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HomeMy WebLinkAbout01-1071 : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY PENNSYLVANIA IN RE: Paul E. Haigh A'N ALL~ED IN CkfA:C 11Air0, : DOCKET NUMBER: ~J- .01- lOll : EMERGENCY GUARDIANSHIP ORDER OF COURT _ I A {oil Q ....3 t:'" 0 2 he 2J i \'\ \,.; c.. ~ J....., 6u $.. :> AND NOW THIS ~ Day of November 2001, it is hereby dete'rmined that Paul E. Haigh is incapacitated from making appropriate medical decisions on his behalf. It is ordered that David F. Tamanini, Esq. shall be appointed guardian of the person of Paul E. Haigh for the purpose of providing medical decision making op b~ha)f of MtHaigh~hiS I J f QJ rr 2.. h ow ~ ) V? d t'S i, uc..... '7 e..)(.~U) de guardianship shall be in force UBtil ~Ith~fllbl:;:.l 27, 26M unless extendod by furthor ordor ef t}bo~. PC) loJ J 20 d?l S..--f J', ~ H'z-.qe.HU 6-.0\'1 w~<:-R() t~'6.'c""riLJ~ 1 d\J2J 12J>IJS.L" S~ _" IJ L <=- ""'- L r. cJ or t V"'1lfPt ?>~, r ~ 411 'L L L~f ,'f!J) + . 1 (/ fI v' 2. (.. 2 6 <9 () iY1T~iEC-Cb1fIiT 1 s.le. l-l 0 ~ f J':> . 2- ru V") d '7 '1 JIVe. ) ~ \O',bD 2,--4') < V'd "0:) DUBpaqUJllO , 'n'~'- J.! ,J ;~>}fJa!~ vL: vd LZ AON LO. SflVl\ lG,\S15e!j jO c~n:)Jo:)aH : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY PENNSYLVANIA IN RE: Paul E. Haigh : DOCKET NUMBER: : EMERGENCY GUARDIANSHIP EMERGENCY PETITION FOR TEMPORARY GUARDIANSHIP OF THE PERSON AND NOW Comes, Carlisle Regional Medical Center by and through its counsel, Farrell & Ricci, P.C. by Joseph A. Ricci, Esq., and requests that this Honorable Court to enter an order granting an emergency limited guardianship of th~~J"so:Il for Mr. Paul E. Haigh for the following reasons: 1. The alleged incapaciated person is Mr. Paul E. Haigh an adult male aged 79. 2. Mr. Haigh is currently a patient at the Carlisle Regional Medical Center. 3. Prior to his hospitalization, Mr. Haigh resided at 416 First Street Carlisle, PA 17013. 4. The only known relative of Mr. Haigh is an alleged niece whose name is Susan Potts, telephone number 545-3628, 516 Ryan Drive Harrisburg, PA 17112-2244. Attempts to contact Ms. Potts to advise her of the situation and the need for the appointment of a guardian have been unsuccessful. 5. Currently Mr. Haigh is receiving medical services at the Carlisle Regional Medical Center, 246 Parker Street, P.O. Box 4100, Carlisle, PA 17013. 6. Prior to his admission to the hospital, Mr. Haigh was receiving residential services from Hospice Preferred Choice, 4811 Jonestown Road, Harrisburg, PA 17112, as well as the Cumberland County Office of Aging, Carlisle, PA 17013. 7. The petitioner requests that this Honorable Court appoint David F. Tamanini, Esq., P.O. Box 6206, Harrisburg, PA 17112 as temporary guardian of the person of Mr. Haigh. 8. Attorney Tamanini provides guardian and power of attorney services to the central Pennsylvania region. (See Description of Guardianship service provided attached hereto as Exhibit "A.") 9. Attorney Tamanini does not have any interest that is adverse to the interests of Mr. Haigh, the alleged incapacitated person. 10. The emergency temporary guardianship of the person is necessary for the following reasons: a) Mr. Haigh is an elderly gentleman who lives alone in public assistance housing. b) Because of his limited financial means, Mr. Haigh lacks the ability to seek private placement for his medical needs. c) The only family member who is known to exist is a niece who resides in the Linglestown area of Harrisburg. d) Mr. Haigh has had no contact with his niece for an extended period of time. e) Mr. Haigh's niece has previously stated that she has no desire to participate in decision making concerning her uncle. f) There are no family members or friends who can provide for surrogate decision making on Mr. Haigh's behalf. g) The Cumberland County Area on Aging has refused to become involved in the care of Mr. Haigh on the grounds that Mr. Haigh refused to sign a form acknowledging his agreement to participate in their services. h) Hospice Preferred Care has relinquished responsibility for the care of Mr. Haigh upon his admission to the Carlisle Regional Medical Center. i) At this time there is no other reasonable alternative to effect the proper care of Mr. Haigh besides the appointment of a temporary guardian of the person. j) Mr. Haigh suffers from terminal, metastatic cancer. As a result of the cancer, Mr. Haigh will suffer from potentially numerous medical complications which will require an ability to understand the nature of the complications and how they will be treated. The treatments necessary will include the need to provide informed consent to permit the medical treatments. k) Mr. Haigh has been found by the Carlisle Regional Medical Center staff psychiatrist, Dr. Rosenthal, to be mentally incompetent and incapable of making reasonable and meaningful decisions on his behalf. (See Affidavit of Dr. Rosenthal attached hereto as Exhibit "B.") 1) Mr. Haigh is currently suffering from significant fluid collections in his lungs and, as a result, is unable to properly breathe. The inability to breathe, in turn, causes confusion because of a lack of proper oxygenation of the brain. m) Mr. Haigh's attending physician Dr. Jurgensen, believes it is medically necessary and appropriate for Mr. Haigh to, in the immediate future, undergo a bronchoscopy to evaluate the condition of Mr. Haigh's lungs and to alleviate the effects of any fluid collections. (See affidavit of Dr. Jurgensen attached hereto as Exhibit "C.") n) A bronchoscopy is a medical procedure which requires the use of a bronchoscope, a device which is inserted into the patients bronchial tree to visually examine the tissues of the bronchus and the lungs. 