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Home My WebLink About99-00374 R" 0' THOMAS. THOMAS & HAfER. I.LP Bv: EVlln BlllCk, /lS(lllirc ,;/enI1jlC(l/ion No, 178M 305 North Front SIred, /" 0, /Io,~ 9\19 /lllrris/!llr!{,l'A 17/08 (717144/-705/ AlwI'/Il'Ys Jilr /)cjl'nd'III/S IN THE COURT OF COMMON PLEAS Of CUMBERLAND COUNT~, PENNS~LV ANIA 1'10,99..)74 CIVIL ACTION' \J',W JUR~ TRIAL DEMANDED lUD\TH R, MOSKO antI EDW ARD MOSKO. HCT H\\sband. Plain\i rfs \I, CANDACE M.f', SHANKS. M,D, and \)INNt\CLE HEAL'f\\ HOSI)\'\' t\15 dlbla MECHt\NICSBURG I;AMIL~ PRACTICE CENTER. Dcfcndan\S M(frlO" FOR CO"I'I"" ."CF. OF O..E"O'"'' C,"D'C', M.F 'D,,,KS M.D. ,,,0 'J!'",C\.F. lltAl;f8 DO"" AI.' 01." Mt&.","IC,..DG "Mil.' ,,,,,cT"" CE"TER - p.fo""'", C"d," M.I' """" M.\). ,.,1 l'iM,d' .""" ."",~,. "",, M"''''''"'''''' ,.nil, p"."" C",o (I""""" "M"in, ,"f"~"'''''\. hY "d "'''0''' ",,,, "",,,,,, "fho"'" .",,,n" & .' "', 1.1. p, ".N'" "," f 0< , ...11"""" " "II'.' , . Tho ,bo"'"'' ,,'" "".., ,. ,,",d"'" '0< , p<<- )',i" C"', """ " ,,,0" 15, ",>3, "" "". ,f M' ,,~ "d,. '" "",,,,, ",,,w' ,. " ' """. ("" [,..", "old bolo" "d" 010. "' "" 16, ",n. '",' " ",,, "",0 w" """,,,'" fo< "" ". ", ",m ,,, ,,'j)" '" (" ,,,bO"'" C ,",,,, II" C ". c"""',, fo< '0'>3 w" ", ,. '" ",bI', """"" '" "'. "..If" d," ,[ "'. "f,," """ " '003" ." \I\\I(\\OW\\' 1 Previous to the Status Conferenee in the instant muller, viu Order dated Muy 28, 2002. Evun Bluek. Esquire, wus allaehed for trial in Jones v, II1IIT\sburl! Hospitul with Judge Lewis of the Dauphin County Court of Common Pleas for the January 27, 2003 Trial Tern!. A trlle and correct eopy of the Order dated May 28, 2002, is attuehed hereto and marked as Exhibit HAll, 4, The Court Calendar for 200] was not prepared at the time of the Status Conference in this maller, so that it was unknown then that there would be a eonnict between trial in this mattei' and trial in Jones, 5, The likely eonnict arises because Jones is not expected to settle prior to trial and trial is expected to last for more than one week, Le, into the week of February 3. 2003, 6, The Jones malleI' involves 3 medical defendants, two plaintiffs and 14 expert witnesses, in addition to any lay witnesses, 7, On December 31, 2002, the "Call-of-the-List" was held in Cumberland County at which time Counsel for Defendants informed President Judge Hoffer of his prior attachment for trial on January 27, 2003 in Dauphin County. and the likcly conniet between it and trial in the instant malleI' scheduled for February 3.2003, 8, Counsel for Defendants further informed President Judge Hoffer !If the fact that the Trial Calendar for Cumberland County hud not been avai lable when the instant matter was scheduled 1'01' trial at the Status Conferencc in July of 2002, and therefore. the potcntial conflict was not known at that time, 9, Counsel for Defcndants also informcd President Judge Hoffer that because trial in thc Jones malleI' is not expected to scllle and is expected to last for more than one weck, thcre was likely to be a eonniet bctwecnthc two trials, 10, Although Counsel for Defendants requested u continuance, said request was denied at that time by Judge Hoffer, II, Counsel for Defendants also has requested that Counsel for Plaintiffs agree to u ,continuance but Counsel for Plaintiff~ has declined to do so, 12, Counsel for Pluintiffs has requested that if trial in the instant malleI' is continued. that it be continued to the March 2003 Trial Term, 13. In fact. Counsel for Plaintiffs has filed a Pmecipe to list the instant matter for the March 2003 Trial Tenn, 14, Because Counsel for Defendants was attached for a date certain in the ,!Ques malleI' prior to being attachcd for a date certain in the instant maller, and trial of the two matters is likely to cause a conflict, Defnndunts respectfully request thut trial in the instunt matter be continued until the next Trial TClm in Cumberland County, 15, If trial in the instant matter is not removed from the Trial List for Fehruary 3, 2003, this would require Defendunt, Dr, Shank. who currently resides und practices medicine in Iowa, and Defendants' four experts, including one expert who resides and practices ill Ohio, to make themselves available for trial on February 3. 2003, even though trial is very unlikely to proceed atlhat time, 16, Under those circumstances. Defendant, Dr, Shank, and Defendants' ex pen from Ohio, would he forced to incur the expense und time of travelling to Pennsylvaniu twice, I.e. once in anticipution of the February }r<l triul dllte, which likely will have to he continued. and agllin for the rescheduled trial dute, exhibit A cJ t;; 0 ~ 0.: "' ~ ee " Ii ... III III W ... <i c;; "' Z 2 2 " U > 2 '" u: 0 00 0 ee ~ u. a: u. '" 0 <5 N ~ oil :I: ;:: ,- ee 0 ee :> ~ 0 "' " Z 2 III C; "> ii' 0 ee ~ "' <1: " 1: "iI' .-,~, i'" '" '~'i !'V. m i';j'i~' III ,',-, i'I f1~,""j('J ,., 'l.id'" l~'n' :Ill": I'. JiI" .I I OUJ ~' liver pl'Ohlel11, Mrs. Mosko was advised thai her lahoratory studies would he sent 10 her pril11ury cure physicians ut Mechllnicshurg Fumily I'melice flll' Ihllow-up. Dr, Goedccke lesti lied thut when he received the results of the luhorulory lesls, he usked his secrelary, Cindy Stulzmun, R,N" to telephone Mrs, Mosko und udvise her thul she needed to Ihllow-up with her primary Curl' physician, Based on Nurse Stutzman's notations on the lub report. on October 24, 1994, she contacted Mrs, Mosko and informed her of the elevated cholesterol and of the liver problems, The labol'lltory results ulso were faxed to Meehaniesburg Family Pracliee, There is no evidenel' that anyone from Dr. Goedecke's offiec or Omega Laboratories telephoncd anyone at Mechunicsburg Family Prnctiee to report Ihe results or the reason for the referral. On Novembcr 15, 1994, Mrs, Mosko was secn at Meehanieshurg Family Practice by Defendanl, Canduee Shanks, M,D. Dr, Shanks had not scen Mrs, Mosko before this date, Moreover. Mrs, Mosko had not been seen at Mechanicshurg Family Practice since 1990, Undcr the suhjectivc portion of the offiCI' notc. Dr, Shanks rccorded that the reason for the visit was to discuss increased cholesterol. Mrs, Mosko had brought with her and infhrmed Dr. Shanks of the ahnormal cholesterol values, Dr. Shanks was not aware of the Omegll lah results or abnormal liver tests at the timc of the visit. Mrs, Mosko also did not mention the abnonnalliver tests. nor did she complain of any symptoms which could be nssoeiated with liver problems, Dr. Shanks evaluated Mrs, Mosko and recommended that Mrs, Mosko return in one year for repeat measurement of her lipids, Mrs, Mosko did not kcep this appointment, and in fact, did not see any physician again until an appointment with IlL Goedeekc on Novembcr 8, 1996, At that time, Mrs, Mosko did not rcport any symptoms which would he consistent with livcr disease llnd Dr, Goedeeke did nOllnl/uire as to whelher any lollow"up had hoen porlhn11ed as a result of the abnorl11alliver lests ofOoloher 24, 1994, The faxed 11Ib sheet lI'om Dr, Goedcl'ke's officc was discovcrcd lInd brought to Dr. Shanks' utlention on February 20, 1<)1J7. Thc cause oflhis delay is undeur. Dr. Shllnks testitied, however, thUllhis was the IIrstlime she had ever seen the IIlxed lub report. Alier reviewing the lab report, Ik Shanks immediately telephoncd Mrs, Mosko lInd informed her of the abnormlll liver tests lInd recommended lhut they he repcated, The lab tests were repellted on February 22, 1997, On March 17, I ()97, Dr. Shanks saw Mrs, Mosko at which timc shc referred her to Paul Lacey, M,D" u gastroentcrologistlhcpatologist, at SOL Gastrocnterololgy Associalcs, for further evaluutionand diugnosis, Upon referrul to Dr. Lucey, a liver biopsy wus performcd and a diagnosis of primary biliary cirrhosis was eonllrmed, Therc is no known cure for this diseasc, Dr, Lacey began lherapy with a drug, Actigull, which is known 10 only slow the progress of liver discase, Mrs, Mosko l'espofl(led to the Actigall wilh a signi f1cant lowcring of her liver function lests und whal Dr, Lacey referred 10 as a dramutic improvemcnt. Mrs, Mosko continues to follow with Dr, Lacey, To date, thcrc have hccnno signs of progression of her liver disease, II. Statement of Rasle Facts as to Damaw See Plaintiffs' Pre" Trilll Memorandum, Moreover, Plaintiffs have the burden of proving dumages, To dale, Plaintiffs have produced documents indicating medical hills in the approximate amount of $5,400,00, Medical hills recoverahle arc amounts accepted in payment. Moorehead v, Crozer:-Chester MediCil1 Center, 765 A,2d 786 (Pa, 20(1), III. Pl'lncinallssnes as 10 Llabllil\' and J}lInlllllcs The following arc the primary Icgal issues inlhis mediealmalpraelice ease: physician named John Go(,deckc, M,(), On October 24, 11)1)4, Mrs, Mosko presented to Dr, Gocdceke for hcr ycarly cxamination, At that timc, she was fifty-six years old, As part of that annual cxamination, Dr. Goedeckc ordercd blood work, which includcd a full chcmistry profilc, At the conclusion of hcr visit, Dr, Goedeckc advised Mrs, Mosko to rcturn in onc year, About two wceks latcr, on or about Novcmhcr 8, 11)1)4, Dr. Gocdeckc's oflice receivcd back from Omcga Mcdical Laboratories thc results of thc gcncral hcalth profilc takcn by Dr, Gocdccke at thc timc of the October 24, I ()l)4, visit. In addition to an abnonnally high cholestcrol Icvel, thc Omcga Laboratory gencral hcalth profile c1carly indicatcd an cxtrcmcly high Icvcl of gamma GT, which rcvcals an abnormal Iivcr test. Dr. Goedcckc's oflicc contaetcd Mrs, Mosko and indicatcd that she should make an appointment with her primary carc physician, Dcfendant, Mcchanicsburg Family Practic\\ and that Dr. Goedecke's oflice would fax 10 Mcchanicsburg Family Practice the Omega Laboratory general health profile results, On Novcmber 15, 191)4. Mrs, Mosko prescnted to De fi:md a III , Mcehanicsburg Family Practice, and was secn by Dcfendant, Dr, Shanks, The Novcmbcr 15. ] 1)1)4, visit bctwecn Mrs, Mosko and Dr, Slwnks only dealt with thc high cholestcrol finding, Defendant, Dr. Shanks, did not in any way addrcss the abnormally high livcr function test as rcvcaled on thc Omcga Laboralory gencral health pro!ik, which had bccn previously fax cd to Dcfendanl, Mcehaniesburg Family Practice, by Dr. Goedecke's ofli('e, Dr. Shanks rccoml1lendcd yearly cholcstcrol protile mcasurcmcnts, On February 20, I ()<)7, mOlT than two yeurs later, Dr. Shanks' rccords rcveal, "lab profilc lI'om 10/24/1)4 recently routed to ille for signature, It revcals hypcrcbolcslcrol, discussed with , 2.~5]OJ .1\11)\1)/ pationt on 11/15/94. and gJovatcd..1U's 119.Ldislll!,~!icd," (Emphusis in original rceord,) Dr. Shanks eontactcd Mrs, Mosko to inllJl'll1 hcr thatthc elcvatcd LFT had not hccn discussed, and Mrs, Mosko was rcfcrrcd f()f' furthcr livcr protilc work-up, Mrs, Mosko was rcferrcd to a gastrocntcrologist/hcpatologist, who madc a dctinitivc diagnosis of primary biliary cirrhosis, II. BASIC FACTS AS TO DAMAGES As a rcsult of thc failurcs of Dcfcndants, Mrs, Mosko wcnt undiagnoscd for 1110rc lhan two ycars with Iivcr discasc, Tcsting in 1997. aftcr Dr. Shanks tinally idcntiticd thc e1cvatcd LFf's, rcvcalcd lhat Mrs, Mosko suffcrcd from picccmcal nccrosis, inflaml11ation, dccreascd numbcr and prolifcration of bioductuals, and stagc II to stage IlItibrosis, Mrs, Mosko is at risk of dcvcloping cnd-stage cirrhosis of thc livcr, and incrcascd risk Illr Iivcr canccr. Mrs, Mosko has had to bc continually monitorcd by a gastrocntcrologist, and as a rcsult of that has incurrcd mcdical bills for carc and trcatmcnt. A copy of thc mcdical bill sUl11mary is allachcd hcrcto as Exhibit "A," III. PRINCIPLE ISSlmS 01<' L1AIHLlTY ANI> I>AMAGES A, Princ;inJQj$:~\!j;s of l,iabUlIY. From Plaintifrs pcrspcctivc, liability is clcar in this casc, Thc cvidcnce has rcvcalcd that thcrc is no qucstion that Dr, Gocdcckc's oflicc Iilxcd thc Omcga Mcdical Laboratory gcncral hcalth prolilc to Dr. Shanks' orncc at Mechanicsburg Family Practicc on 01' about Novcmbcr 8, I ()94, approxil11atcly onc wcck prior to Mrs, Mosko's visit of Novcmbcr 15, 1994, with Ik Shanks, Discovcry has rcvcalcd that contained in thc original chart (If Mcchanicshurg Family Practicc was a nix covcr shcct from Dr. ,1 25.~HHI'.IIl\1J1 Goedecke's office immediulely fhllowed hy u ruxed copy of the Omegu Medioul Luhol'Ulory test results dalcd Octoher 24, 1994, On lhe uppor lell-hand corner of hoth sheets, there arc staple holl,s that nHlteh, and the pages a slightly el'inkled in approximately the same area, In the upper right-hand corner of the Jilx cover sheet, appear the words. "nol seen as of 11/81'>4, app\. 11/151')4 with Dr. Shanks," Till' quoted language on the fax cover sheet is in pencil. The only way that pencil can appear in the original chart on a nix cover sheet is if it was wrillen at the oflice receiving the filX, Thus, it is c!l.ar, eontrury to Defendants' assertions, that Dr. Shanks and Meehaniesblll'g Family Practice did, in filet, receive from Dr. Goedecke's office the lah results conecl'l1ing Mrs, Mosko, which clearly rcvealthe elevated liver function te,!. In addition, on the fax cover sheet, Mrs, Mosko's name in the original chart is highlighted, Again, the only way that a highlighted mark can appear on a faxed piece of paper is if the highlighting was made at the office receiving the lilX, Defendants continued to dispute liability, despite the overwhelming evidence that they did, in fuet, receive the Omegu Medical Laboratory's general health profile form indicating elevllted liver function tests, At tl'ial, Plaintiff will present the testimony of Esteblln Mezey, M,D" Ii'om Johns Hopkins University School of Medicine, Division of Gastroenterology, Dr. Mezey has wrillen a pl'inciple report dated January ~ I, 2002, and two supplemcntal reports. one duted July ~O, 2002, und the other duted Oetoher 7, 2002, All of Dr. Mezey's reports have previously been provided t.) defense counsel, and all arc attached in order hereto as Exhibit "8," 4 2.'\5101 1\/IlI11Z 2, Defondant. Cunduco Shnl1ks, M,D, (As on Cross-Exuminalion); 3, Any of the support stuff personnel of Dcfendnnl. Meehaniesbul'g rumily Pl'lIetice; 4, John Goedecke, M,D,; 5. Estebnn Mezcy, M,D, (Plnintiff's Expert); (" Plainli 1'1' reserves the right to supplcment this lisl inn limely manner prior to trial. V, IDENTITY OF EXBlBIT~ Plnintiffmay use any of the following exhibits at Irinl: ), Medical records of Dr. Goedcckc pertaining to Plaintiff, Judith Mosko; 2. Medical records of Mechnnicsburg Family Practice pertaining to Judith Mosko; 3, Medicnl records of Dr. Lacey pertaining to Judith Mosko; 4, Plninli ffs medical bi lis; 5, Any deposilion transcript; (" Defendants' Answer to Plaintiffs Requests for Admission; 7, Rclevanlmedical trcatises. as appropriate; 8, Anatoll1icalmodels or pictures, as approprinlc; 9, Plaintiff rescrves thc right 10 supplell1ent this list inn timely fashion prior to trial. VI. CURRENT STATUS OF SETTLEMENT NEGOTIATIONS On January 2, 20OJ, Plainti Irs counsel orally cOll1nlllllicated to Defense counsel u demund of $125,000, That del11und was eontinncd in writing hy Ictter daled January 3. 2003. As of the till1e of the tiling of this instant Pre-Trial Memonllldull1, Defendants have not communicated an offcr in responsc to Pluintirf's demand, (, 2~510J I '.IIJ\ll/. ~Atfi.!:!M.!MAGING AMP THER~UTIC ASSOc... 