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Home My WebLink About10-3006IN RE: PETITION FOR THE APPROVAL OF COMPROMISE MINOR SETTLEMENT AND DISTRIBUTION PURSUANT TO PA.R.C.P 2039(a) by BRODE ENGLE, a minor, by his Parents and Guardians STEVE ENGLE and IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA : NO. Ib - 3666 0-,4-y i t `T[?wL LORI ENGLE, Petitioner PETITION FOR APPROVAL OF COMPROMISE MINOR SETTLEMENT AND DISTRIBUTION OF PROCEEDS PURSUANT TO PA.R.C.P. 2039(a) L hJ C-1 C=2 -'C c? AND NOW COMES Steve Engle and Lori Engle as parents and guardians of Brode Engle and file this Petition for Approval of Compromise Minor Settlement and Distribution of Proceeds by his counsel, Gary Lysaght, Esquire, and hereby aver the following: 1. Brode Engle is a minor born December 28, 2004. Brode resides with his parents Steve and Lori Engle at 52 Meadowbrook Drive, Mechanicsburg, Pennsylvania. II. On September 29, 2009 Brode's mother, Lori Engle, went to Applebee's Neighborhood Grill & Bar located at 6055 Carlisle Pike, Mechanicsburg, PA and picked up lunch to bring home for Brode, his home care nurse and herself. 111. Brode began eating his lunch. While eating he began to choke, his mother, a registered nurse, had to take a catheter tube and suction his throat. 496t, oo PA ATwY Ctl 1150 2*aw?c??? IV. Lori Engle suctioned out a one-inch piece of a toothpick from the back of Brode's throat. V. Following the incident Brode had pain in his throat and difficulty swallowing. VI. At the time of the incident Applebee's Neighborhood Grill & Bar was insured by Nationwide Insurance Company. VII. Steve Engle and Lori Engle retained Gary Lysaght to represent Brode Engle regarding all possible claims relating to the bodily injury of September 29, 2009. VIII. Gary Lysaght has investigated the Injury, obtained medical records and other relevant records, contacted Nationwide Insurance company and negotiated with the Nationwide adjustor, Gene Brenzel. IX. Attached as Appendix A is a report from Dr. Schaefer, Penn State Milton S. Hershey Medical Center, dated October 6, 2009 describing Brode's injuries. Brode has fully recovered from his injuries. -2- VIII. A proposed settlement between counsel for Brode Engle and Nationwide Insurance has been reached subject to approval by this Honorable Court. Nationwide has agreed to pay $3,000. IXI. Accordingly, the guardians request the Court approve the following settlement distribution: (a) To Gary Lysaght - Attorney Fees $ 767.00 (b) To Steve and Lori Engle, Parents and Guardians of Brode Engle $2,233.00 XII. Counsel requests permission from the Court that a general release for the benefit of Nationwide Insurance be signed by Brode Engle's parents. Respectfully Submitted: zd? L ght, wire 1350 fishing Creek Valley Road Harrisburg, PA 17112 (717) 599-5320 No: 39183 -3- APPENDIX A Outpt Ltr " Prelimmary Report * Preliminary Report * October 5, 2009 Name: ENGLE, BRODE A HMC Number: 1456092 DOB: 12/28/2004 Date of Service: 10/05/2009 Alawia K. Suliman, M.D. Penn State Milton S. Hershey Medical Center PO Box 850 Hershey, PA 17033 Dear Dr. Suliman: ENGLE, BRODE A - 1456092 I had the opportunity to see Brode in the Pediatric Gastroenterology as a consult. A 4-year-old boy with a history of t-acheostomy, G-tube, Nissen fundoplication, and developmental delay who had a choking episode 6 days ago. A ~oken part of a toothpick was suctioned out of his mouth by his mother. For the last 4 days, the patient has been noticed to be wincing with swallowing. He has also had decreased appetite. He is tolerating regular foods. The patient has also had gagging that started today. The patient has a history of gagging when he has had pain in his ears, pain around the tracheostomy, or throat pain. Patient has been described to be pulling on his trach for the last 5 days. The mother describes that this occurs when the patient is in pain. There has been no vomiting and no drooling. Patient has normal bowel movements. They are twice per day with no blood in the stool. Patient has not required an increased oxygen requirement related to his ventilation by ventilator in the evenings or when he is sleeping. The patient has been described to be breathing a little bit harder that he does usually. Patient last afe at 7 o'clock this morning. He had oatmeal and had yogurt with his medications at 7 o'clock a.m. On review of systems, constitutional: There has been no recent illnesses. Cardiovascular: Patient had a history of PDA ligation at birth. Ear, nose, and throat: The patient has had tracheostomy placed since infancy. Respiratory: The patient is ventilator dependent in the evenings and when he is sleeping. Neurological: The patient