0) A bronchoscope can also be used to provide treatment to the patient in the form of removal of tissues and fluids. p) A bronchoscope can also be used to obtain tissue samples for evaluation in an effort to determine the necessity and propriety of future medical care. q) The use of a bronchoscope is an invasive procedure, which requires a patient's informed consent. r) Mr. Haigh is incapable of providing his informed consent to undergo the suggested bronchoscopy. s) Failure to undergo the bronchoscopy could significantly impair the physical health of Mr. Haigh since it will be impossible to properly evaluate and treat the condition giving rise to the fluid collection in the lungs of the patient. t) Failure to undergo the bronchoscopy could result in the premature death of the patient as a result of congestive heart failure. u) Without the appointment of a guardian, the medical staff of the Carlisle Regional Medical Center are unable to provide the reasonable and necessary medical treatments to properly care for Mr. Haigh since the patient is unable to provide the necessary consents for his continued care. 11. A temporary guardianship will permit the appropriate decision making to take place in the short term and potentially avoid the premature and unnecessary death of Mr. Haigh. 12. It is hoped that once Mr. Haigh undergoes the proposed bronchoscopy he will experience an improvement in his breathing which may permit an increased clarity of thought from the increase in oxygenation. 13. If Mr. Haigh's medical condition improves the need for a temporary guardian may cease to exist. WHEREFORE it is respectfully requested that this Honorable Court issue an order appointing David F. Tamanini, Esq. temporary guardian of the person of Paul E. Haigh for the purpose of providing medical decision making authority. Respectfully submitted, . . . . . . . . EXHIBIT A -::::i:1) ~9 CD~ 3 01 OJ ~~~ ~C)c 6i(X)~lD ~5:C)6. :J . :r: :n 2: "TI ~ _~ @ ~ :::::I. lD "2. ;:..., en -3 "tJ .......g"lD CD~"':J S:~~ :; ~01:E O,j:>..- o ~ 3~~ (X)::!. o~ .......1\) f\) ~ G>> c:tO ~ ~ 0.0 D)" '< :J c: en- i5.. -0 CD ..... ..... a-o 5l 0 1!!,> "0 :J e!.. :D CD So o. :J en =r -5' ~. :r :r CD :E I>> .., a. f\) ~ f\) !=l I>> G> I>> :J c: :J 0.1>>0. :s'a.~ CD iii. 0 CD :J < ..... en- c: ~ C ~ 2g.g, aen(J) :r I>> CD CD i5.. < :E :D g. ~ CD en o..{g o :J en ~ CD" y> C ;;z. CD .., ~" -< CD 3 ~. ." I -Q) Q) D>X-~ 3 .. -...I 00. - -" Q)-...I-...IC" ::J -" - c :5"-...I01cC -.- ~- @01-""1J "'C ~ ~ ):> -5. ~ CXl CD-"O-" =CXlO1::::t ::JO -" ~-...I I\) o o 3 ~ g~~ ii~~~ ~ Q) o 3 = o 0 Q) ::J ::J C" ~1a::rCD ~.I~~ ::J CD_, o CD en CD-eno . Q) C ::J en 0.. en - o 3 CDg ~o 5- m 9:0.. ~. en 0.. CD C ~ D> ~. -0 ::J CD CD en CD 0.. en "'C3 ~ Q) en ::J OQ)'1J ::J co ~ Q)CDO 035: ~~::J ~.....cc ~ 0 ~ .., - CD ::J _ < o :::r -. -.CD CD Q) 0 ~ ffi CD. Ro CD ::J 0.. ~ en en :--l ~?1~~~~ -. -l :a=rC/) OCD_ CD-C>> O)Q.~ OoQ, =r:EC>> o -, ... =:JQ, CD to ." :a 0) OlIO en a a en -. CD :J "'D <0... _.0 C>> o -a n CD 0 _ "tJ ..... -. -O)n ~(j)(1) .. a. D) :1 Q. "'0"'0 o "'" :e 0 CD;" """ en o en ;0- ...:1 ...0) o """G) ::J CD &i '<"", ene: CD 0) ~ :1 -. (") CD tn rot 3 5. So o. :J I>> :J a. r ~: g o. :J a :r CD G> c: I>> .., a. iii. :J en =r -5. o :-CD> < 00: ro~ o xii? 0>3 I\)Q) 0::J 0> -. 2. ~ ~ G> c: 0) a. iii. :J en- :D CD i[ o. :J en =r -5" ~, :r o g. CD .., ~ ~ ~ :--l~?1 ...A.........................~~ ~~~~!=l - !Xl "TI-l ~ra aG> en c: a~ a. :rw CD :J :E; aCD i[ 0' :J en =r "6" ~. g. "TI I>> 2. -< 0) :J a. g'OG>-oS::COG>S::O ....gliia~s.g=>lii~lii_ <_..,"tJI>>'< "'0) crg-Q,CDIO -a9:tO~ 5l - I>> ~ 5. ~O 0) CD )> O:J to 0_:J3 -0S::_ 0 en 5'-I>>=r~5"-~~ S":T::JCDoCi:T....; CD CD~ :EsfCil CD a:J ~~~a:D~;,?~~ mg~en-m>Cil= enCD_men~O"tJ Pi. eno=:?(i)" JOo Pi51>>oG> "TI :J (j)!2: -< :J c: 5"cg CD I>>cg ~ ~ 5. Q i5.. 5. Q, 010 .....(J)IO~ -. :D CD c: :D en e?.51 ~:g51~ R<>"tJ 0.0"tJ..... toO (J)~OO ~~ O:(J)~.~ . 5" 6' = CD C" CD CD= 5.<=en en 2 0- ~ en CD CD CD en en en ~g>~~ I>> a:ro ~ c: 0.. iii~ :DCDg;O CD;a.=E:J ~ iii' 5" s:: cr=tO I>> :::: -< s:: s: < CD .~ CD a. ..... > -. =E :::; ~::;: CD -=r :3 O:D So ~ CD ;;Z" CD <g CD .., a. S" ~ :r =r o c: 5" 10 o .., -0 .., o CD en en o. :J I>> en R<>C-l s::~ffi ~ en" -0 o. o. a e?.:Jo -l3:CD al ~ ~ So 5' a 3 to C CD :D CD :J CD 0 - to en' ~ o' o.:J 5" s:: to I>> S::O: ~cS o. e?. (J) CD < o. CD en 5'(J)-l)> o~ffi:g 30G>o. CD CD c: I>> 0.(j)1>>C" ~ CD 03...... g :::;. iii. j; ~ e.~-=E ;a. o. :D :J CD ai?I :r o' CD ~ :E2: ~~ 0.0 :r CD o o c: ~ EXHIBIT B 11/21/01 16:17 ft7172459198 Nov-21-0~ 02:20P CACS . _~o...02 AFFIDAVIT OF DAVID M. ROSENTHAL. M.D. And nOW this 218' day of November, 20011. Dr. David M. Rosenthal do hereby swear and affirm: 1. 1 am a physician licensed to practice medicine in the Commonwealth of Pennsylvania. 2. My medical practice is limited to tbe specialty of psychiatry. 3. On November 16. 20011 performed a psychiatric evaluation of Carlisle Regional Medical Center patient Paul Haigh. 4. As a result of my psychiatric evaluation. it is my professional opinion, held to a reasonable degree of medical certainty that Mr. Haigb suffers from dementia, Alzheimer's type Additionally I believe that Mr. Haigh suffers from delusions. 5. Mr. Haigh does not have an appreciation of the nature ofMs illness nor the reason for his hospitalization. 6. Mr. Haigh believes he bas been hospitalized because of food poisoning caused when he was allegedly bathed by Hospice social workers with water retained after cleaning Mr. Haigh's food dishes. 7. Mr. Haigh is unable to meaningfully participate in his medical decision making. 