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HomeMy WebLinkAbout09-1600%. ANGINO & ROVNER, P.C. Joseph M. Melillo Attorney ID# : 26211 4503 North Front Street Harrisburg, PA 17110-1708 (717) 238-6791 FAX (717) 238-5610 Attorneys for Plaintiff(s) E-mail: jmelillo@angino-rovner.com DENISE L. KUM PERSONAL REPRESENTATIVE OF THE ESTATE OF MARY MARCONI, Plaintiff IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PA NO. l1 !/ - lkeO jam' o v. CIVIL ACTION - LAW MEDICAL MALPRACTICE HOLY SPIRIT HEALTH SYSTEM d/b/a HOLY SPIRIT HOSPITAL; MARK A. JURY TRIAL DEMANDED OSEVALA, D.O.; and TIMOTHY A. CLARK, M.D., Defendant PRAECIPE FOR WRIT OF SUMMONS TO THE PROTHONOTARY OF SAID COURT: Please issue writ of summons in the above-captioned action on the below-listed three Defendants: Holy Spirit Health System d/b/a Holy Spirit Hospital 503 North 21 St Street Camp Hill, PA 17011 Mark A. Osevala, D.O. 305 North 27 h Street Camp Hill, PA 17011 406241 OoGINP? JA / "1(91A0 p ii - 5 Ut 1 "S' Timothy A. Clark, M.D. 9 Sand Pine Court Mechanicsburg PA 17050 Writ of Summons shall be issued and forwarded to () Attorney (X) Sheriff 9W - Joseph M. Melillo Esquire Angino & Rovner, P.C. gnature of Attorney 4503 North Front Street Harrisburg, PA 17110 I.D. No. 26211 717-238-6791 Dated: 3-13-09 WRIT OF SUMMONS TO THE ABOVE NAMED DEFENDANT: YOU ARE NOTIFIED THAT THE ABOVE-NAMED PLAINTIFF HAS COMMENCED AN ACTION AGAINST YOU. Prothonot Date: by Deputy ( ) Check here if reverse is issued for additional information 406241 P-13 ,lam _ .) THOMAS, THOMAS & HAFER, LLP Evan Black, Esquire Attorney I.D. 17884 Richard S. Wade, Esquire Attorney I.D. 209843 305 North Front Street P.O. Box 999 Harrisburg, PA 17108 (717) 441-7051 Attorneys for Defendant Timothy A. Clark, M.D. DENISE L. KURR, PERSONAL REPRESENTATIVE OF THE ESTATE OF MARY MARCONI, Plaintiff vs. HOLY SPIRIT HEALTH SYSTEM d/b/a HOLY SPIRIT HOSPITAL; MARK A. OSEVALA, D.O.; AND TIMOTHY A. CLARK, M.D., Defendants IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA DOCKET NO. 09-1600 CIVIL ACTION - LAW MEDICAL MALPRACTICE JURY TRIAL DEMANDED ENTRY OF APPEARANCE Please enter the appearance of Evan Black, Esquire, Richard S. Wade, Esquire and the law firm of Thomas, Thomas & Hafer, LLP on behalf of the Defendant Timothy A. Clark, M.D. only, with respect to the above-captioned matter. Respectfully submitted, & HAFER, LLP Date: a// -7 b f By: Evhff Black, Esquire Afforney I.D. No. 17884 Richard S. Wade, Esquire Attorney I.D. No. 209843 305 North Front Street P.O. Box 999 Harrisburg, PA 17108 CERTIFICATE OF SERVICE I, Joan L. Wolfe, an employee of the law offices of Thomas, Thomas & Hafer, LLP, do hereby certify that I served a copy of the foregoing document by depositing the same in the United States mail, first class, postage prepaid, as follows: Joseph M. Melillo, Esquire Angino & Rovner, P.C. 4503 North Front Street Harrisburg, PA 17110-1708 Holy Spirit Health System d/b/a Holy Spirit Hospital 503 North 21 st Street Camp Hill, PA 17011 Mark A. Osevala, D.O. 305 North 27th Street Camp Hill, PA 17011 Date: Jo . Wolfe, Legal Secretary ? N ca f t'. :;o [!?:< co 13 C) -C _a THOMAS, THOMAS & HAFER, LLP Evan Black, Esquire Attorney I.D. 17884 Richard S. Wade, Esquire Attorney I.D. 209843 305 North Front Street P.O. Box 999 Harrisburg, PA 17108 (717) 441-7051 C. O -n i-rt co "D -T3 Attorneys for Defendant ` Timothy A. Clark, M.D. - - -13 DENISE L. KURR, PERSONAL REPRESENTATIVE OF THE ESTATE OF MARY MARCONI, Plaintiff vs. HOLY SPIRIT HEALTH SYSTEM d/b/a HOLY SPIRIT HOSPITAL; MARK A. OSEVALA, D.O.; AND TIMOTHY A. CLARK, M.D., IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA DOCKET NO. 09-1600 CIVIL ACTION - LAW MEDICAL MALPRACTICE JURY TRIAL DEMANDED Defendants PRAECIPE AND RULE TO F€LE COMPLAINT TO THE PROTHONOTARY OF SAID COURT: Please issue a Rule on Plaintiff to file a Complaint in the above case within twenty (20) days after service of the Rule or suffer a judgment of non pros. Respectfully submitted, & HAFER, LLP By: Date: -? - l ? -o EVA Black, Esquire ` orney I.D. No. 17884 Richard S. Wade, Esquire Attorney I.D. No. 209843 305 North Front Street P.O. Box 999 Harrisburg, PA 17108 CERTIFICATE OF SERVICE I, Joan L. Wolfe, an employee of the law offices of Thomas, Thomas & Hafer, LLP, do hereby certify that I served a copy of the foregoing document by depositing the same in the United States mail, first class, postage prepaid, as follows: Joseph M. Melillo, Esquire Angino & Rovner, P.C. 4503 North Front Street Harrisburg, PA 17110-1708 Holy Spirit Health System d/b/a Holy Spirit Hospital 503 North 21 st Street Camp Hill, PA 17011 Mark A. Osevala, D.O. 305 North 27th Street Camp Hill, PA 17011 Date: Jo L. Wolfe, Legal Secretary DENISE L. KURR, PERSONAL REPRESENTATIVE OF THE ESTATE OF MARY MARCONI, Plaintiff VS. IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA DOCKET NO. 09-1600 CIVIL ACTION -LAW MEDICAL MALPRACTICE HOLY SPIRIT HEALTH SYSTEM d/b/a HOLY SPIRIT HOSPITAL; MARK A. JURY TRIAL DEMANDED OSEVALA, D.O.; AND TIMOTHY A. CLARK, M.D., Defendants RULE TO FILE COMPLAINT TO: Denise L. Kurr, Personal Representative of the Estate of Mary Marconi c/o Joseph M. Melillo, Esquire Angino & Rovner, P.C. 4503 North Front Street Harrisburg, PA 17110-1708 You are hereby directed to file a Complaint against Defendant, Timothy within twenty (20) days or non pros seq. reg. DATE: A&A.CI-_ hPC 2w? 0 N rv A? Clad, `?"., rothonot i r1 DENISE L. KURR, Personal Representative IN THE COURT OF COMMON PLEAS of the ESTATE OF MARY MARCONI, CUMBERLAND COUNTY, Plaintiff, PENNSYLVANIA V. NO. 09-1600 CIVIL TERM HOLY SPIRIT HEALTH SYSTEM d/b/a MEDICAL MALPRACTICE HOLY SPIRIT HOSPITAL; MARK A. OSEVALA, D.O.; and TIMOTHY A. CLARK, M.D. Defendant JURY TRIAL DEMANDED ENTRY OF A ARA CE TO THE PROTHONOTARY: Please enter the appearance of Wilbur McCoy Otto and Thomas M. Chairs on behalf of Defendant, Holy Spirit Health System d/b/a Holy Spirit Hospital with respect to the above captioned matter. Respectfully submitted, DICKIE, MCCAMEY & CHILCOTE, P.C. Date: March 20, 2009 By: Wilbur McCoy Otto, Esquire Supreme Court. I.D. #01524 Two PPG Place, Suite 400 Pittsburgh, PA 15222 Phone: (412) 281-7272 Thomas M. Chairs, Esquire PA I.D. # 78565 1200 Camp Hill Bypass, Suite 205 Camp Hill, PA 17011 Phone: (717) 731-4800 Counsel to Defendant Holy Spirit Health System d/b/a Holy Spirit Hospital j CERTIFICATE OF SERVICE I, Wilbur McCoy Otto, Esquire, hereby certify that a true and correct copy of the foregoing Praecipe for Appearance has been served this 20 day of March, 2009, by U.S. Mail, postage prepaid, upon counsel of record. DICKIE, McCAMEY & CHII.COTE, P.C. B Y Wilbur McCoy Otto, Esquire Thomas M. Chairs, Esquire Attorneys for the Defendant, Holy Spirit Health System d/b/a Holy Spirit Hospital Joseph M. Melillo, Esquire Angino & Rovner, P.C. 4503 North Front Street Harrisburg, PA 17110 2 r4 %A !? i * ILO C- ,? . Sheriffs Office of Cumberland County R Thomas Kline ';?64,ttr of clutibrrt?d Edward L Schorpp Sheriff Solicitor Ronny R AndersonJody S Smith Chief Deputy OFF CE CF r^E 54@RIFF Civil Process Sergeant SHERIFF'S RETURN OF SERVICE 03/16/2009 08:10 PM - Dennis Fry, Deputy Sheriff, who being duly sworn according to law, states that on March 16, 2009 at 2010 hours, he served a true copy of the within Complaint and Notice, upon the within named defendant, to wit: Timothy A. Clark by making known unto Carla Clark, wife of defendant, at 9 Sand Pine Court, Mechanicsburg, Cumberland County, Pennsylvania its contents and at the same time handing to her personally the said true and correct copy of the same. 03/18/2009 04:08 AM - Dennis Fry, Deputy Sheriff, who being duly sworn according to law, states that on March 18, 2009 at 1608 hours, he served a true copy of the within Complaint and Notice, upon the within named defendant, to wit: Holy Spirit Health System, by making known unto Ellen Feidt, Risk Manager, at 210 Senate Avenue, Camp Hill, Cumberland County, Pennsylvania its contents and at the same time handing to her personally the said true and correct copy of the same. 03/24/2009 07:15 PM - Michael Barrick, Deputy Sheriff, who being duly sworn according to law, states that on March 23, 2009 at 2015 hours, he served a true copy of the within Writ of Summons, upon the within named defendant, to wit: Mark A. Osevala, by making known unto h i m personally, defendant at 305 N. 27th Street, Camp Hill, Cumberland County, Pennsylvania its contents and at the same time handing to him personally the said true and correct copy of the same. SHERIFF COST: $98.22 March 24, 2009 SO ANSWERS, R THOMAS KLINE, SHERIFF 2009-1600 DENISE L. KURR VS HOLY SPIRIT HEALTH SYSTEM By -_? Duty Sheriff D uty Sheriff ?? ? ? ?; i.s.. ? - a -' ;' .. _ Vas V N '1 ? ?? ?? ?- y' t^? DENISE L. KURR, PERSONAL IN THE COURT OF COMMON PLEAS REPRESENTATIVE OF THE ESTATE OF CUMBERLAND COUNTY, PENNSYLVANIA MARY MARCONI, Plaintiff V. HOLY SPIRIT HEALTH SYSTEM D/B/A HOLY SPIRIT HOSPITAL, MARK A. OSEVELA, D.O, AND TIMOTHY A. CLARK, M.D. Defendant NO. 09-1600 CIVIL ACTION - LAW MEDICAL MALPRACTICE JURY TRIAL DEMANDED ENTRY OF APPEARANCE Kindly enter the appearance of Stevens & Lee on behalf of Defendants Mark Osevala, D.O. in the above action. Serve all papers at 17 North Second Street, 16th Floor, Harrisburg, PA 17101. Notice by copy hereof is given to Plaintiff's counsel of record. Respectfully submitted, STEVENS & LEE Date: March, 2009 -- Michael D. Pipa, Esquire Attorney ID #53624 Karen E. Minehan, Esquire Attorney ID #78050 17 North Second Street, 16th Floor Harrisburg, PA 17101 Phone: (717) 234-1090 Fax: (717) 234-1099 SLl 912469v 1 /041199.00382 DENISE L. KURR, PERSONAL IN THE COURT OF COMMON PLEAS REPRESENTATIVE OF THE ESTATE OF CUMBERLAND COUNTY, PENNSYLVANIA MARY MARCONI, Plaintiff NO. 09-1600 V. CIVIL ACTION - LAW MEDICAL MALPRACTICE HOLY SPIRIT HEALTH SYSTEM D/B/A HOLY SPIRIT HOSPITAL, MARK A. OSEVELA, D.O, AND TIMOTHY A. JURY TRIAL DEMANDED CLARK, M.D. Defendant CERTIFICATE OF SERVICE I, Michael D. Pipa, Esquire, certify that on this date, I served a certified true and correct copy of the foregoing Entry of Appearance upon the following counsel of record, by depositing the same in the United States mail, postage prepaid, addressed as follows: Joseph M. Melillo, Esquire Angino and Rovner, P.c. 4503 North Front Street Harrisburg, PA 17110-1708 Evan Black Esquire Thomas, Thomas and Hafer, LLP 305 North Front Street P.O. Box 999 Harrisburg, PA 17108 Thomas M. Chairs, Esquire Dickie, McCamey & Chilcote, P.C. 1200 Camphill Bypass, Suite 205 Camphill, PA 17011-3700 STEVENS & LEE, P.C. Michae . Pipa, Esq ire Date: March 31, 2009 SL 1912469v l /041199.00382 "offir CE OF THE Plr.-THO"UARY, 2009 APR -2 PM 1: 02 i'CNtv????,? . ?, ANGINO & ROVNER, P.C. Joseph M. Melillo Attorney ID# : 26211 4503 North Front Street Harrisburg, PA 17110-1708 (717) 238-6791 FAX (717) 238-5610 Attorneys for Plaintiff(s) E-mail: jmelillo@angino-rovner.com DENISE L. KURR, PERSONAL REPRESENTATIVE OF THE ESTATE OF MARY MARCONI, Plaintiff V. HOLY SPIRIT HEALTH SYSTEM d/b/a HOLY SPIRIT HOSPITAL; MARK A. OSEVALA, D.O.; and TIMOTHY A. CLARK, M.D., Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PA NO. 09-1600 Civil CIVIL ACTION - LAW MEDICAL MALPRACTICE JURY TRIAL DEMANDED NOTICE TO DEFEND 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 judgment may be entered against you by the Court without further notice for any money claimed in the Complaint or for any other claim or relief requested by the Plaintiff. You may lose money or property or other rights important to you. YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT HAVE A LAWYER, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW. THIS OFFICE CAN PROVIDE YOU WITH INFORMATION ABOUT HIRING A LAWYER. 407994 407721 IF YOU CANNOT AFFORD TO HIRE A LAWYER, THIS OFFICE MAY BE ABLE TO PROVIDE YOU WITH INFORMATION ABOUT AGENCIES THAT MAY OFFER LEGAL SERVICES TO ELIGIBLE PERSONS AT A REDUCED FEE OR NO FEE. Cumberland County Bar Association 32 South Bedford Street Carlisle, PA Telephone number- 717- 249-3166 AVISO USTED HA SIDO DEMANDADO/A EN CORTE. Si usted desea defenderse de las demandas que se persentan mas adelante en las siguientes paginas, debe tomar acci6n dentro de los pr6ximos veinte (20) dias despues de la notificaci6n de esta Demanda y Aviso radicando personalmente o por medio de un abogado una comparecencia escrita y radicando en la Corte por escrito sus defensas de, y objecciones a, las demandas presentadas aqui en contra suya. Se le advierte de que si usted falla de tomar accion como se describe anteriormente, el caso puede proceder sin usted y un fallo por cualquier suma de dinero reclamada en la demanda o cualquier otra reclamacion o remedio solicitado por el demandante puede ser dictado en contra suya por la Corte sin mas aviso adicional. Used puede perder dinero o propiedad u otros derechos importantes para used. USTED DEBE LLEVAR ESTE DOCUMENTO A SU ABOGADO INMEDIATAMENTE. SI USED NO TIENE UN ABOGADO, LLAME O VAYA A LA SIGUIENTE OFICINA. ESTA OFICINA PUEDE PROVEERLE INFORMACION A CERCA DE COMO CONSEGUIR UN ABOGADO. SI USED NO PUEDE PAGAR POR LOS SERVICIOS DE UN ABOGADO, ES POSIBLE QUE ESTA OFICINA LE PUEDA PROVEER INFORMACION SOBRE AGENCIAS QUE OFREZCAN SERVICIOS LEGALES SIN CARGO O BAJO COSTO A PERSONAS QUE CUALIFICAN. Cumberland County Bar Association 32 South Bedford Street Carlisle, PA Telephone number- 717- 249-3166 407994 407721 ANGINO & ROVNER, P.C. Joseph M. Melillo Attorney ID# : 26211 4503 North Front Street Harrisburg, PA 17110-1708 (717) 238-6791 FAX (717) 238-5610 Attorneys for Plaintiff(s) E-mail: jmelillo@angino-rovner.com DENISE L. KURR, PERSONAL REPRESENTATIVE OF THE ESTATE OF MARY MARCONI, Plaintiff IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PA NO. 09-1600 Civil V. HOLY SPIRIT HEALTH SYSTEM d/b/a HOLY SPIRIT HOSPITAL; MARK A. OSEVALA, D.O.; and TIMOTHY A. CLARK, M.D., Defendant CIVIL ACTION - LAW MEDICAL MALPRACTICE JURY TRIAL DEMANDED COMPLAINT 1. The Plaintiff, Denise L. Kurr, is an adult individual residing in Cumberland County, Pennsylvania, who by Letters Testamentary dated May 8, 2007 was appointed personal representative of the Estate of Mary C. Marconi, deceased. 2. Plaintiffs decedent, Mary C. Marconi, died on April 20, 2007. 3. The Defendant, Holy Spirit Health System d/b/a Holy Spirit Hospital, is a corporation organized under the laws of the Commonwealth of Pennsylvania for the delivery of health care services in Cumberland County, Pennsylvania. Plaintiff is asserting a professional liability claim against this Defendant. A Certificate of Merit is filed herewith. 4. The Defendant, Mark A. Osevala, D.O., is a physician practicing the specialty of cardio-thoracic surgery, and his practice at all relevant times included the performance of such 1 surgery at Defendant Holy Spirit Hospital. Plaintiff is asserting a professional liability claim against this Defendant. A Certificate of Merit is filed herewith. 5. The Defendant, Timothy A. Clark, M.D. is a physician specializing in internal medicine, pulmonary medicine, critical care medicine, interventional pulmonology and sleep disorders, who at all relevant times treated Plaintiff's decedent at Holy Spirit Hospital, and who at all relevant times acted as the employee, agent, or ostensible agent for said Defendant Holy Spirit Hospital. Plaintiff is asserting a professional liability claim against this Defendant. A Certificate of Merit is filed herewith. 6. On March 16, 2007, Dr. Osevala performed coronary artery bypass surgery on Mary Marconi at Holy Spirit Hospital. 7. At the time of the discharge from Holy Spirit Hospital on March 21, 2007, eight sternal wires inserted during the bypass surgery were in perfect vertical alignment. 8. However, Ms. Marconi was suffering from an opacification at the base of the left chest consistent with atelectasis of the left lower lung and/or left side pleural effusion. 9. She was transferred to Health South on March 21, 2007, where her admission history and physical note, dictated by James Tyndall, M.D. indicates she is short of breath. Over the next four days Ms. Marconi continued to exhibit signs and symptoms of increasing pulmonary problems and on the 25 h of March, 2007, she was transferred back to Holy Spirit Hospital for treatment. The chest x-ray dated March 22, 2007 shows that the seventh sternal wire was no longer in vertical alignment compared to the other sternal wires. 10. At Holy Spirit Hospital, Ms. Marconi received treatment for her pulmonary problems, including an ultrasound guided thoracentesis removing 500 cubic centimeters of serosanguineous fluid. 2 11. A CT scan of the chest performed March 26, 2007 did not reveal any pulmonary emboli, however there was a complete separation of the lower one-half of the sternum. The lower sternal wires had pulled completely through the lower one-half of the sternum. Disposition of the lower half of the sternum was not noted. 12. The patient was discharged back to Health South Rehabilitation Center on March 30, 2007. 13. At that time, malalignment of the lower sternal wires, particularly malalignment of the seventh sternal wire, compared to the other sternal wires, was evident but was not noted in the records. 14. The records indicate that Ms. Marconi had quite a bit of chest wall pain, and physical examination demonstrated a slowly healing chest wall incision with peri-incisional palpable tenderness. 15. Ms. Marconi's atrial blood gas levels while receiving 5 liters of supplemental oxygen showed a P02 of 55 and a saturation of 88% on April 2, 2007. Later that same day the P02 had decreased to 54 and the oxygen saturation had decreased to 85%. The patient was ordered to be placed on BIPAP. 16. Dr. Inners, on April 2, noted in his assessment that Ms. Marconi had worsening acute/chronic respiratory failure. 17. Therefore, on April 2, 2007, Ms. Marconi was sent back to the Holy Spirit Hospital via ambulance for further evaluation and treatment of increasing shortness of breath and hypoxemia. 18. A chest x-ray performed at Holy Spirit Hospital on April 2, 2007 shows complete disruption of the sternal closure. 3 19. There was an obvious malalignment of all sternal wires. 20. A CT scan of the chest was also performed on April 2, 2007, noting complete separation of the sternum with soft tissue in the stemotomy site, a new finding since the first CT scan dated March 26, 2007. 21. The admission history and physical examination dictated by Lisa Pittinger, PA for Alan J. Sweeny, M.D. noted some fresh bleeding at the lower half of the vertical midline chest incision and ecchymosis. 22. Review of the chest x-ray reported a small left pleural effusion with some atelectasis. 23. The patient deteriorated from a respiratory standpoint and required intubation and mechanical ventilation on April 3, 2007. 24. The initial critical care consolation note authored by Dr. Clark stated that the patient appeared to have a sternal wound infection with non-union of her sternum and a significant amount of fluctuance involving the sternum and surrounding tissue. 25. On physical examination, a sternal non-union was noted on the anterior chest and sternum. It was a 2-3 millimeter defect that was felt longitudinally along the sternum consistent with sternal non-union. 26. Ms. Marconi's progress noted on April 4, 2007 states that the results of CT scan of the chest performed on April 2, 2007 showed dehiscence of the sternum. 27. Dr. Clark's critical care progress note of April 4, 2007 states that the recent chest x-ray shows that the sternal wires are not aligned properly and there is indeed dehiscence. Dr. Clark notes that the source of her admission to the ICU stems from the sternal wound infection. 4 28. A progress note entitled "CVSI" acknowledges the sternal wound dehiscence and indicates the management of the sternal wound will be per Dr. Osevala. 29. The patient was seen by Dr. Osevala in consultation on April 3, 2007 and he confirmed the presence of the sternal dehiscence. His plan indicated that if the patient was not able to extubate, then "she may need sternum repair to help with ventilator wean. Plastic surgery availability at Holy Spirit Hospital still uncertain." 30. The critical care progress note dated April 5, 2007 reports that "right now her sternal wound is being treated conservatively with antibiotics only. It appears that we need to find a plastic surgeon to do the repair. There is a question as to whether there is any plastic surgeon with privileges at Holy Spirit Hospital." 31. The critical care note of April 6, 2007 reports that a consultation to Leo Farrell, M.D. was made to see the patient regarding the sternal dehiscence. 32. A progress note written by Dr. Osevala indicates that "plastic surgery coverage at Holy Spirit Hospital for sternal reconstruction is uncertain. Medical director and Dr. Torchia should be notified of this situation so it can be corrected." 33. The critical care progress note of April 7, 2007 indicates that "we have since found out that there was no plastic surgery coverage for sternal wound repair at Holy Spirit. Dr. Farrell is apparently is not back doing these types of surgeries yet. We will need to make arrangements to transfer her to another facility." 34. In the plans section of this progress note, Ricardo C. Calla, PA-C wrote that the patient will need to be transferred to a center that does sternal reconstruction. 35. The critical care progress note of April 8, 2007 indicates that "we have since found out that there is no plastic surgery coverage for sternal wound repair at Holy Spirit. Dr. 5 Farrell apparently is not back doing these types of surgeries yet. We will need to make arrangements to transfer her to another facility and we will begin the search tomorrow." 36. In the plan portion of this progress note, Ricardo C. Calla PA-C wrote that the patient will need to be transferred to a center that does sternal reconstruction. 37. A progress note dated April 8, 2007 by Dr. Osevala indicates that plastic surgery needs to be secured to care for sternal dehiscence. 38. The critical care progress note of April 9, 2007 stated that "we continue to work on arrangements for Mrs. Marconi's transfer to a facility where she can have sternal wound repair." 39. The plan portion of this progress note states that the plan was to transfer the patient to a center that does sternal reconstruction. 40. A progress note dated April 9, 2007 states that "Dr. Torchia will call Dr. Banducci to see if they will manage the sternal dehiscence at Holy Spirit Hospital. If not, then the patient will need to be transferred to Harrisburg Hospital for management of the sternal dehiscence." 41. The critical care progress note dated April 9, 2007 states that "patient is going to be transferred to Harrisburg Hospital under Dr. Osevala's service here Dr. Banducci from plastics will see her and repair her sternal non-union. She is going to be transferred today." 42. Under the plan portion of this progress note, it is stated that the patient will be transferred to Harrisburg Hospital on April 9, 2007 for definitive repair for sternal non-union. 43. On April 10, 2007, Dr. Osevala wrote that there was not real change in the patient's status. He was awaiting Dr. Torchia's decision on Plastic Surgery coverage. The patient's family was supposedly informed of the status. 6 44. Dr. Osevala's April 10, 2007 note indicates that "she is receiving no IV fluids and no tube feedings." The note also indicates that her BUN continues to elevate. 45. Elevated BUN is an indication of dehydration. 46. Ms. Marconi was admitted to Dr. Osevala's service at Harrisburg Hospital on April 10, 2009 and seen in consultation by Dr. Banducci on April 11. 