore normal joint position. .' !:':;:l;t.,>,_i~ DAILY NOTES Kathy Delgrande (ID# 000006482) June 20, 2000 Examined by: Bradley A. Jahn, D.C. ( SUBJECTIVE The following symptoms were identified by Ms. Delgrande today: - Bilateral neck stiffness which is moderate in intensity and is occurring on an intermittent basis. Kathy describes her discomfort as a throbbing sensation and a sharp or jabbing sensation. - Bilateral upper back stiffness occurring intermittently. Kathy describes her upper back discomfort as moderate in intensity. A throbbing sensation and sharp or jabbing sensation best describes Kathy's discomfort. - Bilateral middle back pain, numbness, and weakness which is moderate to severe in intensity. Kathy states that she has felt the symptoms on a frequent basis. She describes the irritation as a throbbing sensation, a sharp or jabbing sensation, and a tingly or prickly sensation. - Bilateral lower back pain, stiffness, numbness, and weakness which is severe in intensity, The symptoms occur constantly. Kathy describes her discomfort as a throbbing sensation, a sharp or jabbing sensation, and a tingly or prickly sensation radiating into the lower extremity. ( OBJECTIVE) During palpation, a mild muscle spasm in the right upper cervical and bilateral lower thoracic regions was apparent. The left upper cervical, bilateral lower cervical, bilateral upper thoracic, and bilateral upper lumbar regions revealed a moderate muscle spasm. A severe state of muscle spasm was found in the bilateral lower lumbar regions. Palpation revealed edema in the bilateral lower lumbar regions. Muscular trigger points were found in the left upper cervical, bilateral lower cervical, bilateral upper thoracic, bilateral upper lumbar, and bilateral lower lumbar regions, The right upper cervical, bilateral lower cervical, left upper thoracic, bilateral lower thoracic, bilateral upper lumbar, and bilateral lower lumbar regions were tender with palpation today. The cervical, thoracic, and lumbar spine osseous structures were found to be in abnormal position and/or motion during palpation. ASSESSMENT ) Kathy's condition remains essentially unchanged. ( PLAN) The current plan for this patient has not changed, Kathy has been advised to rest at home. ( TREATMENT) The following treatment was provided to Ms. Delgrande today: Moist heat was applied to the bilateral upper cervical, bilateral lower cervical, bilateral upper thoracic, bilateral lower thoracic, bilateral lumbar, and bilateral sacroiliac/hip regions. Electrical myostimulation therapy was applied to the bilateral upper cervical, bilateral lower cervical, bilateral upper thoracic, bilateral lower thoracic, bilateral lumbar, and bilateral sacroiliac/hip regions. Mechanical traction was applied to the cervical region, the thoracic region, the lumbar region, and the full spine. The cervical, thoracic, and lumbar spine were mobilized by manual means. ""._ " ~ _, _ " n, _" _ "'-"".H"" -1-'-' ")"1." "',.'.,-" O'r".' ~ ___.c _ ~'0; , ;-"'_e~;,:);_ .' DAILY NOTES Kathy Delgrande (ID# 000006482) June 16, 2000 Examined by: Bradley A. Jahn, D.C. ( SUBJECTIVE) During this visit Ms, Delgrande indicated she has had the following symptoms: - Bilateral neck stiffness. The symptoms occur on an intermittent basis. The intensity of the neck symptoms is moderate. The pain is described as a dull ache. Since the last treatment, Kathy indicates her neck stiffness has remained the same. - Bilateral upper back stiffness. The symptoms occur intermittently. Kathy describes her upper back discomfort as moderate in intensity. The pain is best described as a dull ache and a throbbing sensation. Kathy states that the last treatment had little effect on the upper back stiffness. - Bilateral middle back pain, stiffness, numbness, and weakness. The symptoms occur on a fr~quent basis. The intensity is described as moderate to severe. The irritation is characterized as a sharp or jabbing sensation and a tingly or prickly sensation. Kathy states that the last treatment had little effect on the middle back pain, stiffness, numbness, and weakness. - Bilateral lower back pain, stiffness, numbness, and weakness. The symptoms occur constantly. The lower back discomfort is severe in intensity. The pain is described as a throbbing sensation, a sharp or jabbing sensation, and a tingly or prickly sensation radiating into the lower extremity. Since the last treatment, Kathy indicates her lower back pain, stiffness, numbness, and weakness has ~emained the same. ( OBJECTIVE) During palpation, a mild muscle spasm was apparent in the bilateral upper cervical, left lower cervical, bilateral upper thoracic, and left lower thQracic regions. A moderate muscle spasm was detected in the right lower cervical, right lower thoracic, and bilateral upper lumbar regions. The bilateral lower lumbar regions were in a state of a severe muscle spasm. During palpation, the bilateral lower lumbar regions were determined to be edematous. Muscular trigger points were found in the right lower cervical, left upper thoracic, bilateral lower thoracic, bilateral upper lumbar, and bilateral lower lumbar regions. The patient expressed tenderness during palpation of the bilateral upper cervical, right lower cervical, right upper thoracic, bilateral lower thoracic, bilateral upper lumbar, and bilateral lower lumbar regions. Palpation indicated abnormal position and/or motion of the osseous structures in the cervical, thoracic, and lumbar spine. Palpation indicated that the following osseous structures were in an abnormal position and/or 'moved in an aberrant fashion: T8, TI0, and L5. ASSESSMENT ) Kathy's condition remains essentially unchanged. ( PLAN) The current plan will remain the same for this patient. Ms. Delgrande has been instructed to rest at home. ( TREATMENT) The following treatment was provided to Ms. Delgrande today: Moist heat was applied to the bilateral upper cervical, bilateral lower cervical, bilateral upper thoracic, bilateral lower thoracic, bilateral lumbar, and bilateral sacroiliac/hip regions. Interferential therapy was administered to the bilateral upper cervical, bilateral lower cervical, bilateral upper thoracic, left lower thoracic, bilateral lumbar, bilateral sacroiliac/hip, and right shoulde~ regions, Mechanical traction was applied to the cervical region, the thoracic region, the lumbar region, and the full spine. The cervical, --<< -,-.-_., '."' .y;--'~-",- -1-' ,C,. .-'- .., ~,,, - ,. -_._ 0___ ili;. .' i !o":\~~{~i'l!t'r'. ',' thoracic, and lumbar spine were mobilized by manual means to improve joint function and restore normal joint position. "',<-c.".' _J'..,"", ,~ ~'I ":. _''_,_c. ,'0 - '-~~''''''' " DAILY NOTES Kathy Delgrande (ID# 000006482) June 14, 2000 Examined by: Bradley A. Jahn, D.C, ( SUBJECTIVE During this visit, Ms. Delgrande described the following symptoms she has been experiencing: - Bilateral occurring on an intermittent basis. Kathy says the intensity of the neck symptoms is moderate. Generally, Kathy's discomfort feels like a dull ache. - Bilateral which is moderate in intensity and is occurring intermittently. The upper back symptoms are best described as a dull ache and a throbbing sensation. - Bilateral middle back stiffness, numbness, and weakness which is moderate to severe in intensity. The symptoms occur on a frequent basis. Kathy characterized the discomfort as a throbbing sensation, a sharp or jabbing sensation, and a tingly or prickly sensation. - Bilateral lower back stiffness, numbness, and weakness which is occurring constantly and is severe in intensity. A throbbing sensation, sharp or jabbing sensation, and tingly or prickly sensation is how Kathy best described her discomfort. The symptoms radiate into the lower extremity. ( OBJECTIVE The bilateral upper cervical, left lower cervical, and right upper thoracic regions experienced a mild muscle spasm during palpation. A moderate muscle spasm in the right lower cervical and left upper lumbar regions was detected. The bilateral lower lumbar regions revealed a severe rrtuscle spasm. Palpation indicated the bilateral lower lumbar regions are edematous. Muscular trigger points were found in the left lower thoracic, bilateral upper lumbar, and left lower lumbar regions. During palpation, the left upper cervical, left lower cervical, left upper thoracic, bilateral upper lumbar, and left lower lumbar regions revealed tenderness. Palpation on the cervical and lumbar spine indicated abnormal position and/or motion of the structures. The osseous structures were palpated and it was apparent that the following are in an abnormal position and/or moved in an aberrant fashion: T8, TIO, and L5. ASSESSMENT ) Kathy's condition remains essentially unchanged. ( PLAN) The treatment plan for this patient remains the same. Kathy has been advised that she should be resting at home. (TREATMENT) The following treatment was given to Kathy today: Moist heat was used on the bilateral upper cervical, bilateral lower cervical, left upper thoracic, left lower thoracic, bilateral lumbar, and bilateral sacroiliac/hip regions. Interferential therapy was administered to the bilateral upper cervical, bilateral lower cervical, left upper thoracic, bilateral lumbar, and bilateral sacroiliac/hip regions. Mechanical traction was used on the cervical region, the thoracic region, the lumbar region, and the full spine. ':~I~llSC" ~ ".~- "." " .- ~ .'-' ,"1 --..,,~~_ .:,,~ " DAILY NOTES Kathy Delgrande (ID# 000006482) June 12, 2000 ( SUBJECTIVE The following symptoms were identified by Ms. Delgrande today: - Bilateral neck stiffness which is moderate in intensity and is occurring ~n an intermittent basis. Kathy describes her discomfort as a throbbing sensation. - Bilateral upper back stiffness occurring intermittently. Kathy describes her upper back discomfort as moderate in intensity. A dull ache and throbbing sensation best describes Kathy's discomfort. middle back pain and stiffness which is moderate to severe in intensity. Kathy states that she has felt the symptoms on a frequent basis. She describes the irritation as a throbbing sensation, a sharp or jabbing sensation, and a tingly or prickly sensation. - Bilateral lower back pain, stiffness, numbness, and weakness which is severe in intensity. The symptoms occur constantly. Kathy describes her discomfort as a throbbing sensation, a sharp or jabbing sensation, and a tingly or prickly sensation radiating into the lower extremity. Pt entered our office complaining of lower and mid back pain, neck pain and stiffness, and leg pain and numbness.. Kathy was a front seat passanger in a vehicle traveling on 1-81 on 11-1-99, when the car ran into highway equipment, pt was wearing her seatbelt but hit her head on the windshield. That night pt woke up vomitting and the next day she had numbness in her legs along with low back, mid back, neck and hip pain and stiffness. She still occasionally has a hard time sleeping. ( OBJECTIVE) During palpation, a mild muscle spasm in the bilateral upper cervical and right upper thoracic regions was apparent. The bilateral lower cervical, left upper thoracic, bilateral lower thoracic, and bilateral upper lumbar regions revealed a moderate muscle spasm. A severe state of muscle spasm was found in the bilateral lower lumbar regions. Palpation revealed edema in the bilateral lower lumbar regions. Muscular trigger points were found in the bilateral lower cervical, left upper thoracic, bilateral lower thoracic, bilateral upper lumbar, and bilateral lower lumbar regions. The right lower cervical, bilateral upper thoracic, right lower thoracic, bilateral upper lumbar, and bilateral lower lumbar regions were tender with palpation today. Straight Leg Raise results: SLR on the right reproduced lower back and radiating lower leg pain. The right SLR was stopped at 60 degrees. SLR on the left reproduced lower back and radiating lower leg pain. A moderate decrease during flexion, right rotation, left rotation, right lateral flexion, and left lateral flexion was found during lumbar range of motion, A significantly decreased lumbar range of motion was apparent during extension. Lumbar flexion, extension, right rotation, left rotation, right lateral flexion, and left lateral flexion caused Kathy to experience pain. The cervical, thoracic, and lumbar spine osseous structures were found to be in abnormal position and/or motion during palpation. Palpation revealed that the following osseous structures moved in an aberrant fashion and/or were in an abnormal position: L4, L5, and right sacroiliac. Ely's test was positive right. Kemp's test was positive bilaterally. Lindner's test was positive with Cx/Tx/Lx pain. Sitting Becterew's was positive bilaterally. Minor's sign was positive bilaterally. Yeoman's test was positive bilaterally. Plantar-patellar reflexes were +2 symmetrically. Deltoid/tricep/brachioradia1is reflexes were +2 symmetrically, Right hamstring reflex was +3 weak, left: +4. Quadricep reflexes were +3 right weak, +4 l~ft, Lumbar Range of Motion: dull pulling at 45 degrees on flexion. Pain in L5/81 area at 18 degrees on extension. Pain at 21 degrees L1-L5/S1 area on Right "'t~_ ._!?_'~ "'''e"!>'~_, -,'.'''' "I. -'1.-- ,,-,- --~ "" ^ . ~, ~ ~. " late"al flexion. Pain at 20 degrees on left lateral flexion L2-L4/L5 area. Tenderness noted to bilateral Lx spine at 20 degrees for rotation. Cx/T~/Lx x-rays report: hyplorctotic Lx spine, lumbosacral anomaly, transistional vertabrae sacralization of LS vertebrae with associated accessory joints bilaterally. Hypolordotic ex spine, IVD spaces adequate, bone density well maintained, negative for fractures. ( ASSESSMENT Dx: 756,l-L/S anomaly. 724.4-Lx neuritis. 722_10-Lx IVD syndrome, 728.85-Tx myospasm, 728.8-Cx myofascitis. Kathy continues to suffer from pain, stiffness, numbness as result of the automobile accident occurring on 11-1-~9. She has had four months of exercise therapy which provided only short term relief of her symptoms. It is our opinion that Mrs. Delgrande did not improve due to complications from her LIS anomaly. Kathy's initial injury to her lumbar joints was not addressed. She was also given exercises too soon before soft tissue healing could have taken place. It is therefore reasonable and necessary to resume care. ( PLAN) A new visit schedule will require Kathy to be seen 4 times per week for 6 period of 4 weeks. K6thy has been advised to rest at home. Kathy will be treated with conservative chiropractic care consisting of spinal joint moblization, manual and mechanical traction, and rnyofascial and active release therapies. We will treat her for approximately 3-4 weeks. If no improvement is noted in her condition at that time, we will schedule her for an MRI. Our goal is to reduce pain and stiffness and increase function and range of motion. We will determine the neccessity for future care in 3-4 weeks. ( TREATMENT) The following treatment was provided to Ms. Delgrande today: To the areas containing trigger points noted in the objective section above, myofascial release was applied. The cervical region, thoracic reg~on, and lumbar region received manual traction. \':t::&w.?T-'Ji!'H~_ _ ":,;."",,'.-~-'F,'T" c-'- "~'_';" ':~I -'""1"'- .,". " , . :C.:" .. 717-263-2655 MADEIRA CHIROPRATIC 464 P02 MRY 15 '01 10:48 ;u~_'x,:rA 'NTUAA"C~:qIl.PIlIlaflQrf Patient: DELGRANDE, KATHY Referring Physician: BRADLEY JAHN DC @n~ ~ Date of Birth: 1/17165 Hagerstown page(s): Date of Exam: July 21,2000 MRI EXAMINATION OF THE CERVICAL SPINE " TECHNIQUE: CUNICAL HISTORY:This is a 35 year old female with a history of neck pain. Also a history of previous MVA in November, 1999, The examination was performed using T1 and T2-welghted techniques, Sagittal, axial and coronal tomographic cuts were obtained. None, COMPARISQNS: FINDINGS: A small and broad-based posterior disc protrusion is noted at C4-C5. The above finding is centrally located. The protruding disc compromises the ventral subarachnoid space but does not affect the cord. A/so, the neural foramina are not affected. This finding is best appreciated on sagittal image #21 and axial image #34. The remainder of the cervical discs are normal. No focal bone abnormality is identified, The cervical cord is normal in size and configuration and shows no signal changes in its parenchyma. CONCLUSION: MRI EXAMINATION OF THE CERVICAL SPINE (07/21/2000) 1, A very small and broad-based posterior disc protrusion is noted at C4-C5_ The above finding represents a very mild disc hemiation which is incomplete, with the annulus fibrosus being only partially disrupted. The protruding disc does not appear to compromise significantly the spinal canal or the neural foramina. The exact age of this lesion cannot be determined with certainty. 2, The remainder of the findings are unremarkable. 'N ?~>-J ~ ~ Nicholas Patronas, M,D.ljcfI07/2312000-796 722.0 (displacementlHNP) 324 East Antietam st., SuUe 308 . Hsgers1own. MO 21740 - Phone: (301) 745-5500 . Fex: (301) 745-4444 i~[ .1,,),1,.. ,,'., "~'"'_~;_'_,..~"._,_ _,_, =,'_', - -'-~I- ~'_ ",'",~_'_,._ _" . ", >',_' . - ~, MADEIRA C~IROPRATIC d64 P03 MAY 15 '01 10:d8 ,,,;v.,.38/" ~lTE~lrOli.\l.COftI'OIV<ri(/N .. Patient: DELGRANDE, KATHY Referring Physician: BRADLEY JAHN DC try'iOl'iiiilOO ';;\/i?)5)1? \ld/.tr' 1J!!1.!N 1l\7l!~ Date of Birth: 1/17/65 Hag, erstown Date of Exam; July 21, 2000 page(s): MRI EXAMINATION OF THE LUMBAR SPINE TECHNIQUE: CLINICAL HISTORY:This is a 35 year old female with low back pain. History of previous MVA in November, 1999. The examination was performed using T1 and T2-weighted techniques, Sagittal, axial and coronal tomographic cuts were obtained. None. COMPARISONS: FINDINGS: There is relatively normal alignment of the lumbar vertebral bodies in the SlJpine position, The vertebral marrow signal intensity is preserved at all levels, The conus medullaris terminates at T12-L1 which is within normal limits. There is no abnormal signal intensity in the cord terminus. The disc height and signal intensity is normal at all levels studied which includes the T11-T12 disc space down through 51. Segmental analysis reveals no canal or nerve root compromise at any of the levels studied. There is no disc herniation. There is no central canal stenosis, There is no neural foraminal narrowing, There is no far lateral disc herniation. There fs no nerve root compromise, CONCLUSION: MRI EXAMINATION OF THE LUMBAR 'PINE (07121(2000) 1. This is an unremarkable MRI of the lumbar spine without disc herniation, central canal stenosis, foraminal narrowing or other focal or specific findings. 2. Incidentally, on the sagittal images. there is a rounded, partially cystic structure within the pelvic cavity. It appears to be just to the left of the uterus. The exact etiology of this is not known. This abnormality measures 5.4 em. in its greatest diameter. Clinical correlation is recommended, and if warranted, a sonogram of the pelvis would be needed to rule out right ovarian pathology, 'N ?~,- ~ , Nicholas Palronas, M.O,~cf'0712312000.1-796 722,10 (displacemenllHNP) 324 East Antietam st.. Suite 308 . Magers/own, /.AD 21740 . Phone: (301) 745-6500 . Fax: (301) 745-4444 :<':,~_1{7! _ 0 ~,.~, _,,~ _","~,__ It~.._ '- ""1"'+ ':~__ _~_",,_ '_""_'-~" , - "'."MM' "~ "~",,..",,-"" -, " .. '11 ~8'D I(tJ~lSilTVTE - 1)2, caAil ~V h ._._,.__"., .' " ORTHO~~DIC INSTITUTE OF PENNSYLVlll,IA (717) 761-5530 Patient: Kathy L, Delgrande DOB: 01/17/65 SSN: 209 60 4571 Chart #: 16332728 Page # 3 ------------------------------------------------------------------------------ 1/31/2000 JOHN R. FRANKENY II Me LEVEL THREE PLAN: Ibuprofen on a more regular basis and continue with therapy at Keystone Spine Center. I'll see her again on an as needed basis. She was given a prescription for Ibuprofen 800 mgs., #60 with one refill_ -CONTINUED- JRF/kir 2/07/2000 JOHN R. FRANKENY II MD REQUEST FOR RECORDS Office notes copied, billed by Quadramed and mailed to ANGINO & ROVNER, ATTORNEYS AT LAW. Elb 2/14/2000 JOHN R. FRANKENY II Me DISABILITY FORM Wage loss update form mailed to Allstate Ins. Co,/jal 3/07/2000 JOHN R. FRANKENY II Me DISABILITY FORM Wage Loss Update form completed for Allstate Insurance Company and mailed.jss 3/27/2000 JOHN R. FRANKENY II Me MISSED AFFT LETTER (Pat) DELGRANDE, KATHY L. 4/17/2000 JOHN R. FRANKENY II Me LEVEL THREE Trindle Road Office CHIEF COMPLAINT: Kathy returns today for evaluation of her back, HISTORY OF COMPLAINT: She is still having an aching pain especially at night time and whenever she is sitting for a while. Once she is active the pain seems to improve. She intermittently has tingling down her right leg. She is attending therapy at the Keystone Spine Center. i" i! REVIEW OF SYSTEMS: The patient's review of systems, past medical history, family history and social history have been re-evaluated and reviewed. i r,.; i I ,I i' , : , I t I I I, I', I I I PHYSICAL EXAM: On examination she has a very back. Her lower extremities are grossly and no spasm curve reversal in her lumbar spine. good range of motion of neurovascularly intact. She sits comfortably. her She has IMPRESSION: Soft tissue injury of the lumbar spine with slow but sure improvement. Functionally she has improved quite nicely. She has residual symptomatology. PLAN: Continue therapy. Continue intermittent ibuprofen. If she does not continue to improve we will certainly obtain an MRI scan. She does not have symptoms_ Suggested the need for surgery so I am not in any rush to get that 'li~\'I!ij!,L;J!)" '""_" -'"c,.',._"_' _ ,'e,'__,__ _ I." 1-"" "",,-, c._'_ . ;.'