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HomeMy WebLinkAbout09-4477 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 JODI KRAUS, Plaintiff V. ROBERT G. MICHELINI, D.O.;SPIRIT PHYSICIAN SERVICES, INC. t/d/b/a GREEN HILL FAMILY HEALTH CENTER; HOLY SPIRIT HEALTH SYSTEM t/d/b/a GREEN HILL FAMILY HEALTH CENTER; GREEN HILL FAMILY HEALTH CENTER; CLEM CICCARELLI t/d/b/a GREEN HILL FAMILY PRACTICE; Defendants IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PA NO. Dq' /V77 Cv.??er?. CIVIL ACTION - LAW MEDICAL MALPRACTICE JURY TRIAL DEMANDED 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 four Defendants: Robert G. Michelini 503 Bridge Street New Cumberland, PA 17070 Spirit Physician Services, Inc. t/d/b/a Green Hill Family Health center 503 N. 21St Street Camp Hill, PA 17011 406241 Holy Spirit Health System t/d/b/a Green Hill Family Health Center 503 N. 21St Street Camp Hill, PA 17011 Green Hill Family Health Center 503 Bridge Street New Cumberland, PA 17070 Clem Ciccarelli t/d/b/a Green Hill Family Practice 503 Bridge Street New Cumberland, PA 17070 Writ of Summons shall be issued and forwarded to () Attorney (X) Sheriff Joseph M. Melillo, Esquire Angino & Rovner, P.C. 4503 North Front Street Harrisburg, PA 17110 I.D. No. 26211 717-238-6791 I ('22?_z z' ig ture of Attorney Dated: WRIT OF SUMMONS TO THE ABOVE NAMED DEFENDANT: YOU ARE NOTIFIED THAT THE ABOVE-NAMED PLAINTIFF HAS COMMENCED AN ACTION AGAINST YOU. Proth otary Date: 6 oZa o 9 by Deputy ( ) Check here if reverse is issued for additional information 406241 OF THE 2009 JUL -b PM 1: 38 1-7 C,t 7?rs3 y n Ai ?- ?-7 ?° i? R Thomas Kline Sheriff Ronny R Anderson Chief Deputy Jody S Smith Civil Process Sergeant Edward L Schorpp Solicitor Sheriffs Office of Cumberland County OF TNr 04 ?kj_ € 14 -jr 1?. T F. F -E RIFF f.JtiJI - is _..y Jodi Kraus vs. Robert G. Michelini, D.O. Case Number 2009-4477 SHERIFF'S RETURN OF SERVICE 07/08/2009 01:45 PM - Noah Cline, Deputy Sheriff, who being duly sworn according to law, states that on July 8, 2009 at 1345 hours, he served a true copy of the within Writ of Summons, upon the within named defendant, to wit: Robert G. Michelini D.O., by making known unto Tammy Letterman, Office Manager at 503 Bridge Street New Cumberland, Cumberland County, Pennsylvania 17070 its contents and at the same time handing to her personally the said true and correct copy of the same. 07/08/2009 01:45 PM - Noah Cline, Deputy Sheriff, who being duly sworn according to law, states that on July 8, 2009 at 1345 hours, he served a true copy of the within Writ of Summons, upon the within named defendant, to wit: Green Hill Family Health Center, by making known unto Tammy Letterman, Office Manager at 503 Bridge Street New Cumberland, Cumberland County, Pennsylvania 17070 its contents and at the same time handing to her personally the said true and correct copy of the same. 07/08/2009 01:45 PM - Noah Cline, Deputy Sheriff, who being duly sworn according to law, states that on July 8, 2009 at 1345 hours, he served a true copy of the within Writ of Summons, upon the within named defendant, to wit: Green Hill Family Health Center t/d/b/a Green Hill Family Practice, by making known unto Tammy Letterman, Office Manager at 503 Bridge Street New Cumberland, Cumberland County, Pennsylvania 17070 its contents and at the same time handing to her personally the said true and correct copy of the same. 07/08/2009 02:26 PM - Noah Cline, Deputy Sheriff, who being duly sworn according to law„ states that on July 8, 2009 at 1426 hours, he served a true copy of the within Writ of Summons, upon the within named defendant, to wit: Spirit Physical Services, Inc. t/d/b/a Green Hill Family Health Center, by making known unto Kay Tipton, Legal Coordinator of Risk Management at 503 N. 21st Street Camp Hill, Cumberland County, Pennsylvania 17011 its contents and at the same time handing to her personally the said true and correct copy of the same. 07/08/2009 02:26 PM - Noah Cline, Deputy Sheriff, who being duly sworn according to law, states that on July 8, 2009 at 1426 hours, he served a true copy of the within Writ of Summons, upon the within named defendant, to wit: Holy Spirit Health Systems t/d/b/a Green Hill Family Health Center, by making known unto Kay Tipton, Legal Coordinator of Risk Management at 503 N. 21st Street Camp Hill, Cumberland County, Pennsylvania 17011 its contents and at the same time handing to her personally the said true and correct copy of the same. SHERIFF COST: $121.24 SO ANSWERS, July 13, 2009 R THOMAS KLINE, SHERIFF Deputy Sheriff 484307 DICKIE, MCCAMEY & CHILCOTE, P.C. ATTORNEY FOR DEFENDANTS BY: Thomas M. Chairs, Esquire ATTORNEY I.D. NO. 78565 BY: Aaron S. Jayman, Esquire ATTORNEY I.D. NO. 85651 1200 Camp Hill Bypass, Suite 205 Camp Hill, PA 17011 (717)731-4800 (Tele) (717)7314803(Fax) JODI KRAUS, IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, Plaintiff PENNSYLVANIA V. ROBERT G. MICHELINI, D.O., SPIRIT PHYSICIAN SERVICES, INC. T/D/B/A GREEN HILL FAMILY HEALTH CENTER, HOLY SPIRIT HEALTH CENTER, HOLY SPIRIT HEALTH SYSTEM T/D/B/A GREEN HILL FAMILY HEALTH CENTER, GREEN HILL FAMILY HEALTH CENTER, CLEM CICCARELLI T/D/B/A GREEN HILL FAMILY PRACTICE, Defendants NO. 09-4477 CIVIL ACTION - MEDICAL JURY TRIAL DEMANDED ENTRY OF APPEARANCE TO THE PROTHONOTARY: Please enter the appearance of the Thomas M. Chairs, Esquire and Aaron S. Jayman, Esquire as counsel for Defendants, ROBERT G. MICHELINI, D.O., SPIRIT PHYSICIAN SERVICES, INC. T/D/B/A GREEN MILL FAMILY HEALTH CENTER, HOLY SPIRIT HEALTH CENTER, HOLY SPIRIT HEALTH SYSTEM T/D/B/A GREEN HILL FAMILY HEALTH CENTER, GREEN HILL FAMILY HEALTH CENTER, CLEM CICCARELLI T/D/B/A GREEN HILL FAMILY PRACTICE, in the above-captioned matter. Respectfully submitted, DICKIE, MCCAMEY & CHILCOTE, P.C. Date: August 17, 2009 By: Tho M. Chairs, Esquire Supreme Court I.D. #78565 1200 Camp Hill Bypass, Suite 205 Camp Hill, PA 17011-3700 (717) 731-4800 Attorney for Defendants 2 CERTIFICATE OF SERVICE AND NOW, August 17, 2009, I, Thomas M. Chairs, Esquire, hereby certify that I did serve a true and correct copy of the foregoing ENTRY OF APPEARANCE 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: Joseph M. Melillo, Esquire AN61NO & ROVNER, P.C. 4503 North Front Street Harrisburg, PA 17110 (Counsel for Plaintiff) Thoma . Chairs, Esquire f LE-' C' OF THE °; '??'-!;^'?sARY 2009 AUG 18 PH 2: 0 7 CUM3L . ';JJN Ty r'EN vlSvL.Vr,aid;A 4~.t~ii~"'~ ~. t .. 24:0 F ~ Z~f ~;~', i i ~ ~:~ C~;f~ ~_ ~ ,~.~ ~ rt _ ANGINO & ROVNER, P.C. Richard A.Sadlock PA Attorney ID# : 47281 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 JODI KRAUS, Plaintiff v. ROBERT G. MICHELINI, D.O.; and SPIRIT PHYSICIAN SERVICES, INC., Defendants IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PA NO. 09-4477 CIVIL ACTION -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. 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. 428941 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 accion dentro de los proximos 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 soma de dinero reclamada en la demanda o cualquier otra reclamacibn 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 428941 ANGINO & ROVNER, P.C. Richard A.Sadlock PA Attorney ID# : 47281 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 JODI KRAUS, Plaintiff v. ROBERT G. MICHELINI, D.O.; SPIRIT PHYSICIAN SERVICES, INC., Defendants IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PA NO. 09-4477 CIVIL ACTION -MEDICAL MALPRACTICE JURY TRIAL DEMANDED COMPLAINT 1. The Plaintiff, Jodi Kraus, is an adult resident of Harrisburg, Dauphin County, Pennsylvania 2. The Defendant, Robert G. Michelini, D.O. is a physician practicing primary care medicine in Cumberland County, Pennsylvania. A professional liability action is asserted against this Defendant and a Certificate of Merit is filed herewith as Exhibit "A." 3. The Defendant, Spirit Physicians Services, Inc., is a corporation organized under the laws of the Commonwealth of Pennsylvania, which at all relevant times employed Defendant 428941 1 Robert G. Michelini, D.O. A professional liability action is asserted against this Defendant and a Certificate of Merit is filed herewith as Exhibit "B." 4. On or about January 12, 2007, Jodi Kraus presented to Defendant Michelini's office with complaints of a clogged right ear for a week and one half. 5. Ms. Kraus also related to Defendant Michelini that she had a lump under her left arm which she would like evaluated. 6. Defendant Michelini's notes indicate that the lump was not painful and was not draining. 7. Ms. Kraus indicated she found it a week prior to the January 12, 2007, examination. 8. Defendant Michelini noted that the lump was on the left axilla. 9. Defendant Michelini decided that the lump should be monitored because it could just be a cyst. 10. Defendant Michelini's records indicate that Ms. Kraus was to let him know if it was still present in a month. 11. Defendant. Michelini advised Ms. Kraus to apply moist heat to the lump. 12. Ms. Kraus next saw Defendant Michelini on April 16, 2007, for testing related to an insurance physical. 13. Ms. Kraus stated she was feeling fine without complaints, but that she still had the left axillary nodule, although it was not reported as painful. 14. Defendant Michelini, upon examination, noted that she had a 1 cm cyst of the left axilla, which was firm and moveable. 15. Defendant Michelini made no further recommendations concerning evaluation of the axillary nodule. 428941 2 16. Ms. Kraus saw Defendant Michelini again on April 24, 2007, because of urinary issues. 17. Defendant Michelini's records do not indicate that he examined the cyst on that date or otherwise evaluated it in any way. 18. Defendant Michelini continued to provide medication for urinary tract issues in April, May, and June of 2007. 19. At no time did Defendant Michelini re-evaluate the axillary nodule or recommend that anything be done in connection therewith. 20. On July 10, 2007, Defendant Michelini saw Ms. Kraus in the office with complaints of muscle weakness, fatigue, dizziness, numb feet, getting worse over the past two weeks. 21. Defendnt Michelini noted that there was no injury to her neck or back. 22. Defendant Michelini's possible assessments included fatigue, dyspne, myalgias, feet numbness, and Raynaud` s disease, and he ordered various tests, including an EKG, chest x-ray, and blood work to further evaluate these problems. 23. Defendant Michelini indicated in his records that he should certainly consider restless leg syndrome as a possible problem. 24. Defendant Michelini did not, at that time, re-evaluate the axillary nodule nor consider whether the axillary nodule could have a contributory role to the presenting symptoms. 25. On July 16, 2007, Defendant Michelini, after reviewing certain test results, recommended that Ms. Kraus receive care from a specialist. 26. On or about August 7, 2007, Ms. Kraus was evaluated by Justin Fisher, M.D., a neurologist. 428941 3 27. Dr. Fisher noted a history of having weakness or numbness in both lower extremities for the past few months and that prior thereto she was a fitness trainer and very active physically. 28. Dr. Fisher noted that beginning about three months prior to his examination, Ms. Kraus had developed numbness and tingling in both feet, which was more recently also associated with weakness in both lower extremities, leading to a significant decline in her ability to exercise. 29. Dr. Fisher noted that the problem started as numbness in the toes of the right foot, which over time came to involve the entire right foot and eventually the entire left foot. The numbness was associated with an uncomfortable tingling or prickly sensation which felt like burning of the feet. 30. Dr. Fisher ordered various tests to help better define the cause of her many neurological-type symptoms. 31. Following performance of various tests, Ms. Kraus again saw Dr. Fisher, this time on August 31, 2007. 32. Dr. Fisher did not feel, at that time, that the prior tests were conclusive as to the cause of the problems and therefore ordered additional tests, including a muscle biopsy. 33. The muscle biopsy was performed on September 6, 2007, by Stephen Powers, M.D., and the pathology evaluation of the extracted tissue indicates a final diagnosis of neurogenicatrophy. 34. Ms. Kraus saw Dr. Fisher again on September 18, 2007, and noted that several days following the biopsy he had ordered steroids empirically, and that some of her symptoms had begun to improve since starting the steroids. 35. Dr. Fisher discussed the biopsy results with Ms. Kraus, but was so unsure as to the underlying cause of her symptoms. 428941 4 36. At that time he decided to order a CT scan of the chest, abdomen and pelvis with and without contrast, but was suspicious for possible underlying paraneoplastic process, although he did not think that a cancerous process was likely. 37. The CT scan was performed September 28, 2007, and Ms. Kraus saw Dr. Fisher again on or about October 3, 2007. 38. Dr. Fisher noted that the CT scan of the chest revealed numerous abnormalities including an enlarged left axillary lymph node measuring 2.1 cm. 39. The results of the CT scan did raise a suspicion for metastatic neoplastic process that could be contributory to the neuropathy and myopathy Ms. Kraus had developed. 40. Dr. Fisher, therefore, referred Ms. Kraus to Dr. Paul Kunkel, a general surgeon, for further evaluation. 41. Ms. Kraus saw Dr. Kunkel, who biopsied the left axillary lymph node and learned via the biopsy that it was cancer. 42. Dr. Fisher notified Ms. Kraus on that date that there was likely a direct relationship between the cancer and her neurologic problems. 43. The cancer was entirely consistent with previously found positive paraneoplastic antibodies, which prompted the cancer workup in the first place. 44. Dr. Fisher concluded on that date that Ms. Kraus indeed very likely had a paraneoplastic neuropathy, which had resulted in the numbness and weakness in her lower extremities and the findings on the EMG/nerve conduction studies. 45. Ms. Kraus had additional treatment and evaluation by multiple physicians, who also concurred that she suffered from neoplastic syndrome in the setting of adenocarcinoma to presume to be of the breast origin. 428941 5 46. In spite of intensive treatment for the condition, by the time it was diagnosed and treatment commenced, it was so advanced that Ms. Kraus remains markedly symptomatic. 47. Early evaluation and treatment of cancers including an axillary lymph node cancer decreases the risk for the development of paraneoplastic syndrome. 48. Early treatment of a developing neoplastic process decreases the risk that it will continue to worsen, and makes optimal treatment or cure more likely. 49. All of Plaintiff s damages as hereinafter related are the direct and proximate result of the negligence of Dr. Robert Michelini, acting within the course and scope of his employment for Spirit Physicians Services, Inc., in that he: a. failed to order appropriate testing to evaluate Ms. Kraus' axillary nodule in January of 2007; b. failed to order afollow-up appointment specifically to evaluate the nodule at a later date; c. failed to evaluate the existing nodule, which continued to persist over time, at any of her subsequent visits, or to inquire about the status of the nodule during any subsequent phone call through July of 2007. 50. As a result of Defendant Michelini's deviations from the standard of care, the risk for Ms. Kraus of developing refractory paraneoplastic syndrome was substantially increased. 51. As a result of the negligence of Defendants, as described above, Plaintiff, Jodi Kraus, has been forced to incur liability for medical treatment, medications, hospitalizations, and similar miscellaneous expenses in an effort to return herself to health, and claim is made therefor to the extent allowed by law. 52. Because of the negligence of Defendants, Plaintiff Jodi Kraus, may be forced to incur similar expenses in the future, and claim is made therefore, to the extent allowed by law. 428941 6 53. As a result of the negligence of Defendants, Ms. Kraus has, and may in the future suffer a loss of earnings and earning capacity, and claim is made therefor. 54. As a result of the negligence of Defendants, Ms. Kraus has undergone, and may in the future undergo, great physical and mental suffering, great inconvenience in carrying out her daily activities, loss of life's pleasures and enjoyment, and claim is made therefor. 55. As a result of the negligence of Defendants, Ms. Kraus has been, and in the future may be, subject to great humiliation and embarrassment, and claim is made therefor. 56. As a direct result of the negligence of the Defendants, Ms. Kraus has suffered compensable loss, and claim is made therefor. WHEREFORE, Plaintiff demands judgment against Defendants in an amount in excess of $50,000 (Fifty Thousand) Dollars, exclusive of interest and costs, and in excess of any jurisdictional amount requiring compulsory arbitration. Respectfully submitted, i Date: February 010 ANG R, P.C. Richard A. Sadlock, Esquire PA I.D. No. 47281 4503 N. Front Street Harrisburg, PA 17110 (717) 238-6791 Counsel for Plaintiff 428941 7 JODI KRAUS, Plaintiff v. ROBERT G. MICHELINI, D.O.~~ and SPIRIT PHYSICIAN SERVICES, INC., Defendants IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PA NO. 09-4477 CIVIL ACTION -LAW MEDICAL MALPRACTICE JURY TRIAL DEMANDED Certificate of Merit as to Spirit Physician Services, Inc. Date: I, Richard A. Sadlock, 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/ the claim that this defendant deviated from an acceptable professional standard is based 1 yon allegations that other licensed professionals for whom this defendant is responsible eviated 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. ,,~ ~~ February ~rysl0 . Sadlock 428941 JODI KRAUS, Plaintiff v. ROBERT G. MICHELINI, D.O.; and SPIRIT PHYSICIAN SERVICES, INC., Defendants IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PA NO. 09-4477 CIVIL ACTION -LAW MEDICAL MALPRACTICE JURY TRIAL DEMANDED Certificate of Merit as to Robert G. Michelini, D.O. I, Rich ci A. Sadlock, certify that: an appropriate licensed professional has supplied a written statement to the undersigned that ere 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: February ~ ,~,~,~,_ Richard A. 5ad1 428941 VERIFICATION I, Jodi Kraus, Plaintiff hereby verify that the facts set forth in the foregoing Complaint are true and correct to the best of my knowledge, information and belief. I understand that any false statements therein are made subject to the penalties of 18 Pa.C.S.A. §4904, relating to unsworn falsification to authorities. WITNESS: 430794 Date: d CERTIFICATE OF SERVICE AND NOW, this ~~ day of February, 2010, I, Kathy A. Tone , an em to ee of the Y p Y law firm of Angino & Rovner, P.C., hereby certify that a true and correct copy of Plaintiff s Complaint 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: Thomas M. Chairs, Esquire Dickie, McCamey & Chilcote, P.C. 1200 Camp Hill Bypass, Suite 205 Camp Hill, PA 17011 Kathy A. oney 428941 g 589806 DICKIE, MCCAMEY & CHILCOTE, P.C. ATTORNEY FOR DEFENDANTS BY: Thomas M. Chairs, Esquire ATTORNEY I.D. NO. 78565 BY: Aaron S. Jayman, Esquire ATTORNEY LD. N0.85651 1200 Camp Hill Bypass, Suite 205 Camp Hill, PA 17011 (717)731-4800 (Tele) (717 731-4803 Fax JODI KRAUS, IN THE COURT OF COMMO LESS ~_ Plaintiff OF CUMBERLAND COUNTY~~ "~ ~ PENNSYLVANIA `' 3 `~ ~ `'" ~' ;... N0.09-4477 r=' ~:- ~ , - t -a-~, ~_., ; t'; CIVIL ACTION - MEDICAL ~ ~ ~ r;? ~~ Win: ROBERT G. MICHELINI, D.O. AND SPIRIT PHYSICIAN SERVICES, INC. JURY TRIAL DEMANDED Defendants NOTICE TO PLEAD TO: Jodi Kraus c/o Richard A. Sadlock, Esquire ANGINO & ROVNER, P.C. 4503 North Front Street Harrisburg, PA 17110 YOU ARE HEREBY NOTIFIED TO PLEAD TO THE WITHIN DEFENDANTS' ANSWER WITH NEVV MATTER TO PLAINTIFF'S COMPLAINT WITHIN TWENTY (20) DAYS OF THE DATE OF SERVICE OF THIS PLEADING OR JUDGMENT MAY BE ENTERED AGAINST YOU. Respectfully submitted, DICKIE, MCCA OTE, P.C. ~~ Date: July 26, 2010 By: Tho s . Chai squire Supreme Court I.D. #78565 1200 Camp Hill Bypass, Suite 205 Camp Hill, PA 17011-3700 (717)731-4800 Attorney for Defendants 588981 DICKIE, MCCAMEY & CHILCOTE, P.C. BY: Thomas M. Chairs, Esquire ATTORNEY I.D. N0.78565 BY: Aaron S. Jayman, Esquire ATTORNEY I.D. N0.85651 1200 Camp Hill Bypass, Suite 205 Camp Hill, PA 17011 (717)731-4800 (Tele) (717)731-4803 (Fax) JODI KRAUS, Plaintiff ATTORNEY FOR DEFENDANTS IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA v. ROBERT G. MICHELINI, D.O. AND SPIRIT PHYSICIAN SERVICES, INC., Defendants NO.09-4477 CIVIL ACTION -MEDICAL JURY TRIAL DEMANDED DEFENDANTS' ANSWER WITH NEW MATTER TO PLAINTIFF'S COMPLAINT AND NOW, come Defendants, ROBERT G. MICHELINI, D.O. AND SPIRIT PHYSICIAN SERVICES, INC., (hereinafter "Answering Defendants"), by and through their counsel, Dickie, McCamey & Chilcote, P.C., and file the within Answer with Matter to Plaintiffls Complaint as follows: 1. Denied. After reasonable investigation, Answering Defendants are without knowledge or information sufficient to form a belief as to the truth of the averments of this paragraph of Plaintiff s Complaint and, therefore, the averments are denied. 2. Admitted in part, denied in part. It is admitted that Dr. Michelini is a physician practicing primary care medicine in Cumberland County, Pennsylvania. It is also admitted that a professional liability action is asserted against Dr. Michelini and that a Certificate of Merit is attached to Plaintiffs Complaint. It is specifically denied that Plaintiff's action against Dr. Michelini has any merit whatsoever. At all relevant times, Dr. Michelini met or exceeded the standard of care and at no time caused or contributed to the injuries as alleged. 3. Admitted in part, denied in part. It is admitted that Spirit Physician Services, Inc. is a corporation organized under the laws of the Commonwealth of Pennsylvania, which at all times employed Dr. Michelini. It is also admitted that Plaintiff is asserting a professional liability action against Spirit Physician Services and that a Certificate of Merit is attached to Plaintiff's Complaint. It is specifically denied that Plaintiffs action against Spirit Physician Services has any merit whatsoever. At all relevant times, Spirit Physician Services, Inc. met or exceeded the standard of care and at no time caused or contributed to the injuries as alleged. 4.-48. Denied. The averments of these paragraphs of Plaintiffs Complaint are denied generally pursuant to Pa. R.C.P. 1029(e). By way of further response, these paragraphs of Plaintiff s Complaint are further denied as medical and legal conclusions which no responses are required. Additionally, Plaintiffs condition and course of treatment are set forth in the medical records which are in writing and speak for themselves. Answering Defendants deny Plaintiffs allegations to the extent that- they are contradicted or supplemented by the relevant medical records and/or the deposition testimony and expert reports submitted on behalf of Answering Defendants in this case. Byway of further response, Answering Defendants were not negligent. At all relevant times, Answering Defendants met or exceeded the standard of care and at no time caused or contributed to the injuries as alleged. 49(a.-c.) Denied. This paragraph and corresponding sub-paragraphs of Plaintiff s Complaint are denied as medical and legal conclusions to which no responsive pleading is required. By way of further response, these paragraphs of Plaintiffs Complaint are further denied as medical and legal conclusions which no responses are required. Additionally, 2 Plaintiffs condition and course of treatment are set forth in the medical records which are in writing and speak for themselves. Answering Defendants deny Plaintiffs allegations to the extent that they are contradicted or supplemented by the relevant medical records and/or the deposition testimony and expert reports submitted on behalf of Answering Defendants in this case. By way of further response, Answering Defendants were not negligent. At all relevant times, Answering Defendants met or exceeded the standard of care and at no time caused or contributed to the injuries as alleged. 50. Denied. This paragraph of Plaintiffs Complaint contains medical and legal conclusions to which no responsive pleading is required. By way of further response, these paragraphs of Plaintiff s Complaint are further denied as medical and legal conclusions which no responses are required. Additionally, Plaintiff s condition and course of treatment are set forth in the medical records which are in writing and speak for themselves. Answering Defendants deny Plaintiffs allegations to the extent that they are contradicted or supplemented by the relevant medical records and/or the deposition testimony and expert reports submitted on behalf of Answering Defendants in this case. By way of further response, Answering Defendants were not negligent. At all relevant times, Answering Defendants met or exceeded the standard of care and at no time caused or contributed to the injuries as alleged. 51. Denied. This paragraph of Plaintiffs Complaint contains medical and legal conclusions to which no responsive pleading is required. By way of further response, these paragraphs of Plaintiff s Complaint are further denied as medical and legal conclusions which no responses are required. Additionally, Plaintiff s condition and course of treatment are set forth in the medical records which are in writing and speak .for themselves. Answering Defendants deny Plaintiffs allegations to the extent that they are contradicted or supplemented by the relevant 3 medical records and/or the deposition testimony and expert reports submitted on behalf of Answering Defendants in this case. Byway of further response, Answering Defendants were not negligent. At all relevant times, Answering Defendants met or exceeded the standard of care and at no time caused or contributed to the injuries as alleged. 