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Commonwealth of Pennsylvania
County of Cumberland
Rodger Brooks and Victoria Brooks, In the Court of Common Pleas of
h / w Cumberland County, Pennsylvania
Plaintiffs
vs No. D 9 - 5? 3 (- eclz, Tom.
Eric Sheaffer
60 Frederick St. APT. 2A Civil action law
Hanover, PA 17331-3505 jury Trial Demanded
Defendant
Writ of Summons
To: Eric Sheaffer
60 Frederick St. APT 2A
Hanover, PA 17331-3505
You are hereby notified that Rodger Brooks
and Victoria Brooks have brought an action
against you.
Prothonotary
Date: February 2, 2009
William P. Douglas, Esq.
Oyler Law Office
31 S. Washington St.
Gettysburg, PA 17325
717-337-3111
SHERIFF'S RETURN - OUT OF COUNTY
CASE NO: 2009-00536 P
COMMONWEALTH OF PENNSYLVANIA:
COUNTY OF CUMBERLAND
BROOKS RODGER ET AL
VS
SHEAFFER ERIC
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:
SHEAFFER ERIC
but was unable to locate Him in his bailiwick. He therefore
deputized the sheriff of YORK County, Pennsylvania, to
serve the within WRIT OF SUMMONS
On March 2nd , 2009 , this office was in receipt of the
attached return from YORK
Sheriff's Costs:
Docketing 18.00
Out of County 9.00
Surcharge 10.00
York County 46.10
Postage .42
83.52
03/02/2009
DOUGLAS LAW OFFICE
So answers-
R. Thomas Kline
Sheriff of Cumberland County
Sworn and subscribe to before me
this day of
A. D.
O
C
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?.k.. ?t Cl.. =="s
LLI
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D r.-
i • ? i ? i i i ? i i
PENNY PRESS OF YORK, INC. Ph (717) 843-4078 Fax (717) 848-1360
COUNTY OF YORK
OFFICE OF THE SHERIFF
45 N. GEORGE ST., YORK, PA 17401
IQMrxar Arrir%lrc cod al
SHERIFF SERVICE USTNAACT
1 DO MT PLOM TYM WILY LM 1 TWW 13
PROCESS RECEIPT and AFFIDAVIT OF RETURN
Ms ROW OW 1 PLAINTIFF/S/ COPM
2. COURT NUMBER
3
SERVICE CALL
(717) 771-9601
09-536 civil
4. TYPE OF WRIT OR COMPLAINT
3. DEFENDANT/S/ ??
Eric Sheaffer Writ of Summons
SERVE 5 NAME OF INDIVIDUAL, COMPANY. CORPORATION. ETC TO SERVE OR DESCRIPTION OF PROPERTY TO BE LEVIED, ATTACHED, OR SOLD
Eric Sheaffer
6. ADDRESS (STREET OR RFO WITH BOX NUMBER, APT NO, CITY, BORO. TWP. STATE AND ZIP CODE)
AT 60 Frederick Street apt 2A Hanover, PA 17331
7. INDICATE SERVICE O PERSONAL O PERSON IN CHARGE 0 DEPUTIZE O C T IL ? 1ST CLASS MAIL O POSTED 0 OTHER
NOW February 4 , 20 09 I, SHERIFF OFAMW UNTY, PA, do h reby deputize the sheriff of
York COUNTY to execute thi a return then rding
to law. This deputization being made at the request and risk of the plaintiff.,
SHERIFF AF
8. SPECIAL INSTRUCTIONS OR OTHER INFORMATION THAT WILL ASSIST IN EXPEDITING SERVICE: aT OF co
Please mail return of service to Cumberland County Sheriff. Thank you.
AM FF,E PAID BY CO SHERIFF
NOME: 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
heroin for any loss, destruction, or removal of any property before sheriff's sale thereof.
9. TYPE NAME and ADDRESS of ATTORNEY / ORIGINATOR and SIGNATURE WILLIAM P. DOUGLAS, ESQ. 10. TELEPHONE NUMBER 11. DATE FILED
31 S. WASHINGTON ST., GETTYSBURG, PA 17325 1717-337-3111. 2-7.-09
12. SEND NOTICE OF SERVICE COPY TO NAME AND ADDRESS BELOW: (This area must be completed it notice is to be mailed)
SHERIFF
13. 1 admowledge receipt of the writ 14. DATE RECEIVED 15. ExpirationA*aring Date
or complaint as indicated above. MCGI LL SO 2-5-09 3-4-09
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 individual, company, etc. named above. (See remarks below.)
16 . tiAIIIIE AND TIT OF INDIVIDUAL SERVED / LI T ADDRESS H E IFMgk SHOWN ABOVE (Relationship to Defendant) 19. Date of service 20. Time of Service
21. A PTS Time Miles Int. Date Time Miles I 'lAt. a Time Miles IM. Dale Time Miles Int. Date Time Miles Int. Date Time Miles Int.
22.
23. Advance Costs 24. Service Costs 25. N/F 26. Mileage 27. Postage 28. Sub Total 29. Pound 30. Notary 31. Surchg. 32. Tot. Cow 33 Costs Due or eked Check No.
100.00 " ?Q 1 rd's 1 /01 LA 0 • M
34. Foerign County Costs 35. Advance Costs 36. Service Costs 37. Notary Cert. 38. Mdeage/PostagalNot Found 39. Total Costs 40. Costs Due or Refund
41.
42.
NOTARIALSEAeft~ /NOTA
LISA L. BOAUN.AN, NOTARY PUBLIC
CITY OF YORK, YORK COUNTY
MY COltir 91S3iON EXc-!RESAUG. 12, 2009
44. Sgnahaeeof (? e( _ 4?` d
Shenlf , v fG1
46. Signature of York 47. DATE
County Sheriff -
4.4.0 -00
RICHARD P. 1 I F 2-20-09
48. Signature of Foreign 49. DATE
County Sheriff
A
DOUGLAS LAW OFFICE
43 W. SOUTH ST.
POB 261
CARLISLE PA 17013
TELEPHONE 717-243-1790
FILED-CEEICE
T`,E Pp, ,-1.1,
20II DEC 29 Phi 2.
^UMBERLAND COUN "'
?E?i;SYt V, ? 3 P,
WILLIAM P. DOUGLAS, ESQ.
Supreme Court I.D.# 37926
......................................................................................................_.............................................,....................................................... .... .........................................................
................
;
Rodger Brooks and Victoria Brooks; In e Court of Common Pleas of
Plaintiff Cumberland County Pennsylvania
vs
No. 2009- 536 Civil Term
Eric Sheaffer Civil Action Law
Defendant 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 Plaintiffs. 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, GO TO OR TELEPHONE THE OFFICE SET FORTH
BELOW. THIS OFFICE CAN PROVIDE YOU WITH INFORMATION ABOUT
HIRING A LAWYER
IF YOU CANNOT AFFORD TO HIRE A LAWYER, THIS OFFICE MAY BE ABLE
TO PROVIDE YOU WITH INFORMATION A°OUT AGENCIES THAT MAY
OFFER LEGAL SERVICES TO ELIGIBLE PERS(AS AT A REDUCE FEE OR NO
FEE:
Cumberland County Bar Association
32 South Bedford Street
Carlisle, PA 17013
017) 249-3166
DATE: December 29, 2010 BY
Complaint
Plaintiffs, Victoria and Rodger Brooks, husband and wife, are adult
individuals residing at 2149 Youngs Road, Hanover, Pennsylvania.
2. Defendant, Eric Sheaffer is an adult individual residing at 60 Frederick
Street, Apartment 2A, Hanover, Pennsylvania, 17331-3505.
3. On or about February 3, 2007, at approximately noon, the Plaintiff, Rodger
Brooks, was traveling in a southerly direction on South Center Street, in
Penn Township in York County, Pennsylvania.
4. At about the same time and place the defendant Eric Sheaffer was
operating his vehicle in northerly direction on the aforesaid street when
suddenly and without warning he crossed the center-line.
5. As a direct and proximate result of the defendant's negligent conduct a
collision resulted between the vehicle of the plaintiff and the vehicle of the
defendant.
6. Eric Sheaffer failed to see Plaintiffs' vehicle, which lawfully had the right-
of-way where it was being operated, before entering the opposite lane of
travel and striking the plaintiff.
7. Eric Sheaffer's negligence consists of, among other things, the following
acts and / or omissions, which substantially contributed to and were the
proximate cause of the injuries suffered by Plaintiffs:
a. Failing to abide by speed limits and traveling at an unlawful speed
in violation of, among other things, 75 Pa.C.S.A. § 3714;
b. Failing to take evasive action to avoid an impact with Plaintiffs;
C. Operating his vehicle while rubber necking;
d. Failing to have his vehicle under proper and adequate control;
e. Failing to apply the brakes in time to avoid the collision;
f. Failing to observe Plaintiffs' vehicle on the highway;
g. Failing to operate his vehicle in accordance with existing traffic
conditions and traffic controls;
h. Failing to keep a reasonable look-out for other vehicles lawfully on
the road;
i. Failing to yield the right-of-way to traffic already upon the road;
Failing to keep a proper lookout for approaching vehicles;
k. Operating his vehicle in a careless disregard for the lives and
property of others in violation of 75 Pa.C.S.A. § 3714;
1. Permitting or allowing his vehicle to strike and collide with the
vehicle operated by the Plaintiff; and
M. Failing to keep a proper lookout and see Plaintiffs' vehicle lawfully
traveling on South Center Street prior to the collision.
COUNTI
RODGER BROOKS
vs
ERIC SHEAFFER
8. The averments of paragraphs 1 through 7, inclusive, are incorporated
herein by reference.
9. As a direct and proximate result of the negligence of Sheaffer as stated
above, Plaintiff suffered numerous serious and permanent physical
injuries, including, but not limited to pain in his cervical and thoracic
spine and related structures.
10. As a direct and proximate result of the negligence of Sheaffer, Plaintiff
was forced to incur medical bills and expenses for the injuries he has
suffered and he will continue to incur medical expenses in the future.
11. As a direct and proximate result of the negligence of Sheaffer, Plaintiff has
suffered, or may suffer, a severe loss of his earnings and impairment of his
earning capacity, and the loss of income and impairment of earning
capacity will, or may, continue in the future.
12. As a direct and proximate result of the negligence of Sheaffer, Plaintiff has
undergone, and may in the future undergo, great mental and physical
pain and suffering, mental anguish and humiliation, loss of life's
pleasures, and a severe limitation in his pursuit of daily activities, all to
his great loss and detriment.
13. Sheaffer had a duty to Plaintiff to act according to the rules of the road
and laws of the Commonwealth, but breached such duty through his
negligence as set forth above.
14. At all times material hereto, Plaintiff acted with due care and was not
contributorily negligent.
WHEREFORE, Plaintiffs demand judgment against Defendant in excess of an
amount requiring compulsory referral to arbitration, including costs of suit. A
jury trial is hereby demanded.
COUNT II
VICTORIA BROOKS
VS
ERIC SHEAFFER
23. The averments of paragraphs 1 through 14, inclusive, are incorporated
herein by reference.
24. Victoria Brooks and Rodger Brooks are husband and wife and were
married at the time of the accident.
25. As a direct and proximate result of the injuries sustained by the plaintiff,
Rodger Brooks, Victoria Brooks has suffered from the loss of the aid,
assistance, comfort, companionship and society of her husband.
WHEREFORE, Plaintiff, Victoria Brooks, demand judgment against Defendant in
excess of an amount requiring compulsory referral to arbitration, including costs
of suit. A jury trial is hereby demanded.
Respectfully bmitt d,
U. l
William P. Douglas, q.
Attorney for Plainti s
December 29, 2010
AFFIDAVIT
I hereby swear or affirm that he foregoing is true and correct to the best of my
knowledge and / or information and belief.
This is made subject to the penalties of 18 Pa.C.S.§4904 relating to unworn
falsification to authorities.
W
December 29, 2010
F . ? f r 1 ;1 r'
i ? rt _ J ? l w0TAR
1 Eti`' -2 F i 2 Cp
E LAND COUNT'S
1,DN'NSYLVANIA
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
RODGER BROOKS AND VICTORIA BROOKS,
Plaintiffs,
VS.
ERIC SHEAFFER,
Defendant.
TO: Rodger Brooks and Victoria Brooks, Plaintiffs
c/o William P. Douglas, Esquire
Douglas Law Office
43 W. South Street, POB 261
Carlisle, PA 17013
NOTICE TO PLEAD
Civil Action - Law
No. 2009-536 Civil Term
JURY TRIAL DEMANDED
You are hereby notified to file a written response to the enclosed New Matter within twenty
(20) days from service hereof or a judgment may be entered against you.
GRIFFITH, STRICKLER, LERMAN, SOLYMOS &
CALKINS
BY: bvv., ? ,
RO RT A. LERMAN #07490
JOHN C. PORTER #90152
Attorneys for Defendant, Eric Sheaffer
110 South Northern Way
York, PA 17402
717-757-7602
717-757-3783 fax
rlerman(a ulsc.com
j orterggslsc.com
Dated: April 29, 2011
contrary is hereby demanded.
6. To the extent the allegations set forth in paragraph 6 of Plaintiffs' Complaint
constitute a conclusion of law no response is required. To the extent a response is required, it is
denied that Defendant, Eric Sheaffer was negligent and further denied that Defendant Sheaffer's acts
and/or omissions substantially contributed to and were the proximate cause of the injuries suffered
by Plaintiffs.
7. To the extent the allegations set forth in paragraph 7 of Plaintiffs' Complaint
constitute a conclusion of law no response is required. To the extent a response is required, it is
denied that Defendant, Eric Sheaffer was negligent and further denied that Defendant Sheaffer's acts
and/or omissions substantially contributed to and were the proximate cause of the injuries suffered
by Plaintiffs. It is further specifically denied that Defendant, Eric Sheaffer:
a. Failed to abide by speed limits and traveling at an unlawful speed in violation of,
among other things, 75 Pa. C.S.A. §3714;
b. Failed to take evasive action to avoid an impact with Plaintiffs;
c. Operated his vehicle while rubber necking;
d. Failed to have his vehicle under proper and adequate control;
e. Failed to apply brakes in time to avoid the collision;
f. Failed to observe Plaintiffs' vehicle on the highway;
g. Failed to operate his vehicle in accordance with existing traffic conditions and
traffic controls;
h. Failed to keep a reasonable look-out for other vehicles lawfully on the road;
i. Failed to yield the right-of-way to traffic already upon the road;
j. Failed to keep a proper lookout for approaching vehicles;
k. Operated his vehicle in a careless disregard for the lives and property of others in
2
violation of 75 Pa. C.S.A. § 3714;
1. Permitted or allowed his vehicle to strike and collide with the vehicle operated by
the Plaintiff; and
m. Failed to keep a proper lookout and see Plaintiffs' vehicle lawfully traveling on
South Center Street prior to the collision.
COUNTI
RODGER BROOKS
VS
ERIC SHEAFFER
8. Answering Defendant, Eric Sheaffer, incorporates herein by reference, as if fully set
forth at length, his Answers to Paragraph Nos. 1 - 7 inclusive, as set forth hereinabove.
9. To the extent the allegations set forth in paragraph 9 constitute a conclusion of law,
no response is required. To the extent a response is required, it is denied that Defendant Sheaffer was
negligent or that Plaintiff's claimed injuries and damages were the result of Defendant's alleged
negligence and strict proof thereof is hereby demanded. The remaining allegations of paragraph 9 of
Plaintiffs' Complaint are denied in that after reasonable investigation, Defendant is without
knowledge or information sufficient to form a belief as to the truth of the allegations and same are
denied and strict proof thereof demanded.
10. To the extent the allegations set forth in paragraph 10 constitute a conclusion of law,
no response is required. To the extent a response is required, it is denied that Defendant Sheaffer was
negligent or that Plaintiff's claimed injuries and damages were the result of Defendant's alleged
negligence and strict proof thereof is hereby demanded. The remaining allegations of paragraph 10 of
Plaintiffs' Complaint are denied in that after reasonable investigation, Defendant is without
knowledge or information sufficient to form a belief as to the truth of the allegations and same are
denied and strict proof thereof demanded.
3
11. To the extent the allegations set forth in paragraph 11 constitute a conclusion of law,
no response is required. To the extent a response is required, it is denied that Defendant Sheaffer was
negligent or that Plaintiff's claimed injuries and damages were the result of Defendant's alleged
negligence and strict proof thereof is hereby demanded. The remaining allegations of paragraph 11 of
Plaintiffs' Complaint are denied in that after reasonable investigation, Defendant is without
knowledge or information sufficient to form a belief as to the truth of the allegations and same are
denied and strict proof thereof demanded.
12. To the extent the allegations set forth in paragraph 12 constitute a conclusion of law,
no response is required. To the extent a response is required, it is denied that Defendant Sheaffer was
negligent or that Plaintiffs claimed injuries and damages were the result of Defendant's alleged
negligence and strict proof thereof is hereby demanded. The remaining allegations of paragraph 12 of
Plaintiffs' Complaint are denied in that after reasonable investigation, Defendant is without
knowledge or information sufficient to form a belief as to the truth of the allegations and same are
denied and strict proof thereof demanded.
13. Denied. To the extent the allegations set forth in paragraph 13 constitute a conclusion
of law, no response is required. To the extent a response is required, it is averred that Defendant
acted according to the rules of the road and laws of the Commonwealth, under the circumstances
existing and did not breach any duty of care alleged to be owed to the Plaintiffs and strict proof
thereof is hereby demanded. By way of further response it is denied that the Defendant was negligent
or that the Defendant's negligence caused the injuries and damages Plaintiff claims.
14. Denied. It is denied that at all times material hereto, Plaintiff acted with due care and
was not contributorily negligent. On the contrary, it is averred the Defendant may not have acted
with due care and may have been contributorily negligent as hereinafter set forth in the New Matter.
4
WHEREFORE, Defendant, Eric Sheaffer demands judgment in his favor and against the
Plaintiffs, together with costs of suit.
COUNT II
VICTORIA BROOKS
VS
ERIC SHEAFFER
23. [sic ]Answering Defendant, Eric Sheaffer, incorporates herein by reference, as if fully
set forth at length, his Answers to Paragraph Nos. 1 - 14 inclusive, as set forth hereinabove.
24. Denied. After reasonable investigation Defendant is without knowledge or
information sufficient to form a belief as to the truth of the allegations set forth in paragraph 24 of
Plaintiffs' Complaint and same are denied and strict proof thereof demanded.
25. To the extent the allegations set forth in paragraph 25 constitute a conclusion of law,
no response is required. To the extent a response is required, it is denied that Defendant Sheaffer was
negligent or that Plaintiffs claimed injuries and damages were the result of Defendant's alleged
negligence and strict proof thereof is hereby demanded. The remaining allegations of paragraph 25 of
Plaintiffs' Complaint are denied in that after reasonable investigation, Defendant is without
knowledge or information sufficient to form a belief as to the truth of the allegations and same are
denied and strict proof thereof demanded.
WHEREFORE, Defendant, Eric Sheaffer demands judgment in his favor and against the
Plaintiffs, together with costs of suit.
5
By way of further Answer, Defendant, Eric Sheaffer, asserts the following:
NEW MATTER
26. Answering Defendant, Eric Sheaffer, incorporates herein by reference, as if fully set
forth at length, its Answers to Paragraph Nos. 1 - 25 inclusive, as set forth hereinabove.
27. Plaintiffs' Complaint fails to state a cause of action against Defendant upon which
relief can be granted.
28. Plaintiffs' Complaint may be barred by applicable statute of limitations.
29. Plaintiffs' injuries and damages, if any, may have been caused solely and directly as
the result of acts or omissions of individuals or entities other than Defendant over whom Defendant
had no responsibility or right of control.
30. The injuries and damages claimed by the Plaintiffs, if any, may have been caused
solely and directly as a result of the negligence, carelessness, and recklessness of the Plaintiff,
Rodger Brooks, which negligence, carelessness and recklessness may have consisted of the
following:
a. Failure to keep alert and maintain a proper lookout for other traffic;
b. Failure to maintain proper control in the operation of his motor vehicle;
c. Alternatively, failing to take appropriate evasive action to move his vehicle to
avoid impact with the vehicle operated by Defendant, Eric Sheaffer; and
d. Failing to exercise appropriate steps to prevent collision of the subject vehicles
when he had the last opportunity to do so.
31. As a result of the negligence, carelessness, and recklessness of Plaintiff, Rodger
Brooks, as set forth in the immediately preceding paragraph, the claims of Plaintiff, Rodger Brooks,
are barred or diminished in accordance with the application of the Pennsylvania Comparative
6
Negligence Act.
32. The claims of the Plaintiff, Victoria Brooks, are derivative in nature and as such, are
barred or diminished in accordance with any comparative negligence attributable to Plaintiff, Rodger
Brooks.
33. Plaintiff, Rodger Brooks, has not sustained a serious injury as defined in the
Pennsylvania Motor Vehicle Financial Responsibility Law (75 Pa. C.S.A. § 1702 et seq. ).
34. Plaintiffs' claims for non-economic damages may be barred because Plaintiffs have
elected a limited tort option as set forth in the Pennsylvania Motor Vehicle Financial Responsibility
Law.
35. Plaintiffs may have failed to mitigate their damages.
36. Plaintiffs have received or are entitled to receive various benefits from insurance
arrangements, programs and group contracts of insurance, including but not limited to benefits under
the Pennsylvania Motor Vehicle Financial Responsibility Law, for medical bills and income loss, and
they may not recover for the same benefits in this proceeding.
37. The Plaintiffs' recovery may be barred or limited by the amount of uninsured or
underinsured motorist benefits, if any, to which Plaintiffs may be entitled to recover; and
38. Defendant may be entitled to have the Court mold any verdict in Plaintiffs' favor to
reflect the amount of uninsured or underinsured motorist benefits, if any, which Plaintiff has
received.
39. The injuries and damages Plaintiffs allege may have preexisted the date of the motor
vehicle accident which is the subject of this litigation and were not caused or aggravated by this
accident.
7
40. The alleged injuries and damages of Plaintiffs may be the result of the motor vehicle
accident in which Plaintiff, Rodger Brooks, was involved subsequent to the date of this accident.
WHEREFORE, Defendant, Eric Sheaffer demands judgment in his favor and against the
Plaintiffs, together with costs of suit.
GRIFFITH, STRICKLER, LERMAN, SOLYMOS &
CALKINS
BY: Am C , Cr
ROBE T A. LERMAN #07490
JOHN C. PORTER #90152
Attorneys for Defendant, Eric Sheaffer
110 South Northern Way
York, PA 17402
717-757-7602
717-757-3783 fax
rlermankgslsc.com
jporter kgslsc.com
Dated:
8
VERIFICATION
I, Erick Sheaffer, hereby verify that the statements made in the foregoing Answer and New
Matter of Defendant, Eric Sheaffer, to Plaintiffs' Complaint are true and correct to the best of my
personal knowledge or information and belief, and in accord with reports, records, conferences and
other investigatory material made available to me. To the extent that the foregoing contains
averments which are inconsistent in fact, I verify that my knowledge or information is sufficient to
form a belief that one or more of them is true, although I am currently unable, after reasonable
investigation, to ascertain which of the inconsistent averments are true.
To the extent that the foregoing contains legal conclusions or opinions, I hereby state that my
Verification is made upon the advice of counsel, upon whom I have relied in the filing this
document.
This Verification is made subject to the penalties of 18 Pa. C.S. § 4904 related to unsworn
falsifications to authorities.
Dated: L- Jb By: 5-,--
V
ERIC SHEAFFER
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
RODGER BROOKS AND VICTORIA BROOKS, Civil Action - Law
Plaintiffs,
vs. No. 2009-536 Civil Term
ERIC SHEAFFER,
Defendant. JURY TRIAL DEMANDED
CERTIFICATE OF SERVICE
AND NOW, this 2a 0'"day of 2011, I, John C. Porter, a member of the firm
of GRIFFITH, STRICKLER, LERMAN, SOLYMOS & CALKINS, hereby certify that I have this
date served a copy of the Answer and New Matter of Defendant, Eric Sheaffer, to Plaintiff's
Complaint by United States Mail, addressed to the party or attorney of record as follows:
William P. Douglas, Esquire
Douglas Law Office
43 W. South Street
POB 261
Carlisle, PA 17013
(Counsel for Plaintiffs)
GRIFFITH, STRICKLER, LERMAN, SOLYMOS &
CALKINS
BY: I C-"' P6?L
ROBE A. LERMAN, ESQUIRE #07490
JOHN C. PORTER, ESQUIRE #90152
Attorney for Defendant, Eric Sheaffer
110 South Northern Way
York, PA 17402
717-757-7602/717-757-3783 fax
rlermanggslsc.com
lporter ,gslsc.com
jml/sheaffer-anm
K
?oII JvN i? 1?M is-•a5
1 C
Griffith Strickler Lerman
Solymos & Calkins
John C. Porter, Esquire
110 S. Northern Way
York, PA 17402
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
RODGER BROOKS AND VICTORIA BROOKS, Civil Action - Law
Plaintiffs,
VS. No. 2009-536 Civil Term
ERIC SHEAFFER, :
Defendant. JURY TRIAL DEMANDED
MOTION OF DEFENDANT. ERIC SHEAFFER, TO COMPEL PLAINTIFFS
TO RESPOND TO WRITTEN DISCOVERY
And now comes Defendant, Eric Sheaffer, by his counsel, John C. Porter and Griffith,
Strickler, Lerman, Solymos & Calkins, and files the following Motion to Compel Plaintiffs to Respond
to Interrogatories, the grounds for which are as follows:
1. Defendants' counsel has contacted Plaintiffs' counsel to discuss this motion and Plaintiffs'
counsel does not concur in this motion.
2. No Judge has previously ruled on any other issue in this case.
3. Plaintiffs instituted this civil action for personal injuries sustained as a result of a motor
R
vehicle accident that occurred on February 3, 2007, by the filing of a Complaint on December
29, 2010 in the Cumberland County Court of Common Pleas.
4. Defendant's Answer and New Matter was filed in response to Plaintiffs' Complaint on
May 2, 2011.
5. On March 4, 2011, Defendant propounded Interrogatories by transmitting same to
Plaintiffs' counsel with a letter dated March 4, 2011. A copy of said transmittal letter and
Interrogatories are attached hereto and collectively marked Exhibit 1.
6. On May 9, 2011, a reminder letter was sent to Plaintiffs' counsel regarding the
delinquent discovery responses and in said letter Plaintiffs' counsel was advised a Motion to
Compel would be filed if the discovery responses were not received on or before May 19,
2011. A copy of said correspondence dated May 9, 2011 is attached and marked Exhibit 2.
7. Plaintiffs have not responded to Defendant's Interrogatories by way of Answers or
Objections.
8. The information and documentation requested in the Interrogatories is for information
with regard to Plaintiffs' liability and damage claims and Defendant's submission of this
discovery constitutes the first stage of the discovery phase of this litigation.
9. Plaintiffs' tardiness in responding to the discovery has delayed this litigation.
WHEREFORE, Defendant, Eric Sheaffer respectfully request this Honorable Court to
issue an Order compelling Plaintiffs to respond to the Interrogatories as described in this
Motion within (ten) 10 days from the date of this Court's Order.
GRIFFITH, STRICKLER, LERMAN
SOLYMOS CALKINS
BY `
J n C. Porter, ID #90152
Attorney for Defendant, Eric Sheaffer
110 South Northern Way
York, PA 17402
Telephone: (717) 757-7602
LAW OFFICES
GRIFFITH, STRICKLER, LERMAN, SOLYMOS & CALKINS
110 S. NORTHERN WAY
YORK, PENNSYLVANIA 17402-3737
ROBERT H. GRIFFITH (1926-2009)
MICHAEL P. BIANCHINI (1939-2010)
TELEPHONE: (717) 757-7602
FAX: (717) 757-3783
EMAIL: info(aposlsc.com
WEBSITE: www.aslsc.com
John C. Porter's EMAIL: JPorterAaslsc.com
ROBERT M. STRICKLER
ROBERT A. LERMAN°
PETER D. SOLYMOS
CHARLES B. CALKINS
PAUL G. LUTZ-
MICHAEL B. SCHEIB*
THOMAS B. SPONAUGLE°+
*Also Member MD Bar
-LL.M (Taxation); also Member CT Bar
'Also Member NY and D.C. Bars
-Also Member NJ Bar
+Board Certified Civil Trial Attorney
By the National Board of Trial Advocacy
March 4, 2011
William P. Douglas, Esquire
Douglas Law Office
43 W. South Street
POB 261 t
Carlisle, PA 17013
RE: Rodger Brooks and Victoria Brooks v. Eric Sheaffer
Cumberland County C.C.P. No. 09-536 Civil Term
Dear Bill:
ANN MARGARET GRAB
DAVID E. COOK
ERICK V. VIOLAGO-
JOHN C. PORTER-
Enclosed please find the Interrogatories of Defendant, Eric Sheaffer to Plaintiffs, Set No. 1.
Respectfully,
e
J C. PERT?
Enclosure
IN THE COURT OF COMMON PLEAS.OF CUMBERLAND COUNTY, PENNSYLVANIA
RODGER BROOKS AND VICTORIA BROOKS,
Plaintiffs,
vs.
ERIC SHEAFFER,
Defendant.
Civil Action - Law
No. 2009-536 Civil Term
JURY TRIAL DEMANDED
INTERROGATORIES OF DEFENDANT, ERIC SHEAFFER
TO PLAINTIFFS SET NO. 1
TO: Rodger Brooks and Victoria Brooks
c/o William P. Douglas, Esquire
Douglas Law Office
43 W. South Street
P. O. Box 261
Carlisle, PA 17013
The Defendant, Erick Sheaffer, by his attorneys, GRIFFITH, STRICKLER, LERMAN,
SOLYMOS & CALKINS, hereby demands that Plaintiffs answer the following Interrogatories
under oath pursuant to Pennsylvania Rules of Civil Procedure 4005 and Pennsylvania Rule of
Civil Procedure 4006 within thirty (30) days from the service hereof. These Interrogatories shall
be deemed continuing so as to require supplemental answers if affiants obtain further
information between the time the answers are served and the time of the trial.
Definition of Terms
THESE DEFINITIONS FORM AN INTEGRAL PART OF THE FOLLOWING
INTERROGATORIES:
A. "And" and "Or" means "and/or," and the singular form shall be deemed to include
the plural and vice versa.
B. "Describe" or "Description" when used with reference to any conversation,
communication, statement, meeting, or discussion or any act, transaction, occurrence, happening,
instance, or event, means to provide the following information:
1. The subject matter and substance of that which took place;
2. The time, date and place thereof;
3. The identification of each person who participated therein, or who was a
witness thereto; and
4. The identification of each communication or document which refers
thereto or which was prepared or made during the course thereof or as a
consequence thereof.
C. "Documents" shall mean the originals, and all non-identical copies (whether
different from the originals because of notes made from such copies or otherwise), of all written,
printed, recorded or graphic matter of every kind and description, including all attachments or
addenda annexed thereto, whether inscribed by hand or mechanical, electronic, microfilm,
photographic or other means, as well as phonic or visual reproductions, in the possession,
custody or control of Plaintiffs, including by way of amplification and not limitation: contracts,
invoices, correspondence, notes, drafts, reports, plans, recordings, diaries, desk calendars,
interoffice and interoffice memoranda, memoranda for file, memoranda of telephone
conversations, and minutes of meetings or conferences.
D. "He" and any other masculine pronoun includes any individual, regardless of sex,
to whom the interrogatory would otherwise apply.
E. "Identify," "Identification" or "Identity" means to provide the following
information:
2
k
1. When used with reference to a natural person, state his full name and
present or last known business and residence address, his last known or
present business affiliation, and his position in business affiliation at the
time of the transaction, occurrence, event, happening, or matter in
question.
2. When used with reference to any entity other than a natural person (e.g.,
corporation, partnership, joint venture or association), state:
(a) Its full names;
(b) The address of its principal place of business; and
(c) Its organization form and its purposes, primary business or
activities.