8. Mr. Haigh suffers from impaired judgment, which prevents him from making rational and appropriate decisions for his medical care. 9vV'<-- 1~/21/01 16:18 Nov-21..01 ~2:20P t:t7172459198 CACS ~003 9_ Mr. Haigh is unable to meaningfullY pTovide consent for medical procedureR necessary for his medical well being- Respectfully submitted, ~,Q lj) MO Dr. David Rosenthal M.. D. //~/ OJ AFFIDAVIT OF DAVID M. ROSENTHAL, M.D. And now this 21st day of November, 2001 I, Dr. David M. Rosenthal do hereby swear and affirm: 1. I am a physician licensed to practice medicine in the Commonwealth of Pennsylvania. 2. My medical practice is limited to the specialty of Psychiatry. 3. On November 16, 2001 I performed a psychiatric evaluation of Carlisle Regional Medical Center patient Paul Haigh. 4. As a result of my psychiatric evaluation, it is my professional opinion, held to a reasonable degree of medical certainty that Mr. Haigh suffers from dementia, Alzheimer's type. Additionally I believe that Mr. Haigh suffers from delusions. 5. Mr. Haigh does not have an appreciation of the nature of his illness nor the reason for his hospitalization. 6. Mr. Haigh believes he has been hospitalized because of food poisoning caused when he was allegedly bathed by Hospice social workers with water retained after cleaning Mr. Haigh's food dishes. 7. Mr. Haigh is unable to meaningfully participate in his medical decision making. 8. Mr. Haigh suffers from impaired judgment, which prevents him from making rational and appropriate decisions for his medical care. 9. Mr. Haigh is unable to meaningfully provide consent for medical procedures necessary for his medical well being. Respectfully submitted, Dr. David Rosenthal . . . . . . EXHIBIT C AFFIDAVIT OF CRAIG J. JURGENSEN, M.D. And now this 21st day of November, 2001, I Dr. Craig Jurgensen do hereby swear and affirm: 1. I am a physician licensed to practice medicine in the Commonwealth of Pennsylvania. 2. My medical practice is limited to the specialty of internal medicine with a subspecialty in neurology. 3. I am the attending physician for Carlisle Regional Medical Center Patient Paul Haigh. 4. Mr. Haigh became my patient on November 14, 2001. 5. Mr. Haigh suffers from lung cancer with metastases to the liver. His condition is ultimately terminal. 6. Mr. Haigh is suffering from pulmonary complications of his lung cancer which are causing the development of bronchial secretions. 7. The presence of the pulmonary secretions causes significant compromise of Mr. Haigh's ability to breath and can lead to significant infectious processes. 8. It is necessary to perform a Bronchoscopy to properly evaluate and treat Mr. Haigh pulmonary secretions. 9. A Bronchoscopy is an invasive procedure which requires a patients informed consent. 10. Mr. Haigh suffers from greatly diminished mental abilities due to a diagnosis of dementia, Alzheimer's type and delusions. 11. Mr. Haigh is incapable of understanding the nature of his illness and the manner in which his illness must be treated. 12. Failure to perform a Bronchoscopy will prevent the evaluation and treatment of Mr. Haigh's pulmonary condition. 13. Failure to perform a Bronchoscopy will result in the premature death of Mr. Haigh. 14. A Bronchoscopy is a reasonable and appropriate medical procedure for the care, evaluation and treatment of the patient. 15. A less invasive diagnostic and treatment regimen is not available. Respectfully submitted, Dr. Craig Jurgenson . VERIFICATION I, Georgeann Reilly, Risk Manager, Carlisle Regional Medical Center, hereby verify that the facts set forth in the foregoing Emergency Petition for Temporary Guardianship of the Person are true and correct to the best of my knowledge, information and belief. I understand that false statements herein are made subject to the penalties of 18 Pa.C.8. ~4904, relating to unsworn falsification to authorities. CARLISLE REGIONAL MEDICAL CENTER, Date: 11--2;-0/ ~~~ Georgeann Reilly Risk Manager IN RE: IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION No. 21-01-1071 PAUL E. HAIGH IN RE: PETITION FOR APPOINTMENT OF EMERGENCY GUARDIAN BEFORE OLER, J. ORDER OF COURT AND NOW, this 26th day of November, 2001, upon consideration of the Emergency Petition for Temporary Guardianship of the Person with respect to Paul E. Haigh, and following a hearing held on this date, it is determined that Paul E. Haigh continues to be an incapacitated person, as determined in the Order of Court dated November 21, 2001, and the order thus entered is confirmed and ratified; provided, that Susan K. Potts, the niece of the incapacitated person, is substituted as emergency guardian of the person of Paul E. Haigh for the purpose of providing medical decisions on behalf of Mr. H~igh. In all other respects, the Order of Court dated November 21, 2001, shall remain in full force and effect. No bond shall be required of the guardian herein appointed. By the Court, J Joseph A. Ricci, Esquire For Petitioner Carlisle Regional Medical Center Gregory Cutler, Esquire Court-Appointed Counsel for Mr. Haigh Paul E. Haigh Carlisle Regional Medical Center 246 Parker Street Carlisle, PA 17013 Susan K. Potts 516 Ryan Drive Harrisburg, PA Court-Appointed 17112-2244 Temporary Guardian of Person wcy IN RE: IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION No. 21-01-1071 PAUL E. HAIGH IN RE: PETITION FOR APPOINTMENT OF EMERGENCY GUARDIAN BEFORE OLER, J. OPINION and ORDER OF COURT Oler, J., November 26, 2001 At issue in the present case is the question of the continuation of the appointment of an emergency guardian of the person for Paul E. Haigh and the question of whether Susan K. Potts, the