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08-6090
IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA No. 0%- IPO 0 Div i _eP m Civil Action - (X) Law ( ) Equity JURY TRIAL DEMANDED PAULFACHENKO 7 Village Court Mecanicsburg, PA 17050 LARYSA FACHENKO 7 Village Court Mechanicsburg, PA 17050 ANDREW FACHENKO, MINOR, by his parent and natural guardian, PAUL FACHENKO, 7 Village Court Mechanicsburg, PA 17050 LYUBOV FACHENKO 7 Village Court Mechanicsburg, PA 17050 Plaintiffs & Addresses PRAECIPE FOR WRIT OF SUMMONS TO THE PROTHONOTARY OF SAID COURT: Please issue writ of summons in the above-captioned action. X Writ of Summons shall be issued and forwarded to (X) Howard B Krua Esquire PURCELL, KRUG & HALLE_ R 1719 N. FRONT STREET HARRISBURG. PA 17102 (717) 234-4178 Name / Address / Telephone No. of Attorney WRIT OF SUMMONS Defendant(s) & Address(es) TO THE ABOVE NAMED DEFENDANT: HARRISBURG PIES, INC. d/b/a DOMINO'S PIZZA YOU ARE NOTIFIED THAT THE ABOVE-NAMED PLAINTIFFS HAVE COMMENCED AN ACTION AGAINST YOU. Z4. Prothonotary Date: 101010k by versus HARRISBURG PIES, INC. d/b/a DOMINO'S PIZZA 1200 Market Street Lemoyne, PA 17043 ( ) Check here if reverse is issued for additional information. Prothon. - 55 Supreme Court ID No. 18626 Date: September 19. 2008 e; 7 . a ? 0 SHERIFF'S RETURN - NOT FOUND CASE NO: 2008-06090 P COMMONTWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND FACHENKO PAUL ET AL VS HARRISBURG PIES INC ET AL R. Thomas Kline Sheriff or Deputy Sheriff, who being duly sworn according to law, says, that he made a diligent search and inquiry for the within named DEFENDANT RUFO ROBERT C PRESIDENT but was unable to locate Him in his bailiwick. He therefore returns the NOTICE AND SUMMONS , the within named DEFENDANT , RUFO ROBERT C PRESIDENT , 1200 MARKET STREET LEMOYNE, PA 17043 NOT FOUND , as to PER BARBER SHOP (NEXT DOOR) DEFENDANTS MOVED OUT 2 MONTHS AGO. NO FORWARDING ON FILE AT POST OFFICE. Sheriff's Costs: Docketing 18.00 Service 14.00 Not Found 5.00 Surcharge 10.00 00 10/a -y/0 P 4 4 Sworn and Subscribed to before me this day of So answerer r ??,•-'` & R. Th?ias Kline Sheriff of Cumberland County PURCELL KRUG HALLER 10/21/2008 A. D. SHERIFF'S RETURN - NOT FOUND CASE NO: 2008-06090 P COMMONTWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND FACHENKO PAUL ET AL VS HARRISBURG PIES INC ET AL R. Thomas Kline Sheriff or Deputy Sheriff, who being duly sworn according to law, says, that he made a diligent search and inquiry for the within named DEFENDANT GINN JAMES G VICE PRESIDENT but was unable to locate Him in his bailiwick. ATO'TT('V ANTr) CTTMMnWTC He therefore returns the NOT FOUND , as to the within named DEFENDANT VICE PRESIDENT 1200 MARKET STREET GINN JAMES G LEMOYNE, PA 17043 PER BARBER SHOP (NEXT DOOR) THEY MOVED OUT 2 MONTHS AGO. NO FORWARDING ON FILE AT POST OFFICE. Sheriff's Costs: So answer Docketing 6.00 r'`M+?- Service ? r .00 Not Found 5.00 R. Thomas nine Surcharge 10.00 Sheriff of Cumberland County .00 ,21 . 00 PURCELL KRUG HALLER 10/21/2008 Sworn and Subscribed to before me this day of , A.D. PAUL FACHENKO, LARYSA FACHENKO, ANDREW FACHENKO, a minor, and LYUBOV FACHENKO, Plaintiffs V. HARRISBURG PIES, INC., Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA NO. 08-6090 CIVIL ACTION - LAW JURY TRIAL DEMANDED PRAECIPE Please reinstate the Writ of Summons filed on October 10, 2008 in the above- captioned matter. RCELL, KRUG Krug, Esquire 1719 North Front Street Harrisburg, PA 17102 Telephone: (717)234-4178 Attorney for Plaintiff R Date: November 7. 2008 Tz) 0 ? N IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA No. 08 - (0090 Ctyi 1 7errl Civil Action - (X) Law ( ) Equity JURY TRIAL DEMANDED PAULFACHENKO 7 Village Court Mecanicsburg, PA 17050 LARYSA FACHENKO 7 Village Court Mechanicsburg, PA 17050 ANDREW FACHENKO, MINOR, by his parent and natural guardian, PAUL FACHENKO, 7 Village Court Mechanicsburg, PA 17050 LYUBOV FACHENKO 7 Village Court Mechanicsburg, PA 17050 Plaintiffs & Addresses HARRISBURG PIES, INC. d/b/a DOMINO'S PIZZA 1200 Market Street Lemoyne, PA 17043 PRAECIPE FOR WRIT OF SUMMONS TO THE PROTHONOTARY OF SAID COURT: Please issue writ of summons in the above-captioned action. X Writ of Summons shall be issued and forwarded to (X) Howard B. Krua. Esauire PURCELL, KRUG & HALLER 1719 N. FRONT STREET HARRISBURG. PA 17102 (717) 234-4178 Name / Address / Telephone No. of Attorney WRIT OF SUMMONS TO THE ABOVE NAMED DEFENDANT: HARRISBURG PIES, INC. d/b/a DOMINO'S PIZZA n N _71 r? ?! 0 Defendant(s) & Address(es) YOU ARE NOTIFIED THAT THE ABOVE-NAMED PLAINTIFFS HAVE COMMENCED AN AGAINST YOU. _ 1W. COPY FROM RECORD In Testin#11 y wt a hn'm UFn1a soi my Inan6 of d t at Car". Pa. 40 D 0 S" ( e te4rel reve or add- itional information. Pro thon. - 55 versus by Supreme Court ID No. 18626 Date: September 19, 2008 SHERIFF'S RETURN - OUT OF COUNTY CASE NO: 2008-06090 P COMMONWEALTH OF PENNSYLVANIA: COUNTY OF CUMBERLAND FACHENKO PAUL ET AL VS HARRISBURG PIES INC ET AL R. Thomas Kline Sheriff or Deputy Sheriff who being duly sworn according to law, says, that he made a diligent search and and inquiry for the within named DEFENDANT GINN JAMES G but was unable to locate Him deputized the sheriff of YORK serve the within NOTICE AND SUMMONS On December 16th , 2008 , this office was in receipt of the attached return from YORK Sheriff's Costs: So ans Docketing 18.00 Out of County 9.00 r' Surcharge 10.00 R. Thomas Kli Dep York County 54.40 Sheriff of Cumberland County Postage 2.19 n 93.59 ? /z? /qJo? `?"' 12/16/2008 PURCELL KRUG HALLER Sworn and subscribe to before me this day of County, Pennsylvania, to VICE PRESIDENT to wit: in his bailiwick. He therefore A. D. SHERIFF'S RETURN - OUT OF COUNTY CASE NO: 2008-06090 P COMMONWEALTH OF PENNSYLVANIA: COUNTY OF CUMBERLAND FACHENKO PAUL ET AL VS HARRISBURG PIES INC ET AL R. Thomas Kline , Sheriff or Deputy Sheriff who being duly sworn according to law, says, that he made a diligent search and and inquiry for the within named DEFENDANT to wit: RUFO ROBERT C PRESIDENT but was unable to locate Him in his bailiwick. He therefore deputized the sheriff of YORK County, Pennsylvania, to serve the within NOTICE AND SUMMONS On December 16th , 2008 , this office was in receipt of the attached return from YORK Sheriff's Costs: So ans Docketing 6.00 Out of County .00 ~ Surcharge 10.00 R. Thomas line .00 Sheriff of Cumberland County .00 Q 16.00 ? 12/16/2008 PURCELL KRUG HALLER Sworn and subscribe to before me this day of A. D. ppppp- 1 OF 2 BOUNTY OF YORK ?t? OF THE SH:RIFF U., G ei PA 17401 a SERVICE CALL (717) 771-9601 i 45".r ORGE 51 *4sTMCT, 3 -SERVICE AFFIDAVIT OF RETURN PLEASE. TYPE OWY 1.M i TiiRU t)o NUT pElr'ACl4 ANY CAMS 2 COURT NUMBER 08-'090 civi 4. TYPE OF WRtT Ta)°e"?PipoS] tiOn Notice to ser COMpANY, CpRQORATiON. ETC TO SERVE OR OESC ice) Ot'tr F ident (personal service) UAL, liti - i3S1n r V1Ce Pres APT NO CITY. SORO. TWP .STATE AND ZIP C +* • - LEVIED. ATTACHED. OR SO' STREET OR RFO V14TH BOX NUMBER, U POSTED 0 O 6 jh]VG York, PA 17404 QCERT. 111 IL aISTCLASSfNA1l 1550 DetVirlleC CHARGE EPUTIZE AT QPEf4SO4 hITY, PA, do hereby deputize the 5,1 z rH,oa7E SERVICE X)OPERSONA 20 08 SHERIFF OF eturn thereof lf, °? er ? COUNTY to execute this V?r? jtc °r SHERIFF OF CO to law. This on being made at the request and risk of the GI SERVICE, CtztllJex'1? OUT OF CO. 8. SPECIAL INSTRUCTIONS OR OTHER INFORMATION THAT WILL ASSISI IN EXPED ADV FEE PAID BY ATTY. C Mty Sheriff. Thank you. of service to Cumberland Please mail return deputy sheriff levying upon or or attaching any prop" under within writ may Ii , without liability on the part of such deputy or the sheriff to ar NOTE: (JNt.Y APPLICABLE ON WRIT OF EXECUTION: N.B. WAIVER OF WATCHMAN of levy or Or attachment without a watchman, in custody of whomever is found in Posbsefore sheriff's sale thereof. 10. TELEPHONE NUMBER > > DJJ herein for any loss. destruction, or removal of any p roperty ESQ . 9 TYPE NAME and ADDRESS of ATTORNEY / ORiGtNATOR and SIGNATUR4 jCtiARD B . KRUG , 717 - 2 3 4 - 417 8 11' completed f nobce is to be matted) 1719 N. FRONT ST.r HARRISBURG, PA 17102 st be i2. SEND NOTICE OF SERVICE COPY TO NAME AND ADDRESS BELOW: area m SHERIFk 13. 1 admowledge recerpr or me -- ., - . nuunt as indicated above. } RESIDENCE ( ) POSTED( 16. HOW SERVED: PERSONAL ( 17 O t hereby certify and return a NOT FOUND because I am unable to locate the i 18. O TITLE OF tNQiViDUAI SERVED/ Lt ADDRESS HERE NO^ 23. Advance Costs oe ?erXj Cpgis 25. N1F 26. Mileage z. $100.00 LJJYE'.1J 34 Fared eatnty Costs 35. Advance Costs 36. Service Costs 41. AFFIRMED and subscribed to bet a me this i -0 4 42. day of --P&WO '1 I NOTARIAL SEAL LISA L. BOWMAN, NOTARY PUBLIC CITY OF YORK, YORK COUNTY -.-AIRSICIN EXPIRES AUG. 12, 2009 SHERIFF'S FFICE ( W' OTHER ( ) _ ----A shi ,see remarks below.) T 28 Sub Trial 29. Pound 30 Notary 31 c7Q 37. Notary Cert. 38. WJPostagelNot found / 44. Signature of ?_Dep. Sheriff 46. Signature o1) County Sheri 48. Signature of Foreign County Sherri i. 32. Tot. Costs 3' 39. Total Costs Ors 5 --TI F .1 COUNTY OF YORK OFFICE 0-of THE SHERIFF S(R?71901` 45 N. GEORGE ST., YORK, PA 17401 m SHERIFF SERVICE INSTRUCTIONS PROCESS RECEIPT and AFFIDAVIT OF RETURN PLEASE TYPE ONLY LINE 1 THRU 12 W NOT DETACH ANY COPIES 1 PLAINTIFF/S/ 2 COURT NUMBER 018 _6090 civil Pc)t 1. racniE!nko et dl 4 TYPE OF WRIT OR COMPLAINT 3 DEFENDANT/S/ Notice t() Tcjk'i D' ??)ositioll Fdr r isburcr Pies Inc Writ of S Rnons SERVE 5 NAME OF INDIVIDUAL, COMPANY. CORPORATION, ETC TO SERVE OR DESCRIPTION OF PROPERTY TO BE LEVIED. ATTACHED, OR SOLD Jd3Tc a Glilll, V1C rEltel7t 'Ta'.Orlcil Si.:IV1Cf? 6 ADDRESS (STREET OR RFO WITH BOX NUMBER. APT NO, CITY, BORO, TWP. STATE AND ZIP CODE) AT 1.550 Detwiler Drive York, PA 17404 7. INDICATE SERVICE X)0 PERSONAL U PERSON IN CHARGE EPUTIZE CE T IL ? 1 ST CLASS MAIL U POSTED U OTHER NOW 1`iovE rber T 2098 I, SHERIFF OF COUNTY, PA, do he eby deputize the sheriff of .cr COUNTY to execute this W I return t ere rding to law. This deputization being made at the re juest and risk of the plaintiff SHERIFF OF COUNTY _ 8. SPECIAL INSTRUCTIONS OR OTHER INFORMATION THAT WILL ASSIST IN EXPEDITING SERVICE O.ilID,, r1cuid Pleds"? r1-'i.1 rei:un) of Service to Cuniberlaild Cbi.mty Snc?riff. Th lit vou. NOTE: ONLY APPLICABLE ON WRIT OF EXECUTION: N.B. WAIVER OF WATCHMAN - Any deputy sherdf levying upon or attaching any property under within writ may leave same without a watchman, in custody of whomever is found in possession, after notifying person of levy or attachment, without liability on the part of such deputy or the sheriff to any plaintiff herein for any loss, destruction, or removal of any property before sheriffs sale thereof 9. TYPE NAME and ADDRESS of ATTORNEY/ ORIGINATOR and SIGNATUR14JOW-k RLj 0) p (y t,, [)t;.; +hi . 110 TELEPHONE NUMBER 111_ DATE FILED 1719 N. FR")NI` S" {-ARf . I S B UPA 17102 i1 )- z ,1'8 1,1 -7 2 12. SENDNOTICE OF SERVICE COPY TO NAME AND ADDRESS BELOW: (This area must be cclniRfelad if is to be mailed) ,00 C _ SPACE BELOW FOR USE OF THE SHOW - BELOW THS LINE 13. 1 acknowledge receipt of the writ 14. DATE RECEIVED 15 Expiration/Hearing Date or complaint as indicated above. N-11-11 1"I(I ,r 16. HOW SERVED' PERSONAL ( RESIDENCE( ) . POSTED ( ) POE( ) SHERIFF'S OFFICE ( OTHER'( ) SEE REMARKS BELOW 17. O 1 hereby certify and return a NOT FOUND because I am unable to locate the, individual, company, etc. named above. (See remarks below) 18. NAME" D TITLE OF INDIVIDUAL SERVED/ LIST ADDRESS HERE IF NOT SHOWN ABOVE (Relationship to Defendant) '1:9 Date of Service 20 Timy of Service i 21 ATtEMPTS Date Time Miles lnt D)a e T me Miles Int Date Time Miles Int. J Date Time Miles Int. Dale Time Miles Int. Date Time Miles Int. ?? , ?i 22. REMARKS r 23. Advance Costs 100.00 L244iieroicie Costs 25 N/F 26 Mileage 27 Postage 28 Sub Total 29. Pound . 30 Notary 31. Surchg. 32. Tot. Costs /,/nI VJQW? Due or Re eck No 34. Foroign County Costs 35. Advance Costs 36 Serv ice Costs 37 Notary Cert 38 M' age/Postage/Nol Found 39. Total Costs 40 Costs ue or a and 'A Rs 41. AFFIRMED and subscribed to befota me this 42 day of _ X11 44. Signature of Dep. Sheriff t. 45. PATE A 7 AT AAAAA NOTARIAL SEAL LISA L. BOWMAN, NOTARY PUBLIC 46. Signature of County Sherirt a7 r ' , f ^ Lf ?, /?f s/?. I7 4 D E { 12 CITY OF YORK, YORK COUNTY MY COMMISSION1 EXPIRES AUG. 12, 2009 ie F keg., County Sheriff 49 DATE 50. 1 AC SIG NATURE 51 DATE RECEIVED OF AUTHORIZED ISSUING AUTHORITY AND TITLE 1. WHITE - Isswng Authority 2. PINK - Attorney 3. CANARY - Sheriffs Office 4. BLUE - Shenfrs office 2 OF2 , COUNTY OF YORK OFFICE -OF THE SHERIFF SERVICE(717) 7,71 96011, 45 N. GEORGE St, YORK, PA 17401 SHERIFF SERVICE INSTRUCTIONS PROCESS RECEIPT and AFFIDAVIT OF RETURN PLEASE TYPE ONLY LINE 1 THRU 12 DO NOT DETACH ANY COPIES 1 PLAINTIFFIS! 2 COURT NUMBER Paul Fachenko et al 3 DEFENDANT/S/ Harrisburg Pies Inc 4. TYPE OF WRIT OR COMPLAINT Notice to Take Deposition SERVE 5 NAME OF INDIVIDUAL, COMPANY, CORPORATION, ETC TO SERVE OR DESCRIPTION OF PROPERTY TO BE LEVIED, ATTACHED. OR SOLD Robert C. Rufo, president (Personal service) PERSONAL 6 ADDRESS (STREET OR RFO WITH BOX NUMBER, APT NO., CITY, BORO, TWP. STATE AND ZIP CODE) AT 1341 Sterling Dr York, PA 17404 OR 2550 Coldspring Rd York, PA 17404 7 INDICATE SERVICE' XX PERSONAL 0 PERSON IN CHARGE DEPUTIZE CERT MA?L ra d 1ST CLASS MAIL ? POSTED ? OTHER NOW November 7 , 20 08 I, SHERIFF OF ?' COUNTY, PA, do hereby deputize the sheriff of York COUNTY to execute this (e return ther o according to law. This deputization being made at the request and risk of the plaintiff., ? / ,.? SHERIFF OF S 8. SPECIAL INSTRUCTIONS OR OTHER INFORMATION THAT WILL ASSIST IN EXPEDITING SERVICE. CLmiberland OUT OF CO. ADV FEE PAID BY ATTY. Please mail return of service to Cwberland County Sheriff. Thank you. NOTE: ONLY APPLICABLE ON WRIT OF EXECUTION: N.B. WAIVER OF WATCHMAN - Any deputy sheriff levying upon or attaching any property under within writ may leave same without a watchman, in custody of whomever is found in possession, after notifying person of levy or attachment, without liability on the part of such deputy or the sheriff to any plaintiff herein for any loss, destruction, or removal of any property before sheriffs sale thereof. 9. TYPE NAME and ADDRESS of ATTORNEY/ ORIGINATOR and SIGNATUREHOWARD B. KRUG, ESQ. 10. TELEPHONE NUMBER 11. DATE FILED 1719 N. FRONT ST., HARRISBURG, PA 17102 717-234-4178 11-7-08 12. SEND NOTICE OF SERVICE COPY TO NAME AND ADDRESS BELOW (This area must be completed d notice is to be mailed) CUMBERLAND CO SHERIFF SPACE KLOW FOR USE OF THE SHERIFF - DO NOT WWM BELOW THIS LN* 13. 1 acknowledge receipt of the writ 14. DATE RECEIVED 15. Expiration/Hearing Date or complaint as indicated above. M J MC G I LL YC S O 111-10-2008 111-26-2008 16. HOW SERVED PERSONAL) RESIDENCE ( ) POSTED( ) POE( ) SHERIFF'S OFFICE ( ) OTHER ( ) SEE REMARKS BELOW IT U I hereby certify and return a N 6T FOUND because I am unable to locate the individual, company, etc named above. (See remarks below.) 18. AAJAIE AND TITLE OFdNDIYIDUAL SERVED ! LIST ADDRESS HERE IF NOT SHOWN ABOVE (Retabonshio to Defendant) 19 Date of Service 20 Time of Service Crr ;5_1*41 6?5_ 23. Advance Costs 24 Service Costs 25 N/F 26. Mileage 27 P 28. Sub Total 29. Pound 30 Notary 31. Surchg. 32 Tot. Costs 33 Costs Due or Refund Check No 34. Foreign County Costs 35. Advance Costs 36 Service Costs Cert 37Notary 38 Mileage/Pos1a e/Not Found 39 Total Costs 40. Costs Due or Refund AFFIRM 4TH 41 SO A RS . 707 VU41&M 42 day Dr- _ 44. Signature of Dep. Sheriff P 45.? AT ? ° NOTARIAL SEMXNOTAR LISA L. BOWMAN, NOTARY PUBLIC CITY OF YORK, YORK COUNTY MY COMMISSION EXPIRES U 46. Signature of Y ??% -! County Shenff !f rle T CHAR DP; it 47 DATE 12/4/08 A G. 12, 2009 48 S ignature of Foreign - 49 DATE County Sheriff 50. 1 AUKNUMILUGt RLU:11'I OF IHE SHERIFF'S RETURN SIGNATURE 151. DATE RECEIVED OF AUTHORIZED ISSUING AUTHORITY AND TITLE 1. WHITE - Isswng Authority 2. PINK - Attorney 3. CANARY - Sheriffs Office 4. BLUE - Sherdfs Office COUNTOF YORK OFFICE -QF THE SHERIFF 45 N. GEORGE ST., YORK, PA 17401 §HERIFF SERVICE PROCESS RECEIPT and AFFIDAVIT OF RETURN 1 PLAINTIFF/S/ pCiu.i rlt' aIlkC3 et dl 3. DEFENDANTS/ )ld3:-r i'St;Urci pies 1110 Z GVUKINUMBER y0-[? 1,71 4 TYPE OF WRIT OR COMPLAINT fl5'Dt2C{.,l' 'Co Tc kS -? D,%g. os 1 t=2C7i1 SERVE UAL, COMPANY, CORPORATION, ETC TO SERVE OR DESCRIPTION OF PROPERTY TO BE LEVIED, ATTACHED. OR SOLD ROert C, t7ufa, r?sid=pat s0r.ri.c j P (PE_rs0I1c1 1. P E F? S E, [v AL 6 ADDRESS (STREET OR RFO WITH BOX NUMBER, APT NO ,CITY, O. TWP , STATE AND ZI CODE) AT 1341 Sterlixlg 17r York, k'A 17404 CSR 2 750 C0_Ldsprirlq Fed York, PA 37404 7. INDICATE SERVICE PERSONAL U PERSON IN CHARGE DEPUTIZE RT MAILdP4 U 1ST CLASS MAIL U POSTED U OTHER NOW ?l'"'rib x 7 , 20 - I, SHERIFF OF rd?000NTY, PA, do hereby deputize the sheriff of 0r. COUNTY to exeCUte t rt a return there f?ccording to law. This deputization being made at ftle request and risk of the plaintiff. - -^L InJ i KUL, I IUNZS UK OTHER INFORMATION THAT WILL ASSIST IN EXPEDITING SERVICE. _. •?. ?. ?? vv T: {t, tm1t arldni M)V k t r? F' ?1 I c ?1n ?f ) Pl<a?s ri i_1 ratt.Irn of sQ vic ? t.0 C'x riberl?iiI(xi ('c:urlt:Y She]-iff. I' aztk - xz, NOTE: ONLY APPLICABLE ON WRIT OF EXECUTION: N.B. WAIVER OF WATCHMAN - Any deputy sheriff levying upon or attachi an ro e without a watchman, in Custody of whomever is found in n9 Y P c rty under within writ may leave same herein for an 1 possession, after notifying person of levy or attachment, without liability on the part of such deputy or the sheriff to any plaintiff any neap.-deswdion, or removal of any property before sheriffs sale thereof. 9. TYPE NAME and ADDRESS of ATTORNEY/ ORIGINATOR and SIGNATURE HOWARD B. M '.Jr SK. 10. TELEPHONE NUMBER 11. DATE FILED :? 719 N. =:'_) NT O'!:"F ,, HARRIS?3URC , PA 12102 717--23.141 8 13 7-08 12. SEND NOTICE OF SERVICE COPY TO NAME AND ADDRESS BELOW. (This area must be completed d notice is lobe mailed) SPACE BELOW FOR USE OF THE SHERFF - DO NOT WRITE BELOW THIS L. 13. I acknowledge receipt of the writ or complaint as indicated above. M J i` C G i L L YC S,-,} 14. DATE RECEIVED 15 Expiration/Hearing Date 1.1-10-2()6= 1.1-26-2003 16. HOW SERVED: PERSONAL ) RESIDENCE ( ) POSTED( ) POE ( ) SHERIFF'S OFFICE ( ) OTHER ( ) SEE REMARKS BELOW 17. U I hereby certify and return a NOT FOUND because I am unable to locate the individual, company, etc named above. (See remarks below.) 18. AID TIT},E OF WDIyIDU L SERVED / LIST ADDRESS HERE IF NOT SHOWN ABOVE (Relationship to Defendant) 19 atrse" jee 20 Time O?fervice 1 TTEMPTS Di to Ti n i s In Date Time Miles Int D to Tirrtc Miles I tS e Tame Mlles Int. Date Time Miles In. ate Time Miles Int. i?i ,?., ,ttr? J? h(t{ tts 7• 22 REMARKS: 23. Advance Costs 124? $O O N, 11415 25 N/F 26 Mileage 27 Postage 28 Sub Total 29. Pound 30 Notary 31. Surchg. 32 Tot. 1 34. Foreign County Costs 1 35. Advance Costs 36 Service Costs 37. Notary Cert. 38. A I, SERVICE CALL (717) 771-9601 INSTRUCTIONS PLEASE TYPE ONLY LINE 1 THRU 12 DO NOT DETACH ANY COPIES 33 Costs Due or Refund ICheck No. Found 1 39 Total Costs 40. Costs Due or Refund 41. AFFIRMED and subscribed to before me this ,' 4 1 r11 - AN RS ,C 42. day of --AO<gD Y)t/d 44. Signature of / Dep. Sheriff r? ?y ! //,, ?1 T+?y? 4? pA r NOTARIAL SEAL 46. Signature of Yor CountySheriR( , "' 'fit: r%t ? i.r i7r 1 Y 47. DATE LISA L. BOWMAN, NOTARY PUBLIC CITY OF YORK, YORK COUNTY 1k, i MY COMMISSION EX.PiRESAUG. 12, 2009 46 Signature of Foreign County Sheriff 49 DATE 50. 1 AC RECEIPT OF THE SHERIFF'S RETURN SIGN ATURE OF AUTHORIZED ISSUING AUTHORITY AND TITLE 51 DATE RECEIVED I. WHITE - Issuing Authority 2. PINK - Attorney 3. CANARY -Sheriff's Office 4. BLUE - Sherdrs Office IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA PAULFACHENKO 7 Village Court Mecanicsburg, PA 17050 LARYSA FACHENKO 7 Village Court Mechanicsburg, PA 17050 ANDREW FACHENKO, MINOR, by his parent and natural guardian, PAUL FACHENKO, 7 Village Court Mechanicsburg, PA 17050 LYUBOVFACHENKO 7 Village Court Mechanicsburg, PA 17050 Plaintiffs & Addresses No. 9-001? - (n D`'t o Civil Action - (X) Law ( ) Equity JURY TRIAL DEMANDED HARRISBURG PIES, INC. d/b/a DOMINO'S PIZZA 1200 Market Street Lemoyne, PA 17043 ROBERT C. RUFO 1341 Sterling Road : York, PA 17404 versus DOMINO'S PIZZA, INC. c/o CT Corporation System 1635 Market Street Philadelphia, PA 19103 Defendant(s) & Address(es) 1?A'5'174J'-' PRAECIPE FOR WRIT OF SUMMONS TO THE PROTHONOTARY OF SAID COURT: Please issue writ of summons in the above-captioned action. X Writ of Summons shall be issued and forwarded to (X) Attorney ( ) Sheriff Howard B. Krug Esquire L. PURCELL, KRUG & HALLER rate: 1719 N. FRONT STREET 4 - HARRISBURG. PA 17102 Court ID No. 18626 (717) 234-4178 2009 Name / Address / Telephone No. of Attorney WRIT OF SUMMONS TO THE ABOVE NAMED DEFENDANTS: HARRISBURG PIES INC. d/b/a DOMINO'S PIZZA. ROBERT C. RUFY, and DOMINO'S PIZZA YOU ARE NOTIFIED THAT THE ABOVE-NAMED PLAINTIFFS HAVE COMMENCED AN ACTION AGAINST YOU. 'Prothonotaryry Date: ?f 7 by ( ) Check here if reverse is issued for additional information. Profhon. - 55 ! OF THWETNMARY 2009 MAY -7 AM !O: 26 PMNNSYL.VANA PAUL FACHENKO, LARYSA IN THE COURT OF COMMON PLEAS FACHENKO, ANDREW FACHENKO, CUMBERLAND COUNTY, PENNSYLVANIA a minor, and LYUBOV FACHENKO, Plaintiffs V. NO. 08-6090 HARRISBURG PIES, INC., CIVIL ACTION - LAW Defendant JURY TRIAL DEMANDED PRAECIPE Please reinstate the Amended Writ of Summons filed on May 7, 2009 in the above-captioned matter. PURCELL, KRUJO & HALLER 16826_x---'??" ri ront Street Harrisburg, PA 17102 Telephone: (717) 234-4178 Attorney for Plaintiff Date: June 2. 2009 C% Ur il ? 4' ; ? ? .e.. V . 7 ? { ?? i ? ` 3 f r'- .? a a?d?? Sheriffs Office of Cumberland County R Thomas Kline ?a,"Iatn of L rrrn6rEdward L Schorpp Sheri ' Solicitor Ronny R Anderson Jody S Smith Chief Deputy OFFICE OF?-E SkERIFF Civil Process Sergeant SHERIFF'S RETURN OF SERVICE 05/07/2009 R. Thomas Kline, Sheriff who being duly sworn according to law states that he made a diligent search and inquiry for the within named defendant, to wit: Robert C. Rufo, but was unable to locate him in his bailiwick. He therefore deputized the Sheriff of York County, PA to serve the within Writ of Summons according to law. 05/19/2009 08:40 AM - York County Return: And now May 19, 2009 at 0840 hours I, Richard P. Keuerleber, Sheriff of York County, Pennsylvania, do herby certify and return that I served a true copy of the within Writ of Summons, upon the within named defendant, to wit: Robert C. Rufo by making known unto himself personally, defendant at 1341 Sterling Road York, PA 17404 its contents and at the same time handing to him personally the said true and correct copy of the same. 06/08/2009 R. Thomas Kline, Sheriff, who being duly sworn according to law, states that he made a diligent search and inquiry for the within named defendant to wit: Harrisburg Pies, Inc., but was unable to locate them in his bailiwick. He therefore returns the within Writ of Summons as not found as to the defendant Harrisburg Pies, Inc. The business Harrisburg Pies, Inc. is no longer in business. SHERIFF COST: $58.00 June 08, 2009 2008-6090 Paul Fachenko V Harrisburg Pies SO ANSWERS, R THOMAS KLINE, SHERIFF C s , C= C :? IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA No. 9-00`6 ^ (D 0`7 0 Civil Action - (X) Law ( ) Equity -a JURY TRIAL DEMANDED PAULFACHENKO 7 Village Court Mecanicsburg, PA 17050 LARYSA FACHENKO 7 Village Court Mechanicsburg, PA 17050 ANDREW FACHENKO, MINOR, by his parent and natural guardian, PAUL FACHENKO, 7 Village Court Mechanicsburg, PA 17050 LYUBOV FACHENKO 7 Village Court Mechanicsburg, PA 17050 versus HARRISBURG PIES, INC. d/b/a DOMINO'S PIZZA 1200 Market Street Lemoyne, PA 17043 ROBERT C. RUFO 1341 Sterling Road York, PA 17404 DOMINO'S PIZZA, INC. c/o CT Corporation System 1635 Market Street Philadelphia, PA 19103 Plaintiffs & Addresses f1r?A!5' RAECIPE FOR WRIT OF SUMMONS TO THE PROTHONOTARY OF SAID COURT: Please issue writ of summons in the above-captioned action. X Writ of Summons shall be issued and forwarded to (X) Attorney ( ) Sheriff Q? c' E LA C D V r? o Lac ?v co Defendant(s) & Address(es) Howard B. Krug, Esquire _ PURCELL, KRUG & HALLER 'g a 6 e 1719 N. FRONT STREET HARRISBURG. PA 17102 preme Court ID No. 18626 (717) 234-4178 Name / Address / Telephone No. of Attorney WRIT OF SUMMONS s 0 c o L 0 o f\; s TO THE ABOVE NAMED DEFENDANTS: HARRISBURG PIES. INC. d/b/a DOMINO'S PIZZA ROBERT C RUFY and DOMINO'S PIZZA YOU ARE NOTIFIED THAT THE ABOVE-NAMED PLAINTIFFS HAVE COMMENCED AN ACTION AGAINST YOU. othonotary Date: e!& :-;7 4; eog by ( ) Check here if reverse is issued for additional information. Prothon. - 55 ? COUNTY OF YORK OFFICE OF THE- SHERIFF 45 N. GEORGE ST., YORK, PA 17401 SERVICE CALL (717) 771-9601 SHERIFF SERVICE PROCESS RECEIPT and AFFIDAVIT OF RETURN 1 PLAINTIFFS/ PAUL FACHENKO, LARYSA FACHENKO, ANDREW FACHENKO Twm rtlrTN) TIT !'[7LITfl/1 INSTRUCTIONS PLEASE TYPE ONLY LINE 1 THRU 12 DO NOT DETACH ANY COPES 2. COURT NUMBER 2008-6090 ..AI cal\IT 3 DEFENDANT/SIHARRISBURGy PIES, INC. D/B/A DOMINO'S PIZZA ROBERT C. RUFO AND DOMINO'S PIZZA INC. SERVE 5 NAME OF INDIVIDUAL, COMPANY, CORPORATION. ETC TO SERVE OR DESCRIPTION OF PROPERTY TO BE LEVIED, A I I AGntU, UK OULU HARRISBURG PIES, INC D/B/A DOMINO'S PIZZA 6. ADDRESS (STREET OR RFO WITH BOX NUMBER, APT NO. CITY, BORO. TWP. STATE AND ZIP CODE) AT 1200 MARKET STREET LEMOYNE, PA 17043 C.a?• ---------------------------- 7. INDICATE SERVICE 30 PERSONAL O PERSON IN CHARGE U DEPUTIZE O CERT MAIL U 1 ST CLASS MAIL U POSTED U OTHER NOW MAY 7, 2009 20 I, SHER COUNTY, PA, do hereby deputize the sheriff of vORK COUNTY to executgS Jli4iake return they of according to law. This deputization being made at the request and risk of the plaintiff., SHERIFF 8. SPECIAL INSTRUCTIONS OR OTHER INFORMATION THAT WILL ASSIST IN EXPEDITING SERVICE. *PERSONAL SERVICE NOTE: ONLY APPLICABLE ON WRIT OF EXECUTION: N.B. WAIVER OF WATCHMAN - Any deputy sheriff levying upon or attaching any property under within writ may leave same without a watchman, in custody of whomever is found in possession, after notifying person of levy or attachment, without liability on the part of such deputy or the sheriff to any plaintiff herein for any loss, destruction, or removal of any property before sheriffs sale thereof. 9. TYPE NAME and ADDRESS of ATTORNEY / ORIGINATOR and SIGNATURE 10. TELEPHONE NUMBER 11. DATE FILED HOWARD P. KRUG, ESQUIRE 717-234-4178 05/07/2009 12. SEND NOTICE OF SERVICE COPY TO NAME AND ADbRE§§ BELOW: (This area must be completed d notice is to De manea) CUMBERLAND COUNTY SHERIFFS OFFICE SPA BELOW FOR USE OF THE SHERIFF - DO NOT WRITE BELOW TENS 1 13. 1 acknowledge receipt of the writ 14. DATE RECEIVED or oomplaint as indicated above. 15. Expiration/Hearing Date 16. HOW SERVED: PERSONAL ( ) RESIDENCE ( ) POSTED( ) POE ( ) SHERIFF'S OFFICE ( ) OTHER( ) SEE REMARKS BELOW 17. O I hereby certify and return a NOT FOUND because I am unable to locate the individual, company, etc. named above. (See remarks below.) 18. NAME AND TITLE OF INDIVIDUAL SERVED / LIST ADDRESS HERE IF NOT SHOWN ABOVE (Relationship to Defendant) 19. Date of Service 20 Time of Service 21. ATTEMPTS Date Time Miles Int. Date Time Miles Int. Date Time Miles Int. Date Time Miles Int. Date Time Miles Int. Date Time Miles Int. 22. OUT OF YORK COUNTY. 23. Advance Costs 24 Service Costs 25. N/F 25. Mileage 27. Postage 28. Sub Total 29. Pound 30 Notary 31. Surchg. 32. Tot. Costs 33 Costs Due or Refund Check N 34. Foreign County Costs 35. Advance Costs 36 Service costs 37. Notary Cert. 38. Mileage/Poslage/Not Found 39. Total Costs 40. Costs Due or Refund SO ANSWERS 41. AFFIRMED and subscribed to befo me IN 29 44. Signature of 45. DATE 42. day of M M p. Sheriff / NOTARY 46. Signature of York 4--1117 ov 47. DATE N,0 `A?-.I; .L a ..'.SAL Y aunty Sheriff LfSA L. BO'?b'ivi NOTARY PUBLIC _2_09 CITY OF YOR<, YORK COUNTY RICHARD P. SHE,R F MY CON'IMISSIOIy EXPIRES AUG. 12, 2009 48. Signature of Foreign 49 DATE County Sheriff 50. 1 ACKNOWLEDGE RECEIPT OF THE SHERIFF'S RETURN SIGNATURE 51 DATE RECEIVED OF AUTHORIZED ISSUING AUTHORITY AND TITLE 1. WHITE - Isswng Authority 2. PINK - Attorney 3. CANARY - Shentrs Office 4. BLUE - Sheriffs Office BRIT OF SUMMONS 77 s" COUNTY OF YORK OFFICE OF THE SHERIFF 45 N. GEORGE ST.,YORIC, PIA 17401 SERVICE CALL (717) 771-9601 SHERIFF SERVICE PROCESS RECEIPT and AFFIDAVIT OF RETURN 1 PLAINTIFF/Sl PAUL t'AL 1I!AN SU, I-At(X AND LYUBOV FACHENKO , ANDREW FACHENKO INSTRUCTIONS PLEASE TYPE ONLY LINE 1 THRU 12 DO NOT DETACH ANY COPIES ijHARRISBURG PIES, INC. D/B/A DCMINO'S PIZZA ROBERT C. RUFO AND DCMINO'S PIZZA, INC. 2 COURT NUMBER 2008-6090 4. TYPE OF WRIT OR COMPLAINT WRIT OF S1144ONS SERVE 5 NAME OF INDIVIDUAL, COMPANY, CORPORATION, ETC TO SERVE OR DESCRIPTION OF PKUPtK i T IV nt LCV ICU, ..-- HARRISBURG PIES, INC. D/B/A DCMINO'S PIZZA 6 DRES TREET OR RFO WITH BOX NUMBER, APT NO CITY, BORO. TWP, STATE AND ZIP CODE) AT 1268 STREET LEMOYNE, PA 1704 7. INDICATE SERVICE X3 PERr NAL D;PERSON IN CHARGE 0 DEPUTIZE 0 CER MAIL 1S 'CLASS MAIL U POSTED , LJ OTHER 2UU9 "F' 20 I, SHER COUNTY, A, d0 ereby?deputiz'e the sheriff of MAY r NOW YORK _ COUNTY to execute thi a return the ording to law. This deputization being matte at the request and risk of the pliaintA. SHERIFF OF OUNTY 8. S CIAL INSTRUCTIONS OR OTHER INFORMATION THAT WILL ASSIST IN EXPEDITING SERVICE. *P RSONAL SERVICE a VWE: ONLY APPLICABLE ON WRIT OF EXECUTION: N.B. WAIVER OF WATCHMAN - Any deputy sheriff levying upon or attaching any properly under within writ may leave same without a watchman, in custody of whomever is found in possession, after notifying person of levy or attachment, without liability on the part of such deputy or the sheriff to any plaintiff .u._:... -- 1- elearnirtinn nr removal of anv Drooerty before sheriffs sale thereof. E and ADDRESS of ATTORNEY / ORIGINATOR and SIGNATURE P. KRUG ESQUIRE 10. TELEPHONE NUMBER 717-234-4178 I7. OA E riLr-u )5/07/2009 1719 N. FROM STREET HARRISMRG, PA 17102 12. SEND NOTICE OF SERVICE COPY TO NAME AND MBOER Sr NDo1M. ("M aremust be aSHERIFFS tOFF'ICEs to be mailed). MM- 1 ODURIMUSE ISCXJARE, 303 CARLISLE, SPACE BELOW FOR USE OF THE SHERFF - DO NOT WRITE BELOW THMS LM 14. DATE RECEIVED 15. Expiration/Hearing Date 13. 