3. When used with reference to an oral communication:
(a) State the place at which and the date on which such oral
communication occurred;
(b) Identify each person making such oral communication, the person
to whom it was made and each other person who was present (in
person or by telephone) when it was made;
(c) State the subject and substance of such oral communication; and
(d) Specify, in accordance with paragraph (b) below, each document
which relates or refers to each such communication or which was
prepared and made during the course hereof or as a consequence
thereof,
F. "Person" means any natural person or any entity other than a natural person,
including, but not limited to, sole proprietorships, partnerships, corporations, associations, joint
ventures, co-ventures and any other legally recognized entity of any description whatever, as
well as all divisions, departments, affiliates, subsidiaries, or other sub-units of the foregoing
entities.
G. "Specify" when used with reference to a "document," calls for:
1. The nature of the document (e.g., letter, contract, chart, memoranda);
2. Its date;
3
i
3. Each author (and, in different, each signer) thereof, and each person to
whom the document was distributed;
4. Its subject matter and substance;
5. Its present or last known location or custodian;
6. The disposition of such document if it was but is no longer in your
possession or subject to your control; and
7. Any other information necessary to enable the custodian to locate the
particular document and necessary for use in a subpoena duces tecum or in
a demand for the production of the documents under Rule 4009. 1, et seq.,
of the Pennsylvania Rules of Civil Procedure.
H. "Date" means the exact day, month and year if ascertainable, or, if not, the best
approximation (including the relation of other events).
1. "You" or "your" refers to and shall be construed to mean the party to whom or to
which these discovery requests are directed, as well as that party's agents, representatives,
including without limitation, that party's counsel, insurance carriers and insurance agents, as well
as investigators hired or retained by the responding party, its agents, representatives, or counsel.
4
A
1. For purposes of compliance with the Medicare Secondary Payer Mandatory
Reporting Provisions in Section 111 of the Medicare/Medicaid and SCHIP Extension Act of
2007 (MMSEA), please provide the following with regard to the injured Plaintiff
a. The HICN or SSN number of the injured Plaintiff;
b. The first initial of the injured Plaintiff's name;
C. The first six characters of the injured Plaintiff's last name;
d. The injured Plaintiff's date of birth; and
e. The injured Plaintiffs gender.
2. Please state your full name, date of birth and present address.
a. Have you ever used or been known by any other name? If so, please state
each other name.
b. How long have you lived at your present address?
C. If you are married, provide the full name of your spouse and the date of
your marriage.
d. If you have children, list their names, genders and date of birth.
5
3. What is your present occupation and state the name and address of your present
employer and describe the specific nature of your employment duties and responsibilities?
4. List the names and addresses of your former employers for the past ten years, if
any, and describe your employment duties and responsibilities.
6
5. State the amount of your gross and net income for each of the past six years.
6. Describe any and all accidents and/or personal injuries you have suffered before
the accident herein sued upon, giving the date, place, and parties involved in each such accident.
(A referral to attached medical records shall not constitute a sufficient response to this
interrogatory.)
7
7. From your knowledge, describe any and all infirmities and disabilities from which
you suffered before the accident in this claim or law suit. (A referral to attached medical records
shall not constitute a sufficient response to this interrogatory.)
8. State the names and addresses of all doctors and hospitals whom you have seen or
with whom you have consulted or where you have been treated during the ten years preceding
the date of this accident, and the nature of the ailment, illness, or other reason, for which such
doctor was consulted. (A referral to attached medical records shall not constitute a sufficient
response to this interrogatory.)
8
9. Give the names and addresses of all hospitals where you have been either as an
in-patient or an out-patient during the ten (10) years prior to the accident complained of and
describe the condition which necessitated each such hospitalization. (A referral to attached
medical records shall not constitute a sufficient response to this interrogatory.)
10. Describe in detail how the accident occurred including from where you were
coming and where you were going to at the time of the accident.
9
11. Of your own knowledge, what injuries did you receive in the accident involved in
this case? (A referral to attached medical records shall not constitute a sufficient response to this
interrogatory.)
12. Of you own knowledge, list any permanent scars, disfigurements, disabilities or
discomforts resulting from the accident involved in this case. (A referral to attached medical
records shall not constitute a sufficient response to this- interrogatory.)
10
13. Of your own knowledge, please set forth the exact nature of all other present
physical complaints, limitations or restrictions which you allege are attributable to the injuries
which you received in the accident involved in this case. (A referral to attached medical records
shall not constitute a sufficient response to this interrogatory.)
14. List all facts in detail that support your contention that you sustained a serious
impairment of a bodily function and/or permanent injury as a result of the accident.
11
15. If you have been hospitalized by reasons of the accident herein sued upon, list the
names and addresses of all such hospitals, clinics, or other medical institutions in which you
were a patient as a result of this accident, giving the dates of confinement and the sums of money
paid by you or on your behalf, or owing to each for services to you. (A referral to attached
medical records shall not constitute a sufficient response to this interrogatory.)
16. Please set forth the full name and address of each and every doctor or other
medical person who has attended or examined you resulting from the accident involved in this
case, and the sums of money paid or owing to each for services to you. (A referral to attached
medical records shall not constitute a sufficient response to this interrogatory.)
12
17. Please identify what employers you were employed by and/or jobs you were
working the six (6) months preceeding the accident and please state on what date you last
worked prior to the accident which is the subject of this litigation.
18. If you have returned to work, either on a full-time or part-time basis, when did
you return and state whether the return has been to full-time or part-time employment and state
exactly how much income, if any, do you claim to have lost to date resulting from the accident
involved in this case and state the method of calculating said loss and the facts upon which you
rely to base your calculations.
13
19. Exactly how much income, if any, do you claim to have lost to date as a result of
the within accident and state the method of calculating said loss and the facts upon which you
relay to base your calculations.
20. Of your own knowledge, will it be necessary for you to have future medical
treatment resulting from the accident involved in this case and, if so, who advised you of the
need for treatment and describe the type of treatment discussed. (A referral to attached medical
records shall not constitute a sufficient response to this interrogatory.)
14
21. Describe any and all accidents and/or personal injuries or ailments/diseases you
have suffered since the accident here sued upon, giving dates, time and place, parties involved
and injuries involved and identifying (by name and address) all medical providers with whom
you have sought treatment or consultation.
22. Do you know of any person who witnessed the alleged occurrence or who has any
knowledge of the relevant facts concerning the nature, character and extent of the injuries,
disabilities, damages, losses or expenses sustained by you as a result of the occurrence and for
which claim is being made in this action? If so, for each person, state:
a. The name and last-known address;
b. , A detailed description of the relevant facts known;
C. Whether written or otherwise recorded statement has been taken and, if so,
the name and address of the person taking the statement and the person in
present: custody of the statement; and
d. If you will do so without a Motion to Produce, attach a copy of each
statement to your Answers to these Interrogatories.
15
23. In the ten (10) minute period before the accident which is the subject of the
Complaint, were you utilizing a cell or mobile phone or texting device and if so, provide the
name of the mobile/cell phone/texting device service provider, the name of the mobile/cell
number, the owner of the mobile/cell phone/texting device account and the billing address.
24. State the name, address, occupation and field of specialization, if any, of each
person whom you expect to call as an expert witness at trial, and state as to each the subject
matter on which the expert is expected to testify.
16
25. Set forth the qualifications of all those persons listed in the Answer to the
preceding Interrogatory and in doing so, as to each expert, list: formal education; the schools
attended, including years of attendance and degrees or certifications received; experience in
particular fields, including names and addresses of employers with inclusive years of
employment and positions held; teaching positions or other affiliations; and a list of all
publications authored by said. persons, including the title of the work, the name of the periodical
or book in which it was printed, and the date of its printing. (In lieu of answering this
Interrogatory, please attach a copy of each expert's Curriculum Vitae or resume.)
26. a. Set forth the facts to which each expert you have listed is expected to
testify; and
b. Set forth the opinions to which each such expert is expected to testify.
17
27. Identify and describe any photographs, experiments, videotapes, movies,
transparencies, models, diagrams, facsimiles, drawings, plans, tests, or other device or thing to be
utilized by any expert to illustrate testimony or otherwise to support any opinion to be offered.
18
28. At the time of this accident, were you covered by any policy of insurance which
protected against the loss which is the subject of this action including but not limited to auto
insurance, health insurance and disability insurance and if so, state for each such policy:
a. The name, principal place of business and telephone number of the
insurer;
b. The name, address and telephone number of the named insured;
C. The policy number;
d. The effective dates of coverage;
e. The amount of liability coverage, specifying the terms thereof;
f. State whether there are any provisions, such as medical pay clauses, first
parry benefits, uninsured motorist's coverage, underinsured motorist's
coverage, or other insurance payment provisions, which will provide
benefits to a parry injured by your vehicle and set forth any conditions,
exclusions or other relevant terms concerning such additional benefits,
including the amount(s) of such coverage;
g. The number of vehicles covered, if applicable.
h. Your legal domicile at the time insurance was applied for;
i. Your legal domicile at the same time each policy of insurance (or any
endorsement thereto) was issued; and
j. Did you elect full tort option or limited tort option?
k. The amount of medical bills paid by each insurer related to this accident.
1. The amount of wage loss benefits paid by each insurer related to this
accident.
19
29. Has the insurance company or companies involved raised any issue as to your
coverage for damages arising from the aforesaid accident? If so, please set forth in detail the
basis for such issue, reservation of right or denial of coverage.
30. If any issue as to coverage arising from this accident has been raised by the
insurance company or companies involved, please set forth your position as to this issue.
20
31. Have you ever filed any claim(s) for worker's compensation benefits for this or
any other incident and, if so, identify the employer, the claim number, describe your injury, and
provide the name and address of the insured or self-insured entity to which your claim was made.
32. Have you ever filed any claims for unemployment compensation benefits and, if
so, identify the employer and provide the name and address of the insured or self-insured entity
to which your claim was made.
21
31. Have you ever filed any claim(s) for worker's compensation benefits for this or
any other incident and, if so, identify the employer, the claim number, describe your injury, and
provide the name and address of the insured or self-insured entity to which your claim was made.
32. Have you ever filed any claims for unemployment compensation benefits and, if
so, identify the employer and provide the name and address of the insured or self-insured entity
to which your claim was made.
21
33. Have you ever filed a claim for disability insurance and, if so, please identify
when the claim was made, the reason for the claim, and the identity of the insurance company or
other entity to whom the claim was submitted.
34. Have you ever filed a claim or lawsuit for personal injuries (other than this one)
and, if so, please identify when the claim and/or lawsuit was filed, the reason for same, the
parties involved in any accident or incident, and the claim number and insurance company and/or
docket number involved.
22
35. Identify by name, address, and subject matter of testimony all trial witnesses you
intend to call.
36. State the total amount of bills you have incurred for medical treatment as a result
of the motor vehicle accident upon which this lawsuit is based and state the amount actually paid
and the amount not paid and why? In the alternative, please describe, in detail, including but not
limited to, any and all medical specials you will claim at trial/arbitration/ADR.
23
37. State the date of your last appointment for medical care, treatment or consultation
for injuries related to the incident in suit, and identify by name or address the health care
provider. (A referral to attached medical records shall not constitute a sufficient response to this
interrogatory.)
38. Are you currently under a physician's care for injuries related to the incident in
suit and, if so, state the name and address of the physician. (A referral to attached medical
records shall not constitute a sufficient response to this interrogatory.)
24
39. Has any physician advised you to limit or restrict your work, employment or
vocational activities due to injuries related to the incident in suit and, if so, identify the physician
by name and address and describe the limitations and/or advice related to you. (A referral to
attached medical records shall not constitute a sufficient response to this interrogatory.)
40. Has any physician advised you to limit or restrict your activities of daily living,
household chores, hobbies, or activities you engaged in (pre-incident) and, if so, identify the
physician by name and address and describe the limitations, restrictions and/or advice relayed to
you. (A referral to attached medical records shall not constitute a sufficient response to this
interrogatory.)
25
41. Have you been convicted of any crime within the past ten (10) years, whether by
verdict or plea of guilty or nolo contendere? If so, please state:
a. the date of each such conviction;
b. the county and state in which you were convicted for each such crime;
C. the nature of the felony or misdemeanor of which you were convicted;
d. whether such conviction resulted from a jury verdict, plea of guilty or plea
of nolo contendere;
e. the name and addresses of the tribunal imposing sentence;
f. the title of the cause and case number assigned by said tribunal to your
case;
g1 the nature of the sentence imposed; and
h. the dates and places of any facility in which you were incarcerated, and
the date(s) of release.
26
42. Have you, at any time, or are you currently preparing or maintaining any records,
notes, logs, ledgers or diaries that in any way describe your injuries, treatments, or activities
since the accident referred to in your Complaint?
43. Please provide specific information with regard to any lien or subrogation interest
against your recovery in this case including but not limited to any lien or subrogation interest of
any health insurance and/or worker's compensation insurance carrier and with respect to each
such lien, identify the lien holder by name and address, claim and/or policy number, the amount
of the lien asserted to date, and the specific basis therefore.
27
11
16
44. Are you aware of any liens or subrogation interest in or to and/or against
Plaintiff's recovery in this case, including but not limited to the Commonwealth of Pennsylvania,
Department of Public Assistance and Medicare/Medicaid or Social Security and if so, please
provide all information known.
GRIFFITH, STRICKLER, LERMAN, SOLYMOS &
CALKINS
DATED: 3 BY:
(7-
PJbert A. Lerman, Esquire #07490
John C. Porter, Esquire #90152
Attorney for Defendant Eric Sheaffer
110 South Northern Way
York, PA 17402
717-757-7602
717-757-3783 Fax
rlerman(2gslsc.com
jporter(ao slg_sc.om
28
William P. Douglas, Esquire
Douglas Law Office
43 W. South Street
POB 261
Carlisle, PA 17013
GRIFFITH, STRICKLER, LERMAN, SOLYMOS &
CALKINS
BY: a (f, /?2?
Ro A. Lerman, Esquire #07490
John C. Porter, Esquire 490152
Attorney for Defendant Eric Sheaffer
110 South Northern Way
York, PA 17402
717-757-7602
717-757-3783 Fax
rlerman@gslsc.com
j op rter(@gslsc.om
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
RODGER BROOKS AND VICTORIA BROOKS, Civil Action - Law
Plaintiffs, :
vs.
ERIC SHEAFFER,
Defendant.
No. 2009-536 Civil Term
CERTIFICATE OF SERVICE
JURY TRIAL DEMANDED
AND NOW, this Yak day of Aa y C41 , 2011, I, John C. Porter , a member of the
firm of GRIFFITH, STRICKLER, LERMAN, SOLYMOS & CALKINS, hereby certify that I
have this date served a copy of the Interrogatories of Defendant Eric Sheaffer to Plaintiffs,
Set No. 1 as indicated below, addressed to the parry or attorney of record as follows:
29
.•*
LAW OFFICES
GRIFFITH, STRICKLER, LERMAN, SOLYMOS & CALKINS
ROBERT H. GRIFFITH (1928-2009)
MICHAEL P. BIANCHINI (1939-2010)
ROBERT M. STRICKLER
ROBERTA. LERMAN°
PETER D. SOLYMOS
CHARLES B. CALKINS
PAUL G. LUTZ^
MICHAEL B. SCHEIB`
THOMAS B. SPONAUGLE'+
'Also Member MD Bar
-LL.M (Taxation); also Member CT Bar
`Also Member NY and D.C. Bars
-Also Member NJ Bar
+Board Certified Civil Trial Attorney
By the National Board of Trial Advocacy
May 9, 2011
William P. Douglas, Esquire
Douglas Law Office
43 W. South Street
POB 261
Carlisle, PA 17013
110 S. NORTHERN WAY
YORK, PENNSYLVANIA 17402-3737
TELEPHONE: (717) 757-7602
FAX (717) 757-3783
EMAIL: infolftsisc.com
WEBSITE: www.osisc.com
John C. Porter's EMAIL: JPorter(cDoslsc.com
RE: Rodger Brooks and Victoria Brooks v. Eric Sheaffer
Cumberland County C.C.P. No. 09-536 Civil Term
Dear Attorney Douglas:
ANN MARGARET GRAB
DAVID E. COOK
ERICK V. VIOLAGO-
JOHN C. PORTER-
ROBERT D. O'BRIEN
Be advised Plaintiffs' responses to Interrogatories of Defendant, Eric Sheaffer to Plaintiffs, Set
No. 1 are more than thirty (30) days overdue. I can grant an additional ten (10) days from the
date of this letter for Plaintiffs to provide responses. After the expiration of ten (10) days I am
authorized to file the requisite motion to compel. I hope your clients do not waste my time so.
Respectfully,
JOHN C. PORTER
bcc: Donna J. MacLafferty, Safeco, Claim No. 202992280003
s+
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
RODGER BROOKS AND VICTORIA BROOKS,
Plaintiffs,
vs.
ERIC SHEAFFER,
Defendant.
Civil Action - Law
No. 2009-536 Civil Term
JURY TRIAL DEMANDED
CERTIFICATE OF SERVICE
AND NOW, this a* day of ?yn s, 2011, I, John C. Porter, a member of the firm
of GRIFFITH, STRICKI R, LERMAN, SOLYMOS & CALKINS, hereby certify that I have
this date served a copy of the Motion of Defendant, Eric Sheaffer, to Compel Plaintiffs to
Respond to Written Discovery, by regular mail, addressed to the party or attorney of record as
follows:
William P. Douglas, Esquire
Douglas Law Office
43 W. South Street
POB 261
Carlisle, PA 17013
GRIFFITH, STRICKLER, LERMAN
SOLYMOS & CALKINS
BY
Jo C. Porter, ID #90152
Attorneys for Defendant, Eric Sheaffer
110 South Northern Way
York, PA 17402
Telephone: (717) 757-7602
RODGER BROOKS and IN THE COURT OF COMMON PLEAS OF
VICTORIA BROOKS, CUMBERLAND COUNTY, PENNSYLVANIA
Plaintiffs :
CIVIL ACTION - LAW c - T'
vs. NO. 09-536 CIVIL ,.mcco C_ - a
MM
ERIC SHEAFFER,
Defendant JURY TRIAL DEMANDED
c"i M.
IN RE: DEFENDANT'S MOTION TO COMPEL' `
c.a
nR DFR
AND NOW, this 16 day of June, 2011, the within motion to compel is DENIED for
the reason that the number of interrogatories propounded exceeds the limit imposed by local rule.
BY THE COURT,
`William P. Douglas, Esquire
For the Plaintiffs
John C. Porter, Esquire
For the Defendant
apies
0
:rlm
FiL`'O-0FFICL
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNS-jfL NVOTHOMOTARY
RODGER BROOKS AND VICTORIA BROOKS,
Plaintiffs,
VS.
ERIC SHEAFFER,
Civil Action- L& V2 JUL -3 AM 11: 0 5
CUMBERLAND COUNTY
VeNNSYLVANIA
No. 2009-536 Civil rm
Defendant. JURY TRIAL DEMANDED
CERTIFICATE PREREQUISITE TO SERVICE
OF SUBPOENA PURSUANT TO RULE 4009.22
As a prerequisite to service of subpoena for documents and things pursuant to Rule 4009.22,
Defendant, Eric Sheaffer, certifies that:
(1) A Notice of Intent to Serve the Subpoena with a copy of the Subpoena attached thereto
was mailed or hand delivered to each party at least twenty (20) days prior to the date on which the
Subpoena is sought to be served;
(2) A copy of the Notice of Intent, including the proposed Subpoena, is attached to this
Certificate;
(3) The attorney for Plaintiffs has waived the notice period, per the attached Waiver; and
(4) The Subpoena which will be served is identical to the Subpoena which is attached to
the Notice of Intent to Serve the Subpoena.
GRIFFITH, STRICKLER, LERMAN,
l SO gYMOS & C
_ wINS
DATE: 6 130 -L BY: e - 0;
R ERT A. LERMAN, #07490
JOHN C. PORTER, #90152
Attorneys for Defendant, Eric Sheaffer
110 South Northern Way
York, PA 17402-3737
(717) 757-7602/(717) 757-3783 fax
rlerman@gslsc.com/jporter@gslsc.com
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
RODGER BROOKS AND VICTORIA BROOKS,
Plaintiffs,
Civil Action - Law
VS.
ERIC SHEAFFER,
Defendant.
: No. 2009-536 Civil Term
JURY TRIAL DEMANDED
NOTICE OF INTENT TO SERVE SUBPOENA TO PRODUCE
DOCUMENTS AND THINGS FOR DISCOVERY PURSUANT TO RULE 4009.21
John C. Porter, Esquire, counsel for Defendant Eric Sheaffer intends to serve a Subpoena
identical to the one that is attached to this Notice. You have twenty (20) days from the date
listed below in which to file of record and serve upon the undersigned an objection to the
Subpoena. If no objection is made, the Subpoena may be served.
GRIFFITH, STRICKLER, LERMAN, SOLYMOS &
CAL INS
DATE: 6 2 6 11 Z-- BY: C . &?? .
ROBERT A. LERMAN, #07490
JOHN C. PORTER, #90152
Attorneys for Defendant, Eric Sheaffer
110 South Northern Way
York, PA 17402-3737
(717) 757-7602/(717) 757-3783 fax
rlerman@gslsc.com/jporter@gslsc.com
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
RODGER BROOKS AND VICTORIA BROOKS,
Plaintiffs,
Civil Action - Law
VS.
ERIC SHEAFFER,
Defendant.
No. 2009-536 Civil Term
JURY TRIAL DEMANDED
SUBPOENA TO PRODUCE DOCUMENTS OR THINGS
FOR DISCOVERY PURSUANT TO RULE 4009.22
To: Thrift Drug, Inc. c/o Rite Aid, 1430 Baltimore Street, Hanover, PA 17331
(Name of Person or Entity)
Within twenty (20) days after service of this Subpoena, you are ordered by the Court to produce the
following documents or things:
Take notice that you are required to produce the following documents or things for the
time period of June 6. 1952 to the present: Any and all pharmacy records and bills
corresponding to treatment and care of Rodger Brooks.
at Griffith, Strickler, Lerman, Solymos & Calkins, 110 S. Northern Way. York. PA 17402-3737
. (Address)
You may deliver or mail legible copies of the documents or produce things requested by this Subpoena,
together with the certificate of compliance, to the party making this request at the address listed above.
You have the right to seek, in advance, the reasonable cost of preparing the copies or producing the
things sought.
If you fail to produce the documents or things required by this Subpoena, within twenty (20) days after its
service, the party serving this Subpoena may seek a Court Order compelling you to comply with it.
THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON:
NAME: JOHN C. PORTER. ESQ.
ADDRESS: GRIFFITH, STRICKLER, LERMAN, SOLYMOS & CALKINS
110 South Northern Way, York. PA 17402
TELEPHONE: (717) 757-7602
SUPREME COURT ID: 07490
ATTORNEY FOR: Defendant. Eric Sheaffer
BY THE COURT:
DATE:
Seal of Court Prothonotary/ Clerk, Civil Division
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
RODGER BROOKS AND VICTORIA BROOKS,
Plaintiffs,
VS.
ERIC SHEAFFER,
Defendant.
Civil Action - Law
No. 2009-536 Civil Term
: JURY TRIAL DEMANDED
CERTIFICATE OF SERVICE
AND NOW, this 16#k day of Ij-Qr , 2012, I, John C. Porter, a member of the firm
of GRIFFITH, STRICKLER, LERMAN, SOLYMOS & CALKINS, hereby certify that I have
this date served a copy of the Notice of Intent to Serve Subpoena to Produce Documents and
Things for Discovery Pursuant to Rule 4009.21 via United States First Class Mail, addressed
to the parry or attorney of record as follows:
William P. Douglas, Esquire
Douglas Law Office
43 W. South Street
POB 261
Carlisle, PA 17013
GRIFFITH, STRICKLER, LERMAN, SOLYMOS &
CAL S
A
BY: ?L C -
RO ERT A. LERMAN, #07490
JOHN C. PORTER, #90152
Attorneys for Defendant,. Eric Sheaffer
110 South Northern Way
York, PA 17402-3737
(717) 757-7602/(717) 757-3783 fax
rlerman@gslsc.com/jporter@gslsc.com
06/29/12 11:41 FAX 7172438955 Douglas Law Office Z002
1
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
RODGER BROOKS AND VICTORIA BROOKS, Civil Action - Law
Plaintiffs,
VS. No. 2009-536 Civil Term
ERIC SHEAFFER,
Defendant. JURY TRIAL DEMANDED
WAIVER OF NOTICE OF INTENT TO SERVE SUBPOENAS
I, William P. Douglas, Esquire, attorney for Plaintiffs, Rodger Brooks and Victoria
Brooks, hereby waive the twenty (20) day Notice of Intent to Serve Subpoenas pursuant to
4009.22. I further have no objection to the Defendant serving the Subpoena directed to the
below listed entities as evidenced by the filing of this Waiver.
• Thrift Drug, Inc. c/o Rite-Aid
Dated:
WILLIAM P. DOUGL , ESQUIRE
Counsel for Plaintiffs,
Rodger Brooks and Victoria Brooks
JUN-29-2012 11:46 7172438955 95%
P.002
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
RODGER BROOKS AND VICTORIA BROOKS,
Plaintiffs,
VS.
ERIC SHEAFFER,
Defendant.
Civil Action - Law
No. 2009-536 Civil Term
JURY TRIAL DEMANDED
CERTIFICATE OF SERVICE
AND NOW, this (.A& day of 1w 20129 I, John C. Porter, a member of the firm of
GRIFFITH, STRICKLER, LERMAN, SOL OS & CALKINS, hereby certify that I have this date
served a copy of Certificate Prerequisite to Service of Subpoena Pursuant to Rule 4009.22 by
United States Mail, addressed to the party or attorney of record as follows:
William P. Douglas, Esquire
Douglas Law Office
43 W. South Street
POB 261
Carlisle, PA 17013
GRIFFITH, STRICKLER, LERMAN,
SO SS?& CA S
DATE: 3?1 Z Zoe BY: l.?
R BERT A. LERMAN, #07490
JOHN C. PORTER, #90152
Attorneys for Defendant, Eric Sheaffer
110 South Northern Way
York, PA 17402-3737
(717) 757-7602/(717) 757-3783 fax
rlerman@gslsc.com/jporter@gslsc.com
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANI*
RODGER BROOKS AND VICTORIA BROOKS, Civil Action - Law
Plaintiffs, rr°
co
vs. No. 2009-536 Civil Terf
?
7
ZG
x?x
r
ERIC SHEAFFER,
JURY TRIAL DEMANDF11 p
Defendant.
CERTIFICATE PREREQUISITE TO SERVICE
OF SUBPOENA PURSUANT TO RULE 4009.22
As a prerequisite to service of subpoena for documents and things pursuant to Rule 4009.22
Defendant, Eric Sheaffer, certifies that:
(1) A Notice of Intent to Serve the Subpoena with a copy of the Subpoena attached
was mailed or hand delivered to each party at least twenty (20) days prior to the date on which
Subpoena is sought to be served;
(2) A copy of the Notice of Intent, including the proposed Subpoena, is attached to
Certificate;
(3) The attorney for Plaintiffs has waived the notice period, per the attached Waiver; and
(4) The Subpoena which will be served is identical to the Subpoena which is attached
the Notice of Intent to Serve the Subpoena.
DATE: Anti-L
GRIFFITH, STRICKLER, LERMAN,
SOLYMOS & GALKINS
BY:
KOBERT A. LERMAN, #07490
JOHN C. PORTER, #90152
Attorneys for Defendant, Eric Sheaffer
110 South Northern Way
York, PA 17402-3737
(717) 757-7602/(717) 757-3783 fax
rlerman@gslsc.com/jporter@gslsc.com
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
RODGER BROOKS AND VICTORIA BROOKS, Civil Action - Law
Plaintiffs,
VS.
ERIC SHEAFFER,
Defendant.
No. 2009-536 Civil Term
JURY TRIAL DEMANDED
NOTICE OF INTENT TO SERVE SUBPOENA TO PRODUCE
DOCUMENTS AND THINGS FOR DISCOVERY PURSUANT TO RULE 4009.21
John C. Porter, Esquire, counsel for Defendant Eric Sheaffer intends to serve a Subpoena
identical to the one that is attached to this Notice. You have twenty (20) days from the date
listed below in which to file of record and serve upon the undersigned an objection to the
Subpoena. If no objection is made, the Subpoena may be served.
GRIFFITH, STRICKLER, LERMAN, SOLYMOS &
( C
DATE: 6 Zg 1 BY: 1c, po?c
R ERT A. LERMAN, #07490
JOHN C. PORTER, #90152 .
Attorneys for Defendant, Eric Sheaffer
110 South Northern Way
York, PA 17402-3737
(717) 757-7602/(717) 757-3783 fax
rlerman@gsisc.com/jporter@gslsc.com
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
RODGER BROOKS AND VICTORIA BROOKS,
Plaintiffs,
Civil Action - Law
VS.
ERIC SHEAFFER,
Defendant.
No. 2009-536 Civil Term
JURY TRIAL DEMANDED
SUBPOENA TO PRODUCE DOCUMENTS OR THINGS
FOR DISCOVERY PURSUANT TO RULE 4009.22
To: Medco Mail Order, P.O.Box 98830, Las Vegas NV 89193-8830
(Name of Person or Entity)
Within twenty (20) days after service of this Subpoena, you are ordered by the Court to produce the
following documents or things:
Take notice that you are required to produce the following documents or things for the
time ueriod of June 6. 1952 to the present: Any and all pharmacy records and bills
corresponding to treatment and care of Rodger Brooks.
at Griffith. Strickler. Lerman. Solvmos & Calkins 110 S Northern Wav York PA 17402-3737
(Address)
You may deliver or mail legible copies of the documents or produce things requested by this Subpoena,
together with the certificate of compliance, to the party making this request at the address listed above.
You have the right to seek, in advance, the reasonable cost of preparing the copies or producing the
things sought.
If you fail to produce the documents or things required by this Subpoena, within twenty (20) days after its
service, the party serving this Subpoena may seek a Court Order compelling you to comply with it.
THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON:
NAME: JOHN C. PORTER. ESQ.
ADDRESS: GRIFFITH, STRICKLER, LERMAN SOLYMOS & CALKINS
110 South Northern Way York PA 17402
TELEPHONE: (717) 757-7602
SUPREME COURT ID: 07490
ATTORNEY FOR: Defendant. Eric Sheaffer
BY THE COURT:
DATE:
Seal of Court Prothonotary / Clerk, Civil Division
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
RODGER BROOKS AND VICTORIA BROOKS,
Plaintiffs,
Civil Action - Law
VS.
ERIC SHEAFFER,
Defendant.
No. 2009-536 Civil Term
JURY TRIAL DEMANDED
CERTIFICATE OF SERVICE
AND NOW, this "LOA day of I,) ^Coo , 2012, I, John C. Porter, a member of the firm
of GRIFFITH, STRICKLER, LERMAN, SOLYMOS & CALKINS, hereby certify that I have
this date served a copy of the Notice of Intent to Serve Subpoena to Produce Documents and
Things for Discovery Pursuant to Rule 4009.21 via United States First Class Mail, addressed
to the party or attorney of record as follows:
William P. Douglas, Esquire
Douglas Law Office
43 W. South Street
POB 261
Carlisle, PA 17013
OS &
GRIFFITH, STRICKLER, GF7
C S
BY: ?
-
RO ERT A. LE
RMAN, #07490
JOHN C. PORTER, #90152
Attorneys for Defendant, Eric Sheaffer
110 South Northern Way
York, PA 17402-3737
(717) 757-7602/(717) 757-3783 fax
rlerman@gslsc.com/jporter@gslsc.com
07/'-'/1-2 14:1-^ FAY 711-72438955 Douglas Law Office
LET THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
RODGER BROOKS AND VICTORIA BROOKS, Civil Action - Law
Plaintiffs,
VS. No. 2009-536 Civil Term
ERIC SHEAFFER,
Defendant. JURY TRIAL DEMANDED
morm
Z002
WAIVER OF NOTICE OF INTENT TO SERVE SUBPOENAS
I, William P. Douglas, Esquire, attorney for Plaintiffs, Rodger Brooks and Victoria
Brooks, hereby waive the twenty (20) day Notice of Intent to Serve Subpoenas pursuant to
4009.22. I further have no objection to the Defendant serving the Subpoena directed to the
below listed entities as evidenced by the filing of this Waiver.
