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Home My WebLink About01-6286 PATRICIA J. THOMSON and ROBERT C. THOMSON, her husband, Plaintiffs IN THE COURT OF COMMON PLEAS CUMBERLAND CO., PENNSYLVANIA NO. 01 - Uf?~ C;u'Ll 't-~"""'- v. KATHRYN A. PEROUTKA, M.D, and ANDREWS & PATEL ASSOCIATES, P,C., CIVIL ACTION - LAW Defendants JURY TRIAL DEMANDED NOTICE YOU HAVE BEEN SUED IN COURT. If you wish to defend against the claims set forth in the following pages, you must take action within twenty (20) days after this Complaint and Notice are served, by entering a written appearance personally or by attorney and filing in writing with the Court your defenses or objections to the claims set forth against you. You are warned that if you fail to do so the case may proceed without you and a judgment may be entered against you by the Court without further notice for any money claimed in the Complaint or for any other claim or relief requested by the Plaintiff. You may lose money or property or other rights important to you. YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU CAN GET LEGAL HELP. Cumberland County Bar Associates 2 Liberty Avenue Carlisle, P A 17013 717/249-3166 or 1-800-990-9108 PATRICIA J. THOMSON and ROBERT C. THOMSON, her husband, Plaintiffs IN THE COURT OF COMMON PLEAS CUMBERLAND CO., PENNSYLVANIA NO, D~ - t".~6 Co ~l y~ v. KATHRYN A. PEROUTKA, M.D. and ANDREWS & PATEL ASSOCIATES, P.C., CIVIL ACTION - LAW Defendants JURY TRIAL DEMANDED NOTICIA Le han demandado a usted en la corte. Si usted guiere defenderse de estas demandas expuestas en las paginas signuientes, usted tiene viente (20) dias de plazo al partir de la fecha de la demanda y la notificacion. Usted debe presentar una apariencia escrita 0 en persona 0 por abogado y archivar en la corte en forma escrita sus defensas 0 sus objeciones alas demandas en contra de su pesona. Sea avisado que si usted no se defiende, la corte tomara medidas y puede entrar una orden contra usted sin previo aviso 0 notificacion y por cualguier gueja 0 alivio que es pedido en la peticion de demanda. Usted puede perder dinero 0 sus propiededes 0 otros derechos importantes para usted. LLEVE EST A DEMANDA A UN ABODAGO INMEDIATAMENTE. SI NO TIENE ABOGADO 0 SI NO TIENE EL DINERO SUFICIENTE DE P AGAR TAL SERVICIO, VA Y A EN PERSONA 0 LLAME POR TELEFOND A LA OFICINA CUY A DIRECCION SE ENCUENTRA ESCRITA ABAJO PARA A VERIGUAR DONDE SE PUEDE CONSEGUlR ASISTENCIA LEGAL. Cumberland County Bar Associates 2 Liberty Avenue Carlisle, P A 17013 717/249-3166 or 1-800-990-9108 6 RECEIVED JUL 01 Z005 /IJI' PATRICIA J. THOMSON and ROBERT C. THOMSON, her husband, Plaintiffs, :IN THE COURT OF COMMON PLEAS :CUMBERLAND COUNTY, PENNSYLVANIA :CIVIL ACTION - LAW v. :NO. 01-6286 Civil Term KATHRYN A. PEROUTKA, M.D., and ANDREWS & PATEL ASSOCIATES, P.c.,: Defendants. :JURY TRIAL DEMANDED ORDER AND NOW, this $'~ day of ~_ , 2005, upon consideration of the Stipulation of Counsel for all parties for the Case Scheduling Order, IT IS ORDERED AND DIRECTED that the following deadlines will be followed: 1) Discovery shall be completed on or before September 30, 2005; 2) Plaintiffs' expert reports shall be forthcoming on or before November 30,2005; 3) Defense expert reports shall be forthcoming, and all dispositive motions shall be filed on or before January 30, 2006; 4) Counsel shall confer with each other in an effort to accomplish the listing of this case for trial duri T. trial term. Distribution List: Catherine Mahady-Smith, Esquire, 3115-A North Front Street, Harrisburg, PA 17110 \ ~ ~ David!. Foster, Esquire, CostopouJOl1~, FostSf & Fields, 831 Market Street, Lemoyne, PA 17M3-0Ztz 1 0' ,,()J Lauralee R Baker, Esquire, Margolis Edelstoin, 3510 Trindle Road, Camp Hill, PA 17011 / ~", ( . ~ VINVII1ASNt13d I I Nn"J'l 1"' ,r, '~r<;"n'" 1\.1. j \ :'.' ,.""" :r'>,::,t.;?11..1 22 :~ Wd s- lflr sooz ^oV10NOHlO~d 3Hl:lO 30l::8o-<B1l:l PATRICIA J. THOMSON and ROBERT C. THOMSON, her husband, Plaintiffs IN THE COURT OF COMMON PLEAS CUMBERLAND CO" PENNSYLVANIA NO. 0 \ - f.,.;{,P-f" Ci (.)1 c.,--~ CIVIL ACTION - LAW v. KATHRYN A. PEROUTKA, M.D. and ANDREWS & PATEL ASSOCIATES, P,C., Defendants JURY TRIAL DEMANDED COMPLAINT 1. Plaintiffs Patricia J. Thomson and Robert C. Thomson are husband and wife, adult individuals residing in Mechanicsburg, Cumberland County, Pennsylvania, 2. Defendant Kathryn A. Peroutka, M.D. is an adult individual licensed to practice medicine in the Commonwealth of Pennsylvania, who in 2000 engaged in the practice of oncology in Camp Hill, Cumberland County, Pennsylvania. 3, Defendant Andrews & Patel Associates, p,c., is a corporate medical institution with offices and medical facilities in Camp Hill, Cumberland County, Pennsylvania, 4. At all relevant times hereinafter, the oncology staff, radiology staff and other ancillary medical personnel who provided care to Mrs. Thomson were actual agents, ostensible agents, apparent agents, servants and/or employees of Defendant Andrews & Patel Associates, P.C, 5. During the time she provided treatment and care to Mrs. Thomson, Defendant Kathryn A. Peroutka, M.D. was at all relevant times hereinafter an actual agent, ostensible agent, apparent agent, servant and/or employee of Defendant Andrews & Patel Associates, p.e, and was acting within the scope of her employment. 6. On or about June 26, 2000, Plaintiff Patricia Thomson was seen by Defendant Peroutka at Andrews & Patel Associates, p.e, for chemotherapy evaluation, 7. At that time, Defendant Peroutka understood that Mrs. Thomson underwent a left modified radical mastectomy for infiltrating ductal carcinoma ofthe left breast. 8, Defendant Peroutka was aware that Mrs, Thomson's axillary nodes were not involved with tumor and histologically the tumor was Stage I, nuclear Grade III, ER and PR negative, and weakly HER-2 positive. 9, With early detection and treatment of her breast cancer, Mrs. Thomson's prognosis was excellent. 10. Defendant Peroutka improperly advised Patricia that she was a good candidate for Adriamycin therapy. II, Adriamycin treatment is contraindicated in patients whose cancer has not spread to lymph nodes. 12. Adriamycin is a chemotherapy drug, which is toxic to the heart and can cause heart muscle damage. 13. Any patient for whom Adriamycin therapy is recommended must first undergo screening with a diagnostic MUGA scan in order to detect early subclinical cardiomyopathy. 14. A MUGA scan, or multi-acquisition gated test, is a simple and effective way of examining the heart and obtaining a baseline ejection fraction, which will ascertain how well the heart pumps blood when it beats and how uniformly the heart contracts, 2 15. Even small doses of Adriamycin in a patient with subclinical cardiomyopathy can result in permanent and irreversible cardiac damage, 16. Administering Adriamycin therapy in any patient without first obtaining a MUGA scan increases the risk of permanent and irreversible cardiac damage. 17, Defendant Peroutka knew, or should have known, that it was contraindicated to treat Mrs. Thomson with Adriamycin therapy without first obtaining a diagnostic MUGA scan. 18. In fact, Defendant Peroutka discussed the performance of a MUGA scan with Mrs. Thomson and even circled the diagnostic test in her chart to be done. 19. However, at no time prior to initiating the Adriamycin therapy did Defendant Peroutka follow-up with the oncology staff regarding a pre-chemotherapy MUGA scan for Mrs. Thomson, 20. On or about July 5, 2000, Defendant Peroutka ordered the first of four cycles of Adriamycin therapy for Mrs. Thomson without obtaining a baseline ejection fraction by MUGA scan. 21. Defendant Andrews & Patel oncology staff inappropriately administered Adriamycin therapy to Mrs. Thomson without first obtaining a MUGA scan. 22. By failing to order and obtain Mrs, Thomson's pre-Adriamycin MUGA scan, Defendant Peroutka exposed her patient to increased risk of permanent and irreversible cardiac damage, 23. Defendant Peroutka improperly authorized the oncology staff at Defendant Andrews & Patel Associates, p.e, to inject Mrs. Thomson with Adriamycin without first obtaining a diagnostic MUGA scan to evaluate the patient's ability to withstand the cardiotoxic effects of the drug, 3 24. As Mrs, Thomson's treating physician, Defendant Peroutka was responsible for all aspects of her management and care, including assessment and evaluation of her cardiac status before, during and after the administration of the cardiotoxic drug, Adriamycin, 25, Mrs. Thomson completed the four cycles of Adriamycin therapy by the fall of 2000. 26, At no time during the Adriamycin therapy did Defendant Peroutka recommend, order or obtain serial MUGA scans or any diagnostic cardiac workup to evaluate Mrs. Thomson's cardiac status. 27. In January 2001, Mrs. Thomson experienced cardiac changes. 28. In an office visit of January 16, 2001, Defendant Peroutka documented Mrs. Thomson as experiencing tachycardia, which was later confirmed to be atrial tachycardia. 29. In addition to persistent tachycardia, Mrs. Thomson developed further cardiac symptoms, including shortness of breath, severe weakness, nausea, vomiting and a poor appetite. 30, On January 27,2001, Mrs, Thomson was admitted to the Harrisburg Hospital in fulminant congestive heart failure. 31. Mrs. Thomson came under the care of cardiology specialists who diagnosed Adriamycin-induced cardiomyopathy with severe LV dysfunction, congestive heart failure, atrial fibrillation and an ejection fraction of only 20 percent. 32. During Patricia's hospital admission, Defendant Peroutka's partner, Dr. Patel evaluated Mrs. Thomson and said that it was likely she experienced Adriamycin-induced cardiac damage, 4 33. As a result of the damage to her heart, Mrs. Thomson required intensive cardiac therapy, including treatment with Aldactone, Lasix, Cardiazem, Lanoxin, Coumadin, Accupril and Amiodarone, 34, After Mrs, Thomson's discharge from the hospital, she required continued follow- up care with numerous specialists, including Dr, Manning, her breast surgeon, who in an office visit in February 2001 asked Patricia, "Didn't they give you a MUGA scan before starting you on Adriamycin"? 35. Mrs. Thomson has been advised that her cardiac condition is serious, permanent and irreversible. 36, Mrs. Thomson has been advised that she will require cardiac treatment and care, including specialist evaluations, and cardiac medications, as well as Coumadin for the remainder of her life. 37. Many of the cardiac medications necessary to treat the cardiac damage that Mrs. Thomson sustained have extremely dangerous side effects, including permanent damage to vital organs such as liver, kidneys, lungs and eyes. 38, As a result of the treatment and care of her cardiac condition, Mrs. Thomson is at increased risk of internal and external bleeding and complications arising therefrom. 39. As a result of her cardiac condition, Mrs. Thomson requires, and in the future will continue to require, follow-up care with numerous specialists, for treatment of side effects resulting from the various prescribed and necessary cardiac medications, including treatment of corneal defects. 40. As a direct and proximate result of the Defendants' negligence, Mrs. Thomson has suffered permanent, irreversible and severe cardiac damage. 5 41. As a direct and proximate result of the Defendants' negligence, Mrs. Thomson presently requires. and will continue to require in the future, close cardiac monitoring and care, as well as close monitoring, evaluation, treatment and care of vital organs affected from complications arising out of treatment with necessary cardiac medications. 42. As a direct and proximate result of the Defendants' negligence, Plaintiffs Patricia and Robert Thomson have been forced to incur liability for medical treatments, medicines, diagnostic tests, office visits, hospitalizations and other similar miscellaneous expenses in an effort to attempt to best maintain and stabilize Mrs. Thomson's health, and because of the nature of these injuries, Plaintiffs have been advised and therefore aver that they will continue to be forced to incur similar and even greater medical and miscellaneous expenses in the future, including long-term care costs, and claim is made therefor. 43. As a direct and proximate result of the Defendants' negligence, Mrs. Thomson has undergone, and in the future will continue to undergo, great physical and mental pain and suffering, great inconvenience in carrying out her daily activities and a loss of life's pleasures and enjoyment, and claim is made therefor. 44. As a direct and proximate result of the Defendants' negligence, Mrs. Thomson has been subject to great humiliation and embarrassment, and in the future will continue to be subject to great humiliation, embarrassment and potential disfigurement for treatment and care of her cardiac condition, and complications therefrom, and claim is made therefor, 45. The substandard care of Defendants Kathryn Peroutka, M.D. and Andrews & Patel Associates, p.e, increased the risk ofhann and injury to Patricia Thomson, 46. Defendants Kathryn Peroutka, M,D. and Andrews & Patel Associates, p.e. are jointly and severally liable for the injuries and damages as set forth herein. 6 47, The serious, permanent and irreversible cardiac damage and complications therefrom will adversely affect Mr. Thomson's life expectancy and is directly attributable to the Defendants' negligence, and claim is made therefor. 48. As a direct and proximate result of the Defendants' negligence, Mrs. Thomson has sustained permanent impairment of her earning power and earning capacity, and claim is made therefor. 49. As a direct and proximate result of the Defendants' negligence, Mrs. Thomson is now at increased risk for developing further cardiac complications and damage associated with the treatment of her cardiac condition, and claim is made therefor. COUNT I - INFORMED CONSENT/BATTERY PATRICIA THOMSON V. KATHRYN A. PEROUTKA. M.D. 50, Paragraphs I through 49 of this Complaint are incorporated herein by reference as if set forth at length. 51. Defendant Peroutka is liable to the Plaintiff, Patricia Thomson, for battery in the form of intentionally inflicting harmful and offensive bodily contact on Mrs. Thomson by failing to obtain her informed consent for chemotherapy administration pursuant to 40 P.S, S1301.811-A, et seq. 52, Plaintiff Patricia Thomson would not have submitted to Adriamycin chemotherapy or Adriamycin therapy without protective medications if she had known of the undisclosed information, risks, consequences, side effects and alternative treatment. 53. As a result, Plaintiff sustained injuries and damages as set forth in Paragraphs 27 through 49 above, which are incorporated herein by reference as if set forth at length, 7 WHEREFORE, Plaintiff Patricia Thomson demands judgment against Defendant Kathryn A. Peroutka, M,D. for compensatory damages in an amount in excess of Twenty-Five Thousand Dollars ($25,000), exclusive of interest and costs, and in excess of any jurisdictional amount requiring compulsory arbitration, COUNT II - NEGLIGENCE PATRICIA THOMSON V. KATHRYN A. PEROUTKA. M.D. 54. Paragraphs I through 49 and Count I of this Complaint are incorporated herein by reference as if set forth at length. 55. Defendant Kathryn A. Peroutka, M.D. is liable to Plaintiff Patricia Thomson for injuries and damages alleged herein which were directly and proximately caused by her carelessness and negligence in: a) improperly advising Mrs. Thomson that she was a good candidate for Adriamycin therapy; b) ordering a contraindicated treatment for Mrs. Thomson; c) failing to recognize that Mrs. Thomson was not a candidate for Adriamycin therapy; d) failing to order and obtain a MUGA scan prior to initiating Adriamycin therapy; e) failing to assess Mrs. Thomson's cardiac status for subclinical cardiomyopathy prior to initiating Adriamycin therapy; 8 f) failing to advise Mrs. Thomson that treatment with Adriamycin, absent the performance of a baseline ejection fraction with a MUGA scan, increased her risk for severe, permanent and irreversible cardiac damage; g) failing to minimize the risk of severe, permanent and irreversible cardiac damage; h) failing to obtain a proper medical history; i) failing to properly treat Mrs. Thomson; j) failing to properly assess and evaluate Mrs, Thomson; k) failing to recognize and diagnose Mrs. Thomson's subclinical cardiomyopathy prior to initiating the Adriamycin therapy; I) failing to follow-up with the oncology staff regarding the performance of a pre-chemotherapy MUGA scan prior to initiating Mrs, Thomson's Adriamycin therapy; m) improperly assuming that Mrs. Thomson was too young and healthy to require a MUGA scan prior to the administration of Adriamycin; n) failing to understand that even small doses of Adriamycin in a patient with subclinical cardiomyopathy can result in permanent, severe and irreversible cardiac damage; 0) increasing the risk of severe, permanent and irreversible cardiac damage; p) causing permanent, severe and irreversible damage to Mrs. Thomson's heart; q) failing to evaluate Mrs. Thomson's ability to withstand the cardiotoxic effects of Adriamycin; 9 r) failing to order or obtain cardiac assessments and evaluations before, during and after the Adriamycin therapy; s) failing to order or obtain serial MUGA scans during the Adriamycin therapy; and t) increasing the risk of severe, permanent and irreversible vital organ damage from Adriamycin-induced cardiomyopathy. 56. As a direct and proximate result of Defendant Kathryn A. Peroutka, M,D.'s negligence, the Plaintiff has sustained injuries and damages as set forth in paragraphs 27 through 49 above, which are incorporated herein by reference as if set forth at length. WHEREFORE, Plaintiff Patricia Thomson demands judgment against Defendant Kathryn A. Peroutka, M.D. for compensatory damages in an amount in excess of Twenty-Five Thousand Dollars ($25,000), exclusive of interest and costs, and in excess of any jurisdictional amount requiring compulsory arbitration. COUNT III - NEGLIGENCE PATRICIA THOMSON V. ANDREWS & PATEL ASSOCIATES. P.c. 57. Paragraphs I through 49 and Counts I and II of this Complaint are incorporated herein by reference as if set forth at length. 58. At all relevant times hereinafter, Defendant Kathryn Peroutka, M.D. was an actual agent, ostensible agent, apparent agent, servant and/or employee of Defendant Andrews & Patel Associates, P.C. 59. At all relevant times hereinafter, the oncology staff, radiology staff and ancillary medical personnel who provided care to Plaintiff, Patricia Thomson, from June 2000 to January 10 2001 were actual or ostensible agents, apparent agents, servants and/or employees of Defendant Andrews & Patel Associates, p.e. 60. Defendant Andrews & Patel Associates, p.e, is liable to the Plaintiff for injuries and damages alleged herein, which were directly and proximately caused by its negligent actions m: a) improperly advising Mrs, Thomson that she was a good candidate for Adriamycin therapy; b) ordering a contraindicated treatment for Mrs. Thomson; c) failing to recognize that Mrs, Thomson was not a candidate for Adriamycin therapy; d) failing to order and obtain a MUGA scan prior to initiating Adriamycin therapy; e) failing to assess Mrs, Thomson's cardiac status for subclinical cardiomyopathy prior to initiating Adriamycin therapy; f) failing to advise Mrs, Thomson that treatment with Adriamycin, absent the performance of a baseline ejection fraction with a MUGA scan, increased her risk for severe, permanent and irreversible cardiac damage; g) failing to minimize the risk of severe, permanent and irreversible cardiac damage; h) failing to obtain a proper medical history; i) failing to properly treat Mrs, Thomson; j) failing to properly assess and evaluate Mrs, Thomson; 11 k) failing to recognize and diagnose Mrs. Thomson's subclinical cardiomyopathy prior to initiating the Adriamycin therapy; I) failing to follow-up with the oncology staff regarding the performance of a pre-chemotherapy MUGA scan prior to initiating Mrs. Thomson's Adriamycin therapy; m) improperly asswning that Mrs. Thomson was too young and healthy to require a MUGA scan prior to the administration of Adriamycin; n) failing to understand that even small doses of Adriamycin in a patient with subclinical cardiomyopathy can result in permanent, severe and irreversible cardiac damage; 0) increasing the risk of severe, permanent and irreversible cardiac damage; p) causing permanent, severe and irreversible damage to Mrs, Thomson's heart; q) failing to evaluate Mrs. Thomson's ability to withstand the cardiotoxic effects of Adriamycin; r) failing to order or obtain cardiac assessments and evaluations before, during and after the Adriamycin therapy; s) failing to order or obtain serial MUGA scans during the Adriamycin therapy; t) increasing the risk of severe, permanent and irreversible vital organ damage from Adriamycin-induced cardiomyopathy; u) inappropriately holding itself out to the public as having all the necessary facilities, equipment and trained personnel and services to care for Mrs, Thomson; v) failing to properly train, instruct and notify staff that every patient treated 12 with Adriamycin must undergo a MUGA scan prior to treatment. w) inappropriately representing that it was able to provide safe and appropriate care and services to Mrs. Thomson; and x) inappropriately representing that Mrs. Thomson was not in danger due to lack of trained staff, facilities, equipment and services, 61. Defendant Andrews & Patel Associates, p.e, by virtue of the actions and/or inactions of its agents, ostensible agents, apparent agents, servants and/or employees, is negligent in failing to properly train, instruct or notify its staff that every patient treated with Adriamycin must first undergo a MUGA scan in order to obtain a baseline ejection fraction prior to the administration of Adriamycin. 62, Defendant Andrew & Patel Associates, p.e. by virtue of the actions and/or inactions of its agents, ostensible agents, apparent agents, servants and/or employees is negligent in failing to obtain a MUGA scan prior to administering Mrs. Thomson's Adriamycin therapy. 63, As a direct and proximate result of Defendant Andrews & Patel Associates, p.e. 's negligence, Plaintiff, Patricia Thomson, has sustained injuries and damages as set forth in paragraphs 27 through 49 above, which are incorporated herein by reference as if set forth at length. WHEREFORE, Plaintiff, Patricia Thomson, demands judgment against Defendant Andrews & Patel Associates, p.e. for compensatory damages in an amount in excess of Twenty- Five Thousand Dollars ($25,000), exclusive of interest and costs, and in excess of any jurisdictional amount requiring compulsory arbitration, I3 CLAIM I ROBERT C. THOMSON V. KATHRYN A. PEROUTKA, M.D. AND ANDREWS & PATEL ASSOCIATES. P.c. 64. Paragraphs 1 through 49 and Counts I through III of this Complaint are incorporated herein by reference as if set forth at length. 65, As a direct and proximate result of the negligence of Defendants Kathryn A. Peroutka, M.D. and Andrews & Patel Associates, P.C., and the resulting severe, permanent and irreversible cardiac damage suffered by his wife, Plaintiff, Robert C. Thomson, has been, and in the future will be, deprived of the care, companionship, consortium and society of his wife, all of which will be to his great detriment, and claim is made therefor. WHEREFORE, Plaintiff, Robert C. Thomson, demands judgment against Defendants Kathryn A. Peroutka, M.D. and Andrews & Patel Associates, P.C, for compensatory damages in an amount in excess of Twenty-Five Thousand Dollars ($25,000), exclusive of interest and costs, and in excess of any jurisdictional amount requiring compulsory arbitration. Respectfully submitted, ~___ T~~::~ gI.,,8.0N&WISNE Date: October 31, 2001 son, Esquire 5287 2040 Lin estow Road, Suite 303 Harrisburg, 711 0 717/541-9205 Counsel for Plaintiffs 14 VERIFICATION We, Patricia J. Thomson and Robert C. Thomson, verify that the facts set forth in the foregoing Complaint are true and correct to the best of our knowledge, information, and belief. We understand that this verification is made subject to the provisions of 18 Pa.C.S. 94904, relating to the unsworn falsification to authorities, Date: IO/jO/OI lf~,,~~/ ~ ..:;Jh~ Patricia . Thomson Date: 10/30/ O{ k~~ I Robert C. Thomson i ~ .(q lJ -1:: f4:- h D-tD , ~ g ~ '- .......... " I '- / ~ ~ ffl/J ~ - tJ i t ~ ~ -0[;'"-; ~d~-,i: 0:~,~: r:,:() ~:~ ~;~ ~ o CO c;;; ~',~ ::;"3 I I.,~ ': !": -- .. c.) C.., -II ~ "1 8 0:'.1 .'. SHERIFF'S RETURN - REGULAR CASE NO: 2001-06286 P COMMONWEALTH OF PENNSYLVANIA: COUNTY OF CUMBERLAND THOMSON PATRICIA J ET AL VS PEROUTKA KATHRYN A MD ET AL CPL TIMOTHY REITZ , Sheriff or Deputy Sheriff of Cumberland County,Pennsylvania, who being duly sworn according to law, says, the within COMPLAINT & NOTICE was served upon PEROUTKA KATHRYN A MD the DEFENDANT , at 0952:00 HOURS, on the 15th day of November, 2001 at 3912 TRINDLE ROAD CAMP HILL, PA 17011 by handing to DOLORES MEALS, OFFICE MANAGER a true and attested copy of COMPLAINT & NOTICE together with and at the same time directing Her attention to the contents thereof. Sheriff's Costs: Docketing Service Affidavit Surcharge 18.00 9.10 .00 10.00 .00 37.10 So Answers: r~-"~~ R. Thomas Kline 11/16/2001 NAVITSKY OLSON WISNESKI Sworn and Subscribed to before By: me this .N. ~ day of ~, oZct;, A.D. , q~. O. n"IIJ,,,~ rothonotary , SHERIFF'S RETURN - REGULAR CASE NO: 2001-06286 P COMMONWEALTH OF PENNSYLVANIA: COUNTY OF CUMBERLAND THOMSON PATRICIA J ET AL VS PEROUTKA KATHRYN A MD ET AL CPL TIMOTHY REITZ , Sheriff or Deputy Sheriff of Cumberland County,Pennsylvania, who being duly sworn according to law, says, the within COMPLAINT & NOTICE was served upon ANDREWS & PATEL ASSOCIATES PC the DEFENDANT , at 0952:00 HOURS, on the 15th day of November, 2001 at 3912 TRINDLE ROAD CAMP HILL, PA 17011 by handing to COLORES MEALS, OFFICE MANAGER a true and attested copy of COMPLAINT & NOTICE together with and at the same time directing Her attention to the contents thereof. Sheriff's Costs: Docketing Service Affidavit Surcharge So Answers: 6.00 .00 .00 10.00 .00 16.00 r~~,,<~ R. Thomas Kline 11/16/2001 NAVITSKY OLSON Sworn and Subscribed to before By: me this aU, t day of I1..l11WAokJo.JL df>(J/ A.D. 0~A. - Ii (1.,00.. "~ rothonotary . LAURALEE B. BAKER, ESQUIRE Pa. Supreme Court I.D. No. 58874 MARGOLIS EDELSTEIN Post Office Box 932 Harrisburg, Pennsylvania 17108-0932 Telephone: [717] 975-8114 Fax: [717J 975-8124 E-Mail: lbaker@margolisedelstein.com Attorney for Defendants: KATHRYN A. PEROUTKA, M.D., and ANDREWS & PATEL ASSOCIATES, P.C. PATRICIA J. THOMSON and ROBERT C. THOMSON, her husband, Plaintiffs, :IN THE COURT OF COMMON PLEAS :CUMBERLAND COUNTY, PENNSYLVANIA :CIVIL ACTION - LAW v. :NO. 01-6286 Civil Term KATHRYN A. PEROUTKA, M.D., and ANDREWS & PATEL ASSOCIATES, P.C.,: Defendants. :JURY TRIAL DEMANDED PRAECIPE TO ENTER APPEARANCE TO THE PROTHONOTARY OF CUMBERLAND COUNTY, PENNSYLVANIA: Kindly enter my appearance on behalf of Defendants, KATHRYN A. PEROUTKA, M.D., and ANDREWS & PATEL ASSOCIATES, P.C., in the above-captioned matter. Respectfully submitted, MARGOLIS EDELSTEIN Date: u I '2d&-f r I By: @L URA EE B. BAKER, ESQUIRE P ttorney I.D. No. 58874 Attorney for Defendants, KATHRYN A. PEROUTKA, M.D., and ANDREWS & PATEL ASSOCIATES, P.C. P. O. Box 932 Harrisburg, PA 17108-0932 (717) 975-8114 - 1 - . CERTIFICATE OF SERVICE I HEREBY CERTIFY that I served a true and correct copy of the foregoing ENTRY OF APPEARANCE on all counsel of record by placing the same in the United States mail at Camp Hill, p~'vania, firae-daaa poaCage prepaid, on Che.$.c( day of ~ 2001, and addressed as follows: Nijole C. Olson, Esquire Navitsky, Olson & Wisneski, LLP 2040 Linglestown Road - Suite 303 Harrisburg, PA 17110 MARGOLIS EDELSTEIN 0 \ j>-= Li-: ~?: \.~ :::J 'f!; () -7 ""- ".~-) <' C..... -,; ::.. '>- -. (;) N :'] ::;::: ~ :> ,~ ~ L ) Uj !'a :U a... ~ ~;;:E ..1" ::;) -1':=) c.::) 0 PRAECIPE FOR LISTING CASE FOR ARGUMENT (Must be typewritten and submitted in duplicate) TO THE PROTHONOTARY OF CUMBERLAND COUNTY: Please list the within matter for the next Argument Court. CAPTION OF CASE (entire caption must be stated in full) PATRICIA J. THOMSON and ROBERT C. THOMSON, her husband, Plaintiffs, v. KATHRYN A. PEROUTKA, M.D., and ANDREWS & PATEL ASSOCIATES, P.C., Defendants. No. 01-6286 Ci vil 2001 1. State matter to be argued (i.e., plaintiff's motion for new trial, defendant's demurrer to complaint, etc.): Preliminary Objections of Defendants, Kathryn A. Peroutka, M.D., and Andrews & Patel Associates, P.C. 2. Identify counsel who will argue case: (a) for plaintiff(s): Address: Nijole C. Olson, Esquire Navitsky, Olson & Wisneski, LLP 2040 Linglestown Road - Suite 303 Harrisburg, PA 17110 (717) 541-9205 (b) for defendant(s): Address: Lauralee B. Baker, Esquire Margolis Edelstein P. O. Box 932 Harrisburg, PA 17108-0932 (717) 975-8114 3. I will notify all parties in writing within two days that this case has been listed for argument. 4. Argument Court Date: January 2, 2002 Dated: December 6, 2001 B. BAKER, ESQUIRE MUMFORD, ESQUIRE Attorney for Defendants, KATHRYN A. PEROUTKA, M.D., and ANDREWS & PATEL ASSOCIATES, P.C. CERTIFICATE OF SERVICE I HEREBY CERTIFY that I served a true and correct copy of the foregoing PRAECIPE FOR LISTING CASE FOR ARGUMENT, on all counsel of record by placing the same in the United States mail at Camp Hill, Pennsylvania, first-class postage prepaid, on the ~ day of ~2001, and addressed as follows: Nijole C. Olson, Esquire Navitsky, Olson & Wisneski, LLP 2040 Linglestown Road - Suite 303 Harrisburg, PA 17110 MARGOLIS EDELSTEIN By: o () c -~ ~ ""'Or:-r: nl rr~ :?..::::' Z'( UJ.,r.