has a history of seizures that are currently under control. Allergy: Patient has no known drug allergies. The remainder of the review of systems is unremarkable. Past Medical History: Medications: Patient's medications include Diuril, bethanechol, albuterol, Flovent, Carbatrol, Miral-ax, potassium chloride, vitamin D, Topamax, Allegra. rinted by: Russell, Kelly A Page 1 of 3 r?rinted on: 10/9/2009 15:24 (Continued) Outpt Ltr ENGLE, BRODE A - 1456092 ' Preliminary Report " Physical Examination: On examination today, the patient's weight is 20.4 kg, which is 85th percentile. General: The patient is noted in no distress and is responsive. Patient doesn't speak, which is his baseline. The tracheostomy is in place. On abdominal exam, his abdomen is soft, nondistended, nontender with no masses palpated and no hepatosplenomegaly. The lungs are clear to auscultation bilaterally. The remainder of the physical examination including HEENT, neck, heart, skin, and extremities is unremarkable. In summary, this is a 4-1/2-year-old <__> developmental delay with dysphagia and nonspecific symptoms since 6 days ago when he was found to be gagging and part of a toothpick was suctioned from his mouth. The toothac4;4V'%cK- may be the source of the patient's symptoms. He currently is n.p.o. since 7 a.m. However, the patient did consume solid food this morning. Therefore, my plan is to have the patient come back into the hospital tomorrow for an upper endoscopy to evaluate for other foreign body of the toothpick in his upper esophagus. The endoscopy is currently scheduled for October 6, 2009, at 8 a.m. Patient will follow up in <.>. Thank you for the opportunity to take part in the care of this patient. Please feel free to contact me at 717-531-;,901, if you have any questions. 102652 Signature Line Electronic Signature on File 123-11 CC: Alawia K Suliman, MD Department of Pediatrics Penn State Milton S. Hershey Medical Center PO Box 850 Hershey, PA 17033-0850 Sincerely, Marc E Schaefer, MD MES /CO DD: 10/05/09 DT: 10/06/09 21:11 Result Type: Outpt Ltr Date of Service: October 05, 2009 00:00 Authorization Status: Prelim/Transcribed Author or Import Date: Schaefer, Marc E on October 05, 2009 15:01 Encounter info: 13567209, HOSPITAL CLINICS, Clinic, 10/5/2009 - 10/6/2009 •inted by: Russell, Kelly A Page 2 of 3 ,rinted on: 10/9/2009 15:24 (Continued) Surgical Pathology Final Report * Final Report * HR Penn State Milton S. Hershey Medical Center Department of Pathology and Laboratory Medicine 500 University Drive Hershey, PA 17033 Phone: 717-531-8246 Fax: 717-531-7741 SURGICAL PATHOLOGY REPORT Patient Name: ENGLE, BRODE A Accession #: S09-31056 MRN#: 01456092 Billing #: Physician(S): Marc E SchaeferAlawia Suliman Service Date: 10/6/2009 Reported: 10/7/2009 12:38 FINAL PATHOLOGIC DIAGNOSIS: A. Stomach, antrum, biopsy: - Vascular congestion, lamina propria. B. Esophagus, biopsies: No pathologic alteration (see Microscopic Description). 'Electronically Signed Out"' Henry S. Crist, M.D. MICROSCOPIC DESCRIPTION A. Biopsies of the stomach in specimen A do not reveal foveolar hyperplasia, elongation of the crypts or serration. There is, however, a prominent vascular congestion involving lamina propria. Changes of angiodysplasia, however, are not present. ENGLE, BRODE A - 1456092 Wk l? 13 B. The surface squamous epithelium focally shows some prominence of glycogenated cells, but these are not sufficient in the biopsies for a diagnosis of glycogen acanthosis. There is no acute or chronic inflammation, and a silver stain for fungus s negative. CLINICAL HISTORY 4 year old male with dysphagia after an episode of gagging and broken ,rnted by: Russell, Kelly A rinted on: 10/9/2009 15:23 Page 1 of 2 (Continued) Surgical Pathology Final Report ' toothpick suctioned from oropharynx. Patches of white in esophagus. Mild erythema in antrum, no toothpick found. Clinical diagnosis: dysphagia. SPECIMEN(S) RECEIVED A: "Antrum" B: "Esophagus" GROSS DESCRIPTION A. The specimen is labeled Brode Engle and medical record number and designated as "Antrum": Received in formalin is one gray-tan fragment of soft tissue measuring 0.3x0.3x0.1 cm. Specimen is entirely submitted. Block summary: Al. B. The specimen is labeled Brode Engle and medical record number and designated as "Esophagus": Received in formalin are numerous gray-tan fragments of soft tissue measuring 0.5x0.3x0.1 cm in aggregate. Specimen is entirely submitted. Block summary: B1. (MLG/ASP) Result Type: Date of Service: Authorization Status: Subject: Author or import Date Verified By: Encounter info: ENGLE, BRODE A - 1456092 A?l Surgical Pathology 1 October 06, 2009 11:03 Final HR Laboratory, Technician on October 06, 2009 