47. Dr. Banducci's impression was that she suffered from a sternal wound infection and his plan was to perform sternal debridement with removal of eight sternal wires and bilateral pectoralis major muscle flap closure of the defect. 48. At surgery, the sternum was noted to have dehiscesed widely. 49. Cultures of the sternum and of dark mediastinal fluid were taken. 50. On April 12, 2007 the patient began to bleed resulting in hypotension. The code blue was called and CPR was instituted. 51. Ms. Marconi was returned to the operating room for re-exploration of her sternal wound. A clot was evaluated and a small bleeding source was found on the undersurface of the pectoralis major muscle was from generalized oozing. 52. Subsequent to this, Ms. Marconi developed a possible cerebralvascular accident. 53. Ms. Marconi died on April 20, 2007 at Harrisburg Hospital. 54. Once the diagnosis of the complete sternal dehiscence with the possibility of a sternal wound infection is made, the standard of care requires prompt surgical treatment, optimally within twenty-four to forty-eight hours, unless the patient's medical condition dictates otherwise. 55. Definitive surgical treatment includes sternal wound re-exploration with possible sternal re-wiring or sternal debridement with immediate or delayed wound closure,. 7 J 56. Ms. Marconi's sternal dehiscence with the possibility of sternal wound infection was diagnosed on or about April 2, 2007, nine days before she received surgical treatment by Dr. Banducci. COUNTI Denise L. Kurr, Personal Representative of the Estate of Mary Marconi, Deceased v. Mark A. Osevala, D.O. 57. Paragraphs 1 through 56 are incorporated herein by reference as if set forth in their entirety. 58. All of Plaintiff's damages are hereinafter related are the direct and proximate result of the negligence of Dr. Osevala, and that he: a. failed to provide surgical care for Ms. Marconi's sternal dehiscence and sternal wound infection within the optimal twenty-four to forty- eight time interval, or at any time thereafter, until Ms. Marconi received surgery on April 11, 2007; b. in the alternative, made insufficient effort to ensure that a different surgeon performed the necessary surgical procedure within the time interval mandated by the standard of care; C. failed to adequately monitor Ms. Marconi's condition during the time she was an inpatient at Holy Spirit Hospital, between April 2 and April 10, 2007; and d. failed to make reasonable effort under the circumstances to identify a different facility at which she could have been accepted for the necessary surgery within the time required by the standard of care, and to arrange for her timely transfer. 8 59 their entirety. COUNT II Denise L. Kurr, Personal Representative of the Estate of Mary Marconi, Deceased v. Timothy A. Clark, M.D. Paragraphs 1 through 56 are incorporated herein by reference as if set forth in 60. All of (Plaintiffs damages are hereinafter related are the direct and proximate result of the negligence of Dr. Clark, acting within the course and scope of his employment, agency, or ostensible agency for Defendant, Holy Spirit Hospital, in that he: a. made insufficient effort to ensure that a surgeon performed the necessary surgical procedure within the time interval mandated by the standard of care; b. failed to adequately monitor Ms. Marconi's condition during the time she was an inpatient at Holy Spirit Hospital, between April 2 and April 10, 2007, and to apprise Dr. Osevala of her treatment and condition; and c. failed to make reasonable effort under the circumstances to identify a different facility at which she could have been accepted for the required surgery within the time required by the standard of care, and to arrange for her timely transfer. COUNT III Denise L. Kurr, Personal Representative of the Estate of Mary Marconi, Deceased v. Holy Spirit Health System d/b/a Holy Spirit Hospital 61. Paragraphs 1 through 56 are incorporated herein by reference as if set forth in their entirety. 9 J 62. All of Plaintiff's damages are also the direct and proximate result of the independent negligence of Defendant Holy Spirit Hospital and that it: a. failed to have policies and procedures in place to assure that follow-up surgical care would be available at its facility to deal with the complications of bypass surgery, including sternal wound dehiscence and infection; b. in the alternative, failed to follow applicable policies and procedures designed to assure that follow-up surgical care was timely available; C. failed to seek and obtain prompt transfer of Ms. Marconi to a different facility where she could receive the required surgical care in a timely fashion; and d. made inadequate effort to identify a surgeon who could perform the required operation at its facility in a timely fashion. CLAIM I - SURVIVAL ACTION Denise L. Kurr, Personal Representative of the Estate of Mary Marconi, Deceased v. Holy Spirit Health System d/b/a Holy Spirit Hospital; Mark A. Osevala, D.O.; and Timothy A. Clark, M.D. 63. Paragraphs 1 through 62 are incorporated herein by reference as if set forth in their entirety. 64. Plaintiff Denise L. Kurr, Personal Representative of the Estate of Mary Marconi, deceased, brings this action on behalf of the Estate of Mary Marconi under and by virtue of the Act of 1976, July 9, P.L. 586, No. 142, §2, 42 Pa. C.S.A. §8302. 65. Plaintiff claims on behalf of said Estate the damages suffered by the said Estate by reason of death of the decedent, for the conscious pain and suffering prior to death, loss of 10 J income for decedent's life expectancy, and for all other damages sustained by the said Estate by reasons of the death of the decedent. WHEREFORE, Plaintiff demands judgment against Defendants in an amount in excess of Fifty Thousand ($50,000.00) Dollars, exclusive of interest and costs and in excess of any jurisdiction amount requiring compulsory arbitration. CLAIM II - WRONGFUL DEATH Denise L. Kurr, Personal Representative of the Estate of Mary Marconi, Deceased v. Holy Spirit Health System d/b/a Holy Spirit Hospital; Mark A. Osevala, D.O.; and Timothy A. Clark, M.D. 66. Paragraphs 1 through 62 are incorporated herein by reference as if set forth in their entirety. 67. Plaintiff Denise L. Kurr, personal representative of the Estate of Mary Marconi, deceased, brings this action for wrongful death of Mary Marconi on behalf of all persons entitled to damages therefor under and by virtue of the Act of 1976, July 9, P.L. 586, No. 412, §2, 42 Pa. C.S.A. §8301. 68. Decedent did not bring an action for her injuries during her lifetime. 69. The following are the names of all persons entitled by law to recover damages for such wrongful death and their relationship to decedent: Name Relationship Address Denise L. Kurr Daughter 626 Gutshall Road Boiling Springs, PA 17077 Robert Marconi Son 218 W. Arch Street Mechanicsburg, PA 17055 Eugene Marconi Son 240 A. Street Carlisle, PA 17013 70. At the time of her death, Mary Marconi was April 20, 2007 (75) years old, having been born August 4, 1931. 11 71. Defendants are liable to Plaintiff, Personal Representative of the Estate of Mary Marconi, deceased, for damages as set forth herein. 72. As a result of the death of the decedent, the individuals identified in paragraph 68 above, have suffered a pecuniary loss, and have been, and in the future will be deprived of the decedent's companionship, contribution, support, comfort, services, and so on, for all of which damages are claimed. 73. As a result of the death of decedent, Plaintiff has incurred funeral, burial, and any other expenses allowed by law, for all of which claim is made. WHEREFORE, Plaintiff demands judgment against Defendants in an amount in excess of Fifty Thousand Dollars ($50,000), exclusive of interest and costs and in excess of any jurisdictional amount requiring compulsory arbitration. Respectfully submitted, ANGINO & ROVNER, P.C. 0, - ? " - ?, Q'?7 Jo p . Melillo, Esquire A d rney I.D. No. 26211 4503 North Front Street Harrisburg, PA 17110 (717) 238-6791 Date: /V Attorney for Plaintiff 12 VERIFICATION I, DENISE L. KURR, Personal Representative of the Estate of MARY MARCONI, Plaintiff, have read the foregoing Complaint and do hereby swear or affirm that the facts set forth in the foregoing are true and correct to the best of my knowledge, information and belief. I understand that this Verification is made subject to the penalties of 18 Pa.C.S.A. Section 4904, relating to unsworn falsification to authorities. Wit s Date: 419/ C' ? DENISE L. =URR? Date: CA /0? l 407994 407721 ANGINO & ROVNER, P.C. Joseph M. Melillo Attorney ID# : 26211 4503 North Front Street Harrisburg, PA 17110-1708 (717) 238-6791 FAX (717) 238-5610 Attorneys for Plaintiff(s) E-mail: jmelillo@angino-rovner.com DENISE L. KURR, PERSONAL IN THE COURT OF COMMON PLEAS REPRESENTATIVE OF THE ESTATE CUMBERLAND COUNTY, PA OF MARY MARCONI, Plaintiff V. HOLY SPIRIT HEALTH SYSTEM d/b/a HOLY SPIRIT HOSPITAL; MARK A. OSEVALA, D.O.; and TIMOTHY A. NO. 09-1600 Civil CIVIL ACTION - LAW MEDICAL MALPRACTICE JURY TRIAL DEMANDED CLARK, M.D., Defendant Certificate of Merit as to Holy Spirit Hospital Health System d/b/a Holy Spirit Hospital I, Joseph M. Mellillo, certify that: ( ) an appropriate licensed professional has supplied a written statement to the undersigned that there is a b sis to conclude that the care, skill or knowledge exercised or exhibited by this defendant in the treatment, practice or work that is the subject of the complaint, fell outside acceptable professional standards and that such conduct was a cause in bringing about the harm; AND/OR ()6 the claim that this defendant deviated from an acceptable professional standard is based solely on allegations that other licensed professionals for whom this defendant is responsible deviated from an acceptable professional standard and an appropriate licensed professional has supplied a written statement to the undersigned that there is a basis to conclude that the care, skill or knowledge exercised or exhibited by the other licensed professionals in the treatment, practice or work that is the subject of the complaint, fell outside acceptable professional standards and that such conduct was a cause in bringing about the harm; OR ( ) expert testimony of an appropriate licensed professional is unnecessary for prosecution of the claim against this defendant. Date: <?' x' l'L seph M. Melillo ANGINO & ROVNER, P.C. Joseph M. Melillo Attorney ID# : 26211 4503 North Front Street Harrisburg, PA 17110-1708 (717) 238-6791 FAX (717) 238-5610 Attorneys for Plaintiff(s) E-mail: jmelillo@angino-rovner.com DENISE L. KURR, REPRESENTATIVE OF OF MARY MARCONI, Plaintiff V. PERSONAL THE ESTATE IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PA NO. 09-1600 Civil CIVIL ACTION - LAW MEDICAL MALPRACTICE HOLY SPIRIT HEALTH SYSTEM d/b/a HOLY SPIRIT HOSPITAL; MARK A. OSEVALA, D.O.; and TIMOTHY A. CLARK, M.D., Defendant JURY TRIAL DEMANDED Certificate of Merit as to Mark A. Osevala, D.O. I, Joseph M. Melillo, certify that: (?) an appropriate licensed professional has supplied a written statement to the undersigned that there is a basis to conclude that the care, skill or knowledge exercised or exhibited by this defendant in the treatment, practice or work that is the subject of the complaint, fell outside acceptable professional standards and that such conduct was a cause in bringing about the harm; AND/OR ( ) the claim that this defendant deviated from an acceptable professional standard is based solely on allegations that other licensed professionals for whom this defendant is responsible deviated from an acceptable professional standard and an appropriate licensed professional has supplied a written statement to the undersigned that there is a basis to conclude that the care, skill or knowledge exercised or exhibited by the other licensed professionals in the treatment, practice or work that is the subject of the complaint, fell outside acceptable professional standards and that such conduct was a cause in bringing about the harm; OR ( ) expert testimony of an appropriate licensed professional is unnecessary for prosecution of the claim against this defendant. Date: 01"-? `t_t" I 11seph M. Melillo ANGINO & ROVNER, P.C. Joseph M. Melillo Attorney ID# : 26211 4503 North Front Street Harrisburg, PA 17110-1708 (717) 238-6791 FAX (717) 238-5610 Attorneys for Plaintiff(s) E-mail: jmelillo@angino-rovner.com DENISE L. KURR, REPRESENTATIVE OF OF MARY MARCONI, Plaintiff V. PERSONAL THE ESTATE IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PA NO. 09-1600 Civil CIVIL ACTION - LAW MEDICAL MALPRACTICE HOLY SPIRIT HEALTH SYSTEM d/b/a HOLY SPIRIT HOSPITAL; MARK A. OSEVALA, D.O.; and TIMOTHY A. CLARK, M.D., Defendant JURY TRIAL DEMANDED Certificate of Merit as to Timothy A. Clark, M.D. I, Joseph M. Melillo, certify that: (`? an appropriate licensed professional has supplied a written statement to the undersigned that there is a basis to conclude that the care, skill or knowledge exercised or exhibited by this defendant in the treatment, practice or work that is the subject of the complaint, fell outside acceptable professional standards and that such conduct was a cause in bringing about the harm; AND/OR ( ) the claim that this defendant deviated from an acceptable professional standard is based solely on allegations that other licensed professionals for whom this defendant is responsible deviated from an acceptable professional standard and an appropriate licensed professional has supplied a written statement to the undersigned that there is a basis to conclude that the care, skill or knowledge exercised or exhibited by the other licensed professionals in the treatment, practice or work that is the subject of the complaint, fell outside acceptable professional standards and that such conduct was a cause in bringing about the harm; OR ( ) expert testimony of an appropriate licensed professional is unnecessary for prosecution of the claim against this defendant. Date: oseph M. Melillo CERTIFICATE OF SERVICE AND NOW, this day of d'4 ? I, Cindy J. Wilson, employee of the law firm of Angino & Rovner, P.C., hereby certify that a true and correct copy of the foregoing document was sent to the following counsel of record by placing a copy of same by First Class in the United States mail, postage prepaid, at Harrisburg, Pennsylvania addressed as follows: Evan Black, Esquire Thomas, Thomas & Hafer, LLP 305 North Front Street Harrisburg, PA 17101 Defendant Timothy A. clack, M.D. Wilbur McCoy Otto, Esquire Dickie, McCamey & Chilcote, P.C. Two PPG Place, Suite 400 Pittsburgh, PA 15222 Defendant Holy Spirit Health System d/h/a Holy Spirit Hospital Thomas M. Chairs, Esquire Dickie, McCamey & Chilcote, P.C. 1200 Camp Hill Bypass, Suite 205 Camp Hill, PA 17011 Defendant Holy Spirit Health System d/h/a Holy Spirit Hospital Michael D. Pipa, Esquire Karen E. Minehan, Esquire Stevens & Lee 17 North Second Street, 16th Floor Harrisburg, PA 17101 Defendant Mark Osevala, D. O. ZA- 6ndy J. ils ri Date: 407994 407721 (Lip FILED "' tr OF T1L i+eM1dlflfii' 7 2099lyJfi r. t ? J ??•?: vi? CERTIFICATE PREREQUISITE TO SERVICE OF A SUBPOENA PURSUANT TO RULE 4009.22 IN THE MATTER OF: COURT OF COMMON PLEAS DENISE L. KURR, REPRESENTATIVE OF THE TERM, ESTATE OF MARY C. MACONI CUMBERLAND -VS- CASE NO: 09-1600 HPOLY SPIRIT HEALTH SYSTEM, ET AL As a prerequisite to service of a subpoena for documents and things pursuant to Rule 4009.22 MCS on behalf of EVAN BLACK, ES certifies that (1) A notice of intent to serve the subpoena with a copy of the subpoena attached thereto was mailed or delivered to each party at least twenty days prior to the date on which the subpoena is sought to be served, (2) A copy of the notice of intent, including the proposed subpoena, is attached to this certificate, (3) No objection to the subpoena has been received, and (4) The subpoena which will be served is identical to the subpoena which is attached to the notice of intent to serve the subpoena. DATE: 05/20/2009 MCS on behalf of /S/ evan Mach, 6,. --o EVAN BLACK, ESQ. Attorney for DEFENDANT R1.84S 133-H DE11-0904291 36716-LO1 COMMONWEALTH OF PENNSYLVANIA IN THE MATTER OF: COUNTY OF CUMBERLAND COURT OF COMMON PLEAS DENISE L. KURR, REPRESENTATIVE OF THE ESTATE OF MARY C. MACONI -VS- HPOLY SPIRIT HEALTH SYSTEM, ET AL CASE NO: 09-1600 NOTICE OF INTENT TO SERVE A SUBPOENA TO PRODUCE DOCUMENTS AND THINGS FOR DISCOVERY PURSUANT TO RULE 4009.21 MOFFITT HEART & VASCULAR GROUP CHRISTOPHER J. BERG, M.D. HEALTHSOUTH HARRISBURG HOSPITAL HARRISBURG HOSPITAL WEST SHORE EMER. MED. SERVICES LEBER WOLF & BANDUCCI PLASTIC MEDICAL RECORDS MEDICAL RECORDS MEDICAL RECORDS MEDICAL RECORDS BILLING ONLY MEDICAL RECORDS MEDICAL RECORDS & BILLING & BILLING & BILLING & BILLING & BILLING TO: JOSEPH MELILLO, ESQ., PLAINTIFF COUNSEL MICHAEL D. PIPA, ESQ. THOMAS M. CHAIRS, ESQ. MCS on behalf of EVAN BLACK, ESQ. intends to serve a subpoena identical to the one that is attached to this notice. You have twenty (20) days from the date listed below in which to file of record and serve upon the undersigned an objection to the subpoena. If the twenty day notice period is waived or if no objection is made, then the subpoena may be served. Complete copies of any reproduced records may be ordered at your expense by completing the attached counsel card and returning same to MCS or by contacting our local MCS office. DATE: 04/28/2009 MCS on behalf of EVAN BLACK, ESQ. Attorney for DEFENDANT CC: EVAN BLACK, ESQ. - JOSEPH MELILLO, ESQ. ANGINO & ROVNER 4503 N. FRONT ST. TERM, THE MCS GROUP INC. 1601 MARKET STREET #800 PHILADELPHIA, PA 19103 (215) 246-0900 HARRISBURG, PA 17110 R1.84S 133-H DE02-0506315 36716-CO1 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND DENISE L. KURR, REPRESENTATIVE OF THE VS. HPOLY SPIRIT HEALTH SYSTEM, ET AL File No. 09-1600 SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009.22 TO: Custodian of Records for MOFFITT HEART a VASCULAR GROUP (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: **** SEE ATTACHED RIDER**** at The M CS Mup, Inc 1601 Market Street, Suite 800 Philadelphia- PA 19103 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: EV ADDRESS: 30-4 TELEPHONE: (215) 246-0900 SUPREME COURT ID #: ATTORNEY FOR: Defendant BY THE COURT: Prothonotary/Clerk, Civil Dciv on MAY 2 0 2009 7 a d Deputy Date: Seal of the Court 36716-01 EXPLANATION OF REQUIRED RECORDS TO: CUSTODIAN OF RECORDS FOR: MOFFITT HEART & VASCULAR GROUP 977 WALNUT BOTTOM ROAD CARLISLE, PA 17013 RE: 36716 MAR`! C. MARCON I Prior approval is required for fees in excess of $150.00 for hospitals, $100.00 for all other providers. Entire medical and billing file including but not limited to any and all records, correspondence to and from the consulting and/or treating physicians, files, memoranda, handwritten notes, history and physical reports, medication/ prescription records, including any and all such items as may be stored in a computer database or otherwise in electronic form, relating to any examination, consultation, diagnosis or treatment pertaining to: Dates Requested: up to and including the present. Subject : MARY C. MARCONI 105 BRIGHTON DRIVE, CARLISLE, PA 17015 Social Security #: XXX-XX-1385 Date of Birth: 08-04-1931 R1.84S 133-H SU10-0783710 36716-LO1 CERTIFICATE PREREQUISITE TO SERVICE OF A SUBPOENA PURSUANT TO RULE 4009.22 IN THE MATTER OF: COURT OF COMMON PLEAS DENISE L. KURR, REPRESENTATIVE OF THE TERM, ESTATE OF MARY C. MACONI CUMBERLAND -VS- CASE NO: 09-1600 HPOLY SPIRIT HEALTH SYSTEM, ET AL As a prerequisite to service of a subpoena for documents and things pursuant to Rule 4009.22 MCS on behalf of EVAN BLACK, ES certifies that (1) A notice of intent to serve the subpoena with a copy of the subpoena attached thereto was mailed or delivered to each party at least twenty days prior to the date on which the subpoena is sought to be served, (2) A copy of the notice of intent, including the proposed subpoena, is attached to this certificate, (3) No objection to the subpoena has been received, and (4) The subpoena which will be served is identical to the subpoena which is attached to the notice of intent to serve the subpoena. DATE: 05/20/2009 MCS on behalf of /S/ evan Mach, e?,. EVAN BLACK, ESQ. Attorney for DEFENDANT R1.84S 133-H DE11-0904296 36716-L02 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND DENISE L. KURR, REPRESENTATIVE OF THE VS. HPOLY SPIRIT HEALTH SYSTEM, ET AL File No. 09-1600 SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009.22 TO: Custodian of Records for CHRISTOPHER J. BERO, M.D. (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: **** SEE ATTACHED RIDER**** at _ The MCS Gm=- Inc.. 1601 Market Street Suite 800- Philadelphia, PA 1910" 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: ADDRESS: TELEPHONE: (15) 246-0900 SUPREME COURT ID #: ATTORNEY FOR: Defendant MAY 2 0 2009 Date: L7, .1-C)o, Seal of the Court BY THE COURT: /.s/ ac-c . ,- Prothonotary/Clerk, Civil Division L;l 6 Deputy 36716-02 EXPLANATION OF REQUIRED RECORDS TO: CUSTODIAN OF RECORDS FOR: CHRISTOPHER J. BERG, M.D. 220 WILSON STREET MEDICAL ARTS BLDG. CARLISLE, PA 17013 RE: 36716 MARY C. MARCONI Prior approval is required for fees in excess of $150.00 for hospitals, $100.00 for all other providers. Entire medical and billing file including but not limited to any and all records, correspondence to and from the consulting and/or treating physicians, files, memoranda, handwritten notes, history and physical reports, medication/ prescription records, including any and all such items as may be stored in a computer database or otherwise in electronic form, relating to any examination, consultation, diagnosis or treatment pertaining to: Dates Requested: up to and including the present. Subject : MARY C. MARCONI 105 BRIGHTON DRIVE, CARLISLE, PA 17015 Social Security #: XXX-XX-1385 Date of Birth: 08-04-1931 R1.84S 133-H SU10-0783712 36716-LO2 CERTIFICATE PREREQUISITE TO SERVICE OF A SUBPOENA PURSUANT TO RULE 4009.22 IN THE MATTER OF: COURT OF COMMON PLEAS DENISE L. KURR, REPRESENTATIVE OF THE TERM, ESTATE OF MARY C. MACONI CUMBERLAND -VS- CASE NO: 09-1600 HPOLY SPIRIT HEALTH SYSTEM, ET AL As a prerequisite to service of a subpoena for documents and things pursuant to Rule 4009.22 MCS on behalf of EVAN BLACK, ESQ. certifies that (1) A notice of intent to serve the subpoena with a copy of the subpoena attached thereto was mailed or delivered to each party at least twenty days prior to the date on which the subpoena is sought to be served, (2) A copy of the notice of intent, including the proposed subpoena, is attached to this certificate, (3) No objection to the subpoena has been received, and (4) The subpoena which will be served is identical to the subpoena which is attached to the notice of intent to serve the subpoena. DATE: 05/20/2009 MCS on behalf of / S / evan 12pach, Coq. EVAN BLACK, ESQ. Attorney for DEFENDANT R1.84S 133-H DE11-0904297 36716-LO3 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND DENISE L. KURR, REPRESENTATIVE OF THE File No. 09-1600 VS. HPOLY SPIRIT HEALTH SYSTEM, ET AL SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 400912 TO: Custodian of Records for HEALTHSOUTH (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: **** SEE ATTACHED RIDER **** at _ The MCS 7_a. Inc.. 1601 Market Street, Suite 800. P ilad .jgj?i , PA 19103 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: EVV ADDRESS: 305 TELEPHONE: (215) 246-0900 SUPREME COURT ID #: ATTORNEY FOR: Defendant BY THE COURT: Prothonotary/Clerk, Civil Division/ MAY 2 0 2009 Deputy Date: 7 a1 Seal of the Court 36716-03 EXPLANATION OF REQUIRED RECORDS TO: CUSTODIAN OF RECORDS FOR: HEALTHSOUTH 1515 NORTH FRONT STREET HARRISBURG, PA RE: 36716 MARY C. MARCONI Prior approval is required for fees in excess of $150.00 for hospitals, $100.00 for all other providers. Entire medical and billing file including