-::- -<-, r:::CJ ~(-;. ....:-(--., Pc Z =<! o o <1 --.t ::'Ii~ um -,-.,-., ;'~";I :::::1 Sr; ;,:'~,~B ;:;c:)rn ~ -< CJ ", n I -J ~ -" r:-? C" c::> PATRICIA J. THOMSON and ROBERT C. THOMSON, her husband, Plaintiffs, :IN THE COURT OF COMMON PLEAS :CUMBERLAND COUNTY, PENNSYLVANIA :CIVIL ACTION - LAW v. :NO. 01-6286 Civil Term KATHRYN A. PEROUTKA, M.D., and ANDREWS & PATEL ASSOCIATES, P.C.,: Defendants. :JURY TRIAL DEMANDED ORDER AND NOW, this ____ day of , 2001, upon consideration of the Preliminary Objections of Defendants, Kathryn A. Peroutka, M.D., and Andrews & Patel Associates, P.C., to Plaintiffs' Complaint, IT IS HEREBY ORDERED AND DECREED: 1. Paragraphs 55h, 55i, 55j, 550, 60h and 600 of Plaintiffs' Complaint are stricken in their entirety; and 2. Paragraphs 61 and 62 of Plaintiffs' Complaint are stricken in their entirety. BY THE COURT: J. LAURALEE B. BAKER, ESQUIRE Pa. Supreme Court 1.0. No. 58874 SHAUN J. MUMFORD, ESQUIRE Pa. Supreme Court 1.0. No. 84176 MARGOLIS EDELSTEIN Post Office Box 932 Harrisburg, Pennsylvania 17108-0932 Telephone: [717] 975-8114 Fax: [717] 975-8124 E-Mail: Ibaker@margolisedelstein.com Attorney for Defendants: KATHRYN A. PEROUTKA, M.D., and ANDREWS & PATEL ASSOCIATES, P.C. PATRICIA J. THOMSON and ROBERT C. THOMSON, her husband, Plaintiffs, :IN THE COURT OF COMMON PLEAS :CUMBERLAND COUNTY, PENNSYLVANIA :CIVIL ACTION - LAW v. :NO. 01-6286 Civil Term KATHRYN A. PEROUTKA, M.D., and ANDREWS & PATEL ASSOCIATES, P.C.,: Defendants. :JURY TRIAL DEMANDED PRELIMINARY OBJECTIONS OF DEFENDANTS KATHRYN A. PEROUTKA, M.D. AND ANDREWS & PATEL ASSOCIATES, P.C., TO PLAINTIFFS' COMPLAINT AND NOW, comes the Defendants, Kathryn A. Peroutka, M.D. and Andrews & Patel Associates, P.C. (hereinafter collectively referred to as "Dr. Peroutka"), by and through their counsel, Margolis Edelstein, and files preliminary objections to Plaintiffs' Complaint and avers the following in support thereof: 1. On or about November 1, 2001, Patricia J. Thomson and Robert C. Thomson ("Plaintiffs") filed a Complaint in the above captioned matter for injuries caused by the alleged medical battery and negligence of Dr. Peroutka. A copy of Plaintiffs' Complaint is attached hereto, incorporated by reference and labeled Exhibit "A." 2. In their Complaint, Plaintiffs contend that Dr. Peroutka failed to properly evaluate Wife-Plaintiff prior to the administration of chemotherapy treatments. I. MOTION TO STRIKE/MOTION FOR MORE SPECIFIC PLEADING PURSUANT TO Pa.R.C.P. l019(a) 3. The foregoing paragraphs are incorporated herein by reference as though fully set forth at length. 4. Plaintiffs make the following allegations of medical negligence against Dr. Peroutka and her association: a. failing to obtain a proper medical history (~~55h and 60h) . b. failing to properly treat Mrs. Thomson (~~55i and 60i) . c. failing to properly assess and evaluate Mrs. Thomson (~~55j and 60j). d. increasing the risk of severe, permanent and irreversible cardiac damage (~~550 and 600) . 5. Plaintiffs fail to state specifically: a) what medical history Defendants failed to obtain, b) how Defendants failed to properly treat Mrs. Thomson, c) in what way Defendants failed to properly assess and evaluate Mrs. Thomson and d) how Defendants increased the risk of severe, permanent and irreversible cardiac damage. 6. Pennsylvania Rule of Civil procedure 1028(a) (3) allows for the filing of preliminary objections for insufficient specificity in a pleading. 7. If left unchallenged, the above listed generic allegations of medical negligence in Plaintiffs' Complaint will - 2 - allow Plaintiffs to file an amended pleading claiming new theories of negligence after the running of the applicable two year statute of limitations. Connor v. Allegheny General Hospital, 501 Pa. 306, 461 A.2d 600 (1983). WHEREFORE, Defendants, Kathryn A. Peroutka, M.D., and Andrews & Patel Associates, P.C., respectfully request that this Preliminary Objection be sustained, and Paragraphs 55h, 55i, 55j, 550, 60h, 60i, 60j and 600 of Plaintiffs' Complaint be stricken. II. MOTION TO STRIKE/MOTION FOR MORE SPECIFIC PLEADING PURSUANT TO Pa.R.C.P. 1028(a) (3) 8. The foregoing paragraphs are incorporated herein by reference as though fully set forth at length. 9. In Count III of Plaintiffs' Complaint allegations of negligence are made for the actions or inactions of the "agents, ostensible agents, apparent agents, servants and/or employees" of Andrews & Patel Associates. (~~61-62) . 10. Plaintiffs make no effort to in any way describe and/or identify the above listed individuals. 11. While it is unnecessary to plead all the various details of an alleged agency relationship, a complainant must allege, as a minimum, facts which: (1) identify the agent by name or appropriate description; and (2) set forth the agent's authority, and how the tortious acts of the agent either fall within the scope of that authority, or, if unauthorized, were - 3 - -.....-,-<--.---...-.-.. ..~'"..,......_.,~-".~ ratified by the principal. Alumni Association v. Sullivan, 369 Pa. Super. 596, 535 A.2d 1095, 1100 n.2 (1987); See also, P.L.E. Agency 1111 174. 12. Pennsylvania Rule of Civil procedure 1028(a) (3) allows for the filing of preliminary objections for insufficient specificity in a pleading. WHEREFORE, Defendants, Kathryn A. Peroutka, M.D., and Andrews & Patel Associates, P.C., respectfully request that this Preliminary Objection be sustained, and Paragraphs 61 and 62 of Plaintiffs' Complaint be stricken. Respectfully submitted, I~j. ( "- LEE B. BAKER, ESQUIRE Attorney I.D. No. 58874 SHAUN J. MUMFORD, ESQUIRE PA. Attorney I.D. No. 84176 Attorneys for Defendants, KATHRYN A. PEROUTKA, M.D., and ANDREWS & PATEL ASSOCIATES, P.C. Date: P. O. Box 932 Harrisburg, PA 17108-0932 (717) 975-8114 - 4 - \!lNvt\lASNNJd JJ.Nn08 n\;ntl'1'~'f'1nQ &\;;:z \4d L- :J3Q \0 ~J::'ilONC1'\.t:,.!~,( .,;! jv 38\.:UCHJ::r'I'~J Exhibit A Sent ~y: ANDREWS & PATEL; e 717 761 8792; Nov-15-01 11:40AMi C Page 2 PATRICIA J. THOMSON and ROBERT C. THOMSON, her husband, Plaintiffs IN THE COURT OF COMMON PLEAS CUMBERLAND CO., PENNSYLVANIA NO, 01- "'.1.n. C?lo~l'-r-~ v. CNlL ACTION LAW KATHRYN A. PEROUTKA. M.D. and ANDREWS & PATEL ASSOCIATES, P.C., Defendants JURY TRIAL DEMANDED NOTICE YOU HAVE BEEN SUED IN COURT. If you wish to defend against the claims set forth in the following pages, you must take action within twenty (20) days after this Complaint and Notice are served. by entering a written appearance personally or by attorney and filing in writing with the Court your defenses or objections to the claims set forth against you. You are warned that if you fail to do so the case may proceed without you and a judgment may be entered against you by the Court without further notice for any money claimed in the Complaint or for any other claim or relief requested by the Plaintiff. You may lose money or property or other rights important to you. YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW TO FIND om WHERE YOU CAN GET LEGAL HELP. Cumberland COWlty Bar Associates 2 Uberty Avenue Carlisle, PA /7013 717/249-3166 or 1-800-990-9108 c C ,-. '-." {: " ~:~ : ~:~ :'~ ...-', . ~". ;...<:~ ~:), <. :. a t....) "j .":! -'. $ent B.y:ANDREWS & PATEL; c 71 7 761 8792; Nov-15-0t 11:40AM; ( Page 3 PATRICIAJ. THOMSON and ROBERT C. TIIOMSON, her husband, Plaintiffs IN THE COURT OF COMMON PLEAS CUMBERLAND CO., PENNSYLV ANlA NO. v, CNIL ACTION - LAW KATIIRYN A. PEROUTKA, M.D. and ANDREWS & PATEL ASSOCIATES, P.c., Defendants JURY TRIAL DEMANDED NOTICIA Le ban demantlJUlo a usted en la corte. Si usted guiere defenderse de cstas dcmandas expucstas ClIIlu paginas signuicntcs, usted ticne vicnte (20) dias de plaza al partir de la fecha de la demanda y Ia notificacion. Usted debe ~ una apariencia cscrita 0 ClII persona 0 por abogado y archivar en la corte en. forma escrita BUS defcnsas 0 BUS objecioncs a las dcmandas en contra de su pcsona. Sea avisado que si usted no se dc1iende, Ia corte tomara medidas y puede cn.trar una orden contra usted sin previo aviso 0 notificacion y por cualguicr gucja 0 alivio que es pedido en 1a pcticion de dcmanda. Usted puedc pcrdcr dincro 0 sus propiededcs 0 otros dcrcchos importantcs para usted. LLBVE ESTA DEMANDA A UN ABODAGO INMEDJATAMENTE. S1 NO TIENE ABOGADQ 0 S1 NO TIENE EL DINERO SUFICIENTE DE PAGAR TAL SERVICIO, V AYA EN PERSONA 0 LLAME POR TELEFOND A LA OFICINA CUY A DIRECCTON SE ENCUENTRA ESCRIT A ABAJO PARA A VERIGUAR DONDE SE PUEDE CONSEGUlR ASISTENCIA LEGAL. Cumberland County Bar Associates 2 Liberty Avenue . Carlisle, PA 17013 7171249-3166 or 1-800-990-9108 Sent ijy: ANDREWS & PATEL; ( 717 761 8792; Nav-15-Q1 11:41AM; C Page 4 PATRICIA J. THOMSON and ROBERT C. THOMSON, her hUsband, Plaintiffs IN THE COURT OF COMMON PLEAS CUMBERLAND CO., PENNS~LV ANIA NO. v. CIVIL ACTION - LAW KATHRYN A. PEROUTKA, M.D. and ANDREWS & PATEL ASSOCIATES, P.C., Defendants JURY TRIAL DEMANDED COMPLAINT I. Plaintiffs Palricia 1. Thomson and Robert C. Thomson are husband and wife, aduJ.t individuals [CSiding in Mechanicsburg, Cumberland County, Pennsylvania. 2. Defcmdant Kathryn A. Peroutka, M.D. is an aduJ.t individual licensed to practice medicine in the Commonwealth of Pennsylvania, who in 2000 engaged in the practice of oncology in Camp Hill, Cumberland County, Pennsylvania. 3. Defendant Andrews & Patel Associates, P.C., is a corporate medical institution with offices and medical facilities in Camp Hill, Cumberland County, Pennsylvania. 4. At all relevant times hereinafter, the oncology staff, radiology staff and other ancillary medical personnel who provided care to Mrs. Thomson were actual agents, ostensible agents, apparent agents. servants and/or employees of Defendant Andrews & Patel Associates, P.C. S. During the time she provided treatment and care to Mrs. Thomson, Defendant Kathryn A. Peroutka, M.D, was at all relevant times hereinafter an actual agent, ostensible agent, Sent ~y: ANDREWS & PATEL; c 717 761 8792; Nov-15-Q1 11:42AM; ( Page 5 apparent agent, servant and/or employee of Defendant Andrews & Patel Associates. P.C. and was acting within the scope of her employment. 6. On or about June 26, 2000, Plaintiff Patricia Thomson was secn by Defendant Peroutka at Andrews & Patel Associates, P.C. for chemotherapy evaluation. 7. At that time. Defendant Peroutka understOod that Mrs. Thomson underwent a left modified radical mastectomy for infiltrating ductal carcinoma of the left breast. 8. Defendant Peroutka was aware that Mrs. Thomson's axillary nodes were not involved with tumor and histologically the tumor was Stage I, nuclear Grade III, ER and PR. ncgative, and weakly HER-2 positive. 9. With early detection and treatment of her breast cancer, Mrs. Thomson's prognosis was excellent. 10. Defendant Peroutka improperly advised Patricia that she was a good candidate for Adriamycin therapy. 11. Adriamycin treatment is contraindicated in patients whose cancer has not spread to lymph nodes. 12. Adriamycin is a chemotherapy drug, which is toxic to the heart and can cause heart muscle damage. 13. Any patient for whom Adriamycin therapy is recommended must first undergo screening with a diagnostic MUGA scan in order to detect early subclinical cardiomyopathy. 14. A MUGA scan, or multi-acquisition gated test, is a simple and effective way of examining the heart and obtaining a baseline ejection fraction, which will ascertain how well the heart pwnps blood when it beats and how uniformly the heart contracts. 2 ~ent By: ANDREWS & PATEL; 717 761 8792; Nav-15-m 11 :42AMj { Page 8 15. Even small doses of Adriamycin in a patient with subclinical cardiomyopathy can result in pennanent and irreversible cardiac damage. 16. Administering Adriamycin ther..py in any patient without first obtaining a MUGA scan increases the risk of permanent and irreversible cardiac damage. 17. Defendant Peroutka knew, or should have known, that it was contraindicated to treat Mrs. Thomson with Adriamycin therapy without first obtaining a diagnostic MUGA scan. 18. In fact, Defendant Peroutka discussed the performance of a MUGA scan with Mrs. Thomson and even circled the diagnostic test in her chart to be done. 19. However, at no time prior to initiating the Adriamyein ther..py did Defendant Peroutka follow-up with the oncology staff regarding a pre-chemotherapy MUGA scan for Mrs. Thomson. 20. On or about July S. 2000, Defendant Peroutka ordered the first of four cycles of Adriamycin therapy for Mrs. Thomson without obtaining a baseline ejection fraction by MUGA scan, 21. Defendant Andrews & Patel oncology staff inappropriately administered Adriamycin therapy to Mrs. Thomson without first obtaining a MUGA scan. 22. By failing to order and obtain Mrs. Thomson's pre-Adriamycin MUGA scan, Defendant Peroutka exposed her patient to increased risk of permanent and irreversible cardiac damage. 23. Defendant Peroutka improperly authorized the oncology staff at Defendant Andrews & Patel Associates, P.C. to inject Mrs. Thomson with Adriamycin without first obtaining a diagnostic MUGA scan to evaluate the patient's ability to withstand the cardiotoxic effects of the drug. 3 Sent By: ANDREWS & PATEL; 717 761 8792; Nov-15-n1 11:43AM; Page 7 24. As Mrs. Thomson's treating physician, Defendant Peroutka was responsible for all aspects of her management and care, including asscssment and evalUlLtion of her cardiac status before, during and after the administration of the cardiotoxic drug, Adriamycin. 25. Mrs. Thomson completed the four cycles of Adriamycin therapy by the fall of 2000. 26. At no time during the Adriamycin therapy did Defendant Peroutka recommend, order or obtain serial MUGA scans or any diagnostic cardiac workup to evaluate Mrs. Thomson's cardiac status. 27. In January 2001, Mrs. Thomson experienced cardiac changes. 28. In an offic~ visit of January 16, 2001, Defendant Peroutka documented Mrs. Thomson as experiencing tachycardia, which was later conftrmed to be atriallachycardia. 29. In addition to persistent tachycardia. Mrs. Thomson developed further cardiac symptoms, including shortness of breath, severe weakness, nausea, vomiting and a poor appetite. 30. On January 27, 2001, Mrs. Thomson was admitted to the Harrisburg Hospital in fulminant congestive heart failure. 3 I. Mrs. Thomson came under the care of cardiology specialists who diagnosed Adriamycin-induced cardiomyopathy with severe LV dysfunction, congestive heart failure, atrial fibrillation and an ejection fraction of only 20 percenl 32. During Patricia's hospital admission, Defendant Peroutka's partner, Dr. Patcl evaluated Mrs. Thomson and said that it was likely she experienced Adriamycin-induced cardiac damagc. 4 'Sent By: ANDREWS & PATEL; 717 761 8792; Nov-15-rtl 11 :43AM; , Pege 8/18 33. As a result of the damage to her heart, Mrs. Thomson required intensive cardiac therapy, including treatment with Aldactone, Lasix, Cardiazem, Lanoxin, Coumadin, AccupriJ and Amiodarone. 34. After Mrs. Thomson's discharge from the hospital. she required continued follow- up care with numerous specialists, including Dr. Manning, her breast surgeon, who in an office visit in February 2001 asked Patricia, "Didn't they give you a MUGA scan before starting you on Adriamycin"? 35. Mrs. Thomson has been advised that her cardiac condition is serious, permanent and irreversible. 36. Mrs. Thomson has been advised that she will require cardiac treatment and care, including specialist evaluations. and cardiac medications, as well as Coumadin for tbe remainder oCher life. . 37. Many of the cardiac medications necessary to treat the cardiac damage that Mrs. Thomson sustained have extremely dangerous side effects, including permanent damage to vital organs such as liver, kidneys, lungs and eyes. 38. As a result of the trealmcnt and care of her cardiac condition, Mrs. Thomson is at increased risk ofintemal and external bleeding and complications arising therefrom. 39. As a result of her cardiac condition, Mrs. Thomson requires, and in the future will continue to require, follow-up care with numerous specialists, for treatment of side effects resulting from the various prescribed and necessary cardiac medications, including treabncnt of corneal defects. 40. As a direct and proximate result of the Defendants' negligence, Mrs. Thomson has suffered pcnnancnt, irreversible and severe cardiac damage. 5 'Sent !lY: ANDREWS & PATEL; c 717 761 8792; NOV-15-ltl 11 :44AM; ( pege 9/18 41. AI> a direct and proximate result of the Defendants' negligence, Mrs. Thomson presently requires, and will continue to require in the future, close cardiac monitoring and care, as well as close monitoring, evaluation, treatment and care of vital organs affected from complications arising out of treatment with necessary cardiac medications. 42. AI> a direct and proximate result of the Defendants' negligence, Plaintiffs Patricia and Robert 1bomson have been forced to incur liability for medical treatments, medicines, diagnostic tests, office visits, hospitalizations and other similar miscellaneous expenses in an effort to attempt to best maintain and stabilize Mrs. Thomson's health, and because oflhe nature of these injuries, Plaintiffs have been advised and therefore aver that they will continue to be forced to incur similar and even greater medical and miscellaneous expenses in the future, including long-term care costs, and claim is made therefor. 43. AI> a direct and proximate residt of the Defendants' negligence, Mrs. Thomson has undergone, and in the future wiIl continue to undergo. great physical and mental pain and suffering, great inconvenience in carrying out her daily activities and a loss of life's pleasures and enjoyment, and claim is made therefor. 44. AI> a direct and proximate result of the Defendants' negligence, Mrs. Thomson has been subject to great humiliation and embarrassment, and in the future will continue to be subject to great humiliation, embarrassment and potential disfigurement for treatment and carc of her cardiac condition, and complications therefrom, and claim is made therefor. 45. The substandard care of Defendants Kathryn Peroutka, M.D. and Andrews & Patel AssociatllS, P.e. increased the risk ofhann and injury to Patricia Thomson. 46. Defendants Kathryn Peroutka, M.D. and Andrews & Patel AI>sociates, P.C. arc joinlly and severally liable for the injuries and damages as set folth herein. 6 'Sent By: ANDREWS & PATEL; 717 761 8792; Nov-15-nlll:44AM; Page 10/18 47. The serious, permanent and irreversible cardiac damage and complications therefrom will adversely affect Mr. Thomson's life expectancy and is directly attributable to the Defendanls' negligence, and claim is made therefor. 48. As a direct and proximate result of the Defendants' negligence, Mrs. Thomson has sustwned permanent impainnent of hcr earning power and earning capacity, and claim is made therefor. 49. As a direct and proximate result of the Defendants' negligence, Mrs. Thomson is now at increased risk for developing further cardiac complications and damage associated with the treatment of her cardiac condition, and claim is made therefor. COUNT 1- INFORMED CONSENT/BATTERY PATRICIA THOMSON V. KAmRYN A. PEROUTKA. M.D. 50. Parolgraphs I through 49 of this Complaint are incorporated herein by reference as if set forth at length. 51. Defendant Peroutka is liable to the Plaintiff, Patricia Thomson, for battery in the form of intentionally inflicting harmful and offensive bodily contact on Mrs. Thomson by failing to obtain her informed consent for chemotherapy administration pursuant to 40 P.S. ~1301.811-A, et seq. 52. Plaintiff Patricia Thomson would not have submitted to Adriamycin chemotherapy or Adriarnycin therapy without protective medications if she had known of the undisclosed information, risks, consequences, side effects and alternative treatment. 53. As a result, Plaintiff sustained injuries and damages as set forth in Paragraphs 27 through 49 above, whieh are incorporated herein by reference as if set forth at length. 7 'Sent By: ANDREWS & PATEL; 717 761 87e2; Nov-15-"' 11:45AM; Page 11/18 WHEREFORE. Plaintiff Patricia Thomson demands judgment against Defendant Kathryn A. Peroutka, M.D. for compensatory uamagcs in an amount in excess of Twenty-Five Thousand Dollars ($25,000), exclusive of interest and costs, and in excess of any jurisdictional amount requiring compulsory arbitration. COUNT II - NI!:GLIGENCE PATRICIA THOMSON V. KATHRYN A. PEROUTKA. M.D. 54. Paragraphs I through 49 and Count I of this Complaint are incorporated herein by reference as if set forth at length. 55. Defendant Kathryn A. Peroutka, M,D. is liable 10 Plaintift. Patricia Thomson for - injuries and damages alleged herein which were directly and prox imately caused by her carelessness and negligence in: a) improperly advising Mrs. Thomson that she was a good candidate for Adriamycin therapy; b) ordering a contraindicaled treatment for Mrs. Thomson; c) failing to recognize thaI Mrs. Thomson was not a candidatc for Adriamycin therapy; d) failing to order and obtain a MUGA scan prior to initiating Adriamycin therapy; e) failing 10 assess Mrs. Thomson's cardiac status for subclinical cardiomyopathy prior to initiating Adriamycin therapy; 8 'Sent By: ANDREWS & PATEL; 717 761 8792; Nov-15-Q1 11 :45AM; Page 12/18 f) failing to advise Mrs. Thomson that treatment with Adriamycin, absent the performance ofa baseline ejection fraction with a MUGA scan, increased her risk for severe, permanent and irreversible cardiac damage; g) failing to minimize the risk of severe, permanent and irreversible cardiac damage; b) failing to obtain a proper medical history; i) failing to properly treat Mrs. Thomson; j) failing to properly assess and evaluate Mrs. Thomson; k) failing to recognize and diagnose Mrs. Thomson's subclinical cardiomyopathy pr~or to initiating the Adriamycin therapy; I) failing to follow-up with the oncology staff regarding the performance of a pre-chemotherapy MUGA scan prior to initiating Mrs. Thomson's Adriamycin therapy; m) improperly assuming that Mrs. Thomson was too young and healthy to require a MUGA scan prior to the administration of Adriamycin; n) failing to understand that even small doses of Adriamycin in a patient with subclinical cardiomyopathy can result in permanent, severe and irreversible cardiac damage; 0) increasing the risk of severe, permanent and irreversible cardiac damage; p) causing permanent, severe and irreversible damage to Mrs. Thomson's heart; q) failing to evaluate Mrs. Thomson's ability to withstand the cardiotoxic effects of Adriamycin; 9 'Sent By: ANDREWS & PATEL; 717 761 8792; Nov-15-Q1 11 : 46AM; ( Page 13/18 r) failing to order or obtain cardiac assessments and evaluations before, during and after the Adriamycin therapy; s) failing to order or obtain serial MUGA scans during the Adriamycin therapy; and t) increasing lhe risk of severe, permanent and irreversible vital organ damage from Adriamyein-induced cardiomyopathy. 56. As a direct and proximate resull of Defendant Kathryn A. Peroutka, M.D. 's negligence, the Plaintiff bas sustained injuries and damages as set forth in paragraphs 27 through 49 above, which are incorporated harein by reference as if set forth at length. WHEREFORE,. P!.&intiff Patricia Thomson demands judgment against Defendant Kathryn A. Peroutka, M.D. for compensatory damages in an amount in excess of Twenty-Five Thousand Dollars ($25,000), exclusive of interest and costs, and in excess of any jurisdictional amount requiring compulsory arbitration. COUNT III - NEGUGENC,E PATRICIA THOMSON V. ANDREWS & PATEL ASSOCIATES. P.C. 57. ParagraphS I through 49 and Counts I and II of this Complaint are incorporated herein by reference as if set forth at length. 58. At all relevant times hereinafter, Defendant Kathryn Peroutka, M.D. was an actual agent, ostensible agent, apparent agent, servant and/or employee ofDefcndant Andrews & Patel Associates, P.C. 59. At all relevant times hereinafter, the oncology staff, radiology staff and ancillary medical personnel who provided care to Plaintiff, Patricia Thomson, from June 2000 to January 10 'Sent B.y: ANDREWS & PATEL; 717 761 8792; Nov-15-01 11:46AM; Page 14/18 2001 were actual or ostensible agents, apparent agents, servants and/or employees of Defendant Andrews & Patel Associates, P.C. 60. Defendant Andrews & Patel Associates, P.C. is liable to the Plaintiff for injuries and damages alleged herein, which were directly and proximately caused by its negligent actions in: a) improperly advising Mrs. Thomson that she was a good candidate for Adriamycin therapy; b) ordering a contraindicated treatment for Mrs. Thomson; e) failing to recognize that Mrs. Thomson was not a candidate for Adriamycin therapy; d) failing to order and obtain a MUGA scan prior to initiating Adriamycin therapy; e) failing to assess Mrs. Thomson's cardiac status for subclinical cardiomyopathy prior to initiating Adriamycin therapy; f) failing to advise Mrs. Thomson that treatment with Adriamycin, absent the perfonnanee of a baseline ejeclion fraction with a MUGA scan, increased her risk for severe, permanent and irreversible cardiac damage; g) fai ling to minimi:le the risk of severe, pennanent and irreversible cardiac damage; h) failing to obtain a proper medical history; i) failing to properly treat Mrs. Thomson; j) failing to properly assess and evaluate Mrs, Thomson; 11 'Sent By: ANDREWS & PATEL; 717 761 87B2; NOV-15-~1 11:47AM; Page 15/18 k) failing to recognize and diagnose Mrs. Thomson's subclinical can:liomyopathy prior to initiating the Adriamycin therapy; 1) failing to follow-up with thc oncology staffregarding the performance of a pre-chemotherapy MUGA scan prior to initiating Mrs. Thomson's Adriamycin therapy; m) improperly assuming that Mrs. Thomson was too young and healthy to require a MUGA scan prior to the administration of Adriamycin; n) failing to understand that even small doses of Adriamycin in a patient with subclinical cardiomyopathy can result in permanent, severe and irreversible cardiac damage; 0) increasing the risk of severe, permanent and irreversible cardiac damage; p) causing pcnnanent. severe and irreversible damage to Mrs. Thomson's heart; q) failing to evaluate Mrs. Thomson's ability to withstand thc cardiotoxic effects of Adriamycin; r) failing to order or obtain cardiac assessments and evaluations before, during and after the Adriamycin therapy; sl failing to order or obtain serial MUGA scans during the Adriamycin therapy; t) increasing the risk of severe, permanent and irreversible vital organ damage from Adriamycin-induced cardiomyopathy; ul inappropriately holding itself out to the public as having all the necessary facilities, equipment and trained personnel and services to care for Mrs. Thomson; v) failing to properly train, instruct and notify staff that every patient treated 12 'Sent By: ANDREWS & PATEL; 71 7 761 8792; Nov- 15._n< 11 :47AM; Page 16/18 with Adriamycin must undergo a MUGA scan prior to treatment. w) inappropriately representing that it was able to provide safe and appropriate care and services to Mrs. Thomson; and x) inappropriately representing that Mrs. Thomson was not in danger due to lack of trained staff. facilities, equipment and services. 61. Defendant Andrews & Patel Associates, P.C. by virtue of the actions andlor inactions ofits agents, ostensible agents, apparent agents, servants andlor employees, is negligent in failing to properly train, instruct or notify its staff that every patient treated with Adriamycin must first undergo a MUGA scan in order to obtain a baseline ejection fnlction prior to the administration of Adriamycin. 62. Defendant Andrew & Patel Associates, P.C. by virtue of the actions and/or inactions of its agents. ostensible agents. appilrent agents, servants andlor employees is negligent in failing to obtain a MUGA scan prior to administering Mrs. Thomson's Adriamycin therapy. 63. As a direct and proximate result of Defendant Andrews & Patel Associates, p.e, 's negligence, Plaintiff, Patricia Thomson, has sustained injuries and damages as set forth in paragraphs 27 through 49 above, which are incorporated herein by reference as if sel forth at length. WHEREFORE. Plaintiff, Patricia Thomson, demands judgment against Defendant Andrews & Patel Associates. P.C. for compensatory damages in an amount in excess of Twenty- Five Thousand Dollars ($25,000), exclusive of interest and costs. and in excess of any jurisdictional amount requiring compulsory arbitration. 13 'Sent Sy: ANDREWS & PATEL; 717 761 8792; Nov-15_-' .11 :46AM; i Page 17/18 CLAIM I ROBERT C. THOMSON V. KATHRYN A. PEROUTKA, M.D. AND ANDREWS & PATEL ASSOCIATES. P.C. 64. Paragraphs I through 49 and Counts I through 1lI of this Complaint are incorporated herein by reference as if set forth at length. 65, As a direct and proximate result of the negligence of Defendants Kathryn A, Peroutka, M.D. and Andrews & Patel Associates, P.C., and the resulting severe, pcnnanent and irreversible cardiac damage suffered by his wife, Plaintiff, Robert C. Thomson, has been, and in the future will be, deprived of the care, companionship, consortium and society of his wife, all of which will be to his great detriment, and claim is made therefor. WHEREFORE, Plaintiff, Robert C. Thomson, demands judgment against Defendants Kathryn A. Peroutka, M.D. and Andrews & Patel Associates, P.C. for compensatory damages in an amount in excess of Twenty-Five Thousand Dollars ($25.000), exclusive of interest and costs, and in excess of any jurisdictional amount requiring compulsory arbitration. Respectfully submitted, ,:~~.TSK~. ?LSON & WISNE J.L.P Date: October 31.2001 Nijole C. son, Esquire I.D. No. $5287 2040 Ling,estow Road, Suite 303 Harrisburg;'PA- 711 0 717/541-9205 Counsel for Plainti Ifs 14 ,Sent ey: ANDREWS & PATEL; ( 717 761 8792; Nov-15, -, 11 :48AM; \ Pege 18/18 VERIFICATION We, Patricia 1. Thomson and Robert C. Thomson. verify that the facts set forth in the foregoing Complaint are true and correct 10 the best of our knowledge, infol1Illition, and belief. We understand that this verification is made subject to the provisions of 18 Pa.C.S. ~4904, relating to the unsworn falsification to authorities. Date: fO/jO/OI ~~...:'., y -.:Ma>...~ Patricia . Thomson Date: (()/~OIOI k~;.._ ~ I Robert C. Thomson CERTIFICATE OF SERVICE I HEREBY CERTIFY that I served a true and correct copy of the foregoing PRELIMINARY OBJECTIONS OF DEFENDANTS, KATHRYN A. PEROUTKA, M.D., AND ANDREWS & PATEL ASSOCIATES, P.C., TO PLAINTIFFS' COMPLAINT, on all counsel of record by placing the same in the United States mail at Camp Hill, Pennsylvania, first- the~d day of ~ ~ class postage prepaid, on 2001, and addressed as follows: Nijole C. Olson, Esquire Navitsky, Olson & Wisneski, LLP 2040 Linglestown Road - Suite 303 Harrisburg, PA 17110 MARGOLIS EDELSTEIN '>- b:: <, e~ (, LU..."'.- (:::" f.!. (~) c> ::J G.~ ;. LL. o ", ("; N ~ L...': '.') .-< )~~ j;~ ':~)2 ."""'6., -:.::12": :-~~ ~ () u.. r- 1 U w'..1 o <:::> PATRICIA J, THOMSON and ROBERT C. THOMSON, her husband, Plaintiffs IN THE COURT OF COMMON PLEAS CUMBERLAND CO., PENNSYL VANIA NO. 01-6286 v. KATHRYN A. PEROUTKA, M.D. and ANDREWS & PATEL ASSOCIATES, P.C., CNIL ACTION - LAW Defendants JURY TRIAL DEMANDED ORDER AND NOW, this day of , 2001 upon consideration of the Preliminary Objections of Defendants Kathryn A. Peroutka, M.D. and Andrews & Patel Associates, P.C. and Plaintiffs' response thereto, it is HEREBY ORDERED AND DECREED that Defendants' Preliminary Objections seeking to strike paragraphs 55(h), 55(i), 55(j), 55(0), 60(h), 60(0), 61 and 62 of Plaintiffs' Complaint is denied. It is further Ordered that Defendants Kathryn A. PeroiItka, M.D. and Andrews & Patel Associates, P.C. file an Answer to Plaintiffs' Complaint within twenty (20) days. BY THE COURT: J. ... ,,,,....... .;,.:".;.;,c,," PATRICIA J. THOMSON and ROBERT C. THOMSON, her husband, IN THE COURT OF COMMON PLEAS CUMBERLAND CO., PENNSYL VANIA Plaintiffs NO, 01-6286 v, KATHRYN A. PEROUTKA, M.D. and ANDREWS & PATEL ASSOCIATES, P.C" CNIL ACTION - LAW Defendants JURY TRIAL DEMANDED PLAINTIFFS' REPLY TO PRELIMINARY OBJECTIONS OF DEFENDANTS KATHRYN A. PEROUTKA. M.D. AND ANDREWS & PATEL ASSOCIATES. P.C. AND NOW, come the Plaintiffs, Patricia and Robert Thomson, by and through their attorneys, Navitsky, Olson & Wisneski LLP, and file a response to the Preliminary Objections of Defendants Kathryn A. Peroutka, M.D, and Andrews & Patel Associates, P.C. to Plaintiffs' Complaint as follows: 1. It is admitted that Plaintiffs set forth sufficient factual allegations of negligence in their Complaint filed against Defendants Kathryn A. Peroutka, M.D. and Andrews & Patel Associates, P.C. on or about November I, 2001. 