1 acknowledge receipt of the writ or complaint as indicated above. 16 HOW,SERVED: PERSONAL ( ) RESIDENCE ( ) POSTED( ) POE ( ) SHERIFF'S OFFICE ( ) OTHER( ) SEE REMARKS BELOW IT O I hereby certify and ie[urn a NOT FOUND because I am unable to locate the individual, company, etc. named above. (See remarks below.) 18. NAME AND TITLE OF INDIVIDUAL SERVED / LIST ADDRESS HERE IF NOT SHOWN ABOVE (Relationship to Defendant) 19. Dale of Service 20 Time of Service 21. ATTEMPTS 'Date Time Miles Int Date Time Miles Int Date Time Miles Int. Date Time Miles InL Date Time Miles Int. Date Time des Int. 22. REMARKS OUT OF YORK COUNTY. 23. Advance Costs 24 Service Costs 25. N/F 26. Mileage 27. P,pstage 28. Sub Total 29. Pound 30 Notary 31. Surchg. 32. Tot. Costa 34. Foreign County Costs 35. Advanc a Costs 36 Service Costs 37. Notary Cert. 38. Mileage/Postage/Not Found 39. Total Costs 41. AFFIRMED and subscribed to befo* me INs -- 4. Signatureof OW'0% ?_ 42, day ep. Sheriff t?!0T„?.!AL 5? -p?p?fMY / NOTAR - 48. Cou Signature of York ShenR nty NOT.,.f;`r ??uBLIC 7LISAL. K COUNTY : . ? KE RICHARD P i TY 0 'YG MISSION FXP1-ESn1JG. 12, 2009 48. Signature of Foreign County Sheriff I ACKNOWLEDGE RECEIPT OF THE SHERIFF'S RETURN SIGNATURE 50 . OF AUTHORIZED ISSUING AUTHORITY AND TITLE 33 Costs (hie or Refund Check n 40. Costs Due or Refund 45. DATE 47. DATE ?- 5-29-09 49 DATE 51 DATE RECEIVED 1. WHITE - Issuing Authority 2. PINK - Attorney 3. CANARY . Sheriffs Office 4. BLUE - Sherdfs Office 4 - i ? IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA No. 9-00`6 ^ (D 0910 Civil Action - (X) Law ( ) Equity JURY TRIAL DEMANDED` PAUL FACHENKO HARRISBURG PIES, INC.; ` d/b/a DOMINO'S PIZZA'' ?_ <<2 7 Village Court 1200 Market Street ° Mecanicsburg, PA 17050 Lemoyne, PA 17043 ° LARYSA FACHENKO v 7 Village Court ROBERT C. RUFO ?s_ -- ° °>_ C7 Mechanicsburg, PA 17050 1341 Sterling Road `v York, PA 17404° z ANDREW FACHENKO, MINOR, by his parent versus -Cand natural guardian, PAUL FACHENKO, DOMINO'S PIZZA, INC. 7 Village Court c/o CT Corporation System W Mechanicsburg, PA 17050 1635 Market Street Philadelphia, PA 19103 LYUBOV FACHENKO 7 Village Court Mechanicsburg, PA 17050 Plaintiffs & Defendant(s) & ?ddresses Address(es) PRAECIPE FOR WRIT OF SUMMONS TO THE PROTHONOTARY OF SAID COURT: Please issue writ of summons in the above-captioned action. X Writ of Summons shall be issued and forwarded to (X) Attorney ( ) Sheriff Howard B Krug Esquire PURCELL KRUG & HALLER rate:Mavy tt6rxev' 1719 N. FRONT ST REET HARRISBURG PA 17102 rt ID No. 18626 (717 234-4178 2009 Name / Address / Telephone No. of Attorney WRIT OF SUMMONS TO THE ABOVE NAMED DEFENDANTS: HARRISBURG PIES INC d/b/a DOMINO'S PIZZA, ROBERT C. RUFY, and DOMINO'S PIZZA YOU ARE NOTIFIED THAT THE ABOVE-NAMED PLAINTIFFS HAVE COMMENCED AN ACTION AGAINST YOU. P o onotary Date: 7. by ) Check here if reverse is issued for additional information. Prothon. - 55 COUNTY OF YORK OFFICE OF THE SHERIFF 45 N. GEORGE ST., YORK, PA 17401 i?t SERVICE CALL. (717) 771-9601 SHERIFF SERVICE PROCESS RECEIPT and AFFIDAVIT OF RETURN INSTRUCTIONS PLEASE TYPE ONLY LINE 1 TAU 12 DO NOT DETACH ANY COPES 1 PLAINTIFF/S/ PAUL FAC'HENKO, LARYSA FACHENKO, ANDREW FACHENKO T VrTonx7 L-Ar =1KTVC) 2 `vuKl NUMCrrt 2008-6090 4. TYPE OF WRIT OR COMPLAINT 3. DEFENDANT/VHARRISBURG PIES. INC. D/B/A DOMINO'S PIZZA I WRIT OF SUMMONS ROBERT C RUFO AND DOMINO'S PIZZA SERVE 5 NAME OF INDIVIDUAL, COMPANY. CORPORATION, ETC TO SERVE OR DESCRIPTION Of PROPERTY TO BE LEVIED ATTACHED OR SOLD ROBERT R OR RFO WITH BOX NUMBER, APT NO. CITY. BORO. TWP., STATE AND ZIP CODE) 6 ADDRESS (STREET OR AT 1341 STERLING ROAD YORK, PA 17404 7. INDICATE SERVICE' 9 PERSONAL U PERSON IN CHARGE U DEPUTIZE U CERT MAIL U 1 ST CLASS MAIL U POSTED U OTHER NOW MAY 7 2009 , 20 I, SHERIF COUNTY, PA, do hereby deputize the sheriff of YORK COUNTY to ex th_i ke return th ?corrd?nngg execute ? SHERIFF OF ito law. This deputization being made at the request and risk of the plaintiff. ??'?"t 8. SPECIAL INSTRUCTIONS OR OTHER INFORMATION THAT WILL ASSIST IN EXPEDITING SERVICE. OUT OF CO CUMBERLAND *PERSONAL SERVICE ADV FEE PAID BY ATTY. NOTE: ONLY APPLICABLE ON WRIT OF EXECUTION: N.B. WAIVER OF WATCHMAN - Any deputy sheriff levying upon or attaching any property under within writ may leave same without a watchman, in custody of whomever is found in possession, alter notifying person of levy or attachment. without liability on the part of such deputy or the sheriff to any plaintiff herein for any loss, destruction, or removal of any property before sheriffs sale thereof. 9. TYPE NAME and ADDRESS of ATTORNEY / ORIGINATOR and SIGNATURE 10. TELEPHONE NUMBER 11. DATE FILED HOWARD P. KRUG, ESQUIRE 717-234-4178 5/07/2009 rra nnTL?DT TtX' DT 171 n7 iled). . 12. SEND NOTICE OF SERVICE COPY TO NAME AND ADDRESS BELOW: (This area must be completed ii notice is to be ma 00 RI SF :SQUARE, W RNF RLTSLE PA 1770 CUMBERLAND CO SHERIFF SPACE BELOW FOR USE OF THE SHERIFF - DO NOT WRITE BELOW THIS LM 14. DATE RECEIVED 15. Expiration/Hearing Date 13. 1 acknowledge receipt of the writ or complaint as indicated above. MJM MCGILL YCSO 5-11-09 6-6-09 16. HOW SERVED: PERSONAL (I RESIDENCE ( ) POSTED( ) POE ( ) SHERIFF'S OFFICE ( ) OTHER ( ) SEE REMARKS BELOW O 1 hereby certify and return a N T FOUND because 1 am unable to locate the individual, company, etc. named above. (See remarks below.) 18. A O TITL OF IN IDU L SERVED /LIST ADD ?Ik1EREt IF SHOvO)/E?Relationship to Defendant) 19. D-teQf Sena 2tTime ??Service 21. ATTEMPTS p to Time Miles nt. Dale Time Miles In. Date Time Miles Int. Date Time Miles Int. Date Time Miles Int. Date Time Miles In . ,e W S 1 10 22. REMARKS: 23. Advance Costs 24. Service Costs 25 ?Nla 2L-M ge 2 X100. 0COD 1 - 34. Foraipn County Costs 35. Advance Costs 36 Service Costs 41. AFFIRMED and subscribed to be re me i 29th 42. day of.?(?? A . 5Fl$RV SEAL LISA L P `.` JOTARY PUBLIC MY C:' "1','J 1!S 1= r Al1G. 12. 21 Dstage 2?Y8. Sub Total 29. Pound :+n u^s"-^' 31. Surch 37. Notary Cert 38. Mileagelpostage(Not Found 44. Signature bf Dep. Sheriff k 46. Signature County Sheriff // RICHARD P . ISE 48 Signature of Foreign County Sheriff g. 32. Tot. Costs 133 Corp Due (t Rele'luunn- j(.;necK N' 39. ial Costs 40. Costs Due or Refund DA 70, 47? 47. DATE 2.9-09 49. DATE 5t. DATE RECEIVED 5o. I ACKRD9VCEDGE 1tEC p1""" "'" OF AUTHORIZED ISSUING AUTHORITY AND TITLE 1. WHITE - lsswng Authority 2. PINK - Attorney 3. CANARY - Sheriffs Office 4. BLUE - Sheriffs Office a« • ' COUNTY OF YORK OFFICE OF T1= a SHERIFF S(R )t77t 96011) 45 N. GEORGE ST.,YORK FA 17401 SHERIFF SERVICE INSTRUCTIONS PROCESS RECEIPT and AFFIDAVIT OF RETURN PLEASE TYPE ONLY U NE 1 THRU 12 DO NOT DETACH ANY COPES 1 PLAINTIFFS/ PAUL FACHENKO, LARYSA FACHENKO, ANDREW FACHENKO AND LYUBOV FACHENKO 3 DEFENDANT/S/ HARRISBURG PIES. INC. D/B/A DOMINO'S PIZZA ROBERT C. RUFO AND DOMINO'S PIZZA `WRIT OF SUMS SERVE 5 NAME OF INDIVIDUAL, COMPANY, CORPORATION. ETC TO SERVE OR DESCRIPTION OF PROPERTY TO BE LEVIED, ATTAGHhU, UK sULU ROBERT C RUFO PFRSnNAi 6 ADDRESS (STREET OR RFO WITH BOX NUMBER. APT NO , CITY, BORO. TWP . STATE AND ZIP CODE) AT 1341 STERLING ROAD YORK, PA 17404 7. INDICATE SERVICE: M PERSONAL O PERSON IN CHARGE U DEPUTIZE U 1 ST CLASS MAIL U POSTED U OTHER pla 4M NOW MAY 7, 2009 , 20 I, SHERI F'OF COUNTY, Ff& d ,hereby deputize the sheriff of YORK COUNTY to execute th" a return th ording to law. This deputization being made at the request and risk of the plaintiff. SHERIFF OF Z OUNTY 8. SPECIAL INSTRUCTIONS OR OTHER INFORMATION THAT WILL ASSIST IN EXPEDITING SERVICE. OUT OF CO CUMBERLAND *PERSONAL SERVICE x ADV FEE PAID BY ATTY. i DOTE: ONLY APPLICABLE ON WRIT OF EXECUTION: N.B. WAIVER OF WATCHMAN - Any deputy sheriff levying upon or attaching any property under within writ may leave same without a watchman, in custody of whomever is found in possession, after notifying person of levy or attachment. without liability on the part of such deputy or the sheriff to any plaintiff herein for any loss, destruction, or removal of any property before sheriffs sale thereof. 9. TYPE NAME and ADDRESS of ATTORNEY / ORIGINATOR and SIGNATURE 10. TELEPHONE NUMBER 11. DATE FILED HOWARD P. KRUG, ESQUIRE 717-234-4178 5/07/2009 1719 N. FRONT STREET HARRISBURG PA 17102 12. SEND NOTICE OF SERVICE COPY TO NAME AND ADDRESS BELOW: (This area must be completed ii notice is to be mailed). 1 OGUMSE ORE,EW303FMISLE, PA 17103 CUMBERLAND CO SHERIFF cr> nr orr nUa 0^0 1IOC nc TLW CLMMMGC - nn NnT WRITE BELOW T14S t_NE 13. 1 acknowledge receipt of the writ r 14. DATE RECEIVED 15 Expiration/Hearing Date or complaint as indicated above. M;M MCGILL YCSO 5-11-09 6-6-09 16. HOW,15fRVED: PERSONAL ( RESIDENCE ( ) POSTED( ) O (:..) SHERIFF'S OFFICE ( ) OTHER ( ) SEE REMARKS BELOW I hereby certify and returna N OT FOUND because I am unable to locate the individual, company, etc. named above. (See remarks below.) MA O TITL FIN DU t SERVED / LIST ADD S ERE IF NAT SHO ABO (Relationship to Defendant) 196atq Se 20 pf Service _ 21. ATTEMPTS O to Time, Miles lnt Date Time iles Int. Date Time Miles Int. J Date Miles Int. Date Time Miles Int. J L 6 l _ ? 22. REMARK5: 23. AdvanceCosts $100.00 34. FooWgn Count t 24. Service Costs 25 N/F 2 ileage 27. Postage 28. Sub Total 29. Pound ;a-M +bw 31. Surchg. 32 Tot Costs 33 Costs Due Refund heck No f fc? ?a Costs 35. Advance Costs 36 Service Costs 37. Notary'Leit 38.0 ieage/Pos 0 39 7rdtal t'iosts` -40"C6d L7t*'Or Refund 41. AFFIRMED amend"subscribed to bet re me i 9th 4.. Signature of 4 AT I'V 0 410 At 42. day of my,Mc wl' Dep. Sheriff / 7 1 47.OATE 46. Signature NOTAR",4L SEAL County Sheriff USA L. NOTARY F3UBUC RICHARD P. , S ERIFF -29-09 CITY O Y Y- .K COUNTY 49. DATE MYC0MMISoI3 XPiPESAUG.12,2009 48. Signatureof County Sheriff 50. 1 ACKNOWLEDGE RECEIPT OF THE SHERIFF'S RETURN SIGNATURE 51 DATE RECEIVED OF AUTHORIZED ISSUING AUTHORITY AND TITLE 2. COURT NUMBER 2008-6090 1. WHITE - Issuing Authority 2. PINK - Attorney '3. CANTY • Sheriffs Office 4 ' BLUE SlIews#OflVe PAUL FACHENKO, LARYSA IN THE COURT OF COMMON PLEAS FACHENKO, ANDREW FACHENKO, CUMBERLAND COUNTY, PENNSYLVANIA a minor, and LYUBOV FACHENKO, Plaintiffs V. HARRISBURG PIES, INC., Defendant NO. 08-6090 CIVIL ACTION - LAW JURY TRIAL DEMANDED PRAECIPE Please reinstate the Amended Writ of Summons filed on May 7, 2009 in the above-captioned matter. PURCELL, KRUG & HAL!LER By re '17 9 North Front Street arrisburg, PA 17102 Telephone: (717) 234-4178 Attorney for Plaintiff Date: June 29, 2009 -6) RLED4--,:=rl CE OF 'ME PPOI I;-N ARY 2099 JUN 30 AN 10: 05 r- I r,I E 411 /d -/I/? o6 IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA No. SLOOP " b D'? 0 Civil Action - (X) Law ( ) Equity JURY TRIAL DEMANDED PAULFACHENKO 7 Village Court Mecanicsburg, PA 17050 LARYSA FACHENKO 7 Village Court Mechanicsburg, PA 17050 ANDREW FACHENKO, MINOR, by his parent and natural guardian, PAUL FACHENKO, 7 Village Court Mechanicsburg, PA 17050 LYUBOVFACHENKO 7 Village Court Mechanicsburg, PA 17050 versus HARRISBURG PIES, INC. d/b/a DOMINO'S PIZZA 1200 Market Street Lemoyne, PA 170,43 ROBERT C. RUFO 1341 Sterling Road York, PA 17404 J, x.- p_. DOMINO'S PIZZA, INC. c/o CT Corporation System 1635 Market Street: Philadelphia, PA 19103 Plaintiffs & Addresses 0A ,80b??J PRAECIPE FOR WRIT OF SUMMONS TO THE PROTHONOTARY OF SAID COURT: Please issue writ of summons in the above-captioned action. p; j " : Defendant(s) &7 Address(es) X Writ of Summons shall be issued and forwarded to (X) Attorney ( ) Sheriff Howard B. Krug, Esquire '? PURCELL, KRUG & HALLER 'g a tt6 e 1719 N. FRONT STREET HARRISBURG, PA 17102 preme court ID No. 18626 (717) 234-4178 ate: ?r to, 2009 Name / Address / Telephone No. of Attorney WRIT OF SUMMONS TO THE ABOVE NAMED DEFENDANTS: HARRISBURG PIES, INC. d/b/a DOMINO'S PIZZA, ROBERT C. RUFY, and DOMINO'S PIZZA YOU ARE NOTIFIED THAT THE ABOVE-NAMED PLAINTIFFS HAVE COMMENCED AN ACTION AGAINST YOU. rothonot?ary Date: 7 _.24:?7y' by ( ) Check here if reverse is issued for additional information. Prothon. - 55 ?J ?? 01b L-PiH617 W IN IN-11 Sheriffs Office of Cumberland County R Thomas Kline a?,t,jv ct urn r ? Edward L Schorpp Sheriff Solicitor Ronny R Anderson Jody S Smith Chief Deputy OFP ?E -_1 '"E S"ERIFF Civil Process Sergeant Paul Fachenko vs. Case Number Harrisburg Pies, Inc. 2008-6090 SHERIFF'S RETURN OF SERVICE 06/23/2009 R. Thomas Kline, Sheriff who being duly sworn according to law states that he made a diligent search and inquiry for the within named defendant, to wit: Domino's Pizza, Inc. c/o CT Corporation, but was unable to locate them in his bailiwick. He therefore deputized the Sheriff of Dauphin County, PA to serve the within Amended Writ of Summons according to law. 07/29/2009 11:10 AM -Dauphin County Return: And now June 29, 2009 at 1110 hours I, Jack Lotwick, Sheriff of Dauphin County, Pennsylvania, do herby certify and return that I served a true copy of the within Amender Writ of Summons, upon the within named defendant, to wit: Domino's Pizza by making known unto Bob Sersch, Coroporate Operations Specialist at 116 Pine Street Suite 320 Harrisburg, PA 17101 its contents and at the same time handing to him personally the said true and correct cony of the same - SHERIFF COST: $37.44 July 02, 2009 ru C=-- ? t 01 i llC: ` ?'Aa am C .) -+i Mary Jane Snyder Real Estate Depu Charles E. Sheaffer Chief Deputy William T. Tully Solicitor Dauphin County Harrisburg, Pennsylvania 17101 ph: (717) 780-6590 fax: (717) 255-2889 Michael W. Rinehart Assistant Chief Deputy Jack Lotwick Sheriff Commonwealth of Pennsylvania County of Dauphin PAUL FACHENKO VS DOMINO'S PIZZA INC Sheriffs Return No. 2009-T-1795 OTHER COUNTY NO. 20086090 And now: JUNE 29, 2009 at 11:10:00 AM served the within AMENDED WRIT OF SUMMONS upon DOMINO'S PIZZA INC by personally handing to BOB SERSCH 1 true attested copy of the original AMENDED WRIT OF SUMMONS and making known to him/her the contents thereof at C/O CT CORP 116 PINE STREET SUITE 320 HBG PA 17101 CORPORATE OPERATIONS SPECIALIST Sworn and subscribed to So Answers, before me this 30TH day of June, 2009 lex? NOTARIAL SEAL ARY JANE SNYDER, Notary Publi Highspiec, Dauphin County Lmy Cmnunissioa Expires Set 1 201 0 Sheriff of phin au, Pa. B Y Deputy Sheriff Deputy: R HOPKINS Sheriffs Costs: $41.25 6/25/2009 ¦ R In The Court of Common Pleas of Cumberland County, Pennsylvania Paul Fachenko VS. Domino's Pizza Inc. c/o CT Corporation 116 Pine Street, #320 Harrisburg, PA 17101 Civil No. 2008-6090 Now, June 23, 2009, I, SHERIFF OF CUMBERLAND COUNTY, PA, do hereby deputize the Sheriff of Dauphin County to execute this Writ, this deputation being made at the request and risk of the Plaintiff. ?'?'????-..mot ,??.? ?• Sheriff of Cumberland County, PA Affidavit of Service Now, _ within upon at by handing to a and made known to Sworn and subscribed before me this day of ,20 copy of the original So answers, the contents thereof. Sheriff of COSTS SERVICE $ MILEAGE_ AFFIDAVIT County, PA 20 , at o'clock K served the ISO 8 THOMAS, THOMAS & HAFER, LLP James K. Thomas, II, Esquire Identification Number: 15613 Stephanie L. Hersperger, Esquire Identification Number: 78735 P.O. Box 999 Harrisburg, PA 17108-0999 717/255-7239 Attorneys for Defendants PAUL FACHENKO, LARYSA FACHENKO, ANDREW FACHENKO, minor, by his parent and natural guardian, PAUL FACHENKO and LYUBOV FENCHKO, IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA Plaintiffs NO. 2008-6090 V. HARRISBURG PIES, INC., d/b/a DOMINO'S PIZZA, ROBERT C. RUFO and DOMINO'S PIZZA, INC CIVIL TERM Defendants JURY TRIAL DEMANDED PRAECIPE FOR ENTRY OF APPEARANCE TO THE PROTHONOTARY: Please enter the appearance of the undersigned as attorneys for Defendants in the above matter. THOMAS, THOMAS & HAFER, LLP By: James .Thomas, II, Esquire Stephanie L. Hersperger, Esquire DATE: Attorneys for Defendants 716254-1 CERTIFICATE OF SERVICE I, Gwen M. Cleck, hereby certify that I have served a true and correct copy of the foregoing document on the following persons by placing same in the United States mail, postage prepaid, on the _rQday of QJ-jj , 2009: Howard B. Krug, Esquire PURCELL, KRUG & HALLER 1719 North Front Street Harrisburg, PA 17102 THOMAS, THOMAS & HAFER, LLP By: Gwen M. Cleck, Secretary 716254-1 I ILEIa OF T, 2 u09 J'U,L 17 011 2* 13 pr-4 IN 0 THOMAS, THOMAS & HAFER, LLP James K. Thomas, II, Esquire Identification Number: 15613 Stephanie L. Hersperger, Esquire Identification Number: 78735 P.O. Box 999 Harrisburg, PA 17108-0999 717/255-7239 Attorneys for Defendants PAUL FACHENKO, LARYSA FACHENKO, ANDREW FACHENKO, minor, by his parent and natural guardian, PAUL FACHENKO and LYUBOV FENCHKO, IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA Plaintiffs V. HARRISBURG PIES, INC., d/b/a DOMINO'S PIZZA, ROBERT C. RUFO and DOMINO'S PIZZA, INC., Defendants NO. 2008-6090 CIVIL TERM JURY TRIAL DEMANDED PRAECIPE FOR RULE TO FILE A COMPLAINT TO THE PROTHONOTARY: Kindly issue a Rule on Plaintiffs to file a Complaint in the above case within twenty (20) days of service of said Rule, or suffer a judgment of non pros pursuant to Pa.R.C.P. 1037(a). THOMAS, THOMAS & HAFER, LLP By: James K. Thomas, II, Esquire Stephanie L. Hersperger, Esquire DATE: '711&1oAttorneys for Defendants 716256-1 20 91 J1 L 17 t ii 2, 12 THOMAS, THOMAS & HAFER, LLP James K. Thomas, If, Esquire Identification Number: 15613 Stephanie L. Hersperger, Esquire Identification Number: 78735 P.O. Box 999 Harrisburg, PA 17108-0999 717/255-7239 Attorneys for Defendants PAUL FACHENKO, LARYSA FACHENKO, ANDREW FACHENKO, minor, by his parent and natural guardian, PAUL FACHENKO and LYUBOV FENCHKO, IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA Plaintiffs NO. 2008-6090 V. HARRISBURG PIES, INC., d/b/a DOMINO'S PIZZA, ROBERT C. RUFO and DOMINO'S PIZZA, INC., CIVIL TERM Defendants JURY TRIAL DEMANDED RULE TO FILE A COMPLAINT TO: Plaintiffs and Plaintiffs' counsel: You are hereby ruled to file a Complaint against Defendants within twenty (20) days of service of this Rule or a judgment of non pros will be entered against Plaintiffs pursuant to Pa.R.C.P. 1037(a). Prothonotary DATE: 4-? 0. 200 9 716256-1 CERTIFICATE OF SERVICE I, Gwen M. Cleck, hereby certify that I have served a true and correct copy of the foregoing document on the following persons by placing same in the United States mail, postage prepaid, on the 10 day of , 2009: Howard B. Krug, Esquire PURCELL, KRUG & HALLER 1719 North Front Street Harrisburg, PA 17102 THOMAS, THOMAS & HAFER, LLP By: Gwen M. Cleck, Secretary716256-1 EILE_ NB ?UL 17 Nit 2: 1 Howard B. Krug, Esquire PA Supreme Court ID# 16826 Purcell, Krug & Haller 1719 North Front Street Harrisburg, PA 17102 Phone: (717) 234-4178 Fax: (717) 234-0409 hkrug@pkh.com PAUL FACHENKO, LARYSA FACHENKO, ANDREW FACHENKO, minor, by his parent and natural guardian, PAUL FACHENKO and LYUBOV FACHENKO, Plaintiffs IN THE COURT OF COMMON PLEAS CUMBERLAND CO., PENNSYLVANIA NO. 2008-6090 vs. HARRISBURG PIES, INC., d/b/a DOMINO'S PIZZA, ROBERT C. RUFO and DOMINO'S PIZZA, LLC, Defendants CIVIL TERM 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 OR THE OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU CAN GET LEGAL HELP. Cumberland County Bar Association 32 S. Bedford Street Carlisle, PA 17013 (717) 249-3166 (800) 990-9108 Howard B. Krug, Esquire PA Supreme Court ID# 16826 Purcell, Krug & Haller 1719 North Front Street Harrisburg, PA 17102 Phone: (717) 234-4178 Fax: (717) 234-0409 hkrug@pkh.com PAUL FACHENKO, LARYSA FACHENKO, ANDREW FACHENKO, minor, by his parent and natural guardian, PAUL FACHENKO and LYUBOV FACHENKO, Plaintiffs IN THE COURT OF COMMON PLEAS CUMBERLAND CO., PENNSYLVANIA NO. 2008-6090 vs. HARRISBURG PIES, INC., d/b/a DOMINO'S PIZZA, ROBERT C. RUFO and DOMINO'S PIZZA, LLC, Defendants CIVIL TERM : JURY TRIAL DEMANDED COMPLAINT AND NOW, come the Plaintiffs, by their attorneys, Purcell, Krug & Haller and state the following Complaint against the Defendants: 1. Plaintiff 1, Paul Fachenko ("Paul"), is an adult individual residing at 412 Brian Court, Mechanicsburg, Cumberland County, Pennsylvania. 2. Plaintiff 2 is Paul Fachenko, parent and natural guardian of Andrew Fachenko ("Andrew"), the minor son of Paul and Larysa Fachenko, who resides with his parents at 412 Brian Court, Mechanicsburg, Cumberland County, Pennsylvania. Defendant was eighteen (18) months old by July 15, 2007. 3. Plaintiff 3, Larysa A. Fachenko ("Larysa"), is an adult individual residing at 412 Brian Court, Mechanicsburg, Cumberland County, Pennsylvania with her spouse, Paul Fachenko. 4. Plaintiff 4, Lyubov Fachenko ("Lyubov"), is the rnother of Paul, and she is an adult individual residing at 1080 Windsor Road, Mechanicsburg, Cumberland County, Pennsylvania. 5. Defendant 1 is Harrisburg Pies, Inc. ("Pies"), a domestic corporation doing business as Domino's Pizza, under a franchise agreement with Defendant 3, with a principal place of business at 1200 Market Street, Lemoyne, Cumberland County, Pennsylvania. 6. Defendant 2 is Robert C. Rufo ("Rufo"), an adult individual residing at 1341 Sterling Drive, York, York County, Pennsylvania. 7. Defendant 3, the franchisor of Pies, is Domino's Pizza, LLC ("Domino's"), a foreign corporation, with a principal place of business at 30 Frank Lloyd Wright Drive, P. O. Box 997, Ann Arbor, MI 48106-0997, with a registered office c/o CT Corporation System, 1635 Market Street, Philadelphia, Pennsylvania. 8. At all times relevant hereto, Rufo was the President of Pies. 9. Rufo prepared and boxed the ham and pineapple pizza which is the subject of this action. 10. At all times relevant hereto, Pies was engaged in the business of preparing pizza pies and various other foods served to the public as a take out or delivery business. 11. At all times relevant hereto, Pies was an authorized franchisee and agent of Domino's. 12. At all relevant times, Domino's directed the manner in which Pies conducted its business. 13. It is believed and therefore averred that the pizza dough and other ingredients used to prepare the subject pizza was manufactured, supplied and/or distributed to Pies by Domino's, or its approved suppliers. 14. On Sunday, July 15, 2007, at approximately 4:15 p.m., Paul entered Pies' place of business and ordered three pizzas: mushroom, pepperoni, and ham with pineapple. 2 15. After the pizzas were prepared, baked, cut, and boxed by Rufo and paid for by Paul, the latter brought them to Lyubov's home for dinner with the other Plaintiffs, after which several slices remained, including the ham and pineapple pizza. 16. On July 15, 2007, all Plaintiffs ate at least one whole slice of ham and pineapple pizza, except Andrew, who ate only the front part of a slice. 17. On the evening of July 15, 2007, and through July 16, 2007, Paul, Larysa, and Lyubov experienced nausea, and Andrew refused to drink liquids. 18. On Monday, July 16, 2007, Paul ate another slice of the pineapple and ham pizza, and Andrew again ate the front portion of a slice. 19. On Tuesday, July 17, 2007, at about 10:00 a.m., Andrew was behaving differently and vomited, and Paul felt cramping in his stomach. 20. Notwithstanding his stomach issues, Paul went to work at approximately 2:30 p.m. on July 17, 2007. 21. At approximately 5:15 p.m., Paul received a hysterical voice mail message from Larysa that she had eaten two more slices of the pineapple and ham pizza before discovering glass embedded in the crust. 22. Paul called Larysa and attempted to calm her, but Larysa explained she felt a sharp pain in her stomach with severe nausea and wanted to go to the emergency room. 23. Paul left work almost four hours early to take Larysa to the Harrisburg Hospital emergency room, where tests were conducted, including but not limited to an abdominal CT scan, x-rays and blood work. 24. Larysa was informed at the hospital that the glass should eventually pass, and the physician prescribed medication to soothe her stomach and fight infection. 3 25. On July 18, 2007, the following events occurred: a. Andrew vomited in the morning and had diarrhea throughout the day; b. Larysa could not eat because of severe stomach pain and nausea; C. Despite abdominal pains, Paul went to work at 2:30 p.m.; d. At approximately 5:00 p.m., Larysa advised Paul by phone that Andrew had been walking around holding his bottom and when she removed the diaper, she saw a blood stain and found three pieces of glass in Andrew's diaper. e. Paul, once again, left work very early and took Larysa and Andrew to the Harrisburg Hospital's emergency room, where the doctor observed glass cuts at Andrew's rectum. f. Andrew was discharged and Paul was given a prescription cream for Andrew's cuts and instructions to observe Andrew for a bloated belly., as the doctor believed Andrew had an infection. 26. On July 19, 2007, the following occurred: a. Paul stayed home from work because of severe abdominal pain; b. Larysa continued suffering with nausea, diarrhea and sharp abdominal pain, and she observed bleeding and glass pieces in the toilet bowl after bowel movements; C. Andrew had diarrhea, loss of appetite and bleeding from his rectum; d. Lyubov's stomach cramps became more severe, she began sweating, and felt increased pain on the left side of her abdomen; 4 e. Paul took Lyubov to the Harrisburg Hospital emergency room, arriving at approximately midnight, and her stomach was found to be tender throughout. f. Lyubov was given intravenous fluids with medication, and an injection of and prescription for Bentyl. She was discharged at approximately 5:45 a. m. The Emergency Room doctor diagnosed Lyubov as having gastroenteritis or stomach and intestinal inflammation. 27. On July 20, 2007, the following occurred: a. Lyubov continued to experience nausea and severe abdominal pain; b. Andrew continued to have bloody diarrhea and loss of appetite; C. Larysa experienced continued and worsening symptoms and pain, causing her to seek medical attention from Belvedere Medical Clinic (BMC), where her physician confirmed blood in her stool, cuts and rectal bleeding. The doctor also opined that Larysa had an infection, and she was sent to another clinic for further treatment. 28. From July 21s through July 23, 2007, the following occurred: a. Andrew continued to suffer with diarrhea, had no appetite and a small piece of glass was found in his diaper; b. Lyubov's abdominal pain continued, and she found glass in the toilet bowl; C. Paul's abdominal pain continued, and he was exhausted from his own physical pain and attending to his family's needs; d. Larysa continued experiencing nausea, diarrhea and sharp abdominal pain. 5 29. On and after July 24, 2007, the following occurred: a. Andrew continued with diarrhea until July 29, 2007; b. Lyubov had continuing diarrhea for one week after her hospital visit (until on or about July 27, 2007); C. Larysa had continuing problems through the middle of August 2007, including diarrhea, stomach pain and nausea; d. Paul continued to have diarrhea for one and a half weeks and cramps for two weeks. 30. As a result of eating the glass-laden pizza, the Plaintiffs incurred significant charges for medical services, including but not limited to charges from the Harrisburg Hospital Emergency Department as follows: a. Lyubov - $4,335.50 b. Larysa - $4,960.10 C. Andrew - $996.00 31. As a further result of Defendants' negligence, Paul experienced wage loss. 32. All Plaintiffs sustained pain, suffering and alarm. Count I - Negligence Plaintiffs v. Rufo 33. Paragraphs 1 through 32 of the Plaintiffs' Complaint are incorporated herein by reference. 34. The ham and pineapple pizza consumed by Paul, Andrew, Larysa and Lyubov contained numerous small particles of glass, with the result that when the Plaintiffs ate the pizza, they ingested glass and suffered the injuries detailed above. 6 35. Rufo owed Paul, Andrew, Larysa and Lyubov, a duty to see that food products manufactured, prepared, boxed and sold to them were free of foreign or deleterious substances that might injure patrons consuming the products. 36. The ingredients, dough, toppings and packaging were in the exclusive control of Rufo until the final pizza product reached the hands of Plaintiffs. 37. After purchase, each of the Plaintiffs handled the pizza in such a manner as to foreclose the possibility that the glass entered the pizza during their possession of it. 38. The injuries to Paul, Andrew, Larysa and Lyubov were directly and proximately caused by the negligence, carelessness and/or recklessness of Rufo in: a. Failing to prepare the pizza with the greatest diligence and precaution; b. Failing to properly inspect and maintain the final baked product and its ingredients to ensure purity and quality; C. Allowing and permitting particles of glass to be mixed with or placed in the pizza when a reasonably appropriate inspection of the pizza's ingredients would have disclosed its presence; d. Serving and selling pizza to the Plaintiffs, despite knowing or having reason to know that the pizza was adulterated with glass; e. Failing to warn the Plaintiffs that they would consume pizza laced with glass, despite knowing or having reason to know that glass particles were embedded and baked in the pizza; f. Failing to establish and maintain such reasonable safety practices in the handling of pizza ingredients, and the creation, baking and distribution of the finished pizza as would have revealed the adulteration before the time of sale. 7 39. As a result of the negligence of Rufo, each of the Plaintiffs became seriously ill, as aforesaid, requiring them to seek medical treatment and to incur associated expenses for same. 40. As a result of the negligence of Rufo, each of the Plaintiffs suffered personal physical pain, embarrassment and great inconvenience, as well as the adult Plaintiffs' great concern for the health of their minor child/grandchild, Andrew. 41. As a further result of the negligence of Rufo, Plaintiffs lost wages. WHEREFORE, the Plaintiffs, Paul, Andrew, Larysa and Lyubov Fachenko, demand judgment against the Defendant Rufo in an amount in excess of the jurisdictional amount requiring arbitration, costs of suit and interest from the date of judgment. Count 11- Vicarious Liability Plaintiffs v. Pies 42. Paragraphs 1 through 41 of the Plaintiffs' Complaint are incorporated herein by reference. 