HomeMy WebLinkAbout01-06515
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HALIE DUNCAN, a minor, by
KIMBERLY DUNCAN, her mother and
natural guardian and KIMBERL Y
DUNCAN in her own right,
Plaintiffs
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYL VANIA
NO. 0\ - fe,,:;I-S C(o'~lT~
CIVIL ACTION - LAW
vs.
JOHNNY K'S, INC., JOHN KRITIKOS,
individually and t/d/b/a JOHNNY K'S,
Defendants
JURY TRIAL DEMANDED
NOTICE TO DEFEND
TO: Johnny K's, Inc.
6437 Carlisle Pike
Mechanicsburg, P A 17055
-and -
John Kritikos, individually and t/d/b/a
Johnny K's
6427 Carlisle Pike
Mechanicsburg, PAl 7055
-and-
50 Hoover Road
Carlisle, P A 17013
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 Plaintiffs. You may lose money or property or other rights important to you.
Document #:219712.1
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YOU SHOULD TAKE TIllS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO
NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE
OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU CAN GET LEGAL HELP.
Cumberland County Bar Association
2 Liberty Avenue
Carlisle, P A 17013
(717) 249-3166 or (800) 990-9108
Document #:219712.1
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HALlE DUNCAN, a minor, by
KIMBERLY DUNCAN, her mother and
natural guardian and KIMBERLY
DUNCAN in her own right,
Plaintiffs
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
NO. 01- ~[;!S Cw~L J-0"Lf
CIVIL ACTION - LAW
vs.
JOHNNY K'S, INC., JOHN KRITIKOS,
individually and t/d/b/a JOHNNY K'S,
Defendants
JURY TRIAL DEMANDED
CIVIL COMPLAINT
1. Plaintiff Kimberly Duncan is an adult individual residing at 321 Hogestown Road,
Mechanicsburg, Cumberland County, Pennsylvania.
2. Plaintiff Kimberly Duncan is the mother and natural guardian of minor Plaintiff
Halie Duncan, who resides with her and who is 15 years old, having been born on December 9,
1985.
3. Minor Plaintiff Halie Duncan has selected Plaintiff Kimberly Duncan, as her
mother and natural guardian, to represent her interests in this action.
4. Defendant Johnny K's, Inc. is a Pennsylvania corporation with a principal place of
business at 6437 Carlisle Pike, Mechanicsburg, Cumberland County, Pennsylvania 17055.
5. Defendant John Kritikos is an adult individual who resides, on information and
belief, at 50 Hoover Road, Carlisle, Cumberland County, Pennsylvania 17013.
6. Defendant John Kritikos owns the property at 6427-6437 Carlisle Pike,
Mechanicsburg, Cumberland County, Pennsylvania 17055 and trades and does business as
Johnny K's.
Document #: 219712.1
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7. On August 19, 2000, Plaintiff Halie and Kimberly Duncan were involved in a
two-car accident caused by Joel Cummings on the Carlisle Pike (U.S. 11 North) in Hampden
Township, Cumberland County, Pennsylvania.
8. The accident occurred when Defendant Joel Cummings swerved into the right
lane in an attempt to pass the vehicle in front of him in the left lane and crashed into the rear of
adult Plaintiffs vehicle pushing her vehicle into the rear of a third vehicle, which then was
pushed into the rear of the fourth vehicle.
9. Following the collision between the vehicles, Joel Cummings fled the scene ofthe
accident, failed to stop for steady red lights and eventually was apprehended by the Silver Spring
Township Police.
10. Joel Cummings was visibly intoxicated when he was apprehended and was placed
under arrest and charged with numerous offenses, including driving while under the influence of
alcohol, accidents involving death or personal injury, violation of traffic control signals and other
offenses.
II. Following his arrest, Joel Cummings was administered a breath alcohol test with a
result ofa 0.162% blood alcohol content.
12. On February 20, 2001, Joel Cummings, with representation by counsel, pled
guilty to driving under the influence of alcohol and accidents involving death or personal injury
and was subsequently sentenced for these offenses on April 3, 2001.
13. On April 24, 2001, Plaintiffs filed a Civil Complaint against Joel Cummings
which is pending in the Court of Common Pleas of Cumberland County at Civil Action - Law,
Docket No. 2001-2398.
-2-
Document #: 219712.1
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14. On September 11,2001, Plaintiffs' counsel took the telephone deposition of Joel
Cwnmings, in the presence of his counsel, to, in part, verify his identity and to investigate the
issues of his alcohol consumption and intoxication.
15. During the aforesaid deposition, Joel Cummings testified that he was consuming
alcohol at a bar located on the Carlisle Pike, Mechanicsburg, Cumberland County, Pennsylvania
on the date of the accident but didn't remember the name of the bar.
16. On October 22, 2001, in Cwnmings' Response to Plaintiffs' Second Set of
Interrogatories, Cummings further specified that he was consuming alcohol at Defendant
establishment ("Johnny K's") located at 6427-6437 Carlisle Pike, Mechanicsburg, Cumberland
County, Pennsylvania on August 19, 2000.
17. During the aforesaid deposition, Joel Cummings testified that he was consuming
alcohol from approximately 3:00 p.m. to 5:00 p.m. on the date of the accident on August 19,
2000.
18. During the aforesaid deposition, Joel Cummings testified that he had consumed
on the date of the accident "one too many."
19. During the aforesaid deposition, Joel Cummings testified that he cut himself off
because he was getting blurred vision.
20. Shortly after he left Johnny K's, Joel Cummings caused the aforesaid accident.
- 3 -
Document #: 219712.1
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COUNT I - NEGLIGENCE
Plaintiff Halie Duncan v. Defendants
20. Paragraphs 1 through 19 hereof are incorporated herein by reference as if fully set
forth.
21. At all relevant times hereto, the Defendants were in the business of furnishing
liquor, malt and/or brewed beverages, and on information and belief were licensed to do so, to
customers and clientele at 6427-6437 Carlisle Pike, Mechanicsburg, Cumberland County,
Pennsylvania 17055.
22. The Defendants individually and/or acting through their employees, servants
and/or agents, sold, furnished and/or gave the aforementioned liquor, malt and/or brewed
beverages to Joel Cummings and/or permitted the aforesaid beverages to be sold, furnished or
given to Joel Cummings while he was visibly intoxicated.
23. The Defendants acts in selling, furnishing and/or giving liquor, malt and/or
brewed beverages to Joel Cummings while he was visibly intoxicated violates the Liquor Code
including 47 P.S. g4-493(1) and g4-497 (hereinafter "Dram Shop Act") and constitutes
negligence per se.
24. The Defendants acts III selling, furnishing and/or giving liquor, malt and/or
brewed beverages to Joel Cummings also were negligent in that they should have known based
on his condition that he should not be served with such alcohol and/or based on the knowledge
that he would be operating a motor vehicle after leaving the establishment:
25. As a direct and proximate resultofthe violations of the Dram Shop Act and/or the
negligent acts of Defendants individually and/or acting through their employees, servants and/or
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Docuf1lent #: 219712.1
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agents, acting within the scope of their authority, Plaintiff Halie Duncan suffered the following
injuries and/or damages:
(a) Personal injuries some of which are or may be permanent, which
are or may be an aggravation and/or exacerbation of pre-existing
conditions and which include, but are not limited to, the following:
(1) Trauma and injury to her back;
(2) Trauma and injury to her neck;
(3) Trauma and injury to her arm; and
(4) Trauma and injury to her head.
(b) Past, present and future physical pain, mental pain, discomfort,
inconvenience, distress, embarrassment and humiliation, present,
past and future loss of her ability to enjoy the pleasure's of life and
limitations in her pursuit of daily activities.
WHEREFORE, Plaintiff Halie Duncan demands judgment in her favor and against the
Defendants, either individually and/or jointly and severally, for the aforesaid damages, which
exceed the limits for compulsory arbitration in Cumberland County and demands costs, interest
and/or damages for delay against Defendants as allowed by law.
COUNT II - NEGLIGENCE
Plaintiff Kimberlv Duncan v. Defendants
26. Paragraphs 1 through 25 hereof are incorporated herein by reference as if fully set
forth.
27. At all relevant times hereto, the Defendants were in the business of furnishing
liquor, malt and/or brewed beverages, and on information and belief were licensed to do so, to
customers and clientele at 6427-6437 Carlisle Pike, Mechanicsburg, Cumberland County,
Pennsylvania 17055.
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28. The Defendants individually and/or acting through their employees, servants
and/or agents, sold, furnished and/or gave the aforementioned liquor, malt and/or brewed
beverages to Joel Cummings and/or permitted the aforesaid beverages to be sold, furnished or
given to Joel Cummings while he was visibly intoxicated.
29. The Defendants' acts in selling, furnishing and/or giving liquor, malt and/or
brewed beverages to Joel Cummings while he was visibly intoxicated violates the Liquor Code
including 47 P.S. g4-493(1) and g4-497 and constitutes negligent per se.
30. The Defendants acts in selling, furnishing and/or giving liquor, malt and/or
brewed beverages to Joel Cummings also were negligent in that they should have known based
on his condition that he should not be served with such alcohol; and/or based on the knowledge
that he would be operating the motor vehicle after leaving the establishment.
31. As a direct and proximate result of the violations of the Dram Shop Act and/or the
negligent acts of Defendants individually and/or acting through their employees, servants and/or
agents, acting within the scope of their authority, Plaintiff Kimberly Duncan suffered the
following injuries and/or damages:
(a) Personal injuries some of which are or may be permanent, which
are or may be an aggravation and/or exacerbation of pre-existing
conditions which include, but are not limited to, the following:
(1) Trauma and injury to her neck;
(2) Trauma and injury to her back;
(3) Trauma and injury to her left shoulder and arm; and
(4) Trauma and injury to her head.
(b) Medical bills and expenses for the diagnosis, treatment and care
for her injuries and further bills and expenses in the future;
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Document #: 219712.1
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(c) Medical bills and expenses for the diagnosis, treatment and care
for her daughter Halie Duncan's injuries and further bills and
expenses in the future;
(d) Loss of earnings, partial, total and/or permanent disability,
impairment, loss of productivity and/or loss of earning capacity;
(e) Past, present and future physical pain, mental pain, discomfort,
inconvenience, distress, embarrassment and humiliation, present,
past and future loss of her ability to enjoy the pleasure's of life and
limitations in her pursuit of daily activities; and
(f) Incidental costs associated with the injuries including the use of
medical appliances and medications.
WHEREFORE, Plaintiff Kimberly Duncan demands judgment in her favor and against
the Defendants, either individually and/or jointly and severally, for the aforesaid damages, which
exceed the limits for compulsory arbitration in Cumberland County and demands costs, interest,
and/or damages for delay against Defendants as allowed by law.
METZGER, WICKERSHAM, KNAUSS & ERB, P.C.
By: ~~~~
Clark DeVere, Esquire ~
Attorney I.D. No. 68768
3211 North Front Street
P.O. Box 5300
Harrisburg, PA 17110-0300
(717) 238-8187
Attorney for Plaintiffs
Dared: November 14, 2001
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Document #: 219712.1
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VERIFICATION
I, Kimberly Duncan, hereby certifY that the following is correct:
The facts set forth in the foregoing Civil Complaint are based upon information which I
have furnished to counsel, as well as upon information which has been gathered by counsel and/or
others acting on my behalf in this matter. The language of the Civil Complaint is that of counsel
and not my own. I have read the Civil Complaint, and to the extent that it is based upon information
which I have given to counsel, it is true and correct to the best of my knowledge, information, and
belief. To the extent that the content of the Civil Complaint is that of counsel, I have relied upon
such counsel in making this Verification. I hereby acknowledge that the facts set forth in the
aforesaid Civil Complaint are made subject to the penalties of 18 Pa C.S.A. 94904 relating to
unsworn falsification to authorities.
Dated: 11/14/01
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. berly D can .
Document #:219712.1
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VERIFICATION
I, Kimberly Duncan, as parent and natural guardian of minor PlaintiffHalie Duncan, hereby
certify that the following is correct:
The facts set forth in the foregoing Civil Complaint are based upon infonnation which I
have furnished to counsel, as well as upon infonnation which has been gathered by counsel and/or
others acting on my behalf in this matter. The language of the Civil Complaint is that of counsel
and not my own. I have read the Civil Complaint, and to the extent that it is based upon infonnation
which I have given to counsel, it is true and correct to the best of my knowledge, infonnation, and
belief. To the extent that the content of the Civil Complaint is that of counsel, I have relied upon
such counsel in making this Verification. 'I hereby acknowledge that the facts set forth in the
aforesaid Civil Complaint .are made subject to the penalties of 18 Pa. C.S.A. 114904 relating to
unsworn falsification to authoritie .
Dated: 11/14/01
can, as parent and natura1
alie Duncan
Document #:219712.1
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SHERIFF'S RETURN - REGULAR
~ 'C~SE NO: 2001-06515 P
COMMONWEALTH OF PENNSYLVANIA:
COUNTY OF CUMBERLAND
DUNCAN HALlE ET AL
VS
JOHNNY K'S INC ET AL
CPL. TIMOTHY REITZ
, Sheriff or Deputy Sheriff of
Cumberland County, pennsylvania, who being duly sworn according to law,
says, the within COMPLAINT & NOTICE
was served upon
JOHNNY K' S INC
the
DEFENDANT
, at 0015:38 HOURS, on the 21st day of November, 2001
at 6437 CARLISLE PIKE
MECHANICSBURG, PA 17055
by handing to
LISA SPRAGUE (BARTENDER)
a true and attested copy of COMPLAINT & NOTICE
together with
and at the same time directing Her attention to the contents thereof_
Sheriff's Costs:
Docketing
Service
Affidavi t
surcharge
So
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18.00
6.50
.00
10.00
.00
34.50
R. Thomas Kline
11/26/2001
METZGER, WICKERSHAM
Sworn and Subscribed to
me this ~qle-: day of
before
By:
l'Lc-~ :J.ov ( A.D.
~h a Ind~~-1~'
rothonotary
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SHERIFF'S RETURN - REGULAR
.,." 'C","SE NO: 2001-06515 P
COMMONWEALTH OF PENNSYLVANIA:
COUNTY OF CUMBERLAND
DUNCAN HALlE ET AL
VS
JOHNNY K'S INC ET AL
CPL. TIMOTHY REITZN
, Sheriff or Deputy Sheriff of
Cumberland County,Pennsylvania, who being duly sworn according to law,
says, the within COMPLAINT & NOTICE
was served upon
KRITIKOS JOHN
the
DEFENDANT
, at 0015:38 HOURS, on the 21st day of November, 2001
at 6437 CARLISLE PIKE
MECHANICSBURG, PA 17055
LISA SPRAGUE (BARTENDER)
by handing to
a true and attested copy of COMPLAINT & NOTICE
together with
and at the same time directing Her attention to the contents thereof.
Sheriff's Costs:
Docketing
Service
Affidavit
Surcharge
6.00
.00
.00
10.00
.00
16.00
So ?~._~~~
R. Thomas Kline
11/26/2001
METZGER, WICKERSHAM
Sworn and Subscribed to before By:
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day of
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SHERIFF'S RETURN - REGULAR
" .~SE NO: 2001-06515 P
COMMONWEALTH OF PENNSYLVANIA:
COUNTY OF CUMBERLAND
DUNCAN HALlE ET AL
VS
JOHNNY K'S INC ET AL
CPL. TIMOTHY REITZ
, Sheriff or Deputy Sheriff of
Cumberland County,Pennsylvania, who being duly sworn according to law,
says, the within COMPLAINT & NOTICE
was served upon
KRITIKOS JOHN T/D/B/A JOHNNY K'S
the
DEFENDANT
, at 0015:38 HOURS, on the 21st day of November, 2001
at 64~7 CARLISLE PIKE
MECHANICSBURG, PA 17055
by handing to
LISA SPRAGUE
a true and attested copy of COMPLAINT & NOTICE
together with
and at the same time directing Her attention to the contents thereof.