2. Denied as stated. Plaintiffs' Complaint is a written document which speaks for itself. I. PLAINTIFFS' REPLY TO DEFENDANTS' MOTION TO STRIKE/MOTION FOR MORE SPECIFIC PLEADING PURSUANT TO Pa.R.C.P. 1019(a) 3. The foregoing paragraphs are incorporated herein by reference as if set forth at length. 4. It is admitted that Plaintiffs' Complaint alleges specific allegations of negligence against Defendants Peroutka and Andrews & Patel Associates for, among other things: .. "'..-....--- ", JiU,;i; ;~r".;':T.., a) Failing to obtain a proper medical history (paragraphs 55(h) & 60(h)); b) Failing to properly treat Mrs. Thomson (paragraphs 55(i) & 60(i)); c) Failing to properly assess and evaluate Mrs. Thomson (paragraphs 55G) & 60(j)); and d) Increasing the risk of severe, permanent and irreversible cardiac damage (paragraphs 55(0) & 60(0)). 5. It is specifical!y denied that Plaintiffs failed to al!ege material facts sufficient to satisfy the requirements ofPa.R.C.P. 1019(a). 6. It is specifical!y denied that Plaintiffs failed to al!ege material facts sufficient to satisfy the requirements ofPa.R.C,P, 10 I 9(a). 7. It is specifical!y denied that paragraphs 55(h), 55(i), 55(j), 55(0) and 60(h), 60(i), 60(j), and 60(0) of Plaintiffs' Complaint al!ege a Conners "failing to use due care and caution under the circumstances" al!egation, Conner v. Al!eghenv General Hosp., 501 Pa. 306, 461 A.2d 600,601 (1983). WHEREFORE, Plaintiffs Patricia and Robert Thomson respectful!y request that This Honorable Court dismiss the Preliminary Objections of Defendants Kathryn Peroutka, M.D. and Andrews & Patel Associates, P.C. seeking to strike paragraphs 55(h), 55(i), 55(j), 55(0), 60(h), 60(i), 60(j) and 60(0). II. PLAINTIFFS' RESPONSE TO DEFENDANTS' MOTION TO STRIKE/MOTION FOR MORE SPECIFIC PLEADING PURSUANT TO Pa.R.C.p. 1028 (a)(3) 8. The foregoing paragraphs are incorporated herein by reference as if set forth at length. 9. Plaintiffs' Complaint is a written document which speaks for itself. By way of further response, paragraph 61 of Plaintiffs' Complaint al!eges that Defendant Andrews & Patel 2 ... i ~,~ .. \, , .. ,..ti'~';"l:bt_i""J~_~~~I;.~t>lJ;;;,-;:~\,":',;" Associates, P.C. by virtue of the actions and/or actions of its agents, ostensible agents, apparent agents, servants and/or employees was negligent in failing to properly train, instruct or notify its staff that every patient treated with Adriamycin must first undergo a MUGA scan in order to obtain a baseline ejection fraction prior to the administration of Adriamycin. Further, in paragraph 62 of their Complaint, Plaintiffs allege that Defendant Andrews & Patel Associates, P.C. by virtue of the actions and/or inactions of its agents, ostensible agents, apparent agents, servants and/or employees was negligent in failing to obtain a MUGA scan prior to administering Mrs. Thomson's Adriamycin therapy. 10. Since the exact names of said agents, apparent agents, ostensible agents, servants and/or employees is within the exclusive knowledge of Defendant Andrews & Patel Associates, P.C. and can only be ascertained through discovery, Plaintiffs cannot reasonably be expected to identify such individuals by name in the Complaint, nor are Plaintiffs required to do so. II. Denied. Moving Defendant misstates the law with regard to what details need to be pled for an alleged agency relationship. The facts in the instant case are entirely distinguishable from those in Alumni Association v. Sullivan, 369 Pa. Super. 596, 535 A.2d 1095, 1100 n.2 (1987), cited in Moving Defendants' motion. Finally, a more specific pleading should not be required where the party filing the objections has, or should have as much or better knowledge than the pleader. 12. It is specifically denied that Plaintiffs' Complaint at paragraphs 61 and 62 lack sufficient specificity to satisfy the requirements ofPa. R.C.P. 1019(a). 3 ,.~.4 . .l -1_' ',,' "",""'''.~";l''_;~~.L'" j:,-.:)]:;,':" (~,J:'l" '\'::): WHEREFORE, Plaintiffs Patricia and Robert Thomson respectfully request that This Honorable Court dismiss the Preliminary Objections of Defendants Kathryn Peroutka, M.D. and Andrews & Patel Associates, P.C. regarding paragraphs 61 and 62 of Plaintiffs' Complaint. Plaintiffs respectfully request that This Honorable Court order Defendants to file an Answer to Plaintiffs' Complaint within twenty (20) days of such dismissal. Respectfully submitted, SKY, OLSON & WISNESKI LLP Date: December 20,2001 4 >" ." ..,-~"" <'Ik"1M_.;1,l.>in.-;.; CERTIFICATE OF SERVICE I, Lois E. Stauffer, an employee of the law firm ofNavitsky, Olson & Wisneski LLP, hereby certifY that a true and correct copy ofthe foregoing PLAINTIFFS' REPLY TO PRELIMINARY OBJECTIONS OF DEFENDANTS KATHRYN A. PEROUTKA, M.D. AND ANDREWS & PATEL ASSOCIATES, P.C. was served upon the following person by first-class United States mail, postage prepaid on December 20, 2001, as follows: Lauralee B. Baker, Esquire MARGOLIS EDELSTEIN P.O. Box 932 Harrisburg, PA 17108-0932 Counsel for Defendants ~eUJ r.~ Lois E. Stauffer g Cl 0 -"1'1 S 0 :,:;:l ~gl 1'1 ~t,:r: n r' N ."cn Vi); ""'9 CT> (Jr") 2CJ -0 ~-,:! ~'f'i 4e:: -* ::n %8 :x C)~ ~ 5 :l>c ;:.; ~ W ~ 0:> .- ,_~"~"",',,..'" LAURALEE B. BAKER, ESQUIRE Pa. Supreme Court I.D. No. 58874 SRAUN J. MUMFORD, ESQUIRE Pa. Supreme Court I.D. No. 84176 MARGOLIS EDELSTEIN Post Office Box 932 Harrisburg, Pennsylvania 17108-0932 Telephone: [717] 975-8114 Fax: [717] 975-8124 E-Mail: Ibaker@margolisedelstein.com Attorney for Defendants: KATHRYN A. PEROUTKA, M.D., and ANDREWS & PATEL ASSOCIATES, P.C. PATRICIA J. THOMSON and ROBERT C. THOMSON, her husband, Plaintiffs, :IN THE COURT OF COMMON PLEAS :CUMBERLAND COUNTY, PENNSYLVANIA :CIVIL ACTION - LAW v. :NO. 01-6286 Civil Term KATHRYN A. PEROUTKA, M.D., and ANDREWS & PATEL ASSOCIATES, P.C.,: Defendants. :JURY TRIAL DEMANDED PRAECIPE TO REMOVE CASE FROM JANUARY 2, 2002 ARGUMENT LIST TO THE PROTHONOTARY OF CUMBERLAND COUNTY: Kindly remove the above captioned matter from the Argument List on January 2, 2002. Respectfully submitted, MARGOLIS EDELSTEIN Date: (~~1l1 By: LA RA E B. BAKER, ESQUIRE PA. torney I.D. No. 58874 SHAUN J. MUMFORD, ESQUIRE PA. Attorney I.D. No. 84176 Attorneys for Defendants, KATHRYN A. PEROUTKA, M.D., and ANDREWS & PATEL ASSOCIATES, P.C. P. O. Box 932 Harrisburg, PA 17108-0932 (717) 975-8114 " .J "- ~ c:> ~ 0 :-; ~~ f'T1 ..1-.." C") rl1r= N "'Om ?Qz 0" ~~ h20 -0 -,~ I ".1-,., ~8 :x o~ z :i>c ~ ~ ~ ,"" ~ N MARGOLIS EDELSTEIN PHILADELPHIA OFFICE TH. CURTIS CENTER FOURTH FLOOR INDEPENDENCE SQUARE WEST PHILADELPHIA, PA 19106-3304 215-922-1100 FAX 215-922-1772 ATTORNEYS AT LAw DELAWARE COUNTY OFFICE 216 SOUTH ORANG. STREET MEDIA, PA 19063 610-565..8311 FAX610-S65-8318 POST OFFICE BOX 932 HARRISBURG, PA 17108-0932 PITTSBURGH OFFICE 1500 GRANT BUILDING PITTSBURGH, PA 15219-2203 412-281-4256 FAX 412-642-2380 STREET ADDRESS: 3510 TRINDLE ROAD CAMP HilL, PA 17011 717-975-8114 FAX 717-975-8124 NEW JERSEY OFFICE P.o. BOX 2222 216 HADDON AVENUE WESTMONT, NJ 08108-2886 609-858-7200 FAX 609-858-1017 WRITER: LAURALEE B. BAKER DIRECT E-MAIL: Ibaker@margolisedelstein.com SCRANTON OFFICE TH. OPPENHEIM BUILDING 409 LACKAWANNA AVENUE SUITE 3C SCRANTON, PA 18503 570-3424231 FAX 570-342-4841 December 18, 2001 Mr. Curt Long, Prothonotary Cumberland County Court of Common pleas cumberland County Courthouse 1 Courthouse Square Carlisle, PA 17013 Re: Thomson v. Peroutka, et al. Docket No. 01-6286 Our File No. 57300.4-000123 Dear Mr. Long: Enclosed herein for filing please find the original and three copies of the Praecipe to Remove Case from January 2, 2002 Argument List of Defendants, Kathryn A. Peroutka, M.D., and Andrews & Patel Associates, P.C., with reference to above captioned matter. Kindly time stamp and return one copy to this office in the self-addressed stamped envelope enclosed for your convenience. In accordance with the Certificate of Service, copies are being served upon all counsel of record. Very truly yours, LBB/jen Enclosures cc: Richard J. Pierce, Court Administrator (w/encl.) Nijole C. Olson, Esquire (w/encl.) CERTIFICATE OF SERVICE I HEREBY CERTIFY that I served a true and correct copy of the foregoing PRAECIPE TO REMOVE CASE FROM ARGUMENT LIST, on all counsel of record by placing the same in the United States mail at Camp Hill, Pennsylvania, first-class postage prepaid, on the ~Vday oftX/l~~, 2001, and addressed as follows: Nijole C. Olson, Esquire Navitsky, Olson & Wisneski, LLP 2040 Linglestown Road - Suite 303 Harrisburg, PA 17110 MARGOLIS EDELSTEIN "J ",.,/ - By: ,6 Ann E. Nelson, Secretary .P ,- . . a 0 0 c: -n so: <::) -00) fT1 p! 92~ n N -".....-\ ~.i 0" ~.,\)y ~~? (2CJ -0 ~.J.: -n ~8 :;!:: ;;::';0 ~ t-:sfTl :i>c: -l ~ ,f:" ~ N '~ PRAECIPE FOR LISTING CASE FOR ARGUMENT (Must be typewritten and submitted in duplicate) TO THE PROTHONOTARY OF CUMBERLAND COUNTY: Please list the within matter for the next Argument Court. ----------------------------------------------------------------- CAPTION OF CASE (entire caption must be stated in full) PATRICIA J. THOMSON and ROBERT C. THOMSON, her husband, Plaintiffs, v. KATHRYN A. PEROUTKA, M.D., and ANDREWS & PATEL ASSOCIATES, P.C., Defendants. No. 01-6286 Civil 2001 1. State matter to be argued (i.e., plaintiff's motion for new trial, defendant's demurrer to complaint, etc.): Preliminary Objections of Defendants, Kathryn A. Peroutka, M.D., and Andrews & Patel Associates, P.C. 2. Identify counsel who will argue case: (a) for plaintiff(s): Address: Nijole C. Olson, Esquire Navitsky, Olson & Wisneski, LLP 2040 Linglestown Road - Suite 303 Harrisburg, PA 17110 (717) 541-9205 (b) for defendant(s) Address: Lauralee B. Baker, Esquire Margolis Edelstein P. O. Box 932 Harrisburg, PA 17108-0932 (717) 975-8114 3. I will notify all parties in writing within two days that this case has been listed for argument. 4. Argument Court Date: February 13, 2002 Dated: December 18, 2001 &-~ "omRE SHAUN J. MUMFORD, ESQUIRE Attorney for Defendants, KATHRYN A. PEROUTKA, M.D., and ANDREWS & PATEL ASSOCIATES, P.C. r- \ e 0 0 ..., -oe5 0 ~ f'T1 S:2!:B C") rn:D r- ~?i N ,,'Om 0" -oJ? ~.::,o :.:;:0 -'~-I -0 IIJ ~O ::x On ~g ~ 2m ~ ~ CJ1 ~ -.I "'-,'..., e, h....".'"......,., , " ..<..'" ,.,....-, CERTIFICATE OF SERVICE I HEREBY CERTIFY that I served a true and correct copy of the foregoing PRAECIPE FOR LISTING CASE FOR ARGUMENT, on all counsel of record by placing the same in the United States mail at Camp Hill, Pennsylvania, first-class postage prepaid, on the ;-Uday Of~~ 2001, and addressed as follows: Nijole C. Olson, Esquire Navitsky, Olson & Wisneski, LLP 2040 Linglestown Road - Suite 303 Harrisburg, PA 17110 MARGOLIS EDELSTEIN ~~ Ann E. Nelson, ecretary ,... l o ~% -o~ ("'> ~~. ~, m~ ::<:. i? --0 12. ,. '%0\ \';'? '7 d' ....l ~ ::t4J rnf::. ,,' -:Y,l;? -:':) J-) '::~j (;'(, "\. "1"\ .,..~-:; %~ o '" ~ ::4: PATRICIA 1. THOMSON: and ROBERT C. THOMSON, her husband, Plaintiffs IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYL VANIA v. CIVIL ACTION - LAW KATHRYN A. PEROUTKA, M.D., and ANDREWS & PATEL ASSOCIATES, P.C., Defendants NO. 01-6286 CIVIL TERM IN RE: DEFENDANTS' PRELIMINARY OBJECTIONS BEFORE HOFFER P.J.. and OLER. J. ORDER OF COURT AND NOW, this 14th day of February, 2002, upon consideration of Defendants' preliminary objections to Plaintiffs' complaint in the form of a motion to strike or for a more specific pleading, and following oral argument at which counsel agreed that objections to paragraphs 55h, 55i, 55j, 550, 60h and 600 may be resolved by construing of the allegations as if they were modified by the phrase "in the manner described herein," it is ordered as follows: 1. Paragraphs 55h, 55i, 55j, 550 and 60h and 600 of Plaintiffs' complaint shall be construed as modified by the phrase "in the manner described herein"; 2. Defendants' preliminary objections as they relate to paragraphs 61 and 62 of Plaintiffs , complaint are denied. BY THE COURT, '"\\ c' ,,06 .YJ~~~ ~\',:~\;\)~;?y~\\Cl },,\3',f\uJ . '3 \ ;'<., \$~ $ \ , \ "'.:\\ j (1\'''' . /Nijole C. Olson, Esq. 2040 Linglestown Road Suite 303 Harrisburg, PA 17110 Attorney for Plaintiffs > /Lauralee B. Baker, Esq. Shaun J. Mumford, Esq. P.O. Box 932 Harrisburg, P A 17108-0932 Attorneys for Defendants :rc L ople~ ~ 0.', \ eJ O~-J'1.(J2 "'"K)\5 ;- ,_ f',' .,J,(,^,,..Ul;',iilUl;;Li,:;,,,,,'d.<i';" " . CERTIFICATE PREREQUISITE TO SERVICE OF A SUBPOENA PURSUANT TO RULE 4009.22 IN THE MATTER OF: COURT OF COMMON PLEAS PATRICIA & ROBERT THOMAS, ET AL. TERM, -VS- CASE NO: 01-6286 KATHRYN A. PEROUTKA, M.D., ET AL. As a prerequisite to service of a subpoena for documents and thingscijur~nt() to Rule 4009.22 C N 'TI :::;;,.. -rt --..\ -om r"'1 ~,'1 nlrr\ CO,-,lr;;:' z:v N ._,,,,,,l'T1 Z r;;: -.I }J (r.~ en...:;-- ,_)( , ~ cj -0 ~{~"~1 ~ ~8 ~ ~hl Z 55 ~ ...J '-< (1) A notice of intent to serve the subpoena with a copy of the subpoena attached thereto was mailed or delivered to each party at least twenty days prior to the date on which the subpoena is sought to be served, MCS on behalf of LAURALEE B. BAKER, ESQ. certifies that (2) A copy of the notice of intent, including the proposed subpoena, is attached to this certificate, (3) No objection to the subpoena has been received, and (4) The subpoena which will be served is identical to the subpoena which is attached to the notice of intent to serve the subpoena. . ~c~ ~~ ~~ah~ ~f /3. StlhA, ~i \ ~~R, ESQ. Attorney for DEFENDANT DATE: 02/21/2002 DEl1-311815 837 56-LOl COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND IN THE MATTER OF: COURT OF COMMON PLEAS PATRICIA & ROBERT THOMAS. ET AL. TERM. -VS- CASE NO: 01-6286 KATHRYN A. PEROUTKA, M.D., ET AL. NOTICE OF INTENT TO SERVE A SUBPOENA TO PRODUCE DOCUMENTS AND THINGS FOR DISCOVERY PURSUANT TO RULE 4009.21 [ Note: see enclosed list of locations ] TO: NIJOLE C. OLSON, ESQ. KCS on behalf of LAURALEE B. BAKER, ESQ. intends to serve a subpoena identical to the one that is attached to this notice. You have twenty (20) days from the date listed below in which to file of record and serve upon the undersigned an objection to the subpoena. If the twenty day notice period is waived or if no objection is made, then the subpoena may be served. Complete copies of any reproduced records may be ordered at your expense by completing the attached counsel card and returning same to MCS or by contacting our local HCS office. DATE: 02/01/2002 MCS on behalf of LAURALEE B. BAKER, ESQ. Attorney for DEFENDANT CC: LAURALEE B. BAKER, ESQ. MICHAEL BOND - THOMSON Any questions regarding this matter, contact THE MCS GROuP INC. 1601 HARKET STREET #800 PHILADELPHIA, PA 19103 (215) 246-0900 DE02-177109 83756-C02 .. >>> LOCATION LIST <<< PAGE: 1 RECORDS REQUESTED MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) LOCATION NAME ROBERT S. NOLTE, D.O. MOFFITT, PEASE & LIK ASSOC. JOHN H. SULLIVAN GEORGE O. ROSENWASSER, H.D. PINNACLE HEALTH AT HARRISBURG PINNACLE HEALTH HOSPITALS KUNlCEL SURGICAL GROUP CARL J _ DORKO, H.D. CENTRAL PA HEMATOLOGY & ONCOL. RONALD H. MALCOH, H.D. .' DE02-177109 837 56-C02 COMMO/';"WEALTH OF PENNSYLVANIA COUNTY OF CUMBERL.-\SD PATRICIA J. THOMSON & ROBERT C. THOMSON VS Fiie So. 01-6286 CIVIL KATHRYN A. PEROUTKA, M.D., ET AL SUBPOENA TO PRODUCE DOCUMD."TS OR Tr{I:,\;G5 FOR DISCOVERY PURSUA...'"T TO RULE 4009..2: TO: CUSTODIAN OF RECORDS FOR: ROBERT S. NOLTE, D.O. {s..'". Qf ?f:"3Gn or ~~=r:r' ~'i~~j:'l ~'e~.. (~) ct.ys UtI:' se!'\"ict of this SUO?'!ft ~~~ftwrt'd by t,'1. ~vn to .~rod~c~ the feiiewing .:o~~ml!!'ItS or ::'llt'\-gS: ., MCS GROUP INC., 1601 MARKET ST., #800, PHILA.,PA 19103 (."44tft1) "(01.1 mOlY dtihoft or m~I tepbl. copies 01 the dor.:m.nrs or product dunp 1"I'q1:lftt.d '=y this sub~OInL tog!::":!!:" .....ith tt'lt c!rTificJtI a: :cl:npliUU~t. to the p.arry z::nwng t:tis request .t the Jdc!nsllisted abov,_ You. }u,", t:"t, ri!i'lt :0 s~~!<. in .d"."n. ~~o ,....on..i. ,oil ot pft?.,;n! the ,opi.. or prodY'inS th.minp -!hI. It ~'OY foil", ;::,.dyn the documenll or things rt,!yired 'Y thil Sy'poef14 w;t....... rwenry (::ll) "'y".tttr itS so,.,';,.. tn. ?""y ser,in! :::.is ':'::poln.1 molY 'Hie.. (0W't order c:=mp1Uins you to comply with =.. nm St"BPOENA WAS ISSUED ATT:-iE REQUE..CT OFTri'E FOLLOwr:-;c; ?ERSOS: . HE: LAURALEE B. BAKER, ESQ. ,"A.., . .1,::;::!;~; PO BX 932 HARRT~RTJRr:_ PA 1710~ TE:E?HO:\E: 215-246-0900 S\.:PRE.\fE COll1tT 10 t: ... TIORS!'\' FOR: DEFENDANT '-... ~~"C9L'l'T' J? ~. A/.J.Li) _ ~~Y'_' ..an aO~ J? _ 'P/2~U----- : _ t"" OAT!: ~bA'Y,(';;/ny -<";:)t'YJ~ ~ - Seal oi the COW": IE!f i /97) EXPlANATION OF REQUIRED RECORDS TO: CUSTODIAN OF RECORDS FOR: ROBERT S. NOLTE, D.O. KLINE FAMILY PRACf1CE CNT 2601 NORTH THIRD ST. HARRISBURG, PA 17110 RE: 83756 PATRICIA J. THOMAS Any and all records, correspondence, files and memorandums, handwritten notes, original X-Rays, billing and payment records, relating to any , examination, consultation, care or treatment. Dates Requested: up to and including the present. Subject: PATRICIA J. THOMAS 701 SOMERSET DRIVE, MECHANICSBURG, PA 17055 Social Security #: 162-36-9310 Date of Birth: 06-14-1945 . SUlO-353374 83756-LOl CERTIFICATE PREREQUISITE TO SERVICE OF A SUBPOENA PURSUANT TO RULE 4009.22 IN THE MATTER OF: COURT OF COMMON PLEAS PATRICIA & ROBERT THOMAS, ET AL. TERM, -VS- CASE NO: 01-6286 KATHRYN A. PEROUTKA, M.D., ET AL. As a prerequisite to service of a subpoena for documents and things pursuant to Rule 4009.22 MCS on behalf of LAURALEE B. BAKER, ESQ. certifies that (1) A notice of intent to serve the subpoena with a copy of the subpoena attached thereto was mailed or delivered to each party at least twenty days prior to the date on which the subpoena is sought to be served, (2) A copy of the notice of intent, including the proposed subpoena, is attached to this certificate, (3) No objection to the subpoena has been received, and (4) The subpoena which will be served is identical to the subpoena which is attached to the notice of intent to serve the subpoena. MCS on behalf of DATE: 02/21/2002 LAURALEE B. BAKER, ESQ. Attorney for DEFENDANT DEll-3118l6 837 S6-L02 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND IN THE MATTER OF: COURT OF COMMON PLEAS PATRICIA & ROBERT THOMAS. ET AL. TERM. -VS- CASE NO: 01-6286 KATHRYN A. PEROUTKA, M.D., ET AL. NOTICE OF INTENT TO SERVE A SUBPOENA TO PRODUCE DOCUMENTS AND THINGS FOR DISCOVERY PURSUANT TO RULE 4009.21 [ Note: see enclosed list of locations ] TO: NIJOLE C. OLSON, ESQ. KCS on behalf of LAURALEE B. BAKER, ESQ. intends to serve a subpoena identical to the one that is attached to this notice. You have twenty (20) days from the date listed below in which to file of record and serve upon the undersigned an objection to the subpoena. If the twenty day notice period is waived or if no objection is made, then the subpoena may be served. Complete copies of any reproduced records may be ordered at your expense by completing the attached counsel card and returning same to HCS or by contacting our local KCS office. DATE: 02/01/2002 KCS on behalf of LAUllALEE B. BAKER, ESQ. Attorney for DEFENDANT CC: .LAUllALEE B. BAKER, ESQ. MICHAEL BOND - THOMSON Any questions regarding this matter, contact THE KeS GROUP INC. 1601 HARKET STREET 1800 PHILADELPHIA, PA 19103 (215) 246-0900 DE02-177109 837 56-C02 .' >>> LOCATION LIST <<< PAGE: RECORDS REQUESTED MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) : 1 LOCATION NAME ROBERT S. NOLTE, D.O. MOFFITT, PEASE & LlK ASSOC. JOHN M. SULLIVAN GEORGE O. ROSENWASSER, M.D. PINNACLE HEALTH AT HARRISBURG PINNACLE HEALTH HOSPITALS KONKEL SURGICAL GROUP CARL J. DORKO, M.D. CENTRAL PA HEMATOLOGY & ONCOL. RONALD H. MALCOM, M.D. DE02-177109 837 56-C02 COMMONWEALTH OF PENNSYLVANIA . COUNTYOFCUMBERL4..."O PATRICIA J. THOMSON & ROBERT C. THOMSON VS FHe :-';0. 01-6286 CIVIL KATHRYN A. PEROUTKA, M.D., ET AL SUBPOENA TO PRODUCE DOCt.T:\ofD."TS OR n-n:'--:G5 FOR DISCOveRY PURSU,.1_,\"'T TO RU1.E 4009.11 TO: CUSTODIAN OF RECORDS FOR: MOFFITT, PEASE & LIM (~.un. oi ?'f:"3GrI or :..,,==::,,) :.:".;:::::1 :---t:-:::," r.::::} Q.lYS .t:t: Sf:'\'ic:~ ai rJ'tis sU=~'Rt ~~amr'!"d by t.~. co=ur: ~Q ~rQc!uC'~ :!'le f~iic.....tr:! :.:IC'':.lments or :",nS" .. MCS GROUP INC., 1601 MARKET ST., #800, PHILA.,PA 19103 /.4,c:ld.""':'lIsI 'You molY de!h"e or m~J Ieport C'opies 01 th, doc:~ment3 or proch:cl t~ ~'l:lI"t.c!::-- this SUCPOf:"tL to!!:.,,:e=- with th~ ce!'Tific:tt:;:' ::~pliUlC'I. tel the Fury m.aklng r:"is reque,r .It the JCIi.~ lisrftf a~~. 'You h..n", t:,e rig!'!::o 5t'!~ in adyoU'lt'!. ::tt :''!1:1ion.3oi, cost or prl!pazin! the C'opie"5 or prod\u::n! the thin!, 5CU5ht~ l! you f~j tc ~:lduC! the d<<-.lm.nt, at things required by ti'tis subpcer-..a. wit.-..i.~ rw':"try (~J c!~Y' Uter its Sf:""":'~. r!'1e Fury 5f!'\'inS :::.i. '.:poen. m.y 'Hie. ,=un order ,"mpellin! you to ,om ply wit.; i:.. rr.IS St"B?OENA WAS ISSUED ATT:-:E REQt..~1 OF T~ FOLlO>v1:-;C :=::\S0~;: :\,A..\.tE: LAURALEE B. BAKER, ESQ. .'.!:'O!':!.:.:: PO BX 932 HARRT!=;BURC::. PA 17l0R TELE?HO:\E: 215-246-0900 S'':?:\!.\fE COL1r!' ID ~ AITOR.\'!Y FOR: DEFENDANT BY DATI: ~ )~AVA~I2.';' .:1 LI .:l r'YI.;t , Se.al or the Cour. ('~!( i /97) EXPLANATION OF REQUIRED RECORDS TO: CUSTODIAN OF RECORDS FOR: MOFFITT, PEASE & LlM ASSOC. 1000 N. FRONT STREET WORMLEYSBURG, PA 17043 RE: 83756 PATRICIA J. THOMAS Any and all records, correspondence, files and memorandums, handwritten noles, original X-Rays, billing and payment records, relating to any examination, consultation, care or treatment. Dates Requested: up to and including the present. Subject: PATRICIAJ. THOMAS 701 SOMERSET DRIVE, MECHANICSBURG, PA 17055 Social Security #: 162-36-9310 Date of Birth: 06-14-1945 5UlO-353376 83756-L02 CERTIFICATE PREREQUISITE TO SERVICE OF A SUBPOENA PURSUANT TO RULE 4009.22 IN THE MATTER OF: COURT OF COMMON PLEAS PATRICIA & ROBERT THOMAS, ET AL. TERM, -VS- CASE NO: 01-6286 KATHRYN A. PEROUTKA, M.D., ET AL. As a prerequisite to service of a subpoena for documents and things pursuant to Rule 4009.22 MCS on behalf of LAURALEE B. BAKER, ESQ. certifies that (1) A notice of intent to serve the subpoena with a copy of the subpoena attached thereto was mailed or delivered to each party at least twenty days prior to the date on which the subpoena is sought to be served, (2) A copy of the notice of intent, including the proposed subpoena, is attached to this certificate, (3) No objection to the subpoena has been received, and (4) The subpoena which will be served is identical to the subpoena which is attached to the notice of intent to serve the subpoena. MCS on behalf of DATE: 02/21/2002 LAURALEE B. BAKER, ESQ. Attorney for DEFENDANT DEll-31181? B 3.7 5 6 - L 0 3 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND IN THE MATTER OF: COURT OF COMMON PLEAS PATRICIA & ROBERT THOMAS. ET AL. TERM, -VS- CASE NO: 01-6286 KATHRYN A. PEROUTKA, M.D., ET AL. NOTICE OF INTENT TO SERVE A SUBPOENA TO PRODUCE DOCUMENTS AND THINGS FOR DISCOVERY PURSUANT TO RULE 4009.21 [ Note: see enclosed list of locations ] TO: NIJOLE C. OLSON, ESQ. MCS on behalf of LAURALEE B. BAKER, ESQ. intends to ,gerve a subpoena identical to the one that is attached to this notice. You have twenty (20) days fram the date listed below in which to file of record and serve upon the undersigned an objection to the subpoena. If the twenty day notice period is waived or if no objection is made, then the subpoena may be served. Complete copies of any reproduced records may be ordered at your expense by completing the attached counsel card and returning same to MCS or by contacting our local MCS office. DATE: 02/01/2002 MCS on behalf of LAURALEE B. BAKER, ESQ. Attorney for DEFENDANT CC: LAURALEE B. BAKER, ESQ. MICHAEL BOND - THOMSON Any questions regarding this matter, contact THE MCS GROuP INC. 1601 HARKET STREET #800 PHILADELPHIA, PA 19103 (215) 246-0900 DE02-177109 837 56-C02 >>> LOCATION LIST <<< RECORDS REQUESTED MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) PAGE: 1 LOCATION NAME ROBERT S. NOLTE, D.O. MOFFITT, PEASE & LIK ASSOC. JOHN H. SULLIVAN GEORGE O. ROSENWASSER, H.D. PINNACLE HEALTH AT HARRISBURG PINNACLE HEALTH HOSPITALS KUNKEL SURGICAL GROUP CARL J. DORKO, H.D. CENTRAL PA BEHATOLOGY & ONCOL. RONALD H. MALCOH, H.D. DE02-177109 837 56-C02 COMMONvV'EALTH OF P'ENNSYl VANIA ' COUNTY OF CUMBERL"-'.;D PATRICIA J. THOMSON & ROBERT C. THOMSON VS Fiie :-\0. 01-6286 CIVIL KATHRYN A. PEROUTKA, M.D., ET AL SUBPOENA TO PRODUCE DOCtJME--1S OR nn:":GS FOR DISCO'VERY PURSW._....l TO RULE 4009.21 TO: CUSTODIAN OF RECORDS FOR: JOHN M. SULLIVAN, M.D. (S..m~ ~i ?"~Q" ar :"-::::;1 ,^'.i::::n row,::::: (:,0) d.ays U:I~ s~rvi(t or ~!'tis su:b?1ft ~~ftW:"..c try- t.,1.t. C-=lar''T :0 .'rodT.:C'~ :::r :cilc...,:r:! :~C':.lml~'ltS or :~ll':!!: .. MCS GROUP INC., 1601 MARKET ST., #800, PHILA.,PA 19103 (.'d.:no., You m.a~' .:I.In"1!!' Of m~I lepoi. ccpi.., of tne dcc'l.l::nenrs or predutl t~ "'.:r~estld 'Y this S1.Z:poe:'lL !:!~:::e:" with thf C'!!"tjfic~tf ~ :c::tpIianel, to the p;..~! ~...x.:::g :~:J :'e'q'':~'~ ;t :~f .ad=--eu: ul'C! a:-cvt'. 'YOIl h.a,", e::r :,~g::::o St~~ in .adn,llcf. :.~iP :"!1Son.Jbi, cost oi prlFuing the co!,i~ or p:ood".lcing the thin5S scu!--"u. Ii ~'ou f4il tc ~oduu the dOC'l.lmfnts or things re~t.lind by this sllbpceN. wit.':in t"W"~r:' (~, c;:,''5 :.~!~ :~~ s~:""::C!. r:,e?~ serdn! :::.iJ J~:FO.n. m.ay tnjc .. c=un order c:unpeJlins you to (OMF!r wit.; =- nm SL'O?OENA WAS ISSUE!> ATniE REQl.T'E='"T OFTr.: FOLLOwt.'iG ?E~SO:-;: ~.~~~ LAURALEE B. BAKER, ESQ. . "r'I= ==:. PO BX 932 "-'-"'--' BARRT~RTmG_ PA 171nR -", ;""'0";' 215-246-0900 I ...__..~. .'_ s;.:?".!.'~ :JL1tTI~" A TIO R. 'Ii!"!' FOR: DEFENDANT OAT!: ~~l){':"O f ...2LJ ~ I"Y',~ I '---- Seal or the Cour: (~!f, 7/97) EXPlANATION OF REQUIRED RECORDS TO: CUSTODIAN OF RECORDS FOR: JOHN M. SULLlV AN 1001 S. MARKET STREET SUITE B MECHANICS BURG, PA 17055 RE: 83756 PATRICIA J. THOMAS Any and all records, correspondence, files and memorandums, handwrittell notes, original X-Rays, billing and payment records, relating to any examination, consultation, care or treatment. Dates Requested: up to and including the present. Subject: PATRICIA J. THOMAS 701 SOMERSET DRIVE, MECHANICSBURG, PA 17055 Social Security #: 162-36-9310 Date of Birth: 06-14-1945 5010-353378 83756-L03 CERTIFICATE PREREQUISITE TO SERVICE OF A SUBPOENA PURSUANT TO RULE 4009.22 IN THE MATTER OF: COURT OF COMMON PLEAS PATRICIA & ROBERT THOMAS, ET AL. TERM, -VS- CASE NO: 01-6286 KATHRYN A. PEROUTKA, M.D., ET AL. As a prerequisite to service of a subpoena for documents and things pursuant to Rule 4009.22 MCS on behalf of LAURALEE B. BAKER, ESQ. certifies that (1) A notice of intent to serve the subpoena with a copy of the subpoena attached thereto was mailed or delivered to each party at least twenty days prior to the date on which the subpoena is sought to be served, (2) A copy of the notice of intent, including the proposed subpoena, is attached to this certificate, (3) No objection to the subpoena has been received, and (4) The subpoena which will be served is identical to the subpoena which is attached to the notice of intent to serve the subpoena. MCS on behalf of DATE: 02/21/2002 LAURALEE B. BAKER, ESQ. Attorney for DEFENDANT DEll-311818 837 S6 -L04 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND IN THE MATTER OF: COURT OF COMMON PLEAS PATRICIA & ROBERT THOMAS, ET AL. TERM, -VS- CASE NO: 01-6286 KATHRYN A. PEROUTKA, M.D., ET AL. NOTICE OF INTENT TO SERVE A SUBPOENA TO PRODUCE DOCUMENTS AND THINGS POR DISCOVERY PURSUANT TO RULE 4009.21 [ Note: see enclosed list of locations ] TO: NIJOLE C. OLSON, ESQ. KCS on behalf of LAURALEE B. BAKER, ESQ. intends to eerve a subpoena identical to the one that is attached to this notice. You have twenty (20) days from the date listed below in which to file of record and serve upon the undersigned an objection to the subpoena. If the twenty day notice period is waived or if no objection is made, then the subpoena may be served. Complete copies of any reproduced records may be ordered at your expense by completing the attached counsel card and returning same to HCS or by contacting our local HCS office. DATE: 02/01/2002 KCS on behalf of LAURALEE B. BAKER, ESQ. Attorney for DEFENDANT CC: LAURALEE B. BAKER, ESQ. MICHAEL BOND - THOMSON Any questions regarding this matter, contact THE KCS GROUP INC. 1601 HARlET STREET #800 PHILADELPHIA, PA 19103 (215) 246-0900 DE02-117l09 837 56-C02 >>> LOCATION LIST <<< PAGE: 1 RECORDS REQUESTED MEDICAL, BILLING, AND X-KAyeS) MEDICAL. BILLING, AND X-KAyes) MEDICAL, BILLING, AND X-KAyeS) MEDICAL, BILLING. AND X-KAyeS) MEDICAL, BILLING, AND X-KAyeS) MEDICAL, BILLING, AND X-KAyeS) MEDICAL. BILLING, AND X-KAyeS) MEDICAL, BILLING, AND X-KAyeS) MEDICAL, BILLING, AND X-KAyeS) MEDICAL, BILLING. AND X-KAyeS) LOCATION NAME ROBERT S. NOLTE. D.O. MOFFITT, PEASE & LIM ASSOC. JOHN M. SULLIVAN GEORGE O. ROSENWASSER. M.D. PINNACLE HEALTH AT HARRISBURG PINNACLE HEALTH HOSPITALS KUNKEL SURGICAL GROuP CARL J. DORKO. M.D. CENTRAL PA HEMATOLOGY & ONCOL. RONALD H. MALCOM. M.D. DE02-177109 837 56-C02 COMMO/l;"WEAlTH OF PENNSYt. VANIA . COUNTY OF CUMBERL~"'D PATRICIA J. THOMSON & ROBERT C. THOMSON VS Fiie :>;0. 01-6286 CIVIL KATHRYN A. PEROUTKA, M.D., ET AL SUBPOENA TO PRODUCE DOCUME.'.'1S OR TriI2';GS FOR DISCOVERY PURSU,J._,,'1 TO RULE 400921 TO: CUSTODIAN OF RECORDS FOR: GEORGE O. ROSENWASSER, MD. 1 '.am. ~{ ?~~Cl'll I2r ~'":=::r, ~'.i::::., ~f~'- (~) ,bys U-:f: 5C:'\'1" or this su::?,ft >A~t{~ftW:....: by t.~. C':'QM ~o ~rOdQC2 :!':e fciic...ing :"(-:.:ml~ns or :~11'1!:S: .. MCS GROUP INC., 1601 MARKET ST., #800, PHILA.,PA 19103 1.....,....1 You "")' ..in.... or m~ll.pblo <opi.. 01 tho dC<'~monts or product t~ /?I;"..,od.y tlUs subpoon.. 'ogo:n., wi,h 'h. '!nific~t, == :::::"l:pH.ut", to the Fury C'\~ng this rt<quc,r ~t the idd..""ISS listed ~~f. 'rou l-~'\', the ri!::.: :0 H<:.(.. in .ad\'Utcl'. :.10:1 :'uscn~bir (ost or pr'fi'ating the copi.., or ptodudng the thin!, 5CU!-o~t. t! .'::"': f~: r: ?,=,~du(l! t:t. dO(~mlnr' or things :"!~l.lired by this subpcen..i. wi:..':.!." t"l"ltt:":ty (:::J) c~ys ~rr i:s 5e:"''':C!. t;,c -;...-:y 5~:"',':n!:~ f:'::pctn~ m..y snk i (=un order c:=znpenins you to comFly wit-lit:. nus St"'3?OENA WAS ISSUED AT THE REQl.re.:'"T OFTn"'E FOLLOWJ:.'jG ?BS0S: ~."'\{E: LAURALEE B. BAKER, ESQ. .1.!:C"-!;~; PO BX 932 HARRTSRTJRC:. 'PA 171nR TE:'E?HO:-'-E: 215-246-0900 S=':P!\E.\f! eOLAT ID ~ A ITO R.''!Y FOR: DEFENDANT - .~,. :: ~~1(..,1 ~f) v ( .;)Lf.. ~t"'.YI;).., 're.