43. Although Rufo assembled, baked and packaged the ham and pineapple pizza, Pies is vicariously liable for the harm suffered by Plaintiffs inasmuch as Rufo was also the President of Pies, directed the manner in which Pies conducted its business, and was at all relevant times acting within the scope and furtherance of his employment duties for Pies. WHEREFORE, Plaintiffs, Paul, Andrew, Larysa and Lyubov Fachenko, demand judgment against Defendant Pies in an amount in excess of the jurisdictional amount requiring arbitration, costs of suit and interest from the date of judgment. 8 Count III - Vicarious Liabilitv Plaintiffs v. Domino's 44. Paragraphs 1 through 43 of the Plaintiffs' Complaint are incorporated herein by reference. 45. Although Rufo assembled, baked and packaged the ham and pineapple pizza, Domino's is vicariously liable for the harm suffered by Plaintiffs inasmuch as Domino's directed the manner in which Pies and Rufo conducted business as an authorized Domino's franchise. 46. Furthermore, Plaintiffs relied upon Domino's name and reputation in selecting this branded outlet. 47. Plaintiffs relied upon Domino's to supervise the practices of Rufo, Pies and its employees and agents to ensure top grade ingredients, provide a clean location to prevent food adulteration and contamination, and inspect the products being sold to avoid glass contamination. WHEREFORE, Plaintiffs, Paul, Andrew, Larysa and Lyubov Fachenko, demand judgment against the Defendant Domino's in an amount in excess of the jurisdictional amount requiring arbitration, costs of suit and interest from the date of judgment. Alternative Count IV - Negligence Plaintiffs v. Domino's 48. Paragraphs 1 through 47 of the Plaintiffs' Complaint are incorporated herein by reference. 49. Domino's owed a duty of care to Plaintiffs, the consumers of their pizza product. 50. The contaminated ham and pineapple pizza at issue was assembled with dough and other ingredients supplied exclusively by a Domino's supply chain center. 9 51. It is believed and therefore averred that a Domino's supply chain center stored the ingredients used in the subject pizza until the time of delivery to Pies' place of business. 52. It is believed and therefore averred that Domino's agents or employees delivered the subject pizza ingredients to Pies' place of business. 53. It is further believed that the subject pizza ingredients left Domino's control containing glass particles. 54. The injuries to Paul, Andrew, Larysa and Lyubov were directly and proximately caused by the negligence, carelessness and/or recklessness of Domino's, its employees or agents in: a. Failing to prepare the pizza dough with the greatest diligence and precaution; b. Failing to properly inspect and maintain the pizza ingredients to ensure purity and quality; C. Allowing and permitting particles of glass to be mixed with or placed in the pizza ingredients when a reasonably appropriate inspection would have disclosed its presence; d. Making the pizza ingredients available for Plaintiff's consumption despite knowing or having reason to know that they were adulterated with glass; e. Failing to warn the Plaintiffs that they would consume pizza laced with glass, despite knowing or having reason to know that glass particles were embedded in the pizza ingredients; f. Failing to establish and maintain such reasonable safety practices in the handling of pizza ingredients as would have prevented or revealed the adulteration before the time of sale. 10 55. Plaintiffs' injuries through their consumption of glass was a proximate result of Domino's negligence. 56. As a result of Domino's negligence, Plaintiffs sustained the damages described herein. WHEREFORE, Plaintiffs Paul, Andrew, Larysa and Lyubov Fachenko, demand judgment against Domino's, in an amount in excess of the jurisdictional amount requiring arbitration, costs of suit and interest from the date of judgment. Count V - Strict Liability Plaintiffs v. Pies and Rufo 57. Paragraphs 1 through 56 of the Plaintiffs' Complaint are incorporated herein by reference. 58. The subject pizza ingredients left Pies' and Rufo's control containing glass particles, rendering it unsafe for its intended use as food. 59. The intended use of the pizza was consumption by the purchaser, Paul Fachenko, and the other Plaintiffs. 60. As a direct and proximate result of the consumption of the ham and pineapple pizza laced with glass particles, Plaintiffs suffered the damages described herein. 61. Pies and Rufo are strictly liable for the injuries suffered by each of the Plaintiffs. WHEREFORE, the Plaintiffs, Paul, Andrew, Larysa and Lyubov demand judgment against Pies and Rufo, in an amount in excess of the jurisdictional amount requiring arbitration, costs of suit and interest from the date of judgment. 11 Alternative Count VI - Strict Liability Plaintiffs v. Domino's 62. Paragraphs 1 through 61 of the Plaintiffs' Complaint are incorporated herein by reference. 63. The contaminated ham and pineapple pizza at issue was assembled with dough and other ingredients supplied exclusively by a Domino's supply chain center. 64. It is believed and therefore averred that a Domino's supply chain center stored the ingredients used in the subject pizza until the time of delivery to Pies' place of business. 65. It is believed and therefore averred that Domino's agents or employees delivered the subject pizza ingredients to Pies' place of business. 66. The subject pizza ingredients left Domino's control containing glass particles, rendering it unsafe for its intended use. 67. The intended use of the pizza was consumption by the purchaser and his family. 68. As a direct and proximate result of the consumption of the ham and pineapple pizza laced with glass particles, the Plaintiffs suffered the damages described herein. 69. Domino's is strictly liable for the injuries suffered by each of the Plaintiffs, especially since it is believed that Domino's, under its franchise agreement, receives fees from gross sales or other sales related compensation. WHEREFORE, the Plaintiffs, Paul, Andrew, Larysa and Lyubov Fachenko, demand judgment against Domino's, in an amount in excess of the jurisdictional amount requiring arbitration, costs of suit and interest from the date of judgment. COUNT V - Breach of the Implied Warranty of Merchantability Under Section 2314 Of the Uniform Commercial Code Plaintiffs vs. Defendants 12 70. Paragraphs 1 through 69 of the Plaintiffs' Complaint are incorporated herein by reference. 71. Section 2315 of the Pennsylvania Uniform Commercial Code contains an implied warranty for merchantability and usage of trade as follows: a. Sale by merchant. - Unless excluded or modified (section 2316), a warranty that the goods shall be merchantable is implied in a contract for their sale if the seller is a merchant with respect to goods of that kind. Under this section the serving for value of food or drink to be consumed either on the premises or elsewhere is a sale. b. Merchantability standards for goods. - Goods to be merchantable must be at least such as: (1) pass without objection in the trade under the contract description; (2) in the case of fungible goods, are of fair average quality within the description; (3) are fit for the ordinary purposes for which such goods are used; (4) run, within the variations permitted by the agreement, of even kind, quality and quantity within each unit and among all units involved; (5) are adequately contained, packaged, and labeled as the agreement may require; and (6) conform to the promises or affirmations of fact made on the container or label if any. 13 C. Course of dealing or usage of trade. - Unless excluded or modified (section 2316) other implied warranties may arise from course of dealing or usage of trade. 13 Pa.C.S.A. §2314. 72. The ham and pineapple pie manufactured, prepared, packaged and sold by Pies, Rufo and Domino's was not fit for the ordinary purpose for which the pizza was intended, i.e., consumption by the public, including the Plaintiffs. 73. Paul's purchase of the ham and pineapple pizza to be consumed as take out was considered a sale under the Uniform Commercial Code. 74. The fact that the ham and pineapple pizza contained glass baked into the crust is a violation of the UCC regarding an implied warranty of merchantability. 75. The defective condition of the ham and pineapple pizza consumed by each of the Plaintiffs was the factual cause of their harm. 76. Plaintiffs are entitled to incidental and consequential damages in addition to contractual damages. WHEREFORE, the Plaintiffs, Paul, Andrew, Larysa and Lyubov demand judgment against the Defendants, Pies, Rufo and Domino's, in an amount in excess of the jurisdictional amount requiring arbitration, plus interest from the date of judgment and costs. Dated: / © - / -- - /- 1) \) 1 Attorney for Plaintiff 14 1719 North Front Street Harrisburg, PA 17102 (717) 234-4178 VERIFICATION I, Paul Fachenko, hereby verify that the facts contained in the foregoing COMPLAINT are true and correct to the best of my knowledge, information and belief. I understand that false statements made herein are subject to the penalties of 18 Pa. C.S. Section 4904, relating to unsworn falsification to authorities. PAULFACHENKO Date: ? ? VERIFICATION I, Paul Fachenko, parent and natural guardian of Andrew Fachenko, hereby verify that the facts contained in the foregoing COMPLAINT are true and correct to the best of my knowledge, information and belief. 1 understand that false statements made herein are subject to the penalties of 18 Pa. C.S. Section 4904, relating to unsworn falsification to authorities. PAUL FACHENKO, parent and natural guardian of Andrew Fachenko Date: 01 ";? ? 09 VERIFICATION I, Larysa Fachenko, hereby verify that the facts contained in the foregoing COMPLAINT are true and correct to the best of my knowledge, information and belief. I understand that false statements made herein are subject to the penalties of 18 Pa. C.S. Section 4904, relating to unsworn falsification to authorities. LARY A F HENKO Date: D 9 , 09 VERIFICATION I, Lyubov Fachenko, hereby verify that the facts contained in the foregoing COMPLAINT are true and correct to the best of my knowledge, information and belief. I understand that false statements made herein are subject to the penalties of 18 Pa. C.S. Section 4904, relating to unsworn falsification to authorities. O Date: O Q. c3• D LYUB C N SO 9 CERTIFICATE OF SERVICE I, Angela S. Shaffer, an employee of Purcell, Krug & Haller, do hereby certify that I served a true and correct copy of the within Complaint upon the following by depositing same in the United States Mail, First Class Postage, Postage Prepaid, addressed as follows: James K. Thomas, Il, Esquire Stephanie L. Hersperger, Esquire Thomas, Thomas & Hafer, LLP P.O. Box 999 Harrisburg, PA 17108-0999 Attorneys for Defendants Angela S. Shaffe'j Dated: /D ' 1 ? ' 7-Lt)9 15 20Vn V41 V T1 f 1'vi. CL '.;:, FI ED TNT 1TARY THOMAS, THOMAS & HAFER, LLP James K. Thomas, II, Esquire Identification Number: 15613 Stephanie L. Hersperger, Esquire Identification Number: 78735 P.O. Box 999 Harrisburg, PA 17108-0999 717/255-7239 Attorneys for Defendants, Harrisburg Pies, Inc., d/b/a Domino's Pizza, Robert C. Rufo and Domino's Pizza LLC PAUL FACHENKO, LARYSA FACHENKO ANDREW FACHENKO, minor, by his Parent and natural guardian, PAUL FACHENKO and LYUBOV FACHENKO, Plaintiffs vs. 2010 JAN 25 AH 11: 44 CtJl U J ` IN THE COURT OF COMMON PLEAS CUMBERLAND CO., PENNSYLVANIA NO.2oo8-6090 CIVIL TERM HARRISBURG PIES, INC., d/b/a DOMINO'S PIZZA, ROBERT C. RUFO, And DOMINO'S PIZZA, LLC, JURY TRIAL DEMANDED Defendants NOTICE TO PLEAD TO: Parties and Counsel: You are hereby notified to plead to the enclosed New Matter within twenty (20) days from service hereof or a default judgment may be entered against you. Respectfully submitted, THOMAS, THOMAS & HAFER, LLP Dated: January 21, 2010 By: lx??4wl JAME K. THOMAS, If, Esquire Identification Number: 15613 STEPHANIE L. HERSPERGER, Esquire Identification Number: 78735 Attorneys for Defendants, HARRISBURG PIES, INC., d/b/a DOMINO'S PIZZA, ROBERT C. RUFO, AND DOMINO'S PIZZA LLC THOMAS, THOMAS & HAFER, LLP James K. Thomas, II, Esquire Identification Number: 15613 Stephanie L. Hersperger, Esquire Identification Number: 78735 P.O. Box 999 Harrisburg, PA 17108-0999 717/255-7239 Attorneys for Defendants, Harrisburg Pies, Inc., d/b/a Domino's Pizza, Robert C. Rufo and Domino's Pizza LLC PAUL FACHENKO, LARYSA FACHENKO ANDREW FACHENKO, minor, by his Parent and natural guardian, PAUL FACHENKO and LYUBOV FACHENKO, Plaintiffs VS. HARRISBURG PIES, INC., d/b/a DOMINO'S PIZZA, ROBERT C. RUFO, And DOMINO'S PIZZA, LLC, Defendants IN THE COURT OF COMMON PLEAS CUMBERLAND CO., PENNSYLVANIA NO. 2008-6090 CIVIL TERM JURY TRIAL DEMANDED ANSWER WITH NEW MATTER OF DEFENDAN'T'S HARRISBURG PIES, INC. d/b/a DOMINO'S PIZZA, ROBERT C RUFO, AND DOMINO'S PIZZA LLC, TO PLAINTIFFS' COMPLAINT AND NOW, come Defendants, HARRISBURG PIES, INC., d/b/a DOMINO'S PIZZA, ROBERT C. RUFO, and DOMINO'S PIZZA LLC, ("Defendants"), by and through their undersigned counsel, James K. Thomas, II, Esquire, and Stephanie L. Hersperger, Esquire, of Thomas, Thomas & Hafer, LLP, and file the following Answer with New Matter to Plaintiffs' Complaint: 1. Admitted in part and denied in part. It is admitted that Paul Fachenko is an adult. The remaining averments contained in this paragraph of Plaintiffs' Complaint are denied as after reasonable investigation, Defendants are without knowledge or information sufficient to form a belief as to the truth of the allegations, and therefore, same are deemed denied and strict proof is demanded at the time of trial. The remaining averments also are denied pursuant to Pa.R.C.P. No. 1029(e). 2. Admitted in part and denied in part. It is admitted that Andrew Fachenko is a minor child. The remaining averments contained in this paragraph of Plaintiffs' Complaint are denied as after reasonable investigation, Defendants are without knowledge or information sufficient to form a belief as to the truth of the allegations, and therefore, same are deemed denied and strict proof is demanded at the time of trial. The remaining averments also are denied pursuant to Pa.R.C.P. No. 1029(e). 3. Admitted in part and denied in part. It is admitted that Larysa A. Fachenko is an adult. The remaining averments contained in this paragraph of Plaintiffs' Complaint are denied as after reasonable investigation, Defendants are without knowledge or information sufficient to form a belief as to the truth of the allegations, and therefore, same are deemed denied and strict proof is demanded at the time of trial. The remaining averments also are denied pursuant to Pa.R.C.P. No. 1029(e). 4. Admitted in part and denied in part. It is admitted that Lyubov Fachenko is an adult. The remaining averments contained in this paragraph of Plaintiffs' Complaint are denied as after reasonable investigation, Defendants are without knowledge or information sufficient to form a belief as to the truth of the allegations, and therefore, same are deemed denied and strict proof is demanded at the time of trial. The remaining averments also are denied pursuant to Pa.R.C.P. No. 1029(e). 5. Admitted only that at all times relevant herein, Defendant, Harrisburg Pies, Inc., was a corporation doing business as Domino's Pizza under a franchise agreement with Domino's Pizza, LLC, and with a principal place of business at 1200 Market Street, 2 Lemoyne, Cumberland County, Pennsylvania. The remaining averments contained in this paragraph of Plaintiffs' Complaint are denied pursuant to Pa.R.C.P. No. 1029(e). 6. Admitted. 7. Admitted in part and denied in part. It is admitted that the franchisor of Harrisburg Pies, Inc., at all times relevant herein, was Domino's Pizza LLC, which had a principal place of business at 3o Frank Lloyd Wright Drive, P.O. Box 997, Ann Arbor, MI, 48io6-o997. It is denied that Domino's Pizza LLC at all times relevant herein is a foreign corporation as it is incorporated in Michigan. Defendants are without sufficient information in order to either admit or deny the remaining allegations contained in this paragraph of Plaintiffs' Complaint, and thus, said allegations are denied and strict proof of same is demanded at the time of trial. 8. Admitted. 9. Admitted although Answering Defendant, Rufo, does not have a specific recollection of the type of pizza ordered and delivered to Plaintiffs. io. Admitted. 11. Admitted in part and denied in part. It is admitted that Harrisburg Pies was an authorized franchisee of Domino's Pizza LLC. However, it is denied that Harrisburg Pies was an agent of Domino's Pizza LLC and strict proof of same is demanded at the time of trial. 12. Denied as a legal conclusion to which no response is deemed necessary. To the extent that a response is deemed necessary, it is admitted only that Harrisburg Pies was a franchisee of Domino's Pizza LLC. However, it is denied that Domino's Pizza LLC directed the manner in which Harrisburg Pies conducted its business. Strict proof of all 3 allegations contained in this paragraph of Plaintiffs' Complaint is demanded at the time of trial. 13. Admitted in part and denied in part. It is admitted that upon reasonable investigation, it is believed that the pizza dough and other ingredients used to prepare the subject pizza were purchased by Harrisburg Pies from Domino's Pizza LLC or approved suppliers. The remaining allegations contained in this paragraph of Plaintiffs' Complaint are denied pursuant to Pa.R.C.P. No. 1029(e) and strict proof of same is demanded at the time of trial. 14. Admitted in part and denied in part. It is admitted that Paul Fachenko entered Defendant, Harrisburg Pies' place of business on, or about, July 15, 2007, and ordered pizza. The remaining averments are denied pursuant to Pa.R.C.P. No. 1029(e) and strict proof of same is demanded at the time of trial. 15. Admitted in part and denied in part. It is admitted that Defendant, Rufo, prepared, baked and boxed the pizzas and that Plaintiff, Paul Fachenko, paid for the pizzas. The remaining averments are denied pursuant to Pa.R.C.P. No. 1029(e) and strict proof of same is demanded at the time of trial. 16.-24. Denied. The allegations contained in these paragraphs of Plaintiffs' Complaint are denied pursuant to Pa.R.C.P. No. 1029(e). Strict proof of same is demanded at the time of trial. 25. (a-f). Denied. The allegations contained in this paragraph and these subparagraphs of Plaintiffs' Complaint are denied pursuant to Pa.R.C.P. No. 1029(e). Strict proof of same is demanded at the time of trial. 4 26. (a-f). Denied. The allegations contained in this paragraph and these subparagraphs of Plaintiffs' Complaint are denied pursuant to Pa.R.C.P. No. 1029(e). Strict proof of same is demanded at the time of trial. 27. (a-c). Denied. The allegations contained in this paragraph and these subparagraphs of Plaintiffs' Complaint are denied pursuant to Pa.R.C.P. No. 1029(e). Strict proof of same is demanded at the time of trial. 28. (a-d). Denied. The allegations contained in this paragraph and these subparagraphs of Plaintiffs' Complaint are denied pursuant to Pa.R.C.P. No. 1029(e). Strict proof of same is demanded at the time of trial. 29. (a-d). Denied. The allegations contained in this paragraph and these subparagraphs of Plaintiffs' Complaint are denied pursuant to Pa.R.C.P. No. 1029(e). Strict proof of same is demanded at the time of trial. 30. (a-c). Denied. The allegations contained in this paragraph and these subparagraphs of Plaintiffs' Complaint are denied pursuant to Pa.R.C.P. No. 1029(e). Strict proof of same is demanded at the time of trial. 31. Denied. The allegations contained in this paragraph of Plaintiffs' Complaint are legal conclusions to which no response is deemed necessary. To the extent a response is deemed necessary, it is denied that Defendants were in any way negligent or caused or contributed to the alleged injuries or damages claimed by Plaintiffs. The remaining allegations contained in this paragraph of Plaintiffs' Complaint are denied pursuant to Pa.R.C.P. 1029(e). Strict proof of all allegations is demanded at the time of trial. 32. Denied. The allegations contained in this paragraph of Plaintiffs' Complaint are legal conclusions to which no response is deemed necessary. To the extent a response is deemed necessary, it is denied that Defendants were in any way negligent or caused or 5 contributed to the alleged injuries or damages claimed by Plaintiffs. The remaining allegations contained in this paragraph of Plaintiffs' Complaint are denied pursuant to Pa.R.C.P. 1029(e). Strict proof of all allegations is demanded at the time of trial. Count I - Negligence Plaintiffs v. Rufo 33• No response is required as this is a paragraph of incorporation. 34• Denied. After reasonable investigation, Defendants are without sufficient information to either admit or deny that the pizza consumed by Plaintiffs contained particles of glass and that Plaintiffs sustained injuries as a result of same. Therefore, all said allegations are denied pursuant to Pa.R.C.P. No. 1029(e) and strict proof of same is demanded at the time of trial. 35• Denied. The allegations contained in this paragraph of Plaintiffs' Complaint are legal conclusions to which no response is deemed necessary. To the extent a response is deemed necessary, it is denied that Defendant Rufo was in any way negligent or caused or contributed to the alleged injuries or damages claimed by Plaintiffs. The remaining allegations contained in this paragraph of Plaintiffs' Complaint are denied pursuant to Pa.R.C.P. No. 1029(e). Strict proof of all allegations is demanded at the time of trial. 36. Admitted in part and denied in part. To the extent that this paragraph of Plaintiffs' Complaint contains conclusions of law, no response is deemed necessary. To the extent a response is deemed necessary, it is admitted that the pizza product was not in control or possession of Plaintiffs until delivered to them by Defendant Rufo and that Defendant Rufo was in possession of same until the time of delivery. The remaining allegations contained in this paragraph of Plaintiffs' Complaint are denied pursuant to Pa.R.C.P. No. 1029(e). Strict proof of all allegations is demanded at the time of trial. 6 37. Denied as stated. The allegations contained in this paragraph of Plaintiffs' Complaint are denied pursuant to Pa.R.C.P. No. 1029(e) and strict proof of same is demanded at the time of trial. 38. (a-f). Denied. The allegations contained in this paragraph and these subparagraphs of Plaintiffs' Complaint are legal conclusions to which no response is deemed necessary. To the extent a response is deemed necessary, it is denied that Defendants were in any way negligent or caused or contributed to the alleged injuries or damages claimed by Plaintiffs. The remaining allegations contained in this paragraph of Plaintiffs' Complaint are denied pursuant to Pa.R.C.P. No. 1029(e). Strict proof of all allegations is demanded at the time of trial. 39•-41- Denied. The allegations contained in these paragraphs of Plaintiffs' Complaint are legal conclusions to which no response is deemed necessary. To the extent a response is deemed necessary, it is denied that Defendants were in any way negligent or caused or contributed to the alleged injuries or damages claimed by Plaintiffs. The remaining allegations contained in these paragraphs of Plaintiffs' Complaint are denied pursuant to Pa.R.C.P. No. 1029(e). Strict proof of all allegations is demanded at the time of trial. WHEREFORE, Defendants, Harrisburg Pies, Inc., d/b/a Domino's Pizza, Robert C. Rufo, and Domino's Pizza LLC, respectfully request that Plaintiffs' Complaint be dismissed in its entirety and judgment entered in their favor. Count II - Vicarious Liability Plaintiffs v. Pies 42. No response is required as this is a paragraph of incorporation. 7 43• Admitted in part and denied in part. To the extent that this paragraph contains legal conclusions, no response is deemed necessary. To the extent a response is deemed necessary, it is admitted only that Defendant Rufo was the President of Harrisburg Pies and employed by Harrisburg Pies at the time he prepared the pizza. The remaining allegations contained in this paragraph are denied pursuant to Pa.R.C.P. No. 1029(e) and strict proof of same is demanded at the time of trial. WHEREFORE, Defendants, Harrisburg Pies, Inc., d/b/a Domino's Pizza, Robert C. Rufo, and Domino's Pizza LLC, respectfully request that Plaintiffs' Complaint be dismissed in its entirety and judgment entered in their favor. Count III - Vicarious Liability Plaintiffs v. Domino's 44• No response is required as this is a paragraph of incorporation. 45• Denied. The allegations contained in this paragraph are denied as legal conclusions and/or pursuant to Pa.R.C.P. No. 1029(e) and strict proof of same is demanded at the time of trial. 46. To the extent this paragraph of Plaintiffs' Complaint contains legal conclusions, no response is deemed necessary. To the extent a response is deemed necessary, after reasonable investigation, Defendants are without sufficient information in order to either admit or deny the remaining allegations contained in this paragraph of Plaintiffs' Complaint, and therefore, strict proof of same is demanded at the time of trial. The remaining allegations contained in this paragraph of Plaintiffs' Complaint are denied pursuant to Pa.R.C.P. No. 1029(e) and strict proof of same is demanded at the time of trial. 47. To the extent this paragraph of Plaintiffs' Complaint contains legal conclusions, no response is deemed necessary. To the extent a response is deemed 8 necessary, after reasonable investigation, Defendants are without sufficient information in order to either admit or deny the remaining allegations contained in this paragraph of Plaintiffs' Complaint, and therefore, strict proof of same is demanded at the time of trial. The remaining allegations contained in this paragraph of Plaintiffs' Complaint are denied pursuant to Pa.R.C.P. No. 1029(e) and strict proof of same is demanded at the time of trial. WHEREFORE, Defendants, Harrisburg Pies, Inc., d/b/a Domino's Pizza, Robert C. Rufo, and Domino's Pizza LLC, respectfully request that Plaintiffs' Complaint be dismissed in its entirety and judgment entered in their favor. Alternate Count IV - Negligence Plaintiffs v. Domino's 48. No response is required as this is a paragraph of incorporation. 49• Denied. The allegations contained in this paragraph of Plaintiffs' Complaint are legal conclusions to which no response is deemed necessary. Strict proof of all allegations is demanded at the time of trial. 50. Admitted in part and denied in part. It is admitted only that that upon reasonable investigation, it is believed that the pizza dough and other ingredients used to prepare the subject pizza were purchased by Harrisburg Pies from Domino's Pizza LLC or approved suppliers. However, it is specifically denied that any dough or ingredients used to prepare the subject pizza were contaminated at the time the pizza left the possession of Defendant Rufo. The remaining allegations contained in this paragraph of Plaintiffs' Complaint are denied pursuant to Pa.R.C.P. No. 1029(e) and strict proof is demanded at the time of trial. 51. Denied as stated. After reasonable investigation, Defendants are without sufficient information in order to either admit or deny the averments contained in this 9 paragraph of Plaintiffs' Complaint, and thus, strict proof of same is demanded at the time of trial. The remaining averments are denied pursuant to Pa.R.C.P. No. 1029(e). 52. To the extent that this paragraph of Plaintiffs' Complaint includes legal conclusions, no response is deemed necessary. To the extent a response is deemed necessary, Defendants are without sufficient information in order to either admit or deny the averments contained in this paragraph of Plaintiffs' Complaint, and thus, strict proof of same is demanded at the time of trial. The remaining averments are denied pursuant to Pa.R.C.P. No. 1029(e). 53• To the extent that this paragraph of Plaintiffs' Complaint includes legal conclusions, no response is deemed necessary. To the extent a response is deemed necessary, it is specifically denied that the subject pizza ingredients left Domino's alleged control containing glass particles, and thus, strict proof of same is demanded at the time of trial. The remaining averments are denied pursuant to Pa.R.C.P. No. 1029(e). 54• (a-f). Denied. The allegations contained in this paragraph and these subparagraphs of Plaintiffs' Complaint are legal conclusions to which no response is deemed necessary. To the extent a response is deemed necessary, it is denied that Defendants were in any way negligent or caused or contributed to the alleged injuries or damages claimed by Plaintiffs. The remaining allegations contained in this paragraph of Plaintiffs' Complaint are denied pursuant to Pa.R.C.P. No. 1029(e). Strict proof of all allegations is demanded at the time of trial. 55•-56. Denied. The allegations contained in these paragraphs of Plaintiffs' Complaint are legal conclusions to which no response is deemed necessary. To the extent a response is deemed necessary, it is denied that Defendants were in any way negligent or caused or contributed to the alleged injuries or damages claimed by Plaintiffs. The 10 remaining allegations contained in these paragraphs of Plaintiffs' Complaint are denied pursuant to Pa.R.C.P. No. 1029(e). Strict proof of all allegations is demanded at the time of trial. WHEREFORE, Defendants, Harrisburg Pies, Inc., d/b/a Domino's Pizza, Robert C. Rufo, and Domino's Pizza LLC, respectfully request that Plaintiffs' Complaint be dismissed in its entirety and judgment entered in their favor. Alternate Count V - Strict Liability Plaintiffs v. Pies and Rufo 57. No response is required as this is a paragraph of incorporation. 