• Medco.com Mail Order
Dated: 7 ^ i) ? ?-?
WILLIAM P. DOUGLAS, F
Counsel for Plaintiffs,
Rodger Brooks and Victoria
JUL-11-2012 14:25 7172438955 95% P
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
RODGER BROOKS AND VICTORIA BROOKS, Civil Action - Law
Plaintiffs,
VS. No. 2009-536 Civil Term
ERIC SHEAFFER,
Defendant. JURY TRIAL DEMANDED
CERTIFICATE OF SERVICE
AND NOW, this -f-day of 2012, I, John C. Porter, a member of the firm
GRIFFITH, STRICKLER, LERMAN, SOLYMOS & CALKINS, hereby certify that I have this d;
served a copy of Certificate Prerequisite to Service of Subpoena Pursuant to Rule 4009.22
United States Mail, addressed to the party or attorney of record as follows:
William P. Douglas, Esquire
Douglas Law Office
43 W. South Street
POB 261
Carlisle, PA 17013
GRIFFITH, STRICKLER, LERMAN,
SOLYMOS & CALKINS
BY: 10y. U - I rfbtlt.
R011ERT A. LERMAN, #07490
JOHN C. PORTER, #90152
Attorneys for Defendant, Eric Sheaffer
110 South Northern Way
York, PA 17402-3737
(717) 757-7602/(717) 757-3783 fax
rlerman@gslsc.com/jporter@gslsc.com
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
RODGER BROOKS AND VICTORIA BROOKS,
Plaintiffs,
vs.
ERIC SHEAFFER,
Defendant.
JURY TRIAL DEMANDED
DEFENDANT, ERIC SHEAFFER'S. MOTION IN LIMINE TO PRECLUDE
DR. DEBRA DEANGELO FROM TESTIFYING AT TRIAL
Defendant, Eric Sheaffer, files and presents this motion in limine by and through his
counsel John C. Porter and Griffith, Strickler, Lerman, Solymos & Calkins seeking the following
relief:
Grant of this motion and entry of the attached proposed Order precluding
1) from trial, testimony of Plaintiff Roger Brooks's pain management phy.an
Debra DeAngelo;y
2) or in the alternative, precluding from trial Dr. DeAngelo's testimony:
0
a. beyond the facts provided in answers to Sheaffer's expert interrogatories
which facts establish the scope of her testimony; or in the alternative
b. beyond the date of the last document Plaintiffs provided in discovery --
July 21, 2009; but in any case
c. that would constitute opinion testimony.
1. Dr. Debra DeAngelo is Plaintiff Roger Brooks's pain management physician.
2. Dr. DeAngelo is listed in Plaintiffs' answers to Defendant, Eric Sheaffer's, expert
interrogatories as an expert who will testify at trial.
3. On February 18, 2013 Dr. DeAngelo testified at a trial deposition conducted after
Civil Action - Law
No. 2009-536 Civil Term
discovery was closed and after the case was listed for trial, which trial was to commence in Court
just seven days later. This was not a discovery deposition. See Notice of Deposition attached
hereto as Exhibit "A."
4. All of the within objections to Dr. DeAngelo's trial testimony were asserted, on
the record, before and during said trial deposition.
5. This motion in limine is provided to this Honorable Court to present those
objections in advance of trial.
6. Dr. DeAngelo has not produced an expert report.
7. Sheaffer propounded interrogatories, including expert interrogatories, upon
Plaintiffs and any experts they might have testify at trial. (All of Sheaffer's Interrogatories are
attached as Exhibit "B," with the expert Interrogatories numbered 24-27.)
8. Plaintiffs answered these interrogatories on or about June 10, 2011. (Plaintiffs'
answers are attached as Exhibit "C.")
9. Plaintiffs answered expert interrogatories for Dr. DeAngelo; Dr. DeAngelo has
not signed the answers as is required pursuant to Pennsylvania Rule of Civil Procedure
4003.5(a)(1)(b). Pa. R.C.P. 4003.4(a)(1)(b)(mandating "[t]he answer or separate report shall be
signed by the expert").
10. When asked to provide the subject matter on which Dr. DeAngelo will testify at
trial, Plaintiffs failed to provide any subject matter. Exhibit "B" at ¶ 24; Exhibit "C" at ¶ 24.
11. When an expert does not produce an expert report, the expert is required to
provide the subject matter of her testimony. Pa. R.C.P. Rule 4003.5(a)(mandating that a party
may require another party to "state the subject matter on which the expert is expected to testify")
12. Plaintiffs and their expert have failed to fulfill the mandate of this rule pertaining
to expert witness disclosures.
13. Accordingly, Dr. DeAngelo should be precluded from testifying as to any subject
matter at trial.
14. Sheaffer also asked Plaintiffs to identify the facts to which Plaintiffs' experts
would testify. Exhibit "B" at ¶ 26.
15. Plaintiffs only identified that Dr. De Angelo would testify as to a nerve block of
medial branch nerves and radio frequency ablation she provided to Plaintiff Roger Brooks.
Exhibit "C" ¶ 26.
16. The nerve block treatment occurred on or about January 21, 2008; the radio
frequency ablation occurred on or about February 11, 2008.
17. No other factual testimony was identified by Plaintiffs or Dr. DeAngelo.
18. The fair scope of a trial expert's testimony "may not" go beyond the facts known
by the expert and developed in discovery proceedings (such as expert interrogatories). Pa.
R.C.P. 4003.5(c); Woodard v. Chatterjee, 827 A.2d 433, 2003 PA Super 207(granting a new trial
when expert's testimony went beyond fair scope of report and the expert "parroted" the findings
of other medical doctors such that the expert's trial testimony constituted impermissible
hearsay).
19. The fair scope rule and the courts disfavor unfair and prejudicial surprise.
Woodard v. Chatterjee at 443.
20. Accordingly, and pursuant to Rule 4003.5(c) and Chatterjee, supra, Dr.
DeAngelo's trial testimony should not include any facts beyond the nerve block treatment that
occurred on or about January 21, 2008 and the radio frequency ablation that occurred on or about
February 11, 2008.
21. Otherwise, Sheaffer will be/has been unfairly surprised at trial and substantially
and materially prejudiced in his defense of this matter.
22. While it admitted that medical records of Dr. DeAngelo that post-date these
treatments were provided by Plaintiffs, nowhere have Plaintiffs indicated that Dr. DeAngelo
would testify as to the facts contained in these records.
23. This is particularly true with respect to whether the fact of these treatments were
causally related to the subject motor vehicle accident.
24. Sheaffer also propounded an expert interrogatory that requested Plaintiffs/Dr.
DeAngelo to disclose the opinions to which she would testify at trial. Exhibit "B" at ¶ 26.
25. As with factual testimony, the fair scope rule limits an expert's opinion testimony
to those opinions disclosed in answers to expert interrogatories or provided within an expert
report. Pa. R.C.P. 4003.5(c); Woodard v. Chatterjee, 827 A.2d 433, 2003 PA Super 207(granting
a new trial when expert's testimony went beyond fair scope of report and the expert "parroted"
the findings of other medical doctors such that the expert's trial testimony constituted
impermissible hearsay).
26. Plaintiffs' response to Sheaffer's expert opinion interrogatories stated that the
opinions would be those contained within the documents attached to the answers to
interrogatories. Exhibit "C" at 126.
27. Those documents contained medical records of treatment through July 21, 2009.
28. Nowhere in the documents does Dr. DeAngelo provide any opinion with respect
to the pain/injuries being treated being caused by, or the treatment being necessitated by, the
subject motor vehicle accident. See Documents attached to Plaintiffs' Answers to Interrogatories
attached hereto as Exhibit "D." (Documents not part of Dr. DeAngelo's medical chart have been
redacted for the court's convenience.)
29. Accordingly, pursuant to Rule 4003.5(c) and Chatterjee, supra, Dr. DeAngelo's
trial opinion testimony should be limited to those opinions contained within the documents
attached to Plaintiffs' answers to interrogatories.
30. Otherwise, Sheaffer will be/has been unfairly surprised at trial and will be
substantially and materially prejudiced in his defense of this matter.
31. While it is admitted that there is reference in the history section of Dr.
DeAngelo's records of Roger Brooks complaining of pain since the subject motor vehicle
accident, this self-reporting must not be construed as a medical opinion of Dr. DeAngelo.
Indeed, at her trial deposition, Dr. DeAngelo admitted that this was simply Roger Brooks's
subjective reporting. (Trial Dep. Transcript of Dr. DeAngelo, 41:1-43:6, Exhibit "E.")
32. If Dr. DeAngelo is permitted to provide opinion testimony, then said opinion
testimony should be limited to the dates of the reports provided, and therefore only through the
date of the last report, or July 21, 2009.
33. It should also be noted that pursuant to Pennsylvania Rule of Civil Procedure
4007.4, Plaintiffs and their expert have a duty to supplement answers to discovery with
information acquired after the discovery was initially answered when the response while correct
when made, is no longer true. Pa. R.C.P. 4007.4(2)(ii).
34. To the extent that Dr. DeAngelo's records post-date July 21, 2009, these records
and Dr. DeAngelo's trial deposition testimony constitute material that establishes that the initial
responses were no longer true, but that (at least in Plaintiffs' mind) the truth -- the facts and
opinions of Dr. DeAngelo extended beyond July 21, 2009. Accordingly, Plaintiffs and Dr.
DeAngelo have failed to supplement their discovery responses as required by Rule 4007.4.
WHEREFORE, Defendant, Eric Sheaffer, respectfully requests this Honorable Court to
Grant this motion and enter the attached proposed Order precluding:
1) from trial, testimony of Plaintiff Roger Brooks's pain management physician Dr.
Debra DeAngelo;
2) or in the alternative, precluding from trial Dr. DeAngelo's testimony:
a. beyond the facts provided in answers to Sheaffer's expert interrogatories
which facts establish the scope of her testimony; or in the alternative
b. beyond the date of the last document Plaintiffs provided in discovery --
July 21, 2009; but in any case
c. that would constitute opinion testimony.
DATE: 2 Zp 113
GRIFFITH, STRICKLER, LERMAN,
SOLYMOS & KINS
BY:?ILEERMAN, R ERT A. #07490
JOHN C. PORTER, #90152
Attorneys for Defendant Eric Sheaffer
110 South Northern Way
York, PA 17402-3737
(717) 757-7602/(717) 757-3783 fax
rlennan@gslsc.com/jporter@gslsc.com
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
RODGER BROOKS AND VICTORIA BROOKS, Civil Action - Law
Plaintiffs,
vs. No. 2009-536 Civil Term
ERIC SHEAFFER,
Defendant. JURY TRIAL DEMANDED
CERTIFICATE OF SERVICE
AND NOW, this _k"day of February, 2013, I, John C. Porter, a member of the firm of
GRIFFITH, STRICKLER, LERMAN, SOLYMOS & CALKINS, hereby certify that I have this
date served a copy of Defendant, Eric Sheaffer's, Motion in Limine to Preclude Dr. Debra
DeAngelo from Testifying at Trial, by United States Mail, addressed to the party or attorney of
record as follows:
William P. Douglas, Esquire
Douglas Law Office
43 W. South Street
POB 261
Carlisle, PA 17013
GRIFFITH, STRICKLER, LERMAN,
SOLYMOS & C INS
BY:
hw? ? '
R ERT A. LERMAN, 407490
JOHN C. PORTER, #90152
Attorneys for Defendant Eric Sheaffer
110 South Northern Way
York, PA 17402-3737
(717) 757-7602/(717) 757-3783 fax
rlerman@gslsc.comJjporter@gslsc.com
EXHIBIT A
u[i14/13 11:45 FAX 7172438955 Doug)_a.s Law Off1_c,
William P. Douglas, Esq.
Supreme Court I.D. #37926
Douglas Law Office
43 West South Street
Carlisle, PA 17013
Telephone (7I7) 243-1790_
Rodger Brooks and Victoria Brooks
Plaintiff
In the Court of Common Pleas of
Cumberland County, Pennsylvania
vs
Eric Sheaffer
Defendant
TO: John C. Porter
Griffith, Strickler, Lerman, Solymos & Calkins
110 S. Northern Way
York, PA 17402-3737
No. 09 -- 536 Civil Term
Civil action law
Jury Trial Demanded
NOTICE OF DEPOSITION
YOU ARE HEREBY NOTIFIED that on February 18, 2013, at 12:00 P.M., we will
take the deposition, upon oral examination, of Debra Deangelo, D.O., for use at
trial,in the Office of Debra Deangelo, 250 Fame Avenue, Entrance D, Suite 115,
Hanover, Pennsylvania, before an official court reporter. This deposition will be
taken under the applicable provisions of the Pennsylvania Rules of Civil
Procedure.
DOUGLAS LAW OFFICE
By
Dated: February 14, 2013 William P. Douglas, squire
Attorney I.D. 37926
Attorney for Plaintiff
43 W. South St.
Carlisle, PA 17013
? OC2
FEB-14-2013 16:59 7172438955
96% P.002
EXHIBIT B
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
RODGER BROOKS AND VICTORIA BROOKS,
Plaintiffs,
Civil Action - Law
VS.
ERIC SHEAFFER,
Defendant.
No. 2009-536 Civil Term
JURY TRIAL DEMANDED
INTERROGATORIES OF DEFENDANT. ERIC SHEAFFER
TO PLAINTIFFS SET NO. 1
TO: Rodger Brooks and Victoria Brooks
c/o William P. Douglas, Esquire
Douglas Law Office
43 W. South Street
P. O. Box 261
Carlisle, PA 17013
The Defendant, Erick Sheaffer, by his attorneys, GRIFFITH, STRICKLER, LERMAN,
SOLYMOS & CALKINS, hereby demands that Plaintiffs answer the following Interrogatories
under oath pursuant to Pennsylvania Rules of Civil Procedure 4005 and Pennsylvania Rule of
Civil Procedure 4006 within thirty (30) days from the service hereof. These Interrogatories shall
be deemed continuing so as to require supplemental answers if affiants obtain further
information between the time the answers are served and the time of the trial.
Definition of Terms
THESE DEFINITIONS FORM AN INTEGRAL PART OF THE FOLLOWING
INTERROGATORIES:
A. "And" and "Or" means "and/or," and the singular form shall be deemed to include
the plural and vice versa.
B. "Describe" or "Description" when used with reference to any conversation,
communication, statement, meeting, or discussion or any act, transaction, occurrence, happening,
instance, or event, means to provide the following information:
1. The subject matter and substance of that which took place;
2. The time, date and place thereof,
3. The identification of each person who participated therein, or who was a
witness thereto; and
4. The identification of each communication or document which refers
thereto or which was prepared or made during the course thereof or as a
consequence thereof.
C. "Documents" shall mean the originals, and all non-identical copies (whether
different from the originals because of notes made from such copies or otherwise), of all written,
printed, recorded or graphic matter of every kind and description, including all attachments or
addenda annexed thereto, whether inscribed by hand or mechanical, electronic, microfilm,
photographic or other means, as well as phonic or visual reproductions, in the possession,
custody or control of Plaintiffs, including by way of amplification and not limitation: contracts,
invoices, correspondence, notes, drafts, reports, plans, recordings, diaries, desk calendars,
interoffice and interoffice memoranda, memoranda for file, memoranda of telephone
conversations, and minutes of meetings or conferences.
D. "He" and any other masculine pronoun includes any individual, regardless of sex,
to whom the interrogatory would otherwise apply.
E. "Identify," "Identification" or "Identity" means to provide the following
information:
2
1. When used with reference to a natural person, state his full name and
present or last known business and residence address, his last known or
present business affiliation, and his position in business affiliation at the
time of the transaction, occurrence, event, happening, or matter in
question.
2. When used with reference to any entity other than a natural person (e.g.,
corporation, partnership, joint venture or association), state:
(a) Its full names;
(b) The address of its principal place of business; and
(c) Its organization form and its purposes, primary business or
activities.
3. When used with reference to an oral communication:
(a) State the place at which and the date on which such oral
communication occurred;
(b) Identify each person making such oral communication, the person
to whom it was made and each other person who was present (in
person or by telephone) when it was made;
(c) State the subject and substance of such oral communication; and
(d) Specify, in accordance with paragraph (b) below, each document
which relates or refers to each such communication or which was
prepared and made during the course hereof or as a consequence
thereof;
F. "Person" means any natural person or any entity other than a natural person,
including, but not limited to, sole proprietorships, partnerships, corporations, associations, joint
ventures, co-ventures and any other legally recognized entity of any description whatever, as
well as all divisions, departments, affiliates, subsidiaries, or other sub-units of the foregoing
entities.
G. "Specify" when used with reference to a "document," calls for:
1. The nature of the document (e.g., letter, contract, chart, memoranda);
2. Its date;
3
3. Each author (and, in different, each signer) thereof, and each person to
whom the document was distributed;
4. Its subject matter and substance;
5. Its present or last known location or custodian;
6. The disposition of such document if it was but is no longer in your
possession or subject to your control; and
7. Any other information necessary to enable the custodian to locate the
particular document and necessary for use in a subpoena duces tecum or in
a demand for the production of the documents under Rule 4009. 1, et seq.,
of the Pennsylvania Rules of Civil Procedure.
H. "Date" means the exact day, month and year if ascertainable, or, if not, the best
approximation (including the relation of other events).
1. "You" or "your" refers to and shall be construed to mean the party to whom or to
which these discovery requests are directed, as well as that party's agents, representatives,
including without limitation, that party's counsel, insurance carriers and insurance agents, as well
as investigators hired or retained by the responding party, its agents, representatives, or counsel.
4
1. For purposes of compliance with the Medicare Secondary Payer Mandatory
Reporting Provisions in Section III of the Medicare/Medicaid and SCHIP Extension Act of
2007 (MMSEA), please provide the following with regard to the injured Plaintiff:
a. The HICN or SSN number of the injured Plaintiff;
b. The first initial of the injured Plaintiff's name;
C. The first six characters of the injured Plaintiffs last name;
d. The injured Plaintiffs date of birth; and
e. The injured Plaintiff s gender.
2. Please state your full name, date of birth and present address.
a. Have you ever used or been known by any other name? If so, please state
each other name.
b. How long have you lived at your present address?
C. If you are married, provide the full name of your spouse and the date of
your marriage.
d. If you have children, list their names, genders and date of birth.
5
3. What is your present occupation and state the name and address of your present
employer and describe the specific nature of your employment duties and responsibilities?
4. List the names and addresses of your former employers for the past ten years, if
any, and describe your employment duties and responsibilities.
6
5. State the amount of your gross and net income for each of the past six years.
6. Describe any and all accidents and/or personal injuries you have suffered before
the accident herein sued upon, giving the date, place, and parties involved in each such accident.
(A referral to attached medical records shall not constitute a sufficient response to this
interrogatory.)
7
7. From your knowledge, describe any and all infirmities and disabilities from which
you suffered before the accident in this claim or law suit. (A referral to attached medical records
shall not constitute a sufficient response to this interrogatory.)
8. State the names and addresses of all doctors and hospitals whom you have seen or
with whom you have consulted or where you have been treated during the ten years preceding
the date of this accident, and the nature of the ailment, illness, or other reason, for which such
doctor was consulted. (A referral to attached medical records shall not constitute a sufficient
response to this interrogatory.)
9. Give the names and addresses of all hospitals where you have been either as an
in-patient or an out-patient during the ten (10) years prior to the accident complained of and
describe the condition which necessitated each such hospitalization. (A referral to attached
medical records shall not constitute a sufficient response to this interrogatory.)
10. Describe in detail how the accident occurred including from where you were
coming and where you were going to at the time of the accident.
9
11. Of your own knowledge, what injuries did you receive in the accident involved in
this case? (A referral to attached medical records shall not constitute a sufficient response to this
interrogatory.)
12. Of you own knowledge, list any permanent scars, disfigurements, disabilities or
discomforts resulting from the accident involved in this case. (A referral to attached medical
records shall not constitute a sufficient response to this'interrogatory.)
10
13. Of your own knowledge, please set forth the exact nature of all other present
physical complaints, limitations or restrictions which you allege are attributable to the injuries
which you received in the accident involved in this case. (A referral to attached medical records
shall not constitute a sufficient response to this interrogatory.)
14. List all facts in detail that support your contention that you sustained a serious
impairment of a bodily function and/or permanent injury as a result of the accident.
11
15. If you have been hospitalized by reasons of the accident herein sued upon, list the
names and addresses of all such hospitals, clinics, or other medical institutions in which you
were a patient as a result of this accident, giving the dates of confinement and the sums of money
paid by you or on your behalf, or owing to each for services to you. (A referral to attached
medical records shall not constitute a sufficient response to this interrogatory.)
16. Please set forth the full name and address of each and every doctor or other
medical person who has attended or examined you resulting from the accident involved in this
case, and the sums of money paid or owing to each for services to you. (A referral to attached
medical records shall not constitute a sufficient response to this interrogatory.)
12
17. Please identify what employers you were employed by and/or jobs you were
working the six (6) months preceeding the accident and please state on what date you last
worked prior to the accident which is the subject of this litigation.
18. If you have returned to work, either on a full-time or part-time basis, when did
you return and state whether the return has been to full-time or part-time employment and state
exactly how much income, if any, do you claim to have lost to date resulting from the accident
involved in this case and state the method of calculating said loss and the facts upon which you
rely to base your calculations.
13
19. Exactly how much income, if any, do you claim to have lost to date as a result of
the within accident and state the method of calculating said loss and the facts upon which you
relay to base your calculations.
20. Of your own knowledge, will it be necessary for you to have future medical
treatment resulting from the accident involved in this case and, if so, who advised you of the
need for treatment and describe the type of treatment discussed. (A referral to attached medical
records shall not constitute a sufficient response to this interrogatory.)
14
21. Describe any and all accidents and/or personal injuries or ailments/diseases you
have suffered since the accident here sued upon, giving dates, time and place, parties involved
and injuries involved and identifying (by name and address) all medical providers with whom
you have sought treatment or consultation.
22. Do you know of any person who witnessed the alleged occurrence or who has any
knowledge of the relevant facts concerning the nature, character and extent of the injuries,
disabilities, damages, losses or expenses sustained by you as a result of the occurrence and for
which claim is being made in this action? If so, for each person, state:
a. The name and last-known address;
b. , A detailed description of the relevant facts known;
C. Whether written or otherwise recorded statement has been taken and, if so,
the name and address of the person taking the statement and the person in
present custody of the statement; and
d. If you will do so without a Motion to Produce, attach a copy of each
statement to your Answers to these Interrogatories.
15
23. In the ten (10) minute period before the accident which is the subject of the
Complaint, were you utilizing a cell or mobile phone or texting device and if so, provide the
name of the mobile/cell phone/texting device service provider, the name of the mobile/cell
number, the owner of the mobile/cell phone/texting device account and the billing address.
24. State the name, address, occupation and field of specialization, if any, of each
person whom you expect to call as an expert witness at trial, and state as to each the subject
matter on which the expert is expected to testify.
16
25. Set forth the qualifications of all those persons listed in the Answer to the
preceding Interrogatory and in doing so, as to each expert, list: formal education; the schools
attended, including years of attendance and degrees or certifications received; experience in
particular fields, including names and addresses of employers with inclusive years of
employment and positions held; teaching positions or other affiliations; and a list of all
publications authored by said persons, including the title of the work, the name of the periodical
or book in which it was printed, and the date of its printing. (In lieu of answering this
Interrogatory, please attach a copy of each expert's Curriculum Vitae or resume.)
26, a. Set forth the facts to which each expert you have listed is expected to
testify; and
b. Set forth the opinions to which each such expert is expected to testify.
17
27. Identify and describe any photographs, experiments, videotapes, movies,
transparencies, models, diagrams, facsimiles, drawings, plans, tests, or other device or thing to be
utilized by any expert to illustrate testimony or otherwise to support any opinion to be offered.
18
28. At the time of this accident, were you covered by any policy of insurance which
protected against the loss which is the subject of this action including but not limited to auto
insurance, health insurance and disability insurance and if so, state for each such policy:
a. The name, principal place of business and telephone number of the
insurer;
b. The name, address and telephone number of the named insured;
C. The policy number;
d. The effective dates of coverage;
e. The amount of liability coverage, specifying the terms thereof;
f. State whether there are any provisions, such as medical pay clauses, first
party benefits, uninsured motorist's coverage, underinsured motorist's
coverage, or other insurance payment provisions, which will provide
benefits to a party injured by your vehicle and set forth any conditions,
exclusions or other relevant terms concerning such additional benefits,
including the amount(s) of such coverage;
g. The number of vehicles covered, if applicable.
h. Your legal domicile at the time insurance was applied for;
i. Your legal domicile at the same time each policy of insurance (or any
endorsement thereto) was issued; and
j. Did you elect full tort option or limited tort option?
k. The amount of medical bills paid by each insurer related to this accident.
The amount of wage loss benefits paid by each insurer related to this
accident.
19
29. Has the insurance company or companies involved raised any issue as to your
coverage for damages arising from the aforesaid accident? If so, please set forth in detail the
basis for such issue, reservation of right or denial of coverage.
30. If any issue as to coverage arising from this accident has been raised by the
insurance company or companies involved, please set forth your position as to this issue.
20
31. Have you ever filed any claim(s) for worker's compensation benefits for this or
any other incident and, if so, identify the employer, the claim number, describe your injury, and
provide the name and address of the insured or self-insured entity to which your claim was made.
32. Have you ever filed any claims for unemployment compensation benefits and, if
so, identify the employer and provide the name and address of the insured or self-insured entity
to which your claim was made.
21
31. Have you ever filed any claim(s) for worker's compensation benefits for this or
any other incident and, if so, identify the employer, the claim number, describe your injury, and
provide the name and address of the insured or self-insured entity to which your claim was made.
32. Have you ever filed any claims for unemployment compensation benefits and, if
so, identify the employer and provide the name and address of the insured or self-insured entity
to which your claim was made.
21
33. Have you ever filed a claim for disability insurance and, if so, please identify
when the claim was made, the reason for the claim, and the identity of the insurance company or
other entity to whom the claim was submitted.
34. Have you ever filed a claim or lawsuit for personal injuries (other than this one)
and, if so, please identify when the claim and/or lawsuit was filed, the reason for same, the
parties involved in any accident or incident, and the claim number and insurance company and/or
docket number involved.
22
35. Identify by name, address, and subject matter of testimony all trial witnesses you
intend to call.
36. State the total amount of bills you have incurred for medical treatment as a result
of the motor vehicle accident upon which this lawsuit is based and state the amount actually paid
and the amount not paid and why? In the alternative, please describe, in detail, including but not
limited to, any and all medical specials you will claim at trial/arbitration/ADR.
23
37. State the date of your last appointment for medical care, treatment or consultation
for injuries related to the incident in suit, and identify by name or address the health care
provider. (A referral to attached medical records shall not constitute a sufficient response to this
interrogatory.)
38. Are you currently under a physician's care for injuries related to the incident in
suit and, if so, state the name and address of the physician. (A referral to attached medical
records shall not constitute a sufficient response to this interrogatory.)
24
39. Has any physician advised you to limit or restrict your work, employment or
vocational activities due to injuries related to the incident in suit and, if so, identify the physician
by name and address and describe the limitations and/or advice related to you. (A referral to
attached medical records shall not constitute a sufficient response to this interrogatory.)
40. Has any physician advised you to limit or restrict your activities of daily living,
household chores, hobbies, or activities you engaged in (pre-incident) and, if so, identify the
physician by name and address and describe the limitations, restrictions and/or advice relayed to
you. (A referral to attached medical records shall not constitute a sufficient response to this
interrogatory.)
25
41. Have you been convicted of any crime within the past ten (10) years, whether by
verdict or plea of guilty or nolo contendere? If so, please state:
a. the date of each such conviction;
b. the county and state in which you were convicted for each such crime;
C. the nature of the felony or misdemeanor of which you were convicted;
d. whether such conviction resulted from a jury verdict, plea of guilty or plea
of nolo contendere;
e. the name and addresses of the tribunal imposing sentence;
f. the title of the cause and case number assigned by said tribunal to your
case;
g. the nature of the sentence imposed; and
h. the dates and places of any facility in which you were incarcerated, and
the date(s) of release.
26
42. Have you, at any time, or are you currently preparing or maintaining any records,
notes, logs, ledgers or diaries that in any way describe your injuries, treatments, or activities
since the accident referred to in your Complaint?
43. Please provide specific information with regard to any lien or subrogation interest
against your recovery in this case including but not limited to any lien or subrogation interest of
any health insurance and/or worker's compensation insurance carrier and with respect to each
such lien, identify the lien holder by name and address, claim and/or policy number, the amount
of the lien asserted to date, and the specific basis therefore.
27
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
RODGER BROOKS AND VICTORIA BROOKS, Civil Action - Law
Plaintiffs,
vs. No. 2009-536 Civil Term
ERIC SHEAFFER,
Defendant. JURY TRIAL DEMANDED
CERTIFICATE OF SERVICE
AND NOW, this Yi% day of Actj Ctj , 2011, I, John C. Porter , a member of the
firm of GRIFFITH, STRICKLER, LERMAN, SOLYMOS & CALKINS, hereby certify that I
have this date served a copy of the Interrogatories of Defendant Eric Sheaffer to Plaintiffs,
Set No. 1 as indicated below, addressed to the party or attorney of record as follows:
William P. Douglas, Esquire
Douglas Law Office
43 W. South Street
POB 261
Carlisle, PA 17013
GRIFFITH, STRICKLER, LERMAN, SOLYMOS &
CALKINS
BY: a C'
Ro A. Lerman, Esquire #07490
John C. Porter, Esquire #90152
Attorney for Defendant Eric Sheaffer
110 South Northern Way
York, PA 17402
717-757-7602
717-757-3783 Fax
rlerman@gslsc.com
jporter ,gslsc.om
29
EXHIBIT C
William P. Douglas, Esq.
Supreme Court I.D. #37926
Douglas Law Office
43 W. South St.
Carlisle, PA 17013
Telephone (717) 243-1790_
RODGER BROOKS and VICTORIA
BROOKS,
Plaintiffs
In the Court of Common Pleas of
Cumberland County, Pennsylvania
No. 2009-536 Civil Term
ERIC SHEAFFER
vs
Defendant
Civil Action - Law
PLAINTIFFS' ANSWERS TO INTERROGATORIES
a. 210-42-2400
b. R
C. BROOKS
d. 07/06/52
e. Male
2. Rodger Brooks, July 6, 1952, 2149 'i oungs Road, Hanover, PA 17331
a. No.
b. Since December 2002.
C. Victoria Brooks, married September 27, 1997
d. Plaintiffs do not have any children together. Rodger has 3 children
as follows:
a. Heath Allen Brooks, Male, 01 / 09 / 1977
b. Brandon Brooks, Male, 05 / 05 / 1981
C. Holly Althoff, Female, 07 / 30 / 1975
3. Plaintiff works in the "sample department" where he makes samples of
bricks and displays them to customers to purchase. Plaintiff also runs a forklift
at Glen-Gary Corporation, York Plant, Brick Center, 1090 E Boundary Ave, York,
PA 17405
4. Plaintiff has been employed at Glen-Gary Corporation over ten years.
5. Plaintiff's income over the past six years ranged from approximately
$42,000 in 2006 to approximately $37,000.
6. Plaintiff's accidents and injuries prior to this accident all happened at
Glen-Gary Corporation and were as follows:
a. Fracture to his right knee. Plaintiff does not recall the specific
dates but estimates it to have happened in 1986 or 1987. There were no
other parties involved.
b. Plaintiff was involved in a natural gas explosion through the course
of his employment on April 5, 1981 at the Alwines facility where he was
lighting a burner that exploded. He suffered bruises with no broken
bones or any other injuries. Plaintiff went to the Hanover Hospital for
one visit and did not need further treatment.
C. Plaintiff was also injured at work at the York plant when a hole
collapsed burying him to his waist on January 8, 1998. Plaintiff had
surgery to repair the cartilage in his knees and received treatment for
frostbite of his feet.