52. Denied. This paragraph of Plaintiffs Complaint contains medical and legal conclusions to which no responsive pleading is required. By way of further response, these paragraphs of Plaintiff s Complaint are further denied as medical and legal conclusions which no responses are required. Additionally, Plaintiff s condition and course of treatment are set forth in the medical records which are in writing and speak for themselves. Answering Defendants deny Plaintiffs allegations to the extent that they are contradicted or supplemented by the relevant medical records and/or the deposition testimony and expert reports submitted on behalf of Answering Defendants in this case. By way of further response, Answering Defendants were not negligent. At all relevant times, Answering Defendants met or exceeded the standard of care and at no time caused or contributed to the injuries as alleged. 53. Denied. This paragraph of Plaintiffs Complaint contains medical and legal conclusions to which no responsive pleading is required. By way of further response, these paragraphs of Plaintiff s Complaint are further denied as medical and legal conclusions which no responses are required. Additionally, Plaintiff s condition and course of treatment are set forth in the medical records which are in writing and speak for themselves. Answering Defendants deny Plaintiffs allegations to the extent that they are contradicted or supplemented by the relevant medical records and/or the deposition testimony and expert reports submitted on behalf of Answering Defendants in this case. By way of further response, Answering Defendants were not 4 negligent. At all relevant times, Answering Defendants met or exceeded the standard of care and at no time caused or contributed to the injuries as alleged. 54. Denied. This paragraph of Plaintiffs Complaint contains medical and legal conclusions to which no responsive pleading is required. By way of further response, these paragraphs of Plaintiffs Complaint are further denied as medical and legal conclusions which no responses are required. Additionally, Plaintiff s condition and course of treatment are set forth in the medical records which are in writing and speak for themselves. Answering Defendants deny Plaintiffs allegations to the extent that they are contradicted or supplemented by the relevant medical records and/or the deposition testimony and expert reports submitted on behalf of Answering Defendants in this case. Byway of further response, Answering Defendants were not negligent. At all relevant times, Answering Defendants met or exceeded the standard of care and at no time caused or contributed to the injuries as alleged. 55. Denied. This paragraph of Plaintiffs Complaint contains medical and legal conclusions to which no responsive pleading is required. By way of further response, these paragraphs of Plaintiffs Complaint are further denied as medical and legal conclusions which no responses are required. Additionally, Plaintiffs condition and course of treatment are set forth in the medical records which are in writing and speak for themselves. Answering Defendants deny Plaintiffs allegations to the extent that they are contradicted or supplemented by the relevant medical records andlor the deposition testimony and expert reports submitted on behalf of Answering Defendants in this case. Byway of further response, Answering Defendants were not negligent. At all relevant times, Answering Defendants met or exceeded the standard of care and at no time caused or contributed to the injuries as alleged. 5 56. Denied. This paragraph of Plaintiffs Complaint contains medical and legal conclusions to which no responsive pleading is required. By way of further response, these paragraphs of Plaintiff s Complaint are further denied as medical and legal conclusions which no responses are required. Additionally, Plaintiff s condition and course of treatment are set forth in the medical records which are in writing and speak for themselves. Answering Defendants deny Plaintiffs allegations to the extent that they are contradicted or supplemented by the relevant medical records and/or the deposition testimony and expert reports submitted on behalf of Answering Defendants in this case. By way of further response, Answering Defendants were not negligent. At all relevant times, Answering Defendants met or exceeded the standard of care and at no time caused or contributed to the injuries as alleged. WHEREFORE, Answering Defendants, Robert G. Michelini, D.O. and Spirit Physician Services, Inc. respectfully request that this Honorable Court ,enter judgment in their favor together with all allowable costs and attorneys' fees. NEW MATTER 57. To the extent that the evidence reveals that Plaintiff failed to follow medical advice, failed to treat properly, or otherwise failed to mitigate her damages, Answering Defendants pleads the defense of the failure to mitigate. 58. To the extent that the evidence reveals that Plaintiff failed to file this action in a timely manner, Answering Defendants pleads the defense of the statute of limitations. 59. To the extent that the evidence reveals that the Plaintiff had apre-existing condition that caused or contributed to her injuries, Answering Defendants pleads the existence of apre-existing condition as a defense. 6 . ~ ~-. 60. If at the time of trial it is established that Answering Defendants accepted less than full payment for certain of Plaintiff s medical expenses or otherwise forgave certain of those expenses, then Answering Defendants pleads any such set-off as an affirmative defense. 61. Answering Defendants raises the acts and/or omissions of third parties over whom Answering Defendants had neither the right nor duty to control as a complete and/or partial bar to Plaintiffs' claims. 62. To the extent that the evidence reveals that Plaintiff lacked the capacity to sue at the time this action was commenced, or at any time relevant hereto, Answering Defendants pleads the lack of capacity to sue as an affirmative defense. 63. To the extent that it is determined that Plaintiff is or was engaged in other litigations or proceedings pertaining to the injuries alleged in this Complaint, Answering Defendants pleads the defenses of accord and satisfaction, arbitration and award, estoppel, and release. 64. At all times relevant hereto, Answering Defendant met or exceeded the standard of care and at no time caused or contributed to the injures as alleged. 65. Nothing Answering Defendant did or failed to do was the cause or the proximate cause of any alleged injury or loss to Plaintiff. 66. Plaintiffs' claims and/or request for damages is barred or limited by the provisions of the Medical Care Availability and Reduction of Error (MCARE) Act, Act. No. 13, House Bill No. 1802, 2202 Pa. ALS 13; 2002, Pa. Laws 13; 2001 Pa. HB 1802, as amended. 67. By way of further answer, Answering Defendants specifically reserve the right to plead hereafter as further New Matter those additional affirmative defenses, including, without limitation, those set forth in Pa.R.Civ.P. 1030, that continuing investigation, discovery in 7 accordance with court rules, and the introduction of evidence at trial may render applicable to claims and causes of action declared upon Plaintiff in the Complaint. WHEREFORE, Answering Defendants, Robert G. Michelini, D.O. and Spirit Physician Services, Inc. denies that it is in any way liable to the Plaintiff and demands that judgment be entered against the Plaintiff and in favor of Answering Defendants. Answering Defendants further requests an award of appropriate costs and fees. Respectfully submitted, DICKIE, MCCAMEY & CHILCOTE, P.C. Date: July 26, 2010 By: Thomas Ctliairs;~,s~uire Supreme ourt I.D. #78565 Aaron S. Jayman, Esquire Supreme Court I. D. #85651 1200 Camp Hill Bypass, Suite 205 Camp Hill, PA 17011-3700 (717) 731-4800 Attorney for Defendants 8 589693 VERIFICATION I, Robert G. Michelins, D.O., hereby verify that the facts set forth in the foregoing Answer with New Matter to Plaintiffs Complaint are tnze and correct to the best of my knowledge, information and belief. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S. §4904, relating to unsworn falsification to authorities. Robert G. Michelins, D.O. Feidt verification VERIFICA~I,ON I, Ellen Feidt, RN, Risk Manager, Holy Spirit Health System and on behalf of Spirit Physician Services, Inc., hereby verifies that the facts set forth in the foregoing, Answers with New Matter to Plaintiff s Complaint are true and correct to the best of my knowledge, information and belief. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S. §4904, relating to unsworn falsification to authorities. SPIRIT PHYSICAINS SERVICES, INC Date: w By: Ellen Feidt, RN Risk Manager Risk Management Department Spirit Physicians Services, Inc CERTIFICATE OF SERVICE AND NOW, July 26, 2010, 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) ....~'~~ Thomas C airs, Es ' e .A 699520/Order/Scheduling Conference JODI KRAUS, v. Plaintiff, IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA N 0.09-4477 CIVIL ACTION - h1EDICAL ROBERT G. MICHELINI, D.O., SPIRIT ~ PHYSICIAN SERVICES, INC. 'I'/D/B/A, Defendants i JL!RY TRIAL DEMANDED ORDER AND NOW this d ~ _ ,day of _ ~~__ 2010, it is hereby ORDERED that: Discovery shall he completed by October i , 201(). Plaintiff's expert repoz-ts shall be produced on or before December 1, 2010. Defense expert reports shall be produced oii or before }~ ebruary 1, 201 l . The parties furthzr agee that depositic:~ns of t+-eating physicilns may be accomplished at any time prior to trial. Any party is free to list this case for trial after l~~br~iary i, 2011. 13Y Honorable F:dv~~as•d 1H:. Guido ~-, ~.~ ~N -- -- ~-~ ~.`,~ ~ ~. s ~._: ~ '.. d -~ c.- O ~. ~ ., 699520/Order/Scheduling Conference Distribution List: chard A. Sadlock, Esquire ANGINO & ROVNER, P.C. 4503 North Front Street Harrisburg, PA 17110 Co~ ~~ S~a.~~ v ~ry~ as M. Chairs, Esquire Dickie, McCamey & Chilcote, P.C. 1200 Camp Hill Bypass, Suite 205 Camp Hill, PA 17011 .~ t:.: _ ~~ . , ,._ t , ~4. ~vCr ~ ~~ t/:io ~, ANGINO & ROVNER, P.C. Richard A. Sadlock Attorney ID# : 47281 4503 North. Front St<eet Harrisburg, PA 17110-1708 (717)238-6791 FAX (717) 238-5610 Attorneys for Plaintiff(s) E-mail: rsadlock@angino-rovner.~okn JODI KRAUS, Plaintiff v. ROBERT G. MICHELINI, I~.IO.; SPIRIT PHYSICIAN SERVICES, II'~1~., Defendants IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PA N0.09-4477 CIVIL ACTION -LAW MEDICAL MALPRACTICE JURY TRIAL DEMANDED PL+A$NTIFF'S REPLY TO NEW MATTER OF DEFENDANTS AND NOW comes Plaintiff Jodi Kraus, by and through her attorneys, Angino & Rovner, P.C., by Richard A. Sadlock i/squire and replies to the New Matter as follows: 57. Defendants' avlerment is a conclusion of law to which no responsive pleading is required. To the extent the ~v~rment may be deemed factual, it is hereby specifically denied. By way of amplification, at all' Mmes applicable hereto, Plaintiff followed medical advice, treated properly, and where appropriate, mitigated her damages. All of Plaintiffls claims and damages are recoverable in the instant ajction. 446135 58. Defendants' averment is a conclusion of law to which no responsive pleading is required. To the extent the averment may be deemed factual, it is hereby specifically denied. By way of amplification, Plaintiff s Complaint was filed within the applicable statute of limitations. 59. Defendants' averment is a conclusion of law to which no responsive pleading is required. To the extent the averment may be deemed factual, it is hereby specifically denied. By way of amplification, Plaintii~f had no pre-existing condition that caused or contributed to her injuries. All of Plaintiff's injuries and damages were caused by the instant Defendants. 60. Defendants' averment is a conclusion of law to which no responsive pleading is required. To the extent the averment may be deemed factual, it is hereby specifically denied. There is no set-off available td the instant Defendants. All of Plaintiff's claims and damages are recoverable in the instant actidn. 61. Defendants' av~nment is a conclusion of law to which no responsive pleading is required. To the extent the averment may be deemed factual, it is hereby specifically denied. By way of amplification, Defendarts' averment lacks the specificity required by the Pennsylvania Rules of Civil Procedure. Further, al~ of Plaintiffs injuries and damages were caused solely and directly as a result of the negligence, ca#~elessness, wantonness and recklessness of the instant Defendants. 62. Defendants' averment is a conclusion of law to which no responsive pleading is required. To the extent the averriler~t lr~ay be deemed factual, it is hereby speciilcally denied. By way of amplification, at all times applicable hereto, Plaintiff had the capacity to sue the instant Defendants. All of Plaintiff s Maims and damages are recoverable in the instant action. 63. Defendants' averment is a conclusion of law to which no responsive pleading is required. To the extent the averment may be deemed factual, it is hereby specifically denied. By way of amplification, the def~nses of accord and satisfaction, arbitration and award, estoppel, 446135 and release do not apply to the instant action. All of Plaintiff's claims and damages are recoverable in the instant action. 64. Defendants' averment is a conclusion of law to which no responsive pleading is required. To the extent the averment may be deemed factual, it is hereby specifically denied. By way of amplification, at all tunes applicable hereto, answering Defendants' care .and conduct fell well below the standard of care and caused the Plaintiff's injuries and damages. Plaintiff incorporates her Complaint herein by reference. 65. Defendants' averment is a conclusion of law to which no responsive pleading is required. To the extent the averment may be deemed factual, it is hereby specifically denied. By way of amplification, Defendants failed to properly care for and treat Plaintiff. The Defendants' actions and failure to act were the cause and proximate cause of the injuries and damages and losses sustained by Plaintiff. 66. Defendants' averment is a conclusion of law to which no responsive pleading is required. To the extent the averment may be deemed factual, it is hereby specifically denied. By way of amplification, the provisions of the Medical Care Availability and Reduction of Error Act in no way bars or limits Plaintiff's claims and damages. All of Plaintiff's claims and damages are recoverable in the instant action. 57. Defendants' averment is a conclusion of law to which no responsive pleading is required. To the extent the averment may be deemed factual, it is hereby specifically denied. By way of amplification, there are no affirmative defenses available to the Defendants in the instant 446135 action. All of Plaintiff s claims and damages are recoverable in the instant action. WHEREFORE Plaintiff demands judgement against Defendants. ANG TER, P.C. ~.,/~~~ ..~icA'~'-A. Sadlock, Esquire PA I.D. No. 47281 4503 N. Front Street Harrisburg, PA 17110 (717) 238-6791 rsadlock@angino-rovner. com Counsel for Plaintiff 446135 COMMONWEALTH OF PENNSYLVANIA: SS. COUNTY OF DAUPHIN 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 New Matter, are trop a~ erect to the best of my knowledge, information, and belief. Esquire Sworn to and subscribed before me this3~ day of ~ , 2010. ~KSC~C Notary Public My Commission Expires: """'_-Np~INNA~ R1~ p~~ M auk ~N~ o. 2~o Y w Con~~^ - 446135 ~• CERTIFICATE OF SERVICE I, Michelle M. Milojevich, an employee of the law firm of Angino & Rovner, P.C., do hereby certify that I am this day serving a true and correct copy of PLAINTIFF'S REPLY TO THE NEW MATTER OF DEFENDANTS on the following via certified mail, return receipt request, postage prepaid, first class United States mail, addressed as follows: Thomas M. Chairs, Esquire Dickie, McCamey & Chilcote 1200 Camp Hill Bypass, Suite 205 Camp Hill, PA 17011-3700 222cr~22~- ~1,~.~ ~ Mlchelle M. Milo~evich Date: 8/3/10 446135 a IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY KRAUS Vs. . NO. 094477 MICHELINI, D.O. . CERTIFICATE PREREQUISITE TO SERVICE OF A SUBPOENA PURSUANT TO RULE 4009.22 As a prerequisite to service of a subpoena(s) for documents and things pursuant to Rule 4009.22 THOMAS M CHAIRS, ESQUIRE certifies that: 1. A Notice of Intent to Serve the Subpoena (s} with a copy of the subpoena(s) attached thereto was mailed or delivered to each party at least twenty days prior to the date on which the subpoena(s) is sought to be served, 2. A copy of the Notice of Intent, including the proposed subpoena(s) is attached to this certificate, 3. No objection to the subpoena(s) has been received, and 4. The subpoena(s) which will be served is identical to the subpoena(s) which is attached to the Notice of Intent to Serve the Subpoena(s). Date: 11/05/10 THOMAS M CHAIRS, ESQUIRE 1200 CAMP HILL BYPASS SUITE 205 CAMP HILL, PA 17011 717-731-4800 ~ tra >- ATTORNEY FOR DEFENDANT ~ ~- s-- Uo = ~`= INQUIRIES SHOIILD B8 ADDR138SSD TO: ~© ~ ~z ~~ °- of MEDICAL LEGAL REPRODUCTIONS, INC. te ~ ~ ~ `~ 4940 DISSTON STREET 'a c n PHILADELPHIA PA 19135 ~~" ~" ~~ (215) 335-3590 t,L~ o ~ ~ }-- ° ~°- By: Theresa Deni IJ.. Q N U MLR File #: M379716 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY KRAUS Vs. MICHELINI, D.O. ~ No. 094477 TO: RICHARD SADLOCK, ESQ (PLAINTIFF) NOTICE OF INTENT TO SERVE A SUBPOENA TO PRODUCE DOCUMENTS AND THINGS FOR DISCOVERY PURSUANT TO RULE 4009.21 DEFENDANT intends to serve a subpoena(s) identical to the one(s) attached to this notice. You have twenty (20) days from the date listed below in which to file of record and serve upon the undersigned an objection to the subpoena. If no objection is made the subpoena may be served. Date: 10/15/10 THOMAS M CHAIRS, ESQUIRE 1200 CAMP HILL BYPASS SUITE 205 CAMP HILL, PA 17011 ATTORNEY FOR DEFENDANT INQIIIRIES SHOIILD BE ADDRESSED TO: MEDICAL LEGAL REPRODUCTIONS, INC. 4940 DISSTON STREET PHILADELPHIA, PA 19135 (215) 335-3590 By: Theresa Deni Enc (s) : Copy of subpoena (s ) Counsel return card File #: M379716 r ` DICKIE, MCCAMEY & CHILCOTE, P.C. BY: Thomas M. Chairs, Esquire ATTORNEY I.D. NO. 78565 BY: Aaron S. Jayman, Esquire ATTORNEY I.D. NO. 85651 1200 Camp Hill Bypass, Suite 205 Camp Hill, PA 17011 (717)731-4800 (Tele) (717)731-4803 (Fax) JODI KRAUS, Plaintiff V. ROBERT G. MICHELINI, D.O., Defendants ATTORNEY FOR DEFENDANT ROBERT G. MICHELM, D.O. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 09-4477 -' CIVIL ACTION - MEDICAL JURY TRIAL DEMANDED " p, F UNCONTESTED MOTION TO EXTEND DISCOVERY DEADLINES 1. By Order dated August 2, 2010, The Honorable Edward E. Guido entered an Order establishing discovery deadlines in this case. 2. The parties have been working to satisfy mutual discovery requests in this case. 3. Notwithstanding the best efforts of counsel additional time is needed to complete discovery in this case. 4. Counsel for all parties of record have agreed to a brief extension of the discovery deadlines preciously established by the Court. 5. A proposed Order establishing a brief extension of the discovery deadlines in this case is filed herewith. . it 6. The parties to this case respectfully request the Court execute an Order establishing a brief extension of the discovery deadlines as set forth in the proposed Order attached hereto. WHEREFORE, Dr. Michelin respectfully requests the Court enter an Order establishing a brief extension of the discovery deadlines in this case. Respectfully submitted, DICKIE, MCCAMEY & ?CHILCOTE, P.C. Date: November 4, 2010 By: Th M. Chairs, Esquire Supreme Court I.D. #78565 1200 Camp Hill Bypass, Suite 205 Camp Hill, PA 17011-3700 (717) 731-4800 Attorney for Defendant, Robert G. Michelini, D. 0. 2 CERTIFICATE OF SERVICE AND NOW, November 4, 2010, I, Thomas M. Chairs, Esquire, hereby certify that I did serve a true and correct copy of the foregoing UNCONTESTED MOTION TO EXTEND DISCOVERY DEADLINES 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) Thomas M. Chairs, Esquire IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY KRAUS rte: e i -? Vs. NO. 094477 MICHELINI, D.O. CERTIFICATE f-.. PREREQUISITE TO SERVICE OF A SUBPOENA c;v , r. PURSUANT TO RULE 4049.22 As a prerequisite to service of a subpoena(s) for documents and things pursuant to Rule 4009.22 THOMAS M CHAIRS, ESQUIRE certifies that: 1. A Notice of Intent to Serve the Subpoena(s) with a copy of the subpoena(s) attached thereto was mailed or delivered to each party at least twenty days prior to the date on which the subpoena(s) is sought to be served, 2. A copy of the Notice of Intent, including the proposed subpoena(s) is attached to this certificate, 3. No objection to the subpoena(s) has been received, and 4. The subpoena(s) which will be served is identical to the subpoena(s) which is attached to the Notice of Intent to Serve the Subpoena(s). Date: 11/05/10 THOMAS M CHAIRS, ESQUIRE 1200 CAMP HILL BYPASS SUITE 205 CAMP HILL, PA 17011 717-731-4800 ATTORNEY FOR DEFENDANT INQUIRIES SHOULD BE ADDRESSED TO: MEDICAL LEGAL REPRODUCTIONS, INC. 4940 DISSTON STREET PHILADELPHIA PA 19135 (215) 335-3590 By: Theresa Deni MLR File #: M379716 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY KRAUS t Vs. MICHELINI, D.O. I No. 094477 TO: RICHARD SADLOCK, ESQ (PLAINTIFF) NOTICE OF INTENT TO SERVE A SUBPOENA TO PRODUCE DOCUMENTS AND THINGS FOR DISCOVERY PURSUANT TO RULE 4009.21 DEFENDANT intends to serve a subpoena(s) identical to the one(s) attached to this notice. You have twenty (20) days from the date listed below in which to file of record and serve upon the undersigned an objection to the subpoena. If no objection is made the subpoena may be served. Date: 10/15/10 THOMAS M CHAIRS, ESQUIRE 1200 CAMP HILL BYPASS SUITE 205 CAMP HILL, PA 17011 ATTORNEY FOR DEFENDANT INQUIRIES SHOULD BE ADDRESSED TO: MEDICAL LEGAL REPRODUCTIONS, INC. 4940 DISSTON STREET PHILADELPHIA, PA 19135 (215) 335-3590 By: Theresa Deni Enc(s) Copy of subpoena (s) Counsel return card File #: M379716 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND KRAUS Vs. MICHELINI, D.O. File No. 094477 SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RUMBIO$2BILLING REQUESTED TO: MEMORIAL HOSP, 325 S BEL1 oEM;soPY&Mtitj}A 17405 ATTN: MEDICAL RECORDS DEPT Within twenty (20) days after service of this subpoena, you are ordered by the court to produce the following documents or things: SEE ATTACHED ADDENDUM at MEDICAL LROAL REPRODUCTIONS, INC, 4940 DISSTON ST., PHILA., PA (Address) You may deliver or mail legible copies of the documents or produce things requested by this subpoena, together with the certificate of compliance, to the party making this request at the address listed above. You have the right to seek in advance the reasonable cost of preparing the copies or producing the things sought. If you fail to produce the documents or things required by this subpoena within twenty (20) days after its service, the party serving this subpoena may seek a court order compelling you to comply with it. THIS SUBPOENA WAS ISSUODM §T TMHFffial f S1 OF THE FOLLOWING PERSON: Name 1200 CAMP HILL BYPASS Address: CAMP HILL, FA IfUll Telephone: Supreme Court ID # DR.FEIM NT M3 7AMWEor: BY THE COURT: jj 10 Prothonotary/Clerk, Civil Division Date: 19 2n 1 Seal of the Court Deputy (Eff. 7/97) ADDENDUM TO SUBPOENA KRAUS a Vs. MICHELINI, D.O. No. 094477 CUSTODIAN OF RECORDS FOR : MEMORIAL HOSP ANY AND ALL MEDICAL RECORDS REGARDING JODI KRAUS FROM 1/1/00 TO THE PRESENT, INCLUDING BUT NOT LIMITED TO ALL CORRESPONDENCE, MEDICAL CONSULTATIONS, MEDICAL RECORDS, MEDICAL EXAM REPORTS, INTAKE FORMS, RADIOLOGY REPORTS, AND BILLING RECORDS. PERTAINING TO: NAME: JODI KRAUS ADDRESS: DATE OF BIRTH: 05/23/61 SSAN: XXXXX5943 MEDICAL BILLING REQUESTED ALL FEES MUST BE APPROVED PRIOR TO RECORDS BEING FORWARDED. RECORD CUSTODIAN - COMPLETE AND RETURN [ 1 RECORDS ARE ATTACHED HERETO: I hereby certify as custodian of records that, to the best of my knowledge, information and belief all documents or things above mentioned have been produced. [ ] NO DOCUMENTS AVAILABLE: I hereby certify that a thorough search has been made and that no record of the following documents have been located (CHECK THE APPROPRIATE BOX): ( ) RECORDS ( ) PATIENT BILLING ( ) X-RAYS ( ) RECORDS / XRAYS have been destroyed Date Authorized signature or MEMORIAL HOSP CUMBERLAND M379716-01 * * * SIGN AND RETURN THIS PAGE * * * 77200 JODI KRAUS, V. Plaintiff, mmi 1 n 2010 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 09-4477 CIVIL ACTION - MEDICAL ROBERT G. MICHELINI, D.O., SPIRIT PHYSICIAN SERVICES, INC. T/DB/A, Defendants I JURY TRIAL DEMANDED ORDER AND NOW this ?, day of 2010, it is hereby ORDERED that: Discovery shall be completed by December 30, 2010. Plaintiff's expert reports shall be produced on or before February 28, 2011. Defense expert reports shall be produced on or before May 2, 2011. The parties further agree that depositions of treating physicians may be accom@is1W at-'n -.Os MW a - --a any time prior to trial. x? C mar= ? ? Any party is free to list this case for trial after May 2, 2011. M ? o vn ? BY T OURT: 5? ?rn By. Honorable Edward E. Guido Distribution List: ichard A. Sadlock, Esquire ANGINO & ROVNER, P.C. 4503 North Front Street Harrisburg, PA 17110 (Counsel for Plaintiff) Q043 t ?S rn-a t LSL //// `/[6 Thomas M. Chairs, Esquire Dickie, McCamey & Chilcote, P.C. 1200 Camp Hill Bypass, Suite 205 Camp Hill, PA 17011 (Counsel for Defendant) IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY KRAUS C: !::a . . Vs. rn F4J & ? ? NO. 09447 7' MICHELINI, D . O . CERTIFICATE -? PREREQUISITE TO SERVICE OF A SUBPOENA ,.. cn PURSUANT TO RULE 4009.22 w° As a prerequisite to service of a subpoena(s) for documents and things pursuant to Rule 4009.22 THOMAS M CHAIRS, ESQUIRE certifies that: 1. A Notice of Intent to Serve the Subpoena(s) with a copy of the subpoena(s) attached thereto was mailed or delivered to each party at least twenty days prior