but not limited to any and all records, correspondence to and from the consulting and/or treating physicians, files, memoranda, handwritten notes, history and physical reports, medication/ prescription records, including any and all such items as may be stored in a computer database or otherwise in electronic form, relating to any examination, consultation, diagnosis or treatment pertaining to: Dates Requested: up to and including the present. Subject : MARY C. MARCONI 105 BRIGHTON DRIVE, CARLISLE, PA 17015 Social Security #: XXX-XX-1385 Date of Birth: 08-04-1931 R1.84S 133-H SU10-0783714 36716-LO3 CERTIFICATE ' PREREQUISITE TO SERVICE OF A SUBPOENA PURSUANT TO RULE 4009.22 IN THE MATTER OF: COURT OF COMMON PLEAS DENISE L. KURR, REPRESENTATIVE OF THE TERM, ESTATE OF MARY C. MACONI CUMBERLAND -VS- CASE NO: 09-1600 HPOLY SPIRIT HEALTH SYSTEM, ET AL As a prerequisite to service of a subpoena for documents and things pursuant to Rule 4009.22 MCS on behalf of EVAN BLACK, ESQ. certifies that (1) A notice of intent to serve the subpoena with a copy of the subpoena attached thereto was mailed or delivered to each party at least twenty days prior to the date on which the subpoena is sought to be served, (2) A copy of the notice of intent, including the proposed subpoena, is attached to this certificate, (3) No objection to the subpoena has been received, and (4) The subpoena which will be served is identical to the subpoena which is attached to the notice of intent to serve the subpoena. DATE: 05/20/2009 MCS on behalf of /S/ evan each, 6C,F. EVAN BLACK, ESQ. Attorney for DEFENDANT R1.84S 133-H DE11-0904302 36716-L04 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND DENISE L. KURR, REPRESENTATIVE OF THE VS. HPOLY SPIRIT HEALTH SYSTEM, ET AL File No. 09-1600 SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4019.22 TO: Custodian of Records for HARRISBURG HOSPITAL (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: **** SFF ATTACHED RIDER **** at The MCI; Gr=, Inc-, 1601 Market Street Suite 800, Pju]gdelghia- PA 19103 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: ADDRESS: TELEPHONE: (215) , 246-0900 SUPREME COURT ID #: ATTORNEY FOR: Defendant MAYa 7 Zoos Date: Seal of the Court BY THE COURT: Prothonotary/Clerk, Civil Division Deputy 36716-04 EXPLANATION OF REQUIRED RECORDS TO: CUSTODIAN OF RECORDS FOR: HARRISBURG HOSPITAL MEDICAL RECORDS 111 S. FRONT STREET HARRISBURG, PA 17101 RE: 36716 MARY C. MARCONI Prior approval is required for fees in excess of $150.00 for hospitals, $100.00 for all other providers. Entire hospital medical file, including but not limited to any and all records, correspondence to and from the consulting and/or treating physician, files, memoranda, handwritten notes, history and physical reports, medication/ prescription records, nurse's notes, doctor's comments, dietary restrictions, and all patient consent or refusal of treatment, procedures, test, and/or medication, lab and diagnostic test results, including any and all such items as may be stored in a computer database or otherwise in electronic form, relating to any examination, consultation, diagnosis, care, treatment, admission, discharge, or emergency care pertaining to: Dates Requested: up to and including the present. Subject : MARY C. MARCONI 105 BRIGHTON DRIVE, CARLISLE, PA 17015 Social Security #: 177-24-1385 Date of Birth: 08-04-1931 R1.84S 133-H SU10-0783716 36716-LO4 CERTIFICATE PREREQUISITE TO SERVICE OF A SUBPOENA PURSUANT TO RULE 4009.22 IN THE MATTER OF: DENISE L. KURR, REPRESENTATIVE OF THE ESTATE OF MARY C. MACONI -VS- HPOLY SPIRIT HEALTH SYSTEM, ET AL COURT OF COMMON PLEAS TERM, CUMBERLAND CASE NO: 09-1600 As a prerequisite to service of a subpoena for documents and things pursuant to Rule 4009.22 MCS on behalf of EVAN BLACK, ESQ. certifies that (1) A notice of intent to serve the subpoena with a copy of the subpoena attached thereto was mailed or delivered to each party at least twenty days prior to the date on which the subpoena is sought to be served, (2) A copy of the notice of intent, including the proposed subpoena, is attached to this certificate, (3) No objection to the subpoena has been received, and (4) The subpoena which will be served is identical to the subpoena which is attached to the notice of intent to serve the subpoena. DATE: 05/20/2009 MCS on behalf of /S/ evan O21ach, en. EVAN BLACK, ESQ. Attorney for DEFENDANT R1.84S 133-H DE11-0904303 36716-L05 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND DENISE L. KURR, REPRESENTATIVE OF THE VS. HPOLY SPIRIT HEALTH SYSTEM, ET AL File No. 09-1600 SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009.22 TO: Custodian of Records for HARRISBURG HOSPITAL (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: **** SEE ATTACHED RIDER **** at The MC. Group- Inc.- 1601 Market Street. Suite 800 PhHadelpbig. PA 19103 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: EVAN B ADDRESS: 305 N. F] TELEPHONE: (215) 246-0900 SUPREME COURT ID #: ATTORNEY FOR: Defendant Ali 2 9P9? Date: Seal of the Court BY THE COURT: Prothonotary/Clerk, Civil Dion Deputy 36716-05 EXPLANATION OF REQUIRED RECORDS TO: CUSTODIAN OF RECORDS FOR: HARRISBURG HOSPITAL BILLING RECORDS PO BOX 2353 HARRISBURG. PA 17105 RE: 36716 MARY C. MARCONI Prior approval is required for fees in excess of $150.00 for hospitals, $100.00 for all other providers. Any and all billing, insurance claims, payments, outstanding and/or delinquent invoices, including any and all such items as may be stored in a computer database or otherwise in electronic form, relating to any examination, consultation, diagnosis, care or treatment pertaining to: Dates Requested: up to and including the present. Subject : MARY C. MARCONI 105 BRIGHTON DRIVE, CARLISLE, PA 17015 Social Security #: 177-24-1385 Date of Birth: 08-04-1931 R1.84S 133-H SU10-0783718 36716-LOS CERTIFICATE PREREQUISITE TO SERVICE OF A SUBPOENA PURSUANT TO RULE 4009.22 IN THE MATTER OF: COURT OF COMMON PLEAS DENISE L. KURR, REPRESENTATIVE OF THE TERM, ESTATE OF MARY C. MACONI CUMBERLAND -VS- CASE NO: 09-1600 HPOLY SPIRIT HEALTH SYSTEM, ET AL As a prerequisite to service of a subpoena for documents and things pursuant to Rule 4009.22 MCS on behalf of EVAN BLACK, ESQ. certifies that (1) A notice of intent to serve the subpoena with a copy of the subpoena attached thereto was mailed or delivered to each party at least twenty days prior to the date on which the subpoena is sought to be served, (2) A copy of the notice of intent, including the proposed subpoena, is attached to this certificate, (3) No objection to the subpoena has been received, and (4) The subpoena which will be served is identical to the subpoena which is attached to the notice of intent to serve the subpoena. DATE: 05/20/2009 MCS on behalf of /S/ evan glach, eN. EVAN BLACK, ESQ. Attorney for DEFENDANT R1.84S 133-H DE11-0904308 36716-L06 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND DENISE L. KURR, REPRESENTATIVE OF THE VS. HPOLY SPIRIT HEALTH SYSTEM, ET AL File No. 09-1600 SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009.22 TO: Custodian of Records for WEST SHORE EMER_ MED. SERVICES (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: **** SEE ATTACHED RIDER **** at The M CS aD=,Inc„ 1601 M rket'Street, Suite 800, Phijadelpbisi 19103 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: -EVAN BLACK. ESQ. ADDRESS: 305 N. FRONT STREET PO BOX 999 HARRISBURG, PA 17108 TELEPHONE:(15) 246-0900 SUPREME COURT ID #: ATTORNEY FOR: Defendant MAY 2 0 2009 Gd 9 Date: Seal of the Court BY THE COURT: Prothonotary/Clerk, Civil Division Deputy U 36716-06 EXPLANATION OF REQUIRED RECORDS TO: CUSTODIAN OF RECORDS FOR: WEST SHORE EMER. MED. SERVICES 210 SENATE AVENUE #3 CAMP HILL. PA 17011 RE: 36716 MARY C. MARCONI Prior approval is required for fees in excess of $150.00 for hospitals, $100.00 for all other providers. Entire medical and billing file including but not limited to any and all records, correspondence to and from the consulting and/or treating physicians, files, memoranda, handwritten notes, history and physical reports, medication/ prescription records, including any and all such items as may be stored in a computer database or otherwise in electronic form, relating to any examination, consultation, diagnosis or treatment pertaining to: Dates Requested: up to and including the present. Subject : MARY C. MARCONI 105 BRIGHTON DRIVE, CARLISLE, PA 17015 Social Security #: XXX-XX-1385 Date of Birth: 08-04-1931 R1.84S 133-H SU10-0783720 36716-L06 CERTIFICATE 6 PREREQUISITE TO SERVICE OF A SUBPOENA PURSUANT TO RULE 4009.22 IN THE MATTER OF: COURT OF COMMON PLEAS DENISE L. KURR, REPRESENTATIVE OF THE TERM, ESTATE OF MARY C. MACONI CUMBERLAND -VS- CASE NO: 09-1600 HPOLY SPIRIT HEALTH SYSTEM, ET AL As a prerequisite to service of a subpoena for documents and things pursuant to Rule 4009.22 MCS on behalf of EVAN BLACK, ES certifies that (1) A notice of intent to serve the subpoena with a copy of the subpoena attached thereto was mailed or delivered to each party at least twenty days prior to the date on which the subpoena is sought to be served, (2) A copy of the notice of intent, including the proposed subpoena, is attached to this certificate, (3) No objection to the subpoena has been received, and (4) The subpoena which will be served is identical to the subpoena which is attached to the notice of intent to serve the subpoena. DATE: 05/20/2009 MCS on behalf of / S / evan 121a ch, e3q. EVAN BLACK, ESQ. Attorney for DEFENDANT R1.84S 133-H DE11-0904309 36716-L07 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND DENISE L. KURR, REPRESENTATIVE OF THE VS. HPOLY SPIRIT HEALTH SYSTEM, ET AL File No. 09-1600 SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009.22 TO: Custodian of Records for LEBER WOLF & BANDUCCI PLASTIC (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: **** SEE ATTACHED RIDER **** at The MCS Ca=, Inc., 1601 Market S c , Suite 800, P it d hia, PA 19103 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: ADDRESS: 305 TELEPHONE: (215) 246-0900 SUPREME COURT ID #: ATTORNEY FOR: Defendant MAY 2 0 2009 Date: 7, az-v9 Seal of the Court BY THE COURT: 2? Prothonotary/Clerk, Civil !Divisio c C-Gr Deputy 36716-07 EXPLANATION OF REQUIRED RECORDS TO: CUSTODIAN OF RECORDS FOR: LEBER WOLF & BANDUCCI PLASTIC SURGERY LTD 2807 N. FRONT STREET HARRISBURG, PA 17110 RE: 36716 MARY C. MARCONI Prior approval is required for fees in excess of $150.00 for hospitals, $100.00 for all other providers. Entire medical and billing file including but not limited to any and all records, correspondence to and from the consulting and/or treating physicians, files, memoranda, handwritten notes, history and physical reports, medication/ prescription records, including any and all such items as may be stored in a computer database or otherwise in electronic form, relating to any examination, consultation, diagnosis or treatment pertaining to: Dates Requested: up to and including the present. Subject : MARY c. MARCONI 105 BRIGHTON DRIVE, CARLISLE, PA 17015 Social Security #: XXX-XX-1385 Date of Birth: 08-04-1931 R1.84S 133-H SU10-0783722 36716-LO7 ' ?`t J ..•( t r r '; ? J ?, . ? ?.` ? C•? t,?{ ?a?j??it L?' `' .. '. `? ??? ? 6 CERTIFICATE PREREQUISITE TO SERVICE OF A SUBPOENA PURSUANT TO RULE 4009.22 IN THE MATTER OF: COURT OF COMMON PLEAS DENISE L. KURR, REPRESENTATIVE OF THE TERM, ESTATE OF MARY C. MACONI CUMBERLAND -VS- CASE NO: 09-1600 HPOLY SPIRIT HEALTH SYSTEM, ET AL As a prerequisite to service of a subpoena for documents and things pursuant to Rule 4009.22 MCS on behalf of EVAN BLACK, ESQ. certifies that (1) A notice of intent to serve the subpoena with a copy of the subpoena attached thereto was mailed or delivered to each party at least twenty days prior to the date on which the subpoena is sought to be served, (2) A copy of the notice of intent, including the proposed subpoena, is attached to this certificate, (3) No objection to the subpoena has been received, and (4) The subpoena which will be served is identical to the subpoena which is attached to the notice of intent to serve the subpoena. DATE: 05/28/2009 R1.84S 133-H MCS on behalf of /S/ evan Ap ach, ejq EVAN BLACK, ESQ. Attorney for DEFENDANT DE11-0909721 36716-L08 OF q% COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND IN THE MATTER OF: DENISE L. KURR, REPRESENTATIVE OF THE ESTATE OF MARY C. MACONI -VS- COURT OF COMMON PLEAS TERM, CASE NO: 09-1600 HPOLY SPIRIT HEALTH SYSTEM, ET AL NOTICE OF INTENT TO SERVE A SUBPOENA TO PRODUCE DOCUMENTS AND THINGS FOR DISCOVERY PURSUANT TO RULE 4009.21 MASLAND ASSOCIATES, INC. MEDICAL RECORDS & BILLING TO: JOSEPH MELILLO, ESQ., PLAINTIFF COUNSEL MICHAEL D. PIPA, ESQ. THOMAS M. CHAIRS, ESQ. MCS on behalf of EVAN BLACK, ESQ. intends to serve a subpoena identical to the one that is attached to this notice. You have twenty (20) days from the date listed below in which to file of record and serve upon the undersigned an objection to the subpoena. If the twenty day notice period is waived or if no objection is made, then the subpoena may be served. Complete copies of any reproduced records may be ordered at your expense by completing the attached counsel card and returning same to MCS or by contacting our local MCS office. DATE: 05/06/2009 MCS on behalf of EVAN BLACK, ESQ. Attorney for DEFENDANT CC: EVAN BLACK, ESQ. _ JOSEPH MELILLO, ESQ. ANGINO & ROVNER 4503 N. FRONT ST. HARRISBURG, PA 17110 THE MCS GROUP INC. 1601 MARKET STREET #800 PHILADELPHIA, PA 19103 (215) 246-0900 R1.84S 133-H DE02-0510589 36716-COl COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND DENISE L. KURR, REPRESENTATIVE OF THE VS. HPOLY SPIRIT HEALTH SYSTEM, ET AL File No. 09-1600 SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009.22 TO: Custodian of Records for MASL.AND ASSOCIATE& IN C. (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: **** SEE ATTACHED RIDER **** at The MCq C= lnc_, 1601 Market Street3Suite 800 Phi adelpbia, EA 19103 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: ADDRESS: TELEPHONE: (215) 246-0900 SUPREME COURT ID #: ATTORNEY FOR: Defendant MAY'2 8 2M) Date: ?f y f ?r'1 Seal of the Court BY THE COURT: Prothonotary/Clerk, Civil Di ion Depu 36716-08 r EXPLANATION OF REQUIRED RECORDS TO: CUSTODIAN OF RECORDS FOR: MASLAND ASSOCIATES, INC. 220 WILSON STREET SUITE 109 CARLISLE, PA 17013 RE: 36716 MARY C. MARCONI Prior approval is required for fees in excess of $150.00 for hospitals, $100.00 for all other providers. Entire medical and billing file including but not limited to any and all records, correspondence to and from the consulting and/or treating physicians, files, memoranda, handwritten notes, history and physical reports, medication/ prescription records, including any and all such items as may be stored in a computer database or otherwise in electronic form, relating to any examination, consultation, diagnosis or treatment pertaining to: Dates Requested: up to and including the present. Subject : MARY c. MARCONI 105 BRIGHTON DRIVE, CARLISLE, PA 17015 Social Security #: XXX-XX-1385 Date of Birth: 08-04-1931 21.845 133-H SU10-0784986 36716-L08 ll? 2MJ' H-I PH 5 THOMAS, THOMAS & HAFER, LLP Evan Black, Esquire Attorney I.D. 17884 Richard S. Wade, Esquire Attorney I.D. 209843 305 North Front Street P.O. Box 999 Harrisburg, PA 17108 (717) 441-7051 Attorneys for Defendant Timothy A. Clark. M.D. DENISE L. KURR, PERSONAL REPRESENTATIVE OF THE ESTATE OF MARY MARCONI, Plaintiff vs. HOLY SPIRIT HEALTH SYSTEM d/b/a HOLY SPIRIT HOSPITAL; MARK A. OSEVALA, D.O.; AND TIMOTHY A. CLARK, M.D., Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA DOCKET NO. 09-1600 CIVIL ACTION -LAW MEDICAL MALPRACTICE JURY TRIAL DEMANDED ANSWER AND NEW MATTER OF DEFENDANT TIMOTHY A. CLARK, M.D. AND NOW, comes Defendant, Timothy A. Clark, M.D. (hereinafter "Answering Defendant"), by and through attorneys of record, Thomas, Thomas & Hafer, LLP, and files this Answer with New Matter to Plaintiffs Complaint and respectfully states and avers as follows: THE PARTIES 1. The allegations and averments contained in paragraph 1 are a conclusion of law to which no response is necessary. To the extent a response is required, upon information and belief, Answering Defendant admits the allegations contained in paragraph 1 of the Complaint. 2. Answering Defendant admits the allegations contained in paragraph 2 of the Complaint. 3. The allegations contained in paragraph 3 of Plaintiff s Complaint are directed to parties other than Answering Defendant. Accordingly, no response is required pursuant to the Pennsylvania Rules of Civil Procedure. 4. The allegations contained in paragraph 4 of Plaintiff s Complaint are directed to parties other than Answering Defendant. Accordingly, no response is required pursuant to the Pennsylvania Rules of Civil Procedure. The allegations and averments contained in paragraph 5 are admitted in part and denied in part. It is admitted that Answering Defendant, Timothy A. Clark, M.D. is a physician specializing in Internal Medicine/Pulmonary Medicine/Critical Care Medicine/Interventional Pulmonology/and Sleep Disorders. It is specifically denied that Answering Defendant was an employee, agent or ostensible agent of defendant Holy Spirit Hospital. 6-56. The allegations and averments contained in paragraphs 6-56 are admitted in part and denied in part. To the extent that the allegations and averments made in paragraphs 6-56 of the Complaint are substantiated in the pertinent medical records, it is admitted only that such information is recorded therein. To the extent that the allegations and averments in paragraphs 6-56 of the Complaint are not substantiated or are contradicted in the pertinent medical records, the allegations and averments are generally denied pursuant to Pa.R.C.P. 1029(e) because after 2 reasonable investigation, the Answering Defendant is without knowledge or information sufficient to form a belief as to the truth of the averments of the corresponding paragraph of the Complaint. Proof is demanded. COUNTI Denise L. Kurr, Personal Representative of the Estate of Mary Marconi, Deceased v. Mark A. Osevala, D.O. 57. Answering paragraph 57, Answering Defendant incorporates the above responses to paragraphs 1-56 as if set forth here and at length pursuant to Pa.R.C.P. 1019(g). 58. The allegations contained in paragraph 58, including all subparagraphs, of Plaintiff s Complaint are directed to parties other than Answering Defendant. Accordingly, no response is required pursuant to the Pennsylvania Rules of Civil Procedure. However, to the extent a response is deemed required by Answering Defendant, all allegations are denied pursuant to Pa.R.C.P. 1029(e) and denied as conclusions of law. All allegations are placed at issue and strict proof thereof is demanded at the time of trial. COUNT II Denise L. Kurr, Personal Representative of the Estate of Mary Marconi, Deceased v. Timothy A. Clark, M.D. 59. Answering paragraph 59, Answering Defendant incorporates the above responses to paragraphs 1-56 as if set forth here and at length pursuant to Pa.R.C.P. 1019(g). 60. The allegations and averments of liability and negligence as described in paragraph 60, including all subparagraphs, are a conclusion of law to which no response is necessary. To the extent a response is required, the allegations and averments contained in paragraph 60, including all subparagraphs, are generally denied pursuant to Pa.R.C.P. 1029(e). All allegations are placed at issue and strict proof thereof is demanded at the time of trial. It is further denied that Answering Defendant was at anytime negligent in any manner whatsoever or as alleged in paragraph 60, including all subparagraphs, of the Complaint. It is expressly averred that at all times relevant hereto, Answering Defendant, provided appropriate medical care and treatment to Mary Marconi and acted within the requisite standard of care at all times. COUNT III Denise L. Kurr, Personal Representative of the Estate of Mary Marconi, Deceased v. Holy Spirit Health System d/b/a Holy Spirit Hospital 61. Answering paragraph 61, Answering Defendant incorporates the above responses to paragraphs 1-56 as if set forth here and at length pursuant to Pa.R.C.P. 1019(g). 62. The allegations contained in paragraph 62, including all subparagraphs, of Plaintiff's Complaint are directed to parties other than Answering Defendant. Accordingly, no response is required pursuant to the Pennsylvania Rules of Civil Procedure. However, to the extent a response is deemed required by Answering Defendant, all allegations are denied pursuant to Pa.R.C.P. 1029(e) and denied as conclusions of law. All allegations are placed at issue and strict proof thereof is demanded at the time of trial. CLAIM I - SURVIVAL ACTION Denise L. Kurr, Personal Representative of the Estate of Mary Marconi, Deceased v. Holy Spirit Health System d/b/a Holy Spirit Hospital; Mark A. Osevala, D.O.; and Timothy A. Clark, M.D. 63. Answering paragraph 63, Answering Defendant incorporates the above responses to paragraphs 1-62 as if set forth here and at length pursuant to Pa.R.C.P. 1019(g). 64. The allegations and averments contained in paragraph 64 are a conclusion of law to which no response is necessary. To the extent a response is required, the allegations and averments contained in paragraph 64 are denied. 65. The allegations and averments contained in paragraph 65 are a conclusion of law to which no response is necessary. To the extent a response is required, the allegations and averments contained in paragraph 65 are denied. Further Answering paragraph 65, it is 4 expressly denied that Plaintiff suffered any damages or injuries, physical or otherwise, including death, as a result of the actions or inactions Answering Defendant. CLAIM II - WRONGFUL DEATH Denise L. Kurr, Personal Representative of the Estate of Mary Marconi, Deceased v. Holy Spirit Health System d/b/a Holy Spirit Hospital; Mark A. Osevala, D.O.; and Timothy A. Clark, M.D. 66. Answering paragraph 62, Answering Defendant incorporates the above responses to paragraphs 1-62 as if set forth here and at length pursuant to Pa.R.C.P. 1019(g). 64-73. The allegations and averments contained in paragraphs 64-73 are a conclusion of law to which no response is necessary. To the extent a response is required, the allegations and averments contained in paragraphs 64-73 are denied. Further Answering paragraph 64-73, it is expressly denied that Plaintiff suffered any damages or injuries, physical or otherwise, including death, as a result of the actions or inactions Answering Defendant. NEW MATTER By way of further response to the allegations in Plaintiff s Complaint, Answering Defendant hereby states and avers as follows: 74. Answering Defendant incorporates by reference Paragraphs 1 through 73 of this Answer as if set forth herein at length. 75. Plaintiff s Complaint fails to state a cause of action against Answering Defendant upon which relief can be granted. 76. Answering Defendant raise all affirmative defenses of the Healthcare Services Malpractice Act, 40 P. S. § 1301.101, et seq. 77. Some or all of Plaintiff s claims may be time barred by the expiration of the applicable statute of limitations. 78. For the purposes of preserving the same and subject to discovery, all or some of Plaintiff s claims may be barred pursuant to the affirmative defenses of relief, offset, or accord in satisfaction. 79. At no time relevant hereto was any natural person, partnership, corporation or legal entity identified in the Complaint acting or serving as an agent, servant, employee or otherwise for or on behalf of Answering Defendant. 