7. See attached medical reports.
8. Dr. Lawrence S. Pollack and Dr. Michael F. Mitrick whose address is 1750
5th Avenue, York, PA for treatment to his legs due to issue in answer to
Question 6c above.
9. Hanover Hospital
10. Plaintiff was coming from visiting his son in York and going to his
mother's home.
11. Neck sprain;
Facial pain;
Back and shoulder pain;
Headaches;
Decreased rotation in cervical s pine with muscle spasms;
Disturbance of skin sensation;
Cervical spine and cervical spondylosis;
Chronic pain; and
Agitation of spinal stenosis in cervical region
12. See answer to Question 11.
13. See answers to above questions and medical records. Additionally, due to
the accident Plaintiff's life style, hobbies and more particularly, his work ability
is now limited. Plaintiff continues to perform at his position at work but he has
continual pain. Before the accident, he had no difficulty working a full day and
over-time. Since the accident, he struggles daily with pain. He is able to
continue to work but the pain is a constant reminder of the accident.
14. See attached medical records and answer to Question 11.
15.
Dr. Kurt Thomas
201 Allegheny Ave
Hanover, PA 17331
First Choice Rehabilitation
Specialists
550 North 12t` Street
Lemoyne, PA
Debra Deangelo
York Adams Pain Specialists
250 Fame Ave
Suite 103
Hanover, PA 17331
MRI
Hanover Radiology
2 Hanover Hospital
Hanover, PA 17331
16. Answer to Question 15 is incorporated herein along with Plaintiff's PIP
file.
17. Answer to Question 3 is incorporated herein along with letter dated
March 28, 2007 from Glen Gary Corporation.
18. Plaintiff worked at Glen-Gary Corporation prior to the accident and
continues to work there now. Due to the accident, Plaintiff has missed
work. Pursuant to letter dated March 28, 2007 from Glen Gary
Corporation signed by Linda Wolf, his wage loss to date is $1,402.72, less
$510.08 he received from State Farm. In addition, he loses four hours for
each doctor appointment at $16.49 per hour.
19. Answer to Question 18 is incorporated herein.
20. Nerve block of medial branch nerves on right C3 through C6 with radio
frequency ablation if nerve blocks proved successful which procedure will
be done as needed.
21. None.
22. Patrolman D. Gartrell of Penn Township Police Department whose
address is 20 Wayne Avenue, Hanover, PA prepared a police report which is
attached and the Parties.
23. No.
24.
Dr. Kurt Thomas
201 Allegheny Ave
Hanover, PA 17331
MD
Family Doctor
Debra Deangelo
York Adams Pain Specialists
250 Fame Ave
Suite 103
Hanover, PA 17331
MD / Pain Management
25. Curriculum vitae will be provided when received.
26. Dr. Kurt Thomas - as to Plaintiff's medical treatment for back pain,
shoulder pain, headaches, Plaintiff's thoracic sprain; neck sprain
and facial pain.
Dr. Deangelo recommended a nerve block of medial branch
nerves and radio frequency ablation procedure.
b. See attached medical records.
27. A determination has not yet been made.
28. 1. Automobile Policy
a. State Farm Fire & Casualty Co
One State Farm Dr, Concordville, PA 19339
717-632-1330
b. Rodger Brooks
2149 Youngs Rd, Hanover, PA 17331
C. 51 3099-F03-38D
d. December 3, 2006 through June 3, 2007
C. $50,000 / $100,00
f. Medical Coverage $25,000
g. See attached Declaration Page
h. See Answer b above.
i. See answer b above.
j. Full Tort
k. See attached Declaration Page.
2. So far all medical benefits have been paid by Plaintiff's automobile
insu rance which has yet to be exhausted.
29. No.
30. Not applicable.
31. Plaintiff has had a
Gary Corp in the
accident in question.
couple small workers compensation claims at Glen
bast but no workers compensation claim for the
32. Objection- irrelevant.
33. No.
34. No.
35. Has not yet been determined.
36. Has not yet been determined.
37. See attached medical reports of Dr. DeAngelo.
38. Yes. See medical reports of Dr. DeAngelo.
39. Plaintiff has been advised to pace himself and work within his limitations.
40. Plaintiff has been advised by his physicians to moderate his work and
activities.
41. No.
42. No.
43. No lien to date.
44. No lien to date.
Date: June 10, 2011
William TT
Attorney for
EXHIBIT D
HILLSIDE PAIN MANAGEMENT, P .C.
k
250 Fame Avenue
Suite 101
Hanover, PA 17331
Phone: 717-632-5478
Fax: 717-633-0257
William P. Douglas, Esq.
43 W. South Street
Carlisle, PA 17013-0261
October 17, 2009
RE: Rodger W. Brooks
Enclosed are the medical records you requested on Rodger W. Brooks. Please remit
$19.80 for retrieval of the record, $95.57 for copying of the record, plus $1.73 for
postage, for-a total of $120.32-made-payable to Hillside Pain Management, PC. Oijr t..ax - -- -
identification number is: 20-0367501.
Sincerely,
Mary Beth Calder
Practice Administrator
Hillside Pain Management Rodger Brooks
DOUGLAS LAW OFFICE
43 14'. South St.
CARLISLE, PENNSYLVANIA 17013-0261
WILLIAMP. DOUGLAS, ESQ.
CERTIFIED AS A CIVIL TRIAL ADVOCATE BY
THE NATIONAL BOARD OF TRIAL ADVOCACY
October 12, 2009
Hillside Pain Management
250 Fame Ave., Suite 101
Hanover, PA 17331
Attn: Dr. DeAngelo
My client: Rodger W . Brooks
DOB: 7/6/53
Auto accident date: 213/07
Dear Dr. DeAngelo:
brooks 000267
717-243-1790
FAX. 717.243-8955
EMAIL: douglaslaw@earthlsnk.net
I have enclosed a new medical authorization signed by Rodger Brooks/
Would you please send me a copy of your records on Mr. Brooks from the
date of the accident until the present.
Thank you.
Sincerely,
ail I L=
WPD:jml
Enclosure
Hillside Pain Management Rodger Brooks brooks 000268
DATE: 9117107
HISTORY: Neck pain. Auto accident.
CERVICAL SPINE: 9/17/07
*****Signed*****
Open-mouth AP, lateral, swimmer's and oblique views of the cervical spine.
C1 through C7 are clearly seen. No fracture, subluxation or prevertebral soft
tissue swelling. Degenerative disc disease and spondylosis, moderate to
marked C5-C6, C6-C7. No paraspinal mass. Neural foramina) narrowing mild to
moderate on the left C3-C4, moderate to severe C5-C6, moderate C6-C7. Neural
foraminal narrowing on the right , moderate to marked C3-C4, C4-C5, C5-C6,
moderate C6-C7. No paraspinal abnormality. Interstitial changes In the upper
lungs.
IMPRESSION: No fracture, subluxation or prevertebral soft tissue swelling.
Bilateral neural foramina) narrowing as described.
.•.*.<<Signature on File-*****
ALICIA MARIE CARTAGENA MD
D: 09/18/07 0803
T: 09/18/07 1224 - MJW
PATIENT IDENTIFICATION
BROOKS,RODGER W SERV: RAID
UNIT #: M000019826 ACCT #: V00002466384
DOB: 0710611952
ORDERING PHYSICIAN: KURT K THOMAS DO
RECIPIENTS: KURT K THOMAS, DO
PATIENT'S PHONE #: (717)632-1661
HANOVER HOSPITAL
RADIOLOGY REPORT
PAGE 1 OF 1
MR #: 564 (Ml)
Hillside Pain Management
Rodger Brooks
*****Signed*****
DATE: 12110107
HISTORY: MVA, 213/07, neck pain since MVA, cervical sprain, pain in both
shoulders.
MRI OF CERVICAL SPINE, UNENHANCED, 12111107
T1 and T2 sagittal, gradient T2 weighted axial images.
No definite vertebral body fractures or metastatic disease Is identified. The
alignment of the vertebral bodies Is maintained. There is disc degeneration
throughout C2-3 through C6-7 levels with moderate to significant disc space
narrowing involving the C5 and C6-7 levels with more mild disc space narrowing
at the C3-4 level. No spondylodiscitis is identified. The spinal cord
reveals no plaquing, masses, syrinx formation, or myelomalacia.
C1-2, C2-3 levels are unremarkable.
C3-4 reveals a tiny disco-osteophyte flattening the theca) sac but no spinal
cord or nerve root contact.
The C4-5 level also demonstrates flattening of the theca) sac without cord or
nerve root contact.
The (Z-b level demonstrates a small disco-osteophyte which flattens the thecai
sac but no definite cord contact. The neural foramina bilaterally demonstrate
some mild narrowing.
The C6-7 level is essentially unremarkable as is the C7-T1 level. There is no
increased fluid within the facet joints.
Incidentally noted are tiny disc protrusions centrally T2-3 and T3-4 levels
thought to be of no clinical significance. No marrow edema is identified
within the posterior elements. No definite muscle straining is identified.
IMPRESSION:
1. Small disco-osteophyte C34, C4-5, C5-6 and C6-7 levels of doubtful
clinical significance.
2. Mild bilateral neural foraminal narrowing C5-6.
3. Tiny central disc protrusions T2-3 and T34 level felt to be of no clinical
significance. No acute fractures or evidence of muscle strain/edema.
4. Vertebral body hemangioma T1 of doubtful clinical significance.
brooks 000269
...•.<<Signature on File>>"-'
PATIENT IDENTIFICATION
BROOKSAODGER W SERV: MRI
UNIT M M000019826 ACCT M V00002518346
DOB: 07/06/1952
ORDERING PHYSICIAN: KURT K THOMAS DO
RECIPIENTS: KURT K THOMAS, DO
PATIENT'S PHONE #: (717)632-1661
HANOVER HOSPITAL
MRI SCAN REPORT
PAGE 1 Or 2
MR #: 568 (8101)
- Hillside Pain Management Rodger Brooks brooks 000270
D: 12/11/07 0952
T: 12/11/07 1336 - EAE
LUTHER WELLS MD
PATIENT IDENTIFICATION
BROOKSAODGER W SERV: MRI
UNIT M M000019826 ACCT #: V00002518346
DOB: 07/0611952
ORDERING PHYSICIAN: KURT K THOMAS DO
RECIPIENTS: KURT K THOMAS, DO
PATIENTS PHONE M (717)632-1661
*****Signed*****
HANOVER HOSPITAL
MRI SCAN REPORT
PAGE 2OF2
MR #: 568 (8101)
Hillside Pain Management
Rodger Brooks
1##AN"ERHE C.4REPWS
PHYSICAL MEDICINE
SPECIALIST OF HANOVER
250 Faroe Avenue, Ewrance B, Suite 100
Hanover, PA 17331
717-646-6915/fax: 717-646-6919
www hannverhospit ai.orV
Physiatry Electrodiagnostic Assessment
DATE OF SERVICE:
PATIENT NAME:
DOB:
REF PROVIDER:
PCP:
Dear Dr. DeAngelo:
01/07108
Brooks, Rodger W
07/06/1952
Dr. Kurt Thomas
Dr. Kurt Thomas
Today I had the pleasure of evaluating Rodger Brooks via electrodiagnostic evaluation,
As you may know, Rodger Brooks is a pleasant patient with a chief complaint of
CERVICALGIA, I am enclosing a copy of the electrodi agnostic report with my
assessment and recommendations for your records.
Thank you for allowing me to participate in the care of your patient. Please feel free to
call with any questions or concerns at 717-646-6915.
Sincerely,
Pq?,
Livia K Baublitz, DO
0??
wn.-;a„ Din KAananomont Rodqer Brooks brooks 000272
DATE: 01/07/08 @ 1624 Hanover Health Corporation EAR **LIVE** PAGE 1
USER: HHC.LMM LIST VISIT DETAIL
NAME BROOKS, RODGER W DOD 07/06/1952
PATIENT M000019826 SEX MALE
CLINICAL VISIT ENC N TCH000450057 DATE 01/03/08 TIME 1500
PROVIDER LOCATION PHYSICAL MED SPEC OF HANOVER
BAUBLITZ,LIVIA K DO VISIT TYPE
CREATED BY JUDITH A HERSHEY
VISIT DIAGNOSIS
723.1 CERVICALGIA
HEIGHT 5 FT 6.5 IN 168.91 C WEIGHT 200 LB 90.120 KG
TEMP PULSE RESP BP POSITION LOCATION
C014MENT
68 16 126/78 SITTING RIGHT ARM
PROCEDURES
95900 NERVE CONDUCTION,EACH NERVE
95903 NERVE CONDUCTION MOTOR W/F WAVE
95904 NERVE CONDUCTION SENSORY
VISIT.TEXT
E-Signed by Livia K Baublitz, D. 0. on n1/07/09 at. 1 026
CHIEF COMPLAINT:
B/L EMG OF UPPER EXTREMITIES
HISTORY OF PRESENT ILLNESS:
Today I had the pleasure of evaluating this patient via
electrodiagnostic evaluation. As you know he is being evaluated and
treated for complaints of neck pain. He was involved in a motor
vehicular accident approximately February of 2007. Since that time he
has been experiencing neck pain bilaterally with radiation to the mid
scapular region bilaterally. He denies any radicular symptoms down
bilateral arms. He reports some mild subjective grip strength
weakness bilaterally. Today he reports the pain is aching in nature.
He has had no improvement in pain since his last visit. His current
pain level is approximately 5/10. He denies any new pain, sensory
deficits, weakness or bowel or bladder control problems. He reports
alleviating factors include ibuprofen. Exacerbating factors include
side bending and rotation of the neck.
RADIOLOGIC REVIEW: As noted the patient did undergo an MRI of the
cervical spine on 12/11/07 which showed spondylosis with disc
osteophyte complex at C3-4, C4-5 and C5-6 as well as C6-7, There was
bilateral neural foraminal stenosis noted at C5-6.
PAST MEDICAL HISTORY:
PAST SURGICAL HISTORY:
Hillside Pain Management Rodger Brooks
brooks 000273
DFfTE: 01/07/08 @ 1624 Hanover Health Corporation EAR **LIVE** PAGE 2
USER: HHC.LMM LIST VISIT DETAIL
'NAME BROOKS, RODGER W DOH 07/06/1952
PATIENT M000019826 SEX MALE
CLINICAL VISIT ENC # TCH000450057 DATE" 01/03/08 TIME 1500
IFAMILY HISTORY:
ISOCIAL HISTORY:
MEDICATIONS:
Patient's existing prescriptions to Ibuprofen (Motrin 800 Mg Tab),
Naproxen (Naprosyn 500 Mg Tab), and Olmesartan Medoxomil (Benicar 20
Mg Tab) were reviewed.
ALLERGIES:
Allergy to No Known Allergies was reviewed.
REVIEW OF SYSTEMS
GENERAL: Negative
SKIN: Negative
HFA? Nrg?rig? - ---- ----
EYES: Negative
EARS: Negative
NOSE: Negative
NECK: Positive
Stiff neck: Yes
Soreness: Yes (VARIES FROM SHARP AND DULL PAIN)
BREASTS: Negative
HEART: Negative
HEME: Negative
THROAT: Negative
GASTRO: Negative
GU: Negative
GYN: Negative
MUSCULO: Positive
Muscular pain: Yes (NECK-RADIATES DOWN LEFT ARM)
NEURO: Negative
PSYCH: Negative
ENDOCRINE: Negative
PHYSICAL EXAM:
Blood pressure 126/78, heart rate 68, respiratory rate 16, pain level
5/10. In general, this is a well-developed, well-nourished male in
no acute distress. Skin reveals extreme callus of bilateral hands.
There are no other rashes noted. No cervical lymphadenopathy is
palpated. There is tenderness noted along bilateral facet joints
from the occiput to C7. Tenderness is also noted in bilateral upper
trapezius regions and cervical paraspinals bilaterally.
Cervical range of motion is grossly within functional limits with
flexion and extension. There is mild decrease in side bending and
Hillside Pain Management Rodger Brooks brooks 000274
DATE: 01/07/08 @ 1624 Hanover Health Corporation EAR {*LIVE** PAGE 3
USER: HHC.LMM LIST VISIT DETAIL
NAME BROORS,RODGER W DOB 07/06/1952
PATIENT M000019826 SEX MALE
CLINICAL VISIT ENC M TCH000450057 RATE 01/03/08 TIME 1500
rotation due to discomfort. Bilateral shoulders, elbows and wrists
appear to be within functional range of motion.
NEUROLOGIC: The patient is awake, alert and oriented x 3. There are
no cranial nerve deficits noted. Sensation appears grossly intact to
light touch bilaterally throughout the C4 through T2 dermatomes with
the exception of the left C5 through C7 dermatomes which are
diminished. Deep tendon reflexes are 2+ and symmetric bilaterally.
Strength is grossly 5/5 bilaterally throughout all myotomes. There
is a negative Hoffmann's bilaterally.
PROVOCATIVE MANEUVERS: There is an equivocal Spurling's on the
right. There is a negative Lhermitte's. Negative Tinel's of the elbow
and wrist bilterally. Negative Phalen's bilaterally.
Briefly, electrod iagnostic testing was performed today. The test was
prematurely terminated at the patient's request due to the feeling of
lightheadedness. He began to develop a vasovagal episode with nerve
stimulation. The test was subsequently stopped. Findings on the
electrodiagnostic evidence showed abnormal median and ulnar responses
`ich were most likely due to technical factor--due to -extreme skin -
impedance. Please refer to the full attached electrodiagnostic
report for complete electrodiagnositc interpretation and
recommendations.
PRELIMINARY DIAGNOSIS:
CERVICALGIA
TREATMENT GOALS:
1. Cervicalgia following motor vehicular accident, symptoms
consistent with a hyperextension/hyperflexion (whiplash) type injury.
2. Probable facet mediated cervicogenic pain.
3. C5-C6 bilateral neural foraminal stenosis, possible cervical
radiculopathy.
4. Status post motor vehicular accident.
THERAPEUTIC PLAN:
1. Unfortunately electrodiagnostic testing could not be fully
completed to assess for cervical radiculopathy. The patient's
symptoms do appear to be consistent with cervicogenic pain secondary
to facet mediated pain following a motor vehicular accident.
2. I would like to refer the patient to Hillside Pain Management to
undergo evaluation for possible facet joint injection versus cervical
medial branch block. The patient does appear to be tender from the
occiput to the C7 region bilaterally.
Hillside Pain Management Rodger Brooks brooks 000275
DATE: 01/07/08 @ 1624 Hanover Health Corporation EAR ""LIVE" PAGE 4
USER: HHC.LMM LIST VISIT DETAIL
NAME 8ROOICS,RODGER W DoH 07/06/1.952
PATIENT M000019826 SEX MALE
CLINICAL VISIT ENC M TCH000450057 DATE 01/03/08 TIME 1500
3. The patient may undergo repeat electrodiagnostic testing if there
is continued clinical suspicion of a cervical radiculopathy
particularly if his symptoms do not improve despite the facet joint
injections.
4. The patient may continue with ibuprofen as needed.
5. 1 will see the patient back in the office in eight weeks following
facet joint injections. Further therapeutic recommendations will be
made at that time.
6. Patient understands information.
cc: Dr. Kurt Thomas
Dr. DeAngelo: Hillside Pain Managment
Messages:
----- Livia K Baublitz, D.O. 01/07/08 9:01am -----
Note Task CLOSED
Hillside Pain Management Rodger Brooks
Hillside Pain Management
New Patient Questionnaire
Main pain complaint:
Description:
How long have you had your pain?
When and how did pain begin?
Was this associated with an injury?
Intensity of Pain, with I being no pain and 10 being the worst pain you can
imagine:
At its worst At its best 3 Currently -?-
brooks
Please check the words that describe your pain:
t/ Constant -Intermittent ? Aching ____Brief Deep ,Burning
Dull -Numbness -Pinching -Pressure Pulling -Sharp
-Shooting Stabbing ^Superficial -Tender 'Throbbing
?Tightness -Tingling Unbearable
What other words would you use to describe your pain?
How frequently do you have pain? Rarely -Frequently
.Often ?Almost all the time Always
What time of day is your pain worst? -"Moming ?Afternoon
?Ivening -Nighttime
Which of the following decreases your pain? ,Cold -Heat
----Acupuncture ?Changing positions Chiropractor Distraction
Massage Medications -Relaxation TENS unit
Which of the following increases your pain? _Sitting ,Bending over
`Twisting -Vacuuming __Standing Walking
Does pain frequently awaken you? Yes --'No
How many times a night?
When awakened, do you Empty bladder -Take medicine
-Sit up awhile
Do you return to sleep easily? -Yes _No
Brooks, Rodger W
State Farm
DOB: 07/0B/1952
Doctor. Debra A Deangeto DO
A U14644
Hillside Pain Management Rodger Brooks
Past Treatment of Your Pain
Have you ever had surgery for your pain problem? N.
Have you ever had injections or nerve blocks for your pain problem? N,,
What kind?
How many and when?
Did any injection relieve your pain? N?
Have you had physical therapy? ycs
When s mri, r o
Where
What did the treatment consist oP Wcwr, 7
Have you had chiropractic manipulation?
Did it help?
Have you had acupuncture??
Did it help?
brooks
Dew--uso any of-th:: followi ng: -_ - - - ---
Walker Sometimes ^Always
Cane
^ Sometimes Always
Crutch Sometimes Always
Wheelchair Sometimes Always
Brace _ Sometimes Always
Neck Collar _ Sometimes - Always
List all medications that you have tried in the past for pain jv4pras??v hy?
If you have had any of the following studies, please list the year and place
performed
MRi ? Dec
Bonescan
Plain or regular X-rays Nuv o7
EMG/NCS (nerve conduction studies)
CT scans
Lab tests relating to pain
Other studies or tests
Marital Status -Single "anied Widowed
-Divorced/Separated -Remarried
Brooks, Rodger W
state Form
DOB: DIAW1952
Doctor: Debra A Deangelo DO
AU14tf44
Hillside Pain Management Rodger Brooks
Number of Children Ages:
Who shares your home?
Highest year of school ;2,
Work status -full time -part time disabled `self retired
-unemployed -student
If disabled, date last worked
If working less than full time, is pain the reason? Yes No
Did your employer allow you to return? '--'Yes No
If you had NO pain, would you go back to work? Yes No
Do you think you can work at your regular job? Yes No
Personal Habits
Tobacco (type, amount per day) c t5*,s
Previous Smoker? -Yes No
When did you quit?
Alcohol (amount per day or week)
Have you had a problem with alcohol? -Yes ?No
Drug use: marijuana (pot), heroin, cocaine, speed, ecstasy, PCP? Yes
No
Coffee, tea and cola beverages (cups/glasses per day) 3 C40a
General Medical History
Have you used anticoagulant medications?
Have you had any of these medical problems? Asthma -Anxiety
ntis -Bleeding disorder -Diabetes ??iigh blood
attacks _vAr
pressure ?Head injury `Heart attack/Heart disease -Heart murmur
?HepatitisAiver disease ----High cholesterol Kidney stones
-Osteoporosis Phlebitis `Pneumonia Polio
-Seizure disorder -Severe depression Stroke
TBAung disease Thyroid trouble -Ulcer Other
Past Surgical History List ail surgeries with Year and Operation:
k c< tcPT-1 12 w
Family History
is there a history of any of the following in a blood relative? -Alcoholism
----Migraine Chronic pain vStroke `diabetes ----Heart attack
,1%h blood pressure -Breast cancer -Disability Depression
Psychiatric illness -Colon cancer
Brooks, Rodger W
state Fart
DOB: 07AW1832
Doctor: Debra A Deangeio DO
AU146"
Hillside Pain Management Rodger Brooks
Please list any allergies:
Please list your current medications with dosage:
Do you have any of the foliowing problems?
General: fevers -chills -sweats ^loss of appetite
fatigue _ weight loss
Eyes: Vblumng visionloss -'trouble with bright light
Ears/Nose/Throat: -ringing decreased hearing
--nasal congestion ___sore throat hoarseness
trouble swallowing
cardiovascular. _chest pains ipalpitations
-shortness of breath on exertion -swelling in legs
Respiratory; _cough -shortness of breath -wheezing
Gastrointestinal: -nausea -vomiting `diarrhea constipation
^change in bowel habits) abdominal pain
Genitourinary: trouble with urination `need to urinate at night
incontinence
Musculoskeletal: ____back pain ---.joint pain `joint swelling
-muscle cramps -muscle weakness ?stifness +--arthritis
Skin: -rash "itching dryness !suspicious lesions
Neurologic: -temporary paralysis weakness seizures
-syncope or passing out
Psychiatric: depression -anxiety ,-memory loss
Endocrine: -cold intolerance ,heat intolerance
frequent urination weight change
Hemenymphatic: ___,abnormal bruising -bleeding
-enlarged lymph nodes
Allergic/Immunologic: __-_hay fever -,persistent infections
HIV exposure
Brooks, Rodger W
State Fa " 1952 O
OWtor: Vera A peangeto !)
A0146"
brooks
Hillside Pain Management
Rodger Brooks
Pain Diagram
Please mark the area of injury or discomfort on the chart below, using the appropriate symbols:
Numbness:----- Burning:- Pins & Needles: oooo Stabbing: 0 0 0 Aching: xxxc
Using the pain scale 1-10, please put a number that describes each
Best 3 worst G Current 3
s
i
Please use the space below to describe your condition further if needed
Date: I -- I ;)-- c 8 Signature: M-Y4 L., fa-?
Brooks, Rodger W
State Form
DO9: o7bd1952 efo DO
Doctor: Debra A Dean9
AU14644
brooks 000280
Hillside Pain Management Rodger Brooks brooks 000281
Hillside Pain Management, P.C.
Terrence M. Calder, M.D.
Patient was seen by: DEBRA DEANGELO DO
Patient Name: RODGER W BROOKS
Date of Birth: 07/06/1952
Date of Service: 01/15/2008
Referred from: LIVIA BAUBLITZ M D
PCP:
Referring Doctor: Livia Baublitz M D
Primary Physician: Dr.Kurt Thomas
Other physicians or providers involved with care:
Debra A. DeAngelo, D.O.
Cl IIEF COMPLAINT Rodger Brooks is a 55 year old new patient seen in the office today. Patient is here today for right
sided cervical pain..
The following forms were reviewed with the patient and scanned into the chart: Pain Diagram, New Patient
Questionnaire.
HISTORY OF PRESENT ILLNESS: 1115108 - Initial Consult - Patient is here today with right sided cervical pain
which occasionally radiates into his right shoulder area. He also has occasional headaches with this pain which radiates
up into the back of his head. Patient has had this pain since 2/3/07 after an automobile accident (near head oil collison)
He describes this pain as constant, aching, throbbing, tightness and always there is some way. Pain is worse in the
morning, afternoon and evening. Increases Pain: particular head positions and quick jolts Decreases Pain: changing
positions and medications. Pain does not usually wake him up at night. Patient has tried PT which gave only temporary
relief. Has also tried Ibuprofen and is currently taking Naprosyn BID with improvement in symptoms enough so that lie
can function and work. Patient has also recently starting having problems with lightheadedness with quick movements.
Pain levels are baseline.
Best pain (out of 10):3
Worst pain (out of 10):6
Current pain (out of 10):3
Patient's goal for treatmencNot having to medicine every day to be pain free
Patient's goal for treatment:0
PAST MEDICAL HISTORY:
MEDICAL: Arthritis, hypertension., concussion in MVA
SURGICAL: Bilateral knee surgery x 2 post war injury, bone spur removed from right elbow.
Medical history, allergies and current medications were reviewed with the patient
ALLERGIES:
NO KNOWN ALLERGIES
MEDICATIONS:
BENICAR ORAL TABLET 20 MG, once daily, status: NEW HISTORY, 01/15/2008.
NAPROSYN ORAL TABLET 500 MG, BID, status: NEW HISTORY, 01/15/2008.
PatientlD: AU 14644
Page I of 7
Hillside Pain Management Rodger Brooks brooks 000282
Hillside Pain Management, P.C.
Terrence M. Calder, M.D.
Debra A. DeAngelo, D.O.
Patient was seen by: DEBRA DEANGELO DO
Patient Name: RODGER W BROOKS
Date of Birth: 07/06/1952
Date of Service: 01/15/2008
Referred from: LIVIA BAUBLITZ M D
PCP:
Is patient taking blood thinning coed?No
SOCIAL HISTORY:
ALCOHOL: Does not give any significant history of alcohol usage.
TOBACCO USE: Smokes cigars.
MARITAL STATUS:
OCCUPATION: Full time - Glen Gery Brick, job requires lifting
CAFFEINE: consumes a" moderate amount of eaffeinated beverages daily. - - - _"
ILLICIT DRUG USE: No history of illicit drug use or prescription misuse.
FAMILY HISTORY:
GENERAL FAMILY ILLNESS: Positive history of cerebrovascular accident, Positive family history of
diabetes, positive history of hypertension.
REVIEW OF SYSTEMS:
GENERAL: No major weight gain, loss or fever.
EYES: Has blurred vision, difficulty looking at bright lights.
EARS/NOSE/MOUTH/ THROAT: No hearing changes, hoarseness, or swallowing difficulties.
RESPIRATORY: No shortness of breath, cough, hemoptysis, or wheezing.
CARDIAC: No chest pain, palpitations, tachyarrhythmias, or edema.
GI: No abdominal pain, change in bowel habits or heartburn.
GU: No urinary problems noted.
MUSCULOSKELETAL: Has joint stiffness, arthritis.
NEUROLOGICAL: See HP1.
SKIN/CHEST WALL: No rashes, sores, blisters, growths. changing moles, discolorations or non-healing
lesions. No abnormalities in chest wall.
PSYCHIATRIC: No recent change in mood or behavior.
ENDOCRINE: No heat or cold intolerance, change in hair distribution, excessive thirst, hunger, or urination,
change in energy level, or significant weight gain or loss.
HEMATOLOGIC/LYMPHATIC: No abnormal bruising or bleeding. No swollen, tender, or painful lymph
nodes.
ALLERGIC/IMMUNOLOGIC: No latex allergies or recurrent infections.
VITAL SIGNS:
VS-HEIGHT: 5ft6.5in
VS-WEIGHT: 204lbs
VS-TEMPERATURE: 97.8°f Tympanic
PatientlD: AU 14644
Page 2 of 7
Hillside Pain Management Rodger Brooks brooks 000283
Hillside Pain Management, P.C.
Terrence M. Calder, M.D.
Debra A. DeAngelo, D.O.
Patient was seen by: DEBRA DEANGELO DO
Patient Name: RODGER W BROOKS
Date of Birth: 07/06/1952
Date of Service: 01/15/2008
Referred from: LIVIA BAUBLITZ M D
PCP:
VS-PULSE: 82 Right Radial, Regular
VS-BLOOD PRESSURE: 150/103 Right Arm Sitting
VS-RESPIRATION: 18
VS-PULSE OXIMETRY: 95%
Documentation gathered by: Lynda Hanchett.
Physician HPI Comments:.Patient was unbelted driver when he was struck on driver's side head on at approx 30+ MPH.
Pain started several hours later. Pain is right side of neck with no radiation.
PHYSICAL EXAM:
GENERAL APPEARANCE: White male, moderately overweight body habitus. In no acute distress.
MUSCULOSKELETAL EXAM:
HEAD/NECK (POSTERIOR), SHOULDER GIRDLE: No erythema, ecchymosis or edema. Moderate
tenderness over the right occipital grove, right cervical facet joints. I-lead and neck in neutral
position. Extension mildly restricted, lateral bending mildly restricted bilaterally, lateral rotation
on the right mildly restricted. Normal stability. Normal strength and tone.
SPINE, RIBS, PELVIS: No kyphosis, lordosis, or scoliosis. Full, painless range of motion of the thoracic
and lumbar spine. Normal stability. Normal strength and tone.
LEFT UPPER EXTREMITY:
INSPECTION: No erythema. No ecchymosis. No edema.
MUSCLE STRENGTH, TONE, ATROPHY: Muscle strength of the major groups is 5/5. Tone of
the major groups is normal. Normal muscle bulk (no atrophy). No fasciculations.
RIGHT UPPER EXTREMITY:
INSPECTION: No erythema. No ecchymosis. No edema.