2.97.00 297.00 03/20/00 Abdomen Compl US TOTAL f9L YCLINIC MED CEI'ilEB 02/22/97 03/17/97 04/11/97 05/14/97 98.60 35,00 344,10 671.60 275.00 230,60 135,50 236.50 65.00 119.25 21,75 13.50 5.20 116,25 83.00 2451.05 08/12/97 11/17/9"' 05/05/96 Laboratory prob Foe Est pt Laboratory surgical Laboratory Supplies IV Solutions OP Room Laboratory Laboratory Hepatic Function Panel GGTP Venipuncture Dexa AxIal DensItometry Laboratory 06/01/98 11/16/96 TOTAL 7992.80 GRAND TOTAl. ~'{O~-I~S ,H?I~K!N~ Division 01 Gaslroenlerolouv 720 Rutland Avenue 1918 Ross Research Bldg, Ballimore, MD m05.2195 (410) 955.26351 fAX (4tO) 955-9677 for clinic appolnlments: (410) 955.4166 January 31, 2002 Mr.James DeClnti Angino & Rovner. P,C, Attorneys at Law 4503 North Front Street Harrisburg. P A 17110-1708 RE: Judith R, Mosko Dear Mr, DeCinti: At your request, 1 reviewed the medical records of Mrs, Mosko relating to her diagnosis and management of primary biliary cirrhosis. I have also reviewed the deposition of Dr, Candace Funk Shanks, I now offer my opinion. Ms. Judy Mosko started hel' primary medical care at Mechanicsburg Family Practicc Center in 1978, and over the years, they saw her for a variety of symptoms unrelated to the present condition, Dr, John Goedecke, a gynecologist was following the patient after management of in situ cervical carcinoma with abdominal hysterectomy III 1979. This carcinoma has since resolved, On 10/:!4/94. Dr, Goedecke obtained blood tests for a general health profile and this revealed the following abnomlalitics: Cholesterol - 309 mgldl Alkaline phosphatase. 837 (normal less than 140) AST - 34 (normal less than 45) Gamma GT - 1435 (normal less than 65) The laboratory reporteo each of the above tests 10 be high, and in respeetto the Gamma GT noted that the high value was veri lied, Dr, Goedecke then sent the patient to Dr. Shanks and faxed Ihe laboratory reports to her offiee, Dr, Shanks saw the patient on 11115/94, no led the high cholesterol level and reeommended dietary management and exercise for the elevated cholesterol. There is no evidence that Dr. Shanks noted the abnormalities in liver tests, She also recommended yearly cholesterol measurements as a follow-up, On 2/22/97, Dr, Shanks apparently becamc aware of the abnormullivcr tests and repeated them and vullles of 2/22/97 reveuled cholesterol of289, alkaline phnsphatase of 773 and AL T of 118. The James DeClnti January 31, 2002 Page Two patient was thereafter referred to Dr, Puul Lucey, u gastroenterologistlheputologist, who made a definitive diagnosis of primary biliury cirrhosis based on the elevated AMA of I :640 and a liver biopsy as well as the exclusion of other causes of liver discase such us viral hepatitis. The liver biopsy showed piccemeal necrosis, inflammation. decreased number and proliferlltion of bile ductules, and stage lito stage 11/ fibrosis, Therapy with ursodeoxycholic acid Was instituted with a decrease in the liver tests, The latest liver tests uvailable on 11/16/98 now reveal an alkaline phosphatase of 389 and ALl' of75, Throughout this time, the palient remained asymptomatic und on physical examination, Ihe only evidence ofliver disease was the presence of spider angiomata and palmar erythema, She has no hepatosplenomegaly und uppcr endoscopy did not reveal esophageal varices. On the basis of the above record. I cun state with a reasonable degree of medical certainty, thai the care provided by Dr, Shanks fcll below the appropriate professional standard. by missing the abnonnality of liver tests which would have led to an earlier investigation of the calise of liver disease and treatment of this patient It is strangc that these abnonnalities were missed since they were on the same puge as the cholestcrol abnonnality and all were indicated as bcing high, The abnOlmally high gamma GGT is further marked as veri fied. Treatment with Actigall is known to result in improvement in biochemical tests, in improvement of liver histology. and in the slower progression of the liver disease toward well-established cirrhosis which would require liver transplantation (Combes, et ai, Hepalology 22:759-766, 1995; lindoI'. et ai, Gastroenterology 106: 1284-1290. 1994), Indeed, biochemical liver tesls in this palient improved on ursodeoxycholic acid during the three ycars of therapy, Hcnce. it can bc stated with a reasonable degree of medical certainty that earlier diagnosis and treatment of this patient with ursodeoxycholic acid would have resulted in improvement in her liver disease and in a slower biochemical and histologiclll progression of her liver disear.e. The patient is at risk of developing end stage cirrhosis, because of the finding of significant scarring (stage" to stuge'III I1brosis) on her originulliver biopsy. It cun be stuted with u reasonable degree of medical certuinty thut the putient would have hud less scarring (fibrosis) and muybe even no scurring if her diugnosis had occurred when first found to huve liver test ubnormulities, Earlier treatment with ursodeoxychlolie ueid would huve 310wed down Ihe inflmllmution and progression of scarring and maybe even prevented the dcvelopment of scarring, This is importunt since scurring (fibrosis) tends tn increuse with time, The progression of scarring to end stagc cirrhosis (stuge IV fibrosis) may take 10-20 years, Eurlier lreutment with ursodcoxycholie acid would huve decreased her risk und oJ' slowed the time frame for the development of end sluge cirrhosis, End ,'1'';'','''/ ," hj"" I;'I'<;'i'I' ;n"~,;,,j ''',l'\.n; "','"I"','Iv,.'J! 'll\'i~ 11, . . . . (#_5) , , ' CJ IU 0 - 0.: w - tt " iii 0- - OJ> <i Oi OJ> '" 0- w ~ Z Z " S! z '" 0 W 00 U, ~ tt u. u. n. '" 0 <3 N i:; oil :r: ,e;: >- tt ':i 025 :> QJ to Z z OJ> - M Ii (!J 0 " ~\1 <( :r: . JAN 092003 'y/ #5 JUDITH R. MOSKO and EDWARD MOSKO, Her Husband Plaintiffs IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA v, CANDICE M,F, SHANKS, M.D. and, PINNACLE HEALTH HOSPITALS d/b/a MECHANICSBURG FAMILY PRACTICE CENTER, Defendants CIVIL ACTION - L~W NO, 99-374 CIVIL TERM IN RE: PRETRIAL CONFERENCE QRDER OF COURT A pretrial conference was held in the chambers of Judge Oler in the above-captioned case on Wednesday, January 15, 2003. Present on behalf of Plaintiff was Lisa M, Benzie, Esquire, standing in for James DeCinU, Esquire, who will be trying the case, Present on behalf of Defendants was Evan Black, Esquire. This is a medical malpractice action arising out of allegedly belated treatment of Plaintiff Judith R, Mosko for liver disease, Defenses include lack of negligence, contributory negligence and absence of damage, Plaintiff Edward Mosko died following institution of this action and by separate order of court pursuant to an agreement of counsel his name will be deleted from the caption, thereby withdrawing his claim for loss of consortium. This will be a jury trial in which each side will have four peremptory challenges for a total of eight, The estimated duration of trial is three days. With respect to the availability of counsel, Defendant's counsel has indicated that, because of a trial in Dauphin County as to which he has been attached, he may not be available until Wednesday of the forthcoming trial week in Cumberland County. Counsel for Plaintiff has indicated that Plaintiff would not oppose a continuance request on the part of Defendants in the event that the Dauphin County trial continues into the Cumberland County trial week, Defendants' counsel has filed a motion for continuance based upon his potential unavailability, which is opposed by the Plaintiff except as in dictated above. By separate order of court, Defendants' motion will be denied by the Court, without prejudice to counsel's right to secure a continuance in the event that his Dauphin County trial does continue into the week of the Cumberland County trial term. An issue which may arise at trial concerns the Plaintiff's right to recover for loss of future earnings and future earning capacity in the absence of expert testimony by a vocational expert. Plaintiff has not identified any expert in this respect, and as of the pretrial conference was not certain whether a claim for future lost earnings and earning capacity would be pursued at trial. In the event that such a claim is to be pursued, Plaintiff is directed to file a notice to that effect and submit to the court a brief in support of her position that such a claim can be pursued in the absence of expert testimony at least seven days prior to commencement of the trial term. To the extent that any deposition testimony is to be shown or read to the jury and contains objections being pursued by counsel, counsel are directed to furnish to the court at least five days prior to commencement of the trial term copies of the transcripts containing such objections, with the areas of objection being pursued highlighted and with brief memoranda in support of their respective positions on the objections, With respect to settlement negotiations, Plaintiff has made a demand, and at this time Defendants' counsel does not have authority to respond to the demand, ~; 01 , (', " ~~ <".' tJJ. ,,~( , p." Ci .J.,; ~,. UI !' '1/ I IT- I! C '.J.."t LI ,-, f" ll.. 'J (ll " 0 (;1) (.) III The COIlI'( of Common Picas of Cumbcrland County, Pcnnsylvania ,Judith R. MOBko, at. (1.1. vs. CondllCO M.I". SlwnkB, M.Il., ot. al. Sorvo, Plntlllc.lo /loa] III /lOBpJltllB, d/b/a Mecllatl:lcBhurg, Family PractIce Center Nfl, 99-374 Civil 19_ .---- Now, _1/21/99 DauphIn - 19_, I SHEIUFF OF CUMIIERLAND COUNTY, P A do herehy depUllze Ihe SherUT of County 10 e~.eule Ihls Writ, this depulollon helng mode olthe recluesl ond risk oflhe PlalnUff. .,.....-;a/ ,../; ,<~;' - _ ."'-,c-<..;/' .. ... . F'. " ., 1 .........i'".,-?;'f{..~~c: 'J ~U1"-':'~...- , .-2- ~ , SherlffofCumherlond County, Po. Affidavit of Service Now, within 19___,01 o'elock M, served the Upon 01 by handing 10_ atlesled copy of Ihe original Ihe conlents thereof. o true and and mode known to So answers, Sheriff of County, Po. COSTS Sworn and subscrlhed before me this _ day of -- SERVICE MILEAGE AHIDA VIT $ 19_ $ medicine at the Meehaniesburg Family Pmeliec Center. The remaining avel'l1lents of Ihe corresponding paragmph arc denied gcncrally and as conclusions of law, 4, Admitted only that Answcring Dcfcndant pmclieed medicine at thc Mcehaniesburg Family Practice Center in Meehanksburg, Cumbcrland County, Pennsylvania, as alleged, and that various physicians pmetiee family medicine at that location at all times relevant. Any remaining allegations atlhe corresponding panlgraph arc denied gencmlly and as conclusions of law, 5, Admitted only that Mechanicsblll'g Family Pmctice Center is a fictitious name presently owncd by Pinnaclc Hcalth Hospitals. Any remaining allegations of the corresponding paragraph arc denicd, 6, Admitted, 7, Admitted, 8, Denied, 9, Admitted that Defendant Shanks was an employee of Pinnacle Health Hospitals and predecessor corporation Capital Health System at all times relevant. 10. Denied, II. It is specifically denied that all individuals lisled in the cOITcsponding paragraph of Ihe Complaint were agents, apparent agents, servants, members, partners and/or employees of Meehanicsburg Family Practice Center. For further res!,JOnse, Answering Defendants are unable to admit 01' deny agency relationships of specific individuals who cannot be identified fl'Om the averments of thc corresponding paragraph, and thus deny the same. For furthcr response, Mechanicshurg Family Pmctice Center is not a named Defcndant in this litigation. Any remaining avenncnts of the con'csponding pamgraph arc denied genemlly and as conclusions of law, -2- 12, /I is specificlllly dcnicd thlltllll individuals listcd intl1l' corrcspllnding parilgruph of Ihe C()mplaint were agcnts, lIppllrent agents, scrvunts, mcmhers, partners und/or cmployccs of Hurrisburg Hospitlll. For I'urthcr response, Answcring Dcl~ndllnts arc unllhlc to admit 01' dcny ugency rellltionships or specific individuals who cllnnot hc idcntified from the i1vermenls or the corresponding pllragraph, lInd thus deny thc samc. For furthcr rcspons,., HlIrrishurg Hospitul is not 1I named Defendllnt in this litigation. Any remaining avermcnts ofthc corresponding paragraph arc denied gencrally lInd liS conclusion or law, 13. It is spccifically denied that all individullls listed in the corrcsponding pamgraph of the Complaint werc agents, appllrent agcnts, servants, mcmhers, partners, and/or cmployees of Defcndllnt Pinnacle. Answcring Defendants arc uJ\lIble to admit 01' deny lIgency rellltionships of specific individullls who ellnnot be identified by the avcrments ol'the corresponding paragraph of the Complaint and therefore deny thc same. Any remaining averments of the corresponding paragraph arc denied generally and as conclusions of law. 14. Denied, Answering Del'endant is without sufficient knowledge or information to admit 01' deny having the right to exercise control, authorily and/or supervision over individuals not specificlllly identified, and thus denies the same, 15. Denied. Answcring Defcndant is without suflicient knowledge 01' information to admit 01' deny having thc right to exercisc control, lIuthority and/or supervision over individuals not specificully identified, and thus dcnies the same. For f\lrthcr response, Mechanicsburg Fllmily Pmctice Ccnter is not a lHulled Defendant in this litiglltion. Any rcmllining lIvermenls or the corresponding paragrllph lire denicd generally and liS conclusions ol'law, -J- 16, Denied. Answering Defendant is without suflicient knowledge or information to admit 01' dcny huving the righl to exercise control, authority and/or supervision OWl' individuals nol specilically identilied, and thus denies the same, For further response, Harrishurg Ilosllitul is not anllmed Defendant in this litigation. Any rcmaining averments ofthc corresponding paragruph arc denied generully and as eondusions of law, 17. Denied, Answcring lklendant is without suflicient knowledge or information to admit 01' deny having the right to exercise control, authority and/or supervision over individuals not sped lieally identi lied, and thus denies the same, Any remaining averments of the corresponding paragmph arc denied generally and as l'ondusions of law, 18, Admittcd in part and dcnied in part. '1'0 the extent that the medical records of Plain tiff Judith Mosko Ih>Ill Meehanieshurg Family Practice Ccnter relieet the aVel'll1ents of the corresponding pal'llgmph of the Complaint, it is admitted only thut such is recorded therein. Otherwise, and tolhe extent the medical records do notreliect and/or contradict the corresponding averments, denied leJr the reasons indicated in Pamgraph I, ahov(). 1'01' further response, Answering Defendants arc without sufl1cicnt knowledge or inlill'll1ationto admit or deny that the physicians al Mecllllnicsburg Family Practice Center were Plaintiff's primary care physicians at all times relevant, lInd thus deny the same. 19. Admitted in part and denied in part. To the extenlthat the mcdical records of Plaintiff Judith Mosko from Mechanicsburg Family Practice Ccnter reflect the averments of the corresponding paragraph of the Complaint, it is admitted only that such is recorded therein. Otherwise, lllld to the extent the medical records do not reflect and/or contradict the corresponding aVel'll1ents, denied for the reasons indicated in Pamgraph I, above, -4- 20-22. Donied, Allor reasonahle investigation, Answering Defendllnts lJI'e without sufficient knowlodge or information to admit 01' deny the lIverments or (he corresponding Jlllragl'llph of lhe Complllinl, and thus deny the same, Striet prooris demllnded at trilll, if wI evan I. 23-24, Admilled in p1ll111nd denied in Jllll1. To the e~tent that the medicalreeOl'du orPlainlitT Judith Mosko from Mechanicsburg Family Practicc Center reflect (he lIverments of the corresponding pllragrllph of the Complainl, it is lIdmitted only that such is reeorded therein. Otherwise, (lnd to the extent the IIledicalreeords do not reflcct lInd/or contradict the corresponding averments, denied for the reasons indicated in Pamgraph I, ahove, 25. Denied generally, For furlher responsc, any infercnee of ncgligence by Answering Defendllnls is speei ficlllly denied. 