Sheriff's Costs:
Docketing
Service
Affidavit
Surcharge
So Answers:
6.00
.00
.00
10.00
.00
16.00
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R. Thomas Kline
11/26/2001
METZGER, WICKERSHAM
Sworn and Subscribed to before
By:
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day of
Ju,.,UM.. ,...J .:2w1 A.D.
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HALlE DUNCAN, a minor, by
KIMBERLY DUNCAN, her mother and
natural guardian and KIMBERLY
DUNCAN in her own right,
Plaintiffs
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYL VANIA
NO. 01-6515 Civil Term
CIVIL ACTION - LAW
vs.
JOHNNY K'S, INC., JOHN KRITIKOS,
individually and tld/b/a JOHNNY K'S,
Defendants
JURY TRIAL DEMANDED
NOTICE TO DEFEND
TO: Johnny K's, Inc. and John Kritikos, individually and tld/b/a Johnny K's
c/o William P. Douglas, Esquire
Douglas, Douglas & Douglas
27 W. High Street
P.O. Box 261
Carlisle, PA 17013-0261
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 Plaintiffs. You may lose money or property or other rights important to you.
Document #:223335.1
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YOU SHOULD TAKE TillS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO
NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE TIlE
OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU CAN GET LEGAL HELP.
Cwnberland County Bar Association
2 Liberty Avenue
Carlisle, P A 17013
(717) 249-3166 or (800) 990-9108
Document #:223335.1
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HALlE DUNCAN, a minor, by
KIMBERLY DUNCAN, her mother and
natural guardian and KIMBERL Y
DUNCAN in her own right,
Plaintiffs
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
NO. 01-6515 Civil Term
CIVIL ACTION - LAW
vs.
JOHNNY K'S, INC., JOHN KRITIKOS,
individually and tld/b/a JOHNNY K'S,
Defendants
JURY TRIAL DEMANDED
AMENDED CIVIL COMPLAINT
1. Plaintiff Kimberly Duncan is an adult individual residing at 321 Hogestown Road,
Mechanicsburg, Cumberland County, Pennsylvania.
2. Plaintiff Kimberly Duncan is the mother and natural guardian of minor Plaintiff
Halie Duncan, who resides with her and who is 16 years old, having been born on December 9,
1985.
3. Minor Plaintiff Halie Duncan has selected Plaintiff Kimberly Duncan, as her
mother and natural guardian, to represent her interests in this action.
4. Defendant Johrmy K's, Inc. is a Pennsylvania corporation with a principal place of
business at 6437 Carlisle Pike, Mechanicsburg, Cumberland County, Pennsylvania 17055.
5. Defendant John Kritikos is an adult individual who resides, on information and
belief, at 50 Hoover Road, Carlisle, Cumberland County, Pennsylvania 17013.
6. Defendant John Kritikos owns the property at 6427-6437 Carlisle Pike,
Mechanicsburg, Cumberland County, Pennsylvania 17055 and trades and does business as
Johrmy K's.
Document #: 213335.1
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7. On August 19, 2000, Plaintiff Halie and Kimberly Duncan were involved in a
two-car accident caused by Joel Cummings on the Carlisle Pike (U.S. 11 North) in Hampden
Township, Cumberland County, Pennsylvania.
8. The accident occurred when Defendant Joel Cummings swerved into the right
lane in an attempt to pass the vehicle in front of him in the left lane and crashed into the rear of
adult Plaintiffs vehicle pushing her vehicle into the rear of a third vehicle, which then was
pushed into the rear of the fourth vehicle.
9. Following the collision between the vehicles, Joel Cummings fled the scene of the
accident, failed to stop for steady red lights and eventually was apprehended by the Silver Spring
Township Police.
10. Joel Cummings was visibly intoxicated when he was apprehended and was placed
under arrest and charged with numerous offenses, including driving while under the influence of
alcohol, accidents involving death or personal injury, violation of traffic control signals and other
offenses.
II. Following his arrest, Joel Cummings was administered a breath alcohol test with a
result ofa 0.162% blood alcohol content.
12. On February 20, 2001, Joel Cummings, with representation by counsel, pled
guilty to driving under the influence of alcohol and accidents involving death or personal injury
and was subsequently sentenced for these offenses on April 3, 2001.
13. On April 24, 2001, Plaintiffs filed a Civil Complaint against Joel Cummings
which is pending in the Court of Common Pleas of Cumberland County at Civil Action - Law,
Docket No. 2001-2398.
-2-
DOCliment #: 223335.1
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14. On September 11,2001, Plaintiffs' counsel took the telephone deposition of Joel
Cummings, in the presence of his counsel, to, in part, verify his identity and to investigate the
issues of his alcohol consumption and intoxication.
15. During the aforesaid deposition, Joel Cummings testified that he was consuming
alcohol at a bar located on the Carlisle Pike, Mechanicsburg, Cumberland County, Pennsylvania
on the date of the accident but didn't remember the name of the bar.
16. On October 22, 2001, in Cummings' Response to Plaintiffs' Second Set of
Interrogatories, Cummings further specified that he was consuming alcohol at Defendant
establishment ("Johnny K's") located at 6427-6437 Carlisle Pike, Mechanicsburg, Cumberland
County, Pennsylvania on August 19,2000.
17. During the aforesaid deposition, Joel Cummings testified that he was consuming
alcohol from approximately 3:00 p.m. to 5:00 p.m. on the date of the accident on August 19,
2000.
18. During the aforesaid deposition, Joel Cummings testified that he had consumed
on the date of the accident "one too many."
19. During the aforesaid deposition, Joel Cummings testified that he cut himself off
because he was getting blurred vision.
20. Shortly after he left Johnny K's, Joel Cummings caused the aforesaid accident.
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Document #: 223335.1
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COUNT I - NEGLIGENCE
Plaintiff Halie Duncan v. Defendants
21. Paragraphs 1 through 20 hereof are incorporated herein by reference as if fully set
forth.
22. At all relevant times hereto, the Defendants were in the business of furnishing
liquor, malt and/or brewed beverages, and on information and belief were licensed to do so, to
customers and clientele at 6427-6437 Carlisle Pike, Mechanicsburg, Cumberland County,
Pennsylvania 17055.
23. The Defendants individually and/or acting through their employees, servants
and/or agents, sold, furnished and/or gave the aforementioned liquor, malt and/or brewed
beverages to Joel Cummings and/or permitted the aforesaid beverages to be sold, furnished or
given to Joel Cummings while he was visibly intoxicated.
24. , The Defendants acts in selling, furnishing and/or giving liquor, malt and/or
brewed beverages to Joel Cummings while he was visibly intoxicated violates the Liquor Code
including 47 P.S. g4-493(1) and g4-497 (hereinafter "Dram Shop Act") and constitutes
negligence per se.
25. The Defendants acts in selling, furnishing and/or giving liquor, malt and/or
brewed beverages to Joel Cummings also were negligent in that they should have known based
on his condition that he should not be served with such alcohol and/or based on the knowledge
that he would be operating a motor vehicle after leaving the establishment.
26. As a direct and proximate result of the violations of the Dram Shop Act and/or the
negligent acts of Defendants individually and/or acting through their employees, servants and/or
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agents, acting within the scope of their authority, Plaintiff Halie Duncan suffered the following
injuries and/or damages:
(a) Personal injuries some of which are or may be permanent, which
are or may be an aggravation and/or exacerbation of pre-existing
conditions and which include, but are not limited to, the following:
(1) Trauma and injury to her back;
(2) Trauma and injury to her neck;
(3) Trauma and injury to her ann; and
(4) Trauma and injury to her head.
(b) Past, present and future physical pain, mental pain, discomfort,
inconvenience, distress, embarrassment and humiliation, present,
past and future loss of her ability to enjoy the pleasure's of life and
limitations in her pursuit of daily activities.
27. The Defendants, on information and belief, served persons who were visibly
intoxicated on prior occasions and received citations for doing so from the Pennsylvania Liquor
Control Board. Despite receiving prior citations, the Defendants have again served a visibly
intoxicated person, to wit Joel Cummings, resulting in injuries to Plaintiffs and others. Plaintiffs
are entitled to punitive damages for the continued indifference and disregard of the law and
safety of persons and for their willful, wanton and reckless conduct.
WHEREFORE, Plaintiff Halie Duncan demands judgment in her favor and against the
Defendants, either individually and/or jointly and severally, for the aforesaid damages, which
exceed the limits for compulsory arbitration in Cumberland County and demands costs, interest,
damages for delay and/or punitive damages against Defendants as allowed by law.
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Document #,223335,/
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COUNT II - NEGLIGENCE
Plaintiff Kimberly Duncan v, Defendants
28. Paragraphs I through 27 hereof are incorporated herein by reference as if fully set
forth.
29. At all relevant times hereto, the Defendants were in the business of furnishing
liquor, malt and/or brewed beverages, and on information and belief were licensed to do so, to
customers and clientele at 6427-6437 Carlisle Pike, Mechanicsburg, Cumberland County,
Pennsylvania 17055.
30. The Defendants individually and/or acting through their employees, servants
and/or agents, sold, furnished and/or gave the aforementioned liquor, malt and/or brewed
beverages to Joel Cummings and/or permitted the aforesaid beverages to be sold, furnished or
given to Joel Cummings while he was visibly intoxicated.
31. ,The Defendants' acts in selling, furnishing and/or .giving liquor, malt and/or
brewed beverages to Joel Cummings while he was visibly intoxicated violates the Liquor Code
including 47 P.S. ~4-493(1) and~4-497 and constitutes negligence per se.
32. The Defendants acts in selling, furnishing and/or giving liquor, malt and/or
brewed beverages to Joel Cummings also were negligent in that they should have known based
on his condition that he should not be served with such alcohol; and/or based on the knowledge
that he would be operating the motor vehicle after leaving the establishment.
33. As a direct and proximate result of the violations of the Dram Shop Act and/or the
negligent acts of Defendants individually and/or acting through their employees, servants and/or
agents, acting within the scope of their authority, Plaintiff Kimberly Duncan suffered the
following injuries and/or damages:
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Document #: 223335.1
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(a) Personal injuries some of which are or may be permanent, which
are or may be an aggravation and/or exacerbation of pre-existing
conditions which include, but are not limited to, the following:
(I) Trauma and injury to her neck;
(2) Trauma and injury to her back;
(3) Trauma and injury to her left shoulder and arm; and
(4) Trauma and injury to her head.
(b) Medical bills and expenses for the diagnosis, treatment and care
for her injuries and further bills and expenses in the future;
(c) Medical bills and expenses for the diagnosis, treatment and care
for her daughter Halie Duncan's injuries and further bills and
expenses in the future;
(d) Loss of earnings, partial, total and/or permanent disability,
impairment, loss of productivity and/or loss of earning capacity;
(e) Past, present and future physical pain, mental pain, discomfort,
inconvenience, :distress, embarrassment and humiliation, present,
past and future loss of her ability to enjoy the pleasure's oflife and
limitations in her pursuit of daily activities; and
(f) Incidental costs associated with the injuries including the use of
medical appliances and medications.
34. The Defendants, on information and belief, served persons who were visibly
intoxicated on prior occasions and received citations for doing so from the Pennsylvania Liquor
Control Board. Despite receiving prior citations, the Defendants have again served a visibly
intoxicated person, to wit Joel Cummings, resulting in injuries to Plaintiffs and others. Plaintiffs
are entitled to punitive damages for the continued indifference and disregard of the law and
safety of persons and for their willful, wanton and reckless conduct.
WHEREFORE, Plaintiff Kimberly Duncan demands judgment in her favor and against
the Defendants, either individually and/or jointly and severally, for the aforesaid damages, which
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exceed the limits for compulsory arbitration in Cumberland County and demands costs, interest,
damages for delay and/or punitive damages against Defendants as allowed by law.
METZGER, WICKERSHAM, KNAUSS & ERB, P.C.
By: ~__~I..?
Clark De V ere, Esquire
Attorney LD. No. 68768
3211 North Front Street
P.O. Box 5300
Harrisburg, PA 17110-0300
(717) 238-8187
Attorney for Plaintiffs
Dated: I ~ 2- -0 Z--
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VERIFICATION
I, Kimberly Duncan, hereby certify that the following is correct:
The facts set forth in the foregoing Amended Civil Complaint are based upon information
which I have furnished to counsel, as well as upon information which has been gathered by counsel
and/or others acting on my behalf in this matter. The language of the Amended Civil Complaint is
that of counsel and not my own. I have read the Amended Civil Complaint, and to the extent that it
is based upon information which I have given to counsel, it is true and correct to the best of my
knowledge, information, and belief. To the extent that the content of the Amended Civil Complaint
is that of counsel, I have relied upon such counsel in making this Verification. I hereby
acknowledge that the facts set forth in the aforesaid Amended Civil Complaint are made subject to
the penalties of 18 Pa. C.S.A. g4904 relating to unsworn falsification to authorities.
Dated: III U I D'
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VERIFICATION
I, Kimberly Duncan, as parent and natural guardian of minor Plaintiff Halie Duncan, hereby
certifY that the following is correct:
The facts set forth in the foregoing Amended Civil Complaint are based upon information
which I have furnished to counsel, as well as upon information which has been gathered by counsel
and/or others acting on my behalf in this matter. The language of the Amended Civil Complaint is
that of counsel and not my own. I have read the Amended Civil Complaint, and to the extent that it
is based upon information which I have given to counsel, it is true and correct to the best of my
knowledge, information, and belief. To the extent that the content of the Amended Civil Complaint
is that of counsel, I have relied upon such counsel in making this Verification. I hereby
acknowledge that the facts set forth in the aforesaid Amended Civil Complaint are made subject to
the penalties of 18 Pa. C.S.A. ~4904 relating to unsworn falsification to authorities.
Dated: l2!lt/OI ~'-fY1.J1JfY'ajV
mberly D can, as parent and natural
guardian to Halie Duncan
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CERTIFICATE OF SERVICE
AND NOW, I, Clark DeVere, Esquire, of Metzger, Wickersham, Knauss & Erb, P.C.,
attorneys for Plaintiffs, hereby certify that I served the foregoing document this day by depositing
the same in the United States mail, first class, postage prepaid, in Harrisburg, Pennsylvania,
addressed to:
Johnny K's, Inc. and John Kritikos, individually and t/d/b/a
Johnny K's
c/o William P. Douglas, Esquire
Douglas, Douglas & Douglas
27 W. High Street
P.O. Box 261
Carlisle, PA 17013"0261
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Clark De Vere, Esquire
Dated: January 2, 2002
Document #: 223716.1
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WILLIAM P. DOUGLAS, ESQUIRE
ATTY. I.D. # 37926
DOUGLAS, DOUGLAS & DOUGLAS
27 WEST IDGH STREET
P.o.B. 261
CARLISLE, P A 17013
TELEPHONE 717-243-1790
ATIORNEY FOR DEFENDANT
HALIE DUNCAN, a minor, by
KIMBERLY DUNCAN, her
mother and natural guardian,
and KIMBERLY DUNCAN,
in her own right,
IN TIIE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY, P A
CML ACTION - LAW
Plaintiffs
NO. 01-6515 CML TERM
VS.
JOHNNY K'S, INC., JOHN
KRITIKOS, individually and
tl d/b I a JOHNNY K'S,
Defendants
JURY TRIAL DEMANDED
ANSWER TO AMENDED CIVIL COMPLAINT
AND NEW MATTER
1. Admitted.
2. Admitted.
3. Admitted.
4. Admitted.
5. Admitted.
6. Admitted.
7. Denied. After reasonable investigation, the defendant is without
knowledge as to the truth of the averments and strict proof thereof
is demanded. Defendant denies the averments generally under Pa.