MUSCLE STRENGTH, TONE, ATROPHY: Muscle strength of the major groups is 5/5. Tone of
the major groups is normal. Normal muscle bulk (no atrophy). No fasciculations.
LEFT LOWER EXTREMITY:
INSPECTION: No erythema. No ecchymosis. No edema.
STRENGTH, 'T'ONE, ATROPHY: Muscle strength of the major groups is 5/5. Tone is normal.
Normal muscle bulk (no atrophy). No fasciculations.
RIGHT LOWER. EXTREMITY:
INSPECTION: No erythema. No ecchymosis. No edema.
STRENGTH, TONE, ATROPHY: Muscle strength of the major groups is 5/5. Tone is normal.
Normal muscle bulk (no atrophy). No fasciculations,
CNs II-XII grossly intact.
POSTURE: Normal.
GAIT/STATION: Gait intact.
REFLEXES: Deep tendon reflexes normal and symmetrical.
PatientlD: AU14644
Page 3 of 7
Hillside Pain Management Rodger Brooks brooks 000284
Hillside Pain Management, P.C.
Terrence M. Calder, M.D.
Debra A. DeAngelo, D.O.
Patient was seen by: DEBRA DEANGELO DO
Patient Name: RODGER W BROOKS
Date of Birth: 07/06/1952
Date of Service: 01/15/2008
Referred from: LIVIA BAUBLITZ M D
PCP:
SPECIAL TESTS: Positive Spurling's test on the right,
GENERAL, EXAM:
ORIENTATION/MOOD/AFFECT: Oriented to person, place, time and general circumstances. Mood
and affect appropriate.
NECK AND THYROID: Symmetrical with no obvious masses. Trachea inidIine. No enlargement,
tenderness, or mass of the thyroid noted.
RESPIRATORY: Normal respiratory effort with symmetrical lung expansion. Lungs clear to
auscultation. No adventitious sounds noted.
CARDIOVASCULAR:
PALPATION & AUSCULTATION: Regular rate and rhythm with no murmurs, gallops, rubs or
abnormal heart sounds.
ASA Physical status 1.
IMAGING STUDIES:
CERVICAL:
CERVICAL PLAIN FILMS: DATE: 9/17/07
HISTORY• Neck pain Auto accident.
CERVICAL SPINE: 9/17/07
Open-mouth AP, lateral, swimmer's and oblique views of the cervical spine.
C 1 through C7 are clearly seen. No fracture, subluxation or prevertebral soft
tissue swelling. Degenerative disc disease and spondylosis, moderate to
marked C5-C6, C6-C7. No paraspinal mass. Neural foraminal narrowing mild to
moderate on the left 0-C4, moderate to severe C5-C6, moderate C6-C7. Neural
foraminal narrowing on the right, moderate to marked C3-C4, C4-C5, C5-C6,
moderate C6-C7. No paraspinal abnormality. Interstitial changes in the upper
lungs.
PatientlD: AU 14644
Page 4 of 7
Hillside Pain Management Rod er Brooks brooks 000285
Hillside Pain 1V?anagement, P.C.
Terrence M. Calder, M.D.
Patient was seen by: DEBRA DEANGELO DO
Patient Name: RODGER W BROOKS
Date of Birth: 07/06/1952
Date of Service: 01/15/2008
Referred from: LIVIA BAUBLITZ M D
PCP:
IMPRESSION: No fracture, subluxation or prevertebral soft tissue swelling.
Bilateral neural foraminal narrowing as described.
D: 09/18/07 0803
T: 09/18/07 1224 - MJW
Debra A. DeAngelo, D.O.
*****<<Signature on File>>*****
ALICIA MARIE CARTAGENA MD
CERVICAL MRI: DATE: 12/10/07
HISTORY: MVA, 2/3/07, neck pain since MVA, cervical sprain, pain in both
shoulders.
MRI OF CERVICAL SPINE, UNENHANCED,12/11/07
TI and T2 sagittal, gradient T2 weighted axial images.
No definite vertebral body fractures or metastatic disease is identified. The
alignment of the vertebral bodies is maintained. There is disc degeneration
throughout C2-3 through C6-7 levels with moderate to significant disc space
narrowing involving the C5 and C6-7 levels with more mild disc space narrowing
at the C3-4 level. No spondylodiscitis is identified. The spinal cord
reveals no plaquing, masses, syrinx formation, or myelomalacia.
C 1-2, C2-3 levels are unremarkable.
C3-4 reveals a tiny disco-osteophyte flattening the thecal sac but no spinal
PatientlD: AU f 4644
Page 5 of 7
Hillside Pain Management Rodger Brooks brooks 000287
Hillside Pain Management, P.C.
Terrence M. Calder, M.D.
Patient was seen by: DEBRA DEANGELO DO
Patient Name: RODGER W BROOKS
Date of Birth: 07/06/1952
Date of Service: 01/15/2008
Referred from: LIVIA BAUBLITZ M D
PCP:
cord or nerve root contact.
Debra A. DeAngelo, D.O.
The C4-5 level also demonstrates flattening of the thecal sac without cord or
nerve root contact.
The C5-6 level demonstrates a small disco-osteophyte which flattens the thecal
sac but no definite cord contact. The neural foramina bilaterally demonstrate
some mild narrowing.
The C6-7 level is essentially unremarkable as is the C7-T1 level. There is no
increased fluid within the facet joints.
Incidentally noted are tiny disc protrusions centrally T2-3 and T3-4 levels
thought to be of no clinical significance. No marrow edema is identified
within the posterior elements. No definite muscle straining is identified.
IMPRESSION:
1. Small disco-osteophyte 0-4, C4-5, C5-6 and C6-7 levels of doubtful
clinical significance.
2. Mild bilateral neural foraminal narrowing C5-6.
3. Tiny central disc protrusions T2-3 and T3-4 level felt to be of no clinical
significance. No acute fractures or evidence of muscle strain/edema.
4. Vertebral body hemangioma T1 of doubtful clinical significance.
PatientlD. AU14644
*****<<Signature on File>>*****
Page 6 of 7
Hillside Pain Management Rod er Brooks brooks 000286
Hillside Pain Wianagement, P.C.
Terrence M. Calder, M.D. Debra A. DeAngelo, D.O.
Patient was seen by: DEBRA DEANGELO DO
Patient Name: RODGER W BROOKS
Date of Birth: 07/06/1952
Date of Service: 01/15/2008
Referred from: LIVIA BAUBLITZ M D
PCP:
LUTHER WELLS MD
D: 12/11/07 0952
T: 12/11/07 1336 - EAE
ASSESSMENT/PLAN:
721,0-CERVICAL SPONDYLOSIS WITHOUT MYELOPATHY
723.0-SPINAL STENOSIS IN CERVICAL REGION
723.4-BRACHIAL NEURITIS OR RADICULITIS NOS
723.1-CERVICALGIA
Assessment:
1. Right cervical pain
2. Cervical spondylosis
3. Cervical spinal stenosis
Plan:
1. Right C3-6 medial branch nerve blocks
2. Radiofrequency ablation of above if good temporary results
3. Follow up
Electronically Signed by: Lynda Hanchett, RN on Tuesday, .January 15, 2008
Electronically Signed by Debra A. DeAngelo, D O on Tuesday. Jantim 15, 2008
PatientlD: AU14644
Page 7 of 7
Hillside Pain Management Rodger Brooks
Pain Diagram
Please mark the area of injury or discomfort on the chart bolow, using the appropriate
Numbness:----- Buming:A- -, Pins & Needles: oooo Stabbing: 0 0 0 Achi
Using the pain scale 1-10, please put a member that describes each
Beat Worst C- Cutrmt -4
r
Please use the space below to desaibe your condition fiuther if needed
Date:
Brooks, Rodger 'VV
brooks 000288
State Farm
DOB: 07/00952 i
Doctor: Debra A Deangelo 00
Auf4W
Hillside Pain Management Rodger Brooks brooks 000289
York Adams Pain Specialists, P.C.
Terrence M. Calder, M.D.
Debra A. DeAngelo, D.O.
Patient was seen by: DEBRA DEANGELO DO
Patient Name: RODGER W BROOKS
Date of Birth: 07/06/1952
Date of Service: 01/21/2008
Referred from: LIVIA BAUBLITZ M D
PCP:
Referring Doctor: Livia Baublitz M D
Primary Physician: Dr.Kurt Thomas
Other physicians or providers involved with care:
CHIEF COMPLAINT Rodger Brooks is a 55 year old established patient seen in the office today. Patient is here today
for a scheduled procedure.
The following forms were reviewed with the patient and scanned into the chart: Pain Diagram.
HISTORY OF PRESENT ILLNESS 1/15/08 -Initial Consult -Patient is here today with right sided cervical pain
which occasionally radiates into his right shoulder area. He also has occasional headaches with this pain which radiates
up into the back of his head. Patient has had this pain since 2/3/07 after an automobile accident (near head on collison)
He describes this pain as constant, aching, throbbing, tightness and always there is some way. Pain is worse in the
morning, afternoon and evening. Increases Pain: particular head positions and quick jolts Decreases Pain: changing
positions and medications. Pain does not usually wake him up at night. Patient has tried PT which gave only temporary
relief. Has also tried Ibuprofen and is currently taking Naprosyn BID with improvement in symptoms enough so that lie
can function and work. Patient has also recently starting having problems with lightheadedness with quick movements.
1/21/08 - Procedure Visit - Patient states that he continues to have pain in the same locations as before. In fact, it is
worse today because he has been working outside in the cold weather. Patient is also having some pain at the base of his
neck today in addition to his right sided neck pain.
Pain levels are baseline.
Best pain (out of 10):3
Worst pain (out of 10):6
Current pain (out of 10):5
Padentll): AU14644
Page I of 5
Hillside Pain Management Roder Brooks brooks 000290
York Adams Pain Specialists, P.C.
Terrence M. Calder, M.D.
Patient was seen by: DEBRA DEANGELO DO
Patient Name: RODGER W BROOKS
Date of Birth: 07/06/1952
Date of Service: 01/21/2008
Referred from: LIVIA BAUBLITZ M D
PCP:
Debra A. DeAngelo, D.O.
PAST MEDICAL HISTORY:
MEDICAL: Arthritis, hypertension., concussion in MVA
SURGICAL: SURGICAL: Bilateral knee surgery x 2 post war injury, bone spur removed from right elbow.
Medical history, allergies and current medications were reviewed with the patient with no changes noted.
CURRENT ALLERGY LIST:
NO KNOWN ALLERGIES
Is patient taking blood thinning med?No
CURRENT MEDICATION LIST:
BENICAR ORAL TABLET 20 MG, once daily
NAPROSYN ORAL TABLET 500 MG, BID
VITAL SIGNS:
VS-TEMPERATURE: 97.81f Tympanic
VS-PULSE: 68 Left Radial, Regular
VS-BLOOD PRESSURE: 158/102 Left Arm Sitting
VS-RESPIRATION: 18
VS-PULSE OXIMETRY: 96%
Documentation gathered by: Lynda Hanchett.
Physician I-IPI Comments:.Patient with continued c/o right neck pain here for right C3-6 MBNB.
PHYSICAL EXAM:
GENERAL APPEARANCE: White male, moderately overweight body habitus. In no acute distress.
PatientlD: AU14644
Page 2 of 5
Hillside Pain Management Roder Brooks brooks 000291
York Adams Pain Specialists, P.C.
Terrence M. Calder, M.D.
Debra A. DeAngelo, D.O.
Patient was seen by: DEBRA DEANGELO DO
Patient Name: RODGER W BROOKS
Date of Birth: 07/06/1952
Date of Service: 01 /21/2008
Referred from: LIVIA BAUBLITZ M D
PCP:
MUSCULOSKELETAL EXAM:
HEAD/NECK (POSTERIOR), SHOULDER GIRDLE: No erythema, ecchymosis or edema. Moderate
tenderness over the right occipital grove, right cervical facet joints. Head and neck in neutral
position. Extension mildly restricted,-lateral bending mildly restricted bilaterally, lateral rotation
on the right mildly restricted. Normal stability. Normal strengrth and tone.
SPINE, RIBS, PELVIS: No kyphosis, lordosis, or scoliosis. Full, painless range of motion of the thoracic
and lumbar spine. Normal stability. Normal strength and tone.
LEFT UPPER EXTREMITY:
INSPECTION: No erythema. No ecchymosis. No edema.
MUSCLE STRENGT-I, TONE, ATROPHY: Muscle strength of the major groups is 5/5. Tone of
the major groups is normal. Normal muscle bulk (no atrophy). No fasciculations.
RIGHT UPPER EXTREMITY:
INSPECTION: No erythema. No ecchymosis. No edema.
MUSCLE STRENGTH, TONE, ATROPHY: Muscle strength of the major groups is 5/5. Tone of
the major groups is normal. Normal muscle bulk (no atrophy). No fasciculations.
POSTURE: Normal.
GAIT/STATION: Gait intact.
SPECIAL TESTS: Positive Spurling's test on the right.
GENERAL EXAM:
ORIENTATION/MOOD/AFFECT: Oriented to person, place, time and general circurnstances. Mood
and affect appropriate.
RESPIRATORY: Normal respiratory effort with symmetrical lung expansion. Lungs clear to
auscultation. No adventitious sounds noted.
CARDIOVASCULAR:
PALPATION & AUSCULTATION: Regular rate and rhythm with no murmurs, gallops, rubs or
PatienttD: AU14644
Page 3 of 5
Hillside Pain Management Rodger Brooks brooks 000292
York Adams Pain Specialists, P.C.
Terrence M. Calder, M.D.
Patient was seen by: DEBRA DEANGELO DO
Patient Name: RODGER W BROOKS
Date of Birth: 07/06/1952
Date of Service: 01/21/2008
Referred from: LIVIA BAUBLITZ M D
PCP:
abnormal heart sounds.
ASA Physical status 1.
- - ."k
1. Right cervical pain
2. Cervical spondylosis
3. Cervical spinal stenosis
Plan: Right C3-6 MBNB
Debra A. DeAngelo, D.O.
Procedure: Cervical Medial Nerve Branch Block.
Procedure performed by Dr. Debra DeAngelo.
Diagnosis: cervical spondylosis w/o myelopathy (721.0).
Post procedure diagnosis: same.
The following medial nerve branches were treated on the right: C-3, C-4, C-5, C-6.
After informed consent was obtained, the patient was taken to procedure room B and placed in a prone position.
Location of pain on the right was identified under fluoroscopy to be over: C-3, C-4, C-5, C-6. Their neck was
sterilely prepped with ChloraPrep. Noninvasive monitors were applied. 22 gauge spinal needles were used.
Fluoroscopy was adjusted to highlight the articular pillars on the right, The needles were advanced under
fluoroscopic guidance until they were positioned in the target zone of: C-3, C-41 C-5, C-6. Placement was
confirmed with oblique, AP, and lateral fluoroscopic views. Each level was injected with I nil of I% ropivacaine
and 81ng kenalog. They tolerated the procedure well, and were taken to the recovery room where they were
observed for at least 20 minutes, and released in good condition.
RETURN VISIT: Patient instructed to return in 2 weeks for RF .
F.lcctronically Signcd by: I.ynda Hanchett, RN on Monday,.lanuary 21, 2009
PatientlD: AU14644
Page 4 of 5
Hillside Pain Management Rodger Brooks brooks 000293
York Adams Pain Specialists, P.C.
Terrence M. Calder, M.D.
Patient was seen by: DEBRA DEANGELO DO
Patient Name: RODGER W BROOKS
Date of Birth: 07/06/1952
Date of Service: 01 /21 /2008
Referred from: LIVIA BAUBLITZ M D
PCP:
Electronically Signed by. Debra A. DcAngelo, D 0 on Tuesday. January 22, 2008
PatlenllD: AU14644
Debra A. DeAngelo, D.O.
Page 5 of 5
Hillside Pain Management Rod er Brooks brooks 000294
Hillside Pain management, P.C.
Terrence M. Calder, M.D.
Patient was seen by: DEBRA DEANGELO DO
Patient Name: RODGER W BROOKS
Date of Birth: 07/06/1952
Date of Service: 01/23/2008
Referred from:
PCP: <9247 NOT AVAILABLE> <9246 NOT AVAILABLE>
DATE: 01/23/2008.
TIME OF CALL: 03:17:00 PM. Pt called just wanted you to know is pain is a 1.
thanks
sandy
ACTION: Noted
APohlman. LPN
Glectronicnlly Signed by apohlman on Wednesday, January 23, 2008
PatientlD: AU 14644
Debra A. DeAngelo, D.O.
Page 1 of 1
Hillside Pain Management
Rodger Brooks brooks 000295
York Adams Pain Specialists
250 flame Avenue, Suite 103, Hanover PA
Phone 637-0943 Fax 633-7829
0 1 2 3 4 5 6 7 8 9 10
No worst pain
Pain Imaginable
Date Time Pain Comments Medications &/or
# other treatments tried
.21- Pro O s
2-1-4 /y Af ? '' {r 4
/. 2,:, -08 i3e+1 - t is o - 'K4 t I
x 2- 4- P•n o r
-:3° I' M 1 eeL
-A3_VCT- 1 ++ 11 tI
r-z3-ca4 L) pia
10 bn
„
2
-2 ?Gf
1( ?rn
•
n It it
- 75-tg 11 1,
yet t l
l- L y n ,. l• r l
.; 5 ?+ 1, i 510. rak I1
P- I I 1. 1 1 1. 1 1 Te. He r r
,, ?1 I I
a y Pte, (., I x
a r, v a NoP
O
W1 -type
b y P/+. Y
I/ r a-^ . ,
- i r '? Prn Y I+ ? 0 ?.
?. Y Arn y ?: + a t f-
11
+' L[NOL ts.? p
i n '+
C V e R+y/
,1
.0P%
y i
z-t z
Brooks, Rodger W
state Farm
Doti: 0710811952
Doctor: Debra A Deangelo DO
ALJ14 41
1 side Pain Management Rodger Brooks
Pain Diagram
Please mark the area of hn ary or discomfort on tie chart below, using the appropriate symbols:
Numbness:----- Burning:,,- Pins & Needles: o00o Stabbing: 0 0 0 Aching: x=
Using the pain scale 1-10, please put a number that describes each
Best_ Worst Current
, 6 Mt
1
brooks 000296
w
? (?1t?-I (C Uz1c?;?Q
Jp
Please use the space below to descn-be your condition further if needed
Date:;' ?' U 0 Signature: fl
Brooks, Rodger W
State Farm
DOB: 07/OB1952
Doctor: Debra A Deangelo DO
AU14844
?yf
n? .
Hillside Pain Management Rodger Brooks brooks 000297
York Adams Pain Specialists, P.C.
Terrence M. Calder, M.D.
Debra A. DeAngelo, D.O.
Patient was seen by: DEBRA DEANGELO DO
Patient Name: RODGER W BROOKS
Date of Birth: 07/06/1952
Date of Service: 02/07/2008
Referred from: LIVIA BAUBLITZ M D
PCP:
Referring Doctor: Livia Baublitz M D
Primary Physician: Dr.Kurt Thomas
Other physicians or providers- involved with care:
CHIEF COMPLAINT Rodger Brooks is a 55 year old established patient seen in the office today. The patient presents
with right sided neck ache, right sided neck burning, right sided neck pain. The patient is scheduled for Procedure.
The following forms were reviewed with the patient and scanned into the chart: Pain Diagram.
HISTORY OF PRESENT ILLNESS 1/15/08 -Initial Consult -Patient is here today with right sided cervical pain
which occasionally radiates into his right shoulder area. He also has occasional headaches with this pain which radiates
up into the back of his head. Patient has had this pain since 213/07 after an automobile accident (near head on collison)
He describes this pain as constant, aching, throbbing, tightness and always there is some way. Pain is worse in the
morning, afternoon and evening. Increases Pain: particular head positions and quick jolts Decreases Pain: changing
positions and medications. Pain does not usually wake him up at night. Patient has tried PT which gave only temporary
relief. Has also tried lbuprofen and is currently taking Naprosyn BID with improvement in symptoms enough so that he
can function and work. Patient has also recently starting having problems with lightheadedness with quick movements.
1/21/08 - Procedure Visit - Patient states that lie continues to have pain in the same locations as before. In fact, it is
worse today because lie has been working outside in the cold weather. Patient is also having some pain at the base of his
neck today in addition to his right sided neck pain.
2/7/08: Patient here for procedure. He continues with the pain in the right cervical area and a headache. The pain
does not radiate down the arm at all. He got good relief with the MNBB, 100% relief for the rest of that night. He
states that it still feels tight. He had bronchitis and the flu since he was here. He was taking Tylenol with codeine
and Naprosyn.
Medial Nerve Branch Block, Cervical: right 3, Right C4, Right C5, right C6.
Date of prior procedure:01/21/2008
Patientil) AU14644
Page 1 of 5
Hillside Pain Management Rodger Brooks brooks 000298
York Adams Pain Specialists, P.C.
Terrence M. Calder, M.D.
Patient was seen by: DEBRA DEANGELO DO
Patient Name: RODGER W BROOKS
Date of Birth: 07/06/1952
Date of Service: 02/07/2008
Referred from: LIVIA BAUBLITZ M D
PCP:
Debra A. DeAngelo, D.O.
Activity has increased.
Percent improvement: 100 ( that day)
Pain levels are following treatment._
Best pain (out of 10):0
Worst pain (out of 10):5 ( with coeds)
Current pain (out of 10):2
PAST MEDICAL HISTORY:
MEDICAL: Arthritis, hypertension., concussion in MVA
SURGICAL: SURGICAL: Bilateral knee surgery x 2 post war injury, bone spur removed from right elbow.
Medical history, allergies and current medications were reviewed with the patient
CURRENT ALLERGY LIST:
NO KNOWN ALLERGIES
Is patient taking blood thinning coed?no
CURRENT MEDICATION LIST:
BENICAR ORAL TABLET 20 MG, once daily
NAPROSYN ORAL TABLET 500 MG, BID
CURRENT PROBLEM LIST:
CERVICAL SPONDYLOSIS WITHOUT MYELOPATHY
SPINAL STENOSIS IN CERVICAL REGION
CERVICALGIA
PatientlD: AU14644
Page 2 of 5
Hillside Pain Management Rodger Brooks brooks 000299
York Adams Pain Specialists, P.C.
'Terrence M. Calder, M.D.
Patient was seen by: DEBRA DEANGELO DO
Patient Name: RODGER W BROOKS
Date of Birth: 07/06/1952
Date of Service: 02/07/2008
Referred from: LIVIA BAUBLITZ M D
PCP:
BRACHIAL NEURITIS OR RADICULITIS NOS
VITAL SIGNS:
VS-TEMPF,RATURF.: 97.5°f Tympanic
VS-PULSE: 85 Right Radial, Regular
VS-BLOOD PRESSURE: 145/92 Left Arm Sitting
VS-RESPIRATION: 18
VS-PULSE OXIMETRY: 96%
Documentation gathered by: Ashley Pohlman.
Debra A. DeAngelo, D.O.
Physician HPI Comments:. Patient with 100% improvement of his pain for the day of the MBNB, now with his pain
increased again. He was not expecting to have RF done today and wants to have sedation but has no driver. It would be
a good idea to have sedation due to his body habitus.
PHYSICAL EXAM:
GENERAL APPEARANCE: White male, moderately overweight body habitus. In no acute distress.
MUSCULOSKELETAL EXAM:
HEAD/NECK (POSTERIOR), SHOULDER GIRDLE: No erythema, ecchymosis or edema. Moderate
tenderness over the right occipital grove, right cervical facet joints. Head and neck in neutral
position. Extension mildly restricted, lateral bending mildly restricted bilaterally, lateral rotation
on the right mildly restricted. Normal stability. Normal strength and tone.
SPINE, RIBS, PELVIS: No kyphosis, lordosis, or scoliosis. Full, painless range of motion of the thoracic
and lumbar spine. Normal stability. Normal strength and tone.
LEFT UPPER EXTREMITY:
INSPECTION: No erythema. No ecchymosis. No edema.
PatienllD: AU14644
Page 3 of 5
Hillside Pain Management Rodger Brooks brooks 000300
York Adams Pain Specialists, P.C.
Terrence M. Calder, M.D. Debra A. DeAngelo, D.O.
Patient was seen by: DEBRA DEANGELO DO
Patient Name: RODGER W BROOKS
Date of Birth: 07/06/1952
Date of Service: 02/07/2008
Referred from: LIVIA BAUBLITZ M D
PCP;
MUSCLE STRENGTH, TONE, ATROPHY: Muscle strength of the major groups is 5/5
the major groups is normal. Normal muscle bulk (no atrophy). No fasciculations.
RIGHT UPPER EXTREMITY:
INSPECTION: No erythema. No ecchymosis. No edema.
MUSCLE STRENGTH, TONE, ATROPHY: Muscle strength of the major groups is 5/5
the major groups is normal. Normal muscle bulk (no atrophy). No fasciculations.
POSTURE: Normal.
GAIT/STATION: Gait intact.
SPECIAL "TESTS: Positive Spurling's test on the right.
GENERAL EXAM:
Tone of
Tone of
ORIENTATION/MOOD/AFFECT: Oriented to person, place, time and general circumstances. Mood
and affect appropriate.
RESPIRATORY: Normal respiratory effort with symmetrical lung expansion. Lungs clear to
auscultation. No adventitious sounds noted.
CARDIOVASCULAR:
PALPATION & AUSCULTATION: Regular rate and rhythm with no murmurs, gallops, rubs or
abnormal heart sounds.
Assessment:
1. Right cervical pain with 100% improvement with MBNB for several hours
2. Cervical spondylosis
3. Cervical spinal stenosis
Plan:
1. Schedule RF with sedation
2. Follow up
PatientlD: AU14644
Page 4 of 5
Hillside Pain Management Rodger Brooks brooks 000301
York Adams Pain Specialists, P.C.
Terrence M. Calder, M.D. Debra A. DeAngelo, D.O.
Patient was seen by: DEBRA DEANGELO DO
Patient Name: RODGER W BROOKS
Date of Birth: 07/06/1952
Date of Service: 02/07/2008
Referred from: LIVIA BAUBLITZ M D
PCP:
Electronically Signed by: apolilman on Thursday, February 07, 2008
Electronically Signed by. Debra A. DeAngelo, D O on Thursday. February 07, 2008
PatientlD: AU14644
Page 5 of 5
Hillside Pain Management
Rodger Brooks
Pain Diagram
Please mark the area of injury or discomfort on te chart below, using the appropriate, symbols:
Numbness:----- Buming:"Am Pins & Neefles: oooo Stabbing: 0 0 0 Aching: =rx
Using the pain scale 1-10, please put a. member that describes each
Beat worst GSnrt
I G57?
r?l
%V
?1/
Re=use the space below to describe your condition 5nthm if heeded
Date: .z2- i1- o s-- Signature: Q4 &_.A-
Brooks, Rodger W
brooks 000302
State Farm
DOB: 0710&1952
Doctor: Debra A Deangato DO
AG148"
Hillside Pain Management Rodger Brooks brooks 000303
York Adams Pain Specialists, P.C.
Terrence M. Calder, M.D.
Debra A. DeAngelo, D.O.
Patient was seen by: DEBRA DEANGELO DO
Patient Name: RODGER W BROOKS
Date of Birth: 07/06/1952
Date of Service: 02/1 1/2008
Referred from: LIVIA BAUBLITZ M D
PCP:
Referring Doctor: Livia Baublitz M D
Primary Physician:
Other physicians or providers involved with care: - - -
CI-41EF COMPLAINT Rodger Brooks is a 55 year old established patient seen in the office today. The patient presents
with cervical pain. The patient is here for a radiofrequency at the cervical level at right C3.. right C4, right C5, facet joint
rhizolysis at C6 right.
The following forms were reviewed with the patient and scanned into the chart: Pain Diagram.
HISTORY OF PRESENT ILLNESS 1/15/08 - Initial Consult -Patient is here today with right sided cervical pain
which occasionally radiates into his right shoulder area. He also has occasional headaches with this pain which radiates
up into the back of his head. Patient has had this pain since 2/3/07 after an automobile accident (near head on collison)
He describes this pain as constant, aching, throbbing, tightness and always there is some way. Pain is worse in the
morning, afternoon and evening. Increases Pain: particular head positions and quick jolts Decreases Pain: changing
positions and medications. Pain does not usually wake him up at night. Patient has tried PT which gave only temporary
relief. Has also tried Ibuprofen and is currently taking Naprosyn BID with improvement in symptoms enough so that lie
can function and work. Patient has also recently starting having problems with lightheadedness with quick movements.
1/21/08 - Procedure Visit - Patient states that he continues to have pain in the same locations as before. In fact, it is
worse today because he has been working outside in the cold weather. Patient is also having some pain at the base of his
neck today in addition to his right sided neck pain.
2/7/08: Patient here for procedure. He continues with the pain in the right cervical area and a headache. The pain
does not radiate down the arm at all. He got good relief with the MNBB, 100% relief for the rest of that night. He
states that it still feels tight. He had bronchitis and the flu since he was here. He was taking Tylenol with codeine
and Naprosyn.
2/11/08 procedure visit: Patient has returned for radiofrequency at right C3-5. He will be having IV sedation
Palientli): AU14644
Page 1 of 9
Hillside Pain Management Rodger Brooks brooks 000304
York Adams Pain Specialists, P.C.
Terrence M. Calder, M.D.
Patient was seen by: DEBRA DEANGELO DO
Patient Name: RODGER W BROOKS
Date of Birth: 07/06/1952
Date of Service: 02/11/2008
Referred from: LIVIA BAUBLITZ M D
PCP:
Debra A. DeAngelo, D.O.
with this procedure and today has arranged for a driver after the procedure.
Medial Nerve Branch Block, Cervical: right 3, Right C5, Right C5.
-Date wprioi ptoced7lrs:.01121/2008
The improvement lasted 1 days.
Percent improvement: 100 ( the day of the MNBB)
Pain levels are following treatment.
Best pain (out of 10):2
Worst pain (out of 10):5
Current pain (out of 10):2
PAST MEDICAL HISTORY:
MEDICAL: Arthritis, hypertension., concussion in MVA
SURGICAL: Bilateral knee surgery x 2 postwar injury, bone spur removed from right elbow.
Medical history, allergies and current medications were reviewed with the patient
CURRENT ALLERGY LIST:
NO KNOWN ALLERGIES
Is patient taking blood thinning med?None
CURRENT MEDICATION LIST:
BENICAR ORAL TABLET 20 MG, once daily
NAPROSYN ORAL TABLET 500 MG, BID
VITAL SIGNS:
VS-TEMPERATURE: 98.6°f Tympanic
VS-PULSE: 78 Apical. Regular
PatientlD: AU 14644
Page 2 of 9
Hillside Pain Management Rodger Brooks brooks 000305
York Adams Pain Specialists, P.C.
Terrence M. Calder, M.D.
Patient was seen by: DEBRA DEANGELO DO
Patient Name: RODGER W BROOKS
Date of Birth: 07/06/1952
Date of Service: 02/1 1/2008
Referred from: LIVIA BAUBLITZ M D
PCP:
Debra A. DeAngelo, D.O.
VS-BLOOD PRESSURE: 127/84 Right Arm Sitting
VS-RESPIRATION: 18
" Pl_ f,":.1 O`{IMETRY: 94%
Documentation gathered by: Linda Buettner.
Physician HPI Comments:.Patient here for cervical RF with c/o right neck pain.
PHYSICAL EXAM:
GENERAL APPEARANCE: White male, moderately overweight body habittls. In no acute distress.
MUSCULOSKELETAL EXAM:
HEAD/NECK (POSTERIOR), SHOULDER GIRDLE: No erythema, ecchymosis or edema. Moderate
tenderness over the right occipital grove, right cervical facet joints. Head and neck in neutral
position. Extension mildly restricted, lateral bending mildly restricted bilaterally, lateral rotation
on the right mildly restricted. Normal stability. Normal strength and tone.
SPINE. RIBS, PELVIS: No kyphosis, lordosis, or scoliosis. Pull, painless range of motion of the thoracic
and lumbar spine. Normal stability. Normal strength and tone.
LEFT UPPER EXTREMITY:
INSPECTION: No erythema. No ecchymosis. No edema.