* ',' ORTHVrBDIC INSTITUTE OF PENNSYLVhdIA (717) 761-5530 Patient: Kathy L. Delgrande DOB: 01/17/65 SSN: 209 60 4571 Chart #: 16332728 Page # 2 ----------------------------------------------------------- 11/09/1999 JOHN R. FRANKENY II MD LEVEL FOUR on average. Possibly the therapy will speed that recovery. I will be glad to see her again at any time, In addition, I gave her samples of a Prednisone Dose Pack which will be followed by Aleve. She is already taking way too much Aleve up to 4 pills four times a day. I advised her on reducing that dosage after the Prednisone Dose Pack is complete. -CONTINUED- JRF /bam 12/13/1999 JOHN R. FRANKENY II NO DISABILITY FORM Completed Attending Physician'S Report for Allstate and mailed on to ins. barn 1/18/2000 JOHN R. FRANKENY II MD DISABILITY FORM Completed attending physician'S report for Allstate and mailed on to ins. co. barn =/MESG-MESSAGE TO CHART T Kathy is still undergoing therapy with Greg Silva at Keystone Spine. He has asked her to do no bending, etc. and just exercises. She has another appt with him the end of the month and will see Dr. Frankeny after that. bam 1/31/2000 JOHN R. FRANKENY II MD LEVEL THREE Trindle Road Office CHIEF COMPLAINT: Continued back pain. HISTORY OF COMPLAINT: Kathy returns today for her questions related to her back. Her back is somewhat uncomfortable. She has no numbness or tingling, She does have an intermittent ache in either leg at night time. REVIEW OF SYSTEMS: The patient's review of systems, past medical history, family history and social history have been re-evaluated and reviewed. PHYSICAL EXAM: On examination there is no deformity or curVe reversal of the lumbar spine. There is superficial tenderness in the lumbar spine. Paraspinous muscle spasm is absent. There are no masses palpable. Range of motion is full and pain free. There is no crepitation or step off palpable suggestive of instability. There is no axial compression pain or rotational pain, Heel and toe walking are performed without evidence of weakness. Sensory, motor, reflex, vascular and lymphatic examinations of both lower extremities are grossly within normal limits_ Straight leg raising and femoral stretch tests are negative. There is negative distraction, straight leg raising tests, Pelvic stability tests are negative. There are no obvious skin lesions in the area of the lumbar spine. IMPRESSION: Mechanical back pain persisting following MVA. ----------------------------------------------- X~^J, -\,,, , "..'__,-"A"""~ ',''- 0 ___ ~ -"'1-= -, - '_:_-'_'_"'7~,_' , -~ :.it>!'. / ORTHC, .;DIC INSTITUTE OF PENNSYLv_ .IA (717) 761-5530 Patient: Kathy L. Delgrande DOB: 01/17/65 SSN: 209 60 4571 Chart #: 16332728 Page # 1 -------~---------------------------------------------------------------- 11/09/1999 LEVEL FOUR Hershey Office JOHN R. FRANKENY II MD /553 '5 q7?;~7 CHIEF COMPLAINT: Neck and back pain. HISTORY OF COMPLAINT: Kathy is a very pleasant 34-year-old woman who spends much of her time training bull dogs. She was well until a week ago yesterday on 11/1/99 in which she was a passenger of a vehicle that nearly hit something on the road. I am not sure of the car hit the construction equipment or simply jamming on the break caused her head to hit the windshield. She was a restrained passenger. She felt okay at that point in time and began to experience neurologic symptoms of numbness in her face and also increase pain in her neck and low back. Her arms feel a bit tired and weak. She denies any bowel or bladder problems, She has had x-rays of her neck, back and CT scan of her head, all of which are apparently read as within normal limits, She is quite frustrated because it has been 8 days and she is still not better. Kr:V~;<;W OF SYSTEMS: Review of systems, past medical h,istury, .family history and social history have been recorded and reviewed. PHYSICAL EXAM: She is a pleasant, well developed woman who is alert and oriented x three. Gait and coordination are grossly normal, On examination she moves about the room with normal attitude and posturing of the head. There is tenderness, There are no muscle spasms present, No masses are palpable. She has pain with extension of her neck. There is no crepitation or palpable step off suggestive of instability. Spurling's maneuver is negative. Sensory. motor and reflex examinations are normal in both upper extremities. There is no hyperreflexia in the lower extremities, There are no skin lesions in the cervical spine area. Examination of her lumbar spine shows she has pain with flexion of her back. She has tenderness in her back. There is no evidence of crepitation or step off suggestive of instability. Paraspinous muscles are of normal strength. There are no skin lesions. Inspection of both upper extremities reveal no deformities. There is no tenderness to palpation. Range of motion and instability of all joints are grossly within normal limits. There are no skin lesions. DIAGNOSTIC TESTS: Outside x-rays of her neck and back are within normal limits. IMPRESSION: I suspect she has a soft tissue lesion of both her neck and low back. I see no evidence of nerve injury whatsoever. PLAN: She is referred to the Keystone Spine Center in hopes of speeding her natural recovery. I told her to anticipate up to 12 weeks of some discomfort --------------------------------------------- "':~ t'\: ,<" - - ,,' .' Item: CM30 User: kirOOl Patient Address DELGRANDE, KATHY L. 504 BRENTON SHIPPENSBURG PA 17257 (Needs to be addressed) ortho Institute of PA Dictation Worklist Chart # : 16332728 Peb 02 2000 {10:34} Page No: 1 H""'. Telephone Telephone Social Security#: 209~60~4571 Date of Birth 1/17/65 #: 717-530-9566 #: 717 Work ALL ERG I E S _ - - - - - _ . w w _ _ _ _ _ _ _ ~ _ _ - - ~ ~ - - - - - - - - - - - - - - - - - - - - - - - - _ ~ ~ _ _ _ _ _ _ ~ ~ _ _ _ _ _ _ _ _ ~ w . _ _ Date Drug Name Strength porm Dispensed Pharmacy Remarks Refille Sig stop Date Provider ,Status ___w_w____~~__~________________~_______~______________-----------~--____________~_~___________________w_w_w__~___~__________w__~____ 01/31/2000 IBUPROFEN OR TABS 800 MG 60 KIR 11/09/1999 PRBDNISONB (PAK) OR TABS 5 MG 21 ham ~~ 0- l AS DIRECTED o AS DIRECTBD ~ -" -,- ACTIVE MEDICA'l'I FRANKENY II MD" SAMPLE MEDICATI FRANKIl'NY I I MD" "~ , ~ 'r' ';" REALm mSTORY ..... ." , '- ".'i-"',_"-",,,: .';'.. . Thefollmving is very important to us in taking care of yo or health. Please take tin:I~ tO~~mpleieIYandaceurately fill oot all of this informatiorL Please also m.1ke suie you update this infor-rnation as c~g~.Odcur;" , ' ", ' " , ~- ,;' '1,' - . ,'-'- - , , , , '" ',," " "' 7 ," ",...,-' , -.. ' ',- ., - - -"" - ' , '"',, "t' '" ,,' , ,.." , ~,33l2- ' Chart Number '..,,' ,',<' patient'sName__H~~ b'43.cc.YtJp Medications You Are Taking N&!Wl . ' . . , , Freqoency " ..,,"::;:~~~r)<!,: ;/:\~- ::::-'~' .~ .",.'" ': : ~""'.:~,:~ .:;t~~~'~. .,1 .' . "'" '"' "~ . ~ :::: ~'i:'~~:!~7'~':h~\ :"';':.. ;,: ._~. )t-: >-:' " " . _ ':' . ,'-, - ;"_" -i-:::'_~"" _".'. .' . "':-"._-"':'"",.':\ ,n,'."', jI:,.:",:,',;--., t~~-:f':"-' ,i:::"'" '....--..--.. ';. .. Are you taking diet medication? No...... .._.._Yes..._ Allergies (Dl'Ilgs and Other AIIerjl1es) , , . I ~ - Penicillin - No Yes-Q.r=tion_~__... LocaJAIlesthetic No Yes_-reaction._..____ (xylocaine) novocaine) Other Allergies Hospitalizations Ho&pita1 ,~~~~. -~-"'-;" ":;";{._:-:-'?;'~:''''''~ ....\';,-..::- :, .~ ,',:, . -',,..':; -' , ,Past i\.iedlcaiIilstoryji,\X I ~31; o?:;).. t3L ",<' "..,.., " ',,' ~', '. .. ..,~< ' ~ , . ,.! '. ,," '.-,' .1;.~lt;1!!~~~(, '[, ]"',",' __.. ","'-"'C"'" ....:+,':' [ ] . ..<''., ;";58::,';,_~it,;:;:e~":~~i{'?!~~~i~;-~':.-, ',' ,.;.-., ii a'i~:,""':' [] r;(),' ",;,:"" , ~ .~-:,.. "'''''~'' "" " i?~;;~;fi;Wf~~':;~z~('j;~ii\i{i~~ji~~ Anemia ':' Astbina ", ." Abnonnal Bleeding " Blood clots I phlebitis Cancer 1 tumor Diabetes Drug abuse Eczema I ps,?nasis Epilepsy I seizures Heart Condition !' low blood pressure Liver disease I hepatitis ! :yellow jaundice Kidney I bladder problems Lung disease Prostate problem.. Stroke Thyroid disease Tuberculosis Uleer in stomach! duodenmn Osteoporosis Arthritis Other bone! joint disease Any nervous system disease , UPDATE [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [] [ ] Social History Do you smoke? Do you drink aleohol? Do you use street drugs? No__ Yes~Amount No.....oYes Am01mt NoPves==Am~unt Continued on back of page.. ... ......-_, 'lt~ .- . ','-" " .; -, , f1uring t.he past. year, have ~ _J had: 1 heartburn OT indigestion?......,........,..........,...........,.........,....,......,...... 2 bowel movements that were bloody or tarry'? ........................;,..,........ 3 any'recentchange in your bowel habits?.....,....................................., '4 frequent urination dUring the day or night?...,.....................,...........,.... , .. 5 any recent loss of control of your bladder'! .......,.............,....,....~........, ,6 b~uning with~atiort?,.:'....:..~,~:";:.:..:..:,~::.,'~.,..:.........."...:.~,.:::.."., " 7 dIfficulty startmg your unn~tion. ....,,;..~.,..;;:::,..,...........,.,~................:" 8 excessive urination? ..... ......'.~~~'... .... ..:.~~i~~~..~.:~;-:~~.:'...~.n......m..~'..~~~~.~;..';:.~. ..'~ ~-, ",> . '-; ," ,. . . exces,sive u:rrst? ..:::..~:~..:.;:.;:),':~:...;:~~~.;;::;~:~';g.'1;I:..;::.j:';:',':,:........ ,', shortness of breath or wheez.no' ..,'i.",.....,...;".,......,..;..",..,.,::..,........ " ..,1,.:e:=~~i0i~~if~tlt~~f;.. 14 swollen feet or ankIes?.'....;,..;......;.....,'...i....",;;..;;;.;...;,;;:...;.;.....,....- . -. . '- ';:: ~ ;--.- :_'---, ~::;~'.'f~~.~.'..:t :';;';:';,;:':i {__,:\L~-:\.:;,;;,::'?,~,;:~:::,;~_~.~<,' ,.,-,.'.):.:<: ': >:.< _" - " ,15 ,frequent headaches?....................................................................... 16 ' difficulty hearll1g? ..:..::...::::ql;;::,:.:;::L::;..i:LED:;;.;~.-;:.::;L.....:........: "'-".' .-,' ,':''','- .'" ,-'. ,-.....".. "'.,,"\- 21 hiD 1 . . ts? " . , -,,>~,-,. -,','. ' ae, g muse es or Jom . ...,~......,.'...,,::i...:...,:...;;....,..........................._... 22 swollen joints?.:............"...:...... :..;..:..,,:.::..........:.... :.... ......,..."......... 23 cold hands I feet?..._...............:.,:......:......................,.....................,.. 24? ' " gangrene. ................'."....'......... ;:.....:.....,... ,..,. .......,.............. .......... 25 loss of consciousness? ..................,,;;....:....., ..............,...................., ,. 26 recent numbness in arms or legs'?,:,;:~.:.........,~....................,.,............ 27 chronic fatigue? .......,......., ..... .......,.,::',,',"....;,: .......... ..;.. ......... .......... .... 28 tlllcontrolled bleeding?.......,..... .:...:.:,::..:" ......:..............,..... ..... .....,... weight loss?......,' ,......................,..",:.., ..................... ..........',.. ........ '",eight gain? ,...::,.... ;.:,..".:;.::;::..,::,.;:'~:~r::,:;;.,::..,...".....,...,...;.... ."",. heat I cold intolerance?,......::...,...."":.]::;;,,.::.......:. ....................,. ......, '. --,-'. ' ~ , . ';' "",- '}'heabove infOrmatio\ s true and c~.:' Patient signature.. ':, f \ No No~' No~_ }{o,,\jJ_' No.s,L No_~' '"No.,.:.~ ,', No...ii2.:' Y~s_y:J Yes_,__ yes____ Yes__ Yes_ Yes_ Yes_ Yes_ No "-.IF, Yes_ No~Yes "'No~'y~s____ :'~~~;?e~-...- , ~o'\f)y es " ," NO~.;<Y~~-'-::- , ~:~:t::~ No~~es No -'-,'fl:,:'Y es , N~~~,i:':"Ye~ No .s:P_ Yes....,.._.._ No..~ No......'i!.. No~.. No ...;.'d!.. No'-P NO'~"'" ---- No No~ NoW -W "No" , No \P Date Yes yes......,....... Yes__,_ Yes_,_ Yes Yes.y!'= Yes_ Yes_.___ Yes Yes YesL 1-6 j- OU r~:' 1J1 ~ Date 11- ,-cr,! Patient Name , , Time_ v~ Doctor rrCJll ~ Chart t "'~ 1(,3327 L, l\ddress HI {)~one Cit 5"30'" '1st; C. Home /-/7-/r;~ S Work l\ge~ Sex F 1'<1 state Zip sst.;L () 9- 6 (). VS-71 Marital Status JIJI1 Occupation MMP 11111 ft rb/ { I)OB Employer Street City State Zip Mother - OOB wt (If patient is a cbild) l'atber - OOB W. - .... ~ '" r - t::mployer Employer ' " , Spouse t0i~ (~OOB@rJ.:)('f ~,l{wt~-;}.?l(5 EmPlOyer~ \0e..J. ' -c ~ ( r Cbild (Scbool) Alternate/Other Contact ':so..ili ~ ~rsible p;/~~~~;d_()1'~ ((MOHrt) Injury, '1€.S DOl )1- ~."tq Sports Auto X Work Related kO"~'~'= ~PP,) ~~{ ~~r ~j:r;: l;,~ ~t9 ,. _~ r: ~ I I ~c( Date symptoms first appeared if not an injury ,. ( INSURANCE AJJ ~dt jp,~A4AJA Ct. Secondary Address--1113 L( ~ d.tuJt tD.I\ _ Address ~~~~,nll}~_. Policy t 'f2!wu:li t)lft>..16Db Suscriber's Name ~ Primary ~ Group t Policy t Subscriber's Name Address Address Family ,Dr. f1~~ J.k1AffJt\ I ~ ~ Referring Dr. - Address Address Send Letter'To. Family Dr. Referring Dr. Neither ,''''~.in':'f'''-1 '." " ", m. .t"'''' ''I' 7-~" "" 1- ," , - ~ - ~-- - " -~ _, ~_7." _ ,.' , r' 1'...,.' .',-,-,. 'DtsA-6IUl1 SLl~ 'i'.: ~~~.C~.C~~d l~:cbH~ .' - "v.uu,-" , .~ WAf:... LOSS UPDATE FORM FRAUD PREVENTION. PENNSYLVANIA WARNING ANT PERSON WHO KNOWINGLY AND WITII INnNT ,10 INJUnE OR DEFRAUD ANT IHIUIlEf\ FILES All APPLICATION OR CLAIM CONT""ING ANY FALSE, INCOMPLEn OR MISLEADING IHFORMAnDN SHALL, UPON CONvtCnDN. BE SUBJECT TO IMPRISOrlMEHT FOR UP 10 SEVEN YEMS AND PAYMENT OF A FINE Of UPTD S15,DDD. ' . , '\\: \~\ Q\) ,. ,~~.o\ l~t UU a.AIM NUMBER; \55~~-~ll~ PATIENT: ~~~ ~ ACCIDENT DATE: ,\\ l\ ct \ PHYSICIAN'S STATEMENT P^RT ^ The above named, patient has presented a claim for wage loss benefits under the Flnlinclal Responsibility Insurance Plan, To be entitled La these benefits, the patient must be physically disabled from performing hIs/her duties. 1$ the patient stili under your care? ~~ Date of last visit 1./- /7-Ci) Next scheduled visit '1 {f!/ 7.) (7).I.{' t;:,c;-.-:2,'?J ( rea code & Phone number) \,~J;k' . , II / I /qc; tl1ru ,.Lfndy/J/Yl;,t 0 I Y If stili disabled, patient may return to work on . .(J/'11Jr/!"l dlA/'T1 ~ ~if\<~ A/-~S~OO (Physician' slgnatu,) (Date) Is the present disability solely a result of this accident? Patient was unable to work from _____________________________________________. ..._.r ____._.____ ~.___________ -------- PART B EMPLOYER'S STATEMENT Dear Employer: Your emPlo)e!l has presented a claim tor wage 105s tleneflts ~nder t~lfi1inclal Responsibility Insl.![ance Plan, Please ~omplete the Information Jeqoested below In order that we may calculi!ltE!, those benefits payable. " ,~" '. ...... Current wage or salary: /hr ." --- /wk /mnth ''',.. " Number of hO\.Jrs worked: '. , ,. .' (day tweek " --- Average of tips or commislaf1: , ./ / Dates absent fOllo,,,ir'ig the accident: from /' Has employe~'recelved or is receiving workman's compensation Ii / ~', ............ (week ~ " /month Number of ,days worked: /day/week/month thru (Supervisor's signature) (Date) / (A.r~If' code II< Phone number) /'" .' , Ai :NOING PHYSICIAN'S REPORl I I , . / .-","1 ( I ) ;}1,. f)(\ 1'4 \"'. (:>~::r(:'" 1" '-JiL";~ ;-~ ",...' ~'f '-...,/ \-.:1 ~Wt> " ~' (fU./"'- "~_,I '""} Lf ~~ I~ ;" ::,\ tt; i " '32 GJ"tL fDATE POUCYHOLDER DATE OF ACCIDENT FILE NUMBER December 27, 1999 WILLIAM 0 DEL GRANDE November 1, 1999 1553597367 KUM PLEASE NOTE: THE ATTENDING PHYSICIAN SHOULD COMPLETE THIS REPORT AND RETURN iT DIRECTLY TO: ~'tC':- Z~^;j~~I?CU ALLSTATE INSURANCE COMPANY 6345 FLANK DR, SUITE 1000 HARRiSBURG PA 17112 1. Patient's Name and Address 2. Ag 3. Sex (. nown) ~ ~\~('r 5, History of Occurrence as Described by P!3tient ,. I '0 ",,,.J \,-"" ~k {N..dL (XJJX:jLhOf;(~"'-WJJ - ~L,)e.'f' hAJ- ~~U(f v"- I\.o~ L/'J'-"IU-' '-"--""- 6, Diagnosis, Diagnosis Codes, and Concurrent or Contributing Conditions' ~r(iLr'.~t-ra:,...'l(Vo{ (,\ec:)( -.} 100& 7. When Did Symptoms First Appear? Date: \\ C ----g:;'las Pa' nt Had Same or imil r Conditions? YES 0 circle one) If "YES", state when and describe' 10. ondition Solely a Result of This Accident? YE I NO (circle one) If "NO", Explain' 11. Is Cond',' n Due to Sickness or Injury Arising Out of Patient's Employment? YES I (circle one) 12. Will In' esult in Permanent Disfigurement or Disabili ? YES NO ircle one) If "YES", Describe' 13. Patient as Disabled (Unable to Work) '} From: Through: \W\z... "'!'vOl\.. 8. When Did Patient First Consult You for This Condition? Date: \ \ q '99 ___ 3'ECEIVtU PAY 14.lf Still Disabled, Date Patient Should Be Able to Return to Work: 7) c!) - 3 (h 01''-\1"'\<;.. OA SERVICE SERVICE ., CODe DESCRIPTION OF SERVICES RENDERED y 0 SERVICE UNITS CHARGES (2;"' , $ $ $ Total $ 16. Is Patient Still Under Your Care for This Condition? YES ,NO (circle one) Estimated Future Charges $ ~18-oo R Ai 'A ~" .j? '::>'t Date Physician's Name (Print Physician's Signature EIN/SSN P:;iS PDplwChu./W'l Rd (',iVY) n 4-r jJ PI! f 7D) I No,' Street City or Town ( Stale Zip Code ()\-.\-'ht~;C':., l'\'\'O-i..O:i1Zok In) 11m "3X1.J PhYSician's Specialty License Number (Area Code) Phone Number FRAUD PREVENTION - PENNSYLVANIA WARNING - ANY PERSON WHO KNOWINGLY AND WITH INTENT TO INJURE OR DEFRAUD ANY INSURER FILES AN APPLICATION OR CLAIM CONTAINING ANY FALSE, INCOMPLETE OR MISLEADING INFORMATION SHALL, UPON CONVICTION, BE SUBJECT TO IMPRISONMENT FOR UP TO SEVEN YEARS AND PAYMENT OF A FINE UP TO $15,DOO. C1216-PA ~Uu RP'YSfSlll SIde Jr Additional SpaCIl II N..ded '/"'(~",", .,,'..c.._,___' _ 0 -' , --, '''"r.", ',', " - ~- ''''-M' __ :;;,..' ~C"- ~ ~- ~M Ke~stone Spine Cent, Ine PHONE NO. : 717 730 90' .... I ,U/IIlI""n, ~n,.IAN :!> KIt:~UK Dee, 02 1999 10:43RM P2 .. 1&3~7 DATE POUCYHOLDER NQv~mb~r 24,1999 WILLIAM D DEL CRANDE PLEASE NOTE:- THE ATTENDING PHYSICIAN SHOULD COMPLETE , THIS REPORT AND RETURN IT-DIRECTLY TO: DATE OF ACCIDENT FILE NUMBER November 1, 19S9 15535873673KK THERESA M, SALINGER ALLSTATE INSURANCE COMPANY 6345 FLANK DR, SUITE 1000 HARRISBURG PA 1,7112 - 5, History of Occurrence as Described by atien~~ - tt\ ~ t-,\ l' 'l::.Or/\L~ ,lrfu Q..owi -~~JA let ~J \ fJ.~(\K. 6, Diagnosis, Diagnosis des. and Concurr~r Contributing Conditions. S~ -\. -\. i ~e. 1'€'5i e-n - N~ c.k '+- \Ot.U Cc..C ( 7. When Did Symptoms First Appear? Date: \\~ - 9, Has P 'ent Had Same or Similar Conditions? YES NO circle one) If "YES., state when and describe' -10. n, ition Solely a Result of This Accident? Y / NO (circle one) If "NO', Explain. 11. Is Cond" n Due to Sickness or (nJulY Arising Out ,}f Patient's Employment? YES . 0 ircte one) '1~. Will In' Result in Permanent Disfigurement or Disability? YES Ii N circle one) If "YES", Describe" 13. Patient Was Disabled (Unable to Work) From: - g.. <=1 ~ Through: 8, When Did Patient First Consult You for This Condition? Date: I i _.g- Q q S.ERVla .. CODE Patl nt Should Be Able to etu SERVtcE UNITS CHARGES SERVICE $ $ $ Total $ tient Stili Under Your Care for This Condition? / NO (circle one) EstImated Future Charges $ ~I ~ ~ ~T Date hysiclan's Name (Print) Physi . EINlSSN - ~ 7;,~"'7t;p1~~r~tl'tlA. ()f ('/1 "" ~,J-"lll City or Town I ~ 's(ate 'Zip Code Physician's Specialty ~bOlj~ ~~~ber (:t~1:l)~:~n~~r FRAUD PReVENTION - PENNSYLVANIA WARNING.. ANY rERSON WHO KNOWlNCl Y AND WITH INTENT TO INJURE OR DEFRAUD ANY INSURER FILES AN APPLICATION OR CLAIM CONTAINING ANY FALSE, INCOMPLETE OR MISLEADING INFORMATION SHALL, UPON CONVICTION, BE SUBJECT TO IMPRISONMENT FO~ UP TO SEVEN YEARS AND PAYMENT OF A FINE UP TO $15,000. C1216-PA ~u~. "....r.. SIl'. II .....IIII'.o~1 s~ I. H..... ;~ ,~"_,_~"Jrl ~If,. ~. ~.,." ",_><> _, ,'" ','.,' ,?':!'<_c:- .' '1-" ._,",. ,., _"or ".- - . ~, ,~ ~ .' MeDICJ\L- biLLS r 1-' (u ,. MADEIRA CHIROPRACTIC P,C. 1124 KENNEBEC DRIVE "CHAMBERSBURG, PA, 17201 Phone: (717) 263-8919 Fax: Detailed Account History Page # 1 Printed: 08/14/2000 49B5 DELGKANLJE, KATHY Case: 1-'1 AUIU 504 BRENTON ST, Primary Ins: ALLSTATE INSURANCE Secondary Ins: SHIPPENSBURG, PA, 17257 Tertiary Ins: Account Balance Summary Ins Balance pt. Balance UnBilled Bal Unapp pt Pmt Bal $902,00 $0.00 $0.00 $0,00 Activity from 06/11/00 To 08/09/00 Svc Date Pvdr Type Code Description Amount Balance 06/12/2000 3 Service 99203 ElM NEW PT DETAILED LlC $85.00 07/25/2000 3 Ins Payment Check ALLSTATE INSURANCE ($85.00) $0.00 06/12/2000 3 Service 72100 LUMBOSACRAL NP AND LAT $48.00 07/25/2000 3 Ins Payment Check ALLSTATE INSURANCE ($38.67) 07/25/2000 3 Adjustment 7 ADJ OFF ACT 6 (PI) ($9.33) $0.00 06/12/2000 3 Service 72070 SPINE THORACIC NP LATERAL $48.00 07/25/2000 3 Ins Payment Check ALLSTATE INSURANCE ($37.91 ) 07/25/2000 3 Adjustment 7 ADJ OFF ACT 6 (PI) ($10.09) $0.00 06/12/2000 3 Service 72040 SPINE CERVICAL NP AND LATERA $45.00 07/25/2000 3 Ins Payment Check ALLSTATE INSURANCE ($36.04) 07/25/2000 3 Adjustment 7 ADJ OFF ACT 6 (PI) ($8,96) $0,00 06/12/2000 3 Service 97140 MANUAL THERAPY TECHNIQUES $35,00 07/25/2000 3 Ins Payment Check ALLSTATE INSURANCE ($28.14) 07/25/2000 3 Adjustment 7 ADJ OFF ACT 6 (PI) ($6,86) $0.00 06/12/2000 3 Product 3 SEMG SPINAL SCAN $0.00 $0.00 06/14/2000 3 Service 98940 CMT ONE REGION $30.00 07/25/2000 3 Adjustment 7 ADJ OFF ACT 6 (PI) ($1.32) 07/25/2000 3 Ins Payment Check ALLSTATE INSURANCE ($28.68) $0,00 06/14/2000 3 Service 97014 ELECTRIC STIM MOD 1/MORE UNAT $32.00 07/25/2000 3 Adjustment 7 ADJ OFF ACT 6 (PI) ($16.32) 07/25/2000 3 Ins Payment Check ALLSTATE INSURANCE ($15.68) $0,00 06/14/2000 3 Service 97012 MECHANICAL TRACTION MOD 1/MOR $35.00 07/25/2000 3 Ins Payment Check ALLSTATE INSURANCE ($18.47) 07/25/2000 3 Adjustment 7 ADJ OFF ACT 6 (PI) ($16.53) $0.00 Continued 1"~'i1ll! , - '<':?_~~"_""_") "0-""" , ""I" , I" -~ ~" ,. .__ ~_ .. _ "'_ c dS .. MADEIRA CHIROPRACTIC P.C, .