26. Admilled in part and dcnied in part. To the extent that the medical records of Plaintiff Jndith Mosko from Mechanicsburg FlImily Practice Center reflcct the averments of the corresponding paragraph of the Complaint, it is admitted only that such is recorded therein, Otherwise, and 10 the extent the medical records do notrefleclllnd/or contradict the corresponding avemlents, denied for thc rcasons indiclIted in PlIragraph I, ahove. 27. Admitted only that Defendant Shanks recommended ycarly cholesterol profile measurements for PllIintift: Any remaining allegations of thc con'esponding Jlllragraph arc denied generally lInd liS conclusions or law. 28, Denied. Allcr rellsonablc invcstigation, Answering Dcfendllnt's arc without sufficient knowledge or information to admit 01' dcny the averments or the corrcsponding pllragmph of the Complaint, and thus deny the same. Strict proof is dcmllnded lit trial, ifrelevanl. -5- 29-35, Admilled in p1ll1 and dcnicd in part. To the extcnl thllt the lI1edicalreeords of PllIintiff Judith Mosko from Meehllnieshurg Family Practice Center rel1ect the uvcrments of the corresponding pal'llgl'llpil of thc COll1pluint, it is admilled only that slwh is recorded therein, Otherwise, and to thc extentthc medieulrecords do notrel1ect and/or contmdiet thc corresponding uvel'lnents, denied Il)r the reasons indicated in Paragraph I, above. 36, Denied. Allcr rcasonablc investigation, Answering Defendant's arc without suff1cient knowledge 01' infermation to admit or deny the averments of the corresponding paragraph of the Complaint, and thus deny the same, Strict pl'Oofis demanded at trial, ifrclevant. 17. The averments of the corresponding pamgraph of the Complaint arc statcments of medicul fuct and not oflegal signil1eunce. Therefore, no response is required. To the extent that any response is deemed required, however, denied for the reusons indieuted in Paragraph I above. 38. Denied. Al1er reasonable investigation, Answering Defendant's ure without sufficient knowledge 01' information to admit or deny the averments of the corresponding pal'llgraph of thc Complaint, and thus deny the samc. Strict proof is dcmanded ut trial, ifrelevant. 39. The averments of the corresponding paragmph of the Complaint arc stutements of medicul factund not oflegal signi ficunce. Therefore, no response is required. To the extent thai any response is deemed required, however, denied for the rcasons indicated in Paragraph I above, 40. Admilled in part and denied in p1ll1. To the extent that the medical records of Plain tiff .Judith Mpsko from Mechanicsburg Family Practice Center rel1ect the averments of the corresponding puragraph of the Comphlint. it is admitted only that such is recorded therein, Otherwise, and to the extent the medical records do notrel1ecl and/or contradict the corresponding averments, denied 1'01' the reasons indicated in Paragraph I, ahove. -6- 41. Thc lIVCI'mcnts 0 I' (Iw corrcsponding plil'Ugmph of thc ('onllllllintllrc stlllol1lents of medical fuetllnd not oi'lcgnl significuncc. Thcwfore, no rcsponse is rcquired. To thc cxtentthutuny rcsponse is deemed rcquired, dcnied gcncrully und liS conclusions of luw. 42. Denicd gcncl'Ully and as conclusions of' law. For tlirther responsc, any inferenccs of negligence by Moving Deflmdants is spccificaLly denicd. 43, Denied generally and us conclusions of law. For further response, any inferenccs of negli~ence 01' causation of' any damages by Answcring Defendants arc specifically dcnied, 44, Denied genemlly and as conclusions of law. 1'01' furthcr answer and response, any inferenees of negligence arc specifically denied. 45.52. Denied generally and as conclusions of law. For further answer and response, il is spt1cifically dcnied that Answering Defendants <Jeted with negligencc as alleged. 53, Donied gencrally and as conclusions of law, For further answer and response, it is specifically denied that Answering Defendants ai'll jointly and sevcrally liable to Plaintiffs as IIl1eged. COUNT I 54. The incorporated averments of Paragraphs I . 53 of thc Complaint arc denicd for the reasons indicaled above. 55, Admit only that AnsIVcring Defcnd<Jnt Shanks WllS an employee of Defendant Pinnacle Health Hospitllls and pwdecessor corporal ions lit all times relevant. Any relllllining allegations to the eorrcsponding paragraph lire dl:nied gellerlllly lInd as conclusions of law. 56, Denied. .7. 57 Donied generally liS conclusions of law. For Illrther IInswcr and response, it is specificlIlly deniod Ihlll Defimdllnl Shanks is liahle to Plaintins fbr injuries IInd dalllllgl's as 1Il1eged, IInd is further specifically denied Ihllt Answering Defendant Shanks lIctcd with negligence in: a) flliling 10 read lind/or revicw Mrs. Mosko's I 0/24/94Iivcr funetion test results 101' over two (2) years; b) failing to sign-off and/or check-ofT Mrs. Mosko's 10/241')4 liver flillction tesl results, which wcre abnorIllally high, l(lI' ovcr two (2) ycars; c) litiling to discuss, notify and/or inform Mrs, Mosko, fill' ovcr two (2) yours, that her livcr funclion teslresults 1'1'0/11 10/24/94 were abnor/11ally high; d) failing to order, rccomlllend, perforllland/or avcll consider rcpeat liver funelion tests on Mrs. Mosko in 1994, 1995 and 1996; 0) failing to order, recommend, performand/or avcll consider the perfOl'Illanee of an lIntimitoehondrial antibody (AM A) titcr on Mrs. Mosko in 1994, 1995 and 1996; f) failing to order, recommend, and/or evcn consider an intcrnalmedieine, hepatic, and/or gaslroentarological consult 01' rcferral for Mrs. Mosko in I <)94, I ()95 lInd 1996; g) failing to diagnosc Mrs, Mosko's liver disease in 1994, 1995 and 1996; h) failing to recognize 01' evell consider the diagnosis of liver discase in 1994, 1995 and 1996, and to take appropriate mcasurcs to aggressivcly pursue definitive diagnoslic and therapeutic mobilities; i) failing to order, 01' at least rccommcnd, yearly physical cxams for Mrs. Mosko; j) I)tiling to recognize the significance and severity of Mrs. Mosko's abnormally high liver function test results in 1994, 1995 and 1996; -8- \'or (urther \Inswer \u,d response, il is 5\\. pel\ied generall~ lIS conclusions o( laW. el' \:,' IClI wilh negligenCe \IS alleged, .",,,,,,\1, ,,,,,,, "" "'WO',,, O".""n' , '^' · ~ , ' , , "",""" "~" "" "' II~,II"O ,.', W,"i"" 0"'.. D' ,."",,, l ",'," "",", ,,' """\II,, \0 ," ",' ,\I "n ,,, " ", ."", ",' ", ,,', ,."", ,'" J """",on' '" """d 'n ,,,,,, \ I I nlllll (or II li(e- ') "II ,,' " "",n"" ,'" '1""'"'' "., " ,,,m" '" ,,,' '" 1'" ' \ ", v II' "" ",,', ,,,,,, ,'" 1\0' "',",'" "", ",. ""','''' ",' ""I" 'n I "J4, I ,rel\IOn,ng lI'll,r, WI' ' . 1995 anll 199b', \} "\II,, \0 "n"'''' , ," """,',' ",,,,,,,, """ ,,\O,1d ,.." ,",,"""' ",~ """,, " ,,,,,, ,.,>1 "d I .~b, ,,,,,, "", "",," h'" ,,,,,,,,,,,,,, ,,,"0, ", ",''' " ",,, " " ",' ,", . ' \' ..\ leslin" lInll i( nol 10 , ' ' . . I" ,""''''''''''''''''''' """,~ """ ,0' ' 1,0IentHIIIY hlc_lhlelllenlng \Vcr con '''' " ,,~, ,,,,""" " """,""'"' '" i """",I ,,",'d ''', ,,,,,, ,. ",'" ,,""',' '" ",i'" re(erral 01' consull; \. " 'r . '00\'0 Wilh hYI""""'"'''''''''''' ",,,,,,,, """,,,,,,"I" ,',,",' ",) l HIgnoSll\g WI s. l~' ,... . d' I ' I" . 'os\:'o's nroblell\S were ," . ,,,,, .11""'"'' ",,, "", ",' ..'" ,.. " blood I,ressllre In I~O"en",er 0' ' n) no subl,aragral'h l n) , .. ' .. "" '" "~",..,"",,""", """,',, ",,,, ,,,d""I" "",,",, 0) Irelllll\g W.\S, I" . n- . . I .,. . 'os\:'o ShOllld alsO oll"e ,..., b ( 1994 wilhOll1 e"er consldcnnlb I "II I',IS, I" blood \'llesSure '" \~o"e\I\ er 0 ' been ewllll\\Cd and trealed (01 li"er disease; I. ."'" "os"o wilh hy"eIChOlcSlelolen,\a, insOn,nia, lInll borderline p) only I \agnosll,g 1"1S. \" .... " """" hi'"' '"'''''' ,,, ",,,,"n'. 0' "", ""on 'n ,,,,, ",., ,,~'" ,I" "'" ,'n,,,~"\I' hi'" "'" ",n" '" ,,,, ~",'" "hi" ,,','""'"' Ii'" """,, relalell 10 liwr Ilisease; _9- fllvor on 1111 PluintifPs claims, IInd inlhe 1Iltlll'lHltivc, demund thul Pluintifl's eluims ugllinstthem be dismissed with prejudice. ( 'OlJNT II 59. The incorporated avennents in pamgl'llphs I-53 in Counl I with the Complaint arc denied for the rClIsons indicated abovc, 60, It is admittcd only that Mcchanicshurg Family Practicc Center Was owned by Defendant PillI'Jl\elc IlclIlth Hospitals and prcdcccssor corporations. Thc remaining averments of the corresponding paragraphs are dcnied gencl'lllly and as conclusions of law. For further response, Mechanicsburg Family Prllctice Center is not a named Defendant in this litigation. 61. Admitted only that ccrtain individuals present at Mechaniesburg Family Practice Center at rclevant times were agents of Defendant Pinnacle Hcalth Hospitals and predecessor corporations. Answering Defendants arc unablc to admit or deny agency relationships of specific individuals who remain unidentified from the avel'lnents of the eorrcspondence pllragraph of PlaintifPs Complaint, and thus deny the same. It is further specifically denied that lJJl individuals in thc category set fOlth in thc eorrcsponding pamgraph wcre agents, apparent agents, servants, members, partners and/or employees of Answering Defendants as allcged, The remaining avennents of the corresponding paragraph arc denied generally in ils conclusions of law. 62. Admitted only that certain individuals prescntat Mechanicsburg Fmllily Pmctice Center at relcvant timcs wcre agents of Dcfendant Pinnacle Health Hospitals and predecessor corporations. Answering Defendants arc unable to illhnit or deny agency rclationships of specific individuals who remain unidentified from the al'crmcnts of the correspondence paragraph of PlaintifPs Complaint, and thus deny thc same, It is further specifically dcnied that ill.! individuals -10- in the category set Ibrth in the eOl'l'esponding pal'Ugl'llph were agents, parenl agents, servants, members, partners and/or employees of AnswlH'ing Dcfcndllnts liS allcgcd. The remaining aVel'/l1ents oflhe corresponding parllgraph lIrc dcnicd gcncrally and ilS conclusions of IlIw. For lin1her rcsponsc, ilny avermcnls that the ahove individuals acted within the course lInd scope of the any employment relationships with Answering Defe;ldants lire denied. 63. Dcnied gcnerillly in its conclusions of IiiII'. For further answer and response, it is specificillly denied that Answering Dcfendllnt is liable to PllIintif'ls lor injuries and damllges allegcd, and it is further specifically denied that Answering Defendant acted with ncgligcnee in: a) failing to properly train and instruct, its c1erie,t1 lInd medicill staff, including Defendant Shanks, on the proper steps to be taken to ensure that iI paticnt's laboratory reports, especially abnormally high results, such as Mrs, Mosko's, ilre reported to the patient and to their primllry carc physician; b) failing to recruit, hire, and employ, clerical and heillth care staff, who arc able to log in, file, process, route and report a patient's lahoratory reports, especially abnormally high results, such as Mrs. Mosko's, to the patient's primary care physician and the respective patient; c) failing to promulgilte and implement policies, procedures and protocol for its agents, apparent agents, members, partners, servants ilnd/or employees to cnsure accurate and prompt repol1ing of a patient's IlIhoratolY reports, especially abnormally high results, such as Mrs. Mosko's, to the patient's primary carc physician and to the respcctivc Piltient; d) failing to implcment and enforce policies, protocols, rules and/or reguliltions that reqnire clerical still'" and/or hcalth carl.' stair (0 noti fy the primary care physician(s) whcn patient Iilboratory reports, especially ilbnormally high rcsults, arc rcceivcd; -II- e) failing to implement and enllll'ce policies, protocols, rules lind/or regulations that requirc clerical stllffand/or hClIlth cllre stllffto have the primary care physician(s) read,review, sign- off and/or chcck.off patient lahoratory reports, especially ahuol'lnally high results, which lire received; t) flliling to implement and enforce polides, protocols, rules and/or regulations (hilt require elcrical staff and/or hcalth care staff to discuss, noti fy and/or infl1l'l11 the paticnt of their respcctive laboratory I'Cports, espccially lIbnormally high results; g) failing to IIdcquately stllfTsumcientnumbcrs of clcricilllInd/or health care employees 10 allow the IIceurate and prompt log in, tiling, processing, routing lInd rcporting of a patient's laboratory reports, especially abnormally high results, such liS Mrs. Mosko's, to the patient's primllry ellrc physieilln and to the respective patient; h) failing to haw designated, trained individuals lIvailablc to log in, file, pl'Ocess, route and rep0l1 a patient's laboratory reports, espedlllly IIbnol'll1ally high results, such as Mrs. Mosko's, to the patient's primary carc physician and to the respective patient; i) fidling to havc a protocol in place that required incoming paticntlahoralory rcsults to be checked-off, acknowlcdged, lind/or signcd-offby clerical staff and/or primary cllre physicians, such as Defendant Slwnks, and sped tic standards for doing so; j) fililing to reach and/or review Mrs. Mosko's IO/24ICJ4liver function test results for over two (2) years; k) flliling 10 sign-off and/or cheek-oil' Mrs. Mosko's 10/24/94 liver function tesl results, which were IIhnol'll1ally high, for OVCI' two (2) YCllI'S; -12- I) failing to discuss, nolify ,lIld/or inrorm Mrs. Mosko, fhr over two (2) years, thai her livel' function test results Ii'om 10/241')4 were abnormally high; m) failing to order, reeommcnd, perfill'lnand/or cven consider repeat liver function tests on Mrs, Mosko in 1994, 1995 and 11)%; n) failing to order, recolllmcnd, pcrfilJ'll1 and/or evcn consider the perfol'mance of an anti mitochondrial anlihody (AMA) titer on Mrs, Mosko in 1994. 19'15 and 1996; 0) failing to order, recommend and/or even consider un inlel'l1almedieine, hepatic, and/or gastroenlel'Ological consult or rcfcrralli)r Mrs. Mosko in 1994, 1995 and 19%; p) thiling to diagnose Mrs, Mosko's liver discase in 1994, 1995 und 1996; q) failing to recognize 01' evcn consider the diagnosis or liver disease in 1994, 1995 and 1996, and to take lIppropriatc measures to aggressively pursue definitive diagnostic and therapeutic mobilities; 1') failing to order, 01' at least recommend, yearly physical eXlIminations for Mrs, Mosko; s) Hliling 10 rccognize the signilicanee and severity of Mrs. Mosko's abnormally high liver function lest results in 1994, 1995 and 1996; t) failing to recognize the increased risk of harm lind/or the Jlotential for a life- threatening injury to Mrs, Mosko based on hcr abnormally high liver functiontcstresults in 1994, 1995 and 1996; u) failing to fonnulllte a differcntial diagnosis which should have included liver diseuse in 1994. 