MUSCLE STRENGTH, TONE, ATROPHY: Muscle strength of the major groups is 5/5. Tone of
the major groups is normal. Normal muscle bulk (no atrophy). No faSClCUlations.
RIGHT UPPER EXTREMITY:
INSPECTION: No erythema. No ecchymosis. No edema.
MUSCLE STRENGTH, TONE, ATROPHY: Muscle strength of the major groups is 5/5. Tone of
the major groups is normal. Normal muscle bulk (no atrophy). No fasciculations.
PatientlD: AU14644
Page 3 of 9
Hillside Pain Management Rodger Brooks
York Adams Pain Specialists, P.C.
Terrence M. Calder, M.D.
Patient was seen by: DEBRA DEANGELO DO
Patient Name: RODGER W BROOKS
Date of Birth: 07/06/1952
Date of Service: 02/11/2008
Referred from: LIVIA BAUBLITZ M D
PCP:
brooks 000306
Debra A. DeAngelo, D.O.
POSTURE: Normal.
GAIT/STATION: Gait intact.
SPECIAL, TESTS: Positive Spnrling's test on the right,
GENERAL EXAM:
ORIENTATION/MOOD/AFFECT: Oriented to person, place, time and general circuinstances. Mood
and affect appropriate.
RESPIRATORY: Normal respiratory effort with symmetrical lung expansion. Lungs clear to
auscultation. No adventitious sounds noted.
CARDIOVASCULAR:
PALPATION & AUSCULTATION: Regular rate and rhythm with no murmurs, gallops, rubs or
abnormal heart sounds.
ASA Physical status 1.
Assessment:
1. Right cervical pain with 100% improvement with MBNB for several hours
2. Cervical spondylosis
3. Cervical spinal stenosis
Plan: Right C3-C6 MBN RP
Procedure: Cervical Medial Nerve Branch Radiofrequency Neuroablation.
Procedure performed by Dr. Debra DeAngelo.
Anes: Local with sedation IV Versed 2mg
Diagnosis: cervical spondylosis w/o myelopathy (721.0).
Post procedure diagnosis: same.
The following medial nerve branches were treated on the right: C-3, C-4, C-5, C-6.
After informed consent was obtained, the patient had an IV placed and was taken to procedure room B and
PatientlD AU14644
Page 4 of 9
Hillside Pain Management Rodger Brooks
York Adams Pain Specialists, P.C.
Terrence M. Calder, M.D.
Patient was seen by: DEBRA DEANGELO DO
Patient Name: RODGER W BROOKS
Date of Birth: 07/06/1952
Date of Service: 02/11/2008
Referred from: LIVIA BAUBLITZ M D
PCP:
brooks 000307
Debra A. DeAngelo, D.O.
placed in a prone position. Location of pain on the right was identified under fluoroscopy to be over: C-3, C-4,
C-5. Their neck was sterilely prepped with betadine. Noninvasive monitors were applied. He was sedated with
`Lnx?^! mn w. 5 rnn). tin! 10 cm radiofrequency needles were used. Fluoroscopy was adjusted to highlight the
articular pillars on the right. The needles were advanced under fluoroscopic guidance until they were positioned
in the target zone of, C-3, C-4, C-5, C-6. Placement was confinned with oblique, AP, and lateral fluoroscopic
views. RF needles were tested for sensory (50 Hz) and motor (2 Hz), and adjusted for maximal response. Final
results are listed below. Each level was injected with 0.5 ml of 4% Lidocaine. Each level was then treated with
radiofrequency as listed below. They tolerated the procedure well, and were taken to the recovery room where
they were observed for at least 20 minutes, and released in good condition.
Patient Data Record
F1
?Date: 11 Feb 2008 Time: 11:44:53 Log Number: 100783
-Patient Name: RODGER BROOKS Patientid: AU 14644
iDoctor: DR. D. DEANGELO Referring Doctor:
I (Comments: Electrode Selection: Two Electrodes RFC i
C!
Time Action Impedance Temp Settings?
11:45:41 Session Start
11:45:44 Sensory Stimulation Enter Freq-501-1z, Width-1 mS, 0-3.0 V
15:03:00 Sensory Stimulation Log Stim Output 0.43 Volts RIGHT C3 MBN
PatientlD AU14644
Page 5 of 9
Hillside Pain Management Rodger Brooks brooks 000308
York Adams Pain Specialists, P.C.
Terrence M. Calder, M.D.
Debra A. DeAngelo, D.O.
Patient was seen by: DEBRA DEANGELO DO
Patient Name: RODGER W BROOKS
Date of Birth: 07/06/1952
Date of Service: 02/1 1/2008
Referred from: LIVIA BAUBLITZ M D
PCP:
15:03:02 Motor Stimulation Enter
__15:03 07
_ Motor Stimulation Log
i I 1
I
15:03:13
Sensory Stimulation Enter
15:03:41 Sensory Stimulation Log
1-
15:03:43
Motor Stimulation Enter
15:03:54 Motor Stimulation Log
? I
15:03:56
Sensory Stimulation Enter
15:07:44 Sensory Stimulation Log
L]IA
15:07:46 Motor Stimulation Enter
15:07:50 Motor Stimulation Log
L! j
15:07:58 Session End
15:08:22 Session Start
I 1
15:08:25
Sensory Stimulation Enter
15:09:13 Sensory Stimulation Log
15:09:14 Motor Stimulation Enter
15:09:18 Motor Stimulation Log
?'1
PatientlD. AU 14644
Freq-21-1z, Width-1mS, 0-3.0 VI 1
Seim OWnto 1_22 Volts RIGHT C3 MBN
Freq-50Hz, Width- IniS, 0-3.0 V?
Stim Output 0.27 Volts RIGHT C3 MBN
Freq-2Hz, Width- 1rnS, 0-3.0 VI I
Stim Output 1.46 Volts RIGHT C3 MBN
Freq-50Hz, Width-ImS, 0-3.0 VF I
Stim Output 0.21 Volts RIGHT C4 MBN
Freq-2Hz, Width- ImS, 0-3.0 V'_'
Stim Output 1.45 Volts RIGHT C4 MBN
Freq-501-1z, Width- ImS, 0-3.0 V?
Stim Output 0.36 Volts RIGHT C5 MBN
Freq-21-1z, Width-1 mS, 0-3.0 V I I
Stim Output 1.23 Volts RIGHT C5 MBN
Page 6 of 9
Hillside Pain Management Rodger Brooks brooks 000309
York Adams Pain Specialists, P.C.
Terrence M. Calder, M.D.
Patient was seen by: DEBRA DEANGELO DO
Patient Name: RODGER W BROOKS
Date of Birth: 07/06/1952
Date of Service: 02/11/2008
Referred from: LIVIA BAUBLITZ M D
PCP:
15:09:21 Sensory Stimulation Enter
15:09:32 Sensory Stimulation Log
15:09:34 Motor Stimulation Enter
1_l 1
15:09:36 Sensory Stimulation Enter
15:10:11 Sensory Stimulation Log
L11
15:10:13 Motor Stimulation Enter
15:10:19 Motor Stimulation Log
15:10:21 Sensory Stimulation Enter
I10
15:10:29 Lesion Enter
15:12:39 Lesion Auto Start
15:12:43 Lesion Timer Start
15:13:47 Lesion Auto Off
15:13:58 Lesion Auto Start
15:14:00 Lesion Tither Start
15:15:04 Lesion Auto Off
-1?
15:15:09 Session End
F1
Debra A. DeAngelo, D.O.
Freq-501-lz, W idth- I mS, 0-3.0 V ?
Stim Output 0.33 Volts RIGHT C6 MBN
Freq-21-1z, Width- I mS, 0-3.0 V
Freq-50Hz, Width-1 mS, 0-3.0 V 0
Stim Output 0.36 Volts RIGHT C6 MBN
Freq-21-1z, Width-i mS, 0-3.0 V F-1
Stim Output 1.34 Volts RIGHT C6 MBN
Freq-50Hz, Width-1mS, 0-3.0 V
2500.00 Ohm 19.00 C Set Temp 80C, SetTime 1:000
263.00 Ohms 37.00 C 0
229.00 Ohms 77.00 C ?
264.00 Ohms 76.00 C -1
226.00 Ohms 58.00 C 0
224.00 Ohms 78.00 C
270.00 Ohms 75.00 C
Set Total Impedance Maximum Average Maximum Average Maximum Average Maximum'
temp time at range power power voltage voltage current current temperatureE
PatientlD: AU14644
Page 7 of 9
Hillside Pain Management Rodger Brooks brooks 000310
York Adams Pain Specialists, P.C.
Terrence M. Calder, M.D.
Debra A. DeAngelo, D.O.
Patient was seen by: DEBRA DEANGELO DO
Patient Name: RODGER W BROOKS
Date of Birth: 07/06/1952
Date of Service: 02/11/2008
Referred from: LIVIA BAUBLITZ M D
PCP:
set temp I
RIGHT C5 MBN
80C> 02:07 ?OR-')SOn.nhms 14.50W 0.07W 48V 3V 302mA 24mA _. 80C11
RIGHT C6 MBNI
80C 02:07 254-358 Ohms 19.29W 1.75W 59V 18V 327mA 97mA 81C11
:-j
15:15:33 Session Start
?j I_
15:15:36 Sensory Stimulation Enter Freq-50Hz, Width- ImS, 0-3.0 V
11 1
15:15:44 Lesion Enter 308.00 Ohms 38.00 C Set Temp 80C, SetTime 1:000
15:15:51 Lesion Auto Start 313.00 Ohms 38.00 C ?
15:15:55 Lesion Timer Start 264.00 Ohms 79.00 C J
15:16:58 Lesion Auto Off 205.00 Ohtns 76.00 C f
15:17:06 Lesion Auto Start 214.00 Ohms 62.00 C F
15:17:07 Lesion Timer Start 210.00 Ohms 79.00 C ?
15:18:10 Lesion Auto Off 277.00 Ohms 77.00 C
01
15:18:14 Session End
Set Total Impedance Maximum Average Maximum Average Maximum Average MaximurnlI
temp time at range power power voltage voltage current current temperature Li
set templ'
RIGHT C3 MBNI.:
80C 02:06 252-313 Ohms 12.72W 0.12W 48V 4V 265mA 31mA 81CE
PatientU AU 14644
Page 8 of 9
Hillside Pain Management Rodger Brooks brooks 000311
York Adams Pain Specialists, P.C.
Terrence M. Calder, M.D.
Debra A. DeAngelo, D.O.
Patient was seen by: DEBRA DEANGELO DO
Patient Name: RODGER W BROOKS
Date of Birth: 07/06/1952
Date of Service: 02/1 1/2008
Referred from: LIVIA BAUBLITZ M D
PCP:
RIGHT C4 MBNLI
80C 02:06 199-256 Ohms 20.05W 0.55W 56V 9V
358mA 61mA 81C?]
RETURN VISIT: Patient instructed to return in a month.
Electronically Signed by: Linda Buettner. RN on Monday, February 11, 2008
Electronically Signed by: Debra A. DeAngelo, DO on Monday, February 11, 2009
Patient(D: AIJ14644
Page 9 of 9
I Hillside Pain Management
Rodger Brooks
PHYSICAL MEDICINE
SPECIALIST OF HANOVER
250 Fame Avenue, Entrance B, Suite 100
Hanover, PA 17331
717-646-6915/fax: 717-646-6919
www.hanoverhospital. org
DATE OF SERVICE:
PATIENT NAME:
DOB:
REFPROWDER
PCP:
Dear Dr. Kurt Thomas:
Physiatry Follow-Up Assessment
02/20/08
Brooks, Rodger W
07/06/1952
Dr. Kurt Thomas
Dr. Kurt Thomas
Today I had the pleasure to re-evaluate Rodger Brooks. As you know, Rodger Brooks is
being treated for a chief complaint of NECK PAIN. I am enclosing a copy of the
progress note for your records with my assessment and recommendations.
Thank you for allowing me to participate in the care of your patient. Please feel free to
call with any questions or concerns at 717-646-6915.
Sincerely,
Hiviablitz, DO
CC: Dr. Debra DeAngelo: Hillside Pain Management
DATE: 02127108 @ 0917 Hanover Health Corporation EAR **LIVE** PAGE 1
USER: HHC.LMM LIST VISIT DETAIL
NAME BROOKS,RODGER W
PATIENT M000019826
DOB 07/06/1952
SEX MALE
ICLINICAL VISIT ENC # TCH000509761 DATE 02/20/08 TIME 1520
I PROVIDER
BAUBLITZ,LIVIA K DO
LOCATION PHYSICAL MED SPEC OF HANOVER
VISIT TYPE
CREATED BY Livia K Baublitz, D.O.
VISIT DIAGNOSIS
723.4 BRACHIAL NEURITIS NOS
723.1 CERVICALGIA
722.4 CERVICAL DISC DEGEN
721.0 CERVICAL SPONDYLOSIS
(HEIGHT 5 FT 6 IN 167.64 C WEIGHT 200 LB 90.720 KG
TEMP PULSE RESP BP POSITION LOCATION
COMMENT
72 16 122/80 SITTING RIGHT ARM
PATIENT STATES HE DOESN'T HAVE PAIN BUT JUST A LITTLE PRESSU
PROCEDURES
99212 OV, EST, PROB FOC HX AND EXM; STRFOR MDM
-VialT. TEXT - --- - -
E-Signed by Livia K Baublitz, D.O. on 02/26/08 at 1646
CHIEF COMPLAINT:
F/U FOR NECK PAIN
HISTORY OF PRESENT ILLNESS:
Today I had the pleasure to reevaluate this patient. As you know he
is a pleasant, 55-year-old, Caucasian male who is being treated for
complaints of neck pain following a motor vehicular accident
sustained February 2007. He was last seen in my office on 1/3/08 at
which time he underwent electrodiagnostic testing. This was an
incomplete evaluation as the test was terminated prematurely at the
patient's request. At that time, the patient's pain symptoms were
primarily of the cervical spine along the facet joints on the right
greater than left from the cervical facet joints C2 through C7. At
that time, consultation was requested to Dr. Debra DeAngelo from
Hillside Pain Management. The patient underwent initial consultation
there on 1/15/08. He underwent diagnostic facet joint injection on
1/21/08 of the right cervical facet C3-C6. The patient received 100%
relief of symptoms following the medial branch block. He has
subsequently undergone radiofrequency ablation of the right C3
through C6 facet joints.
Today the patient reports that he is 75% improved. The pain is
located along the right greater than left facet joint has improved by
100%. He describes only tightness in the area of the upper trapezius
region today. His pain is intermittent in nature. He denies any
exacerbating factors or alleviating factors. He continues to take
Naprosyn as needed.
The patient is overall pleased with his level of improvement. He
13
DATE: 02/27/08 @ 0917 Hanover Health Corporation EAR **LIVE** PAGE 2
USER: HHC.LMM LIST VISIT DETAIL
NAMB BROOKS,RODGER W DOB 07/06/1952
PATIENT M000019826 SEX MALE
CLINICAL VISIT ENC # TCH000509761 DATE 02/20/08 TIME 1520
denies any new pain, sensory deficits, weakness or bowel or bladder
control problems. Of note, the patient does report that he has
intermittent episodes, with the last occurring three months ago,
where he feels tightness in the neck and lightheadedness. He did have
an episode of this a week ago. The symptoms spontaneously resolved.
He denies any blurry vision or difficulty swallowing.
PAST MEDICAL HISTORY:
PAST SURGICAL HISTORY:
FAMILY HISTORY:
SOCIAL HISTORY:
MEDICATIONS
ALLERGIES:
Allergy to No Known Allergies was reviewed.
REVIEW OF SYSTEMS
GENERAL: Negative
None: No
SKIN: Negative
None: No
HEAD: Negative
EYES: Positive
Blurred vision: Yes (BLURRED VISION YESTERDAY WHILE WALKING.
STARTED AT 9:00 IN THE MORNING UNTIL 8:0)
EARS: Negative
None: No
NOSE: Negative
None: No
NECK: Negative
None: No
BREASTS: Negative
None: No
HEART: Negative
None: No
HEMS: Negative
None: No
THROAT: Negative
None: No
4
DATE: 02/27/08 @ 0917 Hanover Health Corporation EAR **LIVE** PAGE 3
USER: HHC.LMM LIST VISIT DETAIL
(NAME SROOKS,RODGER W DOS 07/06/1952
PATIENT M000019826 SEX MALE
ICLINICAL VISIT ENC 0 TCH000509761 DATE 02/20/08 TI24!M 1520
GASTRO: Negative
None: No
GU: Negative
None: No
MUSCULO: Positive
Joint stiffness: Yes (PATIENT HAS OCCASIONAL TIGHTNESS TO NECK.)
NEURO: Positive
Dizziness: Yes (C/O OF DIZZINESS YESTERDAY AT 4:00 AM UNTIL
8.00AM.)
PSYCH: Negative
None: No
ENDOCRINE: Negative
None: No
PHYSICAL EXAM:
Blood pressure 122/80, heart rate 72, respiratory rate 16, pain scale
1/10.
In general, this is a well-developed, well-nourished male in no acute
.distress. Skin reveals no evidence of scars or rashes. There are no
gross deformities noted. Cervical range of motion is wlLhin
functional limits with flexion and side bending and rotation.
Extension is limited without associated pain today.
NEUROLOGIC: The patient is awake, alert and oriented x 3. Cranial
nerves 2-12 grossly intact. Sensation grossly intact C9-T2. Deep
tendon reflexes 2+ symmetric bilateral biceps, triceps and
brachioradialis. Negative Hoffmann's bilaterally. Manual muscle
testing grossly 5/5 bilateral upper extremities throughout all
myotomes. Negative Hoffmann's bilaterally.
Provocative maneuvers reveal a negative Spurling's bilaterally,
negative Adson's and Lhermitte's bilaterally. Negative Hawkin's and
Neer's bilaterally. Negative Tinel's bilateral elbow and wrist.
RADIOLOGIC REVIEW: There are no new radiologic films for review
today.
PRELIMINARY DIAGNOSIS:
TREATMENT GOALS:
1. Cervicalgia following motor vehicular accident, symptoms
consistent with hype rextens ion/hyperflexion (whiplash) type injury.
2. Facet mediated cervicogenic pain-improved following radiofrequency
ablation cervical facet joints right C3-C6.
3. C5-C6 bilateral neural foraminal stenosis questionable history of
cervical radiculopathy-symptoms improved.
15
Hillside Pain Management Rodger Brooks brooks u
DATE: 02/27/08 @ 0917 Hanover Health Corporation EAR **LIVE** PAGE 4
USER: HHC.LMM LIST VISIT DETAIL
NAME BROOKS,RODGER W DOB 07/06/1952
PATIENT M000019826 SEX MALE
CLINICAL VISIT ENC # TCH000509761 DATE 02/20/08 TIME 1520
9. Status post motor vehicle accident by history.
THERAPEUTIC PLAN:
1. The patient appears to have received good results following medial
branch blocks on the right cervical C3 through C6. He has also
responded well with radiofrequency ablation. I anticipate his
symptoms will continue to improve and he will note decreased spasm
and tightness in the upper tzapezius region.
2. Be will continue to work on his regular duty work status.
3. He may continue with Naprosyn as needed.
4. The patient will follow-up with Dr. DeAngelo next week for
follow-up from the radiofrequency ablation.
5. I will see the patient back in the office in three months for
further evaluation. We will monitor his pain symptoms at that time
and further therapeutic recommendations will be made at that time.
cc: Dr. Kurt Thomas
Dr. Debra DeAngelo-13 illside Pain Manaaemsn*
16
Hillside Pain Management Rodger Brooks brooks 000317
Pain Diagram
Please mark the area of injury or discomfort on the chart below, using the appropriate symbols:
Numbness: --- Burning: ^^^^ Pins &. Needles: oooo Stabbing: 0 0 0 Aching: xx)a
Using the pain scale 1-10, please put a number that describes each
Best I Worst .3 Current
Percentage Of Improvement Since Last Visit yo
4
Please use the space below to describe your condition fiutber if needed
Seim ?+?:.? mfr[.. gels 7LyNT-
Date: J- it - op' Signature:` w fbo+K--
Brooks, Rodger W
State Farm
Don: 07108/!852
Doctor: Debra A Deangelo DO
AU14"4
Revised 210
Hillside Pain Management Rodger Brooks brooks 000318
Hillside Pain Management, P.C.
Terrence M. Calder, M.D.
Debra A. DeAngelo, D.O.
Patient was seen by: DEBRA DEANGELO DO
Patient Name: RODGER W BROOKS
Date of Birth: 07/06/1952
Date of Service: 03/11/2008
Referred from: LIVIA BAUBLITZ M D
PCP:
Referring Doctor: Livia Baublitz M D
Primary Physician: Dr. Thomas
Other physicians or providers involved with care:
CHIEF COMPLAINT Rodger Brooks is a 55 year old established patient seen in the office today. The patient is
scheduled for recheck. The patient presents with right sided neck ache, right sided neck burning. right sided neck pain.
The following forms were reviewed with the patient and scanned into the chart: Pain Diagram.
HISTORY OF PRESENT ILLNESS: 1/15/08 -Initial Consult - Patient is here today with right sided cervical pain
which occasionally radiates into his right shoulder area. He also has occasional headaches with this pain which radiates
tip into the back of his head. Patient has had this pain since 2/3/07 after an automobile accident (near head on collison)
He describes this pain as constant, aching, throbbing, tightness and always there is some way. Pain is worse in the
morning, afternoon and evening. Increases Pain: particular head positions and quick jolts Decreases Pain: changing
positions and medications. Pain does not usually wake him up at night. Patient has tried PT which gave only temporary
relief. Has also tried Ibuprofen and is currently taking Naprosyn BID with improvement in symptoms enough so that lie
can function and work. Patient has also recently starting having problems with lightheadedness with quick movements.
1/21/08 - Procedure Visit - Patient states that he continues to have pain in the same locations as before. In fact, it is
worse today because he has been working outside in the cold weather. Patient is also having some pain at the base of his
neck today in addition to his right sided neck pain.
2/7/08: Patient here for procedure. He continues with the pain in the right cervical area and a headache. The pain
does not radiate down the arm at all. He got good relief with the MNBB, 100% relief for the rest of that night. He
states that it still feels tight. He had bronchitis and the flu since he was here. He was taking Tylenol xvith codeine
and Naprosyn.
2/11/08 procedure visit: Patient has returned for radiofrequency at right C3-5. He will be having 1V sedation
with this procedure and today has arranged for a driver after the procedure.
3/11/08: Patient here for follow-up. He continues with some pain in the right posterior cervical area as an aching pain
and tightness. He states that since his RF, his pain has been improved about 90%. It does not radiate down the arms at all-
it's just there at the one area in the neck, and that is not all the time. He takes Ibuprofen prn on days when it gets worse.
Radiofrequency: Right C3. C4, C5, C6.
Date of prior procedure:02/1 1 /2008
Activity has increased.
Percent improvement:90
Pain levels are following treatment.
Best pain (out of 10):1
Worst pain (out of 10):3
Current pain (out of 10):2
PAST MEDICAL HISTORY: MEDICAL: Arthritis, hypertension., concussion in MVA
PatiendD: A014644
Page 1 of 4
Hillside Pain Management Rodger Brooks brooks 000319
Hillside Pain management, P.C.
Terrence M. Calder, M.D.
Patient was seen by: DEBRA DEANGELO DO
Patient Name: RODGER W BROOKS
Date of Birth: 07/06/1952
Date of Service: 03/11/2008
Referred from: LIVIA BAUBLITZ M D
PCP:
Debra A. DeAngelo, D.O.
SURGICAL: Bilateral knee surgery x 2 postwar injury, bone spur removed from right elbow.
Medical history, allergies and current medications were reviewed with the patient
CURRENTALLERGY LIST:
NO KNOWN ALLERGIES
Is patient taking blood thinning coed?no
CURRENT MEDICATION LIST:
BENICAR ORAL TABLET 20 MG, once daily
NAPROSYN ORAL TABLET 500 MG, BID
CURRENT PROBLEM LIST:
CERVICAL SPONDYLOSIS WITHOUT MYELOPATHY
SPINAL STENOSIS IN CERVICAL REGION
CERViCALGIA
BRACHIAL NEURITIS OR RADICULITIS NOS
REVIEW OF SYSTEMS:
Patient denies all symptoms in all systems except as noted. except for HPI.
GENERAL: No major weight gain, loss or fever.
EYES: No loss or change in vision.
EARS/NOSE/MOUTH/ THROAT: No hearing changes, hoarseness, or swallowing difficulties.
RESPIRATORY: No shortness of breath, cough, hemoptysis, or wheezing.
CARDIAC: No chest pain, palpitations, tachyarrhythmias, or edema.
GI: No abdominal pain, change in bowel habits or heartburn,
GU: No urinary problems noted.
MUSCULOSKELETAL: Neck pain.occasionally since RF
NEUROLOGICAL. See HPI.
SKIN/CHEST WALL: No rashes, sores, blisters, growths, changing moles, disco] orations or non-healing
lesions. No abnormalities in chest wall.
PSYCHIATRIC: No recent change in mood or behavior.
ENDOCRINE: No heat or cold intolerance, change in hair distribution, excessive thirst, hunger, or urination,
change in energy level, or significant weight gain or loss.
HEMATOLOGIC/LYMPHATIC: No abnormal bruising or bleeding. No swollen, tender, or painful lymph
nodes.
ALLERGIC/IMMUNOLOGIC: No latex allergies or recurrent infections.
PatientlD: AU14644
Page 2 of 4
Hillside Pain Management Rodger Brooks brooks 000320
Hillside Pain Management, P.C.
Terrence M. Calder, M.D.
Debra A. DeAngelo, D.O.
Patient was seen by: DEBRA DEANGELO DO
Patient Name: RODGER W BROOKS
Date of Birth: 07/06/1952
Date of Service: 03/11/2008
Referred from: LIVIA BAUBLITZ M D
PCP:
VITAL SIGNS:
VS-TEMPERATURE: 98°f Tympanic
VS-PULSE: 73 Right Radial, Regular
VS-BLOOD PRESSURE: 136/85 Left Arm Sitting
VS-RESPIRATION: 18
VS-PULSE OXIMETRY: 96%
I)oc?.,mes?t^tion gathered by: Ashley Pohlman.
Physician HPI Coniments:.Patient feels he has had 90% improvement of his pain with RFA. Feels a stiffness, not pain on
a regular basis.
PHYSICAL EXAM:
GENERAL APPEARANCE: White male, moderately overweight body habitus. In no acute distress.
MUSCULOSKELETAL EXAM:
HEAD/NECK (POSTERIOR), SHOULDER GIRDLE: No erythema, ecchymosis or edema. Mild
tenderness over the right occipital grove. I-lead and neck in neutral position. Normal extension without
pain, lateral bending restricted, normal rotation. Normal stability. Normal strength and tone.
SPINE, RIBS, PELVIS: No kyphosis, lordosis, or scoliosis. Full, painless range of motion of the thoracic
and lumbar spine. Normal stability. Normal strength and tone.
LEFT UPPER EXTREMITY:
INSPECTION: No erythema. No ecchymosis. No edema.
MUSCLE STRENGTH, TONE, ATROPHY: Muscle strength of the major groups is 5/5. Tone of
the major groups is normal. Normal muscle bulk (no atrophy). No fasciculations.
RIGHT UPPER EXTREMITY:
INSPECTION: No erythema. No ecchymosis. No edema.
MUSCLE STRENGTH, TONE, ATROPHY: Muscle strength of the major groups is 5/5. Tone of
the major groups is normal. Normal muscle bulk (no atrophy). No fasciculations.
POSTURE: Normal.
GAIT/STATION: Gait intact.
SPECIAL TESTS: Negative Spurhng's test on the right.
GENERAL EXAM:
ORIENTATION/MOOD/AFFECT: Oriented to person, place, time and general circumstances. Mood
and affect appropriate.
RESPIRATORY: Normal respiratory effort with symmetrical lung expansion. Lungs clear to
auscultation. No adventitious sounds noted.
CARDIOVASCULAR:
PatientlD AU14644
Page 3 of 4
Hillside Pain Management Rodger Brooks brooks 000321
Hillside Pain Management, P.C.
Terrence M. Calder, M.D.
Patient was seen by: DEBRA DEANGELO DO
Patient Name: RODGER W BROOKS
Date of Birth: 07/06/1952
Date of Service: 03/11/2008
Referred from: LIVIA BAUBLITZ M D
PCP:
Debra A. DeAngelo, D.O.
PALPATION & AUSCULTATION: Regular rate and rhythm with no murmurs, gallops, rubs or
abnormal heart sounds.
Assessment:
1. Right cervical pain with 90% improvement with RFA
2. Cervical spondylosis
3. Cervical spinal stenosis
Plan:
1. No further treatment required at this time
2. Patient to call if pain increases
RETURN VISIT: Patient is to return on an as needed basis.
Electronically Signed by: apolilman on Tuesday, March 11, 2008
Electronically Signed by: Debra A. DeAngelo, D U on Tuesday, March 1 I, 2008
PatientlD: AU14644
Page 4 of 4
Hillside Pain Management Rodger Brooks brooks 000322
Pain Diagram
Please mark the area of injury or discomfort on the chart below, using the appropriate symbols:
Numbness:-- Burning:' Pins & Needles: oooo Stabbing: 0 0 0 Aching: xxxx
Using the pain scale 1-10, please put a number that describes each
Best Worst $ Current
Percentage Of Improvement Since Last Visit
Please use the space below to describe your condition further if needed
LOT 8914P .54HAref
Date: 1 j- 131- o B- Signature: iL16 W fb.1
I
n
}i
Brooke, Rodger W
State Farm
DDB: OT/w," to DO
Doctor Debra A De°"!>e
Revised 2/08 AU14444
Hillside Pain Management Rodger Brooks brooks 000323
Hillside Pain Management, P.C.
Terrence M. Calder, M.D.
Debra A. DeAngelo, D.O.
Patient was seen by: DEBRA DEANGELO DO
Patient Name: RODGER W BROOKS
Date of Birth: 07/06/1952
Date of Service: 11/18/2008
Referred from: LIViA BAUBLITZ M D
PCP:
Referring Doctor: Livia Baublitz M D
Primary Physician: Dr. Thomas
Other physicians or providers involved with care:
CHIEF COMPLAINT Rodger Brooks is a 56 year old. established patient seen in the office today. The patient is
scheduled for recheck. The patient presents with right sided neck ache, right sided neck burning, right sided neck pain.
The following forms were reviewed with the patient and scanned into the chart: fain Diagram.
HISTORY OF PRESENT ILLNESS 1/15/08 -Initial Consult -Patient is here today with right sided cervical pain
which occasionally radiates into his right shoulder area. He also has occasional headaches with this pain which radiates
up into the back of his head. Patient has had this pain since 2/3/07 after an automobile accident (near head on collison)
He describes this pain as constant, aching, throbbing, tightness and always there is some way. Pain is worse in the
morning, afternoon and evening. Increases Pain: particular head positions and quick jolts Decreases Pain: changing
positions and medications. Pain does not usually wake him up at night. Patient has tried PT which gave only temporary
relief. Has also tried Ibuprofen and is currently taking Naprosyn BID with improvement in symptoms enough so that he
can function and work. Patient has also recently starting having problems with lightheadedness with quick movements.
1/21/08 - Procedure Visit - Patient states that he continues to have pain in the same locations as before. In fact, it is
worse today because he has been working outside in the cold weather. Patient is also having some pain at the base of his
neck today in addition to his right sided neck pain.
11/18/08: Patient here for follow-up. He continues with the pain in the right side of the neck as an aching pain that
radiates up into the right occipital area and the back of the head. It does not radiate down the right arm at all, but he has
no control of the left hand and it tremors quite often. He states that the RF helped, but lasted about 4 months until the
pain started to return. His blood pressure is up today, he thinks because the pain is bad because he did not take naprosyn
and also he was very upset when he left work today.
Pain levels are following treatment.
Best pain (out of 10):2
Worst pain (out of 10):8
Current pain (out of 10):2
PAST MEDICAL HISTORY: MEDICAL: Arthritis, hypertension., concussion in MVA
SURGICAL: Bilateral knee surgery x 2 postwar injury, bone spur removed from right elbow.