-1124 KENNEBEC DRIVE CHAMBERSBURG, PA, 17201 Phone: (717) 263-8919 Fax: Detailed Account History Page # 2 Printed: 08/14/2000 4986 DELGRANDE, KATHY Case: PI AUTO Svc Date Pvdr Type Code Description Amount Balance Continued 06/16/2000 3 Service 98940 CMT ONE REGION $30.00 07/25/2000 3 Adjustment 7 ADJ OFF ACT 6 (PI) ($1.32) 07/25/2000 3 Ins Payment Check ALLSTATE INSURANCE ($28.68) $0,00 06/16/2000 3 Service 97014 ELECTRIC STIM MOD 1/MORE UNAT $32.00 07125/2000 3 Adjustment 7 ADJ OFF ACT 6 (PI) ($16.32) 07/25/2000 3 Ins Payment Check ALLSTATE INSURANCE ($15.68) $0.00 06116/2000 3 Service 97012 MECHANICAL TRACTION MOD 1/MOR $35.00 07/25/2000 3 Adjustment 7 ADJ OFF ACT 6 (PI) ($16,53) 07/25/2000 3 Ins Payment Check ALLSTATE INSURANCE ($18.47) $0,00 06/20/2000 3 Service 98940 CMT ONE REGION $30.00 07/25/2000 3 Adjustment 7 ADJ OFF ACT 6 (PI) ($1.32) 0712512000 3 Ins Payment Check ALLSTATE INSURANCE ($28.68) $0.00 06/2012000 3 Service 97014 ELECTRIC STIM MOD l/MORE UNAT $32.00 07/25/2000 3 Adjustment 7 ADJ OFF ACT 6 (PI) ($16.32) 0712512000 3 Ins Payment Check ALLSTATE INSURANCE ($15.68) $0,00 06/2012000 3 Service 97012 MECHANICAL TRACTION MOD 1/MOR $35.00 07/25/2000 3 Ins Payment Check ALLSTATE INSURANCE ($18.47) 07/2512000 3 Adjustment 7 ADJ OFF ACT 6 (PI) ($16.53) $0.00 06/21/2000 3 Service 98940 CMT ONE REGION $30.00 07/2512000 3 Adjustment 7 ADJ OFF ACT 6 (PI) ($1.32) 07/25/2000 3 Ins Payment Check ALLSTATE INSURANCE ($28,68) $0.00 06/2112000 3 Service 97014 ELECTRIC STIM MOD 1/MORE UNAT $32.00 07/2512000 3 Adjustment 7 ADJ OFF ACT 6 (PI) ($16.32) 07/2512000 3 Ins Payment Check ALLSTATE INSURANCE ($15,68) $0.00 06/21/2000 3 Service 97012 MECHANICAL TRACTION MOD 1/MOR $35.00 07/25/2000 3 Adjustment 7 ADJ OFF ACT 6 (PI) ($16.53) 07/2512000 3 Ins Payment Check ALLSTATE INSURANCE ($18.47) $0.00 06/23/2000 3 Service 98940 CMT ONE REGION $30.00 07/25/2000 3 Adjustment 7 ADJ OFF ACT 6 (PI) ($1.32) 07/25/2000 3 Ins Payment Check ALLSTATE INSURANCE ($28.68) 0612312000 3 Service 97014 ELECTRIC STIM MOD 1/MORE UNAT $32.00 07/2512000 3 Adjustment 7 ADJ OFF ACT 6 (PI) ($16.32) 07/25/2000 3 Ins Payment Check ALLSTATE INSURANCE ($15,68) $0.0 Continue '~-,~-;''' .. MADEIRA CHIROPRACTIC P.C. .-1124 KENNEBEC DRIVE CHAMBERSBURG, PA, 17201 Phone: (717) 263-8919 Fax: Detailed Account History Page # 3 Printed: 08/14/2000 :,'ii~)-' -, ,P' ~.-'- .' MADEIRA CHIROPRACTIC P,C, 1124 KENNEBEC DRIVE "CHAMBERSBURG, PA, 17201 Phone: (717) 263-8919 Fax: Detailed Account History Page # 4 Printed: 08/14/2000 4986 DELGRANDE, KATHY Case: PI AUTO Svc Date Pvdr Type Code Description Amount Balance Continued 07/05/2000 3 Service 98940 CMT ONE REGION $30.00 07/29/2000 3 Adjustment 7 ADJ OFF ACT 6 (PI) ($1.32) 07/29/2000 3 Ins Payment Check ALLSTATE INSURANCE ($28.68) $0,00 07/05/2000 3 Service 97012 MECHANICAL TRACTION MOD 1/MOR $35.00 07/29/2000 3 Adjustment 7 ADJ OFF ACT 6 (PI) ($16.53) 07/29/2000 3 Ins Payment Check ALLSTATE INSURANCE ($18.47) $0.00 07/05/2000 3 Service 97014 ELECTRIC STIM MOD 1/MORE UNAT $32.00 07/29/2000 3 Adjustment 7 ADJ OFF ACT 6 (PI) ($16.32) 07/29/2000 3 Ins Payment Check ALLSTATE INSURANCE ($15.68) $0.00 07/06/2000 3 Service 98940 CMT ONE REGION $30.00 07/29/2000 3 Adjustment 7 ADJ OFF ACT 6 (PI) ($1.32) 07/29/2000 3 Ins Payment Check ALLSTATE INSURANCE ($28.68) $0.00 07106/2000 3 Service 97012 MECHANICAL TRACTION MOD 1/MOR $35.00 07/29/2000 3 Adjustment 7 ADJ OFF ACT 6 (PI) ($16.53) 07/29/2000 3 Ins Payment Check ALLSTATE INSURANCE ($18.47) $0.00 07/06/2000 3 Service 97014 ELECTRIC STIM MOD 1/MORE UNAT $32.00 07/29/2000 3 Adjustment 7 ADJ OFF ACT 6 (PI) ($16.32) 07/29/2000 3 Ins Payment Check ALLSTATE INSURANCE ($15.68) $0.00 07/06/2000 3 Product PILLOW CX PILLOW $35.00 07/29/2000 3 Adjustment 7 ADJ OFF ACT 6 (PI) ($7.00) 07/29/2000 3 Ins Payment Check ALLSTATE INSURANCE ($28.00) $0,00 07/12/2000 3 Service 98940 CMT ONE REGION $30.00 $30.00 07/12/2000 3 Service 97014 ELECTRIC STIM MOD 1/MORE UNAT $32.00 $32.00 07/12/2000 3 Service 97012 MECHANICAL TRACTION MOD 1/MOR $35,00 $35.00 07/13/2000 3 Service 98940 CMT ONE REGION $30.00 $30,00 07/13/2000 3 Service 97014 ELECTRIC STIM MOD 1/MORE UNAT $32.00 $32,00 07/13/2000 3 Service 97012 MECHANICAL TRACTION MOD 1/MOR $35.00 $35.00 07/14/2000 3 Service 98940 CMT ONE REGION $30.00 $30,00 Continued '~!}~:,"_JL_ "___",__,'':'''~:;.7 ." ,-". - , I '1'- '-'",--, -,,""-'-- ?'~:ir~.' ~ .~c_ ,.-,' - ., ~' MADEIRA CHIROPRACTIC P.C, 1124 KENNEBEC DRIVE "CHAMBERSBURG, PA, 17201 Phone: (717) 263.8919 Fax: Detailed Account History Page # 5 Printed: 08/14/2000 4986 DELGRANDE, KATHY Case: PI AUTO Svc Date Pvdr Type Code DescripHon Amount Balance Continued 07/14/2000 3 Service 97012 MECHANICAL TRACTION MOD 1/MOR $35.00 $35.00 07/14/2000 3 Service 97014 ELECTRIC STIM MOD 1/MORE UNAT $32,00 $32,00 07/18/2000 3 Service 98940 CMT ONE REGION $30.00 $30.00 07/18/2000 3 Service 97012 MECHANICAL TRACTION MOD 1/MOR $35.00 $35,00 07/18/2000 3 Service 97014 ELECTRIC STIM MOD 1/MORE UNAT $32.00 $32.00 07/19/2000 3 Service 99213 E/M EST PT. EXPANDED PROBLEM $56.00 $56.00 07/19/2000 3 Service 97012 MECHANICAL TRACTION MOD 1/MOR $35.00 $35,00 07/19/2000 3 Service 97140 MANUAL THERAPY TECHNIQUES $35.00 $35.00 07/19/2000 3 Service 97535 SELF CARE/HM MGMT TNG (ADL'S) $35.00 $35.00 07/20/2000 3 Service 99212 E/M EST PT PROBLEM FOCUSED S/ $42,00 $42.00 07/20/2000 3 Service 97140 MANUAL THERAPY TECHNIQUES $35.00 $35.00 07/20/2000 3 Service 97014 ELECTRIC STIM MOD 1/MORE UNAT $32.00 $32,00 07/21/2000 3 Service 99213 E/M EST PT. EXPANDED PROBLEM $56.00 $56,00 07/26/2000 3 Service 98940 CMT ONE REGION $30.00 $30,00 07/26/2000 3 Service 97014 ELECTRIC STIM MOD 1/MORE UNAT $32.00 $32.00 07/26/2000 3 Service 97012 MECHANICAL TRACTION MOD 1/MOR $35.00 $35.00 08/08/2000 3 Service 99213 ElM EST PT. EXPANDED PROBLEM $56,00 $56.00 08/08/2000 3 Service 97140 MANUAL THERAPY TECHNIQUES $35.00 $35,00 Total Case Balance: $902.00 ~,i<!f~I1J~.,,,,,', Y"":_:--'-~".-_"'_~~_ "~, -.' --~,".' ,~,> ~." 1"'" .' 'I --'-',' - - -~ , - " - - ~- - - ~ '-"{ .~ Detailed Account History Page # 1 Printed: 10/12/2000 MADEIRA CHIROPRACTIC P.C, 1124 KENNEBEC DRIVE "CHAMBERSBURG, PA, 17201 Phone: (717) 263-8919 Fax: 4986 DELGHANDI:, KA J HY Case: PIAUJO 504 BRENTON ST. Primary Ins: ALLSTATE INSURANCE Secondary Ins: SHIPPENSBURG. PA. 17257 Tertiary Ins: Account Balance Summary Ins Balance pt, Balance UnBilled Bal Unapp pt Pmt Bal $198.00 $67,00 $0.00 $0.00 Activity from 08/08/00 To 10/12/00 Svc Date Pvdr Type Code Description Amount Balance Balance of Items Prior to 08/08/00 $67.UO $67.00 08/08/2000 3 Service 99213 ElM EST PT. EXPANDED PROBLEM $56.00 09/05/2000 3 Ins Payment Check ALLSTATE INSURANCE ($49.70) 09/05/2000 3 Adjustment 7 ADJ OFF ACT 6 (PI) ($6.30) $0.00 08/08/2000 3 Service 97140 MANUAL THERAPY TECHNIQUES $35.00 09/05/2000 3 Ins Payment Check ALLSTATE INSURANCE ($28.14) 09/05/2000 3 Adjustment 7 ADJ OFF ACT 6 (PI) ($6.86) $0.00 08/16/2000 3 Service 98940 CMT ONE REGION $30.00 09/05/2000 3 Adjustment 7 ADJ OFF ACT 6 (PI) ($1.32) 09/05/2000 3 Ins Payment Check ALLSTATE INSURANCE ($28.68) $0.00 08/16/2000 3 Service 97014 ELECTRIC STIM MOD 1/MORE UNAT $32.00 09/05/2000 3 Adjustment 7 ADJ OFF ACT 6 (PI) ($16.32) 09/05/2000 3 Ins Payment Check ALLSTATE INSURANCE ($15.68) $0.00 08/17/2000 3 Service 98940 CMT ONE REGION $30,00 09/05/2000 3 Adjustment 7 ADJ OFF ACT 6 (PI) ($1.32) 09/05/2000 3 In~ Payment Check ALLSTATE INSURANCE ($28.68) $0.00 08/1712000 3 Service 97014 ELECTRIC STIM MOD 1/MORE UNAT $32.00 09/05/2000 3 Adjustment 7 ADJ OFF ACT 6 (PI) ($16.32) 09/05/2000 3 Ins Payment Check ALLSTATE INSURANCE ($15.68) $0.00 08/25/2000 3 Product RECORD MEDICAL RECORDS $30.00 08/25/2000 3 Adjustment 21 ADJ OFF PER DR AGREEMENT ($5.00) 08/25/2000 3 Pl.Pmt Check DELGRANDE. KATHY ($25.00) $0.00 08/29/2000 3 Service 99213 ElM EST PT. EXPANDED PROBLEM $56.00 10/02/2000 3 Ins Payment Check ALLSTATE INSURANCE ($49.70) 1 0/02/2000 3 Adjustment 7 ADJ OFF ACT 6 (PI) ($6.30) $0.00 Continued '"1&:' -, .. Detailed Account History Page # 2 Printed: 10/12/2000 MADEIRA CHIROPRACTIC P,C. 1124 KENNEBEC DRIVE "CHAMBERSBURG, PA, 17201 Phone: (717) 263-8919 Fax: 4986 DELGRANDE, KATHY Case: PI AUTO Svc Date Pvdr Type Code Description Amount Balance Conlinued 08/29/2000 3 Service 97110 THERAPEUTIC EXERC ROM 15 MIN $100.00 10/0212000 3 Ins Payment Check ALLSTATE INSURANCE ($49.63) 10/0212000 3 Adjustment 7 ADJ OFF ACT 6 (PI) ($50.37) $0.00 08/29/2000 3 Service 97112 THERAP NEUROMUSC REED 1/MORE $42.00 1 0/0212000 3 Ins Payment Check ALLSTATE INSURANCE ($25.94) 10/02/2000 3 Adjustment 7 ADJ OFF ACT 6 (PI) ($16.06) $0,00 09/21/2000 3 Service 99213 E/M EST PT, EXPANDED PROBLEM $56.00 $56.00 09/21/2000 3 Service 97110 THERAPEUTIC EXERC ROM 15 MIN $100.00 $100.00 09/21/2000 3 Service 97112 THERAP NEUROMUSC REED 1/MORE $42.00 $42.00 Total Case Balance: $265.00 J-?l\W~lI ,.,-, , I'" - 1-'--- -~ - . - ,;~,,- ALL CHARGES/PAYMENTS I T MIZED STATEMl.JT .. CLAIM: DATE: 02/02/2000 IRS#: 232694750 PATIENT: KATHY DELGRANDE 102552 504 BRENTON SHIPPENSBURG PA 17257 SS#209-60-4571 POL#1553597367 DATE/INJ: 11/01/1999 GRP# EMPLOYER: SELF TO: ALLSTATE INSURANCE CO 6345 FLANK DR SUITE 1000 HARRISBURG PA 17112 KEYSTONE SPINE CENTER, INC. 1521 CEDAR CLIFF DR CAMP HILL PA 17011 717/730-9520 Fax:717/730-9929 DIAGNOSIS: 724.3 SCIATICA 723.3 CERVICOBRACHIAL SYNDROME 723.2 CERVICOCRANIAL SYNDROME Fe: PER-INJURY DATE OF LAST BILL: 02/02/2000 ID# SI162217 =~=====~======================================================================= DATE CPT DESCRIPTION * POS TOS # AMOUNT =~============================================================================= 11/22/1999 97001 WC/MVA INITIAL EVAL * 11 1 56.00 11/22/1999 97110 THER EX * 11 1 25.00 11/22/1999 97112 NEURO RE-ED * 11 1 25.00 11/22/1999 97530 THER ACT * 11 1 25.00 11/22/1999 99070 LUMBAR-CERV ROLL * 3 1 15.00 11/23/1999 97110 THER EX * 11 1 25.00 11/23/1999 97530 THER ACT * 11 1 25.00 11/23/1999 97112 NEUROMUSCULAR RE-EDU * 11 1 25.00 12/01/1999 97110 THER EX * 11 1 25.00 12/01/1999 97530 THER ACT * 11 1 25.00 12/01/1999 97112 NEUROMUSCULAR RE-EDU * 11 1 25.00 12/17/1999 97110 THER EX * 11 1 25.00 12/17/1999 97530 THER ACT * 11 1 25.00 12/17/1999 97112 NEUROMUSCULAR RE-EDU * 11 1 25.00 12/30/1999 97530 THER ACT. * 11 1 25.00 12/30/1999 97140 JOINT MOB. * 11 1 35.00 12/30/1999 97110 THER EX * 11 1 25.00 01/17/2000 97110 THER EX 11 1 28.00 01/17/2000 97530 THER ACT 11 1 28.00 01/17/2000 97112 NEUROMUSCULAR RE-EDU 11 1 28.00 01/17/2000 A9999 NIGHT ROLL 11 1 30.00 02/02/2000 97110 THER EX 11 1 28.00 02/02/2000 97112 NEUROMUSC RE-EDUCATION 11 1 28.00 12/10/1999 PAYMENT IN INS CK# 4233939 #111217 -136.47 12/10/1999 ADJUST IA FORGIVE #111217 -9.53 12/10/1999 PAYMENT IN INS CK# 4233939 #111229 -68.47 CONTINUED ==============================================================~================ SUBTOTAL: 411. 53 Page 1 :,;t".. A~L CHARGES/PAYMENTS I T MIZED S TAT E M 1. .l T ~ CLAIM: DATE: 02/02/2000 IRS#: 232694750 PATIENT: KATHY DELGRANDE 102552 504 BRENTON 8HIPPENSBURG PA 17257 88#209-60-4571 POL#1553597367 DATE/INJ: 11/01/1999 GRP# EMPLOYER: SELF TO: ALL8TATE INSURANCE CO 6345 FLANK DR SUITE 1000 HARRISBURG PA 17112 KEYSTONE SPINE CENTER, INC. 1521 CEDAR CLIFF DR CAMP HILL PA 17011 717/730-9520 Fax:717/730-9929 DIAGNOSIS: 724.3 SCIATICA 723.3 CERVICOBRACHIAL SYNDROME 723.2 CERVICOCRANIAL SYNDROME FC: PER-INJURY DATE OF LAST BILL: 02/02/2000 ID# SI162217 ============================================================================~== DATE CPT DESCRIPTION * POS TOS # AMOUNT =============================================================================== 12/10/1999 ADJUST IA FORGIVE #111229 -6.53 12/13/1999 PAYMENT IN INS CK# 04239073 #111330 -68.47 12/13/1999 ADJUST IA FORGIVE #111330 -6.53 12/30/1999 PAYMENT IN INS CK# 04253539 #111507 -68.47 12/30/1999 ADJUST IA FORGIVE #111507 -6.53 01/11/2000 PAYMENT IN INS CK# 4262586 #111620 -69.28 01/11/2000 ADJUST IA FORGIVE #111620 -15.72 ================================~===========================================~== PROVIDER: GREGORY SILVA PT9907L TOTAL:' $ BALANCE 02/02/2000: $ 170.00 170.00 P age 2 P AlCC/JN=CshlCCllns. payrnnt, CRlDE~Credit/Debit, IA~Ins adj; *~Ins Pd ,:t:,,'~' . ~,~, ALL CHARGES/PAYMENTS ,. I T M I ZED STAT EMF "T , CLAIM: DATE: 05/08/2000 IRS#: 232694750 PATIENT: KATHY DELGRANDE 102552 504 BRENTON SHIPPENSBURG PA 17257 SS#209-60-4571 POL#1553597367 DATE/INJ: 11/01/1999 GRP# EMPLOYER: SELF TO: ALLSTATE INSURANCE CO 6345 FLANK DR SUITE 1000 HARRISBURG PA 17112 KEYSTONE SPINE CENTER, INC. 1521 CEDAR CLIFF DR CAMP HILL PA 17011 717/730-9520 Fax:717/730-9929 DIAGNOSIS: 724.3 SCIATICA 723.3 CERVICOBRACHIALSYNDROME 723.2 CERVICOCRANIAL SYNDROME FC: PER-INJURY DATE OF LAST BILL: 03/06/2000 ID# SI162217 =============================================================================== DATE CPT DESCRIPTION * POS TOS # AMOUNT =============================================================================== 11/22/1999 97001 WC/MVA INITIAL EVAL * 11 1 56.00 11/22/1999 97110 THER EX * 11 1 25.00 11/22/1999 97112 NEURO RE-ED * 11 1 25.00 11/22/1999 97530 THER ACT * 11 1 25.00 11/22/1999 99070 LUMBAR-CERV ROLL * 3 1 15.00 11/23/1999 97110 THER EX * 11 1 25.00 11/23/1999 97530 THER ACT * 11 1 25.00 11/23/1999 97112 NEUROMUSCULAR RE-EDU * 11 1 25.00 12/01/1999 97110 THER EX * 11 1 25.00 12/01/1999 97530 THER ACT * 11 1 25.00 12/01/1999 97112 NEUROMUSCULAR RE-EDU * 11 1 25.00 12/17/1999 97110 THER EX * 11 1 25.00 12/17/1999 97530 THER ACT * 11 1 25.00 12/17/1999 97112 NEUROMUSCULAR RE-EDU * 11 1 25.00 12/30/1999 97530 THER ACT. * 11 1 25.00 12/30/1999 97140 JOINT MOB. * 11 1 35.00 12/30/1999 97110 THER EX * 11 1 25.00 01/17/2000 97110 THER EX * 11 1 28.00 01/17/2000 97530 THER ACT * 11 1 28.00 01/17/2000 97112 NEUROMUSCULAR RE-EDU * 11 1 28.00 01/17/2000 A9999 NIGHT ROLL * 11 1 30.00 02/02/2000 97110 THER EX 11 1 28.00 02/02/2000 97112 NEUROMUSC RE-EDUCATION 11 1 28.00 02/24/2000 97110 THER EX * 11 1 28.00 02/24/2000 97112 NEUROMUSC RE-EDUCATION * 11 1 28.00 03/06/2000 97110 THER EX * 11 1 28.00 03/06/2000 97530 THER ACT * 11 1 28.00 CONTINUED =============================================================================== SUBTOTAL: 738.00 Page 1 t*'''~.,-,,;."." '- ,', ' AJ~L CHJL~GES/PAYMENTS I T M I ZED STATEMF'T . CLAIM: DATE: 05/08/2000 IRS#: 232694750 PATIENT: KATHY DELGRANDE 102552 504 BRENTON SHIPPENSBURG PA 17257 S8#209-60-4571 POL#1553597367 DATE/INJ: 11/01/1999 GRP# EMPLOYER: SELF TO: ALLSTATE INSURANCE CO 6345 FLANK DR SUITE 1000 HARRISBURG PA 17112 KEYSTONE SPINE CENTER, INC. 1521 CEDAR CLIFF DR CAMP HILL PA 17011 717/730-9520 Fax:717/730-9929 DIAGNOSIS: 724.3 SCIATICA 723.3 CERVICOBRACHIAL SYNDROME 723.2 CERVICOCRANIAL SYNDROME FC: PER-INJURY DATE OF LAST BILL: 03/06/2000 ID# SI162217 =============================================================================== DATE CPT DESCRIPTION * POS TOS # AMOUNT =============================================================================== 03/06/2000 97112 NEUROMUSCULAR RE-EDU * 11 1 28.00 12/10/1999 PAYMENT IN INS CK# 4233939 #111217 -136.47 12/10/1999 ADJUST IA FORGIVE #111217 -9.53 12/10/1999 PAYMENT IN INS CK# 4233939 #111229 -68.47 12/10/1999 ADJUST IA FORGIVE #111229 -6.53 12/13/1999 PAYMENT IN INS CK# 04239073 #111330 -68.47 12/13/1999 ADJUST IA FORGIVE #111330 -6.53 12/30/1999 PAYMENT IN INS CK# 04253539 #111507 -68.47 12/30/1999 ADJUST IA FORGIVE #111507 -6.53 01/11/2000 PAYMENT IN INS CK# 4262586 #111620 -69.28 01/11/2000 ADJUST IA FORG IVE #111620 -15.72 02/10/2000 PAYMENT IN INS CK# 04292355 #111778 -92.47 02/10/2000 ADJUST IA FORGIVE #111778 -21.53 02/21/2000 PAYMENT IN INS CK# 04301010 #111906 -50.76 02/21/2000 ADJUST IA FORGIVE #111906 -5.27 03/30/2000 PAYMENT IN INS CK# 04338233 #112129 -50.76 03/30/2000 ADJUST IA FORGIVE #112129 -5.24 03/30/2000 PAYMENT IN INS CK# 04338234 #112217 -75.17 03/30/2000 ADJUST IA FORGIVE #112217 -8.83 05/08/2000 ADJUST IA ERROR ADJ. 0.03 =============================================================================== PROVIDER: GREGORY SILVA PT9907L TOTAL: $ BALANCE 05/08/2000: $ 0.00 0.00 Page 2 PA/CC/IN={;sh/CCllns, paymnt, CR/DE~CreditIDebit; lA~lns adj; *=lns Pd ;"Y~,~-"J-t;!",w__ -;''',.;~!",...-';'' - - '-"'" . ~I--' t-- - ft , , ~.- .'k~ . OSL DB~\ ORTH INSTITUTE OF P~\ 875 POPLAR CHURCH RORD CAMP HILL PR 17011 717~~761-~5530 Ti=IX ID #: 23--187;:;5,,7 iZi2-1Z17-.ll.liZl PATIENT, 1&3327 DELGRANDE .KRTHY L p{n BAL: ms BAL, OTH BAL, .00 ..0iZi .~i0 ------------------------------------------------------------------------------ SERV DATE C INV RP S DR PROC DESC INS A COt'1t~ENT CO C'tH\ PL LINE INVOICE RUNNING AMOUNT B(-,\LANCE BHLJ\NCE 110'::J')9 3 ;:::8 1 3'1 '1 '1 f:0', OFFICE OUT ',::; 1 Y 04 1;:::0.00 1;:::0.0121 fmNALD W LIPPE I"ID DIAG: 8,,7.0 84&.0 E816.1- 0118iZ10 3 28 1 AUTO i'iUTO ALLSTI-'\TE 1- ilo5 -,117.81 2.1'l iZl1i80.) 3 28 1 i=IADJ' AUTO AD.]' 1- 05 --;:::.19 .00 .00 ,-----------,,--------,------------------,--- END OF PATIENT HISTORY --------------,,--------------------------------- ... TOTALS .... CHAFmES: 1;:::0.00 PAYi"lENTS: - 11 -1.81 ADJUSTS: --2.1'3 ===~=================~======================================================== lliZI9'1,;) 1 28 1 35 CU-'\TE CHGE Lf~rER 0", .00 .00 JOHN R FRANf\ENY II 1"1 DH-\G: 110999 2 28 1 35 90000 OC ERFm 04 .00 .0(1 JOHt~ R FRI'iNKEN\/ II j\1 rm-'\G: 847.0 846.0 E816.1 013100 'I' ;:::8 1- 35 CLATE CHGE UHER ~ii .00 .00 JOHN R FR(-,\NKENY II M DH\G: ,--------------,----------_._,,-- E:ND OF OTHER HISTORY ----------,------------------------------------ .n TOTRLS "H. CHARGES: .00 PAYt~r::NTS: .00 ADJUSTS, .00 .00 .00 .00 ==========~==========~===================================================~==== fl ~ > OSL DB,,! ORTH INSTITUTE OF PA 3916 TRINDLE HOAD CAt4P HILL PA 17011 717-761.-5~::i30 TAX ID #: 23-1875547 it.IE.\-'c:1-il.~0 PATIENT: 163327 DEU3RANDE ,KATHY L PAT BAL: Ii% BAL: OTH BAL: ------------------------------------------------------------------------------ .00 .iLl.~ .11)0 SERV C Df'iTE IN'J i:,P S DR PHOC DESC INS A COMMENT CO C#A PL LINE INVOICE RUNNING AMOUNT BALANCE BALANCE ------------------------------------------------------------------------------ 1Y 04 1;~:0.00 110',99 3 213 1 39 ',92ill', OFFICE OUT 45 RONALD "j LIPPE ~1D DIAG: 847.0 EV+6.0 E8H,.1 011130ill 3 213 1 AUTO AUTO ~iLLSTr-'iTE ..111800 3 28 1 >'+ADJ AUTO ADJ 013100 5 28 1 35 99213 OFFICE OUT 45 JOHN R FRANKENY II M DIAG: iV,7..) 846.0 E816.1 030800 5 ;?8 1 COi'lP CO~IP PAY ALLSTI'iTE 03121800 5 28 1 AADJ ,-iUTO ADJ 041700 7 28 1 35 99213 OFFICE OUT JOHN R FRANKEt-iY II ~j DInG: 846.0 E816.1 iZ15;?60iZl 'l 213 1 AUTO AUTO ALLSTATE..:; 05 -'1.9.70 iZ15;:::E:.e'0 7 28 1 AAD,! AUTO ADJ .~ 05 -.30 .00 .--.....-----.-----.--.--.----.-------- END OF PATIENT HISTOi~Y ------.--.-----------.-..--....-..-.-....--- ... TOTALS ''', CHARGES, 220.00 PAY~jENTS: - 217.21 ADJUSTS: 1 l --1:l7.B1 -2~1 '3 50.00 .00 1Z15 05 2'V !Zi1 .'~, "- IZi~5 1115 -49.70 ~~ .31[) 50.\)0 .00 2 4::-; 3Y 01 H,0.0\) 2.19 .00 ,30.011) ,,3121 .iL10 50 a iZllZi a30 .00 -,?'.'79 ============================================================================== 110999 1 213 1 35 CLATE CHGE LATER JOHN R FRANKENY II ~j DH'!G: 110999 2 28 1 35 90000 DC ERRO JOHN R f'- i~I'iNHENY II N DIi'iG: 1,',7.0 13'+6.0 E816. 1 ,,-'L3J.il)ili 1+ ,:::8 1. 3~:; CU'iTE CHGE UnER J'I]HN R FRANKENY II t4 DIAG, iZI4.170.) E, ,:::8 1. 2;5 CUnE CHGE LATER JOHN R FRi4NI"ENY II ~1 OIAG, 846.0 .--...---.---------.--------- END Or- OTHER HISTDFa -.---..--.---.......-.--...-------..--.---------- ... 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J. r.R.!: l'l.!:.N. ~ ,:;;;, ~ .t..i.'i..l.J U. wlh.t.,n J"!..1.:J1W.Ki .-U L AL~ ,.,. -;or", t ,-,.I:i Pd"'_w c..::., : :';It.J. ~ \0\,0 '"' v...!..J_ ---1:.;. f 0.::.). -.~ .'<::J~ .<U," .w'"' .~l..; -:.J\i::J..lLJl4I - - - . -- . - - ~ .. . -- -- - ." -- - - - - - ., - ,-- --------------------------~-------------------------------------------------.-- ~ 1.()1.Ll .l.o/ .'::I.L "".... o.r:J';'.t '.r,J.J,. 06.1.. ..)1 ill. r\.Li....U0i.:J~ ,ll..P.:'l .<o::.J'-" .<lrll.' .\(.1\:..1 .100 .0'<tJ J!LJ."-'~ ..J1iJ.:41l.Ll .<c:.I\lJ' ......l..IJW.::, ~.::>: "c,~ .}2/1:-/99 PAGE 1 THE CHAMBERSBURG HOSPITAL PO BOX 897 - ACCOUNTING CHAMBERSBURG PA 17201 PATIE:NT NAME DEL GRANDE, KATHY L FEDERAL ID 23-0465970 PAT.NO 2666600 FC BIR DATE 14 01/17/65 ADM DATE 11/04/99 DISCH DATE 11/04/99 TO: TYPE 2 O/P FINAL BILLED DEL GRANDE, KATHY L 504 BRENTON SHIPPENSBURG, PA 17257 INSURANCE 'A' ALLS~ATE INSURANCE CO ALLS~ATE INSURANCE CO HARR~SBURG, PA 17112 CERT# 1553597367 INSURANCE 'B' INSURANCE 'c' CV CI) NO INFO P-HLl) DEL GRANDE, KA.THY L CODE REF SRV DT CHARGE DESCRIPTION QTY PRICE TOTAL PREV BILL DT 11/10/99 1561.00 FLEOI-CIO 11/04/99 CYCLOBENZAPRlNE TAB 10MG (FLEXER 1 1.00 1.00 MOT03-CIO 11/04/99 IBUPROFEN TAB (f-1OTRIN) 600MG 1 1.00 1.00 62050-PHO 11/04/99 CERVICAL SPINE 1 259.00 259.00 62lIO-PHO 11/04/99 L-8 SPINE AP,LAT,OBLIQUES & SPOT 1 256,00 256.00 60450-PHO 11/04/519 HEAD UNENHANCED 1 697.00 697.00 06553-511 11/04/5151 CATEGORY D EXTENDED 1 .00 .00 01101-511 11/04/5151 ER SURGERY/TREATMENT RM 1ST 1/2 1 104.00 104.00 01077-513 11/04/99 PHYS COMPREHENSIVE EXAM 1 243.00 243.00 08261-316 11/17/99 PA AUTO INS OP WRITE-OFF -1 1110,60 -1110.60 TOTAL CHARGES 450.40 TOTAL CHARGES 450.40 TOTAL PAYMENTS .00 . * *" * NET TOTAL 450.40 1"-~~~,,~l1!-, ,---~^ . 0, _ ~, "---' -."- ""' I-~' ~,." 0<-'1 <,. o ~. '~:J;; 12./13/99 -. PAGE 2 THE CHAMBERSBURG HOSPITAL PO BOX 897 - ACCOUNTING CHAMBERSBURG PA 17201 FEDERAL ID 23~0465970 PAT.NO 2666600 FC BIR DATE 14 01/17/65 ADM DATE 11/04/99 DISCH DATE 11/04/99 PATIEN'l: NAME DEL GRANDE, KATHY L TYPE 2 o/p FINAL BILLED * * * ~V SUMMARY TOTALS NRV DESCRIPTION TOTAL 250 PHARMACY~GENERAL 2.00 320 RADIOLOGY-GENERAL 515.00 351 CT SCANS -HEAD SCAN 697.00 450 EMERGENCY ROOM~GENERAL 104.00 981 PROFESSIONAL FEES-EMER 243.00 C01 ADJUSTMENTS -1110.60 . . . * NET TOTAL 450.40 '-,;I,m", " '( ;"~," "1"1" ~ _HE CHAMBERS BURG HOSPITAL PO BOX 897 CHAMBERSBURG, PA 17201 DEL GRANDE, KATHY L 14 266660-0 01/17 /65 TO: KATHY L DEL GRANDE 504 BRENTON 11/04/99 DETAIL STATEMENT D 11/04/99 OUTPATIENT FINAL SHIPPENSBURG, PA 17257 DOCTOR: SENECAL MD E, KEITH E MD030857E INSURANCE 'A' ALLSTATE INSURANCE CO DEL GRANDE, KATHY L CERT# 1553597367 INSURANCE 'B' INSURANCE 'C' CODE 959.01 784.0 DIAGNOSIS HEAD INJURY NOS HEADACHE CODE SURGERY DESCRIPTION CODE REF FLEOI-CIO MOT03-CIO SRV DT 11/04/99 11/04/99 CHARGE DESCRIPTION CYCLOBENZAPRINE TAB 10MG (FLEXERIL) IBUPROFEN TAB (MOTRIN) 600MG 250 PHARMACY-GENERAL 62050-PHO 11/04/99 CERVICAL SPINE 72050 62110-PHO 11/04/99 L-S SPINE AP,LAT,OBLIQUES &72110 320 RADIOLOGY-GENERAL 60450-PHO 11/04/99 HEAD UNENHANCED 70450 351 CT SCANS-HEAD SCAN 06553-511 11/04/99 CATEGORY D EXTENDED 01101-511 11/04/99 ER SURGERY/TREATMENT RM IS99281 450 EMERGENCY ROOM-GENERAL 01077-513 11/04/99 PHYS COMPREHENSIVE EXAM 99285 981 PROFESSIONAL FEES-EMER ROOM TOTAL CHARGES TOTAL PAYMENTS * * * * NET TOTAL ',0<-0'-- , ~- U_'_'. 