1995 and 19%, due to Mrs. Mosko's high cholestcrollcvl'is, and thenlo rule in 01' out this potenlially life-threatening liver condition with appropriatc examination and testing, and ifnot, to -13- have lit lellst ordered or recommended an internul medicine, hepatic and/or gustl'Oenterologielll referral; v) dillgnosing Mrs. Mosko with hypercholesterolclIlia, insomnia, and horderlinc elevated hlond pressure in November of 1994, without ever considering thai Mrs. Mosko's problems were relatcd to livcr disease; w) treating Mrs. Mosko 1'01' hypercholesterolemia, inson1l1iu, and horderline elevated blood pressure in November of 19()4, without eVIlI' considering that Mrs. Mosko should also be evaluated and treated It)r liver diseasc; x) only diugnosing Mrs, Mosko with hypcrcholcstcrolemia, insomnia, and bordcrline elevated blood pressure in Novcmher of 1994, when in fact, Mrs. Mosko also had abnormally high liver ItlIlction tesl results which evidenced liver disease, 64. Denied generally as conclusions of law, For further answer and response, it is specifically denied that Answering Defendantacled with negligence as alleged, WHEREFORE, Defendants Cundaee Shunks, M.D. and Pinnucle Health Hospitllls deny liability to any and all parties to thc within litigation, demund thut Judgement be entered in their favor on all PlaintifPs claims, and in the altel'l1ative, demand that Plaintiff's claims against them be dismissed with prejudice. rutlNT III 65. The incorporated averments or paragraphs 1.53 and Count's I and 1/ of the Complaint are denied for the reasons indicated above, 66.67. Denied, Aficr reusonahlc investigation, Answering Defendants arc without sufficient knowledge 01' information to admit 01' deny the avcrments of the corresponding paragraph of the .14. Complaint, and thus deny tho,) sume. Slrlct proof is demanded uttrial, if relevunl. For further unswer and response, L1ny inference ornegligence hy Answering DeI'endants is specifically denied, WHEREFORE, [)efenduuts C'undace Shanks, M.D. and Pinnacle lIealth HoslJilnls deny liability to L1ny and all purlics to the within liligation, demand that Judgement he entcred in their fuvor onull Plaintift's claims, and inlhe ultel'l1utive, demand that PllIinlifTs claims againstthelll be dismissed with prejudice. NEW MATTER DIRI~(TIillJ'O PLAll~!TJ..EF1i Answcring Defendunls hel'ehy rllise the following New Mallcr pursuant to Pa. R, Civ. P. 1026, 1030, LInd 1032, 68, The Plaintiffs may have failed 10 state a cause of action upon which relief may be granted, 69, Investigation lInd discovery may indicate that the applicable statute of limitations expired before the institution of this action. 70, Answering Defendants were not negligent nOl' did they engage in any Iiability- producing conducl at any time relevant to the cause of action ullcged by the Pluintiffs, 71. Any acts 01' omissions of Answering Defendants alleged to constitute negligence were not substanlial causes or fllctors of the subject incidenlnor did tlwy result in the injuries or losses alleged by the Plaintiff.~, 72. Investigutionund discovcry mllY indicate thatthc negligentucts 01' omissions 01' other liability-producing conduct of other individual[;, persons, or c'ntities constituted intervening, superseding causes of the dumugcs 01' injuries ulleged 10 have been susluined by the Plaintiffs, -15. '>, 14' ",-. be; c.:... [ "_1 \ (')~ ~l : .'-- F ..1.. .1 (~< J L'J [''' I 'iil :,It" f w...' f.: lI. , l.:' (j\ 1,' ~ r"" ~ <.""..' r<) c'~ . ~, ~., 0_. <, ~~, ~ :1' L.I" {'-j fEl' " r . .... .' ~..~ ,j I.l U' 0 v, e; . . 3. On 01' IIbout September 30, 1999, Plaintiffs se,ved Responses to Defendants' discovery requests, ^ copy of Plaintiffs' Responses to Defendants' discovery requests lire attached hereto as Exhibit "13" 4, Hem No. 10 of Defendants' Request for Production of Documents requested copies of all of PllIintiff.wife's medlelll reports, hospilalrcports, physicilln's reports and bills concel'l1ing Ihe incident. Plaintifls responded that they were still compiling the medical bills and would supplement their response when the compilation was completed. 5, Item No. II of Defendants' Request for Production of Documents requested ull documcnts recording benefits paid due to the alleged incident. Again, Plaintiffs indicated that they were eompi ling the relcvantmedical records and would supplement thcir response. 6. Item No, 21 of Defendants' Interrogatories requested any and 1111 expenscs, losses 01' speciul damages incuned as a result of the alleged incident. In their response, Plaintiffs again indicated that they were compiling the damages infoJ'lI111tion and would suppleIllenttheir response. 7, After Plaintiffs t~liled to provide full and complete details coneeJ'l1ing their specilll dllll1ages, Defendllnts forwarded a letter on July 29, 2000 requesting that this infoJ'l1Hltion be provided within thil1y (30) days. A copy of Dcfcndants' July 29,2000 cOl'J'espondence is attached hereto as Exhibit "C". 8. Defendants contend that they arc entitled to secure a complete, detailed listing of all of Plaintiffs' special damages, and Ihat said information is rclevant to Defendants so they can accurately assess the value of Plaintiffs' action. Defendants further contend that Plaintiffs huve the burden of proving their actual damages in this case, and have flliled to provide Defendllnts with the requested infoJ'lnation. .2. ElChlbltA Exhibit B .' ,./ ,"'( L:..,. -,l '\.V "\ '_ ') _.1" .. ,Jlll11'/'1I H. MOf;iKO ANlJ EDWAfU> MOSKO, 111m IIUSBAND, PlnintJllt1 IN '/'111\ COUH'/' OF' COMMON I'LI';M CUMBlmLAND COUNTY, I'ENNSYINAN1A v. CIVIL AC'/'ION - LAW CANDACE M.P. S/lANKB, M,O, ANIl PINNACLE IIEAL'l'H HOSl'l'l'ALS d/b/a MECHANICSHURG FAMILY PRAC'J'ICE CEN'J'ER Defendants NO. 99-3,/4 JURY TRIAL IlEMANDED PL,hJ NTIEFS '_.l~.!';SPQN!i!i_TQ__!lliQ.llEST _.l:OHJ~RQ[JU~:TIQJi OF.. DOC!!!,! EN'J'0_nfEQM_DEI'!::tiDAN.'!.'B 1. None presently. 2, Expert r('port.s will be exchanged nt the conclusion of all dIscovery. Please refer to Plnintifl's medical records. By way of further response, no sucll materiols exist other t.han privileged communicHtions between Plaintiffs Hnd tlleir counsel. 3. Plei'1Se refer to Pldintiff' n medicill t~€!c()rds. Expert reports will be exchHnged at tile conclusion of oIl discovery, By Wi1Y of further response, no such other E;tatement>1 exiE,t besides those which are the privileged communIcations between PlaIntiffs and their counsel. 4. Please see PIHintiffs' response to Request. No. 3 above, ~J . Pleasp see PlaintIffs' response to Request No, 3 i~b(Jve , G. Please see PJointiffs' response to Request No, 3 abovo. 7. Curricula vit.ne will be exchnnged nt t.he conclusion of all discovery. 1~;~1929/.JKW H. 'Jo:~:p"'<t ropo'<tn wi 11 bo nxchilnCfnd ilt UI<l cOl\cluHlon of all dincovory. lly wny of turtller '"nSpOl1Elo, thln I:oquent l'xceods tile 1>OI:mIElsi.blo ElCOpO of dincovery under Ponnsylvilni.il Hulo of ci.vi 1 Procedure 4003.5. <), I'lai.ntiftfl hilVO not yot detormInerl wllat documents or otlwr domonstrative evidonco will be intl:oduced or used ilt trlal. Onc,-~ f:llctl dOf-1iqnationr: hilV(\ bPQn m;-ldE-), PlilJnt.it'ffl \</1.1] f;~nuBonnbly BUPP 1 emont th(~ i r response to t.1l I s request in accordance w it.h Cumberland County Pretrial Procedure and t.he Pennsylvilniil Hules of civi.l Procmlure, 10. Plaintiffs merllcill bills conc~'rn.il1q thh1 incident. are st.iU be.inq compilmL Onc(~ such comp.i:lilt.ion lias bool1 complet.ed, Plainti.ff,f:~ will sedsonably supplement thoir rQsponsc~ to this request.. By way of turtller responRe, Plaint.iffs are in possessi.on of t.he followIng medica I records of Pia int.Hf: 1) Hecords of Mecllanicsburg Family Practice - Dr. Candace Shanks; 2) Records of Siegelbaum, Gunder, & I~cey Gast.roenteroloqy ARRoci.at.es - Dr. Paul LaceYi and ~I) H(,cordi; of I'IlYi11l'i,lm; For \vomen'f; "e,lIt.h - Dr, ,John Goodecke. Plaintiffs believe tllat. Defendant is already in possession of all of these records, However, if thi.s i~; incorrect., Plaintiffs will provide a copy of tllo aforementIoned modic"l records at. the Dcfcnd~nt':~ specifi(~ request Rnd expense. 11. Plaindtl'n lIIecl.icnl billn are still beinCj compiled, Once sllcll compilat.ion Iws been completed, Plaint.ift,,, will seasonably ~lllpp] elllont t.hoir responsC' to this roquest. (5) The substance of who said what to whom and the order in which it was said; and (6) Whcthcr that communication 01' any pm1 thcreofis recorded, describcd or relen-ed to in any document (however inforl11a1) and, if so, an identification of such document in the manncr indicated IIbove, (D) If you claim that the subject malleI' ofa documelll 0/' oral communication is privileged, you need not set fOl1h thc briefstatel11ent oftll(' subject malleI' of the documcnt, 01 the substance of the oml communication called for above, You shall, however, otherwise "identify" such document or oml communicHlion and shall state each ground on which you claim that such document or ami communication is privileged, given: (E) Whenever you arc asked to "identify" a person, the following infolmation should be (I) The name, present address and prcsent employer and position of the person; and d) Whether the person has given teslimony by way of deposition or otherwise in any proceeding related to thc present proceeding and/or whether that person has given a statement whether oral, written, or otherwise, and if so, the tille and natme of any such proceeding, the date of the testimony, whether you have a copy of the transcript thereof, the name of the person to whom the st~ltement wus given, where the statement is presently located if written or otherwise transcribed, and the present location of such transcript 01' statement if not in your possession, (n The term "you" shull be deemed to meun und refer to the party to whom these Interrogutories IHI\'e been propounded for answer and shull ulso he decmcd to rcfcr to, but shall not be limitcd to, your uttorneys, consultants, surcties, indclllnitor, insurcrs, investigators, and any other ugents insofar as the Illaterial requested herein is not privileged, The terlll "you" shall also be dccmed to rcfer 10 I'lailllirJ(s), (0) The word "incident" shull be deemcd to mean and refer to the incident as alleged to have OCCUlTed and as set forth in your Complaint. I'ERSOMLMCKGROlJND 1, State your full name, dale and place of birth, present residence, Social Security Number, and marital status,hoth presently and at the time of the incident. 1. Judith R. Mosko, DOB: 6-14-1938, Cllrlisle, "T>., Residence 308 Keith Rd" Mechanicsburg, PA 17055. SSN: 204-28-1465. Married presently Hnd at time of incident. .). 4, Please list all flll11i1y physicians or other medicllllJrllctitioners with whom you 01' IIny person lIeting on your hehalf have consulted in the past ten (10) yeurs for general, physical or I11cdical eOl11plaints during your lifetillle, stating the last known address of each such physician and the period (dates of first and lasl eonsult), 4. 1979 to 1996 Sherman Assoc., Erford Rd., Camp Hill, PA _ Gynecology. 1996 to present Physicians for Womens Health - Dr. John Goedecke and Dr. Rose Eskin - Gynecology, last visit 3-2-99. One Lemoyno Square, Lemoyne, PA. Mechanicsburg Family Practice - Main St" Mechanicsburg, PA _ General practice family doctors. Then they moved to 122 S. Filbert Street. Then she referred me to Dr. Paul Lacey of Seiglebaum, Funder & ~acoy Gastroenterology Assoc., 2626 N. 3rd st, Harrisburg, PA from 3-97 to present. Last visit June 11, 1999. Neurologica 1 Surgery - Dr. Barry Moore. Right hHnd surgery for carpal tunnel. Last visit 3-92. Crumay Parnes Dermatologist - Dr. Orman, Erford Rd., Camp Hill, PA. Last visit April 1999. 5, For a periud often (10) years iml11ediatcly preceding the date of treatment, surgery, or examinationrefen-ed to in the Complaint, please state: (a) The name and address of each of youl employers or, if you were sell~employed during that period, eaeh of your business addresses and the name of the business while self.employed; the pcriod of employment; thc position held; the nature of work heing perfonned; the name of your il11l11ediate supervisor; and (h) Your live rage weekly earnings from each emploYl11ent or self.employment, the average nUl11her of hours worked by you per week in each employment or self.en1ployment, and the amount of ineome from emploYl11ent 01' sel f.employment reported on your fedeml ineome tax return for eaeh year, See attached. 6, If you have engaged in one or more gainful occupations after thc date of the treatment, surgery, examination, or events referred to in the COl11plaint, please state: (a) The name and address ofeaeh ofyolll' employers or, if you were self.employed, eaeh of your husiness addresses and the name of the business while sell~employed; the p<:riod of .5- /" Q ~"c,. ,,sQtI\R"--- j\\\of\wY 10f Defendan\s c~nd\\ee M r Sh\\n"f" M,D., \\nd P\I\n\\c\e H~\\\~h HOSP\\\\\s d1\'>/\\ Mcch\\n\cSb\\f\!. r\\n\\\Y Pf\\C\\ce Cen\Cf , ' I \I\in\!. C\\p\io\\ 01 \\\C . \!'" ,\",~ "", ,', ",rt " _..,hi'" "" w" · "d. Y'~ , ' C\\se and \he diSPosition of s\\\\US 01 \hC n,\\\\er, Respec\fullY sub\\\i\\cd, pOS'\' &. SCHf.\_L, P.C, ", ' .\4. ExhlbllC '.. tll ~ 1':1; - ":.J: ~. " ~'.l'~ II 1" ; :: <,",." " , ;.') 0,': c ) :::e it" ! ~ ..t.:\~ ~~ :.,' ( , ',,,- 'J ~j' ,/J r'"- , ,- L'j ~ ';:' 1.1, , , "') 1:" :[) tJ, "[', I~ , : (.., 'to , , C) 1~) U C.) (J I' " ~ .. III. ARG.llMEl'ff: Pennsylvania Rule ofCivill'rocedure 4005 allows n pllrty to servc written intcn-ogntories to be IInswcred by any other party, The answers to interrogatorics must be in writing lind, unless ohjecled to, must he answered fully and completely, Pa, R,(',P, 400(1. If a party fails to serve answers or ohjcctions to written interrogatories, Pennsylvania Rule ofCivill'rocedure 4019 allows the court to sanetion that party, Pcnnsylvania Rules of Civill'rocedure 4009 allows a party to scrve upon any othcr party a requcst to inspcct and copy any designated documents within the scope of Rules 4(0), I through 400),5 inclusive and which arc in the possession, custody or control ofthe party upon whom the requcst is served, If a party fails to respond tothc request for production of docul11cnts, Pa, R,C.P, 4019 allows the Court to sanction that par1y, 1'1ainti ffs were scrved with Defendants' Interrogatories and Requcst for I'roduction of Documents on or ahout March 4, 1999, When discovery requests are not complied with, Pa, R,C,I', 4019 establishes a l11andatory procedure to he followed, When a party fails to l'omply with a request for discovery, "a motion must be presented to the Court to determine the default, Upon finding that a defaullhas occun-ed, the Court l11ay, , , make an appropriate Order," ROIlliUt','>_I'car1s1cill, 329 I'a, Super, 392,478 A,2d 845 (198.) citing (JonzaleS.Y..PlllCucio13roUlcra'I.ruding..compauy, 2681'a, Super. 245,47 A,2d 1338 (1979), Within its discretion, the Court l11ay enter an Order rcfusing to allow the non.complying party to offer tcstimony or any other evidence designed to support the non.complying pnrty's claim or nny other sanctions liS the courl deel11s just. Willrulness is not a precedent to the il11position of .). .. sanctions, IInd a Court may impose sanctions even if the failure to eOl11ply is not willful. SJ:c ROlllWl, 8I1P/'(/, at 848, Scc.lI1sa, I'a, J{,C,p, 4019 explanatory note. 1978 parugl'llph 2, "In prnetice, however, sanctions Ill!' fllihll'c to rcspolld 10 discovery requests arc gcncrally not imposed until there hilS been II refusal 10 comply with a Court Order directing cOlllplianee," DilllLY._Gradluuc.1iaspilaLoLUlc l111ivcrsiIY-Ofl'cllllsyl'r'a.lua, )(,0 I'a, Supel'. 