80. In the event it is determined that Answering Defendant was negligent with regard to any of the allegations contained in and with respect to Plaintiff s Complaint, said allegations being specifically denied, discovery may establish that said negligence was superseded by the intervening negligent acts of other persons, parties, and/or organizations other than Answering Defendant, and over whom said Answering Defendant had no control, right or responsibility, and therefore, Answering Defendant is not liable. 81. To the extent that the evidence may show that other persons, partnerships, corporations, or other legal entities caused or contributed to the injuries or the pre-existing condition of the Plaintiff, than the conduct of the Answering Defendant was not the legal cause of such conditions or injuries. 82. Any acts or omissions of Answering Defendant alleged to constitute negligence are not substantial factors contributing to the injuries and damages alleged in Plaintiffs Complaint. 83. If any injuries and damages as alleged in Plaintiffs Complaint, were caused in whole or in part by persons or entities over whom Answering Defendant had no duty to supervise or control, then Answering Defendant is not liable. 6 84. Plaintiffs injuries and losses, if any, were not caused by the conduct or negligence of Answering Defendant, but rather were caused by pre-existing medical conditions and causes beyond the control of Answering Defendant and therefore, Plaintiff may not recover against Answering Defendant. 85. Insofar as the Answering Defendant elected a treatment modality which was recognized as proper, but may differ from another appropriate modality, the Answering Defendant raises a "two schools of thought" defense. 86. The outcome of was a known risk associated with the medical procedure performed. Ms. Marconi was fully informed of the benefits, risks, and alternatives to the proposed procedure. 87. Pennsylvania Rule of Civil Procedure 238 is unconstitutional under Pennsylvania law and/or the United States Constitution. 88. If there is a judicial determination that Pa.R.C.P. 238 is constitutional, then any liability for interest imposed by said rule should be suspended during any such period of time that Plaintiff. (a) failed to convey to Answering Defendant a reasonable settlement figure; (b) delayed in responding to Interrogatories and Request for Production of Documents; (c) delayed in producing witnesses for deposition; (d) otherwise delayed in responding to discovery requests; and (e) otherwise delayed in this litigation. 7 89. Plaintiff s claims, the existence of which are still specifically denied by Answering Defendant, may be reduced and/or limited by any collateral source of compensation and/or benefit. 90. Answering Defendant raises all affirmative defenses of the Medical Care Availability and Reduction of Error (Mcare) Act a/k/a Act 13 of 2002 as a limit/bar to Plaintiff s claims. WHEREFORE, Answering Defendant, respectfully demand judgment in their favor and against Plaintiff without cost to them. Respectfully submitted, Thomas, Thomas & Hafer, LLP Date: Oz -©I By: F,?6an Black, Esquire /Attorney I.D. 17884 Richard S. Wade, Esquire Attorney I.D. 209843 Thomas, Thomas and Hafer, LLP 305 North Front Street P.O. Box 999 Harrisburg, PA 17108 (717) 441-7051 Attorneys for Defendant Timothy A. Clark, M.D. 8 JUN-11-2009 THU 0209 PM HSH GI SERVICES FAX No. 711912181 P.002 VERIFICATION 1, TIMOTHY A. CLARK, M.D., have read the foregoing document which has been drafted by my counsel. The factual statements contained therein are known by me and are true and correct to the best of my knowledge, information and belief. This statement and verification is made subject to the penalties of 18 Pa.C.S.A. § 4904 relating to unsworn falsification to authorities, which provides that, if I knowingly make false averments, I may be subject to criminal penalties. Timot lark, M.D. DATE: jl tj f7? CERTIFICATE OF SERVICE I, Richard S. Wade, Esq., of the law firm of Thomas, Thomas & Hafer, LLP, hereby certify that a true and correct copy of the foregoing document was sent to the following counsel of record by placing a copy of same by First Class in the United States mail, postage prepaid, at Harrisburg, Pennsylvania addressed as follows: Joseph M. Melillo, Esquire Angino & Rovner, P.C. 4503 North Front Street Harrisburg, PA 17110-1708 Counsel for Plaintiff Thomas Chairs, Esquire Dickie McCamey & Chilcote, P.C. 1200 Camp Hill Bypass, Suite 205 Camp Hill, PA 17011 Counsel for Holy Spirit Health System d/b%a Holy Spirit Hospital Michael Pipa, Esquire Karen E. Minehan, Esquire Stevens & Lee 17 North Second Street 16th Floor Harrisburg, PA 17101 Counsel for Mark Osevala, M.D. and Cardiovascular Surgical Institute, P. C. Date: /hard Wade, Esq. 9 2L9 10, J,1 15 ; ii I : 17 CERTIFICATE PREREQUISITE TO SERVICE OF A SUBPOENA PURSUANT TO RULE 4009.22 IN THE MATTER OF: DENISE L. KURR, REPRESENTATIVE OF THE ESTATE OF MARY C. MACONI -VS- HOLY SPIRIT HEALTH SYSTEM, ET AL COURT OF COMMON PLEAS TERM, CUMBERLAND CASE NO: 09-1600 As a prerequisite to service of a subpoena for documents and things pursuant to Rule 4009.22 MCS on behalf of EVAN BLACK, ES certifies that (1) A notice of intent to serve the subpoena with a copy of the subpoena attached thereto was mailed or delivered to each party at least twenty days prior to the date on which the subpoena is sought to be served, (2) A copy of the notice of intent, including the proposed subpoena, is attached to this certificate, (3) No objection to the subpoena has been received, and (4) The subpoena which will be served is identical to the subpoena which is attached to the notice of intent to serve the subpoena. DATE: 06/15/2009 MCS on behalf of /S/ Cvan Mach, Crick. EVAN BLACK, ESQ. Attorney for DEFENDANT R1.85S 133-H DE11-0917511 36716-L09 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND IN THE MATTER OF: COURT OF COMMON PLEAS DENISE L. KURR, REPRESENTATIVE OF THE TERM, ESTATE OF MARY C. MACONI -VS- CASE NO: 09-1600 HOLY SPIRIT HEALTH SYSTEM, ET AL NOTICE OF INTENT TO SERVE A SUBPOENA TO PRODUCE DOCUMENTS AND THINGS FOR DISCOVERY PURSUANT TO RULE 4009.21 CARLISLE CARDIOLOGY, INC. MEDICAL RECORDS CAPITAL AREA CARDIOVASCULAR MEDICAL RECORDS HEALTHSOUTH HOSP/SPEC. SERVICE MEDICAL RECORDS LOWER ALLEN TOWNSHIP EMS EMS RECORDS KEVIN CLAWSON, M.D. MEDICAL RECORDS SMART MED PRESCRIPTION/PHARMACEUTICAL RECORDS TO: JOSEPH MELILLO, ESQ., PLAINTIFF COUNSEL MICHAEL D. PIPA, ESQ. THOMAS M. CHAIRS, ESQ. MCS on behalf of EVAN BLACK, ESQ. intends to serve a subpoena identical to the one that is attached to this notice. You have twenty (20) days from the date listed below in which to file of record and serve upon the undersigned an objection to the subpoena. If the twenty day notice period is waived or if no objection is made, then the subpoena may be served. Complete copies of any reproduced records may be ordered at your expense by completing the attached counsel card and returning same to MCS or by contacting our local MCS office. DATE: 05/22/2009 MCS on behalf of EVAN BLACK, ESQ. Attorney for DEFENDANT CC: EVAN BLACK, ESQ. - JOSEPH MELILLO, ESQ. ANGINO & ROVNER 4503 N. FRONT ST. HARRISBURG, PA 17110 THE MCS GROUP INC. 1601 MARKET STREET #800 PHILADELPHIA, PA 19103 (215) 246-0900 R1.85S 133-H DF.02-0516651 36716-COl COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND DENISE L. KURR, REPRESENTATIVE OF THE File No. 09-1600 vs. HOLY SPIRIT HEALTH SYSTEM, ET AL : SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009.22 TO: Custodian of Records for CARLISLE CARDIOLOGY, INC. (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: **** SEE ATTACHED RYDE.R **** at The MCS Groin, Ine.' 1601 Market St=t, Suite 800. Phila"hia. PA 19103 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: EVAN ADDRESS: 305 N. TELEPHONE: (215) 246-0900 SUPREME COURT ID #: ATTORNEY FOR: - Defendant JUN 15 2009 Date: y e? ZdD?1 Seal of the Court --r..., 36716-09 EXPLANATION OF REQUIRED RECORDS TO: CUSTODIAN OF RECORDS FOR: CARLISLE CARDIOLOGY, INC. 850 WALNUT BOTTOM ROAD #304 CARLISLE, PA 17013 RE: 36716 MARY C. MARCONI Prior approval is required for fees in excess of $150.00 for hospitals, $100.00 for all other providers. Entire medical file, including but not limited to any and all records, correspondence to and from the consulting and treating physicians, files, memoranda, handwritten notes, history and physical reports, medication/ prescription records, including any and all such items as may be stored in a computer database or otherwise in electronic form, relating to any examination, diagnosis or treatment pertaining to: Dates Requested: up to and including the present. Subject : MARY C. MARCONI 105 BRIGHTON DRIVE, CARLISLE, PA 17015 Social Security #: XXX-XX-1385 Date of Birth: 08-04-1931 R1.85S 133-H SU10-0786996 36716-LO9 CERTIFICATE PREREQUISITE TO SERVICE OF A SUBPOENA PURSUANT TO RULE 4009.22 IN THE MATTER OF: COURT OF COMMON PLEAS DENISE L. KURR, REPRESENTATIVE OF THE TERM, ESTATE OF MARY C. MACONI CUMBERLAND -VS- CASE NO: 09-1600 HOLY SPIRIT HEALTH SYSTEM, ET AL As a prerequisite to service of a subpoena for documents and things pursuant to Rule 4009.22 MCS on behalf of EVAN BLACK, ESQ. certifies that (1) A notice of intent to serve the subpoena with a copy of the subpoena attached thereto was mailed or delivered to each party at least twenty days prior to the date on which the subpoena is sought to be served, (2) A copy of the notice of intent, including the proposed subpoena, is attached to this certificate, (3) No objection to the subpoena has been received, and (4) The subpoena which will be served is identical to the subpoena which is attached to the notice of intent to serve the subpoena. DATE: 06/15/2009 MCS on behalf of /S/ evan each, ej%. EVAN BLACK, ESQ. Attorney for DEFENDANT R1.85S 133-H DE11-0917512 36716-L10 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND DENISE L. KURR, REPRESENTATIVE OF THE VS. HOLY SPIRIT HEALTH SYSTEM, ET AL : File No. 09-1600 SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009.22 TO: Custodian of Records for CAPITAL AREA CARDIOVASCULAR (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: **** SEE ATTACHED RIDER **** at The MCS Gm=- Ine., 1601 Market Street, Suite 800, P ilad lphia, PA 19103 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: EVAN BLACK. ESQ. ADDRESS: 305 N. FRONTSTREET PO BOX 999 HARRISBURG. PA 17108 TELEPHONE: (215) 246-0900 SUPREME COURT ID #: ATTORNEY FOR: Defendant rJUN 15 2009 Date: ?`,.?????9 Seal of the Court BY THE OURT: thonotary/Clerk, Civil Divisi Deputy 36716-10 EXPLANATION OF REQUIRED RECORDS TO: CUSTODIAN OF RECORDS FOR: CAPITAL AREA CARDIOVASCULAR SURGICAL INSTITUTE 850 WALNUT BOTTOM RD CARLISLE. PA 17013 RE: 36716 MARY C. MARCONI Prior approval is required for fees in excess of $150.00 for hospitals, $100.00 for all other providers. Entire medical file, including but not limited to any and all records, correspondence to and from the consulting and treating physicians, files, memoranda, handwritten notes, history and physical reports, medication/ prescription records, including any and all such items as may be stored in a computer database or otherwise in electronic form, relating to any examination, diagnosis or treatment pertaining to: Dates Requested: up to and including the present. Subject : MARY C. MARCONI 105 BRIGHTON DRIVE, CARLISLE, PA 17015 Social Security #: XXX-XX-1385 Date of Birth: 08-04-1931 R1.85S 133-H SU10-0786998 36716-L10 CERTIFICATE PREREQUISITE TO SERVICE OF A SUBPOENA PURSUANT TO RULE 4009.22 IN THE MATTER OF: DENISE L. KURR, REPRESENTATIVE OF THE ESTATE OF MARY C. MACONI -VS- HOLY SPIRIT HEALTH SYSTEM, ET AL COURT OF COMMON PLEAS TERM, CUMBERLAND CASE NO: 09-1600 As a prerequisite to service of a subpoena for documents and things pursuant to Rule 4009.22 MCS on behalf of EVAN BLACK, ESQ. certifies that (1) A notice of intent to serve the subpoena with a copy of the subpoena attached thereto was mailed or delivered to each party at least twenty days prior to the date on which the subpoena is sought to be served, (2) A copy of the notice of intent, including the proposed subpoena, is attached to this certificate, (3) No objection to the subpoena has been received, and (4) The subpoena which will be served is identical to the subpoena which is attached to the notice of intent to serve the subpoena. DATE: 06/15/2009 MCS on behalf of /S/ evan 12pach, eii. EVAN BLACK, ESQ. Attorney for DEFENDANT R1.85S 133-H DE11-0917517 36716-Lll COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND DENISE L. KURR, REPRESENTATIVE OF THE VS. HOLY SPIRIT HEALTH SYSTEM, ET AL : File No. 09-1600 SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009.22 TO: Custodian of Records for _ HF.ALTHSO JTH HO P/ P ... SERVICE (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: **** SEE ATTACHED RIDFR **** at _ The MCS Group, Ina, 1601 M rk Street, Suite 800 Philadelphia- PA 19103 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: EVAN BLA ADDRESS: 305 N. FRO] TELEPHONE: 12151246-0900 SUPREME COURT ID #: ATTORNEY FOR: Defendant JUN 15 2009 Date: y .2 D. 2C ' Seal of the Court 36716-11 EXPLANATION OF REQUIRED RECORDS TO: CUSTODIAN OF RECORDS FOR: HEALTHSOUTH HOSP/SPEC. SERVICE 4950 WILSON LANE MECHANICSBURG, PA 17055 RE: 36716 MARY C. MARCONI Prior approval is required for fees in excess of $150.00 for hospitals, $100.00 for all other providers. Entire medical file, including but not limited to any and all records, correspondence to and from the consulting and treating physicians, files, memoranda, handwritten notes, history and physical reports, medication/ prescription records, including any and all such items as may be stored in a computer database or otherwise in electronic form, relating to any examination, diagnosis or treatment pertaining to: Dates Requested: up to and including the present. Subject : MARY c. MARCONI 105 BRIGHTON DRIVE, CARLISLE, PA 17015 Social Security #: XXX-XX-1385 Date of Birth: 08-04-1931 R1.85S 133-H SU10-0787000 36716-Lll CERTIFICATE PREREQUISITE TO SERVICE OF A SUBPOENA PURSUANT TO RULE 4009.22 IN THE MATTER OF: COURT OF COMMON PLEAS DENISE L. KURR, REPRESENTATIVE OF THE TERM, ESTATE OF MARY C. MACONI CUMBERLAND -VS- CASE NO: 09-1600 HOLY SPIRIT HEALTH SYSTEM, ET AL As a prerequisite to service of a subpoena for documents and things pursuant to Rule 4009.22 MCS on behalf of EVAN BLACK, ES certifies that (1) A notice of intent to serve the subpoena with a copy of the subpoena attached thereto was mailed or delivered to each party at least twenty days prior to the date on which the subpoena is sought to be served, (2) A copy of the notice of intent, including the proposed subpoena, is attached to this certificate, (3) No objection to the subpoena has been received, and (4) The subpoena which will be served is identical to the subpoena which is attached to the notice of intent to serve the subpoena. DATE: 06/15/2009 MCS on behalf of /S/ elan p..SCach, ej%. EVAN BLACK, ESQ. Attorney for DEFENDANT R1.85S 133-H DE11-0917518 36716-L12 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND DENISE L. KURR, REPRESENTATIVE OF THE VS. File No. 09-1600 HOLY SPIRIT HEALTH SYSTEM, ET AL : SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009.22 TO: Custodian of Records for__ i,OWER i. , .N TOWN HIP .M (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: **** SEE ATTACHED MER **** at The M CS 0roIW- Inc", 1601 Market Street, Suite 800, Philadelphia _ PA 19103 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: _EVAN BLACK O ADDRESS: 305 N. FRONT STREET PO BOX 999 HARRISBURG, PA 17108 TELEPHONE: (15) 246-0900 SUPREME COURT ID #: ATTORNEY FOR: Defendant FJUN 15 2009 Date: l l ? 4l Seal of the Court BY THE C URT: Prothonotary/Clerk, Civi ivisi z9a'__0 -P eputy 36716-12 EXPLANATION OF REQUIRED RECORDS TO: CUSTODIAN OF RECORDS FOR: LOWER ALLEN TOWNSHIP EMS 1993 HUMMEL AVE. CAMP HILL, PA 17011 RE: 36716 MARY C. MARCONI Prior approval is required for fees in excess of $150.00 for hospitals, $100.00 for all other providers. ANY & ALL EMS RECORDS Dates Requested: up to and including the present. Subject : MARY C. MARCONI 105 BRIGHTON DRIVE, CARLISLE, PA 17015 Social Security #: XXX-XX-1385 Date of Birth: 08-04-1931 R1.85S 133-H SU10-0787002 36716-L12 CERTIFICATE PREREQUISITE TO SERVICE OF A SUBPOENA PURSUANT TO RULE 4009.22 IN THE MATTER OF: DENISE L. KURR, REPRESENTATIVE OF THE ESTATE OF MARY C. MACONI -VS- HOLY SPIRIT HEALTH SYSTEM, ET AL COURT OF COMMON PLEAS TERM, CUMBERLAND CASE NO: 09-1600 As a prerequisite to service of a subpoena for documents and things pursuant to Rule 4009.22 MCS on behalf of EVAN BLACK, ESQ. certifies that (1) A notice of intent to serve the subpoena with a copy of the subpoena attached thereto was mailed or delivered to each party at least twenty days prior to the date on which the subpoena is sought to be served, (2) A copy of the notice of intent, including the proposed subpoena, is attached to this certificate, (3) No objection to the subpoena has been received, and (4) The subpoena which will be served is identical to the subpoena which is attached to the notice of intent to serve the subpoena. DATE: 06/15/2009 MCS on behalf of /S/ wart Aach, ej%. EVAN BLACK, ESQ. Attorney for DEFENDANT R1.85S 133-H DE11-0917523 36716-L13 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND DENISE L. KURR, REPRESENTATIVE OF THE vs. File No. 09-1600 HOLY SPIRIT HEALTH SYSTEM, ET AL : SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009.22 TO: Custodian of Records for_ KEVIN CLAWSON, M.D. (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: **** SF.F ATTACHED MER **** at The M Qroiy? Inc 1601 Market Street, Suite 800, Pbilade]1L, PA 19103 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: EVAN BLACK. E ADDRESS: 305 N_ FRONT ST TELEPHONE: (215) 246-0900 SUPREME COURT ID #: ATTORNEY FOR: Defendant 'JUN 15 2009 Date: Seal of the Court BY THE C T: r. ro onotary/Clerk, Civil Division eputy 36716-13 EXPLANATION OF REQUIRED RECORDS TO: CUSTODIAN OF RECORDS FOR: KEVIN CLAWSON, M.D. 220 WILSON STREET #104 CARLISLE. PA 17103 RE: 36716 MARY C. MARCONI Prior approval is required for fees in excess of $150.00 for hospitals, $100.00 for all other providers. Entire medical file, including but not limited to any and all records, correspondence to and from the consulting and treating physicians, files, memoranda, handwritten notes, history and physical reports, medication/ prescription records, including any and all such items as may be stored in a computer database or otherwise in electronic form, relating to any examination, diagnosis or treatment pertaining to: Dates Requested: up to and including the present. Subject : MARY C. MARCONI 105 BRIGHTON DRIVE, CARLISLE, PA 17015 Social Security #: XXX-XX-1385 Date of Birth: 08-04-1931 R1.85S 133-H SU10-0787004 36716-L13 CERTIFICATE PREREQUISITE TO SERVICE OF A SUBPOENA PURSUANT TO RULE 4009.22 IN THE MATTER OF: COURT OF COMMON PLEAS DENISE L. KURR, REPRESENTATIVE OF THE TERM, ESTATE OF MARY C. MACONI CUMBERLAND -VS- CASE NO: 09-1600 HOLY SPIRIT HEALTH SYSTEM, ET AL As a prerequisite to service of a subpoena for documents and things pursuant to Rule 4009.22 MCS on behalf of EVAN BLACK, ESQ. certifies that (1) A notice of intent to serve the subpoena with a copy of the subpoena attached thereto was mailed or delivered to each party at least twenty days prior to the date on which the subpoena is sought to be served, (2) A copy of the notice of intent, including the proposed subpoena, is attached to this certificate, (3) No objection to the subpoena has been received, and (4) The subpoena which will be served is identical to the subpoena which is attached to the notice of intent to serve the subpoena. DATE: 06/15/2009 MCS on behalf of /S/ elan gpach, ejg. EVAN BLACK, ESQ. Attorney for DEFENDANT R1.85S 133-H DE11-0917525 36716-L14 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND DENISE L. KURR, REPRESENTATIVE OF THE VS. File No. 09-1600 HOLY SPIRIT HEALTH SYSTEM, ET AL : SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009.22 TO: Custodian of Records for SMART MRD (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:_ **** SF.. ATTACHED RIDER **** at The MCS -Q= Inc 1601 Mark tr , Suite 800, Philadelphia- PA 19103 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: EVAN BLACK. ES ADDRESS: 305 N. FRONT CTF TELEPHONE: (215) 246-0900 SUPREME COURT ID #: ATTORNEY FOR: Defendant `JUN 15 2009 Date: _- ------------ Seal of the Court BY THE URT: roonotary/Clerk, Civil Divisio ?? Deputy 36716-14 EXPLANATION OF REQUIRED RECORDS TO: CUSTODIAN OF RECORDS FOR: SMART MED 1422 TRIMBLE RD. CARLISLE. PA 17103 RE: 36716 MARY C. MARCONI Prior approval is required for fees in excess of $150.00 for hospitals, $100.00 for all other providers. Entire prescription and/or pharmaceutical file, including but not limited to any and all records, reports, correspondence, memoranda, complete history and payment records, including any and all such items as may be stored in a computer database or otherwise in electronic form, pertaining to: Dates Requested: up to and including the present. subject : MARY c. MARCONI 105 BRIGHTON DRIVE, CARLISLE, PA 17015 Social Security #: XXX-XX-1385 Date of Birth: 08-04-1931 R1.85s 133-H SU10-0787006 36716-L14 FILET'-.? C-^ Tic F, y?,nY 2,"J9 Jv' l 18 P1`1 3: 11 iy 1 , y LJl ?ry V h ?+ 4 ?' y`U11 PENi 0\ LVANIA ANG[NO & ROVNER, P.C. Richard A.Sadlock Attorney ID# : 47284 4503 North Front Street Harrisburg, PA 17110-1708 (717) 238-6791 FAX (717) 238-5610 Attorneys for Plaintiff(s) E-mail: rsadlock@angino-rovner.com DENISE L. KURR, PERSONAL REPRESENTATIVE OF THE ESTATE OF MARY MARCONI, Plaintiff IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PA NO. 09-1600 V. CIVIL ACTION - LAW MEDICAL MALPRACTICE HOLY SPIRIT HEALTH SYSTEM d/b/a HOLY SPIRIT HOSPITAL; MARK A. JURY TRIAL DEMANDED OSEVALA, D.O.; and TIMOTHY A. CLARK, M.D., Defendant PLAINTIFF'S REPLY TO DEFENDANTS CLARK AND CENTRAL PENNSYLVANIA PULMONARY ASSOCIATES' REQUEST FOR ADMISSIONS AND NOW comes Denise L. Kurt, Personal Representative of the Estate of Mary Marconi, Plaintiff, by and through her attorneys, Angino & Rovner, P.C., by Richard A. Sadlock, Esquire, and replies to Defendants Clark and Central Pennsylvania Pulmonary Associates' Request for Admissions as follows: 449274 1. Admitted in part, denied in part. It is admitted that Plaintiff is not asserting a claim for lost wages. However, claims may be asserted for medical bills and medical liens as well as for future economic losses such as loss of social security or pension benefits. To be supplemented as appropriate. 2. See number 1 herein. 