58. Denied. The allegations contained in this paragraph of Plaintiffs' Complaint are legal conclusions to which no response is deemed necessary. To the extent a response is deemed necessary, it is denied that the subject pizza left Defendants' control containing glass particles rendering it unsafe for its intended use as food, and thus, strict proof of same is demanded at the time of trial. The remaining allegations contained in this paragraph of Plaintiffs' Complaint are denied pursuant to Pa.R.C.P. No. 1029(e). Strict proof of all allegations is demanded at the time of trial. 59• Denied. After reasonable investigation, Defendants are without sufficient information in order to admit or deny the allegations contained in this paragraph of Plaintiffs' Complaint, and thus, same are denied and strict proof is demanded at the time of trial. The remaining allegations contained in this paragraph of Plaintiffs' Complaint are denied pursuant to Pa.R.C.P. No. 1029(e). Strict proof of all allegations is demanded at the time of trial. 6o. Denied. To the extent this paragraph of Plaintiffs' Complaint includes legal conclusions, no response is deemed necessary. To the extent a response is deemed 11 necessary, it is denied that the pizza was laced with glass particles when it left the possession of Defendants. The remaining allegations contained in this paragraph of Plaintiffs' Complaint are denied pursuant to Pa.R.C.P. No. 1029(e) and strict proof of same is demanded at the time of trial. 61. Denied. To the extent this paragraph of Plaintiffs' Complaint includes legal conclusions, no response is deemed necessary. To the extent a response is deemed necessary, it is denied that Defendants are strictly liable for the injuries allegedly suffered by each of the Plaintiffs. The remaining allegations contained in this paragraph of Plaintiffs' Complaint are denied pursuant to Pa.R.C.P. No. 1029(e) and strict proof of same is demanded at the time of trial. WHEREFORE, Defendants, Harrisburg Pies, Inc., d/b/a Domino's Pizza, Robert C. Rufo, and Domino's Pizza LLC, respectfully request that Plaintiffs' Complaint be dismissed in its entirety and judgment entered in their favor. Alternate Count VI - Strict Liability Plaintiffs v. Domino's 62. No response is required as this is a paragraph of incorporation. 63. Admitted in part and denied in part. It is admitted only that that upon reasonable investigation, it is believed that the pizza dough and other ingredients used to prepare the subject pizza were purchased by Harrisburg Pies from Domino's Pizza LLC or approved suppliers. However, it is specifically denied that any dough or ingredients used to prepare the subject pizza were contaminated at the time the pizza left the possession of Defendant Domino's Pizza LLC or approved suppliers. The remaining allegations contained in this paragraph of Plaintiffs' Complaint are denied pursuant to Pa.R.C.P. No. 1029(e) and strict proof is demanded at the time of trial. 12 64. Denied as stated. After reasonable investigation, Defendants are without sufficient information in order to either admit or deny the averments contained in this paragraph of Plaintiffs' Complaint, and thus, strict proof of same is demanded at the time of trial. The remaining averments are denied pursuant to Pa.R.C.P. No. 1029(e). 65. To the extent that this paragraph of Plaintiffs' Complaint includes legal conclusions, no response is deemed necessary. To the extent a response is deemed necessary, Defendants are without sufficient information in order to either admit or deny the averments contained in this paragraph of Plaintiffs' Complaint, and thus, strict proof of same is demanded at the time of trial. The remaining averments are denied pursuant to Pa.R.C.P. No. 1029(e). 66. To the extent that this paragraph of Plaintiffs' Complaint includes legal conclusions, no response is deemed necessary. To the extent a response is deemed necessary, it is specifically denied that the subject pizza ingredients left Domino's alleged control containing glass particles, and thus, strict proof of same is demanded at the time of trial. The remaining averments are denied pursuant to Pa.R.C.P. No. 1029(e). 67. Denied. After reasonable investigation, Defendants are without sufficient information in order to admit or deny the allegations contained in this paragraph of Plaintiffs' Complaint, and thus, same are denied and strict proof is demanded at the time of trial. The remaining allegations contained in this paragraph of Plaintiffs' Complaint are denied pursuant to Pa.R.C.P. No. 1029(e). Strict proof of all allegations is demanded at the time of trial. 68. Denied. To the extent this paragraph of Plaintiffs' Complaint includes legal conclusions, no response is deemed necessary. To the extent a response is deemed necessary, it is denied that the pizza was laced with glass particles when it left the 13 possession of Defendants. The remaining allegations contained in this paragraph of Plaintiffs' Complaint are denied pursuant to Pa.R.C.P. No. 1029(e) and strict proof of same is demanded at the time of trial. 69. Denied. To the extent this paragraph of Plaintiffs' Complaint includes legal conclusions, no response is deemed necessary. To the extent a response is deemed necessary, it is denied that Defendants are strictly liable for the injuries allegedly suffered by each of the Plaintiffs. The remaining allegations contained in this paragraph of Plaintiffs' Complaint are denied pursuant to Pa.R.C.P. No. 1029(e) and strict proof of same is demanded at the time of trial. WHEREFORE, Defendants, Harrisburg Pies, Inc., d/b/a Domino's Pizza, Robert C. Rufo, and Domino's Pizza LLC, respectfully request that Plaintiffs' Complaint be dismissed in its entirety and judgment entered in their favor. Count VII (INADVERTENTLY labeled Count V in Plaintiffs Complaint- Breach of the ImDlied Warranty of Merchantability Under Section 2-14 of the Uniform Commercial Code Plaintiffs v. Defendants 70. No response is required as this is a paragraph of incorporation. 71. (a),(b)(1)-(6),(c). Denied. To the extent the allegations contained in this paragraph and these subparagraphs of Plaintiffs' Complaint are legal conclusions, no response is deemed necessary. To the extent a response is necessary, the allegations contained in this paragraph and these paragraphs of Plaintiffs' Complaint are denied pursuant to Pa.R.C.P. No. 1029(e) and strict proof of same is demanded at the time of trial. 72.-73. Denied. To the extent the allegations contained in these paragraphs of Plaintiffs' Complaint are legal conclusions, no response is deemed necessary. To the extent a response is necessary, the allegations contained in these paragraphs of Plaintiffs' 14 Complaint are denied pursuant to Pa.R.C.P. No. 1029(e) and strict proof of same is demanded at the time of trial. 74. Denied. To the extent the allegations contained in this paragraph of Plaintiffs' Complaint are legal conclusions, no response is deemed necessary. To the extent a response is necessary, it is denied that the pizza contained glass baked into the crust or that it was laced with glass when it left Defendants possession and strict proof of any and all such allegations is demanded at the time of trial. The remaining allegations contained in this paragraph of Plaintiffs' Complaint are denied pursuant to Pa.R.C.P. No. 1029(e) and strict proof of same is demanded at the time of trial. 75.-76. Denied. To the extent the allegations contained in these paragraphs of Plaintiffs' Complaint are legal conclusions, no response is deemed necessary. To the extent a response is necessary, the allegations contained in these paragraphs of Plaintiffs' Complaint are denied pursuant to Pa.R.C.P. No. 1029(e) and strict proof of same is demanded at the time of trial. WHEREFORE, Defendants, Harrisburg Pies, Inc., d/b/a Domino's Pizza, Robert C. Rufo, and Domino's Pizza LLC, respectfully request that Plaintiffs' Complaint be dismissed in its entirety and judgment entered in their favor. NEW MATTER 77. Defendants, incorporate herein by reference, as if fully set forth at length, Paragraphs 1 through 76 of their Answer and New Matter to Plaintiffs' Complaint. 78. Plaintiffs' claims may be barred or diminished in accordance with the Pennsylvania Comparative Negligence Act. 79. Plaintiffs may have failed to mitigate their injuries and/or damages. 15 8o. The conduct of Plaintiffs may be the proximate cause of their injuries and damages alleged in Plaintiffs' Complaint. 81. The pizza did not have glass baked into its crust and was not laced with glass or contain glass particles when it left the possession of Defendant Rufo. 82. Plaintiffs were negligent, careless and reckless as follows: (a) they failed to be alert and attentive; and (b) they failed to maintain the pizza in a controlled environment so that it was safe from intentional or unintentional glass contamination. 83. Some or all of Plaintiffs alleged injuries may be a result of pre-existing or non-accident related conditions. 84. Plaintiffs assumed the risk of all injuries which limits and/or bars all claims. 85. Plaintiffs' claims fail to state any cause of action against Defendants upon which relief can be granted. 86. Plaintiffs' claims are barred because of the doctrine of superseding and/or intervening cause. 87. Defendants' conduct was reasonable at all times. 88. Defendants owed no duty to Plaintiffs. 89. Defendants fulfilled any alleged duty or obligations toward Plaintiffs. 9o. Plaintiffs' injuries, if any, were caused by the acts or omissions of third parties, over which Defendants had no control, and/or no obligation to control. 91. There was no defect or dangerous condition that existed in this case that proximately caused Plaintiffs' alleged injuries. 92. No defect existed at the time of sale in any product manufactured, sold or distributed by Defendants and purchased by Plaintiffs or any other parry. 16 93• Defendants were not negligent in any manner. 94• Upon information and belief, Plaintiffs failed to exercise ordinary care on their own behalf and that failure was the sole, intervening and superseding cause of any damage or injury alleged in the Complaint. 95• Upon information and belief, Plaintiffs' claims are barred because Plaintiffs or persons other than Defendants improperly used, misused, or abused the products that are alleged to have caused or contributed to the damages alleged in the Complaint, causation being expressly denied. 96. Upon information and belief, any claims by Plaintiffs based upon alleged warranties, whether express or implied, are barred in that there is no privity of contract between Plaintiffs and Defendants and no timely notice of any alleged breach of warranty was given to Defendants. 97. Defendants did not make any express or implied warranties to Plaintiffs. 98. Any warranties deemed to have been made were satisfied or fulfilled. 99• The product at issue in this matter was fit for all appropriate uses. loo. To the extent that any of Defendants were involved in the distribution of the product at issue in this case, Defendants did not alter the product, and as such, cannot be liable for any alleged defect. ioi. Plaintiffs' injuries and damages, if any, the same being specifically denied, should be reduced for Plaintiffs' failure to mitigate their damages. 102. As discovery may show, Plaintiffs' claims are or maybe barred by the defense of accord and satisfaction, arbitration and award, estoppel, payment, laches, res judicata, release and/or waiver. 17 103. The Plaintiffs or others beyond the control of Defendants may have altered or modified the pizza or its ingredients, either intentionally, or unintentionally, prior to Plaintiffs allegedly consuming same. WHEREFORE, Defendants, Harrisburg Pies, Inc., d/b/a Domino's Pizza, Robert C. Rufo, and Domino's Pizza LLC, respectfully request that Plaintiffs' Complaint be dismissed in its entirety and judgment entered in their favor. Respectfully submitted, THOMAS, THOMAS & HAFER, LLP Dated: January 21, 2010 By: JAME K. THOMAS, II, Esquire Identification Number: 15613 STEPHANIE L. HERSPERGER, Esquire Identification Number: 78735 Attorneys for Defendants, HARRISBURG PIES, INC., d/b/a DOMINO'S PIZZA, ROBERT C. RUFO, AND DOMINO'S PIZZA LLC 18 THOMAS, THOMAS & HAFER, LLP James K. Thomas, II, Esquire Identification Number: 15613 Stephanie L. Hersperger, Esquire Identification Number: 78735 P.O. Box 999 Harrisburg, PA 171o8-o999 717/255-7239 Attorneys for Defendants: Harrisburg Pies, Inc., d/b/a Domino's Pizza, Robert C. Rufo and Domino's Pizza LLC PAUL FACHENKO, LARYSA FACHENKO ANDREW FACHENKO, minor, by his Parent and natural guardian, PAUL FACHENKO and LYUBOV FACHENKO, Plaintiffs VS. IN THE COURT OF COMMON PLEAS CUMBERLAND CO., PENNSYLVANIA NO. 2008-6ogo CIVIL TERM HARRISBURG PIES, INC., d/b/a DOMINO'S PIZZA, ROBERT C. RUFO, And DOMINO'S PIZZA, LLC, JURY TRIAL DEMANDED Defendants VERIFICATION I, Joe Devereaux, Director of Franchise Services, on behalf of Domino's Pizza LLC, have read the foregoing ANSWER AND NEW MATTER OF DEFENDANTS TO PLAINTIFFS' COMPLAINT and hereby affirm that it is true and correct to the best of my personal knowledge, information and belief. This Verification and statement is made subject to the penalties of 18 Pa.C.S. § 4904 relating to unsworn falsification to authorities; I verify that all the statements made in the foregoing are true and correct and that false statements may subject me to the penalties of 18 Pa.C.S. § 4904• January 19 , 2010 Z?11 J X, DIRECTOR OF FRANCHISE SERVICES FOR DOMINO'S PIZZA LLC VERIFICATION I, ROBERT C. RUFO, as an individual Defendant and on behalf of Harrisburg Pies, Inc., d/b/a Domino's Pizza, have read the foregoing ANSWER AND NEW MATTER OF DEFENDANTS TO PLAINTIFFS' COMPLAINT and hereby affirm that it is true and correct to the best of my personal knowledge, information and belief. This Verification and statement is made subject to the penalties of 18 Pa.C.S. § 4904 relating to unsworn falsification to authorities; I verify that all the statements made in the foregoing are true and correct and that false statements may subject me to the penalties of 18 Pa.C.S. § 4904• January solo ?f C /? /ro ROBERT C. RUFO, as an i ividual and on behalf of HARRISBURG PIES, INC. d/b/a DOMINO'S PIZZA 19 CERTIFICATE OF SERVICE I, Stephanie L. Hersperger, hereby certify that a true and correct copy of the foregoing Answers and New Matter of Defendants to Plaintiffs' Complaint was served by depositing the same in the United States Mail, postage prepaid, at Harrisburg, Pennsylvania, on the 21st day of January 2010, on all counsel of record as follows: Howard B. Krug, Esquire PURCELL, KRUG & HALLER 171g North Front Street Harrisburg, PA 17102 Attorneys for Plaintiffs THOMAS, THOMAS & HAFER, LLP By: Step anie L. Hersperger 19 FILIM-OICE OF W. Mt WTAiy 2010 FEB -3 PM 2: 15 PMO? PURCELL, KRUG & HALLER Howard B. Krug, Esquire ID No. 16826 1719 N. Front Street Harrisburg, PA 17102 (717) 234-4178 Attorney for Plaintiffs Email: hkrug0-Pkh corn PAUL FACHENKO, LARYSA FACHENKO, : IN THE COURT OF COMMON PLEAS ANDREW FACHENKO, minor, by his Parent : CUMBERLAND CO., PENNSYLVANIA and Natural Guardian, PAUL FACHENKO, and LYUBOV FACHENKO, Plaintiffs vs. HARRISBURG PIES, INC., d/b/a DOMINO'S PIZZA, ROBERT C. RUFO, and DOMINO'S PIZZA, LLC., Defendants : NO. 2008-6090 CIVIL TERM JURY TRIAL DEMANDED PLAINTIFFS' RESPONSE TO DEFENDANTS' NEW MATTER COMES NOW, Plaintiffs, by and through their attorneys, Purcell, Krug & Haller, and files the following response to Defendants' New Matter, as follows: 77. Denied as more fully stated in Plaintiffs' Complaint. 78. -80. Denied as conclusions of law to which no response is required. 81. Denied as more fully stated in Plaintiffs' Complaint. 82. Denied as a conclusion of law to which no response is required. 83. Denied as more fully stated in Plaintiffs' Complaint. 84.-103. Denied as conclusions of law to which no response is required to the extent that any facts are alleged, they are all denied, as more fully stated in Plaintiffs' Complaint. WHEREFORE, Plaintiffs request that this Honorable Court enter judgment against Defendants and in favor of Plaintiffs, pursuant to the original Complaint of record. L, )(RUG BY: Hovafd--ug, Esquire ID. No. 16826 1719 N. Front Street Harrisburg, PA 17102 (717) 234-4178 Attorney for Plaintiffs Date: 7/' Z VERIFICATION I, Paul Fachenko, hereby verify that the facts contained in the foregoing Answer to New Matter are true and correct to the best of my knowledge, information and belief. I understand that false statements made herein are subject to the penalties of 18 Pa. C.S. Section 4904, relating to unsworn falsification to authorities. 1 Paul Fachenko Date: o"1- 30-- 10 CERTIFICATE OF SERVICE I, Angela S. Shaffer, employee for the law firm of Purcell, Krug & Haller, counsel for Plaintiffs, hereby certify that service of the foregoing Answer to New Matter was made on the following via first class, regular mail on February 2, 2010: Stephanie L. Hersperger, Esquire James K. Thomas, II, Esquire THOMAS, THOMAS & HAFER, LLP P. O. Box 999 Harrisburg, PA 17108-0999 Attorney for Defendants Angela . Shaffer i THOMAS, THOMAS & HAFER, LLP James K. Thomas, H, Esquire Identification Number: 15613 Stephanie L. Hersperger, Esquire Identification Number: 78735 Jason C. Giurintano, Esquire Identification Number: 89177 P.O. Box 999 Harrisburg, PA 17108-0999 717/255-7239 A f DP- A H 'b ' C3 rn z? 2? cn r" r- ? « _? w r ttorneys or a n ants, arras urg Pies, Inc., d/b/a Domino s Pizza,, x. Robert C. Rufo and Domino's Pizza LLC ?o PAUL FACHENKO, LARYSA FACHENKO ANDREW FACHENKO, minor, by his Parent and natural guardian, PAUL FACHENKO and LYUBOV FACHENKO, Plaintiffs IN THE COURT OF COMMON PLEAS CUMBERLAND CO., PENNSYLVANIA NO. 2008-6090 vs. HARRISBURG PIES, INC., d/b/a DOMINO'S PIZZA, ROBERT C. RUFO, And DOMINO'S PIZZA, LLC, Defendants CIVIL TERM JURY TRIAL DEMANDED C'.L rn M C-5 MOTION OF DEFENDANTS TO COMPEL PLAINTIFFS' DISCOVERY RESPONSES AND NOW, come Defendants, HARRISBURG PIES, INC., d/b/a DOMINO'S PIZZA, ROBERT C. RUFO, and DOMINO'S PIZZA LLC, ("Defendants"), by and through their counsel, Thomas, Thomas & Hafer, LLP, and file the following Motion to Compel Discovery: 1. Plaintiffs filed a Complaint on or about October 20, 2009, seeking to recover from Defendants for counts of negligence, strict liability, vicarious liability and breach of implied warranty of merchantability. 2. Discovery requests, in the form of a First Set of Interrogatories and Request for Production of Documents (hereinafter the "Discovery Requests"), were forwarded to counsel for 11 Plaintiffs on or about June 15, 2010. A copy of the Discovery Requests and accompanying correspondence to counsel are attached hereto and collectively marked as Exhibit "A." 3. Plaintiffs were provided with more than adequate time to respond within the discovery period contemplated by the Pennsylvania Rules of Civil Procedure. 4. More specifically, pursuant to Pennsylvania Rules of Civil Procedure 4006 and 4009.12, the answering party must serve a copy of its answers within thirty (30) days of service of the requests. 5. Further, by correspondence to Plaintiffs dated August 11, 2010, October 25, 2010 and November 29, 2010, Defendant again requested that Plaintiffs respond to outstanding discovery. See Exhibits "B," "C" and "D." 6. To date, Plaintiffs have not responded to these discovery requests. 7. The information requested in Defendants' Discovery Requests is not privileged, and is otherwise within the scope of permissible discovery pursuant to the Pennsylvania Rules of Civil Procedure. 8. Despite the proper Discovery Requests and lack of objections, Plaintiffs have failed to provide any responses to said requests. 9. Plaintiffs failure to provide timely responses to the Discovery Requests prejudices the ability of Defendants to defend their case. WHEREFORE, Defendants respectfully request that this Honorable Court order that Plaintiffs serve full and complete responses to Defendants' First Set of Interrogatories and Request for Production of Documents within twenty (20) days, or suffer the imposition of sanctions pursuant to Pa.R.C.P. 4019. 2 9 0 Dated: /? // By: THOMAS, HOMI?AS & HAFER, LLP J JAMES K. THOMAS, II, Esquire Identification Number: 15613 STEPHANIE L. HERSPERGER, Esquire Identification Number: 78735 JASON C. GIURINTANO, Esquire Identification Number: 89177 Attorneys for Defendants, HARRISBURG PIES, INC., d/b/a DOMINO'S PIZZA, ROBERT C. RUFO, AND DOMINO'S PIZZA LLC 3 • 0 • . Street Address 305 North Front Street, Harrisburg, PA 17101 Mailing Address: P.O. Box 999, Harrisburg, PA 17108 Phone: 717.237.7100 Fax: 717.237.7105 Stephanie L. Hersperger (717) 255-7239 sersperger@tthlaw.com June 15, 2010 Howard B. Krug, Esquire PURCELL, KRUG & HALLER 1719 North Front Street Harrisburg, PA 17102 RE: Fachenko, et al v. Domino's Pizza, Inc. et al. Cumberland County C.C.P. No. 20o8-6o9o TTH File No. 815-9o988 Dear Attorney Krug: Enclosed are the following original documents: 1. Interrogatories of Defendants Directed to Plaintiff, Paul Fanchenko (Set One); 2. Interrogatories of Defendants Directed to Plaintiff, Larysa Fanchenko (Set One); 3. Interrogatories of Defendants Directed to Plaintiff, Paul Fanchenko, as the Parent and Natural Guardian of Andrew Fanchenko, Minor (Set One); 4. Interrogatories of Defendants Directed to Plaintiff, Lyubov Fanchenko (Set One); and 5. Defendants' Request for Production of Documents Directed to Plaintiffs (Set No. 1). We look forward to receiving your answers/responses pursuant to the Pennsylvania Rules of Civil Procedure. THOMAS, THOMAS & HAFERTITY Howard B. Krug, Esquire PURCELL, KRUG & HALLER June 15, 2010 Page 2 Please feel free to contact me with any questions you may have regarding these documents. Very truly yours, By: THOMAS, THOMAS & HAFER, LLP Stephanie L. Hersperger SLH:dej Enclosures 717962.7 THOMAS, THOMAS & HAFER, LLP James K. Thomas, II, Esquire Identification Number: 15613 Stephanie L. Hersperger, Esquire Identification Number: 78735 P.O. Box 999 Harrisburg, PA 171o8-0999 717/255-7239 • Attorneys for Defendants, Harrisburg Pies, Inc., d/b/a Domino's Pizza, Robert C. Rufo and Domino's Pizza LLC PAUL FACHENKO, LARYSA FACHENKO ANDREW FACHENKO, minor, by his Parent and natural guardian, PAUL FACHENKO and LYUBOV FACHENKO, Plaintiffs VS. HARRISBURG PIES, INC., d/b/a DOMINO'S PIZZA, ROBERT C. RUFO, And DOMINO'S PIZZA, LLC, Defendants IN THE COURT OF COMMON PLEAS CUMBERLAND CO., PENNSYLVANIA NO.2oo8-6o9o CIVIL TERM JURY TRIAL DEMANDED INTERROGATORIES OF DEFENDANTS DIRECTED TO PLAINTIFF, PAUL FACHENKO, AS THE PARENT AND NATURAL GUARDIAN OF ANDREW FACHENKO, MINOR (SET ONE) TO: Paul Fachenko, as the parent and natural guardian of Andrew Fachenko, minor C/O Howard B. Krug, Esquire PLEASE TAKE NOTICE that you are hereby required, pursuant to Pennsylvania Rules of Civil Procedure, Rule 4005 and 40o6, as amended, to file the original and serve upon the undersigned a copy of your Answers and Objections, if any, in writing and under oath to the following interrogatories within thirty (3o) days after service of the Interrogatories. The Answers shall be inserted in the space provided. If there is insufficient space to answer an Interrogatory, the remainder of the Answer shall follow on a supplemental sheet. These shall be deemed to be continuing Interrogatories. If between the time of your Answers and the time of trial of this case, you, or anyone acting on your behalf, learn of any • further information not contained in your Answers, you shall promptly furnish said information to the undersigned by Supplemental Answers. STANDARD INSTRUCTIONS (1) Duty to answer. -- The interrogatories are to be answered in writing, verified, and served upon the undersigned within thirty (30) days of their service on you. Objections must be signed by the attorney making them. In your answers, you must furnish such information as is available to you, your employees, representatives, agents, and attorneys. Your answers must be supplemented and amended as required by the Pennsylvania Rules of Civil Procedure. (2) Claim of privilege. -- With respect to any claim of privilege or immunity from discovery, you must identify the privilege or immunity asserted and provide sufficient information to substantiate the claim. (3) Option to produce documents. -- In lieu of identifying documents in response to these interrogatories, you may provide copies of such documents with appropriate references to the corresponding interrogatories. "Document" means any written, printed, typed, or other graphic matter of any kind or nature, however produced or reproduced, including photographs, microfilms, phonographs, video and audio tapes, punch cards, magnetic tapes, discs, data cells, drums, and other data compilations from which information can be obtained. "Identify" or "Identity" means when used in reference to -- (1) A natural person, his or her: (a) full name; and 2 • (b) present or last known residence and employment address (including street name and number, city or town, and state or country); (2) A document: (a) its description (e.g., letter, memorandum, report, etc.), title, and date; (b) its subject matter; (c) its author's identity; (d) its addressee's identity; (e) its present location; and (f) its custodian's identity. (3) An oral communication: (a) its date; (b) the place where it occurred; (c) its substance; (d) the identity of the person who made the communication; (e) the identify of each person to whom such communication was made; and (f) the identity of each person who was present when such communication was made. (4) A corporate entity: (a) its full corporate name; (b) its date and place of incorporation, if 'known; and (c) its present address and telephone number; 3 0 0 (5) Any other context: a description with sufficient particularity that the thing may thereafter be specified and recognized, including relevant dates and places, and the identification of relevant people, entities, and documents. "Incident" means the occurrence that forms the basis of a cause of action or claim for relief set forth in the complaint or similar pleading. "Person" means a natural person, partnership, association, corporation, or government agency. "You", "Your" - means the person in whose name this action is brought, his employees, officers, representatives, agents, and attorneys, or any person working for such persons. "Statement" means a written statement signed or otherwise adopted or approved by the person making it, or a stenographic, mechanical, electrical or other recording, or a transcription thereof, which is substantially verbatim recital of an oral statement by the person making it and contemporaneously record. June , 2010 By: Respectfully submitted, THOMAS, THOMAS & HAFER, LLP JAMES K. THOMAS, II;, ESQUIRE Atty. PA I. D. No. 15613 STEPHANIE L. HERSPERGER, ESQUIRE Atty. PA I.D. No. 78735 Attorneys for Defendants, Harrisburg Pies, Inc., d/b/a Domino's Pizza, Robert C. Rufo and Domino's Pizza, LLC 4 0 0 INTERROGATORIES 1. Identify yourself, give your date of birth, place of birth (including hospital), social security number and all names you have been known by in the past. ANSWER: 0 0 2. Identify your genetic parents, identify your adoptive parents, if applicable, and your present custodian and/or guardian, their dates of birth, and social security numbers. ANSWER: 6 0 9 3. State your places of residence since your birth, where you resided for a period of three (3) weeks, or longer, the dates of each such residence, and the identity of all legal guardians and/or other individuals with whom you resided at each such residence. ANSWER: 0 0 4. Identify all physicians and/or other health care providers who treated you for the injuries that the adult Plaintiffs claim you have sustained as a result of the occurrence complained of in the Complaint, the dates of such treatment, and the nature of such treatment. ANSWER: s 5. Identify all physicians or other health care providers who have treated you since your birth for any injuries or illnesses sustained by you, other than the injuries, illnesses and/or symptoms which you claim to have resulted from the occurrence which is the subject of this lawsuit including in your answer the nature of such treatments and the dates thereof. ANSWER: 9 6. Identify all persons not identified elsewhere in your Answers to Interrogatories who have personal knowledge or information regarding the facts and circumstances of the occurrence which forms the basis of your lawsuit. ANSWER: 10 0 7. State specifically the date on which you were first diagnosed as suffering from the injuries identified in your Complaint, the identity of the individual or entity by who you were so diagnosed. ANSWER: 11 0 0 8. Itemize, through listing, all expenses incurred by you, on your behalf or to your benefit which you claim are a result of the occurrence which is the subject matter of this lawsuit by indicating as to each the date on which any such expense was paid, the identify of the person or entity paying and state whether each such expense is subrogated or subject to a lien. ANSWER: 12 0 0 9. State specifically and in detail the nature of all injuries, illnesses and/or symptoms suffered by you which you claim are or were a result of the occurrence complained of herein including in and not limiting your answer to the date of onset of each injury, illness and/or symptom, the dates on which you were treated for each such illness, injury and/or symptom, and which of such injuries, illnesses or symptoms you contend are permanent in nature; if you are making no claim as to permanency for any of such injuries, illnesses and/or symptoms, then state the chronological dates during which these injuries, illnesses and/or symptoms were suffered by you. ANSWER: 13 • io. Detail the history of any treatment and/or health care claimed to have been received by you as a result of the alleged occurrence complained of herein, including in and not limiting your answer to, with respect to each such treatment, the nature of the treatment, the identify of the individual and/or health care provider rendering such treatment and the date on which each such treatment was received by you. ANSWER: 14 • • ii. Please state the name and address of the hospital or other medical facility you were you were born at. ANSWER: 15 • 0 12. State whether you have ever received psychiatric or psychological care or treatment, and if so, state the following: (a) The nature of the disorder for which you were treated and the name and address and specialty of the person treating you; (b) The dates for which treatment was given; and (c) Whether you were ever confined to any institution for the treatment of such disorders, and if so, state the name and address of such institutions and the date of confinement. ANSWER: 16 0 • 13. Please state the name and address of where you received pre-natal care at. ANSWER: 17 9 0 14. Please state the name and address of every health care provider you have seen since birth. ANSWER: 18 15. Have you ever been enrolled or gone to day care or have been taken care of by someone other than a family member? If so, please state the following: (a) Name and address of facility/person; (b) The dates of enrollment or during which you. were cared for by said person or at said facility. ANSWER: June , 2010 By: Respectfully submitted, THOMAS, THOMAS & HAFER, LLP JAMES K. THOMAS, II, ESQUIRE Atty. PA I.D. No. 15613 STEPHANIE L. HERSPERGER, ESQUIRE Atty. PA I.D. No. 78735 Attorneys for Defendants, Harrisburg Pies, Inc., d/b/a Domino's Pizza, Robert C. Rufo and Domino's Pizza, LLC 19 CERTIFICATE OF SERVICE AND NOW, this day of June 2010, I, DAWN E. JARVIS, Paralegal, for the firm of THOMAS, THOMAS & HAFER, LLP, hereby certify that I have this day served the within Interrogatories of Defendants Directed to Paul Fachenko, as the parent and natural guardian of Andrew Fachenko, minor (Set One), by depositing a copy of the same in the United States Mail, postage prepaid, at Harrisburg, Pennsylvania, addressed to: Howard B. Krug, Esq. PURCELL, KRUG & HALLER 1719 North Front Street Harrisburg, PA 17102 Attorney for Plaintiffs By: THOMAS, THOMAS & HAFER, LLP Dawn E. Jarvis, Paralegal for Stephanie Hersperger, Esquire 776145.3 20 THOMAS, THOMAS & HAFER, LLP James K. Thomas, II, Esquire Identification Number: 15613 Stephanie L. Hersperger, Esquire Identification Number: 78735 P.O. Box 999 Harrisburg, PA 17108-0999 717/255-7239 0 Attornevs for Defendants, Harrisburg Pies, Inc., d/b/a Domino's Pizza, Robert C. Rufo and Domino's Pizza LLC PAUL FACHENKO, LARYSA FACHENKO : IN THE COURT OF COMMON PLEAS ANDREW FACHENKO, minor, by his : CUMBERLAND CO., PENNSYLVANIA Parent and natural guardian, PAUL FACHENKO and LYUBOV FACHENKO, : NO. 20o8-6o9o Plaintiffs vs. : CIVIL TERM HARRISBURG PIES, INC., d/b/a DOMINO'S PIZZA, ROBERT C. RUFO, And DOMINO'S PIZZA, LLC, : JURY TRIAL DEMANDED Defendants DEFENDAN'T'S' REQUEST FOR PRODUCTION OF DOCUMENTS DIRECTED TO PLAINTIFFS (SET NO. i Defendants hereby request that you furnish pursuant to Pennsylvania Rules of Civil Procedure, at our expense, or permit the Defendants or someone acting on their behalf to inspect, examine, and copy the folio A4ng items concerning this action which are in the possession, custody, or control of the Plaintiff(s), counsel for Plaintiff(s), or any other person or entity acting on behalf of Plaintiff(s), including any insurer(s) for Plaintiff(s). Said items shall be produced or made available for inspection at the office of Defendants' attorneys located at 305 North Front Street, Harrisburg, Pennsylvania, lA ithin thirty (3o) days after service of this Request, on a date and time to be arranged between counsel: 0 0 1. All statements, including but not restricted to those defined by Pa.R.C.P. 4003.5, signed statements, transcripts of recorded statements or interviews, or any memoranda or summary of transcripts of statements or interviews of any party, person or witness, or their agents or employees, who have any knowledge or information of the facts concerning or pertaining to the incident, the subject matter, the claims, the damages, injuries, or any other matter involved in or pertaining to this case. 2. All photographs, maps, drawings, sketches, motion pictures, videotapes and similar documents showing, representing or purporting to show any of the instrumentalities, locales, persons, property, injuries and any and all other matters related to the subject matter of this litigation. 