'I_'F"<___' _ - -I ::- , .O"v;""", QTY 1 1 PRICE 1. 00 1. 00 1 1 259.00 256.00 1 697_00 1 1 _00 104.00 1 243.00 "'.' ._~-- . PAGE 1 TOTAL 1.00 1.00 2.00 259.00 256_00 515.00 697_00 697.00 .00 104.00 104.00 243.00 243.00 1561. 00 .00 1561. 00 .''ii:i! q 163 Z ERa B A L. g C E 03/05/00 . PATIENT NUMBER PATIENT NAME PAT TYPE FIC CRD STMT CD GRP NUM STMTS DISCHARGE B/D DATE ACCT REP 266660-0 KATHY L DEL GRANDE 2 14 2 1 1 11/04/99 KATHY L DEL GRANDE 504 BRENTON SHIPPENSBURG, PA 17257 (717) 530-9566 PATIENT INFORMATION: ADM FC 14 SEX FRACE W MAR ST M SNN 209-60~4571 DIS ST 01 CNTY 999 AceT REP M/R# 523057 DR# 30857 SENECAL MD E, KEITH E DaB 01/17/65 R&B DAYS 0000 ADM DT 11/04/99 LST STMT DT 00/00/00 RESPONSIBLE PARTY INFORMATION *** CHARGES *** POSTING DATE CHARGE CODE SERVICE DATE REFERENCE BAT TECHNICAL DESCRIPTION AMOUNT FINAL BILL AMOUNT 11/17/99 316 08261 11/17/99 316 PA AUTO INS OP WRITE~O 01/05/00 020 08314 01/05/00 AALLSTA_TE 020 AUTO INSURANCE PAYMENT 01/05/00 020 08261 01/05/00 AAUTO-PA 020 PA AUTO INS OP WRITE-O TOTALS 1561.00 1110.60- 616.01- 165.61 0.00 *** CREDIT NOTES *** MESSAGE ENTRY DATE ACTION DATE FINAL BILL 1561.00 BILLED ALLSTATE $450.40 PER ATTY ANGINO REQ. ITEMIZED STATEMENT TO BE MAILED SENT REQ. TO MEDICAL RECORDS 11/10/99 11/17/99 12/13/99 12/13/99 12/13/99 11/10/99 11/17/99 12/13/99 12/13/99 12/13/99 -"_~!Fi'-_~ -"~'-'-_1d"- ,~_" -~ ~,' -"~~'_'__I_:_ -.'P~ .~ t- ~ GUARANTOR A/R SUMMARY BL PV: GU: 00000314917 DELGRANDE HOME: 717-530-9566 WORK: CHS01 KATHY EXT: 07/17/02 1408 DEST OV: N DEATH IND: N GU BL HOLD: N BPO: ~------------------------------------------------------------------------------- "REP: *DL: 0 *CR: RESP LAST BL LAST PAY BALANCE UNPST PAY 'BPO: _ *HLD: *DEST: B78 012202 .00 .00 TRGF: STS: FC: S K201 071502 128_00 .00 LST FA DT: CD: GUAR 070602 071602 _00 .00 BUS: 0 NAN: 0 TRM: NxT FA DT: TM: ED DT 08/11/02 BD STS: P PREPAY .00 TOT 128.00 AMT: .00 PRG PAY .00 CONTRACT *STS: DT: 'DEL: *AGCY: GU LST PAY 10.00 *EFF DT *SCHED PAY *MAX BAL *BD HLD: GU PAY SNC BL 20_00 'MSG 'ACT CL DESC OV DT_/_/ BD XFR XFR TO ____ TXN CD DB COM TIME PF1 INQ MENU PF5 DTL SUMM* PF10 GU/INS FIN ACT PF14 NEXT RESP PF2 GU DEMO PF6 OPEN ITEMS PF11 GU CASE LIST PF15 RETURN/CANCEL PF3 GU PV LIST PF7 CONTRACT LETTER PF12 REVISE DEMO: G PF4 CMNT/MSGS PF8 A/R ACTIVITY PF13 UPDT TARG FILES PF9 DMND BILL* G PRESS ENTER TO UPDATE NPARGSOO CENTRAL BILLING OFFICE P.O. BOX 1286 HARRISBURG, PA 17108-1286 '?'~ .. ~~- / 1','T_ DTL SUMMARY PT: 00209604571 DELGRANDE KATHY 07/17/02 1404 GU 00000314917 CA 209604571 OP RECUR MED TOTAL 128.00 COV/AMT SCHM 1 BL PV CHS01 IQ PV GUR 8 B78 0 V K201 1 V _00 _00 128 _ 00 LINE# DOS SVC CD DESC BATCH# DTL# POS TOT AMT TYPE DOE PV DX BPO QTY INV# RESP RESP-TO RESP AMT 1 12/27/01 99203 OFFICE VISIT NEW PT 44363 1 11 80_00 01/22/02 02097 530.11 1 202200231 B78 .00 BD P SUP #RESP PTY 3 216500137 K201 .00 2 04/12/02 9994208 NON-PAYMENT TRANSFER 99540 1 80.00 04/13/02 02097 202200231 B78 GUR 80.00 BD SUP #RESP PTY 0 3 02/06/02 155 FORWARD TO KHP 71236 2 _00 05/03/02 02097 GUR .00 BD SUP #RESP PTY 0 4 06/14/02 300 TRANSFER TO INSURANC 81302 3 80.00 06/14/02 CHS01 GUR K201 80.00 BD SUP #RESP PTY 0 PF1 INQ MENU PF2 GU CA LST PF3 CA PV LST NPARDLOO PF7 CS LVL DTLS PF8 GU LVL PRPY PF9 ADDL FIELD PF13 PT INV LST PF16 BDEBT TRAN PF14 PAGE BACK *LN#: PF15 RETURN *ENTER NXT LN 5 PF4 RESP PRTY PF5 CHGE DTLS PF6 PYMT DTLS DTL SUMMARY PT: 00209604571 DELGRANDE GU 00000314917 CA 209604571 OP RECUR MED COV / ANT SCRM 1 GUR 8 B78 .00 DOS DOE 07/05/02 07/12/02 ':'~" ^ 'll'1,,_ to LINE# TYPE 5 6 07/08/02 07/15/02 7 07/05/02 07/12/02 8 07/16/02 07/16/02 DESC BATCH# DX BPO QTY INV# 99213 OFFICE VISIT EST PT 87817 02097 724.5 1 219300186 BD N SUP #RESP PTY 2 72110 XR SPINE LUMBOSACRAL 87834 02097 724_5 1 219600298 BD N SUP #RESP PTY 1 101 GUARANTOR COPAY PMT 02097 BD SVC PV o V .00 CD K201 1 V 128.00 87817 88403 KATHY 07/17/02 TOTAL CHSOl IQ PV 1407 128_00 SUP #RESP PTY o BL PV DTL# POS TOT ANT RESP RESP-TO RESP ANT 2 11 60_00 K201 .00 GURO _00 3 11 128.00 K201 128_00 4 -10.00 GUR -10_00 5 -10_00 GUR -10.00 -------------------------------------------------------------------------------- PFl INQ MENU PF2 GU CA LST PF3 CA PV LST NPARDLOO ,"."_m?li2;r[I~,~ ,'"-: eO_" , . PF4 RESP PRTY PF5 CHGE DTLS PF6 PYMT DTLS PF7 CS LVL DTLS PF8 GU LVL PRPY PF9 ADDL FIELD ,. 1- PF13 PT INV LST PF16 BDEBT TRAN PF14 PAGE BACK *LN#: PF15 RETURN *ENTER NXT LN 1 (^,,;..,;.,,"., ." ..--..1;- ... KATHY DELGRANDE, Plaintiff IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA v. CIVIL ACTION - LAW NO. 01-6185 VALLEY QUARRIES, INC., Defendant JURY TRIAL DEMANDED PLAINTIFF'S REPLY TO DEFENDANT'S NEW MATTER AND NOW come the Plaintiff, by and through her attorneys, Angino & Rovner, P.C., and hereby replies to the New Matter of Defendant as follows: 19. Denied. This averment is a conclusion of law to which no responsive pleading is required. To the extent that a response may be deemed proper, it is specifically denied that Plaintiff's Complaint fails to state a claim upon which relief may be granted. To the contrary, it is averred that Plaintiff's claim sufficiently sets forth a claim for negligence in the operation of a motor vehicle and creating a dangerous condition of the highway for which the named-Defendant is responsible. 20. Denied. This averment is a conclusion of law to which no responsive pleading is required. To the extent that a response may be deemed proper, it is specifically denied. Plaintiff's case arises out of a motor vehicle accident which occurred on November I, 1999 as set forth in Plaintiff's Complaint. Plaintiff filed suit by a Writ of Summons in Cumberland County on October 29,2001 and served on the Defendant on November 19,2001. Thus, Plaintiff's Writ of Summons was fIled within the two-year anniversary of the accident and served on the Defendant within 30 days as required by Pennsylvania statute and Rilles of Civil Procedure_ Thus, Plaintiff's claim was filed within the two-year statute of limitations provided by 42 Pa.C.S.A. ;l5524 pursuant to the Rilles of Civil Procedure for service. 241330.1IMEKIMMM .-'Jli;!ll!ll!l', ,.,'~~.., .,.~. " """.. - "":,+,,,", ^ ,,'"' ''''',p'~'''.' -,,"' _ ---~ ., .- " ",~_' ^'~. ,_ --J__;. ," _ 4 . ."-'.'"' e" ',., ,,"_.J' I - 'T~ ~~ iji'''' >~. 'L."" "~,.-_.' '1'1' .- .' - . '"" ~~.. " , . 21. Denied. This averment is a conclusion of law to which no responsive pleading is required. To the extent that a response may be deemed proper, it is specifically denied that the Doctrine of Assumption of the Risk or comparative or contributorily negligence applies. At that time of the accident, Plaintiff Kathy Delgrande was a passenger in a motor vehicle and had no responsibility or control over the motor vehicle that she was riding in. Plaintiff maintains, therefore, she cannot be held comparatively or contributorily negligent when the driver of the vehicle she was a passenger in struck an object in the highway which was negligently dropped and allowed to remain there by the Defendant Plaintiff further maintains that the Doctrine of Assumption of the Risk is inapplicable to Plaintiff's claim. 22_ Denied_ This averment is a conclusory statement unsupported by any factual statements. It is specially denied that the allegations of negligence set forth in Plaintiff s Complaint were not caused by the Defendant or individuals over whom the Defendant had control.. This is further rebutted by Defendant's own answer to paragraph 6 of Plaintiff's Complaint in which it is admitted by the Defendant that the motor vehicle from which the metal object was dropped was owned by the Defendant and operated by its employee on the date of accident No further response is required by Plaintiff. WHEREFORE, Plaintiff respectfully request that this Honorable Court dismiss Defendant's New Matter enter judgment in favor of Plaintiff and against Defendant R,P.C- ichael E. Kosik, Esquire !.D. No. 36513 4503 N_ Front Street Harrisburg, P A 1711 0 (717) 238-6791 Counsel for Plaintiff 241330.lIMEKIMMM 'll*.;#i _ t.'" ,<: ."-" '"'-~""~'<; -1"''7,\-,:~'__':'' ~", "'"~I: ,- ". --' ,. .." '--'--"'-"--'..'"~"~-,,,, "", -.<- .. ~ '" - t};.. .,' .,,'" VERIFICATION I, KATHY DELGRANDE, Plaintiff, have read the foregoing Reply to New Matter and do hereby swear or affirm that the facts set forth in the foregoing are true and correct to the best of my knowledge, information and belief. I understand that this Verification is made subject to the penalties of 18 Pa.C.S.A. Section 4904, relating to unsworn falsification to authorities. WITNESS: J fA '^ '^"^! '2o,} 2. 0(;2.. 211588.1IMEKIMMM '-, "'''''':'.-"" 1,,: "". " -!"",t._",,:, .tto.::;_,,,,,,-<__ ,,'_" ., "'_~; ~':., '_,~; ~'_ ~_, :.'--:.J,_'--''~''"'r~''"r.N_'. . ,."" .',' ' ~__ ',-, ,-,~ -- ~ '.., <^ --- -,., - .~;~,.' h ','l.."'''-' " ~ CERTIFICATE OF. SERVICE AND NOW, this 25th day of January, 2002 I, Michelle M. Milojevich, an employee of Angino & Rovner, P.e.., do hereby certify that I have served a true and correct copy of the PLAINTIFF'S REPLY TO DEFENDANT'S NEW MATTER in the United States mail, postage prepaid at Harrisburg, Pennsylvania, addressed as follows: Harry D. McMunigal, Esquire Bingaman, Hess, Coblentz & Bell Treeview Corporate Center 2 Meridian Blvd., Ste. 100 Wyomissing, PA 19610 Attorney for Defendant /'(J71iLJJ.{m ~l~h , Michelle M. Milo' vich -~- 241330.1\MEKIMMM :'~'.. LA-o'-.Mi-.,,~ -<~ c,;, ',_ ", "oM .,~. '__ ,",;,,;;,f""'~' . '__<"".""'""'x, ""0'.,1 0,' A 0' '~"cL"'.~,', .__ ~_.,_.,"'_,_~ ,- - - - - u"n "', _0 '^_ ," ,-, ~ -~-'~-~~. - '," ,",'" .""..t._ wo.,,, ",<", .<c'. - ""--,,,,.~;~----~c"';-,N~,,"_>lih" --"'"l1r"r - - - - ~J~~:~~ ~ ~~r 2'r~ (fJ)> J~ -7 <'- =< e; 8/1 . f~3 """- :...<) \,0 .1,"_, ~ i :...1 ?:~; (o:.;"n ~~ -,-,: 5:J -< '.'? co ,-<. , _,,,,_~!ffiy.l~~-'ffli_~lrr!~1~~~~r:J,~~rWf!:,_!lii'I~,!l'!_,__. -~.(""'t,,~~,_,LM'~&- , :iJU~ ._, " '~ , :] j ., 'i ~i " {i :,.'~~-, " BINGAMAN, HESS, COBLENTZ & BELL, P.C. BY: HARRY D. McMUNIGAL, ESQUIRE IDENTIFICATION NO. 38386 TREEVIEW CORPORATE CENTER 2 MERIDIAN BLVD., SUITE 100 WYOMISSING, PA 19610 (610) 374-8377 (610) 376-3105 (Fax) ATTORNEY FOR DEFENDANT V ALLEY QUARRIES, INC. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA KATHY DELGRANDE Plaintiff CIVIL ACTION - LAW NO. 01-6185 v, VALLEY QUARRIES, INC. Defendant v. JUDITH 1. JUMP Additional Defendant JURY TRIAL DEMANDED NOTICE 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 Joinder Complaint is served, by entering a written appearance personally or by attorney and filing in writing with the court your defenses or obj ections 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 with only such further notice to you as may be required by law, for any money claimed in the Joinder Complaint or for any other claim or relief requested by the defendant. You may lose money or property or other rights important to you. YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE, OR 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. Court Administrator 4th Floor Cumberland County Courthouse I Courthouse Square Carlisle, P A 17013 Telephone: 717-240-6200 ,-".,.;"\.",, , ~"'~C'v,rv", '''''"'' ",I ,- '0'/'"' -r~, -:"-' ,. _ _ . ..',..',. ",', .. . .,. '--- -,.,., , _ ,"', ,_.,-:' v.^_' ,., ",{".~,,,~, 7 ,~""'" ""'I'" " .,____" .0--:0-' ,'~--'''' "'~'''''' .-. -, 1--'-1, ',,',"C-,,__,".,__" ':;:"r~~ ~ ,- BINGAMAN, HESS, COBLENTZ & BELL, P.C. BY: HARRY D. McMUNIGAL, ESQUIRE IDENTIFICATION NO. 38386 TREEVIEW CORPORATE CENTER 2 MERIDIAN BL YD., SUITE 100 WYOMISSING, PA 19610 (610) 374-8377 (610) 376-3105 (Fax) ATTORNEY FOR DEFENDANT V ALLEY QUARRIES, INC. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA KATHY DELGRANDE Plaintiff CIVIL ACTION - LAW NO. 01-6185 v, V ALLEY QUARRIES, INC. Defendant v. JUDITH L. JUMP Additional Defendant JURY TRIAL DEMANDED DEFENDANT'S COMPLAINT AGAINST ADDITIONAL DEFENDANT 1. This action is brought for personal injuries allegedly sustained by the Plaintiff as a result of the claimed negligence of Defendant, allegedly arising from the motor vehicle accident on November 1, 1999, on Route 81 Southbound, in Penn Township, Cumberland County, Pennsylvania. 2. Specifically, Plaintiff alleges that she was a passenger in a vehicle being operated by Judith L. Jump, when she sustained personal injuries that allegedly occurred when the vehicle in which she was riding struck a metal object that is claimed to have fallen off of a truck owned by Defendant Valley Quarries, Inc. and operated by one of its agents or employees_ ;;:;;07,,,",,, -~ _ .'" '_'~'"",-f, "'^^~'i"_"':,'?:''';'"''' ,. -,' c" '0"_~C",~__ ." ," -, 1,"""'_""" """'.1'" .1', " ," ",,__ '.'" '~'_ " ," ~_", ,'-" ,~, "n~' '". 'O"',~_ _ ",' "," ^. '-" "-" MlI 3. The allegations of Plaintiffs Complaint are incorporated herein by reference as though fully set forth at length. A true and correct copy of Plaintiffs Complaint is attached hereto as Exhibit "A". 4. Additional Defendant Judith L. Jump is an adult individual residing at 504 Brenton Street, Shippensburg, Cumberland County, Pennsylvania 19257. 5. In the alternative, Additional Defendant Judith L. Jump is an adult individual residing at 1809 Alamo Avenue, Alamogorde, New Mexico 88310. 6. To the extent that Plaintiff did sustain injuries as alleged, which allegations are specifically denied, then said injuries were caused, not as a result of any negligence, carelessness or recklessness of Defendant Valley Quarries, Inc., but rather solely and exclusively as a result of the negligence, carelessness and recklessness of Additional Defendant Judith L. Jump. 7. The negligence, carelessness and recklessness of Additional Defendant Judith L. Jump consisted of the following: a. Failing to keep proper and adequate control over the vehicle that she was driving, in order to avoid any foreign objects in the roadway; b. Failing to avoid striking the metal object in her lane of travel; c. Driving at a speed too fast for the conditions then and there existing on the roadway; d. Striking the foreign object in the roadway; e. Failing to find an alternative means of traveling on that roadway without striking the metal object; f. Failing to warn the Plaintiff of the presence ofthe object in the roadway; ~~i~!\t.~(l:)T_. , , " ; """ .'. it - -~_- , ,"" - T' ~,--,- ,> " .'"-. ,,-''' '_~' \I'~' _': ""-, -,-':',,< ~":'!'i'o- ",' "-,,,", -"., .,-:, ,_- _'- " "" . <.-, , - - > - "~ ,,',,_e_ ,.__ , ff; g. Following too close to the vehicle in front of her so that she was unable to avoid striking the object in the roadway in front of her; h. Failing to slow her vehicle or bring it to a stop in sufficient time to avoid striking the object in the roadway in front of her; and 1. Failing to drive around the metal object in the roadway so as to avoid striking it. 8. As a result of the negligence, carelessness and recklessness of Additional Defendant as stated above, Additional Defendant Judith 1. Jump should be held solely liable to the Plaintiff, jointly and severally liable to the Plaintiff, and/or liable over to Defendant Valley Quarries, Inc. on any judgment that may be entered in favor of Plaintiff and against Defendant Valley Quarries, Inc. WHEREFORE, Defendant Valley Quarries, Inc_ demands that Additional Defendant Judith 1. Jump be held solely liable to the Plaintiff, jointly and severally liable to the Plaintiff, and/or liable over to Defendant Valley Quarries, Inc. on any judgment that may be entered in favor of Plaintiff and against Defendant Valley Quarries, Inc. BINGAMAN, HESS, COBLENTZ & BELL, P.C. H~D~ Attorney for Defendant Valley Quarries, Inc. i{!q~.'1!f >~ ~ ,.' - 'i~ '"("-''',' -_,.;o.y.,~ ~,~, ,--," - :',,, ", c"'''-"': ;':c'I""~""'_ ';"'!'-V c.,., ... . . ",'-.-,<~" ..> -- ''''-'''-'''' " "'.- - " - "-~-' ---~-^ " ~ . . 10176-828 VERIFICATION I, .:r~ tJl1111&lJnIJIlI , state that I am a representative of the Defendant, Valley Quarries, Inc., in the within action and that the facts set forth in the foregoing Defendant's Complaint Against Additional Defendant are true and correct to the best of my knowledge, information and belief. I understand that false statements herein made are subject to the penalties of 18 Pa. C.S.A. Section 4904, relating to unsworn falsification to authorities. Dated: Q I \ \ \ U.0 ~'~~"" - ^L~_," .', , ;",-" ',., ,-,,~,>~,~,,_ ,_ ." ,^' '~':-::'~'-""'I"'/'~~:r,--'-';_-;~"'" To",? oc',_ -"'f" r_o. "'"',_.,__ ,. ,~ __,~, ,,"Co, ",_." ,~_,'~,~H", '",,,',,,,"- f~~f' ,. . BINGAMAN, HESS, COBLENTZ & BELL, P.C. BY: HARRY D. McMUNlGAL, ESQUIRE IDENTIFICATION NO. 38386 TREEVIEW CORPORATE CENTER 2 MERlDIAN BL YD., SUITE 100 WYOMISSING, PA 19610 (610) 374-8377 (610) 376-3105 (Fax) ATTORNEY FOR DEFENDANT VALLEY QUARRIES, INC. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA KATHY DELGRANDE Plaintiff CIVIL ACTION - LAW NO_ 01-6185 v, VALLEY QUARRIES, INC. Defendant v. nmITH L. JUMP Additional Defendant JURY TRlAL DEMANDED CERTIFICATE OF SERVICE I, Harry D. McMuniga1, Esquire, hereby certify that a true and correct copy of the foregoing Defendant's Complaint Against Additional Defendant was mailed by United States first class mail, postage prepaid upon the following party(ies): Michael E. Kosik, Esquire ANGINO & ROVNER, P.C. 4503 North Front Street Harrisburg, P A 17110-1708 lfunyb,,-", DATE:rJ..-I(~O ;...- t'~ > .,^_~IJ1__,. ."-~,<-,q-""-'''>''"'i'''_''"f'?'',",<~' .''0"_ ,_.,...",",r'_! '~1-;:'7" "'~-I"_:: , .-~>-, .. "~ '--,~.'- ,,--_~ ,O_~'?'__"" '-. -,',',_,,,," ,,~,,"_ .y', u e.. ,.,,_, :_~,_r_,:~, _":" I,' .L. " ~"",," ,-",,"~'-'''' L ~. .~'"'., ~, w_"~_," "_. "n_",.,__,,', " ... ~~,. ~"--'~~M-'_""",""" "-P ~ L'~"~ 1""'1'" ",^-,'"'""'~i<~".""",,," . _ _ C) ~:- -""1'""':\- p ~~ r--:: ....,. 1',) ."') -" CO C', mr C) j'''--- -"-It .-''', 11 1"-.) /~.~ '",-"l =<: f;S 87/ - ~ ';. ""","/c"r!'.." ....,JJ .L ~~~"V-_r ",.,,!t~~-;_- :,~,_,_:.!l~:;T;Jum~, -- -. . '; ..)~1 ~)~{i?/ 'tJ:tt;':?,~;;1;>:C::.r~\):'.'" . ',,_.,- '-', .~ .. BINGAMAN, HESS, COBLENTZ & BELL, P.C. BY: HARRY D. McMUNIGAL, ESQUIRE IDENTIFICATION NO_ 38386 TREEVIEW CORPORATE CENTER 2 MERIDIAN BLVD., SUITE 100 WYOMISSING, PA 19610 (610) 374-8377 (610) 376-3105 (Fax) ATTORNEY FOR DEFENDANT VALLEY QUARRIES, INe. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA KATHY DELGRANDE Plaintiff CIVIL ACTION - LAW NO. 01-6185 v, VALLEY QUARRIES, INC. Defendant v. JUDITH L. JUMP Additional Defendant JURY TRIAL DEMANDED AFFIDAVIT OF SERVICE I, Harry D. McMunigal, Esquire, hereby certify that a true and correct copy of the Joinder Complaint was served upon Additional Defendant Judith L. Jump by way of United States Certified Mail, Return Receipt Requested on February 14, 2002. The original Return Receipt is attached hereto as Exhibit "A". I verify that the statements made in this affidavit are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S. 94904 relating to unsworn falsification to authorities. ~E~Wre DATE: J. .,).1-0 rl.../ , . , > ,,~ . ,"~''''r<;-,~''_'c-:' ,~",,~,~ r,': 'C~~" ',-"1';,-1' :." "_~"'il"'. ',".-y -"-~. ~""-. '~i<' ",. ".',,, ',' ~,~..--'.-.,-" -~--~"-,,~-- ~,- ~~.--. ,,'0" ~ . ._~~.- Mi~11I1 Ii;-~,. _ ~7-1D6 4575 1292 1631 :l4JH II I -o(}L.. . 0 o Agent DAadressee_ DVM DNo '~ervjce Type CERTIFIED MAIL P4:--Restricted Delivery? (Extra Fee) ~L...Ar:tideAckl.,Q.=(Uo: ,_ . : \f\s . ~u.~\*" l. ~~~,;~-; .... . tbC)~ A\~M\j ~ . ~ \~ M~()( & \l\(Y\ 88~\O ~"Yes , ~o ~ ~ ~ .~ . ..0 e- - ~ ~:-=-_o .~ ~_ . .. :.,;.:~ ~S''Form 3B11. June 2~~---~----~--~-_-'~ Dom~;tic Return Aecei7 ~ ~~- , ~ ~- ~ -g. ~ - 0' -..i" EXHIBIT A i!II " ~~<mr"C"~;;;~~!i . ~ p f ~ ~ (') c: I:>- (-::, c. ,.. J\- t<> -,.. ~ ., s~: (- ~. ~ r- -.v, 2', , (f ~ ~~ -< c r:::.._ ..-.. .. -;--D i., w ~.. .::::I ~ B,ij ~...,.."........_,.,.".......j"'0''''''''''''''''''''''' ~"'". '. "'v.,,, J~ _,,,~),JQlll~}jJr~:fl~~~,,,,,,,,,,,,_, ~Al'mPlllllliWi!r~'~'!I)~'k,. '>'1i];~f (,;l ':' {>. . ,. KATHY DELGRANDE, Plaintiff : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA vs. : NO. 01-6185 V ALLEY QUARRIES, INC. Defendant vs. JUDITH L. JUMP, Additional Defendant : CIVIL ACTION - LAW : JURY TRlAL DEMANDED PRAECIPE TO THE PROTHONOTARY OF SAID COURT: Please enter my appearance on behalf of Additional Defendant Judith L. Jump in the above-captioned matter. CALDWELL & KEARNS By: Jam L. Goldsmith Att rney LD. #27 15 uglas E. Herman, squire f\ttorney LD. #86569 3631 North Front Street Harrisburg, P A 1711 0 (717) 232-7661 Attorneys for Additional Defendant Dated: ,.t,t!lft, .t).J.. i;',~'i .~, '~_" ,'_-'-,__,_,i"'< "_""'n,,--";'1'lzc_ 'c' ,., ,,-,_,_"~c _;'-'''_ ',',~1'''---- ~ ' "1'. . ~ ~ ''i'~'' . .,"~' ,,C, ., - ~".~". , . .. CERTIFICATE OF SERVICE AND NOW, thisd?.G ~ay of P.h..u;? ~ ' 2002, I hereby certify that I have served a copy ofthe within document on the following by depositing a true and correct copy of the same in the U.S. Mails at Harrisburg, Pennsylvania, postage prepaid, addressed to: Michael E. Kosik, Esquire ANGINa & ROVNER, P.C. 4503 North Front Street Harrisburg,PA 17110-1708 :; Harry D. McMunigal, Esquire BINGAMAN, HESS, COBLENTZ & BELL, P.C. Treeview Corporate Center 2 Meridian Boulevard, Suite 100 Wyomissing, PA 19610 :! CALDWELL & KEARNS B4~ 02-131/36600 J~~;;1iJ; '" "f"-,- ,_._,',"' _C'-C'.'., c. ~,~t'.-;; - , -1- ..,. :,- "' ......... w -"..,....,........!l;..l ...........,.."....... "- 'h --,~<~,. ,:,1,,, :,', ,-*','""~~'-i,,- '.-' 1...