416, 520 A.2d 876 at 882 (1987), Defendants contend that they arc entitled to sccure a complete, dCllliled listing of all of I'laintiffs' special damages, and that said inforl11ation is rclcvant to Defendants inaccurately assessing the value of I'laintiffs' action, Defendants further contend thatl'laintiff.s have the burden of proving their actual damages in this case, and have failed to provide Defendants with the requested inforl11ation, As such, Defendants' only recourse at this point in til11e is to ask the Court to enter an Order directing the I'laintiffs to cOl11ply with Defendants' request lor special damage infonnation, or he precluded from introducing expert witness testimony at trial regarding same, IV. CONCLlISION: Discovery is necessary to allow the pll11ies to adequately prepare for trial, and in II negligence action, such as the instant case, the special damages inforl11ation is extremely important to Defendllnts to IIceurutely assess the value of I'laintiffs' ease, I'llIintiffs' failure to produce said inforl11l1tion hinders Defendllnts' ability to move forward and l11ake such IIn assessl11ent, thereby forcing Defendants to incur additional legal fees, Therefore, it is respectfully requested that this Honorable Coul1 enter an Order grunting Defendants' request and order I'lainti ffs to provide fit II and complete detnils concerning their special dal11ages, or be precluded from offering testimony, .4. III. ARGUMENT: I'ennsylvuniu Rule of Civil Procedure 4005 II110ws II purty 10 serve writtenlnterrogutories to he unswcred hy any other party, The unswers to interrogutories must he in writing lind, unless ohjected to, must he unswered fully und completely, I'a, R,c,l', 4006, If u party fuils to serve unswers or objections to written interrogatories, Pennsylvania Rule of Civil Procedure 401911110ws the courl to sanction that party, Pennsylvania Rules of Civil Proeedure 4009 allows a party to serve upon any other parly II requesl to inspectund copy any designated docul11ents within the seope of Rules 4003,1 through 401J).s inclusive and whieh arc in the possession, custody or eontrol of the party upon whom the request is served, Ifll pm1y (ilils to respond to the request for production of documents, Pa, R,C.P, 401911110ws the Court to sanction that party, I'Jaintiffs were served with Defendants' Interrogatories ami Request for Production of Docul11ents on or ahout March 4, 1999, When discovcry requests are not complied with,l'a, R,C.p, 4019 establishes a mandatory procedurc to he followcd, When a party IIlils to comply with a request for diseovery, "a motion must hc presentcd to the Court to determine the dcfault, Upon finding that a default has occun-ed, thc Court may, , , make an appropriate Order." R0l11l111_v.l'carlstclu, )29 Pa, Super. )92, 478 A.2d 845 (1984) citiug GOllZUlcsv.l'rocucioBrolhersTrucking l'omp,UlY, 2hS Pa, Super, 24S, 47 A,2d 1 D8 ( 1(79), Within its discretion, the Court mllY enter an Order refusing to allow the non,col11plying pm1y to offer testimony 01' any other evidence designed 10 support the non.complying party's claim 01' any other sanetions as the court deems just. Willfiilness is not a preeedentto the imposition of .). sanctions, and a Court may impose sanctions l'ven iftlw fllilure to comply is not willfld, See Roman, .\'11/1/'(/, ut 848, See also, I'a, R ,C'. 1', 4019 explanatOlY note. I 'l78paragl'llph 2, "Inpl'lletiee, however, sunelions for Illilure to respond to discovery requests arc genel'lllly not imposed until there has been a refusal to comply with a Court Order direcling cOlllpliance," Dion v.Graduate Hospital unite UuivcrsityufPcllllliylvwlia, )(,0 I'a, Supel'. 41 (J, 520 ^,2d 87t> at 882 (I (87), Delendrlllts contend that they arc entitled to secure a cGlllplete, detailed listing of all of Plaintiffs' special damages, IInd that said infolllllltion is rclevant to Defendants in accuralely assessing the value ofl'luinliffs' aclion, Defendants further contend that Plaintiffs Iwve the hurden of proving their actual dal11ages inlhis easc, and have failed to provide Defendants with the requested information, ^s such, Defendanls' only reeourse at this point in time is to ask the Court 10 enll~r an Order direcling the Plaintiffs to comply with Deflmdants' request fell' special damage inllmnation, 01' he precluded from introducing ex pCI'I witness testimony at trial regarding sallle, IV. CQ!IICLUSIOJ'lll DiseovelY is necessary to allow the parties 10 mlequalcly prepare 1'01' trial, and in a negligence action, such as the inslant casc, the special damages information is extrcl11ely important to Defendants to accurately assess the value of Plaintiffs' case, Plaintiffs' failure to produce said inllmnation hinders Defendants' ahilily to Illove lelr\vard and make sueh an assessment, therehy forcing Defendants to ineur additional legal fees, Thercllll'e, it is respectfully requested that this Ilonorable Court enter an Order granting Defendants' request and order I'laintiffS to provide fullund completc details concerning their special damages, or be precluded from offering testimony, .4. " ), During this deposition, I'laintifl:wife tcstil1ed that she belonged to a prill1l1ry biliary cirrhosis support group based in Canada, She further testificd that she had in her possession a collcction of booklets, Iitel'llturc and newslettcrs regarding primary biliary cirrhosis, Sec tcstil110ny frol11 Plaintiff.wile's Novcll1hcr ! 5,2000 deposition transcript I'age )5, which is attached hereto as Exhibit "A", 4, Counscl for Defcndants requested thatl'laintiff.wife provide a copy of the literaturc in I'laintiff.wife's possession to her attomey, and that this infol'lnlltion be prodaced to Dcfendants' counsel. See testimony fmm Plaintin:wife's November 15,2000 dcposition transcript, Pagcs 37.38 and 109.110, which lire attachcd hereto as Exhibit "B", 5, During Plaintiff.wife's deposition, she also testified thut she had a lilc in her posscssion, for which she had made notes and/or writings winch lire rcluted to the c1uims mlldc in this litigution, Sec testimony from Plaintiff.wife's Novcmher 15, 2000 depositiontrunscript, Pages 66.67, which arc attached hercto as Exhibit "C", 6, Counsellor Defcndants again rcquestcd that I'lainti ff.wi fe provide a copy of thc filc in her possession to hcr IIltorncy, and tlmtthis infol'lnution be produccd to Defendants' counsel. Sec tes!il11ony from I'laintiff.wifc's Novemhcr 15,2000 dcposition transcript, I'ages 66.67 and 109.110, whieh Ul'C attached hereto as Exhibits "C" and "B", respcctively, 7, At the deposition, Plaintiff.wi fc fL1I1her tcsti fied that shc underwent yearly cholestcrol profile studies done at outsidc laboralories hctwecnthc years of 1995 and 1997, See testimony from Plaintiff.wire's Novcmber 15, 2000 deposition tl'llnseript, I'ages 75 and 84, which ure attachcd hcreto as Exhibit "D", -2. 8, 011 or uhout Novcl11her 17, 2000, und immediately following Pluintiff.wifc's deposition, cOllnse1 for Defendants served Plaintiffs with u SlIpplcmcntal Requcst for I'roduetiol1 of Documcnts addressed 10 I'laintifIs sccking copies ofthc previously requcsted hoo~lcts, ncwslcllcrs and litcrature frolllthc pril11ary hiliary cirrhosis support group, as \\'cllas all writings, documcnts, notes. diarics, calendars, cte, maintained in II home filc hy the Plaintiffs, A copy of Dcfcndants' Novemhcr 17, 2000 Supplcmental Rcqucst for Production of Documcnts is allllched hcrcto as Exhibit "E", 9, Counsel for Defcndants scrved a sccond Supplel11cntal Rcqucst for I'roduction of Doeumcnts to counsel 1'01' Plaintiff~ seeking copics of the yearly hlood studies from 1995, 1996 and 1997, as dcseribed in Plaintiff.wife's tcstil110ny of Novel11ber 15,2000, A eopy of Dcfcndants' Novembcr 21, 2000 Supplcmcntal Requcst for I'roduction of Docul11cnts is attached hcreto liS Exhibit "F", I 0, To dute, thcse discovery requcsts rcmain outstanding, II, Pursuant to I'a, R,C,I', 4009, 12 (a), lhc answcring party shall servc a copy ofanswcrs uod ohjcctions, if ~lI1Y, within thirty ()(J) days ancr the scrvice of the requests for production of doeumcnts in question, 12, Defendants are prcjudiced by Plaintiffs' lack of response to the requested discovclY infonnation, as thcy havc hccn precluded from aSLCrtaining thc IHlture ofl'laintiffs' claillls or gaining the neccssary information to further the course of thc instant litigation, I), Since I'laintiffs havc failcd to rcspond in accordance with the Rules of Civil I'l'Occdure, it is rcspectfully rcquestcd thut this Court issuc an order dirccting I'laintiffs to provide .). EKhlblt A 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 35 Q. Do you have a fHe or keep a collection of information on PRC? 1\. I belong to a SUpport group out of Canada t:hllt constantly sends me booklets and information and I get all the literature I can get from libraries on it. Q. All rtght. Have yoU made any notes or made any wrtttngs of any type concerning the events surrounding your visits to Mechanicsburg Pamily Practice or your cirrhosis diagnOSis? A. I don't understand the question. Q. Okay, have YOLl written out or typed out anything or key boarded on a computer any of the information surrounding your diagnosts or the treatment you've received either from Dr. Lacey or any other physician or anyone from Mechanicsburg Family Practice? 5 A. You're aSking me if I made notes? Q. Yes. A. I've wrote down dates when I discussed it with my attorney. Q. Now when did you first write down dates? A. I think it would have been' 9 __ I CAPITAIJ COURT REPOR7'ING " Exhibit B 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 37 1 2 3 4 K-I-N. Q. All right, and how long has she been your gyn~cologist? A. Well I've been seeing Goedecke who was Sherman Associates that went in with this Women's Healt h. 5 Q. Okay. Well how long has Dr. Eskin been your gynecologist? A. About three years. Q. By the way, did Dr. Lacey or any of the doctors at his practice ever criticize the care you received either by Dr. Shanks or anyone of the doctors at Mechanicsburg Family Practice? A. Never. Q. How about your gynecologists, either Dr. Goedecke or Dr. Esken, have they criticized the care you got at Mechanicsburg Family Practice'? A. Never. Q. Has any doctor ever criticized the care that you received at Mechanicsburg Family Practice regarding your health care overall or your liver and cirrhosis disease in particular? A. No, Q. I'm going to request through your CAPITAL, COURT REPORTING 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 109 1 2 3 4 Qi 'rhis would be your opportunity. A. I don't think so Q. Okay. If you remember something later on after we're done here today that I've asked you and you couldn't remember today but mllybe later on you do.,. 5 A. uh-huh, Q. Would you please" . A. Do you want me to bring you all those newsletters from Canada? Q. ~o, what I'd like you to do is I'd like you to give them to your lawyer. A. Oh, Q, You don't have to bring them to me. A. Oh. Q. I'm going to ask him to make copies, and I think you said you '- whatever you told me you told me but for some reason I think you said you had some sort of notes that you've made. 1~ose are the kinds of things. A. I just have copies of my records from the family practice, which you have. Q. No, you don't need to give me copies of your medical records again, that's just a lot of CAPl'fAl., COURT RI';POR'I'ING .. 110 1 materials. 2 A, That's about all I have. 3 Q, Fair enough. 4 A, And the newsletters. 5 Q, Fair enough. 6 A, Some newspaper articles on PBC, 7 Q. Okay. You can certainly -_ your 8 lawyer and you will review that int:ormation and he'll 9 provide me with. . . 10 A, You want me just to give you what I 11 have and you can decide? 12 MR. BARRICK: (Indicates yes) . 13 BY MR. Bl,ACK: 14 Q. Okay. Any things, any activities 15 that you enjoyed doing before you learned of your 16 liver diagnosis that you have not been able to do 17 since you've become aware that you have contracted the 18 disease, anything in your lifestyle that has changed i9 that you haven't told me about yet? 20 A, No, other than I'm tired and it's 21 just like you push yourself. 22 Q, For instance, were there hobbies that you 23 used to, you know, do? 24 A, Well we used to go out dancing a lot, CAPITAl, COllR'f REPORTING Exhibit C 6'1 1 t:Iwn 11l~ can turn them over to 11I0, Will you fJafegllard 2 them? 3 A. Yes, <1 Q. And to the extent that there lIIay be 5 information in the mllterials that we've discussed 6 today that I don't believe I have neon I'm reserving 7 my right: to ask you to COllie back to test i fy in the 8 event, although It'8 unlikely but in thA event th(H'e 9 in inforlllation in the materials you have at hOlllo or 10 elsewhere that I'vA asked to be produced, in tho event 11 thone matcrialn raino qllentiollfJ that I have not been 12 able to cover today bccausA 1 don't know what's in the 13 materJ.alB, 14 Now the office vinlt that you had :In 1.997 15 with Dr. Shankn that you began to tell me about 16 already, what occurred at: that office visit? 17 A. w(,l.l when I wont in nhe was 18 explaining - - well :r iwked why it: took two yeanl and 19 three monthn to tell mc about: tho problem I had, She 20 explained that, about: tho file clerk, il new filo cl.erk 21 going over the files, again, not.iC'ing that: it was not 22 .initialled and, t.herefore, it: wan not: discuB80d with 23 me. And at that. point tho now blood work still 24 indicated the liver fllnct.ion t.est Wiln high and she CM'ITI\IJ COUf!'1' HP,PORTING Exhibit 0 !:lIhlhll C Exhibit F . litcrature lInd newslellers regarding primary biliary eil'l'hosis, I ('ounsellbr Delondunls reque~ted that Pluintifl~wile provide II copy of the litcrature ill her posscssiollto hIlI' lI11ol'l1ey, ulld thlltthis infonnution be produced to Defmulants' counscl, During Plaintiff.wile's dcposition, shc also tcslilied that she had a file in hcr possession, lor which sbe had made notcs and/or writings which arc relatcd to the claims Illadc in this litigation, Counsel for Dcfendants again requestcd that Plaintiff.wilo provide a copy of thc file in hcr posscssion to Iwr allorney, and that this information be produced to Defendants' counscl. Plaintiff. wife further testified that she underwcnt ycarly cholesterol prolilc studics donc lit outside laboratories between the years of 1995 and 1997, On or about Novcmber 17,2000, mul immediatcly following I'hlintiff.wifc's deposition, eounsel for Defcndants scrved Plainti ff.~ with a Supplemental Request for Production of Documents addrcssed to I'laintiffs secking from I'lainti ffs copies of thc previously requested hook lets, ncwsletters aud literature fl'omthe pril11ary biliary cirrhosis sLJpport group, as well as all writings, doeul11ents, notes, diaries, calendars, ctc, maintained at I'laintiffs' home in file, Counscl for Defendants IIlso scrved a second Supplemental Request flll' I'l'Oduction of Doeulllents to counsel for Plaintiffs seeking copies of the yearly blood studies fhllll 1995, 1996 and 1997, as dcscribed in I'laintiff.wife's testimony, Tn date, these diseovcry requests remain outstanding, True and correct copics of Dcfendants' Exhibits arc allllched to Defenclill1ts' Second Motion to Compol. -2~ or IIny other sanctions as the court dcems just. Willl\ilncss i~ not u prccedent to the imposition of sanctions, und a Court l11ay impose sanetions cvcn il'thc fitilure to comply is not willl\ll. See ROJllllll, SUpl'll, ut 848, Scculsu, I'll, R,C,I', 4019 cxplanatory note. 1978 paragmph 2, "In practice, howevcr, sanctions l'or Iililure to respond to discovery requests arc generally oot imposed until there has been a rcfusalto cOlllply with a Court Ordcr direeting compliance," Diullv.-UrilduutcJluspHuLu.tlhc Univcrsity o[l'cnllsyil'ullia, )60 I'a, Super, 416, 520 A,2d 876 at 882 (1987), DefClllhlllts contcnd that they arc cntitled to thc documcnts rcquestcd in the Supplel11ental Requests, and that said docul11entation is relevant to Defendants as thcy havc bccn precluded li'ol11 ascertaining the nature of I'laintiffs' claims 01' gaining the neccssary inf'ormation to furthcr the course or the instant litigation, As such, Defendants' only rccoursc at this point intimc is 10 ask the Courlto enter an Ordcr directing thc Plaintiffs to eOlllply with Dcfendants' Supplemental Rcquests, or be precluded from introducing expcrt witness testimony at trial regarding samc, IV. CONCLUSlO.N: Discovcry is nec(:ssary to allow the partics to adequatcly prcpare for trial, and in a negligence action, such as the instant case, the documcntation rcquestcd is cxtrcl11cly important to Defcndants to accurately ascertainthc nature or I'binti ffs' claims 01' gaining thc ncccssary information to further the course of this litigation, I'laintirfs' lililurc to pl'Oducc said inforl11ation hinders Delendants' ability to move forward and make sueh an asscssment, thcrcby forcing Defendants to incur additional legal fees, ThcrefoJ'(\ it is respcctfully requeslcd that this Honol'ablc Court enter an Order granting Defcndants' requcst and ordcr I'laintiffs to pl'Ovidc the complctc dnclll11entation rcqllesled, or be .4. POST &. SCHELL, P,O, Ar'c.H\NI!Y~ Ar l.AW a4Q C3A.HW\lIBW .