2 • 3. All documents prepared by you or by any insurer(s), representative(s), agent(s) or anyone acting on your behalf, except your attorney(s), during an investigation of any aspect of the incident in question. Such documents shall include any documents made or prepared through the present time with the exclusion of mental impressions, conclusions or opinions respecting the value or merit of a claim or defense or respecting strategy or tactics. (NOTE: As referred to herein, "documents" includes written, printed, typed, recorded or graphic matter, however produced' or reproduced, including correspondence, telegrams, other written communications, data processing storage units, tapes, videos, films, microfilm, microfiche, contracts, agreements, notes, memoranda, summaries, analyses, projections, indices, work papers, studies, test reports, test results, surveys, diaries, calendars, films, photographs, videos, movies, diagrams, drawings, sketches, minutes of meetings or any other writing [including copies of the foregoing, regardless of whether the parties to whom this request is addressed is not in the possession, custody or control of the original] now in the possession, custody or control of Plaintiffs, their former or present counsel, agents, employees, officers, insurers or any other persons acting on their behalf.) 4. All incident reports or any similar report or document prepared with respect to the accident/incident at issue in this action. 5. All summaries or notes or memoranda of any conversation or interview with any witness or person(s) with respect to any matter that is at issue in this case except for any materials protected from discovery as attorney work product. 3 6. Any reports of any investigation carried out with respect to any matter at issue in the case on behalf of Plaintiffs. 7. Any and all documents or exhibits which you intend to offer as exhibits and/or evidence at the time or trial of this matter. 8. Any and all documents which evidence any facts on the basis of which it will be asserted that the Defendant(s) caused or contributed to the happening of the injuries sustained by the Defendant(s) or that lie assumed the risk. 9. All photographs, videotapes, and documents with regard to any surveillance of Defendant conducted by Plaintiffs or on Plaintiffs' behalf at any time from the date of the incident up to until the present time. 1o. All documents identified in Plaintiffs' Answers to Interrogatories and all documents reviewed by Plaintiffs or anyone acting of behalf of Plaintiff in the preparation of answers to said Interrogatories. 4 0 0 11. All expert opinions, reports, summaries, or other N1,Titings in the custody or control of the Plaintiff, or their attorneys, or insurers, which relate to the subject matter of this litigation, and the curriculum vitae of each expert. 12. All documents, including but not limited to, advertisements, circulars, brochures, pamphlets, leaflets, writings and other such promotional items any expert witness you have retained to use at trial uses and has used in the past to promote his or her services as an expert witness. 13. Identity and current address of any and all persons who have any knowledge of any items previously named in this request. 14. All documents relating in any way to all injuries, damages and losses sustained by Plaintiffs. This should include, but not be limited to bills, invoices, medical reports, medical records, receipts, hospital records, charts and x-rays, wage and employment information, and all other documents in any way relating to Plaintiffs' alleged injuries and damages. 5 0 0 15. Any release or other agreement between any person or entities given or obtained in regard to the subject incident. 16. Any and all documents evidencing or pertaining to any lien by any person or entity against potential recovery of damages by Plaintiffs in this action. 17. All financial records concerning the Plaintiffs including but not limited to any and all tax returns, W-2's, self-employment tax filings, self-employment business records and ledgers, and other filings, employment records, and wage or salary information for the five (5) years preceding this accident to the present. 18. All documents which support or contradict any of the allegations set forth in the Complaint, Answer, or any other pleading to which an affidavit or verification has been attached, which has been filed in this action. 6 0 0 1g. All records regarding any treatment, consultation or therapy for any psychological or psychiatric condition, injury- or issue. 20.All documents related to any insurance claim you submitted or any insurance benefits paid or payable to you or on your behalf relating in any way to any damages or losses you sustained arising from or related to the incident described in Plaintiffs Complaint. 21. Any document or thing obtained by subpoena or authorization. 22. Any other discoverable document or thing in your file, not specifically requested herein above. 7 0 • 23. Any document referring to any bankruptcy filing to which you were or are a party. Respectfully submitted., THOMAS, THOMAS & HAFER, LLP June /60`2010 By: oto?k? 'I"o //Z J E K. THOMAS, II:, ESQUI Atty. PA I.D. No. 15613 STEPHANIE L. HERSPERGER, ESQUIRE Atty. PA I.D. No. 78735 Attorneys for Defendants, Harrisburg Pies, Inc., d/b/a Domino's Pizza, Robert C. Rufo and Domino's Pizza, LLC 8 0 0 CERTIFICATE OF SERVICE I, Dawn E. Jarvis, Paralegal for Thomas, Thomas & Hafer, LLP, hereby certify that a true and correct copy of the foregoing Defendants' Request for Production of Documents directed to Plaintiffs (Set No. 1) was served by depositing the same in the United States Mail, postage prepaid, at Harrisburg, Pennsylvania, on the V k day of June 2010, on all counsel of record as follows: Howard B. Krug, Esquire PURCELL, KRUG & HALLER 1719 North Front Street Harrisburg, PA 17102 Attorneys for Plaintiff THOMAS, THOMAS & HAFER, LLP Pa Stephani ersper r, Esquire 777404.1 9 THOMAS, THOMAS S HAFER, LLP James K. Thomas, II, Esquire Identification Number: 15613 Stephanie L. Hersperger, Esquire Identification Number: 78735 P.O. Box 999 Harrisburg, PA 17108-0999 717/255-7239 C; Attorneys for Defendants, Harrisburg Pies, Inc., d/b/a Domino's Pizza, Robert C. Rufo and Domino's Pizza LLC PAUL FACHENKO, LARYSA FACHENKO ANDREW FACHENKO, minor, by his Parent and natural guardian, PAUL FACHENKO and LYUBOV FACHENKO, Plaintiffs Vs. HARRISBURG PIES, INC., d/b/a DOMINO'S PIZZA, ROBERT C. RUFO, And. DOMINO'S PIZZA, LLC, Defendants IN THE COURT OF COMMON PLEAS CUMBERLAND CO., PENNSYLVANIA : NO. 2oo8-6o9o CIVIL TERM JURY TRIAL DEMANDED INTERROGATORIES OF DEFENDANTS DIRECTED TO PLAINTIFF, LYUBOV FACHENKO (SET ONE) TO: Lyubov Fachenko C/O Howard B. Krug, Esquire PLEASE TAKE NOTICE that you are hereby required, pursuant to Pennsylvania Rules of Civil Procedure, Rule 4005 and 40o6, as amended, to file the original and serve upon the undersigned a copy of your Answers and Objections, if any, in writing and under oath to the following Interrogatories within thirty (3o) days after service of the Interrogatories. The Answers shall be inserted in the space provided. If there is insufficient space to answer an Interrogatory, the remainder of the Answer shall follow on a supplemental sheet. These shall be deemed to be continuing Interrogatories. If between the time of your Answers and the time of trial of this case, you, or anyone acting on your behalf, learn of any further information not contained in your Answers, you shall promptly furnish said information to the undersigned by Supplemental Answers. STANDARD INSTRUCTIONS (1) Dutz7 to answer. -- The interrogatories are to be answered in waiting, verified, and served upon the undersigned within thirty (30) days of their service on you. Objections must be signed by the attorney making them. In your answers, you must furnish such information as is available to you, your employees, representatives, agents, and attorneys. Your answers must be supplemented and amended as required by the Pennsylvania Rules of Civil Procedure. (2) Claim of privilege. -- With respect to any claim of privilege or immunity from discovery, you must identify the privilege or immunity, asserted and provide sufficient information to substantiate the claim. (3) Option to produce documents. -- In lieu of identifying documents in response to these interrogatories, you may provide copies of such documents with appropriate references to the corresponding interrogatories. DEFINITIONS "Document" means any written, printed, typed, or other graphic matter of any kind or nature, however produced or reproduced, including photographs, microfilms, phonographs, video and audio tapes, punch cards, magnetic tapes, discs, data cells, drums, and other data compilations from which information can be obtained. "Identify" or "Identity" means when used in reference to -- (1) A natural person, his or her: (a) full name; and 2 0 0 (b) present or last known residence and employment address (including street name and number, city or toi,\m., and state or country); (2) A document: (a) its description (e.g., letter, memorandum, report, etc.), title, and date; (b) its subject matter; (c) its author's identity; (d) its addressee's identity; (e) its present location; and (f) its custodian's identity. (3) An oral communication: (a) its date; (b) the place where it occurred; (c) its substance; (d) the identity of the person who made the communication; (e) the identify of each person to whom such communication was made; and (f) the identity of each person who was present when such communication was made. (4) A corporate entity: (a) its full corporate name; (b) its date and place of incorporation, if known; and (c) its present address and telephone number; 3 0 i (5) An)- other context: a description with sufficient particularity that the thing may thereafter be specified and recognized, including relevant dates and places, and the identification of relevant people, entities, and documents. "Incident" means the occurrence that forms the basis of a cause of action or claim for relief set forth in the complaint or similar pleading. "Person" means a natural person, partnership, association, corporation, or government agency. "You", "Your" - means the person in whose ?name this action is brought, his employees, officers, representatives, agents, and attorneys, or any person working for such persons. "Statement" means a written statement signed or otherwise adopted or approved b3- the person making it, or a stenographic, mechanical, electrical or other recording, or a transcription thereof, which is substantially verbatim recital of an oral statement by the person making it and contemporaneously record. Respectfully submitted., THOMAS, THOMAS & HAFER, LLP June UK 2010 By: JAMES . THOMAS, II, ESQUIRE Atty. PA I.D. No. 15613 STEPHANIE L. HERSPERGER, ESQUIRE Atty. PA I.D. No. 78735) Attorneys for Defendants, Harrisburg Pies, Inc., d/b/a Domino's Pizza, Robert C. Rufo and Domino's Pizza, LLC 4 0 • INTERROGATORIES 1. Please state: a. Your full name; b. Each other name, if any, which you have used, or by which you have been known; C. The name of your spouse at the time of the accident and the date and place of your marriage to such spouse; d. The address of your present residence and the address of each other residence, which you have had during the past five years; e. Your date and place of birth; f. Your social security number; g. Your military service and positions held, if any- h. The schools you have attended and the degrees, or certificates awarded, if any; and i. Whether you have ever been legally separated from, or resided apart from your spouse, and if so, when and why. ANSWER: 5 • 2. If you are covered by an), type of insurance including first party medical, workers' compensation, disability, excess or umbrella insurance, etc., that might be applicable to the incident in this matter, state the follm,\ring with respect to each such policy: (a) The name of the insurance carrier which issued the policy; (b) The named insured under each policy and the polic}, number of each policy; (c) The type(s) and effective date(s) of each policy; (d) The amount of coverage provided for injury to each person, for each occurrence, and in the aggregate for each policy; and (e) Each exclusion, if any, in the policy which is applicable to any claim thereunder and any reasons, if any, why you or the carrier claim the exclusion is applicable. ANSWER: 6 0 0 3. List and describe all expenses and losses that you have incurred because of the incident. ANSWER: 0 0 4. State N? ith particularity the factual basis for each claim or defense you are asserting in this case. ANSWER: 0 0 5. Identify- each person who: (1) Was a witness to the incident through sight or hearing and/or; (2) Has knowledge of facts concerning the happening of the incident or conditions or circumstances at the scene of the incident prior to, at the time of, or after the incident. (b) With respect to each such person identified, state that person's exact location and activity at the time of the incident. (3) Was at the pizza place on the date and at the time Plaintiff(s) picked up the pizzas. (a) With respect to each such person identified in (3) above, indicate their address and telephone number. ANSWER: 9 0 0 6. If you know of anyone that has given any statement (as defined by the Rules of Ci-61 Procedure) concerning this action or its subject matter, state: (a) The identity of such person; (b) When, where, by whom, and to whom each statement was made, and whether it was reduced to writing or otherwise recorded; and (c) The identity of any person who has custody of any such statement that was reduced to writing or otherwise recorded. ANSWER: 10 Identify documents (except reports of experts subject to Pa.R.C.P. No. 4003.5) which describe the incident or the cause thereof. ANSWER: 11 8. If you know of the existence of any photographs, motion pictures, video recordings, maps, diagrams, or models relevant to the incident, state: (a) The nature or type of such item; (b) The date when such item was made; (c) The identity of the person that prepared or made each item; and (d) The subject that each item represents or portrays. ANSWER: 12 • 9. If you, or someone not an expert subject to Pa.R.C.P. No. 4003.5, conducted any investigations of the incident, identify: (a) Each person, and the employer of each person, who conducted any and (b) All notes, reports, or other documents prepared during or as a result of the investigation (s) and the persons who have custody thereof. ANSWER: 13 • lo. Identify each person you intend to call as a non-expert witness at the trial of this case, and for each person identified, state your relationship with the 'A itness and the substance of the facts to which the NAtness is expected to testify. ANSWER: 14 ll. If you intend to use any admission(s) of a party- at trial., identify such admission(s). ANSWER: 15 0 0 12. Describe separately each injury, condition, or disease, which you contend you sustained as a result of Accident. ANSWER: 16 • 13. State the name and address of every doctor, dentist, chiropractor or other health care provider from whom you have received treatment or by whom you have been examined since July 15, 2007, to the present time, and list each date when you received treatment or were examined by each doctor, dentist, chiropractor or health care provider. ANSWER: 17 • 14. State the name and address of every- hospital or medical facility to which you have been admitted as an in-patient since July, 15, 2007, to the present and list all dates on which you were admitted to each hospital or medical facility. ANSWER: 18 • 0 15. State the name and address of ever- hospital or medical facility at which you received out-patient, emergency, or clinic treatment since July 15, 2007, to the present and list all dates -,,\,hen you received such treatment at each hospital or medical facility. ANSWER: 19 16. If you are claiming a physical and/or mental disability as a consequence of the Accident, state: (a) the specific nature and degree of such disability; (b) whether it is total or partial; and (c) whether it is permanent or temporary. ANSWER: 20 0 0 17. If you had suffered any injuries, conditions, or diseases to any area of the body that you claim was injured or affected by the Accident at any time before that incident, state: (a) the date and place where each such injury occurred; (b) proAde a detailed description of the specific injury- or injuries, conditions or diseases sustained; and (c) if any, such injury required surgery, state the nature of the surgery, state the nature of the surgery performed, the name of the surgeon and the name of the hospital involved. ANSWER: 21 18. If you have suffered any injuries, conditions or diseases to an)' area of the body- that you claim was injured or affected by the Accident at any time after that incident, state: (a) the date and place where each such injury occurred; (b) provide a detailed description of the specific injun, or injuries, conditions or diseases sustained; and (c) if any such injury required surgery, state the nature of the surgery- performed, the name of the surgeon and the name of the hospital involved. ANSWER: 22 19. State the name and address of each person whom you intend to call as a non-expert N?dtness at the trial of this case. ANSWER: 23 0 0 20. List and describe all exhibits which you intend to use at the trial of this case. ANSWER: 24 0 0 21. Identit7 each person whom you expect to call as an exj)ert NAtness at trial and state the subject matter on which each such expert is expected to testify. ANSWER: 25 • 0 22. State whether you have ever been convicted of, charged iAAth, or pled guilty to a felony or a crime involving dishonesty, misrepresentation and/or fraud. If so, please provide the nature of the crime, date of plea or conviction, and court. ANSWER: 26 • 0 23. If you, your attorney or anyone acting on your behalf has conducted an investigation of the subject incident, please provide the name, address, and telephone number of all (a) persons contacted during the course of such investigation, and (b) all lA itnesses identified as a result of the investigation. ANSWER: 27 0 0 24. Did you take any medicine(s), or drug(s) prior to the accident? If so, for each such substance, state: a. The name of the medicine(s) or drug(s); b. The potency of each and the number of doses; C. The time you took each dose; d. A description of the condition which required such medicine(s) or drug(s); e. A description of any effect you experienced from taking the medicine(s) or drug(s); and The name and address of the person who prescribed the medicine(s) or drug(s). ANSWER: 28 • 0 25. State ivhether, as a result of this accident, you have been unable to perform any of your customary occupational duties or social functions and -O ith particularity (a) the duties and/or acti-Oties you have been unable to perform, (b) the periods of time you have been unable to perform, and (c) the names and last known addresses of all persons hay ing knoivledge thereof. ANSWER: 29 • .7 26. Did you speak with any employee, representative and/or agent of Defendants following the accident? If so, please state: (a) Whom did you speak A th; (b) When did you exactly speak with the above individual (date, time, place); (c) Please specify the substance of that conversation. ANSWER: 30 • • 27. HONA7 mane times have you purchased products from Defendant 'A thin the past five (5) years prior to the incident. ANSWER: 31 • • 28. Please state the name and address of any physician, medical care proN ider or hospital were you were seen or treated at in the 5 years leading up to the incident at issue. ANSWER: 32 • • 29. Please state the name and address of your family physician from 2005 through the present. ANSWER: 33 • • CERTIFICATE OF SERVICE AND NOW, this C day of June 2010, I, DAWN E. JARVIS, Paralegal, for the firm of THOMAS, THOMAS & HAFER, LLP, hereby certify- that I have this day served the tif f Lyubov Fachenko (Set One), by within Interrogatories of Defendants Directed to Plain depositing a copy of the same in the United States Mail, postage prepaid, at Harrisburg, Pennsylvania, addressed to: Howard B. Krug, Esq. PURCELL, KRUG & HALLER 1719 North Front Street Harrisburg, PA 17102 Attorney for Plaintiffs THOMAS, THOMAS & HAFER, LLP lawn E. -is, Pa. .P. Litigatio taralegal for Stephanie rs ger, Esquire 776145.4 34 THOMAS, THOMAS & HAFER, LLP James K. Thomas, II, Esquire Identification Number: 15613 Stephanie L. Hersperger, Esquire Identification Number: 78735 P.O. Box 999 Harrisburg, PA 17108-0999 717/255-7239 Attorneys for Defendants, Harrisburg Pies, Inc., d/b/a Domino's Pizza, Robert C. Rufo and Domino's Pizza LLC PAUL FACHENKO, LARYSA FACHENKO ANDREW FACHENKO, minor, by his Parent and natural guardian, PAUL FACHENKO and LYUBOV FACHENKO, Plaintiffs vs. IN THE COURT OF COMMON PLEAS CUMBERLAND CO., PENNSYLVANIA NO. 2008-6090 : CIVIL TERM HARRISBURG PIES, INC., d/b/a DOMINO'S PIZZA, ROBERT C. RUFO, And DOMINO'S PIZZA, LLC, : JURY TRIAL DEMANDED Defendants INTERROGATORIES OF DEFENDANTS DIRECTED TO PLAINTIFF, PAUL FACHENKO, AS THE PARENT AND NATURAL GUARDIAN OF ANDREW FACHENKO, MINOR (SET ONE) TO: Paul Fachenko, as the parent and natural guardian of Andrew Fachenko, minor C/O Howard B. Krug, Esquire PLEASE TAKE NOTICE that you are hereby required, pursuant to Pennsylvania Rules of Civil Procedure, Rule 4005 and 4006, as amended, to file the original and serve upon the undersigned a copy of your Answers and Objections, if any, in writing and under oath to the following Interrogatories within thirty (30) days after service of the Interrogatories. The Answers shall be inserted in the space provided. If there. is insufficient space to answer an Interrogatory, the remainder of the Answer shall follow on a supplemental sheet. These shall be deemed to be continuing Interrogatories. If between the time of your Answers and the time of trial of this case, you, or anyone acting on your behalf, learn of any • further information not contained in your Answers, you shall promptly furnish said information to the undersigned by Supplemental Answers. STANDARD INSTRUCTIONS (1) Duty to answer. -- The interrogatories are to be answered in writing, verified, and served upon the undersigned within thirty (30) days of their service on you. Objections must be signed by the attorney making them. In your answers, you must furnish such information as is available to you, your employees, representatives, agents, and attorneys. Your answers must be supplemented and amended as required by the Pennsylvania Rules of Civil Procedure. (2) Claim of privilege. -- With respect to any claim of privilege or immunity from discovery, you must identify the privilege or immunity asserted and provide sufficient information to substantiate the claim. (3) Option to produce documents. -- In lieu of identifying documents in response to these interrogatories, you may provide copies of such documents with appropriate references to the corresponding interrogatories. DEFINITIONS "Document" means any written, printed, typed, or other graphic matter of any kind or nature, however produced or reproduced, including photographs, microfilms, phonographs, video and audio tapes, punch cards, magnetic tapes, discs, data cells, drums, and other data compilations from which information can be obtained. "Identify" or "Identity" means when used in reference to -- (1) A natural person, his or her: (a) full name; and 2 • (b) present or last known residence and employment address (including street name and number, city or town, and state or country); (2) A document: (a) its description (e.g., letter, memorandum, report, etc.), title, and date; (b) its subject matter; (c) its author's identity; (d) its addressee's identity; (e) its present location; and (f) its custodian's identity. (3) An oral communication: (a) its date; (b) the place where it occurred; (c) its substance; (d) the identity of the person who made the communication; (e) the identify of each person to whom such communication was made; and (f) the identity of each person who was present when such communication was made. (4) A corporate entity: (a) its full corporate name; (b) its date and place of incorporation, if known; and (c) its present address and telephone number; 3 • (5) Any other context: a description with sufficient particularity that the thing may thereafter be specified and recognized, including relevant dates and places, and the identification of relevant people, entities, and documents. "Incident" means the occurrence that forms the basis of a cause of action or claim for relief set forth in the complaint or similar pleading. "Person" means a natural person, partnership, association, corporation, or government agency. "You", "Your" - means the person in whose name this action is brought, his employees, officers, representatives, agents, and attorneys, or any person working for such persons. "Statement" means a written statement signed or othemdse adopted or approved by the person making it, or a stenographic, mechanical, electrical or other recording, or a transcription thereof, which is substantially verbatim recital of an oral statement by the person making it and contemporaneously record. Respectfully submitted, THOMAS, THOMAS & HAFER, LLP June flpm, 2010 By: Awcxa?