to the date on which the subpoena(s) is sought to be served, 2. A copy of the Notice of Intent, including the proposed subpoena(s) is attached to this certificate, 3. No objection to the subpoena(s) has been received, and 4. The subpoena(s) which will be served is identical to the subpoena(s) which is attached to the Notice of Intent to Serve the Subpoena(s). Date: 12/20/10 THOMAS M CHAIRS, ESQUIRE 1200 CAMP HILL BYPASS SUITE 205 CAMP HILL, PA 17011 717-731-4800 ATTORNEY FOR DEFENDANT INQUIRIES SHOULD BE ADDRESSED TO: MEDICAL LEGAL REPRODUCTIONS, INC. 4940 DISSTON STREET PHILADELPHIA PA 19135 (215) 335-3590 By: Theresa Deni MLR File #: M381202 40 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY KRAUS Vs. MICHELINI, D.O. I No. 094477 TO: RICHARD SADLOCK, ESQ (PLAINTIFF) NOTICE OF INTENT TO SERVE A SUBPOENA TO PRODUCE DOCUMENTS AND THINGS FOR DISCOVERY PURSUANT TO RULE 4009.21 DEFENDANT intends to serve a subpoena(s) identical to the one (s) attached to this notice. You have twenty (20) days from the date listed below in which to file of record and serve upon the undersigned an objection to the subpoena. If no objection is made the subpoena may be served. Date: 11/29/10 THOMAS M CHAIRS, ESQUIRE 1200 CAMP HILL BYPASS SUITE 205 CAMP HILL, PA 17011 ATTORNEY FOR DEFENDANT INQUIRIES SHOULD BE ADDRESSED TO: MEDICAL LEGAL REPRODUCTIONS, INC. 4940 DISSTON STREET PHILADELPHIA, PA 19135 (215) 335-3590 By: Theresa Deni Enc(s) Copy of subpoena(s) Counsel return card File ##: M381202 + COM MONNEAM OF PENNSYLVANIA COURN OfamagAm KRAUS Vs. File No. 094477 MICHELINI, D.O. MEDICAL BILLING REQUESTED SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009.22 TO: DR ROBERT WOLF, 1857 CENTER ST, CAMP HILL PA 17011 (Name of Person or Entity) Within twenty (20) days after service of this subpoena, you are ordered by the court to produce the following docLrnents or AM L L71/L,NDEW Ll\1JV1?1 at MEDICAL LEGAL REPRODUCTIONS INC, 4-9 . , . , ----- (Address) You may deliver or mail legible copies of the documents or produce things requested t? this subpoena, together with the certificate of ccrrpliance, to the party making thiT request at the address listed above. You have the right to seek in advance the rea,onablc- 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 thin subpoena may seek a court order c= peiling you to comply with it. THIS SUBPOENA WAS ISSUED AT THE REQIJEST OF THE FOLLOWING PERSON: NAME: THOMAS M CHAIRS, ESQ ADDRESS: 1200 CAMP HILL BYPASS - CAA4-HILL;_ P& 17 011 TELEPHONE: SUPREME OOURT ID # - - ATTORNEY FOR: DEFENDANT M381202-01 BY THE DATE:_i -' -I Seal of the Oourt Jerk, Civi 1 Division Deputy (Eff. 7/97) KRAUS Vs. ADDENDUM TO SUBPOENA MICHELINI, D.O. No. 094477 CUSTODIAN OF RECORDS FOR: DR ROBERT WOLF ALL COPIES OF MEDICAL RECORDS FROM 1/1/00 TO PRESENT, INCLUDING BUT NOT LIMITED TO, ALL CORRESPONDENCE, MEDICAL CONSULTATIONS, MEDICAL RECORDS, MEDICAL EXAM REPORTS, INTAKE FORMS, RADIOLOGY REPORTS, AND BILLING RECORDS. PERTAINING TO: NAME: JODI KRAUS ADDRESS: DATE OF BIRTH: 05/23/61 SSAN: XXXXX5943 MEDICAL BILLING REQUESTED CERTIFIED PHOTOCOPIES WILL BE ACCEPTED IN LIEU OF YOUR PERSONAL APPEARANCE. RECORD CUSTODIAN - COMPLETE AND RETURN [ ] RECORDS ARE ATTACHED HERETO. I hereby certify as custodian of records that, to the best of my knowledge, information and belief all documents or things above mentioned have been produced. [ ] NO DOCUMENTS AVAILABLE. I hereby certify that a thorough search has been made and that no record of the following documents have been located (CHECK THE APPROPRIATE BOX): ( ) RECORDS ( ) PATIENT BILLING ( ) X-RAYS ( ) RECORDS / XRAYS have been destroyed Date Authorized signature for DR ROBERT WOLF CUMBERLAND M381202-01 * * * SIGN AND RETURN THIS PAGE OF PENNSYLVANIA COUNTY OF-CUMBERLAND KRAUS Vs. Fi le No. MICHELINI, D.O. 094477 MEDICAL BILLING REQUESTED SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009.22 WEST SHORE SURGERY CTR, 2015 TECHNOLOGY PKWY, MECHANICSBURG PA 17050 TO: (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 orSPkgA s. ' E1\ND 17DTA ii 7 - at MEDICAL LEGAL REPRODUCTIONS 494U DISSTON ., ., PA (Address) You may deliver or mail legible copies of the documents or produce things requested b? this subpoena, together with the certificate of compliance, to the party making thi request at the address listed above. You have the right to seek in advance the reasonablc- 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 thin subpoena may seek a court ordee cxr pe l l i ng you to cat l y with it. THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON: NAME: THOMAS M CHAIRS, ESQ ADDRESS: 1200 CAMP HILL BYPASS r`?MP HTT T PA 17011 TELEPHONE: SUPREhE OOURT ID # ATTORNEY FOR: M381202-02 DEFENDANT DATE :-i Seal of the Court BY THE COURT. Pro , Civil Division Deputy (Eff. 7/97) KRAUS Vs. ADDENDUM TO SUBPOENA MICHELINI, D.O. No. 094477 CUSTODIAN OF RECORDS FOR: WEST SHORE SURGERY CTR ALL COPIES OF MEDICAL RECORDS FROM 1/1/00 TO PRESENT, INCLUDING BUT NOT LIMITED TO, ALL CORRESPONDENCE, MEDICAL CONSULTATIONS, MEDICAL RECORDS, MEDICAL EXAM REPORTS, INTAKE FORMS, RADIOLOGY REPORTS, AND BILLING RECORDS. PERTAINING TO: NAME: JODI KRAUS ADDRESS: DATE OF BIRTH: 05/23/61 SSAN: XXXXX5943 MEDICAL BILLING REQUESTED CERTIFIED PHOTOCOPIES WILL BE ACCEPTED IN LIEU OF YOUR PERSONAL APPEARANCE. RECORD CUSTODIAN - COMPLETE AND RETURN [ ] RECORDS ARE ATTACHED HERETO: I hereby certify as custodian of records that, to the best of my knowledge, information and belief all documents or things above mentioned have been produced. [ ] NO DOCUMENTS AVAILABLE. I hereby certify that a thorough search has been made and that no record of the following documents have been located (CHECK THE APPROPRIATE BOX) : ( ) RECORDS ( ) PATIENT BILLING ( ) X-RAYS ( ) RECORDS / XRAYS have been destroyed Date Authorized signature for WEST SHORE SURGERY CTR CUMBERLAND M381202-02 '? * * SIGN AND RETURN THIS PAGE RECEIPT FOR PAYMENT ------------------- ------------------- Cumberland County Prothonotary's Office Carlisle, Pa 17013 Case Number 2010-99999 Receipt Date 12/02/2010 Receipt Time 14:01:49 Receipt No. 251843 (VS) Received of PD BY MEDICAL LEGAL REPRODUCT BB Total Non-Cash..... Total Cash......... Change ............. Receipt total...... + 6.00 Check# + .00 - 00 $6.00 29199 ------------------------ Distribution Of Payment: ------------------------ Transaction Description Payment Amount SUBPOENA 6.00 CUMBERLAND CO GENERAL FUND $6.00 L f ANGINO & ROVNER, P.C. Richard A.Sadlock Attorney ID# : 47281 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 FILED-OFFICE OF THE PROTHONOTARY 2011 ,?I! " ') ' !-- J29 S`ID'"' E r• iT Y 1' r I L ` , 1, 1 ,+ JODI KRAUS, Plaintiff V. ROBERT G. MICHELINI, D.O.; SPIRIT PHYSICIAN SERVICES, INC., Defendants IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PA NO. 09-4477 CIVIL ACTION -- LAW MEDICAL MALPRACTICE JURY TRIAL DEMANDED PLAINTIFF'S RESPONSE TO DEFENDANTS REQUEST FOR ADMISSION AND NOW comes Plaintiff Jodi Kraus, by and through her attorneys, Angino & Rovner, P.C., by Richard A. Sadlock, Esquire and replies to Defendant's Request for Admissions as follows: 1. Admitted. 2. Admitted. 3. York Memorial is the only facility that I recall at this time where I had my mammograms performed during this period. 456669 4. Denied. I do not recall how many mammograms I had at Memorial Hospital in York. 5. Denied. Defendant's medical staff may have erroneously listed the above- referenced information in the medical records. Plaintiff's counsel is attempting to schedule the depositing of Defendant's staff member responsible for preparing the referenced office note. 6. Denied. I cannot recall when I had my mammogram in 2007. It was obtained sometime in 2007. 7. Denied. For an accurate description, see Plaintiff's deposition transcript at page 42-44. 8. The medical record speaks for itself. 9. Denied. I have no recollection of not obtainin_? mammogram. ANGINO & ROVNEY,, P.C. Ri ar. Sadlock, E ire Na. 472 4503 N. treet i?arrisburg, PA 17110 (717) 238-6791 rsadlock@angino-rovner.com Counsel for Plaintiff 456669 .116 VERIFICATION I, JODI KRAUS, do swear and affirm that the facts set forth in the foregoing PLAINTIFF'S REPLY TO DEFENDANT'S REQUEST FOR ADMISSIONS 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 the Rules of Civil Procedure relating to unsworn falsification to authorities. WITNESS: Dated: d 203648 • . • CERTIFICATE OF SERVICE I, Michelle M. Milojevich, an employee of the law firm of Angino & Rovner, P.C., do hereby certify that I am this day serving a true and correct copy of PLAINTIFF'S REPLY TO DEFENDANT'S REQUEST FOR ADMISSIONS on the following via certified mail, return receipt request, postage prepaid, first class United States mail, addressed as follows: Thomas M. Chairs, Esquire Dickie, McCamey & Chilcote 1200 Camp Hill Bypass, Suite 205 Camp Hill, PA 17011-3700 Michelle M. Milojevich Date: I / ?Ijptj 456669 4 JN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY KRAUS O C a "'P'1 Vs. ---? NO. 094477 7 rn_. MICHELINI, D.O. -,r- ?rn d CERTIFICATE - o PREREQUISITE TO SERVICE OF A SUBPOENA CD -`' n 0 PURSUANT TO RULE 4009.22 = + -» cn As a prerequisite to service of a subpoena(s) for documents and things pursuant to Rule 4009.22 THOMAS M CHAIRS, ESQUIRE certifies that: 1. A Notice of Intent to Serve the Subpoena(s) with a copy of the subpoena(s) attached thereto was mailed or delivered to each party at least twenty days prior to the date on which the subpoena(s) is sought to be served, 2. A copy of the Notice of Intent, including the proposed subpoena(s) is attached to this certificate, 3. No objection to the subpoena(s) has been received, and 4. The subpoena(s) which will be served is identical to the subpoena(s) which is attached to the Notice of Intent to Serve the Subpoena(s). Date: 12/31/10 THOMAS M CHAIRS, ESQUIRE 1200 CAMP HILL BYPASS SUITE 205 CAMP HILL, PA 17011 717-731-4800 ATTORNEY FOR DEFENDANT INQUIRIES SHOULD BE ADDRESSED TO: MEDICAL LEGAL REPRODUCTIONS, INC. 4940 DISSTON STREET PHILADELPHIA PA 19135 (215) 335-3590 By: Theresa Deni MLR File #: M381532 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY KRAUS Vs. MICHELINI, D.O. I No. 094477 TO: RICHARD SADLOCK, ESQ (PLAINTIFF) NOTICE OF INTENT TO SERVE A SUBPOENA TO PRODUCE DOCUMENTS AND THINGS FOR DISCOVERY PURSUANT TO RULE 4009.21 DEFENDANT intends to serve a subpoena(s) identical to the one(s) attached to this notice. You have twenty (20) days from the date listed below in which to file of record and serve upon the undersigned an objection to the subpoena. If no objection is made the subpoena may be served. Date: 12/08/10 THOMAS M CHAIRS, ESQUIRE 1200 CAMP HILL BYPASS SUITE 205 CAMP HILL, PA 17011 ATTORNEY FOR DEFENDANT INQUIRIES SHOULD BE ADDRESSED TO: MEDICAL LEGAL REPRODUCTIONS, INC. 4940 DISSTON STREET PHILADELPHIA, PA 19135 (215) 335-3590 By: Theresa Deni Enc (s) : Copy of subpoena(s) Counsel return card File #: M381532 COMMONWEALTH OF PENNSYLVANIA COUNIPY OF CUB KRAUS Vs. Fi le No. MICHELINI, D.O. 094477 MEDICAL BILLING REQUESTED SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009.22 TO: FAMILY MEDICINE CTR, 6085 LINGLESTOWN RD, HARRISBURG PA 17112 (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 orS ''EE9AT DEAL- at _ MEDICAL LEGA 1:1011] If ,, (Address) You may deliver or mail legible copies of the documents or produce things requested h) this subpoena, together with the certificate of compliance, to the party making thi- 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 thi subpoena may seek a court drdei. cxmpe l l i ng you to carp 1 y with it. THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON: NAME: THOMAS M CHAIRS, ESQ ADDRESS: 1200 CAMP HILL BYPASS TAMP HILL PA 17011 TELEPHONE: SUPREME COURT ID ATTORNEY FOR: M381532-01 DEFENDANT BYTHE COURT: DATE:_ I ?'k - l b - 1 Seal of the Court /Clerk, Civil Division Deputy (Eff. 7/97') ADDENDUM TO SUBPOENA KRAUS Vs. No. 094477 MICHELINI, D.O. CUSTODIAN OF RECORDS FOR: FAMILY MEDICINE CTR COPIES OF MEDICAL RECORDS FROM 1/1/00 TO PRESENT, INCLUDING BUT NOT LIMITED TO, ALL CORRESPONDENCE, MEDICAL CONSULTATIONS, MEDICAL RECORDS, MEDICAL EXAM REPORTS, INTAKE FORMS, RADIOLOGY REPORTS AND BILLING RECORDS. PERTAINING TO: NAME: JODI KRAUS ADDRESS: DATE OF BIRTH: 05/23/61 SSAN: XXXXX5943 MEDICAL BILLING REQUESTED CERTIFIED PHOTOCOPIES WILL BE ACCEPTED IN LIEU OF YOUR PERSONAL APPEARANCE. RECORD CUSTODIAN - COMPLETE AND RETURN [ ] RECORDS ARE ATTACHED HERETO. I hereby certify as custodian of records that, to the best of my knowledge, information and belief all documents or things above mentioned have been produced. [ ] NO DOCUMENTS AVAILABLE: I hereby certify that a thorough search has been made and that no record of the following documents have been located (CHECK THE APPROPRIATE BOX): ( ) RECORDS ( ) PATIENT BILLING ( ) X-RAYS ( ) RECORDS / XRAYS have been destroyed Date Authorized signature for FAMILY MEDICINE CTR CUMBERLAND M381532-01 * ?` * SIGN AND RETURN THIS PAGE DICKIE, MCCAMEY & CHILCOTE, P.C. ATTORNEY FOR DEFENDANT BY: Thomas M. Chairs, Esquire ROBERT G. MICHELINI, D.O. AND SPIRIT ATTORNEY I.D. NO. 78565 PHYSICIAN SERVICES, INC. BY: Aaron S. Jayman, Esquire ATTORNEY I.D. NO. 85651 Plaza 21, Suite 302 425 North 21st Street Camp Hill, PA 17011 717-7314800 (Tele) 888-811-7144 Fax JODI KRAUS, IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, Plaintiff, PENNSYLVANIA V. ROBERT G. MICHELINI, D.O. AND SPIRIT PHYSICIAN SERVICES, INC., Defendants NO. 094477 CIVIL ACTION - MEDICAL JURY TRIAL DEMANDED TO THE PROTHONOTARY: Please direct all future Notices and correspondence to the following address and the undersigned counsel. Dickie, McCamey & Chilcote, P.C. Plaza 21, Suite 302 425 N. 21St Street Camp Hill, PA 17011 f;.;r "urn Respectfully submitted" ro Y+ i ; 4,5p ^ DICKIE, MCCAMEY & CHILCOJ .4Z Date: February 10, 2011 By: Thomas M. Chairs, Esquire Supreme Court I.D. #78565 Aaron S. Jayman, Esquire Supreme Court I. D. #85651 425 N. 21St Street, Suite 302 Camp Hill, PA 17011-3700 (717) 731-4800 (888) 811-7144 Attorney for Defendants, Robert G. Michelini, D. 0. and Spirit Physician Services, Inc. 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) M - C?"Zlw Thomas M. Chairs, Esquire x IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY KRAUS C - •--s 4 =-n Vs. 094477 NO rnrn . p - C)® MICHELINI, D.O. ' ? -4 C) CERTIFICATE °-n ?? c-) _ =Z5 C> m Z PREREQUISITE TO SERVICE OF A SUBPOENA G i, -• I- PURSUANT TO RULE 4009.22 w As a prerequisite to service of a subpoena(s) for documents and things pursuant to Rule 4009.22 THOMAS M CHAIRS, ESQUIRE certifies that: 1. A Notice of Intent to Serve the Subpoena(s) with a copy of the subpoena(s) attached thereto was mailed or de livered to each party at least twenty days prior to the date on which the subpoena(s) is sought to be served, 2. A copy of the Notice of Intent, including the proposed subpoena(s) is attached to this certificate, 3. No objection to the subpoena(s) has been received, and 4. The subpoena(s) which will be served is identical to the subpoena(s) which is attached to the Notice of Intent to Serve the Subpoena(s). Date: 04/28/11 THOMAS M CHAIRS, ESQUIRE 425 NORTH 21ST ST SUITE 302 PLAZA 21 CAMP HILL, PA 17011 717-731-4800 ATTORNEY FOR DEFENDANT INQUIRIES SHOULD BE ADDRESSED TO: MEDICAL LEGAL REPRODUCTIONS, INC. 4940 DISSTON STREET PHILADELPHIA PA 19135 (215) 335-3590 By: Theresa Deni MLR File #: M385959 t IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY KRAUS Vs. MICHELINI, D.O. I No. 094477 TO: RICHARD SADLOCK, ESQ (PLAINTIFF) NOTICE OF INTENT TO SERVE A SUBPOENA TO PRODUCE DOCUMENTS AND THINGS FOR DISCOVERY PURSUANT TO RULE 4009.21 DEFENDANT intends to serve a subpoena(s) identical to the one(s) attached to this notice. You have twenty (20) days from the date listed below in which to file of record and serve upon the undersigned an objection to the subpoena. If no objection is made the subpoena may be served. Date: 04/07/11 THOMAS M CHAIRS, ESQUIRE 425 NORTH 21ST ST SUITE 302 PLAZA 21 CAMP HILL, PA 17011 ATTORNEY FOR DEFENDANT INQUIRIES SHOULD BE ADDRESSED TO: MEDICAL LEGAL REPRODUCTIONS, INC. 4940 DISSTON STREET PHILADELPHIA, PA 19135 (215) 335-3590 By: Theresa Deni Enc (s) : Copy of subpoena (s) Counsel return card File #: M385959 7 1 905733 DICKIE, MCCAMEY & CHII.COTE, P.C. ATTORNEY FOR DEFENDANTS BY: Thomas M. Chairs, Esquire ROBERT G. MICHELINI, D.O. AND SPIRIT ATTORNEY I.D. NO. 78565 PHYSICIAN SERVICES, INC. Plaza 21, Suite 302 425 North 21st Street Camp Hill, PA 17011 717-731-4800 (Tele) 888-811-7144 (Fax) JODI KRAUS, IN THE COURT OF COMMON PLEAS Plaintiff OF CUMBERLAND COUNTY, PENNSYLVANIA C11 c V. -0= NO. 09-4477 = M ti r _ CIVIL ACTION - MEDICAL M c? °? CD-n ROBERT G. MICHELINI, D.O. AND ep o F) SPIRIT PHYSICIAN SERVICES, INC., ern Defendants -- JURY TRIAL DEMANDED -? vi -T G. MICHELINI. D.O. TO D PROPOUNDED UPON THE PLAINTIFF AND NOW, comes Defendant, Robert G. Michelini, D.O., by and through his counsel, Dickie, McCamey & Chilcote, P.C. and files the within Motion to have deemed admitted Defendant's Request for Admissions Propounded upon the Plaintiff and in support thereof avers as follows: 1. In the course of discovery, Defendant, Robert G. Michelini, D.O. propounded Requests for Admissions upon the Plaintiff. A true and correct copy of the Defendant's Request for Admissions Propounded upon the Plaintiff is attached hereto as Exhibit "A". 2. In nine (9) separately numbered requests, Defendants sought to have Plaintiff admit certain facts surrounding the Plaintiff's mammogram history. 3. In seven (7) of the nine (9) responses, Plaintiff has denied the Defendant's Request for Admissions citing lack of knowledge, lack of discovery or otherwise avoided the 905733 subject matter of the Defendant's Request for Admissions. A true and correct copy of the Plaintiff's Responses to Defendant's Request for Admissions is attached hereto as Exhibit "B". 4. The Plaintiff's theory of liability as against Defendant, Robert G. Michelini, D.O. centers on Dr. Michelini's failure to order radiology tests such as a mammogram in and around January of 2007. 5. Medical records for Defendant, Robert G. Michelini, D.U. document that the Plaintiff reported to Dr. Michelini that she underwent a mammogram as ordered by her GYN physician in January of 2007. 6. Defendant's investigation including subpoenas to the Plaintiffs healthcare providers has failed to reveal that the Plaintiff underwent a mammogram in and/or around the timeframe of January 2007. 7. Defendant's Request for Admissions seek to have the Plaintiff admit that she did not undergo a mammogram in January of 2007 and/or provide Defendant with evidence of the contemporaneous mammogram that Plaintiff contends she did undergo in this timeframe. 8. The Pennsylvania Rules of Civil Procedure provide that a party who has requested an admission may move to determine the sufficiency of the answer or objection. If the court determines that an answer does not comply with the requirements of Pa.R.C.P. 4014, the court may order that the matter is admitted and/or that an amended answer to served. Pa. R.C.P 4014(c). 9. Defendant, Robert G. Michelini, D.O., contends that the Plaintiff's responses to Defendant's Request for Admissions inappropriately claim lack of information or lack of discovery as a means of avoiding the subject matter of Defendant's Request for Admissions. 905733 10. The Pennsylvania Rules of Civil Procedure specifically provide "an answering party may not give lack of information or knowledge as a reason for failure to admit or deny unless the answering party states that he or she has made reasonable inquiry and the information known or readily obtainable by him or her is insufficient to enable him or her to admit or deny." Pa.R.C.P. 4014(b). 11. Contrary to the directives of the Rules of Civil Procedure governing requests for admission, the Plaintiff has cited lack of knowledge, lack of discovery and/or outright avoided answering the following requested items: 3. While residing in central Pennsylvania during the calendar year 2004 through August of 2007, Plaintiff, Jodi Kraus Hicks only underwent mammogram studies at Memorial Hospital in York, Pennsylvania. See Page 26 from Plaintiff's Deposition transcript attached as Exhibit "B." Answer: York Memorial is the only facility that I recall at this time where I had my mammograms performed during this period. 4. The only mammogram study Jody Kraus Hicks had performed at Memorial Hospital in York was accomplished on May 10, 2005. See May 10, 2005 report from Memorial Hospital attached as Exhibit "C." Answer: Denied. I do not recall how many mammograms I had at Memorial Hospital in York. 5. Medical records from Green Hill Family Practice dated April 16, 2007, document that Jodi Kraus Hicks reported to Green Hill Family Practice that Jodi Kraus Hicks had a mammogram performed in January of 2007. See April 16, 2007 office not from Green Hill Family Practice attached as Exhibit "D." Answer: Denied. Defendant's medical staff may have erroneously listed the above-referenced information in the medical records. Plaintiffs counsel is attempting to schedule the deposition of Defendant's staff member responsible for preparing the referenced office note. 6. Jodi Kraus Hicks did not have a mammogram performed in January of 2007. Answer: Denied. I cannot recall when I had my mammogram in 2007. It was obtained sometime in 2007. 905733 7. Jodi Kraus Hicks erroneously reported to Green Hill Family Practice that she had a mammogram performed on January of 2007. See Plaintiff s Deposition transcript attached as Exhibit "B." Answer: Denied. For an accurate description , see Plaintiffs deposition transcript at page 42-44. 8. At an office visit on September 19, 2006 at White Rose OB/GYN Associates an annual screening mammogram was recommended to Jodi Kraus Hicks. See September 19, 2006 office note from White Rose OB/GYN attached as Exhibit "F." Answer: The medical records speaks for itself. 9. Jodi Kraus did not obtain the annual screening mammogram recommended to her by her OB/GYN on September 19, 2006. Answer: Denied. I have no recollection of not obtaining this mammogram. See Plaintiffs responses to Defendant's Request for Admissions attached hereto as Exhibit "B". 12. The Plaintiff has obtained all of the discovery necessary for accurate response to Defendant's Request for Admissions including accomplishing the deposition of Defendant's staff member responsible for the office notes in question. 13. The Plaintiffs failure to meet the substance of the Defendant's Request for Admissions circumvents the purposes for which Rule 4014 was established and it is respectfully requested that the Court enter an Order deeming admitted Defendant's Request for Admissions propounded upon the Plaintiff. 14. Counsel for Defendant, Robert G. Michelini, D.O. sought the concurrence of counsel for the Plaintiff prior to the filing of the within discovery motion. Correspondence requesting concurrence of counsel is attached hereto as Exhibit "C". 905733 15. Counsel for the Plaintiff does not concur in the Motion of Defendant, Robert G. Michelini, D.O. to deem admitted Defendant's Request for Admissions Propounded upon the Plaintiff. WHEREFORE, Answering Defendant, Robert G. Michelini, D.O., respectfully request that this Honorable Court enter an Order deeming admitted the Defendant's Request for Admissions Propounded upon the Plaintiff. Respectfully submitted, DICKIE, MCCAMEY & CKOTE, P.C. Date: April 13, 2011 By: LI Thomas M. Chairs, Esquire Supreme Court I.D. #78565 425 N. 21 S` Street, Suite 302 Camp Hill, PA 17011-3700 (717) 731-4800 Attorney for Defendant, Robert G. Michelini, D. 0. 0 0 UICKIF., <<ICC.I??IEY & CIIILCOTE, P.C. BY: Thomas 1M. Chairs, Esquire A7" TORNEY 1.1). NO. 78565 1200 Camp [fill Bypass, Suite 205 Camp Ilill, PA 17011 (717)731-4800 (Tele) (717)731-4803 (Far) JODI KRAUS, Plaintiff V. ROBERT G. NIICHELINI, D.O., Defendant V7" l'OILNEY N'OR 1) EFENDANT ROBERT G. NIICHELINI, U.O. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 09-4477 CIVIL ACTION - NIEDICAL JURY TRIAL. nFvt,,k ivnv., DEFENDANT'S R ..,..aUO? w"43 rKUPOUN UPONTHE PLAINTIFF Pursuant to the mandates of Pa. R.C.P. 4014, responses to these Requests for Admissions must be provided within thirty (30) days of the date of service hereof or they will be deemed admitted. If an objection is made, the reasons for the objection must be stated. Answers shall admit or deny the matter or set forth in detail the reasons why you cannot truthfully do so. A denial shat I fairly meet the substance of the requested admission, and when good faith requires that a party qualify his answer or deny only a part of the matter of which an admission is requested, he shall specify so much of it as is true and quality or deny the remainder. You may not give lack of intormation or knowledge as a reason tur failure to admit or deny unless you have conducted . a reasonable inquiry and the intormation known or readily obtainable is insufficient to enable you to admit or deny the Requests for Admissions. If the Court determines that an answer does nut comply with the requirements of the Pennsylvania Rules ot'Civil Procedure, it may order that the re quest he admitted. I • Plaintiff, Jodi Kraus flicks resided in Jacksonville, Florida from 1990 through 2003. See Plaintiff's Discovery Response attached as Exhibit "A." ADMITTED DENIED 2. Plaintiff, Jodi Kraus flicks resided in central Pennsylvania from 2004 through the time at issue in this litigation. See Plaintiffs Discovery Response attached as Exhibit "A." ADNIITTED DENIED 3. While residing in central Pennsylvania during the calendar year 2004 through August of 2007, Plaintiff, Jodi Kraus [licks only underwent mammogram studies at Memorial Hospital in York, Pennsylvania. See Page 26 from Plaintiff's Deposition transcript attached as Exhibit "B." ADNIITTED DENIED 4. The only mammogram study Jody Kraus I licks had performed at Memorial Hospital in York was accomplished on May 10, 2005. See May 10, 2005 report from Memorial Hospital attached as Exhibit "C." ADMITTED DENIED 5. Medical records from Green Hill Family Practice dated April 16, 2007, document that Jodi Kraus Hicks reported to Green Hill Family Practice that Jodi Kraus Hicks had a mammogram performed in January of 2007. See April 16, 2007 office not from Green Hill Family Practice attached as Exhibit "D." ADMITTED DENIED 3 6. Jodi Kraus Clicks did not have a mammogram performed in January of'2007. ADINIn-I-ED DENIED 7. Jodi Kraus Hicks erroneously reported to Green Hill Family Practice that she had a mammogram performed on January of 2007. See Plaintiff's Deposition transcript attached as Exhibit "E." ADNIITTED DENIED 8. At an office visit on September 19, 2006 at White Rose OB/GYN Associates an annual screening mammogram was recommended to Jodi Kraus flicks. See September 19, 2006 office note from White Rose OB/GYN attached as Exhibit-F.1, ADMITTED DENIED 4 9. Jodi Kraus did not obtain the annual screening mammogram recommended to her by her OB/GYN on September 19, 2006. ADMirrED Date: December 6, 2010 DENIED Respectfully submitted, DICKIE, MCCAMEY & CIjtLCOTE, P.C. Thom, s M.'Chairs, Esquire Supreme Court I. D. #78565 1200 Camp 1-1111 Bypass, Suite 205 Camp [fill, PA 1701 1-3700 (717) 731-4800 Attornc.v,%r Del6iclunt, Robert G. Michelini, 1). 