-"~r~1(j~~-:rr_"":'~'~'rfJ1Jj1_Wll_ ~'-\Xi"u'11 Cj't~i"'7-:'''-" . " 0 0 {-:) c f-":> -:"1 :;;:: "n --, -r:;rn 0"1 " n"lrn a:> -/-"'"J -r-Ti ':;'-',"'.- N ~~i~ ....l :~.: ~:T'~ -';C) ~Ci ...' ~~~ ~Q ",. p~ l':? ~ (fl ::0 -< E, ;i " ',' ;,>. 'J; 'ii GS 13)/ r/ ['I' .. ... Ii ,. . i,' i: b; l:; h ," -,. ,-,~:-'''','".o"'-1RB~_,~_,.,'''~; ."W3,.:~7'r-_;~_~,J~X~,J::1?,1,,:;::~~~r;1'lI,,-~~~~~.!1 w, '~~~,Jlj1f0~.I:: ii ~ I, ! I, l:~";>~~. 0 '" " , . BINGAMAN, HESS, COBLENTZ & BELL, P.C. BY: HARRY D. McMUNIGAL, ESQUIRE IDENTIFICATION NO. 38386 TREEVIEW CORPORATE CENTER 2 MERIDIAN BLVD., SUITE 100 WYOMISSING, PA 19610 (610) 374-8377 (610) 376-3105 (Fax) ATTORNEY FOR DEFENDANT VALLEY QUARRIES, INC. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA KATHY DELGRANDE Plaintiff CIVIL ACTION - LAW NO. 01-6185 v. VALLEY QUARRIES, INC. Defendant JURY TRIAL DEMANDED CERTIFICATE PREREQUISITE TO SERVICE OF A SUBPOENA PURSUANT TO RULE 4009.22 As a prerequisite to service of a subpoena for documents and tltings pursuant to Rule 4009.22, Defendant certifies that (1) a notice of intent to serve the subpoena with a copy of the subpoena attached thereto was mailed or delivered to each party at least twenty (20) days prior to the date on which the subpoena is. sought to be served, (2) this certificate, a copy of the notice of intent, including the proposed subpoena, is attached to (3) no objection to the subpoena has been received or Plaintiff waived any objection to the subpoena in writing, and (4) the subpoena which will be served is identical to the subpoena which is attached to the notice of intent to serve the subpoena. BINGAMAN, HESS, COBLENTZ & BELL, P.C. Dated: 3/ 'i 10).. ~' c_ (2~ f"' Harry McMunigal, Esquire Attorney for Defendant By: ",,-~, <_.;<'1:'-;<"-\"."",,",..--~.~." . ," ; - ,. I'~?HS;~'_-."-'':]'___', _ r _ -', .' ,>. _" -,. _ ,~.",-." . , " -~ .". "',' - c. - , ,'- , ;-~, - :.:r ~ ' .. . BINGAMAN, HESS, COBLENTZ & BELL, P.C_ BY: HARRY D. McMUNlGAL, ESQUIRE IDENTIFICATION NO. 38386 TREEVIEW CORPORATE CENTER 2 MERIDIAN BLVD., SUITE 100 WYOMISSING, PA 19610 (610) 374-8377 (610) 376-3105 (Fax) ATTORNEY FOR DEFENDANT V ALLEY QUARRIES, INe. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA KATHY DELGRANDE Plaintiff CIVIL ACTION - LAW NO. 01-6185 v. V ALLEY QUARRIES, INe. Defendant JURY TRIAL DEMANDED NOTICE OF INTENT TO SERVE A SUBPOENA TO PRODUCE DOCUMENTS AND TIDNGS FOR DISCOVERY PURSUANT TO RULE 4009.21 Defendants intend to serve a subpoena identical to the one that is attached to this notice. You have twenty (20) days from the date listed below in which to file of record and serve upon the undersigned an objection to the subpoena. Ifno objection is made the subpoena may be served_ BINGAMAN, HESS, COBLENTZ & BELL, PoCo Dated: (- tlJI...oA./ B~ ~ At- H . McMunigal, Esqgr; . Attorney for Defendant ~-~~~"._-" ~ .~ , --' -"!"-' ~~I' I ~= J" . (XM-tJNWE1IL'I:H OF PENNSYLVANIA <XXJNlY OF aJMBERIAND ~THY DELGRANDE Plaintiff v. Fi Ie No_ 01-6185 I\LLEY QUARRIES, INC. Defendant SUBPOENA TO PROOlX;E IXlCt.t-ENTS OR nil NGS FOR D I SCOYERY PrnSUANT TO RULE 4009 _ 22 fO: /\f.r.<;,!,ATE INSURANCE OJMP~, 301 BRUSH CREEK ROAD, WARRENDALE PA 15086 (NOOle of Person or Entity) Within twenty (20) days after service of this subpoena. you are ordered by the court to SEE A'lTACHED produce the fol lowing doa..rnents or things: . Bl"" \"j"8/IIicsin'J. P/\ 19610 t Suite 1 uu, l Merlu.l.cul ~u." at Treeview Corporate Cen er, (Address) 'i You nay de;iver or mail legible copies of the doct.ments or produce things requested by this subpoena, together' with the certificate of carpliance. to the party making this "~I request at the address l;~ted above. You have the right to seek in advance the reasonabl,. ;, cost of p,eparing the copies or producing the things sought. I f yOU fai I to ;.oroduc.e the docunents or things required by this subpo.:;:rl'l within t..enty (20) day$ after its service, the party serving this subpoena IT'ay seek a CO'Jrt order curi>e 11 ir:9 YOl.: to COTp ly with it. Tl-IIS SUllPOENA WAS ISSUED AT 1liE REQUEST OF 1liE FOLLCWING PERSON: NA/'E: Harry D. McMunigal, Esquire ADDRESS: -....1Iee'lliew',.COro.ctr. Sqite 100 2 Meridian Blvd., WyoUlssmg, PA 19610 ~---- rELEPt-()NE: 610.374.8377 'U'REI"E <XUlT I DlI 1!B86 ., TTORNEY FOR: Defendant JAfE:;k_~o;;e COUrt------ BY 1liE CCUlT: r},^T,~ f2 ~~---J<,.- ProthonotarylC :k~ CIvIl Division -~~1P"JI~ty (Eft. 1197) >''11: ,~ " ~. . - , I ," "e, F- r'~" ':;' . ..." , BINGAMAN, HESS, COBLENTZ & BELL, P_e.. BY: HARRY D.. McMUNIGAL, ESQUIRE IDENTIFICATION NO_ 38386 TREEVIEW CORPORATE CENTER 2 MERIDIAN BLVD., SUITE 100 WYOMISSING,PA 19610 (610) 374-8377 (610) 376-3105 (Fax) KATIfY DELGRANDE Plaintiff v. V ALLEY QUARRIES, INe.. Defendant A ITORNEY FOR DEFENDANT VALLEY QUARRIES, INC. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYL VANIA CIVIL ACTION - LAW NO. 01-6185 JURY lRlAL DEMANDED CUSTODIAN OF RECORDS FOR: ALLSTATE INSURANCE COMPANY Any and all PIP files, claims, medical records, medical bills, payment logs; insurance records, adjuster notes, applications for benefits, evaluations, correspondence, etc_ pertaining to any claims filed by or on behalf of: Claimant Name: 88#: Date of Loss: Your Insured: Claim#: """.\il:~'"""'I'i""'"'''''' ~ - -'- - f ,~" 10'. r '-~-" "1- Kathy Delgrande 209-60-4571 5/7/00 William Delgrande 665273070302 ,- - ,~ 184851 ~~" I ~'" ,;,H "', "JilJ' ,Ff _ _ '~,~," Jil!l!l!'3J!1!'_"!, , . . ',"'~~~~'-'_' ~.". . ,H ."""", ,"''''__',~' _ ~ "_~"~O" -"_, _'["_ .~"",!l,,", ,~~'~~)liij!iJl,Jf:,",,~~~f0i'SH"'"H 'i'~--"<""'!"T;lf1',;t:--','tIillf' "."".....,'".,.. ~.......'.' ..".~.'lfi'IIJ illrT 0 CO 0 C IV <'" '-1'1 l}[!~ :-r;: ~-- , fT!fT; ~~ ~.. Z:r ::.:0 " zr-- I " ~~, O~l , '< - v ~;() :X .. );: ~;] " r- .--- "- ~) Z :;:) ::;:.:1 :;! :0 ~ '0 -< cs .(3)/ .,,~1' ~.Ji .' SHERIFF'S RETURN - NOT FOUND ~ASE NO: 2001-06185 P COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND DELGRANDE KATHY VS VALLEY QUARRIES INC R. Thomas Kline ,Sheriff or Deputy Sheriff, who being duly sworn according to law, says, that he made a diligent search and inquiry for the within named defendant, ADD'TL DEFEND JUMP JUDITH but was unable to locate Her in his bailiwick. He therefore returns the WRIT OF SUMMONS , NOT FOUND , as to the within named ADD'TL DEFEND ,JUMP JUDITH BELIEVED TO BE LIVING IN NEW MEXICO. Sheriff's Costs: Docketing Service Not Found Surcharge 18_00 13 _ 80 5_00 10.00 .00 46_80 S. o~nswe . : ///~//;/ ~ / ../ .~/;~ R.! Thomas Kline Sheriff of Cumberland County BINGAMAN HESS COBLENTZ BELL 03/04/2002 Sworn and subscribed to before me this 13f!- day of~ ,2Ov;L A.D. ~I J) ~ $?i' Prot otary , ''"'HO"",,,-,,_,,~~_ '" , r~ . . . .,,, rm.~""" ~: BINGAMAN, HESS, COBLENTZ & BELL, P.C. BY: HARRY D_ McMUNIGAL, ESQUIRE IDENTIFICATION NO. 38386 TREEVIEW CORPORATE CENTER 2 MERIDIAN BL YD_, SUITE 100 . WYOMISSING, PA 19610 (610) 374-8377 (610) 376-3105 (Fax) ATTORNEY FOR DEFENDANT VALLEY QUARRIES, INe.. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA KATHY DELGRANDE Plaintiff CIVIL ACTION - LAW NO. 01-6185 v, VALLEY QUARRIES, INC. Defendant v. JUDITH L. JUMp Additional Defendant JURY TRIAL DEMANDED NOTICE 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 Joinder Complaint is 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 with only such further notice to you as may be required by law, for any money claimed in the Joinder Complaint or for any other claim or relief requested by the defendant. You may lose money or property or other rights important to you. YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE, OR 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_ Court Administrator 4th Floor Cumberland County Courthouse 1 Courthouse Square Carlisle, P A 17013 Telephone: 717-240-6200 '-- TRUE COPY FFtOM RECORD In TBStlmonywilereof.1 here"nto. iny hand Md IDe,?;, said, ~_." PI. ~~n~. ~~ .^"'iRt~'JX'!tjlI!J,l~^" ,.~ .. -. I~--<' - ,~ . I' . , ,... ~ ~ ~ :~ " ""''''-'''~'i'~~ .1 .' f BINGAMAN, HESS, COBLENTZ & BELL, PoCo BY: HARRY D. McMUNlGAL, ESQUIRE IDENTIFICATION NO. 38386 TREEVIEW CORPORATE CENTER 2 MERIDIAN BLVD., SUITE 100 WYOMISSING, PA 19610 (610) 374-8377 (610) 376-3105 (Fax) ATTORNEY FOR DEFENDANT V ALLEY QUARRIES, INe.. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA KATHY DELGRANDE Plaintiff CIVIL ACTION - LAW NO. 01-6185 v, V ALLEY QUARRIES, INC. Defendant v. JUDITH 1. JUMP Additional Defendant JURY TRIAL DEMANDED DEFENDANT'S COMPLAINT AGAINST ADDITIONAL DEFENDANT I. This action is brought for personal injuries allegedly sustained by the Plaintiff as a result of the claimed negligence of Defendant, allegedly arising from the motor vehicle accident on November I, 1999, on Route 81 Southbound, in Penn Township, Cumberland County, Pennsylvania. 2. Specifically, Plaintiff alleges that she was a passenger in a vehicle being operated by Judith 1. Jump, when she sustained personal injuries that allegedly occurred when the vehicle in which she was riding struck a metal object that is claimed to have fallen off of a truck owned by Defendant Valley Quarries, Inc. and operated by one of its agents or employees_ .~m _0 ~ ,I. '. , -', ,.. ~ t<-'~ -- 3. The allegations of Plaintiffs Complaint are incorporated herein by reference as though fully set forth at length. A true and correct copy of Plaintiffs Complaint is attached hereto as Exhibit "A". 4_ Additional Defendant Judith L. Jump is an adult individual residing at 504 Brenton Street, Shippensburg, Cumberland County, Pennsylvania 19257. 5. In the alternative, Additional Defendant Judith L. Jump is an adult individual residing at 1809 Alamo Avenue, Alamogorde, New Mexico 88310. 6. To the extent that Plaintiff did sustain injuries as alleged, which allegations are specifically denied, then said injuries were caused, not as a result of any negligence, carelessness or recklessness of Defendant Valley Quarries, Inc., but rather solely and exclusively as a result of the negligence, carelessness and recklessness of Additional Defendant Judith L. Jump. 7. The negligence, carelessness and recklessness of Additional Defendant Judith L. Jump consisted of the following: a_ Failing to keep proper and adequate control over the vehicle that she was driving, in order to avoid any foreign objects in the roadway; b_ Failing to avoid striking the metal object in her lane of travel; c. Driving at a speed too fast for the conditions then and there existing on the roadway; d. Striking the foreign object in the roadway; e. Failing to find an alternative means of traveling on that roadway without striking the metal object; f. Failing to warn the Plaintiff of the presence of the object in the roadway; -,.,,-,,","4"'<'*"'_< .~-"-"",~.~. ~,-~el 'c--,11'c,' ., .,., ," > ~ 1" ~ g. Following too close to the vehicle in front of her so that she was unable to avoid striking the object in the roadway in front of her; h. Failing to slow her vehicle or bring it to a stop in sufficient time to avoid striking the object in the roadway in front of her; and 1. Failing to drive around the metal object in the roadway so as to avoid striking it. 8. As a result of the negligence, carelessness and recklessness of Additional Defendant as stated above, Additional Defendant Judith L. Jump should be held solely liable to the Plaintiff, jointly and severally liable to the Plaintiff, and/or liable over to Defendant Valley Quarries, Inc. on any judgment that may be entered in favor of Plaintiff and against Defendant Valley Quarries, Inc. WHEREFORE, Defendant Valley Quarries, Inc. demands that Additional Defendant Judith L. Jump be held solely liable to the Plaintiff, jointly and severally liable to the Plaintiff, and/or liable over to Defendant Valley Quarries, Inc. on any judgment that may be entered in favor of Plaintiff and against Defendant Valley Quarries, Inc. BINGAMAN, HESS, COBLENTZ & BELL, P.C. H""D~re Attorney for Defendant V alley Quarries, Inc. ,,'Z'~-'!l'!jlW:9j, "",',_ l'f~"" . f"" 'I" ~ ,I , , ~ C" 10176-828 VERIFICATION I,:::r~ llh""@l.JnlJN , state that I am a representative of the Defendant, Valley Quarries, Inc., in the within action and that the facts set forth in the foregoing Defendant's Complaint Against Additional Defendant are true and correct to the best of my knowledge, information and belief. I understand that false statements herein made are subject to the penalties of 18 Pa. C.S.A_ Section 4904, relating to unsworn falsification to authorities_ Dated: C,(II\ \t~ .\~"rr_~~ '1- - -.- ~~r,'~'.-, , ~=~, ,"~ BINGAMAN, HESS, COBLENTZ & BELL, P.C. BY: HARRY D. McMUNIGAL, ESQUIRE IDENTIFICATION NO. 38386 TREEVIEW CORPORATE CENTER 2 MERIDIANBLVD_, SUITE 100 WYOMlSSING, PA 19610 (610) 374-8377 (610) 376-3105 (Fax) ATTORNEY FOR DEFENDANT V ALLEY QUARRIES, INe. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA KATHY DELGRANDE Plaintiff CIVIL ACTION - LAW NO. 01-6185 v, V ALLEY QUARRIES, INC_ Defendant v. JUDITH L. JUMP Additional Defendant JURY TRIAL DEMANDED CERTIFICATE OF SERVJ[CE I, Harry D. McMunigal, Esquire, hereby certify that a true and correct copy of the foregoing Defendant's Complaint Against Additional Defendant was mailed by United States first class mail, postage prepaid upon the following party(ies): Michael E. Kosik, Esqnire ANGINO & ROVNER, P.C. 4503 North Front Street Harrisburg, P A 17110-1708 DATE:J- - (( ~O;""- '~";-~?~.F_$..~".. "" -~ ,='" "I' ,< I ' !."". '" ~~ 'l',-''o''''-- ',,', ""iiiLrj~tl~!1~,t&t.:~~ilffi%}Zfili"!hj)f""~~~tffi',0'_'t'-,~J.'~"e'i;" " ""~';::*';';5;<"'.,,,~;j,jb"YdM-hh"R:4i~~iliiilllr' t"liJ! :~~':~'t~~Ifil~rrliij(- .. Ill( ofr \l~~: c. \~ 1.';' " hI) \1. ':{ fAqUI ~l (S~ ",JUhO ~I~) 11J&13 dl.!I'~IUl!IJ!!. - ~ .,. .~ "~I \\j> "\\tW~f ~',:":\\'( . "If' j \\3 \"\ "~I L 'I_I... , ,1_1'- '::', \'1 c.',-'< \<.\~ ~I('(,i"" "1' t f\. ,~,' ~" _, j .w " it'........, ~,'- - ~JIIl;!il!li', 1 ~ J "'"''''T'''' vs. : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYL V ANlA : NO. 01-6185 KATHY DELGRANDE, Plaintiff VALLEY QUARRIES, INC. Defendant vs. JUDITH L. JUMP, Additional Defendant : CNIL ACTION.. LAW : JURY TRIAL DEMANDED ANSWER AND NEW MATTER OF ADDITIONAL DEFENDANT. JUDITH L. JUMP. TO DEFENDANT'S ADDITIONAL DEFENDANT COMPLAINT COMES NOW, the Additional Defendant, Judith L. Jump, by and through her counsel, Caldwell & Kearns, and files the within Answer with New Matter to the Additional Defendant Complaint, and in support thereof, avers the following. I. It is admitted that paragraph I of the Additional Defendant Complaint accurately summarizes the nature of Plaintiffs allegations. As to the substance of those allegations, the same are specifically denied. 2. It is admitted that paragraph I of the Additional Defendant Complaint accurately summarizes the nahlre of Plaintiffs allegations. As to the substance ofthose allegations, the same are specifically denied. By way of further answer, Additional Defendant is without knowledge sufficient to permit her to form a belief or opinion as to how the metal object became situated in the roadway. 3. This paragraph is an incorporation paragraph which requires no responsive pleading under the Pennsylvania Rules of Civil Procedure. 4. Denied. Additional Defendant, Judith L. Jump does not reside at the address stated in the Additional Defendant's Complaint. 5. Admitted. 6. Denied. The averments contained in paragraph 6 of the Additional Defendant Complaint are denied as conclusions of law to which no responsive pleading is required by the Pennsylvania Rules '<)~:::: -",,-. '" -'-:'-'"", ". _<''''".~,'''E:)?,,,,~'~''~_',r._~_',''',__/~~i " ". . *"_ _,_ , ";- w_~:'!''''''_ ~-~,. ~ \Oo",rO'I1ll<'f<~'OW of Civil Procedure. 7. This paragraph and its sub-parts are denied pursuant to the provisions of Pennsylvania Rule of Civil Procedure 1029 (e). 8. The averments contained in paragraph 8 of the Additional Defendant Complaint are denied as conclusions of law to which no responsive pleading is required by the Pennsylvania Rules of Civil Procedure. WHEREFORE, Additional Defendant, Judith L. Jump, demands that the Defendant, Valley Quarries, Inc., be held solely liable to Plaintiff on any judgment that may be entered in favor of the Plaintiff. NEW MATTER 9. Additional Defendant hereby incorporates paragraphs 1-8 as though the same were set forth hereunder. 10. Plaintiff's claims are barred in whole or in part by the provisions of the Pennsylvania Motor Vehicle Financial Responsibility Law. 11. All or some of Plaintiff's alleged injuries pre-existed the motor vehicle accident which is the subject of Plaintiff's Complaint. 12. In accord with Section 1722 of the Pennsylvania Motor Vehicle Financial Responsibility Law, the Plaintiff is not entitled to recover any sums "paid or payable" from any group, plan or other arrangement. 13. Plaintiffhas failed to plead that she was bound by the limited or full tort option on the date of the accident, and if she was bound by the limited tort option, Plaintiff has failed to plead any ofthe exceptions to the rule prohibiting recovery of non-economic damages in accord with 75 Pa_C.S. S 1705. 14. Additional Defendant specifically reserves the defenses of contributory/comparative negligence and assumption ofthe risk. !--_l~:":;"~'J' >;' "'. ;--'-_'-'I"'f'_-_:"~; ;".,. ,~-et :""__ 'C'"_",,"'" ,-..-':<n '?' _ f-, --,-t,' "..1"'1; - ""l,.r._'- -'-.-' - "-"'.,- ---,-, w " " .. it" ,,~'.-"~'Y""-,~. ~ 15. The Plaintiffs claim does not exceed $35,000 and should be referred to mandatory arbitration. 16. The Defendant, Valley Quarries, Inc., is solely responsible for any injuries suffered by the Plaintiff due to the following negligence committed by its employees or agents: (A) Failing to secure the metal tripod to its vehicle if, in fact, the tripod fell from a vehicle owned by the Defendant; (B) Failing to remove the tripod from the roadway if the instrument was intentionally or negligently placed there by the Defendant; (C) Failing to warn automobile drivers of the tripod's presence in the roadway; (D) Failing to provide sufficient alternative paths to permit drivers to avoid collision with the tripod; (E) Failing to perform its work in a safe and appropriate fashion. 17. The metal tripod was owned or leased by the Defendant. 18. The metal tripod was located in the roadway when Additional Defendant's car struck it. 19. Defendant provided no warnings that the object was in the roadway. 20. Additional Defendant was traveling at or below the speed limit. 21. Road and weather conditions were favorable. WHEREFORE, Additional Defendant, Judith L. Jump, demands that the Additional Defendant Complaint be dismissed and that any liability for judgment in favor of the Plaintiff be assigned solely to the Defendant, Valley Quarries, Inc. NEW MATTER PURSUANT TO Pa.R.C.P. 2252 (d) 22. Additional Defendant hereby incorporates paragraphs 1- 21 as though the same were set forth hereunder. 23. To the extent that judgment is rendered in favor of the Plaintiff, the Defendant, Valley Quarries, Inc., is solely liable to the Plaintiff for any injuries she suffered or jointly liable with Additional Defendant, Judith L. Jump for the reasons set forth in the following paragraph. ;~,,'c.-ll,k "'~'Y"""'f".":",~-,-""-':' 0'''''''., .0,""-,.-";,,, -, '"I!"'i",.""..'",'i'."""'" ",., ~o _, . .,_,t ,<. ,,' ~ , '..' . ;""1":'" '-,',-",-.-- T:_;",,~ '-",""'_," .-'" 24. The Defendant, Valley Quarries, Inc. is solely responsible for any injuries suffered by the Plaintiff due to the following negligence committed by its employees or agents: (A) Failing to secure the metal tripod to its vehicle if, in fact, the tripod fell from a vehicle owned by the Defendant; (B) Failing to remove the tripod from the roadway if the instrument was intentionally placed there by the Defendant; (C) Failing to warn automobile drivers of the tripod's presence in the roadway; (D) Failing to provide sufficient alternative paths to permit drivers to avoid collision with the tripod; (E) Failing to perform its work in a safe and appropriate fashion. WHEREFORE, Additional Defendant, Judith L. Jump, demands that the Additional Defendant Complaint be dismissed and that any liability for judgment in favor of the Plaintiff be assigned solely to the Defendant, Valley Quarries, Inc. Respectfully submitted, C;dii~u;" AttorneyLD. #27115 Douglas E. Herman, Esquire Attorney LD. #86569 3631 North Front Street Harrisburg, P A 1711 0 (717) 232-7661 Attorneys for Additional Defendant, Judith L. Jump ,,,~o~,_,,__",,,,_,, ,~, ,'~,,__. __",\ - -- . ~~__"I, . '-';^ _ I~,'_'_ '-"-- ". ,~- - ,-' . "- ~, ""Or _c,~ " .V~n~ . i VERIFICA nON I, Judith L. Jump, verifY that the information contained in the Answers and New Matter is true and correct to the best of my information, knowledge and belief. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S. 4904, relating to unsworn falsification to authorities. '-~ ()udt;rX;~ JllIdith L. Jump ~^n;r_~,__-"__,,"_-,_--c-,,~,,,,""'1.'__,","'>"_r ".,-,," ,-.j>" - ,-'-' , , -" ,,~ '."'" ". ~;_,~'.f ~"" ~ ," '" CERTIFICATE OF SERVICE AND NOW, this J-Hr'day of ~ ' 2002, I hereby certify that I have served a copy of the within document on the following by depositing a true and correct copy of the same in the U.S. Mails at Harrisburg, Pennsylvania, postage prepaid, addressed to: Michael E. Kosik, Esquire ANGINa & ROVNER, P.C. 4503 North Front Street Harrisburg, PA 17110-1708 HarryD. McMunigal, Esquire BINGAMAN, HESS, COBLENTZ & BELL, P.C. Treeview Corporate Center 2 Meridian Boulevard, Suite 100 Wyomissing, PA 19610 CALDWELL & KEARNS B~ct~ 02-131/37300 ,',~,,' ~, "> '. ,-"'J' _" <',_.-". - ,,,,,,,, ,~ _"'"_" . -".--"'- , ,~,-- , ~t ,",'=_""., ""'_"_"""'~""__' ,~_ _R_I'lJ,_)llM~" ",",'__"'__0_'. ,~ _,,, ,~_~ .-, '^"'~~,:'~~~JrIl'fiW'l:f,ii.~g!k,,,,, ~,__, 'N"'_ . lUrlmnlrl "J ""iIY' 0 0 c. -' c: '" ','1 s: ".. ~-;} -0(;) --0 mn~ ::v h:i:::IJ Z::O "",~j:"n ~r;- , 652 -- .