/?i JAMES K. THOMAS, II, ESQUIRE Atty. PA I.D. No. 15613 STEPHANIE L. HERSPERGER, ESQUIRE Atty. PA I.D. No. 7873; Attorneys for Defendants, Harrisburg Pies, Inc,., d/b/a Domino's Pizza, Robert C. Rufo and Domino's Pizza, LLC 4 • • INTERROGATORIES 1. Identify yourself, give your date of birth, place of birth (including hospital), social security number and all names you have been known by in the past. ANSWER: 5 2. Identify your genetic parents, identify your adoptive parents, if applicable, and your present custodian and/or guardian, their dates of birth, and social security numbers. ANSWER: • • 3. State your places of residence since your birth, where you resided for a period of three (3) weeks, or longer, the dates of each such residence, and the identity- of all legal guardians and/or other individuals with whom you resided at each such residence. ANSWER: 7 4. IdentiA all physicians and/or other health care providers Who treated you for the injuries that the adult Plaintiffs claim you have sustained as a result of the occurrence complained of in the Complaint, the dates of such treatment, and the nature of such treatment. ANSWER: 5. Identify- all physicians or other health care providers who have treated you since your birth for any injuries or illnesses sustained by you, other than the injuries, illnesses and/or symptoms which you claim to have resulted from the occurrence which is the subject of this lawsuit including in your answer the nature of such treatments and the dates thereof. ANSWER: 0 6. Identify all persons not identified elsewhere in your Answers to Interrogatories who have personal knowledge or information regarding the facts and circumstances of the occurrence which forms the basis of your lawsuit. ANSWER: 10 • E ?. State specifically the date on which you were first diagnosed as suffering from the injuries identified in your Complaint, the identity of the individual or entity by who you were so diagnosed. ANSWER: 11 • • 8. Itemize, through listing, all expenses incurred by you, on your behalf or to your benefit which you claim are a result of the occurrence wJhich is the subject matter of this lawsuit by indicating as to each the date on which any such expense was paid, the identify of the person or entity paying and state whether each such expense is subrogated or subject to a lien. ANSWER: 12 • • 9. State specifically and in detail the nature of all injuries, illnesses and/or symptoms suffered by you which you claim are or were a result of the occurrence complained of herein including in and not limiting your answer to the date of onset of each injury, illness and/or symptom, the dates on which you were treated for each such illness, injury- and/or symptom, and which of such injuries, illnesses or symptoms you contend are permanent in nature; if you are making no claim as to permanency for any of such injuries, illnesses and/or symptoms, then state the chronological dates during which these injuries, illnesses and/or symptoms were suffered by you. ANSWER: 13 0 lo. Detail the history of any treatment and/or received by you as a result of the alleged including in and not limiting your answer to, the nature of the treatment, the identify o provider rendering such treatment and the was received by you. ANSWER: 0 health care claimed to have been occurrence complained of herein, with respect to each such treatment, f the indix idual and/or health care date on which each such treatment 14 • 0 11. Please state the name and address of the hospital or other medical facility you were you were born at. ANSWER: 15 • • 12. State whether you have ever received psychiatric or psychological care or treatment, and if so, state the following: (a) The nature of the disorder for which you were treated and the name and address and specialty of the person treating you; (b) The dates for which treatment was given; and (c) Whether you were ever confined to any institution for the treatment of such disorders, and if so, state the name and address of such institutions and the date of confinement. ANSWER: 16 13. Please state the name and address of where you received pre-natal care at. ANSWER: 17 • • 14. Please state the name and address of every- health. care provider you have seen since birth. ANSWER: 18 • • 15. Have you ever been enrolled or gone to day care or have been taken care of by someone other than a family member? If so, please state the following: (a) Name and address of facility/person; (b) The dates of enrollment or during which you were cared for by said person or at said facility. ANSWER: June , 2010 By: Respectfully submitted, THOMAS, THOMAS & HAFER, LLP JAMES K. THOMAS, II, ESQUIRE Atty. PA I.D. No. 15613 STEPHANIE L. HERSPERGER, ESQUIRE Attyy-. PA I.D. No. 78735; Attorneys for Defendants, Harrisburg Pies, Inc., d/b/a Domino's Pizza, Robert C. Rufo and Domino's Pizza, LLC 19 CERTIFICATE OF SERVICE AND NOW, this I ?t?-daS , of June 2010, I, DAWN E. JARVIS, Paralegal, for the firm of THOMAS, THOMAS & HAFER, LLP, hereby certify, that I have this day served the within Interrogatories of Defendants Directed to Paul Fac:henko, as the parent and natural guardian of Andrew Fachenko, minor (Set One), by depositing a copy of the same in the United States Mail, postage prepaid, at Harrisburg, Pennsylvania, addressed to: Howard B. Krug, Esq. PURCELL, KRUG & HALLER 171g North Front Street Harrisburg, PA 17102 Attorney for Plaintiffs THOMAS, THOMAS & HAFER, LLP Jinds, ralegal-for ie Hersp rger, Esquire 776145.3 20 t THOMAS, THOMAS & HAFER, LLP James K. Thomas, II, Esquire Identification Number: 15613 Stephanie L. Hersperger, Esquire Identification Number: 78735 P.O. Box 999 Harrisburg, PA 17108-0999 717/255-7239 Attorneys for Defendants, Harrisburg Pies, Inc., d/b/a Domino's Pizza, Robert C. Rufo and Domino's Pizza LLC PAUL FACHENKO, LARYSA FACHENKO ANDREW FACHENKO, minor, by his Parent and natural guardian, PAUL FACHENK.O and LYUBOV FACHENKO, Plaintiffs IN THE COURT OF COMMON PLEAS CUMBERLAND CO., PENNSYLVANIA NO. 2ooS-6ogo vs. : CIVIL TERM HARRISBURG PIES, INC., d/b/a DOMINO'S PIZZA, ROBERT C. RUFO, And DOMINO'S PIZZA, LLC, : JURY TRIAL DEMANDED Defendants INTERROGATORIES OF DEFENDANTS DIRECTED TO PLAINTIFF, LARYSA FACHENKO (SET ONE) TO: Larysa Fachenko C/O Howard B. Krug, Esquire PLEASE TAKE NOTICE that you are hereby required, pursuant to Pennsylvania Rules of Civil Procedure, Rule 4005 and 4006, as amended, to file the original and serve upon the undersigned a copy of your Answers and Objections, if any, in writing and under oath to the following Interrogatories within thirty (30) days after service of the Interrogatories. The Answers shall be inserted in the space provided. If there is insufficient space to answer an Interrogatory, the remainder of the Answer shall follow on a supplemental sheet. These shall be deemed to be continuing Interrogatories. If between the time of your Answers and the time of trial of this case, you, or anyone acting on your behalf, learn of any w further information not contained in your Answers, you shall promptly furnish said information to the undersigned by Supplemental Answers. STANDARD INSTRUCTIONS (1) Duty to answer. -- The interrogatories are to be answered in writing, verified, and served upon the undersigned within thirty (30) days of their service on you. Objections must be signed by the attorney making them. In your answers, you must furnish such information as is available to you, your employees, representatives, agents, and attorneys. Your answers must be supplemented and amended as required by the Pennsylvania Rules of Civil Procedure. (2) Claim of privilege. -- With respect to any claim of privilege or immunity from discovery, you must identify the privilege or immunity asserted and provide sufficient information to substantiate the claim. (3) Option to produce documents. -- In lieu of identifying documents in response to these interrogatories, you may provide copies of such documents with appropriate references to the corresponding interrogatories. DEFINITIONS "Document" means any written, printed, typed, or other graphic matter of any kind or nature, however produced or reproduced, including photographs, microfilms, phonographs, video and audio tapes, punch cards, magnetic tapes, discs, data cells, drums, and other data compilations from which information can be obtained. "Identify" or "Identity" means when used in reference to -- (1) A natural person, his or her: (a) full name; and 2 • • (b) present or last known residence and employment address (including street name and number, city or town, and state or country); (2) A document: (a) its description (e.g., letter, memorandum, report, etc.), title, and date; (b) its subject matter; (c) its author's identity; (d) its addressee's identity; (e) its present location; and (f) its custodian's identity. (3) An o ral communication: (a) its date; (b) the place where it occurred; (c) its substance; (d) the identity of the person who made the communication; (e) the identify of each person to whom such communication was made; and (f) the identity of each person who was present when such communication was made. (4) A corporate entity: (a) its full corporate name; (b) its date and place of incorporation, if known; and (c) its present address and telephone number; 3 0 (5) Any other context: a description with sufficient particularity that the thing may thereafter be specified and recognized, including relevant dates and places, and the identification of relevant people, entities, and documents. "Incident" means the occurrence that forms the basis of a cause of action or claim for relief set forth in the complaint or similar pleading. "Person" means a natural person, partnership, association, corporation, or government agency. "You", "Your" - means the person in whose :name this action is brought, his employees, officers, representatives, agents, and attorneys, or any person working for such persons. "Statement" means a written statement signed or otherwise adopted or approved by the person making it, or a stenographic, mechanical, electrical or other recording, or a transcription thereof, which is substantially verbatim recital of an oral statement by the person making it and contemporaneously record. Respectfully submitted., THOMAS, THOMAS & HAFER, LLP June &-201o By: z - Z4 JAME K. THOMAS, II, ESQUIRE Atty. PA I.D. No. 15613 STEPHANIE L. HERSPERGER, ESQUIRE Atty. PA I.D. No. 78735 Attorneys for Defendants, Harrisburg Pies, Inc., d/b/a Domino's Pizza, Robert C. Rufo and Domino's Pizza, LLC 4 0 INTERROGATORIES 1. Please state: a. Your full name; b. Each other name, if any, which you have used, or by which you have been known; C. The name of your spouse at the time of the accident and the date and place of your marriage to such spouse; d. The address of your present residence and the address of each other residence, which you have had during the past five years; e. Your date and place of birth; f. Your social security number; g. Your military service and positions held, if any; h. The schools you have attended and the degrees, or certificates awarded, if any; and i. Whether you have ever been legally separated from, or resided apart from your spouse, and if so, when and why. ANSWER: 5 2. If you are covered by any type of insurance including first party medical, workers' compensation, disability, excess or umbrella insurance, etc., that might be applicable to the incident in this matter, state the following with respect to each such policy: (a) The name of the insurance carrier which issued the policy; (b) The named insured under each policy and the policy number of each policy; (c) The type(s) and effective date(s) of each policy; (d) The amount of coverage provided for injury to each person, for each occurrence, and in the aggregate for each policy; and (e) Each exclusion, if any, in the policy which is applicable to any claim thereunder and any reasons, if any, why you or the carrier claim the exclusion is applicable. ANSWER: 6 3. List and describe all expenses and losses that you have incurred because of the incident. ANSWER: 0 0 4. State v\ ith particularity the factual basis for each claim or defense you are asserting in this case. ANSWER: 0 9 5. Identify each person who: (1) Was a witness to the incident through sight or hearing and/or; (2) Has knowledge of facts concerning the happening of the incident or conditions or circumstances at the scene of the incident prior to, at the time of, or after the incident. (b) With respect to each such person identified, state that person's exact location and activity at the time of the incident. (3) Was at the pizza place on the date and at the time Plaintiff(s) picked up the pizzas. (a) With respect to each such person identified in (3) above, indicate their address and telephone number. ANSWER: 9 • 6. If you know of anyone that has given any statement (as defined by the Rules of Civil Procedure) concerning this action or its subject matter, state: (a) The identity of such person; (b) When, where, by whom, and to whom each statement was made, and whether it was reduced to writing or otherwise recorded; and (c) The identity of any person who has custody of any such statement that was reduced to,"Titing or otherwise recorded. ANSWER: 10 0 7. Identify documents (except reports of experts subject to Pa.R.C.P. No. 4003.5) which describe the incident or the cause thereof. ANSWER: 11 0 8. If you know of the existence of any photographs, motion pictures, video recordings, maps, diagrams, or models relevant to the incident, state: (a) The nature or type of such item; (b) The date when such item was made; (c) The identity of the person that prepared or made each item; and (d) The subject that each item represents or portrays. ANSWER: 12 0 0 9. If you, or someone not an expert subject to Pa.R.C.P. No. 4003.5, conducted any investigations of the incident, identify: (a) Each person, and the employer of each person, who conducted any investigation(s); and (b) All notes, reports, or other documents prepared during or as a result of the investigation(s) and the persons who have custody thereof. ANSWER: 13 io. Identi?- each person you intend to call as a non-expert witness at the trial of this case, and for each person identified, state your relationship with the lA itness and the substance of the facts to which the witness is expected to testify. ANSWER: 14 • • 11. If you intend to use any admission(s) of a part- at trial, identify such admission(s). ANSWER: 15 • • 12. Describe separately each injury, condition, or disease, which you contend you sustained as a result of Accident. ANSWER: 16 • 0 13. State the name and address of ever- doctor, dentist, chiropractor or other health care provider from whom you have received treatment or by whom you have been examined since July 15, 2007, to the present time, and list each date when you received treatment or were examined by each doctor, dentist, chiropractor or health care provider. ANSWER: 17 • • 14. State the name and address of every hospital or medical facility to which you have been admitted as an in-patient since July 15, 2007, to the present and list all dates on which you were admitted to each hospital or medical facility. ANSWER: 18 E 15. State the name and address of every hospital or medical facility at which you received out-patient, emergency or clinic treatment since July :15, 2007, to the present and list all dates when you received such treatment at each hospital or medical facility. ANSWER: 19 16. If you are claiming a physical and/or mental disability as a consequence of the Accident, state: (a) the specific nature and degree of such disability; (b) whether it is total or partial; and (c) whether it is permanent or temporary. ANSWER: 20 17. If you had suffered any injuries, conditions, or diseases to any area of the body that you claim was injured or affected by the Accident at any time before that incident, state: (a) the date and place where each such injury occurred; (b) provide a detailed description of the specific injury or injuries, conditions or diseases sustained; and (c) if any such injury required surgery, state the nature of the surgery, state the nature of the surgery performed, the name of the surgeon and the name of the hospital involved. ANSWER: 21 0 18. If you have suffered any injuries, conditions or diseases to any area of the body that you claim was injured or affected by the Accident at any time after that incident, state: (a) the date and place where each such injury occurred; (b) provide a detailed description of the specific injury or injuries, conditions or diseases sustained; and (c) if any such injury required surgery, state the nature of the surgery- performed, the name of the surgeon and the name of the hospital involved. ANSWER: 22 LJ 19. State the name and address of each person whom you intend to call as a non-expert iN itness at the trial of this case. ANSWER: 23 0 20. List and describe all exhibits vvhich you intend to use at the trial of this case. ANSWER: 24 0 21. Identify- each person whom you expect to call as an ex?)ert lA itness at trial and state the subject matter on which each such expert is expected to testify,. ANSWER: 25 • • 22. State whether you have ever been convicted of, charged with, or pled guilty to a felony or a crime involving dishonesty, misrepresentation anal/or fraud. If so, please provide the nature of the crime, date of plea or conviction, and court. ANSWER: 26 • 0 23. If you, your attorney or anyone acting on your behalf has conducted an investigation of the subject incident, please provide the name, address, and telephone number of all (a) persons contacted during the course of such investigation, and (b) all witnesses identified as a result of the investigation. ANSWER: 27 0 0 24. Did you take any medicine(s), or drug(s) prior to the accident? If so, for each such substance, state: a. The name of the medicine(s) or drug(s); b. The potency of each and the number of doses; C. The time you took each dose; d. A description of the condition which required such medicine(s) or drug(s); e. A description of any effect you experienced from taking the medicine(s) or drug(s); and The name and address of the person who prescribed the medicine(s) or drug(s). ANSWER: 28 0 0 25. State whether, as a result of this accident, you have been unable to perform any of your customary occupational duties or social functions and with particularity (a) the duties and/or activities you have been unable to perform, (b) the periods of time you have been unable to perform, and (c) the names and last known addresses of all persons having knowledge thereof. ANSWER: 29 • 0 26. Did you speak -Mth any employee, representative and/or agent of Defendants follol? ing the accident? If so, please state: (a) Whom did you speak A ith; (b) When did you exactly speak with the above individual (date, time, place); (c) Please specit, the substance of that conversation. ANSWER: 30 0 • 27. How many times have you purchased products from Defendant within the past five (5) years prior to the incident. ANSWER: 31 0 0 28. Please state the name and address of any physician, medical care pro-6der or hospital were N7ou were seen or treated at in the 5 years leading up to the incident at issue. ANSWER: 32 • • 29. Please state the name and address of your family physician from 2005 through the present. ANSWER: 33 • , CERTIFICATE OF SERVICE AND NOW, this Aey?&317 of June 2010, I, DAWN E. JARVIS, Paralegal, for the firm of THOMAS, THOMAS & HAFER, LLP, hereby certit- that I have this day served the within Interrogatories of Defendants Directed to Plaintiff Larysa Fachenko (Set One), by depositing a copy of the same in the United States Mai]., postage prepaid, at Harrisburg, Pennsylvania, addressed to: Howard B. Krug, Esq. PURCELL, KRUG & HALLER 1719 North Front Street Harrisburg, PA 17102 Attorney for Plaintiffs THOMAS, THOMAS & HAFER, LLP awn E. J r is, Pa. .P. Litigation ,aralegal or Stephanie Hersper, ger, Esquire 776145.2 34 0 0 • Street Address: 305 North Front Street, Harrisburg, PA 17101 Mailing Address: P.O. Box 999, Harrisburg, PA 17108 Phone: 717.237.7100 Fax: 717.237.7105 Stephanie L. Hersperger (717) 255-7239 sersperger@tthlaw.com Howard B. Krug, Esquire PURCELL, KRUG & HALLER 1719 North Front Street Harrisburg, PA 17102 RE: Fachenko, et al v. Domino's Pizza, Inc. et al. Cumberland County C.C.P. No. 2008-6090 TTH File No. 815-90988 Dear Attorney Krug: e Please advise when we can expect to receive answers to the written discovery directed to Plaintiffs and served on June 15, 2010. Once we receive the answers and obtain any additional documentation that is necessary, i.e. medical and/or employment records, then we can proceed to schedule Plaintiffs' depositions. Thank you. Very truly yours, August 11, 2010 THOMAS, THOMAS & HAFER, LLP By: Stephanie L. Hersperger SLH/gmc:717962.8 bc: Mike Zobrist, Scottsdale Claim No. 1090820 (via email ZOBRISM@scottsdaleins.com) Mr. Robert Rufa Scott H. Mandel, Esquire (via email scott.mandel@dominos.com) CJA, DEJ (via email) 0 0 • Jtl October 25, 2010 Howard B. Krug, Esquire PURCELL, KRUG & HALLER 1719 North Front Street Harrisburg, PA 17102 RE: Fachenko, et al v. Domino's Pizza, Inc. et al. Cumberland County C.C.P. No. 2008-6090 TTH File No. 815-90988 Dear Attorney Krug: • Street Address: 305 North Front Street, Harrisburg, PA 17101 Mailing Address: P.O. Box 999, Harrisburg, PA 17108 Phone: 717.237.7100 Fax: 717.237.7105 Stephanie L. Hersperger (717) 255-7239 sersperger@tthlaw.com We forwarded written discovery directed to Plaintiffs on June 15, 2010. We followed up on August 11, 2010, requesting the answers to discovery. To date we have not received any request for an extension of time or the answers. Please advise when we can expect to receive the responses. Thank you. Very truly yours, THOMAS, THOMAS & HAFER, LLP By: Stephanie L. Hersperger SLH/gmc:717962.9 bc: Mike Zobrist, Scottsdale Claim No. 1090820 (via email ZOBRISM@scottsdaleins. com) Mr. Robert Rufa Scott H. Mandel, Esquire (via email scott.mandel@do7ninos.com) DEJ (via email) 0 0 • • c..oe. w aa_e.... 305 North Front Street, Harrisburg, PA 17101 Mailing Address: P.O. Box 999, Harrisburg, PA 17108 Phone: 717.237.7100 Fax: 717.237.7105 Stephanie L. Hersperger (717) 255-7239 sersperger@tthlaw.com November 29, 2010 Howard B. Krug, Esquire PURCELL, KRUG & HALLER 1719 North Front Street Harrisburg, PA 17102 RE: Fachenko, et al v. Domino's Pizza, Inc. et al. Cumberland County C.C.P. No. 2oo8-6ogo Dear Attorney Krug: We forwarded written discovery directed to Plaintiffs on June 15, 2010. We followed up on August 11, 201o, and October 25, 201o, requesting answers to the discovery or when we can expect to receive the responses. I have heard nothing from you. Therefore, and unfortunately, unless we receive the answers within 1o days, I will have to file a Motion to Compel, which I hope will not be necessary. If you would like to discuss further, please do not hesitate to contact me. Very truly yours, THOMAS, THOMAS & HAFER, LLP By: Stephanie L. Hersperger SLH/gmc:717962.10 bc: Mike Zobrist, Scottsdale Claim No. 1ogo820 (via email ZOBRISM@scottsdaleins.com) Mr. Robert Rufa Scott H. Mandel, Esquire (via email scott.mandel@doininos.com) DEJ (via email) CERTIFICATE OF SERVICE 0 I, Jason C. Giurintano, Esquire, do hereby certify that on this day I served a true and correct copy of the foregoing document upon the following, by enclosing a true and correct copy in an envelope addressed as follows, postage prepaid: Howard B. Krug, Esquire PURCELL, KRUG & HALLER 1719 North Front Street Harrisburg, PA 17102 Respectfully submitted, THOMAS, THOMAS & HAFER, LLP Dated: By: )ZI-1 ES K. THOMAS, II, Esquire Identification Number: 15613 STEPHANIE L. HERSPERGER, Esquire Identification Number: 78735 JASON C. GIURINTANO, Esquire Identification Number: 89177 Attorneys for Defendants, HARRISBURG PIES, INC., d/b/a DOMINO'S PIZZA, ROBERT C. RUFO, AND DOMINO'S PIZZA LLC 4 PAUL FACHENKO, LARYSA IN THE COURT OF COMMON PLEAS OF FACHENKO, ANDREW CUMBERLAND COUNTY, PENNSYLVANIA FACHENKO, minor by his parents And natural guardian, : PAUL and LYUBOV FACHENKO, Plaintiffs V. HARRISBURG PIES, INC., d/b/a DOMINO'S PIZZA, ROBERT C. RUFO, and DOMINO'S PIZZA, LLC, Defendants : NO. 2008 - 6090 CIVIL TERM ORDER OF COURT AND NOW, this 24th day of FEBRUARY, 2011, a Rule is issued upon the Plaintiffs to Show Cause why Defendant's Motion to Compel Discovery should not be granted. Rule returnable ten (10) days after service. By the Court, Edward E. Guido, J. Howard B. Krug, Esquire For the Plaintiffs Esquire Jason Giurintano , For the Defendants `-..'' ies ma % al a??i? :sld co Cd'3 M,r7 ?' '' p 4 PAUL FACHENKO,LARYSA FACHENKO : IN THE COURT OF COMMON PLEAS ANDREW FACHENKO,minor,by his CUMBERLAND CO.,PENNSYLVANIA Parent and natural guardian,PAUL FACHENKO and LYUBOV FACHENKO, : NO. 2008-6090 Plaintiffs - .,. vs. : CIVIL TERM r �t d HARRISBURG PIES, INC.,d/b/a r- DOMINO'S PIZZA, ROBERT C. RUFO, ` And DOMINO'S PIZZA,LLC, JURY TRIAL DEMANDED Defendants PETITION FOR APPROVAL OF MINOR'S SETTLEMENT Plaintiff, Paul Fachenko, as the parent and natural guardian of Andrew Fachenko, files the instant Petition for Approval of Minor's Settlement, and in support of same, avers as follows: 1. Plaintiff, Paul Fachenko, is the parent and natural guardian of Andrew Fachenko, a minor(hereinafter referred to as "Minor Plaintiff') and filed the instant lawsuit on his behalf.1 2. The instant lawsuit was filed by Paul Fachenko, on his own behalf, and on behalf of Andrew Fachenko, a minor, and by Larysa Fachenko and Lyubov Fachenko. 3. Minor Plaintiff and his parents reside at 525 Poplar Church Road, Camp Hill, Cumberland County, Pennsylvania 17011. 4. Minor Plaintiff was born on January 14, 2006, and is currently 7 years old. 5. This lawsuit arose as a result of Plaintiff, Paul Fachenko, purchasing pizza from a Domino's Pizza, located at 1200 Market Street, Lemoyne, Cumberland County, Pennsylvania, on July 15, 2007. Plaintiff, Larysa Fachenko, also is the parent and natural guardian of Minor Plaintiff. — 6. Plaintiffs claim that each of them consumed some of the pizza and became ill as a result of there having been glass in the pizza. 7. In regards to Minor Plaintiff, Plaintiffs allege that Andrew Fachenko, who was approximately 1 '/2 years old, consumed some of the pizza on July 15th and July 16th 8. The medical records of Larysa Fachenko, Minor Plaintiff's mother, demonstrate that she went to the E.R. on July 17, 2007, complaining that she noticed grinding while eating the pizza and discovered glass; a CAT scan done of the abdomen was negative. She was given a GI cocktail and diagnosed with abdominal pain secondary to gastroenteritis/duodenitis and discharged. Mrs. Fachenko also saw her family physician on one occasion. 9. Plaintiff, Lyubov Fachenko (Paul Fachenko's mother), was seen in the E.R. on July 20, 2007, complaining of abdominal pain. The labs and the CT of her abdomen were unremarkable. She was diagnosed with gastroenteritis and was discharged on Bentyl and told to follow up with her family physician. She had no further treatment 10. Plaintiff, Paul Fachenko, did not receive any medical treatment. 11. Minor Plaintiff, Andrew Fachenko, was seen in the E.R. on one occasion. 12. Specifically, Minor Plaintiff was seen in the Harrisburg Hospital E.R. on July 18, 2007, at which time the chief complaint was rectal bleeding. He had vomiting and diarrhea. The child seemed like his usual self but did not want to drink. A true and correct copy of Minor Plaintiff's medical records, with private information redacted, is attached hereto and marked as Exhibit"A." 13. Minor Plaintiff's examination was normal but there was noted to be perirectal excoriation (tear/wear or abrasion of skin) where the blood was coming from. A first diaper had two pieces of glass in it, with the glass mostly being rounded. There was no glass in the stool 2 though. The parents were told to advance Andrew's diet as tolerated and to have him seen by his pediatrician. Diagnoses included perirectal irritation, glass ingestion and gastroenteritis. 14. Minor Plaintiff received no further medical treatment. 15. Minor Plaintiff fully recovered from his injuries. 16. On October 16, 2009, Plaintiffs filed a Complaint against Defendants, including the owner of the Domino's Pizza franchise, Robert C. Rufo. 17. In the Complaint, Plaintiffs allege that there are outstanding medical bills for the treatment of Plaintiffs in the total amount of $10,291.60; Plaintiffs claimed that this amount included$996.00 for the treatment of Minor Plaintiff 18. A subpoena served on Harrisburg Hospital for any medical bills pertaining to the treatment of Minor Plaintiff resulted in the production of invoices from 2007 (during which year Minor Plaintiff was seen in the E.R.), 2009, and 2010. All of these invoices demonstrate that presently there is a zero balance in regards to Andrew Fachenko. A true and correct copy of the Harrisburg Hospital (Pinnacle) statements are collectively attached hereto and marked as Exhibit 13.55 19. Moreover, a statement from Quantum Health (which performed the x-ray of Minor Plaintiffs abdomen when he was seen in the Harrisburg Hospital E.R.) also shows a zero balance. A true and correct copy of the Quantum Health statement is attached hereto and marked as Exhibit"C." 20. Additionally, none of Minor Plaintiff's medical expenses have been paid by Medicare, Medicaid, or any other type of medical assistance, disability pension, including Social Security benefits and Department of Public Welfare benefits. See the Verifications of Minor 3 Plaintiff's parent and natural guardian, Paul Fachenko, and Minor Plaintiff's mother, Larysa Fachenko, attached hereto. 21. The Complaint sets forth allegations of negligence and strict liability against Defendants for the glass being in the pizza. 22. However, it would be extremely difficult for Plaintiffs to meet their burden of proof in regards to their negligence and strict liability claims as testing of some of the pizza at issue, by two separate labs, has demonstrated that (1) the glass was not window or tempered glass, but green soda glass; and (2) that the position and temperament of the glass indicated that it was not present in the pizza during the cooking and slicing. A true and correct copy of the report of McCrone and Associates, Inc., dated March 3, 2008, is attached hereto and marked as Exhibit"D."2 23. In other words, it would be extremely difficult for Plaintiffs to meet-their burden of proof that the glass became embedded in the pizza during its preparation or the initial slicing of same. 24. In light of the above, Defendants offered a total of$11,359.48,to settle the case. 25. Plaintiffs have accepted said settlement offer, with$500.00 of it to be used for the benefit of Minor Plaintiff. 