~ve~HIII CAMP Hill. PA 1701 1 *tl~--=" * " 1tl/I1ir.,,-- --... 1 870 l),S, pOSTAm: P B Z Z 1 3 877 9524' '00.340 Z 7 5 6 MAilED fROM liP CODE 1 7 0 11 Vicki A, Bolinger I'al'lllegal I'OST & SCHELL, I',C, 240 Gl'undview Avenue Cmnp Hill, PA 17011 1,,,111,,,111",,,,11,,,1111,"1 POST & SCHELL, P,C, AtTOFlNIIVe Al LAW 240 (3RANtJvIIW AVI!N~JI! CMlP ....II~\,., PA 17011 '<' '" II .. .. . olt". It .. . *1'.jf~---"'.:::L..l:1-\Ii",".~:tl . ,*,,'" 12m1P'~...... ...."".....,...., 1 6 1 0 U's,I""'TAtlE P B 2 2 1 3 87 7 I 95'4"t'(m.340 I 2 7 5 8 MAILED FROM ZIP CODE 1 7 0 11 Duane S, .Barrick, Esquire ANGINa & ROVNER, I',c. 4503 North Front Strect Harrisburg, I' A 17110 1",11I",1",11,,,1111,,,11,,.1 '1-.... \.0 ~...- jy, <'( f; r-~ , (}) I , .~~ (', 1 .,') VJ. :; '1.." " , , " , " .' 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(, , ~t~ I I.: ,r,1 l .- , (".1 ) , ":J (,) " ",,' ~S on be\l..1.f ot }:'It.1I ~u.CI. tS . --- ~ttot1'e" tot: ntftl\ll/lll'f CO~O~"'Lorl-l co\J~'l''i' at" olr pt!:~~6"{L,,,"'N-:r.J'o. c u1-'1e.l!: p..L".t~P eouv.1 of eo\oll'\OIl P\....~s \11 1"'" ~11tR OV\ J\J'O\ 1\1 R. \<IOS ~o 1til'\. e~S'" 110\ 99-~1. cwtL S"^II~S, \<I,D. U1\POE~ 'to PRODUCE ~~tftS t.1I.!! "",'C' 0' ,....... TO~$.iirTO~ ~~tJ9~ 0ISCO u=~- \4f.DlcAL ~co9J)S Ii ,.v.'tS ,..... ,. ,...., .... """" -"" . ""." ,""1<"'.... -" -..; """" -"" · ""." S ttGf,L~~U\'\ t.1ID GAlltltR G~s . .. ,- 0<0'.'" ,,,,,,,, -" ~ "'..... .. .,,,,' · ~- ~~\;;~,~~~';~ ,;,,;:,~~0.~~[,~:?~;~' ::I~,.''''' .. .b""'" ,. ," .~.:'~" ........ .., .. ....... ....~,~ ...t~ed o~ ~.,.:.';':~:;;f ,;-:,:..., .. .~'~ ~::::' b~""';::';':"'~-:; '''~, cO\l,e6 old and tetute1l\1!o 6- t\l.e 6tt.c\l.ed coun6e cat \<\CS oUl.ce. 'O~1EI 0212112002 .~S' _ 65066 eel y;'It.1I ~~cl.. ESQ. _eaatdl.n& t\l.1.6 .-ttet. contact /lJ\l l\ue6tton6 . .. 1\1t ~S G\l.OlJ\' tlle. \60\ ~'I: S'f\l.l!.t'f '600 l?\\lVJlEL?l\U' I?~ t910~ (2\!l\ 2~6.0900 nt.02-119!l~!l 87478-CO). CERTIFICATE PREREQUISITE TO SERVICE OF A SU8PO~MA PURSUANT TO RULE 4009.22 COURT OF COMMON PLEAS IN THE MAT'tER OFI TERM, JUDI'tH R. MOSKO CASE NOI 99-374 CIVIL -VS- SIIt.NKS, M.D. As a prerequisite to service of a subpoena for documents and things pursuant to Rule .009.22 MCS on behalf of EVAN BLACK, ESQ. certifles that (I) A notice of lntent to serve the subpoena with a copy of the subpoena attached thereto was malled or delivered to each party at least twenty days prior to the date on which the subpoena ts sOllght to be served, (2) A copy of the notice of intent, including the proposed subpoena, is attached to this certlficate. (3) No objection to the subpoena has been received, and (4) The subpoena which will be served ls tdentical to the subpoena which ls attached to the notice of intent to serve the su~poena. MCS on behalf of DATE I 0~119/2002 EVt.N BLACK, ESQ. Attorney for DEFENDANT DF,1l-317788 B747B-L11 JUDITH R MOSKO and EDWARD IN THE COURT OF COMMON PLEAS OF MOSKO, her husband, CUMBERLAND COUNTY, PENNSYLVANIA Plaintiffs NO, 99-374 v, CIVIl. ACTION - LAW CANDACE MF SHANKS, M,D, and JURY TRIAL DEMANDED PINNACLE HEALTH HOSPITALS d/b/a MECHANICSBURG FAMILY PRACTICE CENTER, Defendants , . STIPt!LATIQt<! TOWlTHPAAW QI,AIMS. flORLOSSOflOON80RTIUM IT IS HEREBY STIPULATED and agreed by and among all parties and their counsel that all claims of Edward Mosko are hereby withdrawn with prejudice, AN.'! .~VNE., .,C. By: \. tf: [jL James DeCinti, Esquire 4503 North Front Street Harrisburg, PA 17110 Counsel for Plaintiffs THOMAS, THOMAS & HER, LLP , ''') / By: Date: 1-1/3/0 L Evan Black, Esquire 305 I~orth Front Street Harrisburg, PA 17101 Counsel for Defendants Date: ,//5/ 0 ~ (,. Discovery continued throughout the yeilr 2001, 7, On FehrUill'Y (" 2002, PIllintiff.~' counsel provided defense counsel with the report of the expert intended to he eillled ilttriill for liilbility and Cllllsiltion. I:!QQ, Exhihit A, 8, On April 17. 2002, Plaintiffs' counsel again wrote to defense counselusking thilt the relllaining discovery he concluded sothillthe CilSC could he resolved in the yeilr 2002, See, Exhihit B, 9, Unfortunately, the partics have not hccnahle to flnali:(.e the remilining issues of discovery, 10. As such, Plaintiffs respeellhlly request lhallhe Courl schedule il sliltUS confcrencc for thc purposc of assisting thc Pilrties in hringing this Cilse to a flnill resolution hy establishing a diseovcry dcadlinc, a deadlinc for the exchange of expcrt rcports, a deadlinc for thc f1Iing of dispositive Motions, ifany, and in selling a trial datc, II, Plaintiffs counsel is Jamcs DcCinti, Esquire, Angino & Rovncr, P,c., 4503 North Front Strcct, Harrisburg, Pcnnsylvania. and his telephonc numbcr is (717) 238-6791, 12, Dcfcnsc counsel is EViln Black, Esquirc, Thomas, Thomas & Hafer, LLp, 305 North Front Strect, Sixth Floor, 1',0, Box 999, Harrishurg, Pcnnsylvaniil, and his telcphone numhcr is (717) 237-7100, 2 -..... ,. I, . ,,- illl () I folll DANNY G, HECKENDORN AND DEBRA S, HECKENDORN, Plaintiffs IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO, 99-3162 CIVIL TERM CIVIL ACTION - LAW IN CUSTODY v, JOSEPH R MATCHESON, Defendant GUIDO, J, -- TEMPORARY ORDER OF COURT AND NOW, this ~,J day of July, 2002, upon consideration of the attached Custody Conciliation Summary Report, it is hereby ordered and directed as follows: 1, The Plaintiffs, Danny G, Heckendorn and Debra S, Heckendorn, shall have full legal and physical custody of the child, Joseph R Matcheson, Jr., born December 2, 1997, subject to periods of supervised visitation with natural Father, Joseph R. Matcheson, as follows: A, For a period of two (2) hours on the folloWing dates: July 13, 2002, August 10,2002, September 7,2002 and October 5,2002, These visits shall be supervised by Plaintiffs and shall occur at the LeTort Park, to commence at noon, unless otherwise agreed, In the event that Father has not appeared for his arranged visit by 12:30 p.m" the Plaintiffs and child are free to leave, If the parties change the time of the visit by mutual agreement. Plaintiffs may leave if Father has not arrived within half an hour of the agreed upon time, In the event that Father cannot attend his scheduled visit, he shall provide notice to Plaintiff's counsel seventy-two (72) hours in advance of the scheduled visit. 2, The Custody Conciliation Conference shall reconvene on Wednesday, October 9, 2002 at 1 :00 p.m. at the office of the Custody Conciliator, Melissa Peel Greevy, 301 Market Street, Lemoyne, Pennsylvania 17043, At the time of the Conference and as per the agreement of the parties, further expansion of Father's custodial time shall be considered, 3, Plaintiffs shall consult with a mental health professional, such as a licensed clinical social worker or licensed psychologist regarding the appropriateness of what to tell the child about the various roles that these adults play in parenting him and in particular whether it is helpful for Plaintiffs to identify themselves as aunt and uncle rather than mother and father, whether it is helpfUl to Inform the child that the Defendant is the father, and the potential Impact of changing the name by which they refer to the child, To the extent that ( , ,1111 II J rroO? DANNY G, HECKENDORN AND DEBRA S, HECKENDORN, IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 99-3162 CIVIL TERM Plaintiffs v. CIVIL ACTION - LAW JOSEPH R MATCHESON, IN CUSTODY Defendant CUSTODY CONCILIATION SUMMARY REPQBI IN ACCORDANCE WITH CUMBERLAND COUNTY RULE OF CIVIL PROCEDURE 1915.3-8, the undersigned Custody Conciliator submits the following report: 1, The pertinent information concerning the child who Is the subject of this litigation Is as follows: NAMf DATE OF BIRTH CURRENTLY IN THE CUSTODY OF _Joseph R Matcheson, Jr, December 2. 1997 Paternal Aunt and Uncle 2, A Custody Conciliation Conference was held on June 24. 2002 with the. following individuals in attendance: the Paternal Aunt and Uncle, Danny G, Heckendorn and Debra S. Heckendorn and their counsel, Lindsay Baird, Esquire; and the Father, Joseph R Matcheson attended pro se, The Conference was reconvened as a result of a letter Mr, Matcheson wrote to the presiding Judge, Edward E, Guido, seeking to modify the Order of July 14, 2000, 3. Father is presently employed at the Harrisburg News Company from 7:00 a,m, to 3:00 p.m" Monday through Friday, while he continues to reside at the Capital Pavilion, which he describes as a private prison, Father is presently on parole for writing bad checks, He hopes and expects to be released from the Capital Pavilion on or about July 1, 2002, Prior to his transfer to the Capital Pavilion, Father had been incarcerated at SCI Dallas, Father states that he is seeking temporary supervised visits two hours a month at the home at the Plaintiffs, However, his longer term goal Is the transfer of the custody of the child to him or joint custody with the Plaintiffs, 4, The child's biological mother apparently has had rights terminated pursuant to an order of the Florida court which was not provided at the time of the Custody Conciliation Conference to the Conciliator. Jud!1e Guido's present Order provides full legal and physical custody to the Plaintiffs, The paternal aunt, Debra S, Heckendorn, Is presently employed outside home on a 3:00 p.m, to 11 :00 p,m, shift, and husband works day shift, by their ~ M~~~~~~ I.,.....V. -l;Il" ""'1 .'9....'....'....01. OR JOHN B OOEoECYE SHERMAN ASSOCIATES U4 ERFORo RD CAMP HILL PA lall ACCESSION, X42vn;; AOEIooal 5b,0bI14/~9 SfllF PHoNEI 717-n7-bn~ DRAWN, 1~/Z4/'4 NO TIME 10: REf: 204~814b~ ZOOllTATI HILL ROAD IUlTllDO WVOMIIIlNQ, PA 11110 (110) 371.1100 "he blOOCl Ie" cen'...e" JII I'.. In PA 00) 222.~~g3 ("0) 37..IOgg ,17 7bJ-8111 ASI'INO" /'Y ^/ .f . (1 ~I V G~J).1 uRESULT-- 6f'L --UN 1 IS-- 4 ~ 01 ~ --TEST-- --RfFEH~NC~ RANOE-- . ..-.-..._---_.~~---, --~"-- .~..-._--~-_._--------,-~-_._...._._,--'".-.. ,', GENERAL HfAL1H PROFILE CHeMISTRY PROFILE GLUCOSE ~~ MOIDL UREA N I TRDGEN I b HO I DL d. ,_CWUN1NE--,.___., __'.._"'0' I 1..n._,__lUl/nl PUN/~HtAllN'NE RATIO 10 URIC ACID 0, ill SODIUM 1~8 POTASSIUM 4.:- CHLORI DE 104 __UCAlllllUl.u.E-1UlU._. __,,_ -_"._.. , .____.",...;u._ ANION GAP ,I~ ,.... ) CHOLESTEROL (;:;09 HJ.-'/ MG/PL lR10LYCEAIDES ~ MOIDL TOTAL ~ILlHU~lN </1.7 MO/OL ALKALINE PHU~PH~II\,t :i!!'BJ7 HI UIL ::'/~~--::~~~~q~:----,.. - .--" -_.--,- _.__._~~:-..1t:;-_._~~~ ..~IPI~D IH U/L 110-2J0 7.~ O/DL b.e'U,~ 4.1 G/DL 3.~-5.~ " u. .___,J>UJ~'" I ~ ,__,__...,...... ...,.,... mo,_ ..,,-----J-L--._,_..___.-4J.QL_,_________-2..a~. :".._.__.._ 1.2 1.~.2.~ 9.1 MO/DL 8.~"1~.~ 1.9 MNOL/L I.~";:.' q,1l\ MO/DL 2.~-~.0 OS-lt5 tfAtT ItW: 8-25 .... ....._...,,_..Jl..5.d.S 9-24 MU/UL MEU/L HEQ/L NEalL JStIll-l.-_... Z. 4,- j', ,. 13~-149 3.5.5.5 ,~.. t I:! .U:,:l~", 9-24 IIP-200 1 ~ -I i'~ ~, 1'1. 2 30- 14,1 .....:1. -:A ~ 5-b~ LUH rOTAL PROTEIN ~LUUMIN AID RATIO CALCIUM IONIZED CALCIUI1 lNORG~NIC PH05PHORUS .. ....... .. .._...~... ....__._._.__........_,.._..,...__-L---__.____...._ CORONARY R18~ A88!88MfNl HOL CHOLESTEROL CHOLt~TEROLfHDL RATIO HI MG/DL 41l\-B0 BELOW AVEKAClE R I St: I <: ~ AVERA8E RISKIJ"~ ABOVE AVERAGE RISKI ~.9 ----lUJili..B.LJ(l",_____."".,), , . na/DL b0-1W MD/Dl, B-'" 84 ,'.7 LOL CHULtsTHDL VLDL CHOL!STEROI. a2 2J HI ... fiNAL REPORT ... rJ~TF RF!.OAlllLLIlLULU__ 0-, '1'- ~ if ~.. ,~,\^\.-4..-o Je"OMe I. liU"CUS, ....0.. Ct/lwlu' ....... t.. ~ ~ ~\),~. ~~~IJ~~ . .' , " rc r ,~ u~ !,"" / , <J" ! ',. " .,.r. ::.:1 , '-:1 , UJ ,. i ., , , , 1'1 !" I rh -,,' ! Lt. ~.( " i './ :~~ ) (.) (,:::J U , , " ~ (', .~ '(;. "~'I ,~ '-)'z:; ~:) ':.;< "\~) , ..' .~. 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' .""" ^""'h,,~. ^", " """""", w" "" Ith .llIfJPOI'II/ , WCl1ng Def'c '~I/ fy " lih" '''" '. · ",p,,,,,,. "'1,1".1, PI", I ''''", ''''', "" '''''W III ICl'nll/g IlIis IIlil/lc/' , II () IIn(/ CIIII(IIICC "I, I, ' ' 0) "II/I(S, M D 6, 1\/. , '''''y I 1I11/1t~rI, 7, 1\ (1tI/iIIC(/, 8, . ._-~--- 'Judp_ Cl4IrllI"l'Olh t::.,..4; COURTROOM NO,I --ft:- VS .--$~...,~,~._,_~ IIA 1'.;1_~. - J - "" 3 Random No. - CASE NO.: . ') ~~..JifA DOCKET NO.1 99, j "7 'I ___.. ,~ "- -~ . , I .r I - Juror 1/ Namfl "...... TTl:'*J~-'- ." - .--.~ -19152lJl410 ., (l-;R 17 HaVI, Sandra K .1875190417 "'l .- ~ A .,1U;1OBJJ. A-,) 3 Fabo, Stephen M .1438731839 1 Barlup, Scoll D -1390009188 II Brown, Lorrie Sue .1089790960 38 Gingrich. John E .931364660 JI ~~---n'a.~ '--- -.83881~i96 .0_,- P-i 15 Schubauer, Palrlcla E .804606691 _po; 18 f.J........~rlv......n f. "'II:tabJII8 19 !lLIIJ,_IUld. "--___._e_ .139797368 p-\ U III :-"41 . R 000 108l1YO I I -h-l 40 Willis, William K .611151516 33 Priebe. Barbara R .507587135 17 Abrahams, Marc A .461973459 10 Campbel~ Galen G -179549013 16 fU..llt., 16..1 69796)31 '.b--y 14 Miller. Stoney D .54614186 7 Sunday, Judy 141591940 49 Grabill, Stephen M 187216354 U .JI.L,. ,___..Li- JN661iUl ~-2.. ~ Smith, Anita F 353411413 9 Batchelor, GuV F 1II 377511041 37 Decrlslofano. Mark 670011887 41 Schweitzer, Robert C 715119513 6 Martin, Corinne M 868780975 5 Ban ny, Rudolph G 913671461 47 Weyant, Laddie E 915149316 I Wilson, Timothy K 1044180947 11 SlIrkev, Vicki L 1143613377 19 Heckendorn, Joyce S 1306361339 39 Pardoe, June M 1351264669 13 Frye, Doris D 1568645310 18 Farrell, Mary Ann 1568778434 1~ McNichol, William M 1599778335 46 Chandler, Elizabeth J 1614384171 r..i~:"!. .. . ,IW Juror" Name "-~""""'''''~'-~'-''''~''-= oo-"-.,,'"=c_,,,,;_;_ ""~' ,---""""-_.,,",,".,_.,~_~'J)!!gJll,.!'!.g,..,.,,,. 1743011769 1746957684 1160571789 1916811154 13 Freundel. Diane L ',., 16 Lebo. Clara L "; 8 Slrlllmaller, John Hi 45 rarlrldMe, Sandra K POINl' NO.7 It is the law in Pennsylvunia that negligent doctors must take their patients as they find them, The fact thut a putient's undcrlying condition muy also contribute to or incrcase the likelihood or severity of the harm which results from a Defendant's negligence docs not diminish the Defendant's responsibility for the outcome, A Defendant doctor is liablc for the harm caused by their negligence, even if Plaintiffs underlying condition ulso contributed to the outcome, as long us Defcndunt's ncgligence is u real contributing factor to the harm, Accept Reject Modified Covered "i.. Fretts v~avetti, 282 Pa, Super, 166,422 A,2d 881 (1980); Lebesco v, Southeastern Pa, Transp, Auth" 251 Pa, Super, 415, 380 A,2d 848 (1977), 8 2562 10. IIJMIl\DZ rOINT NO. 24 The damages recovcrnhle by the Plaintiff in this case and the items thut go to make them up. each of which I will discuss separatcly, arc as follows: (a) Past Pain und Suffcring - The Plaintiff is entitled to he fairly and adequately compensated for such physical pain, mentalunguish, diseomfol1. inconvcniclWc and distress as you find she has endurcd, fwmthe time of the incident until toduy, (h) Future Pain and Suffering - The Plaintiff is entitled to he fairly and adequlItely compensated for such physical pain, mentalllnguish, discomfol1, inconvcnience and distress as you helieve she will endure in the future as a result of her injuries, (c) Emharrassment and Humiliation - The Plaintiff is entitled to be fairly lUld adequately compensated for such embarrassment and humiliation as you believe she has endurcd and will continue to endure in the future as a result of her injuries, (d) Disfigurement - The disfigurcment which the Plaintiff sustained as a rcsult of this incident is a separate item for damages recognized by law, Therefore, in addition to such sums liS you award for pain and suffering and for embarrassment and humiliation, the Plaintiff is entitled to be fairly and adequately compensated for the disfigurement she has suffered in the past liS II result of this incident, and which she will continue to sum'r during the future duration of her life, (e) Enjoyment ofUfe - The Plaintiffis entitled to be fairly and adequately compensatcd for past, present and future loss of her ability to enjoy any pleasures of life as a result of her injuries, In the event that you find in favor of the Plaintiff. you will add these sums of dalllllges together and return your verdict in one single lump sum. 25 256210,I\JMD\DZ .'1011/11 DIIIIII'80.9 he "III., II~'III1I. .r 1101 OOlllpo I 0(/ ~if!J 0-1'00011 IISQllo 1 flto I. 00111 II fo lit ' ellSI It '/10",9111.' e II?lltrO Illdell 1011 fol' " P."