3. Admitted at the present time. However, Plaintiff reserves the right to supplement or amend the instant request upon the completion of discovery. Respectfully submitted, ANGINPO1rROVNUR, P.C. Sa?2288 , Esquire A I N 1 450 . ront Street Harrisburg, PA 17110 (717) 238-6791 rsadlock@angino-rovner.com Counsel for Plaintiff 449274 COMMONWEALTH OF PENNSYLVANIA: COUNTY OF DAUPHIN SS. AFFIDAVIT I, RICHARD A. SADLOCK, ESQUIRE, being duly sworn according to law, deposes and states that I am counsel for Plaintiff, that I am authorized to make this Affidavit on behalf of said Plaintiff, and the facts set forth in the foregoing Reply to Request for Admissions, are true and correct to the best of my knowledge, information, and belief. SADLOCK, ESQUIRE Sworn to and subscribed Y before me this ? ' day of , 2010. Notary Pu is My Commission Expires: cCOMMONWEALTH OF PENNSYLVANIA NOTARIAL SEAL SUSAN HEPP, Notary Public Susquehanna Twp., Dauphin County My commission Expires May 6, 2014 449274 CERTIFICATE OF SERVICE day of September 2010, I, Michelle M. Milojevich, an AND NOW, this qp- employee of the law firm of Angino & Rovner, P.C., hereby certify that a true and correct copy of PLAINTIFF'S REPLY TO DEFENDANTS CLARK AND CENTRAL PENNSYLVANIA PULMONARY ASSOCIATES' REQUEST FOR ADMISSIONS was sent to the following counsel of record by placing same in the first class, United States mail, postage prepaid, at Harrisburg, Pennsylvania, addressed as follows: Evan Black, Esquire Thomas, Thomas & Hafer, LLP 305 North Front Street Harrisburg, PA 17101 Defendant Timothy A. Clark, M. D. Thomas M. Chairs, Esquire Dickie, McCamey & Chilcote, P.C. 1200 Camp Hill Bypass, Suite 205 Camp Hill, PA 17011 Defendant Holy Spirit Health System d1bla Holy Spirit Hospital Michael D. Pipa, Esquire Karen E. Minehan, Esquire Stevens & Lee 17 North Second Street, 16th Floor Harrisburg, PA 17101 Defendant Mark Osevala, D. O. . Michelle M. Milojevic h* 449274 -v 1 '855812 DICIQE, MCCAMEY & CHILCOTE, P.C. ATTORNEY FOR DEFENDANT BY: Thomas M. Chairs, Esquire HOLY SPIRIT HEALTH SYSTEM DB/A ATTORNEY I.D. NO. 78565 HOLY SPIRIT HOSPITAL Plaza 21, Suite 302 425 North 21st Street Camp Hill, PA 17011 717-731-4800 (Tele) 888-811-7144 (Fax) DENISE L. KUM PERSONAL IN THE COURT OF COMMON PLEAS REPRESENTATIVE OF THE ESTATE OF OF CUMBERLAND COUNTY, MARY MARCONI, PENNSYLVANIA Plaintiff, N0:"0'9-1600 & 09-2181 V. HOLY SPIRIT HEALTH SYSTEM DB/A HOLY SPIRIT HOSPITAL, MARK A. OSEVALA, D.O. AND TIMOTHY A. CLARK, M.D., Defendants MEDICAL MALPRACTICE ACTION JURY TRIAL DEMANDED HOLY SPIRIT HEALTH SYSTEM DB/A HOLY SPIRIT HOSPITAL TO THE PROTHONOTARY: Please direct all future Notices and correspondence to the following address and the undersigned counsel. Dickie, McCamey & Chilcote, P.C. r? rr) Plaza 21, Suite 302 425 N. 21" Street F ,'1 Camp Hill, PA 17011 _?. D k Respectfully submitted, DICKIE, MCCAMEY & CHILCOTE, P.C. Date: February 9, 2011 By: Tho Chairs-, Esquire Supreme Court I.D. #78565 Aaron S. Jayman, Esquire Supreme Court I. D. #85651 425 N. 21S` Street, Suite 302 Camp Hill, PA 17011-3700 (717) 731-4800 (888) 811-7144 Attorney for Defendants, Holy Spirit Health System t/d/b/a Holy Spirit Hospital 2 CERTIFICATE OF SERVICE AND NOW, February 9, 2011, I, Thomas M. Chairs, Esquire, hereby certify that I did serve a true and correct copy of the foregoing upon all counsel of record by depositing, or causing to be deposited, same in the U.S. mail, postage prepaid, at Camp Hill, Pennsylvania, addressed as follows: By First-Class Mail: Richard A. Sadlock, Esquire ANGINO & ROVNER, P.C. 4503 North Front Street Harrisburg, PA 17110 (Counsel for Plaintiff) Karen E. Minehan, Esquire Michael D. Pipa, Esquire STEVENS & LEE, P.C. 17 North Second Street 16th Floor Harrisburg, PA 17101 (Counsel for Defendant, Mark A. Osevela, D.O. and Capital Area Cardiovascular Surgical Institute, P.C.) Evan Black, Esquire THOMAS, THOMAS & HAFER, LLP P.O. Box 999 Harrisburg, PA 17108 (Counsel for Timothy A. Clark, M.D. & Central Pennsylvania Pulmonary Associates, LLC) Thom M. Chairs, Esquire DICKIE, MCCAMEY & CHILCOTE, P.C. ATTORNEY FOR DEFENDANT BY: Thomas M. Chairs, Esquire HOLY SPIRIT HEALTH SYSTEM DB/A ATTORNEY I.D. NO. 78565 HOLY SPIRIT HOSPITAL Plaza 21, Suite 302 425 North 21st Street Camp Hill, PA 17011 717-7314800 (Tele) 888-811-7144 ax DENISE L. KURR, PERSONAL IN THE COURT OF COMMON PLEAS REPRESENTATIVE OF THE ESTATE OF OF CUMBERLAND COUNTY c:. MARY MARCONI, PENNSYLVANIA C= Plaintiff ? r OW C- g; NO. 09-1600 & 09-2181 x r V. D C Cf MEDICAL MALPRACTICE A ON =? HOLY SPIRIT HEALTH SYSTEM D/B/A E ° x HOLY SPIRIT HOSPITAL, MARK A. Dc °M OSEVALA, D.O. AND TIMOTHY A. 4 rs ' CLARK, M.D., Defendants JURY TRIAL DEMANDED MOTION FOR SUMMARY JUDGMENT FILED AND NOW, comes Defendant, Holy Spirit Health System, Inc. d/b/a Holy Spirit Hospital (hereinafter referred to as "Holy Spirit Hospital"), by and through its attorneys, Dickie, McCamey & Chilcote, P.C., and files this Motion for Summary Judgment and in support thereof avers as follows: 1. Plaintiff initiated this medical professional liability action with the filing of a Complaint on or about May 6, 2009. See, Exhibit "A." 2. Discovery in this case is closed. 3. Plaintiff's expertreports were served on or about June 10, 2011. 4. The deadline for the production of expert reports by Plaintiff has passed. 5. It is the position of the Holy Spirit Hospital that the evidence adduced by Plaintiff is insufficient to make out a claim for corporate negligence against the Holy Spirit Hospital. 6. Plaintiff's Complaint charges the Holy Spirit Hospital with corporate negligence for care and treatment surrounding Mary Marconi's admission to the Holy Spirit Hospital beginning on April 2, 2007. 7. The expert reports produced by the Plaintiff are authored by Christian T. Campos, M.D. and Joseph M. Darby, M.D. The expert reports of Drs. Campos and Darby are attached hereto as Exhibits "B." and "C". 8. The evidence adduced by the Plaintiff in support if her claim of corporate negligence against the Holy Spirit Hospital is insufficient as a matter of law. 9. The sole claim against the Holy Spirit Hospital appears at Count III of Plaintiff's Complaint. 10. Count III of Plaintiff's Complaint alleges corporate negligence against the Holy Spirit Hospital. 11. The duties a hospital owes directly to its patients under a theory of corporate negligence are: (1) a duty to use reasonable care in the maintenance of safe and adequate facilities and equipment; (2) A duty to select and retain only competent physicians; (3) A duty to oversee all persons who practice medicine within the hospital's walls as to the patient's care; and (4) A duty to formulate, adopt and enforce adequate rules and policies to ensure quality care for its patients. Thompson v. Nason Hospital, 591 A.2d 703 (Pa. 1991). 12. At best, the expert reports of Plaintiff's experts, Dr. Campos and Dr. Darby, make out allegations of medical negligence against Dr. Osevala. Specifically, the expert reports of Dr. Campos in relevant part read as follows: "This delay in the provision of definitive surgical care, and with a reasonable degree of medical certainty, falls below the acceptable standards of care that applied to the care provided to Mary C. Marconi by Mark A. Osevala, D.O., in March and April of 2007". See, Exhibit "B." 13. In addition, the expert report produced by Dr. Darby in relevant part reads as follows: "As the operating surgeon responsible for the early recognition and treatment of post-surgical complications, Dr. Osevala breeched (sic) the standard of care in failing to recognize that a sternal wound infection was present despite the clinical evidence and the learned opinions of consultant physicians. Furthermore, Dr. Osevala breeched (sic) the standard of care in recommending in a timely fashion, that high doses of corticosteroids be rapidly tapered. Finality, despite his capability of performing debridement of the surgical wound, Dr. Osevala breeched (sic) the standard of care and his duty to the patient in failing to perform or ensuring that surgical debridement of the wound infection was performed in a timely manner. Surgical debridement was not performed in a timely manner. Had Dr. Osevala recognized that surgical wound infection was present and surgical debridement performed in a timely manner, more likely than not, the chain of events culminating in her death would not have occurred." See, Exhibit "C." 14. As set forth above, the Plaintiff's experts make allegations of negligence against Dr. Osevala only. 15. There are no breaches in the standard of care identified by Plaintiff's experts against the Holy Spirit Hospital. 16. The Plaintiff's experts specifically fail to identify any issues with respect to credentialing, policies and procedures and/or any corporate issues at the Holy Spirit Hospital to support a claim of corporate negligence in this case. 17. To the contrary, the Plaintiff's expert reports only set forth breaches in the standard of care by Dr. Osevala. 18. In the absence of expert testimony to support these allegations, the Plaintiff cannot meet the burden of proof at trial with respect to her claim of corporate negligence. 19. The Holy Spirit- Hospital respectfully requests the entry of judgment in its favor and against the Plaintiff. WHEREFORE, the Holy Spirit Hospital respectfully request that this Honorable Court grant its Motion for Summary Judgment and enter judgment in favor of the Holy Spirit Hospital. Respectfully submitted, DICKIE, MCCAMEY & CHI COTE, P.C. Date: June 28, 2011 By: Tho s . Chairs, Esquire Supreme Court I.D. #78565 Aaron S. Jayman, Esquire Supreme Court I. D. #85651 425 N. 21" Street, Suite 302 Camp Hill, PA 17011-3700 (717) 731-4800 Attorney for Defendants, HOLY SPIRIT HEALTH SYSTEM DIBIA HOLY SPIRIT HOSPITAL EXHIBIT "A" SI& ANGINO & ROVNER, P.C. Joseph M. Melillo Attorney 1D#: 26211 4503 North Front Street Harrisburg, PA 17110-1708 (717) 238-6791 FAX (717) 238-5610 Attorneys for Plaintiff(s) E-mail. jmelillo@ansno-rovner.com DENISE L. KURR, PERSONAL REPRESENTATIVE OF THE ESTATE OF MARY MARCONI, Plaintiff v. HOLY SPIRIT HEALTH SYSTEM d/b/a HOLY SPIRIT HOSPITAL; MARK A. OSEVALA, D.O.; CAPITAL AREA CARDIOVASCULAR SURGICAL INSTITUTE, P.C.; TIMOTHY A. CLARK, M.D.; and CENTRAL PENNSYLVANIA PULMONARY ASSOCIATES, LLC., Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PA NO. 09-2181 CIVIL ACTION - LAW MEDICAL MALPRACTICE JURY TRIAL DEMANDED COMPLAINT 1. The Plaintiff, Denise L. Kurr, is an adult individual residing in Cumberland County, Pennsylvania, who by Letters Testamentary dated May 8, 2007 was appointed personal representative of the Estate of Mary C. Marconi, deceased. 2. Plaintiffs decedent, Mary C. Marconi, died on April 20, 2007. 3. The Defendant, Holy Spirit Health System d/b/a Holy Spirit Hospital, is a corporation organized under the laws of the Commonwealth of Pennsylvania for the delivery of health care services in Cumberland County, Pennsylvania. Plaintiff is asserting a professional liability claim against this Defendant. A Certificate of Merit is filed herewith. 4. The Defendant, Mark A. Osevala, D.O., is a physician practicing the specialty of cardio-thoracic surgery, and his practice at all relevant times included the performance of such surgery at Defendant Holy Spirit Hospital. Plaintiff is asserting a professional liability claim against this Defendant. A Certificate of Merit is filed herewith. 5. Defendant, Capital Area Cardiovascular Surgical Institute, P.C. is a professional corporation organized under the laws of the Commonwealth of Pennsylvania, which at all relevant times employed Defendant Mark A. Osevala, D.O. Plaintiff is asserting a professional liability claim against this Defendant. A Certificate of Merit is filed herewith. 6. Defendant, Central Pennsylvania Pulmonary Associates, LLC. is a corporation organized under the laws of the Commonwealth of Pennsylvania, which at all relevant times also employed Timothy A. Clark, M.D. Plaintiff is asserting a professional liability claim against this Defendant. A Certificate of Merit is filed herewith. 7. The Defendant, Timothy A. Clark, M.D. is a physician specializing in internal medicine, pulmonary medicine, critical care medicine, interventional pulmonology and sleep disorders, who at all relevant times treated Plaintiff's decedent at Holy Spirit Hospital, and who at all relevant times acted as the employee, agent, or ostensible agent for said Defendant Holy Spirit Hospital. Plaintiff' is asserting a professional liability claim against this Defendant. A Certificate of Merit is filed herewith. 8. On March 16, 2007, Dr. Osevala performed coronary artery bypass surgery on Mary Marconi at Holy Spirit Hospital. 9. At the time of the discharge from Holy Spirit Hospital on March 21, 2007, eight sternal wires inserted during the bypass surgery were in perfect vertical alignment. 10. However, Ms. Marconi was suffering from an opacification at the base of the left chest consistent with atelectasis of the left lower lung and/or left side pleural effusion. It. She was transferred to Health South on March 21, 2007, where her admission history and physical note, dictated by James Tyndall, M.D. indicates she is short of breath. Over the next four days Ms. Marconi continued to exhibit signs and symptoms of increasing pulmonary problems and on the 25th of March, 2007, she was transferred back to Holy Spirit Hospital for treatment. The chest x-ray dated March 22, 2007 shows that the seventh sternal wire was no longer in vertical alignment compared to the other sternal wires. 12. At Holy Spirit Hospital, Ms. Marconi received treatment for her pulmonary problems, including an ultrasound guided thoracentesis removing 500 cubic centimeters of serosanguineous fluid. 13. A CT scan of the chest performed March 26, 2007 did not reveal any pulmonary emboli, however there was a complete separation of the lower one-half of the sternum. The lower sternal wires had pulled completely through the lower one-half of the sternum. --- - - -- -- Disposition of the lower half of the sternum was not noted. 14. The patient was discharged back to Health South Rehabilitation Center on March 30, 2007. 15. At that time, malalignment of the lower sternal wires, particularly malalignment of the seventh sternal wire, compared to the other sternal wires, was evident but was not noted in the records. 16. The records indicate that Ms. Marconi had quite a bit of chest wall pain, and physical examination demonstrated a slowly healing chest wall incision with peri-incisional palpable tenderness. 17. Ms. Marconi's atrial blood gas levels while receiving 5 liters of supplemental oxygen showed a P02 of 55 and a saturation of 88% on April 2, 2007. Later that same day the P02 had decreased to 54 and the oxygen saturation had decreased to 85%. The patient was ordered to be placed on BIPAP. 18. Dr. Inners, on April 2, noted in his assessment that Ms. Marconi had worsening acute/chronic respiratory failure. 19. Therefore, on April 2, 2007, Ms. Marconi was sent back to the Holy Spirit Hospital via ambulance for further evaluation and treatment of increasing shortness of breath and hypoxemia. 20. A chest x-ray performed at Holy Spirit Hospital on April 2, 2007 shows complete disruption of the sternal closure. 21. There was an obvious malalignment of all sternal wires. 22. A CT scan of the chest was also performed on April 2, 2007, noting complete I separation of the sternum with soft tissue in the sternotomy site, a new finding since the first CT .. scan dated March 26, 2007. 23. The admission history and physical examination dictated by Lisa Pittinger, PA for Alan J. Sweeny, M.D. noted some fresh bleeding at the lower half of the vertical midline chest incision and ecchymosis. 24. Review of the chest x-ray reported a small left pleural effusion with some atelectasis. 25. The patient deteriorated from a respiratory standpoint and required intubation and mechanical ventilation on April 3, 2007. 26. The initial critical care consolation note authored by Dr. Clark stated that the patient appeared to have a sternal wound infection with non-union of her sternum and a significant amount of fluctuance involving the sternum and surrounding tissue. 27. On physical examination, a sternal non-union was noted on the anterior chest and sternum. It was a 2-3 millimeter defect that was felt longitudinally along the sternum consistent with sternal non-union. 28. Ms. Marconi's progress noted on April 4, 2007 states that the results of CT scan of the chest performed on April 2, 2007 showed dehiscence of the sternum. 29. Dr. Clark's critical care progress note of April 4, 2007 states that the recent chest x-ray shows that the sternal wires are not aligned properly and there is indeed dehiscence. Dr. Clark notes that the source of her admission to the ICU stems from the sternal wound infection. 30. A progress note entitled "CVSI" acknowledges the sternal wound dehiscence and indicates the management of the sternal wound will be per Dr. Osevala. 31. The patient was seen by Dr. Osevala in consultation on April 3, 2007 and he confirmed the presence of the sternal dehiscence. His plan indicated that if the patient was not able to extubate, then "she may need sternum repair to help with ventilator wean. Plastic surgery availability at Holy Spirit Hospital still uncertain." 32. The critical care progress note dated April 5, 2007 reports that "right now her sternal wound is being treated conservatively with antibiotics only. It appears that we need to find a plastic surgeon to do the repair. There is a question as to whether there is any plastic surgeon with privileges at Holy Spirit Hospital." 33. The critical care note of April 6, 2007 reports that a consultation to Leo Farrell, M.D. was made to see the patient regarding the sternal dehiscence. 34. A progress note written by Dr. Osevala indicates that "plastic surgery coverage at Holy Spirit Hospital for sternal reconstruction is uncertain. Medical director and Dr. Torchia should be notified of this situation so it can be corrected." 35. The critical care progress note of April 7, 2007 indicates that "we have since found out that there was no plastic surgery coverage for sternal wound repair at Holy Spirit. Dr. Farrell is apparently is not back doing these types of surgeries yet. We will need to make arrangements to transfer her to another facility." 36. In the plans section of this progress note, Ricardo C. Calla, PA-C wrote that the patient will need to be transferred to a center that does sternal reconstruction. 37. The critical care progress note of April 8, 2007 indicates that "we have since found out that there is no plastic surgery coverage for sternal wound repair at Holy Spirit. Dr. Farrell apparently is not back doing these types of surgeries yet. We will need to make arrangements to transfer her to another facility and we will begin the search tomorrow." 38. In the plan portion of this progress note, Ricardo C. Calla PA-C wrote that the patient will need to be transferred to a center that does sternal reconstruction. 39. A progress note dated April 8, 2007 by Dr. Osevala indicates that plastic surgery needs to be secured to care for sternal dehiscence. 40. The critical care progress note of April 9, 2007 stated that "we continue to work on arrangements for Mrs. Marconi's transfer to a facility where she can have sternal wound repair." 41. The plan portion of this progress note states that the plan was to transfer the patient to a center that does sternal reconstruction. 42. A progress note dated April 9, 2007 states that "Dr. Torchia will call Dr. Banducci to see if they will manage the sternal dehiscence at Holy Spirit Hospital. If not, then the patient will need to be transferred to Harrisburg Hospital for management of the sternal dehiscence." 43. The critical care progress note dated April 9, 2007 states that "patient is going to be transferred to Harrisburg Hospital under Dr. Osevala's service here Dr. Banducci from plastics will see her and repair her sternal non-union. She is going to be transferred today." 44. Under the plan portion of this progress note, it is stated that the patient will be transferred to Harrisburg Hospital on April 9, 2007 for definitive repair for sternal non-union. 45. On April 10, 2007, Dr. Osevala wrote that there was not real change in the patient's status. He was awaiting Dr. Torchia's decision on Plastic Surgery coverage. The patient's family was supposedly informed of the status. 46. Dr. Osevala's April 10, 2007 note indicates that "she is receiving no 1V fluids and no tube feedings." The note-also-indicates that her BUN continues to elevate. 47. Elevated BUN is an indication of dehydration. 48. Ms. Marconi was admitted to Dr. Osevala's service at Harrisburg Hospital on April 10, 2009 and seen in consultation by Dr. Banducci on April 11. 49. Dr. Banducci's impression was that she suffered from a sternal wound infection and his plan was to perform sternal debridement with removal of eight sternal wires and bilateral pectoralis major muscle flap closure of the defect. 50. At surgery, the sternum was noted to have dehiscesed widely. 51. Cultures of the sternum and of dark mediastinal fluid were taken. 52. On April 12, 2007 the patient began to bleed resulting in hypotension. The code blue was called and CPR was instituted. 53. Ms. Marconi was returned to the operating room for re-exploration of her sternal wound. A clot was evaluated and a small bleeding source was found on the undersurface of the pectoralis major muscle was from generalized oozing. 54. Subsequent to this, Ms. Marconi developed a possible cerebralvascular accident. 55. Ms. Marconi died on April 20, 2007 at Harrisburg Hospital. 56. Once the diagnosis of the complete sternal dehiscence with the possibility of a sternal wound infection is made, the standard of care requires prompt surgical treatment, optimally within twenty-four to forty-eight hours, unless the patient's medical condition dictates otherwise. 57. Definitive surgical treatment includes sternal wound re-exploration with possible sternal re-wiring or sternal debridement with immediate or delayed wound closure,. 58. Ms. Marconi's sternal dehiscence with the possibility of sternal wound infection-- was diagnosed on or about April 2, 2007, nine days before she received surgical treatment by Dr. Banducci. COUNTI Denise L. Kurr, Personal Representative of the Estate of Mary Marconi, Deceased v. Mark A. Osevala, D.O., Capital Area Cardiovascular Surgical Institute, P.C. 59. Paragraphs l through 58 are incorporated herein by reference as if set forth in their entirety. 60. All of Plaintiffs damages are hereinafter related are the direct and proximate result of the negligence of Dr. Osevala, acting in the course and scope of his employment and/or agency for Defendant Capital Area Cardiovascular Surgical Institute, P.C. in that he: a. failed to provide surgical care for Ms. Marconi's sternal dehiscence and sternal wound infection within the optimal twenty-four to forty- eight time interval, or at any time thereafter, until Ms. Marconi received surgery on April 11, 2007; b. in the alternative, made insufficient effort to ensure that a different surgeon performed the necessary surgical procedure within the time interval mandated by the standard of care; C. failed to adequately monitor Ms. Marconi's condition during the time she was an inpatient at Holy Spirit Hospital, between April 2 and April 10, 2007; and d. failed to make reasonable effort under the circumstances to identify a different facility at which she could have been accepted for the necessary surgery within the time required by the standard of care, and to arrange for her timely transfer. COUNT lI Denise L. Kurr, Personal Representative of the Estate of Mary Marconi, Deceased v. Timothy A. Clark, M.D., Central Pennsylvania Pulmonary Associates, LLC. 61. Paragraphs 1 through 58 are incorporated herein by reference as if set forth in their entirety. 62. All of Plaintiff's damages are hereinafter related are the direct and proximate result of the negligence of Dr. Clark, acting within the course and scope of his employment, agency, or ostensible agency for Defendant, Holy Spirit Hospital, and also his employment for Defendant Central Pennsylvania Pulmonary Associates, LLC in that he: a. made insufficient effort to ensure that a surgeon performed the necessary surgical procedure within the time interval mandated by the standard of care; b. failed to adequately monitor Ms. Marconi's condition during the time she was an inpatient at Holy Spirit Hospital, between April 2 and April 10, 2007, and to apprise Dr. Osevala of her treatment and condition; and c. failed to make reasonable effort under the circumstances to identify a different facility at which she could have been accepted for the required surgery within the time required by the standard of care, and to arrange for her timely transfer. COUNT III Denise L. Kurr, Personal Representative of the Estate of Mary Marconi, Deceased v. Holy Spirit Health System d/b/a Holy Spirit Hospital 63. Paragraphs 1 through 58 are incorporated herein by reference as if set forth in their entirety. 