R.c.P. 1029(e).
8. Denied. After reasonable investigation, the defendant is without
knowledge as to the truth of the averments and strict proof ~ereof
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is demanded. Defendant denies the averments generally under Pa.
RCP. 1029(e).
9. Denied, After reasonable investigation, the defendant is without
knowledge as to the truth of the averments and strict proof thereof
is demanded. Defendant denies the averments generally under Pa.
RCP.1029(e).
10. Denied. Aft~r reasonable investigation, the defendant is without
knowledge as to the truth of the averments and strict proof thereof
is demanded. Defendant denies the averments generally under Pa.
RCP. 1029(e).
11. Denied. After reasonable investigation, the defendant is without
knowledge as to the truth of the averments and strict proof thereof
is demanded. Defendant denies the averments generally under Pa.
RCP.1029(e).
12. Denied. After reasonable investigation, the defendant is without
knowledge as to the truth of the averments and strict proof thereof
is demanded. Defendant denies the averments generally under Pa.
RCP. 1029(e).
13. Admitted.
14. Admitted.
15. Denied as stated. The deposition transcript speaks for itself.
However, with respect to the truth or veracity of the content of the
averments, after reasonable investigation, the defendant is unable
to determine same and strict proof thereof is demanded.
16. Denied as stated. The deposition transcript speaks for itself.
However, with respect to the truth or veracity of the content of the
averments, after reasonable investigation, the defendant is unable
to determine same and strict proof thereof is demanded.
17. Denied as stated. The deposition transcript speaks for itself.
However, with respect to the truth or veracity of the content of the
averments, after reasonable investigation, the defendant is unable
to determine same and strict proof thereof is demanded.
18. Denied as stated. The deposition transcript speaks for itself.
However, with respect to the truth or veracity of the content of the
averments, after reasonable investigation, the defendant is unable
to determine same and strict proof thereof is demanded.
19. Denied as stated. The deposition transcript speaks for itself.
However, with respect to the truth or veracity of the conten~ of the
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averments, after reasonable investigation, the defendant is unable
to determine same and strict proof thereof is demanded.
20. Denied. After reasonable investigation, the defendant is unable to
determine the truth or veracity of the averments and strict proof
thereof is demanded. Defendant denies the averments generally
under Pa. RCP. 1029(e).
COUNT I - NEGLIGENCE
Plaintiff Halie Duncan v. Defendants
21. The responses to paragraphs 1 through 20 are incorporated herein
and reference is made thereto.
22. Denied. Defendant Johnnie K's, Inc., was the licensee who was in
the business in question.
23. Denied. After reasonable investigation, the defendant is unable to
determine the truth or veracity of the averments and strict proof
thereof is demanded. Defendant denies the averments generally
under Pa. RCP. 1029(e).
24. Denied. After reasonable investigation, the defendant is unable to
determine the truth or veracity of the averments and strict proof
thereof is demanded. Defendant denies the averments generally
underPa. RC.P. l029(e).
25. Denied. After reasonable investigation, the defendant is unable to
determine the truth or veracity of the averments and strict proof
thereof is demanded. Defendant denies the averments generally
under Pa. RCP, l029(e).
26. Denied. After reasonable investigation, the defendant is unable to
determine the truth or veracity of the averments and strict proof
thereof is demanded. Defendant denies the averments generally
under Pa. RCP. 1029(e).
27. Denied as stated. It is denied that plaintiff is entitled to punitive
damages. It is specifically denied that plaintiff is entitled to any
damages from the defendant, pursuant to Pa. RCP. 1029(e).
WHEREFORE, it is prayed that the Plaintiff's Amended Complaint be
dismissed.
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COUNT II - NEGLIGENCE
Plaintiff Kimberly Duncan v. Defendants
28. The responses to paragraphs 1 through 27 are incorporated herein
and reference is made thereto.
29. Denied. Defendant Johnnie K's, Inc., was the licensee who was in
the business in question.
30. Denied. After reasonable investigation, the defendant is unable to
determine the truth or veracity of the averments and strict proof
thereof is demanded. Defendant denies the averments generally
under Pa. RC.P. 1029(e).
31. Denied. After reasonable investigation, the defendant is unable to
determine the truth or veracity of the averments and strict proof
thereof is demanded. Defendant denies the averments generally
under Pa. RC.P. 1029(e).
32. Denied. After reasonable investigation, the defendant is unable to
determine the truth or veracity of the averments and strict proof
thereof is demanded. Defendant denies the averments generally
under Pa. RC.P. 1029(e).
33. Denied. After reasonable investigation, the defendant is unable to
determine the truth or veracity of the averments and strict proof
thereof is demanded. Defendant denies the averments generally
under Pa. RC.P. 1029(e).
34. Denied. After reasonable investigation, the defendant is unable to
determine the truth or veracity of the averments and strict proof
thereof is demanded. Defendant denies the averments generally
under Pa. RC.P.1029(e).
WHEREFORE, it is prayed that the Plaintiffs Amended Complaint be
dismissed.
.Ji
NEW MATTER
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35. The defendant hereby pleads release as an affirmative defense.
DOUGLAS, DOUGLAS & DOUGLAS
By
Attorney for Defendant
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COMMONWEALTH OF PENNSYLVANIA )
COUNTY OF CUMBERLAND )
SS.
VERIFICA nON
I verify that the statements made in the foregoing document are true and
correct, to the best of my knowledge, information, and belief. I understand that
false statements herein made are subject to the provisions of 18 Pa. C.S.A. S 4904
relating to unsworn falsification to authorities.
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John Kritikos
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HALIE DUNCAN, a minor, by
KIMBERLY DUNCAN, her mother and
natural guardian and KIMBERL Y
DUNCAN in her own right,
Plaintiffs
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
NO. 01-6515 Civil Term
CIVIL ACTION - LAW
vs.
JOHNNY K'S, INC., JOHN KRITIKOS,
individually and t/d/b/a JOHNNY K'S,
Defendants
JURY TRIAL DEMANDED
PT,ATNTTFFS' RF,PT,V TO fiFFFNfiANTS' NFWMATTFR
35. Conclusion of law, no reply required. If a reply is required, the averments are specifically
denied and denied pursuant to Pa.R.C.P. No. 1029(e). By way of further reply, Plaintiffs did not release
any claims against Defendants.
WHEREFORE, Plaintiffs demand that Defendants' New Matter be dismissed and that judgment
be entered in their favor as requested in the Amended Complaint filed in this action.
METZGER, WICKERSHAM, KNAUSS & ERE, P.C.
By: ............0_?>,~
Clark De V ere, Esquire
Attorney I.D. No. 68768
3211 North Front Street
P.O. Box 5300
Harrisburg, PA 17110-0300
(717) 238-8187
Attorney for Plaintiffs
Dated; 3-.1 f. 0.2.-
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I, Kimberly Duncan, as parent and natural guardian of minor Plaintiff Halie Duncan, hereby
certify that the following is correct:
The facts set forth in the foregoing Plaintiff's Reply to Defendants' New Matter are based
upon information which I have furnished to counsel, as well as upon information which has been
gathered by counsel and/or others acting on my behalf in this matter, The language of the
Plaintiff's Reply to Defendants' New Matter is that of counsel and not my own. I have read the
Plaintiff's Reply to Defendants' New Matter, and to the extent that it is based upon information
which I have given to counsel, it is true and correct to the best of my knowledge, information, and
belief. To the extent that the content of the Plaintiff's Reply to Defendants' New Matter is that of
counsel, I have relied upon such counsel in making this Verification. I hereby acknowledge that the
facts set forth in the aforesaid Plaintiff's Reply to Defendants' New Matter are made subject to the
penalties of 18 Pa. C.S.A. g4904 relating to unsworn falsification to authorities_
Dated: 3/28/02
can, as parent and natural
alie Duncan
Document #:230105.1
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I, Kimberly Duncan, hereby certifY that the following is correct:
The facts set forth in the foregoing Plaintiffs Reply to Defendants' New Matter are based
upon infonnation which I have furnished to counsel, as well as upon infonnation which has been
gathered by counsel and/or others acting on my behalf in this matter. The language of the
Plaintiffs Reply to Defendants' New Matter is that of counsel and not my own. I have read the
Plaintiffs Reply to Defendants' New Matter, and to the extent that it is based upon infonnation
which I have given to counsel, it is true and correct to the best of my knowledge, infonnation, and
belief. To the extent that the content of the Plaintiffs Reply to Defendants' New Matter is that of
counsel, I have relied upon such counsel in making this Verification. I hereby acknowledge that the
facts set forth in the aforesaid Plaintiffs Reply to Defendants' New Matter are made subject to the
penalties of 18Pa. C.S.A. ~4904 relating to unsworn falsification to authorities.
Dated: 3/28/02
~'fY)~, j
K mberly D an
Document #:230105.1
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CRRTTFWATR OF SRRVTCR
AND NOW, I, Clark DeVere, Esquire, of Metzger, Wickersham, Knauss & Erb, P.C.,
attorneys for Plaintiffs, hereby certify that I served the foregoing Plaintiffs' Reply to Defendants'
New Matter this day by depositing the same in the United States mail, first class, postage prepaid,
in Harrisburg, Pennsylvania, addressed to:
Johnny K's, Inc. and John Kritikos, individually and t/d/b/a Johnny K's
c/o William P. Douglas, Esquire
Douglas, Douglas & Douglas
27 W. High Street
P.O. Box 261
Carlisle, PA 17013-0261
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Clark De Vere, Esquire
Dated: 3 - 0< 9-0,,2...
Document #:J30105.1
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HALlE DUNCAN, a minor, by
KIMBERL Y DUNCAN, her mother and
natural guardian and KIMBERL Y
DUNCAN in her own right,
Plaintiffs
Ys.
JOEL CUMMINGS,
Defendant
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IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
NO. 01-2398
CIVIL ACTION - LAw
JURY TRIAL DEMANDED
* * * * * * * * * * *
HALlE DUNCAN, a minor, by
KIMBERL Y DUNCAN, her mother and
natural guardian and KIMBERLY
DUNCAN in her own right,
Plaintiffs
vs.
JOHNNY K'S, INC., JOHN KRITIKOS,
individually and t/dlbla JOHNNY K'S,
Defendants
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
NO. 01-6515 Civil Term
CIVIL ACTION - LAW
JURY TRIAL DEMANDED
RULE TO SHOW CAUSE
,
V';JV'# ,/.-'
AND NOW, this ~ day of
, 2002, upon motion of Plaintiffs,
Halie Dlillcan, a minor, by Kimberly Duncan, her mother and natural guardian, and Kimberly
Duncan in her own right, to consolidate, a Rule is entered upon Defendant, Joel Cummings, and
Defendants, Johnny K's, Inc., John Kritikos, individually and t/d/b/a Johnny K's, to show cause, if
any they have, why the relief req, uested in said Motion should no, t, be ,granted. . /1~ ' " . , "',
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HAllE DUNCAN, a minor, by
KIMBERL Y DUNCAN, her mother and
natural guardian and KIMBERL Y
DUNCAN in her own right,
Plaintiffs
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
NO. 01-2398
CIVIL ACTION - LAW
vs.
JOEL CUMMINGS,
Defendant
JURY TRIAL DEMANDED
* * * * * * * * * * *
HALlE DUNCAN, a minor, by
KIMBERL Y DUNCAN, her mother and
natural guardian and KlMBERL Y
DUNCAN in her own right,
Plaintiffs
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
NO. 01-6515 Civil Term
CIVIL ACTION - LAW
vs.
JOHNNY K'S, INC., JOHN KRITIKOS,
individually and Vd/b/a JOHNNY K'S,
Defendants
JURY TRIAL DEMANDED
ORDER
AND NOW, this _ day of
, 2002, upon consideration of the
Motion of Plaintiffs, Halie Duncan, a minor, by Kimberly Duncan, her mother and natural guardian,
and Kimberly Duncan in her own right, and the response of Defendants hereto, it is hereby ordered
that the above captioned actions are consolidated for purposes of discovery and trial under
Cumberland County Civil Action No. 01-2398, which shall hereinafter have a combined caption as
set forth above.
BY THE COURT:
1.
cc: All Counsel
Document #: 239230./
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HALlE DUNCAN, a minor, by
KIMBERLY DUNCAN, her mother and
natural guardian and KIMBERLY
DUNCAN in her own right,
Plaintiffs
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
NO. 01-2398
CIVIL ACTION - LAW
vs.
JOEL CUMMINGS,
Defendant
JURY TRIAL DEMANDED
* * * * * * * * * * *
HALlE DUNCAN, a minor, by
KIMBERLY DUNCAN, her mother and
natural guardian and KIMBERLY
DUNCAN in her own right,
Plaintiffs
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
NO. 01-6515 Civil Term
CIVIL ACTION - LAW
vs.
JOHNNY K'S, INC., JOHN KRITIKOS,
individually and tld/bla JOHNNY K'S,
Defendants
JURY TRIAL DEMANDED
PLAINTIFFS' MOTION FOR CONSOLIDATION
Plaintiffs, Halie Duncan, a minor, by Kimberly Duncan, her mother and natural guardian,
and Kimberly Duncan in her own right, by their undersigned counsel, respectfully requests this
Court enter an Order under Pennsylvania Rule of Civil Procedure No. 213(a) consolidating the
above captioned actions for the purpose of discovery and trial and in support aver as follows:
I. On April 24, 2001, Plaintiffs commenced the above captioned action against Joel
Cummings by filing a Civil Complaint.
2. The Plaintiffs' Complaint alleges that they sustained personal injuries when
Defendant, Joel Cummings, swerved his vehicle into the right lane in an attempt to pass the
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vehicle in front of him in the left lane and crashed into the rear of Plaintiffs' vehicle, pushing that
vehicle into the rear of a third vehicle which was then pushed into the rear of a fourth vehicle on
August 19, 2000, on the Carlisle Pike (U.S. II North) in Hampden Township, Cumberland
County, Pennsylvania.
3. Plaintiffs allege that their injuries were caused by the negligence of Defendant,
Joel Cummings, including driving while under the influence in violation of 75 Pa.C.S.A. Section
3731 and applicable law.
4. At the accident scene, Defendant, Joel Cwnmings, after causing a multi-vehicle
collision, fled the scene of the accident, failed to stop for steady red lights, and eventually was
apprehended by the Silver Spring Township Police. Defendant, Joel Cwnmings, was visibly
intoxicated when he was apprehended and was placed under arrest and charged with numerous
offenses including driving while under the influence of alcohol, accidents involving death or
personal injury, violation of traffic control signals, and other offenses. Following his arrest, Joel
Cwnmings was administered a breath alcohol test with the results revealing a .162 percent blood
alcohol level.
5. On February 20, 2001, Joel Cummings, with representation by counsel, pled
guilty to driving under the influence and accidents involving death or personal injury and was
subsequently sentenced for these offenses on April 3, 200 I.
6. The parties have exchanged written discovery and one deposition has been taken.
7. After the aforesaid Complaint was filed, Plaintiffs conducted discovery including
the deposition of Defendant, Joel Cummings. He testified that he was consuming alcohol in a
bar which was later identified to be Johnny K's located at 6427-6437 Carlisle Pike,
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Mechanicsburg, Cumberland County, Pennsylvania, from approximately 3:00 o'clock p.m. to
5:00 o'clock p.m. on the date of the accident on August 19, 2000. In addition, during the
aforesaid deposition, Defendant, Joel Cummings, testified that he consumed three beers at the
establishment and that he had not had any alcohol in three months. He further testified that he
had cut himself off from drinking because he felt that he had had one too many and because he
felt that his vision was starting to become blurred. Shortly after he left Johnny K's, Joel
Cummings caused the aforesaid accident.