26. Petitioner, Paul Fachenko, as the parent and natural guardian of Minor Plaintiff, Andrew Fachenko, believes the $500.00 to be fair and in the best interest of Minor Plaintiff, in light of all of the above. 'Plaintiffs' counsel has not produced the report by the lab he retained to perform the testing,but has confirmed that it is consistent with the report produced by McCrone and Associates. 4 27. Most of the remaining portion of the $11,359.48, represents outstanding medical bills owed by Plaintiffs, Larysa Fachenko and Lyubov Fachenko; costs incurred by counsel for Plaintiffs also may be taken from that sum. 28. Counsel for Petitioner avers that he will not be receiving any counsel fees or costs from the $500.00 settlement amount for Minor Plaintiff. 29. Petitioner seeks this Court's approval of a minor's compromise settlement, and more specifically, requests authority to execute a full and final general release specifically releasing Defendants. A true and correct copy of the proposed Release is attached hereto and marked as Exhibit"E." 30. Petitioner, Paul Fachenko, as the parent and natural guardian of Minor Plaintiff, requests that the $500.00 be paid directly to him, to be used for the sole benefit of Minor Plaintiff See 20 Pa.C.S. § 5101(c) (providing that "[w]hen the entire real and personal estate, wherever located of a resident or nonresident minor has a net value of$25,000 or less, all or any part of it may be received and held or disposed of by the minor, or by the parent or other person maintaining the minor, without the appointment of a guardian or the entry of security . . . ."). 31. Petitioner, Paul Fachenko, avers that the $500.00 will be used for the sole benefit of Minor Plaintiff. 32. Larysa Fachenko, also Minor Plaintiff's parent and natural guardian, concurs with the request that the $500.00 settlement be paid directly to Petitioner, Paul Fachenko, to be used for the sole benefit of Minor Plaintiff. 5 WHEREFORE, Plaintiff, Paul Fachenko, prays this Honorable Court enter the attached proposed Order approving the proposed settlement and authorizing and directing him to execute a full and final release on behalf of Minor Plaintiff, Andrew Fachenko. Respectfully submitted, Date: 2 4 `" 3 4111b11>/2 • �� o � B. • • lre .171o. 1,6826 Purcell, Krug &Haller 1719 North Front Street Harrisburg, PA 17102 6 EXHIBIT "A" FACHENKO, ANDREW-Enc #280015192-oPT-HER-7/18/2007 Allergy Sheet - 7/18/2007 - 1 pg 4 (1004 (s0p12h8 . 5vOsOb0T'&10L'&17 .5C 4 (3@ Patient Name: FACHENKO ,ANDREca Sex: M Age: 1 DOB: Room/Bed / Pt# Med Rec#: 910050269 Home Address: Home Phone: City: Work Phone• St: Zip: Soc Sec# : Contraindications Date Type Description Reaction Sev Found 4 NKA NONE 07/18/07 Type: 1=Drug, 2=Food, 3=Misc Allergy, 4=No Known Allergies Severity: 1=Severe, 2=Moderate, 3=Mild *Implanted Devices : Inserted Removed *Date of Flu Vaccine Info from previous admission: *Date of Pneumonia Vaccine Info from previous admission: ALLERGY IDENTIFICATION FORM • PERMANENT CHART COPY 07/18/07 20:23 ESTUTZ 18P7 Page 1 of 1 ■ FACHENKO, ANDREW-Enc 428D015192-OPT-KER-7/18/2007 Consent for Treatment - 7/24/2007 - 1 pg CONSENT FOR TREATMENT 07/18/07 Harrisburg Hospital . FACHENKO ,ANDREW M 111•S.'Pront St. Harrisburg PA 17101 CONSENT FOR TREATMENT-I consent to the rendering of medical care, which may include diagnostic procedures and such medical treatment as my attending or consulting physician considers to be necessary. I also understand that, absent emergency circumstances,no invasive or experimental procedure will be performed upon me unless or until I have had an opportunity to discuss the procedure with my physician and give informed consent to the procedure. I understand that the practice of medicine and surgery is not an exact science and that diagnosis and treatment may involve risk of injury or even death. I acknowledge that no guarantee has been made to me regarding any examination or treatment In this hospital. PRE-CERTIFICATION REQUIREMENTS-If my insurance company or third-party requires pre-certification,then I understand that it is my responsibility to contact them to obtain such certification. EXCEPTION: Medicare. ASSIGNMENT OF INSURANCE BENEFITS-I hereby authorize my Medicare and/or medical insurance benefits payable to me under the terms of my insurance policies to be paid directly to Pinnacle Health Hospitals. if my attending physician and/or other physician associated with him or whom he may designate accepts Insurance assignment then I hereby authorize my Medicare and/or medical insurance benefits to be paid directly to those physicians. I assign any and all legal rights that I have to collect benefits to Pinnacle Health Hospitals. I understand that I am financially responsible for non-covered services, as well as any deductibles, coinsurance or amounts in excess of insurance benefits. I permit a copy of this authorization to be used in place of the original. GRIEVANCE APPEAL CONSENT- I hereby authorize Pinnacle Health Hospitals to act on my behalf In requesting a reconsideration of a medical determination made by my managed care plan or utilization review entity regarding my medical care. ADVANCE DIRECTIVES-INPATIENTS ONLY-I understand that Pinnacle Health Hospitals will provide me with written information regarding my rights to make health care treatment decisions in compliance with the Patient Self-Determination.Act of 1890.This information will be provided in the Patient Handbook. MEDICARE INPATIENTS ONLY-I certify that the information given by me In applying for payment under Title XVIII of the Social Security Act is correct. I acknowledge that I have received a copy of"An important Message from Medicare". My signature acknowledges my receipt of this message from Pinnacle Health and does not waive any of my rights to request a review or make me liable for any payment. I realize that lifetime reserve days are a once lifetime maximum of 80 days. If l should use all my full days and co-insurance days, I agree to use my lifetime reserve days for any remaining days. in 'PRIVACY NOTICE- I acknowledge that I have received a copy of Pinnacle Health System's Privacy Notice / PERSONAL VALUABLES-Pinnacle Health Hospitals is not responsible for personal items brought to the hospital. iinitl A safe is available for valuables such as cash, important documents, credit cards and jewelry that can not be sent home. All personal items retained at the bedside are the sole responsibility of the patient. /FrELEPHONE AND TELEVISION-i understand that there is a minimal daily charge for the availability of telephone Iinit1 (local calls only) and television service as these services are not covered by Insurance. This amount will be charged to my home telephone bill of which I am authorized to accept charges and allow the release of only that information to the telephone company that is necessary to bill for those services. PATIENT ANONYMITY-(Facility Directory Opt Out for Patients in the Emergency Department and Those Assigned to an In-House Bed) - I have requested Pinnacle Health Hospitals to control the knowledge of my identity and presence during this course of'care only. i acknowledge that the Pinnacle Health Hospital's Patient Anonymity Policy has been explained to me and that I have been provided with the guidelines. Signs of Patient or Legal Representative Date Signed CONSENT MUST BE SIGNED BY THE PATIENT'S LEGAL REPRESENTATIVE IN THE ASE.O MiN R, OR WHEN THE PATIENT IS PHYSICALLY ORrElITALLY INCAPACITATED. igneture o atli or Legal presentative Data Signed Printed name of Legal representative andIlelatianehip to Patient Patient is unable to�"Z W Hospital Repre solve Hospital Representative • Form INV 9790(04/2003)MR Form 604 153 QM1P MEDICAL RECORD Page 1 of 1 FACHENMO, ANDREW-Enc #280015192-OPT-HER-7/1$/2007 Facesheet - 7/1B/2007 - 1 pg *****PinnacleHealth Outpatient Facesheet***** Patient Name: FACHENKO ,ANDREW Patient No: Nurs Sta: Room/Bed: Med Rec No: -- -- Hosp Svc: HER Admit Date: 07/18/07 Pt Status : ET Pt Type: E Areas : Patient Info: SSN: ' Birthdate: Age: 1 Address: 7 VILLAGE CT City: MECHANICSBURG State: -2- Cd: 17050 Marital Sts : S Sex: M Phone No: Fin Class : D Religion: 1.,n._ face: C Patient Employer Info: Empr Name: CHILD Occupation: Address: City: State: Zip Cd: Phone : - Guarantor Info: Name: FACHENKO , PAUL Patient Rel : P Address: 7 VILLAGE CT City: MECHANICSBURG State: PA Zip Cd: 17050 Phone: Guarantor Employer Info: - Empr Name : SCHAFFER TRUCKING CO Occupation: Address: City: State: Zip Cd: Phone : - Emergency Contact Info: Name: FACHENKO , PAUL ' Patient Rel: F Address: 7 VILLAGE CT City: MECHANICSBURG State: PA Zip Cd: 17050 Home Phone : - Work Phone: - Insurance Information: Ins Code : 580 Priority: 1 Description: UNISON MED PLUS Subscriber: FACHENKO ,ANDREW Policy #: Group #: Precert # : Employer: UNISON MED PLUS Ins Code : Priority: Description: Subscriber: Policy #: Group #: Precert # : Employer: Ins Code: Priority: Description: Subscriber: Policy #: Group # : Precert # : Employer: Ins Code: Priority: Description: Subscriber: Policy #: Group #: Precert #: Employer: Adm Date: 07/18/07 Time : 20 :23 Adm Source: RA Adm Dr Not 00193 Adm Dr Name: EMERGENCY ROOM ASSOC Complaint : RECTAL BLEEDING Comments : IN FROM DAD CARD SCA Resp Party: SNAMUT 21 : 18 07/18/07 FROM P5C5, ZPPRADF1 Page 1 of 1 FACHENKO, ANDREW-Enc 11280015192-OPT-HER-7/18/2007 ED Facesheet - 7/24/2007 - 1 pg 07/18/07 Harrisbui� I ospttal 3 111 S. Fro''t St. EACHENKO ,ANDREW iv' 4. Har"risbur ;PA 17101 (N 11111En lleluliat(�� 111 `�• EMERGENCY DEPARTMENT 4 Age ' (Date of Birth Sex Date Time 4 ,0 1 1 M 07/18/07 20:23 SSN Chief Complaint: j 1 RECTAL BLEEDING Dr.Time in Vfi ❑Medical Command Date/Time Accident: Police Notified: DYes 0 No By: Primary Care Phys: Chief Comp: I/ " HPI: VI i>kf toy-224 y ,,i, AlHx: lergies: Location: Ir Quality/Severity Timing/Duration Meds: Context: Medical: Modifying Factors: Assoc Symptoms: Family: ROS: uneWeb Wain because Social: Const: HEENT: Tobacco: Drugs: ETCH: CV: Living Situation: Resp: PE: BP I P R T GI/GU: Sp02 Wt MS: Const: integ: Mental Status/Psych: Neuro: HEENT: Psych: CV: Endo: Reap: • HemlLymph: GI/GU: AlVtmmun: ❑"Ali other systems negative"C)See nurses note.reviewed integ: Neuro: Dx: f(n-44/ 4 t.s MS: Lymph: EKG: 9 Ll,S S If il4a ED Course: Radiology: 1A14.0 f CC Minutes: • Procedures: Dictated Service/MD Bed Type Follow-Up Referral Consult ❑ Condition on Di charge O Admission ❑MedfSurg CI Stable O Transfer 0 Telemetry Name 0 improved ❑Observation 0 Critical Care /? ❑Other . ?Discharge 0 Psych j Time E.D.Physician Private Physician Physician's Assistant/ Medical Student . Resident Fpmm!## 11111111„/, 1ft 531 Ili )II118N 167 ER ! Page 1 of 1 FACHENKO, ANDREW-Enc #280015192-OPT-HER-7/19/2007 ED Nursing Assessment - 7/24/2007 - 4 pg r.• airlebu 0 CGOH Aa U 1 El 2 1'' r.44 0 5 � Date: 'I j I$)1S7 time: �TI � r9 � i �, f.1 II Ili Patient Name: �tlh .r rc*) _ Aga: I g in Sex M tr3a(kg): {4 k9 a Vital Signs Level of Con- ciousness Ventilation Circulation Chief Complaint a d 54-4 nit% f, Temp: •t "ir-17 .0 a Alert p Clear • -irises C hi M. LIIr el hut -Fr c.A...4 BP: / ❑R O Obstructed (site) "II GAJC/ t �yJ OT ❑Verbal b Pr 2.79 Tie 5)a,h, CA,i Gt- .!❑ abored ,present❑absent Pulse: 1K8 ❑Pain°Ii / Non•Labo.ed /AAA Bib k'� -125,101 C, r')lkU , regular ❑Irregular j J Rasp: 0 Unresponsive DApnels �'slrong ❑weak 14+ ci Lf412J1" Oka 54Y041cy Es* a ❑IntUbated ., ;, ,. ., r, w _ .8/- •pertinent PMH t A 1 iih AliefII KS berw n. Isis n a GAL fa_ Pain Scale: 00 0 0 03 04 05 LAMP:O WA Lactation❑WA ❑Y ON k dA Triage Nurse: 1.6— us PRE HOSPITAL CARE UNIT: Mode of Arrival: Patient Disposition:❑Rndt ,�OUng Room„ Veal Signs BP: p. O BLS PALS Arrived with: AdulUChild ❑1Mieelchalr D&ik. o Identified Needs aft )- Lass o1 ❑Carried Unusualisuspidous marks ONO ❑YES Cied ❑Speaks No English ❑Sexual Abuse § Consciousness ❑ Language: ❑Domestic Violence E ❑ Airway ❑Oral ❑Nasal Ef TUS€ Translation By: ❑Safe Referral Size: IMMUNIZATIONS _II Oxygen ONC Vm CINEMA am 'TETANUS: PSH 1 Sodal ❑Suicide Risk a Pulse oz RA ; ,dhOoCf f Heart Rhythm: Oxygen iD ❑Not UTD Plan:(J f r CPR Started: '0 No ❑Yes Time Triage Protocol ' AED ❑No 0 Yes Time "Interventions: Medications CD IV Gauge Therapy Gai Site Solution a • DextrosUdc Mg/dl Medications Administered . Pre-hospital Signature of Provider. Triage 1 Primary Nurse: (,t,j. Struck 40 Time: r • VENTILATION NEURO❑ALERT❑ORIENTED �PAiN []DENIES bNA •. GU MEWS jWRBINGDIAGNt SJA . OSYW ETTOCALa UN LABORED OasoREHTED ❑ ❑GLASGOW COMA SCALE Ohio ❑DYSURIA 0 INEFFECTIVE ARMY CLEARANCE INEFFECTIVE PATTERN DL OR � " — Radiediam ❑FOLEY HEADACHE ❑f r�GAS�tCIA1 RALESIRitONCt.aLOR OSTMWFNECK SEVERIY(nona.wwro) GYN []DENTE$ DNA ❑FUGVDIULIBix9FIC1T y CI DIMINISHED 0L OR • 0RETRACndJ6 iJDIUINtess !) 1 2 3 4 8 pYAGINAt BLEEDING °ALT.BODY Tom z gRCULAnox EMDTWNAl.000OPERATIVE OABNORRIALFLOVtt_ OALT.Tissue PERFUSION DPULSES(�Ya:) 0UN000PERAT PERIPHERAL!CARDIAC 10EREBRAL O ['RESENT ❑ABSENT ANKIDUS GI COMES ❑� C3 DISCHARGE: ❑IMPAIRED SKIN INTEGRITY g ❑STRONG OweAK 0 FLATAFFECT 0 NAUSEA DUMDUM DEAN:ACUTE!CHRONIC & 0 REGULAR 13 IRREGULAR ❑AVOIDS EYE CONTACT CEXARRHEA 000NSTIPATION gaff ODES DNA a• 0mom:: 'mugs, 0°ARKSTOOLS VISUAL ACUITY: 0 INEFFECTIVE COPING 0 No 0 CAPILLARY REFILL: ❑ABRASION: _ ❑AaOOMEN❑NA ONOTCORRECTED ❑OTHER: 06:2 sEC 0>2 SEC D ACERATION: O SOFT CrIRU out , SKIN ❑ECCHYMOBIS: ❑DISTENDED OTXi ✓ CI PINK ❑PALE O oEFCVtl1TY OTt Ei Cs: CI EPI STApg O R A L 1 DORY O DIAPHORETIC ❑B SOUNOS 5 ❑BUNS: OEARACHE 0 0 D. ❑JAUNDICE OSEE BODY DIAGRAM(ON BACK) 0 PRESENT 0 ABSENT CI SORE THROAT PRIMARY NURSE SIGNATURE: TIME: 41)11' EMERGENCY NURSING PATIENT INFOPU5TIr�AI PINNACLEHfALTH i ,, 0, ,, �ni•'���' `1'1 ill Hospitals ASSESSMENT SHEET I . I� i a '' liii ' MR:910050269 CASE:28001E 192 ���II��11111111 IIIQ 11111111 FACHENKO,ANDREW t DATE: r17118107 DOB: AGE: 1 ED2505 t ph#: SSW: Form INVTte2(12/05)MR MEDICAL RECORD DR: NO(Formarry5401-SMA Page 1 of 4 FACHENKO, ANDREW-Enc #280015192-OPT-HER-7/18/2007 ED Nursing Assessment - 7/24/2007 - 4 pg . GLASGOW COMA SCALE -D EYE OPEN REST MOTOR KEEP. BEST VERBAL KEEP. • --�� 4-SPONTANEOUS I1.OBEYS COMMAND 5.ORIENTED 3.10 SPEECH 5-LOCALIZES PM 4•CONFUSED 2-TO MN 4.1ARiI4ORA1N8 3-INAPPVCRDS '{ 1-NONE 3.ABN FLEXION 21•INCO SOUNDS �)(� F 2-ABNEXTENSION -NONE l�1 1-NONE PUPIL SIZE R-REACTIVE 1 2 3 4 5 $ 7 S 5 . s-SLUGGISH RIGHT N.NONREACTWE LEFT RIGHT LEFT HAND s •...0•*110 4111 ANTERIOR POSTERIOR ,• . I , s — % a BODY SITE INJURIES CODE ❑NA / '1' r A.ABRASION ,\( / AV.AVULSION ' B-BURN CONTUSION ANTERIOR POSTERIOR -DEFORMITY L-LACERATION P-PUNCTURE SW-STAB WOUND RIGHT HAND S.SVVELLING • • , AMP-AMPUTATION - - e = • K • -f- X111/, ANTERIOR POSTERIOR • ti • • • • f Patient Name: - Patient S.S.#: tt • y.je''i.?Ad;1:'t'4134PO'tr%;i01.,Li'.'.,7,•Aria'it*rt"f''..q. ;.e..e•VAt1Yt,. w4tiE.. i L.n 1 A4-11 ti""Ner . - f".Ac-'d,.:.Vl •/r O'A'..r.r4r "."4•. .---,... Page 2 of 4 PACHENKO, ANDREW-Enc 1280015192-OPT-HER-7/18/2007 ED Nursing Assessment - 7/24/2007 - 4 pg Page of_ Procedures Medications 3 D ECG: ❑Labs:: D UA) DATEITtr4E DRUG POSE ROUTE SITE INIT 2 0 X-Ray: ❑BCk2 Bel. BC2: D Cit O WS: ❑ABG: IV Solutions DATE TEE SITE SIZE SOLUTIONNOLUME RATE INIT DateC[Ime BP p R SpDa Os I • PAIN NARRATIVE �- 012345is mpsli Are w WAIL tie ~L ►.. i 0 1 2 9 4 5 tte �rr►gra• ..._.,+~ _ '10123451 I • -"'"--10123451 _ _/-10123451 _dad 012345 • I ''-10 1 2 3 4 5-1 ,..........--10 1 2 3 4 5 r _____.--10 1 2 3 4 51 , _____.----1 0 1 2 3 451 • Admitted ► ;j. .:Ition Assessment Initials/Signature )0 Admit 0 23ahr OBS al ``-,� 2 B/P:4 P: f2:,_ _a ells flol• / ` Attending; 5 Sp02: Bed#: r a scharged • ransfe �It♦ ,,� Report (see Tr. star for, ) ����� �� sport called by: T o: Time: f o r re• 1 1 i. t Fa�li j ,� . r To Bed: Montt. aim altzed tinders '•ing of OYes 0 N 01 rlra .•. am a Mode: o WIC❑ y ri if, . tructions given by: V Stretcher Advanced Directives Discussed Cl Mode: •Ambulatory CI W/C ❑Heilcopte Copy available 0 RN 4 EMS CI Carried 0 Crutches RN EMERGENCY NURSING -• - • 4,PI NNACLEHEALTH CO NT SHE ON itl 1MI ; • 111111011111 11111 111111 111111 MR FACHFNXO,ANDREW CASE:008.280015192 DATE: 07118/07 Form NN 7443(021061 MR 51)2505 FRONT PM: AGE; I (Inn) (rwmwry8401-sex) DR: ESN, Page 3 of 4 FACHENHO, ANDREW-Eno #280015192-OPT-HER-7/18/2007 ED Nursing Assessment - 7/24/2007 - 4 pg .ie °!e •h-1vy Y+h?«.a.•'y}-A{\c.tr-, ""ai'15r'"iL� "tia'�+1`f{j Y+ •t t•"1••-' • wn r . Urinalysis Reference Ranges: Protein Negative Glucose Negative Bilirubin Negative Ketones Negative Blood Negative Nitrates Negative • : Leukocytesi; Negative •• Urobifidogen I Normal pH 5.0-8.0 Specific Gravity 1.003-1.030 Blood Glucose Monitor Reference Range: • 74-118 mg/d1. Troponin I Reference Range; • <0.03 ng/mL 0.49 ng/mL • • • • • • BACK Page 4 of 4 FACHENEO, ANDREW-Enc 9280015192-OPT-HER-7/18/2007 ED Patient Instruction Sheet - 7/24/2007 - 1 pg ` er •I .....r •,. . • • CGOH ED 657-7295 Harrisburg ED 782-5257 3 3 • . . R I �, .t . Please note that the instructions circled br checked/d below pertain to you. . - '` J You have been discharged with the diagnosis of ji d,e/f/rig//,,,,,,,,, /e 4./fig>rf . �.ri���f11)* The examination and treatment you have received in the Emergency Department have been rendered on an emergency .S basis,and not intended to be a substitute for ongoing care provided by a primary care physician or specialist. It is important for you to follow up with your physician and to return to the Emergency Department If you become worse in any way. General Instructions Supplemental Instruction Sheet 0 Yes Rest for ❑ MedicatIon(s) Off work I school from to - Return to work on /040 v414//f o' pi +AS ,s1�.1,s'n.i+ I ' Light duty for Regular duty p Miscellaneous Follow-un Care; 1. Return to the Emergency Department immediately if unexpectedly worse or not Improved. 0 Caution -Medications may cause drowsiness. 2. Emergency Department on -No alcoholic beverages. 3. Fans y Physician -Do not drive,operate machines,or perform 4. See Dr. • u;. on risk taking activities. • at AM/PM. • 4 5. Call the following clinic within one business day for an appointment to be seen in day(s): • Hamilton Health Center,1821 Fulton Street 232-9971 I hereby acknowledge receipt of these instructions,that I Community Health Center have had emergency treatment only,and that I may be -_Adult Outpatient,4th Fl •• 782-6421 released before aft my medical problems are known or Children&Teen Center,2nd Fl 782-4650 treated. I will arrange for follow-up care as I have been instructed. Orthopedic Clinic,4th Fl 782-2142 � � �"�..�, Surgical Clinic,4th Fl 782-6421 \ x � ''J� v1 Women's Outpatient Health Center,3rd Fi 782-4700 ='.41,79' e or Patlen _ -esponsitWe p Dal(: _Kline Family Practice Center,Landis Bldg.2nd Fi 782-2100 ,►, 6. If you smoke you are advised to stop.,Please call 717-221-6250 "gyres !'=." R.N.Signattae •hysl.“ SI•net • or access www.oinnaclehealth.orq for more information on smoking cessation. (-. • X-Ray instructions Date 40 PINNACIEHEALTH Radiology Studies-Including plain Hospitals , X-rays,CT/MR]Scans and Ultrasounds.Your Radiology Studies Emergency Department . Harrisburg-782-5257. CGOH-657-7295 have been reviewed by an P.O.Box 8700 Emergency Physician,Physician's Harrisburg,PA 17105-8700 Assistant or Radiologist. • A final Radiologist's interpretation will be reported and you or your, doctor will be notified of any c abnormalities which require ' follow-up. L Substitution Permissible /^k./ ,M.D.,D.O. IN ORDER FOR :• .NAME PRODUCT TO BE DISPENSED,THE PRESCRIBER MUST WRITE?BRAN a ECESS lb,'OR'BRAND MEDICALLY NECESSARY"IN THIS SPACE 44 PINNACLEHEALTH Hospitals ! !!I1 t uRMATION Emergency Department MAY is �`ir' i�-•—•,T u :r) ll+ t Patient instruction Sheet PA Lk N i?i MR, DEA No. FrgCHENKO.+4/t/D CASE:2800 T 5792 . ��J�III 11111 11111 11111 1111111! PRINT PHYSICIAN NAME . Lure: t)7 � LABEL ALL PRESCRIPTIONS Ph#: ero7 DOB. M ao2so7 Form SF1 29001(11108)MR DR: ALE: First copy- Second copy•Medical Records i (RA) SSA"; >x 2 Page 1 of 1 FACHENKO, ANDREW-Enc 1i280015192-OPT-HER-7/18/2007 ED Physician Orders - 7/24/2007 - 1 pg Date Time -LEVEL OF INTENSITY(LOU): tP+,srteomptstsefvva+o�InuoMuy +erf«mr««iy+w+FV) D Allergies: 1. Procedures/ 3 3 Supplies Lab Time: Initials: _Drug Levels Cultures Radiology C3Cardlac Monitor 0 ABG i7 Glucose Et Acetaminophen ❑Blood x Time ?^iz_!'o� ❑ECG ❑Acetone ❑Hepatic Panel ❑Aspirin ❑Chiamydia Initials:Cam.. ❑Nasogastric tube ❑Amylase ❑H&H ❑CarbamazepIne ❑GC ❑Foley Catheter CI ALT/AST 0 Lactic Acid ❑Dignxin ❑GC/Chlam dfa Portable:0C-spine ❑Stralght Catheter 0 Ammonia ❑Lipase ❑Lithium y CICXR ❑Pelvis ❑IV: ❑BMP 0 Magnesium ❑Phenobarbital 0 (Gene amp] Spine:❑C 0 O US ❑Cardiac 0 Myoglobin ❑Phenytoin 0 Sputum ❑Ankle I R D BNP 0 PT/1NR ❑Theophylline 0 Stool ❑CXR C102 LPM ❑CK-MB Total ❑PTT 0 Urine lox.❑Qua!HCG ❑Valproic acid ❑Stool-C-dfff ❑Elbow L R 0 Tltroat/stre ❑Facial ❑Pulse Oximetry T oponinel 0 Quant HOG Cardiac diiac Blood Bank ❑Urine p ❑Femur L R p oO�invasive 0 CBC w/auto diff` ❑CK-Total ❑Type&Cross ❑Wound: 0 Fos Finger L R COHbg ❑CK-MB ❑Type&Screen - ❑Peak Flow ❑Comp Met Panel ❑CK-Index Cl Rh Factor ❑Forearm L R ❑Neb Treatment: 0 CRP ❑Hand L R ❑D-Dimer(DVT) 0�Hroponin i Bedside Testing 0 Hip L R ❑Electrolytes ❑Sed rate 0 BGM 0 PTIINR CI Humerus L R • ❑ ETOH ❑Urinalysis ❑CG4+ 0 Qua!HCG(urine) ❑Nasal 0 Chem 8+ 0 Troponin I ❑K L R If ST Elevation MI U Thromtxtlysis(Order sheet) Ob Series AMI ❑STAT Cardiology Consult with (PreCath orders) 0 Pelvis Orders ASA 325 mg po 0 STAT, ❑Given PreHospltal, CI Taken at Home ❑Ribs L R Beta Blocker 0 Metoprolol mg IV q__minutes X 3(do not give If BP< and/or HR< ). ❑Shoulder L R ❑Metoprotol_mg po p Carvedidmg po (if EF anticipated to be under 40%) ❑Skull Diuretic: ❑Furosemide mg IVP, U Bumetanide mg IVP D Tiib/Fib L R 0 CHF if urine output<200ml.within 30 minutes consider redosing 0 Wrist L R Orders IV Vasodilating Agent: Symptom: 0 Nitroglycerin ,mcg/min IV . ❑CT:Acute U Vital Signs q 15 minutes Q IV:0.9 NSS a 50 mUhour Cl BGM 1 Cf Stroke Alert Team CVA 0 Labetalol mg IV ❑Nidipi IV ( called @ Time: US; Orders carne mg 13❑Venous Doppler Date Time Additional Orders: D MRI: 0 V-Q Scan ❑Other: •ail r Physician's signature• _ A 1�� Patient .entificat n 4, p,NNACLEHEA 1 `111 EMERGENCY DEPARTMENT • PHYSICIAN'S ORDERS MR: CASE:280015192 FACHENKO,ANDREW � till�� 1 (liii 11 �1 DATE: NK a/U7 00a: r w !! p p 1 Phi: A F. 1 FOND 047 30747(07/Mg MR E02502 OR: Sat: 00D)Pommy 0742.20 Page 1 of 1 • FACHENKO, ANDREW-Enc #280015192-OPT-HER-7/1B/2007 ED Report - 7/23/2007 - 1 pg ACCT#=00280015192 TRANSCRIBED DATE=07/23/2007 14 : 24 UDN= 2172976 FACHENKO, ANDREW RM#: MRN: CASE: DOB: ADM: 07/18/2007 PinnacleHealth System P.O. Box 8700 Harrisburg, PA 17105-8700 EMERGENCY DEPARTMENT CHIEF COMPLAINT: Rectal bleeding. • HISTORY OF PRESENT ILLNESS: This 13-month-old little boy apparently also had pizza yesterday as part of the family who was having. Unfortunately the pizza had pieces of glass. We saw the mother here yesterday. Incidentally the mother also had lymphocytosis. Apparently the little boy had diarrhea and also vomiting. There was no blood in the vomitus . There was no blood in the diarrhea. The parents are bringing two diapers, one contains two pieces of glass, they tell me, and one bloody. He is still his "usual" although he seems to not want to be drinking because it seems like his stomach is "upset" . No fever. No chills . No further nausea. He has not had any other trauma. REVIEW OF SYSTEMS: Review of systems otherwise negative. PAST HISTORY: Medical surgical history is negative . ALLERGIES ARE NONE. Medications are none. He is up to date on immunizations. FAMILY HISTORY: Negative and noncontributory to the present pathology. SOCIAL HISTORY: No cigarettes . No vices. Lives with the family. PHYSICAL EXAMINATION: Vital signs : Pulse 158 . Respirations 26. Temperature is unavailable at this time since he is basically crying and would not want to do a rectal . Constitutional : Awake, alert, little boy in no distress. Psychological : None. Head: Normocephalic; atraumatic. Eyes: Pupils equal and reactive to light. No exudates. ENT: Oropharynx clean. Mucous membranes are moist . Ears and nose without masses, lesions or deformities. Cardiovascular: No murmurs or gallops . Heart sounds normal . Respiratory: Clear to auscultation and percussion. GI/GU: Abdomen is soft. No hepatosplenomegaly or masses . No tenderness . No guarding. No rebound. There is perirectal excoriation where the blood is coming from, from the second diaper (by the way the second diaper did not have any stool, just red blood seen wiping. The first diaper did have two pieces of glass with no points, mostly rounded and the stool was heme negative) . Integument : The remainder of the integument is normal. Neurological : Non-focal . Musculoskeletal : No gross abnormalities noted in the musculoskeletal system. Lymphadenopathies : None. EMERGENCY DEPARTMENT PHYSICIAN TEST INTERPRETATION: The KUB was normal . There was no free air. EMERGENCY DEPARTMENT COURSE: DISPOSITION: At this time, I asked parents to advance diet as tolerated and take him to see his pediatrician. Should there be further problems Page 1 of 2 FACHENKO, ANDREW-Enc #280015192-OPT-HER-7/18/2007 ED Report - 7/23/2007 - 1 pg they can always return to the emergency department. I discussed with the parents the signs and symptoms peritonitis, acute abdomen. And of course it he continues to vomit and not drink they should return him here to the emergency department . DIAGNOSTIC IMPRESSION: 1 . Perirectal irritation. 2 . Glass ingestion. 3 . Gastroenteritis. c: HBG ED BILLING DEPT Signed by GUTIERREZ MD,JULIAN on 29-Jul-200715:53:34-0400 JULIAN GUTIERREZ, MD PATIENT: FACHENKO, ANDREW DD: 07/19/2007 DT: 07/23/2007 /klt D# : 2172976 ER REPORT ER REPORT ER REPORT END OF REPORT REPORT NAME=ER HOSP=POREGION=MB Page 2 of 2 E'ACHENKQ,.ANDREW-Enc 8280015192-OPT-HER-7/18/2007 Radiology Report - ABDOMEN AP VIEW - 7/18/2007 - 1 pg PiNNACLEHEALTH System Radiology imaging Report MR#: NAME: FACHENKO,ANDREW SSN: 7 VILLAGE CT ADM: 000280015192 MECHANICSBURG,PA 17050 DOB: AGE: 18M ORD DR: GUTIERREZ,JULIAN BED: ORD#: 90001 PTCLASS: E ATT DR: EMERGENCY ROOM, ASSOCIATES REASON: Bloody stools COMMENTS: er 5 ***Final Report*** HARRISBURG DIAGNOSTIC DEPARTMENT PROCEDURE: DIA-4000-ABDOMEN AP VIEW PROCEDURE DATE:Jul 18 2007 10:20PM ACCESSION#:5695732 Exam:Abdomen,one view at 2215 hours. History:Bloody stools. Results:A supine view of the abdomen was obtained with no prior studies for comparison. The bowel gas pattern is nonobstructive.No definite abnormal calcifications are identified.The visualized bones are normal for the patient's age. Impression: Nonobstructed bowel gas pattern. DICTATED:(07/19/2007 10:17) TRANS:(LJK/PS)ON:07/20/2007 09:21 INTERPRETED AND REVIEWED BY:CHRISTINE A.GOULDY,MD ELECTRONICALLY SIGNED:07/20/2007 09:21 To provide the best and safest patient care: During routine daytime weekday,weekend,and holiday on-site coverage,a Radiologist can be contacted at 782-5881(HH),857-7199 (CGOH),or 791-2451(Fredricksen Center). Alternatively a Quantum Radiologist can be reached by phone 24 x 7 x 365 at 932-8030. As Cinicians'consultants,the Quantum Radiologists are genuinely committed to providing meaningful interpretations. Accordingly,if the clinical team Is kt search of answers to specific questions,please include your questions(s)on the xray request form,and the question(s) will be specifically addressed in the Radiologist's report. Furthermore,if clinical urgency necessitates an Immediate verbal report,please Insure that the xray request includes a reliable phone number where you can be reached Immediately. • Study Interpretation provided by Quantum Imaging& Therapeutic Associates. if you have received this document by facsimile, the information contained in this transmission is privileged and confidential. If the reader of this message is not the Intended recipient,you are hereby notified that any dissemination,distribution,or copy of this communication is strictly prohibited. If you have received this communication in error,please notify us immediately at:1-717-782-3240. Printed:July 20,2007 9:22 AM Page 1 of 1 • EXHIBIT "B " « r��.-:;.741. .t,;s:t:...i..1�!NP..-:NF�':gaw"5:�'ti5• .:w '�'� r'�,;k�'.2. �..�..._ -?":ics '..,... .a:�..i.,_,.;�'�!._....._.t,..m..;ri:T�,y uri'tl+.: '�='�M�'�t'..'�it:..,:n 3 ' p i• L.,N� !t R_ nF „ 3 ,5 E4' i k , i � t Yom's " ^�a�r��3W$,.r]' kg5 , {p��f qq e. d6. 1 (a ii P•4, f,,. i s,t' -- sI' F ,,7t`ti/ tH. .';at—, .4a . ?!,..F _. .8 B.S.13.N..T.9 Q I 4/ r 9 i # .PTM$ .+ i �, S O�x C... gm R0. ...r P_.__.... N. F.Y 7 'tTy• !nR" 1'P t d f� i 3 H"t' f d ,�j P�*! I� .�j' NJ ({rtld t 5 Ali .{i ttttt ' v 9 `ai t�tth N TYPE Or DATE II Or :.•'....1:"S!-.ow,"1'h .&. . t ik ' `A• DILL II ILL 'r i..¢ x� a , `o„:: . N.. •_ s' s� O.;: p� q'., "r tl � CYCLE NB/02/07 �� ,g ' i t:f s hill- ::lI nr'4, x a.. P.._ ._�w-r R'' WISP AO. • � ��� N n - ':• � '� 39006- • «iNi_no-, PNN W - .+���,t�tt 41.f q fi _"�.: r::.s; :. ..p,�u•.., � .,` i xc.,. 9 �"mow' �-0 �. nuu. KuttPs:• -!t+,.:uniu n.:wcc � "� id:...R'?a.T':';js D E PATH= PAM nn PATIENT JNGNBU SEX ADS ADNISDION DATE DISCHARGE DATE 1 DAYS FACHENKO ANDREW �� M2 8M 07/18/07 M ���:x"�v :,k,�tt1}t' �"�`.r Frt. sNtt:7}kSNd�"Y.�.G.^.q��.:.i1.42'k3�]. a"f�x'ifl.^!ice.P.s:a: '�' 'P:N�i a iqu'.,.!ry.;Air.w4vu4'n PtinS Mni" � t n ZEA w n.i P ,fin ,nnn t fib"lit" fd� cay{ •H. ini 4• nn:nn��• {: t �_ :a:r �} f 1° �a reAecdN_ .NAT3 n �•sNnciiNN- ws ._ _. ,,!,+�St ,', INSURANCE 001IPANY MANE 0100E MOISEE POLICY Room RUARANI.OR PAUL FACHENKO tt UNISON MED PLUS 9001868109 NANO ' ;tit•1 /,,a 7 VILLAGE CT t ADDS MECHANICSBURG PA 17050 t•• % ' UTIERREZ JULIAN Lç .G.,c.F.�:. _3:� Nli�: .. •'Fi:_.� aq n ' � .e . n a r n�unmr'nomxir�n ∎ATE 07 '' Cr SERVICE TOTAL EST. COVERAGE EST. COVERAGE EST. COVERAGE EST. COVERAGE PATIENT SERVICE HOSPITAL SERVICES CODE (51AR051 IId:.CO. DD..I IDS.CO. NO. 2 702.10. 