64. All of Plaintiff"s damages are--also the- direct and proximate, result of the independent negligence of Defendant Holy Spirit Hospital and that it: a. failed to have policies and procedures in place to assure that follow-up surgical care would be available at its facility to deal with the complications of bypass surgery, including sternal wound dehiscence and infection; b. in the alternative, failed to follow applicable policies and procedures designed to assure that follow-up surgical care was timely available; C. failed to seek and obtain prompt transfer of Ms. Marconi to a different facility where she could receive the required surgical care in a timely fashion; and d. made inadequate effort to identify a surgeon who could perform the required operation at its facility in a timely fashion. CLAIM I - SURVIVAL ACTION Denise L. Kurr, Personal Representative of the Estate of Mary Marconi, Deceased v. Holy Spirit Health System d/b/a Holy Spirit Hospital; Mark A. Osevala, D.O.; Timothy A. Clark, M.D.; Capital Area Cardiovascular Surgical Institute, P.C.; and Central Pennsylvania Pulmonary Associates, LLC. 65. Paragraphs 1 through 64 are incorporated herein by reference as if set forth in their entirety. 66. Plaintiff Denise L. Kurr, Personal Representative of the Estate of Mary Marconi, deceased, brings this action on behalf of the Estate of Mary Marconi under and by virtue of the Act of 1976, July 9, P.L. 586, No. 142, §2,42 Pa. C.S.A. §8302. 67. Plaintiff claims on behalf of said Estate the damages suffered by the said Estate by reason of death of the decedent, for the conscious pain and suffering prior to death, loss of income for-decedent's life expectancy, and for all- other -damages sustained by the said Estate by reasons of the death of the decedent. WHEREFORE, Plaintiff demands judgment against Defendants in an amount in excess of Fifty Thousand ($50,000.00) Dollars, exclusive of interest and costs and in excess of any jurisdiction amount requiring compulsory arbitration. CLAIM II - WRONGFUL DEATH Denise L. Kurr, Personal Representative of the Estate of Mary Marconi, Deceased v. Holy Spirit Health System d/b/a Holy Spirit Hospital; Mark A. Osevala, D.O.; Timothy A. Clark, M.D.; Capital Area Cardiovascular Surgical Institute, P.C.; and Central Pennsylvania Pulmonary Associates, LLC. 68. Paragraphs 1 through 64 are incorporated herein by reference as if set forth in their entirety. 69. Plaintiff Denise L. Kurr, personal representative of the Estate of Mary Marconi, deceased, brings this action for wrongful death of Mary Marconi on behalf of all persons entitled to damages therefor under and by virtue of the Act of 1976, July 9, P.L. 586, No. 412, §2, 42 Pa. C.S.A. §8301. 70. Decedent did not bring an action for her injuries during her lifetime. 71. The following are the names of all persons entitled by law to recover damages for such wrongful death and their relationship to decedent: Name Relationshi Address Denise L. Kurr Daughter 626 Gutshall Road Boiling Springs, PA 17077 Robert Marconi Son 218 W. Arch Street Mechanicsburg, PA 17055 Eugene Marconi Son 240 A. Street Carlisle, PA 17013 72. At the time of her death, Mary Marconi was April 20, 2007 (75) years old, having been born August 4, 1931. 73:- - . Defendants are liable to Plaintiff, Personal Representativ6,af the Estate of Mary Marconi, deceased, for damages as set forth herein. 74. As a result of the death of the decedent, the individuals identified in paragraph 68 above, have suffered a pecuniary loss, and have been, and in the future will be deprived of the decedent's companionship, contribution, support, comfort, services, and so on, for all of which damages are claimed. 75. As a result of the death of decedent, Plaintiff has incurred funeral, burial, and any other expenses allowed by law, for all of which claim is made. WHEREFORE, Plaintiff demands judgment against Defendants in an amount in excess of Fifty Thousand Dollars ($50,000), exclusive of interest and costs and in excess of any jurisdictional amount requiring compulsory arbitration. Respectfully submitted, ANGINO & ROVNER, P.C. Joornh . Melillo, Esquire A ey I.D. No. 26211 4503 North Front Street Harrisburg, PA 17110 (717) 238-6791 Attorney for Plaintiff Date: P c?.?f -S a G ? ANGINO & ROVNER, P.C. Joseph M. Melillo Attorney ID# : 26211 4503 North Front Street Harrisburg, PA 17110-1708 (717) 238-6791 FAX (717) 238-5610 Attorneys for Plaintiff(s) E-mail: jmelillo@angino-rovner.com DENISE L. KURR, REPRESENTATIVE OF OF MARY MARCONI, Plaintiff V. PERSONAL THE ESTATE HOLY SPIRIT HEALTH SYSTEM d/b/a HOLY SPIRIT HOSPITAL; MARK A. OSEVALA, D.O.; CAPITAL AREA CARDIOVASCULAR SURGICAL INSTITUTE, P.C.; TIMOTHY A. CLARK, M.D.; and CENTRAL PENNSYLVANIA PULMONARY ASSOCIATES, LLC., Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PA NO. 09-2181 CIVIL ACTION - LAW MEDICAL MALPRACTICE JURY TRIAL DEMANDED Certificate of Merit as to Holy Spirit Hospital Health System d/b/a Holy Spirit Hospital I, Joseph M. Mellillo, certify that: ( X ) an appropriate licensed professional has supplied a written statement to the undersigned that there is a basis to conclude that the care, skill or knowledge exercised or exhibited by this defendant in the treatment, practice or work that is the subject of the complaint, fell outside acceptable professional standards and that such conduct was a cause in bringing about the harm; AND/OR ( X ) the claim that this defendant deviated from an acceptable professional standard is based solely on allegations that other licensed professionals for whom this defendant is responsible deviated from an acceptable professional standard and an appropriate licensed professional has supplied a written statement to the undersigned that there is a basis to conclude that the care, skill or knowledge exercised or exhibited by the other licensed professionals in the treatment, practice or work that is the subject of the complaint, fell outside acceptable professional standards and that such conduct was a cause in bringing about the harm; OR ( ) expert testimony of an appropriate licensed professional is unnecessary for prosecution of the claim against this defendant. Date: S - ? - 0 Q"_? (?._ J ph M. Melillo 409912 ANGINO & ROVNER, P.C. Joseph M. Melillo Attorney ID# : 26211 4503 North Front Street Harrisburg, PA 17110-1708 (717) 238-6791 FAX (717) 238-5610 Attorneys for Plaintiff(s) E-mail: jmelillo@angino-rovner.com DENISE L. KURR, PERSONAL REPRESENTATIVE OF THE ESTATE OF MARY MARCONI, Plaintiff V. HOLY SPIRIT HEALTH SYSTEM d/b/a HOLY SPIRIT HOSPITAL; MARK A. OSEVALA, D.O.; CAPITAL AREA CARDIOVASCULAR SURGICAL INSTITUTE, P.C.; TIMOTHY A. CLARK, M.D.; and CENTRAL PENNSYLVANIA PULMONARY ASSOCIATES, LLC., Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PA NO. 09-2181 CIVIL ACTION - LAW MEDICAL MALPRACTICE JURY TRIAL DEMANDED Certificate of Merit as to Mark A. Osevala, D.O. I, Joseph M. Melillo, certify that: ( X ) an appropriate licensed professional has supplied a written statement to the undersigned that there is a basis to conclude that the care, skill or knowledge exercised or exhibited by this defendant in the treatment, practice or work that is the subject of the complaint, fell outside acceptable professional standards and that such conduct was a cause in bringing about the harm; AND/OR ( ) the claim that this defendant deviated from an acceptable professional standard is based solely on allegations that other licensed professionals for whom this defendant is responsible deviated from an acceptable professional standard and an appropriate licensed professional has supplied a written statement to the undersigned that there is a basis to conclude that the care, skill or knowledge exercised or exhibited by the other licensed professionals in the treatment, practice or work that is the subject of the complaint, fell outside acceptable professional standards and that such conduct was a cause in bringing about the harm; OR ( ) expert testimony of an appropriate licensed professional is unnecessary for prosecution of the claim against this defendant. Date: b S-- 06 ` G 221 929,ka (T101 14h M. Melillo 409812 ANGINO & ROVNER, P.C. Joseph M. Melillo Attorney 1D# : 26211 4503 North Front Street Harrisburg, PA 17110-1708 (717) 238-6791 FAX (717) 238-5610 Attorneys for Plaintiff(s) E-mail: jmelillo@angino-rovner.com DENISE L. KURR, PERSONAL REPRESENTATIVE OF THE ESTATE OF MARY MARCONI, Plaintiff V. HOLY SPIRIT HEALTH SYSTEM d/b/a HOLY SPIRIT HOSPITAL; MARK A. OSEVALA, D.O.; CAPITAL AREA CARDIOVASCULAR SURGICAL INSTITUTE, P.C.; TIMOTHY A. CLARK, M.D.; and CENTRAL PENNSYLVANIA PULMONARY ASSOCIATES, LLC., Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PA NO. 09-2181 CIVIL ACTION - LAW MEDICAL MALPRACTICE JURY TRIAL DEMANDED Certificate of Merit as to Timothy A. Clark, M.D. I, Joseph M. Melillo, certify that: ( X ) an appropriate licensed professional has supplied a written statement to the undersigned that there is a basis to conclude that the care, skill or knowledge exercised or exhibited by this defendant in the treatment, practice or work that is the subject of the complaint, fell outside acceptable professional standards and that such conduct was a cause in bringing about the harm; AND/OR ( ) the claim that this defendant deviated from an acceptable professional standard is based solely on allegations that other licensed professionals for whom this defendant is responsible deviated from an acceptable professional standard and an appropriate licensed professional has supplied a written statement to the undersigned that there is a basis to conclude that the care, skill or knowledge exercised or exhibited by the other licensed professionals in the treatment, practice or work that is the subject of the complaint, fell outside acceptable professional standards and that such conduct was a cause in bringing about the harm; OR ( ) expert testimony of an appropriate licensed professional is unnecessary for prosecution of the claim against this defendant. Date: o ph M. Melillo 409812 ANGINO & ROVNER, P.C. Joseph M. Melillo Attorney ID# : 26211 4503 North Front Street Harrisburg, PA 17110-1708 (717) 238-6791 FAX (717) 23 8-5610 Attorneys for Plaintiff(s) E-mail: jmelillo@angino-rovner.com DENISE L. KURR, REPRESENTATIVE OF OF MARY MARCONI, Plaintiff V. PERSONAL IN THE COURT OF COMMON PLEAS THE ESTATE CUMBERLAND COUNTY, PA HOLY SPIRIT HEALTH SYSTEM d/b/a HOLY SPIRIT HOSPITAL; MARK A. OSEVALA, D.O.; CAPITAL AREA CARDIOVASCULAR SURGICAL INSTITUTE, P.C.; TIMOTHY A. CLARK, M.D.; and CENTRAL PENNSYLVANIA PULMONARY ASSOCIATES, LLC., Defendant Certificate of Merit as to Central 1, Joseph M. Mellillo, certify that: NO. 09-2181 CIVIL ACTION - LAW MEDICAL MALPRACTICE JURY TRIAL DEMANDED Pennsylvania Pulmonary Associates, LLC. ( ) an appropriate licensed professional has supplied a written statement to the undersigned that there is a basis to conclude that the care, skill or knowledge exercised or exhibited by this defendant in the treatment, practice or work that is the subject of the complaint, fell outside acceptable professional standards and that such conduct was a cause in bringing about the harm; AND/OR ( X ) the claim that this defendant deviated from an acceptable professional standard is based solely on allegations that other licensed professionals for whom this defendant is responsible deviated from an acceptable professional standard and an appropriate licensed professional has supplied a written statement to the undersigned that there is a basis to conclude that the care, skill or knowledge exercised or exhibited by the other licensed professionals in the treatment, practice or work that is the subject of the complaint, fell outside acceptable professional standards and that such conduct was a cause in bringing about the harm; OR ( ) expert testimony of an appropriate licensed professional is unnecessary for prosecution of the claim against this defendant. Date: S' 6 v`j J eph M. Melillo 409912 ANGINO & ROVNER, P.C. Joseph M. Melillo Attorney ED# : 26211 4503 North Front Street Harrisburg, PA 17110-1708 (717) 238-6791 FAX(717)238-5610 Attorneys for Plaintiff(s) E-mail: jmelillo cdangino-rovner.com DENISE L. KURR, PERSONAL REPRESENTATIVE OF THE ESTATE OF MARY MARCONI, Plaintiff V. HOLY SPIRIT HEALTH SYSTEM d/b/a HOLY SPIRIT HOSPITAL; MARK A. OSEVALA, D.O.; CAPITAL AREA CARDIOVASCULAR SURGICAL INSTITUTE, P.C.; TIMOTHY A. CLARK, M.D.; and CENTRAL PENNSYLVANIA PULMONARY ASSOCIATES, LLC., Defendant Certificate of Merit as to Capital A I, Joseph M. Mellillo, certify that: IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PA NO. 09-2181 CIVIL ACTION - LAW MEDICAL MALPRACTICE JURY TRIAL DEMANDED rea Cardiovascular Surgical: Institute, P.C. ( ) an appropriate licensed professional has supplied a written statement to the undersigned that there is a basis to conclude that the care, skill or knowledge exercised or exhibited by this defendant in the treatment, practice or work that is the subject of the complaint, fell outside acceptable professional standards and that such conduct was a cause in bringing about the harm; AND/OR ( X ) the claim that this defendant deviated from an acceptable professional standard is based solely on allegations that other licensed professionals for whom this defendant is responsible deviated from an acceptable professional standard and an appropriate licensed professional has supplied a written statement to the undersigned that there is a basis to conclude that the care, skill or knowledge exercised or exhibited by the other licensed professionals in the treatment, practice or work that is the subject of the complaint, fell outside acceptable professional standards and that such conduct was a cause in bringing about the harm; OR ( ) expert testimony of an appropriate licensed professional is unnecessary for prosecution of the claim against this defendant. Date: S-_ 6 _ 0 j 1 ? os409812 VERIFICATION I, DENISE L. KURR, Personal Representative of the Estate of MARY MARCONI, Plaintiff, have read the foregoing Complaint and do hereby swear or affirm that the facts set forth in the foregoing are true and correct to the best of my knowledge, information and belief. I understand that this Verification is made subject to the penalties of 18 Pa.C.S.A. Section 4904, relating to unsworn falsification to authorities. Qz,? (2?7 Witness DENISE L. KURR Date: ?_ _ p Date: s' -.S- - 0 CERTIFICATE OF SERVICE AND NOW, this ? 4*'L day of Y!'Itiy a.oo9 ,1, Cindy J. Wilson, employee of the law firm of Angino & Rovner, P.C., hereby certify that a true and correct copy of the foregoing document was sent to the following counsel of record by placing a copy of same by First Class in the United States mail, postage prepaid, at Harrisburg, Pennsylvania addressed as follows: Evan Black, Esquire Thomas, Thomas & Hafer, LLP 305 North Front Street Harrisburg, PA 17101 Defendant Timothy A. Clark, MD. and Central Pennsylvania Pulmonary Associates, LLC Wilbur McCoy Otto, Esquire Dickie, McCamey & Chilcote, P.C. Two PPG Place, Suite 400 Pittsburgh, PA 15222 Defendant Holy Spirit Health System d/b/a Holy Spirit Hospital Thomas M. Chairs, Esquire Dickie, McCamey & Chilcote, P.C. 1200 Camp Hill Bypass, Suite 205 Camp Hill, PA 17011 Defendant Holy Spirit Health System d1b/a Holy Spirit Hospital Michael D. Pipa, Esquire Karen E. Minehan; Esquire Stevens & Lee 17 North Second Street, 16th Floor Harrisburg, PA 17101 Defendant Mark Osevala, D. 0. and Cardiovascular Surgical Institute, R C. Date: Cindy J. n 678932.2 EXHIBIT "B" SOUTHCOAST CARDIAC AND THORACIC SURGERY, P.C. THOMAS G. CARR, M.D. • CHRISTIAN T. CAMPOS, M.D. • RICHARD T, MILLER, M.D. 300 HANOVER ST. FALL RIVER, MA 02720 TELEPHONE (508) 679.7740 FAX (508) 679-7701 February 1, 2010 Richard A. Sadlock Attorney-at-Law Angino and Rovner, P,C. 4503 North Front Street Harrisburg, Pennsylvania 17110-1708 Re: Mary C. Marconi Dear Attorney Sadlock: 1. I, Christian Theodore Campos, M.D., am a physician licensed to practice medicine in the Commonwealth of Massachusetts and practice in Fall River, Massachusetts. I am certified by the American Board of Surgery and the American Board of Thoracic Surgery and am a practicing cardiovascular and thoracic surgeon with Southcoast Cardiac and Thoracic Surgery, P.C. at the Charlton Memorial Hospital in Fall River, Massachusetts. My educational background, professional training and experience are summarized in my curriculum vitae which is attached. 2. I have been asked to review the medical care provided to Mary C. Marconi and to determine whether the care provided to her breached the applicable standards of care and, if so, whether such conduct caused any injury or injuries to Mary C. Marconi. To execute this task, I have reviewed the following documents: a) Records of Masland .Associates, Inc. b) Records of Capitol Area Cardiovascular Surgical Institute C) Records of Moffitt Heart & Vascular Group d) Records from Health South C) Records from Harrisburg Hospital 0 Records from Holy Spirit Hospital g) X-rays and reports from Holy Spirit Hospital h) X-rays and reports from Health South i) X-rays and reports from I Iarrisburg Hospital Richard A. Sadlock February 1, 2010 Page Two of Eight Re: Mary C. Marconi These documents are normally relied upon by reviewers in performing this task. I have the expertise to evaluate the reliability of such documents and fwd that these documents are reliable. 4. My review disclosed the following pertinent facts: The patient, Mary C. Marconi, in March of 2007, was a 75 year-old woman with a histo off d005 joint disease having undergone a left total knee replacement in Septemberryof 2005 and a right total knee replacement in June of 2006. She developed problems related to the right knee replacement and was scheduled for re-do surgery on her right knee for repair of extensor mechanism rupture. In addition, the patient had a history of obesity, hypertension, hypercholesterolemia, depression/anxiety, Type II diabetes mellitus, gastroesophageal reflux, and had undergone a previous tubal ligation. Her weight was 212 pounds at an office visit on February 9, 2007 and was noted to be 230 pounds at the time of her coronary artery bypass surgery in March of 2007. In preparation for her re-do right knee surgery, a stress myoview test was ordered to assess her cardiac risk. An echocardiogram performed on March 8, 2007 showed normal left ventricular function with an estimated ejection fraction of 55 - 60%. Mild mitral regurgitation was noted. Mild to moderate diastolic dysfunction was present. The stress myoview was markedly positive with inducible ischemia of the lateral wall. Cardiac catheterization was performed on March 15, 2007. This showed a 50% stenosis of the distal left main coronary artery. The left anterior descending coronary artery had a 50% proximal stenosis followed by an 80 -90% long diffuse lesion in the mid-left anterior descending coronary artery. There was a 30 - 40% proximal stenosis in the left circumflex coronary artery. There was a 10 - 20% proximal stenosis in the right coronary artery. Left ventriculography showed an estimated ejection fraction of 55 - 60%. Intravascular ultrasound showed that the distal left main stenosis was approximately 70% compared to the true lumen size of the left main coronary artery. With significant left main and left anterior descending coronary artery disease, she was referred for coron artery bypass surgery prior to her re-do right knee surgery. ?' On March 16, 2007, Mark A. Osevala, D.O. performed coronary artery bypass surgery on Mary C. Marconi at the Holy Spirit Hospital. The left internal mammary artery was placed to the left anterior descending coronary artery. Saphenous vein bypass grafts were placed to the diagonal coronary artery and to the obtuse marginal coronary artery- The sternum was closed with eight interrupted wire sutures. A portable chest x- ray was performed at 1420 on March 16, 2007. This study shows that the sternum was closed with eight interrupted wire sutures which are in perfect, vertical alignment. Richard A. Sadlock February 1, 2010 Page Three of Eight Re; Mary C. Marconi During her initial post-operative course, another portable chest x-ray was performed at 1100 on March 18, 2007. The endotracheal tube had been removed. The chest tubes had been removed. There is opacification at the base of the left chest which is consistent with atelectasis of the left lower lobe of the lung and/or a left-sided pleural effusion. The eight sternal wires remain in perfect vertical alignment. A repeat chest x- ray was performed at 1205 on March 19, 2007. The left hemi-diaphragm was elevated. The previously noted opacification at the base of the left chest remained unchanged. The eight sternal wires were again visualized and remained in perfect, vertical alignment. Referring to the dictated discharge summary, the patient was extubated within the first day of surgery. On postoperative day number two, the chest tubes were removed. She had a renal evaluation due to an increase in her creatinine level to 1.7 mg/dl. She had dopamine for her urine output at that time. On March 20, 2007 (postoperative day number four), her creatinine level was noted to be 0.9 mg/dl. She was to be discharged on March 20, 2007 to Manor Care. However, due to bed (un)availability, the discharge was held. She was discharged on March 21, 2007 (postoperative day number five) to Health South. The patient arrived at Health South on March 21, 2007. She was noted on the admission history and physical examination dictated by James Tyndall, M.D. to be short of breath. Her respiratory rate was twenty-four breaths per minute and was at times labored. She was noted to have decreased breath sounds and dullness to percussion at the left base. A pulmonary consultation was performed by Charles Inners, M.D. on March 22, 2007. He documented a weight of 247.8 pounds compared to a baseline weight of 230 pounds. Her oxygen saturation was noted to be 93% on two liters of supplemental oxygen. A chest x-ray was ordered on March 22, 2007. This x-ray showed volume loss at the base of the left chest which was interpreted as an infiltrate. Multiple sternal wires secondary to a previous sternotomy were noted. It was not noted that the seventh sternal wire was no longer in vertical alignment compared to the other sternal wires and compared to her last chest x-ray performed at Holy Spirit Hospital on March 19, 2007. A PM & R consultation was dictated by Dean Lehman, PA-C on March 23, 2007. On physical examination, it was noted that there was a well healing vertical sternal incision with some palpable tenderness around the incision. On March 24, 2007, another chest x- ray was performed. The left chest showed increasing opacification up to the level of the second rib. Multiple sternal wires secondary to her previous sternotomy were noted. The seventh sternal wire was clearly out of alignment compared to the other sternal wires. This was not noted. An arterial blood gas was performed on March 25, 2007 and showed a p02 of 43 on ten liters of supplemental oxygen with a saturation of 84%. The patient was sent back to Holy Spirit Hospital for further evaluation and treatment. Richard A. Sadlock February 1, 2010 Page Four of Eight Re: Mary C. Marconi The patient was re-admitted to the Holy Spirit Hospital with increasing shortness of breath and hypoxemia with saturations of 89% on ten liters of supplemental oxygen on March 25, 2007. A chest x-ray was performed and significant opacity was seen of the left chest consistent with atelectasis, infiltrate, and/or effusion. It was noted that sternal wires were present. Malalignment of the seventh sternal wire compared to the other sternal wires was not noted. An ultrasound