~~~".. "-..... a 0/'0. '" . P ?!1nuy, J Sui ot the Co.:.",: (:!f. i /97) EXPlANATION OF REQUIRED RECORDS TO: CUSTODIAN OF RECORDS FOR: GEORGE O. ROSENWASSER, M.D. M.S. HERSHEY MEDICAL CNTR 500 UN1Y. DR. - #800 HERSHEY, PA 17033 RE: 83756 PATRICIA J. THOMAS Any and all records, correspondence, files and memorandums, handwritten notes, original X-Rays, billing and payment records, relating to any . examination, consultation, care or treatment. Dates Requested: up to and including the present. Subject: PATRlCIAJ. THOMAS 701 SOMERSET DRIVE, MECHANICSBURG, PA 17055 Social Security #: 162-36-9310 Date of Birth: 06-14-1945 SU10-353380 a 3756 -LO 4 CERTIFICATE PREREQUISITE TO SERVICE OF A SUBPOENA PURSUANT TO RULE 4009.22 IN THE MATTER OF: COURT OF COMMON PLEAS PATRICIA & ROBERT THOMAS, ET AL. TERM, -VS- CASE NO: 01-6286 KATHRYN A. PEROUTKA, M.D., ET AL. As a prerequisite to service of a subpoena for documents and things pursuant to Rule 4009.22 MCS on behalf of LAURALEE B. BAKER, ESQ. certifies that (1) A notice of intent to serve the subpoena with a copy of the subpoena attached thereto was mailed or delivered to each party at least twenty days prior to the date on which the subpoena is sought to be served, (2) A copy of the notice of intent, including the proposed subpoena, is attached to this certificate, (3) No objection to the subpoena has been received, and (4) The subpoena which will be served is identical to the subpoena which is attached to the notice of intent to serve the subpoena. MCS on behalf of DATE: 02/21/2002 LAURALEE B. BAKER, ESQ. Attorney for DEFENDANT DEll-3118l9 837S6-LOS COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND IN THE MATTER OF: COURT OF COMMON PLEAS PATRICIA & ROBERT THOMAS, ET AL. TERM. -VS- CASE NO: 01-6286 KATHRYN A. PEROUTKA. M.D.. ET AL. NOTICE OF INTENT TO SERVE A SUBPOENA TO PRODUCE DOCUMENTS AND THINGS FOR DISCOVERY PURSUANT TO RULE 4009.21 [ Note: see enclosed list of locations ] TO: NIJOLE C. OLSON, ESQ. HCS on behalf of LAURALEE B. BAKER, ESQ. intends to ...erve a subpoena identical to the one that is attached to this notice. You have twenty (20) days from the date listed below in which to file of record and serve upon the undersigned an objection to the subpoena. If the twenty day notice period is waived or if no objection is made, then the subpoena may be served. Complete copies of any reproduced records may be ordered at your expense by completing the attached counsel card and returning same to HCS or by contacting our local HCS office. DATE: 02/01/2002 HCS on behalf of LAURALEE B. BAKER, ESQ. Attorney for DEFEllDANT CC: LAURALEE B. BAKER, ESQ. MICHAEL BOND - THOKSON Any questions regarding this matter, contact THE HCS GROUP INC. 1601 HARKET STREET #BOO PHILADELPHIA, PA 19103 (215) 246-0900 DE02-177109 837 S6 -C02 >>> LOCATION LIST <<< RECORDS REQUESTED MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) ." PAGE: 1 LOCATION NAME ROBERT S. NOLTE, D.O. MOFFITT, PEASE' LIK ASSOC. JOHN M. SULLIVAN GEORGE 0" ROSENWASSER, M.D. PINNACLE HEALTH AT HARRISBURG PINNACLE HEALTH HOSPITALS KllllKEL SURGICAL GROUP CARL J. DORKO, M.D. CENTRAL PA HEMATOLOGY' ONCOL. RONALD H. MALCOM, M.D. DE02-177109 837 56-C02 COMMONWEALTH OF PENNSYlVANIA . COUNTY OF CUMBERL~"D PATRICIA J. THOMSON & ROBERT C. THOMSON VS Fiie :"0. KATHRYN A. PEROUTKA, M.D., ET AL 01-6286 CIVIL SUBPO~'lA TO PRODUCE DOCUM'D.l::: c. nn::'\G5 FOR orSCO""ERY PURSW'_'-l TO RULE 400922 T:J: CUSTODIAN OF RECORDS FOR: PINNACLE HEALTH AT HARRISBURG HOSPITAL (!"\-un. ai ?l'~a" or ~"':=::r, ^ ,::::'::"t :-O-'f::O::: r':=) c~ys Ut,~ sC:,\'jC! ci this sU=:=1a YfM~ftW:.c by t.~. co=un ~o .:roc:luc'l :!'l.r foilc\IlI:n! :~C':.lm.r1"ltt or ::'ut'l!s: .. MCS GROUP INC., 1601 MARKET ST., #800, PHILA.,PA 19103 (.~d':"",,"tl You m..~' d.ii\'e or m.,j'T '!::~lf e~?;~ of tlu c!e<':J~e:"!r'5 or ?roct.:c'! ~!-.i.__~ ~~~tt-: :-y t~~ 5t:::=~~1. ~:'!~~~~:' ."..::~~ :!':t c!!"l'ific.3U :;:' :c:1pli.:1C'1. to the Fury C"I.ak!ng t:,is req:uest .It :he .adci.~ lisr..c .i~f. Y01.l Iu,," t:'!.e rj!~: :0 Sf'!i<.. in .JdVUlC!. !.!':.t :"'!uon.abif cost ot prt;'M1n! the copi.., Or pTodudng the thin!, scu!ht. If you fl.i! re ~~ch.zc! the document' or thinI' r'~uired by th.is su!:tpcen.a. wit.l.:.!.~ t'W1!'It:' (:!Jl c!a~" after its se:"".:('!!. tn, i'u:'Y sf~tin! ::-.iJ I:.::~.n.. m.JY S";c.. ,:un order comp,ilins you to cQmFJywir..~ i:.. n-ns St:B?OENA WAS ISSUED AT THE REQt.'E::'"T OFTn'"E FOLLOW1?'iG :=E~S0:\: ~AME: LAURALEE B. BAKER, ESQ. ...~C:\!;.:: PO BX 932 HARRISBURG. 'PA 171nR TE"E::;O:\':: 215-246-0900 57':?~~\f! COL1U ID ~ AiiOR.\Tf FOR: DEFENDANT "--.... :-...:::.... ):;::J. IU 'a~)' ;)L/ ::l rlo~ . ...... 5ell oi the Cou.-: (E!f. i /97) EXPLANATION OF REQUIRED RECORDS TO: CUSTODIAN OF RECORDS FOR: PINNACLE HEALTH AT HARRISBURG HOSPITAL 111 SOUTH FRONT ST HARRISBURG, PA 17101 RE: 83756 PATRICIA J. THOMAS Any and all records, correspondence, files and memorandums, handwritten notes, original X-Rays, billing and payment records, relating to any . examination, consultation, care or treatment. Dates Requested: up to and including the present. Subject: PATRICIA J. THOMAS 701 SOMERSET DRIVE, MECHANICSBURG, PA 17055 Social Security II: 162-36-9310 Date of Birth: 06-14-1945 5UIO-353382 83756 - LOS CERTIFICATE PREREQUISITE TO SERVICE OF A SUBPOENA PURSUANT TO RULE 4009.22 IN THE MATTER OF: COURT OF COMMON PLEAS PATRICIA & ROBERT THOMAS, ET AL. TERM, -VS- CASE NO: 01-6286 KATHRYN A. PEROUTKA. M.D., ET AL. As a prerequisite to service of a subpoena for documents and things pursuant to Rule 4009.22 MCS on behalf of LAURALEE B. BAKER, ESQ. certifies that (1) A notice of intent to serve the subpoena with a copy of the subpoena attached thereto was mailed or delivered to each party at least twenty days prior to the date on which the subpoena is sought to be served, (2) A copy of the notice of intent, including the proposed subpoena, is attached to this certificate, (3) No objection to the subpoena has been received, and (4) The subpoena which will be served is identical to the subpoena which is attached to the notice of intent to serve the subpoena. MCS on behalf of DATE: 02/21/2002 LAURALEE B. BAKER, ESQ. Attorney for DEFENDANT DEl1-311820 83 756 - L 0 6 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND IN THE MATTER OF: COURT OF COMMON PLEAS PATRICIA & ROBERT THOMAS, ET AL. TERM. -VS- CASE NO: 01-6286 KATHRYN A. PEROUTKA, M.D., ET AL. NOTICE OF INTENT TO SERVE A SUBPOENA TO PRODUCE DOCUMENTS AND THINGS FOR DISCOVERY PURSUANT TO RULE 4009.21 [ Note: see enclosed list of locations ] TO: NIJOLE C. OLSON. ESQ. HCS on behalf of LAURALEE B. BAKER. ESQ. intends to Berve a subpoena identical to the one that is attached to this notice. You have twenty (20) days from the date listed below in which to file of record and serve upon the undersigned an objection to the subpoena. If the twenty day notice period is waived or if no objection is made. then the subpoena may be served. Complete copies of any reproduced records may be ordered at your expense by completing the attached counsel card and returning same to MCS or by contacting our local HCS office. DATE: 02/01/2002 HCS on behalf of LAURALEE B. BAKER. ESQ. Attorney for DEFENDANT CC: LAURALEE B. BAKER. ESQ. MICHAEL BOND - THOMSON Any questions regarding this matter. contact THE MCS GROUP INC. 1601 MARKET STREET #800 PHILADELPHIA. PA 19103 (215) 246-0900 DE02-177109 837 56-C02 >>> LOCATION LIST <<< RECORDS REQUESTED MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) .' PAGE: 1 LOCATION IlAHE ROBERT S. NOLTE, D.O. MOFFITT, PEASE & LIM ASSOC. JOHN M. SULLIVAN GEORGE O. ROSENWASSER, M.D. PINNACLE HEALTH AT HARRISBURG PINNACLE HEALTH HOSPITALS KUNKEL SURGICAL GROUP CARL J. DORKO, M.D. CENTRAL PA HEMATOLOGY & ONCOL" RONALD H. MALCOM, M.D. DE02-177109 837 56-C02 COMMOf\jWEALTIi OF PENNSYl. VANIA . COUNTY OF CUMBERL~'iD PATRICIA J. THOMSON & ROBERT C. THOMSON VS Fii. :-;0. 01-6286 CIVIL KATHRYN A. PEROUTKA, M.D., ET AL SUBPOENA TO PRODUCE DOCUMES-rS OR nn:'-:G5 FOR DISCO\' t:RY PURSU.A_',-r TO RULE 4009..21 TO: CUSTODIAN OF RECORDS FOR: PINNACLE HEALTH C/O POLYCLINIC MEDICAL CENTER 'S.unlf Qf' ~':'3aft at :..-:=r:r' ~';~~j~ :"We:,:,,:,:; r:::l) d.;ys U:,~ sc:-...ict ai rM.is sub?,ft YlM?;ftW:t'd by to". l:'::ur: ~c .:fr::Iduc'l t!"lr :cijcw~n! ~Oc-.lmf1"It' or ...I..!$: " MCS GROUP INC., 1601 MARKET ST., #800, PHILA.,PA 19103 1.'dOno'1 Yau m~y :Jeih'fr Of m.a.iI legible copies of tn. dcc~.u::nent3 or F'roducl tl"'.i.--!=! r"I"I;'Uested ,y this su=poen.t. tcg!:::t:' with tn, c!!'tifiC2tf == ::~pliU\cl. to ~~f F~--ry C't~:'!.g ::-:~J r~;;:;'.;e"..~ :::e ~.:.c!..~ lis::..c a:evt'. "r:1J r..:y~ ~~f ri!1':r:o S!~:<. i:'\ ~c!\'arh:l'. t." ::uon.abif ,cSt ot prep.a:ins the copie or produC'ing the thinp scapt. [! YOI.l ~ljj rc ;=-:::duc:e the doc~m.nts or thinI' re~uiffd by ti'tis S\:b~ ....;t.-..:..,rw,nry (~1 c~Y' a.f:,! ::s St~.':'!, t:,e ?-:y sf:,,':n! ::-..:.s s:'::FOtn.l may tnk.a c=un ord.r c::mptllins you ta l:QC1?ly wit.'1 ~ rriIS Si.:E?OENA WAS ISSUED ATT:-iE REQI.;"C=! OF THE FOLLOW1:';(; ?~:tS0:\: ,. ~. LAURALEE B. BAKER, ESQ. .,A.\.!.: .'.:::;;::!:;3: PO BX 932 HARRT~RtJRC::. PA 1710R T:LE?HO~:: 215-246-0900 5i.:1'!1.E.\fE COli1tr ID ~ ... nOR."n' FOR: DEFENDANT :'.7!: ...1"",,, ;;''''7 ,;; 'I ;) (,h;;)' , -- ~,c U _TVIJ10:'l LZn"..o P ~;...?~YL~ _ .:;r- '-....... Sul of the Cou.-: (E!f. i /97) EXPlANATION OF REQUIRED RECORDS TO: CUSTODIAN OF RECORDS FOR: PINNACLE HEALTH HOSPITALS AT POLYCLINIC MED. CNTR. 2601 NORTH 3RD STREE HARRISBURG" PA 17110 RE: 83756 PATRICIA J. THOMAS Any and all records, correspondence, files and memorandums, handwritten notes, original X-Rays, billing and payment records, relating to any . examination, consultation, care or treatment. Dates Requested: up to and including the present. Subject: PATRICIAJ. THOMAS 701 SOMERSET DRIVE, MECHANICSBURG, PA 17055 Social Security #: 162-36-9310 Date of Birth: 06-14-1945 SUIO-353384 83756 - LO 6 CERTIFICATE PREREQUISITE TO SERVICE OF A SUBPOENA PURSUANT TO RULE 4009.22 IN THE MATTER OF: COURT OF COMMON PLEAS PATRICIA & ROBERT THOMAS, ET AL. TERM, -VS- CASE NO: 01-6286 KATHRYN A. PEROUTKA, M.D., ET AL. As a prerequisite to service of a subpoena for documents and things pursuant to Rule 4009.22 MCS on behalf of LAURALEE B. BAKER, ESQ. certifies that (1) A notice of intent to serve the subpoena with a copy of the subpoena attached thereto was mailed or delivered to each party at least twenty days prior to the date on which the subpoena is sought to be served, (2) A copy of the notice of intent, including the proposed subpoena, is attached .to this certificate. (3) No objection to the subpoena has been received, and (4) The subpoena which will be served is identical to the subpoena which is attached to the notice of intent to serve the subpoena. MCS on behalf of DATE: 02/21/2002 LAURALEE B. BAKER, ESQ. Attorney for DEFENDANT DEll-311821 837 56-LO 7 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND IN THE MATTER OF: COURT OF COMMON PLEAS PATRICIA & ROBERT THOMAS, ET AL. TERM, -VS- CASE NO: 01-6286 KATHRYN A. PEROUTKA, M.D., ET AL. NOTICE OF INTENT TO SERVE A SUBPOENA TO PRODUCE DOCUMENTS AND THINGS FOR DISCOVERY PURSUANT TO RULE 4009.21 [ Note: see enclosed list of locations ] TO: NIJOLE C. OLSON, ESQ. HCS on behalf of LAURALEE B. BAKER, ESQ. intends to serve a subpoena identical to the one that is attached to this notice. You have twenty (20) days from the date listed below in which to file of record and serve upon the undersigned an objection to the subpoena. If the twenty day notice period is waived or if no objection is made, then the subpoena may be served. Complete copies of any reproduced records may be ordered at your expense by completing the attached counsel card and returning same to HCS or by contacting our local HCS office. DATE: 02/01/2002 HCS on behalf of LAURALEE B. BAKER, ESQ. Attorney for DEFENDANT CC: LAURALEE B. BAKER, ESQ. MICHAEL BOND - THOMSON Any questions regarding this matter, contact THE HCS GROuP INC. 1601 HARKET STREET #800 PHILADELPHIA, PA 19103 (215) 246-0900 DE02-177109 837 56-C02 >>> LOCATION LIST <<< RECORDS REQUESTED MEDICAL. BILLING. AND X-KAyeS) MEDICAL. BILLING. AND X-KAyeS) MEDICAL. BILLING. AND X-KAyeS) MEDICAL. BILLING. AND X-KAyeS) MEDICAL. BILLING. AND X-KAyeS) MEDICAL. BILLING, AND X-KAyeS) MEDICAL, BILLING. AND X-KAyeS) MEDICAL. BILLING. AND X-KAyeS) MEDICAL. BILLING. AND X-KAyeS) MEDICAL, BILLING. AND X-KAyeS) .' PAGE: 1 LOCATION NAME ROBERT S. NOLTE. D.O. MOFFITT. PEASE' LIM ASSOC. JOHN M. SULLIVAN GEORGE O. ROSENWASSER. M.D. PINNACLE HEALTH AT HARRISBURG PINNACLE HEALTH HOSPITALS KUNlCEL SURGICAL GROUP CARL J. DORKO. M.D. CENTRAL PA HEMATOLOGY' ONCOL. RONALD H. MALCOM. M.D. DE02-177109 83756-C02 COMMO~WEALJ"H Of' PENNSYlVANIA . COUNTY Of' CUMBERL~"D PATRICIA J. THOMSON & ROBERT C. THOMSON VS Fiie So. 01-6286 CIVIL KATHRYN A. PEROUTKA, M.D., ET AL SUBPOENA TO PRODUCE DOCU?<.fD."'TS OR nn:SG3 FOR DISCOVERY PURSU,.1...""'T TO RULE 4009.21 TO: CUSTODIAN OF RECORDS FOR: KUNKEL SURGICAL GROUP (S.un. ~r' P1'r3QI'I or :..~=::r, Wi:::::'! ~,~.. {:.oJ d~ys U:I~ sc:'\'icI of this su=::,ft ~M~ftW:'.-:.:i ~ t..~. C':tt.aM:O .'r=duc~ ::-:. fciic.....irt! :~C~:nf:'It' or :~lr:!:I:: .. MCS GROUP INC., 1601 MARKET ST., #800, PHILA.,PA 19103 1."c:Id.."""sl You :r:.ay dcU,"r.' or m.a.iI lepoif c=pies of tnr c!cc':J.:::r:u'S or ?r:lCUC'1 t~ l"I'ql3est.c :y this su=::oenol. ecg!::-:e:' with thr c,e:ilfi,.a:, == ::;~pii..l"r. to ,.~c ~~ ~~:lg ,.~is rIque" .t the .aci.:..~ lisrft! abcvf. You !u,', t~e ri!~: to 5t!!<" in .dnn... :~. ,....on.bl. <ost 01 prep.,;ng the <opi.. or produdng the thinp -!ht. If ~'O\l !liI rc ~=ch.lC! the cloc~mrnts or things r,~uirtd by tNs su~pom.a. wit..-..i..., t"'IilIi'en::, (~l c!~Y' ~,: its Sf:"':::!. tl"lr i'at':'Y sf!'\'ing::-.iJ J:::po.n. molY ,"ie.a c::o.:..-: C1rd., ':lmp'Ilin! you ta cotnply 'Wit..~ ~ r~IS S:'"'3?OENA WAS ISSUED ATT:-iE REQLrc.::""T Ofrn~ FOLLOWl:'iG ?E~0:-;: .\'AME: LAURALEE B. BAKER, ESQ. .'.!;C".:.:;: PO BX 932 HARRTSRIJRf:. PA 1710R ELE?:-:C:\!: 215-246-0900 5:":i'!\E.\f: COlZlrrlD ~ ....1"iOR..\'!'!' FOR: DEFENDANT i:AT:: _ )::J'lLt;;''')/.;(1../ ~d. , BYa::~2~,,;.. /hfl.->." [2 ~QP/J~' r- ........... Sui at the Cou.-: (Elf. i /97') EXPLANATION OF REQUIRED RECORDS TO: CUSTODIAN OF RECORDS FOR: KUNKEL SURGICAL GROUP 890 POPLAR CHURCH ROAD SUITE 210 CAMP HILL, PA 17011 RE: 83756 PATRICIA J. THOMAS Any and all records, correspondence, files and memorandums, handwritten notes, original X-Rays, billing and payment records, relating to any . examination, consultation, care or treatment. Dates Requested: up to and including the present. Subject: PATRICIA J. THOMAS 701 SOMERSET DRIVE, MECHANICSBURG, PA 17055 Social Security #: 162-36-9310 Date of Birth: 06-14-1945 SU10-35338683756_L07 CERTIFICATE PREREQUISITE TO SERVICE OF A SUBPOENA PURSUANT TO RULE 4009.22 IN THE MATTER OF: COURT OF COMMON PLEAS PATRICIA & ROBERT THOMAS. ET AL. TERM, -VS- CASE NO: 01-6286 KATHRYN A. PEROUTKA, M.D., ET AL. As a prerequisite to service of a subpoena for documents and things pursuant to Rule 4009.22 MCS on behalf of LAURALEE B. BAKER, ESQ. certifies that (1) A notice of intent to serve the subpoena with a copy of the subpoena attached thereto was mailed or delivered to e.ach party at least twenty days prior to the date on which the subpoena is sought to be served, (2) A copy of the notice of intent, including the proposed subpoena, is attached to this certificate, (3) No objection to the subpoena has been received, and (4) The subpoena which will be served is identical to the subpoena which is attached to the notice of intent to serve the subpoena. MCS on behalf of DATE: 02/21/2002 LAURALEE B. BAKER, ESQ. Attorney for DEFENDANT DEll-311822 a 3 756 -Loa COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND IN THE MATTER OF: COURT OF COMMON PLEAS PATRICIA & ROBERT THOMAS, ET AL. TERM, -VS- CASE NO: 01-6286 KATHRYN A. PEROUTKA, M.D., ET AL. NOTICE OF INTENT TO SERVE A SUBPOENA TO PRODUCE DOCUMENTS AND THINGS FOR DISCOVERY PURSUANT TO RULE 4009.21 [ Note: see enclosed list of locations ] TO: NIJOLE C. OLSON, ESQ. KCS on behalf of LAURALEE B. IlADR, ESQ. intends to serve a subpoena identical to the one that is attached to this notice. You have twenty (20) days from the date listed below in which to file of record and serve upon the undersigned an objection to the subpoena. If the twenty day notice period is waived or if no objection is made, then the subpoena may be served. Complete copies of any reproduced records may be ordered at your expense by completing the attached counsel card and returning same to MeS or by contacting our local MeS office. DATE: 02/01/2002 MeS on behalf of LAURALEE B. BAKER, ESQ. Attorney for DEFENDANT CC: LAURALEE B. IlADR, ESQ. MICHAEL BOND - THOMSON Any questions regarding this matter, contact THE KCS GROUP INC. 1601 HARKET STREET #800 PHILADELPHIA, PA 19103 (215) 246-0900 DE02-177109 837 56-C02 >>> LOCATION LIST <<< RECORDS REQUESTED MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) PAGE: 1 LOCATION NAHE ROBERT S. NOLTE, D.O. HOFFITT, PEASE & LIK ASSOC. JOHN H. SULLIVAN GEORGE O. ROSEIlWASSER, H.D. PINNACLE HEALTH AT HARRISBURG PINNACLE HEALTH HOSPITALS KUllKEL SURGICAL GROUP CARL J. DORKO, H.D. CENTRAL PA HEMATOLOGY & ONCOL. RONALD H. MALCOM, H.D. DE02-177109 837 56-C02 COMMONWEALTH OF PENNSYLVANIA . COUNTY OF CUMBERL"-"D PATRICIA J. THOMSON & ROBERT C. THOMSON VS Fiie :-';0. 01-6286 CIVIL KATHRYN A. PEROUTKA, M.D., ET AL SUBPOENA TO PRODUCE DOCLTM"D.-rs OR nn::'\G5 FOR DISCOVERY PURSU.~_"-r TO Rt.rl..E 4Q09.21 T0: CUSTODIAN OF RECORDS FOR: CARL J. DORKO, M.D. (~.mlt Qi ?'f~GI'lI or ==::r, ~';~:::n :ow,=-:::: r.=) d~ys U':~ sf:"'"dc:t of t!'Us SU~?,~ YfM~ftWrft! by t."_ ~\:~ ~c .:r~c:Iuc2 :~t fciicw:n! :~(~ml:'lrs or :~1t~!s: MCS GROUP INC., 1601 MARKET ST., #800, PHILA.,PA 19103 .. 1."ddrnsl You m.a~' de!h"eo or m~I lepbJe copies 01 tn, dcc~.u:u!!\ts or p~c!1J(1 r~ tl'l;1:Iest1C ;y this S\.::pOre:"tL !Q!!~~t:' with tn, cl!rmlc~tf:r. :cC'lpILann. to the Fury mwng t:,is r'que,: 4: ::-:i: a';':"'""!SIll5t.c Jbcv,. You: 1'uI,', t;,e ri!~::o s~~.<.. in .Ia\'U1cf. :::r :"!.1Scn~bl, ,"ost ot pnpanns the copi.., or producing the thinp SCUpt.. If ~'ou ~liI rc ;::'CCUC! t:" doc~m.nts at things r'~u:ired by this sloIbpcen.a.. wit.~.i:J """e~ry (~l c!:.ys Ut!! ::5 se~.':c!. the Farry St:"\';~!:~ J:.::po.n.a molY snic.a c=un ord., ,emp,IIi"! yay to cOMply w;t., i:. nm St"3?OENA WAS ISSUED ATT:-iE REQt.."E.:'"T OFTn'"E FOLLOW1:'iG ?E~S0~;: s.....',!!: LAURALEE B. BAKER. ESQ. '""l"':O:".. PO BX 932 .'--.'--. HARRISBURG. 'PA 171nR T:LE?:;O-"= 215-246-0900 0'_':;::: !.'-f: ::'~1rr In ~ .>.TiOR.\Tt' FOR: DEFENDANT :,~ ......):=JA )u ;'/.l jf ;:) '-I :J ,...'V} A , . 'rY;~L~"k~ ~OIUICU'"!,c~ y _ 1'1l~" '-- dn/> d c9. Wf)/I/V~ r----- Se.tl or the Cow-: (:!f. i /97) EXPIANATION OF REQUIRED RECORDS TO: CUSTODIAN OF RECORDS FOR: CARL J. DORKO, M.D. 1 LEMOYNE SQUARE SUITE 201 CAMP HILL, PA 17011 RE: 83756 PATRICIA J. THOMAS Any and all records, correspondence, files and memorandums, handwritten notes, original X-Rays, billing and payment records, relating to any . examination, consultation, care or treatment. Dates Requested: up to and including the present. Subject: PATRICIA J. THOMAS 701 SOMERSET DRIVE, MECHANICSBURG, PA 17055 Social Security #: 162-36-9310 Date of Birth: 06-14-1945 5U10-353388 B37S6-LOB CERTIFICATE PREREQUISITE TO SERVICE OF A SUBPOENA PURSUANT TO RULE 4009.22 IN THE MATTER OF: COURT OF COMMON PLEAS PATRICIA & ROBERT THOMAS, ET AL. TERM, -VS- CASE NO: 01-6286 KATHRYN A. PEROUTKA, M.D., ET AL. As a prerequisite to service of a subpoena for documents and things pursuant to Rule 4009.22 MCS on behalf of LAURALEE B. BAKER, ESQ. certifies that (1) A notice of intent to serve the subpoena with a copy of the subpoena attached thereto was mailed or delivered to each party at least twenty days prior to the date on which the subpoena is sought to be served, (2) A copy of the notice of intent, including the proposed subpoena, is attached to this certificate, (3) No objection to the subpoena has been received, and (4) The subpoena which will be served is identical to the subpoena which is attached to the notice of intent to serve the subpoena. MCS on behalf of DATE: 02/21/2002 LAURALEE B. BAKER, ESQ. Attorney for DEFENDANT DEll-311823 a 3 756 - L 09 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND IN THE MATTER OF: COURT OF COMMON PLEAS PATRICIA & ROBERT THOMAS, ET AL. TERM, -VS- CASE NO: 01-6286 KATHRYN A. PEROUTKA, M.D., ET AL. NOTICE OF INTENT TO SERVE A SUBPOENA TO PRODUCE DOCUMENTS AND THINGS FOR DISCOVERY PURSUANT TO RULE 4009.21 [ Note: see enclosed list of locations] TO: NIJOLE C. OLSON, ESQ. MeS on behalf of LAURALEE B. BAKER, ESQ. intends to serve a subpoena identical to the one that is attached to this notice. You have twenty (20) days from the date listed below in which to file of record and serve upon the undersigned an objection to the subpoena. If the twenty day notice period is waived or if no objection is made, then the subpoena may be served. Complete copies of any reproduced records may be ordered at your expense by completing the attached counsel card and returning same to MeS or by contacting our local MeS office. DATE: 02/01/2002 MeS on behalf of LAURALEE B. BAKER, ESQ. Attorney for DEFENDANT CC: LAURALEE B. BAKER, ESQ. MICHAEL BOND - THOMSON Any questions regarding this matter, contact THE MeS GROUP INC. 1601 HARKET STREET #800 PHILADELPHIA, PA 19103 (215) 246-0900 DE02-177109 837 56-C02 >>> LOCATION LIST <<< RECORDS REQUESTED MEDICAL, BILLING, AND X-KAyeS) MEDICAL, BILLING. AND X-KAyeS) MEDICAL, BILLING, AND X-KAyeS) MEDICAL, BILLING, AND X-KAyeS) MEDICAL, BILLING. AND X-KAyeS) MEDICAL, BILLING, AND X-KAyeS) MEDICAL, BILLING, AND X-KAyeS) MEDICAL, BILLING, AND X-KAyeS) MEDICAL, BILLING, AND X-KAyeS) MEDICAL, BILLING. AND X-KAyes) ." PAGE: 1 LOCATION NAME ROBERT S. NOLTE, D.O. MOFFITT, PEASE & LDI ASSOC. JOHN M. SULLIVAN GEORGE O. ROSEIlWASSER. M.D. PINNACLE HEALTH AT HARRISBURG PINNACLE HEALTH HOSPITALS KONKEL SURGICAL GROuP CARL J. DORKO, M.D. CENTRAL PA HEMATOLOGY & ONCOL. RONALD H. MALCOM, M.D. DE02-177109 837 56-C02 COMMON'W'EAlTIi OF PENNSYlVANIA . COUNTY OF CUMBERL"-'iD PATRICIA J. THOMSON & ROBERT C. THOMSON VS Fiie :-;0. 01-6286 CIVIL KATHRYN A. PEROUTKA, M.D., ET AL SUE;:,]?::':", ,0 PRODUCE DOct.TM"E:\."'TS OR r~I:':G5 FOR DISCOVERY PURSU.A..'\"'T TO RULE 4009.l1 TO: CUSTODIAN OF RECORDS FOR: CENTRAL PA HEMATOLOGY & MEDICAL ONCOLONGY ASSOC. (~..me gf ?1'~Qn Qt' :..--:=::r, :~}:::j~ :'Wt~,. r::) d.3Ys U-:r! s~~dc~ of ~:tis Jubp'!ft ~t{~W1"d b:' t.l.te C':Qrt ~= ~rodQc~ :::, fc:iicw~~! :O(~mf:'ln or . ".r.!'s; ., MCS GROUP INC., 1601 MARKET ST., #800, PHILA.,PA 19103 I.'d<inl., You m~y delraorr or m.aiI If~bI, COFi., of the dC<~::"lf:'lt5 Of' pf'Och:cl thi."'!5 f"I'q1:lwsr.c :y thjJ st.z=Foe~.a. !cg~:....e:" ......:::-: :!':t C:!l"!jfi'~tf =i ::~pIiUtC'l. to th, p.u:y C'\~n! t::is rlK;uf,r _t ::,e a~:...~ :l:5:1'C! ;:-CVf. You h.a'\o, tl'1e M!::::O St'e.<" in _cVUlce. :::, ~uon.3bir cost ot pr.puin5 th, copil'S or prcduc:n! the tnin5' scu!ht.. If yeT.: fill rc ~odu(t the doc".lm.nts or things r'~uittd by this subpoena. wit.'::.n rw.!':ty l~l c!.a~'s Ute! its Sf:-,':C!, r!-lf tU":"f .......in!:i'.i.t '""FOen. m.y ,nK' ,= orcler ,ompellins yo.. to ,c...ply ,.;t.'\ i:.. n~!s St:E?OENA WAS ISSUED AT THE REQl.~'"T OFr~"'E FOLLO\o';1:'iG :=E~.s0~: .......ME: LAURALEE B. BAKER, ESQ. .'.=C,,~.:: PO BX 932 HARRISBURG. 'PA 171nR E:..E?HOX= 215-246-0900 S,-"i'!\E.\{! COlilU ID I: A rrOR.'i!,\' FOR: DEFENDANT l! CAr=:........ );q....:;. u... ;=U2.. ,/ ! ..7-1 ;;)ry, a..... , '-.. L2o~ Q~:~~:"r--- :~Jl"" Sul oi the CQ"'~ (Elf. i /97) EXPlANATION OF REQUIRED RECORDS TO: CUSTODIAN OF RECORDS FOR: CENTRAL PA HEMATOLOGY & ONCOL. 50 N. 12TH ST. LEMOYNE, PA 17043 RE: 83756 PATRICIA J. THOMAS Any and all records, correspondence, files and memorandums, handwritten notes, original X-Rays, billing and payment records, relating to any examination, consultation, care or treatment. Dates Requested: up to and including the present. Subject: PATRICIA J. THOMAS 701 SOMERSET DRIVE, MECHANICSBURG, PA 17055 Social Security #: 162-36-9310 Date of Birth: 06-14-1945 5010-353390 837S6-L09 CERTIFICATE PREREQUISITE TO SERVICE OF A SUBPOENA PURSUANT TO RULE 4009.22 IN THE MATTER OF: COURT OF COMMON PLEAS PATRICIA & ROBERT THOMAS, ET AL. TERM, -VS- CASE NO: 01-6286 KATHRYN A. PEROUTKA, M.D., ET AL. As a prerequisite to service of a subpoena for documents and things pursuant to Rule 4009.22 MCS on behalf of LAURALEE B. BAKER, ESQ. certifies that (1) A notice of intent to serve the subpoena with a copy of the subpoena attached thereto was mailed or delivered to each party at least twenty days prior to the date on which the subpoena is sought to be served, (2) A copy of the notice of intent, including the proposed subpoena, is attached to this certificate, (3) No objection to the subpoena has been received, and (4) The subpoena which will be served is identical to the subpoena which is attached to the notice of intent to serve the subpoena. MCS on behalf of DATE: 02/21/2002 LAURALEE B. BAKER, ESQ. Attorney for DEFENDANT DEl1-311824 83756-L10 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND IN THE MATTER OF: COURT OF COMMON PLEAS PATRICIA & ROBERT THOMAS, ET AL. TERM, -VS- CASE NO: 01-6286 KATHRYN A. PEROUTKA, M.D., ET AL. NOTICE OF INTENT TO SERVE A SUBPOENA TO PRODUCE DOCUMENTS AND THINGS FOR DISCOVERY PURSUANT TO RULE 4009.21 [ Note: see enclosed list of locations ] TO: NIJOLE C. OLSON, ESQ. MCS on behalf of LAURALEE B. BAKER, ESQ. intends to serve a subpoena identical to the one that is attached to this notice. You have twenty (20) days from the date listed below in which to file of record and serve upon the undersigned an objection to the subpoena. If the twenty day notice period is waived or if no objection is made, then the subpoena may be served. Complete copies of any reproduced records may be ordered at your expense by completing the attached counsel card and returning same to HCS or by contacting our local HCS office. DATE: 02/01/2002 HCS on behalf of LAURALEE B. BAKER, ESQ. Attorney for DEFENDANT CC: LAURALEE B. BAKER, ESQ. MICHAEL BOND - THOMSON Any questions regarding this matter, contact THE HCS GROUP INC. 1601 MARKET STREET #800 PHILADELPHIA, PA 19103 (215) 246-0900 DE02-177109 837 56-C02 >>> LOCATION LIST <<< RECORDS REQUESTED MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) PAGE: 1 LOCATION NAME ROBERT S. NOLTE, D.O. MOFFITT, PEASE & LIM ASSOC. JOHN M. SULLIVAN GEORGE O. ROSENWASSER, M.D. PINNACLE HEALTH AT HARRISBURG PINNACLE HEALTH HOSPITALS KUllKEL SURGICAL GROUP CARL J. DORKO, M.D. CENTRAL PA HEMATOLOGY & ONCOL. RONALD H. MALCOM, M.D. DE02-177109 837 56-C02 COMM01'<iNEAL TH OF PENNSYLVANIA . COUNTY OF CUMBERL4..'\O PATRICIA J. THOMSON & ROBERT C. THOMSON VS Flit :-;0. 01-6286 CIVIL KATHRYN A. PEROUTKA, M.D., ET AL SUBPOENA TO PRODUCE DOCi.JMD."T5 OR n'E:";G5 FOR DISCO\'ERY PURSUA.....-r TO RULE 4009.2: i :J: CUSTODIAN OF RECORDS FOR: RONALD H. MALCOM, M.D. (!'\.amlt oi ?tnoft Qr =-~=::r' ~'~:::in :'W,:-:-::: (~) d..;ys U:f~ s.:.':ic~ oi ~J-..is Ju=~"it 1M~ftW:.-d by t.~. C"Ou~ to ~roduc'! :::e :ciicw:r:! :oc:.une:"l.ts or ::-ar:!,: MCS GROUP INC., 1601 MARKET ST., #800, PHILA.,PA 19103 .. (.~d~11 YOy CU~. Olin'lf or m~I lepbJ. copies of the doc':.lme!'lts Or product thinp l'I'I;'a:ftttC :y tNs S1:=?Orel'1.a.. !c!!~::e~ wi::: :1'Ir c~~ir:cJ:t::-: :::;:=!:4..~:~. ~o :::~ ;:-~I ::~:":g ::::s ~~T.:~~t.2t the ac!::..~ list~ I~r. You 1"'.4\" the rig::::o s~~<... in 1c!\'U1Cf. :.~, :"'!uon~=jr cost or prepuin5 the c:lpi ~ or j:r::ducins the t;-..in~ scuJ..."t. l! ~'ou fJjl tc ~odun the doc..,ments or things r,~uirtd by this subpceru. wi:."'.,i..,rwe!':ty (~J c!~~.s Ut.! its st:-.'ic!. r:" ~ury u:'\":n! :~s J:'::?Ofn~ :n~y s,"ic J c:un ord.,- ccmp.Hins you to comply wit.; i:.. nm St"3?OENA WAS ISSUED ATT.-iE REQl.1E='"T OF THE FOLLOwt':G ?::,,-S0S: s....\.{!: LAURALEE B. BAKER, ESQ. .1.!:'D!\.!:S: PO BX 932 HARRT~BUR(. ~A 171nR TELE?HOS!: 215-246-0900 S;:i'!\E.\f: COL1n" ID f-: A rrOR..\"!'l" FOR: DEFENDANT r:..\.7!;........)';::J..,{-'~J')..j';;)'-I ~~ I · Sui or the Ccu.~ ." -/~'"I (::1. I ~'I EXPlANATION OF REQUIRED RECORDS TO: CUSTODIAN OF RECORDS FOR: RONALD H. MALCOM, M.D. OAKWOOD erR RAD. ONCOLOGY 880 CENTURY DRIVE MECHAN1CSBURG, PA 17055 RE: 83756 PATR1CIAJ. THOMAS Any and all records, correspondence, files and memorandums, handwritte~ notes, original X-Rays, billing and payment records, relating to any examination, consultation, care or treatment. Dates Requested: up to and including the present. Subject: PATRICIAJ. THOMAS 701 SOMERSET DRIVE, MECHANICSBURG, PA 17055 Social Security #: 162-36-9310 Date of Birth: 06-14-1945 5U10-353392 83756-L10 CERTIFICATE PREREQUISITE TO SERVICE OF A SUBPOENA PURSUANT TO RULE 4009.22 IN THE MATTER OF: COURT OF COMMON PLEAS PATRICIA J. & ROBERT C. THOMSON TERM, -VS- CASE NO: 01-6286 CIVIL KATHRYN A. PEROUTKA, MD.. ET AL As a prerequisite to service of a subpoena for documents and things pursuant to Rule 4009.22 MCS on behalf of LAURALEE B. BAKER, ESQ. certifies that (1) A notice of intent to serve the subpoena with a copy of the subpoena attached thereto was mailed or delivered to each party at least twenty days prior to the date on which the subpoena is sought to be served, (2) A copy of the notice of intent, including the proposed subpoena, is attached to this certificate, (3) No objection to the subpoena has been received, and (4) The subpoena which will be served is identical to the subpoena which is attached to the notice of intent to serve the subpoena. DATE: 03/05/2002 ~~i']E~1 z) &-. Attorney for DEFENDANT DEll-3l42l0 83960-LOl COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND IN THE MATTER OF: COURT OF COMMON PLEAS PATRICIA J. & ROBERT C. THOMSON TERM, -vs- CASE NO: 01-6286 CIVIL KATHRYN A. PEROUTKA, MD., ET AL NOTICE OF INTENT TO SERVE A SUBPOENA TO PRODUCE DOCUMENTS AND THINGS FOR DISCOVERY PURSUANT TO RULE 4009.21 QUANTUM IMAGING (, TBERAPUETIC KATHLEEN SEHPELES MEDICAL, BILLING, AND X-BAyeS) MEDICAL, BILLING, AND X-BAyeS) TO: NIJOLE C. OLSON, ESQ. KCS on behalf of LAURALEE B. BAKER, ESQ. intends to serve a subpoena identical to the one that is attached to this notice. You have twenty (20) days from the date listed below in which to file of record and serve upon the undersigned an objection to the subpoena. If the twenty day notice period is waived or if no objection is made, then the subpoena may be served. Complete copies of any reproduced records may be ordered at your expense by completing the attached counsel card and returning same to KCS or by contacting our local KCS office. DATE: 02/13/2002 KCS on behalf of LAURALEE B. BAKER, ESQ. Attorney for DEFENDANT CC: LAURALEE B. BAKER, ESQ. MICHAEL BOND - 573004-00122 - 3374240102 Any questions regarding this matter, contact THE KeS GROUP INC. 1601 HARKET STREET #800 PHILADELPHIA, PA 19103 (215) 246-0900 DE02-178135 a 3 960 - C 0 2. COMMO~'WEAL TH OF PENNSYlVANIA . COUNTY OF CUMBERLA..'m PATRICIA J. THOMSON & ROBERT C. THOMSON VS KATHRYN A. PEROUTKA, M.D., ET AL File So. 01-6286 CIVIL SUBPOENA TO PRODUCE DOCT.JMD.,.S OR THI~GS FOR DISCOVERY PURSUA....,. TO RULE 4009.22 CUSTODIAN OF RECORDS FOR: QUANTUM IMAGING & THERAPEUTIC ASSOC. INC. TO: l Solm.. oi P~nQft or E:u::if!) Wi:hil'l n--e:,,:,:,!" ~:.o) (.bys &he!' st~.