0. S CERTIFICA"CE OF SERVICE AND NOW, December 6, 2010, 1, Thomas M. Chairs, Esquire, hereby certify that I did serve a true and correct copy of the foregoing DEFENDANTS' REQUEST FOR ADMISSIONS PROPOUNDED UPON THE PLAINTIFF 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 171 10 (Counsel for Plainti ft) Thomas M. C airs; Esquire EXHIBIT A I I • Name and Residence: Please state your full name, age, current residence and residence addresses for the ten (10) years preceding the commencement of this action, with dates you resided at each such address. If your name has changed at any time, please state other name(s) and when and where you used such names. ANSWER: Full Name: Jodi Ann Kraus Current Residence: 7180 ,Jonestown Road, Harrisburg, PA 17112 335 Valley Road, Etters, PA 17319 (2004-2007) 219 Pablo Point Dr., Jacksonville, FL 32225 (1990-2003) Please refer to Plaintiffs Answers to Defendants' Interrogatories (answered on 02/26/10) for name changes. 2. Emnloyment History Have you ever been employed? If so, for each place of employment over the last ten (10) years, please state: (a) The name and complete address of the place of employment; (b) The dates of employment at each such place; (c) The position held in the employment, and the approximate wage or salary paid for the employment. (d) The name of your immediate foreman or other superior to whom you were responsible at each of the places of employment listed above. ANSWER: Please refer to Plaintiffs Answers to Defendants' Interrogatories (answered on 02/26/10) for information regarding her employment history. I am currently Self-employed. I own and operate a residential and commercial cleaning business and physical fitness training service and have done so since 1990 until this incident. 3. Education: Please state the schools which you attended following grade school, the dates you attended such schools, their location, the dates you graduated from those schools, the courses orstudy, and the degrees, if any, which you received upon graduation. ANSWER: Please refer to Plaintiff's Answers to Defendants' Interrogatories (answered on 02/26/10) for information regarding education. I ?.i;o, i EXHIBIT B 1 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 26 29 A. No. Q. How many mammograms do you believe you had performed at the order of somebody at White Rose? A. I believe I had --1 don't recall. Q. Do you believe it was more than one? A. I know for sure I had one. I don't recall if I had a second one. Q. On the one you believe you had prescribed by White Rose and performed at York Memorial, the same question, can you take me through the routine when you presented for the mammogram? A. You mean when I got to the facility to have the mammograrn? Q. Correct. A. The routine? I have to fill out paperwork. Q. Similar paperwork to the paperwork you filled out when you were getting a mammogram In Florida? A. I can assume. Q. Same type of general Inquiries designed to solicit information about disease of the breast? A. Um-hum. Q. Is that a yes? have a town or a street name or anything you 1 can give me to help narrow that down? 2 A. No. 3 Q. You can't give me a town? A. A town for where the facility was that I had 4 5 the actual mammogram? 6 Q. Yes. 7 A. I don't want to guess, you know, but I can give 8 you probably it's Jacksonville. 9 Q. Now, the group that you saw In York, White 10 Rose, did they prescribe mammograms for you? 11 A. Yes. 12 Q. And where did you have the mammograms that they 13 Prescribed performed? 14 A. York Memorial Hospital. 15 Q. And it's fair to say that you considered White 16 Rose to be your gynecologist from 1004 when you 17 returned to Pennsylvania through let's say 18 2009? 19 A. No, I don't believe so. Q. Okay. How am I not correct in that regard? 20 21 A. I believe I did see them when I returned back 22 from Jacksonville in 2004, is when I started seeing them, but I think I stopped and changed 23 24 my gynecologist before 2009. 25 27 Q. When was that that you changed gynecologists do 1 you believe? 2 MR. SADLOCK: Tom, if it helps, that's in 3 answer to interrogatory Number 5. She listed 4 that for you. It speeds things up a little 5 bit. BY MR. CHAIRS: 6 Q. Dr. Crispino here In Harrisburg? 7 8 A. Yes. 9 Q. Other than White Rose and Dr. Crispino, did you 10 see anyone for your gynecologic needs? 11 A. No. Q. Has anyone other than this - your 12 13 interrogatory responses would Indicate that you 14 started with Dr. Crispino in August of 2007. 15 A. I believe that to be correct Q. Is it fair to say that White Rose was where you 16 17 sought your gynecologic treatment, as is 18 indicated here, from April of 2005 through July 19 of 2007? A. I believe that to be correct 20 . Q. For that time period from April of 2005 to July 21 22 of 2006, did anyone other than your healthcare 23 providers at White Rose prescribe a mammogram 24 for you? 25 8 (Pages 26 to 29) 29 A. Yes. I'm sorry. Q. Any physical examination by anybody at the imaging center? A. No. Q. Did you have occasion to speak with the physician that performed or Interpreted the mammogram? A. No. Q. Do you recall anyone that you would have spoken to at York Memorial? A. Anyone that I spoke to? Q. Yes. A. I spoke to the clerk who gave me the papers. I spoke to the technician. Q. As we sit here today, anything remarkable about those conversations or anything that sticks out in your mind about those conversations? A. No. Q. How were the results of those studies communicated to you? A. The results were fine, good. Q. Okay. SIR. SADLOCK: I think he means how did you find out, phone call, letter, that kind of thing. How were you notified? Filius & McLucas Reporting Service, Inc. Harrisburg 717-236-n62A v,,.& ,,, EXHIBIT C ? .5/ 1 /2006 15:46 JIEAIORIAL HOSPITAL YORK. PA 171057113 Pitient: KRAUS, JODI A MRN: 0000 1069 8 9 Exam: BCI - iIMAXINIOGRAPHY CAD-SCREEN (P) Ordering Doctor: TAYLOR, DEBORAH Order Di22noeia- Result Status: "final' Birth: 05/23/1961 visit a: 0002031241 mtstiser-?WNIrE RUSE 0HGYN BREAST CENTER IMAOINO Sex: F Age: 44Y Location: OUTPATIENT Exam Date: 05/10/2005 11:14 AM Dictated By: PAOLANTONIO D.O., FRANK 1/2 Verified Reason: SCREENING Exams: MAXIMSCREEN W/CAD 511012005 12: l OPM 17 Bilateral craniocaudal and NILO asymptomatic 43-year old etnale. IComparisobnais made with 3/7/03. There are bilateral subglandular silicone implants. There is deformity on the left which is not significantly changed which may represent an intracapsular rupture. There are calcifications of the left capsule inferiorly. Bilaterally, no masses, suspicious microcalcifications, or areas of architectural distortion are present. These images were evaluated with a CAD Imagechecker System. No areas were marked for further evaluation. FP!cat Dictated By: FRANKPAOLANTONIO, DO 05/ 1912005 14:45 Transcribed By: TRUESDELLC 05/19/2005 15:06 Verified by: fRANKPAOLANTONIO, DO 0512012005 7:54 RESULT ID / ADDENDUM: 540121 /0 Memorial IfoSp1tLil Con/TdowlaUty Vodce. This fax, including arty attachments, is for the sole use of the intended recipients and may contain confidential and privileged destroy ;dl uitoroy all cc Aopinesof the y o fade on originnal fcr. review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender vtd Pa,Ge I of 2 EXHIBIT D ?. History Phy.SiCiau MUM iiritiuu C;amd: 1 k V OA ?, ? ? ? 5 HT ?eG 'NT .,3 3P j!s G TPR 67?, ?Z //I L CC: ., • `(??//v?"% ? /?L.?t /'?. lf??- hc?,,?v ? ,?`,e,;a?J+c1Ge./it'°?,?e..? `??t- ?lir-,.t_i G?3 LG? tl"7~. 11P1: l ,( S?c?•J ti, L" ROS: kl?sr,oa,o - Exam: dales: Rectal Genital Prostate Females: Rectal Genital rnternal AIA (OVER) NL 4 ' S RTIT Social !r, PNt,4x and Fam Hx Revieucd & Updat.:d Zp/Z 0 7 S I., ./ 110 Signature - Ys Response N =No Response R1 ght V° Eartzs y Frequency (Hz) Tested By 4v Date . $g. n r ?e;rr.?ni EXHIBIT E I? 1 44 L E 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 '1 22 23 24 25 2 I A. mammogram in January of 2007? No. Q. The most recent mammogram that I have for you prior to your diagnosis with cancer was in 2005, May of 2005. Are you aware of any source for a mammogram between May of 2005 and 2007? A. I believe I had a mammogram in 2007. What exact month I had it I don't recall. 4. Okay. But if you had it it would have been at York Memorial? A. Yes. 4. I have records of an office evaluation in July of 2007 at White Rose Ob-Gyn. In this office visit in July of 2007 do you believe you would have been evaluated by Ms. Taylor? A. I believe so. 4. Given the proximity to your breast surgery the following month, do you believe you would have discussed the fact that you're having breast surgery? A. Yes, I believe that we would have. 4. Do you believe that Ms. Taylor performed a physical examination? A. Yes. 4. Do you believe that physical examination would Filius & McLucas Reporting Service, Inc. Harrisburg 717-236-0623 VnA- 717 Q,I= Li sn n. . ..,.. EXHIBIT F 09/19/06 WHITE ROSE OB/GYN ASSOCIATES Jodi Kraus DOB: 05/23/1961 Sex: F Age: 45 years• 18113 CC.' Paten presents for annual gynecological exam. HPI: REPORTS INCREASING ANXIETY, ALTERNATING COLD AND HOT IN TEMPERATURE, TRIED OC'S X 3 IN PAST WITH POOR RESPONSE. STOPPED ESTRACE CREAM 3 MONTHS AGO, NOW BLADDER TENDERNESS BACK ROS: Const: Denies fatigue, fever, weight gain and unexplained weight loss. General health stated as good. GI: Denies constipation, diarrhea, nausea, intermittently bloody stools and vomiting. GU: Genital: denies dyspareunia, dysmenorrhea and menorrhagia. Sexually active: yes, BC VASO Urinary: denies frequency, hematuna, incontinence, retention, urgency and pain on urination. Skin: Denies rash and ulcers. Breast: Denies discharge, masses and pain. Performs BSE. Current Meds: None Allergies: No Known Drug All'gy PMH: OB/Gyn Hx: Menstrual History LMP: 09/08/2006. Cycles regularly every 28 days. SPOTTING TO 5 HEAVY DAYS ALTERNATING Q MONTH Surgeries: Hemorrhoidectomy, Appendectomy, Cystectomy, Laparoscopy Reviewed and updated. FH: Father: History: CAD, Diabetes. Reviewed, no changes. SH: Personal Habits: Does not smoke cigarettes. Occasionally drinks wine. Never used drugs. Does not consume caffeine. Exercises regularly. Always uses a seat belt. Reviewed and updated. Qwtfi5.2Y Ht 65" 5'5.25" Wt: 136 Wt Prior: 141 as of 04/26/05 Wt Dif: -5 BP: 100/62 Exam: Const: Appears healthy and well developed. No signs of acute distress present. Head/Face: Normal on inspection. Neck: Supple and symmetric. Thyroid exhibits no nodules or thyromegaly. Breasts: Breast exam was performed while patient was in a supine position. Breasts are symmetrical. No lesions of the breasts. No dominant masses noted. Nipples: Nipples are normal to palpation. Axillae: Axillae normal. GU: External genitalia: Pubic hair distribution normal for age. Bartholin's and Skene's ducts without mass or abnormal discharge. Urethral Meatus: No mass. Urethra: Shows no mass or tenderness. Bladder: Non distended and sl tender Vagina: Mucosa shows moist and pink coloration, but no lesions. Cervix: Pink, evenly colored. Positioned midline. Surface appears normal. Negative cervical motion tenderness on palpation. Uterus: Mobile, nontender and not enlarged. Adnexa: Structures palpate normally and without tenderness. Anus/Perineum: Anus and perineum appear normal. No perianal masses. Normal sphincter tone. Rectum: Rectal walls smooth, no masses or tenderness. Hematest: negative. Lymph: No palpable lymphadenopathy in the supraclavicular, axillary or inguinal region(s). Musculo: Spine: No tenderness of the spine. Normal muscle tone. Upper Extremities: inspection and palpation. Lower Extremities: Normal to inspection and palpation. Skin: Dry and warm with no discoloration or rash. Normal to Neuro: Alert and oriented x3. Affect is normal. Assessment #1: V72.31 Gyn Exam With/Without Pap Plan for #1: Comments : ANNUAL PAP, SC MAMMO, BSE MONTHLY, CA++ 1000 MG Q DAY, TV/PUS FOR MENORRHAGIA QO MONTH WITH MSMT, TRIAL VAGIFEM TAB INSTEAD OF CREAM, TRIAL ZOLOFT 50 MG Q DAY FOR VASOMOTOR AND ANXIETY Lab : Thinprep RFX HPV Assessment #2: V78.41 Screening For Rectal CA Plan for #2: Plan Other Med Current : Vagifem 25.8 mcg 1 pv 2x/week Zoloft 50 mg 1 po qd Med New Vagifem 25.8 mcg 1 pv 2x/week Zoloft 50 mg 1 po qd Med Disc DD : None Xray : ECHO, Pelvic,B-scan, Complete Seen by. A4sAo . (geA)/c;' ?Wa 12. O.yo- ANGINO & ROVNER, P.C. Richard A.Sadlock Attorney ID# : 47281 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 PC- JUVI KKAUS, Plaintiff V. ROBERT G. MICHELINI, D.O.; SPIRIT PHYSICIAN SERVICES, INC., Defendants IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PA NO. 09-4477 CIVIL ACTION - LAW MEDICAL MALPRACTICE JURY TRIAL DEMANDED PLAINTIFF'S RESPONSE TO DEFENDANTS REQUEST FOR ADMISSION AND NOW comes Plaintiff Jodi Kraus, by and through her attorneys, Angino & Rovner, P.C., by Richard A. Sadlock, Esquire and replies to Defendant's Request for Admissions as follows: I. Admitted. 2. Admitted. 3. York Memorial is the only facility that I recall- at this time where I had my mammograms performed during this period. 456669 4. Denied. I do not recall how many mammograms I had at Memorial Hospital in York. 5. Denied. Defendant's medical staff may have erroneously listed the above- referenced information in the medical records. Plaintiff's counsel is attempting to schedule the depositing of Defendant's staff member responsible for preparing the referenced office note. 6. Denied. I cannot recall when I had my mammogram in 2007. It was obtained sometime in 2007. 7. Denied. For an accurate description, see Plaintiff's deposition transcript at page 42-44. 8. The medical record speaks for itself. 9. Denied. I have no recollection of not obtainin this m ANGINO & RO P. C. ?5r . ado k, E ire No. 472 4503 N. Fro Street -Harrisburg, PA 17110 (717) 238-6791 rsadlock@angino-rovner.com Counsel for Plaintiff 456669 i F VERIFICATION I, JODI KRAUS, do swear and affirm that the facts set forth in the foregoing PLAINTIFF'S REPLY TO DEFENDANT'S REQUEST FOR ADMISSIONS 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 the Rules of Civil Procedure relating to unswom falsification to authorities. WITNESS: Dated: - Zy 203648 ?x?a? r 905860 Thomas M. Chairs Attomey-at-Law Admitted in PA, MD April 8, 2011 VIA E-MAIL Richard A. Sadlock, Esquire Angino & Rovner, P.C. 4503 North Front Street Harrisburg, PA 17110 RE: Jodi Kraus v. Robert G. Michelini, D.O. Docket No.: 09-4477 Our File No.: PC-192 (0029096.0317462) Dear Rich: Direct Dial: 717-731-4800 Direct Fax: 888-811-7144 tchairs@dmclaw.com As we discussed, I believe your client's responses to Dr. Michelini's Request for Admissions inappropriately cite lack of knowledge as a means to circumventing the subject matter of Dr. Michelini's Request for Admissions. As you have had the opportunity to accomplish the deposition of the office personnel that noted Ms. Kraus' history in April of 2007, 1 am requesting that you revisit your client's responses to Dr. Michelini's Request for Admissions. In the event that you would like to stand by your client's responses to Dr. Michelini's Request for Admissions, I would appreciate your notifying me so that I can move forward with the attached Motion. Thank you for your consideration in this matter. Very truly yours, DICKIE McCAMEY & CHILCOTE, P.C. /S/ 2fiomas M Chairs Thomas M. Chairs TMC/nlb Enclosure DICKIE, WCANU & CHILCOTE, P.C. I ATTORNEYS AT LAW AWN: 717-731-4800 FA& BB&B11-7144 Pittsburgh I Harrisburg I Philadelphia I Washington, D.C. I Delaware PLAZA 21, SUITE 302 1 425 NORTH 21 s STREET I CAMP HILL, PA 17011-2223 1 WWW.DMCLAW.COM New Jersey I North Carolina I Ohio I West Virginia 905733 CERTIFICATE OF SERVICE AND NOW, April 13, 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) -? r'l Thomas . Chairs, Esquire T Peel i'f iJ [ 17 V 1fii1 ?f 1: i .. J r, ?(L NO COUNT Y ANGINO & ROVNER, P.C. Richard A.Sadlock Attorney ID# : 47281 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 JODI KRAUS, IN THE COURT OF COMMON PLEAS Plaintiff CUMBERLAND COUNTY, PA V. NO. 09-4477 ROBERT G. MICHELINI, D.O.; SPIRIT CIVIL ACTION - LAW PHYSICIAN SERVICES, INC., MEDICAL MALPRACTICE Defendants JURY TRIAL DEMANDED PLAINTIFF'S ANSWER TO MOTION OF DEFENDANT ROBERT G. MICHELINI, D.O. TO DEEM ADMITTED THE DEFENDANT'S REQUEST FOR ADMISSION PROPOUNDED UPON THE PLAINTIFF AND NOW comes Plaintiff Jodi Kraus, by and through her attorneys, Angino & Rovner, P.C., by Richard A. Sadlock, Esquire and replies to Defendant's Motion as follows: 1. Admitted. 2. Defendant's Request for Admissions speak for themselves. 3. Denied. Defendant has improperly characterized Plaintiff's Response to the Request for Admissions. Plaintiff appropriately responded to each and every request. Further, by letter dated April 11, 2011, Plaintiff's counsel supplemented Plaintiffs 468435 Responses. A copy of the April 11, 2011 letter is attached hereto as Exhibit A. 4. Defendant improperly characterizes Plaintiff's theory of liability. See, Plaintiff's Complaint attached hereto as Exhibit B. 5. Plaintiff's medical record speak for itself. However, Defendant's staff may have improperly recorded information in Plaintiff's medical chart. 6. Denied. Only those medical providers who were subpoenaed did not result in producing the information requested by Defendant. 7. Defendant's Request for Admissions speak for themselves. 8. Pennsylvania Rule of Civil Procedure 4014 speaks for itself. Plaintiff appropriately responded to Defendant's Request for Admissions pursuant to Pa.R.C.P. 4014. 9. Defendant's averment is a conclusion of law to which no responsive pleading is required. To the extent the averment may be deemed factual, it is hereby specifically denied. By way of amplification, as previously indicated herein, Plaintiff appropriately responded to Defendant's Request for Admissions. 10. See Plaintiff's Response to Defendant's Request for Admissions and Exhibit A attached hereto. 11. Again, Plaintiff appropriately responded to Defendant's Request for Admissions. See also Exhibit A attached hereto. 12. See number 11 herein. 13. Defendant's averment is a conclusion of law to which no responsive pleading is required. To the extent the averment may be deemed factual, it is hereby specifically denied. By way of further amplification, as previously indicated herein, Plaintiff appropriately responded to Defendant's Request for Admissions. 468435 14. Defendant's Exhibit C speaks for itself. 15. Admitted. WHEREFORE, Plaintiff respectfully request Your Honorable Court deny Defendant's Motion. ANGINO & ROVNER, P.C. c and A. Sadloc ire woov 1 4503 N. Front Street Harrisburg, PA 17110 (717) 238-6791 rsadlock@angino-rovner.com Counsel for Plaintiff 468435 CERTIFICATE OF SERVICE I, Michelle M. Milojevich, an employee of the law firm of Angino & Rovner, P.C., do hereby certify that I am this day serving a true and correct copy of PLAINTIFF'S ANSWER TO MOTION OF DEFENDANT ROBERT G. MICHELINI, D.O. TO DEEM ADMITTED THE DEFENDANT'S REQUEST FOR ADMISSION PROPOUNDED UPON THE PLAINTIFF on the following via certified mail, return receipt request, postage prepaid, first class United States mail, addressed as follows: Thomas M. Chairs, Esquire Dickie, McCamey & Chilcote 1200 Camp Hill Bypass, Suite 205 Camp Hill, PA 17011-3700 fiche le M. Mil"evic Date: 4/18/11 468435 j? '31, f angino-rovner 4503 NOR'T'H FRONT STREET HARRISBURG, PA 17110.1799 717/23&6791 FAX 717/238-5610 W W W.ANGINO•ROVNER.COM E-MAIL: RSADLOCK@ANGINO-ROVNER.COM April 11, 2011 Thomas M. Chairs, Esquire Dickie, McCamey & Chilcote Plaza 21, Suite 302 425 N. 21st Street Camp Hill, PA 17011 RE: Kraus v. Michelini, et al. Civil Action No. 09-4477 (Cumberland) Dear Tom: RICHARD C. ANGINO NEIL J. RovNER DAVID L. LUTZ MICHAEL E. KOSIK RICHARD A.SADLOCK LISA M. B. WOODBURN DARYL E. CHRISTOPHER Pursuant to your request, I again reviewed Ms. Kraus' Responses to Defendant's Request for Admissions. I do not believe any revision is necessary. To the extent necessary, the Responses will be amended to indicate that Ms. Kraus has made reasonable inquiry and that the information known or readily obtainable by her is insufficient to enable her to further admit or deny the Requests. Sadlock RAS/mmm 467835 0.?If 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 acc16n dentro de los pr6ximos veinte (20) dfas despu6s 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 acci6n 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 reclamaci6n 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 1NFORMACION 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 428941 ANGINO & ROVNER, P.C. Richard A. Sadlock PA Attorney ID# : 47281 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 JODI KRAUS, Plaintiff V. IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PA NO. 09-4477 ROBERT G. MICHELINI, D.O.; SPIRIT CIVIL ACTION - MEDICAL MALPRACTICE PHYSICIAN SERVICES, INC., Defendants JURY TRIAL DEMANDED COMPLAINT 1. The Plaintiff, Jodi Kraus, is an adult resident of Harrisburg, Dauphin County, Pennsylvania 2. The Defendant, Robert G. Michelini, D.O. is a physician practicing primary care medicine in Cumberland County, Pennsylvania. A professional liability action is asserted against this Defendant and a Certificate of Merit is filed herewith as Exhibit "A." 3. The Defendant, Spirit Physicians Services, Inc., is a corporation organized under the laws of the Commonwealth of Pennsylvania, which at all relevant times employed Defendant 428941 1 Robert G. Michelini, D.O. A professional liability action is asserted against this Defendant and a Certificate of Merit is filed herewith as Exhibit "B." 4. On or about January 12, 2007, Jodi Kraus presented to Defendant Michelini's office with complaints of a clogged right ear for a week and one half. 5. Ms. Kraus also related to Defendant Michelin that she had a lump under her left arm which she would like evaluated. 6. Defendant Michelini's notes indicate that the lump was not painful and was not draining. 7. Ms. Kraus indicated she found it a week prior to the January 12, 2007, examination. 8. Defendant Michelini noted that the lump was on the left axilla. 9. Defendant Michelin decided that the lump should be monitored because it could just be a cyst. 10. Defendant Michelin's records indicate that Ms. Kraus was to let him know if it was still present in a month. 11. Defendant. Michelin advised Ms. Kraus to apply moist heat to the lump. 12. Ms. Kraus next saw Defendant Michelin on April 16, 2007, for testing related to an insurance physical. 13. Ms. Kraus stated she was feeling fine without complaints, but that she still had the left axillary nodule, although it was not reported as painful. 14. Defendant Michelin, upon examination, noted that she had a 1 cm cyst of the left axilla, which was firm and moveable. 15. Defendant Michelini made no further recommendations concerting evaluation of the axillary nodule. 428941 2 16. Ms. Kraus saw Defendant Michelin again on April 24, 2007, because of urinary issues. 17. Defendant Michelini's records do not indicate that he examined the cyst on that date or otherwise evaluated it in any way. 18. Defendant Michelin continued to provide medication for urinary tract issues in April, May, and June of 2007. 19. At no time did Defendant Michelin re-evaluate the axillary nodule or recommend that anything be done in connection therewith. 20. On July 10, 2007, Defendant Michelin saw Ms. Kraus in the office with complaints of muscle weakness, fatigue, dizziness, numb feet, getting worse over the past two weeks. 21. Defendnat Michelin noted that there was no injury to her neck or back. 22. Defendant Michelini's possible assessments included fatigue, dyspne, myalgias, feet numbness, and Raynaud`s disease, and he ordered various tests, including an EKG, chest x-ray, and blood work to further evaluate these problems. 23. Defendant Michelin indicated in his records that he should certainly consider restless leg syndrome as a possible problem. 24. Defendant Michelini did not, at that time, re-evaluate the axillary nodule nor consider whether the axillary nodule could have a contributory role to the presenting symptoms. 25. On July 16, 2007, Defendant Michelin, after reviewing certain test results, recommended that Ms. Kraus receive care from a specialist. 26. On or about August 7, 2007, Ms. Kraus was evaluated by Justin Fisher, M.D., a neurologist. 428941 3 27. Dr. Fisher noted a history of having weakness or numbness in both lower extremities for the past few months and that prior thereto she was a fitness trainer and very active physically. 28. Dr. Fisher noted that beginning about three months prior to his examination, Ms. Kraus had developed numbness and tingling in both feet, which was more recently also associated with weakness in both lower extremities, leading to a significant decline in her ability to exercise. 