-, ~..,." en is'r "",C v ::,;:!~~ p.-) ;;-'n.-n ZC ::<: ,";15 '--~CJ r;;> orn )>C: -, Z :.,;> ~ ~ CD -< 1=5 8..1/ __,~e" ",_,M_", ",lX._ L c_ ."Afi1~":,~: 1'~~'""'" -,. .' ~ -'-- - i;-,,,,,t;:,,{_. ... , , .. KATHY DELGRANDE, Plaintiff : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA : NO. 01-6185 vs. VALLEY QUARRIES, INC. Defendant vs. JUDITH L. JUMP, Additional Defendant : CIVIL ACTION - LAW NOTICE TO PLEAD TO: Valley Quarries, Inc. c/o Harry McMunigal, Esquire BINGAMAN, HESS, COBLENTZ & BELL, P.C. Treeview Corporate Center 2 Meridian Boulevard, Suite 100 Wyomissing, PA 19610 YOU ARE HEREBY NOTIFIED that the New Matter set forth herein contain averments against you to which you are required to respond within twenty (20) days after service thereof. Failure by you to do so may constitute an admission. Respectfully submitted, James L. oldsmith, Esquire Attorney LD. #27115 Douglas E. Herman, Esquire Attorney LD. #86569 3631 North Front Street Harrisburg, P A 1711 0 (717) 232-7661 Attorneys for Additional Defendant, Judith L. Jump ,'. -,'~ ,- '-,< ,-'- -",,:.';:"', ,">',,, --;:',,' J" " ~-I."~-"-''!~->.-_,Jt-" ,-. ',' .".'~' '-"", 1 "'" ... KATHY DELGRANDE, Plaintiff vs. VALLEY QUARRIES, INC. Defendant vs. JUDITH L. JUMP, Additional Defendant .-, : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA : NO. 01-6185 : CNIL ACTION - LAW PRAECIPE Please attach the Notice to Plead to the Answer and New Matter of Additional Defendant, Judith L. Jump, to Defendant's Additional Defendant Complaint that was filed with the Court on April 5, 2002, in the above-captioned matter. Date: I.( ...CEo ' 0 1,...- " ., - -. .<- - "", --" ,"-" ~-" -.-, ',' "I~ ,- l_~ _,,'~. '. , ,-'",: Respectfully submitted: James . Goldsmith, Esquire AttorneyI.D. #27115 Douglas E. Herman, Esquire Attorney I.D_ #86569 3631 North Front Street Harrisburg,PA 17110 (717) 232-7661 Attorneys for Additional Defendant, Judith L. Jump ','. " ." , "'. kf'''f')-':J_::'it.--'.~", " ,-- ::.1 :-':'1 >i '.J ,~;;m~_"~_.., " ~ ... -' '.' CERTIFICATE OF SERVICE .... AND NOW, this ~ day of ~.Q..J ,2002, I hereby certify that I have served a copy of the within document on the following by depositing a true and correct copy of the same in the U.S. Mails at Harrisburg, Pennsylvania, postage prepaid, addressed to: Michael E. Kosik, Esquire ANGINO & ROVNER, P .C. 4503 North Front Street Harrisburg, P A 1711 0-1708 Harry D. McMunigal, Esquire BINGAMAN, HESS, COBLENTZ & BELL, P .C. Treeview Corporate Center 2 Meridian Boulevard, Suite 100 Wyomissing, PA 19610 CALDWELL & KEARNS B~ d!kw-J 02-131/37300 .,"-~- " ':il~' "~~~-_->,,-__L'!""': --;c- -- ~: ., 1I -~. ~ ,." ""^-." -, " -"~TuiJW~'/t!cr-t~:lil-lf J-t l ~ j "ilotf!rnr""r'Vji'i+~f'9~fi1.Ft. Ill'" 'jO' o C ;;;'? tV8~ ~~~~ -....~_." !;=C; ~() ~-C~ "". .> .-'-"C Z =< ~3''''' ~__. '_~~_'_'_'__"",~_, f.< f '~t ::p. -OJ -:::rJ I <D *'\1 ,;~\::::! t~F;~ ~ -< (,..11 en p-,.., ~:-.I (311 ",. 7^~'(O"l _'." -c'~:""::_::_ .t'(, _ ~ _,~,~" ,,",,", -~- -'. ~- -, --",~- '" R,- ~,,-' ~_-~~,",r>::7~_:o~~~)15,\"_r'J,,; .";, ,,,_~,,,t.,,,,,:"" -'. :,,:~~~~Ii!H~~~~f'- _'JlI~~ ,I~" ',' ,:~c c' j:'':-' --~-',,.-., ~,,-,r ~_ ;,' ~_ r('~-!':. ,'.'~_r, Jt; :~~>li'<'f'j";'~'-' =-.- ,.. ... - . ,. .. KATHY DELGRANDE, Plaintiff : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA vs. : NO. 01-6185 V ALLEY QUARRIES, INC. Defendant vs. JUDITH 1. JUMP, Additional Defendant : CNlL ACTION - LAW : JURY TRIAL DEMANDED PRAECIPE TO THE PROTHONOTARY OF SAID COURT: Please enter my appearance on behalf of Additional Defendant Judith 1. Jump, in addition to the entry of appearance for Attorney James 1. Goldsmith, Esquire, which was filed with this Court on February 27, 2002, in the above-captioned matter. By: ~l:S~ Douglas E. Herman, Esquire Attorney I.D. #86569 3631 North Front Street Harrisburg, PA 17110 (717) 232-7661 Attorney for Additional Defendant - Dated: L( ...., g ,. 0 'l- :/11, ~_ '< (,1 ,)J , ~7f,">. "' _,- ~- ""- _,_"" -_" e _, __,._,___,_,_~ ',~_,"" ""_W,,"'_ , .- , -, ,-- ,--~ - ,-' ,. . , ,- .. .- . CERTIFICATE OF SERVICE ~ ~ AND NOW, this K day of , 2002, I hereby certify that I have served a copy of the within document on the following by depositing a true and correct copy of the same in the U.S. Mails at Harrisburg, Pennsylvania, postage prepaid, addressed to: Michael E. Kosik, Esquire ANGINa & ROVNER, P .C. 4503 North Front Street Harrisburg, P A 17110-1708 Harry D. McMunigal, Esquire BINGAMAN, HESS, COBLENTZ & BELL, P.e. Treeview Corporate Center 2 Meridian Boulevard, Suite 100 Wyomissing, PA 19610 CALDWELL & KEARNS By flodA1({lh ~ 02-131/38742 i'ir~Jl_, ,'lWf_ '_~_"'_~', -'","'i ,-_,,,_-"-;-,__.\:,,,,0'; -__~"_""---~__":'Y"/_ '__I'~:'~"__, _ -1-' --'-''''-'.' ~-'-", ~ ,''< ,-- -, "'.. ~ -~,,' II I: Ii II Ii i I II il Ie ~ Ie! ;~ 1IIr'IIR . -, ~ - .-, ,;~" ' '",'" ~ ,- ~ _.-~ '~,~~, --~,,~--p ._--"~'" "<.''',~-~~ -- -~, , .. Cl C- '-:;.~- '"1'"1,-.';- 9df.T 7"[" ,:1--'> .-.- ,-. ,-,:' i,.'"._ ~5' {~ ~""",,~~ ~"- --"'- '. :J1 ,~~ '-' ...-. ''in!&!" " C~ r,,) ].~ " ::<::;t '" c....:', C) -q -I -.~,~':J -:-j:::) __;lL t ,_-1 - -- -~..J .~ ~~ f5 g;J """ ~ ";"""__~.~_,.~"'_""'~_::'?:"'}'_ y"",<t!~h.f~;"J~~~1~~T:4~l;j~ ',- ' "!.-"'_'_~\":, ,mojo '-'\\"~-C"",~~m--p,.-,,-- ,m.,~J,,__, ,-_i>:Jl~ BINGAMAN, HESS, COBLENTZ & BELL, P.C. BY: HARRY D. McMUNIGAL, ESQUIRE IDENTIFICATION NO. 38386 TREEVIEW CORPORATE CENTER 2 MERIDIAN BLVD., SUITE 100 WYOMISSING, PA 19610 (610) 374-8377 (610) 376-3105 (Fax) ATTORNEY FOR DEFENDANT VALLEY QUARRIES, INC. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA KATHY DELGRANDE, Plaintiff, vs. : NO. 01-6185 VALLEY QUARRIES, INC, Defendant, : CIVIL ACTION - LAW vs. : JURY TRIAL DEMANDED JUDITH L. JUMP, Additional Defendant CERTIFICATE OF PREREQUISITE TO SERVICE OF A SUBPOENA PURSUANT TO RULE 4009.22 As a prerequisite to service of a subpoena for documents and things pursuant to Rule 4009.22, Defendant certifies that (1) a notice of intent to serve the subpoena with a copy of the subpoena attached thereto was mailed or delivered to each party at least twenty (20) days prior to the date on which the subpoena is sought to be served, (2) a copy of the notice of intent, including the proposed subpoena, is attached to this certificate, (3) no objection to the subpoena has been received, and (4) the subpoena which will be served is identical to the subpoena which is attached to the notice of intent to serve the subpoena. Dated: 5 /3'1",~ BINGAMAN, HES COBLENTZ & BELL, P.C. I... By: Ha . cMunigal, Esquire Attorney for Defendant, Valley Quarries, Inc. 191157 ji ;,_,)IWl: "_"" .,.r!",,'-~~,~'__'_ "., """, '>.'_"<"'" .' "'-;"~_----F:-~_,,~'-__""7~-_-r-"" ,..,.... ~--, ',._.,__~ "0"", ,. > ..., 'v -" _""'"",_',_ .. _~' ''C Of""".'. <__' _"".. n'_" ,~ '7.' _'_'_', ^d'- ',,".,~ IB~I DAvID E. TURNER MARK G. YODER CARL O. CRONRATH. JR. KURT ALTHOUSE LYNNE K. BEUST H1.\RRY D. McMUN1GAL PA.TRICK T, BARRETT EllZABETH D. McMUNIGAL Ei:lJC J. FABRIZIO DOMINIC A. DeCECCO AMY C. ROTHERMEL BINGAMAN, HESS, COBLENTZ & BELL A PROFESSIONAL CORPORATION ATTORNEYS AT LAW RAYMOND K. HESS OF COUNSEL TREEVlEW CORPORATE.CENTER SUITE 100.2 MERIDIAN BOULEVARD WVOMISSING. PA 19610 TELEPHONE (610) 374-8377 FAX # (610) 376-3105 www.bhcb.com J. WENDELL COBLENTZ RALPH J. ALTHOUSE. JR. RETIRED LLEWELLYN R. 61NGAMAN 1907-1996 JAMES F. BELL 1921-1986 May 24,2002 Michael E. Kosik, Esquire Angina & Rovner, PoCo 4503 North Front Street Harrisburg, PA 17110-1708 RE: Delqrande v. Vallev Quarries. Inc. v. Judith L. Jump Cumberland County C.C.P. No. 01-6185 Our File NO.1 0176-828 Dear Mr. Kosik: Enclosed please find a Notice Of Intent To Serve A Subpoena To Produce Documents And Things For Discovery Pursuant To Rule 4009.21 relative to the above- captioned matter.. If you have any objections to same, please advise within the next twenty (20) days. If you are willing to waive objections, please advise me. Very truly yours, BI:OA15 HESS. COBLENTZ & BELL. P.C. H:!;D. McMunigal HDM/MSB:cp Enclosures cc: Douglas E. Herman, Esq. (w/encL) 191157 -".~'{'i<_~~, BINGAMAN, HESS, COBLENTZ & BELL, P.C. BY: HARRY D. McMUNIGAL, ESQUIRE IDENTIFICATION NO. 38386 TREEVIEW CORPORATE CENTER 2 MERIDIAN BLVD., SUITE 100 WYOMISSING. PA 19610 (610) 374-8377 (610) 376-3105 (Fax) ATTORNEY FOR DEFENDANT VALLEY QUARRIES, INC. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA KATHY DELGRANDE, Plaintiff, vs. : NO_ 01-6185 VALLEY QUARRIES, INC, Defendant, : CIVIL ACTION - LAW vs. : JURY TRIAL DEMANDED JUDITH L. JUMP, Additional Defendant NOTICE OF INTENT TO SERVE A SUBPOENA TO PRODUCE DOCUMENTS AND THINGS FOR DISCOVERY PURSUANT TO RULE 4009.21 Defendant intends to serve a subpoena identical to the one that is attached to this notice. You have twenty (20) days from the date listed below in which to file of record and serve upon the undersigned an objection to the subpoena. If no objection is made the subpoena may be served. BINGAMAN, HESS. COBLENTZ & BELL, P.C. Dated: 5/!~/02 By, ",:i?"8.""ig,,. E,q";rn Attorney for Defendant, Valley Quarries, Inc. 191157 .-",A'pry&q,'''~t':f 0._",__~,.o_ ~ <= ~-r ' I " 1- ~~ .... ~~ '- .",~ ., - ,"'. ...c " ~T11 OF pENNSYLVANIA CXXJNI'Y OF aJMBER1.AND KATHY DELGRANDE, PLAINTIFF V. vALLEY <;pARRIES, INC., DEFENDANT V. JUDITH L. JUMP, ADDITIOOAL DE:FmDANr S\.JBPOEHA TO PR<Xll.O:" r:x::ctYENTS Cfl TH I NGS FCfl DISCOVERY PUlSUANT TO RULE 4009.22 Fi Ie No_ 01-6185 roo 'RFrYlRDS CUS'IODIAN , MADEJRA CHIROPRACrIC (Nacre of Person or Entity) Within twenty (20) days after service of this subpOena, you are ordered by the court to produce the fo 1 lowing docunents or things: SEE A1TACHED - - .. - - '--,;,:.,.::;"" HESS C03[EN.[Z& ffiL;.C. mEEVIDlc:rnP. cm:Iffi, ~ EDJD., rnriE 100, WJ.UVlJ.llilNj, j,'}\. 19610 at ~~=:!':!.!.__'_ > 1.__ " _: . . ',;--- _' ~__ -~ (Address) You ITaY de;iver or mail legible copies of the docunents or produce things requested by this subpoena. together' with the certificate of carpliance. to the party making this request at the address 1 ;",ted above. You have the right to seek in advance the reasonab I.. cost of preparing the copies or producing the things sought_ If you fail ( 20 ) days after c:<.11'Pe 11 ir:g yo<..: to to ;-roduc.e the docurents or it" servi:oe, the party ccrrply wit-h it. things reQUired by this subpo.3n'l withir. t><enty serving this subpoena rr.ay seek a CO'~rt orde.' fH I S SUBPOENA WAS I SSUED AT THE REQlEST or THE F<X..LCW I NO PERSON: l-w-t:: : ~ D. MJ1.NlG\L,ESJ]JRE ADORESS :jREEllIElVTRP CFNll'R,.,JVTIE 100, 2 M:RJ:IlItN ELID. ~, PA 196,10 rELEPHONE: (610)_37~ ';lPREM: o::u1T I D 11_38386 .\ rrCflNEY FOR: W\IlEY Q]'IRRIES, I!\C. 'ArE:" !Jl'::1t:""'''''' -.rv<::l -. .d..d...r--~--~ Seal of he Court ~~-~- ~ ----- protkonotarY/Cler~';iS ion ~[!_.?n~.. L!.(t.. C>eputy (Eff _ 1/91} .~ . ~~ BINGAMAN, HESS, COBLENTZ & BELL, P.C. BY: HARRY D. McMUNIGAL, ESQUIRE IDENTIFICATION NO_ 38386 TREEVIEW CORPORATE CENTER 2 MERIDIAN BLVD., SUITE 100 WYOMISSING, PA 19610 (610) 374-8377 (610) 376-3105 (Fax) ATTORNEY FOR DEFENDANT VALLEY QUARRIES, INC. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA KATHY DELGRANDE, Plaintiff, vs_ : NO. 01-6185 VALLEY QUARRIES, INC, Defendant, : CIVIL ACTION - LAW vs. : JURY TRIAL DEMANDED JUDITH L JUMP, Additional Defendant RECORDS CUSTODIAN, CHAMBERSBURG HOSPITAL: Any and all medical bills, hospital records, reports or other documents in any way relating to the examination, diagnosis, observation, investigation, treatment, admission, discharge, radiology studies, evaluations, medication, history, emergency services, ambulance services, opinions, instructions, recommendations, laboratory, nursing assessments, consultations, physicians notations and reports, third party reports records and evaluations, progress reports, including microfilm, microfiche, emergency room reports, operating room reports, discharge summaries, consultation reports, x-ray reports, out-patient records physical therapy records and any other information pertaining to: Patient: Kathy Delgrande Address: 504 Brenton Street Shippensburg, PA 1/17/65 209-60-4571 D.O.B: SSN: 191157 , '''8fiW;.~,~'1c~~J"jI~ _-~ ~<"!'!!iN. , . ~ -"-', . I _n _ _.__l .. , '. . ~TlI OF pENNSYLVlINIA CXXJNIY OF 0JMl3ERL/\ND KATHY DELGRANDE, PLAINl'IFF V. VALLEY' WARRIES, INC., DEFENDANT V. JUDITH L. JUMP, ,~h~ ADDITICl'IAL DEFEND'"".. SUBF'OENA TO PRCCX.X:E o<x:U'1ENTS OR TH I NGS FOR DISCOVERY PIfilSUANT TO RULE 4009 _ 22 Fi Ie No_ 01-6185 TO: RECJ)RDS CIJSTODIAN I ALLSI'ATE INSURANCE <XlMPANY (Nane of PersO<'\ 0<" Entity) within twenty (20) days after service of this subpoena. you are ordered by the court to produce the following doa..ments or things; SEE A'ITACHED_ at ~. IDS,_ cm.ENIZ & IDL, - -- - - - - ~ P.S'1REEVIEW CI:RP.CENIER,2M!RmIlNILVD., ~ 100, _~, t'A l~10 (Address) You may de;iver or mail legible copies of the doct.ments or produce things requested by tl-,;s subpoena. together' with the certificate of carpliance. to the party making this request at the addre.ss l~",ted above_ You have the right to seel< in advance the reasonabl,. cost of preparing the copies or producing the things sought. If you fail (20) days after cc.ni:>e II i r:g yO!.: to to ;.>roduce the docunents or its servi:::e. the party COTPly with it.. things required by this subpo..:on'l. wit.hi" t"'lenty serving this subpoena rr-ay seek a iX)'~rt order' THIS SWPOENA WAS ISSUED AT THE REQ.X;:ST OF TIiE FOLLCWING PERSON: fW"E: Hi>BRY' D. M:M.NIoo"ES;JJJI<E AlXlRESS: ..1EEEllEN.JIRP. cmIER.~ 100, 2 JIIERII1[IN BOJD. ~':l::iII\G, ffi ~10 rELEPl-DNE: (610\ ,;;]4-$77 'U'REMo CCUlT I() 11 38386 ., rrORNEY F 00 : \IAI1E{ Q.W<RIES, n;c. lATE: fYl~t. :;~.I-~b....- Sea I 0 f t e ():)ur1: ~Z~27 .__- Prothonotary/Clerk. I ui';is;on ~2.~-.- f.J:t: ;)eputy (Eff _ 7/97) ,-,.-.;~~~~, ~,~'" .,".. BINGAMAN, HESS, COBLENTZ & BELL, P.C. BY: HARRY D. McMUNIGAL, ESQUIRE IDENTIFICATION NO. 38386 TREEVIEW CORPORATE CENTER 2 MERIDIAN BLVD., SUITE 100 WYOMISSING, PA 19610 (610) 374-8377 (610) 376-3105 (Fax) ATTORNEY FOR DEFENDANT VALLEY QUARRIES. INC. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA KATHY DELGRANDE, Plaintiff, vs. : NO. 01-6185 VALLEY QUARRIES, INC, Defendant, : CIVIL ACTION - LAW vs_ : JURY TRIAL DEMANDED JUDITH L. JUMP, Additional Defendant RECORDS CUSTODIAN, DR. JOHN R. FRANKE NY, II and the ORTHOPEDIC INSTITUTE OF PENNSYLVANIA: Any and all medical bills, hospital records, reports or other documents in any way relating to the examination, diagnosis, observation, investigation, treatment, admission, discharge, radiology studies, evaluations, medication, history, emergency services, ambulance services, opinions, instructions, recommendations, laboratory, nursing assessments, consultations, physicians notations and reports, third party reports records and evaluations, progress reports, including microfilm, microfiche, emergency room reports, operating room reports, discharge summaries, consultation reports, x-ray reports, out-patient records physical therapy records and any other information pertaining to: Patient: Kathy Delgrande Address: 504 Brenton Street Shippensburg, PA 1/17/65 209-60-4571 D.O_B: SSN: 191157 ",,"~BeiIIIi,.~ .~. ~ 0 __I '. BINGAMAN, HESS, COBLENTZ & BELL, P.C. BY: HARRY D_ McMUNIGAL, ESQUIRE IDENTIFICATION NO. 38386 TREEVIEW CORPORATE CENTER 2 MERIDIAN BLVD, SUITE 100 WYOMISSING, PA 19610 (610) 374-8377 (610) 376-3105 (Fax) ATTORNEY FOR DEFENDANT VALLEY QUARRIES, INC. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA KATHY DELGRANDE, Plaintiff, vs. : NO. 01-6185 VALLEY QUARRIES, INC, Defendant, : CIVIL ACTION - LAW vs_ : JURY TRIAL DEMANDED JUDITH L. JUMP, Additional Defendant RECORDS CUSTODIAN, KEYSTONE SPINE CENTER: Any and all medical bills, hospital records, reports or other documents in any way relating to the examination, diagnosis, observation, investigation, treatment, admission, discharge, radiology studies, evaluations, medication, history, emergency services, ambulance services, opinions, instructions, recommendations, laboratory, nursing assessments, consultations, physicians notations and reports, third party reports records and evaluations, progress reports, including microfilm, microfiche, emergency room reports, operating room reports, discharge summaries, consultation reports, x-ray reports, out-patient records physical therapy records and any other information pertaining to: Patient: Kathy Delgrande Address: 504 Brenton Street Shippensburg, PA 1/17/65 209-60-4571 D.O.B: SSN: 191157 -*,,~_c -I CCM-1JNWEALTII OF PENNSYLV1\N1A CC<JNTY OF (JJMBERU\NO KATHY DELGRANDE. PLAINl'IFF v. vl'llEi (pARRIES, INC., DEFENDANT V. JUDITH L. 01-6185 Fi Ie No, JUMP, ~"'~..", ADDITIQ'lAL Dill' "'-''"''''U SUBPCENA TO PR(X){X;€ rx:x::tM:NTS OR TIi I NOS FOR 0 I SCX>VERY PrnSUANT TO RULE 4009.22 TO: RFIDRDS CUS'IODIAN, MADEIRA CHIROPRAcrrc (N<I1le of Person or Ent i ty) within twenty (20) days a.fter service of this subpoena.. you are ordered by the court to Pf'oduce the fo I lowing docurents or things: SEE ATl'ACHED . --~ HEffi ClllENlZ & IDL PC '1REFJ1EW <:rnP. ClNlffi, 2M'RIIIflN aID., aJTIE 100, ~, 11\ 1%10 at . ~ .___ __L' . ' .. a r _ ~_ (Address) You may de; iver or mail legib Ie copies of the docunents or produce things requested by this subpoeoa. together' with the certificate of =Iiance. to the party making this request at the addreoss l;,;ted above. You have the right to seek in advance the reasonablE' cost of preparing the copies or producing the things sought. If you rail (20) days after c:orpe II i r:g yo<.: to to ;>roduce the docunents or i be; serv l.::e, the party =rply with it_ things reQUired by this su~~~ within t~enty serving this subpoena rr'ay seek a CO'Jrt ord",' fH I S SWPCENA WAS I SSUED AT 1l-lE RE<LEST OF 1l-lE FOLLCW I NG PERSON: fW'E : HI'H<Y D. M:M.NIG\L,E8;PJRE ACORESS: ~<:rnP. a:NIERt-llJl'lli 100, 2 M'RJI!I]N EIJiD. ~. PA 1~10 rF.lEPHJNE: (610) TI4-MT7 ';U?REM: a:un ID It_38386 "TTORNEY Foo: VN.IEi QWRIES, The. )ATE: m ';:J 1.: ;) :)...t-;;U:O~ Sea I of he Cout-t- BY TIt?fKT:,. ~~ ---. -. ~ -- -_.------ ProthonotarY/Clerk. Civ u;'.'ision ~[??n~.. L~' ;)eputy (Eff, 7/97) c r - - ,-l1l ~ ",; , ,___c _, BINGAMAN, HESS, COBLENTZ & BELL, P.C. BY: HARRY D. McMUNIGAL. ESQUIRE IDENTIFICATION NO. 38386 TREEVIEW CORPORATE CENTER 2 MERIDIAN BLVD., SUITE 100 WYOMISSING, PA 19610 (610) 374-8377 (610) 376-3105 (Fax) A TIORNEY FOR DEFENDANT VALLEY QUARRIES, INC. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA KATHY DELGRANDE, Plaintiff, vs. : NO_ 01-6185 VALLEY QUARRIES, INC, Defendant, : CIVIL ACTION - LAW vs. : JURY TRIAL DEMANDED JUDITH L. JUMP, Additional Defendant RECORDS CUSTODIAN, MADEIRA CHIROPRACTIC: Any and all medical bills, hospital records, reports or other documents in any way relating to the examination, diagnosis, observation, investigation, treatment, admission, discharge, radiology studies, evaluations, medication, history, emergency services, ambulance services, opinions, instructions, recommendations, laboratory, nursing assessments, consultations, physicians notations and reports, third party reports records and evaluations, progress reports, including microfilm, microfiche, emergency room reports, operating room reports, discharge summaries, consultation reports, x-ray reports, out-patient records physical therapy records and any other information pertaining to: Patient: Kathy Delgrande Address: 504 Brenton Street Shippensburg, PA 1/17/65 209-60-4571 D.O.B: SSN: 191157 --;';-"'J:i-!:J;\;fJf$W-4~Rll'-(l'! ", ,I'I!!iIli!liii!f'f" ~- ~. . I ~ "~" r, . llif"~.' -- ., , '. ~TH OF PENNSYLV1\NIA CXXJNI'Y OF QJMBERLI\ND KATHY DELGRANDE, PLAINI'IFF V. VAUEi cpI\RRIES, INC., DEFENDANT V. JUDITH L. JUMP, ~"...~"..", ADDITICNAL D"",""'''''''''' Fi Ie No.. 01-6185 SUBPa:NA TO PRCCU;E DCO...M::NTS 00 n-tltnS Foo 0 I SCOVERY PillSUANT TO RULE 4009. 2Z ro: RE<J)RDS arSTODIAN, ALLSTATE INSURANCE COMPANY (N<me of PersOfl 0<" Entity) Within twenty (20) days after service of this subpoena, you are ordered by the court to produce the following donmeots or things: SEEATI'ACHED . -"-';:;';,..;,;~:"., ucr..-. ~== & IEIL P.c. 1REEVlEW CIRP. CENlI'R, ~ ILv!)., mrIE 100, Wll..MlH:iJN.j, 11\ 19610 at ~~:~~_ n:::.L:CJ, u..LlLU'U.-U .' . , __ (Address) You may de; ive..- or ma i I legib Ie copies of the doct..ments or produce things requested by this su\)poerla, together- with the certificate of carpliance. to the party making this request at the address li~ted above. You have the right to seek in advance the reasooabl€" cost of preparing the copies or ~roducing the things sought.. I f you fa; I to ;>roduce the docunents or things required by this subpo.:ln'l withir. t'-tenty (20) days after it:; servke, the party serving this subpoe...a tT.ay seek a CO'Jrt ord"," <XIT1'>ellir:g l'()I; to carply with it.. ll-IIS SUBPOENA WAS ISSUED AT 1liE RE~ST OF 1liE FOLLCWING PERSON: IV\I"E : HIffi'l D. M:M.NJG'\L,:ESJjillE J\fXlRESS: ..'IHEE/1Eh1..CIRP. (}NJffif--mrIE 100, 2 M;RJDiNl BID. ~, PA 1%10 rELEPfUlE: (6101 I!4-fBT! 'APRE/"'E exUlt 10 II 38386 ,\ rTORNEY FOR: WIIIEY Q.WR!ES, oc. 8Y 1l-i: ex::un: Di~':ls~()(\ 'ATE: fY/;:;..te ..J~r~~ Sea I of t e Courr (Eff.. 1/97) i~l , '""-,"--,",,,~~". ~. > ,~ <,.. ,'''''''' ,~~ ""~ ~ ,-, -'-t.:--. - " t j BINGAMAN, HESS, COBLENTZ & BELL, P.C. BY: HARRY D. McMUNIGAL, ESQUIRE IDENTIFICATION NO. 38386 TREEVIEW CORPORATE CENTER 2 MERIDIAN BLVD., SUITE 100 WYOMISSING, PA 19610 (610) 374-8377 (610) 376-3105 (Fax) ATTORNEY FOR DEFENDANT VALLEY QUARRIES, INC. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA KATHY DELGRANDE, Plaintiff, vs. : NO. 01-6185 VALLEY QUARRIES, INC, Defendant, : CIVIL ACTION - LAW vs.. : JURY TRIAL DEMANDED JUDITH L.. JUMP, Additional Defendant RECORDS CUSTODIAN, ALLSTATE INSURANCE COMPANY: Any and all PIP files, claims, medical records, medical bills, payment logs, insurance records, adjuster notes, applications for benefits, evaluations, correspondence, etc. pertaining to any claims filed by or on behalf of Claimant: Kathy Delgrande Address: 504 Brenton Street Shippensburg, PA 0.0.8: 1/17/65 SSN: 209-60-4571 Date of loss: 5/7/00 Your Insured: William Delgrande Claim #: 665273070302 191157 -_'<:i%'iBittii~ "-~ -',,", - 1 ~ - ~w '~II!II 11,. ~" ..