-jCI af this Sl.li:lpoen.a. you Ut order": by to". C'CIun to ~roduc. t:,e foiiowin! ':oc':.Im.nrs or :,in5S: SEE ATTACHED ., MCS GROUP INC., 1601 MARKET ST., #800, PHILA.,PA 19103 I.~.,,",,') You m.~' ..in'" or m~llepbJe copi.. of the documents or ~roduc. thin9 ~.....ed 'oy this ...'op..n.. '05"'" wit' .ne c!nilint. ~ :cmpHUlCI. to the pury Inwnl this r~tJest it th, ,addrBllistN above_ 'You n.a,", t!'l. rigru :0 Sf'!)(. in .d,'ann. ~". ",..o""bie co.t of preparins the copi.. or ~roduc:ng the thinI' _!lIL II ~'ou foil rc ~.duc. ,he document. or things ..quirtd by 'N' .ubpoe!U. wi!."..., twenty (=:I) doy. >it.. i.. ,.~..ic.. 'il. ~ury Sfrdn! ::-.lJ f:::~.n.. molY snk i COW't order c:HnpeUins you to (amply wit.... c.. THIS St"'3?OENA WAS ISSUED ATrrlE REQtJE-o:-r OFrrlE FOLLOWING PERSOS: .\'AME: LAURALEE B. BAKER, ESQ. ...OOR!!:: PO BX 932 HARRISBURG. PA 17108 :- .:::..:?:~O~!: 215-246-0900 i;'('3,.:..\fE "::'lw"A; J._' If: A TTOR"'!'l' FOR: DEFENDANT !I ~tc..x. C:v' ~ 4&1J~~ {2 ?lDA","" r-- ~ 3-5~OO~ DATE: D/.J. ~ 12 t J I ~/V'\.;t '- Sell ot the Court (E:f. i /90 EXPIANATION OF REQUIRED RECORDS TO: CUSTODIAN OF RECORDS FOR: QUANTUM IMAGING & THERAPUET1C ASSOC1ATES,INC. 3508 TRINDLE ROAD CAMP HILL, PA 17011 RE: 83960 PATRICIA J. THOMSON Any and all records, correspondence, files and memorandums, handwritten notes, original X-Rays, billing and payment records, relating to any examination, consultation, care or treatment. Dates Requested: up to and including the present. Subject: PATRICIA J. THOMSON 701 SOMERSET DRIVE, MECHANICSBURG, PA 17055 Social Security #: 162-36-9310 Date of Birth: 06-14-1945 SU10-355486 a 3 9 60 - LO 1 CERTIFICATE PREREQUISITE TO SERVICE OF A SUBPOENA PURSUANT TO RULE 4009.22 IN THE MATTER OF: COURT OF COMMON PLEAS PATRICIA J. & ROBERT C. THOMSON TERM, -VS- CASE NO: 01-6286 CIVIL KATHRYN A. PEROUTKA, MD., ET AL As a prerequisite to service of a subpoena for documents and things pursuant to Rule 4009.22 MCS on behalf of LAURALEE B. BAKER, ESQ. certifies that (1) A notice of intent to serve the subpoena with a copy of the subpoena attached thereto was mailed or delivered to each party at least twenty days prior to the date on which the subpoena is sought to be served, (2) A copy of the notice of intent, including the proposed subpoena, is attached to this certificate, (3) No objection to the subpoena has been received, and (4) The subpoena which will be served is identical to the subpoena which is attached to the notice of intent to serve the subpoena. MCS on behalf of DATE: 03/05/2002 LAURALEE B. BAKER, ESQ. Attorney for DEFENDANT DEll-3l4211 83960 -L02 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND IN THE MATTER OF: COURT OF COMMON PLEAS PATRICIA J. & ROBERT C. THOMSON TERM, -VS- CASE NO: 01-6286 CIVIL KATHRYN A. PEROUTKA, MD.. ET AL NOTICE OF INTENT TO SERVE A SUBPOENA TO PRODUCE DOCUMENTS AND THINGS FOR DISCOVERY PURSUANT TO RULE 4009.21 QUAIIT'UK IMAGING' TBERAPUETIC MEDICAL, BILLING, AND X-KAyeS) KATHLEEN SEHPELES MEDICAL, BILLING, AND X-RAY(S) TO: NIJOLE C. OLSON, ESQ. MCS on behalf of LAURALEE B. BAKER, ESQ. intends to serve a subpoena identical to the one that is attached to this notice. You have twenty (20) days from the date listed below in which to file of record and serve upon the undersigned an objection to the subpoena. If the twenty day notice period is waived or if no objection is made, then the subpoena may be served. Complete copies of any reproduced records may be ordered at your expense by completing the attached counsel card and returning same to MCS or by contacting our local HCS office. DATE: 02/13/2002 HCS on behalf of LAURALEE B. BAKER, ESQ. Attorney for DEFENDAIIT CC: LAURALEE B. BAKER, ESQ. MICHAEL BOND - 573004-00122 - 3374240102 Any questions regarding this matter, contact THE HCS GROUP INC. 1601 HARKET STREET #800 PHILADELPHIA, PA 19103 (215) 246-0900 DE02-178135 83960-C02 ~ COMMONWeALTH OF PENNSYt. V ANl~ . COUNTY OF CUMBERL~~D PATRICIA J. THOMSON & ROBERT C. THOMSON VS KATHRYN A. PEROUTKA. M.D.. ET AL Fill So. 01-6286 CIVIL . ~UBPOENA TO PRODUCE DQ~"TS OR-TH!;-.lGS FOR DISCOVERY PURSUA.,,"T TO RULE 4009.12 CUSTODIAN OF RECORDS FOR: KATHLEEN L. SEMPELES, M.n. TO: (."\.u!l1f oi P,non or ==cn V\'i:hin r'N'~' r~) d~ys UTI: servict al d'Li. subpoeN. you UI cud.," by the~" to ~roduC'. tn. (oilawin! :.ocwn'ftrs or ';,ing!: SEE ATTACHED . . II MCS GROUP INC., 1601 MARKET ST.. #800. PHlLA.,PA 19103 1.'._" You m.y d.ii.... or moilllpbll copies of Ih. dOCUll'l.nlS or product IlUnp ~_ed by lhi. subi'...n~ .og""., wi,;, 'h. <.rTiliu.. ai ,ompli."". ro ,hI pvry m&king this re<!unl.1 the .dclr8a Usr.. alloY.. You ""... r;,. right to 'Hie. in ..nnc.. ~,. :'UsoNbl. <Olf of prtpating Ih. <opi.. or producing rh.1tIinp -5lIL If yo. llil r: ~.d.cr tho docum.nfl or lhinp ..quired by tltis .ub~ wit.'WIlWtnty (:0) d.~.s Ii..r its ",,'i<l. 'h. pany ..n'ing :::is ,.="."n. may ...Ie a c""" ardor comp.lling you to cOll'lply w;t!I i:. THIS St"3i'OENA WAS ISSUED ATrrlE REQULt:T OFTrlE FOLLOWING PERSOS: ~....ME: LAURALEE B. BAKER. ESQ. ...0 0 RES!: PO BX 932 HARRISBURG.PA 17108 :-:::'::::=:';0\":: 215-246-0900 5...?'\.i\i:: .,::.......~ ID r. .... rrolt-.;n- FOR: DF.FF.NnANT 3-o-~ocD\ OAn:...... )~A)f..I ';;:l.o j d/.. ~cv}a Seal ot th. Cl1Ut (:!f.7 EXPLANATION OF REQUIRED RECORDS TO: CUSTODIAN OF RECORDS FOR: KATHLEEN SEMPELES 122 S. FILBERT STREET MECHANINCSBURG, PA 17055 RE: 83960 PATRICIA J. THOMSON Any and all records, correspondence, files and memorandums, handwritten notes, original X-Rays, billing and payment records, relating to any examination, consultation, care or treatment. Dates Requested: up to and including the present. Subject: PATRICIA J. THOMSON 701 SOMERSET DRIVE, MECHANICSBURG, PA 17055 Social Security #: 162-36-9310 Date of Birth: 06-14-1945 5U10-355488 83960 -LO 2 >- 0- ~ ;~~~ C)~.~::; C~': ::; Li: '"~- U... o U": (.: z :::)~ ():;:;; ~~ -7~ 2~/2 ,'c........ ldw 0(1- :2: :.:> o 70: c... 0-= -.c.: ::Ie "" C> LAURALEE B. BAKER, ESQUIRE Pa. Supreme Court I.D. No. 58874 MARGOLIS EDELSTEIN Post Office Box 932 Harrisburg, pennsylvania 17108-0932 Telephone: [7171 975-8114 Fax: [717] 975-8124 E-Mail: 1baker@margo1isede1stein.com Attorney for Defendants: KATHRYN A. PEROUTKA, M.D., and ANDREWS & PATEL ASSOCIATES, P.C. PATRICIA J. THOMSON and ROBERT C. THOMSON, her husband, Plaintiffs, :IN THE COURT OF COMMON PLEAS :CUMBERLAND COUNTY, PENNSYLVANIA :CIVIL ACTION - LAW v. :NO. 01-6286 Civil Term KATHRYN A. PEROUTKA, M.D., and ANDREWS & PATEL ASSOCIATES, P.C.,: Defendants. :JURY TRIAL DEMANDED NOTICE TO PLEAD TO: PATRICIA J. THOMSON and ROBERT C. THOMSON, her husband c/o Nijole C. Olson, Esquire Navitsky, Olson & Wisneski, LLP 2040 Linglestown Road - suite 303 Harrisburg, PA 17110 YOU ARE HEREBY NOTIFIED to plead to the enclosed NEW MATTER within twenty (20) days of service hereof, or a default judgment may be entered against you. Respectfully submitted, MARGOLIS EDELSTEIN Date: Sf z-,Ib 2.- BY'~'~' ~ U LEE B. BAKER, ESQUIRE PA. Attorney I.D. No. 58874 Attorneys for Defendants, KATHRYN A. PEROUTKA, M.D., and ANDREWS & PATEL ASSOCIATES, P.C. P. O. Box 932 Harrisburg, PA 17108-0932 (717) 975-8114 ~ LAURALEE B. BAKER, ESQUIRE Pa. Supreme Court I.D. No. 58874 MARGOLIS EDELSTEIN Post Office Box 932 Harrisburg, Pennsylvania 17108-0932 Telephone: [717] 975-8114 Fax: [717] 975-8124 E-Mail: 1baker@margo1isede1stein.com Attorney for Defendants: KATHRYN A. PEROUTKA, M.D., and ANDREWS & PATEL ASSOCIATES, P.C. PATRICIA J. THOMSON and ROBERT C. THOMSON, her husband, Plaintiffs, :IN THE COURT OF COMMON PLEAS :CUMBERLAND COUNTY, PENNSYLVANIA :CIVIL ACTION - LAW v. :NO. 01-6286 Civil Term KATHRYN A. PEROUTKA, M.D., and ANDREWS & PATEL ASSOCIATES, P.C.,: Defendants. :JURY TRIAL DEMANDED ANSWER WITH NEW MATTER OF DEFENDANTS, KATHRYN A. PEROUTKA, M.D., AND ANDREWS &: PATEL ASSOCIATES, P.C., TO PLAINTIFFS' COMPLAINT AND NOW, come Defendants, Kathryn A. Peroutka, M.D., and Andrews & Patel Associates, P.C., by and through their counsel, Margolis Edelstein, and answer Plaintiffs' Complaint and aver the following in support thereof: 1. Denied. After reasonable investigation, Answering Defendants are without information sufficient to form a belief as to the truth or falsity of the averments set forth in the corresponding paragraph of Plaintiffs' Complaint, and, therefore, deny the same and demand strict proof thereof at the time of trial. 2-3. Admitted. 4. Admitted ln part and denied in part. It is admitted that the oncology staff and nursing personnel who provided oncology treatment to Plaintiff, patricia Thomson, at the offices of Andrews & Patel Associates, P.C., were agents and employees. It is specifically denied that the ~radiology staff" and ~other ancillary medical personnel" who are referenced in the corresponding paragraph of Plaintiffs' Complaint were the agents, servants and/or employees of Andrews & Patel Associates, P.C. 5. Admitted. 6-8. Denied. The corresponding paragraphs of Plaintiffs' Complaint are denied in accordance with Pa.R.C.P. 1029(e). By way of further answer, the medical records, being in writing, speak for themselves. By way of further answer, Plaintiff, Patricia Thomson's tumor was pathologically Stage II, not Stage I. 9. Denied. The corresponding averment of Plaintiffs' Complaint sets forth a medical conclusion and as such, it is denied both specifically and generally in accordance with Pa.R.C.P. 1029(e). 10. Denied. It is specifically denied that Dr. Peroutka improperly advised Plaintiff, Patricia Thomson that she was a good candidate for Adriamycin therapy. To the contrary, the choice of Adriamycin therapy was appropriate and the proper treatment for Plaintiff, patricia Thomson's condition. 11-16. Denied. The corresponding paragraph of Plaintiffs' Complaint set forth a medical conclusion and as such, is denied both specifically and generally in accordance with Pa.R.C.P. - 2 - .:. 1029 (e) . 17. Denied. It is specifically denied that it was contraindicated to treat Plaintiff, Patricia Thomson, with Adriamycin without first obtaining a diagnostic MUGA scan. To the contrary, no such contraindication existed. 18-21. Denied. The corresponding paragraphs are denied in accordance with Pa.R.C.P. 1029(e). 22. Denied. It is specifically denied that Dr. Peroutka exposed Plaintiff, Patricia Thomson, to an increased risk of permanent and irreversible cardiac damage. To the contrary, at all times relevant hereto, Dr. Peroutka complied with the standard of care applicable under like circumstances. 23. Denied. It is specifically denied that Dr. Peroutka improperly authorized the injection of Adriamycin. To the contrary, at all times relevant hereto, the administration of Adriamycin was totally appropriate under the circumstances. 24. Admitted in part and denied in part. It is admitted that Dr. Peroutka was responsible for management and care of Plaintiff, Patricia Thomson's oncology needs. To the extent that the corresponding paragraph of Plaintiffs' Complaint implies that a MUGA scan was required prior to administration of Adriamycin, the same is accordingly denied. 25. Admitted. 26. Admitted. By way of further answer, further workup was - 3 - ~ ordered in January, 2001. 27. Admitted. 28. Admitted in part and denied in part. It is admitted that Dr. Peroutka's examination revealed tachycardia. To the extent this was later confirmed to be atrial tachycardia, after reasonable investigation, Dr. Peroutka is without information sufficient to form a belief as to the truth or falsity of this averment, and, therefore, denies the same and demands strict proof thereof at the time of trial. 29-31. Denied. After reasonable investigation, Answering Defendants are without information sufficient to form a belief as to the truth or falsity of the averment set forth in the corresponding averment of Plaintiffs' Complaint, and, therefore, deny the same and demand strict proof thereof at the time of trial. 32. Admitted in part and denied in part. It is admitted that Dr. Patel evaluated Plaintiff, patricia Thomson, during a hospital admission. As to the remainder of the allegations set forth in the corresponding paragraph, it is specifically denied that Dr. Patel's consult note indicates that it was "likely she experienced Adriamycin-induced cardiac damage." 33-36. Denied. After reasonable investigation, Answering Defendants are without information sufficient to form a belief as to the truth or falsity of the averment set forth in the - 4 - corresponding paragraph of Plaintiffs' Complaint, and, therefore, deny the same and demand strict proof thereof at the time of trial. 37. Denied. The corresponding paragraph is a medical conclusion to which no response is required, and, as such, is denied both specifically and generally in accordance with Pa.R.C.P. 1029(e). 38-39. Denied. The corresponding paragraph sets forth a medical conclusion to which no response is required, and, as such, is denied both specifically and generally in accordance with Pa.R.C.P. 1029(e). As to the future complications and treatment that will be required, after reasonable investigation, Answering Defendants are without information sufficient to form a belief as to the truth or falsity of these averments, and, therefore, deny the same and demand strict proof thereof at the time of trial. 40-49. Denied. The corresponding paragraph of Plaintiffs' Complaint set forth a conclusion of law which is deemed to be denied by operation of law, and accordingly, no response is required. By way of further answer, it is specifically denied that Answering Defendants were negligent. To the contrary, at all times relevant hereto, Answering Defendants provided care and treatment to Plaintiffs which was commensurate with the standard of care applicable under like circumstances. As to the remainder - 5 - of the allegations contained in the corresponding paragraphs of Plaintiffs' Complaint, after reasonable investigation, Answering Defendants are without information to verify the accuracy or inaccuracy, and the same are accordingly denied. COUNT I - INFORMED CONSENT/BATTERY PATRICIA THOMSON V. KATHRYN A. PEROUTKA, M.D. 50. The foregoing paragraphs are incorporated herein by reference as though set forth fully at length. 51. Denied. The corresponding paragraph of Plaintiffs' Complaint sets forth a conclusion of law which is deemed to be denied by operation of law, and accordingly, no response is required. By way of further answer, it is specifically denied that Dr. Peroutka is liable to Plaintiff, Patricia Thomson, for battery. To the contrary, at all times relevant hereto, Plaintiff, patricia Thomson, was provided with full informed consent, including the risks, alternatives and complications, which a reasonably prudent person would require under the circumstances. 52. Denied. After reasonable investigation, Answering Defendants are without information sufficient to form a belief as to the truth or falsity of the averment set forth in the corresponding paragraph of Plaintiffs' Complaint, and, therefore, deny the same and demand strict proof thereof at the time of - 6 - trial. 53. Denied in accordance with Pa.R.C.P.1029(e). The foregoing answers to paragraphs 27 through 49 are incorporated herein by reference as though set forth fully at length. WHEREFORE, Defendants, Kathryn A. Peroutka, M.D., and Andrews & Patel Associates, P.C., demand judgment in their favor and against Plaintiffs. COUNT II - NEGLIGENCE PATRICIA THOMSON V. KATHRYN A. PEROUTKA. M.D. 54. The foregoing paragraphs are incorporated herein by reference as though set forth fully at length. 55. Denied. The corresponding paragraph of Plaintiffs' Complaint sets forth a conclusion of law which is deemed to be denied by operation of law, and accordingly, no response is required. 1 By way of further answer, it is specifically denied that Dr. Peroutka is liable to Plaintiff, patricia Thomson, or that she was careless or negligent. To the contrary, at all times relevant hereto, Dr. Peroutka provided care and treatment to Plaintiff, patricia Thomson, which was commensurate with the standard of care applicable under like circumstances. It is further specifically denied that Dr. Peroutka was negligent in: 1 This paragraph has been revised by Court Order attached hereto as "A." Exhibit - 7 - a) improperly advising Mrs. Thomson that she was a good candidate for Adriamycin therapy; b) ordering a contraindicated treatment for Mrs. Thomson; c) failing to recognize that Mrs. Thomson was not a candidate for Adriamycin therapy; d) failing to order and obtain a MUGA scan prior to initiating Adriamycin therapy; e) failing to assess Mrs. Thomson's cardiac status for subclinical cardiomyopathy prior to initiating Adriamycin therapy; f) failing to advise Mrs. Thomson that treatment with Adriamycin, absent the performance of a baseline ejection fraction wit a MUGA scan, increased her risk for severe, permanent and irreversible cardiac damage; g) failing to minimize the risk of severe, permanent and irreversible cardiac damage; h) failing to obtain a proper medical history; i) failing to properly treat Mrs. Thomson; j) failing to properly assess and evaluate Mrs. Thomson; k) failing to recognize and diagnose Mrs. Thomson's subclinical cardiomyopathy prior to initiating the Adriamycin therapy; - 8 - .. 1) failing to follow-up with the oncology staff regarding the performance of a pre-chemotherapy MUGA scan prior to initiating Mrs. Thomson's Adriamycin therapy; m) improperly assuming that Mrs. Thomas was too young and healthy to require a MUGA scan prior to the administration of Adriamycin; n) failing to understand that even small doses of Adriamycin in a patient with subclinical cardiomyopathy can result in a permanent, severe and irreversible cardiac damage; 0) increasing the risk of severe, permanent and irreversible cardiac damage; p) causing permanent, severe and irreversible damage to Mrs. Thomson's heart; q) failing to evaluate Mrs. Thomson's ability to withstand the cardiotoxic effects of Adriamycin; r) failing to order or obtain cardiac assessments and evaluation before, during and after the Adriamycin therapy; s) failing to order or obtain serial MUGA scans during the Adriamycin therapy; and t) increasing the risk of severe, permanent and irreversible vital organ damage from Adriamycin-induced cardiomyopathy. 56. Denied. The corresponding paragraph of Plaintiffs' Complaint sets forth a conclusion of law which is deemed to be - 9 - .' denied by operation of law, and accordingly, no response is required. By way of further answer, it is specifically denied that Dr. Peroutka was negligent. To the contrary, at all times relevant hereto, Dr. Peroutka provided care and treatment to Plaintiff, Patricia Thomson, which was commensurate with the standard of care applicable under like circumstances. By way of further answer, the answers to paragraphs 27-49 are incorporated herein by reference as though set forth fully at length. WHEREFORE, Defendants, Kathryn A. Peroutka, M.D., and Andrews & Patel Associates, P.C., demand judgment in their favor and against Plaintiffs. COUNT III - NEGLIGENCE PATRICIA THOMSON V. ANDREWS & PATEL ASSOCIATES, P.C. 57. The foregoing paragraphs are incorporated herein by reference as though set forth fully at length. 58. Admitted. 59. Admitted in part and denied in part. It is admitted that the oncology staff and ancillary medical personnel who provided oncology treatment to Plaintiff, patricia Thomson, were agents, servants and/or employees of Andrews & Patel Associates, P.C. As to the remaining personnel noted, specifically the "radiology staff" and other "ancillary medical personnel" referenced in the corresponding paragraph of Plaintiffs' - 10 - ." Complaint, it is specifically denied that such individuals were the agents, servants and/or employees of Andrews & Patel Associates, P.C. 60. Denied. The corresponding paragraph sets forth a conclusion of law which is deemed to be denied by operation of law, and accordingly, no response is required.2 It is further specifically denied that the agents or servants of Andrews & Patel Associates, P.C., is liable or was negligent. To the contrary, at all times relevant hereto, the employees of Andrews & Patel Associates, P.C., provided care and treatment to Plaintiff, patricia Thomson, which was commensurate with the standard of care applicable under like circumstances. It is further specifically denied that employees of Andrews & Patel Associates, P.C., were negligent in: a) improperly advising Mrs. Thomson that she was a good candidate for Adriamycin therapy; b) ordering a contraindicated treatment for Mrs. Thomson; c) failing to recognize that Mrs. Thomson was not a candidate for Adriamycin therapy; d) failing to order and obtain a MUGA scan prior to initiating Adriamycin therapy; 2 Exhibit This paragraph has been revised by Court Order attached hereto as "A." - 11 - .' e) failing to assess Mrs. Thomson's cardiac status for subclinical cardiomyopathy prior to initiating Adriamycin therapy; f) failing to advise Mrs. Thomson that treatment with Adriamycin, absent the performance of a baseline ejection fraction with a MUGA scan, increased her risk for severe, permanent and irreversible cardiac damage; g) failing to minimize the risk of severe, permanent and irreversible cardiac damage; h) failing to obtain a proper medical history; i) failing to properly treat Mrs. Thomson; j) failing to properly assess and evaluate Mrs. Thomson; k) failing to recognize and diagnose Mrs. Thomson's subclinical cardiomyopathy prior to initiating the Adriamycin therapy; 1) failing to follow-up with the oncology staff regarding the performance of a pre-chemotherapy MUGA scan prior to initiating Mrs. Thomson's Adriamycin therapy; m) improperly assuming that Mrs. Thomson was too young and health to require a MUGA scan prior to the administration of Adriamycin; n) failing to understand that even small doses of Adriamycin in a patient with subclinical cardiomyopathy can - 12 - result in permanent, severe and irreversible cardiac damage; 0) increasing the risk of severe, permanent and irreversible cardiac damage; p) causing permanent, severe and irreversible damage to Mrs. Thomson's heart; q) failing to evaluate Mrs. Thomson's ability to withstand the cardiotoxic effects of Adriamycin; r) failing to order or obtain cardiac assessments and evaluation before, during and after the Adriamycin therapy; s) failing to order or obtain serial MUGA scans during the Adriamycin therapy; t) increasing the risk of severe, permanent and irreversible vital organ damage from Adriamycin-induced cardiomyopathy; u) inappropriately holding itself out to the public as having all the necessary facilities, equipment and trained personnel and services to care for Mrs. Thomson; v) failing to properly train, instruct and notify staff that every patient treated with Adriamycin must undergo a MUGA scan prior to treatment; w) inappropriately representing that it was able to provide safe and appropriate care and services to Mrs. Thomson; and x) inappropriately representing that Mrs. Thomson was - 13 - not in danger due to lack of trained staff, facilities, equipment and services. 61-62. Denied. The corresponding paragraph of Plaintiffs' Complaint set forth a conclusion of law which is deemed to be denied by operation of law, and accordingly, no response is required. By way of further answer, it is specifically denied that employees of Andrews & Patel Associates, P.C., were negligent. To the contrary, at all times relevant hereto, the agents/employees of Andrews & Patel Associates, P.C., acted appropriately and in accordance with the standard of care applicable under like circumstances. 63. Denied. The corresponding paragraph of Plaintiffs' Complaint sets forth a conclusion of law which is deemed to be denied by operation of law, and accordingly, no response is required. To the contrary, at all times relevant hereto, the employees and servants of Andrews & Patel Associates, P.C., provided care and treatment to Plaintiff, Patricia Thomson, which was commensurate with the standard of care applicable under like circumstances. By way of further answer, the answers to paragraphs 27-49 are incorporated herein by reference as though set forth fully at length. WHEREFORE, Defendants, Kathryn A. Peroutka, M.D., and Andrews & Patel Associates, P.C., demand judgment in their favor and against Plaintiffs. - 14 - CLAIM I - NEGLIGENCE ROBERT C. THOMSON V. KATHRYN C. PEROUTKA, M.D. AND ANDREWS & PATEL ASSOCIATES, P.C. 64. The foregoing paragraphs are incorporated herein by reference as though set forth fully at length. 65. Denied. The corresponding paragraph of Plaintiffs' Complaint sets forth a conclusion of law which is deemed to be denied by operation of law, and accordingly, no response is required. It is further specifically denied that the servants/agents of Andrews & Patel Associates, P.C., or Dr. Peroutka were negligent. To the contrary, at all times relevant hereto, Answering Defendants provided care and treatment to Plaintiff, Patricia Thomson, which was commensurate with the standard of care applicable under like circumstances. As to the claims for damages set forth in the corresponding paragraph of Plaintiffs' Complaint, after reasonable investigation, Answering Defendants are without information sufficient to form a belief as to the truth or falsity of these allegations, and, therefore, deny the same and demand strict proof thereof at the time of trial. WHEREFORE, Defendants, Kathryn A. Peroutka, M.D., and Andrews & Patel Associates, P.C., demand judgment in their favor and against Plaintiffs. - 15 - NEW MATTER 66. The foregoing paragraphs are incorporated herein by reference as though set forth fully at length. 67. Plaintiffs' Complaint fails to state any claim upon which relief can be granted as against Answering Defendants. 68. To the extent currently applicable, or to the extent that it can later become applicable, Answering Defendants plead the statute of limitations to preserve this affirmative defense for the record. 69. At all times and for all purposes material to the events set out in Plaintiffs' Complaint, Answering Defendants acted appropriately in providing oncological care and treatment to Plaintiff, Patricia Thomson. Said treatment was commensurate with a standard applicable under like circumstances. 70. At all times and for all purposes material to the events described in Plaintiffs' Complaint, Answering Defendants followed the teachings, practices and precepts of a respected school of thought followed by a considerable number of practicing medical oncologists and, accordingly, the professional conduct was fully commensurate with an applicable standard of care. 71. To the extent that discovery or the evidence at trial may establish that the Plaintiffs were negligent and that such negligence caused or contributed to cause the injuries and damages of which Plaintiffs complain, Answering Defendants - 16 - expressly reserve the right to assert the affirmative defense of contributory/comparative negligence and/or assumption of risk. 72. To the extent that Plaintiffs sustained any injury or damage as alleged in Plaintiffs' Complaint, which is specifically denied, Answering Defendants aver that any such injury or damage was the result of the acts or omissions of third parties for whom Answering Defendants are in no way liable. 73. To the extent that Plaintiffs sustained any injury or damage as claimed in Plaintiffs' Complaint, Answering Defendants in no way negligently or otherwise caused or contributed to cause any such injury or damage. 74. Plaintiffs' allegations of negligence as against Answering Defendants are without reasonable basis in fact or medicine and may constitute an abuse of civil process. 75. Answering Defendants hereby assert and incorporate by reference any and all defenses which may be available to them under the Pennsylvania Health Care Services Malpractice Act, 40 P.S. ~1301.101, et ~. 76. The injuries and damages claimed by Plaintiffs are the natural and progressive result of the Plaintiff, Patricia Thomson's medical condition, and not the result of any negligence by Answering Defendants. 77. Plaintiff, Patricia Thomson, was provided with full informed consent prior to the administration of chemotherapy in - 17 - accordance with 40 P.S. ~1301.811-A, et seq. Respectfully submitted, MARGOLIS EDELSTEIN Date: 5/1-10'& BY'~PrL- U LEE B. BAKER, ESQUIRE PA. Attorney I.D. No. 58874 Attorneys for Defendants, KATHRYN A. PEROUTKA, M.D., and ANDREWS & PATEL ASSOCIATES, P.C. P. O. Box 932 Harrisburg, PA 17108-0932 (717) 975-8114 - 18 - Exhibit A ...j- 7.3 0 (), r/- cCJ /;(3 PATRICIA J. THOMSON: and ROBERT C. THOMSON, her husband, Plaintiffs IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYL VANIA v. CIVIL ACTION - LAW KATHRYNA. PEROUTKA, M.D., and ANDREWS & PATEL ASSOCIATES, P.C., Defendants NO. 01-6286 CIVIL TERM IN RE: DEFENDANTS' PRELIMINARY OBJECTIONS BEFORE HOFFER. P.J.. and OLER. J. ORDER OF COURT AND NOW, this 14th day of February, 2002, upon consideration of Defendants' preliminary objections to Plaintiffs' complaint in the form of a motion to strike or for a more specific pleading, and following oral argument at which counsel agreed that objections to paragraphs 55h, 55i, 55j, 550, 60h and 600 may be resolved by construing of the allegations as if they were modified by the phrase "in the manner described herein," it is ordered as follows: 1. Paragraphs 55h, 55i, 55j, 550 and 60h and 600 of Plaintiffs' complaint shall be construed as modified by the phrase "in the manner described herein"; 2. Defendants' preliminary objections as they relate to paragraphs 61 and 62 of Plaintiffs' complaint are denied. BY THE COURT, Nijole C. Olson, Esq. 2040 Linglestown Road Suite 303 Harrisburg, P A 17110 Attorney for Plaintiffs .~. L.au alee B. Baker, Esq. S un J. Mumford, Esq. .0. Box 932 / Harrisburg, PA 17108-0932 Attorneys for Defendants :rc VERIFICATION I, KATHRYN A. PEROUTKA, M.D., have read the foregoing ANSWER AND NEW MATTER OF DEFENDANT KATHRYN A. PEROUTKA, M.D., AND ANDREWS & PATEL ASSOCIATES, P.C. which has been drafted by my counsel. The factual statements contained therein are known by me and are true and correct to the best of my knowledge, information and belief. This statement and verification is made subject to the penalties of 18 Pa. C.S.A. Section 4904, relating to unsworn falsifications to authorities, which provides that, if I knowingly make false averments, I may be subject to criminal penalties. Date: sf ()./ J()~ ~LJ~~ KATHRY A. PE<<OUTKA, M.D. VERIFICATION I, KATHRYN A. PEROUTKA, M.D., as an Officer of ANDREWS & PATEL ASSOCIATES, P.C., have read the foregoing ANSWER AND NEW MATTER OF DEFENDANT KATHRYN A. PEROUTKA, M.D., AND ANDREWS & PATEL ASSOCIATES, P.C., which has been drafted by my counsel. The factual statements contained therein are known by me and are true and correct to the best of my knowledge, information and belief. This statement and verification is made subject to the penalties of 18 Pa. C.S.A. Section 4904, relating to unsworn falsifications to authorities, which provides that, if I knowingly make false averments, I may be subject to criminal penalties. Date: 4':0) /) ;;.. . ~~~.