~ '" 'h, . "o"P., , 1'01/gd. $IIh/o I. 001' C 0098 01109109/ ""11 d- Ollf "'If It 1111111& lito Ir' 'Iell ClI'Ii, , oill' ~ /'lIoo/., " 0 .,"" 'lI , , 44<{ P II, .?63 , .18.? 01,.1(/.106 . (f 9?/J. ~ ~.-/ ~u, II is" I/Cls 'Or I} o/'Iho /) Ic Jilry elOliC/.. 10 (Iolc , l?"C/11 i/llt.V 1/lld 'lflll/lc hi /lico 1"1. ' 0,1' S ' ~}Irildicle" Ii/I '?110'''1/ erlOllSIy 1/ "c"i " IIcc I" 'fie IJ, , (,c/lce , " fJlly, 'I//llfirr. o/'jJfJi , SIIOIII.I Si'l/I/. l" 'c , ''11I "'I/'", ' h" ","" Ib ' h"", 'Ii.", ',,", J / ~~ ~/, Uo, 'I'. '. "'", ""I " ''''''I '0;, "'" " by ", ^.2", I, I" P, '<<"PI"" , Q, ""~, 0960 I 'S'lper. J :y IhoJ' 'if, /, ',89, 116 111'.1'. . '..)qJ2 r _ _ , 0(955), ~ 'J1.~, " . Nclso I ' 94p fJ, THOMAS, THOMAS & HAF'f-'R, LLP By: El'I/II /J/ack, Esqllire Idelllijlclllioll No, /7884 By: Sleplu/fIil' l.. lIersperger, Esqllire Idelltificatioll No, 78735 305 Non" Frolll Slre!'l, p, 0. Bo.\' 999 1I111'I'i,I/J/ll'g, P A /7108 (717) 44/-705/ AI/Ol'lleys/or Deji!/ldarlls JUDITH R, MOSKO llnd BDW ARD MOSKO. Her Husullnd. Plaintiffs v, CANDACE M,F, SHANKS, M,D, llnd PINNACLE HEALTH HOSPITALS dlb/a MECHANICSBURG FAMILY PRACTICE CENTER, Defendllnts .. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY. PENNSYLVANIA NO, 99-374 CIVIL ACTION - LAW JURY TRIAL DEMANDED PROPOSED POINTS FOR CHARGE OF DEFENDANTS AND NOW, Defendllnls, Defendllnts, Candllee M,F, Shanks, M,O, llnd Pinnacle Health Hospitals dlb/a Mechllnicsburg Family Practice Centcr, submit thc following Proposed Points for Charge, Dllte: J. "/, . ~ Pil () +/-1 diD - - :~~D6- , 1 L.. i , ,----- Respectfully submitted, THOMAS, TIIOMAS & IIAFER, LLP BY~~Z Evan BlllCk, Esquirc Stephanie L. Hcrspergcr, Esquire Attorncys for Defendllnts . JUDITH R. MOSKO AND EDWARD MOSKO, HER HUSBAND, Plaintiffs IN THE COUR'r OF COMMON PI,EAS CUMBERLAND COUNTY, PENNSVLVANIA V. CIVIL ACTION - LAW CANDACE M.F. SHANKS, M.D. AND PINNACLE HEALTH HOSPITALS d/b/a MECHANICSBURG FAMILV PRACTICE CENTER Defendants NO. V'Y 3'7'( (~~~<i /~~"'<-, JURV TRIAL DEMANDED COMPLAINT 1. Plaintiffs, Judith R. Mosko and Edward Mosko, her husband, are adult individuals who reside in Mechanicsburg, Cumberland County, Pennsylvania. 2. At all relevant times herein, Defendant Candace M. F. Shanks, M.D., was a physician licensed to practice, and practicing as such, within the Commonwealth of Pennsylvania, specifically, in the field of Family Practice. 3. At all relevant times herein, Candace M. F. Shanks, M.D. (hereinafter Defendant Shanks) was an agent, apparent agent, servant, partner, employee, and/or member of the Mechanicsburg Fandly Practice Center. 4. At all relevant times herein, the Mechanicsburg Family Practioe Center (hereinafter Defendant Mechanicsburg) was a group of physioians who praoticed family medicine at 400 W. Main street and/or 122 S. Filbert Street in Mechanicsburg, Cumberland County, Pennsylvania. 3 , 5. Defendant Meohanicsbul'g is listed by the Corporation Bureau as a Pennsylvania fictitious name owned by Harrisburg Hospital. 6. Harrisburg Hospital has merged, consolidated and now exists as Pinnacle Health Hospitals (hereinafter Defendant Pinnacle). 7. Defendant Pinnaole is a corporation with medical facilities, hospitals, and offices in the Cumberland and Dauphin Counties of Pennsylvania. 8. At all relevant times herein, Defendant Shanks was an agent, apparent agent, servant, partner, employee, and/or member of Harrisburg Hospital. 9. At all relevant times herein, Defendant Shanks was an agent, apparent agent, servant, partner, employee, and/or member of Pinnacle Health Hospitals. 10. At all relevant times herein, all physicians, residents, nurses, aides, ancillary health care staff and clerical staff were the agents, apparent agents, servants, members, partners and/or employees of Defendant Shanks. 11. At all relevant times herein, all physicians, residents, nurses, aides, ancillary health care staff and clerical staff were the agents, apparent agents, servants, members, partners and/or employees of Defendant Mechanicsburg. 4 . 12. At all relevant times herein, all physicians, residents, nurses, aides, anoillary health care staff and clerioal staff were the agents, apparent agents, servants, members, partners and/or employees of Harrisburg Hospital. 13. At all relevant times herein, all physicians, residents, nurses, aides, ancillary health care staff and clerioal staff were the agents, apparent agents, servants, members, partners and/or employees of Defendant Pinnacle. 14. At all relevant times herein, Defehdant Shanks had the right and duty to exercise control, authority and/or supervision over these above listed agents, apparent agents, servants, members, partners, and/or employees in their care and contact with Plaintiff and her reoords. 15. At all relevant times herein, Defendant Mechanicsburg had the right and duty to exercise control, authority and/or supervision over these above listed agents, apparent agents, servants, members, partners, and/or employees in their care and oontaot with Plaintiff and her records. 16. At all relevant times herein, Harrisburg Hospital had the right and duty to exercise control, authority and/or supervision over these above listed agents, apparent agents, servants, members, partners, and/or employees in their care and oontactwi th Plaintiff and her records. 17. At all relevant times herein, Defendant Pinnacle had the right and duty to exercise control, authority and/or supervision over these above listed agents, apparent agents, servants, members, 5 " partners, and/or employees in their care and contaot with Plaintiff and her reoords. 18. For approximately nineteen (19) years, April of 1978 to April of 1997, the physicians at Mechaniosburg Family Practioe Center were Mrs. Mosko's primary care physicians. 19. For Mrs. Mosko's obstetrical/gynecological (ob/gyn) care, Defendant Mechanicsburg referred her out to Ob/Gyn specialists. This referral bElgan in 1978 and continued through out all the relevant times of this suit. 20. On October 24, 1994, Mrs. Mosko presented to her ob/Gyn's office for her yearly examination. She was fifty six (56) years old. 21. As part of this exam, the Ob/Gyn ordered blood work, which included a Chemistry Profile, and advised her to return in one (1) year. 22. On or about November 8, 1994, the Ob/Gyn office notified Mrs. Mosko, by telephone, that they were sending her laboratory report to her primary care physicians, and that she should follow up with them to discuss hor test results. 23. On November 15, 1994, Mrs. Mosko presented to her primary care physicians, Defendant Mechanicsburg, and was seen by Defendant Shanks. 24. Defendant Shanks recorded that Mrs. Mosko had a total cholesterol of 309, a HDL of 84, a LDL of 202, and a cholesterol/HDL ratio of 3.4 (even though Mrs. Mosko's actual cholesterol/HDL ratio result from the lab was 3.7). 6 25. At thi. visit, Defendant Shanks only informed Mrs. Mosko of her high oholesterol lp.vels, she did not inform or discuss Mrs. Mosko'. high liver levels, despite their presenoe on the same page of the laboratory report. (Please see Exhibits A & B) 26. Mrs. Mosko's liver levels were as follows: Alkaline phosphatase 837 HI (reference range 30-140); SGOT/AST 84 HI (referenoe range 5-45); and Gamma GT 1435 HI (reference range 5-65). (Please see Exhibit C) 27. Defendant Shanks recommended yearly cholesterol profile measurements for Mrs. Mosko, but 414 not recommend or order any follow up for her high liver levels. 28. For aDDroximatelv two (21-years and three (3) mo~, 11/S/94 to 2/20/97, none of the Defendants notified Mrs. Mosko that she had abnormally high liver levels. 29. On 2/20/97, Defendant Shanks recorded she informed Mrs. Mosko, via telephone, that her lab profile from 10/24/94 had reoently been routed to her for her signature. 30. Defendant Shanks further informed Mrs. Mosko that on 11/15/94, she had discussed with Mrs. Mosko her hypercholesterolemia but had not dis~~~her elevated LFTs (liver function tests). (Please see Exhibit D) 31. At this time, Defendant Shanks recommended a repeat of Mrs. Mosko's liver profile, a repeat cholesterol level and an office visit to check Mrs. Mosko's liver. 32. Mrs. Mosko's 2/22/97 liver profile carne back as Alkaline phosphatase 773 (reference range 50-136); 7 SGPT 111 (refersnce range 21-47) and SGOT 74 (referenoe range 11-32). (Please see Exhibit ~) 33. On 3/17/97, Defendant Shanks dictated that Mrs. Mosko oame to Defendants' office at Shanks' request to disouss her elevated liver function tests. 34. In this 3/17/97 dictated note, Defendant Shanks reported that Mrs. Mosko's elevated liver function testa were not disoussed At the 1994 visit. (Please see Exhibit F) 35. Defendant Shanks referred Mrs. Mosko to Dr. Lacey, a liver specialist, for his opinion regarding further work-up of her liver function tests. 36. Upon further testing by Dr. Lacey, Mrs. Mosko's Antimi.tochondrial antibody (AMA) titer came back as, 1: 640 or greater, and the biopsy of her liver demonstrated piecemeal necrosis, inflammation, and stage II to stage III fibrosis, therefore, the diagnosis of Primary Biliary cirrhosis (hereinafter PBC) was made. 37. Plaintiffs aver that PBC is a chronic liver disease which destroys the bile ducts inside the liver. The bile duots become obstructed and the undrained bile damages the tissues, which leads to soarring, fibrosis and cirrhosis of the liver. 38. Upon her diagnosis of PBC, Dr. Lacey promptly started Mrs. Mosko on the medioation, Actigall. 39. Plaintiffs aver that treatment of patients with Actigall is known to result in improvement in their bioohemical tests, in improvement of their liver histology, and in the slowe~ progression 8 of their liver disease toward well-established oirrhosis whioh would rsquire liver transplantation. 40. Indeed, since initIation of Aotigall therapy, Mrs. Mosko's liver tests have impr.oved dramatically. In her S/12/97 liver profile, her Alkaline phosphatase had gOlle from 837 to 502; her AST had gone from 84 to 60; and her Gamma GT had gone from 1435 to 461. (Please see Exhibit G) 41. Abnormally high liver function tests are often the first sign of a liver problem. 42. Plaintiffs aver that Mrs. Mosko's abnormally high liver funotion tests in 1994 should have been reported to her and that Defendants should have at le.ast immedi.ately repeated the tests, then if still abnormal, ordered an Antimitochondrial antibody (AHA) titer, and a oonsultation with a liver specialist. 43. Plaintiffs aver that earlier diagnosis and treatment of this patient with Actigall would have rosulted in improvement in her liver disease and in a slower biochemical and histological progression of her liver disease. 44. By delaying Mrs. Mosko's diagnosis of PBC, by over two (2) year., or until 1997, Defendants, allowed Mrs. Mosko's disease to progress unrestrained which increased its severity and the likelihood for Mrs. Mosko SUffering cirrhosis, transplantation and harm. 45. Because of Defendants' negligenoe, Mrs. Mosko has an increased risk of liver damage, cirrhosis, and transplantation for the rest of her life. 9 46. As a direot and prox imate result of the Defendants' negligenoe, as alleged herein and incorporated by referenQe, Plaintiff'. condition will cause her residual problems for the remainder of her life, requiring additional medical therapies and a olaim is made therefor. 47. As a direct. and proximate result of the Defl3ndants' negligenoe, as alleged herein and incorporated by reference, Plaintiffs have incurred and will continue to incur liability for medical treatments, medicines, hospitalizations, and similar miscellaneous expenses throughout Mrs. Mosko's life and a olaim is made therefor. 48. As a direct and proximate r.esult of the Defendants' negligenoe, as alleged herein and incorporated by reference, Plaintiff has undergone and in the future will continue to undergo great mental and physical SUffering, and loss of life's pleasures and enjoyment and a claim is made therefor. 49. As a direct and proximate result of the Defendants' negligence, as alleged herein and incorporated by reference, Plaintiff has been and in the future will continue to be subject to great humiliation, disfigurement, and embarrassment and a claim is made therefor. 50. As a direct and proximate result of the Defendants' negligence, as alleged herein and incorporated by reference, Plaintiff has sustained past loss of earnings and loss of earning capacity and in the future will continue to sustain loss of earnings and loss of earning capacity and a claim is made th~refor. 10 51. As a direct and proximate result of the Defendants' negligence, as alleged herein and incorporated by referenoe, Plaintiff has been advised and therefore avers that the damages and injuries as alleged herein are permanent and a olaim is made therefor. 52. As a direct and proximate result of the Defendants' negligenoe, as alleged herein and incorporated by referenoe, Plaintiffs were forced to incur liability for medioal treatments, medicines, hospitalization, and similar miscellaneous expenses in an effort to restore Mrs. Mosko to hea 1 th, and because of the nature of her injuries, will be forced to inour suoh expenses in the future, and a claim is made therefor. 53. Defendants are jointly and severally liable to the Plaintiffs for the injuries and damages alleged herein and incorporated by reference. COUNT I JUDITH R. MOSKO AND EDWARD MOSKO, HER HUSBAND ~ANDACE M.F. SHANKS. M~~ 54. Paragraphs 1 through 53 of this Complaint are incorporated herein by reference as if set forth at length. 55. At all relevant times herein, Defendant Shanks was an agent, apparent agent, servant, member, partner, and/or employee of Defendants Pinnacle Health Hospitals and its predecessor, Harrisburg Hospital. 11 56. At all t'.levant times hereIn, Defendant Shanks was an agent, apparent aqant, servant, member, partner, and/or employee of Defendant Mechanio.burg Family Practioe Center. 