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Home My WebLink About01-06395 " ,,' -; , ,'" ',' 'c--;~. ~',".' '..i~.""'''~"I;;~=Jo1::, """,0., , I""'.?"''';''' ',"-',~ ,,--;;,,"""<~,l:;:;i'...,L';;;~~__,'),:;',: ,,~{.;;(,'<, ~''', ,,-',;t',, t,.'. - -i', ..."--" NOV 1 5 2001~ IN RE: ESTATE OF JOSEPH BURCH, a minor COURT OF COMMON PLEAS OF CUMBERLAND COUNTY - CIVIL DIVISION No. Cl - 1.:.3% C-lu:l y~ ORDER AND NOW, this Jop.r-. daYOf,J ~ ,2001 upon consideration of the Petition to Approve Minor's Compromise, it is hereby ORDERED and DECREED that Petitioner is authorized to enter into settlement with Mechanicsburg CVS and Rea & Derrick, Inc. in the gross sum of Four Thousand Five Hundred Dollars ($4,500.00). The Mechanicsburg CVS shall forward all settlement drafts to Petitioner for proper deposit as set forth below. IT IS FURTHER ORDERED and DECREED that the settlement proceeds shall, in their entirety, be placed in an FDIC insured institution and protected from withdrawal until the minor reaches the age of majority or until further approval of Court is obtained by Petitioner. Petitioner is hereby authorized to execute any and all documentation necessary for the purchase of a savings certificate of deposit from a federally insured bank or savings institution in the sum of Four Thousand Five Hundred Dollars ($4,500.00), with the funds payable to the minor upon reaching age of majority. The certificate shall be titled and restricted as follows: Joseph Burch, a minor, not to be redeemed except for renewal in its entirety, not to be withdrawn, assigned, negotiated or, otherwise alienated before the minor attains the age majority except upon prior Order of this Court. In the Alternative, Petitioner is authorized to execute any and all ,- ,.", 00",' ,-- "", ',q -~' =,~,', - ';'''"'I~i>i. ~,H '". ",',~~', ',,,,,,,,,~,~; ;~,'j'-o'.(,d .:' "-~,~c , ~.!(~$,u-,-i,j . .' . documentation necessary to open a savings account in a federally insured bank or saving institution in the amount of Four Thousand Five Hundred Dollars ($4,500.00) which shall be titled and restricted as follows: Joseph Burch, a minor, not to be withdrawn before the minor attains the age of majority, except for the payment of city, state and/or federal income taxes on the interest earned by the savings account, or upon prior Order of Court. J. " _.' ,,,~> ','- ~ < ,. ITJ!!If" ~"" ~~,~ ., ~' ,. , .." ,~,' '.~'<' "'" '. ,0' """.<, """"', '" ~ "",' _~ ',. "'~ ,,- - (\~ >~ ~'~"'~" ,,',""_~ ~_.' >.~.,' _~w>., I"~_ - '''n~''~'' " <J;GTARY (',I J' ~In;! 'j J' "ij 10: ~a , ll.... ,,_ J H.).,; CUMBi::.r=u\:'u COUNTY PENNSYLVftNIA J- ~ , ~,~1;,'~~j}~fIliif;'l;'fif~~W~, "'"~"",' < :" ", __ ",0 - ~,...,:~~"r~":5;,;,:~AJ~]~'rrrT~,,;~~,~~{ - < , ., , ,,~~, " . - '-- ~ I""<(~"~""_" ., "'''~''''-"' -" "" ~",",""O,'""," ","'~"'" " ,",~,~'~', '""",&1,,;_ " . IN RE: ESTATE OF JOSEPH BURCH, a minor COURTOF COMMON PLI;AS OF CUMBERLAND COUNTY - CIVIL DIVISION No. 0 I - "'395 C~u~L T~ PETITION TO APPROVE MINOR'S COMPROMISE TO THE HONORABLE JUDGES OF SAID COURT: The Petition of Joseph Burch, a minor, by and through his parent and natural guardian, Noel Burch, seeks Court approval of a settlement in favor of her minor son, Joseph Burch, in support thereof, provides as follows: 1. Noel Burch is the sole legal parent and natural guardian of Joseph Burch, a minor, age 6 (QOB:02/28/95)(SSN:. 