8. On November 16,2001, Plaintiffs commenced a separate civil action by filing a
Civil Complaint in the Court of Common Pleas of Cumberland County, Pennsylvania, against
Johnny K's, Inc., and John Kritikos, individually and t/d/b/a Johnny K's at Docket No. 01-6515.
9. An Amended Complaint was filed against Johnny K's, Inc., and John Kritikos,
individually and t/d/b/a Johnny K's on January 3,2002.
10. The Complaint against Johnny K's, Inc., and John Kritikos, individually and
t/d/b/a Johnny K's alleges that the Defendants violated the Liquor Code including 47 P.S.
Section 4-493(1) and Section 4-497 by selling, furnishing, and/or giving liquor, malt, and or
brewed beverages to Defendant, Joel Cummings, while he was visibly intoxicated.
II. The Complaint further alleges that the Defendants' acts of selling, furnishing,
and/or giving liquor, malt, and or brewed beverages to Defendant, Joel Cummings, also was
negligent and that they should have known based on his condition that he should not be served
with such alcohol; based on the knowledge that he would be operating a motor vehicle after
leaving the establishment; and/or based on the knowledge of his prior alcohol consumption at the
establishment and intoxication.
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12. In addition, the Complaint further alleges that Johnny K's, based on information
and belief, served persons who were visibly intoxicated on prior occasions and received citations
for doing so from the Pennsylvania Liquor Control Board and despite receiving these prior
citations, the Defendants have again served a visibly intoxicated person, Defendant, Joel
Cummings, resulting in injuries to Plaintiffs and others.
13. On or about March 5, 2002, Johnny K's, Inc., John Kritikos, individually and
t1d/b/a Johnny K's, filed an Answer to the Amended Civil Complaint with New Matter. On April 2,
2002, Plaintiffs filed a Reply to Defendants' New Matter and the pleadings are now closed.
14. The parties to the second action have exchanged written discovery but have not yet
taken any depositions.
15. Both actions involve the same set of facts and arise from the Plaintiffs' accident on
August 19, 2000.
16. Consolidation of the cases will avoid duplication of expense both in additional
discovery and trial to the benefit of the parties and the Court. Consolidation will also avoid the
necessity of calling the same lay and expert witnesses in two trials, including the parties, medical
witnesses, the investigating police officer and toxicologist.
17. Also, Plaintiffs want to assert their right to claim joint and several liability against
the aforesaid Defendants at trial.
18. Counsel for Defendant, Joel Cummings, has agreed to stipulate to consolidation;
counsel for Defendants, Johnny K's, Inc., John Kritikos, individually and t1d/b/a Johnny K's, has
not agreed to stipulate to consolidation.
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WHEREFORE, Plaintiffs, Halie Duncan, a minor, by Kimberly Duncan, her mother and
natural guardian, and Kimberly Duncan in her own right, respectfully request that this Court
consolidate both actions brought by them as a result of the motor vehicle accident on August 19,
2000, under Cumberland County Civil Action No. 01-2398 and that the actions be consolidated
from this point on for the purposes of discovery and trial.
METZGER, WICKERSHAM, KNAUSS & ERB, P.e.
By: ~ ~d""~U-:;:;
Clark DeVere, Esquire
Attorney LD. No. 68768
Andrew C. Spears
Attorney LD. No. 87737
32 I I North Front Street
P.O. Box 5300
Harrisburg, PA 17110-0300
(717) 238-8187
Attorneys for Plaintiffs
Dated:
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CERTIFICATE OF SERVICE
I, Clark DeVere, Esquire, of the law finn of Metzger, Wickersham, Knauss & Erb, P.c.,
hereby certifY that I served a true and correct copy of the foregoing document with reference to the
foregoing action by first class mail, postage prepaid, this 15th day of August, 2002, on the following:
Joel Cummings
c/o Andrew Lehman, Esquire
Nealon & Gover, P.C.
2411 North Front Street
Harrisburg, PAl 7110
Johnny K's, Inc. and John Kritikos, individually and t/d/b/a Johnny K's
c/o William P. Douglas, Esquire
Douglas, Douglas & Douglas
27 W. High Street
P.O. Box 261
Carlisle, PA 17013-0261
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Clark 15e Vere, Esquire
Document #: 239230,[
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HAllE DUNCAN, a minor, by
KIMBERLY DUNCAN, her mother and
natural guardian and KIMBERLY
DUNCAN in her own right,
PLAINTIFFS
V.
JOEL CUMMINGS,
DEFENDANT
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IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
: 01-2398 CIVIL TERM
HAllE DUNCAN, a minor, by
KIMBERLY DUNCAN, her mother and
natural guardian and KIMBERLY
DUNCAN in her own right,
PLAINTIFFS
V.
JOHNNY K'S INC., JOHN KRITIKOS,
individually and t1dlbla JOHNNY K'S,
DEFENDANTS
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORDER OF COURT
AND NOW, this
~
day of September, 2002, following a review of
plaintiffs' motion for consolidation of the above-captioned cases, and the objection of
defendants, Johnny K's Inc., John Kritikos, individually and t1dlb/a Johnny K's, to
consolidation for purposes of trial, the Rule to show cause entered on August 20, 2002,
is made absolute. The suits at No. 01-2398 and 01-6515, ARE CONSOLlDATED.1
,/
I See Terwilliger v. Kitchen. et al.. 781 A.2d 1201 (Pa. Super. 2001).
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/9lark DeVere, Esquire
For Plaintiffs
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(William P. Douglas, Esquire
For Johnny K's, Inc. and John Kritikos, individually and tld/b/a Johnny K's
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Andrew Lehman, Esquire
For Joel Cummings
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HAllE DUNCAN, a minor, by
KIMBERLY DUNCAN, her mother and
natural guardian and KIMBERLY
DUNCAN in her own right,
PLAINTIFFS .
V.
JOEL CUMMINGS,
DEFENDANT
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IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
: 01-2398 CIVIL TERM
HAllE DUNCAN, a minor, by
KIMBERLY DUNCAN, her mother and
natural guardian and KIMBERLY
DUNCAN in her own right,
PLAINTIFFS
V.
JOHNNY K'S INC., JOHN KRITIKOS,
individually and t1dlb/a JOHNNY K'S,
DEFENDANTS
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
01-6515 CIVIL TERM /
ORDER OF COURT
AND NOW, this 1\ s r day of March, 2003, upon consideration of the
Petition for Approval of Minor Plaintiff's Compromise Settlement, it is hereby ORDERED
AND DECREED that the settlement for the gross sum of Two Thousand Five Hundred
and 00/100 ($2,500.00) Dollars is APPROVED. Counsel fees and expenses are found
to be fair and reasonable and also approved as set forth below. The distribution is
directed as follows:
(a) The sum of $1 ,784.09 shall be placed in a federally insured interest bearing
account in the name of Halie Duncan, born December 9, 1985. The account shall
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contain the following notation: NO WITHDRAWAL SHALL BE MADE BY HAllE
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DUNCAN BEFORE SHE OBTAINS HER MAJORITY UNLESS BY ORDER OF A
COURT OF COMPETENT JURISDICTION.
(b) To be paid to Metzger, Wickerhsham, P.C., for counsel fees, the sum of
$625.00.
(c) To be paid to Metzger, Wickersham, P.C., for expenses, the sum of $90.91.
(d) Counsel for plaintiff shall file proof of said deposit with the Prothonotary with
a copy to be forwarded to chambers.
Clark DeVere, Esquire
For Plaintiffs
William P. Douglas, Esquire J
For Johnny K's, Inc. and John Kritikos, individually and Ud/b/a Johnny K's
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Andrew Lehman, Esquire
For Joel Cummings
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HALlE DUNCAN, a minor, by
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natural guardian and KlMBERL Y
DUNCAN in her own right,
Plaintiffs
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
NO. 01"2398
CIVIL ACTION - LAW
vs.
JOEL CUMMINGS,
Defendant
JURY TRIAL DEMANDED
* * * * * * * * * * *
HALlE DUNCAN, a minor, by
KlMBERL Y DUNCAN, her mother and
natural guardian and KlMBERL Y
DUNCAN in her own right,
Plaintiffs
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYL VANIA
NO. 01-6515 Civil Term /
CIVIL ACTION - LAW
vs.
JOHNNY K'S, INC., JOHN KRITIKOS,
individually and t/d/b/a JOHNNY K'S,
Defendants
JURY TRIAL DEMANDED
PETITION FOR APPROVAL OF MINOR
PLAINTIFF'S COMPROMISE SETTLEMENT
Pursuant to Pa.R.C.P. No. 2039, Kimberly Duncan, as parent and natural guardian of
Halie Duncan, files this Petition for Court Approval of Minor Plaintiff's Compromise Settlement
and in support thereof avers the following:
1. Petitioner, Kimberly Duncan, is an adult individual residing at 321 Hogestown
Road, Mechanicsburg, Cumberland County, Pennsylvania, 17050.
2. Petitioner, Kimberly Duncan, is the parent and natural guardian of minor Plaintiff,
Halie Duncan, who resides with Petitioner, Kimberly Duncan, and who is 17 years old, having
been born on December 9,1985.
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3. Minor Plaintiff, Halie Duncan, has selected Petitioner, Kimberly Duncan, as her
parent and natural guardian, to represent her interest in this Petition.
4. Defendant, Joel Cummings, is an adult individual who resides, on information and
belief, at 12 Valley Street, Duncannon, Perry County, Pennsylvania.
5. Defendant, Johnny K's., Inc., is a Pennsylvania corporation with a former place of
business at 6437 Carlisle Pike, Mechanicsburg, Cumberland County, Pennsylvania, 17055.
6. Defendant, John Kritikos, is an adult individual who resides, on information and
belief, at 50 Hoover Road, Carlisle, Cumberland County, Pennsylvania, 17013.
7. Defendant, John Kritikos, formerly owned the property at 6427-6437 Carlisle
Pike, Mechanicsburg, Cumberland County, Pennsylvania, 17055, and formerly did business as
Johnny K's.
8. On August 19, 2000, Plaintiffs, Halie and Kimberly Duncan, were involved in a
multi-car accident caused by Joel Cummings on the Carlisle Pike, in Hampden Township,
Cumberland County, Pennsylvania.
9. The accident occurred when Defendant, Joel Cummings, swerved into the right
lane in an attempt to pass the vehicle in front of him in the left lane and crashed into the rear of
adult Plaintiff's vehicle pushing her vehicle into the rear of a third vehicle, which was then
pushed into the rear of the fourth vehicle. A true and correct copy of the police accident report is
attached hereto as Exhibit "A" and incorporated herein by reference.
10. On April 24, 2001, Plaintiffs commenced the above captioned action against Joel
Cummings by filing a Civil Complaint which was docketed at Cumberland County Action No.
01-2398.
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11. Plaintiffs allege that their injuries were caused by the negligence of Defendant,
Joel Cummings, including driving while under the influence, a violation of 75 Pa. C.S.A. Section
3731 and applicable law.
11. On February 20, 2001, Joel Cummings, with representation by counsel, pled
guilty to driving under the influence and accidents involving deaths or personal injury and was
subsequently sentenced for these offenses on April 3, 2001.
13. After the aforesaid Complaint was filed, Plaintiffs conducted discovery, including
the deposition of Defendant, Joel Cummings. He testified that he was consuming alcohol in a
bar which was later identified to be Johnny K's located at 6427-6437 Carlisle Pike,
Mechanicsburg, Cumberland County, Pennsylvania, from approximately 3:00 o'clock p.m. to
5:00 o'clock p.m. on the date of the accident on August 19, 2000.
14. In addition, during the aforesaid deposition, Defendant, Joel Cummings, testified
that he consumed three beers at the establishment and that he had not had any alcohol in three
months. He further testified that he had cut himself off from drinking because he felt that he had
had one too many and because he felt that his vision was starting to become blurred. Shortly
after he left Johnny K's, Joel Cummings caused the aforesaid accident.
15. On November 16, 2001, Plaintiffs commenced a separate civil action by filing a
Civil Complaint in the Court of Common Pleas of Cumberland County, Pennsylvania, against
Johnny K's, Inc., and John Kritikos, individually and tJd/b/a Johnny K's, docketed at No.
01-6515.
16. An Amended Complaint was filed against Johnny K's, Inc., and John Kritikos,
individually and tJd/b/a Johnny K's, on January 3, 2002, alleging that the Defendants violated the
- 3-
Documen1 #263049
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Liquor Code including 47 P.S. Section 4-493(1), and Section 4-497(1), and Section 4-497, by
selling, furnishing, and/or giving liquor, malts, and/or brewed beverages to Defendant, Joel
Cummings, while he was visibly intoxicated.
17. On August 15,2002, Plaintiffs filed a Motion for Consolidation for the purpose of
discovery and trial on the basis that both actions have the same set of facts and arise from the
Plaintiffs' accident on August 19, 200, and that consolidation of the cases would avoid
duplication of expense, both in additional discovery and trial, to the benefit of the parties and the
Court and that Plaintiffs wanted to assert their right to claim joint and several liability against
both sets of Defendants at trial.
18. Counsel for Defendant, Joel Cummings, agreed to stipulate to the consolidation;
counsel for Defendants, Johnny K's, Inc., and John Kritikos, individually and t/d/b/a Johnny K's,
declined to stipulate to consolidation.
19. On September 5, 2002, the Honorable Edgar B. Bayley consolidated the two cases
for purposes oftrial.
20. As a result of the aforesaid accident, minor Plaintiff, Halie Duncan, suffered
trauma injury to her back, neck, ann, and head. Halie treated at Holy Spirit Emergency Room on
August 19,2000. She was diagnosed with musculoskeletal back pain and was discharged home
with head injury precautions. Halie treated with her family doctor, Karen Campbell, MD. at the
Mechanicsburg Family Practice Center on August 24, 2000. Dr. Campbell diagnosed Halie with a
cervical and thoracic strain secondary to motor vehicle accident. Halie has not treated since and has
recovered. A true and correct copy of her treatment records are attached hereto as Exhibit "BOO and
incorporated herein by reference.
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21. Minor Plaintiff, Halie Duncan's medical bills in the amount of $323.25 have been
processed for payment under Petitioner's automobile policy with Erie Insurance and there are no
outstanding medical bills to her knowledge.
22. Minor Plaintiff, Halie Duncan, was not employed at the time of the accident and
there is no wage loss claim in her name at this time.
23. Defendant, Joel Cummings' liability insurer has agreed to pay Two Thousand Five
Hundred and 001100 ($2,500.00) Dollars in full and final settlement of minor Plaintiff, Halie
Duncan's claims against both Defendants. A true and correct copy of the offer letter from
Progressive's attorney, Andrew Lehman, is attached hereto as Exhibit "C" and incorporated herein
by reference.
24. Petitioner believes that the acceptance of the offer in settlement of the liability claim
against Defendants would be fair and in the best interest of the minor Plaintiff, Halie Duncan
because of her limited injuries and treatment.
25. Counsel was retained by the Petitioner to represent the minor Plaintiff on a
contingency basis of twenty-five (25%) percent, which fee is fair and reasonable for the time and
effort expended on behalf of the minor Plaintiff, Halie Duncan. A copy of the Fee Agreement is
attached hereto as Exhibit "D" and incorporated herein by reference. Counsel has also incurred the
following expenses on behalf of the minor Plaintiff:
Medical records, Fast Photocopy.
Postage.
Long distance phone calls.
Court related expenses.
TOTAL.
$ 66.24
10.11
5.56
9.00
$ 90.91
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26. Petitioner respectfully requests that this Honorable Court approve the compromise
settlement of this claim in the gross amount of Two Thousand Five Hundred and 00/100
($2,500.00) Dollars, which Petitioner will receive directly for the benefit of the minor.