Medical history, allergies and current medications were reviewed with the patient
CURRENT ALLERGY LIST:
NO KNOWN ALLERGIES
Is patient taking blood thinning coed?no
PatienllD: AU14644
Page 1 of 4
Hillside Pain Management Rodger Brooks brooks 000324
Hillside Pain Management, P.C.
Terrence M. Calder, M.D.
Patient was seen by: DEBRA DEANGELO DO
Patient Name: RODGER W BROOKS
Date of Birth: 07/06/1952
Date of Service: 11/18/2008
Referred from: LIVIA BAUBLITZ M D
PCP:
CURRENT MEDICATION LIST:
BENICAR ORAL TABLET 20 MG, once daily
NAPROSYN ORAL TABLET 500 MG, BID
CURRENT PROBLEM LIST:
CERVICAL SPONDYLOSIS WITHOUT MYELOPATHY
SPINAL STENOSIS IN CERVICAL REGION
CERVICALGIA
BRACHIAL NEURITIS OR RADICULITIS NOS
Debra A. DeAngelo, D.O.
REVIEW OF SYSTEMS:
Patient denies all symptoms in all systems except as noted. except for RPI.
GENERAL: No major weight gain, loss or fever.
EYES: Has blurred vision.
EARS/NOSE/MOUTH/ THROAT: No hearing changes, hoarseness, or swallowing difficulties.
RESPIRATORY: No shortness of breath, cough. hemoptysis, or wheezing.
CARDIAC: No chest pain, palpitations, tachyarrhythmias, or edema.
GL No abdominal pain, change in bowel habits or heartburn.
GU: No urinary problems noted.
MUSCULOSKELETAL: Has joint stiffness, Has arthritis.
NEUROLOGICAL: See HPI.
SKIN/CHEST WALL: No rashes, sores, blisters, growths, changing moles. discolorations or non-healing
lesions. No abnormalities in chest wall.
PSYCHIATRIC: No recent change in mood or behavior.
ENDOCRINE: No heat or cold intolerance, change in hair distribution, excessive thirst, hunger, or urination,
change in energy level, or significant weight gain or loss.
HEMATOLOGIC/LYMPI-IATIC: No abnormal bruising or bleeding. No swollen, tender, or painful lymph
nodes.
ALLERGIC/IMMUNOLOGIC: No latex allergies or recurrent infections.
VITAL SIGNS:
VS-TEMPERATURE: 97.1 °f Tympanic
VS-PULSE: 71 via VS machine, Regular
VS-BLOOD PRESSURE: 149/100 Right Arm Sitting
VS-RESPIRATION: 18
VS-PULSE OXIMETRY: 97%
Documentation gathered by: Ashley Pohlman.
PatientlD: AU 14644
Page 2 of 4
Hillside Pain Management Rodger Brooks brooks 000325
Hillside Pain Management, P.C.
Terrence M. Calder, M.D.
Patient was seen by: DEBRA DEANGELO DO
Patient Name: RODGER W BROOKS
Date of Birth: 07/06/1952
Date of Service: 11 /18/2008
Referred from: LIVIA BAUBLITZ M D
PCP:
Debra A. DeAngelo, D.O.
Physician HP1 Comments: Patient has had an increase in his neck pain. He had RFA 4months ago with good results, but
it appears that the nerves are regenerating. Patient would like to try a different treatment because he is not anxious to
undergo another RFA.
PHYSICAL EXAM:
GENERAL, APPEARANCE: White male, moderately overweight body habitus. In no acute distress.
MUSCULOSKELETAL EXAM:
HEAD/NECK (POSTERIOR), SHOULDER GIRDLE: No erythema, ecchymosis or edema. Mild
tenderness over the right occipital grove. Head and neck in neutral position. Normal extension without
pain, lateral bending restricted, normal rotation. Normal stability. Normal strength and tone.
SPINE, RIBS, PELVIS: No kyphosis, lordosis, or scoliosis. Full, painless range of motion of the thoracic
and lu nbar spine. Normal stability. Normal strength and tone.
LEFT UPPER EXTREMITY:
INSPECTION: No erythema. No ecchymosis. No edema.
MUSCLE STRENGTH, TONE, ATROPHY: Muscle strength of the major groups is 5/5. Tone of
the major groups is normal. Normal muscle bulk (no atrophy). No fasciculations.
RIGHT UPPER EXTREMITY:
INSPECTION: No erythema. No ecchymosis. No edema.
MUSCLE STRENGTH, TONE, ATROPHY: Muscle strength of the major groups is 5/5. Tone of
the major groups is nonnal. Normal muscle bulk (no atrophy). No fasciculations.
POSTURE: Normal.
GAIT/STATION: Gait intact.
SPECIAL TESTS: Negative Spurling's test on the right.
GENERAL EXAM:
ORIENTATION/MOOD/AFFECT: Oriented to person, place, time and general circumstances. Mood
and affect appropriate.
RESPIRATORY: Normal respiratory effort with symmetrical lung expansion. Lungs clear to
auscultation. No adventitious sounds noted.
CARDIOVASCULAR:
PALPATION & AUSCULTATION: Regular rate and rhythm with no murmurs, gallops, rubs or
abnormal heart sounds.
Assessment:
1. Right cervical pain with 90% improvement with RFA
2. Cervical spondylosis
3. Cervical spinal stenosis
4. Components of cervical radict?lopathy
PatientlD: AU 14644
Page 3 of 4
Hillside Pain Management Rod r Brooks brooks 000326
Hillside Pain Management, P.C.
Terrence M. Calder, M.D.
Patient was seen by: DEBRA DEANGELO DO
Patient Name: RODGER W BROOKS
Date of Birth: 07/06/1952
Date of Service: 11/18/2008
Referred from: LIVIA BAUBLiTZ M D
PCP:
Plan:
1. Consider a series of cervical epidural steroid injections
2. Reconsider a repeat RFA
3. Follow up
Electronically Signed by: apohlman on Tuesday, November 18, 2009
Electronically Signed by Debra A. DeAnelo, D O on Thursday, December 04, 2003
PatientiD: AU14644
Debra A. DeAngelo, D.Q.
Page 4 of 4
Hillside Pain Management
Rodger Brooks
Pain Diagram
Please mark the area of injury or discomfort on the chart below, using the appropriate symbols:
Numbness:----- Burning:' Pins & Needles: oooo Stabbing. 0 0 0 Aclun
Using the pain scale 1-10, please put a number that describes each
Best 3 Worst G Current
Percentage Of Improvement Since Last Visit h
q?4
y
?Gu?e
U?
I?
a
Please use the space below to desmibe yow condition further if needed
Date: { Z 3. o r-Signature:
brooks 000327
04
x1v
Brooks, Rodger W
State Farm
DOB. 0710611952
Rrvised 2/08 Doctor.* Debra A Deangefo DO
AU14"41
Hillside Pain Management Rodger Brooks brooks 000328
York Adams Pain Specialists, P.C.
Terrence M. Calder, M.D. Debra A. DeAngelo, D.O.
Patient was seen by: DEBRA DEANGELO DO
Patient Name: RODGER W BROOKS
Date of Birth: 07/66/1952
Date of Service: 12/03/2008
Referred from: LIVIA BAUBLiTZ M D
PCP:
Referring Doctor: Livia Baublitz M D
Primary Physician: Kurt K. Thomas D O
Other physicians or providers involved with care:
CHIEF COMPLAINT Rodger Brooks is a 56 year old established patient seen in the office today. The patient is
scheduled for Procedure. The patient presents with right sided neck ache, right sided neck burning, right sided neck pain.
HISTORY OF PRESENT ILLNESS 1/15/08 -Initial Consult -Patient is here today with right sided cervical pain
which occasionally radiates into his right shoulder area. He also has occasional headaches with this pain which radiates
up into the back of his head. Patient has had this pain since 2/3/07 after an automobile accident (near head on collison)
He describes this pain as constant, aching, throbbing, tightness and always there is some way. Pain is worse in the
morning, afternoon and evening. Increases Pain: particular head positions and quick jolts Decreases Pain: changing
positions and medications. Pain does not usually wake him up at night. Patient has tried PT which gave only temporary
relief. Has also tried lbuprofen and is currently taking Naprosyn BID with improvement in symptoms enough so that lie
can function and work. Patient has also recently starting having problems with lightheadedness with quick movements.
1/21/08 - Procedure Visit - Patient states that lie continues to have pain in the same locations as before. In fact, it is
worse today because he has been working outside in the cold weather. Patient is also having some pain at the base of his
neck today in addition to his right sided neck pain.
11/I808:Patient here for follow-up. He continues with the pain in the right side of the neck as an aching pain that
radiates up into the right occipital area and the back of the head. It does not radiate down the right arm at all, but he has
no control of the left band and it tremors quite often. He states that the RF helped, but lasted about 4 months until the
pain started to return. His blood pressure is up today, he thinks because the pain is bad because he did not take naprosyn
and also he was very upset when lie left work today.
2/7/08: Patient here for procedure. He continues with the pain in the right cervical area and a headache. The pain
does not radiate down the arm at all. He got good relief with the MNBB, 100% relief for the rest of that night. He
PatientiD: AU14644
Page 1 of 5
Hillside Pain Management Rodger rooks brooks 000329
York Adams Pain Specialists, P.C.
Terrence M. Calder, M.D.
Patient was seen by: DEBRA DEANGELO DO
Patient Name: RODGER W BROOKS
Date of Birth: 07/06/1952
Date of Service: 12/03/2008
Referred from: LIVIA BAUBLITZ M D
PCP:
Debra A. DeAngelo, D.O.
states that it still feels tight. He had bronchitis and the flu since he was here. He was taking Tylenol with codeine
and Naprosyn.
2!11!08 procedure visit;. Patient has returned for radiofrequencyat right G3-5. He will behaving IV sedation with this
procedure and today has arranged for a driver after the procedure.
1213/08: Patient here to start a series of cervical epidurals. Patient states the pain is in the right posterior neck radiating
up the the right posterior head.
Pain levels are for the area(s) treated.
Best pain (out of 10):3
Worst pain (out of 10):6
Current pain (out of 10):4
PAST MEDICAL HISTORY:
MEDICAL..: Arthritis, hypertension., concussion in MVA
SURGICAL: Bilateral knee surgery x 2 post war injury, bone spur removed from right elbow.
Medical history, allergies and current medications were reviewed with the patient
CURRENT ALLERGY LIST:
NO KNOWN ALLERGIES
Is patient taking blood thinning coed? No
CURRENT MEDICATION LIST:
BENICAR ORAL TABLET 20 MG, once daily
NAPROSYN ORAL TABLET 500 MG, BID
FLECTOR EXTERNAL PATCH 1.3 %, Apply patch over painful area BID
PatientlD: AU14644
Page 2 of 5
Hillside Pain Management Rodger Brooks brooks 000330
York Adams Pain Specialists, P.C.
Terrence M. Calder, M.D.
Patient was seen by: DEBRA DEANGELO DO
Patient Name: RODGER W BROOKS
Date of Birth: 07/06/1952
Date of Service: 12/03/2008
Referred from: LIVIA BAUBLITZ M D
PCP:
VITAL SIGNS:
VS-TEMPERATURE: 98.4°f Tympanic
`+-'S-PfJI-S£; 68 vi-a V-S machine, Reguli'.r
VS-BLOOD PRESSURE: 143/94 Right Arm Sitting
VS-RESPIRATION: 16
VS-PULSE OXIMETRY: 96%
Documentation gathered by: Carolyn Leskinen.
Debra A. DeAngelo, D.O.
Physician HPI Comments: Patient with right neck pain radiating into occipital region.
PHYSICAL EXAM:
GENERAL APPEARANCE: White male, moderately overweight body habitus. In no acute distress.
MUSCULOSKELETAL EXAM:
HEAD/NECK (POSTERIOR), SHOULDER GIRDLE: No erythema, ecchymosis or edema. Mild
tenderness over the right occipital grove. head and neck in neutral position. Normal extension without
pain, lateral bending restricted, normal rotation. Normal stability. Normal strength and tone.
SPINE, RIBS, PELVIS: No kyphosis, lordosis, or scoliosis. Full, painless range of motion of the thoracic
and lumbar spine. Normal stability. Normal strength and tone.
LEFT UPPER EXTREMITY:
INSPECTION: No erythema. No ecchymosis. No edema.
MUSCLE STRENGTH, TONE, ATROPHY: Muscle strength of the major groups is 515. Tone of
the major groups is normal. Normal muscle bulk (no atrophy). No fasciculations.
RIGHT UPPER EXTREMITY:
INSPECTION: No erythema. No ecchymosis. No edema.
PatientlD: AU14644
Page 3 of 5
Hillside Pain Management Rodger Brooks brooks 000331
York Adams Pain Specialists, P.C.
Terrence M. Calder, M.D.
Patient was seen by: DEBRA DEANGELO DO
Patient Name: RODGER W BROOKS
Date of Birth: 07/06/1952
Date of Service: 12/03/2008
Referred from: LIVIA BAUBLITZ M D
PCP:
Debra A. DeAngelo, D.O.
MUSCLE STRENGTH, TONE, ATROPHY: Muscle strength of the major groups is 5/5. Tone of
the major groups is normal. Normal muscle bulk (no atrophy). No fasciculations.
_POST._11RF: Normal,
GAIT/STATION: Gait intact.
SPECIAL TESTS: Negative Spurling's test on the right.
GENERAL EXAM:
ORIENTATION/MOOD/AFFECT: Oriented to person, place, time and general circumstances. Mood
and affect appropriate.
RESPIRATORY: Normal respiratory effort with symmetrical lung expansion. Lungs clear to
auscultation. No adventitious sounds noted.
CARDIOVASCULAR:
PALPATION & AUSCULTATION: Regular rate and rhythm with no murmurs, gallops, rubs or
abnormal heart sounds.
ASA Physical status I.
Assessment:
1. Right cervical pain with 90% improvement with RFA
2. Cervical spondylosis
3. Cervical spinal stenosis
4. Components of cervical radicuiopathy
Plan: CESI#I
Procedure: cervical epidural injection C6-7.
Diagnosis: cervical radicuiopathy (723.4).
Post procedure diagnosis: same.
Physician: Dr. Debra DeAngelo.
PalientlD: AU14644
Page 4 of 5
Hillside Pain Management Rodger rooks brooks 000332
York Adams Pain Specialists, P.C.
Terrence M. Calder, M.D.
Debra A. DeAngelo, D.O.
Patient was seen by: DEBRA DEANGELO DO
Patient Name: RODGER W BROOKS
Date of Birth: 07/06/1952
Date of Service: 12/03/2008
Referred from: LIVIA BAUBLITZ M D
PCP:
Anesthesia: Local. After informed consent was obtained, the patient was placed in the prone position. The
posterior neck was sterilely prepped with ChloraPrep and draped. The skin was anesthetized with 1% lidocaine
over the C6-7 interspace. A 22 gauge Tuohy needle was then advanced using loss of resistance to air technique_
under fluoroscopic guidance. No CSF, heme or paresthesias were encountered. Non-ionic contrast was injected
which revealed an epidurogratn. 40mg of triamcinolone acetate with 2ml of normal saline was incrementally
injected. The needle was flushed and removed intact. The patient tolerated the procedure well. They were
observed for at least 20 minutes and discharged in stable condition with no neurological changes.
RETURN VISIT: Patient will return in several weeks to evaluate if further interventional treatment is indicated.
Electronically Signed by: Carolyn Leskinen, RN on Wednesday, December 03, 2008
Electronically Signed by: Debra A. DeAngelo. D O on Thursday, December 04, 2008
Patient[D: AU14644
Page 5 of 5
Hillside Pain Management Rodger Brooks brooks 000333
(Z ?? York Adams Pain Specialists
y l t J(?p`v 250 Fame Avenue, Suite 103, Hanover PA
Phone 637-0943 Fax 633-7829
Pain Diary
S e?
3 y'y
0 1 2 3 4 5 6 7 S 9 10
No worst pain
Pain imaginable
Date Time Pain
# Comments Medications,
Other treatments tried
I
c,
V An
i
12- 9- m I
IZ?B Y Prn ! ?•
I'L--9 owl I
r'
it - If
2'10 Y .4s-N I if
Z 10 < f"n 7- <a0 < 9 w so
ly} on 7 <cs
/-
2 b
z
f-??AA?It ?-
r• ??
zyA ea
2 - /9 7)'? S
1'7 -
Hillside Pain Management Rodger Brooks brooks 000334
York Adams Pain Specialists, P.C.
Terrence M. Calder, M.D.
Debra A. DeAngelo, D.O.
Patient was seen by: DEBRA DEANGELO DO
Patient Name: RODGER W BROOKS
Date of Birth: 07/06/1952
Date of Service: 12/03/2008
Referred from: LIVIA BAUBLITZ M D
PCP:
Referring Doctor: Livia Baublitz M D
Primary Physician: Kurt K. Thotnas D O
Other physicians or providers involved with care:
CHIEF COMPLAINT Rodger Brooks is a 56 year old established patient seen in the office today. The patient is
scheduled for Procedure. The patient presents with right sided neck ache, right sided neck burning, right sided neck pain.
HISTORY OF PRESENT ILLNESS 1/15/08 -Initial Consult -Patient is here today with right sided cervical pain
which occasionally radiates into his right shoulder area. He also has occasional headaches with this pain which radiates
up into the back of his head. Patient has had this pain since 2/3/07 after an automobile accident (near head on collison)
He describes this pain as constant, aching, throbbing, tightness and always there is some way. Pain is worse in the
morning, afternoon and evening. Increases Pain: particular head positions and quick jolts Decreases Pain: changing
positions and medications. Pain does not usually wake him up at night. Patient has tried PT which gave only temporary
relief. Has also tried Ibuprofen and is currently taking Naprosyn BID with improvement in symptoms enough so that lie
can function and work. Patient has also recently starting having problems with lightheadedness with quick movements.
1/21/08 - Procedure Visit - Patient states that lie continues to have pain in the same locations as before. In fact, it is
worse today because he has been working outside in the cold weather. Patient is also having some pain at the base of his
neck today in addition to his right sided neck pain.
11/18/08: Patient here for follow-up. He continues with the pain in the right side of the neck as an aching pain that
radiates up into the right occipital area and the back of the head. It does not radiate down the right artn at all, but he has
no control of the left hand and it tremors quite often. He states that the RF helped, but lasted about 4 months until the
pain started to return. His blood pressure is up today, he thinks because the pain is bad because he did not take naprosyn
and also he was very upset when lie left work today.
2/7/08: Patient here for procedure. He continues with the pain in the right cervical area and a headache. The pain
does not radiate down the arm at all. He got good relief with the MNBB, 100% relief for the rest of that night. He
Patientll): AU14644
Page 1 of 5
Hillside Pain Management Rodger Brooks brooks 000335
Pain Diagram
Please mark the area of injury m discomfort an the chart below, using the appropriate symbols:
Numbness;---- Burning:l Pins & Needles: oooo Stabbing 0 H 0 Aching: =
Using the pain scale 1-10, please pat a number that describes each
Best I Womt .21 Currmit
Peroentage Of Improvement Since Last Visit
CO
0?-
7
t
Please use the space below to desenbe your condition fhther if needed
Date: 1.2 - i 7 - oa Signat = C? _ t J
Brooks, Rodger W
State Farm
Revised 2/08 Doe: 0-fI0611952 eto Do
Doctor: Debra A Deong
AU14"4
X
Hillside Pain Management Rodger Brooks brooks 000336
York Adams Pain Specialists, P.C.
Terrence M. Calder, M.D.
Patient was seen by: DEBRA DEANGELO DO
Patient Name: RODGER W BROOKS
Date of Birth: 07/06/1952
Date of Service: 12/17/2008
Referred from: LIVIA BAUBLITZ M D
PCP:
Referring Doctor: Livia Baublitz M D
Primary Physician: Kurt K. Thomas D O
Otl.er t 1 _; is;.anF - pr?avid?rs involved with care:
Debra A. DeAngelo, D.O.
CHIEF COMPLAINT Rodger Brooks is a 56 year old established patient seen in the office today. Patient is here today
for a scheduled procedure.
The following forms were reviewed with the patient and scanned into the chart: Pain Diagram.
HISTORY OF PRESENT ILLNESS 1/15/08 - Initial Consult - Patient is here today with right sided cervical pain
which occasionally radiates into his right shoulder area. He also has occasional headaches with this pain which radiates
up into the back of his head. Patient has had this pain since 213/07 after an automobile accident (near head on collison)
He describes this pain as constant, aching, throbbing, tightness and always there is some way. Pain is worse in the
morning, afternoon and evening. Increases Pain: particular head positions and quick jolts Decreases Pain: changing
positions and medications. Pain does not usually wake him up at night. Patient has tried PT which gave only temporary
relief. Has also tried Ibuprofen and is currently taking Naprosyn BID with improvement in symptoms enough so that he
can function and work. Patient has also recently starting having problems with lightheadedness with quick movements.
1/21108 - Procedure Visit - Patient states that he continues to have pain in the same locations as before. In fact, it is
worse today because lie has been working outside in the cold weather. Patient is also having some pain at the base of his
neck today in addition to his right sided neck pain.
11/18/08:Patient here for follow-up. He continues with the pain in the right side of the neck as an aching pain that
radiates up into the right occipital area and the back of the head. It does not radiate down the right arm at all, but lie has
no control of the left hand and it tremors quite often. He states that the RF helped, but lasted about 4 months until the
pain started to return. His blood pressure is up today, he thinks because the pain is bad because he did not take naprosyn
and also he was very upset when he left work today.
2/7/08: Patient here for procedure. He continues with the pain in the right cervical area and a headache. The pain
PatienllD: AU14644
Page 1 of 5
Hillside Pain Management Rodger Brooks brooks 000337
York Adams Pain Specialists, P.C.
Terrence M. Calder, M.D.
Patient was seen by: DEBRA DEANGELO DO
Patient Name: RODGER W BROOKS
Date of Birth: 07/06/1952
Date of Service: 12/17/2008
Referred from: LIVIA BAUBLITZ M D
PCP:
Debra A. DeAngelo, D.O.
does not radiate down the arm at all. He got good relief with the MNBB, 100% relief for the rest of that night. He
states that it still feels tight. He had bronchitis and the flu since he was here. He was taking Tylenol with codeine
- and Napposyn.
2111/08 procedure visit: Patient has returned for radiofrequency at right C3-5. He will be having IV sedation with this
procedure and today has arranged for a driver after the procedure.
12/3/08: Patient here to start a series of cervical epidurals. Patient states the pain is in the right posterior neck radiating
tip the the right posterior head.
12/17/08 - Patient states 80% improvement, he has some tightness on the right side of his neck but states he really doesn't
haven't pain, his left hand doesn't shake near as much. He gets a headache every now and then on the right side of neck
but he is satisfied with his relief at this time and will call us in the future if pain returns.
Procedure: Cervical C6-7.
Date of prior procedure: 12/03/2008
Activity has increased.
Percent improvement:80
Pain levels are following treatment.
Best pain (out of 10):1
Worst pain (out of 10):2
Current pain (out of 10):1
PAST MEDICAL HISTORY:
MEDICAL: Arthritis, hypertension., concussion in MVA
SURGICAL: Bilateral knee surgery x 2 postwar injury, bone spur removed from right elbow.
Medical history, allergies and current medications were reviewed with the patient
CURRENT ALLERGY LIST:
Patient]D: AU 14644
Page 2 of 5
Hillside Pain Management Rodger Brooks brooks 000338
York Adams Pain Specialists, P.C.
Terrence M. Calder, M.D.
Patient was seen by: DEBRA DEANGELO DO
Patient Name: RODGER W BROOKS
Date of Birth: 07/06/1952
Date of Service: 12/17/2008
Referred from: LIVIA BAUBLITZ M D
PCP:
NO KNOWN ALLERGIES
Is patient taking blood thinning med?No
CURRENT MEDICATION LIST:
BENICAR ORAL TABLET 20 MG, once daily
NAPROSYN ORAL TABLET 500 MG, BID
FLECTOR EXTERNAL PATCH 1.3 %, Apply patch over painful area BID
REVIEW OF SYSTEMS:
Patient denies all symptoms in all systems except for HPI.
VITAL SIGNS:
VS-TEMPERATURE: 98.1 °f Tympanic
VS-PtJLSE: 58 Apical, Regular
VS-BLOOD PRESSURE: 153/87 Right Arm Sitting
VS-RESPIRATION: 18
VS-PULSE OXIMETRY: 96%
Documentation gathered by: Jody Culp, Lynda Hanchett.
Debra A. DeAngelo, D.O.
Physician HPI Comments: Patient had 80% improvement with CESI#l. He just has a tightness in his right neck.
PHYSICAL EXAM:
GENERAL APPEARANCE: White male, moderately overweight body habitus. In no acute distress.
MUSCULOSKELETAL EXAM:
HEADINECK (POSTERIOR), SHOULDER GIRDLE: No erythema, ecchymosis or edema. Mild
PatientlD: AU14644
Page 3 of 5
Hillside Pain Management Rodger Brooks brooks 000339
York Adams Pain Specialists, P.C.
Terrence M. Calder, M.D.
Debra A. DeAngelo, D.O.
Patient was seen by: DEBRA DEANGELO DO
Patient Name: RODGER W BROOKS
Date of Birth: 07/06/1952
Date of Service: 12/17/2008
Referred from: LIVIA BAUBLITZ M D
PCP:
tenderness over the right occipital grove. Head and neck in neutral position. Normal extension without
pain, lateral bending restricted, normal rotation. Normal stability. Normal strength and tone.
SPINE, RIBS, PELVIS: No kyphosis, lordosis, or scoliosis. Full, painless range of motion of the thoracic
and lumbar spine. Normal stability. Normal strength and tone.
LEFT UPPER EXTREMITY:
INSPECTION: No erythema. No ecchymosis. No edema.
MUSCLE STRENGTH, TONE, ATROPHY: Muscle strength of the major groups is 5/5. Tone of
the major groups is normal. Normal muscle bulk (no atrophy). No fasciculations.
RIGHT UPPER EXTREMITY:
INSPECTION: No erythema. No ecchymosis. No edema.
MUSCLE STRENGTH, TONE, ATROPHY: Muscle strength of the major groups is 5/5. Tone of
the major groups is normal. Normal muscle bulk (no atrophy). No fasciculations.
POSTURE: Normal.
GAIT/STATION: Gait intact.
SPECIAL TESTS: Negative Spurling's test on the right.
GENERAL EXAM:
ORIENTATION/MOOD/AFFECT: Oriented to person, place, time and general circumstances. Mood
and affect appropriate.
RESPIRATORY: Normal respiratory effort with symmetrical lung expansion. Lungs clear to
auscultation. No adventitious sounds noted.
CARDIOVASCULAR:
PALPATION & AUSCULTATION: Regular rate and rhythm with no murmurs, gallops, rubs or
abnormal heart sounds.
ASA Physical status 1.
Assessment:
PatientID: AU 14644
Page 4 of 5
Hillside Pain Management Rodger Brooks brooks 000340
York Adams Pain Specialists, P.C.
Terrence M. Calder, M.D.
Patient was seen by: DEBRA DEANGELO DO
Patient Name: RODGER W BROOKS
Date of Birth: 07/06/1952
Date of Service: 12/17/2008
Referred from: LIVIA BAUBLITZ M D
PCP:
Debra A. DeAngelo, D.O.
1. Right cervical pain with 90% improvement with RFA
2. Cervical spondylosis
3 Cervical spinal stenosis
4. Components of cervical radiculopathy - 90% improved with CESI#I
Plan:
1. Hold off on interventional therapy
2. Patient will call if pain increases
RETURN VISIT: Patient is to return on an as needed basis,
Electronically Signed by: Lynda H:mched, RN on Wednesday, December 17, 2008
Electronically Signed by: Debra A. DeAngelo, D O on Wednesday. December 17, 2008
PatlentlD: AU14644
Page 5 of 5
Hillside Pain Management Rodger Brooks brooks 000341
Pain Diagram
Please mark the area of injury or discomfort on the chart below, using the appropriate symbols:
Numbness:----- Buming:^^^^ Pins & Needles: oooo Stabbing: 0 0 0 Aching: )o=
Using the pain scale 1 A 0, please put a number that describes each
Best Worst_ Current_
Percentage Of Improvement Since Lest Visit
1
Please use the space below to describe your condition further if needed
n-&-.
Brooks, Rodger W
- Signatire:
state Farm
DOB: 07110V1952 DO
Doctor. Debra A Doanpil 'o
AU149"
Hillside Pain Management Rodger Brooks brooks 000342
York Adams Pain Specialists, P.C.
Terrence M. Calder, M.D.
Debra A. DeAngelo, D.O.
Patient was seen by: DEBRA DEANGELO DO
Patient Name: RODGER W BROOKS
Date of Birth: 07/06/1952
Date of Service: 07/01/2009
Referred from: LIVIA BAUBLITZ M D
PCP:
Referring Doctor: Livia Baublitz M D
Primary Physician: Kurt K. Thomas D O
Other physicians or providers involved with care:
CHIEF COMPLAINT Rodger Brooks is a 56 year old established patient seen in the office today. Patient is here today
for returned neck pain.
The following forms were reviewed with the patient and scanned into the chart: Pain Diagram.
HISTORY OF PRESENT ILLNESS 1/15/08 -Initial Consult -Patient is here today with right sided cervical pain
which occasionally radiates into his right shoulder area. He also has occasional headaches with this pain which radiates
up into the back of his head. Patient has had this pain since 2/3/07 after an automobile accident (near head on collison)
He describes this pain as constant, aching, throbbing, tightness and always there is some way. Pain is worse in the
morning, afternoon and evening. Increases Pain: particular head positions and quick jolts Decreases Pain: changing
positions and medications. Pain does not usually wake him up at night. Patient has tried PT which gave only temporary
relief. Has also tried Ibuprofen and is currently taking Naprosyn BID with improvement in symptoms enough so that lie
can function and work. Patient has also recently starting having problems with lightheadedness with quick movements.
1/21/08 - Procedure Visit - Patient states that he continues to have pain in the same locations as before. In fact, it is
worse today because he has been working outside in the cold weather. Patient is also having some pain at the base of his
neck today in addition to his right sided neck pain.
11 1 /08:Patient here for follow-up. He continues with the pain in the right side of the neck as an aching pain that
radiates up into the right occipital area and the back of the head. It does not radiate down the right arm at all, but lie has
no control of the left ]land and it tremors quite often. He states that the Rl: helped, but lasted about 4 months until the
pain started to return. His blood pressure is up today, lie thinks because the pain is bad because he did not take naprosyn
and also he was very upset when he left work today.
2/7108: Patient here for procedure. He continues with the pain in the right cervical area and a headache. The pain
PatientlD_ AU14644
Page] of 6
Hillside Pain Management Rodger Brooks brooks 000343
York Adams Pain Specialists, P.C.
Terrence M. Calder, M.D.
Debra A. DeAngelo, D.O.
Patient was seen by: DEBRA DEANGELO DO
Patient Name: RODGER W BROOKS
Date of Birth: 07/06/1952
Date of Service: 07/01/2009
Referred from: LIVIA BAUBLITZ M D
PCP:
does not radiate down the arm at all. He got good relief with the MNBB, 100% relief for the rest of that night. He
states that it still feels tight. He had bronchitis and the flu since lie was here. He was taking Tylenol with codeine
and Naprosyn.
2/11/08 procedure visit: Patient has returned for radiofreyuency at right C3-5. lie will be having 1V sedation with this
procedure and today has arranged for a driver after the procedure.
12/3/08: Patient here to start a series of cervical epidurals. Patient states the pain is in the right posterior neck radiating
up the the right posterior head.
12/17/08 - Patient states 80% improvement, he has some tightness on the right side of his neck but states lie really doesn't
haven't pain, his left hand doesn't shake near as much. He gets a headache every now and then on the right side of neck
but he is satisfied with his relief at this time and will call us in the future if pain returns.
7/1/09 Patient states that he had been doing well after his last injection until several months ago when he noted a return
of his pain that has gotten progressively worse. It has now gotten to the point that it hampers his mobility with pain up
into his head at times. He also has tremor in his left fingers at times.