167-76-1542) who allegedly sustained injuries on ~ ," , ' . -- " , , ' " , or about June 15, 2001, as a result of being prescribed a double dosage of medication. 2. The minor resides with his parent and natural guardian, Noel Burch at 401 South Arch Street, Second Floor, Apartment B, Mechanicsburg, PA 17055. The whereabouts of the minor's biological father is unknown. 3. A guardian has not been appointed for the minor. 4. Noel Burch is the sole legal and custodial parent and the natural guardian of the minor. 5. Petitioner contends that on or about June 15, 2001, the minor was evaluated by his attending pediatrician for poison ivy on his arms and legs. The pediatrician prescribed a Prednisone taper beginning with 17.5 ml on the first and second day and dropping 2.05 ml every other day for a total of 12 days. Petitioner too the Doctor's prescription to the Mechanicsburg CVS to be filled. ""1 ~,.. ^'",' ,.,', , ",',~,,^"<o" '"'~~ "..,'!Me'''-, "";"".,,~,'_"n,~."__ ,""N""",,;;. CI''':i''~ "',~:wo..,;;r~,">' C" t).""',,,--''3<'"''''.'''"' ;iA',,,,,~,\',,"',,,,->-' '-il'~.../.J,,, ~:;~~;C^':;~' -- 6. As a result of the CVS pharmacist's failure to accurately record the dosage instructions, the instructions on the Prednisone medication indicated a dosage of 35 ml (approximately 7 teaspoons) rather than the 7.5 ml (approximately 3.5 teaspoons) as prescribed by the pediatrician. 7. Petitioner alleges that as a result of the overdose of the Prednisone, the minor became agitated,!estless, was overly thirsty and hungry and had facial ,swelling and a rash on his stomach. 8. No additional medical care was necessary for the minor as a result of the overdose of the Prednisone. In fact, minor did not present himself for evaluation to any medical personnel other than a previously scheduled follow-up visit with his ped iatrician. 9. Neither the Department of Welfare nor any other entity has a claim against the minor. 10. Mechanicsburg CVS, Inc. has offered to pay settlement in the amount of $4,500.00 to the minor in full settlement of his claims against Mechanicsburg CVS, Inc., and Rea & Derrick, Inc., for any and all injuries he sustained as a result of this accident in exchange for a full and final release of all claims against the Mechanicsburg CVS Store and Rea & Derrick, Inc. 11. Petitioner has not sustained any out-of-pocket losses and/or damages as a result of this action and believes that the proposed settlement as offered by the Mechanicsburg CVS and Rea 8, Derrick, Inc. is a fair and reasonable settlement. ~ ' ".. "'" '~"'~"" ~ c"k:..,. ~ J,'..' '__^'" , "_' """,<'" """ ,~=,"~' "~"',F~",,"i 'L"-" ,;" '-';<.;, , ~,:,." ,."; ;':i-~,~.l,..,-"~,, T<;'''' i'" ',j;.:,,; ,~" ',',' .;;<,,;;,"j , , 12. Counsel for the Mechanicsburg CVS and Rea & Derrick, Inc. has been notified of this Petition and he has authorized the Petitioner to state that Mechanicsburg CVS and Rea & Derrick, Inc. do not oppose the Petition. An affidavit of Edwin A.D. Schwartz, Esquire is attached hereto as Exhibit "A". WHEREFORE, Petitioner respectfully prays to this Honorable Court that an Order be entered approving the Settlement and Compromise of the above action with all settlement proceeds totle placed in a restricted account not to be withdrawn before