niece of Mr. Haigh, should be substituted as the emergency guardian of his person. A hearing was held in this matter on Monday, November 26, 2001, before the undersigned judge in the hospital room of Mr. Haigh at the Carlisle Regional Medical Center, 246 Parker Street, Carlisle, Pennsylvania. Present at the hearing was Mr. Haigh (albeit in a nonresponsive condition) with his Court-Appointed Counsel, Gregory Cutler, Esquire. Present on behalf of the Petitioner, Carlisle Regional Medical Center, was Joseph A. Ricci, Esquire. Also present were Mr. Haigh's niece, Susan K. Potts, and David F. Tamanini, Esquire. Based upon the evidence presented at the hearing, the following Findings of Fact, Discussion and Order of Court are made and entered: FINDINGS OF FACT 1. The allegedly incapacitated person is Paul E. Haigh, a domiciliary of Cumberland County, Pennsylvania, who has resided most recently at 416 First Street, Carlisle, Cumberland County, Pennsylvania, 17013, and is presently a patient in the intensive care unit of the Carlisle Regional Medical Center, 246 Parker Street, Carlisle, Pennsylvania, 17013. 2. Mr. Haigh is 79 years old. 3. Petitioner is the Carlisle Regional Medical Center, 246 Parker Street, Carlisle, Pennsylvania, 17013. 4. The allegedly incapacitated person, Mr. Haigh, has been diagnosed with dementia, Alzheimer's type, with depressed mood and delusions, acute organic brain syndrome, and organic mental disorder dementia. 5. The prognosis with respect to these mental conditions is not favorable at this time. 6. The allegedly incapacitated person has also been diagnosed with certain physical illnesses, including bronchiogenic carcinoma which has metastasized, and obstructive lung disease. 7. Recently, Mr. Haigh's physical conditions have deteriorated, and he is presently on a life support system. 8. As a result of Mr. Haigh's mental condition, he is an incapacitated person in the sense that his ability to receive and evaluate information effectively and communicate decisions in any way is impaired to such a significant extent that he is at this time totally unable to meet essential requirements for his physical health and safety. 9. Mr. Haigh's condition is such that he lacks capacity and is in need of a guardian of his person; and a failure to make such appointment will result in irreparable harm to his person. 10. Susan K. Potts, 52, is an adult individual who is qualified to act as emergency guardian of the person of Mr. Haigh; she is Mr. Haigh's niece; her address is 516 Ryan Drive, Harrisburg, Dauphin County, Pennsylvania. 11. The foregoing Findings of Fact are made on the basis of clear and convincing evidence. DISCUSSION The provisions respecting an adjudication of incapacity have recently been amended and are contained in 20 Pa. C.S. Sections 5501 et sea. Petitioner has complied with these provisions, as they relate to an emergency guardianship of the person with respect to the subject of these proceedings. Based on the foregoing Findings of Fact and Discussion, the following Order of Court will be entered: ORDER OF COURT AND NOW, this 26th day of November, 2001, upon consideration of the Emergency Petition for Temporary Guardianship of the Person with respect to Paul E. Haigh, and following a hearing held on this date, it is determined that Paul E. Haigh continues to be an incapacitated person, as determined in the Order of Court dated November 21, 2001, and the order thus entered is confirmed and ratified; provided, that Susan K. Potts, the niece of the incapacitated person, is substituted as emergency guardian of the person of Paul E. Haigh for the purpose of providing medical decisions on behalf of Mr. Haigh. In all other respects, the Order of Court dated November 21, 2001, shall remain in full force and effect. No bond shall be required of the guardian herein appointed. By the Court, /s/ J. Wesley Oler. Jr. J. Joseph A. Ricci, Esquire For Petitioner Carlisle Regional Medical Center Gregory Cutler, Esquire Court-Appointed Counsel for Mr. Haigh Paul E. Haigh Carlisle Regional Medical Center 246 Parker Street Carlisle, PA 17013 Susan K. Potts 516 Ryan Drive Harrisburg, PA Court-Appointed 17112-2244 Temporary Guardian of Person wcy G INRE: PAULE. HAIGH IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. 21-01-1071 ORDER OF COURT AND NOW, this 26th day of November, 2001, Gregory Cutler, Esq., is appointed to represent Paul E. Haigh at a hearing to appoint a temporary guardian scheduled for Monday, November 26, 2001, at 10:00 a.m., at the Carlisle Regional Medical Center, Carlisle, Pennsylvania. BY THE COURT, Joseph A. Ricci, Esq. 4423 North Front Street Harrisburg, P A 17110 Counsel for Carlisle Regional Medical Center Gregory Cutler, Esq. 50 East High Street Carlisle, P A 17013 Attorney for Paul E. Haigh :rc Vd I Oi_i>?1JaquUYJ ) >jJ~I~ L L: 17 d 9Z ADN LO. -~t3 ;:~;!6eH JOY:;.Jo::>aH . Nov-21-01 11:51A P.20 CONSULTATION Q211b90 HA1G~. PAUL [ JUR(,E"'Sf.N. J C R" 206 W I ~ ~~ AD" 11/14/200 OOBCb/,"1t922 r/c" I CAClLISLE RE(dO"i COOO1'24i4 Consultation to: U. R ~ ~ -h.,..{ M.D. I. Consultation Reaardina: . . '. . .. PAnENTIlENTIFICATION . IF OUTPAITENT. WRITE NAME, ADDREss, AGE Signatun! Attending Physician Date_ Type Consultation: Check One .. Consultation OnlY Consultation and Follow Patient Consultation and Write Orders If aClreed to aerform Drocedures SUClQested and recommendations t. 'tJ ~t..I., ~ t,. J' c... 2.....,.. f-! j~ h'd~-v\ ~~ 7 7/i7 W if j.,( v Cc- . f~ So} {~ N~f c.~~ ~ kur - C;<.a-,. {~ .-y" J F u--.? ~ ,''"1 t:A -YJ;J b- (tt-v"'t. IV"'f . Wh..~ cJ.. C1 vf t.. ~ f C';;i('.::~ V.IM 11:-Y'\ 1.J1.~ (w-vJ l.l J ....,r." '-' L- ~Jt..' .. '" . "~. "" " I nl.1 . ~L (~ l-Wc.