27. On approval, the Petitioner will sign the Settlement Agreement and Release, a copy
of which is attached hereto as Exhibit "E" and incorporated herein by reference.
28. Upon approval of the minor compromise settlement, the Petitioner also desires to
discontinue the action filed against Joel Cummings and Johnny K's, Inc., John Kritikos, individually
and t/d/b/a Johnny K's, upon receipt of the $2,500.00 to be paid on behalf of Defendants.
29. All Defendants concur with the filing of the Petition and also seek approval of the
minor compromise settlement under the terms set forth above.
WHEREFORE, the Petitioner respectfully requests that this Honorable Court approve of
the minor Plaintiffs compromise settlement and enter an Order distributing the funds as follows:
(a) To be paid to Kimberly Duncan, who is appointed guardian of Halie
Duncan for the purposes of this Petition, the sum of $1,784.09 for the
immediate benefit of Halie Duncan;
(b) To be paid to Metzger, Wickersham, P.C., for counsel fees, the sum of
$625.00; and
(c) To be paid to Metzger, Wickersham, P.C., for expenses, the sum of
$90.91.
METZGER, WICKERSHAM, KNAUSS & ERB, P.C.
By:
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Clark De ere, Esquire
Attorney J.D. No. 68768
P.O. Box 5300
Harrisburg, PA 17110-0300
(717) 238-8187
Attorney for Plaintiffs
Dated: 3-~b-03
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7. ~:r~TIGATIO~ _ J '1-0-0 B;I:IVAL \ q 0 I INTERSECTING ROAD:
-CblDEIII~Q".~TI()~ 2B.ROlfTENO.OR
;""'~ "."""""""",~~,p~~"r"..i,~,.. -: ->'"''':.!r.t,~ STREET NAME
'8' _ 1'1 CTO 10~~~ 27. ~~';.iD
I 0 c-1 _ 12. NUMBER / I
00'-'" OF UNITS .,
4.# INJURED 15. PRIV. PROP. 0
.3 ACCIDENT Y N
17. VEHICLE DAMAGE
o - NONE UNIT 1
1-L1GHT
2 - MODERATE
3. SEVERE
2B. TYPE 9. ACCESS
HIGHWAY CONTROL
IF NOT A T INTERSECTION:
30. CROSSSTREEfOR C A J G'A ft LL. ~ ~,I n\..
SEGMENT MARKER vV'lL.GV-r '-~rLn<1.:-t1 Jl.....D.
31. DIRECTION 32. DISTANCE , '3\l'"
FROM SITE N S FROM SITE -, () FT.
33. DISTANCE WAS
yDN~ Y~ND
lB, HAZARDOUS 0
Y N
~
~
@CONSTRUCTlON
ZONE
MEASURED, ~
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DEVICE
ESTIMATED
PRINCIPAL
[Q)
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UNIT 2
INTERSECTING
-B
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"Z.S"' <6 7'1 S-
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41 ~~~~'k 70Lf 3 C-A;-R-L.IS LC PI KE" #= 31 0
4,. CITY. STATE rr Ln I c" I' C DA- L -, J 3
&ZIPCODE ..........,.."......A;;>~ f '0
43, YEAR 1'1 0 44. MAKE C-l+6"v
45. MODEL - (NOT "7, A-"'" C::-.b
BODY TYPE) Ii:> ~ "-"-"' "-
47. BODY B. PECIAL
TYPE USAGE
5O.INITIALlMPAC, 51. VEHICLE
POINT STATUS
53. VEHICLE 54. DRIVER
GRADIENT PRESENCE
5B~~~~~R 2SS-7S377 57'f3:H
5B~~~~R ..:::roE'L €(2.IC: CVMMINt:.S
59. ~~~i:ss '70'1"3. C,.,+iZ.LA SoLe Pi /LG" #"310
60. ~~;~~~E Cktz.v S U3 ('A- 1'7 CJ I 3
Bl.SEXM B2.DATEOF.-,? 7Q B3.PHONE
BIRTH ,- ,,0_ I
84. COMM. VEH. 65. DRIVER /'
YON CLASS Lo-
67. CARRIER
36. LEGALLY Y N
PARKED?
39. PA TITLE OR
OlfT-oF-STATE VIN
40. OWNER
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UNKD
6B. CARRIER
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69.CITY,STATE
& ZIPCODE
70.USDOT #
,
BB. CARRIER
ADDRESS
B9. CITY. STATE
& ZIPCODE
70. USDOT #
PUC#
72.. EH,
, CONFIG.
75. NO. OF
AXLES
AA-45 (7/9B) ,
PUC#
..
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77. RELEASE OF HAZMAT 75. ND. OF
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74. GWIR
3273021
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79, MEDICAL FACILITY t+a/..'-j $Pr!i..tT 1-/-o$?/ffil.- '
80,'I'EOPLE INFORMATION ' ,
,XB C D E F GNAME
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INCIDENT #: l 70 0-0
ACCIDENT DATE, '/f-I<1-00
, ADDRESS
H
J
K
L M
,
o DO goo
L-j'1 SeD II
L/'73LD11
L/q:SCDI!
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,
(~) ILLUMINATION 1 Z I@ WEATHER [Q]
@ ROAD SURFACE OJ
84. PENNSYLVANIA SCHOOL DISTRICT
(IF APPLICABLE)
86, DIAGRAM /'iI-..T.S.
! '
,
t
----!-- -
...""'''' ...,...........- ...",....... .............-...,--....,._..j,_.,__,......_,_.....__........-L..... '...m____'..... '" m....'_mm "'_m'_.... ..,........1....,,1 '
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85. DESCRIPTION OF DAMAGED PROPERTY
OWNER
ADDRESS
,
PHONE
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UNIT 2
~1' PROBABLE
USE
UNIT 1 I
87. NARRATIVE . IDENTIFY PRECIPITATING EVENTS, CAUSATION FACTORS, SEQUENCE OF EVENTS, WITNESS STATEMENTS, AND PROVIDE ADDITIONAL
DETAILS. LIKE INSURANCE INFORMATION AND LOCATION OF TOWED VEHICLES, IF KNOWN.
VI ~ i<<..Avf:;WN1"? ~(I1-SJ IN~ / --'. - { ^ ,...- ~ '71I-t
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INSURANCE COMP~_/, n .-_",',_'''- INSURANCE COMPANl-a/r":" j_'( ,-v
INFORMATIONI""ILlJ"".<-=S,,,,,,,,,,,, INFORMATION ~Jlc.. <::; '~O>. r-;r-;
UNiT po~gY G,c ss-<o .eN 3, _), UN~T po~gY Q II S- J l::i772 <if H
NAME , ~, ' ADDRESS, ' , ' PHON\;.
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WITNESSES ~~~'1"-i2~...ee. 1.3::' ko,)....BId2-~'1 ~~E~Gl.t:f,q.;..IC.::,lSu-eh PA nuSS-' P~Ijf'_Og-8'7
89 VIOLATIONS INDICATED 90. SECTION NUMBERS10NLY IF CHARGED) TC NTC
. ',' "
UNIT 1 'Du.J:",J\C'-'I'C6NTS IN'J"O/.)/'f\JG p~.".JA-L lj..,;r-~ "S"7"l.I)3'<{"2...: "3112
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92.) TYPE
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DO
DO
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~RESULTS ~NOTEST 94.1NVESTIGATION
, 0 REFUSE COMPLETE 7
'0'_-%0 UNK YES ~ NO 0
AA-45 (7/98)
3273021
PAGE: ~
PcnnDor - BHSTE
~-
1 ~ ; I
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'l:J! 'pOLICE ACCIDENT REPORT
Xl( REFER TO OVERLAY SHEETS REPORT ABLE tiKi NON - REPORTABLE 0 PENNDOT USE ONLY
:~;!~~~~~i~\i\~ihi~t~BOPI9~~R()#M6Iid~:.~;1{!'.J~t~~~~~~: ",'~i~1i(.Aq,q(Q~~I'LOCJi.:fIO~,:?~~~0 .'." , '
NUMBER ' 17 o-~ G-fl.. L.4-N D '2:t
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3~~~~~T 4~~~~OL Sw 'PRINCIPAL ROADWAY INFORMATION
5INVESTIG(1-,OtM . $ r-1 'I D6t2.... ~~~~~ J q -II 22 ~~~~N~~: V S 1/ ~
6, APPROVED BY BADGE 23. SPEED L '0
NUMBER LIMIT 7 0 CONTROL
7'~:itIGATIOrtz_ ''1 -0-0 8.~~~VAL 1'1 D I INTERSECTING ROAD:
~~tlKf~~ct!oENriINfft;RMAf;roN'~~ 26. ROUTE NO. OR
,.i.. ,_ ,,,<;'.. "_",~i~;,,_, ""l..,.~"..-.,;.._"" ,<~::"~.~_,"',,.,"')I-,,c,._>-,_,~..---',o-,,<.,~ STREET NAME
9. ACCIDENT 0 J q ~ 10. D!\:( OF WEEK ' 27. SPEED
DATE l) ~ -LA--' :::...4--""Tt.>-I?-t;.."A- LIMIT
11.TIMEOF I 0--<-1 12. NUMBER II
DAY " 0 () \..,::I OF UNITS' }
13. # KILLED 4.# INJURED 15. PRIV. PROP. yON!VI"
o ACCIDENT lJ"-i.
16. DID VEHICLE HAVE TO BE 17. VEHICLE DAMAGE CD
REMOVED FROM THE SCENE? II O. NONE UNIT Jl!3 I
UNITj( 3 UNIT,K., 1-L1GHT
rVr )Q'\ 2. MODERATE ~
yON'A yON ~ 3-SEVERE UNITJl'Lf~
18. HAZARDOUS 0 IV1 19. PENNDOT
MATERIALS Y N lJ6.I PROPERTY yO
.r"""''"''''i''';'''iil1>,''t:->!~g~~i.a:,,"'''''"'''W,<0~ ""!!I,+ai>';"":ii'~,'"
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~6. LEGALLY Y N 37. REG. -0 Il 07C 38. STATE
PARKED? 0 PLATE pW , 0' A-
~9. PA TITLE OR
OUT-OF-STATEVIN 3'ble'6 QS-2,o
40. OWNE'\,CM M 6 L..-- S ifoleL v"1 &v<1, I/J C .
41. OWNER 2"''''' .1 ,I Y ~
ADDRESS I:>,;;> UN'C-o"l...-l" TTW C
42. CITY, STATE L -r-;~ n fl ^ ..., ( ....,
& ZIPCODE 1>cN~ I l::; 1'- r".,. \ 1...0 L--
43, YEAR I '6 (., 44. MAKE C 1\-61/
45,MOOEL-(NOT '" __ -12 n __
BODY TYPE) L--8!--E,<:>'c,' I
47. BODY 0 II 48. PECIAL
TYPE '""f USAGE
50. INITIAL IMPACT 51. VEHICLE
POINT STATUS
53. VEHICLE ..., 54. DRIVER
GRADIENT &- PRESENCE
66 ~~~~~R 2..S-~ (r; D s-s- 9
58. ~~~~R S~N ,M. If I L.L
59. DRIVER ,
AODRESS 30-0 ,JvtUMPGfL l-N.
60. CITY, STATE ~ I t..L-S '" . n I n ^_
& ZlPCODE V -0v-1"-10 t' rr
61.SEXM 62. DATE OF 2 "''' ()o 0
BIRTH - <.-;:,- D
64. COMM. VEH. 65. DRIVER /1
Y D N CLASS L-
67. CARRIER
30. CROSS STREET OR
SEGMENT M,4.RKER
31. DIRECTION
FROM SITE N S E
33. DISTANCE WAS
28. TYPE 9. ACCESS
HIGHWAY CONTROL -
IF NOT AT INTERSECTION:
.5' fl-t.Gvt CH-v-l2.Lff (<:b .
32. DISTANCE Ii 3 too'
FROM SITE 70FT.
MI.
@CONSTRUCTION
20NE
MEASURED [2g
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CONTROL
DEVICE
EST'MJ\TEO
o
PRINCIPAL
[Q]
INTERSECTING
EJ
UNKD
UNKD
2.
68, CARRIER
ADDRESS
69. CITY. STATE
&ZlPCODE
70. USDOT #
ICC #
PUC#
68. CARRIER
ADDRESS
69. CITY, STATE
& ZIPCODE
70. USDOT#
PUC#
72. VEH.
CONFIG.
75. NO, OF
AXLES
AA-45 (7/96)
74. GWIR 72. VEH.
CONFIG.
77. RELEASE OF HAZMAT 75. NO. OF
yON 0 UNKO AXlES
74.GWIR
3273022
77. RELEASE OF HAZMAT
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'~ 'I.~ -,
, ,~' '.
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79. MeDICAL FACILITY . l-tu L,,'1 SP, R-IT H--0'5PIrA-L ACCIDENT DATE: 'if-l'i-o-o
~eOPLE INFORMATION
, BCD E 'F G NAME ADDRESS H I J K L M
,
, See YG2 ,
,
,
@ ILLUMINATION 1 2-1 @ WEATHER I 01 86. DIAGRAM i
0
@ ROAD SURFACE [J] i
84. P~NNSYLVANIA SCHOOL DISTRICT ._--_......._..~.-- ........I..~h... . ....- ............._._......~+........._;--,._..._.._._........_.. ..".........,,-.- '--'....i--'-"- ...--_............
(IF APPLICABLE) i Stir; Pb L
,
85. DeSCRIPTION OF DAMAGED PROPERTY ' '
._..._..........._.._._*-~.__..j i
......_-_...._......_~.__._..._..,...-...'- .'.-.....'..--.......-.......'......!-.-.-... -........-.-.,..*,..---..-..--....-.,,-...-- ..---.- . ....,...---,~
,
OWNeR
i i
ADDRESS
.-.- .......,....-.- ..........,...~._.~._...._.".._._._._._- ..,.----.-.......,.. '-"'-..--...". ..-..-.-.-.-.-...----.-....- ..........--.--.-.-..- ...-.-....- ...,
i
,
PHONE i
,
8T. NARRATIVE -IDENTIFY PRECIPIT~TlNG EVENTS, C~US~TION F~CTORS, SEQUENCE OF EVENTS, WITNESS ST~TEMENTS, AND PROVIDE MlDITIONAL
D~AILS; LIKE INSURANCE INFORMATION AND LOCATION OF TOWED VEHICLES, IF KNOWN.
B,v-r V( ~\L-G-D Tb 'STUf' f+t2- ~TGA-'b y -f2..hD L-lbt-h~ A-0JD II
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I L.v'c
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INSURANCE comfl.,lc..-1-N 6""1 p '-01 G{t.::, ,,,,So Co. INSURANCE COMPAN;4t.;LS TlrrE" trJbGM,NII'1 Ui.
INFORMATION INFORMATION
u~.:J 3 POLICY .4:vJ"Z. c., t.J- Lf I UN~ I.}. POLICY
NO , NO
NAME ." ADDRESS l'A pJ";:r D %' I 03. (?, [;{HON~ .
68. S\kJ.R.L..1 N r~1>6S 1"2..7'1 I A AN€ w..'l>€1-J 'Ss<,. a,IA - 07'12
WITNESSES NAME , ADDRESS PHON~
,,'
89. VIOLATIONS INDICATED 90. SECTION NUMBERS (ONLY IF CHARGED) TC NTC
UNIT 1 0 0
, DO
UNIT2
~ROBABLE ~:;VPE ..::JRESULTS GllfNO TES:WROBABLE ~TYPE ~RESULTS ~OTEST 94.1NVESTIGATION
USE TEST o REFUSE USE TEST " REFUSE C~~ETE ?
uNiTtI () 0 0'_-%0 UNK UNIT 0 .. 0 0'_-%0 UNK YES 1;0 0
AA.4S (7/98) PAGE: L/. PennDOT . BHSTE
3273022
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'''~ of .~
IfilCIDENT I/D-OO I ACCIDENT $(- - I q 00 COUNTY z..I I MUNICIPAL 10"3,
NUMBER DATE -- CODE CODE
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BCD E F G NAME, ADDRESS H I J K L M
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PAGE.-.r
CENTER FOR HIGHWAY SAFETY
~~
........