29. Dr. Fisher noted that the problem started as numbness in the toes of the right foot, which over time came to involve the entire right foot and eventually the entire left foot. The numbness was associated with an uncomfortable tingling or prickly sensation which felt like burning of the feet. 30. Dr. Fisher ordered various tests to help better define the cause of her many neurological-type symptoms. 31. Following performance of various tests, Ms. Kraus again saw Dr. Fisher, this time on August 31, 2007. 32. Dr. Fisher did not feel, at that time, that the prior tests were conclusive as to the cause of the problems and therefore ordered additional tests, including a muscle biopsy. 33. The muscle biopsy was performed on September 6, 2007, by Stephen Powers, M.D., and the pathology evaluation of the extracted tissue indicates a final diagnosis of neurogenicatrophy. 34. Ms. Kraus saw Dr. Fisher again on September 18, 2007, and noted that several days following the biopsy he had ordered steroids empirically, and that some of her symptoms had begun to improve since starting the steroids. 35. Dr. Fisher discussed the biopsy results with Ms. Kraus, but was so unsure as to the underlying cause of her symptoms. 428941 4 36. At that time he decided to order a CT scan of the chest, abdomen and pelvis with and without contrast, but was suspicious for possible underlying paraneoplastic process, although he did not think that a cancerous process was likely. 37. The CT scan was performed September 28, 2007, and Ms. Kraus saw Dr. Fisher again on or about October 3, 2007. 38. Dr. Fisher noted that the CT scan of the chest revealed numerous abnormalities including an enlarged left axillary lymph node measuring 2.1 cm. 39. The results of the CT scan did raise a suspicion for metastatic neoplastic process that could be contributory to the neuropathy and myopathy Ms. Kraus had developed. 40. Dr. Fisher, therefore, referred Ms. Kraus to Dr. Paul Kunkel, a general surgeon, for further evaluation. 41. Ms. Kraus saw Dr. Kunkel, who biopsied the left axillary lymph node and learned via the biopsy that it was cancer. 42. Dr. Fisher notified Ms. Kraus on that date that there was likely a direct relationship between the cancer and her neurologic problems. 43. The cancer was entirely consistent with previously found positive paraneoplastic antibodies, which prompted the cancer workup in the first place. 44. Dr. Fisher concluded on that date that Ms. Kraus indeed very likely had a paraneoplastic neuropathy, which had resulted in the numbness and weakness in her lower extremities and the findings on the EMG/nerve conduction studies. 45. Ms. Kraus had additional treatment and evaluation by multiple physicians, who also concurred that she suffered from neoplastic syndrome in the setting of adenocarcinoma to presume to be of the breast origin. 428941 5 46. In spite of intensive treatment for the condition, by the time it was diagnosed and treatment commenced, it was so advanced that Ms. Kraus remains markedly symptomatic. 47. Early evaluation and treatment of cancers including an axillary lymph node cancer decreases the risk for the development of paraneoplastic syndrome. 48. Early treatment of a developing neoplastic process decreases the risk that it will continue to worsen, and makes optimal treatment or cure more likely. 49. All of Plaintiff's damages as hereinafter related are the direct and proximate result of the negligence of Dr. Robert Michelini, acting within the course and scope of his employment for Spirit Physicians Services, Inc., in that he: a. failed to order appropriate testing to evaluate Ms. Kraus' axillary nodule in January of 2007; b. failed to order a follow-up appointment specifically to evaluate the nodule at a later date; C. failed to evaluate the existing nodule, which continued to persist over time, at any of her subsequent visits, or to inquire about the status of the nodule during any subsequent phone call through July of 2007. 50. As a result of Defendant Michelini's deviations from the standard of care, the risk for Ms. Kraus of developing refractory paraneoplastic syndrome was substantially increased. 51. As a result of the negligence of Defendants, as described above, Plaintiff, Jodi Kraus, has been forced to incur liability for medical treatment, medications, hospitalizations, and similar miscellaneous expenses in an effort to return herself to health, and claim is made therefor to the extent allowed by law. 52. Because of the negligence of Defendants, Plaintiff Jodi Kraus, may be forced to incur similar expenses in the future, and claim is made therefore, to the extent allowed by law. 428941 6 53. As a result of the negligence of Defendants, Ms. Kraus has, and may in the future suffer a loss of earnings and earning capacity, and claim is made therefor. 54. As a result of the negligence of Defendants, Ms. Kraus has undergone, and may in the future undergo, great physical and mental suffering, great inconvenience in carrying out her daily activities, loss of life's pleasures and enjoyment, and claim is made therefor. 55. As a result of the negligence of Defendants, Ms. Kraus has been, and in the future may be, subject to great humiliation and embarrassment, and claim is made therefor. 56. As a direct result of the negligence of the Defendants, Ms. Kraus has suffered compensable loss, and claim is made therefor. WHEREFORE, Plaintiff demands judgment against Defendants in an amount in excess of $50,000 (Fifty Thousand) Dollars, exclusive of interest and costs, and in excess of any jurisdictional amount requiring compulsory arbitration. Respectfully submitted, ANGIN R, P.C. Date: February 010 VO' Richard A. Sadlock, Esquire PA I.D. No. 47281 4503 N. Front Street Harrisburg, PA 17110 (717) 238-6791 Counsel for Plaintiff 428941 7 JODI KRAUS, Plaintiff V. ROBERT G. MICHELINI, D.O. and SPIRIT PHYSICIAN SERVICES, INC., Defendants IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PA NO. 09-4477 CIVIL ACTION - LAW MEDICAL MALPRACTICE JURY TRIAL DEMANDED Certificate of Merit as to Spirit Physician Services, Inc. Date: I, Richard A. Sadlock, 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 acceptableprofessional standards and that such conduct was a cause in bringing about the harm; WANDI aim that this defendant deviated from an acceptable professional standard is based allegations that o ther licensed professionals for whom this defendant is responsible 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. February 220M 0 .00 1 . ?:??Sadlock 428941 JODI KRAUS, Plaintiff V. ROBERT G. MICHELINI, D.O.; and SPIRIT PHYSICIAN SERVICES, INC., Defendants IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PA NO. 09-4477 CIVIL ACTION - LAW MEDICAL MALPRACTICE JURY TRIAL DEMANDED Certificate of Merit as to Robert G. Michelini, D.O. I, Richard A. Sadlock, certify that: an appropriate licensed professional has supplied a written statement to the undersigned that ere 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: February Richard A. Sadl 428941 VERIFICATION I, Jodi Kraus, Plaintiff hereby verify that the facts set forth in the foregoing Complaint are true and correct to the best of my knowledge, information and belief. I understand that any false statements therein are made subject to the penalties of 18 Pa.C.S.A. §4904, relating to unworn falsification to authorities. WITNESS: 430794 Date: r / CERTIFICATE OF SERVICE 14- AND NOW, this go day of February, 2010, I, Kathy A. Toney, an employee of the law firm of Angino & Rovner, P.C., hereby certify that a true and correct copy of Plaintiff's Complaint 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: Thomas M. Chairs, Esquire Dickie, McCamey & Chilcote, P.C. 1200 Camp Hill Bypass, Suite 205 Camp Hill, PA 17011 Kathy A. oney 428941 8 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY KRAUS rr? ? ?p Vs. NO. 094477 MICHELINI, D.O. CERTIFICATE =CD - C)r- PREREQUISITE TO SERVICE OF A SUBPOENA PURSUANT TO RULE 4009.22 As a prerequisite to service of a subpoena(s) for documents and things pursuant to Rule 4009.22 THOMAS M CHAIRS, ESQUIRE certifies that: 1. A Notice of Intent to Serve the Subpoena(s) with a copy of the subpoena(s) attached thereto was mailed or delivered to each party at least twenty days prior to the date on which the subpoena(s) is sought to be served, 2. A copy of the Notice of Intent, including the proposed subpoena(s) is attached to this certificate, 3. No objection to the subpoena(s) has been received, and 4. The subpoena(s) which will be served is identical to the subpoena(s) which is attached to the Notice of Intent to Serve the Subpoena(s). Date: 04/28/11 THOMAS M CHAIRS, ESQUIRE 425 NORTH 21ST ST SUITE 302 PLAZA 21 CAMP HILL, PA 17011 717-731-4800 ATTORNEY FOR DEFENDANT INQUIRIES SHOULD BE ADDRESSED TO: MEDICAL LEGAL REPRODUCTIONS, INC. 4940 DISSTON STREET PHILADELPHIA PA 19135 (215) 335-3590 By: Theresa Deni MLR File #: M385959 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY KRAUS Vs. MICHELINI, D.O. TO: RICHARD SADLOCK, ESQ No. 094477 (PLAINTIFF) NOTICE OF INTENT TO SERVE A SUBPOENA TO PRODUCE DOCUMENTS AND THINGS FOR DISCOVERY PURSUANT TO RULE 4009,21 DEFENDANT intends to serve a subpoena(s) identical to the one(s) attached to this notice. You have twenty (20) days from the date listed below in which to file of record and serve u on the undersigned an objection to the subpoena. P If no objection is made the subpoena may be served. Date: 04/07/11 THOMAS M CHAIRS, ESQUIRE 425 NORTH 21ST ST SUITE 302 PLAZA 21 CAMP HILL, PA 17011 ATTORNEY FOR DEFENDAN'T' INQUIRIES SHOULD BE ADDRESSED TO: MEDICAL LEGAL REPRODUCTIONS, INC. 4940 DISSTON STREET PHILADELPHIA, PA 19135 (215) 335-3590 By: Theresa Deni Enc (s) : Copy of subpoena(s) Counsel return card File ##: M385959 rrV*CV WEALTH OF PENNSYLVANIA COUNTY OF CUNI3ERIAND KRAUS Vs. File No. 094477 MICHELINI, D.O. SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009.22 TLC CLEANING SERVICES, 2 IRONGATE CT, MECHANICSBURG PA 17050 TO: ATTN: PERSONNEL DEPARTMENT (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 orsgs: TAeHED ADDENDUM at MEDICAL LEGAL REPRODUCTIONS IN?C, 4940 DISSTUN ., ., Fly- - (Address) You may deliver or mail legible copies of the documents or produce things requested b: 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 rea,onablc- 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 thii subpoena may seek a court ordei, cxxnpe i l i ng you to cenp l y with it. THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLCWING PERSON: NAME: THOMAS M CHAIRS, ESQ ADDRESS: 425 NORTH 21ST ST (AMP HTT T ,?A 17011 TELFPHbNE: SUPREME COURT ID # ATTORNEY FOR: DEFENDANT M385959-01 DATE : . '///x/ /I Scat of the Court BY TFE COURT : ])IMVZ O b jeU g u- Prothono ary lerk, Civil Division ?. Deputy (Eff. 9/97) KRAUS Vs. ADDENDUM TO SUBPOENA MICHELINI, D.O. No. 094477 CUSTODIAN OF RECORDS FOR: TLC CLEANING SERVICES RECORDS REGARDING JODI KRAUS (HICKS) FROM 1/1/00 TO THE PRESENT INCLUDING BUT NOT LIMITED TO CORRESPONDENCE, CONTRACTS, PAYROLL DOCUMENTS, JOB ADS, CANCELLED CHECKS, BANK RECORDS AND/OR DOCUMENTS SHOWING PAYMENT OF ANY KIND TO CLAIMANT AND ANY SUBCONTRACTOR DOGS. PERTAINING TO: NAME: JODI KRAUS ADDRESS: DATE OF BIRTH: 05/23/61 SSAN: XXXXX5943 CERTIFIED PHOTOCOPIES WILL BE ACCEPTED IN LIEU OF YOUR PERSONAL APPEARANCE. RECORD CUSTODIAN - COMPLETE AND RETURN [ ] RECORDS ARE ATTACHED HERETO: I hereby certify as custodian of records that, to the best of my knowledge, information and belief all documents or things above mentioned have been produced. [ ] NO DOCUMENTS AVAILABLE. I hereby certify that a thorough search has been made and that no record of the following documents have been located (CHECK THE APPROPRIATE BOX): ( ) RECORDS ( ) PATIENT BILLING ( ) X-RAYS ( ) RECORDS / XRAYS have been destroyed Date Authorized signature or TLC CLEANING SERVICES CUMBERLAND M385959-01 * * * SIGN AND RETURN THIS PAGE * * * IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY KRAUS Vs. NO. 094477 MICHELINI, D.O. CERTIFICATE OF COMPLIANCE WITH SUBPOENA TO PRODUCE DOCUMENTS OR THINGS PURSUANT TO RULE 4009.23 I, TLC CLEANING SERVICES certify to the best of mfr knowledge, information and belief that all documents or thin s required to be produced pursuant to the subpoena issued on 04/28711 have been produced. Date AUTHORIZED SIGNATURE FOR TLC CLEANING SERVICES Complete the APPROPRIATE SECTION ONLY and return entire page. *** THIS PAGE MUST BE COMPLETED AND RETURNED *** NO RECORD STATEMENT I, the undersigned, hereby certify that I am the duly authorized custodian of records for TLC CLEANING SERVICES and I hereby certify to the following: THAT I HAVE RECEIVED A SUBPOENA REQUESTING DOCUMENTS OR THINGS PERTAINING TO THE ABOVE-CAPTIONED INDIVIDUAL AND THAT AFTER HAVING MADE A THOROUGH SEARCH FOR SAID ITEMS, I CERTIFY THAT OUR OFFICE IS UNABLE TO FIND ANY (CHECK APPROPRIATE BOX) ( ) RECORDS ( ) PATIENT BILLING ( ) X-RAY FILMS to AUTHORIZED SIGNATURE FOR TLC CLEANING SERVICES M385959-01 CC: THOMAS M CHAIRS, ESQUIRE 425 NORTH 21ST ST SUITE 302 PLAZA 21 CAMP HILL, PA 17011 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY rn' t? -0, KRAL?S ) L -C Vs. W C --? ro NO. 094477 <o -0 S-n MICHELINI, D . O . =O ors CERTIFICATE x - co :- PREREQUISITE TO SERVICE OF A SUBPOENA PURSUANT TO RULE 4009.22 As a prerequisite to service of a subpoena(s) for documents and things pursuant to Rule 4009.22 THOMAS M CHAIRS, ESQUIRE certifies that: 1. A Notice of Intent to Serve the Subpoena(s) with a copy of the subpoena(s) attached thereto was mailed or delivered to each party at least twenty days prior to the date on which the subpoena(s) is sought to be served, 2. A copy of the Notice of Intent, including the proposed subpoena(s) is attached to this certificate, 3. No objection to the subpoena(s) has been received, and 4. The subpoena(s) which will be served is identical to the subpoena(s) which is attached to the Notice of Intent to Serve the Subpoena(s). Date: 05/20/11 THOMAS M CHAIRS, ESQUIRE 425 NORTH 21ST ST SUITE 302 PLAZA 21 CAMP HILL, PA 17011 717-731-4800 ATTORNEY FOR DEFENDANT INQUIRIES SHOULD BE ADDRESSED TO: MEDICAL LEGAL REPRODUCTIONS, INC. 4940 DISSTON STREET PHILADELPHIA PA 19135 (215) 335-3590 By: Theresa Deni MLR File #: M387409 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY KRAUS. Vs. MICHELINI, D.O. No. 094477 TO: RICHARD SADLOCK, ESQ (PLAINTIFF) NOTICE OF INTENT TO SERVE A SUBPOENA TO PRODUCE DOCUMENTS AND THINGS FOR DISCOVERY PURSUANT TO RULE 4009.21 DEFENDANT intends to serve a subpoena(s) identical to the one(s) attached to this notice. You have twenty (20) days from the date listed below in which to file of record and serve upon the undersigned an objection to the subpoena. If no objection is made the subpoena may be served. Date: 05/23/11 THOMAS M CHAIRS, ESQUIRE 425 NORTH 21ST ST SUITE 302 PLAZA 21 CAMP HILL, PA 17011 ATTORNEY FOR DEFENDANT INQUIRIES SHOULD BE ADDRESSED TO: MEDICAL LEGAL REPRODUCTIONS, INC. 4940 DISSTON STREET PHILADELPHIA, PA 19135 (215) 335-3590 By: Theresa Deni Enc(s): Copy of subpoena(s) Counsel return card File #: M387409 ,yuApNWFALTH OF PENNSYLVANIA COUNTY OF KRAUS Vs. File No. MICHELINI, D.O. . 094477 MEDICAL BILLING REQUESTED SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISOOVERY PURSUANT TO RULE 4009.22 ORTHO INST OF PA, 3399 TRINDLE ROAD, CAMP HILL PA 17011 TO: (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 orsltt ngALrr D ENDT A4 _ at gPr-- --- MEDICAL LEGAL (Address) You may deliver or mail legible copies of the documents or produce things requested h? this subpoena, together with the certificate of compliance, to the party making thi_ request at the address listed above. You have the right to seek in advance the rea,onablE 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 thi, subpoena may seek a court orde-- cxxmpe l l i ng you to coup l y with it. THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON: NAB: THOMAS M CHAIRS, ESQ ADDRESS : 425 NORTH 21ST ST CAMP HILL,- PA 17011 TELEPHONE: 21S S 335-2212 1 2 SUPREME COURT I D # ATTORNEY FOR: DEFENDANT M387409-01 BY THE COURT: DATE : _ 5/ j41I_ Seal of the Court Jerk, Civil Division Deputy (Eff. 1/97) ADDENDUM KRAUS , Vs. MICHELINI, D.O. TO SUBPOENA No. 094477 CUSTODIAN OF RECORDS FOR: ORTHO INST OF PA ALL COPIES OF MEDICAL RECORDS FROM 1/1/00 TO PRESENT, INCLUDING, BUT NOT LIMITED TO, ALL CORRESPONDENCE, MEDICAL CONSULTATIONS, MEDICAL RECORDS, MEDICAL EXAM REPORTS, INTAKE FORMS, RADIOLOGY REPORTS AND BILLING RECORDS. PERTAINING TO: NAME: JODI KRAUS ADDRESS: DATE OF BIRTH: 05/23/61 SSAN: XXXXX5943 MEDICAL BILLING REQUESTED CERTIFIED PHOTOCOPIES WILL BE ACCEPTED IN LIEU OF YOUR PERSONAL APPEARANCE. RECORD CUSTODIAN - COMPLETE AND RETURN [ ] RECORDS ARE ATTACHED HERETO: I hereby certify as custodian of records that, to the best of my knowledge, information and belief all documents or things above mentioned have been produced. [ ] NO DOCUMENTS AVAILABLE. I hereby certify that a thorough search has been made and that no record of the following documents have been located (CHECK THE APPROPRIATE BOX): ( ) RECORDS ( ) PATIENT BILLING ( ) X-RAYS ( ) RECORDS / XRAYS have been destroyed Date Authorized signature or ORTHO INST OF PA CUMBERLAND M387409-01 * * * SIGN AND RETURN THIS PAGE * * * DICKIE, MCCAMEY & CHILCOTE, P.C. ATTORNEY FOR DEFENDANTS: BY: Thomas M. Chairs, Esquire ROBERT G. MICHELINI, D.O. AND SPIRIT ATTORNEY I.D. NO. 78565 PHYSICIAN SERVICES, INC. Plaza 21, Suite 302 425 North 21st Street Camp Hill, PA 17011 717-7314800 (Tele) 888-811-7144 (Fax) JODI KRAUS, IN THE COURT OF COMMON PIKAS* Plaintiff OF CUMBERLAND COUN -- --i r- PENNSYLVANIA c..- ? „ - r- - v. cn ._. , C1 NO. 09-4477 ?. CD CIVIL ACTION - MEDIC C tc- ) ROBERT G. MICHELINI, D.O. AND .:, SPIRIT PHYSICIAN SERVICES, INC., Defendants JURY TRIAL DEMANDED CERTIFICATE PREREQUISITE TO SERVICE OF A SUBPOENA PURSUANT TO RULE 4009.22 As a prerequisite to service of a subpoena for documents and things pursuant to Rule 4009.22, Counsel for Defendants certify that: (1) a Notice of Intent to serve the subpoena with a copy of the subpoena attached thereto was mailed or delivered to each party, (2) a copy of the Notice of Intent, including the proposed subpoena, is attached to this certificate, (3) Counsel for Plaintiff waived the twenty day notice, copy attached, 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. Respectfully submitted, DICKIE, MCCAMEY & CHILCOTE, P.C. Date: (ff S ` ?f By: Thonids M. Chairs, Esquire Supreme Court I.D. #78565 425 N. 21" Street, Suite 302 Camp Hill, PA 17011-3700 (717) 731-4800 Attorney for Defendant, Robert G. Michelini, D. 0. and Spirit Physician Services, Inc. JUN.15.2011 10:32AM ANGINO & ROVNER HBG,PA. NO. 855 P.2 DICKM MCCAMEY & CIHILCOTE, P.C. BY: AARON S. JAYMAN, ESQUIRE ATTORNEY FOR: DEFENDANTS ATTORNEY I.D. NO. 85651 ROBERT G. MICHELINI, D.O. AND SPIRIT BY: FRANCIS E. MARSHALL, JR., ESQUIRE PHYSICIAN SERVICES, INC. ATTORNEY I.D. NO. 27594 BY: THOMAS M. CHAJRS, ESQUIRE ATTORNEY I.D. NO. 7850 Plaza 21, Suite 302 425 North 218t Street Camp Hill, PA 17011 717-7311800 (Tele) 888411-7141 ax JODY KRAUS, IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, Plaintiff PENNSYLVANIA v. ROBERT G. MICHELINI, D.O. AND SPEPUT PHYSICIAN SERVICES, INC., NO. 09-4477 CIVIL ACTION - MEDICAL Defendants JURY TRIAL DEMANDED WAIVER OF TWENT'Y' DAY NOTICE PERIOD FOR NOTICE OF INTENT TO SERVE Ar SUBPOENA TO PRODUCE DOCUMENTS AND TIDINGS FOR DISCOVERY PURSUANT TO RULE 4009.21 I hereby waive the required twenty day period of notice for the Notice of Intent to Serve a Subpoena regarding records of to be Subpoenaed from Care First Blue Cross Blue Shield. e to the Plain;i Date: June 14, 2011 960878 DICKIE, MCCAMEY & CHILCOTE, P.C. ATTORNEY FOR DEFENDANTS: BY: Thomas M. Chairs, Esquire ROBERT G. MICHELINI, D.O. AND SPIRIT ATTORNEY I.D. NO. 78565 PHYSICIAN SERVICES, INC. Plaza 21, Suite 302 425 North 21st Street Camp Hill, PA 17011 717-731-4800 (Tele) 888-811-7144(Fax) JODI KRAUS, V. Plaintiff IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 09-4477 CIVIL ACTION - MEDICAL. ROBERT G. MICHELINI, D.O. AND SPIRIT PHYSICIAN SERVICES, INC., Defendants JURY TRIAL DEMANDED NOTICE OF INTENT TO SERVE A SUBPOENA TO PRODUCE DOCUMENTS AND THINGS FOR DISCOVERY PURSUANT TO RULE 4009.21 Defendants intend to serve a Subpoena identical to the Subpoena attached to this Notice, addressed to the following: CareFirst BlueCross BlueShield. You have twenty (20) days from the date listed below in which to file of record and serve upon the undersigned an objection to the subpoena. If no objection is made the subpoena may be served. Respectfully submitted, DICKIE, MCCAM?EY & C ILC E, P.C. .11 X X Date: By: i i T' -as M. Chairs, Esquire Supreme Court I.D. #78565 425 N. 21" Street, Suite 302 Camp Hill, PA 17011-3700 (717) 731-4800 Attorney for Defendant, Robert G. Michelini, D, 0. and Spirit Physician Services, Inc. CERTIFICATE OF SERVICE AND NOW, June 2011, I, Thomas M. Chairs, Esquire, hereby certify that I did serve a true and correct copy of the foregoing NOTICE OF INTENT TO SERVE A SUBPOENA TO PRODUCE DOCUMENTS AND THINGS FOR DISCOVERY PURSUANT TO RULE 4009.21 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) Thomas N?91airs, Esquire COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND Jodi Kraus Plaintiff VS. Robert G. Michelini, D.O., et al Defendant File No. 09-4477 SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009.22 TO: CareFirst B1ueCross BlueShield (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: Records of Jodi Kraus including all Claims/EXplanation of Benefits Information and Enrollment & Benefit Information. at425 N. 21st St., Suite 302, Camp Hill, PA 17011 (Address) You may deliver or mail legible copies of the documents or produce things requested by this subpoena, together with the certificate of compliance, to the party making this request at the address listed above. You have the right to seek in advance the reasonable cost of preparing the copies or producing the things sought. If you fail to produce the documents or things required by this subpoena within twenty (20) days after its service, the party serving this subpoena may seek a court order compelling you to comply with it. THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON: NAME: Thomas M. Chairs ADDRESS: 425 N. 21st. , St. Suite 302 Camp Hill, PA 17011 TELEPHONE: 717-731-4800 SUPREME COURT ID 1#7565 ATTORNEY FOR: ne f,.ndan G Dater e_ '5-- -2,1911 U Seal of the Court BY THE COURT: P th otary, Civil Division Deputy DICKIE, MCCAMEY & CHILCOTE, P.C. 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) JODI KRAUS, Plaintiff V. ROBERT G. MICHELINI, D.O. AND SPIRIT PHYSICIAN SERVICES, INC., Defendants ATTORNEY FOR DEFENDANTS: ROBERT G. MICHELINI, D.O. AND SPIRIT PHYSICIAN SERVICES, INC. C T IN THE COURT OF COM PkE OF CUMBERLAND COU -, PENNSYLVANIA 'h .+- NO. 09-4477 = c ? t : r CIVIL ACTION - MEDICAL.; Ln .-7 JURY TRIAL DEMANDED CERTIFICATE PREREQUISITE TO SERVICE OF A SUBPOENA PURSUANT TO RULE 4009.22 As a prerequisite to service of a subpoena for documents and things pursuant to Rule 4009.22, Counsel for Defendants certify that: (1) a Notice of Intent to serve the subpoena with a copy of the subpoena attached thereto was mailed or delivered to each party, (2) a copy of the Notice of Intent, including the proposed subpoena, is attached to this certificate, (3) Counsel for Plaintiff waived the twenty day notice, copy attached, 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. Respectfully submitted, DICKIE, MCCAMEY & CHILCOTE, P.C. Date: By: J Supreme Court I.D. #78565 425 N. 21St Street, Suite 302 Camp Hill, PA 17011-3700 (717) 731-4800 Attorney for Defendant, Robert G. Michelini, D. 0, and Spirit Physician Services, Inc. JUN.15.2011 10:33AM ANGINO & ROVNER HBG,PA. liic WE, MCCAME'Y & CIIILC0110 P.C. BY: AARON S. JAYMAN, ESQUIRE ATTORNEY I.D. NO. 85651 BY: MtANCIS E. MARSHALL, JR., ESQUIRE ATTORNEY I.D. NO, 27594 BY: THOMAS M. CHAIRS, ESQUIRE ATTORNEY I.D. NO, 78565 Plaza, 21, Suft 302 425 Nardi 21st Street Camp Hill, PA 17011 717-731-4800 (Tate) J'ODI KRAUS, Plaintiff V. ROBERT G. MICHELINI, D.O. AND SPIRIT PHYSICIAN SERVICES, INC., Defendants NO. 855 P.3' ATTORNEY FOR; DEFENDANTS ROBERT G. MICHEL,INI, D.O. AND SPIRIT PHYSICIAN SERVICES, INC. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 09-4477 CIVIL, ACTION - MEDICAL, JURY TRIAL DEMANDRn WAIVER OF TWENTY DAY NOTICE PERIOD FOR NOTICE OF INTENT TO SERVE A SUBPOENA TO PRODUCE DOCUMENTS AND THINGS FOR DISCOVERY PURSUANT TO RULE 4009.21 I hereby waive the required twenty day period of notice for the Notice ofS?rve a Subpoena regarding records of to be Subpo=ed froMMava Medic nratnriau to the intif Date; June 144, 2oI I 960573 DICKIE, MCCAMEY & CHILCOTE, P.C. 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) JODI KRAUS, V. Plaintiff ROBERT G. MICHELINI, D.O. AND SPIRIT PHYSICIAN SERVICES, INC., Defendants ATTORNEY FOR DEFENDANTS: ROBERT G. MICHELINI, D.O. AND SPIRIT PHYSICIAN SERVICES, INC. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 09-4477 CIVIL ACTION - MEDICAL JURY TRIAL DEMANDED NOTICE OF INTENT TO SERVE A SUBPOENA TO PRODUCE DOCUMENTS AND THINGS FOR DISCOVERY PURSUANT TO RULE 4009.21 Defendants intend to serve a Subpoena identical to the Subpoena attached to this Notice, addressed to the following: Mayo Medical Laboratories. You have twenty (20) days from the date listed below in which to file of record and serve upon the undersigned an objection to the subpoena. If no objection is made the subpoena may be served. Respectfully submitted, DICKIE, MCCAMEY & CHILC97;E, P.C. Date: By: i "Tho as M. Chairs, Esquire Supreme Court I.D. #78565 425 N. 21" Street, Suite 302 Camp Hill, PA 17011-3700 (717) 731-4800 Attorney for Defendant, Robert G. Michelini, D. 0. and Spirit Physician Services, Inc. CERTIFICATE OF SERVICE AND NOW, June 2011, I, Thomas M. Chairs, Esquire, hereby certify that I did serve a true and correct copy of the foregoing NOTICE OF INTENT TO SERVE A SUBPOENA TO PRODUCE DOCUMENTS AND THINGS FOR DISCOVERY PURSUANT TO RULE 4009.21 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) COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND Jodi Kraus Plaintiff VS. File No. 09-4477 Robert G. Michelini, D.O., et al. Defendant SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009.22 TO: Mayo Medical Laboratories (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: Complete chart of Jodi Kraus including, but not limited to, all lab test requests with reported results and correspondence dicated or otherwise. at 425 N. 21st. St.. Suite 302. Camp Hill. PA 17011 (Address) You may deliver or mail legible copies of the documents or produce things requested by this subpoena, together with the certificate of compliance, to the party making this request at the address listed above. You have the right to seek in advance the reasonable cost of preparing the copies or producing the things sought. If you fail to produce the documents or things required by this subpoena within twenty (20) days after its service, the party serving this subpoena may seek a court order compelling you to comply with it. THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON: NAME: Thomas M. Chairs ADDRESS: 425 N. 21st St. Suite 302 Camp Hill, PA 17011 TELEPHONE: 717-731-4800 SUPREMECOURT ID # 78565 ATTORNEY FOR: Defendants Date: e /?:!j? oW// Seal of the Court BY THE T: onotary, C vil Division Deputy JODI KRAUS, Plaintiff vs. ROBERT G. MICHELINI, D.O. and SPIRIT PHYSICIAN SERVICES, INC., : Defendants IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVAN ;A , CIVIL ACTION - LAW rn -'0'r NO. 09-4477 CIVIL Nr a C) c.? ,c© -o n ©-n ma N yam} JURY TRIAL DEMANDED y"-. 00 IN RE: DEFENDANTS' MOTION FOR SUMMARY JUDGMENT BEFORE HESS, P.J. AND GUIDO J ORDER AND NOW, this / 7 ' day of June, 2011, following argument, the Court being satisfied that issues of material fact exist in the record particularly with respect to the time at which the plaintiff should have reasonably ascertained her injury, the motion of the defendants for summary judgment is DENIED. BY THE COURT, -'? (? '00 Kevin ess, P. J. Richard A. Sadlock, Esquire / For the Plaintiff d Thomas M. Chairs, Esquire For the Plaintiffs :rlm paid D? JODI KRAUS, Plaintiff v ROBERT G. MICHELINI, D.O. SPIRIT PHYSICIAN SERVICES, INC., Defendants IN THE COURT OF COMMON PLEA OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW 09-4477 CIVIL TERM IN RE: CALL OF CIVIL TRIAL LIST ORDER OF COURT C m cry ?."` Cr > < :Zr N xa c? AND NOW, this 21st day of June, 2011, upon w'E consideration of the call of the civil trial list, and counsel for the Defendants in the person of Thomas M. Chairs, Esquire, having requested that the case be stricken from the trial list based upon the pendency of a motion for summary judgment which has been argued and based upon the irresolution of a certain issue involving a request for admissions, which the Honorable Edward E. Guido has been involved in, the motion to strike the case from the trial list is denied, without prejudice to Defendants' right to file a formal motion for a continuance prior to the pretrial conference in this case in the event that these matters have not been resolved as of that time. By the Court, Richard A. Sadlock, Esquire 4503 N. Front Street Harrisburg, PA 17110 For Plaintiff Thomas M. Chairs, Esquire 1200 Camp Hill Bypass Suite 205 Camp Hill, PA 17011 For Defendants i ?/, /,4", ]/?, ?; J. esley 01 .,, J. ? Honorable Edward E. Guido -'^ 1?&. V Court Administrator -in (W;P. : mae JODI KRAUS, Plaintiff V. ROBERT G. MICHELINI, D.O.: AND SPIRIT PHYSICIAN SERVICES, INC., Defendants #14 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLV*IAa CD rnw -i ? r r a ., -ai c . <> , j °Q .C © -0 =-n (D -n NO. 09-4477 CIVIL TERM =C N of x IN RE: PRETRIAL CONFERENCE A pretrial conference was held on Wednesday, July 6, 2011, before the Honorable Edward E. Guido, Judge. Present for the Plaintiff was Richard A. Sadlock, Esquire, and present for the Defendants was Thomas M. Chairs, Esquire. This is a medical malpractice case in which the Plaintiff needs additional time to have his expert respond to an expert report received last week. Consequently the matter is continued to the September trial term. The Court Administrator is requested to place this on the September trial list. Richard A. Sadlock, Esquire For the Plaintiff Thomas M. Chairs, Esquire For the Defendants lfh Edward E. Guido, J. 9841318.doc DICKIE, MCCAMEY & CHILCOTE, P.C. 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) JODI KRAUS, Plaintiff V. ROBERT G. MICHELINI, D.O. AND SPIRIT PHYSICIAN SERVICES, INC., Defendants ATTORNEY FOR DEFENDANTS ROBERT G. MICHELINI, D.O. AND SPIRIT PHYSICIAN SERVICES, INC. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA c NO. 09-4477 CIVIL ACTION - MEDICAL JURY TRIAL DEMANDED rm zrn =1r r- --- ?C1 vn ?o G r- r- a> rrs -'v rn C:j CJ --_tca p elf DEFENDANTS' MOTION FOR LEAVE OF COURT TO OBTAIN ADDITIONAL DISCOVERY OF AN OPPOSING PARTY'S ANTICIPATED EXPERT TESTIMONY PURSUANT TO PA.R.C.P. 4003.5(a)(2) AND NOW, come Defendants, Robert G. Michelini, D.O. and Spirit Physician Services, Inc., by and through their counsel, Dickie, McCamey & Chilcote, P.C. and file the within Motion for Leave of Court To Obtain Additional Discovery of an Opposing Party's Anticipated Expert Testimony pursuant to Pa.R.C.P. 4003.5(a)(2), and in support thereof, aver as follows: I. In this medical professional liability action Plaintiff charges Dr. Michelini with negligence for failing to more timely diagnose and treat Plaintiff's breast cancer and related paraneoplastic neuropathy. 2. Plaintiff was diagnosed with a detected adenocarcinoma in the left arm pit that was assumed to have originated from her breast. 3. The primary tumor for Plaintiff's presumed breast cancer has never been radiographically identified nor surgically removed. 4. Simply stated, there are two tumors at issue in this case. A metastatic or secondary tumor in Ms. Kraus's left arm pit that was surgically removed. In addition, Ms. Kraus has a primary tumor that remains unknown to this day. 5. The Plaintiff has produced two (2) expert reports authored by a neurologist, Robert B. Darnell, M.D., Ph.D. 6. The expert reports of Dr. Darnell are attached hereto as Exhibit "A". 7. Dr. Damell's supplemental report dated June 3, 2011 was received by Dr. Michelini's counsel on June 22, 2011. 8. In his supplemental report, Dr. Darnell comments on Plaintiff's paraneoplastic neuropathy as follows: An adenocarcinoma of unknown primary is common in these syndromes. The lack of disease progression 4 years later is also typical of these syndromes as the neuropathy is triggered by an effective immune response to the primary tumor. Supplemental Report, Page 2. 9. On the next page of the supplemental report, Dr. Darnell opines that: "[t]he cause of her paraneoplastic neuropathy was due to a detected adenocarcinoma..." Supplemental Report, Page 3. 10. The report of Dr. Darnell is at least confusing or ambiguous and possibly conflicting. 11. It is the position of Dr. Michelini that Dr. Damell's ambiguous, confusing and/or conflicting statements are insufficient to place Dr. Michelini on notice of the basis for Dr. Damell's conclusions. 2 c' 12. Significantly, in his original report, Dr. Darnell cites as a basis for his opinion medical literature which implies that surgical removal of a primary tumor has been proven to cure or reverse severe paraneoplastic syndromes. How can that medical literature be relevant if Ms. Kraus's primary tumor has never been surgically removed? The only tumor that was surgically removed from Ms. Kraus was a secondary tumor. Was surgical removal of the secondary tumor the event that could have prevented Ms. Kraus's paraneoplastic syndrome or was that surgery irrelevant given Dr. Darnell's statement that the neuropathy is caused by an immune response to the "primary tumor"? 13. In addition, Dr. Darnell has cited medical literature that advocates for vigilant searches for a primary tumor in paraneoplastic cases because the unknown primary tumor can manifest itself months or several years after onset of neurologic symptoms. How can this article be a basis for Dr. Darnell's opinion? Is Dr. Darnell of the opinion that Ms. Kraus's unknown primary tumor has been treated? If yes, how? If yes, when? Conversely, is Dr. Darnell of the opinion that Ms. Kraus's unknown primary tumor is due to manifest itself in the future? 14. It is respectfully submitted that answers to these questions cannot be found within the body of either of Dr. Darnell's reports. 15. Dr. Michelin respectfully requests that this Honorable Court afford Dr. Michelini the opportunity to obtain further discovery by "other" means as provided for under the Pennsylvania Rules of Civil Procedure. 16. Specifically Pa.R.C.P. 4003.5(a)(2) provides that the Court, upon cause shown, may order further discovery of an opposing party's anticipated expert testimony. Pa.R.C.P. 4003.5(a)(2). 3 17. Dr. Michelin respectfully requests the opportunity to take a discovery deposition of Dr. Darnell to clarify and explore the foundation for Dr. Darnell's ambiguous opinions set forth in his supplemental expert reports. 18. In the absence of more specific information from Dr. Darnell, Dr. Michelini is unfairly prejudiced in his ability to prepare an adequate defense to Dr. Darnell's opinions. 19. It has been stated that the Pennsylvania Rules of Civil Procedure do not prevent an expert from testifying as to facts or opinions on matters upon which he has not been interrogated in the discovery proceedings. Takes v. Metropolitan Edison Company, 655 A.2d 138 Pa.Super 1995, (reversed in part on other grounds 695 A.2d 397 Pa. 1997). 20. Dr. Michelini wishes to fulfill his obligation to interrogate Dr. Darnell to clarify which opinion Dr. Darnell will testify to at trial because the opinions as set forth in Dr. Darnell's pre-trial supplemental expert report are ambiguous, confusing and/or conflicting. 21. Plaintiff's counsel does not concur in the instant motion. 22. President Judge Kevin A. Hess and Judge Edward A. Guido have issued prior rulings in this case. WHEREFORE, the Defendants respectfully request that this Honorable Court grant the discovery deposition of Dr. Darnell pursuant to Pa.R.C.P. 4003.5(a)(2). 4 Date: July 14, 2011 By: Thomas M. Chairs, Esqu Supreme Court I.D. #78565 425 N. 21" Street, Suite 302 Camp Hill, PA 17011-3700 (717) 731-4800 Attorney for Defendants, Robert G. Michelini, D. 0. and Spirit Physician Services, Inc. Respectfully submitted, DICKIE, MCCAMEY & CHILCOTE, P.C. T? a ?, . 4??. • ' , ,,.V?. , ?'t ?? s ?; ?x??bl? Robert Darnell, M.D., Ph.D. 1230 York Avenue Nov }'ink. NY Io065o Phone: 212-327-7460 EA-Tail: darnolri?hockelfllor.edn web: 1???«.hh,ni.or}'researcly'im-cstigatoc?!darnoll_hio.hmil Date: January 10, 2011 Richard Sadlock Angino & Rovner 4503 N. Front Street Harrisburg, PA 17110-1799 Dear Mr. Sadlock: V1 Herein please find my assessment of the medical records of Jodi Kraus that you have requested. In preparing this opinion, I have reviewed all of the medical records that you sent me, including those from the Johns Hopkins Medical Center, the Kunkle Surgical Group, Dr. Fisher, Robert G. Michelini, Hershey Medical Center, Andrews and Patel Associates, P.C., Women's First Obstetrics & Gynecology, Sanford, Roumm, Achary Rheumatology, White Rose Obstetrics Associates, Therapies Unlimited, and Associated Cardiologists. Medical history The medical history is well documented. Briefly, the patient was evaluated by Dr. Robert Michelini on January 12, 2007 for a chief complaint of a lump under her left arm which was monitored. This was followed up by a second evaluation April 2007, at which time the left axillary nodule was again noted and monitored. In July 2007 the patient was again seen, for a 2 week history of numbness in her feet that was rapidly progressing. She had been very active, able to run 8 miles per day at a pace of 7'30"/mile, but over the course of those weeks could no longer run one-half mile without pain/numbness in her feet and a sense of weakness in her legs that left her feeling that she might collapse. Neurologic and rheumatologic examinations documented objective findings, including progressive loss of sensation in the legs, the progressive loss of deep tendon reflexes, a sensory motor neuropathy by EMG, normal MRI imaging of the brain, a low positive ANA (1:160), and an inflammatory CSF (9/25/2007: CSF Glu 56, Prot 91, WBC 12, RBC 1; Diff 94% lymph, 6% mono, cytology negative). Over the course of a year, her signs and symptoms progressed and ultimately plateaued, such that she suffered continuous numbness in her feet, pain that required opiate management, weakness in the lower extremities with occasional falling. Documentation of the neurologic exams about one year into her neurologic illness include evaluation at Johns Hopkins ,June 3, 2008, revealing severe decrease in muscle mass bilaterally in the distal lower extremities, 2/5 strength in the ankles, 3/5 strength in the hip flexors, and 4+/5 strength in the knees, with intact upper extremity strength, and absent sensation below the knees, with decreased sensation up to the hip,. Laboratory findings for autoimmune markers revealed negative AChR blocking/binding antibodies, and borderline results for the Hu and Ri antibodies (for Hu, multiple bands were seen, of unknown titer, and for both antibodies, there were low IFA titers of 1:40). Records from physical therapy (Therapies Unlimited) in August 2008 noted that the patient suffered bilateral lower extremity pain of 4/10 at rest; this pain increased to 9/10 with activity (standing for 3 or more minutes and walking), and was of a burning, radiating nature. Upon medical referral to Andrews & Patel Associates (oncologists), a CT was done confirming a left. axillary node, with an otherwise negative EOD workup; the node was found at pathology to be consistent with metastatic poorly differentiated adenocarcinoma. The oncologist, Dr. Robert Gordon, concluded at his intake exam in 10/31/2007 that "die patient clearly has a paraneoplastic syndrome." She was treated with prednisone and received chemotherapy, a regimen that included taxotere, adriamycin and Cytoxan. She subsequently was begun on IVIG atJohns Hopkins, which she remained on, intermittently, through 2010. Diagnosis It is my assessment that the patient does indeed likely have a diagnosis of a paraneoplastic neurologic disorder. Clinically, the patient had an ascending sensorimotor neuropathy of rapid onset and progression, with severe neurologic disability. This was associated with a highly abnormal inflammatory cerebrospinal fluid, with a pleiocytosis and elevated protein. Most paraneoplastic peripheral neuropathies are sensorimotor and axonal, typically symmetrical in distribution (save for vasculitic neuropathies) and usually disabling. The PND antibody testing was unrevealing, which may be seen in adenocarcinoma of unknown primary, and likely represents instances of uncharacterized autoantibodies. The Hu/Yo/Ri panel requested only tests for three known paraneoplastic antigens, for which she did not have significant reactivity (although the quality of the IFA test is sub-optimal); this however does not imply the absence of a paraneoplastic antibody directed against other antigens, for instance those present in sensory/motor nerves. Finally, the patient had an apparent clinical response. to immune suppression with IVIG and prednisone, and with treatment of the tumor. My conclusion would be that the patient had a non-classical paraneoplastic neurologic syndrome, associated with a poorly differentiated adenocarcinoma, resulting in a sudden onset paraneoplastic sensory and motor neuropathy. Notably, non paraneoplastic causes for the patient's condition were appropriately evaluated and were negative (including multiple CSF cytologies). In the absence of extraordinary testing (for example in a research laboratory), the patient received a reasonable diagnosis, a standard medical workup for the cause of her neurologic symptoms, with results leading to an appropriate consensus among her physicians of a diagnosis of a paraneoplastic neurologic syndrome. 2 Assessment It is my assessment that a more timely diagnosis of the patient's axillary mass would have offered a reasonable chance of avoiding her neurologic symptoms altogether, or at least of ameliorating her symptoms. The failure to make a timely diagnosis increased the risk of disease onset and worsening of symptoms. The reasons for this conclusion are as follows. Paraneoplastic neurologic disorders are initiated by inflammatory immune responses against the tumor (Darnell and Posner, 2003b; Darnell and Posner, 2006). It is believed that these immune responses to tumor invariably precede the neurologic disorder, and are likely to occur in cancer patients up to 100 times for each of the rare instances that they progress into the development of clinical neurologic symptom (Darnell and Posner, 2003a). This progression into neurologic disease is believed to require a second event that occurs infrequently, which is the anti-tumor inflammatory response spreading into the nerves (cerebrospinal fluid), breaking what is known as the "immune privileged status" of the nervous system and the "blood-brain-barrier" (i.e. the nerves are normally sequestered from immunologic recognition). Such a second step-wise breach of the immune privileged status of the nerves simply does not occur in many patients who do harbor cancer, and when it rarely does occur, it happens after they have had their tumor for some period of time. When it does occur, it rapidly leads to neurologic symptoms and brings patients to clinical attention. Hence it is reasonable to presume that the patient had not had her "immune-privileged status" disrupted until -July 2007. Logically, disrupting her inflammatory immune response prior to this time, by diagnosis and treatment of the inciting antigen (her poorly differentiated adenocarcinoma) would have been of benefit to the patient. Because the tumor is the initiating factor in causing autoimmune paraneoplastic neurologic symptoms, the mainstay of treatment is to aggressively treat the tumor. PND patients do not typically come to clinical attention until they develop their neurologic symptoms, so we often do not have an opportunity to treat the tumor before the neurologic symptoms develop. However, in at least some instances, it is clear that even after the fact, neurologic symptoms can be arrested or, less commonly, frankly reversed by treating the tumor aggressively. A recent series of studies emphasizes this point (Darnell and Posner, 2009). In the treatment of young women with paraneoplastic neurologic symptoms due to antibodies targeting the NR1 subunit of the NMDA receptor that develop as part of an autoimmune response to gynecologic tumors (teratomas), even severe neurologic symptoms were reversed by identification of the tumor and its surgical removal. Based on these sorts of observations, it is generally believed that treatment/removal of tumors prior to the development of paraneoplastic neurologic disorders would help prevent the disorders (Darnell and Posner, 2003b; Darnell and Posner, 2006). In the current situation, therefore, it is medically sound to presume that diagnosis and treatment of the tumor prior to the development of neurologic symptoms (the window between presentation with an 3 C axillary mass on Jan 2, 2007 and the presentation with symptoms in July 2007) would have offered the patient her best chance to either entirely avoid the development of the neurologic disorder, or to minimize its impact. Supporting this presumption specifically in the current case is the observation that following identification and treatment of the tumor, the patient's neurologic symptoms stabilized and in fact improved (at least this is clear from the time of onset of treatment in October 2007 and May 2009). Prognosis The prognosis in PND's in general, and this case in particular, cannot be definitively determined; there is not a sufficient amount known about the disorder, including sufficient understanding of the pathophysiology and response to potential treatments to make confident predictions. Nonetheless, based upon my experience, and her clinical course since her diagnosis, taking all of her treatments into account, I would predict that the patient will be left with a significant degree of residual peripheral neuropathy in the long term. This may impact her daily activities with respect to activity and the pain the neuropathy is causing her. Factors that might weigh in favor of continued improvement include the improvement that she did experience in the setting of her multimodal treatments (including immune suppression, chemotherapy, and physical therapy). The patient is at risk of autoimmune exacerbation going forward, either spontaneously, or in the setting of recurrent cancer, were that to happen. I hope these comments are helpful to you and to the patient. Please let me know if I can be of any further assistance. Sincerely yours, Robert B. Darnell, M.D., PIi.D. I Ieilbrunn Professor of Cancer Biology Investigator, f Toward Hughes Medical Institute Head, Laboratoiy of Molecular Neuro-Oncology, Rockefeller University Senior Physician and Associate Director, Rockefeller University Hospital Literature Cited Darnell, R. B., and Posner, J. B. (2003a). Observing the invisible: successful tumor immunity in humans. Nat Immunol 4,201. Darnell, R. B., and Posner, J. B. (2003b). Paraneoplastic syndromes involving the nervous system. N Engl J Med 349, 1543-1554. Darnell, R. B., and Posner, J. B. (2006). Paraneoplastic syndromes affecting the nervous system. Semin Oncol 33, 270-298. Daniell, R. B., and Posner, J. B. (2009). Autoimmune encephalopathy: the spectrum widens. Ann Neurol 66, 1- 2. 4 .Robert Darnell, M.D., Ph.D. is 1230 York Avenues New York, NY 100650 Phone: 212-327-7464 E,Mail: darneirgrockefellenedu Web; rvtvw.hhmi.or ?resear4ly"invesd ntar?rd?liell_bio.hn?il Date: June 3, 2011 Richard Sadlock Angino & Rovner 4503 N. Front Street Harrisburg, PA 17110-1799 Dear Mr. Sadlock: Herein please find my assessment of the medical commentaries provided by outside physicians who evaluated the case of your client Jodi Kraus. These include letters from Charles B. Austin, Jr., M.D., Ernest F. Gillan, M.D., and Richard H. Creech, M.D. Charles B. Austin, Jr., M.D. Dr. Austin is a Radiologist who provided a brief comment stating that a mammogram would result in images that include the axilla. Regardless of this comment, the treating physicians recognized that the patient had an axillary mass. A mammogram (presumably a diagnostic mammogram) should in my opinion have been ordered. Regardless of the findings of the mammogram, the only way to have made a definitive diagnosis would have been a biopsy. Ernest F. Gillan, M.D. Dr. Gillan makes several points in his review. First, he acknowledges that the patient presented with a chief complaint of an axillary lump, which was examined by Dr. Michelin. He goes on to note (Page 3) that "axillary lumps are potentially worrisome as a sign of breast cancer." These statements are accurate in my view. The mass was found to be persistent in April 2007, but no action was taken (a diagnostic study such as a diagnostic mammogram or a lymph node biopsy), with the argument made by Dr. Gillan that the patient told the physician that she had had a prior mammogram done in 1/07. Several points are relevant. First, Dr. Michelini did not work up the mass, consider a mammogram, or enquire about one when the patient presented in 1/07, which would have led to the diagnosis. Second, he did not follow-up with the patient (according to the record) in one month, although he apparently thought that was warranted. Third, Dr. Gillan argues that Dr. Michelini was misled by the patient's oral reports of prior mammograms. There are several points to be made here. First, it is apparent that Dr. Michelin never took the time to evaluate those mammograms (by definition, since they apparently didn't exist); pursuing the hypothetical here, if he had, such a mammogram might indeed have shown evidence for a malignancy. In a setting such as this, the standard of care with a purported relevant prior study would be to obtain the study and evaluate it with a radiologist. One would certainly not take the patients word for it that it was normal, although we don't in fact know that the patient even suggested what the result was. Dr. Gillan also tries to make the argument that working up the axillary mass would not have been in time to prevent the onset of her neurologic symptoms, but this is highly conjectural in my opinion- identification and treatment of the malignancy is the mainstay of treatment for paraneoplastic neurologic disorders regardless of when in the course of the disorder the tumor is found. Certainly in this case any chance that the tumor could have been identified and treated prior to the onset of the neuropathy, or even as close as possible to its onset, is a lost opportunity. Moreover, the comments miss the point that a workup was done neither in January when the patient presented, in February when Dr. Michelin wanted to see the patient again, nor in April. Points 6-8 of Dr. Gillan bring up conflicting issues and demonstrate a lack of expertise regarding the paraneoplastic disorders. An adenocarcinoma of unknown primary is common in these syndromes. The lack of disease progression 4 years later is also typical of these syndromes, as the neuropathy is triggered by an effective immune response to the primary tumor. Finally, the point that her tumor was already metastatic is non-sequator, as treatment of patients cancer (with chemotherapy, for example) once diagnosed is the mainstay of treatment for the paraneoplastic syndrome, regardless of the stage of the cancer. Richard H. Creech, M.D. Dr. Creech reviews the case and then states that it is unusual because no primary cancer has been found. This belies ignorance of the paraneoplastic neurologic disorders. As noted above, the neuropathy is triggered by an effective immune response to the primary tumor, and hence it is not uncommon for the tumors, including the primary tumors, to be very difficult to identify. Dr. Creech states that most patients with a paraneoplastic neuropathy have small cell lung cancer. There are however many reports of paraneoplastic neuropathy associated with other cancer types, including adenocarcinoma. If Dr. Creech means to imply that the patient had an additional diagnosed small cell lung cancer, this would be exceedingly unlikely. First, she had a tumor identified that is associated with paraneoplastic neuropathy. Second, she was a non-smoker, and small cell lung cancer is almost invariably found in those with a significant history of smoking. Dr. Creech states that "Since Ms. Kraus has a paraneoplastic neurologic syndrome, which often predates an oncologic diagnosis, an earlier biopsy of the left axillary nodule in January 2007 would not have changed Ms. Kraus' clinical course." I find this to be an illogical and unsubstantiated statement. The fact that paraneoplastic neurologic disorders often (-2/3 of the time) precede the cancer diagnosis is not relevant, since in this case the cancer (left axillary adenocarcinoma, biopsy proven) preceded the 2 r• , neuropathy. As noted above, in general the mainstay of treatment and best hope for a good clinical outcome is to identify and treat the tumor. A golden opportunity was lost here to identify and treat the tumor prior to the onset of the neurologic disorder. This would have offered the possibility of removing the inciting autoicnmune antigen (expressed in tumor tissue) before it could have triggered the neuropathy. Dr. Creech states: "The cause of her paraneoplastic neuropathy is due to an intact undetected primary malignancy." This is misleading. The cause of her paraneoplastic neuropathy was due to a detected adenocarcinoma; the fact that the primary tumor was of unknown origin is not uncommon in paraneoplastic neurologic disease, and irrelevant to the fact that once detected, treatment of the tumor offered the patient her best chance for dealing with the neurologic disease. I hope these comments are helpful to you and to the patient. Please let me know if I can be of any further assistance. Sincerely yours, Robert B. Darnell, M.D., Ph.D. Heilbrunn Professor of Guu:er Biology Investigator, Howard Hughes Medical Institute Head, Laboratoiy of Molecular Neuro-Oncology, Rockefeller University Senior Physician surd Associate Director, Rockefeller University Hospital 3 CERTIFICATE OF SERVICE AND NOW, July 14, 2011, I, Thomas M. Chairs, Esquire, hereby certify that I did serve a true and correct copy of the foregoing DEFENDANTS' MOTION FOR LEAVE OF COURT 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) -?? X. gn/ Thomas M. Chairs, Esquire IL FFj =E P" T110NOTAR ,r C f I J1jL 19 P 11: (? CUMBERLAND COUNTY P04NS YLVANIA ANGINO & ROVNER, P.C. Richard A. Sadlock Attorney ID# : 47281 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 JODI KRAUS, Plaintiff V. ROBERT G. MICHELINI, D.O.; SPIRIT PHYSICIAN SERVICES, INC., Defendants IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PA NO. 09-4477 CIVIL ACTION - LAW MEDICAL MALPRACTICE JURY TRIAL DEMANDED PLAINTIFF'S RESPONSE TO DEFENDANTS' MOTION FOR LEAVE OF COURT TO OBTAIN ADDITIONAL DISCOVERY OF AN OPPOSING PARTY'S ANTICIPATED EXPERT TESTIMONY AND NOW, comes Plaintiff, Jodi Kraus, by and through her attorneys, Angino & Rovner, P.C., and replies to Defendants' Motion for Leave of Court to Obtain Additional Discovery of an Opposing Party's Anticipated Expert Testimony, as follows: 1. See Plaintiff's Complaint. 