~ V'~ !~ (L ~<r~(J;..J ~) ~/'l~ 4'" . f I r L' h.,\ ~"'" . V c, ('\ M1 . ".. ~JJ M If v I=-~ of c... Ir ~~ ~J'(l {().~ 3(.1.. ~411._ 3...> M.D. Date- wl...r ~ ;~~ (~,~\ WNL f () EXHIBIT i I /\ 01 We NOV-21-01 11:51A . , ~,,1.. '7 . .' ~L.-'" ~--'l W . \.Ifv"'" "j. ......:\-- +- I ( /... n I , , -IA.. r ~ /) I . ! r -\ k.L-Y 1...(. w...~ c... 1/. (.('1) () r h>. j I" I \ 1M;). N""" h. d.... :-, k ~...... & ,-Lt.l - ~ ly;~ ("o)(..\LO W~~\.. ~ ('-~ V~~ V~ L ~~ 'tLt 2),ik~. . riA "t..-..." 0 ~~1.1 ~d<. ~f. / ;I'~J'~ ( Q L.\.Nl. C rt.,~rV'\ ~ . ~ li8 Q~ ~ (J 1 tuJ ~~'\ (l ) ~r.~ c}~~ J - L ; J.( 1 v4vc... t t!.rf2 Fr,^-, P wOli::::. _ \f11,\ &, ) \ Mn - ~/..,;~ @J t~ P.21 v.sJ f~ 11) n., G.J.) Q: (<'J~Hl\tn (::;, ~ 5~ 5 (urrr.ll .Q.)! &r~'w\-l. ~ ,'" h~ -/ c..!:f)- ~'f~J; L. '.1 !H\.,rW) l,ou....e. 7....5: Ci. /';Wft C: Ar'! vrl E:' S 1. (h \.. i ~~-l. / ~ L\:v-... j ( r-P ""'-G/Q,") ~ 1 ~ C> ^ ~ f-1(~ 0 /~ ~~ _ v...J,~ ~ ~v~ dL...J:= 1. ~ 1/\ > 1 t"" J. F{..,'--0 - Ct "'Y H,'-"'- '-,.Lv);,- J.. <t-~ ~ k ~ r~\I} I )JY Pf~- - ,.. P.II ~ Nov-21-01 11:46A . HAIGH, PAUL E MS2 0206 W 11/14/2001 172414 CHIEF COMPLAINT: Confusion of disorientation. HISTORY OF PRESENT ILLNESS: This 79-year-old man was recently discharged from the hospital to the Claremont Nursing Home on October gth. His behavior at the nursing home has been unstable. He has been ambulatory and difficult to contain. A psychologic specialist judged that he was competent and he was released to his won quarters on November 1 ~ (?date). He has become disoriented. He was brought to the emergency department today by police. It was evident that he was taking treatment with Zoloft, Vicodin and Robitussin. There was no sign of trauma or seizure. PAST MEDICAL HISTORY: There is evidence for a previous cholecystectomy. He smoked cigarettes for 60 years. The diagnosis of lung cancer was made presumptively in September 2000 - based on a chest x.ray, CT of the chest. No biopsy was done though. Metastatic involvement of the right lobe of the liver was documented by CT. There is no history of seizures. FAMILY HISTORY: He reports having had a brother who died. He has one daughter with whom he is estranged. SOCIAL HISTORY: He served in the military. ?date. His wife died in 1986. He worked for many years as a steel worker. For the next number of years he worked In security at a truck firm. He was placed in the Claremont Nursing Home in October 2001. He has a residence in Carlisle, which answers with a phone message of his own at 218-1016. REVIEW OF SYSTEMS: EAR, NOSE. THROAT: Negative. CARDIORESPIRATORY: He has recurrent cough. GI: Appetite is poor. No report of melena. GU: Negative. NEUROLOGIC: He is unsteady, tremulous. PHYSICAL EXAMINATION GENERAL - He is awake. He comprehends poorly. Attention span is poor. His voice is rough, suspecting laryngeal paralysis. His disoriented to time and place. He has no memory for recent events. He offers< >responses to answers about his work, etc. He has no awareness of the diagnosis of lung cancer. He speaks with sadness concerning the death of his wife 1986(gives the date, time of day and doctors remarks - she had a lung clot). HEENT - Visual function is fair. He is able to count fingers, name objects and follow to the right and left. 9211690 HAIGH, PAUL E MS2 0206 W 172414 11/14/2001 06/17/1922 JURGENSEN, J C Page 1 of 2 ORIGINAL EXHIBIT i, .D L- a ./ tlbId/Oj 0Kl I CARUSLE REGIONAL MEDICAL CENTER HISTORY & PHYSICAL EXAMINATION Nov-21-01 11:46A P.12 HAIGH, PAUL E MS2 0206 W 11/14/2001 172414 The pupils are nonreactive. Praxtic function is done inconsistently with errors. EXTREMITIES - Motor exam shows moderate and generalized weakness. The muscles are :;oft. The legs are hypotonic. Tendon reactions are absent. The toe responses are bilaterally flexor. He is able to stand unsupported but his gait is unsteady, tremulous, mildly ataxic. ADMITTING IMPRESSION - 1. Acute or organic brain syndrome. 2. Organic mental disorder - dementia. 3. Bronchogenic carcinoma - untreated. 4. Obstructive lung disease. JCJ/ja 0: 11/1512001 08:07:21 T: 11/1512001 15:04:01 J. Craig Jurgensen, M.D. C: J. Craig Jurgensen, M.D. 9211690 HAIGH, PAUL E MS2 0206 W 172414 11114/2001 06/17/1922 JURGENSEN, J C Page 2 of 2 ORIGINAL CARLISLE REGIONAL MEDICAL CENTER HISTORY & PHYSICAL EXAMINATION '-;--'~'''':'''~:'''....' ':, '--':'~_:.::::~;i~~~.r~Jf.?f,~:'~.t-::~-~ '-'.' .'," ,~._:c . -, '-':.~:rf{-:~;~:.:~m~'t~,. ~=~:,~~~~; . NOV~Om> Harrisburq. PA 17110 (717) 230-9201 - - -....; ., . r I ! : IN THE COURT OF COMMON PLEAS :CUMBERLANDCOUNTYPENNSYLV~ IN RE: Paul E. Haigh : DOCKET NUMBER: ~l- .01- 1011 : EMERGENCY GUARDIANSHIP ORDER OF COURT - '_. A follow l:'" 0 2. he 2J I :, r\ \ ~ c.. ~ ? -7 bc5'::;'" :J AND NOW THIS ~Day of November 2001, it is hereby dete'rmined that Paul E. Haigh is incapacitated from making appropriate medical decisions on his behalf. It is ordered that David F. Tamanini, Esq. shall be appointed guardian of the person of Paul E. Haigh for the purpose of providing medical decision making oll b~ha)f of Ml;,' . Haigh.:jhis I J f iV rr 2. h ow oS. ) V"? d t ':; ~ ULL,"] e..~~C}) d~ guardianship shall be in force uatH :Novell1Lt:J. 2'7, 200i uak33 extended by further ordgr ef fp-{2-?C!.JiOd Jz.o d/1s. --I- J. L 13 Ottri>A H~)qe.lJU(,-.Oh w~<'!..tlc..r t~It>'./~~fil.J~l 8,\)2.' l2J)/J~ ',' ~~_.J IJ. Le.. W,_dl~C.j err teJ"'1lfl!-fc.d.r~1tl/ bL. ~~f ,'?J) + . 1 (/1\ 2.. (, 2 b <9 I) Ify1THEC,CGmiT 1 s.le. l-/ -=> ~ f /::> 2. ftA<4hd?l J 1\...10\.1. · ~ \O'.CD2,-n. 4 Vd . 