&-J CERTIFICATE OF SERVICE I HEREBY CERTIFY that I served a true and correct copy of the foregoing ANSWER WITH NEW MATTER OF DEFENDANTS, KATHRYN A. PEROUTKA, M.D., AND ANDREWS & PATEL ASSOCIATES, P.C., TO PLAINTIFFS' COMPLAINT, on all counsel of record via facsimile on the..1~,.{day of ~ ' 2002, and addressed as follows: VIA FAX - (717) 541-9206 Nijole C. Olson, Esquire Navitsky, Olson & Wisneski, LLP 2040 Linglestown Road - Suite 303 Harrisburg, PA 17110 MARGOLIS EDELSTEIN --.../ ."-.. c- t,S""' LJ..' () '~) -' L.; , . J../- -_.. r:) [lj'i' k-' I, e:: .....- cn , (".": -;.... ~.:.! '., ("\,-..1 .' .' ~ ......, I./."i' I"~-' ,..... ;://."'j} ~:j () I'''_t ci PATRICIA 1. THOMSON and ROBERT C. THOMSON, her husband, IN THE COURT OF COMMON PLEAS CUMBERLAND CO., PENNSYLVANIA Plaintiffs NO. 01-6286 v. CIVIL ACTION - LAW KATHRYN A. PEROUTKA, M.D. and ANDREWS & PATEL ASSOCIATES, P.c., Defendants JURY TRIAL DEMANDED PLAINTIFFS' REPLY TO NEW MATTER OF DEFENDANTS AND NOW, come the Plaintiffs, Patricia J. and Robert C. Thomson, by and through their attorneys, Navitsky, Olson & Wisneski LLP, and hereby enter the following reply to the New Matter of Defendants to Plaintiffs' Complaint: 66. No response is necessary. By way of further response, the facts set forth in paragraphs 1 through 49 of Plaintiffs' Complaint are incorporated herein by reference as if set forth at length. 67. Denied. Plaintiffs' Complaint states cognizable causes of action against Answering Defendants. 68. Denied. Plaintiffs' Complaint was timely filed. 69. Denied. Plaintiffs' injuries and damages alleged in Plaintiffs' Complaint were the direct and proximate result of the negligence of Answering Defendants. It is specifically denied that Answering Defendants' management and care of Plaintiff was commensurate with a standard applicable under like circumstances. It is further denied that Answering Defendants are without liability in this matter. 70. It is specifically denied that Defendants elected a treatment modality which was ".0.,.,..... recognized as proper under the circumstances. It is specifically denied that it is appropriate to treat a patient with Adriamycin chemotherapy without first obtaining a cardiac work-up, including a baseline MUGA Scan. 71. It is specifically denied that Plaintiffs were contributorily negligent, comparatively negligent and/or assumed the risk of Defendants' negligence. 72. It is specifically denied that Plaintiffs' injuries and damages were caused by the acts or omissions of third parties for whom Answering Defendant had no control. Any and all allegations that the Answering Defendants are without liability in this matter are specifically denied. Plaintiffs' injuries and damages were the direct and proximate result of the Defendants' negligence. It is specifically denied that the Answering Defendants are without liability in this matter. 73. It is specifically denied that Answering Defendants are without liability in this matter. Plaintiffs' injuries and damages were the direct and proximate result of the negligence of Kathryn A. Peroutka, M.D. and Andrews & Patel Associates, PoCo 74. Denied. Plaintiffs' Complaint states cognizable causes of action against Answering Defendants. 75. Denied. The Health Care Services Malpractice Act was declared unconstitutional in nearly all respects years ago. It contains no constitutional limitations on liability or damages applicable to this case. Furthermore, the Answering Defendants were negligent, their negligence caused injuries and damages to Plaintiffs and Plaintiffs should be compensated. 76. Denied. Plaintiffs' injuries and damages were the direct and proximate result of the negligence of Answering Defendants. It is specifically denied that the Answering Defendants are without liability in this matter. 2 77. It is specifically denied that Answering Defendants provided Plaintiff, Patricia Thomson, with full and complete information upon which she could make an informed decision regarding her treatment and care. WHEREFORE, Plaintiffs Patricia J. and Robert C. Thomson respectfully request that the New Matter of Defendants be dismissed, and that judgment be entered in favor of Plaintiffs. Respectfully submitted, A VITSKY, OLSON & WISNESKI LLP .-...- ' '~'- Date: May 24, 2002 3 AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA ss COUNTY OF DAUPHIN I, Nijole C. Olson, Esquire, being duly sworn according to law, depose and say that I am counsel for Plaintiffs and that I am authorized to make this affidavit on behalf of said Plaintiffs, and that the facts set forth in the foregoing document are true and correct to the best of my knowledge, information and belief or, are true and correct based on the information obtained from the Plaintiffs. Sworn to and subscribed before me this {)lJIh day of ..Y11iM{ ,2002. Vl6W f * Notary Public My Commission expires: TA 10lS t STAUFFER /IOTAR\' PIIBUC CITY OF HARRlSBU~ IMUPHIN coum COMMISSION EXPIRES MARCH 28 2005 i I I II Jt;_:~~- )p', i ,:\ ~!.ir.t~ ~:~~:;/ Y I YT/,.:C.:~ ~';i:(1i,;rll ,:j, J" :;r. l' ~,M ,( ~ -"-"~--- ".~ ~.. I .': (.t1.;J I '.; "'1 \ CERTIFICATE OF SERVICE I, Lois E. Stauffer, an employee of the law firm ofNavitsky, Olson & Wisneski LLP, hereby certify that a true and correct copy of the foregoing PLAINTIFFS' REPLY TO NEW MATTER OF DEFENDANTS was served upon the following person by first-class United States mail, postage prepaid on May 24, 2002, as follows: Lauralee B. Baker, Esquire MARGOLIS EDELSTEIN P.O. Box 932 Harrisburg, P A 17108-0932 Counsel for Defendants '/1(~ ~. ~ Lois E. Stauffer o c- <? ""'t.ll5~ nlf', . 2::.1 6jS~,~' r;l~ ......:~ zQ pC, 'C ~ :z }.::;.,. -~ f'o..) 0',) -rJ .c:- :::J PATRICIA J. THOMSON and ROBERT C. THOMSON, her husband, IN THE COURT OF COMMON PLEAS CUMBERLAND CO., PENNSYLVANIA Plaintiffs NO. 01-6286 v. CIVIL ACTION - LAW KATHRYN A. PEROUTKA, M.D. and ANDREWS & PATEL ASSOCIATES, P.C., Defendants JURY TRlAL DEMANDED PRAECIPE TO THE PROTHONOTARY OF CUMBERLAND COUNTY: Please withdraw my appearance on behalf of Plaintiff in the above-captioned matter. NA VITSKY, OLSON & WISNESKI LLP Nijole C. lson, 1.D. No. 55287 2040 Linglestown oad, Suite 303 Harrisburg, PA 17110 (717)541-9205 Counsel for Plaintiffs Please enter my appearance on behalf of Plaintiff in the above-captioned matter. Catherine M. Mahady-Smith, 1.D. No. 47252 3115-A North Front Street Harrisburg, PA 17110 (717) 236-6012 Counsel for Plaintiffs Date: November 7,2002 .. "'...~~... .~~l'_ '/') ;:.- t./~:;..i" ( . , $ J " '.Ii ." CERTIFICATE OF SERVICE I, Lois E. Stauffer, an employee of the law firm ofNavitsky, Olson & Wisneski LLP, hereby certify that a true and correct copy of the foregoing PRAECIPE was served upon the following persons by first-class United States mail, postage prepaid on Nowmber 7, 2002, as follows: Lauralee B. Baker, Esquire MARGOLIS EDELSTEIN P.O. Box 932 Harrisburg, P A 17108-0932 Counsel for Defendants Catherine M. Mahady-Smith, Esquire 3ll5-A North Front Street Harrisburg, PA 17110 ~ " ( &-t~ ~ . ~9/1 Lois E. Stauffer ' o ~~ -r"!p' n':'lf~- :;-~::::~ ~; ~:-~ '-C. ~- ::~C~" ~;:~~j ~ C, 1""") ~ "1 '''._- 1',; ~~ ,,-~} :.n 'r.-: ::u -< r ~..:, LAURALEE B. BAKER, ESQUIRE Pa. Supreme Court 1.0. No. 58874 MARGOLIS EDELSTEIN Post Office Box 932 Harrisburg. Pennsylvania 17108-0932 Telephone: [717] 975-8114 Fax: [717] 975-8124 E~MaiI: Ibaker@margolisedelstein.com Attorney for Defendants: KATHRYN A. PEROUTKA, M.D., and ANDREWS & PATEL ASSOCIATES, P.c. PATRICIA J. THOMSON and ROBERT e. THOMSON, her husband, Plaintiffs, IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA : CIVIL ACTION - LAW v. : NO. 01-6286 Civil Term KATHRYN A. PEROUTKA, M.D., and ANDREWS & PATEL ASSOCIATES, P.e., Defendants. : JURY TRIAL DEMANDED CERTIFICATE PREREOUlSITE TO SERVICE OF A SUBPOENA PURSUANT TO RULE 4009.22 As a prerequisite to service of a Subpoena for Documents and Things pursuant to Rule 4009.22, Defendants, Kathryn A. Peroutka, M.D. and Andrews & Patel Associates, P.e., certify that: (1) a Notice of Intent to serve the Subpoena with a copy of the Subpoena attached thereto was mailed or delivered to each party at least twenty (20) days prior to the date on which the subpoena is sought to be served; (2) a copy of the Notice of Intent, including the proposed Subpoena, is attached to this Certificate; (3) Counsel for the parties has waived the notice requirement; and (4) the Subpoena which will be served is identical to the Subpoena which is attached to the Notice of Intent to serve the Subpoena. Margolis Edelstein Date: February 20, 2004 Laurale B. Baker, Esquire y LD. #58874 Counsel for Defendants Kathryn A. Peroutka, M.D. and Andrews & Patel Associates, P.e. LAURALEE B. BAKER, ESQUIRE Pa. Supreme Court J.D. No. 58874 MARGOLIS EDELSTEIN Post Office Box 932 Harrisburg. Pennsylvania 17108-0932 Telephone: [717] 975-8114 Fax: [717] 975-8124 E-Mail: Ibaker@margolisedelstein.com Attorney for Defendants: KATHRYN A. PEROUTKA, M.D., and ANDREWS & PATEL ASSOCIATES, P.c. PATRICIAJ. THOMSON and ROBERT C. THOMSON, her husband, Plaintiffs, : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA : CIVIL ACTION - LAW v. : NO. 01-6286 Civil Term KATHRYN A. PEROUTKA, M.D., and ANDREWS & PATEL ASSOCIATES, P.c., Defendants. : JURY TRIAL DEMANDED NOTICE OF INTENT TO SERVE A SUBPOENA TO PRODUCE DOCUMENTS AND THINGS FOR DISCOVERY PURSUANT TO RULE 4009.21 Defendants, Kathryn A. Peroutka, M.D. and Andrews & Patel Associates, P.c., intend to serve a Subpoena identical to the one that is attached to this Notice. You have twenty (20) days from the date listed below in which to file of record and serve upon the undersigned an objection to the Subpoena. If no objection is made the Subpoena may be served. Margolis Edelstein Date: February 13, 2004 ~f1.hi <Ii ./iu:uw Lauralee B. Baker, Esquire Attorney I.D. #58874 Counsel for Defendants Kathryn A. Peroutka, M.D. and Andrews & Patel Associates, P.c. PATRICIAJ. THOMSON and ROBERT C. THOMSON, her husband, Plaintiffs, IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA CNIL ACTION - LAW v. NO. 01-6286 Civil Term KATHRYN A. PEROUTKA, M.D., and ANDREWS & PATEL ASSOCIATES, P.c., Defendants. : JURY TRIAL DEMANDED SUBPOENA TO PRODUCE DOCUMENTS OR THINGS TO: Records Custodian OakWood Center 880 Century Drive Mechanicsburg, PA 17055 Within twenty (20) days after service of this Subpoena, you are ordered by the Court to produce the following documents or things: any an all technical records, including all simulation and portal records, as well as notes, reports, studies, films, bills, orders, incoming/outgoing correspondence, documents from other healthcare providers, labs, authorizations, consultations, summaries, sheets, lists, consents, etc. pertaining to Patricia J. Thomson, DOB: 6/14/45, SSN: 162-36-9310, 701 Somerset Drive, Mechanicsburg, PA 17055 at the offices of Margolis Edelstein, 3510 Trindle Road, Camp Hill, Pennsylvania 17011. You may deliver or mail legible copies of the documents or produce things requested by this Subpoena, together with the Certificate of Compliance, to the party making this request at the address listed above. You have the right to seek in advance the reasonable cost of preparing the copies or producing the things sought. If you fail to produce the documents or things required by this Subpoena within twenty (20) days after its service, the party serving this Subpoena may seek a court order compelling you to comply with it. This Subpoena was issued at the request of: Lauralee B. Baker, Esquire Attorney J.D. No. 58874 Margolis Edelstein 3510 Trindle Road Camp Hill, Pennsylvania 17011 (717) 975-8114 Attorney for Defendants BY THE COURT: Date: (Prothonotary) (Seal of the Court) CERTIFICATE OF SERVICE I HEREBY CERTIFY that I served a true and correct copy of the foregoing NOTICE OF INTENT TO SERVE A SUBPOENA TO PRODUCE DOCUMENTS AND THINGS FOR DISCOVERY PURSUANT TO RULE 4009.21, on all counsel of record by placing the same in the United States mail at Camp Hill, Pennsylvania, via telecopier and via first-class postage prepaid, on the 13th day of February, 2004, and addressed as follows: Catherine M. Mahady-Smith, Esquire 3115-A North Front Street Harrisburg, PA 17110 David J. Foster, Esquire Costopoulous, Foster & Fields 831 Market Sh"eet Lemoyne, P A 17043-0222 MARGOLIS EDELSTEIN By: CERTIFICATE OF SERVICE I HEREBY CERTIFY that I served a true and correct copy of the foregoing CERTIFICATE PREREQUISITE TO SERVICE OF A SUBPOENA PURSUANT TO RULE 4009.22 on all counsel of record by placing the same in the United States mail at Camp Hill, Pennsylvania, via telecopier and via first-class postage prepaid, on the 20th day of February, 2004, and addressed as follows: Catherine M. Mahady-Smith, Esquire 3115-A North Front Street Harrisburg, PA 17110 David J. Foster, Esquire Costopoulous, Foster & Fields 831 Market Street Lemoyne, PA 17043-0222 MARGOLIS EDELSTEIN By: ~.o.ca - Vicki A Bolinger, RP 7 (") c ;(~ 1",;.,:; "0 ~;; c' :;.,.'.::: :.< ,..... = c'"' .c- ..." ,." Q.) r-,.) w o " .... :1: "Tl rn-..- r'- -,.....n1 ~~~ ~.:J ~r-. ()~S ()fn :"1 .,t> .0 -< .." r:-? U1 LAURALEE B. BAKER, ESQUIRE Pa. Supreme Court I.D. No. 58874 MARGOLIS EDELSTEIN 3510 Trindle Road Camp Hill, Pennsylvania 17011 Telephone: [717] 975-8114 Fax: [717) 975-8124 R-Mail: Ibakel.@margolisedelstein.com Attorney for Defendants: KATHRYN A. PEROUTKA, M.D., and ANDREWS & PATEL ASSOCIATES, P.C. PATRICIAJ. THOMSON and ROBERT C. THOMSON, her husband, Plaintiffs, :IN THE COURT OF COMMON PLEAS :CUMBERLAND COUNTY, PENNSYLVANIA :CIVIL ACTION - LAW v. :NO, 01-6286 Civil Term KATHRYN A. PEROUTKA, M,D" and ANDREWS & PATEL ASSOCIATES, p,c.,: Defendants, :JURY TRIAL DEMANDED PETITION FOR STATUS CONFERENCE OF DEFENDANTS, KATHRYN A. PEROUTKA, M.D" AND ANDREWS & PATEL ASSOCIATES, PoCo AND NOW, come Defendants, Kathryn A. Peroutka, M.D., and Andrews & Patel Associates, P.C. (collectively referred to as "Petitioning Defendants"), by and through their counsel, Margolis Edelstein, and petition this Honorable Court to schedule a status conference, and aver the following in support thereof: 1. This medical professional liability action was initiated by Plaintiffs by way of a Complaint served on or about November 15, 2001. 2. In their Complaint, Plaintiffs contend Petitioning Defendants were negligent in failing to perform certain testing prior to the administration of chemotherapy. 3. On or about May 23, 2002, Petitioning Defendants filed an Answer With New Matter denying any and all allegations of medical negligence, 4. The depositions of the Petitioning Defendant, Kathryn Peroutka, M.D" took place on November 20, 2003: and the deposition of Plaintiff, Patricia J, Thomson, took place on May 13, 2004, For several months, the Defense has been attempting to schedule the remaining discovery depositions to no avail. \ WHEREFORE, Defendants, Kathryn A. Peroutka, M.D., and Andrew & Patel Associates, P.C., respectfully request that this Honorable Court schedule a Status Conference in order to establish discovery deadlines as well as a time suitable for all counsel for trial. Respectfully submitted, MARGOLIS EDELSTEIN Date: 5 't 05' By:_~~L ~ LEE B, BAKER, ESQUIRE PA. Attorney J.D. No. 58874 Attorney for Defendants, KATHRYN A. PEROUTKA, M.D., and ANDREWS & PATEL ASSOCIATES, P.e. 3510 Trindle Road Camp Hill, PA 17011 (717) 975-8114 " 2 - \ CERTIFICATE OF SERVICE I HEREBY CERTIFY that I served a true and correct copy of the foregoing PETITION FOR STATUS CONFERENCE OF DEFENDANTS, KATHRYN A. PEROUTKA, M.D., AND ANDREWS & PATEL ASSOCIATES, P.C., on all counsel of record by placing the same in the United State~ mail at Camp Hill, Pennsylvania, first- class postage prepaid, on th~ 7'" ~y of (')2~ ' 2005, and addressed as follows: Catherine M. Mahady-Smith, Esquire 3115-A North Front Street Harrisburg, PA 17110 David J. Foster, Esquire Costopoulous, Foster & Fields 831 Market Street Lemoyne, PA 17043-0222 MARGOLIS EDELSTEIN /-j /-, j ", ~ / " -"/ .' // / 'f'-" /'~'. /// / & ,~. / By,"" ",-, /,,/ .' -- t.:::1oAnn . Nelson, Secret~ry ---~.~~_....<." ~ "' \ ,,-\ :;---. -. "'- 7':> S' .t; ~ " ^ >: .;\ ~~.- }A.....l '..1\ - , r. -+- ~") -'" ~ }~ r.) .':J: F -..: "". .,--"~,,,..........- PATRICIA J. THOMSON and ROBERT C. THOMSON, her husband, Plaintiffs, RECEIVED MAY 26 70lJli IlfA :IN THE COURT OF COMMON PLEAS :CUMBERLAND COUNTY, PENNSYL VANIA :CIVIL ACTION - LAW , " v. :NO. 01-6286 Civil Term KATHRYN A. PEROUTKA, M.D., and ANDREWS & PATEL ASSOCIATES, P.C.,: Defendants. :JURY TRIAL DEMANDED ORDER ~t - AND NOW, on this/_ day of V I.c N L , 2005, upon consideration of the Petition for Status Conference filed by Defendants, Kathryn A. Peroutka, M.D., and Andrews & Patel Associates, P.C., IT IS HEREBY ORDERED AND DECREED that a Status Conference is scheduled for the,17~ _V /ANt.. ,2005, at 9: IJ() ~p,m. in Courtroom NO...5:. r. pi l- ' n ~ "- \ "Ij ~..)~ 0/{ , - \;IINVA1ASNN3d AlNno:) (!t)\P!frJ8~\!n() ~'1 :01 WV €;- Nor SOOl Al::W10NOH108d 3Hl :ID .,....,J~..-....rr:n,~ ::Jvw_.V'\J:lI:2 PATRICIAJ. THOMSON and ROBERT C. THOMSON, her husband, Plaintiffs, :IN THE COURT OF COMMON PLEAS :CUMBERLAl'ID COUNTY, PENNSYLVANIA :CIVIL ACTION - LAW v. :NO. 01-6286 Civil Term KATHRYN A. PEROUTKA, M.D., and ANDREWS & PATEL ASSOCIATES, P.C.,: Defendants. :JURY TRIAL DEMANDED STIPULATION FOR CASE SCHEDULING ORDER AND NOW, TO WIT this day or _" , 2005, CDme the parties to the above-captioned matter: Patricia J. Thomson And Robert C. Thomson, by and through their attorneys, Catherine M. Mahady-Smith, Esquire, and David J. Foster, Esquire, Costopoulous, Foster & Fields; and Kathryn A. Peroutka, M.D., and Andrews & Patel Associates, P.C., by and through their counsel, Lauralee B. Baker, Esquire, Margolis Edelstein and stipulate as follows: 1. The parties hereto, by and on behalf of their respective clients, hereby agree and stipulate the deadlines for this action shall be as follows: 1) Discovery shall be completed on or before September 30,2005; 2) Plaintiffs' expert reports shall be fortbcoming on or before November 30,2005; 3) Defense expert reports shall be forthcoming, and all dispositive motions shall be filed on or before January 30, 2006; 4) Counsel shall confer with each other in an effort to accomplish the listing of this case for trial dming or after the March, 2006 trial term. 2. Counsel hereby acknowledges that they have reviewed the contents of this Stipulation with their respective clients and are authorized by their clients to enter into this agreement thereby effectuating same. WHEREFORE, the parties hereto pray this Honorable Court to enter an Order in the form attached, thereby setting forth deadlines for the instant action, Respectfully submitted, LAW OFFICES OF CATHERINE M. MAHADY..SMITH Datej.l/X-L df 2~tJS- BY:~' Catherine M. Mahady- David J. Foster, Esquir Costopoulous, Foster & Fields Counsel for Plaintiffs MARGOLIS EDELSTEIN Date: ~.....ru 1-3 2 tJ(G -r= ) By: ~ _ (6'2 ~. Baker, Esquire Ma.rgolis Fdelstein Counsel for Defendants, Kathryn A. Peroutka, M.D., and Andrews &: Patel Associates, P.C. - 2 - CERTIFICATE OF SERVICE I HEREBY CERTIFY that I served a true and correct copy of the foregoing STIPULA TlON FOR CASE SCHEDULING ORDER on all counsel of record by placing the same in the United States mail at Camp Hill, Pennsylvania, first-class postage prepaid, on the,~tfday 09,. ~ ,2005, and addressed as follows: Catherine M. Mahady-Smith, Esquire 3115-A North Front Street Harrisburg, PA 17110 David J, Foster, Esquire Costopoulous, Foster & Fields 831 Market Street Lemoyne, PA 17043-0222 MARGOLIS EDELSTEIN 2 ~ -051 f11.~' ,~ "2;~'::,; .,-., ~':--;'- 2c ""- '~ ~;~~ -, ~ ~ ~ 'e :;& (..) c:> . -0 ~ ~ ....( ft.'"" ~~ 9...~~. :r::.-.-"f r)n ~5ro "'"' -g: ~ - z;:"" u:> "UJ.).("vJ:W,A KbCORDS Page 3 of4 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND Thomson Court of Common Pleas vs. Peroutka, M.D., et aJ. Case Number: 01-6286 Civil Term (2001) CERTIFICATE PREREQUISITE TO THE SERVICE OF A SUBPOENA PURSUANT TO RULE 4009.22 As a prerequisite to service of a subpoena for documents and things pursuant to Rule 4009.22, Litigation Solutions, Inc. ('LSI') on behalf of Lauraiee Baker, Esquire of Margolis Edelstein certifies that: (1) A notice of intent to serve the subpoena with a copy of the subpoena attached thereto was mailed or delivered to each party at least twenty days prior to the date on which the subpoena is sought to be served; (2) A copy of the notice of intent, including the proposed subpoena, is attached to this certificate; (3) No objection to the subpoena has been received, and; (4) The subpoena which will be served is identical to the subpoena which is attached to the notice of intent to serve the subpoena. Date: 9(6(2005 litigation Solutions, Inc. on behalf of " ,LaLl.r~lee El"ker,E~quj[e~olMaIgQi~1=J!gLs~ln. Attorney for the Defense CC: Lauralee Baker, Esquire Margolis Edelstein 3510 Trindle Road Camp Hill PA 17011 'l-.<<......f/...,,+,., 1:-4-........1 "'............I_"4-...'""'~.~~+,.,f~~~1,....................,, _"....."'_.-1~ ........_01:1:m:~_y\m...,.{"().,..., c_nT :..J_nr , ALnno {)IC/"'lAAC ..I. u.e;'-' 1 V.t J PENNSYLVANIA COURT OF COMMON PLEAS COUNTY OF CUMBERLAND Thomson vs. Peroutka, M.D., et al. Court of Common Pleas 01-6286 Civil Term (2001) NOTICE OF INTENT TO SERVE A SUBPOENA TO PRODUCE DOCUMENTS AND THINGS FOR DISCOVERY PURSUANT TO RULE 4009.21 Provider: Record Type: George Rosenwasser All available TO: Catherine Mahady-Smith, Esquire note: please see enclosed list of all other interested counsel Litigation Solutions, Inc. ('LSI') on behalf of laura lee Baker, Esquire intends to serve a subpoena identical to the one that is attached to this notice. You have twenty (20) days from the date listed below in which to file - - o(r:~c()rd. ~n,d-_$er.(e-_upon the undersigned an objection to the subpoena. If the twenty day notice period-js~-- waived or if no objection is made, then the subpoena may be served. Date of Issue: 8/17/2005 Litigation Solutions, Inc. on behalf of: Lauralee Baker, Esquire Defense C~ av~iis:!Je{'E1e {(crt of Common Pleas If you have any questions regarding this matter, please contact: Litigation Solutions, Inc. (412.263.5656) Brentwood Towne Centre 101 Towne Square Way, Suite 251 Pittsburgh, PA 15227 http://rats.litsoLcom/ratsevents/notice_oC intent.asp?save Jeport _to _ db= X&PLid= PL 1469... 8/17/2005 ---- ~~ ......,.............~... rdg,t; L. U1;) COUNSEL LISTING FOR THOMSON VS. PEROUTKA, M.D., ET AL. County of cumberland Court of Common Pleas Counsel Firm Counsel Type Opposing Counsel Mahady-Smith, Esquire, Catherine 71'1' ~80 ' &o/9,fl;) 31lS-A North Front,3t'7et J-\arJi,?W.llJM,;7110 7/1(, J2fI;7' (t?J(Pf:21.!9 http://rats.litsol.comlratsevents/notice_ oCintent.asp?save Jeport _to _ db= X&PLid=PL1469... 8/17/2005 Thomson COMM:ONWEALTII OF PENNSYL VANIA COUNTY OF CUMBERLAND VS. Peroutka, M.D., et al. FileNo. 01-6286 Civil Term (2001) SUBPOENA TO PRO])UCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009.22 George Rosenwasser TO: (Name of Person or Entity) Wit!rin twenty (20) days after service oftbis subpoena, you are ordered by llie court to produce llie following documents or things: PLEASE SEE ATTACHED RIDER .101 Towne Square Way, Suite 251 Pittsburgh, PA 15227 m . (Address) . You may deliver or mail legtble copies of the documents or produce things requested by tbi~ subpoena, together with lhe certificate of compliance, to llie party n'laking this request at lhe address listeo above. You have lhe right to seek in advance the reasonable cost of preparing lhe copies or producing lhe thingssoughL... _uu_ ..u_...... .. .. ... ... . . If you fail to produce the docUments or things requ;redby tlUS.subpoena withiniWerity(20jaays after its service, lhe party serving this subpoena may seek a court order compelling you to comply willi it. TillS SUBPOENA W AB ISSUED AT THE REQUEST OF THE FOLLOWING PERSON: Lauralee Baker, Esquire . NAME: 3510 Trjnrllo;> ~oad C~mES$i PA. 17nl1 717-q75 6111 TELEPHONE: 56671 SUPREME COUR.l:l'd#1<1n ... ATIORNEY FOR: BY TIIE COURT: of Date: (L:-..rvf- I'l. .2co5 . ---.-.-Se of the Court '__... -- - - - - =''-- ..-.:._.-_.--.:..~",,~;,.===--==o___. ~~"__=--- - ~~.====-~,==.~._2~_...=-~=>=-----.=___.___.. _ -. ~.-' -~---~-, .t'age I at I Rider to Subpoena Explanation of Required Documents and Things TO: CUSTODIAN OF RECORDS FOR: Dr George Rosenwasser 825 Fishburn Road Hershey ?A 17033 Attention: Dr. Rosenwasser Patient: Thomson, Patricia 55#: 162-36"9310 Date of Birth: 06/14/1945 Requested Items: Please remit: a complete copy of any and all documents in your possession from 6/14/45 to Present, regarding the above"named patient including but not limited to: . Medical records - charts, test results, reports, correspondence, office notes. . Billing records. http://rats.litsol.comlratsevents/subpoena Jider.asp?PLid=PL 146908& WRid= WR25022 8/17/2005 CERTIFICATE OF SERVICE I HEREBY CERTIFY that I served a true and correct copy of the foregoing CERTIFICATE PREREQUISITE TO THE SERVICE OF A SUBPOENA PURSUANT TO RULE 4009.22, on all counsel of record by placing the same in the United States mail at Camp Hill, Pennsylvania, first-class postage prepaid, on the 12th day of September, 2005, and addressed as follows: Catherine M. Mahady-Smith, Esquire 3115-A North Front Street Harrisburg, PA 17110 David J. Foster, Esquire Costopoulous, Foster & Fields 831 Market Street Lemoyne, PA 17043-0222 MARGOLIS EDELSTEIN By ~; 0 :/fJ/, (/' Vicki A. Bolinger, RP o -"h :::l ;)'i -:' w (.,) ~ ') i I c: :o_J 0.', -< PRAECIPE FOR LISTING CASE FOR TRIAL (Must be typewritten and submitted in duplicate) TO THE PROTHONJrARY OF CUMBERLAND COUNTY Please list the following case: ORIGINAL (Check one) x for JURY trial at the next term of civil court. for trial without a jury. ----------------------------------------- CAPTION OF CASE (entire caption rrust be stated in full) (check one) PATRICIA J. THOMSON, and ROBERT C. THOMSON, her husband ( X) Civil Action - law ~edical malpractice l ) Appeal from Arbitration (other) (Plaintiff) vs. KATHRYN A. PEROUTKA, M.D., and ANDREWS & PATEL ASSOCIATES, P,C. The trial list will be called on and nl/09/07 , Trials cOll'lrence on 02 / 0 ') / 0 7 (Defendant) Pretrials will be held on 0] / 1 7 /07 (Briefs are due 5 days before pretrials.) vs. (The party listing this case for trial shall provide forthwith a copy of the praecipe to all counsel, pursuant to local Rule 214.1.) No. 01 Civil 6286 Indicate the attorney who will try case for the party who files this praecipe: DAVID J. FOSTER, ESQUIRE, 831 MARKET ST., LEMOYNE, PA 17043 CATIE MAHADY-SMITH, ESQUIRE, 3115 N. FRONT ST., HARRISBURG, PA Indicate trial counsel for other parties if known: 17110 LAURA LEE B. BAKER. ESOUIRE. 3510 TRINDLE ROAD, CAMP HILL, PA 17011 This case is ready for trial. Signed, ~/ Print Name: DavI Cot J. J::'"o st-i'-r Date: '1- 1'1- 0 ~ Attorney for: PT ATNTTFF~ g ~ c::> ~ c::> S t:r' tijm (I) ~:n tn~ M -0 ~~ ,-- N '1~ 2~ 0 <:::: . """'''1 ~~ -0 ~:!:l ::It .~ ~ ~ ~ c.n ~ ~ PATRICIA J. THOMSON, and ROBERT C. THOMSON, her husband, Plaintiffs #3 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA v. NO. 01-6286 CIVIL TERM KATHRYN A. PEROUTKA, M.D.,: and ANDREWS & PATEL ASSOCIATES, P.C., Defendants JURY TRIAL DEMANDED IN RE: PRETRIAL CONFERENCE o ,......, c i5 0 A pretrial conference was held on Wedn~da~ -0 >:l C,", C- -f ri~ ( . ~> :r: :0 January 17, 2007, before the Honorable Edward E. Gui~?t J-erege~F.i .J~. . 0; ,Jj? Present for the Plaintiffs was David J. Foster, Es~ie, and ~~~ "'.::'_ ( ::D> + -d . ~~ [-) Catie M. Mahady-Smith, Esquire. Present for the De~~an~ ~~1 :C~: .. ~ =<! .::- ::0 Lauralee B. Baker, Esquire. 0"". -< This is a straightforward medical malpractice case in which there are no complicated legal issues. The parties anticipate that the trial will take five days. They have requested to be able to start on Monday of trial week. The parties are directed to pre-mark their exhibits and exchange them with opposing counsel on Monday, January 29, 2007. Settlement negotiations have begun, but settlement is not likely. Edward E. Guido, J. David J. Foster ,. Esquire Catie M. Mahady-Smith, Esquire For the Plaintiffs ~othonotary Court Administrator Lauralee B. Baker, Esquire For the Defendants srs LAURALEE B. BAKER, ESQUIRE Pa. Supreme Court I.D. No. 58874 SHAUN J. MUMFORD, ESQUIRE Pa. Supreme Court I.D. No. 84176 MARGOLIS EDELSTEIN Post Office Box 932 Harrisburg, Pennsylvania 17108-0932 Telephone: [717] 975-8114 Fax: [717] 975-8124 E-Mail: lbaker@margolisedelstein.com Attorneys for Defendants: KATHRYN A. PEROUTKA, M.D., and ANDREWS & PATEL ASSOCIATES, P.C. PATRICIA J. THOMSON and ROBERT C. THOMSON, her husband, Plaintiffs, v. IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW NO. 01-6286 Civil Term KATHRYN A. PEROUTKA, M.D., and ANDREWS & PATEL ASSOCIATES, P.C.: Defendants. JURY TRIAL DEMANDED MOTIONS IN LIMINE OF DEFENDANTS AND NOW, corne Defendants, Kathryn A. Peroutka, M.D., and Andrews & Patel Associates, P.C. (hereinafter collectively referred to as ~Dr. Peroutka"), by and through their counsel, Margolis Edelstein, to move, in limine, to preclude the presentation of certain evidence at trial by Plaintiffs, Patricia J. Thomson and Robert C. Thomson (collectively hereinafter referred to as ~Plaintiffs"), and aver the following in support thereof: 1. The above-captioned medical professional liability action is scheduled to begin trial on February 5, 2007. 2. In short, Plaintiffs allege that Dr. Peroutka was medically negligent in her care and treatment provided to Mrs. Thomson for her diagnosis of breast cancer. Specifically, Plaintiffs allege that Mrs. Thomson suffered a cardiomyopathy secondary to Adriamycin chemotherapy administration and that a MUGA scan should have been performed prior to the administration of the same to detect any early subclinical cardiomyopathy. 3. As a result of this alleged medical negligence, Plaintiffs contend that Mrs. Thomson will require cardiac treatment and care as well as Coumadin therapy for the rest of her life. 4. In support of their medical professional liability claims, Plaintiffs have produced expert reports from two oncology specialists, Barry L. Singer, M.D. ("Dr. Singer"), and Michael H. Tirgan, M.D. ("Dr. Tirgan"). A copy of Dr. Singer's expert reports, dated June 27, 2001, and October 31, 2005, are attached hereto collectively as Exhibits "A" and "B." The expert report of Dr. Tirgan, dated November 22, 2005, is attached hereto as Exhibit "C." 5. Dr. Peroutka files the instant Motions ~n limine to preclude the presentation of certain evidence at trial by Plaintiffs' oncology experts, Drs. Singer and Tirgan. I. MOTION IN LIMINE TO PRECLUDE CUMULATIVE EXPERT EVIDENCE 6. The foregoing paragraphs are incorporated herein by reference as if set forth at length. 