minor reaches the age majority or upon prior leave of Court. Respectfully submitted: Dated:~ J~AA~ J Noel Burch ,~~ ',--'''-.''e' ,'" ,,-"', ';""'"'~'~"w''I''''C-,,'-'h__''''' )"";,, ,,;;,.,' """,-,~,<,,~,"~"""~ ",^'.,' ~,0'~__'O"""-",,,,,~ , . " VERIFICATION I, Noel Burch, and the Petitioner in this action hereby verify that the statements made in the foregoing Petition to Settle or Compromise Minor's action are true and correct to the best of my information, knowledge and belief. I understand that the statements in said Petition are made subject to the penalties of 18 Pa.C.S. S 4904, relating to unsworn falsification to authorities. f\MMl1 .W~ Noel Burch Dated: b\ -. " ~ . EXHIBIT "A" . ',"'.=-" ,~,'~~" ,~.<<. ,,' "~',~," --, ~I""",,,<' ,~,- ";''',' .,,,~,,,,;,,, '-"" "', i~,,';"'i."~;.:.~;"'_:,' ;. 'lift !",,,- ' ""f '" '",,--,"'" +' '~'~~,"~ ~-~,. "~~,'-'-, '~, '~''''''''''''''''''~'"'"''>'''''-'"''~''''~''~''';'\~,,~'{';6',1i~j . ~,' . IN RE: ESTATE OF JOSEPH BURCH, a minor COURT OF COMMON PLEAS OF CUMBERLAND COUNTY - CIVIL DIVISION No. AFFIDAVIT I, Edwin A.D. Schwartz, Esquire, hereby state and affirm that I am an attorney licensed to practice in the Commonwealth of Pennsylvania and that I am the attorney representing Mechanicsburg CVS and Rea & Derrick, Inc. with respect to the above- captioned matter. I have reviewed the contents of the foregoing Petition to Approve the Minor's Compromise and have no objection to the Petition Date: /I/~~/ , ~ squire Edwin A.D. Schw Sworn and subscribed to before me this (0 -ll- day of ~ , 2001. K.~ Notary Public NOTA"-';,l,l SEAL Roxanne K" -,r. Notary Public Township of S':'.;:<Jc; ,,11;18, Dauphin County My Com~""G'l Expires May 9,2005 Member, Perln;'ti,/';:;;;:sociation of Notaries , :'~'DJT<~,~~,.,~.~:'.t,.,v ;- _!IlI"'.'-''''';''' '~ii#>'" lWioo~~~r':""'" :,'" ,- WM~Jl~; ',""~ - "~-.- " ~ (.) ~ ~ 1- ~ 0 0 ~ C c> <" "' vt 0 ~:~i'-: ~~:~ "-. ~ :") ~ ....... ;~ ~~~ '"":::: " g ....... ~ 0 8 (F. ~- , ~ C t ~-, I r~ l,~': .....1 ~ ,~ .....:l I -0 (,) ~ ~ ~: ~~~ - ,. ^' ~: ',--; ,_.1 t ::::; :,~.~ -< .~J j:] -< ~ . 1>-":.,,~..,,,~.4IJ, JJLL",~_, _ ,__~=."~ .,..,.",,,~I'I!'i""';:';"',"",,,-"l......,.tt\"C'~"'Ei'm''''''f(~'''''~,,,,,""',HG;O,,,,"".,,,"_"""".<''1'. """',$,,-='KU',,,"A'I " ,_,~.,','.l.N -",""',"","_,,",- .."'",<'",,''', e,"'>,~_,_ , ,~" ,~ - - ""'<~,. ,','C'..,,'" '~ "' - ,., . -, ~,' < ,- --- ~ '^" ."" '~.~,-'.h";-"""""" ~'" .- "'--, ,,-,*~'.o<:'~'"''"~'";''''''' "~'-" :,;-'" ' ,"i, ,,~~~~ IN RE: ESTATE OF JOSEPH BURCH, a minor COURT OF COMMON PLEAS OF CUMBERLAND COUNTY - CIVIL DIVISION No. 01-6395 Civil Term PRAECIPE Please mark the above captioned matter as settled and satisfied and dismissed with prejudice. Respectfully submitted, J1Aej f#r. elv Noel Burch 401 South Arch Street, Apt. B Mechanicsburg, PA 17055 Date: On this I~ d3Y of &~ 2001, before me personally appeared Noel Burch, known to me as the person who executed the foregoing Praecipe, and who acknowledged to me that she voluntarily executed same. ~ ~M~~ . NO Y B rt HOTAlllAl SIAl TEIlESA J. ZIZZI. NoIary ...... Itanloburo. DaupHn CeunIy, PA ,., CooIw.' . . &pIIw AoIg. 12, 3lllIlI ji~;' ,..'>'1l':jIit_ti:--"''O''''l ~,:..,', "i!iit';;',jJi~'~i: "~~;};;Wk.~~~!i!ll'~ ""';"""~"-"'" '"'""'-'-'jj',.. ',~;, ." 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