'OJ plmfJaqWllO l-lno:J ';U<:)-)fJafO V L: V d l Z AON lO. SII!M iO .l8lS15alj JO 92'~r~>p9D.lo:)aH : IN THE COURT OF COMMON PLEAS :CUMBERLANDCOUNTYPENNSYLV~ IN RE: Paul E. Haigh : DOCKET NUMBER: -. : EMERGENCY GUARDIANSIDP EMERGENCY PETITION FOR TEMPORARY GUARDIANSHIP OF THE PERSON AND NOW Comes, Carlisle Regional Medical Center by and through its counsel, Farrell & Ricci, P.C. by Joseph A. Ricci, Esq., and requests that this Honorable Court to enter an order granting an emergency limited guardianship of the person for Mr. Paul E. Haigh for the following reasons: 1. The alleged incapaciated person is Mr. Paul E. Haigh an adult male aged 79. 2. Mr. Haigh is currently a patient at the Carlisle Regional Medical Center. 3. Prior to his hospitalization, Mr. Haigh resided at 416 First Street Carlisle, PA 17013. 4. The only known relative of Mr. Haigh is an alleged niece whose name is Susan Potts, telephone number 545-3628,516 Ryan Drive Harrisburg, PA 17112-2244. Attempts to contact Ms. Potts to advise her of the situation and the need for the appointment of a guardian have been unsuccessful. 5. Currently Mr. Haigh is receiving medical services at the Carlisle Regional Medical Center, 246 Parker Street, P.O. Box 4100, Carlisle, PA 17013. 6. Prior to his admission to the hospital, Mr. Haigh was receiving residential services from Hospice Preferred Choice, 4811 Jonestown Road, Harrisburg, PA 17112, as well as the Cumberland County Office of Aging, Carlisle, PA 17013. 7. The petitioner requests that this Honorable Court appoint David F. Tamanini, Esq., P.O. Box 6206, Harrisburg, PA 17112 as temporary guardian of the person of Mr. Haigh. 8. Attorney Tamanini provides guardian and power of attorney services to the central Pennsylvania region. (See Description of Guardianship service provided attached hereto-as Exhibit "A") 9. Attorney Tamanini does not have any interest that is adverse to the interests of Mr. Haigh, the alleged incapacitated person. 10. The emergency temporary guardianship of the person is necessary for the following reasons: a) Mr. Haigh is an elderly gentleman who lives alone in public assistance housing. b) Because of his limited financial means, Mr. Haigh lacks the ability to seek private placement for his medical needs. c) The only family member who is known to exist is a niece who resides in the Linglestown area of Harrisburg. d) Mr. Haigh has had no contact with his niece for an extended period of time. e) Mr. Haigh's niece has previously stated that she has no desire to participate in decision making concerning her uncle. f) There are no family members or mends who can provide for surrogate decision making on Mr. Haigh's behalf. g) The Cumberland County Area on Aging has refused to become involved in the care of Mr. Haigh on the grounds that Mr. Haigh refused to sign a form acknowledging his agreement to participate in their services. h) Hospice Preferred Care has relinquished responsibility for the care of Mr. Haigh upon his admission to the Carlisle Regional Medical Center. i) At this time there is no other reasonable alternative to effect the proper care of Mr. Haigh besides the appointment of a temporary guardian of the person. j) Mr. Haigh suffers from terminal, metastatic cancer. As a result of the cancer, Mr. Haigh will suffer from potentially numerous medical complications which will require an ability to understand the nature of the complications and how they will be treated. The treatments necessary will include the need to provide informed consent to permit the medical treatments. k) Mr. Haigh has been found by the Carlisle Regional Medical Center staff psychiatrist, Dr. Rosenthal, to be mentally incompetent and incapable of making reasonable and meaningful decisions on his behalf. (See Affidavit of Dr. Rosenthal attached hereto as Exhibit "Rn) 1) Mr. Haigh is currently suffering from significant fluid collections in his lungs and, as a result, is unable to properly breathe. The inability to breathe, in turn, causes confusion because of a lack of proper oxygenation of the brain. m) Mr. Haigh's attending physician Dr. Jurgensen, believes it is medically necessary and appropriate for Mr. Haigh to, in the immediate future, undergo a bronchoscopy to evaluate the condition of Mr. Haigh's lungs and to alleviate the effects of any fluid collections. (See affidavit of Dr. Jurgensen attached hereto as Exhibit "C.") n) A bronchoscopy is a medical procedure which requires the use of a bronchoscope, a device which is inserted into the patients bronchial tree to visually examine the tissues of the bronchus and the lungs. 0) A bronchoscope can also be used to provide treatment to the patient in the form of removal of tissues and fluids. p) A bronchoscope can also be used to obtain tissue samples for evaluation in an effort to determine the necessity and propriety of future medical care. q) The use of a bronchoscope is an invasive procedure, which requires a patient's informed consent. r) Mr. Haigh is incapable of providing his informed consent to undergo the suggested bronchoscopy. s) Failure to undergo the bronchoscopy could significantly impair the physical health of Mr. Haigh since it will be impossible to properly evaluate and treat the condition giving rise to the fluid collection in the lungs of the patient. t) Failure to undergo the bronchoscopy could result in the premature death of the patient as a result of congestive heart failure. u) Without the appointment of a guardian, the medical staff of the Carlisle Regional Medical Center are unable to provide the reasonable and necessary medical treatments to properly care for Mr. Haigh since the patient is unable to provide the necessary consents for his continued care. 11. A temporary guardianship will permit the appropriate decision making to take place in the short term and potentially avoid the premature and unnecessary death of Mr. Haigh. 