7. By way of their reports, both Drs. Singer and Tirgan -2- opine that Dr. Peroutka was medically negligent by failing to have Mrs. Thomson undergo any cardiac evaluation, such as a MUGA scan, prior to the initiation of the Adriamycin chemotherapy to treat the diagnosed breast cancer. As such, the opinions rendered by Drs. Singer and Tirgan are essentially identical. See Exhibits "A," "B," and "C." 8. Dr. Peroutka files the instant Motion ~n limine to preclude Plaintiffs from presenting expert testimony at trial from both Drs. Singer and Tirgan as the same would be cumulative In ncture. 9. Cumulative expert testimony should be precluded in order to promote judicial economy and efficiency. See, Crimi v. Frankford Hospital, Torresdale Division, 2005 Phila. Ct. Com. Pl. LEXIS 313 (C.P. Phila. 2005). 10. Courts have broad discretion in conducting trials and the ability to limit cumulative testimony. rd. 11. "Although relevant, evidence may be excluded if its probative value is outweighed by the danger of unfair prejudice, confusion of issues, or misleading the jury, or bv considerations of undue delay, waste of time, or needless presentation of cumulative evidence." Pa.R.E. 403 (emphasis added). 12. In addition, the preclusion of cumulative expert testimony prevents a jury from deciding a case by improperly -3- basing its decision solely on the number of experts testifying on beha~f of one party or another. WHEREFORE, Defendants, Kathryn A. Peroutka, M.D., and Andrews & Patel Associates, P.C., respectfully request that this Honorable Court issue an Order precluding Plaintiffs from presenting cumulative expert testimony from Drs. Singer and Tirgan at the trial of this matter. II. MOTION IN LIMINE TO PRECLUDE REFERENCES TO DRUG PACKAGE INSERTS OR THE PHYSICIANS' DESK REFERENCE TO THE APPLICABLE ESTABLISH STANDARD OF CARE 13. The foregoing paragraphs are incorporated herein by reference as if set forth at length. 14. In Dr. Tirgan's report, he outlines the inforrration provided on the package insert of Adriamycin, which is quoted verbatim 1n the Physicians' Desk Reference ("PDR"). See Exhibit "C," at pages 5 through 9. 15. In short, the package insert indicates a risk of cardiac toxicity with the use of Adriamycin and recommends cardiac monitoring including MUGA scans. 16. It 1S believed and, therefore, averred that Dr. Tirgan will attempt to utilize the information provided in the package insert and/or PDR to establish the accepted standard of care for the administration of Adriamycin for the treatment of bresat cancer. -4- 17. However, as set forth by the Pennsylvania Superior Court in Spotts v. Reidell, 345 Pa.Super. 37, 497 A.2d 630 (1985), information from the PDR should not be admitted as evidence during trial since the drug manufacturer's entry in the PDR is simply hearsay evidence. 18. Hearsay evidence is generally not admissible at trial as the same cannot be cross-examined. See Pa.R.E. 802. 19. The Foreward to the PDR states that each full length entry provides an exact copy of the drug's government approved labeling. However, the Foreward further mentions that the entries are not meant to "limit the manner in which a physician may use an approved drug. Once a product has been approved for marketing, a physician may choose to prescribe it for uses or in treatment regimens or patient populations that are not included in the approved labeling. The FDA also observes that accepted medical practice includes drug use that is not reflected in approved drug labeling." See Foreward to PDR. 20. As such, Courts have properly declined to allow parties to establish the applicable standard of care by introducing information appearing in the PDR. See Tarter v. Linn, 396 Pa.Super. 155, 578 A.2d 453 (1990) WHEREFORE, Defendants, Kathryn A. Peroutka, M.D., and Andrews & Patel Associates, P.C., respectfully request that this -5- Honorable Court issue an Order precluding Plaintiffs from presenting evidence at trial with regard to Adriamycin's package insert or its entry In the Physicians' Desk Reference to establish the applicable standard of medical care. Respectfully submitted, MARGOLIS TEIN Date: /i 7-'7h-:' , {, By: LAURALE B BAKER, ESQUIRE PA. Attar No. 58874 SHAUN J. UMFORD, ESQUIRE PA. Attorney I.D. No. 84176 Attorneys for Defendants, KATHRYN A. PEROUTKA, M.D., and ANDREWS & PATEL ASSOCIATES, P.C. P. O. Box 932 Harrisburg, PA 17108-0932 (717) 975-8114 ~:\mdir\_ P~SL=C\5730C.4-00123\plead\Motion in Limine.1-17-0'.wpd -6- CERTIFICATE OF SERVICE I HEREBY CERTIFY that I served a true and correct copy of the foregoing on all counsel of record by placing the same in the United States mail at Camp Hill, I> Q -Ill i--\ Pennsylvania, first-class postage prepaid, on the ~ day of ~?{)WfLJ~~_, 2007, and addressed as follows: Catherine M. Mahady-Smith, Esquire 3115-A North Front Street Harrisburg, PA 17110 David J. Foster, Esquire Costopoulous, Foster & Fields 831 Market Street Lemoyne, PA 17043-0222 MARGOLIS EDELSTEIN /l (JJ2[;' ) 1 By. /... {i " _---_ Carol Moose Exhibit A -'J BARRY L. SINGER, M.D. 1 544 DEKALB STREET NORRISTOWN, PENNSYL.VANIA 1940 I 0lf'\..0M0I0'E AMERICAN BOARD OF' NmRNAL MEDICINE 0lf'L!)MA1'E BOARD OF ONO::X..QGV DIPLOMATE BOARD OF HEMATOLOGY TE,.J:f'HOI'E (6101279-7462 F...x (IS 10) 279.3641 June 27,2001 Nijole C. Olson, Esquire Navitsky, Olson & Wisneski, L.L.P. A ttorneys at Law 2040 Linglestown Road, Ste. 303 Harrisburg, PA 17] 10 RE: Patricia Thomson Dear Ms. Olson: At your request, I have reviewed records regarding the above captioned I have reviewed the following items: ]. Medical records of Dr. Peroutka/Andrews & Patel Associates, P.C.~ 2. Medical records of Moffitt, Pease & Urn Cardiology Group; 3. Chemotherapy information and consent form of Andrews & Pate] Associates; 4. Handwritten notes of Dr. Peroutka for the initial consultation of June 26, 2000; 5. Medications of Patricia Thomson as of April 18, 2001. Please consider this a preJiminary report regarding my opinions on this matter. The patient Patricia Thomson age 55, underwent a left modified radical mastectomy with removal of the pectoralis major and a left axillary dissection for infiltrating ductal carcinoma involving the left breast. At the time of surgery, the tumor measured approximately 2.5 ems. in size. No axillary nodes were found involved with the tumor, however the tumor was somewhat aggressive histologically being a Grade 3 nuclear and 2 of3 histologically. In addition. the tumor was ER and PR negative and weakly positive HER 2/new by IHC. The patient was seen by the medical oncology group, 8/t>' aBed !Wd90: to' ~O -8 ~ -Tnr ~~6LB ~9L HL ~131Vd ~ SM3~aNV :A8 +uaS Page 2 RE: Patricia Thomson June 27, 2001 Andn~ws & Patel Associates for chemotherapy evaluation. Tbe patient was seen by Dr. Kathryn Peroutka, Medical Oncologist, on June 26, 2000. Dr. Peroutka reviewed the patient's history and commented that the patient would be a candidate for adjuvant chemotherapy in view of the fact that the tumor was somewhat large at 2.5 ems., and ER negative. The tumor was also considered at somewhat higher risk because it was HER 2 weakly positive. It was recommended by Dr. Peroutka that the patient undergo four cycles of Cytoxan and Adriamycin as adjuvant therapy, Concomitantly the patient was to receive radiation therapy to the chest wall because of the deep lying nature of this tumor. There is no indication that this patient underwent any cardiac evaluation such as MUGA Scan prior to the initiation of the Adriamycin chemotherapy. The patient tolerated the four cycles of chemotherapy and the radiation therapy without too much difficulty. Treatment was completed sometime in November of the year 2000, A few months later, in January of 200 1, the patient began manifesting cardiac changes. Initially, the patient was evaluated for persistent tachycardia. She was then seen by the cardiology group and thought to have a thrombus involving the right atrium. Further evaluation by echocardiography indicated that the patient had globular heart with hypokinesis of the entire ventricle system. In addition, the patient had a markedly reduced ejection fraction of approximately .15 to .20. The patient was thought to have suffered a cardiomyopathy secondary to Adriamycin administration. She is being followed by the cardiologists with multiple cardiac medications to control both her cardiac outP'.1t and congestive heart failure. * · DISCUSSION '" 1/1 From review of the records, it would appear that this patient was given a choice of adjuvant chemotherapy post mastectomy. However, it is also evident that this patient did not undergo appropriate evaluation cardiac-wise before the initiation of an Adriamycin based regimen. The standard of care would require in a patient 55 years of age even without a cardiac history that a MUGA Scan be done to determine whether there is any silent cardiac disease. In this case, if the MUGA had demonstrated that the ejection fraction was significantly low, the patient would not have been a candidate for Adriamycin therapy. Instead, the patient would have received other chemotherapy consisting of such drugs as Cytoxan, Methotrexate and 5 FU which constitute a eMF B/S aBed ~~dLa:~ lQ-Sl-1nr :26L8 ~9L L~L , .13~Vd ~ SM3HON~ :A8 +uaS ,. Page 3 RE: Patricia Thomson June 27, 2001 protocol which would have been entirely appropriate for this patient. In view of the fact this patient had no positive nodes in the axilla, this patient did not require an Adriamycin based regimen. Therefore, with the MUGA Scan showing any depression of cardiac function, it is my opinion that Adriamycin would have been contraindicated and the administration of this drug below accepted medical standards. The patient would have been an excellent candidate for eMF which, in my opinion, \vould have pTovided adequate protection from recurrence of her breast cancer. Instead, this patient was administered Adriamycin over four cycles which caused irreparable damage to her myocardium. As a result, this patient suffers now a significant cardiomyopathy which will not be reversible. This patient wHl require indefinite use of cardiac medications and never attain normal cardiac function. She will eventually become a cardiac cripple within reasonable medical certainty and require further supportive care regarding this situation. The ~;onsideration of adjuvant chemotherapy in this patient was entirely appropriate by the attending oncologist. However, the choice of drugs, in my opinion, was entirely inappropriate without the performance of a MUGA Scan. It is my opinion that the MUGA Scan would have shown silent cardiac dysfunction and therefore, Adriamycin would have been contraindicated leading to the use of alternative drug regimens which in my opinion would have been equally as effective in this patient who had negative axillary nodes. I will be happy to discuss further my comments regarding this case at any future time. Sincerely yours, ~~~ Barry L. Singer, M.D. BLS/bkh 9/9 aBed ~~dQO:v ~O-9~-lnr ~Z6l9 ~9L L~l t .131Yd ~ SM3HONV :^8 lues E~h\ bi-\- B TeST 1234587880 11/28/05 04180pm P. 021 8AR~'( L, SINGER'. M.D. 11:1.. [)FK...Ul' ST"..!'.T NO,.RIS,1'll.l'tVr-.. P~N"'!H'I"'."'" to.OI OIl"LO",,,lf .....c...(;".... BOA"O O~. INTElh....... "I'O'C1NE OIPI.OM"'Tt, BO"'~'" Of ONCOLOGY QIPLO",...H BOAAC O~ '.j(MATOLOGV tE!.ePHONe: 1~ I~, ?T~.746~ "". 1~lrll :11''':16.\ Cktober 31. 2005 David 1. Fostt:r, Esquire Costopoulos, Foster & Fields 831 Market Street P.O. Box 222 ~moyne. Pennsylvania) 7043-0222 RE: Patricia Tbomson Dear Mr, F0skr; At your request, I have reviewed the medical records and depositions regarding the above caplioned. Please see the opinions I expressed in my initial report of June 27. 200t Upon completion of my review of these records, I do have the following medicaJ opinions. Patricia Thompson age 55, underwent a left modified radi~a.l mastectomy witb removal of the pectoralis major and a left axillary dissection for an infiltrating ductal carcinoma involving her left breast. At the time of surgery the tumor measured 2.5 ems. in size. None of rhe axillary nodes were found to be involved with metastatic tumor. However, the histologic grading of the tumor was Grade III nuclei and 2 of) histologically. In addition, the tumor was ER and PR oegative and weakly positive HER 2 NEll by IHC. 'me patient was s\losequendy seen by me medical oncology group, Andrews and Patel Associates for a cheI1101hcm.py evaluation. The patient was seen by Dr. Kathryn Peroutka, medical oncologist on June 26, 2000. Dr, Peroutka who reviewed the patIent's history and commented that the patient would be a candidate for adjuvant chemotherapy in view ofthe fnct that the tumor was 2.5 ems. in size and honnone negative. The patient was also considered to be at some whal higher risk for recurrence because she was HER 2-NEU weakly positive. Dr. Peroutka recommended that the patient uf,dergo four cycles of CYloxant Adriamycin as adjuyant chemol~erapy. Concomitantly the patient WAS to receive radiation therapy to the chest wall because of the deep lying nature of her tumor. -,- Test 1284587880 11/29/05 04:80pm P. 022 Page 2 RE: Patricia Thomson Oatober 3 1 . 200' I have reviewed Dr. Peroutka's deposition and Ms. Thomson's deposition and there 1.\ 110 evidence that the patient was referred for a MUGA scan prior to the initiation of th( Adriamycin/Cytoxan ch<<::motherapy. There is even some reference to the hlct thar Ms. Thomson hllcr asked why she did not undergo MUGA scan when other patients of Dr Peroutka had according to her knowledge. In any case, the patient tolerated lhe four cytks of Adriamycin/Cytoxan with radiation therapy without too much ditliculty. Treatment was completed in November of the year 2000. A f<::w mnnth~ later, in Janu<lr; of2001) the palient began manifesting cardiac changes. Initially, the patient pre~enled ~() Dr. Peroutka with an episode of tachycardia. She was seen by her famiJy ph}'sJcinn and then referred to a cardiology group where she was thought to have a thrombus involving her right atrium. Further evaJuatiQfl by echocardiogram indicated (he patient had .a globular heart with severe hypokinesis of che entire ventricular system In addition, the ejec.tion fraction was markedly decreased from a normal of around 50% to 15 to 20%. The patient was diagnosed as suffering a cardiomyopathy secondary to Adriamy<.:in administration. Her follow up was to be with the cardiologists with multiple cardiac medications to control her congestive heart faiJure and stabitize her cardiac outpUl. ... · DISCUSSION It' . At the time of trealmenL, the patient was unaware ot any personal cardiac problems BUI as any physician knows or should know, that does not rule out cardiac problems, particularly in women of this age. A Iso a closer review of her records indicates thal Jl er family history IS significant in that her father had episodes ora myocardial infarction a..; early as in his 50's. In addition, there .~ no indication) at least according t() Dr. Peroutka's deposition Ihat (he patient was informed that Q MUGA Scan is used as a baseline for patients whorecdve Adriamycin therapy regarding their cardiac sLatus. The manufacturers of Adrjamycin recommend that patients receive a baseline cardiac evaluation. I believe in this sjtu~tion a MUGA Scan is the most appropriate study although certainly referral to a cardiologist is also appropriate. In any C8!;e, this pationl received no such hac;eline studies, 1101' was she informed of the fact that sllch studlt:'s wert':: a\lail.able at the lime of initiation of her chemotherapy. It is my opinion lhat any pruclelll physician (reating a patient with Adriarnycin should have advised the patient that a MUGA Scan is a prtrequisite to the use of Adriamycin to detennine baseline cardiac status and failure to infonn the patient of the faiJure to obtain a MUGA Scan (or cardiac consultation) prior to the administration of Adriamycin, in my opjniol1~ was a d~yjation from accepted medical standards. It IS my opinion that if a MUGA Scan had been done prior to the initiation of chemotherapy this patient would have been found to have some - \ Test lZ846678912l 11/29/05 12l4:80pm P. '~Z8 P d.gc 3 IU~.. Pa\rici~ TJJnm.s,)[) (X110t'>c:r .~ J. :WOS ~i(d'l.l h~Mt di$C&$C. wh.cb ili not lJOcom.mon in wumc:n, parljcuIM~j' at Lllis ag~ onJ older.. I beli~ve ~h~ would have bee 11 rdtrrcd to a r;llrdiologist ao~ l! W"rKtip wl')uJcl have: becn ~1U~CO Clut ChemotherApy c:o....id have beQ"! delayed with ..'\driamyc.iI1lC)'loX:LfI emi! ~'2U"Jiac cvaluati()l\ war. cumpIetc or thi_ paUttm cou1d hlilve "ecci'\"cd etternlltive l.djU.Vl:.,nl <:hemoth~r<tpy w idH"\Ut Adelamycin, In view lH'the tact ti1at this palier:a had nD po!liuve nodell1 in her B..xiJla altemari1lt: :egimens not cODtlining AJri am) c in. In my apinion~ wOllld baVl: b~ju:i\ as ~n.'ect.h:e in redl!\':&ng the likelihood. of rc~ummcc. of hu c&n(.cr, Rc:!gia,ctl., tbm 3re based "'II CVtl"JXM. Me(/lL)tN:<a.I~. 5 FlllONur8Ci.1 w<..uj(i ...~'. b~e-n the n:..a(il1~k ahem'lll....~ OIld I\'~'lfti not hav~ ul.u!icd her cardidC" dy!fu!'lctioll to ~c('ur" UnfortunateJ.)", this patienf was Bdminb;lert~d d1e full foul' (',ycles of AdrinmycUl which C:.UJ$ed her to develop i1Tepareblo damuge to her myocardium. As a reJult toda)', th;g r~i~.Dt su.flers fr.>m Ii sLgnifi~,j.m (.ardlom)'opa.thy whkh wlll not!'te .rev"r~ihll: only lI<:<llablc. C'bis fHlt..ient will require indcfinitt: t,~ of (.:a..diac rncdic:ation'! :1nd nev~r rcgt-lin :lormal (Airdiw.; thJlt:t;ljli. ~"iL'1 rea~wn6t-l~ lneJiQ~1 certainty, OV:'lr :l p~i;(ld oft'~IJ1("., her ..;at'Il.GC fLOllclicn will de\etioratC' R."ut she wm t'\lCtJtua.Uy bctcane tl. C~jd~:1C c;ri~pk in view of the fact thllt ~cr C!vt.ryday fu.l1l:u..Jnlng "lAlU be markedly uU".:llilr:d. The ct.lnsidcratioo ofadjuWil",t ~heT.tlO1het"al)r in :lm patient wu e,ulJreiy QPprtlpriau~"":v rhe; Attenc.in~ oottllogisL Hoy. '::Vt=l", it is my opi rUcn thi'! an)' rc:s9o~ahlr proder., ~h) ~ id~l w"...u}o ha....e di~~':l(:~ "'1-.11 ,he patient the sil;le dre.:~.a: r,t' Adriamy(,; in and ;uJ....i:i~d a MUGA Scar. !.tt'",~ ;V',dent ret'u:>ed such '8 &~u"Y then \:Cfb.i~ly allertl:l.ti,,-e \::hem~hcrapy c(luJd hav~bec.l1 vffere-d ~"Ler whIch) ~l1"".y opi:liaS1, would have bttan ~w ~'nl;;I~i.\ll If lhc: MUGA ~c:u, had. be~n d,lne and showed cll:'t.l.i~h: dy;~.fi.mC'.ti(';n then the !1lldtmt would h~\,t: b":~ ~ill.j~.no.'\eJ ':\'C~ earlier tuu: sUlri~d on a ~C'l'diac regimen f'l"ior tn :i~;1bcr daJ"TlfLge 17~jnb d',;)D~ t\. t;-r hetlrr wI; i..:h was IJTcve;:njble. 1 hotd 111 my opiU':O~h \C- he '.vi:hin 3 rclsonable degrN'l of medlcaJ c:nainty I will b{' ;'~aJlP)" ~c discUSS funllCt my com;neUI.s n::ganlil;g rhi!li '~tt&:r d any future time, r-)~. S!t'lkh ;::::1; YO~F B~' l.. Singer, M.D Exhibit C- Tit_"t lZ845S7SS0 11/29/05 04:80pm P. 008 Michael H. Tirgan, MD 221 West 82nd Street, Suite SF New York, NY 10024 646-320 7256 MEDICAL ONCOLOGY REVIEW AND REPORT For Patricia Thomson SSN: 162-36-9310 DaB: 6/14/1945 1- INTRODUCTION I was asked by Mr. David J. Foster, attorney at law with law offices Costopoulos, Foster & Fields, 832 Market Street, Lemoyne, Pennsylvania to review the medical records of Ms. Patricia Thomson (Ms. Thomson). This review was made to determine whether the medical care that Ms. Thomson received from Dr. Peroutka at "Andrews & Patel Associates, P .C." was in accordance with acceptable standards of care; and also to determine the impact of not performing a MUGA scan prior to initiation and during the course of her chemotherapy. All of my opinions in this report are stated within a reasonable degree of medical certainty. 2- IN PREPARATION OF THIS REPORT, I HAVE REVIEWED AND ANALYZeD THE FOLLOWING: 1. Medical Records from Dr. Kathryn A. Peroutka Page 1 of 18 REPORT PATRICIA THOMSON TGli'S1' 1284587890 11129/05 04:80pm P. 004 2. Medical Records from Andrews & Patel Associates, P.C. 3. Medical Records from P~nnacle Health, Harrisburg Hospital 4. Medical Records from Dr. Donald B. Nardis, 5. Medical Records from Oakwood Center Radiation Oncology, 6. Complaint filed in the Court of Common Please, Cumberland County, PA. 7. Defendants' Answers to Plaintiff's Interrogatories, 8. Deposition transcript of Ms. Thomson 9. Deposition transcript of Dr. Kathryn A. Peroutka 3... QUALIFICATIONS I am familiar with the accepted national standards of care for the diagnosis, care and treatment of breast cancer and administration of chemotherapy drugs, including Adriamycin to patients. In addition, I am familiar with the accepted national standards of care for prevention, early detection, diagnosis, care and treatment of victims of Adriamycin induced cardiomyopathy. All medical providers treating Ms. Thomson practiced medicine in Pennsylvania, in suburbs of Harrisburg, The medical providers in this case were under a national standard of care. I am a board certified internist and medical oncologist, duly licensed to practice medicine in State of New York. 1 have been in the private practice of medicine since July 1990. I have personally administered chemotherapy drugs myself to over 500 patients. In addition, I have been in charge of overseeing the administration of several hundred chemotherapy administrations as the Oncologist in charge. Of those, over 1,000 Page 2 of 18 REPORT, PATRICIA THOMSON Tes"t 12846S789121 11/28/06 04:30pm P. 005 chemotherapy administrations combined, in excess of 400 involved administering the Adriamycin. In all of the chemotherapies I have been involved in the administration of; I have had to possess the knowledge of the standard of care for prevention and management of toxic effects, including toxic effect of Adriamycin on the heart. I was first taught about these standards of care in medical school and when I received my formal training as an Oncology Fellow. Today I teach Oncology Fe/Jows chemotherapy administration and the standard of care ;n prevention and management of toxic effects, including toxic effect of Adriamycin on the heart at Cojumbia University' 5 teaching hospitals, St. Luke's Roosevelt Hospital Center, in New York City. Because of my formal education, training and employment, I am qualified to address the accepted national standard of care in these areas. 4- OVERVIEW OF MS. THOMSON'S RELEVANT MEDICAL HISTORY: In June of 2000, Ms. Thomson was diagnosed with left breast cancer. On June 16, 2000, she underwent left modified radical mastectomy and left axillary node dissection. Pathological evaluation of her mastectomy specimen revealed a 2.5 X 1.9 em invasive, poorly differentiated ductal carcinoma. Tumor was very close to the deep surgical margins. None of the fourteen removed lymph nodes contained cancer. The nuclear grade was III, and tumor was "estrogen" and "progesterone" receptor negative. Following surgery, she saw Dr. Peroutka who advised a course of adjuvant chemotherapy with 4 cycles of Adriamycin and Cytoxan, also known as AC x 4 regimen, which she received on the following dates: Page :3 of 18 REPOHT; PATRICIA Tt-tOf"lS0N Test" 128456788lZl 11/29/lZl5 04:80pm P. lZllZl8 Cycle # 1: July 5, 2000 Cycle # 2: July 26, 2000 Cycle # 3: August 16, 2000 Cycle # 4: September 6, 2000 Dose of Adriamycin was 60mgjm2, total dose of 95 mg for each of the above dates. She received total of 240mg/m2 of Adriamycin. Following completion of chemotherapy, she received radiation to her left chest wall. Radiation was completed in November 2000. In January 2001, she was found to have rapid heart rate. On January 27, 2001, she was admitted to Harrisburg Hospital with Congestive Heart Failure (CHF). Her cardiac function had significantly declined. Cardiology work up led to the diagnosIs of a severe case of Adriamycin induced cardiomyopathy. From that point on, she has become dependant on various cardiac medications. Subsequent to this admission, she had multiple other admissions to Harrisburg Hospital for her heart condition. Due to severity of her heart problem, she was at some point considered for heart transplantation. 5- DISCUSSION OF NATURE OF MS. THOMSON'S BREAST CANCER: Ms. Thomson's breast cancer was such that required further treatment with chemotherapy to reduce her risk of relapse and death from recurrent cancer. Based on the facts that her tumor measured 2.5 em and was estrogen receptor negative and nuclear grade was III, Ms. Thomson had a 10 year risk of mortality without adjuvant treatment of 30.7 0/0. Available data shows that she would have an absolute gain of 5.80/0 in her 10 year risk of Page 4 of 18 REPORT, P~~TRICIA THOMSON TeST 1284687880 11/28/05 04:90pm P. 007 dying from her cancer with addition of the adjuvant chemotherapy she received. Her 10 year risk of relapse without adjuvant treatment would have been 42.60/0. Data afso shows that she would have an absolute gain of 11.30/0 in her 10 year risk of cancer relapse with addition of the adjuvant chemotherapy she received. Based on the above risk assessments, she was a candidate for adjuvant chemotherapy. 6- CHOICES OF ADJUVANT CHEMOTHERAPY FOR WOMEN LIKE MS. THOMSON IN YEAR 2000: In 2000, oncologists had a number of choices in choosing adjuvant chemotherapy for women like Ms. Thomson. Due to high risk of relapse, using an Adriamycin based regimen in 2000 for such women was appropriate only if women had perfect cardiac function. Standard of care in 2000 was to choose eMF regimen for women with abnormal cardiac function on MUGA scan. 7- ADRIAMYCIN WARNINGS AND PRECAUTIONS Adriamycin, (generic name doxorubicin). is one of many intravenous anti cancer drugs that have been approved by the FDA. It is supplied as a sterile, clear, red solution or powder. The package insert of Adriamycin comes with a black box warning, describing the most important information that the oncologist must be aware of, as follows: Myocardial toxicity manifested in its most severe form by potentially fatal congestive heart faiJure may occur either during therapy or months to years after termination of therapy. The probability of Page 5 of 18 r';:EFIORT, PATRICIA THOivtSON Te:s1' 1234567890 11/Z8/05 04:80pm P. 006 developing impaired myocardial function based on a combined index of signs, symptoms, and decline in left ventricular ejection fraction (LVEF) is estimated to be 1 to 2% at a total cumulative dose of 300 mg/m2 of doxorubicin, 3 to 50/0 at a dose of 400 mg/m2, 5 to 80/0 at 450 mg/m2, and 6 to 20% at 500 mg/m2. The risk of developing CHF increases rapidly with increasing total cumulative doses of doxorubicin in excess of 400 mg/m2. Risk factors (active or dormant cardiovascular disease, prior or concomitant radiotherapy to the mediastinal/pericardial area, previous therapy with other anthracyclines or anthracenediones, concomitant use of other cardiotoxic drugs) may increase the risk of cardiac toxicity. Cardiac toxiCity with doxorubicin may occur at lower cumulative doses whether or not cardiac risk factors are present. Under general warnings, the package insert states the following: Special attention must be given to the cardiotoxicity induced by doxorubicin. Irreversible myocardial toxicity, manifested in its most severe form by life-threatening or fatal congestive heart failure" may occur either during therapy or months to years after termination of therapy. The probability of developing impaired myocardial function, based on a combined index of signs, symptoms and decline in left ventricular ejection fraction (LVEF) is estimated to be 1 to 2% at a total cumulative dose of 300 mg/m2 of doxorubicin, 3 to 5010 at a dose of 400 mg/m2, 5 to 80/0 at a dose of 450 mg/m2 and 6 to 20% at a dose of 500 mg/m2 given in a schedule of a bolus injection once every 3 weeks (data on file at Pharmacia & Upjohn). In a retrospective review by Van Hoff et aI, the probability of developing congestive heart Page 6 of 18 REPORT, PATRICIA THOMSON TeST 12845G7890 11/28/05 04:80pm P. 009 failure was reported to be 5/168 (3%) at a cumulative dose of 430 mg/m2 of doxorubicin, 8/110 (70/0) at 575 mg/m2 and 3/14 (210/0) at 728 mg/m2. The cumulative incidence of CHF was 2.20/0. In a prospective study of doxorubicin in combination with cyclophosphamide, fluorouracil and/or vincristine in patients with breast cancer or small cell lung cancer, the cumulative incidence of congestive heart faUure was 5 to 60/0. The probability of CHF at various cumulative doses of doxorubicin was 1.50/0 at 300 mg/m2, 4.9% at 400 mg/m2, 7.7% at 450 mg/m2 and 20.50/0 at 500 mg/m2. Cardiotoxicity may occur at lower doses in patients with prior mediastinal irradiation, concurrent cyclophosphamide therapy exposure at an early age and advanced age. Data also suggest that pre-existing heart disease is a co-factor for increased risk of doxorubicin cardiotoxicity. In such cases, cardiac toxicity may occur at doses lower than the respective recommended cumulative dose of doxorubicin. Studies have suggested that concomitant administration of doxorubicin and calcium channel entry blockers may increase the risk of doxorubicin cardiotoxicity. The total dose of doxorubicin administered to the individual patient should also take into account previous or concomitant therapy with related compounds such as daunorubicin, idarubicin and mitoxantrone. Cardiomyopathy and/or congestive heart fai/ure may be encountered several months or years after discontinuation of doxorubicin therapy. Treatment of doxorubicin induced congestive heart failure includes the use of digitalis, diuretics, after load reducers such as angiotensin I converting enzyme (ACE) inhibitors, low salt diet, and bed rest. Such Page 7 of 18 REPORT, PATRICIA THOMSOI"'J Teso1" 1284567890 11/29/05 04180pm P. 010 intervention may relieve symptoms and improve the functional status of the patient. Monitoring Cardiac Function In adult patients severe cardiac toxicity may occur precipitously without antecedent ECG changes. Cardiomyopathy induced by anthracycHnes is usually associated with very characteristic histopathologic changes on an endomyocardial biopsy (EM biopsy), and a decrease of left ventricular ejection fraction (L VEF), as measured by muftigated radionuclide angiography (MUGA scans) and/or echocardiogram (ECHO), from pretreatment baseline values, However, it has not been demonstrated that monitoring of the ejection fraction will predict when individual patients are approaching their maximally tolerated cumulative dose of doxorubicin. Cardiac function should be carefully monitored during treatment to minimize the risk of cardiac toxicity. A baseline cardiac evaJuation with an ECG, L VEF, and/or an echocardiogram (ECHO) is recommended especially in patients with risk factors for increased cardiac toxicity (pre-existing heart disease, mediastinal irradiation, or concurrent cyclophosphamide therapy). Subsequent evaluations should be obtained at a cumulative dose of doxorubicin of at least 400 mg/m2 and periodically thereafter during the course of therapy. In adults, a 100/0 decline in LVEF to below the lower limit of normal or an absolute L VEF of45%, or a 20% decline in LVEF at any level is indicative of deterioration in cardiac function. In pediatric patients, deterioration in cardiac function during Dr after the completion of therapy with doxorubicin is indicated by a drop in fractional shortening (FS) by an absolute value of 10 percentile units or below 29%, and a decline in L VEF of 10 percentile units or an L VEF Page 8 of 18 REPORT, PATRICIA Tl-iO!