50. I 555.00. NO. E AMOUNT DETA L OF CURRENT CHARGES, PAYMENTS ANN ADJUSTME.TS 07/18 7427091 001 364.00 364.00 ' • VIS T LEVEL 3 E • 99283 07/18 7314000 001 165.00 165.00 ABDNMEN AP VIEW 74000 BALA CE FORWARD 0.00 SUM 'RY OF CURRENT CHARGES 60 EMER DEPT 364.00 364.00 RD RADIOLOGY 165.00 165.00 • SUB— 'OTAL OF CURR. CHARGES 529.00 529.00 GUA• RELATIONSHIP: P SEX: M ;UAR NO: 910050269 ACC DATE: TYPE: TI E: PLACE: EMPL REL: DIANNOSIS: 938 569.3 sTM Nrt PI E E f s ,1: t"'k Isay.rl'<#+., s *' :.:::7.04,Z 9R1 . ..� s'�ap I'� 'tv «di ,�; �.�. tt,+. .M .���!.. �' t�°•r.V`R �qr..1.%..4',. . a .. � < d.N�- t��I 'v_ a PATIENT IE7MDER IVEA5E RESER TO PATIENT ADDITIONAL PATIENr DILL7DD KAY DE NECESSARY S ir'E�" �� A57 N"ydrib.Y 110,1:14'tt . ,O4•.STEER W ALL INQUIRIES FOR ANY 0/TAROTS NOT POSTED MIED THIS STATE- i�yy7Av a • I 1V CORRESPONDENCE. HENS WAS "PARED. OR IF INSURANCE CASSIERD IT.E'R, igl AN • �vy, DO DOT PAY ANT PART 01 THE AMOUNTS SNOW - PINNACLE HEALTH HOSPITALS UNDER ERITIMAIE6 INSURANCE COVERAGE. HARRISBURG, PA . ' FLTOT:ATIZEIW,.F-ERMilf,T FT,2-TliNkli'.54f47'.'71Fir ig.gagriirratiE940:110clilifs0.11EtiffiN,01:iNit gRA4 .•dr ,rAmsrk. :- .,..Ihrurn--•.,,11'.• 40i,131 ,- 14., A -4+,i'. ielim• . ••' ilk •F ‘"- I 4--41.--tiagt-'t . -. "N r4P114,j A'.''...1' * .$'.4A4:4401-1. 14141. 10t . v:ridegji 1 inoia.7::MIIM TYPE OP out OP DILL DILL F41111 6,,,40.iiiikr:;:p7,,,,,':, ,'•,,, ri.:; ,.,.....t.,.:Ji v:!,..0q1k.f ..;„:,:ilaw:BAte 2,1... ,:41:::.?•e,i .4..:SItt.t.`. 113111LEL....,Imig CYCLE 19/24/10 f4.:'.'!mt 1 '41i-M 4..intirtfidwAtii.41rrati• ...!4;k:li'Tittil,i!AsSuirltNa ,gi Hose.110. orate-rr.i;,,, A i•i':,.,4.' ot.:z--7, -:i "". till f'7'%iiittit liripe; larfinp; 10.5 39006"; illi=21144,o-,A.-,4.f., 140,,.,.: 44;,.t...,. .,.siv ;5'r, ;TV '::. .::a I:: ti '. :. y ' IN 1,4;., , ' . •-: • ,,fftilt:r4a, AM-71 niii•;:.-.:'1 liati.,:;i41°Y.TEML,r:'.-1.1119.010104!;;,...iktiAtie,th.;,;;:illhoi.,..g:idge,:'3....24inTquAP ",ricrztrvar:Isur D E PATIENT ILANE . PATIENT PUNIER SIX ACE ADMISSION DATE IISCHARGE DATE DAYS FACHENKO ,ANDREW , -- M 4 09/08/10, i li.6 NOWISEA 4743 3 al VI h”: Epairmiwtr,;.;.:Shitiairecilitimisomailwrosi tow: 11130RAIICE COMPARE MEE MVP MUMMY pArley won 4Pr.f. WAIMMR LARYSA FACHENKO hilL ATEWAY HEALTH PI 22669081 NAXE AMD 52 VILLAGE CT Mtigt- 4..- ADDRESS MECHANICSBURG PA 17050 igfkli e*7T34. h14-',UNHAM ELEANOR Irk ditil.''.-4.10.0p 1.•1,:1.ti: tv,:LIrgtff. 119144.,...NIRIV31.1 i 11.9ilkiL.J.V .8 i:■:. . ,pNIMI.• 1,.z1 L.'',ti 9 ilalitlifgairOtIVAliprili num 1 It OP a-4,4 I ZS ,- SERVICE TOTAL XET. commix PSI. moor EST. COVERAGE EST. COVERAGE SERVICE HOSPITAL SERVICES CODE CRAMS us.co. No. I los.ao. so. 2 153.00. HO. 3 '55.00. NO. 'mow DETA L OF CURRENT CHARGES, PAYMENTS ANY ADJUSTMENTS 09/08 7427091 001 339.00 339.00 VIS T LEVEL 3 E 99283 09/08 7427127 001 268.00 268.00 INT REP F/E/E/N/L <2. 09/08 7359150 001 10.15 10.15 LET SOLN EA 00000 BALA CE FORWARD 0.00 SUMMARY OF CURRENT CHARGES 60 EMER DEPT 607.00 607.00 PHARMACY SELF ADM 10.15 10.15 SUB- OTAL OF CURR. CHARGES 617.15 617.15 GUA RELATIONSHIP: P SEX: F 3UAR NO: 910050269 ACC DATE: 09/08/10 TYPE: 5 TIME: 7:30 PM PL4kCE: EMPL REL: DIA1NOSIS: 873.44 873.44 PROoEDURE: 86.59 09/08/10 12051 09/08/10 owl, iehtst,n,N.vititi,; lir"tg:=1.S.1:1Mr. 04:14$ 4:''TritraMIMM44.'....ffireNr4014,.;;ik: ::a.S1P;'71t1 CPC an-;:4 ",1 iii="plan run= Summx 'Lust um TO rumor morrow. maw RULING NAY Olt mrcusaar pgrigiAgitiiii,:tarf.'? ri44:Erilp .,... MIDGES OH ALL INQUIRIES FOR ANY CHAROES NOT POSTED NEER THIS STATE- .jn„.116„,,,,,W''.--5,410i-,,,Erierlksi -,'7ATA7,4 I. Mb CORRESPONDENCE. Nur Su ammo. on u awn= CARRIERS t4, . .....itML .V..L4K.kA4 ;.•' ' °' or.• DO NOT PAY aar raw or rot moms MIMI wan ESTIMATED INISHUGICZ COMM. PINNACLE HEALTH HOSPITALS HARRISBURG, PA • . .....,: rr:. •sr.:..-,.-r m:- ..:,.'y._.. ...._..___....__. .... .... ^,'.::u_...:.. ?;+if.'..a-'?. ;i'SX •:c � x,.ays� f .� ....,,.: ,;;�.:;?E�"'^' "i'`;a!-f.�:::. .,rd'°5:R :r. _ _,;R....—.. .E, .�.E`-�,r;�;�.:��-€' _..I.;.w .k� L•.,, iiiE .,R.+3 s'i � +_ 1 .. �R''h .P l .,i' i'' 'n:. •!I' „if•s:' :a. ',,.. :a1 1 ,, +E.n r•am-A: .'' o sit S� ryu� g �p+� ... 'i"� ; 4'4','4 S' r R , :0 '.Ail r`n•a o PA :fu_it^.Y!!'l;!i?!'RY:ER'.E' _3.• fvtt _'4:' •R�'-3i,1 ARIL �, �'F3 i:.i74 •4 �' �:r�' I P 9 +,Ea+.k-N� ,•�y� TYPE OP DATE OF DATE OP P i I• .!rTSS x,4 Ej ' -" E I L' a"Ex, Ru t.' 4 a! iASgiaPi DILL DILL PREY-DILL "pl u ��!g. 'i.', `� ,agE�aw3� 2'S,i'E'�`, tylgi` g ,p,.,y pip u'E`tt� , aP 51*,i 5 Isro ,. , pt , . .2tF7t'trf,'j : tikt'§CM'dila CYCLE D1/15/09 q.''iri lR t0 4� 7 E 'Srl �••b •'�'.r""I.�9p' p 6 �oly`R 41R cc:'f.N'NC7Z.^ 21;`..4 HOBP.RO.•OUT P. ,'ii -4'. Pi Yn'n';g-;; e. � I rtz P 4 'g.`i'n •,_it;. iE. •00 • 'N::HS ..` :@+ d'...finiu'.'i". •R +E.4 !' !a rsMw .a•9r ira� E'au'?� " xa:�:rce..rthdd s. �,::_� •�:r,� .-.r.:. �, i:,_... �;,w.r.,...,.s...::::.4 : : a:a+. .-�S€ 1An' ! .+ Z 7,,`•' 0 • E PATIENT NAME PATIENT NUMBER SEE AGE ADMISSION BATE DISCHARGE DATE DAYS FACHENKO ,ANDREW - M 3 01/05/09,• ? R ' .I; i 'w°''iarR +;i_ rw1Wiame n �EFN, .T. .erlg a "m!Am ` ee:;+i t•tAtiuiic ii*Id+ a;ErtEr �! i s +si%•:4 +D s er„. i,tamih +gi J; ILU[MAMCE COMPANY NAME GROUP WR=EN PpEICY min n p >M eNAwMNroR PAUL FACHENKO Na R�:IGATEWAY HEALTH PI 22669081 NAME MID 412 BRIAN CT ' M» ::F AND 3.-h:E a ADDUSS MECHANICSBURG PA 17050 raiiF@.; ar kv 4k T M AL..o--An,-x.�,'Y G m KENNETH W�•„,,:wJ m d - 2 ,,11,4140s61a4c A w . , R I i h ' s` 4,417 a.,, ax S mx w '.' an.ucn' ::•.ar.. .:n , . pt !� ry :. . , �: �g@ .c '.n S, � • I� M 14ipl �.q. . s ^, :.-4-:: .ti a uramm fN� ,i s F ; !r : E ' S 8 : O AON0 ai a ,', ,+r.Bd F2' x `� k a u . h bie r'P .”. c s`re : d R: PAYN:cm u OP DEEM ION St SEIV CE TOTAL EST. COVERAGE ESE. COVRG EST. COVERAGE EST. COVERAGE PATIENT I jjjj OA SERVICE HOSPITAL SERVICES CODS CHARGES IRS.CO. DO. I INS.CO. IA. 2 INS.CO. MO. 3 IMS.M. NO. 4 AMpRIF DETA L OF CURRENT CHARGES, PAYMENTS ANE ADJUSTMEVTS 01/05 7427091 001 380.00 380.00 VIS .T LEVEL 3 E 99283 01/05 7427298 001 78.00 78.00 THE• AP/PROPHYL/DIAG/IN96374 01/05 7357014 001 17.00 17.00 NSS 100 BG 00000 01/05 7359128 005 43.58 43.58 UNA'YN 375MG/ML 00000 BALA CE FORWARD - 0.00 • SUMMARY OF CURRENT CHARGES 60 EMER DEPT 458.00 45.8.00 PHARMACY 60.58 60.58 SUB— TOTAL OF CURR. CHARGES 518.58 518.58 GUA' RELATIONSHIP: P SEX: M 3UAR NO: 910050269 ACC DATE: TYPE: TINE: PLACE: EMPL REL: DIA(NOSIS: . 522.4 784.2 PRO'EDURE: 99.26 01/05/09 • riri;iipici',/p. �,� i .� •:sara+:a,a+s+Ga•t +arx " .tea .z�rT; ha n .. • w. + :+ ,w=r• �!hirog'a.-i.„s,I,,�:a,ti. , wihl+s-lTisa as a;~ p;s^ rz �:'.•+Mn r� S r er t �';+s ''" . i' r,j ,I" k 7'}1.'.' !'fir""""4.1;11•'fr$4.1 a PA TIIIIT; IMIDER PLEASE AEPER TO PATIENT ADDITIONAL PATIENT SIU.IWG WAY BE NECESSARY r�jg I T'+��ifh *„Ai 'RUNNER ON ALL INQUIRIES FOR ANY CHARGES NOT PONIED WHEN THIS SPATE- fir•1i 41,,44 .0,..: .." .'WAN 12 �': AND CORRESPONDENCE. MGM WAS PREPARED. 05 IP INSURANCE CARRIERS ; ".,A-.',,.,:-.,- -: _.I AA.";�',•s5 't:?:..._.•.io.r..!.:: DO.GOT PAY ANY PART OF TIN AMOUNTS SHOWN UNDER ESTIMATED INSURANCE COVERAGE. • PINNACLE HEALTH HOSPITALS HARRISBURG, PA • EXHIBIT "C " • n.-a, I/ b 3 a " el R_ -4 �° e n 0 to x m to (.1 s Z O = a Q al me N , ' G p O to o S 404 V- 3 C C D E, ( OI N s; °o .0 ^. a a o ti'. C v 3 a UI a a N C `^ z m o Da ro C n "4 ?o a. OrCI 49 ffan ° o °o IA h n c Pf nl y CD • V 0 S t1 --4 C M x 0 3 a c 0 -is m r. d 2 •I.,• G) cA N O V N W NX b C Si 4 o m _� 4 O N 6 CO O O n > Q g. 0 ID sQ C. M o -v ro z mz W z °.: K n co io -I =a M .rte. O w QT n N r z ppV O O b Z v D V ^J V C X O O O M -4 O A CO Li b �„ a ac o d to a -r, g m o ., • • EXHIBIT "D " —____ __ . _ . : 4,HaegE@MLE ASSOCIATES. INC. 850 Pasquineili Drive westmant,Nlinais 60559-5539 630-887-7100• Fax:630-887-7417 3 March 2008 Mr. Mike Zobrist Scottsdale Insurance Company 8877 N. Gainey Center Drive Scottsdale, AZ 85258 - ` 0ti. DS O Subject: Examination of a Piece of Pizza for the Possible Presence of Foreign Material Re: McCrone Associates Project MA46360 Dear Mr. Zobrist: We have completed the above referenced analysis and this report confirms information that was provided to you, via e-mail, on 27 February 2008. This report summarizes the analytical methodology used in, and the results that have been obtained from the analysis of one piece of pizza. The analysis has been conducted under the authority of your retainer check. SAMPLE RECEIPT On 15 January 2008, we received one slice of pizza from Mr. Terry McLaughlin, Adjuster in Charge, Crawford & Company, PO Box 1548, Mechanicsburg, PA 17055. The sample arrived intact at ambient temperature and was frozen in our facility until analysis. Mr. McLaughlin requested that we examine the pizza for the presence of foreign particles (possibly glass), that the particles be identified and that we make a possible determination as to how the particles may have arrived in the positions in which they were found. Subsequently, he requested that the final report be directed to your attention. ANALYSIS The sample was a "wedge-shaped" piece of pizza with the tip removed. Upon initial observation, it was thought that the pizza contained pepperoni slices; however, upon closer examination macroscopically and microscopically, it is believed that the pizza contains pineapple and may be ham and pineapple (see Figure 1). The piece of pizza E was initially examined using a stereomicroscope without removal of any material (see " the exception below associated with the photography of"c"). Two locations showed the fi presence of colorless hard material consistent in appearance with glass. These 2 particles were located in the pizza dough, not in the pizza toppings. Location 1 has v t The resub and concxtsans,herein,have been peer-reviewed and are aonaidm d thorough and complete t y McCrone Associates,Inc.The resits apply exclusivey to the samples analyzed and docvmeMed in this report No Weber revisions wilt be made unless a corrective action is deed warranted by McCrone t 1 Associates.Inc.dissemination,interpretabon,and/or reproduction,except in wtmte,are not a commended as doing so may alter and/or nuliiy the results. Page 1 of 5 Mr. Michael Zobrist MA46360 been designated for the tip of the pizza slice and Location 2 for an area along one side of the pizza near the back edge. Figure 2 identifies these two general locations. Location 1 contained three visible pieces of possible glass and Location 2 contained one piece of visible possible glass. Figures 3 through 9 contain detailed photographs and photomicrographs of the Location 1 pieces of possible glass as they were found. Note that in Figures 8 and 9, a flap of dried cheese was removed to expose the"c" particle of possible glass for photography. Figures 10 through 13 contain photomicrographs of the single possible glass particle found in Location 2. The toppings and bottom crust of the pizza were examined for indications of how the possible glass particles arrived in their locations. No visible.evidence of holes in the crust or toppings consistent with the particles having been pushed into their current positions through the bottom crust or the topping was evident. In both locations, the particles could have been pushed in through either of these locations before the pizza was cooked, with the rising of the dough and/or cooking of the pizza obscuring the holes. It can be stated that neither of these areas were the entrance point after the pizza was cooked or after reheating. Figures 14 and 15 contain photomicrographs of the bottom crust from Locations 1 and 2 showing there is no disturbance to the bottom surface of the cooked crust. The stereoscope was further utilized in examining each of the particle locations in an attempt to determine when the particles may have been added to the pizza dough. The areas around each of the particles were examined before and during the excision process of the particles. The excisions were accomplished using a fine tungsten needle, a micro-scalpel and a single-edged razor blade. Figures 18 through 24 show the particles in various stages of being excised and Figures 25 through 28 contain photomicrographs of the fully excised pieces of possible glass. All of the particles were fairly large with the following approximate measurements: • Location 1, "a"—8 mm by 3 mm • Location 1, "b"—7 mm by 4 mm • Location 1, "c"—8 mm by 5 mm • Location 2—6 mm by 2 mm Certain of the particles showed indications in the dough adjacent to the particles that the dough was hot after the glass was located into the dough. Piece"b"had dough and/or cheese surrounding a portion of the exposed end (see Figure 16). During the excision process, this piece, as well as"c"from Location 1, showed the dough well molded into the shape of the particle with a shiny surface to the dough indicating the dough/glass was hot after the glass was in place. Additionally, the possible glass from Location 2 The results and conclusions,herein,have been peer reviewed and are cauidered thorough and complete by McCrcne Associates,Inc. The results apply exclusively to the samples analyzed and documented in this report. No further revisions wtll be made unless a corrective action Is deemed warranted by MoCrone Associates,Inc.Dissembalion,interpretation,andbr reproduction,except ki whole,are not recommended as doing so may alter and'or nuUy the results. Page 2 of 5 Mr. Michael Zobrist MA46360 not only appeared to be larger than the hole it was viewed through but, when partially excised, it appeared to have stringy bits of dough adhering to it (see Figure 17). Each of the glass particles was somewhat wedge-shaped, sharp-edged and positioned in the pizza crust such that each was nearly parallel to the bottom of the pizza crust. After these four particles were removed, a single-edged razor blade was used to split the bottom pizza crust approximately parallel to the bottom surface. No additional large or small particles of glass were found. Examination of the pizza toppings did not include removal of topping ingredients; however, no possible glass particles were seen on or protruding through the toppings. It would seem logical that, if the Location 1 particles were in place when the tip of the pizza slice was removed (cut or bitten), the hard particles would only end up being uniformly exposed if they had been broken together. Given the hardness of the particles, there should be some sign of evident breakage on the exposed edges of the particles andlor the presence of small bits of glass from the breakage process in the dough around the particle and/or some disturbance of the dough around the particle where the cutting/biting process caused the particles to disturb the dough before they were broken. None of these observations were present. It is also curious that all of the located foreign particles were exposed at the edges of the slice of pizza with no additional glass being located interior to the edges of the pizza slice, that all of the particles were relatively large and of similar size and shape, and that the length of each particle was approximately parallel to the crust bottom. in order to confirm that the particles were glass, each particle was agitated in acetone to clean away some of the surface debris and then they were prepared for elemental analysis by scanning electron microscopy (SEM)equipped with energy dispersive x-ray spectrometry(EDS). Appendix I contains representative data from each particle. Each page contains data from one of the four particles. Each page includes an image of a portion of the particle referenced with sampling locations indicated on the image, one representative EDS elemental spectrum and a table listing the elemental weight percents for elements found in each analysis area. The EDS data confirm that the particles are glass and most likely soda-lime glass. Further, the elemental composition is suggestive of possible container glass. The shape of the glass particles indicates that they are not tempered glass. No flat parallel sides were located on any of the particles to suggest this is flat glass (e.g., window glass) or from which to determine a possible thickness of the originating glass object. The type of breakage seen on the particles is somewhat unusual in that certain pieces contain stress fractures with a non-typical appearance and certain pieces contain rounded fracture areas that give the impression that they may be from a container glass application rather than a fiat glass application. The results and condusions,herein,have been pear-reviewed and are considered thorough and complete by*Crone Associates,Inc. The results apply exclusively to the samples analyzed and documented in this report No further revisions win be made unless a corrective action is deemed warranted by*Clone Associates.Inc. Dissemination,interpretation,andlor reproduction.except in whole,are not recommended as doing so may alter and/or mlliy the results. Page 3 of 5 • Mr. Michael Zobrist MA46360 Although this type of data cannot confirm their origins or that the glass pieces share a common origin, there is nothing in their chemical data or physical appearance to suggest different origins. REPORT SUMMARY Four hard colorless foreign particles have been located in two separate locations in the pizza crust and all four have been identified as glass. There are no indicators associated with any of the glass particles to confirm origin; however, all of the pieces are consistent with a common class of glass products known as soda-lime glass. There is no confirming data from the particles showing them to be from a container glass source rather than a flat glass source; however, container glass is suggested from their general appearance and elemental data. Concerning their time of placement in the pizza crust, there are conflicting observations. The size, shape, general placement of the glass particles and a lack of any indication that the glass particles were broken after placement in the tip of the pizza are indicative of the glass being placed in the crust after formation and cutting of the pizza slice. Therefore, since the slice would not have been cut before cooking the pizza, the glass would not have been in place at the time of initial cooking of the pizza. Contradicting this are dough/cheese around small portions of the exposed ends of the glass and the appearance of the dough next to the glass pieces where it appears that the pizza was hot after placement of the glass. One possible explanation for the glass not having not been in place during the initial cooking of the pizza and yet seeing the appearance of heat exposure after the glass was in place would be placement of the glass in the pizza after the pizza was cooked and sliced and then reheating the slice after the glass was in place. The remaining pizza sample and glass particles accompany this report. The pizza slice has been considerably altered in the examination process and four glass pieces have been secured under tape on an index card. This testing was conducted in a Good Manufacturing Practices compliant laboratory. The result,end conclusions,herein,have been peer-reviewed and are considered thorough and complete by MoCrone Associates,Inc. The results apply exclusively to the samples analyzed and documented in this report. No?tether revisions wia be made unless a corrective action is deemed warranted by McCrone Associates,inc. Dissemination,interpretation,and/or reproduction,except h whole,are not recommended as doing so may alter and/or nullify the results, Page 4 of 5 • • • Mr. Michael Zobrist - MA46360 Thank you for consulting McCrone Associates. if you have any questions concerning our services or personnel, please visit our WEB site: www.mccrone.com. If you have any questions concerning the report, please do not hesitate to contact me directly by telephone or e-mail (wchapin @mccrone.com). Sincerely, William Lee Ch pin Senior Research Microscopist WLC:Ins Enclosures Ref: MA46360; Retainer Check CC: Terry McLaughlin Crawford and Company 211 Linda Drive Mechanicsburg, PA 17055 • The results and conclusions.herein,have been peer-reviewed and are considered thorough and complete by McCrone Associates,Inc.The rests apply exclusively to the samples amatyzed and documented in this report No further revisions w be made unless a corrective action is deemed warranted by'acetone Assodates.inc.Dissemination.interpretation,andlor reproduction.except In whole,are not recommended as doing so may alter andlor ntahty the resins. Page 5 of 5 • APPENDIX I EDS Data from Four Glass Particles Recovered from a Slice of Pizza Ref: MA46360 (4 pages) 41 ASSOCIATES,INC. x 0 • s x . it o ►. 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Y .1 /� .y 1 Y F. m '( c) r �v1� a• • EXHIBIT "E " a FULL AND FINAL RELEASE KNOW ALL MEN BY THESE PRESENT,that ANDREW FACHENKO,A MINOR, BY HIS PARENT AND NATURAL GUARDIAN, PAUL FACHENKO, (hereinafter referred to as "Releasor"), in consideration of the sum of five hundred dollars and no cents ($500.00), lawful money paid on behalf of HARRISBURG PIES, INC., d/b/a DOMINO'S PIZZA, ROBERT C. RUFO, and DOMINO'S PIZZA, LLC, does hereby release HARRISBURG PIES, INC., d/b/a DOMINO'S PIZZA, ROBERT C. RUFO, and DOMINO'S PIZZA, LLC and their insurers, employees, agents, and any and all other persons and firms ("Releasees"), of and from any and all actions, causes of action, claims, demands, damages, costs, loss of services, expenses, compensation, consequential damage, or any other thing whatsoever including claims for Releasor's own personal injuries and damages on account of or in any way growing out of, any and all known and unknown personal injuries, debts, and property damage resulting or to result from the purchase of pizza at Domino's Pizza, located at 1200 Market Street, Lemoyne, Cumberland County, Pennsylvania, on or about July 15, 2007, which is the subject of the Complaint filed in the Court of Common Pleas for Cumberland County at Civil Action No. 08- 6321 ("the litigation"). Releasor hereby acknowledges and assumes all risk, chance, or hazard that the said injuries or damages may be or become permanent, progressive, greater, or more extensive than is now known, anticipated, or expected. No promise or inducement which is not herein expressed has been made to Releasor, and in executing this Release, Releasor does not rely upon any statement or representation made by any person, firm, or corporation, hereby released or any agent, physician, doctor, or other person representing him concerning the nature, extent, or duration of said damages or losses, or the legal liability therefore. Releasor understands that this settlement is the compromise of a disputed claim and that the payment is not to be construed as an admission of liability on the part of the persons, firms, and/or corporations hereby released by whom liability is expressly denied. Releasor further certifies, states, acknowledges, warrants, and declares that each and every person, attorney, carrier, entity or association which claims to have a lien on the proceeds of this settlement arising out of this litigation, is aware of this Release and its terms and Releasor understands that said released parties hereunder are relying expressly upon this unconditional express warranty in making payment hereunder. The Releasor accepts responsibility for satisfying any liens that have been asserted against this recovery by any worker's compensation insurance carrier, healthcare provider or insurer and all other entities or associations, and hereby discharges the Releasees from any such responsibility. In further consideration of the above payment, Releasor, for himself, for his heirs, next of kin, executors, administrators, successors, or assigns, covenants and agrees to indemnify and hold harmless HARRISBURG PIES, INC., d/b/a DOMINO'S PIZZA, ROBERT C. RUFO, and DOMINO'S PIZZA, LLC their agents, employees, parents and subsidiaries, insurance carriers, and attorneys, from all claims, demands, and suits for damages, costs, loss of services, expenses, or compensation which may arise in the future on account of or in any way growing out of the injuries or damages Releasor sustained and which is the subject of the litigation. 2 It is further agreed, that the Releasor will obtain court approval concerning the settlement of the claim of Andrew Fachenko, a minor. The Releasor will also reference and incorporate this release into any petition or writings that are submitted to the court to obtain the court's approval of the settlement for Andrew Fachenko, a minor. This Release contains the entire agreement between the parties hereto and the terms of this Release are contractual and not a mere recital. I certify that I am over eighteen (18) years of age and I further state that I have carefully read the foregoing Release with my attorney, and I know the contents thereof and I have signed the same as my free act and intending to be legally bound thereby. IN WITNESS WHEREOF, I have hereunto set my hand and seal this day of , 201 WITNESSES: (SEAL) ANDREW FACHENKO, a minor, by PAUL FACHENKO, parent and natural guardian 3 COMMONWEALTH OF PENNSYLVANIA ) ) SS: COUNTY OF ) On this day of , 201 , before me personally appeared PAUL FACHENKO, to me known, and known to me to be the person whose name is subscribed to the within release, and who executed the above instrument and who acknowledged to me that he executed the same. IN WITNESS WHEREOF, I hereunto set my hand and seal. Notary Public My Commission Expires: 4 PAUL FACHENKO,LARYSA FACHENKO : IN THE COURT OF COMMON PLEAS ANDREW FACHENKO,minor,by his CUMBERLAND CO., PENNSYLVANIA Parent and natural guardian,PAUL FACHENKO and LYUBOV FACHENKO, NO. 2008-6090 Plaintiffs • vs. • CIVIL TERM • HARRISBURG PIES,INC.,d/b/a • DOMINO'S PIZZA,ROBERT C. RUFO, And DOMINO'S PIZZA,LLC, JURY TRIAL DEMANDED Defendants VERIFICATION I, Paul Fachenko, as Parent and Natural Guardian of Andrew Fachenko, a Minor, do hereby verify that I am the Petitioner in the above-captioned action and further verify that I have read the foregoing document and that the facts an averments contained within same 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.S. § 4904,relating to unworn falsification to authorities. Date: i 1 6 o? o,�r 3 / Paul Fachenko, as Parent and Natural Guardian of Andrew Fachenko, a Minor PAUL FACHENKO,LARYSA FACHENKO : IN THE COURT OF COMMON PLEAS ANDREW FACHENKO, minor, by his • CUMBERLAND CO., PENNSYLVANIA Parent and natural guardian, PAUL • FACHENKO and LYUBOV FACHENKO, • NO. 2008-6090 Plaintiffs • vs. • CIVIL TERM HARRISBURG PIES, INC., d/b/a DOMINO'S PIZZA, ROBERT C. RUFO, • And DOMINO'S PIZZA, LLC, JURY TRIAL DEMANDED Defendants VERIFICATION I, Larysa Fachenko, as Parent and Natural Guardian of Andrew Fachenko, a Minor, do hereby verify that I have read the foregoing document and that the facts and averments contained within same 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.S. § 4904, relating to unsworn falsification to authorities. Date: 4� Is__ Cat � Larysa F. e as Parent and Guardian of Andre achel o, a Minor r 1 i PAUL FACHENKO,LARYSA FACHENKO : IN THE COURT OF COMMON PLEAS ANDREW FACHENKO, minor, by his CUMBERLAND CO., PENNSYLVANIA Parent and natural guardian, PAUL . FACHENKO and LYUBOV FACHENKO, NO. 2008-6090 Plaintiffs : vs. . • • . CIVIL TERM HARRISBURG PIES, INC., d/b/a . • DOMINO'S PIZZA,ROBERT C. RUFO, . And DOMINO'S PIZZA, LLC, JURY TRIAL DEMANDED Defendants CERTIFICATE OF SERVICE I hereby certify that a true and correct copy of the foregoing PETITION FOR APPROVAL OF MINOR'S SETTLEMENT,was served by depositing the same in the United States Mail, postage prepaid, at Harrisburg, Pennsylvania, on the 27+k-- day of November, 2013, on all counsel of record as follows: Howard B. Krug, Esquire PURCELL, KRUG& HALLER 1719 North Front Street Harrisburg, PA 17102 THOMAS, THOMAjc HAFER, LLP By: in �(. k' .c-,l a 6_,,,a.c.i M ichele A. Koharcheck : : U 1 _ 3 CEC -5 PM 1: 2t} f, UMBERLAN .1 PENNSYLVANIA PAUL FACHENKO, LARYSA FACHENKO, : IN THE COURT OF COMMON PLEAS ANDREW FACHENKO,minor, by his : CUMBERLAND CO., PENNSYLVANIA Parent and natural guardian, PAUL FACHENKO and LYUBOV FACHENKO, NO. 2008-6090 Plaintiffs • • vs. • CIVIL TERM HARRISBURG PIES, INC., d/b/a DOMINO'S PIZZA, ROBERT C. RUFO, And DOMINO'S PIZZA, LLC, JURY TRIAL DEMANDED Defendants ORDER AND NOW, this day ojLct,'r V!` , 2013 , upon consideration of the within Petition for Approval of Compromise and Settlement of a Minor's Claim, it is hereby ORDERED and DECREED that said Petition is GRANTED and settlement between Minor Plaintiff, by his parent and natural guardian, Paul Fachenko, and Defendants, is APPROVED as follows: • (a) the sum offive h dred dollars an zero cent500.00) will ; n F ±1' and 1 I, ;0; eisovr / (b) Petitioner/Plaintiff is directed to execute a Full and Final Release in the form attached to the Petition. BY THE C URT: 1 ).471'es' n&I ILL g. 4.1 J. 044_y S'. Ne gat€x__, PAUL FACHENKO,LARYSA FACHENKO : IN THE COURT OF COMMON PLEAS ANDREW FACHENKO,minor, by his : CUMBERLAND CO., PENNSYLVANIA Parent and natural guardian, PAUL : FACHENKO and LYUBOV FACHENKO, NO. 2008-6090 r-) ,. Plaintiffs - -rn co „ vs. =z - r • CIVIL TERM w- r) c HARRISBURG PIES, INC., d/b/a ice-:• --,- DOMINO'S PIZZA, ROBERT C. RUFO, < " And DOMINO'S PIZZA, LLC, JURY TRIAL DEMANDED :7- _ Defendants 7d " , --t cr PRAECIPE TO SETTLE,DISCONTINUE AND END TO THE PROTHONOTARY: Please mark the above-captioned matter settled, discontinued and ended with prejudice. Respectfully submi ed, Date: /7 �0 I �� ��� l y if ., , : _ Es,► r. No. 16826 Puree , Krug & Haller 1719 North Front Street Harrisburg, PA 17102 PAUL FACHENKO,LARYSA FACHENKO : IN THE COURT OF COMMON PLEAS ANDREW FACHENKO, minor, by his : CUMBERLAND CO., PENNSYLVANIA Parent and natural guardian,PAUL • FACHENKO and LYUBOV FACHENKO, : NO. 2008-6090 Plaintiffs vs. • • CIVIL TERM HARRISBURG PIES, INC., d/b/a DOMINO'S PIZZA, ROBERT C. RUFO, And DOMINO'S PIZZA, LLC, • JURY TRIAL DEMANDED Defendants CERTIFICATE OF SERVICE I hereby certify that a true and correct copy of the foregoing PRAECIPE TO SETTLE, DISCONTINUE AND END, was served by depositing the same in the United States Mail, postage prepaid, at Harrisburg, Pennsylvania, on the a/ day of January, 2014, on all counsel of record as follows: Howard B. Krug, Esquire PURCELL, KRUG & HALLER 1719 North Front Street Harrisburg, PA 17102 Counsel for Plaintiff THOMAS, THOMAS & HAFER, LLP By: ichele A. Koharcheck