2. Admitted. 3. Admitted. 4. See Plaintiff's Complaint. 5. Admitted. 6. Admitted. 7. Admitted on information and belief. 8. See Dr. Darnell's supplemental report. 9. See Dr. Darnell's supplemental report. 10. Defendants' averment is a conclusion of law to which no responsive pleading is required. To the extent the averment may be deemed factual, it is hereby specifically denied. By way of amplification, Dr. Damell's reports are neither confusing nor ambiguous. 11. Defendants' averment is a conclusion of law to which no responsive pleading is required. To the extent the averment may be deemed factual, it is hereby specifically denied. By way of amplification, Dr. Darnell's reports are very clear, concise, and clearly place Defendant on notice on the basis for Dr. Damell's conclusions. 12-14. Defendants' averments are conclusions of law to which no responsive pleadings are required. To the extent these averments may be deemed factual, they are hereby specifically denied. By way of amplification, Dr. Darnell's report are clear, concise, and appropriate. The issues raised by Defendant herein are subjects for cross examination, not further discovery. 15. Defendants' averment is a conclusion of law to which no responsive pleading is required. To the extent the averment may be deemed factual, it is hereby specifically denied. By way of amplification, no further discovery is warranted. 16. Pa.R.Civ. P. 4003.5(a)(2) speaks for itself. However, no further discovery is warranted in the instant action. 17. See prior responses herein. 475877 2 18. Defendants' averment is a conclusion of law to which no responsive pleading is required. To the extent the averment may be deemed factual, it is hereby specifically denied. By way of amplification, Defendant is in no way prejudiced and is able to prepare a proper and adequate defense. 19. Defendants' averment is a conclusion of law to which no responsive pleading is required. To the extent the averment may be deemed factual, it is hereby specifically denied. No further discovery is warranted in this case. 20. See prior responses herein. 21. Admitted. 22. Admitted. WHEREFORE, Plaintiff respectfully requests your Honorable Court to deny the instant motion. Date: July 18, 2011 I.D. 0.4728/ 4503 nt Street Harrisburg, PA 17110 (717) 238-6791 Counsel for Plaintiff 475877 3 ANGINO & ROVNER, P.C. CERTIFICATE OF SERVICE AND NOW, this 19th day of July 2011, I, Angela D. Horchler, an employee of the law firm of Angino & Rovner, P.C., hereby certify that a true and correct copy of the foregoing 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: Thomas M. Chairs, Esquire Dickie, McCamey & Chilcote Plaza 21, Suite 302 425 N. 21 st Street Camp Hill, PA 17011 An ela D. orc ler 989296 DICKIE, MCCAMEY & CHILCOTE, P.C. 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) JODI KRAUS, Plaintiff V. ROBERT G. MICHELINI, D.O. AND SPIRIT PHYSICIAN SERVICES, INC., Defendants ATTORNEY FOR DEFENDANTS: ROBERT G. MICHELINI, D.O. AND SPIRIT PHYSICIAN SERVICES, INC. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA f ' a NO. 09-4477, -<> CIVIL ACTION -MEDICAL O C:) ? ?:•f .? 7 L?^i : 7 JURY TRIAL DEMANDED C-) DEFENDANTS' MOTION FOR ISSUANCE OF LETTERS ROGATORY AND NOW, come Defendants, by and through their Counsel, Dickie, McCamey & Chilcote, P.C., and respectfully request that this Honorable Court order that Letters Rogatory be issued in order to permit the Defendants to obtain Plaintiffs records from the Mayo Medical Laboratories, and in support thereof, aver as follows: 1. In this medical professional liability action Plaintiff charges Dr. Michelini with negligence for failing to a more timely diagnose and treat Plaintiffs breast cancer and related paraneoplastic neuropathy. 2. During the course of Plaintiffs treatment at Johns Hopkins Hospital, certain laboratory materials were sent to the Mayo Clinic Laboratories for analysis. 3. Dr. Michelini seeks to obtain Plaintiffs records from the Mayo Clinic Laboratories. 4. Dr. Michelini further supplied the Mayo Clinic Medical Laboratories a signed authorization from Plaintiff releasing any and all records related to Plaintiff. See, Exhibit "A" 989296 5. The Mayo Clinic Laboratories refused to process the request for release of Plaintiff's records despite Plaintiff's authorization. See, Exhibit "B." 6. The Mayo Clinic Laboratories indicated that it was not authorized to release records to anyone other than the ordering provider. Id. 7. To date, the ordering provider, Johns Hopkins Hospital, has not responded to our request to obtain Plaintiff's records from the Mayo Clinic Laboratories. 8. The Mayo Clinic Laboratories' records are relevant to Plaintiff's claims in this case and important to the administration of justice. 9. The Mayo Clinic Laboratories resides outside the jurisdiction of this Honorable Court in Rochester, Minnesota. 10. Dr. Michelini seeks to subpoena the Mayo Clinic Laboratories to obtain Plaintiff's records. 11. The Minnesota Prothonotary will issue the required subpoena upon the issuance of this Honorable Court's Letters Rogatory. 12. Dr. Michelini therefore asks this Honorable Court to authorize the issuance of Letters of Rogatory to be filed with the appropriate authority in the State of Minnesota, Olmsted County to obtain Plaintiff's medical records from the Mayo Medical Laboratories. 13. Plaintiff's Counsel concurs in the instant Motion. 14. President Judge Kevin A. Hess and Judge Edward E. Guido have issued prior Rulings in this case. WHEREFORE, the Defendants respectfully requests this Honorable Court to authorize the issuance of Letters Rogatory to be filed with the appropriate authority in the State of 989296 Minnesota, County of Olmsted, to obtain Plaintiff's medical records from the Mayo Medical Laboratories. Respectfully submitted, DICKIE, MCCAMEY & CHILCOTE, P.C. z Date: July 20, 2011 By; Thofhas M. Chairs, Esquire ATTORNEY I.D. #78565 Aaron S. Jayman, Esquire ATTORNEY I.D. #85651 425 N. 21St Street, Suite 302 Camp Hill, PA 17011-3700 (717) 731-4800 Attorney for Defendant, Robert G. Michelini, D. D. EMA&Camey Thomas M. Chairs Direct Dial: 717-731-4800 Attorney-at-Law Direct Fax: 888-811-7144 Admitted in PA, MD tchairs@dmclaw.com June 15, 2011 CERTIFIED iVIAIL - RETURN RECEIPT REOUESTED Mayo Medical Laboratories 200 First Street Southwest Rochester, MN 55905 RE: Jodi Kraus v. Robert G. Michelini, U.O. Our File No.: PC-192 (0029096.0317462) Dear Sir or Madam: Enclosed you will find a Subpoena issued under the authority of the Court of Common Pleas of Cumberland County ordering you to appear for deposition and to produce records in connection with the above-captioned matter. The records should be produced at a deposition to be held in our offices. We must insist that all records of the medical care rendered to Jodi Kraus be produced and not just selected portions. lit liett of your personal appearance, if it would be more convenient to you, you may simply duplicate the records and complete the enclosed Affidavit and submit them to its by mail, but we must insist that till records as detailed in the Subpoena be produced and not just selected portions. Also enclosed please find a copy of our June 6, 2011 letter and executed Authorization to release records signed by Jodi Kraus. . If you have any questions, please do not hesitate to contact our office at your convenience. ¦ Complex items 1, 2, and 3. Also complete item 4 If Restricted Delivery is desired. ¦ Print your name and address on the reverse so that we can return the card to you. ¦ Attactr this card to the track of the mailpiece, or on the front if space permits. 1. Article Addressed to: maxXo tYLQ?t 1 ca t Ca l V ate -?irS?' Sk • .SW ?J 559 as ? Age a s71?? q Ack B. Received by (Printed Name) C. Date of C ,.p D. Is delivery address dMereM from Rem 19 ? Yes r9 If YES, enter delivery address below ? No r- r` E3 C3 C3 3. Service Type O Apermed MaA 13 Express Mali C3 E3 Registered ARetum Receipt-?? m I Postage $ Certified Fee Return Receipt Fee Postmark Here (Endorsement Required) Restricted Delivery Fee (Endorsement Required) Total Postage & Fees $ r-? ? Insured Mam ? C.O.D. Sent To 4. Restricted Delivery? (Extre Fee `? ? Yee c3 SU'Bef ---------- , ;opt: P)a:j 2. Article Ntmfbw ? 0 or Po pox No. (transfer from service tad 7008 1300 0000 7571 4654 ----------•-------------------- Car State, ZiP+4 Dc C--'IQ11 C-w------nAAA COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND Jodi Kraus Plaintiff VS. File No. 09-4477 Robert G. Michelini, D.O., et al. Defendant SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009.22 TO: Mayo Medical Laboratories (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: Complete chart of Jodi Kraus including, but not limited to, all lab test requests with reported results and correspondence dicated or otherwise. at 425 N. 21st, St -quite 302, amp H111. PA 17011 (Address) You may deliver or mail legible copies of the documents or produce things requested by this subpoena, together with the certificate of compliance, to the party making this request at the address listed above. You have the right to seek in advance the reasonable cost of preparing the copies or producing the things sought. If you fail to produce the documents or things required by this subpoena within twenty (20) days after its service, the party serving this subpoena may seek a court order compelling you to comply with it. THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON: NAME: Thomas M. Chairs ADDRESS: 425 N. 21st St. Suite 302 Camp Hill, PA 17011 TELEPHONE: 717-731-4800 SUPREME COURT ID # 78565 ATTORNEY FOR: Defendants Date:_ ?i???o7LJ// Seal of the Court BY THE U T: Profli6fiotary, C vil Division Deputy DEPOSITION AFFIDAVIT OF RECORD CUSTODIAN I, the undersigned, being duly sworn according to law, depose and say that I am a duly authorized custodian of records of Mayo Medical Laboratories with the authority to certify said records, and I hereby certify to the following: The records attached hereto are true and correct copies of the records in my custody, from Mayo Medical Laboratories pertaining to the medical care rendered to Jodi Kraus. I That, including this certification, all records called for in the attached subpoena duces teeum which are in my custody, have been photocopied at my office, in my presence, at my direction and under my supervision by That unless qualified in paragraph (5), all records produced in my presence were prepared in the ordinary course of business by authorized personnel at or near the time of the act, condition or event; and 4 A careful search has been made by me or at my direction for records pertaining to the above identified individual and the records produced pursuant to the attached subpoena duces tecum constitute and are the records of the individual so identified. Additional comments: I declare that the foregoing facts are within my personal knowledge, are true and correct and other facts contained herein are true and correct to the best of my knowledge, information and belief. Date: Signature of Custodian of Records DICKIE, MCCAMEY & CHILCOTE, P.C. ATTORNEY FOR DEFENDANTS: BY: Thomas M. Chairs, Esquire ROBERT G. NIICHELINI, D.O. AND SPIRIT ATTORNEY I.D. NO. 78565 PHYSICIAN SERVICES, INC. Plaza 21, Suite 302 425 North 21st Street Camp Hill, PA 17011 717-731-4800 (Tele) 888-811-7144 (Faxl JODI KRAUS, V. Plaintiff ROBERT G. MICHELINI, D.O. AND SPIRIT PHYSICIAN SERVICES, INC., Defendants IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 09-4477 CIVIL ACTION - MEDICAL JURY TRIAL DEMANDED NOTICE OF DEPOSITION TO: Mayo Medical laboratories 200 First Street Southwest Rochester, MN 55905 PLEASE TAKE NOTICE that pursuant to Pa.R.C.P. 4007. 1, Defendants will take the deposition of the Records Custodian at Mayo Medical Laboratories, upon oral examination, for the purposes of discovery and/or for use at trial, before a person authorized to render an oath, at the offices of DICKIE, McCAMEY & CHILCOTE, P.C., Plaza 21, Suite 302, 425 North 21 st Street, Camp Hill, Pennsylvania, 17011. Deponent is directed to bring to this deposition the following documents: Any and all documents in your care, custody or control relating in any way to medical care provided to Jodi Kraus. This request includes but is not limited to the following documents and/or materials: Complete chart of Jodi Kraus including, but not limited to, all lab test requests with reported results and correspondence dictated or otherwise. DEPONENT IS ADVISED THAT IT IS SUFFICIENT TO PROVIDE THE MATERIAL REQUESTED BY MAIL OR HAND DELIVERY IN LIEU OF APPEARING IN PERSON FOR THIS DEPOSITION, PROVIDED THAT THE DEPONENT CERTIFIES THAT THE RECORDS WHICH HAVE BEEN SENT ARE TRUE, ACCURATE AND COMPLETE COPIES OF THE REQUESTED MATERIAL BY EXECUTING THE ATTACHED AFFIDAVIT BEFORE A NOTARY PUBLIC AND FORWARDING SAME WITH THE DOCUMENTS. Respectfully submitted, DICKIE, MCCAMEY & CHILCOTE, P.C. Date: By: 1 G 4 homas M. Chairs, Esquire Supreme Court I.D. #78565 425 N. 21" Street, Suite 302 Camp Hill, PA 17011-3700 (717) 731-4800 Attorney for Defendant, Robert G. Michelini, D. 0. and Spirit Physician Services, Inc. CERTIFICATE OF SERVICE AND NOW, June l? 2011, I, Thomas M. Chairs, Esquire, hereby certify that I did serve a true and correct co y of the foregoing NOTICE OF INTENT TO SERVE A SUBPOENA TO PRODUCE DOCUMENTS AND THINGS FOR DISCOVERY PURSUANT TO RULE 4009.21 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) Thomas M. ha rs, Esquire 41 953901 Misty Lehman Paralegal June 6, 2011 Mayo Medical Laboratories Attn: Records Custodian 200 First Street Southwest Rochester, MN 55905 RE: Jodi Kraus v. Robert G. Michelini, D.O. Docket No., 09-4477 Our File No.: PC-192 (0029096.0317462) Dear Records Custodian: Direct Dial: 717-731-4600 Fax 888-811-7144 inlehm,in@dmclaw.corn We are requesting the records of Jodi Kraus. Enclosed please find an Authorization releasing any and all records from all locations from 1/ 1/ 1990 to the present. If possible, we need to ask that this request be expedited. If you need any additional information, or have any questions regarding this request. please do not hesitate to contact me. Very truly yours. DICKIE, NICCAMEY & CHILCOTE, P.C. Misty Lehman MDL Enclosure McC;ame Y OICKIE, MQAME7 8 CTII[COTI, P.(. 1 ATTORNEYS AT LAW MAIN: 717.731-4800 FAX: 888-811-1144 PiMhagh I Ha(AU(g I Phllndelphio I W461nglon 11( I Mnwrrt PLAZA 21, SUIT[ 302 415 NORM 21" STRCEi 1 CAMP HR, PA 1/011 2223 WWWAMCIAW.COM New lenev I Nob (vol o I ohm I Weu vorym o f AUTHORIZATION FOR THE RELEASE OF INFORMATION INCLUDING PERSONAL HEALTH INFORMATION PROTECTED BY LAW Patient Information. Natne: Jodi Kraus Date of Birth: 5/23/1961 Social Security Number: 207-48-5943 _ 1. 1 authorize the following persons or organizations Releasor(s) to release/disclose information about the patient identified above m accordance with the provisions of this authorization: Mayo Medical Laboratories 200 First Street Southwest, Rochester. N1N 55905 2. Name and address of person(s) or organization(s) to whom/which health information should be released/disclosed (ARecipient(s)@): The law firm of Dickie McCamev & Chilcote, P.C. its employees agents and expert consultants• 1200 Camp Hill Bypass, S I 205, Camp Hill, PA 17011 3. Purpose of disclosure (intended use of information): Review, evaluation and/or use in connection with a legal claim or lawsuit or potential legal claim. 4. Description of information: a. All health information and other information and things about the patient within the knowledge of or in the control or possession of the Releasor(s), no matter who originally prepared or received the information, including but not limited to: X All information related to diagnoses, prognoses, conditions, tests, procedures, surgeries, treatments and care, including but not limited to the following inpatient and outpatient medical/health records: orders, notes and reports of anv health care provider; history and physicals; admission records; discharge records; medication records; clinical flow charts; tests and test results; laboratory, history, cytology, pathology, radiology, autopsy and other reports. X Films, videos, CDs, disks, tapes and other media on which information about me is kept, including for example, x-rays, CT scans and echocardiograms X Specimens, hardware, blood or body fluids from my body, including specimens contained in blocks and slides. X Pharmacy, drug and prescription records, including NDC numbers and drug information handouts. X Billing records, including all statements, itemized bills and insurance records. X Office, clinic and other medical/health information, records and notes prepared by or for, received from others by or maintained by the Releasor(s) or their staffs, whether typed, handwritten or in other forms. X Memoranda, letters, a-mails and other forms of communication about me, whether created, sent or received by the Releasor(s). b. The following information may also be released unless my initials appear after the word NO: X HIV-related Information (HIV is the virus that causes AIDS) NO _ X Mental Health (Psychiatric) Records NO X information concerning drug and/or alcohol dependence, abuse and/or treatment NO c. Other specific information: _ any and all records d. For the time period I / I / 1990 to present 5. 1 understand that: a) if the Releasor is a health care provider, the Releasor may not condition treatment, payment, enrollment or eligibility for benefits on my execution of this authorization unless allowed by federal law and I was informed o the condition prior to the treatment, enrollment or benefits; b) there is a potential for information disclosed pursuant to this authorization to be subject to re-disclosure by the Recipient(s) and no longer to be protected under federal law (45 C.F.R. § 164.508); c) unless earlier revoked, this authorization will expire at the time the legal claim or lawsuit for which the information is being sought is terminated or resolved; and d) this authorization is subject to my written revocation at any time, but my revocation will not affect information that has already been released or disclosed. (If the Releasor is a licalth Care Provider, a description of how to re%oke is pro%id•d by the Releasor if ough the Releasor's Notice of Priva I' 4,, or (hro other means.) Date: - - - -- [Sigfiat e I - -- - ----??----- If patient cannot sign: of authorized representative) (Relationship to patient or authority to act on behalf of patient EXHIBIT "B" 989862 CERTIFICATE OF SERVICE AND NOW, July 20., 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) Date: July 20, 2011 Th¢mO M. C?hairs,tsquire 989331 DICKIE, MCCAMEY & CHILCOTE, P.C. ATTORNEY FOR DEFENDANTS: BY: Thomas M. Chairs, Esquire ROBERT G. MICHELINI, D.O. AND SPIRIT ATTORNEY I.D. NO. 78565 PHYSICIAN SERVICES, INC. Plaza 21, Suite 302 425 North 21st Street Camp Hill, PA 17011 717-731-4800 (Tele) 888-811-7144 ax JODI KRAUS, IN THE COURT OF COMMON PLEAS Plaintiff OF CUMBERLAND COUNTY, PENNSYLVANIA V. NO. 09-4477 ROBERT G. MICHELINI, D.O. AND SPIRIT PHYSICIAN SERVICES, INC., Defendants CIVIL ACTION - MEDICAL JURY TRIAL DEMANDED DEFENDANTS' MEMORANDUM IN SUPPORT OF MOTION FOR ISSUANCE OF LETTERS ROGATORY In this medical professional liability action Plaintiff charges Dr. Michelini with negligence for failing to a more timely diagnose and treat Plaintiff's breast cancer and related paraneoplastic neuropathy. During the course of Plaintiffs treatment at Johns Hopkins Hospital, certain laboratory materials were sent to the Mayo Clinic Laboratories for analysis. Dr. Michelini seeks to obtain Plaintiffs records from the Mayo Clinic Laboratories. Dr. Michelini further supplied the Mayo Clinic Medical Laboratories a signed authorization from Plaintiff releasing any and all records related to Plaintiff. The Mayo Clinic Laboratories refused to process the request for release of Plaintiffs records despite Plaintiffs authorization. The Mayo Clinic Laboratories indicated that it was not authorized to release records to anyone other than the ordering provider. To date, the ordering provider, Johns Hopkins Hospital, has not responded to our request to obtain Plaintiffs records from the Mayo Clinic Laboratories. The 989331 Mayo Clinic Laboratories' records are relevant to Plaintiff's claims in this case and important to the administration of justice. The Mayo Clinic Laboratories resides outside the jurisdiction of this Honorable Court in Rochester, Minnesota. Dr. Michelin seeks to subpoena the Mayo Clinic Laboratories to obtain Plaintiff's records. The Minnesota Prothonotary will issue the required subpoena upon the issuance of this Honorable Court's Letters Rogatory. Dr. Michelini therefore asks this Honorable Court to authorize the issuance of Letters of Rogatory to be filed with the appropriate authority in the State of Minnesota, Olmsted County to obtain Plaintiff's medical records from the Mayo Medical Laboratories. Respectfully submitted, DICKIE, MCCAMEY & CHILCOTE, P.C. Date: July 20, 2011 By: Tho `s Chairs, Esquire ATTORNEY I.D. #78565 Aaron S. Jayman, Esquire ATTORNEY I.D. #85651 425 N. 21St Street, Suite 302 Camp Hill, PA 17011-3700 (717) 731-4800 Attorney for Defendant, Robert G. Michelini, D. 0. and Spirit Physician Services, Inc. 989862 CERTIFICATE OF SERVICE AND NOW, July 20, 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) Date: July 20, 2011 `' rZ ThomasI. Chairs, squire ANGINO & ROVNER, P.C. Richard A.Sadlock Attorney ID# : 47281 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 _ _J..O? _ 1?,?0TF,01? 0TAFi'( ..i!?'__ 20 Aid 11: 3 - i RLAND COUNTY NNSYLVANIA JODI KRAUS, Plaintiff V. ROBERT G. MICHELINI, D.O.; SPIRIT PHYSICIAN SERVICES, INC., Defendants IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PA NO. 09-4477 CIVIL ACTION - LAW MEDICAL MALPRACTICE JURY TRIAL DEMANDED PLAINTIFF'S REPLY TO DEFENDANT'S MOTION IN LIMINE TO PRECLUDE EVIDENCE OF FUTURE MEDICAL EXPENSES 1. It is admitted that Defendants failed to properly diagnosis and treat Plaintiff's cancer and related neurologic condition. 