~~~ ~.~ '~"".'1""'''''''''''",TA'_'''''''''' "-,,,,c.,,--><,,",~'~"- ~ "~'~',~ (') ~ -r.~C'" !1,:--'-' "'---.'- S> ~~- ~;~ ~~"~ :J 'iI'l'k~"~'"1ITlr'"T": rr"<"n"f o ~. --..: I,"::: " I C} --_i- '-f? ::? CO , ~1" :::-0 -< (;5 1311 1I!l~~~ ~rtl>~~!J:_~~~",~~,!~'m.'!<"i1"'W,;'-";"f~"""~';!'';i'''';;;:;ilJ;:-''j'W"(;;-~'':''-'':-'''''il'''!J;,lWI~m1.%jjl\l~~'JiI't~~;!i1lW1!fili\!Hl!l!~!~,.)at.~~;~,~~~; ::! n :'1 l'; ':i [-j ::-i ',i i-I ",I :-:-1 f:J . , l~1 i'c, I,;] H " 1I I\j 1:1 I' ,I H H i:") H b' n I; r-~ 1 u I,,'! ~' , I f'r U r.,' r: ! ~i ::;.j:'j-_~l,~--,-'f, ., . " . . BINGAMAN, HESS, COBLENTZ & BELL, P.C. BY: HARRY D. McMUNIGAL, ESQUIRE IDENTIFICATION NO. 38386 TREEVIEW CORPORATE CENTER 2 MERIDIAN BL YD., SUITE 100 WYOMISSING, PA 19610 (610) 374-8377 (610) 376-3105 (Fax) ATTORNEY FOR DEFENDANT VALLEY QUARRIES, INC. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA KATHY DELGRANDE Plaintiff CIVIL ACTION - LAW NO. 01-6185 v, VALLEY QUARRIES, INC. Defendant v. JUDITH L. JUMP Additional Defendant JURY TRIAL DEMANDED ANSWER OF DEFENDANT VALLEY QUARRIES, INC. TO NEW MATTER AND NEW MATTER CROSSCLAIM OF ADDITIONAL DEFENDANT JUDITH L. JUMP ANSWER TO NEW MATTER 9. Answering Defendant incorporates herein by reference as though fully set forth at length paragraphs I through 8 of its Complaint against Additional Defendant. 10-15. As these allegations are directed to Plaintiff, no responsive pleading from Defendant is required. 16. Denied. The allegations of paragraph 16 constitute conclusions of law to which no response is required. To the extent that responsive pleading is required, it is specifically denied that answering Defendant acted at any time relevant herein through its employees or agents. The allegations of paragraph 16 are deemed denied pursuant to Pa.R.C.P. 1029. --";",j.' _'."~O -' '., --,-"'.,,--~ o--~_~_-,'~-----',~-0f'_1 ~;- ~', :, :1'" ' ~:_." ,~_.< "'"Cj'_~' --." ." --<-,;-,~-',,-, -' ~, ,o._~_ -,c-__,_,__;_~_, -__~_s" ''',c-''.'' '~~!_.0'" __ '-,'- --,-,',,--.,' r " 17. Denied. It is specifically denied that the metal tripod in question was owned by answering Defendant. The allegations of paragraph 17 are deemed denied pursuant to Pa.R.C,P. 1029. 18-19. The allegations of paragraphs 18 through 19 are deemed denied pursuant to PaRC.P. 1029. 20. Denied. After reasonable investigation, answenng Defendant is without information sufficient to form a belief as to the truth or accuracy of the averments of paragraph 20 of Plaintiffs' Complaint and the same are accordingly denied, Specific proof thereof, if relevant, is demanded at trial. 21. The allegations of paragraph 21 are deemed denied pursuant to Pa.R.C.P. 1029. WHEREFORE, answering Defendant respectfully requests that Additional Defendant's New Matter be dismissed with prejudice and costs. } ~j: r~ ANSWER TO NEW MATTER PURSUANT TO PaRC.P. 2252(d) ~;: 22. Answering Defendant incorporates herein by reference as though fully set forth at (" length paragraphs 1 through 8 of its Complaint against Additional Defendant and paragraph 9 ki co: through 21 of its Answer to Additional Defendant's New Matter. ',; 23. Denied. The allegations of paragraph 23 constitute conclusions of law to which no response is required, ;'-j << 24, Denied. The allegations of paragraph 24 constitute conclusions of law to which I';' no response is required. To the extent that responsive pleading is required, it is specifically r~ ~--i denied that answering Defendant acted at any time relevant herein through its employees or ,-' ;~ --, c" agents. The allegations of paragraph 24 are deemed denied pursuant to Pa_R_C.P. 1029. ., fl t', . Y';!\},,).,4. "-' '- "0' ',,", '.'__" ,"-,"'~ ^ 1-- ,c____,,, 'l'-'-::~'~-' -'"no' '__'_,~, ~,~ ., -" - -,-- ".~--, '~--, --' - - ," - ~. . " ~ ",,~-. ',-,' . _'1_ ,f> <r." .' ~ .. ~':r:~1.:;',.~. . , " WHEREFORE, answering Defendant respectfully requests that Additional.Defendant's New Matter Crossclaim be dismissed with prejudice and costs. BINGAMAN, HESS, COBLENTZ & BELL, P.C. tfy--t-, Harry D?McMunigal, Esquire Attorney for Defendant ""''':'''>'',,,'<O'_':'~_ c.'; ,.,'. ',', '.' ,"',[ .~-:;c.,'.", '~,~O',' <:r"," , _~, "~' ~'" --I ". ',- .", ~.c _' YO _ .....,..< . "'.<",, ~"" ,.~ "" . ii ~ ~~~_. H. _ VERIFICATION The undersigned, being duly sworn according to law, deposes and says that he is counsel for the party or parties indicated on the preceding page as being represented by said counsel, that he has examined the pleadings and the entire investigative file made on behalf of said parties, that he is taking this verification to assure compliance with the pertinent rules pertaining to timely filing of pleadings and other docwnents described by said rules; and that the facts set forth in the foregoing docwnent are true and correct to the best of his knowledge, information and belief. The undersigned understands that the statements therein are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsifications to authorities. Hmy D~"re DATED: 7-r.o~ L".'.;.~-W.,,; 'C -. ".j. "" ; -' "",;":":1 '" ,',~ -1'" ".r;.".,"" ~":".''''-::<;';~, "I' ~ _, .,A . ','--." , c,,','~:" $;'"" -- . '-,,- . . BINGAMAN, HESS, COBLENTZ & BELL, P.C BY: HARRY D. McMUNIGAL, ESQUIRE IDENTIFICATION NO. 38386 TREEVIEW CORPORATE CENTER 2 MERIDIAN BLVD., SUITE 100 WYOMISSING, PA 19610 (610) 374-8377 (610) 376-3105 (Fax) ATTORNEY FOR DEFENDANT VALLEY QUARRIES, INC. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA KATHY DELGRANDE Plaintiff CIVIL ACTION - LAW NO. 01-6185 v, VALLEY QUARRIES, INC. Defendant v. JUDITH L. JUMP Additional Defendant JURY TRIAL DEMANDED CERTIFICATE OF SERVICE I, Harry D. McMunigal, Esquire, hereby certifY that a true and correct copy of the foregoing Answer of Defendant Valley Quarries, Inc. to New Matter and New Matter Crossclaim of Additional Defendant Judith L. Jump was mailed by United States first class mail, postage prepaid upon the following party(ies): Douglas E. Herman, Esquire CALDWELL & KEARNS 3631 North Front Street Harrisburg, PA 17110-1533 Michael E. Kosik, Esquire ANGINO & ROVNER, P.C. 4503 North Front Street Harrisburg, PA 17110-1708 ~....~/ Harry .. McMumgal, Esqrure DATE: 1~ Y-OA- 'I'~.'~, ':7" _",a, l, . .-< -.~"-" ;. ,=---"~-- ,_. ._,-~ ',_?, ~"r_:_", ',1:'T.'~'-- ,1 "q~~i!!!}lt;,_, ,,' ";-,;>- ' '. "-,'" ,_c.__ '_0,._ ill ,~- ~~_,~< ,- _, o~ ~,,_ ,..-;.< '-~'_.-,'__,,""""'''~_''',_Jj__'-,:!'0'-'', 7,,"'f i <_'-o,,~_~_~"_"-~+::'" ,-- _'"._0'" . ,,<' ,,~-,,~~.;," ,,~- ~=r ~ - ~. -, "'..,,, rtlitiiIIHEIT.j["""( ~-, 'c<~I"']":(j';8'~> ;.~f.' ,'. (") C") ~ c: 1''0 ~o!. ., S , -U f-p - rrjl"l~ C 2:::r-' t- " Z c: ~'''!l 0? 0 --,-:':::=J r-5 C- '--.; ,~~) <" .....,.., ,-; .P r~ :-Ji: ~ :"-) Z [~5 "7 :"5 ;.:; c N C) rn Z -::--~1 =< j'.) ~ fj, 13 12~L- _.,':''':'s_'_'<'';,_'-'~I,,!(N''J','?' ,,-,' __,,~1m'i~~'~$Il:~-2I'i,;-lilfl,,_ ,t "'=, ,~~ ,'1' Jl~\_, ,,-" .~EJ'^;;; .%~.~i'1? ,~ ~ .. II ~l 1;::~~,~,_..J\__ ~.. 1 KATHY DELGRANDE, Plaintiff IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA v. CIVIL ACTION - LAW NO. 01-6185 VALLEY QUARRIES, INC., Defendant JURY TRIAL DEMANDED v. JUDITH 1. JUMP, Additional Defendant PLAINTIFF'S REPLY TO ADDITIONAL DEFENDANT'S NEW MATTER AND NOW come the Plaintiff, by and through her attorneys, Angino & Rovner, P.c.., and hereby replies to the New Matter of Defendant as follows: 9. Pennsylvania Rille of Civil Procedure 1030 provides that a party may set forth as New Matter any material facts which are not merely denials of the averments of the preceding pleading.. Additional Defendant's incorporation of her answers to paragraph 1-8 of the Complaint filed by the original Defendant Valley Quarries for the most part appears to be either admissions or denials of the corresponding paragraphs of the Defendant's complaint and therefore no response is requin:d by Plaintiff Kathy Delgrande. 10. Denied. This averment is a conclusion of law to which no responsive pleading is required. To the extent that a response may be deemed proper, it is specifically denied that Plaintiff Kathy Delgrande's claims are barred either in whole or in part by the provisions of the Pennsylvania Motor Vehicle Financial Responsibility Law. 244986.1IMEKIMMM e_. . ,_,,'_''',,_, "'-'-:,'-"0'<1':.' ":"''I.__'.1!''''_',0 -l~::!~cc-~"'_''''- .y'">", ,,~ - . -_ "! --." .. ,-"','--'''"''~',--'- _?~-"'. -~,'- ~.--- ,-- )-~ .' \1 .. 11. Denied. Ibis averment is a conclusory statement unsupported by any factual statements. To the extent that a further response may be deemed proper, it specifically denied that Plaintiff s injuries and damages, which are set forth in her Complaint, pre-existed the motor vehicle accident. To the contrary, it is averred that Plaintiff s injuries and damages as set forth in the Complaint are a direct and proximate result of the motor vehicle accident or an aggravation of a pre- existing condition. 12. Denied. Ibis averment is a conclusion of law to which no responsive pleading is required. To the extent that a response may be deemed proper, it is specifically denied that Plaintiff Kathy Delgrande is seeking to recover any sums paid or payable for any group plan, or other arrangement governed by S 1722 of the Pennsylvania Motor Vehicle Financial Responsibility Law. 13.. Denied. Plaintiff Kathy Delgrande was not required to plead specifically her tort selection. However, Plaintiff was covered by the full tort option. Additionally, Plaintiff Kathy Delgrande did plead that her injuries may be of a permanent nature causing residual problems for the remainder of her life and therefore she maintains that she did sufficiently aver that she had suffered a serious impairment of a bodily function. 14. Denied. It is specifically denied that an Additional Defendant can preserve a defense merely by making reference to it in New Matter. The Rules of Civil Procedure require that the material facts upon which a defense is based must be plead. By way of further response, it isa specifically denied that the defense of assumption of the risk is applicable to a motor vehicle accident claim, especially where the Plaintiff is a passenger.. Additionally, the defense of 244986.1 IMEKIMMM " "". contributorily negligence does not exist under the circumstances which existed at the time of the accident and as set forth in the Plaintiff's Complaint. 15. Denied. This averment is a conclusory statement which is not supported by any factual statements. It is further incorrect in that it states that the jurisdictional limit for arbitration in Cumberland County is $35,000. To the contrary, it is averred that the jurisdictional limit in Cumberland County is $25,000. By way of further response, it is specifically denied that Plaintiff's damages do not exceed the jurisdictional amount necessary for requesting a jury trial. 16. This averment is addressed to Valley Quarries and therefore no response is required by Plaintiff Kathy Delgrande. By way of further response, Plaintiff Kathy Delgrande maintains that Defendant Valley Quarries was responsible for the injuries which Plaintiff sustained as set forth in Plaintiff's original Complaint. 17. This averment is addressed to another party and therefore no response is required by Plaintiff Kathy Delgrande. 18. Admitted. 19. Admitted.. 20. Plaintiff Kathy Delgrande is unable to confirm or deny Additional Defendant's allegation that she was driving at or below the posted speed limit. The police accident report suggest that the Additional Defendant had estimated her speed as 50 miles per hour. 21. Plaintiff Kathy Delgrande is not certain what the Additional Defendant means by the allegation that road and weather conditions were favorable. Plaintiff Kathy Delgrande will admit that there were no adverse weather conditions such as rain, snow, fog, or other weather which 244986.1IMEKIMMM - """,".Il';' ,", ,." I!, .~', v.c'...s ~_ _ ,": ,,_",' ," -I" . -, ".,,", "",", , "--', --",~-" ,~.~. "' ,,~. <"" _. ~..'C '(-,_." _",_ ~ II '. would have affected Additional Defendant Jump's driving.. It is further admitted that the roadway was dry, however, construction was being undertaken on the highway with one lane closed as set forth in Plaintiff's Complaint. WHEREFORE, Plaintiff respectfully request that this Honorable Court dismiss Additional Defendant's New Matter enter judgment in favor of Plaintiff and against Additional Defendant. P.C. ichael E. Kosik, Esquire LD.. No. 36513 4503 N. Front Street Harrisburg,PA 17110 (717) 238-6791 Counsel for Plaintiff 244986.1\MEKIMMM "~q~~~~~ , ,"",,-.,!, -- - ~ -1--'- r-'~ - - ,u":""_">",-,: ?L', ,0_, ..1_ ~ . " VERIFICATION I, KATHY DELGRANDE, do hereby swear and affirm that the facts set forth in the foregoing Reply to New Matter is true and correct to the best of our knowledge, information and belief. I understand that this verification is made subject to the penalties of the Rules of Civil Procedure relating to unsworn falsification to authorities_ Dated: ~ .5 / lee; z.... :':t,,: C-,,"_,,~"1"__ _,< ,~" ::/;~",,-,,<"_:~_:~,_,, ","'" ,':_Pl", :'. II _I . CERTIFICATE OF SERVICE AND NOW, this 4th day of September, 2002 I, Michelle M. Milojevich, an employee of Angino & Rovner, P.C., do hereby certify that I have served a true and correct copy of the PLAINTIFF'S REPLY TO ADDITIONAL DEFENDANT'S NEW MATTER in the United States mail, postage prepaid at Harrisburg, Pennsylvania, addressed as follows: Harry D. McMunigal, Esquire Bingaman, Hess, Coblentz & Bell Treeview Corporate Center 2 Meridian Blvd., Ste. 100 Wyomissing, PA 19610 Attorney for Defendant Douglas Herman, Esquire CALDWELL & KEARNS 3631 North Front Street Harrisburg, PA 17110-1533 Attorney for Additional Defendant rrnnW-t1Yl.~ Michelle M. Miloj ich 244986.lIMEKIMMM ",__,,__-"'-0,.,,----> '1' -, ,-~_ ,^-"', _, ,--, __ ____~_"_N "-.- r- ~> .- _~,jU'M~_ , , """",._ l ~ .. -'.', ,'~'-'<'pc~.' ~,_..,' - ..........r ........ mn.IliiII" . 0 a 0 f; r,.J -n , -" (,;;] ~. -0 ,." -n l-n~T. -u p Z_~L' , ~f~ r":'l Z C C (/.J_-..-. ('''I ~.) , .., 9 -< .<~, r- C._~ ."u '1\ <<. :;"'" c) ~. ,- " r5 :2:. r, ::~ rn J? ",.-' l:...J ':.~~ :;; ",:-~- ~ 53 -j to '< -, ~~ ~_ "'_~'~"'__ "..,' ~'o<'- ,,_~_,",,)'!!J~~Pf~'fl"t~~JU!l~!"~~!l~$iiW_,:~_'lI - __,~J_L~,,~.. C'-"'."~~~'~,'r ;Pt~;,",?,,~,~! n .. ,'f""'I.'r".. .' ~tG~. it KATHY DELGRANDE, IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PA Plaintiff, CIVIL ACTION - LAW v. VALLEY QUARRIES, INc.., NO_ c)/ - t-Lt?S C!1'u~l '-r~ Defendant. JURY TRIAL DEMANDED PRAECIPE FORWRIT OF SUMMONS TO THE PROTHONOTARY: Please issue a Writ of Summons in the above-captioned matter, on Defendant Valley Quarries, Inc. 297 Quarry Road, Shippensburg, Franklin County, P A 17201_ P.C. ichael E.. Kosik, Esquire I.D_ 36513 4503 N. Front Street Harrisburg,PA 17110 (717) 238-6791 Attorneys for Plaintiff DATED: ;'-~~~~I', ~,^ -,' ','- ,'__7',~'? 1-', "-I''' .---,..,",", " ~-, . .- - -., > ,., ~ __ '^_~ - ,I!!!I!!!!!!!! ...~I1'l.~ f."f!, .~'''''.''' 51' 0 * ~' 1.1' I 1 ,., ~., u [; .'" . ~ oj , . ",', " ",',1 ,. ., ~ -~ '-, , ~.~~ ,. "'" .';i"""o'-~"""'~,\<:"-"_ "''' %" "'>'''"W!' ,. ~...,..."?- "- .< ):) (::) ~ F5 ~ -&Q, ~ { ,Ct) ~ ..t 0 ~ d () 0 co ~ c (:; ~ D !~~ .::::> '-q ~ I '" -, I '-1 ~ P? ~ -.....---:;--- u:' re ~ r:: f-~ ~ --' f"'C :-,) J r z " i>-() ". C 1 z .~~ =< ~ ~ , c,.,; --z ~@, ~, !., '." --"-"~-'-'" ,-",,-,"',',--"- - T'"~-~"" ,,,. _, ?_'_".,"__'~_=_ '" _'_'_'-ir'1,,~.~,f~'ii'?1.j'l911'f.!\\'~!~ _ ' '_ _~~F~-~~~~_,_~ ~-_iJ~ll~fl,- ~-_ __ ,-1._J]!:~~-;'_:'_,-',--'3_~-?~JT ~i1f!!,]f]1 "" 11..._", ,,- Commonwealth of Pennsylvania County of Cumberland KATHY DELGRANDE VS. Court of Conunon Pleas VALLEY QUARRIES, INC. 297 QUARRY ROAD SHIPPENSBURG, FRANKLIN COUNTY, No. 01-6185 Civil Term 19____ Civil Action - Law PA 17201 In ____UUhn______________n_________________ To __-~~!!~J[-~~!~~~_~P~~________________ You are hereby notified that Kathy Delgrande ~------------------------------------------------~------------------------------------------------ the Plaintiff has commenced an action in -___________.!:;..:kyH__~g:!:_:lQJ;L=___J;,g~______h______________ against you which you are required to defend or a default judgment may be entered against you. (SEAL) .~--------~-~~_~~__~2~~_____________________ Prothonotary Date October 29, 2001 19____ ~-2---7J2_n_n ~, C Deputy _.L_~kv.aL!J____ .")'t-"lI'I'W~ " '''''~r-~ ~ I' ._~ ~ ~-.~' '"~. .'.--,~ .~ . ,~- - ,-"~ - - ~,.- ~-."; -~- - ~~ ""''''""<><O_~ -." ~~'.~,.-" .--~ ->~li1fl ............JJ,..... , ~ , H-..]::t..,.~ gJ"'< ~ , . f-> ~ Ul . H~~ , 0-..] ag- o . 111 w :g'8~ 0 n , "'I-" , ,,*,W",Z(1) 1-'- , <Xl cr. f--I < ~?OO lil 0 , WI~ 1-'- f-> , """ ~ t>:I f-> f 1!l~~ 8 I , , Ul-..] . :t- O'> 0 f-> ",. ~ f-> >' Wf-> ::l '" () !R13~ 00 ~rtg rt Ul S 1-'- i.~: ~ n j Ul 1-'- g f->rt;>r 1-" -..] '1 . I 1< f->(1) : ' , 1-" f->(1) t>:I if;;' ... t'" i'S :f-' art", = '..., ..q H . :" Z 'm I ~ i~ I I ... , l" , , I 0 I , . I ~ f-> -..] 0 '" f-> I I I , , , I , I. I I I i I I i I I I ., i I I ~ I , !1 I Ii I ts*"', ~I,_~" _ ,,,,,,,<",.1 )l!Jl'f! ,,?,,.lI"!:'!ill,'~l!_;l11fijrl ."" ._~.",,-.';1[![tp'!;lt~. .ij,_'i'l1~"".i!~J<].~'~0'E'#E;;;:H~li~;l.j,~<illl,"",.:;~~!~m~1~.~~l1T,~f" 'J_J,J~~ ",. BINGAMAN, HESS, COBLENTZ & BELL, P.C. BY: HARRY D. McMUNIGAL, ESQUIRE IDENTIFICATION NO. 38386 TREEVIEW CORPORATE CENTER 2 MERIDIAN BLVD., SUITE 100 WYOMISSING, PA 19610 (610) 374-8377 (610) 376-3105 (Fax) ATTORNEY FOR DEFENDANT VALLEY QUARRIES, INC. KATHY DELGRANDE Plaintiff v, VALLEY QUARRIES, INC. Defendants IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW NO. : 01-6185 JURY TRIAL DEMANDED ENTRY OF APPEARANCE Kindly enter my appearance for Defendant, Valley Quarries, Inc., with offices located at Treeview Corporate Center, Suite 100, 2 Meridian Blvd., Wyomissing, Pennsylvania 19610, as the place within the County of Berks where papers, process and notices may be served. BINGAMAN, HESS, COBLENTZ & BELL, P.C. Hafr/p. ~Unigal' Esquire DATED: '.J.li~/<J1 'f~Y""i,",.< ',~::,<, --~ . - ,;':)"l ,<. - . I'~' .- . .., .' ,?-'C ' ~-~ . ";':'~ -- c,- "._ -, -,' , ,~.+. - ~~- - ~ -,;-~._~- """'" - ,~" "~ "~ i,L"'~_!"l" , ~-'"!"'". ,. ?; ~O'_ ,_. __. ._ ".~.~_..)ITm:;~, 1_~_f;.....r;4-J,,,,,~ -" "' -- .-_",~",,~ ~ ';_;;' - ,)1'" .",,"r'3:~!_1_ ,,~. ~_~, -,-, '_--'"~''' '" ',-".., ", ' ",-~-"" j,.~'" v'.~- ",,-," ~,-~ '0'<_"''''_,~''''__ ~,-'"-~'"""~--~.- -- "'''.-'~ .'="~" ~.~ () ~ 92 ~~~~ ,-_<.r (0') ~"'- ~( ~~~ )> ~-~; ,__,W~~1~1_~~~~$I~_f-1!";__"y~n~I1J____ , , .-~! ::s: L".J --< co g Blf ,;.I(IWi_ <,_'"':""~~o-",,,",,:,Yr_"~<JJ~~r~~ ,- -I" --- BINGAMAN, HESS, COBLENTZ & BELL, P.C. BY: HARRY D_ MoMUNIGAL, ESQUIRE IDENTIFICATION NO. 38386 TREEVIEW CORPORATE CENTER 2 MERIDIAN BLVD., SUITE 100 WYOMISSING, PA 19610 (610) 374-8377 (610) 376-3105 (Fax) A TIORNEY FOR DEFENDANT VALLEY QUARRIES, INC. KATHY DELGRANDE Plaintiff IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW NO. : 01-6185 v, VALLEY QUARRIES, INC. Defendants JURY TRIAL DEMANDED PRAECIPE FOR RULE TO FILE COMPLAINT TO: PROTHONTARY OF CUMBERLAND COUNTY: Kindly enter a Rule on the Plaintiff to file a Complaint within twenty (20) days from service of said Rule or suffer a judgment of non pros. BINGAMAN, HESS, COBLENTZ & BELL, P.C. BY: MUNIGAL, ESQUIRE RULE AND NOW, this I?+'- day of O~ . ,2001, a Rule is entered on the Plaintiffs to file a Complaint within twenty (20) days from the service of this Rule or suffer a judgment of non pros. aAA-+~ ) ~~~ PROTHONOTARY CT ~ DATE: "~~o,_, -'--":,Y,';o':"-sc-","-_"- . , '-',--"", .< C :_: I-_:-''''~-' ,. re->.- ~, , ~. ',- - . ',-, , """,.,,' ~, ~.- ~ ,,< ., ~.,. .._,~"", j , b Ii I~ ,j!1!L '.,. ,oJ~_~,-,.<,. '_, ,,',. f",,'- "" I'" ...."',.-~ .;eo' - -''';~''-' 'Y.., ""_r~ ,,,,, ,,"""__M", """r.~~_""'"'' ~~,~ " ~-,-",",,,,,,, "'-'__ p ._ ",'.-, _~.., ",)' ~'L' rn ~-/ ~- [::: -'" <( ~t:~ >::; :::;-) "."JIT]". J.~~!J,~"!>W~OO"llf},.""""..,- ~L __,~ .,. JJ~,"l!_ , ~ .. c:~' €> (3/f, 'J"'''''''<-' '0,,]] ! SHERIFF'S RETURN - OUT OF COUNTY CASE NO: 2001-06185 P COMMONWEALTH OF PENNSYLVANIA: COUNTY OF CUMBERLAND DELGRANDE KATHY VS VALLEY QUARRIES INC R. Thomas Kline , Sheriff or Deputy Sheriff who being duly sworn according to law, says, that he made a diligent search and and inquiry for the within named DEFENDANT VALLEY QUARRIES INC but was unable to locate Them deputized the sheriff of FRANKLIN serve the within WRIT OF SUMMONS , to wit: in his bailiwick_ He therefore County, Pennsylvania, to On December 6th, 2001 , this office was in receipt of the attached return from FRANKLIN Sheriff's Costs: Docketing Out of County Surcharge Dep Franklin Co 18.00 9_00 10.00 24_90 .00 61.90 12/06/2001 ANGINO & ROVNER Sworn and subscribed to before me this /3 ~ day of ~ .;?c-o fA. D _ Cl~u- a~~. I Prothonotary - '-'-"-""'''''''-''''1'J'll_I;!Il~ .. -~,~~ '1 County In The Court of Common Pleas of Cumberland County, Pennsylvania Kathy Delgrande YS. Valley Qua=ies Inc SERVE: same No. 01 6185 civil Now, October 30 ,20 ~ I, SHERIFF OF CUMBERLAND COUNTY, P A, do hereby deputize the Sheriff of Franklin County to execute this Writ, this deputation being made at the request and risk ofthe Plaintiff. . . ~~.'tlft:.~./ Sheriff of Cumberland County, PA Affidavit of Service Now, ,20_, at o'clock M. served the within upon at by handing to a copy of the original and made known to the contents thereof. So answers, Sheriff of County, PA Sworn and subscribed before methis_dayof ,20_ COSTS SERVICE MILEAGE AFFIDA VIT $ $ f_-F~;~"i!$iil,~i~_ " ~- ~,<- ~.