guided thoracentesis was performed removing 500 cc's of serosanguinous fluid. Following this procedure, the patient was noted to be breathing better but still required twelve liters of supplemental oxygen to maintain an oxygen saturation of 94%. A CT scan of the chest was performed on March 26, 2007. No pulmonary emboli were seen. There was a complete separation of the lower one-half of the sternum. The lower sternal wires had pulled completely through the lower one-half of the sternum. The upper one-half of the sternum, including the manubrium, was intact. The upper sternal wires remained around the upper one-half of the divided sternum, and the manubrium was intact. Disruption of the lower one-half of the sternum was not noted. An additional chest-x-ray was performed on March 27, 2007. Malalignment of the lower sternal wires, particularly of the seventh sternal wire, compared to the upper sternal wires was not appreciated. The patient was discharged back to Health South on March 30, 2007. The patient was re-admitted to Health South on March 30, 2007. A chest x-ray was obtained on March 31, 2007. Multiple sternal wires secondary to a previous sternotomy were noted. Improved aeration of the apical portion of the left upper lung was seen with complete opacification of the lower left chest up to the level of approximately the fourth rib was noted. Malalignment of the lower sternal wires, particularly malalignment of the seventh sternal wire compared to the other sternal wires, was evident and was not noted. On April 1, 2007, Dean L. Lehman, PA-C, noted that the patient had quite a bit of chest wall pain. On physical examination, he noted a slowly healing chest wall incision with peri-incisional palpable tenderness. A chest x-ray was performed on April 2, 2007. Opacification of the left lower chest was noted. Post-op changes with sternal wires were noted. Malalignment of the lower sternal wires, particularly of the seventh sternal wires, was not appreciated. On April 2, 2007, an arterial blood gas performed while the patient was receiving five liters of supplemental oxygen showed a P02 of 55 and a saturation of 88%. Later on April 2, 2007, another arterial blood gas performed while the patient was receiving ten liters of supplemental oxygen showed a PO2 of 54 and a saturation of 85%. The patient was ordered to be placed on BI PAP. The patient was seen by Dr. Inners on April 2, 2007 who noted that she was not doing well. He noted that the chest x-ray performed on March 31, 2007 showed slight improvement. fn his assessment, he noted that she had worsening acute/chronic respiratory failure. He suspected that this was a combination of diminished respiratory mechanics from the Richard A. Sadlock February 1, 2010 Page Five of Eight Re: Mary C. Marconi combined pleural parenchymal abnormality in the left chest and her recent surgery as well as her obesity. On April 2, 2007, the patient was sent back to the Holy Spirity Hospital via 911 ambulance for further evaluation and treatment of increasing shortness of breath and hypoxemia. On April 2, 2007, the patient was brought b Department of the Holy Spirit Hospital. A chest x_ra ambulance to the Emergency complete disruption of the sternal closure. There was obvious malali April 2, 2007 shows wires. The dictated report of this chest x-ray noted only that the patient wastpos?l sternal sternotomy. A CT scan of the chest was also performed on April 2, 2007. Comlete separation of the sternum was noted with soft tissue in the sternotomy p site which was a new finding since the prior CT scan dated March 26, 2007. The conclusion from this examination noted post-operative changes of the sternum with diastasis of the surgical incision. There was associated soft tissue density probably representing granulation tissue. The admission history and physical examination dictated by Lisa Pittinger PA f Alan J. Sweeney, M.D. noted some fresh bleeding at the lower half of the vertical midline ' or chest incision. There was also some eccymosis. Review of the chest x-ray reported a small left pleural (effusion) with some atelectasis. No note of the CT findings was made. The patient deteriorated from a respiratory standpoint and required intubation and mechanical ventilation on April 3, 2007. The initial critical care consultation stated that the patient appeared to have a sternal wound infection with non-union of her sternum a significant amount of fluctuance involving the sternum and surrounding tissue. On and physical examination, a sternal non-union was noted of the anterior chest and sternum There was a 2 -3 mm defect that is felt longitudinally along the sternum consistent with sternal non-union. A progress note on April 4, 2007 states that the results of the CT scan of the chest performed on April 2, 2007 showing dehiscence of the sternum were noted The critical care progress note on April 4, 2007 states that the recent chest x-ray shows that the sternal wires are not aligned properly and there is indeed dehiscence. "It a e that the source of her admission to the ICU stems from the sternal wound infection." ars Progress note titled "CVSI" acknowledges the sternal wound dehiscence and indicated the management of the sternal wound will be per Dr. Osevala. The patient was seen by Dr. Osevala in consultation on April 3, 2007. He confirmed the presence of a sternal dehiscence. His plan indicated that if the patient was not able to extubate, then "she may y need sternum repaired to help with ventilator wean. Plastic Surgery availability at Holy Spirit Hospital still uncertain." The critical care progress note dated April 5, ..007 reports that "right now her sternal wound is being treated conservatively with antibiotics Y appears that we need to find a plastic surgeon to do the repair. There is a question aslo ft whether there is any plastic surgeon with privileges at Holy Spirit Hospital." The critic care progress note of April 6, 2007 reports that a consultation to Leo Farrell, M. D. wasal made to see the patient regarding the sternal dehiscence. A progress note written b Dr y • Richard A. Sadlock February 1, 2010 Page Six of Eight Re: Mary C. Marconi Osevala indicates that "Plastic Surgery coverage at holy Spirit Hospital for sternal reconstnction is uncertain. Medical Diretor and Dr. Torchia should be notified of this situation so it can be corrected." The critical care progress note of April 7, 2007 indicates that "we have since found out that there is no plastic surgery coverage for sternal wound repair at Holy Spirit. Dr. Farrell apparently is not back doing these types of surgeries yet. We will need to make arrangements to transfer her to another facility." In the plan section of this progress note, Ricardo C. Calla, PA-C wrote that the patient will need to be transferred to a center that does sternal reconstruction. The critical care progress note of April 8, 2007 indicates that "we have since found out that there is no plastic surgery coverage for sternal wound repair at Holy Spirit. Dr. Farrell apparently is not back doing these types of surgeries yet. We will need to make arrangements to transfer her to another facility and will begin the search tomorrow." In the plan portion of this progress note, Ricardo C. Calla, PA-C wrote that the patient will need to be transferred to a center that does sternal reconstruction. A progress note dated April 8, 2007 by Dr. Osevala indicates that Plastic Surgery needs to be secured to care for sternal dehiscence. The critical care progress note of April 9, 2007 stated that "we continue to work on arrangements for Mrs. Marconi's transfer to a facility where she can have her sternal wound repaired." The plan portion of this progress note states that the plan was to transfer the patient to a center that does sternal reconstruction. A progress note dated April 9, 2007 states that "Dr. Torcia will call Dr. Banducci to see if they will manage the sternal dehiscence at Holy Spirit Hospital. If not, then the patient will need to be transferred to Harrisburg Hospital for management of the sternal dehiscence." The critical care progress note dated April 9, 2007 states that "the patient is going to be transferred to Harrisburg Hospital under Dr. Osevala's service here Dr. Banducci from plastics will see her and repair her sternal non- union. She is going to be transferred today." Under the plan portion of this progress note, it is stated that the patient will be transferred to Harrisburg Hospital on April 9, 2007 for definitive repair of her sternal non-union. On April 10, 2007, Dr. Osevala wrote that there was no real change in the patient's status. He was awaiting Dr. Torchia's decision on Plastic Surgery coverage. The patient's family was informed of the status. He notes that "she is receiving no iv fluids and no tube feedings." The patient was transferred to the Harrisburg Hospital on April 10, 2009. The patient was admitted to Dr. Osevala's service at the Harrisburg Hospital on April 10, 2009. She was seen in consultation by Dr. Banducci on April 11, 2007. His impression was that the patient probably has a sternal wound infection and his plan was to perform sternal debridement with pectoral flap reconstruction. On April 11 2007, Dr. Banducci performed sternal debridement with removal of eight sternal %vires and bilateral pectoralis major muscle flap closure of the defect. At surgery, the sternum was noted to have dehisced widely. Cultures of the sternum and of dark mediastinal fluid were taken. On April 12, 2007, the patient began to bleed resulting in hypotension. A Code Blue was Richard A. Sadlock February 1, 2010 Page Seven of Eight Re: Mary C. Marconi called and CPR was instituted. She was returned to the Operating Room for re- exploration of her sternal wound. Clot was evacuated and a small bleeding source was found on the undersurface of the pectoralis major muscle with some generalized oozing. Subsequent to this, she developed a possible cerebrovascular accident. She expired on April 20, 2007 at the Harrisburg Hospital. 5. 1 am familiar with the standards of care that applied to the care and treatment of Mary C. Marconi in March and April of 2007 and relying on those standards conclude that: A. Once the diagnosis of a complete sternal dehiscence with the possibility of a sternal wound infection had been made based on the chest x-ray performed on April 2, 2007 and the CT scan of the chest performed on April 2, 2007 and confirmed by the physical examination performed by Ricardo C. Calla, PA-C on behalf of Timothy A. Clark, M.D. and by Dr. Osevala on April 3, 2007, definitive surgical care which would have included sternal wound re- exploration with possible sternal re-wiring or sternal debridement with immediate or delayed wound closure should have been performed on an urgent basis, certainly within 24 - 48 hours of the diagnosis unless the patient's medical condition dictated that a delay in the provision of definitive surgical care would be prudent and in the patient's best interests. Definitive surgical care, in the absence of patient factors that would warrant a delay in the provision of definitive surgical care, was not performed until the patient was transferred to Harrisburg Hospital on April 10, 2007, was seen in consultation by Dennis Banducci, M.D. on April 10, 2007, and was operated upon by Dr. Banducci on April 11, 2007. This delay in the provision of definitive surgical care, clearly and within a reasonable degree of medical certainty, falls below the acceptable standards of care that applied to the care provided to Mary C. Marconi in March and April of 2007. 6. Such acts, conduct and negligence contributed to the additional morbidity, pain and suffering suffered by Mary C. Marconi and contributed significantly to her eventual death on April 20, 2007. All of the opinions set forth above are made with a reasonable degree of medical certainty. Richard A. Sadlock February 1, 2010 Page Eight of Eight Re: Mary C. Marconi ctfully u mi ed, / efiristian T. Campo ; Southcoast Cardiac and Thoracic Surgery, P.C. Fall River, Massachusetts cc. File If SOUTHCOAST CARDIAC AND THORACIC SURGERY, P. C. THOMAS G. CARR, M.D. • CHRISTIAN T. CAMPUS, M. D. 300 HgNUVER ST. • RICHARD T. MILLER, M.D. FALL RIVER, MA 02720 TELEPHONE (508) 679-7740 FAX (508) 679-7701 July 20, 2010 Richard A.Sadlock Attorney-at-Law Angino and Rovner, P.C. 4503 North Front Street Harrisburg, Pennsylvania 17110-1708 -n? 'onli nti a? Re: Mary C. Marconi Dear Attorney. Sadlock: I have reviewed the transcripts of the depositions of Timothy A. Clark, M.D dated March 31, 2010 and Mark A. Osevala, D. 0. dated May 11, 2010 have also reviewed the report of my initial at your request. I forwarded to you. review of this case which I have previously After this additional review, my opinions of this case have not changed. As previously stated, I am familiar with the standards of care that applied to the care and treatment of Mar C, 1 Y Marconi in March and April of 2007. Relying on these standards of care, I continue to conclude that: Once the diagnosis of a complete sternal dehiscence with the Possibility o underlying deep sternal wound infection had been made based, in part on t an chest x-ray performed on he chest 2 April 2, 2007 and the CT scan of the chest performed on April , 2007 and confirmed by the physical examination performed b C. Calla, PA-C on behalf of Timothy A. Clark, M. D. and by Mark A. Osevala, D.O. on April , _ Y Ricardo 3 2007, 1 continue to conclude that definitive surgical care which would have included sternal wound re-exploration with possible sternal re-w' ' or sternal debridement with either immediate or delayed sternal wound closure should have been performed on an urgent basis, certainly within 24 _ 4 re-wiring the diagnosis, unless the patient's medical condition dictated that a delay of provision of definitive surgical care would have been prudent and in the 8 hours patient's best interests. Definitive surgical care, as outlined above, in the in the patient factors which would have warranted a delay in the provision of definnti ve e of surgical care, was not performed until the patient was transferred to the Harrisburg i I. Richard A. Sadlock July 20, 2010 Page Two of Two Re: Mary C. Marconi Hospital on April 10, 2007, was seen in consultation by Dennis Banducci, ?M.D. on April 10, 2007, and was operated upon by Dr. Banducci on April 11, 2007. This delay in the provision of definitive surgical care, clearly and with a reasonable degree of medical certainty, falls below the acceptable standards of care that applied to the care provided to Mary C. Marconi by Mark A. Osevala, D.O. in March and April of 2007. This delay in the provision of definitive surgical care contributed to the additio morbidity, pain, and suffering suffered b M na1 significantly to her eventual death on April 200, 007 Iaroni and contributed These opinions outlined above are made with a reasonable degree of medical certainty. es tfull mitt Christian T. amp M.D. Southcoast Cardiac and Thoracic Surgery, P.C. Fall River, Massachusetts 02720 cc. File EXHIBIT "C" .i Kurr v. Holy Spirit Health System et al. Cumberland County No. 09-1600 Received October 15, 2010 Case Analysis and Expert Medical Opinion February 23, 2011 Prepared by: Joseph M. Darby M.D. Scaife Hall, Room 610 3550 Terrace Street Pittsburgh, Pa. 15261 Prepared for: Richard A. Sadlock, Esq. Angino-Rovner 4503 North Front Street Harrisburg, Pa 17110-1799 Kurr v. Holy Spirit et al Page 1 of 8 1 1 Richard A. Sadlock, Esq. February 23, 2011 Angino-Rovner 4503 North Front Street Harrisburg, Pa 17110-1799 Dear Mr. Sadlock, This report is prepared pursuant to your request to review medical records and le pertinent to the hospitalizations, clinical course and death of Mary Marconi following admission to Holy Spirit Hospital on 3/15/07 for corona artery bypass gal documents specifically requested that I provide analysis and expemedi al opin on as teo the cause her of her death and whether the management of her sternal wound infection met th surgery. have the standard of care. QUALIFICATIONS I am board certified in the specialty of Internal Medicine and Critical Care Medicine. engaged in the practice of Critical Care Medicine since 1986 and devote a o been approximately 80 of my time to the care of critically ill patients both inside and outside of the intensive I care unithave. I have been an ICU Director or Co-Director since 1986. My current hospital title is Medical Director of the Critical Care Outreach Service and Associate Director of the Neur at Presbyterian University Hospital. I am a member of the UPMC ati ent safety also the Medical Director of the UPMC Medical Emergency Response Improvement o-Trauma ICU my education, training and clinical experience, I am rgenc knowledgeable xpo committee and evaluation and management of critically ill medical and surgical patients with a variety life Team. 8 threatening conditions including sepsis. On the basis of my knowledge, and experienced in the I am qualified to render expert medical opinions on this case. Additional details of my qualifications are included in my curriculum vitae, y nowledge, training and experience, RECORDS AND DOCUMENTS REVIEWED Medical Records • Selected digital images • Holy Spirit Hospital admission 311512007 • Health South Rehabilitation admission (excerpts) 3/21/2007 • Holy Spirit Emergency Department (3/25/07) and Hospital admission 3/26/200 • Harrisburg Hospital Admission 4/10/07 7 Depositions • Dr. Mark Osevala • Dr. Timothy Clark Expert Reports • Dr. Christian T. Campos Kurr v. Holy Spirit et al Page 2 of 8 ti M ma oMarconi was His r0 her a 7g- RY q was perfor admission to year-old wo N? CLINIC to have ?ned pre HOLY Spirit man with a q? COURS reluct e 3 vessel Operative! H°sp;tal history of e cot ant to hav disease an y Prior to a on Marc hYPerte surgeon arte a surgery no d bypass Sur, Planned a reh ?5, 2007 for 'On and h 9eon D rybypass nethele ery w do kne card: YPerlipid because r• Mark A. grafting on ss, she co as recOmm a replacern ac catheter: ern;a at the of her ,'bo Osevala in March 1 g nsented and eended. The enc. She was zati°n chat her 1Ow'n9 hers 'body habitus anbi jack of any sh y wo I n his operatually un ent and hells covered at r;s?gical;nteNe f anY disc would not be true note event three- °n were pu great Ory co, er than 60 ntl/ , maxi?u n, the patien al vessels to 9r8 ?didare forredrdioth0 aci?el creatinine 01 ?emidiaphra9m Plication tha Ma/War h 201 7 but ubse loped evidenta ° surgery tho discharge Which was that were character/.' Durin fluently decli Of acute usand and transfe likely due t acteri.' g this hos ned to 0 9 kidney in . r to Health O both ate: as basilar o Pitalization s With GFR es ir With Health sOUth 3/?1 South Rehabilitas's and left -sit/es in the re !SO develoin?ated fo /o Marconi was /2007 °n, her white b ood col effus)on. eft was S'ne9 her adiss onnferred to Heal unt was g $ nor to Health o°se'nedro; and lMonary thcon' the Patient South rehabilit Iasi sulr be atio an ele nin9 respiratory x °n Marc ant, Dr. lnn gan develo non Marc CefiPivatiOn in symptomh 22nd. 7-h ers She ping respir h 21, 2007 h me and Vwhite blood c s with a e follow. was started story Probl - 0n the d ypergiycemia. ancOmycin count to 13 chest x-ra ng day (1?? °n high erns for ?v ay S thousand th Ich she marked as well arch 23 per: Ur' l nners also at Suggeste rd) the e cort'Coster failure an pheral edern o nor as Coreg an She wa d Infiltr Patient Olds had d Possible pn un?oniadla9 os saar to patient haansulin for Sd on ntibiot- left base a at the HOI s irl the an er and On Marc t 3/25/2007 at tune was a o crease b ;n ? -in u ed herapy of Spirit hosh 25, 2007 rOnhiti co 9ht alo 9 wit s a Left-si Pit with the patient n9esti n ve With thou dell pi eur Symptoms was transferred hea t levels and' BUN haI effusion. qt Of Pro from pulmoA contrast ad increased the tune of a shortness eaith South na nh to this of Re bilateral eff ernbolis T ced CT s? 7 and there admission h reach, her habilitation and cunt: ec/ s Sh• The Cr sca an of the ch were elevater white cou discOmforr back to Hol 26th and Hoed on comic unde1?'ent t showed baest was obta; m both nt had incr hypOx/a a? Cisa Tkatc ted that her°stero;ds anhoracente silar consOli ned on Ma Pro BNP an eased to lg d h s sur d a s ch 2 d tro 8 recOrnrn aw her n 9ich 2 d tro 8 cal wo ntib for ;otic 5p0 datio cc n left r 6th for pOnin ended control wa continui d did nor a and was cle therapy Dr. of san9ui n eater than rl evaluation of hospital ons poor dur;n n9 CefepimdPear to be con and dry sevala saws f uid, wasght, and was im March 30 9 the cOUr and Van nvinced n infect: the Pat' given Casi estimatbdrOVement in , 200j w?fh se °f hOSpit cO'nycin that She ha Ous d'sea s lent on March x e1nPiric creat;nin renal function her white call Zation Shending the r d its of o a consultant or. ally with Cefeplrrie and of 48 BUN and creaele a ell a t?matelytd' cu tures. GI c rnllrn the ancOm n mi ute, n'ne at 3.4 thous arged fro y emit 34 Kurt v Holy Spirit Ycin for 2 additions 1 an was ato co • 1. resPe r ?