12. It is hoped that once Mr. Haigh undergoes the proposed bronchoscopy he will experience an improvement in his breathing which may permit an increased clarity of thought from the increase in oxygenation. 13. If Mr. Haigh's medical condition improves the need for a temporary guardian may cease to exist. - WHEREFORE it is respectfully requested that this Honorable Court issue an order appointing David F. Tamanini, Esq. temporary guardian of the person of Paul E. Haigh for the purpose of providing medical decision making authority. Respectfully submitted, 'cci, P.C. 4423 North Front Street Harrisburg, P A 17110 (717) 230-9201 Counsel for Carlisle Regional Medical Center EXHIBIT A '::::J:"O ....9 CD.:::! 3010l ~~~ ~C)c 6iCD~lD ~~C)5: ::l . 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CD ~ ~2: CI>"O .... - 0.0 s: CD () o !:: ~ EXHIBIT B '. 11/21/01 16:17 Nov-21-01 02:20P ~7172459198 CACS . .t~U_U2 AFFlDA VlT OF DAVID M. ROSENTHAL, M.D. And now this 21&\ day of November, 2.0011. Dr. David M. Rosenthal do hereby swear and affirm: 1. 1 am a physician licensed to practice medicine in the Commonwealth of Pennsylvania. 2. My medical practice is limited to tbe specialty of psychiatry. 3. On November 16. 2001 I performed a psychiatric evaluation of Carlisle Regional Medical Center patient Paul Haigh. 4. As a result of my psychiatric evaluation. it is my professional opinion, held to a reasonable degree of medical certainty that Mr. Haigh suffers from dementia, Alzheimer's type. Additionally 1 believe that Mr. Haigh suffers from delusions. 5. Mr. Haigh does not have an appreciation of the nature of his illness nor the reason for his hospitalization. 6. Mr. Haigh believes he has been hospitalized because of food poisoning caused when he was allegedly bathed by Hospice social workers with water retained after cleaning Mr. Haigh's food dishes. 7. Mr. Haigh is unable to meaningfully participate in his medical decision making. 8. Mr. Haigh suffers from impaired judgment, which pt"events him from making rational and appropriate decisions for his medical care. 9VI(I~ 11/21/01 16:18 .Nov-21-ril O~:20P -o~7172459198 t.::\.t.:S ~UUJ 9. Mr. Haigh is unable to meaningfullY provide consent for medical procedure~ necessary for his medical well being. Respectfully submitted. C},Q l:Q MO Dr. David Rosenthal M. D. //0)/ 0/ AFFIDAVIT OF DAVID M. ROSENTHAL, M.D. And now this 21st day of November, 2001 I, Dr. David M. Rosenthal do hereby swear and affirm: 1. I am a physician licensed to practice medicine in the Commonwealth of Pennsylvania. 2. My medical practice is limited to the specialty of Psychiatry. - 3. On November 16, 2001 I performed a psychiatric evaluation of Carlisle Regional Medical Center patient Paul Haigh. 4. As a result of my psychiatric evaluation, it is my professional opinion, held to a reasonable degree of medical certainty that Mr. Haigh suffers from dementia, Alzheimer's type. Additionally I believe that Mr. Haigh suffers from delusions. 5. Mr. Haigh does not have an appreciation ofthe nature of his illness nor the reason for his hospitalization. 6. Mr. Haigh believes he has been hospitalized because of food poisoning caused when he was allegedly bathed by Hospice social workers with water retained after cleaning Mr. Haigh's food dishes. 7. Mr. Haigh is unable to meaningfully participate in his medical decision making. 8. Mr. Haigh suffers from impaired judgment, which prevents him from making rational and appropriate decisions for his medical care. 9. Mr. Haigh is unable to meaningfully provide consent for medical procedures necessary for his medical well being. Respectfully submitted, 'Dr. David Rosenthal - ~ . ' EXHIBIT C AFFIDAVIT OF CRAIG J. JURGENSEN, M.D. And now this 21st day of November, 2001, I Dr. Craig Jurgensen do hereby swear and affirm: 1. I am a physician licensed to practice medicine in the Commonwealth of Pennsylvania. . 2. My medical practice is limited to the specialty of internal medicine with a subspecialty in neurology. 3. I am the attending physician for Carlisle Regional Medical Center Patient Paul Haigh. 4. Mr. Haigh became my patient on November 14, 2001. 5. Mr. Haigh suffers from lung cancer with metastases to the liver. His condition is ultimately terminal. 6. Mr. Haigh is suffering from pulmonary complications of his lung cancer which are causing the development of bronchial secretions. 7. The presence of the pulmonary secretions causes significant compromise of Mr. Haigh's ability to breath and can lead to significant infectious processes. 8. It is necessary to perform a Bronchoscopy to properly evaluate and treat Mr. Haigh pulmonary secretions. 9. A Bronchoscopy is an invasive procedure which requires a patients informed consent. 10. Mr. Haigh suffers from greatly diminished mental abilities due to a diagnosis of dementia, Alzheimer's type and delusions. .' 11. Mr, Haigh is incapable of understanding the nature of his illness and the manner in which his illness must be treated. 12. Failure to perform a Bronchoscopy will prevent the evaluation and treatment of Mr. Haigh's pulmonary condition. 13. Failure to perform a Bronchoscopy will result in the premature death of Mr. Haigh. 