)
)
"" ~"
"
- ~ "I~, ,,- :
.
CERTIFICATION
- _ '" 0... '<"'-,,,, ~""I......". ';.;;; _ _ ~ ',; ~":"",
AJ'i>.<I;"""",,.:'-"'i~~;
The copIes of records for which this certification is made are true and complete
reproductions of the original or microfilmed medical records which are in the offices of the
Holy Spirit Health System. The original records were made in the regular course of business
at or near the time of the matter recorded. The certification is given pursuant to 42 Pa.C.S.
Ch. 61 Subch. E (relating to medical records) by the custodian of the records in lieu of his or
her personal appearance.
Patient:
SSN:
DOB:
Halie Duncan
166-68-4040
12/09/85
Medical Record No.:
Number of Pag .
Dated: cr, g-),tV
S~~<.j~ed and @:v2f1.1 tp before me
~dayof~OOO.
Notary Public LfYlltl..o.ili4
My commission expires on:
N!llarial Seal
'"elle L. Stouffer. NoterY Public
1!1\ BoRl, Cumberland CounlY
,~.\on Expires Oac, 11. 2000
Document #; 185090.1
ytvJ
of Holy Spirit Health System
~~
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CONSENT TO MEDICAL TREATMENT
') I HEREBY CONSENT AND AUTHORIZE Holy Splnt Hospital, Its agents, and employees, to the rendenng 01 methcal care, whICh may Include
. routine diagnostic procedures and such medICal Ireatment as my attending or consulting physiCian conSiders to be necessary' also under-
stand IllS cuslomary, absent emergency or extraordinary CIrcumstances, that no subst.nlJal procedures WlU be performed upon me unless or
until I have had an opportunity to diSCUSS Ihem WIth e phySICian or other health care prolesslonalto my sabslaatlon "I am a competent adult I
have the fight to consent or refuse 10 consent I understand that the pract,ce of med.Clne and surgery IS not an exact sCience and that d.agn~.
SIS and treatment may Involve flsks of Injury or even death and acknowledge that no guaranlee hes been made to me as to the rasuns 01 any
exammallon or trealmanl.n thiS Hospital
I understand many 01 the physlCl8I1S on the staff 01 Holy Splnt Hospl1al are not employees or agents of the Hospital, but ralher are .ndependent
contractors who have been granted the prIVIlege 01 uSing these facl~tles for the care and trealment of their patients Further, I rea~ze thiS
Hospital.. a teachlng Hospital and at the Hospital are heahh care personnel In t/llmlng who. unless expressly requested oth9lWlse, may pal1lcipate
or may be present dunng my care as part 01 their education Stili or motion pictures and closed CIrcUIt monrtonng 01 pat.ent care may also be
used for educational purposes, unless I expressly request otherwise
I understand that m order to ensure a safe enVIronment for pallents, vIsitors and staff all property on the premises of Holy SP'r;:.HOSPltalls
subject to reasonable search and/or seIZure at any lime Without rurther nOltce I \ I /
, nllas ~
RELEASE OF MEDICAL INFORMATION
I authOrize Holy SPlfll Hospital 10 release to requesting health Insurance carner(s), their representatives and auditors, and any ref.mng health
care providers, such dlagnostlo and therapeutic mlormatJon (mcludlng any mrormatlon relating 10 treatment for alooha' and RubstFmce aOORe
andlor treatment 01 DsyehlatrlC disorders and/or conhdenbal HlV related .nformal/on. as maybe necessary for them to determine benelltanll-
tlement, to process payment clallns for hea<<h Oare selVlC&s prOVided dUring thIS hospltal,zatlooltrealment eplsode, and for continUIng
careltrealment A photocopy or carbon copy of thiS aulhonzallon shall be conSidered as effective and valid as the Original The underslgn~d
also authonzes Med.care, when applicable, to raleasa to anoth~r Insurance carrier, upon their ".quesl, medIcal Information needed to make
payment upon that claim
I understand and consent that the manufacturer 01 any Implantable daYlce Inserted by my phySICIan dunng the course 01 my sU~pr;>cedure
may be provided With my Identification Informal/on, ,"cludlng sOClal secunty number, as mandated by Federal Law Initials ~ "
INSURANCE ASSIGNMENT OF BENEFITS
I authorIZe paymenlolrectly to Holy SPirit Hospital and my treatong phYSICians 01 all benehts payable under my Insurance po~cles y.,~st~
I am responSible to the Hospital and physiCians for all charges not covered by thiS assignment IrIIl/als ~ '--
) STATEMENTTO PERMIT PAYMENT OF MEDICARE BENEFITS TO PROVIDERS, PHYSICIANS AND PATIENT
I request payment of AuthOrized MedicaTe benefits to me or 00 my behalf lor any sel1l1c&s lum.shed me by or In Holy Spin! Hospllallncludlng
phYSICian services I authorize any holder 01 medical and other ,nlormatlon about me, to release to Medicare and Its agencies any Information
needed to determine these benefIts lor related seNIC&S Imllals
MEDICAL ASSISTANCE RECIPIENT
My Signatures cerllftes that I received a selVlee or Items Irom Holy Splnt Hospital and Dr on the date ~sted below
I understand that payment for thiS service or Ilem WIll be Irom Federal and State funds, snd that any talse olalms, statements, or documents, or
concealment 01 matenal may be prosecuted under applicable Federal and State laws I understand that certa", lasts and procedures may not
be reimbursed by Federal and State lunds and that I may be responSible for non covered charges Also, I agree that d at the lime of ""Mce, II I
alll not e~glble for Medical Assistance, t Will be responSIble for balances owed to Holy Sp"'t HospItal Initials
I have read and understand each 01 the eecllons contained above, I understand that by aillRlng Dlts document, I am agreeing and
providing the authorlzlltlonf consentcontalnad In each of the above seetlons wh my fnlllals.al'8locate.d. I heve had the opportum-
ty to ask qUllS ns I'el/ardlnll each at these s""tlons and all such questions a v been answered to my satlsfactlon.
Signature
Witness
Date
]'/ / (
I .
Time
HOLY SPIRIT HOSPITAL, CAMP HILL, PA
CONSENT FOR TREATMENTI RELEASE OF INFORMATION
INSURANCE ASSIGNMENT
-, \... M' ZO 1783 E
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ADM. DATE: 08/19/2000
CHIEF COMPLAINT: Motor vehicle accident wrth thoracIc back pain
HISTORY OF PRESENT ILLNESS: 14-year-old who was restrained nght front seat passenger
rear-ended by another vehIcle The vehicle she was dnvlng In then struck another vehicle
Their air bags were not deployed The child did ambulate after this event She IS complaining
of mu:lthoraclC back pain She has no other complamts
CURRENT MEDICATIONS: None
PAST MEDICAL HISTORY: EnVironmental allergies Allergy to Penicillin, causes anaphylaXIS
VITAL SIGNS: Nurse's notes reVIewed
REVIEW OF SYSTEMS:
Constitutional
No weight loss, weight gain, fever, or chills
Eyes No VISion loss, eye pain, double VISion, glaucoma, or cataracts
ENT. No VISion loss, earache, dizziness, nosebleeds, SinUS trouble, or sore throat
Cardiovascular No chest pam, palprtabons, swelhng of feet, or heart murmur
Respiratory No cough, sputum production, wheezing, or coughmg up blood
Gastrointestinal No naUSea, vomltJng, diarrhea, constipation, abdommal pam, or rectal
bleedmg
Genitourinary No blood In unne, painful Urination, or frequent unnatlon
Musculoskeletal Mldthoraclc back pain
Skin No rashes, lumps, dryness, ItchinesS, or sores
Neurological No dizziness, blackouts, seIZUres, paralysIs, numbness, or tingling
CONSTITUTIONAL: In general thIS IS a very pleasant 14'year-old female who was Initially
sitting In a chair when I first evaluated her
EYES: ConJuncbva Without discharge or injection uds Without leSIOns. PERRL
HOLY SPIRIT HOSPITAL
Camp HIli, PA
17011
EMERGENCY ROOM REPORT
Page 1 of 3
NAME Duncan, Halie J
MR# 201783
ROOM ER1
DR NOELLE ROTONDO, 0 0
ORIGINAL
"'j
" -;t..i~"~~'-"':'_,
.~ _,.f,t>4,-ilikL
NAME:
MR#:
Duncan, Haire J
201783
)
ENT: Ears Tympamc membranes WIthout perforation, inJection, or bulging
Mouth LIPS, teeth, and gums normal
Throat Oropharynx without lesions or exudate Airway patent
Nose Nasal mucosa normal
Sinuses No SLnus tenderness
NECK: Supple, symmetrical, non-tender, no lymphadenopathy Trachea midline Thyroid n,w
palpable
LUNGS: Normal respiratory effort Breath sounds equal No rales, rhonchi, or wheezes
CARDIAC: Regular rate and rhythm wrthout murmurs, ed:opy. rubs, or gallops No pedal
edema
GlfABDOMEN: S<lft, non-tender, normal bowel sounds, no masses No hepatosplenomegal'l
SKIN: Normal color and turgor No rashes or leSions
EXTREMITIES: Patient With T7 and T6 midline tenderness to palpation
NEUROLOGICAL: Alert and onented to person, place, and time Cramal nerves Intact
Sensory and motor function normal, Reflexes symmetncal
DIAGNOSTIC PLAN: My plan IS to obtain thoraCIC spine films, although climcally I believe the
patient's symptoms are more likely musculoskeletal In nature She was In the emergency
) department With her mother I will be gIVIng her head Injury precautions
DIAGNOSTIC RESUl T8: C-spme films are negatIVe
MEDICAL DECISION MAKING AND COURSE IN THE EMERGENCY DePARTMENT
discharged the patient home with head injUry precautions I believe the etiology of her
symploms are most likely secondary to a thoraCIC strain as a result of the motor vehicle aCCIdent
and IS most likely IS musculoskeletal In nature
DIAGNOSTIC IMPRESSION:
back pain
1 Status post motor vehicle accident With muscu\oskelel~1
DISCHARGE INSTRUCTIONS:
1 Head Injury precautions
)
HOLY SPIRIT HOSPITAL
Camp HIli, PA
17011
EMERGENCY ROOM REPORT
Page 2 of 3
NAME Duncan, HailS J
MR# 201783
ROOM ER1
DR NOELLE ROTONDO, D 0
ORIGINAL
"]
, ..
~;,.
. NAME:
MR#:
Duncan, Halle J
201783
)
NRllb
DOC # 77398
o 08/19/2000
T 0612112000 558 P
009373
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NOELLE ROTONDO, D 0
Page 3 of 3
)
HOLY SPIRIT HOSPITAL
Camp HIli, PA
17011
EMERGENCY ROOM REPORT
NAME Duncan, Halie J
MR# 201783
ROOM ER1
DR NOELLE ROTONDO, D 0
ORIGINAL
~~
~
Initial Lab & X-Ray Ordars:
LIIb8IUrlflfl~
I ] AcetamlnophiEln [ ] ESR
( ] Ak:ohol [ ] Glucose
I ] Amylase/Lipase [ 1 HCGS [
[ 1 APTT 1 Lwef [
( J Blood Cultures Profile l
[ IBMP jLyte, I
[ jCBCP IPTP I
[ I CMP I Salicylate I
( I CAPl 1 Serum Acetone [
[ J Dlgoxtn ] Theaphyllne
[ ] Dllantm J ThyroId ProfIle
Radiology
[ ] Ab~tr Sanas
i lAnld1lt
{ 1 C1a.."c1e
[ I Cerv Spine Lateral
! ] CelV Spine Aoutm&
[ I yhElst Fan / Port I TPA
IIEbow R L
I IFBelal
[ I Femur
I I F'ngOf
I I Foot
[ I Forearm
[ IHand
[ IHrp
[ J Humer...
[ //<no.
I 100he,
R
R
R
R
R
R
R
R
R
R
] T(lx Screen
[ ] Unne Tox Screen
1 ThrOl'l'1bo1ybc labs
~ Type. &. CrQ55 _# of urnt's
] Type & Screen
I UJA
jUnneC&S
] Workman s Camp Drug Screen
1 Other
L
L
I ]KU8
I 1 LIS Sp"',
[ J ...nd....
{ J Nasal
[ IO"'~
[ ] PelVIS
{ I Pyelogram IVP
[ IRm A L
{ I Should.. A L
I I Skull
[ ]St6l'num
P{l TISpine Sh' yYlrJA
I ITlbIF,b R L
[]T<ls_A L
[IWnst A t
R
L
L
L
L
L
L
L
t
t
'1..5]
TIl'I1AJt':RTllnt
SJ1flC/ll/~_.
UIIr__
] AbdDrTlen
I Duplex Doppler
lG",lbIa<ld<lr
I ]P9IVIC
Culture.
] Beta Strep N3 {Culture
I CeNIC",
I CIlla._
1 GC Cuft\m~
I CT Scan of
IVQScan
l~er
Billing CI_lflcatlon:
[ J.J.-II [ I Follow up
'iAlfNel" 1 ~Carsel
I I L....IIII
[ IL....,IV
( ] Level V
T1mRICRTllnt
] SpuwmC&S
ISloolC&6
1 SIOOIO &P
I 51001 C Drfflclle
)WoundC&S
[LA' ~C1dent
I l....."'\
[ J "'_1 Non-emeruancy
Holy Spirit Hospital
Camp HiU, PA
John R Deetz Emergency Cen1er
PhYSICian Order Sheet
~ECVAEV 11199JO BR MD
CHART COpy
.- , . - Ii.;;" '0 " ,_-<(. - ~
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.
Card/lID
I I Monrtor
I J EKG pago<! ..
I )02 ''''''n
I l 02 S1IlIlllllion
Rup/ndmy
[ I ABG~ paged at
{ ] Peak Flows 8eb'eIAfter Reap Tl(
( ] REllSPlratoryTx
--,'
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q~~
ffl;
Time Seen:
Madlcatlona I lV's I Adcllllonal Ordars
Time
IV: NSSI OSWI LRI 0SI.45NSI DUNS
Infuaa at cclhour.
] Obtain old records.
...
tv-..
Initlala:
Initials:
Initials:
Inltla.s:
Signature:
Signature:
Signature:
Signature:
Signature:
Oete:
(20...... .
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~., '_r$TO~N 'oar ERI
:.t'I~S.'1:; PA 170$5
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Age:
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Log-In Time
Tnage rime
Time to ElCllm Room
Tllne returned from Tna
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Command I J WhoelchBlrlCamed
~
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Place Injury occumKt
Inlarmallon obtained from"
,"",:1
[ I Homo [ ] Industry [ ] Rec.....llon MV'" [ ] Othor
lonl [ I FomllylS 0. I ] Record [] ~MTJPoromocllc
Temp q'{;;. 3.pu1se, q -z. A-plraUons: 1..-0
BJP.