2. Defendants' averment is a conclusion of law to which no responsive pleading is required. To the extent the averment may be deemed factual, it is hereby specifically denied. By way of amplification, Plaintiff's experts clearly indicate that Plaintiff will need future treatment. Further, Plaintiff, herself, will testify regarding her current treatment regimen. Additionally, a Medical Bill Summary will be utilized as an Exhibit from which the jury can evaluate the cost of future medical care. 3. Defendants' averment is a conclusion of law to which no responsive pleading is required. To the extent the averment may be deemed factual, it is hereby specifically denied. By way of amplification, Plaintiff's experts clearly indicate that Plaintiff will need future treatment. Further, Plaintiff, herself, will testify regarding her current treatment regimen. Additionally, a 476076 Medical Bill Summary will be utilized as an Exhibit from which the jury can evaluate the cost of future medical care. 4. Defendants' averment is a conclusion of law to which no responsive pleading is required. To the extent the averment may be deemed factual, it is hereby specifically denied. By way of amplification, Plaintiff's experts clearly indicate that Plaintiff will need future treatment. Further, Plaintiff, herself, will testify regarding her current treatment regimen. Additionally, a Medical Bill Summary will be utilized as an Exhibit from which the jury can evaluate the cost of future medical care. 5. Defendants' averment is a conclusion of law to which no responsive pleading is required. To the extent the averment may be deemed factual, it is hereby specifically denied. By way of amplification, Plaintiff's experts clearly indicate that Plaintiff will need future treatment. Further, Plaintiff, herself, will testify regarding her current treatment regimen. Additionally, a Medical Bill Summary will be utilized as an Exhibit from which the jury can evaluate the cost of future medical care. 6. Defendants' averment is a conclusion of law to which no responsive pleading is required. To the extent the averment may be deemed factual, it is hereby specifically denied. By way of amplification, Plaintiff's experts clearly indicate that Plaintiff will need future treatment. Further, Plaintiff, herself, will testify regarding her current treatment regimen. Additionally, a Medical Bill Summary will be utilized as an Exhibit from which the jury can evaluate the cost of future medical care. 7. The reports of Dr. Simmons and Dr. Gordon speak for themselves. 8. Defendants' averment is a conclusion of law to which no responsive pleading is required. To the extent the averment may be deemed factual, it is hereby specifically denied. By 476076 way of amplification, Plaintiff's experts clearly indicate that Plaintiff will need future treatment. Further, Plaintiff, herself, will testify regarding her current treatment regimen. Additionally, a Medical Bill Summary will be utilized as an Exhibit from which the jury can evaluate the cost of future medical care. 9. Defendants' averment is a conclusion of law to which no responsive pleading is required. To the extent the averment may be deemed factual, it is hereby specifically denied. By way of amplification, Plaintiff's experts clearly indicate that Plaintiff will need future treatment. Further, Plaintiff, herself, will testify regarding her current treatment regimen. Additionally, a Medical Bill Summary will be utilized as an Exhibit from which the jury can evaluate the cost of future medical care. 10. Defendants' averment is a conclusion of law to which no responsive pleading is required. To the extent the averment may be deemed factual, it is hereby specifically denied. By way of amplification, Plaintiff's experts clearly indicate that Plaintiff will need future treatment. Further, Plaintiff, herself, will testify regarding her current treatment regimen. Additionally, a Medical Bill Summary will be utilized as an Exhibit from which the jury can evaluate the cost of future medical care. 11. Defendants' averment is a conclusion of law to which no responsive pleading is required. To the extent the averment may be deemed factual, it is hereby specifically denied. By way of amplification, Plaintiff's experts clearly indicate that Plaintiff will need future treatment. Further, Plaintiff, herself, will testify regarding her current treatment regimen. Additionally, a Medical Bill Summary will be utilized as an Exhibit from which the jury can evaluate the cost of future medical care. 476076 12. Defendants' averment is a conclusion of law to which no responsive pleading is required. To the extent the averment may be deemed factual, it is hereby specifically denied. By way of amplification, Plaintiff's experts clearly indicate that Plaintiff will need future treatment. Further, Plaintiff, herself, will testify regarding her current treatment regimen. Additionally, a Medical Bill Summary will be utilized as an Exhibit from which the jury can evaluate the cost of future medical care. WHEREFORE, Plaintiff respectfully requests Your Honorable Court to DENY Defendants' Motion in Limine. A ER, P.C. chard A. Sadlock, Esquire I.D. No. 47281 Date: 4503 N. Front Street Harrisburg, PA 17110 (717) 238-6791 Counsel for Plaintiff 476076 CERTIFICATE OF SERVICE Lk - AND NOW, this day of , 201 0, I, Angela Horchler, an employee of the law firm of Angino & Rovner, P.C., hereby certify that a true and correct copy of the foregoing 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: Thomas M. Chairs, Esquire Dickie, McCamey & Chilcote Plaza 21, Suite 302 425 N. 21st Street Camp Hill, PA 17011 Distribution List: Richard A. Sadlock, Esquire, Angino & Rovner, P.C., 4503 North Front Street, Harrisburg, PA 17110- 1708; Phone: 717-238-6791; Fax: 717-238-5610; email: rsadlock@angino-rovner.com Thomas M. Chairs, Esquire, Dickie, McCamey & Chilcote, Plaza 21, Suite 302, 425 N. 21 st Street, Camp Hill, PA 17011; Phone: 717-731-4800; Fax: 888-811-7144; email: tchairs@dmclaw.com 476076 `F C ANGINO & ROVNER, P.C. Richard A.Sadlock Attorney ID# : 47281 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 -) BERLAND COUNT' PENNSYLVANIA JODI KRAUS, Plaintiff V. ROBERT G. MICHELINI, D.O.; SPIRIT PHYSICIAN SERVICES, INC., Defendants IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PA NO. 09-4477 CIVIL ACTION - LAW MEDICAL MALPRACTICE JURY TRIAL DEMANDED PLAINTIFF'S REPLY TO DEFENDANT'S MOTION IN LIMINE TO PRECLUDE IMPROPER AND CUMULATIVE STANDARD OF CARE OPINIONS 1. It is admitted that Defendant Michelini was negligent for failing to timely diagnosis and treat Plaintiff's cancer and related neurologic condition. 2. It is admitted only that Dr. Michelini's curriculum vitae is attached to Defendants' Motion as Exhibit A. 3. Admitted. 4. Dr. Damell's reports speak for themselves. 5. Dr. Darnell's reports speak for themselves. 6. Dr. Darnell's reports speak for themselves. 7. Defendants' averment is a conclusion of law to which no responsive pleading is required. To the extent the averment may be deemed factual, it is hereby specifically denied. By way of amplification, Dr. Darnell's standard of care report is appropriate and his testimony on that issue is admissible herein. 476078 8. Defendants' averment is a conclusion of law to which no responsive pleading is required. To the extent the averment may be deemed factual, it is hereby specifically denied. By way of amplification, the WARE Act specifically permits Dr. Darnell's standard of care testimony herein. 9. Defendants' averment is a conclusion of law to which no responsive pleading is required. To the extent the averment may be deemed factual, it is hereby specifically denied. By way of amplification, Dr. Darnell's anticipated testimony is expressly permitted by the MCARE Act. 10. Defendants' averment is a conclusion of law to which no responsive pleading is required. Dr. Darnell's curriculum vitae is attached hereto as Exhibit "A." Further, as previously indicated herein, Dr. Darnell's anticipated testimony is admissible pursuant to the WARE Act. 11. Dr. Darnell's supplemental report speaks for itself. 12. Defendants' averment is a conclusion of law to which no responsive pleading is required. To the extent the averment may be deemed factual, it is hereby specifically denied. By way of amplification, Dr. Darnell's opinions are admissible pursuant to §512 of the WARE Act. 13. Defendants' averment is a conclusion of law to which no responsive pleading is required. To the extent the averment may be deemed factual, it is hereby specifically denied. By way of amplification, Dr. Darnell's opinion is admissible herein pursuant to the WARE Act. 14. Defendants' averment is a conclusion of law to which no responsive pleading is required. To the extent the averment may be deemed factual, it is hereby specifically denied. By way of amplification, Dr. Darnell's opinions are proper and admissible herein. Further, Dr. 476078 Darnell's opinions supplement the opinions rendered by Dr. Margo. 15. Plaintiff's experts' reports speak for themselves. 16. Defendants' averment is a conclusion of law to which no responsive pleading is required. To the extent the averment may be deemed factual, it is hereby specifically denied. By way of amplification, Pa.R.C.P. 223 (1), has no relevance to the instant action and in no way limits the testimony of Dr. Darnell. 17. Defendants' averment is a conclusion of law to which no responsive pleading is required. To the extent the averment may be deemed factual, it is hereby specifically denied. By way of amplification, Pa.R.E. 403 and Pa.R.E. 611(a) have no relevance to the instant action and in no way limit the testimony of Dr. Darnell. 18. Defendants' averment is a conclusion of law to which no responsive pleading is required. To the extent the averment may be deemed factual, it is hereby specifically denied. By way of amplification, the testimony of Dr. Darnell and Dr. Margo are both admissible herein and supplement each other. WHEREFORE, Plaintiff respectfully requests Your Honorable Court to DENY Defendants' Motion in Limine. Date: liq r ANGINO & ROVNER, P.C r-- RicTiard A. Sadlock, Esquire I.D. No. 47281 4503 N. Front Street Harrisburg, PA 17110 (717) 238-6791 Counsel for Plaintiff 476078 CERTIFICATE OF SERVICE AND NOW, this day of T414 , 20 It, I, Angela Horchler, an employee of the law firm of Angino & Rovner, P.C., hereby certify that a true and correct copy of the foregoing 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: Thomas M. Chairs, Esquire Dickie, McCamey & Chilcote Plaza 21, Suite 302 425 N. 21st Street Camp Hill, PA 17011 Angela H chler Distribution List: Richard A. Sadlock, Esquire, Angino & Rovner, P.C., 4503 North Front Street, Harrisburg, PA 17110- 1708; Phone: 717-238-6791; Fax: 717-238-5610; email: rsadlock@angino-rovner.com Thomas M. Chairs, Esquire, Dickie, McCamey & Chilcote, Plaza 21, Suite 302, 425 N. 21st Street, Camp Hill, PA 17011; Phone: 717-73 1-4800; Fax: 888-811-7144; email: tchairs@dmclaw.com 476078 I" ANGINO & ROVNER, P.C. Richard A.Sadlock Attorney ID# : 47281 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 36 `Ua BERLAND COUNTY PENNSYLVANIA JODI KRAUS, Plaintiff V. ROBERT G. MICHELINI, D.O.; SPIRIT PHYSICIAN SERVICES, INC., Defendants IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PA NO. 09-4477 CIVIL ACTION - LAW MEDICAL MALPRACTICE JURY TRIAL DEMANDED PLAINTIFF'S REPLY TO DEFENDANT'S MOTION IN LIMINE TO PRECLUDE SPECULATIVE EXPERT OPINION It is admitted that Defendants failed to make a timely diagnosis and treat Plaintiff s cancer and related neurologic condition. 2. Dr. Darnell's report speaks for itself. 3. Defendants' averment is a conclusion of law to which no responsive pleading is required. To the extent the averment may be deemed factual, it is hereby specifically denied. By way of amplification, Dr. Darnell's report and expected testimony about prognosis is sufficient to meet Plaintiff s burden at trial. 4. Defendants' averment is a conclusion of law to which no responsive pleading is required. To the extent the averment may be deemed factual, it is hereby specifically denied. By way of amplification, the anticipated expert testimony on prognosis is legally sufficient. 5. Defendants' averment is a conclusion of law to which no responsive pleading is required. To the extent the averment may be deemed factual, it is hereby specifically denied. By 476069 way of amplification, Defendant appears to be confusing the standard for testimony regarding causation and prognosis. Prognosis testimony is not held to the same standard as causation. Further, our Courts have held that prognosis testimony need only indicate that a future condition may or could possibly be related to the original condition. 6. See Paragraph 5 herein. 7. Defendants' averment is a conclusion of law to which no responsive pleading is required. To the extent the averment may be deemed factual, it is hereby specifically denied. By way of amplification, see Paragraphs 4 and 5 herein. 8. Defendants' averment is a conclusion of law to which no responsive pleading is required. To the extent the averment may be deemed factual, it is hereby specifically denied. By way of amplification, see Paragraphs 4 and 5 herein. 9. Dr. Darnell's report speaks for itself. Dr. Darnell's opinion is legally sufficient and admissible herein. 10. Dr. Darnell's report speaks for itself. Dr. Darnell's opinion is legally sufficient and admissible herein. 11. Dr. Damell's report speaks for itself. Dr. Darnell's opinion is legally sufficient and admissible herein. 12. Defendants' averment is a conclusion of law to which no responsive pleading is required. To the extent the averment may be deemed factual, it is hereby specifically denied. By way of amplification, see Paragraphs 4 and 5 herein. WHEREFORE, Plaintiff respectfully requests Your Honorable Court to DENY Defendants' Motion in Limine. 476069 ANGINO & ROVNER, P.C. Date: Richard A. S , Esquire I.D. No. 47281 4503 N. Front Street Harrisburg, PA 17110 (717) 238-6791 Counsel for Plaintiff 476069 CERTIFICATE OF SERVICE AND NOW, this day of 201J, I, Angela Horchler, an 114 1 employee of the law firm of Angino & Rovner, P.C., hereby certify that a true and correct copy of the foregoing 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: Thomas M. Chairs, Esquire Dickie, McCamey & Chilcote Plaza 21, Suite 302 425 N. 21 st Street Camp Hill, PA 17011 1 Angela Horchler Distribution List: Richard A. Sadlock, Esquire, Angino & Rovner, P.C., 4503 North Front Street, Harrisburg, PA 17110- 1708; Phone: 717-238-6791; Fax: 717-238-5610; email: rsadlock@angino-rovner.com Thomas M. Chairs, Esquire, Dickie, McCamey & Chilcote, Plaza 21, Suite 302, 425 N. 21st Street, Camp Hill, PA 17011; Phone: 717-731-4800; Fax: 888-811-7144; email: tchairs@dmclaw.com 476069 989394 JODI KRAUS, Plaintiff V. ROBERT G. MICHELINI, D.O. AND SPIRIT PHYSICIAN SERVICES, INC., Defendants IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 09-4477 CIVIL ACTION - MEDICAL JURY TRIAL DEMANDED LETTERS ROGATORY TO THE APPROPRIATE AUTHORITY IN THE STATE OF MINNESOTA: THIS CIVIL ACTION, having come before this Court, and IT APPEARING, that this civil action involves an alleged delay in diagnosis of breast cancer and related paraneoplastic neuropathy is pending in the Court of Common Pleas of Cumberland County, Pennsylvania; that Defendants, through Counsel, have represented to this Court that the Mayo Medical Laboratories has medical records related to Plaintiffs medical condition and claims. The Mayo Clinic Laboratories' factual information will be relevant and important to the administration of justice in the above-captioned action; and Defendants, through Counsel, have represented that they desire to obtain Plaintiffs medical records from Mayo Medical Laboratories. The trial of this matter is scheduled for September 2011. IT IS HEREBY REQUESTED, that Olmsted County Court issue a subpoena or other appropriate process requiring the Mayo Medical Laboratories to produce any and all medical records related to Plaintiff and we shall be ready and will to do the same for you in a similar case when required. 969394 r" WITNESS the Honorable Judge of the said Court this day of 2011. J?? -, BY TH RT: Judge, Court of Common Pleas Cumberland County, Pennsylvania F - sq ichard A . gadock ,85 : 7 --? , F,? 11ri omas, Nl . Choirs P 7?a? f N ? ; ? r-- ? rte, , , -: c 989370 JODI KRAUS, V. Plaintiff ROBERT G. MICHELINI, D.O. AND SPIRIT PHYSICIAN SERVICES, INC., Defendants IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 09-4477 CIVIL ACTION - MEDICAL JURY TRIAL DEMANDED ORDER AUTHORIZING ISSUANCE OF LETTERS ROGATORY AND NOW, this ggD day of 2011, the Prothonotary of the Court of Common Pleas of Cumberland County, Pennsylvania, is directed to issue the attached Letters Rogatory to be filed with the appropriate authority in the State of Minnesota, Olmsted County, to obtain Plaintiff's medical records from Mayo Medical Laboratories, 200 First Street, Southwest, Rochester, Minnesota 55905. BY THE COURT: Judge, Court of ommon Pleas, Cumberland County, Pennsylvania ? lock- - E J h3 t'"• paj -j 21, m =' P c -,r N) l a l , :mot- -?'?-Gst= f ICS: i': 9TNONOTAR 1101 28 P14 1:22 CUMBERLAND COUNTY PENNSYLVANIA ANGINO & ROVNER, P.C. Richard A. Sadlock Attorney lD# : 47281 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 JODI KRAUS, Plaintiff V. ROBERT G. MICHELINI, D.O.; SPIRIT PHYSICIAN SERVICES, INC., Defendants IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PA NO. 09-4477 CIVIL ACTION - LAW MEDICAL MALPRACTICE JURY TRIAL DEMANDED PLAINTIFF'S SUPPLEMENTAL ANSWERS TO DEFENDANT'S REOUEST FOR ADMISSIONS AND NOW, comes Plaintiff, Jodi Kraus, by and through her attorneys, Angino & Rovner, P.C., and supplements her answers to Defendant's Request for Admissions as follows: 6. Admitted. ANGINO & ROVNER, P.C. rd A. Sadlock, o.47281 Date: July 27, 2011 4503 N: FfonT'Street Harrisburg, PA 17110 (717) 238-6791 Counsel for Plaintiff 475861 VERIFICATION I, Jodi Kraus, Plaintiff, hereby verify that the facts set forth in the foregoing document are true and correct to the best of my knowledge, information and belief. I understand that any false statements therein are made subject to the penalties of 18 Pa.C.S.A. §4904, relating to unworn falsification to authorities. WITNESS: 41 Date: 7 /,,2 r 4'75861 CERTIFICATE OF SERVICE AND NOW, this 27th day of July, 2011, I, Angela D. Horchler, an employee of the law firm of Angino & Rovner, P.C., hereby certify that a true and correct copy of the foregoing 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: Thomas M. Chairs, Esquire Dickie, McCamey & Chilcote Plaza 21, Suite 302 425 N. 21st Street Camp Hill, PA 17011 Angela D. Horchler 475861 JODI KRAUS, V. ROBERT G. MICHELINI, D.O., & SPIRIT PHYSICIAN SERVICES, INC., Defendants IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA 2009 - 4477 CIVIL NO . =_ - c r `-) ORDER OF COURT ` Plaintiff AND NOW, this 27TH day of JULY, 2011, after consideration of Defendant's Motion for Leave to Obtain Additional Discovery Pursuant to Pa. R.C.P. 4003.5 (a) (2) and Plaintiff" s response thereto, the Motion is DENIED. `Richard A. Sadlock, Esquire ?Thomas M. Chairs, Esquire Court Administrator - in ?i It ?p 11,0111 y the Court, Edward E. Guido, J. sld DICKIE, MCCAMEY & CHILCOTE, P.C. ATTORNEY FOR DEFENDANTS BY: Thomas M. Chairs, Esquire ROBERT G. MICHELINI, D.O. AND SPIR IT ATTORNEY I.D. NO. 78565 PHYSICIAN SERVICES, INC. Plaza 21, Suite 302 425 North 21st Street Camp Hill, PA 17011 717-731-4800 (Tele) 888-811-7144 (Fax) JODI KRAUS, IN THE COURT OF COMMON PLEAS Plaintiff OF CUMBERLAND COUNTY, PENNSYLVANIA k V. - ..V y e - Ma3 NO. 09-4477 r- cn r w -CD CIVIL ACTION - MEDICAL D ?o ROBERT G. MICHELINI, D.O. AND SPIRIT PHYSICIAN SERVICES, INC., :F: W Defendants JURY TRIAL DEMANDED `< v DEFENDANTS' MOTION IN LIMINE TO PRECLUDE EVIDENCE RELIED UPON BY PLAINTIFF'S EXPERT THAT IS NOT OF RECORD AND NOW, come Defendants, by and through their counsel, Dickie, McCamey & Chilcote, P.C., and file the instant Motion in Limine to Preclude Plaintiff s radiology expert from referencing other patients' mammograms and offering opinions that are based on those mammograms because the mammograms relied upon by Plaintiff's expert are not evidence of record in this case, and in support thereof, aver as follows: 1. In this medical professional liability action Plaintiff charges Dr. Michelini with negligence for failing to more timely diagnose and treat the Plaintiff's breast cancer and related neurologic condition. 2. Plaintiff has identified several experts, including Wendy A. Berg, M.D., a radiology, who will testify at trial. 3. Dr. Berg reviewed fifty (50) mammograms from patients of her own practice on May 13, 2011. 4. Specifically, Dr. Berg states in her report: "Indeed, in response to your inquiry, I kept track of visualized lymph nodes on fifty consecutive screening mammograms yesterday (encompassing 100 breasts). For 46 (46%) breasts, no axillary nodes were visualized. For40 (40%), at least a portion of one or two nodes was included. For 12 (12%), at least a portion of from three to five nodes were included. For two (2%), there were more than five lymph nodes included. In the standard specimen from surgical dissection of the axillary lymph nodes, which includes level I and some level II nodes, a median of 17 lymph nodes are found at histopathology." See, Exhibit "A." 5. It is the position of the Defendants that Dr. Berg's opinions are improper and not admissible because the facts underlying her opinions are not of record. 6. The facts underlying an expert opinion must be of record so that the jury can evaluate the veracity of the facts. Folger v. Dugan, 876 A.2d 1049 (Pa.Super. 2005), citing Comm. v. Rounds, 542 A.2d 997 (Pa. 1988). 7. Dr. Berg's opinions are improper because the facts upon which they are based are not of record, i.e., fifty (50) mammograms taken of Dr. Berg's own patients on May 13, 2001. WHEREFORE, the Defendants respectfully request that Dr. Berg be precluded from referencing other patients' mammograms and offering opinions that are based on those mammograms because the mammograms relied upon by Plaintiff's expert are not evidence of record in this case. Respectfully submitted, DICKIE, MCCAMEY & CHILCOTE, P.C. Date: August 31, 2011 By: ffcowLTL-- h m s . Chai , Esquire Su e Court I.D. #78565 425 N. 21St Street, Suite 302 Camp Hill, PA 17011-3700 (717) 731-4800 Attorney for Defendant, Robert G. Michelini, D. 0. and Spirit Physician Services, Inc. ??jl7l--l ;?>/ -, / -- Wendie A. Berg, MD, PhD, FACR Visiting Professor of Radiology University of Pittsburgh School of Medicine Magee-Womens Hospital 300 Halket St. Pittsburgh, PA 15213 May 14, 2011 Richard A. Sadlock Angino & Rovner, P.C. 4503 North Front Street Harrisburg, PA 17110 Phone (717) 238-6795, ext 3037 Fax (717) 238-5610 Email; mziroli@angino-rovner.com Re: Jodi Kraus Dear Mr. Sadlock, On routine mammographic views, such as those obtained for screening, it is uncommon to visualize more than a few of the most inferior and anterior level I axillary lymph nodes, if any. Indeed, in response to your inquiry, I kept track of visualized lymph nodes on fifty consecutive screening mammograms yesterday (encompassing 100 breasts). For 46 (46%) breasts, no axillary nodes were visualized. For 40 (40%), at least a portion of one or two nodes was included. For 12 (12%), at least a portion of from three to five nodes were included. For two (2%), there were more than five lymph nodes included. In the standard specimen from surgical dissection of the axillary lymph nodes, which includes level I and some level II nodes, a median of 17 lymph nodes are found at histopathology [1]. Thus, in keeping with my experience interpreting mammograms for the past 18 years, the vast majority of axillary lymph nodes are not visualized on mammography if they are included at all. Yours sincerely, &?,, ? Wendie A. Berg, MD, PhD, FACR Reference cited: 1. Giuliano AE, Hunt KK, Ballman KV, et al. Axillary dissection vs no axillary dissection in women with invasive breast cancer and sentinel node metastasis: a randomized clinical trial. JAMA 2011; 305:569-575 976746 CERTIFICATE OF SERVICE AND NOW, August 31, 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) Tho as s, Esquire CA/ rL ANGINO & ROVNER, P.C. Richard A.Sadlock Attorney ID# : 47281 4503 North Front Street Harrisburg, PA 171 10-:703 (717) 238-6791 FAX (717) 238-5610 Attorneys for Plaintiff(s) E-mail: rsadlock@angino-rovner.com ?; q 3 rrn cn ? ? M =: r- rtt -° t-- -a m ? C'? C:+ 21 "D r, y?C w N _yi0 JODI KRAUS, Plaintiff v. ROBERT G. MICHELINI, D.O.; SPIRIT PHYSICIAN SERVICES, INC., Defendants IN THE, COURT OF COMMON PLEAS CUMBERLAND COUNTY, PA NO. 09-4477 CIVIL ACTION - LAW MEDICAL. MALPRACTICE JURY TRIAL DEMANDED PRAECIPE TO REMOVE CASE FROM CIVIL TRIAL LIST OF SEPTEMBER 19, 2011 Please remove the above case, Kraus v. Michelini, et al., No. 09-4477, from the September 19, 2::11, Civil Trial List. ANGGS R@VNER, P.C. r A. Sad o 'fc, Esquire I.D. No. 47281 4503 N. Front Street Harrisburg, PA 17110 (717) 238-6791 Date: August 31, 2011 Counsel for Plaintiff CERTIFICATE OF SERVICE AND NOW, this 31s` day of August, 2011, I, Angela D. Horchler, an employee of the law firm of Angino & Rovner, P.C., hereby certify that a true and correct copy of the foregoing 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: Thomas M. Chairs, Esquire Dickie, McCamey & Chilcote Plaza 21, Suite 302 425 N. 21st Street Camp Hill, PA 17011 1? 4 D. Horchler 475861 JODI KRAUS, Plaintiff v ROBERT G. MICHELINI, D.O., AND SPIRIT PHYSICIAN SERVICES, INC., Defendants #s IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW 09-4477 CIVIL TERM IN RE: CASE STRICKEN FROM LIST ORDER OF COURT AND NOW, this 23rd day of August, 2011, upon consideration of the call of the civil trial list at No. 09-4477 Civil Term, and the case having been called for trial by Plaintiff's counsel, with the understanding that the Defendant may file a motion for a continuance based upon certain outstanding discovery, and the Defendant, represented by Francis E. Marshall, Jr., Esquire, having indicated that the case may remain on the trial list at this time, the case shall remain on the trial list. By the Court, J. y J. `'/Richard A. Sadlock, Esquire r 4503 N. Front Street Id Harrisburg, PA 17110 Op ie,` For Plaintiff 9 I Q? ? Francis E. Marshall, Jr., Esquire 1200 Camp Hill Bypass Suite 205 Camp Hill, PA 17011 For Defendants , Court Administrator - to :mae ice you W i p^ ., nj4va4t is