Procedure: Cervical C6-7.
Date of prior procedure: 12/03/2008
Pain levels are baseline.
Best pain (out of 10):2
Worst pain (out of 10):8
Current pain (out of 10):4
PAST MEDICAL HISTORY:
MEDICAL: Arthritis, hypertension., concussion in MVA
SURGICAL: Bilateral knee surgery x 2 post war injury, bone spur removed from right elbow.
Medical history, allergies and current medications were reviewed with the patient
PatientlD: AU14644
Page 2 of 6
Hillside Pain Management Roder Brooks brooks 000344
York Adams Pain Specialists, P.C.
Terrence M. Calder, M.D.
Patient was seen by: DEBRA DEANGELO DO
Patient Name: RODGER W BROOKS
Date of Birth: 07/06/1952
Date of Service: 07/01/2009
Referred from: LIVIA BAUBLITZ M D
PCP:
CURRENT ALLERGY LIST:
NO KNOWN ALLERGIES
Is patient taking blood thinning coed?No
Debra A. DeAngelo, D.O.
MEDICATIONS:
FLECTOR EXTERNAL PATCH 1.3 %, Apply patch over painful area BID, 60 Dispensed, status:
DISCONTINUED, 07/01/2009.
CURRENT MEDICATION LIST:
BENICAR ORAL TABLET 20 MG, once daily
NAPROSYN ORAL TABLET 500 MG, BID
KENALOG INJECTION SUSPENSION 40 MG/ML, for procedure
VITAL SIGNS:
VS-TEMPERATURE: 97.8°f Tympanic
VS-PULSE: 53 via VS machine, Regular
VS-BLOOD PRESSURE: 157/101 Left Arm Sitting
VS-RESPIRATION: 18
VS-PULSE OXIMETRY: 96%
Documentation gathered by: Lynda Flanchett.
Physician "PI Comments: Patient was here last approx 7months ago for his last injection and had done well until approx
2 months ago when his pain increased again in his right neck and into his right hand.
PatientlD: AU14644
Page 3 of 6
Hillside Pain Management Ifd er rooks brooks 000345
York Adams Yain Specialists, P.C.
Terrence M. Calder, M.D.
Debra A. DeAngelo, D.O.
Patient was seen by: DEBRA DEANGELO DO
Patient Name: RODGER W BROOKS
Date of Birth: 07/06/1952
Date of Service: 07/01/2009
Referred from: LIVIA BAUBLITZ M D
PCP:
PHYSICAL EXAM:
GENERAL APPEARANCE: White male. moderately overweight body habitus. In no acute distress.
MUSCULOSKELETALEXAM:
READ/NECK (POSTERIOR), SHOULDER GIRDLE: No erythema, ecchymosis or edema. Mild
tenderness over the right occipital grove. Head and neck in neutral position. Normal extension without
pain, lateral bending restricted, normal rotation. Normal stability. Normal strength and tone.
SPINE, RIBS, PELVIS: No kyphosis, lordosis, or scoliosis. F1.111, painless range of motion of the thoracic
and lumbar spine. Normal stability. Normal strength and tone.
LEFT UPPER EXTREMITY:
INSPECTION: No erythema. No ecchymosis. No edema.
MUSCLE STRENGTH, TONE, ATROPHY: Muscle strength of the major groups is 5/5. Tone of
the major groups is normal. Normal muscle bulk (no atrophy). No fasciculations.
RIGHT UPPER EXTREMITY:
INSPECTION: No erythema. No ecchymosis. No edema.
MUSCLE STRENGTH, TONE, ATROPHY: Muscle strength of the major groups is 5/5. Tone of
the major groups is normal. Normal muscle bulk (no atrophy). No fasciculations.
POSTURE: Normal.
GAIT/STATION: Gait intact.
SPECIAL TESTS: Negative Spurling's test on the right.
GENERAL EXAM:
ORIENTATION/.MOOD/AFFECT: Oriented to person, place, time and general circumstances. Mood
and affect appropriate.
RESPIRATORY: Normal respiratory effort with symmetrical lung expansion. Lungs clear to
auscultation. No adventitious sounds noted.
PalientlD: AU14644
Page 4 of 6
Hillside Pain Management Rodger Brooks brooks 000346
York Adams Pain Specialists, P.C.
Terrence M. Calder, M.D.
Debra A. DeAngelo, D.O.
Patient was seen by: DEBRA DEANGELO DO
Patient Name: RODGER W BROOKS
Date of Birth: 07/06/1952
Date of Service: 07/01/2009
Referred from: LIVIA BAUBLITZ M D
PCP:
CARDIOVASCULAR:
PALPATION & AUSCULTATION: Regular rate and rhythm with no murmurs, gallops, rubs or
abnnrmal heart sounds.
ASA Phvsical status 1.
Assessment:
1. Right cervical pain with 90% improvement with RFA
2. Cervical spondylosis
3. Cervical spinal stenosis
4. Components of cervical radiculopathy - 100% improved with CESI#2 for 5months
Plan: CESI#1
Procedure: cervical epidural injection C6-7.
The patient was identified, along with the procedure, by the physician along with the patient, and the operating
room staff (i.e. a "time out" was taken prior to the procedure).
Diagnosis: cervical radiculopathy (723.4).
Post procedure diagnosis: same.
Physician: Dr. Debra DeAngelo.
Anesthesia: Local. After informed consent was obtained, the patient was placed in the prone position. The
posterior neck was sterilely prepped with ChloraPrep and draped. The skin was anesthetized with 1% lidocaine
over the C6-7 interspace. A 22 gauge Tuohy needle was then advanced using loss of resistance to air technique
under fluoroscopic guidance. No CSF, heme or paresthesias were encountered. Non-ionic contrast was injected
which revealed an epidurogram. 40mg of triamcinolone acetate with 2ml of normal saline was incrementally
injected. The needle was flushed and removed intact. The patient tolerated the procedure well. They were
observed for at least 20 minutes and discharged in stable condition with no neurological changes.
PatientID: AU14644
Page 5 of 6
Hillside Pain Management Rodger Brooks brooks 000347
York Adams Pain Specialists, P.C.
Terrence M. Calder, M.D.
Debra A. DeAngelo, D.O.
Patient was seen by: DEBRA DEANGELO DO
Patient Name: RODGER W BROOKS
Date of Birth: 07/06/1952
Date of Service: 07/01/2009
Referred from: LIVIA BAUBLITZ M D
PCP:
RETURN VISIT: Patient will return in several weeks to evaluate if further interventional treatment is indicated.
Electronically Signed by: Lynda Hanchett, RN on Wednesday, July 01, 2009 336 pm
Electronically Signed by: Debra A. DeAngelo, D 0 on'Nednesday, July 01, 2009 13.49=pm
Pitient[D: AU14644
Page 6 of 6
Hillside Pain Management Rodger Brooks
Pain Diagram
Please mark the area of injury or discomfort on the Lhert below, using the appropriate symbols:
Numbness;---- Burning:^^^^ Pins & Needles: oooo Stabbing: 0 0 0 Aching: toaot
Using the pains scale I -10, please put a number that describes each
Best I J Worst _Current
Percentage Of Improvement Since Last Visit -. ?--
Please use the space below to describe your condition further if needed
Date:' Signature: qAv
Brooks, Rodger W
brooks 000348
?r
r
State Farm
DOB: orMO 1952
Doctor: Debra A Deangelo DO
AU1 4Be1
Hillside Pain Management F?qdaer Brooks brooks 000349
York Adams rain Specialists, P.C.
Terrence M. Calder, M.D.
Debra A. DeAngelo, D.O.
Patient was seen by: DEBRA DEANGELO DO
Patient Name: RODGER W BROOKS
Date of Birth: 07/06/1952
Date of Service: 07/21/2009
Referred from: LIVIA BAUBLITZ M D
PCP:
Referring Doctor: Livia Baublitz M D
Primary Physician: Kurt K. Thomas D O
Other physicians or providers involved with care:
CHIEF COMPLAINT Rodger Brooks is a 56 year old established patient seen in the office today. Patient is here today
for residual neck pain.
HISTORY OF PRESENT ILLNESS 1/1.5/08 -Initial Consult - Patient is here today with right sided cervical pain
which occasionally radiates into his right shoulder area. He also has occasional headaches with this pain which radiates
up into the back of his head. Patient has had this pain since 213/07 after an automobile accident (near head on collison)
He describes this pain as constant, aching, throbbing, tightness and always there is some way. Pain is worse in the
morning, afternoon and evening. Increases Pain: particular head positions and quick jolts Decreases Pain: changing
positions and medications. Pain does not usually wake him up at night. Patient has tried PT which gave only temporary
relief. Has also tried Ibuprofen and is currently taking Naprosyn BID with improvement in symptoms enough so that he
can function and work. Patient has also recently starting having problems with lightheadedness with quick movements.
1/21/08 - Procedure Visit - Patient states that he continues to have pain in the same locations as before. In fact, it is
worse today because he has been working outside in the cold weather. Patient is also having some pain at the base of his
neck today in addition to his right sided neck pain.
11/18/08:Patient here for follow-up. Fie continues with the pain in the right side of the neck as an aching pain that
radiates up into the right occipital area and the back of the head. It does not radiate down the right arm at all, but he has
no control of the left hand and it tremors quite often. He states that the RF helped, but lasted about 4 months until the
pain started to return. His blood pressure is up today, he thinks because the pain is bad because he did not take naprosyn
and also he was very upset when he left work today.
2/7/08: Patient here for procedure. He continues with the pain in the right cervical area and a headache. The pain
does not radiate down the arm at all. He got good relief with the MNBB, 100% relief for the rest of that night. He
Patlen[ID: AU14644
Page I of 6
Hillside Pain Management Rodger rooks brooks 000350
York Adams Pam pecialists, P.C.
Terrence M. Calder, M.D.
Debra A. DeAngelo, D.O.
Patient was seen by: DEBRA DEANGELO DO
Patient Name: RODGER W BROOKS
Date of Birth: 07/06/1952
Date of Service: 07/21/2009
Referred from: LIVIA BAUBLITZ M D
PCP:
states that it still feels tight. He had bronchitis and the flu since he was here. lie was taking Tylenol with codeine
and Naprosyn.
2/11/08 procedure visit: Patient has returned for radiofrequency at right C3-5. He will be having IV sedation with this
procedure and today has arranged for a driver after the procedure.
12/3/08: Patient here to start a series of cervical epidurals. Patient states the pain is in the right posterior neck radiating
up the the right posterior head.
12/17/08 - Patient states 80% improvement, he has some tightness on the right side of his neck but states he really doesn't
haven't pain, his left hand doesn't shake near as much. He gets a headache every now and then on the right side of neck
but he is satisfied with his relief at this time and will call us in the future if pain returns.
7/1/09 Patient states that he had been doing well after his last injection until several months ago when he noted a
return of his pain that has gotten progressively worse. It has now gotten to the point that it hampers his mobility
with pain up into his head at times. He also has tremor in his left fingers at times.
7/21/09 States the last injection did help. Having pain posterior neck, describes pain as "tightness". Takes
Naprosyn which helps with the pain. Also states lie cracks his neck which helps. Overall feeling much better.
Procedure: Cervical C6-7.
Date of prior procedLire: 07/01/2009
Activity has increased.
Percent improve?nent:60
Pain levels are following treatment.
Best pain (out of 10):1.5
Worst pain (out of 10):3.5
Current pain (out of 10):.5
PAST MEDICAL HISTORY:
PatientlD: AU14644
Page 2 of 6
Hillside Pain Management Rodger Brooks brooks 000351
York Adams Pam Specialists, P.C.
Terrence M. Calder, M.D.
Debra A. DeAngelo, D.O.
Patient was seen by: DEBRA DEANGELO DO
Patient Name: RODGER W BROOKS
Date of Birth: 07/06/1952
Date of Service: 07/21/2009
Referred from: LIVIA BAUBLITZ M D
PCP:
MEDICAL: Arthritis, hypertension., concussion in MVA
SURGICAL: Bilateral knee surgery x 2 post war injury, bone spur removed from right elbow.
Medical history, allergies and current medications were reviewed with the patient
CURRENT ALLERGY LIST:
NO KNOWN ALLERGIES
Is patient taking blood thinning tned?no
CURRENT MEDICATION LIST:
BENICAR ORAL TABLET 20 MG, once daily
NAPROSYN ORAL TABLET 500 MG, BID
KENALOG INJECTION SUSPENSION 40 MG/ML, for procedure
EPIDURAL TRAY COMBINATION KIT(MULTIPLE COMPONENT, for injection
REVIEW OF SYSTEMS:
GENERAL: No major weight gain, loss or fever.
EYES: No loss or change in vision.Reading Glasses
EARS/NOSE/MOUTH/ THROAT: No hearing changes, hoarseness, or swallowing difficulties,
RESPIRATORY: No shortness of breath, cough, hemoptysis, or wheezing.
CARDIAC: No chest pain, palpitations, tachyarrhythmias, or edema.
GI: No abdominal pain, change in bowel habits or heartburn,
GU: No urinary problems noted.
MUSCULOSKE,LETAL: Has neck pain.
NEUROLOGICAL: See HI'I.
SKIN/CHEST WALL: No rashes, sores, blisters, growths, changing moles, discolorations or non-healing
PatientlD: AU14644
Page 3 of 6
Hillside Pain Management Rodger Brooks brooks 000352
York Adams Pain Specialists, P.C.
'Terrence M. Calder, M.D.
Debra A. DeAngelo, D.O.
Patient was seen by: DEBRA DEANGELO DO
Patient Name: RODGER W BROOKS
Date of Birth: 07/06/1952
Date of Service: 07/21/2009
Referred from: LIVIA BAUBLITZ M D
PCP:
lesions. No abnormalities in chest wall.
PSYCHIATRIC: No recent change in mood or behavior.
ENDOCRINE: No heat or cold intolerance, change in hair distribution, excessive thirst, hunger, or urination,
change in energy level, or significant weight gain ur iuss.
HEMATOLOGIC/LYMPHATIC: No abnormal bruising or bleeding. No swollen, tender, or painful lymph
nodes.
ALLERGIC/IMMUNOLOGIC: No latex allergies or recurrent infections.
VITAL SIGNS:
VS-TEMPERATURE: 97°f Tympanic
VS-PULSE: 62 via VS machine, Regular
VS-BLOOD PRESSURE: 127/86 Right Arm Sitting
VS-RESPIRATION: 16
VS-PULSE OXIMETRY: 100%
Documentation gathered by: Sue Reh.
Physician HPI Comments: Patient feeling 60% improved with CESI#1. He is currently pleased with his pain relief.
PHYSICAL EXAM:
GENERAL APPEARANCE: White male, moderately overweight body habitus. In no acute distress.
MUSCULOSKELETAL EXAM:
HEAD/NECK (POSTERIOR), SHOULDER GIRDLE: No erythema, ecchymosis or edema. Mild
tenderness over the right occipital grove. Head and neck in neutral position. Normal extension without
pain, normal lateral bending without pain, normal rotation. Normal stability. Normal strength and tone.
SPINE, RIBS, PELVIS: No kyphosis, lordosis, or scoliosis. Full, painless range of motion of the thoracic
PatientlD: AU14644
Page 4 of 6
Hillside Pain Management Rodger Brooks
York Adams Pain Specialists, P.C.
Terrence M. Calder, M.D.
Patient was seen by: DEBRA DEANGELO DO
Patient Name: RODGER W BROOKS
Date of Birth: 07/06/1952
Date of Service: 07/21/2009
Referred from: LIVIA BAUBLITZ M D
PCP:
and lumbar spine. Normal stability. Normal strength and tone.
LEFT UPPER EXTREMITY:
brooks 000353
Debra A. DeAngelo, D.O.
INSPECTION: No erythema. No ecchymosis. No edema.
vlUSCLE STRENGT14, "ONL, A i'KOPHY: Muscle strength of the major groups is S/S-. Toile of
the major groups is normal. Normal muscle bulk (no atrophy). No fasciculations.
RIGHT UPPER EXTREMITY:
INSPECTION: No erythema. No ecchymosis. No edema.
MUSCLE STRENGTH, TONE, ATROPHY: Muscle strength of the major groups is 515. Tone of
the major groups is normal. Normal muscle bull( (no atrophy). No fasciculations.
POSTURE: Normal.
GAIT/STATION: Gait intact.
SPECIAL TESTS: Negative Spurling's test on the right.
GENERAL EXAM:
ORIENTATION/MOOD/AFFECT: Oriented to person, place, time and general circumstances. Mood
and affect appropriate.
RESPIRATORY: Normal respiratory effort with symmetrical lung expansion. Lungs clear to
auscultation. No adventitious sounds noted.
CARDIOVASCULAR:
PALPATION & AUSCULTATION: Regular rate and rhythm with no murmurs, gallops, rubs or
abnormal heart sounds.
Assessment:
1. Right cervical pain with 90% improvement with RFA
2. Cervical spondylosis
3. Cervical spinal stenosis
4. Components of cervical radiculopathy - 60% improved with CESI41
PatientlD: AU14644
Page 5 of 6
Hillside Pain Management Rodger Brooks brooks 000354
York Adams Pain Specialists, P.C.
Terrence M. Calder, M.D.
Patient was seen by: DEBRA DEANGELO DO
Patient Name: RODGER W BROOKS
Date of Birth: 07/06/1952
Date of Service: 07/21/2009
Referred from: LIVIA BAUBLITZ M D
PCP:
Debra A. DeAngelo, D.O.
Plan:
1. No further intervention required at this time
2. Patient will call when his pain increases and he would like to proceed with further treatment
RETURN VISIT: Patient is to return on an as needed basis.
Electronically Signed by: Sue Reh, LPN on Tuesday, .luly 21, 2009 3:27 pm
Electronically Signed by: Debra A. DeAngelo, D O on Monday, August 24, 2009 7:50 am
PatientID: AU14644
Pagc 6 of 6
Hillside Pain Management Rodger Brooks brooks 000355
York Adams Pain Specialists, P.C.
Terrence M. Calder, M.D. Debra A. DeAngelo, D.O.
Patient was seen by: DEBRA DEANGELO DO
Patient Name: RODGER W BROOKS
Date of Birth: 07/06/1952
Date of Service: 07/21/2009
Referred from: LIVIA BAUBLITZ M D
PCP:
Referring Doctor: Livia Baublitz M D
Primary Physician: Kurt K. Thomas D O
Other physicians or providers involved with care:
CHIEF COMPLAINT Rodger Brooks is a 56 year old established patient seen in the office today. Patient is here today
for residual neck pain.
HISTORY OF PRESENT ILLNESS 1/15/08 - Initial Consult - Patient is here today with right sided cervical pain
which occasionally radiates into his right shoulder area. He also has occasional headaches with this pain which radiates
tip into the back of his head. Patient has had this pain since 2/3/07 after an automobile accident (near head on collison)
Ile describes this pain as constant, aching, throbbing, tightness and always there is some way. Pain is worse in the
morning, afternoon and evening. Increases Pain: particular head positions and quick jolts Decreases Pain: changing
positions and medications. Pain does not usually wake him up at night. Patient has tried PT which gave only temporary
relief. Has also tried Ibuprofen and is currently taking Naprosyn BID with improvement in symptoms enough so that Ile
can function and work. Patient has also recently starting having problems with lightheadedness with quick movements.
1/21/08 - Procedure Visit - Patient states that he continues to have pain in the same locations as before. In fact, it is
worse today because he has been working outside in the cold weather. Patient is also having some pain at the base of his
neck today in addition to his right sided neck pain.
11/18/08: Patient here for follow-up. He continues with the pain in the right side of the neck as an aching pain that
radiates up into the right occipital area and the back of the head. It does not radiate down the right arm at all, but he has
no control of the left hand and it tremors quite often. He states that the RF helped, but lasted about 4 months until the
pain started to return. His blood pressure is up today, he thinks because the pain is bad because he did not take naprosyn
and also lie was very upset when he left work today.
2/7/08: Patient here for procedure. He continues with the pain in the right cervical area and a headache. The pain
does not radiate down the arm at all. He got good relief with the MNBB, 100% relief for the rest of that night. He
PatientlD: AU14644
Page i of 6
Hillside Pain Management Rodger Brooks brooks 000356
York Adams Pain Specialists, P.C.
Terrence M. Calder, M.D.
Debra A. DeAngelo, D.O.
Patient was seen by: DEBRA DEANGELO DO
Patient Name: RODGER W BROOKS
Date of Birth: 07/06/1952
Date of Service: 07/21/2009
Referred from: LIVIA BAUBLITZ M D
PCP:
states that it still feels tight. He had bronchitis and the flu since he was here. He was taking Tylenol with codeine
and Naprosyn.
2/11/08 procedure visit: Patient has returned for radiofrequency at right C3-5. He will be having IV sedation with this
procedure and today has arranged for a driver after the procedure.
12/3/08: Patient here to start a series of cervical epidurals. Patient states the pain is in the right posterior neck radiating
up the the right posterior head.
12/17/08 - Patient states 80% improvement, lie has some tightness on the right side of his neck but states he really doesn't
haven't pain, his left hand doesn't shake near as much. Fie gets a headache every now and then on the right side of neck
but he is satisfied with his relief at this time and will call us in the future if pain returns.
7/1/09 Patient states that he had been doing well after his last injection until several months ago when lie noted a
return of his pain that has gotten progressively worse. It has now gotten to the point that it hampers his mobility
with pain up into his head at times. Fie also has tremor in his left fingers at times.
7/21/09 States the last injection did help. Having pain posterior neck, describes pain as "tightness". Takes
Naprosyn which helps with the pain. Also states he cracks his neck which helps. Overall feeling much better.
Procedure: Cervical C6-7.
Date of prior procedure:07/01 /2009
Activity has increased.
Percent improvement:60
Pain levels are following treatment.
Best pain (out of 10):1.5
Worst pain (out of 10):3.5
Current pain (out of 10):.5
PAST MEDICAL HISTORY:
PatientlD: AU 14644
Page 2 of 6
Hillside Pain Management goclger rooky brooks 000357
York Adams rann 4ecialists, P.C.
Terrence M. Calder, M.D. Debra A. DeAngelo, D.O.
Patient was seen by: DEBRA DEANGELO DO
Patient Name: RODGER W BROOKS
Date of Birth: 07/06/1952
Date of Service: 07/21/2009
Referred from: LIVIA BAUBLITZ M D
PCP:
MEDICAL: Arthritis, hypertension., concussion in MVA
SURGICAL: Bilateral knee surgery x 2 post war injury, bone spur removed from right elbow.
Medical history. allergies and current medications were reviewed with the patient
CURRENT ALLERGY LIST:
NO KNOWN ALLERGIES
Is patient taking blood thinning med?no
CURRENT MEDICATION LIST:
BENICAR ORAL TABLET 20 MG, once daily
NAPROSYN ORAL TABLET 500 MG, BID
KENALOG INJECTION SUSPENSION 40 MG/ML, for procedure
EPIDURAL TRAY COMBINATION KIT(MULTIPLE COMPONENT. for injection
REVIEW OF SYSTEMS:
GENERAL: No major weight gain, loss or fever.
EYES: No loss or change in vision.Reading Glasses
EARS/NOSE/MOUTH/ THROAT: No hearing changes, hoarseness, or swallowing difficulties.
RESPIRATORY: No shortness of breath, cough, hemoptysis, or wheezing.
CARDIAC: No chest pain, palpitations, tachyarrhythmias, or edema.
GI: No abdominal pain, change in bowel habits or heartburn.
GU: No urinary problems noted.
MUSCULOSKELETAL: Has neck pain.
NEUROLOGICAL: See HPI.
SKIN/CHEST WALL: No rashes, sores, blisters, growths, changing moles, discolorations or non-healing
Patien?ID: AU14644
Page 3 of 6
Hillside Pain Management Rodger Brooks brooks 000358
York Adams Pain Specialists, P.C.
Terrence M. Calder, M.D.
Debra A. DeAngelo, D.O.
Patient was seen by: DEBRA DEANGELO DO
Patient Name: RODGER W BROOKS
Date of Birth: 07/06/1952
Date of Service: 07/21/2009
Referred from: LIVIA BAUBLITZ M D
PCP:
lesions. No abnormalities in chest wall,
PSYCHiATR1C: No recent change in mood or behavior.
ENDOCRINE: No heat or cold intolerance, change in hair distribution, excessive thirst, hunger, or urination.
change in energy level, car significant ?veight_ gai=t or to s.
HEMATOLOGIC/LYMPHATIC: No abnormal bruising or bleeding. No swollen, tender, or painful lymph
nodes.
ALLERGIC/IMMUNOLOGIC: No latex allergies or recurrent infections.
VITAL SIGNS:
VS-TEMPERATURE: 97°f Tympanic
VS-PULSE: 62 via VS machine, Regular
VS-BLOOD PRESSURE: 127/86 Right Ann Sitting
VS-RESPIRATION: 16
VS-PULSE OXIMETRY: 100%
Documentation gathered by: Sue Reh.
Physician HPl Comments: Patient feeling 60% improved with CESI41. He is currently pleased with his pain relief.
PHYSICAL EXAM:
GENERAL APPEARANCE: White male, moderately overweight body habitus. In no acute distress.
MUSCULOSKELETAL EXAM:
HEAD/NECK (POSTERIOR), SHOULDER GIRDLE: No erythema. ecchymosis or edema. Mild
tenderness over the right occipital grove. Head and neck in neutral position. Normal extension without
pain, normal lateral bending without pain, normal rotation. Normal stability. Normal strength and tone.
SPINF,, RIBS, PELVIS: No kyphosis, lordosis, or scoliosis. Full, painless range of motion of the thoracic
PatientlD: AU14644
Page 4 of 6
Hillside Pain Management octger rookg brooks 000359
York Adams ?A specialists, P.C.
Terrence M. Calder, M.D.
Patient was seen by: DEBRA DEANGELO DO
Patient Name: RODGER W BROOKS
Date of Birth: 07/06/1952
Date of Service: 07/2112009
Referred from: LIVIA BAUBLITZ M D
PCP:
Debra A. DeAngelo, D.O.
and lumbar spine. Normal stability. Normal strength and tone.
LEFT UPPER EXTREMITY:
INSPECTION: No erythema. No ecchymosis. No edema.
Mi "j CLE STRENGTH, TONE, ATROPHY: Muscly: strength of the major groups is 5t5.` runt bf
the major groups is normal. Normal muscle bulk (no atrophy). No fasciculations.
RIGHT UPPER EXTREMITY:
INSPECTION: No erythema. No ecchymosis. No edema.
MUSCLE STRENGTH, TONE, ATROPHY: Muscle strength of the major groups is 5/5. Tone of
the major groups is normal. Normal muscle bulk (no atrophy). No fasciculations.
POSTURE: Normal.
GAIT/STATION: Gait intact.
SPECIAL TESTS: Negative Spurling's test on the right.
GENERAL EXAM:
ORIENTATION/MOOD/AFFECT: Oriented to person, place, time and general circumstances. Mood
and affect appropriate.
RESPIRATORY: Normal respiratory effort with symmetrical lung expansion. Lungs clear to
auscultation. No adventitious sounds noted.
CARDIOVASCULAR:
PALPATION & AUSCULTATION: Regular rate and rhythm with no murmurs. gallops, rubs or
abnormal heart sounds.
Assessment:
1. Right cervical pain with 90% improvement with RFA
2. Cervical spondylosis
3. Cervical spinal stenosis
4. Components of cervical radiculopathy - 60% improved with CESI# I
PatientlD: AU14644
Page 5 of 6
Hillside Pain Mana ement der ooks, brooks 000360
9 York Adams air pecialists, P.C.
Terrence M. Calder, M.D.
Patient was seen by: DEBRA DEANGELO DO
Patient Name: RODGER W BROOKS
Date of Birth: 07/06/1952
Date of Service: 07/21/2009
Referred from: LIVIA BAUBLITZ M D
PCP:
Debra A. DeAngelo, D.O.
Plan:
1. No further intervention required at this time
2. Patient will call when his pain increases and he would like to proceed with further treatment
RETURN VISIT: Patient is to return on an as needed basis.
Electronically Signed by: Sue Reh; LPN on Tuesday, July 21, 2009 3:27 pm
Electronically Signed by: Debra A. DeAngelo, D O on Monday, August 24, 2009 7:50 am
PatientlD: AU 14644
Page 6 of 6
EXHIBIT E
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IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
Rodger Brooks and
Victoria Brooks,
Plaintiffs, No: 09-536 Civil Term
Civil Action Law
- vs - Jury Trial Demanded
Eric Sheaffer,
Defendant.
DEPOSITION OF: DEBRA A. DEANGELO, D.O.
TAKEN BY: Plaintiffs
BEFORE: Kimberly M. Alameda, Court
Reporter and Notary Public
DATE: February 18, 2013, 12:07 p.m.
PLACE: 250 Fame Avenue, Suite 115
Hanover, Pennsylvania
APPEARANCES:
DOUGLAS LAW OFFICE
BY: WILLIAM P. DOUGLAS, ESQUIRE
FOR - PLAINTIFFS
GRIFFITH, STRICKLER, LERMAN, SOLYMOS & CALKINS
BY: JOHN C. PORTER, ESQUIRE
FOR - DEFENDANT
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INDEX TO TESTIMONY
WITNESS DIRECT CROSS REDIRECT RECROSS
Debra A. DeAngelo 10 35 50 50
D.O.
INDEX TO EXHIBITS
NO. DESCRIPTION PAGE
1 Curriculum Vitae for 12
Dr. DeAngelo
INDEX TO OBJECTIONS
PAGE NO. LINE NO.(S)
3 1
13 18
20 5
25 11
33 11
34 5
34 25
35 15
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c
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Q And you've never looked at any
medical records of Mr. Brooks that predate
September 2007; isn't that true?
A That's true.
Q And you've never looked at any
doctors' reports for Mr. Brooks that predate
September 2007; isn't that correct?
A Yes.
Q No doctors' opinions?
A No.
Q No nurses' notes?
A No.
Q No doctors' diagnoses?
A No.
Q In order to determine the causation
of a patient's injury, isn't it important for you
to know about the medical history of that
patient?
A Yes. And we rely upon the patient
to provide that medical history.
Q And let's talk about what the
patient provides. When you say you rely on the
patient to provide that, does that mean that the
patient tells you what the medical history is?
A Yes.
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Q Okay. And let's get into our
definitions then, if we can.
A Sure.
Q What I'd like to do is I'd like to
arrive upon an agreement as to the terms
objective and subjective. Do you think we can do
that?
A Yes.
Q So I think of objective as an
objective fact or an objective statement that is
perceptible to persons other than the reporting
individual.
A Okay.
Q Would you agree with that?
A Yes.
Q So objective, everyone can look at
and see the same thing; is that accurate?
A Yes.
Q Subjective, however, is an
individual's perception or their reporting of
their own state of being, and that's not
observable by a doctor; is that correct?
A That's correct.
Q So when Mr. Brooks comes in, and he
gives you his medical history, that would be a
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subjective history; is that correct?
A That's correct.
Q If you had available to you medical
records that predated September 2007, those would
be more of an objective history; is that correct?
A That is correct.
Q Specifically, MRIs of the cervical
spine would be objective medical history if they
predated September,2007?
A Yes.
Q Now, I'd like to talk about some
other definitions. In January 21, 2008, your
report, I believe, you list as assessments. Now,
are your assessments the same as diagnoses?
A Yes.
Q Okay. So you list as assessments
cervical spondylosis.
A Yes.
Q Did I pronounce that correctly?
A Yes.
Q And cervical spinal stenosis.
A Yes.
Q Let's talk about cervical
spondylosis. I understand cervical spondylosis
is age-related wear and tear that affects the
Rodger Brooks and Victoria Brooks In the Court of Common Pleas of
Cumberland County, Pennsylvania
Plaintiffs
vs
No. 09—536 Civil Term
Eric Sheaffer
Defendant Civil Action Law
Praecipe to Discontinue
Praecipe to Mark Satisfied and Discontinued
Dear Mr.Buell:
Please mark the above captioned matter satisfied and discontinued.
William P. Dougla
May 7, 2013 Attorney for Plain ti s
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