14. A Bronchoscopy is a reasonable and appropriate medical procedure for the care, evaluation and treatment of the patient. -15. A less invasive diagnostic and treatment regimen is not available. Respectfully submitted, Dr. Craig Jurgenson VERIFICATION I, Georgeann Reilly, Risk Manager, Carlisle Regional Medical Center, hereby verify that the facts set forth in the foregoing Emergency Petition for Temporary Guardianship of the Person are true and correct to the best of my knowledge, information and belief. I understand that false statements herein are made subject to the penalties of 18 Pa.C.B. ~4904, relating to unsworn falsification to authorities. CARLISLE REGIONAL MEDICAL CENTER, Date: /1- 2/ -cJ I ~?:./?JAI'/ ~/f< Georgeann Reilly Risk Manager ,., AUTHORITY TO PAY COURT APPOINTED COUNSEL '-'< DEe 1 2 ZOO, if) ~ 1. COURT lICommon Pleas 2. VOUCHER - - o District Justice 0 Appellate o Other N~ 6377 - 3. FOR (D.J., C.P., APPi'kTE) 4. AT (CIr:;S~T1E) /?. 5. BUDGET CODE CO ^" "'" ~ J'\ etAT Cn...r j" c.. 0... (} I-;J~ -kl./ I-DS-/) 6. IN THE CASifF / M . i. 7. CHAR~ffiFENSE (PURDON CITATION) 8. 0 PETIY OFFENSE :Ih /f'e...: OJA. E.~ fA-19' /1/ o FELONY 0 MISDEMEANOR 9. PROCEEDINGS (Describe briefly) 11. PERSON REPRESENTED 12. EiIVIL 6ZCKe, ~_ p~ "Ii;" -(;,. E,....,rz.r/te~ 1 0 Defendant- Adull Or? 'v'S _ 2 0 Defendanl . Juvenile ;),/-01-/07/ G lA.A.rcl ~Y\ 3 0 Appellanl 13. CRIM;:;',MCKET NO. 4 0 Appellee 5 0 Habeas Petitioner 6 0 Malerial Witness 7 o Parol.... Charged Wilh Violation 10. PERSON REPRESENTED (Full Name) 8 o Probationer Charged With Violation 14. AP;lADOCKET NO. ;;/A / E ;-;;'1 J 9 ~ther. Appl Dale I/JU!O} ~ 16. NAME OF ATTORNEY/PAYEE~ND MAILING ADDRESS i CJicu-- T L~p;;~ oj". 7;- ~"[~rc< d /;.J O/V-. ~' NAME OF COMMqN PLEAS JUDGE ASSIGNED TO CASE - ,/t. J 71::>) J 17. TELEjHONE No. ~}IfI~S;(~T~YJ-S= NO (,/7 ;}-;"'1- r-S"Sr CLAIM FOR SERVICES OR EXPENSES 19. SERVICE HOURS DATES AMOUNTS CLAIMED a. Arraignment and/or Plea Multiply rate per hour times total b. Preliminary Hearing hours to obtain "In Court" com. pensatlon. Enter lotal below. e. Motions and Requests .- d. Bail Hearings ,- / I / I " "" a: =' 8. Sentence Hearings '\OP /\ T/ ,. /nd 1/111//JJr=.~ 0 . u f. Trial J '-- '-- 1....'./ - \ ~ g. Revocation Hearings ---- --- --. - h. Juvenile Hearings V /J~.:LI-CI 1"1Jil.1t! f) -.J.I, - {~ 1 , i. Appeals Court (,. -- 19A. TOTAL IN COURT COMPo ~ Other (Specify on additional sheets) - TOTAL HOURS .. X $50 PER HOUR =$ 20. a Interviews and conlerences ,5. , Multiply rate per hour times total b. Obtaining and reviewing records hours. Enter total "Out of Court" ~.- compensation below. Oa: e. Legal research and brief writing .-=' ='0 d. Investigative and other work (Specify on additional sheets) 20A. TOTAL OUT OF COURT au COMPo TOTAL HOURS" $. J ~PE'rI~R .. S ,';; ';NJ , j-U 21. ITEMIZATION OF REIMBURSABLE EXPENSES AMT. PER ITEM Mileage $.25 per mile lC a: w :z: 21A. TOTAL ITEMIZED EXP. ~ 0 -$ 22. CERTIFICATION OF ATTORNEY/PAYEE ~O 23. GRAND TOTAL CLAIMED Has compensation and/or reimbursement for work In this ease previously been applied lor? DYES =$ ~o~C;.SD II yes, were you paid? 0 YES a NO If yes, bywhom_re you paid? How much? 24. DEDUCT. PRIOR PYMTS. Has the person represented paid any mon~~or to your knOW~nYOne else, In connection with the matter for =$ which you were appointed to provide represe n7 0 ~ I' ./"'F.. If yes, give details on add~n%,eets 25. NET AMOUNT C~MED I swear or affirm the truth or correctness " o~ / d J I of the above statements /' J16nature~ Attomey/Psy~ I Date = $ ,-J.:Jt}, .5 (J 26 A"PROV! (II . '-',!/,/ ~ ~()g 27. AMT. APPROVED . FOil Sognalure of ~D.te: .0 ~c... - PAV"'EN' Judge l2 )6'01 .. $ 2.2..'1 ' ~ c:> cMpy 1 - Mail to 6;'urt Administrator at completion of service ..... ; LAW OFFICE OF PAUL BRADFORD ORR 50 East High Street Carlisle, P A 17013 (717) 258-8558 (717) 258-5289 FAX Invoice submitted to: Paul Haigh ******Court Appointed********* File No. 01-280-g December 11, 2001 In Reference To: Emergency Guardianship Invoice #4:25 Professional Services Hrs/Rate Amount 11/21/01 GLC A107 Communicate (outside counsel) 0.30 13.50 Meeting with attorney Joe Ricci to discuss case 45.00/hr 11/23/01 GLC A 104 Review/analyze 0.80 36.00 Review/analyze - client's medical records 45.00/hr GLC A 104 Review/analyze 0.30 13.50 Review/analyze - Emergency Petition 45.00/hr GLC A 107 Communicate (other external) 0.10 4.50 Attempt to reach social worker Diana O'Neil regarding client's condition 45.00/hr GLC A 107 Communicate (other external) 0.30 13.50 Telephone conference with social worker Diana O'Neil in reference to 45.00/hr client's condition and recent deterioration GLC A 107 Communicate (other external) 0.10 4.50 Attempt to contact Dr. Haggerty at Claremont N.H. 45.00/hr GLC A 107 Communicate (other external) 0.10 4.50 Attempt to contact Dr. Haggerty at his office 45.00/hr GLC A 107 Communicate (other external) 0.10 4.50 Attempt to reach Dr. Rosenthal 45.00/hr GLC A 107 Communicate (other external) 0.10 4.50 Attempt to reach Dr. Jurgensen 45.00/hr , __ . r . - . Paul Haigh 11/23/01 GLC A 107 Communicate (other external) Telephone conference with Dr. Jergensen regarding client's condition 11/26/01 GLC A107 Communicate (outside counsel) Telephone conference with attorney David Taminini GLC A 107 Communicate (other external) Telephone conference with Dr_ Haggerty GLC A 107 Communicate (other external) Telpehone conference with Debbie Hornridge regarding client GLC A 109 Appear for/attend Travel time - to and from Carlisle Hospital; and hearing on Emergency Petition For professional services rendered Balance due Page 2 Hrs/Rate Amount 0.20 9.00 45.00/hr 0.20 9.00 45.00/hr 0.20 9.00 45.00/hr 0.30 13.50 45.00/hr 2.00 90.00 45.00/hr 5.10 $229.50 $229.50 We now accept VISA, MASTERCARD, DISCOVER, AMERICAN EXPRESS and other major credit cards. You can also use your MAC or DEBIT/CHECK card for payments!! A late fee of 1 % will be added to all unpaid invoices monthly. HA VE A SAFE AND HAPPY HOLlDA Y SEASON!