A/lerglesIReacllolls:
Late. allergy ~ [ ] y
ImmunlZatlons UTD [I N [ ] Y LasITelan....: LMP WeIgh!' _ ecol"'OSU""'le III "","nont)
Has pa~enl been exposed In Ihe pjlst month to measles, chickenpox orf~ [ ] Y [ JUNK
Are there Advanco D"ectlve~ NIA [ ] N I ] Y Are COpies available? [ ] NJA [ ] N [ ] Y (Attached [] N [ ] Y)
Extremity Evaluation: Tnoged to radiology lar
Deformity Yes I No Sldn'remp Wann I Cool Distal Putull Present' Absent Edema Yes I No
SldnColor Pmkl Cyatw)tK: I Mottled Pain (1-1D) Pared1.a. Present/Absent EcchymQIII. Yes/No
Capillary refit Normal/ Delayed Inte~n.lon
V,suel AcuIty:
ObJOctlve
0.0.
os
o U. _Corrective Lenses
kin temperature & color WNL
h\; J.......- ~'-(
o ~Respllatlons Symmetrical"
)
,
Vital signs
MedicationS
[ IOxygen [J NC I] Mask _UMln
I J IV Soln Gaugo
edlClitlonIDoselFre uen
ImmobiliZAtIOn [ ] CIO [ ] Backboard I J C.CoIlar [ 1 Splint
[]A"way []N...I []Oral [JET.
Site
Las Dole
u
Past MedlcallSurglcal History:
Holy SpirIt Hospital
Camp Hill, PA
John R. Dietz Emergency Center
ECU Nursing Assessment
CHART COpy
R.N
MA
DestInation: I ] Urgl [1 ER I
Triage assessment completed al
AdmlSSton Called r ] AdmiSSIon [ J Observation
Report Called Admitted 10 at
DispoSitIOn r)m Hq~. ~MA [1 R 01
DISCharged "2> J , OIseha Instructions
[ ] Clottllng sheet completed
at by
at .",..hf:S
- ,
1 2 J "83
[
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Date:
.
A_ment' TIme: .
) VIIal 81gns
MOnitor
Physician Assessment
02 Saluratlon
lung Assessment
Visual Acuity
DlognoollCll
eKG -'
labs
PCXAlPort C-Splne
Sent to Aachology
Aeturned from Aadlology
Procedutts
Besplratory Treatment ' ,"
lea
Foley Insertion
NG Insertion
Wound Care
SpllnUOCUShnolCrulCh.s
MlsceUaneous:
Pam SCale (0-10) ',-,
Level of ConsCiousness
S.derslls
Intake & Output
Patient education 1010
other
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IV Therapy
Rale
Date Time Amount Salullon Cathete. Slta Rate Control Condition AIt.......ta 10111.18
CondlUon Code.
o-No lnflamatlOn
1-Edema
2A.Erylhema
2B-Ecchymosls
3.Peln
4-Ha.dness
S.Warmth
Aate
Conl.ol
1-MI
2-8tatMaater
Initial
Im\la\
Initial
Intt,al
Signature
S'llnatur.
Slllnatu.a:Ftt
Slgnatura
CHART COPY
, K~ 2:11783 E
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Holy Spirit Hospital
Camp Hill, PA
Emergency PatIent Documentallon
~
205 ECU Rav'88d 5196 JO, BR, MO
I
l<I>l-"'iID',",'
)
PATIENT.
MR#;
SOC SlOe
ORD DR,
PT TYPE;
ADM DATE.
LOCATION'
Holy $plrlt f10spltal
Department of Radiology and Diagnostic Imaging
Camp Hili, Pennsylvania 17011
(717) 763-2600
DUNCAN, HAllE J
201783
166-68-4040
ED GROUP M D
E
08/19/2000
ER1-
DICTATION DATE: Aug 202000 952A
TRANSCRIPTION DATE: Aug 20 2000 11 11A
ARRIVAL DATE:
HOSP SERVICE' ER1
"'""Final Report"""
EXAMINATION: THORACIC SPINE 72012. Aug 19 2000
COMMENTS INDICATION - back pain follOWing MVA
Exammabon of the thoracIc spine reveals no eVidence for fracture Alignment IS normal There IS no
abnormality of the paras pinal soft tIS$UeS
CONCLUSION. Normal thoracIc spine
DICTATED BY; BARBARA KUNKEL M D J OLG
DATE OF EXAM: Aug 192000
SIGNED BY' BARBARA KUNKEL M 0
DATEFTIME: Aug 20 2000 344P
M 0 ;0 0
Imaging Servlqes Consultation
Page j
!i.,
B";""W!.l'I~ f U.N11!Il URGI CENTBK
(717) 763.2316 ~ (717) 763-2424
'1lle eK.Utunatl{m lUtd ~flffCIlt you iiIlve reCCI~ 111 lli.c Emt.-gcooy Center have been ~ cmagcncy basiS only, and ue (lOt UltellOed to be II- wbaatull!: for or an effort to provnie
Ollmplete medlcal CIllC If)'ou dc:vdop new problems or compllcab.ons conlact YOUI' PhyIlCr.aa.... &ner.genc)' ('-enler FoLWW 1liE .lNS1llUCTlONS CHECKEO BELOW
Pa"",llnf<l_. PaIlent Inlonnetlon e_ COlnlllln I"""'rblnt I~OI\ 10 ....vI.... and keop
o Abdom"ot po'" {) COIl)UIl"'''''.' {l F_/?o. Foli... () l"",,_
{l Ak:ohol ......"" {l CaPO {l Au ON""" Slto",
( ) AllergIC nilactlon ~ ) Cornel abraslon/POl'&Jgn bocty ( ) Fracture ( ) NQMbfeed
o ....!hlll. 0 C"",plbronchl" () HeaOacho I ) 00lIe Me...
( ) ~ck pam ( ) Crutcn wa~ng ( ) tiead Injury ! ) PedllIltnc HElad InJu'Y
( } B1tes-Humlil'VAt'llfflaVlnsect { J Olarmell a~ YomltfngfP<<I Vol'ftltmg ( ) Hyperten!lIOll , J Pecbtrfc:: URI
() Bum (}OruglAlootloJ abuseladdlGbon () Irnml.lfll.UltlorvTetanus ()PIOND
I ) Chest Pom , ) !'E""'" C",""",,,,,, ( ) Kldnoy 8/00" ( } Roall
~I";-I .
.
-'"'
l.lll
!Ii~""'-l:eilF.;;,}
DISCHARGE INSTRUCtlONS
)
WOUND CARE
{ J May gently wash over wound In 24 hours. with soap and water or
perCOOde 00 not soak In w-attH
( ) Chango dr.....g _11mes dolly Redf... _ Ba<:lIr8WIlNoospoon
and sterJle dr6S$lrlg
( ) KllOp wOl1l1d eleen. dry. _orad ()Tetanue/Dlptft&no Boosto' given
SPRAINS. STRAINS, BRUISES, FRACTURES
( I Sl&vale tlte Injurad palt for_days to reduco aW&ibng
( ) Aoply Ice pa"'" Inta!tttltt&l>Uy tor _day. to .-00 &Welling
( ) ""'" wrap lor .uppon for _d&yll
( ) Wear splmt {) At an times- unlit toI\ow-up
I ) For SOlIVIty .. _
( ) Use sling for suppolt
( ) u.. _. (I As needed. _ot bean..... \OW.~
( ) At 011 It""", NO WEIGHT BSAAING
tIECK!\lACK
( ) Woar cerw;o/ collar for .uppalt for _d.ys
{ ) _, evod bending. hl!Jng, strenUoUS actIVity lor _d.ys
( ) Apply mollt h&<<t for mm"'.. .""'" dolly
b&gmnlng .n hoUf'S
ADDITIONAL INSTRUt;;T10NS
( ) Of! _school from to
( ) l1ght Duty ull.1
RestrictIOnS
( ) No lJ)'lTlisports unlll
( ) Follow mstcucbons on Workmen's CompensatIon FORO
( lWooroyoplllchfor l\OOra
( )" """" bleed '''''''18. Pinch nOSil ~rmly for S rnIntJI..
continuously, (SlUm tf b/eedmg not oontrolled
( ) The pt6scobed anbbtotJo may redUce th" atf$cbveness of
ntodlcabon you ore cu<<&nt!y laktng Check paoko1l8
InsltI..1etIons {)I' eons.uli: wrth Pham'\llC1$'l
( ) The If"Iterpretabon of your X-Rays are preliminary reading
Your films Will be reviewed by a rad.Jo~lst You or your
p~101M Win be oonta:cted If 1h\1re 19 e. ohange In tile
dtagnoste
Ad<lttlOOallnstl\lCllOt'ltl
(i)+\ftJ -I ,,') V{I j~ I( ea. v~ j\\~
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HOLY SPIRIT HOSPITAL
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I ) $prwna. ana Strams
i ) Threatened Mtscamage
o ToOthache
( ) URI and Cor..
( ) UTI and Pvelonephntla
OOlf1or
MEDICATIONS
( ) OoItbnUo pmont modt_ o><c&pt
{ I u.. Mvtl (lbuprof&n) or Tylonol os _ for pa"'. \&ve'
eccordl"ll fo peelutge lnotructtons 10, age. weight
( I Use the follOWIng rnedlClllO' "",o<<llng 10 paoi<eg.
II'l.StructlOfll!;
\
2
3
{ ) The foRo'NJnllr medicines may C8US9 dtOWSlll8SS
DO NOr ORIVE Of! OPERATE MIICHfNERY WHIlE. TAKlNG
FOlLOW-UP This IS our l'eCOmmendailOn for fallow-up if your
II1OUranoo (HMO) mqu... e p/1)I8lcIan _110, ."..,.ny
consurlollon, IT 18 YOUR RESPONStBIUTY TO DeTAIN HIE
NECSSSARY APPROVAL
I ) Follow-up Wlltt
III
( ) UI1l' Center
( ) Fenuly DO<(Or
( IWorl<Net
daysfcr
( )F_-up
( ) StilU,e remov.1
( I CoIl os soon .. poostbl<t lor &pllClI<\lmQJlt
( ) Pick up your X'~ 1""" lh& Rodlology O&p&t1m&nt pnor to
your follow-up appolf1trnent call 763-289Ei to have hlms
"'ed)'
( ) See \'Our p/lylllCl8t1 or "l'OCIOla' ~ oat """"vod In
......
( ) Aelurn to 8ne!g&ncy Cont.r d you feel yoor ccnd11um IS W<lIlWIIJl9.
ospec18lIy ~
( } Your bklod pt8BSUre we fivated PlHse hall9 It
",chocked by YOU' ptl\'$J",""
. ( ) Test _he.. boon 91V81l '" you T....tItom WlltIyou to
Ihe ',,"ow.up oppolntm&f1l
Tost _ gtVOfI DCBC DCMP lJEKG DX-FlAY COPY
o IlfIlP [J ASCORDS COPY CHAFlT 0 GUJC
( I PATII!HT VERBAIJZfS UNllElUlTANllING
H'"....,.,..~ I'OOOIptOfltt&.. _uoItons.end
u_nd Ihom ,_ \t\oi I ""'" hod Bt1tOf\lOIlCII
_ 2DIx and 1hot 1 may be _ b&for& 011 Of ITt}'
meebest prat>>ems are known or trend 1 WIll ammge tor
tolt(lw-up care as 1 have beep lntlructecl It IS Yl)IJr respon--
slbllrty ro notify your pnmar'c,? Ph~I?B" Qf thIS \111 f
S1GNATIJIIE ,,1~~JJ..It~t:., r'.J)11 r(~ 't / I/"
P. I or portStble P . D.lo I
llIGNATUllE: (1-
Ph.,...""" M 0 10 0 l'lulsa RN
'OLY SPIRIT HOSPITAL IlMERGENCY CENTER
"'~ NORTH 21ST STREET CAMP HlLL, PA 17011.2288 (7m 763.2316
) 'V anltha Abtaham. M D OJ884QL ( ) Robert Hynr'k. DO OS OOI4OO.L
. ) _ Aldoo, M D Ol7075E , ) Ricltanl Luley, M D 029960-.5
) S&lVal:ore Alfano, M D 025502b ( 1 PhlIhp MagUIre, M D Ol5063~E
) Ramesh Alura, M D 0l6727E ( ) Lawrence Paul. M D m9S24-L
) Gl<. Dauglnry, DO OS006776E ( ) Pca&k Prcc"fho, M D 00364J-E
) J<m. Dub.n, D 0 OS 00699lL ( ) Howard RU~n1ck.. M D ()4OS62-l..aeI
-- -
l ) R.anJana Sharma. M 0 031265-E
( ) David Spomer, 1>1 D OZ350Z-E
l J Alan Tepbs. MD 010018.E
t ) B!ame TbaUner. MD 057303~L
....... Do...d Zunmennon. M D 0056J6-E
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I!~J;';""""hib..nil-.;
( I Elevato tt\o .nJ'lred PM lor_day. to "'"""" _"'n<;!
( ) Apply "'" packs mtemllltently'lor _day. to """'''''_g
( ) Aoe wrap tor support for _doyo
( ) Woor sp/Int I) At oIlfm1e$lJIllIllol/ow-up
( ) For actIVity a. noa<lod
( ) U.. oIong for ouppofl
( ) U.. CIU1chos () As needed, ""!gin beal!ng as tel........
I ) lit llII limo. NO WEIGHT IlEl\AING
2
3
( ) The tolkJWlng medlcmM may cause d1'oW8l1'\El$S
DO I'IDT DRIVE OA OPERATE MACHINERY WHILE TAKINCl
NEeKI8ACK
I )Wesr_OOllsrtorsuppo<ffar_<Ioys
( I Aoot, avoid bondlng, IIftmg, .....nuo"" actIVity for _days
I ) Apply IlIOIst heal tor mlllUl6s _. dO'Y
beginning In hours
IIDDI11DNAL INSTIlUeT10NS
( ) Off worklschoollrom 10
( ) l<!/1' Duly <mill
fteMn.d:lOn6
( ) No gymIopo.... u",1I
( ) Follow m81rucoons on Workmen's C~on Form
( l W.... aye patoh 10t .ou..
( ) It nose blood rewtO, pinch rrOso ftrmJy tor 5 mmutes
oontlnuoualy, ...wm d IlI8adIng not contI'OlIe<I
( ) Thf!!; p~bed &nt1Dlotic may reduce the efleclNeneae. of
medical10n you .... currenuy lakin.9 Chock packogs
_o""",_W1IIlPhaIlllllClSl
( ) Th6 mlarpretallOn of Y"l<< X-Rays "'" prollmmary ...a<ling
YO\lr fUme win be f9VleW8d by a radlOlogtst Voo or your
ptI~l8.n WIll bQ c::onta(:ted "'there IS a change U1 th$
dl8gn08l!