°wev? , then iet at days f ntdnue ely wit e ollowin9 discha?geiOtic therapy PM- - - HO/ S irit 4/3/2007 Mrs, Marconi dischar was re admitted °n April 2 t hYPOXem ao Holy S renal fu , atrial fibrillae. when she p e'st HOSpital ED nctio 34m1/min), in egad dererioratend chest painenred with pro pprOXimatelY 3 morphine. A ergencY de d with BVN Her white co g t asive shortness O aft er her cardiom portable chest partment she Of had ris obtained raY revealed 34 and a creatinine of n to 14 1 thous th, ste aegaly d shad was thou h Baled ass treated wit 1.S a rnoto owed d1 g t to represe mild increase Pt high doses of (estimated GFd and her effusion mY site. There was also Of the priors congestive heart central cone olumedrol a R vidence notom failure, C? stion an d e'xtree early Morning of chronic left lower! as a soft tissue ci of the the mitie , rate lob stele and i'ettin s s eeZursingof April 3 e e densit Chest was ger PAC ?a ctasis Yin the co ) later ' and c she was dOC a pericardial portio Paining of chest in the mornin °nfusion, The umented to n Of the pain a g and n admittin have SolumedrOl do ternotom oted that she pitting ede Y wo and that there g medics! se ?na was was havin Dr. n to Ses, consult ca?nd The initial some fresh b! g difirv ice saw her in the lower consultatio congestive saw hneectious disease egardplan was to contnd/ng a ul?t fr breafh??ga ppare heart er and follow. a if her white ng the perlcar ue antibiotic °m the to Ing pre snoted thatfailue could en his evaluation o- continued ! effusion ngestlve and con - ,tape er r recommended sure'nlury LOShe weighed 226 e!y explain h' nd'cated that to rise. The c consider the h cal therap ' pounds er sympto he wasn,t ardiologY consult ypercapnic res Later that a ft y for a reddened was hypoalb s• A consultat evinced that ant approximately 2 ; 2 ratory failure aoOn' the parie area in the per! iinemlc and n to at the wound care attend ing ph 5 pm. Follo and vas ad nt developed Urn and a s a 9h ris respiratory a fsician addenda wrng the pa admitted to the IC progressive r nutrition consult k for chest. est and that the ternal P°q note indi ate tort eteriwhere che waesPira s nfUbry difficy as lCU Mrs. amission and was posit ?ehor inf ?tit/elton nt had su Written at t aadng oorde Saby R pitted to the iC °n per the CT can Of se Yc'n, and ard° Calla V Under the he sternal and appeared lumedrol 5 0 (PAC) include care of pr, Cl significanOUnd'nfection wave a ste nal wo 6 hrs. pr multiple Clark's culturark es an intensivist. amount ntiblotics o e infectious lnitia! imp 1 diseas of flUCtuanc considered and infectio ression was f Ch fp/me consultation a as Well s ejnvOlving the the sOUrc with an un the infectious' cardiovascular um ne °?hers1On of her s that she and rnu and drain a collection consultant cuPar surge and surrou Psi 's noting that tm. The was a surgery wet ndin at Cher e ncurrent with A cOnsultationand recommindicated r ordered. After tissue. Consult was a vealed normal C e'nitiati t i of a r. Osevalnded CV surgery at she had a steee1ng Mrs. On to pn q function a eVOphed infusion (CV S!) was consult for nal Wound cOni in { BVN/?ril 4?' the white nd a posterior for hYpoteered into theternal ! and D (in ction j that edeyst?at 48/1 and estimate risen to 17 ericardial effusion'Ory. An Bch°ca?diog a23pms/ on at I pecte m coati that the Patient d GFR declin thousand while renal nine of 1.7" a n had deve1oetiologY for herg to 31 ml/mi function consultation for her d that she w pill acute on clinical dec n' Cardiolo deteriorate Karr v sternal w°Unds volume ov ohronic renal mpensat. gy consultants d with Holy S nfectio aded allure bas A renal Opined Plant pmt et al n He Opined that MSSa saw the pari d' charge rcOn? might need ent in her Paaa e r _ sternum repaired if she was unable to be weaned from the ventilator. He did not specifically opine on management of sternal wound infection. A question regarding the availability of plastic surgery at Holy Spirit Hospital was raised by Dr. Osevala. A nutritional assessment on this date indicated that Mrs. Marconi was "high risk" and recommended starting enteral nutrition. On April 5th, her white count remained elevated at 17.1 thousand, renal function remained impaired with new onset of metabolic acidosis. Repeat serum albumin had dropped to 2.7 while orders were entered to start enteral nutrition with Novasource renal at 10cc/hr. The ID consultant's note indicated that the patient would benefit from I and D of the sternal wound and deferred to CT surgery. Dr. Park, a partner of Dr. Osevala saw the patient that day and expressed appreciation for the ID input and then deferred management of the sternal wound to Dr. Osevala. On April 6`h, Mrs. Marconi's daughter (Denise Kerr) called Dr. Osevala's office at or about 3:39 pm and wanted to make an inquiry about whether the sternal wound was going to be debrided. Dr. Leo Farrell (plastics) was subsequently consulted but this physician was apparently on a leave of absence. The CVSI service was made of aware of the situation. Over the course of the next several days, the patient had ongoing failure, renal failure, metabolic acidosis, fluid overload, and hyperglycemia. Blood scpultu es were documented on April 7 to be positive for MRSA by Drs. Clark and Osevala. In addition, there were ongoing discussions regarding her transfer to another facility for "sternal reconstruction". By April 9th, Mrs. Marconi's white count had risen to 21.1 thousand while her renal function and acidosis worsened. BUN and creatinine had risen to 92 and 1.9 (est GFR 26 ml/min) while bicarbonate dropped further to 17 mEq/L. Plans apparently patient to Harrisburg Hospital on this day for repair of her sternal union however, this did not occur. On the morning of April 10th, Mrs. Marconi's white count remained elevated, while her renal function further deteriorated with a BUN of 114 and creatinine of 2.0. Prior to her transfer to Harrisburg Hospital, Dr. Osevala also saw her that morning and opined that while she was in positive fluid balance, she was actually volume depleted. He also raised the question about the need for Solumedrol. He ordered the administration of IV fluids, holding of Lasix and the transfusion of packed red blood cells for a hematocrit that had dropped from 31.7% to 28.9%. The consulting nephrologist noted that she was wheezing, in positive fluid balance and had 2-3+ edema and opined that she was clinically volume repleted. He ordered the discontinuation of IV fluids that had previously been ordered, started an albumin infusion and ordered sodium bicarbonate for ongoing metabolic acidosis. The cardiologist who saw her that day noted that she had MRSA bacteremia and was awaiting surgical treatment of her sternum. Harrisburg Hospital 4/10/2007 Mrs. Marconi was admitted to Harrisburg Hospital to the service of Dr. Osevala on the evening of April 10th. Her initial laboratory data revealed that her white count had risen to 23.8 thousand and that her renal function was further deteriorated with a BUN of 129 and creatinine of 2.4 (estimated GFR was 20.9 ml/hr). The ICU admitting diagnosis was surgical wound infection with sepsis and hypoxemic respiratory failure. Consults to Drs. Goldner (sp) and Pokeryn were ordered regarding surgical wound infection. Vancomycin, Cefipime and Solumedrol were continued. The anticoagulant Arixtra was ordered for DVT prophylaxis as a continuation from her prior hospital admission. Cultures of the urine were obtained and continued to grow yeast (non - candida albicans). Attempts to obtain blood cultures were initially unsuccessful. Kurr v. Holy Spirit et al Page 5 of s Prior to undergoing surgery on April 11`x', Mrs. Marconi's white count remained elevated at 22.8 while renal function was still markedly impaired with BUN at 128, creatinine at 2.4 and estimated GFR at 20.9 ml/min. Later that day, the plastic surgeon (Dr. Banducci performed included sternal debridement and pectoralis flap closure. His preoperative and postoperative which diagnoses were sternal wound infection and dehiscence. Operative and blood cultures subsequently returned as no growth. Dr. Banducci's post operative orders included the resumption of Arixtra, however, Dr. Osevala subsequently discontinued the Arixtra and despite the presence of acute and worsening renal failure, he ordered high doses of Enoxaparin at 70 mg q 12 hours. He also ordered a tapering dosing schedule for Solumedrol. The first dose of Enoxaparin was administered at 9:24 pm on 4/11 with a second dose administered on 4/12 at 7:52 am. By the morning of April 12th, the hematocrit had dropped urine output was declining and she began to develop hemodynamic 9 stability. (It appears 5 am), her the record that Dr. Osevala's physician assistant (Eugene Williams) was managing the patent's hemodynamic instability in the early morning hours including fluid administration and IV amiodarone for atrial fibrillation. A renal consultant (Dr. Montsurg) subsequently became involved with her ICU management and ordered a sodium bicarbonate infusion. At or about 12:40 pm, Dr. Osevala was aware of the emerging hemodynamic instability and hypotension and despite the presence of atrial fibrillation, ordered a dopamine infusion via telephone order. Hypotension and oliguria continued into the early afternoon and was being managed by the renal consultant. A neosynephrine infusion was added to the regimen at or about 3:00 pm. Arterial blood gases were drawn and revealed a severe metabolic acidosis with a base deficit of - 11. Dr. Osevala was informed of the blood gas results. The intensivist (Dr. Clark) came to the patient's bedside at or about 3:35 pm. His initial impression was that she was in septic shock. The bicarbonate infusion was increased and discussions with renal consultants ensued regarding the institution of continuous renal replacement therapy of severe acidosis. Repeat arterial blood gases at or about 5:00 pm revealed vealed a worsening management R metabolic acidosis (base deficit of -15). A levophed infusion was started at or about 5:00 pm. At or about 5:20 pm, the patient sustained a cardiopulmonary arrest preceded by worsening hypotension and evidence of arterial bleeding from the surgical wound. A CBC obtained contemporaneously with the code demonstrated a further decline in hematocrit from 35.7% to 26%. CPR was administered for approximately 5 minutes and two units of packed cells were transfused. Dr. Osevala was called and arrived on the unit about 7:00 pm and took the patient to the operating room. At the time of surgery, there was clot in the mediastinum and soft tissues. Oozing on the left and right along and a small "bleeder" were noted. A Swan Ganz catheter had been inserted with the first cardiac index measured postoperatively at 1.5 L/mim/M2. By the next day (April 13'h), Mrs. Marconi's white count remained elevated and had a further drop in hematocrit to 22.4% along with the development of thrombocytopenia. Pulmonary vascular congestion and low cardiac output remained. Blood components were transfused. CRRT was started at 3:33 pm for renal failure and fluid overload however she was intolerant of fluid removal. Despite continued positive fluid balance, fluid overload, abdominal distention, and generalized weakness, the decision was made to extubate the patient on 4/15 at or about 2:30 pm but she subsequently required non invasive ventilate support failure. Despite all pertinent cultures being negative, the infectious d seaseoc'onsultant opined on 4/17 that Mrs. Marconi had a sternal wound infection. Mrs. Marconi remained fluid overloaded, was oozing fluid from all her extremities, developed ascites and became encephalopathic with a rising bilirubin and elevation in ammonia level and had to be reintubated on 4/18. On this day Mrs. Marconi's white blood count was on a downward trajectory however she had a left shifted differential, toxic granulation of her white cells and a progressively declining platelet count to3 Kurr v. Holy Spirit et al 8 Page 6 of 8 5 thousand. Following intubation she developed recurrent hypotension necessitating the reinstitution of a levophed infusion. Dr. Clark opined that she appeared septic. Noting the development of fever (now off of CRRT), the ID consultant's opinion was that she had a sternal wound infection with repeat cultures ordered. CRRT was discontinued on 4/17. She began her first intermittent hemodialysis session on 4/18 and had a total of 4.7 liters of fluid removed via ultrafiltration. Over the ensuing days, Mrs. Marconi had ongoing problems of worsening respirato vascular congestion, fluid overload, encephalopathy, thrombocytopenia, ry failure with diarrhea, intolerance with enteral feeding and recurrent hypotension requiring a neosynephrine infusion. "Clotting" of the dialysis catheter prevented effective dialytic therapy. She ultimately developed worsening hypotension with the family deciding to forego additi anal therapy. Her status was changed to comfort care and she was allowed to die on April 20th. The death certificate signed by Dr. Osevala on 4/23/07 listed the cause of death as "Renal Failure". The discharge coding summary record included the following discharge diagnoses: post operative infection, sepsis (NOS) and severe sepsis. Kurr v. Holy Spirit et al Page 7 of 8 t OPINIONS Proximate Cause of Death: Sternal wound infection following coronary artery bypass grafting Chain of Events: Mrs. Marconi presented to Holy Spirit Hospital on April 2nd with respiratory and renal failure that was caused by a sternal wound infection. Definitive surgical debridement of this wound infection was not achieved for at least 1 week after it was recognized. During this period of time, Mrs. Marconi developed progressive renal failure as a result of inadequately treated infection. Following surgical debridement of the wound, she developed hemorrhagic shock and cardiopulmonary arrest as a result of bleeding complications related to impaired renal clearance of high doses of the anticoagulant Lovenox as well as impaired platelet function associated with renal failure. Following these events, the patient developed progressive multisystem organ failure and died with the immediate cause of death being septic shock. Breaches in the Standard of Care: The minimum applicable standard of care required to properly and safely manage Mrs. Marconi's sternal wound infection included the early recognition of infection, elimination of unnecessary treatments that perpetuate or exacerbate infectious morbidity and the control of the source of infection. As the operating surgeon responsible for the early recognition and treatment of post-surgical complications, Dr. Osevala breeched the standard of care in failing to recognize that a sternal wound infection was present despite the clinical evidence and the learned opinions of consultant physicians. Furthermore, Dr. Osevala breeched the standard of care in recommending in a timely fashion, that high doses of corticosteroids be rapidly tapered. Finally, despite his capability of performing debridement of the surgical wound, Dr. Osevala breeched the standard of care and his duty to the patient in ,ailing to perform or ensuring that surgical debridement of the wound infection was performed in a timely manner. Surgical debridement was not performed in a timely manner. Had Dr. Osevala recognized that surgical wound infection was present and surgical debridement performed in a timely manner, more likely than not, the chain of events culminating in her death would not have occurred. I hold these opinions to a reasonable degree of medical certainty and reserve the right to amend my opinions on the basis of any additional discovery. Joseph M. Darby MD. Professor Critical Care Medicine and Surgery Kurr v. Holy Spirit et al Page 8 of 8 CERTIFICATE OF SERVICE AND NOW, this 28th day of June, 2011, I, Thomas M. Chairs, Esquire, hereby certify that I did serve a true and correct copy of the foregoing BRIEF IN SUPPORT OF MOTION FOR SUMMARY JUDGMENT FILED ON BEHALF OF DEFENDANT, HOLY SPIRIT HEALTH SYSTEM, D/B/A HOLY SPIRIT HOSPITAL upon all counsel of record by depositing, or causing to be deposited, same in the U.S. mail, postage prepaid, at Camp Hill, Pennsylvania, addressed as follows: By First-Class Mail: Richard A. Sadlock, Esquire ANGINO & ROVNER, P.C. 4503 North Front Street Harrisburg, PA 17110 (Counsel for Plaintiff) Michael D. Pipa, Esquire STEVENS & LEE, P.C. 17 North Second Street 16th Floor Harrisburg, PA 17101 (Counsel for Defendant, Mark A Institute, P.C.) Osevela, D.O. and Capital Area Cardiovascular Surgical Evan Black, Esquire THOMAS, THOMAS & HAFER, LLP P.O. Box 999 Harrisburg, PA 17108 (Counsel for Timothy A. Clark, M.D. & Central Pennsylvania Pulmonary Associates, LLC) FILED-OFFICE OF THE PROTHONOTARY "oII J'JL 12 PSI 3: 23 CUMBERLAND COUNTY PENNSYLVANIA THOMAS, THOMAS & HAFER, LLP Attorneys for Defendant Timothy A. Clark, M.D. Evan Black, Esquire Attorney I.D. 17884 Hugh P. O'Neill, III, Esquire Attorney I.D. 69986 305 North Front Street P.O. Box 999 Harrisburg, PA 17108 (717) 441-7051 DENISE L. KURR, PERSONAL : IN THE COURT OF COMMON PLEAS REPRESENTATIVE OF THE ESTATE CUMBERLAND COUNTY, OF MARY MARCONI, PENNSYLVANIA Plaintiff vs. HOLY SPIRIT HEALTH SYSTEM d/b/a HOLY SPIRIT HOSPITAL; MARK A. OSEVALA, D.O.; TIMOTHY A. CLARK, M.D. AND CENTRAL PENNSYLVANIA PULMONARY ASSOCIATES, LLC., DOCKET NO. 09-1600 CIVIL ACTION - LAW MEDICAL MALPRACTICE JURY TRIAL DEMANDED Defendants STIPULATION OF COUNSEL Pursuant to Pa.R.C.P. 229, the parties by and through undersigned counsel hereby Stipulate that all claims against Defendants, Timothy A. Clark, M.D. and Central Pennsylvania Pulmonary Associates, LLC, are discontinued with prejudice from the within action. Said Defendants may be removed the caption of this for all purposes. The Prothonotary is hereby requested to delete Timothy A. Clark, M.D. and Central Pennsylvania Pulmonary Associates, LLC., names from the caption of the case. All counsel executing this Stipulation hereby represent and warrant that they are so authorized to do so on behalf of their respective clients. The parties agree that this Stipulation may be executed in counterparts so that when separate signature pages are accumulated which collectively bear the signature of all counsel of record, this Stipulation shall be effective. All counsel hereby agree that this Stipulation shall, whenever becomes effective, bear the full force and effect of an Order of Court discontinuing this case as to Timothy A. Clark, M.D. and Central Pennsylvania Pulmonary Associates, LLC., with prejudice. In witness whereof, the parties by their counsel have caused this Stipulation to be executed and intend to be legally bound thereby. Respectfully submitted, THOMAS, THOMAS & HAFER, LLP By: Date: Evan Black, Esquire Hugh P. O'Neill, III, Esquire Thomas, Thomas and Hafer, LLP 305 North Front Street P.O. Box 999 Harrisburg, PA 17108 (717) 441-7051 Attorneys for Defendant, Timothy A. Clark, M.D. and Central Pennsylvania Pulmonary Associates, LLC ANGQW& ROV-P* Of.C. R44YM Smock, Esquire ttorney for Plaintiff Date: - to ho DICKIE, McCAMEY, C)III,r2"OY'E, P.C. Thomaj ?' kaifrs, Esquire Attorney for Holy Spirit Health System l d/b/a Ho77;07; Date: / STEVENS & LEE, P.C. IA? - U Michael Pipa, Esquire Mark A. Osevala, D.O. and Capital Area Cardiovascular Surgical Institute, P.C. Date: 61Z-41 it CERTIFICATE OF SERVICE I, Joan L. Wolfe, an employee of the law offices of Thomas, Thomas & Hafer, LLP, do hereby certify that I served a copy of the foregoing document by depositing the same in the United States mail, first class, postage prepaid, as follows: Richard Sadlock, Esquire Angino & Rovner, P.C. 4503 North Front Street Harrisburg, PA 17110-1708 Thomas Chairs, Esquire DICKIE, McCAMEY, CHILCOTE, P.C. Plaza 21, Suite 302 425 North 21 st Street Camp Hill, PA 17011 Michael D. Pipa, Esquire Stevens & Lee 17 North Second Street 16th Floor Harrisburg, PA 17101 Jo .Wolfe Date: S THOMAS, THOMAS & HAFER, LLP Evan Black, Esquire Attorney I.D. 17884 Hugh P. O'Neill, III, Esquire Attorney I.D. 69986 305 North Front Street P.O. Box 999 Harrisburg, PA 17108 (717) 441-7051 Attorneys for Defendant Timothy A. Clark. M.D. DENISE L. KURR, PERSONAL IN THE COURT OF COMMON PLEAS REPRESENTATIVE OF THE ESTATE CUMBERLAND COUNTY, OF MARY MARCONI, PENNSYLVANIA vs. Plaintiff HOLY SPIRIT HEALTH SYSTEM d/b/a HOLY SPIRIT HOSPITAL; MARK A. OSEVALA, D.O.; TIMOTHY A. CLARK, M.D. AND CENTRAL PENNSYLVANIA PULMONARY ASSOCIATES, LLC., Defendants DOCKET NO. 09-1600 CIVIL ACTION -LAW MEDICAL MALPRACTICE JURY TRIAL DEMANDED ORDER FOR DISMISSAL 011 - AND NOW this day of , 2011, it is hereby ORDERED AND DECREED, that the Defendants, Timothy A. Clark, M.D. and Central Pennsylvania Pulmonary Associates, LLC, only are hereby dismissed with prejudice in accordance with the attached Stipulation of All Counsel, agreeing to the dismissal of less than all Defendants. The Prothonotary is ordered to delete from the caption the names of the dismissed Defendants, Timothy A. Clark, M.D. and Central Pennsylvania Pulmonary Associates, LLC. BY THE COURT: Date: ? e4ae b PPa %l?omgs L-s?- ? van A6 la Ole-, ?e7,5 r• -- ` rnC0 L- =-n rn- r r - --0 ) CD ° -n acres 5 Orn --+ -' 996868 DICKIE, MCCAMEY & CHH.COTE, P.C. BY: Francis E. Marshall, Jr., Esquire ATTORNEY I.D. NO. 27594 BY: Thomas M. Chairs, Esquire ATTORNEY I.D. NO. 78565 Plaza 21, Suite 302 425 North 21st Street Camp Hill, PA 17011 717-731-4800 (Tele) 888-811-7144 (Fax) DENISE L. KURR, PERSONAL REPRESENTATIVE OF THE ESTATE OF MARY MARCONI, Plaintiff V. HOLY SPIRIT HEALTH SYSTEM D/B/A HOLY SPIRIT HOSPITAL, AND MARK A. OSEVALA, D.O., Defendants ATTORNEY FOR: DEFENDANT HOLY SPIRIT HEALTH SYSTEM DB/A HOLY SPIRIT HOSPITAL IN THE COURT OF COMM L S OF CUMBERLAND COUNT-4 `'' ? .j PENNSYLVANIA "<- ` 7 < NO.09-1600 < _r & 09-2181_ ; _ :icr MEDICAL MALPRACTICE ACS 0N(j1:7'- JURY TRIAL DEMANDED UNCONTESTED MOTION TO DISMISS AND NOW, comes Defendant, Holy Spirit Hospital, by and through its counsel, Dickie, McCamey & Chilcote, P.C. and files the within Uncontested Motion to Dismiss and in support thereof avers as follows: Plaintiff initiated this civil action sounding in medical malpractice against the Holy Spirit Hospital and other individually named Defendants. 2. After completion of discovery, counsel for all parties of record stipulate and agree that the Holy Spirit Hospital should be dismissed from this case. A true and correct copy of the Stipulation to Dismiss executed by counsel for all parties of record is attached hereto as Exhibit «A„ WHEREFORE, the Holy Spirit Hospital requests the Court enter an Order approving of the dismissal of the Holy Spirit Hospital from this case and directing the Prothonotary to remove Holy Spirit Hospital from the caption of this case. Respectfully submitted, DICKIE, MCCAMEY & CHILCOTE, P.C. Date: July 28, 2011 By: -- Thomas . Chairs, Esquire Supreme Court I.D. #78565 425 N. 21" Street, Suite 302 Camp Hill, PA 17011-3700 (717) 731-4800 Attorney for Defendant, Holy Spirit Hospital 2 980156 JUL 2 8 2011 DICKIE, MCCAMEY & CHILCOTE, P.C. ATTORNEY FOR DEFENDANT BY: Thomas M. Chairs, Esquire HOLY" SPIRIT HEALTH SYSTEM DB/A ATTORNEY I.D. NO. 78565 HOLY SPIRIT HOSPITAL Plaza 21, Suite 302 425 North 21st Street Camp Hill, PA 17011 717-731-4800 (Tele) 888-811-7144 Fax DENISE L. KURR, PERSONAL IN THE COURT OF COMMON PLEAS REPRESENTATIVE OF THE ESTATE OF OF CUMBERLAND COUNTY, MARY MARCONI, PENNSYLVANIA Plaintiff NO. 09-1600 & 09-2181 V. MEDICAL MALPRACTICE ACTION HOLY SPIRIT HEALTH SYSTEM D/B/A HOLY SPIRIT HOSPITAL, MARK A. OSEVALA, D.O. AND TIMOTHY A. CLARK, M.D., Defendants JURY TRIAL DEMANDED STIPULATION TO DISMISS HOLY SPIRIT HOSPITAL ONLY IT IS HEREBY stipulated and agreed by and between counsel for all parties of record that the Holy Spirit Hospital is voluntarily dismissed from this case pursuant to Pa.R.C.P 229. ANGINO & ROVNER, P.C. By: Richard A. Sad squire (Counsel for Plaintiff) STEVENS & LEE, P.C. By: Michael D. Pipa, uire (Counsel for Defendant, Mark A. Osevela, D.O. and Capital Area Cardiovascular Surgical Institute, P.C.) DICKIE, MCCAMEY & CHILCOTE, P.C. By: - ---- Thor s M. Chairs, Esquire (Counsel for Holy Spirit Health System d/b/a Holy Spirit Hospital) 2 CERTIFICATE OF SERVICE AND NOW, July 28, 2011, I, Thomas M. Chairs, Esquire, hereby certify that I did serve a true and correct copy of the foregoing UNCONTESTED MOTION TO DISMISS upon all counsel of record by depositing, or causing to be deposited, same in the U.S. mail, postage prepaid, at Camp Hill, Pennsylvania, addressed as follows: By First-Class Mail: Richard A. Sadlock, Esquire ANGINO & ROVNER, P.C. 4503 North Front Street Harrisburg, PA 17110 (Counsel for Plaintiff) Michael D. Pipa, Esquire STEVENS & LEE, P.C. 17 North Second Street 16th Floor Harrisburg, PA 17101 (Counsel for Defendant, Mark A. Osevela, D.O. and Capital Area Cardiovascular Surgical Institute, P.C.) Thomas Esquire DENISE L. KURR, PERSONAL REPRESENTATIVE OF THE ESTATE OF MARY MARCONI, Plaintiff V. HOLY SPIRIT HEALTH SYSTEM DB/A HOLY SPIRIT HOSPITAL, MARK A. OSEVALA, D.O., Defendants IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 09-1600 & 09-2181 C) N MEDICAL MALPRACTICE AC'OIY zM c cn ? i JURY TRIAL DEMANDED T_ ORDER FOR DISMISSAL > ay. p? ?l 7JCJ ,C7 AND NOW this _ day of `?t k. , 2011, it is hereby ORDERED and DECREED that Defendant, Holy Spirit Hospital, only are hereby dismissed with prejudice in accordance with the attached Stipulation of All Counsel agreeing to the dismissal of less than all Defendants. The Prothonotary is ordered to delete from the caption the name of the dismissed Defendant, Holy Spirit Hospital. BY THE COURT: Distribution list: 8[3111 Thomas M. Chairs, Esquire p46 DICKIE, MCCAMEY & CHILCOTE, P.C. 425 N. 21" Street Camp Hill, PA 17011 (Counsel for Holy Spirit Health System d/b/a Holy Spirit Hospital) Richard A. Sadlock, Esquire ANGINO & ROVNER, P.C. 4503 North Front Street Harrisburg, PA 17110 (Counsel for Plaintiff) Michael D. Pipa, Esquire STEVENS & LEE, P.C. 17 North Second Street, 16th Floor Harrisburg, PA 17101 (Counsel Capital Area Cardiovascular Surgical Institute) S Bug' Trothonotag Office of the TrufhU7Ut°7 �� County, - annsyrvania -°rk,-.~--o` -~Q Solicitor n d.„,Yc^ CIVIL TERM ORDER OF TERMINATION OF COURT CASES AND NOW THIS 28TH DAY OF OCTOBER, 2014, AFTER MAILING NOTICE OF INTENTION TO PROCEED AND RECEIVING NO RESPONSE - THE ABOVE CASE IS HEREBY TERMINATED WITH PREJUDICE IN ACCORDANCE WITH PA K[.P.2]02. BY THE COURT, DAVID D. BUELL