57. Defendant Shanks is liable to the Plaintiffs for injuries and damages alleged herein which were directly and proximately oaused by her negligence in: a) failing to read and/or review Mrs. Mosko's 10/24/94 liver funotion test results for over two (2) years; b) failing to sign-off and/or check-Off Mrs. Mosko's 10/24/94 liver function test results, whioh wore abnormally high, for over two (2) years; 0) failing to discuss, notify and/or inform Mrs. Mosko, for over two (2) years, that her liver function test results from 10/24/94 were abnormally high; d) failing to order, recommend, perform and/or even consider repeat liver function tests on Mrs. Mosko in 1994, 1995 and 1996; e) failing to order, recommend, perform and/or even oonsider the performance of an antimitochondrial antibody (AMA) titer on Mrs. Mosko in 1994, 1995 and 1996; f) failing to order, recommend, and/or even consider an internal medicine, hepatic, and/or gastroenterologic8l consult or referral for Mrs. Mosko in 1994, 1995 and 1996; g) failing to diagnose Mrs. Mosko's liver disease in 1994, 1995 and 1996; h) failing to recognize or even oonsider the diagnosis of liver disease in 1994, 1995 and 1996, and to take appropriate 12 measure. to aggressively pursue definitive diagnostJo and therapeutio mobilities; i) failing to order, or at least recommend, yearly physical exams tor Mrs. Mosko; j) failing to recognize the significance and severity of Mrs. Mosko's abnormally high liver function test results in 1994, 1995 and 1996; k) failing to recognize the inore~sed risk of harm and/or the potential for a life-threatening injury to Mrs. Mosko based on her abnormally high liver funotion test resulta in 1994, 1995 and 1996; I) failing to formulate a differential diagnosis which should have inoluded liver disease in 1994, 1995 and 1996, due to Mrs. Mosko's high cholesterol levels, and then to rule in or out this potentially life-threatening liver condition with appropriate examination and testing, and if not, to have at least ordered or recommended an internal medicine, hepatic and/or gastroenterological referral or consult; m) diagnosing Mrs. Mosko with hyperoholesterolemia, insomnia, and borderline elevated blood pressure in November of 1994, without ever considering that Mrs. Mosko's problems were related to liver disebse; 0) treating Mrs. Mosko for hypercholesterolemia, insomnia, and borderline elevated blood pressure in November of 1994, without ever oonsidering that Mrs. Mosko should also have been evaluated and treated for liver disease; 13 p) only diagnosing Ml'S. Mosko with hyperoholesterolemia, insomn1.a, and borderline elevated blood pressure in November of 1994, when in tact, Mrs. Mosko also had abnormally high liver funct1.on test res\llts which evidenced liver disease; 58. As a direot and proximate result of Defendant Shanks's negligence, the Plaintiffs have sustained injuries and damages as set forth above, whioh are incorporated her.ein by r.eferenoe, as if Bet forth at length. WHEREFORE, Judith R. Mosko and Edward Mosko, her husband, demand jUdgment against Defendant Candace M.F. Shanks, M.D., for oompensatory damages in an amount in excess of Twenty-Five ($25,000) Thousand Dollars exclusive of interest and costs and in excess of any juriSdictional amount requiring compulsory arb.! tration. ~T II JUDITH R. MOSKO AND EDWARD MOSKO, HER HUSBAND v. PINNACLE HEALTH HOSPITALS d/b/a ME~RG FAMILY PRACTICE CENTER 59. Paragraphs 1 through 53 and Count I of this Complaint are incorporated herein by reference as if set forth at length. 60. At all relevant times herein, Defendant Mechanicsburg Family Practice Center was owned by HarriSburg Hospital and its successor, Defendant Pinnacle Health Hospitals. 61. At all the relevant times herein, all phYSicians, residents, nurses, aides, ancillary health care staff and clerical staff working at Defendant Mechanicsburg' s facilities were the 14 agents, apparent agents, servants, employ... of Defendant Pinnacle predeoessor, Harrisburg Hospital. 62. At all the relevant times herein, all physicians, reaidents, nurses, aides, ancillary health care staff and clerical staff working at Defendant Mechanicsburg's facilities were furthering the interests of Defendant pinnacle and its predecessor, Harrisburg Hospital, and were acting within the snope of their employment. 63. Defendant Pinnacle is liable to the Plaintiffs for the injuries and damages alleged herein which were directly and proximately ~aused by its negligent actions in: a) failing to properly train and instruct, its clerioal and medical staff, including Defendant Shanks, on the proper steps to be taken to ensure that a patient's laboratory reports, especially abnormally hi.gh results, such as Mrs. Mosko's, are reported to the patient and to their primary care physician; b) failing to recruit, hire, and employ, clerioal and health oare ataff, who are able to log in, file, process, route and report a patient's laboratory reports, especially abllormally high results, such as Mrs. Mosko's, to the patient's primary care physioian ancl the respeotive patient; c) failing to promulgate and implement policies, procedures and protocol for its agents, apparent agents, members, partners, servants and/or employees to ensure accurate and prompt. reporti.ng of a patient's laboratory reports, especiallY abnormally high members, partners and/or Health Hospitals and its 15 resulte, euoh as Mrs. Mosko's, to the patient's primary oare physioian and to the respective patient; d) failing to implement and enforce policies, protocols, rules and/or regulations that require clerical staff and/or health oare etaff to notify the primary care physician(s) when patient laboratory reports, especially abnormally high results, are received; e) failing to implement and enforce policies, protoools, rules and/or regulations that require clerioal staff and/or health oare staff to have the primary care physioian(s) read, review, sign-off and/or oheck-off patient laboratory reports, especially abnormally high results, which are received; f) failing to implement and enforoe policies, protocols, rules and/or regulations that require clerical staff and/or health oare staff to discuss, notify and/or inform the patient of their respective laboratory reports, especially abnormally high results; g) failing to adequately staff sufficient numbers of olerioal and/or health care employees to allow the accurate and prompt log in, filing, processing, routing and reporting of a patient's laboratory reports, especially abnormally high results, suoh as Mrs. Mosko's, to the patient's primary care physioian and to the respective patient; h) failing to have designated, trained individuals available to log in, file, process, route and report a patient's laboratory reports, especially abnormally high results, suoh as Mrs. Moako's, 16 to the patient'. primary oare physician and to the respective patient 1 i) failinq to have a protoool in plaoe that required incoming patient laboratory results to be checked-off, acknowledged, and/or signed-off by olerical staff and/or primary oare physioians, suoh as Defendant Shanks, and specific standards for doing so; j) failing to read and/or review Mrs. Mosko's 10/24/94 liver function test results for over two (2) years; k) failing to sign-off and/or check-off Mrs. Mosko's 10/24/94 liver function test results, which were abnormally high, for over two (2) years; l) failing to discuss, notify and/or inform Mrs. Mosko, for over two (2) years, that her liver function test results from 10/24/94 were abnormally high; m) failing to order, reoommend, perform and/or even consider repeat liver funotion tests on Mrs. Mosko in 1994, 1995 and 1996; n) failing to order, recommend, perform and/or even consider the performance of an antimitoohondrial antibody (AMA) titer on Mrs. Mosko in 1994, 1995 and 1996; 0) failing to order, recommend, and/or even consider an internal medicine, hepatic, and/or gastroenterological consult or referral for Mrs. Mosko in 1994, 1995 and 1996; p) failing to diagnose Mrs. Mosko's liver disease in 1994, 1995 and 1996; 17 q) fai linq to l'ecoqnize or even consider the diagnosis of liver disease in 1994, 1995 and 1996, and to take approprhte measure. to aqqr8ssively pursue definitive rtiagnostic and therapeutio mobilities; 1') failing to order, or at least recommend, yearly physical examinations for Mrs. Mosko; s) failing to recognize the significance and severity of Mrs. Mosko's abnormally high liver funotion test results ill 1994, 1995 and 1996; t) failing to recognize the increased risk of harm and/or the potential for a life-threatening injury to Mrs. Mosko based on her abnormally high liver function test results in 1994, 1.995 and 1996; u) failing to formulate a differential diagnosis which should have included liver disease in 1994, 1995 and 1996, due to Mrs. Mosko's high oholesterol levels, and then to rule in or out this potentially life-threat.ening liver condition wit.h appropdate examination and testing, and if not, to have at least ordered or recommended an internal medicine, hepatic and/or gastroenterological referral; v) diagnosing Mrs. Mosko with hypercholesterolemia, insomnia, and borderline elevated blood pressure in November of 1994, without. ever considering that Mrs. Mosko's problems were related to liver disease; w) treating Mrs. Mosko for hypercholesterolemia, insomnia, and borderline elevated blood pressure in November of 1994, without 18 ever oon8iderinq that Mrs. Mosko should also be evaluated and treated for liver disease; x) only diaqnosing Mrs. Mosko with hypercholesterolemia, insomnia, and borderline elevated blood pressure in November of 1994, when in fact, Mrs. Mosko also had abnormally high liver function test results which evidenced liver disease; 64. As a direot and proximate result of Defendant Pinnacle's negligence, the Plaintiffs have sustained injuries and damages as set forth above, which are inoorporated herein by reference, as if set forth at length. WHEREFORE, Judith R. Mosko and Edward Mosko, her husband, demand judgment against Defendant Pinnacle Health Hospitals d/b/a Mechanicsburg Family Practice Center, for compensatory damages in an amount in excess of Twenty--Five ($25,000) Thousand Dollars exclusive of interest and costs and in excess of any jurisdiotional amount requiring compulsory arbitration. COUNT I II ,EDWARD MOSKO v. CANDACE M.F. SHANKS, M.D. AND PINNACLE HEALTH HOSPITA~b/a MECHANICSBURG FAMILV PRACTICE CENTER 65. Paragraphs 1 through 53 and Counts I and II of this Complaint are incorporated herein as if set forth at length. 66. By reason of the aforesaid injuries sustained by his wife, Plaintiff, Edward MOSko, was forced to inour liability for medical treatments, medications, and similar miscellaneous expenses 19 j ...... at "," , , . , '.r , ' , ' , . 'w '- - ...,:.~_...._"",~,,,,-~~,,,,,",,,,,,,,,,,,,_,,,,_,,,,,,,c,,, -"..J;,.,,,,'i,,,~t~;w;,li'!l!t'jll\' -, . ,~, <<_~.- _ ,"- , . j IXNltlT, ,~'",'~~"f";N~f'fI",~'i~~'I,V;~~'~ \"<";,*'~~M.~kt'~_~-i#;,;'<fi~;i)j.~...t~~~_""f,iW>f~!ii~~~~~-.~>,;~{;'i~~d:-_;\;~""~!'"'~.;"'ft\~'!itt~tl("- I' I EXHIBIT C 4';;,,,,,,~j_~~!~__~4':~~~~,W;,~~.~i ~~*~-w;fi~~~/l~it~~"~i'i#~~~~~~~~~,*~~{I:;f:,~;-~~:di~~,; " -'"'"''--~~- " ~ I MlDICAtCAiORATORIES Z001 IT ATE HILL ROAD IUITI100 WVOMll8lNO. PA 1",0 (110) 378.1100 ",he blOOG ,..t cenle,e" DR JDHft '-UU~VI~~I-- SHERMAN ASSOCIATES 1.4 EnFORD RD CAMP HILL PA 17fll n...\-I"....... ...... ,. -. AOf.,DOII 'h\~bI141~a Sfll; PHONil 717-7)7'b't4 DftANM' \"241.4 NO TIML 101 REFI a4~814b~ VY NO/DI. lb HOIDL 1 L.....__,,__.M~-. 10 6,~ MU/UL IJ8 MfU/L 4.~ NEQ/L U4 MEDII. ...__._._..__-U. __. nu.:.l..... .111' ) (~~~ .-t1l--/ NO I DI. ~ M~IOL ~,7 MOIDI. ~BH HI UIL "---Ci4~":' ~-S-.._~~~.__...._. ftwm IH UIL II~-~~e 7,~ O/Dl .,,,,.U. ~ 4.1 OIDL 3,~-~.~ _.....__.. _....... _'. ..___..1.4-.____.._.._...JlJ.QL._..__.____..l......a. ;....----..- 1.2 1,11- 2. ~ '.1 MBIDL B.~'I"~ I,~ "MOtlL l.Y'~,' 4,1 MOIDL 2.~-~.tl j'17 763-8111 /) .1\ ';1 /Y ~;Y \}l>-'f lG --RESUU" 6t --UNITS-- FAS1' INO? --TEST-- -----' _______________".-_,.--..,.~_h _......._, GENERAL H~AL1H PROFIL~ CHEMISTRY PROfiLE GLUCOSE UR~A NITROGEN c- _..--ClWlU.NJ.~._.. -'''-' - -' .-. -... PUN/l:HAllNINE RATIO URIC ACID SODIUM POTASSIUM CHLORIDE __-UCAJllIO~'H IUlU._....._ ANION GA~ CHOLE5TEROL lRl(jLVCERIOE5 TOTAL ~ILlHU~JN ALKALINE PHU~PHA1AS~ . _._--:a.ij"l/,o,1.,: 1_____ -' . ..~'_ _..~..". ;'/;1:'< GAMMA a 1 LOH TOTAL PROTEIN AI.UUMIN _ __"_~_.J:U...uN.11 I w Ala RATIO CALCIUM IONIZED CALCIUI1 INORGANIC PHOSPHORUS n .j. ~I ~ '-~E'!KtiNCt ftAHOt.. ,'. 6~'ll~ tfAClIIlG; "'2~ ......L.lL.I . S 1.24 2 I ~"1 . ~ l~n'IH 3, ~. 5,5 .~ "11 ~ .U:,:.l.~ e..24 11~.~O~ I ~. I ,'fl ~, 1'1. 2 '0" 14,1 ....-_Q...:.A~ ~"b:" .,... ..~. ".,_'..~... ._____.___..._____..,.__-L..-;.---.-'..-......----......'... ............-..-..... HI MOIDL 4'-8& 8ELOW AVERAGE R I HI': ~ AVERAGE RISKI }.~ A80VE AVERAOE RISKI ~., _...-.IlIA" RI;j(I.___"....), ? , HI MOIDL b0-l}' MDIDL B''}z CORONARY RISK ASSESSMENT HDL CHOLESTEROL CHOLESTEROL/HOL RATIO 84 },7 ..--..--.........,----. LDL CHOLESTEROL VLOL CHOL!STEROL ~02 n fit . ttt FINAL REPORT ttt rlt. T' 1l~!11AllD-1J!1.1.'L9.!__ ",~---""*"" - .....*_.._.. ~..... ..\ "W\~-o ~ '\ "e~OMf. I, ...."CUi. W.O" DII.~lu' ~"=~_","'''_''-'-f''"''f,,.-,_,,-~=,-__;,,, . 'if II , , ~~u.. . ,) _____".",,_ _.,,__ ___>'1'_____~~-I..,~~1>~~~~j!'P- ~""~#--;_1'.#n___"";'" ,'~,""'--,,,."""~ ":;",#<-~~~:'_-- --; .-- IXHIIITD \. r, J -":-~~:~~~.;~_~;"~:~;:~~i~~" , IXHIIIT I '~ { ,~ , \0_ ,,"~. ~'!lli;.~re~~-v.1i.\f{.~~ --7"'-. ,,~ ~ - ~ I r 'oj dJ SEIOLE MEMORIAL HOSPITAL. C A CAPITAL HEALTH SYSTEM HOSPITAL . CLINICAL lAS . H, G, KWEE, 1.1.0.. OlR, OF LAB o HARRISBURG HOSPIT,Al. C A Ct-PITAL HEALTH SYSTEM HOSPITAL . CLINICAlLAEl . H. G, KWEE, 1.1,0" OIA, OF LAB . . . PATIENT NAME ~(E'.O , JUOY DATE: r:'::/2::/'~"7 '''H:'~'C: TI~IEI NUMBEP WARO 8E~, AGE SF 2';'4::814~,5 MFf:'C: 'ol'IAI I =f3f~I,1/ 1:2~, 1 ' F'H'iS I C I AN SHI,rW.s CANDACE ,. . PAGE: J. -----.----,---,-,--.------...-----... roo,-,. -..... "''''''''--...,. .-,... ,..- ..__,.... .......__.._L...__......_q.._...._.._..,___..... 1,:EFUFr sr':'TuSI FIII/I~L '..,.. --'----..-------------.+---___.._~.___._______.M'_._.''M'___. t.,. ,. .... .', - _, - - - 'n" _ ,~ _ ._ ._ ,__ _ '--~._--_.._--'--_.__._---_._--------'-'~ - ~ - - 0- ,_~. : t~ E M r 5 T F: '( r- f> I,] F . ! C' I:' j, ... l.... -J rS:ST UI~IT:: NQFMI~(.. '", " L~ILl AU, f"HDb 3C:IF'T IjJi~l[IL UI'~rT~;/L.. Ut'~I"~.:r,-'l... 1;)1~)-1.() 5!)--:36 21-4~ i 1:-:" '~L3 <;.ir'\ ''[.\- F:H''1/I:1L. ~:-. '~--;.1. 2 3:, ,~".S. ,;, [lATE .~Ir'iE 2/:::: >9'l",'J I'" ~' ... ~"'?::,t FI.' ll8f ":' "." , . ~ ' ";'. -~ All f;~JWLTS C8rIP,If;:MED - ~Esr ~'E~E~1'CD , ,~ '-, ~DGDT UNITS/L 11-7,2 [_I~-l IT;; \'".JF'MAL '::.' '.:'1',':: TIMe ;:';:'>.'~ "7 "'4,* ":NU 1]1"', <:,'t:!:'CIF:l"! - '-,"., .' , .. . .~ ';t~~~ ;.-_ ')1 A'1 ---.....-...---.,-.-.~,~.~__._~,___._____M____.__"_."__.~_~.__._._.___.__._._._.____~,_"."_.". .__..,_._..____..._...__.~__.__. H<Ti::.I,;T 1\IAt1C MCSi';CJ ~ JUDy NUt'1f:,EF: ~"'Ai-::[' EiC[ .~GE -3;'" """H 'i';::' I C r At.-~ 2(~~~2814~5 Mf.:PC S~!A~l S~JFW St-IAt.jf;:S CA~IDACE F r:"{1C3~:: 1 " ~ . / IXH..tr, .;n!f~;,r,.~~"~i~~~~fi<'~,h,~_",,,4i:,~~" I/CHIIl' 0 ,'if~~~lilll!~;;'',;:''ii!lf~;i,~~l'ti;'ij,i.~~t*'1i,ji;~.,;\.,.~;,i~~i''\>il''i:;;~';~''1\''~~'ciiiic'''~"''v",C",ri>"'''';'''~fjl't"<'~~~i,1.~>i,c. . ~., c'~ :i'- 0111:';/97 OOlllJ ....lNN .... nlr,;.t"..II, f~l '..- F~"NK_. RUDV,M.D., CHAIRMAN, \)Il...... OF I.AIIORAIUI<Ol:.... H"AAISBUR', itA 17111) NAM!I MOlkO,JUDITH R H. I l~2S146~ LOC. aDO Actt" ~9Y SEX, F "CCT I 29&2%1531 OfJlh 06/14/3a PATIINT PHONE NUMBERI 717-737*5381 ................... PHYSICIAN COpy FOR !)AI LACF.V,t-'IIUL. G ....,. ........~........ gl\,L.ACe:Y,PAUL G ~TE 1A 2SZS NORTH 9T HARRISBURG,PA 17110 T639!l2 09/1U97 12100 08/12197 14'%:3 LAClb:Y,I"AUL G HiPATIC PROFIL.E (;MAC NO. .i TOTAIo PROTiIN AL.B~lN GL.OBUL.IN "IG RATIO BILIRUJ;lIN,TOTAL DILIRUBIN. DIRECT "LK PHOSPHATASE r.z 4.0 a.z 1.3 0.8 0.3 1302 ANALYSIS REPEA"EO 100 lil1 469 ANAL Ya 1 S REPEA TEl) 15.'r -S.I G/DL. :1l.1-tl.l'l GIDl. 1 "B"3.e G/DL. 0.9-;;:.4 0-1.3 Ma/DL. 0-0.. MQ/DL. <<. ~~Q.lI!'l U/L ~ (1,,40 U/L ~ O"4t1 UII. II O-i!oO U/L AST AI.T liAMMA GT MOSKI~. J UP ITH Fl , tI' 4'. cf.'~~ 't'J\ry? ~~ SO 11/ I '~ /" ~~~. -" ~ / /' ~ \~ \,?'" ~ "Q / ~ \~'? fI ~\I /' /" . / " 4...~ ~/ PAGE END OF REPORT .