11:03 Laboratory, Technician on October 06, 2009 11:03 13569207, HMC, Same Day Care, 10/6/2009 - 10/7/2009 Tinted by: Russell, Kelly A Page 2 of 2 Hrinted on: 10/9/2009 15:23 (End of Report) Uytology, Non GYN ' Final Report * Final Report * HCN Penn State Milton S. Hershey Medical Center Department of Pathology and Laboratory Medicine 500 University Drive Hershey, PA 17033 Phone: 717-531-5895 Fax: 717-531-7741 CYTOLOGY REPORT Patient:ENGLE, BRODE A MRN #01456092 Billing # Physician: Marc F Schaefer Report date: 10/8/2009 17:41 Accession #C09-16644 Service Date: 10/6/2009 FINAL CYTOLOGIC DIAGNOSIS: Esophageal brushing (monolayer)- Satisfactory for evaluation. Benign squamous cells, bronchial cells, candida and bacteria present. Negative for malignant cells. -Electronically Signed Out""" Elizabeth E. Frauenhoffer, M.D. SPECIMEN/SOURCE: A: esophageal brushing (monolayer) GROSS DESCRIPTION Received 1 brush Result Type: Cytology, Non GYN Date of Service: October 06, 2009 14:18 Authorization Status: Final Subject: HCN Author or Import Date: Laboratory, Technician on October 06, 2009 14:18 'rinted by: Russell, Kelly A rinted on: 10/9/2009 1523 ENGLE, BRODE A - 1456092 Page 1 of 2 (Continued) VERIFICATION The language of the foregoing document is that of counsel and not necessarily my own; however, I have read the foregoing document and to the extent that it is based upon information that 1 have given to counsel, it is true and correct to the best of my knowledge, information, and belief; to the extent that the content of the foregoing document is that of counsel, I have relied upon counsel in making this verification. I understand that any false statements herein are made subject to the penalties of 18 Pa.C.S.A. §4904, relating to unswom falsification to authorities. AeE Engle a and Guardian of Brode Engle ri Engle as a nt and Guardian of Brode Engle -4- IN RE: PETITION FOR THE APPROVAL OF COMPROMISE MINOR SETTLEMENT AND DISTRIBUTION PURSUANT TO PA.R.C.P 2039(a) by BRODE ENGLE, a minor, by his Parents and Guardians STEVE ENGLE and LORI ENGLE, Petitioner IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA NO. CERTIFICATE OF SERVICE I hereby certify that I have this day served a true and correct copy of the attached Petition for Approval of Compromise Minor Settlement and Distribution of Proceeds Pursuant to Pa.R.C.P. 2039 (a) by first class mail, postage prepaid, addressed to the following persons: Gene Brenzel, Claims Department Nationwide Insurance Company One Nationwide Gateway, Dept 5867 Des Moines, IA 50391-5867 Daterr V G RY LY A HT -5- BRODE ENGLE a minor, by his Parents and Guardians STEVE ENGLE and LORI ENGLE, Petitioner CUMERLAND COUNTY, PENNSYLVANIA NO. 10-3006 CIVIL TERM PROOF OF OPENING A RESTRICTED ACCOUNT PER PA.R.C.P. 2039(BX2) AND NOW, Parents and Guardians Steve Engle and Lori Engle for their minor child, Brode Engle, through their attorney, Thomas A. Placey, Esq. present proof of opening and depositing the distributed settlement monies in a restricted account. 1. On May 10, 2010 this Honorable Court entered approval of settlement distribution to Petitioner in the amount of $2,233.00 with restrictions. 2. On July 12, 2010, Petitioner opened a custodial savings account with Metro Bank, a FDIC Member, and deposited the distributed amount in that account. 3. Proof of the restriction on the account is attached as exhibit A. 4. Proof of the opening of the account is attached as exhibit B. 5. Proof of the deposit into the restricted custodial account is attached as exhibit C. WHEREFORE, it is requested that this proof be accepted for filing within the docket by the Prothonotary. 13-Aug-10 Date !' j ?6 S1 4:r, f IY TRO BANK 3801 Paxton Street Harrisburg - PA • 17111 mymetrabank.com 888.937.0004 Lori Engle 5239 Meadowbrook Dr. Mechanicsburg, PA 17055 July 12, 2010 To Whom It May Concem, This letter is to confirm that a custodial account, number 7760446871, has been created for Brode A. Engle. The bank has placed a restriction on the account that no withdrawals will be made without court ordered approval prior to December 28, 2022. Sincerely, Patricia L Gemberling CSR/Hampden Centre/Metro Bank/717-975-7546 EXHIBIT A Thank you for opening your Metro Bank Accountl Please retain this information for your records: Date: oyiyia APY*: 0.25 % Interest Rate: 0.2500 Product ? Checking ?? Savings Account # 7760446871 Tiered Rates Balance APY* Interest Rate To: From: Over $0.00 0.25 0.25 *Annual Percentage Yield I ?ETRO BANK BR-28 Member FDIC EXHIBIT B o m w w m ? n w m C m rn M-0 Z -4 rn Z N ?40 O mN (nw ? o m w O a gW Tn, ?' N C p6? µ s W3 o? ?g ga a ?. m A? w m O mt O mA N ? m 00 ?a w? D? z ;r, C 3 O°o c Op 00 ? 4' 0 3 EXHIBIT C