~- ~" " SHERIFF'S RETURN - REGULAR .. CKSE NO: 2001-61850 T COMMONWEALTH OF PENNSYLVANIA: COUNTY OF KATHY DELGRANDE VS VALLEY QUARRIES JOHN RIDGE - DEPUTY , Deputy Sheriff of FRANKLIN County, Pennsylvania, who being duly sworn according to law, says, the within PRAE WRIT SUMMONS was served upon VALLEY QUARRIES INC the DEFENDANT , at 0858:00 Hour, on the 19th day of November, 2001 at 297 QUARRY ROAD CHAMBERS BURG , PA 17201 by handing to JOSEPH ZIMMERMAN CEO a true and attested copy of PRAE WRIT SUMMONS l..VriLli SWY\lV'OY\<\ together with and at the same time directing His attention to the contents thereof. Sheriff's Costs: Docketing Service Affidavit Surcharge Mileage So Answers: 9.00 9.00 4.00 .00 2.90 24.90 By JOHN Sworn and Subscribed to before me day of /VoV. N Fl{l(ii Seal patricia S\'n('?; ~otary ,Public Charnbersb ' .-rankHn County My C0rTv'nission t:^t'll odS Nov. 4, 2004 -",_w;:(,.",,,,,,.N"''''''''''''''1lm~1Jlp,>>.,fll1W_"t_~,~ J!'-~"'-1" ~ V. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA 01-6185 CIVIL KATHY DEL GRANDE Plaintiff VALLEY QUARlES, INC. Defendant v. JUDITH L. JUMP Additional Defendant IN RE: ARBITRATION ORDER OF COURT AND NOW, October 24,2003, the appointment of Barbara Sumple- Sullivan, Esquire to the above-captioned arbitration panel is vacated, and Lauralee Baker, Esquire is appointed in her stead. BYth~ Geo~ . Hoffer, . P.J. Jeffrey T. McGuire, Esquire Harry D. McMunigal, Esquire Richard Stewart, Esquire, Chairman Allen Welch, Esquire Lauralee Baker, Esquire Court Administrator '-"'''~'o'~~"'''N18''''J~", ","1'" , , ,_ --,. ,r- " . -.. OCT-31-2003 FRl 01:02 PM LAW OFFICES OF BHCB FAX NO, 6103763105 p, 01/09 BINGAMAN I-lESS A'rrOl,NEYS AT I.AW 1\,\\'1Il1 , 1111' NI ,I~ !\IAIU( Ii YO[)Jo.R KI :I( I ,\I.III()II~I' l ,"N1\J K /11:(1:-'1 IIAI/IIYIl ~I,WJNI(,,\I 1',\11,,('1<; LIl\HIu,'I'1 IIIU.llI':l'llll ~,M,,\\IN\\i~1 11,:1" ,I. i'AllInZIO III/AHL':III A. HA(IOVI'.I(N 1I11,'II:>IIC A.lkC'Et'('() ,\I,\111,(JNJ 1111HR ".lJM!,-itlIIl;/I,'tfill k},}10/11 '1'RIiEV1EW CORPORATE CENTER SUITE 100 . J. MERII)JAN BOULEVARD WYOMISSII'W. PENNSYI,VANIA 1%10 TEI.EPjJONE (610) 374-8377 FAX 11(610) 376-3105 www.bhcb,coJl1 !{AYMUNI)IClIJ S"i RAII'II J AI r//OIISlo.m 1<1.:111(1.11 II.I,WIII YN I< 1.//NliAM ,N 11)07. I (J(}(l ,J WI,NDJ.II....U\lLEN.I/, 1'111.2001 JAM!.S F. nEU. I 'nl.J o~!': FAX TRANSMITTAL COVI~R SIIEKT TO: Rkhanl W. Stcwlll t, Esquire Alleu C Wdeb, l':s'luir,' Shlll,11 ,J. "!lB.lrOnl, Esquire Dale: 10/31/03 FAX NUl\IUER: 717.711\,.1015 717,Z~8,)289 717.975,N124 FROM: HlIITY D. Mcl\1uuignl, Esquirl' CI.IENT 1ft: 10 116-828 OUR FAX NUMBER IS: (610) 376-3105 WE "HE lR\ '1SWTTING <1 MGteS INCLUDING TIllS COVER SHEET ME~SA<m; '.. In C~S,) ,~ra 11':IIISI11I;;51011 pnlb!Clll, please contllct: Malissa . '.~.;.=-' ,~.'::;:"~.'n:r-_"':" ,".':.:=-==.-;-,1:', ......::.=-..' ...,~..-= ...:..;.. __' _.~':='__'=" ~ tjO"lK.7..,(lJ~/':C:l!,!FN7.': The information contained in this lilcsimile message is U'<7A I. V' I'JUVIU'(jF:!) ({lid ("()NFJl)RN7'JtfL inrOnllatioll intended ollly for the use or the individual or entily Tlnl11et\ <lllovc, I r you. the reader or this message, arc 110t tho intcndcd recipient, you ure 1101 elly rlc)lj 11(.d tl1111 ::11l1 sliollld not rurther (\isselllinato, dislriblltc or copy this lelecopy, In ;Hklitioll, if YllLl have :'ec~ilo,! tilis tekcopy ill error, plc.lso immcdiMC'!y noli ry us hy telcpllOne (yolll\lay ,'all ~,llkct ,\I Ilw 11\I1l1bcr sel lorlh .bo\'e) and return the odgillulmcssage to liS at the address above Vi:1 lJniwd Stnks Posta! Service. We guarantee r<:lurn post,lge. Thank you. ~':.":""'\ ..:'==-":r'1:',... _::==>_'""', :._-==:,,,:,, _.=.... ~ '_.'_ ,:;...;'_ .._:---=.='~""_.'-= !iii ~ OCT-31-2003 FRI 01:02 PM LAW OFFICES OF BHCB ,"'!\ FAX NO. 6103763105 P. 02/08 IlAVIP It I'lmNI]~ MAI~I~ (, 'r"1l)1'1~ kl'l~r.l\I.'I'll(nmJi I.Yr-::\m K. 11UlST J IAI~RY 11. Mi'MUN'UlAL r'l\n~I('" 'I. lI:\RIWn l.~ )'1<\TH~1'll n. \l.hMllNl(jAl. ld(/C' J JlAHlH<~IO U V,,\t\l!'\'1I A. MMiovr,\{.N~ 1I1)MIMCA.n('(']'C'('tl ''''~1Y (', RO'JIII'RMloJ. "'1\fW ildllfil1r'd ill Vrrt/wlIl BINGAMAN HEiSS ATTORNEYS A T LAW Tn.'.cview Corpor.at~ Clmtcr Slute 100.2 Mclidian BOllleyard WY<:l\lli"'"g, FA 19610 610.374.8377 Fox 610.376.,105 www.bhcb.com 1~^YMONI}K.JIJ,SS OI,{:OUNfi\'.I, !{Al PII J. AJ.TIIOlJSE, JR. rU\TII{Jill l.1.hW\:',l.YN \{, BINCl^Mi\N l~m.]9l)6 1, Wl:NDI',lJ,COHU',NTZ J911.200J .lAMe.1 f', lIELL 19~r~J9SS October 31, 2003 VIA F'ACSIMILE TO 717-76H015 ANOFjYR"EGULAR MA!L F{ichard W. St,)vt.;;r( Esq. 30'\ M:,lrkGl St'eel 1:l.0. [.lox 'IOD Lemoyne. I'A 17043 VIA f~ACSIMILE TO 717-258-5289 AfI{.p-]y fiEGl1LAR M.AIL Alltlll C. Wolcll. Esq. Law OfficE) of f:lOllll 01'1'. Esq. 50 E. High Sired CE\rlislc, Pf\ 11013 VIA FACSIMILE TO 7'17-975-8124 AND"BY REGULAR iiAic-- Shalltl J.Mun:lford -:-Esq. Margolis Edelstein P. O. Box ~):32 I-Ianisburo, P/\ 17108 RE: fJelm9ndg.y. VI1!!ev Qu~rries, IDC. at al. Gt.llllborland County C.C.P. No. 01.6185 Our File No.1 0176-828 Oem Arbitrcllors: Ple"so find enclosed a copy of Defendant Val/ey Quarries, Inc.'s Arbitration MemorandlJIn in the above-referenced matter which is scheduled for arbitration on Frid:)y, Novell',ber 7, 2003. 2.'16%40 '",__~L ""',",0","","" _ ~..__~ ,=,~'"~,~,- ." . " .. - , - .~ OCT-31-2003 FRI 01:02 PM LAW OFFICES OF BHCB FAX NO. 6103763105 p, 03/09 "' Pilgc .1 PieaSG contacl /no jf Y(JU have any questions in this regard. If I am not available, ple,lse fe(ll free to speak to my parvlegal, Michelle S. Sudd. Thank you. Very truly yours, Imsb SINGAMAN HESS f.- Iv . Hart 6,,.. cMunigal E;llclo$ure cc: Jeffrey T. McGuire. Esq. (w/encl.) MjehilG E. Kosi::, Esq. (w/encl.) 19046., .::----~ .~, -, "I'}"_ ,,__-_)ffi, -, 'i" ,-'~, -y~. -, ,.,,1" -F- 'W5 ;(,<'.;~~-T:-':f"--f ~,-" f.~f~Y~c ,<'..".- ~--~ ".,%--. ~., --~ "" .' - OCT-31-2003 FRI 01:02 PM LAW OFFICES OF BHCB FAX NO, 6103763105 p, 04/09 BINGAMAN. HESS. COm.ENTZ & BELL, P.C. I3Y: HARRY D. McMLNIGAL, ESQ. IDENTIf'IC.A.TION NO. 3.:3386 TREE-VIEW CORPORATE CENTER 2 ME:RIDIAN BLVD., sum: 100 WYOMI$SING,PA 19G10 Phone: (610) 374-8377 Pax: (610) 376"3105 ATTORNEY FOR DEFENDANT VALLEY QUARRIES, INC. KATHY DELGRANDE PI,lintifl ..... ....w- IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW NO. 01-6185 v, VALLEY QUARRIES, INC. Defendant JURY TRIAL DEMANDED v. JUPlnl L JUMP Add tlollal Dcfe;ndant AI1.!:3JTRATlf,lN MEMORANDUM OF DEFENDANT VALLEY QUARRIES.INC. I. STATEMENT OF FACTS 1.)lflinllff filed this action for personal injuries arising out of a motor vehicle . accidont that occ;urrecl at approximately 11 :50 p.m. on 11/1/99. Specifically, Plaintiff was (l pOlS senger in a motor vehicle that was operated by her aunt, Judith Jump, tmvellino southbound on Interstato 81. The vehicle operated by Judith Jump in whicll Plaintiff was ;:1 pElssenger struck a metal sign holder that had fallen into the roadway lrom <l con~trL.clion vSilicle operated by an employee of Defendant VaHey Quarrios, It1C. F'klintiff ~llleges in har Cornpl<1int th"t <lS a result of the accident she sustained injuries to her corvical ancllumbar spino. Plaintiff further alleges negligence by Defendant Valley Qumrics, Inc. 'Nhich has been specifically denied by Defendant. ; >[~;'%: ,tn "~," ^ , " ',. . . o. " ~,~ OCT-31-2003 FRI 01:03 PM LAW OFFICES OF BHCB FAX NO, 8103783105 p, 05/08 Dof"ndt\nt Valley Quarries, Inc. subsequently filod a Joinder Complaint against Ad d;1iofl f.ll Dofendant ,luditl1 Jump asserting contributory or comparative negligence of Judith Jutf:p as the (iriver of the veh:cle involved in the accident. Defendant has domanded lhat Ms. Jump be found eilher solely liable for PI<lintiff's alleged damages, or jointly cl11d sevemlly liable with Defendant Valley Quarries for Plaintiff's alleged dml'1ngos, .mel/or liable over to Defendant Valley Quarries on any judgment entered in Plaintiff's favo', II. ISSUES 0:1. Whelher Defendant Valley Quarries, Inc. was negligent. b. Comparative or contributory negligence by Additional Defendant Judith ,'Limp. c. Causation and extent of Plaintiff's damages. III. DAMAGES PI<.'.intiff Complaint alleges thnt as a result of tile subject accident that she suslained cOr\ical Cl'1d lumbar strain. Plaintiff initially SOUgI1! treatment for her injuries at the omergency room ()f Chambersburg Hospital on 11/4/99, 3 days after the subjecl ilccidenl. TIle) emergclI1cy room records indicate a diagnOSis of cervical and IwnlJar strain ,md furlhor indicClte that Plaintiff could return to work on 11/7/99, PIClintiff then sought treatment with Dr, Frankeny on 1119199. Dr. Frankcny's initial ovaluation Ilo\cs that diagnostic testing was normal and Plaintiff sustained a soft tissue injury from which she could expect 12 weeks of discomfort and a COUrse of physicol tl10mpy was rocommended. Plaintiff then altended 3 Yo months of physiciJl )~ l.< , If""~ - OCT-31-2003 FRI 01:03 PM LAW OFFICES OF BHCB FAX NO. 6103763105 p, 06/09 thorapy al Keystone Spine Centor for neck and back symptoms during the time porlod of 11/22/99 tl1rClu(Jh 3/6/00. Plaintiff was last evaluated by Dr. Frankeny on 4/17/00. On G17/00 PLli1:irf wa,-: involvod in a subsequent motor vehicle accident in which PI<lintiffs vehicle collidmt wilh a deer. As a result of the 5/7/00 accident, Plaintiff chipped her t(.leth Clnd oxperienced neck pain. On 5/18/00. Dr. Frankeny executGd a disability certificDte in support of Plaintiff's application for wage loss benefits with Allstate Insur<1nce thElt Indicated Plaintiff was unable to work as of 11/1/99 and her return to work da!(3 \VEl:.! "unknowll." Approximately 3 months after her last physical therapy treatment at Keystone Spine ConteI' and only 1 month after her collision with the deer, Plaintiff resumed treatment for cervical and lumbar symptoms and began treating with Madeira Chiropractic c:n G/.2f..l0 F'laintirr o:mtinued treating wittl Madeira Chiropractic for approxinmt81y 5 mO:1lhs during the time period of 6/12/00 througI111/1/00. Plaintiff has not Inccived 8ny tmalmont since 11/1/00. Pl1:jintiff wos not employed at the time of the 11/1/99 accident and the c,;llculatkHl::1 provid<'d in support of the aileged wage loss claim are based upon a nursin~l assislnnt job trat Plaintiff was allegealy to start on 11/8f99 at MarlOr Healthcare. A documont from the prospective employer indicated that Plaintiff's initial starting wage on 11fU199 would hove been $6.75 per hour. It was further noted that if Plaintiff successfully completerl the CNA tmining course then her hourly rate would increaso on 12/2/89 to $9.00 pu Lour fo: Vlce<erd hours and $7.25 pOI' hour for woekday hours. Altllougl1 il is purely speculative as to wllother or not Plaintiff would have completed the ti"'linin~J course, Plaintiffs attorney has included the anticipated increase in the 110urly "-, .- ;,,- ~ = OCT-31-2003 FRI 01:03 PM LAW OFFICES OF BHCB FAX NO. 8103783105 P. 07/09 rate in nlC) waue I05S calculation. Plaintiff has also based the wage loss calculations on n return to work date of 11/1/00. There is no treatment record or certificate issued during lho 5~ month pariod between Dr. Frankeny's disability certificate of 5/18/00 and the I~l$t trei1trr'~lnt wit!1 M<1d<)ira Chiropractic on 11/1/00, indicating ttlat Plaintiff was unable to work dllrir,g that time period due to the injuries trom tho 11/1/99 molar vehiclo accident. 8asl'>(1 upon the records that have been provided, Defendant disputes the period of dis8bi/ily nllributablo to the 11/1/99 accident and Plaintiff's entitlement to a clnim for wage loss. IV, WITNESSES Dofendrmt Valley Quarries, Inc. may call the following witnesses at the arbitration of this maHer: 8. PI,1inti f ~ at:1Y Celgr6lnde b. f~1:lr.dy Smith of Valley Quarries, Inc c. Defendant reserves the right to call any witness listed in Plaintiff's or Additional Defendant's Arbitration Memorandums, V. EXHIBITS DofoncJllllt Valley Qwmios, Inc. may introduce the following doculTlenls or portions tl'lereof at the arbitration of this matter: a) ^nyand all plc<ldings filed by any party in this matter; b) ^ny and all discovery responses, or portions thereof, served upon and/or OXCl181lged I)y any party in this matter; c:) I\ny and "II documents, or portions thereof. produced and/or exch8nged by WlY party during the course of discovery in this matter; k-;="",. ,J"_ <_~,_,,. .~_~.,_, "___~'''''''!,,,~''''''','''__''' ~"i '^' x OCT-31-2003 FRI 01:03 PM LAW OFFICES OF BHCB FAX NO, 6103763105 p, 08/09 el) I\ny dccLlmenls obtained by subpoena from the following: 1) Dr. Frankeny I Orthopedic Institute, 2) Ch<ll11bersburg Hospital, 3) Keystone Spine Center, II) Madeira Chiropractic; e) I\ny d;)cllrnents pertaining to Plaintiff's accident of 517/00 involving her collisic n IVil'l a c1eer; and f) Any documents, or portions thereof, listed in any other parlies' designation of oxhibits. BINGAMAN, HESS, COBLENTZ & BELL, P.C. .") --1/;~' / I ." ~ B y:_ f> . ._ ," .. Harrn. cMunigal, Esq. Attorney for Defendant Valley Quarries, Inc. '(;., c," "-". _. ""..,...,._, u,. d.~'.", ,',1' 1"1''T 1- OCT-31-2003 FRI 01:03 PM LAW OFFICES OF SHCS FAX NO, 6103763105 p, 09/09 CERTIFICATE OF SERVICE I, Him} 0 McMul1igal, Esq., herE:by certify that a true and correct copy of the for(,l!joil1fj Arbitration Memorandum of Defendant Valley Quarries, Inc. was provided to tho following nat"ty(ies) and al"bitralors by mail via United States first class mall. postage prepaid i)lltl by f;;'~I~sl.nili): ,Ie"frrey T. r.'lc:Guiro, Esq. CALDWEll. IS. I<EAr~NS 3031 North Front Street H<lrrisburo, PA 17110-1533 Fax; 717-238-56'10 lIilomcy for Adcfilionn/ Dafendant Shaun J. Mumford, Esq. P. O. Box 932 Harrisburg, PA 17108 Fax: 717-975-8124 Arbitrator Mich<loI E. I<:osik, Esq. ANGINO & ROVNER. P.C. 4503 North frollt Street H<lrrisburg, P^ 17110-1708 Fax: 717-232-2766 IIlfomey for r'/;Jin(if{ Allen C. Welch, Esq. LAW OFFICE OF PAUL ORR, ESQ. 50 E. High Street Carlisle, PA 17013 Fax: 717-258-5289 Arbitrator Richard W. Stewart, Esq. 301 Market Stroet P.O. Box 109 LemoynG, PA 17043 Fax: 717.761-3015 Arbitrator .~/ / ,- Harryt~~'(M.. l1i9al, Esq. DATE: /0 /1'1(J"~ o',1.X -,_,~ ,.; _,' ".."'" . __,",_~ ,"'_ " _, I. ~ I Ii V. : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA 01-6185 CIVIL KATHY DEL GRANDE Plaintiff VALLEY QUARlES, INC. Defendant V. JUDITH L. JUMP Additional Defendant IN RE: ARBITRATION ORDER OF COURT AND NOW, October 24,2003, the appointment of Barbara Sumple- '-'; t:! f' i Sullivan, Esquire to the above-captioned arbitration panel is vacated, and r, l;' r: :': l' I Lauralee Baker, Esquire is appointed in her stead. BYthe~ ~offer, . P.J. Jeffrey T. McGuire, Esquire Harry D. McMunigal, Esquire Allen Welch, Esquire ')}~~/- _: :: /0,2<(,0_3 ~ Richard Stewart, Esquire, Chairman ~~ Lauralee Baker, Esquire bS :1 Court Administrator M.0l _ oJ _"'__?"_.,' r--"'1 r " I . . .' 'j~tiij!lliBijt'iliWd'i!i:,,,il~1;k:d'~d;':':B)'-~~~~JLIq:,1~-BR:!!.f.~tllfJMli'.~lit~il~~,'i~bt~~rjl'~U:!JitilI~~~l1.i!jj '-~l!l '"1 ri,t"'7 '::; \~ CUV:::;i.:, "_' i)EN.\iSYL:i/\;\;'lr\ 1-~,_::.JOml~!lfflL".J]U!Nlm J ~"" ,. '."',~""",,_ ,~-".~ ,_ ."",n,q ", ^";"'_"'T""'~,,":, ,,",,,",,,, *,'",' ~~, 12 11\1 ~ l I ,.--", '- "","" >~' ~~"'''.'''';!lliri!l';''.~"~~~~ iitlll' l ! KATHY DEL GRANDE Plaintiff IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA v. 01-6185 CIVIL VALLEY QUARlES, INC. Defendant v. JUDITH L. JUMP Additional Defendant: IN RE: ARBITRATION ORDER OF COURT AND NOW, October 29, 2003, the appointment of Lauralee B. Baker, Esquire to the above-captioned arbitration panel is vacated, and Shaun J. Mumford, Esquire is appointed in her stead. By the Court, P.J. Jeffrey T. McGuire, Esquire Harry D. McMunigal, Esquire Allen Welch, Esquire ~~l 10'30.03 vRichard Stewart, Esquire, Chairman Shaun J. Mumford, Esquire Court Administrator "_i \>'f:~~""'~1illft"!. " ___-,_,,~,- ".e.-- I '1-' 1- . ,0 ~ j'Bt"'.,;:,,;;;,-, ff~:~;ioJ-i~it'W:~~~iil~~li'~i.r~&~,I":l)"'.;~,J<'ill'\f~i."""""",,~~~~~r1ii!l@' : III JllLi '~~.i!ir.Hi '..:M' ....iJ' , <', "Ii. . ""~';''':,j,iM[ T .,^~ '~< \\~~ r:U:D-DFFiCE 0,., T' "-,-.",,..,,<, '^'\'OTAny )j-' ,!-;t~ !'~':,L, ,C1;..Jt l' It\l"\ 03OCi30 AHII:I i CUMBtfli.A'jij CQUNW PENNSYlVANIA '~"\':~ '."""~.:;'i!'\!E,,.g~:::!L:,JfJ1!'Jl[J!] ",,,,-,,,,,',,,,.~_.,,;Im';_,.,, "','-~ . _,.,...,;,;, ,,--.~," _~'M",~,~~_,>';,," ,~"" """'" _ ~_ '.,,",.-, , '",~, >- ~ "<--;"''.0io.:,.C'', .., ..J L ANGINa & ROVNER, P.C. NOV 1 2 Z003 'if 717/238-6791 FAX 717/238-5610 RICHARD C. ANGINO NEILJ. ROVNER JOSEPH M. MELILW 'JERRY S. HYMAN DAVlDL. LUTZ MICHAEL E. KOSIK RICHARDA. SADWCK JOSEPH M. DORIA JAMES DECiNTI JOANL 8rEHuIAK 4503 NORTIl FRoNT STREET HARRISBURG, PA 17110-170S WWW.ANGINo-ROVNER.COM E-MAIL MKOSIK@ANGINOROVNER.COM Tayran Dixon, urt Administra~ ^ I ~ / Cumberland unty Courthouse. rD~ \...J One Courth se Square Carlisle, P 17013 November 10, 2003 RE: Delgrande v. Valley Quarries. Inc. No: 01-6185 Dear Ms. Dixon: My office represents Plaintiff Kathy Delgrande in a case which recently was arbitrated in Cumberland County. At the time of the arbitration, we learned that one of the arbitrators, who we were notified was originally appointed, was no longer serving and that a new Order had been issued and possibly two orders were issued designating a new arbitrator. I am enclosing a copy of the Order of October 24, 2003 that I was provided at the mediation. As you can see, my office and my name do not appear on the distribution list for the Order, and we never received this or any subsequent Orders. Unfortunately, this resulted in the one arbitrator not receiving our Arbitration Memorandum and Exhibits prior to the arbitration. I would appreciate if you would note my office's representation of the Plaintiff in this matter so that we receive a copy of the decision of the arbitrators. Thank you for your attention to this matter. MEK:mmm Enclosure cc: Harry D. McMunigal, Esquire Jeffrey McGuire, Esquire Richard Stewart, Esquire Allen C. Welch, Esquire Shawn Mumfert, Esquire 228443.1 IMEKIMMM I ~"")""v...."".._~ - -" ""'I - - r,- "~., ',' '" - .---' -', ',1,"," " ,. -~ - ",~.,- r~ ~ KATHY DEL GRANDE Plaintiff V. VALLEY QUARlES, INC. Defendant V. JUDITH L. JUMP Additional Defendant IN RE: ARBITRATION IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA 01-6185 CIVIL ORDER OF COURT AND NOW, October 24,2003, the appointment of Barbara Sumple- Sullivan, Esquire to the above-captioned arbitration panel is vacated, and Lauralee Baker, Esquire is appointed in her stead. Jeffrey T. McGuire, Esquire Harry D. McMunigal, Esquire By the Court, Geo . Hoffer, Richard Stewart, Esquire, Chairman Allen Welch, Esquire Lauralee Baker, Esquire Court Administrator i I 'T..-;r.~- ,,,", ~, -,.-"",~-',,-"-.,- '--~':>--I. ,~- :1' v" :-___.'-"51. -" ,-. -,- -- '-."0 -~- P.J. , ,," -,"'<-', v. \lq\\~~ (\?\I4r". rs L"<. '0. ~..J,,~ c:.. V ..J.J..It....1 .j ,,1.1..+1-. L. ~<<......t' Defen"dant(s) IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY. PENNSYLVANIA NO. <!>l - ~ l ~5 CIVIL ACTION - LAW \) \ (".....J..... ~1.,7 e Plaintiff(s) OATH We do solemnly swear (or affirm) that we will support, obey and defend the Constitution of the United States and the Constitution of this Commonwealth and that we will discharge the duties of our office with fidelity. AWARD We. the undersigned arbitrators, having been duly appointed and sworn (or affirmed), make the following award: o/~ ~...A i'" r<l"~,.. ~(:.. *1-,<- t-iv<. ~ ~'hl.~-r- '''' +h.1L ei""'~l>i'\b '() .H......-5. \,0--- f,,,,). ,.. ~'vly'" (Note: If damages for delay are awarded. they shall be separately stated.) f\(l" \-.'t='r- "'...J.. "'~1"3 j-' 0'" 'fi" 1'1.ovs.-t (If (q, ~oo ) . . ~ -thl '" .tJ, ta.... \ 'OejC.",~....r. . Arbitrator. dissents. (Insert name if applicable.) Date of Hearing: ~\leWlLe)o> 7, ;;loo~ . ...~ Date of Award: Nove_L.~~ J 2005 , NOTICE OF ENTRY OF AWA i-- R/.o3 Now, the jil+ day of A/,Jve""bfr , ~ at /1: 36 . ~.M.. the above award was entered upon the docket and notice thereof given by mail to the parties or their attorneys. M(1~41? ~ ~"ota~ By: ^etuc #7 . :r)Ir Dep y Arbitrators' compensation to be paid upon appeal: $ ;"10. ao :155105 -,w~~ ,~-- ,," ~, ,..., . ~I ~ , M {2 , 4.- n ~~~ '"t' A.J s. i Iv ~ /,VdJ,., - 50 e. ~LS;t;uJ- I~ ~ q /n~~' 7ft;~. !lt~. ~ c.,. /1-/3.03 ;'J- .~ " ,~ - . = ~= ~. C~,-~"_' ".-, ''''if'.',~'",'~'-'~-'-~''-;''''<o'''' "-".;"""',~..~-~ ~~~'~'~"~]i--rr'_""T'~~ir~ '" ~ .' ~ ~ ~~ "'- ~ '<;;' ~~, ~ t.; 0 ~~ T'h ~ ~ ':l s> :? ~ ~. \.<\ t:1 ~ "..~ --- h- . ~ ~cJ~ ~q , ;t VI ~ ~ ~ k r-. c> :: ~ '" ~ !:> " ;:;- ,f.:l. , . ~ ~ "" ~ '" S; ~ .., ~. ", ~ '" 0 0 0 c: W .." s: Z !) -001 '=' :? rnr{ :-;.,..-n -% Z:t_: <: :-:lr zr --::;ITl ~ ~~:~- N .J? !<( ':::::)CI ~ ::: =r-j"i~ ').:....,..- "5:0 ~ :f;: ?~~ -l:.. ~.,..o <.. S - ~~rn ~ .. ::::\ L ~ :2 w ;.. 0 -< " 0 :i::::, "..'---,-- ,.,.." )!~?_, _(~Ul'lJii~Q,,:,,,,~__,_,,~~ ~_ .~. .1.._"<"'?~";,..,.,,,~?Di!~~' v. IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW NO. 01-6185 KATHY DELGRANDE, Plaintiff VALLEY QUARRIES, INC., Defendant JURY TRIAL DEMANDED v. JUDITH 1. JUMP, Additional Defendant PRAECIPE TO THE PROTHONOTARY: Please mark the above-captioned action as settled, satisfied, and discontinued, and issue a Certificate of Settlement. P.C. ichael E. Kosik LD. No. 36513 4503 N. Front Street Harrisburg, P A 17110 (717) 238-6791 Attorney for Plaintiff Dated: 12/24/03 cc: Harry D. McMunigal, Esquire Jeffrey T. McGuire, Esquire -,," ,-' :'!!!!I ~."' __, _, , "'~_~"~_'-"""-',0-' .",:"""~,,:,_,c,,_,.~,,_",_,,,_,_ c' 1'"/, . , ~-'" " ~~ ."',-'- ~"'''j.. -~.-,,"~- ik';J.' ,,,-< _"",w~,,,,,<,~-~,".,,,"~ ~'''--'''''''-''''~iiiIlJ. rill" ~ ""Jitm:nur'd (") ,..- ~ ~'C: ':;-:-: C-) ~~~" -;:--;;-0::'-'- .(i _J - ; ~~ . ~.'J \ \ ~\ ,..., = e Cl rr; C-' I".) 0"\ - :',:::c-" -':~C,: .d:'_; -< 4,,; --"'. o -n 1..... rnr -orn ~o7 0,0 :2. ::g Qo ~~fn ,oQ ", (.~) r....J ['ii;:I!.!t~ ~_lT~_1~,.~~~;W'!~}~!'lI~'iffl~:;;'~~-I?;. i';';Il:!'; _.,,,,,,,~I!>~~~~~,,_~~__",_",,,,_!: ~_"" . ~"