\1S0N Tes"t 1284587880 11/28/05 04:80pm P. 011 below 550/0. In general, if test results indicate deterioration in cardiac function associated with doxorubicin, the benefit of continued therapy should be carefully evaluated against the risk of producing irreversible cardiac damage. Acute life-threatening arrhythmias have been reported to Occur during or within a few hours after doxorubicin administration. 8- STANDARD OF CARE FOR ADRIAMYCIN CARDIAC MONITORING IN WOMEN WITH BREAST CANCER: Some of the risk factors for Adriamycin-induced cardiac toxicity include cumulative dose, pre-existing cardiac disease, advancing age, and prior or future chest irradiation. In additionl female sex has been demonstrated to be an independent risk factor. Finally, anti-neoplastic agents such as cyclophosphamide, paclitaxel, docetaxel, an may have an additive effect on Adriamycin-induced cardiomyopathy. Since Ms. Thomson was a woman, was going to receive radiation therapy and chemotherapy with cyclophosphamide, she was already at high risk for development of Adriamycin-induced cardiac toxicity. In absence of contraindications, Adriamycin based chemotherapy regimens were and continue to be proper regimens to offer to women who suffer from breast cancer like Ms. Thomson. In preparation for treating patients like Ms. Thomson with Adriamycin, all women should undergo an objective assessment of their cardiac function. Treatment with Adriamycin shall not commence unless women have a completely normal MUGA scan and normal left ventricular ejection fraction (LVEF). Any abnormality in MUGA scan, or Page 90f 18 REPORT, PATRICIA THOrv1S0N TesT 1234587880 11/29/05 04:80pm P. ~12 LVEF less than 500/0 are clear contraindications to treatment with Adriamycin. It is generally accepted that patients with any risk factor for early toxicity should have baseline evaluation of cardiac function by echocardiography or preferably with MUGA Scan. Many clinicians advocate serial assessment of left ventricular function after everyone to two cycles in this patient population. Women who have normal MUGA Scan and are started on treatment with Adriamycin shall be monitored with repeat MUGA scans during their treatment, after 2nd or at most after the third cycle of therapy. Purpose of such testing is to detect cardlac damage from this drug as 500n as possible; and to select out those women who may develop severe cardiomyopathy as a result of continuation of Adriamycin. Standard of care for such women in 2000 was to omit Adriamycin completely. 9- MEDICAL CARE ISSUES: The main issue in care of Ms. Thomson was that she did not receive proper cardiac work up with a MUGA scan from Dr. Peroutka prior to initiation of her Adriamydn chemotherapy. As indicated above, cardiac monitoring is absolutely mandatory as described in the package insert. Standard of care for past few decades, which was also in effect in early 2000 when Dr. Peroutka treated Ms. Thomson, has been and continues to be that aU patients receiving Adriamycin, regardless of their sex, agel prior history of cardiac events, etc, shall have a pretreatment assessment of their cardiac function and determination of their LVEF before they receive this cardiotoxic Page 10 of 18 REPORT, PATRICIA THOMSON Tes1" 1284587890 11/29/05 04la0~m P. 018 drug. In this setting, there are absolutely no guidelines that would tell physicians who mayor may not, should or should not, have a MUGA scan. Simply put, 100010 of patients should have LVEF determination by MUGA Scan. Dr. Peroutka was indeed cognizant that Adriamycin is a cardiotoxic drug and that Ms. Thomson was at risk for such toxicity. In her response to plaintiff's interrogatory # 11, Dr. Peroutka stated that: "The Dossibilitv of Adriamycin inducinG heart toxicity was discussed and both the Datient and I felt the risk to be low in relation to the benefit of toxicitv. " 10- ADDITIONAL GROUNDS FOR OBTAINING A BASELINE LVEF IN MS. THOMSON: (a) Ms. Thomson was at high risk for having had a prior cardiac event. Ms. Thomson had a positive family history of coronary artery disease. Her father had two silent myocardial infarctions when he was in his fifties (deposition of Ms. Thomson, page 24-25}. Ms. Thomson herself had high cholesterol levels. She also had an abnormality in her June 8, 2000 cardiogram. This EKG shows "Q" waves in inferior leads, a subtle finding that may have been due to an old inferior wall myocardial infarction. By strict electrocardiography criteria, these "Q" waves are not pathological; however they most likely represent an old inferior wall myocardial infarction which would have been evident on MUGA scan had Dr. Peroutka ordered one prior to commencement of chemotherapy. Page 11 of 18 REPORI. PATRICIA THOf'-1S0N Tes"t 12345678812) 11/28/05 04130pm P. 014 (b) Ms. Thomson was/is at high risk of relapse and may require future therapy with Adriamycin: Based on tumor pathology, tumor diameter of 2.5 em, estrogen receptor negativity and nuclear grade III, Ms. Thomson had a 10 year risk of mortality without treatment of 30.7 0/0. She would gain 5.80/0 absolute percentage benefit form adjuvant chemotherapy. Her 10 year risk of relapse without adjuvant treatment would be 42.60/0 and there is 11.3010 absolute benefit and reduction in relapse rate form chemotherapy. Statistics indicate that she was/is at high risk of relapse. Adriamycin is one of the main drugs to be used in treatment of relapsed breast cancer in women like Ms. Thomson. Dr. Peroutka argues, both in her response to interrogatories and also her deposition, that the total Adriamycin dose intended for Ms. Thomson was low, therefore she did not order a MUGA scan. This line of argument in inherently flawed since many patients like Ms. Thomson will relapse following their adjuvant chemotherapy and will need treatment with Adriamycin in future. A prudent oncologist shall consider all these possibilities and have a long term plan of treatment for her patients. The oncologist must take into consideration the future risks of relapse and potential future treatments, as opposed to just having a short term vision and treatment plan and a BAND-AID type of approach. Dr. Peroutka was cognizant of high rate of relapse of Ms. Thomson's cancer. In her deposition, Dr. Peroutka quoted a relapse rate of 25- 30 percent. With that high of relapse rate, oncologist shall not:Jlburn her bridges" and forgo a very simple test such as MUGA scan. Page 12 of 18 REPORT. PATRICIA THOMSON Tes't 12346S7SS0 11/28/06 04180pm P. 016 11- DISCUSSION OF DEVIATIONS FROM STANDARDS OF CARE: As stated above, ALL patients receiving Adrlamycin shall have an objective assessment of their LVEF by a MUGA scan prior to receiving this drug. It IS my opinion, to a reasonable degree of medical certainty that Dr. Peroutka deviated from established standards of care in 2000 by way of NOT obtaining a MUGA scan prior to commencement of Ms. Thomson chemotherapy. Dr. Peroutka also deviated from established standards of care in 2000 by way of NOT obtaining a MUGA scan during the course of treatment of Ms. Thomson with Adriamycin. The prevalence of cardiomyopathy increases significantly when patients are given doses of Adriamycin that is greater than 550 mg/m2. However, more recent studies have shown that lower cumulative doses can cause similar cardiomyopathy. The mortality rate among patients who actually develop late cardiotoxicity has been estimated to be high, but the dismal prognosis can be greatly altered by early recognition and treatment. 12... DISCUSSION OF POTENTIAL FINDINGS ON MUGA SCAN HAD IT BEEN DONE PRIOR TO AND DURING TREATMENT WITH ADRIAMYCIN: Having reviewed Ms. Thomson's medical records and her cardiogram from June 8, 2000, it is my opinion, within a reasonable degree of medical certainty, that Ms. Thomson had an old inferior wall myocardial infarction and an underlying cardiac dysfunction, that wouJd have been detected on MUGA scan had one been performed prior to commencement of her chemotherapy. Such an abnormality would have alerted Dr. Peroutka and hopefully she would have avoided using Adriamycin. Page 13 of 18 REPORT, P/~TRICIA THOf\/ISON Test' 1284567890 11/28/05 04:80pm P. 018 13- CHEMOTHERAPY WITH CMF PROVIDES SAME RESULTS AS FOUR CYCLES OF ADRIAMYCIN AND CYTOXAN: As stated in her deposition, Dr. Peroutka is of opinion that four cycles of Adriamycin and Cytoxan may be superior to eMF chemotherapy regimen, and that she was unaware of any studies comparing the two regimens of eMF and Adriamycin and Cytoxan. eMF regimen incorporates three drugs, Cytoxan, Methotrexate, 5-FU. This regimen does not have a cardiotoxic effect. The National Surgical Adjuvant Breast and Bowel Project (NSABP) study B-23 enrolled 2,008 patients between 1991-1998 and compared six cycles of eMF to four cycles of Adriamycin and Cytoxan, concluding that the two regimens had equal efficacy. 14... GUIDELINES FOR THE ADMINISTRATION AND MONITORING OF PATIENTS RECEIVING DOXORUBICIN. Schwartz, R.G., et al. in one of the landmark articles, titled as "Congestive heart failure and left ventricular dysfunction complicating doxorubicin therapy: Seven-year experience using serial radionucleotide angiocardiography" which was published in American Journal of Medicine in 1987 ( Am. J. Med. 82:1112, 1987) established the following guidelines which we still follow in 2005. I. Patients with pre-treabnent l VEF > 50% A. Repeat LVEF after 350- 300 mg/m2 B. Repeat LVEF after 400 mg/m2 in patients with known heart disease, heart irradiation or cyclophosphamide therapy. or after 450 mg/m2 in patients without these risk factors. C. Repeat lVEF measurements after each subsequent dose of doxorubicin. Page 14of18 REPORT. PATRICIA THOi'v1S0N TeST 1284567890 11/28/06 04180pm P. 017 D. Discontinue doxorubicin therapy if LVEF declines by> 10% to a value of less than 50%. 2. Patients with pre-treatment LVEF < 50% A Do not administer doxorubicin at all to patients with baseline L VEF of < 30%. B. In patients with LVEF of between 30 and 50%. repeat LVEF prior to each dose. C. Discontinue doxorubicin therapy if lVEF declines by > 10% and/or to a value of less than 30%. L VEF ::::: Left ventricular election fraction. measured bv radionuclide cardioanaioaraDhv (MUGA Scan) AdaDted from Schwartz, R. G., et al.: Conaestive heart failure and left ventricular dysfunction comDlicatina doxorubicin theraDv: Seven-year experience usina serial radionucleotide anaiocardjoaraDhv. Am. J. Med, 82:1112, 1987. 14- DISCUSSION OF MS. THOMSON'S DAMAGES: As a result of Adriamycin induced cardiomyopathy, Ms. Thomson has developed multitude of medical problems which have unfortunately impacted quality of her life. Some of her sufferings are: · severe reduction in her LVEF, causing her congestive heart failure requiring chronic treatment with various drugs such as digoxin, diuretics fete · development of blood clot in her heart requiring treatment with anticoagulants and Coumadin; · atrial fibrillation and irregular heart rhythm requiring treatment with anti-arrhythmia drug "Amiodarone"; · vision problem's secondary to Amiodarone; · weight loss and cardiac cachexia from chronic heart disease Page 15 oti8 R[:PORT, PATRICIA THOJV1S0N Test 1294567890 11/28/~5 04:30pm P. 018 . Decline in performance status, Joss of energy, inability to climb stairs, having to move to a one story home; . Loss of sexual drive and ability to enjoy intimacy; . Chronic stress, anxiety and depression. OPINIONS Opinion # 1: Dr. Peroutka's failure to obtain a MUGA scan prior to commencement of Adriamycin fell below applicable standards of care. Grounds for this opinion: Standard of care in effect in 2000, at the time of this occurrence, mandated that oncologists to assess the LVEF with a MUGA scan on all patients receiving Adriamycin. Unfortunately, Dr. Peroutka neglected her duty and responsibility, devtated from standard of care and failed to order this test. Causation and effect: It is my opinion, to a reasonable degree of medical certainty, that Ms. Thomson had an underlying cardiac dysfunction due to a prior inferior wall myocardial infarction. Had Dr. Peroutka obtained a MUGA scan prior to commencement of chemotherapy, this test would have indicated this prior cardiac injury and would have resulted in omission of Adriamycin and therefore Ms. Thomson would not have suffered from Adriamycin cardiomyopathy. Page 16 of 18 REPORT, PATRICIA THO~1S0N Test" 1.294587890 11/29/05 04=30pm P. 019 As a result of Dr. Peroutka negligence and her failure to perform pretreatment MUGA scan, Ms. Thomson was treated with Adriamycin, and developed and suffered from Adrtamycin cardiomyopathy. Opinion # 2: Dr. Peroutka's failure to obtain a MUGA scan during the course of treatment with Adriamycin feU below applicable standards of care. Grounds for this opinion: Standard of care in effect in 2000, at the time of this occurrence, mandated that oncologists to assess the LVEF with a MUGA scan on all patients receiving Adriamycin during the course of treatment. Unfortunately, Dr. Peroutka neglected her duty and responsibitity, deviated from standard of care and failed to order this test while Ms. Thomson was receiving Adriamycin. Causation and effect: It is my opinion, to a reasonable degree of medical certainty, that Ms. Thomson had an under~ying cardiac dysfunction due to a prior inferior wall myocardial infarction. Had Dr. Peroutka obtained a MUGA scan during the course of chemotherapy, this test would have indicated presence of prior cardiac injury and worsening of the same, and would have resulted in omission of Adriamycin and therefore Ms. Thomson would not have suffered from Adriamycin cardiomyopathy. As a result of Dr. Peroutka negligence and her failure to perform MUGA scan while treating Ms. Thomson with Adriamycin, Ms. Thomson continued to Page 17 of '18 REPORT, PATRICIA THOMSON Tesi' 1284567890 11/29/05 04:80pm P. 020 receive Adriamycin, and developed and suffered from Adriamycin cardiomyopathy. Therefore, it is my opinion to a reasonable degree of medical certainty, that Dr. Peroutka deviations from standard of care, as stated above, were the direct and proximate cause of injuries, loss of cardiac function and other damages and costs suffered by Ms. Thomson. This report is based on the existing facts that have been gathered and provided to me to this date. I reserve the rights to amend this report as other pertinent information becomes available. Dated: November 22, 2005 ..--- ,....- ~VV\ \ I~ Michael H. Tirgan, MD Page 18 of 18 REPORT, PATRICIA THOMSON LAURALEE B. BAKER, ESQUIRE Pa. Supreme Court lD. No. 58874 MARGOUS EDELSTEIN 3510 Trindle Road Camp Hill, Pennsylvania 17011 Telephone: [717] 975-8114 Fax: [717] 975-8124 E-Mail: lbaker@margolisedelstein.com Attorney for Defendants: KATHRYN A. PEROUTKA, M.D., and ANDREWS & PATEL ASSOCIATES, P.C. PATRICIA J. THOMSON and ROBERT C. THOMSON, her husband, Plaintiffs, v. :IN THE COURT OF COMMON PLEAS :CUMBERLAND COUNTY, PENNSYLVANIA :CIVIL ACTION - LAW :NO. 01-6286 Civil Term KATHRYN A. PEROUTKA, M.D., and ANDREWS & PATEL ASSOCIATES, P.C.,: Defendants. :JURY TRIAL DEMANDED REQUESTED POINTS FOR JURy CHARGE OF DEFENDANTS, KATHRYN A. PEROUTKA. M.D.. AND ANDREWS & PATEL ASSOCIATES. P.C. AND NOW, come Defendants, Kathryn A. Peroutka, M.D., and Andrews & Patel Associates, P.C., by and through their counsel, Margolis Edelstein, to submit the following requested points for jury charge: Burden of Proof Pa. SSJI (Civ) 11.03 Negligence Pa. SSJI (Civ) 3.00 Pa. SSJI (Civ) 3.01 Pa. SSJI (Civ) 11.00 Pa. SSJI (Civ) 11.01 Causation Pa. SSJI (Civ) 3.15 Pa. SSJI (Civ) 11.02 Expert Testimony Pa. SSJI (Civ) 5.30 Pa. SSJI (Civ) 5.31 Pa. SSJI (Civ) 5.32 Pa. SSJI (Civ) 5.33 Pa. SSJI (Civ) 5.40 - Medical Malpractice - Burden of Proof - Issues in the Case and Factual Cause - Negligence Definition - Medical Professional Negligence - Medical Malpractice - Standard of Care - Factual Cause - Medical Malpractice - Factual Cause - Credibility Generally - Basis for Opinion Generally - Hypothetical Questions - Weighing Conflicting Expert Testimony - Cautionary Charge: Jury Not to Assume Judge has Expressed an Opinion on the Evidence Witnesses Pa. SSJI (Civ) 1.44 Pa. SSJI (Civ) 1.45 Pa. SSJI (Civ) 1.48 Pa. SSJI (Civ) 2.05 Pa. SSJI (Civ) 2.19 Pa. SSJI (Civ) 2.20 Pa. SSJI (Civ) 5.03 Pa. SSJI (Civ) 5.04 Pa. SSJI (Civ) 5.05 Pa. SSJI (Civ) 5.06 Pa. SSJI (Civ) 5.07 Pa. SSJI (Civ) 5.25 Damages Pa. SSJI (Civ) 5.40* Pa. SSJI (Civ) 6.04 Pa. SSJI (Civ) 11.09 Informed Consent Pa. SSJI (Civ) 11.08A General Instructions Pa. SSJI (Civ) 11.13 - Credibility of Witnesses Generally - Discrepancies in Testimony - Evidence - Deposition Testimony - Exhibits - Impeachment or Corroboration of Witness by Prior Inconsist.:m t or Consistent Statement - Number of Witnesses - Conflicting Testimony - Willfully False Testimony - Failure to Produce Evidence (Part I; Part II; and Part IIA) - Direct and Circumstantial Evidence - Lay Opinion Testimony - Evaluating Evidence - Apportionment of Damages - Irrelevant Considerations - Informed Consent - Nondisclosure - General Instructions to Jury on Concluding the Verdict * All references refer to the Pennsylvania Suggested Standard Civil Jury Instructions, Third Edition, October, 2005, unless marked with an asterisk with reference to Second Edition. ..2- A. POINTS FOR GENERAL INSTRUCTIONS NEGUGENCE 1. You are specifically instructed that a doctor is neither a warrantor of a cure nor a guarantor of the result of treatment and that there is no presumption or inference of negligence merely because the medical care provided by a physician terminated in an unfortunate result, which may very well have occurred regardless of the degree of care and skill exercised. Gravel v. Aiwain, 252 Pa. Super. 534, 381 A.2d 975 (1977); Pa. S.S.J.1. (Civ.) 10.01 (1981). The mere occurrence or developn18nt of an injury does not prove negligence or causation. The mere fact that Plaintiffs may have experienced an injury, in and of itself, does not mean that they are entitled to recover damages from any Defendant. The mere development of an injury, or the existence of an opportunity for it to happen, does not entitle Plaintiffs to recover without further evidence of negligence on the part of the Defendants. Novak v. Neff, 399 Pa. 193, 159 A.2d 707 (1960); Hamil v. Bashline, 481 Pa. 256, 392 A.2d 1280 (1978). - 3 - 2. By undertaking professional service to a patient, a health care provider represents that he possesses, and it is his duty to possess, only that degree of learning and skill ordinarily possessed by similar physicians of good standing, practicing medicine under similar circumstances. It is his further duty to use the care ordinarily exercised in like cases by reputable members of his profession practicing in the same or a similar locality and under similar circumstances, and to use reasonable diligence and his best judgment in the exercise of their skill and the application of his learning, in an effort to accomplish the purpose of which he was employed. The law does not require perfection, prophetic insight or infallible judgment by any health care provider. Rather, the law requires that a health care provider possess a reasonable average ability to carry out his professional work and that he exercise reasonable care, skill and judgment in so doing. Pratt v. Stein, 298 Pa. Super. 92, 444 A.2d 674 (1982); Incollingo v. Ewing, 444 Pa. 263, 282 A.2d 206 (1971); Powell v. Risser, 375 Pa. 60, 99 A.2d 454 (1953). - 4 - 3. Ladies and gentleman, you are specifically instructed that under Pennsylvania law, a physician is not liable and is not negligent for an error in judgment or mere mistake in diagnosis as long as the physician exercised his or her medical judgment with the degree of skill, knowledge and care as that normally exercised under similar circumstances. If a physician possesses reasonable and ordinary learning and skill, and uses care such as is ordinarily used in like or similar situations by physicians and health care providers of reasonable and ordinary skill, he or she is not guilty of negligence even though his or her judgment may, in hindsight, prove to have been incorrect. In other V\'ords, if the most the case discloses is an error of judgment on the part of a physician, without sufficiently persuasive evidence that the error of judgment was the result of any negligence of the physician, then there is no liability. Duckworth v. Bennett, 320 Pa. 47, 181 A. 558 (1935); Ward v. Garvin, 328 Pa. 395, 195 A. 885 (1938); Smith v. Yohe, 412 Pa. 84, 194 A.2d 167 (1963); Soda v. Baird, 411 Pa. Super. 80, 600 A.2d 1274 (1991). - 5 - 4. A defendant is not liable for mere mistakes or errors in judgment. If the defendant possessed and exercised the average degree of skill, care and diligence possessed and exercised by other family practitioners and acted reasonably under the circumstances, he is not liable in negligen..::e should you find that his judgment was incorrect merely by hindsight. Smith v. Yohe, 412 Pa. 94, 194 A.2d 167 (1963); Soda v. Baird, 411 Pa. Super. 80, 600 A.2d 1274 (1991), allocatur denied 616 A.2d 986 (1992). - 6 - 5. If a patient should sustain an injury or harm while undergoing medical care, and that injury or harm results from the physician's lack of knowledge or ability, or from his failure to exercise reasonable care, then he is responsible for the injuries which are the result of his act. If, on the other hand, the physician has used his best judgment and he has exercised reasonable care, and has a requisite knowledge or ability, even though complications resulted, then the physician is not responsible. The rule requiring a physician to llse his best judgment does not make the physician liable for a mere error in judgment, provided he does what he thinks best after a careful examination. The rule of reasonable care does not require the exercise of the highest possible degree of care. It requires only that the doctor exercise that degree of care that a reasonably prudent physician would exercise under the same circumstances." Fragale v. Brigham, _ Pa. Super._, 741 A.2d 788 (1999). - 7 - 6. If a physician employs the required judgment and care in arriving at his diagnosis, the mere fact that he errs in his diagnosis will not render him liable, even though his treatment is not proper for condition actually existing. Smith v. Yohe, 412 Pa. 94, 194 A.2d 167 (1963). - 8 - 7. The practice of medicine involves professional skill and training and the application of techniques which are generally beyond the knowledge of individuals who are not physicians. Therefore, in evaluating the conduct of the Defendants in this case, you are cautioned that you must not substitute your own thinking as non- health care providers as to what would be proper treatment under these circumstances, but you must be guided by the testimony of the health care providers and experts you have heard testify as to the standard or standards of care applicable under these circumstances and as to whether the Defendants in this instance fell below a recognized standard of care. Chandler v. Cook, 438 Pa. 447, 265 A.2d 794 (1970); Lambert v. Soltis, 422 Pa. 304, 221 A.2d 173 (1966). - 9 - 8. In determining whether or not a defendant health care provider fulfilled the duties imposed upon him by law, you are not permitted to set up an arbitrary standard of your own. The standard or standards are set by the learning, skill and care ordinarily possessed and practiced at the time in question by others of the same profession in good standing. It follows, therefore, that the only way you may properly learn the standard or standards of care is through evidence presented in this case by physicians and health care providers called as expert witnesses. Chandler v. Cook, 438 Pa. 447, 265 A.2d 794 (1970); Lambert v. Soltis, 422 Pa. 304, 221 A.2d 173 (1966). - 10- 9. In determining the facts, you must not indulge in any guesswork or speculation. If you find that you are unable to decide any factual question in this case without resorting to guesswork or speculation, then the Plaintiffs, who have the burden of proof, have failed to discharge the burden on that question. Lanni v. Philadelphia Railroad Company, 371 Pa 106, 88 A.2d 887 (1952); Strother v. Binkele, 256 Pa. Super. 404,389 A.2d 1186 (1978). - 11 - 10. The Plaintiffs must establish the nature and extent of the claimed injuries with reasonable certainty. The Plaintiffs must establish the injuries and that such injuries were the result of some negligeLce on the part of the Defendants by competent medical testimony which is sufficiently definite to overcome any idea that is conjectural or a mere guess. Maliszewski v. Rendon, 374 Pa. Super. 109, 542 A.2d 170 (1988); Griffin v. Tedseo, 355 Pa. Super. 475, 513 A.2d 1020 (1986). - 12 - 11. Where, as here, Plaintiff brings an action for damages, the Court must necessarily instruct you upon the measure of damages. However, you are not to understand that you are required to give damages simply because instructions have been addressed to you on that subject.. Instructions as to damages are intended to apply only in a case when the plaintiff is entitled to a verdict. Such instructions on damages should not be understood by you as conveying a suggestion that, in the opinion of the Court, Plaintiffs are not entitled to damages. Carter v. Gallo, 27 Som. Leg. J. 181 (Pa. Com. PI. 1972); Wilfv. Philadelphia Modeling &' Charm School, Inc., 205 Pa. Super. 196, 208 A.2d 294 (1965); Burch v. Reading CO'J. 140 F. Supp. 136 (E.n. Pa. 1956), affd 240 F.2d 574 (3rd Cir. 1957), cert. denied 353 U.S. 965, 77 S. Ct. 1049, 1 L.Ed.2d 914 (1957). - 13 - . 12. If you find that Plaintiffs' injuries were caused by pre-existing conditions or injuries from which the Plaintiffs suffered, and that these conditions would have led to the development of the injury alleged, notwithstanding the medical care rendered, the Plaintiffs have failed to meet the necessary burden of proof as to the element of causation, and your verdict must be for the Defendants. Jones v. Montefiore Hospital, 494 Pa. 410, 431 A.2d 920(1981); Gradel v. Inouye, 491 Pa. 534,421 A.2d 674 (1980); Hamil v. Bashline, 481 Pa. 256, 392 A.2d 1280 (1978). - 14- 13. Ladies and gentlemen, as jurors, you are cautioned that you cannot and must not allow any degree of sympathy or bias for one side or the other to influence your decision. Rather, it is your legal duty to decide this case solely upon all of the evidence presented as it pertains to the facts determined by you and the law as I have given it to you. Thus, to the extent that you find yourself feeling sympathy towards one side or the other in this case, you must not allow such feelings to have any bearing on your deliberations. Incollingo v. Ewing, 444 Pa. 263, 282 A.2d 206 (1971); Murphy v. Pennsylvania Railroad Company, 292 Pa. 213, 140 A.2d 867 (1927). Respectfully submitted, MARGOLIS EDELSTEIN Date: '2-H 01 ~(dD2- LA EE B. BAKER, ESQUIRE . Attorney J.D. No. 58874 Attorneys for Defendants, KATHRYN A. PEROUTKA, M.D., and ANDREWS & PATEL ASSOCIATES, P.C. \ \) 3510 Trindle Road Camp Hill, PA 17011 (717) 975-8114 ..15 - r) t:~ r-., C..:J ~ - .-1 -.-! r', G:J , --.J o -11 :::1 -::1 r.) en -...l ... '. PATRICIA J. THOMSON and ROBERT C. THOMSON, her husband, Plaintiffs IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA v. CIVIL ACTION - LAW KATHRYN A. PEROUTKA, M.D., and ANDREWS & PATEL ASSOCIATES, P.C., Defendants NO. 01-6286 CIVIL TERM VERDICT SLIP 1. Do you find that the conduct of the Defendant, Kathryn Peroutka, M.D., was negligent? Yes NOA If your answer to Question #1 is "Yes," proceed to Question #2. If your answer to Question #1 is "No," proceed to Question #3. 2. Was the negligence of the Defendant a factual cause III bringing about Plaintiffs' harm? Yes No If your answer to Question #2 is "yes' or "No," proceed to Question # 3. 3. Was the Plaintiff properly informed of her potential risks, consequences and alternatives prior to the use of Adriamycin/Cytoxcin? Yesl No . If you have answered "Yes" to Questions #1 and #2 or "No," to Question #3, proceed to Question #4. 4. State the amount of damages sustained by Mrs. Thomson $ Mr. Thomson's loss of consortium $ Dated: .2./1/;<007 ( ~~~. J):I(,/{~) L "t"'...v.</ ~ .... .... ,- CASE NO., 3 CO~ &+r-it\iA J.1]1l)tT&n cf.-J?obe.i. ~.~ vs ~thrln p... ~ml)~m Mo ~ A~relA)S'" &ic.l As&:rio..b P.~. DOCKET NO.: DATE: ~ -05 -61.007 :2 161 78 59 51 75 105 102 96 99 81 106 57 S2 73 65 77 61 66 18e 87 89 76 1 -+ ))3 ~ (l 8 9 JO \ I I j 13 1::>'2.- 12 IJ 1-1 ,5 16 1>' J3' f"71' 18 19 'PL 20 2! "'" ~~23 24 ...$ 1:>.5 :;; 5 :P4~ ;p~~ 93 71 10e 58 68 83 II 98 74 6 53 67 103 54 29 32 '" ,) .1 34 35 36 DE BEA9E, LHIDA L. JOIIN:JON, CIIARLE3 F. MCCAUSLIN, ANN KOCHER, AMELIA JO LAUCH1...r:, CIIRf3'fA J MILLER, TAMMY ULSH, BETTY L. SEARFOSS, LELAND A. DAVIS, DOREEN BILZ, ANNA M. MCKILLI~, DONNA M. BAD8RF, MARK ~MITH, LATjR.eN lJANA T A \/T.....OR, RIG lARD ARMJl'ROi~G, JAMffi L. GltOUY, lUCKY FIGI IER, CI If.RLE6 .Ifc ~b-r p~ ,"-~I:l'...IlT' RAMAMURTHY KRISHNAN (he~ J1x.cl Cboldrit hear!) DALY, DANIEL J KELLER, JEFFREY CHUBB, TIMOTHY A. KERN, DAVID LEO, M.^_:rTH~lAT c. ." ARMITAGE, LINDA vv lLLlAM::', I t:lOMA::' o. PR1JV to Y, CRBGOR" f~ L UFT, KININ .P SHRAWDER, CHRISTOPHER ZEIGLER, STEPHEN A. STIMELING JR., JOSEPH A. MCCULLOUGH, KEVIN WABAUNSEE '" A.: "YITZ, TONIA RUSNi"'" EN A , ' .""o.^ _ MELLOTT, RONALD FISSEL, SUSAN DlAN CHRONIS , EARL M. j,clIt ~~e 91980&161 - 1127542517 MedicAl MaJptnence 1198320342 {)I-ID~ BiD 1283419200 1350148177 15 2 1704224782 1749604164 1753003357 1846730359 , . .. 37 85 L. 79 STAUB, JEFFREY ",__0- 64 KRESSLER, ~<?~T'-~' 80 POWERS, SARA E. ~/'-'" .."./,.,.. 1889635231 2092618794 2113556313 2146764643 39 40 .,-' Monday, February 05, 2007 Page 2 of 2 . ORIGINAL PATRICIA J. THOMSON and : IN THE COURT OF COMMON PLEAS ROBERT C. THOMSON, her husband, : CUMBERLAND COUNTY, PENNSYLVANIA Plaintiffs, : CIVIL ACTION - LAW v. : NO. 01-6286 Civil Term KATHRYN A. PEROUTKA, M.D., and ANDREWS & PATEL ASSOCIATES, p.e.,: Defendants. : JURY TRIAL DEMANDED PRAECIPE TO DISCONTINUE AND END TO THE PROTHONOTARY OF CUMBERLAND COUNTY: Please mark the above-captioned matter as discontinued and ended. Respectfully submitted, COSTOPOULODS, FOSTER & FIELDS Date: '1/Z,/dl ~. t\ ~ By: David J. Fa r, E~Uire 831 Market Street Lemoyne, P A 17043-0222 (717) 761-2121 (717) 761-4031-fax Counsel for Plaintiffs . ~ CERTIFICATE OF SERVICE I HEREBY CERTIFY that I served a true and correct copy of the foregoing PRAECIPE TO DISCONTINUE AND END on all counsel of record by placing the same in the United States mail at Camp Hill, Pennsylvania, first-class postage prepaid, on the .~ day of April, 2007, and addressed as follows: Catherine M. Mahady-Smith, Esquire 3115-A North Front Street Harrisburg, PA 17110 Lauralee B. Baker, Esquire Margolis Edelstein 3510 Trindle Road Camp Hill, PA 17011 COSTOPOULOUS, FOSTER & FIELDS B~~-JA. ./~ ::.:2 r--:> = = --' ...... ;;':0 ::;'0 I W o -n ~-n rnE -om ~1.~ i'5~~ 9\ -,...; ~ -0 - -- N .. C) w