FOLLOW.oVP Thts IS our T9CQmml!lndatlOn for fQUow-up If yOur
.",....""" (HMQ) roqIlI..... ph_ Alfarralf<>r_tty
COM_Oil, IT 15 YOUA RESPONSIBILITY TC) OBTAIN TtlE
NECESSARY APPROVAL
( ) Fo""",.up '"""
III
( JUrgl Con''''
( )F.tIlIly Dooror
I lWor1cN01
day.sfar
I )_'''\1
( I Suturo romoval
( } Cat! as $OCIn as poSSftiJe for appamtment
( ) I'lcIc up your X-Rays lrom the I'!adIoIogy Dopartmont pnor 10
your follow-up _ 0111 763-261161o.1Ml hlrm
mody
( ) See your phySIOWl 01 $pect911St If not Impmved in
days
( ) Return to Em&tgency Center If ytJU faai' your condrtwn 18 WOfsenmg,
oopoClolJylf
( ~ Your ~ood presslQ W8e elevated ~ 'hl;lVft It
reehOcked by yo., phys1ClS/\
{ ) Test resutls have been QJv&n to yoo Ta)(e them WIth you 10
the foI/oW'''\1 Oppolntmenl
Teat_gwen C1CBC C1CMP DEKG DX,RI\YCOPY
OBMP ORECORDS COI'YCHART OClLllC
( l PAl1ENT \IElIIIALIUS UNllEllSTAllP\NG
I heJllllV .cknQwlodgoa ""'""" 0/ _ ,n_oM IlI1d
Ullde""'"<llhom I ._nd 1ha11 have hod emergen<Y
troalmenllllllx IlI1d lI1all may be roleased bolo... all ot my
_I probloms Olll _ '" _ I Wlfl.......ge tor
foilow-up care as I ha~~ IMtnJcted it IS vour I'IHPOfl"
Slbllfly(OnotJfy~r P~7Ca Ph~anofttlla\l',
SIGNATURE, '
f' ant Of
Adct1\lolTllllnsfructJons
cI'>+\ful '(I)')\Jltlj v((-n:^.;\I\\~
(j) \~ I f\ \~ lx<<1C1l\--;.., t:R ~'/
~ '
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_AtuIlE
PhY$lcloll
MO 10C) Nu"",RN
HOLY SPIlUT HOSPITAL EMl!IitGENCY CENTER
503 NORTH 21ST STREET CAMP HILL, PA 17011-2288 {717) 763-2316
( ) Van,thi>Abra11am. M 0 038840L ( ) Robert Hymek. 0 0 OS 004400-L
l ) Tho.... AIdo,,", M D 011015E ( ) IUehan\ Luley, M n 029%O-E
I 'Solv'- ...lfOllo, M D OZS502E( 1 PIu1l1p MogUl"', MD 01506J-E
( ) Ramesh. Arora.. M D 0l6127E ( ) Lawrence"Paul, MD 009524-L
( ) Glen Dougbtry, 00 0SlJ06116E ( ) Frank Pro<op.o, M 0 OD:l64J-G
I I Jon Dub," DO OS 00699tL ( ) How.ro Rudmok, MD 040862-
DATE
~
, ) Ran)"". Sharma, MD O~126S.E
( HlllV,d Spurner, M n 023502.E
l ) Alan 1'epllll. M. D 030018~E
( ) Elame Thallner. M D 057~L
, nOwd Zannierman, M D OOS636-E
SIGNATURE
DEA#
REFILL
TIMES
Il"l ()ROM FOR A BRAND NAME PRoor..cr TO BE DlSPENS8D. TfJB
PltESCRfBBSl MUST HMID Wllrm 'BllAND ~ESSARY" OR "BRAND
MEOICAU. Y NBCBSSAaY" IN 'tHE SPAt"R B'eLOW
~ OSUBSTIIUTION Pl!IOOSS1BLB
t ,..
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"Cl'.'HIEJ
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~";"" lC~'J~G PA 11055
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MECHANIC8BURG FAMILY PRACTICE CENTER
DUNCAN, HAllE
DOB: 12/09/1985
88#: 166-68-4040
00210054851
08/24/2000
8: Patient was the passenger in the front seat of a motor vehicle and underwent an accident on 8119100
when car was hit from the rear by a drunk driver and pushed in the car in front of them. Their car was
stopped at the time. Patient did not have any head injury and does not recall any loss of consciousness.
Patient's primary concern is stiffness in her neck and her back.
0: Musculoskeletal: Tender to palpation over the right side of her neck and cervical area and also
tenderness along the thoracic spine. Full range of motion of the neck, although she complains of
discomfort when turning to the right side.
Neuro: Cranial nerves II through XII grossly intact. Grip strength is weak on both sides.
A: Cervical and thoracic strain secondary to motor vehicle accident.
P: Patient advised to use ibuprofen, 3 tablets 3 x a day consistently for 1-2 weeks or Aleve, 2 b.Ld.
2. Given an Rx for Flexeril.
3. Follow up p.r,n.
DO: 08/24/2000
DT: 08/25/2000 10:06 A/rrh
0#: 703956
KARE~' M.D
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NEALO~{6! .
GOVER, PL. i
ATTORNEYS AT LAW i
___------J
.
NO\! 1 ~ 2002
2411 NORTH FRONT STREET
HARRISBURG, PA 17110
TELEPHONE (717) 232-9900
FACSIMILE (717) 236-9119
ANDREW C. LEHMAN
alehman@nealon-gover.com
November 7,2002
Clark DeVere, Esquire
METZGER, WICKERSHAM, KNAUSS & ERB, P.C.
3211 North Front Street
P.O. Box 5300
Harrisburg, PA 17110-0300
Re: Halie Duncan, a minor, by Kimberly Duncan, her mother and natural
guardian, and Kimberly Duncan, in her own right v. Joel Cummings
Docket No.: 2001-2398
Dear Clark:
Regarding the above matter, where do we stand regarding discovery, trial and/or
settlement? I note Progressive previously reached an agreement with you to settle this
law suit against Joel Cummings for $14,000.00 on behalf of Kimberly Duncan and
$2,500.00 on behalf of Halie. I recognize the dram shop issue has complicated this
matter, however I was wondering since the Court has consolidated the two cases if
there has been any movement on the dram shop side of this action. Please advise at
your earliest convenience. I look forward to hearing from you. Until then, I remain
Very truly yours,
NEALON & GOVER, P.C.
.----
Andrew C. Lehman
ACL/lbs
cc: Tyeddie L. Desmarais, Progressive (Claim No.: 005212090)
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CONTINGENT FEE AGREEMENT
1,_1< 1~r/1 D Xlt'aJ'! individually and as parent and natural guardian of
4alll ~ ^"CP1 ' retain and authorize the law firm of Metzger,
Wickersham, Knauss & Erb, P.C" to do whatever they deem necessary or desirable in order to
. represent my daughter in all claims for compensation and reimbursement for personal injuries, wage
loss, and economic and other damages resulting from an accident that occurred on
A'{Soh~l- IGl . Z(J()O
I
1. Attornev'sFees:
The fee of the attorneys shall be contingent as follows:
(a) Thirty-three and one-third percent (33 1/3%) of gross recovery;
(b) SHOULD THERE BE NO RECOVERY BY SUIT OR SETTLEMENT,
SAID ATTORNEYS DO NOT HAVE ANY CLAIM AGAINST ME OF ANY KIND FOR
LEGAL SERVICES RENDERED.
2. Expenses of Litigation:
Actual expenses incurred on the business of the client shall be borne by the client
and my attorney shall be reimbursed out of the balance, after deduction of attorneys fees, of any
recovery for all legal expenses incurred in the prosecution of this claim which have not already been
paid by me.
I do hereby agree to pay all expenses incurred by my attorney in the preparation and
presentation of this case and do understand that these expenses include, but may not be limited to,
costs of medical reports and records, stenographic expenses connected with depositions, expert
witness fees, photocopying charges, and mileage charges connected with the rendering of legal
services. I understand that I am responsible for payment of these expenses regardless of the
eventual outcome ofthe case and further understand that if my attorney deems it necessary, I may
be asked to advance these costs prior to the incurring of any such expenses or the scheduling of any
deposition.
Document #: 182430.1
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3. I hereby further agree that my attorney may charge me reasonable additional
compensation if it is necessary to try the case more than once, if the case is appealed, or if
proceedings in other courts are necessary because of the change of circumstance of a party or for
other reasons.
4. I hereby further agree that my attorney is hereby authorized to bring suit or to settle
and compromise the claim, to execute aU documents pertaining thereto, and to do all lawful acts
requisite for effecting the claim on my behalf.
5. I further authorize my attorney to payout of any proceeds of settlement or trial any
unpaid medical bills for treatments or services made necessary by the injuries sustained in this
accident and any workers' compensation liens,
6, I agree that my attorney accepts this employment on the' condition that he will
investigate this claim, and if it appears to be a recoverable claim, he will proceed to handle the
claim; but if, after investigation, the claim does not appear to be recoverable, said attorney shall then
have the right to rescind this Agreement.
7. I hereby further agree that if I decide to terminate this authority before any
settlement is offered or any award is obtained the firm shall be entitled to reasonable compensation
for all work done on the case up to that point. I agree that reasonable compensation for Clark
De Vere, Esquire, or any other attorney involved in the handling of this case, shall be One Hundred
and Thirty-Five Dollars ($135.00) per hour, or such higher rate as shall constitute his standard
billing rate at the time that the work is performed.
8, I agree that my attorney may withdraw from this case at any time after reasonable
notice to me, and I agree to keep him advised of my whereabouts at aU times and to cooperate at all
times in the preparation and trial of this case, to appear upon reasonable notice for depositions and
Court appearances, and to comply with aU reasonable requests made of me in connection with the
preparation and presentation of this case.
Document #: 182430.1
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IN WI1NESS WHEREOF, I have signed below on this t5'ray of August, 2000.
. ~t 0), ~~
/<' C IENT:
METZGER, WICKERSHAM, KNAUSS & ERB, P.C.
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ATTORNEY: Clark De Vere, Esquire
Document #: 182430.1
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RELEASE OF ALL CLAIMS AND SETTLEMENT AGREEMENT
Adult and Minor
For the consideration as outlined below which is hereby acknowledged and also for future
acknowledgment, I!we release and discharge, and for myself/ourselves my/our heirs,
representatives, executors, administrators, successors and assigns, do hereby remise, release and
forever discharge Joel Cummings, Johnny K's, Inc., John Kritikos, individually and tJd/b/a
Johnny K's hereinafter referred to as the releasee(s), hislher/their/its heirs, executors,
administrators, liability insurers, successors and assigns, of and from any and all causes of
action, suits, judgments, claims and demands of whatsoever kind, in law or in equity, known or
unknown, which IIwe now have or may hereafter have, and/or which a minor Halie Duncan, now
has or may hereafter have arising from the claimed legal liability of releasee(s), which liability
releasee(s) expressly deny(ies), arising from or by reason of any and all bodily or personal injury
and/or property damage known and unknown, foreseen and unforeseen which heretofore
haslhave been or which hereafter may be sustained by me/us or the minor aforementioned arising
out of the accident on or about August 19, 2000, at or near the Carlisle Pike (US 11 North), in
Hampden Township, Cumberland County, Pennsylvania,
I/We agree that the consideration set forth below is specifically applicable to and paid to me/us
with respect to any and all damage to any property, either real or personal, of mine/ours or the
minor aforementioned, and with respect to any and all personal or bodily injury of mine/ours or
the minor aforementioned, whether presently known or unknown, foreseen or unforeseen or
which may subsequently develop and the consequences thereof, all as arising from the
aforementioned accident,
I/We further agree that the consideration set forth below is specifically applicable to and paid to
me/us with respect to any right of contribution the I/we or the minor aforementioned may have
against the releasee(s), hislher/their/its heirs, executors, administrators, insurers, successors and
assigns relative to claims of others that may be brought against me/us or the minor
aforementioned by reason of said accident.
I!We further agree that the consideration set forth below is specifically applicable to my/our
agreement that I/we or the-minor aforementioned will not join nor attempt to join the releasee(s),
hislherltheir/its executors, administrators, insurers, successors and assigns in any capacity, in any
action that may be brought against me/us or the minor aforementioned arising out of said
accident.
Should it appear that two or more persons or entities are jointly and severally liable for the said
injuries to person or damage to property arising out of said accident, the consideration for this
release shall be received in complete satisfaction to the full extent of the fault of releasee(s),
whether proportionally allocated or total, as ultimately determined under the law and for which
releasee(s) are found liable.
In consideration of the below payment, I/we for myself/ourselves and my/our heirs,
representatives, executors, administrators, successors, and assigns do hereby:
Pagel 013
Document #: 262188.1
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(1) agree to indemnify and hold forever harmless the releasee(s) and
his/her/its/their representatives, administrators, or assigns, against loss
from any and all further claims, demands or actions that may hereafter be
made at any time or brought against the releasee(s) by me/us or the minor
aforementioned, or by anyone in our behalf for the purpose of enforcing a
further claim, for which this release is given;
Upon execution and delivery of this Release and Settlement Agreement to releasee(s)
representatives, Progressive will deliver on behalf of Joel Cummings the sum of $14,000.00 for
Kimberly Duncan and the sum of $2,500.00 for Halie Duncan. In addition, Johnny K's, Inc. and
John Kritikos, individually and t/dIb/a Johnny K's will deliver the sum of $10,000.00, said sums
to be delivered to counsel for the Duncans, at his Harrisburg office address, within 10 days of the
delivery of the signed Settlement Agreement and Release. Within 10 days of delivery of the
settlement amounts, the Duncans' counsel will discontinue the civil actions fIled against
releasee(s) as a result of this accident.
I1We specifically preserve and do not remise, release or discharge any claim and/or action I, he,
she or they may have against any medical provider for any treatment or lack of treatment,
including malpractice, and any claims, actions and/or right I, he, she or they may have for
medical payments coverage, first party benefits, income benefits, health insurance, disability
benefits or other similar benefits from any entity, but specifically excluding the releasee(s) and
their liability insurers.
The parties acknowledge that Kimberly Duncan has received the sum of $25,000.00 from her
underinsured motorist carrier Erie Insurance ExchangelErie Insurance Company. In addition,
Progressive has paid a prorated portion of the Duncans' property damage. The monies received
from Erie and Progressive are in addition to the sums set forth herein and there will be no offset,
deduction or reduction from the amounts due herein for the amounts paid by Erie and
Progressive,
The payments totalling $26,500,00 constitutes damages on account of personal injury or sickness
in a case involving physical injury or sickness within the meaning ofIRC ~104(a)(2).
This Release is executed in accordance with the Court Order dated _, 2003, in the
Court of Common Pleas of Cumberland County at Docket No. and will be
interpreted consistent with that Order, A copy of the Order is attached hereto as Exhibit "A" and
incorporated herein by reference.
This Release shall be interpreted in accordance with Pennsylvania law,
Page 2 of3
Document #: 262188.1
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Intending to be legally bound thereby, WI1NESS my/our hand(s) and seales) this _ day of
,2003.
WI1NESS
Kimberly Duncan, individually and as parent and
natural guardian of Halie Duncan
(Seal)
Page 3 of3
Document #: 262188.1
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VERIFICATION
I, Kimberly Duncan, individually and as parent and natural guardian of Halie Duncan, have
read the foregoing Petition for Approval of Minor Plaintiff's Compromise Settlement and do swear
or affirm that the facts set forth in the foregoing Petition 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. 94904, relating to unsworn falsification to authorities.
Dated: 1/ Jt-/ I ()~
I
, as parent and natural
e Duncan
Document #263049
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VERIFICATION
The undersigned hereby certifies that he is the attorney for Plaintiff, Halie Duncan, by
Kimberly Duncan, parent and natural guardian, and that the facts in the foregoing Petition for
Approval of Minor Plaintiff's Compromise Settlement are true and correct to the best of his
knowledge, information and belief, and that said matters relating to the Petition for Approval of
Minor Plaintiff's Compromise Settlement are as known to the undersigned as to the clients, Plaintiff,
Halie Duncan, by Kimberly Duncan, her parent and natural guardian, said knowledge being based
upon information contained in the attorney's file in this matter, and further states that false
statements herein are made subject to the penalties of 18 Pa, C.S.A. 94904 relating to unsworn
falsification to authorities.
<.:.-" "..-)~ ~'7::>
Clark D€vere, Esquire
Dated:...) ~ ~<O -03
Document #263049
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CERTIFICATE OF SERVICE
I, Clark DeVere, Esquire, of the law firm of Metzger, Wickersham, Knauss & Erb, P,C.,
hereby certifY that I served a true and correct copy of the forgoing document with reference to the
foregoing action by first class mail, prepaid postage, this 26th day of March, 2003, on the following:
Joel Cummings
c/o Andrew Lehman, Esquire
Nealon & Gover, P,C.
2411 North Front Street
Harrisburg, P A 1711 0
Johnny K's, Inc., and John Kritikos, individually and tld/b/a Johnny K's
c/o William P. Douglas, Esquire
Douglas, Douglas & Douglas
27 W. High Street
P,O. Box 261
Carlisle, PA 17013-0261
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Clark De V ere, EsqUIre -----......
Document #263049
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